PMID- 11191501
TI  - Consent for HIV counselling and testing.

PMID- 11191502
TI  - Consent for trials in palliative care.

PMID- 11191503
TI  - Operation Smile: plastic surgery with few resources.

PMID- 11191504
TI  - Facial surgery: body and soul.

PMID- 11191505
TI  - The mentally ill in prison: developments in Latvia.

PMID- 11191506
TI  - Mental or criminal?

PMID- 11191507
TI  - Public health in eastern Europe.

PMID- 11191508
TI  - Striving for global drug availability.

PMID- 11191509
TI  - Public-health priorities in the industrialised world.

PMID- 11191510
TI  - Role of education in the use of contraception.

PMID- 11191511
TI  - In-vitro fertilisation: a future with no limits?

PMID- 11191512
TI  - Research resurgence in Uruguay.

PMID- 11191513
TI  - Academic medicine sets focus on clinical research.

PMID- 11191514
TI  - Respiratory diseases in Africa: causes and effects.

PMID- 11191515
TI  - Burden of chronic obstructive pulmonary disease.

PMID- 11191516
TI  - Female genital mutilation: what can be done?

PMID- 11191517
TI  - The changing perceptions of sex and sexuality.

PMID- 11191518
TI  - More than just eczema.

PMID- 11191519
TI  - Availability of pharmaceutical drugs.

PMID- 11191520
TI  - Aesthetic surgery: coming of age.

PMID- 11191521
TI  - Molecular answers to tuberculous questions.

PMID- 11191522
TI  - Multiple-drug-resistant tuberculosis.

PMID- 11191523
TI  - Tropical diseases and the 10/90 gap.

PMID- 11191524
TI  - Response to haemorrhagic fevers in Europe.

PMID- 11191525
TI  - Women's health and human rights needs.

PMID- 11191526
TI  - The two faces of health care for women.

PMID- 11191527
TI  - A leukaemia treatment programme in El Salvador.

PMID- 11191528
TI  - Gene therapy in haematology and oncology.

PMID- 11191529
TI  - Let's not make the same mistakes.

PMID- 11191530
TI  - What's in a name?

PMID- 11191531
TI  - Renal-dose dopamine: will the message now get through?

PMID- 11191532
TI  - Rekindling old controversy on elusive lair of latent tuberculosis.

PMID- 11191533
TI  - Targeting cytokines in asthma therapy: round one.

PMID- 11191534
TI  - Exercise testing in rapid-access clinics for assessment of chest pain.

PMID- 11191535
TI  - Serological diagnosis of inflammatory bowel disease.

PMID- 11191536
TI  - Workplace bullying: icebergs in sight, soundings needed.

PMID- 11191537
TI  - Effect of sibutramine on weight maintenance after weight loss: a randomised
      trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance.
AB  - BACKGROUND: Sibutramine is a tertiary amine that has been shown to induce dose
      dependent weight loss and to enhance the effects of a low-calorie diet for up to
      a year. We did a randomised, double-blind trial to assess the usefulness of
      sibutramine in maintaining substantial weight loss over 2 years. METHODS: Eight
      European centres recruited 605 obese patients (body-mass index 30-45 kg/m2) for a
      6-month period of weight loss with sibutramine (10 mg/day) and an individualised
      600 kcal/day deficit programme based on measured resting metabolic rates. 467
      (77%) patients with more than 5% weight loss were then randomly assigned 10
      mg/day sibutramine (n=352) or placebo (n=115) for a further 18 months.
      Sibutramine was increased up to 20 mg/day if weight regain occurred. The primary
      outcome measure was the number of patients at year 2 maintaining at least 80% of
      the weight lost between baseline and month 6. Secondary outcomes included changes
      in uric acid concentrations and glycaemic and lipid variables. Analysis was by
      intention to treat. FINDINGS: 148 (42%) individuals in the sibutramine group and
      58 (50%) in the placebo group dropped out. Of the 204 sibutramine-treated
      individuals who completed the trial, 89 (43%) maintained 80% or more of their
      original weight loss, compared with nine (16%) of the 57 individuals in the
      placebo group (odds ratio 4.64, p<0.001). Patients had substantial decreases over
      the first 6 months with respect to triglycerides, VLDL cholesterol, insulin, C
      peptide, and uric acid; these changes were sustained in the sibutramine group but
      not the placebo group. HDL cholesterol concentrations rose substantially in the
      second year: overall increases were 20.7% (sibutramine) and 11.7% (placebo,
      p<0.001). 20 (3%) patients were withdrawn because of increases in blood pressure;
      in the sibutramine group, systolic blood pressure rose from baseline to 2 years
      by 0.1 mm Hg (SD 12.9), diastolic blood pressure by 2.3 mm Hg (9.4), and pulse
      rate by 4.1 beats/min (11.9). INTERPRETATION: This individualised management
      programme achieved weight loss in 77% of obese patients and sustained weight loss
      in most patients continuing therapy for 2 years. Changes in concentrations of HDL
      cholesterol, VLDL cholesterol, and triglyceride, but not LDL cholesterol, exceed
      those expected either from weight loss alone or when induced by other selective
      therapies for low concentrations of HDL cholesterol relating to coronary heart
      disease.

PMID- 11191538
TI  - Non-invasive pressure support ventilation versus conventional oxygen therapy in
      acute cardiogenic pulmonary oedema: a randomised trial.
AB  - BACKGROUND: Non-invasive pressure support ventilation (NIPSV) is an effective
      treatment for acute respiratory failure in patients with chronic obstructive
      pulmonary disease. We assessed the efficacy of this therapy in acute cardiogenic
      pulmonary oedema in a randomised comparison with conventional oxygen therapy.
      METHODS: 40 patients were randomly assigned conventional oxygen therapy or NIPSV
      supplied by a standard ventilator through a face mask, with adjustment of tidal
      volume and pressure support in addition to a positive end-expiratory pressure of
      5 cm water. Physiological measurements were obtained in the first 2 h and at 3 h,
      4 h, and 10 h. The main endpoints were intubation rate and resolution time.
      Analyses were by intention to treat. FINDINGS: Three patients were withdrawn on
      the basis of clinical and chest radiography results. Endotracheal intubation was
      required in one (5%) of 19 patients assigned NIPSV and in six (33%) of 18
      assigned conventional oxygen therapy (p=0.037). Resolution time (defined as a
      clinical improvement with oxygen saturation of 96% or more and respiratory rate
      less than 30 breaths/min) was significantly shorter in the NIPSV group (median 30
      [IQR 15-53] vs 105 [50-230] min, p=0.002). NIPSV led to a rapid improvement in
      oxygenation in the first 2 h. There were no differences in hospital length of
      stay or mortality. INTERPRETATION: In this study of acute cardiogenic pulmonary
      oedema, NIPSV was superior to conventional oxygen therapy. Further studies should
      compare NIPSV with continuous positive airway pressure.

PMID- 11191539
TI  - Persistence of DNA from Mycobacterium tuberculosis in superficially normal lung
      tissue during latent infection.
AB  - BACKGROUND: A third of the world's population has latent infection with
      Mycobacterium tuberculosis, and in areas of low endemicity, most cases of active
      tuberculosis arise as a result of reactivation of latent bacilli. We sought to
      establish the cellular location of these latent organisms to facilitate their
      elimination. METHODS: We applied in-situ PCR to sections of macroscopically
      normal lung tissue from 13 individuals from Ethiopia and 34 from Mexico who had
      died from causes other than tuberculosis. Sections of lung tissue from six
      Norwegian individuals (ie, individuals from a non-endemic population) acted as
      negative controls, and six Ethiopian tuberculosis cases acted as positive
      controls. FINDINGS: Control necropsy samples from the Norwegian individuals were
      all negative by in-situ PCR and conventional PCR, whereas all samples from known
      Ethiopian tuberculosis cases were positive by both methods. However, in
      macroscopically normal lung tissue from Ethiopian and Mexican individuals without
      tuberculous lesions, the in-situ PCR revealed five of 13 and ten of 34 positive
      individuals, respectively. These results were confirmed by conventional PCR with
      extracted DNA. Positive cells included alveolar and interstitial macrophages,
      type II pneumocytes, endothelial cells, and fibroblasts. INTERPRETATION: M.
      tuberculosis can persist intracellularly in lung tissue without histological
      evidence of tuberculous lesions. M. tuberculosis DNA is situated not only in
      macrophages but also in other non-professional phagocytic cells. These findings
      contradict the dominant view that latent organisms exist in old classic
      tuberculous lesions, and have important implications for strategies aimed at the
      elimination of latent and persistent bacilli.

PMID- 11191540
TI  - Clinical picture: ipsilateral atherosclerotic and fibromuscular renal artery
      stenosis.

PMID- 11191541
TI  - Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled
      randomised trial. Australian and New Zealand Intensive Care Society (ANZICS)
      Clinical Trials Group.
AB  - BACKGROUND: Low-dose dopamine is commonly administered to critically ill patients
      in the belief that it reduces the risk of renal failure by increasing renal blood
      flow. However, these effects have not been established in a large randomised
      controlled trial, and use of dopamine remains controversial. We have done a
      multicentre, randomised, double-blind, placebo-controlled study of low-dose
      dopamine in patients with at least two criteria for the systemic inflammatory
      response syndrome and clinical evidence of early renal dysfunction (oliguria or
      increase in serum creatinine concentration). METHODS: 328 patients admitted to 23
      participating intensive-care units (ICUs) were randomly assigned a continuous
      intravenous infusion of low-dose dopamine (2 microg kg(-1) min(-1)) or placebo
      administered through a central venous catheter while in the ICU. The primary
      endpoint was the peak serum creatinine concentration during the infusion.
      Analyses excluded four patients with major protocol violations. FINDINGS: The
      groups assigned dopamine (n=161) and placebo (n=163) were similar in terms of
      baseline characteristics, renal function, and duration of trial infusion. There
      was no difference between the dopamine and placebo groups in peak serum
      creatinine concentration during treatment (245 [SD 144] vs 249 [147] micromol/L;
      p=0.93), in the increase from baseline to highest value during treatment (62
      [107] vs 66 [108] micromol/L; p=0.82), or in the numbers of patients whose serum
      creatinine concentration exceeded 300 micromol/L (56 vs 56; p=0.92) or who
      required renal replacement therapy (35 vs 40; p=0.55). Durations of ICU stay (13
      [14] vs 14 [15] days; p=0.67) and of hospital stay (29 [27] vs 33 [39] days;
      p=0.29) were also similar. There were 69 deaths in the dopamine group and 66 in
      the placebo group. INTERPRETATION: Administration of low-dose dopamine by
      continuous intravenous infusion to critically ill patients at risk of renal
      failure does not confer clinically significant protection from renal dysfunction.

PMID- 11191542
TI  - Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway
      hyper-responsiveness, and the late asthmatic response.
AB  - BACKGROUND: Interleukin-5 (IL-5) is essential for the formation of eosinophils,
      which are thought to have a major role in the pathogenesis of asthma and other
      allergic diseases. We aimed to assess the effects of monoclonal antibody to IL-5
      on blood and sputum eosinophils, airway hyper-responsiveness, and the late
      asthmatic reaction to inhaled allergen in patients with mild asthma. METHODS: We
      did a double-blind randomised placebo-controlled trial, in which a single
      intravenous infusion of humanised (IgG-K) monoclonal antibody to IL-5 (SB-240563)
      was given at doses of 2.5 mg/kg (n=8) or 10.0 mg/kg (n=8). The effects of
      treatment on responses to inhaled allergen challenge, sputum eosinophils, and
      airway hyper-responsiveness to histamine were measured at weeks 1 and 4 with
      monitoring of blood eosinophil counts for up to 16 weeks. FINDINGS: Monoclonal
      antibody against IL-5 lowered the mean blood eosinophil count at day 29 from
      0.25x10(9)/L (95% CI 0.16-0.34) in the placebo group to 0.04x10(9)/L (0.00-0.07)
      in the 10 mg/kg group (p<0.0001), and prevented the blood eosinophilia that
      follows allergen challenge. After inhaled allergen challenge, 9 days after
      treatment, the percentage sputum eosinophils were 12.2% in the placebo group and
      lowered to 0.9% (-1.2 to 3.0; p=0.0076) in the 10 mg/kg group, and this effect
      persisted at day 30 after the dose. There was no significant effect of monoclonal
      antibody to IL-5 on the late asthmatic response or on airway hyper-responsiveness
      to histamine. INTERPRETATION: A single dose of monoclonal antibody to IL-5
      decreased blood eosinophils for up to 16 weeks and sputum eosinophils at 4 weeks,
      which has considerable therapeutic potential for asthma and allergy. However, our
      findings question the role of eosinophils in mediating the late asthmatic
      response and causing airway hyper-responsiveness.

PMID- 11191543
TI  - Effects of recombinant human interleukin-12 on eosinophils, airway hyper
      responsiveness, and the late asthmatic response.
AB  - BACKGROUND: Interleukin-12 (IL-12) is a macrophage-derived cytokine that
      modulates T lymphocyte responses and has the capacity to suppress allergic and
      eosinophilic inflammation. METHODS: We carried out a double-blind, randomised,
      parallel group clinical study, in which patients with mild allergic asthma were
      given subcutaneous recombinant human IL-12 at increasing weekly injections of
      0.1, 0.25, 0.5 microg/kg (n=19), or placebo (n=20). We compared responses to
      inhaled allergen challenge 24 h before the first injection and 24 h after the
      final injection. Airways hyper-responsiveness and concentrations of peripheral
      blood eosinophils and sputum eosinophils were also assessed. FINDINGS: IL-12
      caused a significant decrease from baseline in the main peripheral blood
      eosinophil count 24 h after the fourth injection compared with placebo
      (p=0.0001). Sputum eosinophils were also significantly decreased 24 h after
      allergen challenge when treated with IL-12 compared with placebo (p=0.024). IL-12
      caused a non-significant trend towards improvement in airway hyper-responsiveness
      to histamine, but had no significant effect on the late asthmatic reaction after
      inhaled allergen challenge. After administration of IL-12, four of 19 patients
      withdrew prematurely; two with cardiac arrhythmias, one with abnormal liver
      function, and a single patient with severe flu-like symptoms. INTERPRETATION: We
      have shown that IL-12 lowers numbers of blood and sputum eosinophils, but without
      any significant effects on airway hyper-responsiveness or the late asthmatic
      reaction. This questions the role of eosinophils in mediating these reactions,
      and has important implications for development of new anti-inflammatory
      treatments.

PMID- 11191544
TI  - Familial Mediterranean Fever in a cold climate: read The Lancet.

PMID- 11191545
TI  - Chimeric cells of maternal origin in juvenile idiopathic inflammatory myopathies.
      Childhood Myositis Heterogeneity Collaborative Group.
AB  - We identified maternal microchimerism by fluorescence in-situ hybridisation in
      magnetically-separated CD4 or CD8 peripheral blood cells of eight of nine male
      patients with juvenile idiopathic inflammatory myopathy, compared with two of
      nine healthy male controls. We also found maternal microchimerism in inflammatory
      lesions (one skin sample and nine muscle biopsy samples) of all ten patients
      examined, compared with two of ten biopsy samples from patients with other muscle
      disorders. These results suggest that maternal cells may be involved in the
      pathogenesis of juvenile idiopathic inflammatory myopathy.

PMID- 11191546
TI  - Chimerism in children with juvenile dermatomyositis.
AB  - Juvenile dermatomyositis is a disease with similarities to chronic graft-versus
      host disease. To identify whether chimerism is present in juvenile
      dermatomyositis, we investigated the families of 15 children with the disorder.
      Chimerism was identified by PCR in 13 of the 15 affected children, compared with
      five of 35 siblings (p<0.0001). Maternal cells among peripheral-blood mononuclear
      cells were detected in 11 of the 15 boys, compared with five of 17 unaffected
      controls (p=0.02), and in muscle tissue of 12 of 15 compared with two of ten
      unaffected siblings (p=0.005). These results suggest that chimerism may be
      involved in juvenile dermatomyositis.

PMID- 11191547
TI  - Cytogenetics of myelodysplasia and acute myeloid leukaemia in aircrew and people
      treated with radiotherapy.
AB  - Increased risk of acute myeloid leukaemia has been reported in aircrew, possibly
      in association with cosmic radiation. We studied the cytogenetics of seven
      aircrew members who had acute myeloid leukaemia or myelodysplasia and found
      deletion or loss of chromosome 7 in four. The same abnormality was found in eight
      of 19 patients with leukaemia after radiotherapy alone. By comparison, only 81 of
      761 unselected cases of myelodysplasia or acute myeloid leukaemia had the same
      cytogenetic abnormalities. Our results support the concept that deletions or loss
      of the long arm of chromosome 7 in myelodysplasia and acute myeloid leukaemia
      could indicate previous exposure to ionising radiation.

PMID- 11191548
TI  - Serogroup W135 meningococcal disease in Hajj pilgrims.
AB  - An outbreak of W135 meningococcal disease occurred in the spring of 2000 among
      pilgrims returning from Saudi Arabia and their contacts. Clinical isolates from
      England and France were examined and compared with reference strains from other
      countries. Characterisation of isolates by a range of typing methods showed them
      to be of clonal origin (ET-37) and closely related to other meningococci with an
      established propensity to cause disease clusters. A reappraisal of vaccination
      strategies for travellers is required.

PMID- 11191549
TI  - Outlook in oral and cutaneous Kaposi's sarcoma.
AB  - We looked at survival of 138 patients with HIV-1-associated Kaposi's sarcoma.
      Patients with lesions of the oral mucosa had a higher death rate (risk ratio 3.4
      [95% CI 1.6-7.1]; p=0.001) than those having exclusively cutaneous manifestations
      of the disease. Patients with oral Kaposi's sarcoma and a CD4 cell count of at
      least 150/microL had a similar mortality risk to patients with the cutaneous
      disease but CD4 cell concentration of no more than 150/microL. Thus, oral
      Kaposi's sarcoma is an important prognostic marker, at least for patients who do
      not receive triple antiretroviral therapy.

PMID- 11191550
TI  - Alzheimer's amyloid hypothesis gains support.

PMID- 11191551
TI  - Have a healthy new year: easy to say, hard to do.

PMID- 11191552
TI  - Record spending on UK health, but still a long way to go.

PMID- 11191553
TI  - Court ruling favours Indian Navy's HIV policy.

PMID- 11191554
TI  - New report highlights negative health effects of UK asylum system.

PMID- 11191555
TI  - Canadian Act may mean greater access to personal medical records.

PMID- 11191556
TI  - Eraritjaritjaka.

PMID- 11191557
TI  - Silent pirates of the shore: Robert Louis Stevenson and medical negligence.

PMID- 11191558
TI  - Ancient Egyptian prosthesis of the big toe.

PMID- 11191559
TI  - Dr H C Bastian, scientific Jekyll and Hyde.
AB  - The neurological library of S A Kinnier Wilson, now in the Royal College of
      Physicians of Edinburgh, contains two books by Henry Charlton Bastian. Various
      forms of hysterical or functional paralysis (1893) is inscribed "To Dr Wilson by
      the Author, July 1906". Wilson was Bastian's house-physician at the time. The
      second book, given to Wilson's son by Bastian's daughter in 1940, is a lavishly
      illustrated tome, Studies in heterogenesis (1903). The two books testify to a
      scientific Jekyll and Hyde--one of the founders of neurology and a wildly
      unorthodox biologist.

PMID- 11191560
TI  - Hippocrates ridens: a 17th century medico-political journal.

PMID- 11191561
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191562
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191563
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191564
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191565
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191566
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191567
TI  - Pain after stapled haemorrhoidectomy.

PMID- 11191568
TI  - End-of-life decisions in neonatal intensive care.

PMID- 11191569
TI  - Interferon gamma gene in rheumatoid arthritis.

PMID- 11191570
TI  - Interferon gamma gene in rheumatoid arthritis.

PMID- 11191571
TI  - Jejunal ulceration and push enteroscopy.

PMID- 11191572
TI  - Industry-sponsored research.

PMID- 11191573
TI  - Industry-sponsored research. University of Pennsylvania Research Ethics Working
      Group.

PMID- 11191574
TI  - Myopia and its mechanisms.

PMID- 11191575
TI  - Global health status: two steps forward, one step back.

PMID- 11191576
TI  - Family support after stroke.

PMID- 11191577
TI  - Hodgkin's cylinder.

PMID- 11191578
TI  - Ethical, empirical, and epidemiological bases for action.

PMID- 11191579
TI  - Short-term spontaneous improvement rates in depressed outpatients.
AB  - The objectives of the present report were: a) to determine the spontaneous
      remission rate in depressed outpatients who do not receive antidepressant
      medication; b) to develop a novel method for obtaining a control group that can
      be used to gauge the effectiveness of antidepressant medication in clinical
      practice; and c) to compare response rates from the present sample with outcomes
      of depressed patients in our practice who were treated with antidepressant
      medications. By using a naturalistic design, prospective assessments were made on
      all depressed outpatients. Twenty-five patients who met full criteria for a major
      depressive episode ended up not taking antidepressant medication for a variety of
      reasons. "Response" rates to a no-treatment trial were determined with standard
      outcome criteria using the Clinical Global Impression-Improvement scale. Eight
      patients (32.0%) had a positive response, 5 patients (20.0%) had a partial
      response, and 12 patients (48.0%) were nonresponders to a no-treatment trial.
      These response rates were higher than expected, but significantly lower than what
      we had found in a cohort of depressed patients who underwent an antidepressant
      trial (p = .02). Likewise, treatment-resistant patients fared better on
      pharmacotherapy, though this difference was not statistically significant. These
      results suggest that the occurrence of spontaneous remissions may be common in
      clinical practice, and therefore the specific short-term benefits of
      antidepressant medication in clinical practice may frequently be overestimated.
      Despite the high rate of spontaneous remission in our sample, the present study
      allowed us to confirm the effectiveness of antidepressant medication in clinical
      practice using a novel method for obtaining a control comparison group.

PMID- 11191580
TI  - A brief assessment of psychosocial functioning of subjects with bipolar I
      disorder: the LIFE-RIFT. Longitudinal Interval Follow-up Evaluation-Range
      Impaired Functioning Tool.
AB  - Those afflicted with bipolar disorder often suffer from substantial functional
      impairment both when in episode and when in remission. This study examined the
      psychometric properties of a brief assessment of psychosocial functioning, the
      Range of Impaired Functioning Tool (LIFE-RIFT), among subjects with bipolar I
      disorder. The study sample consisted of 163 subjects who presented with bipolar I
      disorder at intake into the NIMH Collaborative Depression Study (CDS). All LIFE
      RIFT items come from the Longitudinal Interval Follow-up Evaluation (LIFE).
      Follow-up data that were used to examine the reliability and validity of the
      scale come from assessments of psychosocial functioning that were conducted 6,
      12, 18, and 24 months after intake into the CDS. The results of factor analyses
      indicate that the scale items are measures of one construct, psychosocial
      functioning. The interrater agreement on the scale score was very good with an
      intraclass correlation coefficient was 0.94. The internal consistency reliability
      among the scale items was uniformly satisfactory over the four assessment
      periods, with coefficient alpha ranging from 0.78 to 0.84. Mixed-effect
      regression analyses showed that during mood episodes subjects were significantly
      more impaired than those in recovery. In conclusion, the psychometric properties
      of the LIFE-RIFT were examined in subjects with bipolar I disorder. The analyses
      from this longitudinal, observational study provide empirical support for the
      reliability and validity of the scale. The LIFE-RIFT provides a brief,
      inexpensive alternative to scales currently used to assess psychosocial
      functioning and can be easily added to semistructured assessments that are used
      in clinical and treatment outcome studies.

PMID- 11191581
TI  - Cognitive, mood, and functional evaluations using touchscreen technology.
AB  - We describe the design and development of the Cognitive Evaluation Protocol
      (CEP), a computer software program for evaluating cognitive and functional
      capacities and mood. The program is self-administered by subjects using
      touchscreen monitors for input. Stimuli in CEP subtests are randomized to reduce
      the effects of learning on repeated assessments. Findings demonstrate that a)
      minimum instruction is required for touchscreen use, even for computer-naive
      subjects; c) both normative subjects and psychiatric patients respond positively
      to self-administered evaluations; and c) CEP can be used for within-subject
      repeated evaluations with minimal distortion of results due to practice effects.
      The CEP Report Generator provides immediate printed performance results and
      creates a database for long-term digital storage and information use.

PMID- 11191582
TI  - Memory, attention, function, and mood among patients with chronic posttraumatic
      stress disorder.
AB  - We report a study of memory, attention, function, and mood among 36 male Vietnam
      War Veterans suffering from chronic posttraumatic stress disorder (PTSD). PTSD
      subjects (N = 36) were in good physical health, suffering from moderate
      depression, and not knowingly suffering from other mental disorders. Control
      subjects (N = 18) were in good physical health, not knowingly suffering from a
      mental disorder, and matched with PTSD subject for age, sex, and level of
      education. Assessment instruments for PTSD subjects included the PostTraumatic
      Stress Diagnostic Scale (clinician administered), the Hamilton Depression Rating
      Scale (clinician administered), and the Cognitive Evaluation Protocol (CEP), a
      touchscreen computer assessment instrument that is self-administered by subjects.
      CEP was administered twice to PTSD subjects 1 month apart; other instruments were
      administered at the beginning of the study. Control subjects took CEP once and
      were administered the Hamilton Depression Rating Scale and the PostTraumatic
      Stress Diagnostic Scale once. Compared with control subjects, PTSD subjects
      performed significantly less well on CEP for the three cognitive domains of
      attention, memory, and function and had highly elevated depression scores. An
      interaction between depression and memory was found but not with depression and
      attention. There was no evidence of reduced information processing speed among
      PTSD subjects. Comparisons between the three assessment instruments showed a high
      degree of cross-assessment agreement. The findings are consistent with reports
      that chronic PTSD is associated with compromised memory, attention, and function.
      The study documents the feasibility of using self-administrated touchscreen
      computer programs to evaluate and track features of mental disorders.

PMID- 11191583
TI  - Prosody impairment in depression measured through acoustic analysis.
AB  - This work attempts to explore the association between depression and prosody
      impairment through acoustic techniques of voice analysis. For this purpose, we
      selected 10 quantitative vocal parameters, obtained instrumentally, and related
      to the variability and psychomotor control of phonation, which we have considered
      as prosody indicators. The sample consisted of 23 patients with diagnosis DSM-III
      R of major depression and a control group of 20 healthy volunteers. We obtained
      results in 7 of the 10 acoustic parameters that suggest reduced prosody in
      depressed subjects. In a second voice test, carried out 2 months after baseline
      situation, and while patients were under antidepressant treatment, it was not
      possible to demonstrate that all these prosody indicators change to normality in
      those 13 subjects who clinically improved.

PMID- 11191584
TI  - Mental imagery and perception in hallucination-prone individuals.
AB  - College students screened for hallucination-proneness using the Launay-Slade
      Hallucination Scale (LSHS) were compared on measures of self-report vividness of
      imagery and on behavioral measures of imagery and perception (visual and
      auditory). Specifically, we tested the hypothesis whether hallucination-prone
      individuals would show smaller differences between imagery and perception
      performance, which may be indicative of increased sensory characteristics of
      mental images. We replicated earlier findings of higher self-report imagery
      ratings in the high hallucination-prone group. However, the two groups did not
      differ on five of six behavioral imagery-perception comparisons. On one visual
      task, hallucination-proneness was associated with larger imagery-perception
      differences. Our results reveal a dissociation between the level of subjective
      experience and the information processing level. Although vividness of mental
      images may be subjectively associated with mild hallucinatory experiences, we
      suggest that cognitive processes associated with reality discrimination rather
      than increased perceptual characteristics of mental images may play a role at the
      information processing level.

PMID- 11191585
TI  - British psychiatrists' attitudes toward optimal psychological functioning for men
      and women.

PMID- 11191586
TI  - Panic-free status is not associated with improvement on continuous measures in
      panic disorder.

PMID- 11191587
TI  - Interpersonal behavior and schizotypy.

PMID- 11191588
TI  - Memory for actions and dissociation in obsessive-compulsive disorder.

PMID- 11191589
TI  - 3rd World Congress of the International Society for Apheresis (ISFA). January 11
      14, 2001. Taipei, Taiwan. Abstracts.

PMID- 11191590
TI  - Network therapy for addiction: bringing family and peer support into office
      practice.
AB  - Network therapy was developed as a specialized type of combined individual and
      group therapy to ensure greater success in the office-based treatment of addicted
      patients by using both psychodynamic and cognitive-behavioral approaches to
      individual therapy while engaging the patient in a group support network composed
      of family members and peers. This article outlines the role of group cohesiveness
      as a vehicle for engaging patients in this treatment; the patient's family and
      peers are used as a therapeutic network, joining the patient and therapist at
      intervals in therapy sessions. This network is managed by the therapist to
      provide cohesiveness and support, to undermine denial, and to promote compliance
      with treatment. The author presents applications of the network technique
      designed to sustain abstinence and describes means of stabilizing the patient's
      involvement. Some specific techniques discussed include ambulatory
      detoxification, disulfiram and naltrexone administration, relapse prevention, and
      contingency contracting. Also discussed are recent research on the use of
      psychiatric residents and counselors for treatment, and use of the Internet in
      dissemination.

PMID- 11191591
TI  - Reflections on group treatments as corrective experiences for addictive
      vulnerability.
AB  - This article addresses how and why groups help people with addictive disorders
      feel better and change. It advances the position that problems in self-regulation
      and the psychological suffering that ensues are at the root of addictive
      disorders. Group work is especially effective in addressing these problems,
      providing a means of relief, and examining co-occurring characterological
      problems. The evolution of these ideas and the generation of a model for group
      therapy for substance abusers are traced over a 30-year period, and a list of
      principles about how and why group treatments work is presented. In addition, a
      number of advantages that group psychotherapy has over 12-step programs for some
      patients are provided. Group psychotherapy is presented as a unique corrective
      emotional experience.

PMID- 11191592
TI  - Group therapy for victims of sexual abuse.

PMID- 11191593
TI  - Group psychotherapy of substance abuse in the era of managed mental health care.
AB  - The changes in health-care financing that have taken place over the last decade
      have spurred interest in finding innovative ways of delivering services at
      manageable cost levels. It comes as no surprise that increased interest and
      research have focused on group therapies as a major vehicle for reaching large
      numbers of people in need of psychological care that is brief, effective, and
      cost-efficient. More specifically, practitioners in the field of substance abuse
      have long recognized the value of group experiences as an integral part of the
      recovery and rehabilitative process. The influence of managed care to contain
      costs has added new incentives to expand the existing knowledge base in group
      treatment of addictions to comply with reduced funding and time constraints.

PMID- 11191594
TI  - Leader dilemmas and countertransference considerations in group psychotherapy
      with substance abusers.
AB  - Leader issues and countertransference dilemmas that emerge in psychotherapy
      groups for substance abusers will be examined along with strategies to extricate
      the therapist from the impasses that emerge. Specific issues include feelings of
      helplessness and inadequacy when a patient relapses and resumes substance use,
      countertransference reactions emanating from an overlapping personal or family
      history of substance abuse, countertransference helplessness when the therapist
      is more invested in the treatment than the patient, feelings of incompetence
      related to partial familiarity with 12-step culture and lingo, and
      countertransference devaluation fostered by systemic issues in substance abuse
      settings.

PMID- 11191595
TI  - Introduction to the special issue on group therapy and substance abuse.

PMID- 11191596
TI  - Addiction as an attachment disorder: implications for group therapy.
AB  - This article presents a perspective on addiction that not only substantiates why
      group therapy is the treatment of choice for addiction, but also integrates
      diverse perspectives from 12-step abstinence-based models, self psychology, and
      attachment theory into a complementary integrative formula. Attachment theory,
      self psychology, and affect regulation theory characterize addiction as an
      attachment disorder induced by a person's misguided attempt at self-repair
      because of deficits in psychic structure. Vulnerability of the self is the
      consequence of developmental failures and early environmental deprivation leading
      to ineffective attachment styles. Substance abuse, as a reparative attempt, only
      exacerbates that condition because of physical dependence and further
      deterioration of existing physiological and psychological structures. Prolonged
      stress on existing structures leads to exaggerated difficulty in the regulation
      of affect, which leads to inadequate modulation of appropriate behavior and self
      care and increased character pathology.

PMID- 11191597
TI  - Group psychotherapy for adolescents comorbid for substance abuse and psychiatric
      problems: a relational constructionist approach.
AB  - The group psychotherapy of adolescents comorbid for psychiatric and substance
      abuse problems is fraught with inconsistent attendance, frequent verbal and
      physical disruptions by the adolescents, and intense countertransference toward
      patients and their parents on the part of treating staff. A relational
      constructionist approach assists staff and patients in overcoming these obstacles
      and in focusing on the adolescents' search for personal meaning. Multiple group
      psychotherapy conducted in a combined day treatment and high school program is
      described and illustrated by case examples during the course of a year of
      treatment. These examples illustrate the importance of a relational non
      hierarchical approach to adolescent patients by treating staff.

PMID- 11191598
TI  - Tenth national congress of Italian Society of Phytochemistry (SIF). May 7-10,
      2000, Florence, Italy.

PMID- 11191599
TI  - New insights in microchimerism: new topic for our journal?

PMID- 11191601
TI  - Bibliography. Current world literature. Assessment of nutritional status and
      analytical methods.

PMID- 11191600
TI  - Bibliography. Current world literature. Nutrition and the gastrointestinal tract.

PMID- 11191602
TI  - Acute thrombosis of limb arteries in horses with sepsis: five cases (1988-1998).
AB  - A hypercoagulable condition and poor perfusion to distal extremities might occur
      during equine endotoxaemic or septic shock, which could cause thrombosis of limb
      arteries. In our review, thrombosis occurred in neonatal foals in association
      with gram-negative bacteraemia. In 3 older foals and adults, thrombosis was
      associated with inflammatory bowel disease, diarrhoea and toxaemia. All patients
      had been treated with broad-spectrum antibiotics, nonsteroidal antiinflammatory
      drugs and i.v. crystalloid solutions. Two horses received i.v. hyperimmune
      plasma. A generalised coagulopathy was not suspected prior to clinical signs of
      distal limb necrosis, although thrombocytopenia occurred in 4 of the 5 cases at
      the time of, or shortly before, thrombosis. Thrombocytopenia, possibly due to
      platelets adherence to exposed subendothelial collagen, which induces contact
      activation of the intrinsic coagulation pathway, has been described in
      endotoxaemic horses and foals with gastrointestinal infectious or inflammatory
      diseases and disseminated intravascular coagulation. Activation of procoagulants
      by endotoxins, decreased blood flow to the limbs and endothelial damage, may have
      been responsible for a hypercoagulable condition leading to thrombosis in these 5
      cases. The 3 enterocolitis patients may have had increased risk of thrombosis
      because of loss of antithrombin III, haemoconcentration and acidosis.

PMID- 11191603
TI  - Pituitary-independent Cushing's syndrome in a horse.

PMID- 11191604
TI  - The present state of equine dentistry.

PMID- 11191605
TI  - Age-related changes in the testes of horses.
AB  - Atrophy of seminiferous tubules and interstitial fibrosis are frequently observed
      in aged horses. Samples from 8 male Thoroughbreds, age 4-24 years, were subjected
      to histological, electron microscopical and immunohistochemical examination and
      statistical analysis. There were statistically significant increases in collagen
      fibres in the lamina propria of seminiferous tubules and testicular interstitium
      in 3 horses age 23 and 24 years compared with 5 horses age 4-20 years (P<0.001).
      Lamina propria surrounding atrophic tubules was thickened by an increase in
      collagen type IV and elastic fibres and by proliferation of bizarre myoid cells.
      Basal lamina was also thickened but had decreased reactivity for collagen type
      IV. Some myoid cells changed morphologically to a swollen and irregular shape and
      contained abundant cytoplasmic organelles. Laser scanning microscopy revealed
      that cytoplasmic actin filaments were decreased; the remaining filaments were
      positive for alpha-smooth muscle actin and vimentin, and matrix metalloproteinase
      2 was secreted. These myoid cells transformed into myofibroblasts. The changes
      are interpreted as evidence of injured structure and function of the lamina
      propria and basal lamina and may explain the functional decline of the blood
      testis barrier. Myoid cells may play an important role in the progression of
      testicular fibrosis.

PMID- 11191606
TI  - Contact areas and pressure distribution on the proximal articular surface of the
      proximal phalanx under sagittal plane loading.
AB  - The objective of this study was to map topographically contact areas and pressure
      distributions on the proximal articular surface (PAS) of the proximal phalanx
      (PI) under various clinically relevant loading conditions. Left and right
      forelimbs of 13 mature horses were transected halfway down the radius and loaded
      in a position mimicking the weightbearing attitude close to the midstance phase.
      Five loads were used which corresponded with loads that can be expected in
      different gaits or during athletic performance (stance: 1800 N, walk: 3600 N,
      trot: 5400 N, gallop: 10,500 N and jumping: 12,000 N). Contact areas and pressure
      distributions at the PAS of PI were determined using a methylene blue dye
      staining technique and 2 pressure sensitive films (low pressure: range 2.5-10 MPa
      and medium pressure: range 10-50 MPa). The contact area of PI was positively
      correlated (r = 0.86; P<0.01) with the applied load. The contact area increased
      from 63% at 1800 N to 95% at 12,000 N and gradually shifted to include more of
      the edges of the articular surface, but especially the dorsal articular margin of
      PI. Pressure distribution patterns were similar under the different loading
      conditions. Pressure was less at the palmar margin and in the central depression
      and highest at the dorsal articular margin. With increasing load, the highest
      peak pressures were measured at sites of the dorsal articular margin that are not
      loaded in the standing or walking horse. The results of this study suggest that
      the frequent occurrence of osteochondral lesions at the dorsal articular margin
      of PI is caused by the combination of the intermittent character and the high
      absolute values of loads at this site as they occur during athletic performance.

PMID- 11191607
TI  - Repeatability of diagnostic ultrasonography in the assessment of the equine
      superficial digital flexor tendon.
AB  - A quantitative investigation of the variation that can occur during the course of
      ultrasonography of the equine superficial digital flexor tendons (SDFT) was
      undertaken. The aim of this investigation was to use an objective measure, namely
      the measurement of CSA, to quantify the variability occurring during the course
      of the ultrasonographic assessment of the equine SDFT. The effects of 3 variables
      on the CSA measurements were determined. 1) Image acquisition operator (IAc): two
      different operators undertaking the ultrasonographic examination; 2) image
      analysis operator (IAn): two different operators undertaking the calculation of
      CSA values from previously stored images; and 3) analytical equipment (used
      during CSA measurement) (IEq): the use of 2 different sets of equipment during
      calculation of CSA values. Tendon cross-sectional area (CSA) measurements were
      used as the comparative variable of 3 potential sources: interoperator, during
      image acquisition; interoperator, during CSA measurement; and intraoperator, when
      using different analytical equipment. Two operators obtained transverse
      ultrasonographic images from the forelimb SDFTs of 16 National Hunt (NH)
      Thoroughbred (TB) racehorses, each undertaking analysis of their own and the
      other operator's images. One operator undertook analysis of their images using 2
      sets of equipment. There was no statistically significant difference in the
      results obtained when different operators undertook image acquisition (P>0.05).
      At all but the most distal level, there was no significant difference when
      different equipment was used during analysis (P>0.05). A significant difference
      (P<0.01) was reported when different operators undertook image analysis, one
      operator consistently returning larger measurements. Different operators
      undertaking different stages of an examination can result in significant
      variability. To reduce confounding during ultrasonographic investigations
      involving multiple persons, one operator should undertake image analysis,
      although different operators may undertake image acquisition.

PMID- 11191608
TI  - The hindlimb in walking horses: 1. Kinematics and ground reaction forces.
AB  - The objective was to study associations between kinematics and ground reaction
      forces in the hindlimb of walking horses. Video (60 Hz) and force (2000 Hz) data
      were gathered for 8 strides from each of 5 sound horses during the walk. Sagittal
      plane kinematics were measured concurrently with the vertical and longitudinal
      ground reaction forces. The hindlimb showed rapid loading and braking in the
      initial 10% stride. The stifle, tarsal and coffin joints flexed and the fetlock
      joint extended during this period of rapid loading. The vertical ground reaction
      force showed 2 peaks separated by a dip; this pattern was similar to the fetlock
      joint angle-time graph. Peaks in the longitudinal ground reaction force did not
      appear to correspond with kinematic events. Total braking impulse was equal to
      total propulsive impulse over the entire stride. Flexion and extension of the hip
      were responsible for protraction and retraction of the entire limb. Maximal
      protraction occurred shortly before the end of swing and maximal retraction
      occurred during breakover. During the middle part of stance the tarsal joint
      extended slowly, while the stifle began to flex when the limb was retracted
      beyond the midstance position at 28% stride. Flexion cycles of the stifle and
      tarsal joints were well coordinated during the swing phase to raise the distal
      limb as it was protracted. The results demonstrate a relationship between limb
      kinematics and vertical limb loading in the hindlimbs of sound horses. Future
      studies will elucidate the alterations in response to lameness.

PMID- 11191609
TI  - The hindlimb in walking horses: 2. Net joint moments and joint powers.
AB  - The objective of the study was to describe net joint moments and joint powers in
      the equine hindlimb during walking. The subjects were 5 sound horses. Kinematic
      and force data were collected synchronously and combined with morphometric
      information to determine net joint moments at each hindlimb joint throughout
      stance and swing. The results showed that the net joint moment was on the
      caudal/plantar side of all hindlimb joints at the start of stance when the limb
      was being actively retracted. It moved to the cranial/dorsal side around 24%
      stride at the hip and stifle and in terminal stance at the more distal joints. It
      remained on the cranial/dorsal side of all joints during the first half of swing
      to provide active limb protraction, then moved to the caudal/plantar aspect to
      reverse the direction of limb motion prior to ground contact. The hip joint was
      the main source of energy generation throughout the stride. It was assisted by
      the tarsal joint in both stance and swing phases and by the fetlock joint during
      the stance phase. The coffin joint acted as an energy damper during stance,
      whereas the stifle joint absorbed almost equal amounts of energy in the stance
      and swing phases. The coffin and fetlock joints absorbed energy as the limb was
      protracted and retracted during the swing phase, suggesting that their movements
      were driven by inertial forces. Future studies will apply these findings to
      detect changes in the energy profiles due to specific soft tissue injuries.

PMID- 11191611
TI  - International Workshop on Equine Chronic Airway Disease. Michigan State
      University 16-18 June 2000.

PMID- 11191610
TI  - Comparison of radiography and scintigraphy in the diagnosis of dental disorders
      in the horse.
AB  - Scintigraphy, with 99mTechnetium methylenediphosphonate (99mTc-MDP) and 99mTc
      labelled leucocytes, was compared to radiography in the diagnosis of dental
      disease in the horse in a prospective case-controlled study, comprising 30 horses
      with clinical signs of dental disease and 30 control horses. In each case, right
      and left lateral, ventral and dorsal soft tissue and bone phase scintigraphic
      images were obtained after i.v. injection of 1 GBq/100 kg bwt 99mTc-MDP, using a
      gamma camera. The same views were acquired in 10 horses with clinical signs of
      dental disease and 12 control horses after injection of 99mTc-labelled
      leucocytes. Standard radiographic projections of the paranasal sinuses and of the
      apices of the maxillary and mandibular teeth were obtained. The scintigraphs and
      radiographs were assessed subjectively by 2 board-certified surgeons and one
      board-certified radiologist, with extensive experience of equine radiology, from
      who the clinical history was withheld. Sensitivity, specificity and kappa, as a
      measure of agreement, were calculated for the different methods. Bone phase
      images were also scored subjectively on a scale from 0 to 3 on the basis of
      isotope uptake over the teeth. Regions of interest were defined over the teeth,
      and normal teeth compared to diseased counterparts. Total scintigraphic counts
      were related to the age of the animal and to the disease process. Differences in
      density ratios between left and right teeth were evaluated using the Mann-Whitney
      Test. Dental disease was confirmed in 22 horses at surgery or postmortem
      examination. Horses with dental disease showed a significant increase in
      scintigraphic activity over the affected tooth compared to the contralateral
      tooth, with a typical pattern for different diseases. The sensitivity of
      scintigraphy with 99mTc-MDP proved to be excellent (95.5%), whereas the
      specificity was moderate (86.4%). In contrast, radiography had excellent
      specificity (95.0%) and a low sensitivity (51.5%). The greatest sensitivity and
      specificity were achieved by evaluating radiographs and scintigrams together. The
      objective scintigraphic density ratios were found to be significantly different
      between diseased and control horses. The results of this study suggest that, if a
      density ratio of 1.5 or greater between a suspected diseased tooth and its
      contralateral number is regarded as abnormal, only 1% false positive diagnoses
      and 20% false negative diagnoses will occur. In contrast, scintigraphy with 99mTc
      labelled leucocytes was not very successful, due to the lack of anatomical detail
      provided by this technique, which made identification of the diseased tooth
      impossible. Accurate radiographic interpretation of dental disease presents
      difficulties, both in terms of missed diagnoses and mistaken diagnoses.
      Scintigraphy complements radiographic examination of dental structures by
      providing information important for accurate diagnosis and is, therefore,
      conceived to be essential for selection of the appropriate treatment for dental
      disease.

PMID- 11191613
TI  - The distribution of intratubular dentine in equine incisors: a scanning electron
      microscopic study.
AB  - The distribution of intratubular (peritubular) dentine was studied by scanning
      electron microscopy in 12 equine incisor teeth. High levels of intratubular
      dentine were found in the peripheral regions of the dentine. In these areas, a
      marked asymmetry occurred, as intratubular dentine was predominantly deposited
      onto the side of the dentinal tubular walls nearest to the dentino-enamel
      junction. The quantity and asymmetry of intratubular dentine were reduced towards
      the centre of the tooth. The significance of these variations in the amount and
      distribution of intratubular dentine between the different dentinal regions is
      discussed.

PMID- 11191612
TI  - Abdominal radiography in monitoring the resolution of sand accumulations from the
      large colon of horses treated medically.
AB  - This retrospective study consisted of 14 horses (age 6 weeks-12 years) with
      radiographically evident sand accumulations cranioventrally in the abdomen and
      clinical signs suggestive of sand enteropathy. The horses were treated medically
      and resolution of sand was monitored radiographically. Routine treatment
      consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral
      oilif needed. Initially, the number, size and shape of the sand accumulations
      showed large variation and the response to therapy was not predictable based on
      the initial appearance of the accumulation. In 2 foals, some of the sand was
      passed and the rest was mixed with other intestinal contents within 2-4 days.
      Even large accumulations disappeared in 2-4 days with psyllium alone or combined
      with mineral oil in 4 horses. In another 4 horses, the size of the accumulations
      decreased but varying amounts remained approximately at the same site, despite
      treatment for 1-4 weeks, and all these horses also had either gastric or large
      colon impaction. Three horses had a limited response to psyllium treatment, but
      the accumulation resolved with repeated doses of magnesium sulphate, with or
      without mineral oil. One horse did not respond to prolonged laxative treatment
      but the accumulation resolved on pasture. Clinical improvement was not
      necessarily related to the resolution of sand. Radiography of the cranioventral
      abdomen was found to be a useful means for monitoring the resolution of sand and
      confirming the effect of medical treatment in removing sand from the large colon
      in the horse.

PMID- 11191614
TI  - The radiographic development of the distal and proximal double contours of the
      equine navicular bone on dorsoproximal-palmarodistal oblique (upright pedal)
      radiographs, from age 1 to 11 months.
AB  - The aim of this study was to monitor the postnatal radiographic development of
      the proximal and distal double contours and the modelling of the shape of the
      proximal articular border. In mature horses, the proximal and distal contours of
      the navicular bone on dorsopalmar dorsoproximal-palmarodistal oblique (upright
      pedal) radiographs are commonly visualised as 2 lines, one being the articular
      border and the second representing the border of the cortex facing the deep
      digital flexor tendon (flexor border). The shape of the proximal articular border
      may be concave, undulating, straight or convex in the mature animal. These shapes
      have been found to be hereditary and to constitute a predisposing factor in the
      pathogenesis of navicular disease. This predisposing role may result from a shape
      dependent distribution of the biomechanical forces exerted on this region. There
      is no agreement in the literature with respect to the moment when the navicular
      bone takes its mature radiographic appearance. Upright pedal radiographs of the
      left front foot of 19 Dutch Warmblood foals were made at age 1 month and
      subsequently at intervals of 4 weeks, until the age of 11 months. The distal
      double contour developed soon after birth and the radiographic visibility of the
      articular border improved from ill-defined at 1 or 2 months to clear
      manifestation at 3 or 4 months. The proximal double contour developed later. The
      articular border became usually visible at age 3 or 4 months and was clearly
      visible from age 9 months. The mature shape of the proximal articular border
      usually became recognisable from age 7 months and was always obvious between 9
      and 11 months. This development was associated with a gradual modelling of the
      lateral and medial extremities of the navicular bone. It was concluded that the
      navicular bone adopts its mature radiological appearance during the first year
      postpartum. Considering this early manifestation of the mature shape of the
      proximal articular border and its previously demonstrated inheritance, a force
      dependent development of this shape, as predicted by the trajectional
      theory/Wolffs law, is improbable. The predisposing role of this shape in the
      pathogenesis of navicular disease may therefore be explained by a shape-dependent
      distribution of the biomechanical forces exerted on the navicular bone.
      Considering the potential application of these findings, from age 1 year shape
      determination enables identification of the individual and breed susceptibility
      for the development of navicular disease.

PMID- 11191615
TI  - Effect of GnRH immunisation on hormonal levels, sexual behaviour, semen quality
      and testicular morphology in mature stallions.
AB  - The aim of this study was to investigate the effect of gonadotrophin-releasing
      hormone (GnRH) immunisation on mature stallions that had been used for breeding.
      Four Standardbred stallions were used in the study: 3 experimental animals and 1
      control animal. Semen was collected regularly, i.e. twice/week, during the 4
      months prior to the experimental period. The stallions were immunised against
      GnRH with a GnRH-BSA conjugate. Equimune was used as the adjuvant. The stallions
      were immunised on 5 occasions, 4 at 2 week intervals, and the fifth 4 weeks after
      the fourth. Blood samples were taken once a week for analysis of GnRH antibody
      titre and every third week for testosterone and oestrone sulphate analyses. Semen
      was collected once a week, and libido and sexual behaviour were observed.
      Ejaculate volume, sperm concentration, total number of sperm in the ejaculate,
      sperm motility and sperm morphology were evaluated. Testicular size was measured
      once a week. At the end of the study, the stallions were castrated, and a
      histological examination of the testes performed. All immunised stallions
      produced antibodies against GnRH, and plasma testosterone concentration
      decreased. However, the effect of immunisation varied between stallions. In 2 of
      the stallions, high levels of antibodies were found, while in the third, the
      level was moderate. Four weeks after the first immunisation, a decrease in libido
      was observed. Two months after the first immunisation, marked changes in semen
      quality were observed in the 2 stallions with high antibody titres. Fourteen
      weeks after the first immunisation, the total number of sperm/ejaculate had
      decreased from >8.6 x 10(9) to <2.7 x 10(9), sperm motility from >59 to <10% and
      the frequency of morphological normal spermatozoa had decreased from >60 to <14%.
      The dominating abnormalities were abnormal head shapes, proximal cytoplasmic
      droplets and detached heads. In the third stallion, only slight changes in semen
      quality were found. No changes were observed in the control stallion. Decreases
      in testicular size were noted in all of the experimental stallions. Pronounced
      histological alterations in the testes were observed in 2 of the stallions. It is
      concluded that the vaccine was effective in stimulating production of GnRH
      antibodies and in suppressing testicular function and androgen secretion.
      However, there was an individual variation in the responses among the stallions
      and, further, libido was not totally suppressed.

PMID- 11191616
TI  - Risk factors associated with hindlimb lameness and degenerative joint disease in
      the distal tarsus of Icelandic horses.
AB  - The aim of this study was to evaluate potential risk factors associated with
      hindlimb lameness and radiographic signs of degenerative joint disease (DJD) in
      the distal tarsus in Icelandic horses. The material consisted of riding horses (n
      = 420) age 6-12 years sired by 17 selected sires representing all major breeding
      lines, and of riding horses (n = 194) in the same age range sired by other sires.
      The examination protocol included the following: interview with owners/trainers,
      assessment of conformation, motion evaluation and radiographic examination. At
      the interview, data related to factors outside the horse (environmental
      variables) and data associated directly with the horse (intrinsic variables) were
      obtained. Data analysis was performed in 2 steps: screening using bivariate
      analysis, followed by testing with a multivariate logistic regression model. In
      the multivariate analysis, the factors of sire, age when broken to saddle and
      stud show participation were strongly associated with the prevalence of lameness.
      Height at the croup and ability to perform different gaits were also associated
      with the prevalence of lameness, but to a lesser degree. The risk factors of age,
      tarsal angle and birthplace were significantly associated with radiographic signs
      of DJD in the distal tarsus. Neither the variation in applied training intensity,
      the use of a professional or amateur trainer nor the temperament or front limb
      action of the individual horse was significantly associated with the prevalence
      of hindlimb lameness and/or radiographic signs of DJD in the distal tarsus in the
      Icelandic horse.

PMID- 11191617
TI  - Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene
      mesh prosthesis.
AB  - Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate
      analgesia was achieved by sedation with detomidine and local flank infiltration
      with mepivacaine. Three portal sites at the paralumbar fossa were used to perform
      the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was
      inserted and fixated in the inguinal canal. Subsequent adhesion formation
      resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive
      technique allowed us to perform a testis sparing herniorrhaphy in the standing
      horse.

PMID- 11191618
TI  - Effect of water restriction on equine behaviour and physiology.

PMID- 11191619
TI  - Dental dysplasia and oligodontia in a thoroughbred colt.

PMID- 11191620
TI  - The ribonucleotide reductase inhibitor trimidox induces c-myc and apoptosis of
      human ovarian carcinoma cells.
AB  - Trimidox (3,4,5-trihydroxybenzohydroxamidoxime), a recently synthesized inhibitor
      of ribonucleotide reductase (RR), was shown to exert anti-proliferative
      activities in HL-60 and K562 human leukemia cell lines and to prolong the life
      span of mice inoculated with L1210 mouse leukemia cells. Here we test whether
      trimidox also exhibits anti-neoplastic properties in ovarian carcinoma cells.
      Since the mode of action of trimidox on cell fate has not been investigated so
      far, we addressed this unresolved item and find that this polyhydroxybenzoic acid
      derivative induces apoptosis of N.1 human ovarian carcinoma cells when tested in
      growth factor deprived medium. Utilizing an improved analysis, based on Hoechst
      33258/propidium iodide double staining, apoptosis is quantified and discriminated
      from necrosis. Trimidox induces c-myc expression, which is indispensible for
      apoptosis of N.1 cells, and expression of plasminogen activator/urokinase type
      (upa), which supports the apoptotic process under more physiological conditions.
      Surprisingly, trimidox does not block dNTP synthesis in N.1 cells at the
      concentrations tested and, therefore, trimidox induces apoptosis independent of
      RR-inhibition. Like TNFalpha or benzamide riboside, which are also inducers of
      apoptosis of N.1 cells, trimidox also down-regulates the G1 cell cycle
      phosphatase cdc25A, whereas cyclin D1 becomes up-regulated. This report shows
      that trimidox destroys human ovarian carcinoma cells by inducing them to undergo
      apoptosis as well as corroborating previous investigations which demonstrated
      that apoptosis of these cells depends on c-myc over-expression when survival
      factors are withdrawn.

PMID- 11191621
TI  - Studies on the involvement of histamine in the hypothalamic-pituitary-adrenal
      axis activation induced by nerve growth factor.
AB  - Nerve growth factor (NGF) has been shown to stimulate the hypothalamic-pituitary
      adrenocortical (HPA) axis. Since NGF induces the release of histamine from mast
      cells and in consideration of the fact that histamine is an HPA axis activator,
      we investigated whether NGF adrenocortical stimulation is mediated by histamine.
      To accomplish with it, the H1 histamine antagonist promethazine and the H2
      antagonists metiamide and zolantidine were used in freely-moving cannulated rats.
      The increase in plasma corticosterone concentration induced by histamine
      administration was prevented completely by promethazine pretreatment but was
      unaffected by the H2 antagonists. Neither H1 nor H2 antagonists affected the
      adrenocortical stimulation induced by NGF administration. Moreover, since mast
      cells are reportedly present in the rat adrenal gland and the locally released
      histamine mediates the release of adrenaline which, in turn, stimulates
      glucocorticoid synthesis and secretion, we studied the effect of NGF on basal and
      ACTH-stimulated corticosterone release from in vitro isolated quartered adrenal
      glands and collagenase-dispersed adrenal cells. The results from these in vitro
      experiments have indicated that NGF modified neither spontaneous nor stimulated
      corticosterone release. Altogether these observations suggest that endogenous
      histamine is unlikely to be involved in HPA axis stimulation by NGF and reinforce
      the previously proposed concept of an active participation of NGF in the control
      of adrenocortical activity.

PMID- 11191622
TI  - Chronic losartan treatment decreases angiotensin II-mediated facilitation of
      noradrenaline release in the caudal artery of spontaneously hypertensive rats.
AB  - Sympathetic activity is modulated by angiotensin II (AII), both at pre- and
      postsynaptic level in the rat caudal artery. In the spontaneously hypertensive
      rat (SHR), this artery receives more dense sympathetic innervation than blood
      vessels of normotensive strains. This fact seems to be linked to the enhanced
      pressor responses elicited by noradrenaline in SHR. In this work we describe, in
      the SHR, the effect of a chronic treatment with the angiotensin II AT1-receptor
      antagonist, losartan, in modulating noradrenergic mechanisms involved in caudal
      artery contraction. The effect of losartan is compared to that of captopril,
      given at doses leading to a similar decrease of both arterial blood pressure and
      left ventricular hypertrophy. The contractile response of caudal artery rings
      induced by endogenous noradrenaline released by low frequency transmural nerve
      stimulation (TNS) has been studied. Under our conditions, TNS (0.5-1 Hz) induced
      higher contractile responses in SHR treated with losartan than in the control and
      captopril-treated groups. This difference seems to be due to an increase of the
      postsynaptic effect of noradrenaline (NA) rather than to an increase of
      noradrenaline release from sympathetic endings, since i) DE50 value for NA was
      lower in losartan-treated SHR than in the other groups, and ii) AII induced a
      dose-dependent increase of TNS-evoked release of radioactivity from caudal artery
      segments loaded with [3H]-NA, in both control and captopril-treated groups but
      had no effect in the losartan-treated group. These results show that chronic
      treatment with losartan, although slightly enhancing the pressor effect of NA at
      postsynaptic level, fully supresses the facilitatory role of AII on NA release.

PMID- 11191623
TI  - Nifedipine and nisoldipine modulate membrane potential of vascular endothelium
      via a myo-endothelial pathway.
AB  - Effects of nifedipine (Nif) and nisoldipine (Nis), dihydropyridine Ca2+ channel
      blockers (DHPs) on membrane potential and currents of endothelial cells, which
      are enzymatically dispersed (dis-ECs) from or exist in arterial segments (seg
      ECs) of rabbit and rat aorta, were examined. Outward currents induced by 1-10
      microM acetylcholine (ACh) in dis-ECs were neither affected by a receptor
      operated Ca2+ channel blocker, SK&F 96365 (SKF), nor DHPs. ACh hyperpolarized dis
      ECs and seg-ECs by 15-20 mV, whereas phenylephrine (Phe) elicited oscillatory
      depolarization in seg-ECs but not in dis-ECs. The Phe-induced response in seg-ECs
      was significantly inhibited by treatment with 18beta-glycyrrhetinic acid, a
      disrupter of gap junctions. Application of 0.3 microM Nif or Nis effectively
      inhibited the Phe-induced oscillatory depolarization, while these DHPs did not
      affect ACh-induced hyperpolarization in seg-ECs. The lack of effect on dis-ECs
      indicates that DHPs have little effect on dis-ECs themselves, nevertheless DHPs
      inhibit the Phe-induced endothelial potential oscillation which is conducted from
      smooth muscle cells via a myo-endothelial pathway.

PMID- 11191624
TI  - Chronic stress influences the immune system through the thyroid axis.
AB  - The aim of the present work was to analyze the effect of chronic stress on
      thyroid axis and its influence on the immune response. For this purpose a murine
      model of chronic stress was developed to evaluate and to correlate thyroid
      hormone levels with humoral alloimmune response. Results show a reduction in
      serum levels of thyroid hormones, specially a significant decrease in serum
      levels of triiodotyronine (T3) in stressed animals. On the other hand,
      alloimmunization was not able to induce an early increment in T3 and thyroxine
      (T4) levels as it was previously reported in normal animals. In addition, lower
      titers of alloantibodies were obtained in animals under stress conditions as
      compared to normal mice. The sustitutive T4 treatment in stressed animals
      increased significantly alloantibody production as well as the early increment in
      thyroid hormones after antigenic challenge. These findings suggest that chronic
      stress induces an alteration of the function of thyroid axis that alters the
      immune response.

PMID- 11191625
TI  - Interaction of ascorbate and alpha-tocopherol enhances antioxidant reserve of
      erythrocytes during anemia in visceral leishmaniasis.
AB  - Visceral leishmaniasis (V.L.) is associated with enhanced lipid peroxidation
      along with impaired function of antioxidant defense system in erythrocytes. The
      effect of chronic treatment with ascorbate and alpha-tocopherol was studied on
      erythrocytes in hamsters infected with Leishmania donovani. Combination treatment
      with both antioxidants proved to be a potential suppressor of lipid hydroperoxide
      formation as well as hypotonic osmotic lysis during the leishmanial infection.
      Positive correlations between the depleted levels of erythrocyte ascorbate, GSH
      and alpha-tocopherol exhibit proportionate alterations in the nonenzymatic
      antioxidant levels at different stages of infection. Indirect measurement of
      transmembrane electron transfer as ferricyanide reduction suggests an active
      participation of endogenous contents of ascorbate and alpha-tocopherol in the
      protection against oxidative damage of membrane lipids. Cooperative behavior of
      both antioxidants in the ferricyanide reducing capacity was further evinced by
      resealing the ghosts in presence of exogenous ascorbate and alpha-tocopherol.
      Furthermore, intravesicular ascorbate serves in the defense of extravesicular
      ferricyanide induced oxidation of endogenous alpha-tocopherol. The results
      suggest an interacting role of ascorbate and alpha-tocopherol in maintaining the
      antioxidant reserve of erythrocytes during anemia in V.L.

PMID- 11191626
TI  - Post-transcriptional inhibition of glutamine synthetase induction in rat liver
      epithelial cells exerted by conditioned medium from rat hepatocytes.
AB  - Recently, a soluble factor produced by primary periportal hepatocytes and
      different from glutamine was found to completely block induction of glutamine
      synthetase (GS) by dexamethasone (DEX) in the liver cell line RL-ET-1G. Using
      Northern and Western blotting we investigated whether this block is regulated on
      the transcriptional or the post-transcriptional level. Three different species of
      GS mRNA were detected that all increased (though in different proportions), when
      the cells were exposed to DEX for 24 h. Further maintenance for another 24 h in
      normal DEX-containing culture medium, conditioned medium from primary periportal
      hepatocytes or medium containing glutamine did not result in significant
      differences in GS mRNA levels. In contrast, GS protein and specific GS-activity
      remained high only under normal culture conditions, whereas both returned to
      basal levels in conditioned and glutamine-supplemented culture medium.
      Throughout, GS protein content and specific GS-activity strongly correlated (r =
      0.98) excluding that GS-activity is regulated by chemical modification. These
      data suggest that the decrease in enzyme activity caused by cultivation in CM is
      controlled on the post-transcriptional level.

PMID- 11191627
TI  - Structurally dissimilar proteins with antiviral and antifungal potency from
      cowpea (Vigna unguiculata) seeds.
AB  - Evidence is presented for the existence of multiple proteins with antifungal and
      antiviral potency in cowpea seeds. The two proteins, designated alpha- and beta
      antifungal proteins in accordance with their order of elution from the CM
      Sepharose column, were capable of inhibiting human immunodeficiency virus (HIV)
      reverse transcriptase and one of the glycohydrolases associated with HIV
      infection, alpha-glucosidase, but beta-glucuronidase was not repressed. The
      ability of the proteins in retarding mycelial growth of a variety of fungi was
      also demonstrated with alpha-antifungal protein being more potent in most of the
      cases. Beta-antifungal protein was more active in only one instance. Both
      antifungal proteins had low cell-free translation-inhibitory activity. The
      proteins were adsorbed on Affi-gel blue gel-and CM-Sepharose but could be
      separated from one another during chromatography on the latter medium by means of
      a linear NaCl concentration gradient. Different molecular weights were exhibited
      by the proteins, being 28 kDa and 12 kDa respectively for alpha- and beta-
      antifungal proteins. Alpha-antifungal protein was characterized by an N-terminal
      sequence showing close resemblance to sequences of chitinases. Beta-antifungal
      protein exhibited an N-terminal sequence hitherto unknown in the literature.

PMID- 11191628
TI  - Ca2+/calmodulin mediated pathways regulate the uptake of L-DOPA in mouse
      neuroblastoma neuro 2A cells.
AB  - The present study examined the involvement of protein kinase A (PKA), protein
      kinase G (PKG), protein kinase C (PKC), protein tyrosine kinase (PTK) and
      Ca2+/calmodulin mediated pathways on the uptake of L-DOPA through the L-type
      amino acid transporter in Neuro 2A cells, an in vitro model of neuronal cells.
      Non-linear analysis of the saturation curve for L-DOPA revealed a Km value (in
      microM) of 54+/-2 and a Vmax value (in nmol mg protein/6 min) of 34+/-1. L-DOPA
      uptake was a sodium-independent process and insensitive to N-(methylamino)
      isobutyric acid (MeAIB, 1 mM), but sensitive to 2-aminobicyclo(2,2,1)-heptane-2
      carboxylic acid (BHC, IC50=82 microM). The Ca2+/calmodulin inhibitors
      calmidazolium and trifluoperazine inhibited L-DOPA (2.5 microM) uptake with
      IC50's of 33 and 105 microM, respectively. The inhibitory effect of BHC on the
      accumulation of L-DOPA was of the competitive type, whereas that of calmidazolium
      and trifluoperazine was of the non-competitive type. Modulators of PKA (cyclic
      AMP, forskolin, isobutylmethylxanthine and cholera toxin), PKG (cyclic GMP,
      zaprinast, LY 83583 and sodium nitroprusside), PKC (phorbol 12,13-dibutirate,
      phorbol 12-myristate 13-acetate and chelerythrine) and PTK (genistein and
      tyrphostin 25) failed to affect the accumulation of a non-saturating (2.5 microM)
      concentration of L-DOPA. It is concluded that L-DOPA uptake in Neuro 2A cells is
      promoted through the L-type amino acid transporter and appears to be under the
      control of Ca2+/calmodulin mediated pathways.

PMID- 11191629
TI  - P38 MAPK, but not p42/p44 MAPK mediated inducible nitric oxide synthase
      expression in C6 glioma cells.
AB  - Recently mitogen-activated protein kinase (MAPK) has been reported to play an
      important role in phosphorylation cascades governing cell growth and protein
      expression in numerous cell types. In order to explore the signaling mechanism by
      which inducible nitric oxide synthase (iNOS) is regulated in C6 glioma cells, we
      investigated the role of MAPK in iNOS expression by using the specific MAPK
      inhibitors. First the induction of nitric oxide by lipopolysaccharide (LPS),
      tumor necrosis factor alpha (TNFalpha), interferon gamma (IFNgamma), alone or
      their combination, was studied in C6 glioma cells. Administration of LPS,
      TNFalpha, or IFNgamma alone had no detectable stimulatory effect on the
      production of nitric oxide (NO). However, combination of the three factors
      elicited a significant elevation of NO level in C6 cell culture medium.
      Subsequently pretreatment of C6 cells with a specific inhibitor of p38 MAPK,
      SB202190, resulted in a dose-dependent inhibition of NO production and iNOS
      expression, but PD98059, an inhibitor of p42/p44 MAPK activation, had no effect.
      These data suggest that p38 MAPK mediates iNOS expression in C6 glioma cells, but
      p42/p44 MAPK is not involved in this process.

PMID- 11191630
TI  - Polynitroxyl albumin plus tempol attenuates liver injury and inflammation after
      hepatic ischemia and reperfusion.
AB  - PNA+Tempol, albumin containing conjugated (polynitroxyl albumin; PNA) and free (4
      hydroxyl-2,2,6,6-tetramethyl-piperidinyl-1-oxyl; Tempol) nitroxide may protect
      against injury caused by reactive oxygen species. Therefore, the actions of
      PNA+Tempol on liver injury and inflammation induced by hepatic ischemia and
      reperfusion (I/R) were examined. Rats were subjected to 1 h ischemia followed by
      24 h reperfusion in the absence (I/R) or presence of PNA+Tempol (25%; 15 mL/kg,
      i.v.) (I/R+PNA+Tempol) or human serum albumin (23%; 13.5 mL/kg, i.v.) (I/R+HSA).
      Test solutions were administered prior to and for 2 h during reperfusion. Sham
      operated rats underwent surgery with neither ischemia nor infusion.
      I/R+PNA+Tempol rats had significantly less liver injury and inflammation than I/R
      rats. I/R+PNA+Tempol livers exhibited focal lesions whereas I/R livers exhibited
      global necrosis. Likewise, plasma ALT activity was significantly lower in
      I/R+PNA+Tempol rats. PNA+Tempol reduced I/R-induced neutrophil accumulation and
      intercellular adhesion molecule-1 (ICAM-1) expression. HSA did not alter I/R
      induced liver injury or inflammation. Sham-operated rats exhibited normal liver
      morphology and no inflammation. Attenuation of I/R liver injury by PNA+Tempol may
      be mediated by its effect on inflammation, the major contributor to I/R injury.
      Reduction of inflammation by PNA+Tempol is most likely due to the antioxidative
      nature of the nitroxides.

PMID- 11191631
TI  - ALEPH-2, a suspected anxiolytic and putative hallucinogenic phenylisopropylamine
      derivative, is a 5-HT2a and 5-HT2c receptor agonist.
AB  - To assess the pharmacodynamic profile of ALEPH-2, a phenylisopropylamine
      derivative with alleged anxiolytic and hallucinogenic properties, Xenopus laevis
      oocytes were microinjected with either of the rat cRNA for the 5-HT2A or the 5
      HT2C receptor. Concentration-response curves were obtained following the exposure
      of the oocytes to varying concentrations of either ALEPH-2 or 5-hydroxytryptamine
      (5-HT) for 10 s. ALEPH-2 is a partial agonist on the 5-HT2A receptor with a
      similar potency to 5-HT. In contrast, ALEPH-2 is a full 5-HT2C receptor agonist
      and is about 15-fold less potent than 5-HT. Pre-application of 1 microM
      ritanserin antagonized the responses induced by 5-HT and ALEPH-2 to the same
      extent; however, the 5-HT2A receptor is more sensitive to ritanserin blockade
      than the 5-HT2C receptor.

PMID- 11191632
TI  - ATP as a presynaptic modulator.
AB  - There is considerable evidence that ATP acts as a fast transmitter or co
      transmitter in autonomic and sensory nerves mostly through activation of
      ionotropic P2X receptors but also through metabotropic P2Y receptors. By analogy,
      the observations that ATP is released from stimulated central nervous system
      (CNS) nerve terminals and that responses to exogenously added ATP can be recorded
      in central neurons, lead to the proposal that ATP might also be a fast
      transmitter in the CNS. However, in spite of the robust expression of P2 receptor
      mRNA and binding to P2 receptors in the CNS, the demonstration of central
      purinergic transmission has mostly remained elusive. We now review evidence to
      suggest that ATP may also act presynaptically rather than solely postsynaptically
      in the nervous system.

PMID- 11191633
TI  - Adhesion molecules on peripheral blood lymphocyte subpopulations in the elderly.
AB  - Adhesion molecules, such as CD49d, CD50 and CD62L, have important roles in many
      adhesive interactions involving cells of the immune system. Since it has been
      shown that many immunological alterations are present in aged subjects, we
      studied, by means of triple colour whole blood immunostaining and multiparametric
      flow cytometry, the expression and intensity level (MFI) of these molecules on
      peripheral blood lymphocyte subpopulations from 23 healthy elderly subjects and
      13 young controls. In the elderly a decrease in total peripheral blood
      lymphocytes bearing CD62L antigen was observed (39 +/- 13% vs 63 +/- 6% and 745
      +/- 312/mm3 vs 1,393 +/- 407/mm3; p<0.001), whereas the numbers of lymphocytes
      expressing CD49d and CD50 antigens were comparable in aged and young subjects. In
      addition, CD50 and CD62L MFI values on total peripheral blood lymphocytes were
      higher in elderly than in young subjects (5.23 +/- 1.03 vs 4.18 +/- 0.44, p =
      0.001 and 2.60 +/- 0.35 vs 2.21 +/- 0.40, p = 0.005 respectively) while the
      intensity expression of CD49d was unchanged. The percentages and absolute numbers
      of T and B lymphocytes expressing CD62L were decreased in elderly compared to
      young subjects (CD62L+CD3+: 43 +/- 15% vs 66 +/- 9% and 581 +/- 257/mm3 vs 1,028
      +/- 418/mm3, p<0.001; CD62L+CD19+: 78 +/- 12% vs 90 +/- 4%, p < 0.005 and 103 +/-
      64/mm3 vs 207 +/- 98, p < 0.001). A decrease in the proportion of CD62L bearing
      NK cells was also observed in the elderly (25 +/- 14% vs 46 +/- 24%, p<0.005),
      although their absolute number was unchanged. No significant differences were
      detected in the proportion of T, B and NK lymphocytes expressing CD49d and CD50
      antigens and only the absolute numbers of B cells expressing these adhesion
      molecules were lower in elderly (CD49d+CD19+: 121 +/- 71/mm3 and CD50+CD19+: 107
      +/- 73/mm3) compared to young donors (CD49d+CD19+: 248 +/- 112/mm3 and
      CD50+CD19+: 235 +/- 120/mm3, p < 0.001). Moreover, the intensity of adhesion
      molecule expression was differentially modulated in the elderly depending on the
      specific lymphocyte cell population considered. The densities of CD49d, CD50 and
      CD62L antigens on B and NK lymphocytes from the two age groups were not
      different; on the contrary, T lymphocytes from elderly donors exhibited increased
      CD49d (1.69 +/- 0.09 vs 1.62 +/- 0.07, p < 0.05), CD50 (4.98 +/- 1.16 vs 3.77 +/-
      0.46, p < 0.001) and CD62L (2.26 +/- 0.38 vs 1.99 +/- 0.37, p < 0.05) MFI values
      compared to young donors.

PMID- 11191634
TI  - Effect of resveratrol on intimal hyperplasia after endothelial denudation in an
      experimental rabbit model.
AB  - The ability of resveratrol to inhibit vascular intimal thickening was tested in
      an experimental model in which endothelial denudation was performed in the normal
      rabbit iliac artery. Resveratrol (2 approximately 4mg/ kg/d) was administered
      intragastrically for 5 weeks beginning 1 week before denudation. At the higher
      concentration of resveratrol, the intimal hyperplasia of injured vascular wall
      was effectively inhibited; the intimal proliferation index also was significantly
      less than that in the untreated control group (0.28 +/- 0.07 vs 0.41 +/- 0.13,
      respectively, p<0.01); the relative luminal area increased from 0.38 +/- 0.06 in
      the untreated control group to 0.53 +/- 0.10 in the resveratrol treatment group
      (p < 0.001); and the count of smooth muscle cells in the thickened intima was
      statistically significantly reduced in the high dose resveratrol treatment group
      than that in the untreated group (1,115 +/- 510 vs 1,796 +/- 963, respectively, p
      < 0.05). Resveratrol added to the culture media of cultured rabbit vascular
      smooth muscle cells inhibited DNA synthesis in a dose-dependent manner. These
      results showing that resveratrol is capable of inhibiting intimal hyperplasia of
      injured artery raise the possibility that this polyphenol might have clinical
      potential in prevention and treatment of restenosis after angioplasty.

PMID- 11191635
TI  - Molecular mechanisms involved in the antiproliferative action of protein tyrosine
      phosphatase inhibitor potassium bisperoxo(1,10-phenanthroline)oxovanadate.
AB  - Potassium bisperoxo(1,10-phenanthroline)oxovanadate, bpV(phen), a powerful
      protein phosphotyrosine phosphatase inhibitor and a potent insulinomimetic,
      influenced three fundamental cellular processes in HL-60 human leukemic cells: 1)
      inhibition of proliferation, 2) induction of differentiation and 3) apoptotic
      cell death. In the presence of micromolar concentrations of bpV(phen) cell number
      and DNA synthesis decreased progressively with time of incubation. A single
      treatment with bpV(phen) (3 microM) activated a differentiation program; after 6
      days of incubation 82% of cells were differentiated, but differentiation started
      already within the first 24 h. Concentrations of 5-10 microM bpV(phen) caused the
      characteristic DNA ladder pattern, starting after 4.5 h. Differentiation in HL-60
      cells appear to be associated with activation of extracellular signal-regulated
      kinase while apoptosis is connected with phosphorylation and activation of both
      extracellular signal-regulated kinase and c-Jun N-terminal kinase in a
      concentration and time-dependent manner. The antiproliferative and apoptotic
      action of bpV(phen) could be exploited in combination chemotherapy in leukemia.

PMID- 11191636
TI  - Rostral ventrolateral medulla catechol involvement upon sino-aortic
      deafferentation: an in vivo voltammetric study.
AB  - Pharmacologically-induced hypertension engages few aminergic ventrolateral
      medullary cells. To further address this issue, reflex hypertension evoked by
      acute sino-aortic deafferentation was chosen as a model. Adrenergic rostral
      ventrolateral neurons were recorded with a continuous, catechol-specific tool,
      i.e. in vivo voltammetry. Controlled hypotension led to the expected increase in
      catechol signal in sham rats (n = 4) but not in deafferented (vagi, superior
      laryngeal and glossopharyngeal nerves) rats (n = 5). Thus, the central
      responsiveness to known stimuli remained intact in this preparation following
      acute sino-aortic deafferentation. However, acute sino-aortic deafferentation
      itself induced no increase in catechol signal (n = 4 or 5 respectively). No
      increase in catechol signal was, observed when deafferentation was performed a)
      under hyperoxic conditions (O2 = 100%, n = 5) b) by extensive deafferentation
      involving also the cervical sympathetic trunk under halothane (n = 5) c) upon
      restrictive deafferentation leaving the vagi intact under pentobarbital (n = 5)
      d) in decerebrate animals (n = 4). Adrenergic rostral ventrolateral medullary
      barosensitive bulbospinal neurons may be primarily involved during hypotension.

PMID- 11191637
TI  - A study of iodothyronine 5'-monodeiodinase activities in normal and pathological
      tissues in man and their comparison with activities in rat tissues.
AB  - The present study was undertaken to investigate the peripheral iodothyronine 5'
      monodeiodination in different human and rat tissues. We studied iodothyronine 5'
      monodeiodinase type I (5'-DI) activity in liver, kidney, intestine, right cardiac
      atrium and skeletal muscle and we compared the results with those in rat tissues.
      Lodothyronine 5'- monodeiodinase type II (5'-DII) activity was studied in normal
      and ischemic human heart and in rat normal myocardium and brain. The 5'-DI
      activity (fmol/min x mg protein) in liver and kidney was significantly higher (p
      < 0.001, ANOVA) in normal rat tissue than in human. However, no significant
      differences were observed in 5'-DI activity between normal and tumoral human
      intestine or between intestinal tissue of man and rat. 5'-DI activity in normal
      human skeletal muscle was significantly higher than that in rat skeletal muscle
      (p < 0.05). The 5'-DI activity was lower in human ischemic myocardium when
      compared to normal myocardium either in humans (p < 0.05) or rat (p < 0.001). The
      Km of 5'-DI was significantly lower in rat than in human kidney and liver (p <
      0.05). We conclude that 1) 5'-DI is distributed widely among extrathyroidal human
      and rat tissues and 5'-DII activity is detectable both in human and rat heart; 2)
      5'-DI activity in liver and kidney is lower in man than in rat; 3) 5'-DI activity
      in the skeletal muscle is higher in man than in the rat; 4) 5'-DI activity is
      decreased in tumoral tissues of human liver and kidney and in ischemic
      myocardium, while no significant difference was found between human and rat
      cardiac 5'-DII activity.

PMID- 11191638
TI  - Negative relationships between erythrocyte Ca-pump activity and lead levels in
      mothers and newborns.
AB  - Lead poisoning induces hematological, gastrointestinal and neurological
      dysfunctions. One of the potential mechanisms is the inhibition of calcium-pump
      (Ca-pump), a transport protein. We investigated the effects of an environmental
      low lead exposure on Ca-pump activity in 247 mothers and their newborns. Maternal
      and cord blood, and newborn and mother hair, were sampled at delivery. Geometric
      means for mother and cord blood lead (Pb-B), and for mother and newborn hair lead
      (Pb-H), were 6.3 and 4.8 microg/dl, and 1.7 and 1.1 microg/g. Means for mother
      and cord basal Ca-pump activities were 2,442 and 2,675 nM/mg/hr. Mother enzymatic
      activity was negatively related to her Pb-B and Pb-H and to the cord Pb-B and
      newborn Pb-H levels. Newborn enzymatic activity was negatively related to his Pb
      H level only. Adjustment for gestational age, child's sex, mother's age at
      delivery, alcohol, coffee and tea consumption, and smoking habits during
      pregnancy did not modify these relationships. Our findings support the hypothesis
      that lead toxicity could be in part mediated by a reduction of Ca-pump activity.
      This effect could be observed at low environmental exposure, in mothers and
      newborns.

PMID- 11191639
TI  - Combined supplementation of vanadium and 1alpha,25-dihydroxyvitamin D3 inhibit
      placental glutathione S-transferase positive foci in rat liver carcinogenesis.
AB  - The combined effects of vanadium (V) and 1alpha,25-dihydroxyvitamin D3
      [1,25(OH)2D3] in inhibiting diethylnitrosamine (DEN)-induced and phenobarbital
      (PB) promoted hepatocarcinogenesis were examined in male Sprague-Dawley rats. All
      the rats were subjected to 70% partial hepatectomy (PH) at week 4 and 24h later
      were administered either solvent trioctanoin (Group B, D, F and H) or 10 mg
      DEN/kg (Group A, C, E and G) by gavage. Briefly after two weeks of DEN
      administration, PB were administered (0.05% in basal diet) to all the DEN-treated
      rats and continued till the completion of the experiment. Supplementary V at the
      dose of 0.5 ppm in drinking water ad libitum (Group C and D), 1,25(OH)2D3 at the
      dose of 3 microg/ml in propylene glycol per os twice a week (Group E and F) or
      both V and 1,25(OH)2D3 at the same above given doses (Group G and H) were started
      4 weeks prior to DEN administration (week 0) and continued thereafter till week
      15. The expression of the number and area of altered hepatocyte foci (AHF)
      positive for placental glutathione S-transferase (GST-P) was maximum in DEN
      treated and PB promoted group (Group A). V (Group C) and 1,25(OH)2D3 (Group E)
      treatment significantly reduced the expression of GST-P-positive hepatocytes by
      36.02% and 45.16% respectively but an additive protective action (61.46%) was
      found in Group G which received both V and 1,25(OH)2D3 for the entire period of
      the study. Moreover, histopathological examination and the incidence of hepatic
      hyperplastic nodules showed that combined action of V and 1,25(OH)2D3 can able to
      minimize the appearance of nodules as well and maintain the normal cellular
      architecture than V and 1,25(OH)2D3 when given alone. These results suggest that,
      when given together V and 1,25(OH)2D3 could be the chemopreventive agents for rat
      liver carcinogenesis.

PMID- 11191640
TI  - In vitro pharmacological profile of peptide III-BTD: a novel ligand for
      nociceptin/orphanin FQ and opioid receptors.
AB  - Peptide III-BTD has been recently identified as a non-selective
      nociceptin/orphanin FQ receptor ligand by screening of a synthetic peptide
      combinatorial library. In the present study we evaluated the pharmacological
      profile of peptide III-BTD in isolated tissues (mouse and rat vas deferens,
      guinea pig ileum) sensitive to both nociceptin and opioid peptides. In the mouse
      vas deferens and guinea pig ileum, III-BTD concentration dependently inhibited
      the electrically induced twitch (pEC50 5.91 and 6.18, respectively; Emax 94 +/-
      1% and 94 +/- 2%) and this effect was blocked by naloxone (1 microM). In the rat
      vas deferens, III-BTD was inactive in most of the tissues, while in few others it
      elicited a slight inhibition only at the highest concentration tested (10
      microM). In the presence of 1 microM naloxone, 1 microM III-BTD shifted to the
      right the concentration response curve of nociceptin in a parallel manner,
      showing pKB values in the range 6.6-6.9. These data confirm on native nociceptin
      receptors the pharmacological profile of peptide III-BTD which behaved as a mixed
      nociceptin receptor antagonist/opioid receptor agonist in the [35S]GTPyS binding
      assay performed on cells expressing the recombinant human receptors.

PMID- 11191641
TI  - Structure and function of Toll-like receptor proteins.
AB  - Beginning in 1997 with the identification of the first human homologue of the
      Drosophila protein Toll, a family of related molecules have been identified in
      both humans and other mammals. These Toll-like receptor (TLR) proteins appear to
      represent a conserved family of innate immune recognition receptors. TLR proteins
      share extended homology with receptors for the cytokines interleukin 1 (IL-1) and
      interleukin 18 (IL-18). These receptors are coupled to a signaling pathway that
      is conserved in mammals, insects, and plants, resulting in cellular activation,
      thereby stimulating innate immune defenses. A variety of bacterial and fungal
      products have been identified that serve as TLR ligands, and more recent studies
      have identified the first endogenous protein ligands for TLR proteins. While TLR
      signaling is likely to be a key feature of innate immune responses, these
      proteins may also regulate homeostasis via interaction with endogenous protein
      ligands.

PMID- 11191642
TI  - Nine polymorphisms of angiotensinogen gene in the susceptibility to essential
      hypertension.
AB  - Even if the importance of angiotensinogen (AGT) gene has been known in gene
      targeting animals and humans genetic studies, its precise mechanism and the
      interaction among AGT gene variants, plasma AGT concentration and risk for
      hypertension remain uncertain. We examined whether AGT gene variants predispose
      to hypertension via an increase of plasma AGT concentration. Plasma AGT
      concentration was estimated from plasma angiotensin I which was cleaved by an
      excess amount of human renin and measured by RIA. Using 9 AGT gene variants which
      included new polymorphisms (G-152A and T+31C), we examined the association with
      hypertension and with plasma concentration by a case-control study. Haplotype
      analysis revealed that G-6A, T+31C and M235T polymorphisms were in absolute
      linkage disequilibrium and were associated with hypertension but not with plasma
      AGT level. On the other hand, -1074t;T235 haplotype was associated with an
      increase of AGT level but not with hypertension. In the haplotype analysis, only
      H3 haplotype frequency, which contained G-6, T+31 and M235 alleles, was
      significantly increased in normotensive subjects, suggesting that this haplotype
      is associated with a hypotensive effect. According to combined haplotype analysis
      of diallele and microsatellite markers, it remains a possibility that M235T,
      T+31C, G-6A, A-20C and G-1074T polymorphisms may play an important role in
      increased risk for essential hypertension. Our results suggest that the positive
      association between AGT polymorphism and hypertension is not simply explained by
      an increase of plasma AGT concentration.

PMID- 11191643
TI  - Liposomes modified with a synthetic Arg-Gly-Asp mimetic inhibit lung metastasis
      of B16BL6 melanoma cells.
AB  - Administration of large amounts of synthetic peptides based on the Arg-Gly-Asp
      (RGD) sequence has been shown to suppress tumor metastasis. To overcome the rapid
      degradation of peptides in the circulation, an RGD mimetic, L-arginyl-6
      aminohexanoic acid (NOK), was synthesized and conjugated with
      phosphatidylethanolamine (PE) (NOK-PE) for liposomalization. Cell adhesion assays
      revealed that B16BL6 murine melanoma cells adhered to immobilized NOK-PE. This
      adhesion was inhibited by addition of either soluble RGDS or NOK at similar
      concentration in a dose-dependent manner. Administration of NOK-PE liposomes
      (equivalent to ca. 500 microg RGD peptides) via the tail vein completely
      inhibited lung colonization of B 16BL6 cells. The same dose of soluble NOK was
      not effective in inhibition of the tumor metastasis. In addition, injection of
      NOK-PE liposomes via the tail vein inhibited spontaneous lung metastasis of
      B16BL6 cells from the primary tumor site in the hind footpad. These results
      suggest that NOK, a structural mimetic of RGD, is capable of suppressing
      metastasis by blockade of the binding of the integrins present on tumor cells to
      the RGD-containing extracellular matrix.

PMID- 11191644
TI  - HPLC-ED measurement of endogenous catecholamines in human immune cells and
      hematopoietic cell lines.
AB  - A rapid and simple HPLC-ED method is described to identify and measure
      catecholamines (CTs) and their major metabolites in immune cells. Using this
      method, intracellular CTs were quantified in human peripheral blood mononuclear
      cells (PBMCs), T and B lymphocytes, monocytes and granulocytes. Immune cell
      subsets were separated by density gradient centrifugation and immunomagnetic cell
      sorting. CTs were also found in the human hematopoietic cell lines NALM-6 (pre-B)
      and (in smaller amounts) in Jurkat (T lymphoblastoid) and U937 (promonocytic). In
      cultured PBMCs, intracellular CTs were reduced by both the tyrosine hydroxylase
      inhibitor alpha-methyl-p-tyrosine and the chromaffin granule depletant reserpine.
      In NALM-6 cells, both alpha-methyl-p-tyrosine and the dopamine-beta-hydroxylase
      inhibitor disulfiram reduced intracellular CTs, supporting the presence of active
      synthetic pathways in these cells. Since sympathoadrenergic mechanisms play a key
      role in the interactions between the immune system and the nervous system, these
      findings may be relevant for a better understanding of the neuro-immune network.

PMID- 11191645
TI  - Localization of the e-NOS enzyme in endothelial cells and odontoblasts of healthy
      human dental pulp.
AB  - Nitric oxide synthases (NOS) are important enzymes present in different cells
      such as endothelial cells, macrophages, etc. Recently, it has been found that
      nitric oxide (NO) is responsible for vasodilation, blood pressure regulation,
      platelet aggregation, cardiac contractility, and the mediation of immunity during
      bacterial infections and inflammation. However, the production and role of NO in
      various structures of the oral cavity have not been investigated extensively. The
      aim of this study was to evaluate the presence of e-NOS in healthy human
      odontoblasts and endothelial cells of the dental pulp. Twenty healthy human
      dental pulps were collected and frozen and pulp slices were obtained using a
      cryostat. The e-NOS enzyme was revealed by immunohistochemical analysis and the
      enzyme level was detected by Western blotting and mRNA expression by RT-PCR. The
      immunohistochemical results demonstrated, for the first time, the presence of e
      NOS in odontoblasts and in endothelial cells. The presence of e-NOS m-RNA was
      confirmed by RT-PCR and the expression of the protein by Western blotting. These
      results clearly show that the e-NOS enzyme is present in both odontoblasts and
      endothelial cells of healthy human pulp. The presence of e-NOS in the odontoblast
      and endothelial cells of the dental pulp may mediate local vasodilation and cell
      proliferation.

PMID- 11191646
TI  - Alterations in tumorigenicity of embryonal carcinoma cells by IGF-I triple-helix
      induced changes in immunogenicity and apoptosis.
AB  - IGF-I antisense gene therapy has been applied successfully to animal models of
      glioma, hepatoma and teratocarcinoma. The antisense strategy has shown that tumor
      cells transfected with vectors encoding IGF-I antisense RNA lose tumorigenicity,
      become immunogenic and are associated with tumor specific immune response
      involving CD8+ lymphocytes. An IGF-I triple helix approach to gene therapy for
      glioma was recently described. The approach we have taken is to establish
      parameters of change using the IGF-I triple helix strategy. PCC-3 embryonal
      carcinoma cells derived from murine teratocarcinoma which express IGF-I were used
      as a model. The cells were transfected with vector which encodes an
      oligoribonucleotide that forms RNA-IGF-I DNA triple-helix structure. The triple
      helix stops the production of IGF-I. Cells transfected in this manner underwent
      changes in phenotype and an increase in MHC-I and B-7 cell surface molecules.
      They also showed enhancement in the production of apoptotic cells (60-70%). The
      "triple helix" transfected cells lost the ability to induce tumor when injected
      subcutaneously in syngeneic 129 Sv mice. When co-transfected in vitro with
      expression vectors encoding both MHC-I and B-7 cDNA in antisense orientation, the
      "triple-helix" transfected cells were down-regulated in expression of MHC-I and B
      7 and the number of apoptotic cells was significantly decreased. Injection of the
      doubly co-transfected cells into 129 Sv mice was associated with induction of
      teratocarcinoma. Comparison between antisense and triple-helix transfected cells
      strategies showed similar immunogenic and apoptotic changes. The findings suggest
      that triple-helix technology may offer a new clinical approach to treatement of
      tumors expressing IGF-I.

PMID- 11191647
TI  - The influence of sex and gonadectomy on the growth hormone and corticosterone
      response to hexarelin in the rat.
AB  - The present study is designed to investigate the role of sex and gonadal status
      in the growth hormone (GH) and corticosterone response to hexarelin (HEXA), a GH
      releasing peptide, which also causes a stimulatory action on the hypothalamic
      pituitary-adrenal (HPA) axis. HEXA (80 microg/Kg) was administered intracarotid
      to anesthetized intact or gonadectomized male (ORC) and female (OVX) middle-aged
      rats. The GH stimulatory response to HEXA was gender-related since the GH
      increase was significantly (p < 0.001) higher in intact males (area under the
      curve, AUC= 12560 +/- 1784 ng/ml.45 min) than in females (AUC= 4628 +/- 257
      ng/ml.45 min). This sex difference does not depend on circulating gonadal
      steroids since it persists in ORC (AUC = 11980 +/- 1136 ng/ml.45 min) and OVX
      (AUC = 5539 +/- 614 ng/ml.45 min) rats. The different effects of HEXA on
      corticosterone secretion detected in male and female rats are probably dependent
      on the prevailing activity of the HPA axis. In fact, in male rats that have low
      basal corticosterone levels, HEXA caused an increase in corticosterone secretion,
      which was significantly (p< 0.05) higher in ORC than in intact rats. The increase
      in corticosterone secretion by HEXA both in intact and OVX females was delayed,
      probably due to the elevated initial corticosterone levels, which could have
      activated the glucocorticoid negative feedback. We suggest that gender-specific
      patterns in the regulation of the hypothalamus-pituitary function could be
      responsible for the GH and corticosterone sexually differentiated responses to
      HEXA.

PMID- 11191648
TI  - A survey of adenine and 4-aminopyrazolo[3,4-d]pyrimidine (4-APP) as inhibitors of
      ribosome-inactivating proteins (RIPs).
AB  - The inhibitory power of adenine and 4-aminopyrazolo[3,4-d]pyrimidine (4-APP) on
      the RNA-N-glycosidase activity catalyzed by bacterial (Shiga toxin 1) and plant
      (ricin, gelonin, momordin, bryodin-R, PAP-S, luffin, trichosantin, saporin 6 and
      barley) RIPs has been compared. The behavior of the two inhibitors is largely
      variable. While Shiga toxin 1 is preferentially inhibited by 4-APP, plant RIPs
      are either preferentially inhibited by adenine, or equally inhibited by the two
      compounds or, finally, only slightly more by 4-APP. Sequence variabilities
      involved in these different behaviors are discussed. The experimental data
      clearly indicate that, in spite of the same mechanism of action, RIPs differ
      widely in the ability to fit small ring molecules in the active cleft. While the
      strong inhibitory power of 4-APP on Shiga toxin 1 opens perspectives of
      therapeutic interventions, the ineffectiveness of the compound on ricin precludes
      its use as a suitable antidote in poisoning.

PMID- 11191649
TI  - Potentiation of DOM-induced stimulus control by non-competitive NMDA antagonists:
      a link between the glutamatergic and serotonergic hypotheses of schizophrenia.
AB  - The present investigation examined the interaction between 2,5-dimethoxy-4
      methylamphetamine [DOM] and non-competitive NMDA antagonists in rats trained with
      DOM [0.6 mg/kg; 75 min pretreatment time] as a discriminative stimulus.
      Pretreatment with phencyclidine [PCP] at a dose of 3 mg/kg shifted the DOM dose
      response relationship to the left. When a fixed dose of DOM [0.1 mg/kg] which by
      itself yielded 32% DOM-appropriate responding was combined with a range of doses
      of PCP, dizocilpine, and ketamine, DOM-appropriate percentages increased to
      maxima of 73%, 84%, and 79%, respectively. When given alone, PCP, dizocilpine,
      and ketamine were followed by maxima of 36%, 15%, and 13%, respectively. It is
      concluded that the effects of DOM as a discriminative stimulus are potentiated by
      pretreatment with non-competitive antagonists of glutamate receptors of the NMDA
      subtype. These data suggest that the application of the technique of drug-induced
      stimulus control may prove useful in the reconciliation and integration of
      current hypotheses as to the etiology of psychotic disorders.

PMID- 11191650
TI  - Frequency-dependent blockade of T-type Ca2+ current by efonidipine in
      cardiomyocytes.
AB  - Efonidipine is a dihydropyridine Ca2+ antagonist with inhibitory effects on both
      L-type and T-type Ca2+ channels and potent bradycardiac activity especially in
      patients with high heart rate. In the present study, we examined the frequency
      dependence of efonidipine action on the T-type Ca2+ channel in isolated guinea
      pig ventricular myocytes. The potency of efonidipine to inhibit the T-type Ca2+
      current was higher under higher stimulation frequencies. The IC50 values were 1.3
      x 10(-8), 2.0 x 10(-6) and 6.3 x 10(-6) M under stimulation frequencies of 1, 0.2
      and 0.05 Hz, respectively. The reduction of T-type Ca2+ current amplitude was not
      accompanied by change in the time course of current decay. Efonidipine (10
      microM) inhibited T-type Ca2+ current elicited by depolarization from holding
      potentials ranging from -90 to -30 mV by about 30%; the voltage-dependence of
      steady-state inactivation was not changed by the drug. Efonidipine slowed the
      recovery from inactivation following an inactivating prepulse. In conclusion,
      efonidipine was shown to have frequency-dependent inhibitory effects on the T
      type Ca2+ channel, which could be explained by slow dissociation of the drug from
      the inactivated state of the channel.

PMID- 11191651
TI  - Effect of vitamin E on the degradation of hydrogen peroxide in cultured human
      umbilical vein endothelial cells.
AB  - Vitamin E reacts with radicals such as lipid peroxyl radical (LOO*) and singlet
      oxygen ((1)O2), and plays a role in inhibiting lipid peroxidation in cell
      membranes and preventing the oxidation of low-density lipoproteins (LDL).
      However, only a few studies have investigated the effect of vitamin E on the
      degradation of hydrogen peroxide (H2O2). Therefore, we examined the effect of
      vitamin E on glutathione redox cycle-dependent H2O2 degradation activity in human
      umbilical vein endothelial cells (HUVEC). Confluent HUVEC were cultured for seven
      days in media containing various concentrations of vitamin E (alpha-tocopherol).
      The level of glutathione redox cycle-dependent H2O2 degradation activity and the
      intracellular glutathione level were determined. HUVEC that had been cultured in
      the presence of higher concentrations of vitamin E had a higher level of H2O2
      degradation activity and a higher intracellular content of the reduced form of
      glutathione (GSH). Therefore, it is suggested that the vitamin E-induced increase
      in H2O2 degradation activity in HUVEC results from an increase in intracellular
      GSH level.

PMID- 11191652
TI  - The diabetic foot 2000.

PMID- 11191653
TI  - Re: Adey et al. Reduced synthesis of muscle proteins in chronic renal failure. Am
      J Physiol Endocrinol Metab 278: E219-E225, 2000.

PMID- 11191654
TI  - Lymphangiogenesis and tumor metastasis: more questions than answers.

PMID- 11191655
TI  - Specific adhesion molecules bind anchoring filaments and endothelial cells in
      human skin initial lymphatics.
AB  - Anchoring filaments are a characteristic feature of initial lymphatic vessels.
      They connect the abluminal membrane of endothelial cells to the surrounding
      elastic fibers. The main molecular component of anchoring filaments is fibrillin.
      Initial lymphatic vessels of human skin were stained with monoclonal antibodies
      to fibrillin, integrins alpha 2 beta 1, alpha 3 beta 1 and alpha v beta 3,
      vinculin, talin, beta-actin and focal adhesion kinase (FAK). A double-labeling
      immunofluorescence method was used to simultaneously stain fibrillin and alpha 3
      beta 1 integrin or FAK. Close contiguities between integrins and anchoring
      filaments were observed. These results suggest that the anchoring filaments
      connect the extracellular matrix and the endothelial cell cytoskeleton through
      the transmembrane integrin and FAK molecule. The results also demonstrate the
      presence of focal adhesions in the wall of initial lymphatic vessels. These
      connections possibly enable transmission of chemical and/or mechanical stimuli
      from the extracellular matrix to the endothelial cells. Here, they are
      transformed in cytoskeleton rearrangements and intracellular signaling events,
      some of which may contribute to the initial formation of lymph.

PMID- 11191656
TI  - An imaging evaluation of angiodysplasia syndromes.
AB  - Current imaging techniques such as magnetic resonance, magnetic resonance
      angiography, computer tomography, ultrasound, plain x-rays, and
      lymphangioscintigraphy have enhanced the ability to define blood and lymph
      vascular malformations in more precise pathophysiologic terms. Not only can these
      imaging modalities distinguish arterial anomalies from lymphatic and venous
      angiodysplasia, but they also readily differentiate edema in the epifascial as
      opposed to the subfascial peripheral compartments. Moreover, visceral
      lymphangiectasia (e.g., chylous and non-chylous reflux), bone and muscle
      overgrowth, agenesis, and fat deposits can also be delineated. Clinical examples
      are provided including an algorithm for approaching these conditions.

PMID- 11191657
TI  - The role of operative management of varicose veins in patients with lymphedema
      and/or lipedema of the legs.
AB  - The role of operative management of "symptomatic" varicose veins in patients with
      lower extremity lymphedema or lipedema is controversial. We reviewed the clinical
      outcome of 261 patients between 1989-1997 at the Foldiclinic with lower extremity
      lymphedema (68 patients), lipo-lymphedema or lympho-lipedema (103 patients) or
      lipedema (90 patients) who had undergone operation for varicose veins. In each
      group, the results were dismal as leg swelling worsened or was unchanged in
      greater than 90% whereas symptoms such as heaviness, fatigue, cramps (termed
      varicogenic symptomatology) were improved in less than 10%. These findings
      support that operations for varicose veins in the legs of patients with
      lymphedema, lipedema, or combinations of these disorders should be undertaken
      only if there is an absolute indication present (ascending phlebitis and/or
      bleeding). Otherwise, complete decongestive physiotherapy is still the best
      treatment approach for these groups of patients.

PMID- 11191658
TI  - Ignorance in AIDS KS and septicemias.

PMID- 11191659
TI  - Lymphoscintigraphic evaluation in patients after erysipelas.
AB  - Erysipelas (cellulitis/lymphangitis) is a superficial cutaneous infection spread
      by the lymphatic system which may result in permanent injury to the lymphatic
      vessels. The study evaluated the lymphatic drainage in the lower limbs of 30
      patients with at least two episodes of erysipelas by means of lymphoscintigraphy.
      Twenty-two (73%) were female and 8 (27%) were male with ages ranging from 26 to
      77 years (mean 52 years). Lymphoscintigraphy was performed by intradermal
      administration of 500 microCi (20 Mbq) of 99mTc antimony sulfur-colloid in two
      interdigital spaces of the feet. Whole body scintigraphy was performed 45 minutes
      after the administration of the radiopharmaceutical using a computerized gamma
      camera. Significant lymphatic abnormalities were found in 23 (77%) of these
      patients. We conclude that most patients with repeated erysipelas have
      significant and even permanent abnormalities in regional lymphatic drainage.
      Recurrent erysipelas suggests underlying primary or secondary lymphedema.

PMID- 11191660
TI  - Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer.

PMID- 11191661
TI  - Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer.

PMID- 11191662
TI  - Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer.

PMID- 11191663
TI  - Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer.

PMID- 11191664
TI  - Shortened zidovudine regimens to prevent mother-to-child transmission of HIV-1.

PMID- 11191665
TI  - Treatment of systemic mast-cell disease with cladribine.

PMID- 11191666
TI  - Survivors of breast cancer.

PMID- 11191667
TI  - Survivors of breast cancer.

PMID- 11191668
TI  - Transmission of histoplasmosis by organ transplantation.

PMID- 11191669
TI  - Aspergillus fungus balls on the mitral valve.

PMID- 11191670
TI  - [Spinal cord disorders and systemic diseases].

PMID- 11191671
TI  - [Dehydroepiandrosterone and adrenal insufficiency].

PMID- 11191672
TI  - [Acute myelitis and Behcet's disease: three case reports].
AB  - INTRODUCTION: Neurological manifestations in Behcet's disease usually consist of
      meningoencephalitis and cerebral thrombophlebitis. Myelitis is rare, especially
      when it is the only neurological manifestation. EXEGESIS: The authors report
      three cases of acute myelitis complicating Behcet's disease demonstrated by
      magnetic resonance imaging. In two cases, Behcet's disease was revealed by
      myelitis. The three cases were transverse myelitis, two of which were juvenile
      Behcet's disease and two were meningomyelitis. CONCLUSION: Magnetic resonance
      imaging can help guide diagnosis of myelitis in Behcet's disease. It can also be
      useful to assess the results of the treatment. Clinical symptoms of Behcet's
      disease must be searched for in the case of myelitis, especially for patients
      from Mediterranean countries.

PMID- 11191673
TI  - [Drug-induced hypersensitivity syndrome in internal medicine: diagnostic and
      therapeutic traps. Eight observations].
AB  - PURPOSE: Drug-induced hypersensitivity syndrome (DIHS) is an acute and severe
      drug reaction. Manifestations include severe skin lesions, fever, nodal
      enlargement, blood eosinophilia and multisystemic involvement. The severe
      systemic manifestations of DIHS are responsible for a 10% mortality rate. The
      pertinence of corticosteroid therapy is discussed. METHODS: The authors report
      eight retrospective cases of DIHS obtained from the PMSI (Programme de
      Medicalisatiopn des Systemes d'Information) between November 1991 and November
      1998. RESULTS: The series consisted of five male and three female patients (mean
      age: 52.6 years; range: 23-83 years). The interval between the introduction of
      the drug and the onset of the reaction varied from two to eight weeks. Due to
      severe systemic manifestations, three patients were given corticosteroid therapy.
      Healing of skin and systemic disorders resolved with a mean delay of 4.4 weeks
      (range: 1 to 56 weeks). CONCLUSION: DIHS can be a diagnostic trap, as there are
      no diagnostic criteria for DIHS. Only the association of multiple arguments such
      as the time to the occurrence of symptoms, clinical similarity to many infectious
      illnesses, hypereosinophilia, atypical lymphocytosis, etc. may help guide
      diagnosis. DIHS can also be a therapeutic trap, as prompt withdrawal of the
      offending drug is essential to minimize morbidity. Although still controversial
      in the literature, the pertinence of corticosteroid therapy may be discussed in
      case of severe systemic effects. Patch testing can be a valuable tool to
      determine the responsibility of a drug; however it proves to be useful only when
      positive.

PMID- 11191674
TI  - [Monoclonal gammopathies of undetermined significance].
AB  - INTRODUCTION: Monoclonal gammopathy of undetermined significance is an
      asymptomatic disorder associated with serum monoclonal immunoglobulin spike. Its
      incidence is about 1% in patients of 50 years of age, and rapidly increases in
      elderly patients. CURRENT KNOWLEDGE AND KEY POINTS: Within the 20 years following
      diagnosis, about 25% of patients will evolve towards either multiple myeloma (for
      patients with IgG or IgA) or malignant lymphoproliferative disorder (for patients
      with IgM). Definition, circumstances associated with a transient monoclonal
      spike, and currently available parameters used for differential diagnosis with
      either multiple myeloma or malignant lymphoproliferative disorder are
      successively discussed. One part of the most usual biological parameters is of
      prognostic value, and is reviewed in more detail. Recent data concerning
      immunophenotype, cytogenetics and molecular biology of plasma cells reinforce the
      link between the asymptomatic condition and multiple myeloma. In monoclonal
      gammopathy of undetermined significance, some plasma cells resemble normal or
      reactive plasma cells, whereas others mimic those found in multiple myeloma.
      FUTURE PROSPECTS AND PROJECTS: The most recent biological data are also discussed
      in order to evaluate whether some would help to discriminate those patients who
      will remain asymptomatic lifelong from those who will evolve towards multiple
      myeloma.

PMID- 11191675
TI  - [Recent progress in the diagnosis, prognostic evaluation and treatment of
      pheochromocytomas].
AB  - INTRODUCTION: Pheochromocytoma is a catecholamine-secreting neoplasm of
      chromaffin tissue. It is a rare disease. Biochemical tests should be performed
      only in patients at high risk of pheochromocytoma, and an imaging procedure only
      in those with positive biochemical tests. CURRENT KNOWLEDGE AND KEY POINTS: The
      most specific and sensitive diagnostic test for the disease is the determination
      of plasma or urinary metanephrines. The tumor can be located by computerized
      tomography, magnetic resonance imaging, and specific scintigraphy. Ten to 20% of
      pheochromocytomas result from hereditary diseases, including multiple endocrine
      neoplasia type 2, von Hippel Lindau disease, and neurofibromatosis 1. Familial
      cases are diagnosed earlier, and are more frequently bilateral and recurring than
      sporadic cases. About 10% of the cases are malignant either at first operation or
      during follow-up, malignancy being diagnosed by the presence of lymph node,
      visceral or bone metastases. The probability of a recurrence is positively
      correlated with the urinary excretion of metanephrines and tumor size.
      Recurrences are more frequent in cases with ectopic tumors and in those with a
      low plasma epinephrine to total catecholamine ratio. Patients, especially those
      with familial tumors or low epinephrine secretion, should be followed-up
      indefinitely. FUTURE PROSPECTS AND PROJECTS: Treatment for malignant recurrences
      includes surgery, therapeutic embolization, chemotherapy, and the application of
      therapeutic doses of metaiodobenzylguanidine. Metyrosine, phenoxybenzamine, or
      somatostatin analogs may help to control blood pressure and to alleviate symptoms
      in patients with malignant pheochromocytoma; however such a treatment has no
      antiproliferative effect.

PMID- 11191676
TI  - [Fabry disease. Clinical and genetic aspects. Therapeutic perspectives].
AB  - INTRODUCTION: This review presents the clinical and genetic aspects of Fabry
      disease, along with recent advances in research. CURRENT KNOWLEDGE AND KEY
      POINTS: Fabry disease is an X-linked inborn error of metabolism due to a
      deficient activity of the lysosomal enzyme alpha-galactosidase A. The enzymatic
      defect leads to the systemic accumulation of neutral glycosphingolipids in plasma
      and tissues. Clinical manifestations in affected hemizygous males are primarily
      due to progressive disease of small vessels, including angiokeratoma, autonomic
      dysfunction, and lifelong debilitating pain. Renal failure and vasculopathy of
      the heart and brain lead to early demise in adulthood. Demonstration of alpha
      galactosidase A deficiency in leukocytes or plasma is the definitive method for
      the diagnosis of affected hemizygous males. Most female carriers are clinically
      symptomatic, they may present isolated acroparesthesia, cardiac symptoms, or the
      characteristic benign corneal dystrophy. Due to random X-chromosomal
      inactivation, enzymatic detection of carriers is often inconclusive. A reliable
      molecular test for detection of heterozygosity is therefore highly desirable for
      accurate genetic counselling. The GLA gene has been mapped to chromosome Xq22,
      and cloned. Several studies have shown the molecular heterogeneity of the
      disease. Currently, no standard treatment exists for Fabry disease. Symptomatic
      treatment is provided as appropriate. In addition, renal transplantation or
      dialysis is available for patients experiencing end-stage renal failure. FUTURE
      PROSPECTS AND PROJECTS: The ability to produce high doses of recombinant alpha
      galactosidase A in vitro has opened the way to preclinical studies in the mouse
      model and led to the development of the first clinical trials with enzyme
      replacement therapy in patients with Fabry disease.

PMID- 11191677
TI  - ["Multiple sclerosis plus": leukoencephalopathies at the frontiers of internal
      medicine].
AB  - INTRODUCTION: Multiple sclerosis (MS) is an inflammatory, demyelinating and
      probably autoimmune disease affecting the white matter of the central nervous
      system (CNS). Due to the absence of specific clinical and laboratory markers,
      diagnosis remains difficult. CURRENT KNOWLEDGE AND KEY POINTS: In particular, no
      clinical or paraclinical investigation is satisfactory to distinguish definite MS
      from other autoimmune or inflammatory diseases, especially when they
      predominantly affect the CNS. Moreover, previous studies have reported that
      patients with definite MS could present clinical systemic signs suggestive of
      other inflammatory or autoimmune diseases, and that MS could be associated with
      other autoimmune diseases. On the other hand, the presence of biological
      autoimmune abnormalities, including antinuclear antibodies and antiphospholipid
      antibodies, has been observed, with a high frequency in patients with MS in
      comparison to control populations. These clinical and laboratory features could
      therefore represent a new nosological entity characterized by a systemic immune
      dysregulation more extensive than the CSN target, or a distinct subgroup of MS
      patients with a classical course of the disease. Because of the impact of the new
      therapeutic approach to MS, an important issue concerning this aspect that should
      be addressed is the use of immunomodulatory therapy, especially with interferon
      beta. It appears necessary to consider these abnormalities before treating MS
      patients with preventive therapy, in particular in the perspective of new
      strategies, such as treatment at an early stage of the disease or combination
      therapies.

PMID- 11191678
TI  - [Myelopathy revealing lupus. Two cases and review of the literature].
AB  - INTRODUCTION: Myelopathy is a rare manifestation of systemic lupus erythematosus,
      occurring most often during the course of the disease. EXEGESIS: We report two
      cases of women with myelopathy as the first manifestation of systemic lupus
      erythematosus; both had an unusual course. We review the literature for
      previously reported cases. CONCLUSION: The clinical presentation of myelitis is
      heterogeneous. Usually, neurologic deficits evolve within a few hours (typically
      acute transverse myelitis) and outcome is usually poor. However, chronic or
      recurrent transverse myelitis has also been reported, including relapsing
      myelitis that resolved spontaneously. Myelopathy can be the first manifestation
      of the disease and this might be more common than initially thought. Magnetic
      resonance imaging (MRI) findings depend on the timing of the examination and the
      stage of the disease; the MRI may therefore be normal. An association with optic
      neuritis is frequently reported in the literature and differential diagnosis with
      multiple sclerosis may be difficult. Overlapping features between both diseases
      have been termed "lupoid sclerosis" and are actually classified as demyelinating
      syndromes associated with lupus. Myelopathy does not appear to be consistently
      associated with antiphospholipid antibodies, as has been previously suggested.
      The best treatment protocol has not been determined; however, in recent years,
      pulses of methylprednisolone and cyclophosphamide have gained acceptance by most
      authors.

PMID- 11191679
TI  - [Laryngeal amyloidosis: a rare cause of hoarseness].
AB  - INTRODUCTION: The larynx is a rare site of deposition for amyloidosis. Diagnosis
      may be delayed and evoked in patients with prolonged hoarseness. We have reported
      two cases of laryngeal amyloidosis. EXEGESIS: One man and one woman suffered from
      hoarseness during one and three years, respectively. Laryngoscopic examination
      showed diffuse infiltration of the larynx. Amyloidosis was confirmed by the
      characteristic Congo-red staining of laryngeal biopsies. The search for other
      localizations of amyloidosis was negative. No monoclonal plasma cell
      proliferation was detected. Both patients received endoscopic CO2 laser excision.
      In one case, chemotherapy was initially associated due to dystrophic plasma cells
      in bone marrow aspiration and then withdrawn because of clinical failure. With a
      6-month follow-up, hoarseness remained stable. CONCLUSION: Laryngeal amyloidosis
      is an essentially localized disease revealed by hoarseness. Treatment is
      endoscopic by laser excision. In nearly half of the cases in the literature, it
      had to be repeated due to localized recurrent lesions. Long-term prognosis of
      localized laryngeal amyloidosis is better than systemic AL amyloidosis.

PMID- 11191680
TI  - [A swelling of the sternum during respiration].

PMID- 11191681
TI  - [Capillary leak syndrome in the course of Gaucher disease: the result of
      monoclonal gammopathy?].

PMID- 11191682
TI  - [Hyperthyroidism: a cause of serum ferritin elevation].

PMID- 11191683
TI  - [Uveitis after the age of 60].

PMID- 11191684
TI  - [Adult-onset Still's disease, a rare cause of acute respiratory distress].

PMID- 11191685
TI  - [Dihydropyrimidine dehydrogenase deficiency and 5-fluorouracil toxicity].

PMID- 11191686
TI  - Risperidone-associated weight gain in children and adolescents: a retrospective
      chart review.
AB  - OBJECTIVE: Risperidone use has been associated with substantial weight gain in
      children and adolescents. Reports available to date have consisted of small case
      series evaluated without standardized indices of developmentally normative weight
      increase. The purpose of this study was to evaluate age- and gender-adjusted
      weight changes linked to risperidone use in a juvenile psychiatric inpatient
      population. METHOD: Thirty-seven child and adolescent inpatients treated with
      risperidone for 6 consecutive months were compared to a group of 33 psychiatric
      inpatients with no atypical neuroleptic exposure. Weight, height, and body mass
      index (BMI) were recorded on at least a monthly basis, and Tanner staging was
      completed on admission. Percent change from baseline weight, changes in
      standardized z scores of weight for age and gender, and proportion of subjects
      experiencing a < or = 7% weight increase from baseline were compared among
      groups. RESULTS: Subjects in both groups were comparable at baseline except for
      gender distribution (more males were in the risperidone group, p < 0.05).
      Risperidone-treated children and adolescents experienced significant weight gain
      between baseline and endpoint (paired t test, p < 0.001) that was first evident
      within 2 months of starting treatment, progressed steadily at an average rate of
      1.2 kg/month, and did not reach a clear plateau during 6 months of observation.
      Significant increases in standardized weight were noted at 3 and 6 months for
      risperidone-treated subjects. Risperidone use conferred a substantial risk of
      gaining over 7% from baseline weight (odds ratio = 3.5, 95% confidence interval =
      1.8-6.6, p < 0.001). CONCLUSIONS: Six-month exposure to risperidone was
      associated with clinically significant weight gain in 78% of treated children and
      adolescents (as opposed to 24% of those in the comparison group, p < 0.001).
      Risperidone dosage, concomitant medication use, and other demographic
      characteristics such as age, pubertal status, gender, and baseline weight and BMI
      were not associated with an increased risk of morbid weight gain. Standardized z
      scores offer advantages for the assessment of weight change among developing
      children and adolescents.

PMID- 11191687
TI  - Cognitive side effects of electroconvulsive therapy in adolescents.
AB  - OBJECTIVE: The primary aim of this study was to determine the presence of
      cognitive impairments among adolescents treated with electroconvulsive therapy
      (ECT) and whether these deficits would persist several months following the
      treatment. METHODS: Retrospective data resulting from standard clinical care of a
      convenience sample with naturalistic follow-up were used. Subjects were 16
      adolescents (13 females, 3 males; mean age = 15.9 +/- 1.6 years) hospitalized
      with a mood disorder (unipolar depression = 14, bipolar depression = 2).
      Cognitive tests administered prior to ECT were compared with results at 7.0 +/-
      10.3 days following the last treatment and with a second testing at 8.5 +/- 4.9
      months after the last treatment. RESULTS: Comparison of pre-ECT and the first
      post-ECT testing administered during the first 10 days of the treatment yielded
      significant impairments of concentration and attention, verbal- and visual
      delayed recall, and verbal fluency. A complete recovery of these functions was
      noted at the second post-ECT testing. There was no deficit in the ability to
      problem solve during the initial or the subsequent testing. CONCLUSION: Cognitive
      parameters found to be impaired during the first few days of ECT recovered over
      several months following the treatment. Therefore, there was no evidence of long
      term damage to concentration, attention, verbal and visual memory, or verbal
      fluency. There were no impairments of motor strength and executive processing,
      even during the early (within 7-10 days) post-ECT period. These results should be
      regarded as preliminary, awaiting confirmation with larger samples.

PMID- 11191688
TI  - Effects of subchronic methylphenidate hydrochloride administration on the
      locomotor and exploratory behavior of prepubertal mice.
AB  - The increasing use of methylphenidate hydrochloride (MPH) in children led us to
      examine the effects of MPH administration in developing mice. Male CD-1 mice were
      administered MPH (40 mg/kg, subcutaneously) or saline daily from postnatal days
      26-32. The mice were then tested from postnatal days 33-37 for locomotion and
      exploration in the open field, anxiety in the elevated plus maze, and learning in
      the Morris water maze. The results indicate that MPH-pretreated mice were more
      exploratory and less fearful in the open field, entering more center squares than
      saline controls. MPH-pretreated mice also exhibited less anxiety, spending more
      time in the open arm and exhibiting more head dips in the elevated plus maze than
      controls. There was no significant difference between MPH and saline-treated mice
      in the time taken to find the visible or hidden platform in the water maze task.
      The results indicate that treatment with MPH has significant effects on later
      behavior, reducing fear and anxiety, and increasing exploration, but no effect on
      performance in a spatial learning task.

PMID- 11191689
TI  - Antidepressant treatment and neural plasticity.
AB  - The use of psychopharmacologic agents in children is complicated by several
      factors. One important neurobiologic consideration is the relationship of the
      effect of the medication to ongoing brain development. Although available data
      are inadequate to address this issue directly, a review of ancillary data
      suggests that there are theoretical reasons to exercise prudence in prescribing
      psychopharmacologic agents. For example, the effects of serotonin on neuronal
      plasticity suggest that agents that can alter serotonergic function may alter
      neuronal wiring. Although this can occur in any brain, it may be of particular
      importance in a developing nervous system. The consequences of these induced
      changes are not clear. Animal studies on the effect of long-term antidepressant
      administration in immature pups may begin to answer some of the clinical concerns
      of these observations.

PMID- 11191690
TI  - The effect of fluvoxamine and behavior therapy on children and adolescents with
      obsessive-compulsive disorder.
AB  - OBJECTIVE: The efficacy of medications, consisting of serotonin partial and
      specific reuptake blockers, and behavior therapy, consisting of exposure and
      response prevention in addition to social skills training, cognitive therapy, and
      habit reversal, in the treatment of obsessive-compulsive disorder are well
      documented. The purpose of the study was to explore if adding behavior therapy to
      medication would enhance treatment efficacy. METHODS: Ten children/adolescents
      who had not previously responded to behavior therapy were randomly assigned to
      two groups: fluvoxamine alone or fluvoxamine with behavior therapy. All 10
      patients received fluvoxamine for 10 weeks-five continued solely on fluvoxamine
      for one year and five engaged in behavior therapy for 20 sessions along with
      fluvoxamine and then continued solely on medication until the end of the year.
      RESULTS: Eight of 10 patients improved significantly on fluvoxamine at week 10 on
      the primary outcome variable, the Children's Yale-Brown Obsessive Compulsive
      Scale (CY-BOCS). According to the other measurements-National Institute of Mental
      Health-Global Obses-sive-Compulsive Scale, Clinical Global Impression-Improvement
      (assessing level of im-provement from week to week), and Clinical Global
      Impression-Severity of Illness Scale (as-sessing how ill the patient is from week
      to week)-improvement was not as evident. According to the CY-BOCS, those who
      received a combination of fluvoxamine and exposure with response prevention
      showed significantly more improvement than those who only took medication. At two
      year follow-up, all patients continued to improve, with those in the combined
      approach improving more than those in the medication-alone group. CONCLUSIONS:
      Future studies should determine the specific effect of each treatment group,
      combined and singularly. Reasons for discrepancy in improvement ratings as noted
      by the different instruments are discussed. The addition of behavior therapy to
      fluvoxamine seems to enhance treatment efficacy, according to the CY-BOCS.

PMID- 11191691
TI  - Combined treatment with haloperidol and trazodone in patients with tic disorders.
AB  - The combination of haloperidol and trazodone was evaluated in an open-label trial
      in 10 patients with chronic tic and Tourette's syndrome. We found a mean
      reduction of symptoms of 58.9% on the Yale Global Tic Severity Scale, with a
      statistically significant difference (p < 0.001) between the baseline and
      endpoint treatment conditions. This approach significantly reduces clinical
      symptoms, with the advantage of a lower dose of haloperidol than usual, with no
      side effects reported by the patients.

PMID- 11191692
TI  - Efficacy of modafinil compared to dextroamphetamine for the treatment of
      attention deficit hyperactivity disorder in adults.
AB  - Our objective was to compare the efficacy of the new wake-promoting drug
      modafinil to that of dextroamphetamine for the treatment of attention deficit
      hyperactivity disorder (ADHD) in adults. Twenty-two adults who met DSM-IV
      criteria for ADHD participated in a randomized, double-blind, placebo-controlled,
      three-phase crossover study comparing placebo, modafinil, and dextroamphetamine
      for the treatment of ADHD. The twice-daily study medications were titrated to
      doses of optimum efficacy over 4-7 days and then held constant during the rest of
      each 2-week treatment phase. Measures of improvement included the DSM-IV ADHD
      Behavior Checklist for Adults, the Controlled Oral Word Association Test (COWAT,
      using the letters C, F, and L version), Stroop, and Digit Span (Wechsler Adult
      Intelligence Scale version). For the 21 (96%) completers, the mean (+/- SD)
      optimum doses of modafinil and dextroamphetamine were 206.8 mg/day +/- 84.9 and
      21.8 mg/day +/- 8.9, respectively. Scores on the DSM-IV ADHD Checklist (p <
      0.001) were significantly improved over the placebo condition following treatment
      with both active medications. Performance on the COWAT (p < 0.05) reached trend
      levels of significance. Both medications were generally well tolerated. This
      preliminary study suggests that modafinil may be a viable alternative to
      conventional stimulants for the treatment of adults with ADHD.

PMID- 11191693
TI  - Sudden death of a child treated with imipramine. Case study.
AB  - Since 1990, there have been seven reported cases of sudden death in children
      treated with tricyclic antidepressants. This case study describes the sudden
      death of an additional child (8 years 9 months old, 29 kg in weight) treated with
      a tricyclic antidepressant, imipramine (100 mg orally, twice daily), and
      dextroamphetamine (10 mg orally every morning). Prior to death, there were signs
      of possible cardiovascular abnormalities after treatment was begun with
      imipramine. The report adds to the concern over the use of tricyclics in
      children.

PMID- 11191694
TI  - Case study. Risperidone-Induced neuroleptic malignant syndrome in an adolescent.
AB  - Neuroleptic malignant syndrome (NMS) is a potentially fatal complication of
      neuroleptic therapy, characterized by fever, rigidity, mental status changes, and
      autonomic instability. Although NMS was previously associated with the use of
      high-potency neuroleptics, cases have begun to emerge with atypical neuroleptics.
      This article presents a risperidone-induced case in the youngest patient to date,
      raising issues concerning our perceptions, the safety of newer neuroleptics, and
      treatment of NMS.

PMID- 11191695
TI  - Change management of shared and local versions of health-care terminologies.
AB  - Local sites that adopt a shared health-care terminology for computer-based
      systems have local needs that prompt the local-terminology maintainers to make
      changes to the local version of the shared terminology. If the local site is
      motivated to conform to the shared terminology, then the burden lies with the
      local site to manage its own changes and to incorporate the changes of the shared
      version at periodic intervals. We call this process synchronization. We survey
      current approaches that address problems of sharing and local modification, and
      we present the CONCORDIA model, which supports carefully controlled divergence of
      a local version from a shared terminology. CONCORDIA provides the underlying
      design and methodology for the implementation of a synchronization-support tool.

PMID- 11191696
TI  - An architecture for a brain-image database.
AB  - The widespread availability of methods for noninvasive assessment of brain
      structure has enabled researchers to investigate neuroimaging correlates of
      normal aging, cerebrovascular disease, and other processes; we designate such
      studies as image-based clinical trials (IBCTs). We propose an architecture for a
      brain-image database, which integrates image processing and statistical
      operators, and thus supports the implementation and analysis of IBCTs. The
      implementation of this architecture is described and results from the analysis of
      image and clinical data from two IBCTs are presented. We expect that systems such
      as this will play a central role in the management and analysis of complex
      research data sets.

PMID- 11191697
TI  - Web-enabled medical databases: a threat to security?
AB  - An increasing number of clinical databases are being adapted to allow access
      through Internet protocols, particularly Hypertext Transfer Protocol (HTTP). The
      World Wide Web (WWW) provides a user-friendly, standardized, broadly distributed
      database interface; at the same time, it may also present a threat to the
      security and confidentiality of patient data. However, there is little empirical
      evidence concerning such threats. Using publicly available records we estimate
      the additional risk of security violations due to web-enabling a database. The
      evidence, though limited, suggests that the additional risk may be small relative
      to more traditional security threats.

PMID- 11191698
TI  - A data mining system for infection control surveillance.
AB  - Nosocomial infections and antimicrobial resistance are problems of enormous
      magnitude that impact the morbidity and mortality of hospitalized patients as
      well as their cost of care. The Data Mining Surveillance System (DMSS) uses novel
      data mining techniques to discover unsuspected, useful patterns of nosocomial
      infections and antimicrobial resistance from the analysis of hospital laboratory
      data. This report details a mature version of DMSS as well as an experiment in
      which DMSS was used to analyze all inpatient culture data, collected over 15
      months at the University of Alabama at Birmingham Hospital.

PMID- 11191699
TI  - Validation of ICTERUS, a knowledge-based expert system for Jaundice diagnosis.
AB  - The study aimed to describe an example of the assessment and validation of
      knowledge-based clinical expert systems. The paper focuses on ICTERUS, an expert
      system for jaundice diagnosis. It describes system design, the methodology
      applied for upgrading and validating the program, and the most important outcomes
      of the validation procedure. The clinical validation of the system on a very
      large European database (Euricterus Project) shows that diagnostic conclusions
      are reliable in about 70% of eligible cases. This figure appears acceptable for a
      system which provides decision support only on the basis of clinical data,
      assuming that the final decision is achieved under user responsibility. Expected
      biases, limitations and inconsistencies in the practical application of the
      system are discussed.

PMID- 11191700
TI  - Data processing at the anesthesia workstation: from data entry to data
      presentation.
AB  - Main requirements for an Anesthesia Information Management System (AIMS) are the
      supply of additional information for the anesthesiologist at his workstation and
      complete documentation of the anesthetic procedure. With the implementation of an
      AIMS (NarkoData) and effective user support, the quality of documentation and the
      information flow at the anesthesia workstation could be increased. Today, more
      than 20,000 anesthesia procedures are annually recorded with the AIMS at 112
      decentralized workstations. The network for data entry and the presentation and
      evaluation of data, statistics and results directly available at the clinical
      workstation was made operational.

PMID- 11191701
TI  - Evaluation of three Swedish ICD-10 primary care versions: reliability and ease of
      use in diagnostic coding.
AB  - If computer-stored information is to be useful for purposes other than patient
      care, reliability of the data is of utmost importance. In primary healthcare
      settings, however, it has been found to be poor. This paper presents a study on
      the influence of coding tools on reliability and user acceptance. Six general
      practitioners coded 152 medical problems each by means of three versions of ICD
      10, one with a compositional structure. At code level the reliability was poor
      and was almost identical when the three versions were compared. At aggregated
      level the reliability was good and somewhat better in the compositional
      structure. Ideas for improved user acceptance arose, and the study explored the
      need for several different tools to retrieve diagnostic codes.

PMID- 11191702
TI  - Computer simulation of hemodynamic parameter changes by mechanical ventilation
      and biventricular circulatory support.
AB  - When a Bi-Ventricular Assist Device (BVAD) is used in conjunction with mechanical
      ventilation (MV) of the lungs with positive intrathoracic pressure (Pt), the
      latter influences hemodynamics. The aim of our study was to assess the
      simultaneous influence of BVAD and MV on hemodynamics. We assumed ventricular
      pathological conditions as reduced elastances and increased rest volumes.
      Peripheral systemic arterial resistance was assumed to have different values.
      Data were obtained by computer simulation. Trends in main hemodynamic variables
      were compared with clinical data from literature. Simulation showed that systemic
      venous, pulmonary arterial and left atrial pressures are very sensitive to Pt (-2
      to 5 mmHg).

PMID- 11191703
TI  - Discrete event simulation in the health policy and management program.
AB  - Students in Health Policy and Management at the Faculty of Health Sciences of
      Maastricht University must learn to analyze and design workflow processes in
      health care. To attain this, a discrete event simulation training, using MedModel
      is used. This paper describes the training in two consecutive years. In both
      years the training was evaluated systematically. The evaluation results
      demonstrate that the simulation training increased the students' knowledge about
      analyzing and designing workflow processes in healthcare. Students considered the
      training as a very important part of their program.

PMID- 11191704
TI  - Disaster drills and continuous medical education using satellite-based Internet.
AB  - We designed and evaluated a satellite-based Internet system for use in medical
      applications. Many experimental telemedicine projects use satellites, but we
      combined digital satellite communication with an ordinary telephone network to
      realize an economical countrywide network for emergency medicine and continuous
      medical education. The system appears to be a useful and practical technology for
      daily clinical activities.

PMID- 11191705
TI  - Realization of security concepts for DICOM-based distributed medical services.
AB  - Exploiting distributed hard- and software resources for telemedicine requires a
      fast, secure, and platform-independent data exchange. Standards without inherent
      security mechanisms such as DICOM may ease non-authorized data access. Therefore,
      exemplary telemedical data streams were analyzed within the Berlin metropolitan
      area network using specialized magnetic resonance imaging techniques and
      distributed resources for data postprocessing. For secure DICOM communication
      both the Secure Socket Layer Protocol and a DICOM-conform partial encryption of
      patient-relevant data were implemented. Partial encryption exhibited the highest
      transfer rate and enabled a secure long-term storage. Different data streams
      between secured and unsecured networks were realized using partial encryption.

PMID- 11191706
TI  - High speed digital circuits for medical communication; the MINCS-UH project.
AB  - In Japan, a high speed, bidirectional digital satellite communication system
      called Medical Information Network by Communications Satellite for University
      Hospitals is currently available in 30 national universities, and many programs,
      including clinical conferences, lectures and tutorials, have been broadcasted.
      Its characteristics are: (1) a state-of-the-art digital high-definition
      television system, (2) excellent security protection using digital encryption (3)
      bidirectional communications using two satellite circuits simultaneously, and (4)
      easy operability. High-quality motion images, and security protection mechanisms
      are essential for use in clinical medicine.

PMID- 11191707
TI  - Canine cognition, aging and neuropathology. Introduction.

PMID- 11191708
TI  - The canine as a model of human cognitive aging: recent developments.
AB  - 1. Aged dogs display many of the cognitive impairments associated with aging and
      dementia. 2. Aged dogs, like humans, display a wide range of individual
      variability in cognitive functioning (i.e., different cognitive functions decline
      at different rates in aged dogs). 3. Different categories of aged canines can be
      identified on the basis of neuropsychological test performance, and these
      categories can be used to model different subgroups of aged humans (i.e.,
      dementia, mild cognitive impairment and successful aging). 4. Additional research
      is required to further validate the dog as a model of human cognitive aging and
      dementia.

PMID- 11191709
TI  - Development of a protocol for studying object recognition memory in the dog.
AB  - 1. Dogs had considerable difficulty learning a delayed-non-matching-to sample
      task at a short delay (approximately 5 seconds) for an extended period (900
      trials). Only 3 of 19 dogs met the learning criterion. 2. Acquisition on the DNMS
      task was markedly improved when a pause was introduced on presentation of the
      stimulus objects, when the objects were approximately 30 cm from the dog; eleven
      of 16 dogs learned the task within 600 trials. 3. Dogs learned the task more
      rapidly at 20 and 30 second delays than at 10-second delays. This indicates a
      transfer of learning. 4. Dogs that did learn the task were able to perform at
      accuracy greater than 85% at delays of 150 and 200 seconds. At a 5-minute delay,
      performance was at 75%. 5. When the animals were switched to a repeated object
      paradigm, accuracy markedly declined. 6. The improved performance produced by
      introduction of the pause is attributable to: (1) presenting the object at a
      distance longer than the dogs' near point, and (2) allowing increased processing
      time.

PMID- 11191710
TI  - Adrafinil: effects on behavior and cognition in aged canines.
AB  - 1. Adrafmil is a novel vigilance promoting agent developed in France by Louis
      Lafon Laboratories. 2. Adrafinil causes increased locomotion without producing
      stereotypical activity in canines tested in an open field. 3. The effectiveness
      of a single treatment is long-lasting, and the effectiveness persists over
      repeated treatments. 4. Acquisition of a size discrimination problem is enhanced
      by adrafinil. This may be linked to performance motivation. 5. Adrafinil causes a
      long-lasting increase in high frequency electroencephalographic activity recorded
      from cortical electrodes. 6. These results indicate that adrafinil is novel
      behavioral stimulant with cognitive enhancing potential. The underlying
      mechanisms of action are still unknown.

PMID- 11191711
TI  - Natural animal models of human psychiatric conditions: assessment of mechanism
      and validity.
AB  - 1. The classic animal models for human psychiatric conditions involves rodents.
      As prey species, their normal behaviors of avoidance would be considered
      pathological in humans and dogs. Hence, such models may not be homologous for
      similar behaviors found in psychiatric pathology in humans. 2. Dogs exhibit
      pathological behavioral conditions that may be equivalent to certain human
      psychiatric conditions. These canine conditions appear spontaneously or
      endogenously in the absence of genetic or neurochemcial manipulation, and as
      such, may be homologous to the human condition. 3. If canine conditions approach
      homology with human conditions they should have excellent face, predictive, and
      construct validity. 4. The canine conditions of separation anxiety, obsessive
      compulsive disorder, cognitive dysfunction, dominance aggression, and panic
      disorder have good to excellent validity at all explored levels for human
      generalized anxiety disorder, obsessive-compulsive disorder, Alzheimer's disease,
      impulse control disorders, and panic disorder. 5. Natural canine models can aid
      our understanding of human psychiatric conditions.

PMID- 11191712
TI  - Initiation and propagation of molecular cascades in human brain aging: insight
      from the canine model to promote successful aging.
AB  - 1. Normal aging is thought to proceed through two stages: initiation and
      propagation. Each of these phases is associated with different neuroanatomical
      events, vulnerabilities to injury and responsiveness to interventions. 2. The
      role of beta-amyloid (Abeta) in neuron dysfunction in the initiation stage may be
      mediated through alterations in signal transduction pathways involving cyclic AMP
      response element binding protein (CREB). CREB phosphorylation is associated with
      the expression of brain derived neurotrophic factor (BDNF), which promotes neuron
      health and survival. In primary neuronal cultures, Abeta decreases the
      phosphorylation of CREB, which results in up to a 31% decrease in BDNF levels. 3.
      In vivo studies also support a role for Abeta in neuron dysfunction since soluble
      Abeta levels correlate with the loss of synapses in brains of non-demented humans
      with high pathology. 4. The authors hypothesize that interventions during the
      initiation stage, when neuron dysfunction, but not overt pathology, is present,
      have the most promise to promote successful aging. The dog can serve as a useful
      model for interventions during the initiation stage since dogs develop
      neuropathology that closely resembles that observed in high pathology human
      brains.

PMID- 11191713
TI  - DNA damage and apoptosis in the aged canine brain: relationship to Abeta
      deposition in the absence of neuritic pathology.
AB  - 1. In addition to beta-amyloid (Abeta) deposition and cytoskeletal
      neuropathology, both the Alzheimer's disease (AD) and Down's syndrome (DS) human
      brain exhibit marked evidence of DNA damage, however, it is difficult to separate
      events that occur in conjunction with neurofibrillary pathology versus Abeta
      pathology in these systems. 2. In contrast, the aged canine brain exhibits the
      accumulation of Abeta into diffuse deposits similar to those found in early AD
      and DS in the absence of neurofibrillary pathology. Furthermore, Abeta deposition
      in canine brain is correlated with cognitive deficits. 3. In order to test the
      hypothesis that TUNEL labeling for DNA damage in AD is not simply a consequence
      of agonal artifacts, postmortem artifacts, or neurofibrillary pathology, and may
      be directly related to Abeta deposition, we examined Abeta immunoreactivity, PHF
      1 immunoreactivity, and TUNEL labeling in this animal model. 4. These experiments
      reveal a relationship between the amount of DNA damage detected by TUNEL labeling
      and levels of Abeta deposition. Further, in animals with no TUNEL labeling, we
      detected no Abeta immunoreactivity. 5. These data support the hypothesis that
      TUNEL labeling in AD ans DS is not a consequence of agonal artifact, postmortem
      artifact, or tau pathology, and may be directly related to Abeta deposition and
      perhaps AD pathogenesis.

PMID- 11191714
TI  - Ultrastructural analyses of beta-amyloid in the aged dog brain: neuronal beta
      amyloid is localized to the plasma membrane.
AB  - 1. An electron microscopic study was undertaken to study beta-amyloid (Abeta)
      deposition and neuropathology in aged dogs. 2. A positive correlation between
      Abeta deposits and neuropathology was found in some dogs. Massive Abeta
      deposition was correlated to advanced lesions. 3. By use of immunocytochemistry
      Abeta fibers were identified within plaques, around vessels and in association
      with cell membranes.

PMID- 11191715
TI  - Canine models for human genetic neurodegenerative diseases.
AB  - 1. Canine models of human neurodegenerative disorders are uncommon. However, the
      similarity between canines and humans in body sizes and physiology provides an
      exceptional opportunity to use these models to study human diseases. 2. The
      authors will present a review on the neurological deficits that have been
      observed in canine models of genetic neurodegenerative diseases, and summarize
      the current gene therapy treatments being developed for some of these conditions.

PMID- 11191716
TI  - Organization of connections underlying the processing of auditory information in
      the dog.
AB  - 1. The canine temporal cortex includes the ectosylvian, composite posterior and
      sylvian gyri. 2. The distinctive features of the canine temporal cortex include
      the ectosylvian sulcus closed in its dorsal side and the substantial development
      of neocortex located within the posterior composite gyrus. 3. Thalamofugal
      connections from particular nuclei of the medial geniculate body, posterior
      thalamus and lateromedial-suprageniculate complex project to specific areas of
      the canine temporal cortex and are arranged as dominant and non-dominant
      projections. 4. Local intracortical connections distinguish the ectosylvian and
      posterior composite areas as unimodal auditory cortex. Long distant connections
      and polymodal convergence indicate that the composite ectosylvian area of the
      anterior ectosylvian gyrus and the anterodorsal sylvian areas are higher order
      association cortex. 5. Analysis of both thalamo-cortical and intracortical
      connections indicate that auditory processing in the cortex occurs in successive,
      hierarchically organized stages and in two main, anterior and ventral pathways.

PMID- 11191717
TI  - Cognitive functions of the temporal lobe in the dog: a review.
AB  - 1 The current paper reviews the role of temporal lobe structures in learning and
      different kinds of memory, with an emphasis on behavioral tasks that re auditory
      stimuli. 2 The effects of lesions to structures in the temporal lobe were
      examined in separate groups of dogs, which were trained on an auditory spatial
      delayed response, or in a trial-unique auditory delayed match to sample
      recognition task. 3 Spatial memory was impaired after bilateral hippocampal
      lesions. On the other hand, neither an anterior temporal lesion or rhinal
      cortical injury nor combined lesion to the hippocampus and the anterior temporal
      lobe, affected postoperative retraining and performance of the spatial task. 4
      Auditory recognition memory task was not impaired after a hippocampal and/or
      rhinal cortex lesion. However, postoperative retraining of the task was impaired
      after a lesion to auditory association areas. 5 These results confirm the role of
      the hippocampus in spatial memory in the dog. On the other hand, the organization
      of auditory recognition functions within the temporal lobe appears to be
      different from those described for visual recognition functions.

PMID- 11191719
TI  - Suppressive effect of sarpogrelate hydrochloride on respiratory failure and right
      ventricular failure with pulmonary hypertension in patients with systemic
      sclerosis.
AB  - We evaluated the effect of 12 months of 300-mg oral sarpogrelate hydrochloride
      (SH) once daily on the symptoms of Raynaud's phenomenon, respiratory failure and
      cardiac function in seven patients with systemic sclerosis. Arterial blood gases,
      pulmonary function, mean pulmonary arterial pressure, left ventricular ejection
      fraction (LVEF), right ventricular ejection fraction (RVEF), white blood cell
      count, C-reactive protein and the plasma concentrations of fibrinopeptide A, beta
      thromboglobulin, platelet factor 4 and thrombomodulin were evaluated before and 2
      and 12 months after SH administration. After 2 and 12 months of SH
      administration, a significant decrease was found in the frequency and duration of
      Raynaud's phenomenon, as well as the coldness, numbness and pain of Raynaud's
      phenomenon. Respiratory failure, as estimated by Hugh-Jones classification, was
      significantly decreased, whereas the percentage carbon monoxide diffusion
      capacity was significantly increased. The mean pulmonary arterial pressure
      decreased significantly, as did plasma fibrinopeptide A, beta-thromboglobulin and
      platelet factor 4. There was no significant change in LVEF after 2 or 12 months,
      but after 12 months of SH administration, RVEF increased significantly. In
      conclusion, use of SH may prevent Raynaud's phenomenon, respiratory failure and
      right ventricular failure in patients with systemic sclerosis.

PMID- 11191718
TI  - The association of low serum cholesterol with depression and suicidal behaviours:
      new hypotheses for the missing link.
AB  - Several observational studies indicate that reduction of serum cholesterol levels
      is related to an increase in violent deaths and suicide but the nature of this
      possible relationship remains unclear. Many confounding factors, e.g. poor
      health, depression and loss of appetite may play a role in the apparent
      relationship between serum cholesterol levels and suicide. Two separate phenomena
      should be considered: lowering total cholesterol and low total cholesterol. This
      review considers the evidence from epidemiological studies on serum cholesterol
      lowering and psychiatric disturbances. The available evidence does not seem to
      substantiate the view that large-scale intervention to reduce cholesterol
      concentrations could lead to more violent and aggressive behaviour, and generally
      greater unhappiness. In recent trials using statin treatment, there were slightly
      fewer deaths from accidents and suicide in the treated group compared with the
      placebo group. We believe that clinicians should not be deterred from prescribing
      cholesterol-lowering drugs, to reduce the risk of death from coronary heart
      disease, when they are indicated.

PMID- 11191720
TI  - Lonidamine cytotoxicity: involvement of the lysosomal compartment.
AB  - Lonidamine (LND) was found to decrease significantly the pH gradient across
      intracellular compartments in Ehrlich ascites tumour cells. The effect was
      maximal in the range 0.2 - 0.3 mM LND, and was observed both in the presence of
      glucose - i.e. conditions in which a high bioenergetic status of the cells was
      maintained by glycolysis (due to a strong Crabtree effect in these cells) - and
      in the absence of glucose. Moreover the LND effect was also observed in the
      presence of bafilomycin, a specific inhibitor of the H+ -vacuolar ATP-ase. Based
      on these findings, we suggest that the LND effect on the proton gradient reflects
      an LND-induced increase in membrane proton conductance. The consequent impairment
      of intracellular proton gradients might be involved in the mechanism of action of
      LND, allowing drugs that are weak bases to accumulate preferentially in the
      cytoplasm and nucleus.

PMID- 11191721
TI  - Autologous serum deprivation restored IL-1 receptor antagonist production by
      peripheral blood mononuclear cells in patients with gastric cancer.
AB  - It has been established that cancer patients have immunosuppressive substances in
      their sera that depress cellular immunity. Although plasma exchanges have been
      attempted to remove these substances and to improve immunity to cancer, little is
      known about its mechanism from the viewpoint of cytokine pattern. The levels of
      the cytokines, tumour necrosis factor-alpha, interleukin 1beta, interleukin 6,
      interferon-gamma and interleukin-1 receptor antagonist (IL-1ra) by peripheral
      blood mononuclear cells (PBMC) were determined simultaneously by the whole-blood
      assay and the PBMC assay in 20 patients with gastric cancer and in 10 healthy
      volunteers. In both assays the cytokine levels were lower in patients with cancer
      compared with healthy controls, with the exception of IL-1ra. In the PBMC assay,
      the IL-1ra level in cancer patients was significantly higher than that in
      controls. No statistical correlation between the cytokine levels determined by
      the two assays was found. We suggest that autologous serum deprivation restored
      and enhanced IL-1ra production, and normalized the cytokine cascade in immune
      response, in patients with gastric cancer.

PMID- 11191722
TI  - Clinical study of cefpirome sulphate in obstetric and gynaecological infections.
AB  - Cefpirome sulphate is a fourth-generation cephem antibiotic, which has a broad
      spectrum of antibacterial activity against Gram-positive and -negative bacteria,
      and is highly stable to beta-lactamase. Cefpirome sulphate was administered to
      166 patients with obstetric or gynaecological infections, and its clinical and
      antibacterial effect was evaluable in 139. Excluding seven patients who violated
      the study protocol by receiving concomitant drugs, the safety of cefpirome
      sulphate was assessed in 159 patients. In the 139 patients in whom efficacy was
      evaluated, the improvement rate was 80.6% (112/139) and the eradication rate
      72.6% (45/62). The eradication rate for bacteria isolated from the patients at
      the start of the study was 84.7% (111/131). No resistance to cefpirome sulphate
      was observed in Enterococcus faecalis or Bacteroides species. Systemic erythema
      and nausea each occurred in one patient, and nine patients showed abnormal
      hepatic function test results. These results suggest that cefpirome sulphate is
      effective in the treatment of obstetric and gynaecological infections and has a
      good side-effect profile.

PMID- 11191723
TI  - Drug-resistant tuberculosis at the University Hospital in Gaziantep, South
      eastern Turkey.
AB  - We aimed to determine the present status of drug resistance of Mycobacterium
      tuberculosis at the Gaziantep University Hospital in south-east Turkey. Data for
      1995 to 1999 were retrospectively evaluated with respect to smear-positive cases,
      first positive culture for Mycobacterium tuberculosis for each patient and drug
      susceptibility tests for the major antituberculous drugs. Cultures were done
      using the Bactec 460 TB method. A total of 106 (40.2%) strains were resistant to
      at least one drug. Single drug resistance was observed in 47 strains (17.8%) and
      resistance to two or three drugs was found in 28 and 29 strains (10.6 and 11.0%),
      respectively. Two strains (0.8%) were resistant to all four drugs. While
      multidrug resistance was observed in 52 (19.7%) strains, resistance to isoniazid
      + rifampin was observed in 20 (7.6%) strains. This retrospective study showed
      that combined drug resistance of M. tuberculosis is highly prevalent in
      southeastern Turkey. Possible reasons for the failure of current control policies
      were considered.

PMID- 11191724
TI  - Results of conversion total hip prosthesis performed following painful
      hemiarthroplasty.
AB  - Fifteen of 18 cases who underwent conversion total hip prosthesis due to painful
      hemiarthroplasty, between 1992 and 1997, were investigated retrospectively. The
      13 (86.6%) women and two (13.4%) men (mean age, 59 years) were followed up for an
      average of 32 months. Pre-operative and post-operative Harris hip scores were
      36.4 (28 - 42) and 85.9 (69 - 98), respectively. In all cases the femoral
      component had more than 2 mm radiolucency in Gruen zones I, IV and VII, and five
      cases had acetabular protrusion; other cases had cartilage erosion. In the last
      follow-up of conversion total hip prosthesis, there was no radiolucency in either
      femoral or acetabular components. Comparing our results of conversion total hip
      prosthesis with primary total hip prosthesis results for femoral neck fractures
      in the literature we conclude that, in elderly patients with femoral neck
      fractures, primary total hip prosthesis has better results.

PMID- 11191725
TI  - Effects of cancer chemotherapy on the blood fibrinogen concentrations of cancer
      patients.
AB  - Blood fibrinogen concentrations and glutamic-pyruvic transaminase activities of
      66 adult cancer inpatients (aged 22 - 70 years) were determined both before and
      after one or two chemotherapy regimens. The percentage of hepatoma patients with
      abnormal blood fibrinogen levels (< 1.5 or > 6.0 g/l) was higher (64.3% of 14
      patients) than that in other cancer categories (19.2% of 52 patients). The mean
      blood fibrinogen concentrations of male (3.5 g/l) and female (4.5 g/l) cancer
      patients were higher than those previously reported for healthy humans (2.8 and
      2.9 g/l, respectively). After chemotherapy, blood fibrinogen concentrations
      decreased in patients whose primary tumours were surgically removed (from 4.8 to
      3.2 g/l) but increased (from 3.0 to 4.8 g/l) in those who did not undergo
      surgery. Glutamic-pyruvic transaminase activities did not appear to be related to
      blood fibrinogen levels. We conclude that the increase in mean blood fibrinogen
      levels of cancer patients is probably related to tumour growth. Different
      mechanisms may operate in patients with hepatoma.

PMID- 11191726
TI  - Isolated factor VII deficiency diagnosed after a life-threatening brain
      haemorrhage.
AB  - A 65-year-old man was admitted to another hospital with a life-threatening brain
      haemorrhage, and laboratory examinations on admission revealed prolonged
      prothrombin time with normal activated partial thromboplastin time. To establish
      the cause of his abnormal coagulation, he was referred to our clinic. Neither the
      patient nor his family had any previous history of bleeding symptoms. His liver
      function was within normal limits but coagulation tests showed increased plasma
      activities of factors II, VIII, IX, X, with reduced activities of factors V and
      VII. The activity of factor VII was less than 2% but no inhibitor of factor VII
      was detected in the plasma. We concluded that the patient had a rare congenital
      isolated factor VII deficiency although he had not shown earlier bleeding
      problems, presumably because of compensation for the factor VII deficiency by
      enhanced activities of components of the extrinsic coagulation pathway, factors
      II, VIII, IX and X.

PMID- 11191727
TI  - The frequency and cost of patient-initiated device removal in the ICU.
AB  - OBJECTIVE: To determine the frequency and pattern with which patients in the
      intensive care unit (ICU) remove medical devices on their own, and the costs
      associated with this problem. DESIGN: Prospective observational study. SETTING:
      Two 10-bed sections of a multidisciplinary ICU in a tertiary care teaching
      hospital. PATIENTS: Adults admitted to the ICU for longer than 24 hours during
      October 1998. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records
      were reviewed prospectively for the occurrence of patient-initiated device
      removal and the responses to those events by health care providers. Associated
      costs were estimated using hospital databases and Medicare physician
      reimbursement schedules. Annual cost estimates were calculated using 1997
      admission statistics for 1211 adults in an ICU for more than 24 hours. Thirty-six
      patients were studied for 199 patient-days. Ten patients (28%) removed 42
      devices: 88% of these events involved gastrointestinal tubes and vascular
      catheters. Significant agitation was documented within 2 hours before 74% of the
      events. Estimated cost associated with device removal was $7606, or $181/event.
      The estimated annual cost in this 42-bed ICU was more than $250,000. CONCLUSIONS:
      Patients commonly remove medical devices on their own, and this represents
      significant consumption of health care resources.

PMID- 11191728
TI  - Aseptic meningitis after intraventricular administration of gentamicin.

PMID- 11191729
TI  - Elevation of hepatic transaminases after enoxaparin use: case report and review
      of unfractionated and low-molecular-weight heparin-induced hepatotoxicity.
AB  - Enoxaparin, a low-molecular-weight heparin (LMWH), is widely used for the
      treatment and prophylaxis of thromboembolic disorders, such as deep vein
      thrombosis. Low-molecular-weight heparin products have smaller and more uniform
      molecular weights than unfractionated heparin, allowing them to exhibit a much
      greater affinity for factor Xa than factor IIa. Compared with traditional
      unfractionated heparin, LMWHs have proved to be equally efficacious and may be
      safer. The distinctive characteristics of LMWHs have resulted in decreased rates
      of bleeding and equivalent rates of thrombocytopenia compared with unfractionated
      heparin. This favorable safety profile has been identified in several studies and
      may have led clinicians to believe that LMWHs have lower frequencies of all
      common side effects. A 66-year-old woman developed increased hepatic
      transaminases during treatment with enoxaparin for a deep vein thrombosis; they
      returned to normal after enoxaparin discontinuation. A causal relationship
      between unfractionated heparin and asymptomatic, transient increases in hepatic
      transaminase levels has been documented; these increased levels also appear to be
      an underrecognized, adverse effect of LMWH therapy.

PMID- 11191730
TI  - Phosphorylation of nucleoside analog antiretrovirals: a review for clinicians.
AB  - Nucleoside analogs (zidovudine, didanosine, zalcitabine, stavudine, abacavir,
      lamivudine) have been administered as antiretroviral agents for more than a
      decade. They undergo anabolic phosphorylation by intracellular kinases to form
      triphosphates, which inhibit human immunodeficiency virus replication by
      competitively inhibiting viral reverse transcriptase. Numerous methods are used
      to elucidate the intracellular metabolic pathways of these agents. Intracellular
      and extracellular factors affect intracellular phosphorylation. Lack of
      standardization and complexity of methods used to study phosphorylation in
      patients limit interpretation of study results and comparability of findings
      across studies. However, in vitro and in vivo studies give important insights
      into mechanisms of action, metabolic feedback mechanisms, antiviral effects, and
      mechanisms of toxicity, and have influenced dosing regimens of nucleoside
      analogs.

PMID- 11191731
TI  - Visual disturbance associated with celecoxib.
AB  - Celecoxib, a specific inhibitor of cyclooxygenase-2, is used to treat the
      symptoms of arthritis. A 79-year-old woman developed an atypical visual
      disturbance associated with this agent that resolved on discontinuation of
      celecoxib. Similar visual disturbances described with the traditional
      nonsteroidal antiinflammatory drugs are discussed.

PMID- 11191732
TI  - A vision of pharmacy's future roles, responsibilities, and manpower needs in the
      United States. Introduction to commentaries.

PMID- 11191733
TI  - A vision of pharmacy's future roles, responsibilities, and manpower needs in the
      United States. American Council on Pharmaceutical Education.

PMID- 11191734
TI  - A vision of pharmacy's future roles, responsibilities, and manpower needs in the
      United States. American Pharmaceutical Association.

PMID- 11191735
TI  - A vision of pharmacy's future roles, responsibilities, and manpower needs in the
      United States. American Society of Health-System Pharmacists.

PMID- 11191736
TI  - A vision of pharmacy's future roles, responsibilities, and manpower needs in the
      United States. Board of Pharmaceutical Specialties.

PMID- 11191737
TI  - Gatifloxacin, an advanced 8-methoxy fluoroquinolone.
AB  - Gatifloxacin is a new 8-methoxy-fluoroquinolone antibiotic approved for use in
      the United States in December 1999. It has a broad spectrum of activity with
      potent activity against gram-positive bacteria, including penicillin-resistant
      Streptococcus pneumoniae, as well as excellent activity against gram-negative and
      atypical organisms. Gatifloxacin is available in both oral and injectable forms
      and is administered once/day. Bioavailability is 96%, with a plasma half-life of
      approximately 8 hours in individuals with normal renal function. Elimination is
      primarily renal excretion of unchanged drug with no cytochrome P450-mediated
      metabolism. The drug is distributed extensively into tissues and fluids and has a
      favorable pharmacodynamic profile against important pathogens. It had excellent
      efficacy in clinical studies of acute sinusitis, acute bacterial exacerbations of
      chronic bronchitis, community-acquired pneumonia, complicated and uncomplicated
      urinary tract infections and pyelonephritis, skin and skin structure infections,
      and uncomplicated gonococcal infections. The agent is well tolerated, with no
      evidence of hepatic, cardiac, or phototoxicity noted thus far. Drug interactions
      are uncommon; however, like other fluoroquinolones, coadministration with
      multivalent cations should be avoided due to significantly decreased absorption.
      Gatifloxacin should prove to be a safe and effective agent for a wide variety of
      infections.

PMID- 11191738
TI  - Misoprostol therapeutics revisited.
AB  - Misoprostol, a prostaglandin E1 analog, is a racemate of four stereoisomers. On
      administration it rapidly de-esterifies to its active form, misoprostolic acid.
      Misoprostolic acid is 85% albumin bound and has a half-life of approximately 30
      minutes. It is excreted in urine as inactive metabolites. No significant drug
      interactions have been reported. Besides its gastrointestinal protective and
      uterotonic activities, misoprostol regulates various immunologic cascades. It
      inhibits platelet-activating factor and leukocyte adherence, and modulates
      adhesion molecule expression. It protects against gut irradiation injury,
      experimental gastric cancer, enteropathy, and constipation. It improves nutrient
      absorption in cystic fibrosis. Misoprostol has utility in acetaminophen and
      ethanol hepatotoxicity, hepatitis, and fibrosis. It is effective in asthmatics
      and aspirin-sensitive asthmatic and allergic patients. It lowers cholesterol and
      severity of peripheral vascular diseases, prolongs survival of cardiac and kidney
      transplantation, synergizes cyclosporine, and protects against cyclosporine
      induced renal damage. It works against drug-induced renal damage, interstitial
      cystitis, lupus nephritis, and hepatorenal syndrome. It is useful in periodontal
      disease and dental repair. Misoprostol enhances glycosoaminoglycan synthesis in
      cartilage after injury. It prevents ultraviolet-induced cataracts and reduces
      intraocular pressure in glaucoma and ocular hypertension. It synergizes
      antiinflammatory and analgesic effects of diclofenac or colchicine and has been
      administered to treat trigeminal neuralgic pain. It reduces chemotherapy-induced
      hair loss and recovery time from burn injury, and is effective in treating
      sepsis, multiple sclerosis, and pancreatitis.

PMID- 11191739
TI  - A multicenter evaluation of gentamicin therapy in the neonatal intensive care
      unit.
AB  - STUDY OBJECTIVE: To evaluate traditional nomogram (TN) versus individualized
      pharmacokinetic gentamicin dosing practices in neonatal intensive care units,
      focusing on achieving target therapeutic concentrations (peak > 8 microg/ml,
      trough < 2 microg/ml), number of dosing changes, number of concentrations
      obtained, and evidence of nephrotoxicity. DESIGN: Retrospective chart review.
      SETTING: Three neonatal intensive care units. PATIENTS: Three hundred nine
      infants prescribed gentamicin. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS:
      Sixty-seven percent of patients receiving pharmacokinetic dosing had initial peak
      concentrations of 8 microg/ml or greater compared with 7% of patients receiving
      TN dosing (p<0.001). Trough concentrations exceeding 2 microg/ml were reported in
      23% of patients receiving TN dosing compared with 2% of pharmacokinetic-dosed
      patients (p<0.001). Forty-two percent and 6%, respectively, required dosage
      adjustments (p<0.01). The mean number of concentrations obtained per patient was
      2.8 and 2.1, respectively (p<0.01). Neither group had evidence of gentamicin
      related nephrotoxicity. CONCLUSION: Compared with TN dosing, administering
      gentamicin loading doses and performing initial pharmacokinetic analysis resulted
      in rapid attainment of desired concentrations and fewer dosage adjustments, and
      allowed for a decrease in the number of gentamicin concentrations.

PMID- 11191740
TI  - Pharmacotherapy of behavioral and psychological symptoms of dementia: time for a
      different paradigm?
AB  - Behavioral and psychological symptoms of dementia can occur in 60-80% of patients
      with Alzheimer's disease or other dementing illnesses, and are important in that
      they are a source of significant caregiver stress and often precipitate nursing
      home placement. These symptoms, namely, aggression, delusions, hallucinations,
      apathy, anxiety, and depression, are clinically managed with a variety of
      psychotropic drugs such as antipsychotics, antidepressants, antiepileptic drugs,
      and benzodiazepines. Various advances in the neuropathophysiology and
      pharmacotherapy must be considered in the optimal design of regimens for patients
      with these symptoms.

PMID- 11191741
TI  - [The phenomenon of rectangularization of the survival curve in the Czech
      population as a result of the concept of successful aging and geriatric
      medicine].
AB  - An overview of conceptions of the successful ageing with positive impacts on the
      improvement of the quality of life, on decreased dependence in activities of
      daily living, and on demands for health-social care in senescence is given.
      Necessity of altering of sanitary services and outlooks on the geriatric patients
      corresponding to the demographic development and improvement of their functional
      state is stressed. Concepts of the upgrowth of the life expectancy are given. The
      phenomenon of rectangularization of the survival curve in the population of the
      Czech Republic during the 20th century is demonstrated and the prospect till the
      middle of 21st century for the population structure, life expectancy, longevity
      index are presented.

PMID- 11191742
TI  - [Ambulatory monitoring of blood pressure--focus on childhood].
AB  - Conventional office measurements of blood pressure (BP) are limited in their
      ability to assess long term hemodynamic load on cardiovascular system. The
      ambulatory blood pressure monitoring (ABPM) offers the advantage of providing
      multiple blood pressure measurements from a subject's normal environment during
      his normal activities, thereby revealing important patterns of blood pressure
      during the whole 24-hour period. Results of ABPM have much better correlation
      with end organ damage than casual BP and provide more sensitive data of ultimate
      prognosis. There is much better long-term reproducibility of ambulatory blood
      pressure compared with conventional office BP measurements. The phenomenon of
      "white coat" hypertension (WCH) defined as mean office BP readings in the
      hypertensive range but ambulatory blood pressure (ABP) readings in the normal
      range represents probably a benign entity not requiring pharmacological
      treatment. Based on normal population of school children and adolescents the
      percentiles of ABP have been recently established and patterns of ABP have been
      studied in children in various clinical settings. WCH has been recognized in
      childhood and its prevalence seems to be higher comparing with adult population.
      ABPM seems to be an effective and well tolerated tool in evaluating BP in
      children and adolescents helping to identify those who need careful checkup and
      treatment.

PMID- 11191743
TI  - [Significance and prevalence of the C282Y gene mutation of primary
      hemochromatosis in the pathogenesis of pophyria cutanea tarda].
AB  - BACKGROUND: Hitherto studies on the ethiopathogenesis of porphyria cutanea tarda
      (PCT) show that the major pathogenic factor is iron ion, which acts via
      inhibition of the uroporphyrinogen decarboxylase. New speculations have appeared
      on the possible relation of this role of iron and the occurrence of mutation of
      the recently discovered gene of the hereditary hemochromatosis HFE, which may
      cause the iron overloading of the organism. Our paper describes prevalence of the
      C282Y gene mutation (HFE) together with the clinical and laboratory record in PCT
      patients. METHODS AND RESULTS: PCT was diagnosed mostly on the basis of clinical
      finding of actinic-traumatic vesicular dermatitis and the typical laboratory
      record of elevated higher-carboxylic porphyrines in urine and stool. Other
      laboratory methods tested the liver functions, plasma iron level and its binding
      capacity, ferritine level. All patient underwent routine haematological testing.
      Presence of antibodies against hepatitis C was also assayed (Elisa test 2nd
      generation, Sanofi Pasteur). In patients with prominent laboratory alterations
      showing possibility of the hepatic structural lesion, histology from the liver
      punctate was done. Frequency data of the C282Y gene mutation (HFE) in PCT
      patients was estimated on the basis of the genetic testing using PCR reaction of
      our own system. Group of PCT patients had 69 persons (63 patients with the
      sporadic form and 6 patients with familiar form of the disease). Hereditary
      haemochromatosis C282Y gene mutation (HH) was found in 15 patients, three of them
      were homozygotes and twelve heterozygotes (three heterozygotes had the familiar
      form of the disease). Nobody in this group was positive in the HIV antibody
      testing. In all porphyria patients with the presence of mutated gene who
      underwent liver biopsy, siderosis of different degrees was identified. In three
      patients neither the phenotypic observation nor the laboratory testing have shown
      haemochromatosis. Prevalence of C282Y gene mutation HFE in patients with
      porphyria cutanea tarda was studied. Such mutation was found in 15 persons (12
      heterozygotes and 3 homozygotes) from the group of 69 tested patients (21.7%).
      Such frequency is significantly higher than in the control--nonporphyric--persons
      (10%). Patients were without clinical symptoms. Laboratory haematological
      changes, typical for HH, manifested in some of them only (elevated level of
      ferritine was found in 10 from 15 porphyria patients, elevated sideremia in one
      of them). Red blood cell counts were in both homo- and heterozygotes normal.
      Concurrence of the two porphyrinogenic factors--presence of gene mutation HFE and
      hepatitis C infection--was not proved. Antibodies against hepatitis C virus were
      not identified in any of the patients. Siderosis was found to be only a
      symptomatic sign, which was pronounced in different degree in all 9 porphyria
      patients with C282Y gene mutation who underwent liver biopsy. CONCLUSIONS:
      Frequency of C282Y gene mutation in our patients with porphyria cutanea tarda
      appears similar to that in other Middle European countries. It differs
      significantly from the frequency found in South European and North European
      countries (British).

PMID- 11191744
TI  - [Relation between serum leptin levels, blood parameters and erythropoietin levels
      in hemodialyzed patients].
AB  - BACKGROUND: Serum leptin levels are significantly increased in hemodialysed
      patients compared to healthy subjects. There are some data suggesting the
      possible relationship of leptin and the regulation of haematopoiesis. The aim of
      our study was to compare serum leptin levels in two groups of hemodialysed
      patients: the group treated by recombinant human erythropoietin (n = 40) (HD +
      EPO), the group without erythropoietin treatment (HD) and the control group of
      healthy subjects (n = 20) to explore the influence of erythropoietin treatment on
      serum leptin levels. METHODS AND RESULTS: The tendency towards lower body fat
      content and higher serum leptin levels was found in both groups of HD patients
      compared to control group, but the differences did not reach statistical
      significance due to high variability of those parameters (leptinu levels: HD 19.5
      +/- 18.5, HD + EPO 24.9 +/- 23.3, K 10.4 +/- 8.8 ng.ml-1). The erythrocyte count
      and haemoglobin levels in both groups of HD patients were significantly lower
      than in control group. The erythrocyte count and haemoglobin levels were
      significantly lower in HD patients treated by erythropoietin compared to
      untreated HD group. The leptin/body fat content ratio was significantly higher in
      HD patients compared to healthy subjects (HD 0.86 +/- 0.72, HD + EPO 0.92 +/-
      0.78, K 0.35 +/- 0.21, p < 0.05). Serum leptin levels in all studied groups
      correlated positively with body fat content and negatively with erythrocyte
      count. No significant relationships of serum leptin levels to erythropoietin
      levels or other parameters studied were found in any of groups. CONCLUSIONS: Our
      study further supported the fact that serum leptin levels in HD patients are
      relatively higher than in healthy subjects. Serum leptin levels in HD patients
      treated by recombinant human erythropoietin did not significantly differ from HD
      patients without this treatment. Except of the negative correlation between serum
      leptin levels and the erythrocyte count no statistically significant
      relationships of serum leptin levels and the blood count parameters were found.

PMID- 11191745
TI  - [Organ-specific antibodies in children with idiopathic inflammatory bowel disease
      and their use in clinical practice].
AB  - BACKGROUND: Ethiopathogenesis of the idiopathic inflammatory bowel disease has
      not been yet fully explained. Several abnormalities of the humoral immunity
      supporting the concept of autoimmune character of the disease have been
      identified. The aim of our study was to characterise occurrence of the organ
      specific antibodies against the intestinal goblet cells and against acinar cells
      of the exocrine pancreatic tissue and to evaluate their significance for the
      diagnostics of the idiopathic inflammatory bowel disease. METHODS AND RESULTS: 69
      children were included in the study. The group consisted of 20 patients with
      idiopathic proctocolitis (11 boys and 9 girls, 6 to 18 years old, average age
      15.5) and 14 patients with Crohn's disease (9 boys and 5 girls, 5 to 18 years
      old, average age 14.7). Control group included 35 children (20 boys and 15 girls,
      average age 14.7). In patients of the idiopathic proctocolitis group, antibodies
      against the intestinal goblet cells were assayed by indirect immunofluorescence
      method in 55%. In patients with Crohn's disease, antibodies against acinar cells
      of the exocrine pancreatic tissue were found in 64.2%. Differences in
      manifestation of antibodies against acinar cells of the exocrine pancreatic
      tissue in Crohn's disease were statistically significant (p = 0.001).
      Statistically significant (p = 0.01) was also the difference of levels of
      antibodies against the intestinal goblet cells in patients with idiopathic
      proctocolitis when compared to patients with Crohn's disease. Statistically
      significant difference (p = 0.01) was found in levels of antibodies against
      acinar cells of the exocrine pancreatic tissue in Crohns disease and antibodies
      against the intestinal goblet cells in patients with idiopathic proctocolitis.
      CONCLUSION: Testing on presence of specific antibodies against acinar cells of
      the exocrine pancreatic tissue and against intestinal goblet cells is a valuable
      tool for the diagnostics of the idiopathic inflammatory bowel disease in
      childhood and adolescence.

PMID- 11191746
TI  - [Tuberculosis in the Czech Republic in 1999].
AB  - Report is given on the tuberculosis (TB) prevalence and the new diseases
      monitoring in Czech Republic (CR) in 1999 using the register of notifiable TB
      diseases. 1631 new TB cases and relapse were notified (15.9/100,000 citizens).
      Majority TB cases, 1369 (13.3/100,000 citizens) were of the respiratory system
      and 262 TB cases were in other locations. 63% of the respiratory system diseases
      were bacteriologically verified. In comparison with the year 1998, the number of
      newly notified TB patients was 9.6% lower, number of TB cases of the respiratory
      system which were bacteriologically verified was 12.3% lower, cases of
      microscopically positive TB were 17.4% less frequent. Among the notified TB
      patients there were 91 foreigners. TB relapse was identified in 61 patients.
      Among the notified TB cases, 987 (60.5%) were males and 644 (39.5%) were females.
      In both sexes patients over 65 predominated. Prevalence of TB cases higher than
      the average for the whole state was found in Prague, northern and western
      Bohemia. Groups with TB prevalence higher than 50/100,000 citizens were
      identified (the risk groups). They include homeless people, drug addicts, asylum
      applicants, and prisoners. Due to subjective troubles of patients TB was
      diagnosed in 70.2% cases, by active investigation in 13.9% patients. Late TB
      diagnosis at autopsy came in 6.8% cases. Decease due to TB was notified in 79
      patients. In 77 of them TB had not been diagnosed premortally. 106 new cases and
      relapses of non-TB mycobacterial disease were notified in 1999. The case of
      tuberculosis in CR was in 1999 restrainable. In comparison with 1998 significant
      decrease of TB prevalence in individual subgroups of TB disease was described (10
      to 17%). Also the decrease of the long-term trend (10 years) of newly notified TB
      patients and TB of the respiratory system was depicted. It is necessary to
      maintain the quality and extend of the TB control program in order to prevent the
      new outbreak of TB disease.

PMID- 11191747
TI  - [Detection of minimal residual disease in Ewing's sarcoma using RT-PCR].
AB  - BACKGROUND: More than 90% of Ewing's sarcomas (ES) contain a fusion of the EWS
      and FLI-1 genes, due to the t(11;22)(q23;q12) translocation. At the molecular
      level, the EWS-FLI-1 rearrangement shows great diversity. Specifically, many
      different combinations of exons from EWS-FLI-1 encode in-frame fusion transcripts
      and result in differences in length and composition of the chimeric protein,
      which function as an oncogenic aberrant transcription factor. The finding of this
      translocation gives evidence for the presence of ES cells. The aim of this
      prospective study was to verify applicability of the RT-PCR method for the
      detection of minimal residual disease in patients with ES. METHODS AND RESULTS:
      Conditions for the detection of Ewing's sarcoma cells by means of the reverse
      transcriptase polymerase chain reaction (RT-PCR) at fusion transcripts in
      peripheral blood, bone marrow (BM) and autologous hematopoietic stem cell grafts
      in patients with ES were appointed. 31 samples of BM, 5 samples of blood and 7
      peripheral blood grafts obtained from 23 patients were investigated. Presence of
      tumor cells was identified in 7 BM samples from 7 different patients (31 samples
      from 16 patients), all the peripheral blood and graft samples were negative.
      CONCLUSIONS: The high sensitivity of RT-PCR method in detection of cells bearing
      t(11;22)(q23;q12) was demonstrated in the experimental model and clinical
      samples. Likewise the literary statements, the RT-PCR method was found to be more
      sensitive than cytology.

PMID- 11191748
TI  - [Combined therapy of acromegaly with a combination of lanreotide and terguride].
AB  - BACKGROUND: The aim of the treatment of acromegaly is to normalise the hormonal
      activity. Besides the surgical and radiation treatment, medical therapy can be
      used. The project was set to determine the value of combined therapy with
      lanreotide and terguride in patients with active acromegaly. METHODS AND RESULTS:
      Nine patients previously treated with lanreotide for at least one year without
      normalisation of hormonal activity were included in the study. Terguride was
      added to lanreotide for one month. The combined treatment brought about reduction
      of growth hormone (GH) levels, however, with marginal significance only. GH-BP,
      IGF-I and IGFBP-3 serum levels were not changed significantly. Considering the
      individual cases, the combined treatment resulted in normalisation of GH levels
      in one patient and that of IGF-I in another one. Substantial decrease of GH
      levels (> 50%) was found in three patients and that of IGF-I (> 20%) in another
      one patient. CONCLUSIONS: The combined treatment of acromegaly appears to be more
      effective than monotherapy with lanreotide only in a subset of acromegalic
      patients.

PMID- 11191749
TI  - [Development of epidemiologic indicators in the diagnosis and therapy of
      pulmonary cancer in the Czech Republic 1970-1999].
AB  - BACKGROUND: Lung cancer (LC) remains serious medical and social problem. In US it
      represents the most frequent cause of malignancy-related deaths both in males and
      females. In Czech Republic about 6000 persons acquires LC each year. The aim of
      the study was to describe developmental trends of the mortality, methods of
      therapy and results of treatment in Czech Republic during the last 30 years.
      METHODS AND RESULTS: Prevalence of LC in males reached maximum in the middle of
      seventies (104/100,000), in females it has still the increasing tendency, being
      highest in 1996 (22.8/100,000). Comparing the swiftness of diagnostics: In years
      1985 to 1996 number of late diagnosed cases diminished and the operability of all
      diagnosed cases increased from 10.4% to 11.8% in males and from 9.4% to 11.2% in
      females. The most frequent type of LC is the epidermoid type reaching in 1998 52%
      of all cases in the CR and 47% of cases treated at the TRN department of the
      Second Medical Faculty. Result of the five years survival have been still
      unsatisfying, only 4% of males and 5.3% females live longer than five years. At
      the department of TRN of the Second Medical Faculty in years 1998 and 1999, 266
      cases of LC were diagnosed. The male/female ratio was 2:1, 21.9% were at first or
      second stadium. Following treatment was employed: 24.4% of all diagnosed cases
      were sent to surgery, 40% underwent radiotherapy, 94.3% of patients with
      parvocellular LC and 22% of non parvocellular LC received chemotherapy.
      CONCLUSIONS: In Czech Republic during the last 25 years numbers of males with LC
      stagnate at inacceptable high values, in females the incidence still progresses.
      Unsatisfying are the results of treatment, numbers of patients surviving longer
      than 5 years are lower than in most of developed countries. To improve the
      situation it would be necessary to limit smoking habits in the population,
      reassess possibilities of depiction of early phases of LC, and improve the
      therapy employing modern approaches as the neoadjuvant chemotherapy, contemporary
      chemotherapeutic regimes in combination with radiotherapy or surgical therapy.

PMID- 11191750
TI  - [Dialysis therapy in the Czech Republic in 1999].
AB  - Number of HDS patients has stabilised; however, the technical background of the
      haemodialysation program is not sufficient, 40% of the dialysation monitors has
      been amortised. In the dialysed population numbers of elderly patients (60%) and
      diabetics (33%) rise, thus rise the number of polymorbid patients and about 1/3
      of new patients come form "the street". Not surprisingly it brings high mortality
      (20%). Six per cent of patients were treated with peritoneal dialysis in 1999,
      the highest number achieved in the present history of this method. This trend
      should be kept in future.

PMID- 11191751
TI  - [Chemoprevention of bronchogenic carcinoma].
AB  - Lung cancer is the leading cause of cancer-related deaths in many developed
      countries. Understanding its carcinogenesis is critical for the development of
      rational approaches to cancer prevention. The concept of chemoprevention is based
      on the idea that the diffuse injury of the respiratory epithelium results from
      chronic carcinogen exposure. Chemoprevention agents should reverse or suppress
      the development of premalignant and malignant changes by different mechanisms. In
      the future, the clinical application to risk groups of patients could lead to
      substantially decreased frequency of the lung cancer. The results of ongoing
      trials are eagerly awaited.

PMID- 11191752
TI  - [A pathology reminder in the case report by L. Jankovec, Z. Rysavy, P. Tesinsky,
      S. Lacinova: Systemic general amyloidosis with kidney involvement].

PMID- 11191753
TI  - [A historical review and some comments on the nuclear transplantation in fish].
AB  - In this review article, a brief history and main results of the studies on the
      nuclear transplantation (cloning) in fish was introduced. Late Professor T. C.
      Tung (TONG Di-Zhou), a noted Chinese Experimental Embryologist and his research
      group at the Institute of Zoology, the Chinese Academy of Sciences (CAS) in
      Beijing, China initiated and established successful technology of nuclear
      transplantation in fish in 1963. During the past 36 years, most of the studies on
      fish cloning were performed mainly by Chinese groups except only one article was
      published by authors in former USSR (Gasaryan et al. 1979), and the other one was
      published by Japanese authors in Japan (Niwa et al. 1999). The primary goals of
      the studies of Tung's group were: (1) to study the inter-relationship between the
      nucleus and the cytoplasm in terms of the controlling effects determined by
      nucleus or cytoplasm or both during the ontogenesis, cell differentiation and
      phenotypic expression in a developing animal; and (2) to produce fish clones of
      commercial importance for agricultural purposes. The most successful results that
      have been obtained by Tung's group in collaboration with the investigators at
      various fisheries institutions in China were the production of nucleocytoplasmic
      adult hybrid fish between different varieties, species, genera and subfamilies
      that produced viable offspring. Furthermore, these nucleocytoplasmic fish hybrid
      revealed that while most phenotypic characteristics are controlled by the
      nucleus, a few are controlled by the cytoplasm or by both. In addition, the
      resulting nucleocytoplasmic fish hybrids also showed some better characteristics
      of economic importance such as faster growth rate, increasing of protein content
      and reducing of fat content in muscle, etc. So far, no such kinds of evidences
      are available either in amphibian or in mammals. Another most important result
      obtained by other Chinese groups showed that the uncultured or cultured adult
      somatic cell in fish which can support the nuclear transplanted eggs developing
      into adults. They were: (1) a 17 month old gold-fish obtained by transplanting an
      adult erythrocytes into an enucleated egg (WU et al. 1982); (2) a subcultured
      kidney cell nucleus of Crucian carp (Carassius auratus) can support the
      transplanted enucleated egg of same species developing into a three years old
      adult with female sexual characteristics (CHEN et al. 1986) and (3) a cultured
      liver cell nucleus from grass carp (Ctenopharyngoden idellus) can support a
      nuclear transplanted unfertilized egg of the same species developing into an
      adult fish at least of one year old when that paper was published. Some
      discussions and comments for evaluating the results obtained from previous
      studies and suggestions for further investigations in this research field are
      also provided. More detailed information could be found in the book--"Cloning in
      Fish-nucleocytoplasmic Hybrids" which was written by Shaoyi Yan in English and
      published by International Union of Biological Sciences and Educational and
      Cultural Press Ltd. Hong Kong in 1998.

PMID- 11191754
TI  - [Progress on studies of nikkomycin structure and some genes related to nikkomycin
      biosynthesis].
AB  - Nikkomycin is a kind of new antifungal antibiotics. More than 20 biologically
      active nikkomycin structures have been isolated and the main active structures
      are nikkomycins X, Z, I, J. Here, we introduce the progress on the studies of
      nikkomycin structures, the relationships between nikkomycin structure and
      biological activity, and genes related to nikkomycin biosynthesis.

PMID- 11191755
TI  - [Studies on the construction and expression of recombinant human fusion gene Nm23
      H1/HbFGF in Escherichia coli].
AB  - First, a piece of intermediate nucleic acid chain was designed according to the
      nucleic acid sequences of Nm23-H1 and HbFGF cDNA, then it was combined with the
      upstream primer of Nm23-H1 or the downstream primer of HbFGF to perform
      Polymerase Chain Reaction (PCR) respectively. The fusion gene Nm23-H1/HbFGF was
      constructed by four steps of PCR, and it was cloned into the plasmid vector
      pBV220. The recombinant was induced at 42 degrees C and analyzed by SDS-PAGE.
      Results show that the fusion gene Nm23-H1/HbFGF highly expresses its product in
      inclusion body in E. coli BL21(DE3). The expressing product is 14% of the total
      bacterial protein and it is 34 kD. ELISA assay and Western blot indicate that the
      inclusion body contains antigens of Nm23-H1 and HbFGF. By denaturation,
      renaturation and purification, the inclusion body was purified. Determination and
      biological activity assay show that the purified product contains two kinds of
      antigens which have biological activities of Nm23-H1 and HbFGF. All these data
      establish good base to study the tumor suppressor activity and oncogenicity of
      the fusion gene Nm23-H1/HbFGF in eukaryocyte.

PMID- 11191756
TI  - [Gene cloning, expression and purification of its production of recombinant human
      superoxide dismutase].
AB  - Human SOD cDNA was cloned and constructed an expression plasmid with high
      sufficient and stabilility expression in E. coli. The rhSOD cDNA was amplified by
      RT-PCR with the template of the total RNA extracted from human liver tissue. The
      expression plasmid, pLY-4/rhSOD, containing rhSOD cDNA, was transformed into the
      E. coli JF1125. The sequence of the cloned rhSOD cDNA was identified with the
      reported data. The expression level reached to more than 68% of total bacteria
      proteins; The technology for protein renature and purification was efficiency and
      fast. The purity of the final products reached more than 98%. The value of
      bioactivity was determined as 2529 u/mg. This study gave enough support for
      production of rhSOD by biotechnology.

PMID- 11191757
TI  - [Expression of human GDNF in methyltrophic yeast Pichia pastoris and silkworm
      larvae].
AB  - The cDNA encoding glial cell derived neurotrophic factor (GDNF) was cloned into
      the Pichia expression vector pPIC9K and then transformed into his4 mutant yeast
      GS115 by electroporation. Multicopy transformants were screened by various G418
      concentrations and induced by methanol. The human GDNF gene was cloned into the
      baculovirus transfer vector pBacPAK8. The recombinant transfer vector pBacPAK
      GDNF was coinfected with linear Bm-BacPAK6 DNA into BmN cells. The recombinant
      virus was screened and plaque-purified. The silkworm larvae were infected with
      the recombinant virus and collected 5 days later. SDS-PAGE and Western blot
      confirmed that GDNF was expressed in Pichia culture medium and silkworm larvae
      hemolymph. The GDNF protein expressed in Pichia and silkworm larvae could
      significantly promote the survival and neurite outgrowth of dopaminergic neurons.

PMID- 11191758
TI  - [Fusion and expression of the gene encoding human Mn-SOD to anti-CEA single-chain
      antibody in Escherichia coli].
AB  - The gene encoding human manganese-superoxide dismutase (Mn-SOD) was fused to anti
      carcinoembryonic antigen single-chain antibody gene to construct the fusion gene,
      then was ligated into prokaryotic expression vector pET-22b(+), The fusion gene
      was expressed in E. coli at high level, accounting for 24% of the total bacteria
      soluble protein; and was characterized by SDS-PAGE and Western-blot analysis; the
      expression product had the CEA-binding ability in RIA, and also had the SOD
      activity by pyrogallol autoxidation assay. So, the Mn-SOD moiety retains
      substantial enzymatic activity, where the ScFv moiety can deliver the fusion
      protein to tumor, Mn-SOD is a potential tumor-suppressor gene, maybe the fusion
      protein can provide a new pathway to tumor therapy.

PMID- 11191759
TI  - [Cloning of the zot gene of Vibrio cholerae and its expression in Escherichia
      coli].
AB  - The zot gene encoding Zonula occludens toxin was amplified from classic Vibrio
      cholerae genomic DNA by PCR. The result of sequencing indicated that zot gene
      encodes 399 amino acid residues. The sequence of zot gene was a little bit
      different from that of reported including 14 nucleotides and four amino acid
      residues. The expression plasmid pET-ZOT was constructed by inserting zot gene
      into plasmid pET-28a(+) containing the T7 promoter. The expression plasmid was
      induced into E. coli BL21 (DE3) and expression strain BLZOT was selected. SDS
      PAGE analysis revealed that the ZOT protein was expressed and accumulated up to
      above 15% of bacterial soluble protein after induced by IPTG. A protein of 47 kD
      was expressed as including body. Western blot analysis revealed that the
      expressed protein was ZOT.

PMID- 11191760
TI  - [Studies of cloning and expression of rat alpha-amidase gene in Streptomyces
      lividans].
AB  - alpha-Amidase catalyzes the C-terminal amidation of active polypeptides in the
      Nerve-Endocrine system. It is important for full biological activity of the
      polypeptides. By using the total RNA of rat atrium as a templet, the cDNA
      encoding alpha-amidase was amplified by RT-PCR and sequenced. The cDNA was fused
      with the coding sequence of mel C1 signal peptide to produce fusion gene mel/AE
      for secretive expression in Streptomyces lividans. The fusion gene mel/AE was
      inserted into plasmid pIJ680 and the recombinant plasmid pIJ-mel/AE680 was
      obtained. The results of SDS-PAGE and biological activity showed that the
      recombinant strain S. lividans TK54[pIJ-mel/AE 680] produced secretly alpha
      amidase.

PMID- 11191761
TI  - [Construction and application of an Escherichia coli high effective expression
      vector with an enhancer].
AB  - In this study, we constructed a high effective fusion expression-vector in E.
      coli. This vector, pTO-T7, was characterized as: (1) an enhancer from tobacco
      mosaic virus (TMV), omega sequence, was ligated in front of a T7 promoter in the
      regulatory sequence; (2) the multi-cloning sites include eight restriction enzyme
      sites. It can facilitate fusion or nonfusion expression; (3) the N terminal of a
      fusion protein starts with the first 12 amino acids of T7 gene 10, and the C
      terminal is the hexahistidine tag; (4) kanmycin resistance gene was used as a
      selective marker. EGFP gene was inserted into pTO-T7 vector as a reporter gene.
      Expression data showed that fused-EGFP accounted to more than 50% of the total E.
      coli protein, and more than 90% of which was soluble. The fluorescence characters
      of fused-EGFP were also studied. The expression yield of target gene from plasmid
      pTO-T7 compared with that from pT-T7 without omega sequence suggested that omega
      sequence in pTO-T7 can improve the expression of target gene significantly.

PMID- 11191762
TI  - [Construction of fusion recombinant plasmid coding for RGD peptide and urokinase
      B chain, its expression in Escherichia coli and preliminary characterization of
      its biological activity].
AB  - A synthetic RGD (Arg-Gly-Asp) peptide-coding sequence was fused with urokinase B
      chain cDNA and then cloned into the prokaryotic expression vector pBV220. The
      fused gene was expressed in E. coli DH5 alpha under the control of PRPL promoter
      by 42 degrees C induction. The expression level of the fusion protein was over
      9.2% of the total bacterial proteins as a or of inactive inclusion body. The
      purified fusion protein was obtained with similar antigenicity as urokinase shown
      by Western blotting. Its in vitro fibrinolysis and anti-platelet aggregation
      activity was also evaluated by bioassay.

PMID- 11191763
TI  - [Transfer of cry1C gene into Bacillus thuringiensis by electroporation to
      construct strain with broader insecticidal activity].
AB  - Three Transformants were selected by transferring cry1C into Bacillus
      thuringiensis strain YBT1535. Plasmid profiles, PCR and Southern blot result all
      proved that cry1C had been transferred into strain YBT1535. Bioassay results
      showed that the transformants of strain YBT1535 displayed significantly higher
      toxicity against Spodoptera exigua than strain YBT1535, but the toxicities
      against Heliothis armigera and Plutella xylostella did not rise except
      transformant YBT1535-2.

PMID- 11191764
TI  - [A recombinant fowlpox virus expressing the fusion protein of Newcastle disease
      virus strain F48E8 and its protective efficacy].
AB  - The transfer vector pFGF1175-1 was constructed by insertion the fusion protein
      gene of Newcastle disease virus (NDV) F48E8 strain into the insertion vector
      pFG1175-1, downstream of P7.5 promotor, and then transfected chicken embryo
      fibroblast (CEF) cell cultures which had been infected with fowlpox virus (FPV)
      Chinese vaccine strain 282E4 for 3-4 hours. Recombinant FPV with blue plaques
      were selected and purified in CEF cell culture laid agar containing X-gal. The
      recombinant FPV named rFPV-NDF was confirmed expressing NDV fusion protein by
      indirect immunofluorescence assay, and could protect chickens against virulent
      NDV challenge, The protective rate was 96.7%.

PMID- 11191765
TI  - [Expression of 2.1 kb enhancin gene fragment from Helicoverpa armigera granulosis
      virus in Escherichia coli].
AB  - The 2.1 kb fragment of enhancin gene from Helicoverpa armigera granulosis virus
      was inserted into vector pQE-30 and expressed successfully in E. coli M15(pREP4).
      The synergy of expression product(P78) on AcMNPV against the larvae of Plutella
      xylostella was also studied. The results indicated that the percentage of correct
      mortality of the larvae increased 27.88%-32.92% in 10 post-infection days.

PMID- 11191766
TI  - [Isolation and characterization of promoters from Phanerochaete chrysosporium].
AB  - Promoter-probe vector pSUPV8 was used to clone promoters from Phanerochaete
      chrysosporium directly in Escherichia coli. Six hygromycin B-resistant
      recombinants were obtained and two inserted fragments of them were sequenced. The
      results indicated that they contain several sequences similar to eukaryotic cis
      regulatory elements. Only pCH6 could transform P. chrysosporium into hygromecin B
      resistance. PCR and dot hybridization analysis indicated that it was introduced
      into P. chrysosporium successfully and leaded to the HmB-resistance. The results
      demonstrated that HmB-resistant gene (hph) could be used as an ideal reporter
      gene for P. chrysosporium transformation.

PMID- 11191767
TI  - [Research on improving rice resistance to the pest by B.t. and SBTi genes].
AB  - B.t. gene alone or and SBTi gene together were introduced into two elite indica
      rice varieties grown in South China by bombardment. And 21 independent transgenic
      lines containing B.t. gene and 4 independent transgenic lines containing B.t.
      gene and SBTi gene were obtained. Molecular and genetics analysis for R1 plants
      showed integration of multiple transgenes occurred at one genetic locus. Northern
      blot result proved B.t. gene expressed in R2 transgenic plants stably. Bioassays
      using R2 transgenic plants with leaf-folder (Cnaphalocrosis medinalis), indicated
      that transgenic rice plants are more resistant to the pest than untransformed
      control plants. And those transgenic plants containing B.t. and SBTi genes showed
      more resistance compared with those plants containing B.t. gene.

PMID- 11191768
TI  - [Direct embryogenesis from protoplast of winter wheat].
AB  - Friable embryogenic calli were obtained on a modified N6 medium (NBD medium) from
      a winter wheat cultivar "Jinghua No. 1" (Triticum aestivum L. cv. Jinghua No. 1)
      and were transferred to a modified MS liquid medium (MSDL medium) to initiate
      embryogenic suspension cultures. Protoplasts were isolated from the suspensions
      and cultured on a modified MS medium (MSDP medium). The somatic embryoids were
      formed directly from the protoplasts and germinated into entire plants. The
      development of the somatic embryoids was very similar to that of zygotic embryos
      of wheat.

PMID- 11191769
TI  - [Study on gallic acid preparation by using immobilized tannase from Aspergillus
      niger].
AB  - Immobilized tannase which had higher ability of transforming tannin from Chinese
      gallotannin into GA was prepared by embedding tannase with calcium alginate
      carrier. The immobilization conditions and some properties of the immobilized
      tannase were studied. The results showed that: The optimal immobilized parametres
      were 90 mg sodium alginate, 546 u(182 u/mL) tannase and 1%-2% CaCl2. The optimum
      temperature and pH value of immobilized tannase were 45 degrees C and 6.5,
      respectively. It was stable in the temperature range of 10-50 degrees C and
      between pH5-7. Based on the optimum program, the laboratory gramme-grade
      preparation experiments of GA were done. The average yield of GA product in three
      preparations was upto 61%, and was about equivalent to the yield of acidic
      hydrolytic method which is used to produce GA industrially now. Thus, the
      research results possessed potential applied value.

PMID- 11191770
TI  - [Photoautotrophic cultivation of Synechococcus sp. PCC7002 in photobioreactor].
AB  - The Photoautotrophic cultivation of Synechococcus sp. PCC 7002 in a 15 L-airlift
      photobioreactor was carried out. The changes of light intensity with cell density
      and optical length in the cultivation system were investigated. Based on
      experimental results, the light attenuation could be described by I = I0exp [-(
      0.0239 + 0.0777 OD750).L]. The effects of the variations of light intensity, CO2
      concentration in gas inlet and culture temperature on the growth of cells during
      the cultivation process have also been studied. The optimized condition was
      determined and a high dry cell density of 3.4 g/L was obtained. The volumetric
      productivity reached 0.57 g/(L.d) under the optimized condition.

PMID- 11191771
TI  - [The ex vivo expansion of cord blood hematopoietic cells: 1. Cell growth
      behavior].
AB  - The population growth and metabolism of hematopoietic cells from cord blood were
      investigated without and with hematopoietic growth factors and the long-term
      growth kinetics of cells was studied. In static cultivation of hematopoietic
      cells, the population specific growth rate was 0.34 d-1, and the average double
      time 2 days. The greater part of glucose was consumed and 40 mmol/L lactate was
      formed during cell culture. For the long-term culture, the maximum output of CFU
      GM appeared between the 2nd and 3rd weeks and that of BFU-E in the first week.
      With 50% medium exchange, the expansions of total cells, CFU-GM, and BFU-E came
      up to 14, 13, and 5 times, respectively.

PMID- 11191772
TI  - [Asymmetric biosynthesis of chiral styrene oxide].
AB  - Used styrene as the sole carbon and energy source, 12 strains of aerobic
      bacterial and two strains of fungi were screened from a series soil samples.
      These strains were able to convert styrene to styrene oxide. HPLC and chiral GC
      method were used for determination the substrate, product and e.e value of
      culture broth. There were obvious effect on the biomass and epoxidase activity
      under various conditions in the fermentation. Styrene epoxidation of the strain
      PS-1206 was studied in different reaction time. 35% of conversion yield and 80%
      e.e value of (R)-styrene oxide could been obtained at the optimum conditions.

PMID- 11191773
TI  - [Metabolic calculation of the growth phase in rHSA fermentation].
AB  - The model equations of the growth phase of rHSA fermentation were derived on the
      base of both elemental balance and metabolic balance. The unknown parameters of
      the model were estimated by multivariable optimization. The model can preferably
      describe the relations between different macroscopic reaction rates of the
      process and provide the key for the high-density cultivation of Pichia pastoris.

PMID- 11191774
TI  - [Coupling model of the substrate premeabling through the cytoplasmic membrane and
      Monod kinetics].
AB  - Based on the analysis of the substrate permeabling through the cytoplasmic
      membrane, the corresponding simple transport models are proposed. By coupling of
      the model with the Monod kinetics, it was discovered that form of Monod kinetics
      doesn't change, but the kinetics parameter affected by the transport processes.
      This result is fit well with the literature conclusion and experimental data.

PMID- 11191775
TI  - [Construction and expression of coexpression plasmid of carcinoembryonic antigen
      and Newcastle disease virus HN gene].
AB  - The eukaryotic expression plasmid (pcDNA3-CEA) containing with the gene coding
      for the Carcinoembryonic antigen(CEA) had been gotten with RT-PCR and gene
      recombination techniques. Using enzymolysis, ligation and other techniques, an
      eukaryotic coexpression plasmid(pcDNA3-CEA/HN) containing two expression unites
      of CEA and Newcastle disease virus HN gene that may have the function of
      immunoenhancement had been constructed. The plasmid will lay a foundation for
      further researching CEA nucleiotide vaccine, adjuvant and their effect of special
      antitumor immune.

PMID- 11191776
TI  - [Proliferation of attenuated infections bursal disease virus(IBDV) on Vero cell
      on large scale].
AB  - Vero cell was selected as productive carrier in production of Attenuated IBDV.
      The optimal conditions in culturing IBDV in agitating bottle were figured out.
      After proliferation, supernatant was harvested in batch process under the
      condition of five-liter-agitated fermenter. The result shows it was successful to
      culture IBDV by this methodology.

PMID- 11191777
TI  - [The medium optimization of xylitol fermentation based on neural networks and
      genetic algorithms].
AB  - Using genetic algorithms(GA) for medium optimization of xylitol fermentation, and
      coupling neural networks model for predicting xylitol concentration is
      introduced. The medium compose determined by GA is as input data of the neural
      networks, while the output data predicted by neural networks is as suitable value
      of GA for predicting. The optimum medium is further validated by experimentation.
      The good result, which save the experimental workload and charge, enhance the
      level of xylitol fermentation as well as reduced the medium consume is obtained.

PMID- 11191778
TI  - [Two different fermentation techniques of steriod 1,4-dehydrogenation and 11
      alpha-hydroxylation].
AB  - Two kinds of micro-organism, Arthrobacter sp. AX86(1,4-dehdrogenator) and Absidia
      sp. A28(11 alpha-hydroxylator) were used in this experiment. Two different
      fermentation techniques were performed to accomplish the multiple conversional
      reactions for producing 16 beta-methyl-11 alpha,17 alpha,21-trihydroxy-1,4
      pregnadiene-3,20-dione(III) from 16 beta-methyl-3 beta,17 alpha,21-trihydroxy-5
      alpha-pregnane-20-one-21-acetate(I): 1) To produce product(III) by means of a two
      step fermentation method which were independently performed first by Arthrobacter
      and next by Absiaia, and 2) the product was obtained by a sequential fermentation
      system of aforesaid two micro-organisms in a single fermentor without isolation
      of the intermediates from the mixture. Our results showed that in both
      fermentation systems high yield of product was obtained. However, according to
      the technical simplicity, shorter duration of fermentation cycle and efficient
      yield of product, the second method is better than the first one.

PMID- 11191779
TI  - Questioning validity in the area of ergonomics/human factors.
AB  - This paper focuses on the analysis of deviation in findings within
      ergonomics/human factors (E/HF) research. The current terms used to address the
      analysis of deviation in empirical research revolve around the notion of
      validity. In E/HF research papers, 'validity' is widely interpreted and includes
      its common parlance usage. More importantly, analysis frequently limits
      'validation' to the equivalent of 'verification', eventually resulting in
      'validity' as a label of little significance. To clarify the analysis of
      deviation, 'investigative syntaxes' are introduced to show what exactly should or
      can be questioned when deviation is observed, i.e. either empirical findings or
      propositions, and how this questioning can be structured. The possibility is
      discussed that, with or without the help of these syntaxes, validation may become
      a method of inquiry; a productive means of generating significant theoretical
      questions which bear directly on empirical work.

PMID- 11191780
TI  - Learning from errors in a driving simulation: effects on driving skill and self
      confidence.
AB  - Two experiments investigated the effect of making errors during training (error
      training) on a driving simulator versus learning from examples of errors (guided
      error training) on driving skill and confidence. Experiment 1 indicated that
      compared with errorless learning (where participants drove through a training run
      not designed to elicit errors), error training led to significantly better
      transfer to driving tests that were analogous to those situations encountered in
      training and more effective use of strategies for coping with a novel driving
      situation. Error training also reduced self-confidence in driving skill at the
      end of training relative to errorless learning. Experiment 2 provided weak
      evidence of the superiority of guided error training over errorless learning
      (where the driver in the video did not make any errors) on analogous tests, and
      no evidence of transfer to a novel test. Furthermore, guided error training did
      not influence self-confidence in driving skill. The potential value of driving
      simulators in providing active processing during driver training is discussed,
      along with the effects of passive and active exposure to errors on driver
      confidence.

PMID- 11191781
TI  - Drivers' impressions of front and rear gaps in queues.
AB  - Drivers' opinions on, and perception of, gaps to a leading and a following car
      were studied in two field experiments. In study 1, the drivers indicated their
      opinion on adequate, critical and legal gap to a leading and a following car at
      40 and 80 km/h. The results showed that drivers indicated longer front gaps than
      rear gaps in all conditions. In study 2, the drivers made judgements of distance
      to a leading and a following car when standing still and when travelling at 80
      km/h. They were also asked to manoeuvre to a position in the middle between the
      leader and the follower. The results in study 2 revealed a perceptual bias in the
      driver when travelling at 80 km/h in that the drivers were closer to the follower
      when they thought they were in the middle between the leader and the follower.
      Gaps were generally underestimated and front gap was more underestimated than
      rear gap. The differences between opinions on gaps in the forward and the
      rearward directions could, partly, be explained by a perceptual bias in the
      driver. The bias should have a safety-promoting effect since it makes the driver
      more tolerant against short rear gaps than without the bias.

PMID- 11191782
TI  - The 'Wheel of Misfortune': a taxonomic approach to human factors in accident
      investigation and analysis in aviation and other complex systems.
AB  - The analysis and reporting of the human factors aspects of accidents in aviation
      and other complex systems continues to present difficulties for investigators and
      analysts alike. Reason's 'latent conditions' model has had a major impact on the
      way accidents are conceptualized but it has proven difficult to apply as a
      practical tool. Recent attempts to overcome these difficulties are discussed and
      an alternative conceptualization is proposed. This conceptualization is based on
      a blend of several well-supported theoretical models in cognitive engineering and
      can be used to formulate a parsimonious analysis system for the investigation and
      reporting of the human factors aspects of accidents. Two well-known examples of
      transportation disasters are briefly described and related to the proposed
      conceptual framework. The proposed framework serves three important functions in
      accident investigation and analysis: a heuristic function, an investigative
      function, and an integrative function.

PMID- 11191783
TI  - Impact of fluid replacement on heat storage while wearing protective clothing.
AB  - This study used partitional calorimetry to determine the influence of fluid
      replacement on heat storage during uncompensable heat stress. Eight males
      performed either light (L; level treadmill walking at 0.97 m x s(-1) (3.5 km x h(
      1)) or heavy (H; 1.33 m x s(-1) (4.8 km x h(-1)) at a 4% grade) exercise at 40
      degrees C and 30% relative humidity while wearing nuclear, biological and
      chemical (NBC) protective clothing. Subjects received either no fluid (NF), or
      200 or 250 ml of fluid (F) as warm water at approximately 35 degrees C
      immediately before and every 15 min during the L and H trials respectively.
      Similar reductions in heart rate were observed at both metabolic rates with F but
      rectal temperature responses were not different between F and NF. Tolerance time
      was extended during L/F (106.5 +/- 22.1 min) compared with L/NF (93.1 +/- 20.8
      min) but fluid replacement had no influence during H (59.8 +/- 9.5 min and 58.3
      +/- 11.1 min for F and NF respectively). Fluid replacement also had no effect on
      the rate of heat storage during L (108.2 +/- 20.6 W x m(-2) and 111.0 +/- 22.6 W
      x m(-2) for F and NF respectively) and H (172.5 +/- 11.5 W x m(-2) and 182.1 +/-
      15.8 W x m(-2) for F and NF respectively). However, heat storage expressed per
      unit of mass was significantly increased during L/F (18.5 +/- 4.0 kJ x kg(-1) )
      compared with the other trials (16.3 +/- 4.8 kJ x kg(-1), 16.6 +/- 3.0 kJ x kg(
      1) and 16.7 +/- 4.0 kJ x kg(-1) for L/NF, H/F and H/NF respectively). It was
      concluded that fluid replacement does not alter the rate of heat storage during
      uncompensable heat stress but does increase the heat storage capacity during
      light exercise when tolerance times are > 60 min.

PMID- 11191784
TI  - Effects of box weight, vertical location and symmetry on lifting capacities and
      ratings on category scale in Japanese female workers.
AB  - The aim was to clarify the effects of box weight, vertical location and symmetry
      on the lifting capacities and subjective burden in Japanese female workers with
      manual material handling tasks. Sixteen healthy females were tested. They
      performed 12 different lifting tasks (three heights * two weights * two
      symmetries). It is difficult for Japanese women to exert dynamic force in lifting
      a 15-kg weight from the elbow to the shoulder level. A remarkable increase was
      observed in heart rate and category scale with ratio properties (CR-10) on large
      muscle group in lifting a 15-kg weight as compared with lifting a 10-kg one.
      Judging from calculation of the Recommended Weight Limit using the application
      manual by the National Institute for Occupational Safe and Health, it was also
      suggested that lifting the 15-kg weight from the elbow to the shoulder level was
      difficult for female workers. Not only peak force, but also the average upward
      acceleration and peak velocity were lower in asymmetric liftings than those in
      symmetric liftings. CR-10 for the left back and right thigh were also higher in
      90 degrees right lateral plane lifting than in the mid-sagittal plane. Thus,
      asymmetric lifting was supposed to impose higher stress on the back
      contralaterally and thigh ipsilaterally to the location of the weight.

PMID- 11191785
TI  - Effects of training on short- and long-term skill retention in a complex multiple
      task environment.
AB  - The paper reports the results of an experiment on the performance and retention
      of a complex task. This was a computer-based simulation of the essential elements
      of a spacecraft's life support system. It allowed the authors to take a range of
      measures, including primary and secondary task performance, system intervention
      and information sampling strategies, mental model structure, and subjective
      operator state. The study compared the effectiveness of two methods of training,
      based on low level (procedure-based) and high level (system-based) understanding.
      Twenty-five participants were trained extensively on the task, then given a 1-h
      testing session. A second testing session was carried out 8 months after the
      first (with no intervening practice) with 17 of the original participants. While
      training had little effect on control performance, there were considerable
      effects on system management strategies, as well as in structure of operator's
      mental model. In the second testing session, the anticipated general performance
      decrement did not occur, though for complex faults there was an increase in
      selectivity towards the primary control task. The relevance of the findings for
      training and skill retention in real work environments is discussed in the
      context of a model of compensatory control.

PMID- 11191786
TI  - [Fine tuning of diagnostic procedures for gunshot wounds in the neck region].
AB  - In four patients, two men aged 25, and two aged 23 and 22 years, who were
      admitted or came to the emergency department, a gunshot wound was found in the
      cervical region. Physical examination is still the key to responsible treatment
      in such patients--immediate surgical exploration is seldom warranted. It is
      important to divide the cervical region into three anatomical parts depending
      upon the location of the entrance wound: zone 1 is the area between clavicula and
      cricoid cartilage, zone 2 between cricoid cartilage and angle of the mandible,
      and zone 3 between the angle of the mandible and the cranial base. Zones 1 and 3
      have deep vital structures which are less accessible to physical investigation or
      surgical exploration. This should be taken into account in deciding for
      additional diagnostic procedures, such as angiography.

PMID- 11191787
TI  - [The "best" hospitals in the Netherlands; comments on results from the Elsevier
      survey].
AB  - Health care workers are increasingly asked to disclose the achievements and
      failures of their medical interventions. Comparative evaluation of hospitals
      seems to be inevitable. In July 2000 about 6000 health care workers in the
      Netherlands received a questionnaire from the general lay weekly Elsevier asking
      them to grade the hospitals in their area: specialists, general practitioners,
      heads of departments in hospitals, nursing staff and hospital directors. The
      questionnaire has serious methodological flaws, e.g. regarding the items included
      (such as 'press sensitivity' and 'waiting lists'), the way in which the score was
      determined (hospitals that were scored by less than 14 respondents were
      excluded), the way the questions were formulated (there was no way respondents
      could indicate their level of experience with the hospitals involved) and the
      very low response rate (13%). In addition there were no data to determine the
      accuracy of the questionnaire, the distribution of the respondents, or whether
      the answers had been adjusted. The questionnaire appears to be primarily aimed at
      creating sensation. It received little attention in the health care sector,
      probably because the results were contrary to the expectations. Hospital care
      will undoubtedly benefit from surveys applying a limited number of well-designed
      indicators for quality of service, but a questionable public qualification based
      on a competitive model such as the Elsevier questionnaire will probably do more
      harm than good.

PMID- 11191788
TI  - [Proatherogenic changes induced by hemodialysis; probably a result of bio
      incompatibility].
AB  - Chronic haemodialysis patients have a disproportionately high risk for developing
      cardiovascular disease, which can only in part be explained by known risk factors
      such as dyslipidaemia, hypertension, hyperhomocysteinemia, diabetes mellitus and
      chronic volume expansion. A possible cause is that the haemodialysis treatment
      itself contributes to the accelerated atherosclerosis, observed in these
      patients. Nowadays, atherosclerosis is considered an inflammatory process,
      mediated by a dysfunction of the vascular endothelium. As a result, blood cells
      adhere to the vascular surface and release a variety of vasoactive mediators,
      cytokines, growth factors and free radicals. Due to the contact between blood and
      dialyzer, humoral systems and cellular elements are stimulated, and this may be
      viewed as an inflammatory reaction. As a consequence of this, the vascular
      surface of haemodialysis patients is repeatedly exposed to the influences of
      cytokines, coagulation products, vasoactive mediators, stimulated leukocytes and
      thrombocytes, and oxidative stress. It is therefore conceivable that the
      haemodialysis treatment itself enhances the greatly increased cardiovascular risk
      in chronic haemodialysis patients.

PMID- 11191789
TI  - [What is to be done with vancomycin-resistant enterococcal infections?].
AB  - Recently, three epidemics in Dutch hospitals were caused by vancomycin-resistant
      enterococci (VRE). Although the number of infections was small, spread of
      colonization was extensive and many infection control measures were necessary to
      prevent further spread. VRE are relatively avirulent bacteria. However, few, if
      any, antibiotics are available for treatment of infections caused by VRE and the
      genetic code for resistance may be transferable to other, more virulent,
      bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA). Although
      colonization and infection with MRSA have become endemic in many surrounding
      countries, such a situation has been prevented in the Netherlands by employing an
      aggressive 'search and destroy' policy. Although many questions regarding the
      optimal approach of VRE remain unanswered, a similar policy as employed for MRSA
      will not be possible. In contrast to MRSA, colonization with VRE occurs in the
      open population, no populations with increased risk for colonization appear to be
      definable and colonization cannot be eradicated. Based on common sense, a
      differentiated approach seems indicated in which extensive infection control
      measures should only be implemented when spread of a single genotype has been
      demonstrated. A reference laboratory should be created for uniform genotyping.

PMID- 11191790
TI  - [From gene to disease; from BRCA1 or BRCA2 to breast cancer].
AB  - Hereditary breast cancer is a heterogeneous syndrome, both phenotypically and
      genetically. It affects about 5% of all breast cancer patients. The presence of
      ovarian cancer or breast cancer in males defines important subtypes. BRCA1 and
      BRCA2 are involved in all hereditary breast cancer syndromes in varying degrees.
      Both genes confer strongly elevated breast and ovarian cancer risks in mutation
      carriers, but these risks may be subject to modifying effects by other factors
      (genetic and/or environmental) at the individual level. In the Netherlands, DNA
      testing is offered under the national health insurance programme and has led to
      the identification of over 500 families with either a BRCA1 or BRCA2 mutation.
      The results of the test are being used widely by Dutch women in the decision for
      or against prophylactic surgery.

PMID- 11191791
TI  - [Diagnostic image (18). Pulmonary tuberculosis].
AB  - In an 8-year-old Somali girl who had been in the Netherlands for 3 years and who
      was suffering from cough for 2 months, tuberculosis of the lung was diagnosed.

PMID- 11191792
TI  - [Psychiatric research in Southern Netherlands; most studies get completed, social
      scientific ones more often than pharmacotherapeutical trials].
AB  - OBJECTIVE: To describe the nature and the course of scientific studies in
      psychiatry that have been reviewed by the Research Ethics Committee in the South
      Netherlands (Toetsingscommissie Zuid-Nederland (TCZ)). DESIGN: Exploratory,
      retrospective. METHOD: Scientific studies in psychiatry that were submitted for
      review in the period 1 January 1988-31 December 1998 by TCZ, were investigated to
      determine their progress and to find out what study features were prognostic for
      completion. RESULTS: In this research project 131 psychiatric studies, which were
      expected to be completed towards the end of 1998, were considered for inclusion.
      Approximately 2/3 of all studies had a social-scientific character, 1/3 being
      pharmacotherapeutical. 116 cases were reviewed and 114 selected. From the 88
      studies started, 77 had been completed. Out of these 77 completed studies 75 have
      been presented and/or published. Seven patients were involved in four studies
      that were stopped prematurely; they were possibly incorrectly burdened. Studies
      described as experimental, painful, pharmacotherapeutical, externally initiated,
      externally financed or multicentered ran a greater risk of not being completed
      than studies without these characteristics. Topics such as a limited number of
      subjects, a large burden or a long duration also jeopardized the successful
      completion of a study. A multivariate analysis showed that the
      pharmacotherapeutical nature of studies was the most important predictor.
      CONCLUSION: In the psychiatric hospitals of the South Netherlands scientific
      research has been carried out. Many of the studies that were approved by the TCZ
      were started and completed. Pharmacotherapeutical research ran a greater risk of
      non-completion than social-scientific research.

PMID- 11191793
TI  - [Prevalence of lower urinary tract symptoms in men and its influence on their
      quality of life: Boxmeer Study].
AB  - OBJECTIVE: To assess the prevalence of lower urinary tract symptoms (LUTS) in men
      and its influence on quality of life. DESIGN: Questionnaire investigation.
      METHODS: Recruitment of subjects was conducted in 1998 in the municipality of
      Boxmeer. Men in the age range between 40-79 years were sampled from the
      Municipality Basic Administration System. Data on LUTS, quality of life, and
      health care seeking behaviour were collected with a postal questionnaire.
      Severity of LUTS was evaluated with the Dutch translation of the seven items of
      the International Prostate Symptom Score (IPSS), to which 6 questions were added
      regarding micturition frequency, dribbling, difficulty to start micturition,
      painful micturition, decreased force of stream since the age of twenty, and how
      long one could wait before micturition from the moment urge was noticed. The
      female partners of the respondents were asked to answer the questions as well.
      RESULTS: 1233 men completed the questionnaire, a response of 70%. One-fifth of
      all participants reported moderate to severe symptoms. Dribbling, reduced force
      of stream and urgency appeared to be the three most prevalent symptoms. The
      prevalence of LUTS increased with age: 10% of men aged 40-49 reported moderate to
      severe symptoms (IPSS > 7) compared with 44% of men over 70. Twenty-nine per cent
      of the men with severe LUTS reported poor disease specific quality of life, while
      another 28% of these men reported excellent disease specific quality of life. All
      men with mild symptoms reported excellent quality of life. Nine percent of all
      men consulted a doctor because of LUTS, with a mean delay of 10 months. The LUTS
      frequencies among the female partners equalled those among the responding men.
      CONCLUSION: LUTS were common among men over forty and among their female
      partners. The prevalence increases with age. Ageing of the population may lead to
      increased numbers of men experiencing LUTS and to concomittant medicalization
      costs. It is therefore of great importance to realise that the impact of symptoms
      on the reported quality of life was not pronounced.

PMID- 11191794
TI  - [Thoracoscopic clipping of thoracic duct in a woman with persisting chylothorax].
AB  - A 78-year-old female had chest pain, radiating to the back, caused by a thoracic
      aneurysm of the aorta. A vascular prosthesis was sutured into place through a
      left-sided thoracotomy. Six days after the operation she developed chylothorax on
      the right side. Following 14 days of conservative management, chyle leakage
      persisted at a rate of 1500 ml per 24 hours. By thoracoscopy the thoracic duct
      was dissected and clipped, which stopped the chyle leakage. The patient recovered
      moderately well. Conservative measures, such as adjusted nutrition, are
      successful in 50% of patients. Clipping of the thoracic duct by thoracoscopy is a
      definitive and minimally invasive procedure to treat persistent chyle leakage.

PMID- 11191795
TI  - [Vancomycin-resistant Enterococcus faecium outbreak in a nephrology ward].
AB  - In April 2000, an outbreak of vancomycin-resistant Enterococcus faecium (VRE) was
      discovered in an internal medicine/nephrology and dialysis ward of the Eemland
      Hospital, Amersfoort, the Netherlands. Although enterococci are considered
      relatively non-virulent, VRE are resistant to almost all commercially available
      antibiotics. Surveillance cultures were obtained from all patients at the ward,
      all patients visiting the dialysis ward and the environment of patients. VRE were
      determined and clustering of strains was analysed using molecular genotyping. In
      all, 12 patients were colonized with the outbreak strain. Transmission of VRE
      usually occurs via the hands of health care workers. The ward was closed for new
      admissions, patients were divided in cohorts of colonized and non-colonized
      patients, and rooms were disinfected after patient discharge. Infection control
      measures (such as handwashing and use of gloves and gowns) were enforced and
      prescriptions of vancomycin and cephalosporins were reduced. With these measures
      the outbreak could be controlled. Epidemiological analysis demonstrated that
      earlier admission and previous use of ciprofloxacin, amoxicillin and amoxicillin
      clavulanic acid were risk factors for colonization. A nearby hospital was a
      possible source of this outbreak.

PMID- 11191796
TI  - [Epidemiologic increase of various genotypes of vancomycin-resistant Enterococcus
      faecium in a university hospital].
AB  - After a report of a possible relationship between an outbreak of vancomycin
      resistant enterococci (VRE) in a nearby hospital and earlier admission of two of
      the patients with this VRE in the University Medical Centre of Utrecht (UMCU),
      the Netherlands, an extensive search for VRE carriers was started in the UMCU. In
      the study period of two months, VRE carriership was diagnosed in 51 patients in
      nine of the 11 wards investigated. Twenty-six patients in eight wards were
      colonized with the same VRE genotype as in the nearby hospital; spread was
      demonstrated in three wards. In addition, six patients of one ward were colonized
      with a second genotype and seven other patients with a third genotype, while 12
      patients were carriers of a unique genotype. Most carriers were found in the
      internal medicine/nephrology and dialysis ward. Far-reaching measures (such as
      cohort nursing, admission stops, use of gowns and gloves, disinfection and
      restriction of use of vancomycin) taken in the four wards where spread was
      demonstrated, appeared effective but in three wards, spread was again
      demonstrated later. Frequent readmissions and transfers of patients appear to
      play an important part in this matter. None of the 51 colonized patients
      developed a serious VRE infection.

PMID- 11191805
TI  - Cultivation-independent techniques for studying methanotroph ecology.
AB  - Methane-oxidizing bacteria (methanotrophs) have attracted considerable attention
      over the past 30 years. They have the unique ability to use methane as sole
      carbon and energy source, they are found in a wide variety of environments and
      play a crucial role in the global methane cycle. Methanotrophs also show
      considerable potential for bioremediation processes such as degradation of ground
      water pollutants, and for production of bulk chemicals from cheap substrates. We
      review here the cultivation-independent molecular biological methods that are
      available for the detection and characterization of methanotrophs in the natural
      environment.

PMID- 11191806
TI  - Current strategies for improving food bacteria.
AB  - Novel concepts and methodologies are emerging that hold great promise for the
      directed improvement of food-related bacteria, specifically lactic acid bacteria.
      Also, the battle against food spoilage and pathogenic bacteria can now be fought
      more effectively. Here we describe recent advances in microbial physiology and
      genomic research of these organisms that enable novel strategies for obtaining
      safe, healthy, and good-tasting fermented food products.

PMID- 11191807
TI  - Transposon-mediated insertional mutagenesis of the D-alanyl-lipoteichoic acid
      (dlt) operon raises methicillin resistance in Staphylococcus aureus.
AB  - Two independent mutants of methicillin-resistant Staphylococcus aureus (MRSA),
      KAN96H1 and KAN96H2, were isolated by insertional mutagenesis with conjugative
      transposon Tn918. In both, the minimal inhibitory concentration (MIC) of
      methicillin was increased to 128 compared to 16 mg/L for the parental strain
      KAN96. By transduction experiments, we verified that the insertion of Tn918
      conferred higher methicillin resistance on KAN96H1, but not on KAN96H2. In
      KAN96H1, the integration site of Tn918 was located in the 6.1-kb HindIII fragment
      of the KAN96 chromosomal DNA. We identified a novel D-alanyl-lipoteichoic acid
      (dlt) operon of S. aureus in this fragment. The amino acid sequences of four open
      reading frames of this operon were highly homologous to those of the dlt operon
      genes of Bacillus subtilis. The nucleotide sequence of the staphylococcal dlt
      operon is under the accession number D86240 in the DDBJ/GenBank/EMBL databases.
      In KAN96H1, Tn918 was inserted in the 5'-terminal region of the putative dltB
      gene which encoded a hypothetical membrane transporter. dlt transcripts of 4.7 kb
      were detected in KAN96, but were truncated to 2.3 kb in KAN96H1. No corresponding
      transcripts were observed in KAN96H2. Our results clearly demonstrated that
      defects in functions of the putative dlt operon resulted in increased methicillin
      resistance in MRSA.

PMID- 11191808
TI  - Determination of the rpoB gene sequences of Bartonella henselae and Bartonella
      quintana for phylogenic analysis.
AB  - Using the Genome Walker procedure, which allows PCR amplification of genomic DNA
      using a single gene-specific primer and direct automated sequencing methodology,
      we obtained the nucleotide sequence of the RNA polymerase beta subunit (rpoB)
      from Bartonella henselae and Bartonella quintana. A phylogenetic tree constructed
      from these data and other rpoB sequences available in GenBank is, in part,
      consistent with those previously derived from 16S rRNA gene sequences and
      confirms the position of Bartonella within the alpha subdivision of
      Proteobacteria. In fact, this analysis showed that rpoB data are similar to 16S
      rRNA data for the alpha, beta and gamma subdivisions of Proteobacteria. In
      contrast, concerning other bacteria included in our study, the topologies of
      phylogenetic trees were different. Based on the bootstrap values derived from
      rpoB phylogenic analysis, we believe that this molecule should contribute to
      better understanding the evolutionary process.

PMID- 11191809
TI  - Changes in external trehalase activity during human serum-induced dimorphic
      transition in Candida albicans.
AB  - Yeast-like cells (blastoconidia) of Candida albicans growing exponentially on a
      glucose-containing medium (YPD) exhibited low external trehalase activity and
      stored a negligible amount of intracellular trehalose. The addition of human
      serum at 37 degrees C to exponential cultures promoted a high degree of germ-tube
      formation with no significant changes in trehalase activity or trehalose content.
      In contrast, stationary cells accumulated a large amount of trehalose, while
      external trehalase remained at a low and practically constant level. However,
      resting cultures were unable to enter the dimorphic program, except when they
      were supplemented with fresh YPD and serum together. Only under these conditions
      was trehalase activated and trehalose hydrolyzed. Specific inhibition of external
      trehalase by validoxylamine A caused a certain delay in, and a lower level of,
      germ-tube formation, but did not totally block the dimorphic conversion. These
      results suggest that external trehalase is not involved in the serum-induced
      morphological transition in C. albicans.

PMID- 11191810
TI  - The trehalose operon of Pseudomonas fluorescens ATCC 17400.
AB  - The trehalose operon of Pseudomonas fluorescens ATCC 17400 consists of treP, treA
      and treR. The gene treP codes for a putative enzyme II subunit of the
      phosphotransferase system that catalyzes the phosphorylation of trehalose
      together with its translocation across the cell membrane and treA encodes a
      putative phosphotrehalase, which hydrolyzes the incoming trehalose-6-phosphate
      into glucose and glucose-6-phosphate. Both genes are negatively regulated by
      TreR, a repressor of the FadR-GntR family of transcription regulators. The operon
      that is induced by trehalose present in the medium shows a high similarity both
      in the function of genes and in the regulation with the trehalose operon of
      Bacillus subtilis.

PMID- 11191811
TI  - Identification and typing of Streptomyces strains: evaluation of interspecific,
      intraspecific and intraclonal differences by RAPD fingerprinting.
AB  - The suitability of random amplified polymorphic DNA PCR for the detection of
      differences between Streptomyces species and strains was evaluated. For this
      purpose, a protocol of RAPD specific for Streptomyces DNA, i.e. suitable for DNA
      presenting a high G+C content, was developed using S. ambofaciens ATCC23877.
      Among the 30 primers tested, all containing 80% G+C, 17 gave a pattern with this
      strain. Six oligonucleotides were chosen to compare 12 strains belonging to six
      species of Streptomyces. These oligonucleotides were then used to determine
      whether these strains could be differentiated at the DNA level with this method.
      All fingerprints obtained with six primers differed from one species to another.
      We showed that the RAPD method could be used to reveal intraspecific and
      intraclonal polymorphisms. Thus, RAPD allows for the rapid, sensitive and
      specific detection of genetic diversity among species and strains of
      Streptomyces.

PMID- 11191812
TI  - Genotypic characterization of enteropathogenic Escherichia coli (EPEC) isolated
      in Belgium from dogs and cats.
AB  - Enteropathogenic Escherichia coli (EPEC) are isolated from man and farm animals
      but also from dogs and cats. They produce typical histological lesions called
      'attaching and effacing' lesions. Both plasmid and chromosomal elements are
      involved in the pathogenesis of EPEC infection. The presence of these genetic
      elements was investigated in 14 dog and three cat EPEC isolates. A bfpA-related
      gene was detected in five of the 17 isolates in association with high molecular
      weight plasmids, and a locus of enterocyte effacement (LEE) was present in all
      isolates. The LEE was inserted in the selC region in only 12% of the isolates.
      The eae, tir, espA and espB genes were analyzed by multiplex PCR. The results
      indicated the presence of those genes in the tested isolates with heterogeneity
      in the gene subtypes present: eae gamma-tir alpha-espA alpha-espB alpha (65%),
      eae beta-tir beta-espA beta-espB beta (29%), eae alpha-tir alpha-espA alpha-espB
      alpha (6%). Moreover, the espD gene was also present in dog and cat EPEC. The
      DEPEC and CEPEC form a heterogeneous group and five of them are closely related
      to human EPEC.

PMID- 11191813
TI  - Evidence for association of lipopolysaccharide with Pseudomonas fluorescens
      strain MF0 porin OprF.
AB  - Lipopolysaccharide (LPS) was found to be associated with the major outer membrane
      protein OprF of the psychrotrophic bacterium Pseudomonas fluorescens MF0, using
      two OprF purification procedures. OprF, purified under mild conditions, presented
      two types of association with LPS: tight (tLPS) and slight (sLPS), both of type
      R. LPS protected OprF from heat modification and trypsin degradation and
      facilitated the reincorporation of purified OprF into an artificial lipid bilayer
      without affecting its pore-forming activity. The size of the OprF channel
      depended on cell growth temperature, as did the extent of LPS phosphorylation: we
      suggest that LPS may be involved in modifications of OprF pore formation.

PMID- 11191814
TI  - Distribution of catabolic pathways in some hydrocarbon-degrading bacteria from a
      subsurface polluted soil.
AB  - Enrichment cultures on naphtha solvent were used to select aromatic hydrocarbon
      degrading bacteria from a BTEX (benzene, toluene, ethylbenzene, xylene)
      contaminated subsoil obtained from beneath a paint factory located in Milan,
      Italy. Fifteen isolated strains were studied for their different biodegradative
      capacities. Among these, 13 were able to grow on naphtha solvent. Ten were
      identified as Pseudomonas putida and three as Pseudomonas aureofaciens. Two other
      degraders were identified as Pseudomonas aeruginosa and Alcaligenes xylosoxidans
      subsp. denitrificans. Further molecular characterization of the isolates was
      carried out by randomly amplified polymorphic DNA analysis to ascertain that all
      the studied strains belonged to different haplotypes. The isolates were
      characterized for the presence of genes encoding for toluene dioxygenase, xylene
      monooxygenase and catechol 2,3-dioxygenase by polymerase chain reaction analysis
      and by Southern analysis. P. putida strain CM23, which showed homology with
      xylA,M, xylE and todC1C2BA genes, possessed multiple pathways which enabled the
      strain to grow on benzene, toluene and m-xylene.

PMID- 11191815
TI  - Carbohydrate assimilation profiles of the first Italian Candida dubliniensis
      clinical isolates recovered from an HIV-infected individual.
AB  - A total of six Candida dubliniensis isolates were obtained during 1 year of
      monitoring by monthly swabs from the oral cavity of an asymptomatic human
      immunodeficiency virus-infected individual in Catania, Italy. To the authors'
      knowledge, this constitutes the first recovery of C. dubliniensis from a human in
      Italy. Our identification procedure was based on colony color on CHROMagar
      Candida and carbohydrate assimilation profiles obtained by two commercial
      systems: API ID 32C and API 20C AUX. Karyotyping by pulsed-field gel
      electrophoresis confirmed the phenotypic identification. The biocodes obtained
      with API 20C AUX and with API ID 32C were 6172134 and 7142140015, respectively,
      for all six isolates. Both biocodes corresponded to those described in the
      literature as being produced by most C. dubliniensis isolates with each of the
      two identification systems. Our results confirm that both API 20C AUX and API ID
      32C are able to rapidly and accurately differentiate C. dubliniensis from C.
      albicans.

PMID- 11191816
TI  - Supplement 1999 (no. 43) to the Kauffmann-White scheme.
AB  - This supplement reports the characterization of 26 new Salmonella serovars
      recognized in 1999 by the WHO Collaborating Centre for Reference and Research on
      Salmonella: 15 were assigned to S. enterica subsp. enterica, seven to subspecies
      salamae, two to subspecies diarizonae, and one to subsp. houtenae; and one to S.
      bongori. In addition, the antigenic factor H:z89 is described.

PMID- 11191817
TI  - High stakes testing: what is at stake?

PMID- 11191818
TI  - Deaf children creating written texts: contributions of American Sign Language and
      signed forms of English.
AB  - The objectives of this descriptive study were to investigate the ways in which
      American Sign Language (ASL) and English-based sign allow for comprehension of
      text content, and to determine how these two avenues of communication might
      mediate the process of reconstructing "signed meaning" in a written text. The
      authors argue that comprehensible input in a visual mode is possible in either
      ASL or English-based sign. They further claim that English-based signing may be
      an effective means of bridging the gap between inner speech and written text.

PMID- 11191819
TI  - Welcome to the real world: reflections on teaching and administration.
AB  - The author compares his former position as an assistant professor in a program
      preparing future teachers of deaf and hard of hearing students with his present
      position as an administrator of a public school program serving these students.
      He maintains that in some ways, teacher training programs in deafness and the
      public school settings hiring these graduates are separate worlds. The emphasis
      in teacher training programs appears to be on preparing graduates to work with
      deaf students in self-contained or residential school settings even though most
      teaching positions are with hard of hearing students mainstreamed in public
      schools. Other important areas, such as collaboration with general education
      teachers, litigation, parental relationships, and individualized education
      programs, seem to be overlooked by teacher training programs. The author employs
      the mockingbird metaphor from the novel To Kill A Mockingbird (Lee, 1960) to
      highlight differences between teacher training programs and public school
      settings, while making recommendations for strengthening connections between the
      two.

PMID- 11191820
TI  - Developmental practicum experiences of preservice teachers in deaf education:
      implications for practicum placement and faculty-student collaborative research.
AB  - The study examined the developmental practicum experiences of second-year
      graduate students in deaf education. Participants in the study consisted of a
      convenient sample of five practicum students. Triangulated data for the study
      came from the researcher's observational notes, e-mail correspondence with
      participants, and participants' journals. Inductive analysis was used to analyze
      the data. Results of the study evinced developmental experiences that are
      different from those reported in previous studies. The results of the study have
      significant implications for (a) practicum placement of graduate students in deaf
      education in terms of site-based orientation, use of the clinical model of
      supervision, opportunities for self-reflection, and periodic practicum seminars;
      and (b) faculty-student collaborative research in terms of planning, ethical
      issues, students' time needs, and training.

PMID- 11191821
TI  - Diversity of deaf identities.
AB  - Social Identity Theory (Tajfel, 1981) posits that members of minority groups
      achieve positive social identity by (a) attempting to gain access to the
      mainstream through individual mobility or (b) working with other group members to
      bring about social change. Some people may use a combination of both strategies.
      Through the use of cluster analysis, the existence of three identities associated
      with these strategies was discerned in a sample of 267 deaf adults: culturally
      hearing identity, culturally deaf identity, and bicultural identity, each
      comprising about a third of the sample. A subset of 56 people were interviewed in
      depth; excerpts are presented to illustrate the identity types. Qualified support
      was found for the prediction that people with culturally deaf and bicultural
      identities would have higher self-esteem.

PMID- 11191822
TI  - Results of two national surveys of leadership personnel needs in deaf education.
AB  - Seventy university teacher preparation programs and 100 instructional programs
      serving at least 120 deaf and hard of hearing students were surveyed separately
      to (a) determine the demand for additional doctoral-level leadership personnel in
      deaf education, (b) obtain guidance for university leadership preparation
      programs in deaf education for the purpose of recruiting leadership personnel,
      and (c) identify experiences that would be relevant to the positions for which
      prospective leadership personnel are preparing. Data representing 54% of teacher
      preparation programs and 65% of instructional programs serving deaf and hard of
      hearing students in the United States evince the need for additional doctoral
      level personnel for faculty positions in university teacher preparation programs
      in deaf education, as well as the need for leadership positions in instructional
      programs serving deaf and hard of hearing children. Data also provide direction
      for leadership preparation programs in addressing the leadership personnel needs
      of the field.

PMID- 11191823
TI  - Syntactic and semantic processing in Hebrew readers with prelingual deafness.
AB  - The experimenter investigated the effect of semantic clues on the reading
      comprehension of deaf and hearing Israeli children. Two groups of students with
      prelingual deafness, and a hearing control group, were asked to read
      syntactically simple and syntactically relative sentences of varying semantic
      plausibility. Sixteen of the participants who were deaf (mean grade 6.9) had been
      trained orally, using spoken language as their principal means of communication
      at home and at school. Another 16 students with deafness (mean grade 6.9), all of
      them children of deaf parents, had acquired sign language as their primary
      language. The mean grade of the hearing control group was 6.5. The results
      suggest that, in contrast to the case with hearing individuals, reading
      comprehension in individuals with prelingually acquired deafness, regardless of
      communication background, is predominantly determined by the semantic processing
      of content words, with only minor attention given to the processing of the
      syntactic structure of the text.

PMID- 11191824
TI  - Documenting English syntactic development in face-to-face signed communication.
AB  - The authors explored the face-to-face English competence of five students who
      were participating in a larger study of teachers' use of English-based signing.
      Using case studies, the authors report on the students' development of English
      based signing at the beginning and end of their involvement in this 4-year study.
      Grammatical forms similar in English and American Sign Language (ASL) were
      initially more readily produced when tested for in English, and showed
      consistently higher attainment levels across all the students, than grammatical
      forms that are different in English and ASL. The authors found emerging English
      forms that could be documented (a) between prompted and imitated utterances and
      (b) within blocks of test items examining the same grammatical constructions. The
      authors conclude that teachers' concerted efforts to use English-based signing as
      a language of instruction enhance deaf students' English acquisition. Such
      signing helps build a bridge between native sign language and the development of
      English skills necessary for literacy.

PMID- 11191825
TI  - Time spent viewing captions on television programs.
AB  - The eye movements of 23 deaf subjects, ages 14 to 61 years, were recorded 30
      times per second while the subjects watched four 2.5-minute captioned television
      programs. The eye movement data were analyzed to determine the percentage of time
      each subject actually looked at the captions on the screen. It was found that
      subjects gazed at the captions 84% of the time, at the video picture 14% of the
      time, and off the video 2% of the time. Age, sex, and educational level appeared
      to have little influence on time spent viewing captions. When caption speed
      increased from the slowest speed (100 words per minute, or wpm) to the fastest
      speed (180 wpm), mean percentage of time spent gazing at captions increased only
      from 82% to 86%. A distinctive characteristic of the data was the considerable
      variation from subject to subject and also within subjects (from video to video)
      in regard to percentage of time spent gazing at captions.

PMID- 11191826
TI  - Transport of [3H]MPP+ in an immortalized rat brain microvessel endothelial cell
      line (RBE 4).
AB  - The aim of this study was to characterize the transport of the organic cation 1
      methyl-4-phenylpyridinium (MPP+) in an immortalized cell line of rat capillary
      cerebral endothelial cells (RBE 4). Verapamil (100 microM) and rhodamine 123 (10
      microM), and decynium22 (2 microM) and corticosterone (100 microM) reduced
      cellular accumulation of [3H]MPP+ applied from the luminal and abluminal cell
      border, respectively. When cells were grown on plastic supports, [3H]MPP+
      accumulated in the cells. The kinetic parameters of the saturable component were:
      Km=25 microM and Vmax=246 pmol per mg protein and 15 min. A selective organic
      anion transport inhibitor and selective inhibitors of the L- and A-type amino
      acid transporters did not affect [3H]MPP+ uptake. Uptake of [3H]MPP+ was Na+
      independent and metabolic energy-, pH- and potential-dependent. It was inhibited
      by several organic cations (e.g., verapamil, quinidine, daunomycin, dopamine) but
      not by others (cimetidine, tetraethylammonium, N-methylnicotinamide). In
      conclusion, [3H]MPP+ is efficiently transported by RBE 4 cells in both abluminal
      to-luminal and luminal-to-abluminal directions. Absorption of [3H]MPP+ seems to
      occur through a carrier-mediated mechanism belonging to the amphiphilic solute
      facilitator (ASF) family of transporters, but distinct from the known members of
      this family.

PMID- 11191827
TI  - Normalisation of blood pressure in hypertensive TGR(mREN2)27 rats by amlodipine
      vs. enalapril: effects on cardiac hypertrophy and signal transduction pathways.
AB  - It is still a controversial issue whether different classes of antihypertensive
      drugs are equally effective in the regression of cardiac hypertrophy and
      associated complications. The present study compared the effects of prolonged
      treatment with the Ca2+-channel blocker amlodipine and the ACE inhibitor
      enalapril, respectively, in TGR(mREN2)27 rats (TGR), an animal model of renin
      dependent hypertension. TGR were divided into three groups and received either
      amlodipine, enalapril or drinking water without addition, Sprague-Dawley rats
      (SPRD) served as normotensive control group. Cardiovascular parameters were
      monitored by radiotelemetry, and drug doses were titrated until 24-h blood
      pressure was reduced to approximately 140/90 mmHg in both active treatment
      groups. After 8 weeks of treatment left ventricular (LV) hypertrophy was
      completely reversed in both treatment groups despite a tenfold increase in plasma
      angiotensin II in amlodipine-treated TGR. In untreated TGR LV catecholamines were
      depleted, and beta1-adrenergic stimulation of adenylyl cyclase was blunted.
      Treatment of TGR with enalapril prevented both the depletion of tissue
      catecholamines and the desensitisation of LV beta1-adrenoceptors. Amlodipine had
      no effect on cardiac adrenergic signal transduction. Basal activity of LV soluble
      guanylyl cyclase was not different between TGR and SPRD, but its sensitivity to
      stimulation by nitric oxide was slightly reduced in TGR. Treatment had no effect
      on basal and stimulated guanylyl cyclase activity. The present study in an animal
      model of renin-dependent hypertension suggests that blood pressure reduction per
      se is sufficient for a regression of cardiac hypertrophy. However, beta
      adrenergic desensitisation was prevented only in the enalapril-treated group,
      supporting a blood pressure-independent contribution of the renin-angiotensin
      system to the regulation of beta-adrenergic signal transduction.

PMID- 11191828
TI  - Different alpha1-adrenoceptor-induced inositol phosphate formation in the two
      portions of rat vas deferens.
AB  - The two portions of rat vas deferens differed in the postjunctional sensitivity
      to noradrenaline. Alpha1-adrenoceptor-linked phosphoinositide breakdown was
      analysed in this tissue. The noradrenaline-induced [3H]inositol phosphate
      accumulation was similar in both ends although the pEC50 was higher in the
      epididymal (5.97+/-0.07) than in the prostatic (5.47+/-0.15, P<0.01) portion.
      [3H]Prazosin showed similar density of binding sites in both portions. Tissue
      pretreated with pertussis toxin did not change [3H]inositol phosphate
      accumulation. Finally, Western blot analysis indicated a smaller concentration of
      Gq/11 protein in the prostatic half (-29+/-5%, P<0.01). These results suggest
      that the different sensitivity to noradrenaline could be due to the higher
      availability of this sort of G protein in the epididymal portion.

PMID- 11191829
TI  - Alpha2-adrenoceptor-mediated inhibition of cultured sympathetic neurons: changes
      in alpha2A/D-adrenoceptor-deficient mice.
AB  - Alpha2-Adrenoceptor-mediated inhibition of [3H]noradrenaline release and alpha2
      adrenoceptor-mediated inhibition of voltage-activated Ca2+ currents were compared
      in cultured thoracolumbar postganglionic sympathetic neurons from newborn
      wildtype (WT) mice and mice in which the alpha2A/D-adrenoceptor gene had been
      disrupted (alpha2A/DKO). In cultures prepared from WT mice and preincubated with
      [3H]noradrenaline, the alpha2-adrenoceptor agonist 5-bromo-6-(2
      imidazolidinylidenamino)quinoxaline (UK 14,304) reduced the (autoinhibition-free)
      release of [3H]noradrenaline elicited by single electrical pulses or trains of 8
      pulses at 100 Hz. The maximal inhibition by UK 14,304 amounted to 70%-85%. Its
      concentration-response curve was shifted to the right by phentolamine (0.3
      microM) and, to a smaller extent, rauwolscine (0.3 microM). Pretreatment of the
      cultures with pertussis toxin abolished the effect of UK 14,304. Phentolamine and
      rauwolscine increased the (alpha2-autoinhibited) release of [3H]noradrenaline
      elicited by 18, 36 or 72 pulses at 3 Hz. In cultures from alpha2A/DKO mice, UK
      14,304 failed to reduce the release of [3H]noradrenaline elicited by single
      pulses and phentolamine and rauwolscine failed to increase the release of
      [3H]noradrenaline elicited by 18-72 pulses at 3 Hz. In neurons from WT mice
      examined with the amphotericin B-perforated configuration of the patch clamp
      method, UK 14,304 reduced depolarisation-evoked Ca2+ currents. The inhibition was
      voltage-dependent as shown by a decline at strong depolarisation during ramp-like
      voltage commands and by an attenuation briefly after a conditioning depolarising
      pulse. The maximal inhibition by UK 14,304 was 39%. Its concentration-response
      curve was shifted to the right by phentolamine (0.3 microM) but not significantly
      changed by rauwolscine (0.3 microM) and prazosin (1 microM). Pretreatment with
      pertussis toxin abolished the effect of UK 14,304. In neurons from alpha2A/DKO
      mice, UK 14,304 also reduced depolarisation-evoked Ca2+ currents, but with a
      smaller maximal effect, namely 18% inhibition. Its concentration-response curve
      was shifted to the right by rauwolscine (0.3 microM) and prazosin (1 microM) but
      not significantly changed by phentolamine (0.3 microM). Pretreatment with
      pertussis toxin abolished the effect of UK 14,304 also in cultures from
      alpha2A/DKO mice. It is concluded that the only presynaptic alpha2-autoreceptors
      that detectably depress transmitter release from cultured thoracolumbar
      sympathetic neurons taken from newborn mice are alpha2A/D. In contrast, the soma
      dendritic alpha2-autoreceptors that inhibit voltage-gated Ca2+ channels are both
      alpha2A/D and non-alpha2A/D (i.e. alpha2B or alpha2c). Both presynaptic alpha2A/D
      and soma-dendritic alpha2A/D- and non-alpha2A/D-autoreceptors operate through
      pertussis toxin-sensitive G proteins in these neurons.

PMID- 11191830
TI  - Single-cell RT-PCR analysis of N-methyl-D-aspartate receptor subunit expression
      in rat locus coeruleus neurones.
AB  - Whole-cell patch-clamp recordings were performed on 12- to 15-day-old rat locus
      coeruleus neurones in a midpontine slice preparation. Application of
      noradrenaline (100 microM) and N-methyl-D-aspartate (NMDA; 100 microM) induced a
      small outward current and a distinct inward current, respectively. Single-cell
      reverse transcriptase-polymerase chain reaction (scRT-PCR), used to analyse the
      expression pattern of NMDA receptor subunits 2A, 2B, and 2C (NR2A-C) subsequent
      to electrophysiological characterization, demonstrated differences in the
      capacity of individual locus coeruleus neurones to express NR2A-C mRNA. NR2C mRNA
      expression predominated over those of NR2A and NR2B mRNA in most neurones. In
      addition, in neurones containing NR2C mRNA NMDA induced significantly larger
      currents than in cells lacking expression of this gene. RT-PCR studies performed
      on tissue preparations of adult rats also revealed a distinct expression of NR2C
      mRNA. In conclusion, the present data demonstrate differences in the mRNA
      expression pattern of NR2A-C of individual locus coeruleus neurones with a
      predominant NR2C mRNA expression in the majority of the cells.

PMID- 11191831
TI  - Fluoxetine-induced Ca2+ signals in Madin-Darby canine kidney cells.
AB  - The effect of fluoxetine on Ca2+ signaling in Madin-Darby canine kidney (MDCK)
      cells was investigated by using fura-2 as a Ca2+ probe. Fluoxetine increased
      [Ca2+]i concentration-dependently between 5 microM and 200 microM with an EC50
      value of 40 microM. The response was reduced by external Ca2+ removal by 30%40%.
      In Ca2+-free medium pretreatment with 1 microM thapsigargin, an inhibitor of the
      endoplasmic reticulum Ca2+ pump, abolished 100 microM fluoxetine-induced Ca2+
      release. Addition of 3 mM Ca2+ to Ca2+-free medium increased [Ca2+]i when cells
      were pretreated with 100 microM fluoxetine. Suppression of 1,4,5-trisphosphate
      (IP3) formation by 2 microM U73122 (a phospholipase C inhibitor) did not affect
      100 microM fluoxetine-induced Ca2+ release. Fluoxetine (5-100 microM) also
      increased [Ca2+]i in neutrophils, prostate cancer cells and bladder cancer cells
      from human and rat glioma cells.

PMID- 11191832
TI  - Pharmacologically elevated levels of endogenous kynurenic acid prevent nicotine
      induced activation of nigral dopamine neurons.
AB  - Previous studies have shown that systemically administered nicotine is associated
      with an activation of rat midbrain dopamine neurons. The aim of the present
      electrophysiological study was to investigate if manipulation of brain kynurenic
      acid, an endogenous excitatory amino acid receptor antagonist, can affect the
      response of nigral dopamine neurons to nicotine. A potent inhibitor of kynurenine
      3-hydroxylase, PNU 156561A (40 mg/kg, i.v., 4-7 h), was utilized to increase the
      levels of kynurenic acid in rat brain. This treatment, which caused a fourfold
      increase in brain kynurenic acid levels, abolished the increase in firing rate
      and burst activity of nigral dopamine neurons as induced by nicotine (25-400
      microg/kg, i.v.). It is proposed that the excitation of dopamine neurons in the
      substantia nigra following nicotine administration is an indirect effect,
      mediated by glutamate release. In addition, our data highlight the role of brain
      kynurenic acid as a potentially important modulator of basic glutamatergic
      responses in brain.

PMID- 11191833
TI  - Characterisation and comparison of novel ligands for the nociceptin/orphanin FQ
      receptor.
AB  - Studies of nociceptin/orphanin FQ (NC) have been hampered by the paucity of
      available ligands with activity at the nociceptin receptor (NCR). In this study
      we have compared the agonist profile of NC and a novel NCR agonist, Ro65-6570, in
      a series of radioligand binding studies and effects on forskolin-stimulated cAMP
      formation in Chinese hamster ovary (CHO) cells expressing the recombinant human
      NCR (CHOhNCR). In addition, we report the effects of three antagonists,
      [Nphe1]NC(1-13)NH2, J-113397 and III-BTD, on these responses. In radioligand
      binding studies Ro65-6570, [Nphe1]NC(1-13)NH2, J-113397 and III-BTD displaced
      [3H]NC with similar pKi values (8.4-8.8). This compares with a pK(D) of 10.2 for
      NC in a direct saturation experiment. [Nphe1]NC(1-13)NH2 and J-113397 showed at
      least 100-fold selectivity over classical opioid receptors. Both NC and Ro65-6570
      produced a concentration-dependent inhibition of cAMP formation with pEC50 values
      of 9.56+/-0.06 and 8.68+/-0.04, respectively. Maximum inhibition achieved was
      100%. [Nphe1]NC(1-13)NH2, J-113397 and III-BTD produced a parallel rightward
      shift in the concentration-response curves to both NC and Ro65-6570 with pK(B)
      values of approximately 6.5, approximately 7.5 and approximately 7.7,
      respectively. Importantly, all three antagonists were devoid of residual agonist
      activity. Collectively, these data indicate the value of Ro65-6570, [Nphe1]NC(1
      13)NH2, J-113397 and III-BTD in studies of the physiological role played by NC.
      However, due to the relatively poor selectivity of Ro65-6570 and III-BTD caution
      should be exercised when using tissues that co-express micro-opioid receptors.

PMID- 11191834
TI  - A quantitative analysis of antagonism and inverse agonism at wild-type and
      constitutively active hamster alpha1B-adrenoceptors.
AB  - In order to characterize inverse agonism at alpha1B-adrenoceptors, we have
      compared the concentration-response relationships of several quinazoline and non
      quinazoline alpha1-adrenoceptor antagonists at cloned hamster wild-type (WT)
      alpha1B-adrenoceptors and a constitutively active mutant (CAM) thereof upon
      stable expression in Rat-1 fibroblasts. Receptor activation or inhibition thereof
      was assessed as [3H]inositol phosphate (IP) accumulation. Quinazoline (alfuzosin,
      doxazosin, prazosin, terazosin) and non-quinazoline alpha1-adrenoceptor
      antagonists (BE 2254, SB 216,469, tamsulosin) concentration-dependently inhibited
      phenylephrine-stimulated IP formation at both WT and CAM with Ki values similar
      to those previously found in radioligand binding studies. At CAM in the absence
      of phenylephrine, the quinazolines produced concentration-dependent inhibition of
      basal IP formation; the maximum inhibition was approximately 55%, and the
      corresponding EC50 values were slightly smaller than the Ki values. In contrast,
      BE 2254 produced much less inhibition of basal IP formation, SB 216,469 was close
      to being a neutral antagonist, and tamsulosin even weakly stimulated IP
      formation. The inhibitory effects of the quinazolines and BE 2254 as well as the
      stimulatory effect of tamsulosin were equally blocked by SB 216,469 at CAM. At WT
      in the absence of phenylephrine, tamsulosin did not cause significant stimulation
      and none of the other compounds caused significant inhibition of basal IP
      formation. We conclude that alpha1-adrenoceptor antagonsits with a quinazoline
      structure exhibit greater efficacy as inverse agonists than those without.

PMID- 11191836
TI  - Cannabinoid CB1 receptor-mediated inhibition of acetylcholine release in the
      brain of NMRI, CD-1 and C57BL/6J mice.
AB  - Cannabinoid CB1 receptors occur as presynaptic receptors producing inhibition of
      neurotransmitter release. To elucidate their physiological role, experiments on
      tissues from CB1 receptor knockout mice would be helpful. We studied whether CB1
      receptor-mediated inhibition of acetylcholine release is detectable in the brain
      of NMRI mice and of CD-1 and C57BL/6J mice (the latter two strains representing
      the wild-type strains of the two CB1 receptor knockout mouse models). Brain
      slices preincubated with [3H]choline were superfused and tritium overflow was
      evoked electrically (3 Hz) or by introduction of Ca2+ into Ca2+-free K+-rich
      medium (35 mM) containing tetrodotoxin. The eletrically evoked tritium overflow
      from NMRI mouse hippocampal slices was inhibited (maximally by 60%) by the
      cannabinoid receptor agonists CP-55,940 and WIN 55,212-2 but not affected by WIN
      55,212-3 (the inactive enantiomer of WIN 55,212-2; pEC50=7.9, 7.4 and <5.5). The
      concentration-response curve of WIN 55,212-2 was shifted to the right by the CB1
      receptor antagonist SR 141716 (apparent pA2=8.6). Compared to hippocampal slices
      from NMRI mice, WIN 55,212-2 1 microM inhibited the electrically evoked overflow
      (1) from cortical slices from NMRI mice to a lesser extent and from striatal
      slices not at all, (2) from hippocampal slices from CD-1 and C57BL/6J mice to an
      identical extent and (3) from hippocampal slices from Sprague-Dawley rats to at
      least the same extent. SR 141716 0.32 microM abolished the effect of WIN 55,212-2
      1 microM in hippocampal slices from NMRI, CD-1 and C57BL/6J mice and in cortical
      slices from NMRI mice. The electrically evoked tritium overflow from NMRI mouse
      hippocampal slices was also inhibited by the muscarinic receptor agonist
      oxotremorine (maximum effect of 85%; pEC50=6.5) and this effect was antagonized
      by the muscarinic receptor antagonist AF-DX 384 (apparent pA2=8.3). The Ca2+
      evoked tritium overflow from NMRI mouse hippocampal slices was inhibited by WIN
      55,212-2 in a manner sensitive to SR 141716. In conclusion, the cholinergic axon
      terminals of the NMRI mouse hippocampus are endowed with presynaptic CB1
      receptors. Such receptors are also detectable in the hippocampus of CD-1 and
      C57BL/6J mice. The maximum extent of the CB1 receptor-mediated inhibition of
      acetylcholine release is lower than the maximum effect mediated via the
      autoreceptor.

PMID- 11191835
TI  - Apical uptake of organic cations by human intestinal Caco-2 cells: putative
      involvement of ASF transporters.
AB  - The aim of this work was to characterise the intestinal absorption of organic
      cations, by testing the possibility of involvement of known members of the
      amphiphilic solute facilitator (ASF) family in this process. For that purpose,
      the characteristics of the uptake of 1-methyl-4-phenylpyridinium, a model organic
      cation, at the brush-border membrane of Caco-2 cells were compared with those of
      the extraneuronal monoamine transporter (EMT)-mediated transport. Uptake of
      [3H]MPP+ by Caco-2 and 293hEMT cells showed pH-dependence: it was significantly
      reduced (to 86% and 62% of control, respectively) when the pH of the
      extracellular medium was decreased to 6.2, and increased (to 116% and 136% of
      control, respectively) when the extracellular pH was increased to 8.2. Uptake of
      [3H]MPP+ by Caco-2 cells and 293hEMT cells showed potential-dependence:
      substitution of KCl for NaCl in the incubation medium resulted in a reduction in
      the inward transport of [3H]MPP+ (to 70% and 40% of control, respectively).
      Uptake of [3H]MPP+ by Caco-2 and 293hEMT cells showed only little dependence on
      Na+: substitution of NaCl of the incubation media with LiCl resulted in a small
      decrease (of 19% and 14%, respectively) in [3H]MPP+ uptake. However, when NaCl
      was substituted with choline chloride, a significant reduction in [3H]MPP+ uptake
      by Caco-2 and 2931hEMT cells (of 56% and 68%, respectively) was observed. The
      effect of various compounds on initial rates of [3H]MPP+ uptake into Caco-2 and
      293hEMT cells was tested. All compounds tested interacted with the specific
      [3H]MPP+ uptake in both cell lines. There was no correlation between the IC50s in
      relation to inhibition of [3H]MPP+ uptake into Caco-2 cells and into 293hEMT
      cells. Reverse transcriptase-polymerase chain reaction indicates that mRNA of
      hEMT and of the human organic cation transporter 1 (hOCT1) are present in Caco-2
      cells. In conclusion, our results suggest that uptake of organic cations at the
      brush-border membrane of Caco-2 cells may occur through two distinct Na+
      independent transporters belonging to the ASF family: hEMT and hOCT1.

PMID- 11191837
TI  - Modulation of noradrenaline-induced microvascular constriction by protein kinase
      inhibitors.
AB  - We have tested the role of various protein kinases in noradrenaline-induced,
      alpha1A-adrenoceptor-mediated constriction of mesenteric and intrarenal rat
      microvessels. The protein kinase C inhibitors, H7 and staurosporine, inhibited
      constriction in both vessel types in concentrations which also inhibit myosin
      light chain kinase. The more selective protein kinase C inhibitors,
      bisindolylmaleimide I and Go 6976, did not inhibit microvessel constriction in
      concentrations selective for protein kinase C. Moreover, the protein kinase C
      activating phorbol ester, phorbol-12-myristate-13-acetate, did not cause
      constriction. The tyrosine kinase inhibitors, genistein and tyrphostin 23,
      inhibited constriction in concentrations compatible with tyrosine kinase
      inhibition. An inhibitor of the extracellular signal-regulated kinase cascade, PD
      98059, also caused concentration-dependent inhibition. While chelation of
      extracellular Ca2+ abolished noradrenaline-induced constrictions, the Ca2+-ATPase
      inhibitor, thapsigargin, had no effects. We conclude that tyrosine kinases and
      extracellular signal-regulated kinase (but not protein kinase C) may be involved
      in noradrenaline-induced rat mesenteric and intrarenal microvessel constriction
      but this appears to occur independently of an effect on sarcoplasmic Ca2+
      storage.

PMID- 11191838
TI  - Chronic treatment with desipramine facilitates its effect on extracellular
      noradrenaline in the rat hippocampus: studies on the role of presynaptic alpha2
      adrenoceptors.
AB  - Adaptive phenomena such as desensitization of autoreceptors are considered an
      important factor in the achievement of therapeutic efficacy of antidepressant
      drugs after chronic treatment. We have studied whether a chronic treatment with
      desipramine had a greater effect than a single dose on the extracellular
      concentrations of noradrenaline in the dorsal hippocampus. Administration of 10
      mg/kg i.p. desipramine once daily for 14 days significantly raised the basal
      extracellular noradrenaline in the dorsal hippocampus 24 h but not 48 h after the
      last drug injection. A challenge dose of desipramine increased extracellular
      noradrenaline in rats treated chronically with vehicle and desipramine. The
      effect was significantly higher in rats treated chronically with desipramine 48 h
      but not 24 h after the last injection. An intraperitoneal administration of the
      alpha2-adrenoceptor agonist clonidine at the dose of 10 microg/kg significantly
      reduced extracellular noradrenaline in the control group but not in animals
      chronically treated with desipramine whereas 30 microg/kg clonidine produced a
      similar decrease in both groups. Three concentrations of clonidine (0.05, 0.5 and
      1 microM) infused into the hippocampus significantly reduced extracellular
      noradrenaline to a similar extent in rats chronically treated with saline or
      desipramine. Fourty-eight hours after the last injection of the chronic
      treatment, [3H]RX-821002 binding to alpha2-adrenoceptors in the rat locus
      coeruleus measured by autoradiography was not significantly modified. A slight
      (17%) but significant decrease of neuronal uptake of [3H]noradrenaline was found
      in synaptosome preparations from dorsal hippocampus of rats chronically treated
      with desipramine, but this was likely due to a decrease in affinity. The results
      suggest that a repeated treatment with desipramine (10 mg/kg i.p. once daily for
      14 days) facilitates its effect on extracellular noradrenaline in the dorsal
      hippocampus and induces adaptive changes probably involving desensitization of
      alpha2-adrenoceptors, with no changes in their density, on noradrenergic neurons
      in the locus coeruleus.

PMID- 11191839
TI  - Unravelling the pharmacological profile of the canine external carotid
      vasodilator '5-HT1-like' receptors: coexistence of sympatho-inhibitory 5-HT1B and
      postjunctional 5-HT7 receptors.
AB  - It has been suggested that the external carotid vasodilatation produced by
      serotonin (5-hydroxytryptamine; 5-HT) in anaesthetised dogs with intact
      vagosympathetic trunks is mediated by sympatho-inhibitory '5-HT1D' receptors and
      musculotropic '5-HT1-like' receptors. The present study has re-analysed this
      suggestion with regard to the classification schemes recently proposed by the NC
      IUPHAR subcommittee on 5-HT receptors. In pentobarbital-anaesthetised dogs with
      intact vagosympathetic trunks, 1-min intracarotid (i.c.) infusions of 5
      carboxamidotryptamine (5-CT; 0.01-0.3 microg/min), 5-HT (0.3-30 microg/ min), 5
      methoxytryptamine (5-MeO-T; 1-100 microg/min) or sumatriptan (1-100 microg/min)
      dose-dependently increased the external carotid blood flow without affecting
      blood pressure or heart rate. The selective 5-HT1D receptor agonist, PNU-142633
      (1-1000 microg/min), was essentially inactive. After mesulergine (300 microg/kg,
      i.v.), an antagonist at cardiovascular 5-HT7 receptors, the above responses to 5
      HT, 5-CT and 5-MeO-T were blocked, whilst those to sumatriptan remained
      unaffected. In contrast, after the 5-HT1B/1D receptor antagonist, GR127935 (10
      microg/kg, i.v.), the responses to 5-HT, 5-CT and 5-MeO-T were not affected, but
      those to sumatriptan were abolished. Furthermore, after the selective 5-HT1B
      receptor antagonist, SB224289 (300 microg/kg, i.v.), the responses to 5-HT, 5-CT
      and 5-MeO-T were significantly enhanced, whereas those to sumatriptan were
      abolished. Interestingly, the responses to all these agonists remained unmodified
      after the selective 5-HT1D receptor antagonist, BRL15572 (300 microg/kg, i.v.).
      The above results suggest that the '5-HT1-like' receptors, which mediate canine
      external carotid vasodilatation, display the pharmacological profile of sympatho
      inhibitory 5-HT1B receptors and musculotropic 5-HT7 receptors, and confirm the
      existence of vasoconstrictor 5-HT1B receptors.

PMID- 11191840
TI  - Cloning of a chick A3 adenosine receptor: characterization of ligand binding and
      receptor-effector coupling of chick A1 and A3 adenosine receptors.
AB  - We have reported previously the cloning and partial characterization of a chick
      A1 adenosine receptor expressed in the heart. We report herein the cloning of a
      chick A3 adenosine receptor and a comprehensive characterization of both the A1
      and A3 receptors expressed in human embryonic kidney 293 cells. [125I]N6-(p
      aminobenzyl)adenosine bound to both receptors with similar affinities and was
      used in competition studies. Although the selectivities of both agonists and
      antagonists were less than in other species, two antagonists, 3-ethyl-5-benzyl-2
      methyl-6-phenyl-4-phenylethynal-(+/-)-dihydropyridine-3,5-dicarboxylate and 3,6
      dichloro-2'-(isopropyloxy)-4'-methylflavone), were at least partially selective
      for A3 receptors while one antagonist [C8-(N-methylisopropyl)amine-N6
      (5'endohydroxy)endonorboman-2-yl-9-methyladenine] was selective for A1 receptors.
      While both receptors coupled to the inhibition of adenylyl cyclase, we were
      unable to detect coupling of either receptor to phospholipase C or D.

PMID- 11191841
TI  - Abolition of (-)-CGP 12177-evoked cardiostimulation in double beta1/beta2
      adrenoceptor knockout mice. Obligatory role of beta1-adrenoceptors for putative
      beta4-adrenoceptor pharmacology.
AB  - Some beta1- and beta2-adrenoceptor-blocking agents, such as (-)-CGP 12177, cause
      cardiostimulant effects at concentrations considerably higher than those that
      antagonise the effects of catecholamines. The cardiostimulant effects of these
      non-conventional partial agonists are relatively resistant to blockade by (-)
      propranolol and have been proposed to be mediated through putative beta4
      adrenoceptors or through atypical states of either beta1- or beta2-adrenoceptors.
      We investigated the effects of (-)-CGP 12177 on sinoatrial rate and left atrial
      contractile force as well as the ventricular binding of (-)-[3H]CGP 12177 in
      tissues from wild-type, beta2-adrenoceptor knockout and beta1/beta2-adrenoceptor
      double knockout mice. The cardiostimulant effects of (-)-CGP 12177 were present
      in wild-type and beta2-adrenoceptor knockout mice but were absent in beta1/beta2
      adrenoceptor double knockout mice. Thus, the presence of beta1-adrenoceptors is
      obligatory for the cardiostimulant effects of (-)-CGP 12177. It appears therefore
      that an atypical state of the beta1-adrenoceptor contributes to the mediation of
      the cardiostimulant effects induced by non-conventional partial agonists.
      Ventricular beta1- and beta2-adrenoceptors, labelled in wild-type with a K(D)
      approximately 0.5 nmol/l (approximately 16 fmol/mg protein), were absent in
      beta1/beta2-adrenoceptor double knockout mice. However, a high density binding
      site (approximately 154-391 fmol/mg protein) that did not saturate completely
      (K(D) approximately 80-200 nM) was labelled by (-)-[3H]CGP 12177 in the three
      groups of mice, being distinct from beta1- and beta2-adrenoceptors, as well as
      from the site mediating the agonist effects of (-)-CGP 12177.

PMID- 11191842
TI  - Beneficial effects of nitric oxide synthase inhibition on the recovery of
      neurological function after spinal cord injury in rats.
AB  - We have demonstrated recently that treatment with N(G)-monomethyl-L-arginine (L
      NMMA) accelerates electrophysiological recovery after transient spinal cord
      ischaemia in anaesthetized cats. To determine whether nitric oxide synthase (NOS)
      inhibition in the acute phase of spinal cord injury results in better functional
      recovery in the chronic phase, we evaluated the influence of L-NMMA on the time
      course of changes of neurological function and the histopathological changes
      after spinal cord compression in rats. Experimental spinal cord injury was
      produced in anaesthetized rats by short-term (5 min) compression with a thread
      placed around the spinal cord at T13. The recovery of motor function was assessed
      by a treadmill test 10, 20 and 30 days after spinal cord compression. The latency
      of potentials evoked by hindlimb stimulation was measured at the funiculus
      posterior at C1 10 days after the spinal cord injury in anaesthetized rats.
      Histological examinations were also performed at the same time. The compression
      induced spinal cord injury resulted in motor dysfunction of hindlimbs, an
      increase in the latency of the evoked potentials and neuronal degeneration in
      funiculus posterior at T13. Repeated administration of L-NMMA for 1 day
      significantly accelerated the recovery of the motor function, shortened the
      latency of the evoked potentials and attenuated the myelin vacuolization in the
      spinal cord. These beneficial effects of L-NMMA on neurological function and
      histopathological changes were abolished by coadministration of L- but not D
      arginine. These results suggest that NOS inhibition during the early stage of
      spinal cord injury has beneficial effects on the recovery of neurological
      function and the histopathological changes in the chronic stage.

PMID- 11191843
TI  - RNA secondary structure: physical and computational aspects.

PMID- 11191844
TI  - Thermodynamics of nucleic acids and their interactions with ligands.

PMID- 11191845
TI  - [Validation of biological dosimetry in patients conditioned with total body
      irradiation: conventional cytogenetics and in situ hybridization(FISH)].
AB  - PURPOSE: Validation of biological dosimetry versus physical dosimetry in
      malignant haemopathy patients conditioned by total body irradiation (TBI) before
      bone marrow transplantation (BMT). PATIENTS AND METHODS: The scoring of
      chromosomal aberrations in peripheral lymphocytes irradiated in vivo was used to
      perform the biological dosimetry. The data were compared to those obtained with
      healthy volunteers' total blood exposed to in vitro irradiation with linear
      accelerator doses (0.2, 0.5, 0.75, 1, 2, 3, 4 and 5 Gy) for dose-response curves.
      In experimental animal models, can in vivo and in vitro responses be considered
      as being the same? All the published human data are based on retrospective dose
      evaluation with very large uncertainties on the dose precisely delivered to the
      subject. TBI before BMT was taken as a model where the dose calculation results
      from the physical method, with homogeneous beam and dose delivered precisely
      along the entire organism. In vivo response allows us to validate biological
      dosimetry in 15 adult patients (female + male), before (D = 0 Gy) and after the
      first fraction of 1.8 Gy, delivered by a linear accelerator (18 MV, dose-rate of
      15.8 cGy/min-1). Two methods, conventional cytogenetics (CCG) and fluorescent in
      situ hybridization (FISH painting) of chromosome 4 were respectively used to
      analyze the unstable chromosome aberrations and stable chromosome aberrations.
      RESULTS: Healthy volunteer lymphocytes, before irradiation, yielded 0.1%
      dicentrics and 0.3% translocations of chromosome 4, with 2.5% for the whole
      genome. Patients before irradiation had 2% dicentrics and 11.48% chromosome 4
      translocations for the whole genome. In the 15 patients, for a physical dose of
      1.8 Gy, the evaluated biological dose was 1.93 Gy (95% CI: 1.85-2.05 Gy) with
      conventional cytogenetics and 2.06 Gy (95% CI: 1.75-2.15 Gy) with FISH.
      CONCLUSION: These results, in which the biologically estimated dose is in
      complete agreement with the dose calculated by physical dosimetry in the
      homogeneous irradiation model, suggest the validation of biological dosimetry in
      TBI conditioning.

PMID- 11191846
TI  - [Evaluation of late radiation-induced changes in superficial microcirculation. I.
      Clinical benefit of the cutaneous Doppler laser].
AB  - OBJECTIVE: The changes that occur in the tissular microcirculation after
      therapeutic irradiation (RT) account for some of the late effects of irradiation,
      especially on the cutaneous level. As a rule, the methods of exploring the
      superficial microcirculation only measure blood flow indirectly. Only the Doppler
      laser can provide direct measurements of blood parameters in vivo in man.
      METHODS: Thirty women who had been irradiated with 45 + 20 Gy of locoregional
      fractionated adjuvant RT for breast cancer developed local radiation-induced
      fibrosis six years later (+/- 5). The local microcirculation was measured in the
      resting state and during thermal stimulation at 42 degrees C, using a Periflux
      cutaneous Doppler laser with p413 probes. Three periods of six minutes each were
      continuously recorded: period 1 (P1) represented basal resting cutaneous
      perfusion, with the slope p corresponding to the increase in perfusion when two
      minutes of thermal stimulation at 42 degrees C began; P2 to plateau perfusion
      during this stimulation; and P3 to perfusion on the return to equilibrium. Each
      individual was its own control. RESULTS: In the women treated by RT, the resting
      microcirculation in the skin underlying an area of late fibrosis rose by a factor
      of 2 during P1 (p < 0.001), and the P2/P1 ratio decreased by a factor of 2 (p <
      0.001), compared to the control area. After thermal stimulation, there was no
      change in p, P2 or P3. CONCLUSION: Although a hypovascularization is frequently
      found in late sequelae of RT, we observed an increase of the cutaneous
      microcirculation associated with a maladjustment of the endothelial response to a
      thermal stimulation. These observations seem to reflect the presence of dilated
      new capillaries of the telangiectatic type, which are macroscopically
      undetectable.

PMID- 11191847
TI  - [Evaluation of late radiation-induced changes in superficial microcirculation
      after acute beta-irradiation. II. Prognostic importance of cutaneous Doppler
      laser].
AB  - OBJECTIVE: The changes that occur in the tissular microcirculation after
      accidental acute irradiation account for some of the early effects of such
      irradiation, especially at the cutaneous level. The prognostic importance of the
      cutaneous laser doppler was tested in an experimental model of acute beta
      irradiation. METHODS: Ten pigs were given beta-irradiation with a high single
      localized dose of 90Sr/90Y (32 or 64 Gy, 7 mg/cm2) delivered to the flank, and
      were evaluated 2, 7, 14, 21 and 28 days thereafter. Each individual was its own
      control. The local microcirculation was measured in the resting state and during
      thermal stimulation at 42 degrees C, using a Periflux cutaneous Doppler laser
      with p413 probes. Three periods of six minutes each were continuously recorded:
      period 1 (P1) represented basal resting cutaneous perfusion, with the slope p
      corresponding to the increase in perfusion when two minutes of thermal
      stimulation at 42 degrees C began; P2 to plateau perfusion during this
      stimulation; and P3 to perfusion on the return to equilibrium. RESULTS: After
      acute beta-irradiation in the pig, all the cutaneous microcirculation parameters
      measured (P1, p, P2 and P3) had risen at day 2 in the irradiated area by a factor
      of 2 to 4, depending on the dose (p < 0.001), compared to the adjacent control
      area. On the other hand, as from day 7, the resting and the stimulated
      microcirculation varied little, except for a reduction of the slope p by a factor
      of 2 (p < 0.05) after the strongest radiation dose. CONCLUSION: After acute
      irradiation, the increase in the resting cutaneous microcirculation may
      correspond to immediate but transitory capillary vasodilatation that accompanies
      the initial erythema in accidental irradiation. The absence of vascular response
      to thermal stimulation seems to be a good means of reaching an early diagnosis of
      delayed cutaneous radiation necrosis.

PMID- 11191848
TI  - [Conservative treatment of extremity soft tissue sarcomas. Functional evaluation
      using LENT-SOMA scales and Enneking scoring].
AB  - OBJECTIVE: The aim of this prospective study is the feasibility of late effects
      assessment by LENT-SOMA scales after conservative treatment of soft tissue
      sarcomas of the extremities and a comparison with the functional evaluation by
      the Enneking score. PATIENTS AND METHODS: During the systematic follow-up
      consultations, a series of 32 consecutive patients was evaluated in terms of late
      effects by LENT-SOMA scales and functional results by the Enneking score. The
      median time after treatment was 65 months. The treatment consisted of
      conservative surgery (all cases) followed by radiation therapy (29 cases), often
      combined with adjuvant therapy (12 concomitant radio-chemotherapy association
      cases out of 14). The assessment of the toxicity was retrospective for acute
      effects and prospective for the following late tissue damage: skin/subcutaneous
      tissues, muscles/soft tissues and peripheral nerves. RESULTS: According to the
      Enneking score, the global score for the overall series was high (24/30) despite
      four the scores zero for the psychological acceptance. According to LENT-SOMA
      scales, a low rate of severe sequellae (grade 3-4) was observed. The occurrence
      of high-grade sequellae and their functional consequences were not correlated
      with quality of exerese, dose of radiotherapy or use of concomitant chemotherapy.
      A complementarity was observed between certain factors of the Enneking score and
      some criteria of the LENT-SOMA scales, especially of muscles/soft tissues.
      CONCLUSION: The good quality of functional results was confirmed by the two mean
      scoring systems for late normal tissue damage. The routine use of LENT-SOMA seems
      to be more time consuming than the Enneking score (mean time of scoring: 13
      versus five minutes). The LENT-SOMA scales are aimed at a detailed description of
      late toxicity and sequellae while the Enneking score provides a more global
      evaluation, including the psychological acceptance of treatment. The late effects
      assessment by the LENT-SOMA scales should be carried on in prospectives studies,
      especially in case of concomitant radio-chemotherapy.

PMID- 11191849
TI  - [Colorectal cancer in patients younger than 40 years of age].
AB  - Between 1988 and 1994, 326 patients with colorectal cancers were treated at the
      Ibn Rochd Oncology Centre in Casablanca; 88 patients were less than 40 years old
      (27%). There were 79 males and nine females. A family history of colorectal
      cancer was noted in 5%. The most frequent symptoms were bleeding and rectal pain.
      The localisation of the tumour was the rectum in 70 cases. According to the
      anatomopathological profile, Dukes stages C and D were the most frequent and
      mucosal adenocarcinoma was noted in 24 cases. Seventy patients had surgery,
      associated with radiation therapy in 59 cases. Adjuvant chemotherapy was given in
      44 cases and palliative treatment in 17 cases. Recurrence occurred in 14 cases
      and metastasis in other six cases. At five years, overall survival and disease
      free survival rates were 24% and 17%, respectively. Worse prognostic factors were
      mucosal adenocarcinoma, poor differentiated adenocarcinoma and Dukes C and D
      stages.

PMID- 11191850
TI  - [Conformal radiotherapy: tomotherapy].
AB  - Conformal radiation therapy allows the possibility of delivering high doses at
      the tumor volume whilst limiting the dose to the surrounding tissues and
      diminishing the secondary effects. With the example of the conformal radiation
      therapy used at the AZ VUB (3DCRT and tomotherapy), two treatment plans of a left
      ethmoid carcinoma will be evaluated and discussed in detail. The treatment of
      ethmoid cancer is technically difficult for both radiation therapy and surgery
      because of the anatomic constraints and patterns of local spread. A radiation
      therapy is scheduled to be delivered after surgical resection of the tumor. The
      treatment plan for the radiation therapy was calculated on a three-dimensional
      (3D) treatment planning system based on virtual simulation with a beam's eye
      view: George Sherouse's Gratis. An effort was made to make the plan as conformal
      and as homogeneous as possible to deliver a dose of 66 Gy in 33 fractions at the
      tumor bed with a maximum dose of 56 Gy to the right optic nerve and the chiasma.
      To establish the clinical utility and potential advantages of tomotherapy over
      3DCRT for ethmoid carcinoma, the treatment of this patient was also planned with
      Peacock Plan. For both treatment plans the isodose distributions and cumulative
      dose volume histograms (CDVH) were computed. Superimposing the CDVHs yielded
      similar curves for the target and an obvious improvement for organs at risk such
      as the chiasma, brainstem and the left eye when applying tomotherapy. These
      results have also been reflected in the tumor control probabilities (equal for
      both plans) and the normal tissue complication probabilities (NTCP), yielded
      significant reductions in NTCP for tomotherapy. The probability of uncomplicated
      tumor control was 52.7% for tomotherapy against 38.3% for 3DCRT.

PMID- 11191851
TI  - [Comparative dosimetry study of two methods of intensity modulation performed on
      the same accelerator].
AB  - Intensity modulated radiation therapy (IMRT) is an advanced method of conformal
      radiotherapy. It permits optimal dose distribution to the target volume while
      preserving surrounding normal tissues. IMRT, with a multileaf collimator, can be
      realised in two different ways: either the segmented mode, which consists of
      combining small elementary static field, or the dynamic mode, which consists of
      moving the leaves while irradiating. The purpose of this work was to study these
      two methods of modulation on a Varian linear accelerator equipped with a
      collimator consisting of 40 pairs of one-centimetre-wide leaves. The
      measurements, obtained by using a diode array, showed that the quality of the
      irradiation in the dynamic mode does not depend on either the dose rate or the
      duration of the irradiation. In the segmented mode, weak magnitude segments are
      preferable, but increase the errors in the delivered dose. Comparisons of various
      profiles showed that the measured profiles are consistent with those programmed.
      Both modes seem to be equivalent for step-shaped profiles. In the case of
      profiles with constant slope, the segmentation generated by the segmented method
      deteriorates the profile. Even though the choice of technique is strongly
      dependent on the material available, the dynamic mode presents greater
      flexibility of use and has been chosen in our institution for IMRT.

PMID- 11191852
TI  - [Quality of medical records in oncology: results of an audit of the Lyon Civil
      Hospices].
AB  - The objective of this study was to assess the quality of information contained in
      the medical files of patients in an oncology unit of the Lyons Civil Hospices.
      Prior to the audit, the health care teams established a set of consensus
      standards to compare with observed procedures. The analysis of the results led to
      propositions for guidelines designed to improve points where significant
      deviations were observed. In the first audit, 80 medical files from patients
      cared for in four oncology units were retrospectively analysed to determine
      information quality. Seven items of this audit were retained for a second audit
      on 127 medical files of patients in a cancerology unit; those items were: postal
      code of birth place, weight, codified evaluation of general status, TNM
      classification, pTNM classification, presence of pathology report, localisation
      of metastasis. Significant deviations were observed for pTNM classification and
      postal code of birth. During the second audit, a manual of procedures was
      distributed in the unit, and a new evaluation will be done in one year to assess
      the impact of guidelines.

PMID- 11191853
TI  - [External contour acquisition system for radiotherapy: an original solution].
AB  - A contour acquisition system has been designed in radiotherapy at the Sagamie
      Hospital complex (Chicoutimi, Quebec) to measure the external contours of the
      patients who do not need a CT exam. This measuring system can produce
      transversal, sagittal or coronal patient contours in the treatment position. The
      absolute accuracy of the system is +/- 1 mm. The contours produced by this
      equipment can be transferred electronically or on paper to the planning system.

PMID- 11191854
TI  - [Male secondary breast cancer after treatment for Hodgkin's disease. Case report
      and review of the literature].
AB  - Hodgkin's disease is now curable in more than 50% of cases, due to its chemo- and
      radio-sensitivity. However, treatment exposes to a risk of secondary cancer
      varying from 1 to 10% depending on chemoradiotherapy doses and schedules. We
      report a case of secondary breast cancer associated with a secondary thyroid
      cancer observed in a 24-year-old man treated when he was 13 years old by
      vinblastin and radiation for stage IIA, a Hodgkin's disease.

PMID- 11191855
TI  - [Radiation-induced glioblastoma and myxoma after treatment for undifferentiated
      carcinoma of the naspharynx].
AB  - Radio-induced tumor have been known for a long time to occur after treatment of
      cancer during childhood. This entity is exceptional following radiotherapy of the
      cavum. Skull and facial osteosarcoma were described after treatment of UCNT. We
      report two observations of radio-induced tumors arising, respectively three and
      seven years after treatment of UCNT. The first one is a temporoparietal
      glioblastoma and the second is a rhino- and pharyngeal myxoma. The two patients
      are alive after treatment of the second tumor. The delay of appearance of these
      tumors, their situation in the field's irradiated and dose received suggests
      their radio-induced nature. However, the cytogenetic study is necessary to
      confirm the implication of radiotherapy in the genesis of these cancers.

PMID- 11191856
TI  - [Is tattooing still justified in breast cancer radiotherapy? Presentation of a
      technique that may be erased after treatment].

PMID- 11191857
TI  - Ultrasound biomicroscopy in the management of Vogt-Koyanagi-Harada disease.

PMID- 11191858
TI  - Macular rings in Terson's syndrome.

PMID- 11191859
TI  - Visual field loss attributable to misting of the trial lens.

PMID- 11191860
TI  - Sperm factors related to in vitro penetration of porcine oocytes.
AB  - This study was designed to evaluate the relationship between sperm factors and
      penetration capacity in an in vitro system with immature porcine oocytes. The
      sperm parameters evaluated in 145 ejaculates were volume, sperm concentration,
      total cells in the ejaculate, ATP content, morpho-anomalies, percentage of motile
      sperm cells, forward progressive motility (FPM), acrosome status (NAR), hypo
      osmotic swelling test (HOS), osmotic resistance test (ORT), eosin-nigrosin
      viability stain and sperm membrane integrity (DCF). Porcine oocytes (a total of
      8,736) were used to evaluate the capacity of the different sperm assays to
      predict penetration. Many parameters were found to be related to in vitro
      penetration ability; all conventional semen parameters, except sperm
      concentration and eosinnigrosin staining, were significantly better in high
      (>75%) than in low penetration rates (<75%). When the ejaculates were preselected
      the number of significantly related parameters was lower. When studying all
      conventional semen parameters through a stepwise multiple linear regression
      analysis of seminal measurements, up to 72.3% of total variance of the
      penetration rate could be predicted. However, as many as 4 parameters were needed
      (FPM in fresh semen, folded tail, NAR in post-treatment semen and DCF) for
      accurate prediction. On the other hand, the multiple logistic regression needed 7
      parameters to discriminate 83.96% of the cases correctly. In summary, the results
      from the present study showed that almost all studied parameters were
      significantly different for predicting penetration process attained or failed,
      but most of them were correlated together. These findings emphasize the
      complexity of sperm functions and the difficulty of assessing the fertilizing
      ability.

PMID- 11191861
TI  - Vitrification and rapid-freezing of cumulus cells from rabbits and pigs.
AB  - To use adult somatic cloning technology in animal breeding, this technology
      should be complemented with nuclear donor cell cryopreservation. Two different
      conventional nonequilibrium methods (vitrification, V: 3.58M EG and 2.82M DMSO in
      PBS plus 20% FCS and rapid-freezing, RF: 0.25M sucrose, 2.25M EG and 2.25M DMSO
      in PBS plus 20% FCS) were assayed here on different cumuli types from rabbits and
      pigs. In rabbits, the cell proliferation capability of fully disaggregated cumuli
      was not affected by cryopreservation procedures (V: 100% and RF: 82%). Vitrified
      samples from partially or non-disaggregated cumuli showed the lowest
      proliferation frequencies (4% and 0%, respectively). In pigs, differences in cell
      proliferation capability were only observed between vitrified non-disagreggated
      cumuli and vitrified or rapid-frozen, fully disaggregated cumuli (72% vs 100% or
      100%, respectively; P < 0.05). In both species, in vitro cultured sub-confluent
      samples were able to survive to a second cryopreservation treatment, maintaining
      the cell proliferation capability in nearly 50% of thawed samples. In conclusion,
      before cryopreservation, disaggregation of cumulus cells from both species into
      small clusters of cells improved their viability after thawing. These results
      allow us to efficiently, easily and rapidly store rabbit and pig cumulus cells,
      from selected high-merit females.

PMID- 11191862
TI  - Influence of the type of energy supply on lh secretion, follicular growth and
      response to estrus synchronization treatment in feed-restricted suckler beef
      cows.
AB  - The present experiment aimed to compare the efficiency of supplementation (+17.5
      MJ Net Energy/d starting 47 +/- 4 days after calving) with concentrate (CS, maize
      grain, n = 10) or with forage (FS, maize silage, n = 10) in estrus-synchronized
      (Norgestomet implant 10 days inserted 60 +/- 4 days postpartum + PMSG at implant
      removal) beef cows previously restricted (47 MJ Net Energy/d, 785 g CP/d, 70% of
      requirements). The type of diet had no significant effect on basal LH
      concentrations (CS: 0.18 +/- 0.12 vs FS: 0.11+/- 0.02 ng/mL), LH pulse frequency
      (CS : 0.7 +/- 0.3 vs FS: 0.8 +/- 0.2 pulse/10 h), LH pulse amplitude (CS: 0.55 +/
      0.50 vs FS : 0.62 +/- 0.50 ng/mL) or estradiol (E2) concentrations (CS: 3.3 +/-
      0.8 vs FS: 4.6+ /- 0.8 pg/mL) 13 days after the beginning of energy
      supplementation. No differences between CS and FS cows were observed for the
      number of small, medium and large follicles nor on the size of the largest
      follicle from 11 days before implant insertion to implant removal (IR). After IR,
      an LH surge was observed in 2 of the CS and 4 of the FS cows. The type of energy
      supplementation had no significant effect on LH (CS: 0.16 +/- 0.06 ng/mL vs FS
      0.48 +/- 0.06 ng/mL; P > 0.05) or on estradiol concentrations (CS : 7.8 +/- 0.2
      vs FS : 8.9 +/- 0.2 pg/mL, P > 0.10) measured hourly from 29 to 49 h after IR.
      Cows that ovulated after IR tended to have higher E2 concentrations than cows
      that did not ovulate (9.4 +/- 0.2 vs 6.3 +/- 0.2 pg/mL, P = 0.08). Similar
      ovulation and pregnancy rates were observed in CS and FS cows (CS: 6/10 vs FS:
      7/10 and CS: 6/10 vs FS: 5/10 respectively, P > 0.05). To conclude, energy
      supplementation with forage was as effective as energy supplementation with
      concentrate to influence follicular growth, ovulation and pregnancy percentage
      after estrus synchronization treatment in diet-restricted beef cows.

PMID- 11191863
TI  - Effect of one spontaneous estrus cycle (after synchronization with PGF2alpha) on
      reproductive performance in dairy cows.
AB  - The objective of the study was to analyze the effect of a spontaneous estrus
      cycle after synchronization of estrus with prostaglandin F2alpha (PGF2alpha) in
      dairy cows on the degree of synchronization and reproductive performance. We
      assigned 557 Holstein cows to two treatment groups. In Group 1 estrus was
      synchronized by two treatments with 25 mg of Dinoprost-Trometamol in 14-day
      intervals. Cows were treated 27 to 33 days postpartum (dpp) and 41 to 47 dpp,
      respectively. Cows in Group 2 were treated with 25 mg of Dinoprost-Trometamol
      three times in 14-day intervals, starting at 34 to 40 dpp. The second and third
      injections were administered at 48 to 54 dpp and 62 to 68 dpp, respectively. All
      cows were inseminated on observed estrus after a voluntary waiting period of 65
      days post partum. Thus cows in Group 1 were inseminated on spontaneous estrus and
      cows in Group 2 on induced estrus. Cows not inseminated at 80 days post partum
      were palpated per rectum and treated according to a predefined protocol. Herd
      reproductive performance measures did not differ significantly between groups.
      The proportion of cows with low serum progesterone levels was significantly
      higher 3 days after synchronization than 24 days after synchronization (97% vs
      39%). The first-service conception rate was 34.8% in Group 1 and 30.7% in Group 2
      (P > 0.05). Days open were 113.5 in Group 1 and 110.9 in Group 2 (P > 0.05). It
      is concluded that postponing artificial insemination for one spontaneous estrus
      cycle after synchronization decreased the degree of synchronization. This
      procedure, however, had no effect on herd reproductive performance compared to
      insemination on first observed estrus after synchronization.

PMID- 11191864
TI  - Sperm cryopreservation of African catfish, Clarias gariepinus: cryoprotectants,
      freezing rates and sperm:egg dilution ratio.
AB  - Methods for cryopreserving spermatozoa and optimizing sperm:egg dilution ratio in
      African catfish Clarias gariepinus were developed. Five percent to 25% DMSO and
      methanol were tested as cryoprotectants, by diluting semen in Ginzburg fish
      ringer and freezing in 1-milliliter cryovials in a programmable freezer. To avoid
      an excess of spermatozoa per egg, post-thaw semen was diluted 1:20, 1:200 or
      1:2,000 before fertilization. Highest hatching rates were obtained by spermatozoa
      frozen in 10% methanol and post-thaw diluted to 1:200. Then, slow freezing rates
      (-2, -5 or -10 degrees C/min) to various endpoint temperatures (range -25 to -70
      degrees C) before fast freezing in liquid nitrogen (LN2) were evaluated. Hatching
      rates equal to control (P > 0.05) were obtained by spermatozoa frozen at -5
      degrees C/min to -45 to -50 degrees C and at -10 degrees C/min to -55 degrees C.
      In 3-step freezing programs, at -5 degrees C/min, the effect of holding
      spermatozoa for 0, 2 or 5 min at -30, -35 or -40 degrees C before fast freezing
      in LN2 was analyzed. Hatching rates equal to control (P > 0.05) were produced by
      spermatozoa frozen to, and held at, -35 degrees C for 5 min and at -40 degrees C
      for 2 or 5 min. Finally, frozen spermatozoa (10% methanol, -5 degrees C/min, 5
      min hold at -40 degrees C, LN2, post-thaw diluted to 1:200) were tested in on
      farm fertilization conditions. Again, no difference (P > 0.05) in hatching rate
      was observed between frozen and fresh spermatozoa. Cryopreservation offers
      utility as a routine method of sperm storage and management for catfish.

PMID- 11191865
TI  - Production efficiency of Japanese black calves by transfer of bovine embryos
      produced in vitro.
AB  - The objective of this study was to examine the production efficiency of Japanese
      Black beef calves after transfer of bovine embryos derived from an in vitro
      procedure. In vitro-produced (IVP) embryos were obtained from in vitro maturation
      and fertilization and in vitro development by co-culture with cumulus cells until
      7 or 8 days after insemination. In vivo-developed (IVD) embryos from
      superovulated Japanese Black heifers and cows 7 days after artificial
      insemination were used as a control group. Bovine embryos were transferred
      nonsurgically to recipient cows on Day 7 +/- 1 of the estrous cycle. Pregnancy
      was diagnosed by palpation per rectum at Day 60 to 70 after estrus. Pregnancy,
      abortion, perinatal accident and birth rates were examined according to the
      origin of embryos (IVP or IVD), the number of transferred embryos (single or
      twin) and the storage status (fresh or frozen-thawed). In Experiment 1,
      production efficiency by twin transfer of fresh IVP embryos was examined. Higher
      pregnancy rates (52 1% vs 42 9%, P < 0.05) and birth rates (47.0% vs. 33.0%, P <
      0.05) were obtained by twin transfer than by single transfer of fresh IVP
      embryos. Thus, the twin transfer of fresh IVP embryos was effective for
      production of calves, although the birth rates for single and twin transfers of
      fresh IVD embryos were still higher (55.5% and 76.1%, P < 0.05). But the abortion
      and perinatal accident rates for twin transfer of fresh IVP embryos were also
      significantly greater than those for single and twin transfer of fresh IVD
      embryos (P < 0.05). In Experiment 2, production efficiency by twin transfer of
      frozen-thawed IVP embryos was examined. Either single or twin transfer of frozen
      thawed IVP embryos resulted in a similar pregnancy rate (41.3% vs. 46.7%, P >
      0.05) and birth rate (34.1% vs. 41.1%, P>0.05). Thus, in combination with frozen
      thawed IVP embryos, the twin transfer did not enhance production efficiency. In
      conclusion, Japanese Black beef calves could effectively produce calves by twin
      transfer to Holstein recipients when using fresh IVP embryos, and by single
      transfer when using frozen-thawed IVP embryos.

PMID- 11191866
TI  - Introducing foreign DNA into tiger shrimp (Penaeus monodon) by electroporation.
AB  - Electroporation was used to introduce pFLAG-CMV-1-BAP, a DNA fragment that
      includes a bacterial alkaline phosphatase gene driven by a human cytomegalovirus
      (CMV) promoter, into Penaeus monodon zygotes. The transgenic tiger shrimp was
      achievedby using 10kV, 28 pulses, 120 g sec pulse time, 10 cycles, and a DNA
      concentration of 37.5 microg/mL. The hatching rate of electroporated zygotes
      (46%) was significantly lower than that of zygotes in the untreated group (89%).
      The survival rate of postlarvae in the electroporated group using a DNA
      concentration of 37.5 microg/mL decreased from 0.6% for postlarva 45 to 0.4% for
      postlarva 120. Based on dot blot analysis, the rate of gene transfer was 37% in
      mysis-stage, 23% postlarva 15(PL15), 19% postlarva 45(PL45), and 21% 4-month-old
      (about PL120). Genomic Southern blotting demonstrated that DNA from transgenic
      tiger shrimp contained fragments of exogenous DNA that were smaller, larger and
      of the same molecular size as pFLAG-CMV-1-BAP. Transferred DNA fragments were
      integrated into the genomes of 31% of the transgenic tiger shrimp. The exogenous
      DNA was mosaically distributed in a wide variety of tissues. Immunohistochemical
      staining revealed that the FLAG-BAP fused-protein encoded by pFLAG-CMV-1-BAP was
      present in the ovaries of some transgenic tiger shrimp.

PMID- 11191867
TI  - Estimates of heterosis for in vitro embryo production using reciprocal crosses in
      cattle.
AB  - In vitro embryo production and exploitation of heterosis are two methods of
      increasing productivity and accelerating genetic progress in many cattle
      production systems. However, it is not known if heterosis exists in bovine
      embryos produced in vitro. Tests for heterosis in in vitro embryo production were
      conducted in two experiments using reciprocal crosses. In the first, gametes from
      Bos taurus and Bos indicus were used; in the second, gametes from dairy and beef
      breeds of Bos taurus were used. In each experiment, both parental groups were
      used as sperm and oocyte donors, producing crossbred and purebred embryos.
      Oocytes obtained from abattoir-derived ovaries underwent in vitro maturation and
      in vitro fertilization with frozen semen. Embryos were cultured to blastocyst
      stage and observed. In the first experiment, higher (P < 0.05) rates of
      blastocyst formation were found for Bos taurus both as sires and as dams.
      Approximately 36% of the purebred Bos taurus oocytes and 21% of the purebred Bos
      indicus oocytes developed to blastocyst. Crosses averaged 16% resulting in a
      heterosis estimate of 45%. Ovaries from Bos indicus cows had more harvestable
      oocytes than did those from Bos taurus cows (P < 0.05). No evidence for heterosis
      was found for crosses within Bos taurus. Oocytes from beef cows had a higher rate
      of blastocyst formation than did those from dairy cows (30 vs. 24%, P < 0.05).
      These seemingly disparate results concerning heterosis were discussed in light of
      the period of genetic isolation of the parental populations in the two
      experiments.

PMID- 11191868
TI  - Effects of semen plasma from different fractions of individual ejaculates on IVF
      in pigs.
AB  - We applied IVM/IVF techniques to investigate effects of preincubation of sperm
      with different fractions of semen plasma harvested from fresh ejaculates on in
      vitro penetration and fertilization of in vitro matured oocytes. Three fractions
      of semen plasma were separated from the complete ejaculate of three Landrace
      boars and used to coincubate sperm obtained from the first sperm-rich fraction of
      the same ejaculates. After 14 to 16 h coincubation at room temperature, sperm
      were preincubated in capacitation medium and then inseminated into fertilization
      medium containing porcine oocytes matured in vitro. The semen plasma used for
      coincubation affected penetration rate (P < 0.001); Sperm coincubated with
      Fraction 1 semen plasma had a higher penetration rate compared with sperm
      coincubated with Fraction 2 (P < 0.05), but not with Fraction 3. Boar affected
      male pronucleus formation rates after insemination (P < 0.05), but no difference
      among boars was found in monospermy rate, average number of sperm penetrating
      into each fertilized oocyte, or the average number of sperm attached. No boar by
      fraction interaction was found for any parameters studied.

PMID- 11191870
TI  - Development of rabbit parthenogenetic oocytes and nuclear-transferred oocytes
      receiving cultured cumulus cells.
AB  - The present study determined a suitable parthenogenetic activation procedure for
      rabbit oocytes and examined the developmental potential of enucleated oocytes
      receiving cultured cumulus cells. Unfertilized oocytes recovered from
      superovulated rabbits were activated with one or two sets of electrical pulses,
      with or without subsequent administration of 6-dimethylaminopurine (6-DMAP). The
      proportion of oocytes treated with one or two sets of electrical pulses and 6
      DMAP that cleaved (87% and 98%, respectively) and developed into blastocysts (77%
      and 85%, respectively) was significantly higher (P < 0.05) than those activated
      with electrical pulses alone (30% and 42% for cleavage, 7% and 17% for
      blastocysts). Cumulus cells separated from ovulated oocytes obtained from mature
      rabbits were cultured for three to five passages and then induced to quiescence
      by serum starvation before nuclear transfer. The enucleated oocytes receiving
      cumulus cells were activated with electrical pulses followed by the addition of 6
      DMAP, and cultured in vitro for 5 to 6 d or transferred to pseudopregnant
      recipient females 1 d after activation. Of 186 nuclear-transferred oocytes, 123
      (66%) cleaved and 42 (23%) developed into blastocysts. After transfer of 174
      nuclear-transferred oocytes to 8 recipient females, a total of 3 implantation
      sites were observed in 3 recipient females but no fetuses were obtained.

PMID- 11191869
TI  - Ion-mediated resistance to osmotic changes of ram spermatozoa: the role of
      amiloride and ouabain.
AB  - The aim of this study was to evaluate whether the Na+/K+ and Na+/H+ exchange can
      maintain the function of fresh ram spermatozoa. We analyzed the quality
      parameters of spermatozoa from fresh ram ejaculates incubated in iso- (about 300
      mOsm), hypo- (about 100 mOsm) and hyperosmotic (about 900 mOsm) media in the
      presence of ouabain a specific inhibitor of the Na+/K+ ATP-ase or amiloride, a
      specific inhibitor of the Na+/H+ antiporter. Ouabain increased the percentage of
      morphologically altered acrosomes in isoosmotic media (from about 10% to 15% in
      control to about 30% with 10(-4) M ouabain) and decreased the percentage of total
      motility (from about 80% in control to about 50% to 55% with 10(-4) M ouabain).
      Ouabain decreased the mean linearity component of motility and decreased the
      frequency of head displacement. The addition of ouabain increased the percentage
      of altered acrosomes in the hypo- and hyperosmotic media, although it did not
      modify viability in either media. Ouabain also increased the percentage of
      swollen tails in the hypoosmotic medium at higher concentrations of the
      inhibitor. Amiloride increased the percentage of altered acrosomes in all media
      although its effect was less intense than that of ouabain. In isoosmotic media,
      total motility was decreased from about 80% in control to about 65% with 10(-4) M
      amiloride. Motile spermatozoa incubated with amiloride showed a clear decrease of
      mean velocity and mean linearity and increased frequency of head displacement. In
      the hyperosmotic medium, adding amiloride decreased the percentage of viability
      and altered tails at concentrations as low as 10(-6) to 10(-5) M. Our results
      indicate that the active mechanisms which control Na+ transport play a
      significant role in the maintenance of function in ram spermatozoa subjected to
      different osmotic environments. These mechanisms may be important in maintaining
      ram sperm function both "in vivo" and "in vitro".

PMID- 11191871
TI  - Cryopreservation of spermatozoa in cyprinid fishes.
AB  - The present study investigated semen cryopreservation in cyprinid fish using
      computer-assisted sperm motility analysis for viability control. Spermatozoa of
      the bleak, Chalcalbumus chalcoides, were used as a basic model to describe the
      toxic and cryoprotective effects of internal and external cryoprotectants, their
      most effective concentrations and combinations, the freezing and thawing
      conditions, and the effects of equilibration. We also used these data to develop
      a cryopreservation protocol for Barbus barbus, Chondrostoma nasus,
      Ctenopharyngodon idella, Cyprinus cario, Hypohtalmichthys molitrix, Leuciscus
      cephalus, Rutilus meidingerii, and Vimba vimba. For all investigated species the
      optimal extender composition was a buffered physiological sperm motility
      inhibiting saline solution containing 10% DMSO and 0.5% glycin. The optimal sperm
      equilibration period in the extender was < or = 5 min. Freezing was performed in
      an insulated box in liquid nitrogen vapor and it was optimal at 4 to 5 cm above
      the surface of the liquid, depending on the species. Thawing was optimal in a 25
      degrees C water bath whereby the thawing time ranged depending on species from 15
      to 45 sec. This cryopreservation protocol resulted in frozen-thawed semen with 35
      to 65% motile and 5 to 25% locally motile spermatozoa depending on the quality of
      fresh semen.

PMID- 11191872
TI  - Fertilizing potential in vitro of semen from young beef bulls containing a high
      or low percentage of sperm with a proximal droplet.
AB  - Fertilizing potential of semen containing a high percentage of sperm with a
      proximal droplet was evaluated using IVF. Design criteria: (a) specified semen
      with >100 x 10(6) sperm/mL with >40% progressively motile spermatozoa, after
      collection via electro-stimulation; (b) designated a droplet group, bulls whose
      semen contained >30% spermatozoa with a proximal droplet and <25% with other
      morphological abnormalities, and a control group, with <25% abnormalities of any
      type; and (c) stipulated evaluations at 11 to 13 mo of age and again -4 wk later.
      At the initial evaluation, when a bull was assigned to the droplet group, the
      next bull meeting control criteria was designated his pair; 15 pairs in four
      herds were studied. Semen was extended in egg-yolk citrate, cooled to 5 degrees C
      over approximately 2.5 h, and held at 5 degrees C. After 20 to 44 h, spermatozoa
      were processed by swimup, incubated with heparin, and co-cultured with oocytes
      (35 to 56 oocytes/sample; 18 h). Ova were observed for cleavage approximately 42
      h after co-culture, and further development was evaluated on day 8. At first
      evaluation, cleavage rates were 18 and 46% for droplet and control groups (P <
      0.01); semen had 34 to 70% and 0 to 12% droplet spermatozoa. For 10 of 15 droplet
      bulls, <10% of ova were cleaved whereas cleavage rate was >15% for all control
      bulls. At second evaluation, only three droplet bulls still had >30% of
      spermatozoa with a proximal droplet. Cleavage rates increased accordingly; only
      four droplet bulls had <10% cleaved ova and 10 had >34% cleaved ova. Three
      control bulls had <10% cleaved ova and nine had > or = 34% cleaved ova.
      Considering all 60 ejaculates, correlation between percentage of spermatozoa with
      a proximal droplet and percentage of cleaved ova was -0.49 (P < 0.0 1).
      Correlations between percentages of motile or normal spermatozoa in field
      evaluations and outcome in IVF were 0.28 and 0.52. Laboratory evaluations of
      spermatozoa concomitant with preparation for IVF revealed that only incidence of
      proximal droplets appeared related to outcome in IVF. We concluded: (a) semen
      from most yearling beef bulls with a high incidence of proximal droplet
      spermatozoa had severely compromised IVF fertility; (b) as these bulls matured,
      the incidence of proximal droplets decreased, and IVF fertilizing potential
      increased; and (c) semen containing >30% spermatozoa with a proximal droplet is
      strong evidence that fertilizing potential of the bull will be low until the
      incidence decreases.

PMID- 11191873
TI  - Expression of fibrillarin in bovine oocytes and preimplantation embryos
      developing in vitro.
AB  - Studies in somatic cells have demonstrated the participation of some defined
      nucleolar specific proteins in pre-rRNA synthesis and processing. Fibrillarin, a
      34 kd protein localized to the dense fibrillar component of the nucleolus, is
      involved in the earliest cleavage step of pre-rRNA processing. Expression of
      fibrillarin has not been characterized during the course of bovine
      preimplantation development. Specific aims of this study were to characterize the
      expression of fibrillarin in bovine oocytes and preimplantation embryos
      developing in vitro. Oocytes and embryos were labeled with an anti-fibrillarin
      primary antibody and an FITC-conjugated goat antihuman secondary antibody and
      dual stained with Hoechst 33342 DNA dye. In germinal vesicle (GV) stage oocytes,
      obtained from 2 to 6 mm follicles, fibrillarin appeared as several large distinct
      fluorescent spheres within the nucleoplasm, but was not strictly localized to the
      nucleolus. Fibrillarin was not detected in metaphase oocytes. Expression of
      fibrillarin was first detected in embryos at the pronucleate stage, appearing as
      small spots or distinct fluorescent spheres randomly distributed within the
      nucleoplasm; this pattern persisted in 2- and 4-cell stage embryos. Beginning at
      the 8-cell stage, fibrillarin signals appeared as distinct fluorescent rings
      encapsulating each nucleolus. From the 16-cell through the blastocyst stage, a
      branching immunofluorescent pattern was observed in association with fully
      reticulated nucleoli. Expression of fibrillarin was absent in 8-cell, but not
      pronucleate stage embryos cultured with alpha-amanitin, indicating that
      fibrillarin is initially recruited from maternal stores in pronucleate stage
      embryos, but then subsequently transcribed beginning at the 8-cell stage,
      coincident with the onset of nucleolar, transcription. Results from this study
      provide further insight into the organization and development of the embryonic
      nucleolus during bovine preimplantation development, and may have important
      implications for assisted reproductive technologies, including nucleus transfer.

PMID- 11191874
TI  - Effects of lactation length and weaning-to-service interval on subsequent
      farrowing rate and litter size in Landrace and Yorkshire sows in Thailand.
AB  - The aim of the present study was to investigate the influence of lactation length
      (LL) on weaning-to-service interval (WSI), and the effect of LL and WSI on the
      subsequent farrowing rate and litter size among purebred Landrace and Yorkshire
      sows under tropical conditions. The variation in litter weight at weaning (LWW)
      was also studied. Data were analyzed from three purebred sow herds located in the
      central part of Thailand, including sows weaned during the period from January
      1993 to December 1996. Data were analyzed with analysis of variance using SAS
      software. The procedure MIXED was used for analysis of the continuous outcome
      variables (namely LL, LWW, WSI, number of total born and number of live born
      piglets). The GLIMMIX macro was used for analysis of the categorical outcome
      variable, farrowing rate (FR). In the statistical analyses, WSI was grouped into
      7 groups, when it was an independent variable, as follows: 1 to 4, 5, 6, 7, 8, 9,
      to 10, and 11 to 21 days. Lactation length was grouped into 4 groups as follows:
      17 to 24, 25 to 27, 28 to 30 and 31 to 35 days. Parities were grouped into 4
      groups as follows: 1, 2, 3 + 4, and 5 to 8. Landrace sows had significantly
      higher LWW (P < 0.001) compared with Yorkshire sows (56.1 vs. 53.6 kg). The LL
      was significantly (P < 0.05) shorter during the cool season than during the other
      seasons while no difference was found in LWW between the hot and the cool season.
      The LL had no effect on WSI, FR and litter sizes. The FR was significantly lower
      when the WSI was 7 to 10 days than when the WSI was 1 to 6 days. An increase in
      WSI between Days 9 to 10 and Day 21 resulted in a significant increase in FR.
      Subsequent litter size decreased by about 0.5 piglets when the WSI increased from
      1 to 5 days to 6 to 7 days. Thereafter, litter size increased as the WSI
      increased from 9 to 10 days to 21 days.

PMID- 11191875
TI  - Effect of cysteamine during in vitro maturation on buffalo embryo development.
AB  - The purpose of this study was to evaluate whether the addition of cysteamine
      during in vitro maturation (IVM) of buffalo oocytes enhances embryo development.
      Cumulus-oocyte complexes (COC) from slaughterhouse ovaries were matured in vitro
      in TCM 199 supplemented with 10% fetal calf serum (FCS), 0.5 microg mL(-1) FSH, 5
      microg mL(-1) LH, 1 microg mL(-1) 17 beta estradiol and 0 (control), 50, 100 or
      200 micromol L(-1) of cysteamine for 24 hours. The matured oocytes then were
      fertilized and cultured for 7 days. No beneficial effect on maturation and
      cleavage rate was related to the addition of cysteamine. However, the percentage
      of embryos that developed to compact morula and blastocyst stage was
      significantly higher (P < or = 0.01) for oocytes matured in medium containing 50
      micromol L(-1) of cysteamine than it was for oocytes matured with 0, 100 and 200
      micromol L(-1) cysteamine (22.6% vs 14.9%, 15.7% and 13% respectively); moreover,
      the addition of 50 micromol L(-1) of cysteamine during IVM significantly (P < or
      = 0.01) increased the proportion of transferable quality (Grades 1 and 2) embryos
      (19.3% vs 11.3%, 11.6% and 11.2% respectively). The present study showed that
      adding a thiol compound (such as cysteamine) to the IVM medium improves buffalo
      in vitro embryo production (IVEP) efficiency, which so far has been
      unsatisfactory.

PMID- 11191876
TI  - Student productivity in a comprehensive care program without numeric
      requirements.
AB  - As the dental students of the Class of 2000 entered the Comprehensive Care Clinic
      at the University of Colorado School of Dentistry in the spring of their second
      year (spring of 1998), a different, competency-based set of clinical expectations
      was communicated to them. These students were presented a list of "Recommended
      Core Experiences" and told that the "requirements" for completion of the
      Comprehensive Care Program were 1) successful performance on all departmental
      competency examinations, and 2) timely completion of the comprehensive dental
      treatment appropriate to each assigned patient. This study examined the number of
      procedures completed during the six semesters in the Comprehensive Care Clinic
      for the Class of 2000, as compared to the clinical activity for the Class of 1999
      during the same stage of their career. The overall mean number of clinical
      procedures performed per student was 7 percent greater for the students in the
      Class of 2000 than for those in the Class of 1999. These results suggest that
      numerical requirements are not necessary to ensure dental student productivity
      and that, in fact, students can complete more clinical procedures in a
      comprehensive care clinical environment without numerical requirements.

PMID- 11191877
TI  - Reasons that orthodontic faculty teach and consider leaving teaching.
AB  - To assess reasons why orthodontic faculty consider leaving academia, a pretested
      questionnaire was mailed to 200 full-time (FT) and 200 part-time (PT) faculty
      randomly selected from the United States and Canada. A total of 144 (72 percent)
      of FT and 120 (60 percent) PT responded. About 38 percent FT and 25 percent PT
      were currently considering leaving academia. The average age of each group was
      about fifty years. Although significant differences were found in fifteen factors
      affecting the decision to leave, three factors ranked as most important (means>
      or =3.4) for FTs: salary support, financial support of department, and control
      over work or destiny. The three factors most important (means>3. 1) for PTs were:
      challenge of private practice, family commitments, and personal. FT and PT were
      similar in the most important and least important factors influencing their
      initial reasons to teach and satisfaction in teaching. However, the reasons why
      FT considered leaving were work related, while the PT's reasons were more
      personal. With the current shortage of FT orthodontic faculty becoming imminently
      greater, it appears that work-related issues could be addressed directly by
      administration.

PMID- 11191878
TI  - Cross-sectional comparison of dental students' knowledge and attitudes before
      geriatric training: 1984-1999.
AB  - The existence of negative attitudes toward aging and a lack of factual
      information has been voiced in the dental and other health professions. With
      increasing numbers of elderly in society, intergenerational social contact is
      more likely to occur and has the potential to reduce negative attitudes and
      increase knowledge about aging. The purposes of this study were to determine if
      the level of intergenerational social contact of dental students in one dental
      school had changed over the last fifteen years and whether any such changes were
      related to shifts in students' baseline knowledge about aging and attitudes
      toward elderly patients. Dental students (n=269) representing three different
      cohorts were surveyed about intergenerational contact, knowledge about aging, and
      attitudes toward elderly patients prior to receiving any geriatric training.
      Overall, findings revealed little evidence of increasing intergenerational social
      contact, an actual decrease in knowledge, an increased negative bias in
      knowledge, and unchanged attitudes toward elderly patients over the past fifteen
      years. Recent students were more likely to have had grandparents living in the
      family home, to have slightly less correct factual knowledge, and to be more
      negatively biased in their incorrect factual knowledge than earlier students.
      There were no differences in attitudes toward elderly patients among cohorts. We
      concluded that additional research is needed to confirm or refute our trends on a
      national scope. Should these trends be confirmed, dental educators would be
      alerted to the continuing necessity of countering the students' potential
      negative biases as well as a lack of basic knowledge about aging.

PMID- 11191879
TI  - Revisiting the status of dental ethics instruction.

PMID- 11191880
TI  - The UCSF post-baccalaureate reapplication program: a preliminary report.
AB  - The University of California San Francisco School of Dentistry initiated a pilot
      project in 1998 to assist economically and/or educationally disadvantaged
      students to gain admission to dental school. Students entering the program have
      completed the requirements for admission to dental school, have applied, and been
      denied admission, and have expressed a desire to care for underserved
      populations. The program features a summer preparation course for the Dental
      Admission Test (DAT), learning skill workshops, seminars, and assistance in the
      reapplication process. The students participate in clinical clerkships and during
      the fall and spring semesters are enrolled in upper-division and graduate-level
      science courses at a local university. Five students participated in the pilot
      project in 1998; they were admitted in 1999 and have successfully completed the
      first year of dental school. The sixteen students enrolled in 1999 have now been
      admitted to one or more dental schools. Fourteen students are currently enrolled
      in the 2000/2001 academic year program.

PMID- 11191881
TI  - Catalytic efficiency determines the in-vivo efficacy of PON1 for detoxifying
      organophosphorus compounds.
AB  - Human paraoxonase (PON1) is a polymorphic, high-density lipoprotein (HDL)
      associated esterase that hydrolyzes the toxic metabolites of several
      organophosphorus (OP) insecticides and nerve agents. The activity polymorphism is
      determined by a Gln/Arg (Q/R) substitution at position 192. Injection of purified
      PON1 protects animals from OP poisoning. In the present study, we investigated
      the in-vivo function of PON1 for detoxifying organophosphorus insecticides in
      PON1-knockout mice that were challenged via dermal exposure with diazoxon,
      diazinon and paraoxon. PON1-knockout mice were extremely sensitive to diazoxon.
      Doses (2 and 4 mg/kg) that caused no cholinesterase (ChE) inhibition in wild-type
      mice were lethal to the knockout mice, which also showed slightly increased
      sensitivity to the parent compound diazinon. Surprisingly, these knockout mice
      did not show increased sensitivity to paraoxon. In-vitro assays indicated that
      the PON1R192 isoform hydrolyzed diazoxon less rapidly than did the PON1Q192
      isoform. In-vivo analysis, where PON1-knockout mice received the same amount of
      either PON1(192) isoform via intraperitoneal (i.p.) injection 4 h prior to
      exposure, showed that both isoforms provided a similar degree of protection
      against diazoxon, while PON1R192 conferred better protection against chlorpyrifos
      oxon than PON1Q192. Injection of purified rabbit PON1 or either human PON1(192)
      isoform did not protect PONI-knockout mice from paraoxon toxicity, nor did over
      expression of the human PON1R192 transgene in wild-type mice. Kinetic analysis of
      the two human PON1(192) isoforms revealed that the catalytic efficiency (Vmax/Km)
      determines the in-vivo efficacy of PON1 for organophosphorus detoxication. The
      results indicate that PON1 plays a major role in the detoxication of diazoxon and
      chlorpyrifos oxon but not paraoxon.

PMID- 11191882
TI  - Genetic polymorphisms of biotransformation enzymes: allele frequencies in the
      population of the Czech Republic.
AB  - Polymerase chain reaction-restriction fragment length polymorphism based
      genotyping assays were used to determine the frequency of polymorphisms in CYP1A1
      (3'-flanking region), CYP2E1 (5'-flanking region and intron 6), EPHX (exon 3 and
      exon 4), GSTM1 (deletion), GSTP1 (exon 5) and GSTT1 (deletion) in a group of 416
      Czech individuals. A comprehensive overview of the methodology is also presented.
      We have found the following frequencies of mutated alleles: CYP1A1-m2, 0.097;
      CYP2E1-C, 0.077; CYP2E1-c2, 0.023; EPHX(exon 3)-His, 0.381; EPHX(exon 4)-Arg,
      0.198; GSTM1-null, 0.51; GSTP1-Val, 0.3; GSTT1-null, 0.164. These values are
      similar to those presented in the majority of studies on European Caucasians,
      although a few cases of significant differences in the distribution of genotypes
      were found. These differences were most probably caused by methodological
      variations or statistical bias in the analyses of low numbers of samples in the
      control groups of some authors. Based on the results of EPHX genotyping, the
      activity of its protein product was deduced and the Czech population was divided
      into three subgroups with low, medium and high EPHX activity. We found that 43%
      of the Czech population would fall into the low, 44% into the medium and 13% into
      the high EPHX activity group. The data obtained may prove to be very useful for
      epidemiological studies on the influence of genetic polymorphisms of
      biotransformation enzymes on carcinogenesis or other environment-related
      diseases.

PMID- 11191883
TI  - Relationship of phenol sulfotransferase activity (SULT1A1) genotype to
      sulfotransferase phenotype in platelet cytosol.
AB  - Sulfation catalysed by human cytosolic sulfotransferases is generally considered
      to be a detoxification mechanism. Recently, it has been demonstrated that
      sulfation of heterocyclic aromatic amines by human phenol sulfotransferase
      (SULT1A1) can result in a DNA binding species. Therefore, sulfation capacity has
      the potential to influence chemical carcinogenesis in humans. To date, one
      genetic polymorphism (Arg213His) has been identified that is associated with
      reduced platelet sulfotransferase activity. In this study, data on age, race,
      gender, SULT1A1 genotype and platelet SULT1A1 activity were available for 279
      individuals. A simple colorimetric phenotyping assay, in conjunction with
      genotyping, was employed to demonstrate a significant correlation (r = 0.23, P <
      0.01) of SULT1A1 genotype and platelet sulfotransferase activity towards 2
      naphthol, a marker substrate for this enzyme. There was also a difference in mean
      sulfotransferase activity based on gender (1.28 nmol/min/mg, females; 0.94
      nmol/min/mg, males, P = 0.001). DNA binding studies using recombinant SULT1A1*1
      and SULT1A1*2 revealed that SULT1A1*1 catalysed N-hydroxy-aminobiphenyl (N-OH
      ABP) DNA adduct formation with substantially greater efficiency (5.4 versus 0.4
      pmol bound/mg DNA/20 min) than the SULT1A1*2 variant. A similar pattern was
      observed with 2-hydroxyamino-1-methyl-6-phenylimidazo[4,5b]pyridine (N-OH-PhIP)
      (4.6 versus 1.8 pmol bound/mg DNA/20 min).

PMID- 11191884
TI  - Compound heterozygosity for missense mutations in the flavin-containing
      monooxygenase 3 (FM03) gene in patients with fish-odour syndrome.
AB  - Fish-odour syndrome is a highly unpleasant disorder of hepatic trimethylamine
      (TMA) metabolism characterized by a body odour reminiscent of rotting fish, due
      to excessive excretion of the malodorous free amine. Although fish-odour syndrome
      may exhibit as sequelae with other conditions (e.g. liver dysfunction), many
      patients exhibit an inherited, more persistent form of the disease. Ordinarily,
      dietary-derived TMA is oxidized to the nonodorous N-oxide by hepatic flavin
      containing monooxygenase 3 (FMO3). Our previous demonstration that a mutation,
      P153L (C to T), in the FMO3 gene segregated with the disorder and inactivated the
      enzyme confirmed that defects in FMO3 underlie the inherited form of fish-odour
      syndrome. We have investigated the genetic basis of the disorder in two further
      affected pedigrees and report that the three propositi are all compound
      heterozygotes for causative mutations of FMO3. Two of these individuals possess
      the P153L (C to T) mutation and a novel mutation, N61S (A to G). The third is
      heterozygous for novel, M4341 (G to A), and previously reported, R492W (C to T),
      mutations. Functional characterization of the S61, 1434 and W492 variants, via
      baculovirus-mediated expression in insect cells, confirmed that all three
      mutations either abolished, or severely attenuated, the capacity of the enzyme to
      catalyse TMA N-oxidation. Although 1434 and W492 were also incapable of
      catalysing the S-oxidation of methimazole, S61 was fully active with this sulphur
      containing substrate. Since an asparagine is conserved at the equivalent position
      to N61 of FMO3 in mammalian, yeast and Caenorhabditis elegans FMOs, the
      characterization of the naturally occurring N61S (A to G) mutation may have
      identified this asparagine as playing a critical role specifically in FMO
      catalysed N-oxidation.

PMID- 11191885
TI  - Tissue specific differences in the regulation of the UDP glucuronosyltransferase
      2B17 gene promoter.
AB  - The human UDP glucuronosyltransferase UGT2B17, glucuronidates androgens and is
      expressed in the liver and the prostate. Although evidence suggests that
      variations in UGT2B17 expression between tissues may be a critical determinant of
      androgen response, the factors that regulate UGT2B17 expression in the liver and
      prostate are unknown. In this study, we have isolated a 596 bp promoter of the
      UGT2B17 gene and studied its regulation in the liver cell line, HepG2 and the
      prostate cell line, LNCaP. The transcription start site of UGT2B17 was mapped and
      proteins that bound to the proximal promoter were detected by DNase1 footprint
      analysis. A region (-40 to -52 bp) which resembled a hepatocyte nuclear factor 1
      (HNF1) binding site bound proteins in nuclear extracts from HepG2 cells, but did
      not bind proteins from LNCaP nuclear extracts. In HepG2 cells, HNF1alpha bound to
      this region and activated the UGT2B17 promoter, as assessed by functional and gel
      shift assays. HNF1alpha activation of the promoter was prevented by mutation or
      deletion of the putative HNF1 site. The related transcription factor HNF1beta,
      which is present in HepG2 cells, did not activate the promoter. The UGT2B17
      promoter could also be activated by exogenous HNF1alpha in LNCaP cells. However,
      because these cells do not contain HNF1alpha, other transcription factors must
      regulate the UGT2B17 promoter. Cotransfection experiments showed that HNF1beta,
      elevates promoter activity in LNCaP cells. This activation did not involve the
      putative HNF1 region (-40 to -52 bp) since mutation of this region did not affect
      promoter activation by HNF1beta. These results suggest that the UGT2B17 promoter
      is regulated by different factors in liver-derived HepG2 and prostate-derived
      LNCaP cells.

PMID- 11191886
TI  - Prospective evaluation of detoxification pathways as markers of cutaneous adverse
      reactions to sulphonamides in AIDS.
AB  - The use of sulphonamides is complicated by a high rate of cutaneous reactions in
      AIDS. Metabolic risk factors have been suspected for these reactions. We
      conducted a prospective study to evaluate whether glutathione S-transferase M1
      null genotype, glutathione deficiency and acetylator status as risk factors. To
      explain the high frequency of slow acetylator phenotype in AIDS patients, we
      compared N-acetyltransferase-2 phenotype and genotype in this population. AIDS
      patients treated with sulphonamides for Pneumocystis carinii pneumonia or
      toxoplasmosis were followed up for cutaneous reactions. Glutathione S-transferase
      genotyping, glutathione level determination, N-acetyltransferase-2 genotyping and
      phenotyping were performed. One hundred and thirty-six AIDS patients were
      studied. Glutathione S-transferase M1 and T1 null genotypes, intracellular
      glutathione level, slow acetylator genotype and phenotype were not risk factors
      for cutaneous sulphonamides reactions. The association of glutathione S
      transferase M1 null genotype and the slow acetylator one was a risk factor
      [Fisher's exact test, odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.2
      5.9; P = 0.02]. A discordance between acetylator genotype and phenotype was found
      in 35% of patients. This frequency was significantly higher than the 6-7%
      expected (Fisher's exact test: OR = 7.5, 95% CI = 4.2-13.4; P < 0.0001).
      Suspected metabolic risk factors for sulphonamides cutaneous reactions were not
      confirmed prospectively. However, the association of glutathione S-transferase M1
      null genotype and the slow acetylator one appeared to increase the risk of
      reactions. We clearly showed that the acetylation phenotype measured by caffeine
      probe could be modified by the disease.

PMID- 11191887
TI  - Distribution of the N-oxidation of dietary-derived trimethylamine in a male
      Chinese population.

PMID- 11191888
TI  - Presidential address. Global change and emerging infectious diseases.

PMID- 11191889
TI  - Introduction of Dr. David S. Lindsay as the recipient of the Henry Baldwin Ward
      medal for 2000.

PMID- 11191890
TI  - Acceptance of the 2000 Henry Baldwin Ward medal.

PMID- 11191891
TI  - Characterization of proteases in the skin mucus of Atlantic salmon (Salmo salar)
      infected with the salmon louse (Lepeophtheirus salmonis) and in whole-body louse
      homogenate.
AB  - As part of an investigation of the biochemical interactions between the salmon
      louse Lepeophtheirus salmonis and Atlantic salmon Salmo salar, we characterized
      protease activity in the skin mucus of noninfected Atlantic salmon and Atlantic
      salmon infected with L. salmonis and in an L. salmonis whole-body homogenate.
      Zymography revealed that mucus from infected salmon contained a series of low
      molecular-mass (17-22 kDa) serine proteases that were not present in the mucus of
      noninfected salmon. Based on molecular mass, inhibition studies, and affinity
      chromatography, the series of proteases was identified as being trypsin-like.
      Similar proteases were observed in the L. salmonis homogenate and in mucus from
      noninfected Atlantic salmon following a 1-hr incubation with live L. salmonis. An
      antibody raised against Atlantic salmon trypsin failed to recognize any proteases
      in the mucus of noninfected salmon or infected salmon or in the L. salmonis
      homogenate. Collectively, these findings suggest that the trypsin-like proteases
      present in the mucus of infected Atlantic salmon were produced by L. salmonis,
      possibly to aid in feeding and evasion of host immune responses.

PMID- 11191892
TI  - Glycogenin-dependent organization of Ascaris suum muscle glycogen.
AB  - In Ascaris suum, muscle glycogen is synthesized during host feeding intervals and
      degraded during nonfeeding intervals. Glycogen accumulation is up to 12-fold
      greater than that observed in mammalian muscle. Previous studies have established
      that many aspects of the parasite glycogen metabolism are comparable with the
      host, but a novel form of glycogen synthase designated GSII also occurs in the
      parasite. In this report glycogenin has been identified as the core protein in
      both mature glycogen and the GSII complex. Digestion of GSII complex glycogen
      generates discreet intermediates that may correspond to a proglycogen pool,
      whereas digestion of mature glycogen does not generate these intermediates.
      Because both GSII complex glycogen and mature glycogen serve as GSII substrates,
      the GSII complex likely represents an intermediate between glycogenin and mature
      glycogen. The regulation of glycogenin synthesis or the regulation of GSII
      activity that converts glycogenin to proglycogen, or both, may account for high
      levels of polysaccharide accumulation that are essential for A. suum survival.

PMID- 11191893
TI  - Differentiation of Trypanosoma cruzi epimastigotes: metacyclogenesis and adhesion
      to substrate are triggered by nutritional stress.
AB  - Differentiation of Trypanosoma cruzi epimastigotes to metacyclic trypomastigotes
      occurs in the insect rectum, after adhesion of the epimastigotes to the
      intestinal wall. We investigated the effect of the nutritional stress on the
      metacyclogenesis process in vitro by incubating epimastigotes in the chemically
      defined TAU3AAG medium supplemented with different nutrients. Addition of fetal
      bovine serum induced epimastigote growth but inhibited metacyclogenesis. In this
      medium, few parasites attached to the substrate. Ultrastructural analysis
      demonstrated reservosomes at the posterior end of the epimastigotes. Incubation
      of the cells in TAU3AAG medium containing gold-labeled transferrin resulted in
      high endocytosis of the marker by both adhered and free-swimming epimastigotes.
      No intracellular gold particles could be detected in trypomastigotes. Addition of
      transferrin gold complexes to adhered epimastigotes cultivated for 4 days in
      TAU3AAG medium resulted in decrease of both metacyclogenesis and adhesion to the
      substrate, as compared with parasites maintained in transferrin-free medium.
      Adhesion to the substrate is triggered by nutritional stress, and proteins
      accumulated in reservosomes are used as energy source during the differentiation.
      A close relationship exists among nutritional stress, endocytosis of nutrients,
      adhesion to the substrate, and cell differentiation in T. cruzi epimastigotes.

PMID- 11191894
TI  - A new species of Swingleus (Monogenea: Gyrodactylidae) from the mummichog
      Fundulus heteroclitus, in the Delaware Bay.
AB  - Swingleus ancistrus n. sp. (Monogenea: Gyrodactylidae) is described from the skin
      and fins of Fundulus heteroclitus from Canary Creek Marsh, Lewes, Delaware.
      Subsequent records from New Jersey, Maryland, Virginia, and North Carolina are
      reported. Swingleus ancistrus is differentiated from S. polyclithroides, the only
      other species of the genus, primarily by its size, haptoral morphology, host, and
      locality. Swingleus ancistrus is larger in almost every dimension and exhibits a
      distinct notch on the anterior border of the opisthaptor, and several features of
      the haptoral anatomy and peduncular bar are unique. The prevalence of infection
      in hosts collected from the type locality in August was 100%. The maximum number
      of S. ancistrus recovered from a single host was 134. The average intensity of
      infection was 24 S. ancistrus per host from the type locality.

PMID- 11191895
TI  - A comparative study of mammalian and reptilian alternative pathway of complement
      mediated killing of the Lyme disease spirochete (Borrelia burgdorferi).
AB  - The potential bactericidal activity of the alternative complement pathway of
      mammalian and reptilian sera to Borrelia burgdorferi sensu stricto (s.s.) was
      evaluated in vitro. Complement-mediated killing was observed when cultured
      spirochetes were inoculated into sera from the western fence lizard (Sceloporus
      occidentalis) and from the southern alligator lizard (Elgaria multicarinata), but
      not when they were inoculated into serum from either the deer mouse (Peromyscus
      maniculatus) or from humans. Spirochetes were still alive after 4 hr in lizard
      serum that had been preheated at 56 C for 30 min to inactivate complement.
      Furthermore, when lizard serum was chelated with 10 mM ethylenediaminetetraacetic
      acid to block all complement activation, borreliacidal activity was arrested.
      When lizard serum was chelated with 10 mM ethylene glycol-bis(beta-aminoethyl
      ether)-N,N,N',N'-tetraacetic acid plus 4 mM MgCl2 to block only classical
      complement pathway activation, >85% of spirochetes were immobilized within 1 hr.
      Differences in B. burgdorferi s.s. mortality were not observed when chelators
      with or without MgCl2 were added to serum from either deer mice or humans.
      Proteins comprising the alternative complement pathway are responsible for the
      borreliacidal activity observed in the blood of S. occidentalis and E.
      multicarinata.

PMID- 11191896
TI  - Huffmanela mexicana n. sp. (Nematoda: Trichosomoididae) from the marine fish
      Sphoeroides annulatus in Mexico.
AB  - A new species of trichosomoidid nematodes, Huffmanela mexicana n. sp., is
      established on the basis of its egg morphology and biological characters. The
      dark-shelled, embryonated eggs of this histozoic parasite occur in masses in the
      inner layer of the swimbladder wall of the bullseye puffer fish Sphoeroides
      annulatus Jenyns, 1843 (Tetraodontidae, Tetraodontiformes) off the Pacific coast
      of Mexico (Sinaloa State) and are characterized mainly by their shape and size
      (63-69 x 30-33 microm), an aspinose surface, relatively small polar plugs, and
      their thick egg wall (4-5 microm). A key to Huffmanela species based on egg
      morphology is presented.

PMID- 11191898
TI  - Argentophilic structures of the miracidia and cercariae of Philophthalmus
      distomatosa n. comb. from Israel.
AB  - The morphology and patterns of distribution of the argentophilic structures of
      miracidia and cercariae of Philophthalmus distomatosa n. comb. are described. The
      epidermal plate arrangement of the vast majority (94.2%) of miracidia studied
      conformed to the formula 6:8:4:2 = 20. The rest (5.8%) displayed the following
      patterns of arrangement of epidermal plates: 6:7:4:2 = 19; 6:6:4:2 = 18; and
      6:4:4:2 = 16. Twenty papillalike structures were observed on the terebratorium.
      They were arranged along 1 axis, in 3 groups. Most commonly, 16 papillae were
      present on the body, located between epidermal plates of the first and second
      rows. The eye spots were located dorsally, near interepidermal space S1. The
      numbers, arrangements, and locations of the excretory pores varied. Patterns of
      distribution of the tegumentary papillae of P. distomatosa n. comb. cercariae are
      given, including those of the cephalic regions, periacetabular region, and tail.
      Argentophilic structures of the mentioned larval stages and of other parameters
      clearly distinguishing between the presently described species and those of P.
      lucipetus from Israel are summarized. On the basis of comparison of the presently
      described larval stages and those of other Melanoides tuberculata-associated
      larval stages of Philophthalmus in Israel and Jordan, the possibility exists that
      a third species occurs in Israel.

PMID- 11191897
TI  - Complement-mediated killing of Borrelia burgdorferi by nonimmune sera from sika
      deer.
AB  - Various species of cervid deer are the preferred hosts for adult, black-legged
      ticks (Ixodes scapularis and Ixodes pacificus) in the United States. Although
      frequently exposed to the agent of Lyme disease (Borrelia burgdorferi), these
      animals, for the most part, are incompetent as transmission reservoirs. We
      examined the borreliacidal activity of normal and B. burgdorferi-immune sera from
      sika deer (Cervus nippon) maintained in a laboratory setting and compared it to
      that of similar sera from reservoir-competent mice and rabbits. All normal deer
      sera (NDS) tested killed > 90% of B. burgdorferi cells. In contrast, normal mouse
      and rabbit sera killed < or = 22% of the Borrelia. Anti-B. burgdorferi antibodies
      could not be detected in any normal sera by indirect fluorescent antibody assay
      (IFA). Sera collected from deer 6 wk after exposure to B. burgdorferi by tick
      feeding exhibited IFA titers of 1:256, whereas sera from mice and rabbits
      similarly exposed had titers of > 1:1,024. Heat treatment (56 C, 30 min) of NDS
      reduced borreliacidal activity, with < 20% of the B. burgdorferi cells killed,
      suggesting complement-mediated killing. The chelators EGTA and EDTA were used to
      block the classical or both the classical and alternative complement pathways,
      respectively. Addition of 10 mM EGTA to NDS had a negligible effect on
      borreliacidal activity, with > 90% of the cells killed. Addition of 10 mM EDTA
      reduced the killing to approximately 30%, whereas the addition of Mg2+ (10 mM)
      restored borreliacidal activity to NDS. The addition of zymosan A, an activator
      of the alternative pathway, increased the survival of B. burgdorferi cells to
      approximately 80% in NDS. These data suggest that the alternative complement
      activation pathway plays a major role in the borreliacidal activity of NDS.
      Additionally, 10 mM EGTA had almost no effect on the killing activity of B.
      burgdorferi-exposed deer sera, suggesting that the classical pathway is not
      involved in Borrelia killing, even in sera from B. burgdorferi-exposed deer.

PMID- 11191899
TI  - Morphologic, host specificity, and genetic characterization of a European
      Cryptosporidium andersoni isolate.
AB  - This study was undertaken in order to characterize a Cryptosporidium muris-like
      parasite isolated from cattle in Hungary and to compare this strain with other
      Cryptosporidium species. To date, the large-type oocysts isolated from cattle
      were considered as C. muris described from several mammals. The size, form, and
      structure of the oocysts of the Hungarian strain were identical with those
      described by others from cattle. An apparent difference between the morphometric
      data of C. muris-like parasites isolated from cattle or other mammals was noted,
      which is similar in magnitude to the differences between Cryptosporidium
      meleagridis and Cryptosporidium felis or between Cryptosporidium serpentis and
      Cryptosporidium baileyi. The cross-transmission experiments confirmed the
      findings of others, as C. muris-like oocysts isolated from cattle fail to infect
      other mammals. The sequence of the variable region of small subunit (SSU) rRNA
      gene of the strain was 100% identical with that of the U.S. Cryptosporidium
      andersoni and C. andersoni-like isolates from cattle. The difference between the
      SSU rRNA sequence of bovine strains and C. muris is similar in magnitude to the
      differences between C. meleagridis and Cryptosporidium parvum anthroponotic
      genotype or between Cryptosporidium wrairi and C. parvum zoonotic genotype. Our
      findings confirm that the Cryptosporidium species responsible for abomasal
      cryptosporidiosis and economic losses in the cattle industry should be considered
      a distinct species, C. andersoni Lindsay, Upton, Owens, Morgan, Mead, and
      Blagburn, 2000.

PMID- 11191900
TI  - Intraspecific heterogeneity in the mini-exon gene localization of Leishmania
      (Viannia) panamensis and Leishmania (Viannia) guyanensis from Colombia.
AB  - Intraspecific heterogeneity was demonstrated in the mini-exon gene localization
      from Leishmania (Viannia) panamensis and L. (Viannia) guyanensis. Different
      karyotypes were detected in human isolates circulating in endemic areas of
      Colombia. The presence of mini-exon gene sequences on chromosomes of different
      sizes, ranging from 370 to 800 kb in L. (V.) panamensis and from 500 to 800 kb in
      L. (V.) guyanensis, was observed and was neither strain nor species specific. In
      some cases, hybridization with 2 chromosomes in the same strain was observed. The
      variability of chromosomal localization of mini-exon gene sequences of these 2
      species highlights the genetic variability of the Viannia subgenus and the
      potential utility of the mini-exon gene as a molecular epidemiologic marker.

PMID- 11191901
TI  - The symbiotic water mite Unionicola formosa (Acari: Unionicolidae) ingests mucus
      and tissue of its molluscan host.
AB  - Unionicola formosa is a symbiotic water mite that passes most of its life cycle
      in the mantle cavity of freshwater mussels. Although mites of this genus are
      often referred to as parasitic, little is known about their nutritional biology.
      A few species reportedly pierce the gill of a host mussel and ingest tissue or
      hemolymph. The present study was undertaken to identify possible sources of
      nutrition for U. formosa. To determine if mites ingested particulate matter in
      the mucous strand produced by a mussel during feeding, mussels with resident
      mites were exposed to a suspension of fluorescent microspheres. There was no
      evidence that U. formosa ingested the beads. Histochemical staining did, however,
      indicate a mucous material present in the midgut of the mites. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoretic assays revealed a high molecular
      weight component, consistent with a mucopolysaccharide, present both in the
      mussel gill and the mites. Results from western blots and an immunoaffinity
      binding assay with antibodies against mussel gill tissue and hemolymph also
      indicated that mites ingested host tissue. Whereas U. formosa probably does not
      ingest particulate material acquired by its host's suspension feeding, it is
      apparent that this mite utilizes host mucus, gill tissue, or hemolymph for at
      least part of its nutrition.

PMID- 11191902
TI  - Developmental and immunological aspects of Drosophila-parasitoid relationships.
AB  - The Drosophila-parasitic wasp (parasitoid) associations involve integrating
      adaptations of considerable complexity. This review focuses on some of the
      factors that influence these interactions including host immunity, nutrition and
      hormonal changes, and parasitoid virulence and mechanisms of immune suppression.

PMID- 11191903
TI  - Growth and emigration of third-stage larvae of Hysterothylacium aduncum
      (Nematoda: Anisakidae) in larval herring Clupea harengus.
AB  - The growth and emigration of Hystherothylacium aduncum in laboratory-reared
      herring larvae Clupea harengus was studied. Experimental infections of 36-day-old
      herring larvae resulted in 126 hosts infected with 306 H. aduncum larvae.
      Regression analyses showed a significant worm emigration from the rectum to the
      head of the fish, accompanied by an increase in worm body length. The emigration
      was independent of worm intensity, which suggests an ontogenetic process. Some
      worms departed from this pattern by moving posteriorly or by penetrating into the
      muscle, and in 5 cases, the larvae were observed to leave living fish. This
      individual variation has not been observed in previous studies and might be
      explained by host signals related to condition or development stage. Indirect
      evidence suggested parasite-induced mortality in the tanks due to the emigrations
      because only 4 of the 126 infected fish survived 8 days postinfection; the
      emigration of H. aduncum affected vital organs, such as the heart and brain, and
      the larvae penetrating or leaving the host's tissues can cause extensive damage
      to the delicate herring larvae.

PMID- 11191904
TI  - Completion of the life cycle of Sarcocystis neurona.
AB  - Sarcocystis neurona is the most important cause of a neurologic disease in
      horses, equine protozoal myeloencephalitis (EPM). The complete life cycle of S.
      neurona, including the description of sarcocysts and intermediate hosts, has not
      been completed until now. Opossums (Didelphis spp.) are definitive hosts, and
      horses and other mammals are aberrant hosts. In the present study, laboratory
      raised domestic cats (Felis domesticus) were fed sporocysts from the intestine of
      a naturally infected opossum (Didelphis virginiana). Microscopic sarcocysts, with
      a maximum size of 700 x 50 microm, developed in the muscles of the cats. The DNA
      of bradyzoites released from sarcocysts was confirmed as S. neurona. Laboratory
      raised opossums (D. virginiana) fed cat muscles containing the sarcocysts shed
      sporocysts in their feces. The sporocysts were approximately 10(-12) x 6.5-8.0
      microm in size. Gamma interferon knockout mice fed sporocysts from experimentally
      infected opossums developed clinical sarcocystosis, and S. neurona was identified
      in their tissues using S. neurona-specific polyclonal rabbit serum. Two
      seronegative ponies fed sporocysts from an experimentally-infected opossum
      developed S. neurona-specific antibodies within 14 days.

PMID- 11191905
TI  - Simultaneous stable expression of neomycin phosphotransferase and green
      fluorescence protein genes in Trypanosoma cruzi.
AB  - The ribosomal RNA (rRNA) gene promoter was used to construct plasmid vectors that
      simultaneously express multiple exogenous genes in Trypanosoma cruzi. Vector
      pBSPANEO expresses neomycin phosphotransferase, and pPAGFPAN expresses both green
      fluorescent protein and neomycin phosphotransferase from a single promoter. Both
      vectors require the presence of the rRNA promoter for stable transfection;
      epimastigotes transfected with pPAGFPAN strongly fluoresced due to green
      fluorescent protein expression. Intact plasmids were rescued from the T. cruzi
      transfected population after >8 mo of culture, indicating stable replication of
      these vectors. Vectors were integrated into the rRNA locus by homologous
      recombination and into other loci, presumably by illegitimate recombination.
      Parasites bearing tandem concatamers of plasmids were also found among the
      transfectants. Transfectants expressing green fluorescent protein showed a bright
      green fluorescence distributed throughout the cell. Fluorescence was also
      detected in amastigotes after infection of mammalian cells with transfected
      parasites, indicating that the rRNA promoter can drive efficient expression of
      these reporter genes in multiple life-cycle stages of the parasite. Expression of
      the heterologous genes was detected after passage in mice or in the insect
      vector. These vectors will be useful for the genetic dissection of T. cruzi
      biology and pathogenesis.

PMID- 11191906
TI  - Molecular and morphological studies of Brazilian Trypanosoma evansi stocks: the
      total absence of kDNA in trypanosomes from both laboratory stocks and naturally
      infected domestic and wild mammals.
AB  - The kinetoplast DNA (kDNA) minicircle molecules of 14 Brazilian stocks of
      Trypanosoma evansi were studied by morphological approaches (Giemsa and 4'-6'
      diamidino-2-phenylindole staining and transmission electron microscopy) and
      molecular approaches (probing with an oligonucleotide complementary to the
      minicircle origin of replication and polymerase chain reaction amplification of a
      minicircle sequence). All methods indicated the absence of both a typical
      kinetoplast and kDNA minicircles, even in a very small number of parasites of a
      single stock or in small numbers of copies of molecules per cell. We did not
      detect any altered kDNA molecules. There were no kDNA molecules in either old or
      new stocks of T. evansi maintained by successive passages in mice. Similarly, no
      kDNA minicircles were detected in trypanosomes in blood smears from naturally
      infected domestic and wild animals. Thus, the total absence of kDNA in Brazilian
      stocks of T. evansi from both domestic and wild mammals is probably the natural
      state of Brazilian T. evansi.

PMID- 11191907
TI  - Clinical coccidiosis in raccoons (Procyon lotor).
AB  - Clinical coccidiosis was diagnosed in wild-caught and captive raccoons. Eimeria
      procyonis-like oocysts were seen in 15 of 15 captive raccoons. In 6 of 6 juvenile
      wild-caught raccoons examined at necropsy, endogenous coccidian stages were seen
      in the small intestine. Two types of schizonts (large and small) were identified.
      Large schizonts were up to 110 microm long, contained 10-microm-long merozoites,
      and were in crypt glandular epithelial cells. Smaller schizonts were 10 microm
      long, contained 5-microm-long merozoites, and were at the tips of the villi. Only
      a few gamonts and no oocysts were seen in sections. These stages were thought to
      be of E. procyonis.

PMID- 11191908
TI  - Redescription of Crepidostomum opeongoensis Caira, 1985 (Trematoda:
      Allocreadiidae) from fish hosts Hiodon alosoides and Hiodon tergisus
      (Osteichthyes: Hiodontidae).
AB  - Crepidostomum opeongoensis Caira, 1985 (Trematoda: Allocreadiidae) is redescribed
      from fish hosts Hiodon alosoides and Hiodon tergisus in southern Manitoba. The
      redescription adds details regarding the surface morphology and reproductive
      structures of the parasite not described previously. These include the
      characteristic tegumental papillae around the oral opening, paired papillae on
      the ventral and dorsal surfaces of the body, and tegumental bosses on the dorsal
      surface of the forebody. Crepidostomum opeongoensis co-occurred with its
      hypothesized sister species. Crepidostomum illinoiense, in all host individuals
      harboring the former, and both species are characteristic of hiodontids. The
      association of C. opeongoensis with hiodontids and the absence of hiodontids in
      Lake Opeongo where C. opeongoensis was originally reported indicate that the
      Algonquin Park region may have had hiodontids in the past and that the life cycle
      may be completed at present without the original fish host.

PMID- 11191909
TI  - Pterygodermatites (Mesopectines) senegalensis n. sp. (Nematoda, Rictulariidae), a
      parasite of Mastomys huberti (Rodentia, Muridae) in Senegal.
AB  - Pterygodermatites (Mesopectines) senegalensis n. sp. (Nematoda: Rictulariidae) is
      described from Mastomys huberti in Senegal. It differs from other species of the
      subgenus by the morphology of the head, which exhibits 4 simple cephalic papillae
      and a nearly axial buccal opening, the length of the spicules, the number of
      precloacal cuticular formations, and the absence of cephalic apophyses.

PMID- 11191910
TI  - Two new species of Litomosoides (Nematoda: Filarioidea) in Sigmodontines
      (Rodentia: Muridae) from Rio de La Plata marshland, Argentina.
AB  - Two new species of coelomic filarioid belonging to Litomosoides are described
      from sigmodontine murids from the Rio de La Plata marshland, Argentina.
      Litomosoides bonaerensis n. sp., a parasite of Oligoryzomys delticola, belongs to
      the carinii group and is close to L. silvai, which differs by the head and tail
      papillae, buccal capsule and cavity, area rugosa, and morphology of the
      microfilaria. Litomosoides oxymycteri n. sp., from Oxymycterus rufus, belongs to
      the sigmodontis group. Differential diagnosis is based on the morphology of the
      buccal capsule, the head and tail papillae, and microfilaria. The ectoparasitic
      gamasid Ornithonyssus bacoti, in which several Litomosoides species develop, has
      been recovered from sigmodontines trapped in the study.

PMID- 11191911
TI  - Phylogenetic relationships among species of Stilestrongylus Freitas, Lent and
      Almeida, 1937 (Trichostrongyloidea: Heligmonellidae: Nippostrongylinae),
      parasites of myomorph rodents (Rodentia: Muridae) in the Neotropics.
AB  - The phylogenetic relationships of 14 species of Stilestrongylus were analyzed
      using the comparative morphology of 21 characters. We obtained 2 shortest trees
      of 50 steps, with a consistency index of 0.540 and 25 apomorphic character
      states. Ingroup monophyly was supported on these trees by 2 and 3 synapomorphies,
      respectively, and the ingroup was defined by the following characters: greater
      number of ventral ridges relative to the number of ridges dorsally, asymmetric
      bursa, and externodorsal rays differing in size. Sister-group relationships among
      Stilestrongylus and the other genera designated as outgroups are relatively
      consistent with those postulated by Durette-Desset's in a classification of the
      Nippostrongylinae. The ancestor of the species groups comprising
      Hassalstrongylus, Guerrerostrongylus, and Stilestrongylus originated and
      diversified in murids in the Neotropical region. Species of Hassalstrongylus
      occur in rodents between southeastern North America and the eastern part of South
      America (Brazil and Argentina), whereas species of Guerrerostrongylus and
      Stilestrongylus diversified exclusively in rodents in the Neotropics.

PMID- 11191912
TI  - Purification of first-stage larvae of Elaphostrongylus cervi (Nematoda:
      Protostrongylidae) from feces.
AB  - Parasites are often found in a milieu that requires extensive preparation and
      labor-intensive cleaning before they are suitable for use in analytical
      procedures. Application of modern techniques in immunology and molecular biology
      demands pure yields of parasites. To purify first-stage (L1) larvae of
      Elaphostrongylus cervi, fecal suspensions from an infected red deer were
      processed by the Baermann method and embedded in a gel matrix with the objective
      of selectively trapping fecal debris. About half the number (50.9%) of embedded
      larvae migrated out of the gel within a 24-hr period and were collected as clean
      parasite suspensions, virtually free from fecal debris. The numbers of L1
      emigrating from gels were inversely proportional to the fecal debris content and
      the thickness of the gel. Removal of fecal debris from Baermann fluid by sieving
      prior to gel embedment enhanced the yield of pure L1.

PMID- 11191913
TI  - Infection by Paragonimus miyazakii cercariae of their crab hosts, Geothelphusa
      dehaani, by percutaneous penetration.
AB  - Identification of the transmission routes of the trematode parasite Paragonimus
      miyazakii into different intermediate hosts would help to explain the natural
      distribution of the parasite. The behavior of P. miyazakii cercariae released
      from snails into water and in the presence of a living host or a whole crab leg
      was observed by stereoscopic or light microscopy at various times after exposure
      started. On encountering a crab leg or cheliped, the cercariae became entangled
      with the host via mucoid strands arising from the cercariae. Within 3 hr, most
      cercariae were attached to the host; cuticular penetration took between 5 and 6
      hr, after which cercariae were found in the cavity of the leg. Crabs examined 102
      149 days after exposure to the cercariae contained fully developed metacercariae.
      The metacercariae were fed to 2 rats, and the rats were killed 83 or 111 days
      later. Some of the metacercariae had reached maturity in the rats. That the
      cercariae were not ingested by the crabs but penetrated the crabs percutaneously
      (through hard as well as soft tissue) means that transmission can occur even in
      areas in which crabs and the host snails do not coexist, as they would if the
      usual route were oral (when the crabs ate infected snails).

PMID- 11191914
TI  - Susceptibility of species A, B, and C of Anopheles culicifacies complex to
      Plasmodium yoelii yoelii and Plasmodium vinckei petteri infections.
AB  - The comparative susceptibilities of colonized species A, B, and C of Anopheles
      culicifacies complex and Anopheles stephensi were determined for 2 rodent malaria
      parasites Plasmodium vinckei petteri and Plasmodium yoelii yoelii. All the 3
      members of the complex were found to support complete sporogony with varying
      success. Controls, A. stephensi, become readily infected, with >70% developing
      oocysts. Of the test groups, species A had the highest percentage of mosquitoes
      with oocysts (>25%) and sporozoites (>15%). Anopheles culicifacies species B were
      least susceptible; less than 10% had oocysts and sporozoites in the salivary
      glands. The results demonstrate that A. culicifacies species A is most
      susceptible and species B is least susceptible to infections with both the
      parasites.

PMID- 11191915
TI  - Comparative biology of Uncinaria spp. in the California sea lion (Zalophus
      californianus) and the northern fur seal (Callorhinus ursinus) in California.
AB  - Studies on several aspects of the life cycle of hookworms (Uncinaria spp.) in the
      California sea lion (Zalophus californianus) and northern fur seal (Callorhinus
      ursinus) were conducted on material collected on San Miguel Island (SMI),
      California and at The Marine Mammal Center, Sausalito, California in 1997, 1998,
      and 1999. Examination of Z. californianus intestines for adult hookworms and
      feces for eggs revealed that longevity of these parasites in pups is about 6-8
      mo, and infections are probably not present in older sea lions. Parasitic third
      stage larvae (L3) were recovered from the ventral abdominal tissue of Z.
      californianus, suggesting transmammary transmission. Callorhinus ursinus pups had
      no hookworm eggs in their feces or adult worms (except for 1 probable
      contaminant) in their intestines in the fall and early winter, revealing that
      adult Uncinaria spp. are spontaneously lost at <3 mo of age of the pups. Sand
      samples from rookeries, used by both Z. californianus and C. ursinus, on SMI were
      negative for free-living, L3 in summer months but positive in fall and winter
      months, indicating seasonality occurred.

PMID- 11191917
TI  - Effect of the antimicrobial peptide, D-hecate, on trichomonads.
AB  - Tritrichomonas foetus and Trichomonas vaginalis are protozoan parasites that
      cause sexually transmitted diseases in cattle and humans, respectively. There is
      a need for new antimicrobial agents to treat or prevent trichomoniasis because
      there are currently no approved chemotherapeutic agents against T. foetus and
      resistance of T. vaginalis to metronidazole does occur. Therefore, we evaluated
      the effect of a novel antimicrobial peptide, D-hecate, on the viability of 6
      isolates of T. foetus and T. vaginalis in vitro. Tritrichomonas foetus and T.
      vaginalis were grown to mid log phase (24 hr) or late log/stationary phase (48
      hr). Parasites at 10(6)/ml were mixed with equal volumes of D-hecate to final
      concentrations of 10 microM, 20 microM. and 40 microM of D-hecate. Controls had
      minimal essential medium (MEM) alone. The numbers of viable parasites were
      determined microscopically after 10, 20, and 30 min of incubation at 37 C with D
      hecate or MEM. Our results show that D-hecate killed all 6 isolates of T. foetus
      and T. vaginalis evaluated. The killing effect was dependent on the concentration
      of the peptide, incubation time, and phase of growth of the parasites.
      Ultrastructural studies of parasites treated with 10 microM of D-hecate revealed
      extensive damage to the plasma membrane of most T. foetus and T. vaginalis cells,
      while a few cells were distorted but remained intact. D-Hecate may be a useful
      chemotherapeutic agent for the treatment of trichomoniasis.

PMID- 11191916
TI  - Detection of the Cryptosporidium parvum "human" genotype in a dugong (Dugong
      dugon).
AB  - The Cryptosporidium "human" genotype was identified in a paraffin-embedded tissue
      section from a dugong (Dugong dugon) by 2 independent laboratories. DNA
      sequencing and polymerase chain reaction/restriction fragment length polymorphism
      analysis of the 18S ribosomal RNA gene and the acetyl CoA synthethase gene
      clearly identified the genotype as that of the Cryptosporidium variant that
      infects humans. This is the first report of the human Cryptosporidium genotype in
      a nonprimate host.

PMID- 11191918
TI  - Occurrence of Sanguinicola occidentalis Van Cleave and Mueller, 1932 in Perca
      flavescens and Campeloma decisum from a Michigan creek.
AB  - Sanguinicola occidentalis (Trematoda: Sanguinicolidae) infected 58 (48%) of 120
      yellow perch collected in 1997 and 40 (50%) of 80 yellow perch collected in 1998
      from Silver Creek in lower Michigan. The mean intensity and mean abundance of
      this blood fluke were higher in 1998 than in 1997. The fluke was found in the
      bulbous arteriosus of the perch heart, free in the petri dishes when the gill
      filaments were teased apart, and in the body cavity washings, and 1 individual
      was associated with an eye. Of the 269 S. occidentalis examined from perch, none
      had eggs. Most perch examined and infected were only 1+ yr in age. Spearman's
      correlation coefficients between S. occidentalis intensity and host length in
      1997 and 1998 were not significant. An additional 25 yellow perch (0+ yr in age)
      collected in 1998 were not infected. Thirty-seven (33%) of 113 snails (Campeloma
      decisum) examined in July and August 1999 from Silver Creek were infected with S.
      occidentalis.

PMID- 11191919
TI  - Monoclonal antibodies to Hammondia hammondi allowing immunological
      differentiation from Toxoplasma gondii.
AB  - Five murine monoclonal antibodies (MAbs) were developed against purified
      sporozoites of Hammondia hammondi. Despite a large antigenic similarity between
      the 2 closely related coccidia, H. hammondi and Toxoplasma gondii, these MAbs
      only reacted with H. hammondi. Three MAbs, ID3, 3F2, and 4C9-7, recognized
      antigens of 38 kDa localized in rhoptries (1D3), in rhoptries and in oocyst and
      cyst walls (3F2), and in rhoptries and the apical region (4C9-7). Another MAb,
      4C9-10, reacted with a 27-kDa antigen in dense granules of sporozoites and
      tachyzoites, and MAB 11B3 labeled an antigen of >94 kDa located in the pellicular
      membrane of the 3 stages of the parasite. These MAbs could be used for a rapid
      discrimination of the 2 coccidia in epidemiological studies or for diagnostic
      purposes in tissues.

PMID- 11191920
TI  - A random amplified polymorphic DNA polymerase chain reaction technique that
      differentiates between Neospora species.
AB  - Neospora caninum is a recently described coccidial parasite that was first
      isolated from a dog in 1988 and has subsequently been shown to infect a wide
      range of mammals. Neospora hughesi, a new species of this genus, has recently
      been isolated from the spinal cord of horses showing clinical signs of equine
      protozoal myeloencephalitis. The random amplified polymorphic DNA polymerase
      chain reaction technique is capable of differentiating between N. caninum and N.
      hughesi.

PMID- 11191921
TI  - The nuclear rDNA region of Gyrodactylus arcuatus and G. branchicus (Monogenea:
      Gyrodactylidae).
AB  - The primary structure of the ribosomal DNA internal transcribed spacers (ITS-1
      and ITS-2) and 5.8S rRNA gene were used to characterize and identify 2 monogenean
      species of Gyrodacrylus living externally on the threespine stickleback
      (Gasterosteus aculeatus). The ITS region was amplified by PCR from freshwater,
      brackish, and marine isolates of Gyrodactylus arcuatus and G. branchicus, and the
      ends of the coding regions were identified by comparative alignment. No
      intraspecific and very low interspecific variation were observed in the 5.8S rRNA
      gene; high inter- and low intraspecific variation were revealed in the ITS-1 and
      ITS-2 regions. The morphological species identification was in all cases
      confirmed by the molecular identification. Intraspecifically, samples from 2
      locations in the North Sea could be differentiated, but the Baltic sample
      resembled North Sea genotypes. Our approach offers perspectives for a multimetric
      genetical, morphometrical, and ecological taxonomy of the genus Gyrodactylus.

PMID- 11191922
TI  - [Development of child guidance clinics in Germany--an overview].
AB  - The development of child guidance centres began before 1910 with single
      institutions characterized by various subject areas (medicine, pedagogy,
      psychology) as well as by the connection of counselling and therapeutic
      treatments. Since about 1920 it has become customary to call such institutions
      child guidance centres. A consistent development lead to the fact that in the
      Child and Adolescent Aid Law of 1990 child guidance centres are called
      institutions which are capable of handling different problems with a multi
      professional staff and various methods, and offering counselling and treatments
      as required. People seeking advice shall be able to contact child guidance
      centres directly of their own free will.

PMID- 11191923
TI  - [Process of institutional child guidance counseling reflected by the Central
      Continuing Education of the Federal Conference for Child Guidance Counseling].
AB  - The Bundeskonferenz fur Erziehungsberatung (bke) is the federation for child
      guidance and family-counseling in Germany. Members are the working groups for
      child guidance and family-counseling of the Lander, where the employees of the
      child guidance are organized. The federation was founded in 1962. It is sponsored
      by the Federal Ministry for Family, Seniors, Women and Youth. Further education
      for professional youth workers is central mission of bke. The constitution of the
      federation lais down these contents. Every autumn the bke publishes the program
      for further education for the following year in a brochure called Zentrale
      Weiterbildung--the program for child guidance, family counseling and youth
      counseling. A special Kommission Zentrale Weiterbildung acquires the contents of
      the program for further education und selects the referents. Since 1968 the
      Zentrale Weiterbildung of Bundeskonferenz fur Erziehungsberatung offers events
      for professional youth workers in child guidance, family counseling. The program
      for further education contributes the quality of the institution of child
      guidance. After a time with above average use of the program for further
      education with therapeutical focal point, the orientation of the program changes
      to child and youth services. A constant number of counselors use the program.
      Beside the change of contents there was a change to effectiveness of contents and
      a reduction of participants.

PMID- 11191924
TI  - [Quality of child guidance counseling--current developments at the beginning of
      the 21st century].
AB  - Development of quality is not a new discussion in child guidance. There has been
      a long tradition about this theme. The continuously changing conditions of
      society and law demands child guidance on the other hand to changing reactions
      also. In modern child guidance we can find them in changed concepts and methods.
      So quality will be developed. The complete analysis shows us also, were new
      discussions are necessary.

PMID- 11191925
TI  - [Where are the children in family counseling? Results of an explorative study].
AB  - Since the late seventies the family setting has become a normal model in
      counseling, not least because of the systemic change in psychotherapy. The lack
      of methodologically well-founded considerations on how to involve the children in
      the family talk is therefore even more surprising. In the present study 40
      counselors were interviewed how they propose to fill the special gap in their
      practical work, what strategies they have developed to involve children and how
      important for them children are in the family talk. The result was that the
      majority of the counselors are adult oriented in their activities and rarely
      include the children actively in the interactive proceedings. Nevertheless all
      those interviewed regarded their presence as necessary because they provide
      helpful diagnostic assistance in uncovering and recognizing parental problems and
      relational conflicts.

PMID- 11191926
TI  - [Adventure conflict--early prevention of violence in child day care centers and
      primary schools].
AB  - The primary target group of the program are children aged 3 to 10 years attending
      child day care centres and primary schools. The intermediate target groups are
      teachers and parents. The objectives for the primary target group are to promote
      good social behavior, to develop constructive solutions to conflict and to set
      out rules and limits for children. The objectives for the intermediate target
      groups are to learn constructive ways of handling conflicts in each team, to
      improve cooperation in the teams and between teachers and parents and to raise
      awareness among parents. The work is done on three levels: children, teachers and
      parents. It provides training, group work, work with creative media, relaxation
      and movement exercises, theory, role play and advice on organization.

PMID- 11191927
TI  - Electrodiagnosis of polyneuropathy.
AB  - Electrodiagnostic studies comprising electromyography (EMG) and nerve conduction
      studies (NCS) are well-established objective methods for the diagnosis,
      quantification and classification of polyneuropathies (PNP). This paper reviews
      examination techniques, their pathophysiological interpretation, examination
      strategies and diagnostic criteria for the diagnosis and classification of a PNP.
      The routine electrodiagnostic evaluation includes sensory NCSs performed with
      surface or needle electrodes, motor NCSs, F-wave studies and EMG by qualitative
      or quantitative techniques. Sensory NCSs and F-wave studies have a high
      sensitivity in PNPs and the different techniques complement each other. The
      distinction between a PNP with predominantly axonal loss and a PNP with
      predominantly demyelination is one of the major aims of the electrophysiological
      examination. There are, however, large variation in suggested criteria for
      predominantly demyelination. The degree of slowing in conduction taken to
      indicate demyelination varies between a decrease of 50 to 30% from mean of
      controls, distal latency prolongation criteria vary from 35% to 70% of mean of
      controls, F-wave latency prolongation criteria vary from 120% to 150% of upper
      limit of controls, and criteria for partial motor conduction block vary from 11
      to 50% reduction of CMAP amplitude and/or area between proximal and distal
      stimulation. Needle EMG studies may be valuable in order to detect and quantify
      denervation activity, to assess chronicity by an evaluation of the extent of
      reinnervation, and to evaluate the topographical distribution of changes. It is
      concluded that electrodiagnostic studies are valuable in patients with suspected
      PNP and the results may have consequences for prognosis and therapy of individual
      patients. Large variation in examination techniques, strategies, interpretations
      and diagnostic criteria have been found among electromyographers and it is
      suggested that the value of electrodiagnostic studies may be further improved by
      international standardisation.

PMID- 11191928
TI  - Neurophysiological characterization of parkinsonian syndromes.
AB  - Electrophysiological examination can provide relevant information on functional
      abnormalities in patients with parkinsonism. The combined use of various
      electrodiagnostic techniques can contribute to the diagnosis of the illness, to
      its correct classification and differentiation from other diseases with a
      clinically similar presentation, and in particular the identification of the
      pathophysiological processes underlying some of the signs and symptoms
      characterizing the movement disorder. Tests which are useful in the differential
      diagnosis of various parkinsonian syndromes can now be performed in most
      electrodiagnostic laboratories. This article reviews some of the most relevant
      observations provided by neurophysiological studies on patients with
      parkinsonism, with a special focus on those that could be of more value in
      neurological clinical practice through their contribution to the characterization
      of the disease or to the recognition of underlying pathophysiological processes.

PMID- 11191929
TI  - Abnormality of N30 somatosensory evoked potentials in Parkinson's disease: a
      multidisciplinary approach.
AB  - PURPOSE OF THE STUDY: Assess the N30 component of median nerve somatosensory
      evoked potentials (SEPs) in patients with Parkinson's disease (PD) and correlate
      its parameters with the severity of the disease, general cognitive ability and
      regional cerebral blood flow (rCBF). PATIENTS AND METHODS: Twenty-three non
      demented, non-depressed PD patients (at stage II and III of the disease) and 23
      age- and education-matched normal controls were enrolled in the study. SEPs were
      elicited by median nerve stimulation. PD patients' cognitive ability was assessed
      by means of: 1) Raven's Colored Progressive Matrices (RCPM); 2) the Test of Non
      Verbal Intelligence (TONI-2); and 3) the Wisconsin Card Sorting Test (WCST). The
      patients' rCBF was evaluated by HMPAO SPECT. RESULTS: There was no difference
      between SEP N30 latency in PD patients and controls (P > 0.05). The P20-N30 peak
      to-peak amplitude was lower in PD patients bilaterally (P < 0.05), and the
      amplitude of N30-P40 was lower on the right side only (P < 0.05). A significant
      increase in the amplitude ratio P14-N20/P20-N30 was observed in PD patients (P <
      0.05). The correlation of these findings with the clinical parameters of the
      disease, and notably motor signs, was not significant. Of the three
      neuropsychological tests only the RCPM showed a positive relation to right P20
      N30 amplitude. Regression analysis between SEP parameters and rCBF showed a
      correlation of N30 amplitude with blood flow in parietal cortical areas, but not
      in frontal regions.

PMID- 11191930
TI  - No, some types of nonconvulsive status epilepticus cause little permanent
      neurologic sequelae (or: "the cure may be worse than the disease").
AB  - Nonconvulsive status epilepticus (NCSE) is characterized by a cognitive or
      behavioral change which lasts for at least 30 minutes, with EEG evidence of
      seizures. Although there is little argument that generalized nonconvulsive status
      epilepticus (GNSE) does not cause lasting deficits, there is still debate
      regarding the morbidity of complex partial status epilepticus (CPSE). Because the
      EEG is used for diagnosis, a strong argument can be made that NCSE is
      significantly under-recognized and diagnosed. Furthermore, since the documented
      cases of permanent neurologic sequelae are few, the potential permanent morbidity
      from CPSE may be significantly exaggerated. The literature indicates that
      comatose patients have a poor prognosis largely as a result of comorbid
      conditions and coma, whereas lightly obtunded or slightly confused patients with
      NCSE have little or no sequelae. Patients with NCSE may suffer (hypotension and
      respiratory suppression) from iatrogenic 'aggressive' treatment with intravenous
      anti-epileptic drugs (IV-AEDs), and the findings in the literature indicate that
      subjects treated with benzodiazepines may have a worse prognosis. The clinician
      must balance the potential but rare neurologic morbidity associated with NCSE
      against the not infrequent morbidity caused by IV-AEDs. Better stratification of
      the level of consciousness and comorbid conditions is needed when evaluating
      outcomes so as to clearly distinguish among the deficits due to: comorbid
      conditions; the effects of treatment and the effects of status epilepticus (SE)
      proper.

PMID- 11191931
TI  - Severe but reversible encephalopathy associated with cefepime.
AB  - In this study, a report has been made of 19 cases of severe encephalopathy in
      patients with renal impairment who were treated during the last three years for
      various infections with cefepime, a new parenteral cephalosporin antibiotic. All
      patients (aged 57 to 91 years) presented a prolonged confusional state associated
      with diffuse rhythmic non-reactive triphasic sharp waves on the EEG. All the
      electroclinical symptomatology disappeared within 24-48 hours after
      discontinuation of drug administration. A clear relation was found between
      encephalopathy and cefepime intake. These observations underline the fact that
      the cefepime dosage should be reduced in renally impaired patients.

PMID- 11191932
TI  - Surgery for atrial fibrillation--use of a sledgehammer to crack a nut?

PMID- 11191933
TI  - Appropriateness of percutaneous transluminal coronary angioplasty in stable and
      unstable angina pectoris. A review.

PMID- 11191934
TI  - Myocardial ischaemia and neuroendocrine stress: metabolic consequences and
      possibilities.

PMID- 11191935
TI  - Arterial revascularization: evidence or presumption?

PMID- 11191936
TI  - Hypothesis: the recent decline in coronary heart disease mortality--mainly a
      shift from fatal to non-fatal events?
AB  - OBJECTIVES: A marked, sequential decline in coronary heart disease (CHD)
      mortality is established, but not its causes. Does it reflect modern treatment
      effects or a spinoff of primary prevention? The aim of this study was to explore
      this issue using a prospective cohort follow-up design. DESIGN: In 1972-1975 and
      1980-1982 Cohorts 1 (n = 613) and 2 (n = 667) of identical age (males, mean 56
      years) were examined, and thereafter followed closely for 14 years. CHD risk- and
      treatment patterns, incidence of non-fatal myocardial infarctions (MIs) and total
      , cardiovascular and CHD mortality rates were studied. RESULTS: CHD risk factors
      were more favourable, medical treatment more aggressive and 14-years CHD
      mortality, as expected, lower in Cohort 2 (7.7%/4.8%, p = 0.032). However,
      hospital- and prospective ECG data revealed opposite trends in non-fatal cohort
      CHD incidence, and aggregated numbers of CHD deaths and non-fatal MI cases were
      16.7%/16.0% in Cohort 1/2 (p = 0.90). CONCLUSIONS: A marked, sequential reduction
      in CHD mortality was followed by a reciprocal increase in non-fatal MIs. This
      phenomenon may prevail in low CHD-endemic areas, and may call for altered primary
      preventive measures for reduction in total CHD incidence.

PMID- 11191937
TI  - Amlodipine versus slow release metoprolol in the treatment of stable exertional
      angina pectoris (AMSA).
AB  - OBJECTIVES: To compare the effects of amlodipine and slow release metoprolol on
      subjective symptoms and signs of ischaemia during bicycle ergometric exercise
      tests in patients with stable angina pectoris. DESIGN: A randomized double-blind
      comparison of the two drugs in patients with documented coronary disease required
      to have at least three attacks of angina per week and to perform a symptom
      limited exercise test with significant signs of ischaemia in the ECG. RESULTS:
      Out of 127 patients, 117 completed the study. Both amlodipine and metoprolol
      significantly increased total exercise time, total workload, time to onset of
      angina and time to 1 mm ST-depression with no significant differences between the
      drugs. Amlodipine was significantly more efficient than metoprolol in reducing ST
      depression at maximum workload. Diary data revealed no differences in patients'
      self-rating of drug effects. CONCLUSIONS: Judged by suppression of subjective
      symptoms and performance on exercise tolerance tests amlodipine represents a
      useful alternative to metoprolol as monotherapy in stable angina pectoris.

PMID- 11191938
TI  - The Maze operation for treatment of atrial fibrillation. Early clinical
      experience in a Scandinavian institution.
AB  - The Maze operation is a potentially curative surgical option in patients with
      disabling atrial fibrillation (AF) refractory to conventional treatment. The aim
      of this study was to evaluate the initial 4-year Maze experience in our
      institution. The study included 26 patients (19 males, mean age 55 years) who had
      undergone the Maze (III) operation between 1994 and 1998. Nine patients had
      surgery for concomitant heart disease. Follow-up was 3-55 (median 18) months. No
      deaths or neurological complications occurred; 22 patients are at present in
      regular sinus-, or junctional rhythm, 2 patients have permanent atrial pacing for
      symptomatic sinus node dysfunction, and 2 patients have had persistent AF, post
      surgery. Sinus node dysfunctions were detected in five patients, though not
      requiring pacemakers. Out of the total 26 patients, 23 are free of anti
      arrhythmic drugs. Echocardiographic signs of left atrial contraction were
      recorded in 50% of the patients. The Maze operation offers a safe alternative to
      conventional therapy, with attractive results justifying expansion in the use of
      this treatment for AF.

PMID- 11191939
TI  - Protective effect of unstable angina in coronary artery bypass surgery.
AB  - OBJECTIVE: To test the hypothesis that recent ischaemic episodes in unstable
      cases have a protective effect on coronary artery bypass graft (CABG) patients.
      MATERIALS AND METHODS: Twenty unstable patients with ischaemic episodes within 3
      days before operation were compared with 20 stable patients. Haemodynamic data
      were monitored up to the first postoperative day. Biochemical markers were
      measured up to the second postoperative day. RESULTS: The cardiac index decreased
      at 1 and 6 h after declamping in the stable group (89% and 97% of baseline) but
      increased in unstable patients (104% and 122%, p =0.038 and 0.036, respectively).
      The depression in the right ventricular stroke work index was significantly
      attenuated in the unstable group (58%, 67% and 83% in stable and 90%, 97% and
      117% in unstable patients, p = 0.027, 0.010 and 0.049 at 1 and 6 h after
      declamping and 1st POD). The release of cardiac troponin I (CTnI) and CK-MB was
      significantly lower in the unstable group at 6 h after declamping (5.6 +/- 2.9
      and 19.0 +/- 6.3 microg/l in unstable vs 17.4 +/- 9.6 and 25.8 +/- 12.3 microg/l
      in stable patients, p = 0.000 and 0.039, respectively). CONCLUSION: Recent
      unstable angina before CABG might act as an ischaemic preconditioning stimulus
      and could improve haemodynamic function and cellular viability. Delayed
      preconditioning most likely causes this protective effect.

PMID- 11191940
TI  - Evaluation of left ventricular function in coronary bypass surgery.
AB  - OBJECTIVES: To evaluate non-invasive indexes measuring systolic and diastolic
      ventricular function. Eleven coronary artery bypass grafting (CABG) patients were
      investigated in order to assess the ability of preoperative ejection fraction
      (EF) and end diastolic pressure (EDP) to predict left ventricular function
      determined non-invasively at surgery. DESIGN: End-systolic elastance (Ees) was
      assessed perioperatively using transoesophageal echocardiographic area estimation
      and arterial pressure monitoring during preload variations (caval balloon).
      Diastolic function was evaluated using three different echo/Doppler indexes.
      RESULTS: EF correlated positively to Ees (r = 0.69, p = 0.03). No correlations
      were found between EDP and the perioperative diastolic indexes. Ees fell from pre
      bypass to post-bypass (from 9.0 +/- 2.7 to 4.7 +/- 1.7 mmHg/cm2, mean +/- SD, p <
      0.001), but no alterations in diastolic parameters occurred. CONCLUSIONS: A
      positive correlation was found between preoperative EF and Ees at surgery. The
      semi-invasive Ees detected a systolic "stunning" after cardiopulmonary bypass and
      is promising as a surveillance tool for left ventricular perioperative function
      and treatment. No correlations between preoperative EDP and non-invasive
      diastolic indexes were found, and assessment of perioperative diastolic function
      needs further refinement.

PMID- 11191941
TI  - Microdialysis of blood from the cardiac venous outflow: a technique for
      monitoring myocardial ischemia.
AB  - OBJECTIVE: To evaluate the possibility of using microdialysis of blood from the
      great cardiac vein for detecting myocardial ischemia. DESIGN: Microdialysis
      catheters were placed in the great cardiac vein and the left atrium of pigs for
      analysis of lactate, glycerol, pyruvate and glucose. Blood samples were drawn for
      measurement of aspartate aminotransferase, alanine aminotransferase, lactic
      dehydrogenase and myoglobin with the objective of verifying myocardial damage.
      Ischemia was induced for 3 h. RESULTS: Fifteen minutes after induction of
      ischemia a significant elevation of lactate to 917 +/- 223%; p < 0.001 in the
      great cardiac vein could be registered. No significant changes in lactate levels
      were detected in the left atrium. Changes in glycerol and pyruvate showed similar
      patterns, with an increase to 722 +/- 297%; p < 0.001 and to 281 +/- 56%; p <
      0.05, respectively. The outflow of aspartate aminotransferase and myoglobine in
      the great cardiac vein increased significantly. CONCLUSION: Early detection of
      metabolic substances is possible through the assessment of metabolic substances
      using microdialysis in the great cardiac vein.

PMID- 11191942
TI  - Primary reconstruction of interrupted aortic arch--surgical management and
      results.
AB  - Type B interrupted aortic arch associated with other extracardiac and
      intracardiac congenital lesions is a lethal defect. Surgical management with a
      one- or two-stage approach is complex, difficult and associated with high
      morbidity and mortality. Between January 1996 and December 1999, 5 consecutive
      patients with type B interrupted aortic arch were operated on. The group included
      3 girls and 2 boys weighing from 2.4 kg to 3.5 kg (mean 2.84 kg) and aged from 4
      to 35 days (mean 15 days). All patients underwent a primary reconstruction of the
      aortic arch and one-stage repair of the associated heart defects. Two patients
      developed symptoms of mild aortic arch narrowing 7-12 months postoperatively.
      Balloon angioplasty of the obstructed site was successfully carried out in one of
      the patients. In the second child, angioplasty was not successful and surgery was
      used. All the patients survived and are being followed-up. This experience
      supports a strategy of primary one-stage repair of IAA type B, including direct
      anastomosis for aortic arch reconstruction, and all associated heart anomalies in
      the neonatal period.

PMID- 11191943
TI  - Short-term results after aortic valve replacement with stentless xenografts in
      elderly patients.
AB  - OBJECTIVE: Our aim was to chart the short-term results of the first 75 of our
      patients who had undergone first-time aortic valve replacement (AVR) with
      stentless xenografts. DESIGN: Our study included a complete follow-up (mean/max.
      1.5/3.7 years) of the first 75 patients (42 males, 33 females; mean age 74, range
      61-84 years) who underwent a first AVR with stentless xenografts. RESULTS: Forty
      three percent of patients were in functional class II and 57% in classes III-IV
      preoperatively. Coronary artery bypass grafting (CABG) was performed in 33
      patients. Early mortality (< or = 30 days) was 6.7%, with no significant relation
      to CABG or age. Crude survival was 81% (95% confidence interval, CI: 71-91 %) at
      3 years. Using a multivariate analysis, we identified a low left ventricular
      ejection fraction as a predictor of early and late mortality. Late survival
      (early mortality excluded) was comparable with the survival of a matched Danish
      background population. There were six embolic events (all cerebral: 3 minor, 1
      major, 2 fatal), while two patients underwent redo-AVR because of either
      endocarditis (fatal) or aortic regurgitation caused by malaligned commissures.
      There were no other valve-related complications. Cumulative freedom was 89% (95%
      CI: 79-99%) for embolism and 86% (95% CI: 76-96 %) for all complications at 3
      years. At the end of the study, 64% of the survivors were in functional class I,
      34% were in class II and 2% in class III. CONCLUSIONS: Considering the age
      composition of our patients, and compared with international results, our early
      mortality rates were acceptable. The absence of late excess mortality compared
      with the background population and the functional status at end-of-study may
      indicate the potential haemodynamic advantages of stentless aortic valves, at
      least in the short term.

PMID- 11191944
TI  - Predictors of atrial fibrillation in patients undergoing surgery for ischemic
      heart disease.
AB  - OBJECTIVES: Atrial fibrillation (AF) remains a common problem after cardiac
      surgery. AF increases the risk for stroke and is associated with increased length
      of hospitalization. The aim of this study was to analyze risk factors for
      postoperative AF in a uniformly managed cohort of patients. DESIGN: The records
      of 775 consecutive patients undergoing coronary artery bypass grafting (CABG) or
      CABG + valve procedures were examined. Forward stepwise multiple logistic
      regression analysis was used for statistical evaluation. RESULTS: Mean age was
      64.6 +/- 8.7 years. The incidence of AF was 29.1% in patients undergoing isolated
      CABG and 48.6% after CABG + valve procedures. Multivariate analysis identified
      advanced age (p = 0.000003), low postoperative mixed venous oxygen saturation (p
      = 0.0018), hypertension (p = 0.0059), preoperative history of AF (p = 0.023) and
      the need for mechanical circulatory support (p = 0.030) as predictors for
      postoperative AF. CONCLUSIONS: In agreement with previous studies, advanced age
      was the most important predictor of AF. Hypertension, history of AF and signs of
      circulatory failure were also predictive of AF. Preventive measures against AF
      should preferably be tested in high-risk populations, such as elderly patients.

PMID- 11191945
TI  - Perioperative myocardial infarction in cardiac surgery--risk factors and
      consequences. A case control study.
AB  - OBJECTIVE: The aim of the study was to analyze risk factors and clinical outcome
      in patients sustaining perioperative myocardial infarction (PMI) after cardiac
      surgery. DESIGN: A retrospective, case control study was conducted, in which 42
      patients fulfilling both Q-wave criteria and enzyme criteria for PMI, or autopsy
      diagnosis, from a cohort of 1147 operated on during the same time period were
      compared with matched controls. A follow-up by telephone interview was conducted,
      on average 24 months after the operation. RESULTS: Unstable angina, peripheral
      vascular disease, short stature and low body weight were more prevalent in the
      PMI group. Intraoperative remarks of poor quality coronary vessels and incomplete
      revascularization were more frequent in the PMI group; 30-day mortality was 24%
      in the PMI group vs 0% in the control group (p < 0.01). The postoperative course
      was more complicated and protracted in the PMI group. At follow-up, the control
      group managed significantly better with regard to freedom from angina and the
      need for nitroglycerine. However, 24 of the 30 survivors in the PMI group
      reported an improved quality of life after surgery. CONCLUSIONS: We found that
      PMI was mainly associated with coronary surgery and that unstable angina was the
      most important preoperative risk factor for PMI. Poorer conditions for
      revascularization may explain some of the infarcts and could also contribute to
      the impaired long-term outcome in the PMI group.

PMID- 11191946
TI  - Five-year experience with a suture annuloplasty for mitral valve repair.
AB  - We present five years' experience with mitral plication annuloplasty, performed
      with a semicircular buttressed suture around the posterior leaflet in 130
      patients (mean age 58 +/- 11 years) with primary mitral valve disease (n = 71) or
      functional mitral regurgitation (n = 59). In 65 cases the mitral valve itself was
      also repaired. Concomitant myocardial revascularization was performed in 40 cases
      and aortic valve replacement in 43. All but three patients were followed up
      (97.6%). Postoperative echocardiography showed acceptable mitral area (2.28 +/-
      0.39 cm2) and good valve competence in all cases. Inhospital mortality was 3% and
      late mortality 4.8%. During the follow-up period (22.8 +/- 10.9 months) 8
      patients (6.6%) required mitral valve replacement because of progression of
      native valve disease (n = 4), technical failure (2) or expansion of the
      annuloplasty suture (2). Mitral annuloplasty thus can be performed simply and
      with good results, using a strong, non-stretchable buttressed suture. This
      procedure can be an inexpensive alternative to ring implantation.

PMID- 11191947
TI  - Closed mitral commissurotomy in Archangel, Northern Russia, 1965-1993. Operative
      assessment of 367 patients operated on for rheumatic mitral stenosis.
AB  - OBJECTIVE: Preoperative and operative assessment of the 367 patients operated on
      for rheumatic mitral stenosis with closed mitral commissurotomy (CMC) at the
      regional hospital in Archangel, northwest Russia, between 1965 and 1993. DESIGN:
      Retrospective survey. RESULTS: Mean age at first attack of rheumatic fever was 15
      years +/- 1.09 years. Mean age at time of surgery was 33.4 years +/- 0.92.
      Preoperatively, most patients (67%, n = 245) were in New York Heart Association
      stage III; 29% (n = 107) in stage IV. Digital commissurotomy alone was performed
      in 16% (n = 57) and a transventricular dilator was used in 84% (n = 310).
      Operative blood loss was average (384.4 ml +/- 34 ml); 20% (n = 73) developed
      wound infection, 21% (n = 77) pericarditis. In-hospital stay was above 50 days
      for both sexes. In-hospital mortality was 1.6% (n = 6). CONCLUSION: Rheumatic
      heart disease developed rapidly in these patients. CMC has a place as a low cost
      treatment of mitral stenosis when a heart lung machine is not available.

PMID- 11191948
TI  - Immunostaining for detecting lymph node metastases in non-small cell lung cancer.
AB  - OBJECTIVE: To detect lymph node metastases by immunohistochemistry, where
      previously undetected by routine histopathology. DESIGN: Immunostaining was
      carried out for high- and low molecular weight cytokeratins, and Ber-EP4 in 19
      consecutive lung cancer patients who had undergone systematic mediastinal lymph
      node dissection. RESULTS: Eleven (58%) epidermoid carcinomas, 6 (32%)
      adenocarcinomas, and 2 (10%) bronchiolo-alveolar carcinomas were detected. These
      included 4 (21%) stage IA carcinomas, 6 (32%) stage IB, 6 (32%) stage IIB, 1 (5%)
      stage IIIB and 2 (10%) stage IV. Immunostaining did not reveal any undetected
      metastases. Two patients (squamous cell carcinoma T1N0; adenocarcinoma T1N0) had
      metastases (skeletal; ipsilateral lung) at time of surgery, and one patient
      (squamous cell carcinoma T2N0) had a regional and systemic relapse 10 months
      later. Serial sectioning with immunostaining of the lymph nodes from these three
      patients was also negative. CONCLUSION: We conclude that, even with the use of
      immunostaining, negative lymph nodes will not assure a good prognosis, and
      different determinants probably exist for lymphatic and hematogenic metastases in
      non-small cell lung cancer.

PMID- 11191949
TI  - Coronary artery bypass surgery after previous pneumonectomy-two case reports.
AB  - Coronary artery surgery after previous pneumonectomy should be considered a high
      risk procedure. We describe two cases with associated morbidity and mortality.
      Pathogenetic mechanisms are discussed.

PMID- 11191950
TI  - Teratoma presenting as a cystic lesion on the chest wall.
AB  - A 28-year-old woman presented with a rare case of chest-wall teratoma. Computed
      tomography of a cystic lesion located in the anterior chest wall revealed a
      hyperdense object with the appearance of a tooth. The cystic mass was totally
      excised via a chest-wall incision without thoracotomy. Pathologic examination
      showed a benign teratoma containing an immature tooth.

PMID- 11191951
TI  - [Applied medicine and ophthalmology].
AB  - Medicine as applied by specialists is an unexplored territory. By the example of
      Ophthalmology some relevant, specific scientific problems are outlined here.

PMID- 11191952
TI  - [Diphtheria antitoxin level 2 years after booster vaccination].
AB  - In a prospective, controlled, randomized, multicenter study the immunogenicity of
      a single (day 0) and two (day 0, 28) booster vaccination against diphtheria were
      compared in subjects who had received their last diphtheria vaccination more than
      10 years ago. Both short-term and long-term immunogenicity was assessed by
      determining diphtheria antitoxin levels four weeks after vaccination and after
      one and two years. 102 subjects received the first booster vaccination, and 83
      were vaccinated twice. Prior to the first vaccination 27% of the subjects had a
      diphtheria antitoxin level below 0.01 I.U./ml; after the first booster only 5%
      were unprotected. The second booster did not show a significant effect, however,
      in 1 of the 5 subjects who were still unprotected after the first booster the
      second elicited an antitoxin level of more than 0.01 I.U./ml. After one and two
      years 7% and 8% of the subjects had diphtheria antitoxin level below 0.01
      I.U./ml. A serological effect of a second booster vaccination four weeks after
      the first one could not be demonstrated neither after one nor after two years.

PMID- 11191953
TI  - [Induction of oral tolerance: a new therapeutic strategy for autoimmune
      diseases?].
AB  - The phenomenon of oral tolerance (the state of systemic hyporesponsiveness after
      oral antigen delivery) has been known for a long time, nevertheless it turned out
      only in the last decades that it could be used for the treatment of autoimmune
      diseases. The induction of oral tolerance was shown to be very effective for the
      prevention of disease development in numerous animal models of human autoimmune
      diseases, and to a lesser extent for the alleviation of symptoms in already ill
      animals. As opposed to these promising experiments, no such considerable results
      were found in human trials. In this review. I will try to summarize the present
      status of these experiments and to discuss the possible advantages and
      disadvantages of this therapeutic protocol.

PMID- 11191954
TI  - Nationwide epidemiology of hospitalized patients with first-time traumatic brain
      injury with special reference to prevention.
AB  - The national data of hospitalized TBI-patients were gathered retrospectively
      during the years 1991-95 from the Hospital Discharge Register. The inclusion
      criteria were: TBI as the primary diagnosis (ICD-9: 800, 801, 803, 850, 851-854),
      no history of previous TBI during the previous three years and the
      hospitalization of the patient. The incidence of TBI varied from 4 793-5 055 (95
      100 per 100,000 people), comprising altogether 24,497 patients. The biggest
      subgroups of external cause were the sudden fall (61%) and vehicle accidents
      (26%). The biggest subgroups of the place of accident were the home (33%) and the
      traffic area (30%). The data reflect an assumption that many causes of TBI are
      preventable.

PMID- 11191955
TI  - [Social vulnerability, social isolation of chronic psychiatric patients].
AB  - Social vulnerability and social isolation as to different, light and severe
      grades of chronically ill psychiatric patients were evaluated. A social
      vulnerability index, composed out of marital status, income, health, living
      conditions, occupation, and risk factors in childhood was used. The vulnerability
      of 64 severely chronically ill patients and of 84 chronically ill patients was
      assessed. According to their vulnerability, the patients were divided into a
      group of highly vulnerable and a group of less vulnerable patients. The social
      isolation of the two groups (severely chronically und chronically ill patients)
      was compared and assessed. We used objective criteria (such as living alone, no
      friends, no contact to family members) and subjective criteria (feeling
      isolated). Social Vulnerability and social isolation are higher in severely
      chronically ill patients compared to chronically ill patients. The severely sick
      group is significantly more affected by objective and/or by subjective isolation
      than the less sick group. In both groups patients have more difficulties in
      social relationships than non-isolated patients. There is no significant
      correlation between objective isolation and subjective isolation.

PMID- 11191956
TI  - [Patulous eustachian tube--diagnosis and therapy].
AB  - The patulous Eustachian tube (tuba aperta) is a benign condition that may be
      overlooked or misdiagnosed. It is a distressing condition for the patient with
      such symptoms as autophony and a sensation of fullness in the ear. One third of
      the women with the diagnosis are pregnant or taking oestrogens. The diagnosis is
      made by the history of fullness or blockage and hearing one's own voice and
      breath in the ear. The drum is usually atrophic and moves with respiration but
      this may not be visible. The usual past history is of weight loss. The patulous
      Eustachian tube is frequently associated with peritubal atrophy, and usually
      responds to conservative measures such as weight gain. The application of nose
      drops is wrong. Why some patients with a patulous tube and movement of the drum
      with respiration have no symptoms and other patients with very bothersome
      symptoms have so few objective signs and no movement of the drum that can be
      observed with respiration, remains a mystery.

PMID- 11191957
TI  - [XXXVI Congress of the French Association for Hand Surgery. Paris, 14-16 December
      2000. Abstracts].

PMID- 11191958
TI  - Blood, sweat, serious fears. Hepatitis C puts rescue workers' lives at risk and
      under scrutiny.

PMID- 11191959
TI  - A new smoking gun? David Kessler unloads on big tobacco's tactics.

PMID- 11191960
TI  - Male pattern boldness.

PMID- 11191961
TI  - Organic foods offer peace of mind--at a price.

PMID- 11191962
TI  - How to beat back a heart attack? With swift and aggressive counterpunching.

PMID- 11191963
TI  - JRCPL becomes Clinical Medicine.

PMID- 11191964
TI  - Two blueprints for the future: cancer services in England and Wales.

PMID- 11191965
TI  - Prevention and treatment of osteoporosis. Clinical guidelines and new evidence.

PMID- 11191966
TI  - Haemodynamic and ventilatory support in severe sepsis.

PMID- 11191967
TI  - Empirical choice of antibiotic therapy in sepsis.

PMID- 11191968
TI  - Sepsis in immunocompromised hosts.

PMID- 11191969
TI  - Mechanisms and detection of bacteraemia.

PMID- 11191970
TI  - Disease emergence and health transitions in the last millennium.
AB  - For most of the first millennium, average expectation of life was only 30 or 40
      years. The beginning of the 20th century saw the start of improvements, which by
      the century's end meant that a baby boy could expect an average 75 years of life,
      a baby girl even longer. The successes of the 20th century were not products of
      advances in medicine alone, but consequences of the great sanitary reforms that
      fuelled the public health movement in late Victorian Britain. However, health
      challenges also grew and changed: the rise in so-called modern epidemics
      (coronary heart disease, cancer, accidents and mental illness); the ageing of the
      population; the containment of the costs of rapid technological advances; the
      marked and intractable inequalities in health status between rich and poor, and
      between North and South. The dawn of a new millennium sees many of these health
      problems carried over from the late 20th century, whilst communicable diseases,
      once thought conquered, continue to pose a serious threat to human health because
      of their global significance. This paper traces progress in the health of the
      population and identifies some of the key challenges for medicine in the 21st
      century.

PMID- 11191971
TI  - Will medicine be revolutionised by genomics?

PMID- 11191972
TI  - What proportion of dyspeptic patients having H. pylori breath test subsequently
      undergo endoscopy?
AB  - BACKGROUND: Helicobacter pylori (HP) testing in young patients with uncomplicated
      dyspepsia has been recommended. A test and treat strategy for dyspeptics positive
      for HP is recommended by the European H. pylori Study Group and the American
      Gastroenterology Association. OBJECTIVES: To assess the rates of re-referral for
      upper GI endoscopy (OGD) and outpatient (OPD) attendance in uncomplicated
      dyspeptic patients following assessment of HP status. METHODS: 190 patients under
      50 years of age with uncomplicated dyspepsia (without alarm symptoms) referred
      from general practitioners (GPs) to the gastroenterology department underwent HP
      urea breath test (UBT). GPs were informed of the results of UBT and recommended
      eradication therapy if positive, and if negative advised symptomatic treatment
      with an acid suppressant with/without a prokinetic. The patients were analysed
      for subsequent attendance at OGD or OPD in the following two years. RESULTS: HP
      was present in 93 of 190 patients. Twenty of 190 (10.5%) patients subsequently
      were re-referred and underwent OGD for continuing dyspeptic symptoms; a further 6
      were seen in OPD but not endoscoped as they have been judged to have
      uncomplicated gastro-oesophageal reflux disease. At time of OGD all patients were
      negative on Campylobacter-like organism (CLO) test for HP. Findings at OGD were
      normal (9), hiatus hernia (6), gastritis (4) and duodenitis (1). No case of
      peptic ulcer disease or gastric cancer has been identified. CONCLUSIONS: In this
      group of dyspeptic patients, adopting a test and treat policy after initial
      analysis of HP resulted in 10.5% being re-referred for subsequent OGD; findings
      in those endoscoped were normal or minimal. A test and treat strategy for H.
      pylori in uncomplicated dyspeptics therefore saves endoscopies and outpatient
      consultations without missing significant underlying pathology.

PMID- 11191973
TI  - Attachments in public health for physicians.
AB  - Hospital-based specialist registrars in Nottingham are offered six month
      secondments in public health medicine. These attachments give clinicians valuable
      skills in public health and an opportunity to influence the development of local
      health service provision. Other skills gained are an understanding of the balance
      between health promotion and disease treatment; the management of limited
      resources; an appreciation of the effects of social deprivation; the chairing and
      preparing of committee meetings; and contact tracing of communicable diseases. We
      strongly recommend the experience gained from working in a lively public health
      department.

PMID- 11191974
TI  - Who gets alcoholic liver disease: nature or nurture?
AB  - The factors determining why fewer than 10% of drinkers develop advanced alcoholic
      liver disease remain largely unknown. There is a weak relationship between
      disease risk and the dose and pattern of alcohol consumed. Obesity increases the
      risk of all stages of alcoholic liver disease, probably reflecting the role of
      steatosis in the pathogenesis of more advanced disease. Women develop disease at
      a lower intake than men due, in part, to their lower volume of distribution for
      alcohol, but also potentially to increased gut permeability to endotoxin. Recent
      studies suggest a non-gender-linked genetic component to disease susceptibility
      and recent case-control studies have suggested that polymorphisms of genes
      encoding cytokines and other immunoregulatory molecules may exert a significant
      effect. The pattern of polymorphisms associated with risk suggests that antibody
      mediated mechanisms play a role in disease pathogenesis. This has implications
      for treatment and for identifying high risk individuals at an early stage.

PMID- 11191975
TI  - Brains and minds: a brief history of neuromythology.

PMID- 11191976
TI  - Science, society and the perplexed physician.
AB  - In a time of changing attitudes to science and medicine, Lord Turnberg asks
      whether there is a future for the physician. The population has never been
      healthier, but, paradoxically, the public seems to be more afraid then ever of
      death and illness. As more information becomes available in the public arena,
      anxious patients want certainty when choices almost always have to be offered in
      the absence of certainty. The author speculates that in this brave new world the
      need for physicians will increase rather than the reverse. However, physicians
      must recognise that effective communication, empathy, and compassion are as
      essential to their role as scientific knowledge and understanding.

PMID- 11191977
TI  - Drug and alcohol abuse: what physicians need to know.

PMID- 11191978
TI  - Modern doctoring.

PMID- 11191979
TI  - Health care practitioners?

PMID- 11191980
TI  - Controversy in thyroid disease.

PMID- 11191981
TI  - Controversy in thyroid disease.

PMID- 11191982
TI  - Controversy in thyroid disease.

PMID- 11191983
TI  - Bellmanism: the distortion of reason.

PMID- 11191984
TI  - Single consultation cerebrovascular disease clinic.

PMID- 11191985
TI  - Virus hepatitis update.

PMID- 11191986
TI  - SmithKline Beecham halts tests of lotrafiban, an oral glycoprotein IIb/IIIa
      inhibitor.

PMID- 11191987
TI  - More than a journal.

PMID- 11191988
TI  - Planetary science. Jupiter's two-faced Moon, Ganymede, falling into line.

PMID- 11191990
TI  - Germany. Chipping away at feudal vestiges in academe.

PMID- 11191989
TI  - Embryo research. British Parliament approves new rules.

PMID- 11191991
TI  - Malaria. Old movie spawns a new discovery.

PMID- 11191992
TI  - Cancer research. Preventing hair loss from chemotherapy.

PMID- 11191994
TI  - Brazil. Society seeks legislative aide fellow.

PMID- 11191995
TI  - Medical research. NIH kills deal to upgrade heart data.

PMID- 11191993
TI  - Evolution. Tooth theory revises history of mammals.

PMID- 11191996
TI  - Astrophysics. Ravenous black holes never say diet.

PMID- 11191997
TI  - India. Scientist restored to top agriculture post.

PMID- 11191998
TI  - Japan. Superagency seeks to reconcile two cultures.

PMID- 11191999
TI  - Policy. NASA's street fighter takes on tangled space science program.

PMID- 11192001
TI  - Archaeology. Japanese fraud highlights media-driven research ethic.

PMID- 11192000
TI  - 2001 U.S. budget. Record year for science, but can it be repeated?

PMID- 11192002
TI  - Pharmacology. How the body's 'garbage disposal' may inactivate drugs.

PMID- 11192003
TI  - Pharmacology. A worrisome side effect of an antianxiety remedy.

PMID- 11192004
TI  - Priorities in HIV prevention.

PMID- 11192005
TI  - Priorities in HIV prevention.

PMID- 11192006
TI  - Helminthic infection and HIV vaccine trials.

PMID- 11192007
TI  - That's no worm...

PMID- 11192008
TI  - Biology and music. The music of nature.

PMID- 11192009
TI  - Biology and music. Music of the hemispheres.

PMID- 11192010
TI  - Chemistry. Switched-on nickel.

PMID- 11192011
TI  - Astronomy. Orion sheds new light on star and planet formation.

PMID- 11192012
TI  - Paleoclimate. Climate change across the hemispheres.

PMID- 11192014
TI  - Microquasars raise megaquestions.

PMID- 11192013
TI  - Bursts, rays, and jets.

PMID- 11192015
TI  - Astronomical odd couple? Or alter egos?

PMID- 11192016
TI  - Tatars' saucy project takes on the world.

PMID- 11192017
TI  - Keeping the beat in a noisy world.

PMID- 11192018
TI  - A fluorescent reporter assay for the detection of ligands acting through Gi
      protein-coupled receptors.
AB  - Accompanying the advances in basic biology of G protein-coupled receptors (GPCRs)
      is the practical need among biopharmaceutical companies for sensitive assays to
      assess GPCR function, particularly formats that are compatible with high
      throughput drug screening. Here we describe a novel cell-based assay format for
      the high-throughput detection of ligands for Gi protein-coupled receptors. Two Gi
      GPCRs, mu-opioid receptor (mu-OPR) and 5-hydroxytryptamine receptor la (5HT1aR)
      are employed as model receptor targets. The key feature of this assay system is
      the isolation of stable, clonal Chinese hamster ovary (CHO) cell lines that carry
      three separate expression plasmids: (1) a chimeric Gq/i5 protein (which re
      directs a negative Gi-type signal to a positive Gq-type response), (2) a given Gi
      GPCR, and (3) a beta-lactamase (beta1a) reporter gene responsive to Gi-GPCR
      signaling. Cell-based assays built using this format show appropriate rank order
      of potency among a reference set of receptor agonist and antagonist compounds.
      Such assays are also robust, reliable, and can be used for industrial-scale
      applications such as high-throughput screening for drug leads.

PMID- 11192019
TI  - Angiotensin antagonists.

PMID- 11192020
TI  - Receptor-dependent regulation of [Ca2+]i and phospholipase C in vascular
      endothelial cells.

PMID- 11192021
TI  - High-altitude pulmonary hypertension and signal transduction in the
      cardiovascular system.

PMID- 11192022
TI  - Penicillin binding proteins, beta-lactams, and lactamases: offensives, attacks,
      and defensive countermeasures.
AB  - A strong outer covering of peptidoglycan (the sacculus) is essential for most
      bacteria. Beta-lactams have evolved billions of years ago and can block saccular
      growth of the organism. This led to the evolution of beta-lactamases and
      resistant penicillin binding proteins (PBPs). With the introduction of lactam
      antibiotics by the pharmaceutical industry, resistance genes in nature were
      laterally transferred to antibiotic-treated disease-causing organisms and
      additional modification of beta-lactamase genes and of the regulatory genes of
      the mecA region took place. However, it can be concluded that very little of
      either type of resistance mechanisms represents new basic evolution against the
      penicillin type antibiotics. In the last 60 years the resistant bacteria in the
      main arose by movement of genes from other organisms, from minor genetic changes,
      and from alteration of the regulation of synthesis.

PMID- 11192023
TI  - Chemistry and microbiology of permeable reactive barriers for in situ groundwater
      clean up.
AB  - Permeable reactive barriers (PRBs) are receiving a great deal of attention as an
      innovative, cost-effective technology for in situ clean up of groundwater
      contamination. A wide variety of materials are being proposed for use in PRBs,
      including zero-valent metals (e.g., iron metal), humic materials, oxides,
      surfactant-modified zeolites (SMZs), and oxygen- and nitrate-releasing compounds.
      PRB materials remove dissolved groundwater contaminants by immobilization within
      the barrier or transformation to less harmful products. The primary removal
      processes include: (1) sorption and precipitation, (2) chemical reaction, and (3)
      biologically mediated reactions. This article presents an overview of the
      mechanisms and factors controlling these individual processes and discusses the
      implications for the feasibility and long-term effectiveness of PRB technologies.

PMID- 11192024
TI  - Baggasse preservation: a need for a biotechnological approach.
AB  - Paper is one of the basic needs of modern life. With the consumption of paper
      likely to grow to 320 million MT by the year 2001, the the worldwide pulp and
      paper industry is gradually realizing that there is a shortage of the traditional
      raw material of cellulosic fiber. Bagasse--a byproduct of the sugar industry,
      presents a potential source of fiber for the paper industry without further
      compromising the environmental concern. It is cheap, perennially replenishible,
      presently does not have an alternative economically attractive value added usage,
      and has adequate chemical and mechanical properties for paper making. However,
      for it to be available to the paper industry throughout the year, it needs to be
      stored and preserved for a period of 6 to 8 months. With inherent problems
      associated with bagasse morphology, intricacies reflected as a result of its
      physicochemical characteristics, army of microbial infestants, cost-effective
      quality expectations of the paper industry, and the ecofriendly approach demanded
      by the society/pollution control boards/environmentalists, there does not seem to
      be any viable alternative except to use biotechnology approaches for bagasse
      preservation. It envisages the preservation of maximally depithed bagasse in the
      piles/heaps, using one-time fine misting of a preservative formulation comprised
      of biodegradable and nondegradable chemicals inhibiting the microbial population
      at selected enzyme levels. Its efficacy is improved by open, dry, windy, and
      moderate sunlit sites for storage. The method is simple, sustainable, and
      superior to the prevalent methods that are cost, capital, and energy intensive,
      non-eco-friendly and have adverse cost:benefit ratios. The biotechnology approach
      has an inherent scope for further optimization, automation, and economization.

PMID- 11192025
TI  - Control of foodborne pathogens during sufu fermentation and aging.
AB  - Control of the foodborne pathogens Escherichia coli O157:H7, Salmonella
      typhimurium, Staphylococcus aureus, and Listeria monocytogenes during sufu
      fermentation was evaluated. Before fermentation, pathogens were inoculated onto
      tofu (substrate for sufu) at 5 log cfu/g or 3 log cfu/g, and starter culture
      (Actinomucor elegans) was inoculated at 3 log cfu/g. After 2 days of fermentation
      at 30 degrees C, the four pathogens reached 7 to 9 log cfu/g, and the mold count
      reached 6 to 7 log cfu/g. After fermentation, sufu samples were aged in a
      solution of 10% alcohol + 12% NaCl. After 1 month of aging, the total bacterial
      count was 6 to 7 log cfu/g, but all foodborne pathogens and mold were reduced to
      nondetectable levels. The total bacterial count decreased after aging for 2
      months and 3 months, but the differences were not significant (P > 0.05) compared
      with the count after 1 month. Microorganism in experimental sufu from different
      aging periods and in commercial sufu were compared. A total of 270 isolates were
      purified and identified by the BBL Crystal Identification System. From the
      experimental sufu samples, 49 Bacillus spp. (20.4%), 167 Enterococcus spp.
      (69.6%), 6 Shewanella putrefaciens (2.4%), and 18 miscellaneous gram-negative
      bacilli (7.5%) were identified. From commercial sufu samples, 17 Bacillus spp.
      (56.7%), 2 Enterococcus durans (6.7%), 5 miscellaneous gram-negative bacilli
      (16.7%), 5 Corynbacterium aquaticum (16.7%), and 1 Shewanella putrefaciens (3.3%)
      were obtained. Although the longer aging period did not significantly decrease
      the total bacterial count, it may help in the development of sufu flavor. This
      study showed that sufu fermentation and aging can control common foodborne
      pathogens, so sufu is a safe product even though its preparation does not include
      pasteurization.

PMID- 11192026
TI  - Lycopene in tomatoes: chemical and physical properties affected by food
      processing.
AB  - Lycopene is the pigment principally responsible for the characteristic deep-red
      color of ripe tomato fruits and tomato products. It has attracted attention due
      to its biological and physicochemical properties, especially related to its
      effects as a natural antioxidant. Although it has no provitamin A activity,
      lycopene does exhibit a physical quenching rate constant with singlet oxygen
      almost twice as high as that of beta-carotene. This makes its presence in the
      diet of considerable interest. Increasing clinical evidence supports the role of
      lycopene as a micronutrient with important health benefits, because it appears to
      provide protection against a broad range of epithelial cancers. Tomatoes and
      related tomato products are the major source of lycopene compounds, and are also
      considered an important source of carotenoids in the human diet. Undesirable
      degradation of lycopene not only affects the sensory quality of the final
      products, but also the health benefit of tomato-based foods for the human body.
      Lycopene in fresh tomato fruits occurs essentially in the all-trans
      configuration. The main causes of tomato lycopene degradation during processing
      are isomerization and oxidation. Isomerization converts all-trans isomers to cis
      isomers due to additional energy input and results in an unstable, energy-rich
      station. Determination of the degree of lycopene isomerization during processing
      would provide a measure of the potential health benefits of tomato-based foods.
      Thermal processing (bleaching, retorting, and freezing processes) generally cause
      some loss of lycopene in tomato-based foods. Heat induces isomerization of the
      all-trans to cis forms. The cis-isomers increase with temperature and processing
      time. In general, dehydrated and powdered tomatoes have poor lycopene stability
      unless carefully processed and promptly placed in a hermetically sealed and inert
      atmosphere for storage. A significant increase in the cis-isomers with a
      simultaneous decrease in the all-trans isomers can be observed in the dehydrated
      tomato samples using the different dehydration methods. Frozen foods and heat
      sterilized foods exhibit excellent lycopene stability throughout their normal
      temperature storage shelf life. Lycopene bioavailability (absorption) can be
      influenced by many factors. The bioavailability of cis-isomers in food is higher
      than that of all-trans isomers. Lycopene bioavailability in processed tomato
      products is higher than in unprocessed fresh tomatoes. The composition and
      structure of the food also have an impact on the bioavailability of lycopene and
      may affect the release of lycopene from the tomato tissue matrix. Food processing
      may improve lycopene bioavailability by breaking down cell walls, which weakens
      the bonding forces between lycopene and tissue matrix, thus making lycopene more
      accessible and enhancing the cis-isomerization. More information on lycopene
      bioavailability, however, is needed. The pharmacokinetic properties of lycopene
      remain particularly poorly understood. Further research on the bioavalability,
      pharmacology, biochemistry, and physiology must be done to reveal the mechanism
      of lycopene in human diet, and the in vivo metabolism of lycopene. Consumer
      demand for healthy food products provides an opportunity to develop lycopene-rich
      food as new functional foods, as well as food-grade and pharmaceutical-grade
      lycopene as new nutraceutical products. An industrial scale, environmentally
      friendly lycopene extraction and purification procedure with minimal loss of
      bioactivities is highly desirable for the foods, feed, cosmetic, and
      pharmaceutical industries. High-quality lycopene products that meet food safety
      regulations will offer potential benefits to the food industry.

PMID- 11192027
TI  - Endoscopic excision of benign tumors in the forehead and brow.
AB  - Twenty-five cases of benign tumor of the forehead and brow were excised
      successfully with endoscope-assisted surgery. The access incision was selected
      strategically behind the front hairline. For tumors in the middle of the
      forehead, the tumor was approached by subgaleal dissection. For those in the brow
      or temporal area, the dissection plane was just superficial to the deep temporal
      fascia. Patient age ranged from 3 to 59 years. The mass varied in size from 1.0 x
      0.5 to 2.0 x 2.0 cm. There were 18 lipomas, 6 dermoid cysts, and 1 pilomatricoma.
      There was no residual mass or recurrence 1 to 24 months postoperatively. There
      was no paresthesia or numbness in the scalp. Patients and their families were
      greatly satisfied with this operation and the absence of visible scarring.

PMID- 11192028
TI  - Operative management of neuromatous knee pain: patient selection and outcome.
AB  - The management of intractable knee pain secondary to neuromata continues to be
      optimized. Forty-three patients with intractable knee pain were studied
      prospectively. Consideration for this procedure requires pain of at least a 1
      year duration, failure of conservative management, pain localization at a Tinel's
      point, and at least a 5-point reduction of pain on a visual analog scale after
      nerve blockade with 1% lidocaine. Thirty patients met the criteria for the
      procedure and 25 patients underwent the procedure. Mean patient age was 50.3
      years and mean duration of pain was 6.6 years. Pain etiology included total knee
      replacement in 10 patients and trauma in 15 patients. Mean number of prior
      operations on the knee was 5.1. Sixty-two nerves were excised in the 25 patients,
      including the infrapatellar branch of the saphenous nerve (N = 24), the
      tibiofibular branch of the peroneal nerve (N = 5), the medial retinacular nerve
      (N = 12), the lateral retinacular nerve (N = 8), the medial cutaneous nerve (N =
      6), the anterior cutaneous nerve (N = 3), and the lateral femoral cutaneous nerve
      (N = 4). Complete pain relief was obtained in 11 patients (44%). Partial pain
      relief was reported in 10 patients (40%). No pain relief was reported in 4
      patients (16%). Follow-up ranged from 1 to 4 years. Selective denervation for
      neuromatous knee pain is beneficial in select patients. Patient satisfaction was
      84% (21 of 25 patients) after the procedure. No patient was made worse.

PMID- 11192029
TI  - A rationale for adjuvant surgical intervention in pyoderma gangrenosum.
AB  - Medical specialists who care for patients with pyoderma gangrenosum have been
      reluctant traditionally to consult plastic surgeons. This is the result of
      previous negative experience with debridement and skin grafting. However, a new
      understanding of the pathophysiology of the disease process, and better
      therapeutic options for control have emerged. Very few studies report the results
      of surgical therapy of this disease, and fewer yet report successful outcome. The
      authors present their limited experience at the American University of Beirut
      with 4 patients who were controlled medically followed by skin grafting their
      large wounds, thus decreasing their morbidity and hospital stay. A review of the
      literature together with insights on the rationale and timing of surgery in this
      particular small group of patients are discussed.

PMID- 11192030
TI  - Etiology and pathogenesis of aponeurotic blepharoptosis.
AB  - How and why aponeurotic blepharoptosis develops was investigated in terms of the
      relationship between the levator aponeurosis and Mueller's muscle functioning as
      the muscle spindle of the levator muscle. A total of 200 consecutive patients
      with moderate to severe acquired blepharoptosis completed questionnaires
      regarding their history of physical irritations to the eyelids, and
      intraoperative conditions of the levator aponeurosis and Mueller's muscle were
      evaluated. Several kinds of physical irritations to the eyelids were reported,
      such as habitual rubbing of the eyelids, contact lens usage, cataract surgery,
      and continuous rubbing of the eyelids while crying all night. The two main
      findings for aponeurosis were that it was disinserted from the tarsus, resulting
      in a large amount of play between the aponeurosis and the tarsus, and that the
      aponeurosis and Mueller's muscle were attenuated and elongated. The authors
      believe that rubbing may have caused disinsertion as well as attenuation and
      elongation of the aponeurosis, which result in transmission failures between the
      levator muscle and the tarsus as well as between the levator muscle and the
      mechanoreceptor of Mueller's muscle, leading to clinical blepharoptosis.

PMID- 11192031
TI  - A primary burn wound does not slow the contraction rate of an adjacent excisional
      wound.
AB  - The response to major burn injury includes systemic release of mediators that may
      have an effect on wound healing. The authors evaluated the effect of a burn
      injury on the contraction of an excisional wound adjacent to the burn, and the
      effect of plasma derived from burn-injured animals on the contraction of the
      fibroblast-populated collagen matrix (FPCM). Nine rats (90-100 days old) under
      anesthesia received a standardized 40% total body surface area burn to the
      dorsum, and eight rats (controls) were sham burned. Immediately thereafter all
      animals had a square (2.25 cm2) of unburned dermis excised from the dorsum,
      superior to the burn wound. The excisional wound area was measured at 2 to 3-day
      intervals postoperatively. Plasma was collected from some animals on postburn day
      15; the contraction-stimulating ability of burn vs. control plasma was measured
      in the FPCM. All animals remained free of sepsis. The excisional wound area in
      all animals decreased to 50% and then 25% of the initial area after approximately
      4 and 8 days respectively. The rate of wound contraction (i.e., wound area
      reduction) did not differ between burn and control animals. Contraction
      stimulated by 5% plasma in the FPCM (expressed as a percentage of the original
      matrix area) was 70.2+/-6.4 (standard deviation) mm2 vs. 62.4 +/-3.9 mm2 for burn
      vs. control rats respectively (p>0.05). Burn injury in this model did not alter
      the contraction of an excisional wound at an unburned site. There was no
      significant difference in the contraction-stimulating ability (FPCM model) of
      plasma from the burned rats compared with plasma from unburned control rats. Burn
      injury appears to have an inconsequential effect on the contraction of an
      adjacent wound.

PMID- 11192032
TI  - Madelung's disease: case report and discussion of treatment options.
AB  - Madelung's disease was first described in 1846. Since then, approximately 200
      patients have been reported in the literature. Its three main characteristics
      typical location of the lesions, symmetry, and the diffusive nature of the fat
      are more often found in men of Mediterranean descent. A clear association with
      alcohol abuse is reported, but the etiology remains uncertain. Patients usually
      complain of their cosmetic appearance, but treatment can be rendered for
      decreased neck motion and/or aerodigestive problems. Given the benign nature of
      the lesion, surgical debulking is the treatment of choice, with liposuction
      reserved for smaller lesions. A standard facelift pattern can be used for skin
      incisions and removal, with good cosmetic results.

PMID- 11192033
TI  - Infusion port dislodgement of bilateral breast tissue expanders after MRI.
AB  - Tissue expanders are placed routinely for breast reconstruction, and magnetic
      resonance imaging (MRI) is a common diagnostic procedure. Many studies have
      reported on the safety of MRI in patients with nonferromagnetic implants;
      however, many tissue expanders contain ferromagnetic components. The authors
      present a case of bilateral tissue expander infusion port dislodgment after MRI.
      A 56-year-old woman underwent bilateral mastectomy and immediate reconstruction
      with McGhan BIOSPAN tissue expanders. These implants contain integral
      nonferromagnetic infusion ports, as well as small, powerful Magna-Site magnets.
      Several weeks postoperatively the patient underwent MRI of her spine, which was
      ordered by her primary physician for back pain. Subsequently, the infusion ports
      could not be located with the finder magnet. A chest radiograph was obtained,
      which demonstrated bilateral dislodgment of the infusion ports. Surgical removal
      and replacement of the tissue expanders were required. Safety considerations of
      MRI have been discussed extensively in the literature, and data on MRI with
      various implanted devices have been obtained. The potential risks of performing
      MRI on patients with metallic implants include conduction of electrical currents,
      heating of the implant, misinterpretation resulting from artifact, and the
      possibility of movement or dislodgment of the implant. The small magnet integral
      to many tissue expanders may be overlooked by patients and physicians during pre
      MRI screening. All patients undergoing tissue expansion with implants that
      contain integral ports should be thoroughly warned about the potential hazards of
      MRI.

PMID- 11192034
TI  - Negative-pressure dressings in the treatment of hidradenitis suppurativa.
AB  - Negative-pressure dressings have been used in the treatment of a variety of open
      wounds, and as a bolster for skin grafts. The benefits of these dressings include
      increased oxygen tension in the wound, decreased bacterial counts, increased
      granulation formation, and the prevention of shear force on wounds. Also, by
      virtue of the diminished need for daily dressing changes, there are the
      additional advantages of enhancing patient comfort, decreasing nursing work, and
      diminished cost of wound care. Hidradenitis suppurativa (HS) is a chronic
      infection of the apocrine sweat glands. Treatment options range from oral
      isotretinoin to radical excision. Wound closure may be achieved by secondary
      intention, skin grafting, or flap closure. Complications may still arise and
      include disease progression and squamous cell carcinoma. Radical excision yields
      the best results in terms of disease eradication. The authors describe using the
      negative-pressure dressing in two cases of bilateral axillary HS to secure skin
      grafts firmly to the wound bed after radical excision of all involved tissues.
      Patient comfort and acceptance was high, and skin graft take was excellent. The
      dressings themselves are simple to apply and are highly effective.

PMID- 11192035
TI  - Bilateral, extended V-Y advancement flap.
AB  - A modification of the V-Y advancement flap for the closure of circular skin
      defects is presented to decrease the tension in the closure and to break the
      midline vertical scar. Bilateral, extended V-Y advancement flaps with additional
      limbs extending to the advancing edges of the standard flaps were marked on both
      sides of the wound. After advancement of the V-Y flaps on their subcutaneous
      pedicle, the upper and lower extensions were hinged downward as transposition
      flaps to close the middle portion of the circular defect, where maximum tension
      occurs. This procedure was applied to 10 patients with sacral and trochanteric
      pressure sores. No complications or recurrences were noted during the 2 to 10
      months of follow-up. Bilateral, extended V-Y advancement flaps enable the
      reconstruction of large defects without midline tension. Also, the resulting scar
      where the flaps meet is a zigzag line, so a straight midline scar is avoided.

PMID- 11192036
TI  - Split gluteus maximus island flaps for concomitant closure of ischial and sacral
      pressure sores.
AB  - The author presents an innovation in the use of the gluteus maximus
      musculocutaneous flap that allows one to repair both sacral and ischial pressure
      sores concomitantly in a paraplegic patient. The musculocutaneous unit is divided
      into superior and inferior halves, each of which is supplied by their respective
      gluteal arteries. The "islanded" flaps can be moved in different directions
      independent of one another to cover both the sacral and ischial regions at the
      same time. The donor area can be closed primarily. Three patients were operated
      using this method. The 1-year follow-up of 1 patient is presented.

PMID- 11192037
TI  - Actinomycosis of the frontal and parotid regions.
AB  - Cervicofacial actinomycosis still occurs infrequently and should be included in
      the differential diagnosis of neoplasms, and chronic suppurative and
      granulomatous lesions of the head and neck region. The authors present two cases
      of actinomycosis. Patient 1 was a 32-year-old man who was first seen with a firm,
      suppurative mass at his left frontal region. Patient 2 was a 36-year-old woman
      with an indurated mass at her left parotid area. Both patients were diagnosed
      histopathologically with cervicofacial actinomycosis, but each patient had a
      different clinical course and different response to antimicrobial and surgical
      treatments.

PMID- 11192038
TI  - Malignant melanoma in a burn scar.
AB  - Cancers of various sorts are occasionally encountered in burn scars. These
      lesions are usually squamous cell carcinomas, and the burn scars are usually old.
      Very rarely, malignant melanoma is encountered. An 87-year-old nursing home
      patient who had been burned by a lightening strike at age 16 was evaluated. She
      had sustained a wound covering 2% or 3% of her body surface involving her neck
      and the upper portion of her anterior trunk that had required several grafts. A
      lesion was noted over the suprasternal notch approximately 3 months before
      admission. The biopsy was reported as malignant melanoma. She was subsequently
      treated by wide reexcision with an associated Z-plasty for neck release. Because
      of the patient's age and the presence of four areas of regional lymph nodes
      nearby into which metastasis might spread, no lymph node dissections were carried
      out. The specimen from the reexcision was reported as squamous cell carcinoma in
      situ, melanoma in situ, and multinucleated giant cell reaction, acute and chronic
      infiltrates. The wound margins were clear.

PMID- 11192039
TI  - Infantile myofibromatosis: case report of a solitary hand lesion with emphasis on
      differential diagnosis and management.
AB  - Infantile myofibromatosis, both solitary and multicentric types, is discussed
      with emphasis on the importance of diagnosing this condition correctly. Its
      distinctive clinical and histological characteristics are described, as are the
      hazards of overhasty and overly ambitious surgical intervention. Other similarly
      presenting fibromatous diseases of infancy and childhood are discussed, including
      aplasia cutis, infantile fibrosarcoma, recurring infantile digital fibromatosis,
      and juvenile aponeurotic fibromatosis. A case of infantile myofibromatosis,
      solitary type, is reported, and the two surgical procedures carried out over a 4
      year period are described. The importance of histological and immunohistochemical
      evaluation of lesions present during the neonatal period is stressed.

PMID- 11192040
TI  - Posttraumatic epidermal inclusion cyst of the deep infratemporal fossa.
AB  - The authors report a case of an epidermal inclusion cyst found in the deep
      infratemporal fossa 12 years after the patient sustained blunt trauma to that
      region. Posttraumatic epidermal inclusion cysts are rare and occur mainly in the
      fingers, palms, and soles. Introduction of the epidermal elements into the dermis
      during the trauma is thought to be the cause. This case is rare in presentation,
      with few reports in the English literature that describe an epidermal inclusion
      cyst in the deep infratemporal fossa. Review of the English literature disclosed
      no other cases of epidermal inclusion cyst after blunt trauma involving the deep
      infratemporal region.

PMID- 11192041
TI  - Fires and burns during plastic surgery.
AB  - Many plastic surgery procedures are performed under local anethesia. When the
      procedure involves the head and neck, oxygen is perilously close to the surgical
      field. A thorough understanding of the fire triangle will allow the plastic
      surgeon to develop a routine that will avoid any risk of fire. The fire triangle
      consists of a heat source, a fuel, and an oxidizer. By removing one component of
      the fire triangle, the risk of fire is averted. An in-depth look at each
      component is needed because fire hazards involve some surprising sources.

PMID- 11192042
TI  - Modified mandibulotomy approach to tumors of the oropharynx.
AB  - The surgical approach to tumors in the deep oral cavity, oropharynx, and
      parapharyngeal space has always been a problem. Midline mandibulotomy for
      exposure and resection of tumors in these areas is usually essential. However,
      postoperatively accurate and stable reconstruction of the symphysis is difficult.
      The authors present a modified notch mandibulotomy in a trapezoidal shape to
      stabilize the symphysis with only a four-hole miniplate. This shape of the
      osteotomy reduces the time to return to an unrestricted diet and permits more
      accurate occlusion.

PMID- 11192043
TI  - The other art-and-science.

PMID- 11192044
TI  - Adrenal incidentaloma as a cause of postoperative exaggerated ecchymosis.

PMID- 11192045
TI  - Ulnar tunnel syndrome secondary to lipoma of the hypothenar region.

PMID- 11192046
TI  - Bilateral lower extremity thrombosis in a patient with protein S deficiency.

PMID- 11192047
TI  - Use of circular subcutaneous tissue flaps to prevent fistulas in urethroplasty.

PMID- 11192048
TI  - Split-thickness skin graft donor site dressing: preliminary results of a
      controlled, clinical comparative study of MEBO and Sofra-Tulle.

PMID- 11192049
TI  - Innervated dorsal adipofascial turnover flap for fingertip amputations.
AB  - Traumatic or thermal injury to the fingertip may result in composite tissue loss.
      Exposed tendon, bone, or joint surface is best treated by flap coverage. The
      authors present their experience with a new technique that provides coverage for
      fingertip defects using the innervated dorsal adipofascial turnover flap, which
      consists of adipofascial tissue only and relies on the arterial anastomotic
      network of this tissue layer to sustain its vascularization. Eight digital
      amputations between the distal phalanx proximal to the nail matrix and midportion
      of the middle phalanx were resurfaced successfully with the innervated dorsal
      adipofascial turnover flap. The flaps survived completely; the mean follow-up was
      9 months. This technique seems to be a relatively simple way of achieving early
      recovery. It does not require the use of distant flap immobilization of adjacent
      digits, nor does it require the use of homodigital flaps, which may jeopardize an
      already injured finger. The main advantages of the innervated dorsal adipofascial
      turnover flap are its ready availability from the local tissue, its sensation,
      and the absence of functional and aesthetic disturbance at the donor site.

PMID- 11192050
TI  - Changes in the elastic properties of tendon structures following 20 days bed-rest
      in humans.
AB  - The purpose of this study was to investigate the effects of 20 days bed-rest on
      the elastic properties of tendon structures of the human knee extensor muscles in
      vivo. Six healthy men carried out a 6 degrees head-down bed-rest for 20 days.
      Muscle volume and maximal voluntary contraction (MVC) torque of the quadriceps
      femoris muscle significantly decreased by an average of 7.8 (SD 2.7)% and 14.9
      (SD 6.9)%, respectively. Before and after bed-rest, the elongation (l) of the
      tendon and aponeurosis of vastus lateralis muscle was measured directly by
      ultrasonography, while the subjects performed ramp isometric knee extension up to
      MVC. The extent of l tended to be greater after bed-rest. The l above 110 N was
      significantly greater after bed-rest. Furthermore, the mean stiffness after bed
      rest [35.5 (SD 7.8) N x mm(-1)] was significantly lower than that before bed-rest
      [52.6 (SD 19.2) N x mm(-1)]. The rate of torque development significantly reduced
      after bed-rest by an average of 47%, and the bed-rest induced a lengthening in
      the electromechanical delay (mean 21%). These results suggest that bed-rest
      results in a decrease in the stiffness of tendon structures with a reduction of
      muscle strength and volume. These adaptations of the tendon structures to bed
      rest would bring about the changes in electromechanical delay and rate of torque
      development.

PMID- 11192051
TI  - A comparison of resistance and aerobic training for mass, strength and turnover
      of bone in growing rats.
AB  - To determine the effects of resistance versus aerobic exercise on the mass,
      strength and turnover of bone. thirty Sprague Dawley rats (4 weeks of age) were
      assigned to one of three experimental groups: sedentary, running or jumping. In
      the jumping group, the trunk was kept upright during electrically stimulated
      jumping exercise for 1 h every other day. The running rats ran at speeds of 24
      m/min for 1 h every other day. After 4 weeks, the jumping rats exhibited
      increases in the mass and strength of the lumbar vertebrae and of the mid
      diaphysis of the femur (mid-femur), and increases in the cross-sectional
      morphology of these bones: the trabecular bone volume per bone surface, the
      trabecular thickness, the trabecular bone formation rate per bone surface
      (BFR/BS). In addition, they exhibited reduced trabecular separation and the area
      of osteoclast surface per bone surface. The running and sedentary rats showed no
      such changes. With regard to the mid-femur, in both the jumping and running rats
      the periosteal BFR/BS was increased. However, only the jumping rats showed a
      reduction in the BFR/BS at the endocortical surface. These results suggest that
      resistance exercise accelerates cortical drift and increases the bone mass and
      strength by stimulating bone formation more efficiently than does aerobic
      exercise.

PMID- 11192052
TI  - The use of magnetic resonance images to investigate the influence of recruitment
      on the relationship between torque and cross-sectional area in human muscle.
AB  - The purpose of the present study was to investigate the effect of recruitment on
      the relationship between peak torque and physiological cross-sectional area
      (PCSA) in human muscle. A group of 11 healthy men participated in this study.
      Isokinetic knee extension torques at seven (0, 30, 60, 120, 180, 240, and 300
      degrees x s(-1)) velocities were determined. Magnetic resonance imaging (MRI) was
      performed to calculate PCSA of right quadriceps femoris (QF) muscle. Exercise
      induced contrast shifts in spin-spin relaxation time (T2)-weighted MRI were taken
      at rest and immediately after repetitive knee-extension exercise and T2 of QF
      were calculated. The MRI pixels with T2 values more than 1 SD greater than the
      means at rest were considered to represent QF muscle that had contracted. The
      area of activated PCSA within the total in QF was expressed as percentage
      activated PCSA and used as an index of muscle recruitment. The PCSA correlated
      with peak torque at 0 degree x s(-1) (r = 0.615, P<0.05); in contrast, activated
      PCSA correlated with peak torque at 120 degrees x s(-1) (r = 0.603, P<0.05) and
      180 degrees x s(-1) (r = 0.606, P<0.05). Additionally, there was a significant
      difference in correlation coefficients between the activated PCSA-peak torque
      relationship and the PCSA-torque relationship (P<0.05). These results suggested
      that muscle recruitment affects the PCSA-torque relationship.

PMID- 11192053
TI  - Effects of breathing control on cardiocirculatory modulation in Caucasian
      lowlanders and Himalayan Sherpas.
AB  - This study was performed to investigate the influence of breathing control on the
      autonomic cardiac regulation at high altitude in adapted and non-adapted awake
      subjects. We recorded electrocardiogram and pulse oximetry in 14 short-term
      acclimatized lowlanders and 14 Himalayan Sherpas during resting conditions at an
      altitude of 5,050 m. Spectrum analysis was performed on synchronized 15 min
      periods of R-R intervals and the oxygen saturation of arterial blood (SaO2).
      Despite mean SaO2 being similar in lowlanders and Himalayan Sherpas [78.5 (SD
      7.0)% compared to 79.4 (SD5.8)%, respectively], fluctuations in SaO2 were
      significantly increased in lowlanders compared to Sherpas, thus indicating an
      unstable regulation of respiration control in lowlanders. Regression analysis
      demonstrated a significant relationship between spectrum power of SaO2 and the
      relative power of R-R intervals in the frequency band between 0.01 and 0.08 Hz in
      lowlanders, but not in Sherpas. Our results demonstrate differences in
      respiratory and autonomic cardiac control between non-adapted lowlanders and
      Himalayan high-altitude residents and indicate that unstable breathing control
      during chronic hypobaric hypoxia is significantly correlated with the autonomic
      cardiocirculatory regulation.

PMID- 11192054
TI  - Energy cost of front-crawl swimming at supra-maximal speeds and underwater torque
      in young swimmers.
AB  - The energy cost of front-crawl swimming (Cs, kJ x m(-1)) at maximal voluntary
      speeds over distances of 50, 100, 200 and 400 m, and the underwater torque (T')
      were assessed in nine young swimmers (three males and six females; 12-17 years
      old). Cs was calculated from the ratio of the total metabolic energy (Es, kJ)
      spent to the distance covered. Es was estimated as the sum of the energy derived
      from alactic (AnA1), lactic (AnL) and aerobic (Aer) processes. In turn, AnL was
      obtained from the net increase of lactate concentration after exercise, AnA1 was
      assumed to amount to 0.393 kJ x kg(-1) of body mass, and Aer was estimated from
      the maximal aerobic power of the subject. Maximal oxygen consumption was
      calculated by means of the back-extrapolation technique from the oxygen
      consumption kinetics recorded during recovery after a 400-m maximal trial.
      Underwater torque (T' x N x m), defined as the product of the force with which
      the feet of a subject lying horizontally in water tends to sink times the
      distance from the feet to the center of volume of the lungs, was determined by
      means of an underwater balance. Cs (kJ x m(-1)) turned out to be a continuous
      function of the speed (v, m x s(-1)) in both males (Cs = 0.603 x 10(0.228v), r2
      =0.991; n = 12) and females (Cs = 0.360 x 10(0.339r), r2 = 0.919; n = 24). A
      significant relationship was found between T' and Cs at 1.2 m x s(-1); Cs =
      0.042T' + 0.594, r = 0.839, n = 10, P<0.05. On the contrary, no significant
      relationships were found between Cs and T' at faster speeds (1.4 and 1.6 m x s(
      1)). This suggests that T' is a determinant of Cs only at speeds comparable to
      that maintained by the subjects over the longest, 400-m distance [mean (SD) 1.20
      (0.07) m x s(-1)].

PMID- 11192055
TI  - Experimental muscle pain modulates muscle activity and work performance
      differently during high and low precision use of a computer mouse.
AB  - The aim was to investigate the influence of experimental muscle pain on
      performance and upper extremity muscle activity during occupational work
      requiring different levels of precision. Experimental muscle pain was induced by
      infusing hypertonic saline (0.3 ml, 5% NaCl) into the extensor carpi ulnaris
      (ECU) muscle. The same amount of isotonic saline was infused on a separate day to
      act as a control. Tasks requiring use of a computer mouse with high and low
      levels of precision were performed during the two sessions. Electromyographic
      (EMG) activity was measured from the ECU, the flexor carpi radialis (FCR) and the
      trapezius muscles. A group of 13 men participated in the study. Performance
      measured as work cycle time, cursor movements on the screen, and velocity of
      cursor movement were unaffected by muscle pain. The ECU muscle pain did not
      modulate EMG profiles of either the trapezius or FCR muscles either during high
      or during low precision work. During the low precision work the painful ECU
      muscle showed lower EMG activity in specific phases of the work cycle (highest
      activity phases) compared to the control session (P<0.05), whereas during the
      high precision work, experimental pain had no effect on the activity of the ECU
      muscle. In conclusion experimental muscle pain seems to modulate motor control
      differently depending on the precision level of the task. This may be of
      importance for our understanding of why some tasks lead to chronic
      musculoskeletal disorders.

PMID- 11192056
TI  - Energy cost and mechanical efficiency of riding a four-wheeled, human-powered,
      recumbent vehicle.
AB  - Oxygen consumption at steady state ( VO2, l x min(-1)) and mechanical power (W,
      W) were measured in five subjects riding a human-powered vehicle (HPV, the
      Karbyk, a four-wheeled recumbent cycle) on a flat concrete road at constant sub
      maximal speeds. The external mechanical work spent per unit of distance (W, J x
      m(-1)), as calculated from the ratio of W to the speed (v, m x s(-1)), was found
      to increase with the square of v: W = 8.12 + (0.262 x v2) (r = 0.986, n = 31),
      where the first term represents the mechanical energy wasted, over a unit of
      distance, against frictional forces (rolling resistance, Rr), and the second term
      (k x v2) is the work performed, per unit distance, to overcome the air drag. The
      rolling coefficient (Cr, obtained dividing Rr by m x g, where m is the overall
      mass and g is the acceleration of gravity) amounted to [mean (SD)] 0.0084
      (0.0008), that is about 60% higher than that of a racing bicycle. The drag
      coefficient was calculated from the measured values of k, air density (p) and
      frontal area (A) [Cx = k x (0.5 x A x rho)-1], and amounted to 1.067 (0.029),
      that is about 20% higher than that of a racing bicycle. The energy cost of riding
      the HPV (Ck, J x m(-1)) was measured from the ratio of metabolic power above rest
      (net VO2, expressed in J x s(-1)) to the speed (v, m x s(-1)); the value of this
      parameter increased with the square of v, as described by: Ck = 61.45 + (0.675 x
      v(2)) (r = 0.711, n = 23). The net mechanical efficiency (eta) was calculated
      from the ratio of W to Ck: over the investigated speed range this turned out to
      be 0.22 (0.021). Best performance times (BPTs) of a "typical" elite athlete
      riding the Karbyk were calculated over the distances of 1, 5 and 10 km: these
      were about 8% longer than the BPTs calculated, on the same subjects, when riding
      a conventional racing bicycle.

PMID- 11192057
TI  - Effect of co-contractions on the cardiovascular response to submaximal static
      handgrip.
AB  - The aim of this study was to investigate the influence of concomitant involuntary
      contractions of different muscles on heart rate (HR) and blood pressure (BP)
      during a sustained, submaximal handgrip. Nine male subjects [23.6 (0.4) years,
      177.0 (1.5) cm, and 73.0 (2.7) kg, means (SE)] participated in the experiment.
      The maximal integrated electromyographic activity (IEMG max) of four ipsilateral
      muscles, flexor digitorum (FD), biceps brachii (BB), rectus abdominalis (RA) and
      vastus lateralis (VA), was recorded. Then, after 30 min of rest, the subjects
      maintained a submaximal isometric handgrip for 2 min. Heart rate (HR), systolic
      (SBP) and diastolic (DBP) blood pressure and surface electromyography (EMG) of
      the four muscles were recorded. The amplitude and power spectrum of the EMG were
      analysed. During the handgrip the force was kept constant at 43 (1)% of the
      maximum voluntary contraction (MVC) only for 90 (12) s. After that time, the
      subjects were unable to maintain the target force which decreased continuously up
      to the end of the contraction (P<0.01) with a residual force of 27 (3)% MVC at t
      = 120 s. HR increased from 75 (3) beats x min(-1) at rest to 109 (6) beats x min(
      1) at t = 120 s (P<0.01). SBP and DBP also increased from 112 (5) and 81 (2) mm
      Hg to 176 (5) and 133 (7) mm Hg, respectively (P<0.01). The EMG activity rose
      significantly for both FD and BB with a moderate increase for RA and VL. In fact,
      the individual contributions of FD and BB to the EMG activity of the four muscles
      were 52 (2)% and 37 (2)%, respectively, whereas the RA and VL contributed only 9
      (1)% and 1.4 (0.1)%. The amplitude ratio of FD's EMG to the total EMG activity of
      the four muscles from which recordings were made decreased with time from 72% to
      33% (P<0.01). The central command's level of activation, as reflected by the
      increased EMG activity of the four recorded muscles, was probably high enough to
      stimulate the cardiovascular centres through cortical spread (sometimes known as
      cortical irradiation). On the other hand, maintaining an isometric handgrip at
      43% MVC reduced local muscle blood flow and metabolites known to stimulate type
      III and IV afferents then accumulated, which in turn induced a reflex-mediated
      elevation of blood pressure. However, the relative forces developed by the co
      contracting muscles were of low intensity (less than 20% MVC) and short duration
      compared to those of the muscle group under study. These results suggest that the
      mass of the muscle groups recruited during a fatiguing submaximal handgrip
      contributes little to the cardiovascular response.

PMID- 11192058
TI  - Physical activity and plasma interleukin-6 in humans--effect of intensity of
      exercise.
AB  - The present study included data from three marathon races to investigate the
      hypothesis that a relationship exists between running intensity and elevated
      concentrations of interleukin (IL)-6 in plasma. The study included a total of 53
      subjects whose mean age was 30.6 [95% confidence interval (CI) 1.4] years, mean
      body mass 77.7 (95% CI 2.0) kg, mean maximal oxygen uptake (VO2max) 59.3 (95% CI
      1.4) ml x min(-1) x kg(-1), and who had participated in the Copenhagen Marathons
      of 1996, 1997 or 1998, achieving a mean running time of 206 (95% CI 7) min.
      Running intensity was calculated as running speed divided by VO2 max. The
      concentration of IL-6 in plasma peaked immediately after the run. There was a
      negative correlation between peak IL-6 concentration and running time (r = -0.30,
      P<0.05) and a positive correlation between peak IL-6 concentration and running
      intensity (r = 0.32, P<0.05). The IL-1 receptor antagonist (IL-1ra) plasma
      concentration peaked 1.5 h after the run and there was a positive correlation
      between the peak plasma concentrations of IL-6 and IL-1ra (r = 0.39, P<0.01).
      Creatine kinase (CK) plasma concentration peaked on the 1st day after the run,
      but no association was found between peak concentrations of IL-6 and CK. In
      conclusion, the results confirmed the hypothesized association between plasma IL
      6 concentration and running intensity, but did not confirm the previous finding
      of a connection between IL-6 plasma concentration and muscle damage.

PMID- 11192059
TI  - Ventilatory and circulatory responses at the onset of voluntary exercise and
      passive movement in children.
AB  - The purpose of this study was to investigate whether or not the ventilatory and
      circulatory responses at the onset of voluntary exercise and passive movement,
      especially at the initial stage (phase I), in children are the same as in adults.
      Ten pre-teenage male children and ten adult men participated in this study.
      Voluntary exercise and passive movement were performed in a sitting position for
      about 20 s. Both the exercise and the movement consisted of flexion-extensions of
      the lower leg from a vertical to horizontal position, either voluntarily or
      passively, with a frequency of about 60 x min(-1). Inspiratory minute ventilation
      (V1), tidal volume (VT), respiratory frequency, partial pressure of end-tidal CO2
      and O2, heart rate (fc) and mean blood pressure (BP) before, during and after
      exercise or movement were measured using breath-by-breath and beat-to-beat
      techniques. Cardiorespiratory responses at the onset of voluntary exercise and
      passive movement were compared with the relative change (delta), which was
      estimated from the value at rest (100%). In the present study, it was found that:
      (1) the V1 during voluntary exercise were significantly lower in the children,
      mainly due to lower deltaVT; (2) the delta(f)c during voluntary exercise was
      almost the same in both groups, while deltaf(c) was significantly lower in the
      children during the last part of passive movement; (3) in the voluntary exercise
      and passive movement, the BP in the children was increased a little or remained
      close to the value at rest, while it was significantly decreased in the adults.
      As a result, there were significant differences in deltaBP between the two groups
      during voluntary exercise. These results suggest that the cardiorespiratory
      responses at the onset of voluntary exercise and passive movement may be modified
      during the growth process.

PMID- 11192060
TI  - Effect of postactivation potentiation on dynamic knee extension performance.
AB  - Six men and four women performed, in separate trials, maximal dynamic knee
      extensions with loads of 15%, 30%, 45% and 60% of maximal isometric knee
      extension peak torque (MVC). The dynamic extensions were done after
      postactivation potentiation (PAP) had been induced with a 10-s MVC, and in a
      control trial without PAP. PAP, measured as the increase in evoked twitch torque,
      was 53 (4)% (SE) and 43 (3)% at the time of the first and second extensions with
      each load. PAP failed to increase the attained peak velocity with any load; on
      the contrary, there was a trend for peak velocity to decrease in the first
      extension, which occurred approximately equal to 15 s after the 10-s MVC. The
      results suggest that fatigue produced by the 10-s MVC suppressed any benefit that
      could be derived from the induced PAP. A surface electromyogram (EMG) recorded
      from one muscle of quadriceps femoris gave no indication of activation failure in
      the first knee extension; however, activation impairment specific to the rate of
      force development cannot be ruled out. It is concluded that the strategy
      employed, namely of having knee extensions performed soon after the 10-s MVC to
      maximize PAP at the time of performance, was unsuccessful because there had been
      insufficient time for recovery from fatigue. It is possible that a longer
      recovery time, even at the cost of a diminished PAP, may have proved beneficial.

PMID- 11192061
TI  - Differential effect of knee extension isometric training on the different muscles
      of the quadriceps femoris in humans.
AB  - This study determined the effects of a short period of knee isometric training on
      the quadriceps muscles accessible to surface electromyography (EMG). For this
      purpose, a training (n = 9) and a control (n = 7) group were tested on five
      identical occasions at 1 week intervals during 4 weeks. The training group
      exercised three times a week by making isometric knee extensions at 80% of the
      maximal voluntary contraction (MVC). During the test sessions, maximal and
      submaximal torque and associated activations of the rectus femoris (RF), vastus
      lateralis (VL) and vastus medialis (VM) muscles were analysed. As a result of
      training, differences between MVC values of the two groups were highly
      significant (P<0.001), whereas only RF-EMG showed significant differences
      (P<0.05). The VL and VM did not present any significant changes in maximal
      activation. The EMG torque relationships were analysed individually before and
      after the training period. For the control subjects, EMG-torque relationships did
      not present significant changes while for the training group, these relationships
      showed a significant increase in RF, VL, and VM maximal activation in 6, 6 and 4
      subjects, respectively, and a significant decrease in 1, 2 and 5 subjects,
      respectively. In almost all cases, a significant downward shift of the
      relationship was observed. This study confirmed that the parts of the quadriceps
      muscle tested present different adaptation capacities and demonstrate inter
      individual variability in the strategies used to enhance muscle strength. In
      conclusion, to analyse the neural effects resulting from training in a large and
      compartmentalized muscle like the quadriceps femoris, it is desirable to take
      into account each muscle independently. Moreover, we suggest that overall results
      obtained from the experiment population should be completed by an analysis on
      individuals.

PMID- 11192062
TI  - Cutaneous vasomotor adjustments during arm-cranking in individuals with
      paraplegia.
AB  - difference, P<0.05). The paraplegics developed a higher esophageal and leg skin
      temperature, which was attributed to the lack of active vasodilation and
      evaporative cooling over the legs. The results indicate that individuals with
      paraplegia suffer from impaired cutaneous vasoconstriction at the onset of arm
      exercise, and possess only a limited vasodilatory capability in the paralyzed
      regions. During intense exercise, thermoregulation depends critically on active
      cutaneous vasodilation and skin cooling.

PMID- 11192063
TI  - Estimation of %VO2 reserve from heart rate during arm exercise and running.
AB  - The purpose of the present investigation was to examine the relationship between
      the percent heart rate reserve (%HRR) in arm exercise and the corresponding
      percent oxygen uptake (VO2) reserve, and to compare this relationship to that
      occurring in running. Fourteen male physical education students took part in the
      study. Each subject performed a maximal running exercise test and a maximal arm
      cycling test. The subjects also performed three submaximal exercise bouts (in
      both exercise modes) at 30%, 60% and 80% of their HRR. The subjects were
      monitored for their heart rate (HR) at rest, maximal HR (HRmax), HR at submaximal
      work loads. maximal VO2 (VO2max), VO2 at rest and VO2 at submaximal loads. For
      each subject, load and exercise mode, %HRR and %VO2 reserve were calculated (from
      HRmax and VO2max as measured during running and arm cycling) and the relationship
      between the two was evaluated. The main finding of the present investigation is
      that the prediction of %VO2 reserve in arm cycling from %HRR is grossly
      overestimated when calculated from HRmax and VO2max measured during running. The
      prediction is better but still overestimated when calculated from HRmax and
      VO2max measured during arm cycling. The findings indicate a better prediction of
      %VO2 reserve from %HRR for running than for arm exercise. These findings should
      be taken into consideration when prescribing the target HR for arm training.

PMID- 11192064
TI  - The effect of motor learning in facioscapulohumeral muscular dystrophy patients.
AB  - Two models of motor learning (ML) practice (complex and simple) were used to
      investigate upper limb function in individuals with facioscapulohumeral dystrophy
      (FSHD). The effect of ML practice was studied by examining changes in the ability
      to undertake a simulated drinking task. In the complex model, seven FSHD patients
      and seven age- and gender-matched healthy volunteers were studied. Performance
      was assessed by measurement of the electromyographic (EMG) activity of the biceps
      brachii and brachioradialis, elbow joint flexion, shoulder joint flexion and
      abduction, maximum acceleration at the onset of movement, movement time and
      reaction time, both before and after a 30-min complex ML task. In the simple
      model, a second group of six FSHD patients and six age- and gender-matched
      healthy subjects were studied. The same parameters were measured as for the
      complex ML task, except that the EMG activity of the triceps and deltoid muscles
      (anterior part) were measured instead of that of the brachioradialis. In both
      studies, the FSHD patients showed significantly larger values for all parameters
      except the flexion of shoulder joint and reaction time, compared with controls
      before the ML task. In the FSHD group, while the complex ML resulted in decreases
      in the brachioradialis EMG activity (P<0.005) and reaction time (P<0.0001), the
      simple ML model resulted in significant changes towards the normal value in all
      parameters measured except shoulder flexion. The change in the measured variables
      towards normal values indicates that ML may help to improve performance in FSHD.

PMID- 11192065
TI  - In humans the oxygen uptake slow component is reduced by prior exercise of high
      as well as low intensity.
AB  - The aim of the study was to examine to what extent prior high- or low-intensity
      cycling, yielding the same amount of external work, influenced the oxygen uptake
      (VO2) slow component of subsequent high-intensity cycling. The 12 subjects cycled
      in two protocols consisting of an initial 3 min period of unloaded cycling
      followed by two periods of constant-load exercise separated by 3 min of rest and
      3 min of unloaded cycling. In protocol 1 both periods of exercise consisted of 6
      min cycling at a work rate corresponding to 90% peak oxygen uptake (VO2peak).
      Protocol 2 differed from protocol 1 in that the first period of exercise
      consisted of a mean of 12.1 (SD 0.8) min cycling at a work rate corresponding to
      50% VO2peak. The difference between the 3rd min VO2 and the end VO2 (deltaVO2(6
      3)) was used as an index of the VO2 slow component. Prior high-intensity exercise
      significantly reduced deltaVO2(6-3). The deltaVO2(6-3) was also reduced by prior
      low-intensity exercise despite an unchanged plasma lactate concentration at the
      start of the second period of exercise. The reduction was more pronounced after
      prior high- than after prior low-intensity exercise (59% and 28%, respectively).
      The results of this study show that prior exercise of high as well as low
      intensity reduces the VO2 slow component and indicate that a metabolic acidosis
      is not a necessary condition to elicit a reduction in deltaVO2(6-3).

PMID- 11192066
TI  - Cardiovascular responses to cold-water immersions of the forearm and face, and
      their relationship to apnoea.
AB  - Apnoea as well as cold stimulation of the face or the extremities elicits marked
      cardiovascular reflexes in humans. The purpose of this study was to investigate
      whether forearm immersion in cold water has any effect on the cardiovascular
      responses to face immersion and apnoea. We recorded cardiovascular responses to
      coldwater immersions of the forearm and face in 19 (part I) and 23 subjects (part
      II). The experimental protocol was divided in two parts, each part containing
      four tests: I1, forearm immersion during eupnoea; I2, face immersion during
      eupnoea; I3, forearm and face immersion during eupnoea; I4, face immersion during
      apnoea; II1, apnoea without immersion; II2, forearm immersion during apnoea; II3,
      face immersion during apnoea; and II4, forearm and face immersion during apnoea.
      The water temperature was 9-11 degrees C. Cold-water immersion of either the
      forearm or face was enough to elicit the most pronounced thermoregulatory
      vasoconstriction during both eupnoea and apnoea. During eupnoea, heart rate
      responses to forearm immersion (3% increase) and face immersion (9% decrease)
      were additive during concurrent stimulation (3% decrease). During apnoea, the
      heart rate responses were not affected by the forearm immersion. The oxygen
      conserving diving response seems to dominate over thermoregulatory responses in
      the threat of asphyxia. During breathing, however, the diving response serves no
      purpose and does not set thermoregulatory adjustments aside.

PMID- 11192067
TI  - Trunk muscle strength in eccentric and concentric lateral flexion.
AB  - The aim of this study was to investigate the position and velocity dependency of
      the strength (torque) output of lateral flexor muscles of the trunk. Twelve male
      volunteers with no history of back pain participated. Movement was constrained to
      the frontal plane and the velocity was controlled by an isokinetic dynamometer.
      The eccentric and concentric strength of lateral flexor muscles on the left side
      was measured in a supine position at velocities of 15, 30, 45 and 60 degrees x s(
      1) and static strength at 20, 10, 0, -10 and -20 degrees of lateral trunk
      flexion. Average peak torque values ranged between 211 and 218 Nm (eccentric) and
      between 66 and 140 Nm (concentric) over all tested velocities, and the average
      static torque ranged between 80 and 172 Nm over all tested positions. The shape
      of the torque position curves was unaffected by speed and peak torque occurred at
      an average position of 11-15 degrees to the contralateral (right) side in both
      eccentric and concentric actions. In eccentric actions, torque output was
      significantly higher than that during concentric and static actions. Increasing
      the speed of contraction did not affect eccentric torque values, whereas both
      peak and angle-specific concentric torque decreased with increasing speed. These
      results are in general accordance with earlier findings from other muscle groups,
      such as the knee extensors. However, they are partially at variance with results
      obtained in studies of lateral lifting and lowering, indicating that there are
      other limiting factors in complex tasks that do not just involve the trunk
      muscles.

PMID- 11192068
TI  - Effect of dehydration on gastrointestinal function at rest and during exercise in
      humans.
AB  - Dehydration leads to the aggravation of gastrointestinal (GI) complaints during
      exercise. The aim of this study was to examine the effect of dehydration on
      various GI parameters during strenuous exercise. Ten healthy well-trained men
      were investigated in dehydrated and in euhydrated conditions. Dehydration took
      place before the experiments using a dehydration regimen in a sauna leading to a
      3% loss of body mass. Each experiment consisted of 1 h pre-exercise rest, 1.5 h
      cycling at 70% maximal exercise intensity, and 3.5 h post-exercise rest. During
      cycling, liquid gastric emptying (GE), orocaecal transit time (OCTT) and
      intestinal permeability and glucose absorption were measured. The GI-symptoms
      were scored using a questionnaire. Body temperature, plasma volume and
      vasopressin were measured before and after cycling. The GE was significantly
      slower during dehydration [median time to peak 13C enrichment in the breath
      sample (13C-TTP) 23.6 min, range 13.7-50.0 min, P = 0.02] than in the control
      situation (median 13C-TTP 17.1 min, range 9.8-38.4 min). The OCTT was unchanged
      (median 173 min, range 98-263 min compared to median 128 min, range 98-195 min, P
      = 0.18). Dehydration did not change intestinal permeability, glucose absorption,
      plasma volume, rectal temperature or plasma vasopressin concentration. In the
      dehydration experiment, exercise induced a significant increase in nausea (P =
      0.01) and epigastric cramps (P = 0.05), in contrast to the control situation. In
      both experiments, exercise led to a significant increase in rectal temperature
      and plasma vasopressin concentration, and a significant decrease in plasma
      volume. The increase in plasma vasopressin concentration was significantly higher
      in the dehydration experiment (P = 0.015). No significant differences in either
      the post-exercise rectal temperatures or in plasma volumes was observed. The
      difference in GE between the two experiments was significantly correlated with
      the difference in nausea score (r = 0.87, P = 0.002). We concluded that
      dehydration leads to a delayed GE but not to differences in OCTT, intestinal
      permeability or glucose uptake during intense cycling. The delay in GE is
      significantly associated with an increase in exercise-induced nausea.

PMID- 11192069
TI  - Vulvar intraepithelial neoplasia: historical aspects and current status.
AB  - Vulvar intraepithelial neoplasia (VIN) is the currently accepted generic
      designation for the spectrum of vulvar lesions with the histologic features of
      squamous dysplasia and squamous cell carcinoma in situ. Although several
      classifications of VIN have been espoused in the past 20 years, VIN can be
      readily classified into two principal clinicopathologic types: classic (bowenoid)
      VIN and simplex (differentiated) VIN. This manuscript summarizes the historical
      development and current status of our knowledge about VIN. Information on the
      clinical and pathologic aspects are detailed and illustrated, as are
      considerations of differential diagnosis.

PMID- 11192070
TI  - A half century in gynecological pathology: reminiscences of Robert E. Scully on
      his career. An interview with Robert H. Young.

PMID- 11192071
TI  - The pathology of intermediate trophoblastic tumors and tumor-like lesions.
AB  - An intermediate trophoblast is a distinctive trophoblastic cell population from
      which four trophoblastic lesions are thought to arise: exaggerated placental site
      (EPS), placental site nodule (PSN), placental site trophoblastic tumor (PSTT),
      and epithelioid trophoblastic tumor (ETT). EPSs and PSTTs are related to the
      differentiation of the intermediate trophoblast in the implantation site
      (implantation site intermediate trophoblast), whereas PSNs and ETTs are related
      to the intermediate trophoblast of the chorion laeve (chorionic-type intermediate
      trophoblast). EPSs and PSNs are nonneoplastic lesions, whereas PSTTs and ETTs are
      neoplasms with a potential for local invasion and metastasis. Microscopically,
      intermediate trophoblastic lesions can be confused with a variety of
      trophoblastic and nontrophoblastic tumors, but an appreciation of the morphologic
      features and immunophenotype allows their diagnosis to be relatively
      straightforward in most instances. Correct diagnosis is important because each of
      these lesions may require different therapeutic approaches.

PMID- 11192072
TI  - Familial ovarian cancer and early ovarian cancer: biologic, pathologic, and
      clinical features.
AB  - Women with ovarian cancer have poor overall survival rates, largely because the
      disease is so often diagnosed at an advanced, less curable stage. Because women
      with early ovarian cancer experience good survival rates, there is great interest
      in the study and detection of early disease. Familial ovarian cancer has been
      relevant to the study of early ovarian cancer in two different ways. First, women
      from ovarian cancer families often undergo prophylactic oophorectomy to prevent
      development of this disease. These ovaries have been studied for pathologic or
      molecular features that might represent early preinvasive disease. Second,
      screening tests to detect presymptomatic ovarian cancer have selectively targeted
      this population because of the increased positive predictive value of these tests
      in this population. A review of the clinical, pathologic, epidemiologic, and
      molecular biologic aspects of familial ovarian cancer provides a background to
      facilitate understanding these issues.

PMID- 11192073
TI  - Immunohistochemical analysis of gynecologic tumors.
AB  - Ancillary techniques such as immunohistochemistry (IHC) enable the surgical
      pathologist to extract additional information from fixed, deparaffinized tissue
      specimens and to provide data critical to optimal clinical management of the
      patient. In this review of applications of IHC to the analysis of gynecologic
      malignancies, the usefulness of immunohistochemical analysis of neoplasms of the
      cervix, endometrium, and ovary is summarized. In the uterine cervix, dysplasia is
      associated with qualitative and quantitative alterations in the expression of the
      Ki-67 antigen expression, as well as an ability to detect human papillomavirus.
      Endometrial endometrioid adenocarcinomas display a highly characteristic
      immunophenotype, with coexpression of cytokeratin and vimentin and demonstration
      of foci of high molecular weight cytokeratin expression; in addition, IHC
      analysis of estrogen and progesterone receptor and p53 expression can provide
      important prognostic information about this tumor. Stromal tumors of the
      endometrium may display a partial smooth muscle immunophenotype, but novel
      markers such as CD10 provide new tools for the identification of these tumors.
      The immunophenotypes of the normal ovarian surface epithelium (OSE) and
      corresponding tumors display significant overlap with, but important distinctions
      from, mesothelium, and important new markers such as the Wilms tumor gene product
      can prove useful in the identification of carcinomas of the OSE. Important
      prognostic markers for carcinomas of the OSE include the HER-2/neu gene product
      and p53, alterations of which can both be assessed by IHC techniques. Finally,
      the recent availability of markers of ovarian stroma, including Melan-A and
      inhibin-alpha, has provided a means for the positive identification of ovarian
      stromal tumors, which can manifest protean histological appearances.

PMID- 11192074
TI  - Value of inhibin staining in gynecological pathology.
AB  - Recent years have seen the publication of many articles investigating the value
      of antibodies against inhibin in diagnostic surgical pathology. This review
      concentrates on the uses of inhibin staining in gynecological pathology. alpha
      inhibin is diagnostically the most useful antibody and is a sensitive
      immunohistochemical marker of most ovarian sex cord-stromal tumors and, as such,
      is of value in the diagnosis of this heterogeneous group of neoplasms that can be
      confused morphologically with a wide range of other tumors. Because the antibody
      is not entirely specific for ovarian sex cord-stromal tumors, it should always be
      used as part of a larger panel. alpha-inhibin staining may also be of value in
      confirming late recurrence or metastasis of an ovarian sex cord-stromal tumor,
      especially a granulosa cell tumor. Sex cord-like elements within uterine tumors
      resembling ovarian sex cord tumors are also commonly immunoreactive with alpha
      inhibin, perhaps indicating true sex cord differentiation. alpha-inhibin staining
      may also be of value in cytological preparations in confirming a functional cyst
      and excluding a cyst or cystadenoma of epithelial origin. Syncytiotrophoblastic
      cells are also immunoreactive, as are most trophoblastic tumors. Thus, positive
      staining may be of value in confirming an intrauterine gestation or in the
      diagnosis of a trophoblastic neoplasm. Another gynecological neoplasm that is
      commonly positive with alpha-inhibin is the so-called female adnexal tumor of
      probable wolffian origin, and, therefore, the antibody is of no value in the
      distinction of this neoplasm from a sex cord-stromal tumor, tumors that are often
      in the differential diagnosis.

PMID- 11192075
TI  - History of gynecological pathology. IX. Dr. John Albertson Sampson. 1921.

PMID- 11192076
TI  - The "resin-capture-release" hybrid technique: a merger between solid- and
      solution-phase synthesis.
AB  - A polymer-assisted organic synthesis that combines the concept of solid-phase
      synthesis with the idea of polymer-supported scavenging reagents has recently
      appeared on the chemistry scene. This technique has frequently been termed the
      "resin-capture-release" methodology and is initiated by the immobilization of a
      small molecule on a polymeric support. This intermediate is subjected to a second
      transformation by adding a new reaction partner in solution. This reactant plays
      two roles: a) the chemical alteration of the polymer-bound intermediate and b)
      the simultaneous release of this reaction product from the resin back into
      solution. This new concept is presented and future prospects are discussed.

PMID- 11192077
TI  - Entropy-driven hydrogen bonding: stereodynamics of a protonated, N,N-chiral
      "proton sponge".
AB  - The C2-symmetric ("[DL]") and achiral ("[meso]") diastereoisomers of the hydrogen
      iodide salt of 1,8-bis-(N-benzyl-N-methylamino)naphthalene ([2H]-[I] )
      interconvert in solution. Direct interconversion of the diastereoisomers of [2H]+
      must involve hydrogen bond fission (to give "[nonHB-2H+]") and rotation-inversion
      of the non-protonated nitrogen centre. The global activation parameters (deltaH++
      and deltaS++) for diastereoisomer interconversion in [D7]DMF have been determined
      from rate data obtained by temperature-drop and magnetisation-transfer 13C NMR
      spectroscopy over a temperature range of 170 degrees C. The process is found to
      have a high entropy of activation in both directions (deltaS++=163(+/-4) and
      169(+/-4) JK(-1)mol(-1)) and this is suggested to arise through hydrogen bonding
      of the ammonium centre in [nonHB-2H+] with the solvent ([D7]DMF). Comparison of
      the enthalpy of activation (deltaH++) with that earlier found for diastereoisomer
      interconversion of the free-base form 2 suggests that the intramolecular hydrogen
      bond in [2H]+ is roughly equal in enthalpic strength (deltaH) with that made with
      the solvent ([D7]DMF) in the non-hydrogen-bonded intermediate [nonHB-2H+]. As
      such, the hydrogen bonding in [2H]+ may be considered as predominantly an
      entropically driven process, without any unusual enthalpic strength.

PMID- 11192078
TI  - Carbenerhodium complexes of the half-sandwich-type: synthesis, substitution, and
      addition reactions.
AB  - A series of carbenerhodium(I) complexes of the general composition [(eta5
      C5H5)Rh(=CRR')(L)] (2a-2i) with R = R'= aryl and L = SbiPr3 or PR3 has been
      prepared from the square-planar precursors trans-[RhCl(=CRR')(L)2] and NaC5H5 in
      excellent yields. Reaction of the triisopropylsibane derivative 2a. which
      contains a rather labile Rh-Sb bond, with CO, PMe3, and CNR (R = Me, CH2Ph, tBu)
      leads to the displacement of the SbiPr3 ligand and affords the substitution
      products [(eta5-C5H5)Rh(=CPh2)(L)] (3-7). In contrast, treatment of the
      triisopropylphosphane compound 2c with CO and CNtBu leads to the cleavage of the
      Rh=CPh2 bond and gives besides [(eta5-C5H5)Rh(PiPr3)(L)] (10, 12) by metal
      assisted C-C coupling diphenylketene Ph2C=C=O (11) or the corresponding imine
      Ph2C=C=NtBu (13). While the reaction of 2a, c with C2H4 yields [(eta5
      C5H5)Rh(C2H4)(L)] (14, 15) and the trisubstituted olefin Ph2C=CHCH3 (16),
      treatment of 2a, c with RN3 leads to the cleavage of both the Rh-EiPr3 and
      Rh=CPh2 bonds and gives the chelate complexes [(eta5-C5H5)Rh(kappa2-RNNNNR)] (19,
      20). The substitution products 3 (L=CO) and 4 (L= PMe3) react with an equimolar
      amount of sulfur or selenium by addition of the chalcogen to the Rh=CPh2 bond to
      generate the complexes [(eta5-C5H5)Rh(kappa2-ECPh2)(L)] (21-24) with thio- or
      selenobenzophenone as ligand. Similarly, treatment of 3 with CuCl affords the
      unusual 1:2 adduct [(eta5-C5H5)(CO)Rh(mu-CPh2)(CuCl)2] (25), which reacts with
      NaC5H5 to form [(eta5-C5H5)(CO)Rh(muCPh2)Cu(eta5-C5H5)] (26). The molecular
      structures of 3 and 22 have been determined by X-ray crystallography.

PMID- 11192079
TI  - The bridging function of an apparently nonbridging ligand: dinuclear rhodium
      complexes with Rh(mu-SbR3)Rh as a molecular unit.
AB  - Novel dinuclear rhodium complexes of the general composition [Rh2Cl2(mu-CRR')2(mu
      SbiPr3)] (4-6) were prepared by thermolysis of the mononuclear precursors trans
      [RhCl(=CRR')(SbiPr3)2] in excellent yield. The X-ray crystal structure analysis
      of 4 (R = R' = Ph) confirms the symmetrical bridging position of the stibane
      ligand. Related compounds [Rh2Cl2(mu-CPh2)(mu-CRR')(mu-SbiPr3)] (7, 8) with two
      different carbene units were obtained either from trans-[RhCl(=CPh2)(SbiPr3)2]
      (1) and RR'CN2 or by a conproportionation of 4 and 5 (R = R' = p-Tol) or 4 and 6
      (R= Ph, R' = p-Tol), respectively. While CO reacts with 4 to give the polymeric
      product [[RhCl(CPh2)(CO)]n] (9), tert-butyl isocyanide replaces the bridging
      stibane and yields [Rh2Cl2(mu-CPh2)2(mu-CNtBu)] (10). The reaction of 4 with
      tertiary phosphanes PR3 leads to complete bridge cleavage and affords the
      mononuclear compounds trans-[RhCl(=CPh2)(PR3)2] (11-15). In contrast, treatment
      of 4 with SbMe3 and SbEt3 yields the related triply bridged complexes [Rh2Cl2(mu
      CPh2)2(mu-SbR3)] (16, 17) by substitution of SbiPr3 for the smaller stibanes. The
      displacement of the chloro ligands in 4-6 and 10 by n5-cyclopentadienyl gives the
      dinuclear complexes [(n5-C5H5)2Rh2(mu-CRR')2] (18-20) and [(n5-C5H5)2Rh2(mu
      CPh2)2(mu-CNtBu)] (21), of which 18 (R = R' = Ph) was characterized
      crystallographically.

PMID- 11192080
TI  - Vibrational circular dichroism and absolute configuration of chiral sulfoxides:
      tert-butyl methyl sulfoxide.
AB  - Mid-infrared vibrational unpolarised absorption and vibrational circular
      dichroism (VCD) spectra of CCl4 solutions of tert-butyl methyl sulfoxide (1) are
      reported. The spectra are compared to ab initio density functional theory (DFT)
      calculations carried out using two functionals, B3PW91 and B3LYP, and two basis
      sets, 6-31G* and TZ2P. The VCD spectra are calculated using Gauge-invariant
      atomic orbitals (GIAOs). The analysis of the VCD spectrum confirms the R(-)/S(+)
      absolute configuration of 1. The advantages and disadvantages of VCD spectroscopy
      in determining the absolute configurations of chiral sulfoxides are discussed.

PMID- 11192081
TI  - Discrimination of A/T sequences in the minor groove of DNA within a cyclic
      polyamide motif.
AB  - Eight-ring cyclic polyamides containing pyrrole (Py), imidazole (Im), and
      hydroxypyrrole (Hp) aromatic amino acids recognize predetermined six base pair
      sites in the minor groove of DNA. Two four-ring polyamide subunits linked by (R)
      2,4-diaminobutyric acid [(R)H2Ngamma] residue form hairpin polyamide structures
      with enhanced DNA binding properties. In hairpin polyamides, substitution of
      Hp/Py for Py/Py pairs enhances selectivity for T. A base pairs but compromises
      binding affinity for specific sequences. In an effort to enhance the binding
      properties of polyamides containing Hp/Py pairings, four eight ring cyclic
      polyamides were synthesized and analyzed on a DNA restriction fragment containing
      three 6-bp sites 5'-tAGNNCTt-3', where NN = AA, TA, or AT. Quantitative footprint
      titration experiments demonstrate that contiguous placement of Hp/Py pairs in
      cyclo-(gamma-ImPyPyPy-(R)H2Ngamma-ImHpHpPy-) (1) provides a 20-fold increase in
      affinity for the 5'-tAGAACTt-3' site (Ka = 7.5 x 10(7)M(-1)) relative to ImPyPyPy
      (R)H2Ngamma-ImHpHpPy-C3-OH (2). A cyclic polyamide of sequence composition cyclo
      (gamma-ImHpPyPy-(R)H2Ngamma-ImHpPyPy-) (3) binds a 5'-tAGTACTt-3' site with an
      equilibrium association constant KA= 3.2 x 10(9)M(-1), representing a fivefold
      increase relative to the hairpin analogue ImHpPyPy-(R)H2Ngamma-ImHpPyPy-C3-OH
      (4). Arrangement of Hp/Py pairs in a 3'-stagger regulates specificity of cyclo
      (gamma-ImPyHpPy-(R)H2Ngamma-ImPyHpPy-) (5) for the 5'-tAGATCTt-3' site (Ka = 7.5
      x 10(7)M(-1)) threefold increase in affinity relative to the hairpin analogue
      ImPyHpPy-(R)H2Ngamma-ImPyHpPy-C3-OH (6), respectively. This study identifies
      cyclic polyamides as a viable motif for restoring recognition properties of
      polyamides containing Hp/Py pairs.

PMID- 11192082
TI  - The first water-soluble 3(10)-helical peptides.
AB  - Two water-soluble 3(10)-helical peptides are synthesized and fully characterized
      for the first time. The sequence of these terminally blocked heptamers comprises
      two residues of the Calpha-trisubstituted alpha-amino acid 2-amino-3-[1-(1,4,7
      triazacyclononyl)]propanoic acid and five residues of a Calpha-tetrasubstituted
      alpha-amino acid (either alpha-aminoisobutyric acid or isovaline). Using CD and
      NMR techniques we were able to show that both heptapeptides are well structured
      in water, and that the type of conformation adopted is indeed the ternary 3(10)
      helix.

PMID- 11192083
TI  - [Cp2V] migration along an octatetrayne chain: from the monometallic complex
      (Cp2V(2-4eta-tBuC triple bond C2-C triple bond CC triple bond CtBu)] to the
      dimetallic complex.
AB  - The oxidative addition of one equivalent of [Cp2V] (4) to the tetrayne ligand
      tBuC triple bond CC triple bond CC triple bond CC triple bond CtBu (5) gives the
      monometallic complex [Cp2V(3-4eta-tBuC triple bond C-C2-C triple bond CC triple
      bond CtBu)] (7). Compound 7 reacts further with a second equivalent of [Cp2V] to
      give the dimetallic complex [(Cp2V)2(1-2eta:7-8eta-tBuC2-C triple bond CC triple
      bond C-C2tBu)] (8), which involves a shift of the first coordinated [Cp2V] unit
      from the internal C3-C4 to the external C1-C2 positions on the alkynyl ligand.
      Compound 8 is also directly obtained by the addition of two equivalents of [Cp2V]
      to 5. Reversibly, reaction of 8 with 5 leads to 7. This exchange reaction between
      7 and 8 by adding successively 5 and 4 has been monitored by EPR spectroscopy. By
      contrast, the oxidative addition of one or two equivalents of [Cp2V] to the
      tetrayne ligand PhC triple bond CC triple bond CC triple bond CC triple bond CPh
      (6) gives the homodimetallic complex [(Cp2V)2(1-2eta:7-8eta-PhC2-CC triple bond
      CC triple bond C-C2-Ph)] (9). Both monometallic and dimetallic complexes 7, 8,
      and 9 have been characterized by X-ray diffraction. Magnetic moment measurements
      for 8 and 9 from 300 to 4 K indicated a weak antiferromagnetic J exchange
      coupling of -12.5 and -4.1 cm(-1), respectively.

PMID- 11192084
TI  - Self-assembly and structure of interconverting multinuclear inorganic arrays: a.
AB  - Coordination of the pentatopic ligand 3 with AgI leads to the simultaneous self
      assembly of two polynuclear architectures: a [4 x 5] grid-type species 10 and a
      quadruple-helicate 11, which contain twenty and ten silver ions. respectively.
      Their structures have been established by X-ray diffraction analysis of the
      crystals obtained as a mixture on crystallisation. Complex 10 contains two [2 x
      5]-AgI10 rectangular subgrids located on opposite sides of an array of parallel
      ligands of 3 that are twisted into a transoid N=C-C=N arrangement around the
      central C-C bond; it may thus be formulated as a grid of grids: [2 x (2 x 5)].
      Complex 11 is an inorganic quadruple helicate that consists of two sets of two
      parallel ligands of 3 connected by an array of ten silver ions. Both compounds 10
      and 11 are novel types of polynuclear complexes that are composed of two
      subunits. Their formation points to the possibility of generating specific arrays
      of metal ions by self-assembly, involving, in particular, a combination of
      subunits within the overall entity. They represent organised patterns of ion dots
      of special significance in view of their formal relationship to quantum dots.

PMID- 11192085
TI  - The binding ability of iron bonded to porphodimethene: structural, magnetic, and
      electronic relationship to iron porphyrin complexes.
AB  - The availability of the parent compound, meso-hexaethylporphodimetheneiron(II),
      [(Et6N4)Fe] (2), of this report results from a novel synthetic methodology that
      makes [Et6N4Li2] (1) easily available. The major focus is on how the axial
      positions, which are the key reactive sites in metalloporphyrins, and the
      electronic configuration of the metal can be affected by the breakdown of the
      aromaticity of the porphyrin skeleton and by the nonplanar conformation of the
      ligand. DFT calculations indicate a 3B1(dz2)1(dyz)1 ground state for 2 versus the
      3A2(dxz)1(dyz)1 ground state in the porphyrin analogue. The intermediate-spin
      state (S = 1) of 2 changed drastically upon addition of one or two axial ligands,
      as hexacoordination is preferred by iron(II). The hexacoordinate complexes
      [(Et6N4)Fe(L)(L')] (L = L' = THF, 3; L = L' = Py, 4; L = PhNO, L' = Py, 14) have
      been isolated and structurally characterized. Strong-field ligands lead to a low
      spin diamagnetic state for iron(II), namely for complexes 4-7, 9, and 14, whereas
      3 is a typical d6 high-spin complex, as is the pentacoordinate
      [(Et6N4)Fe(CN)]Bu4N (8). The structural analysis showed common features for 6, 7,
      9, and 14: i) a small displacement of the metal from the N4 plane, and ii) an N4
      cavity, larger than that in the corresponding porphyrins, affecting the Fe-N bond
      lengths. The 1H NMR spectrum is quite diagnostic of the two-fold symmetry in the
      diamagnetic hexacoordinate complexes, revealing either a D2h or a C2v symmetry.
      The CO stretching frequency (1951 cm(-1)) in complex 6 probes the good electron
      density at the metal. The one-electron oxidation of 2 led to pentacoordinate
      iron(III) derivatives [(Et6N4)Fe(Cl)] (10), [(Et6N4)2Fe2(mu-O)] (11), and
      [(Et6N4)2Fe2(mu-p-OC6H4-O)] (12). Complex 10 is a typical high-spin iron(III)
      (5.85muB at 298 K), while 11 and 12 behave as antiferromagnetic coupled iron(III)
      (J = -9.4cm(-1), 12, and J = -115cm(-1), 11). In complexes 10, 11, and 12 iron is
      sitting in a quite distorted square pyramidal geometry, in which the ligand
      displays a very distorted roof conformation with different degrees of ruffling.
      Distinctive structural and magnetic features have been found for the nitrosyl
      derivative [(Et6N4)Fe-NO], which has a low-spin state (S = 1/2) and the following
      structural parameters: Fe-N-O, 147.3(2) degrees; Fe-N, 1.708(2) A; N-O, 1.172(3)
      A. A comparative structural, magnetic, and theoretical analysis of the compounds
      listed above has been made with the analogous porphyrin derivatives. The detailed
      structural investigation has been mapped through the X-ray analysis of 2, 7, 8,
      9, 11, 13, and 14.

PMID- 11192086
TI  - Quantitative evaluation of Lewis acidity of metal ions derived from the g values
      of ESR spectra of superoxide: metal ion complexes in  relation to the promoting
      effects in electron transfer reactions.
AB  - The g values of ESR spectra of superoxide-metal ion complexes (O2(*-)-Mn+, n = 1,
      2, 3) are determined in acetonitrile at 143 K. The binding energies (deltaE) of
      metal ions with O2*- have been evaluated from deviation of the gzz values from
      the free spin value. The deltaE values are well correlated with the catalytic
      reactivities of metal ions in electron transfer from cobalt(II)
      tetraphenylporphyrin to O2 and p-benzoquinone, which does not occur in the
      absence of metal ions under otherwise the same experimental conditions. The
      deltaE values can thereby be used as the first quantitative measure for Lewis
      acidity of metal ions in relation with the catalytic reactivities in electron
      transfer reactions.

PMID- 11192087
TI  - Interanionic (-)O-H...O(-) interactions: a solid-state and computational study of
      the ring and chain motifs.
AB  - The (-)O-H...O(-) interaction formed by the anions HCO3-, HCO4, HC4O4 and HC5O5-
      (HA-), obtained upon monodeprotonation of the corresponding carbonic, oxalic,
      squaric and croconic acids (H2A), has been investigated theoretically and
      experimentally. The ring (RING) and chain (CHAIN) hydrogen bond motifs
      established between these anions have been analysed in terms of geometry and
      energy and their occurrence in crystalline salts investigated by searching the
      Cambridge Structural Database (CSD) and the Inorganic Chemistry Structural
      Database (ICSD). It has been shown that hydrogen carbonates form RINGs, with the
      notable exception of NaHCO3, while only CHAINs are known for hydrogen oxalates.
      Hydrogen squarates and hydrogen croconates can form both RINGs and CHAINs. The
      structures of Rb- and Cs- hydrogen croconates, which present the two alternative
      motifs, have been discussed together with that of the hydrated salt NaHC5O5.H2O.
      The relationship between RING and CHAIN has been examined in the light of ab
      initio calculations. A rigorous quantum chemical study of the nature of the
      interanionic (-)O-H...O(-) interaction in both vacuum and condensed phase has
      shown that the interaction energy is dominated by the electrostatic component
      which becomes attractive at short O...O distances (less than 2.5 A) if the net
      ionic charge on the anion is delocalised away from the -OH group. It has been
      demonstrated that the RING motif is slightly metastable with respect to
      dissociation in the gas phase, but becomes stable in the crystal owing to the
      influence of the Madelung field. However, the CHAIN motif is unstable both in the
      gas phase and in the crystal. It is argued that interanionic (-)O-H...O(-)
      interactions ought to be regarded as stabilising bonding interactions rather than
      proper intermolecular hydrogen bonds because the RING and CHAIN aggregates are
      not energetically stable on an absolute scale of bonding energy (i.e., in the
      absence of counterions). The presence of very short non-hydrogen-bridged O...O
      contacts resulting from charge compression of polyatomic anions bridged by alkali
      cations is also discussed.

PMID- 11192088
TI  - Sol-gel polycondensation in a cyclohexane-based organogel system in helical
      silica: creation of both right- and left-handed silica structures by helical
      organogel fibers.
AB  - Chiral amide- and urea-type organic gelators (1-6), based on cyclohexanediamine,
      have been prepared, and the superstructures of the organogels were evaluated by
      circular dichroism (CD), transmission electron microscopy (TEM), and scanning
      electron microscopy (SEM). The CD spectrum of the amide-based organogel system
      1+2 exhibited a negative sign for the first Cotton effect, indicating that the
      dipole moments in the gelator aggregate orient into an anticlockwise direction.
      In contrast, the system 3+4 has a positive sign for the first Cotton effect,
      indicating that they orient into a clockwise direction. In the mixture of urea-
      and amide-based organogels, CD spectra of 5+2 and 6+4 revealed negative and
      positive signs, respectively. The helical structure of the amide-based organogels
      1+2 and 3+4 clearly showed left- and right-handed structures, respectively, by
      SEM. To transcribe the chiral, helical structures of the organogels into silica
      gel, the sol-gel polycondensation of tetraethoxysilane (TEOS) was carried out in
      acetonitrile or ethanol. Very surprisingly, the left- and right-handed structures
      of the silica can be created by transcription of left- and right-handed
      structures of the organogels 1+2 (R enantiomer) and 3+4 (S enantiomer),
      respectively. In addition, in the mixture systems of urea- and amide-based
      organogels, the right- and left-handed structures of the organogels 5+2 (R
      enantiomer) and 6+4 (S enantiomer) were precisely transcribed into the silica
      structure. The findings suggest that the sol-gel polycondensation proceeds along
      the surface of the helical structure of the organogels. We therefore believe that
      the sol-gel polycondensation by means of molecular assembly templates abundantly
      built in the organogel phase is a new strategy to create superstructured silica
      materials.

PMID- 11192089
TI  - Imidovanadium(v) complexes as reaction partners for kinetically stabilized
      phosphaalkynes: synthesis of 1,2,4-azaphosphavanada(v)-cyclobutenes, 1,3,5
      triphosphabenzenes, and 1H-1,2,4-azadiphospholes.
AB  - Cycloaddition reactions of the kinetically stabilized phosphaalkynes 1 with the
      imidovanadium(v) trihalides 9 furnish the 1,2,4-azaphosphavanada(v)cyclobutenes
      10. The stability of these novel metallacyclic compounds depends solely on the
      substitutents of the imido unit. Thus, the imidovanadium(v) species 9 with
      tertiary alkyl groups on the N atom form stable addition products with 1 while in
      the cases of compounds 9 with a lower degree of substitution at N (primary and
      secondary alkyl groups) the primarily formed adducts 10 undergo irreversible
      decomposition to afford the 1H-1,2,4-azadiphospholes 13. Reactions of an excess
      of the phosphaaalkyne 1 with the vanadium complexes 9 furnish the corresponding
      triphosphabenzenes 8 in good yields (36-68%). A catalytic reaction course has
      been demonstrated for the all-tert-butyl system 1a/9a in which the metallacyclic
      species 10a serves as the catalytically active species. Poisoning of the catalyst
      leads to a second reaction pathway, which results in formation of the
      azatetraphosphaquadricyclanes 16. By means of the stepwise use of different
      phosphaalkynes 1a,b this methodology provides the first access to the differently
      substituted triphosphabenzenes through cyclotrimerization.

PMID- 11192090
TI  - 4-Oxo-2,3,5,6-tetrafluorocyclohexa-2,5-dienylidene--a highly electrophilic
      triplet carbene.
AB  - The 4-oxocyclohexa-2,5-dienylidenes are an interesting class of highly
      electrophilic carbenes. We investigated the reactivity of the 2,3,5,6
      tetrafluorinated and -tetrachlorinated derivatives 1b and 1c with small molecules
      under conditions of matrix isolation. The reactions with molecular oxygen and
      with carbon monoxide produce the expected carbonyl O-oxides and ketenes,
      respectively. As a result of the extreme electrophilicity of 1b and c both
      carbenes insert with no or very small activation barriers into H2 or the CH bonds
      of hydrocarbons. Obviously, spin restrictions for these formally spin-forbidden
      reactions do not result in substantial thermal activation barriers.

PMID- 11192091
TI  - Spontaneous symmetry breaking in the formation of a dinuclear gadolinium
      semiquinonato complex: synthesis, high-field EPR studies, and magnetic
      properties.
AB  - The synthesis and characterisation of an asymmetric dinuclear gadolinium(III)
      semiquinonato complex, namely [Gd2(HBPz3)2(dtbsq)4] CHCl3 (1; HBPz3 =
      hydrotris(pyrazolyl)borate, dtbsq = 3,5-di-tert-butyl-O-semiquinone), is
      reported. The crystal structure of 1 was determined at room temperature. It
      crystallises in the triclinic system P1, with a = 16.735(5) A, b = 17.705(5) A, c
      = 19.553(5) A, alpha = 99.680(5) degrees, beta = 109.960(5), gamma = 107.350(5)
      degrees, Z = 2 and R = 9.96. The structure of 1 consists of a dinuclear
      asymmetric unit in which the two gadolinium(III) ions have coordination numbers
      of eight and nine. Three of the dioxolene molecules act as asymmetric bridging
      ligands, while the fourth molecule behaves as a bidentate ligand towards a single
      metal ion. The magnetic properties of 1 were investigated by means of
      susceptibility measurements and high-field electron paramagnetic resonance (HF
      EPR) spectroscopy. They revealed an S = 0 ground spin state with excited states
      of higher spin very close in energy and a small negative zero-field splitting
      with a transverse anisotropy term for a S = 7 state.

PMID- 11192092
TI  - The Chatt-Dewar-Duncanson model revisited: X-ray, DFT and NMR studies of rhodium
      alkene binding--deviations from structural ideality.
AB  - An analysis has been made of deviations from ideal centrosymmetric bonding of
      alkenes to transition metals in square-planar complexes. Three separate
      approaches have been employed. Firstly, the geometries obtained for a series of X
      ray crystal structures of monosubstituted rhodium-alkene complexes have been
      obtained. Secondly, DFT computations on closely related rhodium-alkene complexes
      are reported. Thirdly. the data have been augmented by recourse to the crystal
      structure serach and retrieval file (CSSR) database to retrieve the X-ray data
      for square-planar ethene and monosubstituted alkene complexes. The results
      obtained from these analyses provide a consistent picture. Two distortions from
      ideality are important: twisting of the alkene about the axis between the metal
      (M) and the alkene centroid and rolling of the alkene around a cylinder enclosing
      the metal, such that the two C-M bonds remain equal in length. The presence of
      both of these is verified through both X-ray structure determinations and DFT
      calculations. For the rolling distortion, there is a relationship between the
      electronic character of the substituent on the alkene and the direction of roll.
      The net effect of this is to place the more nucleophilic carbon of the alkene
      closer to the square plane. The significance of this for the regiochemistry of
      the Heck reaction is briefly discussed.

PMID- 11192093
TI  - Ladderlike oligomers; intramolecular hydrogen bonding, push-pull character, and
      electron affinity.
AB  - Symmetrical 2,5-bis(2-aminophenyl)pyrazines have been synthesized by application
      of the Stille coupling strategy. These cotrimers feature three important
      properties, namely strong intramolecular hydrogen bonding, push-pull character,
      and high electron affinity. The presence of intramolecular hydrogen bonds has
      been confirmed by 1H NMR, IR spectroscopy, and single-crystal X-ray diffraction.
      The hydrogen bond strength can be increased by substituting the amino groups with
      stronger electron-withdrawing functionalities. Despite the anticipated enhanced
      pi-conjugation through planarization, a hypsochromic shift was observed in the
      UV/Vis spectra, explained by a decrease in push-pull character. The electron
      affinity of the cotrimers was deduced from the first reduction potentials
      measured by cyclic voltammetry and is related to the electron-withdrawing
      character of the amino substituents. The results obtained have been compared with
      those of the corresponding 4-aminophenyl analogues and show that intramolecular
      hydrogen bonds can be used to design polymers with enhanced pi conjugation as
      well as a high electron affinity.

PMID- 11192094
TI  - Biomimetic catalysis with immobilised organometallic ruthenium complexes:
      substrate- and regioselective transfer hydrogenation of ketones.
AB  - Chloro-(eta6-arene) complexes of ruthenium(II) with N-sulfonyl-1,2
      ethylenediamine ligands that have one or two styrene side chains have been
      synthesised and characterised. The chloro ligand was substituted with a
      diphenylphosphinato ligand and the resulting organometallic complexes are
      transition state analogues for the ruthenium-catalysed transfer hydrogenation of
      benzophenone. Following the protocol of molecular imprinting, these complexes
      were copolymerised with ethylene glycol dimethacrylate (EGDMA) in the presence of
      a porogen. The polymers were ground and sieved, and the phosphinato ligand was
      substituted with a chloro ligand, thus generating a shape-selective cavity in
      close proximity to the catalytically active metal centre. When tested for their
      ability to catalyse the reduction of benzophenone, the imprinted polymers showed
      a significantly higher activity (up to a factor of seven) than control polymers
      without cavities. Out of a mixture of seven different aromatic and aliphatic
      ketones, benzophenone was preferentially reduced when the imprinted polymer was
      used. Furthermore, the specificity of the catalyst for diaryl ketones has been
      confirmed in a reaction with a bifunctional substrate, 4-acetyl-benzophenone; the
      diaryl ketone was reduced faster with the imprinted catalyst than the acetyl
      group. The opposite regioselectivity was observed with the control polymer. Both
      the activity and the selectivity of the imprinted catalysts are dependent on how
      the ruthenium complexes are attached to the polymer backbone. A double connection
      proved to give superior results.

PMID- 11192095
TI  - Trimethylsilyl- and trimethylstannyldimethylphosphane--convenient and versatile
      reagents for the synthesis of polyfluoroaryldimethylphosphanes.
AB  - Trimethylsilyldimethylphosphane (Me3SiPMe2) and the corresponding tin compound
      (Me3SnPMe2) were used as reagents for the substitution of fluorine by the Me2P
      group in polyfluoroarenes C6F5X (X = F, H, Cl, CF3) and C5NF5. The reactions
      occur even under mild conditions (T = 0-20 C), either in benzene or without
      solvent, to give as a rule 4-X-1-(dimethylphosphano)tetrafluorobenzenes
      (XC6F4PMe2, 1-4) and 4-(dimethylphosphano)tetrafluoropyridine (C5NF4PMe2, 5),
      respectively, in yields between 75 and 95%. In the case of C6F6, double
      substitution is also observed, which affords 1,4
      bis(dimethylphosphano)tetrafluorobenzene (6). A very efficient route to the
      compounds XC6F4PMe2 (X = F, H, Cl, CF3) and C5NF4PMe2 was developed as a one-pot
      reaction of the corresponding fluoroarenes with tetramethyldiphosphane (P2Me4)
      and trimethyltin hydride (Me3SnH) at moderate temperatures. This process was
      tested for C6F6 and perfluorobiphenyl which gave C6F5PMe2 (1) and 4,4'
      bis(dimethylphosphano)octafluorobiphenyl (7), respectively. The results, which
      included kinetic measurements that used the intensities of the 31P signals,
      revealed the influence of the substrate type on the rate of reaction in the
      sequence: C5NF5>C6F5CF3> C6F5Cl, C6F5PMe2>C6F5H>C6F6>> C6H5F. Ab initio
      calculations were carried out on the model reactions of pentafluoropyridine with
      silylphosphane, phosphane or phosphide to discriminate between possible reaction
      mechanisms. The novel phosphanes were characterised by spectroscopic
      investigations (NMR, MS), by preparation of the related thiophosphanes
      ArFP(=S)Me2 (8-14), their spectroscopic and analytic data and single crystal X
      ray diffraction studies on five of these derivatives.

PMID- 11192096
TI  - Coordination polymerization in water affording amorphous polyethylenes.
AB  - The coordination polymerization of ethylene in water as a reaction medium was
      studied. Rubbery amorphous branched polyethylene was obtained when a known
      cationic diimine-substituted methyl complex was employed as a catalyst precursor.
      High rates of up to 900 TOh(-1) (turnover frequency) were observed. In contrast
      to solution polymerization in an organic solvent, the rate of suspension
      polymerization in water increases greatly with ethylene pressure in the range up
      to 20 bar; this indicates control of the polymerization rate by the concentration
      of the olefin monomer at the catalytically active site. The effect and mode of
      mass transfer phenomena were studied. A high catalyst stability in the aqueous
      coordination polymerization was observed. It was found to be due to an
      "encapsulation" of the water-insoluble catalyst precursor in the hydrophobic
      amorphous polymer during the polymerization reaction, and this resulted in
      strongly restricted accessibility for the aqueous phase. Surprisingly, exposure
      of the water-stable catalyst precursor to ethylene monomer in solution in the
      presence of water resulted in immediate decomposition. Polymer microstructure,
      and thermal and mechanical properties were investigated. The different degree of
      branching, molecular weight, and corresponding macroscopic properties of the
      polymers obtained in water as a reaction medium versus solution polymerization in
      methylene chloride under the same conditions are due to the different phase
      behavior during polymerization (suspension vs. solution), as opposed to an effect
      of water on the catalytically active centers.

PMID- 11192097
TI  - The synthesis and glass-forming properties of phthalocyanine-containing poly(aryl
      ether) dendrimers.
AB  - The synthesis, structural characterisation and properties of a number of
      phthalocyanine-containing dendrimers are described. Peripheral substitution of
      phthalocyanine (Pc) with four poly(aryl ether) dendritic wedges (1st, 2nd or 3rd
      generation) produces materials whose properties are dominated both by the
      columnar self-association of the Pc core and by the glass-forming character of
      the dendritic substituents. Asymmetric Pcs containing a single poly(aryl ether)
      dendron display a columnar mesophase, the structure of which can be frozen into
      an anisotropic glass at room temperature. Placing the dendritic wedges at the
      axial sites of silicon phthalocyanine prohibits self-association and gives
      materials from which can be fabricated robust, isotropic solid solutions of Pc
      with high glass transition temperatures. A single crystal X-ray diffraction
      analysis of one of these compounds illustrates the ability of the axial dendrons
      to prevent cofacial aggregation in the solid state.

PMID- 11192098
TI  - Strategies for the anchoring of metal complexes, clusters, and colloids inside
      nanoporous alumina membranes.
AB  - Two complementary strategies are presented for the anchoring of molecular
      palladium complexes, of cobalt or platinum clusters or of gold colloids inside
      the nanopores of alumina membranes. The first consists in the one step
      condensation of an alkoxysilyl functional group carried by the metal complex with
      the hydroxy groups covering the surface of the membrane pores. Thus, using the
      short-bite alkoxysilyl-functionalized diphosphane ligands (Ph2P)2N(CH2)3Si(OMe)3
      (1) and (Ph2P)2N(CH2)4SiMe2(OMe)] (2) derived from (Ph2P)2NH (dppa) (dppa
      bis(diphenylphosphanyl)amine), the palladium complexes [Pd(dmba)(kappa2-P,P
      (Ph2P)2N(CH2)3Si(OMe)3)] Cl (3) and [Pd(dmba)[kappa2-P,P
      (Ph2P)2N(CH2)4SiMe2(OMe)]]Cl (4) (dmba-H = dimethylbenzylamine). respectively,
      were tethered to the pore walls. After controlled thermal treatment. confined and
      highly dispersed palladium nanoparticles were formed and characterized by
      transmission electron microscopy (TEM). This method could not be applied to the
      cobalt cluster [Co4(CO)8(mu-dppa)[mu-P,P-(Ph2P)2N(CH2)4SiMe2(OMe)]] (7) owing to
      its too limited solubility. However, its anchoring was achieved by using the
      second method which consisted of first derivatizing the pore walls with 1 or 2.
      The covalent attachment of the diphosphane ligands provides a molecular anchor
      that allows subsequent reaction with the cluster [Co4(CO)10(mu-dppa)] 6 to
      generate anchored 7 and this step was monitored by UV/Vis spectroscopy. In
      addition, the presence of carbonyl ligands in the cluster provides for the first
      time a very sensitive spectroscopic probe in the IR region which confirms both
      cluster incorporation and the retaining of its molecular nature inside the
      membrane. The presence of the bridging dppa ligand in 6 provides additional
      stabilization and accounts for the selectivity of the procedure. Using this
      method, platinum clusters (diameter ca. 2 nm) and gold colloids (diameter ca. 13
      nm) were immobilized after passing their solution through the functionalized
      membrane pores. The resulting membranes were characterized by TEM which
      demonstrated the efficiency of the complexation and showed the high dispersion of
      the metal loading. The successful application of these methods has demonstrated
      that nanoporous alumina membranes are not only unique supports to incorporate
      metal complexes, clusters, or colloids but can also be regarded as functional
      matrices or microreactors, thus opening new fields for applications.

PMID- 11192099
TI  - Endometrial ablation: the next generation.

PMID- 11192100
TI  - The impact of maternal serum screening on the birth prevalence of Down's syndrome
      and the use of amniocentesis and chorionic villus sampling in South Australia.
AB  - OBJECTIVES: To describe the impact of maternal serum screening on the birth
      prevalence of Down's syndrome and on the use of amniocentesis and chorionic
      villus sampling in South Australia. DESIGN: A descriptive population-based study.
      SETTING: South Australia (population 1.48 million persons; approximately 20,000
      births per year). PARTICIPANTS: Women who had births or terminations of pregnancy
      with Down's syndrome in 1982-1996, women who had maternal serum screening in 1991
      1996, amniocentesis or chorionic villus sampling in 1986-1996. METHODS: Analysis
      of data from multiple sources on maternal serum screening, amniocentesis and
      chorionic villus sampling, births and terminations of pregnancy. MAIN OUTCOME
      MEASURES: Total prevalence and birth prevalence of Down's syndrome each year in
      1982-1996; proportion of pregnant women using maternal serum screening in 1991
      1996, and proportion using amniocentesis and chorionic villus sampling by
      indication in 1986-1996, by age group. RESULTS: Use of maternal serum screening
      for Down's syndrome increased from 17% when introduced in 1991 to 76% of women
      who gave birth in 1996. Between 1982 and 1986 and 1996, terminations of pregnancy
      for fetal Down's syndrome increased from 7.1 % to 75% and the birth prevalence of
      Down's syndrome fell by 60% from 1.05 to 0.42 per 1,000 births, against the
      background of an increase in total prevalence due to increasing maternal age. The
      use of amniocentesis increased from 5.8% in 1991 to 10.1% in 1996 mainly due to
      the increase among women younger than 35 years with maternal serum screening as
      the main reason. The increasing chorionic villus sampling rate among younger
      women stabilised at 0.4%, while the rate among older women decreased from 11.0%
      to 7.4%. CONCLUSIONS: The introduction of maternal serum screening in South
      Australia has resulted in increased use of any prenatal testing for Down's
      syndrome from about 7% (mainly older women having amniocentesis or chorionic
      villus sampling) to 84% of women (about 8% having direct amniocentesis or
      chorionic villus sampling and 76% having maternal serum screening first). This
      has resulted in a significant fall in the birth prevalence of Down's syndrome.
      maternal serum screening was the first indication of Down's syndrome for about
      half the terminations of pregnancy for Down's syndrome in 1993-1996, including
      three quarters of those in younger women.

PMID- 11192101
TI  - The prevalence of pelvic floor disorders and their relationship to gender, age,
      parity and mode of delivery.
AB  - OBJECTIVE: To define the prevalence of pelvic floor disorders in a non
      institutionalised community and to determine the relationship to gender, age,
      parity and mode of delivery. DESIGN: A representative population survey using the
      1998 South Australian Health Omnibus Survey. SAMPLE: Random selection of 4400
      households; 3010 interviews were conducted in the respondents' homes by trained
      female interviewers. This cross sectional survey included men and women aged 15
      97 years. RESULTS: The prevalence of all types of self-reported urinary
      incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary
      incontinence was more commonly reported in nulliparous women than men and
      increased after pregnancy according to parity and age. The highest prevalence
      (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and
      faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women,
      respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly
      increased the prevalence of major pelvic floor dysfunction, defined as any type
      of incontinence, symptoms of prolapse or previous pelvic floor surgery.
      Multivariate logistic regression showed that, compared with nulliparity, pelvic
      floor dysfunction was significantly associated with caesarean section (OR 2.5,
      95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at
      least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference between
      caesarean and instrumental delivery was significant (P<0.03) but was not for
      caesarean and spontaneous delivery. Other associations with pelvic floor
      morbidity were age, body mass index, coughing, osteoporosis, arthritis and
      reduced quality of life scores. Symptoms of haemorrhoids also increased with age
      and parity and were reported in 19.9% of men and 30.2% of women. CONCLUSION:
      Pelvic floor disorders are very common and are strongly associated with female
      gender, ageing, pregnancy, parity and instrumental delivery. Caesarean delivery
      is not associated with a significant reduction in long term pelvic floor
      morbidity compared with spontaneous vaginal delivery.

PMID- 11192102
TI  - Endocrinological and endometrial factors in recurrent miscarriage.
AB  - OBJECTIVE: To investigate the endocrinological and endometrial factors in women
      with unexplained recurrent miscarriage DESIGN: Prospective, case study SETTING:
      Recurrent miscarriage clinic, Jessop Hospital for Women, Sheffield PARTICIPANTS:
      One hundred and forty-four women with unexplained recurrent (> or =3)
      miscarriages METHODS: A blood sample was obtained in early follicular phase (day
      3-5) to measure follicle stimulating hormone, luteinising hormone, prolactin,
      androgens and thyroid function; daily blood/urine samples were obtained from mid
      follicular phase to measure luteinising hormone until the luteinising hormone
      surge was identified; endometrial biopsy and a further blood sample for
      progesterone measurement were obtained in the mid-luteal phase. A transvaginal
      ultrasonography was performed to evaluate ovarian morphology. RESULTS:
      Hypersecretion of luteinising hormone or ultrasonographic features of polycystic
      ovarian disease was present in 8% and 7.8% of women, respectively. The free
      androgen index was elevated in 14.6% of subjects. In the mid-luteal phase, low
      progesterone level was found in 17.4% and delayed endometrial development was
      noted in 27.1% of women. Although women with recurrent miscarriage women and
      delayed endometrium had significantly lower progesterone levels than those with
      normal endometrial development, only 8/24 had mid-luteal progesterone levels
      below 30 nmol/L. Recurrent miscarriage was not associated with
      hyperprolactinaemia or abnormal thyroid function test. CONCLUSIONS:
      Endocrinological and endometrial abnormalities are present in about a quarter of
      women with unexplained recurrent miscarriage.

PMID- 11192103
TI  - Can glucose tolerance test predict fetal hyperinsulinism?
AB  - OBJECTIVE: To establish cut off levels for oral glucose tolerance test in
      pregnancy using fetal hyperinsulinism as a clinical endpoint. DESIGN: Capillary
      blood glucose levels at 0, 1, and 2 hours after the ingestion of either 1 g/kg or
      75 g glucose, at 28 (SD 5) weeks of gestation were analysed in 220 women with
      elevated amniotic fluid insulin levels [> or =42 pmol/L (> or =7 microU/mL)]
      after a mean (SD) of 31 weeks (3) and in 220 nondiabetic controls. RESULTS: In
      women with elevated amniotic fluid insulin levels the mean (SD) capillary blood
      glucose values at 0, 1, and 2 hours were 5.2 mmol/L (1.0) [94 mg/dL (18)], 10.5
      mmol/L (1.4) [189 mg/dL (25)] and 8.2 mmol/L (2.0) [147 mg/dL (36)],
      respectively. The one-hour value had the highest sensitivity to predict elevated
      amniotic fluid insulin levels. The 5th centile of the one-hour blood glucose
      levels representing a detection rate of 95% was 8.9 mmol/L (160 mg/dL).
      CONCLUSION: Glucose cut off levels in most established oral glucose tolerance
      test criteria are too high, to accurately predict amniotic fluid hyperinsulinism.
      A one-hour test may be sufficient for detecting amniotic fluid hyperinsulinism.
      Since different loads (1 g/kg, 75 g or 100 g) and blood fractions (venous plasma
      or capillary blood) have minimal impact on oral glucose tolerance test results, a
      single one-hour cut off of 8.9 mmol/L (160 mg/dL), independent of the sampling
      method, may be appropriate for the diagnosis of gestational diabetes mellitus
      severe enough to cause amniotic fluid hyperinsulinism.

PMID- 11192104
TI  - Hormonal regulation of neonatal weight: placental leptin and leptin receptors.
AB  - OBJECTIVE: To examine whether umbilical and maternal leptin levels correlate with
      birthweight, placental weight, and maternal weight; and to detect membrane-bound
      leptin receptors in placental tissue as well as soluble leptin receptors in
      umbilical and maternal blood. DESIGN: Prospective observational study. SETTING:
      University teaching hospital. METHODS: Serum levels of leptin and soluble leptin
      receptors were analysed in 31 randomly selected mother/newborn pairs at delivery.
      In addition, placental tissue was assayed for leptin receptors using
      immunocytochemistry and Western blot. RESULTS: The mean [SD] leptin level in
      umbilical cord venous blood (7.1 ng/mL [4.0]) was significantly lower (P<0.001)
      than in maternal blood (22.5 ng/mL [10.8]). Umbilical cord leptin concentrations
      correlated significantly with birthweight (P<0.001), placental weight (P<0.005)
      but not with maternal leptin. Maternal leptin concentrations correlated only with
      maternal weight (P<0.001). In chorionic villous tissue, trophoblasts stained
      strongly positive for leptin receptor-like immunoreactivity. Two membrane-bound
      isoforms of the leptin receptor were also detected in placental tissue. In both
      umbilical and maternal serum, a soluble leptin receptor was found migrating as
      broad band at Mr 97,000 D. CONCLUSION: The present data strongly reinforce the
      idea that circulating leptin levels may provide a growth-promoting signal for
      fetal development during late pregnancy. While membrane-bound leptin receptors
      may be involved in autocrine regulation of placental leptin production, the
      soluble receptor form may serve as a transport vehicle for leptin to fetal
      tissues.

PMID- 11192105
TI  - Accuracy and limitations of transabdominal fetal echocardiography at 12-15 weeks
      of gestation in a population at high risk for congenital heart disease.
AB  - OBJECTIVE: Evaluation of transabdominal fetal echocardiography at 12-15 weeks of
      gestation. DESIGN: Retrospective analysis. SETTING: Tertiary fetal cardiology
      unit. SAMPLE: Two hundred twenty-nine consecutive fetuses imaged at 12-15 weeks
      of gestation over a 45-month period. METHODS: Retrospective analysis of
      echocardiography and autopsy reports. MAIN OUTCOME MEASURES: Accuracy of early
      echocardiography for the detection of abnormalities of the cardiac connections.
      RESULTS: Diagnostic images were obtained in 226/229 fetuses (98.7%).
      Abnormalities of the cardiac connections were detected in 13 fetuses (5.7%) on
      the initial scan. Where information was available (n = 11), the echocardiographic
      findings were confirmed at autopsy or postnatally. In two of the 13 cases of
      congenital heart disease, repeat echocardiography was necessary to provide
      additional cardiological information. Of the 213 cases in whom a normal initial
      report was issued, four (1.7%) had congenital heart disease diagnosed later in
      pregnancy (n = 3) or postnatally (n = 1). Three of these fetuses had
      haemodynamically insignificant ventricular septal defects and one developed a
      dilated cardiomyopathy later in gestation. CONCLUSIONS: Transabdominal fetal
      echocardiography can be performed at 12-15 weeks of gestation permitting accurate
      early detection of major congenital heart defects in a high risk population. Some
      forms of congenital heart disease, usually minor, may not be detectable at such
      an early stage.

PMID- 11192106
TI  - RhD genotyping by quantitative fluorescent polymerase chain reaction: a new
      approach.
AB  - OBJECTIVE: To develop a new method of RhD/d genotype determination using a
      quantitative fluorescent PCR (QF-PCR) assay. METHODS: Polymerase chain reaction
      amplification (PCR) of fragments of exon 7 of both the RHD and RHCE genes was
      performed from 32 amniotic fluid and 26 chorionic villus samples known to be
      heterozygous for the RHD gene, 74 peripheral blood samples of RhD-positive blood
      donors (homozygous or heterozygous) estimated by serologic typing and 24 RhD
      negative fetal samples. The number of copies of the RHD gene in RhD-positive
      samples was determined by comparing the fluorescent intensities of the
      amplification products specific for the RHD and the RHCE genes. RESULTS: A ratio
      of fluorescent intensities of 1:1 clearly indicated D/D homozygous individuals
      whereas a ratio of 1:2 was demonstrated in samples from D/d heterozygous
      individuals. The mean fluorescent intensity ratio of the peak areas of homozygous
      samples was 1.12 (SD 0.128), the mean ratio of the peak areas of heterozygous
      samples was 0.51 (SD 0.060). Complete agreement was obtained between RhD/d typing
      by QF-PCR and RhD genotypes assessed by family studies and serological methods.
      CONCLUSIONS: The fluorescent PCR-based DNA test allows easy, rapid and accurate
      determination of the zygosity for the RHD gene. This new technique provides
      useful information for the clinical management of pregnancies of sensitised RhD
      negative mothers.

PMID- 11192107
TI  - Hepatitis C virus load during pregnancy and puerperium.
AB  - OBJECTIVE: To assess whether pregnancy and delivery influence serum levels of
      hepatitis C virus (HCV) in carrier mothers. DESIGN: A prospective study. SETTING:
      University department of obstetrics and gynaecology. PARTICIPANTS: Ten pregnant
      HCV carriers (group A) and 8 nonpregnant HCV carriers (group B). METHODS: Serum
      samples were collected for group A at first and third trimesters, delivery,
      postpartum 1, 3, 6, 9 and 12 months, and at every three months for 1 year for
      group B. MAIN OUTCOME MEASURES: Each serum sample was tested for serum alanine
      aminotransferase (ALT), anti-HCV titre and HCV-cDNA concentration by a
      competitive polymerase chain reaction (PCR) with a sensitivity of 250 copies/mL
      serum. RESULTS: In group A, the HCV levels remained unremarkably changed during
      pregnancy and delivery. However, all women had decreased HCV levels 1 and 3
      months after delivery. Two women had undetectable serum HCV level postpartum and
      thereafter. Serum ALT values in 3 women were sporadically elevated, but did not
      correlate with decreased serum HCV levels. Anti-HCV titres remained unchanged
      during the study period. In two women from group B, the serum HCV levels were
      undetectable during follow up. Other 6 women showed fluctuations in the serum HCV
      levels but all were above 250 copies/mL. Serum ALT values were normal and anti
      HCV titres remained stationary in all 8 nonpregnant carriers. CONCLUSION: Serum
      HCV levels are decreased 1 and 3 months after delivery. This fact might suggest
      that puerperium is an optimal time for antiviral therapy in HCV carrier mothers.

PMID- 11192108
TI  - Qualitative study of pregnancy and childbirth experiences in Somalian women
      resident in Sweden.
AB  - OBJECTIVE: To explore the attitudes, strategies and habits of Somalian immigrant
      women related to pregnancy and childbirth, in order to gain an understanding as
      to how cultural factors might affect perinatal outcome. METHODS: Interpreter
      assisted qualitative in depth interviews around topics such as attitudes and
      strategies regarding childbirth. PARTICIPANTS: Fifteen women from the Somalian
      community in a city in Sweden, between the ages of 20 and 55 years with delivery
      experience in Somalia and Sweden. RESULTS: The interviews describe how the women
      themselves perceived their experiences of childbirth in the migrant situation.
      Many voluntarily decreased food intake in order to have a smaller fetus, an
      easier delivery and to avoid caesarean section. The participants considered a
      safe delivery to be the same as a normal vaginal delivery They reduced food
      intake in order to diminish the growth of the fetus, thereby avoiding caesarean
      section and mortality. The practice of food intake reduction, while rational for
      the participants when in Somalia, was found less rational in Sweden and may lead
      to suboptimal obstetric surveillance. CONCLUSIONS: Somalian women have childbirth
      strategies that differ from those of Swedish women. These strategies should be
      seen as 'survival behaviours' related to their background in an environment with
      high maternal mortality. The hypothesis generated is that there is a relationship
      between the strategies during pregnancy and adverse perinatal outcome among
      Somalian immigrants. Considering the strong association of the habits to safe
      birth, it seems doubtful whether the women will change their habits as long as
      health care providers are unaware of their motives. We suggest a more culturally
      sensitive perinatal surveillance.

PMID- 11192109
TI  - Folate affects apoptosis in human trophoblastic cells.
AB  - Effects of folate deficiency on the rate of apoptosis in human cytotrophoblastic
      cells has been investigated. Apoptosis was determined in cytotrophoblastic cells
      after culture in 1. control medium, 2. folate-free medium and 3. folate-free
      medium plus 10% fetal calf serum. Apoptosis rates in cells cultured in mediums 2
      and 3 were significantly higher than those cultured in the control medium (P<0.02
      and P<0.03, respectively). In conclusion, human cytotrophoblastic cells show a
      significantly increased rate of apoptosis in vitro after culture in a folate-free
      medium. Possible explanations for the association between folate deficiency and
      pregnancy complications are suggested.

PMID- 11192110
TI  - Congenital chylothorax in siblings.

PMID- 11192111
TI  - Acute lumbar intervertebral disc prolapse: a complication of the lithotomy
      position.

PMID- 11192112
TI  - Theory of DNA electrophoresis: a look at some current challenges.
AB  - Although electrophoresis is one of the basic methods of the modern molecular
      biology laboratory, new ideas are being suggested at an accelerated rate, in
      large part because of the pressing demands of the biomedical community. Although
      we now have, at least for some methods, a fairly good theoretical understanding
      of the physical mechanisms that lead to the observed peak spacings, widths and
      shapes, this knowledge is often too qualitative to be used to guide further
      technical developments and improvements. In this article, we review some selected
      elements of the current state of our theoretical ignorance, focusing mostly on
      DNA electrophoresis, and we offer several suggestions for further theoretical
      investigations.

PMID- 11192113
TI  - Dispersive phenomena in electromigration separation methods.
AB  - A review on dispersive effects and on peak broadening in electromigration
      separation methods (capillary electrophoresis and electrochromatography) is
      presented, mainly covering papers published between the beginning of 1997 and the
      beginning of 2000. Most attention is drawn to work dealing with nonlinear effects
      that cause anomalous electromigration dispersion in electrolyte systems with two
      or multiple coions. Further, topics cover the comparison of electroosmotic and
      pressure-driven modes in electrochromatography, dispersive effects due to
      nonhomogeneous velocity fields in packed electrochromatography columns, to
      nonuniform electroosmotic flow, to sorption of analytes (mainly proteins) at the
      column wall or the stationary phase, and due to the influence of the nonideal
      column geometry like coiling or irregularities in shape.

PMID- 11192114
TI  - Recent progress in capillary isotachophoresis.
AB  - This article is a continuation of previous reviews and summarizes the progress of
      analytical capillary isotachophoresis in the years 1997-1999. Papers reviewed
      include theoretical and methodological aspects as well as analytical
      applications. Included are also papers using isotachophoresis and/or
      isotachophoretic principles as part of multidimensional separation schemes.

PMID- 11192115
TI  - Recent advances in affinity capillary electrophoresis.
AB  - Use of the specificity of (bio)interactions can effectively overcome the
      selectivity limitation faced in capillary electrophoresis (CE), and the resulting
      technique usually is referred to as affinity capillary electrophoresis (ACE).
      Despite the high selectivity of ACE, several important problems still need to be
      addressed. A major issue in all CE separations, including ACE, is the
      concentration detection limit. Using UV detection, this is usually in the order
      of 10(-6) M whereas laser-induced fluorescence (LIF) detection can provide
      detection limits down to the sub-10(-10) M range. However, a marked disadvantage
      of LIF is that labeling of the analytes is usually required, which might change
      the interaction behavior of the solutes under investigation. Additionally,
      labeling reactions at sub-10(-10) M concentration levels are certainly not
      trivial and often difficult to perform quantitatively. Alternative and universal
      detection approaches, particularly mass spectrometric (MS) detection, look very
      promising but (A) CE-MS techniques are still far from routine application.
      Important future progress in sensitive detection strategies is likely to increase
      the use of ACE in the future.

PMID- 11192116
TI  - Capillary electrophoresis-based immunoassays.
AB  - This review covers the progress and developments in the field of capillary
      electrophoresis immunoassay (CEIA) over the past three years. Because many
      excellent descriptions of the principles of these methods are available (e.g., in
      the reviews listed in this article), no elementary introduction is given to the
      field of immunoassays (IAs) or CEIAs. This report focuses exclusively on
      experimental results, dividing the CEIA papers into the categories of direct,
      indirect, and microchip electrophoretic immunoassays. In the last section, a
      brief summary of the current status of the CEIA field is presented.

PMID- 11192117
TI  - Recent developments in electrokinetically driven analysis on microfabricated
      devices.
AB  - This review is devoted to the rapid developments in the field of microfluidic
      separation devices in which the flow is electrokinetically driven, and where the
      separation element forms the heart of the system, in order to give an overview of
      the trends of the last three years. Examples of microchip layouts that were
      designed for various application areas are given. Optimization of mixing and
      injection strategies, designs for the handling of multiple samples, and capillary
      array systems show the enormous progress made since the first proof-of-concept
      papers about lab-on-a-chip devices. Examples of functional elements for on-chip
      preconcentration, filtering, DNA amplification and on-chip detection indicate
      that the real integration of various analytical tasks on a single microchip is
      coming into reach. The use of materials other than glass, such as
      poly(dimethylsiloxane) and polymethylmethacrylate, for chip fabrication and
      detection methods other than laser-induced fluorescence (LIF) detection, such as
      mass spectrometry and electrochemical detection, are described. Furthermore, it
      can be observed that the separation modes known from capillary electrophoresis
      (CE) in fused-silica capillaries can be easily transferred to the microchip
      platform. The review concludes with an overview of applications of microchip CE
      and with a brief outlook.

PMID- 11192118
TI  - Ultrathin-layer gel electrophoresis of biopolymers.
AB  - Emerging need for large-scale, high-resolution analysis of biopolymers, such as
      DNA sequencing polymerase chain reaction, (PCR) product sizing, single nucleotide
      polymorphism (SNP) hunting and analysis of protein molecules necessitated the
      development of automated and high-throughput gel electrophoresis based methods
      enabling rapid, high-performance separations in a wide molecular weight range.
      Scaling down electric field mediated separation processes supports higher
      throughput due to the applicability of higher voltages, thus speeding up analysis
      time. Indeed, efforts in miniaturization resulted in faster, easier, less costly
      and more convenient analyses, fulfilling the needs of the emerging biotechnology
      industry for microscale and massively parallel assays. The two primary approaches
      in miniaturizing electrophoresis dimensions are the capillary and microslab
      formats. This latter one evolved towards ultrathin-layer gel electrophoresis
      which is, except from the thickness of the separation platform, slightly in the
      upper side of the scale, resulting in considerably easier handling. Ultrathin
      layer gel electrophoresis combines the advantages of conventional slab-gel
      electrophoresis (multilane format) and capillary gel electrophoresis (rapid, high
      efficiency separations). It is readily automated, automatic versions of it have
      been extensively used for large-scale DNA sequencing in the Human Genome Project
      and more recently became popular in high throughput DNA fragment analysis.
      Ultrathin-layer techniques are the first step towards the wider use of
      electrophoresis microchips in perfecting a user-friendly interface between the
      user and the microdevice.

PMID- 11192119
TI  - Recent progress in capillary electrochromatography.
AB  - Capillary electrochromatography (CEC) continues to captivate many separation
      scientists. A remarkable activity is apparent from the numerous publications in
      the literature using CEC. A review of the most recent progress in CEC is
      presented herein, covering an extensive fraction of the literature on CEC
      published from the year 1997 until the beginning of 2000. Most of the recent
      developments have concentrated on column technology.

PMID- 11192120
TI  - Nonaqueous capillary electrophoresis: a versatile completion of electrophoretic
      separation techniques.
AB  - Nonaqueous capillary electrophoresis (NACE) is the application of a conductive
      electrolyte dissolved in either one organic solvent or a mixture of several
      organic solvents to carry out zone electrophoresis or related techniques in fused
      silica capillaries. A complete review on the fundamentals, the optimization of
      analytical methods, practical considerations, and applications is given. To
      explain the differences to CE in aqueous media, a brief summary on solvent
      properties and molecular interactions in solutions introduces the reader into
      these fields. The use of additives to tune separation selectivity by means beyond
      a pure zone-electrophoretic mechanism is discussed in detail for organic media.
      Special detection techniques providing high potential for NACE are presented.
      Data on the precision of NACE methods and a list of relevant applications are
      included. More specialized applications like the determination of physicochemical
      constants in NACE or the setup of a semipreparative mode are described.

PMID- 11192121
TI  - Recent advances in electrochemical detection in capillary electrophoresis.
AB  - Recent advances in the design and application of electrochemical (EC) detection
      systems in capillary electrophoresis (CE) are reviewed, with the objective of
      providing the nonelectrochemist with a state-of-the-art picture of CEEC
      instrumentation and an overview of the principal analytes for which CEEC is best
      suited. The detection schemes considered here include those based both on
      amperometry and on potentiometry as both kinds of EC systems are being actively
      developed in CE and have the potential for broad application in analysis. Over
      the three-year period covered by this review, an important direction that CEEC
      has taken is the construction of more complex electrode systems beginning with
      the use of multiple EC electrodes and culminating with the adaptation of EC
      detection to microfabricated "lab-on-a-chip" analysis devices. In addition, CEEC
      applications have now grown to include a broad variety of inorganic, organic, and
      biochemical analytes and samples.

PMID- 11192122
TI  - Derivatization trends in capillary electrophoresis.
AB  - This survey gives an overview of recent derivatization protocols, starting from
      1996, in combination with capillary electrophoresis (CE). Derivatization is
      mainly used for enhancing the detection sensitivity of CE, especially in
      combination with laser-induced fluorescence. Derivatization procedures are
      classified in tables in pre-, on- and postcapillary arrangements and, more
      specifically, arranged into functional groups being derivatized. The amine and
      reducing ends of saccharides are reported most frequently, but examples are also
      given for derivatization of thiols, hydroxyl, carboxylic, and carbonyl groups,
      and inorganic ions. Other reasons for derivatization concern indirect chiral
      separations, enhancing electrospray characteristics, or incorporation of a
      suitable charge into the analytes. Special attention is paid to the increasing
      field of research using on-line precapillary derivatization with CE and
      microdialysis for in vivo monitoring of neurotransmitter concentrations. The on
      capillary derivatization can be divided in several approaches, such as the at
      inlet, zone-passing and throughout method. The postcapillary mode is represented
      by gap designs, and membrane reactors, but especially the combination of
      separation, derivatization and detection on a chip is a new emerging field of
      research. This review, which can be seen as a sequel to our earlier reported
      review covering the years 1991-1995, gives an impression of current
      derivatization applications and highlights new developments in this field.

PMID- 11192123
TI  - Capillary electrophoresis of peptides and proteins in isoelectric buffers: an
      update.
AB  - Capillary electrophoresis in acidic, isoelectric buffers is a novel methodology
      allowing fast protein and peptide analysis in uncoated capillaries. Due to the
      low pH adopted and to the use of dynamic coating with cellulose derivatives,
      silanol ionization is essentially suppressed and little interaction of
      macromolecules with the untreated wall occurs. In addition, due to the low
      conductivity of quasi-stationary, isoelectric buffers, high-voltage gradients can
      be applied (up to 800 V/cm) permitting fast peptide analysis with a high
      resolving power due to minimal diffusional peak spreading. Four such buffers are
      here described: cysteic acid (Cys-A, pI 1.85), iminodiacetic acid (IDA, pI 2.23),
      aspartic acid (Asp, pI 2.77) and glutamic acid (Glu, pI 3.22). A number of
      applications are reported, ranging from food analysis to the study of
      folding/unfolding transitions of proteins.

PMID- 11192124
TI  - Polymeric and polymer-supported pseudostationary phases in micellar
      electrokinetic chromatography: performance and selectivity.
AB  - Several types of synthetic ionic polymers have been employed as pseudostationary
      phases in electrokinetic chromatography. The polymers have been shown to have
      some significant advantages and different chemical selectivity relative to
      conventional surfactant micelles. Polymeric phases are effective for the
      separation and analysis of hydrophobic and chiral compounds, and may be useful
      for the application of mass spectrometric detection. Additionally, the polymeric
      phases often demonstrate unique selectivity relative to micellar phases, and can
      be designed and synthesized to provide desired selectivity. This review covers
      efforts to develop and characterize the performance, characteristics, and
      selectivity of synthetic polymeric pseudostationary phases since their
      introduction in 1992. Some ideas for the future development of polymeric
      pseudostationary phases and the role they may play in electrokinetic separations
      are presented.

PMID- 11192125
TI  - Capillary electrochromatography with physically and dynamically absorbed
      stationary phases.
AB  - Adsorption is always considered a troublesome effect in capillary electrophoresis
      (CE) and capillary electrochromatography (CEC). However, the adsorption effect
      can also be exploited to prepare or optimize the stationary phase in CEC.
      Compared with the chemical synthesis of new stationary phase materials for CEC,
      this method is simpler and more convenient. This review is focused on CEC with
      physically and dynamically adsorbed stationary phases. Separation of some acidic,
      basic and neutral solutes as well as enantiomers in CEC with dynamically adsorbed
      stationary phases are presented. The theory for the migration of charged solutes
      and the stationary phases currently used in CEC are also briefly reviewed.

PMID- 11192126
TI  - Polymeric matrices for DNA sequencing by capillary electrophoresis.
AB  - We review the wide range of polymeric materials that have been employed for DNA
      sequencing separations by capillary electrophoresis. Intensive research in the
      area has converged in showing that highly entangled solutions of hydrophilic,
      high molar mass polymers are required to achieve high DNA separation efficiency
      and long read length, system attributes that are particularly important for
      genomic sequencing. The extent of DNA-polymer interactions, as well as the
      robustness of the entangled polymer network, greatly influence the performance of
      a given polymer matrix for DNA separation. Further fundamental research in the
      field of polymer physics and chemistry is needed to elucidate the specific
      mechanisms by which DNA is separated in dynamic, uncross-linked polymer networks.

PMID- 11192128
TI  - Recent progress in enantiomer separation by capillary electrochromatography.
AB  - Enantiomer separation by electrochromatography (CEC) can be performed in three
      modes: (i) open-tubular capillary electrochromatography (o-CEC), in which the
      chiral selector is physically adsorbed coated, and thermally immobilized or
      covalently attached to the internal capillary wall; (ii) packed capillary
      electrochromatography (p-CEC), in which the capillary is either filled with
      chiral modified silica particles or with an achiral packing material, and a
      chiral selector is added to the mobile phase; and (iii) monolithic (rod)
      capillary electrochromatography (rod-CEC) in which the chiral stationary phase
      (CSP) consists of a single piece of porous solid. We present an overview on
      methods and new trends in the field of electrochromatographic enantiomer
      separation such as CEC with either nonaqueous mobile phases or stationary phases
      with incorporated permanent charges, or with packing beds consisting of nonporous
      silica particles or particles with very small internal diameters.

PMID- 11192127
TI  - Recent progress in chiral separation principles in capillary electrophoresis.
AB  - This review summarizes recent developments in the field of chiral separations by
      electromigration techniques including capillary zone electrophoresis (CZE),
      capillary gel electrophoresis (CGE), isotachophoresis (ITP), electrokinetic
      chromatography (EKC), and capillary electrochromatography (CEC). This overview
      focuses on the development of new chiral selectors and the introduction of new
      techniques rather than applications of already established selectors and methods.
      The mechanisms of the different chiral separation principles are discussed.

PMID- 11192129
TI  - Enantioseparations using capillary electromigration techniques in nonaqueous
      buffers.
AB  - This review summarizes recent developments in the field of enantioseparations in
      capillary electromigration techniques using nonaqueous background electrolytes.
      The more established and rather intensively reviewed field of nonaqueous chiral
      capillary electrophoresis (NAQ-CE) is covered in less detail whereas more
      attention is paid to the relatively new field of nonaqueous capillary
      electrochromatography (NAQ-CEC).

PMID- 11192130
TI  - Recent progress in capillary electrophoresis of metal ions.
AB  - Advances in the fundamental studies and methodology of capillary electrophoresis
      (CE) as applied to metal ion analysis over the last two years are reviewed, with
      the objective of providing the interested reader with a state-of-the-art picture
      of technique's potentialities in the area. In particular, novel strategies for
      separation selectivity control and CE system innovations designed to enhance the
      detection sensitivity are described. In addition, a brief overview of the primary
      metal analytes and samples for which the technique appears to be best suited is
      given. The current limitations of the technique regarding most of all the
      implementation for routine use are considered along with the approaches on how
      they could be addressed. Finally, some pointers as to the likely trends in the
      future research are discussed.

PMID- 11192131
TI  - Safety profile and tolerability of amprenavir in the treatment of adult and
      pediatric patients with HIV infection.
AB  - BACKGROUND: Amprenavir (APV) is a new HIV-I protease inhibitor used in
      combination with other antiretroviral agents for the treatment of HIV-1
      infection. OBJECTIVE: The aim of this study was to assess the safety profile and
      tolerability of APV. METHODS: A review of data from 358 adults enrolled in 2
      phase III, randomized, 48-week, controlled studies and from 268 children enrolled
      in 1 phase II and 1 phase III study was conducted. The adult data were collected
      between February 25, 1997, and April 1, 1999. Data were collected in children
      from September 10, 1997, to January 15, 1999; these data were collected before
      completion of either study. Adults and children who had and had not been treated
      previously with antiretroviral agents were enrolled. In these studies, APV was
      used in combination with 2 nucleoside reverse transcriptase inhibitors. RESULTS:
      The most common drug-related adverse events in patients receiving APV were
      gastrointestinal events and oral/perioral paresthesia. The majority of adverse
      events were mild or moderate in intensity, early in onset, and transient. Nausea
      (27/358 patients, 8%), vomiting (15/358, 4%), rash (11/358, 3%), and
      diarrhea/loose stools (9/358, 3%) were the most common adverse events associated
      with treatment discontinuation. Severe laboratory abnormalities possibly related
      to APV were rare. In children, the nature and frequency of adverse events were
      similar to those in adults. Metabolic complications were infrequent in APV
      studies to date; symptoms related to fat redistribution were reported in <3% of
      patients treated with APV. Lipid or glucose laboratory abnormalities were
      reported with similar frequency in the APV and control groups in both studies in
      adults. CONCLUSIONS: In the clinical trials reviewed, APV was generally well
      tolerated when administered with other antiretroviral agents in adult and
      pediatric patients with HIV infection.

PMID- 11192132
TI  - Pioglitazone hydrochloride in combination with metformin in the treatment of type
      2 diabetes mellitus: a randomized, placebo-controlled study. The Pioglitazone 027
      Study Group.
AB  - BACKGROUND: Their complimentary mechanisms of action suggest that a combination
      of pioglitazone hydrochloride and metformin may have clinically beneficial
      effects in the treatment of patients with type 2 diabetes. OBJECTIVE: This study
      was undertaken to assess the efficacy and tolerability of pioglitazone in
      combination with metformin in patients with type 2 diabetes mellitus. METHODS:
      This was a 16-week, double-blind study with the option of enrollment in a
      separate open-ended, open-label study. It included patients with poorly
      controlled diabetes mellitus (glycated hemoglobin [HbA1c] > or =8.0%, fasting C
      peptide >1.0 ng/mL) who had been receiving a stable regimen of metformin for > or
      =30 days. Patients with diabetic retinopathy, nephropathy, or neuropathy;
      impaired liver or kidney function; or unstable cardiovascular or cerebrovascular
      conditions were excluded. Patients were randomized to receive once-daily
      pioglitazone 30 mg + metformin or placebo + metformin. Patients in the open-label
      extension received pioglitazone 30 mg (with optional titration to 45 mg) +
      metformin. RESULTS: Three hundred twenty-eight patients were randomized to
      treatment (168 pioglitazone + metformin, 160 placebo + metformin), and 249
      completed the study. Of these, 154 elected to enter the open-label extension
      study. Patients' mean age was 56 years; most (84%) were white and slightly more
      than half (57%) were male. Patients receiving piogli- tazone 30 mg + metformin
      had statistically significant mean decreases in HbA1c (-0.83%) and fasting plasma
      glucose (FPG) levels (-37.7 mg/dL) compared with placebo + metformin (P < or =
      0.05). Decreases in FPG levels occurred as early as the fourth week of therapy,
      the first time point at which FPG was measured. The pioglitazone + metformin
      group had significant mean percentage changes in levels of triglycerides (-18.2%)
      and high-density lipoprotein cholesterol (+8.7%) compared with placebo +
      metformin (P < or = 0.05). Mean percentage increases were noted in low-density
      lipoprotein cholesterol levels (7.7%, pioglitazone + metformin; 11.9%, placebo +
      metformin) and total cholesterol (4.1%, pioglitazone + metformin; 1.1%, placebo +
      metformin), with no significant differences between groups. In the extension
      study, patients treated with open-label pioglitazone + metformin for 72 weeks had
      mean changes from baseline of -1.36% in HbA1c and -63.0 mg/dL in FPG. The
      incidence of adverse events was similar in both groups. Throughout the study, no
      patient in either treatment group had an alanine aminotransferase (ALT) value >
      or =3 times the upper limit of normal, a commonly used marker of potential liver
      damage. Thus, no evidence of drug-induced hepatotoxicity or drug-induced
      elevations in serum ALT was observed. CONCLUSIONS: In this study in patients with
      type 2 diabetes mellitus, pioglitazone + metformin significantly improved HbA1c
      and FPG levels, with positive effects on serum lipid levels and no evidence of
      drug-induced hepatotoxicity. These effects were maintained for >1.5 years,
      including the open-label extension.

PMID- 11192133
TI  - Phase III, randomized, double-blind study of clarithromycin extended-release and
      immediate-release formulations in the treatment of patients with acute
      exacerbation of chronic bronchitis.
AB  - BACKGROUND: Clarithromycin has an established efficacy and safety profile in the
      treatment of respiratory tract infections. OBJECTIVE: The purpose of this study
      was to compare the clinical and bacteriologic efficacy and tolerability of
      clarithromycin extended-release and immediate-release formulations in patients
      with acute exacerbation of chronic bronchitis (AECB). METHODS: In a phase III,
      randomized, double-blind, parallel-group, multicenter study. patients aged > or
      =12 years with signs and symptoms of AECB and a productive cough with purulent
      sputum received treatment with extended-release (two 500-mg tablets once daily)
      or immediate-release (one 500-mg tablet twice daily) clarithromycin for 7 days.
      Assessments were performed before treatment, within 48 hours after treatment, and
      at the test-of-cure visit (study days 19-21). Patients who took > or =1 dose of
      study drug were included in the safety analysis. RESULTS: Of 620 patients
      randomized and treated, 182 were clinically and bacteriologically assessable (100
      in the extended-release group and 82 in the immediate-release group). Treatment
      groups were well matched with respect to demographic characteristics and medical
      and social history. At the test-of-cure visit, 83% (83/100) of patients in the
      extended-release and 82% (67/82) of patients in the immediate-release group
      achieved clinical cure; 86% (85/99) and 85% (70/82), respectively, demonstrated
      bacteriologic cure. Overall pathogen eradication rates were 86% (100/116) in the
      extended-release group and 88% (86/98) in the immediate-release group. The most
      frequently reported adverse events were diarrhea (6% in extended-release group vs
      4% in immediate-release group; no significant difference), taste alterations (4%
      in each group), and nausea (3% in each group); no clinically meaningful changes
      in laboratory values or vital signs, as assessed by the investigator, were
      observed. CONCLUSION: This study suggests that clarithromycin extended-release
      and immediate-release formulations have equivalent clinical and bacteriologic
      efficacy and tolerability in patients with AECB.

PMID- 11192134
TI  - Phase III, randomized, double-blind study of clarithromycin extended-release and
      immediate-release formulations in the treatment of adult patients with acute
      maxillary sinusitis.
AB  - BACKGROUND: Clarithromycin has an established bacteriologic efficacy and safety
      profile in the treatment of respiratory tract infections. OBJECTIVE: This study
      compares the efficacy and tolerability of extended-release and immediate-release
      formulations of clarithromycin in patients with acute maxillary sinusitis.
      METHODS: Fourteen days' treatment with once-daily clarithromycin was compared
      with the immediate-release, twice-daily formulation in a phase III, randomized,
      double-blind, parallel-group, multicenter study. Patients aged > or =12 years
      with signs, symptoms, and a radiologically confirmed diagnosis of acute maxillary
      sinusitis were eligible. Patients were assessed before treatment, within 48 hours
      after treatment, on study days 16 to 18, and at the test-of-cure visit on study
      days 24 to 31. Patients who received > or =1 dose of study drug were included in
      the safety analysis. RESULTS: Of 283 patients treated, 245 were included in the
      efficacy analysis (122 in the extended-release group, 123 in the immediate
      release group). Treatment groups were well matched with respect to demographic
      characteristics and medical condition and history. At the test-of-cure visit, 85%
      of patients in the clarithromycin extended-release group and 79% in the immediate
      release group were deemed clinical cures; 89% and 91% in the extended-release and
      immediate-release groups, respectively, demonstrated radiographic success.
      Overall incidences of study drug-related adverse events were similar in the 2
      treatment groups (32% in the extended-release group and 28% in the immediate
      release group); however, significantly fewer patients receiving extended-release
      clarithromycin (2/142 11%]), compared with those receiving the immediate-release
      formulation (10/141 [7%]: P = 0.02) discontinued therapy because of drug-related
      gastrointestinal symptoms or abnormal taste. No clinically meaningful changes in
      laboratory values or vital signs were observed during the study. CONCLUSION:
      Although the efficacy of the 2 formulations was comparable, once-daily
      clarithromycin extended-release was better tolerated than the twice-daily
      immediate-release formulation by patients with acute maxillary sinusitis.

PMID- 11192135
TI  - Rechallenge of patients who had discontinued alendronate therapy because of upper
      gastrointestinal symptoms.
AB  - BACKGROUND: There have been reports from physicians in clinical practice that up
      to 30% of patients taking bisphosphonate therapy develop upper gastrointestinal
      (UGI) symptoms, many or most of which they assume to be related to the drug.
      However, in several large placebo-controlled clinical trials of bisphosphonates,
      the incidence of UGI symptoms has been > or =30%, even among patients receiving
      placebo, perhaps reflecting a high background incidence of UGI events in
      osteoporotic patients. OBJECTIVE: To assess the relationship between alendronate
      treatment and UGI complaints in patients who had discontinued treatment with
      alendronate in clinical practice because of UGI symptoms, we compared the
      incidence of such events on rechallenge with alendronate or placebo. METHODS:
      This was a multicenter, double-blind trial in which postmenopausal women with
      osteoporosis who had previously discontinued alendronate therapy because of a UGI
      adverse experience were randomized to daily treatment with either alendronate 10
      mg or matching placebo (1:1 ratio) for 8 weeks. The primary end point was the
      cumulative incidence of discontinuations due to any UGI adverse experience.
      Secondary end points were the incidence of any clinical adverse experiences and
      the percentage change from baseline in urinary N-telopeptide adjusted for urinary
      creatinine at week 8. RESULTS: A total of 172 women were included in the study.
      They were a mean of 20.9 years past menopause, ranging in age from 41 to 90 years
      (mean, 67.0 years); 90.7% were white. On rechallenge, 14.8% (13/88) of patients
      in the alendronate group and 16.7% (14/84) in the placebo group discontinued
      treatment because of UGI adverse experiences. CONCLUSION: The results of this
      study suggest that many UGI adverse experiences reported during therapy with
      alendronate may reflect a high background incidence of UGI complaints and an
      increased sensitivity to detection of such complaints, rather than a causal
      relationship to therapy.

PMID- 11192136
TI  - Pharmacokinetics, pharmacodynamics, and relative pharmacokinetic/pharmacodynamic
      profiles of zaleplon and zolpidem.
AB  - OBJECTIVE: This study compared the pharmacokinetics, pharmacodynamics, and
      pharmacokinetic/pharmacodynamic (PK/PD) profile of zaleplon, a new
      pyrazolopyrimidine hypnotic, with those of zolpidem and placebo. METHODS: This
      was a double-blind, 5-period crossover study in which healthy volunteers with no
      history of sleeping disorder were randomized to 10- or 20-mg oral doses of
      zaleplon, 10- or 20-mg oral doses of zolpidem, or placebo. The pharmacokinetic
      characteristics of the active drugs were estimated using a noncompartmental
      method and NONMEM. Pharmacodynamic characteristics were determined using
      psychophysical tests, including measures of sedation, mood, mental and motor
      speed, and recent and remote recall. Results of these tests were used to compare
      the drugs' relative PK/PD profiles. RESULTS: Ten healthy male and female
      volunteers, aged 23 to 31 years, took part in the study. The apparent elimination
      half-life of zaleplon (60.1+/-8.9 min) was significantly shorter than that of
      zolpidem (124.5+/-37.9 min) (P < 0.001). Zaleplon produced less sedation than
      zolpidem at the 2 doses studied (P < 0.001). The sedation scores of the zaleplon
      groups returned to baseline in less time than those of the zolpidem groups (4 vs
      8 hours; P < 0.05). Zaleplon had no effect on recent or remote recall, whereas
      zolpidem had a significant effect on both measures (P < 0.05). CONCLUSIONS: In
      this study in 10 young, healthy volunteers, zaleplon was eliminated more rapidly,
      produced no memory loss, and caused less sedation than zolpidem at the same
      doses.

PMID- 11192137
TI  - Comparison of the clinical efficacy and comfort of olopatadine hydrochloride 0.1%
      ophthalmic solution and nedocromil sodium 2% ophthalmic solution in the human
      conjunctival allergen challenge model.
AB  - BACKGROUND: Mast cell stabilizers, such as the ocular antiallergic agent
      nedocromil sodium 2% ophthalmic solution, are not rapid acting and often require
      a loading period of > or =2 weeks for maximal efficacy. Olopatadine hydrochloride
      0.1% ophthalmic solution is a member of a new class of topical antiallergic
      agents that have combined antihistaminic and mast cell-stabilizing properties.
      OBJECTIVE: The purpose of this study was to compare the clinical efficacy and
      comfort of olopatadine with those of nedocromil in the conjunctival allergen
      challenge model. METHODS: This was a single-center, 3-visit, randomized, double
      masked, contralaterally controlled study. Seventy-five subjects with a history of
      allergic conjunctivitis were screened, and the 52 who responded to conjunctival
      allergen challenge at visits I and 2 were randomized by eye to receive
      olopatadine, nedocromil, or placebo (a "natural tears" lubricant eye drop).
      Because nedocromil may require a 2-week loading period for maximal efficacy, the
      eyes assigned to that agent received nedocromil for 14 days (between visits 2 and
      3), whereas the eyes assigned to olopatadine or placebo received placebo during
      this period. Throughout the loading phase, subjects instilled 1 drop of the
      assigned masked medication in each eye twice daily. At the assessment visit
      (visit 3), subjects received I drop of masked olopatadine, nedocromil, or placebo
      in each eye and were asked to rate the comfort of each drop on a scale from 0 to
      8. Fifteen minutes after instillation of medication, subjects were challenged
      with the allergen concentration that had elicited a positive conjunctival
      allergic response at the previous visits. Subjects then scored their itching on a
      scale from 0 to 4 at 3, 5, and 10 minutes after challenge. Mean itching scores
      for all eyes were compared by treatment. Paired t tests were performed on the
      mean itching and ocular comfort scores at each time point. At the end of the
      study, subjects were asked which treatment they preferred in terms of comfort and
      efficacy. RESULTS: Forty-nine subjects completed the study. Forty eyes received
      olopatadine, 36 received nedocromil, and 22 received placebo. Olopatadine was
      clinically and statistically superior to nedocromil at reducing itching in the
      conjunctival allergen challenge model (mean unit difference: -1.60 at 3 minutes, 
      1.68 at 5 minutes, -1.19 at 10 minutes; P < 0.001). One drop of olopatadine was
      more efficacious than 29 drops of nedocromil. Olopatadine-treated eyes were rated
      as being significantly more comfortable than nedocromil-treated eyes (0.73 vs
      1.55; P = 0.034). Of the 14 subjects treated with olopatadine and nedocromil who
      stated a preference, 10 (71%) were more satisfied with olopatadine than with
      nedocromil. CONCLUSION: In the conjunctival allergen challenge model, olopatadine
      was more efficacious and comfortable than nedocromil in reducing the itching
      associated with allergic conjunctivitis.

PMID- 11192138
TI  - Treatment of hypertension in patients > or =65 years of age: experience with
      amlodipine.
AB  - BACKGROUND: Hypertension is a common finding in patients > or =65 years of age
      that contributes to cardiovascular morbidity and mortality, but many patients are
      untreated or their hypertension inadequately controlled. Recent randomized
      controlled studies have demonstrated the benefits of treating hypertension in the
      elderly. OBJECTIVE: This study was undertaken to assess the efficacy and
      tolerability of amlodipine, a long-acting calcium channel blocker, in elderly (>
      or =65 years of age) patients with mild to moderate hypertension (diastolic blood
      pressure 95 to 114 mm Hg). METHODS: This was an open-label, multicenter, 10-week,
      general-practice study involving patients >18 years of age. Patients with
      malignant or secondary hypertension or unstable angina were excluded, as were
      those who had experienced an acute myocardial infarction or stroke in the
      preceding 3 months or had been treated with an alpha-blocker in the preceding 6
      months. Patients were assigned to 1 of 4 treatment schedules: amlodipine
      monotherapy or combination therapy and amlodipine given once daily in the morning
      or in the evening. Approximately 50% of patients would receive a morning dose,
      and approximately 80% would receive amlodipine as monotherapy. The paired t test
      was used to assess the significance of differences from baseline values, with
      significance set at P < 0.05. RESULTS: A total of 5135 patients received
      amlodipine and were included in the tolerability analysis. Of these, 3511 of 3628
      patients (96.8%) <65 years and 1471 of 1507 patients (97.6%) > or =65 years
      (including 336 of 349 [96.3%] > or =75 years) were included in the efficacy
      analysis. Significant reductions (P < 0.05) in blood pressure were noted in all
      groups after 4 and 8 weeks of treatment. The equivalence of efficacy in all age
      groups was seen in terms of reduction in blood pressure (reduction of 21/15 mm Hg
      in patients <65 years of age, 25/16 mm Hg in those > or =65 years of age, and
      26/17 mm Hg in those > or =75 years of age) compared with baseline. Therapy was
      successful in 2878 patients (82.0%) <65 years of age, in 1238 patients (84.2%) >
      or =65 years of age, and in 284 patients (84.5%) > or =75 years of age. The
      incidence of adverse events was similar in all age groups (18.0%, <65 years;
      22.3%, > or =65 years; and 24.1%, > or =75 years), with no statistically
      significant differences between groups. Tolerability was rated as good or
      excellent in all patients, with no significant differences between groups.
      CONCLUSIONS: Once-daily amlodipine was effective in the treatment of mild to
      moderate hypertension in this patient population and demonstrated a low frequency
      of adverse events, a high degree of tolerability, and improved well-being.
      Morning rather than evening dosing appeared to confer a slight advantage.

PMID- 11192140
TI  - Effect of citalopram on plasma levels of oral theophylline.
AB  - BACKGROUND: Citalopram and theophylline may be prescribed together to treat
      patients with depression and asthmatic disease. Because theophylline has a low
      therapeutic index, small changes in plasma levels may result in therapeutic
      failure or adverse effects. Both citalopram and theophylline are metabolized by
      cytochrome P450 (CYP) isozymes. Theophylline is metabolized by CYP1A2; however,
      the extent to which citalopram interacts with this isozyme in vivo is not known.
      OBJECTIVE: This study was conducted to investigate whether citalopram alters
      plasma levels of oral theophylline. METHODS: In an open-label, multiple-dose
      study, healthy nonsmoking volunteers 18 to 45 years of age were administered a
      single oral dose of theophylline (300 mg) on day 1. Beginning on day 3,
      citalopram 40 mg was administered daily through day 24 to achieve steady-state
      plasma levels. On day 23 a single oral dose of theophylline 300 mg was
      coadministered with citalopram 40 mg. Fasting plasma levels of theophylline were
      measured on day 1 (in the absence of citalopram) and on day 23 (in the presence
      of steady-state plasma concentrations of citalopram) periodically for 36 hours.
      RESULTS: Thirteen subjects (8 men and 5 women) participated; all completed the
      study. One subject was not included in the pharmacokinetic calculations.
      Citalopram treatment had no effect on the pharmacokinetic characteristics of
      theophylline. CONCLUSIONS: Citalopram dosing to steady state did not inhibit or
      induce the metabolism of theophylline in this population of healthy volunteers.
      Dose adjustment of theophylline thus may not be necessary in patients receiving
      concurrent therapy with citalopram.

PMID- 11192139
TI  - Regional lung deposition of a technetium 99m-labeled formulation of mometasone
      furoate administered by hydrofluoroalkane 227 metered-dose inhaler.
AB  - BACKGROUND: A new inhaled suspension formulation of mometasone furoate (MF), a
      potent corticosteroid with minimal systemic availability, has been developed for
      the treatment of asthma. This formulation is delivered by metered-dose inhaler
      (MDI) using the nonchlorofluorocarbon propellant hydrofluoroalkane 227 (HFA-227).
      OBJECTIVE: The primary goal of this study was to determine the respiratory tract
      deposition of this formulation of MF. A secondary objective was to measure plasma
      concentrations of MF and a putative metabolite, 6-X-OH MF, to determine the
      systemic exposure to corticosteroid. METHODS: This was a single-dose, open-label
      study in which 200 microg of technetium 99m (99mTc)-radiolabeled MF was
      administered to patients with asthma. Gamma scintigraphy was used to quantify
      lung, oropharyngeal, stomach, and MDI mouthpiece deposition patterns of MF.
      RESULTS: Eleven patients, aged 21 to 47 years, with a history of asthma were
      enrolled in and completed the study. The mean (+/- SD) whole lung deposition of
      MF was 13.9%+/-5.7% of the metered (ex-valve) dose. The central lung zone
      received 5.3%+/-2.8% of the dose; the intermediate zone received 4.7%+/-1.9%; and
      peripheral lung deposition was 4.0%+/-1.5%. The mean (+/- SD) ratio of peripheral
      to central lung deposition was 0.8+/-0.2. Oropharyngeal deposition was 79.1%+/
      8.7% of the ex-valve dose, with 6.3%+/-7.8% deposited on the MDI mouthpiece and
      0.7%+/-0.5% exhaled. The majority of plasma samples taken for analysis of MF and
      6-13-OH MF concentrations were below the limit of quantification (50 pg/mL) in
      all patients after inhalation of 200 microg 99mTc-labeled ME CONCLUSION: The lung
      deposition of MF when administered via HFA-227 MDI is comparable to the 10 to 20%
      lung deposition seen with other corticosteroid suspension for- mulations
      administered by MDI that have demonstrated effectiveness in the treatment of
      asthma.

PMID- 11192141
TI  - Meta-analysis of the effect of latanoprost and brimonidine on intraocular
      pressure in the treatment of glaucoma.
AB  - OBJECTIVE: The purpose of this study was to indirectly quantify and compare the
      intraocular pressure (IOP)-lowering effects of latanoprost and brimonidine eye
      drops at baseline and after 3 and 6 months in the treatment of primary open-angle
      glaucoma. METHODS: This meta-analysis combined data from all randomized
      controlled trials comparing the effects on IOP of latanoprost and brimonidine
      treatment in adults with a baseline IOP > or =20 mm Hg. MEDLINE and EMBASE were
      searched for reports of the ophthalmic administration of either drug versus the
      other, placebo, or active therapy. Included studies reported IOP as either means
      or differences (with SD or SE) and sample sizes. A random-effects model was used
      to pool data within each drug group. As a proxy for success rates, area under the
      curve (AUC) was calculated for the proportion of patients having an IOP <20 mm
      Hg. RESULTS: One hundred fifty-five articles reporting on 158 trials were
      identified; 147 papers were rejected (141 were not randomized controlled trials,
      5 were duplicates, and 1 had nonextractable data), leaving 9 trials from 8
      articles. A total of 2152 patients were included in the meta-analysis: 597
      received latanoprost, 571 received brimonidine, and the remainder received
      timolol or betaxolol. Baseline IOPs were similar in patients randomized to
      latanoprost or brimonidine (25.3 and 24.6 mm Hg, respectively). At 3 months,
      latanoprost and brimonidine reduced IOP by 8.4 and 6.5 mm Hg, respectively (P =
      0.004 latanoprost vs brimonidine), and at 6 months by 8.0 and 6.2 mm Hg,
      respectively (P = 0.045). AUC was 0.834 and 0.675 at 3 months for latanoprost and
      brimonidine, respectively, and 0.817 and 0.715 at 6 months, respectively (both, P
      < 0.001). CONCLUSIONS: This indirect comparison of data from the available
      randomized clinical trials showed latanoprost to be statistically superior to
      brimonidine in reducing IOP in adults with primary open-angle glaucoma.
      Additional long-term, head-to-head comparisons of the efficacy, safety, and cost
      of latanoprost and brimonidine are needed to support and supplement these
      findings.

PMID- 11192142
TI  - Duration of effect of botulinum toxin type A in adult patients with cervical
      dystonia: a retrospective chart review.
AB  - BACKGROUND: Clinical trials have established the efficacy and safety of botulinum
      toxin type A (BTX-A) in patients with cervical dystonia. To maintain the clinical
      benefits of BTX-A, injections need to be repeated whenever patients' symptoms
      begin to recur. OBJECTIVE: The purpose of this study was to determine, in
      clinical practice settings, the mean duration of effect of BTX-A in the treatment
      of adult patients with cervical dystonia. METHODS: A retrospective chart review
      was undertaken at an academic center and a private neurology practice. At each
      site, > or =50 patients being treated for cervical dystonia were identified and
      randomized for chart review. Patients had to have received the first assessable
      injection of BTX-A between January 1, 1998, and March 31, 1998, to coincide with
      the clinical availability of the most current formulation of the neurotoxin. A
      chart was eligible for review if the patient was aged > or =18 years, had a
      documented diagnosis of idiopathic cervical dystonia, was being treated with BTX
      A, and had been under the continuous care of investigators from January 1, 1998,
      to August 31, 1999. Of the 102 patients initially identified, the first 30 from
      each site who met the study inclusion criteria were assessed for (1) age and sex;
      (2) severity of dystonia; (3) years of BTX-A use; (4) dates of first, second,
      third, and fourth BTX-A injections; (5) drug dose; (6) use of electromyography;
      (7) use of other prescribed therapies; (8) laboratory tests; and (9) adverse
      events. The mean interval between each visit and mean per-patient duration of
      effect were calculated and stratified by patient characteristics. RESULTS: The
      mean age of the patients was 56.4 years. Two thirds of the patients were women.
      Forty-one of the 60 patients (68.3%) had either moderate or severe disease, and
      48 (80.0%) had experienced cervical dystonia for >5 years. The mean per-patient
      duration of effect across the 4 visits was 15.5 weeks (range, 12.2-24.3 weeks).
      The duration of effect did not differ significantly between study sites despite
      the differences in disease severity, drug dose, and use of adjunctive therapy.
      CONCLUSION: BTX-A the controls symptoms of cervical dystonia for 12 to 24 weeks,
      with a mean duration of effect per patient of 15.5 weeks.

PMID- 11192143
TI  - Pharmacokinetic comparison of oral solution and tablet formulations of
      citalopram: a single-dose, randomized, crossover study.
AB  - BACKGROUND: Citalopram tablets fulfill most dosing needs in the treatment of
      depression, but some patients may have difficulty swallowing tablets and thus may
      be less likely to comply with their medication regimen. A liquid formulation of
      citalopram could be beneficial for such patients. OBJECTIVE: This study was
      undertaken to compare the pharmacokinetic profiles of oral solution and tablet
      formulations of citalopram in healthy volunteers. METHODS: In this open-label,
      single-dose, randomized, crossover, bioequivalence study, healthy volunteers
      alternately received one 60-mg dose of citalopram as an oral solution (10 mg/5
      mL) and one 60-mg dose as a tablet. Doses were separated by a 14-day interval.
      RESULTS: Of 24 subjects enrolled (mean age 27 years), 24 (16 men and 8 women)
      received the citalopram oral solution and 23 (15 men and 8 women) received the
      tablet; 1 subject discontinued before receiving the tablet. Citalopram was
      rapidly absorbed, with peak plasma concentrations occurring at approximately 4
      hours with both formulations. The rate and extent of absorption were similar
      between the 2 formulations, and no statistically significant differences were
      observed in half-life or oral clearance between formulations. Similarly, the
      pharmacokinetic profile for demethylcitalopram (the major metabolite of
      citalopram) did not differ between the 2 formulations. Both formulations were
      well tolerated, with no serious adverse events reported. CONCLUSION: The oral
      solution and tablet formulations of citalopram 60 mg were determined to be
      bioequivalent in this population.

PMID- 11192144
TI  - One-year tolerability and efficacy of sumatriptan nasal spray in adolescents with
      migraine: results of a multicenter, open-label study.
AB  - OBJECTIVE: The objective of this study was to determine the 1-year tolerability
      and efficacy of sumatriptan nasal spray (NS) at doses of 5, 10, and 20 mg for the
      treatment of acute migraine in adolescents. METHODS: This was a prospective,
      multicenter, open-label, 1-year, multiple-attack study. Adolescents (aged 12-17
      years) with a > or =6-month history of migraine with or without aura, 2 to 8
      moderate or severe migraines per month, and a typical migraine duration of > or
      =4 hours were eligible for participation. After initial treatment with
      sumatriptan 10 mg, the dose could be adjusted down to 5 mg or up to 20 mg at the
      investigator's discretion to optimize tolerability or efficacy. Patients could
      treat an unlimited number of moderate or severe migraine attacks, provided there
      was a 24-hour headache-free period between treated attacks and a 2-hour period
      between doses of sumatriptan NS. A second dose of sumatriptan NS was available
      for headache recurrence 2 to 24 hours after initial treatment; no more than 2
      doses could be used within a 24-hour period. Adverse events, vital signs,
      electrocardiographic and physical findings, and laboratory variables were
      assessed. Headache response (reduction of moderate/severe predose pain to mild/no
      pain) and pain-free response (reduction of moderate/severe predose pain to no
      pain) were reported by patients 2 hours after dosing. RESULTS: A total of 437
      patients treated > or =1 migraine; 3272 total attacks were treated, with 3675
      drug exposures (mean, 1.1 dose/attack). Patients had a mean age of 14.1 years,
      91% were white, and 53% were female. Seven patients used the 5-mg dose;
      meaningful conclusions concerning this dose could not be made. Drug-related
      adverse events were reported in 33% of attacks with the 10-mg dose and 31% with
      the 20-mg dose; most were related to taste disturbance. Adverse events did not
      increase with a second dose or over time. Four percent (16/437) of patients
      withdrew due to drug-related adverse events. One serious adverse event, a facial
      nerve ischemic event (10-mg dose), was considered drug related. No drug-related
      changes in vital signs or electrocardiographic findings were observed. Headache
      response 2 hours after dosing was reported by 76% of patients taking the 10-mg
      dose and 72% of those taking the 20-mg dose. Pain-free response 2 hours after
      dosing was reported by 43% and 40% of patients in the 10- and 20-mg groups,
      respectively. CONCLUSIONS: Based on these results, sumatriptan NS at doses of 10
      and 20 mg was well tolerated and effective in the 1-year treatment of multiple
      migraine attacks in adolescents.

PMID- 11192145
TI  - Use of the term elderly in the scientific literature.

PMID- 11192146
TI  - Rivastigmine for Alzheimer's disease: Canadian interpretation of intermediate
      outcome measures and cost implications.
AB  - BACKGROUND: Clinical studies have shown that patients with Alzheimer's disease
      (AD) who are treated with rivastigmine have statistically significantly better
      scores on 5 scales used to assess AD than control patients receiving placebo.
      However, the clinical meaning and cost implications of these differences are not
      clear. OBJECTIVE: The purpose of this study was to assess the clinical meaning
      and cost implications of statistically significant results obtained in clinical
      trials of rivastigmine for the treatment of AD. Potential cost implications for
      the health care system, caregivers, and society are considered. METHODS: Data on
      clinical effects of rivastigmine were obtained from published North American and
      European clinical studies of patients with mild to moderately severe AD receiving
      rivastigmine 6 to 12 mg/d (n = 828) or placebo (n = 647). Differences in scores
      on the Alzheimer's Disease Assessment Scale-Cognitive Function, Clinician's
      Interview-Based Impression of Change with both clinical and caregiver information
      considered, Progressive Deterioration Scale, Mini-Mental State Examination
      (MMSE), and Global Deterioration Scale were assessed. A convenience panel of 9
      Canadian specialists experienced in the treatment of AD provided their opinions
      on the clinical importance of the trial results. Chart review was performed to
      identify specific behaviors that improved, and cost implications of improvements
      were assessed. RESULTS: The panel determined that statistically significant
      differences in scores on all scales except the MMSE were likely associated with
      functional or cognitive differences that were clinically relevant for patients,
      reflecting stabilization that would have beneficial consequences for caregivers
      and health care resource use. Subsequent chart review showed that improvement on
      specific scale items confirmed the physician panel's opinion. Analysis of
      possible cost implications to society indicated that medication expenditures
      would be offset largely by delays in the need for paid home care and
      institutionalization, positive effects on caregiver health, and less time lost
      from work for the caregiver. CONCLUSIONS: From the perspective of a Canadian
      specialist panel, rivastigmine treatment for AD produces clinically relevant
      effects for patients that are beneficial to caregivers. These effects suggest
      decreased use of caregiver resources and delays in the need for
      institutionalization, both of which reduce societal costs.

PMID- 11192147
TI  - Cost-efficacy comparison of inhaled fluticasone propionate and budesonide in the
      treatment of asthma.
AB  - BACKGROUND: The results of a recent meta-analysis comparing 2 inhaled
      corticosteroids, fluticasone propionate (FP) and budesonide, demonstrated that FP
      had an improved efficacy-to-safety ratio compared with budesonide. However,
      limited data are available on the relative economic benefits of these 2 regimens.
      OBJECTIVE: This pharmacoeconomic analysis used individual patient data from
      studies in the meta-analysis to compare the relative cost-efficacy of 2 asthma
      regimens from the perspective of a US third-party payer. METHODS: This analysis
      included all 7 studies in the meta-analysis that compared budesonide with FP
      dosed at approximately half the dose of budesonide and that included measurement
      of daily morning peak expiratory flow (PEF). RESULTS: The total daily per-person
      cost of asthma management was higher for patients treated with budesonide than
      with FP ($3.00 vs $2.25, respectively). Treatment with FP had greater cost
      efficacy than treatment with budesonide, based on a range of outcome measures
      that included improvement in morning PEF, symptom-free days, and episode-free
      days. The daily cost per effectively treated patient (an increase in PEF of > or
      = 10%) was $5.62 with FP and $10.05 with budesonide. The cost per symptom-free
      day was $4.36 with FP, compared with $6.67 with budesonide. The cost per episode
      free day was $5.60 with FP and $9.42 with budesonide. The pharmacoeconomic
      difference continued to favor FP as the criteria for success were made more
      stringent and the cost of budesonide was lowered. CONCLUSION: Based on data from
      the 7 randomized, controlled trials, treatment of asthma with FP was more
      effective and less expensive, using US health care assumptions and costs, than
      treatment with budesonide.

PMID- 11192148
TI  - Trends in the rate of depressive illness and use of antidepressant
      pharmacotherapy by ethnicity/race: an assessment of office-based visits in the
      United States, 1992-1997.
AB  - OBJECTIVE: This study was undertaken to determine ethnicity/race-specific (white,
      black, and Hispanic) population-adjusted rates of US office-based physician
      visits in which a diagnosis of a depressive disorder was recorded or in which a
      diagnosis of a depressive disorder was recorded and antidepressant
      pharmacotherapy was prescribed. METHODS: Data from the National Ambulatory
      Medical Care Survey for 1992 through 1997 were partitioned into three 2-year
      periods: 1992-1993, 1994-1995, and 1996-1997. For each 2-year period, data from
      office-based physician visits for patients aged 20 to 79 years were extracted to
      assess, by ethnicity/race, (1) the number of visits in which a diagnosis of a
      depressive illness was recorded (International Classification of Diseases, Ninth
      Revision, Clinical Modification codes 296.2-296.36, 300.4, or 311) and (2) the
      number of visits in which a diagnosis of a depressive illness was recorded and
      antidepressant pharmacotherapy was prescribed. We calculated ethnicity/race
      specific rates (per 100 US population aged 20 to 79 years) of office-based visits
      in which a diagnosis of a depressive disorder was recorded and in which a
      diagnosis of a depressive disorder was recorded and antidepressant
      pharmacotherapy was prescribed. The specialty of the reporting physician and the
      proportion of patients receiving a selective serotonin reuptake inhibitor (SSRI)
      were also discerned. RESULTS: From 1992-1993 to 1996-1997, the rate of office
      based visits (per 100 US population aged 20 to 79 years) in which a diagnosis of
      a depressive disorder was recorded increased 3.7% for whites (from 10.9 to 11.3;
      P = 0.001), 31.0% for blacks (from 4.2 to 5.5; P = 0.001), and 72.9% for
      Hispanics (from 4.8 to 8.3; P = 0.001). The rate of office-based visits in which
      a diagnosis of a depressive disorder was recorded and antidepressant
      pharmacotherapy was prescribed increased 18.5% for whites (from 6.5 to 7.7 per
      100; P = 0.001), 38.5% for blacks (from 2.6 to 3.6 per 100; P = 0.001). and
      106.7% for Hispanics (from 3.0 to 6.2 per 100; P = 0.001). Between 1992-1993 and
      1996-1997, use of an SSRI increased among whites and blacks (from 50.0% to 65.8%
      and from 40.5% to 58.2%, respectively), but declined among Hispanics (from 51.4%
      to 48.6%; all comparisons P = 0.001). CONCLUSION: By 1996-1997, the population
      adjusted rates for Hispanics were within a quartile of those observed for whites,
      whereas the rates for blacks remained at less than half those observed in whites.
      The observed divergence in population-adjusted rates by ethnicity/race may
      reflect the nature of the patient-physician relationship, sensitivity and
      specificity of diagnostic techniques and instruments, and the wider social
      context in which an office-based visit occurs, including access to and type of
      health insurance and coverage for mental health services.

PMID- 11192149
TI  - Treatment strategies for gastroesophageal reflux disease.

PMID- 11192150
TI  - Stacking in capillary zone electrophoresis.
AB  - Due to the short light path of the capillaries, the CE detection limit based on
      concentration, is far less than that of HPLC and not sufficient for many
      practical applications. Several methods, based on different electrophoretic
      maneuvers, can concentrate the sample (stack) easily on the capillary before the
      separation step of capillary zone electrophoresis (CZE). These methods
      incorporate different types of discontinuous buffers as the means for invoking
      different velocities to the same analyte molecules to produce a sharpening of the
      band (stacking). In CZE, these buffers can be often very simple such as sample
      dilution or adding to the sample a high concentration of a fast mobility ion.
      However, in other applications these buffers can be as complicated as those
      required for isotachophoresis. Stacking can often yield a concentration factor of
      5-30-fold, which can improve greatly in CZE the detection limits bringing them
      very close to those of HPLC. Different methods of stacking, the importance of
      discontinuous buffers and the different mechanism for concentration on the
      capillary are reviewed here. As there is a need for more practical applications,
      there will be more methods devised for stacking in CZE.

PMID- 11192151
TI  - Sample stacking of cationic and anionic analytes in capillary electrophoresis.
AB  - The behavior of charged species along concentration boundaries in capillary zone
      electrophoresis (CZE) that was first described in detail by Everaerts et al. in
      1979 assured the possibility of concentrating charged solutes inside the
      capillary. The concentration effect is based on the sudden change in analyte
      electrophoretic velocity brought about by the difference in the magnitude of the
      electric field. Furthermore, this on-line method could be the needed solution to
      the problem of low concentration sensitivity in CZE. Sample stacking, which is
      now its well known name, has then found valuable use in applying CZE in many
      fields, especially after the in-depth studies performed in the early 90s by Chien
      and Burgi. This article reviews the theory and methodological developments of
      sample stacking developed for charged analytes in CZE and also in electrokinetic
      chromatography. A table conveying the reported applications especially in the
      biomedical and environmental fields is given. On top of this, other on-line
      concentration methods for charged species, namely, sample self-stacking,
      acetonitrile stacking, sweeping, cation selective exhaustive injection-sweeping,
      and use of a pH junction, are briefly discussed.

PMID- 11192153
TI  - Solid-phase microextraction in biomedical analysis.
AB  - Chromatographic methods are preferred in the analysis of organic molecules with
      lower molecular mass (<500 g/mol) in body fluids, i.e., the assay of drugs,
      metabolites, endogenous substances and poisons as well as of environmental
      exposure by gas chromatography (GC) and liquid chromatography (LC), for example.
      Sample preparation in biomedical analysis is mainly performed by liquid-liquid
      extraction and solid-phase extraction. However, new methods are investigated with
      the aim to increase the sample throughput and to improve the quality of
      analytical methods. Solid-phase microextraction (SPME) was introduced about a
      decade ago and it was mainly applied to environmental and food analysis. All
      steps of sample preparation, i.e., extraction, concentration, derivatization and
      transfer to the chromatograph, are integrated in one step and in one device. This
      is accomplished by the intelligent combination of an immobilized extraction
      solvent (a polymer) with a special geometry (a fiber within a syringe). It was a
      challenge to test this novel principle in biomedical analysis. Thus, an
      introduction is provided to the theory of SPME in the present paper. A critical
      review of the first applications to biomedical analyses is presented in the main
      paragraph. The optimization of SPME as well as advantages and disadvantages are
      discussed. It is concluded that, because of some unique characteristics, SPME can
      be introduced with benefit into several areas of biomedical analysis. In
      particular, the application of headspace SPME-GC-MS in forensic toxicology and
      environmental medicine appears to be promising. However, it seems that SPME will
      not become a universal method. Thus, on-line SPE-LC coupling with column
      switching technique may be a good alternative if an analytical problem cannot be
      sufficiently dealt with by SPME.

PMID- 11192152
TI  - Solid-phase trapping of solutes for further chromatographic or electrophoretic
      analysis.
AB  - Because of its simplicity, speed and effectiveness, solid-phase extraction (SPE)
      has become the preferred technique for concentration of selected analytes prior
      to chromatographic or electrophoretic analysis. In this review the historical
      development of SPE is briefly traced. Then the principles of SPE are reviewed in
      some detail. Numerous references are given on the format, sorbents, elution
      conditions, online techniques and automation with special emphasis on relatively
      recent developments. The principles and recent advances in solid-phase
      microextraction (SPME) are also reviewed. The final section on selected recent
      applications includes an extensive list of references to work published within
      the last three years. Future trends and developments are discussed briefly.

PMID- 11192154
TI  - Microextraction of drugs.
AB  - This review will attempt to provide an overview as well as a theoretical and
      practical understanding of the use of microextraction technologies for drug
      analysis. The majority of the published reports to date focus on the use of fibre
      solid-phase microextraction and so the review is significantly focused on this
      technology. Other areas of microextraction such as single drop and solvent film
      microextraction are also described. Where there are insufficient examples in the
      literature to illustrate important concepts, examples of non-drug analyses are
      presented. The review is intended for readers new to the field of microextraction
      or its use in drug extraction, but also provides an overview of the most recent
      advances in the field which may be of interest to more experienced users.
      Particular emphasis is placed on the effect various sample matrices have on
      extraction characteristics.

PMID- 11192155
TI  - Analytical applications of membrane extraction in chromatography and
      electrophoresis.
AB  - An overview of the analytical applications of membrane-based systems for sample
      enrichment in chromatography and capillary electrophoresis is presented. A brief
      introduction to the different types of membranes and the main forces related to
      the transport through them is also given.

PMID- 11192156
TI  - Membrane-based techniques for sample enrichment.
AB  - Sample preparation techniques based on non-porous membrane extraction generally
      offer a high degree of selectivity and enrichment power, together with convenient
      possibilities for direct and automated connections to chromatographic and other
      analytical instruments. In this review principles and applications for techniques
      as supported liquid membrane extraction, microporous membrane liquid-liquid
      extraction, polymeric membrane extraction and membrane extraction with a sorbent
      interface are described and compared.

PMID- 11192157
TI  - Analytical-scale microwave-assisted extraction.
AB  - Microwave-assisted extraction (MAE) is a process of using microwave energy to
      heat solvents in contact with a sample in order to partition analytes from the
      sample matrix into the solvent. The ability to rapidly heat the sample solvent
      mixture is inherent to MAE and the main advantage of this technique. By using
      closed vessels the extraction can be performed at elevated temperatures
      accelerating the mass transfer of target compounds from the sample matrix. A
      typical extraction procedure takes 15-30 min and uses small solvent volumes in
      the range of 10-30 ml. These volumes are about 10 times smaller than volumes used
      by conventional extraction techniques. In addition, sample throughput is
      increased as several samples can be extracted simultaneously. In most cases
      recoveries of analytes and reproducibility are improved compared to conventional
      techniques, as shown in several applications. This review gives a brief
      theoretical background of microwave heating and the basic principles of using
      microwave energy for extraction. It also attempts to summarize all studies
      performed on closed-vessel MAE until now. The influences of parameters such as
      solvent choice, solvent volume, temperature, time and matrix characteristics
      (including water content) are discussed.

PMID- 11192158
TI  - Surfactant cloud point extraction and preconcentration of organic compounds prior
      to chromatography and capillary electrophoresis.
AB  - The use of preconcentration steps based on phase separation by the cloud point
      technique offers a convenient alternative to more conventional extraction
      systems. It has been used successfully for the preconcentration of species of
      widely differing character and nature, such as metal ions, proteins and other
      biomaterials, or organic compounds of strongly differing polarity. Here we
      address the most recent analytical applications of this methodology when used as
      an isolation and trace enrichment step prior to the analysis of organic compounds
      (polycyclic aromatic hydrocarbons, polychlorinated compounds, pesticides,
      phenolic derivatives, aromatic amines, vitamins, etc.) via liquid and gas
      chromatography or capillary electrophoresis.

PMID- 11192159
TI  - Headspace solid-phase microextraction procedures for gas chromatographic analysis
      of biological fluids and materials.
AB  - Solid-phase microextraction (SPME) is a new solventless sample preparation
      technique that is finding wide usage. This review provides updated information on
      headspace SPME with gas chromatographic separation for the extraction and
      measurement of volatile and semivolatile analytes in biological fluids and
      materials. Firstly the background to the technique is given in terms of
      apparatus, fibres used, extraction conditions and derivatisation procedures. Then
      the different matrices, urine, blood, faeces, breast milk, hair, breath and
      saliva are considered separately. For each, methods appropriate for the analysis
      of drugs and metabolites, solvents and chemicals, anaesthetics, pesticides,
      organometallics and endogenous compounds are reviewed and the main experimental
      conditions outlined with specific examples. Then finally, the future potential of
      SPME for the analysis of biological samples in terms of the development of new
      devices and fibre chemistries and its coupling with high-performance liquid
      chromatography is discussed.

PMID- 11192160
TI  - Preconcentration of contaminants in water analysis.
AB  - Among the environmental areas, in this review attention will be focused on water
      matrices and both on organic (e.g., pesticides, herbicides, phenols, polycyclic
      aromatic hydrocarbons), inorganic species and anion pollutants, since these kinds
      of substances include a wide number of compounds with different physical and
      chemical properties and different effects on human health. Analytical methods for
      control of quality of waters are required to be highly specific and possibly
      highly sensitive for the determination of even low amounts of pollutants. The
      main problems encountered during the analysis are the separation of matrix
      components from the pollutants of interest and the achievement of low detection
      limits. Therefore an overview on different materials and techniques available for
      sample concentration and/or matrix removal will be provided and discussed
      according to the chemical characteristics of the pollutant that has to be
      enriched.

PMID- 11192161
TI  - Chemically modified polymeric sorbents for sample preconcentration.
AB  - Solid-phase extraction is an attractive alternative in sample preparation because
      it overcomes many drawbacks of liquid-liquid extraction and makes on-line
      determination possible by hyphenation with chromatographic techniques. Driven by
      the need for more effective and more selective sorbents, advances in solid-phase
      extraction include the development of new materials. This paper describes
      different types of chemically modified sorbents for the solid-phase extraction of
      compounds from aqueous samples. Chemical introduction of different functional
      groups into a polymeric resin improves the efficiency of solid-phase extraction
      by providing better surface contact with the aqueous samples; also, these
      sorbents have a greater capacity than the typical solid-phase materials for polar
      compounds have. The most important new sorbents are the chemically modified
      resins based on styrene-divinylbenzene copolymers. Preparation of these new
      sorbents is described, and advantages and drawbacks of off-line procedures and on
      line procedures are also discussed. Applications for off-line and on-line
      chromatographic determinations of polar compounds are presented.

PMID- 11192162
TI  - Solid-phase extraction coupling to capillary electrophoresis with emphasis on
      environmental analysis.
AB  - This article reviews the status of solid-phase extraction (SPE) coupled with
      capillary electrophoresis (CE). It focuses on some of the organic pollutants
      which have captured the interest of analytical chemists--phenols, surfactants,
      dyes, polynuclear aromatic hydrocarbons (PAHs), aromatic and aliphatic amines,
      aromatic acids and aromatic sulfonic acids--and, in particular, on monitoring
      pesticides from different sources. It shows that the coupling of SPE to CE has
      considerable potential in the analysis of environmental pollutants.

PMID- 11192163
TI  - Liquid-liquid extraction procedures for sample enrichment in capillary zone
      electrophoresis.
AB  - This review article presents an overview of applications of liquid-liquid
      extraction (LLE) for analyte enrichment and clean-up of samples prior to
      capillary zone electrophoresis (CZE). The basic principles of LLE are discussed
      with special emphasis on analyte enrichment. In addition, attention is focused on
      the requirements for the final extract to be compatible with CZE. The paper
      discusses selected examples from the literature with special emphasis on
      detection limits in drug analysis and in environmental chemistry. Finally, the
      paper focus on alternative liquid-phase extraction concepts based on
      electroextraction, supported liquid membranes, and liquid-phase microextraction.

PMID- 11192164
TI  - Effect of temperature and flow-rate on analysis of basic compounds in high
      performance liquid chromatography using a reversed-phase column.
AB  - The peak shape and retention of some basic probes together with a neutral
      reference compound were investigated as a function of temperature and flow-rate
      using a reversed-phase HPLC column at both pH 3.0 and pH 7.0. The retention of
      bases often showed an anomalous increase with temperature; retention mechanisms
      are complex as shown by studies of the effect of buffer cation concentration on
      retention. Considerable improvements in column efficiency for bases may result
      from operation at elevated temperature. Improvements did not seem attributable
      either to incidental changes in the retention factor, or (in this particular
      study where low sample masses were utilised) to the influence of sample load. The
      optimum flow-rate for highest efficiency is generally lower for basic compounds
      than neutrals, and due to the steepness of the Van Deemter curves obtained, high
      flow-rates appear to be particularly detrimental in the chromatography of basic
      compounds.

PMID- 11192165
TI  - Test to evaluate countercurrent chromatographs. Liquid stationary phase retention
      and chromatographic resolution.
AB  - Countercurrent chromatography (CCC) is a liquid chromatography (LC) technique
      with a special column able to retain a liquid stationary phase while the liquid
      mobile phase is pumped through. The coil planet centrifuge machines are made of
      open tube wound on spools. A simple test is proposed. The methanol-water (90:10,
      v/v)-heptane biphasic system is used with heptane as the mobile phase in the
      ascending or tail-to-head mode. The methanol-water stationary phase retention
      volume is measured at different flow-rates and rotor rotation speeds. After every
      machine equilibration, an alkylbenzene mixture is injected and the retention
      factors, peak efficiencies and resolution factors are measured or calculated for
      each solute. The wealth of information contained in the data set obtained is
      demonstrated. Four coil planet centrifuge machines of very different
      characteristics and one hydrostatic CCC machine with channels and ducts were
      submitted to the test. It was shown that the Sf, stationary retention factor,
      obtained with these machines was linearly dependent on the square root of F, the
      mobile phase flow-rate [Q. Du, C. Wu, G. Qian, P. Wu, Y. Ito, J. Chromatogr. A
      835 (1999) 231-235]. It is shown that the slopes of the Sf versus F(1/2) lines
      could be related to a minimum rotor rotation, omega(mini), necessary to obtain
      the hydrodynamic equilibrium. The Sf and F parameters give the mobile phase
      linear velocity, u. It is shown that u is proportional to the square root of
      omega, the rotor rotation speed. The slope and intercept of the latter
      relationship also result in an omega(mini) value coherent with the first one.
      With the peak efficiencies and chromatographic resolution factors obtained for
      toluene and hexylbenzene, the parameters: number of plates per tubing turn,
      machine volume for one plate, and tubing length for one plate, were calculated
      and compared for the five machines. The internal diameter of the tubing used is
      shown to be a critical parameter acting on the machine volume and number of
      tubing turns.

PMID- 11192166
TI  - Ion chromatography detector based on solid-state ion-selective electrode array.
AB  - A variety of neutral carrier type ionophores for monovalent cations were employed
      to prepare solid-state cation-selective electrodes (SSEs) for use as a detector
      in single-column ion chromatography (IC). The polyurethane-based pseudoreference
      electrode made it possible to assemble an array type SSE detector for IC. An SSE
      based detector provides not only the overall chromatogram for the separated ion
      species (monensin methyl ester-nonactin-based membrane), but also the enhanced
      chromatogram for specified ions of interest (valinomycin as K+ and nonactin for
      NH4+). This feature makes it possible to perform highly quantitative analysis
      with low detection limits even if the separation efficiency of the ion-exchange
      is not sufficient. Since SSE-based IC detectors are easily miniaturized and
      replaceable at low cost, they are an ideal component of a portable IC system.

PMID- 11192167
TI  - Enantiomeric separation of some pharmaceutical intermediates and reversal of
      elution orders by high-performance liquid chromatography using cellulose and
      amylose tris(3,5-dimethylphenylcarbamate) derivatives as stationary phases.
AB  - Several pairs of enantiomers of pharmaceutical intermediates were separated by
      HPLC directly on cellulose and amylose tris(3,5-dimethylphenylcarbamate)
      derivatives (Chiralcel OD and Chiralpak AD) using hexane as mobile phase with 2
      propanol or ethanol as modifier. The separation and elution order of the
      enantiomers on the two columns using different alcohol modifiers were compared.
      Reversal of the elution order of some enantiomeric pairs associated with
      increased retention of many of these solutes upon changing the mobile phase
      modifier from 2-propanol to ethanol was observed. The effect of structural
      variation of two pairs of enantiomers on their k' and separation factor alpha was
      noted. Chiralcel OD and Chiralpak AD columns provided different retention,
      separation and elution order of some of the enantiomeric pairs.

PMID- 11192168
TI  - Micelle formation for improvement of continuous subcritical water extraction of
      polycyclic aromatic hydrocarbons in soil prior to high-performance liquid
      chromatography-fluorescence detection.
AB  - A new method for the extraction-individual separation-determination of polycyclic
      aromatic hydrocarbons (PAHs) in soil is reported. The method is based on the
      integration of three steps: continuous subcritical extraction, solid-phase clean
      up/preconcentration, and HPLC separation with post-column fluorimetric
      determination. Sodium dodecyl sulfate (SDS) was added to the water for favouring
      the extractability of the low-polarity analytes. Soil samples spiked with the
      target PAHs were subjected to static-dynamic extraction with SDS-water at 50 bar,
      150 degrees C, for 15 min of static extraction and 10 min dynamic extraction at a
      flow-rate of 3 ml/min. Recoveries from 73.6 to 110.4% were obtained in the
      presence of SDS versus 30 to 80% obtained with water as extractant. The
      calibration graphs provided by HPLC-fluorimetric detection were run between 0.031
      and 0.375 microg/ml for each analyte with regression coefficients between 0.917
      and 0.999 and precision, expressed as RSD, between 1.2 and 11.5%. The method was
      applied to a certified reference material [CRM 524, BCR (Community Bureau of
      Reference), industrial soil/organic] for validation and the results obtained were
      in agreement with the certified values.

PMID- 11192169
TI  - Negative atmospheric pressure chemical ionisation low-energy collision activation
      mass spectrometry for the characterisation of flavonoids in extracts of fresh
      herbs.
AB  - The flavonoid composition of commonly eaten fresh herbs such as dill, oregano and
      parsley was analysed by combined LC, MS and low-energy collision induced
      dissociation (CID) MS-MS. Negative atmospheric pressure chemical ionisation
      (APCI) MS and MS-MS were used to provide molecular mass information and product
      ion spectra of the glycosyl compounds. The most prominent fragment was found to
      arise from the aglycone ion, which provides molecular mass information about the
      glycosyl substituent and the aglycone. Product-ion spectra of the aglycone
      verified the identity by comparison with product-ion spectra of authentic
      standards. Methoxylated flavonoids provide characteristic fragmentation, i.e.,
      loss of *CH3, which add to the usefulness of the method for identifying unknown
      flavonoids. Negative-mode APCI-MS is thus demonstrated to be a good alternative
      to the commonly employed positive mode operation.

PMID- 11192170
TI  - Separation ability and stoichiometry of cyclodextrin complexes.
AB  - Gas-liquid chromatography has been applied to search relations between
      selectivity towards isomers and stoichiometry of cyclodextrin complexes. The
      model tested compounds were: dimethylnaphthalenes and alpha- and beta-pinenes as
      constitutional isomers; cis/trans decalins, anetholes and isosafroles as
      diastereomers and as enantiomers (+/-)-alpha-pinenes and (+/-)-camphenes.
      Experimental retention data are used to confirm a simple theoretical model that
      allows distinguishing formation of G x CD complexes (1:1) and G x CD2 complexes
      (1:2). Based on the experimental data, stability constants K were evaluated. It
      has been found that remarkable selectivity factor alpha may appear both within
      the range of 1:1 stoichiometry (beta-CD complexes of decalins and of alpha- and
      beta-pinenes) and 1:2 stoichiometry (alpha-CD complexes with (+/-)-alpha-pinenes
      and (+/-)-camphenes). Occasionally selectivity arises from a different
      composition, when one isomer forms a 1:1 stoichiometry complex while another
      forms a 1:2 complex (dimethylnaphthalenes, cis/trans-anetholes and cis/trans
      isosafroles).

PMID- 11192171
TI  - Determination of floral fragrances of Rosa hybrida using solid-phase trapping
      solvent extraction and gas chromatography-mass spectrometry.
AB  - Floral fragrances emanated from Rosa hybrida were determined by solid-phase
      trapping extraction and GC-MS. A novel protocol of sampling technique was
      established. There is a variation in the recoveries depending on the adsorbent
      and components. A total of 41 compounds were identified in the floral fragrances
      of Rosa hybrida. These include alcohols, aldehydes, alkanes, monoterpenes,
      sesquiterpene, esters, ether and ketones. Citral, n-nonane, n-butyl acetate, n
      decane, beta-phenylethyl acetate and hexadecanol were major components. Floral
      fragrances differ between rose species and sample to sample within a single
      species. Interestingly, endocrine disruptors such as bis(2-ethylhexyl) phthalate
      were detected simultaneously.

PMID- 11192172
TI  - Simple cryoconcentration technique for the determination of peroxyacyl and alkyl
      nitrates in the atmosphere.
AB  - A gaseous mixture of methyl nitrate, n-propyl nitrate, peroxyacetyl nitrate and
      peroxypropionyl nitrate was successfully cryoconcentrated using a gas sampling
      valve with its loop filled with glass beads placed inside the GC oven which was
      cooled at -50 degrees C. The technique offered linearity over a ten fold
      concentration variation and sample volume range of 1-280 ml. The detection limit
      for 150 ml sample varied from 0.02-10 pptv depending on the compound.

PMID- 11192173
TI  - Solvating gas chromatography with chemiluminescence detection of nitroglycerine
      and other explosives.
AB  - A separation technique known as solvating gas chromatography (SGC), which
      utilizes packed capillary columns and neat carbon dioxide as mobile phase, was
      used for the separation of nitroglycerine (NG) and other nitrogen-containing
      explosives including 2,6-dinitrotoluene (2,6-DNT), 2,4-dinitrotolulene (2,4-DNT),
      2,4,6-trinitrotoluene (2,4,6-TNT), and pentaerythritol tetranitrate (PETN). SGC
      was coupled for the first time to a selective chemiluminescence thermal energy
      analyzer (TEA) detector for nitro-functional group specificity and sensitive
      detection of these compounds. TEA calibration curve for NG showed linearity in
      the sub-microg ml(-1) range. Soil samples containing NG were used to test the
      validity of the technique. Detector response of SGC-TEA versus SGC-flame
      ionization detection for NG was also evaluated.

PMID- 11192174
TI  - Hindered amine stabilizers investigated by the use of packed capillary
      temperature programmed liquid chromatography. II: Poly-(N-beta-hydroxyethyl
      2,2,6,6-tetramethyl-4-hydroxypiperidyl succinate).
AB  - Three different trademark products of a hindered amine stabilizer with the IUPAC
      name poly-(N-beta-hydroxyethyl-2,2,6,6-tetramethyl-4-hydroxypiperidyl succinate),
      have been analyzed and compared to each other by the use of packed capillary
      temperature programmed liquid chromatography and light scattering detection. The
      analysis by this method has shown that the products contained approximately 50
      different homologues and/or other components. The method also demonstrated its
      potential in purity control of products from different manufacturers.

PMID- 11192175
TI  - Potential artifact formation of dioxins in ball clay during supercritical fluid
      extraction.
AB  - Earlier surveys indicate that meat, fish and dairy products are the principal
      source of polychlorinated dibenzo-p-dioxin (PCDD) exposure in the diet. A recent
      finding by others of PCDDs in chickens that consumed a feed containing PCDD led
      to the finding of ball clay, an anti-caking agent, as the source. Supercritical
      fluid extraction (SFE) was studied as a means to isolate PCDDs from commercial
      ball clays using GC-electron capture detection (muECD) as a means to screen for
      these contaminants. The finding of ng/g amounts and recoveries >100% in several
      samples of ball clay containing octachlorodibenzo-p-dioxin (OCDD) suggested that
      PCDD may form artifactually as a result of analysis. Studies on pentachlorophenol
      (PCP) fortified ball clay were carried out by SFE and soxhlet extraction and the
      results compared. The values obtained by SFE were considered more problematic.
      The results obtained from ball clay suggest that precautions need to be exercised
      when using SFE to analyze for dioxins in solid samples containing chlorophenols.

PMID- 11192176
TI  - Separation of amino acids by ion mobility spectrometry.
AB  - The mobilities of the 20 common amino acids were determined by electrospray
      ionization ion mobility spectrometry. It was found that each amino acid had a
      different drift time and hence a different reduced mobility constant K0. This
      difference in drift time was less than 0.1 ms in many cases. With the instrument
      used in this study it would not be possible to resolve mixtures of some of the
      amino acids. It would however be possible to determine any single amino acid. In
      addition, the detection limits were determined for the 20 amino acids. They
      ranged from 50 to 700 pg. This indicates that the detection limits were less than
      3 pmol for all of the amino acids and that many amino acids had detection limits
      less than 1 pmol.

PMID- 11192177
TI  - Short synchronization system for estrus cycles in dairy heifers: a preliminary
      report.
AB  - In previous studies we demonstrated that the administration of a luteolytic dose
      of cloprostenol to dairy cows in luteal phase, followed by hCG plus estradiol
      benzoate (EB) 12 h later, led to successful timed AI 48 h after the initiation of
      treatment. This article reports two consecutive studies. In Study 1 we determined
      the pregnancy rate of dairy heifers in luteal phase (established by palpation per
      rectum) treated with cloprostenol followed by 250 IU of hCG plus 1 mg of EB 12 h
      later, and inseminated 48 h after cloprostenol injection. Study 2 was designed to
      evaluate the efficiency this synchronization protocol, irrespective of the estrus
      stage of the animals. In Study 1, 1272 Friesian heifers aged 14 to 16 months with
      a palpable corpus luteum received 500 mcg cloprostenol. Heifers were then
      synchronized either according to the hCG plus EB protocol (hCG-EB, n=637), or by
      a second dose of cloprostenol 11 d later (PG, n=636). Animals in this last group
      served as controls and were inseminated 72 and 96 h after the second cloprostenol
      injection. The pregnancy rate was significantly higher (P<0.0001) in the hCG-EB
      group (59.5%, 379/637) than in PG (44.8%, 285/636). In Study 2, 135 contemporary
      heifers (with no corresponding information on estrus stage) were subjected to the
      same protocol as those in the hCG-EB group of Study 1. These animals were
      classified in retrospect according to estrus stage established by plasma
      progesterone concentration. Pregnancy rates were 66.7% (24/36), 51% (25/49) and
      58% (29/50) for animals in the follicular, early/late luteal, and mid-luteal
      phase, respectively. The total pregnancy rate was 57.8% (78/135). These findings
      indicate an improved pregnancy rate for heifers subjected to single insemination
      after cloprostenol/hCG/EB synchronization, compared to double insemination after
      synchronization by 2 cloprostenol injections 11 d apart. The cloprostenol/hCG/EB
      protocol did result in acceptable pregnancy rates after timed AI of dairy heifers
      regardless of their estrus cycle phase.

PMID- 11192178
TI  - Follicular and hormonal response to experimental suppression of FSH during
      follicle deviation in cattle.
AB  - A near steroid-free fraction of bovine follicular fluid was used to suppress FSH
      concentrations at the expected time of follicle deviation or when the largest
      follicle of Wave 1 reached > or = 8.0 mm (actual mean diameter, 8.4 mm; Hour 0).
      It was hypothesized that the low concentrations of FSH associated with deviation
      are inadequate for the smaller follicles but are needed for continued growth of
      the largest follicle. Control heifers (n=8) received 10 mL of saline, and treated
      heifers (n=16) received either 8.8 mL or 13.3 mL of the follicular-fluid fraction
      at Hours 0, 12, and 24. Between Hours -48 and 0, FSH concentrations decreased
      (P<0.05) and diameters of the 4 largest follicles increased (Hour effect,
      P<0.0001) similarly between groups. Concentrations of LH in the controls
      increased (P<0.05) between Hours -24 and -12 and decreased (P<0.05) between Hours
      8 and 36, demonstrating a transient LH surge encompassing the expected beginning
      of deviation. In the treated group, a comparable increase in LH occurred before
      deviation but a decrease did not occur until after Hour 48. By Hour 4.5, the FSH
      concentrations in the treated group decreased (P<0.05) to below the
      concentrations in the controls. Suppressed diameter (P<0.001) of the largest
      follicle was detected at the first post-treatment examination (Hour 12; 7.5 h
      after FSH suppression) and was accompanied by reduced (P<0.04) systemic estradiol
      concentrations. The mean growth rates of the 3 smaller follicles in both the
      treated and control groups began to decrease at Hours -12 to 24 and were not
      different between groups during Hours 0 to 36. Concentrations of FSH in the
      treated group returned to control concentrations by Hour 24 (hour of last
      treatment). A rebound (P<0.05) in concentrations of FSH to >100% above control
      concentrations occurred by Hour 48 and was accompanied by resumed growth of the
      largest follicle in 75% of the heifers between Hours 48 and 72. The results
      demonstrated that the low concentrations of FSH associated with deviation can be
      further reduced by treatment with a nonsteroidal factor of follicular origin.
      Transient reduction of FSH concentrations to below the already low control
      concentrations inhibited the largest follicle but did not further inhibit the
      smaller follicles. These results support the hypothesis that the low FSH
      concentrations associated with follicle deviation are below the minimal
      requirements of the smaller or subordinate follicles but are needed for continued
      growth of the largest or dominant follicle in cattle.

PMID- 11192179
TI  - High-density ovine endometrial cells exhibit natural killer activity during early
      pregnancy.
AB  - Natural killer (NK)-like activity was assessed for peripheral blood lymphocytes
      (PBL) and unfractionated and fractionated endometrial cells recovered from ewes
      during the estrus cycle (Days 12 to 14) and early pregnancy (Days 16 to 18). The
      PBL and endometrial cells (each designated as effector cells) were cocultured
      with chromium-51 (51Cr) labeled NK-sensitive K-562 target cells in
      effector:target cell ratios ranging from 25:1 to 200:1, respectively. Lytic
      activity (i.e., release of 51Cr into the medium) was assessed at 22 h of culture.
      A high-density (> or = 1.088 g/mL) population of endometrial cells from the
      pregnant ewes exhibited NK-like activity, whereas endometrial cells from the
      cyclic ewes failed to exhibit activity. Lytic activity of these cells was greater
      (P < 0.05) for pregnant than for cyclic ewes (12.0 and 2.1%, respectively) at the
      effector:target cell ratio of 100:1, respectively. For both groups of ewes, PBL
      exhibited NK-like activity. These data indicate that the ovine endometrium
      contains NK-like cells with lytic activity between Days 16 and 18 of pregnancy.

PMID- 11192180
TI  - Assessment of stallion spermatozoa viability by flow cytometry and light
      microscope analysis.
AB  - Viability of spermatozoa can be assessed by numerous methods, but many are slow
      and poorly repeatable, and subjectively assess only 100 to 200 spermatozoa per
      ejaculate. We collected two ejaculates from each of 4 stallions, and extended
      them to 50x10(6) sperm/mL in a nonfat dried milk solids glucose extender (EZ
      Mixin). Half the ejaculate was freeze-killed by immersing in liquid nitrogen for
      10 min. Aliquots using appropriate volumes of live and freeze-killed spermatozoa
      provided the following ratios of live:dead spermatozoa: 100:0, 75:25, 50:50,
      25:75, 0:100. We determined the viability of each aliquot by 1) motility; 2)
      eosin-nigrosin staining; and 3) dual fluorescent staining. For the latter,
      aliquots incubated with SYBR-14 and propidium iodide had live and dead
      spermatozoa quantitated by fluorescent microscope (2 x 100 sperm/sample) and flow
      cytometry (10,000 sperm/sample). We found a linear relationship between the ratio
      of live:dead spermatozoa and the percentage of spermatozoa counted as live
      (P<0.0001). For fresh spermatozoa, correlation coefficients of the known
      live:dead ratio were high for all methods (eosin-nigrosin, r>0.75; fluorescent
      microscope, r>0.76; flow cytometry, r>0.75; motility, r>0.76). To determine
      viability of cryopreserved equine spermatozoa, we froze 17 fresh ejaculates from
      6 stallions in a glycine extender. Each sample was thawed, extended 1:1 with EZ
      Mixin and evaluated as above. Cryopreserved spermatozoa assessed by flow
      cytometry tended to be less well correlated (r<0.68) with the other methods, and
      estimates were significantly higher with eosin-nigrosin staining (P<0.001). This
      study shows that different methods may equally estimate viability of fresh equine
      spermatozoa. However, evaluation by flow cytometry appears to be less precise
      with cryopreserved spermatozoa.

PMID- 11192181
TI  - Growth hormone gene polymorphisms and growth performance traits in Duroc,
      Landrace and Tao-Yuan pigs.
AB  - This study investigated the restriction fragment length polymorphism (RFLP) of
      the porcine growth hormone (pGH) gene in Duroc, Landrace, and Tao-Yuan pigs and
      its effects on growth performance and levels of plasma growth hormone in
      peripheral circulation. Genomic DNA extracted from 81 Tao-Yuan, 60 Landrace and
      48 Duroc pigs were subjected to Southern blot hybridization with a pGH cDNA
      probe. Polymorphism was detected with the restriction enzymes TaqI and DraI. A
      comparison of these three breeds showed significant differences in allelic
      frequencies. Blood samples for radioimmunoassay (RIA) of GH were collected
      biweekly during the experimental period from pigs 12 to 40 weeks of age. Tao-Yuan
      pigs showed a mean plasma GH level (2.51 +/- 1.23 ng/mL) that was much lower than
      that of the Landrace (3.80 +/- 1.52 ng/mL) and Duroc (4.20 +/- 1.03 ng/mL) pigs
      (P < 0.05). Moreover, the Tao-Yuan pigs also showed poorer growth performance
      than the Landrace and the Duroc pigs both in the daily weight gain (0.37 +/- 0.06
      vs. 0.67 +/- 0.05 and 0.70 +/- 0.05 kg/day, P < 0.01) and feed efficiency (3.12
      +/- 0.28 vs. 2.60 +/- 0.14 and 2.52 +/- 0.12, P < 0.05). These results suggest
      that the growth performance trait in these pigs is highly correlated with their
      growth hormone genotype.

PMID- 11192182
TI  - Development of bovine embryos on Vero/BRL cell monolayers (mixed co-culture).
AB  - The objective of this study was to test a new co-culture system of bovine
      embryos, which we call "mixed co-culture." This system consists of culturing
      embryos on cell monolayers composed of both Vero and BRL cells (Vero/BRL).
      Cumulus-oocyte complexes from ovaries of slaughtered cows were matured and
      fertilized in vitro. The presumptive zygotes were cultured with Vero/BRL (Group
      1), BRL (Group 2) or Vero (Group 3) cell monolayers, in 40 microL drops of Menezo
      B2 medium supplemented with 10% FBS and antibiotics. The development of the
      presumptive zygotes was compared on Day 2 [48 h post insemination (pi)] and Day 7
      (168 h pi). On Day 2, there was no difference between the groups. On Day 7, the
      highest percentage of compacted morulae/blastocysts was observed in mixed co
      culture of Vero/BRL cells: 40% versus 36% on BRL versus 27% on Vero cell
      monolayers. The differences were statistically significant (P < or = 0.05). Among
      compacted morulae/blastocysts, blastocysts prevailed in mixed co-culture: 67% on
      Vero/BRL as compared with 55% on BRL and 27% on Vero cell monolayers. The
      differences were highly statistically significant (P < or = 0.01). The results
      suggest that Vero/BRL cells improve the development of bovine embryos.

PMID- 11192183
TI  - Relationship between heparin binding to spermatozoa and the fertility of dairy
      bulls.
AB  - The presence of heparin in in vitro media has been implicated in improved
      fertility parameters of bull spermatozoa. In a previous study, Zhang et al. (25)
      obtained an estimate of bull nonreturn rates based on spermatozoal concentration,
      motility and zona pellucida binding (24). The objective of this study was to test
      for a relationship between fertility parameters previously estimated for the same
      batch of cryopreserved semen (25) and amount of heparin bound to spermatozoa. 3H
      heparin binding to spermatozoa was assessed by radioimmunoassay, and statistical
      correlations were drawn to previously measured sperm characteristics. Preliminary
      experiments established optimal binding conditions of 25 degrees C, and 60 min
      incubation with 3H-heparin at a concentration of 50,000 cpm. 3H-heparin bound to
      an average of 2.2 x 10(6) receptors/cell with a Kd of 2.0 x 10(-7) M. The total
      3H-heparin bound to spermatozoa from different bulls was significantly different
      (P<0.003). However, the total 3H-heparin bound to spermatozoa was not correlated
      with any measured sperm parameter, including zona pellucida binding, embryo
      cleavage and blastocyst formation, and 56-day nonreturn rates (P>0.19). Thus, the
      total amount of heparin bound to the surface of spermatozoa may not be relevant
      to fertilizing ability.

PMID- 11192184
TI  - A novel approach for in vitro production of bovine embryos: use of the Oxoid
      atmosphere generating system.
AB  - The importance of the incubator type is often overlooked when protocols for in
      vitro production of embryos are evaluated. In this study the ability of a
      standard CO2 Heraeus incubator and the Oxoid CO2Gen atmosphere-generating system
      to support bovine in vitro oocyte maturation, fertilization and embryo
      development is described for the first time. The Oxoid CO2Gen gas generating
      system, originally designed for the growth of bacteria, is based on the chemical
      reaction of ascorbic acid and air. When the sachet with ascorbic acid is placed
      in the confined volume of the airtight AnaeroJar, an atmosphere of 6% CO2 in 15%
      O2 is created, which is comparable to the 5% CO2 and 20% O2 used for standard in
      vitro production of bovine embryos. In the first set of experiments oocyte in
      vitro maturation (IVM), fertilization (IVF) and embryo culture (IVC) were
      allocated to one or the other of the culture systems. In the second set of
      experiments IVM and IVF took place in the Heraeus incubator, while IVC was
      allocated either to the Heraeus or to the AnaeroJar. During experiments the
      AnaeroJar was placed in the Heraeus incubator to ensure identical incubation
      temperatures of 38.8 degrees C. A standard protocol was used for production of
      embryos: 23 h of IVM in TCM-199, 20 h of IVF with frozen-thawed washed
      spermatozoa in TALP medium and 7 days of IVC (8 days after insemination) in B2
      medium with bovine oviduct epithelial cells. In the first set of experiments,
      based on a total of 766 inseminated oocytes, the Day 8 blastocyst rates were the
      same in the Heraeus incubator and the AnaeroJar: 30% vs. 30% with oviduct cell
      coculture, and 21% vs. 18% without coculture. In the second set of experiments,
      based on 1963 inseminated oocytes, the average blastocyst rates were 27% vs. 32%
      from the Heraeus incubator and the AnaeroJar. In 2 of 6 replicates blastocyst
      rates were lower in the Heraeus incubator than in the jar; in the remaining
      replicates they were alike. No differences were noted in blastocyst kinetics or
      morphology. In conclusion, the Oxoid gas generating system seems to be a cheap,
      convenient and stable alternative to expensive CO2 incubators, not only for the
      growth of bacteria, but also for in vitro production of bovine embryos.

PMID- 11192185
TI  - Transvaginal collection and ultrastructure of llama (Lama glama) oocytes.
AB  - Ultrasound-guided transvaginal follicle aspiration has been described as a
      noninvasive and repeatable procedure for oocyte collection in several species,
      but its use has not been described for any of the members of the family,
      Camelidae. A study was designed to determine the feasibility of an ultrasound
      guided transvaginal approach for oocyte collection in llamas. Fifteen non
      pregnant, adult female llamas (10 non-stimulated and 5 superstimulated) were
      examined by transrectal ultrasonography with a 7.5-MHz linear-array transducer to
      determine the number and diameter of follicles available for aspiration. After
      caudal epidural anesthesia was induced, the 7.5-MHz linear-array transducer was
      fastened to a long rigid handle and inserted intravaginally. The free hand was
      placed into the rectum to manipulate the ovaries, one at a time, in position
      against the vaginal wall over the face of the transducer. A 20-gauge, 55-cm-long,
      single-lumen needle was advanced through the vaginal fornix and into follicles >
      or = 3 mm in diameter. Follicular contents were aspirated using a regulated
      vacuum pump (flow rate = 33 mL/min; approximately 150 mm Hg) into a tube
      containing 3 mL of phosphate buffered saline and 0.2% BSA. Fluid was filtered (75
      microm mesh), and oocytes were located and morphologically evaluated using a
      stereomicroscope. Overall, 134 follicles were aspirated, and 76 oocytes were
      collected (collection rate = 57%). Thirty-two oocytes (42%) were surrounded by
      multiple layers of compacted granulosa cells and had homogenous dark ooplasm; 13
      oocytes (17%) were surrounded by the corona radiata layer only and had heavily
      granulated ooplasm; 9 oocytes (12%) were denuded and had homogenous dark ooplasm;
      and 22 oocytes (29%) were denuded and displayed signs of ooplasm degeneration.
      The ultrastructure of llama oocytes was similar to that of cattle except for
      conspicuous accumulation of large lipid droplets in the cytoplasm. Twenty-four
      hours after follicle aspiration, the ovaries were examined by transrectal
      ultrasonography and intrafollicular hematomas were detected in 3 llamas (9 of 48
      follicles aspirated). Results demonstrate the potential utility of a transvaginal
      ultrasound-guided technique for oocyte collection and in vitro embryo production
      in llamas. Oocytes of llamas bear an ultrustructural resemblance to those of
      cattle, but are distinguished by a predominance of cytoplasmic lipid.

PMID- 11192186
TI  - Mummification of fetal membranes in the bovine vagina: a case report.
AB  - Papyraceous, mummified fetal membranes were found in the vagina of a cow at the
      end of the fourth month after a normal delivery. The uterus and cervix were
      without any pathological changes. The cow conceived on Day 36 after removal of
      the mummified fetal membranes upon the second insemination. Apart from the
      uncommon nature of the case, it proves that after calving the bovine vagina can
      maintain a sterile environment and that the constrictive mechanism of the vagina
      can be strong enough to hinder for a long time the discharge of fetal membranes
      and access of microbes to the vagina.

PMID- 11192187
TI  - Treatments resulting in pregnancy in nonovulating, hormone-treated oocyte
      recipient mares.
AB  - Synchronization of follicle growth between oocyte donor and recipient mares is
      difficult. To avoid this, recipient mares in a clinical program were used during
      a period of low follicular activity, and were treated with estrogen before
      transfer and progesterone after transfer. Five pregnancies were established after
      oocyte transfer to nonovulating, hormone-treated recipient mares. One pregnancy
      was lost before 30 d gestation, and the other 4 foals were carried to term. One
      foal died at birth. Establishment and maintenance of pregnancy in these mares
      indicates that nonovulating, hormone-treated mares may offer an alternative to
      cyclic recipients in oocyte transfer programs.

PMID- 11192188
TI  - Effect of boar contact on follicular development and on estrus expression after
      weaning in primiparous sows.
AB  - Boar contact can induce ovarian activity, advance estrus and stimulate estrous
      behavior in sows. High amounts of boar contact can, however, suppress estrous
      behaviour. The present study with primiparous sows was designed to compare sows
      that had contact with a teaser boar during detection of estrus, with sows that
      had no boar contact at all. Number of sows detected in estrus within 9 d after
      weaning, onset and duration of estrus, follicular dynamics and timing of
      ovulation were studied. Boar contact increased the number of sows that ovulated
      and showed estrus from 14 of 47 to 24 of 47 (P < 0.05). Average timing of
      ovulation was later for sows with boar contact (165 h vs 150 h after weaning).
      Duration of estrus, detected without a boar, was similar in the two groups. For
      the sows with boar contact, duration of estrus detected with a boar was longer
      than estrus detected without a boar (56 vs 38 h; P < .01). Follicular dynamics
      were not affected by boar contact; boar contact only increased the number of sows
      with ovulation. Ovulatory sows showed a larger increase in follicular diameter (P
      < 0.01) from weaning to Day 4 after weaning (from 2.3 to 5.4 mm) than anovulatory
      sows (from 2.5 to 4 mm). Anovulatory sows did not show follicular growth after
      Day 4. It is concluded that boar contact can increase the number of sows that
      ovulate and show estrus after weaning. Estrous behavior does not seem to be
      suppressed by contact with a teaser boar, compared to sows without boar contact.

PMID- 11192189
TI  - Postovulatory effect of repeated intravenous administration of ACTH on the
      contractile activity of the oviduct, ova transport and endocrine status of
      recently ovulated and unrestrained sows.
AB  - The effect of repeated intravenous administration of ACTH (Synacthen depot) on
      the contractile activity of the oviduct, ova transport and endocrine status was
      studied in 11 Swedish crossbred (Landrace x Yorkshire) multiparous sows. In the
      second estrus after weaning, the ACTH group (Group A, n=6) sows were administered
      0.01 mg/kg body weight of ACTH every 6 h commencing 4 to 8 h after ovulation,
      whereas the control group (Group C, n=5) sows were administered saline solution.
      Immediately after standing estrus, a Millar pressure transducer was placed about
      3 cm into the isthmus via a laparotomy. Blood samples for hormonal analyses and
      pressure recordings of the oviduct were collected from all sows until slaughter.
      After slaughter, the genital tract opposite to the side with the transducer was
      retrieved, and 3 equal isthmic segments and the first third of the uterine horn
      portion adjacent to the UTJ were flushed separately for ova recovery. Cortisol
      levels were significantly (P<0.05) elevated after ACTH administration.
      Progesterone and PGF2alpha metabolite levels were significantly (P<0.05) elevated
      only after the first ACTH administration. No significant differences (P>0.05)
      were seen in the mean pressure and frequencies of phasic pressure fluctuations
      either before or after every ACTH administration between Groups A and C. No
      significant difference (P>0.05) was seen in the proportion of ova recovered in
      the different segments between Groups A and C. It can be concluded from the
      present study that the administration of ACTH (0.01 mg/kg body weight) to sows at
      4 to 8 h after ovulation, and after each subsequent ACTH administration, elevates
      cortisol levels, whereas progesterone and PGF2alpha metabolite levels are
      elevated only after the first treatment, and that this has no effect on the mean
      isthmic pressure, the frequency of phasic pressure fluctuations or ova transport.

PMID- 11192190
TI  - A meta-analysis of studies of the effect of GnRH 11-14 days after insemination on
      pregnancy rates in cattle.
AB  - A number of studies have used GnRH between 11 and 14 days after insemination to
      improve pregnancy rates in cows, however published results have not been
      consistent. We wished to investigate whether a consolidated estimate of the
      response could be quantified. Therefore we conducted a meta-analysis of the
      available data, 19 studies from 14 published papers, on the effect of GnRH
      analogs on pregnancy rate when given between Days 11 and 14 after first
      insemination. Odds ratios (the relative probability of pregnancy between treated
      and control cows) were compared for each study and found to vary significantly
      among studies, ranging from 0 to 22%. We showed by logistic regression analysis
      that response to GnRH treatment varied with cow type (beef or dairy), age (cow or
      heifer), estrus synchronization (synchronized or natural), pregnancy diagnosis
      (method and time) and effect of individual study. When all these variables were
      included only 6 of 14 publications could be analyzed, representing 2,541 instead
      of 10,945 cows. In this limited subgroup of data, a significant improvement in
      pregnancy rate was detected among treated cattle (odds ratio = 1.33; P<0.01).

PMID- 11192192
TI  - [Preimplantation genetic diagnosis, finally a reality in France].

PMID- 11192191
TI  - A combination of EGF and IGF-I accelerates the progression of meiosis in bovine
      follicular oocytes in vitro and fetal calf serum neutralizes the acceleration
      effect.
AB  - The effects of a combination of EGF and IGF-I (GFs) on the progress of meiosis
      and on their developmental competence were examined in cumulus-enclosed bovine
      oocytes. Exposure to GFs in serum-free, 0.3% PVP-containing maturation medium
      significantly (P<0.05) increased the frequency of oocytes with the first polar
      body (PB) at 16 h of culture and decreased those with PB at 20 h. The cleavage
      rates of PB-extruded oocytes after fertilization were not affected by treatment
      of GFs during maturation culture, and blastocyst yield was not improved by GFs
      treatment. Although replacement of PVP from GFs-containing medium with fatty acid
      free BSA did not affect the timing of PB extrusion, replacement with 10% FCS
      neutralized the acceleration effects of GFs. Replacement for macromolecule in
      maturation medium did not improve blastocyst yield of PB-extruded oocytes after
      fertilization. These results indicate that the progression of meiosis in bovine
      oocytes with cumulus cells is accelerated by exposure to GFs in serum-free
      maturation medium but their developmental competence is not improved, and that
      the acceleration effects on the progress of meiosis is neutralized by the
      presence of FCS in maturation medium with no improvement of developmental
      competence after in vitro fertilization.

PMID- 11192193
TI  - [Evaluation of thomboembolic risk before ovarian stimulation: what balance? What
      prevention?].
AB  - The pathophysiology of thrombotic events remains unclear among women undergoing
      ovulation induction. In this review, present knowledge is summarized from the
      literature. Prospective studies are needed to determine risk factors and
      therapeutic approach of these thrombotic complications.

PMID- 11192194
TI  - [Major vascular complications from gynecologic laparoscopy].
AB  - OBJECTIVE: To specify the circumstances of occurence, the means of diagnosis, the
      risk factors and the means of prevention for major vascular injuries (MVI) during
      gynecologic laparoscopic procedure. STUDY DESIGN: Retrospective case review study
      of 24 patients. RESULTS: Twenty-four patients with 31 MVI were identified. The
      average age of the patients was 32.8 +/- 10.6 years and the mean body index mass
      was 22.4 +/- 4.0 kg/m2. Three of four of the MVI occurred during the setting-up
      phase of laparoscopy (19 cases; 79.2%). In five cases (20.8%) MVI occurred during
      the laparoscopic surgical procedure. Fifteen of the MVI occurring during the set
      up phase were secondary to insertion of the umbilical trocar and four to
      insertion of the needle used to create the pneumoperitoneum. A minimum of six MVI
      secondary to insertion of the umbilical trocar were observed with disposable
      trocars. In every case diagnosis was performed during the laparoscopic procedure.
      Five patients (20.8%) died and three others (12.5%) presented serious
      complications (phlebitis (one case); ischemia (two cases) with a reoperation for
      one patient). CONCLUSION: MVI are rare but serious complications of gynecologic
      laparoscopy. Prevention relies on the surgeon's experience and strict respect of
      the safety rules. In the vast majority of cases, it is necessary to convert to
      laparotomy immediately, calling in a vascular surgeon.

PMID- 11192195
TI  - [Non-palpable breast lesions: radio-pathologic correlations on open excisional
      biopsies. Significance of the choice of technique for minimal excisional biopsy].
AB  - OBJECTIVE: To decrease the number of open excisional breast biopsies,
      percutaneous breast biopsies have been developed to perform the histologic
      diagnosis of non-palpable breast lesions. Some techniques allow a complete
      removal of small radiologic lesions. To evaluate the accuracy of a pathologic
      analysis performed only on the radiologic findings, we studied the radiologic and
      histologic correlation on open excisional biopsy (OEB) specimens. The aim of our
      study was to determine how many carcinomas were found distant from the radiologic
      findings. MATERIAL AND METHODS: Non-palpable breast lesions have been excised
      after preoperative localization. The radiologic findings were classified in
      microcalcifications, masses, architectural distortion and in sonographic masses.
      The correlation between the radiologic and pathologic findings was studied and
      all the lesions incidentally discovered on histology with no correlation with the
      imaging findings or distant from the radiologic findings were described. One
      hundred and twenty-nine lesions have been evaluated in 99 patients. Radiologic
      findings included 79 clusters of microcalcifications, 30 masses, six
      architectural distortions and 14 sonographic lesions. RESULTS: The
      histopathological results were benign in 41.9%, malignant in 49.6% and atypical
      hyperplasia lesions were discovered in 8.5%. All benign lesions were correlated
      to radiologic findings. No malignant lesion was found at a distance. In three
      cases atypical hyperplasia lesions were coexistent with the radiologic findings
      correlated with benign lesions and in three cases they were found at a distance.
      All but two malignant lesions were correlated with radiologic findings. In two
      cases a microinvasive carcinoma and foci of labular carcinoma in situ were found
      coexistent with benign lesions. The subgroup of small lesions lesser than 10 mm
      included 31 benign lesions. A complete removal of these lesions should be
      obtained with percutaneous biopsies. CONCLUSION: A pathologic analysis targeted
      on radiologic findings is accurate. Numerous open excisional biopsies performed
      for benign pathology should be avoided.

PMID- 11192196
TI  - [Morphological aspect of embryos obtained after fertilization in vitro for male
      factor or ICSI].
AB  - OBJECTIVE: In order to study the eventual impact on fertilization and embryo
      characteristics of the microinjection procedure we compared the quality of the
      embryos obtained by ICSI with those of in vitro fertilization with male factors
      (MF IVF). MATERIAL AND METHODS: One hundred thirty-four cycles of IVF treatment
      (group 1) were selected with oligoasthenozoospermia according to WHO criteria
      with a total number of motile spermatozoa between 500,000 and 1 million. One
      thousand eighty-eight mature oocytes and 486 embryos were obtained. One hundred
      forty-three cycles of intracytoplasmic sperm injection (group 2) were performed
      in couples whose in vitro fertilization was imparticable because of extreme sperm
      impairment. One thousand one hundred forty-seven mature oocytes were injected and
      626 embryos were obtained. RESULTS: In group 1, the pregnancy rate per embryo
      transfer and the implantation rate were respectively 22.7% and 12.3%. In group 2,
      the pregnancy rate per embryo transfer was 37.1% and the implantation rate was
      17%. The statistical analysis of the embryos obtained in the two different groups
      did not demonstrate any difference in the distribution of the more regular and
      less fragmented embryos (group A) and those of the more irregular and fragmented
      embryos (group B). No statistical difference was demonstrated in the chronology
      of the division of these embryos (groups 1 and 2). CONCLUSION: The pregnancy rate
      by cycle and by transfer reported by ICSI (p < 0.003 and p < 0.015 respectively)
      could be related to a significantly higher mean number of transferred embryos
      (2.65 vs 2.02) in probable relation with a higher cleavage rate (p < 0.00001).

PMID- 11192197
TI  - [The experience of menstruation and its disorders in 603 women using
      contraception in 1999].
AB  - AIM: An epidemiological survey completed during the first quarter of 1999
      assesses the frequency of menstrual disorders as well as their effects on the
      lives of women using contraception. MATERIALS AND METHODS: The results presented
      involve a sample of 603 women, with 405 using the pill and 198 fitted with an
      IUD. The average age of onset of menstruation in the sampled population was 12.8
      years. Although most women declared that they felt no anxiety at the time, over
      one-third of the women surveyed explained that they felt a certain hesitancy in
      discussing the topic. Even today, certain feelings, such as shame or pride, are
      still evoked in the interviews. Although over half believe that it is normal to
      menstruate, the process is nevertheless considered "somewhat bothersome" by
      certain women who also refer to "purification." Traditional cultural perspectives
      remain a strong influence. Menstrual disorders predating the initial use of
      contraception were reported in 150 women (occasional intermenstrual bleeding, 130
      cases; other anomalies excluding metrorrhagia, 27 cases). Even if most of the
      women believe these problems to be inevitable, they also claim to be relatively
      troubled by these disorders, which often involve a considerable degree of
      discomfort. Such disorders are significantly more frequent in the "IUD" group, as
      well as in women who claim a very early onset of menstruation and those who
      consider explanations provided by the physician as "insufficient." CONCLUSION:
      The difference creates a certain fear with respect to any social or individual
      norm that may have been internalized. Thus the information presented in this
      study may provide ways and means to better understand women in general and our
      women patients in particular.

PMID- 11192198
TI  - [Pathology of gestational trophoblastic tumors].
AB  - Gestational trophoblastic tumours result from an abnormal proliferation of
      different types of trophoblasts. The morphological pattern, together with the
      immunohistochemical aspect, the cytogenetic data and the clinical profile, helps
      identify each pathological entity. Hydatiform moles represent malformed placentas
      caused by genetic aberrations of the villous trophoblast. A complete hydatiform
      mole displays an hydropic degeneration of all the chorionic villi with a more or
      less marked proliferation of trophoblasts. A partial hydatiform mole is made up
      of molar vesicles interspersed with normal chorionic villi. In an invasive
      hydatiform mole or chorioma destruens, molar vesicles penetrate the myometrium
      giving rise to a mass distorting the uterine wall. A choriocarcinoma is a
      malignant proliferation of atypical villous trophoblasts without villi formation.
      Necrosis, haemorrhage, vascular invasion and distant metastases strongly
      compromise its outcome. A trophoblastic implantation site tumor, clearly less
      frequent, results from a proliferation of extravillous trophoblasts, particular
      for their secretion of human placental lactogen hormone (hPL). This tumour,
      exceptionally malignant, should be differentiated from the exaggerated placental
      site and its variants. Except for the placental site trophoblastic tumour, and
      whatever the outcome (benign or malignant), all gestational trophoblastic tumours
      secrete the beta-subunit of the chorionic gonadotropic hormone (beta-hCG) more or
      less abundantly. The serum or urinary level of this unit is proportional to the
      tumour volume and represents a fundamental basis for the follow-up of these
      tumours. Multidisciplinary care of high-risk cases allows us to cure the disease,
      and helps the patient recover her reproductive uterine function.

PMID- 11192199
TI  - [Response of the authors to the correspondence of B. Broussin].

PMID- 11192200
TI  - [In response to the article by P. Martel et al. Use of CO2 laser in continuous or
      pulse mode for accomplishing conization: apropos of 230 cases. Gynecol Obstet
      Fertil 2000; 28: 536-46 ].

PMID- 11192201
TI  - [In response to the article by E. Leblanc et al. The treatment of early stage
      cervical cancer with pelvic lymph node involvement. Gynecol Obstet Fertil 2000;
      28: 518-25].

PMID- 11192202
TI  - [In response to the article by M.C. Rojat-Habib et al. Usefulness of endocervical
      margin analysis of conization specimens. Gyneol Obstet Fertil 2000; 28: 518-25 ].

PMID- 11192203
TI  - [The concept of selective action steroids].

PMID- 11192204
TI  - [Measuring the risk of infection after premature rupture of the membranes:
      consideration of complemenatary examinations and biological markers?].

PMID- 11192205
TI  - [Extemporaneous anatomopathological examinations in mammary and thyroid
      pathologies].

PMID- 11192206
TI  - [Should colposcopy be systematically performed on all women presenting with
      cytologic anomalies?].

PMID- 11192207
TI  - [Systematic colposcopy for generating overevaluations].

PMID- 11192208
TI  - [The first World War and the explosion of venereal disease morbidity. III. The
      hunting for prostitutes: an impossible war?].

PMID- 11192209
TI  - Suggestion of a cause-and-effect relationship among coal rank, airborne dust, and
      incidence of workers' pneumoconiosis.

PMID- 11192210
TI  - Identifying the determinants of viable microorganisms in the air and bulk
      metalworking fluids.
AB  - Exposure assessment was conducted for an epidemiologic study of the respiratory
      effects of exposure to metalworking fluids (MWF). As part of the study, airborne
      microorganisms were collected with a two-stage microbial impactor, and a sample
      of the bulk soluble MWF was collected from each machine sump, as well as
      information about the work environment. These data were then used to develop
      multivariate statistical models of the determinants bulk MWF and airborne
      microbial levels. Microbial concentrations in the bulk MWF ranged from 5 x 10(4)
      to 5 x 10(10) colony-forming units (CFU)/mL, with a geometric mean of 3.4 x 10(7)
      CFU/mL. The geometric mean airborne microbial level was 182 CFU/m3 (for particles
      size <8 microm) with a range of 1 to 8,308 CFU/m3. In modeling the determinants
      of bulk microorganisms, fluid-related factors were the most important
      characteristics associated with microbial levels, followed by process-related and
      environmental factors. The final full multivariate model predicted a significant
      reduction in bulk microbial levels by increasing pH of the fluid and reducing the
      amount of tramp oil leaking into the fluid. For the airborne microbial models,
      process-related factors were the major characteristics associated with microbial
      levels, followed by factors related to worker activities and environmental
      factors. The final full multivariate model predicted a significant control of
      airborne microorganisms by increasing worker distance from the machine, reducing
      the number of machines within 10 feet of the worker, decreasing the bulk
      microbial levels, and adding machine enclosures. These models can be used to
      prioritize nonbiocidal interventions to control microbial contamination of the
      bulk MWF and the air.

PMID- 11192211
TI  - Particle settling after lead-based paint abatement work and clearance waiting
      period.
AB  - This study investigated the evolution of airborne particle concentration and size
      distribution following abatement work in a controlled environment utilizing
      direct real-time particle monitoring and used it to project potential lead
      loadings as those particles settle. An 860 ft3 environmental test chamber with
      sophisticated ventilation and air purifying systems was built. Wooden doors with
      lead-based paint were dry sanded or scraped to generate the highest feasible
      airborne lead concentrations. Size-fractional airborne particle concentrations
      decreased exponentially with time in all tests, even with no air exchange,
      consistent with the stirred model of constantly mixed air, which predicts longer
      settling than for tranquil settling. Very low levels of air mixing generated by
      temperature gradients and initial room air turbulence affected particle settling.
      About 90% of airborne lead mass settled within 1 hour after active abatement,
      before final cleaning began. During the second waiting period of 1 hour, which
      followed cleaning of the floor, additional dust settled so that the additional
      potential lead loading from remaining airborne lead was less than 20 microg/ft2.
      For this worst case scenario, the underestimate of the lead loading done by the
      clearance sampling did not exceed about 30%. For more realistic conditions, the
      underestimates are projected to be much lower than the new 40 microg/ft2 Housing
      and Urban Development (HUD) clearance standards for floor dust lead. These
      results were obtained for the first waiting period (between the end of active
      abatement and the beginning of cleaning) of 1 hour, as recommended by HUD
      guidelines. Thus, this study demonstrates no need to increase either the first or
      second waiting period.

PMID- 11192212
TI  - A new passive sampler for regulated workplace ketones.
AB  - A new solid sorbent passive air sampler for ketones has a silicone membrane atop
      a diffusion cylindrical path length of 1.1 cm and diameter 1.3 cm above a pellet
      of Tenax TA coated with 10% (w/w) O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine
      hydrochloride. Vapors of known concentrations approximating their workplace
      permissible exposure limits of Occupational Safety and Health Administration
      regulated ketones at a relative humidity (RH) of 3 +/- 1% were generated by a
      syringe pump connected to a dynamic air dilution system connected to an exposure
      chamber that allowed measurement of face velocities, temperatures, exposing vapor
      concentrations, and RHs. The O-oxime derivative was desorbed with hexane, and an
      aliquot injected for gas chromatographic analysis on a nonpolar capillary column
      by mass spectrometric or electron capture detection. The experimental passive
      sampler sampling rates in milliliters per minute at 25 degrees C were 4.07 +/-
      0.49, cyclohexanone; 6.30 +/- 0.59, diethyl ketone; 6.31 +/- 0.31, ethyl n-butyl
      ketone; 3.78 +/- 0.25, methyl n-amyl ketone; 3.43 +/- 0.19, methyl n-butyl
      ketone; 6.48 +/- 0.64, methyl ethyl ketone; 4.37 +/- 0.43, methyl isopropyl
      ketone; and 4.57 +/- 0.17, methyl n-propyl ketone. These preliminary data show
      that sterically unhindered ketones can be sampled by the passive sampler as well
      as aldehydes.

PMID- 11192213
TI  - Lead exposure among workers renovating a previously deleaded bridge: comparison
      of trades, work tasks.
AB  - Airborne and surface lead exposures were evaluated for construction trade groups
      at a previously deleaded bridge renovation site in the midwestern United States.
      Although all lead-based paint should have been removed, old layers of leaded
      paint were still present on some sections of the bridge. Ironworkers performing
      metal torch cutting had the highest exposures (188 microg/m3), followed by
      workers engaged in clean-up operations and paint removal (p < 0.001). Respirators
      were most frequently worn by workers with the greatest lead exposures; however,
      laborers performing clean-up operations had exposures to lead dust of 43
      microg/m3 and often wore no respiratory protection. Wipe samples revealed that
      almost all contractor vehicles were contaminated with lead. Heavy equipment
      operators with low airborne lead exposure had the highest levels of surface
      contamination in personal vehicles (3,600 microg/m2). Laborers cleaning
      structural steel with compressed air and ironworkers exposed to lead fumes from
      cutting had the highest concentrations of lead dust on clothing (mean 4,766
      microg/m2). Handwashing facilities were provided, but were infrequently used. No
      separate clothes changing facility was available at the site. The potential for
      "take-home" contamination was high, even though this site was thought to be
      relatively free of lead. Construction contractors and their workers need to be
      aware that previous deleading of a site may not preclude exposure to significant
      amounts of lead.

PMID- 11192214
TI  - A method for the analysis of butyltin chlorides in air by gas chromatography with
      atomic emission detection.
AB  - An initial screening test compared the use of tropolone (2-hydroxy-2,4-6
      cycloheptatrienone) in acetic acid with sodium diethyldithiocarbamate (NaDDC) as
      chelating agents for the extraction of butyltin chlorides from glass fiber
      filters and XAD-2 resin tube. NaDDC was chosen for subsequent analyses. Mono-, di
      , and tributyltin chloride were spiked onto glass fiber filters and XAD-2 resin,
      extracted in toluene with NaDDC and derivatized with pentylmagnesium bromide.
      Derivatized butyltin species were determined by gas chromatography with plasma
      atomic emission detection. Glass fiber filters and XAD-2 resin were found to
      provide high retention of butyltin compounds during sampling and efficient
      recovery of butyltin compounds by extraction with NaDDC.

PMID- 11192215
TI  - Lip lead as an alternative measure for lead exposure assessment of lead battery
      assembly workers.
AB  - This study investigated lead exposures of lead battery assembly workers in
      Taiwan. A special attempt was made to evaluate the use of lip lead as an
      alternative index for occupational lead exposure. Ninety-six of 113 workers from
      a lead battery plant were recruited as study subjects. Air lead; lead loadings on
      workers' sleeves, gloves, hands, cheeks, and lips; and blood lead were determined
      for exposure assessment. A questionnaire also was administered to collect
      information on work history, suspected exogenous lead sources, and personal
      behavior and activities. Geometric means of total air lead at different subareas
      ranged from 0.070 (2.5 geometric standard deviation [GSD]) to 0.159 (1.8 GSD)
      mg/m3. Geometric means of respirable air lead level for different subgroups of
      workers varied from 0.009 (2.0 GSD) to 0.032 (1.9 GSD) mg/m3, whereas those of
      the blood lead level ranged from 22.4 (1.3 GSD) to 44.5 (1.3 GSD) microg/dL. The
      heaviest lead loadings were found for plate-processing workers (e.g., 66.4 [1.5
      GSD] on gloves, 0.80 [3.7 GSD] on cheeks, and 0.79 [3.2 GSD] microg/cm2) on bare
      hands after washing. Blood lead level was significantly correlated with lead
      levels in air, lead loadings on lips, and bare hands after washing (r=0.24-0.30).
      Results of multiple regression analysis showed that only lip lead had a
      significant effect on the blood lead, whereas respirable air lead and personal
      behavior had only mild effects in this model. It was concluded that lip lead
      level may be used as an alternative index of lead exposure to facilitate the
      estimation of lead uptake through ingestion.

PMID- 11192216
TI  - Copper exposure and metal fume fever: lack of evidence for a causal relationship.
AB  - A systematic search was made of the world literature concerned with possible
      adverse health effects of inhalation exposure to copper fume and dust. Seven
      reports published over the past 88 years were identified that contain original
      human data and purport to document that exposure to copper dust or fume caused
      metal fume fever (MFF) or an MFF-like syndrome. Insufficient evidence was found
      to conclude that exposures to copper dust and copper fume cause MFF. Limitations
      included absence of exposure measurements, atypical symptoms and complaints, and
      lack of consistency among types of work associated with symptoms. Given the
      extensive use of copper in many industries and operations, it is evident that if
      copper-induced MFF does occur, it is a rare event.

PMID- 11192217
TI  - A quantitative study of aromatic amine permeation through protective gloves using
      amine adsorptive pads.
AB  - A quantitative study of aromatic amine permeation through a glove material using
      Permea-Tec aromatic amine pads, used for the detection of chemical breakthrough
      of protective clothing, was performed for aniline following the microwave
      extraction process and gas chromatographic analysis. Aniline exhibited >99%
      adsorption on the pads at a spiking level of 1.94 mg (1.9 microL). Aniline showed
      recoveries from 65 to 89% (RSD < or =5.6%) over the range 1.1-1.9 microL (1.12
      1.94 mg) of aniline applied to pads. The modified ASTM F739 and direct
      permeability testing procedures were used to determine breakthrough times for
      five protective glove materials using aniline as a challenge chemical.
      Breakthrough times for six protective gloves were determined, ranging from 182
      sec to 82 min. The quantitative concentration of aniline on the pads following
      permeation through the gloves also was determined, ranging from 0.53 to 0.55
      mg/cm2 (1.79-1.88 mg/pad).

PMID- 11192218
TI  - National Occupational Health Service policies and programs for workers in small
      scale industries in China.
AB  - Over the 14 years since economic reform began, and the restructuring of the
      economy to encourage international trade, a large number of township enterprises
      have been developed and put into operation in the Peoples Republic of China. From
      1978 to 1991, the number of enterprises has increased 11.5 times; the number of
      employees has increased 2.4 times; the fixed assets have increased 13.7 times;
      and the value of the total output has increased 22.5 times. In this article, a
      report is given on a sample survey in 30 counties in 1990, which showed that
      82.69% of rural industrial enterprises had at least one type of occupational
      hazard in their work environments. Workers engaged in at least one type of
      hazardous working environment accounted for 33.91% of the blue-collar workers.
      Physical examinations were performed for seven types of occupational diseases:
      silicosis, coal worker's pneumoconiosis, asbestosis, chronic lead poisoning,
      benzene analogs poisoning, chronic chromium poisoning, and noise-induced hearing
      loss. The total detectable rate of the seven types of occupational diseases was
      4.4% among those workers. In addition, 11% had illnesses suspected of being
      (though not proven to be) caused by occupational exposures. Most township
      enterprises do not provide basic occupational health services. The coverage of
      five routine occupational health service activities provided for township
      enterprises were very limited, from 1.4 to 36%.

PMID- 11192219
TI  - Evaluation of portable air samplers for monitoring airborne culturable bacteria.
AB  - Airborne culturable bacteria were monitored at five locations (three in an
      office/laboratory building and two in a private residence) in a series of
      experiments designed to compare the efficiency of four air samplers: the Andersen
      two-stage, Burkard portable, RCS Plus, and SAS Super 90 samplers. A total of 280
      samples was collected. The four samplers were operated simultaneously, each
      sampling 100 L of air with collection on trypticase soy agar. The data were
      corrected by applying positive hole conversion factors for the Burkard portable,
      Andersen two-stage, and SAS Super 90 air samplers, and were expressed as log10
      values prior to statistical analysis by analysis of variance. The Burkard
      portable air sampler retrieved the highest number of airborne culturable bacteria
      at four of the five sampling sites, followed by the SAS Super 90 and the Andersen
      two-stage impactor. The number of bacteria retrieved by the RCS Plus was
      significantly less than those retrieved by the other samplers. Among the
      predominant bacterial genera retrieved by all samplers were Staphylococcus,
      Bacillus, Corynebacterium, Micrococcus, and Streptococcus.

PMID- 11192220
TI  - Performance of Air-O-Cell, Burkard, and Button Samplers for total enumeration of
      airborne spores.
AB  - Performance of three devices used for the total enumeration of airborne spores
      the Air-O-Cell sampling cassette, the Burkard personal volumetric air sampler,
      and the Button Aerosol Sampler--was evaluated under controlled laboratory
      conditions. The first two are glass-slide impactors; the third collects spores on
      a filter. The samplers were challenged with 0.44-5.10 microm polystyrene latex
      particles and five microorganisms of 0.84-3.07 microm mean aerodynamic diameter:
      Streptomyces albus, Bacillus subtilis, Cladosporium cladosporioides, Penicillium
      brevicompactum, and Penicillium melinii. An optical particle counter measured the
      particle concentrations upstream and downstream of each sampler, and thus
      determined the physical collection efficiency of the three samplers. Collection
      efficiency of the Button Aerosol Sampler was close to 100% for the entire
      particle size range studied. The cut-off size of each impactor was 2.3-2.4
      microm. Acridine orange (with epifluorescent microscopy) and lactophenol cotton
      blue (with bright light microscopy) staining techniques were used for the
      microscopic enumeration of spores. No significant difference in microscopic
      counts was found (at the 95% significance level) when using these two techniques
      with the Button Aerosol Sampler filters. When the lactophenol cotton blue
      staining was used to compare total microbial counts yielded by all three
      samplers, the Button Sampler showed significantly higher counts for the smaller
      size microorganisms (B. subtilis and C. cladosporioides). For the larger
      microorganisms (P. brevicompactum and P. melinii) all three samplers yielded
      similar results. Uniformity of particle deposition on the collection surface was
      highest for the Button Aerosol Sampler due to the design of its inlet. Thus, the
      filter collection method used with the Button Aerosol Sampler is suitable and can
      be advantageous for the enumeration of total airborne spores.

PMID- 11192222
TI  - Effects on heat stress of a flame-retardant ensemble for aluminum smelters.
AB  - A common belief is that a flame-retardant clothing ensemble will increase the
      level of heat stress over ordinary cotton work clothes. This is supported by
      bench tests on fabrics that indicate higher insulation and vapor resistance
      values for flame-retardant clothing. This research compared a flame-retardant
      clothing ensemble for an aluminum smelter (Zirpo wool shirt and FR8 denim pants)
      with typical cotton work clothing. Four young men walked on a treadmill at two
      work levels inside a climatic chamber under controlled conditions of heat stress.
      During each test, heart rate, core temperature, and skin temperatures were
      continuously monitored and recorded every 5 min. After a physiological steady
      state was achieved, temperature and humidity were slowly increased to maintain a
      relative humidity of 50%. The critical condition was the time when thermal
      regulatory control was lost (called the inflection point, marked by a steady
      increase in core temperature). The climatic conditions at the inflection point
      were used to assign a critical wet-bulb globe temperature (WBGT). A three-way
      analysis of variance examined the effects on critical WBGT of clothing, work
      level, subjects, and the interaction between clothing and work level. There were
      no significant findings. Therefore, there should be no difference in the level of
      heat stress between the two clothing ensembles under the same environmental and
      work conditions.

PMID- 11192221
TI  - Coast Guard exposure to gasoline, MTBE, and benzene vapors during inspection of
      tank barges.
AB  - A field study was conducted June through August 1996 in an attempt to quantify
      short-term exposure levels to Coast Guard personnel performing routine inspection
      activities aboard commercial tank barges carrying gasoline. Transfer and fleeting
      operations were monitored in the ports of Pittsburgh, Pa., Huntington, W.Va.,
      Baton Rouge, La., and Galveston, Tex. A total of 43 personal and 68 area samples
      were analyzed for benzene and total hydrocarbons as gasoline ("gasoline").
      Results can be summarized as follows: Personal exposure to benzene gave 15-min
      time-weighted-average (TWA) results ranging from <0.10 to 0.50 ppm. Area benzene
      levels ranged from <0.04 to 170 ppm. Personal monitoring for gasoline revealed a
      range of <2.0 to 590 mg/m3 with a GM of 23 mg/m3. Area sample results for
      gasoline ranged from 1.7 to 90,000 mg/m3. Twelve personal samples were collected
      for methyl-tert butyl ether (MTBE). Only two of these were above the limit of
      detection and had 15-min time-weighted averages of 22 ppm and 1.3 ppm. Eighteen
      MTBE area samples ranged in value from <3.0 to 38 ppm. Although none of the
      personal samples met or exceeded proposed or established short-term exposure
      standards, many of the area sampling results indicated that a significant risk of
      acute exposure exists in the vicinity of valves, pressure lines, and connections.
      This includes anticipated sources such as pressure vent valves as well as
      unexpected sources resulting from structural deficiencies onboard the vessels.
      These results further emphasize the value of safe work practices and proper
      vessel maintenance in controlling exposure to harmful chemicals.

PMID- 11192223
TI  - Determining parameters of lognormal distributions from minimal information.
AB  - The lognormal distribution has a number of properties that do not lend themselves
      to simple "back-of-the-envelope" calculations. Mathematical relationships are
      presented for the basic parameters of the large population lognormal distribution
      as a function of characteristics available to, or needed by, the risk analyst. A
      freeware computer program called LOGNORM4 has been written to take the tedium out
      of determining various characteristics of lognormal distributions, given 1 of 15
      sets of values that uniquely specify a lognormal distribution.

PMID- 11192224
TI  - Hydrocarbon solvent exposure data: compilation and analysis of the literature.
AB  - An occupational exposure database for hydrocarbon solvent end-use applications
      was constructed from the published literature. The database provides exposure
      assessment information for such purposes as regulatory risk assessments, support
      of industry product stewardship initiatives, and identification of applications
      in which limited exposure data are available. It is quantitative, documented, and
      based on credible data. Approximately 350 articles containing quantitative
      hydrocarbon solvent exposure data were identified using a search of computer
      databases of published literature. Many articles did not report sufficient
      details of the exposure data for inclusion in the database (e.g., full-shift
      exposure or task-based exposure data). Others were excluded because only limited
      summary statistics were provided, which precluded statistical analysis of the
      data (e.g., arithmetic mean concentration presented, but no sample number).
      Following evaluation, 16,880 hydrocarbon solvent exposure measurements from 99
      articles were entered into a database for analysis. Methods used to identify and
      evaluate published solvent exposure data are described along with more detailed
      analysis of worker exposure to hydrocarbon solvents in three major end-use
      applications: painting and coating, printing, and adhesives. Solvent exposures
      were evaluated against current ACGIH threshold limit values (TLVs) and trends
      were identified. Limited quantitative data are available prior to 1970. In
      general, reported hydrocarbon solvent exposures decreased fourfold from 1960 to
      1998, were below the TLVs applicable to specific hydrocarbon solvents at the
      time, and on average have been below 40% of the TLV since 1980. The database
      already has proved valuable; however, the utility of published exposure data
      could be further improved if authors consistently reported essential data
      elements and supporting information.

PMID- 11192225
TI  - Building materials used in construction can affect indoor fungal levels greatly.
AB  - This article summarizes the results of a fungal investigation of a new, seven
      story, 170-room hotel. The owners of the building were refused an occupancy
      permit by local building officials because of concerns about fungal
      contamination. This article discusses the processes that were used to investigate
      and abate the fungal concerns in this building. This investigation involved
      comparing fungal infestation levels in various building materials, including two
      different types of gypsum wallboard. During initial testing the indoor air
      concentrations of problematic fungi were up to 50 times higher than outdoor
      levels. After the removal of the fungal-infested materials and the replacement
      with more acceptable materials, the indoor air concentration of problematic fungi
      dropped to less than one-fourth of outdoor levels.

PMID- 11192226
TI  - PAT Program report: background and current status. Proficiency Analytical
      Testing.

PMID- 11192227
TI  - ELPAT Program report: background and current status. Environmental Lead
      Proficiency Analytical Testing.

PMID- 11192228
TI  - Asthma management: curtailing costs and improving patient outcomes.
AB  - As our understanding of asthma has evolved, so have pharmaceutical strategies for
      managing this disorder. Once considered a disorder of airway smooth muscle,
      asthma now is regarded primarily as a chronic inflammatory disorder of the
      airways. Traditional therapy sought to suppress bronchoconstriction and other
      signs and symptoms of asthma when they occurred, but contemporary strategies
      center on managing the underlying inflammation through long-term medications
      intended to reduce the overall risk of acute attacks. Direct and indirect costs
      of illness for asthma were estimated at $6.2 billion in 1990. Undoubtedly the
      costs are considerably higher today due to the increasing prevalence of the
      disorder. The costs associated with the illness are not distributed evenly among
      the 15 million Americans with asthma. About 20% of the patients account for 80%
      of the expenditures. By identifying the high-cost patients and educating them
      regarding the proper use of medication, it may be possible to curtail costs
      associated with asthma. Healthcare professionals, especially in their role as
      educators, are critical to reducing morbidity, mortality, and costs associated
      with asthma patients.

PMID- 11192229
TI  - Risk factors for pediatric asthma emergency visits. Milwaukee Childhood Asthma
      Project Team.
AB  - The purpose of this study was to identify risk factors for pediatric asthma
      emergency department (ED) visits. A cross-sectional sample of 307 families (24%)
      responded to a mailed survey. Respondents were similar to the target population
      of 2487 children with asthma. Thirty-seven percent of respondents had two or more
      asthma ED visits in the past year. Asthma ED use was associated with persistent
      asthma symptoms, parents without high school diplomas, age under 4 years, African
      American race/ethnicity, use of written care plans, and use of spacers at school.
      The latter two variables were associated with severe asthma. High-risk children
      can be targeted for office-based medical care.

PMID- 11192230
TI  - Value of bronchial challenge in scuba diving candidates.
AB  - Bronchial challenges were effected with carbachol in 76 subjects who were
      candidates for a scuba diving group. Bronchial reactivity was assessed through
      airway resistance and forced expiratory volume in 1 sec (FEV1) measurements.
      Medical interrogation had revealed symptoms of recent (RA) or ancient (AA)
      asthma, or allergic rhinitis (AL). Nearly half of the subjects (47%) presented
      bronchial hyperresponsiveness (BHR), which was much more frequent in the RA
      group, but whose strength did not depend on clinical presentation. Prevalence of
      BHR was fairly high (36%) in the AL group. BHR constituted a contraindication to
      scuba diving because it may promote pulmonary barotrauma.

PMID- 11192231
TI  - Comparable bronchodilation with hydrofluoroalkane-134a (HFA) albuterol and
      chlorofluorocarbons-11/12 (CFC) albuterol in children with asthma.
AB  - This was an open-label, parallel group, randomized, age-stratified, multicenter
      study designed to compare the safety and efficacy of regular use of albuterol
      formulated in hydrofluoroalkane-134a (HFA albuterol) and albuterol formulated in
      chlorofluorocarbons-11/12 (CFC albuterol) in children with asthma. Children age 4
      11 years using a short-acting inhaled beta2-agonist for 6 months to manage stable
      asthma, and with a prestudy forced expiratory volume in 1 sec (FEV1) of >50%
      predicted after withholding short-acting inhaled beta2-agonists for at least 6
      hr, an increase in FEV1 > or = 12% within 30 min after two puffs of CFC
      albuterol, and the capability to comply with medication withholding requirements
      were eligible for study entry. After screening evaluation, patients entered a
      minimum 7-day run-in period. On study day 1 spirometry and a baseline 12-lead
      electrocardiogram (ECG) were performed, pulse and blood pressure were measured,
      and patients self-administered two puffs of their randomized study drug, either
      HFA albuterol or CFC albuterol. Serial spirometry was performed over 6 hr after
      study drug dosing. Pulse and blood pressure were measured just prior to each
      spirometry and a 12-lead ECG was performed at 60 min postdose. Patients took two
      puffs of their study drug four times a day for 4 weeks. At study week 4, study
      day 1 procedures were repeated. Patients maintained a daily diary of morning
      (A.M.) and evening (P.M.) peak expiratory flow (PEF), daytime asthma symptom
      scores, nighttime asthma sleep disturbance scores, and study drug use.
      Demographics and baseline characteristics of the 63 patients randomized to HFA
      albuterol (33) and CFC albuterol (30) were similar. No significant differences
      were found between the HFA albuterol and CFC albuterol treatment groups for any
      of the primary or secondary FEV1 efficacy variables either at study day 1 or
      study week 4. No significant differences were noted between treatment groups for
      A.M. and P.M. PEF, individual asthma symptom scores, nighttime asthma sleep
      disturbance scores, and rescue study drug use over the 4-week study. No
      significant differences were found between the two treatment groups for change
      from predose in heart rate, systolic and diastolic blood pressure, and 12-lead
      ECG intervals at either study day 1 or study week 4. Adverse event reporting was
      similar for the two treatment groups. In this study, with regular use of HFA
      albuterol in children with asthma, there was a similar safety profile and
      comparable bronchodilator efficacy as with CFC albuterol.

PMID- 11192232
TI  - Descriptive epidemiology of asthma in Trinidad, West Indies.
AB  - This cross-sectional study documents the demographic features of asthmatics
      seeking acute asthma care at four institutions on the island of Trinidad from
      January 1 to December 31, 1997. More than 15,000 (15,035) different patients made
      27,353 visits during the study period. Pediatric and adolescent male patients
      outnumbered females, but this was reversed in patients aged 20-69 years.
      Frequency of visits per patient ranged from 1 to 242. Significant variation in
      monthly admissions was observed; admission rates were highest in the last quarter
      of the year but were lowest in July and August. The overall crude prevalence rate
      was estimated at 1.71 per 100 (range 1.16-2.34).

PMID- 11192233
TI  - Allergy history does not predict skin test reactivity in asthmatic children.
AB  - We prospectively assessed how well patient report of allergy to cat, dust mite,
      and grass predicted the results of skin prick testing to those allergens in 95
      asthmatic children. Children between 4 and 18 years old with physician-documented
      asthma provided a detailed standardized allergy history and then underwent skin
      prick testing. The children were categorized by asthma severity. The diagnostic
      accuracy, which was the primary outcome measure, as well as sensitivity,
      specificity, and positive and negative predicted values were calculated for
      allergy history with regards to skin test reactivity. The diagnostic accuracy of
      allergy history in identifying skin test reactivity was 65%, 50%, and 56% for
      cat, dust mite, and grass, respectively. Asthma severity did not affect the
      diagnostic accuracy. Allergy history was a poor predictor of skin test reactivity
      in this group of asthmatic children.

PMID- 11192234
TI  - The influence of polymorphism at position 16 of the beta2-adrenoceptor on the
      development of tolerance to beta-agonist.
AB  - Polymorphism at position 16 of the beta2-adrenoceptor alters receptor down
      regulation in vitro. Our aim was to compare the development of tolerance to beta
      agonist in homozygous Gly-16 patients with patients harboring the "wild" genotype
      (homozygous Arg-16) during regular treatment with salmeterol. In a prospective,
      randomized, double-blind, placebo-controlled, cross-over study, 20 subjects with
      mild to moderate asthma (10 Gly-16, 10 Arg-16) received 2 weeks of treatment with
      inhaled salmeterol 100 microg b.i.d. Thereafter, dose responses to inhaled
      salbutamol were constructed for forced expiratory volume in 1 sec (FEV1), heart
      rate, QTc interval, serum potassium and glucose, and finger tremor. The
      protective effect of salbutamol against adenosine monophosphate (AMP) challenge
      was also measured. Salmeterol resulted in a significant reduction in the area
      under curve (AUC) for FEV1 (p = 0.01), heart rate (p = 0.01), QTc interval (p =
      0.01), and tremor (p = 0.05), and in the maximum responses for FEV1 (p = 0.05),
      heart rate (p = 0.02), and glucose (p = 0.02). The protective effect of
      salbutamol against AMP was reduced by 3.61 doubling doses (p < 0.001). However,
      differences between Gly-16 and Arg-16 patients were small and nonsignificant.
      Thus, although tolerance is influenced in vitro by polymorphism of the beta2
      adrenoceptor, the magnitude of between-genotype differences in vivo is unlikely
      to be significant.

PMID- 11192235
TI  - Relapse following treatment of acute asthma in the emergency department.
AB  - Most patients presenting to the emergency department (ED) with acute asthma will
      have some, if not significant, relief of respiratory distress following
      treatment. The majority of patients are discharged to home; however, a
      significant portion of patients relapse and require urgent medical treatment.
      Many patients have continued respiratory symptoms and impairment in activities of
      daily living after ED treatment. In a large multicenter trial, we found that 17%
      of patients relapse within 2 weeks, requiring urgent medical treatment. The
      factors associated with asthma relapse were a history of numerous ED visits over
      the previous year, a history of urgent clinic visits over the previous year, use
      of a home nebulizer, multiple asthma triggers, and duration of symptoms between 1
      and 7 days. In other studies, we found that many patients relapse before they can
      see their primary care physician, and that the lack of an identifiable primary
      care physician is associated with a higher incidence of relapse. Two
      interventions have been shown in studies to decrease the rate of relapse. The
      first, the administration of corticosteroids, has been adopted into general
      medical practice. Despite the routine use of corticosteroids following ED
      treatment, however, relapse remains a substantial problem. The second
      intervention involves focused long-term management by an asthma specialist.
      Several projects have demonstrated the efficacy of this approach in decreasing ED
      visits. Although it is time- and resource-intensive, this approach may be
      necessary for those patients who have frequent ED visits. Whether this approach
      is generalizable has yet to be demonstrated. In this article, we review the
      previous work on asthma relapse and suggest areas for further study.

PMID- 11192237
TI  - School preparation for the asthmatic student.
AB  - Questionnaires given to school nurses were used to collect data regarding
      emergency asthma equipment and plans. Sixty-three percent reported <10 asthmatic
      visits per month, 25% reported 10-50, and 12% reported >50. Only 20% of school
      nurses reported that 75%-100% of asthmatic students had an emergency plan, and
      24% did not know if asthmatic students had a plan. Only half of the nurses had
      input into the plan. Equipment varied: 16% had oxygen, 45% had peak flow meters,
      0% had MDIs, and 20% had nebulizers available. Many asthmatic students lack
      emergency plans, and many school nurses are not involved in the plans.

PMID- 11192236
TI  - Atopic status and level of bronchial responsiveness in parents of children with
      acute bronchiolitis.
AB  - To examine whether children with a genetic predisposition to asthma are more
      likely to be afflicted with bronchiolitis, we studied 122 parents of infants who
      were hospitalized with the diagnosis of acute bronchiolitis (index group) and 120
      parents of children who had never suffered from this disease (control group). The
      parents underwent bronchial challenge testing with methacholine and skin prick
      testing with common airborne allergens, and gave blood specimens for measurement
      of serum total IgE. There was no difference in atopic status, as assessed by the
      prevalence of atopy (at least one positive response to the allergens tested) or
      by serum total IgE levels, between index and control parents. The prevalence of
      bronchial hyperresponsiveness (BHR) (concentration of methacholine causing a 20%
      reduction in forced expiratory volume in 1 sec [PC20] < 18 mg/mL) was higher in
      index parents than in control parents (17.2% vs. 7.5%, p = 0.02). Bronchial
      responsiveness (BR) index was significantly higher in index parents than in
      control parents (1.135 +/- 0.088 vs. 1.104 +/- 0.071, p < 0.01). Parents of
      children who were hospitalized with acute bronchiolitis showed a higher level of
      BR, but not atopy. This suggests that in terms of BHR, there may be a genetic
      predisposition to the development of bronchiolitis.

PMID- 11192238
TI  - Synthesis of tumor associated sialyl-T-glycopeptides and their immunogenicity.
AB  - Sialyl-T-glycopeptides were synthesized by solid-phase techniques, using a PEGA
      resin as the solid support. An appropriately protected building block containing
      alpha-Neu5Ac-(2 --> 3)-beta-Gal-(1 --> 3)-alpha-GalN3-(1-->) attached to Fmoc
      Thr/Ser-OPfp was employed in a solid phase glycopeptide assembly of a 10-mer
      glycopeptide, using a general Fmoc/OPfp-ester strategy. Reduction of the azido
      group of the GalN3 residue was effected on solid-phase, using DTT and DBU. After
      acidolytic cleavage from the resin, the methyl ester of the sialic acid residue
      and acetyl groups were removed with 30% NaOMe/MeOH in MeOH and water pH 14, at 
      30 degrees C for 2 h. At this low temperature, the highly basic conditions did
      not result in any detectable beta-elimination. However, one O-acetyl group,
      located at the 2-position of the Gal was resistant to hydrolysis. To remove this
      remaining acetyl group, reaction with hydrazine hydrate in CHCl3 and MeOH at room
      temperature for 2.5 h was successful. The two target sequences of sialyl-T
      glycopeptides were obtained in good yield. In contrast to the the analogs
      carrying the T-antigen, the Sial-T-glycopeptides were nonimmunogenic, supporting
      the idea that the sialylation is a method of circumventing the recognition by the
      immune system.

PMID- 11192239
TI  - Alpha-azido acids for direct use in solid-phase peptide synthesis.
AB  - Several new alpha-azido acids have been synthesized and their use in solid-phase
      peptide synthesis has been demonstrated. The azido group allows for high
      activation of the carboxyl group as an acid chloride without formation of
      byproducts and with no detectable racemization. An analog of Leu-enkephalin has
      been prepared and tested in the mouse vas deferens and guinea pig ileum
      bioassays: it displays moderate activity at the delta-opiod receptor.

PMID- 11192240
TI  - Structural properties of DNO investigated with pyrene excimer formation.
AB  - Four diamino acid-Nalpha-substituted oligopeptide (DNO) oligomers substituted
      with pyrenyl as photophysical probes were synthesized. The excimer formation and
      ground-state association of the pyrenyl groups were investigated by means of
      absorption and steady-state fluorescence spectroscopy together with time-resolved
      fluorescence techniques. The photophysical parameters obtained from the different
      derivatives reflect the secondary structural properties of the DNO backbones.

PMID- 11192241
TI  - Solid-phase synthesis of MEN 11270, a new cyclic peptide kinin B2 receptor
      antagonist.
AB  - An efficient synthesis of the cyclic decapeptide MEN 11270 [H-DArg1-Arg2 Pro3
      Hyp4-Gly5-Thi6-Dab7-DTic8-Oic9-Arg10 c(7gamma - 10alpha)] was developed. Two
      three-dimensional orthogonal strategies were applied and compared: Fmoc/Tos/Boc
      (procedure A) and Fmoc/Pmc/Dde (procedure B). Both resulted in a 23-step strategy
      comprising the stepwise solid-phase chain assembly of the linear protected
      peptide, partial deprotection, solution-phase cyclization and final full
      deprotection. The stepwise assembly of the linear peptide was optimized by double
      coupling and acylation time prolongation for critical residues (Tic, Dab, Thi,
      Pro). O-(7-azabenzotriazol-1-yl)-N,N,N',N' tetramethyluronium (HATU) was
      preferred as coupling reagent for Dab. In the cyclization step, the partial
      racemization of Arg10 (31% using 1-ethyl-3-(3'-dimethyl-aminopropyl)
      carbodiimide/1-hydroxybenzotriazole (EDC/HOBt) as activation system) was reduced
      to 3% with HATU. The final deprotection was performed in the presence of
      dimethylsulfide (procedure A) and thiocresol (procedure B) as scavengers, to
      avoid the sulfation of Hyp side chain. The final compound and the main by
      products were characterized by mass spectroscopy (MS), nuclear magnetic resonance
      (NMR) and racemization test. Procedure B produced operationally simpler and more
      efficient results than A (28% overall yield versus 4%).

PMID- 11192242
TI  - An imidazoline pseudodipeptide suitable for solid phase peptide synthesis.
AB  - This paper describes the synthesis of two diastereoisomers of an imidazoline
      dipeptide mimetic (a 4,5 dihydroimidazole-4-carboxylic acid), suitably protected
      for incorporation into solid phase peptide synthesis (SPPS) using the Fmoc
      protocol, from a phenylalanine-derived thioimidate and an alpha,beta
      diaminopropanoic acid ester, followed by protecting group manipulation.

PMID- 11192243
TI  - Quantitative small-animal surrogate to evaluate drug efficacy in preventing wear
      debris-induced osteolysis.
AB  - Individuals who suffer from severe joint destruction caused by the various
      arthritidies often undergo total joint arthroplasty. A major limitation of this
      treatment is the development of aseptic loosening of the prosthesis in as many as
      20% of patients. The current paradigm to explain aseptic loosening proposes that
      wear debris generated from the prosthesis initiates a macrophage-mediated
      inflammatory response by resident macrophages, leading to osteoclast activation
      and bone resorption at the implant interface. No therapeutic interventions have
      been proved to prevent or inhibit aseptic loosening. The development of
      therapeutic strategies is limited due to the absence of a quantitative surrogate
      in which drugs can be screened rapidly in large numbers of animals. We have
      previously described a model in which titanium particles implanted on mouse
      calvaria induce an inflammatory response with osteolysis similar to that observed
      in clinical aseptic loosening. Here, we present new methods by which the
      osteolysis in this model can be quantified. We determined that 6-8-week-old mice
      in normal health have a sagittal suture area of 50 (+/-6) microm2, which contains
      approximately five osteoclasts. As a result of the titanium-induced inflammation
      and osteolysis, the sagittal suture area increases to 197 (+/-27) microm2, with
      approximately 30 osteoclasts, after 10 days of treatment. The sagittal suture
      area and the number of osteoclasts in the calvaria of sham-treated mice remained
      unchanged during the 10 days. We also determined the effects of pentoxifylline, a
      drug that blocks the responses of tumor necrosis factor-alpha to wear debris, and
      the osteoclast inhibitor alendronate. We found that both drugs effectively block
      wear debris-induced osteolysis but not osteoclastogenesis. In conclusion, we
      found the measurements made with this model to be reproducible and to permit
      quantitative analysis of agents that are to be screened for their potential to
      prevent aseptic loosening.

PMID- 11192244
TI  - In vivo kinematics of total knee arthroplasty: flat compared with concave tibial
      joint surface.
AB  - This study evaluated the influence of the geometric configuration of the tibial
      joint area on the kinematics of the knee. Twenty-two patients with
      noninflammatory arthritis and minor preoperative deformity were studied. They
      each received an AMK total knee replacement with retention of the posterior
      cruciate ligament. Eleven patients without any knee abnormalities were used as
      controls. The patients were stratified to either the flat (terminology of the
      manufacturer: standard) or concave (terminology of the manufacturer: constrained)
      polyethylene insert (n = 11 in each group). Knee kinematics were assessed 1 year
      after the operation by having the patient ascend a platform corresponding to an
      extension of the knee from 50 to 70 degrees of flexion. During this motion, two
      film-exchangers simultaneously exposed six to 13 pairs of serial
      stereoradiographs. The concave geometric configuration of the tibial insert
      resulted paradoxically in increased anterior-posterior translations compared with
      the flat insert but no significant change of rotations and translations in the
      other directions. Compared with normal knees, the most obvious abnormality was
      increased anterior-posterior translations (p < 0.004). At 50 degrees of flexion,
      the implants with the flat tibial polyethylene insert had displaced 2 times and
      the concave ones had displaced 2.5 times more posteriorly than the normal knees
      (p < or = 0.001). Less internal tibial rotation was also recorded in the flexed
      positions for both types of inserts compared with the normal knees (p < 0.02).
      Four knees in four patients, who reported symptoms of instability and abnormal
      knee function, showed significantly increased proximal displacement of the center
      of the tibial plateau in the flexed position. The findings suggest that current
      prosthetic designs and surgical technique do not restore normal knee kinematics
      and indicate that design improvements should rely on in vivo kinematic studies.

PMID- 11192245
TI  - Plate fixation of prostheses after segmental resection for bone tumours.
AB  - This study investigated the concept of using plates to attach endoprostheses to
      bone after segmental resection for bone tumours in an animal model. Titanium
      alloy plates integrated with the prosthesis and coated with hydroxyapatite were
      attached to bone by screws. This type of uncemented fixation relied on the
      induction of periosteal bone formation into and around the plates to secure the
      implant to bone. Two, three, and six-slotted plate designs were investigated. On
      retrieval, each plate was securely fixed by new bone. Bone apposition on the
      external surface of the plates occurred through a combination of periosteal bone
      production, invasion of bone through slots in the plate, and bone growth over the
      ends of the plates. Most plates became incorporated into a remodelled cortex.
      Higher bone turnover rates (microm day(-1)) were seen in bone in the slots of the
      plate compared with normal cortical bone turnover (p < 0.05). Significantly
      higher rates of turnover were measured beneath slotted parts of the plates
      compared with regions below the unslotted parts (p < 0.05). The cross-sectional
      area of bone surrounding the six-plate implant design was significantly higher
      than that of the three-plate (p < 0.05) and two-plate (p < 0.05) designs. In
      addition, significantly more bone formed adjacent to the six-plated implant
      design compared with that in the contralateral limb (p = 0.002). However, no
      significant difference was found when the total cortical area around the three
      plated design was compared with that of the contralateral limb (p = 0.63). In
      contrast, significantly less bone was measured adjacent to the two-plate design
      than in the untreated limb (p = 0.001). Image analysis also demonstrated
      increased cortical porosity adjacent to the six-plate design compared with the
      three-plate (p = 0.004) and two-plate (p < 0.05) designs. Finite element analysis
      demonstrated that the six and three-plate designs increased the second moment of
      area compared with that in the left tibia (p = 0.003 and 0.066, respectively).
      However, the attachment of the more flexible two-plate design did not
      significantly increase the second moment of area compared with that in the
      contralateral limb (p = 0.235). It was concluded that due to both mechanical and
      biological effects, the hydroxyapatite-coated plate designs generated new bone
      that enhanced fixation and encouraged plate integration into the load-bearing
      structure of the cortex. This method of fixation may be an alternative to the use
      of intramedullary cemented stems in patients requiring bone tumour implants and
      may be the only way to preserve the joint in difficult cases where only short
      segments of bone remain.

PMID- 11192246
TI  - Pamidronate prevents bone loss associated with carrageenan arthritis by reducing
      resorptive activity but not recruitment of osteoclasts.
AB  - Carrageenan arthritis is associated with high-turnover bone loss. We sought to
      determine whether the bisphosphonate pamidronate can modify this effect of
      inflammatory arthritis. Sixty mature, New Zealand White rabbits were randomly
      assigned to five groups: normal; normal with a therapeutic dose of pamidronate
      (300 microg/kg/day, administered subcutaneously); arthritis (induced in the right
      tibiofemoral joint with 10 intraarticular carrageenan injections); arthritis with
      a therapeutic dose of pamidronate (300 microg/kg/day, subcutaneous); and
      arthritis with a low dose of pamidronate (7.5 microg/kg/day, subcutaneous). All
      animals received the fluorochrome calcein green (0.5 g/l/day) in drinking water
      ad libitum from days 21 to 49. Undecalcified, transverse sections of the distal
      femur were photographed or imaged to determine bone volume; new bone volume;
      resting, eroded, osteoid, and osteoblast perimeters; and osteoclast number.
      Results were evaluated with analysis of variance and pairwise Bonferroni's tests.
      In trabecular bone adjacent to the joint affected by carrageenan arthritis,
      resting perimeter was substantially reduced compared with normal joints, and
      primary indices of osteoblast and osteoclast activity were abnormally high (p <
      0.001). Daily treatment with a therapeutic dose of pamidronate (300
      microg/kg/day, subcutaneous) during the induction of arthritis significantly
      decreased new bone volume, osteoid perimeter, and osteoblast perimeter compared
      with the untreated arthritis group (p < 0.001). Osteoclast number and eroded
      perimeter remained abnormally high despite treatment with pamidronate. The
      concomitant increase of bone volume and these osteoclast indices show that
      pamidronate prevents bone loss in this model of experimental inflammatory
      arthritis by inhibiting the resorptive activity, but not the formation or
      recruitment, of osteoclasts. These findings are relevant to the use of
      bisphosphonates in the treatment of rheumatoid arthritis.

PMID- 11192247
TI  - Enhanced proliferation and differentiation of human articular chondrocytes when
      seeded at low cell densities in alginate in vitro.
AB  - Dedifferentiated human articular chondrocytes exhibited a wide variation in their
      capacity to proliferate and redifferentiate in an alginate suspension culture
      system. The greatest extent of proliferation and redifferentiation was seen to be
      dependent on the formation of clonal populations of chondrocytes and correlated
      inversely with the initial cell seeding density. Redifferentiating chondrocytes
      seeded at low density (1 x 10(4) cells/ml alginate) compared with chondrocytes
      that were seeded at high density (1 x 10(6) cells/ml alginate) showed a nearly 3
      fold higher median increase in cell number. a 19-fold greater level of type-II
      collagen mRNA expression, a 4-fold greater level of aggrecan mRNA expression, and
      a 6-fold greater level of sulfated glycosaminoglycan deposition at 4 weeks of
      culture. Matrix molecules from low-density cultures were assembled into
      chondrocyte-encapsulated, spherical extracellular matrices that were readily
      visualized in sections from 12-week cultures stained with antibodies against
      types I and II collagen and aggrecan. Ultrastructural analysis of 12-week low
      density cultures confirmed the presence of thin collagen fibrils throughout the
      matrix.

PMID- 11192248
TI  - Viscoelastic properties of chondrocytes from normal and osteoarthritic human
      cartilage.
AB  - The deformation behavior and mechanical properties of articular chondrocytes are
      believed to play an important role in their response to mechanical loading of the
      extracellular matrix. This study utilized the micropipette aspiration test to
      measure the viscoelastic properties of chondrocytes isolated from macroscopically
      normal or end-stage osteoarthritic cartilage. A three-parameter standard linear
      solid was used to model the viscoelastic behavior of the cells. Significant
      differences were found between the mechanical properties of chondrocytes isolated
      from normal and osteoarthritic cartilage. Specifically, osteoarthritic
      chondrocytes exhibited a significantly higher equilibrium modulus (0.33 +/- 0.23
      compared with 0.24 +/- 0.11 kPa), instantaneous modulus (0.63 +/- 0.51 compared
      with 0.41 +/- 0.17 kPa), and apparent viscosity (5.8 +/- 6.5 compared with 3.0 +/
      1.8 kPa-s) compared with chondrocytes isolated from macroscopically normal,
      nonosteoarthritic cartilage. The elastic moduli and relaxation time constant
      determined experimentally in this study were used to estimate the apparent
      biphasic properties of the chondrocyte on the basis of the equation for the gel
      relaxation time of a biphasic material. The differences in viscoelastic
      properties may reflect alterations in the structure and composition of the
      chondrocyte cytoskeleton that have previously been associated with osteoarthritic
      cartilage. Coupled with earlier theoretical models of cell-matrix interactions in
      articular cartilage, the increased elastic and viscous properties suggest that
      the mechanical environment of the chondrocyte may be altered in osteoarthritic
      cartilage.

PMID- 11192249
TI  - Biomechanical regulation of matrix metalloproteinase-9 in cultured chondrocytes.
AB  - Abnormal mechanical loading of joints may induce degeneration of articular
      cartilage. Shear stress is one mode of mechanical loading that may regulate
      chondrocyte metabolism. We investigated the mechanism by which shear stress
      induces the gene encoding matrix metalloproteinase-9, a mediator of the
      progressive degradation of articular cartilage in osteoarthritis. In vitro
      experiments using passaged rabbit chondrocytes in monolayer culture subjected to
      a shear stress of 16 dyn/cm2 (1.6 Pa) in a flow channel showed increased
      expression of the matrix metalloproteinase-9 gene. The induction of matrix
      metalloproteinase-9 appeared to depend on a region in the 5' promoter of the gene
      that contains a 12-0-tetradecanoylphorbol 13-acetate-responsive element.
      Transfection experiments using a construct containing a luciferase reporter
      driven by a 12-0-tetradecanoylphorbol 13-acetate-responsive element indicated
      that shear stress activated a 12-0-tetradecanoylphorbol 13-acetate-responsive
      element-mediated transcription in chondrocytes. Similar experiments showed that
      shear stress induced a matrix metalloproteinase-9 promoter construct (matrix
      metalloproteinase-9-luciferase). Shear stress activated c-Jun NH2-terminal
      kinase, extracellular signal-regulated kinase, and p38. Transfection of matrix
      metalloproteinase-9-luciferase together with the dominant negative mutant of c
      Jun NH2-terminal kinase, but not with that of extracellular signal-regulated
      kinase or p38, attenuated the shear-induced matrix metalloproteinase-9 promoter
      activity. In addition, transfection of constructs encoding dominant negative
      mutants of Ras, Rac, and Cdc42 attenuated the induction of c-Jun transcriptional
      activity by shear stress. Thus. shear stimulation of chondrocytes stimulates Ras,
      Rac, and Cdc42, which subsequently activate c-Jun NH2-terminal kinase to induce a
      12-0-tetradecanoylphorbol 13-acetate-responsive element-mediated expression of
      matrix metalloproteinase-9.

PMID- 11192250
TI  - Delamination rates of tissue flaps used in articular cartilage repair.
AB  - A popular strategy in the treatment of articular cartilage lesions involves the
      introduction of cell suspensions into the defect void and its closure with a
      periosteal flap (autologous chondrocyte transplantation technique). We applied
      this methodology in goats and discovered that all sutured flaps (n = 6 animals)
      became detached from nonimmobilized joints during the recovery period. The
      purpose of this study was to ascertain whether postoperative restriction of joint
      movement could prevent the delamination of flaps. Partial-thickness defects were
      created in the knee joint cartilage of 27 goats. These defects were then filled
      with a fibrin matrix and covered with periosteal (n = 6) or fascial (n = 21)
      flaps, which were sutured with simple, interrupted stitches to the surrounding
      tissue. The joints were immobilized by means of a modified Robert Jones bandage
      for periods of 2-6 weeks, after which time they were inspected for the absence or
      presence of flaps. In four animals, joint immobilization for 3 weeks was followed
      by free movement for a similar period. Four of the six periosteal flaps and two
      of the 21 fascial ones became delaminated after the period of immobilization. In
      the four goats permitted 3 weeks of free joint movement following a similar
      period of joint immobilization, all flaps (which had been retained up to the end
      of the immobilization period) became detached. These findings indicate that joint
      immobilization hinders the delamination of flaps but that this restriction of
      movement must be sustained for an undefined period of time. The nature of the
      tissue used for flaps also influences their rate of retention by immobilized
      joints.

PMID- 11192251
TI  - Quantitative assessment of in vivo bone regeneration consolidation in distraction
      osteogenesis.
AB  - We present a new method for quantitatively assessing the consolidation of bone
      regeneration by performing distraction osteogenesis in micropigs. We measured in
      vivo stiffness using a newly developed, revolving, bone-healing meter. After the
      micropigs were killed, we obtained maximum torsional moment data for the
      regenerated bones by destructive mechanical testing, and we then correlated these
      data with the data for stiffness. We found a highly significant regression
      between in vivo stiffness and maximum torsional moment (r2 = 0.80), suggesting
      that monitoring stiffness may be useful for the prediction of bone regeneration
      in distraction osteogenesis. Therefore, our method may be a reliable tool for
      future quantitative monitoring of healing progress in patients with healing bones
      or in animal studies addressing treatments to increase bone formation in long
      bone defects.

PMID- 11192252
TI  - Cellular contribution of bone graft to fusion.
AB  - Although a number of studies have examined the fate of graft-derived cells during
      the process of fusion, there remains no consensus regarding their exact
      contribution to bone formation within the fusion mass. We developed two chimeric
      mouse isograft fusion models that allowed us to track the fate of graft cells
      within the host fusion bed. Cortical/cancellous bone graft (1:1 ratio of pelvic
      to vertebral body bone) from male mice was placed between (a) the tibia and
      fibula or (b) the coccygeal spine transverse processes of syngeneic female hosts.
      Both models were characterized histologically and histochemically. Graft-derived
      cells were then identified by fluorescent in situ hybridization for Y-chromosome
      sequences present in only the graft (male) cells. When the fusion mass was
      healing but not yet fused (at 1 and 2 weeks), numerous graft-derived cells were
      observed throughout the fusion site. The predominant graft-derived cell types
      included chondrocytes, osteoblasts, and fibroblasts. Chondrocytes arose from
      precursor cells in the graft de novo. as cartilage was not transplanted during
      the surgical procedure. By the time a mature fusion mass had formed (at 6 weeks),
      graft-derived cells persisted as osteocytes within the cortical rim surrounding
      the fusion mass. These osteocytes likely differentiated from graft-derived
      precursors that had directly formed bone, because transplanted osteocytes within
      cortical bone graft fragments were noted to rarely survive even at 1 and 2 weeks.
      Collectively, our results demonstrate for the first time that bone graft
      contributes cells that, in conjunction with host cells, directly form bone within
      the fusion mass during all phases of fusion rather than just the early phases.

PMID- 11192253
TI  - Extracellular collagen regulates expression of transforming growth factor-beta1
      gene.
AB  - A complex interrelationship exists between the extracellular matrix and cytokine
      signaling in articular chondrocytes. We sought to determine whether the
      extracellular matrix serves as a regulatory component of transforming growth
      factor-beta1 expression. Bovine articular chondrocytes were isolated and
      resuspended in alginate, yielding final extracellular protein concentrations of 0
      to 1.5% (wt/vol) for type-II or type-I collagen. Cultures were maintained for 7
      days in the presence or absence of transforming growth factor-beta1-supplemented
      medium (10 ng/ml). The amount of transforming growth factor-beta1 mRNA was
      examined with quantitative competitive reverse transcription-polymerase chain
      reaction analysis. The results indicate that exogenous transforming growth factor
      beta1 stimulates endogenous transforming growth factor-beta1 mRNA expression
      approximately 8-fold. This effect depended on the concentration of extracellular
      type-II collagen. As the concentration of extracellular type-II collagen is
      increased, the expression of transforming growth factor-beta1 mRNA decreases in
      both basal and transforming growth factor-beta1-stimulated cultures. Exogenous
      extracellular type-I collagen also served to negatively modulate transforming
      growth factor-beta1 gene expression but with a different concentration profile.
      The results demonstrate that transforming growth factor-beta1 mRNA expression was
      upregulated by exogenous transforming growth factor-beta1 and was downregulated
      by extracellular type-I and type-II collagens. The profoundly different effects
      on transforming growth factor-beta1 expression by the two collagens are
      consistent with those reported for mammary epithelial cells and likely serve as a
      negative feedback mechanism to preserve tissue homeostasis.

PMID- 11192254
TI  - Osteoprogenitor cells within skeletal muscle.
AB  - The formation of ectopic bone within skeletal muscle is a widely observed
      phenomenon. However, the source of the osteoprogenitor cells responsible for
      ectopic bone formation remains unknown. This study was designed to test for
      osteogenic differentiation among cells isolated from skeletal muscle tissue.
      Different subpopulations of cells derived from an adult mouse skeletal muscle
      were tested for induction of alkaline phosphatase activity after exposure to bone
      morphogenetic protein-2 in vitro. A responsive subpopulation was identified,
      transduced with a retrovirus encoding for beta-galactosidase (Rv-lacZ) and an
      adenoviral construct encoding for one bone morphogenetic protein-2, and injected
      into the hindlimb of immune compromised (severe combined immunodeficient, or
      SCID) mice. The injected cells appeared to actively participate in the ectopic
      bone formation. The existence of lacZ-positive muscle-derived cells colocalized
      with osteocalcin-producing cells within lacunae of newly formed bone matrix
      suggests osteoblast and osteocyte differentiation. Although a specific cell was
      not isolated, these data support the contentions that osteoprogenitor cells
      reside within skeletal muscle and that muscle may represent a source other than
      bone marrow for the harvest of these cells.

PMID- 11192255
TI  - Is the circumferential tensile modulus within a human medial meniscus affected by
      the test sample location and cross-sectional area?
AB  - Quantifying the material properties of the human menisci is paramount to
      understanding their biomechanical functions within the knee. One important
      intrinsic material property governing the biomechanical functions of the meniscus
      is the circumferential tensile modulus. The purpose of this study was to
      determine if the circumferential tensile modulus of the human medial meniscus
      depends on the location and thickness of the sample tested. The following three
      hypotheses were tested: (a) the circumferential location (anterior, central, and
      posterior) does not significantly affect the tensile modulus, (b) the radial
      location (inner to outer) significantly affects the tensile modulus, and (c) the
      thickness (cross-sectional area) significantly affects the tensile modulus. Test
      samples, whose length was oriented in parallel with the circumferential collagen
      fibers, were collected from different circumferential and radial locations
      throughout 30 human medial menisci. Samples of three different thicknesses (0.5,
      1.5, and 3.0 mm) were taken from three equal groups of 10 menisci (i.e., one
      thickness per group). The circumferential tensile modulus was measured under
      quasi-static loading. Statistical analysis showed no significant effect of the
      circumferential or radial location of the sample on the circumferential tensile
      modulus. This indicates that an overall circumferential tensile modulus may be
      calculated for the human medial meniscus by averaging the values determined at
      the various locations. However, the thickness of the test sample had a
      significant effect on the measured circumferential tensile modulus; the modulus
      varied inversely with the thickness. Thus, moduli determined from test samples
      that are too small in cross-sectional area overestimate the effective modulus of
      the tissue on the whole, and the cross-sectional area of the sample must be
      considered when determining a representative circumferential tensile modulus for
      the medial meniscus in a human knee.

PMID- 11192256
TI  - Tendon-Defect and muscle-unloaded models for relating a rotator cuff tear to
      glenohumeral stability.
AB  - Rotator cuff tear and glenohumeral instability are closely related. Any tear may
      disturb muscle force generation due to pain inhibition. In addition, a full
      thickness tear may foster instability by removing a structural element
      constraining the joint. It was hypothesized that the loss of both dynamic force
      and static constraint with a rotator cuff tear will affect glenohumeral
      stability. In a tendon-defect model, dynamic and static elements of the joint
      were sacrificed. In a muscle-unloaded model, only the dynamic element was
      removed. The location and size of the defect were also investigated. The effect
      on instability of a small tendon defect was less than that of muscle unloading,
      implying that a patient with a small tear would have less instability than a
      patient with weak or nonfunctioning supraspinatus and infraspinatus muscles. On
      the other hand, with a larger tear the defect had a greater effect than muscle
      unloading because sectioning of the glenohumeral and coracohumeral ligaments was
      included in the model. Clinically, such a defect in the front is critical for
      anterior stability because it might insult the important anterior capsule
      ligamentous complex. Orthopaedic surgeons should pay attention, therefore, to the
      effect of possible associated lesions of static constraints based on the size and
      location of the tear in addition to the dynamic stabilizer.

PMID- 11192257
TI  - Murine model for skeletal metastases of Ewing's sarcoma.
AB  - Ewing's sarcoma shows a strong tendency to metastasize to the lungs or the
      skeleton, or both. A peculiar feature of the secondary involvement of bone with
      this tumor is that it may also appear in the absence of clinically evident lung
      metastases, both at clinical presentation and during the course of the disease.
      Although osseous metastases are critically relevant for prognosis, the
      pathogenesis of this peculiar feature of Ewing's sarcoma is poorly understood,
      partly due to the lack of appropriate experimental in vivo models. We show that
      the intravenous injection of TC-71 Ewing's sarcoma cells into athymic 4-5-week
      old Crl/nu/nu (CD1) BR mice reproducibly colonizes specific sites of the skeleton
      in addition to the lungs and lymph nodes. The distribution and the morphologic
      appearance of these experimental bone metastases mimic the pattern of skeletal
      involvement observed in humans. This experimental model of bone metastasis of
      Ewing's sarcoma may be the basis for future studies aimed at understanding the
      pathophysiology and treatment of Ewing's sarcoma.

PMID- 11192258
TI  - Osteoprotegerin inhibits tumor-induced osteoclastogenesis and bone tumor growth
      in osteopetrotic mice.
AB  - Osteoprotegerin and osteoprotegerin ligand have recently been identified as novel
      proteins that inhibit and stimulate, respectively, osteoclast formation. We
      examined the possibility that osteoprotegerin would inhibit cancer-induced
      osteoclastogenesis and cancer growth in bone. An experimental model was used in
      which osteolytic tumors are known to stimulate osteoclastogenesis and grow in
      femora of osteoclast-deficient mice (op/op). Osteoprotegerin treatment decreased
      the number of osteoclasts by 90% (p < 0.0007) at sites of tumor in a dose
      dependent manner and decreased bone tumor area by greater than 90% (p < 0.003).
      The mechanisms through which osteoprotegerin decreased osteoclast formation in
      tumor-bearing animals included (a) an osteoprotegerin-mediated, systemic
      reduction in the number of splenic and bone marrow-residing osteoclast precursor
      cells, (b) a decrease in the number of osteoclast precursor cells at sites of
      tumor as detected by cathepsin K and receptor activator of NFkappaB mRNA
      expression, and (c) a decrease in osteoprotegerin ligand mRNA at sites of tumor.
      These findings suggest that osteoprotegerin treatment, in addition to having
      direct antagonistic effects on endogenous osteoprotegerin ligand, decreases the
      number of osteoclast precursors and reduces production of osteoprotegerin ligand
      at sites of osteolytic tumor.

PMID- 11192259
TI  - Cyclooxygenase-2 inhibitor SC-236 attenuates mechanical allodynia following nerve
      root injury in rats.
AB  - Low back pain is a common problem, affecting approximately two-thirds of the
      adult population. Of these individuals, a significant percentage will exhibit
      symptoms of radicular pain or sciatica. The purpose of this study was to
      determine the effect of one systemic (2 mg/kg) or intrathecal (0.2 mg/kg) dose of
      a selective cyclooxygenase-2 inhibitor (SC-236) in decreasing existing mechanical
      allodynia in a rat model of radiculopathy. Gait disturbance and mechanical
      allodynia (increased response to non-noxious von Frey monofilament stimuli) were
      assessed daily until the rats were killed 7 days after surgery. Robust mechanical
      allodynia developed in the rats in all groups except for those in the sham group
      by day 1 after surgery. Mechanical allodynia was significantly lower in the rats
      that received the systemic or the intrathecal dose of SC-236 than in those in the
      vehicle control group (analysis of variance followed by Bonferroni multiple
      comparison test, p = 0.002). The intrathecal drug route of administration
      produced greater attenuation in allodynia than the systemic dose, supporting a
      central mechanism of action of the cyclooxygenase-2 inhibitor (p = 0.002). The
      hypothesis that cyclooxygenase-2 is involved in spinal nociceptive processing
      after a nerve root injury was supported by this study. In addition, these data
      support continued basic science research to further elucidate central
      inflammatory processes that follow nerve root injury.

PMID- 11192260
TI  - Methylprednisolone reduces the early vascular permeability increase in spinal
      nerve roots induced by epidural nucleus pulposus application.
AB  - Autologous nucleus pulposus is known to have injurious effects on spinal nerve
      roots when applied epidurally. Both inflammatory and immunological mechanisms
      have been implicated in this regard. Various proinflammatory substances might be
      released or activated by nucleus pulposus and might affect the endoneural nerve
      root vessels. The present study assessed nucleus pulposus-induced early vascular
      reactions and the possibility of blocking these reactions with intravenous, high
      dose, methylprednisolone pretreatment. In 25 pigs, the S2 and S3 nerve roots were
      exposed. In five pigs (control group), retroperitoneal fat was applied epidurally
      on the nerve roots, and the other 20 pigs had nucleus pulposus applied. This
      group was sub-divided into the treatment group (n = 8), in which the pigs were
      pretreated with intravenous high-dose methylprednisolone (30 mg/kg body weight),
      and the nontreatment group (n = 12), in which the pigs received a corresponding
      volume of saline solution. After 2 hours, Evans blue labeled albumin was injected
      intravenously 5 minutes before death. Endoneural extravasation of Evans blue
      labeled albumin was evaluated with fluorescence microscopy. A marked albumin
      leakage was found in 67% of the nontreated animals, in 25% of those in the
      treatment group, and in none of the control animals. These results demonstrate
      that nucleus pulposus can induce a rapid increase in endoneural vascular
      permeability in spinal nerve roots after epidural application. This increase can
      be partially prevented by pretreatment with high-dose methylprednisolone.

PMID- 11192261
TI  - Reinsertion of stimulated nucleus pulposus cells retards intervertebral disc
      degeneration: an in vitro and in vivo experimental study.
AB  - Reinsertion of autogenous nucleus pulposus, an innovative method to delay further
      disc degeneration, has been proved with an experimental animal model. This study
      examined whether coculture of nucleus pulposus cells with annulus fibrosus cells
      (a) activates annulus fibrosus cells and (b) retards disc degeneration when
      reinserted into the disc in a rabbit model of disc degeneration. Coculture of the
      two cell types stimulated proliferation of each, as indicated by increased DNA
      synthesis measured by increases in DNA polymerase alpha expression and uptake of
      5-bromo-2'deoxy-uridine assessed by an enzyme-linked immunosorbent assay. In a
      model of disc degeneration in rabbits, reinsertion of activated nucleus pulposus
      cells delayed the formation of clusters of chondrocyte-like cells, the
      destruction of disc architecture, and the elaboration of type-II collagen as
      measured immunohistochemically compared with no treatment. The direct reinsertion
      of activated nucleus pulposus cells into the disc offers a promising line of
      investigation for delaying intervertebral disc degeneration, although these
      results obtained with notochordal cells may not necessarily apply when mature
      central nucleus pulposus cells are used.

PMID- 11192262
TI  - Thermoregulation in Antarctic fulmarine petrels.
AB  - We measured resting metabolic rates at air temperatures between ca. -5 and 30
      degrees C in snow petrels (Pagodroma nivea), cape petrels (Daption capense),
      Antarctic petrels (Thalassoica antarctica), and Antarctic fulmars (Fulmarus
      glacialoides). We measured seven age classes for each species: adults, and
      nestlings that were 3, 8, 15, 28, 35, and 42 days old. Basal metabolic rate (BMR)
      and thermal conductance (C) of adults averaged, respectively, 140% and 100% of
      values predicted allometrically for nonpasserine birds. Minimum metabolic rates
      of unfasted nestlings aged 15-42 days averaged, respectively, 97% and 98% of
      predicted adult BMR in Antarctic petrels and snow petrels, versus 119% and 126%
      of predicted in Antarctic fulmars and cape petrels. Nestlings of the southerly
      breeding snow petrel and Antarctic petrel were relatively well insulated compared
      with nestlings of other high-latitude seabirds. Adult lower critical temperature
      (T1c) was inversely related to body mass and averaged 9 degrees C lower than
      predicted allometrically. As nestlings grew, their T1c decreased with increasing
      body mass from ca. 14 to 22 degrees C (depending upon species) at 3 days of age,
      to -4 to 8 degrees C when nestlings attained peak mass. Nestling T1c subsequently
      increased as body mass decreased during pre-fledging weight recession. Nestling
      T1c was close to mean air temperature from the end of brooding until fledging in
      the three surface nesting species.

PMID- 11192263
TI  - Salt gland blood flow in the hatchling green turtle, Chelonia mydas.
AB  - Microsphere and morphometric techniques were used to investigate any circulatory
      changes that accompany secretion by the salt glands of hatchling Chelonia mydas.
      Salt glands were activated by a salt load of 27.0 mmol NaCl x kg body mass (BM)(
      1), resulting in a mean sodium secretion rate of 4.14 +/- 0.11 mmol Na x kg BM(
      1) x h(-1) for a single gland. Microsphere entrapment was approximately 160-180
      times greater in the active salt gland than the inactive gland, inferring a
      similar change in blood flow through salt gland capillaries. The concentration of
      microspheres trapped in the salt gland was significantly correlated with the rate
      of tear production (ml x kg BM(-1) x h(-1)) and the total rate of sodium
      secretion (mmol Na x kg BM(-1) x h(-1)) but not with tear sodium concentration
      (mmol Na x l(-1)). Adrenaline (500 microg x kg BM(-1)) inhibited tear production
      within 2 min and reduced microsphere entrapment by approximately 95% compared
      with active glands. The volume of filled blood vessels increased from 0.03 +/-
      0.01% of secretory lobe volume in inactive salt gland sections to 0.70 +/- 0.11%
      in active gland sections. The results demonstrate that capillary blood flow in
      the salt gland of C. mydas can regulate the activity of the gland as a whole.

PMID- 11192264
TI  - The absorption of calcium ions from the ovine reticulo-rumen.
AB  - Net Ca2+ and Mg2+ absorption rates were measured in vivo from buffer solutions
      placed in the washed reticulo-rumen, isolated in situ in 30 conscious, trained
      sheep. An increase in concentration of short chain fatty acids (SCFA) in the
      buffer, over the range 0-50 mM, was shown to stimulate the net rates of
      absorption of Ca2+ and Mg2+ ions from the rumen. Similarly, the results of in
      vitro experiments, carried out with ovine rumen epithelium mounted in short
      circuited Ussing chambers, showed that the absence of SCFA from the chamber fluid
      resulted in a reduction in Jnet Ca2+ caused by reduced flux of Ca2+ ions in the
      mucosal to serosal direction (Jms Ca2+). The addition of 1 mM acetazolamide, an
      inhibitor of carbonic anhydrase, to the ruminal buffer used in the in vivo
      experiments led to significant reductions in the net absorption rates of Ca2+ and
      Mg2+ ions in the presence of SCFA (50 mmol x l(-1)) but not in the absence of
      SCFA. However, in the in vitro experiments, the addition of 60 microM
      ethoxyzolamide had no significant effect on Jnet Ca2+. A reduction in pH of the
      intraruminal buffer in vivo from 6.8 to 5.4 led to significant increases in the
      net absorption rates of Ca2+ and Mg2+ ions, an effect which was duplicated for
      Ca2+ in preliminary in vitro experiments in which the pH of the mucosal buffer
      was reduced from 7.4 to 5.4. This stimulatory effect was confined to Jms Ca2+ and
      Jnet Ca2+. Ussing chambers were also used to demonstrate that Jnet Ca2+ was
      reduced by a high transmural potential difference (PD), caused by voltage
      clamping, independently of the mucosal K+ concentration. Both unidirectional Ca2+
      fluxes consisted of a PD-dependent and a K+-insensitive PD-independent component.
      The latter may be represented by a Ca2+/ 2H+ antiporter. It is postulated that
      SCFA, and to a lesser extent H2CO3, can stimulate Jms Ca2+ by activation of an
      apical Ca2+/2H+ antiporter through the provision of protons within the ruminal
      epithelial cell. A mild reduction in ruminal pH may also lead to a similar
      stimulation of this putative electroneutral exchange.

PMID- 11192265
TI  - Selective stimulation and blockade of beta-adrenergic receptors in the mandibular
      gland of the red kangaroo, Macropus rufus.
AB  - Intracarotid infusions of noradrenaline (0.15 nmol x kg(-1) x min(-1)) either
      alone or accompanied by phentolamine (1.5 nmol x kg(-1) x min(-1)) caused similar
      sized increases in salivary protein, magnesium and bicarbonate, and decreases in
      osmolality, sodium, potassium and chloride whereas intravenous noradrenaline
      stimulated much smaller responses. Concurrent infusions of the beta1-antagonist,
      CGP20712A, blocked these noradrenaline-induced changes in salivary composition
      more effectively than equimolar infusions of the beta2-antagonist, ICI118551,
      thereby confirming the presence of beta1-adrenoceptors. Intracarotid infusion of
      salbutamol at 0.15, 0.3 and 1.5 nmol x kg(-1) x min(-1) caused increasing but
      qualitatively similar changes in salivary composition, sodium excepted, to
      intracarotid noradrenaline with 0.3 nmol being most similar quantitatively.
      Intravenous infusion of salbutamol caused larger changes in salivary composition
      than equimolar intravenous noradrenaline thereby indicating that the response to
      salbutamol may, in part, be mediated by reflex increases in general sympathetic
      tone triggered by lowered blood pressure. Eliminating this hypotensive effect by
      concurrent intravenous and intracarotid infusions of beta1-(CGP or atenolol) and
      beta2-(ICII18551) antagonists with intracarotid salbutamol showed that IC1118551
      was more potent than the beta1-antagonists thereby demonstrating the presence of
      beta2-receptors. It was concluded that the kangaroo mandibular has functional
      beta1- and beta2-adrenoceptor subtypes in both endpieces and excurrent ducts and
      that the duct system has two populations of cells, each expressing one receptor
      subtype.

PMID- 11192266
TI  - Galactan biosynthesis in snails: a comparative study of beta-(1--> 6)
      galactosyltransferases from Helix pomatia and Biomphalaria glabrata.
AB  - Adult snails synthesize in their albumen glands a polysaccharide which is
      composed exclusively of D- or D- and L-galactose (Gal) residues which are
      interglycosidically linked by 1 --> 3 and 1 --> 6 bonds. It is the only
      carbohydrate source for embryos and freshly hatched snails. Two
      galactosyltransferases are described in this study which are most likely involved
      in the biosynthesis of this polysaccharide. One identified in Helix pomatia acts
      on oligosaccharides and could be used to synthesize a tetrasaccharide when the
      branched trisaccharide D-Gal-beta-(1 --> 3)-[D-Galbeta-(1 --> 6)]-D-Galbeta-1 -->
      OMe was offered as acceptor. This enzyme, requiring Mg++-and Mn++-ions for
      activity, introduced a linear beta-(1 --> 6) linkage at the terminal non-reducing
      ends and was not detected in Biomphalaria glabrata. The other enzyme, which
      introduced beta-(1 --> 6) linkages at subterminal D-Gal residues, thus forming
      branching points in the polysaccharide, was found in H. pomatia, Arianta
      arbustorum and B. glabrata with comparable activities. With the enzyme
      preparation of H. pomatia, up to four D-Gal residues were introduced into vicinal
      positions, forming single-membered side chains, if a hexasaccharide with five
      linearly beta-(1 --> 3)-linked D-Gal residues was offered as a acceptor. The
      multiple-branched structure formed is typical for snail galactans, making this
      enzyme a prime candidate for the branching enzyme in galactan synthesis. The
      enzyme activity could be solubilized and purified by affinity chromatography. In
      SDS-polyacrylamide electrophoresis, the Helix-derived eluate displayed two bands
      (68, 37 kDa) and that of Biomphalaria five bands (68, 63, 17.5; 15; 13 kDa). The
      purified material showed only 8% of the total activity of the crude extracts, but
      it could be shown that a phosphatase present in the crude extract can degrade UDP
      formed in the transfer reaction and thus drive the reaction to completion.

PMID- 11192267
TI  - Osmotic and ionic hemolymph concentrations of bathyal and abyssal amphipods of
      Lake Baikal (Siberia) in relation to water depth.
AB  - We studied the adaptive variations of the hemolymph concentrations in relation to
      water depth and pressure using deep-dwelling amphipods from Lake Baikal.
      Hemolymph osmolality was determined in six bathyal and abyssal species
      immediately after capture when values come closest to the habitat concentrations.
      In three species, hemolymph osmolalities correlated positively with depth of
      capture. Prevalent ions in the hemolymph are sodium and chloride. Lactate, our
      indicator for capture stress, was highest after trawling (2-6 mM) and lowest
      after retrieval from cages (0-0.6 mM). Acclimation to different pressure was
      studied by exposing the specimens to different water depths over several days.
      Hemolymph concentrations did not change after acclimation to surface pressure in
      the sublittoral Acanthogammarus albus, a native also to shallow water, but
      decreased by 30-80 mosmol/kg H2O in the bathyal and abyssal species
      Acanthogammarus grewingki, Acanthogammarus reicherti, and Parapallasea lagowskii.
      Similarly, hemolymph osmolality decreased in A. reicherti and P. lagowskii
      originating from deep water, when acclimated to reduced water depth, and, in A.
      reicherti hemolymph osmolality reached its original high value when returned to
      the depth of capture. Higher hemolymph osmolalities and NaCl concentrations,
      demonstrated here for the first time, may provide selective advantages to abyssal
      species.

PMID- 11192268
TI  - The autumnal fattening of the long-distance migratory garden warbler (Sylvia
      borin) is stimulated by intermittent fasting.
AB  - To investigate the proximate influence of a changing food availability on the
      seasonal fattening of migratory birds, garden warblers (Sylvia borin) following
      postnuptial moult were food restricted once a week. Body mass, food intake,
      plasma hormone and metabolite levels were measured and compared to birds which
      always had ad libitum food access. The food-restricted birds increased their body
      mass significantly earlier than the controls. The accelerated fattening was
      initially not accompanied by hyperphagia and may be due to either an increased
      food utilisation efficiency or a reduced metabolic rate. An increase of basal
      glucagon and corticosterone and a decrease of insulin levels prior to fattening
      were not significant, however, they resulted in a significant decrease of the
      insulin:glucagon ratio. This ratio was also lower in food-restricted birds than
      in control birds and may account for the difference in the fattening progress. We
      conclude that seasonal fattening may be stimulated by a catabolic impulse which
      could be imposed in free-living birds by a decrease of food availability and/or
      by an increase of energy expenditure. A negative energy balance is hypothesised
      to be a common proximate factor affecting migratory as well as winter fattening.

PMID- 11192269
TI  - Daily energy expenditure of the grey mouse lemur (Microcebus murinus): a small
      primate that uses torpor.
AB  - We aimed to investigate the pattern of utilisation of torpor and its impact on
      energy budgets in free-living grey mouse lemurs (Microcebus murinus), a small
      nocturnal primate endemic to Madagascar. We measured daily energy expenditure
      (DEE) and water turnover using doubly labelled water, and we used temperature
      sensitive radio collars to measure skin temperature (Tsk) and home range. Our
      results showed that male and female mouse lemurs in the wild enter torpor
      spontaneously over a wide range of ambient temperatures (Ta) during the dry
      season, but not during the rainy season. Mouse lemurs remained torpid between 1.7
      8.9 h with a daily mean of 3.4 h, and their Tsk s fell to a minimum of 18.8
      degrees C. Mean home ranges of mouse lemurs which remained normothermic were
      similar in the rainy and dry season. During the dry season, the mean home range
      of mouse lemurs showing daily torpor was significantly smaller than that of
      animals remaining normothermic. The DEE of M. murinus remaining normothermic in
      the rainy season (122 +/- 65.4 kJ x day(-1)) was about the same of that of
      normothermic mouse lemurs in the dry season (115.5 +/- 27.3 kJ x day(-1)). During
      the dry season, the mean DEE of M. murinus that utilised daily torpor was 103.4
      +/- 32.7 kJ x day(-1) which is not significantly different from the mean DEE of
      animals remaining normothermic. We found that the DEE of mouse lemurs using daily
      torpor was significantly correlated with the mean temperature difference between
      Tsk and Ta (r2 = 0.37) and with torpor bout length (r2 = 0.46), while none of
      these factors explained significant amounts of variation in the DEE of the mouse
      lemurs remaining normothermic. The mean water flux rate of mouse lemurs using
      daily torpor (13.0 +/- 4.1 ml x day(-1)) was significantly lower than that of
      mouse lemurs remaining normothermic (19.4 +/- 3.8 ml x day(-1)), suggesting the
      lemurs conserve water by entering torpor. Thus, this first study on the energy
      budget of free-ranging M. murinus demonstrates that torpor may not only reflect
      its impact on the daily energy demands, but involve wider adaptive implications
      such as water requirements.

PMID- 11192270
TI  - On health inequality.

PMID- 11192271
TI  - Births, gestation and birthweights in South Tees 1990-1996.
AB  - BACKGROUND: The UK government has specified that all health authorities are to
      develop local health improvement programmes. Birthweight and gestational age are
      important health determinants, and therefore indicators of the health status of
      children in a community. They also have important resource implications for
      health and social services. Data regarding birthweight and its relationship to
      gestational age are not routinely available. This paper describes the results of
      the measurement of the birthweights and gestational ages of children born to
      residents in a UK health district, and their relationship with deprivation.
      METHODS: Routinely collected birthweight and gestational age data for children
      born to parents resident in the South Tees district during the period 1990-1996
      inclusive were downloaded from the community child health department mainframe
      computer. The data were analysed and compared with national standards. RESULTS:
      The analysis showed that, despite the high levels of deprivation, birthweights
      were close to or slightly above average for most gestational ages. However, when
      compared with the average district in England and Wales, 8 per cent more low
      birthweight children, of which 42 per cent were less than 28 weeks gestation,
      were born in the area. Materially deprived mothers were more likely to give birth
      to pre-term and light for gestational age infants. CONCLUSIONS: This study has
      shown that it is now possible to use routine sources of information to monitor
      local trends in birthweight and gestation, and their relationship with
      deprivation.

PMID- 11192272
TI  - An audit of clinical nurse practitioner led thrombolysis to improve the treatment
      of acute myocardial infarction.
AB  - BACKGROUND: The aim of the study was to audit the impact of cardiac nurse
      practitioner led thrombolysis as a method of reducing call to needle times for
      acute myocardial infarction (AMI) in a single district hospital. METHODS: This
      was a prospectively planned, observational study, comparing time delay between
      arrival at hospital and the administration of thrombolysis ('door to needle'
      time) in patients presenting with AMI in a district general hospital serving a
      population of 270000. The 6 months before and 6 months after initiation of the
      scheme were compared. RESULTS: There were 151 consecutive patients (undergoing
      163 thrombolysis episodes). The median door to needle time fell from 60 min
      (range 42-110 min) to 30 min (range 20-61 min) (p<0.01). In those patients
      eligible for immediate thrombolysis the number of cases treated within 30 min of
      arrival rose from 10/58 (17 per cent) to 48/64 (75 per cent) (p<0.01). The
      proportion of cases where there was an initial delay as a result of non
      diagnostic ECG or possible contra-indication to therapy remained constant, 20/78
      (25 per cent) cases before and 21/85 (25 per cent) cases after initiation of the
      scheme. The number of cases of inappropriate thrombolysis fell from 73 per cent
      to 30 per cent. CONCLUSION: The provision of i.v. thrombolysis by cardiac nurse
      practitioners is safe and should be considered as a method for achieving
      acceptable door to needle times in the management of acute myocardial infarction.

PMID- 11192273
TI  - An audit of current clinical practice in the management of osteoporosis in
      Nottingham.
AB  - BACKGROUND: Osteoporosis is now recognized by the World Health Organization and
      the Department of Health as a major public health problem. In 1994, the Advisory
      Group on Osteoporosis (AGO), set up by the Department of Health, recommended that
      Health Authorities and general practitioner fundholders should purchase bone
      densitometry services for the management of osteoporosis. The aims of this study
      were to assess the criteria for requests for bone densitometry from primary care
      in comparison with the AGO recommendations and to compare the numbers of patients
      referred with a low-trauma osteoporotic fracture with the expected number of
      fractures in the Nottingham area. METHODS: Patient referral data and requests for
      bone densitometry were collected by case note review of all new patients referred
      to the Nottingham Osteoporosis Clinic over a 12 month period and then compared
      with the AGO recommendations. The patients referred with a history of a low
      trauma fracture were then compared with the expected incidence of fractures,
      calculated using age-sex-specific fracture incidence data applied to the
      Nottingham population Census statistics. RESULTS: A total of 413 patients were
      referred to the Osteoporosis Clinic for bone densitometry. Almost two-thirds of
      the patients had no clinical indicators for requests for scanning, in comparison
      with the AGO recommendations. Seventy-seven patients were referred with vertebral
      fracture, 12 hip, 20 colles and 26 other fractures. Using age-sex-specific
      fracture incidence data applied to the Nottingham population Census statistics,
      it was estimated that the expected incidence of hip fractures would be 812,
      distal forearm fractures 514 and vertebral fractures presenting to clinical
      attention 625. This represents 1.5 per cent of the total hip fractures, 3.9 per
      cent distal forearm and 12.3 per cent vertebral actually presenting to the
      Osteoporosis Clinic. CONCLUSION: Bone densitometry was requested in up to 60 per
      cent of the patients with no clinical risk factors to warrant bone densitometry.
      Osteoporosis-related fractures remain unrecognized in clinical practice. The
      majority of patients do not receive specialist assessment despite being at high
      risk of future fracture. Further steps are necessary to educate health care
      professionals in primary and secondary care, but more importantly, to direct
      services more proactively in those at high risk of future fracture.

PMID- 11192274
TI  - Assessment of parents' concerns and evaluation of outcomes.
AB  - BACKGROUND: Clinical and service evaluation often fails to accommodate
      sufficiently to parental perspectives and priorities concerning health
      interventions. Although parent satisfaction questionnaires are widely used, these
      assess issues chosen by the researcher. Quality of life research methods,
      however, can assess individual priorities. METHODS: A Schedule for Evaluation of
      Quality of Life was adapted to record the nature, and relative importance of
      parental concerns about their child before child psychiatric hospital admission.
      Level of concern or worry was assessed pre- and post-admission, and at 1 year
      follow-up, with a waiting-list control. Data were analysed qualitatively and
      quantitatively for individuals and groups of cases. RESULTS: The adapted
      instrument was feasible and clinically useful. It did not show repeated
      measurement effects but was sensitive to the effects of intervention (hospital
      admission). Effects (reduction in levels of concern) remained evident at 1 year
      follow-up. CONCLUSION: The instrument is brief, non-intrusive, and sensitive to
      change. It has utility for clinical case evaluation. It may complement
      satisfaction questionnaires, and has advantages over rating scales for the
      evaluation of treatment outcomes.

PMID- 11192275
TI  - Twenty year follow-up of a cohort based in general practices in 24 British towns.
AB  - BACKGROUND: A national prospective study of cardiovascular disease (CVD) was set
      up in 1978 to explain the reasons for the marked geographical variation in CVD
      rates in Great Britain. A total of 7735 males, aged 40-59 years (born between
      1919 and 1939) randomly selected from one general practice age-sex register in
      each of 24 towns, responded to a screening invitation from their general
      practitioner (GP) and were examined in 1978-1980. We describe the methods used
      and the contact maintained after following a cohort for 20 years. METHODS: The
      established system of patient registration with a GP was used for tracing and
      maintaining contact with a low-mobility cohort through local area health
      authority networks and the National Health Service Central Register. RESULTS: By
      31 December 1997, there were 1856 recorded deaths (14 known to have occurred
      abroad), 66 emigrations/ living overseas/lost from follow-up. In addition, 1500
      study subjects had registered with new GPs who, every 2 years, provided
      information on both fatal and non-fatal cardiovascular events to complement
      information supplied by the original practices. Information was obtained on all
      cardiovascular events and deaths for 99.5 per cent of the surviving sample.
      Questionnaires mailed to surviving subjects 5 years after recruitment (1983-1985)
      and again in November 1992 and 1996 were returned by 98, 90 and 88 per cent,
      respectively, providing information on lifestyle changes, new cardiovascular
      symptoms and new diagnoses. CONCLUSION: Using the NHSCR framework for primary
      care registration procedures, maximum follow-up has been maintained. Brief and
      structured enquiry forms have gained and maintained co-operation from subjects
      and their GPs with considerable success. Mortality reporting from dual sources
      identified 5 per cent more cases.

PMID- 11192276
TI  - Democratic prioritization of maternity care: a rational basis for planning a
      clinical effectiveness programme.
AB  - BACKGROUND: The aim of the study was to evaluate the use of a democratic process
      for prioritizing the ASQUAM (Achieving Sustainable Quality in Maternity) clinical
      effectiveness programme. METHODS: Twenty-two improvements in the standards of
      maternity care were chosen as top-topic priorities at the 1996 and 1997 ASQUAM
      meetings. We wished to assess the relative priorities of local and national
      delegates, by comparing their voting patterns at the two meetings. The setting
      was North Staffordshire ASQUAM prioritization days, and the subjects were all the
      delegates at the 1996 and 1997 ASQUAM meetings. Main outcome measures were
      comparison of numbers of votes cast by local and national delegates for each of
      the 20 topics presented at the two ASQUAM meetings, and proportions of the 11 top
      topics decided at each meeting that were chosen by local and national delegates.
      RESULTS: In 1996, significantly more local than national delegates voted for two
      topics related to maternal mortality or morbidity (incontinence and hypertensive
      diseases of pregnancy), but there were no statistically significant differences
      between the proportions of votes cast for any of the other 18 topics presented on
      the day. Indeed, local delegates had prioritized 11/11 of the final top-topics,
      and only one was omitted by the national delegates (10/11). In 1997,
      significantly more national than local delegates voted for three topics relating
      to professional stress levels, user involvement in working groups and antibiotic
      prophylaxis, but there were no statistically significant differences between the
      proportions of votes cast for any of the other 17 topics presented on the day.
      Again, local delegates had prioritized 11/11 of the final topics, with only one
      being omitted by the national delegates (10/11). CONCLUSION: There appeared to be
      a remarkable concordance between local and national delegates at both meetings,
      suggesting an underlying rationality to decision making. We believe this to be a
      reflection of the process of careful evaluation of outcome and intervention
      supported by the protection of a secret ballot, allowing free expression of
      individual's values.

PMID- 11192277
TI  - The health of students in institutes of higher education: an important and
      neglected public health problem?
AB  - BACKGROUND: A survey of students in three UK higher education establishments was
      undertaken to obtain information about students' physical and emotional well
      being, their attitudes to, and beliefs about health, and the prevalence of risk
      factors for future ill health. METHODS: Health was measured by the prevalence of
      longstanding illness and by the SF-36 health status measurement tool. Survey
      results were compared with equivalent data for 18- to 34-year-olds in the local
      population. The prevalence of long-standing illness was also compared with two
      national surveys. RESULTS: The survey achieved a 49 per cent response rate. More
      than one-third of respondents reported a long-standing illness, a higher
      prevalence than in all comparison surveys. Students scored significantly worse
      than their peers in the local population on all eight SF-36 dimensions. The
      greatest difference was for role limitations as a result of emotional problems.
      The main sources of emotional distress were study or work problems and money.
      CONCLUSION: The poor response rate in this survey dictates the need for caution
      in interpretation of the results. However, they suggest that the health of
      students is poor relative to that of their peers, and that their emotional health
      is more of a problem than their physical health. Public health practitioners
      might want to pay more attention to the health of this important and relatively
      neglected group. Worries about studies and money appear to be affecting students'
      academic work, and this should be of concern to higher education establishments.

PMID- 11192278
TI  - The effects of neonatal screening for sickle cell disorders on lifetime treatment
      costs and early deaths avoided: a modelling approach.
AB  - BACKGROUND: The aim of the study was to calculate the cost to the UK National
      Health Service of providing treatment services for patients with sickle cell
      disorders. The rates of differential morbidity and mortality, in the first 10
      years of life, between screen-detected early diagnosed and clinically presenting
      late diagnosed cohorts of sickle cell disorder patients are also estimated.
      METHOD: A cost model was developed, based on predictions of survival and the
      incidence of sickle cell disorder-related events. Direct data from the NHS are
      lacking, so data were incorporated from disparate sources. Patients with sickle
      cell disorders were divided into two categories: those with sickle cell anaemia
      and those with sickle HbC disease. RESULTS: Differentiating between sickle cell
      anaemia and sickle HbC disorder patients, the results show that the undiscounted
      (discounted at 6 per cent) lifetime treatment costs range from pound sterling
      92323 (pound sterling 24917) to pound sterling 185614 (pound sterling 53861). The
      number of early deaths avoided per 100 births, as a result of early diagnosis
      through screening, ranges from 0.57 to 1.25. CONCLUSIONS: The resulting estimates
      may act as a guide to those involved in the planning of health care provision
      with regard to the resources required to treat sickle cell disorder patients.
      Such information may also be incorporated into the evaluation of both antenatal
      and neonatal screening programmes for sickle cell disorders.

PMID- 11192279
TI  - Effective management of the elderly hearing impaired--a review.
AB  - In the United Kingdom, two and a half million people over 70 are thought to have
      hearing impairment that would benefit from an aid. Only one-third of these will
      possess one, and as many as 10 per cent probably never use their aid. Although it
      is important to examine the relative merits of different aids, there is also a
      need to look at how audiological services may reduce the unmet need that results
      from underuse of aids. This review examines the important question of 'what is
      the most effective way of providing hearing aids for the elderly affected by
      presbyacusis?' Extensive searching of four electronic databases and hand
      searching of relevant journals revealed the paucity of evidence to guide
      audiology practice. In particular there is little consensus on the best outcome
      measures for evaluating audiological rehabilitation or hearing aid fitting.
      Audiological services for the elderly are another example of an area where there
      is a need to fund research and development rather than continue to commission
      services that are variable and poorly evaluated.

PMID- 11192280
TI  - The Global Burden of Disease Study: a useful projection of future global health?
AB  - One major conclusion of the Global Burden of Disease Study (GBDS) is that the
      global burden of disease will not change significantly from 1990 to 2020, in
      developed regions, developing regions or as a whole. Using the disability
      adjusted life year (DALY), the Study estimates the burden as a result of 107
      diseases, accidents and their disabling sequelae, disaggregated with respect to
      cause, sex, age and geographical region. The basic data used to construct
      estimates are sparse, and the DALY as a tool has received many criticisms. It
      obscures the distribution of disease and its impact in terms of handicap, and
      includes several social and economic value judgements. This weakens its power as
      a guide for the rational allocation of health resources at any point in time.
      Does it have use in guiding future planning and preventive action? At a global
      level, exceeding ecological capacity primarily through relative overpopulation is
      likely to be the greatest threat to overall health, yet overpopulation is not
      considered as a risk factor in itself. This reflects the understanding of health
      as an issue of the individual rather than the community. Together with the
      productivity-orientated weighting of DALYs, the Study appears to be more
      concerned with cost-effectiveness of health interventions rather than their
      equity. This underlies the reservations of the World Health Organization
      regarding the Study's use as a rational tool in health policy.

PMID- 11192281
TI  - Contamination of allotment soil with lead: managing potential risks to health.
AB  - BACKGROUND: In the context of contaminated land, assessing risk involves
      identifying a source, a pathway and a receptor. We describe how this approach
      worked in practice following the discovery of high lead levels in the soil of an
      allotment site in a London borough. METHODS: Soil and produce analyses were
      undertaken. A worst-case scenario was constructed to estimate the maximum
      potential lead intake by consumers. A questionnaire survey was undertaken of
      individuals who either worked on the allotment or ate significant amounts of
      produce grown on it. They were also offered blood lead tests. RESULTS: High lead
      levels were found in soil and produce. The worst-case assessment showed that the
      estimated lead intake by a hypothetical consumer of allotment produce exceeded
      the provisional tolerable weekly intake almost 10-fold. Further tests on produce
      indicated that soil contamination had contributed to the high lead levels. The
      questionnaire survey did not reveal any chronic illness related to lead exposure.
      Of the five tested, none had raised blood lead levels. CONCLUSIONS: A decision
      was made to remediate the site. Pending this, we advised the allotment holders
      not to cultivate the land or eat any produce grown on it as we could not be sure
      that preparation of the produce before consumption would remove all adherent lead
      contaminated soil, and continued cultivation could also expose them to lead in
      the soil dust.

PMID- 11192282
TI  - Screening for HIV, HBV and HCV markers among drug users in treatment in rural
      south-east England.
AB  - BACKGROUND: This study was designed as an opportunistic screening to estimate the
      prevalence of blood-borne viral infection among drug users in treatment in the
      rural population and to investigate related risk factors and use of general
      health services. METHODS: A total of 102 patients aged 18 years and over (78
      male, 24 female) with problematic self-reported drug use, recruited between 1
      February 1996 and 31 January 1997, in a mixed urban-rural population in south
      east England, were interviewed for information on socio-demographic status, drug
      use history, HIV-related risk behaviours, hepatitis B vaccination, general
      practice consultations, and use of A&E departments and medical out-patient
      clinics. Diagnostic testing was offered to all patients for anti-HIV-1, anti-HBc,
      HBsAg and anti-HCV. RESULTS: The mean age at onset of illicit drug use for the
      entire sample was 15.33 (SD 3.36) years; 3.7 per cent (1/27), 20.4 per cent
      (18/88), and 55.8 per cent (48/86) had antibodies to HIV-1, HBc and HCV,
      respectively; 1.1 per cent (1/88) tested positive for HBsAg indicative of a
      carrier state. All 18 patients anti-HBc seropositive were male (p = 0.009). There
      was no gender difference for anti-HCV serological status. The proportion of town
      residents and village dwellers seropositive for anti-HBc and anti-HCV did not
      differ significantly. Patient's age at interview, age at onset of opioid use and
      duration of opioid use showed a significant association with anti-HBc and anti
      HCV serological status. The proportion directly sharing injecting equipment was
      too small for rigorous statistical analysis; however, indirect sharing involving
      cooking equipment and frontloading rituals achieved statistical significance.
      Anti-HBc serological status showed a significant association with vaginal
      intercourse without a condom (p = 0.03); none of the sexual risk behaviour
      variables revealed any significant association with HCV infection. Although only
      one-third of the sample consented to HIV antibody test, consenting and non
      consenting groups did not differ significantly except on one variable: having a
      drug-using sexual partner (chi2 = 5.6167; p = 0.017). Serum aspartate amino
      transferase and gamma-glutamyl transpeptidase concentrations were raised above
      the upper limit in 23 (25.7 per cent) of the 89 patients who gave blood
      specimens; 41.2 per cent (42/102) were referred to treatment by their general
      practitioners. There was no significant relationship between HBV and HCV
      serological status and general practice consultations. Only eight (7.8 per cent)
      had received hepatitis B vaccination, and although 48 (47.1 per cent) had in the
      preceding 12 months used A&E departments, only seven (6.2 per cent) had been seen
      in medical out-patient clinics. CONCLUSION: In this study the prevalence of HIV,
      HBV and HCV in the rural population is as high as has been reported for inner
      cities. The poor uptake of hepatitis B vaccination among drug users, their poor
      response to HIV antibody test and poor health service utilization suggest the
      need for an urgent appraisal of service provision and a review of prevention and
      treatment strategies.

PMID- 11192283
TI  - STDs aren't sexy: health professionals' lack of adherence to clinical guidelines
      in an area of high STD endemicity.
AB  - BACKGROUND: In 1997 the Health Department of Western Australia distributed
      clinical guidelines aimed at improving the outcomes of care of patients with
      STDs. In recognition of the high STD rates and issues peculiar to the Kimberley
      region, a Kimberley Supplement was inserted into copies distributed in the
      region. Since then, annual STD workshops have been conducted for all Kimberley
      health professionals involved in any aspect of STD management. This study aimed
      to assess whether health professionals were observing the Guidelines and its
      Kimberley Supplement, and whether adherence improved after the 1998 Kimberley STD
      workshop tour. METHODS: Over two periods, pre- and post-STD workshops, all
      pathology request forms for gonorrhoea and chlamydia tests were collected from
      all laboratories in the region. The outcomes of interest were which of the
      recommended tests had been requested. Logistic regression was used to analyse
      associations between adherence to the Guidelines and patient's age, sex and
      postcode, profession of practitioner, reason for testing and whether the test was
      performed pre- or post-STD workshops. RESULTS: Minimum appropriate tests were
      ordered on only 14.5 per cent (98/676) of request forms. Univariate and
      multivariate analyses showed that minimum appropriate testing was more likely to
      have been requested on male patients and if the practitioner was a doctor. No
      improvement was observed after the STD workshops. CONCLUSION: The poor adherence
      and lack of improvement observed can be explained by Kotter's framework on why
      transformation efforts fail. This study demonstrates that clinical guidelines are
      of little value unless they are continuously evaluated.

PMID- 11192284
TI  - Quarterly communicable disease review: April to June 2000--from the PHLS
      Communicable Disease Surveillance Centre.

PMID- 11192285
TI  - Pollution from chrome waste.

PMID- 11192286
TI  - A live attenuated West Nile virus strain as a potential veterinary vaccine.
AB  - This article reviews the development of two attenuated West Nile virus (WNV)
      variants, WNI-25 and WNI-25A. These variants have lost the neuroinvasion trait of
      the parental virus. Attenuation was achieved through serial passages in mosquito
      cells and neutralization escape from WNV-specific monoclonal antibody. Genetic
      analysis reveals amino acid changes between the parental and each of the
      variants. The attenuated variants preserve the ability to replicate in mice and
      geese and to induce a protective immune response. WNI-25A was found to be a
      genetically stable virus. This variant was successfully used as a live vaccine to
      protect geese against a wild-type virulent WNV field isolate that closely
      resembles the WNV isolated during the 1999 New York epidemic.

PMID- 11192287
TI  - West Nile virus in the New World: appearance, persistence, and adaptation to a
      new econiche--an opportunity taken.

PMID- 11192288
TI  - European experience with the West Nile virus ecology and epidemiology: could it
      be relevant for the New World?
AB  - A review of West Nile virus (WNV) and the epidemiology of West Nile fever (WNF)
      in Europe is presented. European epidemics of WNF reveal some general features.
      They usually burst out with full strength in the first year, but few cases are
      observed in the consecutive 1 to 2 (exceptionally 3) years, whereas smaller
      epidemics or clusters of cases only last for one season. The outbreaks are
      associated with high populations of mosquitoes (especially Culex spp.) caused by
      flooding and subsequent dry and warm weather, or formation of suitable larval
      breeding habitats. Urban WNF outbreaks associated with Culex pipiens biotype
      molestus are dangerous. Natural (exoanthropic, sylvatic) foci of WNV
      characterized by the wild bird-ornithophilic mosquito cycle probably occur in
      many wetlands of climatically warm and some temperate parts of Europe; these foci
      remain silent but could activate under circumstances supporting an enhanced virus
      circulation due to appropriate abiotic (weather) and biotic (increased
      populations of vector mosquitoes and susceptible avian hosts) factors. It is very
      probable that WNV strains are transported between sub-Saharan Africa and Europe
      by migratory birds. The surveillance system for WNF should consist of four main
      components: (1) monitoring of mosquito populations and their infection rate; (2)
      wild vertebrate surveys; (3) sentinel birds (domestic ducks rather than
      chickens); and (4) monitoring of human disease. In the case of persisting high
      risk of WNF for humans and equids in certain enzootic areas, immunization against
      WNF should be considered. For that purpose a commercially available, cross
      protective vaccine against Japanese encephalitis could be used.

PMID- 11192289
TI  - West Nile virus investigations in South Moravia, Czechland.
AB  - Seven virus isolates were obtained from 11,334 mosquitoes after the 1997 Morava
      River flooding in South Moravia (Czech Republic): 6 strains of Tahyna bunyavirus,
      California antigenic group (5 from Aedes vexans, 1 from Ae. cinereus), and 1
      strain of West Nile flavivirus (WNV) from Culex pipiens. In 1999, one isolate of
      Tahyna virus from Ae. vexans and one isolate of WNV from Cx. pipiens were
      recovered from a total of 14,354 mosquitoes examined in the same area, whereas no
      virus was detected there in 1,179 overwintering mosquitoes (mostly Cx. pipiens)
      in March 2000. The infection rate of mosquitoes with arboviruses was
      significantly higher in 1997, the year of the flood and an enormously high
      population density of mosquitoes. Antibodies neutralizing WNV were detected in 13
      of 619 (2.1%) hospitalized patients or persons seeking outpatient clinics of the
      area in 1997. Five of the seroreactors revealed clinical symptoms compatible with
      West Nile fever: in 2 of them (children), recent infection with WNV was confirmed
      by a significant increase of antibody titer between acute and convalescent serum
      samples.

PMID- 11192290
TI  - Discovery and molecular characterization of West Nile virus NY 1999.

PMID- 11192291
TI  - The emergence of West Nile virus: the Australian connection.

PMID- 11192292
TI  - West Nile virus in New York State: the 1999 outbreak and response plan for 2000.

PMID- 11192293
TI  - West Nile virus in the United States: guidelines for detection, prevention, and
      control.
AB  - The epidemic/epizootic of West Nile (WN) encephalitis in the northeastern United
      States in the summer and fall of 1999 was an unprecedented event, underscoring
      the ease with which emerging infectious pathogens can be introduced into new
      geographic areas in today's era of rapid transportation and increased movement of
      people, animals, and commodities. This epidemic/epizootic and the increased
      frequency of other exotic pathogens being imported into the United States raises
      the issue of whether local, state, and national public health agencies are
      prepared to deal with epidemics/epizootics of vector-borne infectious diseases.
      The overwintering of WN virus and the epizootic transmission in the summer of
      2000 reinforces the need to rebuild the public health infrastructure to deal with
      vector-borne diseases in this country. This article summarizes guidelines for
      surveillance, prevention, and control of WN virus that were drafted in December
      1999 to help prepare state and local health departments for monitoring WN virus
      activity in the spring and summer of 2000 and also summarizes the data collected
      from those surveillance systems through September 2000.

PMID- 11192294
TI  - Innate and acquired immunity at mucosal surfaces.

PMID- 11192295
TI  - CD8+ cell lines isolated from HIV-1-infected children have potent soluble HIV-1
      inhibitory activity that differs from beta-chemokines.
AB  - CD8+ cells from human immunodeficiency virus type 1 (HIV-1) infected individuals
      have been shown to suppress HIV-1 replication both through a major
      histocompatibility complex (MHC)-restricted cytolytic pathway as well as through
      a noncytolytic pathway mediated through soluble factors. To characterize this
      soluble activity and its potential role in disease progression further, we
      studied the HIV-1 inhibition by supernatants derived from herpesvirus saimiri
      transformed CD8+ cells isolated from infected children. Three of the six CD8+
      cell lines derived had a phenotype consistent with an unusual natural killer (NK)
      cells phenotype with low CD3, high CD56, and low CD16. Supernatants from some of
      the cell lines derived from children with rapid progression as well as long-term
      nonprogressors exhibited broad HIV-1-inhibitory activity in primary CD4+ cells as
      well as in primary macrophages. In contrast to a cocktail of beta-chemokines, the
      supernatants inhibited T-tropic as well as M-tropic viruses, efficiently
      inhibited infection in primary macrophages, and inhibited HIV-1 activation in the
      chronically infected U1 cell line. The HIV-1-inhibitory activity was heat stable
      and active over a broad pH range. Fractionation of the supernatant by size and
      ion exchange chromatography demonstrated activity in the complete absence of
      RANTES as well as interferons-alpha, beta, and gamma and in a size range of less
      than 10 kD and greater than 3 kD. CD8+ cell supernatants contain additional
      unidentified factors that have anti-HIV activity to account for this broad
      phenomenon.

PMID- 11192296
TI  - Altered prevalence and reactivity of anti-Epstein-Barr virus antibodies in
      patients with multiple sclerosis.
AB  - In this study, the prevalence and reactivity of anti-Epstein-Barr virus (EBV)
      antibodies were investigated in 107 patients with multiple sclerosis (MS) in
      comparison to age- and gender-matched healthy controls from a north German state.
      We found a significant 100% EBV-seropositivity and a significant lack of primary
      EBV infections in the MS group, indicating that all MS patients are infected with
      EBV before the development of MS. Although there were no differences in
      reactivities of EBV-specific anti-early antigen (EA)-immunoglobulin G (IgG), 
      IgM, and -IgA antibodies between each group, MS patients had significant lower
      anti-Epstein-Barr nuclear antigen (EBNA)1-IgG antibody titers as a possible
      serological sign for a defective control of the persistent latent EBV carrier
      state and EBV reactivations. Longitudinal studies of MS patients are necessary to
      further determine the implications of EBV reactivations on the course and disease
      activity of MS.

PMID- 11192297
TI  - QS-21 synergizes with recombinant interleukin-12 to create a potent adjuvant
      formulation for the fusion protein of respiratory syncytial virus.
AB  - In the murine model of respiratory syncytial virus (RSV) infection, recombinant
      interleukin-12 (rIL-12) was previously demonstrated to be most effective as an
      adjuvant for fusion (F) protein-based vaccines after adsorption to alum adjuvant.
      Alum, however, is a potent inducer of polarized T-cell responses and the type 2
      phenotype. In addition, studies in human cancer patients demonstrated that rIL-12
      was toxic when administered systemically at high doses. Because of these issues,
      we investigated whether the saponin QS-21 could facilitate a reduction in dose of
      rIL-12 when F protein was prepared in the absence of alum (F/rIL-12). The results
      demonstrated that a suboptimal dose (0.8 microg) of QS-21 enhanced the capacity
      of F/rIL-2 to elicit antigen-dependent killer cell precursors and complement
      assisted neutralizing antibodies in spleens and sera respectively of BALB/c mice.
      The killer cell activity of mice vaccinated with F/rIL-12 (0.1 microg) plus 0.8
      microg QS-21 was equivalent to that elicited after vaccination by experimental
      infection, or with an optimal dose of QS-21. The neutralizing titers generated by
      F/rIL-12 (0.01 to 1.0 microg) were also significantly elevated in the presence of
      0.8 microg QS-21. Thus, rIL-12 and QS-21 together form a potent adjuvant for
      eliciting functional cell-mediated and humoral immune responses against F
      protein.

PMID- 11192298
TI  - Cytolytic function for pseudorabies virus-stimulated porcine CD4+ CD8dull+
      lymphocytes.
AB  - We previously observed that pseudorabies (PRV) virus-specific killing in vitro
      was mediated by CD6+ CD8+ lymphocytes. Also a high percentage of CD4+
      lymphocytes, among these CD6+ CD8+ lymphocytes, was observed. The purpose of this
      study was, therefore, to further characterize the killing ability of PRV
      stimulated CD4+ CD8+ lymphocytes. Peripheral blood mononuclear cells (PBMC) were
      isolated from blood of PRV-immune pigs and were stimulated in vitro with PRV.
      After 6 days, the frequency of CD4+ CD8+ lymphocytes in peripheral blood was
      determined by flow cytometry analyses. Lymphocytes were separated using a magnet
      activated cell sorter or a FACSVantage SE, and the cytolytic activity of the
      isolated populations was determined. Flow cytometry analyses demonstrated that
      PRV stimulation of immune PBMC resulted in the occurrence of 26% +/- 4% CD4+
      CD8dull+ lymphocytes. We further demonstrated that killing by PRV-stimulated PBMC
      was mediated by CD4+ CD8dull+ T lymphocytes and CD4- CD8+ T lymphocytes (classic
      cytolytic T lymphocytes and natural killer cells). The CD4+ CD8dull+ T
      lymphocytes showed major histocompatibility complex (MHC) II-restricted PRV
      specific killing. The CD4- CD8+ T lymphocytes showed both PRV-specific and
      natural killing. The CD4+ CD8dull+ lymphocytes, which are unique in the pig,
      seemed to have a more heterogeneous function than was earlier demonstrated. In
      conclusion, we demonstrated that PRV-specific CD4+ CD8dull+ lymphocytes are able
      to kill PRV-infected target cells in a MHC II-restricted manner.

PMID- 11192299
TI  - Immunological responses in patients who have spontaneously eradicated hepatitis C
      virus infection.
AB  - We examined the proliferative responses of peripheral blood mononuclear cells
      obtained from 60 untreated patients who were seropositive by enzyme immunoassay,
      but negative for hepatitis C virus (HCV) RNA by reverse transcriptase-polymerase
      chain reaction (RT-PCR). We used second- and third-generation recombinant
      immunoblot assay (RIBA) for further serological characterization. In vitro HCV
      specific proliferative responses of mononuclear cells were compared to those of
      both untreated chronic HCV patients and patients who showed sustained virological
      response to interferon-alpha monotherapy, in order to assess the relative
      contribution of the immune response to the eradication of HCV. We found that
      frequency of responses to nonstructural proteins showed statistically significant
      differences, which were attributable to vigorous, polyspecific responses by cells
      from the RIBA-positive patients. In this group, core-specific proliferation was
      significantly associated with intravenous drug use as route of acquisition. Both
      other patient groups and the RIBA-indeterminate patients showed indistinguishable
      frequencies of proliferative responses. No association was detected between
      residual humoral responses, as determined from the RIBA results, and elapsed time
      since infection. The frequency of antibodies to NS5 differs between spontaneous
      cure and chronically infected patients. Cell-mediated and humoral immunity appear
      to be maintained in this population of patients.

PMID- 11192300
TI  - An immunodominant, cross-reactive B-cell epitope region is located at the C
      terminal part of the hamster polyomavirus major capsid protein VP1.
AB  - The VP1 represents the major capsid protein of the hamster polyomavirus (HaPV).
      Here we describe the mapping of epitopes along the VP1 using Escherichia coli
      expressed VP1-dihydrofolate reductase (DHFR) fusion proteins and PepScan
      analysis. By use of DHFR fusion proteins an immunodominant region was localized
      in the C-terminal part of VP1 between amino acids 320-384. Further epitopes are
      located in the regions amino acids 1-133 and amino acids 133-320, respectively.
      There were no obvious differences in the reactivity between sera of tumor-bearing
      and papilloma-free naturally HaPV-infected hamsters. In contrast, PepScan
      analysis revealed linear epitopes in the regions amino acids 79-97 and amino
      acids 353-367 for tumor-bearing animals and amino acids 101-113 and amino acids
      165-179 for papilloma-free animals. The region between amino acids 320-384 of
      HaPV-VP1 was found to be involved in cross-reactivity of VP1 from HaPV and other
      polyomaviruses. Previously we have demonstrated that heterologous expression of
      HaPV-VP1 allowed the formation of virus-like particles (VLPs). From epitope
      mapping data and structural predictions it has been suggested that HaPV-VP1-VLPs
      may tolerate foreign peptides in the region amino acids 81-88 and the C-terminal
      part of VP1.

PMID- 11192301
TI  - Short synthetic peptides derived from viral proteins compete with HIV gp120 for
      the binding to CD4 receptors.
AB  - In the complex mechanism of adhesion, internalization, and infection of cells by
      human immunodeficiency virus (HIV) viral particles, a determinant role is played
      by the viral envelope glycoprotein gp120, which binds to CD4 receptors of T cells
      and monocytes. We tested the ability of a panel of 7- to 12-residue synthetic
      peptides, selected from the region 414-434 of the HIV-1 gp120, to inhibit the
      binding of the viral protein to CD4 receptors of cultured human lymphoid cells.
      The assay was based on the observation that the binding of gp120 to the receptors
      interferes with the binding of a specific anti-CD4 monoclonal antibody, as a
      result of the masking of the antibody epitope; thus, we tested whether
      preincubation of cells with the peptides before gp120 addition might restore the
      recognition of the CD4 molecule by the antibody. High expression of CD4 receptors
      was thus assumed as indication that the binding of the viral protein had been
      inhibited. Maximum activity was displayed by a 9-residue peptide located near the
      amino terminal end of the 414-434 fragment. In addition, several fragments
      deduced from other viral proteins, possessing partial amino acid sequence
      homology with the HIV gp120 fragment, exhibited a similar type of interaction
      with the CD4 receptor. All active peptides contain the Cys residue (position 423
      of gp120). This residue is essential, although not sufficient, for inhibiting
      gp120 binding, as few other amino acid residues within the fragment play a
      complementary role in increasing or decreasing the inhibitory ability.

PMID- 11192302
TI  - Five-year clinical experience with Abiomed BVS 5000 as a ventricular assist
      device for cardiac failure.
AB  - Mechanical support for the failing heart has interested and challenged cardiac
      specialists for decades. In the United States alone, there are close to 375,000
      cardiac surgical procedures performed each year, and, despite the recent advances
      in myocardial protection, surgical techniques, intra-aortic balloon therapy and
      maximal pharmacological support, postoperative ventricular dysfunction continues
      to occur in 0.5-1.0% of all patients undergoing cardiac surgery. This
      retrospective review describes our 5-year clinical experience at the Brigham and
      Women's Hospital with the Abiomed BVS 5000 as a means of ventricular support.
      During the period of 1994 to present, 7,428 cardiac surgical operations were
      performed at our institution. The Abiomed BVS 5000 has been implanted in 47
      patients exhibiting ventricular failure. There were 38 patients in the bridge-to
      recovery group and nine patients in the bridge-to-transplantation group. Twenty
      five patients (66%) in the bridge-to-recovery group were weaned and 16 patients
      (42%) went on to discharge. In the bridge-to-transplantation group, one patient
      actually recovered myocardial function and one expired on the device. The
      remaining seven patients (77%) underwent cardiac transplantation with post
      transplant survival at 66%. Overall, patients were supported in the isolated left
      ventricular mode (28%), in the biventricular mode (45%) and in the isolated right
      ventricular mode (28%). The Abiomed BVS 5000 has been shown to be a safe and
      simple cardiac support system with no mechanical failure. Our experience shows
      that a substantial number of patients suffering from ventricular failure will
      benefit from the use of this device. The results also justify the use of this
      device in groups of patients other that of postcardiotomy ventricular failure.

PMID- 11192303
TI  - Significant reduction of air microbubbles with the dynamic bubble trap during
      cardiopulmonary bypass.
AB  - Air microbubbles mostly occur unnoticed during cardiopulmonary bypass and are
      predominantly responsible for serious postoperative psychoneurological
      dysfunction. A dynamic bubble trap (DBT), which removes air microbubbles from the
      arterial blood, was tested in a clinical study. The aim was to evaluate the
      efficiency of microbubble removal under clinical conditions. As blood passes
      through the DBT, which is placed in the arterial line between the arterial filter
      and arterial cannula, it is converted into a rotating stream. The bubbles are
      directed to the centre of the blood flow and are collected in the distal end of
      the DBT, from where they are returned to the cardiotomy reservoir. Doppler
      ultrasonography was used to detect the microbubbles before and after the DBT, and
      also the number of high-intensity transient signals (HITS) in the right and left
      middle cerebral artery during extracorporeal circulation. A significant reduction
      of microbubbles in the arterial line (3,990 before DBT, 537 after, p < 0.001) and
      HITS in the brain (51 in the DBT group, 77 in the placebo group, p = 0.04) was
      measured.

PMID- 11192304
TI  - Inflammo-coagulatory response, extrinsic pathway thrombin generation and a new
      theory of activated clotting time interpretation.
AB  - When blood is subjected to contact with foreign surfaces, as during
      cardiopulmonary bypass (CPB), the whole body inflammatory response is initiated,
      resulting in the expression of procoagulant molecules on the vascular endothelium
      and white blood cells. These surface bound procoagulants participate in the
      extrinsic coagulation pathway. It appears that the primary source of thrombin
      generation during CPB is due to extrinsic pathway activation. Thrombin not only
      converts fibrinogen to fibrin, it also acts as a proinflammatory agent resulting
      in a positive feedback loop or the inflammo-coagulatory response. Extrinsic
      pathway thrombin generation occurs as a membrane bound event. Membrane bound
      factors are resistant to heparin/ATIII inhibition. Therefore, the anticoagulant
      effect of heparin/ATIII is due to thrombin inhibition, not the inhibition of
      thrombin generation. Interpretation of the activated clotting time (ACT) must
      take into account the thrombin concentration [T]; this results in the coagulatory
      ratio, ACT is proportional to ([Hep -ATIII]/[T]). Considering this
      proportionality, it can be seen that the ACT cannot be used to quantitate heparin
      concentration. Changes in the ACT can reflect changes in [Hep - ATIII], changes
      in [T], or changes in both concentrations. Anti-inflammatory agents which
      suppress or inhibit the extrinsic pathway, such as aprotinin, result in decreased
      thrombin generation. As thrombin generation decreases, the ACT-heparin dose
      response curve is warped, resulting in a dose response curve resembling a PTT
      heparin dose response curve. We can no longer assume that the disproportionate
      rise in the ACT relative to the [HEP - ATIII] when aprotinin is used as
      indicative of failure of the ACT to provide a credible indication of
      anticoagulation.

PMID- 11192305
TI  - Does heparin pretreatment affect the haemostatic system during and after
      cardiopulmonary bypass?
AB  - In this clinical pilot study, the influence of heparin pretreatment on the
      haemostatic system during and after cardiopulmonary bypass (CPB) was
      investigated. Thirteen patients scheduled for elective coronary artery bypass
      grafting (CABG) were divided into two groups: heparin pretreated (HP, n = 6) and
      non-heparin pretreated (NHP, n = 7). Blood samples were taken for measurements of
      plasma antithrombin-III (AT-III) activity, plasma heparin levels, activated
      clotting time with (HACT) and without (ACT) heparinase, whole blood platelet
      function, platelet count, thrombin-antithrombin-III complexes and D-dimer levels.
      Also, the mediastinal blood loss within the initial 20 h after surgery, and the
      blood transfusion requirements were monitored. The mean duration of the heparin
      pretreatment was 55 h (range 24-161 h). There was no significant difference in
      plasma AT-III activity and platelet count between the groups. Before and after
      CPB, the platelet responsiveness was better in the NHP group (p < 0.05). The HACT
      was prolonged in the NHP group during and after CPB compared to baseline values
      (p < 0.05), whereas, in the HP group, no significant changes were found. Plasma
      heparin levels and ACT values suggested adequate anticoagulation during CPB.
      However, the extent of thrombin inhibition and fibrinolysis increased with time
      on CPB, but did not differ between the two groups. Twenty hours after surgery,
      the thrombin inhibition showed to be significantly higher in the NHP group.
      Furthermore, mediastinal blood loss showed a tendency to be lower in the HP group
      (p = 0.08). However, there was no difference in blood transfusion requirements
      between the groups. These data suggest that short-term heparin pretreatment
      affects the perioperative platelet responsiveness and attenuates the consumption
      of coagulation factors.

PMID- 11192306
TI  - Modified ultrafiltration removes serum interleukin-8 in adult cardiac surgery.
AB  - Cardiopulmonary bypass (CPB) causes an increase in serum cytokine levels and
      systemic inflamatory responses, which may trigger the onset of various types of
      postoperative organ failure. In the present study, modified ultrafiltration (MUF)
      was applied in cases of adult cardiac surgery and an attempt was made to
      determine whether MUF reduces serum interleukin-8 (IL-8) levels. Nine patients
      who underwent cardiovascular surgery with CPB and MUF between June 1996 and June
      1997 were compared with nine control patients who underwent cardiovascular
      surgery without MUF in the same period. Modified ultrafiltration was performed,
      based on a method proposed elsewhere. Serum IL-8 was measured by enzyme
      immunoassay at the start of CPB, immediately after CPB, immediately after MUF and
      3 h after MUF. The mean filtrated volume was 1550.0 +/- 173.2 ml. In the MUF
      group, haematocrit increased significantly from 21.2 +/- 2.0 to 24.9 +/- 3.3% (p
      = 0.0008), while systolic blood pressure increased from 97.5 +/- 16.7 to 116.5 +/
      23.9 mmHg (p = 0.0024) after MUF. In contrast, there were no changes in either
      haematocrit or blood pressure in the control group. In the MUF group, serum IL-8
      was reduced from 69.5 +/- 33.5 to 58.9 +/- 32.4 pg/ml after MUF (p = 0.0029),
      whereas it was not reduced in the control group. The results of the present study
      suggest that MUF has beneficial effects on postoperative haemodynamics, and can
      reduce serum IL-8 levels in adult cardiac surgery.

PMID- 11192307
TI  - Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass
      reduces myocardial injury.
AB  - Improved myocardial protection and cardiopulmonary bypass (CPB) have limited, but
      not abolished, intraoperative myocardial damage due to surgical reperfusion
      injury after release of the aortic crossclamp. In this double-blind, randomized
      study, we evaluated whether short-term leukocyte filtration during reperfusion
      may further reduce myocardial damage. Thirty-eight patients with coronary artery
      disease were randomly assigned to CPB with (group I; n = 19) or without leukocyte
      filtration (group II; n = 19). There was no difference in bypass time or
      crossclamp time between the groups. No patient in group I required
      catecholamines, whereas three patients in group II were supported with adrenaline
      or dobutamine on the first and second postoperative day. In addition, troponin T
      plasma levels were lower in group I (p < 0.05), whereas other markers for tissue
      injury (CK, CK-MB, LDH, S-GOT and S100B) did not differ. In conclusion, leukocyte
      filtration during reperfusion may further improve CPB by reducing myocardial
      damage.

PMID- 11192308
TI  - Leucodepletion during cardiopulmonary bypass reduces blood transfusion and
      crystalloid requirements.
AB  - Cardiopulmonary bypass (CPB) is associated with the production of inflammatory
      responses, which can have significant influence on prognosis. We studied the
      effects of leucocyte-depletion filters on inflammatory parameters and early
      postoperative prognosis during coronary revascularization. Twenty patients
      undergoing elective coronary revascularization were randomly divided into two
      groups. Ten patients had leucocyte-depletion filters added to the CPB circuit
      (treatment group) and 10 were used as control cases (control group). Expression
      of CD11b on neutrophils, and production of myeloperoxidase and lactoferrin, were
      measured in arterial samples between induction and 3 h postbypass. In addition,
      clinical parameters were measured during inpatient recovery. CD11b neutrophil
      expression, and myeloperoxidase and lactoferrin production, were found to be
      upregulated during CPB and then to decline to preoperative levels by the third
      postoperative hour. Blood transfusion requirements were reduced in the treatment
      group, equalling 1.5 +/- 1.2 units, compared to 2.7 +/- 1.1 units for the control
      group (p value = 0.034) and so were the volumes of crystalloid infused during the
      first 24 h postoperatively, equalling 3.9 +/- 1.21 in the treatment group and 3.3
      +/- 0.71 in the control group (p value = 0.021). Overall, the application of
      leucocyte depletion produced an early clinical advantage, underlining the need
      for an improved understanding and manipulation of the inflammatory response to
      CPB.

PMID- 11192309
TI  - Oxygen free radical generation in healthy blood donors and cardiac patients: the
      protective effect of allopurinol.
AB  - Cardiopulmonary bypass (CPB) activates the complement system, which leads to
      granulocyte activation and free radical production. Free radical activity during
      CPB has been associated with myocardial dysfunction. However, the relationship
      between cardiac enzymes and granulocytes to lipid peroxidation in cardiac surgery
      patients is unknown. Moreover, the effect of allopurinol on lipid peroxidation
      during mechanical trauma has to be explored. Thirty-four patients undergoing
      coronary bypass surgery and 26 healthy blood donors participated in this
      prospective study where granulocyte counts, cardiac enzymes and malondialdehyde
      (MDA) were measured and related. Allopurinol was used ex vivo, as scavenger, to
      explore its effect on lipid peroxidation. In the patient group, the mean
      preoperative MDA level (2.2 +/- 0.7, nmol/ml) significantly increased after 30
      min of bypass (3.3 +/- 0.9 nmol/ml; p < 0.0001), and showed a second peak at
      aortic declamping (4.1 +/- 0.9 nmol/ml). There were significant correlations
      between MDA and granulocyte counts (r = 0.59, p < 0.0001) and cardiac enzymes (r
      = 0.55, p < 0.0001). In an ex vivo setting, further mechanical trauma to blood
      significantly increased the MDA levels, both in the control (p < 0.0001) and in
      the patient group (p < 0.0001) and this effect could be reduced by allopurinol (p
      < 0.0001). CPB and mechanical trauma generate oxygen free radicals. Allopurinol
      was found to reduce lipid peroxidation of red cells following mechanical trauma
      and this has to be further investigated regarding its ability to reduce morbidity
      in patients undergoing open heart surgery.

PMID- 11192310
TI  - Comparison of tumor necrosis factor-alpha effect on the expression of iNOS in
      macrophage and cardiac myocytes.
AB  - Proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha), are
      elevated during cardiopulmonary bypass (CPB), heart failure, and inflammatory
      cardiac and systemic diseases. Elevated TNF-alpha has been linked to diminished
      cardiac function, decreased systemic vascular resistance, as well as renal and
      pulmonary dysfunction. It is understood that myocardial tissues can express TNF
      alpha, which results in the induction of inducible nitric oxide synthase (iNOS)
      leading to a significant decline in cardiac function and other direct effects.
      The hypothesis of this study was to determine if TNF-alpha would stimulate iNOS
      and its product nitric oxide (NO) similarly in immortalized macrophage and
      cardiac myocytes. Cultured macrophages (RAW 264.7) and cardiac myocytes (HL-1)
      were placed into two treatment groups and a control. The treatments included: (1)
      TNF-alpha and lipopolysaccharide (LPS); and (2) LPS, TNF-alpha, interleukin-1beta
      (IL-1beta) and interferon-gamma (IFN-gamma) incubated for 8 h. The macrophage
      expression of iNOS increased by 365% (p < 0.01) and its product, NO, increased
      proportionally. The expression of iNOS in the cardiac myocyte did not increase
      with TNF-alpha and LPS. However, with the addition of IFN-alpha and IL-1beta iNOS
      increased to 140% of control (p < 0.05). Myocyte cGMP and NO did not increase
      significantly with TNF-alpha treatment. This study suggests that HL-1 myocyte
      iNOS cannot be induced by TNF-alpha, unlike macrophage iNOS. Furthermore, the
      resultant cardiac dysfunction, secondary to proinflammatory cytokines effects, is
      regulated via diverse pathways.

PMID- 11192311
TI  - Neurological injury during cardiopulmonary bypass in the rat.
AB  - Cerebral injury is a well-known complication of cardiac surgery. Investigations
      of both injury mechanisms and neuroprotective strategies have partially been
      limited by the lack of an adequate preclinical model of small animal
      cardiopulmonary bypass (CPB). We sought to determine if neurological injury could
      be demonstrated in a recovery model of complete CPB in the rat. Rats (n = 5)
      underwent 45 min of normothermic CPB followed by 24 h of recovery. Compared to
      sham-operated rats (n = 5), the CPB group showed a worse neurological outcome
      score (median, 25-75th percentile) compared to controls (5, 4-7 vs 9, 8-9, p =
      0.016). This rat model of CPB may allow for the study of CPB-associated
      neurological injury.

PMID- 11192312
TI  - Cryofibrination: did it really happen?
AB  - Cryofibrin precipitation is a phenomenon which has only recently been described,
      although it might have been present since the advent of membrane oxygenators for
      cardiopulmonary bypass procedures. The deposition of the cold-reactive protein,
      cryofibrin, causes progressive occlusion of the heat-exchanger part of the
      cardiopulmonary circuit, thus leading to a high pressure-drop phenomenon. We
      describe our experience with a few cases in which the cryofibrination phenomenon
      developed while using the 'Avecor-Affinity Medtronic' membrane oxygenator.

PMID- 11192313
TI  - Role of iron in Helicobacter pylori: its influence in outer membrane protein
      expression and in pathogenicity.
AB  - The acquisition of iron is a necessity for bacterial growth in
      Helicobacterpylori, as it is for other organisms. In addition, iron is a critical
      factor for the virulence of this organism. Therefore, it is not surprising that
      H. pylori isolates have the potential to express at least three major iron
      acquisition mechanisms. The association of H. pylori infection with host iron
      deficiency might indicate that the iron-scavenging systems play a role in the
      virulence of H. pylori.

PMID- 11192314
TI  - Iron influences the expression of Helicobacter pylori outer membrane vesicle
      associated virulence factors.
AB  - BACKGROUND: Helicobacter pylori shed outer membrane vesicles (OMV) in vitro and
      in vivo. These OMV, which contain active VacA, provide a potential vehicle for
      the delivery of H. pylori virulence factors to the gastric mucosa. OBJECTIVE: To
      assess the influence of environmental iron levels on H. pylori OMV VacA and
      protease expression in vitro. METHODS: Three well-characterized H. pylori type
      strains were grown for 72 h under normal (Brucella broth, 5% fetal calf serum)
      and iron-limiting (Brucella broth, 5% fetal calf serum, 50 micromol/l
      deferoxamine) conditions. Following harvesting by differential centrifugation,
      the ratio of whole cells to OMV was determined. OMV VacA levels in response to
      iron availability were determined by ELISA and immunolabelling of washed
      bacteria. Protease activity was detected by zymography of OMV in the presence and
      absence of enzyme inhibitors and activators. HEp-2 cells were used to assay for
      OMV-associated cytopathogenic toxins. RESULTS: Decreased iron availability, which
      limited bacterial growth but not OMV release, also influenced the expression of
      OMV-associated virulence factors. VacA levels were reduced, whereas two new
      proteolytic enzymes were expressed on these OMV. When an iron salt was added to
      counteract the effect of the deferoxamine, VacA levels were restored in the outer
      membrane and the proteolytic activity disappeared. CONCLUSIONS: These results
      suggest that OMV release by H. pylori is influenced by environmental iron levels,
      and that the qualitative changes that occur in outer membrane composition may
      contribute to the clinical patterns of H. pylori-associated disease.

PMID- 11192315
TI  - Scoring system has better discriminative value than Helicobacter pylori testing
      in patients with dyspepsia in a setting with high prevalence of infection.
AB  - OBJECTIVE: To prospectively assess the accuracy of a scoring system to predict
      organic diseases in dyspeptic patients in an area of South Europe, and to compare
      it with that of Helicobacter pylori testing in patients with dyspepsia in an
      environment with high prevalence of H. pylori infection. METHODS: Symptoms and
      demographic data were recorded in 501 consecutive dyspeptic patients referred to
      an outpatient gastroenterology clinic. A simple scoring system was constructed
      from the predictive factors obtained in a multi-variate logistic regression
      analysis. Overall predictive accuracy was assessed with the c statistic. The
      model was validated using bootstrap techniques. The accuracy of clinical
      judgement and H. pylori testing to predict endoscopic diagnosis was also
      assessed. RESULTS: Organic dyspepsia (peptic ulcer, oesophagitis or malignancies)
      was diagnosed in 45% of the patients. The test for H. pylori was positive in 68%,
      and 29% of infected patients had an ulcer. The organic dyspepsia predictive model
      had an accuracy of 0.79, which decreased to 0.77 after validation adjustment. The
      predictive accuracies for clinical judgement and H. pylori testing were 0.69 and
      0.61, respectively. The addition of H. pylori testing to the scoring system
      resulted in a minor improvement of the predictive accuracy. CONCLUSION: In an
      environment with a high rate of H. pylori infection and a low prevalence of
      peptic ulcer among infected patients, a scoring system has higher predictive
      accuracy for the diagnosis of organic disease than H. pylori testing. Moreover,
      in this setting, H. pylori testing adds a minimum value to the predictive
      capability of the scoring system.

PMID- 11192316
TI  - Helicobacter pylori infection and peptic disease in coeliac disease.
AB  - OBJECTIVE: To evaluate Helicobacter pylori (HP) and peptic disease prevalence in
      coeliac disease patients and in a control group. DESIGN: In the retrospective
      study, data collected on 690 upper endoscopies in coeliac patients, carried out
      between 1990 and 1997, were analysed. In the prospective study 263 consecutive
      adult patients were studied for follow-up of coeliac disease or suspected
      malabsorption/coeliac disease. Tests included routine blood tests; serum dosage
      of EMA; IgG anti-HP and, in a subgroup of participants, anti-CagA antibodies;
      upper endoscopy with multiple gastric and duodenal biopsies; histological
      examination of gastric and duodenal specimens with staining providing evidence
      for the presence of HP. SETTING: A centre for the treatment of malabsorptive
      diseases, University Federico II of Naples, Italy. PARTICIPANTS: Adults with
      coeliac disease at the time of diagnosis and follow-up. RESULTS: In the
      retrospective study, peptic disease had a prevalence of 0.72% in the endoscopy
      series of coeliac patients examined. In the prospective study, the prevalence of
      HP infection was significantly lower in untreated coeliac patients when compared
      with treated patients and controls (20.7%, 32.4% and 55.3%, respectively; P =
      0.001, chi2). The prevalence of HP was related to both gender and age. It was
      found more frequently in men and the frequency increased with age in all groups.
      The study confirmed the low prevalence of peptic disease in coeliac patients
      compared with controls (0.9% vs 3.8%, P = 0.001). CONCLUSION: Patients with
      coeliac disease show a significantly lower prevalence of HP infection and peptic
      disease when compared to controls. Gluten free diet-induced changes in the
      intestinal environment and/or the host immuno-response may explain the increased
      HP prevalence in treated coeliac patients.

PMID- 11192317
TI  - Investigation of the association between infection with Helicobacter pylori and
      with TT virus, a novel DNA virus, in patients with gastroduodenal ulcer or ulcer
      scar.
AB  - OBJECTIVE: Recently, a novel DNA virus (TT virus; TTV) has been isolated. Enteric
      transmission is suggested as a route of transmission of TTV, with high prevalence
      of this virus infection in the general population, and age and geographical
      distributions of TTV prevalence very similar to those of Helicobacterpylori
      infection. We analysed an association between TTV and H. pylori infection in
      patients with gastroduodenal ulcer or ulcer scar. METHODS: In 181 patients with a
      gastroduodenal ulcer or ulcer scar (102 with a gastric lesion, 60 with a duodenal
      lesion, and 19 with both sites involved), specimens were cultured for H. pylori
      and TTV infection was sought in serum by a polymerase chain reaction. RESULTS: H.
      pylori infection was demonstrated in 152 patients (84.0%) and TTV was detected in
      168 patients (92.8%). Patients with TTV were significantly older than those
      without TTV (P = 0.0001), while no age difference was observed between patients
      with and without H. pylori infection. No difference was apparent in the
      prevalence of TTV infection between patients with and without H. pylori
      infection, and vice versa. CONCLUSIONS: We found no association between TTV
      infection and H. pylori infection in patients with peptic ulcer diseases, which
      is consistent with a lack of association between TTV infection and peptic ulcer.
      However, larger studies including surveys of the general population will be
      required to analyse the overall association between TTV and H. pylori.

PMID- 11192318
TI  - Helicobacter pylori infection, gastric metaplasia in the duodenum and the
      relationship with ulcer recurrence.
AB  - OBJECTIVE: To study the prevalence of Helicobacter pylori (H. pylori) infection
      and gastric metaplasia (GM) in the duodenum a large group of patients with
      duodenal ulcer was evaluated to determine whether these factors are related to
      the number of ulcer recurrences. METHODS: Three hundred and seven patients
      diagnosed by endoscopy as having active duodenal ulcers were studied. At
      endoscopy, all patients had gastric biopsies taken for histology, the rapid
      urease test and culture. Three duodenal biopsies were also taken and processed
      for histology (haematoxylin & eosin, Giemsa, Warthin-Starry, and PAS stain).
      RESULTS: GM and H. pylori in the duodenum was identified in 73% (68-78%) and 66%
      (60-71%) of the cases, respectively. All patients with H. pylori in the duodenum
      also had GM at this location, while areas with GM but without H. pylori were
      described. The kappa statistic for concordance between GM and H. pylori at the
      duodenum was 0.82. The prevalence of GM and H. pylori, depending on the number of
      ulcer recurrences, was: 1st episode, 34% and 27%, respectively; 2nd episode, 84%
      and 80%; and > or = 3rd episode, 90% and 79% (P < 0.001 when comparing 1st vs 2nd
      or > or = 3rd episode). In the multivariate analysis, age and number of ulcer
      recurrences correlated both with GM and with H. pylori in the duodenum. Chronic
      duodenitis was demonstrated in all duodenal biopsies, 87% being active chronic
      duodenitis. H. pylori in the duodenum was more frequent in patients with active
      duodenitis (73%) than in those with inactive duodenitis (13%) (P < 0.001).
      CONCLUSIONS: Patients with recurrent ulcer disease have a higher prevalence of
      both GM and H. pylori infection in the duodenum, suggesting that these two
      factors are related with the chronicity and recurrence of duodenal ulcer disease.
      H. pylori infection in the duodenum always appears in areas of GM, although GM is
      not necessarily colonized by the organism. H. pylori infection cannot be excluded
      based only on the results of duodenal biopsies, as false negative results at this
      area are frequent.

PMID- 11192319
TI  - Helicobacter pylori infection delays healing of ischaemia-reperfusion induced
      gastric ulcerations: new animal model for studying pathogenesis and therapy of H.
      pylori infection.
AB  - OBJECTIVE: Helicobacter pylori (Hp) infection is a major risk factor of peptic
      ulcerations but studies on its pathogenicity are limited due to the lack of an
      adequate animal model. In this study we developed the new model of gastric Hp
      infection in rat gastric mucosa, with acute gastric erosions progressing into
      ulcers in animals subjected initially to ischaemia-reperfusion (I/R). DESIGN: I/R
      lesions were produced in rats by clamping the coeliac artery for 0.5 h followed
      by 1 h reperfusion and gastric inoculation with type I Hp strain (CagA and VacA
      positive) or type II Hp strain (CagA and VacA negative), obtained from fresh
      clinical isolates, or with vehicle (saline). Gastric secretion during recovery
      from I/R lesions was determined in a separate group of rats equipped with chronic
      gastric fistula to inoculate the animals with Hp and then to collect gastric
      juice for determination of gastric acidity and pepsin outputs as well as luminal
      content of somatostatin. METHODS: The animals were killed at 0, 3, 12 or 24 h and
      3, 5, 10 or 15 days after Hp inoculation and the area of gastric lesions was
      determined planimetrically and gastric blood flow (GBF) was measured by the H2
      gas clearance technique. The venous blood was withdrawn for measurement of plasma
      interleukin (IL)-1beta and tumour necrosis factor alpha (TNFalpha) by ELISA and
      plasma gastrin, luminal somatostatin by RIA and the mucosal expression of
      transforming growth factor (TGFalpha) was analysed using RT-PCR with specific
      primers. Gastric Hp infection was assessed by histology, rapid urease test and Hp
      culture. The effect of triple therapy with omeprazole, amoxycillin and tinidazole
      on Hp infection and ulcer healing was also determined. RESULTS: Ischaemia alone
      resulted in an immediate fall in GBF and almost complete suppression of gastric
      secretion but without any gastric lesions. When ischaemia was followed by 1 h of
      reperfusion, acute gastric erosive lesions immediately occurred, reaching a
      maximum at 12 h after I/R and progressing after 3 days to deeper gastric ulcers
      that disappeared after 15 days. In Hp-inoculated rats, the number of viable Hp
      colonies gradually increased, reaching maximum at day 10 with infection with type
      I and at day 15 with infection with type II Hp. At day 15 the difference in Hp
      colonization was not significantly different between the stomachs infected by
      type I and type II Hp. Inoculation, especially with the type I Hp strain,
      significantly delayed healing of I/R-induced acute lesions and accelerated their
      progression into deeper chronic ulcers. This effect was accompanied by a
      significant fall in GBF and a higher increment in plasma IL-1beta and TNFalpha
      levels. Gastric acid secretion, which was completely inhibited up to 12 h after
      I/R, returned to the control value 24 h upon completion of the I/R procedure.
      This return was delayed in Hp-infected rats and accompanied by a significant
      elevation of plasma gastrin and a decrease in luminal somatostatin. The
      immunoreactivity of TGFalpha and expression of TGFalpha mRNA determined by RT-PCR
      were well defined in intact gastric mucosa but were significantly decreased,
      especially in mucosa infected with type I Hp strain, at day 15 after I/R. The
      triple therapy which cured Hp infection completely abolished the delay in ulcer
      healing caused by Hp. CONCLUSIONS: (1) Gastric infection with the Hp strain
      expressing cagA and vacA encoded cytotoxins delays healing of I/R-induced acute
      gastric lesions due to an impairment of gastric microcirculation, and excessive
      proinflammatory cytokine release and suppression of anti-ulcer TGFalpha
      expression. (2) The I/R induced suppression of gastric acid secretion may
      contribute to the hypergastrinaemia as a secondary phenomenon and may account for
      the spread of Hp infection observed during the progression of acute erosions into
      chronic ulcers. (3) I/R induced gastric ulcers may be a useful model for studying
      the action of Hp infection on gastric ulcerogenesis in ischaemic stomach and for
      testing anti-Hp therapy.

PMID- 11192320
TI  - Limited usefulness of a seven-day twice-a-day quadruple therapy.
AB  - OBJECTIVE: To test the usefulness of a twice-a-day, simplified quadruple therapy
      to cure Helicobacter pylori infection. DESIGN: Helicobacter pylori-positive ulcer
      patients were treated with omeprazole 20 mg twice a day (b.d.), amoxicillin 1 g
      b.d., tinidazole 500 mg b.d. and bismuth subcitrate 240 mg b.d. for 7 days in an
      experimental, noncomparative pilot study. SETTING: The gastroenterology unit of a
      county hospital. PARTICIPANTS: Forty-four consecutive patients with peptic ulcer
      disease and H. pylori infection. MEASUREMENTS: Cure was tested by either
      endoscopy or breath test after 2 months, and by urea breath test 6 months after
      therapy. RESULTS: One patient was lost to follow-up. Of the remaining 43, 37 were
      cured at the first control, giving an intention-to-treat cure rate of 84.1% (95%
      CI 69-93%) and a per protocol cure rate of 86% (95% CI 71-94%). Thirty-three
      cured patients agreed to return for a six-month breath test. All but one were
      cured (long-term per protocol cure rate 82.1%; 95% CI 66-92%). CONCLUSIONS: This
      particular quadruple therapy is well tolerated and easy to comply with. However,
      cure rates did not reach 90%.

PMID- 11192321
TI  - Amantadine for chronic hepatitis C: pilot study in 14 patients.
AB  - BACKGROUND: Amantadine, a widely available antiviral drug, has been previously
      reported to be effective in patients with chronic hepatitis C who failed to
      respond to interferon-alpha therapy. Nevertheless, its efficacy has not been
      fully studied, particularly in naive patients. OBJECTIVE AND DESIGN: We conducted
      a pilot study to determine the efficacy and the safety of amantadine as initial
      therapy in patients with chronic hepatitis C. METHODS AND PARTICIPANTS: Fourteen
      consecutive patients (mean age, 40 years; M/F ratio, 9/5) with chronic hepatitis
      C, elevated alanine aminotransferase (ALT) and without cirrhosis were treated
      with a 6-month course of amantadine, 100 mg orally twice daily. Main outcome
      measures were ALT concentrations and serum hepatitis C virus-RNA (HCV-RNA) levels
      at the end of therapy. RESULTS: All adverse events were mild or moderate and were
      not treatment limiting. At the end of treatment, all patients had detectable
      serum HCV-RNA and only one patient had a normal ALT level. The serum HCV-RNA
      median level and the ALT median level were not significantly different at the end
      of treatment as compared to baseline levels. CONCLUSIONS: Our results show that
      amantadine alone cannot be recommended as an alternative therapy in patients with
      chronic hepatitis C.

PMID- 11192322
TI  - Administering granulocyte colony-stimulating factor to acute liver failure
      patients corrects neutrophil defects.
AB  - OBJECTIVES: Neutrophil function is defective in acute liver failure (ALF) and the
      in vitro ability of granulocyte colony-stimulating factor (G-CSF) to reverse
      these defects has been reported. The effects of administering G-CSF to ALF
      patients are presented in this study. DESIGN: This was a prospective, phase I/II,
      open label, study. SETTING: The liver intensive therapy unit at King's College
      Hospital, London. PARTICIPANTS: Sequential patients admitted with acute liver
      failure due to acetaminophen overdose. INTERVENTIONS: G-CSF was given to four
      groups (each n = 6) of ALF patients as a daily infusion at 25, 50, 100 or 150
      microg/m2. A control group of eight patients did not receive G-CSF. MAIN OUTCOME
      MEASURES: Neutrophil phagocytosis and killing of Staphylococcus aureus and
      superoxide release before G-CSF administration and at 24 and 96 h thereafter.
      RESULTS: Neutrophils from patients receiving 50, 100 or 150 microg/m2 G-CSF, but
      not from control patients or those receiving 25 microg/m2, showed significantly
      increased phagocytosis and killing at 96 h. Doses of 50 or 150 microg/m2 G-CSF
      resulted in increased superoxide production at 96 h. No patients discontinued
      treatment as a consequence of side effects related to G-CSF administration.
      CONCLUSIONS: G-CSF administration is a safe and effective means of reversing the
      neutrophil defects of ALF, and may have a role in the prevention and treatment of
      infection in these patients. A dose of 50 microg/m2/day is as effective as higher
      doses and was associated with fewer side effects.

PMID- 11192323
TI  - Polymorphisms in tumour necrosis factor alpha, interleukin-10 and transforming
      growth factor beta1 genes and end-stage liver disease.
AB  - OBJECTIVE: To determine any relationship between polymorphisms in the genes
      encoding tumour necrosis factor alpha (TNFalpha), interleukin-10 (IL-10) and
      transforming growth factor beta1 (TGFbeta1) and end-stage liver disease. METHODS:
      Whole-blood samples were taken from patients attending the Scottish Liver
      Transplant Unit with end-stage liver disease (primary biliary cirrhosis, n = 61;
      alcoholic liver disease, n = 25; primary sclerosing cholangitis, n = 17; viral
      disease, n = 8; type 1 auto-immune hepatitis, n = 8; acute liver failure, n =
      20). DNA was extracted and the polymorphisms at positions TNF -308, IL-10 -1082
      and TGFbeta1 +869 and +915 were determined using sequence-specific
      oligonucleotide probes. Samples were also analysed from normal healthy controls.
      RESULTS: There was a significant difference between patients with primary
      sclerosing cholangitis and healthy controls, with 65% of patients (11/17)
      possessing at least one TNF2 allele (A at position -308) compared with 38% of
      controls (P = 0.02). Four of the eight patients with auto-immune hepatitis were
      homozygous for TNF2 while the other four were heterozygous (P = 0.001). No
      significant difference between controls and patients was seen in polymorphisms
      for IL-10 or TGFbeta1. No association between genotype and Child's class was
      found in primary biliary cirrhosis. CONCLUSION: Patients with primary sclerosing
      cholangitis and auto-immune hepatitis are more likely to possess TNF2 than normal
      controls. This allele has been associated with an increased production of
      TNFalpha in vitro and may indicate a predisposition to these inflammatory
      conditions.

PMID- 11192324
TI  - Comparison of two tubeless function tests in the assessment of mild-to-moderate
      exocrine pancreatic insufficiency.
AB  - BACKGROUND: Faecal elastase 1 (FE1) and the pancreolauryl test (PLT) are widely
      used for the non-invasive diagnosis of exocrine pancreatic insufficiency (EPI).
      Whether one of these two tests is superior for the detection of mild-to-moderate
      EPI is the subject of controversy. The aim of this study was to compare the
      diagnostic performance of the PLT and FE1 for the detection of EPI in patients
      with chronic pancreatitis. METHODS: Forty consecutive patients (27 males, 13
      females, 23-72 years) with chronic pancreatitis based on imaging procedures
      (computed tomography, endoscopic retrograde pancreatography and endoscopic
      ultrasound) were admitted to the study. A secretin-caerulein test (SCT) was
      performed after an overnight fast by giving secretin (1 U/kg/h) and caerulein
      (100 ng/kg/h) intravenously over 90 min. Duodenal contents were aspirated at 15
      min intervals and analysed for pH, bicarbonate, amylase, lipase and elastase. EPI
      was graded on the basis of the results of the SCT as absent, mild, moderate or
      severe. A serum PLT was performed in accordance with a modified protocol
      previously described. A commercial ELISA was used for determination of FE1. The
      cut-off values were > or = 4.5 mg/l for PLT and > or = 200 microg/g for FE1. and
      13 severe) on the basis of the results of the SCT. The sensitivity of the PLT for
      diagnosing EPI of all degrees of severity was 82% (27/33), compared with 50% for
      FE1 (16/ 33). In patients with severe EPI, the PLT was abnormal in 100% (13/13)
      and FE1 was abnormal in 85% (11/13) of the cases. The sensitivity decreases for
      both tests in the group of mild/moderate EPI (PLT 70% (14/20), FE1 35% (7/20)).
      In all seven patients with normal exocrine pancreatic function, both PLT and FE1
      were also normal. CONCLUSIONS: The PLT is more sensitive than FE1 for the
      diagnosis of mild-to-moderate EPI, and is therefore more appropriate for
      completing the staging of chronic pancreatitis.

PMID- 11192325
TI  - Blindness following gastrointestinal haemorrhage.
AB  - Loss of vision is a rare but well known complication of distant and recurrent
      haemorrhage. It shares a poor prognosis, with only 10-14% of cases likely to make
      a complete recovery. Visual symptoms, due to ischaemic anterior optic neuropathy,
      vary from blurred vision to complete loss of vision in one or both eyes. The
      pathogenesis of such ischaemia remains unclear. Gastrointestinal bleeding seems
      to be the leading cause of loss of vision secondary to haemorrhage. However,
      complete and permanent blindness following gastrointestinal bleeding has rarely
      been reported. We report the case of a 51 -year-old woman who complained of
      complete blindness following blood loss, secondary to peptic ulcer, and discuss
      the pathogenesis of such a complication.

PMID- 11192326
TI  - Fat and gastro-oesophageal reflux disease.
AB  - It is common practice to prescribe avoidance of fatty foods to patients with
      gastro-oesophageal reflux disease; however, there is no good evidence supporting
      the benefit of such a prescription. Several reports looking at gastro-oesophageal
      reflux after meals of different fat content have been controversial probably
      because of differences in caloric load, volume and osmolarity, factors which may
      independently influence reflux. Recent observations suggest that fatty meals do
      not promote gastro-oesophageal reflux nor alter the competence of the
      oesophagogastric junction in comparison to balanced meals, provided they contain
      the same energy load. The possibility that fat increases heartburn by modulating
      perception of acid reflux seems to have little relevance. It is concluded that,
      in the light of present evidence, there is no sound rationale for clinicians
      recommending that patients with GORD follow a low-fat diet.

PMID- 11192327
TI  - Gallstones in obesity and weight loss.
AB  - The prevalence of cholesterol gallstones is increased in obese persons. The risk
      is especially high in those with the highest body mass index (relative risk 5-6).
      Weight loss further increases the risk of gallstones: the prevalence of new
      gallstones reaches 10-12% after 8-16 weeks of low-calorie diet and more than 30%
      within 12-18 months after gastric by-pass surgery. About one-third of the stones
      are symptomatic. The increased prevalence of stones is mostly due to
      supersaturation of bile with cholesterol, because of an increased synthesis by
      the liver and secretion into bile. Saturation is further increased during weight
      loss. It returns toward normal after weight stabilization at a lower level,
      allowing spontaneous stone dissolution in some cases. Identified risk factors for
      gallstones during weight loss are a relative loss of weight greater than 24% of
      initial body weight, a rate of weight loss greater than 1.5 kg per week, a very
      low calorie diet with no fat, a long overnight fast period and a high serum
      triglyceride level. Ursodeoxycholic acid decreases cholesterol saturation of bile
      and gallstone incidence during weight loss. Other preventive measures include a
      control of weight loss rate, a reduction of the length of overnight fast, and
      maintenance of a small amount of fat in the diet.

PMID- 11192328
TI  - Gastric acidity and preneoplastic/neoplastic changes of the stomach.

PMID- 11192329
TI  - Development and validation of an ultrasonographic activity index of Crohn's
      disease.

PMID- 11192330
TI  - Control of vascular tone in the syndromes of Bartter and Gitelman.
AB  - Bartter's and Gitelman's syndromes can be used as models to gain insight into the
      mechanisms responsible for maintaining/controlling vascular tone. In fact, the
      study of patients with these syndromes provides important insights into
      mechanistic details of the most relevant pathways of vascular tone. So far,
      several experimental findings in patients with these syndromes point to G protein
      abnormalities and suggest that the intracellular signaling systems that involve
      the G protein complex transducing components may be defective, leading to altered
      vascular reactivity. These results are also of particular interest because the
      derangements found in Bartter's and Gitelman's syndromes are the mirror images of
      those involved in the pathophysiology of hypertension.

PMID- 11192331
TI  - Thyroid-associated ophthalmopathy: clinical features, pathogenesis, and
      management.
AB  - Thyroid-associated ophthalmopathy (TAO) is a progressive eye disorder
      characterized by immune-mediated inflammation of the extraocular muscles and
      orbital connective tissue. TAO is linked, in a unique way, with thyroid
      autoimmunity, in particular Graves' hyperthyroidism. Our working hypothesis for
      the pathogenesis of TAO is that recognition of a thyrotropin receptor (TSHR)-like
      protein in the orbital preadipocytes by antibodies may be the initial event
      leading to homing of lymphocytes into the orbital tissues. In the course of
      thyroid inflammation, antibodies and T cells reactive against G2s expressed in
      thyroid membranes cross-react with the protein in the eye muscle fiber, leading
      to eye muscle damage and dysfunction. Those patients with anti-G2s antibodies
      develop ocular myopathy. Antibodies against flavoprotein, the 64-kDa protein,
      which are produced in the context of eye muscle fiber damage and mitochondrial
      rupture, are sensitive markers of immune-mediated fiber necrosis in patients with
      ophthalmopathy but do not directly damage the eye muscle. Antibodies against type
      XIII collagen, which is localized in the plasma membranes of orbital fibroblast,
      may be a new marker for the congestive ophthalmopathy subtype of TAO. The
      measurement of antibodies against key eye muscle and orbital connective tissue
      autoantigens may have a role in the management of active ophthalmopathy and its
      prediction in patients with Graves' hyperthyroidism.

PMID- 11192332
TI  - Hepatic, metabolic, and nutritional disorders of alcoholism: from pathogenesis to
      therapy.
AB  - Much progress has been made in the understanding of the pathogenesis of alcoholic
      liver disease, resulting in an improvement in treatment. Nutritional deficiencies
      should be corrected when present but, because of the alcohol-induced disease
      process, some of the nutritional requirements change. For instance, methionine,
      one of the essential amino acids for humans, must be activated to S
      adenosylmethionine (SAMe), but, in severe liver disease, the activity of the
      corresponding enzyme is depressed. Therefore, the resulting deficiencies and
      associated pathology can be attenuated by the administration of SAMe, but not by
      methionine. Similarly, phosphatidylethanolamine methyltransferase (PEMT)
      activity, which is important for hepatic phosphatidylcholine (PC) synthesis, is
      also depressed in alcoholic liver disease, therefore calling for the
      administration of the products of the reaction. Inasmuch as free radical
      generation by the ethanol-induced CYP2E1 plays a key role in the oxidative
      stress, inhibitors of this enzyme have great promise and PPC, which is presently
      being evaluated clinically, is particularly interesting because of its innocuity.
      In view of the striking negative interaction between alcoholic liver injury and
      hepatitis C, an antiviral agent is eagerly awaited that, unlike Interferon, is
      not contraindicated in the alcoholic. Antiinflamatory agents may also be useful.
      In addition to steroids, down-regulators of cytokines and endotoxin are being
      considered. Finally, anticraving agents such as naltrexone or acamprosate should
      be incorporated into any contemplated therapeutic cocktail.

PMID- 11192333
TI  - The disablement process in very late life: a study of the oldest-old in Sweden.
AB  - The study examines physical and functional health problems and their relationship
      to the activity of daily living (ADL) disability experience of a cross-section of
      Swedish men and women aged over 80 years (N = 203). Using a model of disablement,
      the relationships among disability variables were simultaneously explored.
      Results confirmed relatively high rates of disability in this age group, with 36%
      of respondents having some basic ADL difficulty. Functional impairments (vision
      and grip strength) and functional limitations (upper and lower body limitations
      and cognition) were strongly related to disability, with functional limitations
      being a main driving force for disability. The role of psychosocial variables
      (depression, subjective health, and social integration) was explored through
      subsequent model testing. Results showed depression, subjective health, and
      social integration to potentially mediate the influence of risk factors,
      impairments, and limitations in the model. The study suggests that modifying
      psychosocial experiences can greatly affect the disability experience.

PMID- 11192334
TI  - Balancing parent care with other roles: interrole conflict of adult daughter
      caregivers.
AB  - This study examined interrole conflict experienced by 278 women who
      simultaneously occupied 4 roles: parent care provider, mother to children at
      home, wife, and employee. Compared with women who experienced no conflict between
      parent care and their other roles, women reporting parent care conflict tended to
      have fewer socio-economic resources, to have older children, and to be caring for
      parents with greater impairment. Women who reported conflicts between parent care
      and employment were older; had more education; had marriages of longer duration;
      and had older, more self-sufficient children than women who reported conflict
      between the parent care role and the mother role. Some evidence was found for the
      hypothesis that interrole conflict between parent care and other roles mediates
      the relationship between parent care stress and psychosocial well-being. Results
      suggest that one way parent care stress exerts its deleterious effects on the
      well-being of adult daughters is through the incompatible pressures of parent
      care and other roles.

PMID- 11192335
TI  - A reevaluation of the common factor theory of shared variance among age, sensory
      function, and cognitive function in older adults.
AB  - The common cause hypothesis of the relationship among age, sensory measures, and
      cognitive measures in very old adults was reevaluated. Both sensory function and
      processing speed were evaluated as mediators of the relationship between age and
      cognitive function. Cognitive function was a latent variable that comprised 3
      factors including memory, speed, and verbal ability. The sample was population
      based and comprised very old adults (n = 894; mean age = 77.7, SD = 5.6 years)
      from the Australian Longitudinal Study of Ageing. The results showed that there
      was common variance in the cognitive factor shared by age, speed, vision, and
      hearing but that specific effects of age on cognition remained. Furthermore,
      speed did not fully mediate the effect of age or sensory function on cognition.
      Some age differences in cognitive performance are not explained by the same
      processes that explain age differences in sensory function and processing speed.

PMID- 11192336
TI  - Social support and treatment response in older depressed primary care patients.
AB  - A previously tested theoretical model that specifies relationships among
      depression, activities of daily living (ADL) impairment, and social support
      components was validated with 307 patients aged 60 and older from a multisite
      effectiveness trial of 3 treatments (antidepressant, placebo, Problem-Solving
      Treatment) for dysthymia or minor depression in primary care. Participants
      completed interviews and self-reports at baseline and at 6 and 12 weeks. The
      short-term, longitudinal data were analyzed with covariance structure modeling
      techniques. Consistent with the previous model, impairment in ADLs was associated
      with subsequent increases in depression, a larger emotionally close network that
      made frequent visits was associated with subsequent increases in perceived
      support, and perceived support was associated with subsequent decreases in
      depression. This last effect was significant only among participants randomly
      assigned to receive placebo with clinical management. The similar results in 2
      different studies are a substantial validation of the theoretical model. The
      effect of perceived support primarily in the placebo group suggests that those
      with greater perceived social support and subsyndromal depression may be more
      likely to have a positive response to nonspecific clinical treatment components.

PMID- 11192337
TI  - Psychological improvements associated with behavioral and drug treatment of urge
      incontinence in older women.
AB  - The purpose of this study was to explore changes in psychological distress
      associated with behavioral treatment and drug treatment for urge incontinence in
      community-dwelling older women. Participants were 197 ambulatory, nondemented
      women (aged 55 years or older) with persistent urge urinary incontinence.
      Participants were patients in a randomized clinical trial comparing biofeedback
      assisted behavioral treatment, drug treatment with oxybutynin chloride, and a
      placebo-control condition. Psychological distress was measured before and after
      treatment using the Hopkins Symptom Checklist (SCL-90-R). Multivariate and
      univariate analyses of variance showed that the two treatment groups and the
      control group had similar significant improvements on the nine subscales and the
      global severity index. Analysis of individual SCL-90-R subscale scores revealed
      trends suggesting that behavioral treatment tended to produce the largest
      improvements. The reductions of distress were not correlated consistently with
      reduction of incontinence. The results of this study showed that psychological
      distress was significantly reduced after treatment, regardless of the type of
      treatment.

PMID- 11192338
TI  - Protecting sleep quality in later life: a pilot study of bed restriction and
      sleep hygiene.
AB  - We tested two interventions for improving sleep consolidation and depth in normal
      elderly participants: a modification of sleep-restriction therapy and sleep
      hygiene education. Twenty-one elderly participants without sleep disorders were
      randomized to sleep hygiene plus bed restriction (i.e., restricting time in bed
      by 30 minutes nightly for one year) or to sleep hygiene alone. Participants in
      the bed-restriction group showed a median increase in sleep efficiency of 6.1%
      versus 1.8% in participants receiving sleep hygiene instruction, and an increase
      in allnight delta EEG power. Self-reported mood on awakening in the morning
      showed greater improvement over the first eight weeks in the sleep-hygiene
      condition. The use of sleep hygiene was associated with initial improvement in
      daytime well-being, whereas bed restriction led to sustained improvements in
      sleep continuity and sleep depth.

PMID- 11192339
TI  - Embedding health-promoting changes into the daily lives of independent-living
      older adults: long-term follow-up of occupational therapy intervention.
AB  - The Well Elderly Study was a randomized trial in independent-living older adults
      that found significant health, function, and quality of life benefits
      attributable to a 9-month program in preventive occupational therapy (OT). All
      participants completing the trial were followed for an additional 6 months
      without further intervention and then reevaluated using the same battery of
      instruments. Long-term benefit attributable to preventive OT was found for the
      quality of interaction scale of the Functional Status Questionnaire and for six
      of eight scales on the RAND SF-36: physical functioning, role functioning,
      vitality, social functioning, role emotional, and general mental health (p<.05).
      Approximately 90% of the therapeutic gain observed following OT treatment was
      retained in follow-up. The finding of a sustained effect for preventive OT is of
      great public health relevance given the looming health care cost crisis
      associated with our nation's expanding elderly population.

PMID- 11192340
TI  - Severity of upper and lower extremity functional limitation: scale development
      and validation with self-report and performance-based measures of physical
      function. WHAS Research Group. Women's Health and Aging Study.
AB  - OBJECTIVES: To better understand disablement and transitions from impairment to
      disability, discrete valid measures of functional limitation are needed. This
      study reports the development and criterion-related validity of scales that
      quantify severity of upper and lower extremity functional limitation. METHODS:
      Data are from 3,635 cognitively intact community-dwelling women aged 65 years and
      older and 1,002 moderately to severely disabled participants in the Women's
      Health and Aging Study. Scales assessing severity of upper and lower extremity
      functional limitation were constructed from commonly available questions on
      functional difficulty. Criterion-related validity was evaluated with self-report
      and performance-based measures. RESULTS: The upper and lower extremity scales
      range from 0 to 6 and 0 to 9, respectively. Scale scores were well distributed in
      the disabled group and discriminated limitations in the broader community. For
      both scales, rates of difficulty for all ADL and IADL increased (p<.001) with
      increasing severity score, and percent able and mean performance on respective
      upper and lower extremity tasks decreased (p<.01). DISCUSSION: These scales,
      constructed from commonly used self-report measures of function, provide discrete
      measures of upper and lower functional limitation. Because these scales are
      distinct from measures of disability and impairment, their use should facilitate
      increased understanding of the disablement process.

PMID- 11192341
TI  - Influences of family obligations and relationships on retirement: variations by
      gender, race, and marital status.
AB  - OBJECTIVE: This study examined whether economic and care obligations for family
      and kin salience influence retirement decisions and whether such influences
      differ by race, gender, and marital status. DATA: Data from the first 2 waves of
      the National Survey of Families and Households were used. The sample consisted of
      individuals who were employed at baseline and aged 55-75 at follow-up (N = 897).
      Cox proportional hazard regressions were used. RESULTS: Economic kin obligations
      impeded the likelihood of retiring. Individuals who made financial contributions
      to children outside the household and White women with resident children in the
      household were less prone to retire. Among Blacks, household composition effects
      were more complex and seemed to depend on the mix of care obligations, financial
      obligations, and financial contributions by resident kin. Kin salience also
      impinged on retirement decisions. Some groups who lacked family ties (e.g.,
      nonmarried childless men) were less inclined to retire, whereas other subgroups
      (e.g., nonmarried men with monthly pre-retirement contacts with children) were
      more likely to retire. CONCLUSIONS: Our data suggest the importance of family
      obligations and relationships in retirement decisions and demonstrate
      considerable diversity in these processes. Models of retirement should pay
      greater attention to the interdependence of work and family spheres and to the
      diversity of retirement processes among various population groups.

PMID- 11192342
TI  - Attachment styles in older European American and African American adults.
AB  - OBJECTIVES: Differential attachment styles have been linked to differential
      emotion regulation and ability to cope with stress in samples of young adults.
      There are few data on attachment styles in older adults despite the fact that
      attachment relationships are said to play a significant role in psychological
      well-being throughout the life span. The goal of the study was to examine
      attachment patterns in older adults. METHODS: Participants were 800 community
      dwelling older European Americans and African Americans (M = 74 years) living in
      a large urban community. Attachment measures included the family and friend
      intimacy subscales from the Network Analysis Profile and the Relationship Scales
      Questionnaire. RESULTS: In contrast to findings with younger individuals, where
      the majority of respondents have been found to be secure (i.e., comfortable with
      closeness and dependency), the majority of the present sample were found to be
      dismissing/avoidant (i.e., uncomfortable with closeness, compulsively self
      reliant). European Americans scored higher than African Americans on attachment
      security, whereas African Americans scored higher than European Americans on
      dismissing attachment. However, the assessment of relatedness based on the
      Network Analysis Profile, where respondents named their closest kin, indicated
      that African Americans had higher scores than European Americans, though their
      networks were smaller. DISCUSSION: Age and ethnicity differences appear to
      reflect cohort effects related to the impact of economic hardship on families
      earlier this century and racial prejudice. The high rates of dismissing
      attachment and low rates of secure attachment in this large urban population
      suggest that these individuals may be at risk for social isolation and poor
      health as they become older and more frail.

PMID- 11192343
TI  - The impact of involuntary job loss on subsequent alcohol consumption by older
      workers: findings from the health and retirement survey.
AB  - OBJECTIVE: To estimate the effect of involuntary job loss on subsequent alcohol
      consumption by older workers in the United States. METHODS: Using longitudinal
      data from the 1992 and 1994 waves of the Health and Retirement Survey, the
      authors estimated multivariate models to assess the impact of involuntary job
      loss on subsequent alcohol use. Two outcomes were investigated: reported daily
      alcohol consumption and onset of drinking. The analysis sample included 207
      workers who experienced involuntary job loss between survey dates and a
      comparison group of 2,866 continuously employed workers. RESULTS: After baseline
      alcohol consumption and a variety of socioeconomic and illness-related covariates
      were controlled, involuntary job loss was not associated (p>.05) with number of
      daily drinks consumed at follow-up. However, among those who did not consume
      alcohol at baseline, individuals who suffered involuntary job loss were twice as
      likely as continuously employed individuals to start drinking by follow-up (OR =
      2.01; CI = 1.06-3.80). The majority of those who began drinking at follow-up
      reported drinking less than 1 drink per day. DISCUSSION: The findings provide
      evidence of a significant relationship between job loss and subsequent alcohol
      use among baseline nondrinkers. However, the magnitude of the changes in drinking
      was quite modest.

PMID- 11192344
TI  - Changing attitudes toward aging policy in the United States during the 1980s and
      1990s: a cohort analysis.
AB  - OBJECTIVES: This research assessed how the attitudes of Americans toward
      government programs that serve older people changed between the mid-1980s and
      late 1990s and how much of the shift was dueto intracohort change and how much
      was due to cohort replacement. METHODS: Data come from three nationally
      representative cross-sectional samples, surveyed by telephone in 1986 (N =
      1.209), 1990 (N = 1,500), and 1997 (N = 1,559). RESULTS: Attitudes of Americans
      have become less supportive of expanding entitlement programs for older people
      and more supportive of cutting their costs and benefits. Between 1986 and 1997,
      most cohorts, particularly older adults, grew more in favor of maintaining Social
      Security benefit levels but less in favor of expanding them. Young adults tended
      to be driving the societal shift in attitudes toward decreasing benefits.
      Intercohort change was more important than cohort replacement in this process.
      Analyses of change in 2 attitude domains between 1990 and 1997 revealed that the
      general population felt less strongly that older people are entitled to benefits
      and expressed greater opposition to the associated costs. However, young adults
      moderated their concerns about costs as they got older, although the young adults
      in the cohort replacing them had become more critical of the principle of
      entitlement. DISCUSSION: These findings enhance the understanding of the roles
      that historical conditions and aging play in shaping the attitudes of adult
      cohorts toward public programs for older citizens. Discrepant findings based on
      the intercohort change in younger age groups are reconciled by differentiating
      maturation effects from period effects on impressionable youth.

PMID- 11192345
TI  - Immigration and the regional demographics of the elderly population in the United
      States.
AB  - OBJECTIVES: This research examined the impacts of past international and
      interregional migration flows on regional elderly population growth and
      distribution patterns. METHODS: The authors used 1960, 1970, 1980, and 1990
      Census data and multiregional demographic models to analyze changes in the
      sources of regional elderly population growth rates, age compositions, and
      spatial distributions over time. RESULTS: Past elderly interregional migration
      patterns have exhibited considerable stability and have contributed less than
      aging-in-place in shaping regional elderly population geographies. Also the
      effects of immigration on elderly dependency ratios have been very modest.
      DISCUSSION: Little evidence exists of any significant breaks with past trends in
      internal elderly migration patterns. Reconstruction of elderly population changes
      between 1950 and 1990 reveals that the driving force behind the changes was net
      aging-in-place and not net migration. Finally, analysis of the possible
      population rejuvenating effects of immigration suggests that although its impact
      has contributed to lower elderly-to-worker dependency ratios, its level over the
      past decades has been insufficient to counteract the much stronger countervailing
      impact of population aging.

PMID- 11192346
TI  - Gender differences in the depressive effect of widowhood in later life.
AB  - OBJECTIVES: This study documented the stronger adverse effect of widowhood on the
      psychological well-being of men than that of women and explained why this gender
      difference in the effect of widowhood exists. METHODS: Data came from Wave 1 of
      the National Survey of Families and Households. Married and widowed people aged
      65 and older were selected (n = 1,686). The dependent variable was the Center for
      Epidemiologic Studies--Depression scale (CES-D). RESULTS: Widowhood was indeed
      more depressing for men than women. However, this was due primarily to the fact
      that married men were much less depressed than married women; widowed men and
      women were comparably depressed. Other contributors to the stronger effect of
      widowhood for men included men's shorter average time since widowhood, lower
      frequency of church attendance, stronger dislike of domestic labor, and lessened
      ability to assist their children. DISCUSSION: Although widowhood has a strong
      depressive effect for older men, its effect for women is nonsignificant, and it
      explains a small proportion of the variation in depressive symptomatology. This
      suggests that most people, particularly women, adapt relatively well in the long
      run.

PMID- 11192347
TI  - Treatment of heart failure with beta-blockers. Mechanisms and results.
AB  - Sympathetic activation is a significant predictor of a poor prognosis in heart
      failure. Excessive stimulation with norepinephrine produces apoptosis,
      tachycardia and arrhythmias thereby leading to progression of left ventricular
      dysfunction and worsening of outcome. Beta-blockers reduce morbidity and improve
      cardiac function. They have been shown to improve survival (MERIT-HF, CIBIS II
      and US-Carvedilol Trials). A careful uptitration of dosages is achievable with a
      low rate of side effects. The mechanism of beta-blocker effects in heart failure
      are cardiac protection from beta1-adrenoceptor overstimulation, antiarrhythmic
      effects, reduction in heart rate and positive energetic effects or a combination
      thereof.

PMID- 11192348
TI  - Clinical trial data on the cardioprotective effects of beta-blockade.
AB  - In most patients with heart failure the underlying cause is coronary artery
      disease (CAD). They have a poor prognosis and die slowly from deteriorating
      cardiac function or suddenly from ventricular fibrillation or atheromatous plaque
      rupture. Two key aims of treatment, therefore, are to slow the progression of the
      underlying CAD and the resulting heart failure and to reduce the risk of sudden
      death. The impact of drugs on CAD and sudden death can be assessed most
      effectively in patients who have recovered from a myocardial infarction (post-MI
      patients). Beta-blockers have been studied in at least 25 trials in post-MI
      patients and their capacity to reduce mortality and re-infarction has been well
      documented. About 50% of those who die in post-MI trials die suddenly and beta
      blockers particularly propranolol, timolol and metoprolol have been shown to
      reduce the risk of sudden death significantly. Further evidence that beta
      blockers are cardioprotective in post-MI patients can be obtained from trials of
      other drugs by noting the mortality rates in those patients who were also on a
      beta-blocker. In three trials of antiarrhythmic drugs and two trials of ACE
      inhibitors, those on beta-blockers had a better prognosis. There is therefore
      good evidence that in a patient population known to have serious CAD, beta
      blockers can effectively reduce the risk of major coronary events and are
      particularly effective in reducing the risk of sudden death.

PMID- 11192349
TI  - The management of heart failure--an overview.
AB  - National and international societies have issued guidelines on the management of
      heart failure: The European Society of Cardiology, WHO, ACC/AHA Task Force
      Report, US Department of Health and Human Services, German Society of Cardiology.
      The therapeutic approaches to heart failure have undergone considerable changes
      during the last few years. The guidelines have to be updated almost yearly due to
      new results from prospective randomized studies. Although an agreement could be
      reached with respect to general measures and drug treatment, no agreement on
      mechanical devices, pacemakers and surgical interventions has been reached. The
      basis for medical treatment of chronic heart failure depends on diuretics,
      digitalis, ACE inhibitors, and beta-blockers. Calcium antagonists and other
      positive inotropic drugs, other than digitalis, should be avoided as far as
      possible. Thiazides, loop diuretics and aldosterone antagonists are needed for
      acute and chronic treatment of heart failure, alone or in combination (diuretic
      resistant heart failure!). Digitalis glycosides are needed in patients with
      atrial fibrillation with a fast ventricular rate or atrial flutter and in
      patients with systolic dysfunction, large hearts and symptomatic failure class
      NYHA III and IV. However, digitalis does not convert atrial fibrillation to sinus
      rhythm. Today there is no question that ACE inhibitors improve the prognosis of
      all patients with heart failure in all stages, if ejection fraction is reduced.
      Therefore, most patients after myocardial infarction or after having experienced
      pump failure due to myocarditis or cardiomyopathy are treated with ACE inhibitors
      and diuretics. The beneficial effects of ACE inhibitors seem to be most
      pronounced the worse the situation is. Relative risk reductions (mortality!)
      between 10% and 40% have been published depending on the severity of symptomatic
      left ventricular dysfunction. Those patients with high absolute risk have more to
      gain than those with low risk for any given "risk reduction", of course. Recent
      studies also indicate that most high risk cardiac patients profit from ACE
      inhibitors even if pump function is normal (i.e., patients with coronary heart
      disease, diabetes mellitus, cerebral vascular disease, hypertension) (15). AT1
      antagonists can substitute for ACE inhibitors, if the latter are not tolerated
      due to cough. Up to now, beta-blocking agents apart from diuretics seem to be the
      best investigated drugs in heart failure. Large controlled studies with
      bisoprolol, carvedilol and metoprolol in addition to diuretics, digitalis and ACE
      inhibitors convincingly yielded positive results in chronic left ventricular
      failure patients. Reduction of mortality by 35% and even of sudden cardiac deaths
      by 40% have been proven beyond doubt. Thus, heart failure patients today should
      also receive beta-blocking agents in all stages of the disease. In the era of
      controlled prospective studies (evidence-based medicine), physicians are well
      advised to use only drugs that have been proven beneficial in large controlled
      studies.

PMID- 11192350
TI  - Beta-blockers: recognising the assets in relation to coronary artery disease.
AB  - Beta-blockers have been shown to reduce the risk of coronary events and reduce
      the mortality of patients with hypertension and in those who have had a
      myocardial infarction. Furthermore, the evidence for long-term benefits in these
      two patient groups are much more convincing for beta-blockers than for other
      therapeutic agents used to treat these patient groups. In spite of this beta
      blockers are underused because doctors believe that these drugs are
      contraindicated in many vulnerable patient groups. The data now available from
      the many trials and observational studies have shown that patients such as the
      elderly, those with some degree of heart failure, diabetics and those with
      chronic lung disease not only tolerate beta blockers but derive more benefit than
      more healthy patient groups.

PMID- 11192351
TI  - Sudden death: ACE inhibitors and beta-blockers.
AB  - Sudden death is extremely common in patients suffering from cardiovascular
      diseases. At least one third of those with hypertension and probably about half
      of those who survive a myocardial infarction or suffer from cardiac failure who
      die in a clinical trial, die suddenly. Beta-blockers reduce the risk of sudden
      death in patients with cardiovascular disease, particularly in those who have had
      a myocardial infarction or heart failure. ACE inhibitors are perhaps less
      effective. Other cardiovascular drugs have not been shown to reduce the risk of
      sudden death.

PMID- 11192352
TI  - Cardioprotection with beta-adrenoceptor blockers. Does lipophilicity matter?
AB  - Beta-blockers have several beneficial cardiovascular effects in patients with
      hypertension, angina pectoris, myocardial infarction, and congestive heart
      failure. In patients with myocardial infarction and congestive heart failure some
      beta-blockers have been found to reduce mortality and morbidity. The beta
      blockers with a proven effect on prognosis include timolol, metoprolol,
      propranolol, bisoprolol, and carvedilol. One important question is whether all
      cardiovascular effects obtained by beta-blockers can be considered to be class
      effects. The beta-blockers with favorable effects on prognosis include two with
      more selective beta1-receptor blockade (metoprolol and bisoprolol) and three non
      selective (timolol, propranolol and carvedilol). One non-selective beta-blocker,
      which also has a more pronounced class III effect, sotalol, has been studied in a
      large postinfarction study without a significant effect on mortality. However,
      sotalol reduced the incidence of reinfarction similarly to the other beta
      blockers with proven effect on mortality after myocardial infarction. Sotalol had
      no influence at all on sudden cardiac death, while all the other beta-blockers
      referred to above have a very marked effect on sudden cardiac death, in fact more
      marked than on overall mortality. The beta-blockers with proven effect on
      mortality and on sudden death have one property in common and that is some
      degreee of lipophilicity. Sotalol and atenolol are hydrophilic. From animal
      experimental data it has been suggested that beta-bockers with some degree of
      lipophilicity penetrate into the brain and have an indirect effect on vagal
      activity, which is of importance for prevention of ventricular fibrillation and
      sudden cardiac death. It can be summarized that some beta-blockers have been
      found to reduce mortality and sudden cardiac death in patients after myocardial
      infarction and in congestive heart failure, while others have not. It seems that
      the major properties of the beta-blockers with proven effects on mortality and
      sudden cardiac death are beta1-receptor blockade and some degree of
      lipophilicity. Until we know more about the mechanisms behind prevention of death
      and especially sudden cardiac death by beta-blockers, only drugs with proven
      effects on prognosis should be used.

PMID- 11192353
TI  - Achieving optimal beta1-blockade with metoprolol CR/Zok.
AB  - The metoprolol CR/Zok is a multi-unit formulation containing metoprolol succinate
      controlled release (CR/Zok) in the form of individual drug delivery units
      (microcapsules). Each microcapsule acts as a diffusion cell and is designed to
      deliver metoprolol succinate at a near constant rate for about 20 hours
      independently of food intake, pH and other physiological variations. Taking the
      half-life of metoprolol into account this yields an even plasma concentration
      over 24 hours with a once daily dosage scheme. The formulation allows for once
      daily dosing, avoiding peaks and troughs in the plasma concentration of the drug.
      This leads to an even beta1-blockade over 24 hours in dose ranges from 12.5 mg to
      200 mg once daily. Plasma fluctuations are considerably decreased compared with
      immediate release formulations and cardioselectivity is well maintained also on
      200 mg CR/Zok. Vital important beta1-blockade is maintained for 24 hours.
      Metoprolol CR/Zok is well tolerated and well-being has been shown to be improved
      with metoprolol CR/Zok in patients with chronic heart failure as illustrated in
      the findings from the MERIT-HF study.

PMID- 11192354
TI  - Coronary artery disease: the role of lipids, hypertension and smoking.
AB  - Pioneering epidemiological projects such as the Seven Countries study, and the
      Framingham Heart study established the classical risk factor concept for coronary
      heart disease (CAD). These landmark studies showed that a raised serum total
      cholesterol, high blood pressure (systolic and diastolic) and smoking increase
      the risk of developing CHD in men and women in a graded fashion. Women develop
      CHD about 10 years later than men and women's risk is smaller. In the years and
      decades following these early studies many more prospective cohort studies
      primarily in the US and Europe have confirmed the early findings. In Germany two
      occupational and one population based cohort studies have contributed further
      information on this topic. In addition interactions between the three classical
      risk factors have been quantified, demonstrating for example that smoking carries
      a much higher risk for CHD in persons with high cholesterol values. Most cohort
      studies have confirmed that the relative risks for the classical risk factors are
      very similar. However, the respective absolute risks can differ tremendously,
      indicating that many more factors such as socio-economic conditions, nutrition,
      physical activity and others are of importance for the development of CHD. The
      scientific community, however, did not accept the consistent findings from the
      many observational studies as proof of causality. They required evidence that the
      risk for CHD could be reduced when the respective risk factor(s) was (were)
      diminished or eliminated. The late 1960s early 1970s thus saw the beginning of
      the era of randomized controlled trials (RCTs) following the advice of Archibald
      Cochrane who once wrote "we have to find that point on the distribution curve
      where therapy does more good than harm". We now know from meta-analyses of RCTs
      that a 1% reduction in serum cholesterol produces a 2-3% decline in risk for CHD
      and we can achieve reductions in total cholesterol of 20% or more. Regarding
      treatment of high blood pressure, meta-analyses of RCTs have shown that a
      reduction of 1 mmHg in diastolic blood pressure (DBP) produces a 2-3% decline in
      risk of CHD, and we can achieve reductions in DBP on average of 5-6 mmHg. With
      regard to smoking cessation, observational studies have shown that within 1-5
      years of cessation those who stop smoking have a 50-70% lower risk than current
      smokers. Thus the findings from observational studies, RCTs and studies on
      mechanisms have clearly established the importance of the three classical risk
      factors for CHD. The successful treatment of these risk factors will not only
      lower the burden of CHD in the population but promises to be the most effective
      way of improving the health of the whole population.

PMID- 11192355
TI  - Coronary artery disease: an inflammatory or infectious process.
AB  - It is well accepted that coronary artery disease is linked to an inflammatory
      process. It is unknown which agents may cause or accelerate coronary artery
      disease. An inflammation of the vessel wall may be caused by a number of
      mechanisms such as accumulation of glycosylated proteins in diabetic patients,
      oxidised LDL in patients with hypercholesterolemia or infectious agents. Among
      the possible infectious agents Chlamydia pneumoniae is the most likely
      microorganism involved in atherosclerosis. The arguments in favour of Chlamydia
      pneumoniae result from seroepidemiologic studies and from detection of chlamydial
      DNA in atherosclerotic plaques by polymerase chain reaction (PCR). In addition
      this microorganism is the only one that could be isolated from atherosclerotic
      tissue. This review summarises the present understanding of the role of an
      inflammatory process in the development or progression of coronary artery
      disease.

PMID- 11192356
TI  - Coronary artery disease--free radical damage, antioxidant protection and the role
      of homocysteine.
AB  - Traditional risk factors for coronary artery disease (CAD) can only explain
      approximately two thirds of the observed clinical events. This has maintained
      interest in other nutritional and biochemical factors that might contribute to
      the underlying pathophysiology of vascular disease. Two such factors are dietary
      antioxidants and plasma homocysteine. Established risk factors such as
      hypertension, smoking and diabetes mellitus are all associated with increased
      oxidative stresses due to excess free radical activity in the vascular wall. This
      may facilitate the development of vascular disease because of (i) increased
      oxidation of low-density lipoprotein (LDL) particles which increases their
      propensity to deposition in the vascular wall, (ii) inactivation of endothelium
      derived nitric oxide, and (iii) direct cytotoxicity to endothelial cells.
      Protective antioxidant molecules include vitamin C and vitamin E of which the
      latter is lipid soluble and is the primary antioxidant defence in circulating LDL
      particles. Epidemiological studies have suggested strongly that individuals who
      have high circulating concentrations or dietary intake of natural antioxidant
      vitamins are protected against vascular disease events (18). Furthermore, many
      studies have demonstrated a beneficial effect of natural and synthetic
      antioxidants on surrogate markers of vascular disease such as endothelial
      function and lipoprotein oxidation. However, large prospective randomized
      controlled intervention trials, mostly involving vitamin E (e.g. CHAOS, HOPE
      (22)), have failed to demonstrate any beneficial effect upon vascular mortality
      in high risk individuals. Possible reasons for these disappointing results
      include the pro-oxidant effects of high dose antioxidant supplements,
      particularly in patients with established vascular disease. Homocysteine is a
      sulphydryl-containing amino acid derived from the demethylation of dietary
      methionine. Epidemiological studies over 30 years have shown that increased
      concentrations of homocysteine are associated with vascular disease. This link is
      independent of other risk factors, is consistent across many studies and is
      strongly dose-related. Recently, evidence has accumulated to suggest that this
      link is also biologically plausible because homocysteine promotes oxidant injury
      to the vascular endothelium, impairs endothelium-dependent vasomotor regulation
      and may also alter the coagulant properties of the blood. Plasma homocysteine
      levels can be reduced by dietary supplements of folic acid and B vitamins.
      Studies are currently being undertaken to examine the impact of these vitamins in
      high risk patients and, thereby, establish a causative role for homocysteine in
      promoting vascular events.

PMID- 11192357
TI  - Renal disease as a risk factor for cardiovascular disease.
AB  - Cardiovascular disease is the major cause of death in patients with end-stage
      renal disease (ESRD). ESRD patients are almost invariably hypertensive. They all
      have acquired combined hyperlipidemia and increased Lp(a), hyperhomocysteinemia,
      decreased physical activity, psychosocial stress, insulin resistance,
      procoagulant factors, left ventricular hypertrophy, and increased oxidative
      stress. Diabetes mellitus, a major risk factor for both cardiovascular disease
      and ESRD, has become the commonest cause of ESRD. If ESRD patients choose to
      smoke, the additive risk is profound. Moreover, ESRD patients are becoming older
      and are often menopausal if female. Finally, ESRD patients have a dramatic
      tendency for vascular and cardiac calcification, probably related to
      hyperphosphatemia and hyperparathyroidism. Cardiovascular disease is also a major
      risk in patients with decreased renal function of nearly any degree. Data from
      the HDFP study showed that patients with a serum creatinine concentration > 1.5
      mg/dl had a profoundly higher risk of cardiovascular disease than patients with
      creatinine values below this value. These data were recently corroborated in the
      HOPE study. Microalbuminuria (MAU), with or without diabetes mellitus, indicates
      increased cardiovascular disease risk even without decreases in glomerular
      filtration rate. We found earlier that nondiabetic hypertensive patients with MAU
      had much higher rates of myocardial infarction, stroke, and peripheral vascular
      disease, than similar hypertensive patients without MAU. In conclusion, the
      presence of decreased renal function or MAU is a major cardiovascular risk
      factor. ESRD can be regarded as a catastrophic risk factor. Prophylactic measures
      known to be effective in reducing the risk from cardiovascular disease are
      grossly underused. Unfortunately, they are less effective in patients with renal
      disease, and new strategies are needed.

PMID- 11192358
TI  - Coronary artery disease--is menopause a risk factor?
AB  - Cardiovascular disease, especially coronary artery disease (CAD), are leading
      causes of morbidity and mortality in women over the age of 50, whereas this is
      rarely the case in younger women. This fact, the overall lower incidence of and
      the 10-15 year retarded occurrence of CAD in women, has led to the
      controversially discussed question whether menopause is a risk factor for CAD.
      There has been universal agreement that surgically induced early menopause with
      bilateral oophorectomy is a risk factor for CAD, associated with a relative risk
      of 2, unless estrogen is replaced. Yet pertinent naturally occurring menopause
      studies showed variable results. This review focuses on the criteria required for
      an association to be accepted as a risk factor. The occurrence of natural
      menopause is influenced by preexisting risk factors in different, partly opposing
      ways. Smoking leads to an earlier occurrence of menopause, obesity, hypertension
      and diabetes to a later occurrence. These complex interactions complicate
      statistical analysis. Natural menopause is associated with profound biochemical
      and metabolic changes, which are established risk factors, e.g., increase in LDL
      and decrease in HDL cholesterol. These biochemical and metabolic changes are the
      mechanisms by which menopause can act as a risk factor. CONCLUSIONS: Menopause
      can be accepted as a risk factor, even if not all requirements, particularly that
      of reversibility, are fulfilled. The occurrence of menopause indicates the
      transition from a low to a higher risk for CAD in women.

PMID- 11192359
TI  - ACE inhibitors in heart failure: an update.
AB  - Angiotensin-converting enzyme (ACE) inhibitors are now accepted as part of the
      routine management of patients with heart failure. Their use has been mandated in
      all the new major mortality trials to test the efficacy of beta-blockers in heart
      failure. Morbidity and mortality remain high in those with heart failure even
      with the benefits proven for both these groups of agents. In spite of the
      evidence for benefit of ACE inhibitors they are persistently used in lower doses
      in clinical practice than tested in the large-scale trials. This was so prevalent
      as to allow the conduct of a substantial study, the ATLAS trial, to compare high
      and low dose ACE inhibition. Its equivocal findings have allowed different
      interpretations. Clinical experience would suggest that starting with a low dose
      is appropriate but the dose should be titrated then without undue delay to the
      levels used in the trials wherever possible. The evidence for benefit with these
      drugs had been obtained largely in patients with impaired systolic function.
      However the AIRE study selected patients with clinical evidence of heart failure
      after myocardial infarction rather than with impaired systolic function. A
      substantial and long-term benefit was found from ACE inhibition. A cohort of
      patients had ventricular function assessed and as anticipated almost one half had
      preserved systolic function. Whilst the absolute benefit in lives saved was
      greater in the higher risk/low ejection fraction group, the relative risk
      reduction was not significantly different between those with preserved or
      impaired systolic function. The publication of the HOPE trial, although not a
      study of patients with heart failure, has clarified the situation considerably
      for those taking day to day care of patients. The HOPE study selected patients on
      the basis of high cardiovascular risk excluding those with known impaired
      systolic function. Although not an entry requirement for the study, ejection
      fraction was measured in a substantial majority and was above 40% indicating
      preservation of systolic function. The ACE inhibitor ramipril markedly reduced
      the combined end-point of cardiovascular death, stroke and myocardial infarction.
      Importantly there was a highly significant 20% risk reduction in the rate of
      myocardial infarction, a prospectively defined end-point, over the average four
      and a half year follow-up. Taken together with the retrospectively derived
      evidence from the heart failure trials there is now compelling evidence that the
      ACE inhibitors prevent myocardial infarction. The majority of patients with
      clinical heart failure have underlying ischaemic heart disease. Prevention of
      myocardial infarction and control of blood pressure are two key factors in the
      management of these patients irrespective of systolic ventricular function. The
      ACE inhibitors like the beta-blockers therefore have a pivotal role in their
      management. A challenge to current clinical trials is to determine whether these
      properties are shared to the same degree by the angiotensin antagonists or if
      even further gains in benefit can come from their combination. The neutral
      findings of the ELITE II study comparing the angiotensin antagonist, losartan,
      with the ACE inhibitor, captopril, have heightened interest in the on-going
      trials addressing these issues.

PMID- 11192360
TI  - The background of the MERIT-HF trial.
AB  - In the not so distant past, the idea of using beta-blockers as a primary therapy
      for congestive heart failure to improve symptoms and prognosis seemed
      paradoxical. The cardiac community reacted with skepticism when, in 1975, the
      pioneering report of Waagstein et al. appeared in the British Heart Journal.
      Since then numerous groups have investigated the effects of beta-adrenoceptor
      antagonists in patients with congestive heart failure. Unfortunately, the results
      of these trials have sometimes contradicted one another. Exercise tolerance and
      left ventricular ejection fraction improved in the trials with a duration of
      treatment of longer than 3 months, but no benefit was observed when beta-blockers
      were administered for only 1 month. Now, in the year 2000 we have proof for the
      concept that beta-blockade improves symptoms and prolongs life in heart failure.
      Three large placebo-controlled clinical trials with more than 9000 patients have
      shown that carvedilol, bisoprolol and metoprolol significantly reduce morbidity
      and mortality in heart failure. These agents, therefore, are clearly indicated in
      the majority of patients with mild to moderate heart failure.

PMID- 11192361
TI  - MERIT-HF--description of the trial.
AB  - The MERIT-HF study was a randomized, double-blind, placebo-controlled trial with
      a single-blind, two-week placebo run-in period. There were two primary
      objectives: total mortality; and the combined endpoint of total mortality or all
      cause hospitalizations (time to first event). Several other combined endpoints
      were also predefined, as were number of hospitalizations due to heart failure and
      other cardiovascular causes, withdrawal of study medicine due to all causes, and
      due to worsening heart failure, and change in NYHA class. The effect on Quality
      of Life was assessed in a substudy. The major inclusion criteria were symptomatic
      heart failure for at least 3 months corresponding to NYHA class II-IV; and a left
      ventricular ejection fraction of 0.40 or less in 40 to 80 year old men and women.
      The patients had to be on optimal treatment for at least 2 weeks prior to
      randomization, defined in principle as any combination of diuretics and an ACE
      inhibitor. The recommended starting dose was half a 25 mg tablet of metoprolol
      CR/Zok once daily in patients in NYHA functional class III-IV, and one 25 mg
      tablet once daily in patients in NYHA class II. It was recommended to double the
      dose after each 2-week period in order to reach the highest tolerated dose aiming
      for a target dose level of 200 mg once daily of metoprolol CR/Zok or placebo.
      This dosage regimen could be modified according to the judgement of the
      investigator. Randomization began on February 14, 1997, and the last patient was
      randomized April 14, 1998. 1990 patients were randomized to metoprolol CR/Zok and
      2001 to placebo. The International Steering Committee stopped the study by
      October 31, 1998, upon recommendation from the Independent Safety Committee. The
      second pre-planned interim analysis (50% point) had shown that the pre-defined
      criterion for termination of the study was met and exceeded. The mean follow-up
      time was 1 year.

PMID- 11192362
TI  - MERIT-HF mortality and morbidity data.
AB  - This survival study was designed to address whether beta-1-blockade utilizing
      metoprolol CR/XL (controlled release/extended release) once daily added to
      standard therapy reduces mortality and morbidity in patients with decreased
      ejection fraction and symptoms of heart failure. Enrolled in a double-blind
      randomized study were 3991 patients with chronic heart failure in NYHA functional
      class II-IV and ejection fraction < or = 0.40 stabilized on optimal standard
      therapy. Randomization was preceded by a 2-week single blind placebo run-in
      period. The study medication was uptitrated during 8 weeks starting with 12.5 mg
      (NYHA functional class III-IV) or 25 mg once daily (NYHA functional class II).
      The target dose was 200 mg once daily. The primary endpoints were all-cause
      mortality and combined all-cause mortality and hospitalization (time to first
      event) and other objectives were cause-specific data on hospitalization, NYHA
      functional class and quality of life. Mean follow-up time was 1 year. All-cause
      mortality was reduced in the metoprolol CR/XL group compared with the placebo
      group, 145 versus 217 deaths, 7.2% per patient year of follow-up versus 11.0%
      with a relative risk of 0.66 (95% CI 0.53-0.81, nominal p = 0.00009, p adjusted
      for interim analysis = 0.0062). This effect was consistent across all predefined
      subgroups. Sudden deaths were fewer in the metoprolol group (79 versus 132
      deaths), RR 0.59 (p = 0.0002). Also deaths from worsening heart failure were
      fewer in the metoprolol group (30 versus 58 deaths), RR 0.51 (p = 0.0023). The
      combined endpoint total mortality or all-cause hospitalizations was also reduced
      by metoprolol (641 versus 767 events), RR 0.81 (p = 0.00012). Total mortality or
      hospitalizations due to worsening heart failure was also reduced (311 versus 439
      events), RR 0.69 (p < 0.00001). The number of hospitalizations due to worsening
      heart failure (317 versus 451, p < 0.00001) and days in hospital due to worsening
      heart failure (3401 versus 5303 days, p < 0.00001) were also reduced by
      metoprolol. There was also an improvement in NYHA functional class, assessed by
      the physicians as well as the McMaster Overall Treatment Evaluation questionnaire
      (OTE), assessed by the patients (p = 0.028 and p = 0.089, respectively).
      Permanent early discontinuation was 13.9% in the metoprolol group and 15.3% in
      the placebo group (RR = 0.90). In conclusion, in patients with symptomatic heart
      failure metoprolol CR/XL once daily improved survival by 34%, sudden death by
      41%, and deaths from worsening of heart failure by 49%. In addition to
      improvement of survival there was also a reduced need of hospitalizations for
      worsening heart failure and an improved NYHA functional class and of quality of
      life assessed in a substudy. Metoprolol was well tolerated with no difference in
      early discontinuation rate from placebo treatment.

PMID- 11192363
TI  - Effects of growth hormone on cardiac dysfunction and gene expression in genetic
      murine dilated cardiomyopathy.
AB  - Beneficial cardiac effects of growth hormone (GH) have been shown in heart
      failure in several settings, but studies are lacking on this and other forms of
      treatment in the cardiomyopathic (CM) mouse heart. In mice with dilated
      cardiomyopathy due to disruption of the muscle LIM protein (MLP) gene [MLP null
      mice (MLP-/-)], natural history was first assessed by an initial echocardiogram
      at 8 weeks and a later follow-up study (n = 31). In most mice, left ventricular
      (LV) dilation increased and/or function decreased by 5 months, and 3 of 12 mice
      followed for 9 months died. At the end of follow-up, 22 MLP-/- mice (average age
      10.2 months) had both LV dilation and reduced LV function and were selected for
      studies of GH effects on cardiac function and gene expression; mice were
      randomized to vehicle (controls) or recombinant human (rh) GH and restudied after
      2 weeks. In the GH-treated group compared to the control group, LV % fractional
      shortening and LV wall thickness (echocardiography) were increased, the LV
      dP/dtmax (catheter-tip micromanometry) was enhanced, and LV relaxation (tau)
      improved; however, the LV weight was not significantly increased. The LV
      expression of many genes was altered in MLP-/- mice, and several were influenced
      by GH. Thus, short-term RhGH treatment improved LV function in a setting of
      chronic cardiac deterioration and significantly reduced elevated LV mRNA
      expression of some (ANP, BNP) but not other members of the embryonic gene
      program. The MLP null cardiomyopathic mouse can be useful for exploring altered
      signaling and therapeutic interventions in heart failure.

PMID- 11192364
TI  - Hyperpolarization is not responsible for the acetylcholine-induced negative
      chronotropic action in the presence of isoproterenol.
AB  - It has been reported that acetylcholine hyperpolarizes the maximum diastolic
      potential of canine Purkinje fibers through a pathway involving a G protein and
      induces a decrease in their automaticity. It is unclear, however, whether the
      negative chronotropic action of acetylcholine in the presence of beta-adrenergic
      stimulation is due to the hyperpolarization of the maximum diastolic potential or
      a decrease in the slope of phase 4 depolarization. We used standard
      microelectrode techniques to study the negative chronotropic mechanism of
      acetylcholine in the presence of isoproterenol in adult canine Purkinje fibers.
      Fibers were incubated for 24 hours in Tyrode's solution alone (n = 10) or plus
      pertussis toxin (n = 10), and then superfused with acetylcholine (10(-9) to 10(
      4) M) in the presence of isoproterenol (10(-7) M). Acetylcholine in the presence
      of isoproterenol significantly decreased automaticity without hyperpolarization
      of the maximum diastolic potential, and decreased the slope of phase 4
      depolarization. The effects of acetylcholine on automaticity and the slope of
      phase 4 depolarization were attenuated by pertussis toxin. The present findings
      indicate that the negative chronotropic action of acetylcholine in the presence
      of isoproterenol is due to the decrease in the slope of phase 4 depolarization
      through a pathway involving a pertussis toxin-sensitive G protein and that it is
      not the result of hyperpolarization of the maximum diastolic potential.

PMID- 11192365
TI  - Effects of BIIB513 on ischemia-induced arrhythmias and myocardial infarction in
      anesthetized rats.
AB  - Na+/H+ exchange (NHE) plays an important role in the regulation of the
      intracellular pH (pHi) and in cardiac cell injury induced by ischemia and
      reperfusion. In the present study, we investigated the effects of BIIB513, a
      selective NHE-1 inhibitor on myocardial ischemia induced arrhythmias and
      myocardial infarction, provoked by 30 minutes of left main coronary artery
      occlusion followed by 2 hours of reperfusion in an anesthetized rat model.
      Intravenous administration of BIIB513 (0.01-3.0 mg/kg) did not induce changes in
      blood pressure or heart rate. BIIB513 (0.01, 0.1, 0.3, 1.0, 3.0 mg/kg) given
      prior to the coronary artery occlusion dose-dependently reduced ventricular
      premature beats, ventricular tachycardia, and a complete suppression of
      ventricular fibrillation down to the dose of 0.1 mg/kg. BIIB513 (0.01, 0.1, 0.3,
      1.0, 3.0 mg/kg) given prior to the coronary artery occlusion dose-dependently
      reduced the infarct size with an ED50 value of 0.16 mg/kg. BIIB513 (1.0 mg/kg)
      given prior to reperfusion also reduced infarct size by 47.3 +/- 13.1%. The
      reduction in infarct size was accompanied by a decrease in circulating levels of
      creatine phosphokinase (CPK). In conclusion, the present study demonstrates the
      cardioprotective ability of NHE-1 inhibition during myocardial ischemia and
      reperfusion by reducing serious ventricular arrhythmias and myocardial infarct
      size in anesthetized rats.

PMID- 11192366
TI  - Brief preconditioning ischemia alters diacylglycerol content and composition in
      rabbit heart.
AB  - In order to give further insight into the potential role of PKC in the beneficial
      effects of ischemic preconditioning, we have characterized the production of
      diacylglycerol, the endogenous activator of PKC, and its molecular species
      composition in ischemic control and preconditioned hearts. Preconditioning was
      induced by 1 cycle of 5 min of ischemia followed by 5 min of reperfusion. In
      control and preconditioned groups, hearts were harvested under deep anesthesia at
      baseline (preischemia) and at 2, 5 and 10 min into the sustained coronary artery
      occlusion, i.e., preceding myocyte death. Diacylglycerol content and fatty acid
      composition were analyzed by thin-layer chromatography (TLC) and high-performance
      liquid chromatography (HPLC), respectively. Myocardial diacylglycerol content was
      increased at 2 min into the sustained ischemia in the control group (481 +/- 34
      vs 292 +/- 64 ng x mg(-1) at baseline; p < 0.05), but was comparable to the
      baseline value at 5 and 10 min. In the preconditioned group, diacylglycerol
      production remained unchanged throughout the 10-min test ischemia (317 +/- 17 at
      2 min vs 312 +/- 38 ng x mg(-1) at baseline; p = NS). A detailed analysis of the
      molecular species composition at the time of 2 min revealed a reduced
      contribution of phosphatidylinositol to diacylglycerol production in
      preconditioned myocardium (global correlation coefficient 0.57 vs 0.66 in control
      myocardium) with a trend toward an enrichment of diacylglycerol composition with
      some species originating from phosphatidylcholine. Thus, our study revealed that
      brief preconditioning ischemia: (1) prevents the increase of diacylglycerol
      content in the early minutes of the sustained ischemia, and (2) emphasizes the
      contribution of phosphatidylcholine in diacylglycerol formation to the detriment
      of that of phosphatidylinositol.

PMID- 11192367
TI  - SB 203580, an inhibitor of p38 MAPK, abolishes infarct-limiting effect of
      ischemic preconditioning in isolated rabbit hearts.
AB  - There is debate concerning the involvement of p38 mitogen-activated protein
      kinase (MAPK) in ischemic preconditioning (PC). At the center of the controversy
      are data obtained after administration of SB 203580, a specific inhibitor of p38
      MAPK. Whereas several studies have reported that SB 203580 abolishes the
      cardioprotective effect of PC, others claim that this compound is actually
      cardioprotective against ischemia. Many of these latter observations have been
      made in isolated myocardial cells. Accordingly the present study was designed to
      test the effect of SB 203580 in a model of preconditioning in intact rabbit
      hearts in which infarct size was the end-point. Isolated hearts experienced 30
      min of regional ischemia followed by 120 min of reperfusion. Infarct size was
      measured with triphenyltetrazolium chloride. In control hearts infarction was
      30.2 +/- 3.3% of the risk zone. PC with 5 min of global ischemia and 10 min of
      reperfusion before the 30-min period of ischemia significantly reduced infarct
      size to 10.2 +/- 2.4% (P < 0.05 vs. control). SB 203580 (2 microM) added to the
      perfusate for 20 min starting 5 min before the index ischemia totally blocked the
      protection from PC (27.4 +/- 3.3% infarction). SB 203580 alone had no effect on
      infarct size (28.6 +/- 4.6% infarction). These results reveal that SB 203580 does
      not affect infarct size on its own, but selectively blocks preconditioning's anti
      infarct effect in the intact rabbit heart.

PMID- 11192368
TI  - The p38 MAPK inhibitor, SB203580, abrogates ischaemic preconditioning in rat
      heart but timing of administration is critical.
AB  - There is debate concerning the involvement of p38 mitogen activated protein
      kinase (MAPK) in the mediation of ischaemic preconditioning. Pharmacological
      inhibition of p38 MAPK with SB203580 has been reported to block preconditioning
      in some studies but not in others. We hypothesised that this divergence could be
      due to differences in the timing of inhibitor administration. Isolated rat hearts
      were perfused in the Langendorff mode and subjected to 35 min regional ischaemia
      followed by 120 min reperfusion. Hearts were then double stained with Evans' blue
      and triphenyltetrazolium chloride to determine risk (R) and infarct zones (I),
      expressed as I/R% ratios. Preconditioned hearts were subjected to 2 times 5 min
      global ischaemia with 10 min intervening reperfusion. SB203580 10 microM was
      perfused either during the preconditioning protocol (PC+/-SB-early),just prior to
      and during the first 15 min of the lethal ischaemia (PC+/-SB-late) or prior to
      regional ischaemia in the absence of preconditioning. Ischaemic preconditioning
      significantly limited infarct size (I/R 38.9 +/- 3.0% in control vs 13.4 +/-
      2.4%, P < 0.01). In the PC+/-SB-early group, preconditioning was still fully
      protective (I/R% 14.6 +/- 1.0). However, in the PC+/-SB-late group, SB203580
      completely blocked the protection afforded by preconditioning (I/R% 33.6 +/-
      4.4%, P < 0.01 vs 13.4 +/- 2.4% in preconditioned hearts, p < 0.05). SB203580
      alone did not affect infarct size when given prior to and during regional
      ischaemia (I/R 36.2 +/- 2.7%). These histological data are corroborated by a
      significant increase in p38 MAPK activation in the preconditioned hearts during
      sustained ischaemia in comparison with the controls. In conclusion the activation
      of p38 MAPK during lethal ischaemia, but not during the ischaemic preconditioning
      protocol, is essential for the mediation of protection and may resolve some of
      the earlier controversy surrounding the use of SB203580 in preconditioning
      studies.

PMID- 11192369
TI  - Evidence for an essential role of cyclooxygenase-2 as a mediator of the late
      phase of ischemic preconditioning in mice.
AB  - Recent studies have demonstrated that cyclooxygenase-2 (COX-2) is an essential
      mediator of the cardioprotective effects of the late phase of ischemic
      preconditioning (PC) in rabbits. The goal of this study was to determine whether
      COX-2 also plays an essential role in late PC in the mouse. B6129F2/J mice
      underwent a 30-min coronary occlusion followed by 24 h of reperfusion.
      Administration of the COX-2 selective inhibitor, NS-398, 30 min prior to the 30
      min occlusion (5 mg/kg i.p.) had no appreciable effect on infarct size compared
      with untreated controls (58.8 +/- 2.1%, vs. 58.8 +/- 4.3% of the risk region,
      respectively). When mice were preconditioned with six cycles of 4-min coronary
      occlusion/4-min reperfusion 24 h prior to the 30-min occlusion, infarct size was
      markedly reduced (19.3 +/- 3.4%), indicating a late PC effect. The protective
      effect of late PC was completely abrogated by administration of NS-398 30 min
      before the 30-min coronary occlusion (67.7 +/- 3.0%), but not by administration
      of vehicle alone (23.6 +/- 3.7%). These results indicate that COX-2 mediates the
      late phase of ischemic PC in the mouse and imply that the role of this enzyme in
      cardioprotection is not species-specific.

PMID- 11192370
TI  - Regulation of angiotensinogen gene expression and protein in neonatal rat cardiac
      fibroblasts by glucocorticoid and beta-adrenergic stimulation.
AB  - We previously demonstrated the presence of components for a renin-angiotensin
      system in fibroblasts cultured from neonatal rat ventricles, the regulation of
      expression of which has not been studied. Since glucocorticoids and beta
      adrenergic stimuli have been implicated in cardiac hypertrophy, and function as
      regulators of the circulating renin-angiotensin system, we examined the effects
      of dexamethasone and isoproterenol on angiotensinogen mRNA levels and protein
      secretion in cultured neonatal rat cardiac fibroblasts. Treatment of cardiac
      fibroblasts for 8 h with 10 micromol/l isoproterenol or 100 nmol/l dexamethasone
      increased angiotensinogen mRNA levels by 246 +/- 7% and 1406 +/- 207%,
      respectively. Over 24 h, dexamethasone and isoproterenol increased
      angiotensinogen secretion by 148 +/- 32% and 123 +/- 26%, respectively.
      Angiotensin II, which has been reported to be a positive regulator of
      angiotensinogen synthesis and secretion in liver, markedly attenuated the effects
      of dexamethasone and isoproterenol on angiotensinogen mRNA expression and
      secretion. In the presence of 1 micromol/l angiotensin II, the stimulation in
      angiotensinogen secretion observed with dexamethasone and isoproterenol was
      decreased by 62% and 76%, respectively. The negative feedback of angiotensin II
      on angiotensinogen expression was primarily mediated through the type one
      angiotensin II (AT1) receptor (IC50 = 0.30 +/- 0.02 nmol/l). In summary, results
      from this study demonstrate that angiotensinogen mRNA levels and protein
      secretion in cardiac fibroblasts are positively regulated by glucocorticoid and
      beta-adrenergic stimulation. In addition, angiotensinogen production by cardiac
      fibroblasts is under negative feedback control of angiotensin II.

PMID- 11192371
TI  - Adaptive mechanisms of the cardiovascular system in transgenic mice--lessons from
      eNOS and myoglobin knockout mice.
AB  - Transgenic mice have turned out to be important in the analysis of cardiovascular
      physiology and pathology. A large number of gene knockout and overexpression
      models have been generated, including genes involved in blood pressure
      regulation, cardiac function and hemostasis. In this review we concentrate on two
      models, the endothelial NO synthase and the myoglobin knockout mice. It will be
      shown that the genetic approach of gene function analysis in mice not only
      provides new insight into the actual role of the encoded gene product, but also
      uncovers possible secondary alterations which compensate for the induced change.
      In the case of NOS knockout mice, upregulation of other NOS isoforms, induction
      of signal molecules such as prostaglandins or endothelium-derived hyperpolarizing
      factor may conserve the vasodilatory potential of NOS deficient vessels. In the
      case of myoglobin knockout mice, even structural changes may contribute to
      compensate a loss of gene function as shown by the elevated capillary density,
      which may enhance the oxygen supply to mitochondria. Thus, results obtained by
      the analysis of gene function in transgenic animals may differ from acute
      pharmacological interventions in that they reveal the striking ability of an
      intact organism to effectively adapt to chronic changes in gene expression.

PMID- 11192372
TI  - Using gene-targeted mice to investigate the pathophysiology of myocardial
      reperfusion injury.

PMID- 11192373
TI  - Mouse models of focal arterial and venous thrombosis.
AB  - Mouse models of arterial and venous thrombosis have gained increasing interest
      over the last 15 years, due to direct availability of a growing number of
      genetically modified mice, improved technical feasibility, standardization of new
      models of local thrombosis, and low maintenance costs. In order to provide an
      overview of suitable models for the study of arterial and venous thrombosis in
      mice, we have systematically searched MEDLINE electronic databases for
      publications reporting on murine thrombo-embolic models from 1966-1999. We found
      that the variety of murine thromboembolic models through 1995 was rather limited,
      as most methods used intravenous injections of strong coagulation triggers such
      as thrombin, thromboplastin and collagen, causing lethal thromboembolism. Between
      1996 and the end of 1999, a number of more sophisticated murine models of local
      acute or chronic thrombosis have been established. They seem to be more suitable
      for mimicking the natural scenario of thrombosis and, therefore, are preferable
      models for pathophysiological or drug evaluation studies. In this paper various
      models are described and their advantages and limitations discussed.

PMID- 11192374
TI  - Mechanical ventilation of mice.
AB  - Due to growing interest in murine functional genomics research, there is an
      increasing need for physiological stable in vivo murine models. Of special
      importance is support and control of ventilation by artificial respiration, which
      is difficult to execute as a consequence of the small size of the animal and the
      technically demanding breathing pattern. In addition, numerous genetically
      altered mice show depressed spontaneous ventilation or impaired respiratory
      responses. After an introduction in murine respiratory physiology we describe
      options for ventilatory support, its monitoring and the potential side effects.
      This review will provide an overview on current possibilities in the field of
      airway support in mouse research.

PMID- 11192375
TI  - How is a tissue built?
AB  - Tissues change in many ways in the period that they are part of a living
      organism. They are created in fairly repeatable structural patterns, and we know
      that the patterns are due to both the genes and the (mechanical) environment, but
      we do not know exactly what part or percentage of a particular pattern to
      consider the genes, or the environment, responsible for. We do not know much
      about the beginning of tissue construction (morphogenesis) and we do not know the
      methods of tissue construction. When the tissue structure is altered to
      accommodate a new loading, we do not know how the decision is made for the
      structural reconstruction. We do know that tissues grow or reconstruct themselves
      without ceasing to continue with their structural function, but we do not
      understand the processes that permit them to accomplish this. Tissues change
      their structures to altered mechanical environments, but we are not sure how.
      Tissues heal themselves and we understand little of the structural mechanics of
      the process. With the objective of describing the interesting unsolved mechanics
      problems associated with these biological processes, some aspects of the
      formation, growth, and adaptation of living tissues are reviewed. The emphasis is
      on ideas and models. Beyond the objective is the hope that the work will
      stimulate new ideas and new observations in the mechanical and chemical aspects
      of developmental biology.

PMID- 11192376
TI  - Functional tissue engineering: the role of biomechanics.
AB  - "Tissue engineering" uses implanted cells, scaffolds, DNA, protein, and/or
      protein fragments to replace or repair injured or diseased tissues and organs.
      Despite its early success, tissue engineers have faced challenges in repairing or
      replacing tissues that serve a predominantly biomechanical function. An evolving
      discipline called "functional tissue engineering" (FTE) seeks to address these
      challenges. In this paper, the authors present principles of functional tissue
      engineering that should be addressed when engineering repairs and replacements
      for load-bearing structures. First, in vivo stress/strain histories need to be
      measured for a variety of activities. These in vivo data provide mechanical
      thresholds that tissue repairs/replacements will likely encounter after surgery.
      Second, the mechanical properties of the native tissues must be established for
      subfailure and failure conditions. These "baseline data" provide parameters
      within the expected thresholds for different in vivo activities and beyond these
      levels if safety factors are to be incorporated. Third, a subset of these
      mechanical properties must be selected and prioritized. This subset is important,
      given that the mechanical properties of the designs are not expected to
      completely duplicate the properties of the native tissues. Fourth, standards must
      be set when evaluating the repairs/replacements after surgery so as to determine,
      "how good is good enough?" Some aspects of the repair outcome may be inferior,
      but other mechanical characteristics of the repairs and replacements might be
      suitable. New and improved methods must also be developed for assessing the
      function of engineered tissues. Fifth, the effects of physical factors on
      cellular activity must be determined in engineered tissues. Knowing these signals
      may shorten the iterations required to replace a tissue successfully and direct
      cellular activity and phenotype toward a desired end goal. Finally, to effect a
      better repair outcome, cell-matrix implants may benefit from being mechanically
      stimulated using in vitro "bioreactors" prior to implantation. Increasing
      evidence suggests that mechanical stress, as well as other physical factors, may
      significantly increase the biosynthetic activity of cells in bioartificial
      matrices. Incorporating each of these principles of functional tissue engineering
      should result in safer and more efficacious repairs and replacements for the
      surgeon and patient.

PMID- 11192378
TI  - Direction-dependent constriction flow in a poroelastic solid: the intervertebral
      disc valve.
AB  - We hypothesize that a direction-dependent flow resistance exists in the
      intervertebral disc due to constriction flow in the cartilage endplates. A
      comparison of the hydrostatic pressure in the nucleus of the healthy
      intervertebral disc during daily loading with the relatively low osmotic swelling
      pressure during rest, suggests the necessity of such direction-dependent flow
      resistance to ensure that all the fluid exuded from the disc during loading is
      recovered during rest. A physical model demonstrating the direction-dependent
      resistance of constriction flow in a poroelastic solid is presented. A finite
      element model was developed and validated against this physical model. The finite
      element model showed that decrease of the constriction hole area not only
      increases the resistance to fluid flow, but also causes the direction-dependency
      of flow resistance to decrease. Through this mechanism, endplate sclerosis could
      affect normal daily fluid exchange in the intervertebral disc, resulting in
      decreased mass transport and/or dehydration of the disc.

PMID- 11192379
TI  - Extrinsic cell infiltration and revascularization accelerate mechanical
      deterioration of the patellar tendon after fibroblast necrosis.
AB  - This study was performed to determine the contribution of extrinsic cell
      infiltration and revascularization into the patellar tendon in alteration of the
      mechanical properties of the patellar tendon after intrinsic fibroblast necrosis
      using 77 rabbits. In Group I, after the patellar tendon underwent the in situ
      freeze-thaw treatment, a wrapping treatment was performed to inhibit any
      extrinsic cell infiltration into the tendon. In Group II, the patellar tendon
      underwent the freeze-thaw treatment without any of the wrapping treatment. In
      Group III, the patellar tendon underwent the same wrapping treatment but without
      any freeze-thaw treatment. The cell culture study demonstrated that the in situ
      freeze-thaw treatment killed from 97 to 100 percent of the cells in the patellar
      tendon. Histologically, no cells were found in the midsubstance of the patellar
      tendon in Group I at 1, 3, and 6 weeks. In Group II, a number of cells and some
      vessels were found scattered in the tendon at 3 and 6 weeks. Mechanically, the
      elastic modulus and the tensile strength of the patellar tendon of Group II were
      significantly lower than those of Groups I and III at 3 and 6 weeks. These facts
      suggest that extrinsic cell infiltration and revascularization from the
      surrounding tissues accelerate the deterioration of the mechanical properties of
      the patellar tendon matrix after intrinsic fibroblast necrosis.

PMID- 11192377
TI  - A Conewise Linear Elasticity mixture model for the analysis of tension
      compression nonlinearity in articular cartilage.
AB  - A biphasic mixture model is developed that can account for the observed tension
      compression nonlinearity of cartilage by employing the continuum-based Conewise
      Linear Elasticity (CLE) model of Curnier et al. (J. Elasticity, 37, 1-38, 1995)
      to describe the solid phase of the mixture. In this first investigation, the
      orthotropic octantwise linear elasticity model was reduced to the more
      specialized case of cubic symmetry, to reduce the number of elastic constants
      from twelve to four. Confined and unconfined compression stress-relaxation, and
      torsional shear testing were performed on each of nine bovine humeral head
      articular cartilage cylindrical plugs from 6 month old calves. Using the CLE
      model with cubic symmetry, the aggregate modulus in compression and axial
      permeability were obtained from confined compression (H-A = 0.64 +/- 0.22 MPa, k2
      = 3.62 +/- 0.97 x 10(-16) m4/N.s, r2 = 0.95 +/- 0.03), the tensile modulus,
      compressive Poisson ratio, and radial permeability were obtained from unconfined
      compression (E+Y = 12.75 +/- 1.56 MPa, v- = 0.03 +/- 0.01, kr = 6.06 +/- 2.10 x
      10(-16) m4/N.s, r2 = 0.99 +/- 0.00), and the shear modulus was obtained from
      torsional shear (mu = 0.17 +/- 0.06 MPa). The model was also employed to predict
      the interstitial fluid pressure successfully at the center of the cartilage plug
      in unconfined compression (r2 = 0.98 +/- 0.01). The results of this study
      demonstrate that the integration of the CLE model with the biphasic mixture
      theory can provide a model of cartilage that can successfully curve-fit three
      distinct testing configurations while producing material parameters consistent
      with previous reports in the literature.

PMID- 11192380
TI  - Static and fatigue strength of a fixation device transducer for measuring
      anterior cruciate ligament graft tension.
AB  - To determine which exercises do not overload the graft-fixation complex during
      intensive rehabilitation from reconstructive surgery of the anterior cruciate
      ligament (ACL), it would be useful to measure ACL graft loads during
      rehabilitative activities in vivo in humans. A previous paper by Ventura et al.
      (1998) reported on the design of an implantable transducer integrated into a
      femoral fixation device and demonstrated that the transducer could be calibrated
      to measure graft loads to better than 10 percent full-scale error in cadaveric
      knees. By measuring both the static and fatigue strengths of the transducer, the
      purpose of the present study was to determine whether the transducer could be
      safely implanted in humans without risk of structural failure. Eight devices were
      loaded to failure statically. Additionally, seven devices were tested using the
      up-and-down method to estimate the median fatigue strength at a life of 225,000
      cycles. The average ultimate strength was 1856 +/- 74 N and the median fatigue
      strength was 441 N at a life of 225,000 cycles. The maximum graft load during
      normal daily activities is estimated to be 500 N and the 225,000 cycle life
      corresponds to that of the average healthy individual during a 12-week period.
      Considering that patients who have had an ACL reconstruction are less ambulatory
      than normal immediately following surgery and that biologic incorporation of the
      graft should be well developed by 12 weeks thus decreasing the load transmitted
      to the fixation device, the FDT can be safely implanted in humans without undue
      risk of structural failure.

PMID- 11192381
TI  - Comparison of mechanical properties of various suture repair techniques in a
      partially lacerated tendon.
AB  - The technique of surgical repair for zone two flexor tendon injuries has been
      debated extensively throughout the years, yet adhesion formation, suture rupture,
      and suture locking on the pulley edge remain possible consequences of a poor
      repair. The partially lacerated tendon is especially challenging to treat since
      there can be justification for not intervening surgically. In a partial
      laceration canine model we measured failure load and suture gap formation for
      tendons repaired with the Lee, modified four-strand Savage, Kessler, modified
      Kessler, and Augmented Becker core suture techniques and with a simple running
      peripheral suture. The modified Kessler (106.3 N, SD 18.8 N) and modified Savage
      (108.2 N, SD 19.9 N) repair techniques had a significantly higher failure load
      than the Lee (85.0 N, SD 20.6 N) suture method (P < 0.05), while there were no
      differences among the other techniques. There were no significant differences in
      resistance to gap formation among the repair techniques, with the mean values
      ranging from 38.9 N/mm (SD 15.7 N/mm) using the simple running suture to 53.2
      N/mm (SD 25.8 N/mm) with the Kessler repair. The mean load to produce a 1.5 mm
      repair site gap ranged from 71.1 N (SD 21.5 N) in the Lee repair to 91.3 N (SD
      22.2 N) in the Augmented Becker repair although there were no significant
      differences among repair methods. All repair methods were much weaker than
      tendons left unrepaired (184.7 N, SD 41.3 N).

PMID- 11192382
TI  - Effects of stress shielding on the transverse mechanical properties of rabbit
      patellar tendons.
AB  - With the aim of studying mechanisms of the remodeling of tendons and ligaments,
      the effects of stress shielding on the rabbit patellar tendon were studied by
      performing tensile and stress relaxation tests in the transverse direction. The
      tangent modulus, tensile strength, and strain at failure of non-treated, control
      patellar tendons in the transverse direction were 1272 kPa, 370 kPa, and 40.5
      percent, respectively, whereas those of the tendons stress-shielded for 1 week
      were 299 kPa, 108 kPa, and 40.4 percent, respectively. Stress shielding markedly
      decreased tangent modulus and tensile strength in the transverse direction, and
      the decreases were larger than those in the longitudinal direction, which were
      determined in our previous study. For example, tensile strength in the transverse
      and longitudinal direction decreased to 29 and 50 percent of each control value,
      respectively, after 1 week stress shielding. In addition, the stress relaxation
      in the transverse direction of stress-shielded patellar tendons was much larger
      than that of nontreated, control ones. In contrast to longitudinal tensile tests
      for the behavior of collagen, transverse tests reflect the contributions of
      ground substances such as proteoglycans and mechanical interactions between
      collagen fibers. Ground substances provide lubrication and spacing between
      fibers, and also confer viscoelastic properties. Therefore, the results obtained
      from the present study suggest that ground substance matrix, and interfiber and
      fiber-matrix interactions have important roles in the remodeling response of
      tendons to stress.

PMID- 11192383
TI  - Tissue-level thresholds for axonal damage in an experimental model of central
      nervous system white matter injury.
AB  - In vivo, tissue-level, mechanical thresholds for axonal injury were determined by
      comparing morphological injury and electrophysiological impairment to estimated
      tissue strain in an in vivo model of axonal injury. Axonal injury was produced by
      dynamically stretching the right optic nerve of an adult male guinea pig to one
      of seven levels of ocular displacement (Nlevel = 10; Ntotal = 70). Morphological
      injury was detected with neurofilament immunohistochemical staining (NF68,
      SM132). Simultaneously, functional injury was determined by the magnitude of the
      latency shift of the N35 peak of the visual evoked potentials (VEPs) recorded
      before and after stretch. A companion set of in situ experiments (Nlevel = 5) was
      used to determine the empirical relationship between the applied ocular
      displacement and the magnitude of optic nerve stretch. Logistic regression
      analysis, combined with sensitivity and specificity measures and receiver
      operating characteristic (ROC) curves were used to predict strain thresholds for
      axonal injury. From this analysis, we determined three Lagrangian strain-based
      thresholds for morphological damage to white matter. The liberal threshold,
      intended to minimize the detection of false positives, was a strain of 0.34, and
      the conservative threshold strain that minimized the false negative rate was
      0.14. The optimal threshold strain criterion that balanced the specificity and
      sensitivity measures was 0.21. Similar comparisons for electrophysiological
      impairment produced liberal, conservative, and optimal strain thresholds of 0.28,
      0.13, and 0.18, respectively. With these threshold data, it is now possible to
      predict more accurately the conditions that cause axonal injury in human white
      matter.

PMID- 11192384
TI  - Geometric and mechanical properties of human cervical spine ligaments.
AB  - This study characterized the geometry and mechanical properties of the cervical
      ligaments from C2-T1 levels. The lengths and cross-sectional areas of the
      anterior longitudinal ligament, posterior longitudinal ligament, joint capsules,
      ligamentum flavum, and interspinous ligament were determined from eight human
      cadavers using cryomicrotomy images. The geometry was defined based on spinal
      anatomy and its potential use in complex mathematical models. The biomechanical
      force-deflection, stiffness, energy, stress, and strain data were obtained from
      25 cadavers using in situ axial tensile tests. Data were grouped into middle (C2
      C5) and lower (C5-T1) cervical levels. Both the geometric length and area of
      cross section, and the biomechanical properties including the stiffness, stress,
      strain, energy, and Young's modulus, were presented for each of the five
      ligaments. In both groups, joint capsules and ligamentum flavum exhibited the
      highest cross-sectional area (p < 0.005), while the longitudinal ligaments had
      the highest length measurements. Although not reaching statistical significance,
      for all ligaments, cross-sectional areas were higher in the C5-T1 than in the C2
      C5 group; and lengths were higher in the C2-C5 than in the C5-T1 group with the
      exception of the flavum (Table 1 in the main text). Force-deflection
      characteristics (plots) are provided for all ligaments in both groups. Failure
      strains were higher for the ligaments of the posterior (interspinous ligament,
      joint capsules, and ligamentum flavum) than the anterior complex (anterior and
      posterior longitudinal ligaments) in both groups. In contrast, the failure stress
      and Young's modulus were higher for the anterior and posterior longitudinal
      ligaments compared to the ligaments of the posterior complex in the two groups.
      However, similar tendencies in the structural responses (stiffness, energy) were
      not found in both groups. Researchers attempting to incorporate these data into
      stress-analysis models can choose the specific parameter(s) based on the
      complexity of the model used to study the biomechanical behavior of the human
      cervical spine.

PMID- 11192385
TI  - Biomechanical analysis of the three-dimensional foot structure during gait: a
      basic tool for clinical applications.
AB  - A novel three-dimensional numerical model of the foot, incorporating, for the
      first time in the literature, realistic geometric and material properties of both
      skeletal and soft tissue components of the foot, was developed for biomechanical
      analysis of its structural behavior during gait. A system of experimental
      methods, integrating the optical Contact Pressure Display (CPD) method for
      plantar pressure measurements and a Digital Radiographic Fluoroscopy (DRF)
      instrument for acquisition of skeletal motion during gait, was also developed in
      this study and subsequently used to build the foot model and validate its
      predictions. Using a Finite Element solver, the stress distribution within the
      foot structure was obtained and regions of elevated stresses for six subphases of
      the stance (initial-contact, heel-strike, midstance, forefoot-contact, push-off,
      and toe-off) were located. For each of these subphases, the model was adapted
      according to the corresponding fluoroscopic data, skeletal dynamics, and active
      muscle force loading. Validation of the stress state was achieved by comparing
      model predictions of contact stress distribution with respective CPD
      measurements. The presently developed measurement and numerical analysis tools
      open new approaches for clinical applications, from simulation of the development
      mechanisms of common foot disorders to pre- and post-interventional evaluation of
      their treatment.

PMID- 11192386
TI  - Head injury in facial impact--a finite element analysis of helmet chin bar
      performance.
AB  - The chin bar of a motorcycle helmet protects the rider from facial and head
      injuries. To evaluate the protective performance of chin bars against head
      injuries from facial impacts, an explicit finite element method was used to
      simulate the Snell Memorial Foundation test and a proposed drop test. The maximum
      acceleration and Head Injury Criterion (HIC) were employed to assess the impact
      absorbing capability of the chin bar. The results showed that the proposed
      approach should be more practical than the Snell test, and provided more
      information for improving the chin bar design to protect against head injuries.
      The shell stiffness was important in determining the protective ability of the
      chin bar, but a chin bar with only an outer shell and comfort foam offered
      inadequate protection. An energy-absorbing liner was essential to increase the
      protective performance of the chin bar and the liner density should be denser
      than that used in the cranial portion of the helmet. For the chin bar with energy
      absorbing liner, a shell design that is less stiff would provide better
      protection.

PMID- 11192387
TI  - Fatigue fracture of the stem-cement interface with a clamped cantilever beam
      test.
AB  - A clamped cantilever beam test was developed to determine the fatigue crack
      propagation rate of the CoCr alloy/PMMA cement interface at high crack tip phase
      angles. A combination of finite element and experimental methods was used to
      determine the fatigue crack growth rates of two different CoCr alloy/PMMA cement
      surfaces. A crack tip phase angle of 69 deg was found, indicating that loading at
      the crack tip was mixed-mode with a large degree of in-plane shear loading. The
      energy required to propagate a crack at the interface was much greater for the
      plasma-sprayed CoCr surface when compared to the PMMA-precoated satin finish (p <
      0.001). Both interface surfaces could be modeled using a Paris fatigue crack
      growth law over crack propagation rates of 10(-4) to 10(-9) m/cycle.

PMID- 11192388
TI  - Correlation of patellar tracking pattern with trochlear and retropatellar surface
      topographies.
AB  - The study was aimed to test the hypothesis that in the knee extension range 100
      to 30 deg, the patellar "out-of-plane" tracking pattern is controlled by the
      passive restraint provided by the topographic interaction of the patellofemoral
      contacting surfaces. The out-of-plane tracking pattern, i.e., the pattern of
      patellar displacements not in the plane of knee extension/flexion, consists of
      translation in the medial-lateral direction, and rotations about the anterior
      posterior axis (spin) and the proximal-distal axis (tilt). Using 15 fresh-frozen
      knees subjected to extensor moment magnitudes comparable to those in the "static
      lifting" activity (foot-ground reaction = 334 N), the patellar displacements were
      measured using a calibrated six-degree-of-freedom electromechanical goniometer.
      The topographies of the trochlear and retropatellar surfaces were then measured
      using a calibrated traveling dial-gage arrangement and the same coordinate system
      used for the displacement measurements. Three indices were defined to quantify
      particular natural features of the three-dimensional topographies that are
      expected to control the patellar displacements. Correlation of the indices with
      their corresponding displacements showed that topographic interaction was
      significant in the control of all three displacements. However, for patellar
      spin, unlike for the other two displacements, the direction of the active
      quadriceps tension vector was also a significant controlling factor. Patellar
      medial-lateral translation was found to be controlled dominantly by the trochlear
      topography, while retropatellar topography also had a significant role in the
      control of the other two displacements.

PMID- 11192389
TI  - Maximal wall shear stress in arterial stenoses: application to the internal
      carotid arteries.
AB  - Maximal wall shear stress (MWSS) in the convergent part of a stenosis is
      calculated by the interactive boundary-layer theory. A dimensional analysis of
      the problem shows that MWSS depends only on a few measurable parameters. A simple
      relationship between MWSS and these parameters is obtained, validated, and used
      to calculate the magnitude of MWSS in a carotid stenosis, as a function of the
      patency of the circle of Willis and the stenotic pattern. This demonstrates the
      huge effect of collateral pathways. Elevated MWSS are observed even in moderate
      stenoses, provided they are associated with a contralateral occlusion, a large
      anterior, and narrow posterior communicating arteries, suggesting a potential
      risk of embolus release in this configuration.

PMID- 11192390
TI  - Computer simulation of intraventricular flow and pressure gradients during
      diastole.
AB  - A two-dimensional axisymmetric computer model is developed for the simulation of
      the filling flow in the left ventricle (LV). The computed results show that
      vortices are formed during the acceleration phases of the filling waves. During
      the deceleration phases these are amplified and convected into the ventricle. The
      ratio of the maximal blood velocity at the mitral valve (peak E velocity) to the
      flow wave propagation velocity (WPV) of the filling wave is larger than 1. This
      hemodynamic behavior is also observed in experiments in vitro (Steen and Steen,
      1994, Cardiovasc. Res., 28, pp. 1821-1827) and in measurements in vivo with color
      M-mode Doppler echocardiography (Stugaard et al., 1994, J. Am. Coll. Cardiol.,
      24, 663-670). Computed intraventricular pressure profiles are similar to observed
      profiles in a dog heart (Courtois et al., 1988, Circulation, 78, pp. 661-671).
      The long-term goal of the computer model is to study the predictive value of
      noninvasive parameters (e.g., velocities measured with Doppler echocardiography)
      on invasive parameters (e.g., pressures, stiffness of cardiac wall, time constant
      of relaxation). Here, we show that higher LV stiffness results in a smaller WPV
      for a given peak E velocity. This result may indicate an inverse relationship
      between WPV and LV stiffness, suggesting that WPV may be an important noninvasive
      index to assess LV diastolic stiffness, LV diastolic pressure and thus atrial
      pressure (preload).

PMID- 11192391
TI  - Estimated flow resistance increase in a spiral human coronary artery segment.
AB  - Coronary flow estimates were made for a spiral coronary artery segment
      (identified from a post-mortem replica casting) by using a modified Dean number
      based on the approximate coil radius of curvature, as suggested earlier. The
      estimates were found to correlate experimental pressure drop data for helical
      coiled tubes. Over a physiological range of mean Reynolds numbers from 100 to 400
      for blood flow through main coronary arteries, estimates of the flow resistance
      increase relative to a straight lumen segment ranged from about 20 to 80 percent,
      and were of similar magnitude to those found in a flow study in a sinuous
      coronary vessel segment with no spiral.

PMID- 11192392
TI  - Stability analysis and finite element simulation of bone remodeling model.
AB  - Bone remodeling is widely viewed as a dynamic process--maintaining bone structure
      through a balance between the opposed activities of osteoblast and osteoclast
      cells--in which the stability problem is often pointed out. By an analytical
      approach, we present a bone remodeling model applied to n unit-elements in order
      to analyze the stationary states and the condition of their stability. In
      addition, this theory has been simulated in a computer model using the Finite
      Element Method (FEM) to show a relationship between the bone remodeling process
      and the stability analysis.

PMID- 11192393
TI  - The impact of the Internet on quality measurement.
AB  - Consumers are eager for information about health. However, their use of such data
      has been limited to date. When consumers do consider data in making health care
      choices, they rely more on word-of-mouth reputation than on traditional quality
      measures, although this information has not necessarily been readily accessible.
      The Internet changes the exercise of quality measurement in several ways. First,
      quality information--including reputation--will be more readily available.
      Second, consumers will increasingly use it. Third, the Internet provides a low
      cost, standard platform that will make it vastly easier for providers to collect
      quality information and pass it on to others. However, major barriers still stand
      in the way of public access to quality information on the Internet as well as of
      having that access actually improve patients' care.

PMID- 11192394
TI  - Patients, physicians, and the Internet.
AB  - The Internet will have a profound effect on the practice and business of
      medicine. Physicians, eager to provide high-quality care and forced by
      competition to offer online services, will introduce e-mail and patient-friendly
      Web sites to improve administrative services and manage common medical
      conditions. Patients will identify more health information online and will take
      more responsibility for their care. The doctor/patient relationship will be
      altered: Some aspects of electronic communication will enhance the bond, and
      others will threaten it. Patients will have access to vast information sources of
      variable validity. Many physician organizations are preparing for the electronic
      transformation, but most physicians are unprepared, and many are resistant.

PMID- 11192395
TI  - e-Health: technologic revolution meets regulatory constraint.

PMID- 11192396
TI  - Self-regulation: who needs it?

PMID- 11192397
TI  - Virtually exposed: privacy and e-health.

PMID- 11192398
TI  - e-health, HIPAA, and beyond.

PMID- 11192399
TI  - Sovereign immunity and health care: can government be trusted?
AB  - When government provides or arranges for health care, it is held to lower legal
      standards than private parties are, especially when liability is barred by
      "sovereign immunity". This paper examines sovereign immunity and its implications
      for health care quality by comparing private-sector and government accountability
      in several legal contexts. It then considers whether the law should be changed;
      the possible relationship between limited government accountability and public
      mistrust of a larger government role in health care; and the potential role of
      disparate legal standards if a lower tier of care evolves in government programs.

PMID- 11192400
TI  - Measuring community benefits provided by for-profit and nonprofit hospitals.
AB  - Nonprofit hospitals are expected to provide benefits to their community in return
      for being exempt from most taxes. In this paper we develop a new method of
      identifying activities that should qualify as community benefits and of
      determining a benchmark for the amount of community benefits a nonprofit hospital
      should be expected to provide. We then compare estimates of nonprofits' current
      level of community benefits with our benchmark and show that actual provision
      appears to fall short. Either nonprofit hospitals as a group ought to provide
      more community benefits, or they are performing activities that cannot be
      measured. In either case, better measurement and accounting of community benefits
      would improve public policy.

PMID- 11192401
TI  - The economics of for-profit and not-for-profit hospitals.
AB  - This paper examines the economics of for-profit and not-for-profit hospitals
      through the prism of capital acquisitions. The exercise suggests that of two
      hospitals that are equally efficient in producing health care, the for-profit
      hospital would have to charge higher prices than the not-for-profit hospital
      would, to break even on capital acquisitions. The reasons for this divergence are
      (1) the typically higher cost of equity capital that for-profit hospitals face;
      and (2) the income taxes they must pay. The paper recommends holding tax-exempt
      hospitals more formally accountable for the social obligation they shoulder, in
      return for their tax preference.

PMID- 11192402
TI  - Hospital conversions, margins, and the provision of uncompensated care.

PMID- 11192403
TI  - Are patients a scarce resource for academic clinical research?
AB  - Managed care has affected clinical research at academic medical centers (AMCs) in
      various ways. It has reduced revenues for both faculty practice plans and major
      teaching hospitals, thus constraining the internal funds available for the cross
      subsidy of research. It has increased the amount of patient care required of
      academic clinicians to meet target incomes, thus reducing the time for research.
      Has managed care also reduced the availability of patients for academic clinical
      research, either indirectly by diverting patients to community hospitals or
      directly by constraining access to such research, including clinical trials?
      Consistent with other studies and based on extensive interviews at nine AMCs,
      this research found little evidence that patients were a scarce resource for
      academic clinical research.

PMID- 11192404
TI  - Update on the nation's health care system: 1997-1999.
AB  - A major component of the Community Tracking Study is biennial site visits to
      twelve communities randomly selected to be representative of metropolitan areas.
      In the second round of visits, conducted in 1998 and 1999, we found an
      intensification of an earlier trend toward looser forms of managed care to be
      causing enormous turmoil, as health care organizations stumbled over and often
      abandoned strategies conceived for more tightly managed care. Communities' health
      care systems are not evolving as many anticipated but rather have focused
      increasingly on horizontal consolidation and regional scope.

PMID- 11192405
TI  - Tracking health care costs: inflation returns.

PMID- 11192406
TI  - The growth of multihospital firms in California.

PMID- 11192407
TI  - Health care reform and the new economy.
AB  - The objectives and assumptions of health care reform have changed repeatedly
      during the past century and may now be entering a new historical phase as a
      result of the "new economy" rooted in information technology. In a high-growth
      context, proponents of reform may no longer feel obliged to bundle expanded
      coverage with tighter cost containment. At the same time, the new digital
      environment may facilitate innovations intended to inform and expand consumer
      choice and to improve quality. The new environment elevates "transparency" to a
      guiding principle. Health informatics has long been peripheral to reform and must
      now become more central.

PMID- 11192408
TI  - Old before its time: HIPAA and e-health policy.

PMID- 11192409
TI  - A life in health policy.

PMID- 11192410
TI  - Traversing the digital divide.

PMID- 11192411
TI  - Despierta!

PMID- 11192412
TI  - Health information, the Internet, and the digital divide.
AB  - Through an analysis of recent data on adults' and children's computer use and
      experiences, this DataWatch shows that use of computers and the Internet is
      widespread and that significant percentages of the public are already using the
      Internet to get health information. The surveys also show that the Internet is
      already a useful vehicle for reaching large numbers of lower-income, less
      educated, and minority Americans. However, a substantial digital divide continues
      to characterize computer and Internet use, with lower-income blacks especially
      affected. Implications for the future of health communication on the Internet
      also are explored.

PMID- 11192413
TI  - Pharmaceutical cost growth under capitation: a case study.
AB  - Rising drug spending has generated concern among purchasers and policymakers.
      This paper compares drug cost growth in a capitated system with that in managed
      care systems that generally did not place physicians directly at risk for drug
      spending. We focus on cost growth because a substantial body of literature
      indicates that managed care interventions that reduce the level of costs may not
      influence the rate of cost growth. Drug cost growth under capitation initially
      was below that of other systems but still above targeted rates. Over time the
      capitation rates rose, the amount of risk transferred to physicians declined, and
      spending growth accelerated.

PMID- 11192414
TI  - Improving care at the end of life: what does it take?

PMID- 11192415
TI  - Mental health benefits under SCHIP.

PMID- 11192416
TI  - Clinician versus policymaker.

PMID- 11192417
TI  - Skepticism overdone: managed care and costs.

PMID- 11192418
TI  - Race and patient satisfaction.

PMID- 11192419
TI  - Understanding the value of prevention.

PMID- 11192420
TI  - Two old hands and the new new thing. Interview by Rob Cunningham.

PMID- 11192421
TI  - The Internet and managed care: a new wave of innovation.
AB  - Managed care firms have been under siege in the political system and the
      marketplace for the past few years. The rise of the Internet has brought into
      being powerful new electronic tools for automating administrative and financial
      processes in health insurance. These tools may enable new firms or employers to
      create custom-designed networks connecting their workers and providers, bypassing
      health plans altogether. Alternatively, health plans may use these tools to
      create a new consumer-focused business model. While some disintermediation of
      managed care plans may occur, the barriers to adoption of Internet tools by
      established plans are quite low. Network computing may provide important leverage
      for health plans not only to retain their franchises but also to improve their
      profitability and customer service.

PMID- 11192422
TI  - Vaporware.com: the failed promise of the health care Internet.
AB  - Contrary to the claims of its well-financed promoters, the Internet will not
      solve the administrative redundancies, economic inefficiencies, or quality
      problems that have plagued the U.S. health care system for decades. These
      phenomena are the result of economic, organizational, legal, regulatory, and
      cultural conflicts rooted in a health care system grown from hybrid public and
      private financing; cultural expectations of unlimited access to unlimited medical
      resources; and the use of third-party payers rewarded to constrain those
      expectations. The historic inadequacy of information technology to solve health
      care's biggest problems is a symptom of these structural realities, not their
      cause. With its revolution of information access for consumers, the Internet will
      exacerbate the cost and utilization problems of a health care system in which
      patients demand more, physicians are legally and economically motivated to supply
      more, and public and private purchasers are expected to pay the bills.

PMID- 11192423
TI  - Financing the health care Internet.
AB  - Internet-related health care firms have accelerated through the life cycle of
      capital finance and organizational destiny, including venture capital funding,
      public stock offerings, and consolidation, in the wake of heightened competition
      and earnings disappointments. Venture capital flooded into the e-health sector,
      rising from $3 million in the first quarter of 1998 to $335 million two years
      later. Twenty-six e-health firms went public in eighteen months, raising $1.53
      billion at initial public offering (IPO) and with post-IPO share price
      appreciation greater than 100 percent for eighteen firms. The technology-sector
      crash hit the e-health sector especially hard, driving share prices down by more
      than 80 percent for twenty-one firms. The industry now faces an extended period
      of consolidation between e-health and conventional firms.

PMID- 11192424
TI  - Beyond the hype: a taxonomy of e-health business models.
AB  - This paper describes a business model of e-commerce, its application to health
      care, and the reasons why the health policy community should monitor its
      development. The business model identifies the market barriers health e-commerce
      firms must overcome and provides perspective on opportunities for building a
      health care data infrastructure that is capable of delivering both a private and
      a public good.

PMID- 11192425
TI  - Networking health: learning from others, taking the lead.
AB  - The Internet provides one of the most compelling examples of the way in which
      government research investments can, in time, lead to innovations of broad social
      and economic impact. This paper reviews the history of the Internet's evolution,
      emphasizing in particular its relationship to biomedical computing and to the
      nation's health care system. Here I summarize current national research programs,
      emphasizing the need for greater involvement by the medical research community
      and leadership from federal health care agencies.

PMID- 11192426
TI  - [Different evolution rule of SRY gene between hominoid and Old World monkey].
AB  - The complete SRY gene of P. nemaeus and M. arctiodes were amplified by using PCR
      and sequenced. Combined with the same regions of other primate animals, sequence
      analysis confirmed the conservation of HMGbox. In molecular phylogenetic tree
      constructed, we made the Ka/Ks value pairwise comparison of HMGbox flanking
      sequences both intra- and inter- Hominoid and the Old World monkey. To our
      interest, the pairwise comparison of species in Hominoid suggested a higher Ka/Ks
      ratio than that in the Old World monkey or between the Old World monkey and
      marmoset, which showed existent of different pattern of evolution. In addition,
      in Hominoid Ka/Ks ratio for HMGbox sequences was obviously on the increase. The
      rate of nonsynonymous substitutions per nonsynonymous site is faster than that of
      synonymous substitutions per synonymous site in Hominoid (driven by positive
      directional selection). Our analysis suggested that it might be resulted from
      functional change of this gene and the system error or the close relationship
      among Hominoid species. It is also supposed that the positive selection was
      functioned at the beginning of the divergence of Hominoid species.

PMID- 11192427
TI  - [The genetic effect of estrogen receptor(ESR) on litter size traits in pig].
AB  - Litter size is one of the most important economic traits in pig production, and
      the more piglet numbers per litter is capable to increase pork production and
      bring more economic profit for pig industry. ESR (estrogen receptor) gene has
      been determined to be one of the major genes affecting phenotype of litter size
      without any genetic negative correlation to growth and carcass traits. An
      optimized standard PCR-RFLP protocol is employed to type 262 sows from 5
      different breeds in ESR loci, and then with the computation based on linear model
      ESR gene is confirmed to be a major locus significantly associated with litter
      size (P < 0.001). The genetic effect of ESR gene is quite large in these breeds,
      especially in these Chinese pig population. The sows of beneficial homozygote BB
      produce 1.40-3.37 total number born/litter and 0.63-3.58 number born alive/litter
      more than the sows of non-beneficial homozygote AA do. The information found in
      the present study is very important and could be utilized as DNA marker for
      improvement of reproduction trait in practice of pig breeding.

PMID- 11192428
TI  - Identification of QTL affecting important traits on porcine chromosome 12.
AB  - To screen the whole porcine chromosome 12 for QTL affecting economically
      important traits, ten genetic markers were genotyped in two F2 populations
      generated from the cross of genetically diverse breeds: European Wild pig and
      commercial pig breed Pietrain (W x P), and Chinese Meishan and Pietrain (M x P).
      Fifty-one traits were recorded. A least squares method was used for chromosome
      wide screening for QTL. An association analysis between genotypes at the GH locus
      and traits was also carried out. The least squares analysis did not reveal the
      presence of genome-wide significant QTL affecting the traits, while the
      association study showed significant (P < 0.01) associations between GH genotypes
      and fatness traits in M x P, but not in W x P. F2 pigs carrying the genotype
      C1A2/C4A2 at the GH locus displayed the thinnest backfat (21.76 mm), while the
      ones carrying the genotype C2A2/C2A2 had the thickest (31.41 mm).

PMID- 11192429
TI  - [Observation on sex-linkage inheritance of skin color in some local breeds of
      chicken].
AB  - The sex-linkage inheritance of skin color was observed in some local breeds of
      chicken. The results showed that there was a pair of melanin genes PP in
      autosomes in Taihe Silky Fowl, an Id gene in sex chromosome in Xianju Fowl,
      Xiaoshan Fowl and Beijing You Fowl, and an id gene in sex chromosome in Langshan
      Fowl, Gushi Fowl and Taihe Silky Fowl, respectively. The offspring produced by
      crossing of Taihe Silky Fowl(Male) with the fowl(Female) carrying Id gene (such
      as Xianju Fowl, Xiaoshan Fowl and Beijing You Fowl) can autosexingly determinate
      by skin color, male chicken has yellow skin, female chicken has black skin.

PMID- 11192430
TI  - [Developmental genetic analysis of brown rice thickness of indica rice (Oryza
      sativa L.)].
AB  - Analysis of developmental genetic effects for brown rice thickness (BRT) trait in
      indica rice (Oryza sativa L.) at four different filling stages was conducted and
      a developmental genetic model and corresponding statistical approaches for
      quantitative traits of triploid endosperm in cereal crops was used. The results
      indicated that the diploid maternal plant, triploid endosperm and cytoplasmic
      genetic effects were important for BRT trait at all filling stages of rice and
      those effects were the major effect at initial medium, filling period and mature
      period respectively. The additive and dominance effects were the major effect
      alternatively at four filling stages of rice. Significant endosperm and maternal
      dominance effects for BRT suggest that the utilization of heterosis for BRT is
      viable. The results of conditional genetic variance components shown that the
      expression of new quantitative genes in endosperm, cytoplasm and maternal plant
      for BRT was found at most filling stages of rice. The gene expression was most
      active at the early filling stages, especially at the second stage (8-14 days
      after flowering). Near to mature period (22-28 days after flowering), however,
      the expression of genes decreased sharply and even closed. The phenomena that the
      genes expressed spasmodically, i.e. the net genetic effects equaled to zero in
      some filling stages were detected for some genetic effects. Dominance and
      cytoplasmic correlation coefficients were significant at 0.05 or 0.01 probability
      level in some filling stages meanwhile there were the most strong relationship
      between mature period and other periods for BRT.

PMID- 11192431
TI  - [Characterization of a wheat-Agropyron intermedium translocation line by
      sequential GISH and FISH].
AB  - The chromosome constitution on H96276-2, which is a stable line derived from a
      sterile wheat-Agropyron intermedium partial amphiploid Zhong 3 cross to common
      wheat Hui 75, was analyzed by sequential GISH and FISH. The results of GISH using
      genomic DNA of Agropyron intermedium as probe showed that H96276-2 possessed 20
      pairs of wheat chromosomes and one pair of translocation chromosomes of wheat and
      Ag. intermedium. The translocated alien chromosome fragments located on the
      terminals of one pair of wheat chromosomes. Furthermore, reprobing of repeat
      sequence pSc119 was used to identify the wheat chromosomes involved in the
      translocation. It was determined that the alien fragments located in the
      terminals of the short arms of 2B chromosomes of wheat.

PMID- 11192432
TI  - [Segregation distortion of molecular markers in recombinant inbred populations in
      soybean (G. max)].
AB  - The segregation distortion of 238 molecular markers in a RILs population from
      cultivated/semi-wild soybean cross was analysed. 29.4% of the loci were found
      with segregation distortion, and direction of deviation was mainly towards
      cultivated variety Changnong 4. RAPD markers have a higher distortion rate than
      other molecular markers.

PMID- 11192433
TI  - [Meiosis-like reduction in the culture system for somatic embryogenesis of
      Arabidopsis thaliana].
AB  - The somatic meiosis-like reduction was observed in some cells in the embryogenic
      calli of Arabidopsis thaliana. One type was somatic chromosome reductional
      grouping, in which the chromosomes in a cell either separated into two groups, or
      separated into more than two groups at prophase or metaphase. The chromosomes
      separated directly, the morphology of the chromosomes did not show any role of
      the spindle fibers. Chromosome reductional grouping happened more frequently in
      polyploid cells. The other type was somatic meiossi which was analogous to that
      existed in the process of gametogenesis, and characterized by the pairing and
      synapsis of homologues chromosomes. In the embryogenic calli cultured on
      dedifferentiation medium, about 3% of the observed cells contained haploid number
      of chromosomes, while the tetrad cells occurred at a frequency of about 4%. The
      somatic meiosis-like reduction could result in the recombination of chromosomes
      in the cells generated by these processes. The roles of somatic meiosis-like
      reduction in the somatic embryogenesis and somaclonal variations were discussed.

PMID- 11192434
TI  - [ScII-like protein is localized in the nuclei, chromosomes and chromosome
      scaffolds of Allium cepa].
AB  - The nuclei were isolated from the root meristematic cells of Allium cepa and the
      nuclear matrices were prepared. A 135 kD polypeptide, which is equivalent to Sc
      II in molecular weight, was revealed in the nuclei by SDS-PAGE and was then
      demonstrated to be an Sc II-like protein by Western blot with an anti-chicken Sc
      II antiserum. Neither the 135 kD polypeptide nor the positive labelling of the
      anti-Sc II antiserum was found in the nuclear matrices. The immuno-fluorescence
      tests showed that the nuclei labelled with the anti-Sc II antiserum emanated
      strong, specific fluorescence, while the fluorescence of the nuclear matrices was
      too weak to be detected. The results of immunoelectron microscopy indicated that
      a large number of the gold particles were concentrated in the condensed chromatin
      of the nuclei, but very few gold particles were distributed in cytoplasm and
      nucleoplasm. These results strongly suggested that an Sc II like protein is a
      component of the nuclei of A. cepa and is mainly located in the condensed
      chromatin regions, but the nuclear matrices contain no or very little amount of
      that protein. By means of immunofluorescence and immunoelectron microscopy, the
      chromosomes and chromosomal scaffolds of A. cepa labelled with the anti-chicken
      Sc II antiserum were observed to send off specific fluorescence and have many
      gold particles representing the presence of the Sc II-like protein distributed
      among them. The significance of the Sc II-like protein as a novel component in
      the nuclei, chromosomes and chromosome scaffolds of higher plants is discussed.

PMID- 11192435
TI  - [Identification of quantitative trait loci associated with fruit traits in
      watermelon [Citullus lanantus (Thanb) Mansf] and analysis of their genetic
      effects].
AB  - In this study, we mapped and characterized quantitative trait loci (QTL)
      affecting watermelon fruit traits. A total of 118 F2 progenies derived from the
      cross 97103 (which is a cultivar with higher total soluble solids concentration,
      thin rind, susceptible to Fusarium wilt disease) x PI296341(which is a wild
      germplasm with lower total soluble solids concentration, thick rind, resistant to
      Fusarium wilt disease) were used to construct a 96-markers map in watermelon. By
      using interval mapping 4 QTLs for total soluble solids concentration, 5 QTLs for
      hardness of rind, 2 QTLs for thickness of rind, 3 QTLs for weight of simple
      fruit, and 6 QTLs for weight of one thousand grain seeds were identified. In
      addition, the explained variations, additive effects and dominance effects for
      all detected QTLs were analyzed.

PMID- 11192436
TI  - [Properties and nucleotide sequence of mitochondrial plasmid-like DNA pC1 of
      cucumber].
AB  - Four kinds of plasmid-like DNA, designated pC1, pC2, pC3 and pC4 were found in
      the mitochondrion of cucumber Jinyan No. 4. The circle plasmid-like DNA pC1 was
      cloned into the EcoR I site of pUC19 using E. coli JM109 as host. The cloned pC1
      DNA was isolated and used as probes in Southern analyses of total mitochondrial
      DNA, nuclear DNA and chloroplast DNA. Evidences were obtained that the pC1 did
      not show any homology with nuclear, chloroplast, main mitochondrial genomes and
      the other plasmid-like DNAs. Sequence analysis revealed that pC1 was 2,889 bp
      long. It contained many forward and reverse repeat sequences. Three main open
      reading frames in pC1 were longer than 800 bp. Computer-assisted searching the
      nucleotide sequence in GenBank database revealed pC1 had no significant homology
      with known sequences of mitochondrial and plasmid-like DNA, but had homology with
      the E. coli, Mycobaterium tuberculosis and Anacystis nidulans genomes. The
      predicted proteins of pC1 main ORFs show homology with the sulfate transport
      system in bacteria, alga and liverwort. It suggested that pC1 may encode
      functional proteins.

PMID- 11192437
TI  - [Construction of linkage map and mapping resistance gene of Scterotinia
      scterotiorum in Brassica napus].
AB  - Scterotinia scterotiorum (Lib.) de by is a world-wide disease, which seriously
      decreases the yield and the quality of oil of rapeseed. Mapping resistance genes
      of S. scterotiorum is of vital effect to breed new elite cultivars resisting the
      disease. In this paper, we reported that a RAPD linkage map was constructed,
      including 193 RAPD markers, 19 linkage groups and covering 1,324 cM, by using
      Mapmaker 3.0. On the basis of map, and resistance genes, Sc1, Sc2 and Sc3, were
      located in 4th, 8th and 18th linkage groups. Among three QTLs, Sc2 has the
      characteristics of major gene with explained 29%. The three QTLs together
      explained about 56% of phenotypic variation.

PMID- 11192438
TI  - [Subcloning and sequencing of DNA fragment related to salt tolerance in
      Sinorhizobium fredii RT19].
AB  - A 23 kb DNA fragment related to salt tolerance was obtained from the gene library
      of S. fredii strain RT19. In this study, BamH I was selected to digest 23 kb DNA
      fragment into different length of DNA fragments. The resulting fragments were
      ligated with plasmid pML122, then the recombinant plasmids were transformed to
      competent cells of E. coli S17-1 on selective medium and three transformants TR
      were obtained. Two-parental mating experiments were carried out with these
      transformants as donor and salt sensitive S. fredii strain RC3-3 as recipient,
      and the transconjugant BR2 was selected on FY plates containing gentamycin and
      0.4 mol/L NaCl. Thus, a 4.4 kb DNA fragment related to salt tolerance was
      obtained. Based on its physical map, six restriction fragments were subcloned
      into plasmid pUC18 for DNA sequencing. Subsequently, sequencing and analysis of
      4.4 kb DNA fragment showed that fixO, fixN genes and three ORFs were obtained.

PMID- 11192439
TI  - [Cloning of plasmid pBMB2062 in Bacillus thuringiensis strain YBT-1520 and
      construction of plasmid vector with genetic stability].
AB  - A small plasmid pBMB2062 in Bacillus thuringiensis strain YBT-1520 was cloned and
      sequenced. Its 2,062 bp sequence contains two potential open reading frames
      (orfs). The orf1 and orf2 encode a tentative replication initial protein
      consisting of 289 amino acid residues and a tentative replication protein
      consisting of 80 amino acid residues, respectively. Two homological plasmids were
      found by Blast searching. There are 23 nucleotides difference occurring among
      three of the plasmids. The difference occurred in the orf1 causes different
      encoding capability. Comparing with the orf1 in pBMB2062, the orf1 in the
      homological plasmids are truncated, one at the N-terminal and another at the C
      terminal. cDNA synthesis and PCR detection showed that the mRNA corresponding to
      orf1 in pBMB2062 really occurs. Shuttle vectors were constructed based on
      pBMB2062 and showed the ability to express insecticidal crystal gene. Under
      nonselective condition, recombinant plasmids based on pBMB2062 were genetically
      stable.

PMID- 11192440
TI  - Photovoltaic technology comes of age.

PMID- 11192441
TI  - A simple, thoughtful design provides comfort and shelter for those in need.

PMID- 11192442
TI  - CAD pioneer reflects on the past and the future. Interview by Jerry Laiserin.

PMID- 11192443
TI  - Going solo.

PMID- 11192444
TI  - A discourse on the complications of retrobulbar and peribulbar blockade.

PMID- 11192445
TI  - Effect of prophylactic antibiotics and incision type on the incidence of
      endophthalmitis after cataract surgery.
AB  - BACKGROUND: There is controversy as to the efficacy of various measures in the
      prophylaxis of endophthalmitis after cataract surgery. In addition, it has been
      suggested that clear-corneal incisions may convey an increased risk of
      postoperative infection. We performed a retrospective review to assess the effect
      of prophylactic antibiotics and incision type on the incidence of endophthalmitis
      after cataract surgery. METHODS: A retrospective chart review and surgeon survey
      were used to collect data for the 13,886 consecutive cataract operations
      performed between Sept. 1, 1994, and Jan. 31, 1998 by nine surgeons at a hospital
      based surgical unit in Saskatoon. All cataract extractions were by
      phacoemulsification. All cases of endophthalmitis arising from the unit are
      managed at the hospital except in extenuating circumstances. We assessed the
      effect of preoperative administration of antibiotic drops, subconjunctival
      antibiotic injections at the conclusion of surgery and clear-corneal versus
      scleral tunnel incisions on the incidence of endophthalmitis by means of
      univariate and multivariate Poisson regression analysis. RESULTS: The incidence
      of postoperative endophthalmitis was significantly lower with subconjunctival
      antibiotic injections than without such injections (0.011% vs. 0.179%) (p =
      0.009, odds ratio 16.23 [95% confidence interval 1.92 to 137.14]). The difference
      in the incidence of endophthalmitis with preoperative use of antibiotic drops
      (0.066%) and with no antibiotic drops preoperatively (0.115%) was not
      significant. Similarly, the difference in the incidence of endophthalmitis with
      clear-corneal (0.129%) and scleral tunnel (0.050%) incisions was not significant.
      INTERPRETATION: Our results suggest that prophylactic subconjunctival antibiotic
      injections at the conclusion of cataract surgery decrease the incidence of
      postoperative endophthalmitis.

PMID- 11192446
TI  - Characteristics of patients presenting with central retinal artery occlusion with
      and without giant cell arteritis.
AB  - BACKGROUND: In patients with concurrent central retinal artery occlusion (CRAO)
      and giant cell arteritis (GCA), prompt recognition and early treatment are
      crucial to prevent further visual loss in the contralateral eye. The objective of
      this study was to describe a series of patients with CRAO resulting from GCA and
      to compare them with patients with isolated CRAO. METHODS: The patient database
      for a retina service in Philadelphia was searched to identify patients admitted
      between 1983 and 1993 with a diagnosis of biopsyproven GCA and CRAO. For every
      patient with CRAO caused by GCA, the next patient admitted for management of
      acute isolated CRAO was identified; these latter patients constituted the control
      group. The visual acuity and baseline characteristics of the two groups were
      compared. RESULTS: Eleven patients with acute CRAO and GCA were admitted during
      the study period. In both the case and control groups seven patients (64%) were
      women and nine patients (82%) were white. Six subjects (54%) in the case group
      and seven (64%) in the control group had a history of hypertension; the values
      for diabetes mellitus were two (18%) and zero respectively. Four patients (36%)
      with CRAO and GCA were cigarette smokers, compared with eight patients (73%) with
      CRAO alone. None of these differences were statistically significant. Patients
      with CRAO related to GCA were more likely than those with isolated CRAO to have
      counting fingers or better vision at presentation (odds ratio 2.22 [95%
      confidence interval 0.37 to 13.2]), but this trend was not statistically
      significant. INTERPRETATION: Patients who presented with CRAO related to GCA were
      more than twice as likely as those with CRAO alone to have counting fingers or
      better visual acuity at the time of presentation. However, owing to the small
      sample, the power of this study to detect a true difference between the two
      groups was limited.

PMID- 11192447
TI  - Prevalence of ocular hemorrhage in patients receiving warfarin therapy.
AB  - BACKGROUND: Warfarin, the drug most commonly used for outpatient anticoagulation
      therapy, has bleeding as its main side effect. The objective of this study was to
      determine the prevalence of ocular hemorrhage in patients receiving warfarin and
      to compare it to the prevalence in the general population. METHODS: Patients
      receiving warfarin therapy who were attending the anticoagulation clinic at a
      tertiary care hospital in Montreal between October and December 1996 received a
      flyer inviting them to have their eyes examined to look for "ocular bleeding."
      Consenting patients were examined for subconjunctival hemorrhage, gross hyphema,
      and vitreous and retinal hemorrhages through external ocular examination and
      funduscopic examination with the pupils dilated using direct and indirect
      ophthalmoscopy. RESULTS: Of the 1225 patients seen at the clinic 126 (10%) agreed
      to participate. Four patients (3%) were found to have intraretinal hemorrhage at
      the time of examination. All hemorrhages were visually insignificant.
      INTERPRETATION: The risk of retinal hemorrhage in patients without preexisting
      ocular disease, such as retinal neovascularization or choroidal vasculopathy, who
      are receiving warfarin therapy is so small that it should not deter physicians
      from prescribing this drug when indicated.

PMID- 11192448
TI  - Essential iris atrophy mimicking iris neoplasm: an ultrasound biomicroscopic
      study.

PMID- 11192449
TI  - Angioma formation: a late complication of scleral buckling surgery.

PMID- 11192450
TI  - Choroidal neovascularization following argon laser photocoagulation for macular
      edema associated with branch retinal vein obstruction.

PMID- 11192451
TI  - The genome of the smartest pathogen decoded: is the cholera war over?

PMID- 11192452
TI  - Clinical quiz. Intestinal amyloidosis.

PMID- 11192453
TI  - Does consensus equal correctness?

PMID- 11192454
TI  - Gastrointestinal decontamination: maybe we're both right (commentary).

PMID- 11192455
TI  - Poison centers at the millennium and beyond.

PMID- 11192456
TI  - Urinary excretion of trace elements in humans after sodium 2,3-dimercaptopropane
      1-sulfonate challenge test.
AB  - OBJECTIVE: To evaluate the effects of intravenous sodium 2,3-dimercaptopropane-1
      sulfonate (DMPS, Dimaval) on urinary excretion of essential trace elements in
      subjects who received this chelating agent as a mercury challenge test. SUBJECTS:
      Eleven subjects sought medical attention due to concern with the toxicity of
      mercury released from dental amalgam fillings. DESIGN: The subjects were given
      DMPS 3 mg/kg intravenously. Spot urine samples were collected 1 hour before and 1
      hour after the DMPS dose for laboratory analysis. In addition to mercury, the
      urinary excretion of copper, zinc, selenium, magnesium, manganese, molybdenum,
      chromium, cobalt, and aluminum were measured. RESULTS: A significant increase in
      urinary excretion of mercury (3- to 107-fold) was observed after the DMPS dose.
      The DMPS treatment led to a 2- to 119-fold increase in copper excretion; 3- to
      43.8-fold in selenium excretion; 1.6- to 44-fold in zinc excretion; and 1.75- to
      42.7-fold in magnesium excretion. The excretion of manganese, chromium, cobalt,
      aluminium, and molybdenum remained unchanged. CONCLUSIONS: In this study, an
      intravenous DMPS challenge test produced a significant increase in mercury
      excretion and also led to an increased excretion of copper, selenium, zinc, and
      magnesium.

PMID- 11192457
TI  - Transdermal kinetics of a mercurous chloride beauty cream: an in vitro human skin
      analysis.
AB  - BACKGROUND: Crema de Belleza-Manning is a popular mercurous chloride-containing
      beauty cream used to smooth and lighten the complexion and treat acne. Hundreds
      of people in the Southwestern US border states have been identified with elevated
      (>20 microg/L) urine mercury levels believed to be secondary to using this cream.
      The kinetic characteristics of percutaneous mercury absorption are incompletely
      defined. The objective of this study was to determine the transdermal kinetics of
      two formulations of mercurous chloride from a beauty cream in an in vitro human
      skin model. METHODS: A proprietary formulation and an aqueous formulation of the
      beauty cream were studied using modified Franz diffusion cells. Mercury content
      in the skin samples and the underlying diffusion buffer was determined using
      atomic absorption spectrophotometry. RESULTS: A rapid initial increase in mercury
      content both in the skin and the buffer was noted for both formulations. Mercury
      concentrations in the aqueous samples were significantly (p < 0.05) higher in
      both the skin and the diffusion buffer compared to parallel samples containing
      glycerol. CONCLUSIONS: Mercury was readily absorbed through the skin in this in
      vitro human skin model. The aqueous preparation had a markedly increased rate and
      extent of mercury absorption relative to the proprietary formulation.

PMID- 11192458
TI  - Effect of age and sex on liver damage due to excess dietary copper in Fischer 344
      rats.
AB  - OBJECTIVE: The aim of this study was to investigate the morphologic and
      biochemical effects of excess dietary copper in young and adult rats of different
      sex. METHODS: Adult Fischer 344 male and female rats were given a diet containing
      1500 ppm copper for 18 weeks. Young male and female rats were fed a similar
      copper-loaded diet from birth until 16 weeks of age. Age- and sex-matched control
      rats were fed a normal rodent diet (<10 ppm copper). Serum liver enzyme activity
      was determined in all rats. Livers were sampled for histology, histochemistry
      (rhodanine), immunohistochemical detection of metallothionein and copper analysis
      by atomic absorption spectrophotometry. Hepatic metallothionein and zinc
      concentrations were measured in adult rats. RESULTS: Excess dietary copper caused
      substantial liver injury, as evidenced by morphologic changes and increased
      activity of serum ALT, GGT, and SDH. All copper-loaded rats had significantly (p<
      0.05) increased hepatic copper concentrations compared to controls. However,
      young copper-loaded rats accumulated more hepatic copper, had more severe liver
      changes, and had higher serum liver enzyme activities than adult rats. Histologic
      changes in copper-loaded rats consisted of multifocal hepatitis and widespread
      single-cell necrosis. Cytoplasmic copper was detected histochemically in
      centroacinar zone 1 (portal) and mid-zone in copper-loaded rats. Immunoreactivity
      for metallothionein was prominent in necrotic hepatocytes and within inflammatory
      foci in copper-loaded rats. However, differences in hepatic metallothionein
      concentrations were not detected between adult copper-loaded and control rats.
      CONCLUSIONS: Young Fischer 344 rats are more susceptible than adults to copper
      induced liver injury.

PMID- 11192459
TI  - Tolerance develops to the sympathomimetic but not the local anesthetic effects of
      cocaine.
AB  - OBJECTIVES: The cardiovascular effects of cocaine are complex and include
      sympathomimetic as well as local anesthetic effects. The aim of the present study
      was to delineate cocaine toxicity in a model simulating cocaine binging patterns.
      DESIGN: Prospective laboratory investigation. Twelve dogs were randomized to
      receive 6 intravenous boluses of cocaine 5.25 mg/kg (high dose, n = 5), 3.5 mg/kg
      (low dose, n = 4), or placebo (n = 3) at 15-minute intervals. Arterial pressure,
      electrocardiogram, and serum cocaine were measured at control, then at fixed time
      intervals after each bolus of cocaine or placebo. Statistical significance was
      determined by ANOVA. RESULTS: Peak serum cocaine concentrations were 3500 ng/mL
      and 2167 ng/mL in the high- and low-dose groups. There were progressive decreases
      in mean arterial pressure in the high-dose cocaine group by as much as 32% (p =
      .003) after each cocaine bolus. However, in the low-dose group, increases in mean
      arterial pressure were observed after the initial cocaine boluses by as much as
      31% (p = .013). Significant QRS prolongation was observed in both the high- and
      low-dose cocaine groups by as much as 65% (p < .001) and 10% (p < .03),
      respectively. However, the prolongation observed in the high-dose group was more
      pronounced and cumulative, while in the low-dose group the prolongation was
      transient. CONCLUSIONS: At low doses, cocaine's sympathomimetic properties
      predominate but tolerance develops. At high doses, cocaine's local anesthetic
      properties predominate, become more pronounced with repeated administration, and
      may have implications for cocaine-related dysrhythmias, cardiovascular collapse,
      and sudden death.

PMID- 11192460
TI  - Concentrations and frequencies of polychlorinated biphenyl congeners in a Native
      American population that consumes Great Lakes fish.
AB  - OBJECTIVE: Polychlorinated biphenyl congener profiles were examined in serum
      samples from 61 Native American (Ojibwa) volunteers who regularly consumed fish
      harvested from the Great Lakes region. A total of 93 peaks are reported which
      represent 126 individual chlorobiphenyls. RESULTS: When ranked by frequency, 13
      peaks comprising single or co-eluting chlorobiphenyls occurred in all 61 samples
      (a frequency of 100%). These included chlorobiphenyls 138 + 158 + 163, 105 + 132
      + 153, 180, 118, 196 + 203, 74, 182 + 187, 199, 183, 114 + 134, 195 + 208, 206,
      and 194. These 13 peaks also occurred at concentrations higher than those of all
      other measured chlorobiphenyls, except for the addition of the peak containing
      chlorobiphenyls 170 and 190, which was below detection in 15% of the samples and
      ranked fifth in average concentration. The highly chlorinated chlorobiphenyls
      resembled human serum profiles previously reported in the literature. METHODS:
      Individual chlorobiphenyls were identified using a gas chromatograph equipped
      with a 60-meter DB-5 capillary column and electron capture detection. CONCLUSION:
      When compared to other human residue analyses for fish-eating populations, the
      Ojibwa samples contained higher proportions of lightly chlorinated and labile
      chlorobiphenyls such as 8, 16 + 32, 17, 18, 25, 41 + 64 + 71, 33, 52, 110, and
      129. These proportions were similar to those found in carp, whitefish, or
      whitefish livers harvested from the Great Lakes region. These data indicate that
      regular meals of lower trophic level fish, such as whitefish from the Great
      Lakes, may distort steady-state human chlorobiphenyl profiles with respect to
      certain lightly chlorinated or labile chlorobiphenyls.

PMID- 11192461
TI  - Clinical effects and plasma concentration determination after 2,4
      dichlorophenoxyacetic acid 200 mg/kg administration in the dog.
AB  - OBJECTIVE: To investigate the clinical effects and to determine the 2,4
      dichlorophenoxyacetic acid plasma concentrations after a dose of twice the
      reported LD50 (100 mg/kg) was administered orally to dogs. Investigation included
      electromyographic evaluations and biochemical parameter determinations, as well
      as observable clinical signs. METHODS: Six beagle dogs were administered 2,4
      dichlorophenoxyacetic acid 200 mg/kg orally. Dogs were monitored for the
      development of clinical signs and were anesthetized at 24 hours for needle
      electromyography. Blood was collected pre- and 24-hours postadministration.
      Plasma was analyzed for total and unbound 2,4-dichlorophenoxyacetic acid by high
      performance liquid chromatography with fluorescence detection. Serum was
      submitted for clinical chemistry parameter analysis. Statistical analyses of the
      chemistry parameters were performed using paired t-tests. RESULTS: All 6 dogs
      survived after oral administration of twice the reported LD50. Clinical signs
      observed were vomiting in 33% and diarrhea in 100% of the dogs. No gait
      abnormalities were seen in awake dogs. Electromyographic findings revealed
      predominantly insertional myotonia with 1 dog having spontaneous fibrillations.
      Decreases from baseline measurements were seen in serum calcium, potassium, and
      total bilirubin. The mean total and unbound plasma 2,4-dichlorophenoxyacetic acid
      concentrations were 511 mg/L and 129 mg/L, respectively. CONCLUSIONS: This study
      demonstrates that the beagle dog is less sensitive to the acute effects of 2,4
      dichlorophenoxyacetic acid than previously reported. The main clinical effects
      seen after oral administration of twice the reported LD50 were vomiting and
      diarrhea. Total and unbound plasma 2,4-dichlorophenoxyacetic acid concentrations
      may be a useful indicator of toxicity.

PMID- 11192462
TI  - Multicenter case series of valproic acid ingestion: serum concentrations and
      toxicity.
AB  - BACKGROUND: Valproic acid exposures reported to poison centers have increased
      more than 4-fold over the last 5 years. There are no large case series published
      on valproic acid ingestion. METHODS: A prospective multicenter case series of all
      patients reporting an ingestion of valproic acid. Data collected included: age,
      gender, dose ingested, concomitant medications, symptoms and vital signs,
      laboratory values, length of hospital stay, and medical outcome. Entrance into
      the study required a serum valproic acid concentration above the therapeutic
      threshold of 100 microg/mL. Statistical analysis was by Fisher's exact test.
      RESULTS: A total of 335 patients were reported to participating centers of which
      186 (55%) had serum valproic acid concentrations greater than 100 microg/mL. Of
      the 186 cases, 53 were multiple drug exposures leaving 133 cases of sole valproic
      acid ingestion for evaluation. Age ranged from 2 to 66 years with a mean of 30.1
      years +/- 12. Peak serum valproic acid concentrations ranged from 110 microg/mL
      to 1840 microg/mL with a mean of 378.3 microg/mL +/- 310.2 microg/mL. Time from
      postingestion to the peak measured valproic acid concentration ranged from 1 to
      18 hours, with a mean of 7.4 hours +/- 3.9. Symptoms included lethargy (n = 94),
      coma (n = 19), tachycardia (n = 24), aspiration (n = 8), metabolic acidosis (n =
      8), and hypotension (n = 4). A peak concentration of > 450 microg/mL was more
      likely to be associated with a moderate or major adverse outcome (p < 0.005). A
      peak concentration > 850 microg/mL was more likely to be associated with coma (p
      < 0.005) and acidosis (p < 0.005). Eleven patients experienced transient
      thrombocytopenia (platelets < 150,000) and all had peak valproic acid
      concentrations >450 microg/mL. Four patients experienced transient leukopenia
      (WBC < 3,500). The mean hospital stay for all patients was 42 +/- 33.1 hours. A
      hospital stay > 48 hours was more likely to be associated with a peak valproic
      acid concentration > 450 microg/mL (p < 0.05). There were 2 fatalities.
      CONCLUSIONS: In this case series, patients with peak valproic acid concentrations
      above 450 microg/mL were more likely to develop significant clinical effects and
      have longer hospital stays. A peak valproic acid concentration above 850
      microg/mL was more likely to be associated with coma, respiratory depression,
      aspiration, or metabolic acidosis.

PMID- 11192463
TI  - A method for detecting current temporal clusters of toxic events through data
      monitoring by poison control centers.
AB  - BACKGROUND: Poison control centers have become a widely recognized source of data
      for chemical and other environmental exposures. Concurrently, increased emphasis
      on early identification of temporal clustering of toxic exposures has stimulated
      development of sensitive statistical methods to detect clusters at the time of
      occurrence. METHOD: This paper discusses the scan test which has been applied to
      retrospective data to detect carbon monoxide poisoning clusters. We propose a
      more sensitive method, based on the binomial distribution to detect current
      clusters of only 1 or more days duration during the ongoing data collection and
      monitoring process. RESULTS: Applied to daily carbon monoxide poisoning incidence
      data on which the scan test has been applied, the new test for current clustering
      evidently has much more power. For retrospective identification of previous
      clusters lasting more than 1 day, the scan test is recommended. However, for
      previous daily clusters, a third method is recommended. CONCLUSION: Certain toxic
      events such as carbon monoxide poisoning occasionally occur in daily clusters, or
      in clusters lasting a few days. Timely detection of clusters requires application
      of early intervention strategies fostered by sensitive statistical methods of
      detection, as presented here.

PMID- 11192464
TI  - Thallium poisoning during pregnancy: a case report and comprehensive literature
      review.
AB  - BACKGROUND: Thallium salts were once used to treat a variety of disorders such as
      tuberculosis, sexually transmitted diseases, and ringworm of the scalp. Although
      the clinical manifestations and treatment of patients with thallium poisoning are
      well characterized, little information is available on the outcome of pregnancy
      in thallium-poisoned women. A case of thallium poisoning that began during the
      first trimester of pregnancy and resulted in fetal demise is reported. METHODS:
      An extensive literature search identified reported cases of thallium poisoning
      during pregnancy from 1903 until the present time. All articles were obtained,
      translated, and abstracted using a standardized data collection form. References
      were hand-searched and abstracted to identify additional cases. RESULTS: From a
      total of 25 cases identified, only 18 met satisfactory criteria for inclusion.
      Five exposures occurred during the first trimester, 5 during the second
      trimester, and 8 during the third trimester. Mothers developed classic signs and
      symptoms of thallium poisoning. Summary of these cases demonstrates a range of
      fetal effects from severe toxicity with residual sequelae to outwardly normal
      development. Interestingly, some newborns appeared normal despite severe maternal
      toxicity. The only consistent effect identified was a trend toward prematurity
      and low birth weight in children exposed during early gestation. CONCLUSIONS:
      These cases document the transfer of thallium both across the placenta and in
      breast milk. Insufficient data are available to evaluate prognostic markers of
      fetal outcome, or the risks and benefits of various treatment regimens in
      pregnant patients with thallium poisoning.

PMID- 11192465
TI  - Recovery from severe arsenic-induced peripheral neuropathy with 2,3-dimercapto-1
      propanesulphonic acid.
AB  - CASE REPORT: A 33-year-old female with a 1.5-year history of multisystem illness
      was diagnosed with arsenic poisoning. Twenty-four-hour urine arsenic was 1030
      microg/dL (normal 0-99) and root hair arsenic was 130 microg/g (normal 0-3).
      Despite treatment with succimer meso-2,3-dimercaptosuccinic acid, her neuropathy
      progressed to ventilator dependence and quadriplegia. Subsequent intravenous
      treatment with 2,3-dimercapto-1-propanesulfonic acid sodium salt was associated
      with arsenic diuresis, marked neuropathic improvement, and extubation. At 1-year
      follow-up, neuropathy was limited to mild distal lower extremity weakness and
      sensory loss. The use of 2,3-dimercapto-1-propanesulphonic acid in the treatment
      of severe arsenic neuropathy was associated with increased urinary elimination of
      arsenic and dramatic clinical recovery.

PMID- 11192466
TI  - Mephenytoin overdose--phenytoin poisoning incognito? Case report and
      mephenytoin/phenytoin comparison.
AB  - BACKGROUND: Unlike phenytoin, overdose from mephenytoin (CAS No. 50-12-4) is
      rare. A review of mephenytoin shows a number of differences from phenytoin,
      including structural, metabolic, pharmacodynamic, and toxicologic effects.
      Mephenytoin metabolism is also characterized by genetic polymorphism, which can
      result in prolonged elimination. Routine blood testing for phenytoin may show no
      interference from mephenytoin. Mephenytoin levels are not readily available nor
      clinically useful when they do become available; urine toxicology screen may be
      positive for barbiturates. CASE REPORT: A 26-year-old female overdosed on
      approximately 12 g of mephenytoin and an unknown amount of valproic acid. She
      became comatose, developing pulmonary aspiration and pancreatitis with fever. Her
      Intensive Care Unit treatment was prolonged with slow resolution over 10 days. A
      review of mephenytoin and comparison to phenytoin overdose is provided in the
      context of this case report.

PMID- 11192467
TI  - Butoxyethanol ingestion with prolonged hyperchloremic metabolic acidosis treated
      with ethanol therapy.
AB  - BACKGROUND: Severe toxic ingestions of butoxyethanol (CAS No. 111-76-2) are rare
      despite the prevalence of this glycol ether in products such as glass and surface
      cleaners. Manifestations of acute butoxyethanol toxicity include metabolic
      acidosis, hemolysis, hepatorenal dysfunction, and coma, but vary widely in
      reported cases. Furthermore, the optimal therapeutic approach is not yet
      established. Much of the toxicity of butoxyethanol has been ascribed to its
      aldehyde and acid metabolites which are similar to those produced by oxidative
      metabolism of methanol and ethylene glycol. Although the roles of alcohol
      dehydrogenase inhibition with ethanol or fomepizole and hemodialysis are clear in
      the case of toxic ingestions of methanol and ethylene glycol, they remain poorly
      defined for butoxyethanol poisoning. CASE REPORT: We report the case of a 51-year
      old female who ingested up to 8 ounces of Sanford Expo White Board Cleaner
      (butoxyethanol and isopropanol). She developed prolonged hyperchloremic metabolic
      acidosis and mental status depression and was treated with ethanol therapy but
      not hemodialysis. This patient recovered without apparent sequelae. The kinetics
      of butoxyethanol metabolism in this case are described and the potential
      therapeutic options are discussed.

PMID- 11192468
TI  - Nystagmus secondary to fomepizole administration in a pediatric patient.
AB  - BACKGROUND: Fomepizole is an alcohol dehydrogenase inhibitor used to treat
      ethylene glycol poisoning in adults, with only one report describing the use of
      fomepizole in the pediatric population. We report a case of nystagmus associated
      with fomepizole treatment of a 6-year-old female who ingested ethylene glycol 15
      hours prior to admission. CASE REPORT: A previously healthy 6-year-old presented
      to the emergency department mottled, comatose, and with Kussmaul respirations.
      Initial arterial blood gases: pH 7.11, PO2 200, HCO3 2, base excess -29, and
      within 20 minutes her pH dropped to 7.03. The patient was responsive to pain
      only. Initially, crystalluria without fluorescence was observed in the emergency
      department; 2 hours after admission, the urine fluoresced under Wood's light.
      Laboratory data were significant for increased anion and osmolar gaps. She was
      fluid-resuscitated, NaHCO3, thiamine, and pyridoxine were administered, and she
      was admitted to the pediatric intensive care unit. Within 4 hours of admission, a
      loading dose of fomepizole (15 mg/kg) was infused due to the severity of the
      patient's clinical status. Hemodialysis was initiated but discontinued
      temporarily due to catheter thrombus formation. The initial (3-hour
      postadmission) ethylene glycol concentration was 13 mg/dL. She developed coarse
      vertical nystagmus within 2 hours of fomepizole infusion. The ethylene glycol
      concentration was 5 mg/dL 3 hours after hemodialysis which then was discontinued.
      No further fomepizole was administered and the child recovered uneventfully.
      CONCLUSION: There was no evidence of the more frequently cited adverse events,
      such as headache, nausea, and dizziness. Fomepizole has been incompletely
      evaluated in the pediatric population, and the nature and occurrence of adverse
      events have not been described adequately. The use of fomepizole appeared safe in
      this patient although she developed transient nystagmus.

PMID- 11192469
TI  - Central nervous system toxicity and early peripheral neuropathy following dermal
      exposure to methyl bromide.
AB  - CASE REPORT: We describe a case of early peripheral neuropathy and central
      nervous system toxicity as a result of acute predominantly dermal exposure to
      methyl bromide. A 32-year-old male was admitted after an accidental predominantly
      dermal exposure to methyl bromide while fumigating soil for pest control. The
      patient suffered dermal burns and vesicles on the upper and lower limbs. One week
      following exposure, he developed progressive weakness of the lower limbs, ataxia,
      paresthesiae of both legs and the left arm, hyperactive tendon reflexes in the
      lower limbs, and left Babinski sign. Nerve conduction velocity testing was
      compatible with axonal neuropathy. The patient recovered gradually from his
      burns. Three months postexposure he showed no signs of central nervous system
      toxicity, but the peripheral neuropathy was still present. DISCUSSION:
      Neurological effects primarily referable to the central nervous system following
      severe inhalation of methyl bromide have frequently been reported. The patient
      described in this study developed an unusual early peripheral neuropathy
      following dermal exposure. Peripheral neuropathy can be an outcome of methyl
      bromide intoxication, but is usually a late sequela of acute central nervous
      system toxicity or an aftereffect of repetitively inhaled chronic exposure. In
      this case, exposure to methyl bromide through abraded skin caused early
      peripheral neuropathy and central nervous system toxicity.

PMID- 11192470
TI  - Intoxication with huperzine A, a potent anticholinesterase found in the fir club
      moss.
AB  - BACKGROUND: Herbs from Lycopodium are generally reputed to be nontoxic and are
      occasionally used for preparing a salubrious tea. In Europe, the common
      Lycopodium clavatum can be easily confused with Lycopodium selago, the fir club
      moss. CASE REPORT: We report 2 patients who drank a tea, erroneously prepared
      from dried herbs of Lycopodium selago, which resulted in sweating, vomiting,
      diarrhea, dizziness, cramps, and slurred speech. These symptoms were suggestive
      of a cholinergic mechanism. To elucidate the active principle, aqueous extracts
      of Lycopodium selago were checked for their suspected anticholinesterase activity
      using human erythrocytes as an enzyme source in a modified Ellman assay. The
      extracts did exhibit significant anticholinesterase activity. The
      anticholinesterase(s) were most effectively extracted with dichloromethane and
      isolated by high-performance liquid chromatography. The major compound with
      anticholinesterase activity co-chromatographed with authentic huperzine A, but
      had a 2-3-fold higher inhibitory potency than the racemic standard. The amount of
      huperzine A found in the Lycopodium selago sample used for the tea preparation
      was calculated to be sufficient for a relevant acetylcholinesterase inhibition.
      CONCLUSION: The signs and symptoms of Lycopodium selago poisoning are consistent
      with the anticholinesterase activity of huperzine A and should favorably respond
      to atropine therapy. This report demonstrates once more that laymen should not be
      encouraged to gather their remedies from "Mother Nature" without advanced
      botanical knowledge.

PMID- 11192471
TI  - Apparent suicide with Renewtrient.

PMID- 11192472
TI  - The role of population pharmacokinetics in drug development in light of the Food
      and Drug Administration's 'Guidance for Industry: population pharmacokinetics'.
AB  - Population pharmacokinetics (PPK) has evolved from a discipline primarily applied
      to therapeutic drug monitoring to one that plays a significant role in clinical
      pharmacology in general and drug development in particular. In February 1999 the
      US Food and Drug Administration issued a 'Guidance for Industry: Population
      Pharmacokinetics' that sets out the mechanisms and philosophy of PPK and outlines
      its role in drug development. The application of PPK to the drug development
      process plays an important role in the efficient development of safe and
      effective drugs. PPK knowledge is essential for mapping the response surface,
      explaining subgroup differences, developing and evaluating competing dose
      administration strategies, and as an aid in designing future studies. The mapping
      of the response surface is done to maximise the benefit-risk ratio, so that the
      impact of the input profile and dose magnitude on beneficial and harmful
      pharmacological effects can be understood and applied to individual patients. PPK
      combined with simulation methods provides a tool for estimating the expected
      range of concentrations from competing dose administration strategies. Once
      extracted, this knowledge can be applied to labelling or used to assess various
      future study designs. PPK should be implemented across all phases of drug
      development. For preclinical studies, PPK can be applied to allometric scaling
      and toxicokinetic analyses, and is useful for determining 'first time in man'
      doses and explaining toxicological results. Phase I studies provide initial
      understanding of the structural model and the effect of possible covariates, and
      may later be used to evaluate PPK differences between patients and healthy
      individuals. Phase II studies provide the greatest opportunity to map the
      response surface. With these PPK models it is possible to gain an improved
      understanding of the role of the dose on the response surface and of the range of
      expected responses. In phase III and IV studies, PPK is implemented to further
      refine the PPK model and to explain unexpected responses. Planning for the
      implementation of PPK across all phases of drug development is necessary, as well
      as planning for individual PPK studies. Planning should include: defining
      important questions, identifying covariates and drug-drug interactions that need
      to be investigated, and identifying the applications and intended use of the
      model(s). The plan for each project must have a strategy for data management,
      data collection, data quality assurance, staff training for data collection, data
      analysis and model validation.

PMID- 11192473
TI  - Clinical pharmacokinetics of pravastatin: mechanisms of pharmacokinetic events.
AB  - Pravastatin, one of the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase
      inhibitors (statins) widely used in the management of hypercholesterolaemia, has
      unique pharmacokinetic characteristics among the members of this class. Many in
      vivo and in vitro human and animal studies suggest that active transport
      mechanisms are involved in the pharmacokinetics of pravastatin. The oral
      bioavailability of pravastatin is low because of incomplete absorption and a
      first-pass effect. The drug is rapidly absorbed from the upper part of the small
      intestine, probably via proton-coupled carrier-mediated transport, and then taken
      up by the liver by a sodium-independent bile acid transporter. About half of the
      pravastatin that reaches the liver via the portal vein is extracted by the liver,
      and this hepatic extraction is mainly attributed to biliary excretion which is
      performed by a primary active transport mechanism. The major metabolites are
      produced by chemical degradation in the stomach rather than by cytochrome P450
      dependent metabolism in the liver. The intact drug and its metabolites are
      cleared through both hepatic and renal routes, and tubular secretion is a
      predominant mechanism in renal excretion. The dual routes of pravastatin
      elimination reduce the need for dosage adjustment if the function of either the
      liver or kidney is impaired, and also reduce the possibility of drug interactions
      compared with other statins. which are largely eliminated by metabolism. The
      lower protein binding than other statins weakens the tendency for displacement of
      highly protein-bound drugs. Although all statins show a hepatoselective
      disposition, the mechanism for pravastatin is different from that of the others.
      There is high uptake of pravastatin by the liver via an active transport
      mechanism, but not by other tissues because of its hydrophilicity, whereas the
      disposition characteristics of other statins result from high hepatic extraction
      because of high lipophilicity. These pharmacokinetic properties of pravastatin
      may be the result of the drug being given in the pharmacologically active open
      hydroxy acid form and the fact that its hydrophilicity is markedly higher than
      that of other statins. The nature of the pravastatin transporters, particularly
      in humans, remains unknown at present. Further mechanistic studies are required
      to establish the pharmacokinetic-pharmacodynamic relationships of pravastatin and
      to provide the optimal therapeutic efficacy for various types of patients with
      hypercholesterolaemia.

PMID- 11192474
TI  - Clinical pharmacokinetics of reboxetine, a selective norepinephrine reuptake
      inhibitor for the treatment of patients with depression.
AB  - Reboxetine is a novel selective norepinephrine inhibitor that has been evaluated
      in the treatment of patients with depression. Reboxetine is a racemic mixture,
      and the (S,S)-(+)-enantiomer appears to be the more potent inhibitor. However,
      the ratio of the areas under the concentration-time curves of the (S,S)-(+)- and
      (R,R)-(-)-enantiomers in vivo is approximately 0.5. There is no evidence for
      chiral inversion. Differences in the clearances of the 2 enantiomers may be
      explained by differences in protein binding. The pharmacokinetics of reboxetine
      are linear following both single and multiple oral doses up to a dosage of 12
      mg/day. The plasma concentration-time profile following oral administration is
      best described by a 1-compartment model, and the mean half-life (approximately 12
      hours) is consistent with the recommendation to administer the drug twice daily.
      Reboxetine is well absorbed after oral administration. The absolute
      bioavailability is 94.5%, and maximal concentrations are generally achieved
      within 2 to 4 hours. Food affects the rate, but not the extent, of absorption.
      The distribution of reboxetine appears to be limited to a fraction of the total
      body water due to its extensive (>97%) binding to plasma proteins. The primary
      route of reboxetine elimination appears to be through hepatic metabolism. Less
      than 10% of the dose is cleared renally. A number of metabolites formed through
      hepatic oxidation have been identified, but reboxetine is the major circulating
      species in plasma. In vitro studies show that reboxetine is predominantly
      metabolised by cytochrome P450 (CYP) 3A4; CYP2D6 is not involved. Reboxetine
      plasma concentrations are increased in elderly individuals and in those with
      hepatic or renal dysfunction, probably because of reduced metabolic clearance. In
      these populations, reboxetine should be used with caution, and a dosage reduction
      is indicated. Ketoconazole decreases the clearance of reboxetine, so that the
      dosage of reboxetine may need to be reduced when potent inhibitors of CYP3A4 are
      coadministered. Quinidine does not affect the in vivo clearance of reboxetine,
      confirming the lack of involvement of CYP2D6. There is no pharmacokinetic
      interaction between reboxetine and lorazepam or fluoxetine. Reboxetine at
      therapeutic concentrations has no effect on the in vitro activity of CYP1A2, 2C9,
      2D6, 2E1 or 3A4. The lack of effect of reboxetine on CYP2D6 and CYP3A4 was
      confirmed by the lack of effect on the metabolism of dextromethorphan and
      alprazolam in healthy volunteers. Thus, reboxetine is not likely to affect the
      clearance of other drugs metabolised by CYP isozymes.

PMID- 11192475
TI  - Clinical and preclinical pharmacokinetics of raltitrexed.
AB  - Raltitrexed is a specific, folate-based inhibitor of thymidylate synthase with
      activity in advanced colorectal cancer comparable with that of fluorouracil (5
      fluorouracil) plus folinic acid. Its activity is enhanced by rapid cellular entry
      and polyglutamation, with the polyglutamated derivatives having approximately 100
      fold greater inhibitory potency than the parent compound. A number of phase
      I/pharmacokinetic studies have been performed, including schedules involving a 15
      minute infusion every 3 weeks, weekly x 6 every 8 weeks, and every 2 weeks. The
      maximum tolerated dose (MTD) for the 3-weekly schedule was 3.5 to 4.5 mg/m2 in
      adults and 6 mg/m2 in a paediatric population. The MTDs for the other schedules
      have not yet been reported. The disposition of raltitrexed in patients is best
      described by a 3-compartment model with a terminal half-life (t1/2gamma) of 260
      hours, the latter being subject to significant interpatient variability. A
      similar protracted t1/2gamma has been detected in all of the animal species
      studied. Together with evidence from the mass-balance studies performed, this
      delayed elimination suggests considerable sequestration of raltitrexed in
      tissues, predominantly as polyglutamate forms. Nevertheless, there has been no
      pharmacokinetic evidence of drug accumulation in plasma following repeated
      administration. On the basis of animal experiments, the oral bioavailability and
      penetration of raltitrexed into cerebrospinal fluid are both likely to be limited
      in the clinical setting. Raltitrexed is over 90% bound to plasma protein over the
      concentration range of 20 to 100 micromol/L. Apart from poly-glutamation,
      raltitrexed does not appear to be metabolised to a significant extent, and most
      of the excreted drug (approximately 20% of the administered dose) is recovered
      unchanged in the urine within the first 24 hours post-administration. The average
      clearance of raltitrexed is 2.4 L/h (40 ml/min), and this value is significantly
      reduced in patients with compromised renal function (glomerular filtration rate
      of 25 to 65 ml/min). These patients are more likely to experience severe
      antiproliferative toxicity with raltitrexed. A careful evaluation of renal
      function, particularly in the elderly, is warranted. It has not been possible to
      establish strong correlations between the plasma pharmacokinetics of raltitrexed
      and toxicity, and the cellular pharmacokinetics of raltitrexed may be more
      predictive. Studies in mice have demonstrated that delayed administration of
      folinic acid can assist in the recovery of animals from antiproliferative
      toxicity, possibly by promoting the release of polyglutamated drug from tissues.
      This approach should be evaluated as a rescue regimen in patients with severe
      proliferative toxicity.

PMID- 11192476
TI  - Monitoring antiplatelet therapy: What is the best method?
AB  - Platelet function tests measure different aspects of platelet function, which
      include adherence, activation, aggregation and secretion. Clinically, the goal of
      platelet function testing is to provide information about the platelet
      contribution to the risk of thrombotic or haemorrhagic events and the
      optimisation of antiplatelet therapy. The important clinical questions are
      whether an antiplatelet agent is having the desired effect on platelet inhibition
      (effectiveness) and whether the patient has sufficient residual platelet function
      to avoid bleeding (safety). The role of aspirin (acetylsalicylic acid) and
      thienopyridines is well established in the management of patients with coronary
      artery disease and in the setting of coronary interventions. The last several
      years have demonstrated the unequivocal effectiveness of intravenously
      administered platelet glycoprotein (GP) IIb/IIIa antagonists in the management of
      acute coronary syndromes and in the setting of percutaneous coronary
      interventions. With the increasing use of these GPIIb/IIIa antagonists, it is
      becoming more important clinically to measure platelet inhibition with these
      agents. This paper reviews major techniques and instrumentation for platelet
      monitoring and discusses the goals of the best method.

PMID- 11192478
TI  - Dump the data dump.

PMID- 11192477
TI  - Chiral bioequivalence: effect of absorption rate on racemic etodolac.
AB  - BACKGROUND: For many racemic drugs, bioequivalence assessment based on isomer
      nonspecific assays is appropriate because enantiomeric area under the
      concentration-time curve (AUC) exposure ratios are close to unity. Use of
      nonspecific methods in cases in which the ratio is substantially greater or less
      than 1, however, may obscure real therapeutic differences among formulations,
      especially if the enantiomers exhibit differing pharmacological potencies.
      OBJECTIVE: To examine the influence of absorption rate on etodolac bioequivalence
      as measured by total [(R,S)-] and (S)-etodolac. DESIGN: Single dose, 3-period,
      crossover, pharmacokinetic study in 24 healthy volunteers in which the
      administration rate of etodolac was varied. METHODS: Participants received
      etodolac 400mg in solution, given as a single dose over 1 minute or as divided
      doses over 30 and 90 minutes. Unresolved and enantiomer concentrations of
      etodolac were measured by a validated HPLC assay. The enantiomer ratio was
      similarly measured by HPLC. RESULTS: Bioequivalence parameters derived for both
      unresolved and (S)etodolac indicate that peak plasma drug concentration (Cmax)
      was not bioequivalent. By delaying absorption, bioequivalence was lost.
      CONCLUSIONS: Collectively, these data demonstrate that bioequivalence between 2
      products of etodolac based on enantiomerically nonspecific criteria alone may not
      generalise to the pharmacologically relevant (S)-enantiomer. This suggests that
      enantiospecific assays are necessary for bioequivalence assessments.

PMID- 11192479
TI  - Getting started. Interview by Jeffrey C. Bates and M. Walt Carroll.

PMID- 11192480
TI  - MedBytes.

PMID- 11192481
TI  - Second-quessing the insurers.

PMID- 11192482
TI  - Politics versus policies.

PMID- 11192483
TI  - Redistricting: where politicians eat their young.

PMID- 11192484
TI  - Paper tiger.

PMID- 11192485
TI  - Unhealthy children.

PMID- 11192486
TI  - Saving country doctors.

PMID- 11192487
TI  - Physician assistants in Texas.
AB  - Understanding the health requirements of a state begins with identifying the
      population at need and the workforce available to meet those needs. A descriptive
      study was undertaken to examine the physician assistant (PA) workforce in Texas
      as part of an ongoing effort to meet the health needs of Texas residents. In
      September 2000, Texas had 2237 licensed PAs practicing in 186 counties. Education
      for PAs in Texas began in 1970 and currently includes one private, one military,
      and six public programs. Most practicing PAs in Texas graduate from in-state
      programs and tend to locate within the state. Preparations are under way to shift
      the public undergraduate programs to graduate degree programs. Although barriers
      to health care access in Texas remain a substantial public health issue, PAs have
      helped reduce these barriers, especially in many rural communities. The supply of
      and demand for Texas PAs appear to be in equilibrium. Policy implications are
      discussed.

PMID- 11192488
TI  - Congress, legislature facing tough issues.

PMID- 11192489
TI  - Efficacy of sulphasalazine plus methotrexate in rheumatoid arthritis.
AB  - Early intervention with slow acting anti-rheumatic drugs (SAARDs) has led to
      improvement in substantial proportion of rheumatoid arthritis (RA) patients. The
      present open, controlled study was designed to assess whether a combination of
      SAARDs offer any added benefit. Fifty-four adult RA patients were randomly
      allocated to methotrexate (MTX) (n = 27) and MTX plus sulphasalazine (SSZ) (n =
      27) groups. The subjects were followed-up fortnightly for four weeks then monthly
      for six months. The disease activity was assessed with the help of 10 clinical
      and four laboratory indices. The improvement was graded as: minor, mild decreases
      in indices, non-steroidal anti-inflammatory drugs (NSAIDs) continued, physician's
      global assessment (PGA) decreased by one; marked, acceptable decreases in
      indices, NSAIDs being taken sparingly, PGA decreased by at least 2, and complete,
      all indices normalised and patients discontinued NSAIDs completely. The
      improvement was considered clinically important when marked or complete
      improvement occurred. Adverse drug reactions resulted in withdrawal of 4 subjects
      from the MTX + SSZ group and 1 from the control groups. Four and three subjects
      in the combined and MTX groups respectively were lost to follow-up. Subjects in
      both groups showed significant decline in all indices except hemoglobin and
      neutrophil count. The differences between the two groups in the pre-treatment and
      post-treatment values were insignificant. Complete, marked, minor and no
      improvement occurred in 4 (21%), 12 (63%), 3 (16%) & 0 in the MTX and in 11
      (48%), 7 (30%), 4 (17%) & 1 (4%) in MTX + SSZ groups respectively. The
      differences in the rates of complete and clinically important improvement between
      the two groups were insignificant (P 0.1398 and 0.7092). The incidence of side
      effects was insignificantly higher in the MTX + SSZ group. Most of them were mild
      and transient. The combination of SAARDs offered little added advantage in RA.
      However, the higher rate of complete improvement in the combination group
      justifies trials including larger samples.

PMID- 11192490
TI  - Serological response to immunization with tetanus toxoid.
AB  - A total of two hundred women were immunized with tetanus toxoid vaccine. Two
      batches of toxoid prepared at the Institute of Public Health (IPH), Dhaka and one
      batch of imported vaccines, were being used by the EPI in Bangladesh for
      immunization. Each hundred women were immunized by IPH and imported vaccine. Two
      human doses were given in one month interval. Blood samples from all the study
      subjects were collected on the day of 1st dose and one month after second dose.
      Both the preimmunized sera and the sera after vaccination were tested to
      determine the antibody titre against tetanus toxoid by the haemagglutination
      method. The preimmunized sera showed the presence of protective antibody in
      50(25%) subjects who had the history of previous immunization. Including these
      initial antitoxin positive cases the seroconversions found among 95% and 96% of
      the study population respectively after immunization with IPH and imported
      toxoids, which were 93.05% and 94.87% when these 50 subjects were excluded. No
      significant difference (p = 1.0) was observed between the immunity of the
      subjects after receiving IPH and imported vaccine. Antibody titre of initial
      tetanus-antitoxin positive cases raised eight folds after getting more doses. The
      result gave fair indication of the antigenicity of all the toxoids used in the
      study.

PMID- 11192491
TI  - Characterisation of Jack fruit lectin.
AB  - Jack fruit (Artocarpus Heterophyllus) seed extract contains a lectin termed Jack
      fruit lectin (JFL) which possesses diversed biological properties. A detailed
      analysis of its properties has been lacking. The present investigation was
      initiated to study the detail properties of JFL. After extraction and
      purification on affigel galactosamine-agarose column, JFL was subjected to ND
      PAGE. Several different charged species from ND-PAGE upon SDS-PAGE gave rise to
      two dissimilar trimeric subunit at 12.5 and 15.0 KDa and retain biological
      activity. It was possible to elute the subunit bands separately from
      polyacrylamide gel to investigate their biological activity. Each subunit was
      found to be retained the lectin activity. Agglutinating activity of smaller
      subunit was found to be more, may be due to the greater amount of the subunit.
      This also suggests that each unit of trimeric JFL have similar lectin activity.

PMID- 11192492
TI  - Isolation modifies the behavioural response in rats.
AB  - Twenty-four male wister rats were reared from weaning either alone (isolation
      reared) or in groups of five (socially reared) for 6 weeks. Thereafter, the
      present study examined and compared the behaviour of isolation and socially
      reared rats in the test of social interaction, in the elevated plus-maze test of
      anxiety, in the open field behavior of exploration and locomotion activity, and
      the depressive behaviour in forced swim test. Under high light in unfamiliar
      conditions isolation reared rats spent significantly more time in aggressive
      interactions (P < 0.05) and high levels of aggressive behaviour compared to the
      socially reared rats (P < 0.05). Isolation reared rats had spent less time in the
      open arms than the socially reared rats in the maze test (P < 0.05). Isolation
      reared rats were more exploratory than the socially reared rats in the open field
      test and the defaecation scores were less compared to the socially reared
      controls (P < 0.05). Isolated rats spent less time immobile on the rats' forced
      swim test behaviour but the difference was not statistically significant. These
      findings suggest that isolation reared rats are nervous, aggressive and
      hyperactive animals in a novel field. It appears that isolation rearing in the
      early stages of life has modified a variety of behaviour in the adult rats, and
      the investigation of the pattern of behavioural changes in isolation reared rats
      may help to explore the environmental influences on the development of human
      psychopathology.

PMID- 11192493
TI  - Lymphoscintigraphy in staging and management of breast cancer.
AB  - Internal mammary lymphoscintigraphy (IML) is a simple non-invasive and
      reproducible technique to determine the extent of the parasternal node invasion
      in patients suffering from breast cancer. A total forty four patients--37 before
      surgery or any sort of treatment and seven patients after having undergone
      surgery, chemotherapy and/or radiotherapy were included in this study to assess
      the potential role of lymphoscintigraphy in the context of the present 'state of
      the art' of staging and management of breast cancer patients in Bangladesh. The
      scintigraphic test was done using Technetium 99m (Tc-99m) Antimony sulfide
      colloid in a dose of 500 microCi injected interstitially into the sub-costal
      space. Images were obtained after two to three hours on a Gamma Camera and the
      study findings were then interpreted as normal, abnormal and equivocal. The
      scintigraphic images obtained in patients who had undergone surgery, chemotherapy
      and/or radiotherapy were difficult and more challenging to interpret than those
      images obtained from patients before surgery or other therapy. This was evidenced
      by the high number (71%) equivocal cases of IML findings in patients after
      treatment as compared to only 22% equivocal cases in patients studied before
      surgery or other therapy. Parasternal lymph node involvement was found to occur
      regardless of the site or size of the primary tumour. Thirty three percent of
      tumours located in the outer quadrant showed abnormal nodes on IML. When the size
      was considered, IML was found abnormal in 22.20% patients with tumour size less
      than 2 cm in diameter. Correlation of IML with clinically palpable lymph nodes
      showed abnormal scan findings in 18% patients without clinically demonstrable
      axillary lymph nodes. These findings are in agreement with previously published
      data and suggests that conventionally classified stage I patients may in effect
      be in stage II or even in stage III of the disease. In conclusion, when the
      technique of lymphoscintigraphy is done with a comprehensive overview of the
      patient, and when the interstitial injection site is correct, it will generally
      lead to a logical and clinically useful interpretation of the data for more
      efficient management of the patient with breast cancer.

PMID- 11192494
TI  - Winston R. Maxted and the type specificity of group A streptococci.

PMID- 11192495
TI  - Primary brain abscess with Nocardia otitidiscaviarum in an intravenous drug
      abuser.
AB  - A primary brain abscess with Nocardia otitidiscaviarum in an intravenous drug
      abuser is reported. Nocardia brain abscess has been reported infrequently and
      normally only in immunocompromised patients. The lungs are the most common
      primary focus, but brain abscess may also occur following direct cutaneous
      inoculation. In this case the clinical presentation was first diagnosed as an
      astrocytoma. However, N. otitidiscaviarum was isolated from the lesion after
      emergency craniotomy. In contrast to five cases described previously the patient
      survived after surgical removal and antibiotic treatment with imipenem and
      trimethoprim-sulphamethoxazole.

PMID- 11192496
TI  - Increases in the mutation frequency at which fusidic acid-resistant
      Staphylococcus aureus arise with salicylate.
AB  - Salicylate was shown to increase the frequency at which a fusidic acid
      susceptible strain of Staphylococcus aureus underwent mutation to become fusidic
      acid-resistant. These fusidic acid-resistant mutants had alterations in
      spectinomycin and kanamycin resistance levels indicative of mutations in fusA,
      the gene that encodes elongation factor-G, the target of fusidic acid.

PMID- 11192497
TI  - A clinical isolate of Bacteroides fragilis from Hungary with high-level
      resistance to imipenem.

PMID- 11192498
TI  - Gellan gum as a suitable gelling agent in microbiological media for PCR
      applications.

PMID- 11192499
TI  - Immunogeneity and structural organisation of some pLCR-encoded proteins of
      Yersinia pestis.
AB  - A novel method of cultivation of Yersinia pestis EV-76 and its isogenic strains
      KM-217 (pPst-;pCad+;pFra-) and KM-218 (pPst-;pCad-;pFra-) and careful extraction
      of Y. pestis proteins (YPPs) permitted isolation of >35 low Ca2+ response plasmid
      (pLCR)-encoded products, some of which are potentially new members of the LCR
      family. Immunisation with each YPP demonstrated that 25-, 54-, 72- and 87-kDa
      YPPs provided the highest level of protection in mice challenged with Y. pestis
      virulent strain 231. Their immunological relationship was established with
      monoclonal antibodies (MAbs) and revealed several common properties, including
      oligosaccharide binding with specificity for N-acetylglucosamine. Affinity
      chromatography with MAb to the 25-kDa YPP permitted purification of the relevant
      antigen and its precursor. Their existence in the form of a complicated protein
      molecule was shown.

PMID- 11192500
TI  - Binding of alpha2-laminins by pathogenic and non-pathogenic mycobacteria and
      adherence to Schwann cells.
AB  - The ability of Mycobacterium leprae to specifically bind alpha2-laminins of
      Schwann cells has been described recently as being an important property of the
      leprosy bacillus, which could explain the neural tropism of M. leprae. Therefore,
      the extent of the expression of alpha2-laminin-binding properties among
      mycobacteria was investigated. In an ELISA-based assay, all three species of
      Mycobacterium tested (M. tuberculosis, M. chelonae and M. smegmatis) expressed
      laminin-binding capacity, suggesting that the ability to bind alpha2-laminins is
      conserved within the genus Mycobacterium. This report also demonstrated that not
      only M. leprae but all the mycobacterial species tested readily interacted with
      the ST88-14 cells, a human schwannoma cell line, and that the addition of soluble
      alpha2-laminins significantly increased their adherence to these cells. These
      results failed to demonstrate the presence in M. leprae of a unique system based
      on alpha2-laminins for adherence to Schwann cells.

PMID- 11192501
TI  - Molecular analysis of clinical isolates of Providencia alcalifaciens.
AB  - In an attempt to elucidate the virulence factors and the pathogenic mechanisms of
      Providencia alcalifaciens, 36 isolates identified in 1994-1995 in Recife city,
      Brazil were analysed by PCR to investigate the presence of DNA sequences
      homologous to virulence genes described in other invasive enterobacteria, as well
      as their ability to invade HeLa cells, their plasmid profiles and antibiotic
      resistance patterns. The genetic diversity of the isolates was also analysed by
      RAPD-PCR. No homologous sequences of virulence genes were observed with any of
      the P. alcalifaciens isolates studied. Ten isolates had no plasmid and 26
      harboured one-to-five plasmids of 147-<6.9 kb. Invasion of HeLa cells was
      observed in only 10 isolates. No correlation between the plasmid content of the
      strains, their invasion of HeLa cells or their resistance to antimicrobial drugs
      could be established. The isolates could be distributed into 10 genotypic groups
      by RAPD-PCR. Considering the genotypic profile and ability to invade HeLa cells,
      7 of the 10 invasive isolates belonged to the same genotypic group. The presence
      of invasive isolates in the same or a related genotypic group suggests the
      existence of a clonal lineage responsible for the invasiveness.

PMID- 11192502
TI  - Involvement of staphylococcal protein A and cytoskeletal actin in Staphylococcus
      aureus invasion of cultured human oral epithelial cells.
AB  - Following the coincidental discovery that beta-actin isolated from renal
      epithelial cells was precipitated by staphylococcal protein A (SPA), the
      possibility that SPA and cytoskeletal actin filaments may be involved in
      Staphylococcus aureus infection of epithelial cells was considered. Therefore, to
      clarify the potential role of SPA and actin filaments in S. aureus infection, the
      invasion efficiency of S. aureus was determined quantitatively by measuring the
      number of cfu of viable organisms recovered from cultured KB cells. S. aureus
      invasion was found to be time dependent (0-60 min) and increased linearly when
      increasing numbers of bacteria were added (10(4)-10(6) cfu/ml). However,
      significant variation in the level of invasion was noted in protein A-deficient
      S. aureus Wood 46. Cytochalasin B inhibited the invasion efficiency of S. aureus
      in a dose-dependent manner. The present study suggests that interaction of
      staphylococcal protein A and cytoskeletal actin filaments is involved in the S.
      aureus invasion of cultured KB cells, and this process may contribute, in part,
      to the intracellular movement, cell-to-cell spread and dissemination of S. aureus
      within human oral epithelial cells in vivo.

PMID- 11192503
TI  - Induction of necrosis factor-alpha and interleukin-6 in mice in vivo and in
      murine peritoneal macrophages and human whole blood cells in vitro by Micrococcus
      luteus teichuronic acids.
AB  - Earlier studies showed that Micrococcus luteus cells and cell walls induced
      anaphylactoid reactions leading to death, in some instances within 1 h, in
      C3H/HeN mice primed with muramyl dipeptide (MDP). They also induced serum
      cytokines in the surviving mice. The present study investigated the structural
      components responsible for these activities. Teichuronic acids, a component of M.
      luteus cell walls, induced tumour necrosis factor-alpha (TNF-alpha) and
      interleukin-6 (IL-6) in MDP-primed C3H/HeN mice. Peptidoglycans had little effect
      on the cytokine-inducing activities. Reducing teichuronic acids, i.e.,
      teichuronic acids whose carboxyl groups had been reduced, lost their cytokine
      inducing activities. Neither peptidoglycans nor teichuronic acids induced
      anaphylactoid reactions in the MDP-primed mice. Purified teichuronic acids also
      induced TNF-alpha and IL-6 production in C3H/HeN murine peritoneal macrophages
      and human whole-blood cells in the culture, but reduced teichuronic acids did
      not. The purified teichuronic acids induced no TNF-alpha and only low levels of
      IL-6 in MDP-primed C3H/HeJ mice, and neither cytokine in peritoneal macrophage
      cultures from C3H/HeJ mice with a single point of mutation in Toll-like receptor
      4 (TLR4) gene. These findings suggest that induction of cytokines by teichuronic
      acids is mainly TLR4-dependent.

PMID- 11192504
TI  - The sensitivity of Porphyromonas gingivalis and Fusobacterium nucleatum to
      different (pseudo)halide-peroxidase combinations compared with mutans
      streptococci.
AB  - Previous studies have shown that the peroxidase system with iodide is
      particularly effective against Actinobacillus actinomycetemcomitans. In the
      present study, the effects of iodide, chloride and thiocyanate in combinations
      with lactoperoxidase (LP) and myeloperoxidase (MP) on the viability of
      Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus mutans and S.
      rattus were analysed. Bacteria were incubated in buffer solution containing
      peroxidase, substrate(s) and H2O2 (all in oral physiological concentrations), and
      plated after 0, 0.5 and 1 h. The oxidation product of iodide was the most
      bactericidal against all the bacteria tested. The effect was significantly weaker
      on mutans streptococci. Physiological concentrations of thiocyanate abolished the
      effects of LP-H2O2-iodide and MP-H2O2-iodide/chloride combinations. Thiocyanate
      peroxidase systems have already been used in oral hygiene products. The
      incorporation of iodide into these products could make them much more potent
      against periodontal pathogens, and also help to prevent transmission of these
      pathogens from person to person via saliva.

PMID- 11192505
TI  - Reduced bactericidal activity against Staphylococcus aureus and Pseudomonas
      aeruginosa of blood neutrophils from patients with early adult respiratory
      distress syndrome.
AB  - This study investigated the bactericidal capability of circulating neutrophils
      from blunt trauma patients admitted to an Intensive Care Unit against
      Staphylococcus aureus and Pseudomonas aeruginosa. Among those patients, two
      groups were considered and compared: patients who developed adult respiratory
      distress syndrome (ARDS) and patients who developed only pneumonia. Peripheral
      blood samples were drawn as soon as a diagnosis of pneumonia or ARDS was made,
      followed by the isolation of neutrophil cells and assessment of bacteria
      phagocytosis and killing. The results demonstrated that in patients with ARDS,
      phagocytosis and killing efficiency were significantly impaired in comparison
      with patients with pneumonia and healthy controls. A possible dysregulation of
      reactive oxygen species production involving the release of humoral mediators in
      early ARDS may be involved.

PMID- 11192506
TI  - Distribution of immunoglobulin classes and IgG subclasses against a culture
      filtrate antigen of Burkholderia pseudomallei in melioidosis patients.
AB  - The class and subclass distribution of antibody response to the culture filtrate
      antigen (CFA) of Burkholderia pseudomallei was examined in the sera of 45
      septicaemic and 17 localised melioidosis cases and 40 cases clinically suspected
      of melioidosis and the results were compared with those from high-risk and
      healthy control groups. The geometric mean titre index (GMTI) values for all
      classes and subclasses of immunoglobulins examined were higher for sera from the
      proven and clinically suspected melioidosis cases than for the control groups.
      However, the highest response in the three patient groups was that of IgG with
      GMTIs ranging from 219.4 to 291.6 and the lowest was for IgM with GMTIs of 22.5,
      24.3 and 28.7. The IgA response was intermediate with GMTIs ranging from 119.2 to
      170. The GMTIs were highest for IgG in septicaemic and localised infections and
      for IgA and IgM in localised infections. As regards IgG subclass distribution,
      IgG1 and IgG2 were the predominant subclasses produced against the CFA in
      contrast to IgG3 and IgG4, which were produced in low amounts. None of the sera
      from the control groups had any significant titres of antibodies.

PMID- 11192507
TI  - Evaluation of serological markers for the immunodiagnosis of acute acquired
      toxoplasmosis.
AB  - The detection of specific IgM antibodies has been the most frequently used
      serological marker for diagnosing recent toxoplasmosis. However, the persistence
      of specific IgM antibodies in some patients and the use of tests with a low
      specificity have complicated the interpretation of serological results when
      toxoplasmosis is suspected. The purpose of the present study was to determine the
      value of newer serological techniques in the diagnosis of acute acquired
      toxoplasmosis. Sixty-four sera, 31 from patients with Toxoplasma gondii infection
      and 33 from patients with latent infection, were tested. Anti-T. gondii IgA was
      measured by two antibody capture ELISA tests (Platelia Toxo IgA and ETI-TOXOK A)
      and an automated direct ELISA (IMx Toxo IgA); all three assays detected antibody
      levels compatible with a recent infection in sera from all 31 patients with acute
      toxoplasmosis. However, significant levels of IgA were also detected with high
      frequency by all three assays in sera from patients with latent infection. IgE
      antibodies detected by IgE immunosorbent agglutination assay (ISAGA) were present
      in 26 (84%) of 31 patients with acute toxoplasmosis and in sera from two subjects
      with latent infection taken >1 year after the beginning of the clinical symptoms
      of infection. Thirty (97%) of 31 patients with a recent T. gondii infection and
      15 (45%) of 33 subjects with latent infection had an AC/HS pattern compatible
      with acute toxoplasmosis. The avidity of T. gondii IgG was evaluated by two
      methods. One method was based on the titration of each serum sample and
      calculation of the titres, in the absence and presence of urea, in relation to a
      defined cut-off value. In the other method, a single serum dilution was used and
      the absorbances of the reactions in the presence and absence of urea were
      compared. The titration method was more sensitive for diagnosing recent primary
      infection; all 31 sera from patients with acute toxoplasmosis had avidity indices
      compatible with acute toxoplasmosis by the titration method, whereas with the
      single dilution method, sera from four patients had equivocal results. In the 33
      individuals with latent infection, similar results were obtained with the two
      avidity methods; only one serum sample had a non-compatible avidity value with
      the titration method. The results obtained in the present study show that the
      current serological markers used for diagnosing acute acquired toxoplasmosis have
      significant limitations. The data suggest that determination of the avidity of T.
      gondii-specific IgG by the titration method in patients with detectable IgM
      antibodies defines most accurately the stage of infection by T. gondii.

PMID- 11192508
TI  - Carriage of class 1 integrons and antibiotic resistance in clinical isolates of
      Acinetobacter baumannii from northern Spain.
AB  - A collection of 70 clinical isolates of Acinetobacter baumannii from Bilbao in
      northern Spain was examined by PCR for the presence of class 1 integron
      structures. The organisms comprised 21 distinct RAPD genotypes, with 10 distinct
      antibiogram patterns. Four different integron structures were detected in a total
      of 59 (84%) of the 70 isolates, with two predominant integron structures found in
      20 and 30 isolates each. No clear antibiogram differences could be correlated
      with the presence or absence of integron structures, but sequence analysis of two
      of the internal integron regions indicated homology with genes encoding ANT(2'')
      adenyltransferase activity and AAC(6')-Ib acetyltransferase activity. Phenotypic
      analysis of aminoglycoside resistance profiles indicated that many isolates
      produced a combination of aminoglycoside-modifying enzymes, with most of the
      observed resistance to amikacin being associated with a gene encoding APH(3')-VI
      phosphotransferase, as detected by PCR. RAPD analysis indicated that all the
      Bilbao isolates producing APH(3')-VI were distinct from an epidemic integron
      carrying and APH(3')-VI-producing Acinetobacter strain found in other regions of
      Spain. It is concluded that, although class 1 integrons are widely disseminated
      amongst clinical isolates of A. baumannii from the Bilbao region of Spain, at
      present they are not playing a major role in the dissemination of antibiotic
      resistance genes in this region.

PMID- 11192509
TI  - Effect of fluconazole on agar invasion by Candida albicans.
AB  - Subinhibitory concentrations of azoles are known to inhibit hyphal branching of
      Candida albicans in liquid media. This study showed that subinhibitory
      concentrations of fluconazole also inhibit agar invasion by C. albicans in YPD
      solid medium. Agar invasion was markedly inhibited in two C. albicans strains
      that were resistant to fluconazole. This suggests that the degree to which
      fluconazole inhibits agar invasion by C. albicans hyphae could serve as a marker
      of susceptibility to azoles.

PMID- 11192510
TI  - Isolation and characterisation of an anticryptococcal protein in human
      cerebrospinal fluid.
AB  - An earlier study reported that human cerebrospinal fluid (CSF) has fungistatic
      activity for Cryptococcus neoformans. The present study reports that molecular
      sieve fractionation of concentrated CSF yielded three protein peaks, one of which
      (p2) had anticryptococcal activity. On a DEAE-Sephacel anion-exchange column the
      active molecular sieve peak (p2) gave two peaks that contained anticryptococcal
      activity. The first (DEAE-1) eluted with 0.1 M NaCl and the second (DEAE-2)
      eluted with 0.2 M NaCl in buffer. Fungistatic activity of DEAE-1 was reversed by
      FeCl3. Moreover, FeCl3 reversed inhibition of C. neoformans growth by CSF. In
      contrast, activity of DEAE-2 was not reversed by FeCl3, indicating that
      inhibition was produced by an iron-independent mechanism. Immunoblot assays
      showed that transferrin was present in DEAE-1 but not in DEAE-2, whereas albumin
      was present in DEAE-2 but not in DEAE-1. On NuPAGE, DEAE-1 protein migrated as a
      single band corresponding to transferrin and DEAE-2 protein gave a single band
      corresponding to albumin. In control experiments, human serum albumin subjected
      to the same isolation protocol acquired anticryptococcal activity similar to that
      of DEAE-2. Therefore, CSF albumin (DEAE-2) activity was associated with the
      isolation protocol. These data indicate that transferrin, present in or isolated
      from CSF, sequesters trace amounts of ferric iron, inhibits growth of C.
      neoformans and acts as an innate defence mechanism.

PMID- 11192511
TI  - Restriction endonuclease analysis of RAPD-PCR amplicons derived from Shiga-like
      toxin-producing Escherichia coli O157 isolates.
AB  - Shiga-like toxin-producing Escherichia coli O157 isolates were characterised by
      random amplification of polymorphic DNA by PCR (RAPD-PCR) analysis developed to
      allow robust epidemiological typing of E. coli. Amplification with primer 1247 or
      1290 generated a reproducible profile, but was not capable of distinguishing
      sufficiently between epidemiologically unrelated strains. Subsequent digestion of
      the amplicons with selected restriction endonucleases improved the discriminatory
      ability of this method for strains showing limited differentiation following RAPD
      PCR analysis alone. Restriction endonuclease analysis of RAPD-PCR fragments
      generated from closely related strains has the potential to provide additional
      discriminatory information without loss of specificity.

PMID- 11192512
TI  - First isolation of Leptospira fainei serovar Hurstbridge from two human patients
      with Weil's syndrome.
AB  - Leptospira fainei serovar Hurstbridge is a recently discovered Leptospira species
      and so far it has only been cultured from animal sources. Based on positive
      serology and positive PCR for L. fainei among patients suspected of having
      leptospirosis, a role in human disease seems likely. This study describes two
      patients with Weil's disease from whom L. fainei was cultured. A local source of
      the infections was suspected, as these two patients resided in the same area of
      Denmark, were hospitalised approximately at the same time and had not been
      travelling recently. The Leptospira species was determined by serology, PCR and
      sequencing of bacterial DNA. One patient developed autoimmune hepatitis in the
      course of the L. fainei infection and was treated with both antibiotics and
      immunosuppression with good effect. The other patient had a self-limiting disease
      and did not receive any treatment.

PMID- 11192513
TI  - Effect of high-frequency oscillatory ventilation on the upper airways of kittens.
AB  - BACKGROUND: High-frequency oscillatory ventilation (HFOV) has become the
      preferred method of ventilation for the fragile lungs of neonates and infants
      because its beneficial effects on lungs are well known; however, its benefits on
      upper airways are not yet known. We investigated the effects of HFOV and
      conventional mechanical ventilation (CMV) on the airways of kittens with normal
      lungs. METHODS: Ten healthy cross-bred kittens, 2-3-months-old, with a mean
      bodyweight of 0.98 kg, were randomly divided into two groups: HFOV and CMV.
      Kittens were intubated and ventilated for 24 h. A semiquantitative scoring system
      was used to grade histopathological tissue changes in the cricoid, mid-trachea,
      carina and left bonchus. The injury scores of the two groups were ranked and
      compared using a two-tailed Mann-Whitney rank test. RESULTS: Histopathologic
      changes were similar and mild in both groups under light microscopic examination.
      There was no significant difference in airway injury between the two groups.
      CONCLUSIONS: We conclude that, in this animal model, HFOV results in minimal
      airway damage when properly managed and causes no greater tracheobronchial injury
      than CMV.

PMID- 11192514
TI  - Pulmonary sequelae in long-term survivors of bronchopulmonary dysplasia.
AB  - BACKGROUND: Bronchopulmonary dysplasia (BPD) is a common problem in premature
      babies. Long-term sequelae are the main concerns. METHODS: A retrospective review
      of all BPD children born in Queen Mary Hospital, a teaching hospital of the
      University of Hong Kong, from January 1987 to December 1995 was conducted.
      Children with cerebral palsy, immunodeficiency, congenital heart disorders, renal
      or liver failure were excluded from analysis. Chest radiography (CXR),
      electrocardiogram (ECG) and pulse oximetry were routinely performed. RESULTS:
      Fifty-five children completed the study. The female to male ratio was 1:1.1. The
      mean gestational age was 28 weeks. Twenty-five children were born with a
      birthweight of less than 1001 g. Mean age at assessment was 5.4 years. Twenty
      four children (44%) demonstrated signs or symptoms of current asthma. Only seven
      children managed to perform the spirometry satisfactorily. One child had low
      forced vital capacity and one had hyperresponsive airway. The only risk factor
      found to be associated with current asthma was the birth month, with those
      children born early in the year at higher risk of developing current asthma.
      Seventeen of 48 children (35%) had a bodyweight below the third percentile at the
      corrected age of 1 year. Eleven of these seventeen children (65%) demonstrated
      catch-up growth at assessment. Abnormal CXR was found in 25 of 40 children (63%).
      All had normal pulse oximetry and ECG. CONCLUSIONS: Bronchopulmonary dysplasia
      children had a significantly higher risk than the general population of
      developing current asthma (odds ratio 4.7; 95% confidence interval 3.4-6.5;
      P<0.0001). The importance of birth month suggests that early life experience is
      important in the pathogenesis of asthma, even in BPD children. The long-term
      growth of BPD children was much better than previously reported.

PMID- 11192515
TI  - Laparoscopic surgery in neonates and infants weighing less than 5 kg.
AB  - BACKGROUND: Laparoscopic surgery in small infants is still an uncommon procedure
      in Japan. The present study was conducted to evaluate the advantages and
      disadvantages of laparoscopic surgery in neonates and infants weighing less than
      5 kg. METHODS: Between July 1997 and November 1999, 54 infants underwent
      laparoscopic surgery. They were evaluated for length of operation, intra- and
      postoperative complications, changes in intra-operative body temperature, time to
      postoperative feeding, length of hospital stay and changes in serum levels of C
      reactive protein (CRP), creatinine phosphokinase (CPK) and interleukin (IL)-6 on
      days 0, 1 and 4. These parameters in the laparoscopic pyloromyotomy (LP) and
      laparoscopic fundoplication groups were compared with those in the open
      pyloromyotomy (OP) and open fundoplication groups, respectively, which were
      performed during the same period. RESULTS: Three laparoscopy cases were converted
      to open procedures. One case of fundoplication had panperitonitis due to failed
      gastrostomy and required long-term parenteral nutrition. Time to postoperative
      feeding and length of hospital stay in the LP group were significantly shorter
      than in the OP group. In LP group, intra-operative body temperature did not
      markedly decrease during CO, pneumoperitoneum. Although serum levels of CRP, CPK
      and IL-6 were elevated in all groups on postoperative day 1, there were no
      significant differences between the groups. CONCLUSIONS: Better quality of life
      after laparoscopy is a significant advantage over conventional surgical
      procedures. This advantage not only outweighs the incidence of intra- and
      postoperative complications in small infants, but further emphasizes the need to
      improve laparoscopic techniques to avoid complications.

PMID- 11192517
TI  - Stepwise multimodal approach in the treatment of Kasabach-Merritt syndrome.
AB  - BACKGROUND: The purpose of the present study was to evalutate the various
      treatment modalities for Kasabach-Merritt syndrome (KMS) and to identify the most
      reliable treatment modalities. METHODS: A retrospective analysis was performed on
      37 KMS patients who were admitted to Seoul National University Hospital between
      January 1979 and June 1999. Age, sex, locations of the hemangiomas, clinical
      symptoms and hematologic data were analyzed by multivariate logistical regression
      analysis to determine the response to various treatment modalities. RESULTS:
      Twenty-four of 37 patients (20 boys and 17 girls) were diagnosed during infancy.
      The locations of hemangioma were superficial skin in 31 patients, combined skin
      and visceral organs in four patients and visceral organs only in two patients.
      Tumor size was more than 5 cm in diameter in all cases, except for one. The
      treatment principle of KMS in our center involves a stepwise multimodal approach.
      Of the 37 cases, surgical resection was performed in two. Steroids were tried
      initially in 35 patients over a 1 week period, with an initial response rate of
      11.4% (4/35). Combined steroid/radiation treatment was given in 28 cases, with a
      response rate of 75.0% (21/28). Four of five patients with additional interferon
      (IFN)-alpha therapy improved. No significant correlations were found between the
      prognostic factors, such as age, sex, size and locations of the hemangioma,
      hematologic data and the treatment modalities. CONCLUSIONS: Based on the
      experiences in a single center over a period of 20 years, we recommend a stepwise
      multimodal approach for the treatment of KMS; for example, steroid, radiation
      therapy and IFN-alpha in this order. However, surgical treatment is helpful if
      total resection is possible.

PMID- 11192516
TI  - Low serum lipids suggest severe bone marrow failure in children with aplastic
      anemia.
AB  - BACKGROUND: Significantly low serum lipid levels are occasionally seen at the
      time of diagnosis in children with aplastic anemia (AA). The aim of the present
      study was to clarify the pathologic and clinical significance of pretreatment
      serum lipid levels in AA. METHODS: A questionnaire seeking precise data about AA
      in pediatric patients, including the initial laboratory data at the time of onset
      of AA and the clinical course of these patients, was sent to 18 institutes in
      Japan; 13 institutes responded to the questionnaire. In this retrospective study,
      data concerning hematologic examination and serum lipids were available for
      analysis in 127 children with AA. Serum lipoprotein patterns were analyzed using
      conventional agarose electrophoresis in eight patients. In order to elucidate the
      cause of hypolipidemia in AA, we assayed serum macrophage colony stimulating
      factor (M-CSF), which is well known to have apparent cholesterol-lowering
      activity, by using an enzyme-linked immunosorbent assay in seven patients with
      hypocholesterolemia and compared the results with those obtained in patients with
      iron-deficiency anemia (IDA). RESULTS: We found that pretreatment total
      cholesterol (TC) and triglyceride levels in the serum correlated well with counts
      of both nucleated cells and hemopoietic cells in the bone marrow (BM) and were
      inversely correlated with the lymphocyte ratio in both the BM and peripheral
      blood. Patients with serum TC lower than 150 mg/dL showed a poor response to any
      form of therapy except BM transplantation. There was no difference in the serum
      lipoprotein patterns between the controls and patients examined. The serum M-CSF
      level was significantly higher in patients with TC levels lower than 150 mg/dL
      compared with controls. CONCLUSIONS: These results indicate that the pretreatment
      serum lipid level may reflect hematopoietic activity within the BM and can help
      to predict the therapeutic response of each case of AA to treatment with
      immunosuppressive drugs, corticosteroids and anabolic steroids. These results
      also indicate that M-CSF may be one of the contributing causes of the
      hypocholesterolemia that occurs in both AA and IDA.

PMID- 11192518
TI  - Short-term developmental outcome of iron prophylaxis in infants.
AB  - BACKGROUND: Previous studies on the cognitive effects of iron treatment have
      focused on anemic or non-anemic iron-deficient infants. The effect of iron
      supplementation on cognitive development among iron-sufficient infants has not
      been studied. The aim of the present study was to examine the effect of iron
      supplementation on performance in the Bayley Scales of Infant Development (BSID)
      and anthropometric measurement in 6-month-old iron-sufficient healthy infants.
      METHODS: Healthy, iron-sufficient infants who were 6 months of age and were
      attending the Well Baby Clinic were considered for enrollment. Infants were
      randomly assigned to take ferrous sulfate supplementation (1 mg/kg per day) or no
      supplementation and were followed for 3 months. Anthropometric measurement,
      hematologic status and BSID were evaluated on admission and after 3 months.
      RESULTS: Seven infants in the intervention group and nine in the control group
      completed the study. No significant differences were observed in anthropometric
      measurements and complete blood counts between the two groups after the 3 month
      study period. The mean transferrin saturation (TS) level decreased significantly
      in the control group during the study period (from 15.3+/-2.6 to 7.8+/-5.1%; P =
      0.0117), but no such reduction was seen in the intervention group. At the end of
      the study, the TS of the control group was found to be significantly lower than
      that of the intervention group (7.8+/-5.1 vs. 19.9+/-7.9%, respectively; P =
      0.0033). The BSID scores of infants in both groups were within the normal range
      on admission and at the end of the study period. CONCLUSIONS: Short-term iron
      supplementation did not change developmental test scores despite the hematologic
      response in iron-sufficient healthy infants. The high prevelance of iron
      deficiency anemia and its relationship with adverse developmental outcome
      suggests that prevention of iron-deficiency anemia with prophylaxis needs to be
      emphasized, rather than treatment.

PMID- 11192519
TI  - Killing of human Herpes virus 6-infected cells by lymphocytes cultured with
      interleukin-2 or -12.
AB  - BACKGROUND: Human Herpes virus 6 (HHV-6) is a causative agent of exanthema
      subitum and replicates mainly in lymphocytes. The aim of present study was to
      investigate cytotoxicity against HHV-6-infected cells by cord blood mononuclear
      cells (CBMC) and adult peripheral blood mononuclear cells (PBMC). METHODS: Human
      herpes virus 6-infected and -uninfected lymphocytes were used as target cells.
      Killing of target cells by CBMC and PBMC was investigated by the chromium release
      cytotoxicity assay. RESULTS: Freshly isolated CBMC and PBMC did not lyse HHV-6
      infected and -uninfected cells. When CBMC and PBMC were cultured with interleukin
      (IL)-2, HHV-6-infected cells were significantly lysed compared with uninfected
      cells. Deletion of CD16+ cells by treatment of effector cells with anti-Leu-11b
      (CD16) antibody with complement reduced cytotoxicity against HHV-6-infected cells
      and T lymphocyte-rich cells did not lyse HHV-6-infected cells. Treatment of
      effector cells with anti-Fas ligand antibody and treatment of HHV-6-infected
      cells with anti-Fas antibody reduced cytotoxicity against HHV-6-infected cells.
      DNA fragmentation was detected in the supernatant from HHV-6-infected cells
      cultured with IL-2-activated lymphocytes. Culture of CBMC and PBMC with IL-12
      also enhanced cytotoxicity against HHV-6-infected cells. CONCLUSIONS: These data
      suggest that lymphocytes cultured with IL-2 or IL-12 mediate killing against HHV
      6-infected cells and killing of HHV-6-infected cells was through apoptosis. Fas
      Fas ligand interaction is one pathway by which HHV-6-infected cells are killed.
      Killing of HHV-6-infected cells by NK cells activated by cytokines may play a
      role in the recovery from HHV-6 infection in vitro.

PMID- 11192520
TI  - Plasma levels of granulocyte elastase-alpha1-proteinase inhibitor complex in
      children with hemolytic uremic syndrome caused by verotoxin-producing Escherichia
      coli.
AB  - BACKGROUND: Activated neutrophils play an important role in the pathogenesis of
      renal injury in humans and in experimental models of hemolytic uremic syndrome
      (HUS). To evaluate the clinical significance of the circulating granulocyte
      elastase-alpha1-proteinase inhibitor complex (GEPIC), which is a marker of
      neutrophil activation, we investigated the plasma concentrations of GEPIC in
      children with hemolytic uremic syndrome (HUS) associated with verotoxin-producing
      Escherichia coli (VTEC), VTEC gastroenteritis without HUS and in normal controls.
      METHODS: Of 22 children (1-19 years of age; mean age 5.5 years) with VTEC
      infection, nine were diagnosed with HUS. Plasma GEPIC, soluble thrombomodulin
      (sTM) and thrombin-antithrombin-III complex (TAT) levels were measured by ELISA.
      RESULTS: The number of polymorphonuclear leukocytes and the levels of plasma
      GEPIC in patients with HUS were significantly higher than those in non-HUS
      (9850+/-5091 vs. 5278+/-3327 /microL, P<0.05; 432.1+/-211.7 vs. 188.3+/-117.0
      ng/mL, P<0.01) or control subjects (9850+/-5091 vs. 4728+/-1977 /microL, P<0.05;
      432.1+/-211.7 vs. 105.9+/-51.1 ng/mL, P<0.001). Furthermore, plasma GEPIC levels
      showed a positive correlation with sTM (r = 0.522; P<0.01), a marker of
      endothelial cell injury, and TAT (r = 0.594; P<0.01), a marker of thrombin
      activity. CONCLUSIONS: These results suggest that an increase in circulating
      GEPIC levels in patients with VTEC-associated HUS may be related to endothelial
      injury, which may possibly lead to a more severe episode of this disease.

PMID- 11192521
TI  - Efficacy of interferon-alpha2b treatment in children with chronic hepatitis B who
      have previously undergone therapy for cancer.
AB  - BACKGROUND: The aim of the present study was to evaluate the efficacy of
      treatment with recombinant interferon (IFN)-alpha2b in 12 children with chronic
      hepatitis B who had previously undergone therapy for cancer. METHODS: Nine
      children had acute leukemias and the other three children had solid tumors. The
      mean (+/-SD) age of the children was 8.4+/-3.8 years (range 4-16 years). All
      cases were hepatitis B virus (HBV)-DNA positive and 11 were hepatitis B e antigen
      (HBeAg) positive. One was anti-HBe positive (mutant strain). Four cases were anti
      delta IgG positive. Liver biopsy revealed chronic hepatitis B in 11 patients and
      cirrhosis in one patient. Interferon-alpha2b was given at a dose of 5 MU/m2 three
      times a week, subcutaneously, for 12 months. RESULTS: Elimination of serum HBV
      DNA was obtained in three cases, but a further three patients demonstrated a
      marked decrease in HBV-DNA levels after therapy. Three of 11 patients
      seroconverted from HBeAg to anti-HBe. Alanine aminotransferase (ALT) levels
      returned to normal in three of nine cases in whom the ALT levels were high before
      treatment. At the end of therapy, the mean histologic activity index score was
      significantly diminished (P = 0.0039). CONCLUSIONS: In conclusion, a 12 month
      course of IFN-alpha2b induces some beneficial effects on virologic, biochemical
      and histologic indices in children with chronic hepatitis B who have previously
      undergone therapy for cancer.

PMID- 11192522
TI  - Transient hypogammaglobulinemia of infancy: clinical and immunologic features of
      40 new cases.
AB  - BACKGROUND: Transient hypogammaglobulinemia of infancy (THI) results from a delay
      in the maturation of immunoglobulin production. METHODS: The clinical and
      immunologic data of 40 patients with THI are presented. Clinically, the majority
      of patients presented with recurrent respiratory infections and otitis media,
      bronchitis and/or bronchial asthma and recurrent gastroenteritis. RESULTS: Ten of
      40 children had isolated low IgG; isolated low IgA and isolated low IgM were
      detected in one and three patients, respectively. At initial evaluation, levels
      of all three immunoglobluins were low in nine patients. Ten patients had
      diminished IgG and IgA levels, six had diminished IgA and IgM levels and one had
      low IgG and IgM levels. Two patients were given intravenous immunoglobulin
      replacement therapy for 1 year. None of the patients has experienced serious
      infections during their follow-up period. CONCLUSIONS: Prospective evaluation of
      patients (age range 5-60 months) revealed that immunoglobulin levels in 33
      patients recovered before 36 months of age. Seven patients still had low
      immunoglobluin levels at 40-57 months of age. Three of these patients had low
      levels of both IgG and IgA, while two patients had low IgM levels and a further
      two patients had low IgA levels.

PMID- 11192523
TI  - Ventricular energetics in Fontan circulation: evaluation with a theoretical
      model.
AB  - BACKGROUND: Both pulmonary and systemic circulation must be maintained by a
      single pump in Fontan circulation. This unique property of Fontan circulation may
      be related to decreased exercise tolerance or increased instantaneous
      postoperative mortality rate, often observed in patients with this circulation.
      To better understand Fontan physiology, the present study theoretically
      investigated cardiac performance of Fontan circulation by using ventricular
      vascular coupling framework analysis. METHODS: End-systolic volume elastance
      (Ees), as a chamber contractile property, and effective arterial elastance (Ea),
      a lumped measure of ventricular afterload, were estimated both in normal left
      ventricular systemic circulation and in Fontan circulation. RESULTS: End-systolic
      volume elastance was decreased and Ea was increased in Fontan circulation. Both
      ventricular external stroke work (SW) and mechanical efficiency (EFF) under
      Fontan circulation were lower compared with those under normal circulation.
      Furthermore, the Ees-Ea relationship in Fontan circulation predicted limited
      cardiac reserve in terms of SW and EFF. Such cardiac performance in Fontan
      circulation stemmed from increased impedance due to the additional connection of
      the pulmonary vascular bed to the systemic vasculature and from the lack of a
      compensatory increase in contractility for increased afterload. CONCLUSIONS:
      Thus, it was inferred that Fontan circulation had intrinsic disadvantages and
      this may explain, in part, abnormal functional status and decline in survival
      following this procedure.

PMID- 11192524
TI  - Restenosis after balloon angioplasty of coarctation: relationship with ductus
      arteriosus.
AB  - BACKGROUND: Recently, balloon angioplasty (BA) has been used for the treatment of
      coarctation of the aorta (CoA) and the effectiveness of this treatment has been
      reported. However, the restenosis rate following BA in native CoA in the infant
      is high and the cause may be related to tissue properties at the origin of the
      ductus arteriosus (DA). However, the mechanisms responsible for restenosis remain
      uncertain. METHODS/RESULTS: The present study was designed to examine
      transformation of the smooth muscle cell (SMC) phenotypes using immunohistologic
      studies and to investigate the cause of restenosis of CoA following BA. A CoA
      model was surgically created in 15 newborn pigs (10-14-days-old; 2.4-4.1 kg).
      Balloon angioplasty was performed 1 month after the initial operation. One or 3
      months after BA, animals were killed and immunohistologic studies on smooth
      muscle cell (SMC) antibodies against SM1, SM2 and SMemb of the myosin heavy chain
      (MHC) isoform were performed in the aorta at the CoA and DA. In the neointima,
      only SMemb was positive. In the SMC layer of the DA, only SM2 was positive. One
      month after BA, the external layer of the tunica media was strongly positive for
      SM2 only in the area around the origin of the DA. CONCLUSIONS: The first cause of
      restenosis is obstructive neointimal formation caused by the proliferation of
      undifferentiated SMC into the subendothelial tissue. This proliferation seems to
      be triggered by BA. The distribution of SM2 1 month after balloon angioplasty
      showed a similar pattern of proliferation of SMC in the external layer around the
      DA. This may represent a second mechanism of restenosis.

PMID- 11192525
TI  - Headache etiology in children: a retrospective study of 125 cases.
AB  - BACKGROUND: To determine the headache etiology in children in the middle Anatolia
      region of Turkey. METHODS: The clinical and laboratory findings of 125 patients,
      who were followed up after a diagnosis of headache in our hospital, were reviewed
      retrospectively. The criteria defined by the International Headache Society (IHS)
      were used in the classification of patients. The patients were divided into two
      subgroups according to age intervals: (i) group 1, 5-10 years of age; and (ii)
      group II, 11-16 years of age. RESULTS: There were 62 males and 63 females in the
      study. The patients' ages ranged from 5 to 16 years (mean (+/- SD) age 10.67+/
      2.72 years). Headache was more commonly noted between 11 and 16 years of age.
      While headache was more frequent in male children in group I, there was female
      predominance in group II. However, there was no significant difference between
      the groups with respect to age and gender (P>0.05). The most frequent cause of
      headache was migraine and the remaining causes, in decreasing order, included
      sinusitis (no. 11 according to IHS criteria) and tension-type and psychosomatic
      headaches (no. 13 according to IHS criteria). Of the 125 patients in the study,
      85 (68%) had acute headache and 40 (32%) had chronic headache; 44 (35.2%)
      patients had acute localized-type headache, 39 (31.2%) suffered from acute
      recurrent-type headache, 38 (30.4%) had chronic non-progressive headache and
      acute generalized and chronic progressive-type headache were diagnosed in two
      (1.6%) patients. Computed tomography (CT) and magnetic resonance imaging (MRI) of
      the brain were performed in 50 and seven patients, respectively; there were
      abnormal findings in six patients on CT examiniation and in two patients
      following MRI. CONCLUSIONS: In conclusion, we stress that the most frequent cause
      of headache in childhood is migraine and the remaining causes, in decreasing
      order of frequency, were sinusitis and tension-type and psychosomatic headaches.
      Neuroimaging studies, such as CT or MRI, need to be performed, especially in
      patients with complicated symptoms.

PMID- 11192526
TI  - Safety and immunogenicity of live attenuated varicella vaccine in 9-month-old
      children.
AB  - BACKGROUND: The present study was conducted to evaluate the safety and
      immunogenicity of live attenuated varicella vaccine (Oka-strain) in 9-month-old
      infants. METHODS: One hundred and fourteen infants were vaccinated once with live
      attenuated varicella vaccine (Valrix; SmithKline Beecham Biologicals, Rixensart,
      Belgium) containing a mean virus titer of 10(4.0) plaque-forming units (p.f.u.)
      per dose. Signs and/or symptoms after vaccination were followed for 42 days. Home
      visits were made to detect solicited local reactions (0-3 days) and solicited
      general reactions (0-21 days), as well as unsolicited reactions. Specific
      varicella antibodies were determined by an indirect immunofluorescence method.
      The geometric mean titer and seroconversion rate were calculated. RESULTS: Signs
      and/or symptoms were reported in 47.4% (54/114) of cases following vaccination.
      The only local symptom reported was pain on digital pressure at the injection
      site and this was reported in 28.1% (32/114) of infants. General symptoms were
      reported in 38.6% (44/114) of cases. The most frequently reported findings were
      fever (27.2%), which was mostly mild, restlessness (20.2%) and cough (11.4%).
      Only four unsolicited symptoms were reported and they were all unrelated to
      vaccination. No serious adverse event was reported. Of the 109 infants included
      in the immunogenicity analysis, 105 were seronegative and four were seropositive
      for antibodies against varicella before vaccination. The vaccine elicited
      seroconversion in 97.1% of initially seronegative cases. The post-vaccination
      geometric mean titer for these infants was 30.9 geometric mean titer (GMT).
      CONCLUSIONS: The vaccine was found to be safe and immunogenic when given to
      infants as young as 9 months of age. This may be of clinical significance during
      outbreaks of varicella and especially for developing countries.

PMID- 11192527
TI  - Pattern of human leukocyte antigens in Turkish children with celiac disease.
AB  - BACKGROUND: Regional variations in the human leukocyte antigen (HLA) distribution
      patterns of celiac disease (CD) have been reported. The aim of the present study
      was to assess the distribution of HLA class I and class II in Turkish children
      with CD and to compare the findings with a control group. METHODS: Human
      leukocyte antigen typing was performed in 33 children with CD and in 77 healthy
      individuals, who served as controls, by using standard National Institutes of
      Health lymphocytotoxicity techniques. RESULTS: A positive association was found
      between HLA A2 (42 vs 19% for sick subjects compared with healthy controls,
      respectively), B8 (39 vs. 9% for sick subjects compared with healthy controls,
      respectively), CW7 (45 vs. 25% for sick subjects compared with healthy controls,
      respectively), DR3 (70 vs. 17% for sick subjects compared with healthy controls,
      respectively), DR7 (30 vs. 13% for sick subjects compared with healthy controls,
      respectively) and DQ2 (52 vs. 34% for sick subjects compared with healthy
      controls, respectively). The combinations of DR3-DQ2 (30 vs. 12% for sick
      subjects compared with healthy controls, respectively), DR3-DR4 (21 vs. 1% for
      sick subjects compared with healthy controls, respectively) and DR7-DQ2 (21 vs.
      6% for sick subjects compared with healthy controls, respectively) were also
      found to be significantly important in children with CD. The highest relative
      risk (RR) was for HLA B8 in class I (RR 6.50), for DR3 (RR 11.30) in class II and
      for combination of DR3-DR4 (RR 20.46). The highest etiologic fraction (EF) was
      for the DR3 antigen (EF 0.55). CONCLUSIONS: The present study emphasizes that HLA
      genotypes are an important background to CD development, but some additional
      susceptibility factors remain to be identified.

PMID- 11192528
TI  - Can zinc deficiency be used as a marker for the diagnosis of celiac disease in
      Turkish children with short stature?
AB  - BACKGROUND: It is generally accepted that celiac disease (CD) must always be
      considered when dealing with growth failure in children. Therefore, it is
      important to develop screening tests for detecting patients that need an
      intestinal biopsy. The aim of the present study was to investigate the value of
      plasma zinc levels for the diagnosis of monosymptomatic CD in short-statured
      children. METHODS: Fourty-nine children with a short stature and 34 healthy
      controls were investigated. Plasma zinc levels were assayed by atomic absorption
      spectrophotometry in short-statured children and controls. All patients with
      short stature underwent endoscopic small intestinal biopsy. RESULTS: Duodenal
      mucosal histopathology was normal in 25 children. Low plasma zinc values were
      observed in 54.2% of patients with CD, 32.0% of patients with idiopathic short
      stature and 14.8% of controls. The mean values of plasma zinc levels were not
      significantly different among the three groups. Sensitivity, specificity and the
      positive and negative predictive values for plasma zinc were 45.8, 76.0, 64.7 and
      59.4%, respectively. CONCLUSIONS: These results indicate that zinc deficiency is
      an important problem in CD children with short stature; however, plasma zinc
      levels are not useful as a screening test for selecting patients for jejunal
      biopsy.

PMID- 11192529
TI  - 3beta-hydroxy-delta5-C27-steroid dehydrogenase/isomerase deficiency in a 23-year
      old woman.

PMID- 11192530
TI  - Point mutation in intron 11 of Bruton's tyrosine kinase in atypical X-linked
      agammaglobulinemia.

PMID- 11192531
TI  - Hemorrhagic telangiectasia with thrombocytopenia in a newborn infant.

PMID- 11192532
TI  - Neonatal listeriosis with severe respiratory failure responding to nitric oxide
      inhalation.

PMID- 11192533
TI  - Liver abscess due to Lactococcus lactis cremoris.

PMID- 11192534
TI  - A case of persistent Enterobacter cloacae bacteremia.

PMID- 11192535
TI  - Possible splenic tuberculosis presenting as unexplained fever.

PMID- 11192536
TI  - Childhood idiopathic thrombocytopenic purpura associated with human parvovirus
      B19 infection.

PMID- 11192537
TI  - Coxiella burnetii lymphadenitis: a possible fever focus in acute Q fever.

PMID- 11192538
TI  - Intrathoracic kidney combined with pneumomediastinum in an asphyxiated neonate.

PMID- 11192539
TI  - N-acetyl-L-cysteine inhibits bleomycin-induced interleukin-8 secretion by
      bronchial epithelial cells.
AB  - OBJECTIVE: Bleomycin (BLM) has proven effective for the treatment of cancers, but
      the most serious dose-limiting side-effect is the development of pulmonary
      toxicity. Although the precise mechanism in the pathogenesis of BLM-induced lung
      injury has not been determined, oxygen radicals and neutrophils are indicated to
      play a key role in it. Interleukin-8 (IL-8) is thought to be an important
      mediator of the pathogenesis of acute lung injury. METHODOLOGY: The IL-8
      production from bronchial epithelial cell line, BEAS-2B cells was measured by
      enzyme-linked immunosorbent assays for IL-8. RESULTS: The concentrations of IL-8
      were reportedly elevated in BLM-induced lung injury, suggesting the involvement
      of IL-8 in the pathogenesis of BLM-induced lung injury. In the present study, we
      showed that BLM induced the expression of IL-8 protein and mRNA in BEAS-2B cells,
      and N-acetyl-L-cysteine (NAC) inhibited IL-8 expression. In addition, the
      structurally unrelated antioxidant, pyrrolidine dithiocarbamate (PDTC) also
      effectively inhibited BLM-induced IL-8 production. CONCLUSION: These results
      suggest that anti-oxidant-sensitive mechanism might be involved in the inhibition
      of IL-8 secretion by BLM-stimulated bronchial epithelial cells and that NAC might
      be useful for the treatment of BLM-induced lung injury.

PMID- 11192540
TI  - Increased incidence of autoantibodies to interleukin-1a in rheumatoid arthritis
      with interstitial lung disease.
AB  - OBJECTIVE: To clarify the clinical significance of autoantibodies (auto-Ab) to
      interleukin-1alpha (IL-1alpha) in rheumatoid arthritis (RA) with interstitial
      lung disease (ILD), we examined the IL-1alpha auto-Ab level in serum of patients
      with RA with/without ILD. METHODOLOGY: We investigated the level of IL-1alpha
      auto-Ab in serum of 70 patients with RA with/without ILD and 40 control patients
      (CP). Levels of IL-1alpha auto-Ab were measured by radioimmunoassay, and serum
      was regarded as IL-1alpha auto-Ab positive at an auto-Ab level of more than 5
      ng/mL. RESULTS: Interleukin-1alpha auto-Ab was detected in the serum of 30 out of
      70 RA patients (42.9%), and six out of 40 CP (15%) (P < 0.05). Interleukin-1alpha
      auto-Ab were detected in the serum of 18 out of 32 patients with RA with ILD
      (56.2%) and 12 out of 38 patients with RA without ILD (31.5%). The positive rate
      of these autoantibodies in RA with ILD was significantly higher than that in RA
      without ILD (P < 0.05). Although C-reactive protein, immunoglobulin G, rheumatoid
      factor and rheumatoid arthritis particle agglutination levels in serum from
      patients with RA with ILD were not significantly different between the IL-1alpha
      auto-Ab-positive and -negative groups, the lactate dehydrogenase level (LDH) and
      AaDO, in the IL-1alpha auto-Ab-positive group were significantly higher than
      those in the negative group (LDH: P < 0.001, AaDO2: P < 0.05). CONCLUSION: These
      results suggest that IL-1alpha auto-Ab are generated in response to the
      immunoinflammatory process of ILD in RA, and these autoantibodies may neutralize
      and regulate the IL-1alpha activity.

PMID- 11192541
TI  - Determination of adenosine deaminase activity and its isoenzymes for diagnosis of
      pleural effusions.
AB  - OBJECTIVE: We aimed to investigate adenosine deaminase (ADA) activity and the
      activities of its ADA1 and ADA2 isoenzymes in pleural effusions and also sera
      with different aetiological origins. METHODOLOGY: The pleural effusions of 87
      patients were examined. The patients were separated into four groups:
      transudates, parapneumonic, malignant, and tuberculous effusions. The cases were
      also designated as tuberculous or non-tuberculous group. Adenosine deaminase
      activity was determined by the colorimetric method described by Giusti and
      Galanti. RESULTS: The intermean differences were statistically significant for
      total ADA, ADA1 and ADA2, except for pleural fluid ADA1 in the malignant group
      when compared to the tuberculous effusion group. The intermean differences
      between the tuberculous and non-tuberculous group were statistically significant
      for all three parameters except for pleural fluid and serum ADA1 activity. The
      sensitivities of total ADA, ADA1 and ADA2 activities for tuberculosis were 91, 57
      and 93%, respectively; their specificities 89, 88 and 92%, respectively; their
      positive predictive values 82, 70 and 86%; and their diagnostic accuracies 89, 76
      and 92%, respectively, in pleural fluid. CONCLUSIONS: Determination of ADA and
      its isoenzymes can help to differentiate the causes of pleural effusion.
      Increased ADA2 activity is a striking marker of tuberculous effusions. In
      contrast, increased ADA1 activity was significantly elevated in parapneumonic
      effusions.

PMID- 11192542
TI  - The role of cytokine-induced neutrophil chemoattractant-1 in neutrophil-mediated
      remote lung injury after intestinal ischaemia/reperfusion in rats.
AB  - OBJECTIVE: Remote lung injury is induced by ischaemia/reperfusion (I/R) of the
      gastrointestinal tract and the liver following hypovolaemic shock. In the present
      study, the role of cytokine-induced neutrophil chemoattractant (CINC), a member
      of the interleukin (IL)-8 family, in neutrophil-mediated remote lung injury
      following intestinal I/R was investigated in anaesthetized rats. METHODOLOGY: The
      I/R group was subjected to 60 min of occlusion of the superior mesenteric artery
      with laparotomy, followed by 240 min of intestinal reperfusion. The sham-operated
      (sham) group was subjected to the same procedures with the exception of
      intestinal I/R. RESULTS: In the I/R group, the permeability index of the lung,
      the neutrophil count in pulmonary vascular lavage fluid and bronchoalveolar
      lavage fluid (BALF), lung myeloperoxidase activity and neutrophil oxidative
      production were all significantly greater than those in the sham group. Cytokine
      induced neutrophil chemoattractant-1 levels in blood and BALF were significantly
      increased at 240 min after intestinal reperfusion. There was a significant
      relationship between neutrophils in BALF and CINC-1 level in BALE CONCLUSION:
      These findings suggest that intestinal reperfusion was associated with activation
      and accumulation of neutrophils in the lung and resulted in remote lung injury
      with increased microvascular permeability. Thus, CINC-1 in BALF may induce
      neutrophil migration from the pulmonary vessels to the interstitium and alveolar
      spaces in remote lung injury after intestinal I/R.

PMID- 11192543
TI  - Echocardiographic findings of pericardial involvement in patients with malignant
      pleural mesothelioma with a history of environmental exposure to asbestos and
      erionite.
AB  - OBJECTIVE: The aim of the present study was to evaluate the pericardial
      involvement in patients with malignant mesothelioma caused by exposure to
      different minerals. METHODOLOGY: Forty-two patients (mean age of 52 +/- 12 years)
      with malignant mesothelioma were examined with transthoracic echocardiography.
      Thirty-three (78.9%) patients had a history of environmental exposure to asbestos
      and nine (21.4%) had a history of environmental exposure to erionite. RESULTS: In
      19 (45.2%) patients with malignant pericardial mesothelioma, pericardial
      involvement was determined by echocardiography. The other 23 (54.8%) patients had
      no pericardial involvement. Pericardial effusion was detected in nine (64.3%)
      patients and pericardial effusion was small in six (14.3%) patients, moderate in
      one (2.4%) patient and large in two patients. Thickening of the pericardium was
      observed in eight (19%) patients. In another two (7.1%) patients pericardial
      calcification was observed. Among the 33 patients who had been exposed to
      asbestos, 15 (45.5%) had pericardial involvement, and among the nine patients
      with a history of exposure to erionite, four (44.4%) had pericardial involvement.
      There was no difference in terms of pericardial involvement in different stages
      of the tumour (P > 0.05). CONCLUSIONS: Pericardial involvement is commonly seen
      in patients with malignant mesothelioma. Among patients exposed to asbestos or
      zeolite there was no difference in terms of pericardial involvement. Furthermore,
      pericardial involvement was not related with the stage of the tumour.

PMID- 11192544
TI  - Comparison between tidal breathing and dosimeter methods in assessing cough
      receptor sensitivity to capsaicin.
AB  - OBJECTIVE: Dosimeter method and tidal breathing method have been used to assess
      cough sensitivity to inhaled capsaicin, a C-fibre ending stimulator. The aim of
      the present study was to evaluate the repeatability of and the agreement between
      the two methods. METHODOLOGY: Cough threshold, the lowest concentration of
      capsaicin causing five or more coughs, was measured twice 1-3 weeks apart by each
      method in 26 normal subjects. Increasing concentrations of capsaicin were inhaled
      by a single breath in the dosimeter method or by 15 s tidal breathing in the
      tidal breathing method in 1 min intervals. RESULTS: Coefficients of repeatability
      of the cough threshold measurement were 1.89 and 2.71 doubling concentration in
      the tidal breathing method and the dosimeter method, respectively, suggesting
      good repeatability in the cough threshold measurement by both methods. The cough
      threshold was significantly (P < 0.0001) greater by 1.75 doubling concentration
      on the dosimeter method than the tidal breathing method. The coefficient of
      agreement between the two methods was 2.53 doubling concentration. Five subjects
      complained of burning sensation in the throat in the dosimeter method but no
      patient complained about the tidal breathing method (P < 0.05). CONCLUSIONS:
      Although the agreement between the two methods was considered to be good, higher
      concentrations of capsaicin solution were required to determine the cough
      threshold in the dosimeter method, resulting in an unpleasant sensation in the
      throat.

PMID- 11192545
TI  - Parasympathetic neurotransmission in rabbit isolated bronchus is modulated at
      prejunctional sites via endothelinB receptor stimulation.
AB  - OBJECTIVE: The aim of this study was to investigate the mechanism involved in
      endothelin-induced potentiation of the response to parasympathetic nerve
      stimulation. METHODOLOGY: We used autoradiographic and functional studies in
      rabbit isolated bronchi. RESULTS: Autoradiography revealed dense binding sites
      for radiolabelled endothelin-3 over bronchial parasympathetic ganglia. The
      contractile response of the bronchus to electrical field stimulation was
      significantly potentiated by endothelin-3, endothelin-1, sarafotoxin S6c and BQ
      3020 to 326+/-53%, 293+/-63%, 514+/-119% and 655+/-178%, respectively, of control
      values. The endothelin-3-induced potentiation of neurally evoked responses was
      not affected by the presence of propranolol, phentolamine or hexamethonium. The
      potentiation was also unaltered by pretreatment with the endothelinA receptor
      antagonist BQ-123 (3 micromol/L), but was significantly reduced in the presence
      of the combined endothelinA/endothelinB receptor antagonist PD 145065, indicating
      that the potentiation was mediated via endothelinB receptors. Confirmation of
      endothelinB receptor involvement in the neuropotentiation was obtained by
      demonstration of a significant amelioration of the potentiation in the presence
      of the endothelinB receptor selective antagonist BQ-788, and after endothelinB
      receptor desensitization by the endothelin, receptor selective agonist
      sarafotoxin S6b. CONCLUSIONS: These results suggest that the endothelin-induced
      potentiation of parasympathetic neural responses in the rabbit bronchus is
      mediated via endothelinB receptor activation.

PMID- 11192546
TI  - Lung cancer in patients younger than 40 years in a multiracial Asian country.
AB  - OBJECTIVE: This study aimed to determine whether the clinicopathological features
      of lung cancer in patients younger than 40 years differ from that of older
      patients in an Asian country. METHODOLOGY: We undertook a review of the
      clinicopathological data of all patients with confirmed primary lung cancer at
      the Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur,
      Malaysia, from October 1991 to September 1999. RESULTS: Of the 580 patients with
      lung cancer, 36 (6.2%; 23 males, 13 females) were 21-39 years old at diagnosis.
      The percentage of people who had never smoked was higher among the younger
      patients (58.3% vs 19.1%, P < 0.001). Although adenocarcinoma was the most common
      cell type in both groups, its incidence was higher in the younger patients (24/36
      (66.7%) vs 228/544 (41.9%), P = 0.007). The mean World Health Organization
      performance status at presentation was worse in the younger patients (2.4 vs 2, P
      = 0.007). In the case of non-small cell lung cancer, all the younger patients
      presented with either stage IIIb or metastatic disease compared to 77.2% of the
      older patients (P < 0.001). CONCLUSIONS: Younger lung cancer patients were more
      likely than older patients to have never smoked, to have adenocarcinoma, and to
      present with poorer performance status and with more advanced-stage non-small
      cell lung cancer.

PMID- 11192547
TI  - A comparative analysis of the biochemical parameters used to distinguish between
      pleural exudates and transudates.
AB  - OBJECTIVE: The aim of the present study was to compare the various parameters
      used to identify exudates. METHODOLOGY: The study included 255 patients with
      pleural effusions. According to aetiological diagnosis, 105 pleural effusions
      were labelled as transudates and 150 were labelled as exudates. RESULTS: Using
      the criteria of Light et al., 94.5% of the effusions were correctly classified,
      yielding a sensitivity and specificity of 99.3% and 87.6%, respectively. Use of
      the pleural fluid/serum bilirubin ratio produced results of 92.9%, 90.7%, and
      96.2%, respectively. Using pleural fluid cholesterol level yielded results of
      95.7%, 95.3%, and 96.2%, respectively. When the combination of pleural fluid
      cholesterol level and lactate dehydrogenase (LDH) level was used, the specificity
      and accuracy were found to be higher than that using the criteria of Light et al.
      We found that there was no significant difference among the parameters with
      respect to accuracy. CONCLUSION: When the accuracy and cost are considered,
      differentiation of pleural exudates and transudates can be achieved only by
      pleural fluid cholesterol level or LDH level; and when two parameters were used
      together, the accuracy and specificity were higher than that using the criteria
      of Light et al.

PMID- 11192548
TI  - Bronchiolitis obliterans in children: clinical profile and diagnosis.
AB  - OBJECTIVE: The aim of the study was to determine the clinical profile, aetiology
      and radiological categories in children diagnosed with bronchiolitis obliterans
      (BO). METHODOLOGY: We undertook a review of the medical records and radiological
      studies of 14 children with BO. RESULTS: Unresolving cough and wheeze after a
      short respiratory illness was the commonest presentation. A viral pneumonitis was
      identified as the initial respiratory event prior to the development of BO in six
      children and Mycoplasma pneumoniae was the cause in another three children. Chest
      X-ray findings could be divided into four distinct patterns that were
      hyperinflation (n=5), mixed pattern of atelectasis, hyperlucency and bronchial
      thickening (n=4), unilateral small hyperlucent lung (n=3) and unilateral collapse
      of one lung (n=2). High resolution computed tomogram (HRCT) chest showing areas
      of hyperaeration and mosaic ground glass patterns with bronchial thickening were
      commonly found in patients whose chest X-ray showed bilateral changes. Patients
      with bilateral lung changes were more likely to have failure to thrive and
      persistent respiratory symptoms on follow up. CONCLUSION: A diagnosis of BO can
      be made from typical clinical features combined with an understanding of the
      different chest X-ray categories and HRCT of the chest. A viral aetiology was the
      commonest cause for BO in our series.

PMID- 11192549
TI  - Tracheobronchopathia osteochondroplastica.
AB  - Tracheobronchopathia osteochondroplastica (TO) is a rare disorder with unknown
      aetiology. We report one case of TO in a patient with non-Hodgkin pulmonary
      lymphoma and benign epidermal and trichylemmal cysts on the periorbital region
      and scalp. To the authors' knowledge, the coincidence of these processes has
      never been described before. The case was evaluated with conventional X-ray,
      computed tomography, magnetic resonance imaging, fibre-optic bronchoscopy with 2
      months interval, histopathological evaluation, Tc-99 m MDP bone scintigraphy and
      microbiological studies including PCR testing of bronchial biopsy and lavage
      specimens for Mycobacterium tuberculosis. Additionally, case reports of TO in the
      Turkish literature are summarized.

PMID- 11192551
TI  - Respiratory bronchiolitis associated interstitial lung disease (RB-ILD)
      presenting with haemoptysis.
AB  - Respiratory bronchiolitis associated interstitial lung disease is an uncommon
      condition in current or ex-smokers. The presentation is non-specific, but
      haemoptysis is uncommonly reported in this condition. We report the case of a 25
      year-old woman who presented with significant haemoptysis, dyspnoea, reduced
      transfer factor and normal clinical examination. In addition, a Medline
      literature search was performed to review the clinical features and prognosis of
      this disease. Other causes of haemoptysis were excluded with extensive
      investigation. The diagnosis was made on thoracoscopic lung biopsy. The patient
      had significant postoperative complications of prolonged air leak and
      hydropneumothorax requiring further surgery and prolonged hospital stay. Advice
      regarding smoking cessation was given. Her pulmonary physiology remains abnormal
      on follow up but symptoms have improved. Respiratory bronchiolitis-ILD may
      present with normal examination and radiology. Haemoptysis in this case may have
      been associated with the underlying disease but could have been incidental.
      Diagnosis, in general, requires lung biopsy. As in this patient, lung function
      does not appear to improve significantly on follow up.

PMID- 11192550
TI  - A case of pulmonary arteritis with stenosis of the main pulmonary arteries with
      positive myeloperoxidase-antineutrophil cytoplasmic autoantibodies.
AB  - A 53-year-old woman was referred to our hospital with the main symptoms of
      productive cough, fever and exertional dyspnoea. Chest X-ray revealed enlargement
      of the left hilar shadow and cavitary infiltration in the right upper lobe.
      99mTechnetium-macroaggregated albumin (99mTc-MAA) perfusion scintigram showed
      complete hypoperfusion through the entire right lung. A pulmonary angiogram
      revealed stenotic lesions in the right and left main pulmonary arteries. Right
      cardiac catheterization showed an elevated right ventricular systolic pressure.
      There was no evidence of systemic arterial lesions nor vasculitis. The patient
      was positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic autoantibodies
      (ANCA) (168 EU). The Mycobacterium avium complex sputum culture was positive. The
      pulmonary stenotic lesions were surgically resected. The resected pulmonary
      arterial lesions were pathologically diagnosed as non-specific vasculitis. The
      cavitary lesion disappeared 6 months after the surgery. Two years after the
      surgery, although the MPO-ANCA level had decreased to 12 EU, stenosis of the
      pulmonary arteries reappeared. It is suggested that the patient became positive
      for MPO-ANCA in association with the Mycobacterium avium complex infection, and
      that the presence of MPO-ANCA may not be related to the development of pulmonary
      stenosis of the main pulmonary arteries.

PMID- 11192552
TI  - Use of montelukast in the treatment of early childhood wheezing from clinical
      experience with three cases.
AB  - Leukotrienes were found to be raised in respiratory syncytial virus
      bronchiolitis. Montelukast is a cysteinyl leukotrienes antagonist. We report our
      experience with the use of montelukast in three young children from 5-months to
      20-months old. The first case was a 5-month-old boy with previous good health. He
      had prolonged respiratory distress secondary to adenovirus type 3 infection. The
      second case was a 20-month-old boy with bronchopulmonary dysplasia. He had
      respiratory syncytial virus and an adenovirus type 3 infection leading to
      prolonged wheeze. The third case was a 20-month-old girl with chronic lung
      disorder after an episode of severe E. coli pneumonia at 1 month old. She
      developed acute virus-negative severe wheeze after a few days of running nose and
      low-grade fever. All three cases responded poorly to inhaled steroids and
      bronchodilators. Addition of montelukast was associated with marked clinical
      improvement within 1 week. The three cases were very heterogeneous and differed
      from usual simple virus-induced acute bronchiolitis. The use of multiple drugs
      including montelukast did not enable any definite conclusions; however, the
      addition of montelukast was closely related to clinical improvement. Further
      studies in the use of montelukast in severe virus-induced bronchiolitis are
      warranted.

PMID- 11192553
TI  - Pulmonary nocardiosis during immunosuppressive therapy for idiopathic pulmonary
      fibrosis.
AB  - Nocardiosis is a subacute or chronic suppurative infection caused by Nocardia
      species. Although it is more common in immunocompromised hosts, idiopathic
      pulmonary fibrosis (IPF) has not been recognized as a predisposing factor for
      nocardial infection. We report a case of IPF, in which pulmonary nocardiosis
      developed during treatment with prednisolone and cyclophosphamide. The risk of
      pulmonary nocardiosis may be increased in cases of IPF on immunosuppressive
      therapy. Since IPF often accompanies lung carcinoma, it is important to correctly
      differentiate nocardiosis from carcinoma.

PMID- 11192554
TI  - An unusual case of double tuberculous broncho-oesophageal fistulas in an adult.
AB  - Broncho-oesophageal fistula associated with tuberculosis is rarely reported in
      the literature and has not been reported in Hong Kong. We describe a 30-year-old
      Chinese human immunodeficiency virus (HIV)-negative man with double tuberculous
      broncho-oesophageal fistulas proven by histology. Constitutional symptoms of
      active tuberculosis were absent and chest radiograph did not show an obvious lung
      lesion. Our case shows that broncho-oesophageal fistula can be the sole
      manifestation of active tuberculosis and that the diagnosis should be suspected
      in patients who are seen with chronic respiratory symptoms in areas where the
      prevalence of tuberculosis is high.

PMID- 11192555
TI  - The rapid diagnosis of smear-negative pulmonary tuberculosis: a cost
      effectiveness analysis.
AB  - OBJECTIVE: The prompt diagnosis of smear-negative pulmonary tuberculosis (PTB) is
      a clinical challenge. It may be achieved by a number of tests which have varying
      accuracies, costs and degrees of invasiveness. The objective of this study was to
      compare the cost-effectiveness of clinical judgement (empirical), the Roche Cobas
      amplicor assay for Mycobacterium tuberculosis (amplicor), acid-fast staining of
      bronchoalveolar lavage specimens (BAL), nucleic acid amplification tests of
      bronchoalveloar lavage specimens for M. tuberculosis (BAL + NAA), computed
      tomography (CT) and amplicor assay followed by BAL. METHODOLOGY: The range of
      predictive values of the various strategies were derived from published data and
      a new study of 441 consecutive adult patients with suspected smear-negative PTB
      prospectively stratified into three pretest risk groups: low, intermediate and
      high. The cost-effectiveness was evaluated with a decision tree model (DATA
      software). RESULTS: The incidence of PTB was 5.7% (4% culture positive) for the
      whole group, 95% in the high-risk group, 0.9% in the low-risk group and 3.4% in
      the intermediate-risk group. The sensitivity of the empirical approach was 49%
      and of the amplicor assay was 44%. Patient outcomes were expressed as life
      expectancy for the base case of a 58-year-old man with a pretest probability of
      5.7%. At this low pretest risk the differences in life expectancies between tests
      was < 0.1 years and the empirical approach incurred the lowest cost. Sensitivity
      analysis at increasing pretest risks showed better life expectancies
      (approximately 1 years) for CT scan and test combinations than empirical and
      amplicor for additional costs of US$243-US$309. Bronchoalveolar lavage had the
      worst overall cost-effectiveness. CONCLUSIONS: We conclude that the pretest risk
      of active PTB was a key determinant of test utility; that the AMPLICOR assay was
      comparable to clinical judgement; that BAL was the least useful test; and that
      with increasing risks, CT scan and test combinations performed better. Further
      studies are needed to better define patients with intermediate risk for PTB and
      to directly compare the cost-effectiveness of more sensitive nucleic acid
      amplification tests such as the enhanced Gen Probe, CT scan and test
      combinations/sequences in these patients.

PMID- 11192556
TI  - Bronchoscopic, radiologic and pulmonary function evaluation of endobronchial
      tuberculosis.
AB  - OBJECTIVE: Endobronchial tuberculosis (EBTB) causes problems in both making a
      diagnosis and following up the endobronchial lesion, because the lesion is not
      evident in simple chest radiograph. Frequently, the diagnosis and follow up of
      EBTB lesion during treatment mainly depend on bronchoscopy. Chest computed
      tomography (CT) and pulmonary function test (PFT) have also been used in
      evaluating EBTB and differentiating it from the other diseases. Primary purpose
      of the present study was to observe the change of EBTB lesion during treatment
      and determine the optimal time and the indication of follow-up bronchoscopy. We
      also evaluate the usefulness of chest CT and PFT in EBTB. METHODOLOGY: Eighty-one
      biopsy-proven EBTB patients were enrolled from 1992 to 1997. Endobronchial
      tuberculosis was classified into seven subtypes: actively caseating,
      fibrostenotic, oedematous-hyperaemic, tumorous, ulcerative, granular, and non
      specific bronchitic type according to bronchoscopic features by Chung's
      Classification. The change of bronchoscopic findings during treatment in each
      subtype of EBTB was evaluated prospectively. Follow-up bronchoscopy was done each
      month until there was no subsequent change in endobronchiat lesion, and every 3
      months thereafter, and at the end of treatment. Chest CT and PFT were performed
      in 26 and 68 patients respectively, at initial bronchoscopy. RESULTS: Twenty-two
      of the 34 cases of actively caseating EBTB changed into the fibrostenotic type,
      and the other 12 healed without sequelae. Seven of the 11 cases of oedematous
      hyperaemic EBTB changed into the fibrostenotic type, and the other four healed.
      Nine of the 11 cases of granular EBTB, six cases of non-specific bronchitic EBTB,
      and two cases of ulcerative EBTB resolved completely. However, the other two
      cases of granular EBTB changed into the fibrostenotic type. Seven cases of
      fibrostenotic EBTB did not improve despite antituberculosis chemotherapy. These
      various changes in bronchoscopic findings occurred within 3 months of treatment.
      In 10 cases of tumorous EBTB, seven progressed to the fibrostenotic type. In
      addition, new lesions appeared in two cases, and the size of the initial lesions
      increased in another two cases, even at 6 months after treatment. On chest CT
      findings of 26 EBTB patients, the length of bronchial involvement was measured
      from 10 to 55 mm. Bronchial stricture was noticed in 25 cases and the range of
      narrowing was from total occlusion to near normal, and there was wide variation
      in bronchial stricture even within same subtype of EBTB. The dominant feature of
      PFT in EBTB at the diagnosis was restrictive pattern. CONCLUSION: The therapeutic
      outcome of each subtype of EBTB can be predicted by follow-up bronchoscopy during
      the initial 3 months, with the exception of the tumorous type. In tumorous EBTB,
      the evolution of the lesions during treatment is very complicated, and bronchial
      stenosis may develop at a later time. Chest CT was useful in measuring the length
      of involved bronchus and degree of stricture in EBTB. PFT may be useful in
      differential diagnosis and follow up of EBTB.

PMID- 11192557
TI  - Pulmonary complications in patients with AIDS: a report from a Beijing hospital.
AB  - OBJECTIVE: The aim of this study was to improve the awareness of pulmonary
      complications in patients with AIDS. METHODOLOGY: Nine patients with AIDS with
      pulmonary involvement from March 1992 to March 2000 were analysed. RESULTS: Of
      the nine cases, there were eight cases complicated with Pneumocystis carinii
      pneumonia (PCP). The clinical presentation of PCP was fever (8/8), dyspnoea on
      exertion or at rest (7/8), and hypoxaemia with a mean PaO2 of 58 mmHg. Chest X
      ray films showed bilateral diffuse interstitial or alveolar infiltrates.
      Pulmonary tuberculosis, tuberculous lymphadenitis and bronchial fungal infection
      were found in three cases. CONCLUSIONS: AIDS patients are at high risk of
      suffering from pulmonary complications, of which PCP is most common. If young
      patients who were healthy in the past suddenly suffered from pneumonia and
      respiratory failure, PCP should be considered. When opportunistic pulmonary
      infection is diagnosed under special circumstances, one should be alert to the
      possibility of AIDS and examine serum antihuman immunodeficiency virus (HIV)
      antibody.

PMID- 11192558
TI  - Clinical manifestations of tuberculosis in HIV-infected patients.
AB  - OBJECTIVE: The purpose of the present study was to evaluate the impact of HIV
      infection on the clinical presentation of tuberculosis. METHODOLOGY: We
      retrospectively studied the impact of HIV infection on the clinical presentation
      of tuberculosis. A total of 60 consecutive patients co-infected with HIV and
      tuberculosis were identified. RESULTS: Majority were male (88.3%) and the most
      common transmission category was heterosexual contact (80%). Most were in the
      advanced stage of HIV infection; 93% had CD4 cell count less than 200/mm3.
      Concerning the site of tuberculosis involvement, 37% had pulmonary involvement
      alone, 13% had extrapulmonary disease involving one single site, 50% had both
      pulmonary and extrapulmonary involvement. Fifteen (25%) patients also met the
      criteria of disseminated tuberculosis, who had a significantly lower mean CD4
      cell count than those with pulmonary involvement alone (mean 40 vs 102; P =
      0.048). Chest radiographs comprised a wide spectrum of manifestations. A
      considerable proportion had primary pulmonary tuberculosis pattern (38%) and
      normal radiographs (8.5%). CONCLUSIONS: Our patients generally had advanced HIV
      infection; 93% of those had CD4 lymphocyte count < 200/mm3. Extrapulmonary
      involvement and disseminated disease were common. Radiographic manifestations of
      pulmonary tuberculosis were often 'atypical' due to the greater proportion of
      primary tuberculosis among our patients.

PMID- 11192559
TI  - Comparison of frequency doubling perimetry with humphrey visual field analysis in
      a glaucoma practice.

PMID- 11192560
TI  - Frequency doubling technology perimetry for detection of glaucomatous visual
      field loss.

PMID- 11192561
TI  - Rehabilitation and total hip replacement: patients' perspectives on provision.
AB  - This paper examines the effectiveness of the rehabilitation component of total
      hip replacement (THR). It focuses on contrasting rehabilitation regimes in two
      hospitals in the north of England. Using qualitative methods, patients' perceived
      needs and goals are described, and the responsiveness of the interventions to
      their requirements is examined. The provision of information, equipment, and
      therapy was found to be useful in terms of preparing patients for their operation
      and facilitating their recovery, but less so in terms of helping them cope with
      any problems experienced after the operation. Drawing on patients' perspectives,
      a set of guidelines for good practice in rehabilitation for THR is presented.

PMID- 11192562
TI  - Assessment, education and placement: an integrated approach to vocational
      rehabilitation.
AB  - Taking into account that a great number of people in the Netherlands are
      considered incapacitated for work, reintegration activities are becoming
      increasingly important. Thus far, no studies have been conducted in the
      Netherlands to investigate the long-term effectiveness of vocational
      rehabilitation programmes. This study assessed the long-term effectiveness of the
      programmes of three vocational rehabilitation centres. The centres relate their
      success to the proportion of trainees participating in the competitive labour
      market. The centres provide integrated programmes in certified occupational
      training and personal skills training. After five years, 80% of the trainees are
      working in the competitive labour market. In addition, their personal skills have
      improved. Within 4 to 7 years the decrease in social security costs of
      reintegrated employees will outweigh the total costs of the vocational training
      programme.

PMID- 11192563
TI  - Multidisciplinary vocational rehabilitation focusing on work training and case
      management for unemployed sick-listed people.
AB  - Twenty-four unemployed sick-listed people were referred during 1996 and 1997 to a
      multidisciplinary vocational rehabilitation programme with additional work
      training and case management. Twelve months after the programme, 54.2% in the
      study group had lowered their benefit levels compared with those at the start
      while 26.1% in the control group - who underwent a conventional rehabilitation
      programme - had lowered their benefit levels (p = 0.050, Chi-squared test). There
      were no significant differences regarding fewer sick days three and 12 months
      after the programme between the study group and the control group. Regarding self
      assessed quality of life, there were no significant differences within or between
      the groups. We conclude that this multidisciplinary vocational rehabilitation
      programme with work training and case-management affected the outcome positively
      regarding lowered level of benefits 12 months after termination of programme
      compared with level at start. Studies of the long-term effect of the programme
      should, however, be performed with more subjects in both study group and control
      group.

PMID- 11192564
TI  - Factors indicating need of rehabilitation--occupational therapy among persons
      with long-term and/or recurrent pain.
AB  - The aim of the study was to elucidate selection criteria for need of
      rehabilitation/occupational therapy, and to state criteria for participation in
      occupational therapy, among persons with long-term and/or recurrent pain causing
      activity limitations or restricting participation in daily life. The study
      involved 914 persons aged 18-58 years who answered a postal questionnaire
      concerning demography, pain, occupations in daily life, work, treatments and
      health care staff visited. The direct method in logistic regression analysis was
      used to test two models: (1) need of rehabilitation/occupational therapy and (2)
      participation in occupational therapy. The results for the first model revealed
      the selection criteria (1) 'feelings of irresolution', (2) 'gnawing/searing pain'
      and (3) 'use of technical aids'. The odds for need of rehabilitation/occupational
      therapy were higher for women than for men. The criteria derived from the second
      model, participation in occupational therapy, were whether (1) the participants
      had 'used tricks and/or compensated ways to perform tasks', (2) the participants
      had 'pain in shoulders' and (3) 'changes had been made at work due to health
      conditions'.

PMID- 11192565
TI  - Information needs of families when one member has a severe brain injury.
AB  - Despite calls for health and social services to respond to the needs of informal
      carers, there is little evidence to guide practioners in the best way to provide
      support and/or information in situations of complex need such as brain injury.
      This study addressed such an intervention in a prospective descriptive study,
      using both qualitative and quantitative methodology. Eighty-nine patients who had
      been admitted to a regional neurorehabilitation unit for management of traumatic
      or haemorrhagic brain injuries were consecutively discharged to the community
      over a period of 12 months. Eighty-two of these people identified a carer who
      agreed to be interviewed at approximately six weeks after discharge regarding
      their concerns. The study identified that even soon after discharge from
      inpatient rehabilitation, carers wanted more information. In many cases the need
      for information was unrelated to either the severity of injury or level of
      functional deficit. In addition, requests for information were in many cases not
      sought spontaneously, but required prompting. Such findings have implications if
      interventions in this field are to have the optimum chance of succeeding in
      providing support and assistance.

PMID- 11192566
TI  - Attitudes of community-living staff toward the integration of persons with mental
      retardation in the community.
AB  - The present study was conducted to determine the extent to which the current
      philosophical approach of inclusion and integration in the community of persons
      with mental retardation is embodied in the attitudes of staff members who are
      charged with implementing it. The research sample was comprised of 106 staff
      members who work in three major geographical districts of community-living
      settings in Israel. Overall, the results suggest that a true understanding of and
      agreement with this philosophy is far from being achieved. The findings of this
      study provide evidence that staff members charged with providing services and
      support to persons with mental retardation have not fully adopted the attitudes
      of the community-living approach. Findings are interpreted in relation to
      practice.

PMID- 11192567
TI  - Hearing-impaired students' reading characteristics compared to dyslexic students
      (tested in Hebrew).

PMID- 11192568
TI  - Guided exploration enhances tactual picture recognition in blindfolded sighted
      children: implications for blind children.

PMID- 11192569
TI  - The use of virtual reality to train powered wheelchair users and test new
      wheelchair systems.

PMID- 11192570
TI  - Family rehabilitation of psychiatric patients: a study of course of involuntary
      admissions to a psychiatric hospital.

PMID- 11192571
TI  - Rehabilitation psychiatry--description of a pioneering facility in Pakistan.

PMID- 11192572
TI  - Excerpts of an Executive Summary of Research and Evaluation of the International
      Leadership Forum for Women with Disabilities (ILFWD), Bethesda, MA, USA, 1997.

PMID- 11192573
TI  - Neuroendocrine cell-specific expression and regulation of the human secretogranin
      II gene.

PMID- 11192574
TI  - Characterization of chromogranins in the frog Rana ridibunda. Structure,
      expression, and functional implications.

PMID- 11192575
TI  - Expression of equine chromogranin A. CDNA sequence and distribution of mRNA in
      endocrine and exocrine tissues.

PMID- 11192576
TI  - Salivary secretion of chromogranin A. Control by autonomic nervous system.

PMID- 11192578
TI  - Endothelial handling of chromogranin A.

PMID- 11192577
TI  - Proteolytic processing of chromogranins.

PMID- 11192579
TI  - Tissue plasminogen activator and chromaffin cell function.

PMID- 11192580
TI  - Chromogranin A immunoreactivity in neuroendocrine cells in the human
      gastrointestinal tract and pancreas.

PMID- 11192581
TI  - Chromogranin A and its derived peptides in the rat and porcine gastro-entero
      pancreatic system. Expression, localization, and characterization.

PMID- 11192582
TI  - Chromogranins: current concepts. Structural and functional aspects.

PMID- 11192583
TI  - Regulation of parathyroid secretion. Chromogranins, chemokines, and calcium.

PMID- 11192584
TI  - Vasostatins. Vascular targets.

PMID- 11192585
TI  - Vasostatins. Dilators of bovine resistance arteries.

PMID- 11192586
TI  - Pancreastatin. Biological effects and mechanisms of action.

PMID- 11192587
TI  - The novel catecholamine release-inhibitory peptide catestatin (chromogranin A344
      364). Properties and function.

PMID- 11192588
TI  - Secretoneurin--a novel link between the nervous and the immune system.
      Conservation of the sequence and functional aspects.

PMID- 11192589
TI  - Chromogranin A induces a neurotoxic phenotype in brain microglial cells.

PMID- 11192590
TI  - Antibacterial and antifungal peptides derived from chromogranins and
      proenkephalin-A. From structural to biological aspects.

PMID- 11192591
TI  - The chromogranins. Historical perspectives.

PMID- 11192592
TI  - Measurements of chromogranins and chromogranin-related peptides by immunological
      methods.

PMID- 11192593
TI  - Chromogranins as diagnostic and prognostic markers in neuroendocrine tumours.

PMID- 11192594
TI  - Assessment of chromogranin A using two-site immunoassay. Selection of a
      monoclonal antibody pair unaffected by human chromogranin A processing.

PMID- 11192595
TI  - Chromogranin A and tumor necrosis factor-alpha (TNF) in chronic heart failure.

PMID- 11192596
TI  - Chromogranin A (CGA) and the enterochromaffin-like (ECL) cell.

PMID- 11192597
TI  - Chromogranins in non-endocrine tumours.

PMID- 11192598
TI  - Chromogranin A in human disease.

PMID- 11192599
TI  - A physiological role for the granins as prohormones for homeostatically important
      regulatory peptides? A working hypothesis for future research.

PMID- 11192600
TI  - Signal-mediated sorting of chromogranins to secretory granules.

PMID- 11192601
TI  - The condensed matrix of mature chromaffin granules. The soluble form of dopamine
      beta-hydroxylase is catalytically inactive.

PMID- 11192602
TI  - Functional role of chromogranins. The intragranular matrix in the last phase of
      exocytosis.

PMID- 11192603
TI  - Inositol 1,4,5-trisphosphate receptor and chromogranins A and B in secretory
      granules. Co-localization and functional coupling.

PMID- 11192604
TI  - Regulation of chromogranin A transcription and catecholamine secretion by the
      neuropeptide PACAP. Stimulation and desensitization.

PMID- 11192605
TI  - The neuronal survival effects of rasagiline and deprenyl on fetal human and rat
      ventral mesencephalic neurones in culture.
AB  - The neuronal survival properties of rasagiline (R(+)-N-propargyl-1-aminoindane
      mesylate or TVP-1012), a novel monoamine oxidase B inhibitor, have been
      investigated using neuronal cell cultures from fetal rat and human ventral
      mesencephalon. The ability of rasagiline to reduce the rate of neuronal cell loss
      in vitro was tested using primary neuronal cell lines and immunohistochemistry to
      quantify the reduction in cell death. Direct comparison was made with deprenyl, a
      widely used and long established monoamine oxidase B inhibitor. Rasagiline was
      shown to act 15-20% more effectively as a neuronal survival agent than deprenyl,
      increasing both the survival of the total number of neurones and selectively
      increasing the survival of dopaminergic neurones with no statistically
      significant increase in survival of GABAergic neurones.

PMID- 11192606
TI  - Intraventricular galanin produces a time-dependent modulation of 5-HT1A receptors
      in the dorsal raphe of the rat.
AB  - Galanin given i.c.v. increased the K(D) values of 5-HT1A receptors in the DR by
      100% 10 min after administration. This effect had disappeared 2 h and 5 h after
      galanin administration. In contrast, i.c.v. galanin caused a 40% increase in the
      Bmax values at 2 h without affecting the Bmax values 10 min and 5 h after i.c.v.
      galanin. The mRNA levels of 5-HT1A receptors and of galanin in the DR were
      significantly decreased by 33% and 56% respectively 2h but not 5h after i.c.v.
      galanin. These results suggest that in vivo galanin can modulate somatodendritic
      5-HT1A receptors in the DR in a time-dependent manner via galanin-5-HT1A receptor
      interactions. The findings implicate a potential role of galanin in affective
      disorders.

PMID- 11192607
TI  - Temperature set-point changes induced by DA D2/3 and 5-HT1A receptor agonists in
      the rat.
AB  - The DA D2/3 receptor agonist 7-OH-DPAT (2 micromol kg(-1)) and the 5HT1A receptor
      agonist 8-OH-DPAT (0.6 micromol kg(-1)) both produced a marked and similar
      decrease in core temperature of 3-4 degrees C at 10 and 20 degrees C ambient
      temperature. At 30 degrees C there were no, or weak, effects. The decrease in
      core temperature was accompanied by a sudden increase in tail temperature,
      followed by a decrease as core temperature returned to basal values. The results
      suggest that the hypothermia produced by the respective DA D2/3 and the 5-HT1A
      receptor agonists 7-OH-DPAT and 8-OH-DPAT is an active process, in all
      probability due to changes in a hypothalamic set-point for temperature
      regulation.

PMID- 11192608
TI  - Locomotor activity and a conditioned fear response: correlation with cortical and
      subcortical binding of the dopamine D1 receptor antagonist.
AB  - Rat behavior in the open field and conditioned fear response test was correlated
      with specific binding of dopamine D1 receptor antagonist [3H]SCH 23390 within
      different brain structures assayed with autoradiography. A significant positive
      correlation was found between the ligand binding in the substantia nigra pars
      reticulata and both animal motor activity (r = 0.67, p < 0.05) and the number of
      entries into the central sector of the open field (r = 0.59, p < 0.05). On the
      other hand, rat motility and the central entries were negatively correlated with
      [3H]SCH 23390 binding within the caudate putamen (r = -0.64, p < 0.05 and r = 
      0.61 p <0.05, respectively). No correlation was revealed between the ligand
      binding in the examined brain areas and freezing reaction in the contextual fear
      conditioning test. The present data indicate for the first time a significant,
      structure-dependent correlation between rat motor behavior and the dopamine D1
      receptor ligand binding within the nigrostriatal system.

PMID- 11192609
TI  - Cortical activation evoked by visual mental imagery as measured by fMRI.
AB  - One of the major controversies in cognitive neuroscience is whether the primary
      visual cortex and nearby areas are involved in visual mental imagery. In an fMRI
      study we examined the brain activity of 10 healthy subjects under different task
      conditions: in the perception condition subjects saw complex geometrical shapes
      and had to decide whether other highlighted stimuli fell inside or outside the
      figure. In the imagery condition subjects saw only the highlighted stimuli and
      were instructed to imagine the previously studied geometrical shapes to solve the
      same task. Although the behavioral data show a distance effect that would be
      expected based on topographically organized mental images, the functional imaging
      data do not show increased activity in the primary visual cortex in the imagery
      condition. In the occipital cortex a slightly increased activity was found only
      in the visual association cortex (BA 19), whereas the highest activation was
      observed in the parietal cortex (BA 7 and 40). The results of the study do not
      support the assumption that the primary visual cortex is involved in visual
      mental imagery, but rather that a network of spatial subsystems and higher visual
      areas appears to be involved.

PMID- 11192610
TI  - Modulated expression of secreted frizzled-related proteins in human retinal
      degeneration.
AB  - Inherited retinal degenerations such as retinitis pigmentosa (RP) are
      characterized by progressive loss of photoreceptors, apparently by apoptosis, and
      our recent report of increased secreted Frizzled-related protein-2 (SFRP2) in RP
      retinas suggests altered Wnt signalling may be a component of the degenerative
      process. The present study shows that levels of SFRPI, SFRP3 and SFRP5 mRNAs are
      also abnormal in RP, giving rise to idiosyncratic expression patterns. In highly
      degenerative retinas, the SFRP proteins localize mainly to the inner limiting
      membrane, but in a well-preserved retina SFRPI and SFRP5 are notably localized to
      the surviving photoreceptors. Together with increased c-jun mRNA expression in
      all cases examined, these results support the notion that disruptions of Wnt
      network signalling are involved retinal neurodegeneration.

PMID- 11192611
TI  - Corticosteroids protect oligodendrocytes from cytokine-induced cell death.
AB  - The present data show that the simultaneous exposure to tumor necrosis factor
      alpha (TNFalpha) and interferon-gamma (IFNgamma) induces cell death with
      characteristics of apoptosis in cultured rat oligodendrocytes; TNFalpha alone was
      ineffective. We have also demonstrated that different corticosteroids
      (aldosterone, deoxycorticosterone, dexamethasone and corticosterone) protect rat
      oligodendrocytes in culture from apoptosis induced by TNFalpha plus IFNgamma.
      This effect seems to be exerted via the interaction with both type I and type II
      corticosteroid receptors since all steroids considered are effective. Since
      oligodendrocyte apoptosis represents an important event in multiple sclerosis and
      in several demyelinating diseases, the present observations might be considered
      an interesting background for further researches directed to the possibility of
      controlling in vivo the death of these cells.

PMID- 11192612
TI  - The use of a recombinant lentiviral vector for ex vivo gene transfer into the rat
      CNS.
AB  - A major obstacle in ex vivo gene transfer has been the loss of transgene
      expression soon after implantation of the grafted transduced cells. Recently, a
      lentiviral vector system has been developed which has proven to express high
      levels of transgenes in vivo after direct injection into the tissue. In this
      study, we have investigated the use of such a vector for ex vivo gene transfer to
      the brain. A number of neural cell types were found to be permissive to
      transduction by the lentiviral vector in vitro and a majority of them expressed
      the transgene after transplantation to the rat brain. Transgene expression was
      detected up to 8 weeks post-grafting. These findings suggest that recombinant
      lentiviral vectors may be used for further development of ex vivo gene therapy
      protocols to the CNS.

PMID- 11192613
TI  - Magnetic resonance imaging of the membranous labyrinth during in vivo gadolinium
      (Gd-DTPA-BMA) uptake in the normal and lesioned cochlea.
AB  - MRI with a T1 contrast agent was used to investigate the normal and noise-damaged
      cochlea. The time course and distribution of the in vivo uptake of the
      gadodiamide chelate bound paramagnetic Gd ion (GdDTPA-BMA) throughout the
      membranous labyrinth of normal and impulse noise-damaged guinea pig cochleae were
      measured by MRI at 4.7T. Simultaneous signal enhancement of the basal, medial and
      apical scala tympani (ST) and scala vestibuli (SV) was observed within 10 min
      following i.v. injection, reaching maximum levels at around 100 min. ANOVA and
      post hoc paired t-tests showed statistically significant differences in the
      levels and rates of Gd uptake-enhancement between the scalae. The ST revealed the
      most rapid and extensive enhancement throughout the period of active Gd uptake,
      while the SV showed comparatively slower and less enhancement, and the intact
      scala media (SM) indicated insignificant enhancement. The in vivo Gd penetration
      and enhancement of the membranous SM increased significantly in the noise-damaged
      cochlea, suggesting lesioning of the cochlear membranes.

PMID- 11192614
TI  - Skewing of the brain midline in schizophrenia.
AB  - Our laboratory has observed marked craniofacial dysmorphology along the
      frontonasal-maxillary juncture in schizophrenic probands and their relatives.
      Embryologic fate-mapping studies relate this craniofacial juncture to the
      diencephalic-mesencephalic border, and on the basis of this correspondence we
      have predicted brain midline maldevelopment arising at this border in
      schizophrenia. Analysis of magnetic resonance images has borne out this
      prediction, with midline deviation scores in schizophrenia exceeding control
      values. High deviation scores were also observed among the siblings of these
      schizophrenic patients. Further, brain and face dysmorphology scores cohered
      within subjects, supporting this embryologically derived model.

PMID- 11192615
TI  - Phase-locked responses to pure tones in guinea pig auditory cortex.
AB  - Phase-locked responses to pure tones are a characteristic of most auditory cells
      at the level of the brain stem and allow sophisticated analyses based on
      coincidence detection. Phase-locking to tones has not previously been shown at
      the level of the auditory cortex in single unit studies. We have now identified
      phase-locked responses in 10% of low-frequency (< 1 kHz) units in the
      ventrorostral belt, a strip of cortex immediately ventral to the primary auditory
      area. All of these units showed phase-locking in their response to binaural tone
      pips of 60-200 Hz and showed narrow band pass characteristics within this range.

PMID- 11192616
TI  - Two circadian oscillatory mechanisms in the mammalian retina.
AB  - To investigate the mechanism that controls circadian rhythms in the mammalian
      retina, we examined the mRNA expression rhythms of serotonin N-acetyltransferase
      (NAT), the mammalian clock gene rPer2 and a clock-controlled gene Dbp in the
      retina of rats with lesions of the suprachiasmatic nucleus (SCN), the master
      clock in mammals. Northern blot analyses showed that retinal NAT mRNA still
      exhibited the circadian expression in the SCN-lesioned rats, whereas the lesion
      abolished the rhythms of rPer2 and Dbp mRNAs. These findings suggest that the
      mammalian retina has two circadian oscillatory mechanisms: one can generate
      rhythmicity independent of the SCN and the other requires the SCN to maintain
      circadian oscillation.

PMID- 11192617
TI  - CNTF promotes the regrowth of retinal ganglion cell axons into murine peripheral
      nerve grafts.
AB  - Autologous peripheral nerves were transplanted onto transected optic nerves of
      adult mice. We examined whether intraocular CNTF injections increased retinal
      ganglion cell (RGC) axon regeneration, and what types of RGCs regrew axons into
      grafts. After temporal CNTF eye injections there were more fluorogold-labelled
      regenerating RGCs (mean +/- s.e.m. 342+/-113.1; n=6) than in sham eye-injected
      mice (133+/-27.6; n=8). Greater numbers of regenerating RGCs (1198+/-367.6; n=6)
      were seen in mice receiving both nasal and temporal CNTF injections. The range of
      soma areas in regenerate and normal retinas was similar but the average size of
      regenerating RGCs was greater (212 microm2 vs 111 microm2). Most regenerating
      RGCs had large dendritic fields. The data suggest a heterogeneous response to
      axotomy in adult mice, large RGCs preferentially regrowing axons into PN grafts.

PMID- 11192618
TI  - Basal expression of bradykinin B1 receptor in peripheral sensory ganglia in the
      rat.
AB  - The bradykinin B1 receptor is thought to be induced by tissue injury and
      inflammation. In the present study, we have investigated whether there is a basal
      expression of B1 receptor in dorsal root ganglion (DRG) and trigeminal ganglion
      neurons in rats. A substantial number of neurons in both DRGs and trigeminal
      ganglia were found to be B1-immunoreactive in rats. Both small and medium-sized
      DRG neurons were B1-immunoreactive, suggesting that they are likely to be Adelta-
      or C-fibre neurons which are involved in nociceptive transmission. These results
      support a possible role for B1 receptors in the modulation of nociceptive sensory
      transmission.

PMID- 11192619
TI  - Calpain inhibitor inhibits secretory granule maturation and secretion of GH.
AB  - Clathrin- and AP-1-coated buds are present on immature secretory granules of
      endocrine cells that mature into clathrin-uncoated granules. The mechanism of
      clathrin and adaptor protein uncoating has remained obscure. Benzyloxycarbonyl-L
      leucyl-L-leucinal (ZLLal), a calpain inhibitor, reduced growth hormone (GH)
      secretion with intracellular accumulation, in a GH-secreting rat pituitary tumor
      cell. Pulse and chase demonstrated that ZLLal retarded the turnover of clathrin
      (Clt.H) and adaptins. ZLLal-treatment co-immunoprecipitated the increased amounts
      of GH with Clt.H and adaptins compared to control cells, suggesting the
      intracellular accumulation of immature secretory granules. Clt.H and adaptins
      were limited-proteolyzed by m-calpain in vitro, indicating that calpain may be
      involved partly in the maturation of secretory granules in endocrine cells via
      the process of clathrin uncoating.

PMID- 11192620
TI  - High frequency repetitive transcranial magnetic stimulation (rTMS) of the
      dorsolateral prefrontal cortex in schizophrenic patients.
AB  - Repetitive transcranial magnetic stimulation (rTMS) has been tried
      therapeutically in major depression. In order to investigate the therapeutic
      efficacy of rTMS in psychotic patients, 12 participants (four women, eight men)
      with schizophrenia according to DSM-IV criteria, aged 25 to 63 years (mean (+/
      s.d) 40.4+/-11.0), were enrolled in the study. Following a double-blind crossover
      design, patients were treated at random with 2 weeks of daily left prefrontal
      rTMS (20 2s 20 Hz stimulations at 80% motor threshold over 20 min, dorsolateral
      preforntal cortex) and 2 weeks of sham stimulation. The Brief Psychiatric Rating
      Scale decreased under active rTMS (p <0.05), whereas depressive symptoms (BDI)
      and anxiety (STAI) did not change significantly. Prefrontal rTMS might be
      effective in the non-pharmacological treatment of psychotic patients.

PMID- 11192621
TI  - Differential impact of periodic and aperiodic speech-like acoustic signals on
      magnetic M50/M100 fields.
AB  - Voiced and unvoiced sounds, characterized by a periodic or aperiodic acoustic
      structure, respectively, represent two basic information-bearing elements of the
      speech signal. Using whole-head magnetencephalography (MEG), magnetic fields
      (M50/M100) in response to synthetic vowel-like as well as noise-like signals
      matched in spectral envelope were recorded in 20 subjects. Aperiodic events gave
      rise to increased M50 concomitant with reduced M100 activity as compared to their
      periodic cognates. Attention toward the auditory channel enhanced the effects of
      signal periodicity. These data provide first evidence that speech-relevant
      acoustic features differentially affect evoked magnetic fields as early as the
      M50 component. Conceivably, the M50 field reflects an ongoing monitoring process
      whereas the M100 component is bound to more specific operations such as detection
      of signal periodicity.

PMID- 11192622
TI  - Lesion-induced changes in NMDA receptor subunit mRNA expression in rat visual
      cortex.
AB  - Focal lesions in the visual cortex are well known to induce pronounced
      perilesional reorganization of the neuronal circuitry. Since NMDA receptors
      crucially control synaptic plasticity and reorganization, we studied lesion
      induced changes in their subunit expression and biophysical properties. Between 8
      and 10 days after focal thermolesioning, pyramidal neurones in the near surround
      of the lesion were studied in acute brain slices. We found a significant decrease
      in the ratio of NR2A and NR2B subunit mRNA as compared to neurones from sham
      operated animals. Interestingly, no significant differences in the properties of
      NMDA receptor-mediated postsynaptic currents (NMDA PSCs) were observed between
      lesioned and sham operated animals. Thus, the observed perilesional changes in
      the NR2A/NR2B mRNA ratio appear to be subthreshold to result in significant
      changes in the functional properties of NMDA receptors.

PMID- 11192623
TI  - Evidence for proportional synaptic scaling in neocortex of intact animals.
AB  - Neocortical neurons in culture can modify their global synaptic strength
      according to their recent activity level. This process has been termed synaptic
      scaling. We explored possible effects of synaptic scaling in intact animals by
      comparing EPSPs of two identified synaptic tracts on single cortical neurons in
      acute slices. We show that the amplitude and rise-time of unitary thalamocortical
      and intracortical EPSPs vary among different neurons, but are highly correlated
      on single cells. Likewise, the AMPA-to-NMDA receptor ratio in EPSPs evoked from
      the two tracts is correlated in single neurons, although intracortical pathways
      within layer 5 exhibit a significantly larger NMDA component. These findings
      demonstrate that, under physiological conditions, cortical neurons actively
      regulate their own response magnitude, regardless of the input source.

PMID- 11192624
TI  - Elevated plasma levels of transforming growth factor beta1 in patients with
      muscular dystrophy.
AB  - The progression of muscular weakness of patients suffering from muscular
      dystrophies directly correlates with the progressive loss of myofibers,
      accompanied by fibrosis. Since transforming growth factor beta1 (TGF-beta1)
      promotes tissue fibrosis, we measured the plasma TGF-beta1 level in patients with
      various muscular dystrophies in order to determine whether the level is elevated
      in patients with muscular dystrophy and if the level reflects the severity of
      tissue fibrosis. The plasma TGF-beta1 level was significantly elevated in
      patients with Duchenne muscular dystrophy and congenital muscular dystrophy
      (CMD), but not in those with Becker muscular dystrophy. Growth factors related to
      muscle fiber regeneration and fibrosis might be a key factor in the progression
      of muscular dystrophy and could be a target for therapeutic studies.

PMID- 11192625
TI  - The effect of autonomic arousal on attentional focus.
AB  - This study investigates the effect of arousal on visual selection processes.
      Arousal is predicted to narrow the window of attention surrounding a point of
      focus. BOLD response to a letter discrimination task was measured under aroused
      (aversive noise) and non-aroused conditions (n = 8). Results revealed spatially
      distinct responses for trials invoking a narrow versus wide attentional focus.
      Under arousal a wide focus showed posterior thalamic activation similar to that
      associated with the narrowed attentional focus. This reflects altered stimulus
      filtering and supported the hypothesis. Relevant neuroanatomy involving the locus
      coeruleus and a triangular circuit of selective attention is discussed. The data
      demonstrates the intersection of arousal and visual stimulus selection systems,
      identifies a cognitive consequence of arousal, and provides the first fMRI
      evidence for brain stem autonomic arousal.

PMID- 11192626
TI  - Dopaminergic regulation of synaptotagmin I and IV mRNAs in hemiparkinsonian rats.
AB  - Synaptotagmins (Syts) I and IV are synaptic proteins involved in the regulation
      of neurosecretion. Dopaminergic drugs have been shown to modulate their
      expression. Here we investigate whether dopaminergic regulation of syt I and syt
      IV expression could play a role in the hypersensitive striatum of rats with
      unilateral lesions of dopaminergic nigrostriatal neurons with 6-hydroxydopamine.
      We show that chronic dopaminergic denervation resulted in a small down-regulation
      of striatal syt I mRNA, whereas acute treatment with SKF-82958, a dopamine D1
      receptor agonist, induced a massive syt IV mRNA upregulation in the striatum on
      the lesioned side. We conclude that chronic lack of dopamine and treatment with
      dopamine D1 receptor agonists alter the synaptic plasticity in dopamine depleted
      basal ganglia.

PMID- 11192627
TI  - Leptin and TGF-beta synergistically regulate VIP cytokine response element
      transcription.
AB  - Leptin was originally described as an adipocyte-derived cytokine that signals to
      the hypothalamus to regulate food intake and energy expenditure. Leptin signals
      through the Ob receptor, which is closely related to the gp130 cytokine receptor.
      Here we show that leptin can induce expression of the neuropeptide gene
      vasoactive intestinal peptide (VIP) through the VIP cytokine response element,
      the same element that mediates the response to the gp130 cytokines. Leptin acts
      synergistically with TGF-beta to activate transcription through this element.
      Transcriptional responses to leptin are increased when transmitted through ObR
      mutated at Tyr986, the SHP-2 docking domain, yet this mutation does not alter the
      synergy between TGF-beta and leptin. These data emphasize the functional
      similarity between leptin and the gp130 cytokines.

PMID- 11192628
TI  - Facilitation of NMDA-induced currents and Ca2+ transients in the rat substantia
      gelatinosa neurons after ligation of L5-L6 spinal nerves.
AB  - This study employing a rodent model of neuropathic pain investigated the
      influence of partial nerve injury on the ability of NMDA receptor activation to
      induce membrane currents and rises in cytosolic concentration of free calcium
      ([Ca2+]i) in the rat substantia gelatinosa (SG) neurons using simultaneous whole
      cell patch-clamp recording and fura-2 calcium imaging in spinal slices. The novel
      findings are that: (I) L5-L6 spinal nerve ligation produces a sustained
      facilitation of NMDA-mediated membrane currents and [Ca2+]i rises both in the
      soma and dendrites of SG neurons on the injured side on post-operative days 4-13
      after injury. (2) It appears that SG neurons in slices from injured rats recover
      from Ca2+ load less efficiently than neurons from naive rats. (3) The membrane
      depolarization-induced Ca2+ transients in SG neurons are not modified following
      spinal nerve ligation. The temporal profile of the changes in Ca2+ transients
      correlated well with the development of mechanical and thermal allodynia and
      hyperalgesia. These results suggest an important role of NMDA-mediated calcium
      signalling in the pathogenesis of neuropathic pain following spinal nerve injury.

PMID- 11192629
TI  - Motor activity-mediated partial recovery in ischemic rats.
AB  - Spontaneous partial recovery in motor and/or cognitive dysfunctions in stroke
      patients has been documented, but the factors that affect such functional
      improvement have not been well elucidated. The present study demonstrates that
      repeated behavioral testing (daily or once a week over a period of 4 weeks)
      promoted partial recovery from motor asymmetry in adult ischemic rats. In
      contrast, ischemic animals that were only tested once every 2 weeks or once after
      4 weeks did not show such partial recovery. These results suggest that repeated
      behavioral testing (i.e., increased use of the ischemia-affected limbs and body
      parts) may contribute to partial recovery of motor deficits following an
      experimental stroke, even in the absence of pharmacological therapeutic
      intervention.

PMID- 11192630
TI  - GDNF and neublastin protect against NMDA-induced excitotoxicity in hippocampal
      slice cultures.
AB  - The potential neuroprotective effects of glial cell line-derived neurotrophic
      factor (GDNF) and neublastin (NBN) against NMDA-induced excitotoxicity were
      examined in hippocampal brain slice cultures. Recombinant human GDNF (25-100 ng/
      ml) or NBN, in medium conditioned by growth of transfected, NBN-producing HiB5
      cells, were added to slice cultures I h before exposure to 10 microM NMDA for
      48h. Neuronal cell death was monitored, before and during the NMDA exposure, by
      densitometric measurements of propidium iodide (PI) uptake and loss of Nissl
      staining. Both the addition of rhGDNF and NBN-containing medium significantly
      reduced the NMDA-induced PI uptake in the CA1 (p < 0.01), suggesting
      neuroprotective effects of these factors, beyond their well-known trophic effects
      on dopaminergic neurons.

PMID- 11192631
TI  - Information processing in the spinocerebellar system.
AB  - The purpose of this study was to determine whether sensory information about limb
      kinematics relayed to the cerebellum over spinocerebellar pathways may be
      modified at the cerebellar level. We tested this by recording from dorsal
      spinocerebellar tract (DSCT) and Purkinje cells under the same experimental
      conditions in which the hindlimbs of anesthetized cats were passively moved
      through a series of step-like movement cycles. A population analysis of the
      response behavior showed that DSCT neurons encode a combination of limb axis
      position and movement velocity, whereas the Purkinje cells located in the DSCT
      cerebellar target areas encode limb axis velocity and position independently. We
      conclude from this that the cerebellum may somehow extract a velocity component
      from the afferent input signal.

PMID- 11192632
TI  - Temporal encoding in auditory evoked neuromagnetic fields: stochastic resonance.
AB  - Recent investigations have demonstrated that temporal patterns of sensory neural
      activity detected by magnetoencephalography (MEG) reflect features of the
      stimulus. In this study, neuromagnetic activity was investigated using an event
      detection algorithm based on the correlation coefficient. The results of the
      technique are compared with widely used methods of analysis in two experimental
      conditions and are shown to identify features in the single-trial MEG response
      that are not apparent in the response obtained by averaging across repeated
      trials. As an example of the technique, the physiologic jitter in latency
      associated with the M100 of auditory evoked fields was reproducibly measured.
      Specifically, higher intensity sounds were associated with an increased
      reliability. The technique was also applied to the noise-enhanced evoked auditory
      response, producing an objective demonstration of a cortical manifestation of the
      phenomenon of stochastic resonance-the paradoxical enhancement in the measurement
      of the signal-to-noise ratio (SNR) induced by optimal addition of noise to system
      input.

PMID- 11192633
TI  - Concussions in athletes produce brain dysfunction as revealed by event-related
      potentials.
AB  - We have used event-related potentials (ERP) to assess cerebral activity following
      mild traumatic brain injuries in 20 college athletes practising contact sports.
      Concussion victims showed a striking decrease in P300 amplitude, an effect
      presumed to reflect alterations in attentional-cognitive processes. Moreover, the
      degree of impairment was strongly related to the severity of post-concussion
      symptoms. Our data suggest that concussions cause objectively measurable changes
      in the electrophysiological markers of brain activity and hence in the functions
      of the structures from which they originate. ERPs may thus constitute a reliable
      method to accurately monitor the clinical course and recovery of head injuries in
      athletes.

PMID- 11192634
TI  - Lexical retrieval during fluent speech production: an fMRI study.
AB  - We investigated the neural correlates of lexical retrieval during fluent speech
      production using fMRI. Blood oxygenation level dependent (BOLD) contrast was
      measured while subjects spoke about 7 Rorschach inkblots for 3 min each. Varying
      degrees of speech rate were elicited during each run. In a within-subject design,
      the number of words produced was correlated with the BOLD contrast in the two
      runs in each subject that showed the highest variance of speech output. The rate
      of articulation was positively correlated with activation in the left superior
      temporal (BA 22) and supramarginal (BA 39/ 40) gyri. The main negative
      correlations were in the fusiform gyri bilaterally (BA 19), the posterior
      cingulate (BA 30) and superior occipital gyrus (BA 19). Lexical retrieval during
      continuous language production engages areas in the left temporal and inferior
      parietal cortex. This pattern of activation differs from that evident during the
      generation of single words (verbal fluency), which is more associated with left
      prefrontal activation.

PMID- 11192635
TI  - Startle responses, heart rate, and temperature in 5-HT1B receptor knockout mice.
AB  - Relative to wildtype mice, mice lacking 5-HT1B receptors (5-HT1B KO) exhibit
      exaggerated heart rate and body temperature responses to environmental stimuli.
      In contrast, acoustic startle reactivity is reduced in 5-HT1B KO mice. We
      combined heart rate and temperature measurement with startle response paradigms
      in order to elucidate this apparent contradiction. Habituation and footshock
      induced sensitization paradigms modulate startle reactivity. Reduced startle
      reactivity and unaltered habituation in 5-HT1B KO mice were replicated. Heart
      rate and temperature were unaffected by startle stimuli, but increased markedly
      in response to transportation and handling procedures. Footshocks caused a mild
      startle-sensitization and tachycardia in both genotypes. The physiological hyper
      reactivity in 5-HT1B KO mice is a subtle phenotypic difference that contrasts
      with the phenotypic decrease in startle reactivity.

PMID- 11192636
TI  - Assembly of functional alpha6beta3gamma2delta GABA(A) receptors in vitro.
AB  - Transgenic mice deficient in the alpha6 subunit of the GABA(A) receptor show
      reduced levels of the delta subunit protein and an altered GABA(A) receptor
      pharmacology, suggesting selective assembly mechanisms. Delta reduced the binding
      of [3H]Ro15-4513 or t-butylbicyclophosphoro[35S]thionate and, to a lesser extent,
      [3H]muscimol to recombinant alpha1beta1gamma2(delta), alpha4beta1gamma2(delta)
      and alpha6beta1gamma2(delta) receptors, paralleled by diminished GABA-evoked
      maximal currents in electrophysiological recordings for the latter one. The delta
      subunit gave rise to a lower EC50 for GABA and a slowed desensitization
      indicating its assembly in alpha6beta2delta, alpha6beta1gamma2delta and
      alpha6beta2gamma2delta receptors. The data show that the delta subunits assemble
      in various functional GABA(A) receptor subtypes in vitro to reduce GABA-evoked
      maximal currents and ligand binding, but increase the potency for GABA.

PMID- 11192637
TI  - Stem cell research--will further work be permitted?

PMID- 11192638
TI  - Who to support tropical disease research programmes in Africa.

PMID- 11192639
TI  - Genetic studies in Drosophila: vesicle pools and cytoskeleton-based regulation of
      synaptic transmission.
AB  - Presynaptic plasticity mechanisms rely on modulation of the synaptic vesicle
      fusion machinery and the regulated mobilization of synaptic vesicles at the
      active zone. This review discusses recent evidence suggesting that the relative
      proportions of synaptic vesicles in the reserve and ready releasable pools is the
      primary determinant of synaptic transmission strength, and that transport of
      vesicles between these pools is mediated by cytoskeletal mechanisms. Recent
      efforts to identify the molecules required for regulation of the presynaptic
      cytoskeleton suggest that common mechanisms may exist to regulate synaptic
      vesicle pools in widely divergent neuronal types, ranging from synaptic
      modulation at the Drosophila neuromuscular junction to the synaptic plasticity
      required for learning and memory in the mammalian brain.

PMID- 11192640
TI  - Leadership and fecal coliforms: Walkerton 2000.

PMID- 11192641
TI  - About those waiting lists....

PMID- 11192642
TI  - About those waiting lists....

PMID- 11192643
TI  - Competency of adolescents to make informed decisions.

PMID- 11192644
TI  - Beta-blockers as first-line therapy for hypertension.

PMID- 11192645
TI  - Unintended subcutaneous and intramuscular injection by drug users.

PMID- 11192646
TI  - An author by any other name.

PMID- 11192647
TI  - Secular trends in the body mass index of Canadian children.
AB  - BACKGROUND: Various changes in society have created the opportunity for more
      sedentary behaviour and the consumption of food that is high in kilojoules, which
      may lead to a progressive increase in body mass over time. The purpose of this
      study was to examine secular changes in the body mass index (BMI) of Canadian
      children between 1981 and 1996. METHODS: Nationally representative data from the
      1981 Canada Fitness Survey, the 1988 Campbell's Survey on the Well-being of
      Canadians and the 1996 National Longitudinal Survey of Children and Youth were
      used in the analysis. Regression analyses were used to assess population changes
      in BMI from 1981 to 1996 for children aged 7-13 years. Changes in the
      distribution of BMI results were evaluated by plotting the residuals from
      regression analyses of BMI on age, assessed separately by sex, using the 1981
      data as baseline. The proportions of children exceeding the 85th and 95th age-
      and sex-specific percentiles from the 1981 (baseline) data were also calculated.
      RESULTS: Since 1981, BMI has increased at the rate of nearly 0.1 kg/m2 per year
      for both sexes at most ages, indicating a clear secular trend toward an increase
      in BMI of Canadian children. The prevalence of overweight among boys increased
      from 15% in 1981 to 28.8% in 1996 and among girls from 15% to 23.6%. The
      prevalence of obesity in children more than doubled over that period, from 5% to
      13.5% for boys and 11.8% for girls. INTERPRETATION: Secular trends indicate that
      Canadian children aged 7-13 years are becoming progressively overweight and
      obese.

PMID- 11192648
TI  - The economic burden of physical inactivity in Canada.
AB  - BACKGROUND: About two-thirds of Canadians are physically inactive. As a risk
      factor for several chronic diseases, physical inactivity can potentially be a
      substantial public health burden. We estimated the direct health care costs
      attributable to physical inactivity in Canada, the number of lives lost
      prematurely each year that are attributable to a sedentary lifestyle and the
      effect that a reduction of 10% in inactivity levels (a Canadian objective for
      2003) could have on reducing direct health care costs. METHODS: We calculated
      summary relative risk (RR) estimates from prospective longitudinal studies of the
      effects of physical inactivity on coronary artery disease, stroke, colon cancer,
      breast cancer, type 2 diabetes mellitus and osteoporosis. We then computed the
      population-attributable fraction (PAF) for each illness from the summary RR and
      the prevalence of physical inactivity (i.e., 62%) and applied the PAF to the
      total direct health care expenditures for 1999 and to the number of deaths in
      1995 associated with each disease to determine the health care costs and lives
      lost prematurely that were directly attributable to physical inactivity. RESULTS:
      About $2.1 billion, or 2.5% of the total direct health care costs in Canada, were
      attributable to physical inactivity in 1999. A sensitivity analysis
      (simultaneously varying each of the health care costs and PAF by +/- 20%)
      indicated that the costs could be as low as $1.4 billion and as high as $3.1
      billion. About 21,000 lives were lost prematurely in 1995 because of inactivity.
      A 10% reduction in the prevalence of physical inactivity has the potential to
      reduce direct health care expenditures by $150 million a year. INTERPRETATION:
      Physical inactivity represents an important public health burden in Canada. Even
      modest reductions in inactivity levels could result in substantial cost savings.

PMID- 11192649
TI  - Hematologic dyscrasia associated with ticlopidine therapy: evidence for
      causality.
AB  - BACKGROUND: Several rare, potentially fatal types of hematologic dyscrasia, such
      as agranulocytosis, aplastic anemia, neutropenia, pancytopenia, thrombocytopenia
      and thrombotic thrombocytopenic purpura (TTP), have been associated with
      ticlopidine therapy. The extent to which ticlopidine is the causative factor has
      not been addressed quantitatively. METHODS: We identified 211 published case
      reports of hematologic dyscrasia associated with ticlopidine therapy from a
      MEDLINE search. We analyzed the 91 reports that could be evaluated, using the
      Bayesian Adverse Reaction Diagnostic Instrument to calculate the posterior
      probability that ticlopidine caused the hematologic dyscrasia based on
      epidemiologic and clinical trial data (prior odds) and case information
      (likelihood ratio). RESULTS: The median posterior probability values (and range)
      for agranulocytosis, aplastic anemia, neutropenia, pancytopenia, thrombocytopenia
      and TTP were 0.95 (0.53-0.98), 0.81 (0.57-0.93), 0.86 (0.75-0.96), 0.78 (0.61
      0.89), 0.74 (0-0.92) and 1.0 (0.33-1.00) respectively. The posterior probability
      was 0.75 or greater in 82 (90%) of the case reports. INTERPRETATION: This
      systematic analysis provides stronger evidence to implicate ticlopidine as the
      causative factor in the various types of hematologic dyscrasia in most published
      case reports.

PMID- 11192650
TI  - Preventive health care, 2000 update: prevention of child maltreatment.
AB  - OBJECTIVES: To update the 1993 report from the Canadian Task Force on the
      Periodic Health Examination (now the Canadian Task Force on Preventive Health
      Care) by reviewing the evidence for the effectiveness of interventions aimed at
      preventing child maltreatment described in the scientific literature over the
      past 6 years. OPTIONS: Screening: a variety of techniques including assessment of
      risk indicators. PREVENTION: programs including home visitation; comprehensive
      health care programs; parent education and support, combined services and
      programs aimed specifically at preventing sexual abuse. OUTCOMES: Occurrence of
      one or more of the subcategories of physical abuse, sexual abuse, neglect and
      emotional abuse in childhood. EVIDENCE: MEDLINE, PSYCINFO, ERIC and several other
      databases were searched, experts were consulted, and published recommendations
      were reviewed. Original research articles and overviews that examined screening
      for or prevention of child maltreatment were included in the update. No meta
      analysis was performed because the range of manoeuvres precluded comparability.
      BENEFITS, HARMS AND COSTS: Because of the high false-positive rates of screening
      tests for child maltreatment and the potential for mislabelling people as
      potential child abusers, the possible harms associated with these screening
      manoeuvres outweigh the benefits. Two randomized controlled trials showed a
      reduction in the incidence of childhood maltreatment or outcomes related to
      physical abuse and neglect among first-time disadvantaged mothers and their
      infants who received a program of home visitation by nurses in the perinatal
      period extending through infancy. It is expected that a reduction in incidence of
      child maltreatment and other outcomes will lead to substantial government
      savings. Evidence remains inconclusive on the effectiveness of a comprehensive
      health care program, a parent education and support program, or a combination of
      services in preventing child maltreatment. Education programs designed to teach
      children prevention strategies to avoid sexual abuse show increased knowledge and
      skills but not necessarily reduced abuse. VALUES: The systematic review and
      critical appraisal of the evidence were conducted according to the evidence-based
      methodology of the Canadian Task Force on Preventive Health Care.
      RECOMMENDATIONS: There is further evidence of fair quality to exclude screening
      procedures aimed at identifying individuals at risk of experiencing or committing
      child maltreatment (grade D recommendation). There is good evidence to continue
      recommending a program of home visitation for disadvantaged families during the
      perinatal period extending through infancy to prevent child abuse and neglect
      (grade A recommendation). The target group for this program is first-time mothers
      with one or more of the following characteristics: age less than 19 years, single
      parent status and low socioeconomic status. The strongest evidence is for an
      intensive program of home visitation delivered by nurses beginning prenatally and
      extending until the child's second birthday. There is insufficient evidence to
      recommend a comprehensive health care program (grade C recommendation), a parent
      education and support program (grade C recommendation) or a combination of home
      based services (grade C recommendation) as a strategy for preventing child
      maltreatment, but these interventions may be recommended for other reasons. There
      is insufficient evidence to recommend education programs for the prevention of
      sexual abuse (grade C recommendation); whether such programs reduce the incidence
      of sexual abuse has not been established. VALIDATION: The members of the Canadian
      Task Force on Preventive Health Care reviewed the findings of this analysis
      through an iterative process. The task force sent the final review and
      recommendations to selected external expert reviewers, and their feedback was
      incorporated. SPONSORS: The Canadian Task Force on Preventive Health Care is
      funded through a partnership between the Provincial and Territorial Ministries of
      Health and Health Canada.

PMID- 11192651
TI  - The spread of the childhood obesity epidemic.

PMID- 11192652
TI  - Bayesian assessment of adverse drug reactions.

PMID- 11192653
TI  - Clinical decision rules in the emergency department.

PMID- 11192654
TI  - Will increasing fiscal resources promote physical fitness?

PMID- 11192655
TI  - Views of mental illness in Morocco: Western medicine meets the traditional
      symbolic.

PMID- 11192656
TI  - Environment and health: 6. Endocrine disruption and potential human health
      implications.

PMID- 11192657
TI  - Program description: a hospitalist-run, medical short-stay unit in a teaching
      hospital.
AB  - A hospitalist-run medical short-stay unit (MSSU) was created at a university
      affiliated teaching hospital in Montreal in 1989. Its primary aim was to provide
      efficient and high-quality care to patients requiring a brief stay in hospital
      for short-lived medical conditions. After evaluation in the emergency department
      (ED), patients judged to have acute conditions requiring a short hospital stay
      are admitted directly to the MSSU. Conversely, patients with more complex
      conditions requiring a longer stay in hospital are admitted to a clinical
      teaching unit (CTU). Care in the MSSU is provided by a rotating group of
      hospitalists. Ensuring the admission of appropriate patients during non-daytime
      hours was the main difficulty identified. Preliminary evaluation of the MSSU
      suggested that ED consultants were effective at selecting suitable patients for
      admission to the MSSU, because only 1 in 5 patients later required transfer to
      other hospital wards. The 5 most common MSSU discharge diagnoses were asthma and
      chronic obstructive lung disease, pneumonia, congestive heart failure, urinary
      tract infection and cellulitis. MSSU patients had a shorter length of stay, lower
      rates of in-hospital complications and lower rates of readmission within 30 days
      of discharge compared with CTU patients. Our hospitalist-run MSSU appears to
      offer a workable system of health care delivery for patients with acute, self
      limited illness requiring a brief stay in hospital. The MSSU appeared to promote
      the efficient use of hospital beds without compromising patient outcomes,
      however, further research is required to compare the efficiency and outcomes of
      care directly with that provided by the traditional CTU system.

PMID- 11192658
TI  - Bioethics for clinicians: 20. Chinese bioethics.
AB  - Chinese Canadians form one of the largest groups in the Canadian cultural mosaic.
      Many of the assumptions implicit in a Western autonomy-based approach to
      bioethical deliberation may not be shared by Chinese Canadians. In traditional
      Chinese culture, greater social and moral meaning rests in the interdependence of
      family and community, which overrides self-determination. Consequently, many
      Chinese may vest in family members the right to receive and disclose information,
      to make decisions and to organize patient care. Furthermore, interactions between
      Chinese patients and health care workers may be affected by important differences
      in values and goals and in the perception of the nature and meaning of illness.
      Acknowledging and negotiating these differences can lead to considerable
      improvement in communication and in the quality of care.

PMID- 11192659
TI  - The medicine-literature connection moves online.

PMID- 11192660
TI  - A prediction.

PMID- 11192661
TI  - Pharmacist shortage. Prescription: power.

PMID- 11192662
TI  - Employee recruitment. Down to a science.

PMID- 11192663
TI  - HIPAA complications. Who's compliant?

PMID- 11192664
TI  - Gloria Jackson-Bacon.

PMID- 11192665
TI  - Flu inoculation. Speedy shots.

PMID- 11192666
TI  - Alternative medicine. CAM can do.

PMID- 11192667
TI  - Diagnostic imaging. Digital lifesaver.

PMID- 11192668
TI  - Electricity regulation. Power mad.

PMID- 11192669
TI  - Information technology. Keep up--or else.

PMID- 11192670
TI  - 1Q[3a] Do we need a nationwide physician licensure program?

PMID- 11192671
TI  - Easing doctor-nurse conflict.

PMID- 11192672
TI  - Trash sites.

PMID- 11192673
TI  - Norma Rae, R.N.

PMID- 11192674
TI  - When disaster strikes. Crises test leaders' nerve and range of skills.

PMID- 11192675
TI  - Pain management. Tools for implementing JCAHO's new standards.

PMID- 11192676
TI  - Going wireless.

PMID- 11192678
TI  - No better time.

PMID- 11192677
TI  - Wireless & handheld resource guide.

PMID- 11192679
TI  - Managed care, it's your move.

PMID- 11192680
TI  - Long live the public-sector carve-out!

PMID- 11192681
TI  - It's time to get ready for HIPAA.

PMID- 11192682
TI  - Don't 'treat' people; support them!

PMID- 11192683
TI  - Criminal-justice needs foster provider innovation.

PMID- 11192684
TI  - Better treatment from the bench.

PMID- 11192685
TI  - DTAP (Drug Treatment Alternative to Prison) offers model for helping offenders.

PMID- 11192687
TI  - The Gold Book buyer's guide. Company section.

PMID- 11192686
TI  - Is it time to switch methods?

PMID- 11192688
TI  - The Gold Book buyer's guide. Toll-free & fax numbers.

PMID- 11192689
TI  - The Gold Book buyer's guide. Product section.

PMID- 11192690
TI  - Key changes in state EMS offices.

PMID- 11192691
TI  - State & province survey.

PMID- 11192692
TI  - Government agencies.

PMID- 11192693
TI  - EMS organizations.

PMID- 11192694
TI  - Reactivity of Cd7-metallothionein with Cu(II) ions: evidence for a cooperative
      formation of Cd3,Cu(I)5-metallothionein.
AB  - Reaction of Cd7-metallothionein-2 (MT) with Cu(II) ions has been studied by a
      variety of spectroscopic techniques including UV-absorption, circular dichroism
      (CD) and luminescence spectroscopy. The addition of up to 5 Cu(II) equivalents to
      Cd7-MT resulted in a cooperative formation of the monomeric Cd3,Cu5-MT form, as
      revealed by the analytical data and the presence of isosbestic or isodichroic
      points in the respective UV and CD spectra. The presence of Cu(I) luminescence
      and the absence of Cu(II) EPR signal indicated that copper is bound in the Cu(I)
      oxidation state, i.e., Cd3,Cu(I)5-MT. Consequently, the reduction of Cu(II) ions
      is accompanied by the oxidation of thiolate ligands of the protein. The
      absorption features and the luminescence data at 77 K are consistent with the
      presence of an air-stable Cu(I)-cluster in Cd3,Cu(I)5-MT. The participation of
      other ligands, besides cysteine thiolates, in metal coordination cannot be ruled
      out. With more than 5 Cu(II) equivalents added a mixture of unstable MT
      metalloforms were formed. The concomitant reduction and binding of copper ions by
      metallated MT represent a new aspect of the MT structure.

PMID- 11192695
TI  - The DNA-bound orientation of Cu(II)-Xaa-Gly-His metallopeptides.
AB  - The DNA-bound orientations of Cu(II) x Xaa-Gly-L-His metallopeptides (where Xaa
      is Gly, L-Lys or L-Arg) were investigated by DNA fiber EPR spectroscopy and
      molecular modeling. Observed and calculated EPR spectra indicated that the g//
      axes of 1:1 Cu(II) complexes of the tripeptides tilted about 50 degrees from the
      DNA fiber axis. These results suggest that the complexes are stereospecifically
      oriented in the DNA minor groove. Although the side chain of the N-terminal amino
      acid residue did not affect the orientation of the DNA-bound complexes, it
      contributed to their stability in the presence of DNA; the Cu(II) complex of Gly
      Gly-L-His was found to dissociate to hydrated Cu(II) ion more extensively than
      the respective L-Lys-Gly-L-His and L-Arg-Gly-L-His complexes. The ionic
      interaction between the positively charged lysine or arginine residues and the
      negatively charged DNA phosphodiester backbone may result in the reduced
      dissociation of these complexes when bound to the DNA minor groove.

PMID- 11192696
TI  - Complexation of the antihypertensive drug oxprenolol with copper(II).
AB  - The complexation between copper(II) and the antihypertensive drug oxprenolol
      (HOxp) was studied both in methanol and slightly alkaline aqueous media at
      Cu:HOxp molar ratio from 1:1 to 1:10. Copper(lI) forms two types of complexes-a
      mononuclear violet one, CuOxp2, with bidentately bound ligands and a green
      dimeric one, Cu2Oxp2Cl2, in which the two Cu(II) centres are linked by the ligand
      through oxygen bridges. The crystal structure of the Cu2Oxp2Cl2 complex consists
      of two crystallographically non-equivalent centrosymmetric copper dimers. Each
      copper atom is four-coordinated in a distorted square-planar environment. The
      Cu2O2 structural core is characterized by a Cu1-O1-Cu1' angle of
      104.15(13)degrees (Cu2-O2-Cu2' 104.30(13) degrees) and a relatively short Cu1
      Cu1' separation of 3.026(1) A (Cu2-Cu2'-3.023(1) A). Magnetic susceptibility and
      EPR measurements indicate an antiferromagnetic coupling of the copper(II)
      centers.

PMID- 11192697
TI  - Platinum(II) and palladium(II) complexes with dithiocarbamates and amines:
      synthesis, characterization and cell assay.
AB  - The [M(ESDT)Cl]n (M = Pd or Pt; ESDT = EtO2CCH2(CH3)NCS2, methylamino-acetic acid
      ethyl ester-dithiocarboxylate) species have been reacted with various amines (py,
      pyridine; PrNH2, n-propylamine; c-BuNH2, cyclobutylamine; en, ethylenediamine) in
      dichloromethane or chloroform with the aim to obtain mixed ligand complexes. The
      neutral complexes [M(ESDT)(L)Cl] (L = py, PrNH2 or c-BuNH2) and the ionic species
      ([M(ESDT)(L)2]Cl and [M(ESDT)(En)]Cl) have been isolated, and characterized by IR
      and proton NMR spectroscopies. The crystal structure of [Pd(ESDT)(PrNH2)Cl] has
      been determined by X-ray crystallography. The behaviour of the complexes in
      various solvents was described on the basis of the proton NMR spectra. The
      complexes and the dithiocarbamato intermediates have been tested for in vitro
      cytostatic activity against human leukemic HL-60 and HeLa cells.

PMID- 11192698
TI  - Synthesis, characterization, antioxidative and antitumor activities of solid
      quercetin rare earth(III) complexes.
AB  - Eight rare earth metal(II) complexes with quercetin ML3 x 6H2O [L=quercetin (3-OH
      group deprotonated); M = La, Nd, Eu, Gd, Tb, Dy, Tm and Y] have been synthesized
      and characterized by elemental analysis, complexometric titration, thermal
      analysis, conductivity, IR, UV, 1HNMR and fluorescence spectra techniques as well
      as cyclic voltammetry. The quercetin:metal stoichiometry and the equilibrium
      stability constant for metal binding to quercetin have been determined. The
      antioxidative and antitumor activities of quercetin x 2H2O and the complexes were
      tested by both the MTT and SRB methods. The results show that the suppression
      ratio of the complexes against the tested tumour cells are superior to quercetin
      x 2H2O. The property of LaL3 x 6H2O reacting with calf thymus DNA was studied by
      fluorescence methods. The La-complex binding to DNA has been determined by
      fluorescence titration in 0.05 M Tris-HCl, 0.5 M NaCl buffer (pH 7.0). The
      results indicate that the interaction of the complex with DNA is very evident.

PMID- 11192699
TI  - DNA-binding and photocleavage studies of cobalt(III) polypyridyl complexes:.
AB  - Two complexes of [Co(phen)2IP]3+ (IP=imidazo[4,5-f][l,10]phenanthroline) and
      [Co(phen)2PIP]3+ (PIP=2-phenylimidazo[4,5-f][1,10]phenanthroline) have been
      synthesized and characterized by UV/VIS, IR, EA and mass spectra. The binding of
      the two complexes with calf thymus DNA has been investigated by absorption
      spectroscopy, cyclic voltammetry, viscosity measurements and DNA cleavage assay.
      The spectroscopic studies together with cyclic voltammetry and viscosity
      experiments support that both of the complexes bind to CT DNA by intercalation
      via IP or PIP into the base pairs of DNA. [Co(phen)2PIP]3+ binds more avidly to
      CT DNA than [Co(phen)2IP]3+, which is consistent with the extended planar and pi
      system of PIP. Noticeably, the two complexes have been found to be efficient
      photosensitisers for strand scissions in plasmid DNA.

PMID- 11192700
TI  - Metal-ion speciation in blood plasma incorporating the tetraphosphonate, N,N
      dimethylenephosphonate-1-hydroxy-4-aminopropilydenediphosphonate (APDDMP), in
      therapeutic radiopharmaceuticals.
AB  - In a quest for more effective radiopharmaceuticals for pain palliation of
      metastatic bone cancer, this paper relates results obtained with 166Ho and 153Sm
      complexed to the bone seeking phosphonate, N,N-dimethylenephosphonate-1-hydroxy-4
      aminopropylidenediphosphonate (APDDMP). APDDMP is synthesised from the known bone
      cancer pain palliation agent 1-hydroxy-3-aminopropylidenediphosphonate (APD) and
      was complexed to lanthanide trivalent metal ions. This work is performed to
      utilise the idea that the energetic beta-particle emitter, 166 Ho, coupled with
      phosphonate ligands such as APD and APDDMP could afford a highly effective
      radiopharmaceutical in the treatment of bone cancer. Complex-formation constants
      of APDDMP with the important blood plasma metal-ions, Ca2+, Mg2+, and Zn2+ and
      the trivalent lanthanides Ho3+ and Sm3+ were measured by glass electrode
      potentiometry at 37 degrees C and I = 150 mM. Blood plasma models were
      constructed using the computer code ECCLES and the results compared with those
      gathered from animal tests. The 166Ho-APDDMP complex was found to have little
      liver or bone uptake while 153Sm-APDDMP had a moderate bone uptake. This was
      primarily due to the high affinity of APDDMP for Ca(II). Clinical observations
      could be explained by the blood plasma modelling.

PMID- 11192701
TI  - Comparison of three fungal laccases from Rigidoporus lignosus and Pleurotus
      ostreatus: correlation between conformation changes and catalytic activity.
AB  - The conformation changes in solution of three fungal laccases in different
      environmental conditions were examined by circular dichroism (CD) and electron
      paramagnetic resonance (EPR) spectroscopy. CD measurements indicate that the
      secondary structure of proteins depends slightly on the pH or ionic strength,
      though the presence of salt could interfere in the molecular recognition process
      between substrates and enzymes. The enzymes, however, are highly destabilized by
      prolonged exposure to low pH or high temperature. The observed unfolding of the
      proteins coincides with their inactivation and, in some cases, with
      precipitation. On the other hand, these conditions do not determine the
      disruption of the geometric arrangement of their metal centres, and this fact
      suggests that these centres represent the more stable core of the proteins.

PMID- 11192702
TI  - Copper(II) complexes with phenoxyalkanoic acids and nitrogen donor heterocyclic
      ligands: structure and bioactivity.
AB  - The copper complexes with the phenoxyalkanoic acids MCPA, 2,4-D, 2,4,5-T and 2,4
      DP in the presence of a nitrogen donor heterocyclic ligand, phen or bipyam, were
      prepared and characterized. Interaction of Cu(II) with phenoxyalkanoic acids and
      bipyam leads to dinuclear or uninuclear neutral complexes while in the presence
      of phen uninuclear neutral or cationic forms have been isolated. The crystal
      structure of bis(1,10-phenanthroline)(2-methyl-4-chloro-phenoxyacetato)copper(ll)
      chloride-methanol(1/1)-water(1/0.6), 1 has been determined and refined by least
      squares methods using three-dimensional MoK, data. 1 crystallizes in space group
      P1, in a cell of dimensions a = 14.577(6)A, b = 1 1.665(5) A, c = 12.249(6) A,
      alpha = 98.38( 1)degrees, beta = 112.18( 1) degrees, gamma = 104.56(1 ) degrees,
      V= 1,798( 1) A3 and Z= 2. The cyclic voltammograms of uninuclear cationic
      complexes in dmf exhibit an extra cathodic wave due to the chloride ion. The
      available evidence supports an increasing antimicrobial effeciency for the
      cationic complexes.

PMID- 11192703
TI  - Whole-body scintigraphy in melanoma patients: comparison of 99Tcm-tetrofosmin and
      201Tl.
AB  - The aim of this study was to determine the diagnostic value of 99Tcm-tetrofosmin
      whole-body imaging in comparison to 201Tl scintigraphy in patients with
      metastatic melanoma. In 27 patients with known or suspected melanoma metastases
      we performed 201Tl scintigraphy and 99Tcm-tetrofosmin scintigraphy using a 1-day
      protocol. In five patients with known locoregional metastasis the in vivo uptake
      kinetics of both radiotracers were compared. The final diagnosis was confirmed by
      surgical histology in 39 lesions (group I) and computed tomography (CT) and
      clinical course in 14 lesions (group II). In group I, containing mainly
      locoregional metastases, 201Tl scintigraphy correctly identified 36 of 39
      metastases and 99Tcm-tetrofosmin 35 of 39 resulting in a sensitivity of 92% and
      90% respectively. The T/B ratios of 201Tl (1.4-4.0, mean 2.15) were statistically
      significantly higher in comparison to tetrofosmin (1.3-3.0, mean 1.88). However,
      both radiotracers showed similar uptake and washout kinetics with a maximum of
      tracer uptake between 1 and 5 min p.i. In group II, containing mainly cerebral
      and pulmonary metastases, both methods correctly identified six of 14 metastases
      resulting in a sensitivity of only 43%. We conclude that the uptake of 99Tcm
      tetrofosmin and 201Tl in melanoma metastases is very similar. The T/B ratios with
      99Tcm-tetrofosmin are significantly lower than with 201Tl. In locoregional
      melanoma metastases the sensitivity of tetrofosmin scintigraphy is identical with
      201Tl imaging and amounts to 90%. In cerebral and lung metastases the sensitivity
      of both methods is limited when using whole-body scintigraphy.

PMID- 11192704
TI  - Factors influencing the accuracy of renal output efficiency.
AB  - Output efficiency (OE) has been proposed as an objective tool for the estimation
      of renal emptying. The aim of this paper was to evaluate some factors that may
      affect the value of this parameter obtained by a 99Tcm MAG3 renogram. In 22
      patients, the effect of different types of renal background correction was
      calculated. In 10 patients, simultaneous gamma camera renography and multiple
      blood sampling allowed the error of using a heart curve instead of a plasma curve
      to be evaluated. Finally, an evaluation was carried out on the effect of
      neglecting the change of plasma activity between the end of the furosemide
      acquisition and the post-micturition view obtained after repositioning of the
      patient on the gamma camera: 142 patients who had had multiple blood sampling
      were retrospectively selected for that purpose. It has been shown that all these
      factors may significantly affect the value of OE, particularly in cases with poor
      renal drainage. Unless standardization of the procedure is introduced for some of
      these factors, the cut-off levels for good, fair and poor drainage may vary
      between centres.

PMID- 11192705
TI  - Dobutamine combined with low-level exercise for myocardial perfusion
      scintigraphy.
AB  - Increased abdominal background activity is one of the limitations of dobutamine
      myocardial perfusion scintigraphy which may interfere with interpretation of the
      images. In this study, we evaluated the value of low-level exercise
      supplementation to dobutamine infusion in improving image quality. The control
      group (n = 32, Group A) received dobutamine alone, while the study group received
      dobutamine plus low-level exercise for the last 2 min of dobutamine
      administration (n = 26, Group B). One hundred and eleven MBq of 201Tl was
      injected 1 min before cessation of peak dose. The ratios of cardiac/hepatic
      (C/HEP), cardiac/subdiaphragmatic (C/INF) and cardiac/pulmonary (C/PUL) were
      calculated from anterior planar images taken immediately following the test.
      Cardiac/non-cardiac activity was also visually graded on a three-point scale.
      Visual evaluation showed improved cardiac/non-cardiac ratios as confirmed by
      significantly higher C/HEP and C/INF ratios for Group B (1.5+/-0.3 and 1.7+/-0.2,
      respectively) compared to corresponding values in Group A (1.2+/-0.4 and 1.4+/
      0.4, respectively) (P<0.05). The cardiac/pulmonary (C/PUL) ratio was also higher
      for Group B (2.3+/-0.5) as compared to corresponding value in Group A (2.0+/-0.6,
      respectively), but this difference did not reach statistical significance (P >
      0.05). No difference in the frequency of side effects and ECG changes were
      detected between the two groups (P > 0.05). Low-level exercise supplementation to
      dobutamine infusion for myocardial perfusion scintigraphy is a safe method and
      leads to a significant decrease in uptake by the areas adjacent to the heart,
      improving image quality.

PMID- 11192706
TI  - Impact of radionuclide ventriculography prior to elective abdominal aortic
      reconstruction.
AB  - We evaluated how preoperative radionuclide ventriculography (RNV) influences the
      clinical management of 96 patients referred for elective infrarenal abdominal
      aortic surgery. Of these, 11 had aortoiliac occlusive disease and 85 an abdominal
      aortic aneurysm. In 89 patients (93%), there was a known history or clinical
      evidence of coronary artery disease prior to RNV. The scan was abnormal in half
      the patients. There were 56 patients with left ventricular ejection fraction
      (LVEF) > 50% and 40 with LVEF < or = 50%. The LVEF ranged between 10% and 88%
      with a mean of 52.8+/-14.1%. There was normal wall motion in 56 patients and wall
      abnormalities were present in 40, including four LV aneurysms. After initial
      assessment, 19 patients did not proceed to surgery for a variety of reasons.
      Cardiology consultation was requested in 11 patients, six of which were delayed
      or turned down for surgery mainly on cardiac grounds. Only one of these underwent
      cardiac catheterization. Of the remaining 77 patients who underwent surgery, 15
      were seen by a cardiologist and one was delayed in order to optimize his cardiac
      status. No patient underwent prophylactic coronary angioplasty/stenting or
      revascularization preoperatively. In addition, based on the RNV results and in
      conjunction with the clinical findings, six patients had pulmonary artery
      catheters inserted either the night prior to operation (n = 3) or after induction
      to anaesthesia (n = 3). This is the largest reported British series of cardiac
      testing using RNV prior to abdominal aortic surgery. Coronaryartery disease is
      very common amongst such patients. RNV influences our decision-making and
      patientselection. An abnormal result may alter the clinical management, lead to a
      cardiology referral (26/96, 27% in this series) and have anaesthetic
      implications.

PMID- 11192707
TI  - The role of rhinoscintigraphy in the evaluation of nasal mucociliary clearance
      function in patients with sinusitis.
AB  - Nasal mucociliary clearance is one of the homeostatic systems of the respiratory
      mucosa. Various rhinopathic conditions may involve alterations in nasal
      mucociliary clearance. The aim of this study was to assess the clinical role of
      rhinoscintigraphy in the evaluation of nasal mucociliary clearance function of
      sinusitis patients in comparison with a healthy control group. A single droplet
      of 99Tcm-labelled macroaggregated albumin (99Tcm-MAA) was deposited on the floor
      of the nasal meatus about 1 cm behind the mucocutaneous junction, and its course
      was followed with a gamma camera. The nasal mucociliary clearance was presented
      as the velocity (mm x min(-1)) of nasal mucociliary transport of the 99Tcm-MAA
      droplet. A significant difference in nasal mucociliary clearance was observed
      between the two groups, with a mean of 4.28+/-1.38 mm x min(-1) (4.3+/-1.35 mm x
      min(-1) in the right nostril, 4.27+/-1.42 mm x min(-1) in the left nostril) for
      the controls; and 1.8+/-0.64 mm x min(-1) (1.79+/-0.65 mm x min(-1) in the right
      nostril, 1.82+/-0.63 mm x min(-1) in the left nostril) for the patients with
      sinusitis. Rhinoscintigraphy is a safe, easy, quick and reliable imaging method
      for evaluating the ciliary activity of nasal mucosa and the nasal mucociliary
      clearance function in patients with sinusitis.

PMID- 11192708
TI  - Does bowel preparation improve the quality of abdominal gallium scintigraphy?
AB  - Physiological accumulation of gallium in the intestine is a major weakness of
      gallium scintigraphy in evaluating the abdomen. In this study, we used two
      different cathartics to evaluate the efficacy of bowel cleansing in improving the
      quality of abdominal gallium imaging. One hundred and fifty patients underwent
      gallium scintigraphy and were randomly divided into three groups. Group A
      received no bowel preparation, Group B received 30 ml of castor oil the night
      before imaging, and Group C received bisacodyl the night before imaging. Gallium
      activity in the intestine was rated on a three-point scale from 0 to II based on
      the anterior view of a delayed 48-h gallium image. Our data showed that the
      incidence of gallium accumulation in the small intestine was low. On the
      contrary, there was high prevalence of gallium activity in the colon. Forty-eight
      percent of Group A patients had obvious gallium activity in the colon. The
      percentage decreased significantly to 28% and 22% in Groups B and C,
      respectively. No significant difference was noted between Group B and Group C. In
      conclusion, our data suggest that the application of either castor oil or
      bisacodyl significantly improves the quality of 48-h abdominal gallium
      scintigraphy. There were no significant differences in the efficacy of bowel
      cleansing on gallium activity between these two laxatives.

PMID- 11192709
TI  - A simplified method for processing dynamic images of gastric antrum.
AB  - By means of a dynamic acquisition protocol and a Fourier transform algorithm the
      scintigraphic technique can be used to assess gastric antral motility. In
      previous approaches, however, the definition of a region of interest (ROI) that
      gives rise to an unequivocal result of the analysis of the corresponding time
      activity curve might be crucial. To overcome this problem we evaluated a new
      technique based on a fixed box-ROI and a simple weighting principle. Eight
      healthy volunteers ingested a meal that contained a 99Tcm-stannous colloid
      labelled omelette. Gastric emptying was assessed from static images taken at 30
      mm intervals for 2 h. Anterior dynamic frames of 1 s each, which were acquired
      for 5 mm after each static acquisition, were used to determine the frequency of
      antral contractions. In order to allow for precise outlining of the antrum, each
      set of dynamic images was at first reframed into a single 5-mm image. The same
      ROI (20 pixels vertical, 15 pixels horizontal) was then positioned over the
      distal portion of the antrum on each reframed image. On each 1-s frame the
      obtained counts in each of the 15 columns of 20 pixels were summed. Then the
      localization of the geometric centre of radioactivity in the 15 columns was
      determined. On the assumption that the horizontal oscillations of the geometric
      centre of radioactivity in the ROI reflected the contractile activity of the
      antrum, the frequency of these contractions was calculated by fast Fourier
      transform analysis of the obtained time versus geometric centre curve. In all
      subjects, our technique gave unequivocal frequencies of antral contractions at
      each time point. Statistical analysis did not reveal any intraindividual
      variation in this frequency during gastric emptying. We believe that the
      simplified scintigraphic method is an advantageous alternative for assessing the
      frequency of antral contractions.

PMID- 11192710
TI  - A 99Tcm-labelled leukotriene B4 receptor antagonist for scintigraphic detection
      of infection in rabbits.
AB  - In a search for a rapid and accurate imaging agent for scintigraphic detection of
      infection and inflammation, an LTB4 receptor antagonist, 99Tcm-RP517, which
      contains the hydrazino nicotinamide moiety, has been developed recently. To study
      the in vivo behaviour of 99Tcm-RP517, rabbits with Escherichia coli infection
      were injected intravenously with 99Tcm-RP517. Gamma camera images were obtained
      and ex vivo bio-distribution was determined at several hours post-injection
      (p.i.). In a separate set of rabbits the choledochal duct was cannulated to
      quantitatively monitor the hepatobiliary clearance of the radiopharmaceutical.
      The receptor binding fraction of the radiolabelled RP517 exceeded 70%.
      Accumulation of 99Tcm-RP517 in the abscess was visualized as early as 1 h p.i.
      Due to rapid blood clearance (t1/2 alpha=18+/-0.6 min, t1/2 beta=6.5+/-0.4 h) and
      high abscess uptake, the abscess-to-muscle ratios increased with time from 7.0+/
      2.3 at 1 h p.i. to 44.3+/-4.6 at 20 h p.i. The agent mainly cleared via the
      hepatobiliary route: 50% of the radiolabel was recovered in the small bowel at 1
      h p.i., whereas 85% was found in cecum and sigmoid at 20 h p.i. In conclusion,
      99Tcm-RP517 rapidly visualized E. coli abscesses in rabbits. The agent rapidly
      cleared from the blood, mainly via the hepatobiliary route. High abscess-to
      background ratios were achieved. The accumulation in the intestines could limit
      the applicability of this agent for detecting infectious processes in the
      abdominal area. The development of a more hydrophilic analogue of 99Tcm-RP517
      could improve the clinical applicability of this agent.

PMID- 11192711
TI  - Effect of E5510, a novel antiplatelet agent, on platelet deposition in
      atherothrombotic lesions: evaluation by 111In platelet scintigraphy.
AB  - We evaluated the short-term effects of a novel antiplatelet agent, 4-cyano-5,5
      bis(methoxyphenyl)-4-pentenoic acid (E5510), using 111In platelet scintigraphy
      (PSG) and B-mode ultrasonography (US). Fifteen patients with platelet deposition
      at either the carotid bifurcation or abdominal aorta on PSG were randomized into
      two groups: seven were followed without anti-thrombotic medication (Group A) and
      eight received E5510 (4 mg x day(-1)) (Group B). After 8 weeks, PSG and US were
      repeated in all patients. Platelet deposition was assessed visually and semi
      quantitatively using a platelet accumulation index. Visual analysis showed that
      seven out of eight patients became negative for platelet deposition after
      treatment in Group B, while none changed in Group A. The platelet accumulation
      index of vessels with platelet deposition was significantly reduced after
      treatment in Group B (12.4+/-3.9% vs 6.0+/-7.1%, p <0.01), while there was no
      significant change in the vessels without platelet deposition (2.9+/-3.0% vs
      2.9+/-4.1%). In Group A, none of the vessels showed any change (8.1+/-6.4% vs
      8.9+/-7.3%). However, there was no significant reduction of carotid plaque size
      in either group. Short-term E5510 therapy inhibited platelet deposition in active
      atherothrombotic lesions, and the combination of PSG and US was useful for
      evaluating the effectiveness of anti-thrombotic drugs in vivo.

PMID- 11192712
TI  - The effect of protein or energy restriction on the biodistribution of Na99TcmO4
      in Wistar rats.
AB  - The effect of malnutrition on the biodistribution of radiopharmaceuticals is not
      known. We studied the biodistribution of 99Tcm-labelled sodium pertechnetate
      (Na99TcmO4) in two rat models of malnutrition. Three groups of 2-month-old rats
      were separated according to their diets: (1) control diet, 23% protein (C); (2)
      protein-restricted, receiving 8% protein (PR), both ad libitum; and (3) energy
      restricted, receiving 60% of control diet (ER). After 21 days of the diet, 99Tcm
      was injected and the animals were killed after 30 min. The organs were isolated,
      their weight determined and the absolute per cent (%ID) and the per cent per gram
      injected dose (%ID x g(-1)) calculated. The %ID and %ID x g(-1) had a similar
      pattern, increasing in stomach and brain and decreasing in the thyroid, but did
      not change significantly in kidney, lung, liver, bone or testis in PR rats,
      except in the heart where the increase was only observed in the %ID x g(-1). In
      the ER group the %ID x g(-1) was decreased in the bone only, and did not change
      in the other organs. It is suggested that when using Na99TcmO4 scintigraphy in
      malnourished patients, the different patterns of distribution must be kept in
      mind.

PMID- 11192713
TI  - A receptor-specific peptide for imaging infection and inflammation.
AB  - The chemotactic peptide N-formylmethionyl-leucyl-phenylalanine (fMLP), when
      radiolabelled, continues to be an attractive agent for imaging infection or
      inflammation. Previously, several analogues of fMLP have been prepared and
      radiolabelled using a bifunctional chelating agent conjugation procedure that was
      relatively long and complex. We have prepared a new analogue of fMLP, TP765, by
      the addition of 4-aminobutyric acid (4-ABA) and a group of four amino acids, Gly
      Gly-d-Ala-Gly, to the carboxy terminus (i.e. to the phenylalanine) of fMLP. The
      adduct -(4-ABA)-Gly-Gly-d-Ala-Gly- serves as a chelating moiety for strong
      chelation with 99Tcm. The use of a peptide as a chelating moiety greatly
      simplified the synthetic procedure and rendered the analogue ready for instant
      chelation with 99Tcm. HPLC analysis revealed that 99Tcm-TP765 was a single
      chemical entity that retained biological activity and neutrophil specificity.
      99Tcm-TP765 was stable when challenged with strong chelating agents in vitro and
      had rapid but biphasic blood clearance (alphat1/2 = 7 min, betat1/2 = 45 min).
      Approximately 90% of the radioactivity had cleared from circulation within 45 min
      post-injection and the agent had accumulated in experimental bacterial or sterile
      abscesses in significantly (P<0.05) higher quantities than the analogues
      evaluated previously. Generally, the biodistribution pattern of 99Tcm-TP765 was
      similar to that of other analogues examined and its abscess uptake was
      independent of the abscess age. In conclusion, a new analogue of fMLP, 99Tcm
      TP765, was prepared by a simple procedure. This new analogue has properties
      similar to those of previously examined analogues used as agents for imaging
      infection or inflammation.

PMID- 11192714
TI  - Clinical outcome after standardized versus dosimetric radioiodine treatment of
      hyperthyroidism: an equivalence study.
AB  - The aim of this study was to investigate the equivalence in outcome of
      standardized versus uptake-adjusted dosing of radioactive iodine (131I) for
      hyperthyroidism. We performed a 1-year follow-up study of two patient cohorts:
      326 patients referred for 131I treatment of hyperthyroidism in Graves' disease
      (GD; n=216) or toxic multinodular goitre (TMG; n=110) in the period June 1995 to
      January 1998. Of these patients 128 were treated according to a standardized
      regimen, based on palpated thyroid volume and diagnosis, and 198 with a 131I
      uptake-adjusted dosimetric method. The incidence of hypothyroidism, euthyroidism
      or recurrence of disease was recorded. In Graves' disease hypothyroid outcome in
      the standardized versus adjusted method was 40.7% vs 44.6% (95% CI difference, 
      17.4 to +9.5%); it was 67.4% vs 70.8% (95% CI difference -15.9 to +9.3%) for all
      non-euthyroid outcomes. In TMG, due to wide confidence interval ranges a
      conclusion of equivalence could be made only for recurrence of hyperthyroidism
      (mean -3.2%, 95% CI, -13.8 to +7.5%). A simplified dosage method for 131I
      treatment of hyperthyroidism, which omits 131I uptake adjustment, may improve
      procedure efficiency and patient convenience, and leads to an equivalent outcome
      in GD and probable equivalent outcome in TMG.

PMID- 11192715
TI  - Use of the rat pancreatic CA20948 cell line for the comparison of radiolabelled
      peptides for receptor-targeted scintigraphy and radionuclide therapy.
AB  - We have evaluated the usefulness of the rat pancreatic CA20948 tumour as an in
      vitro cell culture model and as an in vivo model in Lewis rats comparing
      different radiolabelled peptides for receptor-targeted scintigraphy. In vitro the
      receptor-specific uptake and internalization of different radiolabelled analogues
      of somatostatin, bombesin, substance P and cholecystokinin were demonstrated.
      Analogues were selected based on high-affinity binding to their respective
      receptors. Their uptake and internalization in CA20948 cells were compared to
      these processes in AR42J cells, a well-known rat pancreatic tumour cell line used
      for peptide-receptor studies. Receptor-specific internalization, which was
      blocked by excess unlabelled peptide analogue, was found in both the CA20948 and
      AR42J cells for all the peptide analogues tested. This indicates specific
      receptor expression for all the different peptides, making these cells highly
      suitable for peptide studies. Internalization of the different peptides was as
      follows, in increasing order: [111In-DOTA0]CCK < [111In-DTPA0,Arg1]substance P <
      [111In-DTPA0]octreotide < [111In-DTPA0,Pro1,Tyr4]bombesin. Internalization
      appeared to be time and temperature dependent. In accordance with the in vitro
      experiments, receptor-specific uptake of all the peptide analogues was also found
      in vivo in the solid CA20948 tumour. The in vivo tumour uptake of [111n
      DTPA0]octreotide was the highest amongst the peptides tested, the order of tumour
      uptake being [111In-DTPA0]octreotide >[111In-DTPA0,Pro1,Tyr4]bombesin >[111In
      DTPA0,Arg1]substance P > [111In-DOTA0]CCK, which is different from the in vitro
      findings and points to either different receptor numbers on the tumour cells for
      the different peptide receptors in vitro and in vivo or to differences between
      the peptides with regard to metabolic stability. It can be concluded that the
      CA20948 tumour, both in cell culture and as a solid tumour in rats, is a very
      useful model for peptide receptor scintigraphy and radionuclide therapy studies.

PMID- 11192716
TI  - Labelling efficiency of ten radiopharmaceuticals.

PMID- 11192717
TI  - Nuclear nephrourology, no more the cinderella of nuclear medicine.

PMID- 11192718
TI  - Follow-up of differentiated thyroid cancer: comparison of multiple diagnostic
      tests.
AB  - The radioablation of thyroid remnants improves the prognosis of differentiated
      thyroid cancer. In our prospective study an activity of 3.7 GBq 131I failed to
      completely ablate the remnants in 46 out of 101 patients, but a 3-year follow-up
      period was uneventful. One other patient had a recurrence early after
      thyroidectomy. In view of possible stunning effects of 131I it might be
      advantageous to visualize such remnants by imaging modalities which do not emit
      beta-particles. Our data have revealed that neither magnetic resonance imaging
      (MRI), nor ultrasonography (US), nor 99Tcm-sestamibi scintigraphy, nor positron
      emission tomography could detect or reliably exclude minimal remnants. Such
      remnants did not produce thyroglobulin (Tg). A 123I and 131I uptake of> 10% after
      thyroidectomy was associated with about a 90% probability of persistent remnants.
      On the other hand, MRI was helpful in the patient group (n = 32) with Tg>4ng x
      ml(-1) at the second whole-body scintigraphy (TSH>30 mU x l(-1)) for planning the
      management of lymph node metastases (n = 15 patients): 12 patients had subsequent
      surgery and three patients radioiodine therapy. We recommend that MRI be used
      early in follow-up care when Tg is elevated. The decision of whether or not to
      treat persistent thyroid remnants should not be made on the basis of MRI, US or
      nonspecific scintigraphic methods. Complete ablation did not appear to have any
      clinical benefit in our study group.

PMID- 11192719
TI  - Electron transfer in natural proteins theory and design.

PMID- 11192720
TI  - Methylamine dehydrogenase. Structure and function of electron transfer complexes.

PMID- 11192721
TI  - Trimethylamine dehydrogenase and electron transferring flavoprotein.

PMID- 11192722
TI  - Amine oxidases and galactose oxidase.

PMID- 11192723
TI  - Electron transfer and radical forming reactions of methane monooxygenase.

PMID- 11192724
TI  - Flavocytochrome b2.

PMID- 11192725
TI  - Flavin electron transfer proteins.

PMID- 11192726
TI  - Flavocytochrome P450 BM3 substrate selectivity and electron transfer in a model
      cytochrome P450.

PMID- 11192727
TI  - Peroxidase-catalyzed oxidation of ascorbate. Structural, spectroscopic and
      mechanistic correlations in ascorbate peroxidase.
AB  - Ascorbate-dependent peroxidase activity was first reported in 1979 (Groden and
      Beck, 1979; Kelly and Latzko, 1979) and ascorbate peroxidase (APX) is, therefore,
      a relative newcomer to the peroxidase field--horseradish (HRP) and cytochrome c
      (CcP) peroxidases were, for example, first identified in 1903 (Bach and Chodat,
      1903) and 1940 (Altschul et al., 1940) respectively. The APX area was reviewed by
      Dalton in 1991 (Dalton, 1991): at that time, there was very little detailed
      kinetic, spectroscopic or functional information available and no structural
      information had been published. Since 1991, there have been some major advances
      in the field, most notably with the publication, in 1995, of the first crystal
      structure for an APX enzyme (Patterson and Poulos, 1995). This information,
      together with the availability of new recombinant expression systems (Yoshimura
      et al., 1998; Caldwell et al., 1998; Dalton et al., 1996; Patterson and Poulos,
      1994), served as a catalyst for the publication of new functional and
      spectroscopic data and has meant these data could be sensibly rationalized at the
      molecular level. The aim of this review is to summarize the more recent advances
      in the APX area and, as far as possible, to draw comparisons with other, more
      well-characterized peroxidases. The review will concentrate on the ways in which
      structural, spectroscopic and mechanistic information have been used in a
      complementary way to provide a more detailed picture of APX catalysis. The more
      biological and physiological aspects of APX enzymes have been previously covered
      in a comprehensive manner (Dalton, 1991) and will not, therefore, be dealt with
      in detail here.

PMID- 11192728
TI  - Adenosylcobalamin-dependent enzymes.

PMID- 11192729
TI  - Ribonucleotide reductase. A virtual playground for electron transfer reactions.

PMID- 11192730
TI  - Molybdenum enzymes.

PMID- 11192731
TI  - Nickel containing CO dehydrogenases and hydrogenases.
AB  - The two redox catalysts described here can generate very low potential electrons
      in one direction and perform chemically difficult reductions in the other. The
      chemical transformations occur at unusual metal clusters. Spectroscopic,
      crystallographic, and kinetic analyses are converging on answers to how the
      metals in these clusters are arranged and how they are involved in the chemical
      and redox steps. The first structure of CO dehydrogenase, which will appear in
      the next year, will help define a firm chemical basis for future mechanistic
      studies. In the immediate future, we hope to learn whether the hydride
      intermediate in hydrogenase or the carbonyl intermediate in CO dehydrogenase bind
      to the Ni or Fe subsites in these heterometallic clusters. Or perhaps could they
      be bridged to two metals? Inter- and intramolecular wires have been proposed that
      connect the catalytic redox machine to proximal redox centers leading eventually
      to the ultimate redox partners. Elucidating the pathways of electron flow is a
      priority for the future. There is evidence for molecular channels delivering
      substrates to the active sites of these enzymes. In the next few years, these
      channels will be better defined. The products of CO2 and proton reduction are
      passed to the active sites of other enzymes and, in the case of H2, even passed
      from one organism to another. In the future, the mechanism of gas transfer will
      be uncovered. General principles of how these redox reactions are catalyzed are
      becoming lucid as the reactions are modeled theoretically and experimentally.
      Proton and CO2 reduction and the generation of C-C bonds from simple precursors
      are important reactions in industry. H2 could be the clean fuel of the future.
      Hopefully, the knowledge gained from studies of hydrogenase, CO dehydrogenase,
      and acetyl-CoA synthase can be used to improve life on earth.

PMID- 11192732
TI  - Cytochrome cd1 nitrite reductase structure raises interesting mechanistic
      questions.

PMID- 11192733
TI  - Mitochondrial cytochrome bc1 complex.

PMID- 11192734
TI  - Bovine heart cytochrome c oxidase.

PMID- 11192735
TI  - Reaction centres of purple bacteria.
AB  - The bacterial reaction centre is undoubtedly one of the most heavily studied
      electron transfer proteins and, as this article has tried to describe, it has
      made some unique contributions to our understanding of biological electron
      transfer and coupled protonation reactions, and has provided fascinating
      information in areas that concern basic properties such as protein heterogeneity
      and protein dynamics. Despite intensive study, much remains to be learned about
      how this protein catalyses the conversion of solar energy into a form that can be
      used by the cell. In particular, the dynamic roles played by the protein are
      still poorly understood. The wide range of time-scales over which the reaction
      centre catalyses electron transfer, and the relative ease with which electron
      transfer can be triggered and monitored, will ensure that the reaction centre
      will continue to be used as a laboratory for testing ideas about the nature of
      biological electron transfer for many years to come.

PMID- 11192736
TI  - Methanol dehydrogenase, a PQQ-containing quinoprotein dehydrogenase.

PMID- 11192737
TI  - [Factors influencing liberation of drug from semisolid dosage forms].
AB  - Liberation of salicylic acid--as a model active agent--was investigated from
      white petrolatum, creams w/o and o/w types and hydrogels. Active agent was
      applied in suspended, dissolved forms, in inclusion complexes and solubilized
      state. The process of liberation was studied by a continuous through-flow method,
      with Hanson vertical diffusion cell. The results of experiments were evaluated by
      factorial design method. Increase of the concentration of salicylic acid,
      polarity of vehicle and solubilized state of drug increased the drug release. It
      was established that the partitioning released drug was the most important step
      of drug release. Factors changing partitioning influenced the liberation to the
      highest degree.

PMID- 11192738
TI  - [In vitro study of emulsions containing methoxsalen].
AB  - Vitiligo is an acute disease of skin with inflammation which means damage of
      melanocites, their defined partial paint lack. It is a frequent sickness which is
      very conspicuous and disturbing illness. For its treatment, systematically and
      topically psoralen-derivatives, UV-A radiation and other possibilities are used.
      Metoxsalen is one of them which is practically insoluble in water. Authors
      planned to increase the solubility of the pharmacon, and they studied with in
      vitro diffusion method, how the type of the emulsions influence the liberation
      and diffusion of metoxsalen.

PMID- 11192739
TI  - [Preparation of pellets with a centrifugal granulator].
AB  - It has been investigated how the centrifugal-granulator is applicable to form
      paracetamol pellets with good mechanical, powder rheological and dissolutional
      properties. During the preparation process the mechanical parameters were the
      same only the percentage of the effective material was changed. The authors found
      that the centrifugal-granulator is well applicable to form good pellet particles
      which have good dissolution and mechanical parameters to from needle shaped raw
      materials.

PMID- 11192740
TI  - [Comparison of in vitro model examinaitons with respect to drug release from
      suppositories].
AB  - 9 lipophilic suppository bases with different physical-chemical parameters were
      examined. Buspiron-hydrochloride, an anxiolytic drug with good water-solubility
      was used--partly as a model--as a pharmacon, in a concentration of 10.0 mg/2.00
      g. The rate and extent of in vitro drug release was monitored with static and
      dynamic methods. Kidney-dialysing membranes with various surfaces were used. The
      quantitative measurements were carried out spectrophotometrically and the amount
      of the diffused drug was determined at lambda = 298 nm. The mean values were
      calculated from 5 parallel measurements each time. The percentage values of in
      vitro relative availability revealed that the results of the two static diffusion
      studies did not differ significantly (p < 0.05) and were almost independent of
      the size of the membrane surface. The results of the dynamic diffusion method
      were well-reproducible but were vehicle-dependent. The process of release was
      characterized by the mathematical transformation of the release curves, while the
      correlation coefficients described the closeness of the relation. Two German
      vehicles, namely Witepsol H 15 with a medium hydroxyl value and Massa Estarinum
      299, and a French vehicle, Suppocire AS2X were found to be excellent for the
      formulation of suppositories containing Buspiron-hydrochloride.

PMID- 11192741
TI  - [Tin compounds in pharmacy and nutrition].
AB  - The occurrence of tin in plants, animals and humans is discussed, in relation to
      its abundance in the lithosphere and hydrosphere and the range of the different
      tin(II) and tin(IV) complexes formed. A reasoned consideration of its
      essentiality for living species is provided. It is concluded that tin is
      beneficial, even if not yet proved to be an essential element. After reference to
      the chemistry of tin compounds, there is a detailed discussion of their toxicity
      in animals and humans. Feasible routes for tin intake and uptake into humans are
      described. The past and current use of tin pharmaceuticals is reviewed and the
      areas for which they are currently permitted for use in humans as dentifrices and
      mouth washes, as radio-pharmaceuticals and for the treatment of jaundiced
      newborns are described. A detailed review of tin-containing antitumour agents as
      representative tin pharmaceuticals is also given. Finally, a list of tin
      containing drugs and drug candidates is also shown.

PMID- 11192742
TI  - A nonlinear model for mammary gland growth and regression in lactating sows.
AB  - The objective was to propose an empirical mathematical model to describe mammary
      gland growth and regression in lactating sows. A nonlinear dynamic model based on
      the logistic function was constructed, and data from 61 sows were used to
      illustrate the model. Sows were fed four diets with two levels of energy and of
      protein during lactation, and individuals were slaughtered over a 30-d period to
      produce a cross sectional data set on weight and composition variables from
      suckled mammary glands. Data (y(x)) were obtained for each day of lactation (x)
      and fitted by nonlinear regression. The logistic distribution function was
      modified for different durations of growth (f; days/gram of weight or
      composition) and regression (g; days/gram of weight or composition): [formula in
      text] where y(max) is maximum weight or composition and x(max) is day of
      lactation at maximum. Based on results for wet weight, for example, individually
      suckled mammary glands grow until between Day 21 and 28 of lactation and reach a
      maximum of about 500 to 600 g, depending on diet. Growth pattern of mammary
      glands can be described well with an asymmetric nonlinear model, using different
      durations for growth and regression. From this model, it was possible to estimate
      directly biologically important parameters: maximum weight or composition, day of
      lactation at maximum weight or composition, and durations of growth and
      regression. This model can be applied to describe mammary gland growth patterns
      for other species and to describe similar growth or production patterns.

PMID- 11192743
TI  - Analysis of inheritance of growth trajectories in laboratory populations of guppy
      fish.
AB  - We analysed the variation of growth trajectories for body length from 40 to 90
      days of age in three laboratory populations of Poecilia reticulata. The
      populations used were two lines of guppy-fish obtained by artificial selection
      for increased and decreased body length at 70 days and one line maintained under
      free-breeding condition. The factor analysis performed on the phenotypic
      correlation matrices among age-specific values of body length showed that a very
      large portion of the phenotypic variation is confined to a single factor. This
      factor corresponds to a simultaneous increase/decrease at all ages, hence
      representing the variation in the height of the growth trajectories. A smaller
      portion of the variation describes an increase/decrease at early ages followed by
      the reverse in the later ages, which corresponds to the variation in the shape of
      the trajectories. The genetic analysis performed on the height and shape of the
      growth curves showed a additive genetic component for the height in the free
      breeding population and for the shape in the selected lines.

PMID- 11192744
TI  - Relationships among biological growth parameters for body weight in Japanese
      children.
AB  - Longitudinal weight records for 360 boys and 345 girls from birth to young
      adulthood are used. The Count-Gompertz growth curve is fitted to individual
      growth records in order to characterize individual body weight growth. The
      authors present the mean-constant growth curves of boys and girls divided by
      weight at the peak weight velocity for boys and girls, and also girls are
      subdivided by their weight at menarche. Adult weight has no simple relationship
      with the timing of adolescence and menarcheal age. Adult weight is, nevertheless,
      negatively correlated with the timing of adolescence (or menarcheal age) when
      weight at the timing of adolescence (or menarcheal weight) and/or age at growth
      completion are held constant. Age at growth completion also negatively correlated
      with weight at menarche when adult weight and menarcheal age are held constant.
      Even if it is difficult to find a simple biological relationship among these
      parameters, for researchers looking for relationships and structures among
      biological parameters, this partial correlation may be useful. A contra-pair of
      biological parameters, age and weight, at two growth epochs of weight is
      introduced, and its properties are discussed in detail.

PMID- 11192745
TI  - Role of tirofiban in the medical treatment of the intermediate-risk patient with
      an acute coronary syndrome cannot be denied.

PMID- 11192746
TI  - Estimating the prevalence of aspirin use in the prevention of myocardial
      infarction.

PMID- 11192747
TI  - Low-dose dobutamine imagings predicting regional improvement in left ventricular
      function after revascularization.

PMID- 11192748
TI  - [Antioxidative properties of ascorbic acid].
AB  - Vitamin C (ascorbic acid) is an important hydrophilic compound with antioxidative
      effect. In the introduction the authors describe possible consequences of loss of
      vitamin C synthetic ability in an evolutionary ancestor of Anthropoidea.
      Metabolism of this vitamin is described briefly along with possibilities of its
      supplementation and determination in biological fluids. Highest attention is paid
      to metabolic effects of vitamin C, respectively to changes which can be observed
      after its deprivation, or after the supplementation with this vitamin. Protective
      effect of vitamin C against lipoperoxidation, its role in modulation of immunity
      and tumorigenesis are described. Many effects of vitamin C can be explained by
      its antioxidative activity. The authors show that under concrete conditions,
      administration of vitamin C can be accompanied by a prooxidative effect. Since
      vitamin C works in cooperation with other antioxidants, its administration in
      diseases which are followed by oxidative stress is move effective when used in
      combined preparations.

PMID- 11192749
TI  - [Atypical eating disorders, a diagnostic and therapeutic problem?
AB  - Paper deals with problems of atypical forms of food intake disorder. Such
      disorders can be divided into three groups. First group included sub-clinical
      forms of food intake disorders. Patients with signs of thinning are included into
      the second group; however, their active role in slimming cannot be identified. In
      the third group the accompanying syndromes prevail, e.g. the syndrome of
      depression and obsessive-compulsive syndrome. Problems in the diagnostics and
      therapy of those atypical forms are discussed.

PMID- 11192750
TI  - [Resistance of hematologic neoplasm cells to cytostatics. Part II].
AB  - Resistance to cytotoxic drugs is a serious drawback in the treatment of patients
      with tumours, both of the haemopoietic and non-haemopoietic origin. The cytotoxic
      effect of drugs on the malignant cells manifests as the process of apoptosis. In
      the resistant malignant cells, apoptosis becomes prevented by several mechanisms.
      The multidrug resistance (MDR) is one of the principal mechanisms when the cancer
      cells develop resistance to multiple chemically and functionally unrelated
      cytotoxic compounds. The decrease of the cytotoxic drug concentration at the
      molecular target site may come from activation of some efflux membrane systems
      participating in the transport of cytotoxic drugs out of the cell (e.g. Pgp, MDR,
      and LRP). Another mechanism of resistance is the increased enzymatic
      detoxification of the drug by glutathion-s-transferase system. Changes in the
      molecular target of the cytotoxic drug such as topoisomerase molecule can be also
      responsible for the resistance. At least two additional mechanisms of resistance
      of tumour cells were identified. Resistance can come from either deregulation of
      proapoptotic mechanisms in tumour cells or by increased activity of reparation
      processes which control the damaged molecule of DNA. Several methods that detect
      the cause of resistance in distinct cell populations have been developed. The
      great effort is now focused on both the detection of mechanisms of the resistance
      and on the clinical procedures of overcoming the resistance to cytotoxic drugs.

PMID- 11192751
TI  - [Molecular basis of hereditary antithrombin defects in 10 Czech families].
AB  - BACKGROUND: Molecular basis of antithrombin deficiency has not yet been studied
      in Czech Republic. We looked for the causal mutations throughout the antithrombin
      gene in 26 patients from 10 unrelated families with antithrombin defect. METHODS
      AND RESULTS: We screened the gene by conformation sensitive gel electrophoresis
      and sequenced the mismatched regions using fluorescence technology to
      characterise mutations and polymorphisms. Mutations were detected in all ten
      families. Four novel mutations were identified in four families with type I
      antithrombin defect: Trp-6Arg, 5386-5387delCT, Glu163Stop, and 13246-13248del TGA
      causing deletion of Glu377 with change of Asn376 to Lys. In other three type I
      families we found following mutations: splicing site mutation G2777C, Arg197Stop
      and entire gene deletion. In the family carrying Trp-6Arg mutation antithrombin
      Vienna (Gln118Pro) was also detected. Leu99Phe recurrent in south-eastern Europe
      was identified in three families with type II defect. Only the homozygous carries
      of the mutation were symptomatic, although the heterozygous carries had decreased
      functional levels. CONCLUSIONS: Four novel mutations in families with type I
      antithrombin deficiency were characterised. In one family two different genetic
      defects were identified to be responsible for type I and II phenotypes.
      Altogether our data agree with the expected heterogeneity of the AT genetic
      defect.

PMID- 11192752
TI  - [Autoantibodies to GAD65, IA2 and insulin in Czech children with type 1
      diabetes].
AB  - BACKGROUND: Autoimmune insulitis leading to insulin dependent diabetes mellitus
      (IDDM, Type 1 Diabetes) is accompanied by autoantibodies as its invaluable
      markers. The aim of the study was to determine the frequency of autoantibodies
      against GAD65, IA2 and insulin in Czech diabetic children at the disease onset.
      METHODS AND RESULTS: Sera of 105 newly diagnosed children with IDDM drawn within
      24 hours after the first insulin dose were investigated for anti-GAD65, anti-IA2
      and insulin autoantibodies (IAA) using RIA methods. The cut-off normal levels
      were determined as the 99th percentile of 105 non-diabetic children. At given 99%
      specificity, the sensitivity was 71% for anti-GAD65, 73% for anti-IA2, and 46%
      for IAA. 29% diabetic children were positive for all three autoantibodies, 25%
      had anti-GAD65 and anti-IA2 (IAA negative), 5.7% anti-GAD65 and IAA (anti-IA2
      negative), 7.6% anti-IA2 and IAA (anti-GAD65 negative). As the only positive
      autoantibody, anti-GAD65 was found in 12%, anti-IA2 in 11%, and IAA in 3.8%
      children. In 5.7% children, none of the investigated autoantibodies was positive.
      Diabetic children diagnosed before the age of 5 years had significantly higher
      prevalence of IAA than the older ones. CONCLUSIONS: We have determined normal
      levels in healthy children, and prevalence at childhood IDDM onset of
      autoantibodies against three main molecular-defined autoantigens.

PMID- 11192753
TI  - [Dynamic liver function study using the lidocaine test].
AB  - Lidocaine clearance test may reflect the integrity of various oxidative pathways
      of hepatocytes. Lidocaine is a highly sensitive indicator of hepatic dysfunction.
      This test is applicable to assessment of stage and prognosis of the liver
      disease, to timing of the liver transplantation, and to assessment of the
      pretransplant prognosis in the end-stage of chronic liver disease. Formation of
      the major lidocaine metabolite monoethylglycinexylidide (MRGX) depends on the
      hepatic cytochrome P-450 activity and on the liver blood flow.

PMID- 11192754
TI  - [Discussion of the article by T. Haas "Ethics and statistics--difficult
      approaches to data"].

PMID- 11192755
TI  - [60 years' of antibiotics--resistance: a time bomb for the third millenium].
AB  - More then 50 years of antibiotic era has brought to clinical use many antibiotics
      with, specific and also with broad spectrum activity. Excessive use of
      antibiotics brought and brings serious problems--the resistance of many important
      bacteria and so the loss of effectivity of these scarce substances. Significant
      negative role in this process has the transferability of the resistance genes
      between bacteria. Bacterial strains are able to accept block of genes for
      multiresistance, exchange them inter species and spread to susceptible ones.
      There is an important task for the 3rd millennium to reduce the prevalence of the
      antibiotic resistance. Changes of the empiric treatment regiments (reduction in
      antibiotic use, antibiotic rotation, infection control, monitoring of resistance)
      and the strict hospital hygiene could help to solve the problems of antibiotic
      resistance in the future.

PMID- 11192756
TI  - [Resistance to cytostatics in hematologic neoplasm cells. Part III].
AB  - Resistance to cytotoxic drugs is a serious drawback in the treatment of patient
      with tumours, both of the haemopoietic and non-haemopoietic origin. The cytotoxic
      effect of drugs on the malignant cells manifests as the process of apoptosis. In
      the resistant malignant cells, apoptosis becomes prevented by several mechanisms.
      The multidrug resistance (MDR) is one of the principal mechanisms when the cancer
      cells develop resistance to multiple chemically and functionally unrelated
      cytotoxic compounds. The decrease of the cytotoxic drug concentration at the
      molecular target site may come from activation of some efflux membrane systems
      participating in the transport of cytotoxic drugs out of the cell (e.g. Pgp, MDR,
      and LRP). Another mechanism of resistance is the increased enzymatic
      detoxification of the drug by glutathion-S-transferase system. Changes in the
      molecular target of the cytotoxic drug such as topoisomerase molecule can be also
      responsible for the resistance. At least two additional mechanisms of resistance
      of tumour cells were identified. Resistance can come from either deregulation of
      proapoptotic mechanisms in tumour cells or by increased activity of reparation
      processes which control the damaged molecule of DNA. Several methods that detect
      the cause of resistance in distinct cell populations have been developed. The
      great effort is now focused on both the detection of mechanisms of the resistance
      and on the clinical procedures of overcoming the resistance to cytotoxic drugs.

PMID- 11192757
TI  - [High-dose chemotherapy in the treatment of children with malignant lymphoma].
AB  - BACKGROUND: Children with primary refractory or recurrent malignant lymphoma have
      usually poor prognosis. Less than 10% of those, who were treated with
      conventional-dose regimens had survived for 2 years. In an attempt to improve the
      outcome for these patients, we explored the role of consolidation high-dose
      chemotherapy with autografting. METHODS AND RESULTS: Forty-five patients with
      poor-prognosis lymphoma, of whom 27 were males, underwent megatherapy between
      January 1992 and December 1999. High-dose chemotherapy was indicated in patients
      with poor initial response to first-line chemotherapy (14 cases) or in the
      relapse (31 cases). The group consisted of 27 patients with Hodgkin's disease and
      18 patients with non-Hodgkin's lymphoma. The median age was 14.7 years. The
      conditioning for Hodgkin's disease patients contained cyclophosphamide, etoposide
      and busulfan or carmustine. Patients with non-Hodgkin's lymphomas received
      cyclophosphamide, etoposide and busulfan or total body irradiation. Bone marrow
      was used as the source of haemopoietic stem cells in ten patients, peripheral
      blood in twenty-eight, and both sources were used in seven patients. After the
      median follow-up of 47 months, the final survival was 61%. Eleven patients died
      of the disease progression, four of the infectious complications, one at a car
      accident. Median time to relapse after the transplantation was 7.5 months.
      CONCLUSIONS: Further improvement of these results will require earlier
      transplantation, improved preparative regiments or early posttransplant
      immunotherapy.

PMID- 11192758
TI  - [Determination of soluble HLA class I molecules in children in bone marrow
      transplantation].
AB  - BACKGROUND: sHLA molecules are the soluble forms of their membrane bound
      counterparts. sHLA class I. were recently reported to be a useful marker in the
      prediction of graft versus host reaction (GVHR) in adults. To confirm these
      presumptions in children we measured sHLA class I. serum levels in children after
      allogeneic bone marrow transplantation (BMT). We also investigated the levels of
      sHLA in the supernatants of mixed lymphocyte cultures (MLC) as possible
      predictors of GVHR prior to BMT. METHODS AND RESULTS: Group of 6 investigated
      children included 1 child with severe combined immunodeficiency, 3 children with
      acute lymphoblastic leukemia, 1 with severe combined immunodeficiency, 3 children
      with acute lymphoblastic leukemia, 1 with severe aplastic anemia and 1 with non
      Hodgkin lymphoma. The period of follow up varied from 15 days to 21 months
      according to the course of the disease. In the prediction of GVHR the levels of
      sHLA were measured in 5 children with acute leukemia in supernatants of MLC and
      the results were compared with the grade of GVHR classified according Seattle
      criteria. Soluble HLA class I. molecules were evaluated by ELISA. Rise of the
      levels of sHLA preceded 1-2 days the clinical signs of GVHR, however, it could
      not be distinguished from the occasional rise of a different cause. The levels of
      sHLA found in the supernatants of MLC showed individual results, which did not
      correspond to the level of cytokines in the same culture, or to the grade of GVHR
      observed. However, twice higher levels of sHLA in the culture of donor
      lymphocytes correlated with the lethal outcome of GVHR despite the fact that the
      donors were HLA identical siblings. CONCLUSIONS: The usefulness of sHLA levels as
      the predictors of GVHR has to be interpreted with great caution, but they can be
      used as a part of the mosaic composed of the clinical image and other laboratory
      results indicating GVHR. The predictive value of sHLA in supernatants of MLC is
      still to be evaluated.

PMID- 11192759
TI  - A high occurrence of BRCA1 and BRCA2 mutations among Czech hereditary breast and
      breast-ovarian cancer families.
AB  - BACKGROUND: About 5-10% of breast and ovarian cancer can be of hereditary origin.
      Germline mutations in BRCA1 or BRCA2 and probably other yet unknown genes may
      cause predisposition to these cancers. METHODS AND RESULTS: Molecular genetic
      testing of BRCA1 and BRCA2 genes in 21 high-risk breast and breast/ovarian cancer
      families was performed in order to find the types and the frequency of mutations
      in the South Moravian region of the Czech Republic. A germline mutation was found
      in 12 of 21 tested families (57%), 9 mutations in BRCA1 gene and 3 mutations in
      BRCA2 gene. In 4 unrelated families the same germline mutation in the BRCA1 gene
      (5382insC) was identified. In 12 families diagnosed with breast cancer only
      syndrome 3 families harbouring BRCA1 mutations and 3 families harbouring BRCA2
      mutations were found. In 9 families with breast-ovarian cancer syndrome 6
      families carrying BRCA1 mutations were detected. CONCLUSION: Molecular genetic
      testing of BRCA1 and BRCA2 genes in high-risk women with breast/ovarian cancer is
      effective in determining genetic predisposition to cancer. Spectrum of mutations
      found in both genes is variable and further investigation is needed for
      estimation of more frequent or "founder" mutations. The genetic counselling and
      preventive clinical follow-up of gene carriers has to be part of the genetic
      program.

PMID- 11192760
TI  - [Disorders of urinary acidification in patients with monoclonal gammapathies].
AB  - BACKGROUND: In patients with monoclonal gammapathy (MG), renal impairment becomes
      the frequent complication. At the same time, its exact pathogenetic mechanism
      remains to be identified. We tried to detect urinary acidification defect that
      may become the first sign of the kidney parenchymal injury. The goal of our work
      was to estimate the incidence of the acidification impairment, the contribution
      of proximal and distal types of renal tubular acidosis and the dependency of the
      defect on the type of light chain paraprotein. METHODS AND RESULTS: In the group
      of 21 patients aged 38 to 82 years (14 females and 7 males) with monoclonal
      gammapathy accompanied with creatinemia lower than 180 micromol/l, the short
      acidification test was performed (calcium chloride was administrated and the
      urinary acidity was monitored). Renal tubular acidosis was diagnosed in those
      patients whose urinary acidity after the CaCl2 administration did not reach pH
      5.25 or less. The control group consisted of 19 volunteers (6 males and 13
      females) with normal renal functions. Results of the tests in MG patients and in
      control persons were compared using the unpaired Student's t-test. In 11 patients
      (52.4%) the urinary acidification defect of the incomplete type was detected.
      Eight of these patients (38.1%) had the distal and three (14.3%) had the proximal
      type of impairment. Eight patients with the acidification defect had the
      paraproteinuria kappa and four of them had that of lambda type. In persons
      without the acidification impairment kappa chains were found in 5 persons, lambda
      chains in 4 of them. CONCLUSIONS: In our group of MG patients acidification
      defect occurred in more than half of them. Contrary to the assumed higher
      nephrotoxicity of the lambda chains, the disturbance was more frequently found in
      patients with paraproteinemia of the kappa type.

PMID- 11192761
TI  - [Biochips].
AB  - A new revolution technology that may become promising for research, diagnostics
      and therapy enters into biology and medicine. The basic idea of the biochip
      technology is to convert the chemistry of life into a static form programmed to
      monitor genes, proteins and relations between them. Biochip programmed by known
      sequences of DNA/RNA or proteins can recognized the real genes, mutations, levels
      of expression,... Biochip technology is highly effective method that allows
      monitoring of thousands of genes/alleles at a time in computerized automatic
      operations with minimal volumes of necessary reagents. Biochips promise an
      important shift in molecular biology, DNA diagnostics, pharmacology, research in
      carcinogenesis and other diseases and also the possibility of a better
      understanding of the world of biology in its globality.

PMID- 11192762
TI  - [The compartment syndrome--still a threat in traumatology].
AB  - Paper presents current opinions on the definition, causes, classification,
      diagnosis and treatment of the compartment syndrome (CS). The development of CS
      after the long-bone fractures of the lower extremity and also after the limb
      operations or trauma without fracture is discussed. The importance of early and
      correct diagnostics and treatment is also revealed. Authors present several case
      reports and they stress the importance of early fasciotomy when necessary.

PMID- 11192763
TI  - [Gene expression in white blood cells in chronic myeloid leukemia].
AB  - BACKGROUND: The new technologies that have the DNA laboratory over recent years
      and the general progress in knowledge of the human genome, have allowed the
      simultaneous observation of the activity of a large number of genes. Chronic
      myeloid leukemia is characterized with abnormal tyrosine kinase activity of the
      fused bcr/abl gene, which is most often product of translocation between
      chromosomes 9 an 22. It is as yet unknown whether this is the only and sufficient
      cause of the disease, or whether other supporting and co-active abnormalities
      exist. It is also not yet clear whether an increase of proliferating activity or
      reduced programmed cell death plays the dominant role. The aim of this study was
      to make further steps in resolving the question as to which of these hypotheses
      fits better. METHODS AND RESULTS: Membrane macroarrays (Clontech 7742-1: Human
      Cancer cDNA Expression Array with 588 gene probes) were used throughout the
      study, on which cDNA reverse-transcribed from total RNA in turn isolated from
      peripheral white blood cells and labelled with 32P was hybridized. Cells obtained
      from 5 patients with confirmed diagnoses by cytogenetic and molecular (bcr/abl)
      analyses, but who had not yet been treated by chemotherapy, were the source of
      the material. In some cases mononuclears and granulocytes were also isolated by
      Ficoll-Paque centrifugation. Radioactivity was detected by autoradiography or by
      a Phosphorimager (Fujifilm FLA-2000). Comparison with normal gene expression
      (healthy donor) was made by subtraction using Clontech AtlaImage 1.5 software.
      Although changes of expression of identical genes were not observed in all of
      patients examined, the majority of them were concordant. Values at least double
      those of the controls applied to the activity of c-jun N-terminal kinase, MMP-8,
      MMP-9, integrin alpha E, integrin beta and PDGF, whereas the expression of ZAP
      70, IRF1, MCL-1, STAT 5B, RARA, CDC25B, RPSA, TNFR decreased. Increases of PCNA,
      MMP-17, CD59, rho G, CRAF1 and PIG7 or decreases of notch, caspase 8, caspase 4,
      interleukin 6 receptor, rho B and TIMP1 were observed only in some cell samples.
      CONCLUSIONS: It seems that some maturation processes and transmembrane signalling
      are blocked, as well as the effectors of apoptosis. On the other hand, the
      reduced activity of ZAP-70, IRF1 and MCL-1 also indicated that proliferation
      breaks were weakened. The involvement of both processes-released replication and
      ineffective apoptosis--was evident; the problem of bcr/abl gene fusion being the
      necessary first and sufficient step on the way towards developing chronic myeloid
      leukemia, however, remained unresolved.

PMID- 11192764
TI  - [Serum leptin levels and soluble leptin receptors in female patients with
      anorexia nervosa].
AB  - BACKGROUND: Leptin action in peripheral tissues is enabled by an interaction with
      specific transmembrane receptors. Several of leptin receptor isoforms were
      identified, including soluble leptin receptor isoform structurally identical to
      extracellular domain of the the long leptin receptor isoform. The soluble
      receptor isoform is released to the circulation and acts probably as leptin
      binding factor. The aim of our study was to measure serum concentrations of the
      soluble leptin receptor in patients with anorexia nervosa and in the control
      group of healthy women. Relationships of soluble leptin receptor levels to body
      mass index (BMI), body fat content, serum leptin, TNF-alpha and insulin levels
      were also studied. METHOD AND RESULTS: 16 patients with anorexia nervosa and 16
      age-matched lean healthy women were included into the study. All of the subjects
      were measured and weighed, the body fat content was estimated from the skinfold
      thickness measurement. The blood for the determination of leptin, soluble leptin
      receptor and other hormonal parameters was obtained from all subjects after the
      overnight fasting. BMI, body fat content, serum leptin and insulin levels in
      patients with anorexia nervosa were significantly lower than in the control group
      (BMI: 14.98 +/- 2.32 vs. 22.21 +/- 2.48, p < 0.01, % fat content: 16.43 +/- 4.56
      vs. 27.19 +/- 4.59, p < 0.01, leptin: 1.37 +/- 1.85 ng.ml-1 vs. 7.19 +/- 3.49
      ng.ml-1, p < 0.01, insulin: 12.97 +/- 2.89 mU.l-1 vs. 17.09 +/- 5.57 mU.l-1, p <
      0.05). Serum soluble leptin receptor levels in patients with anorexia nervosa
      were significantly higher compared the to control group (24.67 +/- 8.3 U.ml-1 vs.
      15.71 +/- 2.79 U.ml-1, p < 0.01). No significant differences in serum TNF-alpha
      levels between the groups studied were found. Serum leptin levels in both groups
      correlated positively with BMI and body fat content. Serum soluble leptin
      receptor levels in both groups correlated negatively with BMI only. No
      statistically significant relationships between serum soluble leptin receptor
      levels and the rest of parameters studied were found in any of the groups
      studied. CONCLUSIONS: Serum soluble leptin receptors levels in patients with
      anorexia nervosa were significantly higher in comparison with the healthy
      subjects. Except of the negative correlation between serum soluble leptin
      receptor levels and BMI no statistically significant relationships between serum
      soluble leptin receptor and the rest of parameters studied were found.

PMID- 11192765
TI  - [Determination of biological age--a group of biophysical tests].
AB  - BACKGROUND: Biological age is defined as real state of organism with respect to
      the processes of aging. From the gerontological point of view, the methodology of
      determination of biological age is a tool for verification of theories. The role
      of biological age determination in medicine is wide. It consists, among others in
      the assessment of the efficiency of anti-aging interventions or in detection of
      premature aging. Many different batteries of methods for the measurement of
      biological age were developed till now. The currently applied methods are not
      standardized and they are, as a rule, significantly time-consuming. METHODS AND
      RESULTS: The goal of the work was to develop a routine method for biological age
      determination. Simplicity and reproducibility of measurements was stressed. The
      result of our work is a set of 7 biophysical methods. Some of the methods are
      newly developed (measurement of rheological properties of the skin), others are
      modified classical methods (measurement of accommodation of eye, perception of
      high frequencies of sound, reaction times). CONCLUSIONS: The battery of
      biophysical test for the routine biological age assessment was developed in our
      laboratory. The information is processed by computer, using multiple linear
      regression analysis for obtaining the best assessment of personal biological age.
      The duration of measurement is roughly 120 min.

PMID- 11192766
TI  - [Carbohydrate-deficient transferrin. Methods of determination and clinical
      significance in the detection of alcohol abuse].
AB  - Last decade witnessed the increasing use of serum levels of carbohydrate
      deficient transferrin (CDT) as a highly specific and sensitive marker of chronic
      alcoholism. This paper deals with the explanation of the physiological principle
      of the test and the development of laboratory techniques of CDT measurement. The
      evaluation of the state-of-art of CDT tests is based on published data as well as
      on the practical experience of the author with three commercial diagnostic kits.
      The second part of the review article draws attention to some still open
      questions of how to harmonize the different methodologies used. The use of the
      CDT measurement in various clinical settings, the specificity and sensitivity of
      CDT in different population samples and/or in comparison with already established
      markers such as GGT is discussed.

PMID- 11192767
TI  - [Bladder dysfunction is often a cause of therapy resistant enuresis. The
      condition should be removed from the group of psychiatric diagnoses].

PMID- 11192768
TI  - [Oculoplastic surgery implies restoration to "normalcy". Cosmetic surgery is
      performed only for congenital malformations or disease].
AB  - Ophthalmic plastic or oculoplastic surgery is the current term for the surgical
      treatment of disorders of the eyelid, the lacrimal apparatus and the orbit. The
      most frequent causes are congenital malformations, malpositions, abnormal
      motility, tumors and injuries. A good functional result with the best possible
      appearance is the goal; cosmetic surgery is performed only when the underlying
      cause is a malformation or disease. Several specialties have qualifications
      relevant to this field or parts of it; this article describes the tasks of an
      ophthalmologist working in this field and what he can accomplish.

PMID- 11192769
TI  - [Use the entire "analysis package" when investigating patients with venous
      thrombosis! Don't forget the relatives...].
AB  - During the last few years several genetic markers have been discovered that
      contribute to an increased risk of venous thrombosis. Patients who have several
      genetic markers are at a considerably higher risk of being affected than patients
      with only one marker. Recommendations are made as to which patients should be
      investigated, with appropriate laboratory analyses, when an increased risk of
      venous thrombosis is suspected. Most of the analyses can be done even if the
      patient is undergoing warfarin treatment.

PMID- 11192770
TI  - [Drugs or enuresis alarm can help more children stay dry at night. To wet oneself
      is distressing and taxing for self-confidence].
AB  - Monosymptomatic primary nocturnal enuresis (PNE) is commonly treated with
      desmopressin (Minirin), resulting in dry nights for approximately 70-85 percent
      of affected children. However, nocturnal enuresis is sometimes accompanied by
      signs of bladder dysfunction. A history of urgency, frequency, daytime wetting or
      urinary tract infection may indicate the presence of a hyperactive, unstable
      bladder. In these cases, desmopressin in combination with an anticholinergic drug
      (i.e. oxybutynin; Ditropan) given at bedtime, or desmopressin and a bed alarm,
      will increase the number of patients with dry nights. This therapy can now be
      offered not only by pediatricians but also by general practitioners.

PMID- 11192771
TI  - [Multiple pregnancy is the most known risk of fertilization in vitro. Review of
      the relevant literature].

PMID- 11192772
TI  - [Varices and venous insufficiency--therapeutic philosophy prior the 2000's].
AB  - Varicose veins represent everything from a cosmetic problem to a risk of venous
      leg ulcers. Predicting the risk of complications has been difficult, not least
      due to less than satisfactory diagnostic procedures. Recent investigations have
      pointed out some important new concepts: Superficial venous incompetence may give
      rise to an ulcer, and such an ulcer may be prevented by varicose vein surgery.
      Recanalization and stenting may be useful in treating chronic iliac and caval
      venous occlusions; however, long-term outcome is yet to be established. Venous
      diameter can be reduced, thus effecting valve competence. To what extent this
      result is long-lasting is not known. Neither has the method been attempted on
      deep veins. Clinical diagnosis is never sufficient in cases of suspected chronic
      venous incompetence. The minimum requirement is the use of a hand-held Doppler.
      Frequently, a more detailed ultrasonographic analysis is required, and for a
      global assessment of venous function, plethysmographic techniques are useful.
      Primary health care may contribute effectively to the care of venous leg ulcers.

PMID- 11192773
TI  - [Feministic research means that all research is political].
AB  - The article is a review of different trends and epistemologies in women's
      studies/feminist research within the field of medicine. In the beginning of the
      1980s, women's studies entered the field of medicine in the Nordic countries.
      They are now a part of the feminist research that has been established within
      most sciences both nationally and internationally. The gender power relation and
      its impact on health--first of all women's, but in extension also men's--has been
      in focus. Moreover, science itself, its limits and possibilities, and the kind of
      knowledge it produces, is discussed. In this respect, feminist theory of science
      is a useful tool.

PMID- 11192774
TI  - [Artificial respiration at home seen in a 5-year perspective. Established
      treatment, but remarkable differences among the counties].
AB  - The Swedish prevalence of home mechanical ventilation is 8.2 per 100.000 with 10%
      annual increase. There is a large span (20 vs 2 per 100.000) between "top level"
      and "low level" counties, in spite of Sweden's homogeneous publicly financed
      system for provision of health care. The largest prevalence difference was found
      in patients with obstructive sleep apnoea syndrome (Pickwickian type), but their
      blood gas and lung function data were identical in top-level vs low-level
      counties. These data refute the hypothesis of overprescription in top-level
      counties. We conclude that the most probable explanation is under-recognition of
      patients in low-level counties.

PMID- 11192775
TI  - [Computer tomography or hospital monitoring in brain concussion? Current
      conclusions in a new SBU-report].

PMID- 11192777
TI  - [Literature can help to train the empathic ability].

PMID- 11192776
TI  - [Will genetics make a revolution in health care? Skepticism concerning the
      exaggerated expectations].

PMID- 11192778
TI  - [Forensic psychiatry and criminal politics--ethics must be discussed prior to the
      introduction of a new system].

PMID- 11192779
TI  - [A final reply on cervix cancer screening: nobody is disputing its effects,
      but... ].

PMID- 11192780
TI  - [Revise the control of communicable diseases in connection with immigration to
      Sweden!].

PMID- 11192781
TI  - [Sleep apnea--who is actually taking care of this syndrome?].

PMID- 11192782
TI  - [Successful treatment of vocal cord paralysis].

PMID- 11192783
TI  - [Is the concept of general practitioner an insult?].

PMID- 11192784
TI  - [Vitamin B12--good, better, best! ].

PMID- 11192785
TI  - [On Swedish front line research].

PMID- 11192786
TI  - [300 videothoracoscopy procedures--personal experience].
AB  - Videothoracoscopy and video-assisted thoracic surgery are by now already standard
      therapeutic procedures in thoracic surgery. The authors submit their experience
      with the method after 300 thoracoscopic operation at the surgical clinic of the
      Faculty Hospital in Plzen from the end of 1993 to the beginning of 2000. The main
      indications for this mini-invasive procedure is the treatment of spontaneous
      pneumothorax, diagnostic biopsy in pulmonary dissemination of obscure etiology,
      diagnosis and treatment of pleural exudates and elimination of minor peripheral
      pulmonary lesions. The authors discuss different surgical procedures in the most
      frequent diagnoses, their advantages and risks, indication criteria,
      complications. Attention is also paid to the causes of 10% conversions. In case
      of treatment of a spontaneous pneumothorax the authors consider videothoracoscopy
      as the method of first choice, while in case of primary carcinoma of the lungs
      they recommend the classical procedure. Other possibilities for the wider
      application of thoracoscopy and its development in their own department include
      in particular traumatic thoracic surgery.

PMID- 11192787
TI  - [Assessment of metastatic potential of pulmonary carcinoma].
AB  - The authors evaluated in a group of 25 patients after radical lung resection on
      account of a non-small cell carcinoma the correlation between tumour grading,
      invasion into lymphatic and blood vessels, proliferation markers (Ki-67, PCNA),
      ploidy, cell polymorphism and mitotic cell activity of the lung tumour and the
      lymphogenic or haematogenic metastatizing proved before or during surgery. From
      the investigation patients after induction chemotherapy were eliminated. It was
      of interest that the great majority of investigated parameters was positive or
      elevated in patients with lymphogenic or haematogenic metastases. Conversely in
      patients where the majority of these parameters was negative on the day of the
      operation, no metastases were detected. In the group of patients where the
      investigated indicators were positive and no metastasis was found, similarly as
      in both previous sub-groups, the author will continue to follow-up the following:
      recurrence, median survival and five-year survival. From the assembled parameters
      a table was prepared stratifying the risk of metastases.

PMID- 11192788
TI  - [Transmyocardial laser revascularization of the myocardium and coronary
      reconstruction without extracorporeal circulation].
AB  - The authors report their experience with myocardial revacularization using
      transmyocardial laser revascularization combined with aortocoronary
      reconstruction without the use of extracorporeal circulation. The discussion
      section addresses indications for the procedure, operative tactics, the benefits
      and limitations of the above technique.

PMID- 11192789
TI  - [Simultaneous occurrence of acute myasthenia gravis and acute polymyositis in 3
      patients and in 2 patients also associated with a thymoma].
AB  - In the Slovak Centre for Neuromuscular Diseases 768 patients with myasthenia
      gravis are on the records. 112 myasthenics (14.5%) have another associated
      autoimmune disease. Most frequently a combination with an autoimmune disease of
      the thyroid gland or rheumatoid arthritis is involved. Extremely rare is the
      concurrent manifestation of the acute form of mysthenia gravis and acute
      polymyositis, observed by the authors in three patients,incl. two associated with
      a thymoma. In all three patients the disease had a serious clinical picture which
      called for controlled ventilation and a nasogastric tube. From the prognostic
      aspect rapid and correct diagnosis and early adequate treatment--combined
      immunosuppressive treatment (prednisone, azathioprin) is most important, incl.
      large i.v. doses of methylprednisone, repeated plasmaphereses, i.v.
      administration of human immunoglobulin, 0.4 g/kg body weight for a period of five
      days and optimally timed thymectomy with removal of the thymoma.

PMID- 11192790
TI  - [Extensive defect in the inguinal region and damaged femoral arteries. Single
      stage reconstruction of the arterial supply and skin coverage. Case Report].
AB  - The authors present an account on a patient with extensive damage of the tissue
      in the area of the right groin with complete severing of the artery and vein.
      After control of the infections they reconstructed the arterial supply and skin
      cover in one stage. They used a PTFE prosthesis with an extraanatomical
      localization and a muculocutaneous flap formed from the musculus rectus abdominis
      on a caudal stalk.

PMID- 11192791
TI  - [The harmonic scalpel in thyroid surgery].

PMID- 11192792
TI  - [Kidney transplantation from living donors].
AB  - From Jan. 1, 1994 till August 31, 1999 in the Transplantation Centre of the F. D.
      Roosevelt Hospital and Policlinic 202 transplantations of the kidneys were made,
      incl. 11 from live donors. The survival of patients and renal grafts in our group
      is 100%, i.e. all transplanted kidneys are so far functional. In transplantations
      of kidneys from dead donors the one-year survival of grafts was 85% and the 5
      year survival only 70%. During removal of kidneys from live donors we had only
      one minor complication--a surface infection of the surgical wound. The authors
      describe their own experience with assessing the indication criteria, criteria
      for selection of the most suitable donor-recipient pair. Consistently with work
      of authors from abroad, they consider transplantations of the kidneys from live
      donors as one of the best alternatives how to increase the number and quality of
      renal transplantations and to prevent thus an increase of the number of patients
      on the waiting list.

PMID- 11192793
TI  - [The current method of staging gastrointestinal (GIT) tumors].
AB  - The authors analyzed in a retrospective study the stage of carcinomas of the
      stomach and colorectum in their material. In 1996-1998 they operated 35 patients
      with gastric tumours and 77 patients with colorectal cancer. In both groups they
      operated more than 50% of the patients in the IIIrd or more advanced stage of the
      disease. 22.8% gastric tumours and 19.5% colorectal tumours were operated in the
      acute stage. The situation in the group is alarming, it is essential to improve
      the early diagnosis and thus also treatment in all links of the chain: patient-
      attending physician--surgeon--society.

PMID- 11192794
TI  - [Methods of surgical treatment of necrotizing pancreatitis].
AB  - The authors present a group of 49 patients operated on account of acute
      necrotizing pancreattis in 1990-1999. They describe the indications and methods
      of treatment. The principle of treatment was careful necrosectomy with an
      additional procedure which involved rinsing and drainage of the omental bursa,
      laparostomy ("open packing") or a combination of both methods. They re-operated
      20 patients where they performed a total of 57 re-operations. Fifteen patients
      died (30.6%) which according to the literature corresponds to the mortality
      quoted in this group of the most severely affected patients.

PMID- 11192795
TI  - [Radical treatment of rectal cancer].
AB  - The authors present an account on radical resections of the rectum in 73 patients
      during 1991-1995. A radical operation with excision of the mesorectum was
      performed 69 times, local excisions 4 times. Five-year survival was recorded in
      57.90% patients, local relapses were recorded in 10.14% patients. Remote
      metastases or generalization of the disease was found in 18.84% patients.
      Adjuvant treatment was administered to 74% patients.

PMID- 11192796
TI  - [Compression therapy of leg ulcers].
AB  - The authors present a group of 76 patients with chronic venous insufficiency in
      the stage or crural ulceration. After staging of the disease (C 6, E prim, E sec,
      A sup. pr. ref., P re) in the first stage they used a conservative approach, the
      method of compressive bandages: either an elastic bandage or zinc-glue bandage
      (Varolast). 49 patients were cured by conservative treatment (64.5%) in the
      course of 5 months. 12 patients were indicated for surgery (15.8%). Thus the
      authors cured finally 80.2% patients. A relapse was recorded in 6 patients (7.8%)
      and in 9 patients treatment failed (11.8%). For treatment with zinc-glue bandages
      they recommend patients without obstruction in the deep venous system, with large
      chronic ulcers and associated oedema of the whole leg.

PMID- 11192797
TI  - [Prevention and therapy of dehiscent laparotomy wounds].
AB  - Dehiscence of laparotomic wounds is always unpleasant, starting with the
      resentment of the patient and the lack of confidence leading as far as complete
      negation of a favourable result of the operation. Due to lack of more suitable
      materials we elaborated ten years ago our own technique which we use nowadays for
      treatment but in particular for prevention. We feel that it could be a certain
      asset because it is simple and financially feasible.

PMID- 11192798
TI  - [Treatment of ingrown toenails].
AB  - Surgery of ingrowing toe nails are one of the most frequent operations in
      ambulatory practice. It is well known that a minor operation which relieves the
      patient of his complaints is appreciated more than the most complicated
      operation. Based on the article of Dr. Krticka we wish to present our own
      modification of an operation called Klapp's operation. We found that the results
      when using a modified vertical U stitch are better than when the classical
      technique is applied.

PMID- 11192799
TI  - [Alexithymia and depression in eating disorders].
AB  - Patients suffering from eating disorder show elevated rates of alexithymia and
      depression. We compared alexithymia and depression ratings for non-hospitalized
      women meeting DSM IV criteria for anorexia nervosa (n = 32) and bulimia nervosa
      (n = 32) to healthy women (n = 74). Alexithymia was evaluated by the Toronto
      Alexithymia Scale (TAS-20) and depression by the Hospital Anxiety and Depression
      Scale (HAD). We found that TAS and HAD scores were significantly higher in
      anorexic compared to bulimic patients, although alexithymia and depression, as
      evaluated, were significantly and positively correlated with each other (r =
      0.53, p = 0.001). Finally, a logistic regression with alexithymia and depression
      as independent variables showed a strong correlations between the HAD ratings and
      anorexia, but no correlations between TAS score and the eating disorder
      subgroups. In eating disorder patients, alexithymia, as evaluated by the Toronto
      Alexithymia Scale, seems to exhibit a thymo-dependent component which could be
      secondary to concurrent depression. Through recent studies and results of our
      research, we analyze and give several interpretations which may explain this
      correlation between alexithymia and depression.

PMID- 11192800
TI  - [Psychometric properties of a new instrument for evaluating quality of life, the
      WHOQOL-26, in a population of patients with neuromuscular diseases].
AB  - This study describes the principal psychometric properties of the French version
      of the WHOQOL-26, a short version (26 questions) of the WHOQOL-100, which are
      World Health Organization instruments for evaluation of quality of life (QOL)
      which include four dimensions (physical, psychological, environmental, social
      relations). The use of this tool with psychiatric patients is discussed.
      Collection of data was performed during a national inquiry on persons with
      neuromuscular disorders. The population included 2,102 subjects (mean age 42.9 +/
      15 years). Ten different clinical entities were represented, which differed in
      the type of lesion of the motor unit, the permanence and localization of the loss
      of muscle strength, the progression of the respiratory deficit, the moment of its
      occurrence and seriousness of prognosis. This questionnaire was well-adapted to
      the study population (weak effect of extremes) and was well-accepted (only 5% non
      responses). Compared with the long version, homogeneity is less pronounced, but
      remains acceptable (the item-scale correlation is superior to 0.40 for 66.7% of
      some items), which is the same as the reliability (Cronbach's alpha coefficient
      always over 0.65). The sensitivity in relation to the diagnosis is verified for
      all four dimensions (p = 0.05). The concurrent validity, studied using general
      QOL evaluation scores, satisfaction with health, and the importance of
      repercussions of incapacities on daily life was also globally demonstrated (p <
      0.0001).

PMID- 11192801
TI  - [Validation of the French version of the Raine Schizotypal Personality Disorder
      Questionnaire--categorial and dimensional approach to schizotypal personality
      traits in a normal student population].
AB  - Most of existing self-report measures of schizotypal personality assess only few
      of the nine traits of Schizotypal Personality Disorder (SPD) according to DSM III
      R or DSM IV. The Raine's Schizotypal Personality Questionnaire (SPQ) is one of
      the most widely used questionnaire for SPD diagnosis. This well adapted tool for
      screening SPD in large samples from general population allows simple and quick
      evaluations by the mean of 74 items and nine sub-scales exploring DSM IV criteria
      of the trouble. With the original sample of American students, Raine found SPQ to
      have high internal reliability (0.91) and reported cutoffs for the top and the
      bottom ten percents of SPQ scores at respectively 41/74 and 12/74. We reported
      here the validation study of the French version of the SPQ in a sample of 232
      students (males: n = 107; females: n = 125; mean age: 21.17 +/- 1.47; mean
      educational level: 13.36 +/- 1.06). The French version has high internal
      reliability (SPQ total: Cronbach's alpha = 0.91; SPQ nine subscales: Cronbach's
      alpha = 0.57 to 0.76). The ten percent high and low cutoff scores on the
      distribution of SPQ scores are respectively 40/74 and 7/74 for the total sample.
      However, gender differences are observed: 38/74 and 9/74 for females; 42/74 and
      6/74 for males. A Principal Component Analysis (PCA) confirms the high internal
      reliability. Moreover, PCA evidences a three-factor model of schizotypy
      reflecting "positive or cognitive-perceptual", "negative or social
      interpersonal", and "disorganization" latent factors. These results replicate
      previous works on the topic with the same instrument.

PMID- 11192802
TI  - [What information do patients with schizophrenia have about their illness and
      treatment?].
AB  - Improved compliance with antipsychotic medication is a major issue in
      schizophrenic management. For this purpose educational programs have been used,
      but up to now, little or no information has been gathered or published in France
      concerning schizophrenic patients' opinion on information they have about their
      disease and their treatment. Thus we conducted a survey in concert with 78
      psychiatrists from the French psychiatric health service. From this cross
      sectional survey we assessed 336 outpatients (male: 72%; mean age: 36 +/- 10.4
      years) with schizophrenia according to the DSM IV (paranoid sub type: 57%,
      disorganized: 12%, catatonic: 1%, undifferentiated: 12%, residual: 18%). The mean
      duration of the illness was 11.6 years (sd: 8.5) and the mean duration of the
      follow up with the same psychiatrist was 5.4 years (sd: 5.1). Patients completed
      a questionnaire which assessed their level of information on mental illness and
      treatment. The diagnosis of schizophrenia has been told to their patients by 39%
      of the psychiatrists, and treatment has been explained to the patients by 96% of
      the practitioners. Results indicate less than half of the patients (45%) felt
      ill, only 46% thought they knew their illness well or very well (nevertheless
      only 31% of them named spontaneously the diagnosis of schizophrenia or
      psychosis), and 61% considered that they had been given sufficient information.
      Most of the patients (79%) were persuaded that their treatment was useful, and
      75% of patient were completely satisfied with their treatment. Surprisingly 92%
      reported taking their medication regularly. Most patients think that a high level
      of information about their illness (74%) and treatment (79%) help them to cope
      better with their schizophrenia. Analysis performed according to patients
      characteristics indicated that paranoid patients felt more ill (p = 0.035) than
      others, thought to know less about their illness (p = 0.0065), and were less
      satisfied with their treatment (p = 0.04) and their level of information (p =
      0.03). Patients with a duration of their illness longer than 10 years were more
      convinced of the utility of their treatment (p = 0.02) and had debated more on
      the choice of their treatment with their psychiatrist (p = 0.047). Patients older
      than 35 years were more satisfied with their information (p = 0.002). More
      patients with atypical antipsychotics accepted to take their treatment on a
      regular basis (p = 0.035) compared to patients under classical neuroleptics. This
      survey underlines that mental health consumers' opinions can be obtained even in
      the field of schizophrenia, and argues in favour of further such investigations.
      It also highlights the need for educational programs on schizophrenia and
      antipsychotic medications.

PMID- 11192803
TI  - [Epidemiologic, clinical and institutional analysis of 2 outpatient psychiatric
      patient management facilities].
AB  - A cohort of 100 patients was followed up over 6 months in two extra-hospital
      closed clinics. One of them offers free entrance care while the other one offers
      structuring contractual care for psychotic patients; 57% of the patients are
      psychotic and 27% suffer from neurosis; 8% of the patients have a borderline
      undetermined diagnosis. The mean age was 43 years. The youngest was 18 and the
      oldest 75. There were more males (59%) than women (41%). There were no
      significant difference between socio-medical and self patient reference. The
      relative stability of the attendance shows the interest of the population toward
      the clinics. Most of the care for psychotic patients were done in the clinic
      which offers self entrance care. It happens that the theoretical distinction
      between the two clinics does not appear on the field. Psychotic patients seem to
      prefer free entrance care than structuring contractual care which is
      theoretically destinated to them. The analysis of health personnel competence
      could help understanding. However, we can ask ourself about care protocols in
      psychiatry, and especially contractual care for psychotic patients in our
      environment.

PMID- 11192804
TI  - [Quality of life of children: importance of its evaluation. Comparison of
      children in good health with those at risk (psychological, social, somatic)].
AB  - A multicentric study was performed in France and Spain: 490 children were
      evaluated with a previously validated questionnaire including open-ended
      questions and structured response format questions. Children are either in good
      health or suffering from somatic diseases, psychological problems or social
      difficulties; 38% of the children are Spanish, 62% are French; the questionnaire
      validation was checked again, and confirmed. Children are happy about their
      leisure, and unhappy when separated from their families. Among the factors
      affecting the answers to the structured format questions the most important are
      the social difficulties and to a lesser extent the psychological problems.
      Somatic diseases impair the child's quality of life in Spain. Children differ
      according to the country where they live. Among children in good health, Spanish
      children report a better quality of life than French children. Open-ended answers
      were only studied in France. They were very different when children with social
      difficulties or psychological problems filled out the questionnaire and were
      compared to children in good health or with somatic diseases. Both children with
      psychological and social difficulties mention more often the relationship domain.
      Children with social problems never mention their activities as a source of
      happiness.

PMID- 11192805
TI  - [Chronobiological paradigms of mental life and clincial neurosciences]].
AB  - Circadian fluctuations of normal and abnormal behavioural processes have been
      classically reported from statistically validated chronograms (averaged displays
      of data as a function of time). Going more deeply into the research with
      rhythmometric investigations reveals that the temporal organization of
      psychophysiological functions involving several oscillatory systems may compose
      possible circadian paradigms of brain integration and pathological chronorisk for
      clinical neuroscience (seizure susceptibility for epilepsy and related states,
      brain circulatory disturbances, stress-related events, emotional or affective
      manifestations, and psychosomatic disorders). Rhythmometrically analyzed, the
      temporal fluctuations of behavioural events tend to indicate that cerebral
      integrations are circadian, circaseptidian or infradian stage-dependent processes
      whose chronobiologic characteristics are possibly predictable on the basis of
      mathematical models. More generally, the present study reveals that: 1) several
      neurological or psychiatric disorders are directly or indirectly concerned with
      chronobiologic processes, and that 2) cerebral and behavioural time variations
      can be detected and described in neurology and psychiatry as algorithmically
      formulatable recurring psychophysiological changes with a waveform validated by
      inferential statistical computer methods. Such rhythmometric procedures applied
      to neurological or psychiatric events suggest also the development of new
      epistemological concepts in the fields of comparative psychophysiology and
      theoretical neuroscience.

PMID- 11192807
TI  - [Psychological factors associated in smoking cessation in patients with arterial
      occlusive disease of the legs].
AB  - Few studies have focused on psychological factors involved in the course of
      peripheral atherosclerosis, particularly in smoking cessation, which is a major
      point in the outcome of the disease. In this view, we assessed in 19 men
      hospitalised for intermittent claudication, some personality and emotional
      characteristics associated with the patients' recent smoking behaviour. Patients
      included tend to have high scores of state-anxiety and alexithymia (with
      difficulty to identify and express their emotions), and to benefit from an
      efficient social support made of few persons. Concerning the smoking behaviour
      from the past six months, only 8 subjects stopped smoking and 13 subjects made an
      effort in this way, despite relatively low nicotine dependence scores, severe
      peripheral atherosclerosis with frequent erection disorders, and awareness of the
      importance to stop smoking to improve the outcome. Presence of erection
      disorders, and eventually higher alexithymia scores, may facilitate the smoking
      cessation. The main reasons explaining the difficulty to stop smoking don't seem
      to be pharmacologically induced, neither a denegation of the bad effects of
      smoking on outcome, but more surely a psychological and complex dependence. It
      would be essential to assess more precisely the psychological characteristics of
      the patient to propose more efficient treatment.

PMID- 11192806
TI  - [Executive and amnestic functions of a group of first-degree relatives of
      schizophrenic patients].
AB  - Several lines of evidence seem to indicate that some neurocognitive measures
      could be phenotypic markers of predisposition to schizophrenia. The aim of this
      study was to investigate 21 patients with schizophrenia, 51 of their first-degree
      relatives and 46 nonpsychiatric controls, with a series of tests known to be
      sensitive to prefrontal cortical damage--the Trail Making Test, part B (TMT B),
      the Wisconsin Card Sorting Test (WCST) and a verbal fluency test (VFT)- and/or
      sensitive to temporo-hippocampic dysfunctions: verbal and visual memory and
      verbal learning tests from the Wechsler Memory Scale-Revised (Wechsler, 1987).
      Since parents and siblings share on average 50% of their genes with the
      schizophrenic proband, firstly we predicted that the first-degree relatives'
      performance would be at an intermediate level between patients and control
      subjects and secondly, we expected that a higher proportion of relatives than of
      control subjects would be impaired. The patients demonstrated deviant patterns of
      neuropsychological performance on the three tests sensitive to frontal
      dysfunctions and on most of the memory and learning tests. In the relative group,
      performance on the TMT B, VFT, immediate verbal recall and verbal learning was at
      an intermediate level between both other groups and significantly impaired
      compared to control subjects. However, the relative group did not differ from the
      control group on the WCST, immediate visual recall, and delayed verbal and visual
      recalls. Furthermore, compared to the control group, the percentages of patients
      and relatives who scored one standard deviation below the mean control group were
      significantly higher for the VFT and immediate verbal recall scores. Among all
      the tests studied, the verbal fluency and the immediate verbal recall appeared to
      be valuable phenotypic markers of schizophrenia since: (i) their mean scores were
      poorer in the patient and in the relative groups, (ii) the percentages of
      patients and relatives with poor performance were higher than the percentage of
      controls, (iii) these deficits were not due to poorer general intellectual
      abilities in the relative group, (iv) these deficits did not correlate with
      anxiety or depression scores.

PMID- 11192808
TI  - [Value of trimeprazine among hypnotics in a psychiatric facility].
AB  - Trimeprazine (TPZ) has been marketed in France since 1959, as tablets and
      solution containing respectively 5 mg and 40 mg/ml. TPZ is a phenothiazine
      derivative with known antihistaminic and sedative effects. The first approved
      indication for TPZ is in the treatment of allergy. However, its frequent sedative
      effects are undesirable in this indication. The second approved indication is in
      the treatment of insomnia (5-20 mg/day) and TPZ is an alternative to conventional
      hypnotics as diazepam, flunitrazepam, zolpidem, butobarbital... Due to the
      prescription frequency of this medicine in our hospital, we analyzed the
      naturalistic prescriptions mode and the clinical end point in patients
      hospitalized for mental illness. On the one hand, using the hospital prescription
      software, we analyzed: prescriptions frequency, dose regimen and drug
      associations with hypnotics, anxiolytics and sedative antipsychotics. On the
      other hand, we came into contact with physicians in order to know their opinion
      on TPZ and the whole point of that indication. The results showed a very high
      prescription frequency (139/400 patients; 35%), a marked increase in dose
      compared to those approved by the French Drug Administration (5-20 mg/day: 5%; 20
      200 mg/day: 95%) and main drug association with hypnotics, tranquilizers or
      antipsychotics, respectively 38%, 65% and 91%. Clinical end points are: non
      addictive properties and an easily adequation of posology for the drinkable drop
      form in contrast with tablets. Thus, TPZ appears as a first-line hypnotic in
      spite of its adverse effects common to phenothiazine (atropinic and
      antidopaminergic effects) and is a usefull medicine for the treatment of insomnia
      in psychotic patients.

PMID- 11192809
TI  - [A case of leukopenia in treatment with risperidone in an adolescent].
AB  - The safety and efficacity of atypical antipsychotics in comparison with
      conventional neuroleptics allow their prescription in children and adolescents
      who are particularly at risk for developing neurological or cardiac side-effects.
      Hematological complications of new antipsychotics are less known, except for
      clozapine treatment in which blood monitoring strategy is well established. We
      report on a case of risperidone-associated leucopenia in an african adolescent
      treated for schizophrenia. He developed leucopenia 10 days after starting
      risperidone therapy (4 mg/day). The cessation of treatment was followed by a
      normalization of the white blood cell differential count and the rechallenge was
      positive (2 mg/day). No hematological abnormalities were observed with olanzapine
      therapy in this patient. Therefore olanzapine may represent a safe therapeutic
      alternative. We concluded that risperidone therapy may create a risk for
      leucopenia especially in patients who present a risk of leucopenia for ethnic
      reasons. We propose hematological monitoring during risperidone treatment.

PMID- 11192810
TI  - [Study of antisocial personality conforms hypothesis of cerebral organization].

PMID- 11192811
TI  - Health claim. For foods that could lower heart disease risk.

PMID- 11192812
TI  - Robots help surgeons perform more precise surgery.

PMID- 11192814
TI  - Cell phones & brain cancer. No clear connection.

PMID- 11192813
TI  - Preventing colon cancer. Screening and early detection save lives.

PMID- 11192815
TI  - Jesse Gelsinger.

PMID- 11192816
TI  - Prescription IDs.

PMID- 11192817
TI  - Single-use device reprocessing.

PMID- 11192819
TI  - The public's right to know.

PMID- 11192818
TI  - Counterfeiting couple pays high price for baby formula fraud.

PMID- 11192820
TI  - Mifepristone for termination of early pregnancy.

PMID- 11192821
TI  - Home for the holidays: preventing foodborne illness at family gatherings.

PMID- 11192822
TI  - Screening for prostate cancer by PSA determination: a time for caution.

PMID- 11192823
TI  - Elevated serum endothelin-1 levels in patients with colorectal cancer; relevance
      for prognosis.
AB  - BACKGROUND: It has been demonstrated that the Doppler Perfusion Index (DPI) is
      increased in patients who are at risk of developing liver metastases from
      colorectal cancer. It has been postulated that a circulating hormonal factor is
      involved in the relative vasoconstriction throughout the splanchnic bed.
      Endothelin-1 (ET-1), a potent vasoconstrictor which has been associated with
      tumor growth and is produced by colorectal tumors, may play an important role in
      this phenomenon. In this paper the prognostic value of serum ET-1 in colorectal
      cancer is discussed. METHODS: Preoperative serum levels of ET-1 were assessed in
      three groups of patients: group A underwent resection of the colorectal tumor and
      remained free of recurrence (n=20); group B developed metachronous liver
      metastases at least six months after colorectal resection (n=14); and group C
      presented with colorectal cancer and synchronous liver metastases (n=22).
      RESULTS: The mean (SD) serum ET-1 levels in groups A, B and C were 1.59 (0.41)
      pmol/L, 1.70 (0.32) pmol/L and 1.85 (0.47) pmol/L, respectively. These values
      were significantly different from those of healthy controls (1.22 (0.31),
      p<0.05). Kaplan-Meier analyses revealed no prognostic value of preoperative serum
      ET-1 levels. CONCLUSIONS: These preliminary results demonstrate that serum ET-1
      levels are raised in patients with colorectal cancer. Serum ET-1 levels do not
      seem to be of prognostic value for survival.

PMID- 11192824
TI  - Early 5-fluorouracil-induced changes of poly(A) polymerase in HeLa and WISH
      cells.
AB  - 5-Fluorouracil (5-FU), a drug with numerous mechanisms of action which has a long
      term suppressive effect on human cancer cell proliferation, mediates both partial
      dephosphorylation and inactivation of poly(A) polymerase (PAP) [EC. 2.7.7.19] as
      detected by immunoblotting analysis and non-specific enzyme assay, respectively,
      in human carcinoma HeLa and diploid WISH cells at a concentration of 100 microM.
      When the same experiment is done in the presence of phosphatase inhibitors, 5-FU
      induced partial PAP dephosphorylation is abolished. Moreover, a cell type
      modulated, differential response of HeLa cells (5-FU chemosensitive cells) versus
      WISH cells (drug-resistant diploid cells) is observed. These results suggest that
      5-FU induces early direct or indirect changes in the structure and function of
      PAP and may regulate pre-mRNA cleavage-polyadenylation.

PMID- 11192825
TI  - Molecular detection of codon 12 K-RAS mutations in circulating DNA from serum of
      colorectal cancer patients.
AB  - Point mutations of the K-RAS gene at codon 12 are found in about 40% of cases
      with colorectal cancer. The diagnostic implications of the detection of these
      mutations and their clinical utility are still unclear. The aim of this study was
      to test both the feasibility of the detection of the mutated K-RAS gene in serum
      and its potential role in colorectal cancer detection and monitoring. Codon 12 K
      RAS mutations were examined in DNA extracted from the serum of 35 patients with
      colorectal cancer and were compared with the K-RAS status in the corresponding
      primary tumor. Molecular detection was performed by the mutant-enriched PCR (ME
      PCR) assay, a sensitive method capable of distinguishing a small quantity of
      mutated DNA in the presence of abundant wild-type DNA. The occurrence of
      mutations was compared with clinicopathological parameters as well as CEA and
      CA19.9 serum levels. We found codon 12 K-RAS mutations in the tissue of 13/35
      (37%) patients. Serum mutations were detected in 5/13 (38.5%) patients with
      mutated K-RAS in the tissue. 26/35 (74%) patients showed an identical K-RAS
      pattern in tissue and serum. No codon 12 K-RAS alterations were found in serum
      samples of 22 patients with benign gastrointestinal diseases. Elevated serum CEA
      levels were detected in 16 patients, four of whom also presented serum RAS
      mutations. Our results confirm that K-RAS mutations can be found in circulating
      DNA extracted from serum samples of patients with colorectal cancer and show that
      there is a correspondence between serum and tissue K-RAS patterns.

PMID- 11192826
TI  - Chemotherapy and angiogenesis in advanced cancer: vascular endothelial growth
      factor (VEGF) decline as predictor of disease control during taxol therapy in
      metastatic breast cancer.
AB  - Angiogenesis is essential for tumor growth. Since vascular endothelial growth
      factor (VEGF) represents the main angiogenic factor, the control of VEGF
      secretion could constitute the most important mechanism to achieve the inhibition
      of angiogenesis-related processes. High blood concentrations have been proven to
      correlate with poor prognosis in advanced cancer. In experimental conditions,
      chemotherapeutic agents such as taxol appeared to inhibit VEGF-induced
      angiogenesis, while at present there are no data about the influence of
      chemotherapy on VEGF secretion in cancer patients. This preliminary study was
      performed to evaluate the effect of taxol therapy on VEGF secretion in advanced
      cancer patients in relation to the clinical response. The study included 14
      patients with metastatic breast cancer who were treated with taxol
      monochemotherapy (175 mg/m2 i.v. every 21 days for three cycles). Serum levels of
      VEGF were measured by ELISA in blood samples collected before therapy and at 21
      day intervals. The clinical response consisted of partial response (PR) in three
      and stable disease (SD) in six patients, whereas the other five patients had
      progressive disease (PD). Abnormally high pre-treatment levels of VEGF were seen
      in 8/14 patients. VEGF mean values significantly decreased during taxol therapy
      in patients with PR or SD, whereas no decline was observed in patients with PD.
      Moreover, the percent of normalization or decline greater than 50% in VEGF levels
      was significantly higher in patients with PR or SD than in those with PD (5/9 vs.
      0/5). This preliminary study would suggest that the efficacy of taxol therapy in
      metastatic breast cancer - at least in terms of disease stabilization - may be
      associated with a decrease in VEGF blood levels followed by potential inhibition
      of cancer-related neovascularization.

PMID- 11192827
TI  - Two novel monoclonal antibodies against the MUC4 tandem repeat reacting with an
      antigen overexpressed by lung cancer.
AB  - In this study we investigated the immunochemical and cytochemical reactivity of
      two monoclonal antibodies against the 16-amino acid tandem repeat of MUC4 to
      demonstrate a possible variation of the mucin core peptide expression related to
      lung cancer. The immunocytochemical anti-MUC4 reactivity was analyzed in four
      lung cancer cell lines (Calu-1, Calu-3, H460, SKMES) and in other tumor cell
      lines, as well as in frozen materials from 21 lung adenocarcinomas (ACs),
      including five bronchioloalveolar carcinomas (BACs), and 11 squamous cell lung
      carcinomas (SqCCs). A weak fluorescence anti-MUC4 positivity (range: 10.3-16.2)
      was observed only in acetone-fixed lung cancer cell lines Calu-1, Calu-3 and
      H460. These three lung cancer cell lines also showed a cytoplasmic
      immunoperoxidase reactivity. The immunostaining in lung cancer tissues showed a
      granular cytoplasmic reactivity: 15/21 (71%) and 17/21 (80%) ACs were positive
      with BC-LuC18.2 and BC-LuCF12, respectively. All BACs were positive. Moderate to
      strong reactivity was present in well-differentiated ACs. In the normal lung
      parenchyma counterparts weak reactivity was found only in bronchiolar cells. All
      SqCCs were negative. Anti-MUC4 reactivity was also observed in the alveolar
      mucus. In conclusion, our anti-MUC4 MAbs detect a secretion product present in
      mucus and this product is elaborated by lung cancer cells and overexpressed in
      well-differentiated lung ACs.

PMID- 11192828
TI  - Monitoring therapy by serum HER-2/neu.
AB  - We have evaluated the performance of the Bayer Immuno 1 serum HER-2/neu assay.
      The precision is excellent and varied between 1.7% and 2.1% at values of HER
      2/neu ranging from 16.8 ng/mL to 108.6 ng/mL. In normal women who were followed
      on a monthly basis the average deviation was 6%. The concentration (mean +/- SD)
      in normal women was 8.7 +/- 3.2 ng/mL. There was no difference between pre and
      postmenopausal women. The normal/abnormal cutoff was defined as greater than 15
      ng/mL. In normal women and those with benign disease the specificity varied
      between 95% and 100%. In women with breast cancer the sensitivity was 1.7% in
      stage I disease, 3.0% in stage II, 16.7 in stage III and 35.5% in stage IV. There
      were 56 elevations (14.7%) in the total group of 285 women with breast cancer.
      There was an excellent correlation with a microtitre plate method (r=0.9944).
      Longitudinal studies showed clearly that women who expressed HER-2/neu in their
      tissue had elevated serum levels and these levels reflected the clinical course
      of the patient. More extensive control studies are required to establish the role
      of HER-2/neu assays in the management of women with breast cancer.

PMID- 11192829
TI  - CA 15-3: a prognostic marker in breast cancer.
AB  - CA 15-3 (also known as MUC1) is the most widely used serum marker in breast
      cancer. MUC1 is a large transmembrane glycoprotein which is frequently
      overexpressed and aberrantly glycosylated in cancer. Physiologically, MUC1
      appears to play a role in cell adhesion and the high levels present in cancer may
      be causally involved in metastasis. At present the main uses of CA 15-3 are in
      preclinically detecting recurrent breast cancer and monitoring the treatment of
      patients with advanced breast cancer. In a prospective study of 368 patients we
      show that patients with high preoperative levels of CA 15-3 (>30.4 U/mL) had a
      worse outcome than patients with low levels of the marker. In multivariate
      analysis CA 15-3 as a prognostic marker was independent of both tumor size and
      nodal status. Furthermore, in multivariate analysis the prognostic impact of CA
      15-3 was stronger than that of tumor size and at least as strong as nodal status.
      CA 15-3 may thus be the first independent prognostic serum marker in breast
      cancer.

PMID- 11192830
TI  - Surrogate markers of tumoral angiogenesis.
AB  - BACKGROUND: Angiogenesis is a prerequisite for tumor growth and metastasis.
      Vascular cell adhesion molecule1 (VCAM-1) is expressed on endothelial cells as a
      result of vascular endothelial growth factor (VEGF) stimulation. PURPOSE: To
      determine if measurement in serum of VEGF or VCAM-1 provides an accurate measure
      of tumor angiogenesis. METHODS: VCAM-1 and VEGF were measured in the serum of
      women with early and advanced breast cancer by ELISA. Levels were compared to
      levels of VCAM-1 and VEGF in women with normal breasts and levels of the
      endothelial glycoprotein von Willebrand factor. Levels of VEGF and VCAM-1 in
      women with early breast cancer were correlated with established
      clinicopathological prognostic markers and intratumoral microvessel density
      (IMD). RESULTS: In early breast cancer serum VCAM-1 correlated closely with the
      microvessel density in tumors (r=0.61, p<0.001). Women with lymph node-positive
      and high-grade tumors had higher levels of serum VCAM-1 than women with lymph
      node-negative and low-grade tumors. Serum VEGF demonstrated no correlation with
      established prognostic features or IMD. Levels of VCAM-1 and VEGF were raised in
      women with advanced breast cancer. CONCLUSION: Serum VCAM-1 is a surrogate marker
      of angiogenesis in breast cancer and its measurement may help in the assessment
      of antiangiogenic drugs currently in phase II trials.

PMID- 11192831
TI  - The prognostic value of the tumor marker CA 15-3 at initial diagnosis of patients
      with breast cancer.
AB  - CA 15-3 has been most widely used as a serum tumor marker in follow-up and
      detection of breast cancer recurrence. In this study we have specifically focused
      upon the prognostic implications and utility of preoperative CA 15-3 levels. We
      have identified on our database 414 patients with breast cancer in whom serial
      levels of the serum tumor marker CA 15-3 had been determined at diagnosis and
      follow-up. We have analyzed the follow-up and clinical outcomes in these patients
      and from this data we have assessed the potential of CA 15-3 as a predictor of
      five-year overall and disease-free survival. Our results show that an initially
      elevated CA 15-3 level is associated with a very poor prognosis in both early and
      late stage disease. Elevated pre-biopsy CA 15-3 levels are associated with 14%
      five-year disease-free survival rates and 17% overall survival rates at five
      years. In contrast, normal CA 15-3 levels are associated with 47% five-year
      disease-free survival rates and 54% overall survival rates at five years
      (p<0.01). Comparison of five-year survival rates between patients with elevated
      and normal CA 15-3 levels in early breast cancer (stage I and II) also showed
      significant differences, with survival being 41% and 75%, respectively (p<0.01).

PMID- 11192832
TI  - Human MUC1 mucin: a multifaceted glycoprotein.
AB  - Human MUC1 mucin, a membrane-bound glycoprotein, is a major component of the
      ductal cell surface of normal glandular cells. MUC1 is overexpressed and
      aberrantly glycosylated in carcinoma cells. The role MUC1 plays in cancer
      progression represents two sides of one coin: on the one hand, loss of polarity
      and overexpression of MUC1 in cancer cells interferes with cell adhesion and
      shields the tumor cell from immune recognition by the cellular arm of the immune
      system, thus favoring metastases; on the other hand, MUC1, in essence a self
      antigen, is displaced and altered in malignancy and induces immune responses.
      Tumor-associated MUC1 has short carbohydrate sidechains and exposed epitopes on
      its peptide core; it gains access to the circulation and comes into contact with
      the immune system provoking humoral and cellular immune responses. Natural
      antibodies to MUC1 present in the circulation of cancer patients may be
      beneficial to the patient by restricting tumor growth and dissemination: early
      stage breast cancer patients with a humoral response to MUC1 have a better
      disease-specific survival. Several MUC1 peptide vaccines, differing in vectors,
      carrier proteins and adjuvants, have been tested in phase I clinical trials. They
      are capable of inducing predominantly humoral responses to the antigen, but
      evidence that these immune responses may be effective against the tumor in humans
      is still scarce.

PMID- 11192833
TI  - Treatment of trichiasis with argon laser.
AB  - PURPOSE: In this prospective study, argon laser photocoagulation was used to
      eliminate misdirected cilia. The cases were followed up to see the results and
      recurrences with this treatment. METHODS: 60 eyelids of 45 patients with
      trichiasis were treated with the argon laser. After topical anesthesia a blue
      green argon laser was used with 1 watt power, for 0.20 seconds, with 100
      micrometer beam diameter. The beam was directed coaxially to the lash follicle to
      create a 2-3 mm crater and vaporization was observed. After crater formation, the
      laser parameters were changed to 1.2 watt power, for 0.20 seconds, with 200
      micrometer beam diameter, to destroy residual follicular tissue. Up to five
      lashes were treated in one session. At the end of each session an antibiotic
      ointment was used t.i.d. for a week. RESULTS: Patients have been followed for 4
      12 months (mean 6 months). Recurrences have been seen in 15 of 60 eyelids (25%).
      Laser treatment has been used with the same protocol for the cases with
      recurrence and results have been successful in eight of them. Postoperatively
      severe pain, hemorrhage, scar formation, neovascularization of lid margin, or
      infection were not seen in any patient. In three cases mild hypopigmentation and
      in three other cases mild lid notching were observed. CONCLUSIONS: Argon laser
      lash ablation can be done as an effective office procedure with topical
      anesthesia. The advantages include low recurrence and complication rates in
      carefully selected patients and minimal postoperative discomfort.

PMID- 11192834
TI  - The control of matrix metalloproteinase-2 expression in normal and keratoconic
      corneal keratocyte cultures.
AB  - PURPOSE: Early phase keratoconic corneas and their cultured keratocytes
      abnormally produce the Mr 62,000 form of the matrix metalloproteinase-2 (MMP-2).
      It is known that platelet derived growth factor (PDGF) and transforming growth
      factor-beta (TGF-beta) are involved in the regulation of MMP activity and tissue
      inhibitor of metalloproteinase (TIMP) production in non-ocular tissues. The
      purpose of this enquiry was to determine whether these growth factors also play a
      role in the activity and/or production of corneal MMP-2 and TIMP, and whether
      their activity could account for the existence of the Mr 62,000 form of MMP-2 in
      keratoconic corneas. METHODS: Confluent cultures of normal and early-phase
      keratoconic corneal keratocytes were established and incubated in serum-free
      media in the presence or absence of PDGF and TGF-beta. The proteins secreted by
      these cells over periods of 7 days were harvested for analysis. The total protein
      produced was determined spectrophotometrically. MMP-2 was visualised by SDS
      gelatin polyacrylamide gel electrophoresis and assayed using radiolabelled type
      IV collagen as substrate. The enzyme inhibitors, TIMP-1 and TIMP-2, were
      quantified by dot blot immunoassay. RESULTS: The addition of PDGF or TGF-beta to
      the culture medium of keratoconic corneal keratocytes had no significant effect
      on overall protein production, MMP-2 activity or on the amounts of TIMP- 1 and
      TIMP-2 secreted. These observations also applied to normal corneal keratocytes,
      with the exception that PDGF induced expression of the Mr 62,000 species of MMP
      2. CONCLUSIONS: PDGF may be involved in the production of the Mr 62,000 species
      of MMP-2 that is abnormally produced by early-phase keratoconic corneal
      keratocytes.

PMID- 11192835
TI  - Preoperative gentamicin eye drops and chlorhexidine solution in cataract surgery.
      Experimental and clinical results.
AB  - PURPOSE: 1) To evaluate the effects on the conjunctival flora of gentamicin
      ophthalmic eye drops 0.3%, given four times in 45 minutes, and a conjunctival
      rinse with 10 ml chlorhexidine 0.05% solution. 2) To investigate retrospectively
      the rate of endophthalmitis after cataract operations when these antimicrobials
      were applied preoperatively. METHODS: Seventy-six patients undergoing standard
      phacoemulsification operations were enrolled in the experimental part of the
      study. Cultures were taken preoperatively, 5 minutes after prophylaxis with
      either chlorhexidine or gentamicin. To assess the combined effects of
      chlorhexidine and gentamicin, cultures were taken after the cataract operation.
      Hospital charts were reviewed for cases of endophthalmitis in 1994 and 1995, when
      this prophylactic protocol was used at the St Erik's cataract surgery department.
      RESULTS: The conjunctival microflora was significantly suppressed by
      chlorhexidine rinsing alone (p = 0.001), while no other significant anti
      bacterial effects were observed with the experimental prophylaxis. The
      endophthalmitis rate was 32/12. 806 operations (0.25%). CONCLUSIONS: Topical
      rinsing with chlorhexidine solution suppresses conjunctival flora in the short
      term. Combined topical chlorhexidine and gentamicin prophylaxis does not
      eliminate postoperative endophthalmitis caused by gram-positive bacteria.

PMID- 11192836
TI  - Surgical approach in terson syndrome: vitreous and retinal findings.
AB  - PURPOSE: To report some interesting findings in patients with bilateral Terson
      syndrome. METHODS: We describe six eyes from three patients with Terson syndrome.
      Pars plana vitrectomy was performed in one eye twelve weeks, and in four eyes six
      months after the acute event. In one eye blood was suddenly spontaneously
      absorbed after four months. RESULTS: The four eyes operated six months after
      injury showed severe complications and final visual acuity was between light
      perception and 0.6. The eye with surgical attendance twelve weeks after the acute
      injury had an uneventful course, and final visual acuity was 0.7. CONCLUSIONS:
      Because of severe ocular complications and with a view to early rehabilitation,
      vitrectomy has been recommended for eyes with bilateral Terson syndrome, without
      spontaneous blood resorption. Surgery should be performed in at least one eye not
      later than four to eight weeks after the acute injury.

PMID- 11192837
TI  - Macular translocation: histopathologic findings in swine eyes.
AB  - PURPOSE: Macular translocation has been proposed as an alternative technique in
      the treatment of some cases of choroidal neovascularization. The purpose of the
      paper is to report the histopathologic findings in the retina of swine eyes
      undergone macular translocation. METHODS: Ten eyes of ten Yucatan pigs underwent
      posterior pars plana vitrectomy and scleral imbrication to achieve macular
      translocation. Mattress sutures were preplaced at the equator of the eyes. After
      a pars plana vitrectomy, balanced saline solution was injected under the temporal
      retina to produce a retinal detachment. Scleral imbrication was achieved by
      tightening the mattress sutures. An air-fluid exchange was performed and the eye
      was filled with sulfur hexafluoride 18%. The eyes were enucleated 2, 4, 8 and 12
      weeks after surgery and analyzed under light and electron microscopy. RESULTS:
      Macular translocation was achieved in all cases. The major findings consist of a
      minimal decrease in the number of photoreceptors outer segments; also a change in
      the morphology was noted. This included some degree of loss of vertical alignment
      and an increase in the interphotoreceptor space. There was a recovery in the
      morphology of the photoreceptors over time. CONCLUSIONS: Minimal changes in the
      photoreceptors and retinal pigment epithelium are observed when macular
      translocation is performed with recovery of these changes over time. Scleral
      imbrication is an effective technique to achieve translocation of the fovea.

PMID- 11192838
TI  - Visual outcome and prognostic factors after vitrectomy for posterior segment
      foreign bodies.
AB  - PURPOSE: To identify the prognostic factors that predict final visual outcome in
      eyes with posterior segment intraocular foreign body (IOFB) injuries managed by
      primary pars plana vitrectomy. METHODS: Ninety-six consecutive patients with
      posterior segment IOFB injuries were retrospectively reviewed. Factors analyzed
      included initial visual acuity (VA), time between injury and presentation, site
      of entrance wound, uveal prolapse, vitreous prolapse, traumatized iris,
      endophthalmitis, location and size of IOFB, use of scleral buckling and/or an
      encircling band, gas tamponade, lensectomy, number of surgical procedures, and
      development of retinal detachment. Data were analyzed using univariate and
      multivariate logistic regression analysis. RESULTS: After a mean follow-up of 8.6
      months, 63 eyes (65.6%) achieved VA of 20/200 or better, and 9 eyes (9.4%) had
      total retinal detachment complicated by inoperable proliferative
      vitreoretinopathy. On univariate analysis, predictors of poor vision (hand
      movements or less) were poor initial VA, corneoscleral entrance wound, uveal
      prolapse, vitreous prolapse, traumatized iris, and development of retinal
      detachment. In contrast, predictors of good visual outcome (20/200 or better)
      were absence of uveal prolapse, no endophthalmitis, and no retinal detachment.
      Multivariate analysis identified corneoscleral entrance wound, uveal prolapse,
      and development of retinal detachment as the only factors significantly
      associated with poor visual outcome. Absence of uveal prolapse was the only
      factor significantly associated with good visual outcome. CONCLUSIONS: Final
      visual outcome is greatly determined by the severity of the primary injury. On
      multivariate analysis, significant predictive factors of final VA were
      corneoscleral entrance wound, presence or absence of uveal prolapse, and
      development of retinal detachment.

PMID- 11192839
TI  - Immunohistochemical demonstration of metallothionein in eyes with choroidal
      melanomas.
AB  - PURPOSE: The since immunohistochemically detectable metallothionein (MT)
      overexpression has been described in a variety of human tumours, including skin
      melanomas, in relation to different stages of tumour development and progression.
      MATERIALS AND METHODS: We used a monoclonal antibody to investigate the
      distribution of MT in 18 formalin-fixed, paraffin-embedded, surgically enucleated
      eyes with choroidal melanomas, from 18 patients (8 male, 10 female; age range 30
      83 years, mean 58.7). Clinico-pathological details and follow-up data (2-124
      months, mean 36.1) were also available. MT immunoreactivity was recorded and the
      percentage of stained cells was graded for semiquantitative purposes.
      Correlations between immunohistochemical data and morphological characteristics
      of melanomas were investigated using non-parametric methods; survival analysis
      was done by the Kaplan-Meier method and the survival curves were compared by the
      Mantel-Cox log-rank test. RESULTS: MT immunoexpression was found in 15/18 cases
      (83.3%) with staining scores from 1 to 3; MT staining varied in intensity and was
      mainly localized in the cytoplasm, although a combined nuclear/cytoplasmic
      reactive pattern was seen in neoplastic elements. No differences in MT
      immunostaining were seen in relation to age or sex, tumour size, histotype and
      amount of pigment; univariate analysis of survival data showed no prognostic
      significance regarding MT expression. CONCLUSIONS: The immunohistochemical
      evidence of MT in neoplastic elements could be related to the production of this
      scavenging protein in the tumour for cell defense mechanisms against hydroxyl
      free radicals, and to act as a Zn donor, since Zn is required for the synthesis
      of DNA and DNA-repair enzymes.

PMID- 11192840
TI  - Alterations in antithrombin III activity and other blood coagulation parameters
      after retinal detachment surgery.
AB  - PURPOSE: To evaluate perioperative changes in blood coagulation in patients
      undergoing retinal detachment surgery. MATERIALS: Prospective study of 56
      patients, aged from 19 to 82 (mean +/- S.D. 53 +/- 16.8) years, undergoing
      retinal detachment surgery (encirclement with scleral buckling) under general
      anesthesia. Excluded were patients with venous or arterial disease and any other
      factors that could affect the parameters under consideration. METHODS: Blood was
      sampled from the cubital vein one day before surgery, immediately after induction
      of anesthesia but before surgery, immediately after completion of the operation
      but before the termination of anesthesia and on days 1 and 4 after the operation.
      We measured antithrombin III activity (AT III), platelet count, fibrinogen
      concentration, activated partial thromboplastin time (aPTT) and prothrombin time
      (PT). RESULTS: Intraoperative AT III activity and platelet count were
      significantly lower, aPTT was shortened and PT prolonged, although all values
      remained within the normal range. These results indicate moderate activation of
      coagulation during retinal detachment surgery. On the first postoperative day
      coagulation activity was reduced, with increases in AT III activity, fibrinogen
      concentration and platelet count and prolongation of aPTT. CONCLUSIONS: During
      retinal detachment surgery there is moderate activation of coagulation in the
      systemic circulation.

PMID- 11192841
TI  - Systematic, combined treatment approach to nasolacrimal duct obstruction in
      different age groups.
AB  - PURPOSE: To report the outcome of a step-by-step treatment approach for
      congenital nasolacrimal duct obstruction (CNDO). METHODS: Three-hundred and fifty
      eyes with CNDO were included in the study. A number of treatment methods were
      applied systematically until a successful outcome was achieved. Listed in order
      from simple to more complex, the following methods were used: conservative
      management (massage and topical antibiotics), high-pressure syringing, probing,
      and silicone intubation. Treatment efficacy was determined according to age
      (Group 1: 0-6 months, Group 2: 7-12 months, Group 3: 13-24 months, Group 4: 25-72
      months) and success rates were compared. RESULTS: Conservative management was
      applied only in children less than 1 year of age, and was successful in 91.8% of
      Group 1 and 60% of Group 2 eyes. The difference between these two success rates
      was significant (p = 0.003). High-pressure syringing was performed in children
      under 24 months of age, with success rates of 41.7% in Group 1, 33.3% in Group 2,
      and 12.5% in Group 3. The overall success rate for first probing in all groups
      was 76.1%, with a range of 69.4% to 80.9%. After second probing, the overall cure
      rate for the entire cohort was 88.0%, with a range of 74.9% to 94.8%. There was
      no real difference in probing cure rates relative to age (p > 0.05). Silicone
      intubation was indicated and performed in two eyes of Group 2 children, three
      eyes of Group 3, and nine eyes of Group 4. Two ducts in Group 4 eyes remained
      obstructed after silicone intubation. CONCLUSIONS: The systematic treatment
      approach to CNDO, including conservative management and minimally invasive
      procedures such as high-pressure syringing, probing, and silicone intubation, is
      highly successful. In this study, the cure rate for this combined approach was
      100% in youngsters under 2 years of age and 94.5% in children 2 to 6 years old.

PMID- 11192842
TI  - Merkel cell carcinoma of the eyebrow extending into the orbit.
AB  - BACKGROUND: Merkel cell carcinoma is a rare and aggressive cutaneous neoplasm
      with high local recurrence and metastatic rates. PURPOSE: To highlight an unusual
      presentation of a Merkel cell carcinoma. CASE REPORT: We report a large Merkel
      cell tumor in an 85-year-old woman. It extended from the eyebrow into the upper
      nasal orbit posterior to the equator of the eye globe. Local resection resulted
      in microscopically complete removal of the tumor. During follow-up (20 months) no
      local recurrence was noticed but there was a metastasis in a lymphatic nodule.
      CONCLUSIONS: Merkel cell carcinoma often presents in the eyelids and periorbital
      region. However, extension from the eyebrow deep into the orbit is unusual.

PMID- 11192843
TI  - Ibopamine treatment in chronic hypotony secondary to long-lasting uveitis. A case
      report.
AB  - PURPOSE: To assess the clinical efficacy of ibopamine eye drops in severe
      hypotony secondary to chronic progressive uveitis. METHODS: Case report. A 47
      year-old man with a 37-year history of diffuse uveitis and severe refractory
      hypotony was treated with topical 2% ibopamine (Trazyl) six times a day.
      Intraocular pressure, visual acuity, visual field and side effects were recorded
      during 15 months of follow-up. RESULTS: IOP, visual acuity and visual field
      increased after four days of therapy and lasted for two months when the drug was
      suspended because of the onset of filamentous keratopathy. A new course of
      treatment with 2% ibopamine eye drops in a different solvent (BSS) resulted in a
      stable increase in IOP, VA and visual field, with no side effects in a follow-up
      of 13 months. CONCLUSIONS: Ibopamine 2% eye drops in BSS solvent seem effective
      in the treatment of uveitis-related hypotony.

PMID- 11192844
TI  - Magnetic resonance imaging in cavitary choroidal melanoma.
AB  - PURPOSE: To report the development of a cavitary choroidal melanoma in a patient
      with nevus of Ota and describe its magnetic resonance imaging (MRI) features.
      PATIENT: A 66-year-old man with right oculodermal melanocytosis and an
      ipsilateral choroidal cavitary melanoma was seen. Diagnosis was suspected on the
      clinical, ultrasonographic and MRI findings. RESULTS: T1-weighted image showed a
      hyperintense solid mass containing hypointense cystic-like spaces delineated by
      hyperintense septa with respect to the vitreous. The reverse image was observed
      on T2-weighted images. A choroidal melanoma comprising epithelioid and spindle
      cells with multilocular cavities was documented histopathologically. CONCLUSIONS:
      There may be an association between cavitary melanoma and nevus of Ota.
      Characteristic MRI findings could be helpful in the differential diagnosis of
      cavitary uveal melanoma.

PMID- 11192845
TI  - Birdshot retinochoroidopathy: measurement of the posterior fundus spots and
      macular edema using a retinal thickness analyzer, before and after treatment.
AB  - PURPOSE: To measure the retinal thickness in the macular area and at the typical
      fundus spots in a patient with birdshot retinochoroidopathy, using the retinal
      thickness analyzer (RTA), a new image analyzer involving laser-slit
      biomicroscopy, and to quantify the changes after systemic corticosteroid therapy.
      CASE REPORT: A 54-year-old man with posterior uveitis underwent visual acuity
      measurement, fluorescein and indocyanine green (ICG) angiographies, optical
      coherence tomography (OCT) and RTA measurements before and after steroid
      treatment. RESULTS: The thickness at the birdshot spots measured with RTA
      remained unchanged after treatment, but the thickness at the fovea decreased in
      both eyes. Fluorescein and ICG angiographies and OCT showed no change with
      treatment. CONCLUSIONS: RTA seems a more sensitive method for assessing changes
      in macula thickness in the course of birdshot retinochoroidopathy and can help
      document the effect of treatment.

PMID- 11192846
TI  - Bilateral anterior ischaemic optic neuropathy due to optic disc drusen.
AB  - PURPOSE: To report a case of bilateral anterior ischaemic optic neuropathy due to
      buried optic disc drusen. METHODS: Case report. RESULTS: A 64-year-old man
      presented with swollen optic discs and features suggestive of anterior ischaemic
      optic neuropathy (AION) in the left and right eye on two separate occasions ten
      months apart. Detailed ocular examination at presentation and systemic
      investigations did not reveal an underlying cause for the AION. At a later follow
      up, optic disc drusen were noted in both eyes as partial optic atrophy had set
      in. This was confirmed by ultrasound B scan and demonstration of
      autofluorescence. CONCLUSIONS: In patients presenting with AION uncommon
      underlying causes must be considered. Routine ultrasound B scan at presentation
      can easily establish or exclude optic disc drusen as an underlying cause.

PMID- 11192848
TI  - SIBioC 2000. 32nd National Congress of the Italian Society of Clinical
      Biochemistry and Clinical Molecular Biology. Rimini, Italy, 12-15 September 2000.
      Abstracts.

PMID- 11192847
TI  - Anterior segment ischemia and retinal detachment after vertical rectus muscle
      surgery.

PMID- 11192849
TI  - T-helper cell responses to HIV envelope peptides in cord blood: protection
      against intrapartum and breast-feeding transmission.
AB  - BACKGROUND: Acquired HIV-specific cell-mediated immune responses have been
      observed in exposed-uninfected individuals, and it has been inferred, but not
      demonstrated, that these responses constitute a part of natural protective
      immunity to HIV. This inference was tested prospectively in the natural exposure
      setting of maternal-infant HIV transmission in a predominantly breast-fed
      population. METHODS: Cord blood from infants of HIV-seropositive women in Durban,
      South Africa, were tested for in vitro reactivity to a cocktail of HIV envelope
      peptides (Env) using a bioassay measuring interleukin-2 production in a murine
      cell line. Infants were followed with repeat HIV RNA tests up to 18 months of age
      to establish which ones acquired HIV-infection. RESULTS: T-helper cell responses
      to Env were detected in 33 out of 86 (38%) cord blood samples from infants of HIV
      seropositive women and in none of nine samples from seronegative women (P =
      0.02). Among infants of HIV-seropositive mothers, three out of 33 with T-helper
      responses to Env were already infected before delivery (HIV RNA positive on the
      day of birth), two were lost to follow-up, and none of the others (out of 28)
      were found to be HIV infected on subsequent tests. In comparison, six out of 53
      infants unresponsive to Env were infected before delivery, and eight out of 47
      (17%) of the others were found to have acquired HIV infection intrapartum or post
      partum through breast-feeding (P = 0.02). CONCLUSIONS: T-helper cell responses to
      HIV envelope peptides were detected in more than one-third of newborns of HIV
      infected women; no new infections were acquired by these infants at the time of
      delivery or post-natally through breast-feeding if these T-helper cell responses
      were detected in cord blood.

PMID- 11192850
TI  - Treatment of cervicitis is associated with decreased cervical shedding of HIV-1.
AB  - OBJECTIVE: To determine whether cervical mucosal shedding of HIV-1 RNA and HIV-1
      infected cells decreases following successful treatment of cervicitis. DESIGN:
      Prospective interventional study. SETTING: Sexually Transmitted Infections
      Clinic, Coast Provincial General Hospital, Mombasa, Kenya. PARTICIPANTS: Thirty
      six HIV-1 seropositive women with cervicitis: 16 with Neisseria gonorrhoeae,
      seven with Chlamydia trachomatis, and 13 with non-specific cervicitis.
      INTERVENTIONS: Treatment of cervicitis. MAIN OUTCOME MEASURES: Levels of total
      (cell-free and cell-associated) HIV-1 RNA and presence of HIV-1 DNA (a marker for
      infected cells) in cervical secretions before and after resolution of cervicitis.
      RESULTS: After treatment of cervicitis, the median HIV-1 RNA concentration in
      cervical secretions was reduced from 4.05 to 3.24 log10 copies/swab (P = 0.001).
      Significant decreases in cervical HIV-1 RNA occurred in the subgroups with N.
      gonorrhoeae (3.94 to 3.28 log10 copies/swab; P = 0.02) and C. trachomatis (4.21
      to 3.19 log10 copies/swab; P = 0.02). Overall, the prevalence of HIV-1 infected
      cells in cervical secretions also decreased after treatment, from 67% to 42%
      (odds ratio, 2.8; 95% confidence interval, 1.3-6.0; P = 0.009). Detection of
      infected cells was associated with higher mean HIV-1 RNA levels (4.04 versus 2.99
      log10 copies/swab; P< 0.0001). CONCLUSIONS: Effective treatment of cervicitis
      resulted in significant decreases in shedding of HIV-1 virus and infected cells
      in cervical secretions. Treatment of sexually transmitted diseases may be an
      important means of decreasing the infectivity of HIV-1 seropositive women by
      reducing exposure to HIV-1 in genital secretions.

PMID- 11192851
TI  - Changes in host cell molecules acquired by circulating HIV-1 in patients treated
      with highly active antiretroviral therapy and interleukin-2.
AB  - OBJECTIVE: To analyse cell membrane proteins (CMP) acquired by HIV-1 present in
      the plasma of asymptomatic patients, and their modifications after a cycle of
      highly active antiretroviral therapy (HAART) and interleukin (IL)-2. DESIGN AND
      METHODS: Plasma samples from eight drug-naive asymptomatic subjects underwent
      immobilized antibody capture (IAC) to detect CMP on the surface of circulating
      HIV-1. The CMP considered were lymphocyte subset markers (CD45RA, CD45RO),
      activation markers (HLA-DR), adhesion molecules (LFA-3), costimulatory proteins
      (B7-2), lymph-node homing receptors (CD62L) and pro-apoptosis molecules (FasL).
      This analysis was repeated after one cycle of HAART + IL-2, after virus rebound.
      RESULTS: LFA-3, followed by CD45RO and HLA-DR, are the most represented CMP on
      the surface of circulating virions in naive asymptomatic patients; CD45RA, CD62L,
      B7-2 and FasL are detected only occasionally. After rebound, a significant
      reduction of CD45RO and HLA-DR, but not of LFA-3, is observed on virions, whereas
      CD45RA and CD62L, as well as other molecules, are not affected, remaining almost
      undetectable. CONCLUSIONS: Assuming that CMP on HIV-1 reflect the cellular origin
      of virions, activated T cells expressing CD45RO, HLA-DR, and LFA-3 may be the
      main source of HIV-1 in asymptomatic patients. After a cycle of HAART + IL-2,
      followed by therapy interruption, CD45RA and CD62L are detected on virions
      rarely, indicating that even during virus rebound, expanded naive T cells do not
      become a major target of virus replication. Furthermore, the presence of HLA-DR
      on rebound HIV-1 is decreased, consistent with decreased activation of the HIV
      producing cells. More extensive investigation may clarify the significance of
      these findings with respect to pathogenesis.

PMID- 11192852
TI  - Effect of computer-assisted self-interviews on reporting of sexual HIV risk
      behaviours in a general population sample: a methodological experiment.
AB  - OBJECTIVES: To develop methods to maximize the accuracy of reporting HIV risk
      behaviours in a general population survey. We assessed the feasibility of using a
      computer-assisted self-completion interview (CASI) in comparison with pen-and
      paper self-completion interview (PAPI). DESIGN: A probability sample survey of
      residents aged 16-44 years in Britain, with alternate assignment of addresses to
      interview by CASI (462) or PAPI (439). METHODS: Personal interviews exploring
      demographic and sexual behaviour variables. Principal outcome measures were the
      impact of CASI in relation to PAPI on data quality and rates of reporting a range
      of behaviours. RESULTS: A total of 901 interviews were completed; 829 individuals
      were eligible for and accepted the self-completion module. Internal consistency
      of data items was greater with CASI than PAPI and item non-response was lower.
      Overall, there was no significant difference in rates of reporting between CASI
      and PAPI. The main effect for CASI compared with PAPI in a generalized estimating
      equation (GEE) analysis was an OR (95% CI) of 1.04 (0.92-1.17). Variables were
      also examined individually, including homosexual partnership (adjusted OR 1.26
      95%, CI 0.69-2.29), payment for sex (adjusted OR 0.68 95% CI 0.29-1.59),
      masturbation (adjusted OR 0.89 95% CI 0.66 1.22) and five or more partners in the
      past 5 years (OR 0.85 95% CI 0.61 -1.19). CONCLUSION: We found no evidence of a
      consistent effect of CASI on rates of reporting sexual HIV risk behaviours in
      this sample. CASI resulted in improvement in internal consistency and a reduction
      in missed questions.

PMID- 11192853
TI  - Reassessing the goal of antiretroviral therapy in the heavily pre-treated HIV
      infected patient.

PMID- 11192854
TI  - Cross-staining of cytotoxic T lymphocyte populations with peptide-MHC class I
      multimers of natural HIV-1 variant antigens.

PMID- 11192855
TI  - Enteric microtubule depolymerization in HIV infection: a possible cause of HIV
      associated enteropathy.

PMID- 11192856
TI  - HIV resistance assay results and their effect on therapeutic decisions.

PMID- 11192857
TI  - Efavirenz-associated breast hypertrophy in HIV-infection patients.

PMID- 11192858
TI  - The ADAM study continued: maintenance therapy after 50 weeks of induction
      therapy.

PMID- 11192859
TI  - Predictors of progression in chronically infected naive patients with plasma
      viraemia below 5000 copies/ml and CD4 T lymphocytes greater than 500 x 10(6)/I.

PMID- 11192860
TI  - Absence of an effect of herpes simplex virus type 2 infection on HIV disease
      progression: data from a cohort of HIV-positive individuals with known date of
      seroconversion.

PMID- 11192861
TI  - Pathological fractures in AIDS patients with osteopenia and osteoporosis induced
      by antiretroviral therapy.

PMID- 11192862
TI  - Alopecia universalis and Graves' disease in the setting of immune restoration
      after highly active antiretroviral therapy.

PMID- 11192863
TI  - Renal tubular acidosis and hypophosphataemia after treatment with nucleoside
      reverse transcriptase inhibitors.

PMID- 11192864
TI  - Monocytes harbour replication-competent, non-latent HIV-1 in patients on highly
      active antiretroviral therapy.
AB  - OBJECTIVE: To determine whether HIV-1 can be recovered from blood monocytes as
      well as resting, memory CD4 T lymphocytes of patients on highly active
      antiretroviral therapy (HAART) with undetectable plasma viraemia and whether
      infection is active or latent. DESIGN: Five patients with plasma HIV-1-RNA levels
      of less than 500 copies/ml for at least 3 months and less than 50 copies/ml at
      the time of sampling were initially selected, followed by an additional five
      patients with viral loads of less than 50 copies/ml for 3 months or more.
      METHODS: Monocytes were isolated from blood by plastic adherence, then further
      purified by a second adherence step or CD3 depletion before co-culture with CD8
      depleted donor peripheral blood mononuclear cells. Virus isolates were examined
      for mutations conferring resistance to reverse transcriptase or protease
      inhibitors and for genotype. The highly purified monocytes were also analysed for
      the presence of proviral and unintegrated viral DNA and multiply spliced (MS)
      viral mRNA by polymerase chain reaction. RESULTS: Virus was recovered from
      monocytes of five patients. Sequencing of the recovered viruses did not reveal
      multiple drug resistance, and was consistent with a non-syncytium-inducing/CCR5
      phenotype. Proviral DNA was detectable in monocytes from all subjects, and
      unintegrated HIV-1 DNA and MS RNA was found in four out of five populations
      examined. CONCLUSION: Recovery of replication-competent virus from some HAART
      patients indicates that monocytes can also harbour HIV-1. Detection of circular,
      viral DNA and spliced RNA, albeit at very low levels, in these cells suggests
      that their infection is recent and transcriptionally active rather than latent.

PMID- 11192865
TI  - Discontinuation of maintenance therapy for cytomegalovirus retinitis in HIV
      infected patients receiving highly active antiretroviral therapy.
AB  - OBJECTIVE: To study the safety of discontinuing cytomegalovirus (CMV) maintenance
      therapy among patients with cured CMV retinitis receiving highly active
      antiretroviral therapy (HAART). METHODS: Patients with a history of CMV retinitis
      who were receiving anti-CMV maintenance therapy and who had a CD4 cell count > 75
      x 10(6) cells/l and a plasma HIV RNA level < 30000 copies/ml while on HAART were
      included in a multicentre prospective study. Maintenance therapy for CMV
      retinitis was discontinued at enrolment and all the patients were monitored for
      48 weeks by ophthalmological examinations and by determination of CMV markers,
      CD4 cell counts and plasma HIV RNA levels. T helper-1 anti-CMV responses were
      assessed in a subgroup of patients. The primary study endpoint was recurrence of
      CMV disease. RESULTS: At entry, the 48 assessable patients had been taking HAART
      for a median of 18 months. The median CD4 cell count was 239 x 10(6) cells/l and
      the median HIV RNA load was 213 copies/ml. Over the 48 weeks, 2 of the 48
      patients had a recurrence of CMV disease. The cumulative probability of CMV
      retinitis relapse was 2.2% at week 48 (95% confidence interval, 0.4-11.3) and
      that of all forms of CMV disease 4.2%. CMV blood markers remained negative
      throughout follow-up. The proportion of patients with CMV-specific CD4 T cell
      reactivity was 46% at baseline and 64% at week 48. CONCLUSIONS: CMV retinitis
      maintenance therapy may be safely discontinued in patients with CD4 cell counts
      above 75 x 10(6) cells/l who have been taking HAART for at least 18 months.

PMID- 11192866
TI  - Phase I/II dose escalation and randomized withdrawal study with add-on
      azodicarbonamide in patients failing on current antiretroviral therapy.
AB  - BACKGROUND: Azodicarbonamide (ADA), a HIV-1 zinc finger inhibitor, targets a new
      step in viral replication and cell infectivity. OBJECTIVE: A first phase I/II
      clinical study of ADA. METHODS: ADA was administered at escalating doses
      concomitantly with current antiviral therapy during a 3-month open-label period
      in patients with advanced AIDS and documented virological failure. After 3
      months, patients were randomized in a double-blind placebo-controlled withdrawal,
      ADA being given at the highest tolerated dosage. RESULTS: Fifteen patients with
      advanced disease failing on combined antiretroviral therapy, 75% of them with
      proven phenotypic resistance, had a median baseline CD4 cell count of 85 x 10(6)
      cells/l, CD4/CD8 cell ratio of 0.09 and median plasma RNA viral load of 4.2 log10
      copies/ml. Tolerance to ADA was dose dependent and some patients developed
      nephrolithiasis, glucose intolerance or showed an ADA-related cytotoxicity
      towards CD4 cells at higher dosages. No patient died during the study period. ADA
      increased CD4 cell percentage, increased the CD4/CD8 cell ratio and decreased
      plasma RNA viral load from baseline. At the end of the double-blind period, the
      ADA group, but not the placebo group, showed a significant response (P < 0.05).
      No phenotypic resistance to ADA was observed. Overall, 3/11 patients (27%) had
      consistent viral load reductions > 0.5 log10 copies/ml compared with baseline and
      5/ 11 (45%) showed a CD4 cell recovery from baseline > 33%. In responders, ADA
      induced a median peak increase in CD4 cell percentage change from baseline of 65%
      (range 47-243%), and viral load decrease of 1.04 log10 copies/ml (range 0.52
      1.23). CONCLUSIONS: The maximal tolerated dosage of ADA appears to be 2 g (three
      times daily). This study provides safety results that will allow larger clinical
      trials to confirm the preliminary efficacy data.

PMID- 11192867
TI  - The virological response to highly active antiretroviral therapy over the first
      24 weeks of therapy according to the pre-therapy viral load and the weeks 4-8
      viral load.
AB  - OBJECTIVES: To describe the viral response to HAART by weeks 4 and 8 in
      previously antiretroviral-naive patients. To assess whether the weeks 4 or 8
      viral loads are useful predictors of viral suppression by week 24. DESIGN: A
      large clinical database including 453 antiretroviral-naive patients whose plasma
      viral load was monitored every 4 weeks. METHODS: Observed probabilities of
      achieving a viral load < or = 500 copies/ml by week 24 (days 84-168) from
      starting highly active antiretroviral therapy (HAART) were calculated according
      to viral loads at weeks 4 and 8. RESULTS: A total of 42.4% of patients (153/361)
      reached < or = 500 copies/ml viral load by week 4 and 70.4% (245/348) by week 8.
      Viral suppression below 500 copies/ml by 4-8 weeks was similar irrespective of
      the pre-HAART viral load. In patients with viral loads above 10000 copies/ml at
      week 4, 60.6% (20/33) achieved < or = 500 copies/ml by week 24. In patients with
      viral loads still above 10000 copies/ml at week 8, only 42.3% (11/26) achieved <
      or = 500 copies/ml by week 24, and only 33.3% (3/9) maintained viral suppression
      below 500 copies/ml to week 48. CONCLUSION: Viral loads at weeks 4 and 8 should
      be monitored to detect early signs of low subsequent viral suppression. For
      previously antiretroviral-naive patients whose viral loads after 8 weeks of HAART
      are still above 10000, there is an urgent need to assess adherence to therapy,
      drug levels and resistance, so management can be modified accordingly to reduce
      the rate of week 24 virological failure.

PMID- 11192868
TI  - Bacteremia due to Mycobacterium tuberculosis or M. bovis, Bacille Calmette-Guerin
      (BCG) among HIV- positive children and adults in Zambia.
AB  - BACKGROUND: Among adults with advanced HIV infection in developing countries,
      bacteremia due to Mycobacterium tuberculosis (MTB) is common and bacteremia due
      to M. bovis (bacille Calmette-Guerin; BCG) is rare. Comparable data are not
      available for children with HIV. OBJECTIVE: To compare the prevalence of
      bacteremia due to M. tuberculosis or M. bovis BCG in hospitalized children and
      adults with HIV infection in a developing country with a high prevalence of
      tuberculosis and HIV and > 95% BCG immunization coverage. DESIGN: Descriptive
      cross-sectional study. METHODS: Prospectively hospitalized patients in Lusaka,
      Zambia who were suspected to have HIV infection underwent phlebotomy for HIV
      ELISA, HIV viral load, and lysis-centrifugation blood culture for mycobacteria.
      Histories were obtained and patients were examined for BCG scars. Mycobacterial
      isolates were identified using DNA probes for MTB complex (MTBC), multiplex PCR
      and IS6110 typing. RESULTS: The median age of 387 HIV-positive children was 15
      months; 98% were BCG immunized. The median age of 344 HIV-positive adults was 32
      years; 44% were BCG immunized. Blood cultures were positive for mycobacteria in
      six children (2%) and 38 adults(11%) (P < 0.001). The six pediatric isolates
      included five MTBC (40% clustered) and one BCG. The 38 adult isolates included 36
      MTBC (16% clustered) and two M. avium complex. CONCLUSION: Bacteremia due to MTB
      is less common among children than adults with advanced HIV infection in Zambia.
      Bacteremia due to M. bovis BCG is rare even among children with recent BCG
      immunization and symptomatic HIV infection.

PMID- 11192869
TI  - Multiple drug rescue therapy for HIV-infected individuals with prior virologic
      failure to multiple regimens.
AB  - OBJECTIVES: To characterize the antiviral response and tolerability of a multi
      drug rescue therapy (MDRT) among heavily pretreated patients. METHODS:
      Observational study conducted in a single, university-based tertiary referral
      clinic. Patients (n = 106) who failed several prior regimens started MDRT
      including at least five antiretroviral (ARV) drugs between August 1997 and June
      1998. The most common starting regimen included three nucleoside reverse
      transcriptase inhibitors and two protease inhibitors, which was prescribed to 45
      (42.5%) patients. Virologic response was defined as plasma viral load < 400
      copies/ml on at least two consecutive visits. RESULTS: Median prior ARV exposure
      was seven drugs over a median time of 43 months. Fifty-nine percent of the
      patients were phenotypically (VIRCO Antivirogram) resistant at baseline to seven
      or more ARV. Median plasma viral load change following initiation of MDRT was 
      1.04 log10 copies/ml over a median of 15 months. Using intention-to-treat
      analysis 40% of patients had plasma viral load values < 400 copies/ml between
      weeks 47 and 57 of follow-up. Twenty-six patients (25%) experienced severe
      laboratory abnormalities or subjective adverse drug effects and six of these
      participants discontinued therapy. CONCLUSION: MDRT induced a substantial
      antiviral response in this heavily pretreated group of patients despite extensive
      phenotypic resistance at baseline. Adverse effects were frequent but generally
      manageable. Our data suggest that relying exclusively on historical, clinical and
      laboratory evidence may not be sufficient to rule out a possible antiviral
      response when multiple drug regimens are used in this heavily pretreated patient
      population.

PMID- 11192870
TI  - Efavirenz plasma levels can predict treatment failure and central nervous system
      side effects in HIV-1-infected patients.
AB  - OBJECTIVE: Limited information exists on the clinical usefulness of drug level
      monitoring for efavirenz, a once-daily non-nucleoside reverse transcriptase
      inhibitor (NNRTI). The aim of this study was to determine whether efavirenz
      plasma concentration monitoring could predict treatment failure and central
      nervous system (CNS) tolerability. METHODS: Blood samples were obtained from 130
      HIV-infected patients receiving efavirenz in combination with other
      antiretroviral agents for more than 3 months. Efavirenz plasma concentrations
      were measured by high-performance liquid chromatography. An evaluation of CNS
      side-effects was performed and the viral load, CD4 cell count and other clinical
      and laboratory data were assessed. In 85 patients, these measures were repeated
      at 3 month intervals. RESULTS: Efavirenz plasma levels (n = 226) were measured at
      an average of 14 h after drug intake. Drug concentrations ranged from 125 to
      15230 microg/l (median 2188). Large inter-patient (CV 118%) and limited intra
      patient (CV 30%) variabilities were observed in efavirenz levels. Virological
      failure was observed in 50% of patients with low efavirenz levels (< 1000
      microg/l) versus 22 and 18% in patients with 1000-4000 microg/l or more than 4000
      microg/l, respectively. CNS toxicity was approximately three times more frequent
      in patients with high efavirenz levels (> 4000 microg/l) compared with patients
      with 1000-4000 microg/l. CONCLUSION: Treatment failure and CNS side-effects are
      associated with low and high efavirenz plasma levels, respectively. The important
      inter-individual variability in efavirenz levels strongly argues for dose
      adjustment on the basis of therapeutic drug monitoring to optimize treatment.

PMID- 11192871
TI  - Understanding delay to medical care for HIV infection: the long-term non
      presenter.
AB  - OBJECTIVE: To examine delayed presentation for HIV testing and primary care in
      the second decade of the AIDS epidemic. DESIGN: Cohort study in two urban
      hospitals in the USA between February 1994 and April 1996. METHODS: A total of
      203 consecutive outpatients on initial HIV primary care presentation were
      interviewed about sociodemographic characteristics, alcohol and drug use, social
      support, sexual practices, HIV testing, awareness of possible HIV infection, and
      CD4 cell count. MAIN OUTCOME MEASURE: Duration of delay to medical presentation
      in years based on CD4 cell count, factors independently associated with low CD4
      cell counts, frequency of awareness of HIV risk before testing. RESULTS: The
      estimated mean duration between acquiring HIV infection and initial presentation
      to primary care was 8.1 years (95% CI 7.5, 8.6) based on our cohort's median
      initial CD4 cell count of 280/microl. Male sex, older age, and no jail time were
      associated with lower CD4 cell counts; 34% reported not being aware that they
      were at risk of HIV before testing. Heterosexual intercourse as a risk behavior
      for HIV was the most statistically significant factor for personal unawareness of
      HIV risk. Of those who acknowledged awareness, the mean time between awareness of
      HIV risk and testing was 2.5 years (median 1.0 year). CONCLUSION: In the pre
      highly active antiretroviral therapy era, HIV-infected patients frequently
      initiated primary medical care years after initial infection, at a time of
      advanced immunosuppression. Over one-third of HIV-infected patients were not
      cognisant of their HIV risk before testing, a condition significantly associated
      with heterosexual intercourse as the only HIV risk behavior.

PMID- 11192872
TI  - Factors associated with HIV-1 infection among sex workers of Addis Ababa,
      Ethiopia.
AB  - OBJECTIVE: To study the prevalence and risk factors for HIV infection among sex
      workers of Addis Ababa, Ethiopia. DESIGN AND METHODS: Cross-sectional survey on
      socio-demographic characteristics, behaviours, and HIV serological status of sex
      workers attending two health centres of Addis Ababa. RESULTS: HIV prevalence
      among sex workers was 274 of 372 (73.7%). Several factors were significantly
      associated with an increased risk of being HIV-infected [among others, working in
      'shared rooms', high number of clients, use of injectable hormones, and positive
      Treponema pallidum particle agglutination (TPPA) serology], and others with a
      decreased risk (being born in Addis Ababa, high level of education, peer
      education on sex work, condom use, use of oral pill, and use of condoms for
      contraception). Of interest, sex workers who were using condoms for contraception
      were, compared with others, more likely to use condoms consistently (65 versus
      24%, respectively; P < 0.001), and less likely to be HIV-infected (55 versus 86%,
      respectively; P < 0.001). In multivariate analysis [log-binomial model, giving
      estimates of the prevalence ratio (PR)], being born in Addis Ababa (PR = 0.74;
      95% confidence interval (CI), 0.61-0.91), using condoms for contraception (PR =
      0.73; 95% CI, 0.64-0.85), and a positive TPPA serology (PR = 1.21; 95% CI, 1.09
      1.36), remained significantly associated with HIV infection. CONCLUSIONS: HIV
      prevalence was remarkably high among sex workers of Addis Ababa. Condom use was
      higher, and HIV prevalence lower, in sex workers using condoms not only for
      prevention of HIV and sexually transmitted diseases, but also for contraceptive
      purpose. This finding is of particular interest for its implications for
      prevention strategies among sex workers in the developing world.

PMID- 11192873
TI  - Trend in HIV-1 prevalence in an antenatal clinic in North Uganda and adjusted
      rates for the general female population.
AB  - OBJECTIVES: To estimate HIV-1 prevalence among women attending an antenatal
      clinic in the Gulu District (North Uganda) and, based on these data, among the
      district's female population. METHODS: Anonymous HIV-1 screening was performed
      for 8555 antenatal clinic attendees aged 15-39 years in the period 1993-1997. The
      results were used to estimate the prevalence among the district's female
      population, accounting for differences in fertility rates by HIV-1 serostatus.
      RESULTS: Among antenatal clinic attendees, HIV-1 prevalence showed a significant
      linear decrease (P < 0.001), from 26.0% in 1993 [95% confidence Interval (CI),
      23.2-29.0%] to 16.1% in 1997 (95% CI, 14.8-17.5%). This decrease was mostly due
      to a marked decrease until 1995 (14.3%; 95% Cl, 12.7-16.0%) and was more
      pronounced among women aged under 30 years (P < 0.001), from both urban and rural
      areas (P < 0.001). The risk of being infected was higher among women from urban
      areas (Gulu Municipality), both over the entire period (adjusted prevalence
      proportion ratio = 1.54; 95% CI, 1.40-1.68) and by individual year. The estimated
      prevalence for the 15-39-year-old female population, standardized by age and area
      of residence, decreased from 25.4% in 1993-1994 to 17.8% in 1996-1997; these
      rates were 1.22 and 1.28 times higher, respectively, than those among antenatal
      clinic attendees. CONCLUSIONS: The trend of decrease among young women, for whom
      changes in HIV-1 prevalence more closely reflect incidence, could be partially
      due to a reduction in risk behaviour and a consequent decreasing incidence.
      Differences in fertility rates by HIV-1 serostatus should be addressed when using
      antenatal clinic data to estimate prevalence among the general female population.

PMID- 11192874
TI  - ABT-378/ritonavir plus stavudine and lamivudine for the treatment of
      antiretroviral-naive adults with HIV-1 infection: 48-week results.
AB  - OBJECTIVE: To evaluate the safety and antiviral activity of different dose levels
      of the HIV protease inhibitor ABT-378 combined with low-dose ritonavir, plus
      stavudine and lamivudine in antiretroviral-naive individuals. DESIGN:
      Prospective, randomized, double-blind, multicenter. METHODS: Eligible patients
      with plasma HIV-1 RNA > 5000 copies/ml received ABT-378 200 or 400 mg with
      ritonavir 100 mg every 12 h; after 3 weeks stavudine 40 mg and lamivudine 150 mg
      every 12 h were added (group I, n = 32). A second group initiated treatment with
      ABT-378 400 mg and ritonavir 100 or 200 mg plus stavudine and lamivudine every 12
      h (group II, n = 68). RESULTS: Mean baseline HIV-1 RNA was 4.9 log10 copies/ml in
      both groups and CD4 cell count was 398 x 10(6)/l and 310 x 10(6)/l in Groups I
      and II respectively. In the intent-to-treat (ITT; missing value = failure)
      analysis at 48 weeks, HIV-1 RNA was < 400 copies/ml for 91% (< 50 copies/ml, 75%)
      and 82% (< 50 copies/ml, 79%) of patients in groups I and II respectively. Mean
      steady-state ABT-378 trough concentrations exceeded the wild-type HIV-1 EC50
      (effective concentration to inhibit 50%) by 50-100-fold. The most common adverse
      events were abnormal stools, diarrhea and nausea. No patient discontinued before
      48 weeks because of treatment-related toxicity or virologic rebound. CONCLUSIONS:
      ABT-378 is a potent, well-tolerated protease inhibitor. The activity and durable
      suppression of HIV-1 observed in this study is probably attributable to the
      observed tolerability profile and the achievement of high ABT-378 plasma
      concentrations.

PMID- 11192875
TI  - Early clinical results: SOUNDTEC implantable hearing device phase II study.
AB  - OBJECTIVE: To assess the safety and efficacy of a new semi-implantable
      electromagnetic hearing device, the SOUNDTEC Direct Drive Hearing System (DDHS),
      and to compare its performance with that of subjects' previously worn, optimally
      fit hearing aids. Preliminary results for the first 10 subjects are presented.
      STUDY DESIGN: The protocol specified in the Investigational Device Exemption is
      used in this ongoing FDA phase II 100-subject multicenter clinical trial.
      METHODS: For baseline, each subject is tested wearing his or her own optimally
      fit hearing aid in the ear to be implanted. Six-month postoperative outcome
      measures using the SOUNDTEC DDHS are compared with the baseline. Multiple
      objective and subjective outcomes (as listed under Results) were measured.
      RESULTS: When compared with the subjects' optimally fit hearing aids, the
      SOUNDTEC DDHS provided an average improvement of 52% in functional gain (250-6000
      Hz), 22% in aided thresholds, 3.8% for speech discrimination in quiet, 17% for
      speech in noise, 13.1% in articulation index scores, 28% in aided benefit, 27.3%
      in sound quality of speech, and a 16.7% increase in overall subject satisfaction.
      In addition, with the SOUNDTEC DDHS, subjects reported absence of acoustic
      feedback, little or no occlusive effects, and more natural sound perception.
      CONCLUSION: Analysis of data on the first 10 subjects using the SOUNDTEC DDHS
      indicates positive outcomes regarding safety and efficacy, although the small
      sample size is not sufficient to permit valid statistical inferences to be drawn
      from our preliminary data. Results also demonstrate improvement in performance
      compared with the subjects' optimally fit hearing aids and an improvement in
      quality of life as demonstrated by objective and subjective tests and measures.

PMID- 11192876
TI  - Distortion-product otoacoustic emissions and glycerol testing in endolymphatic
      hydrops.
AB  - OBJECTIVES/HYPOTHESIS: Aural fullness is a frequent symptom of endolymphatic
      hydrops. Its evaluation may provide valuable information on the initial stage of
      development of endolymphatic hydrops. STUDY DESIGN: The present investigation was
      specifically designed to ascertain the ability of the glycerol test, combined
      with pure tone audiometry and distortion product otoacoustic emissions (DPOAEs)
      testing, to diagnose endolymphatic hydrops early and to identify patients who may
      evolve toward Meniere's disease. For these purposes, patients who complained
      about aural fullness as their only audiologic symptom were selected. METHODS:
      This investigation consisted of 19 consecutive patients with unilateral or
      bilateral aural fullness who received no treatment. Each patient underwent
      glycerol testing measured with conventional pure tone audiometry and with both
      DPOAEs. For the traditional pure-tone glycerol test, a hearing improvement of at
      least 10 dB, at the lower two or three frequencies (125, 250, and 500 Hz), was
      judged as a positive result. For the DPOAE glycerol test, a smaller positive
      difference (5 dB) for at least three frequencies was interpreted as an
      ameliorative fluctuation. RESULTS: The outcomes of the glycerol tests (24 ears
      examined) showed variable patterns. Seven ears showed no significant changes of
      either the pure-tone audiogram or DPOAE. In seven other ears, the comparison of
      the traditional glycerol test and the DPOAE glycerol test indicated an
      improvement in both measures. Another seven ears showed negative glycerol tests,
      whereas DPOAE responses gradually recovered reaching levels significantly higher
      than those recorded before glycerol administration. The three remaining ears
      showed contrasting results. CONCLUSIONS: Patients with aural fullness in the
      absence of other associated symptoms may potentially be in the initial stages of
      Meniere's disease. This notion is confirmed by the present findings showing a
      high rate (58%) of positive glycerol tests in the selected patients. The
      importance of DPOAE testing is supported by their ability to detect minimal
      dysfunction, possibly representing endolymphatic hydrops that goes undetected by
      routine pure-tone audiometry.

PMID- 11192877
TI  - Vestibular end-organ impairment in an animal model of type 2 diabetes mellitus.
AB  - OBJECTIVES/HYPOTHESIS: To define and assess the functional impairment of the
      vestibular part of the inner ear in a diabetic state, using a direct and
      objective test for evaluating the vestibular end-organ and an animal model for
      diet-induced type 2 diabetes mellitus. STUDY DESIGN: Prospective controlled
      animal study. METHODS: Two groups of sand rats (Psammomys obesus) were maintained
      on two different diets. The experimental group received a specially designed high
      energy diet known to induce a diabetic state, and the control group a low-energy
      diet maintaining these animals in a normal metabolic state. After 1 month of
      documented hyperglycemia in the experimental group, recordings of vestibular
      evoked potentials (VsEPs) and recordings of auditory brainstem response (ABR)
      were conducted in all animals. The latency and the amplitude of the first wave of
      both responses, shown to reflect end-organ activity, were compared between the
      two groups. RESULTS: The mean latency of the first wave of the VsEPs was
      significantly (P = .002) prolonged and the amplitude was significantly (P = .005)
      decreased in the diabetic group in comparison to the control group. The latency
      of the first wave of ABR was significantly (P = .02) prolonged, the amplitude was
      not significantly decreased, and threshold was significantly elevated (P = .01)
      in the diabetic group. CONCLUSION: For the first time, using an objective
      assessment test, functional impairment of the vestibular part of the inner ear
      has been demonstrated in the diabetic metabolic state. Despite this being an
      animal study, these findings would seem to indicate that the vestibular-end-organ
      should be added to the long list of organs and tissues adversely affected by
      diabetes.

PMID- 11192878
TI  - Chronic otitis media sequelae in skeletal material from medieval Denmark.
AB  - OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in
      archaeological skeletal materials from various ages. COMS reflecting episodes of
      upper respiratory tract infection may be used as a paleopathological indicator of
      general health. Estimation of the frequency of COMS may be useful in the gross
      evaluation of general standard of living. MATERIALS AND METHODS: Temporal bones
      and auditory ossicles from 659 individuals from two Danish medieval rural parish
      cemeteries, dated to 1050-1200 and 1150-1350, respectively, were examined
      otomicroscopically. RESULTS: Osseous fistulae from mastoid abscesses, remodelling
      of the hypotympanon, and erosion of the incus were among the convincing
      indications of COMS. A minimum frequency of COMS of 1% to 7% was found. The
      youngest material displayed the highest frequency of pathological changes.
      CONCLUSION: Indications of a rising incidence of infectious middle ear disease in
      early medieval Denmark were found. This may reflect a deterioration of living
      conditions from the 11th through the 14th centuries.

PMID- 11192879
TI  - Complications associated with the Sistrunk procedure.
AB  - OBJECTIVE: To assess the type and rate of complications in the postoperative
      period of pediatric patients undergoing the Sistrunk procedure. STUDY DESIGN: A
      retrospective review of patients with a diagnosis of thyroglossal duct cyst who
      had not had corrective surgery previously. An attempt to standardize the study
      was made as follows: all patients had surgery under the direction of one surgeon,
      using the Sistrunk procedure with minor modifications from its original
      description. Complications were divided into major and minor categories. METHODS:
      Charts were reviewed for age, sex, preoperative assessment, and postoperative
      follow-up. Complications were recorded. A postoperative telephone survey was
      conducted. RESULTS: A minor complication rate of 29% was observed. There were no
      recurrences or major complications. CONCLUSIONS: The Sistrunk procedure remains
      the operation of choice for removal of the thyroglossal duct cyst. When the
      surgery is properly performed, with attention to key surgical landmarks, the risk
      of major complication is minimal. Complications that do occur are minor and wound
      related.

PMID- 11192880
TI  - Overexpression of p53-related proteins predicts rapid growth rate of head and
      neck cancer.
AB  - OBJECTIVES/HYPOTHESIS: The p53 tumor suppressor gene plays an important role for
      cell cycle regulation and is the most frequent mutated gene in head and neck
      cancer. Controversy remains regarding the biological and clinical value of
      immunohistochemical identification of the proteins accumulated in association
      with inactivation of the p53 gene and increased tumor growth. Therefore, the
      objective of the present study was to perform a cell kinetic analysis of cases
      with untreated squamous cell carcinoma and to compare the result with
      immunostaining for p53-related proteins in the tumor cells. STUDY DESIGN: A
      prospective series of 32 patients presenting with various stages of untreated
      squamous cell carcinoma of the head and neck were included. Bromodeoxyuridine
      (BrdU) was injected as a tracer dose before tumor biopsy for cell kinetic
      analysis, and p53 protein accumulation was detected using two antibodies (DO7 and
      PAb 1801). RESULTS: Antibody DO7 showed the highest and the optimal
      immunoreactivity. Diploid tumors were found in 27 cases (84%), and the mean
      potential doubling time (Tpot) was 55 +/- 7 hours for these tumors. Positivity of
      DO7 (>1%) was demonstrated in 85% of the cases. However, a discrimination level
      exceeding 20% was required to obtain a significant negative relationship
      (Spearman's rank correlation coefficient test, P < or = .03) between Tpot and DO7
      positivity. At that level, 33% of the tumors remained DO7-positive. The
      corresponding Tpot was not significantly different from the overall mean. The
      rates of metastatic disease and survival were not dependent on DO7
      immunoreactivity or cancer cell kinetics. CONCLUSION: Accumulation of p53-related
      proteins is associated with an unrestrained growth of head and neck cancer.

PMID- 11192881
TI  - A prospective study of p53 expression and its correlation with clinical response
      of radiotherapy in nasopharyngeal carcinoma.
AB  - OBJECTIVES/HYPOTHESIS: Nasopharyngeal carcinoma (NPC) is a common malignant
      neoplasm of the head and neck that occurs in people in the southeastern Asian
      area, including Taiwan. The significant association of p53 expression in NPC
      suggested that p53 overexpression seemed to occur at an early stage in the
      development of NPC. Alterations of p53 status were probably the most commonly
      encountered in head and neck carcinomas, and there was extensive evidence that
      p53 status might determine tumor response to therapy. Ionizing radiation was
      studied extensively for the relationship between its damaging effect and p53
      status in human cancer cells. STUDY DESIGN: This study was carried out to
      investigate whether there was any correlation between overexpression of p53
      protein and locoregional tumor response in patients with NPC treated with 7000
      cGy of radiotherapy. METHODS: Sixty-eight patients (50 males, 18 females) with
      NPC who were diagnosed and treated with radiotherapy were studied prospectively.
      Before they had received a radiation dose of 7000 cGy in 35 fractions, five
      fractions a week, p53 status from a nasopharyngeal biopsy was studied using
      immunohistochemical staining (IHC). RESULTS: The locoregional response rate of
      primary tumor was analyzed statistically. Forty-seven patients (69.1%) showed
      positive p53 staining in their tumors. There were 5 positive stains in 6 squamous
      cell carcinomas (SCC; 83.3%), 34 positive in 53 non-keratinizing carcinomas (NKC;
      64.2%), and 8 positive in 9 undifferentiated carcinomas (UC; 88.9%). The mean
      ages for patients with three different histopathologies were 48.5, 46.1, and 61.1
      years. There were 8 patients (7 positive stains, 1 negative stain) with residual
      tumor after radiotherapy and all were NKC (6 males, 2 females). Therefore, the
      clinical response rate of primary tumor was 85.1% in positive p53 immunostaining
      (40 of 47 cases), 95.2% in those with no immunostaining (20 of 21 cases); the
      former was poorer in locoregional tumor response than the latter, but there was
      no significant difference (P > .05, chi2 test). CONCLUSIONS: We conclude that
      there is no statistically significant correlation in locoregional response of
      primary tumor between p53 overexpression and radiotherapy in patients with NPC (P
      > .05, Fisher exact test).

PMID- 11192882
TI  - Modern concepts of frontal sinus surgery.
AB  - OBJECTIVES/HYPOTHESIS: To validate the endonasal surgical approach to frontal
      sinus in inflammatory sinus disease, trauma, and selective tumor surgery, and to
      define the role of external approaches to the frontal sinus. Endonasal frontal
      sinusotomy can range from endoscopic removal of obstructing frontal recess cells
      or uncinate process to the more complex unilateral or bilateral removal of the
      frontal sinus floor as described in the Draf II-III drainage procedures. In
      contrast, the osteoplastic frontal sinusotomy remains the "gold standard" for
      external approaches to frontal sinus disease. METHODS: A retrospective review of
      1286 patients undergoing either endonasal or external frontal sinusotomy by the
      authors at four university teaching programs from 1977. Prior author reports were
      updated and previously unreported patient series were combined. RESULTS: Six
      hundred thirty-five patients underwent type I frontal sinusotomy, 312 type II
      sinusotomy, and 156 type III sinusotomy. A successful result was seen in these
      groups, 85.2% to 99.3%, 79% to 93.3%, and 91.5% to 95%, respectively. External
      frontal sinusotomy or osteoplastic frontal sinusotomy was successfully performed
      in 187 of 194 patients. Clinical symptoms, endoscopic findings, computed
      tomography, and magnetic resonance image scanning, and reoperation rate measured
      postoperative success. CONCLUSIONS: A stepwise approach to the surgical treatment
      of frontal sinusitis, trauma, and selective benign tumors yields successful
      results as defined by specific criteria which vary from 79% to 97.8%. The details
      of specific techniques are discussed, essential points emphasized, and author
      variations noted.

PMID- 11192883
TI  - Argon plasma surgery for the inferior turbinate of patients with perennial nasal
      allergy.
AB  - OBJECTIVES: Argon plasma coagulation (APC) is a new electrosurgical modality. The
      advantages of APC are coagulating of the target tissue without contact and the
      creation of uniformly deep devitalized and coagulated zones. The objectives of
      the present study were to determine the clinical effects of APC for the inferior
      turbinate of patients with nasal allergy and to clarify the histological changes
      in the mucosa after APC. STUDY DESIGN: In a prospective study, 95 patients with
      perennial nasal allergy were treated with APC. Nasal symptoms and intranasal
      findings were evaluated preoperatively and 1, 3, and 6 months, and 1 year after
      the APC. Mucosal specimens from the turbinates were examined under light and
      electron microscopy. RESULTS: Nasal stuffiness was improved in 77 of 79 (97.5%)
      patients after 1 month, in 50 of 51 (98.0%) patients after 3 months, in 20 of 23
      (87.0%) patients after 6 months, and in 9 of 12 (75.0%) patients at 1 year after
      the APC. Rhinorrhea was improved in 46 of 75 (61.3%) patients after 1 month, in
      40 of 51 (78.4%) patients after 3 months, in 16 of 21 (76.2%) patients after 6
      months, and in 6 of 10 (60.0%) patients at 1 year after the APC. The sneezing was
      improved in 32 of 54 (59.3%) patients after 1 month, in 21 of 35 (60.0%) patients
      after 3 months, in 10 of 14 (71.4%) patients after 6 months, and in 6 of 8
      (75.0%) patients at 1 year after the APC. In the intranasal findings, congestion
      of the inferior turbinate improved in 75 of 76 (98.7%) patients after 1 month, in
      49 of 52 (94.2%) patients after 3 months, in 20 of 23 (87.0%) patients after 6
      months, and in 7 of 11 (63.6%) patients at 1 year after the APC. The nasal
      discharge was reduced in 40 of 75 (53.3%) patients after 1 month, in 32 of 52
      (61.5%) patients after 3 months, in 15 of 22 (68.2%) patients after 6 months, and
      in 5 of 11 (45.5%) patients at 1 year after the APC. No patients needed nasal
      packing after the APC. CONCLUSIONS: This is the first report on the clinical
      effects of turbinate surgery for nasal allergy using APC. APC was useful fer
      turbinate surgery of nasal allergy, especially for nasal stuffiness and
      congestion of the turbinate.

PMID- 11192884
TI  - Insecticidal activity of common reagents for insect foreign bodies of the ear.
AB  - OBJECTIVE: Insects commonly present as painful and distressing foreign bodies of
      the external ear canal. Removing live insects can be challenging, especially for
      primary care physicians who have limited equipment. The purpose of this study is
      to compare the insecticidal activity of commonly available preparations for
      insects that are most frequently recovered from ear canals: cockroaches (German
      and American), ticks, beetles, and honeybees. STUDY DESIGN: Prospective, blinded.
      METHODS: One hundred seventy insects of each species were placed in test tubes
      and submerged in 17 test preparations (10 tubes per preparation, 1 insect per
      test tube). Insect activity was stimulated by agitation of the test tube.
      Responses were monitored, and the time until death was measured. RESULTS: Most
      test preparations exhibited some insecticidal activity against most insect
      species. Ticks were completely resistant to all of the test reagents. Ethanol
      killed the American cockroaches (mean time, 32.6 s), German cockroaches (mean
      time, 29.6 s), and honeybees (mean time, 19.6 s) the most rapidly. CONCLUSION:
      Many commonly available reagents may be used to kill or immobilize insect foreign
      bodies of the ear.

PMID- 11192885
TI  - Changes of nasal function after temperature-controlled radiofrequency tissue
      volume reduction for the turbinate.
AB  - OBJECTIVES: Temperature-controlled and temperature-monitored radiofrequency
      tissue volume reduction (RFTVR) for the turbinate is a new treatment modality for
      nasal obstruction secondary to turbinate hypertrophy. We compared the nasal
      functions after the treatment ofRFTVR and laser vaporizing turbinoplasty (LVT)
      using subjective symptom scores and objective tests. STUDY DESIGN: Prospective,
      randomized clinical trial. METHODS: Twenty-four patients with nasal obstruction
      secondary to inferior turbinate hypertrophy were prospectively evaluated from
      March 1999 to October 1999 at Seoul National University Hospital (Seoul, Korea).
      Sixteen patients were treated with RFTVR, and eight patients with LVT. The
      preoperative and postoperative nasal functions were investigated by visual
      analogue scale of symptoms, butanol threshold test, saccharine test, acoustic
      rhinometry, rhinomanometry, and ciliary beat frequency. RESULTS: At 8 weeks
      postoperatively, the severity and the frequency of nasal obstruction improved
      subjectively in 81.3% and 93.8% of RFTVR group and in 87.5% and 87.5% of LVT
      group, respectively. Significant improvement of nasal symptoms began from 2 to 3
      days after the operation in the RFTVR group, whereas there was significant
      improvement of nasal symptoms at 8 weeks after operation in the LVT group.
      However, objective nasal functions including nasal volume and total nasal
      resistance were significantly improved at 8 weeks after surgery in both groups.
      Among patients reporting symptoms of hyposmia, 55.6% of RFTVR group and 63.6% of
      LVT group showed improved olfaction. Saccharin transit time and ciliary beat
      frequency were preserved after RFTVR CONCLUSION: RFTVR for the turbinate may be
      useful as an alternative approach for the treatment of chronic turbinate
      hypertrophy.

PMID- 11192886
TI  - Local vasodilator response to mobile phones.
AB  - OBJECTIVES: The use of mobile phones with the resulting generation of potentially
      harmful electromagnetic fields (EMF) is the focus of public interest. Heat
      generation and the activation of the inducible form of nitric oxide (NO) synthase
      may be possible causes of the biological effects of EMF exposure. We investigated
      if a mobile telephone conversation can modify skin temperature, NO, and nasal
      resistance. METHODS: We studied the effect of an EMF (900 MHz) generated by a
      commercially available cellular phone during a 30-minute telephone conversation
      on skin temperature, nasal NO measured by chemiluminescence, and nasal minimal
      cross-sectional area (MCA) measured by rhinometry. Eleven normal subjects (mean
      age +/- standard error of mean [SEM], 32 +/- 5 y; 10 male) were studied. RESULTS:
      There was a similar and significant increase in skin temperature of the nostril
      and occipital area on the same side as the telephone (maximal increase 2.3 +/-
      0.2 degrees C at 6 min) as well as a tendency for higher nasal NO levels (maximal
      increase 12.9 +/- 4.9% at 10 min), whereas the MCA was significantly reduced
      (maximal decrease -27 +/- 6% at 15 min). Such changes were not recorded when an
      earpiece was used to avoid the direct exposure to the electromagnetic field.
      There were no changes in the skin temperature and nasal NO measured on the
      opposite side to the mobile phone, whereas the MCA was significantly increased
      (38 +/- 10%). CONCLUSIONS: Exposure to EMF produced by a mobile phone produces
      biological effects that can be easily measured. Microwaves may increase skin
      temperature and therefore cause vasodilation and reduce MCA. Further studies are
      needed to study the long-term effects of mobile phone use and the relation among
      NO production, vasodilation, and temperature.

PMID- 11192887
TI  - Evaluation of the effect of passive smoking on otitis media in children by an
      objective method: urinary cotinine analysis.
AB  - OBJECTIVES: We aimed to determine objectively the effect of the passive smoking
      on otitis media with effusion (OME) and recurrent otitis media (ROM) by using the
      method of cotinine urinalysis. STUDY DESIGN: We designed a prospective case
      control study with follow-up of the case group for 1 year after insertion of
      tympanostomy tubes to evaluate postoperative complications such as otorrhea and
      early extrusion (<6 months), in case a significant risk factor was found.
      METHODS: One hundred fourteen children between 3 and 8 years of age requiring
      tympanostomy tubes because of OME and ROM were chosen and compared with 40 age
      matched children. Exposure to environmental tobacco smoke was assessed by
      cotinine urinalysis, which was performed by means of the radioimmunoassay method.
      RESULTS: In this study, 73.7% (84 of 114) of the children in the case group and
      55.0% (22 of 40) of the children in the control group were found to be "exposed"
      (P = .0461). This difference was statistically significant. Comparing the
      cotinine urinalysis results with parental smoking histories, 23.1% (9 of 39) of
      the children without parental smoking histories were "exposed" to tobacco smoke
      versus 84.3% (97 of 115) of the children with parental smoking histories (at
      least one person smoking). CONCLUSIONS: Our results indicate that sidestream
      smoking increases the risk of OME and ROM. Legal regulations and guidelines must
      be established to protect children from passive smoking. Because cotinine
      urinalysis is a noninvasive and reliable method for the determination of passive
      smoking, it can be used for that purpose.

PMID- 11192888
TI  - Laser arytenoidectomy for bilateral median vocal fold fixation.

PMID- 11192889
TI  - A new turbinoplasty technique for the management of concha bullosa: our short
      term outcomes.

PMID- 11192890
TI  - Target-controlled infusion in sleep endoscopy.

PMID- 11192891
TI  - Primary intubation of cartilage tympanoplasties.

PMID- 11192892
TI  - Office myringoplasty with alloderm.

PMID- 11192893
TI  - Is it time to develop an 'ultrastaging system' for use in patients with head and
      neck malignancies?

PMID- 11192894
TI  - Pediatric fluctuating sensorineural hearing loss: problems in medical management.
AB  - OBJECTIVES: To discuss the diagnosis and management of children with fluctuating
      sensorineural hearing loss, especially focusing on those problems dealing with
      autoimmune inner ear disease. STUDY DESIGN: A retrospective chart review of a
      large pediatric otolaryngology practice. A series of 40 children with progressive
      hearing losses was identified. Of that group, 22 children, aged 1.5 to 12.2 years
      at first audiogram, were considered to have fluctuating sensorineural hearing
      loss (FSNHL). Criteria for inclusion in the FSNHL group were threshold variations
      of 15 dB or more in at least one ear at two or more of the standard audiometric
      frequencies on at least 2 testing days. METHODS: Charts were reviewed for age,
      sex, otologic history, laboratory evaluations, medical or surgical treatments,
      significant medical history, and family medical history. RESULTS: Twenty-two
      children met the criteria for fluctuating sensorineural hearing loss. Of those
      with fluctuating hearing loss, 15 were idiopathic, 3 had positive lymphocyte
      transformation tests (LTT) suggestive of autoimmune inner ear disease (AIED), and
      4 had fistula on middle ear exploration. Average fluctuation for all groups was
      29.1 dB. Average duration of fluctuations was 4.95 years. CONCLUSIONS: The
      majority of pediatric FSNHL cases (15 of 22) were idiopathic in nature. Of those
      FSNHL children with positive LTTs, only one was treated with steroid therapy. In
      the other patients with positive LTTs, parents or other physicians were often
      reluctant to treat, or the patient was lost to follow-up. Mean fluctuations
      varied substantially across all standard audiometric frequencies for all groups.

PMID- 11192895
TI  - Outcome analysis of cochlear implant reimplantation in children.
AB  - OBJECTIVES: We review our experience gained in performing cochlear reimplantation
      in 25 children who have had multichannel cochlear implant device failure at the
      Cochlear Implant Center of the Manhattan Eye, Ear and Throat Hospital and Lenox
      Hill Hospital (New York, NY), to assess the feasibility of cochlear
      reimplantation in children and the effect of reinsertion on audiological
      performance. STUDY DESIGN: We retrospectively analyzed the outcome of 27
      consecutive multichannel cochlear implant reinsertions performed in 25 children
      at the Manhattan Eye, Ear and Throat Hospital and Lenox Hill Hospital. These
      reimplantations were performed between 1990 and 1999, with a minimum follow-up of
      6 months for both surgical and audiological performance. METHODS: Charts were
      reviewed for patient factors, findings at the time of initial operation and
      repeat operation, and results of audiological testing both before and after
      reimplantation. RESULTS: Surgical complications of reimplantation included two
      intraoperative cerebral spinal fluid leaks and two late postoperative flap
      breakdowns with implant extrusions. For the most part, depth of electrode
      insertion was unchanged. Open-set speech recognition scores and speech perception
      abilities remained stable or improved compared with results before
      reimplantation. CONCLUSION: Our results confirm that cochlear implant
      reimplantation is technically feasible and allows for continued auditory
      development for the child who has a cochlear implant device failure.

PMID- 11192896
TI  - Management of acute pulmonary hemorrhage in children.
AB  - OBJECTIVE: Acute pulmonary hemorrhage can result from a variety of causes. This
      report offers a diagnosis and treatment plan for children with acute, life
      threatening pulmonary hemorrhage resulting from a variety of causes. METHODS:
      Retrospective review of children with acute pulmonary hemorrhage cared for at a
      tertiary care children's hospital during from January 1, 1993 to September 1,
      1999. PATIENTS: Fourteen children were identified with life-threatening pulmonary
      hemorrhage during the study period. INTERVENTIONS: Bronchoscopy was the keystone
      to diagnosis of pulmonary hemorrhage in this series. All of the children
      underwent multiple procedures to stabilize the airway and control blood loss.
      These interventions included CO2 laser bronchoscopy, Nd-YAG laser bronchoscopy,
      endoscopic balloon occlusion of a lobe or main bronchus, topical airway
      vasoconstrictors, endoscopic tumor excision, transcatheter embolization of
      bronchial vessels, and lobectomy. OUTCOMES: Three children died and 11 survived
      without neurological sequelae. CONCLUSIONS: Control of acute pulmonary hemorrhage
      is a difficult problem and often requires multiple procedures. Endoscopic control
      is usually required for palliation until more definitive therapy can be
      undertaken.

PMID- 11192897
TI  - A histologic analysis of three-dimensional versus two-dimensional tissue
      expansion in the porcine model.
AB  - OBJECTIVE: Recently, a two-dimensional Silastic Dacron stretching skin device has
      been developed for scalp reduction surgery. Attached subgaleally, this device
      stretches skin over time, while avoiding the visible volumetric distention that
      is typical of three-dimensional tissue expanders. Unlike three-dimensional
      expanders, the histological changes observed with a two-dimensional stretching
      device have not been described in the literature. The present study compares the
      histological effects of two-dimensional and three-dimensional skin tissue
      expansion in the porcine model. STUDY DESIGN: A university Institutional Review
      Board-approved study in which 16 domestic piglets were used. The 16 piglets were
      divided evenly into four cohorts as follows: 1, 1-week control cohort; 2, 1-week
      experimental cohort; 3, 4-week control cohort; and 4, 4-week experimental cohort.
      METHODS: Tissue expanders (three-dimensional) and Dacron Silastic tissue
      stretchers (two-dimensional) were surgically inserted into the lateral skin of 16
      domestic pigs. Animals were killed at either 1 or 4 weeks based on group
      assignment. Light microscopic ocular micrometry and stereological point counting
      were used to determine the depth of the epidermis, dermis, and subdermal adipose
      tissue layer; width of the panniculus muscle; diameter of sweat gland follicles;
      percentage ratio of dermal collagen, blood vessels, and tissue space; and
      epidermal mitotic index in 100 specimens. One-way ANOVA was used to evaluate
      statistical differences. RESULTS: Both tissue expanders yielded increased values
      compared with control subjects, with respect to epidermal, dermal, and fat widths
      and blood vessel counts, whereas adnexal structures in the panniculus muscle
      width were unaltered. CONCLUSIONS: Although statistically the two types of
      expansion produced histologically similar changes, the degree of change varied
      according to the type of expander that was used and the duration of tissue
      expansion. Most notably, three-dimensional expansion produced more tissue gain
      per unit area expanded at both the 1-week and the 4-week time intervals, and
      early (1-week) two-dimensional tissue expansion stimulated a greater angiogenic
      response than three-dimensional expansion. These findings will assist the surgeon
      in understanding the physical changes that occur with these two forms of tissue
      expansion, as well as the potential clinical advantages and shortcomings of each
      method.

PMID- 11192898
TI  - Endoscopic arytenoid repositioning for unilateral arytenoid fixation.
AB  - OBJECTIVES: To describe a new endoscopic technique for medialization of the
      laterally fixed arytenoid. The surgical technique, endoscopic arytenoid
      repositioning, is described, and the results of a series of cases are discussed.
      STUDY DESIGN: Retrospective chart review. METHODS: Eight patients underwent the
      procedure. Six patients were available for long-term follow-up. Preoperative and
      postoperative voice ratings were compared to evaluate the success of the
      procedure. Follow-up ranged from 3 to 64 months (mean follow-up, 31.5 mo).
      RESULTS: Long-term follow-up in six cases revealed that 67% (4 of 6) patients had
      normal or near-normal postoperative voices and one patient experienced moderate
      improvement. The mean preoperative voice score was 4.24, and the mean
      postoperative voice score was 1.83 (range, 1-5). The difference was statistically
      significant (P < 0.001). CONCLUSIONS: Endoscopic arytenoid repositioning is a
      newly described procedure with a very specific indication: a unilateral,
      laterally fixed arytenoid complex resulting in a severely dysphonic voice. Though
      technically demanding, this procedure provides a promising option for
      medialization of the posterior glottis in a scarred larynx.

PMID- 11192899
TI  - Neonatal subglottic stenosis--incidence and trends.
AB  - OBJECTIVE/HYPOTHESIS: Neonatal subglottic stenosis is a known entity arising from
      endotracheal tube intubation. In the 1970s and 1980s, estimates of the incidence
      of subglottic stenosis were in the range of 0.9% to 8.3% of intubated neonates.
      Because of improved techniques of handling neonates who require ventilatory
      support, we thought the actual incidence of neonatal subglottic stenosis in the
      late 1990s was much lower. STUDY DESIGN: We retrospectively reviewed all neonatal
      intensive-care unit (NICU) admissions from 1997 at our institution, which serves
      as a level 3 NICU. We also performed a MEDLINE search of the reported incidence
      of neonatal subglottic stenosis between 1960 and 1999. METHODS: Analysis was
      performed to identify all children who developed subglottic stenosis at our
      institution. Data were also collected and analyzed with regard to average
      gestational age, average birth weight, average duration of intubation, and the
      number of children requiring tracheostomy. The reports identified in the
      literature were reviewed as to the incidence of subglottic stenosis. RESULTS: A
      total of 544 neonates were admitted to the unit. Of these, 281 were intubated for
      an average of 11 days. No patients developed subglottic stenosis. Three patients
      required tracheostomies for other reasons. All studies published after 1983
      reported an incidence of neonatal subglottic stenosis as less than 4.0%, and all
      studies published after 1990 reported an incidence of neonatal subglottic
      stenosis as less than 0.63%. CONCLUSIONS: Although our report applies to only a
      single institution in a single year, after reviewing the literature we think a
      downward trend exists in the incidence of neonatal subglottic stenosis in the
      late 1990s. The current incidence of neonatal subglottic stenosis is likely
      between 0.0% and 2.0%.

PMID- 11192900
TI  - Electroporation therapy for head and neck cancer including carotid artery
      involvement.
AB  - OBJECTIVES: Electroporation therapy with intralesional bleomycin (EPT) is a
      novel, technically simple outpatient technique in which high-voltage electric
      impulses delivered into a neoplasm transiently increase cell membrane
      permeability to large molecules, including cytotoxic agents, causing localized
      progressive necrosis. Unlike many laser ablation methods, EPT can treat bulky
      tumors (>2 cm) with complete penetration. Our recent publication confirms an
      excellent response rate in the use of EPT in a clinical trial. STUDY DESIGN,
      PATIENTS, AND METHODS: Following our initial prospective study report in 1998, we
      have followed our entire initial cohort (10 patients) of patients with head and
      neck cancer beyond 24-months follow-up. Additionally, we have used this approach
      to treat four additional patients (total: 9 males/5 females) with upper
      aerodigestive tract squamous cell carcinoma, including three with internal
      carotid artery (ICA) involvement up to or within the skull base. Two patients
      underwent preoperative balloon test occlusion with cerebral perfusion studies
      followed by carotid embolization. EPT was then done safely at least 2 weeks later
      to avoid the temporary hypercoagulable state. RESULTS: Within the overall cohort
      (14 patients) 6 patients had a complete response, 6 had a partial response, and 2
      did not respond (overall 85.7% response rate). Both patients with ICA involvement
      had a partial or complete response to treatment; neither patient had a
      hemorrhagic or neurologic complication. Overall, 13 of the 14 patients were
      treated for persistent or recurrent head and neck cancer. Two of the four
      patients with early recurrent stage tumors had no evidence of recurrence after
      EPT with an average follow-up of 31.5 months. The overall early stage tumor group
      had four complete responders out of five (80%). On the contrary, only 2 of 9
      patients with advanced recurrent stage tumors were disease-free at 18 months.
      Morbidity was low for early stage tumors, but higher for advanced tumors with
      complications, including poor wound healing, dysphagia, and osteomyelitis. There
      were no treatment-related deaths. CONCLUSION: We found EPT to be safe and
      efficacious in patients with head and neck cancer, even with internal carotid
      artery involvement. Patients with early stage recurrences have the potential for
      prolonged survival beyond 2 years without the morbidity of surgery and radiation
      or toxicity of systemic chemotherapy. Because of its superb access qualities even
      for bulky tumors, EPT is a potential method of delivery for other tumoricidal
      agents such as in genetic-altering schemes.

PMID- 11192901
TI  - Recurrent respiratory papillomatosis.
AB  - Recurrent respiratory papillomatosis (RRP) is the most common benign neoplasm of
      the larynx in children. Despite its benign histology, RRP has potentially morbid
      consequences and is often difficult to treat because of its tendency to recur and
      spread throughout the respiratory tract. Long neglected from an epidemiological
      standpoint, recent initiatives to better understand this disease process have
      been launched through coordination between the Centers for Disease Control and
      Prevention and the American Society of Pediatric Otolaryngology. In this clinical
      review, I discuss what we currently know regarding the etiology, epidemiology,
      and transmission of this disease. Clinical features including pertinent aspects
      of the history, physical examination, airway endoscopy, and other considerations
      are highlighted. A detailed description of the surgical and anesthetic management
      of these challenging cases is presented. Adjuvant modalities of surgical and
      nonsurgical treatment and their indications are discussed. Ongoing research
      initiatives and the Practice Guidelines of the Recurrent Respiratory
      Papillomatosis Task Force are also included.

PMID- 11192902
TI  - Building the powerful 10-minute office visit: Part II. Beginning a critical
      literature review.
AB  - OBJECTIVE: This is the second part in a series of sequential Tutorials in
      Clinical Research. The objective of this tutorial is to introduce methods of
      searching the vast stores of information now available, to review some of the
      computer resources available, to reintroduce the concept of an a priori design
      for the search, and to reveal the need for assessment of the clinical importance
      and validity of each pertinent article found. STUDY DESIGN: Tutorial. METHODS: An
      open working group has been formed with the specific aim of surveying and
      translating the large volume of complex information on research design and
      statistics into easily understood, useable, and non-threatening tutorials for the
      busy practitioner. The hypotheses under which this work is conducted are highly
      intelligent, but extremely busy, surgeons are interested in evidence-based
      medicine and will increase personal participation in critical reading of the
      literature, pending an expanded familiarity with clinical research design and
      statistics. RESULTS: Available resources for literature searching, methods of
      quick personal overviews, and quick question-specific reviews are discussed.
      Additionally, the methods, with examples, of beginning a critical literature
      review are presented. CONCLUSIONS: Rapid, personal, critical literature review
      requires succinct formulation of the question, efficient search for the best
      available evidence, and critical appraisal of the pertinent individual articles
      to determine if sufficient evidence exists to support a clinical contention.

PMID- 11192903
TI  - Preoperative functional assessment of auditory cortex in adult cochlear implant
      users.
AB  - OBJECTIVES: To explore functional neuroanatomical responses to auditory
      stimulation before and after implantation. STUDY DESIGN: A prospective study of
      three cochlear implant candidates (pure-tone averages of 90 dB HL or greater
      bilaterally and hearing in noise test [HINT] performances of <40%) in which
      regional cerebral blood flow (rCBF) was assessed using single photon emission
      computed tomography (SPECT). METHODS: Candidates watched a 15-minute videotaped
      story under four conditions: audio presented monaurally in the right and left
      ears (aided), audio presented binaurally (aided), and visual-only presentation of
      the story. Five minutes into each story, 20 to 25 mCi of technetium 99m (99mTc)
      hexamethyl-propyleneamine-oxime (HMPAO) (Ceratec; Nycomed Amersham, Princeton,
      NJ, U.SA) was injected over a 30-second period to ensure that subjects were
      unaware of tracer administration. Subjects were scanned for 20 minutes using a
      PRISM 3000 gamma camera (Picker International, Cleveland, OH, U.S.A.). Data were
      normalized and co-registered, and subtraction images were compiled. Subtraction
      images contrasted activation patterns generated under the visual-only control
      condition to the auditory activation states acquired monaurally and binaurally.
      RESULTS: Right and left ear monaural stimulation in normal hearing subjects
      resulted in significant bilateral activation of Brodmann areas 41, 42, 21, 22,
      and 38. Although substantial intersubject response variability was noted,
      subjects generally failed to bilaterally activate these areas under monaural
      hearing aid presentations; however, bilateral activation of areas 41 and 22 was
      noted under binaural presentations. CONCLUSIONS: Despite relatively similar
      hearing losses in each ear, significant differences in preoperative auditory
      cortex activation were observed between ears. These data suggest that functional
      brain imaging provides a useful tool for exploring the responsiveness of the
      auditory cortex in cochlear implant candidates.

PMID- 11192904
TI  - A new clinical classification for Usher's syndrome based on a new subtype of
      Usher's syndrome type I.
AB  - OBJECTIVES: Usher's syndrome is an autosomal recessive disorder characterized by
      sensorineural hearing loss and progressive visual loss secondary to retinitis
      pigmentosa. Usher's syndrome is both clinically and genetically heterogeneous.
      Three clinical types are known today. METHODS: We conducted a study on 74
      patients with Usher's syndrome, performing complete audiological and
      neurotological examinations. RESULTS: Twenty-six patients had total profound
      hearing loss and retinitis pigmentosa (Usher's syndrome type I), and 48 patients
      had moderate to severe sensorineural hearing loss and retinitis pigmentosa
      (Usher's syndrome type II). We identified 9 of the 26 Usher's syndrome patients
      with profound hearing loss who showed a normal response to bithermal vestibular
      testing. CONCLUSIONS: The combination of profound hearing loss and normal
      response to bithermal vestibular testing has not been previously described in
      Usher's syndrome. Therefore we describe a new subtype of Usher's syndrome type I
      and suggest a modified clinical classification for Usher's syndrome.

PMID- 11192905
TI  - Atypical indications for OtoScan laser-assisted myringotomy.
AB  - OBJECTIVE: To describe the role of OtoScan laser-assisted myringotomy (OtoLAM)
      for indications other than chronic otitis media or recurrent acute otitis media.
      STUDY DESIGN: Cross-sectional review. METHODS: Twenty-seven office-based OtoLAM
      procedures were performed in 21 patients for "atypical" reasons. The indications
      included middle ear dysfunction with necessary air travel (n = 10) or hyperbaric
      oxygen treatment (n = 6), mastoiditis with postauricular cellulitis (n = 2),
      canal exostosis prohibiting tympanostomy (n = 1), acute otitis media accompanied
      by seizures (n = 1), and chronic middle ear effusion in a patient with hemophilia
      (n = 1). RESULTS: In each of the 20 cases available for follow-up, middle ear
      disease resolved with closure of the laser-assisted myringotomy. At a later date,
      two patients (10%) underwent another OtoLAM in the opposite ear and four patients
      (20%) required repeat OtoLAM in the same or both ears. Three patients (15%)
      ultimately underwent myringotomy tube placement because of recurrent middle ear
      dysfunction. CONCLUSIONS: Although this report contains preliminary data, the
      data suggest that OtoLAM may provide an additional option in the care of certain
      patients who have previously been treated with myringotomy tubes.

PMID- 11192906
TI  - The diagnosis of a conductive olfactory loss.
AB  - OBJECTIVES/HYPOTHESIS: Two of the most common causes of olfactory loss include
      upper respiratory infection (URI) and nasal or sinus disease. The etiology of
      most URI-related losses is thought to be viral and, as yet, there is no available
      treatment. In contrast, nasal or sinus disease produces an obstructive or
      conductive loss that often responds dramatically to appropriate therapy.
      Therefore, the distinction is important but in many cases may be difficult
      because such patients often present with no other nasal symptoms, and routine
      physical findings may be nonspecific. The purpose of this report is to
      characterize those aspects of the history and physical examination that will help
      to substantiate the diagnosis of a conductive olfactory loss. STUDY DESIGN: A
      retrospective, nonrandomized study of consecutive patients presenting with a
      primary complaint of olfactory loss. METHODS: This study reviewed 428 patients
      seen at a university-based taste and smell clinic from July 1987 through December
      1998. Of this total, 60 patients were determined to have a conductive olfactory
      loss. All patients were referred specifically because of a primary chemosensory
      complaint. The University of Pennsylvania Smell Identification Test (UPSIT;
      Sensonics, Inc., Haddon Heights, NJ) was administered in all cases. RESULTS: The
      most commonly diagnosed etiologies of olfactory loss were head injury (18%),
      upper respiratory infection (18%), and nasal or sinus disease (14%). Of the 60
      patients with a conductive loss, only 30% complained of nasal obstruction,
      whereas 58% described a history of chronic sinusitis. Only 45% reported that
      their olfactory loss at times seemed to fluctuate in severity. Anterior
      rhinoscopy failed to diagnose pathology in 51% of cases, whereas nasal endoscopy
      missed the diagnosis in 9%. Systemic steroids elicited a temporary reversal of
      conductive olfactory loss in 83% of patients who received them, offering a useful
      diagnostic maneuver, whereas topical steroids did so in only 25%. CONCLUSIONS:
      The etiology for olfactory loss can in many cases be difficult to determine, but
      it is important to establish prognosis and to predict response to therapy.
      Diagnosis requires a thorough history, appropriate chemosensory testing, and a
      physical examination that should include nasal endoscopy. A trial of systemic
      steroids may serve to verify that the loss is indeed conductive.

PMID- 11192907
TI  - Middle ear effusions and structure of the tympanic membrane.
AB  - OBJECTIVE: To study the effect of various middle ear effusions on the structure
      of the lamina propria of the tympanic membrane. METHODS: Sterile and infective
      middle ear effusions were induced by obstruction of the eustachian tube in
      specific pathogen-free (SPF) rats and in rats with upper airway infections (URI),
      respectively. The condition of the tympanic membrane was monitored at regular
      intervals. After varying survival times, the animals were killed and the tympanic
      membranes processed for light and electron microscopy. RESULTS: Sterile effusions
      always resulted in tympanosclerotic lesions. These lesions did not develop in the
      presence of primary-infected effusions. These effusions had a severe destructive
      effect on the lamina propria, followed by fibrosis. Generally, secondary
      infection did not markedly affect preexisting tympanosclerotic lesions. Moreover,
      calcification disappeared when re-aeration of the middle ear occurred, but the
      abnormal collagen depositions persisted. CONCLUSIONS: Both sterile and infective
      effusions result in comprehensive irreversible changes in the lamina propria of
      the pars tensa. The development of tympanosclerosis is confined to sterile
      effusions. Mechanical injury and compromised vascularization of the lamina
      propria are likely to be important etiological factors in the development of
      tympanosclerosis.

PMID- 11192908
TI  - Spontaneous otoacoustic emissions in humans with endolymphatic hydrops.
AB  - OBJECTIVE/METHODS: The origin and clinical implications of spontaneous
      otoacoustic emissions (SOAEs) have not been well revealed. To investigate the
      relationship between the ear with endolymphatic hydrops and SOAE, SOAEs were
      measured in 31 patients with unilateral endolymphatic hydrops and 10 volunteers
      with normal hearing levels that had less than 25 dB hearing level (HL) on average
      for five frequencies (0.25, 0.5, 1, 2, and 4 kHz). RESULTS: SOAEs were detected
      in 18 (58%) of the 31 ears with hydrops. In 15 hydropic ears in which the hearing
      levels were less than 25 dB HL on average, SOAEs were observed in 11 (73%). The
      results of examining the relationship between changes in hearing level after
      administering the glycerol test and SOAE frequency showed that four (50%) of
      eight hydropic ears had SOAEs that were detectable between the frequency in which
      hearing level improved more than 5 dB and the frequency with no hearing level
      change in the audiogram. In 28 contralateral ears, except for three cases of
      delayed endolymphatic hydrops, SOAEs were detected in 17 (61%). In 14
      contralateral ears in which the hearing levels were less than 25 dB HL on average
      for the five frequencies noted above, SOAEs were observed in nine ears (64%). In
      20 normal ears, SOAEs were detected in eight (40%). Prevalence of SOAEs in
      hydropic ears and contralateral ears of the patients with unilateral hydrops
      tended to be greater than that in normal ears; however, there was no significant
      statistical difference between them. CONCLUSION: The present results suggest that
      it is not possible to mention the characteristics of SOAE in the hydropic ear
      only in terms of the prevalence of SOAEs. SOAEs may occur in a specific portion
      of the basilar membrane corresponding to the frequency in which hearing levels
      improve after the glycerol test, in some cases with endolymphatic hydrops.

PMID- 11192909
TI  - Factors influencing the use of breast reconstruction postmastectomy: a National
      Cancer Database study.
AB  - BACKGROUND: Advances in surgical techniques and changes in our understanding of
      the biology of breast cancer have made immediate or early breast reconstruction a
      viable option for the majority of women with breast cancer. Little is known about
      national patterns of use of reconstruction. This study was undertaken to
      determine national patterns of care and factors that influence the use of breast
      reconstruction. STUDY DESIGN: A large convenience sample reported to the National
      Cancer Data Base was studied. Patients coded as undergoing mastectomy between
      1985 and 1990 (n = 155,463) and between 1994 and 1995 (n = 68,348) were
      evaluated. The use of reconstruction in the two time periods was compared, and
      patient and tumor factors influencing the use of the procedure were compared.
      RESULTS: Between 1985 and 1990, 3.4% of mastectomy patients had early or
      immediate reconstruction, increasing to 8.3% in 1994-5. Patient age, income,
      geographic location, type of hospital where treatment occurred, and tumor stage
      all influenced the use of reconstruction in univariate analysis. In multivariate
      analysis, patients age 50 or under had a 4.3-fold greater likelihood of having
      reconstruction than their older counterparts. Patients with ductal carcinoma in
      situ were twice as likely as those with invasive cancer to have reconstruction.
      Family income of $40,000 or more (Odds Ratio 2.0), ethnicity other than African
      American (Odds Ratio 1.6), surgery in a National Cancer Institute-designated
      cancer center (Odds Ratio 1.4), and surgery in a geographic region other than the
      Midwest or South (Odds Ratio 1.3) remained significant predictors of the use of
      reconstruction in multivariate analysis. CONCLUSIONS: Breast reconstruction is an
      underused option in breast cancer management. Predictors of the use of
      reconstruction do not reflect contraindications to the procedure, and indicate
      the need for both physician and patient education.

PMID- 11192910
TI  - Genetic markers in sepsis.

PMID- 11192911
TI  - Organ allocation in the United States: where does it stand? Point.

PMID- 11192912
TI  - Organ allocation in the United States: where does it stand? Counterpoint.

PMID- 11192913
TI  - Sister Mary Joseph's sign from metastatic disease of the pancreas.

PMID- 11192914
TI  - Gallbladder surgery reveals Ascaris lumbricoides.

PMID- 11192915
TI  - Hand-assisted laparoscopic live-donor nephrectomy.

PMID- 11192916
TI  - In situ pedicle resection in left trisegmentectomy of the liver combined with
      reconstruction of the right hepatic vein to an inferior vena caval segment
      transpositioned from the infrahepatic portion.
AB  - A combination of an in situ pedicle resection of the liver and a hepatic vein
      reconstruction using a cranially transpositioned segment of the IVC after
      implantation of an ePTFE graft at the missing IVC was useful in treating a
      patient who suffered from a huge liver tumor involving all of the hepatic venous
      confluence and the IVC. Although early tumor recurrence remains an unresolved
      problem for such patients, a surgical approach is feasible. This technique can be
      justified as a therapeutic modality, not only because it improves quality of
      life, but also because it provides patients with an opportunity for additional
      treatment.

PMID- 11192917
TI  - Controversy: length of stay.

PMID- 11192918
TI  - Incisional endometriosis.

PMID- 11192919
TI  - Use of healthcare resources among medically and surgically treated patients with
      gastroesophageal reflux disease: a population-based study.
AB  - BACKGROUND: Gastroesophageal reflux disease (GERD) is a common disorder that may
      be effectively managed medically or surgically. Direct evaluations of medical
      resource use are needed to better understand the relative costs of these
      alternatives. This study compared medical care use for a group of patients
      receiving surgical treatment for GERD with that for a comparable group of
      patients receiving medical management. STUDY DESIGN: We conducted a retrospective
      matched cohort study of Tennessee Medicaid (TennCare) patients with GERD
      undergoing surgical treatment in 1996 and a group of patients who received
      medical therapy during the same period. Administrative TennCare data provided
      computerized records that could be used to identify patients and measure
      healthcare use. There were 7,502 people who met all of the conditions for
      inclusion in the study, including at least two encounters with a diagnosis of
      GERD. One hundred thirty-five of these who underwent fundoplication constituted
      the surgically treated cohort. The 250 persons in the medically treated cohort
      were selected randomly from the remaining nonsurgical patients and matched to the
      surgical cohort by age, gender, race, managed care organization, and acid
      suppression drug use in the baseline year. The principal outcome of interest was
      total use of medical resources, including prescription medication. RESULTS: The
      surgical and medical cohorts did not differ significantly by demographic
      characteristics or by baseline use of pharmaceuticals. During the baseline year
      the surgically treated patients were prescribed 302 (95% CI: 270-334) days ofGERD
      treatment and the matched medical patients were prescribed 292 (95% CI: 267-317)
      days of GERD treatment. Surgically treated patients used more GERD-related
      outpatient resources (physician visits and diagnostic testing) in the baseline
      year, particularly in the 3 months before operation, when they had a mean of more
      than four outpatient encounter-days. In the followup year, use of GERD-related
      pharmaceuticals decreased markedly in the surgical cohort. These patients were
      prescribed an average of 123 days (95% CI: 94-153) of therapy, which was only 36%
      of that for medical patients (339 days [95% CI: 308-370]). More than 29% of
      surgical patients were prescribed no GERD-related drugs in the followup year
      compared with 6% of the medically treated group. The mean number of inpatient
      days for the fundoplication procedure was 3.2 (95% CI: 2.7-3.6), with a range of
      0 to 13 days. There were no differences between the two groups in other
      healthcare use. CONCLUSIONS: Our results show that in a 1-year period of
      followup, surgical treatment of severe gastroesophageal reflux disease led to a
      64% postsurgical reduction in GERD medication use, with no increase in use of
      other medical services.

PMID- 11192920
TI  - The Turkish experience with curative gastrectomies for gastric carcinoma: is D2
      dissection worthwhile?
AB  - BACKGROUND: The only possible curative treatment in gastric carcinoma is surgery,
      and there is still controversy surrounding the value of extended lymph node
      dissection. STUDY DESIGN: A retrospective cohort study was conducted in patients
      who underwent curative D1 or D2 resection for operable gastric carcinoma.
      Survival and multivariate prognostic factor analyses were carried out to
      determine whether dissection type was significant for outcomes, and which
      subgroup of patients would benefit from D2 dissection. RESULTS: Three hundred one
      patients who had potentially curative treatment were eligible to enter the trial.
      Although mortality rates were 3.1% in the D1 group and 4.3% in the D2 group (p =
      NS), morbidity rates in the D1 and D2 groups were 6.2% and 27.9%, respectively
      (p<0.05). Multivariate analysis showed that lymph node dissection type, Borrmann
      type of tumor, number of metastatic lymph nodes, and depth of wall invasion were
      the most important independent prognosticators. Five-year disease-free and
      overall survival rates were 19% and 36% in D1, and 49% and 54% in D2,
      respectively (p<0.05). After stratifying for pT and pN, the significant survival
      advantage with D2 was observed in subgroups of pT2, pT3 and pN1, pN2. The subset
      analysis showed a significant prognostic benefit with D2 dissection in patients
      in stages II and III-A. CONCLUSIONS: D2 dissections can be carried out with low
      mortality rates, but they have high morbidity rates and a survival advantage over
      D1 dissection of only 18%. In principle, a survival benefit with D2 is obtained
      especially when the tumor invades muscularis propria, penetrates serosa without
      invasion of adjacent structures, or metastasizes to fewer than fifteen regional
      lymph nodes. Data in this homogeneous population support the use of extended
      lymphadenectomy for selected group of patients with gastric carcinoma.

PMID- 11192921
TI  - Hepatic resection for hepatocellular carcinoma in the elderly.
AB  - BACKGROUND: Although the number of elderly people undergoing surgery for
      hepatocellular carcinoma (HCC) has increased because of the prolonged life
      expectancy rate, potential benefits of hepatectomy for elderly patients with HCC
      have not been fully delineated. STUDY DESIGN: Using medical records, surgical
      outcomes of HCC in 103 patients 70 years of age or older undergoing hepatic
      resection (older group) were clarified and compared with those of 283 patients
      younger than 70 years of age (younger group) in this retrospective study.
      Postresection prognostic factors were evaluated by multivariate analysis using
      Cox's proportional hazards model. RESULTS: There were no significant differences
      in postoperative complication, operative mortality, and overall hospital death
      rates between the two groups. Overall 3- and 5-year survival rates for the older
      group and the younger group were 51.0% versus 55.2%, and 42.2% versus 40.0%,
      respectively (p = 0.95). Disease-free 3- and 5-year survival rates for the older
      group and the younger group were 35.2% versus 37.6%, and 16.6% versus 24.2%,
      respectively (p = 0.66). Multivariate analysis revealed that the presence of
      liver cirrhosis and vascular invasion were independently significant factors of
      poor overall survival. CONCLUSIONS: Selected elderly patients with HCC benefited
      from resection as much as young patients, and age by itself may not be a
      contraindication to surgery. Postresection longterm prognosis in the elderly was
      determined by the presence of liver cirrhosis and vascular invasion.

PMID- 11192922
TI  - Extended hepatic resection: a 6-year retrospective study of risk factors for
      perioperative mortality.
AB  - BACKGROUND: Extended hepatic resection (more than four liver segments) is a major
      operative procedure that is associated with significant risk. The purpose of this
      study was to assess the impact of perioperative variables on in-hospital
      mortality after extended hepatectomy. STUDY DESIGN: Consecutive patients who
      underwent extended hepatic resection were studied. The prognostic value of 29
      perioperative variables was evaluated using in-hospital mortality as the
      endpoint. For each variable, the odds ratio (95% confidence interval) for in
      hospital mortality was calculated. Those variables with a lower confidence limit
      > 1 were considered important risk factors. The population was stratified into
      categories of patients having the same number of risk factors, and mortality was
      estimated for each group. These data were used to develop a risk assessment
      algorithm. RESULTS: There were 14 deaths (6%) in 226 patients. Three preoperative
      variables (cholangitis, creatinine > 1.3 mg/dL, and total bilirubin > 6 mg/dL)
      and two operative variables (blood loss > 3 L and vena caval resection) appear to
      be important factors for in-hospital mortality. The mortality associated with the
      presence of any two of the five factors was 100% (5 of 5), and the mortality
      associated with the absence of these factors was 3% (6 of 191). CONCLUSIONS:
      Perioperative evaluation of patients undergoing extended hepatic resection should
      include the quantitation of mortality risk factors. The combination of any two
      factors among preoperative cholangitis, elevated serum creatinine, elevated serum
      bilirubin, high operative blood loss, and vena cava resection may carry a high
      mortality risk. These results require prospective validation.

PMID- 11192923
TI  - The effect of cyclooxygenase-2 inhibitor FK3311 on ischemia-reperfusion injury in
      a canine total hepatic vascular exclusion model.
AB  - BACKGROUND: Liver grafts from non-heart-beating donors inevitably suffer from
      warm ischemic injury. In these grafts, large quantities of inflammatory cytokines
      and arachidonic acid metabolites are induced, further aggravating injury.
      Cyclooxygenase (COX) is an intracellular enzyme that converts arachidonic acid
      into prostaglandin (PG)G2 and PGH2. COX has two isoforms: constitutive COX-1 and
      inducible COX-2. The aim of this study was to evaluate the effects of COX-2
      inhibition by FK3311 (FK) on warm ischemic injury in a canine total hepatic
      vascular exclusion (THVE) model. STUDY DESIGN: Sixteen mongrel adult dogs were
      studied. The portal triad of the hilum and the inferior vena cava above and below
      the liver was clamped for 1 hour. Splanchnic decompression was achieved by active
      splenofemorojugular bypass. The animals were divided into two groups. FK (1
      mg/kg) was administered in the FK group (n = 8), and saline was administered in
      the control group (n = 8). Hepatic venous blood was collected to measure serum
      alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase
      (LDH), and hyaluronic acid levels. Serum thromboxane (Tx)B2 and 6-keto-PGF1alpha
      levels were also measured. Hepatic tissue blood flow was estimated
      simultaneously. Liver specimens were harvested for histologic study and
      polymorphonuclear neutrophils were counted. RESULTS: Alanine aminotransferase,
      aspartate aminotransferase, and hyaluronic acid 2 and 6 hours after reperfusion
      and LDH 30 minutes and 2 and 6 hours after reperfusion were significantly (p <
      0.05) lower in the FK group than in the control group. Hepatic tissue blood flow
      remained significantly (p < 0.05) higher in the FK group than in the control
      group 1, 2, and 6 hours after reperfusion. Histologic tissue damage was mild and
      polymorphonuclear neutrophil infiltration was significantly lower (p < 0.05) in
      the FK group than in the control group 1 and 6 hours after reperfusion. Thirty
      minutes after reperfusion, TxB2 was significantly reduced (p < 0.05) in the FK
      group, and 6-keto-PGF1alpha was not significantly lower. CONCLUSIONS: FK
      protected against hepatic warm ischemia-reperfusion injury by marked inhibition
      of TxA2.

PMID- 11192924
TI  - Surgical complications after primary nephrectomy for Wilms' tumor: report from
      the National Wilms' Tumor Study Group.
AB  - BACKGROUND: Surgical complications are a recognized morbidity of the treatment of
      patients with Wilms tumor. This study examines the incidence of surgical
      complications in the most recently completed study from the National Wilms' Tumor
      Study Group (NWTSG). STUDY DESIGN: The fourth National Wilms' Tumor Study (NWTS
      4) enrolled 3,335 patients from August 1986 to August 1994. A random sample of
      534 patients was selected from 2,290 eligible patients randomized to treatment
      regimens or enrolled in the followed category and treated according to NWXTSG
      protocol. The patient records received at the NWTSG Data and Statistical Center
      were analyzed for surgical complications (intraoperative and postoperative).
      RESULTS: Sixty-eight patients (12.7%) experienced 76 complications. Intestinal
      obstruction was the most common complication (5.1% of patients), followed by
      extensive hemorrhage (1.9%), wound infection (1.9%), and vascular injury (1.5%).
      The incidence of surgical complications in NWTS-4 was significantly lower than
      NWTS-3 (12.7% versus 19.8%, p < 0.001). There has been a marked decrease in the
      risk of extensive intraoperative bleeding and major intraoperative complications.
      Factors previously shown to be associated with an increased risk for surgical
      complications, together with indicators of type of hospital and surgeon
      specialty, were analyzed by multiple logistic regression analysis. Intravascular
      extension into the inferior vena cava (IVC), the atrium, or both (p = 0.02; odds
      ratio [OR] 3.8, 95% confidence interval [CI] 1.2, 11.8), and nephrectomy
      performed through a flank or paramedian incision (p = 0.02; OR 5.3, 95% CI 1.3,
      22) were both associated with increased risk of complications. Tumor diameter
      greater than or equal to 10cm was also associated with an increased risk of
      surgical complications (p = 0.05; OR 2.0, 95% CI 1.0, 3.9). The risk of
      complications was higher if the nephrectomy was performed by a general surgeon
      (OR 9.0, 95% CI 1.3, 65; p = 0.03) rather than a pediatric surgeon (reference
      group, OR 1.0) or pediatric urologist (OR 0.7, 95% CI 0.3, 1.8). CONCLUSIONS: The
      incidence of surgical complications in NWTSG patients undergoing primary
      nephrectomy has significantly decreased over the past decade. But surgical
      morbidity should not be overlooked. It is important that surgeons treating young
      children with solid tumors are aware of their role and the potential risks
      encountered in removal of the primary tumor. This study found that surgical
      specialists who primarily treat children can perform these operations with lower
      surgical morbidity.

PMID- 11192925
TI  - Breast reconstruction--from never to now.

PMID- 11192926
TI  - Is this a practical approach?

PMID- 11192927
TI  - Ethical principles for everyone in health care.

PMID- 11192928
TI  - John Holter's shunt.

PMID- 11192929
TI  - The water of life: a century of confusion.

PMID- 11192931
TI  - Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids.
AB  - BACKGROUND: Earlier studies demonstrated the efficacy of uterine fibroid
      embolization (UFE). We seek to demonstrate the success of the procedure in a
      community hospital setting, and we attempt to identify patients likely not to
      benefit from embolization, if possible, before the procedure. STUDY DESIGN: The
      study followed all women treated with UFE for menorrhagia or postmenopausal
      bleeding at a community hospital between 1997 and 1999. Relief of symptoms,
      ultrasound changes, and complications were documented. Six months after the
      procedure, analysis was performed on ultrasound and interview data from patients
      who underwent UFE. A smaller number of patients has been followed for 12 months
      and were available for the analysis. We examined characteristics of patients and
      procedures performed in an attempt to identify likely failures of treatment. We
      calculated complication and failure rates based on the entire group of patients.
      RESULTS: From 183 patients who applied for UFE, 16 were excluded because
      ofpathologic conditions found during preembolization evaluation; 167 women had an
      embolization, 163 were successfully embolized bilaterally, and 4 were embolized
      unilaterally because of technical failure. Eighty-eight percent of the patients
      (147 of 167 patients) reported an improvement or stabilization of symptoms 6
      months after UFE. Forty-six patients followed for 12 months experienced myoma
      shrinkage of 37% (a significant shrinkage over 6 months, p < 0.001), and total
      uterine volume decreased 52%. Analysis of shrinkage data revealed no demographic
      or procedure variable associated with shrinkage. Six patients underwent
      hysterectomy (3.5%) after embolization, one as a result of postprocedure
      infection. Pain in the first 24 hours postprocedure affected almost all patients.
      Five percent of the patients passed submucous myomata after UFE; all these
      patients at risk were identified at preembolization hysteroscopy. Four patients
      experienced premature menopause after embolization early in the study. There were
      three criteria for failure, of which a patient had to meet only one:
      hysterectomy, < 10% shrinkage ofmyoma 6 months after UFE, or worsening symptoms
      after UFE. No variables of age or size of the uterus could be shown to predict
      failure. Patients who had undergone earlier pelvic surgery were more likely to
      fail UFE (p = 0.012). CONCLUSIONS: Uterine fibroid embolization, an alternative
      treatment for myomas, offering low morbidity, can be performed in a community
      hospital setting. Eighty-eight percent of patients reported improvement or
      stabilization of symptoms. Total uterine volume decreased an average of 49% at 6
      months after embolization. Shrinkage was unaffected by the size of the uterus,
      myoma, or patient characteristic before UFE. Longterm followup study reveals a
      significant continuing shrinkage of total uterine volume and myomata at 12
      months. There has been no regrowth of fibroids. Earlier surgery was a factor
      predicting failure of UFE in our series. The risks to future fertility were
      small.

PMID- 11192930
TI  - The effects of postinjection massage on the sensitivity of lymphatic mapping in
      breast cancer.
AB  - BACKGROUND: The technique of lymphatic mapping and sentinel lymph node (SLN)
      biopsy is rapidly becoming the preferred method of staging the axilla of the
      breast cancer patient. This report describes the impact of postinjection massage
      on the sensitivity of this surgical technique. STUDY DESIGN: Lymphatic mapping at
      the H Lee Moffitt Cancer Center is performed using a combination of isosulfan
      blue dye and Tc99m labeled sulfur colloid. Data describing the rate of SLN
      identification and the node characteristics from 594 consecutive patients were
      calculated. Patients who received a 5-minute massage after injection of blue dye
      and radiocolloid were compared with a control group in which the patients did not
      receive a postinjection massage. RESULTS: When compared with controls, the
      proportion of patients who had their SLN identified using blue dye after massage
      increased from 73.0% to 88.3%, and the proportion of patients who had their SLN
      identified using radiocolloid after massage increased from 81.7% to 91.3%. The
      overall rate of SLN identification increased from 93.5% to 97.8%. The proportion
      of nodes that were stained blue among those removed increased from 73.4% to 79.7%
      after massage. CONCLUSIONS: As experience increases with this new procedure, the
      surgical technique of lymphatic mapping continues to evolve. The addition of a
      postinjection massage significantly improves the uptake of blue dye by SLNs and
      may also aid in the accumulation of radioactivity in the SLNs, further increasing
      the sensitivity of this procedure.

PMID- 11192932
TI  - The fight against rheumatism: from willow bark to COX-1 sparing drugs.
AB  - Man has been fighting rheumatism for thousands of years. Early therapy began with
      the use around the world of decoctions or extracts of herbs or plants such as
      willow bark or leaves. Most or all of these turned out to contain salicylates.
      The first record was about 3,500 years ago in the Ebers papyrus. Hippocrates,
      Celsus, Pliny the Elder, Dioscorides and Galen all recommended decoctions
      containing salicylate for rheumatic pain. A country parson, the Reverend Edward
      Stone of Chipping Norton in Oxfordshire, made the first "clinical trial" of
      willow bark (1). He was surprised by its bitter taste, which reminded him of
      cinchona bark (containing quinine), then being used to treat malaria. He
      harvested a pound of willow bark, dried it, pulverized it and dispersed it in
      tea, small beer or water. He found in 50 patients that doses of 1 dram (1.8g)
      cured their fever. He concluded "I have no other motives for publishing this
      valuable specific, than that it may have a fair and full trial in all its variety
      of circumstances and situations, and that the world may reap the benefits
      accruing from it". Salicylic acid was chemically synthesised in 1860 by Kolbe in
      Germany and its ready supply led to even more extended usage as an external
      antiseptic, as an antipyretic and in the treatment of rheumatism.

PMID- 11192933
TI  - Regulation of cyclooxygenase isoforms in the renal thick ascending limb: effects
      of extracellular calcium.
AB  - We previously showed that primary cultures of mTAL cells express cyclooxygenase 2
      (COX-2) when challenged with tumor necrosis factor alpha (TNFalpha) or phorbol
      myristate acetate (PMA). Moreover, expression of COX-2 was linked to decreases in
      TNFalpha-mediated 86Rb uptake, an in vitro correlate of natriuresis. mTAL cells
      in primary culture express calcium sensing receptor (CaR), a G-protein coupled
      receptor that senses changes in extracellular calcium concentration and
      ultimately increases intracellular calcium concentration ([Ca2+]i) and protein
      kinase C (PKC) activity. PGE2 synthesis by mTAL cells increases in a dose- and
      time-dependent manner after exposure of these cells to extracellular Ca2+.
      Similar effects were observed when cells were challenged with the CaR-selective
      agonist, poly-L-arginine. These data suggest that intracellular signaling
      mechanisms initiated via activation of CaR contribute to mTAL PGE2 synthesis. As
      TNF production is calcium-sensitive in some cells types, we postulate that these
      effects involve the regulation of COX-2 expression via a TNF-dependent mechanism.
      The functional implications of these studies relate to a cytokine-mediated
      mechanism that contributes to salt and water balance, and suggests that small
      changes in Ca(2+)o may contribute to the regulation of these events. The
      possibility that the effects of Ca(2+)o involve activation of CaR suggests that
      novel calcimimetic molecules might be useful in conditions, such as hypertension
      or other conditions, in which manipulation of extracellular fluid volume provides
      beneficial effects.

PMID- 11192934
TI  - Trans-arachidonic acids: new mediators of inflammation.
AB  - Inflammation and many other pathological processes lead to increased production
      of free radicals that target critical macromolecules such as proteins, DNA and
      lipids. Structural modifications of these molecules, induced by free radicals,
      typically result in alterations of vital biochemical processes. Hydroxyl radical
      initiated lipid peroxidation is known to generate a variety of toxic oxidized
      lipids, many of which originate from polyunsaturated fatty acids esterified to
      cellular membrane phospholipids. Recent interests have focused on a group of
      lipids known as isoeicosanoids that are formed from peroxidation of arachidonic
      acid, and share structural similarity to enzymatically-derived prostaglandins and
      leukotrienes. However, little is known about lipid peroxidation processes
      initiated by nitrogen free radicals. NO2 is a toxic free radical and an abundant
      urban air pollutant, which is also generated in vivo from oxidations of nitric or
      nitrite and decomposition of peroxynitrite. The NO2-induced lipid peroxidation
      mechanisms involving arachidonic acid have not been characterized. Described here
      is the isomerization of arachidonic acid, a new process induced by NO2, which
      leads to a mixture of trans-arachidonic acids. We observed that the levels of
      trans-arachidonic acids in rat plasma increased following infusion of bacterial
      endotoxin; therefore, the isomerization of arachidonic acid is likely to occur in
      vivo by a mechanism involving NO2.

PMID- 11192935
TI  - Paracetamol-inhibitable COX-2.
AB  - Although paracetamol potently reduces pain and fever, its mechanism of action has
      so far not been satisfactorily explained. It inhibits both COX-1 and COX-2 weakly
      in vitro, but reduces prostaglandin synthesis markedly in vivo. In mouse
      macrophage J774.2 cells, COX-2 induced for 48 hr with high concentrations of
      NSAIDs is more sensitive to inhibition with paracetamol than endotoxin-induced
      COX-2. In the rat pleurisy model of inflammation, a second peak of COX-2 protein
      appears 48 hr after administration of the inflammatory stimulus, during the
      resolution phase of the inflammatory process. Inhibition of the activity of this
      late-appearing COX-2 with indomethacin or a selective COX-2 inhibitor, delays
      resolution and the inflammation is prolonged. Cultured lung fibroblasts also
      express COX-2 activity after stimulation with IL-1beta which is highly sensitive
      to inhibition with paracetamol. Thus, evidence is accumulating for the existence
      of a COX-2 variant or a new COX enzyme which can be inhibited with paracetamol.

PMID- 11192936
TI  - Changes in renal autacoids in aged human hypertensives.
AB  - The aging process determines several modifications of the kidney, that, however,
      do not provoke any dysfunction in normal conditions. But in the elderly--in the
      presence of stressful situations and particularly when adrenergic activation is
      present--the kidney is more vulnerable than in the young, and renal failure may
      arise. Variations typical of the aging kidney are accelerated when hypertension
      overlaps the physiological renal process, because both senescence and
      hypertension weight on the same structures, i.e. glomeruli. We studied renal
      hemodynamic adaptation capacity both in the healthy elderly and in patients
      affected by isolated systolic hypertension, in an acute experiment which requires
      the application of a mental stress-induced adrenergic activation. In hypertensive
      patients we have already demonstrated a total lack of renal adaptation capacity.
      In fact, while the elderly normotensives react with a prolonged and pronounced
      vasoconstriction, in those with isolated systolic hypertension, adrenergic
      activation induces a passive renal vasodilation and glomerular hyperfiltration.
      The anomalous adaptation capacity of renal hemodynamics is probably due to an
      impairment in the paracrine response of renal vasculature. Indeed in the
      hypertensive elderly, unlike in the normotensive one, no variations of autacoid
      production occur during the adrenergic activation. Following on from this,
      pattients affected by isolated systolic hypertension passively suffer the many
      hypertensive peaks which characterize their every day life. The altered renal
      autoregulation of the elderly with isolated systolic hypertension may explain the
      accelerated glomerulosclerosis and the greater incidence of renal damage and end
      stage renal disease which characterize this condition. These aspects underline
      the primary role of the antihypertensive treatment of isolated systolic
      hypertension, not only for the prevention of cardiovascular mortality but also of
      renal damage and/or end-stage renal disease.

PMID- 11192937
TI  - Clinical pharmacology of eicosanoids, nicotine induced changes in man.
AB  - Smoking is an important risk factor for respiratory and cardiovascular diseases.
      The role of numerous chemical, partly uncharacterised compounds existing in
      tobacco smoke is not known. (-)-Nicotine, its stereoisomer (+)-nicotine and main
      metabolite cotinine are biologically active compounds influencing e.g.
      catecholamine and eicosanoid systems. The precise mechanisms are not well known.
      The purpose of the present study consisting of a PhD thesis (11) and five
      original papers was to investigate the in vitro effects of nicotine isomers and
      cotinine on eicosanoid production in polymorphonuclear leukocytes, platelets and
      whole blood in vitro, and to clarify the effects of smoking without and with
      nicotine substitution on eicosanoid production in vivo and ex vivo. It was found
      that all the tested compounds modulated blood cell eicosanoid synthesis. Nicotine
      isomers and cotinine increased PGE2 but decreased TXB2, LTB4 and LTE4 synthesis
      in vitro. Eicosanoid synthesis in vivo and ex vivo was higher in smokers (n = 60)
      than in non-smoking controls (n = 20). This may contribute to the harmful
      cardiovascular effects of smoking. Cessation of smoking without, but not with,
      nicotine substitution reduced eicosanoid synthesis measured ex vivo as whole
      blood production or in vivo as urinary excretion of eicosanoid metabolites after
      3, 7 and 14 days. Thus long-term nicotine substitution diminishes the beneficial
      effects of smoking cessation.

PMID- 11192938
TI  - Anti-microinflammatory lipid signals generated from dietary N-3 fatty acids via
      cyclooxygenase-2 and transcellular processing: a novel mechanism for NSAID and N
      3 PUFA therapeutic actions.
AB  - Aspirin therapy inhibits prostaglandin biosynthesis; yet via acetylation of
      cyclooxygenase 2 (COX-2) it leads to bioactive lipoxins epimeric at carbon 15 (15
      epi-LX, also termed aspirin-triggered lipoxin or ATL). Here, we review our
      findings indicating that inflammatory exudates from mice treated with omega-3
      PUFA and aspirin (ASA) generate a novel array of bioactive lipid signals. Also,
      human endothelial cells, both HUVEC and microvascular, with upregulated COX-2 and
      treated with ASA converted C20:5 omega-3 to 18R-hydroxyeicosapentaenoic acid
      (HEPE) and 15R-HEPE. Human PMN activated with serum treated zymosan (STZ)
      utilized each of these R-HEPEs to generate novel classes of trihydroxy-containing
      mediators including 5-series 15R-LX and 5,12,18R-triHEPE. The novel products were
      potent inhibitors of human PMN transendothelial migration and infiltration of PMN
      in dorsal air pouches in vivo. In addition to ASA, both acetaminophen and
      indomethacin also permitted 18R-HEPE and 15R-HEPE generation with recombinant
      human COX-2 as well as omega-5 and omega-9 oxygenations of other fatty acids that
      act on leukocytes, platelets and endothelial cells. These findings establish new
      transcellular routes for producing arrays of lipid mediators via COX-2-NSAIDs and
      cell-cell interactions that impact microinflammation. Moreover, they provide
      novel mechanism(s) that could underlie the many reported therapeutic benefits of
      omega-3 dietary supplementation of interest in inflammation, cancer, and vascular
      disorders.

PMID- 11192939
TI  - Selective inhibition of arachidonic acid epoxidation in vivo.
AB  - Cytochrome P450 (CYP)-derived arachidonic acid metabolites, including
      epoxyeicosatrienoic acids (EETS) and 20-HETE, have been implicated in the
      regulation of renal function and vascular tone. Studying the function of specific
      CYP arachidonate metabolites has been hampered due to lack of selective
      inhibitors and difficulty in their solubilization. We have identified MS-PPOH as
      a potent and selective inhibitor of CYP-catalyzed arachidonate epoxidation in
      vitro. We used 2-hydroxypropyl-beta-cyclodextrin as a vehicle in order to
      administer MS-PPOH in vivo. One hour after administration, MS-PPOH (5 mg, IV
      bolus) significantly inhibited arachidonic acid epoxidation in rat renal cortical
      microsomes (vehicle-282 +/- 12 pmol/mg/min, MS-PPOH-206 +/- 10 pmol/mg/min, p <
      0.05) but had no effect on 20-HETE formation (vehicle-383 32 pmol/mg/min, MS-PPOH
      367 +/- 9 pmol/mg/min). The inhibitory effect lasts at least for 6 hours. There
      was no inhibition of 20-HETE synthesis at any time point. We also examined the
      effect of MS-PPOH on renal excretiry function. Three hours after MS-PPOH
      administration to anesthetized rats, urine flow rate became significantly higher
      (vehicle-275 +/- 16 microl/hour, MS-PPOH-406 +/- 44 microl/hour, p < 0.05).
      Sodium excretion rate was also significantly higher (vehicle-28.7 +/- 4
      micromol/hour, MS-PPOH-63.3 +/- 10 micromol/hour, p < 0.05) but potassium
      excretion rate was not affected (vehicle-65.5 +/- 5 micromol/hour, MS-PPOH-79.2
      +/- 2 micromol/hour). These results suggest that MS-PPOH may be useful as a
      selective inhibitor of CYP-catalyzed arachidonic acid epoxidation in vivo, and
      implicate EETs and anti-diuretic and anti-natriuretic in the regulation of renal
      function.

PMID- 11192940
TI  - Isoprostanes in atherosclerosis.
AB  - Isoprostanes (IP) are a new family of compounds formed during oxidation injury. 8
      epi-prostaglandin (PG) F2alpha, a vasoconstrictory and mitogenic substance, is
      increased in hyperlipidemia in blood and urine as well as at the vascular level
      in the intima, in particular along foam cells. Similarly, cigarette smoking is
      associated with an immediate increase in 8-epi-PGF2alpha and a quick drop after
      quitting. Also diabetes and even the more a combination of risk factors (for the
      development of atherosclerosis) results in increased 8-epi-PGF2alpha in various
      compartments. Others, such as sex, age, hypertension and obesity were of minor
      influence. These findings further indicate, that in-vivo oxidation injury as
      reflected by increased IP may play a relevant role in atherogenesis. IP may serve
      as useful markers to assess oxidation injury at a local level.

PMID- 11192941
TI  - Thrombolysis by thienopyridines and their congeners.
AB  - We propose that anti-platelet thienopyridines, such as ticlopidine or
      clopidogrel, are thrombolytic owing to endothelial release of prostacyclin (PGI2)
      and tissue plasminogen activator (t-PA). In this study we used anaesthetised
      Wistar rats with extracorporal circulation in which arterial blood superfused
      thrombi which adhered to a strip of collagen. Weight of thrombi was continuously
      monitored. When administered intravenously, clopidogrel or its R enantiomer
      deprived of anti-platelet action, both at doses of 3 mg x kg(-1), produced lost
      in weight of thrombi by 14.1 +/- 1.3% or 16.0 +/- 1.4% (n = 9), and at doses 10
      mg x kg(-1) by 28.3 +/- 2.3% or 30.4 +/- 1.9% (n = 8), respectively. Maximum of
      thrombolysis occurred 30-45 min following the drug administration. Ticlopidine at
      a dose of 30 mg x kg(-1) reduced weight of thrombi by 33.7 +/- 1.7% (n = 32).
      Thrombolytic action of ticlopidine was accompanied by a rise in 6!keto-PGF1alpha
      blood levels from 0.42 +/- 0.10 to 1.58 +/- 0.29 ng x ml(-1) and t-PA antigen
      plasma levels from 4.70 +/- 1.00 to 12.90 +/- 1.15 ng x ml(-1) (n = 7). Five out
      of eleven tested thienopyridine congeners with pyrimidine or pyrimidinone instead
      of pyridine rings had thrombolytic potencies similar to that of clopidogrel
      (ED30s at a range of 6.2-11.4 mg x kg(-1)). A substantial increase in
      thrombolytic potency (ED30s at a range of 0.3-2.1 mg x kg(-1)) was observed for
      congeners in which thienyl ring was condensed with an additional cyclopentyl,
      cyclohexyl or cycloheptyl structures or in which thienopyridine complex was
      replaced for a pyridopyrimidine one. We claim that thienopyridines, independently
      of their delayed anti-platelet action, do produce immediate thrombolysis in vivo.
      This new activity emulates capacity of their native, non-metabolised molecules to
      release prostacyclin and tissue plasminogen activator. We have also shown that
      structural changes in molecules of thienopyridines may intensify their
      thrombolytic potency.

PMID- 11192942
TI  - The protective role of nitric oxide in the brain ischemia.
AB  - A role of nitric oxide in ischemia/reperfusion (I/R) injury of brain in
      normotensive (Sprague-Dowley rats, SD) and stroke-prone spontaneously
      hypertensive rats (SHR-SP) was studied. Cerebral ischemia was produced in rats by
      occlusion of the middle cerebral artery (MCA). NO and O2- releases in the brain
      in response to MCA occlusion followed by reperfusion were simultaneously
      monitored (2h) using electrochemical microsensors. The size of infarct was
      evaluated in the course of I/R from images of brain slices stained with 2,3,5
      triphenyltetrazolium chloride. Similar patterns of NO and O2- releases were
      exhibited for SD and SHR-SP rats in the entire course of the experiments.
      However, the concentration of NO release was significantly lower during I/R in
      SHR-SP than in SD rats (the maximal NO concentration was 2.61 +/- 0.22 micromol/L
      for SD and 1.51 +/- 0.16 micromol/L for SHR-SP rats; *P < 0.01). In contrast, the
      concentration of O2- release during cerebral ischemia was significantly higher in
      SHR-SP than SD rats (the maximal increase was 122 +/- 24 nmol/L for SD and 220 +/
      44 nmol/L for SHR-SP rats; *P<0.01). The infarct sizes revealed in the course of
      I/R were larger in SHR-SP than SD rats (1.8 +/- 0.4% vs. 1.1 +/- 0.4% at 30 min.,
      2.84 +/- 0.8% vs. 2.21 +/- 0.6% at 100 min. and 9.20 +/- 1.1% vs. 5.8 +/- 0.6% at
      180 min. ofthe brain weights, respectively; *P < 0.01 for each time-point). These
      studies indicate that nitric oxide plays a protective role during I/R and
      deficiency of NO in SHR-SP rats is due to excess of O2- production. The
      deficiency in NO concentration correlates positively with the increase of
      cerebral I/R injury.

PMID- 11192943
TI  - Losartan inhibits the adhesion of rat platelets to fibrillar collagen--a
      potential role of nitric oxide and prostanoids.
AB  - The aim of the study was to evaluate the effect of losartan on rat platelet
      adhesion to fibrillar collagen. Washed platelets were counted before and after 15
      minutes incubation with collagen (50 microg/ml) and the percentage of adhering
      platelets was calculated as the index of their adhesion. When the platelets were
      incubated with collagen 40.8 +/- 0.3% of the platelets adhered. Losartan produced
      a dose dependent decrease in a number of adhering platelets both when the drug
      was administered to the animals ex vivo at doses of 3, 10 and 30 mg/kg (p < 0.01
      0.001) or was added to the preparation of washed platelets in vitro in
      concentrations of 10(-8)-10(-5) M (p < 0.01-0.001). In the next step of the study
      we assessed the influence of L-NAME (10 mg/kg ex vivo, 30 microM in vitro) and
      indomethacin (2.5 mg/kg ex vivo, 30 microM in vitro) on the antiadhesive effect
      of losartan (10 mg/kg ex vivo, 10(-6) M in vitro). Blockade of nitric oxide
      synthase with L-NAME partially reversed the antiadhesive effect of losartan both
      ex vivo and in vitro. Indomethacin diminished the inhibitory effect of losartan
      on platelet adhesion when administered ex vivo, but it failed to modify this
      parameter when added to the suspension of platelets in vitro. In conclusion,
      losartan reduces platelet adhesion to fibrillar collagen in a dose-dependent
      manner. The observed action of losartan seems to be mediated mainly by
      endothelium- and platelet-derived nitric oxide.

PMID- 11192944
TI  - Antiplatelet action of losartan involves TXA2 receptor antagonism but not TXA2
      synthase inhibition.
AB  - Various AT1 receptor antagonists including losartan are known to inhibit human
      platelet activation by antagonising TXA2/PGH2 receptors (TP receptors).
      Presently, we check a hypothesis that losartan, an imidazole derivative in
      contrast with valsartan, a non-imidazole compound, may inhibit human platelet
      activation also through inhibition of TXA2 synthesis. Inhibitory action of
      losartan (2-n butyl-4-chloro-5-hydroxymethyl-1-beta(2'-(1H-tetrazol-5yl)biphenyl
      4-yl)methyl] imidazole), its active metabolite EXP 3174 (2-n-butyl-4-chloro-1
      beta (2-(1H-tetrazol-5-yl) biphenyl-4-yl) methyl]imidazole-5-carboxylic acid) and
      valsartan ((S)-N-valeryl-N-(beta2'-(1H-tetrazol-5-yl)biphenyl-4
      yl]methyl]valine), on collagen-induced platelet aggregation and TXA2 generation
      was compared to effects achieved by each compound on U46619-induced aggregation
      in aspirinized platelets. Losartan and aspirin inhibited collagen-induced
      platelet aggregation with approximately the same potency, whereas EXP 3174 and
      valsartan showed much weaker antiplatelet effects. Interestingly, losartan, EXP
      3174 and valsartan displayed similar potencies as inhibitors of U46619-induced
      aggregation in asprinized platelets as in collagen-induced aggregation in non
      aspirinized platelets. None of the above three AT1 antagonists, up to a
      concentration of 300 microM, did influence collagen-induced TXA2 synthesis in
      human platelets. In conclusion, antiplatelet effects of AT1 antagonists,
      irrespective of the presence or absence of non-condensed imidazole in their
      chemical structure, involve antagonism of TP receptors but not inhibition of TXA2
      synthesis in platelets.

PMID- 11192945
TI  - The role of platelet-activating factor (PAF) antagonists and nitric oxide in
      cardiac actions of PAF. Electrophysiological and morphological study.
AB  - Electrophysiological and ultrastructural effects of platelet-activating factor
      (PAF) antgonists, WEB 2086 and BN 52021 were compared in isolated guinea-pig
      hearts preparations. We studied the possible role of nitric oxide (NO) in
      electromechanical actions of PAF. Isometric twitches and intracellular action
      potentials (APs) were recorded from guinea-pig right ventricular papillary
      muscles and left atria. For electron microscopic study the hearts were perfused
      according to Langendorff technique. WEB 2086 (5 x 10(-9)-5 x 10(-7) M)
      significantly shortened the duration of atrial AP without changing the
      ventricular one, however, BN 52021 decreased both of them. The shortening of
      atrial and ventricular AP duration (APD) by both PAF antagonits were abolished by
      4-aminopyridine (10(-3) M), a blocker of one type of K+ channels (IKto).
      Glibenclamide (10(-6) M) the blocker of ATP-dependent K channels prevented the
      shortening effect of BN 52021 (10(-6) M) on ventricular APD. Electron microscopic
      study of myocardial samples from hearts subjected to 30 min hypoxia/reoxygenation
      showed intracellular oedema, intramitochondrial swelling and fragmentation of
      mitochondrial christae, separation of intercalated disc. Pretreatment with WEB
      2086 (5 x 10(-7) M) warded off nearly all damage caused by hypoxia/reoxygenation.
      Both WEB 2086 and NO synthase inhibitor NG-nitro-L-arginine methyl esther (L
      NAME) (10(-3) M) abolished the negative inotropic effect of PAF (10(-7), 10(-6)
      M). L-NAME prevented the shortening of APD induced by 10(-7) M PAF. These results
      suggest that PAF may be responsible for myocardial ischemia and the beneficial
      effects of PAF antagonists in this pathological process could be due to their
      possible K+ channel stimulator property. These data support the possibility that
      NO contributes to the cardiac electromechanical alterations induced by PAF.

PMID- 11192946
TI  - Helicobacter pylori, gastrin and cyclooxygenases in gastric cancer.
AB  - BACKGROUND: Tumors arising in the stomach have worldwide distribution and the
      infection with Helicobacter pylori (HP) has been implicated in causation of this
      disease. The HP discovery, which is considered as the greatest advance of
      gastroenterology at the dawn of 3rd millennium, is accompanied by
      hypergastrinemia, which seems to play a key role in gastric cancerogenesis but no
      study was undertaken to assess the relationship between the HP infection and
      coexpression of gastrin and cyclooxygenases (COX), the rate limiting enzymes in
      the eicosanoids production. AIMS: Since gastrin is recognized as a effective
      gastric mitogen, it could be capable to induce COX-2, a potent tumor growth
      promoting and angiogenic factor, we decided 1) to compare the seroprevalence of
      HP and its cytotoxic protein, CagA, in gastric cancer patients with those in age-
      and gender-matched controls; 2) to determine the gene expression of gastrin and
      its receptors (CCK(B)-R) in gastric cancer, 3) to assess the plasma levels,
      gastric lumen and tumor tissue contents of gastrin and 4) to examine the mRNA and
      enzyme protein expression of COX-1 and COX-2 in cancer tissue and intact gastric
      mucosa before and after HP eradication. MATERIAL AND METHODS: The trial material
      included 20 patients with gastric cancers and 100 age- and gender-matched
      controls. Anti-HP and anti-CagA IgG seroprevalence was estimated by specific
      antisera using ELISA tests. Gene expressions of gastrin, CCK(B)-R, COX-1 and COX
      2 was examined using RT-PCR with GAPDH as a reference and employing Western blot
      for COX-2 expression, while gastrin was measured by RIA. RESULTS: The
      seroprevalence of HP, especially that expressing CagA, was significantly higher
      in gastric cancers than in controls. Both gastrin and CCK(B)-R mRNA were detected
      by RT-PCR in the cancer tissue and similarly COX-2 mRNA and protein were found in
      most of cancers and in the HP infected antral mucosa but not in HP eradicated
      patients in whom only cancer tissue but not gastric mucosa expressed COX-2. The
      gastric cancer tissue contained 20 times more of immunoreactive gastrin than the
      HP infected antral gastric mucosa and following HP eradication the gastrin
      content in the tumor and antrum showed a marked and significant reduction. No
      significant change in CCK(B)-R expression was noticed before and after HP
      eradication in the tumor and the corpus mucosa. CONCLUSIONS: 1). Gastric
      carcinoma coexpresses gastrin, its receptors (CCK(B)-R), and COX-2; 2) HP
      infection may contribute to gastric cancerogenesis via gastrin andCOX-2 that may
      account for the stimulation of tumor growth, angiogenesis, and reduction in
      apoptosis 3) HP positive patients developing gastric cancer should be considered
      for HP eradication to reduce the HP provoked hypergastrinemia and COX-2
      overexpression in the tumor tissue.

PMID- 11192947
TI  - Involvement of cyclooxygenase (COX)-2 products in acceleration of ulcer healing
      by gastrin and hepatocyte growth factor.
AB  - Ulcer healing involves expression of various growth factors including hepatocyte
      growth factor (HGF) at the ulcer margin and the rise in plasma gastrin but the
      effects of locally applied HGF and gastrin, which are known to act as trophic
      factors for the gastric mucosa, with or without neutralizing antibodies against
      HGF and gastrin or COX-1 and COX-2 inhibitors on ulcer healing and the expression
      of cyclooxygenase (COX)-1 and COX-2 during this healing have been little studied.
      Rats with gastric ulcers induced by serosal application of acetic acid (ulcer
      area 28 mm2) received a submucosal injection of either: 1)vehicle (saline), 2)
      HGF and 3) gastrin with or without neutralizing antibodies against HGF and
      gastrin or treatment with indomethacin (2 mg/kg-d i.p.), a non-specific inhibitor
      of COX, or NS-398 (5 mg/kg-d i.g.) and Vioxx (10 mg/kg-d i.g.), both highly
      specific COX-2 inhibitors. Each growth factor and specific antibodies against HGF
      and gastrin (100 ng/100 microl each) were injected just around the ulcer
      immediately after ulcer induction and this local application was repeated at day
      2 following anesthesia and laparotomy. At day 13 and 21, the area of ulcers was
      determined by planimetry, the gastric blood flow (GBF) at ulcer margin was
      examined by H2-gas clearance technique and mucosal generation of PGE2 and the
      expression of COX-1 and COX-2 mRNA in the non-ulcerated and ulcerated gastric
      mucosa was analyzed using RT-PCR. The gastric ulcers healed progressively within
      21 days and this effect was accompanied by significant increase in the GBF at the
      ulcer margin and expression of COX-2 mRNA and COX-2 protein at the ulcer area.
      Treatment with HGF and gastrin significantly accelerated the rate of ulcer
      healing and raised GBF at ulcer margin causing further significant upregulation
      of COX-2 mRNA and COX-2 protein (but not of COX-1 mRNA ) in the ulcerated mucosa.
      The upregulation of COX-2 mRNA induced by HGF was significantly attenuated by the
      concurrent local treatment with antibody against this growth peptide.
      Indomethacin and both COX-2 inhibitors significantly prolonged the ulcer healing,
      while suppressing the generation of PGE2 in non-ulcerated and ulcerated gastric
      mucosa and the GBF at ulcer margin. The acceleration of ulcer healing by HGF and
      gastrin and accompanying rise in the GBF at ulcer margin were significantly
      attenuated by the concurrent treatment with indomethacin or NS-398 and Vioxx. HGF
      injections produced a significant rise in the plasma gastrin levels and this was
      significantly attenuated by the cotreatment with NS-398. We conclude that 1)
      neutralization of HGF and gastrin by their specificantibodies delays ulcer
      healing due fall in the microcirculation around the ulcer and a decrease in the
      COX-2 expression, 2) COX-2 derived prostaglandins may play an important role in
      acceleration of the ulcer healing by various growth factors including HGF and
      gastrin, 3) enhancement of the local pool for growth factors such as HGF and
      gastrin at the ulcer site could offer a new modality for treatment of gastric
      ulcer.

PMID- 11192948
TI  - Sedation in outpatient bronchoscopy.
AB  - Bronchoscopy is a procedure that is likely to provoke anxiety as the patient is
      surrounded by monitoring and bronchoscopy equipment, and care is administered by
      strangers who perform intimate, invasive, and sometimes, painful procedures.
      Sedation is needed, therefore, to allay anxiety and reduce stress, improve
      patient comfort and co-operation, provide amnesia and facilitate the
      bronchoscopic procedure. In this review we try to summarize the current knowledge
      on currently used sedation protocols with special reference to the commonly used
      pharmacological agents. We believe sedation should be used routinely in
      fiberoptic bronchoscopy in order to achieve a safe and pleasant procedure for
      both the patient and the pulmonologist.

PMID- 11192949
TI  - Ventilatory response to CO2 re-breathing before and after nocturnal nasal
      intermittent positive pressure ventilation in patients with chronic alveolar
      hypoventilation.
AB  - Long-term nocturnal nasal intermittent positive pressure ventilation (NIPPV) has
      beneficial effects on daytime PaCO2 in patients with chronic alveolar
      hypoventilation. Our aim was to investigate if these beneficial effects are
      related to improved respiratory drive as measured by ventilatory response to CO2.
      In 17 hypoventilated patients (mean age 62 years) we obtained daytime arterial
      blood gases, nocturnal transcutaneous oxygen saturation, nocturnal transcutaneous
      PaCO2 ventilatory response to CO2 re-breathing, spirometry and indices of
      respiratory muscle strength before and after 9 months of NIPPV. Patients served
      as their own controls. After 9 months of NIPPV day-time PaCO2 decreased from 7.1
      kPa to 6.3 kPa, (P<0.001) and PaO2 increased from 8.1 kPa to 9.3 kPa, (P<0.01).
      The changes in morning and daytime PaCO2 and in nocturnal transcutaneous oxygen
      saturation were significantly correlated to the changes in several variables
      derived from the ventilatory response to CO2 re-breathing. In patients with
      substantial improvement in daytime PaCO2 we found significant improvements in
      ventilatory response to CO2 re-breathing. The present study confirms the
      beneficial effect of long-term NIPPV on daytime arterial blood gases. The results
      are consistent with the hypothesis that the improvement of daytime PaCO2 is
      related to improved respiratory drive observed after NIPPV.

PMID- 11192950
TI  - Experience of totally implantable venous access devices (TIV ADs) in adults with
      cystic fibrosis over a 13-year period.
AB  - Totally implantable venous intravenous access devices (TIVADs) have an essential
      role in the frequent delivery of antibiotics in cystic fibrosis (CF) patients.
      This study at the Royal Brompton Hospital (RBH) reports the experience of TIVADs
      in patients attending the RBH adult CF unit implanted at the RBH and elsewhere
      over a 13-year period. The case notes of adult CF patients who had undergone
      TIVAD insertion were reviewed retrospectively. The patients were divided into
      those who had the insertion carried out at the RBH and those who had the device
      inserted elsewhere. All devices were cared for the at the RBH. A total of 115
      devices in 74 patients were reviewed. The median duration of function of 109
      devices was 1429 days (range 2-3989) or 3.9 years, with a total exposure of
      91,188 days or 249.8 years. There was no significant difference between devices
      inserted at the RBH and those inserted elsewhere (P= 0.59). Thirty-four patients
      had devices installed without complications. Forty patients had complications in
      62 devices. The incidence of complications was 34.5% at the devices inserted at
      RBH and 73.7% elsewhere (P<0.001). Of the 115 devices, mechanical complications
      occurred in 42 (36%) with a median time of diagnosis of 373 days (range 1-2554),
      infectious complications occurred in 16 (14%), with a median time of diagnosis of
      413 days (range 40-2556) and symptomatic venous thrombosis occurred in four
      (3.5%). RBH-inserted devices had significantly fewer mechanical complications
      (P<0.001) compared with those inserted elsewhere. The group as a whole had fewer
      infectious complications than in most other reported series. We conclude that
      TIVADs provide effective and long-term intravenous access and have fewer
      complications if they are inserted and cared for at a centre with special
      expertise in their insertion and management.

PMID- 11192951
TI  - Effects of anti-reflux surgery on chronic cough and asthma in patients with
      gastro-oesophageal reflux disease.
AB  - This two-group prospective study evaluated the effect of anti-reflux surgery
      (fundoplication) on 24 patients with severe gastro-oesophageal reflux disease
      (GORD) and concomitant asthma (n=13) or chronic cough (n=11). Twenty-four hour
      oesophageal pH monitoring and lung function tests (FEV1, FVC) were done before
      and within 1 year after anti-reflux surgery. A diary was kept by the patient
      during the 4-week period prior to surgery and during 4-week periods 6 and 12
      months postoperatively, with daily monitoring of peak expiratory flow rate,
      respiratory and reflux symptoms and medication. In non-asthmatic patients,
      coughing was reduced by 47% and 80% during the day and night, respectively, 12
      months after surgery (P < 0.01). Concomitant hoarseness and expectoration were
      also significantly reduced (P<0.05). No effect on lung function was seen. In
      patients with asthma, small, non-significant reductions in asthma symptom scores
      and consumption of rescue medication were seen. Twenty-two patients were
      completely free from their GORD symptoms after surgery. In conclusion, anti
      reflux surgery in patients with GORD had a more favourable effect on concomitant
      cough than concomitant asthma.

PMID- 11192952
TI  - Role of spirometric and arterial gas data in predicting pulmonary complications
      after abdominal surgery.
AB  - The aim of this study was to evaluate the predictive value of preoperative
      spirometric and arterial gas data on severe pulmonary complications (PC) after
      elective abdominal surgery. We retrospectively studied 480 patients, 254 males
      and 226 females, mean (SD) age 63 (11) years, at risk for PC according to
      standardized criteria, who underwent laparotomy for resection of gallbladder for
      gallstones (44% of patients), resection of colon, rectum or stomach for malignant
      tumours (37%), and other abdominal surgery (19%). The overall incidence of
      postoperative PC was 18%. In a logistic regression analysis adjusted for smoking
      habit and clinical history of chronic bronchitis, FEV1<61% of predicted [odds
      ratio (OR)=16.86, 95% confidence interval (95%CI)=5.62-50.58] and PaO2<9.33 kPa
      (OR=6.42, 95%CI=2.48-16.61) were the main determinants of PC. Ischaemic heart
      disease (OR=3.44, 95%CI=1.08-10.93), operation for malignant tumours (OR=3.24,
      95%CI=1.75-6.00) and age (OR=1.04, 95%CI=1.00-1.08) were also independent
      predictors of PC. Patients with moderate-to-severe airway obstruction combined
      with hypoxaemia had a significant higher risk of PC in comparison with patients
      with a normal respiratory pattern. Taking into account age, type of operation,
      and comorbidity, a preoperative respiratory functional assessment could be useful
      in identifying an increased risk of major PC in selected patients.

PMID- 11192953
TI  - Blood gases at rest and during exercise in patients with alpha1-Pi deficiency.
AB  - Alpha1-protease inhibitor (Pi) deficiency is associated with a protease-anti
      protease imbalance leading to premature destruction of lung tissue and early
      emphysema. Little is known about the blood gases of these patients in the various
      stages of the disease. The purpose of this study was to evaluate blood gases in
      patients with alpha1-Pi deficiency when patients were at rest and during
      exercise, and to correlate these with lung function measurements. A total of 369
      patients with severe alpha1-Pi deficiency had pulmonary function test and blood
      gas analysis, 282 also had blood gases taken during steady state submaximal
      exercise testing. Only 21% of the patients had normal blood gases at rest; 71%
      had mild hypoxaemia; 8% had severe hypoxaemia. Surprisingly, 61% of the patients
      with mild lung disease and a FEV1 of more than 65% predicted were hypoxaemic.
      During exercise 65% of the patients had a drop in PO2 of more than 0.40 kPa. FEV1
      was a significant predictor for the PO2 values at rest and during exercise.
      During exercise the arterial-alveolar gradient increased in about 50% and
      decreased in 25% of the patients. Many patients with alpha1-Pi have blood gas
      abnormalities. Impaired blood gases in early stages of the disease result in a
      discrepancy between lung function parameters and blood gases. FEV1 measurements
      inadequately capture the extent of lung disease in patients with alpha1-Pi
      deficiency, and both blood gases at rest and during exercise are needed in the
      assessment of all stages of the disease.

PMID- 11192954
TI  - Home-based exercise is capable of preserving hospital-based improvements in
      severe chronic obstructive pulmonary disease.
AB  - We examined the feasibility of home-based walking training to maintain the
      benefits of a short-term exercise training in patients with severe chronic
      obstructive pulmonary disease (COPD). After initial recovery from an
      exacerbation, 46 patients were randomized into a training and a control group,
      and 30 patients completed the programme (mean +/- SD FEV1, 36 +/- 7% predicted).
      The training group performed a 10-day walking training programme in the hospital,
      followed by a 6-month programme of supervised walking training at home,
      integrated into daily activities. The control group did not have exercise
      training in the hospital or at home. Until 6 months after discharge, lung
      function, exercise performance and symptom scores were assessed. Six-minute
      walking distance in the training group improved from day 1 to day 10 (P<0.001)
      and this effect was maintained over 6 months (P<0.001). On average, daily walking
      distance at home was 2308 m and walking was reported on 157 days. Quality of life
      (QoL) scores changed significantly over 6 months (P<0.001). The control group
      showed no significant changes in exercise performance or QoL scores throughout
      the whole study period. Therefore, (i) significant improvements in exercise
      performance and Chronic Respiratory Disease Questionnaire (CRQ) scores could be
      achieved after recovery from an exacerbation and (ii) these improvements were
      maintained after discharge, when supported by a home-based walking training.

PMID- 11192955
TI  - The effectiveness of the visual analogue scale 8 in measuring health-related
      quality of life for COPD patients.
AB  - The Visual Analogue Scale 8 (VAS8), consisting of eight linear scales, has been
      developed to measure health-related quality of life (HRQoL) in chronic
      obstructive pulmonary disease (COPD) patients. The purpose of this study was to
      examine the validity and responsiveness of the VAS8. First, HRQoL was assessed in
      a cross-sectional study with the VAS8 and the St George's Respiratory
      Questionnaire (SGRQ) in 46 COPD patients. Relationships between the VAS8 and
      various physiological parameters were examined. Second, in a longitudinal study,
      changes in HRQoL scores after pulmonary rehabilitation were evaluated in 29 COPD
      patients. The total VAS8 scores showed a weak correlation with vital capacity and
      maximal inspiratory pressure and a moderately strong correlation with 6-min
      walking distance and dyspnoea rating. The total VAS8 score showed a significant
      correlation with each SGRQ score. Furthermore, almost every VAS8 and SGRQ score
      improved significantly after pulmonary rehabilitation. The change in the total
      VAS8 value showed a strong correlation with that of the SGRQ. The VAS8 is well
      suited to assess HRQoL in COPD patients. Visual analogue scales are generally
      useful in measuring HRQoL in COPD patients, and the VAS8 is particularly
      beneficial because of its ease of use.

PMID- 11192956
TI  - Eosinophil influx into the airways in patients with exercise-induced asthma.
AB  - Exercise-induced asthma is a common phenomenon, the mechanism of which is
      undetermined. Eosinophils have been suggested as playing a role in its
      occurrence. We studied the effect of exercise-induced asthma on the cellular and
      mediator composition of spontaneously obtained sputum. Twenty-five patients with
      bronchial asthma were investigated by studying sputum spontaneously obtained
      before and following challenge. One group with (n=9) and one without (n=9)
      exercise-induced asthma performed exercise challenge. A third group (n=7)
      performed methacholine challenge. The sputum was analysed using Giemsa staining
      for differential cell count, measuring eosinophil cationic proteins and mixtures
      of leukotrienes (D4, E4 and C4) in the liquid phase using ELISA. The group with
      exercise-induced asthma had a mean drop of 23.7+/-7.4% in FEV1, significantly
      (P=0.001) higher than the group without it. Following challenges, there were
      significant increases in sputum eosinophils only in the group with exercise
      induced asthma (from 8.1+/-13.9% to 18.3+/-20.2%, P=0.0017) and not in control
      groups (from 0.9+/-0.9% to 1.5+/-15%) or in those who had methacholine challenge
      (from 23.6+/-27.2% to 22.3+/-23.8%). Eosinophil cationic proteins did not change
      significantly in any group. In the liquid phase of the sputum, the amount of
      leukotrienes increased following exercise in six of the seven patients with
      exercise-induced asthma in whom it was measured. The influx of eosinophils to the
      airway in patients who develop exercise-induced asthma can be partially explained
      by the leukotrienes in the airways of those patients.

PMID- 11192957
TI  - Efficacy of nebulized fluticasone propionate compared with oral prednisolone in
      children with an acute exacerbation of asthma.
AB  - The aim of the present study was to investigate the efficacy and safety of
      nebulized fluticasone propionate (FP Nebules) compared with oral soluble
      prednisolone in children with an acute exacerbation of asthma. The study used an
      international, multi-centre, randomized, double-blind, parallel group design.
      Three hundred and twenty-one patients, aged 4-16 years old, who presented with an
      acute exacerbation of asthma, were randomly allocated to either nebulized FP (1
      mg b.d.) or oral prednisolone (2 mg kg(-1) day(-1) for 4 days then 1 mg kg(-1)
      day(-1) for 3 days) for 7 days. Patients in the FP group showed a significantly
      greater increase in diary card morning peak expiratory flow (PEF) over 7 days
      compared with patients in the prednisolone group (difference = 9.51 min(-1), CI =
      2.1, 16.8, P = 0.034). Similar increases for both treatments were shown for
      evening PEF. Clinic PEF improved with both treatments, but was significantly
      greater in patients taking FP after 7 days (difference = 11.41 min(-1), CI = 2.8,
      20.0, P = 0.029). Both treatments reduced symptom scores to a similar extent. The
      two treatments were well tolerated, and there was no difference in the incidence
      of adverse events. The present study demonstrated that nebulized FP is at least
      as effective as oral prednisolone in the treatment of children presenting with an
      acute exacerbation of asthma.

PMID- 11192958
TI  - Circulating levels of soluble Fas ligand and soluble Fas in patients with chronic
      obstructive pulmonary disease.
AB  - Fas- and tumour necrosis factor (TNF) receptor-mediated apoptosis are known to be
      two principal apoptotic mechanisms in humans. Although there are several
      distinctions between these two systems, in vitro studies have demonstrated
      similar hypoxic activation and a functional relationship. Since patients with
      chronic obstructive pulmonary disease (COPD) show chronic hypoxaemia and the
      activation of the TNF-alpha system, we investigated whether these
      pathophysiological changes influence the Fas-Fas ligand system. We measured the
      circulating soluble Fas ligand (sFas-L) level, an inducer of apoptosis, and the
      soluble Fas receptor (sFas) level, an inhibitor of apoptosis, in 34 COPD patients
      and 35 age-matched healthy controls. In addition, we investigated the
      relationships between the levels of sFas-L or sFas and clinical variables
      including the TNF-alpha system; circulating TNF-alpha and soluble TNF-receptor
      (sTNF-Rs: sTNF-R55 and R75) levels, in the COPD patients. Although circulating
      TNF-alpha, sTNF-R55 and R75 levels were significantly higher in the COPD patients
      than in the healthy controls, serum level of sFas-L (Fisher's exact probability
      test; P = 0.26) and plasma level of sFas [COPD patients vs. controls; mean (SD);
      3.74 (0.63) vs. 3.67 (0.48) ng/ml; P = 0.89) were not increased in the COPD
      patients. There was no significant correlation between the levels of sFas-L or
      sFas and clinical variables in COPD patients. These results suggest that the Fas
      Fas ligand system does not independently play an important role in the
      pathophysiology of patients with COPD.

PMID- 11192959
TI  - Impact of hypoxaemia on neuroendocrine function and catecholamine secretion in
      chronic obstructive pulmonary disease (COPD). Effects of long-term oxygen
      treatment.
AB  - The aim of the study was to investigate the effects of chronic hypoxaemia on
      neuroendocrine function in hypoxaemic chronic obstructive pulmonary disease
      (COPD). The stress level was assessed by measurement of daytime plasma
      catecholamine and nocturnal urinary catecholamine levels and endocrine function
      was assessed by measuring serum gonadotropins, peripheral sex hormones and
      peripheral thyroid hormones, and by measuring thyroid stimulating hormone (TSH),
      prolactin and growth hormone before and after thyroid releasing hormone challenge
      in 12 male, stable, hypoxaemic COPD patients before and after at least 4 months
      of long-term oxygen treatment (LTOT). Mean pre-treatment PaO2 was 7.39 +/- 0.78
      kPa and mean nocturnal arterial oxygen saturation (MSaO2) was 86.6 +/- 3.2%.
      Plasma norepinephrine (NE) levels were higher than normal, while all other pre
      treatment hormone levels were within normal range. Low forced expiratory volume
      in 1 sec (FEV1) was associated with low basal and stimulated TSH (P < 0.01).
      Urinary NE excretion correlated positively to nocturnal time spent with SaO2<85%
      (P<0.05). In similarity with normal controls, positive correlations were found
      between sex hormone binding globulin and testosterone both before and after LTOT
      (P<0.01). No significant hormonal changes were noted following an average of 8
      months of LTOT for the entire study group. However, in a subgroup (n = 6) with an
      increase in MSaO2 exceeding 7% points following LTOT, nocturnal excretion of NE
      and epinephrine were reduced by 30% (P<0.05) and S-free thyroxin by 20% (P<0.05).
      In conclusion, patients with chronic hypoxaemia secondary to COPD exhibit
      elevated plasma NE levels but otherwise normal endocrine levels, including a
      normal hypothalamic-pituitary testicular axis. The severity of airway obstruction
      is associated with reduced basal and stimulated TSH. The endocrine function is
      not significantly changed following LTOT except for a subgroup with severe
      nocturnal hypoxaemia, where elevated nocturnal NE excretion was noted, which was
      reduced only if whole night oxygenation was normalized during oxygen therapy.

PMID- 11192960
TI  - Efficacy of salbutamol via Easyhaler unaffected by low inspiratory flow.
AB  - The fine particle dose delivered via dry powder inhalers (DPIs) is often affected
      by the inspiratory flow rate generated during inhalation. This has clinical
      implications, since the fine particle dose determines the amount of drug reaching
      the lungs. With Easyhaler DPI the fine particle dose remains relatively constant
      over the range of inspiratory flow rates from 30-60 l min(-1). The aim of this
      study was to confirm that clinical efficacy is maintained even at low flow rates
      by comparing the bronchodilating effect of salbutamol (100 microg) delivered via
      Easyhaler at a target inspiratory flow of 30 l min(-1) with the same dose of
      salbutamol via pressurised metered-dose inhaler (pMDI) plus spacer. This was a
      double-blind, randomized, cross-over study with double-dummy technique. Twenty
      one paediatric and adult asthmatic patients completed the study, which was
      conducted over 2 study days. The main outcome parameter was forced expiratory
      volume in 1 sec (FEV1). The patients were trained to generate a low peak
      inspiratory flow rate (PIFR) of 30 l min(-1), and the actual PIFR through
      Easyhaler was recorded. The average PIFR through Easyhaler was 28.7 l min(-1).
      The difference in the maximum value of FEV1 (FEV1max) between the treatments
      after drug inhalation was 0.01 l. The mean of FEV1max was 2.67 l after pMDI plus
      spacer compared to 2.69 l after Easyhaler. Improvements in FEV1 were clinically
      significant. No significant differences between treatments were found. A
      reasonably low inspiratory flow rate through Easyhaler produces an equivalent
      improvement in lung function to a correctly used pMDI plus spacer. Hence,
      Easyhaler can be used with confidence in patients who may have difficulty in
      generating a high inspiratory flow rate, such as children and the elderly.

PMID- 11192961
TI  - Early discharge of patients hospitalized with acute asthma: a controlled study.
AB  - There is no consensus on the optimal length of stay and timing of release from
      hospital in patients admitted with acute asthma. We hypothesize that it might be
      safe to discharge patients from hospital once they have responded clinically to
      intensive anti-asthma treatment. In a non-randomized prospective controlled
      study, we compared two discharge protocols in consecutive patients admitted for
      acute severe exacerbations of bronchial asthma. Patients in group A were
      discharged after remission of signs and symptoms and those in group B after
      improvement but before complete remission of signs and symptoms. Peak expiratory
      flow rates (PEFR) were monitored but were not used as discharge criteria for
      either group. Patients with complicating disease and who were likely to be non
      compliant were excluded. The length of hospital stay (LOS) and best PEFR at
      discharge were significantly lower in group B (87 admissions) than group A (80
      admissions). The mean (+/-SD) LOS was 1.8(+/- 1) days vs. 3.5(+/- 1.4) days and
      best PEFR was 58(+/- 17)% predicted versus 71(+/- 15)% predicted respectively (P
      < 0.001 for both variables). No patient in either group relapsed within 4 weeks
      of discharge from hospital. We concluded that the release of asthmatics who
      respond promptly to intensive treatment and are compliant with medication despite
      incomplete resolution of symptoms, signs and PEFR at the time of discharge from
      hospital may not be associated with increased risk of early relapse.

PMID- 11192962
TI  - Pulmonary involvement in Niemann-Pick disease: case report and literature review.
AB  - Niemann-Pick disease (NPD) is a rare, inherited, autosomal recessive, lipid
      storage disease. The pathognomonic intracellular accumulation of sphingomyelin
      results in the production and accumulation of 'foam cells'. Interstitial lung
      disease is a rare manifestation of NPD. We present the case of a 48-year-old
      white female with NPD involving the lungs, liver and spleen. The chest radiograph
      showed bilateral, predominantly basal reticulonodular infiltrates and serial
      pulmonary function tests over a period of years showed preserved expiratory
      airflow and a severely decreased diffusion capacity for carbon monoxide (DLCO).
      In view of her visceral involvement, lack of neurological symptoms and survival
      into adulthood, we believe our patient represents a case of type B NPD. In this
      type of NPD, aside from prominent hepatosplenomegaly and sexual immaturity,
      significant pulmonary infiltration with 'Pick cells' has been reported. To date,
      no therapeutic modality has been shown to alter the natural history of this
      disease, which results in progressive debilitation and death. This case is unique
      in that it provides the longest physiological follow-up in the literature, and
      provides data on the natural history of pulmonary involvement in NPD.

PMID- 11192963
TI  - Administering, monitoring and withdrawing oxygen therapy.

PMID- 11192965
TI  - [Veterinarian emergencies].

PMID- 11192964
TI  - [Treatment of ectopic pregnancy with methotrexate].

PMID- 11192966
TI  - [Frequency and nature of neurologic emergencies].
AB  - In the last decade, it has been shown that neurological problems account for
      approximately 15% of medical emergencies treated in metropolitan France, in all
      types of medical establishments. Four major diagnostic groups are concerned:
      stroke, epilepsy and loss of consciousness, headache, confusional syndromes and
      behavioural disorders. Among patients seen in emergency units for neurological
      problems, 80% require hospital admission. These figures underline the need for
      medical and administrative directors of public hospitals to take greater account
      of the neurological emergency in providing adequate means to meet this demand.

PMID- 11192967
TI  - [Confusional state and agitation].
AB  - Delirium is a neurologic emergency representative of 10% of the hospitalized
      patients. It is characterized by an acute and fluctuating change of consciousness
      and cognition. A strict procedure is necessary to treat quickly the responsible
      cause among the multiple possible ones. An associated agitation need a quick
      specific treatment. The treatment should prevent the risk factors, notably
      iatrogenic, especially in the elderly patients or with previous altered cognitive
      functions.

PMID- 11192968
TI  - [Acute headaches].
AB  - Etiologic diagnosis of acute headache is made by accurate history of the pain and
      systematic examination in search of associated signs: the aim of this reasoning
      procedure is identification of secondary (organic) headache disorders which are
      infrequent but are needing urgent evaluation and care from primary headaches
      whose various methods of treatment are specific.

PMID- 11192969
TI  - [Acute vertigo].
AB  - Three questions are raised when a patient experiences sudden vertigo. Is it due
      to a disease of the vestibule? This would be suggested in case of a revolving
      nature of the vertigo, the presence of nystagmus and of vestibular ataxia. Are
      there associated otological (infection of the labyrinth, zoster neuritis) or
      neurological (ischemic vascular accidents of the cerebral trunk and of the
      cerebellum, cerebellar haemorrhage) signs? What is the evolution of the sudden
      vertigo? A single, isolated episode of vertigo will generally be related to
      vestibular neuritis. However, it may rather be a first episode of repeated
      vertigo, Meniere's disease, recurrent vertigo, migraine, or very rarely
      transitory ischemic accident.

PMID- 11192970
TI  - [Epileptic emergencies].
AB  - Convulsive status epilepticus is a major epileptic emergency. Prompt and
      effective treatment is requested to prevent death or neurological sequel. First
      line drugs must have a favourable benefit to risk ratio. Refractory status must
      be treated aggressively by second-line sedative drugs. In this situation, EEG
      monitoring must diagnose subtle status epilepticus by controlling the
      disappearance of ictal discharges. Non-convulsive generalized or partial status
      epilepticus is a diagnostic challenge, best solved by emergency EEG. Immediate
      discontinuation of antiepileptic drugs is requested to avoid potentially serious
      idiosyncratic side-effects. Prescriptions habits will be avoided to prevent
      recurrence of isolated convulsive seizures.

PMID- 11192971
TI  - [Head injuries in the acute phase].
AB  - Half of patients with traumatic head injuries are comatose (Glasgow coma scale <
      or = 8); motor vehicle accidents among young people are the predominant mode of
      injury. CT scanner reveals a large variety of lesions such as extracerebral
      hematomas, focal or diffuse hematomas, deep lesions. Surgery is performed in one
      quarter of these patients and indications are extracerebral hematomas, depressed
      fracture or craniofacial wounds. Indications for surgery in focal intracerebral
      lesions are difficult and depend on patient age, evolutivity and delayed
      intracranial hypertension; shift on CT scanner and compression of basal cisterns
      are the predictors of developing intracranial hypertension. Medical treatment
      depends on patient severity state; with comatose patient, intensive care unit is
      required with intubation, ventilation and intracranial pressure measurement by
      ventricular drain. If the pressure is greater than 20 mmHg, barbiturate therapy
      is indicated.

PMID- 11192972
TI  - [Cerebrovascular accident].
AB  - Stroke is a medical emergency that is common and severe. Its diagnosis is based
      on questioning of the patient or those around him and on clinical examination.
      Stroke requires rapid investigation by imagery of the brain and intra- and
      extracranial vessels. Currently these investigations associate CT scan of the
      brain (which differentiates infarcts and haemorrhage) and cervical and
      intracranial ultrasound examination, or angiography if vascular malformation is
      suspected. Magnetic resonance imaging, when available for emergency use, is
      greatly superior in its earlier detection of signal abnormalities, its diagnostic
      precision and visualisation of the vessels. Recent clinical trials have shown the
      effectiveness of stroke management in specialised units (30% reduction in the
      number of deaths or institutionalised patients) and of very early intravenous
      administration of rt-PA (within less than 3 hours). Thus, neurovascular emergency
      treatment centres should be rapidly established, as has been done in cardiology
      for emergency care of myocardial infarcts.

PMID- 11192973
TI  - [Good practice of neuroimaging in neurological emergencies].
AB  - CT-scan is the preferred investigation in skull trauma and in any patient with
      suspected meningeal haemorrhage. Any suspicion of compression of the medulla or
      of a cauda equina requires emergency investigation by MRI. This investigation is
      also standard when cerebral thrombophlebitis or meningeal encephalitis is
      suspected. A future increase in available MRI equipment is desirable in order to
      enlarge the indications of such imaging, particularly in the case of recent
      cerebral vascular accident.

PMID- 11192974
TI  - [Medical studies: new objectives and program of the 2nd cycle].

PMID- 11192975
TI  - [Accidental hypothermia].

PMID- 11192976
TI  - [Drug-induced skin diseases. Diagnosis].

PMID- 11192977
TI  - [Bimalleolar fracture in adults. Mechanism, diagnosis, treatment].

PMID- 11192978
TI  - [Macrocytic anemia in adults. Physiopathology, etiology, diagnosis, and
      treatment].

PMID- 11192979
TI  - [Threatened premature labor. Etiology, diagnosis, treatment].

PMID- 11192980
TI  - [Clinical trials. Methodologic principles and ethical aspects of treatment
      evaluation].

PMID- 11192981
TI  - [Ear effusion, otalgia. Diagnostic guide].

PMID- 11192982
TI  - Placental/umbilical cord blood (PCB) stem cells for transplantation: early
      clinical outcomes and the status of ex vivo expansion strategies.
AB  - Placental/umbilical cord blood (PCB) stem cells for transplantation provide a
      potentially useful alternative for patients who do not have an HLA-matched family
      or unrelated bone marrow donor. Concerns regarding this source of stem cells
      include the limited number of stem cells in a PCB unit and the delayed time to
      platelet engraftment. Because of the limited number of stem cells, there is a
      very clear cell dose effect for both success of engraftment and time to
      engraftment. As a result, many transplant centers will only consider PCB stem
      cells as a second choice for transplanting adults, despite the very favorable
      profile of post-transplant graft-versus-host disease (GvHD). This has resulted in
      considerable interest in the development of ex vivo stem cell expansion
      strategies. This review outlines the current status of PCB transplant outcomes as
      well as the status of our understanding of stem cell expansion with the currently
      available technologies. A stem cell dose-limiting effect on outcome will result
      in a narrower window of clinical indications for the use of this stem cell
      source, despite the acknowledged reduction in GvHD. The trade-offs between poor
      engraftment and reduction in fatal or severe chronic GvHD remain to be
      quantitated.

PMID- 11192983
TI  - Genetic structure of the five-factor model of personality in a Japanese twin
      population.
AB  - Dimensional approaches have been used to describe the fundamental dimensions that
      underlie the entire domain of normal and pathological personality. We tested the
      five factor model of personality structure in a sample of Japanese twins, to
      clarify the contributions of genetic and environment. The revised NEO personality
      inventory (NEO-PI-R) was administered to 251 twin pairs, ranging in age from 15
      to 27 years of age. The NEO-PI-R is a 240-item questionnaire which was developed
      to assess the dimensions of personality. Univariate genetic analysis showed that
      the AE model in which phenotypic covariances are explained only by additive
      genetic (A) and nonshared environment (E) is still a plausible model, and that
      the relative proportion of genetic influence was comparable to that reported by
      Loehlin (1992). Multivariate genetic analysis of the Japanese data
      suggested/revealed that the five factors are genetically dependent on each other
      and one common genetic factor mediates their interdependence. Previous studies
      have assumed that they are phenotypically independent and robust. Although there
      are sampling biases in the present study, it is noteworthy that the results for
      all five factors depicted by the NEO-PI-R were comparable to those reported by
      Western researchers, and the genetic structure of the five-factor model is
      complex.

PMID- 11192984
TI  - Searching for mechanisms of retinal direction selectivity.
AB  - A classic example of a complicated neurocomputation carried out by a relatively
      simple neuronal circuitry is that some mammalian retinal ganglion cells respond
      selectively to direction of motion. Search for the mechanisms of direction
      selectivity in the mammalian retina started some 35 years ago. It has been shown
      that direction selectivity is caused by an asymmetrical inhibition induced by
      GABA acting on GABAA receptors. However, the physical circuitry underlining this
      computation is still not clear. A few recent breakthroughs provide important
      evidence for the sites where the computation takes place.

PMID- 11192985
TI  - A case of poorly differentiated hilar lung adenocarcinoma of an unidentified
      histological type.
AB  - The patient was a 74-year-old man, a physician, whose chief complaint was an
      unproductive cough. The shadow of a mass was seen at the hilum of the left lung,
      and the mediastinal lymph nodes on both sides were swollen. No histological
      diagnosis was obtained even after bronchoscopy, including transbronchial needle
      aspiration biopsy, but large-cell carcinoma of the lung was diagnosed on the
      basis of ultrasound-guided biopsy of a shadow in the liver suspected of being a
      metastatic tumor (T2N3M1, Stage IV). Two courses of chemotherapy (CBCDA + VDS)
      failed to gain any improvement, and the pain resulting from recurrent bone
      metastases was managed mainly by the administration of the best supportive care.
      The patient was readmitted to the hospital after development of numbness in the
      right upper extremity followed by complication of pneumonia and heart failure,
      and he passed away. Autopsy revealed a primary hilar lung tumor with a
      histological diagnosis of poorly differentiated adenocarcinoma.

PMID- 11192986
TI  - Child and adolescent mental health care.

PMID- 11192987
TI  - Peptic ulcer disease in the tropics--lessons from India.

PMID- 11192988
TI  - Seroconversion rate following measles vaccination.
AB  - OBJECTIVE: To assess the seroconversion rate following measles vaccination in Sri
      Lankan children. DESIGN: A descriptive study. SETTING: Immunisation clinic, Lady
      Ridgeway Hospital, Colombo (LRHC). SUBJECTS: 134 infants who attended the LRHC
      for measles vaccination. MEASUREMENTS: Pre- and post-vaccination blood samples
      were collected and serum was tested for the presence of anti-measles 1gG
      antibodies using the ELISA technique. RESULTS: Of the 134 infants only 102 were
      brought for the post-vaccination sample. Of these 102 samples, 101 were negative
      for anti-measles antibodies before vaccination. Of the 101 sero-negative samples
      94 became sero-positive 6 to 8 weeks after vaccination. These results indicate
      that the seroconversion rate is 93.06%, which is similar to the results of
      studies done in other countries. CONCLUSION: Most infants are susceptible to
      measles infection by the age of 9 months, and it is appropriate to vaccinate
      infants at this age, as is the practice at present. However, further studies are
      needed to assess the duration of protection with a single dose of measles
      vaccine.

PMID- 11192989
TI  - An attempt to measure burden of disease using disability adjusted life years for
      Sri Lanka.
AB  - INTRODUCTION: Disability adjusted life years (DALY) is a measure of burden of
      disease (BOD) that assesses the years of healthy life lost due to disease or
      illness. OBJECTIVE: The main objective of the study was to develop a draft
      measure of the BOD in Sri Lanka, using DALY. METHODS: Computation was done for
      100 disease categories identified to reflect the disease pattern in Sri Lanka.
      Factors that were considered for the calculation of DALY were incidence, degree
      of disability, duration of the illness and age of onset. RESULTS: Injuries,
      ischaemic heart disease, asthma, disease of the pulmonary circulation and burns
      contribute to 55% of BOD in Sri Lanka. CONCLUSION: The highest burden was due to
      non-communicable diseases, as their duration and degree of disability are high.
      Diseases such as malaria, which are short term illnesses with low disability,
      although affecting large numbers, did not give a high value for DALY.

PMID- 11192990
TI  - The isolation of Burkholderia cepacia in a hospital setting in Sri Lanka.
AB  - INTRODUCTION: Burkholderia cepacia is widely prevalent in nature. The natural
      habitat of this organism is soil, water and vegetation, but the hospital
      environment remains the main source of infection. It causes a wide variety of
      infections in hospitalised patients. Since there are no reports of its prevalence
      in Sri Lanka, a data retrieval and analysis was undertaken to determine its
      incidence among patients at Sri Jayawardenepura General Hospital (SJGH).
      OBJECTIVE: To determine the prevalence, morphological characteristics,
      biochemical profile and antibiotic susceptibility pattern of B cepacia in a Sri
      Lankan tertiary care hospital. METHODS: Relevant clinical data were retrieved
      from all isolates of B cepacia from SJGH for 12 months from October 1996.
      Standard procedures were used to isolate the organism from clinical specimens.
      API 20E was employed for biochemical identification. Antibiotic susceptibility
      tests was carried out using the modified Kirby Bauer method. RESULTS: B cepacia
      was isolated from 17 patients. 16 of them were hospitalised and were from the
      medical, surgical, and intensive care units. All were in a compromised state of
      health. The organism was isolated from a variety of specimens which included
      swabs of surgical wounds, chronic ulcers, sputum, bronchial lavage, endotracheal
      aspirate, urine, peritoneal fluid and blood. Blood agar, MacConkey agar and
      cystine lactose electrolyte deficient medium supported the growth of all strains.
      They were motile Gram negative rods. All strains were oxidase positive. Strains
      gave variable results with other biochemical tests. Antibiograms too were
      variable. All strains were sensitive to ceftazidime, and the majority of the
      strains were sensitive to the other third generation cephalosporines. All strains
      were resistant to four or more antimicrobial agents included in the study. Of the
      17 patients from whom B cepacia was isolated, only 9 seem to have had actual
      infection; others were probably instances of colonisation or contamination.
      CONCLUSIONS: The present report confirms the prevalence and importance of B
      cepacia as a hospital pathogen in Sri Lanka. Hospital laboratories should be
      equipped to isolate, identify and perform antibiotic sensitivity test on these
      strains. Antibiotic susceptibility testing is necessary as the patterns seem to
      differ among strains. The multiple drug resistant nature of the organism warrants
      strict infection control measures to prevent spread in a hospital setting.

PMID- 11192991
TI  - Gender differences in undergraduate medical examination results in Sri Lanka.
AB  - OBJECTIVE: To identify possible gender related differences in performance at
      undergraduate medical examinations in Sri Lanka. STUDY DESIGN AND METHODS:
      Results of examinations conducted by the faculty of medicine, University of
      Kelaniya in 1997 and 1998, and data published by the University Grants Commission
      (UGC) on final examinations conducted by 4 other Sri Lankan medical faculties (in
      the Universities of Colombo, Peradeniya, Ruhuna and Jaffna) in 1996 and 1997,
      were analysed for sex related differences. RESULTS: The proportion of women in
      each batch of students who sat for 8 examinations conducted at the faculty of
      medicine, University of Kelaniya in 1997 and 1998, ranged from 40.7 to 48.4%
      (average 44.3%). Among students sitting for the final MBBS examinations in other
      medical faculties in 1996 and 1997, the proportion of women ranged from 37.3% in
      Peradeniya to 53.7% in Jaffna. The proportions of women who obtained "classes"
      were higher than that of men in 12/15 examinations, with statistically
      significant differences in four. Higher proportions of men were referred or
      failed in all 8 examinations analysed; the differences were statistically
      significant in two. CONCLUSIONS: Women appear to do marginally better than men in
      undergraduate medical examinations in Sri Lanka.

PMID- 11192992
TI  - Prevalence of skin diseases in suburban Sri Lanka.
AB  - BACKGROUND: In Sri Lanka the only available measures of disease frequency related
      to skin disorders are from hospital-based clinic studies. They reflect only the
      patterns of clinic attendance, and the actual prevalence of skin diseases in the
      community is unknown. The main objective of this study was to determine the
      prevalence of skin diseases in a selected area. METHODS: A household survey based
      on health interviews and clinical examination was conducted over a period of 4
      months. 418 households were selected for modified cluster sampling from
      predetermined areas in Piliyandala. RESULTS: There were 1806 people residing in
      the 418 households surveyed. 894 cases were identified, of which 34 people could
      not be traced for clinical examination. 33 households did not have anyone with a
      skin lesion. The prevalence of skin disease was 47.6%. Fungal infections,
      followed by dermatitis, were found to be the commonest problems. There was only
      one case of leprosy. Psoriasis was found to be of low prevalence. CONCLUSIONS:
      The overall prevalence of skin disease was high in the community that we
      surveyed. There were marked differences between community prevalence and hospital
      dermatology clinic attendance data for a number of skin diseases.

PMID- 11192993
TI  - Male and female filarial worms Dirofilaria (Nochtiella) repens recovered from the
      scrotum.

PMID- 11192994
TI  - A perforated duodenal ulcer in a child.

PMID- 11192995
TI  - Urinary tract infection in children; collection and transport of urine, and
      colony counts.

PMID- 11192996
TI  - Neonatal purpura fulminans due to protein C deficiency.

PMID- 11192997
TI  - Salmonella typhi and chloramphenicol resistance.

PMID- 11192998
TI  - Primary writing tremor.

PMID- 11193000
TI  - Some problems at the General Hospital, Jaffna.

PMID- 11192999
TI  - Interfollicular Hodgkin's disease with histological features of Castleman's
      disease.

PMID- 11193001
TI  - Neurotransmitters adenosine triphosphate and noradrenaline induce nitric oxide
      release in rat vas deferens.
AB  - 1. In rat vas deferens, electrical field stimulation (EFS) evoked a muscular
      biphasic tetrodotoxin (TTX)-sensitive contractile response. 2. The amplitude of
      this response increased with the frequency of stimulation. 3. After each
      stimulation, nitric oxide (NO) release was assayed and found to be released in a
      frequency-dependent manner. 4. NO release also occurred after treatment with
      exogenous neurotransmitters, adenosine 5'-triphosphate (ATP) and noradrenaline
      (NA). 5. Prazosin and pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid
      (PPADS), respective antagonists of alpha1-adrenoceptors and P2x purinoceptors,
      inhibited NO release induced by NA and ATP. Both prazosin and PPADS inhibited NO
      release by EFS. 6. TTX failed to modify the NO release induced by exogenous
      neurotransmitters but abolished the release of NO and contractile response by
      EFS. 7. EFS and released noradrenaline and ATP induce the release of NO through
      postjunctional alpha1 -adrenoceptors and P2x-purinoceptors, respectively.

PMID- 11193002
TI  - The alpha-adrenoceptor antagonist, zolertine, inhibits alpha1D- and alpha1A
      adrenoceptor-mediated vasoconstriction in vitro.
AB  - 1. The antagonist effect of zolertine (4-phenyl-1-[2-(5
      tetrazolyl)ethyl]piperazine trihydrochloride), on vascular contraction elicited
      by noradrenaline in aorta, carotid (alpha1D-adrenoceptors), mesenteric (alpha1A/D
      adrenoceptors) and caudal arteries (alpha1A-adrenoceptors) from Wistar Kyoto
      (WKY) and spontaneously hypertensive (SHR) rats and rabbit aorta (alpha1B
      adrenoceptors), was investigated in endothelium-denuded arterial rings. 2. The
      selective alpha1D-adrenoceptor agonist, noradrenaline, elicited concentration
      dependent contractions in all arterial rings from both species. Noradrenaline
      selectivity was: carotid = aorta >> mesenteric = rabbit aorta > caudal arteries.
      3. The contractile responses induced by noradrenaline were competitively
      antagonized by zolertine in rat carotid and aorta arteries, yielding pA2 values
      of WKY, 7.48 +/- 0.18; SHR, 7.43 +/- 0.13 and WKY, 7.57 +/- 0.24; SHR, 7.40 +/-
      0.08, respectively. Zolertine was a non-competitive antagonist in some blood
      vessels as Schild plot slopes were lower than unity. The pKb estimates for
      zolertine were WKY, 6.98 +/- 0.16; SHR, 6.81 +/- 0.18 in the mesenteric artery,
      WKY, 5.73 +/- 0.11; SHR, 5.87 +/- 0.25 in the caudal artery and 6.65 +/- 0.09 in
      rabbit aorta. 4. Competition binding experiments using the alpha1-adrenoceptor
      antagonist [3H]prazosin showed a zolertine pKi of 6.81 +/- 0.02 in rat liver
      (alpha1B-adrenoceptors) and 6.35 +/- 0.04 in rabbit liver (alpha1A-adrenoceptors)
      membranes. 5. Zolertine showed higher affinity for alpha1D-adrenoceptors compared
      to alpha1A-adrenoceptors, while it had an intermediate affinity for alpha1B
      adrenoceptors. The ability of the alpha1-adrenoceptor antagonist zolertine to
      block alpha1D-adrenoceptor-mediated constriction in different vessels of WKY and
      SHR rats may explain its antihypertensive efficacy despite its low order of
      potency.

PMID- 11193003
TI  - Functional antagonism between nitric oxide and ATP in the motor responses of
      guinea-pig ileum.
AB  - 1. The interaction of nitric oxide and ATP in the non-adrenergic, non-cholinergic
      (NANC) motor responses and the presence of NADPH-diaphorase and quinacrine
      positive myenteric neurones were studied on guinea-pig ileum using
      mechanographic, histochemical and quinacrine-fluorescence techniques. In the
      presence of phentolamine, propranolol and atropine, the non-precontracted
      longitudinally oriented organ bath preparations responded to sodium nitroprusside
      (1-100 microM) or ATP (5-50 microM) with tetrodotoxin (0.1 microM)-resistant
      relaxation or contraction, respectively. The effects of ATP were suramin (50
      microM)- and apamin (5 microM)-sensitive. 2. The NANC motor responses elicited by
      electrical stimulation (0.8 ms, 1-20 Hz, 20 s) consisted of tetrodotoxin
      sensitive relaxation phase followed by a phase of twitch-like and tonic
      contractions. 3. NG-nitro-L-arginine (L-NNA, 0.1-0.5 mM) inhibited or abolished
      the relaxation phase. L-arginine (0.5 mM), but not D-arginine (0.5 mM), restored
      the relaxation phase in L-NNA-pretreated preparations. The relaxation phase
      increased after ATP-induced desensitization of purinoceptors and in the presence
      of suramin (50 mciroM) but was abolished by apamin (5 microM). 4. The phase of
      contractions was enhanced by L-NNA (0.1-0.5 mM) and restored by L-arginine (0.5
      mM). The twitch-like and tonic contractions were decreased during ATP-induced
      purinoceptor desensitization and in the presence of suramin (50 microLM). Apamin
      (5 microM) inhibited the tonic contractions. 5. The desensitization of
      purinoceptors by ATP did not change the L-NNA-induced inhibition of the
      relaxation phase but decreased the L-NNA-increased phase of contractions. L-NNA
      reduced the relaxation phase and increased the phase of contractions during
      purinoceptor desensitization. 6. We conclude that in the longitudinal muscle
      layer of the guinea-pig ileum, nitric oxide mediates the relaxation phase while
      ATP contributes via smooth muscle P2 purinoceptors to the phase of contractions
      suggesting a postjunctional functional antagonism between nitric oxide and ATP.
      The presence of NADPH-diaphorase- and quinacrine-positive neuronal cells and
      processes running to the muscle cells confirms a physiological role of nitric
      oxide and ATP in the ileal neurotransmission.

PMID- 11193004
TI  - Effects of natural tachykinins on porcine lower urinary tract smooth muscle.
AB  - 1. The aim of our study was to ascertain the possible differences and/or
      similarities in natural tachykinin activity in vitro on lower urinary tract of
      large-sized animals as compared with data obtained in laboratory animals. 2.
      Besides tachykinins normally present in mammals, namely substance P (SP),
      neurokinin A (NKA) and neurokinin B (NKB), we tested non-mammalian tachykinins,
      such as eledoisin (ELED), physalaemin (PHYS), kassinin (KASS) and PG-kassinin II
      (PG-KASS II). 3. NKA, KASS and ELED were found to be the most potent peptides in
      contracting detrusor strips from porcine bladder. In particular, NKA showed a pD2
      of 7.14, whereas KASS and ELED showed pD2 values of 7.20 and 7.22, respectively.
      The activity of NKB and PG-KASS II corresponded to 72.4 and 55.0% respectively of
      that of NKA. SP and PHYS activity corresponded to only 2% of that of NKA. 4. NKA
      (pD2 7.92) was the most active peptide in contracting bladder neck tissues as
      well. ELED and KASS were found to have lower, similar pD2 values (7.62 and 7.70,
      respectively), whereas NKB and PG-KASS II were much less active (pD2 7.12 and
      6.74, respectively). Moreover, SP and PHYS showed an activity range lower than 2%
      of that of NKA. 5. The reported results confirm that, on pig vesical neck and
      detrusor, NK1 receptors represent a minority as compared with NK2 and NK3
      receptors. By contrast, the presence of NK2 receptors is demonstrated by a
      greater potency of NKA. The presence of NK3 receptors both on detrusor and neck
      is evidenced by NKB activity and by results achieved with PG-KASS II.

PMID- 11193005
TI  - Effects of eicosanoids and nitric oxide on the noradrenaline-induced contractions
      in the rat mesenteric bed.
AB  - 1. The effects of the inhibition of the metabolism of arachidonic acid (AA) on
      the constrictor responses to noradrenaline (NA) were studied in the rat perfused
      mesenteric bed. The inhibitor of all the pathways of AA metabolism, 10 microM
      eicosatetraynoic acid (ETYA), reduced the constrictor responses to all the
      concentrations of NA assayed. 2. The constrictor responses to NA were also
      reduced by the cyclooxygenase (COX) inhibitor, indomethacin (10 microM), as well
      as by the lipoxygenase inhibitor, nordihidroguaiaretic acid (1 microM; NDGA),
      whereas they were unmodified by the cytochrome P450 monooxigenase inhibitors,
      clotrimazole (10 microM), metyrapone (10 microM) and proadifen (10 microM). 3.
      The reduction in NA contractility induced by indomethacin was reverted with a
      decreasing order of potency by the thromboxane A2 analogue, U-46619 >
      prostaglandin (PG) E2 > PGF2alpha. The exposure of the mesenteric bed to NA
      increased the production of PGF2alpha, whereas it did not modify the production
      of the remaining AA metabolites. 4. The increase in the NA-induced contractions
      caused by endothelium removal, as well as by the inhibition of nitric oxide
      synthase (NOs) with NG-nitro-L-arginine methyl ester (400 microM; L-NAME), was
      suppressed by indomethacin but not by NDGA. These observations suggest that the
      lipoxygenase-derived metabolites are formed in the endothelium, whereas the COX
      derived metabolites are formed in the vascular smooth muscle. 5. The TP receptor
      antagonist, SQ29548, did not modify the NA-induced contractions, either in the
      presence or in the absence of the endothelium. 6. Contractions elicited by KCI
      (60-100 mM) were unmodified by the AA metabolism inhibitors, ETYA, NDGA and
      indomethacin. 7. In summary, these results show that metabolites of AA, through
      both the COX and the lipoxygenase pathways, are involved in the NA-induced
      contractions in the rat mesenteric bed. The lipoxygenase metabolites are likely
      to be formed in the vascular endothelium, whereas the COX metabolite, which could
      be PGF2alpha, is apparently formed within the vascular smooth muscle.

PMID- 11193006
TI  - M3 muscarinic receptors but not M2 mediate contraction of the porcine detrusor
      muscle in vitro.
AB  - 1. The objective of the study was to determine the role of muscarinic receptor
      subtypes in mediating contraction of the porcine detrusor smooth muscle in vitro.
      2. Strips of pig detrusor muscle were set up in physiological salt solution and
      the tensions developed by the tissues were recorded. Responses to carbachol were
      obtained in the absence and presence of a range of muscarinic antagonists (4
      DAMP, methoctramine, darifenacin, oxybutynin, tolterodine and pirenzepine).
      Antagonist affinity values (pKB values) were calculated and compared with those
      quoted in the literature for these antagonists at each of the muscarinic receptor
      subtypes. 3. The M3-selective antagonists, 4-DAMP and darifenacin had high
      affinities (pKB values of 9.4 and 8.6, respectively). Oxybutynin, tolterodine and
      pirenzepine had affinities of 8.2, 8.1 and 6.8, respectively, whilst the M2
      selective agent methoctramine had a relatively low affinity (pKB = 6.1). The rank
      order of affinities was, therefore, 4-DAMP > darifenacin > oxybutynin >
      tolterodine > pirenzepine > methoctramine for the pig detrusor. Correlation of
      the antagonist affinities obtained on the bladder with those published for these
      antagonists at the five muscarinic receptor subtypes identified the M3(m3)
      receptor as the muscarinic subtype mediating detrusor contractile responses in
      vitro. 4. These data suggest that a small population of M3-muscarinic receptors
      must mediate direct contractile responses of the pig detrusor muscle to
      muscarinic receptor stimulation in vitro.

PMID- 11193008
TI  - Effects of clofilium on cardiovascular tissues from normo- and hypertensive rats.
AB  - 1. The overall aim was to test whether clofilium has some potential as a positive
      inotrope for heart failure. We used Wistar Kyoto normotensive rats (WKY) and
      spontaneously hypertensive rats (SHRs) and studied the effects of clofilium on
      isolated blood vessels, left ventricular action potentials and left ventricular
      contractility. 2. Clofilium at < or = 10(-6) M had no effect on WKY portal vein
      contractions and at < or = 3 x 10(-4) M had no effect on WKY or SHR quiescent
      mesenteric and intralobar pulmonary arteries. 3. Clofilium at 10(7) - 10(-5) M
      prolonged the WKY left ventricular action potentials and with 10(-6) and 10(-5)M
      this included after-depolarizations. 4. Clofilium at < or = 3 x 10(-5) M
      augmented the peak force, prolonged the contractions and did not cause
      arrhythmias in the absence and presence of isoprenaline on left ventricle strips
      from 12-month-old WKY. 5. The 12-month-old SHR has hypertrophy of the left
      ventricle with reduced peak force and prolongation of relaxation. The effects of
      clofilium on 12-month-old SHR left ventricle contractility were similar to those
      in the age-matched WKY. 6 In summary, clofilium has positive inotropic effects on
      the rat left ventricle that are maintained in hypertrophy. Clofilium does not
      have effects on blood vessels that would be detrimental in heart failure.
      Clofilium prolongs the rat left ventricle action potential and causes after
      depolarizations. The pro-arrhythmic potential of clofilium, however, makes it
      unlikely that it could be used as a positive inotrope in the treatment of heart
      failure.

PMID- 11193007
TI  - Functional innervation of the biliary sphincter of the guinea-pig revealed by
      anti-autonomic drugs.
AB  - 1. The roles of excitatory and inhibitory intrinsic motor nerves on contractions
      reflexly evoked by wall distension were investigated in the isolated sphincter of
      Oddi of the guinea-pig (SO-GP). 2. Distension of the terminal bile duct for 30-60
      s time periods increased the frequency of contractions from about 2 to 12 min(-1)
      (n = 16). 3. Hexamethonium (HEX; 300 microM) largely prevented the distension
      evoked increase in contraction frequency (4.5 min(-1), n = 8) as did atropine
      (ATR; 1 microM) (0.8 min(-1), n = 6), while tetrodotoxin (TTX; 1 microM) blocked
      the contractions triggered during distension. 4. L-nitroarginine (L-NA; 100
      microM) significantly increased the frequency of contractions during and in the
      absence distension while apamin (APAM; 0.5 microM) significantly increased their
      frequency and doubled their mean amplitude during distension. 5. These results
      suggest that distension activates excitatory cholinergic motor nerves to increase
      the frequency of contractions in the SO-GP. These actions are modulated by the
      concomitant activation of intrinsic nitrergic and non-nitrergic inhibitory motor
      nerves.

PMID- 11193009
TI  - Hearing where we're coming from--ethically and professionally.
AB  - Anthropologists concerned about the discipline's ability to cope ethically and
      ethnographically with a globalized world should not dismiss too hastily the
      methodology--and the ethics built into it--that anthropology developed over the
      last century. This methodology of making "displacing" translations, based on
      ethnographic experience and a politics of translation, can still provide a
      workable ethics and a viable labor of ethnography even in the world at present.

PMID- 11193010
TI  - Negotiating ethical and legal mazes in the federal workplace.
AB  - The mandates that control actions in the federal workplace often challenge
      academic principles of conduct. Particularly vulnerable is the anthropologists'
      image of themselves as champions of powerless and voiceless groups in an arena
      perceived as dominated by a hostile government. This is coupled with convictions
      that socially responsible anthropology respects individual privacy while
      disseminating data to encourage culturally informed public and federal decisions.
      Using examples involving federal cultural and natural resources, we show
      conflicts within this suite of perspectives and with the demands of the federal
      workplace. The need for legally defensible decisions, responses to publics with
      diverse agendas, and requirements for confidentiality and public access to
      government records test our anthropological convictions as well as available
      legal protections of individual privacy and the public's right to know. Perhaps
      the anthropological community will strategize about more effective remedies for
      the problems of meeting the concerns of the individuals and the publics it cares
      about.

PMID- 11193011
TI  - The practice and politics of archaeology in Egypt.
AB  - Archaeologists working in Egypt have rarely considered the local/global
      ramifications and responsibilities of their field practices: many continue to
      operate under what might be termed the residual effects of colonialism. Taking an
      explicitly postcolonial stance I argue that there is much more at stake than the
      intellectual enterprise. This paper outlines the ways in which scholars could
      undertake a more engaged archaeology and how we might more closely be involved
      with the people and pasts of modern Egypt. The connected tensions of tourism and
      terrorism are foregrounded, demonstrating that heritage issues are salient to
      both spheres. Finally, I explore the nation's relationship to its pharaonic past
      over the past few centuries and include some contemporary articulations and
      representations.

PMID- 11193012
TI  - Ethical issues in the ethnography of cyberspace.
AB  - The project of developing an anticipatory anthropology of the future reveals
      unique ethical opportunities. For example, the increased importance of
      performance means there is a substantial potential for a substantive
      "resocialing" of work in organizations, just as the decline of Modernism opens
      space for collective, situated ethics as opposed to individualized categorical
      imperatives. An anthropology of the future should address the question of the
      future of ethics in general. The very possibility of human agency, of informed
      individual moral action, is brought into question in new ways. The profound
      flexibility of the computer as a medium carries with it the dangers of hyper
      abstraction, while the consolidation of capital reproduction on a global level
      increases the scope for apparently permanent mystification. Also important are
      the new ethical challenges raised for those engaged in knowledge "production" or
      science broadly conceived. These include the necessary effort to acknowledge
      fully the role of non-human agency, and the potentially profound possibilities in
      a transformation in the character of knowledge, a correlate, at least in part, of
      the commodification of knowledge associated with distance learning. These
      challenges accompany the more overt threats of transgenic entities and ecological
      degradation. How can one be an ethical intellectual or academic under these
      circumstances, let alone teach others to be? There are also some specific
      challenges facing anthropology in particular. Some derive from the increasing
      "privatization" of ethnography, both in its growing popularity in modes of social
      reproduction more directly implicated in the reproduction of capital and in the
      declining academic support for anthropology. In a very specific sense,
      anthropology has grounded its ethics on an appreciation of and support for the
      reproduction of "really existing" culture. This ethical compass is not available
      to the ethnographer who studies the future. How do we participate ethically in
      the construction of a future in whose character we are inevitably implicated?

PMID- 11193013
TI  - Working toward an ethical anthropology. Where do we go from here?
AB  - This article posits an ethical anthropology for the 21st century that addresses
      and informs our understanding of international conflict situations and their
      solutions while providing methodologies for anthropologists of color to position
      their issues of concern at the center of social science discourse.

PMID- 11193014
TI  - Ethics in anthropology: dilemmas and conundrums.
AB  - This paper is a call for awareness and continual examination of the multifaceted
      nature of ethics and closely related ideas as they relate to anthropology. At the
      very least, the lack of common understanding of these ideas has been and
      continues to be a pressing prblem for all who practice anthropology. In this
      vein, abbreviated etymologies of these critical concepts are put forth as
      prologue to forays into ethics in the academy and of science as context for
      ethical maneuver. Shifting conditions in anthropology are then described in
      relation to altered ethical orders with examples of early hints of the
      contemporary scene being drawn from Oscar Lewis's commentary on the raucous
      reception in Mexico of his book The Children of Sanchez.

PMID- 11193015
TI  - Ethical dilemmas. What's new, what's not.
AB  - The ethical issues and conflicts facing anthropology have precedents in the past
      because they are intrinsic to anthropological practice. What is different about
      them now is that they are played out in new sites, with added complexities, and
      without changed relations of anthropologists to those with stakes in their
      research, especially "the people" they study. A review of the unintended
      consequences of the American Anthropological Association's efforts to define a
      code of ethics in the 1960s offers lessons that are applicable today.

PMID- 11193016
TI  - Towards a public health approach to bioethics.
AB  - In this paper we examine the central commitments of bioethical enquiry and
      reasoning from a public health perspective. We argue that a core element of
      American national culture is individualism, which resonates in scholarly and
      popular debates. Our contention is that the habitus of bioethical debate is in
      large measure animated by an overriding concern with the individual, and the
      resulting social practice of the community has been to downplay the importance
      and legitimacy of group-level health care dilemmas. This paper calls for re
      focusing of bioethics by employing a public health perspective, which would
      include a population focus, evidence-based research topics, and engagement of the
      ethical dilemmas that arise from decisions concerning prevention. Racial and
      ethnic health disparities throughout the life span of a population in central New
      York State are used to illustrate the need for a public health focus in
      bioethics.

PMID- 11193017
TI  - Globalization of research and international standards of ethics in anthropology.
AB  - Ethics and anthropology have entered the era of globalization, and professional
      discourse about ethics can no longer be confined to a national or domestic
      dialogue. Anthropology must vigorously join the international dialogue and debate
      over globalization and the conduct of research across cultures; indeed it is the
      discipline most suited to command the high ground in this discourse. American
      anthropology historically has been more reactive than proactive in ethics, but
      cannot remain so as the nature and condition of research have fundamentally
      changed in a postcolonial world. Indigenous peoples, Third World researchers,
      international development workers in government and non-government agencies, and
      other anthropologists outside of the U.S. are raising questions about
      international research that are generating new standards of conduct. Anthropology
      as a discipline and a profession must keep apace with these developments or it
      will lose ground in a crucial arena of global discourse.

PMID- 11193018
TI  - Facing racism and the moral responsibility of human rights knowledge.
AB  - Anthropologists working in arenas of human rights advocacy must be prepared to
      negotiate dilemmas of human responsibility. Those focusing on racial
      discrimination as a breach of international human rights conventions must contend
      with trends in social research that feed into politically consequential claims
      that neither race nor racism exist as significant social facts. An examination of
      the global sociocultural and geopolitcal landscape, the human rights system, and
      models of change reveals that contemporary racism in both its marked and unmarked
      varieties warrants anthropologists' critical scrutiny and, depending on
      individual epistemological and political inclination, sociopolitical
      intervention.

PMID- 11193019
TI  - If anthropology is global, then so are its ethical dilemmas.
AB  - This paper reviews three personal situations of the author as a student: an NGO
      activist in the women's movement and a UN official working on women's health and
      tobacco. Each situation, the kinds of ethical issue posed and lessons for the
      future direction of ethics in anthropology are outlined. The paper argues that
      applied anthropology is embedded in the position of the field of anthropology
      within the politics of the State and that this defines the parameters of
      individual choice. Contradictions in ethical situations and decision-making are
      posed by changing from the distant observer to active involvement and these may
      not be resolved by logic alone. Furthermore, governance and defining global
      ethical standards such as for the behavior of the tobacco multinational
      corporations is a fascinating new realm for anthropological ethical resolve.

PMID- 11193020
TI  - "Who knows the power of his bones". Reburial redux.
AB  - This paper discusses the repatriation of human remains to indigenous peoples in
      Australia and the United States and the role anthropologists play in the
      construction of past, present, and future identities for contemporary indigenous
      peoples. Using examples from both countries, I suggest that many of the
      participants at the reburials, and in the events leading up to them, were not
      only reburying their dead ancestors and addressing religious concerns, but were
      also redeeming past social injustices, renegotiating the status quo, and
      affirming their modern social and religious identity--all important issues for
      Fourth World peoples living in First World nation-states today. Reburials are
      powerful social dramas, testimony to the complex historical relationships between
      and among all concerned, living and dead, indigenous and non-indigenous. I also
      argue that as Fourth World peoples attempt to renegotiate the status quo by
      turning to the past and reburying their ancestors, the important role of
      anthropologists in this effort should be considered in terms of both practice and
      theory. Because of the combination of heritage/cultural resource management
      legislation, government regulations, a changing professional ethic in regards to
      issues of repatriation, anthropologists in all subdisciplines are increasingly
      involved in the witting and unwitting reproduction of indigenous social orders.
      The implications of this and its ethical dilemmas for anthropologists working in
      all the subdisciplines and in varied workplaces are explored. The necessity of
      working with indigenous communities is underscored and suggestions for working
      toward a common universal heritage are presented.

PMID- 11193021
TI  - Molecular anthropology and race.
AB  - Molecular analyses have led to many recent advances in the study of human
      variation. The addition of DNA analyses of fossils now allows the testing of
      hypotheses derived from sampling living people. Further sampling of all of the
      regions of the human genome has led to a remarkably consistent evolutionary
      scenario that helps to explain the patterns of variation found today.

PMID- 11193022
TI  - Ethics and anthropology: Facing future issues in human biology, globalism, and
      cultural property. Proceedings of a meeting. April 14, 2000. New York, New York,
      USA.

PMID- 11193023
TI  - Programmed cell death (PCD). Apoptosis, autophagic PCD, or others?
AB  - The occurrence of cell death as a physiological event in multicellular organisms
      has been known for more than 150 years; in 1972 the term apoptosis was introduced
      on morphological grounds. However, accumulating evidence suggests that programmed
      cell death (PCD) is not confined to apoptosis, but that cells use different
      pathways for active self-destruction as reflected by different morphology:
      condensation prominent, type I or apoptosis; autophagy prominent, type II; etc.
      Autophagic PCD appears to be a phylogenetically old phenomenon; it may occur in
      physiological and disease states. We have studied the relation between
      morphological and biochemical events during autophagic and apoptotic PCD in human
      mammary, lymphoblast, and colon cancer cells using electron microscopy and
      proteom analysis. We find that autophagic cell death (type II) PCD includes
      degradation of Golgi apparatus, polyribosomes, and endoplasmic reticulum, which
      precedes nuclear destruction. Intermediate and microfilaments are largely
      preserved; presumably the cytoskeleton is required for autophagocytosis.
      Apoptosis (type I) PCD is characterized by condensation of cytoplasm and
      preservation of organelles; cytoskeletal elements disintegrate in early stages.
      Either type of PCD involves synthesis of distinct proteins. Finally, both types
      of PCD share features some of a cell's stress response (e.g., translocation of
      hsp90). In conclusion our findings support the concept that autophagic cell death
      is a separate pathway of PCD distinctly different from "classical" apoptosis.
      However, autophagic and apoptotic PCD should not be considered as mutually
      exclusive phenomena. Rather, they appear to reflect a high degree of flexibility
      in a cell's response to changes of environmental conditions, both physiological
      or pathological.

PMID- 11193024
TI  - Mechanisms of cell death II. Proceedings of the 3rd Annual Conference of the
      International Cell Death Society. May 6-10, 2000. Escorial, Spain.

PMID- 11193025
TI  - First and second messenger role of calcium. Survival versus apoptosis in serum
      free cultured granulosa explants.
AB  - In order to elucidate the causal relationship between increased intracellular
      free calcium ([Ca2+]i) and induction of apoptosis, serum-free cultured granulosa
      cell (GC) explants were subjected to various experimental protocols interfering
      with normal Ca2+ homeostasis. Modulation of apoptotic indices was calculated on
      DAPI-stained GC explants. In some experiments [Ca2+]i was measured with the Ca2+
      probe fura-2 in combination with epifluorescence microscopy. Buffering of [Ca2+]i
      with BAPTA-AM resulted in inhibition of apoptosis, while increasing extracellular
      Ca2+ (otherwise called [Ca2+]e load) resulted in a biphasic response
      characterized by an initial inhibitory effect on apoptosis followed by a delayed
      phase of increased apoptosis that became apparent at 4 h after withdrawal of the
      [Ca2+]e load. The initial inhibitory effect of the [Ca2+]e load on apoptosis was
      dependent on the concentration of the load (range 2-50 mM), was augmented when
      the [Ca2+]e load was applied in the presence of the Ca2+ channel blocker
      methoxyverapamil, and was mimicked by applying Mg2+ and Gd3+, two Ca(2+)-receptor
      agonists. These observations point towards the involvement of an extracellular
      Ca(2+)-sensing receptor (CaR). Measurements of [Ca2+]i showed that the ion was
      increased just after [Ca2+]e load, followed by recovery that was complete at 2 h
      after the load. Collectively these data suggest that a [Ca2+]e load initiates
      apoptosis, becoming manifest 4 h later, by the provoked [Ca2+]i increase, and
      this effect is preceded by an apoptosis-inhibiting phase presumably involving CaR
      activation. We conclude that Ca2+ may act as a first (extracellular) messenger
      promoting cell survival and as a second (intracellular) messenger activating the
      cell death pathway.

PMID- 11193026
TI  - Primary human fibroblasts from a maple syrup urine disease patient undergo
      apoptosis following exposure to physiological concentrations of branched chain
      amino acids.
AB  - Maple syrup urine disease (MSUD) is an inborn error of metabolism caused by a
      deficiency in branched chain alpha-ketoacid dehydrogenase. We have recently found
      that MSUD neurodegeneration may result, at least in part, from apoptosis
      triggered by branched chain amino acids and their alpha-ketoacid derivatives. In
      the present study, we investigated the sensitivity of MSUD fibroblasts to defined
      mixtures of MSUD metabolites. Defined combinations of MSUD metabolites, at levels
      comparable to those in MSUD patients, triggered cell death in skin fibroblasts
      from a MSUD patient, while control fibroblasts were resistant. The mechanism of
      cell death was confirmed as apoptosis by in situ end labeling.

PMID- 11193027
TI  - Heat shock protein 70 is required for the survival of cancer cells.
AB  - The major stress-inducible heat shock protein, Hsp70, is a chaperone protein
      abundantly and preferentially expressed in human tumors and tumor cell lines.
      Owing to the ability of Hsp70 to protect cells from a wide range of apoptotic and
      necrotic stimuli, it has been assumed that Hsp70 may confer survival advantage to
      tumor cells. To investigate this hypothesis in human tumor cell lines, we
      generated an adenovirus expressing antisense Hsp70 (Ad.asHsp70). The effective
      and specific depletion of Hsp70 by Ad.asHsp70 resulted in massive cell death of
      all tumorigenic cell lines tested (carcinomas of breast, colon, prostate and
      liver as well as glioblastoma). In spite of an effective depletion of Hsp70,
      Ad.asHsp70 had no effect on the survival or growth of fetal fibroblasts or non
      tumorigenic epithelial cells of breast or prostate. Anti-apoptotic proteins Bcl
      2, Bcl-XL and CrmA as well as peptide-inhibitors of caspases, DEVD-CHO and zVAD
      FMK, failed to rescue tumor cells from Ad.asHsp70-induced cell death. These
      results indicate that the high expression of Hsp70 is a prerequisite for the
      survival of human cancer cells of various origins and reveal Hsp70 as the only
      protein described so far whose expression is specifically needed for the survival
      of tumorigenic cells.

PMID- 11193028
TI  - The interaction of HSP27 with Daxx identifies a potential regulatory role of
      HSP27 in Fas-induced apoptosis.
AB  - The heat shock protein HSP27 protects cells against a wide variety of toxic
      treatments and blocks apoptosis induced by exposures to anticancer drugs and
      activation of the death receptor Fas. The molecular mechanisms of protection are
      unknown but appear to be regulated by phosphorylation of HSP27. Two apoptotic
      pathways can be activated downstream of Fas. The Fas-adaptor FADD mediates a
      caspase-dependent pathway. Fas also activates a caspase-independent pathway which
      correlates with Fas-induced translocation of Daxx from the nucleus to the
      cytoplasm and involves the interaction of Daxx with Fas and Ask1. We found that
      phosphorylated dimers of HSP27 interact with Daxx, preventing its interaction
      with Ask1 and Fas and blocking Daxx-mediated apoptosis. Expression of HSP27 also
      prevents the translocation of Daxx from the nucleus to the cytoplasm which is
      induced upon expression of Ask1 or stimulation of Fas. The observations reveal a
      new level of regulation of the Fas pathway. Whereas the FADD axis can be
      modulated by expression of FLIP, a natural inhibitor of FADD, our results show
      that HSP27 can accomplish a similar function for the Daxx axis.

PMID- 11193029
TI  - Apoptosis as a scaffold for building up the B cell repertoire.
AB  - Control of cell number is determined by a balance between cell proliferation and
      cell death, both of which are highly regulated processes, with numerous checks
      and balances. Cells control their own death through activation of an internally
      coded suicide program that, when activated, initiates a characteristic form of
      cell death called apoptosis. This type of regulation allows elimination of cells
      that have been produced in excess, that have developed improperly, or that have
      sustained genetic damage. Apoptosis is, therefore, the most common physiological
      form of cell death and occurs during embryonic development, tissue remodeling,
      immune regulation, cell activation and tumor regression.

PMID- 11193030
TI  - A single cell analysis of apoptosis. Ordering the apoptotic phenotype.
AB  - Microcinematography was applied to the analysis of the kinetics of apoptotic cell
      death. Apoptosis was found to be a process that proceeds in different cells at
      different times after an initial stress, and therefore kinetic studies of
      apoptotic events in bulk cultures can be problematic. Using single cell analysis
      we found that stronger apoptotic stimuli induce an earlier onset of apoptosis,
      but that there is no relationship between time of onset and duration of the
      apoptotic process. That is, cells that initiate apoptosis shortly after induction
      do not proceed more rapidly through the process. This suggests an all-or-non
      mechanism that is supported by some models of the biochemical pathways of
      apoptosis.

PMID- 11193031
TI  - Molecular mapping of the physiological cell death process. Mitochondrial events
      may be disordered.
AB  - The mitochondrion plays a central role in Bcl-2-inhibitable physiological cell
      deaths. The detailed order of mitochondrial and other events during cell death in
      vivo remains ambiguous, however. As part of an effort to explore this issue, we
      have asked whether mitochondrial dissolution during physiological cell death
      occurs in an orderly and concerted process. Here, we describe the
      characterization of two elements of mitochondrial disintegration on the level of
      individual cells. Using a novel cytofluorimetric approach, we have assessed
      simultaneously the release of cytochrome c (specifically a fluorescently tagged
      transfected construct) from mitochondria and the dissipation of mitochondrial
      membrane potential. Our results indicate that mitochondrial disintegration does
      not follow a strictly ordered process and is not concerted. We are extending
      these studies to further characterize mitochondrial events in the context of Bcl
      2 family members and place them definitively within the context of the caspase
      cascade.

PMID- 11193032
TI  - Mitochondrial control of cell death induced by HIV-1-encoded proteins.
AB  - In most examples of physiological or pathological cell death, mitochondrial
      membrane permeabilization (MMP) constitutes an early critical event of the lethal
      process. Signs of MMP that precede nuclear apoptosis include the translocation of
      cytochrome c and apoptosis-inducing factor (AIF) from mitochondria to an extra
      mitochondrial localization, as well as the dissipation of the mitochondrial
      transmembrane potential. MMP also occurs in HIV-1-induced apoptosis. Different
      HIV-1 encoded proteins (Env, Vpr, Tat, PR) can directly or indirectly trigger
      MMP, thereby causing cell death. The gp120/gp41 Env complex constitutes an
      example for an indirect MMP inducer. Env expressed on the plasma membrane of HIV
      1 infected (or Env-transfected) cells mediates cell fusion with CD4/CXCR4
      expressing uninfected cells. After a cell type-dependent latency period, syncytia
      then undergo MMP and apoptosis. Vpr exemplifies a direct MMP inducer. Vpr binds
      to the adenine nucleotide translocator (ANT), a mitochondrial inner membrane
      protein which also interacts with apoptosis-regulatory proteins from the Bcl
      2/Bax family. Binding of Vpr to ANT favors formation of a non-specific pore
      leading to MMP. The structural motifs of the Vpr protein involved in MMP are
      conserved among most pathogenic HIV-1 isolates and determine the cytotoxic effect
      of Vpr. These data suggest the possibility that viruses employ multiple
      strategies to regulate host cell apoptosis by targeting mitochondria.

PMID- 11193033
TI  - Morphologic, biochemical and molecular mitochondrial changes during reperfusion
      phase following brief renal ischemia.
AB  - Ischemia/reperfusion of organs and cells induces apoptosis through a complicated
      series of changes in mitochondria, mainly the generation of oxygen free radicals,
      permeability transitions, calcium translocations, and release of apoptogenic
      factors such as cytochrome c and Bcl-2 family members. The liberation of these
      factors occurs very early after reoxygenation and it has been assumed that it
      takes place without any structural alteration of the mitochondrial membranes. The
      aim of this study was to detect ultrastructural changes of mitochondria in the
      initial stages of reperfusion at the time when Bcl-2 and succinic dehydrogenase,
      located in the outer and inner membranes, respectively, were released.
      Ischemia/reperfusion was produced in adult rats by clamping one renal artery for
      60 min and reoxygenating for 60, 120, 180, and 240 min. A model of chemical
      hypoxia with intra-arterial 50 mM sodium azide served as comparison, allowing
      free blood flow for 30, 60, 120 and 180 min. Light and electron microscopy,
      immunostaining for Bcl-2, and enzyme histochemistry for succinic dehydrogenase
      were performed. Our results showed mitochondrial swelling, rupture of inner and
      outer membranes, and leakage of mitochondrial matrix into the cytoplasm in
      ischemia after 120 min of reperfusion. Bcl-2 immunoreactivity and focal lowering
      of SDH reactivity were also noted and became more pronounced at the same time
      that the mitochondrial ultrastructure demonstrated more evident changes including
      rupture of the inner and outer membranes. Our studies seem to indicate that in
      early ischemia-reperfusion and in chemical hypoxia-induced apoptosis, the
      earliest ultrastructural changes take place in mitochondria and that swelling and
      rupture of mitochondrial membranes occur in parallel with the loss of Bcl-2 and
      SDH activity.

PMID- 11193034
TI  - Role of ECM remodeling in thyroid hormone-dependent apoptosis during anuran
      metamorphosis.
AB  - Programmed cell death or apoptosis is an important aspect in organogenesis and
      tissue remodeling. It is precisely controlled both temporally and spatially
      during development. Amphibian metamorphosis is an excellent model to study
      developmental control of apoptosis in vertebrates. This process involves the
      transformation of essentially every organ/tissue as tadpoles change to frogs, yet
      is controlled by a single hormone, thyroid hormone (TH). Although different
      organs and tissues undergo vastly different developmental changes, including de
      novo development and total resorption, most require apoptotic elimination of at
      least some cell types. Such properties and the dependence on TH make frog
      metamorphosis a unique model to isolate and functionally characterize genes
      participating in the regulation of tissue specific cell death during organ
      development in vertebrates. Indeed, molecular studies of the TH-dependent gene
      regulation cascade have led to the discovery of a group of genes encoding matrix
      metalloproteinases (MMPs) participating in metamorphosis. In vivo and in vitro
      studies have provided strong evidence to support a role of MMP-mediated
      remodeling of the extracellular matrix in regulating apoptotic tissue remodeling
      during metamorphosis.

PMID- 11193035
TI  - A caspase-independent cell clearance program. The LEI/L-DNase II pathway.
AB  - The discovery of caspase-mitochondrial pathway counts as one of the most
      important discovery in apoptosis biochemistry. Today, however, we begin to
      recognize its limits. Inhibition of caspase does not prevent cell death in many
      mammalian models. Targeted disruption of caspases does not impair every type of
      apoptosis. Other pathways, caspase independent, are now described. Here we
      present one of these pathways. It is a serine-protease dependent pathway and its
      key event is the transformation of LEI (a serine protease inhibitor) into L-DNase
      II (an endonuclease). When using this apoptotic pathway the cell activates, at
      the same time, its endonuclease activity (L-DNase II appears) and its protease
      activity (there is a release of inhibition of proteases).

PMID- 11193036
TI  - Role of apoptosis in the response of lung carcinomas to anti-cancer treatment.
AB  - Resistance of tumor cells to treatment often accounts for the failure of
      traditional forms of anti-cancer therapy. It is well known that tumors from the
      same histological group and stage of development are highly heterogeneous in
      their sensitivity to therapy. Among the factors that can influence tumor
      sensitivity are DNA repair capacity, distribution of cells throughout the cell
      cycle, proliferation potential, etc. In many cases, anti-cancer therapy
      eliminates tumor cells via apoptosis, an active form of cell death characterized
      by cell shrinkage and the removal of cells in a neat, orderly fashion. However,
      this process is not always efficient. In the present review, the precise role
      that apoptosis plays in the response of lung carcinomas to chemotherapy and
      radiation treatment is discussed.

PMID- 11193037
TI  - The central role of phosphatidylserine in the phagocytosis of apoptotic
      thymocytes.
AB  - Apoptotic thymocytes inactivate the aminophospholipid translocase, which
      transports phosphatidylserine (PS) to the inner leaflet of the plasma membrane,
      and activate the scramblase, which randomizes phospholipids across the membrane
      and brings PS to the cell surface. Although different macrophages use at least
      two different systems to recognize and engulf apoptotic thymocytes, both systems
      recognize PS on the apoptotic target. Thymocytes treated with Ca2+ and ionophore
      to inactivate the translocase and activate the scramblase immediately expose PS
      on their surface and are immediately recognized and phagocytosed. These targets,
      on which PS has been artificially exposed, are recognized by the PS exposed on
      their surface. However, they apparently also engage the vitronectic receptor, a
      lectin-like receptor and CD14. All of these receptors are implicated in the
      phagocytosis of apoptotic thymocytes, suggesting that loss of asymmetry and/or
      exposure of PS is sufficient to generate the ligands recognized by those
      receptors. The role of PS is not confined to the target cell surface, however. PS
      is constitutively exposed on the surface of macrophages and is as necessary for
      apoptotic cell engulfment as is recognition of PS on the target cell surface.

PMID- 11193038
TI  - Opsonization of apoptotic cells. Implications for uptake and autoimmunity.
AB  - As a part of innate immunity, soluble host proteins called opsonins, which
      include complement ligands and immunoglobulins, initially coat microorganisms
      that penetrate the mammalian sterile milieu. The main purpose of opsonization is
      to allow subsequent clearance of opsonized particles by specific receptors on the
      surface of leukocytes. Similarly, several proteins that may act as opsonins and
      have a role in uptake of apoptotic cells and bodies include thrombospondin I, the
      complement system, beta 2GPI, immunoglobulins, CRP, and some unidentified others.
      The surface changes that lead to opsonization include the appearance of
      phosphatidylserine that acts as an activator molecule for some known opsonins as
      the complement system and beta 2GPI. The consequence of altered opsonization is
      demonstrated by the development of autoimmunity in C1q deficient mice, and the
      pro-inflammatory response by macrophages ingesting apoptotic cell opsonized by an
      autoantibody.

PMID- 11193039
TI  - HIV, cytokines and programmed cell death. A subtle interplay.
AB  - HIV infection is marked by the progressive destruction of the CD4 T lymphocyte
      subset, an essential component of the immune system and a vital source of
      cytokines required for differentiation of natural killer (NK) and gamma delta T
      cells, for maturation of B lymphocytes into plasmocytes, and for differentiation
      of CD8+ T cells into virus-specific cytotoxic T lymphocytes. CD4 T lymphocytes
      are also a source of chemokines which control migration of lymphocytes to the
      site of infection and which also inhibit HIV entry into CD4-expressing targets.
      Continuous production of viral proteins leads to an unbalanced immune activation
      and to the triggering of apoptotic programs, turning mononuclear cells, including
      CD4 T cells, CD8 T cells and APC, into effectors of apoptosis, leading to
      fratricidal destruction of healthy uninfected cells expressing the death
      receptors. Inappropriate PCD is also responsible for the disappearance of T
      helper cells primed for type-1 cytokine synthesis, thus contributing to the lack
      of survival factors which could prevent spontaneous lymphocyte apoptosis. Under
      potent anti-retroviral therapies, a significant decrease in spontaneous, TCR- and
      CD95-induced lymphocyte apoptosis is observed, concomitant with a partial
      quantitative and qualitative restoration of the immune system in treated
      patients. However, owing to the suppressive effect of anti-retroviral drugs on
      physiological apoptosis, these therapies are associated with alteration of TNF
      alpha-regulated T cell homeostasis, leading to an accumulation in the blood of T
      cells primed for TNF-alpha synthesis, and contributing to the development of a
      new syndrome associated with these treatments, the lipodystrophy syndrome.

PMID- 11193040
TI  - Quantitation of CD95 and CD95L mRNA expression in chronic and acute HIV-1
      infection by competitive RT-PCR.
AB  - Human immunodeficiency virus-type 1 (HIV-1) infection is characterized by
      increased immune cell apoptosis. Apoptosis can be triggered by signals that arise
      from within the cell, or by signals that are elicited by binding of extracellular
      "death ligands" to their "death receptors," most of which belong to the tumor
      necrosis factor (TNF)-receptor family, such as CD95 (Fas/Apo-1). In immune cells
      the oligomerization of CD95, induced by its ligand CD95L, and the recruitment of
      different intracytoplasmic molecules that in turn activate FLICE/caspase 8 are
      crucial. To study the role of CD95/CD95L interactions during HIV-1 infection, we
      developed an original method based upon quantitative-competitive (QC) RT-PCR that
      allowed us to quantify the amounts of mRNA coding for the total (tCD95) and
      membrane (mCD95) forms of CD95. We first studied the expression of different
      forms of CD95 mRNA in a classical model of chronic HIV infection using two
      infected cell lines of different origin--lymphocytic (ACH-2) or monocytic (U1).
      We have shown that infected cells of monocytic origin preferentially produce the
      "protective" (soluble) form of CD95, and no detectable CD95L mRNA, while lymphoid
      cells produce more mRNA for the membrane form of CD95 (which triggers apoptosis)
      along with low but detectable amounts of CD95L mRNA. One can hypothesize that a
      complex balance exists between pro-apoptotic events, perhaps triggered by the
      host to limit viral production, and anti-apoptotic events likely triggered by the
      virus to increase its production and survival. In cells of monocytic origin,
      which act as a reservoir for the virus, the anti-apoptotic molecules are favored;
      in cells of lymphocytic origin, molecules with an apoptotic meaning are
      prevalent.

PMID- 11193042
TI  - Tissue biology of apoptosis. Ref-1 and cell differentiation in the developing
      retina.
AB  - Programmed cell death by apoptosis plays a major role in neurogenesis. The
      sensitivity to apoptosis in developing nervous tissue is strongly dependent on
      cell interactions taking place within a highly structured environment, composed
      of various cell types at distinct stages of differentiation. In this article, we
      review evidence gathered both in vivo and in a histotypical retinal explant
      preparation in vitro that the bifunctional AP endonuclease/redox factor Ref-1
      (HAP1, APE, APEX) may be an anti-apoptotic protein associated with cell
      differentiation in the developing retina.

PMID- 11193041
TI  - The complexity of TNF-related apoptosis-inducing ligand.
AB  - One of the major goals of researchers in the field of apoptosis is to understand
      the molecular mechanisms of the various components of the apoptotic pathways,
      with the hope to identify targets for novel cancer therapies. The discovery of a
      TNF-related, apoptosis-inducing ligand, TRAIL, that kills transformed cells with
      great specificity in vitro, has provided the hope that TRAIL may be used to
      induce cell death in tumor cells without affecting normal tissues. However, TRAIL
      signaling is very complex and a clear understanding of its function is necessary
      before it can be used in cancer therapy. Complexity of TRAIL-induced signaling is
      apparent from its ubiquitous expression, its ability to interact with five
      receptors, and its tumor-selective induction of apoptosis. The signaling events
      that mediate the tumor selectivity of TRAIL-induced apoptosis and the biological
      functions of each of the TRAIL receptors are not well characterized. This review
      will focus on the complexity of TRAIL and the role of c-FLIP in mediating TRAIL
      function.

PMID- 11193043
TI  - Modulation of cell death in the rat thymus. Light and electron microscopic
      investigations.
AB  - In mammals, the thymus is the primary central organ of the lymphoid system; after
      birth, it progressively diminishes in size, undergoing gradual atrophy.
      Physiological maturation and/or involution of the thymus may be accelerated by
      endogenous or exogenous factors. Exposure to extremely low frequency EMF seems to
      interfere with thymic cell death. Data suggest that, in the rat model, a
      prolonged exposure to 50 Hz electric and magnetic fields, independently from
      field strength, seems to affect thymic cell death and possibly thymic physiology,
      since alterations in the balance of cell death and other parameters such as
      mitoses might interfere with the positive and negative selection of thymocytes
      and with the immunosurveillance properties of the thymus.

PMID- 11193044
TI  - The role of the pro-apoptotic Bcl-2 family member bim in physiological cell
      death.
AB  - Apoptosis, an evolutionarily conserved process for killing unwanted cells in
      multicellular organisms, is essential for normal development, tissue homeostasis
      and as a defense against pathogens. The control of apoptosis is of considerable
      importance for clinical medicine, as its deregulation can lead to cancer,
      autoimmunity or degenerative diseases. We have disrupted the Bim gene in the
      mouse and demonstrated that it plays a major and non-redundant role in
      embryogenesis, in the control of hematopoietic cell death, and as a barrier
      against autoimmunity.

PMID- 11193045
TI  - Evolution of functions within the p53/p63/p73 family.
AB  - Even though the tumor suppressor gene p53 is highly important in human cancer, as
      indicated by the fact that it is mutated in about 50% of cases, up to a few years
      ago no similar proteins had been identified. Recently, two p53 homologues have
      been identified, p73 and p63, with high amino acid identity suggesting similar
      functions. Indeed, like p53, p73 as well (i) can bind mdmX, mdm2, p300/CAF and
      adenovirus E4-orf6 proteins, (ii) can trigger several promoters including p21,
      bax, mdm2, gadd45, cyclin G, IGFBP3, 14-3-3 sigma, (iii) is able to trigger cell
      death, (iv) is involved in the DNA damage response, although through a different
      pathway. Here we analyze the data present in the literature in search of
      diverging pathways among the p53, p63, p73 family. Both p63 and p73 present two
      significant structural peculiarities: the presence of an extended non-conserved C
      terminus containing a sterile alpha motive (SAM), typical of developmental
      proteins, and the presence of number of different splicing isoforms differing in
      the N-terminus or in the absence of the transactivation domain (delta N forms),
      acting as dominant negative. The mouse knockout of p63 and p73, unlike the ones
      for p53, shows developmental abnormalities; p63 and p73 are rarely mutated in
      human cancers; both genes are regulated in different differentiation models. This
      strongly suggests the involvement of p63 and p73 in development. A picture is
      emerging showing a gradient of function among p53, p73, p63 ranging from tumor
      suppression to development.

PMID- 11193046
TI  - Microarray techniques in pathology: tool or toy?
AB  - Microarray technology allows the simultaneous analysis of up to thousands of
      different genes in histological or cytological specimens. Although microarray
      technology has so far mainly been applied in the research setting, its clinical
      application in pathology is expected in the foreseeable future. This paper
      presents an overview of the technical "ins and outs" of microarray technology,
      and discusses several putative applications in diagnostic pathology, which
      include tumour classification, the prediction of responses to certain
      chemotherapeutical or hormonal agents, the biological staging of tumours, the
      risk assessment of premalignant lesions, and the detection of microorganisms.

PMID- 11193047
TI  - Cell receptors and cell signalling.
AB  - All cells in a multicellular organism are constantly exposed to a variety of
      extracellular signals that they need to interpret and translate into an
      appropriate response to their environment. These signals can be soluble factors
      generated locally (for example, synaptic transmission) or distantly (for example,
      hormones and growth factors), ligands on the surface of other cells, or the
      extracellular matrix itself. To achieve this, cells maintain a diversity of
      receptors on their surface that respond specifically to individual stimuli. These
      receptors fall into families, based primarily on the way in which they generate
      the intracellular signals that give rise to the particular functional responses.
      Moreover, the activity of a given receptor can be modulated by other signalling
      pathways in a variety of ways, generating the flexibility required of such a
      complex system. This review aims to describe the function of the major classes of
      receptor, including G protein coupled receptors, receptor tyrosine kinases,
      ligand gated ion channels, integrins, and cytokine receptors, and to demonstrate
      the "crosstalk" that exists between these systems.

PMID- 11193048
TI  - Thrombophilia, polymorphisms, and vascular disease.
AB  - Thrombophilia traditionally refers to rare inherited defects leading to enhanced
      coagulation, especially of the venous system. In recent years, a broader search
      for genetic polymorphisms of prothrombotic genes has been carried out to
      determine the relative impact on venous and arterial thrombosis. The bulk of
      evidence is drawn from numerous, often small, heterogeneous, case control
      association studies, with a variety of end points (deep venous thrombosis,
      myocardial infarction, or stroke). The data are often conflicting and
      inconclusive with only factor V Leiden and prothrombin polymorphisms having clear
      associations with venous thrombosis. Many of the polymorphisms interact with
      established cardiovascular risk factors, in particular smoking, to increase
      greatly the risk of a thrombotic episode. Future studies will need to consider
      the confounding factors of sample size, race, and clinical end points as well
      gene-environment interactions.

PMID- 11193049
TI  - Plasminogen activator system, vascular endothelial growth factor, and colorectal
      cancer progression.
AB  - AIMS: To plasminogen activator system (PAS) consists of the plasminogen
      activators (urokinase (uPA) and tissue-type (tPA) plasminogen activators), the
      uPA receptor (uPAR), and the plasminogen activator inhibitors (PAI-1 and PAI-2).
      Plasminogen activators activate plasminogen to plasmin, which can break down
      extracellular matrix (ECM) components. Vascular endothelial growth factor (VEGF)
      is a mitogen for endothelial cells and is involved in angiogenesis. VEGF has been
      shown to upregulate uPA and this may facilitate tumour angiogenesis further.
      METHODS: PAS components and VEGF were determined by enzyme linked immunosorbent
      assay (ELISA) in paired colorectal tumour and normal tissue (n = 50) and
      correlated with pathological staging. RESULTS: uPA, uPAR, PAI-1, and VEGF values
      were significantly higher in tumour tissue (for example, tumour uPA: median, 2.3
      (range, 0.1-6.7) ng/mg protein v normal uPA: median, 0.2 (range, 0-2.6) ng/mg
      protein). tPA was significantly higher in normal mucosa and there was no
      difference in PAI-2. uPA, uPAR, PAI-1, and VEGF values significantly correlated
      with each other and with Dukes's staging (uPA in adenomas: median, 0.42 (range,
      0.1-1.2) ng/mg protein; upA in Dukes's B tumours: median, 2.1 (range, 0.4-4.3)
      ng/mg protein; and uPA in Dukes's D tumours: median, 4.0 (range, 3.7-4.2) ng/mg
      protein) and lymphatic invasion. In addition PAI-1 also correlated with tumour
      size and differentiation. CONCLUSION: The involvement of the PAS and VEGF in
      colorectal cancer appears to be complex. uPA, uPAR, PAI-1, and VEGF were
      upregulated in tumour tissue and this correlated with Dukes's staging and
      lymphatic invasion.

PMID- 11193050
TI  - Imbalances of chromosome 17 in medulloblastomas determined by comparative genomic
      hybridisation and fluorescence in situ hybridisation.
AB  - AIMS: To investigate the status of chromosome 17 in a series of medulloblastomas
      using comparative genomic hybridisation (CGH) and fluorescence in situ
      hybridisation (FISH). METHODS: Frozen tissue and formalin fixed, paraffin was
      embedded tissue from 27 medulloblastomas were analysed by CGH and FISH,
      respectively. CGH ratio profiles for chromosome 17 were compared with the results
      of FISH, for which loss or gain of 17p or 17q was assessed in two distinct ways
      using a combination of differentially labelled subtelomeric and centromeric
      probes and analysing 200 nuclei in each tumour. RESULTS: CGH revealed imbalances
      consistent with isochromosome 17q in eight of 27 tumours. Either loss of 17p or
      gain of 17q was identified in a further nine tumours, whereas 10 tumours were
      apparently balanced. Using control results from preparations of paraffin wax
      embedded tonsils, thresholds for the detection of abnormalities by FISH were
      established, either by determining the dominant pattern of signals in each case,
      or the mean ratio of subtelomeric to centromeric signals. Results by CGH and FISH
      were concordant in 21 of 27 tumours. In the remainder, most discrepancies related
      to methodological differences. CONCLUSIONS: CGH has a role in disclosing common,
      genome wide chromosomal gains or losses in tumours, the clinical relevance of
      which can then be studied in large archival series of paraffin wax embedded
      tumours using FISH.

PMID- 11193051
TI  - The imprinted H19 gene is a marker of early recurrence in human bladder
      carcinoma.
AB  - AIMS: To investigate the expression of the imprinted oncofetal H19 gene in human
      bladder carcinoma and to examine the possibility of using it as a tumour marker,
      similar to other oncofetal gene products. METHODS: In situ hybridisation for H19
      RNA was performed on 61 first biopsies of bladder carcinoma from Hadassah Medical
      Centre in Jerusalem. The intensity of the reaction and the number of tumour cells
      expressing H19 in each biopsy were evaluated in 56 patients, excluding biopsies
      with carcinoma in situ. The medical files were searched for demographic data and
      disease free survival. RESULTS: More than 5% of cells expressed H19 in 47 of the
      56 (84%) biopsies. There was a decrease in the number of cells expressing H19
      with increasing tumour grade (loss of differentiation) (p = 0.03). Disease free
      survival from the first biopsy to first recurrence was significantly shorter in
      patients with tumours having a larger fraction of H19 expressing cells,
      controlling for tumour grade. This was also supported by the selective analysis
      of tumour recurrence in patients with grade I tumours. CONCLUSIONS: It might be
      possible to use H19 as a prognostic tumour marker for the early recurrence of
      bladder cancer. In addition, for the gene therapy of bladder carcinoma that is
      based on the transcriptional regulatory sequences of H19, the expression of H19
      in an individual biopsy could be considered a predictive tumour marker for
      selecting those patients who would benefit from this form of treatment.

PMID- 11193053
TI  - A unique junctional palindromic sequence in mitochondrial DNA from a patient with
      progressive external ophthalmoplegia.
AB  - A polymerase chain reaction (PCR) based procedure was modified to determine the
      deletion of mitochondrial DNA (mtDNA). The protocol consists of coamplification
      both of deleted and wild-type segments of mtDNA using a long PCR technique;
      evaluation of the deleted portion within the amplified DNA segments by
      restriction enzyme digestion followed by densitometrical analysis; and direct
      subcloning into a plasmid vector for DNA sequencing. The procedure revealed a 5.3
      kb deletion of mtDNA in the biopsied muscle tissue obtained from a patient
      clinically diagnosed with progressive external ophthalmoplegia. The 5' and 3'
      sequences at both sides of the breakpoint comprise a 17 bp palindrome and 5 bp
      tandem repeats, suggesting that the deletion might occur through slipped
      mispairing and other novel mechanisms. This improved procedure has the potential
      to detect deletions occurring in the entire length of mtDNA, and mighty be useful
      for clinical screening of progressive external ophthalmoplegia.

PMID- 11193052
TI  - Prediction of the interacting surfaces in a trimolecular complex formed between
      the major dust mite allergen Der p 1, a mouse monoclonal anti-Der p 1 antibody,
      and its anti-idiotype.
AB  - BACKGROUND: Two mouse monoclonal antibodies (mAbs) have been described recently;
      namely, mAb 2C7 (IgG2b kappa), which is directed against the major house dust
      mite allergen Der p 1, and mAb 2G10 (IgG1 kappa), which is an anti-idiotypic
      antibody raised against mAb 2C7. The anti-idiotype mAb 2G10 does not block the
      binding of mAb 2C7 to Der p 1, which means that mAb 2C7 can simultaneously bind
      to Der p 1 and to mAb 2G10, thereby generating a trimolecular complex consisting
      of antigen-idiotype-anti-idiotype. AIMS: To sequence and model the V region of
      the anti-idiotypic antibody mAb 2G10 to enable the prediction of the interacting
      surfaces in the trimolecular complex consisting of Der p 1-mAb 2C7-mAb 2G10.
      METHODS: DNA sequencing of mAb 2G10 was carried out and the Swiss Model and Swiss
      PDB-Viewer programs were used to build a three dimensional model of the
      trimolecular complex. RESULTS: Complementarity of shape and charge was revealed
      when comparing the protrusion of the previously determined Der p 1 epitope
      (Leu147-Gln160) with the cavity formed by the complementarity determining regions
      (CDRs) of mAb 2C7. Such complementarity was also observed between the mAb 2C7
      epitope predicted to be recognised by mAb 2G10 (residues Lys19 from framework
      region 1 (FRW1) and Ser74-Gln81 from FRW3) and residues from the CDRs of mAb 2G10
      (a negatively charged patch flanked by the residues Asp55H/Glu58H and
      Glu27L/Glu27cL). As expected, the location of the mAb 2C7 epitope recognised by
      mAb 2G10 does not appear to interfere with the binding of Der p 1 to mAb 2C7.
      CONCLUSION: Although the results obtained represent only an approximation, they
      nevertheless provide a rare insight into how an antigen (Der p 1) might bind to
      its antibody (mAb 2C7) while in complex with an anti-idiotype (mAb 2G10).

PMID- 11193054
TI  - Formic acid decalcification of bone marrow trephines degrades DNA: alternative
      use of EDTA allows the amplification and sequencing of relatively long PCR
      products.

PMID- 11193055
TI  - The quality of expectation: healing, palliation or disappointment.

PMID- 11193056
TI  - To cure or not to cure, that is not the question.

PMID- 11193057
TI  - Is early management of acoustic neuroma important?

PMID- 11193058
TI  - Behavioural phenotypes.

PMID- 11193059
TI  - Expectations and quality of life of cancer patients undergoing radiotherapy.
AB  - Expectations, real or false, affect the way patients respond to their illnesses.
      We assessed therapy-related expectations in relation to global quality of life in
      55 cancer patients before and after radiotherapy. Factor analysis indicated that
      therapy-related expectations come into three broad categories--pain/emotional
      control, healing and tumour/symptom control. 35 patients expected 'healing' even
      though curative treatment was intended in only 19 and all patients had been fully
      informed. The expectation of healing was associated with high quality of life,
      and the same was true of perception of healing after radiotherapy. In the group
      as a whole, quality of life was little altered by radiotherapy, but it became
      substantially worse in those patients who had expected healing but perceived that
      this had failed, even though physician-assessed Karnofsky status did not change.
      These findings indicate that the expectation of healing, in cancer patients, is a
      component of a good global quality of life, whereas more limited expectations
      (pain control, tumour control) relate to lower quality of life. Patients'
      expectations deserve further study as a novel approach to improving care.

PMID- 11193060
TI  - Decision support systems.

PMID- 11193061
TI  - Haemothorax via an intact diaphragm.

PMID- 11193062
TI  - Acromegaly, primary thyrotoxicosis, a dense left hemiparesis and a right internal
      carotid aneurysm.

PMID- 11193063
TI  - Rupture of the ankle extensor retinaculum in a dancer.

PMID- 11193064
TI  - Malign anterior knee pain.

PMID- 11193065
TI  - Group A streptococcal meningitis with an infected BCG scar.

PMID- 11193066
TI  - RSM 1907: the acceptance of specialization.

PMID- 11193067
TI  - The case of Jane Anderson, Portobello, 1889-1914.

PMID- 11193068
TI  - Predictions for psychiatry.

PMID- 11193069
TI  - Hidradenitis suppurativa.

PMID- 11193070
TI  - Hospitalists for the NHS.

PMID- 11193071
TI  - Whiplash: a double injury.

PMID- 11193072
TI  - Clinical diagnosis and the function of necropsy.

PMID- 11193073
TI  - Molecularly imprinted microparticles for capillary electrochromatographic
      enantiomer separation of propranolol.
AB  - Molecularly imprinted microparticles imprinted against (S)-propranolol were
      synthesised and studied for use in capillary electrochromatographic separation of
      propranolol enantiomers. The imprinted microparticles were in the size range of
      0.2-0.5 micron as determined by scanning electron microscopy. The microparticles
      were suspended, in high concentration, in the electrolyte and used to perform
      enantiomer separation by a partial filling technique.

PMID- 11193074
TI  - Enhancement of luminol chemiluminescence by cysteine and glutathione.
AB  - Cysteine enhancement of cobalt(II)-catalysed chemiluminescence of hydrogen
      peroxide and luminol occurs in carbonate buffer (but not in borate buffer),
      whether cysteine mixes with hydrogen peroxide before it mixes with luminol
      cobalt(II) or vice versa. Enhancement was measured by the ratio of the signals in
      the presence and absence of cysteine; standard errors were generally < 5% of the
      mean ratio. Cystine in sufficiently acidic solution also enhances the
      chemiluminescence but otherwise diminishes the emission. The emission is also
      inhibited by glutathione. A mixed solution of cysteine and cystine gives rise to
      enhanced signals. In all the above cases, enhancement occurs only in the presence
      of a cobalt(II) catalyst. Luminol-peroxynitrite chemiluminescence is enhanced by
      cysteine and by glutathione without the presence of a catalyst.

PMID- 11193075
TI  - A fluorescent-labeled oligopeptide for monitoring PKA-mediated phosphorylation.
AB  - A fluorescent-labeled oligopeptide (DACM-CLRRASLK-fluorescein), containing a
      consensus amino acid sequence (RRXSL) of cyclic AMP (cAMP) dependent protein
      kinase A (PKA) substrate-proteins, was designed. The fluorescent peptide was a
      good substrate of PKA, and the phosphorylation of its serin residue caused an
      intensive change in fluorescent intensity. We expect that the peptide will be
      useful as a fluorescent indicator for monitoring PKA activity in living cells.

PMID- 11193076
TI  - Photoelectrochemistry as a novel strategy for DNA hybridization detection.
AB  - The special properties of ssDNA and dsDNA molecules in structure and electric
      behavior, may offer us some new ideas for the fabrication of genosensors and DNA
      chips. In this work, the photoelectrochemical method was firstly employed to
      characterize the photoelectric behavior of a ssDNA probe electrode, which was
      prepared with the self-assembly technique, and its resulting dsDNA electrode. The
      obvious decrease in the photocurrent of the dsDNA modified electrode at open
      potential or a bias voltage indicated that photoelectrochemistry was another
      useful method for DNA hybridization detection. Using the special design of ssDNA
      probes, we attempt to discuss further the relationship between the properties of
      DNA molecules and their photoelectric behaviors. In addition, the electrochemical
      impedance method was employed to verify the occurrence of some modifications over
      the electrode interface before and after the hybridization event.

PMID- 11193077
TI  - Tetraethylammonium tetrafluoroborate: a novel electrolyte with a unique role in
      the capillary electrophoretic separation of polyphenols found in grape seed
      extracts.
AB  - A capillary electrophoretic method for resolving phenolic compounds found in
      grape seed extracts was developed using a quaternary ammonium salt as the main
      electrolyte solution. Seven polyphenols were separated and identified. The
      separation mechanism seems to involve association between quaternary ammonium
      cations and the polyphenols. Migration times roughly correlate with the size of
      the known phenols. The role of the alkyl substituents on the quaternary ammonium
      ions was investigated and is discussed. The method of analysis proposed herein
      exhibits high reproducibility in terms of migration times for a complex mixture
      using a single component background electrolyte.

PMID- 11193078
TI  - Enzymatic activity measurement of phospholipid hydroperoxide glutathione
      peroxidase by capillary electrophoresis.
AB  - Based on the separation of 1-palmitoyl-2-(13-hydroperoxy-cis-9,trans-11
      octadecadienoyl)-L-3- phosphatidylcholine (PC-OOH) and 1-palmitoyl-2-(13-hydroxy
      cis-9,trans-11-octadecadienoyl)-L-3- phosphatidylcholine (PC-OH) and the
      quantitative determination of PC-OH, the enzymatic activity of phospholipid
      hydroperoxide glutathione peroxidase (PHGPx) can be measured by capillary
      electrophoresis. The separation was carried out in a fused-silica capillary (30
      cm x 100 microns id) at 15 kV positive voltage. Sodium borate (100 mM; pH = 8.4)
      was used as the running buffer, and the photodiode array detector wavelength was
      232 nm. The determination can be completed in 5 min. The detection limit was 5
      pmol; and the relative standard deviation (RSD) of the peak area was less than 1%
      with an average recovery of 98.6%. Compared with traditional methods such as HPLC
      and spectrophotometry, it is faster and more convenient. Using capillary
      electrophoresis, the enzymatic activities of PHGPx expressed by the rice PHGPx
      gene in E. coli. M15 was determined as 1.25 x 10(-5) mumol min-1, and the
      specific activity of partially purified trans-gene PHGPx was 3.1 x 10(-2) mumol
      min-1 per mg. The stability of the trans-gene PHGPx was also studied.

PMID- 11193079
TI  - Development of a rapid screening technique for organochlorine pesticides using
      solvent microextraction (SME) and fast gas chromatography (GC).
AB  - A novel, fast screening method for organochlorine pesticides (OCPs) in water
      samples has been developed. Total analysis time was less than 9 min, allowing 11
      samples to be screened per hour. The relatively new technique of solvent
      microextraction (SME) was used to extract and preconcentrate the pesticides into
      a single drop of hexane. The use of a conventional carbon dioxide cryotrap was
      investigated for introduction of the extract onto a micro-bore (0.1 mm) capillary
      column for fast GC analysis. A pulsed-discharge electron capture detector was
      used which yielded selective and sensitive measurement of the pesticide peaks.
      Fast GC conditions were optimised and tested with the previously developed SME
      procedure. Calibration curves yielded good linearity and concentrations down to
      0.25 ng mL-1 were detectable with RSD values ranging from 12.0 to 28% and LOD for
      most OCPs at 0.25 ng mL-1. Spiked river water samples were tested and using the
      developed screen we were able to differentiate between spiked samples and samples
      containing no OCPs.

PMID- 11193080
TI  - Determination of airborne methyl isocyanate as dibutylamine or 1-(2
      methoxyphenyl)piperazine derivatives by liquid and gas chromatography.
AB  - The usefulness of a glass fibre filter method to collect airborne methyl
      isocyanate (MIC) was studied in laboratory experiments and in a workplace during
      manufacture of mineral wool insulation material. Filter collection was based on
      derivatisation in situ with 1-(2-methoxyphenyl)piperazine (2MP). 2MP impinger
      sampling was also evaluated in the workplace. Impinger sampling with dibutylamine
      (DBA) was used as an independent method. The samples were analysed by liquid and
      gas chromatography using various detection techniques: mass spectrometry,
      ultraviolet and electrochemical detection (LC-MS, LC-UV, LC-EchD and GC-MS). The
      sampling efficiency of 2MP filters for MIC varied with the origin of the glass
      fibre filter. Two Whatman filters (diameter 25 mm) with altogether 21 mumol of
      2MP collected 100% of 9.8 micrograms of MIC during 30 min at an airflow rate of 1
      l min-1. The workplace measurements were performed at two concentration levels,
      0.003 and 0.09 mg m-3. The theoretical amounts of derivatisation reagent were 42
      mumol (2MP filter), 52 mumol (2MP impinger) and 100 mumol (DBA). MIC
      concentrations were 20% lower by the 2MP methods compared with the DBA method
      (statistically significant difference). Breakthrough was 6% for the DBA method
      and 9% for the 2MP impinger method. To trap both MIC and isocyanic acid, which
      was also present in the workplace samples, a tenfold molar amount of 2MP reagent
      was used. The precision of sample preparation, expressed as relative standard
      deviation, was 3.5% (0.17 microgram ml-1, n = 6). The precision of sampling in
      the workplace was 15% (0.002 mg m-3, n = 6). The limit of quantification was
      0.0006 mg m-3 for 30 l of air by the 2MP impinger method and 0.03-0.05 mg m-3 by
      the 2MP filter method. Hence, airborne MIC can be determined using 2MP as
      derivatisation reagent. Impinger sampling is preferable when low concentration
      levels are expected.

PMID- 11193081
TI  - Description and validation of an analytical method for the determination of
      paromomycin sulfate in medicated animal feeds.
AB  - A procedure for the extraction of paromomycin from different animal feed matrices
      (rabbit, chicken, pig feeds) and its subsequent determination via a reversed
      phase ion-pair HPLC separation coupled with pulsed amperometric detection is
      described. The procedure optimised in terms of the extracting solvent and the
      solid phase extraction stationary phase allows the total recovery of the
      aminoglycoside antibiotic. The criteria used for the validation of the analytical
      method applied to the cited matrices are the linear dynamic range of the
      response, the detection limit, the repeatability, the intermediate repeatability
      and the accuracy. A comparison with a method described in the literature for the
      bulk analysis of this antibiotic is made.

PMID- 11193082
TI  - Determination of 4-nonylphenol and 4-octylphenol in human blood samples by high
      performance liquid chromatography with multi-electrode electrochemical
      coulometric-array detection.
AB  - Alkylphenols can affect human health because they disrupt the endocrine system.
      In this study, an analytical method for determining trace amounts of 4
      nonylphenol (NP) and 4-octylphenol (OP) in human blood samples was developed.
      Reversed-phase HPLC with multi-electrode electrochemical coulometric-array
      detection was used for the determination of NP and OP in plasma and serum samples
      prepared with a solid-phase extraction method. The separation was achieved using
      an isocratic mobile phase of 0.7% phosphoric acid-acetonitrile with a C18
      reversed phase column. The detection limits of NP and OP were 1.0 and 0.5 ng ml
      1, respectively. The recoveries of NP and OP added to human plasma samples were
      above 70.0% with a relative standard deviation of less than 15.5%. The method was
      found to be applicable to the determination of NP and OP in various human blood
      samples such as serum and plasma.

PMID- 11193083
TI  - Binding patterns of co-existing aluminium and iron to human serum transferrin
      studied by HPLC-high resolution ICP-MS.
AB  - Serum transferrin (Tf) is an iron-binding glycoprotein. Aluminium in the blood is
      bound to the transferrin. In the present study, the chemical forms of co-existing
      Al and Fe bound to human serum Tf were studied by combined on-line HPLC and high
      resolution ICP-MS (HPLC-HR-ICP-MS). Samples were subjected to HPLC equipped with
      an anion-exchange column. The levels of 27Al, 56Fe and 32S, which are interfered
      with by polyatomic ions such as 13C14N+, 12C15N+ and 12C14N1H+, 40Ar16O+ and
      40Ca16O+, and 16O2+, respectively, when using quadrupole ICP-MS, were monitored
      simultaneously by HR-ICP-MS at a resolution of m/delta m = 3000. Al added to apo
      Tf as Al-citrate was preferentially bound to the N-lobe site almost selectively.
      Al in serum from a healthy person without any in vitro Al spike was present both
      as AlN-Tf and AlN,FeC-Tf. The chemical states were reproduced in the apo-Tf
      solution supplemented with Fe (Fe/Tf ratio = 0.6) and Al (Al/Tf ratio = 1)
      successively. The 32S level was useful for monitoring the protein levels in the
      HPLC eluate. The clean-up column procedures employed reduced the detection limit
      for 27Al to 0.1 microgram l-1 (3SB) at the middle resolution.

PMID- 11193084
TI  - Determination of triazine herbicides in foods with liquid chromatography mass
      spectrometry.
AB  - Eight residual triazine herbicides and three metribuzin metabolites in foods were
      determined by liquid chromatography mass spectrometry (LC-MS) with an atmospheric
      pressure chemical ionization (APCI) interface, under both positive and negative
      ion modes. Herbicides were extracted with acetonitrile, and no cleanup procedure
      was adopted in this method. Four foods were spiked with eight herbicides and
      three metabolites at 0.05 ppm. The average recoveries of these herbicides usually
      ranged from 82 to 99% and the relative standard deviations were usually around
      10%. These results suggest that LC-MS with APCI can be used to determine residues
      of triazine herbicides in foods.

PMID- 11193085
TI  - Improved measurement of iodine in food samples using inductively coupled plasma
      isotope dilution mass spectrometry.
AB  - A new ICP-MS method for the determination of iodine in food samples is presented.
      The method makes use of a new miniature cyclonic spray chamber and a concentric
      glass nebulizer that is designed for low sample uptakes and is operated in a self
      aspirating mode. As a consequence the wash-out was accelerated over conventional
      systems. This configuration allows the direct determination of iodine in
      mineralized solutions following digestion with nitric acid only. No strong
      oxidizing reagents such as perchloric acid or lengthy sample preparation were
      necessary to alter the chemical form of potentially volatile species. The isotope
      dilution technique using the long-lived isotope 129I was applied to obtain
      freedom from matrix effects. The present study reports on results for total
      iodine in selected nutritional and biological reference materials and makes a
      comparison with instrumental neutron activation analysis.

PMID- 11193086
TI  - The quantification of potassium using a quartz crystal microbalance.
AB  - N,N'-dibenzyl-4,13-diaza-18-crown-6 (A) and bis[(benzo-15-crown-5)-4'-ylmethyl]
      pimelate (B) were tested as coatings for two piezoelectric crystals for potassium
      quantification. Both sensors showed stability, reversibility and sensitivity
      characteristics that allowed their use in quantitative analysis. However,
      compound A is much more sensitive to potassium than B. Compound A also shows a
      larger relative sensitivity for potassium with regard to sodium than B. A
      pharmaceutical sample of known composition was analysed both by an acoustic wave
      sensor with a crystal coated with compound A and by conductivity. No
      statistically significant difference in the median of the results was found
      (alpha = 0.05), although precision is superior for the conductivity methodology.
      Performance of the sensor in terms of frequency stability and selectivity was
      improved by the incorporation of PVC, a plasticizer and a lipophilic salt in the
      coating composition. Limits of detection found for potassium were 1.92 ppm, or
      1.75 ppm for a crystal with a frequency decrease due to coating of 2.9 kHz or 3.9
      kHz, respectively. Selectivity coefficients (fixed interference 80 ppm) for
      potassium over Na, Ca, Al, Zn, Mg, and Fe ranged from 0.103 to 0.332.

PMID- 11193087
TI  - Phasor transform to extract glucose and ascorbic acid data in an amperometric
      sensor.
AB  - A method for separating the signals from glucose and ascorbic acid on a single
      recognition surface using an ac immittance technique is presented. It is proposed
      that each oxidation process can be represented by a unique vector based on psi
      and YO, and that the concentration of each analyte can be determined by
      monitoring the change in the admittance magnitude in the direction of the
      characteristic angle for that particular species. The total Faradaic admittance
      (YF,total) for all electroactive species present is given by a linear combination
      of the independent vectors from the different species. In the system tested, the
      analytes are glucose and ascorbic acid, the former being estimated via the
      measurand, hydrogen peroxide. Thus, one of the electroactive species (hydrogen
      peroxide) is not a bulk solution species, but is 'generated' in the enzyme
      matrix. The admittance measurements from ascorbic acid and the enzyme-generated
      hydrogen peroxide showed the characteristic phase angles of each oxidation
      signal, allowing for good spatial resolution. The behaviour of each of these
      analytes is presented and calibration curves tested. Based on the calibration
      curves and the basis vectors, samples containing both glucose and ascorbic acid
      were measured by transforming the measured total admittance from the complex
      Cartesian space into 'analyte space', where the X-Y axes are given by the basis
      vectors yEGHP,GOD and yAA,GOD, respectively.

PMID- 11193088
TI  - Optical biosensing of nitrite ions using cytochrome cd1 nitrite reductase
      encapsulated in a sol-gel matrix.
AB  - Nitrite is an important human health and environmental analyte. As such, the
      European Union (EU) has imposed a limit for nitrite in potable water of 0.1 mg l
      1 (2.18 microM). In order to develop an optical biosensing system for the
      determination of nitrite ions in environmental waters, cytochrome cd1 nitrite
      reductase has been extracted and purified from the bacterium Paracoccus
      pantotrophus. The protein has been spectroscopically characterised in solution
      and important kinetic parameters of nitrite reduction of the cytochrome cd1
      enzyme, i.e., Km, Vmax and kcat have been determined. The influence of pH on the
      activity of the cytochrome cd1 has been investigated and the results suggest that
      this enzyme can be used for the determination of nitrite in the pH range 6-9.
      Biosensing experiments with the cytochrome cd1 in solution suggested that the
      decrease in intensity of the absorption band associated with the d1 haem (which
      is the nitrite binding site), at 460 nm, with increasing nitrite concentrations
      would enable the measurement of this analyte with the optimum limit of detection.
      The cytochrome cd1 has been encapsulated in a bulk sol-gel monolith with no
      structural changes observed and retention of enzymatic activity. The detection of
      nitrite ions in the range 0.075-1.250 microM was achieved, with a limit of
      detection of 0.075 microM. In order to increase the speed of response, a sol-gel
      sandwich thin film structure was formulated with the cytochrome cd1. This
      structure enabled the determination of nitrite concentrations within ca. 5 min.
      The sol-gel sandwich entrapped cytochrome cd1 enzyme was found to be stable for
      several months when the films were stored at 4 degrees C.

PMID- 11193089
TI  - Single-use phosphorimetric sensor for the determination of nalidixic acid in
      human urine and milk.
AB  - A single-use phosphorimetric sensor to determine the germicide nalidixic acid is
      proposed. The sensing action is based on the absorption of the analyte into the
      sensing zone and the subsequent measurement of the phosphorescence intensity
      emitted by the analyte fixed in the sensor. This plane drop sensor is made up of
      a 3 x 1.6 cm sheet of the polyester Mylar as solid support, and a circular film 5
      mm in diameter and 20 microns in thickness, formed by poly(vinyl chloride) and
      tributyl phosphate as the plasticizer, adhered to its surface. The sensor is
      introduced for 2 h into the sample solution, after which it is dried and the
      phosphorescence intensity is measured directly at lambda ex = 332 nm, lambda em =
      412 nm, with a delay time of 0.15 ms and a gate time of 10 ms, under a dry
      nitrogen stream. The characteristic parameters of the construction of the sensing
      zone and of the processes of fixing the analyte along with the emission of
      phosphorescence were studied. The applicable concentration range was from 60 to
      1500 ng ml-1, with a detection limit of 20 ng ml-1 and a precision of 2%
      expressed as relative standard deviation. The method was applied to the
      determination of nalidixic acid in milk and human urine with recoveries ranging
      between 96.0 and 103.7%. The calibration process was carried out by applying a
      mathematical method of finite elements that expresses the analytical signal as a
      function of the analyte concentration and equilibration time between the sensor
      and the sample solution.

PMID- 11193090
TI  - Modified microelectrodes and multivariate calibration for flow injection
      amperometric simultaneous determination of ascorbic acid, dopamine, epinephrine
      and dipyrone.
AB  - Flow injection amperometric quantification of ascorbic acid (AA), dopamine (DA),
      epinephrine (EP) and dipyrone (DI) in mixtures (in the microgram g-1 range) was
      successfully performed by using an array of microelectrodes with units modified
      by the electrodeposition of different noble metals, together with multivariate
      calibration analysis. The four groups of microelectrodes utilized included a pure
      gold electrode and electrodes modified by electrodeposition of platinum,
      palladium or a mixture of platinum + palladium. The array of microelectrodes was
      inserted in a flow cell and the amperometric data acquisition was performed with
      a four-channel potentiostat. The analysis of the resulting signals was carried
      out by a multivariate calibration method, using a group of 16 standard mixtures
      selected by a two-level factorial design. The analysis of synthetic samples and
      pharmaceutical compounds containing AA and DI led to very similar values to those
      obtained by the classical iodimetric analysis. The average absolute errors (in
      microgram g-1) calculated for each analyte were 0.3, 0.2, 0.4 and 0.4 for AA, DA,
      EP and DI, respectively.

PMID- 11193091
TI  - Electrochemical oxidation at carbon paste electrode of tacrine and 1
      hydroxytacrine and differential pulse voltammetric determination of tacrine in
      pharmaceuticals and human urine.
AB  - The electrochemical oxidation of tacrine and its 1-OH-metabolite, has been
      studied by cyclic voltammetry and differential pulse voltammetry by using carbon
      paste electrodes. The peak current-concentration relationship was found to be
      linear up to 20 micrograms ml-1 with detection limits of 0.06 microgram ml-1 for
      tacrine and 0.18 microgram ml-1 for 1-OH-tacrine and quantitation limits of 0.20
      microgram ml-1 for tacrine and 0.37 microgram ml-1 for 1-OH-tacrine. A method for
      determining tacrine by differential pulse voltammetry in pharmaceuticals and
      human urine, in the presence of 1-OH-tacrine, has been developed.

PMID- 11193092
TI  - Principal component analysis and cluster analysis for the characterization of
      dental composites.
AB  - Various experimental dental materials were characterized using chemometric
      methods. The main aim of the study was to ascertain which composite materials
      present the best properties for use in restorative dentistry. Bisphenol-alpha
      glycidyl methacrylate-based composites containing hydroxyapatite as a filler and
      a coupling agent were prepared using a photocuring polymerization procedure.
      Several chemical and mechanical properties of experimental composites were
      measured and the corresponding data were further studied using principal
      component analysis and cluster analysis. Results from the characterization
      allowed the most appropriate materials to be selected. Various composites
      presented acceptable general properties suggesting their suitability as
      substitutes for commercial materials in dentistry.

PMID- 11193093
TI  - Non-invasive determination of ethanol, propylene glycol and water in a multi
      component pharmaceutical oral liquid by direct measurement through amber plastic
      bottles using Fourier transform near-infrared spectroscopy.
AB  - Fourier transform near-infrared (FT-NIR) spectroscopy was used to quantify
      rapidly the ethanol (34-49% v/v), propylene glycol (20-35% v/v) and water (11-20%
      m/m) contents within a multi-component pharmaceutical oral liquid by measurement
      directly through the amber plastic bottle packaging. Spectra were collected in
      the range 7302-12,000 cm-1 and calibration models set-up using partial least
      squares regression (PLSR) and multiple linear regression. Reference values for
      the three components were measured using capillary gas chromatography (ethanol
      and propylene glycol) and Karl Fischer (water) assay procedures. The calibration
      and test sets consisted of production as well as laboratory batches that were
      made to extend the concentration ranges beyond the natural production variation.
      The PLSR models developed gave standard errors of prediction (SEP) of 1.1% v/v
      for ethanol, 0.9% v/v for propylene glycol and 0.3% m/m for water. For each
      component the calibration model was validated in terms of: linearity,
      repeatability, intermediate precision and robustness. All the methods produced
      statistically favourable outcomes. Ten production batches independent of the
      calibration and test sets were also challenged against the PLSR models, giving
      SEP values of 1.3% v/v (ethanol), 1.0% v/v (propylene glycol) and 0.2% m/m
      (water). NIR transmission spectroscopy allowed all three liquid constituents to
      be non-invasively measured in under 1 min.

PMID- 11193094
TI  - Chemiluminescence detection of nine corticosteroids in liver.
AB  - A method for the determination of nine corticosteroids in bovine liver was
      developed. The liquid-liquid extraction method consisted in the addition of
      sodium hydroxide to the tissue sample followed by extraction with ethyl acetate.
      After centrifugation, the extract was evaporated to dryness and the residue
      redissolved in acetonitrile. The removal of fats was performed with n-hexane and
      the acetonitrile layer was evaporated. Afterwards, analysis of the extracts was
      performed using high-performance liquid chromatography with chemiluminescence
      detection employing luminol as reagent. The recovery curves, performed at five
      spiking levels (different for each corticosteroid), showed that recoveries of at
      least 70.5% could be obtained from liver. The chemiluminescence detection gave
      satisfactory results with respect to sensitivity, and the LOQ ranged from 0.13
      ppb for prednisolone to 8.40 ppb for betamethasone. The maximum mean RSD was 4.8%
      and 7.3% for intra- and inter-day assay, respectively.

PMID- 11193096
TI  - Bibliography. Current world literature. Nutrition and ageing.

PMID- 11193095
TI  - Normal and differential demasking flow-injection manifold for the direct
      spectrophotometric determination of zinc(II) in biological materials and
      pharmaceutical formulations.
AB  - A normal and a differential demasking flow-injection (FI) manifold were developed
      and optimized for the spectrophotometric determination of microamounts of Zn(II)
      in biological materials and pharmaceutical formulations. The reported method is
      very sensitive, rapid, simple and it is based upon the reaction of Zn(II) with
      2,2'-dipyridyl-2-pyridylhydrazone (DPPH) in a strongly basic medium to form a
      yellow-coloured complex (lambda max = 448 nm). By using the differential
      demasking manifold, the tolerance of the method to many cations was enhanced by a
      mean factor of 25. The obtained calibration graphs were linear in the range of 0
      10 mg l-1 Zn(II), at a sampling rate of 120 injections h-1 in both cases. The
      precisions of both manifolds were very good (RSD = 0.6 and 0.8%, respectively)
      and the 3 sigma detection limits were quite satisfactory (cL = 4 and 6 ng ml-1
      respectively). The method has been successfully applied to the determination of
      Zn(II) in serum, human hair and pharmaceutical formulations with recoveries
      ranging between 98.0 and 101.6%. The obtained results were also in excellent
      agreement with flame atomic absorption spectrometry (FAAS), since the mean
      relative error was er = 0.9%.

PMID- 11193097
TI  - Bibliography. Current world literature. Protein metabolism.

PMID- 11193098
TI  - Inhibitory control of synaptic activity in goldfish Mb bipolar cell terminals
      visualized by FM1-43.
AB  - To investigate the physiology and plasticity of mixed rod-cone ON-bipolar cells
      (Mb) in the goldfish retina, we established a slice preparation which allows us
      to optically monitor the synaptic activity of bipolar cell axon terminals. We
      used the styryl dye FM1-43 which is incorporated into active axon terminals due
      to synaptic vesicle cycling and thus reflects synaptic activity. Different
      activity states of the axon terminals were revealed when slices prepared from
      light-adapted retinae were incubated in the presence of FM1-43 under various
      conditions. Depolarizing high K+ Ringer (50 mM) and the gamma-butyric acid (GABA)
      antagonist bicuculline (100 microM) resulted in more than two-fold increase in
      the number of stained terminals compared to slices stained in normal Ringer. In
      contrast, GABA treatment (0.5 mM) reduced the frequency of stained terminals.
      Thus, in light-adapted retinal slices the synaptic activity of Mb axon terminals
      can be modulated towards higher and lower activity states. The fact that the GABA
      antagonist bicuculline had similar effects as stimulatory high K+ Ringer suggests
      that inhibitory control is an important component in the regulation of synaptic
      activity and transmitter release in Mb terminals.

PMID- 11193099
TI  - Long-term maturation of visual pathways.
AB  - Previous research in adults has demonstrated the utility of the visual evoked
      potential (VEP) to measure the integrity of the chromatic and achromatic visual
      pathways. The VEP has also been shown to be a valuable indicator of maturation of
      these pathways in infants up to 1 year of age. The present manuscript reports
      changes in the visual pathways from 2 years to adulthood as measured by the
      spatio-chromatic VEP. The responses to achromatic reversal stimuli designed to
      preferentially activate the low spatial-frequency achromatic (luminance) pathways
      appear adult-like by 1 year of age. The responses to low spatial-frequency
      isoluminant onset stimuli designed to preferentially activate the chromatic
      pathway do not appear as they do in the adult until after 12-13 years of age. The
      shapes of the chromatic VEP waveforms shift from a positive-negative complex to a
      negative-positive complex. These changes can be modeled by a decrease in the
      latency of a large negative component between the ages of 1 year and adulthood.
      The results suggest that for low spatial-frequency stimuli, there are long-term
      changes in the development of the chromatic pathways that are not observed in the
      low spatial-frequency achromatic pathways. The changes in the chromatic VEP
      waveforms with age may be a physiological correlate of reported behavioral
      changes.

PMID- 11193101
TI  - Salamander rods and cones contain distinct transducin alpha subunits.
AB  - The mammalian retina is known to contain two distinct transducins that interact
      with their respective rod and cone pigments. However, there are no reports of a
      nonmammalian species having two distinct transducins. In the present study, we
      report the cloning and cellular localization of two transducin a subunits (G
      alpha t) from the tiger salamander. Through degenerate polymerase chain reaction
      (PCR) and subsequent screening of a salamander retina cDNA library, we have
      identified two forms of G alpha t. When compared to existing sequences in
      GenBank, the cloned subunits showed high similarity to rod and cone transducins.
      The salamander G alpha t-1 has 91.2-93.7% amino acid sequence identity to
      mammalian rod G alpha t subunits and 79.7-80.9% to mammalian cone Gats. The
      salamander G alpha t-2 has 86.2-87.9% sequence identity to mammalian cone G alpha
      ts and 78.9-80.9% to mammalian rod G alpha ts at the amino acid level. The G
      alpha t-1 cDNA encodes 350 amino acids while the G alpha t-2 cDNA encodes 354
      residues, which is typical for rod and cone G alpha ts, respectively, and we thus
      identified the G alpha t- 1 as rod and G alpha t-2 as cone G alpha t. Sequences
      identified as effector binding sites and GTPase activity regions are highly
      conserved between the two subunits. Genomic Southern blot analysis showed that
      rod and cone G alpha t subunits are both encoded by single-copy genes. Northern
      blot analysis identified retina-specific transcripts of 3.0 kb for rod G alpha t
      and 2.6 kb for cone G alpha t. Immunohistochemistry in the flat-mounted
      salamander retina demonstrated that rod G alpha t is localized to rods,
      predominantly in the outer segments; similarly, cone G alpha t is localized to
      cone outer segments. The results confirm that the two sequences encode rod and
      cone transducins and demonstrate that this lower vertebrate contains two distinct
      transducins that are localized specifically to rod and cone photoreceptors.

PMID- 11193100
TI  - Functional dopamine deficits in the senile rat retina.
AB  - The activity of the endogenous retinal dopamine (DA) pathway has been examined in
      the pigmented rat using retinas obtained from normal adult (approximately 3
      months) and senile adults (approximately 24 months) using an in vitro
      electrophysiological approach. By comparing the pharmacological sensitivity of
      the horizontal cells (HCs) to exogenous DA, a D1 receptor antagonist (SCH 23390)
      and a DA-transport inhibitor (nomifensine), it is suggested that there is a
      functional deficit in the endogenous DA activity in the senile retina. Cells
      recorded from retinae obtained from senile animals are more sensitive to
      exogenous DA, whilst the senile retina is insensitive to SCH 23390. In addition,
      nomifensine was effective in potentiating subthreshold DA applications, but only
      in the normal adult retina. The data may suggest that endogenous DA release upon
      the HCs and selective re-uptake are suppressed in these retinae. These functional
      deficits also appear to be associated with changes in the receptive fields of the
      HCs, suggesting there is a corresponding deficit in spatial processing at the
      outer plexiform layer (OPL) of the senile rat.

PMID- 11193103
TI  - Mathematical models for the spatial receptive-field organization of nonlagged X
      cells in dorsal lateral geniculate nucleus of cat.
AB  - Spatial receptive fields of relay cells in dorsal lateral geniculate nucleus
      (dLGN) have commonly been modeled as a difference of two Gaussian functions. We
      present alternative models for dLGN cells which take known physiological
      couplings between retina and dLGN and within dLGN into account. The models
      include excitatory input from a single retinal ganglion cell and feedforward
      inhibition via intrageniculate interneurons. Mathematical formulas describing the
      receptive field and response to circular spot stimuli are found both for models
      with a finite and an infinite number of ganglion-cell inputs to dLGN neurons. The
      advantage of these models compared to the common difference-of-Gaussians model is
      that they, in addition to providing mathematical descriptions of the receptive
      fields of dLGN neurons, also make explicit contributions from the geniculate
      circuit. Moreover, the model parameters have direct physiological relevance and
      can be manipulated and measured experimentally. The discrete model is applied to
      recently published data (Ruksenas et al., 2000) on response versus spot-diameter
      curves for dLGN cells and for the retinal input to the cell (S-potentials). The
      models are found to account well for the results for the X-cells in these
      experiments. Moreover, predictions from the discrete model regarding receptive
      field sizes of interneurons, the amount of center-surround antagonism for
      interneurons compared to relay cells, and distance between neighboring retinal
      ganglion cells providing input to interneurons, are all compatible with data
      available in the literature.

PMID- 11193102
TI  - Spatial summation and center-surround antagonism in the receptive field of single
      units in the dorsal lateral geniculate nucleus of cat: comparison with retinal
      input.
AB  - Spatial summation and degree of center-surround antagonism were examined in the
      receptive field of nonlagged cells in the dorsal lateral geniculate nucleus
      (dLGN). We recorded responses to stationary light or dark circular spots that
      were stepwise varied in width. The spots were centered on the receptive field.
      For a sample of nonlagged X-cells, we made simultaneous recordings of action
      potentials and S-potentials, and could thereby compare spatial summation in the
      dLGN cell and in the retinal input to the cell. Plots of response versus spot
      diameter showed that the response for a dLGN cell was consistently below the
      response in the retinal input at all spot sizes. There was a marked increase of
      antagonism at the retinogeniculate relay. The difference between the retinal
      input and dLGN cell response suggested that the direct retinal input to a relay
      cell is counteracted in dLGN by an inhibitory field that has an antagonistic
      center-surround organization. The inhibitory field seems to have the same center
      sign (ON- or OFF-center), but a wider receptive-field center than the direct
      retinal input to the relay cell. The broader center of the inhibitory field can
      explain the increased center-surround antagonism at the retinogeniculate relay.
      The ratio between the response of a dLGN cell and its retinal input (transfer
      ratio) varied with spot width. This variation did not necessarily reflect a
      nonlinearity at the retinogeniculate relay. Plots of dLGN cell response against
      retinal input were piecewise linear, suggesting that both excitatory and
      inhibitory transmission in dLGN are close to linear. The variation in transfer
      ratio could be explained by sustained suppression evoked by the background
      stimulation, because such suppression has relatively stronger effect on the
      response to a spot evoking weak response than to a spot evoking a strong
      response. A simple model for the spatial receptive-field organization of
      nonlagged X-cells, that is consistent with our findings, is presented.

PMID- 11193104
TI  - Cyclic AMP has no effect on the generation, recovery, or background adaptation of
      light responses in functionally intact rod outer segments: with implications
      about the function of phosducin.
AB  - In retinal rods, light exposure decreases the total outer segment content of both
      cGMP and cAMP by about 50%. The functional role of the light-evoked change in
      cAMP is not known. It is postulated to trigger changes in the phosphorylation
      state of phosducin, a phosphoprotein that is phosphorylated in the dark by cAMP
      dependent protein kinase (PKA) and dephosphorylated by basal phosphatase activity
      when PKA is inhibited by the light-evoked drop in cAMP. In biochemical studies,
      dephosphorylated phosducin binds to free beta gamma dimer of transducin (Tbeta
      gamma) and prevents the regeneration of heterotrimeric transducin by blocking the
      re-association of the beta gamma and alpha subunits. Phosducin's interaction with
      Tbeta gamma is blocked when it is phosphorylated on a single residue by PKA. To
      evaluate the effect of the light-evoked fall in cAMP, functionally intact
      isolated lizard rod outer segments were dialyzed in whole-cell voltage clamp with
      a standard internal solution and electrical light responses were recorded with
      and without adding cAMP to the dialysis solution. Since the total outer segment
      content of cAMP in darkness is approximately 5 microM, internal dialysis with
      solution containing a much higher concentration (100 microM) of cAMP (or 8-bromo
      cAMP) will overcome the effects of a light-evoked decrease in its concentration
      by keeping cAMP-dependent processes fully activated. Neither cyclic nucleotide
      had any influence on the generation, light sensitivity, recovery, or background
      adaptation of the flash response. These results also argue against the
      participation of phosducin in the sequence of events that are responsible for
      these aspects of rod function. This does not exclude the possibility of phosducin
      being involved in adaptation caused by higher light levels than used in the
      present study, that is, bleaching adaptation, or in light-dependent processes
      other than phototransduction.

PMID- 11193105
TI  - Distribution of terminals from pedunculopontine tegmental nucleus and synaptic
      organization in lateralis medialis-suprageniculate nucleus of cat's thalamus:
      anterograde tracing, immunohistochemical studies, and quantitative analysis.
AB  - The cat's lateralis medialis-suprageniculate nuclear complex (LM-Sg) in the
      thalamus receives input from various brain regions such as the superior
      colliculus, brain stem, and spinal cord, as well as from visual association
      cortex. In a previous study, we demonstrated that LM-Sg receives cholinergic
      fibers from the pedunculopontine tegmental nucleus (PPT) and that cholinergic
      terminals make synaptic contacts with the dendrites of glutamatergic projection
      neurons and of GABAergic interneurons (Hoshino et al., 1997). In this study, we
      investigate the distribution and the organization of PPT terminals by means of a
      combined anterograde tracer (biotinylated dextran amine, BDA) and
      immunohistochemical methods. When stained by acetylcholinesterase (AChE), the LM
      Sg is not uniformly immunoreactive, but rather is patchily labeled and shows a
      streaming type of reactivity. The tissue content appears high in enzyme activity
      in AChE-positive zones and is much lighter in activity in AChE-negative zones. We
      compared the synaptic organization between AChE-positive and AChE-negative
      portions of the LM-Sg in separate groups of electron-microscopic material: four
      types of vesicle containing profiles (RS, RL, F1, and PSD) as well as synaptic
      glomeruli were observed in this nucleus. Among these, the PSD profiles were
      observed more frequently in AChE-positive portions than in AChE-negative zones.
      Furthermore, the number of glomeruli was significantly higher in AChE-positive
      than in AChE-negative zones. Following the injection of BDA into PPT, labeled
      terminals within LM-Sg were rather more concentrated in the AChE-positive
      portion. Although the majority of PPT terminals made synaptic contacts with
      dendrites in the neuropil, a few terminals were involved in the synaptic
      glomeruli. The present results show that the synaptic organization is distinctly
      different between the AChE-positive and AChE-negative portions of LM-Sg. These
      results suggest that the AChE-positive portions of LM-Sg are relatively more
      involved in integrating information arising from a diverse set of inputs and
      processing that information within glomeruli in a complex manner than occurs in
      the AChE-negative portion of LM-Sg.

PMID- 11193106
TI  - The timecourse of neuronal connections of the rotundoectostriatal pathway in
      chicks (Gallus gallus) during embryogenesis: a retrograde transport study.
AB  - The avian retinotectofugal pathway has been suggested to be homologous to the
      mammalian retinotectofugal pathway. The projection of the nucleus rotundus upon
      the ectostriatum is equivalent to that of the pulvinar nucleus upon the
      extrastriate cortex in mammals. In this system, the optic tectum relays retinal
      input to the nucleus rotundus, which then ascends to the ectostriatum of the
      telencephalon. Given the fact that the chick retinotectofugal system becomes
      mature early during development, the present study attempted to investigate the
      timecourse of neuronal connections of the embryonic rotundoectostriatal pathway.
      We used multiple injections of cholera toxin B subunit (CTb) in the ectostriatum
      of chick embryos to retrogradely trace projections to the nucleus rotundus. We
      found CTb-labeled neurons in the nucleus rotundus at embryonic day 7.5-8. By
      embryonic day 8-8.5, increased numbers of CTb-labeled neurons were seen in the
      nucleus rotundus. It was noted that the time of this initial connection between
      the nucleus rotundus and the ectostriatum is nearly synchronous with that of the
      retinotectal and tectorotundal pathways, respectively (Crossland et al., 1975;
      Thanos & Bonhoeffer, 1987; Wu et al., 2000). These findings, combined with the
      present study, suggest that the retinotectofugal system becomes established, at
      least at a structural level, by embryonic day E8.

PMID- 11193107
TI  - Divergent mechanisms for phototransduction of invertebrate microvillar
      photoreceptors.
AB  - Recently, it was reported that the polyunsaturated fatty acids (PUFAs),
      arachidonic acid (AA) and linolenic acid (LNA), activate the light-sensitive
      channels in Drosophila photoreceptors (Chyb et al. 1999). We have examined
      whether these PUFAs activate the light-sensitive channels in Limulus ventral
      photoreceptors. We find that, whether applied from the outside or injected into a
      Limulus ventral photoreceptor, either AA or LNA fails to activate the light
      sensitive channels. Moreover, the synthetic diacylglycerol analog, 1-oleoyl-2
      acetyl-sn-glycerol, also fails to activate the light-sensitive channels. We
      suggest that these findings require us to rethink our view about the generality
      of the process of phototransduction in invertebrate microvillar photoreceptors.
      We propose that the photoreceptors of Drosophila and Limulus evolved to utilize
      different branches of the phosphoinositide pathway for phototransduction: those
      of Limulus evolved to utilize IP3-mediated calcium release while those of
      Drosophila evolved to utilize diacylglycerol and it's downstream products.

PMID- 11193108
TI  - The feedforward component in depolarizing red responses of R/G horizontal cells
      in carp retina.
AB  - Light responses of R/G chromaticity-type horizontal cells (R/G HCs) and
      luminosity-type horizontal cells (LHCs) were intracellularly recorded in isolated
      superfused carp retina, and the response dynamics analyzed. The results revealed
      that (1) No significant difference in delay was detected between R/G HC red and
      green responses; (2) The rising speed was quicker for R/G HC depolarizing red
      responses compared to that of its hyperpolarizing green responses; and (3)
      Dynamic characteristics of R/G HC red responses and its changes caused by green
      background illumination did not follow that of LHC red response. All these
      results suggest that the depolarizing response of the R/G HCs cannot be entirely
      mediated by the negative feedback pathway from LHCs onto cones. A direct
      inhibitory input from red cones to R/G HCs may exist.

PMID- 11193109
TI  - GABA and GABA(A) receptor antagonists alter developing cone photoreceptor
      development in neonatal rabbit retina.
AB  - Gamma aminobutyric acid (GABA) has been established as an important developmental
      signal in a number of regions of the central nervous system (CNS), including
      retina. Our previous studies have shown that GABAergic horizontal cells act as
      the initial synaptic target for developing cone photoreceptors in neonatal rabbit
      retina. Since intraocular injections of the GABA(A) receptor antagonists,
      picrotoxin or bicuculline, disrupt cone synaptogenesis in vivo, GABA released
      from horizontal cells may provide a necessary signal for cone axon growth and/or
      synapse formation. In the current report, we have used cultured retinal explants
      to examine the effects of GABA(A) receptor antagonists on other aspects of
      developing cones. These include the distribution pattern of cone cell bodies
      across the outer surface of the retina and the expression of GABA(A) receptors
      within both cone cell bodies and axonal processes. Peanut agglutinin (PNA), a
      plant lectin that specifically labels cone plasma membrane and extracellular
      matrix, was used to monitor cone development, and a GABA(A) receptor antibody
      against the beta2/3 subunits of the protein was used to label GABA(A) receptors.
      Results showed that cones maintained in the explant culture express GABA(A)
      receptors in a temporal and spatial pattern similar to that observed in vivo,
      namely a low expression of receptors on cone cell bodies at postnatal day 1 (P1),
      peaking around P3 and diminishing by P7. Neonatal retinal explants exposed to the
      GABA(A) receptor antagonists, bicuculline (10 microM) or SR95531 (5 microM), for
      24 h in culture showed disruption of the normal distribution of cone cell bodies.
      When GABA (100 microM) was added along with either antagonist, cone cell bodies
      appeared normal. Neither bicuculline nor SR95531 alone had any effect on the
      general morphology of other retinal layers, suggesting that these GABA(A)
      receptor antagonists at the concentrations used were not acting as nonspecific
      disruption agents. The effects of GABA antagonists were confined to the first
      week after birth with no disruption seen in P9 or adult explant cultures. These
      data provide a direct demonstration of the necessity for GABAergic input to cones
      during active synaptogenesis. As we have previously shown, GABA(A) receptor
      activation causes a substantial increase in intracellular calcium concentrations
      in cones and thereby could provide a mechanism by which GABA regulates cone
      maturation.

PMID- 11193110
TI  - Photoreceptor types and distributions in the retinae of insectivores.
AB  - The retinae of insectivores have been rarely studied, and their photoreceptor
      arrangements and expression patterns of visual pigments are largely unknown. We
      have determined the presence and distribution of cones in three species of shrews
      (common shrew Sorex araneus, greater white-toothed shrew Crocidura russula, dark
      forest shrew Crocidura poensis; Soricidae) and in the lesser hedgehog tenrec
      Echinops telfairi (Tenrecidae). Special cone types were identified and quantified
      in flattened whole retinae by antisera/antibodies recognizing the middle-to-long
      wavelength-sensitive (M/L-)cone opsin and the short-wavelength-sensitive (S-)cone
      opsin, respectively. A combination of immunocytochemistry with conventional
      histology was used to assess rod densities and cone/rod ratios. In all four
      species the rods dominate at densities of about 230,000-260,000/mm2. M/L- and S
      cones are present, comprising between 2% of the photoreceptors in the nocturnal
      Echinops telfairi and 13% in Sorex araneus that has equal diurnal and nocturnal
      activity phases. This suggests dichromatic color vision like in many other
      mammals. A striking feature in all four species are dramatically higher S-cone
      proportions in ventral than in dorsal retina (0.5% vs. 2.5-12% in Sorex, 5-15%
      vs. 30-45% in Crocidura poensis, 3-12% vs. 20-50% in Crocidura russula, 10-30%
      vs. 40-70% in Echinops). The functional and comparative aspects of these
      structural findings are discussed.

PMID- 11193111
TI  - Cortical area V4 is critical for certain texture discriminations, but this effect
      is not dependent on attention.
AB  - This study examined the question of which features of a complex grouping
      discrimination make it vulnerable to permanent elimination by V4 lesions. We
      first verified that the line element grouping discrimination, which we previously
      reported to be devastated by V4 lesions, was similarly affected in the monkeys of
      this study. The permanence of the deficit was established by mapping its visual
      field distribution and then testing this discrimination for an extended period at
      a locus on the border of the deficit. Also, a staircase procedure was used to
      provide the monkey with within session instruction in the grouping
      discrimination, but this did not improve V4 lesion performance. Grouping was then
      compared with several discriminations that shared some features with it, but
      which were found not to be permanently eliminated by V4 lesions. This comparison
      suggested that grouping (rather than segmentation or response to a single
      element) was one feature that made the discrimination vulnerable, a second was
      the similarity in shape of the texture elements to be grouped. Finally, we tested
      visual crowding, a property of peripheral vision that is thought to reflect
      neuronal interactions early in visual cortex, possibly in area V1, and found no
      effect of V4 lesions. A control experiment with human observers tested whether
      the elimination of grouping by V4 lesions might be due to an alteration of
      attention, but found no evidence to support this hypothesis. These results show
      that severe disruption of texture discriminations by V4 lesions depends on both
      the nature of the discrimination and the type of texture elements involved, but
      does not necessarily involve the disruption of attention.

PMID- 11193112
TI  - Two-frequency analysis of interactions elicited by Vernier stimuli.
AB  - In five subjects, we measured visual evoked potentials (VEPs) elicited by Vernier
      targets in which the contrast of the two components of the stimuli were modulated
      by sinusoids at distinct frequencies fl and f2. This approach allows for the
      extraction of VEP signatures of spatial interactions, namely, responses at
      intermodulation frequencies n1f1 + n2f2, without the need to introduce motion
      into the stimulus. The most prominent interactions were at the sum frequency f1 +
      f2, and, for frequency pairs that were sufficiently separated, the difference
      frequency f1- f2. These responses had a systematic dependence on the temporal
      parameters of the stimulus, corresponding to an effective latency of 145 to 165
      ms. Fourth-order interactions were also detected, particularly at the frequencies
      2f1 +/- 2f2. These VEP signatures of interaction were similar to interactions
      seen for colinear line segments separated by a gap. Thus, for Vernier stimuli
      devoid of motion, VEP signatures of interaction are readily detected but are not
      specific to hyperacuity displacements. The distribution of interactions across
      harmonic orders is consistent with local rectification preceding the spatial
      interactions. Their effective latencies and dependence on spatial parameters are
      consistent with interactions within V1 receptive fields or mediated by horizontal
      connections between cells with a similar orientation tuning within V1.

PMID- 11193113
TI  - Supracondylar fractures of the humerus in children--back to basics.

PMID- 11193114
TI  - The Internet: another facet to the paradigm shift in healthcare.
AB  - The Internet is an extremely powerful innovation that has and will continue to
      shape the healthcare industry in the years to come. Albeit a little too slowly,
      doctors are starting to catch onto this new wave of digital empowerment and
      creating niches that will enhance their ability to care for their patients and
      ultimately add value to their practices. The challenge is to encourage every
      doctor to come on board. The paradigm shift in healthcare delivery is that the
      Internet brings about the power of information to the patient. This balances the
      power in the doctor patient relationship. Taken positively, the doctor too can
      benefit from Internet technology. The biggest contribution of the Internet in the
      area of electronic medical records is the web-based display environment that is
      operating-system independent. The Internet can therefore be exploited to provide
      a supra system that can draw personal medical information together from anywhere
      to create a virtual electronic medical record. The Internet can also be used to
      shape up an Internet-based healthcare delivery system. The healthcare delivery
      paradigm shift brought about by the Internet calls for an eHealth strategy.

PMID- 11193115
TI  - Profile of a menopause clinic in an urban population in Malaysia.
AB  - The object of this study is to determine the status of an urban Malaysian woman
      in her menopause age group with reference to her menopausal symptoms, lipid
      profile, breast, pelvis and bone. One hundred and sixty four women attending the
      Menopause Clinic of University Hospital, Kuala Lumpur who had not previously been
      on hormone replacement therapy were studied. Forty nine women were
      perimenopausal, 74 women were in early menopause (within 5 years of menopause)
      and 41 women were in late menopause (after 5 years of menopause). The most common
      symptoms were hot flushes (56%) and generalised tiredness (49%). Eighty four
      percent (84%) of women had high cholesterol levels. Serum triglycerides were
      highest in the late menopause group. There were 2 cases of intraductal carcinoma
      diagnosed on routine mammography, with 8 cases of fibrocystic breast disease and
      7 cases of suspicious breast lumps. Routine ultrasound (pelvic and abdominal)
      revealed two women with ovarian cysts, 6 women with an endometrial thickness of
      more than 5 mm and 8 women with uterine fibroids. Eighty five women (51.8%) had
      mild osteoporosis while four women had moderate osteoporosis on dual photon
      measurements for bone mineral density. Menopause clinics should aim at
      investigating a woman in her menopause as a whole. Vasomotor symptoms were common
      in the urban Malaysian menopausal woman. There was a high incidence of lipid
      abnormalities. Routine mammography, pelvic ultrasound examinations and bone
      mineral density tests detected significant pathology and abnormalities.

PMID- 11193116
TI  - Gradual reduction of supracondylar fracture of the humerus in children reporting
      late with a swollen elbow.
AB  - AIM: To study the outcome of gradual reduction by skin traction of supracondylar
      fracture of the humerus in children with swollen elbow, who seek treatment two
      days or longer after the injury. METHOD: Fifteen children aged between 4 and 11
      years (average 7 years 11 months), who had initially consulted a traditional
      practitioner, reported between 2 and 21 days (average 7.5) after the injury were
      treated by skin traction with the elbow kept straight and the forearm in position
      of comfort. RESULTS: The average duration of stay in hospital was 14 days. All
      fractures healed; there was no incidence of myositis ossificans or neurovascular
      deficit. All patients had functional range of movements at the elbow within 6
      months. Five patients developed cubitus varus deformity greater than 5 degrees,
      they were classified as poor result. Four out of these 5 patients had sought
      treatment after a delay of 7 days or longer. There were 9 good (60%), 1 fair (7%)
      and 5 poor (33%) results. CONCLUSION: Gradual reduction by skin traction is safe.
      It is possible to achieve satisfactory reduction if the delay is up to 7 days.
      The results with regards to deformity and function were comparable with those
      obtained following open or closed Kirschner wire fixation.

PMID- 11193117
TI  - Squamous cell carcinoma of the temporal bone: diagnosis, treatment and prognosis.
AB  - Squamous cell carcinoma of the external ear canal is an uncommon condition that
      is associated with a poor outcome. The development of an accepted staging system
      has not been forthcoming and this has inhibited the formation of an evidence
      based therapeutic protocol. We report the findings in 14 patients with squamous
      cell carcinoma of the external ear canal treated in our institutions. The most
      common presenting symptoms were otorrhoea and otalgia. Four patients had a
      history of chronic ear discharge and one had previous radiotherapy for
      nasopharyngeal carcinoma. Five patients had facial palsy which was a poor
      prognostic sign. Only one patient had clinical neck disease. Pre-operative
      imaging with CT or MRI scans was accurate in determining the extent of tumour
      involvement. The initial T-staging relied heavily on these findings. With
      combination treatment involving surgery, radiotherapy and chemotherapy, disease
      free survival achieved was 69% (9 of 13) over a mean follow-up period of 24.7
      months. One patient absconded treatment. Patients with early stage tumours faired
      better than patients with advanced tumours (100% vs 33%). There was low incidence
      of involvement of the parotid gland (1 of 7 patients). Patients with facial nerve
      involvement had a significantly poorer outcome (p = 0.035).

PMID- 11193118
TI  - Results of fixation of clavicle alone in managing floating shoulder.
AB  - AIM OF STUDY: A retrospective review on the outcomes of four floating shoulder,
      ipsilateral scapular neck and clavicular fractures, treated with open reduction
      and internal fixation of the clavicle alone using plate and screws. METHODS: All
      patients were evaluated by interview, physical examination and radiological
      examination at an average follow up period of 3.3 years (range: 2-4 years).
      Functional outcomes were rated using Rowe's score. RESULTS: Radiological union of
      both fractures occurred at an average of 2.8 months (range: 8-12 weeks).
      Excellent result was seen in three cases and good in one. CONCLUSION: Plating of
      clavicle alone restored stability of shoulder and allowed early range of motion
      exercises. All cases gained good and excellent function.

PMID- 11193119
TI  - Abdominal pregnancy: a case report and literature review.
AB  - We report a rare and unusual case of an Abdominal pregnancy that was delivered
      successfully at term. It is the first documented case in the local literature in
      almost 30 years. What makes it even more exceptional is that despite the high
      mortality associated with the condition, both mother and baby survived the
      ordeal. She subsequently delivered another child, 2 years later by an elective
      lower segment caesarean section and had a tubal ligation performed concomitantly.
      A review of the topic and its management is also presented.

PMID- 11193120
TI  - Aberrant regeneration of the third nerve.
AB  - We describe three patients with aberrant regeneration of the third nerve
      secondary to traumatic brain injury. The full blown features of the syndrome
      include horizontal gaze-eyelid synkinesis, pseudo-Graefe sign, limitation of
      elevation and depression of the eye with retraction of the globe on attempted
      vertical movements, adduction of the involved eye on attempted elevation or
      depression, pseudo-Argyll Robertson pupil and absent vertical optokinetic
      response. The 'misdirection' incidence in our study is 15%.

PMID- 11193121
TI  - Successful repair of traumatic aortic tears using left heart bypass.
AB  - Aortic tears commonly occur in multiply injured patients. Recognizing this injury
      is important. A chest X-ray is helpful and a CT-angiogram or aortogram
      confirmatory. After attending to life-threatening injuries, the aortic tear
      should be repaired immediately. Using the left heart bypass technique has the
      lowest risk of operative neurologic injury. We review our experience over the
      last 2 years, discuss our preferred technique and report on the outcome.

PMID- 11193122
TI  - Meningioma with rhabdoid transformation.
AB  - A 29-year-old man was operated on for an intracranial tumour with the gross
      features of a meningioma. Histology showed features of a rhabdoid tumour. The
      tumour recurred in 1997, 17 months after the first operation, and was re-excised
      and showed identical histology. Meningiomas with rhabdoid change are very rare.
      The clinicopathologic features are presented and the differential diagnoses
      discussed.

PMID- 11193123
TI  - Percutaneous interventional strategies in the treatment of chronic total coronary
      occlusions.
AB  - Chronic total coronary occlusions which make up 10% to 20% of all interventional
      procedures in high-volume centres remain a vexing problem for invasive
      cardiologists for 2 main reasons. First, they are only successfully recanalised
      in about 60% of attempts with most failures resulting from an inability to cross
      the lesions. Laser guidewire appears to be a promising innovation in overcoming
      this obstacle. Second, after initially successful recanalisation with
      conventional balloon angioplasty (PTCA), a high restenosis rate (range, 45% to
      75%) is observed. Stent placement, by conferring maximal luminal expansion,
      appears to have resolved this problem to a large extent; both observational and
      randomised studies indicate that after stent placement, restenosis rate is at
      least halved that of PTCA.

PMID- 11193124
TI  - Clinics in diagnostic imaging (53). Hepatic portal venous gas due to mesenteric
      infarction.
AB  - A 43-year-old woman presented with acute abdominal pain and signs of ileus. CT
      scan of the abdomen showed hepatic portal venous gas. At surgery, a long segment
      of gangrenous bowel extending from the jejunum to the proximal hemicolon was
      found. The cause was superior mesenteric artery occlusion. The aetiology, imaging
      features and clinical significance of hepatic portal venous gas are discussed.

PMID- 11193125
TI  - Postmenopausal hormone replacement therapy and hypertension.

PMID- 11193126
TI  - Hormone replacement therapy and hypertension.
AB  - For many years, Hormone Replacement Therapy (HRT) was considered to be
      contraindicated in postmenopausal women with hypertension and many such women
      were excluded from HRT because of concerns that HRT may have an adverse effect on
      blood pressure. This perception was mainly due to the effects of oral
      contraceptive drugs, especially the oestrogen component, in increasing blood
      pressure. Differences exist between the formulation and doses of oestrogen
      preparations used, either as oral contraceptives in premenopausal women (in whom
      high-dose synthetic oestrogens are used) or as HRT in postmenopausal women (in
      whom low "replacement" doses of natural oestrogens are used). This is not
      inconsequential, as postmenopausal women represent the largest category of women
      at risk for hypertension. The aim of this review is to give a balanced view on
      the effects of HRT on blood pressure in postmenopausal women.

PMID- 11193127
TI  - Association analysis of two tyrosine hydroxylase gene polymorphisms in
      normotensive offspring from hypertensive families.
AB  - OBJECTIVE: We have studied possible association between predisposition to
      essential hypertension, plasma noradrenaline level and two polymorphisms of the
      gene for tyrosine hydroxylase (TH), the rate-limiting enzyme of catecholamine
      biosynthesis. DESIGN AND METHODS: One hundred and one normotensive sons from
      normotensive parents (SN) and 107 normotensive sons of hypertensive families (SH)
      were studied. Tetranucleotide TCAT repeat and Va181Met polymorphisms of the TH
      gene were determined by polymerase chain reaction (PCR) technique. RESULTS: SH
      had higher systolic BP and plasma noradrenaline concentration than the SN group.
      No significant difference was found between the allele and genotype frequencies
      in the SH and SN groups for both polymorphisms. The two polymorphisms were in
      tight linkage disequilibrium. The CD genotype of the microsatellite marker was
      associated with increased plasma noradrenaline concentration in both groups.
      Genotypes AB, AE and BB of the TCAT repeat polymorphism and genotypes VM and MM
      of the Va181Met polymorphism exhibited the greatest difference in plasma
      noradrenaline concentration between the SH and SN groups. CONCLUSION: The studied
      TH polymorphisms do not appear to be associated with family history of essential
      hypertension. Nevertheless, some genotypes of TH might be related to disturbance
      of plasma noradrenaline concentration.

PMID- 11193128
TI  - "To better know hypertension": educational meetings for hypertensive patients.
AB  - BACKGROUND: Pilot educational meetings were conducted to (1) verify the support
      of hypertensive patients in this initiative; (2) test the knowledge of patients
      regularly followed-up in our Hypertension Centre Outpatient Clinic concerning
      problems related to hypertension; (3) improve patients knowledge about
      hypertension through a formal teaching session, (4) compare the knowledge of
      these patients with that of a control group. METHODS: An invitation to
      participate in an educational program on hypertension was extended to 210
      consecutive patients (group I ) followed-up in the outpatient clinic of our
      Hypertension Centre. Each meeting included four sessions: (1) an interactive
      phase with electronic devices aimed at evaluating the degree of information about
      hypertension by means of multiple-choice questionnaires, (2) a traditional
      teaching session, (3) an interactive phase to assess the compliance to treatment,
      and (4) a general discussion session. The control group (II) included 144
      hypertensive patients referred for the first time to our Hypertension Centre.
      Before the initial visit the patients were asked to answer a questionnaire
      identical to that provided to group I during the meetings. RESULTS: The meetings
      were attended by 183 out of the 210 patients in group I (participation rate =
      87%). The answers to the questions were corrected as a percentage ranging from
      73.7 to 95.6 in group I and from 43.9 to 74.7 in group II (p < 0.01). The
      provision of more detailed information about problems in hypertension was
      associated with better compliance to treatment and blood pressure control. (BP
      under treatment 138 +/- 14/83 +/- 7 mmHg in group I, 152 +/- 15/91 +/- 11 mmHg in
      group II; (p < 0.01). CONCLUSIONS: Our data indicate that this type of
      educational approach is appreciated by patients (participation rate 87%) and that
      the level of knowledge about hypertension and compliance to treatment are greater
      in selected patients than in control patients.

PMID- 11193129
TI  - Pulse pressure: a predictor of cardiovascular mortality among young normotensive
      subjects.
AB  - Wide pulse pressure has been associated with increased cardiovascular disease
      events among hypertensive subjects. To test the hypothesis that this association
      also exists among normotensive subjects, data from the first National Health and
      Nutritional Examination Survey and the 1992 Epidemiological Follow-up Study were
      analyzed. The study group included 7346 participants, aged 25-74 years, with
      baseline blood pressure levels <140/90 mmHg and without a history of
      hypertension. Deaths from cardiovascular disease and all other causes were
      determined. At entry, mean age and blood pressure level were 43.4 years and
      118/76 mmHg. During an average follow-up period of 17.4 years, there were 1443
      (19.6%) deaths, 557 of them ascribed to cardiovascular disease. Age-race-adjusted
      cardiovascular mortality was significantly higher for those in the highest
      quartile of pulse pressure (> or = 50 mmHg). However, after stratification into
      age <55 years and > or = 55 years, and controlling for other cardiovascular risk
      factors, increased pulse pressure was associated with cardiovascular mortality
      only in younger men and women. In these subjects, men and women with pulse
      pressures > or = 48, and > or = 46 mmHg, respectively, had a relative risk (95%
      confidence in terval) of 2.35 (1.21-4.38) and 2.90 (1.34-4.98) for cardiovascular
      mortality with those with pulse pressures of less than 36 and 34 mmHg,
      respectively (p < 0.05) as reference. While systolic blood pressure by itself was
      a weaker predictor of cardiovascular mortality than pulse pressure, diastolic and
      mean arterial pressure were not predictive at all. No measure of blood pressure
      was related to mortality in those aged > or = 55 years. In conclusion, among
      young subjects, but not older normotensive persons, at very low risk of
      cardiovascular disease, a wide pulse pressure is associated with increased
      cardiovascular mortality.

PMID- 11193130
TI  - Substituting lifestyle management for pharmacological control of blood pressure:
      a pilot study in Australian general practice.
AB  - The HEART project was conducted in general practice to determine whether
      lifestyle strategies, aimed at increasing physical activity and dietary
      modification, can be substituted for drug therapy in patients who have been well
      controlled on antihypertensive medication. In addition to blood pressure (BP) and
      risk factor outcomes, lifestyle behaviours, quality of life of patients, and the
      acceptability of the approach to both general practitioners (GPs) and patients
      involved in the trial were assessed. Patients (n = 45) with a history of
      hypertension and who had been well controlled for at least the past 6 months (BP
      < 160/ 95 mmHg) were randomised to a continued medication (C) group (n = 24) or a
      withdrawal (W) group (n = 21). Subjects had received antihypertensive therapy for
      an average of 7.8 years (range 1-28 years). Drug therapy in the W group was
      recommenced if BP exceeded 160/95 mmHg on two consecutive visits. Both groups
      were counselled regarding lifestyle behaviour change by their GP throughout the
      study and were provided with specifically developed self-help materials. Subjects
      were reviewed at least monthly over a 9-month period. Following randomisation,
      there were no significant differences between the two groups for BP, heart rate,
      age, duration of therapy, total cholesterol or body mass index. All but three
      subjects (one from the W and two from the C group) completed 9 months of
      monitoring following randomisation and there were no cardiovascular events; 71%
      of subjects remained off drug therapy and were well controlled at the 9-month
      follow-up (15/21) with mean BP of 141/85 mmHg (W) and 139/ 86 mmHg (C). Systolic
      BP tended to increase during the study period in both W and C groups, however, no
      significant differences were observed in mean systolic or diastolic BP either
      between the two groups or within each group in comparison to baseline values.
      Resting heart rate, body mass index and cholesterol levels remained unchanged in
      both W and C groups after 9 months follow-up. There were no changes attributable
      to the lifestyle intervention in the subjects continuing drug therapy in BP or
      lifestyle variables over the study period. However, the group stopping therapy
      had a 6% reduction in body mass index after 9 months. These data suggest that a
      proportion of motivated patients willing to trial a lifestyle approach can cease
      drug therapy and be adequately maintained by the prescription of lifestyle advice
      via their GP for at least a 9-month period. Cessation of drug therapy may be an
      important motivating factor to achieve weight loss in this group.

PMID- 11193131
TI  - Dose response effect of conjugated equine oestrogen on blood pressure in
      postmenopausal women with hypertension.
AB  - OBJECTIVE: This study was designed to compare with placebo the dose-response of
      conjugated equine oestrogen (CEE) on blood pressure in hypertensive
      postmenopausal women. DESIGN AND METHODS: Fourteen postmenopausal women with
      grade 1-2 hypertension participated in the study which used a double-blind
      crossover design. There were four randomised treatment phases, each lasting 4
      weeks. The four treatments were CEE 0.3 mg, CEE 0.625 mg, CEE 1.25 mg and
      placebo. Each subject also received non-blinded medroxyprogesterone acetate (MPA)
      10 mg for the final 14 days of each 28-day treatment cycle. Clinic blood pressure
      was measured weekly with the mean values of weeks 3 and 4 of each phase used for
      analysis. Ambulatory blood pressure was performed in week 4 of each phase.
      RESULTS: Compared with placebo, clinic systolic blood pressure was reduced in the
      CEE 0.3 mg and CEE 0.625 mg phases (p < 0.05) and clinic diastolic blood pressure
      was reduced in the CEE 0.625 mg phase (p < 0.05). There was no significant effect
      of CEE on ambulatory blood pressure, although the blood pressure pattern was
      similar to clinic measurements. CONCLUSION: In hypertensive postmenopausal women,
      daily CEE together with cyclical MPA has a variable effect on blood pressure
      depending on CEE dose. The "lower" and "middle" doses of CEE produced a small
      reduction in blood pressure which reached a nadir and tended to reverse with the
      "higher" CEE dose.

PMID- 11193132
TI  - Comparison between isosorbide dinitrate in aerosol and in tablet form for the
      treatment of hypertensive emergencies in the elderly.
AB  - BACKGROUND: Isosorbide dinitrate in spray form is an effective and safe option
      for the treatment of hypertensive emergencies. The aim of this study was to
      evaluate whether isosorbide dinitrate spray is as effective and safe as treatment
      in tablet form for the management of hypertensive emergencies in the elderly.
      METHODS: Forty patients with hypertensive emergencies were randomly divided into
      two groups of 20 patients each. Group A received 1.25 mg isosorbide dinitrate
      aerosol upon arrival and a second dose 15 min later when mean systemic arterial
      pressure (MAP) reduction was <15% . Group B patients received a single 5 mg
      tablet of sublingual isosorbide dinitrate. RESULTS: Blood pressure in Group A
      patients decreased from 193 +/- 13/123 +/- 6.6 mmHg to 154 +/- 15/92.5 +/- 7.6
      mmHg (p < 0.005), the reduction beginning 10 min after drug administration; no
      adverse effects were found. Two patients in Group B did not respond but for the
      other patients in this group blood pressure decreased from 197 +/- 10/121 +/- 7
      to 154 +/- 11/90 +/- 4 mmHg, (p < 0.005), the reduction beginning 45 min after
      receiving the medication; 8 patients suffered headache. CONCLUSION: Our results
      indicate that isosorbide dinitrate aerosol is more effective than tablets for the
      treatment of elderly patients with hypertensive emergencies.

PMID- 11193133
TI  - Divergent effects of different beta-blocking agents on endothelium-dependent
      vasodilatation in the human forearm.
AB  - OBJECTIVE: The aim of this study was to evaluate the direct effect of three
      principally different beta-receptor blocking agents on endothelium-dependent
      vasodilatation (EDV) in the human forearm. METHODS: In 27 young normotensive
      subjects forearm blood flow (FBF) was measured with venous occlusion
      plethysmography during local intra-arterial infusions of methacholine (MCh),
      evaluating EDV, and sodium nitroprusside (SNP), evaluating endothelium
      independent vasodilatation (EIDV). The measurements of EDV and EIDV were
      undertaken at baseline conditions and repeated after 1 h of concomitant intra
      arterial infusion of atenolol (n = 8, 1.2 mg/h), propranolol (n = 7, 1.2 mg/h),
      labetalol (n = 7, 16 mg/h) or saline (n = 5). RESULTS: The selective beta-blocker
      atenolol showed a tendency to improve the FBF response to MCh (from 28.8 +/- 9.2
      to 32.6 +/- 8.7 ml/min/ml tissue, p < 0.05). The nonselective beta-blocker
      propranolol attenuated the FBF response to MCh significantly (from 30.5 +/- 6.7
      to 22.8 +/- 4.5 ml/min/ml tissue, p < 0.01). In these groups baseline FBF and
      EIDV were unchanged. Labetalol, a combined non-selective beta-blocker and
      selective alpha-1-blocker, increased baseline FBF and increased the response to
      both MCh and SNP in parallel (p < 0.05 for MCh and p = 0.07 for SNP). Saline did
      not change baseline FBF, EDV or EIDV. CONCLUSIONS: This study showed that local
      infusion of different beta-blocking agents in normotensive subjects affects
      endothelial vasodilatory function differently. This technique could be used to
      evaluate the direct effect of vasoactive drugs on EDV.

PMID- 11193134
TI  - Blood pressure control in essential hypertension and impairment of renal function
      with age.
AB  - Hypertension has been recognized to be an important cause for the development of
      end-stage renal disease (ESRD). We assessed the quality of blood pressure control
      in 103 patients with essential hypertension and correlated renal function and
      age. Patients were stratified into three subgroups by their blood pressure level
      under current medication. Group 1 were hypertensive patients with normalized
      blood pressure (<140/90 mmHg, n = 25), group 2 patients with mild hypertension
      (140-159/90-99 mmHg, n = 43) and group 3 patients with moderate to severe
      hypertension (> 160/100 mmHg, n = 35). A negative correlation between age and
      creatinine clearance (Ccr) could be confirmed for patients of group 1
      (correlation coefficient r1 = -0.56; p, < 0.01) and group 2 (r2 = -0.55; P2 <
      0.001). Furthermore the regression coefficient (m) of decline in C(Cr) versus age
      was higher in group 2 patients (m2 = -1.83) than in group 1 (m1 = -1.30). In
      group 3 we found no correlation of renal function with age, indicating that age
      may not be the leading variable. Patients in group 1 were all within normal
      limits of age adjusted Ccr, but 12% in group 2 and 23% in group 3 had impaired
      C(Cr). Furthermore proteinuria was found to be 20% (group 1), 26% (group 2) and
      31% (group 3). This analysis provides further evidence of the importance of blood
      pressure control in essential hypertension to preserve renal function.

PMID- 11193135
TI  - L-arginine partially reverses established adrenocorticotrophin-induced
      hypertension and nitric oxide deficiency in the rat.
AB  - BACKGROUND: L-arginine treatment prevents adrenocorticotrophin (ACTH) induced
      hypertension in the rat. This study examined whether L-arginine treatment could
      reverse established ACTH hypertension and its effects on markers of decreased NO
      activity. METHODS: Sixty-four male Sprague-Dawley rats were randomly divided into
      6 groups given 12 days of treatment: (1) sham (0.9% NaCl, 0.5 ml/kg,
      subcutaneously, sc, n = 16); (2) ACTH (0.5 mg/kg/day, sc, n = 16); (3) sham + L
      arginine (0.6% in food, from treatment day 8 onwards, n = 10); (4) ACTH + L
      arginine (n = 10); (5) sham + D-arginine (0.6% in food, from T 8 onwards) (n =
      6); and (6) ACTH + D-arginine (n = 6). Systolic blood pressure, water intake,
      urine volume, and body weight were measured every second day. At the end of the
      experiments, plasma and urinary nitrate/nitrite (NOx), plasma amino acid
      concentrations (in groups 1-4), and urinary cyclic guanosine monophosphate (cGMP)
      concentrations were measured. RESULTS: Sham, sham + L-arginine, and sham + D
      arginine treatments did not affect blood pressure. ACTH increased systolic blood
      pressure (from 121 +/- 1 to 147 +/- 2 mmHg, p < 0.001, pooled control vs
      treatment day 12, mean +/- sem), and this was partially reversed by L-arginine
      (group 4: from 141 +/- 2 on day 8 to 133 +/- 1 mmHg on day 12, n = 10, p <
      0.001). In contrast, D-arginine did not affect blood pressure in ACTH-treated
      rats (group 6). ACTH increased water intake and urine volume and decreased body
      weight, and L-arginine administration did not alter these parameters. ACTH
      decreased plasma citrulline (group 1 vs 2: 115 +/- 7 vs 67 +/- 6 micro M/L, n =
      16, p < 0.001) and NOx concentrations (group 1 vs 2: 8.3 +/- 0.8 vs 4.5 +/- 0.6
      microM/L, n= 10, p < 0.001) and these decreases were reversed by L-arginine
      treatment (group 4: citrulline 98 +/- 9 micro M/L, NOx 9.1 +/- 1.6 micro M/L,
      group 2 vs 4, both p < 0.05). ACTH produced marked increases in urinary cGMP
      excretion (group 1 vs 2: 0.5 +/- 0.1 vs 1.9 +/- 0.4 nmol/24 h, p < 0.01).
      CONCLUSION: Supplementation with L-arginine partly reversed established ACTH
      induced hypertension and restored plasma NOx and citrulline concentrations to
      levels seen in sham-treated rats. These data are consistent with previous studies
      suggesting that functional NO deficiency has a role in ACTH-induced hypertension
      in rats.

PMID- 11193136
TI  - Clinical Lewy body syndromes.
AB  - Lewy bodies are spherical, intracytoplasmic, eosinophilic, neuronal inclusions
      comprising abnormally truncated and phosphorylated intermediate neurofilament
      proteins, alpha-synuclein, ubiquitin, and associated enzymes. The clinical
      presentation of LB disease varies according to the site of LB formation and
      associated neuronal loss. Three main clinicopathological syndromes have been
      described--movement disorder, autonomic failure, and dementia. Parkinsonism is
      the most common presentation of LB disease developing in middle life. In older
      patients, a mixture of cognitive, autonomic, and motor dysfunction is more
      common. Dementia with LB (DLB) is a relatively recently described
      clinicopathological syndrome that accounts for up to 20% of all cases of dementia
      in old age. Patients, typically in their seventh and eighth decades, have LB
      pathology in cortical neurons as well as in the brain stem. LB disease should be
      considered in the differential diagnosis of a wide range of clinical
      presentations including episodic disturbances of consciousness, syncope, sleep
      disorders, and unexplained delirium.

PMID- 11193137
TI  - High frequency of mutations in four different disease genes in early-onset
      dementia.
AB  - Heterozygous mutations in the genes for amyloid precursor protein (APP), the
      presenilins (PS1, PS2), prion protein (PrP), neuroserpin, and tau are associated
      with early-onset dementia (EOD) with or without neurological signs in the early
      disease stage. To investigate the proportion of EOD without early neurological
      signs attributable to known genes we prospectively (i.e., ante mortem) screened
      these six genes for mutations in 36 patients with EOD before age 60. Family
      history for dementia was positive (PFH) in 16, negative (NFH) in 17, and unknown
      (UFH) in 3 patients. In 12 patients, we found 5 novel mutations (PS1: F105L; PS2:
      T122P, M239I; PrP: Q160X, T188K) and 5 previously reported mutations (APP: in
      three most likely unrelated patients V717I; PS1: A79V, M139V; PrP: P102L, T183A)
      that all are considered disease causing. Of these 12 patients, 9 had PFH. This
      indicates a detection rate of 56% (9/16) in patients with PFH. We found 2
      mutations (APP V717I) in 2 of the 3 the UFH-patients, and only 1 mutation (PrP
      T188K) in 1 of the 17 patients with NFH. No mutation was found in tau and
      neuroserpin genes. To date, three patients died and FAD, predicted by PS
      mutations in two patients, and prion disease, predicted by a PrP mutation in the
      third one, were histopathologically confirmed at autopsy. Up to now, mutation
      findings may be the most specific biomarkers for an ante mortem diagnosis of FAD
      or hereditary prion disease.

PMID- 11193138
TI  - Pathological tau phenotypes. The weight of mutations, polymorphisms, and
      differential neuronal vulnerabilities.
AB  - In tauopathies, comparative biochemistry of tau aggregates shows that they differ
      in both phosphorylation and content of tau isoforms. Six tau isoforms are found
      in human brain that contain either three (3R) or four microtubule-binding domains
      (4R). In Alzheimer's disease, all six of the tau isoforms are phosphorylated and
      aggregate into paired helical filaments. They are detected by immunoblotting as a
      major tau triplet (tau 55, 64, and 69). In corticobasal degeneration and
      progressive supranuclear palsy, only phosphorylated 4R-tau isoforms aggregate and
      appear as a major tau doublet (tau 64 and 69). In Pick's disease, only
      phosphorylated 3R-tau isoforms aggregate into filaments and are characterized by
      another major tau doublet (tau 55 and 64). Finally, recent findings provide a
      direct link between a genetic defect in tau and its abnormal aggregation into
      filaments in frontotemporal dementia with parkinsonism linked to chromosome 17.
      In the present study, the question of a relationship between tau isoforms and
      cell morphology is raised. To answer this question, stably transfected human
      neuroblastoma SY5Y cell lines with either 3R- or 4R-tau isoforms are established.
      Cell morphology and tau phosphorylation were modified, suggesting that cells
      undergo profound changes in their metabolism and viability.

PMID- 11193139
TI  - Coexistent tau and amyloid pathology in hereditary frontotemporal dementia with
      tau mutations.
AB  - Hereditary frontotemporal dementia with Parkinsonism linked to chromosome 17
      (FTDP-17) is associated with different mutations in the microtubule-associated
      protein (MAP) tau gene. Pathological changes consist of accumulation of
      hyperphosphorylated tau protein in frontal and temporal cortex, hippocampus, and
      some subcortical nuclei. We describe the neuropathological findings in five
      patients with P301L mutation, and in two affected sibs with R406W mutation. The
      P301L brains all showed a pretangle-type tauopathy of the frontal and temporal
      cortices. One of these patients, however, also showed an Alzheimer-type tauopathy
      with neurofibrillary tangles (NFT), neuritic plaques, and amyloid angiopathy of
      the temporoparietal cortex. Three tau bands (64, 68, and 72 kDa) were seen in the
      frontal cortex, while the temporal cortex revealed four bands (60, 64, 68, and 72
      kDa), containing all six tau isoforms. The first R406W brain showed many NFT in
      affected regions with only a few diffuse amyloid plaques. The second R406W brain
      contained a much higher density of NFT in affected regions, and an extensive
      amyloid deposition consisting of both diffuse and neuritic plaques with dense
      cores. An intriguing question is whether the FTD and Alzheimer disease changes
      are concomitant, or whether there is an interaction between tau and amyloid
      pathology. An acceleration of NFT formation due to amyloid deposition has been
      observed in nondemented aging and preclinical AD. The question whether this
      mechanism occurs in FTD with tau mutations remains to be elucidated.

PMID- 11193140
TI  - The clinical spectrum of Guam ALS and Parkinson-dementia complex: 1997-1999.

PMID- 11193141
TI  - In vivo analysis of wild-type and FTDP-17 tau transgenic mice.
AB  - Mutations in the coding and intronic regions of the tau gene cause frontotemporal
      dementia and parkinsonism linked to chromosome 17 (FTDP-17). Some of these
      mutations lead to an overproduction of tau isoforms with four microtubule-binding
      repeats, followed by the development of fibrillary lesions and selective cell
      death. In order to analyze the development of these neurofibrillary lesions in
      transgenic mice, the longest four-repeat human brain tau isoform was expressed
      under control of two different neuron-specific promoters. In a first model,
      utilizing the human Thy1 promoter, transgenic tau was hyperphosphorylated and
      abnormally localized to cell bodies and dendrites. In a second model, which made
      use of a human Thy1.2 expression vector, transgenic expression levels were much
      higher, and an additional phenotype was observed: Large numbers of pathologically
      enlarged axons containing neurofilament- and tau-immunoreactive spheroids were
      present, especially in spinal cord. Signs of Wallerian degeneration and
      neurogenic muscle atrophy were observed. Behaviorally, transgenic mice showed
      signs of muscle weakness. Our data show that overexpression of human four-repeat
      tau in itself is sufficient to lead to nerve cell dysfunction and amyotrophy. We
      have now extended our initial studies by introducing exonic mutations including
      G2t 2V and PS01L into the tau gene in order to achieve a more advanced FTDP-17
      associated phenotype.

PMID- 11193142
TI  - Pathogenic mechanisms of Alzheimer's disease analyzed in the APP23 transgenic
      mouse model.
AB  - APP23 transgenic mice overexpress human APP with the Swedish double mutation. The
      mice start to develop amyloid plaque pathology at about six months of age,
      followed somewhat later by vascular amyloid deposits. Plaques are mostly of the
      compact type and increase exponentially during aging. Female mice show a slightly
      more rapid A beta plaque deposition than do male animals. Associated with the
      amyloid are inflammatory reactions, neuritic and synaptic degeneration as well as
      tau hyperphosphorylation. Older mice have a reduced cholinergic fiber length and
      a reduced neuron number in the hippocampal CA1 region. Crossbreeding with
      transgenic mice expressing human presenilin 1 carrying Alzheimer's disease-linked
      mutations lead to an enhancement of the pathology. The APP23 line is a suitable
      model to analyze the contribution of APP, A beta, and amyloid to the pathogenesis
      of Alzheimer's disease.

PMID- 11193143
TI  - Prions: pathogenesis and reverse genetics.
AB  - Spongiform encephalopathies are a group of infectious neurodegenerative diseases.
      The infectious agent that causes transmissible spongiform encephalopathies was
      termed prion by Stanley Prusiner. The prion hypothesis states that the partially
      protease-resistant and detergent-insoluble prion protein (PrPsc) is identical
      with the infectious agent, and lacks any detectable nucleic acids. Since the
      latter discovery, transgenic mice have contributed many important insights into
      the field of prion biology. The prion protein (PrPc) is encoded by the Prnp gene,
      and disruption of Prnp leads to resistance to infection by prions. Introduction
      of mutant PrPc genes into PrPc-deficient mice was used to investigate structure
      activity relationships of the PrPc gene with regard to scrapie susceptibility.
      Ectopic expression of PrPc in PrPc knockout mice proved a useful tool for the
      identification of host cells competent for prion replication. Finally, the
      availability of PrPc knockout and transgenic mice overexpressing PrPc allowed
      selective reconstitution experiments aimed at expressing PrPc in neurografts or
      in specific populations of hemato- and lymphopoietic cells. The latter studies
      helped in elucidating some of the mechanisms of prion spread and disease
      pathogenesis.

PMID- 11193144
TI  - Presenilin function in APP processing.
AB  - Familial Alzheimer's disease (FAD) is now linked to at least three genes encoding
      the amyloid precursor protein (APP) on chromosome 21, and presenilin 1 and 2 on
      chromosome 14 and 1, respectively. FAD cases in whom presenilin mutations occur
      are more frequent than those with APP mutations. However, altogether they only
      account for approximately 0.1% of all the people suffering from Alzheimer's
      disease (AD), and the causes of the remaining 99.9% of the sporadic form of AD or
      senile dementia remain unknown. Since FAD presents with the same
      neuropathological features as sporadic AD, i.e., cognitive impairments and the
      amyloid plaques and tangles in the brain, our working hypothesis is that similar
      molecular pathogenic mechanisms underly both sporadic and familial AD. It follows
      that APP and the presenilins must be key players in the disease. Detailed
      knowledge about the cell biology of these proteins will be a rich source of
      insight into the pathology of AD, but will also shed light on the fundamental
      neurobiology of these proteins.

PMID- 11193145
TI  - The alpha-synucleinopathies: Parkinson's disease, dementia with Lewy bodies, and
      multiple system atrophy.
AB  - Parkinson's disease is the second most common neurodegenerative disease, after
      Alzheimer's disease. Neuropathologically, it is characterized by the degeneration
      of populations of nerve cells that develop filamentous inclusions in the form of
      Lewy bodies and Lewy neurites. Recent work has shown that the filamentous
      inclusions of Parkinson's disease are made of the protein alpha-synuclein and
      that rare, familial forms of Parkinson's disease are caused by missense mutations
      in the alpha-synuclein gene. Besides Parkinson's disease, the filamentous
      inclusions of two additional neurodegenerative diseases, namely, dementia with
      Lewy bodies and multiple system atrophy, have also been found to be made of alpha
      synuclein. Recombinant alpha-synuclein has been shown to assemble into filaments
      with similar morphologies to those found in the human diseases and with a cross
      beta fiber diffraction pattern. The new work has established the alpha
      synucleinopathies as a major class of neurodegenerative disease.

PMID- 11193146
TI  - Role of presenilin-1 in murine neural development.
AB  - Our previous studies showed that presenilin-1 (PS1) is required for murine neural
      and skeletal development. Here we report that the reduction in the neural
      progenitor cells observed in the PS1-/- mouse brain is due to premature
      differentiation of progenitor cells, rather than to increased apoptotic cell
      death or decreased cell proliferation. In the ventricular zone of PS1-/- mice,
      expression of the Notch1 downstream effector gene Hes5 is reduced, and expression
      of the Notch1 ligand Dll1 is elevated, indicating reduced Notch signaling. These
      results provide direct evidence that PS1 is involved in the regulation of
      neurogenesis and Notch signaling during development.

PMID- 11193147
TI  - Modulation of A beta deposition in APP transgenic mice by an apolipoprotein E
      null background.
AB  - Several lines of evidence implicate apolipoprotein E (apoE) and its receptor--the
      low density lipoprotein receptor related protein (LRP)--in Alzheimer's disease
      (AD) pathogenesis, including increased amyloid deposition in human AD brains of
      people containing the apoE epsilon 4 allele, presence of apoE and LRP in amyloid
      plaques, and in vitro uptake of amyloid precursor protein (APP) and amyloid beta
      protein (A beta) by LRP. Studies of crosses of apoE knockout mice with APP
      transgenic mice support a complex interaction between apoE and A beta deposition.
      In the Tg2576 mice expressing human APPK670N-M671L, apoE determines the amount,
      morphology, vascular pattern, and neuropil response to A beta deposits. In the
      PDAPP mice expressing human APPV717F, apoE also affects the anatomical
      localization of cerebral A beta deposits. Thus, APP transgenic mice can serve as
      models to investigate genetic influences on the amount and timing of cerebral
      amyloidosis, the morphology of amyloid plaques, and the vulnerability of specific
      neuroanatomical regions to A beta deposition.

PMID- 11193148
TI  - The value of transgenic models for the study of neurodegenerative diseases.
AB  - Transgenic animal models are useful in studying the features of APP- and PS1
      linked FAD and SOD1-linked FALS. These models help to investigate the nature of
      the cellular/biochemical/molecular alterations in neural tissue; the character
      and evolution of neuronal and/or glial abnormalities; the ways mutant proteins
      cause damage to neurons; and the biochemical pathways associated with cell death.
      New technologies will help to define changes in a variety of genes/gene products
      and the events and conformational changes in mutant proteins that are implicated
      in pathogenic cascades. It is hoped such study will result in novel treatments
      for testing in transgenic models that can then be translated into new treatments
      for human neurodegenerative diseases.

PMID- 11193149
TI  - Identifying proteases that cleave APP.

PMID- 11193151
TI  - Recent advances in the understanding of the processing of APP to beta amyloid
      peptide.

PMID- 11193150
TI  - Toward the characterization and identification of gamma-secretases using
      transition-state analogue inhibitors.
AB  - The amyloid-beta protein (A beta), strongly implicated in the etiology of
      Alzheimer's disease (AD), is formed from the amyloid-beta precursor protein (APP)
      through sequential proteolysis by beta- and gamma-secretases. Cleavage by gamma
      secretase takes place within the middle of the single transmembrane region of APP
      and results primarily in 40- and 42-amino acid A beta C-terminal variants, A beta
      40 and A beta 42. The latter form of A beta is highly fibrillogenic, is
      invariably elevated in autosomal-dominant forms of AD, and is the major A beta
      component found presymptomatically in cerebral deposits. Thus, blocking
      production of A beta in general and A beta 42 in particular is considered an
      important therapeutic goal. We have developed transition-state analogue
      inhibitors of gamma-secretase as molecular probes for characterizing the active
      site of this enzyme, as pharmacological tools for understanding its role in
      biology, and as affinity labels toward its definitive identification.
      Specifically, we found that: (1) difluoro ketone and difluoro alcohol
      peptidomimetics are effective inhibitors of gamma-secretase activity in APP
      transfected cells, strongly suggesting an aspartyl protease mechanism; (2) gamma
      secretases that form A beta 40 and A beta 42 are pharmacologically distinct but
      are nevertheless closely similar; (3) large hydrophobic P1 substituents increase
      the inhibitory potency of these peptidomimetics, suggesting a large complementary
      S1 pocket for gamma-secretases; (4) A beta 42 production is increased several
      fold over control by these gamma-secretase inhibitors after replacement with
      inhibitor-free media; (5) a bromoacetamide derivative of one of these analogues
      continues to inhibit total A beta and A beta 42 production hours after
      replacement with compound-free media and should help identify the target(s) of
      these protease transition-state mimics.

PMID- 11193152
TI  - Presenilin-1: a component of synaptic and endothelial adherens junctions.

PMID- 11193153
TI  - Alpha-secretase activity of the disintegrin metalloprotease ADAM 10. Influences
      of domain structure.
AB  - Disintegrin metalloproteases from different organisms form the ADAM (a
      disintegrin and metalloprotease) family. All members display a common domain
      organization and possess four potential functions: proteolysis, cell adhesion,
      cell fusion, and cell signaling. Members of the ADAM family are responsible for
      the proteolytic cleavage of transmembrane proteins and release of their
      extracellular domain. The proteolytic process is referred to as ectodomain
      shedding, which is activated by phorbol esters and inhibited by hydroxamic acid
      based inhibitors. We have shown that the disintegrin metalloprotease ADAM 10 has
      both constitutive and regulated alpha-secretase activity. Expression of a
      dominant negative mutant of ADAM 10 in HEK cells decreases the secretion of APPs
      alpha. In order to investigate the influence of distinct protein domains of ADAM
      10 on alpha-secretase activity, several deletion mutants of ADAM 10 were
      constructed. Our findings demonstrate that the deletion of the disintegrin domain
      results in a mutant ADAM 10 with remaining alpha-secretase activity, whereas the
      deletion of the prodomain destroys the proteolytic activity of ADAM 10.

PMID- 11193154
TI  - Rapid Notch1 nuclear translocation after ligand binding depends on presenilin
      associated gamma-secretase activity.
AB  - Recent data suggest an intimate relationship between the familial Alzheimer
      disease gene presenilin 1 (PS1) and proteolytic processing of both the amyloid
      precursor protein (APP) and the important cell signaling molecule, Notch1. We now
      show, using mammalian cells transfected with full-length Notch1, that the C
      terminal domain of Notch1 rapidly translocates to the nucleus upon stimulation
      with the physiologic ligand Delta and initiates a CBF1-dependent signal
      transduction cascade. Using this assay, we demonstrate that the same aspartate
      mutations in PS1 that block APP processing also prevent Notch1 cleavage and
      translocation to the nucleus. Moreover, we show that two APP gamma-secretase
      inhibitors also diminish Notch1 nuclear translocation in a dose-dependent
      fashion. However, Notch1 signaling, assessed by measuring the activity of CBF1, a
      downstream gene, was reduced but not completely abolished in the presence of
      either aspartate mutations or gamma-secretase inhibitors. Our results support the
      hypothesis that similar PS1-related enzymatic activity is necessary for both APP
      and Notch1 processing, yet suggest that Notch signaling may remain relatively
      preserved with moderate levels of gamma-secretase inhibition.

PMID- 11193155
TI  - GSK3 beta forms a tetrameric complex with endogenous PS1-CTF/NTF and beta
      catenin. Effects of the D257/D385A and FAD-linked mutations.
AB  - We have previously shown that the endogenous C-terminal fragment of presenilin 1
      co-immunoprecipitates with endogenous beta-catenin. Since PS1 has been suggested
      to be involved in beta-catenin stabilization, we further investigated whether
      GSK3 beta, responsible for beta-catenin phosphorylation and degradation, is part
      of the PS1/beta-catenin complex. In naive H4 and CHO cells, PS1 co
      immunoprecipitated with both endogenous beta-catenin and GSK3 beta. In addition,
      GSK3 beta endogenously binds to the PS1-CTF/NTF complex and beta-catenin in naive
      CHO cells. GSK3 beta also co-immunoprecipitated with PS1 full length in CHO cell
      lines overexpressing PS1 wild type. Given that it has been recently shown that
      PS1 mutations of aspartate 257 or 385 result in prevention of PS1 endoproteolysis
      and inhibition of gamma-secretase activity, we also tested whether PS1
      endoproteolysis is required for beta-catenin/GSK3 beta/PS1 binding and whether
      PS1 FAD-linked mutations affect GSK3 beta recruitment in the PS1/beta-catenin
      complex. GSK3 beta was detected in PS1 immunoprecipitates from H4 cell lines
      overexpressing PS1 wild type, delta E10, A286E, L246V and in CHO cell lines
      overexpressing aspartate or M146L mutations. The latter data show that the
      absence of PS1 endoproteolysis (D257A/D385A and delta E10) or the presence of PS1
      FAD mutations does not interfere with beta-catenin/GSK3 beta/PS1 complex
      formation.

PMID- 11193156
TI  - An empirical model of gamma-secretase activity.
AB  - gamma-Secretase catalyzes the cleavage at the carboxyl terminus of A beta to
      release it from the APP. While gamma-secretase is a major therapeutic drug target
      for the treatment of Alzheimer's disease (AD), it appears to be an unusual
      proteolytic activity, and, to date, no protease responsible for this activity has
      been identified. Based on studies of APP transmembrane domain (TMD) mutants, it
      is apparent that there are multiple pharmacologically distinct gamma-secretase
      activities that are spatially restricted and that presenilins (PS) regulate
      cleavage by gamma-secretases in a protease independent fashion. Based on these
      studies, we propose a multiprotease model for gamma-secretase activity and
      predict that the gamma-secretases are likely to be closely related proteases.

PMID- 11193157
TI  - Overexpression of presenilin-2 enhances apoptotic death of cultured cortical
      neurons.
AB  - Presenilin-2 (PS2) is a gene of unknown function linked with some forms of
      familial Alzheimer's disease. To investigate the biological role of PS2 in
      neurons, we overexpressed PS2 in primary cortical neurons using recombinant
      adenoviral vectors. Western blot and immunohistochemical analyses showed enhanced
      expression of PS2 proteins in infected neurons after infection of recombinant
      adenoviruses containing the human wild-type or mutant PS2 gene. Neuronal survival
      was decreased by approximately 30% in cultures infected with adenovirus
      expressing either wild-type or mutant PS2, as compared with those infected with
      adenovirus expressing the LacZ gene. Fragmented nuclei were frequently observed
      in dying neurons. These data suggest that apoptotic death of cultured cortical
      neurons is enhanced by PS2 overexpression.

PMID- 11193158
TI  - Alpha 1-antichymotrypsin inhibits A beta degradation in vitro and in vivo.
AB  - The neuropathology of Alzheimer's disease (AD) is characterized by extensive
      deposition of the toxic amyloid beta peptide (A beta) in selected regions of the
      brain and brain vasculature (Selkoe, 1999). Thus, lowering the levels of A beta
      may be beneficial for AD patients. A beta is a proteolytic fragment derived from
      the amyloid precursor protein (APP). The mechanisms of A beta formation from its
      precursor have been studied extensively; however, considerably less effort has
      been invested into studying A beta clearance. We find that the degradation of A
      beta in our system is dependent upon the presence of a metallopeptidase
      E.C.3.4.24.15 (MP24.15) (Yamin et al., 1999). We have previously purified MP24.15
      to homogeneity from AD brain and identified it as an APP-processing protease in
      vitro (Papastoitsis, 1994). To confirm its role in cell culture, we transfected
      SKNMC neuroblastoma cells with sense and antisense cDNAs of MP24.15 and with a
      mock construct. Compared to mock conditioned media (CM), CM of MP24.15
      overexpressing cells had very high A beta-degrading activity. Conversely, CM of
      antisense-expressing cells lacked A beta-degrading activity. These results
      suggested that MP24.15 is involved in A beta degradation. Characterization of the
      proteolytic activity directly responsible for A beta degradation using a spectrum
      of protease inhibitors revealed that only serine protease inhibitors completely
      blocked A beta degradation. Therefore, MP24.15 appears to activate a serine
      protease, which then cleaves A beta. Interestingly, alpha 1-antichymotrypsin
      (ACT) which we discovered to be highly elevated in AD brain (Abraham, et al.,
      1988) also inhibited A beta degradation. To our delight, ACT proved to be an
      inhibitor of A beta degradation in vivo as well. When we crossed transgenic mice
      expressing human ACT with plaque-producing mice expressing human APP, the doubly
      transgenic mice had twice as many plaques at 20 months of age as the APP mice
      (Mucke et al., 2000). Successful completion of this study could lead to the
      design of reagents that would reduce the amyloid load in AD patients.

PMID- 11193159
TI  - Activated mitogenic signaling induces a process of dedifferentiation in
      Alzheimer's disease that eventually results in cell death.
AB  - Neurodegeneration in Alzheimer's disease (AD) is associated with the appearance
      of dystrophic neuronal growth profiles that most likely reflect an impairment of
      neuronal reorganization. This process of morphodysregulation, which eventually
      goes awry and becomes a disease itself, might be triggered either by a variety of
      life events that place an additional burden on the plastic capability of the
      brain or by genetic pertubations that shift the threshold for decompensation.
      This paper summarizes recent evidence that impairment of the p21ras intracellular
      signal transduction, which is is mediated by a hierarchy of phosphorylation
      signals and eventually results in loss of differentiation control and an attempt
      of neurons to re-enter the cell-cycle, is critically involved in this process.
      Neurodegeneration might thus be viewed as an alternative effector pathway of
      those events that in the dividing cell would lead to cellular transformation.
      This hypothesis might be of heuristic value for the development of a therapeutic
      strategy.

PMID- 11193160
TI  - Inhibition of the neuronal insulin receptor. An in vivo model for sporadic
      Alzheimer disease?
AB  - It has been hypothesized that a central even in the early pathogenesis of
      sporadic Alzheimer disease (SAD) is the dysfunction of the neuronal insulin
      receptor signal transduction. To prove this, this receptor was inhibited by a
      triplicate icv application of STZ. Insulin binding sites were upregulated as in
      SAD. With respect to glucose transport proteins, detailed investigations are
      necessary.

PMID- 11193161
TI  - Cytoplasmic presenilin aggregates in proteasome inhibitor-treated cells.

PMID- 11193162
TI  - Regulation of APP synthesis and secretion by neuroimmunophilin ligands and
      cyclooxygenase inhibitors.
AB  - We and others previously showed that both the synthesis of the amyloid precursor
      protein (APP) and its processing (i.e., to amyloidogenic A beta peptides; soluble
      nonamyloidogenic APPs; and other APP fragments) are regulated by
      neurotransmitters. Transmitters that elevate cellular cAMP levels (like
      norepinephrine and prostaglandins, which act on beta-adrenergic receptors and
      prostaglandin E2 receptors respectively) enhance APP synthesis and the formation
      of amyloidogenic APP holoprotein. Transmitters that stimulate
      phosphatidylinositol hydrolysis (by activating muscarinic m1 or m3 receptors,
      serotoninergic 5HT2a or 5HT2c receptors, or metabotropic glutamate receptors of
      subtypes 1 or 5) increase the conversion of APP to soluble APPs, and decrease the
      formation of A beta. These findings suggest that drugs that regulate the activity
      of neurotransmitter receptors might be useful in preventing the excessive
      formation of A beta or other amyloid precursors in Alzheimer's disease. We now
      show that neuroimmunophilin ligands (like cyclosporin A or FK-506) and
      nonsteroidal antiinflammatory agents (NSAIDs), including cyclooxygenase (COX)-2
      inhibitors, can also prevent APP overexpression and the overproduction of
      amyloidogenic peptides. We observe that the enhancement of APP overexpression by
      prostaglandin E2 is inhibited by neuroimmunophilin ligands like cyclosporin A or
      FK-506 (tacrolimus). We also find that the NSAIDs, which reduce prostaglandin
      synthesis by inhibiting COX-1 and -2 enzymes, might also be expected to lower APP
      levels. Our present data confirm that these drugs, as well as drugs that
      selectively inhibit COX-2, reduce the levels of amyloidogenic APP holoprotein in
      cultured neurons or in cultured astrocytes. We previously showed that elevations
      in cAMP, perhaps generated in response to prostaglandins, can suppress APPs
      secretion. The NSAIDs and COX inhibitors also increased levels of soluble APPs in
      the media of cultured astrocytes and neurons, perhaps acting by inhibition of
      prostaglandin production. Since APP holoprotein can be amyloidogenic, while APPs
      may be neurotrophic, our findings suggest that some neuroimmunophilin ligands,
      NSAIDs and COX-2 inhibitors might suppress amyloid formation and enhance neuronal
      regeneration in Alzheimer's disease.

PMID- 11193163
TI  - Abeta modulation: the next generation of AD therapeutics.

PMID- 11193164
TI  - Prevention and reduction of AD-type pathology in PDAPP mice immunized with A beta
      1-42.
AB  - In AD certain brain structures contain a pathological density of A beta protein
      deposited into plaques. The effect of genetic mutations found in early onset AD
      patients was an overproduction of A beta 42, strongly suggesting that
      overproduction of A beta 42 is associated with AD. We hypothesized that an
      immunological response to A beta 42 might alter its turnover and metabolism.
      Young PDAPP transgenic mice were immunized with A beta 1-42, which essentially
      prevented amyloid deposition; astrocytosis was dramatically reduced and there was
      reduction in A beta-induced inflammatory response as well. A beta 1-42
      immunization also appeared to arrest the progression of amyloidosis in older
      PDAPP mice. A beta immunization appears to increase clearance of amyloid plaques,
      and may therefore be a novel and effective approach for the treatment of AD.

PMID- 11193165
TI  - Genetics of Parkinson's disease.
AB  - Several genetic factors have been recently recognized as related to the etiology
      of Parkinson's disease. Mutations in the genes coding for alpha-synuclein and
      ubiquitin carboxy-terminal hydrolase have been identified in families with
      autosomal dominant Parkinson's disease. Mutations in the Parkin gene are
      responsible for autosomal recessive parkinsonism. These first pieces of the
      molecular puzzle of Parkinson's disease offer novel insights into the
      pathophysiology of the illness.

PMID- 11193166
TI  - Treatment with the selective muscarinic agonist talsaclidine decreases
      cerebrospinal fluid levels of total amyloid beta-peptide in patients with
      Alzheimer's disease.
AB  - Brain amyloid load in Alzheimer's disease (AD) is, at least in genetic forms,
      associated with overproduction of amyloid beta-peptides (A beta). Thus, lowering
      A beta production is a central therapeutic target in AD and may be achieved by
      modulating such key enzymes of amyloid precursor protein (APP) processing as beta
      , gamma-, and alpha-secretase activities. Talsaclidine is a selective muscarinic
      M1 agonist that stimulates the nonamyloidogenic alpha-secretase pathway in model
      systems. Talsaclidine was administered double-blind, placebo-controlled, and
      randomized to 24 AD patients and cerebrospinal fluid (CSF) levels of total A beta
      were quantitated before and after 4 weeks of drug treatment. We observed that
      talsaclidine decreases CSF levels of A beta significantly over time within the
      treatment group (n = 20) by a median of 16% as well as compared to placebo (n =
      4) by a median of 27%. We conclude that treatment with selective M1 agonists may
      reduce A beta production and may thus be further evaluated as a potential amyloid
      lowering therapy of AD.

PMID- 11193167
TI  - Metal chelation as a potential therapy for Alzheimer's disease.
AB  - Alzheimer's disease is a rapidly worsening public health problem. The current
      lack of effective treatments for Alzheimer's disease makes it imperative to find
      new pharmacotherapies. At present, the treatment of symptoms includes use of
      acetylcholinesterase inhibitors, which enhance acetylcholine levels and improve
      cognitive functioning. Current reports provide evidence that the pathogenesis of
      Alzheimer's disease is linked to the characteristic neocortical amyloid-beta
      deposition, which may be mediated by abnormal metal interaction with A beta as
      well as metal-mediated oxidative stress. In light of these observations, we have
      considered the development of drugs that target abnormal metal accumulation and
      its adverse consequences, as well as prevention or reversal of amyloid-beta
      plaque formation. This paper reviews recent observations on the possible
      etiologic role of A beta deposition, its redox activity, and its interaction with
      transition metals that are enriched in the neocortex. We discuss the effects of
      metal chelators on these processes, list existing drugs with chelating
      properties, and explore the promise of this approach as a basis for medicinal
      chemistry in the development of novel Alzheimer's disease therapeutics.

PMID- 11193168
TI  - Regulation of gene expression by muscarinic acetylcholine receptors. A
      comprehensive approach for the identification of regulated genes.

PMID- 11193169
TI  - Cholinergic modulation of amyloid processing and dementia in animal models of
      Alzheimer's disease.

PMID- 11193170
TI  - M1 muscarinic agonists as potential disease-modifying agents in Alzheimer's
      disease. Rationale and perspectives.
AB  - A cholinergic hypofunction in Alzheimer's disease (AD) may lead to formation of
      beta-amyloids that might impair the coupling of M1 muscarinic ACh receptors
      (mAChRs) with G proteins. This disruption in coupling can lead to decreased
      signal transduction, to a reduction in levels of trophic amyloid precursor
      proteins (APPs), and to generation of more beta-amyloids that can also suppress
      ACh synthesis and release, aggravating further the cholinergic deficiency. These
      "vicious cycles," a presynaptic and a postsynaptic one, may be inhibited, in
      principle, by M1 selective agonists. Such properties can be detected in the
      functionally selective M1 agonists from the AF series [e.g., project drugs,
      AF102B, AF150(S)]. These M1 agonists promote the nonamyloidogenic APP processing
      pathways and decrease tau protein phosphorylation. The effects on tau proteins
      suggest a link between M1 mAChR-mediated signal transduction system(s) and the
      neuronal cytoskeleton via regulation of phosphorylation of tau microtubule
      associated protein. This may indicate a dual role for M1 agonists: as inhibitors
      of two "vicious cycles," one induced by beta-amyloids, and the other due to
      overactivation of certain kinases (e.g., glycogen synthase kinase-3, GSK-3) or
      downregulation of phosphatases, respectively. Prolonged administration of
      AF150(S) in apolipoprotein E-knockout mice restored cognitive impairments,
      cholinergic hypofunction, and tau hyperphosphorylation, and unveiled a high
      affinity binding site to M1 mAChRs. Except M1 agonists, there are no reports of
      compounds having such combined effects, for example, amelioration of cognition
      dysfunction and beneficial modulation of APPs together with tau phosphorylation.
      This unique property of M1 agonists to alter different aspects of AD pathogenesis
      could represent the most remarkable, yet unexplored, clinical value of such
      compounds.

PMID- 11193171
TI  - Cholinesterase inhibitors stabilize Alzheimer's disease.
AB  - During the last decade, a systematic effort to develop a pharmacological
      treatment for Alzheimer disease (AD) has resulted into three drugs being
      registered for the first time in the USA and Europe for this specific indication.
      All three are cholinesterase inhibitors (ChEI). The major therapeutic effect of
      ChEI on AD patients is to maintain cognitive function at a constant level during
      a six-month to one-year period of treatment, as compared to placebo. Additional
      drug effects might slow cognitive deterioration and improve behavioral and daily
      living conditions. Comparison of clinical effects of six ChEI demonstrates a
      rather similar magnitude of improvement in cognitive measures. For some drugs,
      this may represent an upper limit, whereas for other it may still be possible to
      further increase the benefit. In order to maximize and prolong positive drug
      effects, it is important to start early and adjust dosage during the treatment.
      Recent studies show that in many patients the stabilization effect produced by
      ChEI can be prolonged for as long as a 24-month period. In order to explain the
      stabilizing effect of ChEI, a mechanism other than AChE inhibition, based on beta
      amyloid metabolism, is postulated.

PMID- 11193172
TI  - Nasal A beta treatment induces anti-A beta antibody production and decreases
      cerebral amyloid burden in PD-APP mice.

PMID- 11193173
TI  - Physiology and pathophysiology of alpha-synuclein. Cell culture and transgenic
      animal models based on a Parkinson's disease-associated protein.
AB  - The 15-20 kDa synuclein (SYN) phosphoproteins are abundantly expressed in nervous
      tissue. Members of the family include alpha- and beta-SYN, and the more distantly
      related gamma-SYN and synoretin. SYN genes have been identified in Torpedo,
      canary, and several mammalian species, indicating an evolutionary conserved role.
      Expression of alpha-SYN was found to be modulated in situations of neuronal
      remodeling, namely, songbird learning and after target ablation of dopaminergic
      striatonigral neurons in the rat. The presynaptic localization of alpha-SYN is
      further supportive of a direct physiological role in neuronal plasticity. The
      extensive synaptic co-localization of alpha- and beta-SYN might indicate
      functional redundancy of these highly homologous synucleins. However, alpha-SYN
      was the only family member identified in Lewy bodies and cytoplasmic inclusions
      characteristic for multiple system atrophy. Moreover, alpha-SYN was genetically
      linked to familial Parkinson's disease. The two Parkinson's disease-associated
      mutations accelerated the intrinsic aggregation property of alpha-SYN in vitro.
      Post-translational modifications, such as phosphorylation and proteolysis, and/or
      interaction with other proteins, might regulate alpha-SYN fibril formation in
      vivo. Cytoskeletal elements and signal transduction intermediates have been
      recently identified as binding partners for alpha-SYN. Preliminary data available
      from transgenic mice suggest that (over)expressed human alpha-SYN proteins are
      less efficiently cleared from the neuronal cytosol. Thus, Parkinson's disease
      associated mutations might perturb axonal transport, leading to somal
      accumulation of alpha-SYN and eventually Lewy body formation.

PMID- 11193174
TI  - Cytidine (5')diphosphocholine modulates dopamine K(+)-evoked release in striatum
      measured by microdialysis.
AB  - Experiments were performed to determine whether exogenous cytidine
      (5')diphosphocholine (CDP-choline) could modify the release of dopamine (DA) in
      the striatum. Rats were divided into two groups, receiving either a standard diet
      (UAR 004) or the same diet supplemented with CDP-choline (250 mg/kg day) for 28
      days. On the last day the dialysis probes were inserted in the striatum, and DA,
      homovanillic acid (HVA), and 3,4-dihydroxyphenylacetic acid (DOPAC) efflux were
      measured in the dialysis stream basally and during K+ depolarization (80 mM K+).
      Basal DA, HVA, and DOPAC did not show any difference between treated and
      untreated groups. Depolarization with K+ increased DA levels by up to 3,000% in
      the control group and by up to 4,770% in the CDP-choline-treated group (p <
      0.05), and reduced extracellular HVA and DOPAC concentration by up to 45 and 35%,
      respectively, both in the untreated and CDP-choline-treated groups. These results
      show that long-term treatment with CDP-choline increases the K+ induced release
      DN and suggest, in accordance with previous research, that by providing exogenous
      choline and cytidine, CDP-choline modulates dopaminergic transmission.

PMID- 11193175
TI  - Accelerated oligomerization by Parkinson's disease linked alpha-synuclein
      mutants.

PMID- 11193176
TI  - Classification and description of frontotemporal dementias.
AB  - A number of distinct clinical syndromes have been described that are associated
      with focal degeneration of the frontal and temporal lobes and have a non
      Alzheimer pathology. The nosological status of frontotemporal lobar degeneration
      (FTLD) has been a matter of controversy, in view of the diversity of clinical
      manifestations and distribution and nature of histopathological change. This
      paper describes the major clinical syndromes of frontotemporal dementia,
      progressive aphasia, and semantic dementia; it discusses their underlying
      pathologies and considers their molecular status. Common histopathological
      changes are demonstrated across the three clinical syndromes, highlighting the
      link between these clinical disorders. It has been suggested that these disorders
      should be regarded as tauopathies on the basis of the tau pathology seen in a
      number of cases and the mutations in the tau gene in some familial cases.
      However, in a series of 47 consecutive autopsy series of FTLD, only 36% had tau
      pathology and 10% mutations in the tau gene, suggesting that FTLD does not
      constitute a unitary etiological disorder and that its characterization as a
      tauopathy may be potentially misleading.

PMID- 11193177
TI  - Progress in hereditary tauopathies: a mutation in the Tau gene (G389R) causes a
      Pick disease-like syndrome.
AB  - We describe the clinical and pathologic phenotypes of the G389R mutation in exon
      13 of the Tau gene. Progressive aphasia and memory disturbance are the initial
      signs and begin in the fourth or fifth decade of life, followed by apathy,
      indifference, hyperphagia, rigidity, pyramidal signs and dementia. Death occurs
      after two to five years. Magnetic resonance imaging and neuropathologic studies
      show frontal and temporal atrophy. Pick body-like and axonal filamentous
      inclusions found in the neocortex and subcortical white matter, respectively, are
      tau immunoreactive. Immunoblot analysis of sarkosyl-insoluble tau shows two major
      bands of 60 and 64 kDa that, upon dephosphorylation, resolve into four bands of
      three- and four-repeat isoforms. Isolated tau filaments are often straight and
      occasionally twisted. Recombinant mutant tau protein shows a reduced ability to
      promote microtubule assembly, suggesting that this may be the primary effect of
      the mutation. The present findings indicate that the G389R mutation in Tau can
      cause a dementia similar to that in Pick's disease.

PMID- 11193178
TI  - Molecular genetics of chromosome 17 tauopathies.
AB  - The identification of mutations in the gene encoding the microtubule associated
      protein tau in frontotemporal dementia and parkinsonism linked to chromosome 17
      (FTDP-17) demonstrated that tau dysfunction can lead to neurodegeneration. At
      least 11 missense mutations and 1 deletion mutation (delta K280) have been
      identified in exons 9-13 that encode the microtubule binding domains of tau. In
      addition, five mutations have been found close to the 5' splice site of exon 10.
      The different FTDP-17 mutations have multiple effects on the biology and function
      of tau. These varied pathogenic mechanisms likely explain the wide range of
      clinical and neuropathological features observed in different families with FTDP
      17. In addition to the highly penetrant mutations that are found in large
      families with FTDP-17, a common extended haplotype in the tau gene also appears
      to be a risk factor in the development of the apparently sporadic tauopathy,
      progressive supranuclear palsy (PSP). The mechanism by which this common
      variability in the tau gene influences the development of PSP is unclear;
      however, it further suggests a central role for tau in the pathogenesis of
      several neurodegenerative conditions including Alzheimer's disease (AD).

PMID- 11193179
TI  - Tau gene mutations in frontotemporal dementia and parkinsonism linked to
      chromosome 17 (FTDP-17). Their relevance for understanding the neurogenerative
      process.
AB  - Tau is a microtubule-associated protein that binds to microtubules and promotes
      microtubule assembly. Six tau isoforms are produced in adult human brain by
      alternative mRNA splicing from a single gene. Inclusion of a 31 amino acid repeat
      encoded by exon 10 of the tau gene gives rise to the three isoforms with four
      microtubule-binding repeats each. The other three tau isoforms have three repeats
      each. Abundant neurofibrillary lesions made of tau protein constitute a defining
      neuropathological characteristic of Alzheimer's disease. Filamentous tau protein
      deposits are also the defining characteristic of other neurodegenerative
      diseases, many of which are frontotemporal dementias or movement disorders, such
      as Pick's disease, progressive supranuclear palsy, and corticobasal degeneration.
      It is well established that the distribution of tau pathology correlates with the
      presence of symptoms of disease. However, until recently, there was no genetic
      evidence linking tau to neurodegeneration. This has now changed with the
      discovery of more than 15 mutations in the tau gene in frontotemporal dementia
      and parkinsonism linked to chromosome 17 (FTDP-17). The new work has shown that
      dysfunction of tau protein causes neurodegeneration.

PMID- 11193180
TI  - Amyloidogenesis in familial British dementia is associated with a genetic defect
      on chromosome 13.
AB  - Familial British dementia (FBD) is a disorder characterized by the presence of
      amyloid deposits in cerebral blood vessels and brain parenchyma coexisting with
      neurofibrillary tangles in limbic areas. The amyloid subunit (ABri) is a 4 kDa
      fragment of a 266 amino acid type II single-spanning transmembrane precursor
      protein encoded by the BRI gene located on chromosome 13. In FBD patients, a
      single base substitution at the stop codon of this gene generates a larger 277
      residue precursor (ABriPP-277). Proteolytic processing by a furin-like enzyme at
      the C-terminus of the elongated precursor generates the 34 amino acid ABri that
      undergoes rapid aggregation and fibrillization. ABri is structually unrelated to
      all known amyloids including A beta, the main component of the amyloid lesions in
      Alzheimer's disease (AD), indicating that cerebral deposition of amyloid
      molecules other than A beta can trigger similar neuropathological changes leading
      to neuronal loss and dementia. These data support the concept that amyloid
      deposition in the vascular wall and brain parenchyma is of primary importance in
      the initiation of neurogeneration.

PMID- 11193181
TI  - Clinical and neuropathological correlates of dementia with Lewy bodies.
AB  - Dementia with Lewy bodies (DLB) is characterized pathologically by widespread
      Lewy body (LB) neuronal inclusions in the brain, but the contribution of LBs to
      the clinical syndrome of dementia and parkinsonism is unclear. In a clinical
      pathological study of 25 cases with DLB, we examined the regional neuroanatomical
      distribution of Lewy-related pathology using alpha-synuclein immunostaining to
      evaluate the relationship between LBs, neuronal loss, Alzheimer-type changes, and
      the clinical phenotype. Compared to traditional ubiquitin immunostaining, alpha
      synuclein immunohistochemistry was more specific and slightly more sensitive,
      staining about 5% more intracytoplasmic structures. There was a consistent
      pattern of vulnerability to LB formation across subcortical, paralimbic, limbic,
      and neocortical structures, which was independent of concomitant Alzheimer-type
      changes. There were no significant differences in regional LB densities among
      patients with or without cognitive fluctuations, visual hallucinations,
      delusions, recurrent falls or parkinsonism. Duration of disease correlated weakly
      with LB density. There was no neuronal loss in superior temporal sulcus or
      entorhinal cortex in pure DLB cases compared to nondemented controls. Thus, DLB
      is characterized by a specific neuroanatomical vulnerability to LB pathology,
      distinct from AD pathology, with a complicated relationship to clinical symptoms.

PMID- 11193182
TI  - Familial British dementia: expression and metabolism of BRI.
AB  - Vidal et al. (1999. Nature 399: 776-778) discovered that the underlying genetic
      lesion in familial British dementia (FBD) is a T-A transversion at the
      termination codon of a membrane protein, termed BRI. The mutation creates an
      arginine codon; translational read-through generates a novel protein, termed BRI
      L, that is extended by 11 amino acids at the carboxyl-terminus. BRI-L is the
      precursor of the ABri peptide, a component of amyloid deposits in FBD brain. We
      demonstrate that both BRI and its mutant counterpart are constitutively processed
      by furin, resulting in the secretion of carboxyl-terminal peptide derivatives
      that correspond to all, or part of, ABri. Notably, elevated levels of peptides
      are generated from the mutant BRI precursor, suggesting that subtle
      conformational alterations at the carboxyl-terminus may influence furin-mediated
      processing. We have examined BRI/BRI-L processing by other members of the
      prohormone convertase (PC) family (PACE4, LPC, PC 5/6) and found that these
      enzymes also process BRI, albeit inefficiently. Moreover, BRI-L processing by the
      other PC members is severely compromised. Finally, our electron microscopic
      studies reveal that synthetic ABri peptides assemble into insoluble beta-pleated
      fibrils. Collectively, our results support the view that enhanced furin-mediated
      processing of mutant BRI generates amyloidogenic peptides that initiate the
      pathogenesis of FBD.

PMID- 11193183
TI  - Nuclear envelope organization in papillary thyroid carcinoma.
AB  - Papillary thyroid carcinomas (PTCs) have characteristic nuclear shape changes
      compared to follicular-type thyroid epithelium. We tested the hypothesis that the
      altered nuclear shape results from altered distribution or expression of the
      major structural proteins of the nuclear envelope. Lamin A, lamin B1, lamin C,
      lamin B receptor (LBR), lamina-associated polypeptide 2 (LAP2), emerin, and
      nuclear pores were examined. PTC's with typical nuclear features by H&E were
      compared to non-neoplastic thyroid and follicular neoplasms using confocal
      microscopy, and semi-quantitative immunoblotting. Lamin A/C, lamin B1, LAP2,
      emerin, and nuclear pores all extend throughout the grooves and intranuclear
      inclusions of PTC. Their distribution and fluorescent intensity is not
      predictably altered relative to nuclear envelope irregularities. By
      immunoblotting, the abundance (per cell) and electrophoretic mobilities of lamin
      A, lamin B1, lamin C, emerin, and LAP2 proteins do not distinguish PTC, normal
      thyroid, or follicular neoplasms. These results do not support previously
      published predictions that lamin A/C expression is related to a loss of
      proliferative activity. At least three LAP2 isoforms are identified in normal and
      neoplastic thyroid. LBR is sparse or undetectable in all the thyroid samples. The
      results suggest that the irregular nuclear shape of PTC is not determined by
      these nuclear envelope structural proteins per se. We review the structure of the
      nuclear envelope, the major factors that determine nuclear shape, and the
      possible functional consequences of its alteration in PTC.

PMID- 11193184
TI  - Inhibited differentiation of Langerhans cells in the rat epidermis upon systemic
      treatment with cyclosporin A.
AB  - The immunosuppressant drug cyclosporin A (CsA) is known to cause reduction in
      number, DNA synthesis and function of Langerhans cells (LC). Since also the
      differentiation of LC is known to be hampered in conditions of acquired
      immunodeficiency not due to drugs, we investigated whether this occurs with CsA.
      Rats were injected subcutaneously with CsA (5, 10 and 50 mgxkg(-1) x d(-1)) for
      three weeks; the skin was analyzed by Ia immunohistochemistry and by electron
      microscopy. Epidermal immunolabeled cells were 15+/-3.5 (mean +/- SEM) per 100
      basal keratinocytes in untreated controls and 8.75+/-1.3, 4.75+/-1.0 and 1.7+/
      1.2 upon increasing doses of CsA (p<0.01). By electron microscopy, monocytoid
      cells with deep invaginations of the plasma membrane and roundish LC poor in
      Birbeck granules appeared in the epidermis upon treatment. The results suggest
      that CsA inhibits the differentiation of LC precursors in the epidermis and that
      this can in part explain the selective increase in the risk of skin viral disease
      and cancer in chronically treated patients.

PMID- 11193185
TI  - Immunohistochemical expression of p53 in animal tumors: a methodological study
      using four anti-human p53 antibodies.
AB  - Mutations in the p53 tumor suppressor gene are the most common genetic
      alterations in human cancers. These mutations usually lead to strongly enhanced
      protein stabilization and allow detection by immunohistochemistry. Two monoclonal
      (DO-7 and PAb-240) and two polyclonal (Ab-7 and CM-1) antibodies were evaluated
      by standard immunoperoxidase method in domestic animal tumors, chiefly squamous
      cell carcinomas (SCC), and osteosarcomas as positive controls. Immunoreactivity
      was detected in SCC of cattle, sheep, horse and cat as well as in feline actinic
      keratosis, with PAb-240 and CM-1 antibodies. One polyclonal antibody (Ab-7) did
      not give positive result at all, whereas DO-7 monoclonal antibody did not react
      in dogs and cats. Immunodetection of p53 protein is thus possible in all domestic
      species tested, especially with CM-1 and PAb-240 antibodies, and p53 alterations
      seem to occur early in carcinogenesis of feline SCC as in comparable human
      lesions.

PMID- 11193186
TI  - Morphological study of erythrocyte shapes in red pulp of mouse spleens revealed
      by an in vivo cryotechnique.
AB  - The purpose of this study was to clarify erythrocyte shapes in splenic cords of
      living mouse spleens, using our in vivo cryotechnique followed by scanning (SEM)
      or transmission (TEM) electron microscopy. Some spleens of mice were quickly
      frozen by the in vivo cryotechnique while their hearts were beating under
      anesthesia. In contrast, other spleens were prepared by an in vitro freezing
      method after they were taken out from the abdominal cavity. They were routinely
      freeze-substituted, and prepared for SEM and TEM. A few mouse spleens were also
      routinely fixed and embedded in Quetol-812 to obtain conventional morphology.
      Erythrocytes in living mouse spleens showed a variety of shapes with narrow
      spaces between them, trapped among reticular fiber tissues. Similar various
      shapes of erythrocytes were kept in the red pulp even after blocking normal blood
      circulation, as prepared by the in vitro freezing method. In comparison to the
      above-mentioned findings, some erythrocytes were changed to biconcave discoid
      shapes by the conventional immersion fixation with chemical fixatives. They also
      showed wide spaces between each other among reticular fiber tissues. Such
      conventional morphological studies could hardly reveal the in vivo shapes of
      erythrocytes in functioning spleens with normal blood circulation. In contrast,
      the various shapes of erythrocytes in the functioning spleens were demonstrated
      by our in vivo cryotechnique. It is suggested that most erythrocytes congesting
      in spleens keep their original configuration in spite of microenviromental
      alteration in splenic blood circulation.

PMID- 11193187
TI  - Effects of neonatal diethylstilbestrol exposure on c-fos and c-jun protooncogene
      expression in the mouse uterus.
AB  - Quantitative and cell-type-specific expression of c-fos and c-jun genes after
      17beta-estradiol (E2) stimulation, was investigated in the uteri of neonatally
      diethylstilbestrol (DES)-exposed and ovariectomized adult mice (neoDES-mice),
      employing Northern blot analysis, immunohistochemistry and in situ hybridization.
      The c-fos mRNA level before E2 injection (at baseline) was about 2.2-fold higher
      in neoDES-mice than in vehicle-treated control mice. In controls, E2 treatment
      transiently increased c-fos mRNA levels, showing a peak value (15.8-fold relative
      to the baseline) after 2 hours. In neoDES-mice, c-fos mRNA level reached a peak
      showing a 2.1-fold increase compared with its baseline value 1 hour after E2
      injection. Immunohistochemistry and in situ hybridization revealed that c-fos
      protein (Fos) and mRNA are induced in the epithelium and vascular endothelium in
      both groups. Most uterine epithelia of neoDES-mice revealed low sensitivity to
      the c-fos expression after E2 administration compared with those of vehicle
      treated controls, whereas few epithelia showed high c-fos mRNA expression even at
      baseline. The c-jun mRNA concentration in the neoDES-mice uteri at baseline was
      70% of that in vehicle-treated controls. At 1 hour after E2 injection, c-jun mRNA
      levels increased 1.8-fold in controls and 1.3-fold in the neoDES-mice relative to
      each baseline value. There were no significant differences in the distribution
      pattern of c-jun protein (Jun) and mRNA in the uteri of either groups; E2
      stimulated c-jun mRNA expression in the stromal and myometrial cells but
      suppressed it in the epithelial cells, whereas intensity of c-jun immunostaining
      increased in the three cell types. The permanent changes in the expression of
      estrogen-regulated protooncogenes, c-fos and c-jun genes, by neonatal DES
      exposure may be responsible for the wide range of abnormalities in the genital
      tract of mature animals.

PMID- 11193188
TI  - Isoforms of Na+, K+-ATPase in human prostate; specificity of expression and
      apical membrane polarization.
AB  - The cellular distribution of Na+, K+-ATPase subunit isoforms was mapped in the
      secretory epithelium of the human prostate gland by immunostaining with
      antibodies to the alpha and beta subunit isoforms of the enzyme. Immunolabeling
      of the alpha1, beta1 and beta2 isoforms was observed in the apical and lateral
      plasma membrane domains of prostatic epithelial cells in contrast to human kidney
      where the alpha1 and beta1 isoforms of Na+, K+-ATPase were localized in the
      basolateral membrane of both proximal and distal convoluted tubules. Using
      immunohistochemistry and PCR we found no evidence of Na+, K+-ATPase alpha2 and
      alpha3 isoform expression suggesting that prostatic Na+, K+-ATPase consists of
      alpha1/beta1 and alpha1/beta2 isozymes. Our immunohistochemical findings are
      consistent with previously proposed models placing prostatic Na+, K+-ATPase in
      the apical plasma membrane domain. Abundant expression of Na+, K+-ATPase in
      epithelial cells lining tubulo-alveoli in the human prostate gland confirms
      previous conclusions drawn from biochemical, pharmacological and physiological
      data and provides further evidence for the critical role of this enzyme in
      prostatic cell physiology and ion homeostasis. Na+, K+-ATPase most likely
      maintains an inwardly directed Na+ gradient essential for nutrient uptake and
      active citrate secretion by prostatic epithelial cells. Na+, K+-ATPase may also
      regulate lumenal Na+ and K+, major counter-ions for citrate.

PMID- 11193189
TI  - Glomerular profile numerical density per area and mean glomerular volume in rats
      submitted to nitric oxide synthase blockade.
AB  - Rats submitted to chronic inhibition of nitric oxide synthase (NOS) have
      developed systemic hypertension and consequent renal injury. The present study
      aims to determine glomerular quantitative changes due to NOS inhibition in rats.
      Adults and normotensive Wistar rats were separated into control and L-NAME groups
      (each group n=10). The animals received water and food ad libitum, while L-NAME
      rats received NG-Nitro-L-Arginine methyl Ester hydrochloride to inhibit NOS
      (50mg/kg/day) in drinking water during 40 days. After that period the rats were
      sacrificed, the kidneys were removed, measured, and prepared for histological and
      stereological analyses. The glomerular density per area [NA(glom)] and the mean
      glomerular volume [v] were determined per animal in 15 random fields. In L-NAME
      rat the blood pressure was 76% higher than the respective control group with the
      same age. Glomeruli had global or segmental glomerular sclerosis; some glomeruli
      only presented an atrophic structure. The renal volume was not different between
      control and L-NAME rats (p>0.05). However, L-NAME rats had the NA(glom) 33%
      smaller than the control rats (p=0.0001) and, concomitantly, L-NAME rats had the
      v (glom) 33% higher than the control ones (p=0.004). These results demonstrate
      morphological renal alterations caused by NOS inhibition and hypertension.

PMID- 11193190
TI  - Studies on the involvement of endogenous neuropeptides in the control of
      thymocyte proliferation in the rat.
AB  - The possible involvement of endogenous vasoactive intestinal peptide (VIP),
      cholecystokinin (CCK) and neurotensin (NT) in the control of thymocyte
      proliferation has been investigated in vivo in the immature rat. For this task,
      we have studied the effects of the administration of selective antagonists of the
      receptors of the three neuropeptides on the mitotic index (% of metaphase
      arrested cells after vincristin injection) of thymocytes. Both CCK- and TN
      receptor antagonists were ineffective. In contrast, two VIP receptor antagonists
      (VIP-As) enhanced the mitotic index of thymocytes. VIP reversed the effect of VIP
      As, but when administered alone it did not alter the mitotic activity of
      thymocytes. In light of these findings, we conclude that endogenous VIP exerts a
      maximal tonic inhibitory influence on the basal proliferative activity of rat
      thymocytes, while endogenous CCK and NT do not play a relevant modulatory role in
      this process.

PMID- 11193191
TI  - Myenteric plexus of obese diabetic mice (an animal model of human type 2
      diabetes).
AB  - The myenteric plexus of the gastrointestinal tract was investigated in the obese
      diabetic mouse, an animal model of human type 2 diabetes. Sections were
      immunostained by the avidin-biotin complex method, using a general nerve marker,
      protein gene product 9.5 (PGP 9.5), as well as antibodies to several important
      neurotransmitters. Computerized image analysis was used for quantification. When
      diabetic mice were compared with controls, no difference was found in the density
      of PGP 9.5-immunoreactive (IR) nerve fibres in antrum, duodenum or colon. In
      antrum and duodenum, diabetic mice showed a decreased number of vasoactive
      intestinal peptide (VIP)-IR neurons in myenteric ganglia as well a decreased
      relative volume density in myenteric plexus (though not significantly in antrum,
      p=0.073). No difference was found regarding VIP-IR nerves in colon. The volume
      density of nitric oxide synthase (NOS)-IR nerve fibres was decreased in antrum
      and duodenum of diabetic mice, whereas no difference was found in colon. The
      density of galanin-IR nerve fibres was decreased in duodenum. Whereas
      neuropeptide Y (NPY)- and vesicular acetylcholine transporter (VAChT)-IR nerve
      fibres was increased in density in colon of diabetic mice, no difference was
      found in antrum and duodenum. Regarding substance P, there was no difference
      between diabetic and control mice in antrum, duodenum or colon. The present study
      shows that gut innervation is affected in this animal model of human type 2
      diabetes. It is possible that the present findings may have some relevance for
      the gastrointestinal dysfunctions seen in patients with type 2 diabetes.

PMID- 11193192
TI  - Microglial reaction in focal cerebral ischaemia induced by intra-carotid
      homologous clot injection.
AB  - This study examined the microglial reaction in a simulated thrombo-embolus
      ischaemia in rats given an intracarotid injection of a suspension of homologous
      blood clot. All rats including the controls receiving vehicle injection were
      perfused at 5 hours, and 1, 3 and 7 days post-operation. The brains were removed
      and processed for immunohistochemistry using a panel of monoclonal antibodies: OX
      42, OX-18 and OX-6 for labeling of microglia. In rats given saline injection OX
      42 immunoreactive microglial cells were observed to be distributed quite evenly
      throughout the whole brain. When injection of clot suspension was given,
      microglial cells responded vigorously, particularly in the ipsilateral
      hippocampus. Microglial reaction was also detected in the ipsilateral cerebral
      cortex, caudate as well as septal nuclei. The majority of the detected reactive
      microglial cells were hypertrophied showing thick or stout processes. Some rod
      like and amoeboid microglia were also observed. Rarely did the reactive microglia
      express OX-6 immunoreactivity. All microglial cells were unreactive for OX-18.
      The actual mechanisms leading to the microglial activation as well as functions
      of reactive microglia in focal cerebral ischaemia remain speculative. In the
      absence of direct evidence, it could only be suggested that they may act as
      sensor cells for detection of subtle alterations in the microenvironment,
      probably in response to focal ischaemia and/or leakage of serum-derived factors
      induced by thrombo-embolus stroke.

PMID- 11193193
TI  - A salvianolic acid B-rich fraction of Salvia miltiorrhiza induces neointimal cell
      apoptosis in rabbit angioplasty model.
AB  - Apoptosis has been suggested to participate in stabilizing cell number in
      restenosis. Salvia miltiorrhiza (SM) Bunge which is a Chinese herb widely used
      for the treatment of cardiovascular disorders contains a potent antioxidant,
      Salvianolic acid B. To determine whether the antioxidant affects vascular
      apoptosis, the present study examined the frequency of apoptotic cell death in
      atherosclerotic plaques and in restenotic lesions of cholesterol-fed rabbits. New
      Zealand White rabbits were treated with a normal diet (normal), a 2% cholesterol
      diet (HC), a 2% cholesterol diet and endothelial denudation (HC-ED), a 2%
      cholesterol diet with 5% water-soluble extract of SM (4.8 g/Kg B.W./day) and
      endothelial denudation (HC-ED-SM), or with a 2% cholesterol diet containing
      probucol (0.6 g/kg B.W./day) and endothelial denudation (HC-ED-probucol).
      Apoptosis and associated cell types were examined in serial paraffin sections by
      in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling and
      immunohistochemistry. The expression of p53, an apoptosis-related protein, was
      also examined. Apoptosis was mainly detected in the neointima of the three groups
      with endothelial denudation. The percentage of apoptotic cells in SM-treated
      group (68.5+/-5.9%) was significantly higher than that of normal (0%), HC (1.9+/
      1.2%), HC-ED (46.1+/-5.4%), and probucol-treated (32.8+/-3.9%) groups. The SM
      treatment markedly reduced the thickness of the neointima which was mainly
      composed of smooth muscle cells with few macrophages. In accordance with the
      apoptotic cell counts, positive immunoreactivity for p53 was observed in
      restenotic lesions from HC-ED, SM-treated and probucol-treated groups but not in
      the intima of the other two groups. These results suggest that the treatment with
      salvianolic acid B-rich fraction of SM induces apoptosis in neointima which in
      turn may help prevent the neointimal thickening.

PMID- 11193194
TI  - Histopathological changes in avian kidney caused by Bothrops insularis (jararaca
      ilh a) venom and a phospholipase A2-containing fraction.
AB  - The histopathological changes induced in avian kidney by the intramuscular
      injection of Bothrops insularis (jararaca ilh a) venom and its phospholipase A2
      (PLA2)-containing fraction were examined. Acute experiments (3 h and 24 h) with
      B. insularis crude venom (20 microg and 80 microg) or its PLA2-contaning fraction
      (10 microg and 40 microg) resulted in significant structural damage to the
      kidneys of 5-12-day-old chicks. Histopathological analysis indicated that the
      venom and its fraction acted on the renal tubules and glomeruli. The
      morphological changes, although widespread, varied in intensity from cell to
      cell, and from tubule to tubule in venom-injected chicks. The tubular and
      glomerular changes produced by the venom and its PLA2-containing fraction may be
      the result of a direct cytotoxic effect potentiated by ischemia-related
      disturbances in the regional hemodynamics. The venom and its fraction affected
      more segments along reptilian-type nephrons than along mammalian ones. This
      divergent sensitivity to the venom and its fraction may reflect the species
      specific characteristics of B. insularis snake, an example of geographical
      isolation influencing its diet which is almost exclusively avian.

PMID- 11193195
TI  - Function of inflammatory cells and neoral cyclosporin-A in heart transplant
      associated coronary vasculopathy.
AB  - The role of Sandimmun Neoral (S-n) and the immune response in transplant
      associated coronary vasculopathy (TACV) was evaluated in a Lewis (Lew)-to-Fischer
      344 (F344) rat abdominal heterotopic heart transplant model. Some of the
      transplant recipients were treated with S-n (5mg/kg/day) for 14 days post
      transplant, or until sacrifice. Grafts were subjected to immunohistochemical
      (ED1, CD4, CD8 and alpha-actin+ cells) analysis from day 7 to 100 post
      transplant. Singenic controls did not develop TACV, irrespective of whether they
      had received the drug or not. TACV was detected in Lew-F344 transplants
      regardless of S-n administration with participation of ED1+, CD8+ and alpha
      actin+ cells, although its incidence was lower in animals receiving prolonged S-n
      treatment. In this model, accelerated arteriosclerosis of the graft appeared to
      be related more to the rejection effect than to the action of the
      immunosuppressive agent.

PMID- 11193196
TI  - Detection of altered retinoic acid receptor expression in tissue sections using
      in situ hybridization.
AB  - Nuclear retinoid receptors mediate retinoid effects in controlling cell growth,
      differentiation, apoptosis, and carcinogenesis. Altered expression or activity of
      these receptors could abolish the retinoid signal transduction pathway and be
      associated with human carcinogenesis. In situ hybridization is a powerful tool
      for analyzing gene expression in formalin-fixed, paraffin-embedded tissue
      sections, especially for newly cloned genes or when no antibodies are available.
      Detection of altered retinoid receptor expression using in situ hybridization in
      premalignant and malignant tissues has provided important information about the
      roles of these receptors in cancer development and the response of these tissues
      to retinoid treatment. Among these receptors, altered expression of retinoic acid
      receptor-beta (RAR-beta) has been mostly detected in human cancers, including
      those of the head and neck, lung, esophagus, mammary gland, pancreas, and cervix.
      RAR-beta is thus currently used as a surrogate endpoint biomarker in different
      clinical prevention trials of various cancers.

PMID- 11193197
TI  - Ageing of the human oviduct: lectin histochemistry.
AB  - The aim of the present research was to investigate the changes of the sugar
      residues in the oviduct in the course of ageing in postmenopausal women vs
      normally menstruating women, by means of lectin histochemistry. Twenty
      asymptomatic postmenopausal women (48-83 years old) were recruited among patients
      who underwent a vaginal hysterectomy. Eight normally menstruating women were
      recruited as controls. Fragments of Fallopian tubes (pars ampullaris) were fixed
      in 10% formalin and routinely processed. The sections were labelled with HRP
      lectins (PNA, SBA, DBA, WGA, Con A, LTA, UEAI). Some sections were pre-treated
      with neuraminidase prior to staining with HRP-lectins. Among the postmenopausal
      patients, our histochemical data showed that there was no difference in the
      localization and distribution of sugar residues of glycoconjugates as detected by
      various HRP-lectins. Moreover, our results demonstrated that the oviductal
      epithelium is characterized by apical reactivity in both ciliated and non
      ciliated cells. In the course of ageing, the ciliated cells changed their
      morphology from bathyprismatic to large and rounded shape. ConA lectin reacted
      intensely with such highly degenerating ciliated cells and could be considered a
      marker of these cells. The degenerating ciliated cells are also characterized by
      the absence of sialic acid. In comparison with the sugar residues present in the
      control group, the oviductal epithelium of postmenopausal women is characterized
      by the loss of reactivity with DBA, WGA and ConA. Moreover, PNA reactive material
      was present at the free border of the ciliated and non-ciliated cells. The latter
      findings were statistically confirmed and could be considered strictly related to
      the ageing process.

PMID- 11193198
TI  - Bone marrow engraftment: histopathology of hematopoietic reconstitution following
      allogeneic transplantation in CML patients.
AB  - Following myelo-ablative treatment and allogeneic bone marrow transplantation
      (BMT) in chronic myelogenous leukemia (CML) histopathological features assumed to
      exert a significant impact on engraftment have been rarely investigated
      systematically. This review is focused on immunohistochemical and morphometric
      techniques involving nucleated erythroid precursors, resident macrophages and
      their various subsets, megakaryocytes and finally argyrophilic (reticulin
      collagen) fibers. Regarding standardized intervals of examination in the
      postgraft sequential trephine biopsies a pronounced reduction in cellularity was
      obvious and accompanied by a decrease in the quantity of erythro- and
      megakaryopoiesis. A significant correlation between the number of erythroid
      precursors and CD68+-macrophages could be determined in the areas of regenerating
      hematopoiesis. This finding is in keeping with the important functional role of
      the centrally localized mature macrophages during erythropoiesis. A relevant
      pretransplant reduction of the red cell lineage and an early to advanced
      reticulin fibrosis were correlated with a low hemoglobin level (anemia) and
      splenomegaly and furthermore associated with a significant delay to reach
      transfusion independence. This result was supported by corresponding findings in
      biopsy specimens performed shortly after day 30 following BMT (standard interval
      for assessment of engraftment). Samples revealed an enhancement of fiber density
      and a conspicuous decrease in the amount of erythropoiesis in the small fraction
      of patients who did not conform with the usually accepted criteria for successful
      hematopoietic reconstitution. Considering the compartment of histiocytic
      reticular cells the recurrence of Pseudo-Gaucher cells (PCGs) in the engrafted
      donor marrow was remarkable and most prominently expressed in the first two
      months following BMT. This feature was presumed to be functionally linked with a
      pronounced degradation of cell debris in the sequel of myelo-ablative therapy
      (scavenger macrophages). According to planimetric measurements in the postgraft
      bone marrow the atypical dwarf-like CD61+-megakaryocytes characteristic for CML
      disappeared. On the other hand, normalization of megakaryocyte size and nuclear
      lobulation were absent in sequential examination of the few patients developing a
      leukemic relapse. In a number of patients with manifest myelofibrosis at onset,
      an initial regression after BMT was followed by an insidiously occurring
      retrieval which was concentrated on the areas of reconstituting hematopoiesis.
      Similar to its relevant pretransplant association the postgraft reappearance of
      myelofibrosis was significantly correlated with the quantity of CD61+
      megakaryocytes. Altogether a number of histological features in the pre-and
      postgraft bone marrow exhibited significant correlations with each other and thus
      indicated functional relationships. Moreover, quantity of erythropoiesis and
      amount of reticulin fibers (myelofibrosis) exerted a significant impact on
      engraftment status.

PMID- 11193199
TI  - A new morpho-functional classification of the Fallopian tube based on its three
      dimensional myoarchitecture.
AB  - The recent direct observations, under scanning electron microscopy (SEM), of the
      three-dimensional architecture of myosalpinx in different mammals allows us
      classify salpinxes according to the myoarchitecture of their tubo-uterine
      junction (TUJ) and isthmus segments. Based upon the myoarchitecture of the outer
      wall of the TUJ we could find barrier-like species (rat and sow), sphincter-like
      species type a (rabbit and ewe) and sphincter-like species type b (cow and
      woman). The different architecture of TUJ can be explained by the different
      nature of the mating process. Based upon the myoarchitecture of the isthmus we
      could distinguish type 1 (rat) and type 2 (rabbit, ewe, sow, cow and woman)
      salpinxes. In the latter the close fusion of musculature deriving from the meso
      (extrinsic musculature) with the musculature of salpinx (intrinsic musculature)
      suggests the existence of a unique mesosalpinx contractile system. The myosalpinx
      is mostly made up of a single network of muscular fibers. Such a plexiform
      structure, owing to the uneven distribution of fibers, rather than producing a
      series of regular contraction waves, is more likely to generate random
      contraction waves. The random propagation of muscular network contraction may
      deform the plexiform wall of the myosalpinx causing the stirring of tubal
      contents. By such a stirring movement the contact between hormones and nutrients
      and the eggs or embryos is intensified, thus favoring a correct fertilization and
      early embryo development. Taken all together, these systematic results probably
      suggest an additional and rather new function for the musculature of the tube,
      namely to increase fertility in a large number of species.

PMID- 11193200
TI  - Pax genes in development and maturation of the vertebrate visual system:
      implications for optic nerve regeneration.
AB  - Pax genes play a pivotal role in development of the vertebrate visual system.
      Pax6 is the master control gene for eye development: ectopic expression of Pax6
      in Xenopus laevis and Drosphila melanogaster leads to the formation of
      differentiated eyes on the legs or wings. Pax6 is involved in formation of
      ganglion cells of the retina, as well as cells of the lens, iris and cornea. In
      addition Pax6 may play a role in axon guidance in the visual system. Pax2
      regulates differentiation of the optic disk through which retinal ganglion cell
      axons exit the eye. Furthermore, Pax2 plays a critical role in development of the
      optic chiasm and in the guidance of axons along the contralateral or ipsilateral
      tracts of the optic nerve to visual targets in the brain. During development Pax7
      is expressed in neuronal cells of one of the major visual targets in the brain,
      the optic tectum/superior colliculus. Neurons expressing Pax7 migrate towards the
      pia and concentrate in the stratum griseum superficiale (SGFS), the target site
      for retinal axons. Together, expression of Pax2, 6 and 7 may guide axons during
      formation of functional retinotectal/collicular projections. Highly regulated Pax
      gene expression is also observed in mature animals. Moreover, evidence suggests
      that Pax genes are important for regeneration of the visual system. We are
      currently investigating Pax gene expression in species that display a range of
      outcomes of optic nerve regeneration. We predict that such information will
      provide valuable insights for the induction of successful regeneration of the
      optic nerve and of other regions of the central nervous system in mammals
      including man.

PMID- 11193201
TI  - Hepatocyte growth factor activators, inhibitors and antagonists and their
      implication in cancer intervention.
AB  - Hepatocyte growth factor (HGF), otherwise known as scatter factor (SF), has been
      demonstrated over the past decade to elicit a number of functions that may be
      tumorigenic, and enhance the invasive/metastatic nature of cancer cells. Clinical
      studies have also demonstrated that HGF/SF, together with its receptor, cMET, is
      closely related to the disease progression and prognosis of patients with cancer.
      The past few years have seen the identification of numerous inhibitors and
      antagonists to the action of HGF/SF. These factors have demonstrated a possible
      role in minimising the action of HGF/SF on cancer cells, and may be of
      therapeutic value in the future. This article overviews the activators,
      inhibitors, and antagonists to HGF/SF and discusses the possible implications in
      cancer therapy.

PMID- 11193202
TI  - Farnesyltransferase inhibitors define a role for RhoB in controlling neoplastic
      pathophysiology.
AB  - A long-standing goal in cancer research is to identify cellular functions that
      have selective roles in regulating neoplastic pathophysiology. Farnesyl
      transferase inhibitors (FTIs) are a novel class of cancer chemotherapeutics which
      have little effect on normal cell physiology but which inhibit or reverse
      malignant cell phenotypes. FTIs were originally developed as a strategy to
      inhibit oncogenic Ras, the activity of which depends upon posttranslational
      farnesylation. However, recent work indicates the antineoplastic effects of FTIs
      are not linked to Ras inhibition but instead to alteration of RhoB, a small
      GTPase of the Rho family of cytoskeletal regulators that controls trafficking of
      cell surface receptors. Rho proteins integrate signals from integrins and
      cytokine receptors with cell shape via the actin cytoskeleton. A connection
      between FTIs and Rho alteration is interesting given that histological
      differences have long been used to define clinical cancer. RhoB is dispensable
      for normal cell growth and differentiation in mice. Thus, research into the
      antineoplastic effects of FTIs has led to the identification of a function(s)
      that is unnecessary for normal cell physiology but crucial for controlling
      malignant phenotypes.

PMID- 11193203
TI  - Vasculature of the normal and arthritic synovial joint.
AB  - The vasculature of the normal and arthritic knee is described. The joint contains
      a number of different tissues, many of which are heterogeneous and each with
      varying degrees of vascularization. In the normal joint the vasculature is highly
      organised, some tissues are highly vascular with well defined vascular
      organisation, whilst other tissues are avascular. During arthritis vascular
      turnover is increased. This vascular plasticity leads to redistribution of the
      vascular bed and may compromise its functional ability. The normal joint is able
      to regulate its blood flow, but this ability may be compromised by the
      inflammation and increased synovial fluid volume that are associated with joint
      disease. Growth of the subchondral vasculature into the articular cartilage may
      also occur, leading to ossification of the articular cartilage.

PMID- 11193204
TI  - Involvement of gap junctional communication and connexin expression in
      trophoblast differentiation of the human placenta.
AB  - Gap junctional intercellular communication (GJIC) permits coordinated cellular
      activities during development and differentiation processes, and its dysfunction
      or mutation of connexin genes have been implicated in pathologies. In the human
      placenta, two distinct differentiation pathways of cytotrophoblastic cell coexist
      leading to a double model: fusion phenotype (villous trophoblast) and
      proliferative/invasive phenotype (extravillous trophoblast). This review focuses
      on current knowledge on the connexin expression and the implication of GJIC in
      trophoblastic differentiation. Experimental evidence obtained in human placenta
      demonstrates the involvement of connexin 43-gap junctions in the trophoblastic
      fusion process and of a connexin switch during the spatially and temporally
      controlled proliferation/invasion process.

PMID- 11193205
TI  - Effect of endurance running on cardiac and skeletal muscle in rats.
AB  - We studied the effect of resistance running on left cardiac ventricle size and
      rectus femoris muscle fiber composition. Ten male Wistar rats were trained on a
      treadmill 6 days per week for 12 weeks. Ten rats remained sedentary and served as
      controls. A higher endurance time (40%) and cardiac hypertrophy in the trained
      animals were indicators of training efficiency. Morphometric analysis of the left
      ventricle cross-sectional area, left ventricular wall, and left ventricular
      cavity were evaluated. The endurance-running group demonstrated a hypertrophy of
      the ventricular wall (22%) and an increase in the ventricular cavity (25%);
      (p<0.0001). Semi-quantitative analysis of rectus femoris fiber-type composition
      and of the oxidative and glycolytic capacity was histochemically performed.
      Endurance running demonstrated a significant (p<0.01) increase in the relative
      frequency of Type I (24%), Type IIA (8%) and Type IIX (16%) oxidative fibers, and
      a decrease in Type IIB (20%) glycolytic fibers. There was a hypertrophy of both
      oxidative and glycolytic fiber types. The relative cross-sectional area analysis
      demonstrated an increase in oxidative fibers and a decrease in glycolytic fibers
      (p<0.0001). Changes were especially evident for Type IIX oxidative-glycolytic
      fibers. The results of this study indicate that the left ventricle adapts to
      endurance running by increasing wall thickness and enlargement of the ventricular
      cavity. Skeletal muscle adapts to training by increasing oxidative fiber Type.
      This increase may be related to fiber transformation from Type IIB glycolytic to
      Type IIX oxidative fibers. These results open the possibility for the use of this
      type of exercise to prevent muscular atrophy associated with age or post
      immobilization.

PMID- 11193206
TI  - The histogenesis of giant cell tumour of bone: a model of interaction between
      neoplastic cells and osteoclasts.
AB  - Giant cell tumour of bone (GCT) is a benign primary neoplasm of a bone
      characterised by distinctive clinical, radiological and pathological features.
      Females are slightly more often affected than males, and the majority of patients
      present between the ages of 20 and 50. GCT is locally aggressive and produces
      expansive and lytic lesions, most commonly in the epiphyses of long tubular
      bones. Histologically, it is composed of oval and spindle mononuclear cells,
      uniformly distributed amongst which are large multinucleated osteoclast-like
      giant cells. Although the term "Giant Cell Tumour" (and the erroneous historical
      term 'osteoclastoma') may imply that it is the multinucleated giant cells which
      are responsible for the proliferative capacity of the tumour, there is evidence
      that the stromal-like cells, the major component of the mononuclear cell
      population, represent the true neoplastic component of the neoplasm. The
      diagnosis and management of conventional GCT are often challenging and there is
      considerable current interest in its pathobiology. The precise histogenesis of
      GCT and the nature of its varying cellular constituents have remained a matter of
      some controversy. Factors influencing the clinical course and biological
      aggression of GCT are also unclear. In this selective review, the
      clinicopathological characteristics of GCT are summarised and current areas of
      interest in the study of the neoplasm are presented and discussed. Lastly, a
      hypothetical model of the mechanism of histogenesis and the biological behaviour
      of GCT is presented.

PMID- 11193207
TI  - Photodynamic therapy: shedding light on the biochemical pathways regulating
      porphyrin-mediated cell death.
AB  - Photodynamic therapy (PDT) is a clinically approved treatment for the ocular
      condition age-related macular degeneration, and certain types of cancer. PDT is
      also under investigation for other ocular, as well as, immune-mediated and
      cardiovascular indications. PDT is a two step procedure. In the first step, the
      photosensitizer, usually a porphyrin derivative, is administered and taken up by
      cells. The second step involves activation of the photosensitizer with a specific
      wavelength of visible light. Exposure to light of an activating wavelength
      generates reactive oxygen species within cells containing photosensitizer. PDT
      with porphyrin photosensitizers induces rapid apoptotic cell death, an event
      which may be attributed to the close association of these compounds with
      mitochondria. Thus, PDT is an attractive method to treat ailments such as cancer,
      viral infections, autoimmune disorders and certain cardiovascular diseases in
      which the apoptotic program may be compromised. The present review examines the
      cellular events triggered at lethal and sublethal PDT doses and their
      relationship to the subsequent effects exerted upon cells.

PMID- 11193208
TI  - Molecular medicine of TFF-peptides: from gut to brain.
AB  - TFF-peptides (i.e. TFF1, TFF2, TFF3; formerly P-domain peptides, trefoil factors)
      have been established as secretory products typical of the gastrointestinal
      tract. Their synthesis has recently been recognized in a number of mucin
      producing epithelial cells, for example, of the respiratory tract, the salivary
      glands, the uterus and of the conjunctiva. They have a pivotal role in
      maintaining the surface integrity of these delicate epithelia as constituents of
      mucus gels as well as by their anti-apoptotic properties and their motogenic
      activity modulating cell migratory processes. The latter is important for rapid
      healing in particular of gastrointestinal and respiratory epithelia by a process
      termed "restitution". On the other hand, one of these peptides--namely TFF3--has
      been detected as a new neuropeptide of the human hypothalamo-pituitary axis where
      it is synthesized in oxytocinergic neurons of the paraventricular and supraoptic
      nuclei. From there it is transported to the posterior pituitary where it is
      released into the blood stream. Synthesis of TFF-peptides also occurs
      pathologically as result to chronic inflammatory diseases, for example of the
      gastrointestinal tract. Aberrant synthesis of TFF-peptides is observed in many
      tumors.

PMID- 11193209
TI  - Significance of proneural basic helix-loop-helix transcription factors in
      neuroendocrine differentiation of fetal lung epithelial cells and lung carcinoma
      cells.
AB  - In this brief review article, we describe how cell fate determination by which
      the airway epithelial cells become neuroendocrine or non-neuroendocrine is
      regulated by a network of basic helix-loop-helix transcription (bHLH) factors in
      a similar manner to neuronal differentiation, and how this system could work to
      determine cell differentiation of human lung carcinomas. Immunohistochemical
      studies reveal that mammalina achaete-scute complex homologue (Mash)1 is
      expressed in pulmonary neuroendocrine cells (PNEC), while hairy and Enhancer of
      split (Hes)1 is expressed in pulmonary non-neuroendocrine cells (non-PNEC).
      Studies using gene-deficient mice for the bHLH factors revealed that in Mash1
      homozygous null mice no PNEC are detected, while PNEC increase markedly in Hes1
      homozygous null mice. These observations suggest that Mash1 is an essential
      positive factor for neuroendocrine differentiation of lung epithelium, and that
      Hes1 is one of the repressive factors for neuroendocrine differentiation.
      Moreover, immunohistochemical studies revealed that Notch receptors are detected
      in non-PNEC, and thus the Notch signalling pathway could play a role in the
      determination of airway epithelial cell differentiation. In human lung
      carcinomas, a similar bHLH network should operate to determine cell
      differentiation phenotypes. Generally, expression of the human homologue of Mash1
      (HASH1) is detected in small cell carcinoma and carcinoids, while Hes1 seems to
      be expressed mainly in non-small cell carcinoma. Thus, proneuronal bHLH factors
      may play roles in cell fate determination of the airway epithelial system, and
      may regulate human airway epithelial cells in diseased conditions.

PMID- 11193210
TI  - Ultrastructural evidence in vitro of osteoclast-induced degradation of calcium
      phosphate ceramic by simultaneous resorption and phagocytosis mechanisms.
AB  - Osteoclasts are physiological polykaryons specialized in the resorption of
      calcified tissue. In the context of the clinical use of calcium-phosphate (CaP)
      ceramics as bone substitutes, this study used transmission electron microscopy to
      investigate the in vitro mechanisms of CaP ceramic degradation by osteoclastic
      cell types. Osteoclasts cultured on CaP ceramic developed typical ultrastructural
      features of bone osteoclasts, such as a polarized dome shape, a clear zone and a
      ruffled border. Modification of the shape and density of CaP crystals under the
      ruffled border indicated an acidic microenvironment. Moreover, osteoclasts were
      able to degrade ceramic by simultaneous resorption and phagocytosis mechanisms.
      Phagocytosis did not alter the ability of osteoclasts to resorb CaP ceramic. The
      phagocytosis mechanism consisted of three steps: crystal phagocytosis,
      disappearance of the endophagosome envelope membrane and fragmentation of
      phagocytosed crystals within the cytoplasm. The common mechanism of phagocytosis
      described here is similar to that observed with the monocyte/macrophage lineage,
      confirming that osteoclasts are part of the mononuclear phagocyte system.
      Osteoclasts are thus clearly involved in CaP degradation by means of resorption
      and phagocytosis.

PMID- 11193211
TI  - Counts and areas of S-100-positive epidermal dendritic cells in atypical
      molluscum contagiosum affecting HIV+ patients.
AB  - Molluscum contagiosum is a common and self-limiting viral infection, that in HIV+
      patients courses as an opportunist affection with atypical clinical features.
      Impaired cell-mediated immune response could be involved in such atypical growth.
      We evaluated the density and area of Langerhans cells (LC) using S-100
      immunohistochemistry in seven atypical molluscum contagiosum. LC density was
      quantified by three different methods using computer-assisted morphometry as well
      as estimating the relative area of LC with respect to epidermal area. Results
      were compared with two control groups (normal skin specimens and molluscum
      contagiosum affecting non-AIDS healthy patients). We found a virtual absence of
      LC in areas of molluscum lesions affecting both HIV+ and non-AIDS patients.
      Likewise we observed an evident decrease in LC density in perilesional epidermis
      of atypical molluscum with respect to both control groups. Upon comparing the
      counts and areas, we observed that this reduction in LC count was statistically
      significant only when considering LC related to length of basement membrane in
      atypical molluscum with respect to normal skin specimens. Our finding of a
      reduced number of LC in the perilesional epidermis of HIV+ patients with atypical
      molluscum could explain the high frequency and clinical challenge of molluscum
      contagiosum in immunocompromised people. In spite of these results, further
      studies of LC kinetics and functions are required to precisely elucidate their
      role in the course of molluscum contagiosum in HIV+ patients.

PMID- 11193212
TI  - Human lung fructose-1,6-bisphosphatase is localized in pneumocytes II.
AB  - The localization of fructose-1,6-bisphosphatase (Fru-1,6-Pase EC 3.1.3.11) in
      human alveolar epithelium was determined immunohistochemically using a polyclonal
      antibody raised against the enzyme purified from human liver. The
      immunohistochemical analysis revealed that the Fru-1,6-Pase was localized in
      pneumocytes II and was absent in pneumocytes I. Hypothetically Fru-1,6-Pase
      participating in glucose-6-phosphate synthesis from noncarbohydrate precursors
      increases NADPH level which is used for surfactant synthesis and for glutathione
      redox cycle.

PMID- 11193213
TI  - The fibronexus in reactive and tumoral myofibroblasts: further characterisation
      by electron microscopy.
AB  - Forty two surgical specimens containing myofibroblasts were studied to clarify
      the criteria for identifying the fibronexus, an ultrastructural feature regarded
      as a marker for myofibroblastic differentiation. Granulation tissue, tumour
      stroma, fibro-proliferative lesions (nodular fasciitis, myofibromatosis,
      inflammatory myofibroblastic tumour) and malignancies (myofibrosarcoma and
      fibrosarcoma) were studied. Comparable results were found throughout these
      specimens, although fibronexus junctions were better developed in reactive
      compared with tumoral myofibroblasts. By electron microscopy, myofibroblasts were
      identified by abundant rough endoplasmic reticulum, peripheral smooth-muscle
      myofilaments with focal densities, and fibronexus junctions. The latter were
      recognised as the points of convergence on the myofibroblast surfaces of
      intracellular myofilaments and extracellular fibronectin fibrils. The fibronectin
      fibrils were often co-linear with myofilaments. Also, fibronectin fibrils were
      dark-staining, straight and rigid-looking, and had a longitudinal filamentous
      substructure. A striking feature was the tendency of fibronectin fibrils to
      project into the surrounding extracellular space, away from the myofibroblast
      surface: in these respects, they differed significantly from lamina ("basement
      membrane"). The presence of fibronectin fibrils correlated positively with
      fibronectin immunostaining by light and electron microscopy. Laminin and collagen
      IV showed variable and weak staining in the intercellular spaces in a minority of
      cases and never strongly stained myofibroblast surfaces. The data emphasise that
      the fibronexus has a number of distinctive features permitting identification,
      and constitute a reference-point for pathologists wishing to use electron
      microscopy to refine light microscopy diagnoses of putative myofibroblastic
      lesions. The role of the fibronexus in the definition of the myofibroblast is
      discussed.

PMID- 11193214
TI  - Glypican-3 (GPC3) expression in human placenta: localization to the
      differentiated syncytiotrophoblast.
AB  - The expression of glypican-3 (GPC3), a heparan-sulfate proteoglycan associated
      with the Simpson-Golabi-Behmel fetal overgrowth syndrome, was studied in normal
      human placental tissue and cell lines derived from human placentae.
      Cytotrophoblasts derived from term placentae expressed GPC3 mRNA at low levels in
      culture. GPC3 mRNA expression increased markedly during trophoblast
      differentiation. By contrast, fibroblast cell lines derived from normal placentae
      did not express GPC3 in culture. Similarly, choriocarcinoma cell lines derived
      from human placentae (BeWo, JAR, and JEG) failed to express GPC3 mRNA. In situ
      hybridization confirmed the localization of GPC3 mRNA to the syncytiotrophoblast.
      Furthermore, immunohistochemical staining of paraffin imbedded placental tissue
      demonstrated intense staining of the syncytiotrophoblast cell layer and less
      intense staining of cytotrophoblasts. No staining of mesenchymal elements was
      noted. These data confirm the presence of GPC3 in human placenta and suggest it
      is expressed by the differentiated syncytiotrophoblast at term.

PMID- 11193215
TI  - Apoptotic cell death and cell proliferative activity in the rat fetal central
      nervous system from dams administered with ethylnitrosourea (ENU).
AB  - Ethylnitrosourea (ENU), a well known DNA alkylating agent, induces anomalies in
      the central nervous system (CNS), craniofacial tissues and male reproductive
      organs, and the enhancement of apoptosis is found in these tissues immediately
      after the administration of ENU (Katayama et al., 2000a). In this study, pregnant
      rats were treated with 60mg/kg of ENU at day 13 of gestation, and kinetics of
      apoptotic cells, mitotic cells and bromodeoxyuridine (BrdU)-positive cells in the
      fetal CNS were examined from 3 to 48 hours after the treatment (HAT). From 3 HAT,
      a significant increase in the number of apoptotic cells and a significant
      decrease in the number of mitotic cells were detected in the fetal CNS, and BrdU
      positive cells significantly decreased in accordance with the increase in the
      number of apoptotic cells. The present results strongly suggest that both excess
      cell death by apoptosis and cell growth arrest indicated by decreased number of
      mitotic cells and BrdU-positive cells may have a close relation to the later
      occurrence of microencephaly following ENU-administration, and that ENU affects
      mainly S-phase cells and causes apoptosis.

PMID- 11193216
TI  - TIMP-1 promotes VEGF-induced neovascularization in the retina.
AB  - Proteolysis of vascular basement membranes and surrounding extracellular matrix
      is a critical early step in neovascularization. It requires alteration of the
      balance between matrix metalloproteinases (MMPs) and proteins that bind to and
      inactivate MMPs, tissue inhibitors of metalloproteinases (TIMPs). TIMP-1 has been
      demonstrated to inhibit neovascularization in chick chorioallantoic membranes.
      However, TIMP-1 has also been shown to either promote or inhibit cell
      proliferation and migration in different settings. To determine whether genetic
      alteration of the MMP/TIMP-1 ratio would alter retinal neovascularization, we
      crossed mice that express vascular endothelial growth factor (VEGF) in
      photoreceptors with TIMP-1-deficient mice or mice that overexpress TIMP-1.
      Compared to VEGF transgene-positive/TIMP-1-sufficient mice, VEGF transgene
      positive/TIMP-1-deficient mice showed smaller neovascular lesions. There was also
      no difference between the two groups of mice in the appearance of the
      neovascularization by light or electron microscopy. Compound VEGF/TIMP-1
      transgenic mice had increased expression of both VEGF and TIMP-1 in the retina,
      and had more neovascularization than mice that had increased expression of VEGF
      alone. These gain- and loss-of-function data suggest that alteration of the TIMP
      1/MMP ratio modulates retinal neovascularization in a complex manner and not
      simply by altering the proteolytic activity and thereby invasiveness of
      endothelial cells.

PMID- 11193217
TI  - Prognostic value of p53 protein expression and clinicopathological factors in
      infiltrating ductal carcinoma of the breast. A study of 192 patients.
AB  - The p53 gene is located on the short arm of chromosome 17. It encodes a 53-kd
      nuclear protein (p53) found in scant amounts in normal tissue. Mutations of the
      p53 gene have been reported in different human tumours. In breast cancer, it has
      been noted that the overexpression of p53 protein in the nucleus is an indicator
      of poor prognosis, although there is a high degree of variability, which may be
      due to different immunohistochemical techniques, varying assessment of results
      and the type of monoclonal antibody used. This study is an immunohistochemical
      analysis of p53 expression in 192 cases of infiltrating ductal carcinoma of the
      breast, correlating it with clinicopathological factors and the clinical course
      of the disease. Of all the breast-cancer tissue analysed, stains for p53 antibody
      were found in 87 tumours (45.3%). The results of multivariate analysis show that
      the independent predictors related to recurrence are tumour size, lymph-node
      metastasis and p53, while those related to death are necrosis, lymph-node
      metastasis and p53. In summary, our series showed prognostic significance between
      the expression of p53 and shorter survival time and disease-free interval for all
      patients in general as well as those who presented lymph-node metastases at the
      time of diagnosis.

PMID- 11193218
TI  - Volume visualization in radiation treatment planning.
AB  - Radiation treatment planning (RTP), historically an image-intensive discipline
      and one of the first areas in which 3D information from imaging was clinically
      applied, has become even more critically dependent on accurate 3D definition of
      target and non-target structures in recent years with the advent of conformal
      radiation therapy. In addition to the interactive display of wireframe or shaded
      surface models of anatomic objects, proposed radiation beams, beam modifying
      devices, and calculated dose distributions, recently significant use has been
      made of direct visualization of relevant anatomy from image data. Dedicated
      systems are commercially available for the purpose of geometrically optimizing
      beam placement, implementing in virtual reality the functionality of standard
      radiation therapy simulators. Such "CT simulation" systems rely heavily on 3D
      visualization and on reprojection of image data to produce simulated radiographs
      for comparison with either diagnostic-quality radiographs made on a simulator or
      megavoltage images made using the therapeutic beams themselves. Although
      calculation and analysis of dose distributions is an important component of
      radiation treatment design, geometric targeting with optimization based on 3D
      anatomic information is frequently performed as a separate step independent of
      dose calculations.

PMID- 11193219
TI  - Tarsal joint kinematics via 3D imaging.

PMID- 11193220
TI  - An age-related decline in melatonin secretion is not altered by food restriction.
AB  - Melatonin has been found to exhibit youth-maintaining and disease-preventing
      properties. The current study examined whether the age-retarding regimen of
      chronic food restriction (FR) slowed the decline in melatonin secretion reported
      to occur with age. Total nocturnal melatonin secretion was assessed by
      radioimmunoassay of the primary metabolite, 6-sulphatoxymelatonin (6-S-OH-MLT),
      in urine. Measurements were made through adulthood (70 to 765 days) on male
      Wistar rats maintained on the FR regimen (60% of the normal intake) with the
      control animals fed ad libitum (AL). The data of animals exhibiting gross
      pathology were excluded. Analyses of covariance found the FR regimen had no
      effect on either the levels or pattern of decline observed in 6-S-OH-MLT
      excretion through adulthood. However, the FR body-weight-indexed metabolite
      measures were approximately double those of the AL (p = .06). The possibility
      that this result may reflect unusually high melatonin peaks in the FR tissues is
      discussed.

PMID- 11193221
TI  - Age-associated accumulation of the apolipoprotein C-III gene T-455C polymorphism
      C allele in a Russian population.
AB  - Apolipoprotein C-III (apoC-III) is the major component of triglyceride-rich
      lipoproteins. One of six identified polymorphisms in the apoC-III 5'-untranslated
      region (T-455C) is located within a functional insulin-response element. In a
      group of 137 elderly individuals (70-106 years old), the allele distribution was
      analyzed using restriction fragment length polymorphisms. Statistical analysis of
      allele frequencies was performed on subgroups selected by age and in elderly
      patients with arterial hypertension or ischemic heart disease. A greater
      frequency of the apoC-III -455C allele was demonstrated with aging (p < .005). No
      statistically significant difference in allele distributions was detected between
      healthy subjects and groups of elderly patients of the same age with either
      ischemic heart disease or arterial hypertension. The increased incidence of the C
      allele with advanced age indicates that this variant promoter is associated with
      longevity. The greater incidence of this allele is detectable only in adults
      older than 80 years of age.

PMID- 11193222
TI  - Accuracy of equations for predicting stature from knee height, and assessment of
      statural loss in an older Italian population.
AB  - We determined the applicability of deriving the stature from knee height in an
      older Italian population, and, in the same population, we assessed longitudinally
      the change in stature over a 6-year interval. The standing stature and knee
      height in a supine position were measured in the entire home-dwelling older (65 +
      years) population of a small Italian town (N = 606). Stature measured in 1989 and
      in 1995 was used to assess longitudinal changes in 258 subjects of the same
      population. Stature derived from knee height was greater than measured stature in
      this population and in the two sexes. This difference disappeared when subjects
      with evident kyphosis were excluded. From 1989 to 1995, stature decreased by
      1.7+/-3.0 cm, with women showing a larger decrement than men. Stature estimated
      from knee height is more accurate than measured stature in subjects with
      kyphosis. In accordance with previous studies, stature decreases with aging, and
      such height loss is greater in women than in men.

PMID- 11193223
TI  - Effects of chronic food restriction and exercise training on the recovery of
      cardiac function following ischemia.
AB  - Clinical and experimental data suggest that exercise training (ET) and food
      restriction (FR) improve cardiovascular function. However, the effects of long
      term FR or FR in combination with ET on the recovery of cardiac function
      following ischemia have not been determined. Male Wistar rats were assigned to ad
      libitum-fed, FR, ad libitum-exercise, and FR-exercise groups. Mechanical function
      of isolated working hearts was assessed in response to increases in afterload
      resistance and following global no-flow ischemia. At low workload, there was a
      significant FR effect on aortic flow as well as an interaction between FR and ET
      on systolic pressure. These effects remained when hearts were subjected to
      increases in aortic afterload resistance. During reperfusion of ischemic hearts,
      there was a significant FR effect on aortic flow and systolic pressure and a
      significant ET effect on diastolic pressure. An interaction between FR and ET on
      heart rate was also seen during reperfusion. In terms of percent recovery of
      heart function following ischemia, FR continued to affect aortic flow, and we
      observed an interaction between FR and ET on aortic flow. Our results clearly
      indicate that the myocardium from the FR animal or the FR, exercise-trained rat
      is more resistant to ischemia.

PMID- 11193224
TI  - Low- or high-intensity strength training partially restores impaired quadriceps
      force accuracy and steadiness in aged adults.
AB  - Because many daily tasks are executed at only a fraction of maximal strength, an
      understanding of submaximal force control may be important for improving function
      in aged adults. We compared the effects of low- and high-intensity (LI and HI,
      respectively) strength training on maximal and explosive strength and on the
      accuracy (force error) and steadiness (variability) of submaximal quadriceps
      force in elderly humans. Older subjects (age, 72 years; n = 27) had 57% lower
      maximal strength in comparison with young subjects (age, 21 years; n = 10). Older
      subjects had 190% (19 N), 50% (1 N), and 80% (4 N) more force error in matching
      25 N of quadriceps force during eccentric, isometric, and concentric
      contractions, and had 157%, 0%, and 60% more variability in these forces compared
      with young subjects. Force error and force variability were correlated with each
      other but not with maximal strength. Thirty sessions of LI (n = 9 participants)
      or HI (n = 9 participants) training of equal total work increased maximal
      strength in the older subjects by 29%. Training also significantly reduced force
      error and variability--by 31% and 30%, respectively--of eccentric and concentric
      contractions. A control group of older subjects (n = 9) showed no significant
      changes in any variables. LI or HI strength training was equally effective in
      partially restoring elderly adults' maximal strength and control of submaximal
      force.

PMID- 11193225
TI  - Human diploid fibroblasts that undergo a senescent-like differentiation have
      elevated ceramide and diacylglycerol.
AB  - Senescent human diploid fibroblasts (HDF) have elevated levels of ceramide and
      diacylglycerol (DAG) compared with young HDF. DNA fragmentation analysis
      demonstrated the increased ceramide in senescent HDF was not associated with
      apoptosis, whereas in young HDF, exogenous ceramide induced apoptosis. In young
      HDF treated with both exogenous ceramide and DAG, less DNA fragmentation was
      observed. Thus, elevated DAG levels in senescent HDF might protect against
      ceramide-induced apoptosis. To determine which characteristics of senescent HDF
      (aging per se, cell cycle arrest, elevated p21Sdi1,Waf1,Cip1, and senescent-like
      differentiation) might influence ceramide and DAG, we examined transformed or
      mitomycin C-treated HDF that shared some of these properties with senescent HDF.
      The elevation of ceramide and DAG did not depend on aging per se, cell cycle
      arrest, or elevation of p21. Rather, ceramide and DAG may be elevated as part of
      a program of differentiation that is induced by either aging or DNA damage.

PMID- 11193226
TI  - Prevalence rate of urinary incontinence in community-dwelling elderly
      individuals: the Veneto study.
AB  - BACKGROUND: Urinary incontinence (UI) is a common problem in elderly people, due
      mainly to functional impairments and concurrent medical diseases. Few studies,
      however, have assessed the prevalence of UI in noninstitutionalized individuals.
      The objectives of the present work were to estimate the prevalence of UI in a
      community-based population of elderly Italians and to determine the associated
      physical, social, and psychological factors. METHODS: A random sample of
      noninstitutionalized men (n = 867) and women (n = 1531), aged 65 years and older,
      from the Veneto region of northeastern Italy, were interviewed at home, using an
      extensive multidisciplinary questionnaire, to assess their quality of life and
      social, biological, and psychological correlates. RESULTS: The prevalence rate of
      UI was of 11.2% among men and of 21.6% among women. Among those reporting the
      condition, approximately 53% of women and 59% of men reported experiencing
      incontinence daily or weekly. Association of UI was found for participants older
      than 70 years in both men (odds ratio [OR] 2.49, 95% confidence interval [CI]
      1.45-4.28) and women (OR 1.49, 95% CI 1.11-2.02). Three of the medical conditions
      investigated were associated with increases in the odds in women, namely chronic
      obstructive pulmonary disease (OR 1.53, 95% CI 1.11-2.12), Parkinsonism (OR 2.27,
      95% CI 1.14-4.54), and hip fracture (OR 1.38,95% CI 1.02-1.88), whereas chronic
      diarrhea was the only condition associated with UI in men (OR 6.92, 95% CI 2.22
      21.5). Participants with a physical disability were two times more likely to
      report incontinence, and the odds were increased by 50% in women who had sleep
      disturbances. CONCLUSIONS: Incontinence is highly prevalent in the Italian
      elderly population, and several common chronic conditions are significantly
      associated with it. Moreover, very few people with incontinence seek health care
      or are aware of potential treatments.

PMID- 11193227
TI  - New-onset incontinence and markers of frailty: data from the Hispanic Established
      Populations for Epidemiologic Studies of the Elderly.
AB  - BACKGROUND: Urinary incontinence in older adults has many distinct etiologies and
      is associated with lower self-reported health. However, it is unclear whether the
      new onset of urinary incontinence marks newly emergent frailty. METHODS: Using a
      longitudinal population-based survey of older Mexican Americans (N = 2660) across
      five south-western states, this study compared the strength of association
      between markers of physical frailty such as activities of daily living (ADLs),
      instrumental activities of daily living (IADLs), and performance (timed walk,
      timed chair rise, and tandem balance) with baseline incontinence (prevalent
      disease) and new-onset incontinence (incident disease). RESULTS: We found that
      14.1% of the participants (n = 329) were incontinent at baseline (prevalent
      cases) and 11.6% (n = 208) were newly incontinent 2 years later (incident cases).
      Controlling for other covariates, prevalent incontinence was only associated with
      a 60% increased risk of having difficulty walking 8 ft. Incident incontinence was
      associated with a twofold increased risk of impairment in ADLs and IADLs, and
      poor performance on all three physical measures. CONCLUSIONS: Incident
      incontinence is associated with an increased risk of more global functional
      impairment. Thus, incident disease may be an important early marker for signaling
      the onset of frailty among persons who become incontinent after the age of 65
      years.

PMID- 11193228
TI  - Age 85+ years accelerates large-fiber peripheral nerve dysfunction and diabetes
      contributes even in the oldest-old: the Women's Health and Aging Study.
AB  - BACKGROUND: Both diabetes mellitus and advancing age are associated with
      peripheral nerve dysfunction (PND). However, the independent and potentially
      synergistic effects of these factors in old age are poorly described, especially
      among the oldest-old and among people with an existing disability. METHODS: A
      total of 894 women aged 65+ years participating in the Women's Health and Aging
      Study received a baseline home interview and clinical examination during which
      PND was evaluated by the Vibratron II. Age and diabetes were examined in relation
      to the level of PND (normal, mild, moderate, or severe). Height, alcohol
      consumption, smoking, report of neurologic symptoms, and diabetes duration were
      examined as potential confounders. RESULTS: Eighteen percent of the sample
      reported diabetes, 42% had normal nerve function, and 23.9%, 14.5%, and 19.5% had
      mild, moderate, and severe PND, respectively. Women aged 85+ years had 6.5, 7.5,
      and 13.3 times the odds of mild, moderate, and severe PND relative to women aged
      65-74 years, adjusted for diabetes and height. Women who reported diabetes had
      1.8, 2.4, and 1.6 times the risk of mild, moderate, and severe PND relative to
      those who did not, adjusted for age and height. No interaction between age and
      diabetes was observed. CONCLUSIONS: Age is strongly associated with decrements in
      large-fiber peripheral nerve function in disabled women aged 65+ years, with
      greatly accelerated risk among those aged 85+ years. Despite the overwhelmingly
      strong effects of advancing age on PND in this cohort, diabetes remains a
      significant correlate of PND. Future studies may determine whether prevention or
      control of diabetes is effective in reducing the occurrence of PND in old age and
      whether a reduction in PND will translate into reduced disability in this age
      group.

PMID- 11193229
TI  - Epidemiology of urinary incontinence.

PMID- 11193230
TI  - Reliability assessment of the bladder diary for urinary incontinence in older
      women.
AB  - BACKGROUND: A reliable method of documenting the frequency of incontinent
      episodes is essential for assessment of treatment outcome in both clinical
      practice and research studies. Bladder diaries, completed prospectively by the
      patient, have been widely used for this purpose. This study investigated the
      number of consecutive days of bladder diary reports of incontinence frequency
      necessary to obtain adequate internal consistency (reliability). METHODS:
      Participants were 214 community-dwelling women, aged 40 to 90 years, with a
      history of stress, urge, or mixed urinary incontinence, persisting at least 3
      months with a frequency of two or more episodes of urine leakage per week. Each
      participant kept a 14-day bladder diary documenting the time and circumstances of
      each incontinence episode. RESULTS: The mean age of participants was 63.5 years;
      16.9% were African American. Women with predominantly urge incontinence (n = 138)
      reported a daily frequency of 2.1 incontinent episodes. Although there was a
      statistically significant difference between Week 1 (2.4 episodes per day) and
      Week 2 (2.0 episodes per day; p < .0001), five days were necessary to obtain an
      internal consistency of .90 for Cronbach's alpha. Women with predominantly stress
      incontinence (n = 76) had no statistical difference between Week 1 and Week 2 in
      frequency of incontinence, reporting an average 2.2 accidents per week in Week 1
      and 2.1 in Week 2. However, 7 days of bladder diary were required before adequate
      internal consistency was reached. CONCLUSION: Seven consecutive days of bladder
      diary provides a stable and reliable measurement of the frequency of incontinence
      episodes in community-dwelling women.

PMID- 11193231
TI  - The effects of antidepressants on obstructed and unobstructed gait in healthy
      elderly people.
AB  - BACKGROUND: Elderly patients treated with antidepressants for depression are at
      high risk for injury due to falling. The primary purpose of this study was to
      determine the effects of amitriptyline, desipramine, and paroxetine on the gait
      of healthy elderly subjects during unobstructed and obstructed (i.e., stepping
      over obstacles) gait. Psychomotor and mood tests were also performed. METHODS: A
      randomized, crossover, four-period, double-blind, placebo-controlled laboratory
      trial was performed. Twelve healthy elderly subjects (average age, 67 years;
      range, 65-72 years) were tested. Subjects were assigned the three antidepressant
      drugs or a placebo in a random order. Single doses of amitriptyline 50 mg,
      desipramine 50 mg, paroxetine 20 mg, or placebo were given 4 hours prior to gait
      testing. Temporal-distance measures and kinematics of the lower trailing limb
      (i.e., limb going over obstacle last) were obtained. RESULTS: Compared with
      placebo, amitriptyline significantly reduced gait velocity by as much as 8.0% (p
      = .028), cadence by as much as 4.9% (p = .012), angular velocity of hip flexion
      by as much as 10.0% (p = .004), and angular velocity of knee flexion by as much
      as 8.3% (p = 018) during the crossing strides when stepping over obstacles.
      Except for knee flexion angle, unobstructed gait was not affected. Amitriptyline
      affected integrative capacity of the central nervous system (CNS) and ability to
      concentrate as measured by psychomotor and mood tests. CONCLUSIONS: The results
      for amitriptyline suggest that the subjects slowed their obstacle crossing speeds
      as a result of reduced CNS integrative capacities. Neither paroxetine nor
      desipramine significantly affected gait, psychomotor function, or mood.

PMID- 11193232
TI  - Elderly subjects' ability to recover balance with a single backward step
      associates with body configuration at step contact.
AB  - BACKGROUND: In the event of a slip or trip, one's ability to recover a stable
      upright stance by stepping should depend on (a) the configuration of the body at
      the instant of step contact and (b) the forces generated between the foot and
      ground during step contact. In this study, we tested whether these two variables
      associate with elderly subjects' ability to recover balance by taking a single
      backward step after sudden release from an inclined position. METHODS: Twenty-six
      community-dwelling subjects (12 women, 14 men) of mean age 75+/-4 (SD) years each
      underwent five trials in which they were suddenly released from a backward
      inclination of 7 degrees and instructed to "recover balance with a single step."
      Body segment motions and foot contact forces were analyzed to determine step
      contact times, stepping angles, body lean angles at step contact, and the
      magnitudes and times (after step contact) of peak foot-floor contact forces and
      peak sagittal-plane torques at the ankle, knee, and hip of the stepping leg.
      RESULTS: Fifty percent of subjects were predominantly single steppers (successful
      at recovering with a single step in greater than three of five trials), 27% were
      multiple steppers (successful in less than two of five trials), and 23% were
      mixed response steppers (successful in two of five or three of five trials).
      Recovery style associated with the ratio of stepping angle divided by body lean
      angle at step contact (p = .003), which averaged 1.4+/-0.5 for single steppers
      and 0.6+/-0.5 for multiple steppers, but not with step contact time, stepping
      angle, or contact forces and joint torques during step contact. CONCLUSIONS:
      These results suggest that elderly subjects' ability to recover balance with a
      single backward step depends primarily on the configuration of the body (in
      particular, the ratio of stepping angle to body lean angle) at step contact.

PMID- 11193233
TI  - The correlation of cytokine levels with body weight after megestrol acetate
      treatment in geriatric patients.
AB  - BACKGROUND: Cachexia is associated with elevated levels of cytokines in cancer
      and human immunodeficiency virus patients. Studies in cancer and acquired
      immunodeficiency syndrome patients showed that treatment with megestrol acetate
      (MA) is associated with improvement in appetite and weight gain. Reduction in the
      levels of cytokines is associated with weight gain in laboratory animals with
      cancer. This study evaluates the correlation between changes in cytokine (or
      their receptor) levels and weight following MA treatment in geriatric weight-loss
      patients. METHODS: Veterans Administration Medical Center nursing home patients
      (N = 69) with a weight loss of > or =5% of usual body weight over the past 3
      months or body weight 20% below their ideal body weight participated in a 12
      week, randomized, double-blind, placebo-controlled trial, with an additional 13
      week follow-up period. Patients were randomly assigned to receive a placebo or MA
      oral suspension of 800 mg/d for 12 weeks. Levels of the following cytokines (or
      their receptors) were measured at baseline and after 12 weeks of treatment: tumor
      necrosis factor soluble receptor (TNFR) subunits. TNFR-p55 and TNFR-p75:
      interleukin 6 (IL-6); and the soluble interleukin-2 receptor (sIL-2R). The
      subjects' weight and body composition were measured at the start of the study.
      Weight and mortality were followed up for another 13 weeks after discontinuing
      the MA study drug. RESULTS: Elevated levels of IL-6 in almost all geriatric
      cachexic patients, compared with normal volunteers (mean, <4.6 pg/ml). were noted
      at baseline. At 12 weeks after the study drug treatment, there was a decrease in
      cytokine levels (or their receptors) in the MA group (mean change in IL-6, 3.63+/
      6.62 pg/ml; TNFR-p55, -0.06+/-0.11 ng/ml; TNFR-p75. -0.01+/-0.29 ng/ml; and sIL
      2R, 0.08+/-0.07 ng/ml) and the placebo group (mean change in IL-6, -2.08+/-3.92
      pg/ml; TNFR-p55, -0.02+/-0.08 ng/ml; TNFR-p75, -0.20+/-0.18 ng/ml; and sIL-2R,
      0.02+/-0.03 ng/ml). Although the change in cytokine levels was not statistically
      significant between the two groups, significant negative correlation (p < .05)
      was found. For example, increased weight correlated with decreased sIL-2R levels
      (r = .36) and TNFR-p75 (r = -.31; fat-free mass (FFM) gain and reduction of sIL
      2R (r = -.39), TNFR-p75 (r = -.30). There was a significant correlation between
      weight gain and reduction of TNFR-p75 (r = .54), TNFR-p55 (r- = .47), and sIL-2R
      (r = -.53); FFM gain and reduction of sIL-2R (r = -.59), TNFR-p75 (r = -.41),
      TNFR-p55 (r = -.42); and fat gain and reduction of TNFR-p75 (r = -.41) in the MA
      group (p < .05), but not in the placebo group. CONCLUSIONS: Although there was no
      significant change in cytokine levels between the two groups, the reduction in
      cytokine levels after MA treatment correlated with improvement in weight, fat
      mass, and FFM at 12 weeks.

PMID- 11193234
TI  - Diabetes in elderly adults.
AB  - Diabetes is common in the elderly population. By the age of 75, approximately 20%
      of the population are afflicted with this illness. Diabetes in elderly adults is
      metabolically distinct from diabetes in younger patient populations, and the
      approach to therapy needs to be different in this age group. Diabetes is
      associated with substantial morbidity from macro- and microvascular
      complications. Several lines of evidence suggest that optimal glycemic control
      and risk factor modification can substantially reduce the risk of complications
      in elderly patients. In the past, treatment options were limited. However, recent
      studies have delineated several new and exciting therapeutic opportunities for
      elderly patients with diabetes.

PMID- 11193235
TI  - Self-reported and clinical oral health in users of VA health care.
AB  - BACKGROUND: This article describes the oral health of users of Veterans
      Administration (VA) health care using both clinical and self-report measures, and
      models relationships between these measures and self-perceived oral health.
      METHODS: We conducted a cross-sectional study of 538 male users of VA outpatient
      care in the Boston area. Questionnaires assessed self-reported oral health, oral
      specific health-related quality of life, health behaviors, and sociodemographic
      information. Clinical data were collected on oral mucosa status, number of teeth
      and root tips, dental caries, and periodontal treatment need. We report clinical
      and self-reported oral health status by age group (era of military service). We
      regressed models of self-perceived oral health on clinical indices and self
      reported measures of the impact of oral health on daily life, adjusting for
      sociodemographic characteristics and health behavior. RESULTS: Among those
      participants aged 65 to 91 years old, 2.8%, 18.7%, and 41.5% rated their oral
      health as excellent, very good, or good, respectively. Among 50- to 64-year-old
      men, the corresponding values were 1.4%, 18.5%, and 40.4%, while among those aged
      22 to 49 years old, the values were 2.3%, 17%, and 34.1%. Tooth loss was common
      among users of VA care; 34% of those aged 65-90 years, 28% of those aged 50-64
      years, and 8% of those aged 25-49 years had no teeth. Periodontal treatment needs
      were uniformly high among persons with teeth; mild mucosal change was common, and
      10% had root tips. Regression models showed self-perceived oral health was better
      in persons with more teeth and recent dental treatment, and worse with tooth
      mobility, coronal decay, and more medical problems. Measures of the impact of
      oral conditions on daily life added significantly to the amount of explained
      variance in self-perceived oral health. CONCLUSIONS: Clinical conditions and the
      impact of oral health on daily life are important determinants of self-perceived
      oral health.

PMID- 11193236
TI  - Molecular markers of bone turnover: biochemical, technical and analytical
      aspects.

PMID- 11193238
TI  - Preanalytical variability of biochemical markers of bone turnover.

PMID- 11193237
TI  - The use of biochemical markers of bone turnover in osteoporosis. Committee of
      Scientific Advisors of the International Osteoporosis Foundation.

PMID- 11193239
TI  - Prediction of bone loss in postmenopausal women.

PMID- 11193240
TI  - Markers of bone turnover for the prediction of fracture risk.

PMID- 11193241
TI  - Markers of bone turnover for monitoring treatment of osteoporosis with
      antiresorptive drugs.

PMID- 11193242
TI  - Osteoprotegerin and its ligand: a new paradigm for regulation of
      osteoclastogenesis and bone resorption.
AB  - In just 3 years, striking new advances have been made in understanding the
      molecular mechanisms that govern the crosstalk between osteoblasts/stromal cells
      and hematopoietic osteoclast precursor cells that leads to osteoclastogenesis.
      Led first by the discovery of osteoprotegerin (OPG), a naturally occurring
      protein with potent osteoclastogenesis inhibitory activity, rapid progress was
      made to the isolation of RANKL, a transmembrane ligand expressed on
      osteoblasts/stromal cells that binds to RANK, a transmembrane receptor on
      hematopoietic osteoclast precursor cells. The interaction of RANK and RANKL
      initiates a signaling and gene expression cascade that results in differentiation
      and maturation of osteoclast precursor cells to active osteoclasts capable of
      resorbing bone. OPG acts as a decoy receptor, binding to RANKL and blocking its
      interaction with RANK, inhibiting osteoclast development. Many of the
      calciotropic hormones and cytokines, including 1,25(OH)2D3, PTH, PGE2 and IL-11,
      appear to act through a dual capacity to inhibit production of OPG and stimulate
      production of RANKL. Estrogen, on the other hand, appears to inhibit production
      of RANKL and RANKL-stimulated osteoclastogenesis. Recently, the results of the
      first clinical trial with OPG supported its potential as a therapeutic agent for
      diseases such as osteoporosis. The new understanding provided by the
      RANK/RANKL/OPG paradigm for both differentiation of osteoclasts and their
      activation has had tremendous impact on the field and opened new avenues for
      development of possible treatments of diseases characterized by excessive bone
      resorption.

PMID- 11193243
TI  - Timed loaded standing: a measure of combined trunk and arm endurance suitable for
      people with vertebral osteoporosis.
AB  - Chronic back tiredness or fatigue is a common complaint of people who have a
      history of osteoporotic vertebral fracture. Trunk muscle endurance has not been
      studied in people with vertebral osteoporosis, partly due to the lack of
      assessment tools. We developed a measure of combined trunk and arm endurance
      suitable for people with vertebral osteoporosis, timed loaded standing (TLS). TLS
      measures the time a person can stand while holding a two-pound dumbbell in each
      hand with the arms at 90 degrees of shoulder flexion and the elbows extended.
      Intraclass correlation coefficients (ICCs) for same day inter-trial and six to
      ten day test-retest reliability were 0.89 (lower bound 95% confidence interval
      [LB 95% CI] 0.79) and 0.84 (LB 95% CI 0.68), respectively, in a sample of 21
      older women with no known osteoporosis. In 127 women with vertebral fractures,
      the ICC for same day inter-trial reliability was 0.81 (LB 95% CI 0.75). In a sub
      sample of 30 of these women with vertebral fractures, the six to ten day test
      retest reliability was 0.85 (LB 95% CI 0.75). Moderately strong and statistically
      significant (p < or = 0.05) correlations were found between TLS and sixteen of
      eighteen measures of physical impairment and function. Functional reach distance,
      gait velocity, MOS-36 Physical Function Subscale, shoulder flexion strength, and
      six minute walk distance were most strongly associated with TLS time. Women with
      vertebral fractures who endorsed having back tiredness when standing and working
      with the arms in front of the body, sitting to rest because of back tiredness or
      pain, and planning rest periods because of back tiredness or pain had
      significantly lower TLS times. TLS is a simple, safe physical performance measure
      of combined trunk and arm endurance that demonstrates acceptable reliability
      (inter-trial and test- retest) and concurrent validity.

PMID- 11193244
TI  - Quantitative ultrasound of the calcaneus in Brazilian Caucasian women: normative
      data are similar to the manufacturer's normal range.
AB  - Quantitative ultrasound (QUS) can be a helpful alternative to identify
      osteoporotic patients. In this study we establish the QUS Brazilian normal range
      (BNR) and compare its values (means and standard deviations) with the
      manufacturer's normal range (MNR). We measured three QUS parameters (broadband
      ultrasound attenuation, BUA; speed of sound, SOS; stiffness index, SI) at the
      right calcaneus in 352 healthy Caucasian Brazilian women, aged 20-84 years. We
      studied the age-dependent changes in QUS values and correlation with body size
      and years since menopause (YSM). A comparison of fracture risk classification
      using the BNR and MNR is also presented. Age was the most significant predictor
      for all QUS parameters (r = -0.49 for BUA, r = -0.66 for SOS, r = -0.64 for SI).
      Weight was accepted as the second determinant for BUA (final regression model:
      BUA = 101.3 - 0.282 x Age + 0.373 x Weight; p < 0.001; adjusted R2 = 0.33). Body
      mass index (BMI) was accepted as the second predictor for SI (SI = 94.8 -0.595 x
      Age +0.851 x BMI; p<0.001; adjusted R2 = 0.44). Height and YSM were accepted as
      second and third determinants for SOS values (SOS = 1718.7 - 1.147 x Age - 69.863
      x Height - 0.521 x YSM; p < 0.001; adjusted R2 = 0.45). There was a decline in SI
      of about 41% from the values in young adulthood to those of women in their
      eighties, about 76.4% of which occurred from age 45-49 years onward. Variation of
      mean SI with age from the BNR was consistent with the MNR in all but two 5-year
      age groups. In these two groups (50-54 years, p<0.01; 65-69 years, p<0.05),
      values derived from the BNR were 5.08% and 5.45% higher than the MNR values,
      respectively. Comparison of standard deviations in SI with age between the two
      populations did not show statistically significant differences. Using the
      fracture risk criteria proposed by the manufacturer, we observed that the MNR was
      appropriate for skeletal fragility evaluation in Brazilian women.

PMID- 11193245
TI  - Long-term continuous combined hormone replacement therapy in the prevention of
      postmenopausal bone loss: a comparison of high- and low-dose estrogen-progestin
      regimens.
AB  - We studied the effect of four continuous combined estradiol valerate (E2V) and
      medroxyprogesterone acetate (MPA) dose combinations in six treatment groups (n =
      70 per group) receiving regimens containing 1 mg or 2 mg E2V combined to 2.5 mg
      or 5 mg MPA, on bone mineral density (BMD) and endometrium in 419 healthy
      postmenopausal women over 4 treatment years. In two groups the 1 mg dose of E2V
      was increased to 2 mg after the first 6 months, while the MPA doses remained
      constant (2.5 mg or 5 mg). The remaining four groups received 1 E2V + 2.5 mg MPA,
      1 mg E2V + 5 mg MPA, 2 mg E2V + 2.5 mg MPA, or 2 mg E2V + 5 mg MPA throughout the
      study. BMD at the spine and hip was measured by dual-energy X-ray absorptiometry
      and endometrial biopsy samples were taken at 6, 12, 24, 36 and 48 month follow
      ups. Combinations containing the low dose of 1 mg of E2V (with 2.5 mg or 5 mg
      MPA) resulted in a mean BMD increase of 6.2% at the spine and 2.9% at the femoral
      neck after 4 years of treatment. With 2 mg E2V the corresponding increases were
      7.4% and 2.9%, respectively. The largest increases in BMD were seen in women for
      whom the E2V dose was doubled after the initial 6 months of treatment: 8.9% at
      the spine and 4.2% in the femoral neck. Both MPA doses (2.5 mg and 5 mg)
      effectively prevented estrogen-induced stimulation of the endometrium. No
      endometrial hyperplasia was observed in any of the treatment groups. Lower-dose
      combinations of continuous combined estrogen-progestin regimens are effective in
      increasing and maintaining BMD and provide a good endometrial safety profile for
      the long-term prevention of osteoporosis in postmenopausal women.

PMID- 11193246
TI  - Calcium supplementation with calcium-rich mineral waters: a systematic review and
      meta-analysis of its bioavailability.
AB  - The relevance of calcium (Ca2+), an essential bone mineral, to the prevention and
      treatment of osteoporosis is well established. However, a good deal of evidence
      casts doubt on the validity of current RDAs (recommended daily allowance), i.e.,
      800-1000 mg/day. New guidelines consistently advocate higher daily intakes (up to
      1500 mg/day), a goal that may be difficult to achieve for many patients.
      Environmental as well as individual behavioral factors may limit the consumption
      of dairy products, whereas calcium supplements require a high level of compliance
      and cause additional costs. Calcium-rich mineral waters may offer a promising
      alternative. A systematic literature search was performed (Medline, years 1966
      1998) to identify experimental studies on the bioavailability of calcium-rich
      mineral waters. First, all publications on calcium absorption from mineral waters
      were identified, and, in a second step, studies comparing calcium absorption from
      mineral waters with that from dairy products. Four studies fulfilled all
      inclusion criteria. A meta-analysis based on published p values indicated calcium
      absorption from mineral waters was significantly higher (p = 0.03) than that from
      dairy products. Although only few studies with a relatively small number of
      subjects are available to date, the bioavailability of calcium from calcium-rich
      mineral waters thus seems to be at least comparable to, and possibly better than,
      that from dairy products. These results are in keeping with the assumption that
      calcium-rich mineral water is a useful calcium source to achieve new, higher
      recommended daily allowances of calcium.

PMID- 11193247
TI  - Relative influence of physical activity, muscle mass and strength on bone
      density.
AB  - In a population-based sample of 348 men (age 22-90 years) and 351 women (age 21
      93 years), we evaluated the relationship of bone density assessed at a variety of
      skeletal sites by dual-energy X-ray absorptiometry (DXA) with various muscle mass
      estimates obtained also from the DXA scan and with physical activity by interview
      and strength assessed both subjectively and objectively. All these parameters
      declined with age as judged from these cross-sectional data. All estimates of
      total skeletal muscle mass were strongly correlated with bone density at
      different skeletal sites. Muscle mass, in turn, was correlated with physical
      activity and hand strength. In multivariate models including these variables,
      muscle mass was the strongest determinant of bone density, accounting for 6-53%
      (mean 27%) of the variance at the different skeletal sites. Physical activity
      (and/or a physical activity x age interaction) was an independent predictor of
      bone mass in 48% of the site-specific models and accounted for 0.03-39% (mean
      10%) of the variance, while hand strength (and/or a hand strength x age
      interaction) accounted for up to 4% (mean 1%) of the variance as an independent
      predictor of bone density in a third of the models. Although these variables
      together accounted for a large proportion of the variance in bone density, other
      potential predictors were not assessed in these analyses. The dramatic decline in
      physical activity over life seemed unable to completely explain the age-related
      loss of bone mass, and additional research is needed to determine whether the
      relationship of muscle mass with bone density is a direct one or due instead to
      other factors such as circulating hormone levels.

PMID- 11193248
TI  - Metacarpal morphometry using a semi-automated technique in the assessment of
      osteoporosis and vertebral fracture risk.
AB  - Metacarpal morphometry represents a potentially cheap and widely available non
      invasive assessment of skeletal status. In two cross-sectional studies, we
      compared the performance characteristics of a semiautomated technique (the Teijin
      Bonalyzer) with an in-house manual measurement, and with measures of skeletal
      strength at other sites. The metacarpal cortical index (mCI) was measured on hand
      radiographs of 178 osteoporotic women using both the Teijin Bonalyzer and a
      digitizing tablet. Measurements on the latter were consistently lower than with
      the Bonalyzer except for mCI (0.443+/-0.080 vs 0.364+/-0.060, p<0.001), although
      correlation coefficients between these two methods were highly significant (r =
      0.62-0.83, p<0.001). The reproducibility errors of metacarpal bone mineral
      density (mBMD) were constant (1.1-1.2%) whilst those for mCI showed a marked
      operator-dependency (2.0-7.9%). In 379 elderly community-dwelling women,
      Bonalyzer mCI and mBMD showed a significant decline with age (r = -0.30 and -0.27
      respectively, p<0.05). Both mCI and mBMD correlated significantly with forearm
      BMD (r = 0.50 and 0.57 respectively, p<0.001) and hip BMD (r = 0.48 and 0.53
      respectively, p<0.001). After adjustment for age and weight, hip BMD demonstrated
      the best discrimination for prevalent vertebral fractures as judged by the
      gradient of risk for a 1 SD decrease in measurement (odds ratio (OR) 2.17, 95% CI
      1.56-3.01). Similar but smaller gradients of risk were shown by Bonalyzer mCI (OR
      1.32, 95% CI 1.00-1.75), mBMD (OR 1.35, 95% CI 1.02-1.78) and forearm BMD (OR
      1.39, 95% CI 1.08-1.80). MCI, and in particular mBMD, may be useful assessments
      of bone mass and fracture risk. In our study, it is comparable to peripheral
      assessment of skeletal status by forearm densitometry.

PMID- 11193249
TI  - A comparison of continuous alendronate, cyclical alendronate and cyclical
      etidronate with calcitriol in the treatment of postmenopausal vertebral
      osteoporosis: a randomized controlled trial.
AB  - A number of drugs are now available for the treatment of established osteoporosis
      and have been shown to significantly increase bone mineral density (BMD). There
      are, however, few comparative treatment studies and, furthermore, adverse events
      remain a problem with some of the newer agents, particularly in the elderly, in
      everyday clinical practice. We report a 12 month, open labeled, randomized
      controlled, prospective treatment study in 140 postmenopausal women with
      established vertebral osteoporosis, comparing the effect of continuous
      alendronate, cyclical alendronate and cyclical etidronate with calcitriol in
      terms of gain in BMD, reduction in bone turnover markers and adverse event
      profile. The mean percentage increases in BMD at 12 months, at the spine and hip
      respectively, were: continuous alendronate 5.7%, 2.6%; cyclical alendronate 4.1%,
      1.6%; cyclical etidronate 4.9%, 2.0% (p<0.0 1) and calcitriol 2.0%, 0.4% (NS). In
      comparison with calcitriol, the mean changes in BMD at the spine and hip
      respectively were greater in the other groups; continuous alendronate: 3.7% (95%
      CI 1.4 to 8.3), 2.2% (95% CI 0.7 to 4.0); cyclical alendronate: 2.1% (95% CI 1.2
      to 6.4), 1.2% (95% CI -0.3 to 3.0); cyclical etidronate: 2.9% (95% CI 1.9 to
      6.5), 1.6% (95% CI 0.9 to 3.1)). The reduction in bone turnover markers was
      between 26% and 32% in the alendronate and etidronate groups (p<0.01), with a
      trend toward greater reduction in the continuous alendronate group. Eight
      patients discontinued the study: 6 in the continuous alendronate group, 1 in the
      cyclical alendronate group and 1 in the calcitriol group. Two patients in the
      cyclical etidronate group were unable to tolerate the Cacit component, but
      continued on substituting Cacit with Calcichew. In summary, 12 months of
      treatment with continuous alendronate, cyclical alendronate and cyclical
      etidronate are effective in terms of the gain in BMD at the anteroposterior spine
      and total hip in a comparable treatment population. These treatments are more
      effective than calcitriol and were generally well tolerated. Continuous
      alendronate showed a trend toward a larger gain in BMD and greater suppression of
      bone turnover markers than the other treatment groups, but had a higher incidence
      of adverse events, particularly within the older subgroup. Cyclical alendronate
      offers a lower adverse event profile and appears to be effective in comparison
      with continuous treatment, and may possibly be an alternative in the elderly.
      However, further studies are necessary, but more importantly with fracture end
      points.

PMID- 11193250
TI  - Calcaneal ultrasound imaging in healthy children and adolescents: relation of the
      ultrasound parameters BUA and SOS to age, body weight, height, foot dimensions
      and pubertal stage.
AB  - We investigated the quantitative ultrasound (QUS) parameters broadband ultrasound
      attenuation (BUA) and speed of sound (SOS) measured in the posterior part of the
      calcaneus at the region of interest (ROI) with the lowest attenuation, using an
      ultrasound imaging device (UBIS 3000) in 491 healthy Caucasian children and
      adolescents (262 girls, 229 boys) between 6 and 21 years old. The relation of
      age, body weight, height, foot dimensions and pubertal stage to BUA and SOS was
      assessed. BUA increased nonlinearly with age in boys and girls, r2 being 0.44
      (p<0.001) and 0.57 (p<0.001), respectively. SOS increased linearly with age in
      girls (r2 = 0.04, p<0.001). There was no significant increase in SOS in boys (r2
      = 0.01, p>0.05). Heel width was significantly correlated with BUA (r = 0.20,
      p<0.005 in boys; r = 0.27, p<0.05 in girls) and with SOS (r = -0.19, p<0.005 in
      boys; r = -0.08, p<0.05 in girls). After downward adjustment of the ROI size
      according to foot length quartiles, significantly lower BUA and SOS values were
      found compared with those with the standard ROI size of 14 mm. After correction
      for heel width and adjustment of the ROI size based on foot length, BUA and SOS
      were significantly associated with age in boys (r2 = 0.36, p<0.001 and 0.06,
      p<0.05) and in girls (r2 = 0.53 and 0.06, both p<0.001). Tanner stage was
      significantly correlated with BUA (r = 0.62, p<0.001 in boys; r = 0.73, p<0.001
      in girls) but not with SOS. BUA but not SOS increased significantly with the
      number of years since menarche (p<0.001). In a multiple stepwise regression
      analysis in boys, age, weight and foot length were independent predictors for
      BUA, and age and foot length for SOS. In girls, age and weight were independent
      predictors for BUA and age was the only independent predictor for SOS. After
      correction for age, pubertal stages and heel width were no longer determinants
      for QUS parameters in either boys or girls. In conclusion, BUA increased
      significantly with age in both sexes. SOS increased with age in both boys and
      girls, but the increase was small and not statistically significant in boys. SOS,
      as measured with the UBIS 3000 device, may therefore not be appropriate to assess
      skeletal status in healthy children. Whether SOS and BUA are affected in children
      with skeletal disorders has yet to be determined. In boys, age, weight and foot
      length were independent predictors for BUA and age and foot length for SOS. In
      girls, age and weight were independent predictors for BUA and age was the only
      independent predictor for SOS. In our opinion, children with small feet should be
      measured with a smaller ROI diameter than those with larger feet.

PMID- 11193251
TI  - Effects of body size and skeletal site on the estimated prevalence of
      osteoporosis in women and men.
AB  - There is growing awareness that therapeutic decision-making may be confounded by
      discrepancies in the prevalence of osteoporosis by World Health Organization
      criteria when bone density is measured at different skeletal sites. To explore
      this issue, we measured bone density at a variety of skeletal sites in a
      population-based sample of 348 men (age 22-90 years) and 351 women (age 21-93
      years). Men had greater areal bone mineral density (BMD, g/cm2) than women at
      almost every subregion on total body, anteroposterior (AP) and lateral lumbar
      spine, proximal femur and forearm scans by dual-energy X-ray absorptiometry.
      However, adjustment for height or, where possible, calculation of bone mineral
      apparent density (BMAD, g/cm3) reduced or eliminated these differences. In
      addition, three different patterns of change in bone density over life were
      observed at the various skeletal sites as judged from cross-sectional data: no
      apparent age-related bone loss (e.g., AP spine BMD in men); linear bone loss over
      life in both sexes beginning in young adulthood (e.g., femoral neck BMD); and
      bone loss beginning around the time of menopause or a comparable age in men
      (e.g., midradius BMD). The various adjustments for bone size and the different
      patterns of age-related change in bone density had profound effects on the
      estimated prevalence of osteoporosis by World Health Organization criteria, which
      ranged from 2% to 45% among postmenopausal women and from 0 to 36% among men 50
      years of age and older depending upon the skeletal parameter that was assessed.
      These observations emphasize the difficulties involved in attempts to standardize
      BMD scores and definitions of osteoporosis for clinical use.

PMID- 11193252
TI  - Response to the letter by Sanchez concerning Osteoporos Int 1999;10:325-9.

PMID- 11193253
TI  - [The German Orthopedic History and Research Museum. A museum for research and
      public health].
AB  - The German historical museum of orthopaedic surgery was founded 1959 in Wurzburg.
      The main task of this institution is the furtherance of science in medical
      history. Since the beginning, 41 years ago, the number of books and exhibits
      increased continuously. The library of the museum is the biggest public
      collection in Germany and contains more then 6000 books and publications in
      orthopaedics. Furthermore the museum includes a big amount of exoprostheses of
      the upper and lower limb, alloarthroplasties of hip- and knee-joints,
      traumatologic implants and instruments of orthopaedic surgery. A big number of
      bone-preparations with pathologic alterations and variations will also be
      presented. The exhibition and the library is open to the public and is available
      to those people in the history of orthopaedic surgery. Local requirements in
      Wurzburg were one of the reasons to transfer the place of the museum to
      Frankfurt/Main. The museum was reopened at 6th of June 1998 at the university of
      Frankfurt/Main, department of orthopaedic surgery.

PMID- 11193254
TI  - [200 years orthopedics. Images from the past].
AB  - The term orthopaedics was first used by a French physician named Nicolas Andry in
      1742. Since then the meaning of the term has changed dramatically. Starting as
      the planned title of a guidebook for parents it developed to become the name of a
      new medical discipline. During the 19th century orthopaedic surgery was dominated
      by private institutions, which were a privilege of the wealthy. Orthopaedic
      surgery as we know it in Germany today developed mostly from the so called
      "cripple asylums" (Kruppelheime). Their main objective was the treatment of
      infections of bones and joints, scoliosis and of hereditary diseases. Many of
      these orthopaedic diseases lost their importance due to prophylaxis and early
      diagnosis. The great improvements in the living conditions led to a change
      regarding the age of the patients and the diseases treated. Until world war II
      mostly children were treated by orthopaedic surgeons. After world war II
      orthopaedic surgeons have adjusted to the demographic change and have
      increasingly been treating elder patients. The development and the spread of
      prostheses display the increasing importance of age related illnesses.

PMID- 11193255
TI  - [History of artificial limbs for the leg].
AB  - Following the development of prosthetics for the lower limb since the middle of
      the 18th century one will find very interesting similarities to modern
      prostheses. This becomes evident when looking at former knee and ankle joint
      mechanisms or socket designs. Also, the materials used for the prostheses
      underwent very interesting variations. In our paper we will describe the
      development of socket designs and several materials from the beginning of the
      19th century. Several still obtainable books dealing with 200 years of
      prosthetics development, were reviewed. Charles White describes in the year 1761
      a supramalleolar amputation using the flap technique and the specially built BK
      prostheses the socket. V. Brunninghausen describes in 1809 a socket made of tin
      sheet. It was built oval, as the normal transverse section of the thigh is. Stump
      adhesion was obtained when a shortly trimmed dog fur--panelling the socket and
      covering the stump--was attached like brushes end on end. A similar fitting was
      described by Heine in 1811, v. Dornbluth in 1831, and Mrs. Eichler in 1836.
      Hermann first mentioned the need of a perpendicular construction of prostheses.
      Parmelee developed in 1868 the first suction socket. The first tuber-enclosing
      socketdesign was made by Riedel in 1911. We will show documents from this time
      and will also show, that muscle-physiological aspects had a very important
      influence on socket designs.

PMID- 11193256
TI  - [From sciatica to intervertebral disk displacement. On the history of a disease
      concept].
AB  - Since antiquity low back pain spreading down to the buttock and the leg with or
      without neurological symptoms has repeatedly been described by medical
      authorities. To extract well defined nosological entities out of the medley of
      "sciatica" was a demanding process within a labyrinth of often misleading clues.
      Although the herniated intervertebral disk was recognised about the middle of the
      19th century the causal nexus between intervertebral disk displacement and
      sciatica was only demonstrated in the thirties of the 20th century. The critical
      appraisal of pathomorphological lesions in patients suffering from sciatica was,
      as it still is, a challenging task even for experienced physicians. Key texts and
      their authors recall the main steps towards our modern concept of lumbar
      intervertebral disk displacement to the readers mind.

PMID- 11193257
TI  - [History of meniscus surgery. From excision of joint loose bodies to meniscus
      suture].
AB  - In comparison with other operative procedures, the history of meniscal-surgery
      offers some particular differences. Over a long period of time injuries of the
      semilunar-cartilages of the knee-joint were not generally recognised. In the 18th
      century only was the clinical picture roughly outlined. There is evidence, that
      parts of the meniscus were removed much earlier than we have historic proof of.
      These meniscal fragments were generally mistaken for "loose bodies" in the
      joints, not knowing the exact etiology. Operative interference with joints was
      afflicted with a very high incidence of infections and thus complications. Due to
      this reliable standards of sterility were imperative to obtain reproductive and
      satisfactory results in surgery of the knee-joint and this is why the discovery
      and implementation of antiseptic and aseptic principles play such an important
      role in joint- and, in particular, in meniscal-surgery. The development of
      meniscal-surgery is dominated by a lengthy discussion about the way in which the
      injuries of the semilunar cartilages should be dealt with operatively.
      Fundamental techniques such as fixation of the cartilage by sutures, limited or
      total removal of the meniscus were established as early as 1895. Over a long
      period they existed concurrently and their adequate application remained cause
      for a highly controversial discussion until the end of the 20th century. Not
      before more detailed knowledge was gained about the exact morphology of the
      meniscus and the rising of arthroscopic surgery offered new surgical
      perspectives, it was possible to establish a widely accepted standard of meniscal
      surgery.

PMID- 11193258
TI  - [History of 1906 census of handicapped patients].
AB  - The census of cripples ("Reichskruppelzahlung") in the German Reich plays a
      central role in the development of orthopaedic surgery. Local censuses conducted
      by protestant ministers had already pointed out the great number of disabled
      children without appropriate care. It was the achievement of Konrad Biesalski,
      who was an orthopaedic surgeon, and of Eduard Dietrich, a Prussian government
      official, that a nation-wide census for disabled people was conducted. The
      concerns of the Reich-health-administration, which had complained about the way
      the survey was to be made, were neglected. These concerns were not all
      unjustified. Both the planning of the census itself and the technical
      interpretation of the obtained numbers were full of errors. The number of
      cripples in need of a place in an asylum were very exaggerated. Biesalski is to
      be held responsible for this systematic error. For him the census was only a way
      to influence the public opinion and had no scientific value. The public was
      worried by the great numbers of cripples in need of medical care and the
      foundation of asylums for cripples was added to the social political agenda.
      Along with these asylums came the promotion of orthopaedic surgery. The law,
      which laid the foundation for these institutions, the "law for the welfare of the
      cripples in Prussia" of 1920, would have never been passed, if it had not been
      for Biesalski's manipulated numbers. One can say that the artificially inflated
      numbers of the "Reichskruppelzahlung" were a lie for a good cause.

PMID- 11193259
TI  - [Historical aspects of joint prosthesis implantation. A bibliographic study].
AB  - Joint replacements are frequent and effective. The results are generally very
      positive. It is important to understand former techniques and the historical
      development of artificial joints by reviewing the bibliographical sources. This
      article provides a thorough synopsis of former efforts to fully appreciate
      present-day successes.

PMID- 11193260
TI  - [Changes in the concept of fracture healing and callus formation].
AB  - Although the treatment of fractures has repeatedly been documented throughout
      history, little attention has been paid to the historical development of the
      understanding of fracture healing and callus formation in itself. In antiquity,
      the capability of bone to regenerate was doubted, and Galen attributed the
      consolidation of a bone fracture to a sap (succus ossificus) that came from the
      food ingested. Later, in the eighteenth century, a haughty debate broke out as to
      the seat of the organ that controlled the by now accepted process of new bone
      formation. While Duhamel du Monceau (1700-1781) believed the periosteum was
      responsible for the callus formation--this idea being based on his observations
      of trees--Albrecht von Haller (1708-1777) and his scholars and disciples ascribed
      this function to the succus ossificus and to the bone marrow. The studies on
      experimental fracture healing that began during the seventeenth century resulted
      in the eighteenth-century discovery of the complex processes involved in the
      formation of callus with the aid of madder staining. The conciliation of the two
      major schools of thought was finally brought about when in the nineteenth century
      both periosteal and endosteal callus formation were shown to occur. The
      anatomical reposition of the fractured components and the stable fixation through
      osteosynthesis led to a novelty of the twentieth century: callus-free healing of
      bone fractures. Based on key texts and their authors, the zigzag course taken by
      our understanding of bone fracture healing and callus formation is illustrated.

PMID- 11193261
TI  - [Effects of early estrogen replacement therapy on bone stability of
      ovariectomized rats. A biomechanical and radiologic study of the tibial plateau].
AB  - Postmenopausal osteoporosis leads to a significant increase in bone fragility. In
      this study we used the rat tibia plateau fracture model to investigate the
      efficiency of estrogen replacement therapy (ERT) to mitigate the post-ovariectomy
      decrease in fracture load. A total of 73 virgin Sprague Dawley rats had been
      ovariectomized and 26 animals underwent sham operation. The ovariectomized
      animals were either untreated (n = 35) or treated with estrogen injections (10
      micrograms/kg per day 3 days a week until sacrifice), starting treatment at
      either 0, 5, 8, or 13 days post surgery. Before starting ERT and at 50 days post
      surgery, the trabecular structure of the right proximal tibial metaphysis of each
      animal was imaged non-invasively using high resolution X-ray topography. The
      animals were then sacrificed and the right knee from each animal was harvested
      and mounted into a servo-hydraulic materials testing system so that the distal
      femoral condyle could be forced into the proximal tibial plateau until fracture
      occurred. The failure load (F) of the ovariectomized group without estrogen
      administration was significantly less than that for the sham group. The mean
      stiffness (K) of the ovariectomized group was 22 percent less than that of the
      sham group, though this difference did not reach statistical significance. Across
      all groups, the failure load and stiffness were significantly correlated with the
      trabecular bone volume. Our data suggest that prompt ERT can increase the
      fracture load and stiffness of trabecular bone by allowing bone formation to
      continue in previously activated bone remodeling units while suppressing the
      production of new remodeling units. This may be the mechanism by which estrogen
      and other antiresorptive agents increase bone mass, and thereby reduce the risk
      of osteoporotic fractures in postmenopausal women.

PMID- 11193262
TI  - [It is worthwhile exploring the roots!].

PMID- 11193263
TI  - As simple as possible, but not simpler.

PMID- 11193264
TI  - End-tidal CO2: physiology in pursuit of clinical applications.

PMID- 11193265
TI  - Treatment of stroke on an intensive stroke unit: a novel concept.
AB  - In industrialised nations stroke ranks as number three among causes of death and
      is the most frequent cause of disability in old age. Demographic changes will
      result in stroke gaining increasing importance for individuals as well as for
      society as a whole. Stroke is already a major cost factor for healthcare and
      social security systems because of its high long-term costs. Therapeutic
      nihilism, although still widespread among patients and some physicians, is no
      longer justified. Long-term outcome after stroke can be significantly improved by
      providing therapy in wards specialised in early rehabilitation, so-called 'stroke
      units'. Recent magnetic resonance imaging (MRI) and positron emission tomography
      (PET) studies, as well as lysis therapy studies have shown that the first 3-6 h
      are crucially important. For this reason, the concept of "intensive stroke units"
      also called "intensive care stroke units" has been implemented in Germany. The
      goal of an intensive stroke unit is the optimal care of stroke patients under
      intensive care conditions for the first 3-4 days with the aim of improving
      outcome, long-term morbidity, and reducing long-term healthcare costs. Another
      important objective is the development and research of new therapeutic concepts
      and approaches that are based on pathophysiological considerations. A further
      goal is the initiation of specific therapies depending on the suspected
      underlying pathophysiology, for example, local or systemic thrombolysis, full
      dose heparinisation, platelet aggregation inhibitors, oral anticoagulants,
      neuroprotective agents, decompression craniotomy, sympathomimetically supported
      volume therapy and hypothermia. A final objective is to minimise the number of
      complications through intensive monitoring. Basic acute management includes
      optimal oxygen supply, rapid normalisation of blood glucose and body temperature,
      volume therapy, maintaining a high blood pressure and cardiac output to improve
      remaining cerebral perfusion in the presence of ischaemically impaired
      autoregulation, treating cerebral oedema, prophylaxis of thrombosis, and early
      mobilisation. Rapid and easy access to computerised tomography (CT), MRI, Doppler
      and duplex scanning of the brain-supplying blood vessels, and echocardiography is
      essential. The ready availability of intensive care monitoring (blood pressure,
      electrocardiography, central venous pressure, transcranial Doppler (TCD), TCD
      embolism detection, cerebral pressure, electroencephalography and cardiac output
      is also imperative. We would like to stress at this point that this manuscript is
      a personal view describing stroke care in Germany. Many of the principles
      described have not been widely adopted elsewhere, perhaps in part due to a lack
      of available facilities. However, many of our recommendations are based on
      logical principles and thus, we feel, bear further scrutiny.

PMID- 11193266
TI  - Expiratory time constants in mechanically ventilated patients with and without
      COPD.
AB  - OBJECTIVE: In mechanically ventilated patients, the expiratory time constant
      provides information about the respiratory mechanics and the actual time needed
      for complete expiration. As an easy method to determine the time constant, the
      ratio of exhaled tidal volume to peak expiratory flow has been proposed. This
      assumes a single compartment model for the whole expiration. Since the latter has
      to be questioned in patients with chronic obstructive pulmonary disease (COPD),
      we compared time constants calculated from various parts of expiration and
      related these to time constants assessed with the interrupter method. DESIGN:
      Prospective study. SETTING: A medical intensive care unit in a university
      hospital. PATIENTS: Thirty-eight patients (18 severe COPD, eight mild COPD, 12
      other pathologies) were studied during mechanical ventilation under sedation and
      paralysis. MEASUREMENTS AND RESULTS: Time constants determined from flow-volume
      curves at 100%, the last 75, 50, and 25% of expired tidal volume, were compared
      to time constants obtained from interrupter measurements. Furthermore, the time
      constants were related to the actual time needed for complete expiration and to
      the patient's pulmonary condition. The time constant determined from the last 75%
      of the expiratory flow-volume curve (RCfv75) was in closest agreement with the
      time constant obtained from the interrupter measurement, gave an accurate
      estimation of the actual time needed for complete expiration, and was
      discriminative for the severity of COPD. CONCLUSIONS: In mechanically ventilated
      patients with and without COPD, a time constant can well be calculated from the
      expiratory flow-volume curve for the last 75% of tidal volume, gives a good
      estimation of respiratory mechanics, and is easy to obtain at the bedside.

PMID- 11193267
TI  - End-tidal CO2 pressure determinants during hemorrhagic shock.
AB  - OBJECTIVES: To examine the relationship between end-tidal CO2 (PETCO2) and its
      physiological determinants, pulmonary blood flow (cardiac output, CO) and CO2
      production (VCO2), in a model of hemorrhagic shock during fixed minute
      ventilation. DESIGN AND SETTING: Prospective, observational study in a research
      laboratory at a university center. SUBJECTS AND INTERVENTIONS: Six anesthetized,
      intubated, and mechanically ventilated mongrel dogs. Progressive stepwise
      bleeding. MEASUREMENTS AND RESULTS: We continuously measured PETCO2 with a
      capnograph, pulmonary artery blood flow with an electromagnetic flow probe,
      arterial oxygen saturation (SaO2) with a fiberoptic catheter, and oxygen
      consumption (VO2) and VCO2 by expired gases analysis. Oxygen delivery (DO2) was
      continuously calculated from pulmonary blood flow and SaO2. We studied the
      correlation of PETCO2 with CO and VCO2 in each individual experiment. We also
      calculated the critical point in the relationships PETCO2/ DO2 and VO2/DO2 by the
      polynomial method. As expected, PETCO2 was correlated with CO. The best fit was
      logarithmic in all experiments (median r2 = 0.90), showing that PETCO2 decrease
      is greater in lowest flow states. PETCO2 was correlated with VCO2, but the best
      fit was linear (median r2 = 0.77). Critical DO2 for PETCO2 and VO2 was 8.0 +/-
      3.3 and 6.3 +/- 2.5 ml x min(-1) kg(-1), respectively (NS). CONCLUSIONS: Our data
      reconfirm the relationship between PETCO2 and CO during hemorrhagic shock. The
      relatively greater decrease in PETCO2 at lowest CO levels could represent
      diminished CO2 production during the period of VO2 supply dependency.

PMID- 11193268
TI  - Acute respiratory distress syndrome in trauma patients: ICU mortality and
      prediction factors.
AB  - OBJECTIVES: To study the factors that influence the intensive care unit (ICU)
      mortality of trauma patients who develop acute respiratory distress syndrome
      (ARDS) and to evaluate determinants of length of ICU stay among these patients.
      DESIGN: Study on a prospective cohort of 59 trauma patients that developed ARDS.
      SETTING: ICU of a referral trauma center. Fifty-nine patients were included
      during the study period from 1994 to 1997. METHODS: The dependent variables
      studied were the mortality and length of ICU stay. The main independent variables
      studied included the general severity score APACHE III, the revised trauma and
      injury severity scores (RTS, ISS), emergency treatment measures, the gas exchange
      index (PaO2/FIO2) recorded after the onset of ARDS and the development of
      multiple system organ failure (MSOF). Univariate and multivariate analyses were
      performed. RESULTS: The mean age of patients was 42.1 +/- 16.7 years, 49 patients
      (83 %) were male, the mean APACHE III score was 52.7 +/- 33.7 points, the ISS
      28.5 +/- 11.4 points and the RTS 8.9 +/- 2.5 points. ICU length of stay was 28.5
      +/- 24.5 days and the mortality rate 31.7 % (19 deaths). Mortality was associated
      with the following: PaO2/FIO2 ratio on the 3rd, 5th and 7th days post-ARDS; high
      volume of crystalloid/colloid infusion during resuscitation; the APACHE III
      score; and the development of MSOF According to the multivariate analysis, the
      mortality of these patients was correlated with the PaO2/FIO2 ratio on the 3rd
      day of ARDS, the APACHE III score and the development of MSOF. This analysis also
      showed days on mechanical ventilation to be the only variable that predicted ICU
      length of stay. CONCLUSIONS: The ICU mortality of trauma patients with ARDS is
      related to the APACHE III score, the gas exchange evolution as measured by the
      PaO2/FIO2 on the 3rd day and the progressive complications indicated by the onset
      of MSOF. The length of ICU stay of these patients is related to the number of
      days on mechanical ventilation.

PMID- 11193269
TI  - High survival in adult patients with acute respiratory distress syndrome treated
      by extracorporeal membrane oxygenation, minimal sedation, and pressure supported
      ventilation.
AB  - OBJECTIVES: To evaluate the results of treatment of severe acute respiratory
      distress syndrome (ARDS) with extracorporeal membrane oxygenation (ECMO), minimal
      sedation, and pressure supported ventilation. DESIGN AND SETTING: Observational
      study in a tertiary referral center, Intensive Care Unit, Astrid Lindgren
      Children's Hospital at Karolinska Hospital, Stockholm, Sweden. SUBJECTS AND
      METHODS: Seventeen adult patients with ARDS were treated with venovenous or
      venoarterial ECMO after failure of conventional therapy. The Murray score of
      pulmonary injury averaged 3.5 (3.0-4.0) and the mean PaO2/FIO2 ratio was 46 (31
      65). A standard ECMO circuit with nonheparinized surfaces was used. The patients
      were minimally sedated and received pressure-supported ventilation. High
      inspiratory pressures were avoided and arterial saturation as low as 70% was
      accepted on venovenous bypass. RESULTS: In one patient a stable bypass could not
      be established. Among the remaining 16 patients 13 survived (total survival rate
      76%) after 3-52 days (mean 15) on bypass. Major surgical procedures were
      performed in several patients. The cause of death in the three nonsurvivors was
      intracranial complications leading to total cerebral infarction. CONCLUSION: A
      high survival rate can be obtained in adult patients with severe ARDS using ECMO
      and pressure-supported ventilation with minimal sedation. Surgical complications
      are amenable to surgical treatment during ECMO. Bleeding problems can generally
      be controlled but require immediate and aggressive approach. It is difficult or
      impossible to decide when a lung disease is irreversible, and prolonged ECMO
      treatment may be successful even in the absence of any detectable lung function.

PMID- 11193270
TI  - Effect of epidural blockade on indicators of splanchnic perfusion and gut
      function in critically ill patients with peritonitis: a randomised comparison of
      epidural bupivacaine with systemic morphine.
AB  - OBJECTIVES: (a) To measure gastric tonometry values in critically ill patients
      with peritonitis and to assess the impact of epidural analgesia on these values.
      (b) To assess the impact of epidural analgesia on gastro-intestinal motility by
      abdominal ultrasound and paracetamol absorption. (c) To observe any change in
      clinical outcome that may result from the use of epidural analgesia in such
      patients. DESIGN: A double-blinded, prospective, randomised and controlled study
      of general intensive therapy unit (ITU) patients. PATIENTS: Twenty-one patients
      admitted with peritonitis and adynamic small bowel following abdominal surgery
      were randomly allocated to receive either intravenous morphine or epidural
      bupivacaine for analgesia. MEASUREMENTS AND RESULTS: Gastric intramucosal pH
      (pHig) and the mucosal:arterial PCO2 gradient (Pg-PaCO2) were measured at
      admission and after 24 h of analgesia. Analysis of mean changes in tonometry
      values showed a rise in Pg-PaCO2 and a fall in pHig in the morphine group and a
      significant difference between groups in the Pg-PaCO2 trends (p = 0.024).
      Significant improvements in the ultrasound appearance of the small bowel were
      observed in the epidural group (p = 0.0037, Mann-Whitney U test of median changes
      in a locally developed scoring system). There were no significant differences
      between the groups in any of the variables derived from the paracetamol
      absorption test (n = 10); both groups showed persistently delayed gastric outflow
      throughout the study period. CONCLUSIONS: Epidural analgesia resulted in
      improvements in gastric mucosal perfusion and the ultrasound appearance of the
      small bowel, indicating potential clinical benefit in a group of patients in whom
      epidural catheterisation is traditionally contraindicated.

PMID- 11193271
TI  - Differential effects of in vitro and in vivo hyperthermia on the production of
      interleukin-10.
AB  - OBJECTIVE: To determine whether hyperthermia activates an anti-inflammatory
      response. DESIGN: A prospective study. SETTING: Heatstroke Center, Makkah, and
      King Faisal Specialist Hospital, Riyadh, Saudi Arabia. PATIENTS: Twenty-five
      heatstroke patients pre-cooling (rectal temperature 42.4 +/- 0.8 degrees C)
      (group 1) and 13 normothermic heat-stressed subjects were studied (group 2).
      Twelve of the 25 heatstroke patients were also studied post-cooling (group 3).
      Mononuclear cells from six healthy blood donors resting at 24 degrees C were used
      for in vitro study. INTERVENTIONS: Mononuclear cells were cultured at a
      concentration of 1 x 10(6)/ml without and with lipopolysaccharide (LPS) added at
      concentration of 10, 100, and 1000 ng/ml. The cells were incubated for 24 h at
      37, 39, 41, and 43 degrees C. ELISA was used to measure IL-10 in the supernatant
      and plasma from heatstroke and heat-stressed subjects. RESULTS: All patients in
      group 1, 40% of group 2, and 37% of group 3, showed elevation of IL-10 (1289 +/-
      2519, 248 +/- 393, and 172 +/- 226 pg/ml, respectively) compared with normal
      control levels, (< 100 pg/ml) P < 0.05. IL-10 level on admission did not
      correlate with degree of hyperthermia. During 24 h incubation at 37 degrees C
      without LPS, no IL-10 was detected, whereas with 10 ng/ml LPS, monocytes released
      658 +/- 291 pg IL-10/10(6) cells. At 39 degrees C and 41 degrees C IL-10 release
      was decreased to 225 +/- 114, and 245 +/- 90 pg/10(6) cells, respectively; and
      was completely inhibited at 43 degrees C (67 +/- 10 pg/10(6) cells), P < 0.0001.
      CONCLUSION: Heat-stress with and without hyperthermia is associated with anti
      inflammatory response in vivo. However, it does not seem to be the direct effect
      of heat on monocytes, suggesting that other environmental or genetic factors may
      be involved.

PMID- 11193272
TI  - Continuous veno-venous hemofiltration without anticoagulation in high-risk
      patients.
AB  - OBJECTIVE: To study the safety and operative efficacy of continuous veno-venous
      hemofiltration (CVVH) without anticoagulation in patients at high risk of
      bleeding. DESIGN: Prospective cohort study and comparison to control group.
      SETTING: Tertiary, multidisciplinary intensive care unit. PATIENTS: Forty
      hemofiltration circuits in 12 patients with severe acute renal failure (ARF)
      deemed at high risk of bleeding. Forty control circuits in 14 patients treated
      with low-dose pre-filter heparin infusion. INTERVENTIONS: CVVH at 21/h of pump
      controlled ultrafiltration without anticoagulation or saline flush in patients at
      high risk of bleeding. Collection of data at the bedside. MEASUREMENTS AND MAIN
      RESULTS: Mean circuit life was 32 h (95% CI: 20-44.4) in patients receiving CVVH
      without anticoagulation. Forty-three per cent of filters lasted longer than 30 h.
      Circuit lifespan did not correlate with international normalized ratio (INR),
      activated partial thromboplastin time (APTT) or platelet count. There were no
      bleeding complications and azotemic control was not compromised by lack of
      circuit anticoagulation with a mean serum urea of 16.0 mmol/l (95% CI: 14.9-18.1)
      during treatment. A control group of consecutive similarly ill patients not at
      high risk of bleeding received low-dose pre-filter heparin (mean dose 716 IU; 95%
      CI: 647-785). Their mean filter life was 19.5 h (95% CI: 14.2-23.8),
      significantly shorter than in the study patients (p = 0.017). CONCLUSIONS:
      Critically ill patients at high risk of bleeding who require continuous renal
      replacement therapy (CRRT) can be safely managed without circuit anticoagulation.
      This strategy minimizes bleeding risks and is associated with an acceptable
      filter life. CRRT without anticoagulation should be strongly considered in high
      risk patients.

PMID- 11193274
TI  - Body position does not influence the location of ventilator-induced lung injury.
AB  - OBJECTIVE: To ascertain whether the locations of ventilator-induced lung injury
      (VILI) are influenced by body position. DESIGN: Randomized prospective short-term
      study. SETTING: Animal laboratory at a university school of medicine.
      INTERVENTIONS: Twelve white rabbits were mechanically ventilated in IMV mode with
      an infant ventilator (V.I.P. Bird, Bird Products, Palm Springs, Calif., USA).
      Based on the results of a preliminary study to determine the ventilator settings
      at which the lungs of rabbits were injured within 5 h in the supine position, the
      ventilator was set at F(I)O2 0.21, at a rate of 30/min, T(I) 0.6 s, peak
      inspiratory pressure 30 cm H2O, inspiratory flow 10 l/min with no applied
      positive end-expiratory pressure (PEEP). Six of the animals were tested in the
      supine position and the other six in the prone position. Respiratory gases were
      measured and CT scanning was performed every 30 min. The animals were ventilated
      for 5 h or until pulmonary parenchymal opacification was detected. The lungs were
      divided into three areas from apex to base and three levels from ventral to
      dorsal, and the location of opacification was ascribed according to this scheme.
      After the experiment, the lungs were excised and examined histologically.
      MEASUREMENTS AND RESULTS: Parenchymal opacification occurred mainly in the dorsal
      lung areas. The time from the beginning of ventilation to the appearance of lung
      damage was 60-120 min in the supine (S) group, and 60-270 min in the prone (P)
      group, and it was significantly longer in the prone group (P < 0.01). We observed
      diffuse lung damage, including hyaline membrane formation, intra-alveolar edema,
      and infiltration of inflammatory cells. CONCLUSIONS: Body position affected the
      time course of the development of VILI, but it did not affect the location.

PMID- 11193273
TI  - Contribution of ultrasonography and cholescintigraphy to the diagnosis of acute
      acalculous cholecystitis in intensive care unit patients.
AB  - OBJECTIVES: To assess the respective value of ultrasonography (US) and morphine
      cholescintigraphy (MC) in the diagnosis of acute acalculous cholecystitis (AAC).
      DESIGN AND SETTING: Prospective study in an intensive care unit of a university
      hospital. PATIENTS AND INTERVENTION: Twenty-eight patients with clinically and
      biologically suspected of AAC. US was performed at the bedside and less than 12 h
      later MC. US was considered positive if three major criteria were present: wall
      thickness greater than 4 mm, hydrops, sludge; MC results were regarded as
      positive if the gallbladder could not be visualized. These latter patients
      underwent cholecystectomy and the diagnosis of AAC was confirmed through
      histopathological study. MEASUREMENTS AND MAIN RESULTS: Sensitivity of US and MC,
      respectively, was 50% and 67%, specificity 94% and 100%, positive predictive
      value 86% and 100%, negative predictive value 71% and 80%, and accuracy 75% and
      86%. The correlation between US and MC findings was 71%, with chi = 0.31. By
      Bayesian analysis the probability of disease if the MC finding was positive was
      100% regardless of US results. A positive US finding was associated with a 86%
      probability of disease, but with a probability of only 66% in case of negative MC
      results. MC is thus superior to US for confirming AAC in selected critically ill
      patients. Nevertheless, US is an easy, noninvasive, and effective method of
      bedside screening. The combination of the two imaging tests improves diagnostic
      accuracy and reduces false-positive and false-negative rates. Poor agreement
      between the two tests leads to better diagnostic complementarity.

PMID- 11193275
TI  - Hemodynamic, biochemical and morphological changes induced by aminoguanidine in
      normal and septic sheep.
AB  - OBJECTIVE: To define the acute hemodynamic, metabolic, and morphological changes
      induced by aminoguanidine, a selective iNOS inhibitor, in septic sheep. DESIGN:
      Prospective, nonrandomized animal study. SETTING: Animal research facility in a
      University Hospital. INTERVENTIONS: Adult sheep, sedated and mechanically
      ventilated, were monitored with a pulmonary arterial catheter and an ultrasonic
      blood flow probe in the mesenteric artery, to measure the systemic (Q(TOT)I) and
      the mesenteric (Q(MES)I) blood flow indices, and an ileal tonometer. Four groups
      of sheep were studied: nonseptic, septic, nonseptic treated with aminoguanidine,
      and septic treated with aminoguanidine (100 mg kg(-1) h(-1)) (n = 6 for each
      group). Sepsis was induced by the intravenous administration of E. coli.
      Hemodynamic and biochemical parameters were measured during 300 min. Histological
      changes in the liver and small intestinal mucosa were analyzed at the end of the
      experiment. MEASUREMENTS AND MAIN RESULTS: In nonseptic animals, aminoguanidine
      slightly increased mean systemic arterial pressure (MAP), decreased Q(TOT)I, and
      increased vascular resistance index (SVRI) and pulmonary vascular resistance
      index. Q(MEs)I did not change and Q(MES)I/Q(ToT)I increased. Aminoguanidine also
      induced intestinal intramucosal hypercarbia, hyperlactatemia, acidemia,
      hypoglycemia, and morphological signs indicative of tissue ischemia in the small
      intestinal mucosa. In septic sheep, aminoguanidine increased SVRI and MAP only at
      4 h after the septic challenge and thereafter, and worsened gas exchange.
      CONCLUSIONS: In this model, exogenous administration of aminoguanidine induces
      beneficial hemodynamic effects 4 h after the septic challenge. In normal animals,
      however, aminoguanidine was associated with hypoglycemia, acidosis,
      hyperlactatemia, and intestinal mucosal ischemia.

PMID- 11193276
TI  - Prostaglandin E1 improves hepatic encephalopathy produced by ischaemia
      reperfusion liver injury in rats.
AB  - OBJECTIVE: To investigate the action of prostaglandin E1 on hepatic
      encephalopathy. DESIGN: Prospective, randomised, controlled animal study.
      SETTING: University animal laboratory. SUBJECTS: Male Wistar rats. INTERVENTIONS:
      After passive avoidance learning, acute liver failure was induced by occlusion of
      the left portal vein and the hepatic artery for 90 min. Then memory retention was
      evaluated 48 h later. The effects of prostaglandin E1 on memory retention were
      examined in animals treated with the agent systemically (intravenous injections
      with prostaglandin E1 twice before and after surgery, 20 microg/kg each time) and
      animals treated with the agent topically (intracerebroventricular injection with
      prostaglandin E1, 0.1 microg/h for 48 h beginning at liver ischaemia).
      MEASUREMENTS AND RESULTS: Marked damage was found on plasma analysis in animals
      subjected to liver ischaemia, and the memory retention was also impaired.
      Intravenous administration of prostaglandin E1 improved both the liver injury and
      memory retention. However, intracerebroventricular administration of
      prostaglandin E1 alleviated neither. CONCLUSION: These findings show that
      prostaglandin E1 contributes to the amelioration of hepatic encephalopathy by
      improving liver function.

PMID- 11193277
TI  - The renal and neurohumoral effects of the addition of low-dose dopamine in septic
      critically ill patients.
AB  - OBJECTIVES: Dopamine exerts a complicated action on the cardiovascular-renal and
      neurohumoral systems. We evaluated the effects of the addition of different doses
      of dopamine on top of treatment with norepinephrine on the haemodynamics, renal
      function and neurohormones of septic shock patients. DESIGN: Open, uncontrolled,
      dose-finding study. SUBJECTS: Dopamine was administered, after fluid
      resuscitation, to septic shock patients who were more than 2 h haemodynamically
      and pulmonary stable with the use of a constant dose norepinephrine. Patients
      with a serum creatinine above 180 micromol x l were excluded. METHODS: Dopamine
      doses of 0, 2, 4, 6 and 0 microg x kg(-1) x min(-1) were given consecutively for
      1 h each. Neurohormones were measured hourly after baseline levels had been
      taken. Systemic haemodynamics were measured using a pulmonary artery (PA)
      catheter every 30 min, whereas urine collections were examined every hour during
      the study period. RESULTS AND STATISTICAL ANALYSES: Eight patients (mean age 46
      +/- 13 years, M/F 3/5) were included. The median norepinephrine dose at the start
      of the study was 0.29 microg x kg(-1) x min(-1) (range 0.07-0.48 microg x kg(-1)
      x min(-1)). Cardiac output (CO) rose during the dopamine infusion for all doses
      from 7.9 +/- 1.74 l/min to a maximum of 10.1 +/- 1.71 l/min, achieved at the 4
      microg x kg(-1) x min(-1) dopamine dose, whereas systemic vascular rate (SVR)
      decreased slightly for all doses. Heart rate remained unchanged during the 2
      microg x kg(-1) x min(-1) dose of dopamine but increased for the 4 and 6 microg x
      kg(-1) x min(-1) doses from 108 +/- 17 to a maximum of 124 +/- 24 beats/min.
      Filling pressures remained unchanged whereas the mean arterial blood pressure
      increased (from 83 +/- 7 to 93 +/- 11 mmHg). Plasma renin activity (PRA) was
      relatively high (but remained unchanged) as were aldosterone levels. Sodium
      excretion and diuresis increased for all doses, accompanied by an increase of
      fractional sodium excretion at the 4 and 6 microg x kg(-1) x min(-1) doses of
      dopamine. Creatinine clearances remained unchanged. All changed values returned
      to baseline values after cessation of the dopamine administration. CONCLUSION:
      During norepinephrine infusion, increasing doses of dopamine from 2 to 6 microg x
      kg(-1) x min(-1) augments CO, diuresis and sodium excretion in patients treated
      for septic shock, without changes in creatinine clearance. Higher doses of
      dopamine (4 and 6 microg x kg(-1) x min(-1)) also induce an increase in heart
      rate. PRA, aldosterone and norepinephrine levels remain unchanged during dopamine
      infusion.

PMID- 11193278
TI  - Possibilities and limits of treatment in patients with thrombotic
      thrombocytopenic purpura.
AB  - Results of treatment of 18 patients fulfilling the criteria for TTP are
      presented. Thrombocytopenia was present in all patients (100%). Sixteen of the 18
      patients (88.8%) had mental status changes, and seven of the 18 patients (38.8%)
      had renal impairment. One patient had a secondary type of TTP, caused by non
      Hodgkin's lymphoma of the large intestine (that was diagnosed later) and was
      excluded from the study. Immunosuppresive therapy with steroids, plasma exchange
      and replacement of removed volume with fresh frozen plasma in a dosage of 25
      ml/kg body weight resulted in a statistically significant increase of platelet
      count (P = 0.00222), and a significant improvement in consciousness defined by
      increased GCS after 2 weeks (P = 0.00222). In two patients renal function
      recovered, and in one of them hemodialysis was no longer needed. This improvement
      in a small group of patients had no statistical significance. TTP recurred in
      seven patients. High doses of steroids caused serious side effects in two
      patients: in one patient, steroid diabetes, and in the other one, intestinal
      perforation.

PMID- 11193279
TI  - Transfusion requirements during continuous veno-venous haemofiltration: -the
      importance of filter life.
AB  - OBJECTIVE: To investigate the relationship between loss of haemofilter circuits
      due to blood clots and requirement for blood transfusion in intensive care
      patients. DESIGN: Retrospective case note review. SETTING: A British, nine-bed,
      tertiary, medical and surgical intensive care unit (ICU) serving a 950-bed
      university teaching hospital. PATIENTS: Thirty-three ICU patients requiring
      haemofiltration for more than 48 h. Thirty-three comparison patients requiring 7
      or more days of intensive care, without haemofiltration. METHODS: ICU,
      haemofiltration and haematology records were examined retrospectively. Note was
      taken of demographic data, daily haemoglobin concentrations and the dates and
      numbers of blood transfusions and haemofilter clots. RESULTS: The study groups
      did not differ significantly in terms of age, sex and length of ICU stay.
      Haemofiltered patients had higher APACHE II scores (21 vs 15, p = 0.006), lower
      haemoglobin concentrations (102 vs 110 g/l, p = 0.0001) and higher blood
      transfusion rates (1.1 vs 0.3 units/day, p < 0.0001) when compared to the non
      haemofiltered group. There was a positive correlation between haemofilter blood
      clot rate and blood transfusion rate (r = 0.48). More blood was transfused on
      days when haemofilter blood clots occurred than on days when no haemofilter clot
      occurred (1.0 vs 0.59 units, p = 0.03). CONCLUSION: Haemofiltration is associated
      with an increased requirement for transfusion of blood. The temporal relationship
      between occurrence of haemofilter blood clots and transfusion of blood suggests
      that haemofilter lifespan may be an important determinant of this.

PMID- 11193280
TI  - Critical illness onychomadesis.
AB  - OBJECTIVE: To present our observation of the development of a rare nail deformity
      in the prolonged course of disease of a critically ill patient with a pulmonary
      abscess. DESIGN: Case report. SETTING: Tertiary referral, 16-bed, level I
      surgical ICU in an academic hospital. PATIENT: A 48-year-old Caucasian male was
      treated with penicillin for a pneumococcal meningitis and pneumonia. He developed
      a large pulmonary abscess of the right upper lobe and needed prolonged mechanical
      ventilation. Extensive surgical treatment was successful eventually. A remarkable
      feature concerned the occurrence of onycholysis of all finger nails and toe nails
      resulting in complete shedding of the nails (onychomadesis). This phenomenon can
      be regarded as an extreme manifestation of Beau's lines precipitated by a severe
      systemic insult. CONCLUSION: We observed the development of onychomadesis in a
      critically ill patient with a large pulmonary abscess. This association has not
      been described before.

PMID- 11193281
TI  - Coagulation inhibitors in sepsis and disseminated intravascular coagulation.
AB  - Sepsis is a syndrome that is increasing in frequency and continues to be
      associated with an unacceptably high mortality. DIC is an important and common
      sequel of sepsis, is implicated in the development of multiple organ failure, and
      has been shown repeatedly to connote a poor prognosis. Increasing understanding
      of the pathogenesis of DIC has suggested several novel therapies designed to
      correct deficiencies in inhibitors of coagulation. To date, small randomized,
      controlled studies of antithrombin III concentrates in sepsis and DIC have shown
      a trend to increased survival, but have not achieved statistical significance.
      Currently, a large randomized controlled trial of antithrombin III in sepsis is
      being conducted. Until more data are available, important questions remain as to
      its proper place in the treatment of sepsis, septic shock, and DIC. Similarly,
      therapy with protein C and tissue factor-pathway inhibitor has been beneficial in
      animal models of sepsis and DIC. The results of controlled clinical trials in
      humans are eagerly awaited.

PMID- 11193282
TI  - Tracheal obstruction caused by minitracheotomy.

PMID- 11193283
TI  - Visible endotracheal cuff: caution!

PMID- 11193284
TI  - Multi-organ failure in a patient with sepsis due to Salmonella precipitated by
      liver trauma.

PMID- 11193285
TI  - Successful temporary left ventricular assistance with the hemopump assist device
      during acute myocardial infarction after complex mitral valve surgery.

PMID- 11193286
TI  - Hypokalemic coma with tetany following pseudo-Bartter syndrome.

PMID- 11193287
TI  - Hemophagocytic syndrome in the critically ill.

PMID- 11193288
TI  - Buflomedil poisoning: a potentially life-threatening intoxication.

PMID- 11193289
TI  - Endogenous endophthalmitis.

PMID- 11193290
TI  - Shock and other severe manifestations following ethanol-methanol copoisoning.

PMID- 11193291
TI  - Cold adapted enzymes.
AB  - The number of reports on enzymes from cold adapted organisms has increased
      significantly over the past years, and reveals that adaptive strategies for
      functioning at low temperature varies among enzymes. However, the high catalytic
      efficiency at low temperature seems, for the majority of cold active enzymes, to
      be accompanied by a reduced thermal stability. Increased molecular flexibility to
      compensate for the low working temperature, is therefore still the most
      dominating theory for cold adaptation, although there also seem to be other
      adaptive strategies. The number of experimentally determined 3D structures of
      enzymes possessing cold adaptation features is still limited, and restricts a
      structural rationalization for cold activity. The present summary of structural
      characteristics, based on comparative studies on crystal structures (7), homology
      models (7), and amino acid sequences (24), reveals that there are no common
      structural feature that can account for the low stability, increased catalytic
      efficiency, and proposed molecular flexibility. Analysis of structural features
      that are thought to be important for stability (e.g. intra-molecular hydrogen
      bonds and ion-pairs, proline-, methionine-, glycine-, or arginine content,
      surface hydrophilicity, helix stability, core packing), indicates that each cold
      adapted enzyme or enzyme system use different small selections of structural
      adjustments for gaining increased molecular flexibility that in turn give rise to
      increased catalytic efficiency and reduced stability. Nevertheless, there seem to
      be a clear correlation between cold adaptation and reduced number of interactions
      between structural domains or subunits. Cold active enzymes also seem, to a large
      extent, to increase their catalytic activity by optimizing the electrostatics at
      and around the active site.

PMID- 11193292
TI  - Telomerase, immortality and cancer.
AB  - Replication of eukaryotic linear chromosomes is incomplete and leaves terminal
      gaps. The evolutionary widely distributed solution to this "end replication" is
      twofold: chromosome ends are capped with telomeres, bearing multiple copies of
      redundant telomeric sequences, and the telomerase enzyme can add (lost) telomeric
      repeats. Telomerase in humans, as in all mammals, is ubiquitous in all embryonic
      tissues. In adults, telomerase remains active in germs cells, and, although down
      regulated in most somatic tissues, telomerase is active in regenerative tissues
      and notably, in tumor cells. Telomerase activity is linked to cellular
      proliferation, and its activation seems to be a mandatory step in carcinogenesis.
      In contrast to mammals, indeterminately growing multicellular organisms, like
      fish and crustaceae, maintain unlimited growth potential or 'immortality' in all
      somatic tissues throughout their entire life. Also this cell immortalization is
      brought about by maintaining telomerase expression. Disease prognosis for human
      tumors includes evaluation of cell proliferation, based on the detection of
      proliferation markers with monoclonal antibodies. The significance of the
      classical marker Ki-67, and of a novel marker repp-86 are compared with
      semiquantitative telomerase assays. For tumor therapy, telomerase inhibitors are
      attractive tools. Results with telomerase knock-out mice have revealed promise,
      but also risk of this approach. On the other side, telomerase stimulation is
      attractive for expanding the potential of cellular proliferation in vitro, with
      possible applications for transplantation of in vitro expanded human cells, for
      immortalizing primary human cells as improved tissue models, and for the
      isolation of otherwise intractable products, like genuine human monoclonal
      antibodies.

PMID- 11193293
TI  - Molecular diagnostics of infectious diseases: state of the technology.
AB  - In this review, the basic technologies and procedures currently used in clinical
      laboratories performing molecular diagnostics are described. Special emphasis on
      specimen processing has been made since it is one of the most challenging steps
      involved in molecular testing. Representative examples are given for each type of
      technology, especially tests that are currently available in the market. The
      types of hybridization-based and amplification-based procedures are detailed.
      Finally, current problems and future developments are discussed.

PMID- 11193294
TI  - Combined chemical-biological treatment of wastewater containing refractory
      pollutants.
AB  - Biological processes are usually most efficient for degrading pollutants
      occurring in wastewater. Refractory and toxic compounds contained limit their
      applicability. In such cases combinations with chemical oxidation processes may
      improve the overall efficiency and efficacy. Most suitable oxidation processes
      for combination with biological treatment are wet air oxidation, ozonation,
      hydrogen peroxide treatment and other advanced oxidation processes. Most
      effective are OH-radicals produced in all these oxidation processes. Chemical
      oxidation produces intermediates with usually improved biodegradability. Process
      combinations may be serial or with recycling between chemical oxidation and
      biological treatment. Design criteria, control of combined processes and recent
      applications are reviewed.

PMID- 11193295
TI  - Biodegradation of nitroaromatic pollutants: from pathways to remediation.
AB  - Nitroaromatic compounds are important contaminants of the environment, mainly of
      anthropogenic origin. They are produced as intermediates and products in the
      industrial manufacturing of dyes, explosives, pesticides, etc. Their toxicity has
      been extensively demonstrated in a whole range of living organisms, and
      nitroaromatic contamination dating from World War II is the proof of the
      recalcitrance of such compounds to microbial recycling. In spite of this,
      bacteria have evolved diverse pathways that allow them to mineralize specific
      nitroaromatic compounds. Degradation sequences initiated by an oxidation, an
      attack by a hydride ion, or a partial reduction have been documented. Some of
      these reactions have been exploited in bioreactors. Although pathways and enzymes
      involved are rather well understood, the molecular basis of these pathways is
      still currently under investigation. However, productive metabolism is an
      exception. As a rule, most bacteria are only able to reduce the nitro group into
      an amino function. This reduction is cometabolic: the metabolism of exogenous
      carbon sources is required to provide reducing equivalents. Composting and
      processes in bioreactors have exploited the easy reduction of the nitroaromatic
      compounds. In the case an amino-aromatic compound is produced, it is important to
      incorporate it in the remediation scheme. Some processes dealing with both nitro-
      and amino-aromatic compounds have been described, the amino derivative being
      either mineralized by the same or, more often, another microorganism, or
      immobilized on soil particles. Depending on the nitroaromatic compound and the
      environment it is contaminating, a whole range of reactions and reactor studies
      are now available to help devise a successful remediation strategy.

PMID- 11193296
TI  - Prevention of marine biofouling using natural compounds from marine organisms.
AB  - All surfaces that are submerged in the sea rapidly become covered by a biofilm.
      This process, called biofouling, has substantial economic consequences. Paints
      containing tri-butyl-tin (TBT) and copper compounds are used to protect marine
      structures by reducing biofouling. However, these compounds have damaging effects
      on the marine environment, as they are not biodegradable. It has been noted that
      many seaweeds and invertebrates found in the sea are not covered by a mature
      biofilm. This is due to the release of compounds into the surrounding seawater
      that deter the settlement of fouling organisms. In addition, seaweeds and
      invertebrates have bacteria on their surfaces that produce compounds to deter
      settling organisms. The production of compounds by bacteria and their living
      hosts work in concert to protect the hosts' surfaces. All of these compounds can
      be collected so they may be natural alternatives to TBT and copper compounds.
      However, the benefits associated with the use of bacteria as sources of these
      compounds means that bacteria are the organisms of choice for obtaining natural
      products for antifouling coatings.

PMID- 11193297
TI  - Biotechnological applications of plant freezing associated proteins.
AB  - Plants use a wide array of proteins to protect themselves against low temperature
      and freezing conditions. The identification of these freezing tolerance
      associated proteins and the elucidation of their cryoprotective functions will
      have important applications in several fields. Genes encoding structural
      proteins, osmolyte producing enzymes, oxidative stress scavenging enzymes, lipid
      desaturases and gene regulators have been used to produce transgenic plants.
      These studies have revealed the potential capacity of different genes to protect
      against temperature related stresses. In some cases, transgenic plants with
      significant cold tolerance have been produced. Furthermore, the biochemical
      characterization of the cold induced antifreeze proteins and dehydrins reveals
      many applications in the food and the medical industries. These proteins are
      being considered as food additives to improve the quality and shelf-life of
      frozen foods, as cryoprotective agents for organ and cell cryopreservation, and
      as chemical adjuvant in cancer cryosurgery.

PMID- 11193298
TI  - [A study on parameters to predict tumor volume for stage T1c prostate cancers of
      Gleason score 6 or less].
AB  - The number of cases of stage T1c prostate cancer has dramatically been increasing
      since the introduction of PSA as a screening test. The patients with T1c prostate
      cancer are usually treated by radical prostatectomy. In this group, however, some
      cancers are of small tumor volume and with a Gleason score of less than 7. These
      cancers are considered to be good candidates for watchful waiting management. We
      have investigated 40 patients with T1c prostate cancer treated by radical
      prostatectomy between 1996 and 1998. All 9 patients harboring tumors of Gleason
      score 7 or greater had tumors larger than 0.5 cm3. We have investigated PSA
      related parameters including total PSA (PSA), PSA density (PSAD), free PSA, and %
      free PSA in 31 patients with T1c cancers of Gleason score 6 or less in order to
      clarify good preoperative predictors of tumor volume. We compared the
      distribution of PSA, PSAD, free PSA, and % PSA between the larger and smaller
      tumor groups. There was no significant difference in PSA, PSAD, or free PSA
      value. The small tumor group had a greater mean % free PSA than the larger tumor
      group (23.27 versus 11.88, p = 0.007). Areas under receiver operating
      characteristic curves were 0.715, 0.794, 0.636, and 0.842 for PSA, PSAD, free PSA
      and % free PSA. In stage T1c prostate cancer of Gleason score 6 or less, % free
      PSA may be the most useful preoperative predictor for tumor volume of 0.5 cm3 or
      greater.

PMID- 11193299
TI  - [A randomized long-term comparative study of clinical efficacy of alpha 1-blocker
      with or without antiandrogen therapy for benign prostatic hyperplasia: focusing
      on improvement of I-PSS].
AB  - This study was conducted to examine the efficacy of administration of tamsulosin
      hydrochloride alone or in combination with chlormadinone acetate (CMA) against
      lower urinary tract symptoms for a period of 52 weeks in 33 patients with benign
      prostatic hyperplasia. The patients were randomly allocated into a group
      administered tamsulosin alone and a group administered tamsulosin in combination
      with CMA. Based on the assessment of the total I-PSS (International Prostate
      Symptom Score), significant symptomatic improvement was noted 4 weeks after the
      commencement of drug administration in the tamsulosin + CMA group, whereas no
      significant improvement was observed in the tamsulosin group. Both irritative and
      obstructive bladder symptoms improved significantly at any time of assessment
      after 4 weeks of drug administration in the tamsulosin + CMA group; however,
      significant improvement was noted only at week 16 and week 52 for irritative
      symptoms and at week 16 for obstructive symptoms in the tamsulosin group. In
      particular, obstructive symptoms showed significant improvement at week 4 in the
      tamsulosin + CMA group, as compared with that in the tamsulosin group. The
      average value of peak urinary flow rate was significantly increased in the
      tamsulosin + CMA group (10.4 ml/s to 15.6 ml/s) as compared with that in the
      tamsulosin group (8.5 ml/s to 10.5 ml/s). These findings indicate that combined
      administration of tamsulosin and CMA resulted in early improvement of lower
      urinary tract symptoms in these patients. Long-term combined administration of
      tamsulosin and CMA thus appears to be a promising treatment strategy for the
      improvement of obstructive symptoms and peak urinary flow rate, particularly, 16
      weeks onward after administration in patients with benign prostatic hyperplasia.

PMID- 11193300
TI  - [Transurethral microwave thermotherapy for benign prostatic hyperplasia].
AB  - The clinical efficacy of transurethral microwave thermotherapy using the
      PROSTCARE apparatus was evaluated in 60 patients with bladder outlet obstruction
      associated with benign prostatic hyperplasia. All of the 60 patients received a
      single thermal session for 60 minutes with an average intraprostatic temperature
      of 45 degrees C. They were evaluated by analyzing the international prostate
      symptom score (IPSS), quality of life (QOL) index, maximum urinary flow rate and
      prostate volume at 2 months after the treatment to estimate criteria for efficacy
      of treatment in BPH. Both IPSS and QOL index improved significantly. The maximum
      urinary flow rate improved but there was no significant change. There was no
      significant change in prostate volume. The rates of improvement in IPSS, QOL
      index and maximum flow rate were 73%, 78% and 47% of the patients respectively.
      The rate of overall improvement was 78% of the patients. As a complication after
      the treatment, 2 patients complained of ejaculation disturbance.

PMID- 11193301
TI  - [A case of effective endotoxin adsorption therapy for septic shock due to acute
      pyelonephritis].
AB  - Although septic shock has a high mortality rate of 43%, recently the endotoxin
      adsorption column was established and its efficacy is interesting. We report a
      very effective case of endotoxin adsorption the rapy for septic shock due to
      acute pyelonephritis. A 59-year-old man with chief complaints of pyrexia and
      right backache was referred to our hospital with a small right ureteral stone (4
      mm) associated with a low degree of right hydronephrosis. Since it was diagnosed
      as right acute pyelonephritis, antibiotics were administered; and then septic
      shock occurred on the day of hospitalization. Endotoxin adsorption therapy was
      performed for two days and hemodynamic stability was achieved. The concentration
      of blood endotoxin was reduced remarkably and the efficacy of endotoxin
      adsorption therapy was suggested.

PMID- 11193302
TI  - [Brain metastasis of bladder carcinoma after total cystectomy: a case report].
AB  - A 74-year-old woman underwent total cystectomy with ureterostomy on March 1993 on
      a diagnosis of advanced bladder cancer. The pathological diagnosis was
      transitional carcinoma grade 3, pT3a pN0 pV1, pL2. Two courses of adjuvant
      chemotherapy with CDDP and MTX were added. Three years and 3 months later, she
      began to suffer from amnesia and hemiparalysis on her left side. Brain MRI
      examination revealed a solid tumor, 4 x 4 x 3 cm in size, in the right frontal
      lobe of the cerebrum. No other metastatic lesions were found. She underwent
      surgical resection of the tumor and subsequent irradiation to right frontal lobe
      in the cerebrum. Pathological examination confirmed its origin of bladder cancer.
      She has been enjoying a disease-free life for 3 years with minimal neurological
      symptoms.

PMID- 11193303
TI  - [A case of ileus as a late complication of an ileal conduit in a patient with
      primary signet ring cell carcinoma of the bladder].
AB  - A 69-year-old man visited our hospital with a complaint of dysuria. Intravenous
      excretory urography, ultrasonography and CT scan showed a tumor at the base of
      the bladder and the prostate. Transrectal needle biopsy revealed signet ring cell
      carcinoma. Radical cystectomy and ileal conduit were performed, and a
      histological diagnosis was a primary signet ring cell carcinoma of the bladder.
      No recurrence or metastasis was found either on ultrasonography or CT scan at 26
      months after the operation. He suddenly suffered from severe abdominal pain, and
      died of hypovolemic shock by ileus as a late complication of an ileal conduit at
      27 months after the operation. An ileus with extensive necrosis of small
      intestine and cancer recurrence at the junction of the ureter and ileal conduit
      were observed at autopsy.

PMID- 11193304
TI  - [Two cases of nephrogenic adenoma in the bladder diverticulum].
AB  - We report two cases of a nephrogenic adenoma in the bladder diverticulum. The
      first patient was an 81-year-old man with gross hematuria. Cystoscopy revealed
      bladder diverticulum and a papillary tumor within. Bladder diverticulectomy was
      performed and the histopathological diagnosis was a nephrogenic adenoma. The
      second patient was a 50-year-old man with gross hematuria and dysuria.
      Transabdominal ultrasound revealed bladder diverticulum. Transurethral
      coagulation of the bladder diverticulum was performed. Then three papillary
      tumors were detected, and were resected transurethrally. The histopathological
      diagnosis was a nephrogenic adenoma. These are the first and second cases of a
      nephrogenic adenoma in the bladder diverticulum reported in Japan.

PMID- 11193305
TI  - [Clinical experiences of endotoxin removal columns in septic shock due to
      urosepsis: report of three cases].
AB  - Clinical experiences of endotoxin removal using polymyxin B immobilized fiber
      column (PMX) in three septic shock patients are reported. The patients were
      referred to our hospital with complaints of high fever and severe pain during
      urination. Physical examination and laboratory data revealed severe hypotension,
      tachycardia, and pyuria. Diagnoses of septic shock due to urosepsis were made.
      After antibiotic therapy and anti-shock therapy, direct hemoperfusion using
      polymyxin B immobilized fiber column (PMX) was carried out. Thereafter,
      cardiovascular instabilities were improved without increasing the supply of
      catecholamines. PMX therapy for systemic inflammatory response due to infection
      was effective in treatment of cardiovascular instabilities.

PMID- 11193306
TI  - [Intra-arterial infusion chemotherapy for liver metastases of testicular tumors:
      report of two cases].
AB  - Two cases of testicular tumors with lymph node involvement and multiple lung and
      liver metastases were treated successfully with intra-arterial infusion
      chemotherapy. Case 1: A 30-year-old man presented with right scrotal swelling and
      an abdominal mass. He had a large retroperitoneal mass and multiple lung and
      liver metastases on computed tomographic (CT) scan and chest X-ray. Right
      inguinal orchiectomy was performed. Histopathological diagnosis revealed
      embryonal cell carcinoma and choriocarcinoma. Cisplatin, vinblastine, VP-16 and
      pepleomycin combination chemotherapy (PVeBV) was started and repeated for 2
      courses. The retroperitoneal mass and lung tumors decreased in size, but liver
      tumors enlarged. Systemic and intrahepatic arterial infusion combined with
      chemotherapy was administered, and intra-arterial chemotherapy (cisplatin, VP-16)
      was added. The patient also received systemic chemotherapy (carboplatin, VP-16,
      ifosfamide). After chemotherapy, retroperitoneal lymph node dissection was
      performed. Microscopic examination revealed no viable cancer cells. On CT scan,
      no retroperitoneal, liver, or lung tumor was detected. Case 2: A 43-year-old man
      presented with right scrotal swelling and an abdominal mass. CT scan revealed a
      large retroperitoneal mass as well as lung and multiple liver metastases. Right
      inguinal orchiectomy was performed. Histopathological diagnosis revealed
      seminoma. Cisplatin, vinblastine, VP-16 and pepleomycin combination chemotherapy
      (PVeBV) was administered, but the liver tumors ware enlarged on CT scan.
      Intrahepatic arterial infusion chemotherapy (cisplatin, VP-16) was started and
      repeated for 4 courses. On CT scan, the lung metastasis seemed to have
      disappeared, and the retroperitoneal mass and liver metastases were decreased in
      size.

PMID- 11193307
TI  - [Burned-out testicular tumor: a case report].
AB  - A 29-year-old man was referred to our hospital with loss of appetite and a left
      lower abdominal mass. A small nodule was palpable in his left testis and
      ultrasonographic examination demonstrated that the nodule was low echoic.
      Computed tomography showed a large mass in his left retroperitoneal space. We
      thought the mass was a metastatic lesion from a testicular tumor. Left
      orchiectomy was done and microscopic examination revealed no viable tumor cells.
      Only fibrous tissue, small calcified areas, and hyaline bodies were found. As
      tumor markers were normalized after 3 courses of chemotherapy with bleomycin,
      etoposide, and cisplatine, the retroperitoneal mass was removed with the left
      kidney. It consisted of embryonal carcinoma, mature teratoma, and yolk sac tumor.
      One course of adjuvant chemotherapy was done and the patient has since been free
      from recurrence. We suppose that the tumor was a so-called 'burned-out'
      testicular tumor.

PMID- 11193308
TI  - [Staging urinary bladder cancer with dynamic MR imaging].
AB  - This article reviews the magnetic resonance (MR) staging of bladder cancer. The
      multiplanar and soft-tissue characterization capabilities of MR imaging make it a
      valuable diagnostic tool to image the urinary bladder. Recent advances of MR
      imaging such as fast imaging, pelvic phased array coil, and dynamic imaging
      improve the image quality and diagnostic accuracy for staging bladder cancer.
      Some patient-related factors are also important for optimal imaging of the
      urinary bladder, especially motion artifacts from the gastrointestinal tract and
      the degree of bladder distension. An anticholinergic agent should be used for
      suppressing the motion artifacts. Optimal bladder filling can be achieved by
      asking patients to void and drink water 1 hour before examinations. Scanning
      perpendicular to the bladder wall is necessary for optimal evaluation for staging
      bladder cancer. Oblique scanning is needed in cases when a tumor is not located
      on the dome, base, anterior wall, posterior wall, or lateral walls. The early
      phase image of dynamic imaging is most useful for staging tumors. Better contrast
      between tumor and bladder wall on dynamic images provides high staging accuracy,
      especially in differentiation between superficial tumors and tumors with muscle
      invasion. MR imaging is comparable to computed tomography (CT) in the evaluation
      of lymph nodes. Although MR imaging currently is not appropriate for screening
      for bladder cancer and detecting small tumors, it has been proved to be most
      useful in the staging of bladder cancer.

PMID- 11193309
TI  - [Ultrasound in urodynamics].
AB  - Recent developments of ultrasound imaging have contributed much to the
      understanding of urodynamics in patients with lower urinary tract symptoms
      (LUTS). These include ultrasound estimated bladder weight (UEBW), transrectal
      power Doppler imaging of the prostate and transrectal ultrasonography during
      voiding (voiding TRUS). UEBW, which is obtained by measuring the thickness of the
      anterior bladder wall using a 7.5 MHz probe, represents well the degree of
      bladder hypertrophy caused by obstruction. This parameter is, accordingly, of
      clinical use in the evaluation of obstruction. The UEBW predicted the presence of
      obstruction as determined by pressure-flow study with a diagnostic accuracy of
      73%. Transrectal power Doppler imaging of the prostate has made it easy to detect
      prostatic vessels and furthermore to obtain their resistive index (RI).
      Accumulating data suggest strongly that RI reflects the intraprostatic pressure.
      More interestingly, RI decreases significantly during voiding in normal subjects
      but not in patients with benign prostatic hyperplasia. Thus, this method is of
      particular use in monitoring noninvasively the dynamic change in intraprostatic
      pressure during voiding. Voiding TRUS makes it possible to monitor the movement
      of not only the posterior urethra but also the prostate during voiding. Based on
      our recent study, the anterior fibromuscular stroma (AFMS) seems to contract to
      open the urethra. Although the physiological function of the AFMS in the prostate
      remains unknown, AFMS may play a significant role in normal micturition. Due to
      its noninvasiveness and ease of application, ultrasound imaging would play a
      vital role in the diagnostic process for patients with LUTS in future.

PMID- 11193310
TI  - [Prenatal diagnosis of urological abnormalities].
AB  - The frequent discovery of fetal congenital abnormalities has led to a better
      understanding of pediatric urological disorders. On the other hand, new questions
      on clinical examinations and management of the children have given rise to much
      controversy. We reviewed the difficulties and pitfalls surrounding the urological
      prenatal diagnosis. Accuracy of ultrasonography is operator-dependent, and main
      factors leading misdiagnosis include oligohydramnios and rare incidence of the
      abnormalities. Underlying disorders of prenatal hydronephrosis are
      multifactorial. Efforts to obtain co-existing findings, such as ureteral
      dilatation or bladder abnormalities, are essential to make accurate diagnosis.
      Evaluation of fetal renal function is mandatory in critical cases with decreased
      amniotic fluid volume. Biochemical analysis of fetal urine may be most reliable
      in differentiating fetuses with a good prognosis from those with a poor
      prognosis.

PMID- 11193312
TI  - [Staging and tissue characterization of prostate carcinoma: role of endorectal MR
      imaging and MR spectroscopy].
AB  - The role of magnetic resonance (MR) imaging and MR spectroscopy with an
      endorectal coil in tissue characterization and local staging was reviewed.
      Endorectal coil (ERC) MR imaging demonstrated the detailed zonal anatomy of the
      normal prostate. The sensitivity and specificity of staging prostate cancer for
      ERC MR imaging was superior to both conventional MR imaging and transrectal
      ultrasound. ERC MR imaging is the most accurate noninvasive method of staging
      prostate cancer. However, the accuracy of the diagnosis made by inexperienced
      radiologists was significantly inferior to that made by experienced radiologists.
      Endorectal MRI failed to differentiate benign from malignant lesions in some
      patients demonstrating low signal intensity on T2-weighted imaging in the
      peripheral zone. MR spectroscopy may provide additional information on tissue
      characterization, monitoring after treatment and staging.

PMID- 11193311
TI  - [Evaluation of prostate cancer using FDG-PET].
AB  - The clinical usefulness of 18F-fluorodeoxyglucose positron emission tomography
      (FDG-PET) was examined in 54 patients with prostate cancer. FDG accumulation was
      positive in 38 of 54 the prostates (70%), 3 of 8 the lymph node metastases (38%)
      and 10 of 16 the bone metastases (63%), which suggested that FDG-PET is not
      superior to other conventional imaging methods as a tool for tumor detection. On
      the other hand, a quantitative value for FDG uptake in the prostate, expressed as
      a standardized uptake value (SUV), significantly correlated to the histological
      grade, clinical stage and serum PSA of the patients. A decrease of SUV was
      observed in all the patients who responded to endocrine treatment, and the
      patients with high pre-treatment SUV were shown to be at the risk for disease
      progression after initial treatment. The present results indicated that FDG-PET
      could provide us with useful prognostic information for the patients with
      prostate cancer by evaluating the malignant potential of the tumor.

PMID- 11193313
TI  - [Diagnosis of urinary disorders using ultra-thin ultrasound probe].
AB  - We have developed a new diagnostic instrument, to visualize small or early
      lesions from inside by introducing a flexible ultra-thin probe (2 mm in diameter)
      into the urinary system. The frequency of the oscillator is 20 to 30 MHz, so the
      tomogram obtained by the method is extremely fine compared with the ultrasonogram
      obtained by the scanning from outside of the body. Three-dimensional
      reconstruction of tomogram is also realized. This display method is valuable to
      plan operations, follow the progress of therapy, and obtain well informed consent
      from the patient. We are now developing systems to bend and twist the tip of the
      intraureteral probe. They are applications of shape memory alloy, thermo-electric
      actuator and magnetic torque.

PMID- 11193314
TI  - [Usefulness of arousals for the detection of sleep breathing disorder].
AB  - Because of the difference of sensitivity among measurement techniques, upper
      airway obstruction events cannot always be scored as apnea or hypopnea. We
      hypothesized that arousal accompanied with breathing disturbance is a more
      sensitive index for the diagnosis of sleep breathing disorders than others. We
      studied 75 patients with sleep breathing disorder by polysomnograph. Breathing
      disturbance related arousal (B-Ar) was defined as an arousal accompanied with at
      least one of the following (apnea, hypopnea, more than 4% oxygen desaturation,
      snoring), and the breathing disturbance indices were compared. There were close
      relationships between B-ArI and apnea hypopnea index (AHI), oxygen desaturation
      index (DI), and percent of total sleep time with SpO2 below 90% in all patients
      (r = 0.93, r = 0.58, r = 0.92, respectively, all p < 0.001). In 25 patients whose
      AHI was below 20 per hour, no relationship between B-ArI and AHI was found, and B
      ArI was significantly greater than AHI. Thus, B-ArI seemed to be more sensitive
      than AHI. In all 6 patients whose AHI was below 10, B-ArI was lowered decreased
      by continuous nasal positive airway pressure therapy. These results suggest that
      B-ArI may be more sensitive in the detection of sleep breathing disorders than
      the other indices when AHI is below 20 per hour.

PMID- 11193315
TI  - [A case of idiopathic tracheal stenosis].
AB  - A 44-year-old woman who had been treated for bronchial asthma for 5 years was
      admitted for further evaluation of progressive dyspnea. Physical examination
      revealed wheezing originating in the neck. A flow-volume curve suggested upper
      airway stenosis. The patient had no history of trauma, endotracheal intubation,
      granulomatous diseases, or any other severe respiratory tract infections. Chest
      radiography and laboratory examination showed no abnormalities. Tracheal X-P,
      computed tomography and magnetic resonance imaging of the neck, and bronchoscopy
      demonstrated circumferential subglottic tracheal stenosis extending for 40 mm.
      The diameter of the lumen was 5 mm at its narrowest. The trachea distal to the
      lesion was normal. Bronchoscopic biopsy revealed thickened tracheal mucosa and
      submucosa with increased fibrous tissue and chronic inflammatory cell
      infiltration, suggesting a nonspecific inflammatory process. These findings are
      compatible with idiopathic tracheal stenosis, which was reported by Bhalla et al.
      The patient was treated with Nd-YAG laser surgery via a fiberoptic bronchoscope,
      which resulted in a great improvement in respiration. Regression of the lesion
      has not occurred in the 40 months since the laser surgery. The majority of
      patients with this condition have been treated by surgical resection of the
      stenotic lesion and reconstruction. However, the success of Nd-YAG laser surgery
      in the present case suggests that this approach would be a satisfactory
      alternative procedure for treatment of idiopathic tracheal stenosis.

PMID- 11193316
TI  - [Acute effects of oxygen on dyspnea and exercise tolerance in patients with
      pulmonary emphysema with only mild exercise-induced oxyhemoglobin desaturation].
AB  - The effects of oxygen on dyspnea and exercise tolerance during a 6-mimute walk
      test were examined in 10 patients with chronic pulmonary emphysema (CPE) who had
      only mild hypoxemia at rest (PaO2 > 60 Torr) and mild exercise-induced
      oxyhemoglobin desaturation (lowest SpO2 > 88%) on compressed air. As a whole,
      oxygen supplementation (2 l/min) resulted in a 7% increase in the distance walked
      in 6 min (6 MD), a 3% increase in the lowest SpO2, and an 8% decrease in the
      dyspnea score. In 6 of 7 patients with severe airflow limitation (one-second
      forced expiratory volume (FEV1) < 40% of predicted value), 6 MD (7-15%) increased
      significantly on oxygen, an improvement that correlated significantly with FEV1
      (r = -0.65, p < 0.05). These results suggest that supplementary oxygen improves
      dyspnea and exercise tolerance in CPE patients with only mild exercise-induced
      hypoxemia despite severe airflow limitation. The long-term efficacy of oxygen in
      such patients needs further study.

PMID- 11193317
TI  - [Safety of and untoward reactions to 23-valent pneumococcal vaccine: a
      prospective study].
AB  - The study objective was to demonstrate the safety of Streptococcus pneumoniae
      vaccine in 430 geriatric patients at high risk of infection. The reactions after
      inoculation were classified as follows: (1) Grade 1: slight pain at the site of
      injection; mild systemic fatigue to improve within 3 days. (2) Grade 2: symptoms
      of swelling, erythema, or pain lasting for more than 3 days; inability to move
      upper limb due to pain; systemic symptoms such as a temperature above 38 degrees
      centigrade. (3) Grade 3: reactions requiring immediate medical therapy. Seventy
      patients (16.3%) showed inoculation reactions, and 360 (83.7%) were asymptomatic.
      Of the symptomatic reactions, 50 (11.6%) were grade 1.17 (4.0%) grade 2, and 3
      (0.7%) grade 3. About 5% of the patients with grade 1 and 2 reactions needed
      special management. One chronic heart failure patient complained of severe heart
      failure symptoms after inoculation.

PMID- 11193318
TI  - [Clinical analysis of patients referred for lung transplantation in eastern
      Japan].
AB  - We investigated the indications for lung transplantation (LTx) in Japan and
      discussed questions regarding the current Japanese criteria of LTx. This study
      examined 37 patients referred to our institute for LTx. Among these patients,
      there were 11 cases of primary pulmonary hypertension (PPH), 6 of
      lymphoangiomyomatosis (LAM), 4 of Eisenmenger's syndrome, 3 of bronchiolitis
      obliterans, 2 each of bronchiectasis, idiopathic pulmonary fibrosis (IPF), and
      pneumoconiosis, and 7 of other diseases. The most frequent age group was 30-39
      years (12 cases, 32.4%), and more than half of the patients were female (22
      cases, 59.5%). The regions of residence of the patients were Tohoku (19
      patients), Kanto (16), and Chubu (2). Patients were referred from all over
      eastern Japan. On evaluation, LTx was contraindicated in 5 cases, in 4 of which
      mechanical ventilation had been installed before consultation with us. Six
      patients died before registration on the Japan Organ Transplant Network (JOT). 6
      transplant candidates were registered with JOT, but one (PPH) died after 6 months
      of waiting, and one (LAM) received a lung transplant from a brain dead cadaver
      donor. We propose to reform and clarify the Japanese criteria for LTx-both
      indications and contraindications, to include such indications as a survival
      probability of less than two years, and such contraindications as mechanical
      ventilation. Early consultation at LTx centers was hoped for, in accordance with
      the International Guidelines and a transplant window.

PMID- 11193319
TI  - [Pulmonary Nocardia otitidiscaviarum infection in an immunocompetent host].
AB  - A rare case of pulmonary Nocardia otitidiscaviarum (N. otitidiscaviarum) was
      encountered in an immunocompetent host. A 74-year-old man was admitted to our
      hospital with a high fever and a productive cough. His chest radiograph and CT
      scan revealed infiltrative shadows in the right middle and lower lung fields.
      Although several antibiotics (third-generation cephalosporin, minocycline,
      imipenem) were administered, the fever and cough persisted, and C-reactive
      protein remained elevated. Repeated sputum cultures showed normal flora, so a
      transbronchial lung biopsy and bronchoalveolar lavage (BAL) were performed
      bronchoscopically at the right S5. The BAL fluid contained acid-fast, branching
      filamentous structures. The microorganism was identified as N. otitidiscaviarum
      by the Research Center for Pathogenic Fungi and Microbial Toxicoses (Chiba
      University). Trimethoprim-sulfamethoxazole was therefore administered, but the
      fever continued to rise daily, and C-reactive protein remained elevated. This
      isolated N. otitidiscaviarum showed resistance to multiple antimicrobial agents
      in vitro when examined by the disk diffusion method, and so, on the basis of the
      antibiogram, the patient was treated with clarithromycin (oral, 600 mg/day) plus
      amikacin (400 mg/day), which proved successful. Testing for pulmonary nocardiosis
      should be added to the differential diagnosis procedures for refractory pneumonia
      as an opportunistic infection and for community-acquired pneumonia.

PMID- 11193320
TI  - [A case of latex allergy with bronchial asthma].
AB  - A 26-year-old nurse consulted our department because of shortness of breath,
      wheezing and skin eruption after eating lunch several days before. At the
      consultation, the symptoms had disappeared, pulmonary function showed no
      abnormality, and there were no abnormal findings on chest auscultation. Latex
      allergy was suspected because of a history of wheezing and skin eruption after
      wearing latex gloves and an elevated serum IgE level specific to latex antigen.
      After a usage test of medical latex gloves, wheezing, skin eruption, and a
      decrease of FEV1.0 on pulmonary function testing were observed. The case was
      therefore diagnosed as latex allergy with bronchial asthma. Her symptoms were not
      observed after polymer coated gloves were substituted. Latex allergy is apt to
      complicate food allergy, an initial symptom of the present case. Specific IgE for
      several kinds of food was also elevated.

PMID- 11193321
TI  - [Diagnostic efficacy of 18F-fluorodeoxy glucose-positron emission tomography in
      multiple solitary pulmonary nodules].
AB  - A 73-year-old man was admitted to our hospital for evaluation of abnormal lung
      shadows in the left lung. Chest computed tomography revealed a cavitary lesion
      with irregular edges in the right S10 and a nodular lesion with well-defined
      margins in the left S6. Histological examination of a specimen obtained by
      transbronchial lung biopsy revealed squamous cell carcinoma in the right S10 but
      no significant findings in the left S6. Thirdly, 18F-fluorodeoxyglucose-positron
      emission tomography (18F-FDG-PET) demonstrated that the nodular shadow in the
      left S6 was a low-uptake structure and that the cavitary lesion in the right S10
      was a high-uptake lesion. We therefore considered that the nodular shadow in the
      left S6 was not one of neoplastic disease. Partial lung resection of the left S6
      was carried out by videoassisted thoracoscopic surgery. The pathological
      diagnosis of the left S6 was epithelial granuloma with caseation. A culture of
      the same resected specimen was positive for Mycobacterium avium. The eventual
      clinical staging for the squamous cell carcinoma in the right S10 was cT2N0M0
      (IB). Radical surgical treatment and right lower lobectomy were performed for the
      S10 lesion. We considered that 18F-FDG-PET was an effective noninvasive procedure
      for diagnosis of solitary or multiple solitary nodular shadows in the lung.

PMID- 11193322
TI  - [Psoas abscess caused by nephrolithiasis with perirenal abscess complicated with
      pleural effusion].
AB  - Left pleural effusion was found in a 60-year-old woman in whom chest radiography
      performed during a physical check up revealed no abnormality. Abdominal CT
      scanning revealed an abscess in the left psoas muscle. The psoas abscess was
      eliminated temporarily by drainage under ultrasonographic guidance and by the
      administration of antibiotics, but recurred one month later. A stag-horn renal
      stone considered to have caused the psoas abscess by formation of a perirenal
      abscess was eliminated by left nephrectomy. It is suggested tentatively that the
      psoas abscess might have been the cause of the pleural effusion.

PMID- 11193323
TI  - [A case of colon cancer with tension pneumothorax and empyema as a consequence of
      colo-pleural fistula].
AB  - A 63-year-old man was admitted to our hospital with fever and chest pain. Chest
      radiography revealed left pleural effusion with left pneumothorax and small
      nodular shadows in the right lung field. On CT of the chest and abdomen, multiple
      nodules were seen in both lung fields, and masses appeared in the liver and
      spleen. Fiberoptic colonoscopy showed obstruction at the end of the transverse
      colon. Biopsy of this obstruction proved it to be cancer. In this patient, a colo
      pleural fistula was also diagnosed using thoracoscopy under local anesthesia and
      from the inflow of contrast medium from the colon into the thoracic cavity seen
      in abdominal radiographs. This was a rare case of a colo-pleural fistula without
      diaphragmatic deficiencies. Medical thoracoscopy is useful for the diagnosis of
      complicated pleural effusions as was seen in this case.

PMID- 11193324
TI  - [Bronchial atresia with atelectasis of the left upper lobe].
AB  - A 69-year-old woman visited her physician on October 1 complain of dry cough.
      However, the chest radiograph revealed no abnormalities. She was later admitted
      to our hospital because a radiograph taken by another physician on November 26
      revealed a massive lesion in the right upper mediastinum. Computed tomographic
      findings showed a massive lesion containing a branching structure with a few
      calcifications, suggesting a case of atelectasis of the left upper lobe with
      mucus plug. Bronchoscopic examination revealed complete obstruction of the
      orifice of the left upper lobe bronchus, and so a diagnosis of bronchial atresia
      was made. However, since the patient had a history of tuberculous peritonitis and
      the mass lesion was somewhat calcified, the possibility that this was an acquired
      case could not be ruled out. After treatment with oral antibiotics, the size of
      the atelectasis was decreased. Therefore, we considered that the expansion of the
      atelectasis could have been due to superimposed bacterial infection.

PMID- 11193325
TI  - [A case of pulmonary manifestation associated with myelodysplastic syndrome].
AB  - A 69-year-old woman with myelodysplastic syndrome (MDS) was admitted to our
      hospital because of recurrent fever and pulmonary infiltration shadows. On the
      seventh day of hospitalization, she had an attack of high fever and cough and
      laboratory tests revealed an elevated leukocyte count and elevated serum C
      reactive protein. Chest radiographs showed infiltration shadows in the right
      middle and lower lung fields. Because a diagnosis of bacterial pneumonia was
      initially suggested, she was treated with antibiotics. However, the infiltration
      shadows on the chest radiograph had not improve, so bronchofiberscopy was
      performed. Analysis of fluid obtained by bronchoalveolar lavage (BAL) showed an
      increase in the total cell count, predominantly in lymphocytes and neutrophils. A
      transbronchial biopsy specimen showed infiltration of numerous neutrophils with
      necrosis under the bronchial epithelium, and edematous septa were infiltrated
      with numerous neutrophils and lymphocytes. BAL, blood, urine, bone marrow, and
      sputum cultures were all free of bacteria, mycobacteria and fungi. Interstitial
      infiltration by numbers of neutrophils associated with MDS was diagnosed and
      steroid treatment was performed.

PMID- 11193326
TI  - [A case of primary Sjogren's syndrome with interstitial pneumonia showing
      bronchiolitis obliterans organizing pneumonia pattern and lymphofollicular
      formation].
AB  - A 46-year-old woman with a 2-year history of xerostomia, who had had an episode
      of suspected Sjogren's syndrome in 1995, was admitted to our hospital because of
      a dry cough. Chest radiography on admission showed ground-glass infiltrates and
      reticular shadows in both lower lung fields. Primary Sjogren's syndrome was
      diagnosed by lip biopsy. Video-assisted thoracoscopic lung biopsies revealed the
      co-existence of interstitial pneumonia with the BOOP pattern and follicular
      bronchiolitis. Treatment with oral prednisolone improved the symptoms, and
      reduced the abnormal chest shadows. This was an interesting case of the BOOP
      pattern in a lung lesion associated with primary Sjogren's syndrome.

PMID- 11193327
TI  - [Dramatic improvement of severe Pneumocystis carinii pneumonia by corticosteroids
      despite lack of antipneumocystis therapy in acquired immunodeficiency syndrome].
AB  - A 30-year-old Thai man was admitted to our hospital complaining of general
      fatigue, pyrexia, dyspnea, and a productive cough. He was in serious respiratory
      failure and had a PaO2 of 45.9 Torr in room air. Chest radiography showed marked
      infiltration of both lungs. Pneumocystis carinii pneumonia (PCP) associated with
      acquired immunodeficiency syndrome (AIDS) was ruled out by a negative test for
      HIV antibody. He was given corticosteroids including methylprednisolone mini
      pulse therapy and antibiotics. This therapy improved his condition and his
      radiological picture dramatically without antipneumocystis therapy. Bronchoscopy
      was performed and the transbronchial lung biopsy revealed PCP. On re-examination
      for HIV-1 antibody, the result was positive. Western blot analysis yielded a
      definite diagnosis of HIV-1 infection. Our experience strongly supports previous
      reports that advocated corticosteroids as adjunctive therapy for moderate to
      severe PCP associated with AIDS and gives us the significance of corticosteroids.

PMID- 11193328
TI  - [Periodicity in biomacromolecules and creation of artificial proteins from
      repeats of a microgene].

PMID- 11193329
TI  - [Developmental roles of forkhead genes in organogenesis].

PMID- 11193330
TI  - [Understanding the enzyme catalysis: the use of multidimensional energy profile].

PMID- 11193331
TI  - [Functional analysis of glycolipids in galactosylceramide synthase(CGT)-deficient
      mice: arrest of male meiosis and compensation of renal function].

PMID- 11193332
TI  - [Physiological role of novel metabolic pathway of platelet-activating
      factor(PAF): PAF-dependent transacetylation].

PMID- 11193333
TI  - [The complete genome sequence of Arabidopsis thaliana].

PMID- 11193334
TI  - [SWISS-PROT: the curated protein sequence database on Internet].

PMID- 11193335
TI  - [Tissue engineering: bioartificial organs for treatment of metabolic diseases].

PMID- 11193336
TI  - [Structural analysis of membrane proteins and their charge distribution].

PMID- 11193337
TI  - Malignant histiocytosis in cattle.
AB  - Malignant histiocytosis was diagnosed in 4 cows. In all cases the tumor tissues
      were composed of cytologically atypical histiocytes with evidence of
      erythrophagocytosis. The tumor in case 1 appeared highly anaplastic with marked
      nuclear pleomorphism, and had areas of spindle cell differentiation, but had no
      relation to malignant fibrous histiocytoma. The neoplastic tissue in case 2,
      characterized by cohesive growth of tumor cells, was distinguishable from
      anaplastic carcinoma cells by cytokeratin immunostaining. There were many
      hemosiderin-laden neoplastic cells suggestive of high phagocytic activity in a
      lymph node of case 3. The neoplastic cells in case 4, frequently multinucleated,
      were less atypical than in the other cases. All cases expressed histiocyte
      associated markers (lysozyme and HAM56), and were negative for cytokeratin, S100,
      and T- and B-cell lineage-specific markers (CD3 and CD79a). The most frequent
      HAM56 immunoreactivity was detected in case 4, and the giant, multinucleated
      forms, reminiscent of epithelioid cell differentiation. seemed not to indicate
      cytological pleomorphism as a result of neoplastic transformation.

PMID- 11193338
TI  - Unilateral intrauterine horn insemination of fresh semen in cats.
AB  - The sperm count required were investigated to obtain a conception rate of 80% by
      unilateral intrauterine insemination (UIUI) of fresh semen in cats. The
      conception rates obtained by insemination before and after ovulation were also
      examined. Thirty-six female cats aged 1-7 years were used in the experiments, and
      the number of experimental cases was 44. Seven male cats aged 2-12 years from
      which semen could be collected by the artificial vagina method were used. In
      artificial insemination, 100 iu x 2 or 250 iu of hCG was administered on days 2-4
      of estrus, and sperm were introduced into the uterine horn with a greater number
      of ovulations (or mature follicles) 15, 20 and 30 hr after hCG administration by
      laparotomy. The inseminated sperm counts were 2 x 10(6) (Exp. 1). 4 x 10(6) (Exp.
      2), and 8 x 10(6) (Exp. 3). As a result, ovulation was induced in 42 of 44 cases
      (induction rate: 95.5%) regardless of the dosage of hCG. Conception was obtained
      by UIUI in two of 16 animals (conception rate: 12.5%) in the Exp. 1, five of 16
      animals (31.3%) in Exp. 2, and eight of 10 animals (80.0%) in Exp. 3. Regarding
      the relationship between the ovulation state at insemination and conception, the
      conception rate obtained by insemination before ovulation was clearly higher than
      that obtained by insemination after ovulation (p<0.05). Regarding the number of
      kits compared to the number of ovulations on the inseminated side, the
      percentages of cases in which the number of kits exceeded the number of
      ovulations on the inseminated side were similar in all groups inseminated with a
      different number of sperm. It is therefore necessary to investigate conception
      rates obtained by bilateral insemination to increase the fertility rate. Based on
      the above findings, it was shown that the sperm count required for fertilization
      by UIUI is 8 x 10(6).

PMID- 11193339
TI  - Unilateral intrauterine horn insemination of frozen semen in cats.
AB  - Frozen feline semen was prepared using two types of extenders, egg yolk Tris
      fructose citric acid (EYT-FC) and egg yolk sodium citrate solution (EYC), and the
      semen qualities after thawing and the conception rates obtained by unilateral
      intrauterine horn insemination (UIUI) were investigated. Cats used in the
      experiment were six males and 11 females aged 2-12 years (the number of
      experimental cases was 17). For preparation of frozen semen, semen collected by
      the artificial vagina method was adjusted to I x 10(8) sperm/m/ and 7% glycerol,
      put in 250 microl straws, and then frozen using a cell freezer. The mean sperm
      motility after thawing was 30.0+/-9.7 (SE) % in the semen prepared with EYT-FC
      and 30.0+/-3.3% in the semen prepared with EYC. Four of seven animals were
      fertilized by UIUI using two straws in both extenders, and the conception rate
      was 57.1%. The mean ratios of number of kits to the number of ovulations in the
      inseminated side were 61.1+/-24.5% and 30.5+/-3.4% for EYT-FC and EYC,
      respectively, showing that the ratio tended to be higher in the semen prepared
      with EYT-FC. The above findings, comparing the two extenders for preparation of
      frozen feline semen, showed that EYT-FC is slightly superior to EYC. To increase
      conception and fertility rates, it may be important to increase the sperm count
      for insemination and to inseminate both uterine horns.

PMID- 11193340
TI  - Morphological and histochemical changes in the regenerating vomeronasal
      epithelium.
AB  - Receptor cell degeneration and regeneration within the vomeronasal organ (VNO) of
      the rat was studied using both electron microscopy and histochemical methods.
      Electron microscopy was employed to examine the morphological changes along the
      surface of the sensory epithelium, and histochemical markers were used to monitor
      the changes in the epithelial cell layers. Transection of the vomeronasal nerves
      induced selective degeneration of the receptor cells, and within six days, a
      significant decrease in the number of receptor cells was observed. During the
      subsequent stage of receptor cell regeneration, cilia and bud-like structures
      characteristic of a developing sensory epithelium were seen. By day 15, thin
      microvilli covering the surface of the receptor cells reappeared in the sensory
      epithelium. The neural cell adhesion molecule (NCAM) and two vomeronasal system
      specific lectins; 1) Bandeiraea simplicifolia lectin (BSL-I) and 2) Vicia villosa
      agglutinin (VVA) were used as the histochemical markers. NCAM immunoreactivity on
      the surface of the epithelium was observed to be decreased significantly six days
      after nerve transection, and was restored during receptor cell regeneration (day
      15). The reactivity of the two lectins, BSL-I and VVA, was decreased slightly
      during degeneration, but was still detectable at the time of maximum receptor
      cell degeneration (day 6). Lectin reactivity was restored to control levels by
      day 15. These findings suggest that (1) NCAM is a useful marker for vomeronasal
      receptor cells and that the vomeronasal system-specific lectins may bind to both
      receptor and supporting cells and (2) degeneration of vomeronasal receptor cells
      occurs during the first week (day 6) following nerve transection and the receptor
      cell population begins to recover within 15 days. The morphological changes
      observed during receptor cell regeneration suggest that the stages of VNO
      receptor cell regeneration are similar to those observed during development.

PMID- 11193341
TI  - Reduction in serum lecithin:cholesterol acyltransferase activity prior to the
      occurrence of ketosis and milk fever in cows.
AB  - Lecithin:cholesterol acyltransferase (LCAT) is the enzyme responsible for
      production of cholesteryl esters in plasma. The LCAT activity is reduced in cows
      with fatty liver developed during the nonlactating stage and those with the fatty
      liver-related postparturient diseases such as ketosis. The purpose of the present
      study was to examine whether reduced LCAT activity during the nonlactating stage
      could be detected before the occurrence of postparturient diseases. Sera from 24
      cows were collected at approximately 10-day intervals from -48 to +14 days from
      parturition. Of the 24 cows, 14 were apparently healthy, whereas 7 had ketosis
      and 3 had milk fever at around parturition. Of the 14 healthy cows, 7 had
      unaltered LCAT activity during the observation period, whereas 7 showed reduced
      activity from -20 to +14 days. Ketosis and milk fever occurred at from -3 to +10
      days, but reductions of LCAT activity in diseased cows had already been observed
      from days -20 to 0. These results suggest that LCAT activity is virtually
      unaffected during the peripartum period at least in some healthy cows and also
      that the reduction in LCAT activity can be detected before the occurrence of
      ketosis and milk fever.

PMID- 11193342
TI  - Enzyme-linked immunosorbent assays of canine apolipoproteins B-100 and A-I.
AB  - An enzyme-linked immunosorbent assay (ELISA) for canine blood apolipoprotein
      (apo) B-100 and A-I was developed. The working range for the assay was 1.8 to
      28.7 ng/well for apoB-100 and it was 50 to 410 ng/well for apoA-I. The intra- and
      inter-assay coefficients of variation for the assay for apoB-100 were 5.4 and
      6.9%, respectively, and for apoA-I they were 5.8 and 10.6%, respectively. The
      average concentrations of apoB-100 and A-I in 25 beagles (males, aged 3-4 years)
      were 0.084 +/- 0.028 (mean +/- SD) mg/ ml and 6.29 +/- 1.55 mg/ml, respectively.
      The ratios of canine (C) apoB-100 to CapoA-I were 1.41 +/- 0.58%. The respective
      concentrations in one case of hyperlipidemia with systemic atherosclerosis were
      0.454 mg/ml and 11.28 mg/ml (a ratio of 4.03%). These values were larger than
      those of the controls. These results suggest that the measurements of CapoB-100
      and A-I concentrations by this newly developed ELISA are helpful for diagnosis of
      lipidosis.

PMID- 11193343
TI  - Rapid and direct detection of clostridium chauvoei by PCR of the 16S-23S rDNA
      spacer region and partial 23S rDNA sequences.
AB  - Clostridium chauvoei causes blackleg, which is difficult to distinguish from the
      causative clostridia of malignant edema. Therefore, a single-step PCR system was
      developed for specific detection of C. chauvoei DNA using primers derived from
      the 16S-23S rDNA spacer region and partial 23S rDNA sequences. The specificity of
      the single-step PCR system was demonstrated by testing 37 strains of clostridia
      and 3 strains of other genera. A 509 bp PCR product, which is a C. choauvoei
      specific PCR product, could be amplified from all of the C. chauvoei strains
      tested, but not from the other strains. Moreover, this single-step PCR system
      specifically detected C. chauvoei DNA in samples of muscle from mice 24 hr after
      inoculation with 100 spores of C. chauvoei, and in clinical materials from a cow
      affected with blackleg. These results suggest that our single-step PCR system may
      be useful for direct detection of C. chauvoei in culture and in clinical
      materials from animals affected with blackleg.

PMID- 11193344
TI  - Genotyping of feline MHC (FLA) class II DRB by PCR-RFLP method using group
      specific primers.
AB  - For genotyping of feline major histocompatibility complex (FLA) class II DRB, the
      polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP)
      method using group-specific primers was tried. Sixty-six DRB genes were
      classified into 8 groups according to differences in the first 5' amino acid
      sequences. The group-specific primers were designed as forward ones, which were
      specific for 5' base sequences of genes in each group. Three to 7 appropriate
      restricted enzymes were selected by computer analysis for RFLP typing of the
      genes divided into each group. In 6 out of 9 cats, the results of DRB typed by
      direct sequence method agreed with results of the PCR-RFLP method using group
      specific primers. In the other 3 cats, the number of genes amplified by group
      specific primers was I or 2 more than those detected by direct sequence method.
      The direct sequence method in 9 cats identified 5 new FLA-DRB genes. The PCR-RFLP
      method using group-specific primers could divide 66 genes into 37 genes and 10
      subgroups from the RFLP pattern. One to 6 genes in each cat, and a total of 203
      genes and subgroups were detected in 68 domestic cats. The genes detected might
      be biased to the subgroup G1-1a (28.8%), DRB*0501 (10.3%), G1-2a (9.4%) and G6b
      (7.4%). The PCR-RFLP method using group-specific primers may be useful in typing
      FLA class II DRB.

PMID- 11193345
TI  - Detection of thermophilic Campylobacter from sparrows by multiplex PCR: the role
      of sparrows as a source of contamination of broilers with Campylobacter.
AB  - The best combination of primers and the annealing temperature of multiplex PCR
      for Campylobacter jejuni, Campylobacter coli, and Campylobacter lari were
      examined. The multiplex PCR was able to detect type strains of the three species.
      All results of identification of wild strains (30 strains of C. jejuni, 20
      strains of C. coli, and 4 strains of C. lari) by the multiplex PCR coincided with
      those of the conventional biochemical identification tests, suggesting that the
      multiplex PCR can simultaneously differentiate C. jejuni, C. coli, and C. lari
      from wild strains of campylobacters easily and rapidly. Campylobacters were
      detected from sparrow feces by the multiplex PCR and antimicrobial sensitivities
      of the strains were determined to discuss the role of sparrows in contamination
      of broilers with C. jejuni. Three out of 13 strains of C. jejuni isolated from
      sparrow feces showed quinolone resistance. From the frequent use of quinolones
      for treatment of industrial animals like chickens, pigs, and cows, the three
      strains of quinolone-resistant C. jejuni in sparrows must have been originated
      from those industrial animals. Sparrows that have quinolone-resistant C. jejuni
      were considered to have contacted with industrial animals or thier feed. It may
      be presumed, on the contrary, that C. jejuni in sparrows could be a potential
      source of contamination of broilers.

PMID- 11193346
TI  - Hypercholesterolemia in Shetland sheepdogs.
AB  - Plasma lipoprotein cholesterol in 64 clinically healthy Shetland sheepdogs was
      evaluated to assess whether the breed is more susceptible to
      hypercholesterolemia. The incidence of hypercholesterolemia was clearly higher in
      Shetland sheepdogs and mean plasma cholesterol level was significantly higher in
      Shetland sheepdogs than in control dogs. Blood biochemical examinations did not
      evidence the abnormalities, which imply the causative disorders, and thyroid
      hormone levels were not significantly different from the controls. These results
      suggest that the cholesterolemia is a primary disorder. Cholesterol fractionation
      by agarose gel electrophoresis and ultracentrifugation revealed that accumulation
      of alpha2-migrating lipoproteins was the common characteristic of dogs showing
      cholesterol level over 250 mg/dl in the breed. Increase in prebeta-beta
      lipoproteins was also found in Shetland sheepdogs with marked
      hypercholesterolemia over 500 mg/dl. Therefore. Shetland sheepdogs may include
      more dogs with primary disorders in lipoprotein metabolism, which cause
      hypercholesterolemia. at least in Japan.

PMID- 11193347
TI  - Differentiation of hamster liver oval cell following Clonorchis sinensis
      infection.
AB  - Oval cells which appear in the liver after hepatic injuries are suspected to be
      progenitor cells for both hepatocytes and bile duct cells. Oval cell isolated
      from the livers of the hamsters treated with diethylnitrosamine and 2
      acetylaminofluorene and infected with Clonorchis sinensis (CS). cultured for 2
      weeks and evaluated for differentiation and plasticity by electron microscopy and
      immunohistochemistry. In the CS-uninfected group, glycogen granules and
      peroxisomes were noted in the cells that were cultured for 2 weeks. Starting at 1
      week postculture, immunoreactivity of the cells to cytokeratin 19 markedly
      decreased but that to albumin and alpha-fetoprotein gradually increased. This
      means that oval cells isolated from hamsters that were not infected with CS
      differentiated toward hepatocyte lineage. However, in the CS-infected group,
      cultured cells contained numerous rough endoplasmic reticulum and showed
      immunoreactivity that was generally in reverse to that of CS-uninfected group,
      meaning that cells isolated following CS infection were primed by CS and
      differentiated toward bile duct cell lineage. The results of this study suggested
      that oval cells are indeed bipolar progenitor cells for hepatocytes and bile duct
      cells and can differentiate toward either lineage depending upon the priming
      factor.

PMID- 11193348
TI  - Plasma levels of the chemokine RANTES in macaque monkeys infected with pathogenic
      and non-pathogenic SIV/HIV-1 chimeric viruses at an early stage of infection.
AB  - Plasma levels of the chemokine RANTES were examined in monkeys infected with
      either a pathogenic simian and human immunodeficiency chimeric virus (SHIV) or a
      non-pathogenic SHIV to determine whether RANTES levels were related to the
      pathogenicity of the virus, the plasma viral load, or the kinetics of CD4+ T
      cells. In the results no significant correlation was found between the RANTES
      kinetics and changes in the CD4+ T-cell numbers nor the plasma viral loads in any
      of the monkeys, although a transient decrease of the RANTES level was observed in
      the pathogenic virus-infected monkeys. At least, the plasma RANTES level can not
      be used as an index of the pathogenicity of the virus at the early stage of
      infection.

PMID- 11193349
TI  - The effect of 0.12% unoprostone isopropyl (rescula) on intraocular pressure in
      normotensive dogs.
AB  - Rescula (0.12% unoprostone isopropyl) is the first docosanoid compound approved
      for treatment of glaucoma in humans. It is commercially available in Japan, and
      is undergoing clinical testing elsewhere. The aim of this study was to evaluate
      the effect of Rescula on intraocular pressure (IOP) in normotensive dogs. After
      establishing a baseline diurnal IOP curve, six dogs were unilaterally treated
      with Rescula while the contralateral eye was treated with a placebo. Applanation
      tonometry was performed in both eyes, and pupil size was evaluated, 30 min after
      treatment, and at 1-hr intervals for the next 9 hr. Rescula caused a significant
      (p=0.014) and long-lasting decrease in IOP, from 20.49+/-2.02 mm Hg in control
      eyes to 15.49+/-0.69 mm Hg in treated eyes. These results suggest that Rescula is
      potentially efficacious in treatment of canine glaucoma.

PMID- 11193350
TI  - Effect of liquid paraffin on antibody responses and local adverse reactions of
      bivalent oil adjuvanted vaccines containing newcastle disease virus and
      infectious bronchitis virus.
AB  - Effects of liquid paraffin on antibody responses and local adverse reactions
      after intramuscular injection of oil adjuvanted vaccines containing Newcastle
      disease (ND) and infectious bronchitis (IB) virus were investigated in chickens.
      Each vaccine was prepared with a liquid paraffin such as Carnation, Crystol 52
      and Lytol. These vaccines induced sustained antibody responses against ND and IB.
      Among local adverse reactions, Lytol induced granulomatous reactions and
      abscesses, but Carnation and Crystol 52 did not. The residual weight of liquid
      paraffin at the injection site decreased in the order Carnation, Crystol 52,
      Lytol. Crystol 52 was composed of relatively few short-chain hydrocarbons (i.e.,
      <n-C16H34) and long-chain hydrocarbons (i.e., >n-C20H42). The vaccine with liquid
      paraffin mainly composed of n-C16H34-n-C20H42 was suggested to induce fewer
      adverse reactions.

PMID- 11193351
TI  - Three cases of cat scratch disease diagnosed by indirect immunofluorescence
      antibody assay and/or polymerase chain reaction of 16S rRNA gene of Bartonella
      henselae.
AB  - Three suspected cases of cat scratch disease were diagnosed by indirect
      immunofluorescence antibody assay and/or polymerase chain reaction. Patient 1 was
      a 10-year-old female who presented swelling of the right axillary [corrected]
      lymph nodes with pain and fever. She kept a kitten, and many scratches were
      observed on her both legs and dorsum manus. Antibody titers against Bartonella
      (B.) henselae were 1:32 for IgM 3 weeks after the onset of the symptoms and 1:64
      for IgG 8 weeks after the onset. The DNA for 16S rRNA type I of B. henselae was
      detected from the blood sample obtained 3 weeks after the onset of symptoms by
      polymerase chain reaction for the first time in Japan. Patient 2 was a 22-year
      old female veterinary student with a cat scratch at the bottom of her neck by a
      male kitten. She developed a papule at the scratch, slight fever, and neck pain.
      Although both Bartonella-specific IgG and IgM antibodies were negative before the
      scratch, the IgG antibody titer rose to 1:512 14 weeks after the onset. B.
      henselae was isolated from the kitten and its DNA found to be for 16S rRNA type I
      by PCR. Patient 3 was a 23-year-old female veterinary student with a cat scratch
      on her left forearm. A small reddish papule developed on the scratch, and she
      experienced swelling of the left axillary [corrected] lymph node and pain. Both
      the IgG and IgM antibodies against B. henselae were negative before the cat
      scratch, and the IgG titer rose significantly to 1:128 and 1:1,024 in 2 and 5
      weeks, respectively, after the onset of the symptoms.

PMID- 11193352
TI  - Unique hemagglutination activity of an isolate of Newcastle disease virus.
AB  - The MET95 strain of a lentogenic Newcastle disease virus (NDV) isolated from a
      broiler in Japan, showed unique hemagglutination (HA) activity. The MET95 strain
      failed to show HA when examined by rapid glass plate method although they showed
      HA titer of 1:1,024 by micro-plate method. This unique HA was also observed after
      the MET95 strain was passaged ten times in chickens. The failure of HA by rapid
      glass plate method was not shown in any other NDVs examined.

PMID- 11193353
TI  - Serological monitoring on layer farms with specific pathogen-free chickens.
AB  - To monitor the existence of avian pathogens in laying chicken flocks, specific
      pathogen-free (SPF) chickens were introduced into two layer farms and reared with
      laying hens for 12 months. SPF chickens were bled several times after their
      introduction and examined for their sero-conversion to avian pathogens. As a
      result, antibodies to eight or ten kinds of pathogens were detected in SPF
      chickens on each farm. Antibodies to infectious bronchitis virus (IBV), avian
      nephritis virus, Mycoplasma gallisepticum and M. synoviae were detected early
      within the first month. Antibody titer to IBV suggested that the laying chickens
      were infected with IBV repeatedly during the experiment on both farms. However,
      antibodies to infectious bursal disease virus and 6 pathogens were not detected.

PMID- 11193354
TI  - Prevalence of capsular polysaccharide (CP) types of Staphylococcus aureus
      isolated from bovine mastitic milk and protection of S. aureus infection in mice
      with CP vaccine.
AB  - To determine the prevalence of capsular polysaccharide (CP) types of
      Staphylococcus aureus isolated from bovine mastitic milk in Korea, the protective
      effect of the conjugates, composed of microencapsulated S. aureus clinical
      isolate type 8 CP bound to Pseudomonas aeruginosa exotoxin A (ETA) was evaluated
      in mice. Of 107 S. aureus isolates, serotype 5 and 8 accounted for only 26 or
      24.2%. When serotype 336 antiserum was employed, fifty of the remaining 81
      isolates were typed as 336, 26 reacted with two serotypes, and 5 were
      nontypeable. Mice challenged with the same strain used for immunization had fewer
      S. aureus cells in their kidneys than mice challenged with the heterologous
      strain. But the magnitudes of difference on bacterial clearance were similar in
      both groups, indicating that the significance of this result remains to be
      determined. Mice immunized with the conjugate elicited an antibody response 3
      days post injection, which persisted for 13 days of the observation period after
      second injection in some mice. The mice immunized with the CP8-ETA conjugates
      developed antibodies significantly higher than those immunized with CP-Freund's
      adjuvant or PBS. In in vivo bacterial challenge experiment, the survival rate of
      mice immunized with CPS-ETA conjugate was significantly higher than that of mice
      immunized with PBS. It was suggested that CP8-ETA vaccine had a potential to
      protect mice against experimental S. aureus bacteremia.

PMID- 11193356
TI  - [Direction of genome-based science].

PMID- 11193355
TI  - [Clinical implication of comprehensive geriatric assessment].

PMID- 11193357
TI  - [Supplement with target hormone in aged patients with endocrine dysfunction:
      thyroid hormone replacement therapy].
AB  - Hypothyroidism is not rare in aged people. Hashimoto thyroiditis and radiation to
      the neck region are main causes of hypothyroidism in aged subjects. The symptoms
      are slowly progressing, and are similar to those of the aged subjects free from
      thyroid disease. Thus, it is difficult to make a diagnosis of hypo-thyroidism in
      the elderly. Administration of T4 (not T3) to patients with hypothyroidism
      completely releases them from symptoms, indicating that supplement with T4 is
      important in maintaining QOL. However, a risk of acute coronary syndrome is
      usually associated with the supplement. Rapid decrease in serum levels of TBG is
      frequently associated with acute coronary syndrome. Slowly increasing the dose of
      T4 and monitoring serum thyroxine-binding globulin (TBG) and electrocardiogram
      (ECG) are important during the period of increasing the dose of T4.

PMID- 11193358
TI  - [Diseases of the biliary tract and pancreas in the aged--results obtained by
      investigation of the autopsy cases].
AB  - Gross and histological examination of the autopsy cases in the aged revealed
      that: 1. Acute interstitial pancreatitis, which was characterized by rupture of
      the ducts and ductules associated with profuse intraluminal exudation of
      polymorphonuclear leucocytes and protein plugs formation, was found in nine cases
      (0.62%) out of 1457 autopsies. There was scarce parenchymal or fat necrosis which
      might be caused by impaired secretion by atrophic parenchyma. The interstitial
      type may represent characteristics of acute pancreatitis in the aged. 2.
      Pancreatic lithiasis was found in six of 85 cases, or 7.1%. 3. Sites of isolated
      islets of Langerhans were found in an incidence of 26.5% (53/200), which
      increased with age. 4. Incidence of endocrine tumors was 10% (6/60) in
      individuals having histological studies of all sections and 1.6% (12/738) in
      individuals having histological studies of three random sections of the pancreas.
      The facts that multiple hormone production was found in as much as 70% and
      glucagon cells in as much as 85% were characteristics. 5. The atypical epithelia
      were observed with the highest incidence in the common pancreaticobiliary channel
      of the papilla of Vater, where carcinoma may arise most frequently. 6. The
      incidence of cystic lesions increased with age. Small cystic lesions appear to
      have the potential to progress to malignancy. 7. it may be possible to remove the
      head of the pancreas while preserving of the vascular arcades and their branches
      to the duodenum, the bile duct and the papilla of Vater. The artery toward the
      papilla of Vater is very important for the blood supply of both the papilla and
      second portion of the duodenum, and should be preserved in duodenum-preserving
      subtotal resection of the head of the pancreas. Gallbladder carcinoma was found
      in 94 cases, or 2.1% and gallbladder stone was found in 957 cases, or 21.4% among
      4482 cases. Incidence of gallbladder carcinoma was six times higher in the cases
      with cholecystolithiasis than those without stone.

PMID- 11193359
TI  - [Treatment of the elderly dementia patients].

PMID- 11193360
TI  - [Treatment and care for depression and delusion in late life].

PMID- 11193361
TI  - [Problems and strategies in the treatment of mental disorders in elderly patients
      with physical illness].
AB  - There is a high prevalence of mental disorders in the community population of
      older adults, especially in medical treatment facilities. Therefore, clinicians
      who treat geriatric patients cannot neglect the psychiatric vulnerability of the
      elderly population. The fragility of psychological functioning of the elderly is
      caused not only by psychological contributors, such as various kinds of
      experiences of loss, but also by biological factors such as decreases in
      neurotransmitters and in the number of neurons. Another point geriatric
      clinicians should pay attention to is the powerful mind-body connection in the
      elderly. Recent psychoneuroimmunological research demonstrates that depression or
      other types of emotional stress damages the immune system, which can induce some
      physical diseases. This is especially true for the elderly, who have weakened
      cell-mediated immune function and are more susceptible to influence by the
      damaged immune function caused by such psychiatric dysfunction. Also, depression
      in the elderly can often lead to malnutrition or dehydration, which can induce
      various kinds of physical illness. On the other hand, physical illness in the
      elderly can induce depression, because of the psychological vulnerability of the
      elderly. Due to the strong mind-body connection in the elderly, the availability
      of psychiatric care is essential. When providing psychiatric care for the
      elderly, the clinician should attend to all symptoms, not minimizing the
      importance of biological treatment, while also trying to support the elderly
      patients psychologically through acceptance of their need for interdependency and
      respect for their narcissism.

PMID- 11193363
TI  - [Rehabilitation approaches to CVA in the acute stage].

PMID- 11193362
TI  - [The mentally impaired people in old age, care givers, and the society].

PMID- 11193364
TI  - [Effects of intensive exercise to facilitate the functional recovery of the
      hemiplegica due to the stroke].

PMID- 11193365
TI  - [Postural and gait instability in patient with Alzheimer's disease].

PMID- 11193366
TI  - [Fracture and bedridden in the elderly].

PMID- 11193367
TI  - [The relationship between left atrial thrombus and hematological markers in
      patients with chronic non-rheumatic atrial fibrillation].
AB  - We examined the relationship between left atrial thrombus and hematological
      variables in patients with chronic non-rheumatic atrial fibrillation (NRAf). This
      study consisted of 122 patients, 76 men and 46 women with a mean age of 73.
      Transesophageal echocardiography was performed to detect left atrial thrombi, and
      at the same time hematological variables including hematocrit, platelet count,
      fibrinogen level, thrombin-antithrombin III complex (TAT), D-dimer (DD) and
      fibrin degradation product E (FDP-E) levels were measured. Left atrial thrombi
      were detected in 28 (23%) of the 122 chronic NRAf patients. The serum fibrinogen
      was significantly higher in thrombus-positive patients than thrombus-negative
      patients (400 +/- 140 mg/dl vs. 274 +/- 69 mg/dl, p < 0.0001). The patients with
      left atrial thrombi had significantly higher levels of serum DD (302 +/- 200 vs.
      157 +/- 101 ng/ml, p < 0.0001) and FDP-E (169 +/- 129 vs. 85 +/- 68 ng/ml, p <
      0.0001) than the patients without. Scoring was made based on the levels of
      fibrinogen, DD and FDP-E as follows: 0 points if fibrinogen was under 380 mg/dl
      and 1 points if was 380 mg/dl or over, 0 points if DD was under 150 ng/ml, 1
      points if 150 ng/ml or over and under 250 ng/ml, 2 points if 250 ng/ml or over, 0
      points if FDP-E was under 70 ng/ml, 1 points if 70 ng/ml or over and under 140
      ng/ml, 2 points if 140 ng/ml or over. According to the combined scores for these
      3 markers, the prevalence of positive left atrial thrombi was 4% in 46 patients
      with 0 points, 18% in 38 patients with 1 or 2 points, 38% in 26 patients with 3
      or 4 points and 75% in 12 patients with 5 points.

PMID- 11193368
TI  - [Ability to avoid falls among aged residents in a barrier-free welfare
      institution].
AB  - This study was carried out to investigate the physical functions of the elderly,
      living in a barrier-free home for the aged and to obtain basic data for giving
      appropriate guidance on exercise and daily life. A total of 38 women were tested.
      These included 18 persons (aged 72-87: mean: 80.7) who were living in the home
      for the aged, and 20 (aged 75-86: mean: 78.3) who voluntarily participated in the
      "fall prevention school", established in Tokyo Kosei-Nenkin Hospital. The
      following examinations were done: 1) BMI, Waist/Hip ratio; 2) good walker's index
      consisting of 10 m walking times, maximum length of steps, and 40 cm-staircase
      climbing; and 3) equilibrium examination done by gravinography. Statistical
      analysis was carried out using a paired t-test (p < 0.01). Values for the "good
      walker's index" were significantly lower in, the "home" group than in the
      "school" group (p < 0.01). This was especially obvious with 40 cm-staircase
      climbing. Many of the subjects from the institution group required assistance and
      there was a significant difference in the chi-squire square distribution between
      the two groups. Furthermore, on gravinography, the "home" group had significantly
      inferior values in total length (cm) and Romberg's ratio (p < 0.01). It was clear
      that residents in the barrier-free home had a significant reduction in good
      walker's index, indicating an apparent weakening of physical function.

PMID- 11193369
TI  - [A study of mental health in community-dwelling older persons--influence of cared
      elderly].
AB  - This study aimed to evaluate mental health of elderly persons living in the
      community and understand the various backgrounds and effects of care giving. The
      study used a questionnaire from similar to the one used by Matsubayashi et al in
      the Kahoku-cho study. The Japanese Version of General Health Questionnaire 12
      (GHQ-12) was used to evaluate mental health. Responses were received from 2,799
      (81.5%) of 3,432 Numura-cho residents (81.5%). After removing inadequate
      responses, 1,268 (36.9%) (575 men and 693 women) were analyzed. Fifty-five men
      (9.6%) and 69 women (10.0%) were caring for someone at home. Multiple logistic
      regression analysis which examined the relation between mental health and the
      background factors such as having someone to care for, revealed that their mental
      health was significantly poor compared to those having no one to care for (odds
      ratio (OR) = 2.01, 95% confidence interval (CI), 1.29-3.15). As for the relation
      between the degree of care giving and their mental health, the subjective burden
      was significantly poor at 72-100% (OR = 3.40, 95% CI, 1.71-6.78) and for those
      with three to eight years of care-giving (OR = 2.22, 95% CI, 1.00-4.90), disabled
      activity of daily living (almost bed ridden) of the cared for person (OR = 5.53,
      95% CI, 2.23-13.7), severely demented state (OR = 5.13, 95% CI, 2.14-12.3), their
      mental health was significantly poor. However, being able to participate in an
      event (OR = 0.12, 95% CI, 0.03-0.49) and strong emotional support (OR = 0.12, 95%
      CI, 0.03-0.49) were negatively associated with caregivers' psychiatric distress.
      Having someone to care for largely affected mental health of the elderly to
      subjects living in the community. Services should be devised to serve the needs
      such as psychological care of care-givers as well as those being cared for.

PMID- 11193370
TI  - [Relation between hippocampal damage and cerebral cortical function in
      Alzheimer's disease].
AB  - We investigated the relation between hippocampal damage and cerebral cortical
      dysfunction in Alzheimer's disease (AD) using MRI and SPECT. Nineteen patients
      with AD and 10 control subjects were studied. Hippocampal damage (including
      hippocampal formation, entorhinal cortex, and parahippocampal white matter) was
      assessed to evaluate the severity of atrophy and the magnetization transfer ratio
      (MTR) and cerebral cortical dysfunction was evaluated by quantitative cerebral
      blood flow (CBF) measurements using SPECT with 99mTc-ECD. Compared with controls,
      patients with AD had significantly more atrophy of the medial temporal lobe and a
      decrease in MTRs of the hippocampus and parahippocampus. There were significant
      correlations between the severity of hippocampal damage and regional CBF in
      temporoparietal lobes. Mini-Mental State Examination scores significantly
      correlated with the severity of hippocampal damage and regional CBFs in
      temporoparietal lobes. These results suggest that the functional effect of
      hippocampal damage occurs in temporoparietal lobes in AD, probably due to
      neuronal disconnections between hippocampal areas (including the entorhinal
      cortex) and temporoparietal lobes.

PMID- 11193371
TI  - [Factors influencing continuation of home life after returning home from
      geriatric intermediate care facilities in a metropolitan suburb].
AB  - A follow-up study was conducted to elucidate the factors influencing continuation
      of home life after returning home from geriatric intermediate care facilities
      (GICFs). The subjects were 237 elderly persons (56 men, 181 women, average age of
      84 years) who were admitted to three GICFs located in the suburbs of Osaka, and
      their family caregivers. A follow-up study was performed from 1997 to 1998.
      Seventy percent of the elderly were bedridden persons with grade B or C of
      activities of daily living (ADL) according to the criteria of disabled elderly of
      the Japanese government. Dementia was observed in 82.3% of them. Family
      caregivers were sons (30.7%), daughters (27.4%), daughters-in-law (27.8%) and
      spouses (9.7%). The percentage of families spending all day long with the elderly
      person was 57.5%. Although the rate of having their own detached house was high,
      that of a private room for the elderly individuals was only about 60%. Most of
      the families cared for the elderly before admission to the GICFs. The families
      desired them to stay in the GICFs for as long as possible. Therefore, the
      families did not want to take the elderly into their home after discharge and
      only 45% of the families desired home care after the discharge. Concerning the
      flow of the 237 elderly subjects, the rate of admission from hospitals was high
      (60.8%), and that of discharge to hospitals was also high (44.3%). The place of
      residence at the end of follow-up was the GICF (35.4%), the elderly subject's
      home (19.0%), and hospital (16.0%). Of the 96 elderly who had returned home from
      GICFs, 40.6% were re-admitted to GICFs. According to multiple logistic analysis,
      the factors related to continuation of home life were "the elderly with family
      caregivers who can always supervise him/her", and "the elderly without problem
      behavior". From the results obtained, it is important that in order for disabled
      elderly individuals to continue their home life, the GICFs must be the function
      as the center of a comprehensive service system in the community.

PMID- 11193372
TI  - [Stress management in the workplace in the era of industrial and economic
      change].
AB  - The globalization of the economy and the recent economic recession in Japan has
      accelerated down-sizing or restructuring of corporations and has resulted in the
      induction of a wage system according to achievement instead of the traditional
      seniority wage system, break-down of the life-long employment system, excess
      labor and increased unemployment. These rapid changes in the labor situation have
      increased job stress. It was reported in the survey conducted by the Ministry of
      Labor in 1997 that 62.8 percent of 16,000 workers had anxiety, worry and stress
      regarding their working life. The need for effective stress management at work
      has been increasing in this situation, but in the survey mentioned above only
      26.5 percent of 12,000 companies replied that they had incorporated mental health
      measures. The characteristic features of the approaches for stress management in
      Japan are summarized as follows: 1) The most popular approaches are education and
      consultation for individual workers. 2) Systematic preventive approaches such as
      work control, working environment control, organizational change in the health
      management system, and systematic and continuous educational programs for
      managers are inadequate. 3) Systems to evaluation the effectiveness of these
      interventional approaches are also inadequate. Considering the current situation
      in which there is increasing job stress and a need for the occupational mental
      health promotion, we propose a series of mini-reviews regarding stress management
      at work and mention the composition of this series.

PMID- 11193373
TI  - [Job stress control at workplace: how to plan and conduct].
AB  - This review addressed that stress control activities at workplace could be
      classified into four categories: (1) improvement of work environment; (2)
      education/training; (3) health care for stress; (4) mental health service.
      Research has demonstrated that each of these activities is effective to some
      extent. The review also pointed out that stress control at workplace could be
      planned and conducted under occupational health systems, e.g., occupational
      safety & health management system. Then I proposed a possible effective strategy
      for planning and conducting stress control at workplace.

PMID- 11193374
TI  - [Role of occupational health staff considered in the case frostbite caused by
      exposure to liquid chlorine].

PMID- 11193375
TI  - [A study on coordination of occupational and community health--a survey of
      occupational health nurses].
AB  - The survey was conducted on occupational health nurses to find out their
      awareness of the issue, levels of coordination practiced at work and contributing
      factors. Based on the results, measures to facilitate the coordination of the two
      areas were examined. The major findings are as follows: 1. Cooperation between
      occupational and community health nurses: More than 40% of the occupational
      health nurses surveyed were aware of the necessity for cooperation with community
      health nurses. However, less than 7% of those surveyed actually practiced it at
      work. The deciding factors included the use of a support system in the community,
      previous training in community health, and work experience in health centers in
      the community. To facilitate the cooperation between the two sectors, it is
      suggested that occupational health nurses acquire more knowledge of community
      health issues. 2. Coordination through focusing on the employee's life in the
      community: More than 85% of those surveyed were aware of the necessity of
      coordinating occupational and community health issues through focusing on the
      lives of the employees in the community. However, less than 30% practiced it at
      work. Awareness and practice of occupational health planning scored the lowest.
      The deciding factors included completion of a public health nursing course and
      the number of employees assigned to each nurse, the use of a support system in
      the community, and previous training in community health. To facilitate
      coordination of occupational and community health issues, it is suggested that
      occupational health nurses acquire more knowledge of community health issues, the
      number of employees assigned be carefully considered, and that activities
      focusing on community health be incorporated into occupational health planning.

PMID- 11193376
TI  - [Development of new synthetic method and function of ynolate anions].
AB  - Ynolates are carbanions having a triple bond in place of the double bond in
      enolate anions. Ynolates are ketene anion equivalents, thus ynolates introduce a
      ketene unit into substrates and the resulting products possess high reactivity.
      This allows ynolates to undergo unique reaction sequences. For the past 20 years,
      several methods for the generation of ynolates and their reactions have been
      developed. Recently, we have developed a novel efficient method for their
      generation via cleavage of ester dianions. Starting from this success, we have
      found new reactions of ynolate anions. Ynolate anions react with carbonyl
      compounds to give beta-lactone enolates, which are converted into olefins with
      high E-selectivity. It is noteworthy that high E-selectivity was achieved in the
      synthesis of tetrasubstituted olefins. Utilizing the strong nucleophilicity of
      the beta-lactone enolates, we have succeeded in the first tandem [2 + 2]
      cycloaddition-Dieckmann condensation to lead synthetically useful 2,3
      disubstituted-2-cycloalkenones in good yields. Ynolate anions were found to react
      with N-sulfonyl aldimines to give beta-lactams. N-2-methoxyphenyl aldimines
      efficiently activate their cycloaddition of lithium ynolates via chelation to
      give beta-lactams and alpha,beta-unsaturated amides. We have demonstrated the
      high functionality of ynolate anions. Ynolate chemistry has begun and much
      remains to be discovered.

PMID- 11193377
TI  - [Research and development of cilostazol: an antiplatelet agent].
AB  - In our study, we focused on the fact that platelets play a significant role in
      thrombus formation in the arterial vessels, and started exploratory research on
      the antiplatelet agent with a vasodilating action in order to discover a more
      effective drug for arterial thrombosis. We synthesized many 2(1H)-quinolinone
      derivatives and evaluated their inhibition of platelet aggregation and their
      vasodilating activities. First we found cilostamide, which has an amide moiety in
      the side chain. This compound possessed desired activities, but it caused a side
      effect of tachycardia, and so, unfortunately, we were unable to pursue its
      development. After many efforts to modify the side chain moiety to eliminate this
      side effect, we finally invented cilostazol (OPC-13013), a 2(1H)-quinolinone
      derivative with a tetrazol ring in the side chain. Cilostazol inhibited human
      platelet aggregation induced by various stimuli including shear stress in vitro
      and showed potent antiplatelet effects both in vitro and ex vivo. It was also
      shown that the drug has antithrombotic effects in experimental thrombus models
      and a vasodilating activity of the femoral artery and vertebral artery. The
      mechanism of the action for cilostazol is specific inhibition of cyclic
      nucleotide phosphodiesterase type 3 (PDE3). Cilostazol was marketed first in
      Japan in 1988 and later in seven other countries for the treatment of chronic
      arterial occlusion. It was launched in the U.S. in 1999, and approved in United
      Kingdom for the treatment of intermittent claudication. More recently, cilostazol
      was shown to be effective in a clinical prevention study on recurrence of
      cerebral infarction, and has been applied to the approval of the indication in
      Japan.

PMID- 11193378
TI  - [Angiotensin II receptor antagonists: candesartan cilexetil].
AB  - Blockade of the action of angiotensin II (AII) has long been a target for the
      development of novel antihypertensive agents. We recently discovered a novel
      class of potent nonpeptide AII receptor antagonists, benzimidazole-7-carboxylic
      acids including candesartan. Candesartan is a highly potent and insurmountable
      AII type-1 receptor (AT1)-selective antagonist. Structure-activity relationship
      (SAR) studies revealed that the adjacent arrangement of a lipophilic substituent,
      a tetrazolylbiphenylmethyl moiety and a carboxyl group was the important
      structural requirement for potent AII antagonistic activity. Especially, the
      presence of a carboxyl group at the 7-position was found to be essential for
      insurmountable antagonism. To improve bioavailability of candesartan, chemical
      modification was examined to yield candesartan cilexetil, a prodrug of
      candesartan. Candesartan cilexetil is a potent and long-acting blocker that, when
      given once a day to patients, provides effective 24 hr blood pressure control.

PMID- 11193379
TI  - [Modulation of cytokine production from human mononuclear cells by several
      agents].
AB  - We investigated the effects of drugs, especially anti-pulmonary disease agents,
      on the production of cytokines from human peripheral blood mononuclear cells
      (PBMC). Roxithromycin (RXM), a macrolide antibiotic with the structure of 14
      member macrocycline ring increased adherent cells (monocyte/macrophages), whereas
      it suppressed the proliferation of PBMC stimulated with phytohemagglutinin (PHA).
      RXM suppressed the production of IL-1 beta and TNF-alpha from lipopolysaccharide
      (LPS)-stimulated PBMC in a dose-dependent manner. Levofloxacin, a fluorinated
      quinolone, increased IL-2 production by PBMC stimulated with PHA. The production
      of GM-CSF and soluble IL-2 receptor was suppressed at high concentrations of
      LVFX. LVFX suppressed IL-1 beta production, but did not the production of TNF
      alpha and IL-8 production. A beta-adrenoceptor agonists (beta-agonist),
      procaterol, clenbuterol, fenoterol and terbutaline suppressed the production of
      TNF- and IL-1 beta. TNF-alpha production was almost completely suppressed by
      dibutyryl cyclic AMP (dbcAMP), whereas IL-1 beta production appeared to be
      partially refractory even at the highest concentration examined. Both procaterol
      and theophylline elevated cAMP levels in LPS-stimulated PBMC, but the effect of
      procaterol was limited. The inhibition of the production of TNF-alpha and IL-1
      beta by procaterol was additively potentiated with theophylline. Of examined
      phosphodiesterase (PDE) isozyme inhibitors type IV PDE inhibitors were more
      effective in inhibiting the production of TNF-alpha and IL-1 beta by LPS
      stimulated PBMC than a nonselective, type III or type III/IV inhibitor. The
      addition of the beta-agonist increased the inhibitory effect of tested PDE
      inhibitors on the production of TNF-alpha and IL-1 beta Type IV, type III and
      nonselective PDE inhibitors were effective in inhibiting the production of IFN
      gamma and IL-2 in a dose-dependent manner. In contrast, the production of IL-4
      and IL-5 was inhibited by only the highest concentration of type IV inhibitor,
      and other agents had no effect on the production. Similarly, dbcAMP inhibited the
      production of IFN-gamma and IL-2 more potently than that of IL-4 and IL-5. The
      addition of the beta-agonist increased the inhibitory effect of tested PDE
      inhibitors on the production of IFN-gamma and IL-2 production. These findings
      indicate that these agents have an immunodulatory action on the production of
      cytokines by PBMC and also indicate that they could be potent pharmacological
      agents for the treatment of diseases in which several cytokines are important
      etiological factors.

PMID- 11193381
TI  - [Stereoselective synthesis of cyclopentanones using dirhodium(II)-catalyzed
      intramolecular C-H insertion reaction].
AB  - This review summarizes novel stereoselective syntheses of 3,4-cis- and 3,4-trans
      3-alkyl-4-silyloxycyclopentanones using a dirhodium(II)-catalyzed intramolecular
      C-H insertion reaction as a key reaction. Treatment of diazoketoesters (20a-e)
      with 1 mol % of dirhodium(II) tetraacetate gave 2,3-trans-3,4-cis-cyclopentanones
      (21a-e) as major products. The presence of both the keto and ester groups in the
      precursors was found to be essential for this chemo- and stereoselective
      intramolecular C-H insertion reaction to take place. A possible interpretation
      for the observed stereoselectivity is presented. Optically active Corey lactone
      (38) was synthesized using a similar reaction of chiral alpha-diazo-beta
      ketoester (33). Next, reactions of 5,6-bisoxygenated diazoketones with Rh2(OAc)4
      were investigated. An acetonide derivative (39), upon treatment with Rh2(OAc)4,
      gave 3,8-dioxabicyclo[3.2.1]octane (42) via oxonium ylide formation/1,2-shift. On
      the other hand, similar treatment of 5,6-bis(tert-butyldimethylsilyloxy)
      derivative (47) gave a C-H insertion product (51) which was purified by silica
      gel column chromatography to give 4-silyloxycyclopentenone (48). Direct reduction
      of 51 with lithium aluminum hydride gave stereoselectively diol (52) in 52% yield
      from 47. Reaction of 2-methoxycarbonylcyclopentenone (48) and a 2-benzenesulfonyl
      congener (50) with R2CuLi or RMgBr-CuI stereoselectively gave 2,3-trans-3,4-trans
      cyclopentanones (22, 57) as a major diastereoisomer. On the other hand, reaction
      with R3 Al in toluene exclusively gave the corresponding 3,4-cis-adducts (21 and
      58).

PMID- 11193380
TI  - [Molecular neuropharmacology of nociceptive transmission and opioid receptors].
AB  - This review summarizes our studies using pharmacological, neurochemical and
      molecular biological methods on the nociception in the CNS and opioid receptors
      (OPRs). We designed an in vitro fluorometric on-line monitoring system including
      an immobilized glutamate dehydrogenase column, and for the first time actually
      demonstrated that capsaicin induced the release of glutamate from rat dorsal horn
      slices containing the terminal area of primary afferents, in concentration
      dependent, extracellular Ca(2+)-dependent and tetrodotoxin-resistant manners.
      Further, such a release was shown to be inhibited through mu- and delta-opioid
      receptors and alpha 2-adrenoceptors. On the other hand, we found that
      intracerebroventricular injections of interleukin (IL)-1 beta in rats produced
      biphasic effects on the mechanical nociception in rats (hyperalgesia in lower
      concentrations but analgesia in higher ones) and that similar injections of
      cytokine-induced neutrophil chemoattractant-1 (CINC-1) facilitated mechanical
      nociception in rats. The above described facts suggest that glutamate and some
      sorts of cytokines (IL-1 beta and CINC-1) contribute to nociception at least from
      the primary afferents to the spinal dorsal horn neurons and in higher brain,
      respectively. We have cloned rat kappa- and mu-opioid receptors. Using cloned
      cDNA for OPRs, we demonstrated (1) the distribution of mRNAs for OPRs in the rat
      central nervous system, (2) coexistence of each type of mRNA for mu-, delta- and
      kappa-OPRs and pre-protachykinin A mRNA in the dorsal root ganglion neurons, (3)
      an increased expression of mu- and kappa-OPR mRNAs in the I-II layers of rat
      lumbar dorsal horn with an adjuvant arthritis in the hind limb, (4) the
      inhibitions of N- and Q-types of Ca2+ channels by mu- and kappa-OPR agonists and
      (5) cross-desensitization of the inhibition through a common intracellular
      phosphorylation-independent mechanism, (6) pharmacological characterization of
      "antagonist analgesics" as partial agonists at every type of OPRs, and (7) the
      key-structure(s) of OPRs for discriminative binding of DAMGO to mu-OPR.

PMID- 11193382
TI  - [Efficient chiral control based on five-membered heterocyclic and related
      systems].
AB  - The synthetic potential of some simple five-membered heterocycles, including 2
      oxazolone, 1,3-dihydro-2-imidazolone and 2-thiazolone as building blocks for
      chiral polyfunctional compounds as well as chiral heterocyclic auxiliaries for
      asymmetric synthesis is reviewed. The stereodefined introduction of easily
      replaceable groups to the 4,5-olefinic moiety of the 2-oxazolone ring to give
      versatile chiral synthons, followed by stereospecific and stepwise substitution,
      provides a working and versatile strategy for achieving a chiral synthesis, which
      leads to the preparation of a wide variety of 2-amino alcohols of biological
      interest. Sterically constrained chiral 2-oxazolidinones and the derived
      conformationally rigid amino alcohols, which are derived from cycloaddition
      reactions of the 2-oxazolone to cyclic dienes such as 9,10-dimethylanthracene and
      hexamethylcyclopentadiene, represent excellent chiral auxiliaries and chiral
      ligands which are of general use in asymmetric synthesis. The strategy developed
      using 2-oxazolone can also be used in the cases of the structurally similar 1,3
      dihydro-2-imidazolone and 2-thiazolone derivatives.

PMID- 11193383
TI  - [A design and development of novel polymeric prodrugs prepared by mechanochemical
      solid-state polymerization].
AB  - The mechanochemical polymerization of solid-state monomer was first reported in
      1959. Nevertheless, relatively little work has been done. We reported the first
      in-depth study of the mechanochemical polymerization of specially synthesized
      solid-state monomers, methacryloyl derivatives of bioactive compounds including
      detailed mechanistic implications. There are many advantages for this reaction.
      One of the most striking properties observed in the resulting polymers is that
      these polymeric prodrugs are of very low heterogeneity (narrow molecular weight
      distribution) which is of great value in pharmaceuticals for highly
      functionalized polymeric prodrugs. Thus, the present reaction provides a novel
      and simple methodology for the syntheses of highly functionalized polymeric
      prodrugs through a totally dry process. The nature of drug release from many
      kinds of polymeric prodrugs prepared by mechanochemical polymerization was also
      investigated. The rate of drug release from the polymeric prodrugs can be
      controlled by the property of comonomer and the structure of spacer between the
      main chain of polymer and drug. Several applications of polymeric prodrugs
      (chemoembolization and hybrid polymeric prodrugs) were also described. We have
      carried out the mechanochemical polymerization in the presence of pharmaceutical
      aids to exploit the features of this reaction. If one takes the physicochemical
      property of pharmaceutical aids into consideration, novel composite polymeric
      prodrugs possessing a variety of rates of drug release can be synthesized
      simultaneously with mixing.

PMID- 11193384
TI  - [Roles of human cytochrome P450 enzymes involved in drug metabolism and
      toxicological studies].
AB  - Multiple forms of cytochrome P450 (P450 or CYP) enzymes play important roles in
      the oxidation of structurally diverse xenobiotics and endobiotics.
      Interindividual variations in the level and activity of P450 enzymes were
      investigated in the human liver microsomes. Although the total P450 content was
      higher in Caucasian samples than in Japanese ones, the relative levels
      (percentage of total P450) of individual forms of P450 determined
      immunochemically were not very different. CYP3A (about 30% of total P450) and
      CYP2C (about 20%) enzymes were major forms. Different P450 enzymes in the human
      liver play major roles in a variety of drug oxidations and the hepatic contents
      of these P450 forms could be affective to determine which P450 enzymes play major
      roles in drug metabolism in individual humans. Recently recombinant P450 enzymes
      from different sources, e.g., microsomes of human lymphoblastoid cells, of yeast,
      and insect cells infected with baculovirus systems, and Escherichia coli
      membranes containing coexpressed P450 and reductase, have been widely used for
      drug metabolism research. However, the marker activities or kinetic parameters of
      human P450 enzymes reported are not always similar. Cytochrome b5 can enhance the
      activities of recombinant P450 systems in some cases using different mechanisms.
      These differences in activities may be a critical factor for understanding the
      roles of human P450 enzymes involved in drug metabolism. This review provides
      useful information for the study of drug biotransformation in humans and for the
      basis of drug toxicities and carcinogenesis.

PMID- 11193385
TI  - [Phytochemical study of liverworts Conocephalum conicum and Chiloscyphus
      polyanthos].
AB  - Four hundred samples of Conocephalum conicum, collected in various places have
      been analyzed by GC-MS. This resulted in the presence of three chemo-types of C.
      conicum. One of them elaborate (-)-sabinene (type-I) as a major compound. The
      other two types characteristically contained (+)-bornyl acetate (type-II) and
      methyl cinnamate (type-III) as major constituent respectively. The structures of
      three new monoterpenic esters, isolated from the ether extract of C. conicum
      (type-I and/or II) have been established by chemical and spectral means. They
      were shown to be monoterpenic esters of (+)-borneol and p-coumaric acid
      derivatives. The ether extract of the liverwort Chiloscyphus polyanthos afforded
      sesquiterpenoids which are enantiomeric to those found in another liverwort
      Lepidozia vitrea. The absolute configurations of the sesquiterpenoids found in
      the C. polyanthos were determined by spectroscopic evidence, chemical
      derivatization and/or x-ray crystallographic analysis. The ether extract of the
      liverwort Porella perrottetiana afforded (-)-alpha-eudesmol, which showed an
      opposite sign of the optical rotation to that found in higher plants. Present
      work on the absolute configuration and an optical purity of (-)-alpha-eudesmol
      strongly suggested that the positive values (e.g. +28.5 degrees) described in
      many previous papers should be revised. Since the absolute configuration of (-)
      alpha-eudesmol was identical to that (+)-beta-eudesmol found in the higher
      plants, it was apparent that the expression of the positive sign might be revised
      to (-)-alpha-eudesmol. The optical purity, reconfirmation of the absolute
      configuration and synthesis of (-)-alpha-eudesmol will be discussed.

PMID- 11193386
TI  - [Anti-carcinogenic structural modification by fluorine-substitution in aza
      polycyclic aromatic hydrocarbons].
AB  - One of the major goals of a series of our studies is to explore the availability
      of a method for anti-genotoxic modification of carcinogens by fluorine
      substitution. Quinoline, a hepatocarcinogen, mutates bacterial tester strains in
      the presence of rat liver microsomal enzymes and induces GST-P (placental
      glutathione S-transferase)-positive foci in a medium-term bioassay system for
      hepatocarcinogenesis. On the other hand, 3-fluorinated quinoline (3-FQ) was
      neither mutagenic nor carcinogenic in the same assay system, whereas 5
      fluoroquinoline (5-FQ) was mutagenic and carcinogenic. Quinoline, 3-FQ, and 5-FQ
      were also tested in an in vivo mutagenicity assay system using a lacZ-transgenic
      mouse (Muta Mouse). Mutation was induced by quinoline and 5-FQ only in the liver,
      the target organ of carcinogenesis by quinoline, but not in the other organs
      examined. 3-FQ was non-mutagenic in all of the organs. The results strongly
      indicate that fluorine-substitution at the position-3 of quinoline could be an
      anti-genotoxic structural modification of quinoline in a wide range of its
      genotoxic end-points. Additionally, seventeen mono- and di-fluorinated
      derivatives of 1,7-phenanthroline, 1,10-phenanthroline, benzo[h]quinoline, and
      benzo[f]quinoline were subjected to analysis of their structure-mutagenicity
      relationship. The results support that the enamine epoxide structure of the
      pyridine moiety, as well as the bay-region epoxide structure, is responsible for
      mutagenicity. These results suggest that the introduction of a fluorine atom to
      the molecule in question may be a useful tool to modify their mutagenic potency
      and to better understand the mechanism of mutation.

PMID- 11193387
TI  - [Suppressive effect of protein kinase C inhibitors on tumor cell function via
      phosphorylation of p53 protein in mice].
AB  - We examined the role of protein kinase C (PKC) in the phosphorylation of a p53
      protein. Exposure to a protein kinase inhibitor, 1-(5-isoquinolinesulfonyl)-2
      methylpiperazine dihydrochloride (H7), increased the phosphorylation of the wild
      type p53 protein, whereas exposure to a tumor promoter phorbol ester, 12-O
      tetradecanoyl-phorbol-13-acetate (TPA), decreased it in vivo after incubation
      with mouse epidermal JB6 cells for 3 h. Exposure to a cAMP dependent protein
      kinase (PKA) activator, forskolin, did not decrease the phosphorylation of p53
      protein. In the transient transfection/luciferase reporter transactivation assay,
      H7 slightly increased the mouse double minute (MDM) 2 reporter transactivation
      activity of the p53 protein after treatment for 24 h, whereas TPA completely
      blocked it. Exposure to H7 and a specific PKC inhibitor, bisindolylmaleimide
      (bis), dose-dependently reduced the lung-colonizing potential of highly
      metastatic B16-F10 mouse melanoma cells in syngeneic mice. These results suggest
      that the phosphorylation of the wild type p53 protein is inversely related to PKC
      activation, and also suggest that the phosphorylation of the p53 protein is
      involved in the function of its transcription factor. The PKC inhibitor may
      exhibit a potent anti-metastatic effect through the phosphorylation of wild type
      p53 protein and the activation of its function.

PMID- 11193388
TI  - [Control mechanisms of renal functions: effects of cardiovascular drugs on
      vasoconstrictive and antinatriuretic stimuli in the in vivo kidney].
AB  - The kidney contributes to cardiovascular homeostasis through Na+ and water
      excretion and renin secretion. Changes in renal functions, therefore, have a
      close relationship to pathophysiology of cardiovascular diseases and to drug
      efficacy for them. The functions of the kidney are controlled by the sympathetic
      nervous system and various kinds of humoral factors and by their complicated
      interactions. Studies in the intact and working kidney in vivo have been
      providing physiologically significant information on the renal functions and drug
      actions. This review, by demonstrating data obtained in our laboratory with
      experiments in anesthetized dogs in vivo, refers mainly to the neural control of
      renal functions and renal actions of atrial natriuretic peptide (ANP) and an
      adenylate cyclase activator NKH477, either of which could be used for the
      treatment of congestive heart failure. Electrical stimulation of the renal
      nerves, which could mimic the events during elevation of renal sympathetic nerve
      activity, induces frequency-dependent renal norepinephrine release, renal
      vasoconstriction, antinatriuresis and renin secretion. ANP causes potent
      natriuresis and suppresses the nerve stimulation-induced renin secretion and
      renal vasoconstriction without affecting the norepinephrine release. Effects of
      ANP on other vasoconstrictive and antinatriuretic stimuli such as angiotensin II
      and endothelin are also demonstrated. Renal actions of NKH477 had been unknown,
      but we revealed that NKH477 elevates renal cAMP level and causes vasodilation and
      natriuresis. NKH477 also suppresses the nerve stimulation-induced renal
      vasoconstriction, and thereby blunts the antinatriuresis. The renal actions of
      these drugs clarified in our study may contribute to their curative effects on
      congestive heart failure.

PMID- 11193389
TI  - [Molecular mechanisms of DNA recognition and function by bioactive compounds].
AB  - Molecular mechanisms of DNA recognition and functional expression by bioactive
      compounds such as bleomycin, enediyne antibiotics, and zinc finger proteins are
      an important research subject in the pharmaceutical scientific field. Cleavage of
      cellular DNA by bleomycin substantially contributes to the antitumor activity of
      this drug. Some physicochemical data have clearly demonstrated that the bleomycin
      iron (II) complex forms a dioxygen adduct species. Of special interest is the
      fact that the bleomycin-iron complex and cytochrome P450 have a similar dioxygen
      activation cycle. Probably, the site-specific iron-peroxide species of bleomycin
      accounts for the action mechanism of selective DNA cleavage by bleomycin. The
      enediyne antibiotics possess an unprecedented chemical structure, potent
      anticancer activity, and a fascinating mode of biological action. A new compound,
      C-1027, consists of a carrier apoprotein and an enediyne chromophore. The high
      resolution NMR experiments clarified that novel chromophore interacts with DNA
      through its benzoxazolinate and aminosugar moiety, and also with apoprotein
      through the benzoxazolinate and macrocyclic moiety. The results provide a
      molecular basis for the host-recognition mode, the reaction mechanism, and the
      drug delivery system of chromoprotein C-1027. In addition, we found unique
      reactivity of C-1027 chromophore toward a tRNA(Phe). RNA as well as DNA might be
      also a potent biological target of the enediyne antibiotics. On the basis of
      characteristic DNA binding mode of Cys2His2-type zinc finger motif, artificial
      zinc finger proteins have been created, and new functions such as DNA cleavage,
      long sequence binding, and DNA bending are produced. The first artificial His4
      type zinc finger protein is also made from Cys-->His mutations of the Cys2His2
      type transcription factor Sp1. Such novel zinc finger proteins may be useful as a
      gene therapeutic agent and a tool for genetic engineering.

PMID- 11193390
TI  - [Molecular mechanism of exocytosis in neural and immune system].
AB  - Exocytosis is a common process for the secretion of physiologically active
      substances such as neurotransmitter, hormone, and inflammatory mediators.
      Exocytosis is triggered by an increase in intracellular calcium ion
      concentration. At the nerve terminal, voltage dependent calcium channels (VDCCs)
      are responsible for this calcium increase. There are several types of VDCC which
      are different from each other in their electro-physiological and pharmacological
      characteristics. In order to identify the types of VDCC at the cholinergic nerve
      terminal, acetylcholine (ACh) release from the electric organ synaptosomes was
      measured in the presence of type-specific channel blockers. At least three types
      of VDCC were involved in the ACh release, and N- and P/Q-type VDCC had a major
      contribution. Adenosine receptor A1 was coupled with N-type VDCC and had negative
      feedback regulation of ACh release, while A2 receptor coupled with P/Q-type VDCC
      enhanced the ACh release. Investigation of the inhibitory effects of antibodies
      from patients of autoimmune disease Lambert-Eaton syndrome on ACh release
      revealed that P/Q-type channel was a target for the autoantibodies. Unlike the
      nerve terminal, little is known about the mechanism and molecules involved in the
      exocytosis of immune cells. Ion channel activities of secretory granule proteins
      of mast cells were observed. The calcium dependency of the open probability of
      the channel was similar to that of histamine release from mast cells. We also
      showed the expression of some SNARE proteins in RBL-2H3 cells. Localization and
      dynamics of VAMP-7 and syntaxin-3 after antigen stimulation suggested the
      involvement of SNARE proteins in the exocytosis of mast cells.

PMID- 11193391
TI  - [Competitive binding of some alkyl p-hydroxybenzoates to human estrogen receptor
      alpha and beta].
AB  - Alkyl p-hydroxybenzoates such as isobutyl p-hydroxybenzoate (PHBA-iBu), butyl p
      hydroxybenzoate (PHBA-nBu), isopropyl p-hydroxybenzoate (PHBA-iPr), propyl p
      hydroxybenzoate (PHBA-nPr), ethyl p-hydroxybenzoate (PHBA-Et), and methyl p
      hydroxybenzoate (PHBA-Me) are widely used as preservatives, stabilizers and
      antiseptics for medical supplies, cosmetics, foodstuffs etc. We determined the
      binding affinity of alkyl p-hydroxybenzoates to human estrogen receptor alpha (ER
      alpha) and beta (ER beta) by non-RI receptor binding assays. PHBA-iBu had a high
      binding affinity for ER alpha (IC50: 6.0 x 10(-6) M, the relative binding
      affinity (RBA): 0.267) and ER beta (IC50: 5.0 x 10(-6) M, RBA: 0.340). These IC50
      values and RBA were almost the same as those of bisphenol A. The ranking of the
      estrogenic potency of alkyl p-hydroxybenzoates for both ERs is different; that
      is, PHBA-iBu > PHBA-nBu[symbol: see text]PHBA-iPr[symbol: see text]PHBA-nPr >
      PHBA-Et >> PHBA-Me. Alkyl p-hydroxybenzoates bound with equal relative affinity
      to both ER alpha and beta proteins. Alkyl p-hydroxybenzoate having a long alkyl
      side-chain showed a high affinity for ER alpha and beta. These findings suggest
      that p-hydroxybenzoates may be endocrine disruptors.

PMID- 11193392
TI  - [Consultation and survey for drug interaction in outpatients taking the medicines
      potentially interact with St. John's Wort].
AB  - Ministry Health Welfare of Japan announced the caution for drug interaction of
      St. John's Wort (SJW), a herbal supplement occasionally used for depression, on
      May, 2000. Immediately after the announcement, we conducted drug consultation for
      outpatients prescribed the medicines potentially interacting with SJW. We
      provided information concerning possible drug interaction with SJW for 741
      outpatients (except for pediatrics) during the period of May 22-June 16, 2000.
      The potential drugs prescribed frequently were warfarin (28.0%), theophylline
      (19.7%), digitalis (18.4%), carbamazepine (7.2%), disopyramide (6.9%) and
      cyclosporin (6.3%). Of the patients, 401 subjects were surveyed by collecting the
      questionnaires to clarify the background of SJW drug interaction. Twenty-two
      subjects (5.5%) have known commercially available SJW products, 5 subjects (1.2%)
      have ever taken SJW products before and 2 subjects (0.5%) have taken SJW products
      concomitant with prescribed medicines. Gender difference was observed in paying
      attention to SJW products; female subjects (8.6%) tended to have more interest in
      SJW products than male subjects (2.8%). Two subjects taking SJW have realized for
      the first time that the supplements they took were SJW products when their
      package photographs were shown at the consultation. Showing the package
      photographs might be helpful for making the patients easy to identify the SJW
      products, because most patients do not pay attention to whether the supplements
      contain SJW or not. It is recommended that drug consultation should be provided
      to avoid serious drug interaction with SJW while the outpatients are taking
      potential medicines prescribed.

PMID- 11193393
TI  - Deduced amino acid sequence and possible catalytic residues of a thermostable,
      alkaline cellulase from an Alkaliphilic bacillus strain.
AB  - Alkaliphilic Bacillus sp. strain KSM-S237 (a relative of Bacillus pseudofirmus)
      produces a thermostable, alkaline endo-1,4-beta-glucanase (Egl). The entire gene
      for the enzyme harbored a 2,472-bp open reading frame (ORF) encoding 824 amino
      acids, including a 30-aminoacid signal peptide. The deduced amino acid sequence
      of the mature enzyme (794 amino acids, 88,284 Da) showed very high similarity to
      those of family 5 mesophilic, alkaline Egls from some alkaliphilic bacilli. The
      enzyme had a region similar to a novel cellulose binding domain proposed for an
      Egl (EngF) from Clostridium cellulovorans. Expression of the Bacillus Egl gene in
      Bacillus subtilis resulted in high carboxymethy cellulase activity (2.0 g/l) in
      the culture broth, concomitant with the appearance of a protein band on an SDS
      gel at 86 kDa. Site-directed mutagenesis delineated the importance of Arg111,
      His151, Glu190, His262, Tyr264, and Glu305 in catalysis and/or substrate binding
      of the enzyme.

PMID- 11193394
TI  - Effect of dietary linoleate/alpha-linolenate balance on the brain lipid
      composition, reproductive outcome and behavior of rats during their prenatal and
      postnatal development.
AB  - The effect of the dietary linoleate (LA)/alpha-linolenate (LNA) balance during
      development on the brain lipid composition, reproductive outcome and behavior of
      rats was studied. Female rats were fed on experimental diets during pregnancy and
      the resulting pups for 16 weeks. The dietary LA/LNA ratios were 1.07 (LA1), 2.64
      (LA2), 4.45 (LA3), 7.68 (LA4) and 10.35 (LA5). The relative content of
      docosahexaenoate (DHA) in the brain of pups tended to increase with decreasing
      LA/LNA ratio at 0 and 3 weeks, while the level of DHA was maintained constant at
      16 weeks regardless of the dietary LA/LNA ratio. The learning ability was
      measured at 12 weeks of age, and there was no difference among the groups. In an
      open field test, the exploratory index was significantly lower in the LA1 group
      than in the LA2 group. The LA1 group had a smaller litter size and lower survival
      rate than the other groups. We conclude that if the diet contained appropriate
      amounts and balance of LA and LNA, it was possible for rats to synthesize an
      appropriate amount of DHA and have normal behavioral activity without DHA
      supplementation.

PMID- 11193395
TI  - Antigen binding of an ovomucoid-specific antibody is affected by a carbohydrate
      chain located on the light chain variable region.
AB  - We cloned the variable regions of heavy and light chain genes of an anti
      ovomucoid monoclonal antibody (MAb-OM21) produced by the mouse hybridoma cell
      line OM21. DNA sequence analysis showed that the light chain of the MAb-OM21 has
      only one potential N-glycosylation consensus sequence in the complementarity
      determining region 2 of the light chain. To find whether carbohydrate chains are
      located on the light chain, we assayed for the size of the light chain, after
      treatment with N-glycosidase, by western blotting, and also detection of the
      carbohydrate chains on the light chain was done using the lectin blot assay. A N
      linked carbohydrate chain has been shown to bind to the light chain. To clarify
      the role of this carbohydrate chain in the light chain, we produced carbohydrate
      variant antibodies by N-deglycosylation using glycosidase or by expressing the
      antibody from different host cells. The N-deglycosylated variant antibody has
      greater antigen binding, and the antibody produced from the different host cells
      showed a reduced antigen binding activity and acquired the ability to react to
      ovalbumin. These results suggest that antigen binding of the ovomucoid specific
      antibody MAb-OM21 can be affected by the carbohydrate chain on the light chain
      variable region.

PMID- 11193396
TI  - Isolation and characterization of thermotolerant Gluconobacter strains catalyzing
      oxidative fermentation at higher temperatures.
AB  - Thermotolerant acetic acid bacteria belonging to the genus Gluconobacter were
      isolated from various kinds of fruits and flowers from Thailand and Japan. The
      screening strategy was built up to exclude Acetobacter strains by adding gluconic
      acid to a culture medium in the presence of 1% D-sorbitol or 1% D-mannitol. Eight
      strains of thermotolerant Gluconobacter were isolated and screened for D-fructose
      and L-sorbose production. They grew at wide range of temperatures from 10 degrees
      C to 37 degrees C and had average optimum growth temperature between 30-33
      degrees C. All strains were able to produce L-sorbose and D-fructose at higher
      temperatures such as 37 degrees C. The 16S rRNA sequences analysis showed that
      the isolated strains were almost identical to G. frateurii with scores of 99.36
      99.79%. Among these eight strains, especially strains CHM16 and CHM54 had high
      oxidase activity for D-mannitol and D-sorbitol, converting it to D-fructose and L
      sorbose at 37 degrees C, respectively. Sugar alcohols oxidation proceeded without
      a lag time, but Gluconobacter frateurii IFO 3264T was unable to do such
      fermentation at 37 degrees C. Fermentation efficiency and fermentation rate of
      the strains CHM16 and CHM54 were quite high and they rapidly oxidized D-mannitol
      and D-sorbitol to D-fructose and L-sorbose at almost 100% within 24 h at 30
      degrees C. Even oxidative fermentation of D-fructose done at 37 degrees C, the
      strain CHM16 still accumulated D-fructose at 80% within 24 h. The efficiency of L
      sorbose fermentation by the strain CHM54 at 37 degrees C was superior to that
      observed at 30 degrees C. Thus, the eight strains were finally classified as
      thermotolerant members of G. frateurii.

PMID- 11193397
TI  - High P diet induces acute secretion of parathyroidhormone without alteration of
      serum calcium levels in rats.
AB  - To find whether a high phosphorus (P) diet stimulate the secretion of PTH, a high
      P diet was fed to rats and an increase in serum P levels has occurred. All rats
      were fed a control diet (0.5% calcium (Ca), 0.5% P) for 7 days, while they were
      being adapted, for 1 hour at 8:00 AM and again at 8:00 PM. Four groups were
      switched to the high-P diet (0.5% Ca, 1.5% P) at the time of their morning meal
      for 1 hour. The other 4 groups continued to receive the control diet. Blood
      samples were collected from the rats in the remaining group, which served as a
      pre-feeding control. Every 30 minutes after the start of feeding (30, 60, 90, 120
      min), blood samples were collected from the rats in the groups fed the control
      and high-P diets. Serum P concentrations increased upon intake of the high P
      diet, within 30 minutes after the start of feeding. Serum PTH levels also
      increased upon intake of the high P diet, within 30 minutes after the start of
      feeding, and the levels were significantly higher in the high-P group than in the
      control group. However, no significant difference was observed in serum Ca levels
      between the two groups. From these results, our findings suggest that an increase
      in serum P concentration might be a trigger of PTH secretion without any changes
      of serum calcium levels.

PMID- 11193398
TI  - Synthesis of optically active olivil type of lignan from L-arabinose using threo
      selective aldol condensation as a key reaction.
AB  - The threo-selective aldol condensation of (3R, 4S)-3-hydroxy-5-trityloxy-4
      pentanolide, which was prepared from L-arabinose, with piperonal was applied to
      the stereoselective synthesis of the olivil type of lignan, (2R, 3R, 4R)-4-benzyl
      4-hydroxy-3-hydroxymethyl-2-(3,4-methylenedioxyphenyl)tetrahydrofuran.

PMID- 11193399
TI  - Molecular cloning and sequence analysis of an endoinulinase gene from Penicillium
      sp. strain TN-88.
AB  - A genomic DNA segment and cDNAs encoding an extracellular endoinulinase of
      Penicillium sp. strain TN-88 were cloned and sequenced. Southern blot analysis
      indicated that the endoinulinase gene (inuC) was present as a single copy in the
      genome. An open reading frame, consisting of 1,545 bp, was not interrupted by
      introns, and it encoded a 25 amino acid signal peptide and a 490 amino acid
      mature protein. The mature protein contained three Cys residues and ten potential
      N-linked glycosylation sites. Three distinct transcriptional start points were
      observed at positions -242 (A), -215 (A), and -75 (C) from the start codon. The
      5'-noncoding region had a putative TATA box at position -120 (TATATATA) and two
      contiguous CAAT sequences at -159 to -151. The deduced amino acid sequence showed
      72 and 85% identities with those of Aspergillus niger and Penicillium
      purpurogenum endoinulinase genes, respectively. A neighbor-joining tree showed
      that fungal endoinulinases form a distinct cluster from other members of the beta
      fructofuranosidase superfamily and that they are more closely related to
      bacterial levanases than to a fungal fructosyltransferase, yeast invertases, or a
      yeast exoinulinase.

PMID- 11193400
TI  - Role of tyrosine 114 of L-methionine gamma-lyase from Pseudomonas putida.
AB  - L-Methionine gamma-lyase from Pseudomonas putida has a conserved tyrosine residue
      (Tyr114) in the active site as in all known sequences of y-family pyridoxal 5'
      phosphate dependent enzymes. A mutant form of L-methionine y-lyase in which
      Tyr114 was replaced by phenylalanine (Y114F) resulted in 910-fold decrease in
      kcat for alpha,gamma-elimination of L-methionine, while the Km remained the same
      as the wild type enzyme. The Y114F mutant had the reduced kcat by only 28- and 16
      fold for substrates with an electron-withdrawing group at the gamma-position,
      namely O-acetyl-L-homoserine and L-methionine sulfone, respectively, and also the
      similar reduction of kcat for alpha,beta-elimination and deamination substrates.
      The hydrogen exchange reactions of substrate and the spectral changes of the
      substrate-enzyme complex catalyzed by the mutant enzyme suggested that gamma
      elimination process for L-methionine is the rate-limiting determination step in
      alpha,gamma-elimination overall reaction of the Y114F mutant. These results
      indicate that Tyr114 of L-methionine gamma-lyase is important in y-elimination of
      the substrate.

PMID- 11193401
TI  - Purification and characterization of novel transglutaminase from Bacillus
      subtilis spores.
AB  - Transglutaminase activity was detected in suspensions of purified spores prepared
      from lysozyme-treated sporulating cells of Bacillus subtilis AJ 1307. The enzyme
      was easily solubilized from the spores upon incubation at pH 10.5 at 37 degrees
      C. The transglutaminase activity was separated into two fractions upon
      purification by hydrophobic interaction chromatography (TG1 and TG2). Each enzyme
      was purified to electrophoretic homogeneity (about 1,000-fold). Both enzymes had
      the same molecular weight of 29,000 as estimated by SDS-PAGE, had the same N
      terminal 30 amino acid sequence, and also showed the same optimal temperature (60
      degrees C) and pH (8.2). The purified enzyme catalyzed formation of cross-linked
      epsilon-(gamma-glutamyl)lysine isopeptides, resulting in the gel-formation of
      protein solutions such as alphas-casein and BSA.

PMID- 11193402
TI  - Characterization of O-acetyl-L-serine sulfhydrylase purified from an alkaliphilic
      bacterium.
AB  - O-Acetyl-L-serine sulfhydrylase (EC 4.2.99.8) activity was shown to be very high
      compared with O-acetyl-L-homoserine sulfhydrylase (EC 4.2.99.10) activity and L
      cystathionine cleaving activities, in an extract of cells of an alkaliphilic
      bacterium grown in a synthetic medium. The synthesis of the first enzyme was
      repressed by approximately 55% by both L-cystine and L-djenkolic acid added to
      the medium at a concentration of 0.5 mM, but L-methionine (1 mM) and S-adenosyl-L
      methionine (0.5 mM) affected it to lesser extents. Its enzyme activity was
      inhibited by 25% and 12% by methionine (10 mM) and S-adenosylmethionine (5 mM),
      respectively. The enzyme was purified from the extract through ammonium sulfate
      fractionation, heat treatment, and chromatography on columns of DEAE-cellulose,
      Sephacryl S-300, and Octyl Sepharose CL-4B with a recovery of 21%. Polyacrylamide
      gel electrophoresis with sodium dodecylsulfate of the preparation obtained
      finally showed its homogeneity and the molecular mass of 37,000 Da for
      dissociated subunits. Gel filtration of the enzyme on a Sephacryl S-300 column
      showed an approximate molecular mass of 72,000 Da, suggesting that the enzyme was
      comprised of two identical subunits. The enzyme catalyzed the beta-replacement
      reaction with O-acetylserine as a substrate, and showed no reactivity to other O
      substituted amino acids tested. The reaction proceeded best at 40 degrees C (when
      tested at pH 7.5), and at pH 6.5 (at 40 degrees C). The enzyme kept 90% its
      activity after incubation at 65 degrees C (at pH 7.5) for 30 min, and more than
      90% after 30 min incubation at pHs 7-12 at 30 degrees C. The enzyme had a Km of 4
      mM for O-acetyl-L-serine and a Vmax of 37.0 micromol/min/mg of protein, a very
      low value compared with those of other organisms. However, the content of the
      enzyme in the extract was calculated to be approximately 3.5% total protein.
      Sensitivity of the enzyme to carbonyl reagents was very low, although it was
      shown to have pyridoxal 5'-phosphate as a cofactor by examination of its
      absorption spectrum. Sulfhydryl reagents tested showed no inhibition. The novelty
      of this enzyme among analogous sulfhydrylases purified from other organisms was
      discussed.

PMID- 11193403
TI  - Purification and characterization of thermostable pectate lyase with
      protopectinase activity from thermophilic Bacillus sp. TS 47.
AB  - A strain of thermophilic bacterium, Bacillus sp., with pectolytic activity has
      been isolated. It produced an extracellular endo-polygalacturonate trans
      eliminase (PL, EC 4.2.2.1) when grown at 60 degrees C on a medium containing
      polygalacturonate (PGA). The PL was purified by hydrophobic, cation exchange, and
      size exclusion column chromatographies. The molecular mass of the enzyme was 50
      kDa by SDS-PAGE. The isoelectric point of the enzyme was pH 5.3. The enzyme had a
      half-life of 13 and 1 h at 65 and 70 degrees C, respectively, and showed optimal
      activity around at 70 degrees C and pH 8.0. It had protopectinase activity,
      besides PL activity, on lemon protopectin and cotton fibers. The first 20 amino
      acids sequence of the enzyme had significant similarity with that of PL from
      methophilic Bacillus subtilis, with 50% identity.

PMID- 11193404
TI  - Potent inhibition of macrophomate synthase by reaction intermediate analogs.
AB  - Potent inhibitors for macrophomate synthase, which has recently been found to
      catalyze a highly unusual five-step chemical transformation, were explored. Among
      11 oxalacetate analogs tested, only three analogs had moderate to relatively
      strong inhibitory activities (I50 1.3-8.1 mM). On the other hand, among 35
      bicyclic intermediate analogs synthesized, two diacids were found to be the most
      potent inhibitors (I50 0.80, 0.84 mM) which had a much higher affinity than that
      of the natural substrate 2-pyrone. (-)-Enantiomers of the diacids showed 30 times
      stronger activity (I50 0.34, 0.41 mM) than (+)-ones. The I50/Km values (0.20,
      0.24) showed their potent inhibitions. Competitive inhibitions were observed in
      two representative inhibitors.

PMID- 11193405
TI  - Qualitative and quantitative analysis of endogenous jasmonoids in potato plant
      (Solanum tuberosum L.).
AB  - Qualitative and quantitative analyses of endogenous jasmonoids were done by
      liquid chromatography/ selected ion monitoring (LC-SIM) using deuterium-labeled
      compounds as internal standards. To prove the practicality of this way of
      analyzing the contents of endogenous jasmonoids in plants, the method was used
      for estimating jasmonoids in potato plants.

PMID- 11193406
TI  - Gordonan, an acidic polysaccharide with cell aggregation-inducing activity in
      insect BM-N4 cells, produced by Gordonia sp.
AB  - An acidic polysaccharide, termed gordonan, was isolated from the culture medium
      of Gordonia sp. as an inducer of cell aggregation in an insect cell line, BM-N4.
      Gordonan had an average molecular weight of 5 x 10(6) and its structure was
      identified as -->3)-4-O-(1-carboxyethyl)-beta-D-Manp-(1-->4)-beta-D-GlcAp-(1-->4)
      beta-D-Glcp-(1--> mainly by acid hydrolysis experiments and NMR analysis. It
      induces cell aggregation at the concentration of 4 microg/ml. A partially
      hydrolyzed polysaccharide derived from gordonan with a molecular weight of 5 x
      10(5) showed weak activity, while any fragment molecules with lower molecular
      weights prepared from gordonan showed no activity.

PMID- 11193407
TI  - Dietary antioxidants fail in protection against oxidative genetic damage in in
      vitro evaluation.
AB  - Carcinogenesis is believed to be induced through the oxidative damage of DNA, and
      antioxidants are expected to suppress it. So, the polyphenolic antioxidants in
      daily foods were investigated to see whether they protect against genetic damage
      by active oxygen. In the evaluation, we used a bioassay and a chemical
      determination, a Salmonella mutagenicity test for mutation by a N-hydroxyl
      radical from one of the dietary carcinogens 3-amino-1-methyl-5H-pyrido[4,3
      b]indole and the formation of 8-hydroxyl (8-OHdG) from 2'-deoxyguanosine (2'-dG)
      in a Fenton OH-radical generating system. Thirty-one antioxidants including
      flavonoids were compared in terms of radical-trapping activity with bacterial DNA
      and 2'-dG. Antioxidants inhibited the mutation but the IC50 values were in the mM
      order. Against 8-OHdG formation, only alpha-tocopherol had a suppressive effect
      with an IC50 of 1.5 microM. Thus, except alpha-tocopherol, the dietary
      antioxidants did not scavenge the biological radicals faster than bacterial DNA
      and intact 2'-dG, indicating that they failed to prevent oxidative gene damage
      and probably carcinogenesis.

PMID- 11193408
TI  - Two novel diterpenoids, erinacines H and I from the mycelia of Hericium
      erinaceum.
AB  - Novel diterpenoids, erinacines H (1) and I (3), were isolated from the cultured
      mycelia of Hericium erinaceum. The structures of the compounds were determined by
      interpretation of the spectral data. Erinacine H showed stimulating activity of
      nerve growth factor (NGF)-synthesis.

PMID- 11193409
TI  - Synthesis of novel heterobranched beta-cyclodextrins from alpha-D
      mannosylmaltotriose and beta-cyclodextrin by the reverse action of pullulanase,
      and isolation and characterization of the products.
AB  - Alpha-D-mannosyl-maltotriose (Man-G3) were synthesized from methyl alpha
      mannoside and maltotriose by the transfer action of alpha-mannosidase. (Man-G3)
      betaCD and (Man-G3)2-betaCD were produced in about 20% and 4% yield, respectively
      when Aerobacter aerogenes pullulanase (160 units per 1 g of Man-G3) was incubated
      with the mixture of 1.6 M Man-G3 and 0.16 M betaCD at 50 degrees C for 4 days.
      The reaction products, (Man-G3)-betaCD were separated to three peaks by HPLC
      analysis on a YMC-PACK A-323-3 column and (Man-G3)2-betaCD were separated to
      several peaks by HPLC analysis on a Daisopak ODS column. The major product of
      (Man-G3)-betaCDs was identified as 6-O-alpha-(6(3)-O-alpha-D
      mannosylmaltotriosyl)-betaCD by FAB-MS and NMR spectroscopies. The structures of
      (Man-G3)2-betaCDs were analyzed by TOF-MS and NMR spectroscopies, and confirmed
      by comparison of elution profiles of their hydrolyzates by alpha-mannosidase and
      glucoamylase on a graphitized carbon column with those of the authentic di
      glucosyl-betaCDs. The structures of three main components of (Man-G3)2-betaCDs
      were identified as 6(1),6(2)-, 6(1),6(3)- and 6(1),64-di-O-(63-O-alpha-D-mannosyl
      maltotriosyl)-betaCD.

PMID- 11193410
TI  - Gene cloning, purification, and characterization of two cyanobacterial NifS
      homologs driving iron-sulfur cluster formation.
AB  - Iron-sulfur proteins are essential in the photosynthetic system and many other
      biological processes. We have isolated and characterized enzymes driving the
      formation of iron-sulfur clusters from Synechocystis sp. PCC6803. Two genes
      (slr0387 and sll0704), showing similarity to nifS of Azotobacter vinelandii, were
      cloned, and their gene products (SsCsdl and SsCsd2) were purified. They catalyzed
      the desulfuration of L-cysteine. Reconstitution of a [2Fe-2S] cluster of
      cyanobacterial ferredoxin proceeded much faster in the presence of L-cysteine and
      either of these enzymes than when using sodium sulfide. These results suggest
      that SsCsdl and SsCsd2 facilitate the iron-sulfur cluster assembly by producing
      inorganic sulfur from L-cysteine. Synechocystis sp. PCC6803 has no gene coding
      for a protein with similarity to the N-terminal domain of NifU of A. vinelandii,
      which is believed to cooperate with NifS to assemble iron-sulfur clusters. Thus,
      the cluster formation in the cyanobacterium probably proceeds through a mechanism
      that is different from that in A. vinelandii.

PMID- 11193411
TI  - A novel lantibiotic, nukacin ISK-1, of Staphylococcus warneri ISK-1: cloning of
      the structural gene and identification of the structure.
AB  - Staphylococcus warneri ISK-1, which we had previously reported as Pediococcus sp.
      ISK-1, produces a novel bacteriocin, nukacin ISK-1. Edman degradation of the
      chemically reduced nukacin ISK-1 produced a sequence of 27 amino acids, 7 of
      which were unidentified. Using single-specific-primer-PCR product as a probe, a
      3.6-kb HindIII fragment containing the nukacin ISK-1 structural gene (nukA) was
      cloned and sequenced. The deduced amino acid sequence of nukacin ISK-1 had 57
      amino acids, including a 30-amino acid leader region. The propeptide sequence
      showed significant similarity to those of lacticin-481 type lantibiotics. In the
      region upstream of nukA, a part of a long open reading frame (ORF), designated as
      nukM, encoding a putative modification enzyme was oriented in the opposite
      direction. In the region downstream of nukA, ORF1 was found in which the sequence
      of the putative translational product was similar to various response regulatory
      proteins.

PMID- 11193412
TI  - Synthesis and tumor-promoting activities of 12-Epi-phorbol-12,13-dibutyrate.
AB  - 12-Epi-phorbol-12,13-dibutyrate (1), the C12-epimer of the most frequently used
      phorbol ester probe, phorbol-12,13-dibutyrate (PDBu), has been synthesized from
      phorbol in 9 steps in order to investigate the structural requirements for tumor
      promoting activity. Compound 1 showed about 100-fold weaker in vitro biological
      activities related to in vivo tumor promotion, Epstein-Barr virus early antigen
      (EBV-EA)-inducing ability, superoxide (O2-) generation-inducing ability, and
      binding to the protein kinase C (PKC) regulatory domain surrogate peptides. The
      results indicated that the beta-stereochemistry at position 12 of the phorbol
      skeleton is important for optimal activity. Binding selectivity to each PKC C1
      domain of 1 was almost equal to that of PDBu.

PMID- 11193413
TI  - Expression of soluble bovine pancreatic ribonuclease A in Pichia pastoris and its
      purification and characterization.
AB  - A Pichia pastoris expression system for bovine pancreatic RNase A was
      constructed: the RNase A sequence was fused to the PHO1 signal and the AOX1
      promoter was used for efficient secretion. Approximately 5 mg of soluble enzymes
      were secreted per liter of the culture, but one half of them were glycosylated.
      After a series of purifications by cation-exchange chromatography, the
      glycosylated enzyme was removed and the pure recombinant soluble unglycosylated
      RNase A was obtained in the final yield of 1 mg per liter of the culture. N
      Terminal sequence, molecular weight, secondary structure, thermal stability, and
      activity were completely identical with those of commercial RNase A. Glycosylated
      RNase A had a decreased kcat, 60-70% of the activity of wildtype RNase A, as in
      the case of RNase B. Its carbohydrate moiety seemed to destabilize the enzyme
      differently from RNase B since Tm of the glycosylated RNase A was decreased by 6
      degrees C. The carbohydrate moiety of the glycosylated enzyme contained no
      GlcNAc. The N34A mutant RNase A, in which the only potential N-glycosylation
      site, Asn34, is mutated to alanine, was also glycosylated, implying that
      glycosylation is not N-linked but O-linked.

PMID- 11193414
TI  - Family 19 chitinases from Streptomyces thermoviolaceus OPC-520: molecular cloning
      and characterization.
AB  - Family 19 chitinase genes, chi35 and chi25 of Streptomyces thermoviolaceus OPC
      520, were cloned and sequenced. The chi35 and chi25 genes were arranged in tandem
      and encoded deduced proteins of 39,762 and 28,734 Da, respectively. Alignment of
      the deduced amino acid sequences demonstrated that Chi35 has an N-terminal domain
      and a catalytic domain and that Chi25 is an enzyme consisting of only a catalytic
      domain. Amino acid sequences of the catalytic domains of both enzymes, which are
      highly similar to each other, suggested that these enzymes belong to the family
      19 chitinases. The cloned Chi35 and Chi25 were purified from E. coli and S.
      lividans as a host, respectively. The optimum pH of Chi35 and Chi25 were 5-6, and
      the optimum temperature of Chi35 and Chi25 were 60 and 70 degrees C,
      respectively. Chi35 bound to chitin, Avicel, and xylan. On the other hand, Chi25
      bound to these polysaccharides more weakly than did Chi35. These results indicate
      that the N-terminal domain of Chi35 functions as a polysaccharide-binding domain.
      Furthermore, Chi35 showed more efficient hydrolysis of insoluble chitin and
      stronger antifungal activity than Chi25. In the polysaccharide-binding domain of
      Chi35, there are three reiterated amino acid sequences starting from C-L-D and
      ending with W, and the repeats were similar to xylanase (STX-I) from the same
      strain. However, the repeats did not show sequence similarity to any of the known
      chitin-binding domains and cellulose-binding domains.

PMID- 11193415
TI  - Purification of stearidonic acid (18:4(n-3)) and hexadecatetraenoic acid (16:4(n
      3)) from algal fatty acid with lipase and medium pressure liquid chromatography.
AB  - Stearidonic acid (18:4(n-3)) and hexadecatetraenoic acid (16:4(n-3)) are included
      in some edible marine algae such as Undaria pinnatifida and Ulva pertusa with
      relatively high compositions (up to 40%) of total fatty acids. In order to
      prepare 16:4(n-3) and 18:4(n-3) enriched fatty acid concentrates, we screened for
      a suitable lipase which concentrates these acids by the removal of other fatty
      acids in the selective esterification reaction reported by Shimada et al.
      (Shimada et al. (1997), J. Am. Oil Chem. Soc., 74, 1465-1470). In combination
      with the lipase reaction and reversed-phase medium pressure liquid
      chromatography, we purified 18:4(n-3) and 16:4(n-3) to more than 95% purity.

PMID- 11193416
TI  - Inhibition of alpha-glucosidase and amylase by luteolin, a flavonoid.
AB  - Twenty-one naturally occurring flavonoids were tested for inhibitory activities
      against alpha-glucosidase (EC 3.2.1.20) and alpha-amylase (EC 3.2.1.1). Luteolin,
      amentoflavone, luteolin 7-O-glucoside, and daidzein were the strongest inhibitors
      among the compounds tested. Luteolin inhibited alpha-glucosidase by 36% at the
      concentration of 0.5 mg/ml and was stronger than acarbose, the most widely
      prescribed drug, in inhibitory potency, suggesting that it has the possibility to
      effectively suppress postprandial hyperglycemia in patients with non-insulin
      dependent diabetes mellitus. Luteolin also inhibited alpha-amylase effectively
      although it was less potent than acarbose. The clinical value of luteolin needs
      to be further evaluated.

PMID- 11193417
TI  - Increases in 1,5-anhydroglucitol levels in germinating amaranth seeds and in
      ripening banana.
AB  - To examine whether 1,5-anhydroglucitol (AG) is derived from starch degradation in
      plant tissues, we colorimetrically measured AG contents of germinating amaranth
      seeds and ripening banana pulp. In both cases, as starch degradation proceeded,
      AG levels were significantly increased, but were 1,700-5,000 times lower than
      those of total soluble carbohydrates. alpha-1,4-Glucan lyase activity, which is
      measured by the 1,5-anhydrofructose (AF) liberated from non-reducing glucose
      residues of starch or glycogen, was too low to be detected in amaranth or banana
      by the 3,5-dinitrosalicylic acid method. On the other hand, AF reductase, which
      reduces AF to AG, was detected in germinating amaranth seeds and banana pulp.
      Thus, the increases in AG levels are conceived to be derived from starch
      breakdown, although further investigation is needed to answer whether the starch
      degradation pathway via alpha-1,4-glucan lyase/AF reductase exists in plant
      tissues.

PMID- 11193418
TI  - Influence of exogenous natural oils on the omega-1 and omega-2 hydroxy fatty acid
      moiety of sophorose lipid produced by Candida bombicola.
AB  - Candida bombicola can synthesize monohydroxy fatty acid as a moiety of sophorose
      lipids. The hydroxy fatty acids contained in a major lactone were identified by
      GC-MS, after culturing with natural oils such as coconut, rapeseed, olive, and
      soybean oils. Hydroxy fatty acids of C18 and C16 were always synthesized, but
      differences were observed among the oils regarding the positions of hydroxyl
      groups, unsaturation, and composition of the fatty acids. A new C17 hydroxy acid
      was found without addition of oil.

PMID- 11193419
TI  - Dietary beta- and gamma-cyclodextrins stimulation of hepatic metallothionein gene
      expression in rats.
AB  - This study investigated whether hepatic metallothionein gene expression is
      affected by dietary cyclodextrins. Young male Wistar rats were fed a basal diet
      or cyclodextrin-supplemented (50 g of cyclodextrin per kg diet) diets for 7 d.
      Copper content in the liver did not show any significant changes among rats fed
      the basal, beta- and gamma-cyclodextrin diets. There were no differences in liver
      or serum zinc among groups. Copper content in serum was markedly decreased in
      rats fed the gamma-cyclodextrin-supplemented diet. Liver metallothionein mRNA
      levels were significantly elevated in both beta- and gamma-cyclodextrins-fed
      rats, but not in alpha-cyclodextrin-fed rats. Thus, the increase in hepatic
      metallothionein mRNA levels might be due to this mechanism except for the
      contents of copper and zinc in the liver.

PMID- 11193420
TI  - Simple synthesis of 5,9-dimethylated long-chain alkanes, the sex pheromones of
      leaf miner moths.
AB  - Each stereoisomeric mixture of 5,9-dimethylpentadecane and 5,9
      dimethylhexadecane, the major and the minor sex pheromone components of
      Perileucoptera coffeella, respectively, was synthesized in about 25% overall
      yield through 6 steps from beta-citronellol. 5,9-Dimethylheptadecane, the major
      sex pheromone component of Leucoptera malifoliella, was also synthesized
      analogously as a stereoisomeric mixture in a 22% overall yield.

PMID- 11193421
TI  - Affinity of placental decorin for collagen.
AB  - Decorin was isolated from 7 M urea extract of bovine placental cotyledons by ion
      exchange and hydrophobic chromatography. Decorin and its core protein showed a
      broad band at about 115 kDa and a single band at 47 kDa, respectively by SDS
      PAGE. Anti-decorin core protein antiserum from pig skin was reacted with
      placental decorin and its core protein in western blotting. The NH2-terminal
      amino acid sequence of core protein from placental cotyledons was not different
      from that of core protein from skin and bone. Glycosaminoglycan of decorin was
      identified as dermatan sulfate by electrophoresis on a cellulose-acetate membrane
      and chondroitinase digestivity. Decorin bound to collagen in the order for type
      III, I, and V.

PMID- 11193422
TI  - Elongation factor 2 in the liver and skeletal muscle of mice is decreased by
      starvation.
AB  - We examined whether starvation affected the amount of EF-2 protein as well as the
      level of its mRNA in the liver and skeletal muscle of mice, to understand the
      molecular mechanism for nutritional adaptation of protein-turnover. Although the
      amount of EF-2 was diminished by starvation in each of the tissues examined, the
      amount of EF-2 mRNA did not decrease in parallel with the protein.

PMID- 11193423
TI  - Compilation and characterization of histidine-containing phosphotransmitters
      implicated in His-to-Asp phosphorelay in plants: AHP signal transducers of
      Arabidopsis thaliana.
AB  - Histidine (His)-to-Aspartate (Asp) phosphorelay signal transduction systems are
      generally made up of a "sensor histidine (His)-kinase", a "response regulator",
      and a "histidine-containing phosphotransmitter (HPt)". In the higher plant,
      Arabidopsis thaliana, results from recent intensive studies suggested that the
      His-to-Asp phosphorelay mechanism is at least partly responsible for propagation
      of environmental stimuli, such as phytohormones (e.g. ethylene and cytokinin).
      Here we compiled the members of the HPt family of phosphotransmitters in
      Arabidopsis thaliana (AHP-series, Arabidopsis HPt phosphotransmitters), based on
      both database and experimental analyses, in order to provide a comprehensive
      basis at the molecular level for understanding the function of the AHP
      phosphotransmitters that are implicated in the His-to-Asp phosphorelay of higher
      plants.

PMID- 11193424
TI  - Molecular cloning and characterization of a cDNA for a rice Sec31p homolog.
AB  - A cDNA for a putative Sec31p in rice has been cloned and sequenced. In yeast,
      Sec31p is a component of a protein-coated vesicle, COPII, which functions in the
      transport of cargo proteins from the endoplasmic reticulum to the cis-Golgi
      network. Structural similarities between yeast Sec31p and the rice putative
      homolog are discussed.

PMID- 11193425
TI  - Identification and characterization of a novel gene, hos2+, the function of which
      is necessary for growth under high osmotic stress in fission yeast.
AB  - hos2 mutants of the fission yeast Schizosaccharomyces pombe showed the phenotype
      of high osmolarity sensitivity for growth. An S. pombe strain carrying the hos2
      M10 allele cannot form colonies on agar plates containing 2 M glucose, but the
      parental strain can do so very well, as demonstrated previously. In this study,
      the hos2+ gene was identified as one that encodes a small protein of 94 amino
      acids, which shows no sequence similarity to any other proteins in the current
      databases. The hos2-M10 mutation resulted in Gln-62 to TAG-termination codon. A
      Hos2-defective (hos2delta) strain, which we then constructed, showed the
      phenotype of high osmolarity sensitivity, as in the case of the original hos2-M10
      mutant. For this hos2delta mutant, three multicopy suppressor genes were isolated
      and one of which was identified as the pgk1+ gene, encoding a phosphoglycerate
      kinase.

PMID- 11193426
TI  - Tributyrin specifically induces a lipase with a preference for the sn-2 position
      of triglyceride in Geotrichum sp. FO401B.
AB  - The extracellular Lipases A and C produced by Geotrichum sp. FO401B have a
      preference for the sn-1,3 and sn-2 positions of triglyceride, respectively. Total
      production of these lipases was increased by plant oils and tributyrin. Butyl
      Toyopearl column chromatography demonstrated that only Lipase C was produced in
      the presence of tributyrin. Lipase C hydrolysed natural fats except sardine oil
      preferentially at the sn-2 position, but it showed little stereoselectivity for
      triolein.

PMID- 11193427
TI  - Inhibition by (+)-persenone [corrected] A-related compounds of nitric oxide and
      superoxide generation from inflammatory leukocytes.
AB  - We have previously reported that persenone A, isolated from avocado fruit, is an
      effective inhibitor of both nitric oxide (NO) and superoxide (O2-) generation in
      cell culture systems. In this study, we have prepared four persenone A-related
      compounds and examined their inhibition of NO and O2- generation from
      inflammatory leukocytes. Some structural importance in persenone A to attenuate
      free radical generation is discussed.

PMID- 11193428
TI  - An avocado constituent, persenone A, suppresses expression of inducible forms of
      nitric oxide synthase and cyclooxygenase in macrophages, and hydrogen peroxide
      generation in mouse skin.
AB  - We investigated the suppressive effects of an avocado constituent, persenone A,
      on lipopolysaccharide- and interferon-y-induced inducible nitric oxide synthase
      (iNOS) and cyclooxygenase (COX-2) in a mouse macrophage cell line RAW 264.7.
      Persenone A at concentration of 20 microM almost completely suppressed both iNOS
      and COX-2 protein expression. In mouse skin, double treatments with persenone A
      (810 nmol) significantly suppressed double 12-O-tetradecanoylphorbol-13-acetate
      (TPA, 8.1 nmol) application-induced hydrogen peroxide (H2O2) generation.
      Treatment with persenone A before the second TPA treatment was sufficient to
      inhibit H2O2 generation, while the first treatment was not. This study thus
      suggests that persenone A is a possible agent to prevent inflammation-associated
      diseases including cancer.

PMID- 11193429
TI  - Regulation of virulence factors of enterohemorrhagic Escherichia coli O157:H7 by
      self-produced extracellular factors.
AB  - Enterohemorrhagic Escherichia coli (EHEC) O157:H7 causes serious diarrhea and
      hemolytic uremic syndrome in humans. The expressions of EspD and intimin by
      O157:H7 have now been shown to be down-regulated by medium conditioned by O157:H7
      grown at stationary phase. Preparation of conditioned medium showing the effect
      on the amount of EspD was not dependent on temperature or growth medium, but was
      dependent on growth phase. Inhibition of EspD and intimin expression was also
      induced by medium conditioned by E. coli K-12 strains and homoserine lactone, a
      signal molecule of the quorum-sensing system in gram-negative bacteria. These
      results suggest the possibility that the quorum-sensing system mediated by self
      produced extracellular factors plays an important role in control of colonization
      of EHEC O157:H7.

PMID- 11193430
TI  - Molecular cloning of the gene encoding an outer-membrane-associated beta-N
      acetylglucosaminidase involved in chitin degradation system of Alteromonas sp.
      strain O-7.
AB  - The gene encoding beta-N-acetylglucosaminidase (GlcNAcaseA) was cloned using PCR
      with degenerate oligonucleotide primers from the partial amino acid sequence of
      the enzyme. The gene encoded a polypeptide of 863 amino acids with a predicted
      molecular mass of 97kDa. A characteristic signal peptide, which was present at
      the amino-terminus of the precursor protein, contained four amino acids (Ala-Gly
      Cys-Ser) identical in sequence and location to the processing and modification
      sites of the outer membrane lipoprotein of Escherichia coli, indicating that the
      mature GlcNAcaseA is a lipoprotein the N-terminal cysteine residue of which would
      be modified by the fatty acid that anchors the protein in the membrane. The
      predicted amino acid sequence of GlcNAcaseA showed similarity to bacterial beta-N
      acetylglucosaminidases belonging to the family 20 glycosyl hydrolases.

PMID- 11193431
TI  - Binding affinity of the methyl ester of AK-toxin I to membrane fractions from
      Japanese pear leaves.
AB  - The binding site of AK-toxin, a host-specific toxin against Japanese pear, was
      searched for in the membrane fractions of the pear leaves, using 3H-labeled AK
      toxin I methyl ester. Binding activity, which was displaceable by the unlabeled
      ligand, was observed for microsomal fraction from a toxin-susceptible cultivar,
      Nijisseiki. However, the binding was also observed for those from toxin-resistant
      cultivars, Kosui and Hosui. Detection of the specific binding failed for the
      plasma membrane fraction which was prepared from microsomal fraction of the toxin
      susceptible cultivar by aqueous two-phase separation, and the hitherto presumed
      model of the AK-toxin receptor in the plasma membrane could not be verified.

PMID- 11193432
TI  - [Clinical application of reticulated platelet analysis using the matic-modified
      thiazole orange method and flow cytometry].
AB  - Reticulated platelet (RP) analysis using thiazole orange (TO) and a flow
      cytometer is a convenient and promising method for estimating platelet kinetics
      in patients with thrombocytopenia. Among many different modifications of the TO
      method, a novel protocol reported by Matic in 1998 seems to be superior because
      it allows RP analysis using a sample of whole blood very quickly and accurately.
      Therefore, we used this method to analyze platelet kinetics in patients with
      idiopathic thrombocytopenic purpura (ITP) and hemophagocytic syndrome (HPS), as
      well as patients with hematopoietic malignancies (HM) after intensive
      chemotherapy. The proportion of RP was increased in the patients with ITP and
      HPS, and furthermore showed a negative linear correlation with the platelet
      count. The change in the proportion of RP occurred about one week before the
      change in the circulating platelet count in the patients with HM after
      chemotherapy. This modification of the TO method by Matic is expected to become a
      standard protocol for RP analysis.

PMID- 11193433
TI  - [Idiopathic mediastinal and subcutaneous emphysema in a patient with acute
      lymphocytic leukemia after allogeneic bone marrow transplantation].
AB  - A 45-year-old man was diagnosed as having Ph1+ acute lymphocytic leukemia (ALL)
      in February 1997. Complete remission was achieved by chemotherapy. Allogeneic BMT
      from his HLA-identical sister was performed on June 11, 1997. Engraftment was
      relatively quick, but acute GVHD (grade I) developed. The patient was discharged
      on day 113. Seven months after BMT, in January 1998, exertional dyspnea developed
      gradually. Chest X-ray examination showed diffuse interstitial pneumonia, for
      which corticosteroid was started immediately. The symptoms and signs gradually
      improved. However, on the 20th hospital day (February 23), bilateral subcutaneous
      emphysema developed in the neck and supraclavicular region. Chest X-ray and CT
      examinations showed pneumomediastinum without pneumothorax. The pneumomediastinum
      and subcutaneous emphysema gradually subsided after 3 weeks of bed rest.
      Subcutaneous emphysema and pneumomediastinum are relatively rare complications of
      allogeneic BMT.

PMID- 11193434
TI  - [Clinical features of essential thrombocythemia in three children].
AB  - Essential thrombocythemia (ET) is one of the quite rare myeloproliferative
      disorders in children. The natural course and outcome of this disease have been
      reported to vary. We report three children (two boys and one girl, mean age at
      diagnosis 12 yr) with ET who showed different clinical courses. The girl was
      asymptomatic, but the boys had ankle pain and priapism, respectively. The
      platelet count ranged between 2300 and 2900 x 10(9)/L, and the diagnoses were
      made according to the criteria of the Polycythemia Vera Study Group. The serum
      thrombopoietin level reached 0.33 and 0.47 fmol/ml in two patients. All three
      children were administered aspirin or dipyridamole orally. Normalization of the
      platelet count was observed in two patients, and stable disease persisted in one.
      The 12 pediatric patients with ET reported previously in Japan demonstrated a low
      incidence of serious thrombohemorrhagic complications and a favorable outcome,
      none developing acute leukemia. Careful continuous observation and conservative
      treatment may be preferable in pediatric patients who do not have cardiovascular
      symptoms, avoiding the use of potential leukemogens such as alkylating agents and
      hydroxyurea.

PMID- 11193435
TI  - [Cytomegalovirus mononucleosis with severe thrombocytopenia].
AB  - In October 1998, a 37-year-old man was admitted because of petechiae and
      thrombocytopenia following flu-like symptoms. On admission, there were numerous
      petechiae on the back and extremities. The WBC count was 3,700/microliter with 3%
      atypical lymphocytes, the lymphocyte CD4/CD8 ratio 0.37, and the platelet count
      1,000/microliter. Mild splenomegaly was detected by CT. Results of blood
      chemistry and coagulation tests were normal. A bone marrow aspirate was
      normocellular with no signs of dysplasia, and the megakaryocyte count was normal.
      The patient was initially diagnosed as having virus infection-associated
      thrombocytopenia. Steroid therapy was started immediately, and the platelet count
      rose to 15 x 10(4)/microliter on day 21. The PA-IgG level was 652 ng/10(7)
      platelets. Mild liver dysfunction developed, and atypical lymphocytes increased
      in number thereafter. Because IgM anti-cytomegalovirus (CMV) antibody (Ab) was
      positive and IgG CMV Ab was negative, a diagnosis of CMV mononucleosis was made.
      Gancyclovir was therefore started. Four months later, steroid therapy was
      discontinued, and partial remission has since been maintained. In healthy
      individuals, CMV infection is usually latent, and the development of
      mononucleosis is rare. So far, 11 cases of CMV-induced mononucleosis associated
      with severe thrombocytopenia have been reported in immunocompetent adults.

PMID- 11193436
TI  - [Retardation of platelet recovery after autologous stem cell transplantation in a
      patient with acute lymphoblastic leukemia: possible role of decreased
      thrombopoietin production by bone marrow stromal cells].
AB  - A 16-year-old boy was diagnosed as having acute lymphoblastic leukemia and
      underwent autologous stem cell transplantation at the time of his second complete
      remission. Retardation of platelet recovery was evident at day 90 (< 5 x
      10(4)/microliter), and at day 660 after transplantation the platelet count was
      8.5 x 10(4)/microliter. Neutrophils and RBCs showed only slightly retarded
      recovery. Bone marrow stromal cells, which are thought to play an integral role
      in megakaryopoiesis, were examined. Although TPO mRNA expression per cell was
      normal, CFU-F was significantly decreased, resulting in a decrease of total TPO
      mRNA expression. In contrast, expression of G-CSF mRNA per cell was increased. It
      was thought that chemotherapy before bone marrow transplantation may have reduced
      the number of stromal cells, leading to retardation of platelet recovery because
      of low TPO expression.

PMID- 11193437
TI  - [Disseminated MALT lymphoma associated with macroglobulinemia].
AB  - We report a case of disseminated MALT lymphoma with macroglobulinemia in an 80
      year-old man who presented with a persistent fever. A radiograph of the chest
      showed infiltration of the left lung and pleural effusion of the right lung. The
      fluid contained numerous atypical lymphoid cells, which were positive for CD19,
      CD20, and HLA-DR, and negative for CD5 and CD10. Analysis of a pleural biopsy
      sample demonstrated no abnormality. A CT scan of the abdomen showed extensive
      thickening of the wall of the stomach adjacent to a peritoneal mass. Endoscopic
      examination disclosed antral ulceration. Histopathological examination of gastric
      samples revealed infiltration by centrocyte-like cells and lymphoepithelial
      lesions. Serum electrophoresis detected a macroglobulin peak at 34.5 g/l, and
      immunoelectrophoresis revealed an IgM kappa component. A bone marrow aspirate
      showed infiltration by the same lymphoid cells as those in the pleural fluid. A
      chromosome study of the lymphoid cells from both the bone marrow and pleural
      fluid showed a normal karyotype. The final diagnosis was MALT lymphoma involving
      the stomach, lungs and bone marrow. The patient did not consent to chemotherapy,
      and instead was given oral prednisolone. He died of respiratory distress one year
      and four months after diagnosis. Autopsy revealed wide dissemination of the tumor
      cells.

PMID- 11193438
TI  - [Intravascular large B-cell lymphoma associated with hypoalbuminemia and
      hypoxemia].
AB  - A 67-year-old man was referred to our hospital for treatment of hemophagocytic
      syndrome. Hypotension, hypoxemia, pleural effusion, severe anasarca, and
      splenomegaly were noticed at the time of admission. Laboratory findings showed
      anemia (7.7 g/dl), thrombocytopenia (4.5 x 10(4)/microliter), an increase of
      serum LDH (1,466 IU/L) and severe hypoalbuminemia (1.9 g/dl). Bone marrow
      aspiration revealed an increase of reticulum cells with active hemophagocytosis
      and the presence of immature lymphocytes (6.0%). Lymphoma was suspected, but
      effective chemotherapy could not be performed because of progressive hypoxemia
      and severe hypoalbuminemia, and the patient died of the disease 2 weeks after
      admission. Autopsy revealed large lymphoid cells packed within systemic vessels
      as well as invasion into organs such as the liver, lungs, and spleen. The
      postmortem diagnosis was intravascular large B-cell lymphoma. Hypoalbuminemia and
      hypoxemia appear to be important clinical features of intravascular large B-cell
      lymphoma.

PMID- 11193439
TI  - [Development of factor VIII inhibitor in three non-hemophiliac patients].
AB  - Infrequently, inhibitors against factor VIII can develop in non-hemophiliac
      patients and cause serious bleeding. In the last year, we have experienced 3 non
      hemophiliac patients who developed factor VIII inhibitors. Here, we describe the
      clinical courses of the three patients and the characteristics of the inhibitors.
      Case 1: A 69-year-old man underwent a partial gastrectomy because of early
      gastric cancer, and one month later developed signs of a bleeding tendency such
      as hematemesis, tarry stools and intramuscular hemorrhage. Blood coagulation
      tests revealed prolongation of the activated partial thromboplastin time (aPTT),
      which had been normal on admission. Case 2: A 78-year-old woman with no previous
      disease history developed generalized subcutaneous purpura. Blood coagulation
      tests performed on admission revealed a prolonged aPTT. Case 3: A 30-year-old man
      was admitted to an emergency hospital because of left intrapleural hemorrhage and
      liver injury caused by a traffic accident. Two months later, a hematoma developed
      at the site of drainage in the left chest, and blood coagulation tests revealed
      prolongation of the aPTT, which had been normal on admission. Plasma factor VIII
      procoagulant activities in cases 1, 2 and 3 were 3%, 1% and 5%, respectively. The
      respective factor VIII inhibitor titers were 78, 870 and 0.5 Bethesda units/ml.
      The immunoglobulin class and subclass of the inhibitors examined by an ELISA
      method were: case 1, IgG1 and 4; case 2, IgG2 and 4 (dominant); case 3, IgG4. In
      cases 1 and 3, the patients recovered after glucocorticoid therapy, but in case 2
      the patient died of intraperitoneal hemorrhage despite receiving two courses of
      methylprednisolone pulse therapy. The above clinical experience suggests that
      patients, who develop high titers of inhibitors may be refractory to ordinary
      immunosuppressive therapy, and therefore more aggressive therapy such as plasma
      exchange and/or bypass therapy using activated prothrombin complex concentrates
      or an activated factor VII preparation should be considered.

PMID- 11193440
TI  - [An autopsy case of pulmonary mucormycosis with fatal hemoptysis from a rupture
      of the thoracic descending aorta during remission from acute myelocytic
      leukemia].
AB  - A 16-year-old girl was hospitalized because of anemia and thrombocytopenia in
      April 1998, and was diagnosed as having AML (FAB:M2). After failure of initial
      remission induction therapy, she was successfully treated with the MEC regimen as
      a second-line chemotherapy. On June 22, the first consolidation therapy was
      started. One week later, the patient developed a high fever with backache. Chest
      computed tomography (CT) on July 8 showed a 3cm mass lesion adjacent to the
      thoracic descending aorta in the left upper lobe. She was given fluconazole and
      antibiotics, and remained in remission. On July 24, the mass lesion changed to a
      cavitary lesion on chest CT, suggesting a fungal infection, probably
      aspergillosis. With recovery from neutropenia, the patient became asymptomatic,
      and fluconazole was changed to itraconazole. On July 27, she suffered sudden,
      massive hemoptysis and died. Autopsy revealed a localized adhesion between the
      cavitary lesion and the thoracic descending aorta, and the aortic wall was
      ruptured at this site. Microscopic examination revealed invasion of mucormycotic
      hyphae into the wall of the aorta with infiltration of inflammatory cells. The
      vasa vasorum were occluded by thrombi, in which mucormycotic hyphae were
      detected.

PMID- 11193441
TI  - [Lymphocytic infundibuloneurohypophysitis during the first remission in acute
      lymphoblastic leukemia].
AB  - A 15-year-old girl developed acute lymphoblastic leukemia (ALL). The patient was
      treated according to the 13th protocol of the Tokyo Children's Cancer Study
      Group, and thereafter remained free of disease. However, at the age of 20, she
      complained of polyuria, polydipsia and amenorrhea. Hematological or meningeal
      relapse was ruled out on the basis of clinical and laboratory findings. The
      plasma concentrations of GH, TSH, LH, FSH, ACTH and ADH were low or below the
      detectable limits. There was no increase in urine osmolarity after water
      deprivation. Arginine, LH-RH, TRH and CRH tolerance tests revealed no or low
      responses of GH, LH/FSH, TSH, and ACTH/cortisol, respectively. Magnetic resonance
      imaging demonstrated thickening of the pituitary stalk, which was homogeneously
      enhanced by gadolinium administration. A biopsy specimen showed fibrosis and
      infiltration of CD8-positive T lymphocytes in a portion of the pituitary stalk,
      whereas the adenohypophysis was normal. In addition, no leukemic cells were
      observed in the samples. Thus, a diagnosis of lymphocytic
      infundibuloneurohyophysitis (LIN) was established. All the symptoms were improved
      by treatment with hydrocortisone, L-thyroxine, desamino-8-d-arginine vasopressin,
      estrogen and gestagen. This is the first reported case of ALL complicated by LIN.

PMID- 11193442
TI  - [Anhidrosis during long-term hydroxyurea therapy in a patient with chronic
      myelogenous leukemia].
AB  - A 62-year-old man was diagnosed as being in the chronic phase of chronic
      myelogenous leukemia (CML) in 1990, and subsequently treated with hydroxyurea
      (HU). The total HU dose administered reached 2,929 g (average, 1.44 g/day). In
      December 1995, the patient was admitted to our hospital for control of the CML.
      Following HU therapy, he often experienced high fever (38-39 degrees C) due to
      infection or blastosis, and at that time his skin showed marked pigmentation,
      dryness and scaling with itching and anhidrosis. A skin biopsy sample from the
      left scapula showed atrophic change of the skin and epidermal tissues with
      fibrotic changes and damage to the subcutaneous glands. This was strongly
      suspected to have been caused by the continuous HU administration, and the
      anhidrosis and dryness was considered to have contributed to the patient's high
      body temperature. Frequent cooling of the patient's body was effective.

PMID- 11193443
TI  - [Clinical significance of a multiple myeloma cell line, derived from a case
      associated with hyperammonemia].
AB  - Recently, there have been several reports describing patients with multiple
      myeloma complicated by consciousness disturbance due to hyperammonemia. Here we
      report a patient with multiple myeloma and hyperammonemia, who died after rapid
      progression of the disease. A 71-year-old man who had been diagnosed as having
      Bence Jones protein (kappa)-type multiple myeloma in 1996 was readmitted to our
      hospital in February 1997 because of worsening bone pain, renal dysfunction, and
      hypercalcemia. Bone marrow aspiration yielded an almost dry tap, and the bone
      marrow was found to be completely occupied by immature plasma cells. Although
      liver dysfunction was slight, the serum ammonia level was high and increased
      gradually. Despite treatment, the patient died due to cerebral embolism and
      progression of plasmacytic leukemia in October 1997. Peripheral blood sampled at
      the time of death showed a serum ammonia level of 204 micrograms/dl, and the
      myeloma calls were cultured using monolayered bone marrow stromal cells as feeder
      cells. This led to the successful establishment of a cell line. The level of
      ammonia in the supernatant was high, indicating that the cultured myeloma cells
      produced and released ammonia.

PMID- 11193444
TI  - [Recovery from pancytopenia and liver dysfunction after administration of
      thiamazole for hyperthyroidism].
AB  - A 45-year-old woman was referred to our hospital because of hyperthyroidism
      complicated by atrial fibrillation and heart failure. Laboratory data revealed
      pancytopenia, with a white blood cell count of 2,600/microliter, red blood cell
      count of 330 x 10(4)/microliter, and platelet count of 6.2 x 10(4)/microliter.
      The patient had normal transaminase levels, but tests for hepaplastin and
      cholinesterase showed values of 34% and 1.4 U/ml, respectively, indicating liver
      dysfunction. There was also decreased excretion of indocyanine green. After
      initiation of treatment with 30 mg thiamazole and 20 mg propranolol daily, the
      patient's thyroid function normalized and the other abnormal laboratory findings
      such as pancytopenia and liver dysfunction also disappeared. Pancytopenia is a
      rare complication of hyperthyroidism. In this case, various laboratory
      abnormalities were normalized by antithyroid therapy alone, indicating that the
      hyperthyroidism itself was closely related to the pathogenesis of pancytopenia
      and liver dysfunction.

PMID- 11193445
TI  - [Severe hemolysis and SIADH-like symptoms induced by vincristine in an ALL
      patient with liver cirrhosis].
AB  - An 11-year-old boy was diagnosed as having acute lymphoblastic leukemia (ALL, L1)
      in 1987 and underwent treatment with an ALL high-risk protocol (prednisolone,
      vincristine (VCR), daunorubicin, 1-asparaginase), which resulted in complete
      remission. In 1990 he developed chronic hepatitis C and received interferon
      therapy. In December 1994, ALL recurred, and the patient was treated with VCR. He
      subsequently developed severe hemolysis (Hb 12.5 g/dl-->6.8 g/dl) with increases
      of indirect bilirubin, AST, and LDH. Furthermore, symptoms resembling a syndrome
      of inappropriate secretion of ADH (SIADH) and DIC developed. Upon incubation of
      the patient's red blood cells with VCR in vitro, extreme deformity of the cells
      was observed. These findings suggested that splenomegaly, due to liver cirrhosis
      which had developed rapidly from chronic hepatitis C while the patient was in an
      immunosuppressed state induced by anticancer drugs, had trapped the deformed red
      blood cells and resulted in severe hemolysis. The patient died on the 165th day
      after admission due to liver failure.

PMID- 11193446
TI  - [Usefulness of early tetrofosmin myocardial SPECT during subacute period to
      estimate salvaged myocardium in patients with acute myocardial infarction-
      comparing with tetrofosmin myocardial SPECT during chronic period and evaluating
      regional wall motion using QGS method].
AB  - To evaluate salvaged myocardium of acute myocardial infarction (AMI), we
      performed rest 99mTc-tetrofosmin (TF) SPECT with rest Tl and Tc-pyrophosphate
      (PYP) dual SPECT within 10 days after admission in 19 patients with initial AMI,
      who all were reperfused successfully and without restenosis. TF SPECT was
      obtained at 15 minutes (E) after tracer injection, 4 hours later (D), and 5
      months later (FU). We calculated the regional uptake score (RUS) of infarcted
      area estimated by Tc-PYP uptake and defined RUS(FU) of TF(FU) as salvaged
      myocardium, and then regarded RUS/RUS(FU) x 100 (%) as subacute predicted value
      of salvaged myocardium. Furthermore, we regarded the improvement of wall motion
      estimated by QGS method as the guidepost of myocardial viability. The subacute
      predicted value of TF(E) was 85 +/- 25%, which was significantly higher than 61
      +/- 28% of Tl and 36 +/- 24% of TF(D) (p < 0.01). Sensitivity and specificity of
      myocardial viability based on the improvement of wall motion SPECT image were 78%
      and 73% for Tl, 90% and 87% for TF(E) and 52% and 87% for TF(D). TF myocardial
      early imaging in subacute period was useful to detect salvaged myocardium.

PMID- 11193447
TI  - [Coronary flow reserve evaluated by 201Tl myocardial perfusion SPECT after
      coronary artery bypass grafting (CABG) for angina pectoris].
AB  - We compared the flow reserves of the coronary bypass vessels between arterial and
      venous grafts by 201Tl myocardial perfusion SPECT on the patients with angina
      pectoris who had no past history of myocardial infarction or intervention therapy
      such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and
      66 of them were proved to be patent at postoperative CAG. Reversible defects were
      observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11
      of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative
      reversible defects was higher in the areas grafted by artery but this had no
      relation with the severity of coronary artery stenosis before CABG. This
      reversible defect is most likely to be caused by the character of artery graft
      itself and this should not be considered to highly suggest the restenosis or
      occlusion of the graft vessel.

PMID- 11193448
TI  - [A new method for pharmacokinetic analysis of 99mTc-GSA using two-compartment and
      two-parameter model].
AB  - Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin
      (99mTc-GSA) is a liver scintigraphy agent which binds to asialoglycoprotein
      receptor in hepatocyte. Twenty-six patients with liver dysfunction were examined
      with 99mTc-GSA liver scintigraphy using two-compartment and two-parameter model
      (2C2P model). The 99mTc-GSA was assumed to move within two compartments (whole
      blood and liver). k1 and k2 were parameters which represented transfer rate
      constant from blood to liver, and from liver to blood, respectively. Two
      differential equations based on 2C2P model were integrated, so that k1, k2, k1/k2
      and VLmg were estimated from the time-activity curves of the heart and liver.
      VLmg was computed as maximum amount of 99mTc-GSA binding to liver. The results
      were compared with the liver function tests and the conventional 99mTc-GSA
      indices: HH15, LHL15, and LU15. k1/k2 and VLmg values had positive correlation
      with the result of the serum liver function tests, Plt., T.Bil., ChE, GOT, LDH,
      ALP and gamma GTP. It is concluded that this new method using 2C2P model is not
      invasive and simplest in the 99mTc-GSA liver scintigraphies, and may be useful in
      evaluating liver function.

PMID- 11193449
TI  - [99mTc-HMDP accumulation in soft tissue tumor].
AB  - Accumulation with bone scintigraphy using technetium-99m hydroxymethylene
      diphosphonate (99mTc-HMDP) in 68 cases with radiographically or pathologically
      verified soft tissue tumor was examined. Radiographical or histopathologic
      diagnoses of the 68 cases included; 14 lipomas, 11 liposarcomas, 11 neurinomas or
      neurofibromas, 6 malignant lymphomas, 5 malignant fibrous histiocytomas, 5
      hemangioma, rhabdomyosarcomas, 2 Langerhans cell histiocytoses, 2 desmoid tumors
      and one each of neuroblastoma, hemangiopericytoma, angiomyxoma, plasmacytoma,
      liomyosarcoma, lymphangioma, fibrosarcoma, elastofibroma, synovial sarcoma, and
      ganglion. Thirty-seven (54%) showed positive accumulation and 31 were negative.
      One half of soft tissue tumors can be accumulated by 99mTc-HMDP.

PMID- 11193450
TI  - [Electrocardiographic findings in pulmonary thromboembolism--comparison with lung
      perfusion scan and echocardiographic findings].
AB  - This study investigated the usefulness of electrocardiography (ECG) in pulmonary
      thromboembolism (PTE), compared with lung perfusion scan and echocardigraphic
      findings on evaluation of the severity. We checked ECG findings associated with
      PTE at hospital admission, with the seven abnormal findings described by Sreeram
      N, et al. On Lung perfusion scan, severity of perfusion defect was assessed total
      defect score (TDS), calculated as the sum of the scores for all 18 segment of
      lung. On echocardiography, severity of right ventricular overload was assessed.
      The number of the seven ECG abnormal findings and TDS were larger in patients
      with the right ventricular overload (p < 0.01). The number of the ECG findings
      was positively correlated with TDS (r = 0.75). The number of abnormal ECG
      findings in PTE is associated with the severity evaluated by lung perfusion scan
      and echocardiography.

PMID- 11193451
TI  - [Regional assessment of treatment in lung cancer using lung perfusion and
      ventilation images].
AB  - In 30 patients with lung cancer undergoing non-surgical treatment, we performed
      perfusion lung imaging using 99mTc-MAA and inhalation lung studies using
      Technegas before and after treatment and evaluated regional perfusion and
      ventilation status in the lung regions where bronchogenic carcinoma was located.
      Regional ventilation status was preserved rather than perfusion counterpart (V >
      P) in 18 patients (18/30 = 60.0%) before treatment, while the former was better
      than the latter in 27 patients (27/30 = 90.0%) after treatment, indicating that
      regional ventilation status improved more significantly than regional perfusion
      counterpart after treatment (p = 0.005). We also classified the therapeutic
      effect for regional perfusion and ventilation status as improved, unchanged, or
      worsened, respectively; improvement in regional perfusion status was observed in
      17 patients (56.7%) and that in regional ventilation status in 24 patients
      (80.0%). There was a statistically significant correlation between improved
      regional perfusion and ventilation status (p = 0.0018) when therapeutic effect
      was recognized. The patients who showed improvement in regional perfusion status
      after treatment always showed improved regional ventilation status, but 7
      patients showed either unchanged or worsened regional perfusion status after
      treatment, although regional ventilation status was improved. In conclusion the
      pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and
      improvement in regional perfusion status was revealed to be more difficult than
      that in regional ventilation status after treatment.

PMID- 11193452
TI  - [Results of radioiodine therapy in patients with pulmonary metastases of
      differentiated thyroid cancer].
AB  - Factors affecting the effect of 131I treatment and survival after pulmonary
      metastases in patients with differentiated thyroid cancer, were studied. Between
      1984-1999, pulmonary metastases was observed in 51 out of 153 patients with
      differentiated thyroid cancer at our institution. Of these 41 patients had
      papillary and 10 follicular thyroid cancer. There were 37 females and 14 males
      with mean age (+/- S.D.) of 50.5 +/- 19.0 years. These 51 patients were subjected
      to 131I therapy. The effect of 131I treatment and the prognostic values of the
      following variables were examined: sex, age at the time of 131I treatment,
      histologic type of cancer, size of pulmonary metastases on CT, total-body
      scintigraphy with 201Tl and 131I, serum thyroglobulin levels and presence of
      metastases in distant sites other than lung. The effect of 131I treatment was
      evaluated by means of changes in the number and size of metastatic shadows on
      chest CT and by serum thyroglobulin levels. The minimum duration of follow-up was
      12 months. Therapeutic 131I dose scans revealed detectable uptake in 25 of 51
      patients. Therapeutic 131I dose uptake was achieved more frequently in patients
      under 40 years of age and in those with follicular cancers. Of the 51 patients,
      13 were evaluated to be treated successfully. Those under 40 years of age, with
      131I uptake in the lung and presence of other metastases showed a good response
      to treatment than others. Follicular cancer showed a more significant association
      with coarse type of lung metastases (> 5 mm in diameter on chest CT) and good
      131I uptake than papillary cancer. Of all the variables studied, the best
      prognosis for survival was demonstrated by increased 131I uptake in pulmonary
      metastases. These results indicate that age, 131I uptake and presence of other
      metastases are important factors in predicting the effect of 131I treatment for
      pulmonary metastases of differentiated thyroid cancer.

PMID- 11193453
TI  - [The usefulness of 99mTc-MIBI scintigraphy in a patient with hyperparathyroidism
      who underwent percutaneous ethanol injection therapy].
AB  - 99mTc-MIBI scintigraphy was performed in a 67-year-old male with
      hyperparathyroidism who underwent percutaneous ethanol injection therapy (PEIT).
      Abnormal 99mTc-MIBI uptake was clearly recognized. 99mTc-MIBI scintigraphy was
      useful also in the evaluation of hyperparathyroidism after imperfect PEIT.

PMID- 11193454
TI  - [A case of bone metastases from carcinoma of the lung demonstrating increased
      uptake of 99mTc-ECD].
AB  - A 48-year-old man with carcinoma of the lung had loss of consciousness during
      radiation therapy and underwent 99mTc-ethyl cysteinate dimer (99mTc-ECD) SPECT to
      evaluate brain tumor seen on CT scan. Incidentally 99mTc-ECD SPECT imaging showed
      intense accumulation in the frontal and occipital bone. The tumor in the
      occipital bone had been histologically proven to be a metastasis from carcinoma
      of the lung. We presented a very rare case of bone metastasis demonstrating
      increased uptake of 99mTc-ECD.

PMID- 11193455
TI  - [Allergic rhinitis in the new millennium].

PMID- 11193456
TI  - [Food allergy and food components].

PMID- 11193457
TI  - [Japanese guideline for treatment and management of childhood asthma].

PMID- 11193458
TI  - [A study of food-dependent exercise-induced anaphylaxis by analyzing the Japanese
      cases reported in the literature].
AB  - We surveyed and analyzed cases of food-dependent exercise-induced anaphylaxis
      (FDEIA) in the Japanese literature. We found 167 cases which were reported as
      FDEIA since 1983. Analyzing these case, following characteristic features were
      revealed: 1) Recent upward trend in the number of reports of FDEIA was noted. 2)
      Male cases were more frequent than female cases, while about half of the cases
      were teenager. 3) More than half of the cases were proved to be induced by wheat
      followed by shrimp. In those under 20, shrimp was the most popular cause rather
      than wheat. 4) Skin test and/or IgE RAST showed positive results in most cases,
      suggesting that the response itself is linked to type I allergic reaction. 5)
      About 40% of the patients had history of atopic disease, indicating that atopic
      condition may play some role in FDEIA. 6) All cases who performed provocation
      test with aspirin responded to food challenge and/or exercise in combination with
      aspirin. This indicates that aspirin plays a key provoking factor in FDEIA. 7) In
      17 cases FDEIA attacks were observed during noon recess or physical education
      class after lunch at school. We stress here the importance of a nation-wide
      education to school teachers the potential danger of this disorder.

PMID- 11193459
TI  - [Change in skin reactivity to common allergens in allergic patients over a 30
      year period. Association with aeroallergen load].
AB  - Five-year changes in the percentage of positive intradermal test to allergens in
      patients with bronchial asthma (BA) and allergic rhinitis (AR) over a period of
      30 years from 1969 to 1998 were analyzed, with consideration of their association
      with the yearly changes in the levels of airborne pollens and molds over 30
      years. Allergens used throughout the period were house dust, pollens from various
      plants (Japanese cedar, pine, oak, Japanese alder, Zelkova, orchard grass,
      ragweed, mugwort and Japanese hop) and molds (Alternaria, Cladosporium,
      Aspergillus, Penicillium and Candida). Overall percentages to house dust were
      higher in BA patients than in AR patients, but those to pollens were distinctly
      higher in the latter. Those to molds were higher in BA patients, except that
      those to Alternaria were about the same in both BA and AR patients. Therefore,
      the clinical expression of allergy may differ according to the type of allergen
      to which subjects are sensitized. Over the course of 30 years, the increase in
      the percentage of positive intradermal test to all of the allergens used was
      noted in both BA and AR patients, although this did not always reflect the
      aeroallergen load. This includes the two extremes to pollens from Japanese cedar
      and pine, either of which is the most common source of allergen in Japan.
      Significant increases in the percentages to Japanese cedar pollen (from 12.5% to
      54.4% in BA patients, and from 35.1% to 81.5% in AR patients) appeared to be
      roughly correlated to marked increases in pollen count. In contrast, that to pine
      pollen was kept low at about 2%, because of their weak allergenicity, but
      abruptly increased to 5-6% in the last decade, despite the almost invariable
      pollen count over the last 30 years. Therefore, the increased sensitivity to
      aeroallergens may also be associated with other factors besides their load in the
      air.

PMID- 11193460
TI  - [Atopic dermatitis in early infancy in Matuyama city: prevalence and seasonal
      variations].
AB  - From Jun 1996 to May 1999, 1280 infants were examined by the author 6 times from
      birth to 12 month-old in each 0, 1, 3, 6, 9, 12 month-old time at NTT Nishinihon
      Matuyama Hospital. The 12-month cumulative prevalence of AD was 28.5%. Out of the
      cases 82.2% showed the symptoms before 3 month-old. There were 217 male infants
      in AD group (59.5%). This percentage was significantly higher than 45.2% in non
      AD group (p < 0.001). Approximately 70% cases in AD group had family history of
      allergic diseases. This ratio was significantly higher compared to 49.6% in non
      AD group (p < 0.001). According to the season of birth, there were significant
      differences in the 12-month cumulative prevalence of AD (p < 0.005). Infants born
      in the spring, summer, autumn and winter showed 21.1%, 27.2%, 31.3%, and 33.9% of
      cumulative prevalence of AD respectively. The prevalence of AD at 3 month-old and
      the ratio that the symptoms appeared before 3 month-old also had similarly
      significant tendency (p < 0.001) (Infants born in the spring showed 15.4% and
      73%. Infants born in the winter showed 31.5% and 92.9%). There were no
      relationship between the cumulative prevalence of AD and the precipitation.

PMID- 11193461
TI  - [Relation between serum eosinophil cationic protein (ECP) level and asthma attack
      in children].
AB  - Serum eosinophil cationic protein (sECP) levels were measured in 339 patients
      with childhood asthma, and the clinical courses of these patients were followed
      for 57 weeks. While considering the history and characteristics of each patient,
      we examined the correlation between asthma attack frequency and sECP, blood
      eosinophil count, and serum total IgE (tIgE) to determine their usefulness in
      predicting asthma attacks. Among patients with no other allergic diseases, sECP
      levels in patients who had no asthma attacks two weeks before or after the
      measurement were significantly lower than those of patients who had attacks
      during the same four-week period. Among patients who had attacks, those patients
      with no attack for a year after the measurement were also found to have low sECP
      levels. Similarly, even among patients with asthma attacks and high sECP levels,
      there were cases where attacks were well controlled using nebulizer treatments
      with DSCG or BDP. The incident rate of attacks for patients with other allergic
      diseases and a low sECP was low. Yet, there was no common trend in patients with
      high sECP levels. Moreover, this study detected a significant correlation between
      sECP level and blood eosinophil count as well as between sECP level and serum
      tIgE. The most significant correlation with asthma attack frequency was sECP
      level. Thus, sECP level seems to reflect the allergy activity level, especially
      two weeks prior to and after the measurement. For patients without other allergic
      diseases, asthma attack prediction during the two weeks period after the
      measurement of sECP also seems possible. Therefore, periodic measurement of sECP
      level is useful in objectively monitoring the improvement of symptoms and
      establishing the treatment plan, including treatment with DSCG or BDP.

PMID- 11193462
TI  - [A clinical case of 13 years old boy of aspirin-induced asthma with food
      allergy].

PMID- 11193463
TI  - [A new spacer, Babyhaler, for BDP inhalation therapy in severe infantile asthma].
AB  - Recently, it has been recognized that airway inflammation is the most important
      pathogenesis of bronchial asthma, and inhaled corticosteroids therapy is
      effective for childhood asthma. However, using metered dose inhalers (MDI) of
      beclomethasone dipropionate (BDP) is difficult for infants. In this study, we
      administered BDP inhalation therapy with a new spacer, Babyhaler, for five cases
      of early childhood with severe infantile asthma that we could not control even by
      combination of theophylline round the clock (RTC) therapy and disodium
      cromoglycate (DSCG) + beta 2 stimulant (beta 2) regular use. We compared symptom
      score of asthma attack between the pre-treatment period (prior 2 weeks) and post
      treatment period (following 8 weeks) of BDP inhalation therapy with Babyhaler. As
      a result, symptom score decreased significantly within 4 weeks after treatment of
      BDP with Babyhaler as compared with the score before treatment of BDP. These
      findings suggest that Babyhaler is useful for BDP inhalation therapy in infantile
      asthma.

PMID- 11193464
TI  - [Study on casein allergy in children].
AB  - Casein a component of milk is used for food additives, industrial materials and
      drugs. However casein is known to be a main allergen in milk allergy. Recently
      several cases of anaphylaxis to antibiotics including casein have been reported.
      In this study we investigated casein allergy in milk allergy. 6 out of 8 patients
      who were positive for milk RAST were also positive for casein RAST. In these
      positive cases only 3 out of 6 patients had some allergic symptoms after taking
      antibiotics. In 3 patients DLST was also positive to casein. There was one
      patient who was positive in DLST without any symptoms after taking the same
      antibiotics. It is needed to pay attention to casein allergy when giving the
      medication which includes casein.

PMID- 11193465
TI  - 5th Congress of the European Federation of Neurological Societies. 14-18 October
      2000. Copenhagen, Denmark. Abstracts.

PMID- 11193468
TI  - Gastric polyps: an update of their pathology and biological significance.
AB  - Gastric polyps are clinically important lesions that are frequently encountered
      in routine pathology (2-3% of all gastroscopies). Polyps may occur sporadically
      or in polyposis syndromes, such as familial adenomatous polyposis coli (FAP),
      Peutz-Jeghers syndrome, juvenile polyposis, Cowden's disease and Cronkhite-Canada
      syndrome. In biopsy specimens taken during routine gastroscopic examinations, it
      is almost always possible to differentiate between neoplastic and non-neoplastic
      polyps and to type polyps. In this review, we focus on the morphological spectrum
      of gastric polyps in an attempt to assist the pathologist and the
      gastroenterologist in recognising the lesion and in treating patients with
      gastric polyps, respectively. Further, we propose that the World Health
      Organization (WHO) classification should be modified to include the following
      categories: non-neoplastic polyps (WHO: tumour-like lesion), hamartomatous
      polyps/polyps of polyposis syndromes (WHO: tumour-like lesion), heterotopic
      tissue polyps (WHO: tumour-like lesion), neoplastic polyps (WHO: epithelial, non
      epithelial and endocrine tumours) and reactive polypoid lesions.

PMID- 11193469
TI  - Mantle cell lymphoma, in leukaemic phase with prominent splenomegaly. A report of
      eight cases with similar clinical presentation and aggressive outcome.
AB  - Mantle cell lymphoma (MCL) is a well-defined peripheral B-cell lymphoma usually
      diagnosed upon peripheral lymph node biopsy. We report eight cases of peripheral
      B-cell leukaemia that demonstrate presumptive evidence of mantle cell
      characteristics. The patients had a median age of 68.5 years, and five were male.
      All presented with an enlarged spleen without any peripheral lymphadenopathies,
      and they were leukaemic at presentation (median lymphocytosis, 38x10(9)/l).
      Morphological diagnosis of MCL was very difficult in five cases but easier in
      three because we were able to analyse either pre- or post-mortem lymph nodes and
      spleen. The immunophenotype of blood lymphocytosis using flow cytometry, the
      presence of a t(11;14)(q13;q32) and a cyclin D1 expression by leukaemic cells all
      fit with the diagnosis of MCL. All patients progressed and died with a median
      overall survival of 8 months. Multifocal areas of transformation in blastoid or
      large cell variants were observed in the three autopsied patients. In summary,
      one should consider the diagnosis of MCL at presentation in leukaemic phase even
      in the absence of peripheral adenopathies.

PMID- 11193470
TI  - beta-catenin expression pattern in primary oesophageal squamous cell carcinoma.
      Relationship with clinicopathologic features and clinical outcome.
AB  - beta-Catenin has an essential role in intercellular adhesion and signal
      transduction. beta-catenin functions as a transcriptional activator downstream in
      the Wnt signalling pathway. Cytoplasmic stabilisation of beta-catenin, mainly due
      to inactivating mutations of the adenomatous polyposis coli (APC) tumour
      suppressor gene or activating mutations in exon 3 of the beta-catenin gene, can
      activate this important pathway in the development of several carcinomas. To
      determine whether this pathway for malignant transformation is important in
      oesophageal cancer, we analysed 39 primary oesophageal squamous cell carcinomas
      (OSCC). Immunohistochemical expression of beta-catenin was studied in formalin
      fixed, paraffin-embedded tissue samples. Results were correlated with
      clinicopathological parameters and immunohistochemical expression of the proteins
      p53, E-cadherin, bcl-2 and Ki-67. All examined OSCC had beta-catenin expression
      localised in the cellular membrane, frequently with a heterogeneous pattern.
      Seven (18%) cases also showed immunoexpression in the cytoplasm and nuclei of the
      tumour cells. These seven tumours were localised in the upper (three) or in the
      middle third (four) of the oesophagus. Only one patient had p53 expression and
      all had bcl-2 expression. The consensus sequence for glycogen synthase kinase
      (GSK) 3beta phosphorylation in exon 3 of the beta-catenin gene was studied using
      polymerase chain reaction and direct sequencing in the seven cases with nuclear
      beta-catenin expression. No genetic alteration was found. These results suggest
      that beta-catenin expression may characterise a subset of OSCC.

PMID- 11193471
TI  - Comparison of loss of heterozygosity and microsatellite instability in
      adenocarcinomas of the distal esophagus and proximal stomach.
AB  - Adenocarcinoma of the gastroesophageal junction is rapidly rising in incidence.
      It has been proposed that these tumors be classified as three different types:
      distal esophageal (AEG I), cardia (AEG II), and subcardia (AEG III). Using
      comparative genomic hybridization (CGH) analysis, one recent study reported that
      the 14q chromosomal arm showed a significantly higher rate of deletion in
      esophageal than in cardia adenocarcinoma. Using a microsatellite analysis
      technique, we analyzed this area and regions in the vicinity of the APC, DCC, and
      p53 genes. Tumor and normal tissues were microdissected from 54 cases (27 AEG I
      and 27 AEG III). DNA was extracted and then amplified using seven fluorescent
      labeled microsatellite markers, one pair each on 5q, 18q, and 17p and four on
      14q. The results were analyzed for loss of heterozygosity (LOH) and
      microsatellite instability (MSI). LOH varied from 20% to 30% at each locus except
      for the 17p locus, where it was slightly above 50% in both groups. No significant
      differences in LOH or MSI were found between the esophageal and gastric tumors,
      including the 14q chromosomal arm. These results fail to confirm the finding that
      abnormalities on the 14q chromosomal arm distinguish between distal esophageal
      and proximal gastric tumors.

PMID- 11193472
TI  - Assessment of tumor angiogenesis in invasive breast carcinomas: absence of
      correlation with prognosis and pathological factors.
AB  - Different retrospective studies have shown that microvessel counting (MVC) is an
      independent prognostic marker for clinical outcome in breast cancer. The aim of
      this study was to evaluate the prognostic value of MVC alone or in association
      with classical clinicopathological parameters, as well as the reproducibility of
      the technique. We analyzed a retrospective series of 216 cases of breast
      carcinoma. Tissue sections were stained for Factor-VIII-related antigen.
      Microvessel quantification was performed at x400 magnification in the three most
      vascular areas of the tumors (hot spots). Mean and highest values were studied.
      Furthermore, a semi-quantitative evaluation of MVC was performed by use of an
      image-analysis system. The effect of multiple factors on survival was tested
      under a Cox multivariate proportional hazards model. In ten cases, a study of the
      reproducibility was done by evaluating MVC in different sections of the same
      block and in different blocks of a same tumor. There was no association between
      MVC (determined at a microscopic level or by image analysis) and overall survival
      or relapse-free survival. No association was found with tumor size, tumor grade,
      and lymph-node status. The study of reproducibility showed a very high intra
      tumoral variation of MVC. The intra-individual coefficient of variation (CV)
      varied between 20 and 80%. This study did not show any significant correlation
      between angiogenesis, as assessed by MVC, and relapse-free survival or overall
      survival in infiltrating breast carcinomas. The low reproducibility of the MVC
      for the same tumors suggests that this technique must still be optimized before
      routine application.

PMID- 11193473
TI  - Stromelysin-3 expression in invasive ovarian carcinomas and tumours of low
      malignant potential.
AB  - Stromelysin (ST)-3 is considered to be a marker of invasion and preinvasive
      lesions to indicate the likelihood of subsequent invasion. The expression of ST-3
      has not been systematically studied in ovarian neoplasms. We studied 47 ovarian
      carcinomas and 49 ovarian tumours of low malignant potential (LMP) to see whether
      the expression of ST-3 correlated with any histopathologic features and, in the
      LMP tumours, whether its expression might be a prognostic indicator. All of the
      primary tumours and available metastases or implants were studied using
      immunohistochemistry (IHC) for ST-3 and, in 52 selected lesions, in situ
      hybridisation (ISH) using a cDNA probe. Expression of ST-3 was seen in 42 of 47
      (89%) of the carcinomas and in 16 of 49 (33%) of the LMP cases. A significantly
      higher percentage of carcinomas than LMP tumours (P<0.00001) expressed ST-3 in
      the stroma adjacent to the tumour, with a correlation to increasing FIGO
      (International Federation of Gynecology and Obstetrics) tumour stage. ST-3 was
      expressed in the surrounding stroma of 1 of 8 LMP implants and 46 of 55 (84%) of
      the carcinoma metastases. The single LMP patient who died of tumour recurrence
      had ST-3 expression, but a significant prognostic impact was not found. The
      infrequent expression of ST-3 in LMP compared with carcinoma metastases appears
      to be more consistent with a peritoneal "field effect" than spread from the
      ovarian LMP tumour.

PMID- 11193474
TI  - Nuclear changes in the normal-looking columnar epithelium adjacent to and distant
      from prostatic intraepithelial neoplasia and prostate cancer. Morphometric
      analysis in whole-mount sections.
AB  - Subtle morphological changes and molecular alterations have been reported in
      normal-appearing tissue in prostates with high-grade prostatic intraepithelial
      neoplasia (PIN) and prostate cancer (PCa). The severity and the distribution of
      these changes and alterations within the prostate gland have not been addressed
      in previous publications. The aim of this study was to investigate
      morphometrically the nuclear changes of the normal-looking columnar epithelium
      adjacent to and distant from high-grade PIN and PCa. Karyometry was performed on
      the whole-mount histological sections of three radical prostatectomy (RP)
      specimens. Two concentrical lines, one corresponding to the outer surface (or
      capsule) of the prostate and the other corresponding to one centimeter towards
      the center, were drawn with a black pen on each whole-mount section. The part of
      the prostate tissue between these two boundaries was then divided into twelve
      equal sectors or regions. The part within the inner line was divided into two
      regions. The analysis was also performed on the slides of the apex and base of
      the prostate. One prostate contained normal-looking epithelium only (case no. 1).
      Another contained both high-grade PIN and PCa, the former occupying larger areas
      than the latter (case no. 2). Both high-grade PIN and PCa were present in the
      third sample, in which PCa was more widely distributed than PIN (case no. 3). The
      lesion measured in each region was always the most severe, e.g., either high
      grade PIN or PCa. When neither were identifiable, then the normal-looking
      columnar epithelium was analyzed. For each sector, the mean and standard
      deviation of the nuclear area, maximum nuclear diameter, nuclear roundness
      factor, and nucleolar area were calculated. In normal-looking columnar
      epithelium, the mean of the mean nuclear area of the sectors of case no. 1 was
      35.19 microm2 (SD 4.14). The mean nuclear areas in cases no. 2 and no. 3 were
      37.94 microm2 (SD 4.65) and 37.31 microm2 (SD 4.36), respectively. The mean of
      the mean nuclear area of the sectors with high-grade PIN of case no. 2 was 49.85
      microm2 (SD 8.44), whereas it was 54.26 microm2 (SD 2.91) in case no. 3. The mean
      of the nuclear area values obtained in the sectors of cases no. 2 and no. 3 with
      PCa was 56.74 microm2 (SD 6.56) and 61.17 microm2 (SD 8.13), respectively. When
      considering the normal-looking tissue of the second and third case, 79% and 90%,
      respectively, of the regions showed nuclear area values greater than 34.94
      microm2 (e.g., the 50th percentile of the mean nuclear area values of the regions
      of the first case). Sectors with normal-looking epithelium, whose nuclear area
      was above this threshold, were both adjacent to and at a distance of more than 1
      cm from those with PIN or PCa. The other nuclear features showed a similar trend
      of value changes. This study demonstrates that the normal-looking ducts and acini
      from prostate harboring preneoplastic and neoplastic lesions show morphological
      nuclear abnormalities that are not seen by the human eyes but that can be
      detected with image analysis. Such changes may be of diagnostic importance,
      especially in cases where clinical suspicion for cancer prevails after a negative
      biopsy.

PMID- 11193475
TI  - Thyroglobulin mRNA expression helps to distinguish anaplastic carcinoma from
      angiosarcoma of the thyroid.
AB  - The existence of angiosarcoma (AS) of the thyroid has been a matter of debate for
      many years, because some authors believe that most if not all ASs are in fact
      "angiomatoid" anaplastic carcinomas (ACs). Immunohistochemistry alone was not
      successful in solving the problem, since cytokeratin expression is a known
      occurrence in AS. Therefore, we wanted to compare nine cases of AS with ten cases
      of AC, assessing whether thyroglobulin (TG) mRNA was still transcribed in
      undifferentiated tumors and could be helpful to distinguish AC from AS. The cases
      were analyzed for TG mRNA expression by means of radioactive in situ
      hybridization. The silver grains were counted using an automated device, and
      their amount was compared with that of stroma, background, and peritumoral
      thyroid. A weak signal was present in all AC but not in AS (mean counts 35.7 and
      9.6 arbitrary units, respectively: P<0.01). In two cases of AC, residual areas of
      poorly differentiated insular carcinoma had a strong signal (similar to that of
      peritumoral thyroid). These findings further confirm that AC and AS of the
      thyroid are unrelated malignant tumors.

PMID- 11193476
TI  - Two cases of ectopic hamartomatous thymoma.
AB  - Ectopic hamartomatous thymoma (EHT) is a rare benign neoplasm. Since it was named
      by Rosai et al. in 1984, 24 cases have been reported. We herein report two cases
      of EHT, one of which presented with massive myoid cells, and review the
      literature related to EHT. Both of our cases displayed the typical features of
      EHT: (1) nests of epithelial cells, including solid, cystic, or glandular
      epithelial islands; (2) spindle cells dominating the microscopic picture; and (3)
      adipose cells which intermingle haphazardly to impart a hamartomatous quality to
      the tumor. In this paper, we observed massive myoid cells and the transition from
      spindle epithelial cell to myoid cell in one of our cases. Immunohistochemical
      examinations showed that the main component of EHT, spindle cells, was positive
      for cytokeratin and epithelial membrane antigen (EMA). Intriguingly, the myoid
      cells simultaneously expressed cytokeratin, EMA, myoglobin, and creatine kinase
      mm, suggesting that myoid cells may originate from epithelial cells and are an
      intermediate state between epithelial cells and muscular cells.

PMID- 11193477
TI  - Proliferation and number of Clara cell 10-kDa protein (CC10)-reactive epithelial
      cells and basal cells in normal, hyperplastic and metaplastic bronchial mucosa.
AB  - Clara cell 10-kDa protein (CC10) is an inhibitor of phospholipase A2 and binds to
      phosphatidylinositol. It may therefore interfere with intracellular signal
      transduction. Bronchial CC10-reactive cells have been described by several
      authors. In contrast to the bronchiolar CC10-containing Clara cell, which is a
      progenitor cell of terminally differentiated airway epithelium, the role of
      bronchial CC10-reactive cells remains to be elucidated. We assessed the number of
      bronchial CC10-reactive cells in relation to cytokeratin (CK) expression and
      proliferative activity in normal, hyperplastic and squamous metaplastic
      epithelium. Sixty-five human bronchial mucosal specimens were investigated
      immunohistochemically for CK expression (CK7, CK13 and CK5/6), proliferative
      activity (MIB-1) and number of CC10-reactive epithelia. The proliferation
      fraction of CC10-reactive cells was assessed with double staining for MIB-1 and
      CC10. The proliferation index of the epithelium differed significantly between
      normal, hyperplastic and metaplastic epithelium. The number of CC10-reactive
      cells was inversely related to the epithelial proliferation. Bronchial CC10
      reactive cells showed no proliferative activity as assessed using
      immunohistochemical double staining for CC10 and MIB-1. In contrast to normal and
      hyperplastic epithelium, squamous metaplasia disclosed CK5/6 in all epithelial
      layers, a loss of CK7 and a gain of CK13. We conclude that CC10-reactive cells
      have no progenitor role in the bronchial mucosa. However, because the
      proliferative activity is inversely related to the number of CC10-reactive cells,
      the CC10 protein may play a role in the regulation of epithelial repair. Squamous
      metaplasia most likely originates from basal cells.

PMID- 11193478
TI  - Phlegmonous colitis: a specific and severe complication of chronic hepatic
      disease.
AB  - Phlegmonous colitis (PC) is an acute infectious entity caused by bacteria. In
      this study, we reviewed 8,822 autopsy cases and found 13 cases of PC (0.15%). PC
      affected 2.43% of patients with hepatic cirrhosis or subacute liver atrophy, both
      of which were considered to be due to hepatitis viral infection. Before autopsy,
      none of the cases studied was suspected to involve PC, irrespective of the
      immediate cause of patient death. Thirteen autopsy cases showed some or all of
      the following pathohistologic characteristics: (1) involvement of the cecum (9
      cases, 76.9%), (2) phlegmonous inflammatory changes and edema in the submucosa
      (100%), (3) bacterial infection (100%), (4) no microscopically detectable mucosal
      injuries (12 cases, 92.3%), and (5) acute serositis (peritonitis) (2 cases,
      15.4%). These results suggest that PC is an unrecognized, but fatal complication
      of patients with some hepatic diseases and that PC has pathohistologic
      characteristics in common with previously reported spontaneous bacterial
      peritonitis in animal models. PC probably arises due to spontaneous infection in
      patients with hepatic cirrhosis.

PMID- 11193479
TI  - Inducible nitric oxide synthase expression in human urinary bladder cancer.
AB  - Nitric oxide (NO) is generated by a family of enzymes, nitric oxide synthases
      (NOS), in a wide range of mammalian cells. NO produced by the inducible NOS
      isoform (iNOS) has been suggested to play an important role in tumor biology with
      both tumor promoter and anti-tumor activity. Here, the cellular localization of
      iNOS in tissue of 100 cases of urinary bladder cancer was assessed
      immunohistologically using a commercially available antiserum. Positive iNOS
      immunostaining was detected in all samples of tumor tissue, whereas nonmalignant
      tissue adjacent to malignant areas did not show any iNOS positivity. The tumor
      tissue revealed a highly inhomogeneous staining pattern. In addition to uniformly
      stained tumor specimens, we also found markedly iNOS-positive tumor islets in the
      midst of unstained tumor tissue and scattered individual tumor cells expressing
      marked staining. In some cases, the tumor tissue showed no or only weak staining
      intensity. In some instances, the superficial epithelial layer of papillary
      carcinomas was extremely immunoreactive, in other cases it was not. Thus we were
      unable to show a clear correlation to tumor grade or stage. Further studies with
      a diversity of tumor markers including molecular genetics techniques will be
      necessary to elucidate how and to what extent NO and bladder cancer of different
      grades and stages are functionally interrelated.

PMID- 11193480
TI  - Influence of the chronic nitric oxide synthesis inhibition on cardiomyocytes
      number.
AB  - This work analyzes the relationship between the number of viable cells and
      alteration of the cardiomyocytes growth response capacity of the hypertensive rat
      myocardium. Hypertension was induced in Wistar rats by means of nitric oxide
      synthesis blockade using NG-nitro-L-arginine methyl ester (L-NAME). L-NAME (12
      mg/kg per day) was given to animals in drinking water ad lib for 15 weeks.
      Proliferating cell nuclear antigen (PCNA) protein expression and the disector
      method were used to evaluate the proliferation capacity of the cardiomyocytes and
      its numerical density alteration (Nv[m]), respectively. Terminal deoxynucleotidyl
      transferase-mediated dUTP-biotin nick end labeling (TUNEL) and monoclonal
      antibody to single-stranded DNA were two methods that detected the process of the
      apoptotic cell death. The association of the p53 expression with the apoptosis
      was investigated using anti-p53 antibody. The heart weight, body weight, and
      heart weight/body weight ratio of the control rats increased 114%, 77%, and 22%,
      respectively, and the Nv[m] decreased 60% (P<0.0001) relative to the L-NAME rats.
      The cardiomyocytes did not present PCNA labeling, indicating the absence of
      cellular proliferation. The decline of the Nv[m] was also associated with
      apoptotic cell death in the myocardium of the hypertensive rats. A p53-dependent
      pathway seems to mediate the programmed cell death in this model of hypertension.

PMID- 11193481
TI  - Primary neuroendocrine carcinoma with ganglion cell differentiation in a crural
      lymph node.
AB  - A primary neuroendocrine carcinoma with ganglion cell differentiation is
      described in a crural lymph node. The patient, a 48-year-old woman, presented a
      palpable lymph node of the crural region in March 1994. Histologically, the
      lesion was composed mostly of small cells immunoreactive for cytokeratins, neuron
      specific enolase and synaptophysin. The small cells merged gradually with areas
      containing ganglion cells immersed in a fibrillar matrix resembling neuropil.
      Ganglion cells expressed neuron-specific enolase, synaptophysin, neurofilament
      proteins and S-100 protein. Moreover, a minority of them featured cytokeratin
      expression. Electron microscopy was performed in the small cell component. These
      cells featured attenuated desmosomes and electron dense granules with an average
      size of 120 nm within bundles of intermediate filaments. Clinically, no tumour
      was found elsewhere despite extensive work-up over the 76-month follow-up period.
      Although similarities with previous cases of primary neuroendocrine carcinoma of
      lymph node, ganglion cell differentiation has never been described.

PMID- 11193482
TI  - Absence of a PDX-1 mutation and normal gastroduodenal immunohistology in a child
      with pancreatic agenesis.
AB  - Pancreatic agenesis is a rare condition, of which only a limited number of cases
      have been described. One recent paper reported a homozygous mutation in the
      pancreatic duodenal homeobox gene 1 (PDX-1) in a child with pancreatic agenesis.
      We report a 6-year-old boy with pancreatic agenesis, treated medically, without
      abnormalities in the PDX-1 gene coding sequence and with normal gastroduodenal
      endocrine cell distribution. Genes other than PDX-1 also appear to be involved in
      human pancreatic agenesis.

PMID- 11193483
TI  - CT scanning in lung cancer.

PMID- 11193484
TI  - "Opportunist" mycobacterial infection.

PMID- 11193485
TI  - Tuberculosis in Cuba.

PMID- 11193486
TI  - Birth weight and adult lung function in China.

PMID- 11193487
TI  - Hyperventilation syndrome.

PMID- 11193488
TI  - Supplemental oxygen in COPD.

PMID- 11193489
TI  - [Immunological aspects in H. pylori-associated chronic gastritis].

PMID- 11193490
TI  - [Host factors in Helicobacter pylori infection].

PMID- 11193491
TI  - [Cyclooxygenase activity in chronic gastritis].

PMID- 11193492
TI  - [The significance of magnetic resonance cholangiopancreatography in acute
      cholecystitis].
AB  - To clarify the significance of magnetic renonance cholangiopancreatography (MRCP)
      in the acute phase of acute cholecystitis, MRCP was carried out in forty-five
      patients with acute cholecystitis in their acute phase. The MR pericholecystic
      high signal was observed in 38 of the 45 patients (84%). Enlargement of the
      gallbladder, presence of gallstones, and impacted stones was seen in 71%, 53%,
      and 18%, respectively. The MR pericholecystic high signal was classified into
      four categories: type 0, not observed; type 1, a liner high signal; type 2, a
      band-like high signal; type 3, a radiating high signal. In patients who showed a
      type 3 MR pericholecystic high signal, 91% required percutaneous transhepatic
      gallbladder drainage, and most of the gallbladders were diagnosed as necrotic
      cholecystitis by histology. The accuracy of MRCP for the diagnosis of
      choledocholithiasis was 96%. It was suggested that MRCP for patients with acute
      cholecystitis in the acute phase provides useful information for planning the
      treatment.

PMID- 11193493
TI  - [An alpha-fetoprotein and PIVKA-II producing carcinoma of the colon: report of a
      case].

PMID- 11193494
TI  - [A case of intractable intrahepatic cholestasis treated with coenzyme Q10
      (ubidecarenone)].

PMID- 11193495
TI  - [A case of hepatocellular carcinoma fed by the cystic artery treated with
      chemolipiodolization therapy].

PMID- 11193496
TI  - [A case of hepatic biloma after less invasive therapy for HCC].

PMID- 11193497
TI  - [A case of IIa + IIb-like advanced gallbladder cancer: usefulness of endoscopic
      double contrast cholecystography].

PMID- 11193498
TI  - [A case of primary sclerosing cholangitis having autoimmune hepatitis-resembling
      clinical features at the onset of illness].

PMID- 11193499
TI  - Dexa-measured bone density changes over time after intertrochanteric hip
      fractures.
AB  - The local bone density after an intertrochanteric hip fracture changes over time.
      In this study, bone density was measured in proximal femur and third lumbar
      vertebrae in patients treated for an intertrochanteric hip fracture at various
      periods. There were 60 patients (mean age 71.4 years) and 50 control patients
      (mean age 62.4 years). Bone density measurements were performed with Dual energy
      X-ray absorptiometry (DEXA). Bilateral measurements of the greater trochanter,
      lesser trochanter and femoral diaphysis as well as the third lumbar vertebrae
      were performed. Each area showed different course of change. The bone density of
      the greater trochanter and the lesser trochanter in the injured side increased
      after three months as compared with the control. After three years, the bone
      density of the greater trochanter decreased. The bone density of the femoral
      diaphysis and the third vertebrae gradually decreased over time. The authors
      suggest that bone density changes under the influence of callus formation, bone
      remodeling, decrease in daily activity, and use of ambulatory aids, etc.

PMID- 11193501
TI  - Chondromyxoid fibroma of the finger.
AB  - We report a case of chondromyxoid fibroma arising from the middle phalanx of the
      index finger. The radiographic and pathologic findings are described.

PMID- 11193500
TI  - The role of cyclooxygenase-2 and inflammatory cytokines in pain induction of
      herniated lumbar intervertebral disc.
AB  - Lumbar disc herniation (LDH) is the disease which is the major cause of
      radiculopathy. In terms of the pathogenesis of disease, it is reported that
      prostaglandinE2 (PGE2) plays an important role to induce radiculopathy.
      Arachidonate cascade, which is the process of PGE2 synthesis, is mainly regulated
      by two kinds of enzymes, phospholipaseA2 (PLA2) and cyclooxy genase (COX).
      Previously, PLA2 was recognized as the rate-limiting enzyme of this cascade, and
      some authors reported the clinical significance of PLA2 at the site of LDH
      concerning the radicular pain. Recently, COX was elucidated to consist of 2 types
      of isoform, a constitutive form of COX-1 and an inducible form of COX-2. COX-2
      has been focused as a key enzyme to regulate PGE2 synthesis and plays an
      important role in inflammation, because COX-2 was induced in many types of cells
      by the stimulation of inflammatory cytokines such as interleukin-1 beta (IL-1
      beta) and tumor necrosis factor alpha (TNF alpha). However, it is not fully
      discussed whether or not, COX-2 is induced in lumbar disc tissue and if it plays
      a significant role in the pathogenesis of LDH. To clarify the role of COX-2 in
      the pathomechanism of radiculopathy of LDH, we have investigated the expression
      of COX-2, IL-1 beta and TNF alpha in herniated lumbar disc tissue.
      Immunohistologically, they were detected in the cytosol of chondrocytes
      constituting the disc tissue. RT-PCR showed that herniated lumbar disc-derived
      cells expressed mRNA of COX-2, IL-1 beta and TNF alpha in the presence of
      inflammatory cytokines in vitro. The disc-derived cells also produced much PGE2
      by stimulating of inflammatory cytokines at the same time and this PGE2
      production was distinctly suppressed by a selective inhibitor of COX-2, 6-methoxy
      2-naphtyl acetic acids (6MNA). These results suggest that COX-2 and inflammatory
      cytokines might play a causative role in the radiculopathy of LDH through
      upregulating PGE2 synthesis.

PMID- 11193502
TI  - A case of adenoma of the ampulla of Vater.
AB  - A case of adenoma of the ampulla of Vater is presented in a 48-year-old man who
      was admitted with epigastric pain. Gastroendoscopy revealed a sessile tumor about
      3 cm in diameter at the ampulla of Vater, and the pathological diagnosis of a
      biopsy specimen was adenoma with moderate atypia. Because of the possibility of a
      malignant component, pylorus-preserving pancreatoduodenectomy was performed to
      avoid local recurrence. The final pathological diagnosis was adenoma with severe
      atypia.

PMID- 11193503
TI  - The results of anterior radical debridement and anterior instrumentation in
      Pott's disease and comparison with other surgical techniques.
AB  - Classic procedure in the treatment of vertebral tuberculosis is drainage of the
      abscess, curettage of the devitalized vertebra and application of antituberculous
      chemotherapy regimen. Posterior instrumentation results are encouraging in the
      prevention or treatment of late kyphosis; however, a second stage operation is
      needed. Recently, posterolateral or transpedicular drainage without anterior
      drainage or posterior instrumentation following anterior drainage in the same
      session is preferred to avoid kyphotic deformity. Seventy-six patients with
      spinal tuberculosis were operated in the 1st Department of Orthopaedics and
      Traumatology, Ankara Social Security Hospital, between January 1987 and January
      1997. There were four children in our series. Average follow-up period was 36.1
      +/- 14.5 months and the average age at the time of operation was 40.8 +/- 15.2
      years. This study reports the surgical results of 45 patients with Pott's disease
      who had anterior radical debridement with anterior fusion and anterior
      instrumentation [14 patients with Z-plate and 31 patients with Cotrel-Dubousset
      Hopf (CDH system)]. The results are compared with those of 8 patients who had
      posterolateral drainage and posterior fusion, 12 patients who had only anterior
      drainage and anterior strut grafting and, 11 patients who had posterior
      instrumentation following anterior radical debridement in the same session in
      terms of fusion rates, correction of kyphotic deformity, recurrence rate and
      clinical results. All patients had one year consecutive triple drug therapy.
      Preoperative 23.2 degrees +/- 12.5 degrees local kyphosis angle was lowered to
      6.1 degrees +/- 6.9 degrees with a correction rate of 77.4 +/- 22.3%. When the
      other three groups which had been instrumented were compared, the correction
      rates in the local kyphosis angle values were not statistically different and the
      variation in loss of correction at the last follow-up was also statistically
      insignificant. The sagittal contour of the involved vertebra's region did not
      change in the uninstrumented group, while it did so in instrumented groups which
      had normal range values postoperatively. Overall, 27 patients had neurologic
      deficits preoperatively. Twenty of these (74.1%) had complete, and 5 (18.5%) had
      partial recovery with a combined 92.6% neurologic improvement. All the patients
      had a solid fusion mass at the last controls. Reactivation was not seen.
      Additionally, contrary to the common belief, anterior instrumentation which
      anterior autologous strut grafting following anterior radical debridement can be
      a good treatment option with low complication rate, high correction rate in acute
      local kyphosis, and high fusion rate.

PMID- 11193504
TI  - Diagnostic value of MRI for the female urethral diverticulum.
AB  - A woman, who discharged pus at the time of intercourse, was diagnosed to have a
      urethral diverticulum by combination of urethroscope and MRI. MRI provided clear
      view of the diverticulum in terms of the relationship with the surrounding
      organs.

PMID- 11193505
TI  - A study on the development and the deodorizing capability of metal-phthalocyanine
      processed stump socks for amputees.
AB  - The socks which were treated with Metal-Phthalocyanine, a derivative of an
      artificial enzyme, were developed by the author and called Kobe Stump Socks(KSS).
      KSS was made of a cotton cloth that had undergone an ammonium salt cationization
      process and also a Metal-Phthalocyanine process. The study from a bacteriological
      view and the moisture absorption effect of KSS revealed that the mechanism of the
      deodorizing ability was bared on the decomposition function of Metal
      Phthalocyanine, while the antibacterial function came from the cationization and
      also that the high water absorption speed and capacity further enhanced these two
      functions. In this report, the author studied the deodorizing capability of KSS.
      To measure the adherence of an odor substance, ammonia, a testing device that
      measured this adherence was used. As a result, the adherence of ammonia to KSS
      was more than three times that of an unprocessed cloth. KSS had been used as
      stump socks on the stumps of amputees who were using prosthetic limbs, and a
      snuff test on the difference of the odor strength inside the socket was done. Of
      33 subjects, 32 recognized a deodorizing effect. From these facts, KSS was proven
      to dry and deodorize the limb surface with the moisture absorption effect and
      deodorizing capabilities due to the Metal-Phthalocyanine process. These
      characteristics were never recognized in other stump socks. These date mentioned
      above suggested that KSS was the best material to deodorize prosthetic limb
      sockets.

PMID- 11193506
TI  - Early lesions of cerebral atherosclerosis from induced hypertension in Watanabe
      heritable hyperlipidemic rabbits.
AB  - Watanabe heritable hyperlipidemic (WHHL) rabbits are well known to develop severe
      atherosclerotic lesions in extracranial arteries but not in cerebral arteries. In
      the present work we produced and investigated atherosclerotic lesions in cerebral
      arteries of WHHL rabbits by inducing hypertension. Hypertension was induced by
      right nephrectomy and surgically induced stenosis of the left renal artery. Six
      months after surgery the rabbits were killed for morphologic, immunohistochemical
      and transmission electron microscopic studies of extracranial and cerebral
      atherosclerosis. A significant rise in systolic blood pressure was evident 3
      months after surgery in the hypertensive group (p < .001). Atherosclerotic
      lesions had developed areas near the vertebral-basilar arterial confluence and
      the circle of Willis in the hypertensive Watanabe rabbits by 6 months after
      surgery (p < .001). Atherosclerotic lesions in cerebral arteries remained less
      severe than in the aorta and coronary arteries, and showed qualitative
      morphologic differences. This is the first report of production by hypertension
      of experimental cerebral atherosclerosis in the WHHL rabbits, indicating that
      hypertension as well as hyperlipidemia was required for development of lesions in
      cerebral arteries. This model should be useful for studying development of
      cerebral atherosclerosis and may contribute to improved prevention and treatment
      of the human disease.

PMID- 11193507
TI  - [The effect of sevoflurane and enflurane on renal sympathetic nerve activity in
      sinoaortic denerved rabbits].
AB  - We assessed the effects of sevoflurane and enflurane, i.e. halogenated volatile
      anesthetics, on blood pressure, heart rate, and renal sympathetic nerve activity
      (RSNA) in rabbits. To eliminate the influence of baroreceptor reflex, bilateral
      carotid sinus nerve branches and vagus nerves were resected before the
      measurements. Sevoflurane and enflurane [0.5-1.15 MAC (minimum alveolar
      anesthetic concentration)] did not significantly change heart rate, but decreased
      mean blood pressure in a concentration-dependent manner. On the other hand, while
      sevoflurane did not significantly attenuate RSNA, enflurane decreased it in a
      concentration-dependent manner. There was a significant difference between
      sevoflurane and enflurane in their effects on RSNA. These results suggest that a
      decrease in blood pressure caused by sevoflurane is related to factors other than
      sympathetic nerve activity, and that hypotension caused by enflurane is related
      more closely to attenuated activity of sympathetic nerve, at least, in comparison
      with sevoflurane.

PMID- 11193508
TI  - [Effects of intravenous nicardipine, prostaglandin E1, nitroglycerin, sodium
      nitroprusside, and epidural lidocaine on hepatic and renal blood flow during
      hypotensive anesthesia].
AB  - We studied the effects of intravenous nicardipine (NIC), prostaglandin E1 (PGE1),
      nitroglycerin (TNG), sodium nitroprusside (SNP) and epidural lidocaine (LID) on
      hepatic and renal blood flow during general anesthesia (nitrous oxide-oxygen
      sevoflurane) in 46 female patients undergoing unilateral total hip arthroplasty.
      During operations, hepatic blood flow, glomerular filtration rate, renal plasma
      flow, and renal tubular injury were measured by R 15 ICG (15 minutes retention
      rate of indocyanine green), CCR (creatinine clearance), CPAH (para-aminohippuric
      acid clearance), and urinary excretion of NAG and beta 2-microglobulin.
      Significant elevation of R 15 ICG was observed in the hypotensive state in the
      TNG group and the elevation of R 15 ICG indicates that blood flow to the liver
      has decreased during hypotensive anesthesia. Urine volume in the PGE1 group was
      larger than that in the TNG, SNP or LID group. CCR in the PGE1 group was larger
      than that in the NIC, TNG or SNP groups. CPAH in the PGE1 group was larger than
      that in the SNP or LID group. The value of urine NAG in the TNG group was larger
      than that in the NIC or PGE1 group. The value of urine beta 2-microglobulin in
      the NIC group was larger than that in the PGE1 or SNP group. The results of urine
      volume, CCR, CPAH, urine NAG, and urine beta 2-microglobulin indicate that blood
      flow to the kidneys was greater in the PGE1 group as compared to other groups.
      This study indicates that prostaglandin E1 is the best hypotensive drug for
      hepatic and renal blood flow during hypotensive anesthesia.

PMID- 11193509
TI  - [Hemodynamic and pulmonary effects of fluid resuscitation from hemorrhagic shock
      in the presense of mild pulmonary edema].
AB  - The hemodynamic and pulmonary effects of fluid resuscitation with crystalloid and
      colloid solutions in the presence of mild pulmonary edema were investigated.
      Anesthetized dogs received oleic acid to increase pulmonary capillary
      permeability, and one hour later bled to produce hemorrhagic shock. One hour
      after the shock, resuscitation was performed with Ringer's lactate, 6%
      hydroxyethyl starch (HES) solution, or dog's plasma. Resuscitation from
      hemorrhagic shock restored hemodynamics to pre-hemorrhagic levels with all of the
      above solutions. Ringer's lactate resuscitation resulted in increases in
      extravascular lung water volume (EVLWV) and oxygen consumption, and decreases in
      colloid osmotic pressure and oxygen delivery. Resuscitation with HES solution and
      plasma did not result in increases in EVLWV, but with HES solution resulted in
      decreases in colloid osmotic pressure to pre-hemorrhagic levels in two hours.
      This suggests that the resuscitation with HES solution can not maintain colloid
      osmotic pressure for more than two hours. The author concludes that the
      hemodynamic and pulmonary effects of HES solution and plasma are similar in mild
      lung injury cases.

PMID- 11193510
TI  - [Adrenergic receptor and knockout mouse: 1) Beta adrenergic receptor knockout
      mouse].
AB  - Functional analysis of beta 1 and beta 2 adrenergic receptor (AR) subtypes has
      been made possible by establishing knockout mice (KO) with abolished beta 1
      and/or beta 2 AR expression. Neither resting heart rate nor resting blood
      pressure of beta 1 AR KO, beta 2 AR KO, or beta 1/beta 2 KO differed
      significantly from those of wild-type mice. The chronotropic response to
      isoproterenol was significantly attenuated in beta 1 AR KO and beta 1/beta 2 KO,
      whereas there was no detrimental effect on heart rate in beta 2 AR KO. This
      suggests that chronotropy is mediated by beta 1 AR. In terms of the vasodilatory
      response to isoproterenol, there appears to be a graded and additive attenuation
      of the hypotensive response in beta 1 AR KO, beta 2 AR KO, and beta 1/beta 2 KO.
      Vascular relaxation is thought to be controlled by both beta 1 AR and beta 2 AR.
      Tachycardia induced by exercise was significantly attenuated in beta 1 AR KO, and
      beta 1/beta 2 KO. beta 2 AR KO subjected to treadmill exercise showed significant
      hypertension, increased oxygen consumption, and ability of long distance running.

PMID- 11193511
TI  - [One-stage surgery of minimally invasive direct coronary artery bypass, abdominal
      aortic aneurysm repair and carotid endarterectomy].
AB  - A 74 year-old man with bladder transitional carcinoma had severe multivascular
      disease; coronary artery stenosis, abdominal aortic aneurysm and right internal
      carotid artery stenosis. First, transurethral bladder tumor resection (TUR-Bt)
      was performed twice but in the second TUR-Bt, no carcinoma cell was found. One
      stage surgery of minimally invasive direct coronary artery bypass (MIDCAB),
      abdominal aortic aneurysm (AAA) repair and carotid endarterectomy (CEA) was
      proposed. MIDCAB was performed first. Inspite of the bradycardia, heart
      oppression by stabilizer and coronary artery clamping, blood pressure and ST
      segments were stable. With heparinization and the chest left open, AAA repair was
      carried out. On aorta clamping and declamping, blood pressure and heart rate were
      stable. After completion of AAA repair, heparinization was reversed with
      protamine. Chest and abdominal wounds were closed simultaneously. CEA was
      performed lastly, because the patient had no cerebral ischemic symptom and no
      risk of cardiopulmonary bypass. After the operation, no neurologic deficit
      appeared. This experience of one stage surgery was reported with review of
      literatures. One stage surgery is a possible approach to the patients with severe
      multivascular disease.

PMID- 11193512
TI  - [Influence of injection speed of the spread of 4.0 ml of 0.5% isobaric
      bupivacaine in spinal anesthesia].
AB  - Influence of injection speed on the spread of isobaric 0.5% bupivacaine 4.0 ml
      was studied in 100 patients to analyze the correlation between analgesia levels
      and patient's characteristics. All patients (ASA PS I.II) were scheduled for
      orthopedic or urological procedures, and received no premedication. They were
      randomly divided into two groups by injection speed; group 1 of 0.2 ml.sec-1 and
      group 2 of 0.03 ml.sec-1. Spinal tap was performed in lateral decubitus position
      at the L 3-4 intenspace with median approach, using a 25 G Quincke needle.
      Immediately after the injection, the patient was placed in supine position. The
      maximum sensory block was tested by pinprick method, and no significant
      difference in the height of sensory block was observed between the two groups. No
      significant correlation with patient's characteristics was observed except body
      weight in group 1. This study suggests that the speed of injection does not
      influence the spread of isobaric 0.5% bupivacaine 4.0 ml.

PMID- 11193513
TI  - [A modified technique for insertion of the laryngeal mask airway in children].
AB  - We modified the technique for laryngeal mask airway (LMA) insertion in children.
      This modification involves inserting a two-thirds inflated LMA with its lumen
      facing laterally toward left and then rotating it 90 degrees clockwise as it
      passes downwards into position behind the larynx. Then the cuff is inflated
      fully. We conducted a survey on the use of LMA in ten consecutive children for
      minor superficial surgery. After slow induction, anesthesia was maintained with
      3.0% of end-tidal sevoflurane concentration in 100% oxygen for 5 minutes before
      insertion of LMA. No muscle relaxant was used. Successful insertion was judged by
      the clinical integrity of the airway. The standard LMA insertion technique or
      another airway device was applied when three trials had failed. Traumatic
      insertion was observed by the attachment of blood clots to the surface of the
      removed LMA. A satisfactory airway was achieved in all of the children who
      participated in the survey. There were no significant differences in vital signs
      between pre- and post-insertion. Only one child was found to have attachment of
      blood clots on the surface of the removed LMA. We conclude that our technique
      would be one recommended method in pediatric practice.

PMID- 11193514
TI  - [Anesthetic management of two patients with polymyositis].
AB  - We report anesthetic experience of two patients suffering from polymyositis. The
      first case is a 56 year old woman who underwent tympanoplasty for cholesteatoma
      of the middle ear. Anesthesia was induced with thiopental and deepened with
      oxygen-nitrous oxide and sevoflurane. No muscle relaxant was used for
      endotracheal intubation and for maintaining anesthesia. Another is a 61 year old
      man who underwent open reduction and internal fixation for condyle fracture of
      the tibia. Epidural catheter was inserted at L 3-L 4. Epidural blockade was
      established with 2% mepivacaine, and sedation was achieved by intravenous
      midazolam. Concerning the anesthetic management of a patient with polymyositis,
      there are some informations on the appropriate use of muscle relaxants. It is
      generally believed that the patient is sensitive to nondepolarizing muscle
      relaxants and the use of antagonist drug (reversal) may cause muscle weakness,
      severe dysrhythmia, et al. Therefore we think it is appropriate to manage such a
      patient without muscle relaxants.

PMID- 11193515
TI  - [A case of fixed drug eruption due to ephedrine hydrochloride].
AB  - We report the case of a 29-year old female who developed a fixed drug eruption
      due to ephedrine hydrochloride administered intravenously during the cesarean
      section. On the day of the operation a palm-sized dark brown macula with half egg
      sized erosion appeared on her right lower thigh. We diagnosed her disease as
      fixed drug eruption and examined the causative agent among all the 14 drugs used
      from admission to the appearance of fixed drug eruption. Each of systemic
      challenge, patch test on the lesion, intradermal and subcutaneous injection on
      the lesion with ephedrine hydrochloride showed positive reaction. As far as we
      have been able to search, our case is the first one of fixed drug eruption due to
      ephedrine hydrochloride.

PMID- 11193516
TI  - [Localized right atrial tamponade after aortic valve replacement].
AB  - A 78-year-old man developed isolated right atrial tamponade 15 hours following
      aortic valve replacement. There were excessive postsurgical bleeding, low blood
      pressure, and low cardiac output. Volume expansion and inotropic therapy did not
      increase blood pressure. There were no cardiomegaly and echo-free space.
      Diagnosis was made by appearance of pulsus paradoxus and transthoracic
      echocardiography and confirmed by surgery. The clinical picture was improved
      dramatically after surgical removal of the hematoma. Right atrial tamponade leads
      to a unique clinical conglomeration of hemodynamic and echocardiographic
      features. Constant attention to this entity is necessary to make a timely
      diagnosis.

PMID- 11193517
TI  - [Anesthetic management of MIDCAB in a patient with Wolff-Parkinson-White
      syndrome].
AB  - We experienced the anesthetic management of a minimally invasive direct coronary
      artery bypass (MIDCAB) in a patient with Wolff-Parkinson-White (WPW) syndrome. A
      55-year-old male had chest pain on effort and was diagnosed as having stenosis of
      the left coronary artery (#6). He was scheduled to undergo MIDCAB. Anesthesia was
      induced with midazolam 5 mg, fentanyl 300 micrograms, and vecuronium 10 mg and
      maintained with air-oxygen, propofol, and fentanyl (27 micrograms.kg-1).
      Diltiazem was continuously infused at a rate of 0.5-1.5 micrograms.kg-1.min-1
      throughout the surgery. The hemodynamic parameters were maintained stable and
      paroxysmal supraventricular tachycardia was not observed during the procedure. We
      conclude that the administration of propofol and a medium dose of fentanyl is
      useful for the anesthetic management of MIDCAB in patients with WPW syndrome and
      that intraoperative administration of diltiazem might be needed to avoid
      paroxysmal supraventricular tachycardia.

PMID- 11193518
TI  - [Anesthetic management of a patient with hepatocellular carcinoma with tumor
      thrombus extending into the right atrium].
AB  - A 58 year-old male was scheduled for surgery of his hepatic cancer. Tumor invaded
      to the right atrium through the inferior vena cava. The operative method of
      removing the tumor in the right atrium was scheduled under extracorporeal
      circulation after the left lobe hepatectomy. Since there was a tumor in the right
      atrium, central venous pressure monitoring could not be reliable. Transesophageal
      echocardiography (TEE) was employed in order to detect the part of the tumor
      flowing into the pulmonary artery or occluding the tricuspid valve. Due to
      massive blood loss during hepatectomy, the capacity in the right atrium decreased
      and the tumor was often about to engage the tricuspid valve. After the rapid
      fluid therapy, the right atrium capacity increased preventing the engagement of
      the tumor. TEE was useful not only to observe the movement of the tumor in the
      right atrium but also to monitor the circulating blood volume.

PMID- 11193519
TI  - [Problems in clinical use of intraarterial blood gas monitoring system, Paratrend
      7].
AB  - We evaluated the intraarterial blood gas monitoring system Paratrend 7 in
      clinical use. One hundred and sixty six sensors used for patients receiving
      thoracic, open heart or great vessel surgery were tested for one year,
      prospectively. Sensors were inserted through a 20 G intraarterial cannula into
      the radial artery before operation and removed when they malfunctioned or seemed
      to be not necessary for patient management in critical care unit. We encountered
      several problems such as, initial calibration failure (5/166), impossible sensor
      insertion (2/166), arterial pressure wave change (5/166), parameter display
      failure (21/166), and thrombus in the circuit (9/166). Parameter display failure
      after insertion tended to occur on patient's arm movement imparing the sensor. No
      serious accident, such as arterial thrombosis was experienced. Some troubles were
      due to staff's incorrect handling of the apparatus. Training of staffs is
      indispensable for safe and sufficient utilization of Paratrend 7.

PMID- 11193520
TI  - [Analysis of inadvertent epidural injection of drugs].
AB  - We asked 31 anesthesiologists, who were on the Japanese Board of Anesthesiology,
      about inadvertent injection of drugs into the epidural space, and received
      answers from 28 (90%). Fifteen (54%) had an experience of inadvertent epidural
      injection, and five of them had two experiences. Injected drugs were ephedrine (6
      times), a mixture of neostigmine and atropine (3), thiopental (2), etilefrine
      (2), vecuronium (1), suxamethonium (1), bicarbonate (1), midazolam (1), lactated
      Ringer's solution (1), nicardipine (1), and pentazocine (1). The inadvertent
      injection of thiopental or bicarbonate was noticed by back pain during injection.
      No treatment was added after the inadvertent injections, except a patient with an
      epidural steroid injection following thiopental. No neurological complications
      were found in any patients.

PMID- 11193521
TI  - [Anesthesia in a children's hospital in Nepal].
AB  - The author experienced ten cases of anesthesia in a children's hospital in Nepal.
      Eight cases were pediatric surgeries and two cases were gynecological procedures.
      Halothane or intravenous ketamine anesthesia was performed in pediatric cases.
      Regional block or intravenous ketamine anesthesia was performed in gynecological
      cases. Oxygen supply stopped during anesthesia in one case, and patient was
      resuscitated by ambu-bag with room air. Electricity was interrupted in one case,
      and operation was continued with only one battery light. There is no mechanical
      ventilator nor nitrous oxygen in the hospital. Air conditioning was not in the
      operating room although the hospital was situated in the subtropical area and
      room temperature reached up to 40 degrees. Electrocardiogram and suction machines
      were present, but they were out of order. The anesthetic technique required in
      the developing countries is not so simple. Especially for young doctors trained
      among so many sophisticated monitors, anesthesia in the developing countries is
      not only an experience of volunteer, but provides effective training of pediatric
      anesthesia for strengthening their sense and skills.

PMID- 11193522
TI  - [Safety of intraoperative autotransfusion using the closed-circuit
      autotransfusion system in Jehovahs witnesses patient].

PMID- 11193524
TI  - [Tentorial meningioma: surgical anatomy and approaches].

PMID- 11193525
TI  - [Postoperative evaluation of EC/IC bypass surgery--long-term follow up study by
      donor artery compression test].
AB  - Focal cerebral vascular dependency of donor arteries was evaluated in 45 patients
      who had undergone EC/IC bypass surgery. During EEG recording, digital compression
      was applied to the anastomosed donor superficial temporal artery (STA) at the
      preauricular region. The appearance of slow waves on the EEG recording suggests
      hypofunction of the local brain. In cases showing positive response to the STA
      compression test, we suggest that the blood supply via STA is an essential
      collateral route to the ischemic brain. The test was periodically repeated in the
      postoperative follow-up period for a mean of seven years. Eleven cases (24%)
      showed positive results in the STA compression test during the long-term
      postoperative follow-up period.

PMID- 11193526
TI  - [Diagnosis of brain tumor with proton MR spectroscopy--the quantification of
      gliomas compared with normal brain].
AB  - We conducted quantification of proton MR spectroscopy (MRS) using water signal as
      an internal standard, in order to quantify the concentrations of metabolites in
      normal adult brains and in gliomas in vivo. Single-voxel spectra were acquired
      using a point-resolved spectroscopic (PRESS) pulse sequence as part of the Probe.
      P spectroscopy package on a GE Signa Horizon Hispeed LX1.5T scanner (TR/TE/Ave =
      3000 msec/30 msec/64). The volume of interest (VOI) varied from 15.0 x 15.0 x
      15.0 mm3 to 20.0 x 20.0 x 20.0 mm3 for the brain. The present study included 26
      healthy volunteers and 12 patients with gliomas, whose diagnoses were verified by
      histologic examination. The calculated concentrations of N-acetyl-aspartate
      (NAA), creatine (Cre) and choline (Cho) in normal hemispheric white matter were
      23.66 +/- 1.94 mM (mean +/- SD), 12.97 +/- 1.44 mM, and 4.38 +/- 0.60 mM,
      respectively. We found they were not necessarily uniform in different parts of
      the brain, for example, in the pons and basal ganglia. The concentrations of NAA
      and Cre decreased in all gliomas (p < 0.001). Cho concentration also decreased in
      the glioma (p < 0.005). The NAA/Cre, NAA/Cho, and Cre/Cho ratios can distinguish
      normal brain from gliomas, and NAA/Cho ratio can distinguish low-grade
      astrocytoma from the high-grade group. The results indicate that this noninvasive
      method offers reasonable estimation of metabolite concentrations in the brain in
      vivo and therefore is useful in diagnoses of gliomas.

PMID- 11193527
TI  - [The efficacy and safety of the nicardipine prolonged-release implant in a canine
      double hemorrhage model].
AB  - A drug delivery system using copoly (lactic/glycol acid) was tested to determine
      its efficacy and safety in preventing cerebral vasospasm following subarachnoid
      hemorrhage in dogs. Rod shaped implants (1 mm diameter, 10 mm length, and
      approximately 10% of nicardipine) was prepared by a heat compression method. Ten
      dogs were assigned to two groups: double hemorrhage group and double hemorrhage
      group treated with implants. Vertebral angiography and arterial blood injection
      into the cisterna magna were performed, followed by midline suboccipital
      craniectomy and laminectomy of the atlas and placement of nicardipine implants in
      the cisterna magna. On day 2, arterial blood injection into the cisterna magna
      was repeated (double hemorrhage model). On day 7, vertebral angiography was
      repeated. The animals were then sacrificed and the brain and blood clot were
      taken out. All the animals involved in both groups had been clinically well.
      Though 5 animals of the control group showed severe vasospasm, no vasospasm was
      observed in 3 animals and only very mild vasospasm in 2 of the nicardipine
      treated group. There was a statistically significant difference in diameter
      between the two groups (0.5 mm vs 1.1 mm, p = 0.009). Histological examination
      showed no specific changes related to implants. Furthermore, left frontotemporal
      craniotomy and placement of nicardipine implants in the carotid-optico cistern
      were preformed in 3 dogs. Neither clinical symptoms related to implants nor
      specific histological changes were observed (e.g. hypotension, seizure). These
      results suggested that nicardipine-prolonged release preparation is safe as well
      as effective for cerebral vasospasm.

PMID- 11193529
TI  - [Ultrasonic aspirator with controllable suction system--variable action suction
      adapter and clinical experience with it].
AB  - While the ultrasonic aspirator (UA) has been widely used as one of the
      indispensable tools in the field of neurosurgery, a potential risk when using the
      present UA is injury to the neurovascular structures due to ultrasonic
      pulverization and constant forceful suction power. We have devised a small
      variable action suction adapter that can be used in a similar manner to
      conventional surgical suction tubes. The UA control unit and the handpiece used
      in this study were the Sonopet UST-2000 and HA-01, respectively (M & M
      Corporation Tokyo, Japan). The handpiece is slim, with the mid-portion diameter
      of 13 mm, and it weighs 100 grams. A variable action suction adapter was made
      from polycarbonate of 15 x 12 x 13 mm in size. The adapter was connected to the
      suction tube using a Y-shaped connector (Fig. 2 A), which was integrated into the
      handpiece. The suction power is regulated by variably closing the oval-shaped
      hole. The adapter can be variously placed on and rotated around the handpiece
      (Fig. 2 B and C) so that either the right or left hand handles it in a similar
      fashion to conventional suction tubes. We used this UA in surgery for 8 patients
      with large brain tumors (meningioma in 5 cases, metastatic brain tumor in 2 cases
      and glioma in one case). It reduced the risk of suction-related injury to the
      neurovascular structures and was handled in a similar manner to conventional
      suction tubes. This adapter ensures the complete control of suction power, which
      will reduce the risk of suction injury.

PMID- 11193528
TI  - [Recurrence of cerebral aneurysms in the long-term follow-up after aneurysm
      surgery].
AB  - We investigated late aneurysmal recurrence in 71 patients who underwent direct
      operations for intracranial aneurysms during the period from 1981 to 1988 and
      were under 50 years old at the time of operation with ADL rating of 1 or 2 at
      discharge. And out of the 71 patients, four had already sustained reattack of SAH
      and been confirmed to have recurrent anuerysms. Another two had been diagnosed as
      harboring unruptured recurrent aneurysms. Cerebral angiography was carried out
      for nine patients in the remaining 63, revealing aneurysmal recurrence in four
      patients. Overall, 14 recurrent aneurysms, 11 de novo and 3 regrowth aneurysms,
      have been found in 10 patients. Considering the high risk of aneurysmal
      recurrence, postoperative long-term follow-up including MRA and angiography is
      mandatory, especially for relatively young patients.

PMID- 11193530
TI  - [Surgical treatments for 7 pituitary adenomas in multiple endocrine neoplasia
      type 1].
AB  - We analyzed 7 pituitary adenomas in patients with multiple endocrine neoplasia
      type 1 (MEN1). Their incidence was 1.6% among 450 patients with pituitary
      adenomas which had been treated surgically in our department between 1978 and
      1999. The age, gender, symptoms, type of hormone secretion, pathological and
      operative findings in the MEN1 patients were not apparently different from those
      in the non-MEN1 patients. Incidence of non-functioning pituitary adenomas,
      however, was more frequently encountered in our series than that in previous
      reports among Caucasian people. One patient who had 5 previous operations for the
      MEN tumors died following postoperative subarachnoid hemorrhage. Four of the
      seven patients presented initial symptoms related to pituitary adenomas and
      increased serum Ca level was retrospectively recognized in three of the four at
      the time of treatment for the pituitary adenomas.

PMID- 11193531
TI  - [Production and clinical application of fibrin sealant with high concentrated
      fibrin (fibrin patch)].
AB  - OBJECT: The sealing properties of fibrin sealant with high concentrated fibrin
      (fibrin patch) were examined. MATERIAL AND METHODS: A commercial fibrin sealant
      (Bolheal) produced from pooled human plasma was utilized for this study. The
      fibrin sealant made of fibrinogen and thrombin solutions mixed in a volume ratio
      5:1 was applied as the fibrin sealant with high concentrated fibrin (fibrin
      patch). The burst pressure of the fibrin clots of either 1:1 or 5:1 mixing ratio,
      which sealed the small holes, was measured by a water-leak preventing model. The
      tensile strength of the fibrin patch was measured by the breaking pressure of the
      fibrin clot. The burst pressure of the fibrin patch, which sealed the dural
      defect with a diameter of 15 mm, was compared with that of expanded
      polytetrafluoroethylene (ePTFE). RESULTS: The burst pressure was elevated from
      287 +/- 23.1 to 445 +/- 30.5 mmHg by changing the mixing ratio from 1:1 to 5:1.
      The breaking pressure of the fibrin patch showed 131 +/- 25.4 mmHg and that of
      the patch mixed at the ratio of 1:1 showed 46.6 +/- 9.9 mmHg. The result of dural
      repair with the fibrin patch revealed higher sealing effectiveness than that of
      ePTFE. The burst pressure averaged 70.5 +/- 21.4 mmHg in the fibrin patch samples
      and 51.4 +/- 13 mmHg in the ePTFE samples. CONCLUSION: The fibrin patch revealed
      higher performance as a sealant and has the potential to be a candidate for
      acceptance as the new dural repair material.

PMID- 11193532
TI  - [Improvement of visual function after balloon angioplasty for innominate artery
      stenosis: a case report].
AB  - Occlusive disease of the innominate artery is relatively rare, but visual
      disturbance is a frequently encountered manifestation of this disease. A 48-year
      old man presented with a 1-year history of right amaurosis fugaxs. During the
      nine years prior to admission, the patient had undergone aortic artery-coronal
      artery bypass surgery two times. Upon ophthalmological examination, the patient
      was found to have impaired right retinal sensitivity and prolonged right arm-to
      retina circulation time. Aortic arch angiography demonstrated severe stenosis of
      the innominate artery near its origin. The stenosis was successfully treated by
      balloon angioplasty. Subsequently, right retinal sensitivity improved and right
      arm-to-retina circulation time normalized following the procedure. These findings
      indicate that this patient had sufferred impaired visual function due to
      hemodynamic retinal ischemia caused by innominate artery stenosis.

PMID- 11193533
TI  - [Two cases with coil embolization following incomplete neck clipping].
AB  - We report two cases with embolization (coil embolization) using Guglielumi
      detachable coils of residual aneurysms following incomplete neck clipping. The
      first case, a 75-year-old woman suffered from a subarachnoid hemorrhage due to
      the rupture of a left internal carotid posterior communicating aneurysm in June,
      1997. Neck clipping of the aneurysm was performed at day 1. Follow-up angiogram
      at day 7 showed a residual aneurysm involving the dome of the initial aneurysm.
      We performed coil embolization of the residual aneurysm following the angiogram.
      Almost complete obliteration of the aneurysm lasted during the follow-up period
      of two and a half years. The second case, a 71-year-old woman suffered from a
      subarachnoid hemorrhage due to the rupture of a right internal carotid posterior
      communicating aneurysm in May, 1999. Neck clipping of the aneurysm was performed
      at day 1. Follow-up angiogram at day 7 showed a residual aneurysm involving only
      a part of the initial aneurysm near the neck. Because no spontaneous thrombosis
      of the residual aneurysm was obtained after 2 months, we performed coil
      embolization of the residual aneurysm. Almost complete obliteration of the
      aneurysm lasted during the follow-up period of 7 months. These patients were
      discharged with good performance status. We consider the morphologic feature of
      the residural aneurysm to be most important for determining when to perform coil
      embolization of such residual aneurysms.

PMID- 11193534
TI  - [Craniopharyngioma presenting a symptom of pituitary apoplexy and hyponatremia: a
      case report].
AB  - We report a case of a 70-year-old woman admitted to our hospital with sudden
      headache, drowsiness and hyponatremia. MRI on admission showed an intrasellar
      mass with suprasellar extension. Serum examination revealed decreased sodium and
      hypopituitarism, but they were normalized gradually by compensation using
      hydrocortisone, thyroid hormone and salt. Afterwards, masked diabetes insipidus
      appeared and required aqueous pitressin for the control of urine volume. A
      removal operation was performed uneventfully using the transsphenoidal approach
      and histological examination confirmed squamous-papillary type craniopharyngioma.
      Intratumoral hemorrhage of the craniopharyngioma is extremely rare. These cases
      tend to occur after over 15 years of maturation and the squamous-papillary type
      tend to bleed more than the adamantinomatous type. However, it is very difficult
      to make a differential diagnosis between craniopharyngioma with intratumoral
      hemorrhage and pituitary apoplexy, judging only by symptoms or interventional
      radiology. The definite mechanism of hyponatremia associated with a parasellar
      lesion is still obscure, but compression to the anterior hypothalamus or
      pituitary gland by an enlargement of the parasellar tumor is generally
      hypothesized.

PMID- 11193535
TI  - [A case of metastatic tumor of the pituitary gland presenting as a subarachnoid
      hemorrhage].
AB  - We reported the case of a 55-year-old man with metastatic tumor of the pituitary
      gland who suffered from symptomatic pituitary apoplexy with subarachnoid
      hemorrhage. The patient, who had sigmoid colon carcinoma and left parietal
      metastatic brain tumor, developed severe headache and decrease of right visual
      acuity. CT showed a pituitary mass with subarachnoid hemorrhage. Transsphenoidal
      surgery was performed after replacement therapy with corticosteroids.
      Histological examination revealed metastasis of adenocarcinoma. Pituitary
      apoplexy is an unusual manifestation of metastatic pituitary tumor. The case of
      metastatic tumor of the pituitary gland presenting as subarachnoid hemorrhage
      such as this case is especial rare.

PMID- 11193536
TI  - [Multiple sclerosis].

PMID- 11193537
TI  - [Therapy of paraneoplastic neurological syndrome].

PMID- 11193538
TI  - [Treatment of chronic inflammatory demyelinating polyradiculoneuropathy(CIDP)--a
      review].
AB  - This is a review article about the recent progress and the general consensus of
      the treatment of chronic inflammatory demyelinating polyradiculoneuropathy
      (CIDP). Although the first line treatment is believed to be adrenocorticosteroid
      prescribed orally or intravenously, some insist that plasmapheresis or
      intravenous immunoglobulin is better. The latter two are expensive but the
      effects are comparable to that of steroid, and in some patients complete
      remission might be induced. On the other hand, about 30% of patients do not
      respond to any of these conventional procedures, and for these the combination of
      two or three of them might be effective. As another choice, immunosuppressant or
      interferon (alfa-2 a or beta-1 a) has been applied although its usefulness is
      still inconclusive. For any of these here mentioned, the clinical response
      greatly varies among patients, and the elucidation of predictive factors of
      effectiveness is eagerly awaited from the standpoint of reasonable treatment
      selection and cost-effectiveness.

PMID- 11193539
TI  - [Human immunodeficiency virus-associated dementia: review of pathogenesis and
      treatment studies].

PMID- 11193541
TI  - [Staged total callosotomy for medically intractable seizures].
AB  - For the treatment of intractable generalized epilepsies, two-staged total
      callosotomy was performed in five patients. In all patients, preceded anterior
      callosotomy failed to obtain satisfactory seizure control. All patients showed
      mental retardation with various degrees. Mean age at the first operation was 10.2
      years and 4 patients were operated in their childhood. All patients showed
      various types of seizures; drop attack (DA) in 3 patients, tonic seizure (TS) in
      2, myoclonus (MY) in 2, complex partial seizure (CPS) in 2, atypical absence (AA)
      in 1, and head drop (HD) in 2. After anterior callosotomy, complete cessation of
      CPS and 50-80% reduction of DA was obtained in one, respectively. However, only
      less than 50% reduction of seizures was obtained in other types of seizures. Two
      years after anterior callosotomy, posterior portion of the corpus callosum was
      divided. After staged total callosotomy, complete cessation of DA was obtained in
      all patients and 80-100% reduction of AA was obtained in one patient. One adult
      patient showed the disconnection syndrome which did not affect activities of his
      daily life. Our study revealed the efficacy of posterior callosotomy in DA
      patients with unsatisfactory results after anterior callosotomy. This strategy
      should be considered especially in childhood cases, since obvious complication
      was not observed in such cases.

PMID- 11193540
TI  - [Comparison of nerve conduction studies between conventional and
      lumbrical/interossei recording methods in diabetics].
AB  - Median nerve conduction studies were performed by conventional and
      lumbrical/interossei recording methods. The former is composed of recordings of
      compound muscle action potential from abductor pollicis brevis (APB) and sensory
      nerve action potential from second digit (D) after wrist stimulation. In the
      latter the recording electrode was placed lateral to the midpoint of the 3rd
      metacarpal bone, and recorded compound muscle action potential from the 2nd
      lumbrical (2 L) and sensory nerve action potential from the digital nerve (N)
      after wrist stimulation. Subjects were 57 healthy individuals and 97 patients
      with diabetes mellitus. Particularly in diabetic patients values of coefficient
      of correlation between each measurement were high enough; i.e., r = 0.91 between
      latencies to 2 L and APB, r = 0.55 between amplitudes of 2 L and APB, r = 0.86
      between amplitudes of N and D. Corresponding measurements by conventional method
      and lumbrical/interossei method were identical in the values of coefficient of
      correlation between measurements. The characteristics of lumbrical/interossei
      method are to be able to record compound muscle action potentials and nerve
      action potential from the same electrode. In this study values obtained by
      lumbrical/interossei method showed identical correlation between measurements to
      the corresponding ones by conventional method. In conclusion recordings of APB
      and D by conventional method can be replaced with the recordings of 2 L and N by
      lumbrical/interossei method in the evaluation of diabetic neuropathies.

PMID- 11193542
TI  - [A case of moyamoya disease presenting with geographic mislocation, person
      misidentification and fantastic confabulation].
AB  - A 52-year-old woman presented with geographical mislocation (misidentification
      for place), person misidentification and fantastic confabulation as a result of
      cerebral infarction. Head MRI demonstrated a focal lesion in the right frontal
      lobe. Cerebral angiogram demonstrated occlusion in the circle of Willis with
      moyamoya vessels. The neuropsychological examination revealed memory impairment
      and frontal lobe dysfunction. The patient's misidentification for place and
      person as well as confabulation lasted for 1.5 months since admission, then
      gradually disappeared. We speculate that there existed a common mechanism for
      these three symptoms; i.e., misidentification and confabulation were based upon
      the impaired interpretation of the small events and partial objects in the
      surrounding circumstances, which might interfere with the appropriate integration
      and judgments of the outside information in general. The impaired monitoring and
      frontal dysfunction caused by the right frontal lesion appeared to be responsible
      for causing her deficits.

PMID- 11193543
TI  - [A case report of chronic myelocytic leukemia with multiple brain metastases,
      which responded to the gamma-knife therapy].
AB  - We report a 78-year-old woman who had multiple leukemic cell tumors in the brain
      in the course of chronic myelocytic leukemia (CML). As far as we could survey,
      such brain tumors were extremely rare. She had been followed because of chronic
      phase of CML until October, 1998, when she noticed muscle weakness in her left
      upper and lower extremity. A head MRI revealed multiple masses in the brain, a
      biopsy of which revealed a tumor of CML cells. Although 40 Gy gamma-knife therapy
      had reduced the size and numbers of brain tumors, we found recurrence of left
      hemiparesis and tumors three months after the gamma-knife therapy. Whole brain
      irradiation therapy (total 30 Gy) was somewhat effective to the tumor and
      hemiparesis transiently subsided. Thereafter her general condition worsened
      again, and she died in June, 1999, eight months after the diagnosis of the brain
      tumors of leukemic cells. We had not seen any other clinical evidence of
      generalized blastic crisis in this patient. In our case, MRI of the brain showed
      two patterns of metastases, tumor forming and cortical invasive type. We thought
      that these two patterns of brain involvement might show different responses to
      the radiation therapy, and it was characteristic in this patient.

PMID- 11193544
TI  - [A case of hypertrophic cranial pachymeningitis developed skull lesion].
AB  - We report a case of hypertrophic cranial pachymeningitis (HCP) developed skull
      lesion. A 70-year-old male presented with the symptom of left hemiconvulsion. MRI
      revealed that the enhanced intraosseous mass infiltrated into the the dura and
      brain parenchyma under the parasagittal region of the right parietal bone.
      Histological examination revealed chronic inflammation with lymphoplasmacytic
      infiltrate and fibrosis of both intraosseous mass and dural invasive lesion.
      Steroid therapy resulted in improvement of clinical symptoms and enhanced lesion
      of MRI. Three years later, the patient presented with generalized convulsion and
      weakness of right upper and lower limbs. MRI revealed dural thickening with
      gadolinium enhancement in the bilateral parasagittal region and falx. Angiography
      showed occlusion of the superior sagittal sinus. The cause of relapsing symptoms
      in this patient may have been related to the occlusion of the superior sagittal
      sinus, due to HCP. We considered that the incipient intraosseous mass resulted
      from a response of the marrow by destructive progression of chronic inflammation
      passed through the fracture crack or the cavity of arachnoid granulation.

PMID- 11193545
TI  - [A case of effective urgent irradiation therapy for metastatic spine tumor].
AB  - A 74-year-old man noticed weakness in bilateral lower limbs 2 months prior to
      admission. The weakness had rapidly progressed and he could not stand by himself
      on admission. All thoracic vertebral bodies showed mosaic pattern on T 2 weighted
      image. At Th 10 and Th 11, two enhanced masses compressed spinal cord
      posteriorly. Basal-serum tumor markers, such as LDH, ALP, total-acid phosphatase
      and prostatic acid phosphatase were elevated, metastatic spine tumor from
      prostatic carcinoma was suspected. Biopsy specimen from its prostate revealed low
      differentiated adenocarcinoma. Because sphincter dysfunction progressed rapidly
      after admission, we started 3 Gy/day irradiation within 24 hr from its appearance
      targeting both Th 10 to L 1 vertebral bodies and the prostate in total 30 Gy. The
      clinical symptoms started to resolve immediately, and the disappearance
      completely within 7 months. This case illustrated that urgent irradiation was
      effective for broad metastatic spinal tumor with rapidly progressive neurological
      deficits.

PMID- 11193546
TI  - [Small epidermoid induced trigeminal neuralgia unrecognized by conventional CT
      and MRI for over 25 years].
AB  - A 65-year-old woman had been conservatively treated as idiopathic trigeminal
      neuralgia for over 25 years, because conventional computed tomography (CT) and
      magnetic resonance imaging(MRI) showed no abnormality in the cerebello
      pontine(CP) angle cistern. She received a detailed MRI by constructive
      interference in steady state and diffusion weighted image(DWI) sequences. Those
      sequences on MRI well demonstrated a epidermoid tumor in the CP angle cistern,
      and the removal of the tumor completely resolved the neuralgia. Since a small
      epidermoid in the CP angle cistern seems to be unrecognized by conventional CT
      and MRI, detailed evaluation by DWI sequence, which has been widespread recently,
      is required for patients with trigeminal neuralgia.

PMID- 11193547
TI  - [Anosognosia for hemiplegia in a patient with pontine infarction].
AB  - We report a patient with anosognosia for hemiplegia associated with a right
      pontine infarction. A 51-year-old woman with histories of hypertension and
      diabetes mellitus was admitted because of weakness of her left upper and lower
      extremities. On neurologic examination, she was alert and oriented without
      dementia. Visuospatial hemineglect was not present. Hemiparesis of her left upper
      and lower extremities was noted. Her brain MRIs showed a large infarction in the
      right pons. On admission, she could recognize her illness but was indifferent to
      her hemiplegia, so she said that there was not well-off for her life. Two weeks
      after the onset, her neurological symptoms gradually improved. Simultaneously,
      her interest in her hemiparesis increased. We proposed that, in the present
      patient, anosognosia for hemiplegia was caused by the pontine infarction. Since
      pontine anosognosia for hemiplegia has been rarely reported to date, it is
      expected that the findings of the present patient will be useful to the better
      understanding of mechanisms underlying anosognosia.

PMID- 11193548
TI  - [3 D-MRA of idiopathic carotid-cavernous fistula].

PMID- 11193549
TI  - [Postictal magnetic resonance imaging mimicking the dissemination in patient with
      anaplastic astrocytoma].

PMID- 11193550
TI  - [Current topics on classification and nomenclature of bacteria. 3. The present
      condition and role of the subcommittees on taxonomy].

PMID- 11193551
TI  - [A Shigella sonnei outbreak in Nagasaki].
AB  - We have experienced an outbreak of dysentery in Nagasaki. Shigella sonnei were
      positively cultured from 467 patients out of suspected 821 cases, and 346
      patients were admitted. 121 patients were treated with oral antimicrobials in the
      outpatient clinic. Five patients were diagnosed as secondary infection. We
      treated a total of 96 patients in Nagasaki Municipal Medical Center, and studied
      the clinical and bacterial features in these 96 patients. Chief complaints
      included fever, abdominal pain and diarrhea. Most diarrheal patients showed
      waterly diarrhea and only a few were bloody (3 of 47). Treatment of levofloxacine
      300 mg a day for 5 days successfully eliminated S. sonnei from all culture
      positive patients. An environmental surveillance revealed that water in a well at
      the university to which many patients were using was the origin of the infection
      with positive cultures of S. sonnei. No difference between the clinical and
      environmental isolates was observed in results on biochemical, serological and
      enzymatic tests. All isolates were susceptible to levofloxacin and to ofloxacin,
      but three isolates showed resistance of fosfomycin with MIC above 64
      micrograms/ml. In analysis of pulsed-field gel electrophoresis, both clinical and
      environmental isolates were considered to be closely related.

PMID- 11193552
TI  - [Comparison of cost and benefits of each model for rubella immunization in
      Japan].
AB  - MMR (measles-mumps-rubella) immunization in Japan was suspended in 1993 due to
      the high incidence of mumps meningitis as a complication. As a result,
      immunization coverage for rubella still remains at the 50-60% level in Japan. One
      way to increase the coverage rate is to increase the frequency of immunization.
      We calculated the predicted positivity rate of the antibody and cost and the
      benefits is three models of double vaccination, i.e., vaccination twice. The
      first model consists of simply two identical vaccinations. The second model
      consists of two vaccinations with mass vaccination at school for the second
      immunization. The third model consists of two vaccinations with screening of the
      urinary antibody for rubella in the second immunization. To calculate the
      predicted values we used coefficients from Ibara City. The predicted positivity
      rates and cost increases ranged from 60% to 90% and from 7.3 billion to 12.8
      billion yen from the first to third models, respectively. Screening for the
      urinary antibody should be much cheaper than the presumed price because more than
      a million subjects will be screened. Since it would cost less than half the
      price, the third model should be best for the positivity rate of the antibody and
      cost and benefits. Therefore, we think that third model is the best correction
      until MMR immunization can be reintroduced.

PMID- 11193553
TI  - [Comparison of the morphology and the reactivity of Chlamydia pneumoniae isolated
      in north-Kanto Area, Ibaraki Prefecture, Japan].
AB  - To compare the morphology among Chlamydia pneumoniae (C. pneumoniae), strain
      TW183 and strains which were isolated in the area of Kasumigaura, Ibaraki from
      1992 to 1995. C. pneumoniae were infected on HL cell monolayers and cultured in
      5% CO2 at 35.5 degrees C for about 60 hrs. The cells were harvested and fixed
      with 2.5% glutaraldehyde, and then the regular procedure for observation of
      Chlamydia in inclusion by transmission electron microscope was performed.
      Immunoblot assay was carried out by using highly and partially purified C.
      pneumoniae TW183 and 4 isolates with partial purification as antigens. The
      results were as follows: the shape of TW183 and the isolates included pear and
      round shapes, respectively. Immunoblotting profiles were the same in terms of
      band-formation patterns with the serum from a patient infected with C.
      pneumoniae. These results may indicate that the round shape of C. pneumoniae
      elementary body (EB) is predominantly pandemic in Japan, although pear-shaped EBs
      of C. pneumoniae were found in the neighboring prefecture of Chiba.

PMID- 11193554
TI  - [Virucidal activity of disinfectants: virucidal activities of disinfectants on
      some viruses coated on several materials and its durability].
AB  - First, four disinfectants were tested for virucidal activity on viruses coated
      upon materials. Disinfectants of the aldehyde and halogen groups had a
      destructive effect on both enveloped and non-enveloped DNA and RNA viruses coated
      on a cotton gauze, stainless chips, wood shavings, polyplopylene resin chips and
      latex resin chips, respectively. Disinfectant of the biguanide group had a
      virucidal activity on both enveloped DNA and RNA viruses. Secondary, five
      disinfectants were tested for the durability of their virucidal activity on two
      DNA and RNA viruses after preparing working solutions. The disinfectants of the
      aldehyde group maintained their virucidal efficiency for 2 to 3 days.
      Disinfectants of the invert and amphoteric soap groups, the biguanide group and
      the halogen group maintained their virucidal efficiency for 1 to 2 days. In the
      presence of bovine serum, the virucidal activity of the aldehyde group and the
      halogen group were not influenced but that of the invert and amphoteric soap
      groups were strongly influenced and lost their effect.

PMID- 11193555
TI  - [Clinical evaluation of rapid diagnostic kit detecting separately influenza A and
      B viruses].
AB  - The Directigen Flu A + B kit, a rapid diagnostic device for influenza virus A and
      B was evaluated. The nasopharyngeal aspirates were obtained from 239 patients who
      visited our hospital, between January and March, 2000, presenting flu-like
      symptoms. Influenza virus AH1: 77 and AH3: 51 were isolated from 128 specimens
      and none from 111 specimens. Directigen Flu A + B showed 115 specimens positive
      and 106 specimens negative. The sensitivity and specificity of this kit were
      89.8% (115/128) and 95.5% (106/111) compared with viral isolation. Agreement on
      positive and negative interpretations between Direction Flu A and this kit was
      97.9% (234/239). In the evaluation of this kit for influenza B virus, 60 frozen
      nasopharyngeal aspirates collected from February to April, 1999 were used. The
      sensitivity and specificity of this kit were 88.9% (16/18) and 88.1% (37/42)
      compared with viral isolation. Agreement on positive and negative interpretations
      between FLU OIA and this kit was 91.7% (55/60). The Directigen A + B demonstrated
      sensitivity and specificity equivalent to the conventional kits in nasopharingeal
      aspirates. This kit can also differentiate influenza A and B viruses, a feature
      which is useful for treatment using anti-viral agents such as amantadine and
      neuraminidase inhibitor. To date, the kit is the most effective tool for the
      rapid diagnosis of influenza.

PMID- 11193556
TI  - [Sensitivity and specificity of rapid diagnosis kit detecting separately
      influenza A and B viruses].
AB  - Sensitivity and specificity of the Directigen Flu A + B kit, a rapid test for
      influenza virus A and B, were evaluated. This test detects influenza A and B
      viruses separately by EIA. Reactivity of the kit was tested using a total of 23
      isolates: 13 isolates of human influenza virus A (H1N1, H3N2) and 10 isolates of
      human influenza virus B. All of the isolates were tested positive and no
      difference in reactivity was found in antigenic variables and subtypes. The kit
      was only reactive to influenza virus A and B, not reactive to other viruses.
      Typical influenza A and B strains were tested for detection limit. 7.8 x 10(3)
      pfu/ml was a detection limit for influenza virus A (H1N1: Beijing/262/95), 4.7 x
      10(4) pfu/ml for influenza virus A (H3N2: Kitakyusyu/159/93), and 3.1 x 10(4)
      pfu/ml for influenza virus B (Guangdong/05/94). The Directigen Flu A + B kit was
      a easy-to-use, rapid detection device and the kit has sensitivity and specificity
      equivalent to other diagnostic devices, suggesting the kit are useful in medical
      institutions.

PMID- 11193557
TI  - [Clinical efficacy and safety of the selective oral neuraminidase inhibitor
      oseltamivir in treating acute influenza--placebo-controlled double-blind
      multicenter phase III trial].
AB  - We conducted the placebo-controlled double-blind multicenter Phase III trial of
      newly developed selective oral neuraminidase inhibitor, oseltamivir phosphate
      (Ro64-0796), in order to evaluate the efficacy and safety, when Ro64-0796 was
      administered orally to both type A and type B influenzavirus infected patients.
      Patients were randomly assigned to either Ro64-0796 75 mg twice daily group or
      matching placebo group for five days. A total of 316 patients (Ro64-0796 group;
      154 and placebo group; 162) were recruited, and intent-to-treat infected
      population, which was defined as the patients that study drug was administered
      one or more and laboratory-confirmed influenzavirus infection was demonstrated,
      were 122 and 130, respectively. Ro64-0796 decreased significantly median viral
      titers after 72 hours (p = 0.0009. Analysis of covariance), indicating the rapid
      inhibition of virus replication, and duration of illness which was primary
      variable of efficacy, was reduced statistically significant by one day (23.3
      hours) (p = 0.0216, generalized Wilcoxon test). Ro64-0796 treatment also resulted
      in the reduction of the fever duration and severity of clinical symptoms.
      Concerning the safety evaluation, the main accompanied symptoms with Ro64-0796
      application were gastrointestinal disorders such as bellyache, nausea and
      vomiting. Most of these events were mild and allowable for the clinical use.
      There was no abnormal change attributable to Ro64-0796 application in the
      clinical laboratory tests as well as the physiological tests. Our data suggests
      that Ro64-0796 is useful in treating the acute influenzavirus infection.

PMID- 11193559
TI  - [Two cases of HIV infection accompanied with borderline personality disorder].
AB  - We report here two cases of HIV infection with a borderline personality disorder.
      Case 1 was a 25-year-old male patient who was diagnosed with HIV infection 4
      years ago. Borderline personality disorder was also diagnosed at that time.
      Although he was referred to our hospital in 1999, we had to refer him to another
      hospital for his regular outpatient hemodialysis. Case 2 was a 24-year-old male
      patient who had borderline personality disorder since 1996. He was diagnosed with
      HIV infection in 1999 and referred to our hospital. He ignored rules in visiting
      clinics such as prior reservations and frequently called doctors, case-workers
      and nurses. After several visit he intentionally took excessive sedative
      medicines and called a case-workers at our hospital. He was admitted to our
      hospital for three days. After he was discharged, we set limitations for his
      behavior not to harm himself and to obey the rules in visiting clinics. In other
      countries investigators report that borderline personality disorder is more
      common in HIV-infected persons. It may be because persons with borderline
      personality disorder are more likely to engage in high-risk sexual behavior,
      which is also applicable to these two cases. As HIV infection is rapidly
      prevailing in Japan, it is possible that the chance are that this disorder will
      be seen more frequently in HIV infected cases.

PMID- 11193558
TI  - [Efficacy and safety of the selective oral neuraminidase inhibitor oseltamivir
      for prophylaxis against influenza--placebo-controlled double-blind multicenter
      phase III trial].
AB  - We have investigated the long-term prophylactic efficacy and safety of
      oseltamivir phosphate (Ro64-0796), an orally bioavailable prodrug of novel,
      potent and selective type A and type B influenzavirus neuraminidase inhibitor,
      when Ro64-0796 was administered orally to the healthy volunteers. Participants
      older than 16 year-old were randomly assigned to either Ro64-0796 75 mg once
      daily group or matching placebo group for six weeks. A total of 308 participants
      (Placebo group; 153 and Ro64-0796 group; 155) were enrolled in this trial. The
      primary variable of efficacy, incidence of laboratory-confirmed influenzavirus
      infected subjects accompanied by both fever of 37.5 degrees C or higher and at
      least two influenza symptoms (group 1) were 1.3% in Ro64-0796 group in contrast
      with 8.5% in placebo group, inducing 85% inhibition of infection (p = 0.00323,
      Fisher's exact test). As secondary variable, incidence of laboratory-confirmed
      influenzavirus infected subjects who lack either fever (37.5 degrees C or higher)
      or at least two influenza symptoms (group 2) and incidence of asymptomatic
      infected subjects (group 3) were tend to decrease in Ro64-0796 group, and finally
      cumulative inhibition rate was 76% in group 1 + 2 combined (p = 0.000891.
      Fisher's exact test), and 63% in group 1 + 2 + 3 combined (p = 0.002150, Fisher's
      exact test). As for the safety evaluations, Ro64-0796 was well tolerated but was
      associated with gastrointestinal disorders such as nausea and vomiting which were
      mild and allowable for the clinical use. There was no abnormal change
      attributable to Ro64-0796 application in the clinical laboratory tests as well as
      the physiological tests. Our results demonstrate that oseltamivir is safe and
      effective for the prevention of influenza.

PMID- 11193560
TI  - [A case of pyogenic vertebral osteomyelitis caused by Haemophilus aphrophilus].
AB  - On Aug. 3, 1999, a 73-year-old male was admitted to our hospital with the chief
      complaint of pain in the neck, high fever, and numbness in the arm. MRI of the
      cervix showed high intensity at the C3/C4 disc space. Laboratory data showed
      several signs of inflammation. Haemophilus aphrophilus was detected from the
      specimen of the disc space, and the diagnosis of pyogenic vertebral osteomyelitis
      caused by H. aphrophilus was made. After the identification of H. aphrophilus,
      antibiotic therapy with Cefotiam (2 g/day) was given but his vertebral collapsed.
      Surgical treatment consisted of curettage and anterior spinal body fusion using
      the iliac bone, was performed on his 23rd hospital day, successfully. The
      antibiotic therapy of Cefazolin (2 g/day) was continued for the first 3 days,
      followed by Cefotiam (2 g/day) and later Levofloxacin (300 mg/day). The patient
      was discharged on the 88th hospital day. The origin of infecting H. aphrophilus
      in this patient was not clear, but oral source was suspected. We reported the
      first case of pyogenic vertebral osteomyelitis caused by H. aphrophilus in Japan.

PMID- 11193561
TI  - Expression and function of Na+HCO3- cotransporters in the gastrointestinal tract.
AB  - The stomach, duodenum, colon, and pancreas secrete HCO3- ions into the lumen.
      Although the importance of HCO3- secretion for the maintenance of mucosal
      integrity, a normal digestion, and the reabsorption of Cl- has been well
      established, the molecular nature of the apical and basolateral HCO3-
      transporting proteins has remained largely unknown. Functional studies have
      suggested that a Na+HCO3- cotransport system, similar but not identical to the
      well-characterized Na+HCO3- cotransporter in the basolateral membrane of the
      kidney proximal tubule, is present in duodenal and colonic enterocytes,
      pancreatic ducts cells, and gastric cells and involved in HCO3- uptake from the
      interstitium. This report describes our work towards understanding the molecular
      nature, cellular origin, and functional relevance of the Na+HCO3-
      cotransporter(s) in the stomach and intestine and reviews work by others on the
      function and localization of Na+HCO3- cotransport processes in the
      gastrointestinal tract.

PMID- 11193562
TI  - Epithelial transport and barrier function: pathomechanisms in gastrointestinal
      disorders. Proceedings of a conference. March 26-27, 1999. Berlin, Germany.

PMID- 11193563
TI  - Tumor necrosis factor-alpha potentiates ion secretion induced by muscarinic
      receptor activation in the human intestinal epithelial cell line HT29cl.19A.

PMID- 11193564
TI  - Investigation of motility and secretion in perfused guinea pig colon ex situ.

PMID- 11193565
TI  - Stimulation by portal insulin of intestinal glucose absorption via hepatoenteral
      nerves and prostaglandin E2 in the isolated, jointly perfused small intestine and
      liver of the rat.
AB  - Insulin infused into the portal vein acutely enhanced intestinal glucose and
      galactose absorption via the sodium-dependent glucose cotransporter-1 in the
      isolated, jointly perfused small intestine and liver of the rat. Atropine and
      tetrodotoxin infused into the superior mesenteric artery completely prevented the
      portal insulin-dependent increase in intestinal glucose absorption, and carbachol
      caused an increase similar to that of portal insulin. Thus, a signal was
      transmitted against the bloodstream in a retrograde direction from the portal
      vein to the small intestine via hepatoenteral cholinergic nerves. The
      intracellular messenger in the enterocytes was cAMP, and the link between the
      muscarinic receptors, which do not increase cAMP concentrations, and adenylate
      cyclase was found to be prostaglandin E2.

PMID- 11193566
TI  - Effects of HIV protease inhibitors on barrier function in the human intestinal
      cell line HT-29/B6.

PMID- 11193567
TI  - Induction of endothelial barrier function in vitro.

PMID- 11193568
TI  - The structure and function of claudins, cell adhesion molecules at tight
      junctions.
AB  - Tight junctions (TJs) play a pivotal role in compartmentalization in
      multicellular organisms by sealing the paracellular pathway in epithelial and
      endothelial cell sheets. Recently, novel integral membrane proteins, claudins,
      have been identified as major cell adhesion molecules working at TJs. Claudins
      comprise a multigene family, and each member of approximately 23 kDa bears four
      transmembrane domains. To date, 15 members of this gene family have been
      identified. When expression vectors of each species of claudins were transfected
      into fibroblasts lacking endogenous claudins or TJs, well-developed TJs were
      observed between adjacent transfectants. Furthermore, claudins were shown to be
      directly involved in the barrier function of TJs by experiments using Clostridium
      perfringens enterotoxin. Now that claudins have been identified, the structure
      and functions of TJs should be determined in detail in molecular terms.

PMID- 11193569
TI  - Intestinal cell adhesion molecules. Liver-intestine cadherin.
AB  - The cadherin superfamily comprises a large number of cell adhesion molecules,
      several of which are expressed in the gastrointestinal tract. LI-cadherin
      represents a novel type of cadherin within the cadherin superfamily distinguished
      from other cadherins by structural and functional features described in this
      review. In the mouse and human, LI-cadherin is selectively expressed on the
      basolateral surface of enterocytes and goblet cells in the small and large
      intestine, whereas in the rat this cadherin is additionally detectable in
      hepatocytes. LI-cadherin is capable of mediating Ca(2+)-dependent homophilic cell
      cell adhesion independent of interactions with the cytoskeleton, indicating that
      the adhesive function of this novel cadherin is complementary to that of E
      cadherin and desmosomal cadherins co expressed in the intestinal mucosa.

PMID- 11193570
TI  - Molecular diversity of plaques of epithelial-adhering junctions.
AB  - In biochemical and immunocytochemical comparisons of adhering junctions of
      different epithelia, we have observed differences in molecular composition not
      only between the intermediate filament-attached desmosomes and the actin
      filaments-anchoring adherens junctions but also between desmosomes of different
      tissues and of different strata in the same stratified epithelium. In addition we
      now report cell type-specific differences of molecular composition and
      immunoreactivity in both desmosomes and adherens junctions of certain simple
      epithelia. Whereas the zonula adhaerens of human intestinal and colonic
      epithelial cells, and of carcinomas derived therefrom, contains the additional
      armadillo-type plaque protein ARVCF, this protein has not been detected in the
      zonula adhaerens of hepatocytes. Similarly, plakophilin 3 is present in the
      desmosomal plaques of intestinal and colonic cells but appears to be absent from
      the hepatocytic desmosomes. We suggest that these profound compositional
      differences in the junctions of related simple epithelia are correlated to
      functional differences of the specific type of epithelium.

PMID- 11193571
TI  - Characterization and molecular localization of anion transporters in colonic
      epithelial cells.
AB  - This study describes the identification and characterization of anion
      transporters in apical membrane (APM) and basolateral membrane (BLM) of rat
      distal colon. Cl-HCO3, Cl-OH, Cl-butyrate, and butyrate-HCO3 exchanges and Na
      HCO3 cotransporter are present in rat distal epithelial cells. Cl-HCO3 exchange
      (1) is present only in APM from surface, but not from crypt cells; (2) is also
      present in BLM; and (3) of surface cell is encoded by anion exchange (AE)-1
      isoform, whereas BLM Cl-HCO3 is encoded by AE2 isoform. Cl-OH exchange is present
      only in APM, but not in BLM from surface and crypt cells, and is responsible for
      regulation of cell functions (i.e., cell pH and cell volume regulation). Butyrate
      HCO3 exchange (1) is also present in apical membrane vesicles (AMV) from surface,
      but not from crypt cells; (2) is present in BLM; and (3) is responsible for SCFA
      dependent HCO3 secretion. By contrast, Cl-butyrate exchange: (1) is present in
      APM from both surface and crypt cells; (2) is not present in BLM; and (3)
      recycles butyrate by absorbing Cl. Na-HCO3 cotransport: (1) is present only in
      BLM; (2) is expressed predominantly in midcrypt regions; and (3) may be linked to
      HCO3 secretion. A mechanism for HCO3 movement across the crypt apical membrane
      has not as yet been identified.

PMID- 11193572
TI  - Neutrophil migration across intestinal epithelium.
AB  - Transmigration of neutrophils across epithelial surfaces is the hallmark of
      inflammatory mucosal diseases of diverse organs. In disorders such as Crohn's
      disease, ulcerative colitis, pyelonephritis, and bronchitis, for example,
      neutrophil transmigration correlates with clinical disease activity, is
      associated morphologically with injury to the epithelium, and is central to
      disease pathophysiology. The mechanisms by which neutrophils transmigrate across
      epithelia are, therefore, of considerable significance for numerous pathologic
      states. In this paper, we discuss current evidence that defines these mechanisms
      in intestinal epithelium, emphasizing the structural constituents determining
      adhesive interactions and a subset of the complex regulatory signals between
      neutrophils and epithelium.

PMID- 11193574
TI  - Role of M cells in intestinal barrier function.
AB  - M cells are known as specialized epithelial cells of the follicle-associated
      epithelium of the gastrointestinal tract. As M cells have a high capacity for
      transcytosis of a wide range of microorganisms and macromolecules, they are
      believed to act as an antigen sampling system. The primary physiological role of
      M cells seems to be the rapid uptake and presentation of particular antigens and
      microorganisms to the immune cells of the lymphoid follicle to induce an
      effective immune response. In contrast to absorptive enterocytes, M cells do not
      exert direct defense mechanisms to antigens and pathogens in the gut lumen.
      Therefore, they provide functional openings of the epithelial barrier. Although M
      cells represent a weak point of the epithelial barrier, even under noninflamed
      conditions, there seems to be a balance between antigen uptake and immunological
      response. The low number of M cells in the gastrointestinal tract and the direct
      contact to immune cells in the lamina propria usually prevent the occurrence of
      mucosal inflammation. During chronic intestinal inflammation we observe an
      increase of M cell number and apoptosis selectively in M cells. M cell damage
      seems to be responsible for the increase of the uptake of microorganisms that is
      observed during intestinal inflammation. Under inflammatory conditions in the
      intestine, the maintenance of the epithelial barrier is broken and M cells seem
      to play a major role during this process.

PMID- 11193573
TI  - Expression and function of death receptors and their natural ligands in the
      intestine.
AB  - The tumor necrosis factor receptor (TNFR) family is a still-growing group of
      homologous transmembrane proteins, some of which bear an intracellular "death
      domain" and are able to directly mediate apoptosis. Apoptosis is induced upon
      trimerization of the receptors by their natural ligands' constituting the
      complementary TNF family. The best-characterized apoptosis-mediating TNFR family
      member is CD95 (APO-1/Fas). CD95 is functionally expressed on the basolateral
      surface of colonic epithelial cells regardless of their position along the crypt
      axis. The biological significance of this CD95 expression in the gut, however, is
      still under discussion. Although it is unlikely that the CD95/CD95L system is
      involved in the physiologic regeneration of the intestinal epithelium, this
      system may play an important role in the pathogenesis of inflammatory bowel
      diseases. In contrast to the normal epithelium, colon carcinoma cell lines are
      mostly resistant to CD95-induced apoptosis. The detection of CD95L expression in
      colon carcinoma cell lines has led to the concept of carcinomas as
      "immunoprivileged sites," where invading immune cells are killed by CD95L
      expressing tumor cells. A more recently described member of the TNF family is
      TRAIL, which is also able to induce apoptosis. As yet, four TRAIL receptors have
      been cloned, two of which (TRAIL-R1 and 2) bear a death domain and mediate
      apoptosis, whereas two others (TRAIL-R3 and 4) lack (functional) death domains
      and are supposed to act as decoy receptors. Because many tumor cell lines in
      vitro are sensitive to TRAIL-induced apoptosis while their normal counterparts
      are not, TRAIL is currently under discussion as a possible anticancer therapeutic
      agent.

PMID- 11193575
TI  - Nutrient transporter function studied in heterologous expression systems.
AB  - Although a large number of plasma cell nutrient transport proteins has been
      cloned in the last couple of years, much remains to be learned about their
      structure-function relationships, membrane topology, posttranslational
      regulation, and bioenergetics of transport. Major progress in the study of the
      human and animal transporters has come from heterologous expression systems,
      which offer the benefits of ease of genetic selection and manipulation, short
      generation time of the organisms in which transporters are expressed, and
      comparatively high levels of expression of the recombinant proteins. Because our
      main focus is mammalian peptide transporters, the intestinal peptide transporter,
      PEPT1, and its renal counterpart, PEPT2, will serve here as models for the
      analysis of their structure and function when they are heterologously expressed
      in different cell systems.

PMID- 11193576
TI  - Epithelial barrier defects in HT-29/B6 colonic cell monolayers induced by tumor
      necrosis factor-alpha.
AB  - The barrier function of intestinal epithelia relies upon the continuity of the
      enterocyte monolayer and intact tight junctions. After incubation with tumor
      necrosis factor-alpha TNF-alpha, however, the number of strands that form the
      tight junctions decreases, and apoptosis is induced in intestinal epithelial
      cells. These morphological changes lead to a rise of transepithelial ion
      permeability, because the paracellular ion permeability increases and leaks
      associated with sites of apoptosis increase by number and magnitude. Thus
      apoptosis and degradation of tight junctions contribute to the increased
      permeability observed after exposure to TNF-alpha. These mechanisms explain
      clinical manifestations in the inflamed intestinal wall containing cytokine
      secreting macrophages--for example, leak flux diarrhea and invasion of bacterial
      enterotoxins.

PMID- 11193577
TI  - Enhanced expression of iNOS in inflamed colons of IL-2-deficient mice does not
      impair colonic epithelial barrier function.
AB  - On the basis of recently observed high levels of iNOS expression that correlated
      with intestinal inflammation in interleukin-2-deficient [IL-2(-/-)] mice, it was
      postulated that nitric oxide may damage colonic epithelial cells or impair
      intestinal epithelial barrier function. This damage may result in an increased
      permeability of the colonic epithelium leading to high antigenic exposure of the
      intestinal immune system, which may perpetuate chronic inflammation. Our data
      demonstrate that high expression of iNOS in IL-2(-/-) mice is correlated with the
      length/weight ratio (L/W ratio), a widely accepted marker for intestinal
      inflammation. However, no reduction of epithelial resistance was observed, as
      would be expected in case of a damaged, leaky epithelium. Our results suggest
      that enhanced formation of NO in IL-2(-/-) mice does not cause impairment of
      epithelial barrier function.

PMID- 11193578
TI  - Regulation of intercellular tight junctions by zonula occludens toxin and its
      eukaryotic analogue zonulin.
AB  - The intestinal epithelium represents the largest interface between the external
      environment and the internal host milieu and constitutes the major barrier
      through which molecules can either be absorbed or secreted. There is now
      substantial evidence that tight junctions (tj) play a major role in regulating
      epithelial permeability by influencing paracellular flow of fluid and solutes. Tj
      are one of the hallmarks of absorptive and secretory epithelia. Evidence now
      exists that tj are dynamic rather than static structures and readily adapt to a
      variety of developmental, physiological, and pathological circumstances. These
      adaptive mechanisms are still incompletely understood. Activation of PKC either
      by Zonula occludens toxin (Zot) or by phorbol esters increases paracellular
      permeability. Alteration of epithelial tj is a recently described property for
      infectious agents. Clostridium difficile toxin A and B and influenza and
      vesicular stomatitis viruses have been shown to loosen tj in tissue culture
      monolayers. Unlike what occurs after the Zot stimulus, these changes appear to be
      irreversible and are associated with destruction of the tj complex. On the basis
      of this observation, we postulated that Zot may mimic the effect of a
      functionally and immunologically related endogenous modulator of epithelial tj.
      We were able to identify an intestinal Zot analogue, which we named zonulin. It
      is conceivable that the zonulins participate in the physiological regulation of
      intercellular tj not only in the small intestine, but also throughout a wide
      range of extraintestinal epithelia as well as the ubiquitous vascular
      endothelium, including the blood-brain barrier. Disregulation of this
      hypothetical zonulin model may contribute to disease states that involve
      disordered intercellular communication, including developmental and intestinal
      disorders, tissue inflammation, malignant transformation, and metastasis.

PMID- 11193579
TI  - Analysis of low-molecular-weight GTP-binding proteins in two functionally
      different intestinal epithelial cell lines.
AB  - Low molecular weight GTP-binding proteins are molecular switches that are
      believed to play pivotal roles in cell growth, differentiation, cytoskeletal
      organization, and vesicular trafficking. In this study, for the first time,
      members of this family of proteins in two functionally different intestinal
      epithelial cell lines are identified and characterized. [alpha-32P]GTP blot
      overlay assays of cytosolic and membranous fractions revealed the presence of
      specific GTP-binding proteins in the range of 20-30 kDa (small GTPases) in both
      fractions, with considerably higher amounts in the membranous insoluble fraction.
      Analysis by two-dimensional electrophoresis, immunoprecipitation using monoclonal
      and sequence-specific polyclonal antibodies, and C3 exoenzyme-mediated ADP
      ribosylation demonstrated the presence of Ras, Rap, Rho, Rac, Rab, and several
      other small GTPases. The pattern of small GTP-binding proteins corresponded to
      the characteristics of the cell lines. Caco-2 cells showed a Rab5 protein that is
      known to be involved in endocytosis but was not found in T84 cells. On the
      contrary Rab3 has been shown to participate in secretory processes. It is highly
      expressed in T84 cells (sixfold compared to Caco-2 cells).

PMID- 11193580
TI  - Increased tight junction permeability can result from protein kinase C
      activation/translocation and act as a tumor promotional event in epithelial
      cancers.
AB  - Exposure of LLC-PK1 epithelial cell cultures to phorbol ester tumor promoters
      causes immediate translocation of protein kinase C-alpha (PKC-alpha) from
      cytosolic to membrane-associated compartments. With a very similar time course, a
      dramatic and sustained increase in tight junctional (paracellular) permeability
      occurs. This increased permeability extends not only to salts and sugars but
      macromolecules as well. Fortyfold increases of transepithelial fluxes of
      biologically active EGF and insulin occur. Recovery of tight junction barrier
      function coincides with proteasomal downregulation of PKC-alpha. The failure to
      downregulate activated membrane-associated PKC-alpha has correlated with the
      appearance of multilayered cell growth and persistent leakiness of tight
      junctions. Accelerated downregulation of PKC-alpha results in only a partial and
      transient increase in tight junction permeability. Transfection of a
      dominant/negative PKC-alpha results in a slower increase in tight junction
      permeability in response to phorbol esters. In a separate study using rat colon,
      dimethylhydrazine (DMH)-induced colon carcinogenesis has been preceded by linear
      increases in both the number of aberrant crypts and transepithelial permeability,
      as a function of weeks of DMH treatment. Adenocarcinomas of both rat and human
      colon have been found to have uniformly leaky tight junctions. Whereas most human
      colon hyperplastic and adenomatous polyps contain nonleaky tight junctions,
      adenomatous polyps with dysplastic changes did possess leaky tight junctions. Our
      overall hypothesis is that tight junctional leakiness is a late event in
      epithelial carcinogenesis but will allow for growth factors in luminal fluid
      compartments to enter the intercellular and interstitial fluid spaces for the
      first time, binding to receptors that are located on only the basal-lateral cell
      surface, and causing changes in epithelial cell kinetics. Tight junctional
      leakiness is therefore a promotional event that would be unique to epithelial
      cancers.

PMID- 11193581
TI  - Stress-induced decrease of the intestinal barrier function. The role of
      muscarinic receptor activation.
AB  - Recently the breakdown of the barrier function of the intestinal epithelium after
      application of an experimental psychological and physical stress protocol in rats
      has been observed. Not only did smaller molecules pass from the luminal to the
      serosal side, but so also did larger proteins with the dimensions of luminal
      antigens and toxins. The increased permeability for macromolecules is primarily
      due to a decrease of the tightness of the zonula occludens, but an increased
      endocytotic uptake indicates that transcytosis is increased also. From studies of
      model systems it can be concluded that activation of the intracellular protein
      kinase C route by muscarinic receptor activation or histamine receptor activation
      can be one of the underlying cellular pathways. The physical pathway relaying the
      stress from the brain to the intestinal tract appears to be the parasympathetic
      branch of the autonomic nervous system. The difference in reaction of different
      strains suggests that coping style is an important determinant of the response of
      the intestinal barrier to stress.

PMID- 11193582
TI  - Immunologically mediated transport of ions and macromolecules.
AB  - There is increasing evidence supporting the involvement of immune cells and
      mediators in the control of intestinal physiology. Cell coculture systems and
      epithelial cell lines have provided convenient model systems for the study of
      immunomodulation of epithelial function. Abundant cytokines and immune mediators
      have been shown to directly or indirectly alter epithelial transport of ions and
      macromolecules. Animal models of hypersensitivity have shown that luminal antigen
      challenge in the intestine of sensitized rats induces a rapid ion secretory
      response due to enhanced transepithelial transport of antigen. Transport of ions
      and macromolecules is highly regulated and an important component of host
      defense. Dysregulation of epithelial function may play a role in several
      intestinal disorders, such as inflammatory bowel diseases and food allergy.

PMID- 11193583
TI  - Carbachol-induced Ca2+ entry into rat colonic epithelium.

PMID- 11193584
TI  - Effects of endotoxin on human large intestine.

PMID- 11193585
TI  - Increased paracellular macromolecular transport and subnormal glucose uptake in
      duodenal biopsies of patients with microvillus inclusion disease. Comparisons to
      other chronic diarrhea patients and to nondiarrhea patients.

PMID- 11193586
TI  - Apoptosis and intestinal barrier function.
AB  - The signal transduction pathways of the induction of apoptosis in the
      gastrointestinal tract have in part been discovered. However, almost nothing is
      known about the functional influence of apoptotic signals on intestinal barrier
      function. In this study the effect of camptothecin-induced apoptosis in HT-29/B6
      monolayers and the influence of apoptosis on epithelial barrier function were
      characterized. We demonstrated that camptothecin causes a decrease of
      transepithelial resistance and an increase in fluxes of the paracellular marker
      [3H]mannitol. Camptothecin increased the apoptotic rate and the conductance of
      single-cell apoptosis as measured by the conductance scanning technique. We
      conclude that in our model of HT-29/B6 cells camptothecin is a potent inductor of
      apoptosis that causes significant barrier defects measured by the Ussing chamber
      technique and the conductance scanning technique. Based on these results we are
      able to investigate the effect of other cytokines--TGF-beta, for instance, and
      its role in apoptotic conditions.

PMID- 11193587
TI  - p53-independent apoptosis induced by menadione in the human colon carcinoma cell
      line Caco-2.

PMID- 11193588
TI  - Epidermal growth factor, polyamines, and epithelial remodeling in Caco-2 cells.

PMID- 11193589
TI  - Effect of TNF alpha and IFN gamma on epithelial barrier function in rat rectum in
      vitro.

PMID- 11193590
TI  - Colectomy and ileal pouch. Transport and barrier in pouchitis.

PMID- 11193591
TI  - Mechanisms of epithelial barrier impairment in HIV infection.
AB  - Diarrhea and malabsorption due to intestinal dysfunction are common symptoms in
      HIV infection. The pathophysiologic mechanisms of these alterations are often not
      known, and the role of HIV per se is still controversially discussed. We measured
      the epithelial transport and barrier function by means of a miniaturized Ussing
      chamber system in the duodenum of HIV-infected patients in different disease
      stages, determined by the CD4 cell count in the serum as well as symptoms in
      patients with and without diarrhea. We could show that diarrhea induced by HIV
      per se is caused by a leak flux mechanism due to impaired epithelial barrier
      function. Antisecretory therapy does not seem to be useful in these patients,
      because we did not find increased active ion secretion. Along the course of the
      HIV infection, the epithelial transport and barrier function varies with HIV
      disease stage (expressed by CD4 cell status). In addition, an in vitro model was
      studied to characterize the effect of HIV-infected human immune cells on the
      epithelial barrier function using the human colonic epithelial cell line HT
      29/B6. HIV infection of human immune cells induced an increase in cytokine
      release--for example, TNF-alpha, IL-1 beta, IFN-alpha, and IFN-gamma-
      downregulating the epithelial barrier function of the human colonic epithelial
      cell line HT-29/B6. Taken together we postulate a specific stage-dependent
      cytokine pattern released from HIV-infected immune cells in the mucosa, which,
      corresponding to the HIV disease stage, is responsible for the variation in
      epithelial function.

PMID- 11193593
TI  - Cytokine-induced alteration of the epithelial barrier to food antigens in
      disease.
AB  - The alteration of the intestinal epithelial barrier is often a consequence of
      various intestinal diseases but may also be the starting point of these diseases.
      Undigested food antigens are transported across the intestinal epithelium by a
      transcytotic mechanism, including a processing within the enterocytes, and
      leading to the passage of intact proteins, peptides, and amino acids to the
      underlying mucosa. Inflammation and infection lead to the upregulation of the
      transport and processing of food proteins; for example, IFN gamma increases the
      rate of transcytosis and alters, like TNF alpha, the tight junction permeability.
      Infection of gastric digestive epithelia with Helicobacter pylori also increases
      the antigenic load transmitted to the underlying immune system by inhibiting the
      enterocytic lysosomal degradation of proteins. In allergic diseases, such as
      cow's milk allergy, TNF alpha may be involved in the intestinal dysfunction and
      the associated enteropathy.

PMID- 11193592
TI  - Short-term regulation of NHE3 by EGF and protein kinase C but not protein kinase
      A involves vesicle trafficking in epithelial cells and fibroblasts.
AB  - NHE3 is an intestinal epithelial isoform Na+/H+ exchanger that is present in the
      brush border of small intestinal, colonic, and gallbladder Na(+)-absorbing
      epithelial cells. NHE3 is acutely up- and downregulated in response to some G
      protein-linked receptors, tyrosine kinase receptors, and protein kinases when
      studied in intact ileum, when stably expressed in PS120 fibroblasts, and in the
      few studies reported in the human colon cancer cell line Caco-2. In most cases
      this is due to changes in Vmax of NHE3, although in response to cAMP and
      squalamine there are also changes in the K'(H+)i of the exchanger. The mechanism
      of the Vmax regulation as shown by cell surface biotinylation and confocal
      microscopy in Caco-2 cells and biotinylation in PS120 cells involves changes in
      the amount of NHE3 on the plasma membrane. In addition, in some cases there are
      also changes in turnover number of the exchanger. In some cases, the change in
      amount of NHE3 in the plasma membrane is associated with a change in the amount
      of plasma membrane. A combination of biochemical studies and transport/inhibitor
      studies in intact ileum and Caco-2 cells demonstrated that the increase in brush
      border Na+/H+ exchange caused by acute exposure to EGF was mediated by PI 3
      kinase. PI 3-kinase was also involved in FGF stimulation of NHE3 expressed in
      fibroblasts. Thus, NHE3 is another example of a transport protein that is acutely
      regulated in part by changing the amount of the transporter on the plasma
      membrane by a process that appears to involve vesicle trafficking and also to
      involve changes in turnover number.

PMID- 11193594
TI  - Epithelial barrier and transport function of the colon in ulcerative colitis.

PMID- 11193595
TI  - Diarrhea in ulcerative colitis. The role of altered colonic sodium transport.
AB  - In normal human colon, water and sodium (Na+) absorption are directly related.
      Defective Na+ absorption may therefore be an important factor in the pathogenesis
      of diarrhea in ulcerative colitis (UC). Electrophysiological studies have
      revealed profound decreases in channel-mediated apical Na+ entry and Na(+)-K(+)
      ATPase-mediated basolateral Na+ extrusion in surface epithelial cells in inflamed
      human distal colon. Recent molecular biological studies indicate that mucosal
      inflammation in UC leads to significant decreases in Na+ channel beta- and gamma
      subunit expression in the apical membrane of surface colonocytes, with a marked
      reduction in the levels of beta- and gamma-subunit-specific mRNAs. In addition,
      basolateral expression of the Na(+)-K(+)-ATPase alpha 1-isoform is reduced along
      the surface cell-crypt cell axis in UC, although there is no change in the level
      of the corresponding mRNA. Diarrhea in ulcerative colitis is therefore related,
      at least in part, to a major defect in electrogenic Na+ absorption, which
      reflects changes in the levels of expression of critical subunits of both the
      apical Na+ channel and basolateral Na(+)-K(+)-ATPase.

PMID- 11193596
TI  - Barrier dysfunction and Crohn's disease.
AB  - Crohn's disease is a debilitating illness of unknown etiology. A current
      hypothesis of disease pathogenesis suggests that this illness represents an
      abnormal immunological reaction to a luminal antigen. As part of this theory it
      is suggested that the luminal antigen is delivered to the mucosal immune system
      by a paracellular route. If this theory is correct several testable predictions
      can be made. In this manuscript these predictions are presented and the evidence
      to support or refute them is presented.

PMID- 11193597
TI  - Mechanisms of cholera toxin-induced diarrhea.
AB  - In the pathogenesis of cholera, cyclic adenosine monophosphate, 5
      hydroxytryptamine, prostaglandins, and the function of neuronal structures have
      been implicated. To elucidate the role of different isoforms of cyclooxygenase
      (COX)-1 and COX-2, selective COX-2 inhibitors were used. The selective COX-2
      inhibitors NS-398 and DFU completely suppressed cholera toxin-induced
      prostaglandin E2 biosynthesis and caused a dose-dependent inhibition of cholera
      toxin-induced fluid secretion in the rat jejunum in vivo. Constitutive expression
      of COX-1 but also of COX-2 mRNA was found in mucosal scrapings of the rat
      jejunum. Cholera toxin had no effect on COX-1 as well as COX-2 mRNA expression.
      Treatment of rats with dexamethasone did not effect cholera toxin-induced
      prostaglandin E2 biosynthesis and did not influence the expression of COX-2 mRNA,
      further substantiating that cholera toxin does not cause an induction of COX-2
      mRNA. Treatment of rats with E. coli lipopolysaccharide caused a marked increase
      in COX-2 mRNA expression that was inhibited by dexamethasone. In conclusion, the
      results provide evidence that cholera toxin, in addition to other mediators, uses
      prostaglandin E2 to exert its secretory effect and that in the case of cholera
      toxin prostaglandins are metabolized via COX-2.

PMID- 11193598
TI  - Effects of Clostridium difficile toxins on epithelial cell barrier.
AB  - Clostridium difficile is the primary agent responsible for many patients with
      antibiotic-associated diarrhea and almost all patients with pseudomembranous
      colitis following antibiotic therapy. C. difficile infection is the most frequent
      form of colitis in hospitals and nursing homes and affects millions of patients
      in the United States and abroad. The first event in the pathogenesis of C.
      difficile infection involves alterations of the indigenous colonic microflora by
      antibiotics, followed by colonization with C. difficile. C. difficile causes
      diarrhea and colitis by releasing two high molecular weight protein exotoxins,
      toxin A and toxin B, with potent cytotoxic and enterotoxic properties. Evidence
      presented here indicates that C. difficile toxins compromise the epithelial cell
      barrier by at least two pathophysiologic pathways, one involving disaggregation
      of actin microfilaments in colonocytes via glucosylation of the Rho family of
      proteins leading to epithelial cell destruction and opening of the tight
      junctions, whereas the other appears to involve early release of proinflammatory
      cytokines from intestinal epithelial cells probably via activation of MAP
      kinases. We speculate that cytokines released from intestinal epithelial cells in
      response to toxin A exposure will diffuse into the lamina propria and activate
      macrophages, enteric nerves, and sensory neurons to release SP, CGRP, and NT,
      which, in turn, interact with immune and inflammatory cells and amplify the
      inflammatory response. Dissection of this inflammatory cascade may help us
      understand the pathophysiology of inflammatory diarrhea caused by this important
      pathogen.

PMID- 11193599
TI  - Ion transport during growth and differentiation.
AB  - The major function of the adult colon is to reabsorb fluid from the chyme. This
      ability to conserve salt and water is especially important in newborns, where
      reserves are small and diarrhea is frequent. Although much is known about
      regulation of Cl- transport in the adult colon, postnatal changes in electrolyte
      transport are not well characterized. We have established an in vitro model to
      study colonic epithelial cells (colonocytes) at different stages of development.
      Primary cultures were isolated from newborn, weanling, and adult rabbit colon and
      properties such as growth and Cl- transport characterized. The isolation
      procedure yielded a crypt-enriched population of cells, and the cell yield per
      gram mucosa increased with age. The colonocytes also showed an age-related
      decrease in attachment to extracellular matrix, with maximum attachment seen with
      Matrigel and collagen IV. The crypt enrichment was confirmed by demonstrating
      that the cell population was capable of transporting Cl-, which was stimulated by
      agents such as forskolin and phorbol esters at all ages. Agents that increased
      intracellular cGMP, however, did not increase Cl- transport at any age. It was
      interesting to observe that the secondary bile acid, taurodeoxycholate,
      stimulated Cl- transport only in the adult but not newborn or weanling distal
      colonocytes. We have demonstrated that rabbit distal colonocytes can be kept
      viable in culture and transport Cl- at all ages. However, the regulation of Cl-
      transport changes during ontogeny and depends on the signaling pathway.

PMID- 11193600
TI  - Cl-dependent Na-H exchange. A novel colonic crypt transport mechanism.
AB  - This communication summaries a series of observations of the transport function
      of the crypt of the rat distal colon. Development of methods to study both 22Na
      uptake by apical membrane vesicles prepared from crypt cells and intracellular
      pHi (pHi), fluid movement (Jv), and bicarbonate secretion during microperfusion
      of the crypt has led to the identification of (1) a novel Cl-dependent Na-H
      exchange (Cl-NHE) that most likely represents the coupling of a Cl channel to a
      Na-H exchange isoform that has not as yet been identified and (2) bicarbonate
      secretion that appears to be most consistent with HCO3 uptake across the
      basolateral membrane by a mechanism that is closely linked to Cl transport and
      its movement across the apical membrane via an anion channel. Na-dependent fluid
      absorption is the constitutive transport process in the crypt, while fluid
      secretion is regulated by one or more neurohumoral agonists. Cl-NHE is
      responsible for both the recovery/regulation of pHi in crypt cells to an acid
      load and fluid absorption.

PMID- 11193601
TI  - Coupling between Na+, sugar, and water transport across the intestine.
AB  - Water is absorbed across the small intestine in the absence of external driving
      forces. However, it has been established that water transport is secondary to
      active sodium transport. In the upper intestine both sodium and water absorption
      are largely dependent on the presence of D-glucose. The link between active
      sodium transport and glucose is the coupled transport of sodium and glucose
      across the brush border membrane of enterocytes by the Na+/glucose cotransporter
      (SGLT1). Na+ that enters the cells with glucose is pumped out towards the blood
      by 3Na+/2K+ pumps on the basolateral membrane, and glucose passes out across the
      basolateral membrane by facilitated diffusion, the net result being that glucose
      and sodium are transported across the epithelium. The coupling between Na+,
      glucose, and water transport is less well understood. It is commonly thought that
      Na+ transport increases the local osmotic pressure in the lateral intercellular
      spaces, and that this in turn generates osmotic water flow across the epithelium.
      Recent work suggests a more direct link between Na+, glucose, and water
      transport; that is, water is cotransported along with Na+ and sugar through
      SGLT1. Here we review the evidence for Na+/glucose/water cotransport.

PMID- 11193602
TI  - Regulation of chloride secretion. Novel pathways and messengers.
AB  - The capacity for active chloride secretion, thereby driving the secretion of
      fluid, is an important property of the intestinal epithelium. Chloride secretion
      is stimulated by mechanisms involving increases in either cyclic nucleotide or
      cytoplasmic calcium concentrations. The calcium-dependent response is transient
      and limited in its magnitude, implying that negative signaling events may
      restrict the overall extent of this mode of chloride transport. We have uncovered
      a number of negative signaling mechanisms intrinsic to the epithelium that
      uncouple increases in calcium from the downstream response of chloride secretion.
      These involve various kinase cascades, the generation of messengers derived from
      membrane phospholipids, and interactions of G protein-coupled receptors with
      those for peptide growth factors such as epidermal growth factor. This chapter
      will review emerging information on the details of these negative signaling
      mechanisms, as well as points of convergence and divergence. The possible
      physiological and pathophysiological significance of such signaling will also be
      discussed.

PMID- 11193603
TI  - Neurotransmitters in neuronal reflexes regulating intestinal secretion.
AB  - The intestinal crypt cell secretes chloride into the lumen, resulting in
      accumulation of fluid that normally thins out mucus or, at higher secretory
      rates, flushes out the contents. The regulation of chloride secretion occurs by
      neural reflex pathways within the enteric nervous system. Mechanical stimulation
      releases 5-hydroxytryptamine (5-HT) from enterochromaffin cells with subsequent
      activation of intrinsic primary afferents that carry electrical signals to
      submucosal ganglia. After processing, interneurons activate cholinergic and
      vasoactive intestinal peptide (VIP) secretomotor neurons. Acetylcholine and VIP
      bind to epithelial receptors and stimulate sodium chloride and fluid secretion.
      Reflex-evoked secretory rates can be modulated by a variety of mediators at the
      level of the enterochromaffin cells, neurons within the reflex pathway, or
      epithelial cells. Understanding the complex regulatory mechanisms for chloride
      secretion is likely to provide mechanistic insights into constipation and
      diarrhea.

PMID- 11193604
TI  - Three 5'-variant mRNAs of anion exchanger AE2 in stomach and intestine of mouse,
      rabbit, and rat.
AB  - AE2 is one of three known isoforms of the anion exchanger (AE) gene family. The
      use of alternative promoters, resulting in a tissue-specific transcript pattern,
      was reported for all AE genes. Three N-terminal variant AE2 subtypes are
      described: AE2a, AE2b, and AE2c. Although the basolaterally located parietal cell
      anion exchanger is known to be an AE2, the molecular identity of the basolateral
      and apical anion exchangers throughout the gut are still unknown. This article
      summarizes functional, immunohistochemical, and Western blot data demonstrating
      the basolateral localization of the gastric and intestinal AE2 in rabbit, mouse,
      and rat, and showing the AE2 subtype mRNA expression pattern in the stomach and
      along the intestine of rabbit and mouse: AE2a is expressed in all studied
      tissues, but most strongly in the colon; AE2b is expressed mainly in the stomach;
      and AE2c is detected nearly exclusively in the stomach. Further investigation is
      necessary to characterize the apical anion transport protein involved in NaCl
      absorption and HCO3- secretion in the gut.

PMID- 11193605
TI  - Differential regulation of ENaC by aldosterone in rat early and late distal
      colon.

PMID- 11193606
TI  - Epithelial phosphate transporters in small ruminants.

PMID- 11193607
TI  - Inflammatory mediators influencing submucosal secretory reflexes.

PMID- 11193608
TI  - The role of the OIE in international trade.
AB  - The OIE (Office International des Epizooties), the world animal health
      organization, has been addressing the most serious animal diseases throughout the
      globe for the past 75 years. It has developed guidelines for safe international
      trade in animals and animal products as part of its original mandate. Since the
      establishment of the World Trade Organization and the Sanitary and Phytosanitary
      Agreement, the role for the OIE has changed. At this point in the history of the
      OIE, new demands, expectations and challenges lie ahead as the OIE faces a new
      role in international trade.

PMID- 11193610
TI  - A Swedish/European view of bioterrorism.
AB  - Bioterrorism includes possible use of Weapons of Mass Destruction (WMD),
      preferably biological agents, by non-state terrorist groups as well as criminal
      clusters. The threat from terrorists to utilize biological agents to achieve
      goals is not new, but the threshold to realize the threats seems to be lower than
      previously expected. It can be argued that as targets for bioterrorism Sweden and
      Europe are less likely than is the U.S. However, with the collapse of the former
      Soviet Union heavy mafia-based groups have emerged in Russia with the intent to
      obtain and trade material and utilities for the creation of WMD. Such activities
      are reaching far beyond the borders and can thus be found in Sweden as well as
      the other countries of Europe. This together with the fact that groups of
      different shades of political opinion can come in open conflict in the most
      unexpected countries of Europe have given bioterrorism a face in Sweden, as well
      as in the rest of Europe.

PMID- 11193609
TI  - Cryptosporidiosis. A global challenge.
AB  - During the last 30 years, our concept of cryptosporidiosis has changed from that
      of a rare, largely asymptomatic disease, to an important cause of diarrhea in
      animals and humans worldwide. Significant disease first appeared in cattle.
      Subsequently, the zoonotic danger of the organism was recognized in HIV-infected
      persons and young children. Cryptosporidium are now ubiquitous and disease has
      been described in over 79 host species. Cryptosporidiosis has become a major
      cause of calfhood diarrhea worldwide. In humans it accounts for up to 20% of all
      cases of childhood diarrhea in developing countries and is a potentially fatal
      complication of AIDS. Waterborne contamination is a growing concern as a source
      of widespread outbreaks of disease. Factors that have contributed to the
      emergence of cryptosporidiosis in animals include biological features of the
      organism, the lack of an effective treatment or preventative, increased
      environmental contamination, and trends in livestock production. In humans the
      zoonotic nature of infection and an increased at-risk population have contributed
      to disease. Genetic characterization of Cryptosporidium, improved detection
      methods, and a better understanding of the factors that predispose to disease are
      important contributions to understanding the epidemiology of cryptosporidiosis.

PMID- 11193611
TI  - Response to bio-terrorism directed against animals.
AB  - The Animal and Plant Health Inspection Service (APHIS) has a long history of
      rapid direction, control, and eradication of devastating diseases. Our immediate
      response mechanisms to diseases such as avian influenza, Venezuelan equine
      encephalomyelitis, and Newcastle disease, have long been recognized by the global
      emergency response community as models of control and eradication. APHIS and the
      U.S. livestock industries, in partnership with the Animal Agriculture Coalition,
      re-evaluated the Nation's animal health emergency preparedness and response
      systems. The group identified areas that negatively impact, biologically and/or
      economically, the Nation's animal and food production industries. To counter the
      increased risks including bioterrorism, APHIS plans to establish a world-class
      "Center of Excellence for Animal Health Emergency Management." APHIS,
      Intelligence agencies, other Federal departments, State governments, and
      industries are working together to provide accurate information on the foreign
      and domestic threats posed to the U.S. agricultural sector by biological weapons.
      Additionally, the same agencies and organizations are evaluating, updating, and
      improving the coordination and training mechanisms necessary to respond in the
      even of a widespread pest or disease outbreak.

PMID- 11193612
TI  - Mitigation of bioterrorist threats in the 21st century.
AB  - There is a raising level of awareness and concern that agriculture and food
      supplies might serve as targets for bioterrorists. To minimize such threats a
      number of new initiates are urgently needed: 1. Greater levels of financial
      commitment from federal, state, and international organizations for research on
      highly infectious diseases and for emergency response infrastructure; 2.
      Wellorchestrated emergency response plans based on inter-agency, inter
      departmental and stakeholder working groups; 3. Teams prepared for risk
      assessment and risk communication; 4. Modern systems of animal identification and
      accurate trace-back for animal movement; 5. Increased biosecurity in intensive
      production operations; 6. Accurate intelligence as to what pathogens pose the
      highest risks for economic and social impact; 7. Establishment of new
      international animal and plant disease research networks and partnerships; 8.
      Strengthen international disease surveillance networks for early detection and
      intervention; 9. New generations of rapid diagnostic tests for pathogen detection
      that are practical for field and diagnostic laboratories; 10. Increased level of
      commitment to pathogen genomics research for molecular epidemiology and vaccine
      development; 11. New chemical and immunological intervention strategies to
      prevent or control disease outbreaks; 12. Increased level of training on exotic
      and emerging animal diseases in basic veterinary education and through continuing
      education for veterinarians, state and federal field personnel and laboratory
      diagnosticians.

PMID- 11193613
TI  - The role of diagnostic laboratories in disease control.
AB  - Recognition of disease is the foundation of disease control and prevention. In
      the process of disease recognition, the diagnostic laboratory forms the third
      (and last level) following the animal owner and the practitioner. The
      diagnostician's main role is determination of disease etiology. Secondary but
      equally important roles played by the diagnostic laboratory include: 1)
      consultative/advisory role; 2) interpretative role; and 3) disease surveillance
      role. This presentation will discuss these various roles and the interactions of
      the diagnostic laboratory with other players in the process of disease
      recognition.

PMID- 11193614
TI  - The role of the World Reference Laboratories for Foot-and-Mouth Disease and for
      Rinderpest.
AB  - The World Reference Laboratories for Foot-and-Mouth Disease and for Rinderpest
      provide a worldwide diagnostic and surveillance service for these disease for FAO
      and OIE. Both laboratories are housed within the high security facility of the
      Institute for Animal Health, Pirbright, UK. Foot-and-mouth disease (FMD) and
      rinderpest (RP) are OIE List A diseases and historically have caused huge losses
      to agricultural economies around the world, prompting the establishment of
      veterinary colleges in Europe and environmentally controversial control programs
      in Africa. FMD and RP have now been geographically restricted, but the large
      legal and illegal world trade in live animals and animal products constantly
      threatens to allow them to spread back into disease-free areas. The Reference
      Laboratories provide a center of excellence for the development of improved
      diagnostic techniques and a repository of isolates collected over many years.
      These libraries provide material for investigations of the molecular epidemiology
      and evolution of the viruses and a data base against which new isolates can be
      compared. Thus it is possible to individually characterize new outbreak strains,
      identify their likely origin and provide the most up-to-date support for their
      control.

PMID- 11193615
TI  - Development, testing and commercialization of a new brucellosis vaccine for
      cattle.
AB  - Vaccines used against brucellosis do not generally protect completely against
      infection or abortion. Genetic analysis has revealed differences in arrangements
      of DNA sequences between these vaccine strains and the virulent parent strain and
      permits the specific identification of field isolates of B. abortus as wild-type
      or vaccine strain. B. abortus strain 19 is a low-virulence, live vaccine
      developed for use in cattle. Although it is effective, strain 19 vaccine had a
      tropism for the placenta and caused abortion when given to pregnant cows, was
      infectious for humans, and caused serologic responses in calves that could not be
      differentiated from those in cattle infected with natural field strains. In the
      mid-1980s the need for a new vaccine emerged when the USDA increased its efforts
      in brucellosis eradication. In the 1990s, research on biosafety, vaccine efficacy
      and field application rapidly established the fact that strain RB51 is protective
      in cattle at doses comparable to those of strain 19. Thus, Brucella abortus
      strain RB51 is the vaccine of choice against brucellosis of cattle in the United
      States. Studies have established the relative efficacy of strain RB51 vaccine on
      bison, and the vaccine has also been accepted for use in commercial bison herds
      in the U.S.

PMID- 11193616
TI  - Culture-derived parasites in vaccination of cattle against tick-borne diseases.
AB  - The major economically important tick-borne diseases of cattle are theileriosis,
      babesiosis, anaplasmosis, and cowdriosis. Culture-derived attenuated schizonts of
      Theileria annulata have proved to be safe for all types of cattle and they
      protect against tick-borne theileriosis. T. parva was also successfully grown in
      vitro; however, inoculation of cattle with allogeneic schizont-infected cells
      resulted in rejection and destruction of the parasites together with the host
      cells. The number of schizont-infected cells needed for immunization is greater
      than for T. annulata theileriosis. Culture-propagated Babesia bovis and B.
      bigemina were used for large scale vaccination in the field. An avirulent
      population of Babesia spp. was obtained by in vitro cloning; inoculation of
      cattle did not induce clinical babesiosis, but produced specific antibodies.
      Culture-derived exoantigens of Babesia spp. proved to be completely safe for
      cattle, however, they conferred less protection than live parasites. Cell
      cultured Cowdria ruminantium was highly infective for susceptible animals but,
      attenuated in vitro, could offer a potential source for vaccination. Anaplasma
      marginale, successfully grown in tick cell culture, may be developed for
      vaccines. Factors that should be considered in the developing of vaccines against
      tick-borne diseases include: the protective immune response to the pathogenic
      parasite developmental stages, virulence, immunological strain differences, and
      antigenic variations in cattle and in culture.

PMID- 11193617
TI  - Biocontrol of ticks.
AB  - The increasing resistance of arthropodes to pesticides, their high price, and the
      growing public demand for safer food and a cleaner environment are obliging
      animal growers to minimize the use of pesticides by introducing alternative means
      for tick control. The development of a biological tick control method has been
      neglected as compared to the control of plant pests or dipterous insects harmful
      to men and animals. There are abundant observations, but only a few studies have
      as yet been conducted on pathogens, parasitoides, and predators of ticks. A first
      attempt at tick biocontrol was made with the introduction of tick-parasitic wasps
      from France to the USA and Russia. During the past decade, interest in developing
      antitick biocontrol agents such as birds (Brazil, Kenya, and Zimbabwe),
      parasitoides (Kenya and USA), entomopathogenic nematodes (Egypt, Israel,
      Guadeloupe, and USA), entomopathogenic fungi (Brazil, Cuba, Israel, Kenya, and
      USA), and bacteria (Brazil) has gained momentum. The reintroduction of oxpecker
      birds in some areas of Zimbabwe remains up to now the only known successful
      attempt at tick biocontrol.

PMID- 11193618
TI  - Eradication and surveillance of the tropical bont tick in the Caribbean. An
      international approach.
AB  - The Caribbean Amblyomma program (CAP) is a multidonor funded effort involving
      several technical organizations and national governments in the eradication of
      the tropical bont tick. The Food and Agriculture Organization (FAO) is the lead
      technical agency, providing both technical and administrative support to the CAP
      Regional Coordination Unit (RCU) based in Barbados. All collaborating agencies,
      donors, and national representatives are members of the Amblyomma Program Council
      (APC), the overall governing body of the CAP. In addition to FAO, the other
      organizations involved are the Caribbean Community (CARICOM), the European Union
      (EU), the Inter-American Institute for Cooperation on Agriculture (IICA), the
      International Fund for Agricultural Development (IFAD), and the United States
      Department of Agriculture (USDA). Several agencies (EU, FAO, IFAD, and USDA) are
      also major donors. The CAP cooperates with the complementary Plan POSEIDOM
      Veterinaire Program in the French West Indies. The University of the West Indies
      (UWI), the International Institute for Biological Control (IIBC), and the
      Departement d'Elevage et de Medecine Veterinaire des Pays Tropicaux (EM-VT) in
      Guadeloupe are other collaborators.

PMID- 11193619
TI  - World Trade, disease and Florida's animal populations. The changing dynamics.
AB  - One of Florida's three leading economic industries is agriculture. Agriculture
      feeds and enhances the lives of millions of people in Florida, the United States,
      and the entire world. Agriculture in Florida results in more than $6 billion in
      farm cash receipts, employment for more than 60,000 people a month, more than $18
      billion in farm-related economic activity and stretches from the farm gate to the
      state's supermarkets with an impact of nearly $45 billion. The domestic and wild
      animal populations of Florida, our unique relationship to the Caribbean, Atlantic
      Ocean, Gulf of Mexico, Central and South America, as well as tourism, diverse
      human population growth and immigration, all add to the complexity of an
      environment capable of establishing many animals, animal pests and diseases not
      native to the United States. Never before have the dynamics of disease control
      involved as much challenge and diversity. Is the balance at risk, or is the risk
      over-balanced? Can science, economics and politics blend to maintain this
      balance? How will the balance affect world trade, disease control and the animal
      populations of Florida?

PMID- 11193620
TI  - Screwworm eradication in the Americas.
AB  - The screwworm fly, Cochliomyia hominivorax (Coquerel), is a parasite that attacks
      all warm-blooded animals including humans. This parasite has caused significant
      losses to the livestock industries of the Americas. Since the screwworm
      eradication program was initiated in the Southeastern United States in 1957, the
      eradication program has successfully progressed to its current location in
      Panama. A variety of technologies and tools have been used in the eradication
      programs. The cooperative agreement has been a significant tool in the success of
      the program. In the United States, the State-Federal Cooperative programs
      provided the mechanism for carrying out screwworm eradication. Once screwworms
      were eradicated from the United States, the need to expand the program
      internationally, in order to protect the United States, became evident. A
      cooperative agreement created the Mexico-United States Commission for the
      Eradication of Screwworms (Commission). Commission-Guatemala and Commission
      Belize Cooperative Agreements were used to eradicate screwworms from these
      countries. Followup programs in El Salvador, Honduras, Nicaragua, Costa Rica, and
      Panama were implemented by cooperative agreements between the United States
      Department of Agriculture and the individual countries. The positive and negative
      aspects, as well as the necessary elements of successful cooperative agreements,
      are discussed.

PMID- 11193621
TI  - International approach to eradication and surveillance for foot-and-mouth disease
      in the Americas.
AB  - Foot-and-mouth disease (FMD) was introduced into the Americas in 1870. At that
      time the disease was described simultaneously in the North coast of the United
      States of North America, the Province of Buenos Aires in Argentina, the central
      region of Chile, Uruguay, and South Brazil. At the beginning of the twentieth
      century the disease spread to the rest of Brazil, Bolivia, Paraguay, and Peru. In
      1950 the disease was introduced into Venezuela, and in the same year to Colombia,
      and from there to Ecuador. The United States of America eradicated an outbreak of
      FMD in 1929. Outbreaks of FMD were also eradicated from Mexico in 1947 and from
      Canada in 1952. The last outbreak that occurred in Mexico in 1954 was also
      eradicated. In 1951 the Americas Animal Health Authorities decided to establish a
      Pan-American Foot-and-Mouth Disease Center (PANAFTOSA), initially as a special
      program within the American States Organization (OAS). The center was later
      transferred to the Pan-American Health Organization (PAHO). In the early 1970s
      PANAFTOSA developed a proposal for a continental surveillance system for
      vesicular diseases, which was approved by Agriculture Ministers at an
      International Meeting for FMD and Zoonoses (RICAZ). Since then, PANAFTOSA
      dedicated all efforts to collaborate with each country in the implementation of
      the system and to receive, analyze, and distribute a weekly report of vesicular
      diseases. The model was elaborated using coordinate grid maps, one for the South
      American Continent, others for each country in the region. The reports from each
      country consist of the grid location for any suspicious outbreak of vesicular
      disease. Using the information gathered during visits to the countries, as well
      as weekly reports, and by studying the most frequent animal movements within the
      region, PANAFTOSA developed a proposal for FMD eradication. This plan was
      approved by the Government of South America and implemented in cooperation with
      PANAFTOSA. The hemispheric plan for FMD eradication (PHEFA), has been implemented
      and today Chile and Uruguay are FMD free without vaccination; Argentina,
      Paraguay, and the states of Rio Grande do Sul and Santa Catarina in Brazil are
      also recognized by the OIE to be FMD Free, with vaccination. The use of the
      continental surveillance system is the main strategy for achieving the
      eradication of FMD in South America. At this time PANAFTOSA is working to improve
      the system, and to add other diseases indicated by the governments of the
      Americas.

PMID- 11193622
TI  - Animal trypanosomiasis in South America. Current status, partnership, and
      information technology.
AB  - Animal trypanosome species of economical importance in South America include T.
      vivax and T. evansi. Both species are described in Brazil, Bolivia, Colombia,
      French Guyana, Peru, Suriname, and Venezuela. In Argentina and Guyana, only T.
      evansi and T. vivax are found, respectively. Our studies on T. vivax indicated
      that the parasite was spreading around 1.3 km per day in Bolivia. We found severe
      leukopenia in bovines from Pantanal (Brazil) and the Department of Santa Cruz
      (Bolivia). Because it can cause immunosuppression, the importance of
      trypanosomiasis control in ensuring success of vaccination campaigns against foot
      and mouth disease (FMD) in the Pantanal and Bolivia should be considered. The use
      of one needle for several animals during FMD campaigns in Brazil and Bolivia
      could also contribute to the spread of T. vivax. The anticipated losses due to T.
      vivax could exceed $160 million, assuming there are 11 million head of cattle in
      the Brazilian Pantanal and Bolivian lowlands. International collaboration among
      research institutes is needed to deal with these diseases and parasites. Previous
      efforts using information technologies resulted in the creation of two discussion
      lists (Tryplink and Trypan), the edition of the on-line version of Trypnews and
      Internet conferences.

PMID- 11193623
TI  - An international approach to laboratory diagnosis of animal diseases.
AB  - During the past thirteen years, and as part of an overall support program for
      developing countries, the Joint FAO/IAEA Division has developed a series of
      standardized and internationally validated ELISA-based systems for the diagnosis
      and surveillance of the major epizootics affecting livestock in the developing
      world. Linked to comprehensive internal and external quality assurance protocols
      and to the use of standardized equipment and data management software, veterinary
      laboratories in many developing countries are now able to provide quality assured
      results on the prevalence of the major diseases affecting their livestock. This
      internationally standardized approach can rapidly enable developing countries to
      both monitor the effectiveness of their disease control and eradication programs
      and to meet requirements for international disease status recognition and for
      trade in livestock and livestock products.

PMID- 11193624
TI  - Assessing infestation risk by vectors. Spatial and temporal distribution of
      African ticks at the scale of a landscape.
AB  - Control of major livestock diseases in the tropics, such as theileriosis or
      trypanosomosis, is still largely based on the control of their vectors.
      Understanding the distribution of vectors, such as ticks and tsetse flies, is
      needed in order to improve the efficiency and economical viability of control
      operations. Technical improvements such as remote sensing and global information
      systems have allowed valuable improvements for the prediction of large-scale
      vector distribution (continental to national), but trying to make these
      predictions at the scale of a landscape is facing other challenges. At this
      scale, an analysis of host/vector interactions with an evolutionary point of view
      is useful. A study was undertaken on a mixed game/cattle ranch in Zimbabwe during
      which we monitored variations in the abundance and spatial distribution of the
      immature free stages of Rhipicephalus appendiculatus/R. zambeziensis and R. e.
      evertsi, two major groups of tick species in Southern Africa. We found two
      contrasting distributions in relation to contact between tick larvae. The
      ungulate-host R. e. evertsi appeared to be unpredictable, whereas R.
      appendiculatus/R. zambeziensis were predictable in time and space, but associated
      with key-resources for ungulates (water and forage resources). The consequences
      of such distributions are discussed in terms of vector control.

PMID- 11193625
TI  - An in vivo model to investigate lymphocyte-mediated immunity during acute
      hemoparasitic infections. Use of a monoclonal antibody to selectively deplete
      CD4+ T lymphocytes from thymectomized calves.
AB  - Thymectomized calves were selectively depleted of CD4+ T lymphocytes with a
      monoclonal antibody (mAb) specific for the bovine CD4 monomer (ILA-11). Calves
      were treated with high loading doses of ILA-11 during the first week of the study
      then treated with subsequent lower maintenance doses. Depletion of CD4+ T
      lymphocytes was assessed weekly by flow cytometric analysis of PBMC and
      mononuclear cells from lymph node and spleen biopsies. Treatment with high doses
      of ILA-11 resulted in rapid and marked depletion of CD4+ T lymphocytes from the
      peripheral blood, peripheral lymph nodes, and spleen. Although CD4+ T lymphocytes
      slowly returned to the peripheral blood, peripheral lymph nodes, and spleen by
      day 21 post-treatment, the numbers of CD4+ T lymphocytes in depleted calves
      remained below pre-depletion levels for the duration of the study. CD4+ T
      lymphocytes failed to be effectively depleted from a non-thymectomized calf
      treated with the mAb ILA-11. Development of a T lymphocyte depletion model in
      thymectomized calves will permit testing of the hypothesis that CD4+ T
      lymphocytes and IFN-gamma are required in cattle for control of acute
      anaplasmosis. In subsequent planned studies, thymectomized calves depleted of
      CD4+ T lymphocytes will be experimentally infected with A. marginale and
      parameters of disease compared between depleted and non-depleted calves.

PMID- 11193626
TI  - Challenges of non-tsetse transmitted animal trypanosomoses (NTTAT). An outline
      and some perspectives.
AB  - Non-tsetse transmitted animal Trypanosomoses (NTTAT) result from infection by
      Trypanosoma evansi, T. equiprdum, and T. vivax. The latter is present both in
      South America and in tsetse depopulated areas of Africa. Since the inception of
      the OIE group, numerous studies have been carried out to result in a better
      understanding of this infection and hope for immunological control.

PMID- 11193627
TI  - Protecting health, facilitating trade, or both?
AB  - The General Agreement on Tariffs and Trade (GATT) has existed and dealt with
      trade issues since 1947. However, to take on the question of to what extent can
      we set fair and science-based rules allowing countries to have the sovereign
      right to set measures for protecting public, animal and plant health and food
      safety, while not creating unjustified barriers to trade was the challenge of the
      Uruguay Round negotiators. The outcome of this seven-year exercise was the SPS
      Agreement discussed here. A number of key issues are addressed: transparency
      including notification, special and differential treatment for developing
      countries, harmonization, equivalence, regionalization, risk analysis, and other
      matters. Early warning and exposure of these issues has encouraged countries to
      resolve their problems quickly. Some of the issues that should be taken into
      consideration during this next round are the following: biotechnology,
      aquaculture, consumer concerns, animal welfare, the environment, organic foods,
      morality in trade, compliance with the WTO, compensation, and the precautionary
      principle. Compliance with the decision of the WTO is an area of grave concern,
      especially if developed and powerful countries continue to threaten the survival
      of the WTO system through lengthy and costly legal interpretations and appeals of
      dispute settlements without serious efforts by all parties to find win-win
      solutions. In spite of these problems, over all we must recognize the significant
      gains in trade thanks to the SPS Agreement. The most flagrant trade violations
      have been eliminated as a result of improved transparency in the process.
      Consumers are in general better off, since they have greater diversity and
      increased safety in what they can buy.

PMID- 11193628
TI  - Rapid recovery and identification of anthrax bacteria from the environment.
AB  - Bacillus anthracis has been recognized as a highly likely biological warfare or
      terrorist agent. We have designed culture techniques to rapidly isolate and
      identify "live" anthrax from suspected environmental release. A special medium
      (3AT medium) allows for discrimination between closely related bacilli and non
      pathogenic strains. Nitrate was found to be a primary factor influencing spore
      formation in Bacillus anthracis. Nitrate reduction in anthrax is not an
      adaptation to saprophytic environmental existence, but it is a signal to enhance
      environmental survival upon the death of the anthrax host, which can be mimicked
      in culture.

PMID- 11193629
TI  - Future perspectives on veterinary hemoparasite research in the tropics at the
      start of this century.
AB  - This paper has two main objectives: (1) to promote discussion about the future of
      veterinary hemoparasite research at the start of the twenty-first century and the
      third millennium, and (2) to stimulate young students to start research on
      parasitology, in particular in the field of veterinary tropical diseases. It is
      well known that in the twenty-first century human society will be challenged by
      several major problems resulting from the demographic explosion, since the
      Earth's population for the year 2020 will reach 8.5 billion, or 10 billion for
      the year 2050, as long as the birth rate decreases from 2.8 births per woman
      today to 2.0 by the year 2030 (data released by the U.N. Population Fund, 1998).
      Since the food production rate, either from plant or animal origin, is lower than
      the human birth rate, the challenge ahead will be to produce enough food for ten
      billion people. Consequently, to deal with this problem, especially in developing
      nations, it is proposed: (1) to give priority status to scientific research in
      the agriculture and animal fields; (2) to concentrate financial support and
      efforts for research especially on hemoparasitic diseases (i.e., babesiosis,
      anaplasmosis, cowdriosis, ehrlichiosis, and trypanosomosis), in particular to
      apply biotechnology techniques to those animal diseases; and (3) to grant a
      better role to studies on veterinary and medical parasitology in universities of
      the Americas and Europe, since in these universities parasitology is currently
      considered a secondary subject.

PMID- 11193630
TI  - Ethnoveterinary medicine and indigenous pharmacopoeia of Passore Province in
      Burkina Faso.
AB  - A study of traditional animal health care practices in Passore province of
      Burkina Faso led to the characterization of 24 diseases, together with their
      local names, causes of their appearance, and their treatment. Most (95%) of the
      medicinal recipes used to treat affected animals were based on plants.

PMID- 11193631
TI  - The epidemiology of Theileria parva infections on smallholder dairy farms in
      Kenya.
AB  - The purpose of the study was to characterize the differences in epidemiology
      (risks of infection, morbidity, mortality) and potential control of East Coast
      fever (ECF) between the selected strata. Evidence of Theileria parva infection
      was assessed by increased antibody levels as measured in an indirect ELISA test
      by the percent positivity (PP) of serum samples relative to a strong positive
      reference serum. A prospective cohort study was conducted in five purposively
      sampled agroecological zone (AEZ)-grazing system strata in Murang'a District,
      Kenya, between March 1995 and June 1996. The study strata were selected to
      represent the widest range of ECF risks in the district and included, zero
      grazing and open-grazing farms in the Upper Midlands (UM) one and four AEZs and
      zero-grazing farms in the UM2 AEZ. In total, 225 calves from 188 smallholder
      farms were examined from birth to age six months. Calves were recruited into the
      study at birth and visited within the first two weeks of life and thereafter at
      biweekly intervals for up to 14 visits. Important differences were observed
      between the different AEZ-grazing strata. Seroconversion risks of T. parva were
      highest in the UM4-open grazing stratum. Antibody prevalence in adult cattle and
      ECF morbidity and mortality risks were also highest in this stratum. In the open
      grazing strata, particularly in the lower elevation AEZ, UM4, there was stronger
      challenge and a greater impact of ECF. There is likely to be an expansion of
      smallholder dairy farming into this area so that it is likely to be the most
      important target production system for ECF control in the central highlands of
      Kenya.

PMID- 11193632
TI  - Phylogenetic analysis by rRNA comparison of the highly pathogenic sheep-infecting
      parasites Theileria lestoquardi and a Theileria species identified in China.
AB  - In the Northwestern part of China there have been reports of clinical cases in
      small ruminants of a haemoparasite with the characteristics of Theileria hirci
      (T. lestoquardi). However, some properties of this parasites argue against its
      classification as T. lestoquardi. In this paper, we present evidence that T.
      lestoquardi and the Chinese Theileria isolate are distinct parasite species.
      Phylogenetic analysis of determined nucleotide sequences of small subunit
      ribosomal RNA (srRNA) genes of T. lestoquardi and the Chinese Theileria parasite
      show that they belong to different clades within the phylogenetic tree of
      piroplasms. The srRNA sequence of the Chinese parasite was found to be most
      closely related to T. buffeli, which, with T. sergenti, belongs to an
      evolutionary lineage of non-lymphoproliferative Theileria species. On the other
      hand, it was clearly divergent to a lineage of lymphoproliferative Theileria
      species; T. annulata, T. parva, T. taurotragi, and T. lestoquardi, the latter
      being most closely related to T. annulata.

PMID- 11193633
TI  - Lymphocyte stimulatory capacity of Theileria annulata-infected ovine
      lymphoblastoid cells.
AB  - T. annulata, the causative agent of tropical theileriosis in cattle, is
      transmitted by ticks of the genus Hyalomma. Sporozoites of this parasite invade
      their target cells, where they differentiate to macroschizonts. T. annulata
      additionally invades and transforms ovine and caprine leukocytes. T. annulata
      infection in the ovine system is poorly studied, thus we used a mixed lymphocyte
      culture (MLC) to analyze the capacity of these cells to activate naive uninfected
      ovine cells. The peak response was observed on day three or four and the response
      could not be induced by lysates of infected cells or their supernatants. The
      stimulated cells expressed IL-2 and secreted an IL-2-like growth factor.

PMID- 11193634
TI  - Humoral immune response of dogs immunized with salivary gland, midgut, or
      repeated infestations with Rhipicephalus sanguineus.
AB  - The antibody (Ab) responses of dogs immunized with adult tick salivary gland
      (TSG), midgut (TMG), or repeated infestations of Rhipicephalus sanguineus were
      monitored to determine if there is an association between Ab production and R.
      sanguineus performance. Tick-naive dogs were immunized with TSG or TMG and
      subjected to two challenge infestations. The control group was infested five
      times at 21-day intervals. The ELISA technique was used to measure Ab levels in
      sera from these dogs, which expressed different forms of resistance against R.
      sanguineus. In dogs immunized with TSG or TMG, similar Ab levels were detected
      against TMG, TSG, muscle, synganglion, and reproductive organs. However, these
      sera had different Ab levels against egg mass, unfed larvae, fed larvae, and
      nymph antigens. Ab levels to muscle, nerve, and reproductive antigens were lower
      than those observed when TMG or TSG antigens were used. Sera from dogs immunized
      with TMG or TSG responded to most tick stages or tissue antigens, whereas
      repeated infestation sera showed the lowest response among the three groups.

PMID- 11193635
TI  - Ticks associated with wild animals in the Nhecolandia Pantanal, Brazil.
AB  - A study of ticks associated with wild animals was carried out from September 1996
      to April 1998 at the Fazenda Alegria (21,000 ha), in the Nhecolandia Pantanal,
      State of Mato Grosso do Sul, Brazil, a sunken plain bordering the upper Paraguay
      river, located 19 x 08'S; 56 x 46'W. A total of 81 wild animals (13 species, 6
      orders) were captured with the aid of nets, and ticks were found on 63 (78%).
      Tick species identified included Boophilus microplus (Canestrini), Amblyomma
      cajennense (F.), A. parvum (Aragao), A pseudoconcolor (Aragao), A. scalpturatum
      (Neumann), A. nodosum (Neumann), A. ovale (Koch), and A. tigrinum (Koch).
      Dragging from grasslands (campos) yielded negative results compared to the high
      concentration of ticks, mainly nymphs, that were collected from leaves in the
      forests (capao). Predominance of immature instars (Amblyomma genera) was observed
      in the end of winter (August-September). Ticks were associated mainly with
      coatis, deer (Mazama gouazoubira) and anteater, and these animals may play a role
      in the epidemiology of tick-transmitted pathogens in the Pantanal if one
      considers their co-existence with local domestic animals.

PMID- 11193636
TI  - Thermal constant estimation in tropical horse tick, Anocentor nitens
      (Acari:Ixodidae).
AB  - Experience has demonstrated that the exclusive use of acaricides as a control
      method against cattle ticks causes several problems, and is not totally
      effective. Other methods need to be added in order to achieve better and more
      profitable control of these parasites. Groups of 12 to 15 engorged ticks, bred on
      bovines, were individually incubated at six temperatures (T = 24, 26, 28, 30, 32,
      and 34 degrees C) and four relatives humidities (RH = 100, 80, 75.5, and 70%),
      creating 24 variants. The onset of oviposition and eclosion (emergence of larvae
      from eggs) was observed in all ticks, and preeclosion times (PET) were
      determined. A linear regression equation for the velocity of development with
      temperature as a function of the inverse of PET was calculated for each RH value.
      For each RH the minimum thermal threshold (MTT) was obtained by extrapolation and
      the effective temperature summation (ETS) calculated from the equation
      (incubation temperature--MTT) x PET. The four MTT values obtained were not
      significantly different; the mean value of MTT was 15.25 degrees C. The thermal
      constants did not prove to be not statistically different over the range of RH
      values employed in the experiments, the mean being 354.04 degrees C-day.

PMID- 11193637
TI  - Laboratory evaluation of pathogenicity of entomogenous nematodes to African tick
      species.
AB  - Five strains of entomogenous nematodes, Steinernema carpocapsae strains DD,
      Mexican, SR, and Heterorhabditis bacteriophora strains 1S5 and HP88, were tested
      for their pathogenicity to various developmental stages of five African tick
      species namely; Rhipicephalus appendiculatus, R. evertsi, Amblyomma variegatum,
      A. gemma, and Boophilus decoloratus. In engorged female R. appendiculatus, all
      nematodes at a concentration of 1,000 infective juveniles (IJ)/dish, except S.
      carpocapsae Mexican strain, induced high mortalities (56-100%), whereas in
      engorged female R. evertsi, only S. carpocapsae DD and H. bacteriophora HP88
      induced high mortalities (78% and 56%, respectively). In engorged B. decoloratus,
      S. carpocapsae DD, Mexican, SR and H. bacteriophora HP88 (100 IJ/dish) induced
      mortalities of 85%, 65%, 80%, and 100%, respectively. In all cases, except for S.
      carpocapsae Mexican strain, a higher concentration (5,000 IJ/dish) did not result
      in higher mortality than occurred with 1,000 IJ/dish. Unfed females and immature
      stages of ticks were found to be generally resistant to the nematodes. The
      feasibility of using entomogenous nematodes for biological control of African
      tick species are briefly discussed.

PMID- 11193640
TI  - Artificial feeding in Boophilus microplus (Acari:Ixodidae) through micropipettes.
AB  - Newly molted Boophilus microplus females obtained in a laboratory at 30 degrees C
      and environmental relative humidity (RH) were employed. An original device was
      used to hold ticks during feeding. Three groups of 15 ticks each were created:
      unfed, fed with heparinized blood, and fed with defibrinated blood. Ticks were
      weighed before and after feeding. Females were restricted by group in three
      isolators attached on the skin of a bovine. Ten sexually competent males were
      added to each isolator. Time of coupling, tick mortality, time of detachment, and
      weight of engorged ticks were determined. Engorged females were incubated at 30
      degrees C and 100% RH. Periods of nonparasitic phase, laying efficiency, and
      fertility of eggs were noted. There were no statistical differences between the
      three groups. This means that feeding with micropipettes does not affect the non
      parasitic phase of B. microplus, the differences between heparinized and
      defibrinated blood are not significant.

PMID- 11193638
TI  - Larval survival of Anocentor nitens under simulated natural conditions.
AB  - Basic knowledge about the survival of free living stages of ticks is of great
      importance as a practical tool to improve control methods. For Anocentor nitens
      there is little information on this subject. Eighty-four engorged females were
      incubated at 30 degrees C and 100% relative humidity. After 17 days, groups of
      5,500 eggs each were collected and isolated in vials. Age zero was defined as 10
      days after eclosion had begun. At this time vials with larvae were attached to 40
      Sorghum halepense plants sowed in clay pots, under outdoor conditions, and
      separated from one another by 30 cm in order to prevent the larvae from mixing.
      Four hours later vials were retired and the larvae remaining in the vials were
      counted. The next day four plants were sampled and this survival considered as
      100%. Each week for eight weeks the same sampling procedure was performed. The
      remaining four plants were used to determine the maximum larval survival (MLS).
      Four repetitions of the procedure were performed, two in March 1989 and two in
      September 1989.

PMID- 11193639
TI  - International trade. Multinational aspects.
AB  - Of numerous regional economic agreements, the European Union (EU), the North
      American Free Trade Agreement (NAFTA), South American Common Market (MERCOSUR),
      the Association of Southeast Asian Nations (ASEAN), the South Asian Association
      for Regional Cooperation (SAARC) and the Australia-New Zealand Closer Economic
      Relations Agreement are examples that are actively pursuing regional integration
      for freer trade of animals and animal products. The World Trade Organization
      (WTO) believes that regional and multinational integration initiatives are
      complements rather than alternatives in the pursuit of more open trade. In the
      efforts to harmonize SPS standards among multilateral trading nations, it is
      recommended that national requirements meet the standards developed by the OIE
      and the FAO/WHO Codex Alimentarius Commission as the minimum requirements rather
      than adopting the standards of the lowest common denominator. Regional grouping
      may hinder multilateral or bilateral trade between the countries of a group and
      those of the other groups. How to eliminate such non-tariff barriers as
      traditional trade custom remains to be examined. Ongoing activities of VICH
      (Harmonisation of Technical Requirements for Registration of Veterinary Medical
      Products) may pave the way for more open trade in pharmaceutical products between
      multilateral regional groups.

PMID- 11193641
TI  - Tropical bont tick (Amblyomma variegatum) eradication in the Caribbean. The St.
      Kitts experience.
AB  - The tropical bont tick (TBT) was first identified in St. Kitts in 1978.
      Initially, infestation was observed on cattle that developed a severe dermatitis.
      Over a period of seven years, the TBT spread to most areas of the island,
      affecting cattle, sheep, and goats. The ruminant livestock population declined
      from, 6,000, 9,000, and 7,000 cattle, sheep, and goats, respectively, in 1984 to
      an estimated 400, 800, and 1,000, cattle, sheep, and goats in 1990. A project to
      control the tropical bont tick on St. Kitts was implemented in 1983. This effort
      was based on the use of plunge dips located in communal grazing areas. In October
      of 1995, the Caribbean Amblyomma Programme was initiated on St. Kitts to
      eradicate the TBT from the Caribbean. In 1996, there were 416 animal owners with
      2,000, 4,300, and 4,000 cattle, sheep, and goats, respectively. Cases of
      dermatophilosis, declined from 657 in 1995 to 153 in 1996. During the period 1997
      to 1998 treatment with Flumethrin continued. The Department of Agriculture
      initiated activities for treatment compliance, monitoring, and TBT surveillance.
      The animal population increased to 3,000, 6,000, and 4,500 cattle, sheep, and
      goats, respectively, and with 810 animal owners participating. The number of
      cases of dermatophilosis declined to 42. In 1998, the TBT was confined to three
      foci. The remainder of the island was declared provisionally tick free.

PMID- 11193642
TI  - The eradication of contagious bovine pleuropneumonia from south western Africa. A
      plan for action.
AB  - Contagious bovine pleuropneumonia (CBPP) caused by the Mycoplasma mycoides
      subspecies mycoides SC is one of the major plagues affecting cattle. With the
      imminent eradication of rinderpest from Africa, CBPP will become the major
      epidemic disease on the continent, because the majority of countries in sub
      Saharan Africa have the infection in their cattle. There is an enclave of CBPP on
      the borders of Angola, Botswana, Namibia, and Zambia. There has been endemic
      infection in the cattle herds on the borders of Angola and Namibia for more than
      100 years, with irregular spread from these animals to the cattle of Botswana or
      Zambia. However, much of Angola and Namibia and all of Botswana and Zambia are
      currently free from the disease. This paper explains the origins of the problem
      and describes the current disease situation. A plan for the eradication of CBPP
      from this area is proposed and discussed. If this plan is successful it will
      release valuable resources to tackle other constraints on livestock and food
      production. Furthermore, it will act as a model for the eradication of CBPP from
      the remainder of the continent.

PMID- 11193643
TI  - At the end of the day. The socioeconomic impacts of eradicating contagious bovine
      pleuropneumonia from Botswana.
AB  - In February 1995, an outbreak of contagious bovine pleuropneumonia occurred in
      the Northwest district of Ngamiland, Botswana. The government of Botswana
      determined to eradicate the disease by depopulating the entire district of
      cattle. In total, 320,000 cattle were destroyed. Measures were put in place by
      government to mitigate the effects of eradication on the affected communities and
      household monitoring was instituted. This paper reports the major findings of the
      monitoring exercise. It is observed that although 45% of households said they
      would rely on arable cropping as a coping strategy, only 29% expected to produce
      sufficient food for themselves. Use of permanent, male agricultural labor fell by
      33%, whereas both permanent and temporary female labor increased substantially.
      Although eight out of ten respondents planned to rebuild their herds, routine
      household demands on the generally small cash compensation received suggest that
      economic recovery for many of Ngamiland's households is likely to be prolonged.
      It is recommended that relief programmes continue but with improved targeting.
      Objective indicators are needed to determine when government assistance can be
      terminated.

PMID- 11193644
TI  - Mammalian reservoirs and epidemiology of rabies diagnosed in human beings in the
      United States, 1981-1998.
AB  - Between 1981 and 1998, 37 cases of rabies were diagnosed in human beings in the
      United States. Information directly linking the cause of infection to animal bite
      was available for only eight of these cases. Indirect incrimination of the vector
      by analysis of cDNA sequences obtained by reverse transcriptase polymerase chain
      reaction of samples indicated that for all cases (12/12) believed to have been
      acquired in foreign countries, variants of the rabies virus (VRVs) associated
      with dogs (7/12 involved known bite histories) were the cause of the rabies
      infections. In contrast, VRVs associated with bats (bat-associated VRVs or BAVs)
      were implicated as the cause of 88% (22/25) of infections believed to have been
      acquired within the United States (1/22 involved known bite histories). Sequence
      analyses revealed that a single BAV (Ln/Ps), associated with rabid silver-haired
      (Lasionycteris noctivagans) and Eastern pipistrelle (Pipistrellus subflavus)
      bats, was implicated in 73% (16/22) of bat-associated infections. Silver-haired
      bats are predominantly solitary and migratory. Eastern pipistrelle bats may occur
      individually or in small clusters. Both species are only infrequently submitted
      for rabies testing. Unrecognized bites and unique properties of the Ln/Ps BAV may
      explain its association with the majority of rabies infections in human beings in
      the United States.

PMID- 11193645
TI  - Emergence of Nipah virus in Malaysia.
AB  - A pig-borne virus causing viral encephalitis amongst human beings in Malaysia was
      detected in 1997 by the Ministry of Health. Initially, the disease was considered
      to be Japanese encephalitis. Subsequently, it was thought to be a Hendra-like
      viral encephalitis, but on 10th April, 1999 the Minister of Health announced this
      mysterious and deadly virus to be a new virus named Nipah virus. The virus was
      characterized at CDC, Atlanta, Georgia. The gene sequencing of the enveloped
      virus revealed that one of the genes had 21% difference in the nucleotide
      sequence with about 8% difference in the amino acid sequence from Hendra virus
      isolated from horses in Australia in 1994. The virus was named after the village
      Nipah. In all, the Ministry of Health declared 101 human casualties, and 900,000
      pigs were culled by April, 1999. The worst affected area in Malaysia was Negri
      Sembilan. The symptoms, incubation period in human being and pigs, animal to
      human transmission, threat of disease to other livestock, and control program
      adopted in Malaysia is described.

PMID- 11193646
TI  - Evaluation of a new sandwich ELISA kit that uses serum for detection of cattle
      persistently infected with BVD virus.
AB  - Cattle immunotolerant to and persistently infected (PI) with bovine viral
      diarrhea (BVD) virus (BVDV) constitute the mechanism by which BVDV persists in
      and spreads among cattle herds. Detection and elimination of PI cattle are
      necessary for control of BVD. Serum is an excellent specimen for BVD PI testing
      because of high survivability of BVDV in serum and ease of collection, storage,
      and handling. Currently, microtiter virus isolation (VI) employing serum and
      sandwich ELISAs (S-ELISA) on tissues or leukocytes are used for BVDV PI
      screening. This paper evaluates a new S-ELISA kit that uses serum as the
      diagnostic sample. Cattle sera (n = 408) were tested using VI and the S-ELISA.
      The VI detected 172 BVDV-positive sera. Of these, 18 were confirmed PI cattle.
      The S-ELISA was positive on all PI samples. Considering only the PI animals, and
      using VI as the gold standard, the relative sensitivity of S-ELISA was 100%. The
      overall relative sensitivity was 93.6% and the agreement quotient (kappa) was
      0.94. The relative specificity of the kit, based on 236 VI-negative sera, was
      100%. These data indicate that the new kit is very adequate for detection of BVDV
      PI cattle.

PMID- 11193647
TI  - The impact of diseases on the importation of animals and animal products.
AB  - For decades the veterinary services of the United States and other nations
      protected their livestock and poultry industries from the ravages of introduced
      animal diseases by rigorous import restrictions. This policy of zero risk
      frequently translated to no or reduced trade in animals and animal products or
      dramatic trade inequities. However, GATT articles enforced by the WTO require
      that imported products be treated no less favorably than domestically produced
      goods with regard to animal health restrictions. Under authority from the WTO,
      the OIE establishes recommendations and guidelines for the regulation of trade in
      animals and products of animal origin through the OIE International Animal Health
      Code, sets animal health standards, and reports global animal health situations
      and statuses. Diseases often have a dramatic impact on the animal agricultural
      industries of a nation--disease outbreaks may be deleterious to the
      competitiveness of the products of one nation but offer opportunities for others.
      The potential dangers of lax vigilance, insufficient scientifically valid data,
      inadequate SPS measures, and errors in assessing risk can turn the heady
      experience of seemingly unlimited growth in international markets and demand for
      one's products into a catastrophic return to reality. The experience of the
      United Kingdom and countries of Europe with bovine spongiform encephalopathy is a
      case in point. It is estimated that the cost of the outbreak of this disease to
      the economy of the UK has been more than $3 billion. Responses of their trading
      partners, including the US, to this outbreak were abrupt and restrictive.
      Although the decision was controversial, the US stopped importation of live
      cattle from the UK in the late 1980's and subsequently, in 1997, importation of
      all products of ruminant origin was stopped from all countries of Europe. The
      transmission of the disease to continental Europe and the disclosure that the
      pathogen was associated with a fatal human illness, rocked consumer confidence in
      the safety of the UK beef supply, brought down the ruling political party in the
      UK, and forced major changes in the beef industry.

PMID- 11193648
TI  - Comparison between c-ELISA and CFT in detecting antibodies to Mycoplasma mycoides
      mycoides biotype SC in cattle affected by CBPP in Botswana.
AB  - Contagious bovine pleuropneumonia (CBPP), caused by Mycoplasma mycoides mycoides
      biotype small colony (SC) (MmmSC) appears to be making a serious comeback in
      Africa after successful control programs in many parts of the continent during
      the 1960s and 1970s. Botswana, a country that has been free from the disease for
      more than 50 years, was affected in 1995. An eradication policy was adopted by
      the Government of Botswana in which 320,000 cattle in the affected district of
      Ngamiland, Northwestern Botswana were slaughtered. This was followed by a
      restocking exercise in which 70,000 cattle were sent to the outbreak areas as
      replacement stock. It became necessary to carry out serosurveillance in order to
      ensure that the disease did not reenter Botswana and to ensure that the
      replacement stock remained free from the disease. The specificity and sensitivity
      of the complement fixation test (CFT) in Botswana was assessed in 82 cattle
      affected by the disease and held in a double fenced quarantine camp. The newly
      developed competitive ELISA was made available to the National Veterinary
      Laboratory (NVL) through the FAO/IAEA Joint Division in Vienna, Austria. Using
      postmortem lesions as the gold standard and a 2 x 2 contingency table, the two
      tests were compared in terms of their sensitivity and specificity in detecting
      antibodies to MmmSC. The CFT was found to be slightly more sensitive than the c
      ELISA, and this could be related to the stage of the disease. A long-term study
      comparing the progression of the disease with the two tests is, therefore,
      essential.

PMID- 11193649
TI  - Conservation medicine.
AB  - The Field Veterinary Program (FVP) of the Wildlife Conservation Society (WCS) was
      created in 1989 to combat the wildlife disease and health problems that
      increasingly complicate the process of wildlife conservation. The FVP provides
      veterinary services for the more than 300 WCS conservation projects located in
      more than 50 countries around the world. Most of these projects are in tropical
      regions and many have a wildlife/domestic livestock component. Wildlife health
      care provided by the FVP staff includes (1) identifying critical health factors;
      (2) monitoring health status; (3) crisis intervention; (4) developing and
      applying new technologies; (5) animal handling and welfare concerns; and (6)
      training. Additionally, the staff of the FVP give expert advice to many
      governmental and non-governmental agencies that are involved in setting policies
      directly related to wildlife health and conservation issues. In this paper, two
      FVP projects are presented as examples of studies that have increased our
      understanding of the role wildlife diseases may play in the health of livestock
      and human populations, as well as the role humans and livestock may play in the
      health of wildlife populations. Examples of the collaborative work between the
      FVP staff and scientists from many disciplines (e.g., acarologists, mycobacterium
      experts, ecologists, and biologists) are also presented.

PMID- 11193650
TI  - Detection of mucosally delivered antibody to Cryptosporidium parvum p23 in
      infected calves.
AB  - We have developed an assay to detect mucosally delivered antibody to
      Cryptosporidium parvum sporozoite antigens. We absorbed a recombinant 23-kD
      sporozoite protein to polystyrene microspheres, and used flow cytometry to
      detect, titer, and determine the isotype of antibody to p23 that was shed in the
      feces of experimentally infected calves. Noninoculated calves have low levels of
      mucosal antibody to p23, with IgG1 as the predominant isotype. Antibody titers
      rise in inoculated calves as the animals recover from cryptosporidiosis. A calf
      that was naturally protected from cryptosporidiosis had mucosal IgM and IgG1
      isotype anti-p23 antibodies prior to challenge with C. parvum oocysts. Ten days
      after challenge, the calf had high titers of IgM, IgA, IgG1, and IgG2 anti-p23
      antibodies. Together, the data show that this method can be used to assess
      mucosally delivered antibody to C. parvum.

PMID- 11193651
TI  - A study on the time of ovicidal effect of some anthelmintics in Djallonke sheep
      and its implication for the control of parasitic helminth infections.
AB  - The time lag between the administration of five different anthelmintics and the
      exertion of their ovicidal effect on worm eggs was monitored in five groups of
      Djallonke sheep. In this experiment, all the animals in all treated groups and an
      untreated control group were grazed together. Worm egg output and the number of
      infective strongylate nematode larvae (L3s) recovered from fecal cultures from
      each group were observed every four hours for 72 h. The earliest time observed
      for the occurrence of ovicidal effect resulting in the absence of L3s in fecal
      cultures was 8 h after the administration of the anthelmintics. However, this
      time was not the same for all the anthelmintics. The implication of the results
      are discussed in relation to its application for worm control.

PMID- 11193652
TI  - Standardization of the diagnostic criteria for canine ehrlichiosis. Towards a
      universal case definition.
AB  - Canine ehrlichiosis is a highly variable syndrome presenting a significant
      differential diagnostic difficulty. It imitates many metabolic and infectious
      diseases and lacks standardized diagnostic criteria, common reagents, and
      database resources. A clinical diagnosis of canine ehrlichiosis may be based on
      the manifestation of fever, thrombocytopenia, anorexia, nasolacrimal discharge,
      epistaxis, and exclusion of autoimmune and common canine vector borne diseases.
      These parameters are not invariably observed especially in the atypical form of
      the disease often caused by species other than Ehrlichia canis. A definitive
      diagnosis is based on the presence of specific antibodies to ehrlichial agent(s),
      the demonstration of the etiologic agent(s) itself, or specific amplicons by a
      strigently quality controlled PCR protocol. The relationship of the various
      clinical and laboratory parameters, the status of the currently available tests,
      and their real or presumed predictive value are discussed in the context of
      stimulating an effort to formulate an international standard for the diagnosis of
      this and related diseases of man and animals.

PMID- 11193653
TI  - Ten years of research activities on tropical parasitology of dromedaries, cattle,
      and small ruminants in Mauritania.
AB  - In the past, the essential part of the activity of the parasitology laboratory of
      the Centre National d'Elevage et de Recherches Veterinaires (CNERV) was
      represented by diagnostic work that enabled the construction of an inventory of
      local parasitic fauna and a good collection of specimens. However, the small and
      irregular number of samples each year, led us to switch our activities in 1990
      toward work that could better justify the existence of CNERV. We started work on
      applied research topics, such as tick-borne diseases, helminthology
      (nemathelminths and plathelminths), and trypanosomosis. These results were
      valorized through scientific publication and communication at international
      meetings. The most valuable information was conveyed to herders.

PMID- 11193654
TI  - A perspective on animal protein production in sub-Saharan Africa.
AB  - A large survey of animal protein production in sub-Saharan Africa was performed.
      The objective was to identify specific production needed to ensure sustainable
      development. Starting from data collection and analysis to gain control of this
      information, the study proposes possible paths of evolution for supply and demand
      for animal production. Africa will be the continent where the demand will grow
      the most (together with Asia), because of demography and urbanization.
      Urbanization will represent an extraordinary opportunity for the development of
      animal production. In 2020, the global demand will be 20 million tons per year
      (7.3 in 1994) for meat, 45 million tons for milk (18.6 in 1994) and 2.9 million
      tons for eggs (1.1 in 1994). Red meat, which now provides 55.6% of present meat
      consumption will satisfy only 36.5% in 2020. This underlines the immense effort
      needed to intensify ruminant production and/or to develop monogastric production.
      Consequently, there is a need in tropical animal health and research for better
      knowledge and control of monogastric diseases and particularly those linked to
      intensification. The development of peri-urban milk production will require
      particular attention to hemoparasitic diseases. Globally, there is an urgent need
      to set up projects for the development of animal production.

PMID- 11193655
TI  - Development of a molecular probe to baboon interleukin-10 mRNA for in situ
      hybridization during experimental schistosomiasis.
AB  - A nucleic acid probe complementary to baboon interleukin 10 (IL-10) mRNA was
      developed for in situ hybridization. Highly conserved IL-10 protein sequences
      from several mammals were aligned to design oligonucleotide primers flanking a
      270-bp sequence of the target cDNA. RNA was isolated from stimulated peripheral
      blood mononuclear cells (PBMC). IL-10 cDNA was reverse-transcribed from the total
      PBMC RNA and amplified with the polymerase chain reaction (PCR). Cloning and
      sequencing of the PCR product confirmed it to be of baboon IL-10 origin, with
      97.8% identity to human and 100% identity to macaque mRNA sequences. The baboon
      IL-10 DNA probe hybridized in Southern blots to a 7.9-Kbp or 8.6-Kbp band after
      digestion of genomic baboon DNA with Bam H1 or Eco R1, respectively. Preliminary
      results with an antisense riboprobe derived from this sequence showed the
      presence of IL-10 mRNA in sections of granulomatous tissues.

PMID- 11193657
TI  - VSV-NJ on Ossabaw Island, Georgia. The truth is out there.
AB  - Ossabaw Island, Georgia, is the only recognized enzootic focus of vesicular
      stomatitis virus New Jersey (VSV-NJ) in the United States and has been the
      subject of VSV-NJ research since 1981. To date, VSV-NJ antibodies have been
      detected only from feral swine, cattle, equines, deer, and raccoons. VSV-NJ
      transmission occurs annually, is seasonal, and is associated with the maritime
      forest. Despite high transmission rates the clinical disease is rarely detected.
      A sand fly (Lutzomyia shannoni) occurs on the Island, and experimental and field
      data suggest that it is a biological vector of VSV-NJ at this site. Many
      questions relating to the epidemiology of VSV-NJ on Ossabaw remain. What is the
      maintenance cycle of VSV-NJ? Is a vertebrate amplifying host(s) needed? Are other
      insect vectors involved in mechanical or biological transmission? Why do
      vesicular lesions develop on some but not all infected animals? Do native and
      domestic animals play the same role in the maintenance cycle? These questions
      challenge researchers in all areas where VSV-NJ occurs. It is our hope that
      Ossabaw Island will provide a much needed model system for gaining insight into
      the epidemiology of this virus.

PMID- 11193656
TI  - Longitudinal studies in the epidemiology of vesicular stomatitis on Costa Rican
      dairy farms.
AB  - Twenty-three Costa Rican dairy herds from an vesicular stomatitis (VS) endemic
      area were under an active surveillance between April 1997 and March 1999. Ninety
      two confirmed cases of VS New Jersey were found. Factors associated with clinical
      cases of VS virus New Jersey were: Parity (animals of parity 4 or 5 were 5.3
      times more likely to present a clinical case than animals of parity 3 and lower;
      on the other hand, animals of parity 6 and higher showed an odds 4.6 times
      greater than animals of parity 3 and lower.) Ecological life zone (animals in
      premountain moist forest were 7.4 times more likely to present clinical cases
      than animals in lower mountain rain forest). Factors associated with
      seropositivity at the time of birth were farm and breed (Jersey calves had an
      odds 14.7 times greater than Holstein calves). Seroconversion, defined as the
      first twofold increase in the titers of the blood, was associated with farm and
      showed four peaks during the study period, September (wet season) 1997, February
      (dry season) 1998, September 1998, and February 1999. Finally, time to event
      analysis showed difference between farms and age, older animals showed the first
      seroconversion earlier than younger animals.

PMID- 11193658
TI  - Laboratory vector competence of black flies (Diptera:Simuliidae) for the Indiana
      serotype of vesicular stomatitis virus.
AB  - In previous experiments we have demonstrated that colonized and wild black flies
      are competent laboratory vectors of different Mexican and Western USA isolates of
      vesicular stomatitis virus, serotype New Jersey (VSV-NJ). We have recently
      demonstrated biological VSV-NJ transmission by black flies using animal models.
      In the study described here, we tested the vector competence of colonized and
      wild black flies for the vesicular stomatitis virus, serotype Indiana (VSV-IN). A
      1998 equine isolate was used. After a 10 day incubation period, saliva from
      experimentally infected Simulium vittatum and S. notatum was individually
      collected and tested for the presence of infectious virus. Virus was detected in
      the saliva of both species following oral infection, indicating that they are
      competent laboratory vectors of VSV-IN. In addition, the results suggest that the
      black fly gut may exert evolutionary pressures on the virus.

PMID- 11193659
TI  - Pharmacological factors in the saliva of blood-feeding insects. Implications for
      vesicular stomatitis epidemiology.
AB  - Vesicular stomatitis (VS) epizootics in the Western United States have caused
      substantial economic losses to U.S. livestock industries in 1995, 1997, and 1998.
      The role of arthropods in transmitting VS to U.S. livestock is unclear. In
      particular, the impact of arthropod salivary gland factors in VS infections in
      livestock needs study. Pharmacological effects of arthropod salivary gland
      factors on animals are reviewed. The potential effects of arthropod saliva on the
      transmission and spread of VS virus to livestock in the Western U.S. is presented
      with emphasis on the biting midge, Culicoides sonorensis. Information is
      discussed with attention to vector potential of C. sonorensis, and its use as a
      model for evaluating insect salivary gland pharmacology on livestock response to
      VS.

PMID- 11193660
TI  - Survey of small rodents and hematophagous flies in three sentinel farms in a
      Costa Rican vesicular stomatitis endemic region.
AB  - A survey of rodents and hematophagous flies was conducted on three farms located
      in an area endemic for vesicular stomatitis to determine the species composition
      of each zoological group occurring in these areas. Eleven species of small
      rodents were collected and identified. Individuals from forty-nine species of
      hematophagous flies of the families Ceratopogonidae, Culicidae, and Phlebotominae
      were captured and identified. The species compositions in each group were
      compared between farms. Rodents were tested for antibodies to vesicular
      stomatitis, New Jersey and Indiana serotypes. Seven species had antibody titers
      greater than 1:10. Attempts to isolate the virus produced negative results for
      all the species tested.

PMID- 11193661
TI  - Vaccines against Theileria parva.
AB  - Bovine theileriosis caused by Theileria parva continues to be a major economic
      problem in many parts of Eastern, Southern, and Central Africa. Due to the
      unsustainable nature of the present control method--using toxic acaricides to
      kill ticks--alternative control methods are being sought. Live vaccines are being
      used in many countries in the region. These vaccines are based on the infective
      sporozoite stage of the parasite. Sporozoites are inoculated in cattle with
      simultaneous administration of a long-acting formulation of oxytetracycline.
      These vaccines are poorly adopted in the region, mainly because of problems
      associated with the use of live parasites. An experimental recombinant vaccine
      based on a sporozoite surface antigen (p67) has been developed. Immunization with
      this antigen induces neutralizing antibodies and, under laboratory conditions,
      this technique protects approximately 70% of the immunized cattle to a defined
      needle challenge. The efficacy of the vaccine is currently being evaluated under
      field challenge in Kenya. Since a vaccine based on a single antigen may not be
      sustainable under field conditions, a search for schizont antigens that induce
      protective cell-mediated immune responses continues. It is expected that the
      ultimate vaccine against theileriosis will incorporate a mixture of several
      antigens derived from both sporozoite and schizont stages, contributing to robust
      immunity.

PMID- 11193662
TI  - Anaplasmosis control and diagnosis in South Africa.
AB  - Anaplasmosis is widespread in South Africa with more than 99% of the total cattle
      population at risk. Five tick species have been experimentally shown to be
      capable of transmitting Anaplasma in South Africa. Mechanical transmission
      through blood contaminated instruments and biting flies also occurs. Vaccination
      against Anaplasma marginale by administration of an Anaplasma centrale live-blood
      vaccine has been practiced in this country since 1912. Although generally a mild
      pathogen, Anaplasma centrale can cause severe clinical reactions following
      vaccination and also does not afford complete protection against all A. marginale
      isolates. Anaplasmosis vaccine is routinely available in a deep-frozen form and
      approximately 220,000 doses of vaccine are sold per annum. Microscopic
      examination of stained thin blood smears is still the most reliable and cost
      effective method of confirming a clinical diagnosis of anaplasmosis. Several
      diagnostic tests, such as the complement fixation tests, card agglutination test,
      and enzyme-linked immunosorbent assay (ELISA) have been developed to identify
      carrier cattle. A competitive inhibition ELISA test, based on antibody binding to
      a recombinant MSP-5 protein conserved among Anaplasma species, is routinely used
      at this laboratory.

PMID- 11193663
TI  - Vaccination against tropical theileriosis.
AB  - Theileria annulata, the cause of tropical theileriosis is propagated in cattle
      with stage-to-stage transmission by Hyalomma ticks. Three stages in the life
      cycle of the parasite--tick-derived sporozoites, intramononuclear schizonts, and
      erythrocytic merozoites--infect cattle. When cattle are inoculated with schizont
      infected cells, the parasite is transferred from the donor cell to the recipient.
      The main pathological damage in cattle is induced by the schizont stage. Each
      development stage of T. annulata elicits a specific immune response. Schizont
      infected lymphoid cells can be grown indefinitely in culture and prolonged
      cultivation results in loss of virulence. Blood-derived schizonts induce stronger
      immunity than culture-derived schizonts, which suggests that restrictions on the
      parasite population or antigenic variation occur during prolonged cultivation.
      The duration of immunity following sporozoite or schizont infections has not yet
      been determined, but does not appear to be lifelong. The attenuated, culture
      derived anti-theileria vaccine proved to be safe and effective in prevention of
      field theileriosis in large enzootic areas.

PMID- 11193664
TI  - OIE List A disease as a constraint to international trade.
AB  - World Trade Organisation agreements have swept aside many of the previous
      constraints to international trade in animals and animal products and have looked
      critically at those that still survive. The presence of disease, in particular
      the OIE list A diseases, still provide legitimacy for barriers to trade, and as a
      consequence the importance of reliable animal disease surveillance has increased.
      However, the economic consequences of reporting the occurrence of a List A
      disease have also increased, as this provides trading partners with sufficient
      reason to impose an embargo that could severely compromise the national
      agricultural industry. The dilemma for some developing economies, reliant on
      agricultural exports, is how to balance a transparent and efficient disease
      reporting service, sufficient to provide the necessary information for importing
      countries to make realistic risk assessments, with the perceived political damage
      from being honest with trading partners who might take advantage of the
      information to require additional safeguards and health certification.

PMID- 11193665
TI  - Anaplasmosis control. Past, present, and future.
AB  - Control methods for anaplasmosis have not changed markedly during the past 50
      years and include arthropod control, chemoprophylaxsis, vaccination, and
      maintenance of an Anaplasma-free herd. Control measures implemented vary with
      geographic location, and depend on availability, cost, and the feasibility of
      application. Vaccination has been an effective means of preventing outbreaks of
      anaplasmosis, but these vaccines, both live and inactivated, are dependent on
      bovine blood as the source of infection or antigen. Blood-derived vaccines are
      difficult to standardize and bear the risk of transmitting other bovine pathogens
      inapparent at the time of blood collection. Extensive purification is required to
      remove bovine cell membranes, which may cause side effects. Most importantly,
      geographic isolates of A. marginale are often not cross-protective. Development
      of a tick cell culture system for A. marginale shows promise as a source of
      antigen for development of an improved inactivated vaccine in the near future
      that is free from bovine pathogens. Development of an antigenically defined
      molecular vaccine appears to be a realistic goal, although further research is
      required to determine epitopes involved in both humoral and cellular immunity, to
      define antigenic variation during cyclic rickettsemia, and to develop effective
      delivery systems for optimization of the immune response.

PMID- 11193666
TI  - Babesiosis (Babesia bovis) stability in unstable environments.
AB  - Enzootic stability (herd immunity) in bovine babesiosis occurs when the rate of
      transmission (inoculation rate) of Babesia spp by the tick vector is sufficient
      to immunize a majority of susceptible calves before the loss of calfhood
      resistance. The effect of three tick (Boophilus microplus) control strategies
      (none, threshold, and strategic) on enzootic stability and the likelihood of
      babesiosis (Babesia bovis) outbreaks was studied using a spreadsheet age-class
      computer simulation model. The model was driven by weekly bovine tick counts from
      Brazil and Uruguay. The Eldorado do Sul, RS, Brazil bovine population (30 degrees
      05' South latitude) was found to be in a naturally occurring state of enzootic
      stability, corresponding to an inoculation rate exceeding 0.005 throughout the
      year. Threshold dipping strategies should not increase the risk of babesiosis in
      cattle so managed. Strategic dipping resulted in an extended period of enzootic
      instability lasting 30 weeks, which requires protection of the herd through
      immunization. Because of the more prolonged low winter temperature conditions,
      the Tacuarembo, Uruguay bovine population (31 degrees 40' South latitude) was
      found to be in a naturally occurring state of enzootic instability, characterized
      by a 28 week period in which the inoculation rate was below 0.005. Strategic
      dipping should lead to eradication of the babesial parasite from tick and bovine
      populations, but would not result in eradication of the tick vector. This could
      lead to subsequent outbreaks if Babesia carrier animals were to be introduced
      into the herd. In both populations, strategic tick control could be accompanied
      by concurrent babesiosis vaccination.

PMID- 11193667
TI  - Characterization of attenuated Theileria annulata vaccines from Spain and the
      Sudan.
AB  - Theileriosis caused by Theileria annulata can be effectively prevented by
      vaccination with attenuated, cultured schizonts. Although these attenuated
      vaccines have been applied for a long time, not much is known about the fate of
      the vaccine strain in the field. Here, two experimental Spanish vaccine strains
      originating in Cadiz and Caceres, and one Sudanese strain are studied to address
      the development of a carrier status and the infectivity for Hyalomma ticks.
      Moreover, the heterogeneity of the merozoite surface protein, Tams1, was analyzed
      in search for an attenuation marker. Using the sensitive reverse line blot (RLB)
      hybridization, the development of a low level carrier status was demonstrated in
      the Caceres and Sudanese line vaccinated calves. Although no signal was detected
      in the Cadiz line vaccinated calves, seroconversion against the schizont stage
      was observed, as it was in all other calves. The experimental transmission of T.
      annulata by Hyalomma ticks to naive calves was unsuccessful for all cell line
      inoculated calves. Tams1 heterogeneity indicated a clonal selection of parasites
      during the process of attenuation, but the Tams1 sequence itself has no
      connection with the attenuation status. In conclusion, a carrier status develops
      in attenuated schizont culture vaccinated calves, but is not infective for
      Hyalomma ticks. Based on these data, the risk for spread of the vaccine strains
      in the field may be very low.

PMID- 11193668
TI  - Integrated molecular diagnosis of Theileria and Babesia species of cattle in
      Italy.
AB  - A reverse line blot hybridization (RLB) test was developed to specifically
      identify six Theileria spp. (T. annulata, T. parva, T. mutans, T. velifera, T.
      taurotragi, and T. buffeli/orientalis) and three Babesia spp. (B. bovis, B.
      bigemina, and B. divergens). No cross reaction was observed with other livestock
      pathogens (such as Anaplasma marginale, A. centrale, A. ovis, Cowdria
      ruminantium, Trypanosoma brucei, T. congolense, and T. vivax). This method was
      used to test bovine blood samples collected in Sicily in April and November,
      1998. Preliminary results indicated that T. annulata and T. buffeli/orientalis
      were the main species observed in cattle blood. Babesia species represented 1.8%
      and 23.5% in April and November, respectively.

PMID- 11193669
TI  - Vaccination against bovine babesiosis.
AB  - Bovine babesiosis is an important disease caused by Babesia bovis, B. bigemina,
      and B. divergens. Solid immunity develops after infection and this feature has
      been exploited with the use of live attenuated organisms as immunogens.
      Attributes of live vaccines include a durable immunity to heterologous challenge
      after one vaccination. To overcome disadvantages relating to poor quality control
      (risk of contamination and adverse reactions), production procedures have been
      modified to meet the requirements of codes of good manufacturing practice. This
      includes development of methods to allow production of cryopreserved vaccine and
      limit antigenic drift. Killed vaccines have also been used on a limited basis and
      consist of antigens extracted from cultured material or blood of infected calves,
      and given with adjuvant. The degree and duration of immunity against heterologous
      challenge is not well documented. Attempts are being made to develop subunit
      vaccines but the progress has been slow. A better understanding of the mechanisms
      involved in the expression of protective immunity against Babesia spp will aid in
      the identification of protective antigens.

PMID- 11193670
TI  - Past and present national tick control programs. Why they succeed or fail.
AB  - The historical reasons for the introduction of tick control during the nineteenth
      century are reviewed. Background and concepts for the choice between long-term
      tick control and tick eradication are compared. Case studies of large-scale tick
      control or eradication programs in Africa, Australia, the United States, and the
      Caribbean are used to highlight successes and failures. The main reasons for lack
      of sustainability, or failure, of programs are discussed. These include the
      economic constraints that were faced in several African countries, or technical
      shortcomings such as were perceived as a major problem in Puerto Rico. The
      successes are generally associated with enforcement of appropriate legislation
      and good management, such as occurred in Zimbabwe. These case studies are
      analyzed to identify features that may assist in the implementation of the
      ongoing tropical bont tick eradication program in the Caribbean. The paper
      concludes with some practical suggestions for the future, and the need to
      reassess the economics of control and the potential additional animal health
      benefits derived from tick control programs.

PMID- 11193671
TI  - The increasing significance of international trade in equids and its influence on
      the spread of infectious diseases.
AB  - Expansion in international trade in equids and equine semen has been especially
      notable over the past 10-15 years among those countries historically identified
      as having significant breeding and performance horse industries. The continuing
      trend towards globalization of the horse industry received additional impetus in
      January, 1995, following establishment of the World Trade Organization (WTO),
      whose primary goal is to promote freer economic exchange between member countries
      through the reduction or elimination of protectionist barriers to trade.
      Continued growth in international trade, closely related to changing trends in
      the horse industry, has greatly increased the risk of spread of a wide range of
      equine infectious diseases between countries. In consequence, the global
      distribution of certain of these diseases is likely to change in the future.
      Within the past 30-40 years, there have been numerous confirmed instances of the
      spread of specific diseases through the international movement of equids or
      shipment of semen, some of which have resulted in epidemics of major economic
      importance. Under the Sanitary-Phytosanitary Agreement of the WTO, national
      agencies have had to rethink their traditional "zero-risk" approach in regulating
      the importation of equids or equine semen from other countries. Mindful of the
      risks of disease spread inherent in such transactions, authorities must now
      accept that primary emphasis in today's global economic climate must be on
      greater facilitation of trade, rather than attempting to provide absolute disease
      preventive safeguards.

PMID- 11193672
TI  - Trials to control South American ticks with entomopathogenic fungi.
AB  - Ticks are parasites of great importance to man, domestic, and wild animals. In
      spite of the progress of the science, thus far, ticks are controlled mainly by
      chemical acaricides and when this technique is used in an indiscriminate way it
      can lead to ambiental pollution and development of tick resistance to acarcides.
      The studies developed in the Universidade Federal Rural do Rio de Janeiro
      demonstrate that some isolates of the fungi Metarhizium anisopliae and Beauveria
      bassiana are pathogens for ticks and their action effects the mortality of ticks
      and reduces the populational levels in subsequent generations. In future,
      research needs to address the search of new pathogens; the association of
      biological with chemical products seeking an synergistic action; the search of
      formulations that propitiate increased stability, and careful studies on the
      safety of biological products for use in animals.

PMID- 11193673
TI  - Laboratory and field evaluation of entomogenous fungi for tick control.
AB  - Aqueous and oil-based formulations of two entomogenous fungi, Beauveria bassiana
      and Metarhizium anisopliae were tested for their efficacy against the three major
      species of African ticks; namely, Amblyomma variegatum, Rhipicephalus
      apendiculatus, and Boophilus decoloratus. Both fungal species and formulations
      were observed to induce high mortalities, especially in the larvae. The oil-based
      formulation was found to be more effective than the aqueous formulation. Monthly
      application of aqueous formulations of B. bassiana and M. anisopliae on
      vegitation in paddocks significantly reduced numbers of the tick R.
      appendiculatus on cattle. Possibilities for using entomogenous fungi in tick
      control, alone, or in combination with the conventional acaricides are discussed.

PMID- 11193675
TI  - Skin test and tick immune status in susceptible and resistant cattle in Brazil.
AB  - A cutaneous hypersensitivity test (CHT) was used to correlate host resistance to
      ticks and type of reaction elicited to unfed larval extract-ULE of the cattle
      tick Boophilus microplus in European and Indian cattle. Twenty calves were
      separated into four groups of five animals each: naive or preinfested Indian or
      European cattle. CHT was induced by intradermal inoculation of 0.1 ml of ULE
      cattle tick B. microplus (50 micrograms protein) in the calf ear. Ear thickness
      was measured using calipers before and 10 min, 1, 2, 6, 18, 24, 48, 72, 96, and
      144 h postinoculation (PI). Preinfested European calves showed only an immediate
      type reaction with maximum response (75% increase in ear thickness) at 10 min PI.
      On the other hand, preinfested Indian calves presented an immediate response with
      maximum reaction (70% increase in ear thickness) between 10 min and one hour PI,
      and a delayed type reaction at 72 h PI (60% increase in ear thickness). These
      results point out the crucial role of the cellular immune response of cattle in
      the expression of resistance to cattle tick B. microplus. Skin test might be
      useful in the ranking of cattle according to the susceptibility/resistance to
      ticks.

PMID- 11193674
TI  - Role of grooming in biological control of ticks.
AB  - Although many species of wild bovids live in tick infested environments, tick
      loads are usually kept to very low levels, primarily by frequent self grooming.
      Evidence from numerous studies on antelope in Africa strongly support the concept
      that the delivery of bouts of grooming reflects programmed grooming rather than
      stimulus driven or reactive grooming. In other words, grooming occurs in response
      to an endogenous generator that produces grooming bouts at periodic intervals,
      resulting in removal of ticks before they attach and begin to feed. In the same
      tick exposure environment, animals that groom most have the fewest ticks. The
      rate of programmed grooming is modulated by a number of interspecific and
      intraspecific determinants. Interspecific determinants include adult body size
      and whether or not the evolutionary habitat is tick dense or tick sparse.
      Intraspecific determinants include developmental stage of growth, gender (e.g.,
      territorial male vs. female), ectoparasite exposure, and stage of arousal. Some
      of the intraspecific determinants appear to be mediated by systemic physiological
      influences suggesting there may be ways to improve grooming activity in weak
      groomers, such as cattle.

PMID- 11193676
TI  - The potential for antitick plants as components of an integrated tick control
      strategy.
AB  - Extracts from various African plants have been shown to possess strong acaricidal
      and/or tick repellent properties. Some of the plant extracts are capable of
      reducing tick feeding, molting, fecundity, and viability of eggs. Pasture grasses
      capable of repelling, trapping, and killing ticks have also been reported. These
      grasses possess hairs (trichomes) that retard ticks from climbing to the top of
      the grasses in order to attach themselves to passing animals. Furthermore, some
      grass species, such as Stylosanthes, produce viscous fluids that poison and kill
      ticks. Results obtained with antitick plants are presented in this paper and
      feasibility of using them in an integrated tick control strategy is discussed.

PMID- 11193677
TI  - Present and future technologies for tick control.
AB  - Arsenic dips were the first effective method for controlling ticks and tick-borne
      diseases, and were used in many parts of the world for over 50 years before
      resistance to the chemical became a problem. Until organochlorine products became
      available about 1946 as alternatives to arsenic, significant losses occurred in
      cattle herds exposed to arsenic-resistant tick strains. Since the discovery of
      organochlorines, virtually every chemical group of pesticides developed for the
      control of arthropods is represented among the list of products employed for the
      control of ticks on cattle. The evolution of tick resistance to acaricides has
      been a major determinant of the need for new products. The variety of procedures
      for treating animals with acaricides ranges from dipping cattle to injecting
      systemic acaricides, but regardless of the treatment method used, producers need
      to know and follow proper application procedures to derive maximum benefits. The
      possibility of stocking with cattle breeds that acquire pronounced resistance to
      ticks or using recombinant antigen antitick vaccines are the most promising
      alternatives to acaricides. Most ranchers depend completely on acaricides to
      control ticks, but do not have access to guidelines on how to make a profit from
      their tick control program or how to detect and resolve problems with resistance
      to acaricides. Extension programs are needed to help ranchers manage animal
      health problems, including how to control ticks and tick-borne diseases.

PMID- 11193678
TI  - Biocontrol of ticks by entomopathogenic nematodes. Research update.
AB  - Entomopathogenic nematodes (EPNs) are lethal to ticks even though they do not use
      their normal propagation cycle within tick cadavers. The tick Boophilus annulatus
      was found to be far more susceptible to EPNs than Hyalomma excavatum,
      Rhipicephalus bursa, or Rhipicephalus sanguineus. Ticks seem to be less
      susceptible to nematodes when feeding on a host. Preimaginal tick stages were
      less susceptible to nematodes than adult ticks. The mortality rate of unfed
      females was highest, followed by unfed males, and engorged females. The virulence
      of nematodes to ticks varied greatly among different nematode strains. In most
      cases, the Heterorhabditis sp. strains were the most virulent strains tested in
      petri dishes. In buckets containing sandy soil sprayed with 50 nematodes/cm2 and
      engorged B. annulatus females, the LT50 of the ticks was less than five days. The
      addition of manure to soil or a manure extract to petri dishes reduced nematode
      virulence. Since ticks spend most of their life cycle in the upper humid layer of
      the ground, and many nematode strains share this same ecological niche, the use
      of EPNs for biocontrol of ticks appears promising.

PMID- 11193679
TI  - Generation of cytotoxic T lymphocytes and cytostatic acting cells in T. annulata
      immune cattle.
AB  - Cattle immunized against Theileria annulata with schizont containing autologous
      cell lines are immune to challenge with a homologous parasite strain. Two cell
      types have been detected in the peripheral blood of the immunized animals:
      cytotoxic T lymphocytes (CTL) and cytostatic acting cells (CAC). Killing the
      target cells by CTL is infection associated and is MHC class I restricted. Hence,
      no cytotoxicity was observed against target cells that were treated with the
      theilericidal drug buparvaquone or autologous Con A-blasts. The growth inhibition
      of CAC is MHC unrestricted, and not mediated by cytokine interferon gamma (IFN
      gamma).

PMID- 11193680
TI  - What and how do we communicate?
AB  - The rapid, inexpensive transmission of words and data, brought about by the
      internet and cheap computers, is changing the world faster than anything mankind
      has ever experienced, reaching into nearly every aspect of our lives, public and
      private, commercial and governmental. We are in an Information Age with an
      essentially instantaneous availability of large volumes of information and data.
      Technological pressures have their own momentum. The changes and improvements in
      data handling and information sharing will take place, however much or little we
      do in veterinary medicine, whether at the international or national levels. In
      addition, there are new superpowers emerging in the world. These are the small
      and medium third world countries that are gradually gaining democracy through
      political restructuring and involving the civil society in decision making. There
      are also the marginal pressure groups, once too small and insignificant to be
      noticed. These are changing the rules by which the way the world is governed and
      they are doing it now by the internet and banding together to serve their common
      interests. The rapid provision of accurate information on animal diseases is
      desirable goal from a public health as well as an economic viewpoint.

PMID- 11193681
TI  - Efficacy and safety of new adjuvants.

PMID- 11193682
TI  - Cross reactivity between instars of the Rhipicephalus sanguineus (Latreille,
      1806) tick.

PMID- 11193683
TI  - Emerging diseases of Africa and the Middle East.
AB  - The term "emerging diseases" has been used recently to refer to different
      scenarios, all of which indicate changes in the dynamics of disease in the
      population. Of the OIE List A diseases, major changes have been experienced with
      rinderpest, peste des petit ruminants (PPR), contagious bovine pleuropneumonia
      (CBPP), foot-and-mouth disease, African swine fever, lumpy skin disease, and Rift
      Valley fever. Rinderpest represents a success story of the 1990s, thanks to the
      programs of the Pan African Rinderpest Campaign (PARC). The situation has changed
      from that of the 1980s when rinderpest was widespread throughout most of Tropical
      Africa and the Middle East. PPR is a disease that has become of increasing
      importance throughout Tropical Africa and the Middle East. CBPP, which had
      previously been reduced to sporadic incidence within endemic areas, invaded new
      areas, causing heavy mortality. African swine fever has extended to West Africa
      and to Madagascar, in both regions resulting in heavy losses. Climatic changes in
      both East and West Africa were associated with an upsurge of Rift Valley fever.
      Deficiencies in national veterinary services have contributed to failures in
      early detection and response; in many regions investigation and diagnosis
      services have deteriorated. The continuing structural adjustment program for
      national veterinary services will need to take into account their transformation
      from providers of services (e.g., vaccinations, medicines) to inspection and
      quality assurance services. Surveillance, early warning, and disease emergency
      preparedness will need to be pursued more vigorously in Africa and the Middle
      East as vital components of national veterinary services.

PMID- 11193684
TI  - Preliminary results of a larval resistance test to ivermectins using Boophilus
      microplus reference strains.

PMID- 11193685
TI  - Attenuated trivalent vaccine against babesiosis and anaplasmosis in Colombia.

PMID- 11193686
TI  - Immunological control of ticks through vaccination with Boophilus microplus gut
      antigens.
AB  - The control of tick infestations and the transmission of tick-borne diseases
      remain a challenge for the scientific community. Traditional control methods have
      been only partially successful. Recently, vaccination with recombinant Boophilus
      microplus gut antigens has been shown to control tick infestations. Our Bm86
      containing vaccine formulation (Gavac) has been effective for the control of
      artificial infestations of B. annulatus, B. decoloratus, and chemically sensitive
      and resistant B. microplus strains from Australia, Africa, America, and Iran.
      Preliminary results with Hyalomma spp. and Rhipicephalus spp. suggest partial
      cross protection. In field trials, vaccination with Gavac controlled B. microplus
      and B. annulatus infestations and reduced the transmission of babesiosis,
      resulting in important savings for the cattle industry. Different degrees of
      susceptibility to the vaccination with Bm86 and sequence variations in the Bm86
      locus have been reported. The Bm95 antigen was isolated from the Argentinean Bm86
      resistant B. microplus strain A. A Bm95-based vaccine was used to protect cattle
      against tick infestations under production conditions with similar results to
      that obtained with Gavac. The Bm95 antigen from strain A was able to protect
      against infestations with Bm86-sensitive and Bm86-resistant tick strains, thus
      suggesting that Bm95 could be a more universal antigen in protecting cattle
      against infestations by B. microplus strains from different geographical areas.
      These results clearly demonstrate the advantage and possibilities for the
      immunological control of ticks.

PMID- 11193687
TI  - Evaluation of the MAP1b ELISA for the diagnosis of heartwater in South Africa.

PMID- 11193688
TI  - Insecticide resistance studies on Blattella germanica (Dictyoptera:Blattellidae)
      from Cuba.
AB  - We studied the levels of resistance to seven insecticides: malathion,
      chlorpyrifos, pirimiphos-methyl, propoxur, cypermethrin, deltamethrin, and lambda
      cyhalothrin in nine strains of Blattella germanica (Linnaeus, 1717) collected
      from sites in Santiago de Cuba and Havana City. The strains from Santiago de
      Cuba, generally had high levels of resistance to malathion, cypermethrin,
      deltamethrin, and lambda-cyhalothrin, but only low levels of resistance to
      pirimiphos-methyl, chlorpyrifos, and propoxur. In the strains from Havana City we
      found a moderate resistance to the organophosphate insecticides, resistance to
      the pyrethroids (except for three strains that showed susceptibility to lambda
      cyhalothrin), and susceptibility to the carbamate insecticide (propoxur).

PMID- 11193690
TI  - The genetic basis for emerging antibiotic resistance in veterinary pathogens.

PMID- 11193689
TI  - Serological evidence of exposure to Ehrlichia species in dogs in Spain.

PMID- 11193691
TI  - Association of botulism and tetanus as causative agents of an outbreak of bovine
      paraplegic mortality in the eastern plains of Colombia.

PMID- 11193692
TI  - Immune response of naive cattle to successive infestations of Boophilus microplus
      ticks.

PMID- 11193693
TI  - Identification of stage-specific genes in Schistosoma mansoni.

PMID- 11193694
TI  - Homologous and heterologous immune reactions between Venezuelan geographic
      isolates of Anaplasma marginale.

PMID- 11193695
TI  - Improving egg production in two indigenous communities through the adaptation of
      management practices and local knowledge. The results of participative research.
AB  - Free-ranging poultry (FRP) are known to be efficient in the recycling of residues
      of agroforestry systems. The objective of this paper is to present the results of
      participative applied research on the improvement of egg production in two
      indigenous communities in Costa Rica. This involved a dialectic process of
      adaptation between indigenous knowledge and introduced management practices. We
      report an increase in egg production through the use of nests and improved diets.

PMID- 11193696
TI  - Anaerobic dog bite wound infection.

PMID- 11193697
TI  - Isolation and partial characterization of the Montecitos strain of Boophilus
      microplus (Canestrini, 1877) multiresistant to different acaricides.

PMID- 11193698
TI  - Isolation and morphological characterization of mosquito spirochetes from a Lyme
      disease endemic area.

PMID- 11193699
TI  - Proliferation and cytokine profile of T. annulata-infected ovine, caprine, and
      bovine lymphoblastoid cells.
AB  - T. annulata, the causative agent of tropical theileriosis in cattle, can also
      infect ovine and caprine leukocytes in vitro. In vivo studies showed that this
      parasite causes a mild infection in both these animal species, and in sheep
      merozoite stage development seems to be inhibited. Since the nature of T.
      annulata infected caprine and ovine cells is not known, all three cell lines were
      karyotyped and phenotypically characterized by flow cytometry. They all express
      mRNA of cytokines IL-1 alpha, IL-1 beta, IL-8, and TNF-alpha, but not of IFN
      gamma, IL-2, and IL-4. In contrast, IL-6 mRNA was expressed in the cattle cell
      line only, while mRNA of IL-10 was exclusively produced by the sheep cell line.
      The observed differences in cytokine mRNA expression may be responsible for the
      different pathogenesis of T. annulata infection in cattle and sheep.

PMID- 11193701
TI  - Red meat production and meat losses in Burkina Faso (1987-1997).
AB  - Based on monthly recorded data collected from 1987 to1997 in all official
      slaughter houses across the country, this study analyzes the trends of ruminant
      meat production and importance of meat condemnations by veterinary inspection in
      Burkina Faso. The average beef production per year is estimated at 6.717.5 + or -
      2.969.1 tons, nd for small ruminant meat it is 8,715.5 + or - 4,161.3 tons.
      During the ten-year period (1987-1997) it appears that a large drop in production
      (up to 18%) occurred in 1994-1995 consistent with monetary devaluation. The
      average amount of red meat theoretiacally available for each inhabitant is
      estimated at 2.14 + or - 0.27 kg per year. Approximately 10 to 16 tons of
      diseased red meat is condemned every year by veterinary inspection. This is very
      important for a country where malnutrition and undernutrition is quasi endemic.

PMID- 11193700
TI  - Safety testing of needle free, jet injection devices to detect contamination with
      blood and other tissue fluids.
AB  - Needle free jet injection guns have been used extensively in both veterinary and
      human health to deliver both vaccine and drugs, but in recent years, concerns
      have mounted for their potential to transmit blood borne disease agents among
      consecutive vaccinates. A Ped-O-Jet type jet injection device was used to deliver
      serial subcutaneous injections of 0.5 mL saline (as a surrogate for vaccine) into
      calves and pigs, with intervening ejectates collected in vials to represent what
      the next vaccinate would have received. An enzyme linked immunosorbant assay was
      developed to detect species specific albumin as a marker for blood, using
      calibration standards from known dilutions of bovine or porcine blood. Assay
      sensitivity of 20 pL/mL corresponded to the estimated minimal chimpanzee
      infectious dose of 10 pL for hepatitis B virus. The methodology and available
      results for evaluating the safety of jet injector devices are reported.

PMID- 11193702
TI  - Canine colonization and transmission of Bordetella pertussis.

PMID- 11193703
TI  - Prevention of disease transmission in primate conservation.

PMID- 11193704
TI  - Contagious bovine pleuropneumonia. A reassessment of the efficacy of vaccines
      used in Africa.
AB  - Contagious bovine pleuropneumonia is a major threat for cattle in Africa. Since
      1956 the T1/44 strain has been used as a vaccine, and later on, T1sr, a
      streptomycin-resistant variant that gives fewer post-vaccinal reactions had been
      developed. These vaccines are known not to be very efficient but they normally
      should provide protection for about eight months. However, recent emergency
      vaccinations, performed in various countries in the southern part of the
      continent apparently met with failure, casting doubts on the identity as well as
      the protection afforded by the T1sr strain. A vaccine trial has been designed to
      reassess the real protection afforded by these vaccines in face of recently
      isolated pathogenic strains. Great care has been taken to test the original
      vaccinal strains at a dose corresponding to the minimum requirement by
      international standards. The test was performed in Cameroon, Kenya, and Namibia
      as to take into account the genetic diversity that exists among the pathogenic
      strains. In those conditions, the protection rate at three months varied from 33
      to 67%, whatever the strain used, T1/44 or T1sr. These results call for
      additional research for vaccine development and careful planning of strategies in
      the fight against CBPP.

PMID- 11193705
TI  - American canine hepatozoonosis. An emerging disease in the New World.
AB  - Hepatozoon canis was first described from dogs in 1905 in India and Rhipicephalus
      sanguineus was identified as the vector. Dogs on the Texas Gulf Coast were
      recognized in 1978 to have hepatozoonosis, and it was thought that H. canis had
      entered the New World. Later, it was realized that American canine hepatozoonosis
      (ACH) is more debilitating than its Old World counterpart, often resulting in
      death. When the malady and parasite were characterized, a new species, H.
      americanum, was described, in 1997. Phylogenetic analysis, based on 18S rRNA gene
      sequence and classical taxonomic features, revealed that the two dog parasites
      are closely related. Amblyomma maculatum, the Gulf Coast tick (GCT), has been
      demonstrated to be an excellent vector; nymphal ticks were readily infected and
      oocysts from newly molted adults were uniformly infectious for dogs. The
      merogonic cycle of H. americanum in dogs and the sporogonic development in the
      invertebrate host have been described. ACH is diagnosed primarily by histologic
      examination of skeletal muscle. Curative therapy is not available, but anti
      protozoal and anti-inflammatory drugs may prolong life. Naturally infected
      coyotes have been found in Oklahoma and Texas, and experimental infections have
      been produced in this canid. Additional effort is needed to determine the
      vertebrate host range of H. americanum and to define the enzootic cycle of which
      dogs have become a part; likewise, more work is required to determine whether
      larval GCTs can acquire infection and transmit it as nymphs.

PMID- 11193706
TI  - Neosporosis. Aspects of epidemiology and host immune response.
AB  - Neospora caninum is a recently recognized protozoan parasite which has been
      described as causing a neuromuscular paralysis in dogs and is emerging as a major
      cause of bovine infertility and abortion worldwide. The parasite is known to
      infect a range of warm blooded animals but the disease predominates in dogs and
      cattle. It is not yet known if N. caninum can infect and cause disease in people.
      The dog has recently been identified as the definitive host and the parasite may
      be transmitted through the ingestion of oocysts or congenitally from mother to
      fetus. N. caninum is known to infect red foxes (Vulpes vulpes) and coyotes (Canis
      latrans) and the role of wildlife species as reservoirs of infection requires
      further investigation. Little is known about the range of parasite genotypes
      within the environment or the variation in virulence between different strains.
      RAPD-PCR analysis of geographically distinct bovine and canine isolates has
      revealed little genetic variation. Epidemiological studies from different areas
      of the world have investigated the importance of N. caninum as an abortifacient
      agent and longitudinal studies have shown the high rate (approximately 80%) of
      congenital transmission within infected herds. Information on the rates of repeat
      abortion due to neosporosis are less well defined however current estimates put
      this at 5% suggesting that cattle may develop some form of protective immunity
      against N. caninum-induced abortion. Diagnosis of the disease is based upon
      detection of the parasite in the tissues, most commonly using
      immunohistochemistry with additional information provided by serology. However,
      although positive fetal serology is a strong indicator of exposure to the
      parasite, care should be taken in the interpretation of maternal serology. As we
      understand more about the epidemiology of neosporosis we are also better able to
      interpret the results of diagnostic tests. The mere presence of the parasite does
      not necessarily infer that this was the primary cause of abortion. CD4+ T-cells,
      interferon gamma and macrophages have all been found to significantly inhibit
      multiplication of N. caninum tachyzoites. The nature of a protective immune
      response and its modulation in the pregnant animal is discussed.

PMID- 11193707
TI  - A brief history of the Society for Tropical Veterinary Medicine.

PMID- 11193708
TI  - Catabolic response to stress and injury: implications for regulation.
AB  - Muscle catabolism is an important component of the metabolic response to stress
      and injury, including sepsis and burn injury. Muscle wasting and weakness in
      catabolic patients may adversely affect the outcome in these patients owing to
      delayed ambulation and involvement of respiratory muscles. An understanding of
      the regulation of muscle protein breakdown during sepsis and following injury
      therefore is of great importance from a clinical standpoint and is essential for
      the development of new therapeutic modalities to prevent protein loss from muscle
      tissue. Studies in experimental animals and in patients have provided evidence
      that the myofibrillar proteins actin and myosin are particularly sensitive to the
      effects of sepsis and injury. (Glucocorticoids, interleukin-1, and tumor necrosis
      factor participate in the regulation of muscle protein breakdown. Most muscle
      proteins are degraded by the ubiquitin-proteasome-dependent proteolytic pathway.
      Because the proteasome does not degrade intact myofibrils, a calcium-dependent Z
      band disintegration and release of myofilaments from the myofibrils may be an
      important initial step of muscle breakdown during sepsis and other catabolic
      conditions. Continued studies to define mechanisms of the catabolic response to
      stress and injury are important for improving the metabolic care of patients with
      muscle catabolism.

PMID- 11193709
TI  - Metabolic assessment.
AB  - Although no techniques are currently available that meet the needs of nutrition
      support professionals, the future is promising. This article reviews various
      methods and techniques used to assess the metabolic and nutritional status of
      surgical patients. Technologic advances in bioengineering, molecular biology, and
      physiology are providing exciting new tools that may eventually replace or
      supplement traditional static indices of metabolic assessment. At the very least,
      an increased understanding of the cellular abnormalities associated with various
      diseases will likely change our view of illness and our approaches to nutritional
      and metabolic intervention.

PMID- 11193710
TI  - Access routes for nutritional therapy.
AB  - Enteral nutrition (EN) and total parenteral nutrition (TPN) may provide life
      sustaining therapy for surgical patients. The duration of nutritional therapy
      (enteral or parenteral) implies distinct access routes. We review the main
      aspects related to access routes for nutrient delivery. The enteral route,
      whenever feasible, is preferred. For EN lasting less than 6 weeks, nasoenteric
      tubes are the route of choice. Conversely, enterostomy tubes should be used for
      longer-term enteral feeding and can be placed surgically or with fluoroscopic and
      endoscopic assistance. The first choice for patients who will not be submitted to
      laparotomy is percutaneous endoscopic gastrostomy. Postpyloric access, although
      not consensual, must be considered when there is a high risk of aspiration. For
      intravenous delivery of nutrients lasting less than 10 days, the peripheral route
      can be used. However, because of frequent infusion phlebitis, its role is still
      in discussion. Central venous catheters (CVCs) for TPN delivery may be (1)
      nonimplantable, percutaneous, nontunneled-used for a few days to 3 to 4 weeks;
      (2) partially implantable, percutaneous, tunneled-used for longer periods and
      permanent access; or (3) totally implantable subcutaneous ports-also used for
      long-term or permanent access. The subclavian vein is usually the insertion site
      of choice for central venous catheters. Implantable ports are associated with
      lower rates of septic complications than percutaneous CVCs. The catheter with the
      least number of necessary lumens should be applied. Central venous nutrient
      delivery can also be accomplished through peripherally inserted central
      catheters, which avoid insertion-related risks.

PMID- 11193711
TI  - Advances in perioperative nutrition: cancer.
AB  - The role of perioperative nutritional support in the management of cancer
      patients remains controversial. The benefit of supplemental calories is not the
      only current issue: in fact, the route of delivery, composition of basic
      nutrients (carbohydrate, protein, fat), and the role of supplemental additives
      (arginine, glutamine, omega-3 fatty acids, nucleotides) in improving immune
      status and ultimate outcome have been the focus of much discussion. Emerging data
      suggest that the use of supplemental agents is associated with improvement in
      immune status in these patients, although there is little clear evidence that
      this improves outcome. Ongoing studies are aimed at defining the group of
      patients who would most benefit from nutritional interventions during the
      perioperative period.

PMID- 11193712
TI  - Short bowel syndrome.
AB  - The short bowel syndrome is a symptom complex that occurs in adults who have less
      than 200 cm of jejunum-ileum remaining after intestinal resection. Similar
      symptoms are observed in infants and children following massive bowel resection
      or congenital anomalies and in individuals with longer segments of intestine with
      severe mucosal disease. Initial care should focus on a thorough excision of
      nonviable bowel, an exact measurement of the remaining viable bowel, placing all
      intestine in continuity at the initial or subsequent operation, and controlling
      initial food intake. With time, adaptation of the remnant intestine occurs, and
      absorptive function may be maximized by enhancing the enteral diet and minimizing
      parenteral nutrition. Growth factors and specialized nutrients may also enhance
      this process. Intestinal transplantation should be considered in selected
      individuals with the short bowel syndrome who fail intestinal rehabilitation
      protocols.

PMID- 11193713
TI  - Advances in intravenous lipid emulsions.
AB  - Over the past decade, our views have considerably evolved with respect to the
      metabolism of intravenous lipid emulsions and their composition. Substantial
      progress has been made in understanding the metabolic pathways of emulsion
      particles and the delivery of their various components (fatty acids and vitamins)
      to specific tissues or cells. Although soybean long-chain triglycerides represent
      a valuable source of energy, concerns have been raised about their high content
      of polyunsaturated fatty acids (mainly n-6 essential fatty acids), which may
      adversely affect immune functions and antioxidant status. Introduction of medium
      chain triglycerides or olive oil to lipid emulsions can largely help bypass these
      disadvantages. Recently, incorporation of n-3 fatty acids in lipid preparations
      was suggested to have potential application in several chronic and acute diseases
      because of their ability to reduce inflammatory and thrombotic responses and cell
      sensitivity to various stimuli. Hence lipid emulsions should no longer be
      considered only as a means of providing energy substrates; they also modulate key
      metabolic functions. Such improved knowledge may lead to optimizing the metabolic
      care of certain patients.

PMID- 11193714
TI  - Perioperative nutrition and metabolism in pediatric patients.
AB  - A developing child, with a high metabolic rate and low body stores of nutrients,
      is susceptible to metabolic disturbances due to surgical stress. For
      perioperative nutritional care of infants, the distinct physiologic features of
      their body fluids must be carefully considered. The postoperative metabolic
      response is the same as that in adults, but in children this response is more
      rapid. Based on the urinary excretion of 3-methylhistidine in infants, the
      postoperative degradation of muscle protein is thought to be twice the
      preoperative level. This transient increase during the early postoperative period
      was not suppressed by increased amino acid intake, and energy intake was
      sufficient. To prevent postoperative metabolic complications, the energy intake
      of glucose or fat should correspond to the patient's requirements, and excess
      carbohydrate should be avoided. The quantity and quality of the amino acid
      formula used must be carefully evaluated.

PMID- 11193715
TI  - Glutamine.
AB  - Relatively little was known about glutamine metabolism until the 1930s, when Sir
      Hans Krebs first demonstrated glutamine hydrolysis and biosynthesis in the
      kidney. Subsequent studies by Rose in 1938 demonstrated that glutamine is a
      nonessential (dispensable) amino acid, as it can be readily synthesized de novo
      in virtually all tissues in the body. Because the body has the capacity to
      synthesize considerable quantities of glutamine, it has been assumed that
      glutamine is not required in the diet. However, this amino acid becomes quite
      depleted during the course of a catabolic insult such as injury or infection,
      indicating that the ability of glutamine production to meet demands during a
      variety of surgical illnesses is impaired. In states of health, the assumption
      that glutamine is not required in the diet is probably valid, although it is
      difficult to test the hypothesis, as glutamine is present in virtually all
      dietary proteins. Most naturally occurring food proteins contain 4% to 8% of
      their amino acid residues as glutamine; therefore less than 10 g of dietary
      glutamine is likely to be consumed daily by the average person. In contrast to
      this usual dietary availability, studies in stressed patients indicate that
      considerably larger amounts of glutamine (20-40 g/day) may be necessary to
      maintain glutamine homeostasis. Thus from a nutritional standpoint, glutamine may
      be thought of as a drug as well as a nutrient. This paper reviews the physiology
      and biochemistry of glutamine with an emphasis on its metabolism in surgical
      illnesses and its role as a conditionally essential amino acid.

PMID- 11193716
TI  - Growth factors in clinical practice.
AB  - Growth factors enhance protein synthesis and thus reduce the catabolic response
      to injury. As a result of bioengineering and new manufacturing techniques several
      anabolic agents have become available for clinical use and have been evaluated in
      surgical patients with catabolic illness. Data support the anabolic effects of
      growth home in such patients, but its expense and possible deleterious effects
      during the acute phase of illness limit its use to selected patient groups.
      Insulin-like growth factor-1 has also been studied, but specific indications for
      its use have not been identified in catabolic patients. Testosterone and
      derivatives of this hormone exert anabolic effects, but few randomized trials
      include catabolic surgical patients, and higher doses of some derivative
      compounds are associated with hepatic dysfunction. Nonetheless, as we move into
      the future, studies will determine the specific doses for administration of these
      and other anabolic factors in specific patient groups. Anabolic therapy will
      shorten the length of therapy and improve the outcome in the future.

PMID- 11193717
TI  - Creation, evaluation, and continuing assurance of excellence of the certified
      surgical specialist.
AB  - A position paper on the subject of certified surgical specialists was published
      in 1966 under the direction of Professor Charles Wells of Liverpool, England.
      President John Terblanche of the International Federation of Surgical Colleges
      brought together leaders in surgical education from four nations (Australia,
      Japan, South Africa, United States) to update current "state-of-the art" views.
      Presentations were made at the 38th Congress of the International Society of
      Surgery, August 18, 1999 in Vienna, Austria. After careful review of the four
      presentations, it was clear that surgeons all over the world have made great
      improvements in the many facets of surgical education. Yet the advances remain
      spotty, with gaps noted when viewed from an international perspective.

PMID- 11193719
TI  - Lower limb revascularization and free flap transfer for major ischemic tissue
      loss.
AB  - The objective of this study was to assess the value of lower limb
      revascularization and free flap transfer (LLR-FFT) in the management of critical
      leg ischemia and major tissue loss. A total of 29 consecutive patients with
      critically ischemic leg and major tissue loss underwent 24 simultaneous and 6
      staged LLR-FFT procedures. The main outcome measures were bypass graft patency,
      free flap viability, leg salvage, patients alive with salvaged leg, and survival.
      At the 2-year follow-up, the bypass graft patency rate was 85%, secondary free
      flap viability rate was 82%, and 82% of patients achieved leg salvage and were
      ambulant. If the success was defined as patients being alive with a salvaged leg,
      the corresponding rate was 80%. Three patients achieved long-term primary patency
      and leg salvage despite free flap failure, which occurred during the 30-day
      postoperative period. Lower extremity revascularization plus free flap coverage
      of large ischemic lesions is valuable in achieving long-term leg salvage. Because
      revascularization and conventional management of major tissue loss alone can be
      effective in the management of a small number of cases, staged LLR-FFT is
      indicated, when appropriate, for better selection of patients undergoing such an
      aggressive and demanding treatment.

PMID- 11193718
TI  - Role of malignancy and preoperative embolization in the management of carotid
      body tumors.
AB  - The purpose of this retrospective study is to present our approach to the
      management of patients with carotid body tumors (CBTs), emphasizing the role of
      malignancy and preoperative embolization. Between 1975 and 1998 a series of 18
      patients with CBTs were treated, and 16 of them underwent successful excision of
      the tumor. According to the Shamblin classification, six of the tumors were type
      I, six type II, and six type III. In three of these patients (two with type II
      tumors and one with type III) in whom preoperative embolization had been
      performed, mean intraoperative blood loss was 400 ml, whereas in the remaining 13
      cases this loss was 700 ml. Two patients with intracranial tumor spread underwent
      only radiotherapy. Neither postoperative deaths nor strokes occurred. Temporary
      cranial nerve injury occurred in four cases (25%). Local lymph node invasion was
      found in two patients, establishing the diagnosis of malignancy. One of these
      patients developed distal metastases 3 years after the operation and was treated
      with radiotherapy and octreotide. Follow-up ranging from 30 months to 23 years
      (mean 5 years) revealed no local recurrence except for the two patients who were
      treated with radiotherapy only. In conclusion, surgical excision remains the
      treatment of choice for CBTs and can be performed without major risks and with
      low morbidity and mortality. Preoperative embolization is helpful by diminishing
      intraoperative bleeding, and malignancy, though rare justifies early management.

PMID- 11193720
TI  - Remaining small bowel length: association with catheter sepsis in patients
      receiving home total parenteral nutrition: evidence of bacterial translocation.
AB  - Patients with short bowel syndrome (SBS) receiving total parenteral nutrition
      (TPN) have a high incidence of catheter-related sepsis, one of its major
      complications. The aim of this study was to correlate the length of remaining
      small bowel (RSB) with septic episodes related to the central venous catheter in
      a group of patients with severe SBS with home TPN. The length of the RSB (<50 cm
      or > or = 50 cm) was related to the frequency of catheter sepsis, time until the
      first episode, and the agents responsible in eight SBS patients receiving home
      TPN. There were 13 episodes of catheter infection (0.88 per patient-year). The
      group with a shorter RSB length (five patients) presented 1.3 to 2.76
      infections/year and 2 to 9 months until the first episode, compared to 0 to 0.75
      infections/ year (p = 0.0357) and 11 to 65 months until the first episode (p =
      0.0332) in the group with the longer RSB. In the first group, the agents isolated
      were Enterobacteriae (Enterobacter sp., Klebsiella sp., Pseudomonas sp., and
      Proteus sp.) in eight episodes and Candida sp. in one. In the latter sepsis was
      caused by Staphylococcus sp. in three episodes and Pseudomonas sp. in one.
      Therefore patients with remaining small bowel shorter than 50 cm have a higher
      frequency of catheter-related sepsis, particularly by enteric microorganisms.
      This might be an evidence of the occurrence of bacterial translocation and its
      role in the pathogenesis of catheter-related sepsis in patients with an extremely
      short RSB receiving home TPN.

PMID- 11193721
TI  - Relation between effective utilization of exogenous fat emulsion as energy
      substrate and oxygen metabolism after surgery.
AB  - It is known that fat oxidation is increased in patients who have sustained
      surgical stress, but it is not clear whether fat emulsion should be administered
      during the early postoperative period. The aim of this study was to evaluate the
      utilization of exogenous fat emulsion after major surgery. Total parenteral
      nutrition composed of glucose/amino acids or glucose/amino acids/fat was
      administered for 6 days to 18 patients who had undergone esophagectomy. The
      caloric intake was significantly less than the resting energy expenditure (REE),
      and there was no difference in substrate utilization in either group up to
      postoperative day (POD) 2. After POD 4, fat utilization was significantly
      increased in the fat group. The total ketone body concentration was higher in the
      fat group than in the glucose group on POD 1 and 2. The arterial ketone body
      ratio (AKBR), which reflects the rate of turnover of the Krebs cycle, was
      positively correlated with the caloric intake/REE ratio. It was negatively
      correlated with the oxygen delivery index, oxygen consumption, and lactate
      concentration between POD 0 and POD 2. The lactate concentration was decreased
      and the AKBR was increased by POD 4. Fat emulsion was effectively utilized as
      energy substrate after POD 4, after the relative tissue hypoxia had improved and
      the AKBR had increased. The utilization of exogenous fat emulsion was closely
      related to deficient caloric intake and oxygen metabolism.

PMID- 11193722
TI  - Evaluation of the Maruyama computer program accuracy for preoperative estimation
      of lymph node metastases from gastric cancer.
AB  - Controversy still exists about the optimal lymph node (LN) dissection for
      potentially curable gastric cancer. For rational LN dissection it is important to
      know the incidence of metastasis at each LN station. For this purpose a computer
      program was developed using data from 4302 primary gastric cancers treated at the
      National Cancer Center Hospital in Tokyo between 1969 and 1989. To evaluate the
      accuracy of the computer program, the differences between the individual reports
      generated by the computer and the stored data were investigated in 282 Italian
      patients submitted to curative gastrectomy and D2 or more extended LN dissections
      for gastric cancer. Receiver operating characteristic (ROC) analysis was used to
      assess the sensitivity and specificity of the program for predicting LN
      metastases in each of the 16 regional LN stations. The computer program showed
      good predictive ability for LN metastases in most of the 16 LN stations, as the
      areas under the curve ranged from 0.741 (station 15) to 0.944 (station 8), with a
      mean of 0.856. A critical cutoff point of 18% of the program's expected
      percentage was the value maximizing the validity of the prediction. Using an
      "absolute" cutoff point of 0%, the overall rate of false-negative (FN)
      predictions in 176 N+ patients was 11.9%; of these, 11 (6.2%) were absolute FNs,
      in which the program totally failed to estimate LN metastases; the remaining 10
      cases (5.7%) were relative FNs because the specific prediction was positive for a
      different depth of stomach invasion. The low number of D3/D4 lymph-adenectomies
      in the historical database may affect the low estimate of metastases to N3/N4
      nodes generated by the program. Based on these data, the program predicts with
      good accuracy the extent of LN metastases from gastric cancer, but it is not
      recommended for directing the surgeon to perform more extensive lymphadenectomy.

PMID- 11193723
TI  - Risk factors for recurrence after resection of hepatitis C virus-related
      hepatocellular carcinoma.
AB  - Although there have been many studies of the risk factors for recurrence after
      resection of hepatocellular carcinoma (HCC), the subjects were patients with
      various viral status in the previous studies, and hepatitis C viremia has not
      been evaluated. We investigated risk factors, including hepatic C viremia and
      histologic findings of noncancerous hepatic tissue, for recurrence after
      resection of hepatitis C virus (HCV)-related HCC. A total of 223 patients who
      underwent liver resection for HCV-related HCC were studied. HCV viremia,
      laboratory data, degree of HCC malignancy, histologic findings in noncancerous
      hepatic tissue, preoperative interferon therapy, and operative methods were
      evaluated for recurrence risk by univariate and multivariate analyses. Serum
      levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and
      total bilirubin, and the proportion of patients with a high histologic activity
      score (mild to severe active hepatitis) were significantly higher in patients
      with HCV viremia than in those without viremia. Serum albumin was significantly
      lower in patients with HCV viremia. By univariate analysis, older age (> 65 years
      old), HCV viremia, elevated AST (> 40 IU/L) and ALT (> 45 IU/L), large tumors (>
      40 mm), multiple HCCs, moderately or poorly differentiated HCC, portal invasion,
      mild to severe active hepatitis, and lack of preoperative interferon therapy were
      risk factors for recurrence. Multivariate analysis showed that older age, HCV
      viremia, high AST, multiple HCCs, and portal invasion were independent risk
      factors. For HCV-related HCCs, not only the degree of malignancy of the HCC but
      also HCV viremia and active hepatitis are risk factors for recurrence.

PMID- 11193724
TI  - Additional hepatocellular carcinomas undetectable before surgery.
AB  - The presence of small additional hepatocellular carcinomas (HCCs) undetectable
      before hepatic resection is a crucial topic for hepatic surgeons. We assessed the
      incidence of pathologically diagnosed multiple HCCs in 267 patients who underwent
      hepatic resection for HCC. Ninety-five additional HCC nodules were detected in 72
      of the patients (27%). The survival rate of these 72 patients was significant
      worse than for the 195 with single nodular HCC (p = 0.0013). Twenty-one (22%)
      were detected before surgery, 29 (31%) during surgery, and 45 (47%) on pathologic
      examination after surgery. The mean nodule diameters for each group were 2.1,
      1.0, and 0.9 cm, respectively (p < 0.0001). None of the 21 nodules detected
      before surgery was well differentiated, whereas 30 of the 74 nodules in the other
      two groups were well-differentiated. Although the mean nodule diameter of the
      well-differentiated HCC group was the smallest, there was no significant
      difference among the three groups assigned according to tumor differentiation (p
      = 0.2355). Altogether, 9 of 16 patients with additional nodules detected before
      surgery (56%) and 49 of 59 with additional nodules detected during or after
      surgery (88%) had cirrhosis of the liver. The odds ratio for detecting a new HCC
      nodule during or after surgery in the presence of cirrhosis was 5.444 (p =
      0.0087). Improvement in the detection of small additional HCC nodules before and
      during surgery and meticulous follow-up after surgery are necessary for patients
      with cirrhosis. For patients without cirrhosis, surgical treatment may be
      performed according to the results of preoperative imaging studies.

PMID- 11193725
TI  - Upper airway obstruction in patients with goiter studies by flow volume loops and
      effect of thyroidectomy.
AB  - The patient with goiter and his or her physician frequently overlook symptoms of
      upper respiratory obstruction. Conventional radiology is the accepted method for
      detecting upper airway obstruction in these patients. Flow volume loops provide
      additional information on airflow dynamics. Twenty-five patients of goiter
      undergoing surgery were evaluated for upper airway obstruction by symptomatology,
      conventional radiology, and flow volume loops. Flow volume loops were repeated 1
      month after surgery. Ten (40%) patients had mild symptoms on direct questioning.
      Tracheal deviation, compression, or both were noted in eight (32%) patients on
      radiology. Flow volume loops detected upper airway obstruction in 15 (60%)
      patients. Surgery resulted in normalization of all preoperative abnormal curves.
      The flow volume loop is a simple noninvasive method for detecting upper airway
      obstruction in patients with goiter. Abnormal upper airway dynamics are present
      in more patients with goiter than previously recognized, and relief of this
      obstruction should be an important aspect of thyroid surgery.

PMID- 11193726
TI  - Preoperative localization of parathyroid adenoma in patients with concomitant
      thyroid nodular disease.
AB  - We have previously demonstrated the role of high-resolution ultrasonography (US)
      in preoperative localization of parathyroid adenoma in patients with primary
      hyperparathyroidism (PHPT) and no thyroid abnormalities. The present study
      prospectively evaluated the possible additional value of 99mTc-sestamibi (MIBI)
      in patients with PHPT and concomitant multinodular thyroid disease (MND).
      Patients with PHPT underwent US and MIBI scintigraphy prior to neck exploration.
      Imaging data were correlated with the site and pathology of the parathyroid
      tissue removed and were analyzed separately for patients with MND and those with
      a normal thyroid gland. Among 77 patients with a solitary parathyroid adenoma at
      surgery, 40 had concomitant MND, whereas 37 patients had no morphologic changes
      in the thyroid gland, on US or at surgery. Prior to surgery, MIBI scintigraphy
      depicted 58 of the 77 adenomas (75%) and US localized 51 (66%): the combined
      sensitivity was 87% (67/77). Among the 37 patients with no thyroid nodules, MIBI
      located 29 (78%) and US identified 30 (81%) of the adenomas; the combined
      sensitivity was 89%. In the 40 patients with MND, MIBI identified 29 adenomas
      (73%) and US localized only 53% (21/40); the combined sensitivity was 85%.
      Overall, the positive predictive value (PPV) of MIBI for detecting a solitary
      parathyroid adenoma was 94%, for US it was 88%, and with the two tests combined
      it was 97%. In patients with no thyroid abnormalities, the PPV of MIBI and US was
      97%, but it decreased to 91% and 78%, respectively, in patients with MND. Two
      patients with false-positive findings on both MIBI and US had associated thyroid
      disease. Hence MIBI scintigraphy contributes to localization of a solitary
      parathyroid adenoma mainly in patients with concomitant MND. The combined MIBI
      and US modalities result in sparing these patients bilateral neck exploration.

PMID- 11193727
TI  - Pancreastatin plasma levels in patients with primary hyperparathyroidism.
AB  - Pancreastatin, a C-terminally amidated peptide derived from chromogranin A, is
      known to inhibit insulin secretion, pancreatic enzyme release, and gastric acid
      secretion. It also inhibits parathyroid hormone (PTH) secretion in animals. The
      physiologic and clinical relevance of pancreastatin in humans, however, is not
      known. Because pancreastatin has been found in parathyroid adenomas, we
      investigated the plasma levels in patients with primary hyperparathyroidism
      (pHPT). Thirteen patients operated on for solitary parathyroid adenoma were
      investigated. Plasma levels of pancreastatin and serum levels of ionized calcium
      and intact PTH were measured before and 6 weeks after operation. In 10 patients
      the levels were also monitored before and 60 minutes after adenoma excision. The
      adenomas were investigated for pancreastatin immunoreactivity by
      immunocytochemistry. The median weight of the excised parathyroid adenoma was
      0.64 g (range 0.07-2.00 g). Cells displaying pancreastatin immunoreactivity were
      present in all adenomas examined and varied in number and immunostaining
      intensity among and within the adenomas. Intraoperatively, after adenoma excision
      the levels of PTH and pancreastatin declined (p < 0.01), whereas the levels of
      ionized calcium did not change (p = 0.96). At the 6-week follow-up the levels of
      ionized calcium and PTH had decreased compared to the preoperative levels (p <
      0.01), and all patients were normocalcemic. In contrast, the pancreastatin levels
      were not changed (14.5 +/- 6.1 pmol/L preoperatively vs. 12.8 +/- 11.2 pmol/L 6
      weeks postoperatively; p = 0.12). In patients with pHPT, pancreastatin is likely
      to be produced by the parathyroid adenoma. The changes in pancreastatin levels
      immediately after surgery warrant further investigation.

PMID- 11193728
TI  - Comparison of coagulation parameters for healthy subjects and Behcet disease
      patients with and without vascular involvement.
AB  - Behcet disease (BD) is an inflammatory illness that may attack several systems.
      Vascular involvement with thrombosis is one of the basic characteristics of this
      disease. The etiology of thrombosis tendency in BD has not been understood well.
      In this study, the role of primary coagulation parameters in patients with BD who
      have thromboembolic events was evaluated. In addition, the relation between the
      clinical activity of the disease and these parameters was compared. A total of 96
      patients with a diagnosis of BD were studied at Ankara University, Medical
      School, Department of General Surgery and Behcet Center. BD patients were
      separated into two groups with respect to vascular involvement. Group A contained
      22 patients with vascular attacks, and group B contained 74 patients without
      vascular attacks. In addition, 25 healthy persons comprised the control group
      (group C). The coagulation parameters assessed included protein C, protein S,
      antithrombin III activity, fibrinogen level, prothrombin time (PT), and partial
      thromboplastin time (PTT). There were no differences among the three groups with
      respect to protein C, protein S, fibrinogen, PT, and PTT values (p > 0.05). The
      antithrombin III value was found to be high in BD patients compared to those in
      the control group (p = 0.011). There was no difference regarding the antithrombin
      III value between BD patients with or without vascular attacks (p = 0.954). There
      was no correlation between the activity of disease and coagulation parameters (p
      > 0.05), but a positive correlation was seen between the duration of illness and
      vascular involvement. Fifty percent of patients who had had BD more than 8 years
      had vascular involvement (p = 0.002). We could not determine a specific pathology
      in relation to coagulation parameters that could explain the etiology of
      thrombosis in patients with BD. The elevated antithrombin III levels in patients
      with BD (compared to controls) may be due to a compensatory defense mechanism
      against increased procoagulant activity. There was a correlation between the
      duration of illness and vascular involvement.

PMID- 11193729
TI  - II. Vinzenz Czerny (1842-1915): grand seigneur of oncologic surgery--life,
      influence, and work of the Second Congress President of the ISS/SIC.
      International Society of Surgery/Societe Internationale de Chirurgie.
AB  - Vinzenz Czerny, chairman and professor of surgery in Freiburg im Breisgau and in
      Heidelberg, Germany, is the typical example of a prominent surgeon with an
      elegant technique, who was also a keen observer and scientist at the turn of the
      nineteenth into the early twentieth century. Starting his career in Vienna,
      Austria, he can be looked upon as the most important disciple of Theodor
      Billroth. Whereas Billroth may be regarded as the father of modern
      gastrointestinal surgery, Czerny can be considered the father of modern surgery
      for intestinal malignancies and multimodal treatment. The early history of
      visceral cancer therapy is linked with his career. He became a surgeon of the
      highest rank, with great clinical skill, rare judgment, and vision who
      contributed essentially to the development of modern surgery. From his early
      education he maintained a lifelong affection for the natural sciences and was an
      excellent physiologist and pathologist. During his professional life he
      successfully built up a well deserved reputation for general and cancer surgery
      and for the introduction of radio- and chemotherapy into the treatment of tumors.
      Czerny founded and chaired the first experimental Institute for Cancer Research
      in Germany. Two years later, in 1908, he presided at the 2nd Congress of the
      International Society of Surgery/Societe Internationale de Chirurgie (ISS/SIC) in
      Brussels, a congress that was almost entirely devoted to the etiology of visceral
      cancer and the progress and achievements of its treatment. Czerny left a clear
      legacy of opinion and methods on which the modern era of surgical cancer
      treatment is based.

PMID- 11193730
TI  - Plant Virus Epidemiology: Challenges for the twenty-first century. 11-16 April
      1999. Conference proceedings.

PMID- 11193731
TI  - An extremely interesting conference.

PMID- 11193732
TI  - Emerging new biotechnologies and the patent attorneys' struggle to best protect
      them.

PMID- 11193733
TI  - Biomonitoring, ecoextrapolation and then bioremediation for ecorestoration?

PMID- 11193734
TI  - Chloroplast genetic engineering.

PMID- 11193735
TI  - Tubular carcinoma of the breast: a histologic subtype indicative of breast
      conserving therapy.
AB  - We reviewed the clinical and pathologic features of pure tubular carcinoma of the
      breast with particular emphasis on the reported risk factors associated with
      local recurrences and survival following breast-conserving therapy. Of 1653 cases
      of invasive breast cancer, 12 (0.7%) were identified as pure tubular carcinoma.
      Clinical/pathologic features of pure tubular carcinoma were compared with those
      of T1 invasive carcinoma of all other histologic types (T1 IC). Of the 12
      patients with pure tubular carcinoma (median tumor diameter 1.4 cm; range 0.5-3.0
      cm), a multicentric association was identified in one patient while a multifocal
      association was seen in two. One patient had nodal metastatic disease out of the
      ten who underwent axillary dissection. No lymphatic vessel invasion was
      identified in any tumors (P < 0.1 vs T1 IC). In addition, extensive intraductal
      spread was not present in any tumors (P < 0.05 vs T1 IC). This study shows that
      patients with pure tubular carcinoma are appropriate candidates for breast
      conserving therapy based on the clinical/ pathologic features. When a multifocal
      association is suspected preoperatively, either a wide local excision or a
      quadrantectomy which includes other lesions is thus recommended.

PMID- 11193736
TI  - The prognosis of patients with non-small cell lung cancer found to have
      carcinomatous pleuritis at thoracotomy.
AB  - Non-small cell lung cancer with carcinomatous pleuritis is considered to be a
      contraindication of surgical resection. The objective of this study was to
      clarify the prognosis of patients with non-small cell lung cancer in whom
      carcinomatous pleuritis was found at thoracotomy. A questionnaire survey on the
      survival of patients with carcinomatous pleuritis found at thoracotomy between
      January 1985 and December 1994 was conducted by the Japan Clinical Oncology
      Group. According to the data collected from 21 hospitals, 8813 patients with non
      small cell lung cancer underwent thoracotomy, 284 (3.2%) of whom were found to
      have carcinomatous pleuritis. Information on survival was available for 227 of
      these patients, 34 (15%) of whom underwent thoracotomy alone without resection,
      whereas 193 (85%) underwent surgical resection. Of the 193 resected patients, 155
      had no macroscopical residual tumor apart from the carcinomatous pleuritis. The 5
      year survival rate was 14%. According to a univariate analysis, female sex, the
      presence of adenocarcinoma, a tumor size of less than 3.0 cm, no clinical lymph
      node metastasis, and no macroscopical residual tumor had a significantly
      favorable impact on survival. A multivariate analysis revealed that the extent of
      clinical lymph node metastasis (P = 0.006), histology (P = 0.028), and the
      absence or presence of a macroscopic residual tumor after the operation (P =
      0.045) were predominant prognostic factors. The 5-year survival rate of 83
      patients with three positive variables was 24%. The prognosis of patients with
      adenocarcinoma found to have carcinomatous pleuritis at thoracotomy was not
      necessarily unfavorable if there was no clinically detected lymph node metastasis
      and no residual tumor apart from the carcinomatous pleuritis.

PMID- 11193737
TI  - A phase II trial of a new 5-fluorouracil derivative, BOF-A2 (Emitefur), for
      patients with advanced gastric cancer.
AB  - The antineoplastic effects of BOF-A2 (Emitefur), a 5-fluorouracil (5-FU)
      derivative, in capsule form were assessed in patients with advanced gastric
      cancer, in a multicenter late phase II study and at 11 different hospitals. The
      patients were scheduled to receive a minimum of two courses of BOF-A2 orally,
      with each course of BOF-A2 consisting of 200 mg twice daily for 2 weeks followed
      by a withdrawal period of 2 weeks. Of the 24 patients entered into the study, the
      clinical response was able to be evaluated in 21 cases and the toxicity was
      determined in 23 cases. Eleven (45.8%) patients had been treated previously with
      other anticancer drugs. There was a 38.1% (8/21) response rate (95% confidence
      interval 17.3-58.9) with 1 (4.8%) complete response (CR) and 7 (33.3%) partial
      responses (PR), and these responses continued for over 4 months. In particular,
      the response rate for the primary lesion was 33.3% (3/9). No change (NC) in the
      disease was observed in 5 (23.8%) patients, and in 8 (38.1%) the disease
      progressed (PD). At the time of analysis, the median survival of the responders
      was 13 months, while that of the NC group was 7 months and that of the PD group
      was 2 months. The major adverse events consisted of gastrointestinal symptoms,
      myelosuppression, and skin symptoms, while toxicities of grade 3 or more occurred
      in 26.1% (6/23). These toxicities all resolved within 1-37 days after
      discontinuing the drug treatment. Based on the above findings, BOF-A2 is
      considered to be a promising anticancer drug for patients with advanced gastric
      cancer.

PMID- 11193738
TI  - Lymph node metastasis-related carbohydrate epitopes of gastric cancer with
      submucosal invasion.
AB  - This study was conducted to examine the lymph node metastasis-related
      carbohydrate epitopes of cancer cells in primary lesions of gastric cancer with
      submucosal invasion (sm gastric cancer). A total of 118 formalin-fixed and
      paraffin-embedded surgical specimens were studied. Carbohydrate epitopes were
      detected histochemically using 17 kinds of biotin-labeled lectins and three kinds
      of monoclonal antibodies (mAbs) against Thomsen-Friedenreich antigen (HB-T1), Tn
      (HB-Tn1), and sialyl Tn antigens (HB-STn1). The node-positive group showed
      significantly lower reactivities with Ricinus communis I (RCA-I), Lotus
      tetragonolobus (Lotus), Triticum vulgaris (WGA), and Concanavalia ensiformis
      (ConA), and higher reactivities with HB-STn1. When sm gastric cancer was
      classified into differentiated and undifferentiated types, lower reactivities
      with RCA-I and ConA were observed in the differentiated type cancers, whereas
      lower reactivities with Lotus, WGA, and higher reactivity with HB-STn1 were
      observed in the undifferentiated type cancers. Nodal status was able to be
      predicted with high precision by a combination of these carbohydrates and
      histological subtypes. Since neuraminidase treatment rarely changed the
      reactivity of cancer cells with these lectins, we conclude that the loss of
      certain kinds of carbohydrates that are restricted by histological subtypes is
      related to lymph node metastasis in sm gastric cancer.

PMID- 11193739
TI  - Immunocytochemical analysis of cellular infiltrates in human appendicitis.
AB  - This study was conducted to determine the immunologic cellular composition in
      human appendicitis and its association with the development of perforated
      appendicitis. Appendiceal specimens from 27 patients with acute appendicitis were
      immunostained to detect lymphocyte surface markers. Moreover, the lymphocyte
      surface markers of peripheral blood were analyzed by laser flow cytometry in 12
      patients. Helper T lymphocytes (CD4) were present in all the patients, while B
      lymphocytes (CD19), natural killer (NK) cells (CD56), and cytotoxic T lymphocytes
      (CD8) were present in 7 (70%), 10 (100%), and 9 patients (90%) with perforated
      appendicitis, and in 12 (63.2%), 10 (58.8%), and 6 (54.5%) patients without
      perforation, respectively. There were significant differences between the
      patients with a perforated appendix and those without perforation, in the
      positivity rate for CD8 and CD56 cells (P < 0.05). The number of cells positive
      for CD56, being NK cells, in the blood from the patients with perforation was
      significantly lower than that in the blood from those without perforation (P <
      0.05). The infiltration of a greater number of cytotoxic T lymphocytes and NK
      cells was observed in the appendices from patients with perforated appendicitis
      than in those from patients with nonperforated appendicitis.

PMID- 11193740
TI  - The effect of upper dorsal thoracoscopic sympathectomy on the total amount of
      body perspiration.
AB  - Thoracoscopic T2-T3 sympathectomy is the treatment of choice for primary palmar
      hyperhidrosis (PPH); however, compensatory hyperhidrosis (CH) is a disturbing
      sequela of this operation, the mechanism of which is poorly understood. This
      study was conducted to evaluate the effect of heat stress on total body
      perspiration after thoracoscopic T2-T3 sympathectomy, and determine its
      correlation with CH. A total of 17 patients with PPH who underwent bilateral T2
      T3 sympathectomy were subjected to heat stress induced by a 10-min sauna bath
      (ambient temperature 70 degrees C), 1 day before and 1 month after surgery. The
      naked body weight was recorded before and immediately following the sauna bath,
      and the patients were followed up to assess whether CH had developed and the
      degree of its severity. Postoperatively, the amount of perspiration increased in
      13 patients and decreased in 1. The amount of perspiration induced by the sauna
      bath ranged from 60 to 480 g, with a mean value of 185.29 +/- 125.80 g, before
      the operation, and from 60 to 540 g, with a mean value of 265.88 +/- 154.05 g,
      after the operation (P = 0.0113). There was no correlation between the degree of
      alteration in total body perspiration and the development of CH. Performing
      thoracoscopic T2-T3 sympathectomy for PPH affects the total body sweating
      response to heat; however, the development of CH does not correlate with this
      alteration.

PMID- 11193741
TI  - The effect of immunosuppression on aortic dilatation in a rat aneurysm model.
AB  - This study was conducted to investigate whether systemic immunosuppression
      attenuated aortic dilatation in a rat aneurysm model. Sprague-Dawley rats were
      subjected to elastase infusion of the infrarenal aorta and divided into two
      groups of 12 rats each. The immunosuppression group (group 1) was given
      subcutaneous injections of cyclosporine A (5 mg/kg per day), azathioprine (2
      mg/kg per day), and methylprednisolone (2 mg/kg per day) from the operative day
      until postoperative day (POD) 6. An additional subcutaneus injection of
      cyclophosphamide 30 mg/kg was also given on the operative day. The control group
      (group 2) was given subcutaneous injections of saline. Relaparotomy was performed
      on POD 7. After measurement of the aortic diameter, aortography and
      ultrasonography were performed in three rats from each group, following which the
      aortas were excised for histologic examination. The aortic diameter was
      significantly smaller in group 1 (2.58 +/- 0.37 mm) than in group 2 (6.21 +/-
      1.74 mm) (P < 0.01) and the aortic lumen was slightly dilated in group 1, whereas
      it was spherically dilated in group 2. Total loss of elastic tissue was seen in
      both groups. Inflammatory cell infiltration and collagen fiber fragmentation were
      noted in group 2, whereas very little inflammatory cell infiltration and well
      preserved collagen fibers were seen in group 1. These findings showed that
      immunosuppression attenuates aortic dilatation, partly by preserving the collagen
      fibers, in this rat aneurysm model.

PMID- 11193742
TI  - Therapeutic effect of TNP-470 on spontaneous liver metastasis of colon tumors in
      the rabbit.
AB  - Even though angiogenesis inhibitor is thought to be one of the promising agents
      in tumor dormancy therapy, its optimal administration is still unknown.
      Therefore, the efficient protocol using TNP-470 was examined regarding its
      treatment affect against spontaneous liver metastases of colon tumors in the
      rabbit. A spontaneous liver metastases model was established in the rabbit by the
      inoculation of VX-2 tumors into the subserosal space of the colon. The
      therapeutic effect of TNP-470 was then investigated by monitoring both the number
      of metastatic nodules in the liver and the microvessel density (MVD) in the tumor
      by immunohistochemical staining using anti-CD31 monoclonal antibody. TNP-470 did
      not show any effect on the primary tumor. It was able to reduce the metastatic
      spread to liver when it was administered at the microscopic metastatic stage.
      Treatment at this stage, however, was not able to sufficiently control the
      disease. These results indicated that TNP-470 could efficiently cause the tumor
      to enter into a dormant state by inhibiting angiogenesis when it was used at the
      initial stage of the metastatic process in the liver. Regarding its clinical
      application, TNP-470 might be useful for preventing the metachronous liver
      metastases of colorectal cancer when it is administered as adjuvant therapy after
      curative surgery.

PMID- 11193743
TI  - Rhabdomyosarcoma presenting as an anterior cervical mass in an adult: report of a
      case.
AB  - We report herein the case of a 61-year-old man who was referred to our hospital
      for treatment of a rapidly growing tumor in the right anterior cervical region. A
      13 x 14 x 15 cm mass was palpated on physical examination. Computed tomography
      (CT) findings indicated a thyroid tumor, but cytology results suggested
      rhabdomyosarcoma. A tumor, measuring 9.3 x 7.2 x 5.2 cm and weighing 220 g, was
      resected and histopathological examination confirmed a diagnosis of
      rhabdomyosarcoma. Cervical rhabdomyosarcoma is rarely found in adults.

PMID- 11193744
TI  - Reexpansion pulmonary edema due to high-frequency jet ventilation: report of a
      case.
AB  - Barotrauma is well known to be a relatively common complication of high-frequency
      jet ventilation (HFJV); however, the occurrence of reexpansion pulmonary edema
      (REPE) is extremely rare. We report herein a case of REPE caused by difficulties
      encountered with anesthesia using HFJV during video-assisted thoracic surgery
      (VATS) for a spontaneous pneumothorax. We believe the rapid increase in pressure
      in the lung after degassing for VATS resulted in REPE as well as typical
      barotrauma.

PMID- 11193745
TI  - Left ventricular myxoma: report of a case.
AB  - Although recent advances in echocardiography have made it easier to detect
      cardiac tumors, left ventricular myxomas are still rare and often not found until
      the patient presents with a history of syncopal episodes or systemic
      embolization. Left ventricular myxomas are usually benign and curable; however,
      unreliable excision of the myxoma due to poor visualization of the left
      ventricular cavity can result in recurrence. To prevent recurrence, it is
      necessary to select the most appropriate surgical approach to excise the myxoma
      completely. We report herein the case of a patient in whom surgical excision of a
      left ventricular myxoma arising from the posterior wall of the left ventricle was
      successfully performed.

PMID- 11193746
TI  - Surgical treatment of a sigmoid volvulus associated with megacolon: report of a
      case.
AB  - Sigmoid volvulus occurring concomitantly with megacolon is an uncommon cause of
      bowel obstruction, and various approaches to treatment have been proposed. We
      report herein a case of sigmoid volvulus with megacolon that was successfully
      treated by elective surgery following endoscopic reduction during the same
      hospital stay. A 70-year-old woman was admitted to our hospital with abdominal
      pain, distension, and severe constipation. Physical examination, plain abdominal
      X-ray, and barium enema confirmed a sigmoid volvulus and further examinations
      revealed concomitant megacolon. An elective sigmoid colectomy was performed
      following successful endoscopic decompression. The postoperative course was
      uneventful and there was no residual colonic dysmotility. Histologically, no
      aganglionic tissue was observed in the resected specimen.

PMID- 11193747
TI  - Metastasis to the forearm skeletal muscle from an adenocarcinoma of the colon:
      report of a case.
AB  - While the liver and lung are primary targets for distant metastasis from
      colorectal carcinoma, metastasis in other distant sites is rarely found. We
      report herein an unusual case of metastasis to the skeletal muscle of the right
      forearm from an adenocarcinoma of the transverse colon. A 60-year-old man was
      originally admitted to our hospital for surgical treatment of an intestinal
      obstruction caused by a transverse colon carcinoma. Transverse colon resection
      along with lymph node dissection was performed and no evidence of distant
      metastatic foci was found. Angiography-enhanced computed tomography scanning done
      14 months after the first operation revealed multiple hepatic metastases which
      were resected. A metastasis was subsequently detected in the right extensor carpi
      ulnaris muscle 2 years after the primary resection, and a major part of the right
      extensor carpi ulnaris and the extensor digiti minimi muscle were resected,
      warranting a sufficient margin of 5 cm of normal tissue from the tumor.
      Reattachment of the residual muscles into the ulna was performed. Metastases to
      bone and/or soft tissues from colorectal carcinomas are extremely rare and to our
      knowledge, only eight other cases have been reported in the world literature.
      This low incidence may be related to the anatomical characteristics and/or the
      biochemical environment of the skeletal muscle, but it is also possible that the
      true incidence is underestimated. Recent improvements in interventional
      radiological procedures may facilitate a diagnosis of skeletal muscle metastasis
      being made more frequently.

PMID- 11193748
TI  - Membranous glomerulonephritis associated with diffuse malignant pleural
      mesothelioma: report of a case.
AB  - Membranous glomerulonephritis is associated with a variety of malignant
      neoplasms. However, an association between membranous glomerulonephritis and
      pleural mesothelioma is very rare. We report herein a case of pleural
      mesothelioma associated with membranous glomerulonephritis. A 52-year-old man
      with severe proteinuria was diagnosed to have diffuse malignant pleural
      mesothelioma. A left extrapleural pneumonectomy was thus performed. The
      proteinuria resolved postoperatively. However, 6 months postoperatively, the
      proteinuria recurred. A renal biopsy revealed membranous glomerulonephritis.
      Simultaneously, a recurrence of the mesothelioma in the left pleural cavity was
      confirmed. Although rare, membranous glomerulonephritis appears to be one type of
      paraneoplastic syndrome associated with malignant pleural mesothelioma.

PMID- 11193749
TI  - Discovery and perspectives from the blastokinin era.
AB  - The events and rationalizations that led to one discovery of the rabbit uterine
      protein, then called blastokinin, are narrated in historical perspective and
      related to the independent discovery of the same protein, named uteroglobin. The
      period when the name "blastokinin" remained in partial use, roughly from the
      original publication in 1967 until the early 1980s, is considered here as the
      blastokinin era. Subsequent perspectives, originating from the era, are presented
      on the hormonal regulation of blastokinin, as well as its distribution,
      biological function, and potential relationships with other entities that exist
      coincidentally.

PMID- 11193750
TI  - Crystal structure analysis of recombinant human uteroglobin and molecular
      modeling of ligand binding.
AB  - Uteroglobin, a steroid-inducible, cytokine-like, secreted protein with
      immunomodulatory properties, has been reported to bind progesterone,
      polychlorinated biphenyls (PCB), and retinol. Structural studies may delineate
      whether binding of ligands is a likely physiological function of human
      uteroglobin (hUG). We report a refined crystal structure of uncomplexed
      recombinant hUG (rhUG) at 2.5-A resolution and the results of our molecular
      modeling studies of ligand binding to the central hydrophobic cavity of rhUG. The
      crystal structure of rhUG is very similar to that of reported crystal structures
      of uteroglobins. Using molecular modeling techniques, the three ligands--PCB,
      progesterone, and retinol--were docked into the hydrophobic cavity of the dimer
      structure of rhUG. We undocked the progesterone ligand by pulling the ligand from
      the cavity into the solvent. From our modeling and undocking studies of
      progesterone, it is clear that these types of hydrophobic ligands could slip into
      the cavity between helix-3 and helix-3' of the dimer instead of between helix-1
      and helix-4 of the monomer, as proposed earlier. Our results suggest that at
      least one of the physiological functions of UG is to bind to hydrophobic ligands,
      such as progesterone and retinol.

PMID- 11193751
TI  - Antiflammins. Bioactive peptides derived from uteroglobin.
AB  - Uteroglobin/Clara cell 10-kDa protein (UG/CC10) is a hormonally regulated small
      secretory protein that has a variety of in vitro and in vivo pharmacological
      effects. These include a potent anti-inflammatory activity and inhibitory effects
      on neutrophil migration, thrombin-induced platelet aggregation, in vitro
      chemoinvasion, as well as "tumor suppressor"-like effects and other properties.
      Several mechanisms of action have been proposed for these effects.
      Pharmacological properties suggest that UG itself or substances derived from it
      may be used as experimental drugs for several indications. The group of
      oligopeptides collectively known as "antiflammins" (AFs) were originally
      described in 1988. Their design was derived from the region of highest sequence
      similarity between UG and another group of proteins with anti-inflammatory
      properties, the lipocortins or annexins. Nanomolar concentrations of these
      peptides can reproduce several of the pharmacological activities of UG, including
      its in vivo anti-inflammatory effects and inhibition of platelet aggregation. The
      AFs have been safely and effectively used to suppress inflammation and fibrosis
      in several animal models. Progress in clarifying the mechanism of action of the
      AFs may facilitate the structure-based design of a novel class of potent anti
      inflammatory, antichemotactic drugs.

PMID- 11193752
TI  - Therapeutic applications of antiflammin peptides in experimental ocular
      inflammation.
AB  - Antiflammins are synthetic peptides derived from the region of highest local
      similarity between uteroglobulin and lipocortin. These peptides have shown anti
      inflammatory activity on carrageenan-induced rat footpad edema. They are potent
      inhibitors for phospholipase A2 activation both in vitro and in vivo. Previously,
      we have demonstrated the effectiveness of topical antiflammins in suppressing
      acute ocular inflammation and allergic response in rodent endotoxin-induced
      uveitis and murine allergic conjunctivitis. The mechanisms by which antiflammins
      protect against inflammation and allergy in these ocular models may involve
      inhibition of phospholipase A2 and inducible nitric oxide synthase (iNOS) as well
      as the production of proinflammatory cytokine, interleukin-6.

PMID- 11193753
TI  - Antiflammin peptides in the regulation of inflammatory response.
AB  - This review focuses on the role of antiflammins in the regulation of the
      inflammatory response, in particular acute inflammation. The results show that
      antiflammins were effective on several classical models of inflammation.
      Preliminary data suggest that antiflammin action may be due to their ability to
      suppress leukocyte trafficking to the lesion.

PMID- 11193754
TI  - Regulation of the Clara cell secretory protein/uteroglobin promoter in lung.
AB  - Clara cell secretory protein/uteroglobin (CCSP/UG) is specifically expressed in
      the conducting airway epithelium of the lung in a differentiation-dependent
      manner. The proximal promoter region of the rodent CCSP/UG gene directs Clara
      cell specificity. Previously, it was shown that the forkhead transcription
      factors HNF-3 alpha and beta and the homeodomain factor TTF-1 are important
      transcription factors acting through this region, suggesting that they contribute
      to cell specificity of the CCSP/UG gene. Members of the C/EBP family of
      transcription factors can also interact with elements of the proximal rat and
      mouse CCSP/UG promoters. The onset of C/EBP alpha expression in Clara cells
      correlates with the strong increase of CCSP/UG expression. Thus, C/EBP alpha may
      play a crucial role for differentiation-dependent CCSP/UG expression.
      Transfection studies demonstrate that C/EBP alpha and TTF-1 can synergistically
      activate the murine CCSP/UG promoter. Altogether, these results suggest that
      C/EBP alpha, TTF-1, and HNF-3 determine the Clara cell-specific, differentiation
      dependent expression of the CCSP/UG gene in murine lung. The relative importance
      of these three transcription factors, however, differs in rabbits and humans.

PMID- 11193755
TI  - Uteroglobin gene transcription: what's the RUSH?
AB  - Prolactin enhances progesterone-dependent transcription of the rabbit uteroglobin
      gene. RUSH transcription factors are implicated in the signal transduction
      pathway. The RUSH acronym identifies key features of these nuclear
      phosphoproteins, that is, RING-finger motif, binds the uteroglobin promoter,
      structurally related to the SWI/SNF family of transcription factors, and helicase
      like. Cloned by recognition site screening, RUSH proteins bind to an 85-bp region
      (-170/-85) of the uteroglobin promoter that was subsequently identified as a
      novel prolactin-responsive region by promoter deletion analysis. Gel shift and
      linker-scanning assays further reduced the RUSH target site to -160/-110. A
      hexameric core of MCWTDK was identified as the RUSH-specific DNA-binding site (
      126/-121) by CASTing. This site overlaps authentic HNF3 beta and OCT-1 binding
      sites. A unique Type IV P-type ATPase that is embedded in the inner nuclear
      membrane binds the RING domain of RUSH. The conformationally flexible loop
      portion of this RING-finger binding protein (RFBP) extends into the nucleoplasm
      to contact euchromatin. The physical association of RFBP with transcriptionally
      active chromatin supports the speculation that RFBP targets RUSH transcription
      factors to the active uteroglobin promoter.

PMID- 11193756
TI  - Physiological regulation of uteroglobin/CCSP expression.
AB  - Uteroglobin/CCSP is expressed specifically in the Clara cells. This allows the
      gene to be used as a marker to identify the elements regulating the physiologic
      and cell-specific expression of this gene. The regulation of UG/CCSP by IFN-gamma
      was shown to be at the level of the proximal promoter by the upregulation of HNF3
      beta. This has allowed the determination of the factors responsible for the
      expression of UG/CCSP.

PMID- 11193757
TI  - Tumor necrosis factor alpha stimulation of human Clara cell secretory protein
      production by human airway epithelial cells.
AB  - Clara cell secretory protein (CCSP) or uteroglobin/CC10 is a product of
      epithelial cells in a variety of organs including the lung. CCSP has anti
      inflammatory properties and may act as an inhibitor of secretory phospholipase
      A2's. Tumor necrosis factor alpha (TNF-alpha) is capable of inducing the
      expression of gene products including a variety of cytokines and chemokines in
      the airway epithelium that may upregulate the airway inflammatory response.
      Therefore, it was of interest to determine whether this proinflammatory cytokine
      might also induce the production of a counterregulatory protein such as CCSP,
      which might modulate the inflammatory response in the airway. Normal human
      tracheobronchial epithelial cells in primary culture and a human bronchial
      epithelial cell line (BEAS-2B) were studied. CCSP mRNA levels in BEAS-2B cells
      were detected by ribonuclease protection assay. CCSP mRNA levels increased in
      response to TNF-alpha (20 ng/mL) stimulation after 8-36 h, with the peak increase
      at 18 h. Immunoblotting of CCSP released from BEAS-2B cells into the culture
      media demonstrated that TNF-alpha induced the synthesis and secretion of CCSP
      over 8 to 18 h. Similarly, TNF stimulated the release of CCSP from human
      tracheobronchial epithelial cells in primary culture at 8 and 18 h. The CCSP
      reporter gene including 801 bases 5' of the transcription start site did not
      increase transcriptional activity in response to TNF-alpha stimulation. A CCSP
      mRNA half-life assay indicated that TNF-alpha induced increases in CCSP mRNA at
      least in part at a posttranscriptional level. Therefore, TNF-alpha induces airway
      epithelial cell expression of human CCSP and may modulate airway inflammatory
      responses in this manner.

PMID- 11193758
TI  - Pulmonary phenotype of CCSP/UG deficient mice: a consequence of CCSP deficiency
      or altered Clara cell function?
AB  - Clara cell secretory protein (CCSP) is the most abundant secreted protein within
      airways of the lung. Moreover, CCSP levels are modulated in human lung disease,
      supporting a potentially important role for CCSP and/or Clara cells in lung
      homeostasis. However, in vivo roles for CCSP remain elusive. A popular hypothesis
      is that CCSP is a regulator of the inflammatory response. The purpose of this
      review is to provide an overview of the phenotype of CCSP null mice and relate
      this phenotype to proposed functions for the protein. Phenotypic analysis of mice
      homozygous for the CCSP-1 null allele of the CCSP gene (CCSP-/-1) revealed
      susceptibility to inhaled oxidant gases. Sensitivity of CCSP-/-1 mice to inhaled
      ozone is unrelated to alterations in antioxidant defenses, but is associated with
      increased cellular injury. Additional studies investigating inflammatory control
      in CCSP deficient mice found no differences between wild-type and CCSP-/-1 mice
      in their inflammatory response to low-dose inhaled endotoxin exposure, arguing
      against a role for CCSP in regulation of pulmonary inflammation. The findings
      among CCSP-/-1 mice of ultrastructural alterations to Clara cell secretory
      apparatus, with associated changes in airway lining fluid protein composition,
      demonstrate that the CCSP-/-1 genotype results in more complex changes to airways
      than CCSP deficiency per se. It can be concluded that CCSP does not regulate
      endotoxin-induced pulmonary inflammation. Moreover, CCSP-/-1 mice represent a
      valuable tool for probing functional roles for Clara cells in regulation of
      airway lining fluid composition and lung pollutant susceptibility.

PMID- 11193759
TI  - Insight into the physiological function(s) of uteroglobin by gene-knockout and
      antisense-transgenic approaches.
AB  - To determine the physiological function(s) of uteroglobin (UG), a steroid
      inducible, homodimeric, secreted protein, we have generated transgenic mice that
      either are completely UG-deficient due to UG gene-knockout (UG-KO) or are
      partially UG-deficient due to the expression of UG antisense RNA (UG-AS). Both
      the UG-KO and UG-AS mice develop immunoglobulin A (IgA) nephropathy (IgAN),
      characterized by microhematuria, albuminuria, and renal glomerular deposition of
      IgA, fibronectin (Fn), collagen, and C3 complement. This phenotype of both UG-KO
      and UG-AS mice is virtually identical to that of human IgAN, the most common
      primary glomerulopathy worldwide. The molecular mechanism by which UG prevents
      this disease in mice appears to center around UG's interaction with Fn. Since Fn,
      IgA, and UG are present in circulation and high plasma levels of IgA-Fn complex
      have been reported in human IgAN, we sought to determine whether UG interacts
      with Fn and prevents Fn-Fn and/or IgA-Fn interactions, essential for abnormal
      tissue deposition of Fn and IgA. Our coimmunoprecipitation studies uncovered the
      formation of Fn-UG heteromers in vitro and these heteromers are detectable in the
      plasma of normal mice, but not UG-KO mice. Further, high plasma levels of IgA-Fn
      complex, a characteristic of human IgAN patients, were also found in UG-KO mice.
      Finally, coadministration of UG + Fn or UG + IgA to UG-KO mice prevented
      glomerular deposition of Fn and IgA, respectively. Our results define a possible
      molecular mechanism of IgAN and provide insight into at least one important
      physiological function of UG in maintaining normal renal function in mice.

PMID- 11193760
TI  - Uteroglobin binding proteins: regulation of cellular motility and invasion in
      normal and cancer cells.
AB  - Uteroglobin (UG) is a multifunctional, secreted protein with anti-inflammatory
      and antichemotactic properties. While its anti-inflammatory effects, in part,
      stem from the inhibition of soluble phospholipase A2 (sPLA2) activity, the
      mechanism(s) of its antichemotactic effects is not clearly understood. Although
      specific binding of UG on microsomal and plasma membranes has been reported
      recently, how this binding affects cellular function is not clear. Here, we
      report that recombinant human UG (hUG) binds to both normal and cancer cells with
      high affinity (20-35 nM, respectively) and specificity. Affinity cross-linking
      studies revealed that 125I-hUG binds to the NIH 3T3 cell surface with two
      proteins of apparent molecular masses of 190 and 49 kDa, respectively. UG
      affinity chromatography yielded similar results. While both the 190- and 49-kDa
      proteins were expressed in the heart, liver, and spleen, the lung and trachea
      expressed only the 190-kDa protein. Some cancer cells (e.g., mastocytoma,
      sarcoma, and lymphoma) expressed both the 190- and 49-kDa proteins. Further,
      using functional assays, we found that UG dramatically suppressed the motility
      and extracellular matrix invasion of both NIH 3T3 and some cancer cells. In order
      to further characterize the anti-ECM-invasive properties of UG, we induced
      expression of hUG into cancer cell lines derived from organs that, under
      physiological circumstances, secrete UG at a high level. Interestingly, it has
      been reported that a high percentage of the adenocarcinomas arising from the same
      organs fail to express UG. Our results on induced hUG expression in these cells
      show that inhibition of motility and ECM invasion requires the expression of both
      UG and its binding proteins. Taken together, our data define receptor-mediated
      functions of UG in which this protein regulates vital cellular functions by both
      autocrine and paracrine pathways.

PMID- 11193761
TI  - The role of CC10 in pulmonary carcinogenesis: from a marker to tumor suppression.
AB  - CC10 is infrequently expressed in human non-small cell lung cancers (NSCLCs),
      despite being abundantly produced by progenitor cells for normal and neoplastic
      epithelium. Many abnormalities in the surrounding lung associated with field
      carcinogenesis, which reflect prolonged exposure to such carcinogens as tobacco
      smoke, also revealed altered expression of CC10. Exposure of hamsters and mice to
      the tobacco-specific carcinogen NNK led to reduced CC10 expression, which was
      partially reversible. Overexpression of CC10 in immortalized bronchial epithelial
      cells delayed the induction of anchorage-independent growth in response to NNK.
      The data suggest that downregulation of CC10 contributes to carcinogenesis
      because CC10 antagonizes the neoplastic phenotype.

PMID- 11193762
TI  - All human genes of the uteroglobin family are localized on chromosome 11q12.2 and
      form a dense cluster.
AB  - Rabbit uteroglobin is the founder member of a family of mammalian proteins that
      has expanded to more than 20 members within the last few years. All members are
      small, secretory, rarely glycosylated dimeric proteins with unclear physiological
      functions and are mainly expressed in mucosal tissues. A phylogenetic analysis
      shows that the family can be grouped into five subfamilies, A to E. Subfamily A
      contains rabbit uteroglobin and its orthologues from various species; most of
      these have been described to form antiparallel homodimers via two intermolecular
      disulfide bonds. All other subfamily members contain a third conserved cysteine
      and, from existing biochemical data, it can be predicted that a member of
      subfamily B or C will likely form heterodimers with a partner from subfamily E or
      D, respectively. Besides the mentioned cysteines, only one central lysine is
      conserved in all family members. In the known uteroglobin structures, this lysine
      forms an exposed salt bridge with an aspartate side chain, which is conserved in
      almost all sequences. Using radiation hybrid mapping and P1 clone analysis and
      utilizing data from the human genome project, we show that all known five human
      family members (Clara cell 10-kDa protein, lipophilins A and B, lacryglobin,
      mammaglobin) and a new member, we call lymphoglobin, are localized on chromosome
      11q12.2 in a dense cluster spanning not more than approximately 400 kbp.

PMID- 11193763
TI  - Development of an enzyme-linked immunosorbent assay for Clara cell 10-kDa
      protein: in pursuit of clinical significance of sera in patients with asthma and
      sarcoidosis.
AB  - We have produced nine monoclonal antibodies to human CC10/protein-1 and analyzed
      their characterization. TY-5, TY-7, and TY-8 recognized restricted possible
      hydrophobic epitopes and their binding to CC10 prevented the other clones from
      CC10 binding, suggesting that these antibodies induce strong conformational
      change. TY-1, TY-2, TY-3, TY-6, and 6D4 recognize amino acid residues 61-68 and
      the presence of disulfide bonds might be essential for epitope expression of
      these five clones. The best combination was TY-1 and TY-2 in developing an enzyme
      linked immunosorbent assay (ELISA), whereas TY-5 was most suitable for
      immunohistochemistry and immunoblotting. We found significantly lower serum CC10
      levels in asthmatic subjects and higher serum CC10 levels in sarcoidosis subjects
      than in controls. Data of CC10 levels in BAL fluids of sarcoidosis subjects were
      similar to those in the circulation. CC10-positive epithelial cells were
      significantly lower in small airways of asthmatic subjects than in controls, and
      CC10-positive epithelial cells were inversely correlated with T cell and mast
      cell accumulation in the airways of asthmatic subjects. CC10 may be a
      downregulator in both Th1- and Th2-mediated chronic inflammatory diseases. The
      use of these MoAbs and recombinant CC10 is a powerful tool to investigate the
      clinical roles of CC10/P1 and the structure and function of CC10/P1.

PMID- 11193764
TI  - Rationale for the development of recombinant human CC10 as a therapeutic for
      inflammatory and fibrotic disease.
AB  - CC10/uteroglobin is a remarkable protein whose physiological roles have only
      recently been explored in vivo. Both transgenic mice that have been rendered
      deficient and humans that have been characterized as deficient in this protein
      exhibit tendencies toward inflammatory, fibrotic, and oncologic disease,
      demonstrating the potential of the protein as a therapeutic agent. The protein
      itself is an excellent candidate for clinical development because of its inherent
      physical properties. It is relatively small, resistant to proteases, stable to
      extremes of heat and pH, and can be produced by recombinant methods. The
      physiological roles of this multifunctional protein continue to be uncovered as
      research progresses in vitro, in animals, and eventually in humans. The pathways
      through which CC10 mediates its effects, its receptors, and other family members
      will be a rich source of exciting research, as well as potential diagnostic and
      therapeutic agents. This paper is an introductory, noncomprehensive review of
      some of the scientific and medical rationale in support of CC10-based therapies
      in selected clinical applications.

PMID- 11193765
TI  - C/EBP alpha and TTF-1 synergistically transactivate the Clara cell secretory
      protein gene.

PMID- 11193766
TI  - Human uteroglobin gene polymorphisms and genetic susceptibility to asthma.

PMID- 11193767
TI  - Amino acid residues in alpha-helix-3 of human uteroglobin are critical for its
      phospholipase A2 inhibitory activity.

PMID- 11193768
TI  - Mammaglobin complexes with BU101 in breast tissue.

PMID- 11193769
TI  - Uteroglobin in situ hybridization: novel monitoring of epithelial differentiation
      in the rabbit endometrium.

PMID- 11193770
TI  - Prolactin augments progesterone-dependent expression of a nuclear P-type ATPase
      that associates with the RING domain of RUSH transcription factors in the
      endometrium.

PMID- 11193771
TI  - A novel in situ method of SV40 transfection for the establishment of immortal
      pulmonary alveolar type II cell lines.

PMID- 11193772
TI  - Uteroglobin expression and release in the human endometrium.

PMID- 11193773
TI  - Expression of inflammatory cytokines in a mouse transformed Clara cell line by
      tumor necrosis factor-alpha.

PMID- 11193774
TI  - Binding of rhCC10 to fibronectin and its effect on cellular adhesion.

PMID- 11193775
TI  - Mammaglobin as a marker for the detection of tumor cells in the peripheral blood
      of breast cancer patients.

PMID- 11193776
TI  - In vivo and in vitro analysis of hyperoxia-induced gene expression in mouse lung
      and mouse transformed Clara cells.

PMID- 11193777
TI  - Uteroglobin/Clara cell 10-kDa family of proteins: nomenclature committee report.

PMID- 11193778
TI  - Clara cell proteins.
AB  - Clara cells are nonciliated, nonmucous, secretory cells of the pulmonary airways.
      These cells are known to secrete a variety of proteins, including Clara cell 10
      kDa protein/uteroglobin. This protein consists of a homodimer of 70-77 amino acid
      polypeptides arranged in antiparallel fashion. In vitro testing suggests that the
      protein suppresses inflammation. The physiologic role of the protein remains to
      be determined.

PMID- 11193779
TI  - Secretory lipophilins: a tale of two species.
AB  - Secretory lipophilins are "lipid-loving" proteins that are major constituents of
      several mammalian secretions, including the prostatic fluid of rats and the tears
      of humans and rabbits. These proteins form covalent heterodimers that are
      stabilized by three intramolecular cystine disulfide bonds. The heterodimers,
      some of which are glycosylated, may undergo additional non-covalent assembly to
      form tetramers. The peptide components found in secretory lipophilins are from
      two subfamilies: lipophilins A/B and lipophilin C. The C subfamily members
      described in this report are three rabbit and one human lipophilin, plus human
      mammaglobin and the C3 subunit of rat prostatein. Human A/B and C lipophilins are
      expressed by many tissues and are especially prominent in endocrine-responsive
      organs. The gene for human lipophilin B resides at chromosome 10q22-23. This
      region harbors the PTEN/MMAC1 gene and is believed to contain additional tumor
      suppressor genes. Although the functions of secretory lipophilins are imperfectly
      understood, their abundance in glandular secretions and in hormone-responsive
      tissues suggests that they deserve considerably more attention than they have
      received to date.

PMID- 11193780
TI  - Clara cell secretory protein (CC16): features as a peripheral lung biomarker.
AB  - Clara cell protein (CC16 or CC10) is a 15.8-kDa protein secreted all along the
      tracheobronchial tree and especially in the terminal bronchioles where Clara
      cells are localized. Even though the exact in vivo function of CC16 remains to be
      clarified, evidence is accumulating that CC16 plays an important protective role
      in the respiratory tract against oxidative stress and inflammatory response.
      CC16, however, presents also a major interest as a peripheral lung marker for
      assessing the cellular integrity or the permeability of the lung epithelium. The
      serum concentrations of CC16 are decreased in subjects with chronic lung damage
      caused by tobacco smoke and other air pollutants as a consequence of the
      destruction of Clara cells. By contrast, serum CC16 increases in acute or chronic
      lung disorders characterized by an increased airways permeability. The
      sensitivity of serum CC16 to an increased leakiness of the lung allows for the
      detection of defects of the epithelial barrier at ozone levels below current air
      quality guidelines. Although the clinical significance of these early epithelial
      changes detected by serum CC16 remains to be determined, these results clearly
      show that the assay in serum of lung secretory proteins such as CC16 represents a
      new noninvasive approach to evaluate the integrity of the respiratory tract.

PMID- 11193781
TI  - Mammaglobin, a breast-specific gene, and its utility as a marker for breast
      cancer.
AB  - The mammaglobin gene encodes a 10-kDa glycoprotein that is distantly related to a
      family of proteins that includes rat estramustine binding protein
      (EMBP)/prostatein and human Clara cell 10-kDa protein (CC10)/uteroglobin. Among
      normal adult tissues, mammaglobin mRNA expression has been detected only in the
      mammary gland. As an initial step to determine mammaglobin's clinical utility as
      a breast tumor marker, we evaluated the frequency and specificity with which
      mammaglobin expression could be detected in primary breast tumors, metastatic
      breast tumors, and breast tumor cells present in the peripheral circulation.
      Approximately 80% of all primary and metastatic breast tumors examined were
      strongly immunopositive for mammaglobin protein, and staining was independent of
      tumor grade. Among peripheral stem cell collections from breast cancer patients,
      mammaglobin mRNA could be detected in 60% of cases. Recent work has identified
      the secreted mammaglobin protein in the sera of some breast cancer patients using
      both Western blot and ELISA. This study demonstrates that the detection of
      mammaglobin protein and mRNA in clinical samples may be a useful marker for
      primary, metastatic, and occult breast cancer.

PMID- 11193782
TI  - The discovery of uteroglobin and its significance for reproductive biology and
      endocrinology.
AB  - The discovery of uteroglobin resulted from investigations on the biochemical
      composition of oviductal and uterine secretions of the rabbit and other mammals.
      These determinations about physiological composition were urgently requested to
      prepare culture media for research on early mammalian development in vitro.
      Discovery of significant proteins during the sixties reflected the laboratory
      skills of that time. Protein characterization was achieved by isolation via
      Sephadex gels, electrophoresis on polyacrylamide gels, and finally
      immunoprecipitation using classical polyclonal antibodies. The molecular biology
      was not yet established. Uteroglobin could be found as the major protein
      component of rabbit uterine secretion. From the beginning, it was already
      identified as an unusually small, spheric uterine secretory molecule without any
      carbohydrates--hence its name. Uteroglobin was the first mammalian protein that
      turned out to be progesterone-regulated and, at the same time, released in mg
      amounts actually in one organ compartment. Moreover, uteroglobin and its gene
      proved to be a reliable model for the description of progesterone/progesterone
      receptor complex action at the DNA level. After its original observation in the
      uterus, however, uteroglobin was detected also in several other organs, for
      example, the epididymis, the seminal vesicle, and the lung. Initially, it could
      not be found in the blood, which challenged the hypothesis that uteroglobin
      specifically should operate by local activation rather than by a humoral or
      endocrine effect. Later, though, the human uteroglobin molecule, isolated from
      blood filtrate, was used for detailed structural analyses. The rabbit uteroglobin
      model certainly was beneficial for reproductive biological research. Experimental
      interference with steroid hormone regulation during preimplantation presented
      surprising effects, which led to the discovery of the transposition of the
      implantation window. The uterine secretion protein patterns, in particular the
      uteroglobin fraction and the beta-glycoprotein fraction, served as decisive
      marker profiles to identify the biological stage of the intrauterine
      microenvironment during preimplantation. This diagnostic procedure, using only
      protein parameters, enabled us to precisely predict the receptive stage of the
      endometrium for donated blastocysts to achieve implantation successfully.

PMID- 11193783
TI  - The uteroglobin fold.
AB  - Uteroglobin (UTG) forms a fascinating homodimeric structure that binds small- to
      medium-sized ligands through an internal hydrophobic cavity, located at the
      interface between the two monomers. Previous studies have shown that UTG fold is
      not limited to the UTG/CC10 family, whose sequence/structure relationships are
      highlighted here, but can be extended to the cap domain of Xanthobacter
      autotrophicus haloalkane dehalogenase. We show here that UTG fold is adopted by
      several other cap domains within the alpha/beta hydrolase family, making it a
      well-suited "geode" structure allowing it to sequester various hydrophobic
      molecules. Additionally, some data about a new crystal form of oxidized rabbit
      UTG are presented, completing previous structural studies, as well as results
      from molecular dynamics, suggesting an alternative way for the ligand to reach
      the internal cavity.

PMID- 11193784
TI  - Alzheimer's disease: a compendium of current theories. Proceedings of a
      conference. April 30-May 2, 1999. Orlando, Florida, USA.

PMID- 11193785
TI  - Genetic factors in the genesis of Alzheimer's disease.
AB  - At least four different genes have been identified that are associated with
      inherited susceptibiltiy to Alzheimer's disease. Some of the genes are highly
      penetrant (PS1, PS2, beta APP); the other, APOE, is a weaker susceptibility
      factor. Several additional genes are suspected to exist but have not yet been
      cloned.

PMID- 11193786
TI  - Comprehensive theory of Alzheimer's disease. The effects of cholesterol on
      membrane receptor trafficking.
AB  - Neurotrophic factors (NTFs), once known for their role in development, have
      recently been shown to contribute to the maintenance and plasticity of the adult
      nervous system. This knowledge has provoked hypotheses implicating NTFs in
      neurodegenerative conditions, particularly Alzheimer's disease (AD). Many of
      these hypotheses, however, fail to place the possibility of trophic factor
      dysfunction in the context of recent advances in the molecular pathogenesis of
      AD. Most notable has been the discovery of several genetic risk factors and three
      causative Alzheimer's genes. Genetic advances, in turn, have not yet shed much
      light on an important pathological feature of AD, synaptic loss. We propose here
      an hypothesis based on recent cell biological research that attempts to integrate
      findings in these areas. Our hypothesis states that AD pathogenesis results from
      disruption of cholesterol uptake and metabolism and that this in turn results in
      abnormal trafficking of membrane proteins critical to normal neuronal function
      and synaptic plasticity.

PMID- 11193787
TI  - The brain's microenvironment, early functional loss, and the conversion to
      Alzheimer's disease.
AB  - We hypothesize that insults in the local microenvironment may cause selective,
      local neurite degeneration by apoptotic-like mechanisms, leading to the loss of
      synaptic connectivity observed in the Alzheimer disease brain. This may be an
      early mechanism of neurodegeneration, potentially contributing to neuronal
      vulnerability and disease pathogenesis.

PMID- 11193788
TI  - A "protease activation cascade" in the pathogenesis of Alzheimer's disease.
AB  - A pathway to Alzheimer's disease (AD) relevant to sporadic AD pathogenesis is
      described that involves the early and progressive activation of proteolytic
      systems including, but not limited to, the calpain-calpastatin and endosomal
      lysosomal systems. Activation of these proteolytic systems is initiated by normal
      brain aging and is propelled by the genetic and environmental factors known to
      increase AD risk. Recent studies show how cathepsins and calpains, acting
      directly or indirectly through other proteolytic pathways and cellular signaling
      cascades, may promote beta-amyloidogenesis, neurofibrillary pathology, as well as
      mediate neurodegeneration in AD.

PMID- 11193789
TI  - A perspective on inflammation in Alzheimer's disease.
AB  - Although there have been hundreds of recent papers that document a role for
      innate inflammatory responses in Alzheimer's disease (AD), several global issues
      and organizational points are still worth emphasizing. These include etiologic
      versus pathogenic roles for AD inflammation, the potency of AD inflammation, the
      sources of AD inflammation, and the highly interactive nature of AD inflammatory
      responses.

PMID- 11193790
TI  - Impaired cerebromicrovascular perfusion. Summary of evidence in support of its
      causality in Alzheimer's disease.
AB  - After nearly a century of inquiry, the cause of Alzheimer's disease (AD) remains
      to be found. In this review, basic and clinical evidence is presented that
      assembles and hypothetically explains most of the key pathologic events
      associated with the development of AD. These pathologic events are triggered in
      AD by impaired cerebral perfusion originating in the microvasculature that
      affects the optimal delivery of glucose and oxygen and results in an energy
      metabolic breakdown of brain cell biosynthetic and synaptic pathways. We propose
      that two factors must be present before cognitive dysfunction and
      neurodegeneration is expressed in the AD brain: (1) advanced aging, (2) presence
      of a condition that lowers cerebral perfusion, such as a vascular risk factor.
      The first factor introduces a normal but potentially menacing process that lowers
      cerebral blood flow in proportion to increased aging, while the second factor
      adds a crucial burden that further lowers brain perfusion and places vulnerable
      neurons in a state of metabolic compromise leading to a death pathway. These two
      factors will lead to a critically attained threshold of cerebral hypoperfusion
      (CATCH). CATCH is a self-sustaining and progressive circulatory insufficiency
      that will destabilize neurons, synapses, neurotransmission, and cognitive
      function, creating in its wake a neurodegenerative process characterized by the
      formation of senile plaques, neurofibrillary tangles, amyloid angiopathy, and, in
      some cases, Lewy bodies. Since any of a considerable number of vessel-related
      conditions must be present in the aging individual for cognition to be affected,
      CATCH supports the heterogeneic disease profile assumed to be characteristic of
      the AD syndrome. A brief discussion of target therapy based on the proposed
      pathogenesis of AD is also reviewed.

PMID- 11193791
TI  - Existing data suggest that Alzheimer's disease is preventable.
AB  - The ultimate goal of Alzheimer's disease (AD) research is to prevent the onset of
      the neurodegenerative process and thereby allow successful aging without
      cognitive decline. Herein I argue that a simple and effective preventative
      approach for AD may be in hand. AD is a disorder associated with the aging
      process and is, accordingly, characterized by cellular and molecular changes that
      occur in age-related diseases in other organ systems. Such changes include
      increased levels of oxidative stress, perturbed energy metabolism, and
      accumulation of insoluble (oxidatively modified) proteins (prominent among which
      are amyloid beta-peptide and tau). The risk of several other prominent age
      related disorders, including cardiovascular disease, cancer, and diabetes, is
      known to be influenced by the level of food intake--high food intake increases
      risk, and low food intake reduces risk. An overwhelming body of data from studies
      of rodents and monkeys has documented the profound beneficial effects of dietary
      restriction (DR) in extending life span and reducing the incidence of age-related
      diseases. Reduced levels of cellular oxidative stress and enhancement of energy
      homeostasis contribute to the beneficial effects of DR. Recent findings suggest
      that DR may enhance resistance of neurons in the brain to metabolic, excitotoxic,
      and oxidative insults relevant to the pathogenesis of AD and other
      neurodegenerative disorders. While further studies will be required to establish
      the extent to which DR will reduce the incidence of AD, it would seem prudent
      (based on existing data) to recommend DR as widely applicable preventative
      approach for age-related disorders including neurodegenerative disorders.

PMID- 11193792
TI  - Oxidative stress leading to loss of critical proteases in Alzheimer's disease. An
      alternative view of the etiology of AD.
AB  - An alternative view of the etiology of Alzheimer's disease is suggested which
      focuses on the relationship between oxidative stress and the decrease in
      proteases seen in aging. Proteases act to govern the acceleration of the
      pathology of aging and, as damage from oxidative stress increases, the loss of
      proteases in at-risk persons leads to symptoms of AD. Controlling the damage to
      proteases or controlling the generator(s) of oxidative stress may help to control
      the onset or progression of Alzheimer's disease.

PMID- 11193793
TI  - Oxidative metabolism.
AB  - There is a large body of evidence showing both metabolic defects and oxidative
      damage in Alzheimer's disease. Studies of cybrid cell lines show reduced
      cytochrome oxidase. There is also substantial evidence for a defect in alpha
      ketoglutarate dehydrogenase. It is therefore possible that therapeutic strategies
      to improve brain metabolism or ameliorate oxidative damage might be useful in
      treating Alzheimer's disease.

PMID- 11193794
TI  - Toward a comprehensive theory for Alzheimer's disease. Hypothesis: Alzheimer's
      disease is caused by the cerebral accumulation and cytotoxicity of amyloid beta
      protein.
AB  - A central challenge of research on Alzheimer's disease (AD) is to assemble the
      enormous body of scientific observations about the disorder, some of them
      seemingly in conflict with others, into a coherent and credible mechanism of
      pathogenesis. In this article, I attempt to synthesize the disparate findings on
      AD into a unified sequence that essentially begins with alterations in the
      production or clearance of the amyloid beta-protein (A beta). Mounting evidence
      from many laboratories supports an A beta accumulation in limbic and association
      cortices as the fundamental initiator of the disease, with attendant therapeutic
      implications.

PMID- 11193795
TI  - The mitochondrial spiral. An adequate cause of dementia in the Alzheimer's
      syndrome.
AB  - A variety of chronic, relatively low-grade injuries to the brain occur in
      Alzheimer's disease (AD). The extent to which each of these contributes to the
      clinical syndrome is unclear. Several of the abnormalities that occur in AD brain
      can cause dementia by themselves, even in people who do not have the
      neuropathological hallmarks of AD. Prominent among these abnormalities is a
      deleterious "mitochondrial spiral," which consists of reduced brain metabolism,
      oxidative stress, and calcium dysregulation. The hypothesis presented in this
      paper is that the mitochondrial spiral contributes to dementia in AD and presents
      a reasonable target for the development of new approaches to the treatment of
      this syndrome.

PMID- 11193796
TI  - Toward a comprehensive theory of Alzheimer's disease--challenges, caveats, and
      parameters.
AB  - The task of developing a unifying theory of Alzheimer's disease faces several
      impediments. The most difficult include: the impact of scientific orthodoxy on
      the acceptance of new ideas; the uncertain relationship between aging and
      disease(s); the long time course of the degenerative process; the heterogeneity
      in the genotype and phenotype of the disease; the complex interactions among
      genetic and other risk factors (many of which are not yet known); the poorly
      understood nonlinear relationships between the neurobiological and the clinical
      phenotypes of the disease--namely, viewing clinical symptoms as emergent
      behavior(s) of a complex system; and the paucity of appropriate models or
      modeling systems for human disease(s) such as Alzheimer's.

PMID- 11193797
TI  - The pathogenesis of Alzheimer's disease. Is amyloid beta-protein the beginning or
      the end?
AB  - A central issue in Alzheimer's disease research is whether amyloid beta-protein
      (A beta) is a cause or effect of the pathogenic process. Several independent
      lines of evidence argue for causality, although human clinical trials may be
      required to finally settle the issue.

PMID- 11193798
TI  - Pathways to primary neurodegenerative disease.
AB  - Genetic analysis has revealed the pathogenic lesions that cause autosomal
      dominant Alzheimer's disease, prion disease, and some forms of Parkinson's
      disease. Molecular biological experiments based on these genetic findings allow a
      hypothesis to be configured linking these and the other diseases in which tangles
      or Lewy bodies are a pathological feature. In this article, this hypothesis is
      presented in the context of deriving curative treatments for these disorders.

PMID- 11193799
TI  - Arson. Tracking the culprit in Alzheimer's disease.
AB  - By focusing on the lesions in Alzheimer's disease, and regarding them as either
      critical or irrelevant, researchers may have missed much regarding the origin and
      pathogenesis of this disease. In this article we consider that the lesions are so
      obvious not only because they are pathognomonic for Alzheimer's disease, but also
      because they represent a major departure from normal physiology. We suggest that
      these myriad pathological changes are homeostatic compensatory mechanisms to
      aging.

PMID- 11193800
TI  - Synaptic structure and function in transgenic APP mice.
AB  - Efforts using transgenic mice are being made to understand the molecular and
      structural basis for dementia in Alzheimer's disease. Transgenic mice 12 to 18
      months of age with amyloid plaques and impaired cognition show no neuronal or
      synaptic loss in the CA1 hippocampal subfield. Electrophysiological studies may
      yield new insights.

PMID- 11193801
TI  - A plasticity-based theory of the pathogenesis of Alzheimer's disease.
AB  - Amyloid plaques (APs) and neurofibrillary tangles (NFTs) are the two diagnostic
      markers of Alzheimer's disease (AD). The neuropsychological features of AD are
      closely correlated with the distribution of the NFTs and therefore favor a
      disease process revolving around neurofibrillary degeneration. The genetics,
      however, favor a disease process revolving around the APs, principally because
      mutations in the amyloid precursor protein (A beta PP) are sufficient to cause
      AD. The inability to reconcile these two aspects of AD has prevented the
      formulation of a unified theory of pathogenesis. It is interesting to note that
      all genetic causes and risk factors of AD can increase the physiological burden
      of neuroplasticity. My hypothesis is that the resultant intensification of the
      plasticity burden leads to an initially adaptive upregulation of tau
      phosphorylation and A beta PP turnover, to the subsequent formation of NFTs and
      APs as independent consequences of excessive plasticity-related cellular
      activity, and to the eventual loss of neurons, dendrites, and synapses as the
      ultimate expression of plasticity failure. The two pathological markers of AD are
      therefore independent manifestations of a more fundamental process through which
      the many different genotypes of AD trigger an identical clinical and
      neuropathological phenotype.

PMID- 11193802
TI  - Vulnerability of select neuronal types to Alzheimer's disease.
AB  - From a morphological perspective, Alzheimer's disease (AD) is primarily a
      degenerative disorder of the neuronal cytoskeleton involving lipofuscin-laden
      cortical projection neurons with long, thin, and sparsely myelinated axons. The
      neocortical primary fields, relatively small in extent but functionally
      sophisticated, exhibit an early and brief myelination cycle, whereas the much
      more expansive but relatively simply organized association areas undergo a late
      and prolonged myelination process. The greater the degree of myelination and the
      less intense the pigmentation, the more resistant a given projection neuron may
      be to oxidative stress as well as to the development of AD-related
      neurofibrillary changes and vice versa. The neurofibrillary pathology commences
      from those cortical areas that are less completely myelinated and gradually
      progresses to the most functionally developed cortical fields that display the
      highest degree of myelination, thereby reflecting a hierarchy in the
      susceptibility of diverse cortical areas to the evolution of the AD-associated
      cytoskeletal pathology.

PMID- 11193803
TI  - "Fatal attractions" of proteins. A comprehensive hypothetical mechanism
      underlying Alzheimer's disease and other neurodegenerative disorders.
AB  - Abnormal protein-protein interactions that result in the formation of
      intracellular and extracellular aggregates of proteinacious fibrils are common
      neuropathological features of many, albeit diverse, neurodegenerative disorders,
      such as sporadic and familial Alzheimer's disease, Parkinson's disease,
      amyotrophic lateral sclerosis, and prion encephalopathies. Indeed, increasing
      evidence suggests that abnormal protein-protein interactions and/or the lesions
      that result from the aggregation of pathological protein fibrils could play a
      mechanistic role in the dysfunction and death of neurons or glial cells in
      neurodegenerative diseases. Here we propose that "fatal attractions" between
      brain proteins are the key pathological events underlying Alzheimer's disease and
      a large number of other seemingly diverse neurodegenerative disorders. This
      hypothesis predicts that the abnormal interaction between normal brain proteins
      alters their conformation and promotes the assembly of these pathological
      conformers into filaments that progressively accumulate as intracellular or
      extracellular fibrous deposits in the central nervous system. Further, the
      transformation of the normal proteins into pathological conformers is predicted
      to result in losses of critical functions, and the disease proteins or their
      progressive accumulation into filamentous aggregates are predicted to acquire
      neurotoxic properties, all of which culminate in the dysfunction and death of
      affected brain cells. Thus, the "fatal attractions" hypothesis describes a
      plausible unifying mechanism that accounts for the onset/progression of
      Alzheimer's disease and a large number of other seemingly unrelated
      neurodegenerative disorders characterized neuropathologically by filamentous
      brain lesions formed by different proteins.

PMID- 11193804
TI  - The role of synaptic proteins in Alzheimer's disease.
AB  - Synaptic damage is an early event common to neurodegenerative disorders such as
      Alzheimer's disease (AD) and is the best correlate to the cognitive impairment
      found in these patients. Recent studies have shown that several of the molecules
      involved in neurodegenerative disorders are in fact synaptic proteins with
      amyloidogenic potential (SPWAP). Here we propose a unified theory to explain the
      neurodegenerative process in AD based on the idea that abnormal folding and/or
      aggregation of these molecules leads to cell death. The most important
      predictions of this hypothesis are that: (1) there are other yet unknown SPWAP
      that might be involved in AD, and their identity can be predicted by defining
      what makes a protein amyloidogenic; (2) there are endogenous anti-amyloidogenic
      molecules that regulate the aggregation state of SPWAP; and (3) there might be
      forms of the disease associated with decreased production of endogenous anti
      amyloidogenic molecules or with unbalance of pro- versus anti-amyloidogenic
      factors.

PMID- 11193805
TI  - The long reach of evolution and development. Effects on the Alzheimer brain.
AB  - Genes that cause late-onset neurodegenerative disease may have the property of
      evolvability. Their tendency to collect mutations may have contributed to the
      rapid evolution of the brain.

PMID- 11193806
TI  - A very incomplete comprehensive theory of Alzheimer's disease.
AB  - For this meeting, I was asked to put down some ideas toward the development of
      theories of the etiology and pathogenesis of Alzheimer's disease. This charge has
      led to a first attempt to consider the "big picture," at least as seen from my
      viewpoint. Many details of the schemes I propose could be discussed in much
      greater depth, but I have tried to avoid getting bogged down in this way. It is
      sometimes valuable to step back from our own little domains of research and to
      attempt to integrate what we have collectively discovered into a more
      comprehensive framework.

PMID- 11193807
TI  - Apolipoprotein E and Alzheimer's disease. A role in amyloid catabolism.
AB  - It has been shown over the past few years that apolipoprotein E (apoE) plays a
      central role in the brain response to injury and neurodegeneration in mammalian
      species. The coordinated expression of apoE and its different receptors, the so
      called LDL receptor family, appears to regulate the transport of cholesterol and
      phospholipids during the early and middle phases of the reinnervation in the
      adult mammalian brain. As neurons undergo dendritic remodelling and
      synaptogenesis using cholesterol internalization through the apoE/LDL receptor
      pathway, they progressively shut down 3,3-hydroxymethylglutaryl-Coenzyme A (HMG
      CoA) reductase activity, the rate-limiting enzyme in the synthesis of
      cholesterol. These results suggest that cholesterol delivery and synthesis in the
      brain are tightly regulated through an apoE-dependent mechanism. The discovery
      that the apolipoprotein e4 allele is strongly linked to both sporadic and
      familial late-onset Alzheimer's disease (AD) has raised the possibility that a
      dysfunction of lipid transport could explain the poor compensatory synaptogenesis
      reported by several independent research groups in the brain of AD subjects.
      Recently, it has been shown that alterations of cholesterol homeostasis in the
      brain by exogenous administration of dietary cholesterol, or through inhibition
      of cholesterol synthesis, markedly affect beta amyloid production (1-40 and 1-42)
      and deposition and significantly impair amyloid precursor protein (APP)
      metabolism. In vivo, it has been shown that breeding of APP-overexpressing mice
      with apoE knockout mice completely abolishes amyloid plaque deposition in the
      brain of hybrid animals, without affecting beta amyloid steady state levels.
      Conversely, introduction of the human apoE3 and apoE4 genes in APP-overexpressing
      mice drastically reduced beta amyloid deposition in the brain of hybrid mice,
      confirming the proposed biological role of apoE in the clearance of extracellular
      beta amyloid. These results indicate that lipid homeostasis is controlled in
      large part by the apoE lipoprotein transport system in the extracellular space,
      whereas alterations in intracellular lipid homeostasis markedly affect APP
      processing, beta amyloid production and plaque formation in vivo. The convergence
      of the so-called amyloid cascade hypothesis (Hardy et al., 1992) and of the
      apoE/lipid recycling cascade model (Poirier, 1994) is consistent with the notion
      that alterations in lipid homeostasis could serve as the common denominator for
      apoE and beta amyloid dysfunctions in Alzheimer's disease. It is also interesting
      to note that lipid homeostasis is also a central feature of one of the most
      important neurotransmitter systems in the brain: the cholinergic system. This
      system is unique in the CNS since it relies heavily on lipid bioavailability to
      locally synthesize acetylcholine. It is thus quite tempting to propose that two
      of the most common neuropathologic landmarks of AD--namely, cholinergic
      dysfunction and amyloid deposition--may in fact depend on the integrity of local
      lipid homeostatic processes, which in turn are strongly dependent upon proper
      lipid delivery by the apoE transport system.

PMID- 11193808
TI  - Apolipoprotein E and Alzheimer's disease.
AB  - The specific molecular pathway by which apolipoprotein E modifies the expression
      of Alzheimer's disease remains elusive. Isoform-specific interactions of
      apolipoprotein E with other molecules determine the outcome from other neurologic
      disorders and may provide more tractable model systems.

PMID- 11193809
TI  - Estrogens and estrogen-like non-feminizing compounds. Their role in the
      prevention and treatment of Alzheimer's disease.
AB  - The present position paper is intended to provide evidence that estrogen
      deprivation contributes to the occurrence and course of Alzheimer's disease (AD)
      and that currently available estrogen preparations may be useful in the
      prevention and treatment of AD in women. Additionally, there is now substantial
      preclinical evidence to support the development of novel non-feminizing estrogens
      for use in male and female subjects for the protection of neurons from damage and
      death that underlies the neuropathology of AD. Estrogens and non-feminizing
      estrogen-like compounds may exert their beneficial effects in AD through a
      variety of mechanisms, directly through their neuroprotective actions and
      indirectly through their neurotrophic effects. Inasmuch as estrogens are
      comparatively free of both acute and chronic toxicities, and non-feminizing
      estrogens are expected to be even safer, their use for years to decades for the
      prevention or treatment of AD is possible.

PMID- 11193810
TI  - Alzheimer's disease and some speculations about the evolution of its modifiers.
AB  - In this paper we consider the evolution of Alzheimer's-like neuropathology in the
      aging primate brain. In particular, we examine the evolutionary pressures that
      have likely selected for the neuroprotective effects of estrogen and of the
      apolipoprotein E2 and E3 isoforms. We analyze this in the context of the
      altricial nature of new-born primates, their long period of dependency on
      competent maternal care, and the requirement of cognitive intactness for such
      competency.

PMID- 11193811
TI  - In vitro evaluation of VIP/PACAP receptors in healthy and diseased human tissues.
      Clinical implications.
AB  - The evaluation of peptide receptors in man is relevant to identifying the
      physiological target tissues of a given peptide and to selecting diseases with a
      sufficient receptor overexpression for diagnostic or therapeutic intervention.
      VIP/PACAP receptors have been evaluated in normal and diseased human non-neuronal
      tissues by using in vitro receptor autoradiography with 125I-VIP or 125I-PACAP in
      tissue sections. As assessed by subtype-selective VIP analogs, VIP receptors of
      the VPAC1 subtype are found in a wide variety of tissues including liver, breast,
      kidney, prostate, ureter, bladder, pancreatic ducts, gastrointestinal mucosa,
      lung, thyroid, adipose, and lymphoid tissues. VPAC2 receptors are predominantly
      found in vessels and smooth muscles, whereas PAC1 receptors are present in the
      adrenal medulla. VIP/PACAP receptors are expressed in the majority of the most
      frequently occurring human tumors, including breast, prostate, pancreas, lung,
      colon, stomach, liver, and bladder carcinomas, as well as lymphomas and
      meningiomas, predominantly as VPAC1 receptors, as do their tissues of origin.
      Although leiomyomas predominantly express VPAC2 receptors, glial tumors,
      pituitary adenomas, neuroblastomas, paragangliomas, pheochromocytomas, and
      endometrial carcinomas preferentially express PAC1 receptors. The very wide
      distribution of VIP/PACAP receptors in the normal human body is indicative of the
      key role of these peptides in human physiology and pathophysiology. Moreover, the
      receptor expression in tumors is the molecular basis for clinical applications of
      VIP/PACAP such as in vivo scintigraphy and radiotherapy of tumors as well as
      VIP/PACAP analog treatment for tumor growth inhibition.

PMID- 11193812
TI  - Neuropeptide action in sympathetic ganglia. Evidence for distinct functions in
      intact and axotomized ganglia.

PMID- 11193813
TI  - Chemokines released from astroglia by vasoactive intestinal peptide. Mechanism of
      neuroprotection from HIV envelope protein toxicity.
AB  - The mechanism through which VIP prevents neurotoxicity associated with HIV
      envelope protein has been shown to involve the release of a beta-chemokine, MIP-1
      alpha. Astrocytes stimulated with subnanomolar concentrations of VIP caused the
      release of MIP-1 alpha and RANTES, both of which have been shown to prevent
      neuronal cell death associated with gp120. It is further proposed that gp120
      causes neuronal cell death, in part, by competing with endogenous chemokines at
      various chemokines receptors in the brain that are necessary for neuronal
      survival. Although the chemokines are known to be mediators of inflammation, our
      studies suggest that these compounds have additional roles as neuroprotective
      agents that depend on the concentration of chemokine, cellular microenvironment,
      and stage of development of target neurons. Our studies further imply that in a
      developing system, stimulation with a MIP-1 alpha like substance is necessary for
      neuronal survival and interference with this action results in neuronal cell
      death.

PMID- 11193814
TI  - A novel VIP responsive gene. Activity dependent neuroprotective protein.
AB  - Activity dependent neuroprotective protein (ADNP, 828 amino acids, pI 5.99) is a
      glial-derived protein that contains a femtomolar active neuroprotective peptide,
      NAPVSIPQ (NAP). VIP induces a two- to threefold increase in ADNP mRNA in
      astrocytes, suggesting that ADNP is a VIP-responsive gene. ADNP is widely
      distributed in the mouse hippocampus, cerebellum, and cerebral cortex. VIP has
      been shown to possess neuroprotective activity that may be exerted through the
      activation of glial proteins. We suggest that ADNP may be part of the VIP
      protection pathway through the femtomolar-acting NAP and through putative
      interaction with other macromolecules.

PMID- 11193815
TI  - Neuroprotective effects of PACAP38 in a rat model of transient focal ischemia
      under various experimental conditions.
AB  - In the study reported here, we investigated the neuroprotective effect of PACAP38
      in a rat model of middle cerebral artery occlusion (MCAO) under various
      experimental conditions. Stroke patients often develop mild hyperthermia that
      increases the infarct size and worsens the outcome. We compared the
      neuroprotective effect of PACAP38 in normothermic and moderately hyperthermic
      animals. Brain damage was more extensive in the hyperthermic animals, but PACAP38
      significantly reduced the infarct size, measured 48 h after MCAO, in both the
      normothermic and the moderately hyperthermic animals, by more than 50%. However,
      a significant neuroprotection with PACAP38 could only be demonstrated when
      animals with no definite circling behavior and/or convulsions were excluded from
      the evaluations. In conclusion, moderate hyperthermia did not influence the
      effect of PACAP38, but animals with questionable brain damage or convulsions must
      be excluded from the sample in order to demonstrate the neuroprotection with
      PACAP38.

PMID- 11193816
TI  - PACAP action in nervous system development, regeneration, and neuroblastoma cell
      proliferation.
AB  - Pituitary adenylate cyclase activating peptide (PACAP) may play a role in
      neurogenesis, nerve injury, and neural tumor growth. A PACAP ligand receptor
      system functionally coupled to cAMP production was found to be expressed in the
      embryonic mouse neural tube at the onset of neurogenesis. PACAP was found to
      inhibit DNA synthesis and antagonize sonic hedgehog signaling in cells isolated
      from the neural tube, suggesting that PACAP interacts with patterning factors to
      regulate neurogenesis and phenotypic specification in the developing CNS. PACAP
      and PACAP receptor (PAC1) mRNA levels were strongly increased and decreased,
      respectively, in motor neurons in adult rats after facial nerve axotomy,
      indicating that PACAP may also act in nerve regeneration. Experiments using a
      neuroblastoma tumor cell line model indicate that PACAP may execute growth
      related functions by activating MAP kinase in addition to cAMP-dependent protein
      kinase A.

PMID- 11193817
TI  - Characterization of intestinal receptors for VIP and PACAP in rat and in PAC1
      receptor knockout mouse.
AB  - The receptors for VIP and PACAP were characterized in vitro on rat ileal and
      colonic longitudinal smooth muscle with adherent myenteric ganglia. Colon strips
      from PAC1 receptor knockout and wildtype mice were also examined. VIP, PACAP-38
      and PACAP-27 all caused concentration dependent relaxations. In rat ileum three
      different types of smooth muscle VIP/PACAP receptors were defined: (1) a PACAP-27
      preferring receptor coupled to apamin sensitive Ca(2+)-dependent K+ channels, (2)
      a PAC1 receptor activated by both PACAP-27 and PACAP-38, and (3) a VIP specific
      receptor regulated by NPY. The receptors identified in rat colon were: (1) a PAC1
      receptor localized on NO synthesizing neurones. Activation leads to increased NO
      production. (2) A smooth muscle PAC1 receptor. The responses elicited by both
      receptors were abolished by apamin. (3) A smooth muscle VIP specific receptor.
      PAC1 receptor knockout mice did not respond to PACAP-27 or PACAP-38, whereas VIP
      induced a relaxatory response indicating the presence of a VIP specific receptor.
      In wildtype mice all three peptides elicited relaxatory responses.
      Pharmacological characterization of intestinal VIP/PACAP receptors indicates the
      existence of receptors, such as a PACAP-27 preferring receptor and a VIP specific
      receptor, distinct from those that have been cloned (VPAC1, VPAC2, and PAC1).

PMID- 11193818
TI  - Mutational analysis of the glucose regulatory element in the promoter of the
      glucagon receptor gene.
AB  - Recently, we identified a glucose regulatory element in the promoter of the rat
      glucagon receptor gene. The effect of glucose is centered on a highly palindromic
      sequence of 19 nucleotides that we called the G box (Portois et al., 1999, J.
      Biol. Chem. 274: 8181-8190). This sequence contains two E boxes. Recently, we
      investigated the role of each individual E box, as well as the contribution of
      the sequences located upstream and downstream from this G box. (1) Mutation of
      nucleotides "CA" to "GT" in the first E box (position -543 to -542) suppressed
      the activation of the CAT reporter gene by glucose. In contrast, mutation of the
      nucleotides "CA" to "GT" in the second E box (position -534 to -533) had no
      effect on this glucose activation. (2) Deletion of a sequence upstream from the G
      box (nucleotides -579 to -555) suppressed the activation by glucose, whereas
      deletion of a sequence located downstream from the G box (nucleotides -501 to 
      443) had no effect on this parameter. (3) Subcloning of a small promoter fragment
      of only 49 nucleotides (-560 to -512) into the pCat5 plasmid conferred to
      transfected cells sensitivity to glucose in terms of CAT activity. Consequently,
      all transactivation factors required for this glucose effect must act via this
      short gene fragment.

PMID- 11193819
TI  - Molecular characterization of the VIP receptor transcriptional repressor protein.
AB  - The rat type 1 VIP receptor transcriptional repressor protein (VIPR-RP) is a
      recently isolated novel transcription factor. In the study reported here, the
      functional domains of VIPR-RP were characterized. To map the DNA binding domain,
      various regions of VIPR-RP were either transcribed and translated in vitro or
      expressed in and purified from E. Coli as a glutathione S-transferase (GST)
      fusion. The ability of the truncated proteins to bind to VIPR-RP specific binding
      sequence was tested by gel mobility shift assays. The results indicated that the
      amino acid sequences between 367 and 475 play an essential role for VIPR-RP DNA
      binding. To determine the amino acid sequences required for transcriptional
      repression, fusion proteins containing the GAL4 DNA binding domain and various
      parts of VIPR-RP were constructed, and their ability to repress transcription of
      the reporter gene containing GAL4 DNA binding sequences were tested in
      transiently transfected COS7 cells. The results showed that VIPR-RP contains two
      separate transcriptional repression domains located between amino acids 50 to 101
      and 470 to 527.

PMID- 11193820
TI  - Regulation of vasoactive intestinal peptide receptor expression in developing
      nervous systems.
AB  - Vasoactive intestinal peptide (VIP) is a 28-amino acid peptide that has several
      functions, including the regulation of water and electrolyte secretion, hormone
      and cytokine release, bronchodilitation, and neurogenesis. VIP effects are
      mediated by specific G-protein coupled receptors. Three distinct receptor
      subtypes, with differing affinity for VIP, have been cloned and characterized as
      receptors 1 and 2 (VPAC1 and VPAC2) and pituitary adenylate cyclase activating
      polypeptide receptor (PAC1). Our laboratory has demonstrated that upregulation of
      VPAC1 in SK-N-SH neuroblastoma cells results in marked shift in cell type to the
      glial lineage with a corresponding loss of neuronal lineage and suppression of
      xenograft tumor growth. To understand the molecular mechanisms responsible for
      regulation of the VPAC1 gene in neuronal lineage, we have cloned and sequenced
      2.6-kb of the 5'-flanking sequences of the human VPAC1 gene. Sequence analysis
      demonstrated that the human VPAC1 promoter sequence contains putative binding
      sites for several known transcription factors, including Sp1, NFkB, and cETS-1.
      To study the temporal and spatial expression pattern of human VPAC1 promoter
      sequences, we have generated transgenic mice expressing the bacterial beta
      galactosidase gene under the control of the 2.6-kb 5'-flanking and promoter
      sequence of the human VPAC1 gene. Transgene expression was detected in brain,
      spinal cord, and lung in 14-day-old animals. Taken together, these results
      demonstrate that VPAC1 may play an important role in the nervous system, and
      suggest a role for VIP in neuronal differentiation.

PMID- 11193821
TI  - Differential activation of phospholipase D by VPAC and PAC1 receptors.
AB  - To investigate the phospholipase D (PLD) responses of the VIP/PACAP receptors,
      VPAC1 and VPAC2, and the PACAP-specific PAC1 receptors (short and "hop"
      intracellular loop 3 (i3) splice variants), stable CHO cell lines expressing
      similar levels of each wildtype receptor were generated (except for the VPAC1
      receptor clone which showed considerably lower expression and lesser responses in
      signalling assays). All clones caused activation of PLD in response to agonists,
      as monitored by [3H]phosphatidylbutanol production. The PLD responses of the PAC1
      "hop", but not the "null" receptor, were sensitive to the ARF inhibitor,
      brefeldin A (BFA) (as were VPAC1 and VPAC2 responses). Chimeric constructs of
      VPAC2 receptors containing i3 of either PAC1 hop or PAC1 null receptors were
      transiently expressed in COS 7 cells and PLD responses were measured. Only the
      PLD response of the hop construct was sensitive to BFA. This suggests that i3
      motifs in certain Group II GPCRs may play a key role in determining their linkage
      to ARF-dependent PLD activation.

PMID- 11193822
TI  - PACAP modulates rat sympathetic neuron depolarization through IP3.

PMID- 11193823
TI  - Essential structural motif in the C-terminus of the PACAP type I receptor for
      signal transduction and internalization.
AB  - The objectives of the study reported here were to identify amino acid residues of
      the C-terminus that are critical for intracellular signaling. A total of nine
      amino acid substitution and truncation mutants were constructed by PCR and
      confirmed by sequencing. Mutant and wildtype receptors were stably transfected
      into NIH/3T3 fibroblasts and studied for their ability to bind PACAP-27 and
      activate phospholipase C (PLC) and adenylyl cyclase (AC). Receptor affinity of
      125I-PACAP-27 for the wildtype and mutants were similar (Kd = 0.6-1.5 nM).
      However, truncation of the entire 63 amino acids of the hPAC1 resulted in no
      signaling to either AC or IP. Addition of the proximal 10 amino acids of the C
      terminus failed to restore AC or IP signaling, whereas addition of the proximal
      27 amino acids of the C-terminus resulted in reconstitution of complete AC and IP
      responses, identical to the WT. Point mutations within this 17 amino acid region
      identified specific amino acids involved in PAC1 signaling. These results
      indicate that a structural motif within the proximal region of the carboxyl
      terminus is critical for G protein coupling.

PMID- 11193824
TI  - PACAP peptides modulate guinea pig cardiac neuron membrane excitability and
      neuropeptide expression.
AB  - Morphological studies identified PACAP-immunoreactive nerve fibers in dense
      pericellular arrangements around virtually every cholinergic parasympathetic
      neuron of guinea pig cardiac ganglia; all postganglionic cardiac neurons
      expressed membrane-associated PAC1 receptor protein. Characterization of the
      alternative splice variants established predominant expression of the PAC1(very
      short) receptor transcript containing neither HIP nor HOP exons. PACAP
      depolarized cardiac neurons and increased membrane excitability; the excitability
      resulted from neither altered action potential properties nor inhibition of IM.
      Treatment of cardiac ganglia explants with PACAP significantly reduced the
      numbers of cholinergic neurons coexpressing somatostatin immunoreactivity, which
      did not appear to be correlated with prosomatostatin mRNA expression. The PACAP
      mediated decrease in somatostatin immunoreactive neurons required calcium influx
      through L-type calcium channels and activation of adenylyl cyclase, whereas
      activation of phospholipase C or protein kinase A was not required. These
      observations indicate that PACAP through the PAC1 receptors elicits complex
      actions on guinea pig parasympathetic cardiac ganglia neurons, including
      modulation of membrane ion conductances and modulation of neuropeptide
      expression.

PMID- 11193825
TI  - Functional significance of colocalization of PACAP and catecholamine in nerve
      terminals.
AB  - Medullary neurons containing pituitary adenylate cyclase-activating polypeptide
      (PACAP) and noradrenalin (NA) project to the hypothalamus and they are involved
      in the regulation of arginine vasopressin (AVP) neurons. At the ultrastructural
      level, PACAP immunoreactivity was detected in the granular vesicles in
      catecholaminergic nerve terminals that made synaptic contact with AVP neurons.
      Both PACAP (at least 1 nM) and NA (at least 1 microM) induced large increases in
      the cytosolic Ca2+ concentration ([Ca2+]i) in isolated AVP cells. PACAP at 0.1 nM
      and NA at 0.1 microM had little effects, if any, on [Ca2+]i. However, when 0.1 nM
      PACAP and 0.1 microM NA were combined, they evoked large increase in [Ca2+]i in
      AVP neurons. An inhibitor of protein kinase A (PKA) completely inhibited the
      PACAP-induced increase in [Ca2+]i, but only partly inhibited the NA-induced
      increase in [Ca2+]i. In AVP cells that were prelabeled with quinacrine, PACAP and
      NA acted synergistically to induce a loss of quinacrine fluorescence, indicating
      secretion of neurosecretory granules in AVP neurons. The results suggest that
      PACAP and NA, coreleased from the same nerve terminals, act in synergy to evoke
      calcium signaling and secretion in AVP neurons, and that the synergism is
      mediated by the interaction between cAMP-PKA pathway an as yet unidentified
      factor "X" linked to L-type Ca2+ channels. The synergism between PACAP and NA may
      contribute to the regulation of AVP secretion under physiological conditions.

PMID- 11193826
TI  - VIP- and PACAP-induced salivary chromogranin A secretion in the isolated perfused
      submandibular gland of rats.
AB  - In the study reported in this paper, sensitive ELISA for rat CgA was developed
      using synthetic rat CgA(359-389) as antigen, N alpha-biotinylated glycylglycyl
      rat CgA(359-389), and antirat CgA(359-389) serum for the measurement of CgA-LI in
      rat saliva. CgA-LI in rat submandibular tissues and saliva was characterized by
      both immunohistochemical and immunochemical methods. Using isolated perfused rat
      submandibular gland. VIP at 0.1-1.0 nM in the presence of 0.1 microM ACh was
      found to cause CgA-LI secretion, whereas neither PACAP-27 nor PACAP-38 showed any
      effect on CgA secretion.

PMID- 11193827
TI  - New developments in the biology of the glucagon-like peptides GLP-1 and GLP-2.
AB  - Glucagon-like peptides 1 and 2 (GLP-1 and GLP-2) are coencoded within a single
      mammalian proglucagon precursor, and are liberated in the intestine and brain.
      GLP-1 exerts well known actions on islet hormone secretion, gastric emptying, and
      food intake. Recent studies suggest GLP-1 plays a central role in the development
      and organization of islet cells. GLP-1 receptor signaling appears essential for
      beta cell signal transduction as exemplified by studies of GLP-1R-/- mice. GLP-2
      promotes energy assimilation via trophic effects on the intestinal mucosa of the
      small and large bowel epithelium via a recently cloned GLP-2 receptor. The
      actions of GLP-2 are preserved in the setting of small and large bowel injury and
      inflammation. The biological actions of the glucagon-like peptides suggest they
      may have therapeutic efficacy in diabetes (GLP-1) or intestinal disorders (GLP
      2).

PMID- 11193828
TI  - Role of PACAP1 receptor in regulation of ECL cells and gastric acid secretion by
      pituitary adenylate cyclase activating peptide.
AB  - We previously reported that PAC1 is expressed on ECL cells resulting in
      stimulation of [Ca2+]i, histamine and acid secretion. The study reported here
      characterized the signaling by PAC1 on ECL cells; determined the effects of PACAP
      on the gastric acid secretion in vivo, and determined the effects of chronic
      administration of PACAP-27 on ECL cell proliferation. PACAP-27 dose dependently
      stimulated ECL cell Ca2+ and AC with detectable stimulation at 1 nM and maximal
      stimulation at 100 nM (six-fold). In rats PACAP-27 administration (10 pmol/kg/h)
      increased the rate of gastric acid secretion when an antisomatostatin antibody
      was co-administered. Chronic administration of PACAP (10 pmol/h for seven days)
      via osmotic pump resulted in a more than twofold increase in BrdU incorporation
      into ECL cells. PACAP acting at the PAC1 results in dual signaling responses to
      both [Ca2+]i. AC in ECL cells stimulates gastric acid secretion via the actions
      of histamine acting at the parietal cell and in whole animals leads to
      proliferation of ECL cells when administered chronically.

PMID- 11193829
TI  - Integrative mitogenic role of protein kinase B/Akt in beta-cells.
AB  - Protein kinase B/Akt (PKB/Akt) is activated by phosphatidylinositol 3-kinase (PI
      3-K) and is a central mediator of cellular proliferation and protection against
      apoptosis. Insulin, insulin-like growth factor (IGF-1), and glucagon-like peptide
      1 (GLP-1) act as glucose-dependent growth factors for pancreatic beta-cells. We
      assessed signaling pathways and stimulation patterns of PKB/Akt activation by
      these ligands in the beta-cell line INS-1. Insulin, IGF-1, and GLP-1 induced
      distinctive time dependent, dose dependent, and glucose dependent phosphorylation
      of PKB/Akt. Insulin and IGF-1 stimulated PI 3-K activity was mainly associated
      with insulin receptor substrate (IRS) isoforms IRS-1 and IRS-2 and less so with
      the IRS-isoform Grb-2 associated binder-1 (Gab-1). In contrast, GLP-1 induced PI
      3-K activity mainly in Gab-1 and also in IRS-2 immunoprecipitates, although in an
      attenuated kinetic. Thus, activation pathways of PKB/Akt by insulin, IGF-1, and
      GLP-1 converge at the level of IRS-isoforms and PI 3-K inducing differential
      activation of PKB/Akt. These data indicate an essential role of PKB/Akt in
      regulation of beta-cell proliferation.

PMID- 11193830
TI  - The effects of PACAP on insulin secretion and glucose disposal are altered by
      adrenalectomy in mice.
AB  - We previously showed that pituitary adenylate cyclase-activating polypeptide
      (PACAP) potently stimulates insulin secretion in vivo in mice without altering
      glucose disposal. Such a combination of results would be explained if epinephrine
      released by PACAP counteracts the action of insulin and, therefore, that the
      glucose disposal after PACAP administration is altered by adrenalectomy. In the
      study reported in this paper, we examined the influence of PACAP27 (1.3 nmol/kg
      i.v.) on insulin secretion and glucose disposal during an intravenous glucose (1
      g/kg) tolerance test in mice subjected to bilateral adrenalectomy 48 h prior to
      the tolerance test. We found that in control mice, PACAP potentiated glucose
      stimulated insulin secretion threefold without affecting glucose disposal.
      Adrenalectomy potentiated the augmentation by PACAP27 of glucose-stimulated
      insulin secretion, and in adrenalectomized mice, PACAP27 simultaneously augmented
      glucose disposal (elimination rate 2.30 +/- 0.07%/min vs. 2.56 +/- 0.05%/min; p =
      0.011). Furthermore, PACAP27 augmented glucose elimination stimulated by i.v.
      insulin administration only in adrenalectomized, but not in control mice. We,
      therefore, conclude that under in vivo conditions, epinephrine released by PACAP
      from the adrenals prevents the marked insulinotropic action of the peptide from
      augmenting glucose disposal.

PMID- 11193831
TI  - Intraperitoneal PACAP administration decreases blood glucose in GK rats, and in
      normal and high fat diet mice.
AB  - PACAP is an islet peptide that serves as an endogenous amplifier of glucose
      induced insulin secretion. Furthermore, we has recently found that PACAP also
      potentiates insulin stimulated glucose uptake in adipocytes. Therefore, an
      antidiabetic action of PACAP is possible. In the present study, we examined the
      effect of PACAP treatment of the hyperglycemia in GK rats, an animal model of
      type 2 diabetes, and in high fat fed C47BL/6J mice, an animal model for glucose
      intolerance. GK rats housed with normal diet exhibited a normal level of blood
      glucose until three weeks old but significant hyperglycemia at eight weeks. When
      GK rats were treated with daily PACAP38 (i.p. injection, 6 pmol/kg) from age
      three weeks, development of hyperglycemia was prevented. In high fat fed mice,
      i.p. administration of PACAP27 for five (25 nmol/kg twice daily) reduced plasma
      glucose levels to 6.9 +/- 0.2 mmol/l compared to 8.1 +/- 0.2 mmol/l in saline
      injected animals (p < 0.001) without altering baseline insulin levels. We
      conclude that PACAP reduces circulating glucose in animal models of type 2
      diabetes and glucose intolerance. The mechanism of this action needs to be
      established.

PMID- 11193832
TI  - VPAC1 receptors and lung cancer.
AB  - VIP/PACAP are autocrine growth factors for lung cancer. VIP and/or PACAP mRNA is
      present in most lung cancer cell lines examined. Although mRNA for VPAC2-R is not
      common, VPAC1-R and PAC1-R mRNA is present in many lung cancer cell lines. 125I
      VIP binds with high affinity to lung cancer cells and specific 125I-VIP binding
      is inhibited with high affinity by (Lys15, Arg16, Leu27)VIP1-7 GRF8-27, the VPAC1
      R specific agonist, but not by Ro25-1553(18), the VPAC2-R specific agonist. VIP
      elevates cAMP and increases c-fos gene expression. The increase in cAMP and c-fos
      mRNA caused by VIP is inhibited by SN(VH). (SH)VH inhibited the proliferation of
      NCIH1299 cells in the MTT assay, which is based on cytotoxicity. In a recent cell
      line screen, (SN)VH inhibited the growth of 51 of 56 cancer cell lines including
      leukemia, lung cancer, colon cancer, CNS cancer, melanoma, ovarian cancer, renal
      cancer, breast cancer, and prostate cancer (T. Moody, unpublished). It remains to
      be determined if (SN)VH will be useful for treatment of a wide variety of
      cancers.

PMID- 11193833
TI  - The Viktor Mutt Memorial Lecture. Protection by VIP and related peptides against
      cell death and tissue injury.

PMID- 11193834
TI  - Cyanine dye labeled vasoactive intestinal peptide and somatostatin analog for
      optical detection of gastroenteropancreatic tumors.

PMID- 11193835
TI  - Analysis of VIP and CGRP plasma levels after radiotherapy for treatment of
      metastasis from prostatic carcinoma.
AB  - It has previously been shown that radiotherapy leads to an increased level of
      neuropeptides in various organs. In the study we report here, we examined whether
      the plasma levels of two neuropeptides, vasoactive intestinal peptide (VIP) and
      calcitonin gene-related peptide (CGRP), are influenced by radiotherapy. Blood was
      collected at four time intervals after radiotherapy; 1-12 days after treatment
      for skeletal metastasis from prostatic carcinoma. The VIP- and CGRP-plasma
      levels, as analyzed by radioimmunoassay, were not statistically different between
      the different time points analyzed.

PMID- 11193836
TI  - Anti-inflammatory actions of VIP/PACAP. Role in endotoxemia.

PMID- 11193837
TI  - The effect of cardiac arrest on the permeability of the mouse blood-brain and
      blood-spinal cord barriers to PACAP.

PMID- 11193838
TI  - PACAP acts as a neurotrophic factor during histogenesis of the rat cerebellar
      cortex.
AB  - During development of the rat cerebellum, PAC1 receptors are transiently
      expressed by neuroblasts of the external granule cell layer (EGL). We have
      previously shown that PACAP is a potent stimulator of granule cell survival in
      vitro. In the study reported in this paper, we have investigated the effect of
      PACAP on the development of the rat cerebellar cortex in vivo. PACAP induces a
      transient increase in the volume of the cerebellar cortex, with a maximum effect
      at postnatal day 12, which can be accounted for by an increase in the number of
      granule cells in the EGL, the molecular layer, and the internal granule cell
      layer (IGL). The effect of PACAP on the number of granule cells is blocked by the
      antagonist PACAP(6-38), which, by itself, produces a slight inhibition of the
      number of granule cells in the IGL. These data indicate that PACAP activates
      proliferation and/or inhibits programmed cell death of granule cells in the
      developing rat cerebellum. PACAP also stimulates neuronal migration from the EGL
      to the IGL. Thus, it appears that PACAP can act in vivo as a neurotrophic factor
      controlling histogenesis of the cerebellar cortex.

PMID- 11193839
TI  - Molecular cloning, mRNA distribution and pharmacological characterization of a
      VIP/PACAP receptor in the frog Rana ridibunda.

PMID- 11193840
TI  - Distribution of PACAP receptor mRNAs and PACAP binding sites in the rat brain
      during development.

PMID- 11193841
TI  - Immunohistochemical and immunochemical evidence for expression of human lung
      PACAP/VIP receptors.

PMID- 11193842
TI  - Expression and coupling of PACAP/VIP receptors in cortical neurons and type I
      astrocytes.

PMID- 11193843
TI  - Ultrastructural localization of PACAP immunoreactivity in the rat retina.

PMID- 11193844
TI  - PACAP and VIP in the photoneuroendocrine system. From the retina to the pituitary
      gland.

PMID- 11193845
TI  - Synaptic interaction between galanin immunoreactive neurons and axon terminals
      immunopositive for VIP and PACAP in the bed nucleus of the stria terminalis in
      the rat.

PMID- 11193846
TI  - Downregulation of VPAC1R expression in breast cancer cell lines.
AB  - The breast carcinoma cell line T47D was tested for 17 beta-estradiol (E2)
      mediated regulation of vasoactive intestinal polypeptide receptor type-1 (VPAC1)
      expression. E2 was found to downregulate the mRNA level. The number of VIP
      binding sites was reduced 66% on treatment with E2 for 72 h. Experiments with
      cycloheximide suggested that the effect was independent (at least partly so) of
      protein synthesis. Experiments with the transcriptional inhibitor, actinomycin D,
      showed that E2 did not influence the VPAC1 mRNA halflife. Both of two
      antiestrogens, ICI 182,780 and 4-hydroxy-tamoxifen, mediated a concentration
      dependent inhibition of the effect of E2 on the mRNA level. Transient
      transfection with reporter-gene constructs containing various portions of the
      VPAC1 5'-flanking sequence revealed the most proximal 100 bp to be essential for
      the basal transcriptional activity. However, E2 did not influence the expression
      of the reporter gene using up to 3,250 bp of the VPAC1 5'-flanking region.

PMID- 11193847
TI  - Prohormone convertase PC4 processes the precursor of PACAP in the testis.

PMID- 11193848
TI  - Presence of PACAP-immunoreactive neurons in the trigeminal ganglion of the sheep.
      Indications for a trigeminal innervation of the pineal gland.

PMID- 11193849
TI  - Genomic organization and chromosomal localization of the mouse pituitary
      adenylate cyclase activating polypeptide (PACAP) gene.

PMID- 11193850
TI  - PACAP receptor expression in the rat adrenal medulla by in situ hybridization and
      immunocytochemistry.

PMID- 11193851
TI  - Alanine scanning of VIP. Structure-function relationship for binding to human
      recombinant VPAC1 receptor.

PMID- 11193852
TI  - Postnatal development of vasoactive intestinal peptide receptor-effector system
      in rat immunocompetent cells.

PMID- 11193853
TI  - Sequences (103-110) and (116-120) of the rat secretin receptor are implicated in
      secretin and VIP recognition.

PMID- 11193854
TI  - Gene expression for PACAP receptor mRNA in the rat retina by in situ
      hybridization and in situ RT-PCR.

PMID- 11193855
TI  - Imaging tumors in humans with Tc-99m-VIP.
AB  - Vasoactive intestinal peptide (VIP) was modified at the C terminus with a spacer
      and four amino acids to serve as a chelating moiety. The modified peptide, TP
      3654, was labeled with Tc-99m and evaluated in normal volunteers, as well as in
      patients with a history of cancer. Renal clearance (67%) was the primary route of
      excretion, with approximately 20% of the radioactivity clearing through the
      hepatobiliary system. No adverse reaction was noted in any of the subjects and
      all, except one small, of the known lesions as seen by CT, MRI, Tc-99m-MIBI, or
      mammography were correctly identified within a few minutes of an i.v. injection
      of approximately 10 mCi of Tc-99m-TP 3654 (specific activity 11.3 x 10(3) Ci/m
      mol). The scans were in concordance in nine patients. In the remaining two, one
      with a visible mass in the neck from high grade spindle cell sarcoma and the
      other with a palpable mass in a breast from ductal epithelial hyperplasia, were
      localized only with Tc-99m-TP 3654, but not with Tc-99m-MIBI. Both malignancies
      are known to express VIP receptors. The VIP analog promises to be a nontoxic and
      reliable agent for imaging cancers in humans that express VIP receptors.

PMID- 11193856
TI  - Organization of the rat PACAP gene.
AB  - The rat PACAP gene has been isolated, cloned, and sequenced. The gene
      organization is very similar to that of the mouse and human PACAP genes. An
      analysis of the 5'-UTR in proPACAP mRNAs indicates that multiple transcripts are
      generated by using different splice sites within exons 1A, 1B, and 2 to form the
      5'-UTR. Analysis of PACAP promoter activity in PC12 cells suggests that forskolin
      responsiveness of the gene is dependent on elements located between -77 and -413
      bp from the transcription start site.

PMID- 11193857
TI  - Distribution of PACAP receptor and its splice variants in the rat brain by in
      situ RT-PCR.

PMID- 11193858
TI  - Ontogeny of PACAP receptor and its splice variants in the rat brain.

PMID- 11193859
TI  - Effect of flutamide androgen-receptor blockade on rat prostatic VIP
      receptor/effector system.

PMID- 11193860
TI  - Dual contacts between peptide agonist ligands and the secretin receptor directly
      established by photoaffinity labeling.
AB  - Structural analysis of secretin in solution has demonstrated extended helical
      domains within both amino- and carboxyl-terminal halves, with a possible turn in
      between. However, the conformation of this peptide as it resides in its binding
      site within the receptor has not been established. In the work reported here, we
      performed affinity labeling of the secretin receptor with radioiodinated secretin
      analogues having photolabile benzoyl-phenylalanine residues positioned in each
      half of the peptide. The probes had sites of covalent attachment in positions 6
      and 22, and have been recently synthesized and characterized to represent high
      affinity agonist ligands. Both covalently labeled the secretin receptor in a
      saturable, specific, and efficient manner. After purification of the labeled
      receptor, we used a series of chemical and enzymatic cleavage techniques to
      define the domain of labeling. We complemented this by receptor mutagenesis,
      followed by additional cleavage and Edman degradation sequencing to refine our
      insights into the labeled residues. This has allowed us to demonstrate that sites
      of attachment were both within the extracellular aminoterminal domain of the
      receptor. Of particular interest, both probes labeled residues within the amino
      terminal thirty residues at the distal end of the receptor. It will be
      particularly interesting to use these molecular approximations to model the
      binding domain of this important receptor.

PMID- 11193861
TI  - VIP regulates angiotensinogen synthesis in the liver.

PMID- 11193862
TI  - Nerve growth factor upregulates the PAC1 promoter by activating the MAP kinase
      pathway in rat PC12 cells.
AB  - We report that: (1) An increase in the transcription activity is a mechanism by
      which trophic peptides may regulate the expression of PAC1. (2) An activation of
      the PAC1 promoter does not necessarily correlate with the neurotrophin-promoted
      neuritogenesis. (3) Activation of the PAC1 promoter is probably an early event
      since the EGF response is rather weak and transient in PC12 cells. (4) MAP kinase
      pathway activation is necessary for the NGF effect. The mechanism of the
      antagonism between PACAP and NGF observed on the PAC1 promoter activity and
      already described in regulating chromaffin cell proliferation, remains to be
      explained.

PMID- 11193863
TI  - Different domains of the VIP receptors modulate agonist affinity and intrinsic
      activity.

PMID- 11193864
TI  - PAC1 null females display decreased fertility.
AB  - We report here that PAC1 KO females display decreased fertility, whereas male
      fertility was normal. ICC on pituitary section showed that FSH, LH, and prolactin
      synthesis were not affected in KO mice. Moreover, the pituitary-gonadal axis
      responded properly to an acute fasting test in KO mice. Hence, the phenotype of
      PAC1 null mice provides clear evidence for the role of PAC1 receptor in
      reproduction process.

PMID- 11193865
TI  - The inhibitory effect of PACAP38 on ovulation is mediated by CRF and endogenous
      opioids.

PMID- 11193866
TI  - PACAP and VIP induce changes in cytosolic calcium in putative folliculostellate
      cells of the mouse pituitary.

PMID- 11193867
TI  - PACAP augments nitric oxide synthesis in rat vascular smooth muscle cells
      stimulated with IL-1 alpha.

PMID- 11193868
TI  - Synergistic interaction between VIP-related peptides and bombesin on ion
      transport in guinea pig distal colonic mucosa.

PMID- 11193869
TI  - The effect of VIP on progesterone (PROG) release in dehydrated male rats.

PMID- 11193870
TI  - Occurrence and effect of PACAP in the human fetal adrenal gland.
AB  - In the study reported in this paper, we characterized PACAP in the human fetal
      adrenal gland and we investigated the effect of PACAP on steroid secretion from
      cultured fetal adrenal cells. The adrenal gland from 20-week-old fetuses
      contained substantial concentrations of PACAP-immunoreactive material (88.6 ng/g
      wet tissue). HPLC analysis of adrenal extracts revealed the presence of both
      PACAP27 and PACAP38, the latter being the predominant form. Incubation of
      cultured fetal adrenal cells with PACAP38 (10(-7) M) significantly increased
      cortisol and DHEAS secretion. Administration of the beta-adrenoreceptor agonist
      isoproterenol mimicked the stimulatory effect of PACAP on both steroid secretion
      whereas preincubation of fetal cells with the beta-adrenoreceptor antagonist
      propranolol suppressed the steroidogenic effect of PACAP. These data, together
      with the observation that PACAP receptors are exclusively located on chromaffin
      cells, suggest that, in the fetal human adrenal gland, the effect of PACAP on
      steroid secretion is mediated via the local release of catecholamines.

PMID- 11193871
TI  - Distribution of vasoactive intestinal polypeptide and its effect on glucagon
      secretion from normal and diabetic pancreatic tissue fragments in rat.

PMID- 11193872
TI  - PACAP activates pancreatic alpha-cells in a glucose independent manner.

PMID- 11193873
TI  - The role of VIP and somatostatin in the control of GH and prolactin release in
      anorexia nervosa and in obesity.

PMID- 11193874
TI  - Vasoactive intestinal peptide (VIP) receptor type 2 (VPAC2) is the predominant
      receptor expressed in human thymocytes.
AB  - Vasoactive intestinal peptide (VIP) binding sites have been identified in the
      human thymus, but the receptor subtype and how these receptors are distributed in
      the human thymus subsets is unknown. To assess gene expression, distribution, and
      receptor regulation of the two G-protein-associated VIP receptors, VPAC1 and
      VPAC2 mRNAs were quantified using a novel fluorometric-based kinetic (real-time)
      RT-PCR. Bulk and fractionated thymocytes were stimulated via the TCR/CD3 receptor
      complex and anti-CD28. Our results demonstrate that thymocytes express higher
      levels of VPAC2 compared to VPAC1 expression in bulk thymocytes, CD4+CD8+
      selected double positives (DP), and CD8 depleted thymocytes. Double negative
      cells express low levels of VPAC2 mRNA. We demonstrate T-cell activation
      dependent down-regulation of VPAC1, but not VPAC2, in human thymocytes. This
      study reports the first direct evidence of a differential distribution and
      selective regulation of VPAC1 and VPAC2 gene expression in normal human thymocyte
      subsets.

PMID- 11193875
TI  - PACAP27 sensitizes glucose induced insulin secretion in INS-1 cells.

PMID- 11193876
TI  - Distinctive effects of glicentin, GLP-1 and GLP-2 on adaptive response to massive
      distal small intestine resection in rats.

PMID- 11193877
TI  - Cytosolic calcium handling in islets of normal Wistar and diabetic Goto Kakizaki
      rats in the presence of glucose and truncated glucagon-like peptide 1 (7-36)
      amide.

PMID- 11193878
TI  - Colocalization of GLP-1 and GIP in human and porcine intestine.

PMID- 11193879
TI  - Insulinotropin PACAP potentiates insulin action. Stimulation of glucose uptake in
      3T3-LI adipocytes.
AB  - PAC1 receptor was expressed in the rat fat tissue and 3T3-L1 adipocytes. PACAP-38
      (10 nM) significantly enhanced insulin induced 2-deoxyglucose uptake by 3T3-L1
      adipocytes. GLP-1 has a similar effect. PACAP-38 further increased insulin
      stimulated phosphatidylinositol (PI) 3-kinase activity, but has not effect on
      tyrosine phosphorylation of insulin receptor beta-subunit or IRS-1. These results
      reveal that PACAP-38 enhances insulin induced glucose uptake, an effect probably
      mediated by PI 3-kinase. In conclusion, PACAP potentiates not only insulin
      secretion but also insulin action in adipocytes, thereby exhibiting antidiabetic
      actions at two important steps of glucose metabolism (Fig. 2).

PMID- 11193880
TI  - VIP and PACAP inhibit activation induced apoptosis in T lymphocytes.
AB  - Apoptosis in T and B lymphocytes is a major element controlling the immune
      response. Activation induced cell death (AICD) in T cells is a main mechanism for
      maintaining peripheral tolerance and for limiting an ongoing immune response.
      AICD is initiated by antigen reengagement of the T cell receptor (TCR), and
      mediated through Fas/Fas ligand (FasL) interactions. VIP and PACAP are two
      multifunctional neuropeptides present in the lymphoid microenvironment that act
      primarily as anti-inflammatory agents. In this study we report on the role of VIP
      and PACAP on T cell AICD, and on the mechanisms involved. VIP and PACAP inhibit
      AICD in vivo and in vitro, in peripheral T cells and T cell hybridomas. The
      effect is dose dependent and is mediated through the specific receptors VPAC1 and
      VPAC2. The inhibition of AICD is achieved through reduction in FasL expression at
      protein and mRNA level. By affecting FasL expression, VIP and PACAP may play a
      physiological role in both the generation of memory T cells and the inhibition of
      FasL-mediated T cell cytotoxicity.

PMID- 11193881
TI  - VIP and PACAP induce shift to a Th2 response by upregulating B7.2 expression.
AB  - VIP and PACAP, two structurally related neuropeptides produced within the
      lymphoid microenvironment, modulate several immunological functions. Although
      primarily anti-inflammatory in nature, VIP and PACAP also affect resting
      macrophages. In this study, we report on the role of VIP and PACAP on macrophage
      B7 expression and costimulatory function for antigen-primed CD4+ T cells, and on
      the macrophage-induced regulation of Th1/Th2 differentiation in vitro and in
      vivo. VIP and PACAP upregulate B7.2, but not B7.1, MHC class II, or ICAM-1
      expression, and activate macrophages to stimulate the proliferation of naive T
      cells in response to soluble anti-CD3 or allogeneic stimulation. The stimulatory
      effect is mediated through the specific receptor VPAC1, and involves the cAMP/PKA
      pathway as second messengers. The enhancement in B7.2 expression occurs at both
      mRNA and protein levels, and correlates with the VIP/PACAP induced upregulation
      of the costimulatory activity of macrophages for antigen-primed CD4+ T cells.
      VIP/PACAP-treated macrophages gain the ability to induce Th2-type cytokines such
      as IL-4 and IL-5, and to reduce Th1-type cytokines such as IFN gamma and IL-2. In
      vivo administration of VIP or PACAP in antigen-immunized mice reduces the numbers
      of IFN gamma-secreting cells, enhances the numbers of IL-4-secreting cells, and
      affects the pattern of antigen-specific Ig isotypes. The preferential
      differentiation into Th2 effector cells induced by VIP/PACAP-treated macrophages
      is mediated through the upregulation of B7.2 expression. Since Th1-dominated
      responses are associated with some autoimmune diseases and inflammatory reactions
      typical of cell-mediated immunity, the VIP/PACAP inhibition of Th1 development
      may represent an additional mechanism for the general anti-inflammatory activity
      of the two neuropeptides.

PMID- 11193882
TI  - Vasoactive intestinal peptide mediation of development and functions of T
      lymphocytes.
AB  - The first phase in investigating neural regulation of immunity has delineated
      anatomical connections, shared mediators and receptors for mediators with
      distinctive effects, and the immune functional consequences of altering relevant
      neural activities. Vasoactive intestinal peptide (VIP) and pituitary adenylyl
      cyclase-activating peptide (PACAP) are represented prominently in immune organs.
      They have potent novel effects on many aspects of immunity, are derived from and
      serve as autacoids in some sets of immune cells, and they participate in both
      physiological and pathological immune responses. The present phase of neuroimmune
      research has begun to elucidate the genetic determinants of expression and
      functions of neuromediators in immunity. Our evolving understanding of the novel
      mechanisms for adaptation and specificity in the VIP/PACAP neuroimmune network
      suggests the importance of immunoselective transcriptional control of expression
      of VIP/PACAP receptors in T cells, a dominant role for numerous cytokines, and
      the critical involvement of small subsets of VIP-/PACAP-responsive thymocytes and
      T cells.

PMID- 11193883
TI  - Receptors and transcriptional factors involved in the anti-inflammatory activity
      of VIP and PACAP.
AB  - VIP and PACAP modulate the function of inflammatory cells through specific
      receptors. VIP/PACAP inhibit the production of TNF alpha, IL-6, IL-12, and nitric
      oxide (NO), and stimulate IL-10 in peritoneal macrophages and Raw 264.7 cells.
      Here we report on the specific VIP/PACAP receptors, transduction pathways, and
      transcriptional factors involved in the regulation of these macrophage factors by
      VIP and PACAP. Both neuropeptides inhibit IL-6 production mainly through PAC1
      binding, PKC activation, and the subsequent shedding of the LPS receptor CD14 in
      macrophages. However, the effects on TNF alpha, IL-10, IL-12, and NO are mostly
      mediated through the constitutively expressed VPAC1 receptor, although the
      inducible expressed VPAC2 may also participate. VIP/PACAP binding to VPAC1
      induces both a cAMP-dependent and a cAMP-independent pathways that regulate
      cytokine and NO production at the transcriptional level. VIP/PACAP inhibit TNF
      alpha through reduction in NFkB binding and changes in the composition of CRE
      binding complexes; they inhibit IL-12 through reduction in NFkB binding and
      changes in the composition of the ets-2 complexes. VIP/PACAP inhibit iNOS
      expression through reduction in NFkB and IRF-1 binding, and augment IL-10 by
      increasing CREB-binding. Whereas the inhibition of IRF-1 and CRE-binding
      complexes seems to be mediated through the cAMP-dependent pathway, VIP/PACAP
      inhibition of NFkB nuclear translocation is mediated through a reduction in IkB
      alpha degradation mediated by the cAMP-independent pathway. This study provides
      new evidence for the understanding of the molecular mechanism by means of which
      VIP and PACAP attenuate the inflammatory response.

PMID- 11193884
TI  - Mechanism of action of camptothecin.
AB  - Camptothecin (CPT) class of compounds has been demonstrated to be effective
      against a broad spectrum of tumors. Their molecular target has been firmly
      established to be human DNA topoisomerase I (topo I). CPT inhibits topo I by
      blocking the rejoining step of the cleavage/religation reaction of topo-I,
      resulting in accumulation of a covalent reaction intermediate, the cleavable
      complex. The primary mechanism of cell killing by CPT is S-phase-specific killing
      through potentially lethal collisions between advancing replication forks and
      topo-I cleavable complexes. Collisions with the transcription machinery have also
      been shown to trigger the formation of long-lived covalent topo-I DNA complexes,
      which contribute to CPT cytotoxicity. Two novel repair responses to topo-I
      mediated DNA damage involving covalent modifications of topo-I have been
      discovered. The first involves activation of the ubiquitin/26S proteasome
      pathway, leading to degradation of topo-I (CPT-induced topo-I downregulation).
      The second involves SUMO conjugation to topo-I. The potentials roles of these new
      mechanisms for repair of topo-I-mediated DNA damage in determining CPT
      sensitivity/resistance in tumor cells are discussed.

PMID- 11193885
TI  - Homocamptothecins: E-ring modified CPT analogues.
AB  - Homocamptothecins (hCPT) are modified camptothecins (CPT) with a seven-membered
      beta-hydroxylactone instead of the naturally occurring six-membered alpha
      hydroxylactone. This E-ring modification fully conserves the ability to stabilize
      topo I-DNA single-strand breaks and stimulates high levels of DNA cleavage. A key
      feature is the irreversibility of E-ring opening, which should give reduced
      toxicity. Substituted hCPTs have been selected for their high antiproliferative
      activity on a panel of tumor cell lines, including those with cross resistance,
      and were found to be active at very low doses in a variety of human tumor
      xenografts when administered orally. BN 80915, a difluoro-hCPT, has entered
      clinical trials.

PMID- 11193886
TI  - Molecular and biological determinants of the cytotoxic actions of camptothecins.
      Perspective for the development of new topoisomerase I inhibitors.
AB  - Camptothecin, originally discovered in 1957 as an antitumor activity in plant
      extracts, has recently become one of the most promising leads to new anticancer
      drugs. After lingering for many years, interest in camptothecin was revitalized
      in 1985 upon discovery of its specific action on topoisomerase I. Detailed
      elucidation of action mechanisms at the molecular, cellular, and pharmacologic
      levels has made camptothecin and its congeners perhaps the best understood among
      clinical anticancer drugs. Promising chemical variants of camptothecin, and
      recently other chemical categories of topoisomerase I-targeted drugs, provide
      unusually rich opportunities for rational drug selection and design. This is made
      possible by current concepts based, for the most part, on a sound experimental
      foundation, which points the way towards optimally effective therapy.

PMID- 11193887
TI  - The cascade radical annulation approach to new analogues of camptothecins.
      Combinatorial synthesis of silatecans and homosilatecans.
AB  - An overview of the cascade radical annulation approach to the camptothecin family
      of antitumor drugs is presented. This combinatorial synthetic approach involves
      two key steps: (1) N-propargylation of a lactone/pyridone D/E ring fragment and
      (2) cascade radical annulation of an A-ring isonitrile to form rings B and C. The
      synthesis is probably the most flexible and general route to the camptothecin
      class of molecules. The parallel synthesis of several libraries of silatecan and
      homosilatecan libraries is summarized. One of the first-generation silatecans, DB
      67, is emerging as a serious candidate for cancer chemotherapy.

PMID- 11193888
TI  - Structure-activity relationship of alkyl camptothecin esters.
AB  - The cytotoxicity of camptothecin (CPT) esters 1-6 was measured. Like parental
      camptothecin, esters 2 and 3, but not 1, 4, 5, and 6, inhibited proliferation of
      human leukemia cells in culture and induced programmed cell death as assessed by
      flow cytometry studies. Exhibition of similar levels of antiproliferative
      activities of CPT 2 and 3 required different incubation time periods in cell
      cultures, with CPT and 3 requiring the shortest and longest periods,
      respectively. Both 2 and 3 were inactive against cells resistant to the
      semisynthetic CPT derivative 9-nitrocamptothecin and unable to stabilize DNA
      topoisomerase I (Topo I) "cleavable complexes" in a cell-free system, suggesting
      that Topo I activity was required but insufficient for the mechanism of action of
      2 and 3. Mouse liver homogenate converted esters to parental CPT, but the
      conversion rates were different with different esters. Of four tested esters in
      this experiment, ester 2 had the fastest conversion rate. In vivo studies showed
      that ester 2 had an exceptional lack of toxicity in nude mice, even at enormous
      doses, and demonstrated extensive activity against human breast and colon tumors
      grown as xenografts in immunodeficient nude mice, whereas no antitumor activity
      was observed for the other esters. In conclusion, ester 2 is a prodrug of the
      antitumor compound CPT, and it can be administered at very high doses in mice
      with no appearance of toxicity. This study provides a basis for further
      evaluation of CPT ester 2 as an investigational anticancer agent.

PMID- 11193889
TI  - Conjugation of camptothecins to poly-(L-glutamic acid).
AB  - Conjugation of water-insoluble cancer chemotherapeutic drugs to macromolecular
      polymers can lead to improved pharmaceutical properties and improved therapeutic
      ratios due to accumulation of the polymer-drug conjugate in tumor tissue through
      the enhanced permeability and retention (EPR) to macromolecules associated with
      tumor vasculature. Pharmaceutical shortcomings of certain active camptothecins
      including difficulty in formulation and instability of the active lactone form
      due to interactions with human albumin might be improved by conjugation to
      polymers. In this report, conjugations of camptothecin (CPT), 10-hydroxy-CPT, and
      9-amino-CPT to poly-(L-glutamic acid) (PG) are described; coupling was
      accomplished either through the 20(S)-hydroxyl or 9 and 10 substituents with and
      without the use of a glycine linker. Studies using a PG paclitaxel conjugate (PG
      TXL), which is currently in Phase I testing, demonstrated that PG enhanced
      aqueous solubility, prolonged plasma residence time, and greatly increased the
      distribution of paclitaxel to tumor tissue in a murine model. In this report, we
      describe the use of similar conjugation technology for CPT derivatives and
      demonstrate that these difficult to formulate compounds can be rendered water
      soluble, that their maximum tolerated doses are increased, and that they retain
      substantial anti-tumor activity in syngeneic and xenogeneic tumor models.
      Preliminary data suggest that PG with molecular weights between 37 and 50 kDa
      with CPT loading between 14% and 37% with or without glycine linkers display
      enhanced efficacy compared with nonconjugated camptothecins administered at their
      maximum tolerated dose.

PMID- 11193890
TI  - 9-Nitrocamptothecin liposome aerosol treatment of human cancer subcutaneous
      xenografts and pulmonary cancer metastases in mice.
AB  - The purpose of this study was to test the anticancer properties of the water
      insoluble derivative of camptothecin, 9-nitrocamptothecin (9NC), administered in
      a liposome formulation (L-9NC) in aerosol to mice with subcutaneous xenografts of
      three human cancers and in mice with murine melanoma and human osteosarcoma
      pulmonary metastases. The drug was formulated with dilauroylphosphatidylcholine
      and nebulized in particle sizes of 1.2-1.6 microns mass median aerodynamic
      diameter and a geometric standard deviation of 2.0. The aerosol was generated
      with the nebulizer flowing at 10 l/min and delivered to mice in sealed plastic
      cages or in a nose-only exposure chamber. Aerosol was administered for 15 min to
      2 hr daily, delivering deposited doses in the respiratory tract of 8.1-306.7
      micrograms of 9NC/kg. With subcutaneous tumors, growth was greatly inhibited or
      tumors were undetectable after several weeks of treatment. We also showed that
      oral dosage with L-9NC had no detectable effect on cancer growth, and thus the
      benefit from aerosol treatment was due to pulmonary deposition and not the larger
      fraction of drug deposited in the nose of mice during aerosol treatment which is
      promptly swallowed. Intramuscular L-9NC in slightly larger doses than given in
      the aerosol had detectable anticancer activity, but it was significantly less
      than in mice receiving the drug by aerosol. With metastatic pulmonary cancers,
      treated animals showed highly significantly less cancer growth than control
      animals. L-9NC aerosol showed a major therapeutic benefit in the treatment of
      subcutaneous human cancer xenografts in nude mice, suggesting that cancers at
      systemic sites might be responsive to this treatment. In addition, the strong
      anticancer effect of L-9NC aerosol on pulmonary metastases offers a therapeutic
      approach for treatment of pulmonary cancers. Thus, L-9NC aerosol may have
      applicability in the treatment of cancers throughout the body.

PMID- 11193891
TI  - Modified lactone/carboxylate salt equilibria in vivo by liposomal delivery of 9
      nitro-camptothecin.
AB  - The lactone stability of camptothecins is critical for their anticancer activity.
      A stable liposomal 9-nitro-camptothecin formulation was developed to circumvent
      the drawbacks of low aqueous solubility and lactone instability and to provide
      sustained release of the agent in blood circulation. The potential merits of the
      formulation were demonstrated by its profoundly improved lactone stability in
      vivo, favorable pharmacokinetic and biodistribution characteristics in rats, and
      enhanced preclinical efficacy in tumor-bearing athymic mice.

PMID- 11193892
TI  - New analogues of camptothecins. Activity and resistance.

PMID- 11193893
TI  - Intraperitoneal topoisomerase-I inhibitors. Preliminary findings with 9
      aminocamptothecin.
AB  - The i.p. administration of topoisomerase I (Topo I) inhibitors has a
      pharmacologic advantage over intravenous application, including preservation of
      the biologically active lactone form. In our ongoing study, patients have
      received 9-amino-20(S)-camptothecin (9-AC) i.p. on days 1, 3, 5, 8, 10, and 12,
      repeated every 4 weeks. The daily dose has been escalated to level IV of 1.5
      mg/m2 (9.0 mg/m2 per course), median of 3 cycles, range 1-4, with a reversible
      Grade 3 neutropenia in one patient. Responses included one CR (resolution of a
      pleural effusion), two patients without progressive disease (PD), two not
      evaluable, and two patients too early for evaluation. The area under the curve
      (AUC)i.p./AUCpl ratio (pharmacologic advantage) ranged from 7.6 to 16.5 on
      average, and, using nonlinear modeling, the pharmacologic decay data were fit to
      one- or two-compartmental models. Overall, a 9-AC i.p. application is well
      tolerated and anticipated to be an active regimen against i.p. malignancies,
      particularly those known to be sensitive to systemic Topo-I inhibitors.

PMID- 11193894
TI  - Transport of topoisomerase I inhibitors by the breast cancer resistance protein.
      Potential clinical implications.
AB  - The multidrug resistance protein BCRP (breast cancer resistance protein) is a
      member of the ATP-binding cassette family of drug transporters. Overexpression of
      BCRP caused by exposure of cells to mitoxantrone (MX) or doxorubicin/verapamil
      resulted in a resistance pattern that is different from what is generally seen in
      the case of P-glycoprotein and MRP1 overexpression. Recently, the BCRP gene has
      been described in ovarian, breast, colon, and gastric cancer and fibrosarcoma
      cell lines. Our human tumor cells T8 and MX3, derived from the ovarian cancer
      cell line IGROV1 by stepwise increased exposure to topotecan and MX, are
      resistant to topotecan, CPT11, SN38, and 9-aminocamptothecin as well as MX.
      Increased energy-dependent efflux of affected drugs was noted. BCRP is a very
      efficient transporter of topotecan. Our recent studies, using the monoclonal
      antibody (mAb) BXP34, revealed that BCRP is located in the plasma membrane of the
      T8 and MX3 cell lines. Preliminary results of staining of human tumor cells
      showed low or absent levels of BCRP in a panel of solid tumors and acute myeloid
      leukemia cells.

PMID- 11193895
TI  - Pharmacokinetics of orally administered camptothecins.
AB  - Phase I trials of oral camptothecins, including camptothecin (CPT) and irinotecan
      (CPT-11), have reported substantial interpatient variability in systemic
      exposure, which could result in suboptimal antitumor activity in some patients or
      enhanced risk for toxicity in others. This investigation evaluates the
      contribution of intestinal absorption and first-pass metabolism in the
      disposition of oral CPT and CPT-11, respectively. The transport of CPT in Caco-2
      cell lines (validated model of intestinal drug transport) was concentration
      dependent and saturable (Vmax: 34 x 10(-5) cm/sec and Km: 20 microM), and was
      temperature dependent with an activation energy (Ea) of 11.7 kcal/mole.
      Cumulatively, this data was indicative of carrier-mediated intestinal transport.
      In addition, a reduction of transport in the presence of sodium azide plus
      deoxyglucose suggested ATP dependence. Thus, variable expression and availability
      of intestinal transporters could contribute to the observed wide variability in
      the exposure to oral CPT. CPT-11 is hydrolyzed by the ubiquitous enzyme carboxyl
      esterase to active SN-38, and first-pass metabolism of oral CPT-11 would include
      both intestinal and hepatic hydrolysis. Incubation of CPT-11 with S9 fractions of
      human liver and intestinal tissues resulted in variable rates of formation of SN
      38. The mean (+/- SD) specific activities (pmoles/min/mg) were: liver (8.57 +/-
      10.4, n = 8), duodenum (5.06 +/- 3.7, n = 4), jejunum (6.44 +/- 2.8, n = 5),
      ileum (4.81 +/- 2.4, n = 5), colon (1.93 +/- 1.5, n = 6), and rectum (0.82, n =
      1). Interestingly, there was a decrease in SN-38 formation by tumor tissue
      compared to matched normal liver and colon tissues. Therefore variable first-pass
      metabolism could contribute to the substantial differences in the systemic
      exposures to CPT-11 and SN-38 in patients receiving oral CPT-11.

PMID- 11193896
TI  - Metabolism of CPT-11. Impact on activity.
AB  - Irinotecan (CPT-11) is a semi-synthetic camptothecin with a broad spectrum of
      clinical activity. It is a prodrug that is cleaved by esterases to the potent
      topoisomerase I poison, SN-38. In humans, this activation is relatively
      inefficient, but this may result in a more protracted formation of SN-38 lactone.
      Some intratumoral activation may also occur, but the significance of this process
      is uncertain. CPT-11 is metabolized by cytochrome P450 3A to yield a number of
      comparatively inactive compounds. SN-38 is glucurono-conjugated in the liver, and
      this metabolite, although inactive, may participate in the enterohepatic cycling
      of SN-38 after hydrolysis in the intestinal lumen. Overall, the production of SN
      38 from CPT-11 is the result of the complex interplay of several metabolic
      pathways and the source of considerable interpatient variability.

PMID- 11193897
TI  - Pharmacology of camptothecin esters.
AB  - An intact lactone ring of camptothecins is a structural requirement for their
      anticancer activity. Propionate esters of camptothecin (CPT) and 9
      nitrocamptothecin (9NC), CZ48 and CZ112, respectively, have been synthesized as
      derivatives resistant to lactone hydrolysis and are chemotherapeutically active.
      In this study, we have examined the mechanism of action of CZ48 and CZ112 and
      their distribution, metabolism, and toxicity. CZ112 incubated in human plasma
      retained its lactone structure longer than 9NC (t1/2: 10.5 and < 1 hr for CZ112
      and 9NC, respectively). This resistance to lactone hydrolysis was also observed
      in mouse plasma or albumin solutions. Neither CZ48 nor CZ112 inhibit
      topoisomerase I and thus are prodrugs dependent on hydrolysis to CPT or 9NC,
      respectively. Rates of hydrolysis of CZ48 to CPT are higher by homogenates of
      mouse liver, spleen, lung, and kidney than by plasma. Rates of hydrolysis by
      tumor cells in culture vary and were higher by breast cancer and melanoma cells
      than by colon cancer cells. On the basis of these and other data, it is proposed
      that CZ48 and CZ112 may act as anticancer agents by resisting hydrolysis to
      camptothecins while in circulation. Hydrolysis in tissues may release intact
      lactone in target tissues.

PMID- 11193898
TI  - The clinical development of 9-aminocamptothecin.
AB  - 9-Aminocamptothecin (9-AC) is a topoisomerase I-targeting agent first synthesized
      by Wani and Wall in 1986. Because of its potent in vitro effects and promising
      preclinical activity in colorectal cancer animal models, it was designated a high
      priority compound for further drug development by the NCI. In 1993, 9-AC first
      entered clinical trials as a 72-hour intravenous (i.v.) infusion. Predictable
      myelosuppression was the major dose-limiting toxicity, and pharmacokinetic
      studies showed a relatively short plasma half-life and unstable lactone ring.
      Unfortunately, phase II studies using this schedule showed minimal or no activity
      in tumors such as colorectal and lung cancer. Modest activity was observed in
      ovarian cancer and in refractory lymphomas. Efforts to improve systemic drug
      exposure by utilizing alternative schedules of administration of 9-AC such as
      prolonged, continuous intravenous infusions have also been tested. However, phase
      II studies of 120-hour weekly infusions of 9-AC have not shown improved activity
      against solid tumors such as colorectal cancer. More recently, a daily times 5
      days i.v. administration schedule has been tested. Currently, further development
      of intravenously administered 9-AC for the treatment of colorectal cancer is not
      promising. Thus, topotecan and irinotecan remain the only two successfully
      developed topoisomerase I-targeting drugs in the United States. This experience
      with 9-AC raises important questions regarding how to best select new
      topoisomerase I-targeting drugs for future clinical development.

PMID- 11193899
TI  - Alternative administration of camptothecin analogues.
AB  - The binding of camptothecin (CPT) to the DNA-topoisomerase complex is reversible,
      but it needs to be maintained for maximal inhibitory activity. It is also
      dependent on the chemical structure of CPT. The lactone form is thought to be
      necessary for the activity. In human serum, the equilibrium between lactone and
      carboxylate is in favor of the latter. For these reasons, alternative
      administration of CPT analogues is being evaluated. The ideal compound would
      remain in lactone form and would expose the host for long periods of time to its
      effects. Oral administration of irinotecan (CPT-11) and topotecan (TPT) is
      discussed by other investigators. We studied oral rubitecan and reported a low
      lactone to total drug area under the plasma concentration-time curve (AUCP) ratio
      (14.7%), with low plasma concentration over time despite repeated administrations
      and the presence of an enterohepatic cycle. Aerosolization of a liposomal
      formulation of rubitecan is currently under study. Six patients have been treated
      once a day for 5 days every 3 weeks. The dose was 6.7 micrograms/kg/day. Plasma
      levels are dose for dose higher than those after oral administration, but the
      ratio of lactone versus total drug is low. No toxicity was observed. The study
      will continue with increasing doses and lengths of administration. Intrathecal
      administration of topotecan has been studied in a phase I trial in children.
      Doses of 0.4 mg are tolerated without toxicity, and clinical responses have been
      seen in patients with refractory meningial carcinomatosis. Phase II studies are
      planned. Intraperitoneal (i.p.) administration of topotecan has been studied in a
      phase I trial as a 24-hour infusion in 5% dextrose at pH 3.5 every 21 days. Dose
      limiting toxicity is 4 mg/m2. Toxic effects are neutropenia, anemia, emesis,
      fever, and pain. Five of 10 patients with ascites had symptomatic relief.
      Pharmacokinetic analysis demonstrates a second-order kinetics with elimination
      half-lives of 0.49 and 2.7 hours. The peritoneal to plasma AUC ratio was 31.2.
      Intramuscular, transdermal, and subcutaneous administrations have been
      extensively studied in the mouse.

PMID- 11193900
TI  - Topotecan (hycamptin) and topotecan-containing regimens in the treatment of
      hematologic malignancies.
AB  - Single-agent topotecan is an active drug in chemotherapy-naive MDS and CMML and,
      to a lesser degree, in refractory/relapsed acute leukemias, low-/intermediate
      grade lymphoma, and myeloma. Its combination with cytosine arabinoside induces
      complete remissions in high-risk MDS/CMML. A triple-combination regimen of
      cyclophosphamide, cytosine arabinoside, and topotecan (CAT) was extensively
      tested in refractory/relapsed as well as in untreated AML. By proving effective
      in inducing complete remission in newly diagnosed AML at rates comparable to
      those achieved by anthracycline-cytosine arabinoside regimens, for example, CAT
      offers a useful treatment alternative. Topotecan combined with paclitaxel is
      promising in low-/intermediate-grade lymphomas. The activity of topotecan
      justifies further evaluation of topotecan-containing combination regimens,
      particularly in MDS/CMML and acute leukemias.

PMID- 11193901
TI  - DX-8951f: summary of phase I clinical trials.
AB  - Exatecan mesylate (DX-8951f) is a new hexacyclic camptothecin analogue with
      favorable attributes compared to topotecan and CPT-11, including watersolubility,
      greater potency against topoisomerase I, lack of esterase-dependent activation,
      broad antitumor activity, and low cross-resistance against MDR-1 overexpressing
      tumors. In preclinical studies, the compound demonstrated a favorable toxicology
      profile with hematologic dose-limiting toxicity and moderate gastrointestinal
      toxicity, linear pharmacokinetics, P450 hepatic metabolism (CYP3A4 and CYP1A2),
      and predominately fecal excretion. The results of six U.S. and European phase I
      clinical trials as well as two Japanese studies are presented including total DX
      8951 and lactone DX-8951 pharmacokinetics. The toxicity profile was similar for
      all schedules of administration. Hematologic toxicity was dose-dependent and
      reversible. Neutropenia was dose-limiting in minimally pretreated patients,
      whereas neutropenia and thrombocytopenia were dose-limiting in heavily pretreated
      patients. Non-hematologic toxicity included moderate gastrointestinal toxicity
      (nausea, vomiting > diarrhea), transient elevation of hepatic transaminases,
      asthenia, and alopecia. Two cases of acute pancreatitis not predicted by
      preclinical toxicology were also observed. Antineoplastic activity was detected
      in several solid tumor types: non-small cell lung cancer, extrapulmonary small
      cell cancer, colorectal cancer, hepatocellular cancer, and sarcoma. Antitumor
      activity was seen in CPT-11 and topotecan-resistant tumors. Pharmacokinetics were
      linear within the dose range tested. A pharmacokinetic/pharmacodynamic model
      predictive of DX-8951f-induced neutropenia in individual patients was developed.
      The daily x5, every 3-week schedule with the drug administered as a 30-minute
      intravenous infusion was selected for future phase II clinical trials based on
      its superior antitumor activity.

PMID- 11193902
TI  - Dependence of anticancer activity of camptothecins on maintaining their lactone
      function.
AB  - Camptothecins contain a lactone ring that exists in the closed form below ph 7.
      Above 7, the open (CPT+) and the closed (CPT) form coexist in a 50-50 ratio in
      mouse plasma and in a 90-10 ratio in human plasma due to the high affinity of
      human serum albumin (HSA) for CPT+. CPT+ is much less toxic than CPT and it is
      excreted much faster. In complete RPMI 1640 culture medium, the equilibrium
      CPT(+)-CPT is 50-50. If 4% HSA is added, it moves to 90-10 modeling for the human
      physiological situation.

PMID- 11193903
TI  - Cellular and molecular responses to topoisomerase I poisons. Exploiting synergy
      for improved radiotherapy.
AB  - The efficacy of topoisomerase (Topo) I-active drugs may be improved by better
      understanding the molecular and cellular responses of tumor compared to normal
      cells after genotoxic insults. Ionizing radiation (IR) + Topo I-active drugs
      (e.g., Topotecan) caused synergistic cell killing in various human cancer cells,
      even in cells from highly radioresistant tumors. Topo I poisons had to be added
      either during or immediately after IR. Synergy was caused by DNA lesion
      modification mechanisms as well as by concomitant stimulation of two pathways of
      cell death: necrosis (IR) + apoptosis (Topo I poisons). Cumulative data favor a
      mechanism of synergistic cell killing caused by altered DNA lesion modification
      and enhanced apoptosis. However, alterations in cell cycle regulation may also
      play a role in the synergy between these two agents in certain human cancers. We
      recently showed that NF-kappa B, a known anti-apoptotic factor, was activated in
      various cancer cells after poisoning Topo I using clinically active drugs. NF
      kappa B activation was dependent on initial nuclear DNA damage followed by
      cytoplasmic signaling events. Cytoplasmic signaling leading to NF-kappa B
      activation after Topo I poisons was diminished in cytoplasts (lacking nuclei) and
      in CEM/C2 cells that expressed a mutant Topo I protein that did not interact with
      Topo I-active drugs. NF-kappa B activation was intensified in S-phase and blocked
      by aphidicolin, suggesting that activation was a result of double-strand break
      formation due to Topo I poisoning and DNA replication. Dominant-negative I kappa
      B expression augmented Topo I poison-mediated apoptosis. Elucidation of molecular
      signal transduction pathways after Topo I drug-IR combinations may lead to
      improved radiotherapy by blocking anti-apoptotic NF-kappa B responses. Recent
      data also indicate that synergy caused by IR + Topo I poisons is different from
      radiosensitization by beta-lapachone (beta-lap), a "reported" Topo I and II-alpha
      poison in vitro. In fact, beta-lap does not kill cells by poisoning either Topo I
      or II-alpha in vivo. Instead, the compound is "activated" by an IR (damage)
      inducible enzyme, NAD(P)H:quinone oxidoreductase (NQO1), a gene cloned as x-ray
      inducible transcript #3, xip3. Unlike the lesion modification pathway induced by
      IR + Topo I drugs, beta-lap kills cells via NQO1 futile cycle metabolism.
      Downstream apoptosis caused by beta-lap appears to be noncaspase-mediated,
      involving calpain or a calpain-like protease. Thus, although Topo I poisons or
      beta-lap in combination with IR both synergistically kill cancer cells, the
      mechanisms are very different.

PMID- 11193904
TI  - In vitro antitumor activity of 9-nitro-camptothecin as a single agent and in
      combination with other antitumor drugs.
AB  - Preclinical studies at Roswell Park Cancer Institute by Minderman, Cao, and
      Rustum (unpublished results) showed that a combination of SN-38 and 5-FU against
      HCT-8 human colon carcinoma cells in vitro was synergistic, with the best
      interaction occurring when the drugs were added sequentially, SN-38 first. Their
      in vivo studies using HCT-8 tumor xenografts implanted s.c. in nude athymic mice
      demonstrated superior efficacy for a sequential i.v. administration of CPT-11, 24
      hr before 5-FU. On the basis of these studies, our group has begun to evaluate
      effects of RFS2000 (9-nitro-20(S)-camptothecin) (9-NC) in combination with a
      series of other antitumor agents. Using a panel of human tumor cell lines
      including A121 ovarian cancer, HCT-8 colon cancer, H-460 NSCLC, HT-1080
      fibrosarcoma, and MCF7 mammary cancer, we found that a 2-hr exposure to 9-NC
      resulted in ID50 values of < 1.0 microM, whereas continuous exposure to drug
      resulted in ID50 values of < 1.0 nM. Tumor growth inhibitory activities of 5-FU,
      gemcitabine, and paclitaxel were determined for comparison. Combinations of these
      agents were evaluated with 9-NC using the human HCT-8 colon tumor cell line.
      Concurrent and sequential combinations of 9-NC with 5-FU had some regions of the
      concentration-effect surface with local synergy and some with local antagonism.
      However, sequential combination of 9NC or SN-38 followed by 5-FU, 24 hr later
      appeared to be highly synergistic at high dose-effect levels (i.e., ID90),
      suggesting that sequential drug administration may be more efficacious at high
      effect level and that the order of drug addition is very important. Overall, our
      results were similar to that found earlier by Rustum's group with CPT11 (or SN
      38) and 5-FU, suggesting that sequential combination of 9-NC (or other
      camptothecin analogues) followed by 5-FU has potential for the treatment of
      cancer in man.

PMID- 11193905
TI  - p53 and p21 are major cellular determinants for DNA topoisomerase I-mediated
      radiation sensitization in mammalian cells.

PMID- 11193906
TI  - The homocamptothecin, BN 80927, is a potent topoisomerase I poison and
      topoisomerase II catalytic inhibitor.

PMID- 11193907
TI  - The dual topoisomerase inhibitor, BN 80927, is highly potent against cell
      proliferation and tumor growth.

PMID- 11193908
TI  - Ubiquitin, SUMO-1, and UCRP in camptothecin sensitivity and resistance.

PMID- 11193909
TI  - A spectrophotometric study of the pH-dependent and DNA binding properties of
      topotecan.

PMID- 11193910
TI  - Kinetics of in vitro hydrolysis of homocamptothecins as measured by fluorescence.

PMID- 11193911
TI  - The combinatorial synthesis of racemic homosilatecan libraries via a cascade
      radical annulation.

PMID- 11193912
TI  - Combined radiation and 9-nitrocamptothecin (rubitecan) in the treatment of
      locally advanced pancreatic cancer.

PMID- 11193913
TI  - Preclinical and phase I clinical studies with Ckd-602, a novel camptothecin
      derivative.

PMID- 11193914
TI  - Action of topoisomerase targeting drugs on non-Hodgkin's lymphoma and leukemia.
      Correlation of clinical and cell culture studies.

PMID- 11193915
TI  - Improvement of therapeutic index of low-dose topotecan delivered per os.

PMID- 11193916
TI  - Camptothecin dose, schedule, and timing of administration for clinical radiation
      sensitization.

PMID- 11193917
TI  - Rapid chromatin reorganization induced by topoisomerase I-mediated DNA damage.

PMID- 11193918
TI  - NF-kappa B activation in topoisomerase I inhibitor-induced apoptotic cell death
      in human non-small cell lung cancer.

PMID- 11193919
TI  - Phase I study of 9-nitro-20(S)-camptothecin in combination with cisplatin for
      patients with advanced malignancies.

PMID- 11193920
TI  - Phase II study of intravenous DX-8951f in patients with advanced ovarian, tubal,
      or peritoneal cancer refractory to platinum, taxane, and topotecan.

PMID- 11193921
TI  - Feasibility, phase I, and pharmacological study of aerosolized liposomal 9-nitro
      20(S)-camptothecin in patients with advanced malignancies in the lungs.

PMID- 11193922
TI  - Inhibition of DNA replication in camptothecin-treated cells is regulated by
      protein kinases.

PMID- 11193923
TI  - Camptothecin design and delivery approaches for elevating anti-topoisomerase I
      activities in vivo.
AB  - The camptothecins as a class have exhibited unique dynamics and reactivity in
      vivo, with respect to both drug hydrolysis and blood protein interactions. These
      factors have confounded their pharmaceutical development and clinical
      implementation. Recent bench and clinical research alike indicates that the
      combination of medicinal chemical and drug delivery approaches has been and will
      continue to be highly valuable in improving the overall therapeutic indices of
      camptothecin-based anti-topoisomerase I therapies. In the future the development
      of camptothecin analogues that exhibit highly specific human albumin interactions
      will likely be avoided, and agents such as the highly lipophilic DB-67 analogue
      with improved tissue stability will be evaluated. Drug delivery scientists will
      also devise better ways of targeting camptothecin therapies to solid tumors by
      using carriers such as tumor-targeted long-circulating liposomes.

PMID- 11193924
TI  - Mechanisms of resistance to camptothecins.
AB  - Camptothecins are broad-spectrum anticancer drugs that specifically target DNA
      topoisomerase I. Although the availability of camptothecins has had a significant
      impact on cancer therapeutics, de novo or acquired clinical resistance to
      camptothecins is common. Studies of camptothecin resistance using yeast and
      mammalian cell culture models suggest three general mechanisms of resistance: (1)
      reduced cellular accumulation of camptothecins, (2) alteration in the structure
      or location of topoisomerase I, and (3) alterations in the cellular response to
      camptothecin-DNA-ternary complex formation. The relevance of these mechanisms to
      clinical drug resistance is not yet known, but evaluation of these models in
      clinical specimens should enhance the use of camptothecins both as single agents
      and in combination with other anticancer drugs.

PMID- 11193925
TI  - Structure-based analysis of the effects of camptothecin on the activities of
      human topoisomerase I.
AB  - The sole target for the anticancer drug camptothecin (CPT) is the type I
      topoisomerase. The drug poisons the topoisomerase by slowing the religation step
      of the reaction, thereby trapping the enzyme in a covalent complex on the DNA. In
      addition, CPT has been shown to inhibit plasmid DNA relaxation in vitro. The
      structural bases for these two activities of CPT are explored in relation to the
      recently published crystal structure of the enzyme with bound DNA.

PMID- 11193926
TI  - Mechanisms of DNA topoisomerase I-induced cell killing in the yeast Saccharomyces
      cerevisiae.
AB  - DNA topoisomerase I (Top1) catalyzes the relaxation of supercoiled DNA by a
      mechanism of transient DNA strand cleavage characterized by the formation of a
      phosphotyrosyl bond between the DNA end and active site tyrosine. Camptothecin
      reversibly stabilizes the covalent enzyme-DNA intermediate by inhibiting DNA
      religation. During S-phase, collisions with advancing replication forks convert
      these complexes into potentially lethal lesions. To define the DNA damage induced
      by alterations in Top1p catalysis and the cellular processes that mediate the
      repair of such lesions, the yeast Saccharomyces cerevisiae was used. Substitution
      of conserved residues N-terminal to the active site tyrosine (Tyr-727) produced
      alterations in the camptothecin sensitivity or catalytic cycle of DNA Top1. For
      example, substituting Ala for Thr-722 in Top1T722A increased the stability of the
      covalent enzyme DNA intermediate. As with camptothecin, Top1T722A-induced
      cytotoxicity was ascribed to a reduction in DNA religation. By contrast, enhanced
      covalent complex formation by Top1N726H resulted from a relative increase in the
      rate of DNA cleavage. Conditional yeast mutants were also selected that exhibit
      temperature-sensitive growth only in the presence of the self-poisoning Top1T722A
      enzyme. Subsequent analyses of these tah mutants identified 9 genes whose
      function suppresses the cytotoxic action of camptothecin and Top1T722A. These
      include genes encoding essential DNA replication proteins (CDC45 and DPB11) and
      proteins involved in SUMO- or ubiquitination (UBC9 and DOA4).

PMID- 11193927
TI  - Camptothecins as probes of the microenvironments of topoisomerase I--DNA
      complexes.
AB  - By uncoupling the cleavage and ligation reactions of DNA oligonucleotides
      mediated by topoisomerase I, it has been possible to demonstrate modification of
      DNA oligonucleotide structure by the enzyme. These modifications indicate an
      unusual flexibility inherent in the behavior of topoisomerase I and may reflect
      some of the cellular roles played by the enzyme. The ability of individual
      camptothecin analogues to inhibit these modification processes differentially
      provides insight into the relative nature of the microenvironments present. To
      the extent that these enzyme-mediated structural modifications do constitute
      models of cellular roles for the enzyme, the observed differential inhibition
      also provides a potential strategy for assessing the function and importance of
      such modifications.

PMID- 11193928
TI  - Preclinical and clinical trials of topoisomerase inhibitors.
AB  - CPT-11, developed by Yakult Honsha, has achieved the position of standard
      chemotherapy for colorectal cancer in the United States and in Western countries
      because CPT-11 + 5FU + LV showed survival benefit compared with 5FU-LV in two
      randomized controlled trials. CPT-11 has been distributed to almost all
      countries. In Japan, combination therapy of CDDP + CPT-11 was significantly
      superior to CDDP-VP-16 in the treatment of extensive disease small cell lung
      cancer. This combination is also active against non-small cell lung cancer.
      Daiich Pharmaceutical Co. developed a more active nonmasked form of camptothecin
      derivative, DX-8915f. The phase I study of a new camptothecin inhibitor, DX
      8915f, has just been completed. The new topoisomerase I inhibitors of
      indolocarbazol derivatives, NB-506 and J107088, developed by Banyu Co., have
      strong antitumor activity and a wide therapeutic ratio. The phase I trial of
      J107088 is currently ongoing in the United States and Japan. These do not show
      any cross-resistance to MDR drugs.

PMID- 11193929
TI  - The Camptothecins: Unfolding Their Anticancer Potential. Proceedings of a
      conference. March 17-20, 2000, Arlington, Virginia, USA.

PMID- 11193930
TI  - [Establishment and characterization of rat myelomonocytic leukemia clones
      undergoing differentiation or apoptosis].
AB  - It has not clearly been elucidated how differently differentiation-inducing drugs
      act on tumor cells, whether they promote differentiation or apoptosis. To
      elucidate the mechanisms whether leukemic cells responding to ONO-4007, a lipid A
      derivative, undergo differentiation or apoptosis, we established two cell clones
      from a rat myelomonocytic leukemia c-WRT-7/P2 clone which undergoes
      differentiation followed by apoptosis by ONO-4007-treatment. One of the clones
      (1D6) showed the features of differentiation, such as phagocytosis when treated
      with ONO-4007 more than 24 hrs. The other clone (3B1) clearly showed the features
      of apoptosis, such as DNA ladder formation within 24 hrs after incubation with
      ONO-4007. We then examined expression of CD14, p21, p38MAPK, JNK/SAPK, and bcl-2,
      functional p53 statuses and cell cycle in these two clones, and revealed the
      following: Without treatment with ONO-4007; 1) CD14, p21, and bcl-2 proteins were
      equally expressed in both clones; 2) wild-type and non-functional mutated-type
      p53 were present in both clones and the p53 in 3B1 clone was recessive whereas
      that in 1D6 clone was dominant negative; 3) p38MAPK in 3B1 clone was already
      phospholyrated whereas that in 1D6 clone was not. After treatment with ONO-4007;
      1) neither expressions of CD14 nor that of p21 protein was changed in any of the
      clones; 2) p38MAPK in 3B1 clone was dephospholyrated at 1 and 2 hrs after
      treatment whereas that in 1D6 clone was phospholyrated at 4 and 8 hrs after
      treatment; 3) the expression of bcl-2 protein in 3B1 clone was reduced. These
      findings suggest that p53 may be one of the key factors in leading these cells to
      differentiation or apoptosis, and that bcl-2 may suppress the apoptosis.

PMID- 11193931
TI  - [Development of a detection system (APC yeast color assay) of APC mutations by
      color change of yeast].
AB  - The author developed a sensitive yeast-based color assay which expresses APC-ADE2
      (reporter) fusion protein in yeast and can screen almost the entire coding region
      of the APC gene. In this assay, the wild-type APC coding sequence of 8.5 kb is
      divided into 5 overlapping regions which are respectively ligated in-frame with
      an ADE2 open reading frame. The resulting five constructs containing a part of
      wild-type APC gene preserve the ADE2(+) phenotype (white yeast colony) when
      introduced into the yeast, whereas the yeast transfected with plasmids containing
      frameshift mutations of the APC gene shows an ADE2(-) phenotype (red yeast
      colony). Six human colon cancer cell lines were analyzed by this yeast color
      assay. HCT116 cells with wild-type APC and normal colonic mucosa gave low
      percentages of red colonies (0-9.9%) in all the regions. On the other hand, more
      than 96% red colonies were observed in one of the five regions in SW480, Colo201
      and Colo320DM cells. Sequence analysis demonstrated the clonal APC mutations at
      codon 1,338 in SW480, 1,554 in Colo201 and 811 in Colo320DM. Moreover, the assay
      detected a germline mutation of the APC gene in polyps of a familial adenomatous
      polyposis (FAP) patient which gave about 50% red colonies. For testing the assay
      for clinical utilization, 18 colon cancer tissues were subjected to the assay.
      Eleven cancers (61%) gave more than 10% red colonies (17-57%) and clonal
      mutations were detected in all these samples. The same mutations were
      demonstrated in both DNA and RNA samples derived from idendical tissues. These
      results suggest that this APC yeast color assay is powerful means for detection
      of APC mutations in clinical samples.

PMID- 11193932
TI  - [Roles of neuropeptide Y in the expression of anticipatory corticosterone peak in
      rats under restricted daily feeding].
AB  - NPYmRNA in the arcuate nucleus (ARC) and the nucleus of the solitary tract (NST)
      was measured by quantitative RT-PCR and in situ hybridization in rats under 48
      hour food deprivation (FD) or under restricted daily feeding (RF) in which free
      access to food was restricted to 2 hours per day for 3 weeks. Plasma
      corticosterone levels were elevated immediately prior to daily food supply under
      RF, while they remained essentially unchanged by 48-hour FD. On the other hand,
      the NPYmRNA levels in the ARC were increased by 48-hour FD and RF, while those in
      the NST were elevated by RF but not by 48-hour FD. These findings indicate that
      the NPY neurons in the NST are specifically involved in the prefeeding
      corticosterone peak in the rats the under RF, while the NPY neurons in the ARC
      are involved in the feeding activity in general and stimulated by decreased food
      availability.

PMID- 11193933
TI  - [Development of a new method for sequential monitoring of transcriptional
      activities of growth hormone genes by a secreted bioluminescence reporter].
AB  - The genetic reporter system has been introduced as a tool for sensitive and
      convenient monitoring of gene expression. In the present study, the promoter
      activity of growth hormone (GH)-coding gene was sequentially monitored in GH3
      cells (rat pituitary adenoma cell-line) by means of bioluminescence which was
      evoked by a secreted reporter, Vargula hilgendorfii (VH) luciferase. Three kinds
      of expression plasmids were constructed, which consisted of a rat GH promoter
      fragment and VH luciferase cDNA, and transfected into GH3 cells. The sensitivity
      of the reporter was revealed to be extremely high from the dose-response curve of
      VH luciferase. With the use of the stable transformant, the reporter activity as
      well as that of GH was sequentially measured in plate culture. The intracellular
      dynamics of reporter signals was analyzed through the response to inhibitors of
      transcription, protein synthesis and vesicle transport, which suggested that the
      overall time from transcription to secretion was essentially identical to those
      of the VH luciferase and GH although the both proteins took different time course
      at different intracellular stages. When the GH promoter was activated by
      triiodothyronine (T3), the reporter activity was enhanced, and well correlating
      with the amount of GH mRNA, which indicated a reliability of the reporter system.
      Furthermore, in the present reporter system, a synergistic effect of T3 and
      dexamethasone was observed not only on the GH transcription but also on the
      stability of mRNA. It is concluded that the bioluminescence reporter system using
      the VH luciferase is an excellent tool for sequential monitoring of the GH
      transcriptional activity.

PMID- 11193934
TI  - [Anxiolytic effects of serotonin reuptake inhibitors and their mechanism of
      action].
AB  - The purpose of this study was to examine the anxiolytic effects of serotonin (5
      HT) reuptake inhibitors and to clarify their action mechanisms and roles in the
      brain serotonergic system in the psychopathology of anxiety. It has been proposed
      that conditioned fear stress (CFS)-induced freezing behavior in rats could be
      used as a model of anxiety. In the experiment using this model, acute treatment
      with the 5-HT reuptake inhibitors reduced CFS-induced freezing behavior, while
      acute treatment with the noradrenaline or dopamine reuptake inhibitors failed to
      alter CFS-induced freezing. CFS elevated extracellular 5-HT levels in the medial
      prefrontal cortex, and this elevations of 5-HT level was followed by a resolution
      of the freezing. A dose of 10 mg/kg of a selective 5-HT reuptake inhibitor
      (SSRI), citalopram, administered 60 min before exposure to CFS increased
      extracellular 5-HT concentrations immediately and potently, and reduced freezing.
      The 5-HT1A receptor antagonists, particularly at low doses, enhanced the
      antifreezing effect of citalopram. While the antifreezing effect of citalopram
      (10 mg/kg) disappeared by prolongation of the period between conditioning and
      exposure to CFS, acute challenge of citalopram (10 mg/kg) reduced freezing in the
      rats into which citalopram (10 mg/kg) had been injected twice daily for 7 days.
      From these findings, it is indicated that 1) 5-HT reuptake inhibitors decrease
      anxiety, 2) 5-HT release is increased at the nerve terminal under anxiety
      conditions, 3) the elevation of 5-HT levels in the terminal has an anxiolytic
      action which is closely related to the pharmacological effects of SSRI-class of
      anxiolytics, and 4) 5-HT1A receptor antagonist enhances the antifreezing effect
      of SSRI by blocking the autoreceptor-mediated negative feedback mechanisms of 5
      HT neurons. By prolonging the period between conditioning and exposure to CFS,
      the author recognized the feasibility to establish an animal model which reflects
      the psychopathology of anxiety disorder more precisely. Presynaptic 5-HT1A
      receptor desensitization may account for the mechanism of action of repeated
      treatment with SSRI.

PMID- 11193935
TI  - The main factor causing prolonged reaction time on force producing process
      following anterior cruciate ligament reconstruction.
AB  - This study investigated the electromechanical properties of atrophied human
      quadriceps femoris muscle during a voluntarily elicited maximal isometric
      contraction (MVC) and a peripherally stimulated twitch contraction. Nineteen
      patients were recruited 2-3 months following a unilateral anterior cruciate
      ligament (ACL) reconstruction. Both the involved leg as well as the uninvolved
      leg were studied. Maximal twitch response was elicited and surface
      electromyograms (EMG) were recorded from the vastus lateralis. Total reaction
      time (TRT) for both MVC and twitch on involved leg was prolonged (251.47 msec,
      26.01 msec). This prolongation suggests an extended lag in avoiding injury such
      as during sports. Pre-motor time during both MVC and twitch (PMTmvc, PMTtwitch)
      did not differ between both groups. Electromechanical delay during MVC (EMDmvc)
      was prolonged on involved leg (53.42 msec), and also evoked twitch EMD
      (EMDtwitch) (20.04 msec) as compared to the opposite side. Prolonged EMDtwitch
      may be due to a decrease in stiffness of the series elastic component, changes of
      peripheral muscle composition to containing more slow type muscle fibers, or a
      decrease in function of the excitation-contraction (E-C) coupling process. A
      prolonged EMDtwitch can also explain the prolonged EMDmvc. These findings also
      suggested that prolonged TRTmvc to visual stimulus during MVC in atrophied human
      quadriceps femoris muscle after disuse was principally due to prolongation of
      EMDmvc. Prolonged EMDmvc may have resulted from decreased muscle stiffness, which
      was evident in the prolongation of the EMDtwitch.

PMID- 11193936
TI  - Bilateral simultaneous oblique MR imaging of the proximal femur.
AB  - Oblique axial and oblique coronal MR images parallel to the femoral neck provide
      more valuable information concerning the proximal femur than orthogonal images.
      The main disadvantage of the unilateral oblique imaging is that the imaging time
      is significantly increased when both hips need to be imaged. If the bilateral
      oblique imaging is performed simultaneously, this increase in imaging time is
      eliminated because the scanning time for the bilateral oblique imaging and the
      orthogonal imaging is the same.

PMID- 11193937
TI  - Is communication to endocardium necessary for angiogenesis in transmyocardial
      laser revascularization?
AB  - There is evidence of angiogenesis being induced after transmyocardial laser
      revascularization (TMLR), although the precise mechanism has not been fully
      elucidated. This study was designed to examine whether or not blood flow from the
      left ventricle through the channels is essential for angiogenesis following TMLR.
      Ten dogs underwent the creation of two types of laser channels in the left
      ventricle: 1) a transmural channel (TMC), which penetrates the myocardium, and 2)
      a non-transmural channel (NTMC), which does not open to the epicardium. The
      animals were sacrificed on the 28th postoperative day and the vascular density
      was examined. Vessels with smooth muscle media were seen within or around the
      channel remnant. The vessel density was compared between TMC and NTMC. The outer
      and inner halves of the myocardium in the TMC region were compared in the same
      way. The density of vessels within and around the channel remnants was
      significantly higher in TMC than in NTMC (1.439 versus 0.685 vessels/microscopic
      visual field (mvf=40X); p=0.0025). The vascular density was significantly higher
      in the region adjacent to TMC than in a distant region (>3 mm from the channel
      center). The vascular density was significantly higher in the outer half than in
      the inner half of the myocardium (1.730 versus 1.180 vessels/mvf: p=0.0459).
      These findings demonstrate that communication to the left ventricular lumen
      enhances angiogenesis of TMLR, although blood flow in the channel did not exist 4
      weeks after TMLR and angiogenesis tended to be more highly enhanced in the outer
      half than in the inner half of the myocardium.

PMID- 11193938
TI  - Clinicocytopathological and immunohistochemical study of adenoma malignum of the
      uterine cervix.
AB  - Adenoma malignum is a rare type of very highly differentiated adenocarcinoma of
      the uterine cervix, and is quite difficult to diagnose because there are few
      findings definitely suggesting malignancy on cytologic or histologic examination.
      We recently encountered four patients with adenoma malignum and reviewed their
      clinicocytopathological and immunohistochemical findings. The most characteristic
      symptom was a watery discharge and an enlarged cervix was palpable, while
      multiple cystic lesions (MCL) were observed by transvaginal and abdominal
      ultrasonography, CT or MRI. On cytodiagnosis, the cervical gland cells formed
      large sheets or showed a palisading arrangement. Slightly enlarged nuclei and
      yellowish-orange staining of the cytoplasmic mucus were the characteristic
      findings. On histological examination, many cervical glands of different sizes
      were present and extended deep into the muscle layer, while branching or
      papillary growth into the lumen was also observed. On immunohistochemical study,
      HIK1083, a monoclonal antibody for gastric gland mucous cell mucin, was found to
      be positive in 3 of 4 cases, and this was fairly useful in the diagnosis of
      adenoma malignum.

PMID- 11193939
TI  - Laparoscopic cholecystectomy in a patient on continuous ambulatory peritoneal
      dialysis.
AB  - The patient was a 72-year-old man who was receiving continuous ambulatory
      peritoneal dialysis (CAPD) with a diagnosis of chronic renal failure. Although
      his response to dialysis therapy was favorable, right hypochondralgia and fever
      occurred, and gallstones were detected by abdominal ultrasonography and computed
      tomography. Drip-infusion cholangiography (DIC) revealed neither dilation nor
      calculus in the common bile duct. The patient was diagnosed as having acute
      cholecystitis and cholecystolithiasis and, in consideration of his general
      condition, laparoscopic cholecystectomy was carried out. Pneumoperitoneum was
      performed through a CAPD tube, and a 10 mm-trocar was carefully introduced
      through a supraumbilical incision so as not to injure the CAPD tube. Since
      intraoperative cholangiography showed a condition similar to preoperative DIC,
      only cholecystectomy was undertaken. The postoperative course was uneventful,
      with neither postoperative hemorrhage nor leakage of dialysate from the wound.

PMID- 11193940
TI  - [Macular disease].

PMID- 11193941
TI  - [Optic neuritis--from diagnosis to optic nerve transplantation].
AB  - Optic neuritis is a clinical syndrome resulting from inflammation, demyelination,
      or infection of the optic nerve. Its diagnosis and treatment are complicated. In
      1884, Nettleship first reported 28 cases of optic neuritis whose clinical
      symptoms have been accepted up to the present without any change. On the other
      hand, the development of diagnostic procedures and steroid therapy have also
      altered the clinical features of optic neuritis. Among several developed
      diagnostic procedures, the visually evoked cortical potential (VECP) has become a
      good tool to prove the impairment of the optic nerve. In 1971, we reported a
      decrease of threshold intensity required to evoke VECPs in optic neuritis
      patients whose visual acuity was relatively well preserved. In the same year,
      Halliday et al. reported that pattern VECP (PVECP) was delayed in 93% of patients
      with multiple sclerosis (MS) without optic neuritis. Stimulated by this report, a
      great number of studies appeared to show the usefulness of PVECP in the diagnosis
      of MS. However, few of these studies gave descriptions of ophthalmic findings.
      PVECP later become known to be closely related with ophthalmic conditions. In the
      ophthalmological field, we reported the influence of pupillary size,
      accommodation power, refractive powers, eccentricity of stimulated retinal area,
      retinal luminance, contrast, wavelengths, spatial and temporal frequencies,
      stimulus field etc. On the basis of our results, we developed a television
      display system in 1975 and applied it clinically. In the present study, we
      reviewed the medical records of a total of 272 cases of optic neuritis who
      presented in our clinic between 1978 and 1999. In the diagnostic, therapeutic
      point of view in relation with the data of other countries, the study was
      important regarding the racial differences and recent conceptions of optic
      neuritis. The results showed that there were no racial difference in optic
      neuritis as had been thought. The development from optic neuritis to multiple
      sclerosis was not less than in Caucasian patients. Regarding steroid therapy, we
      found that the most effective method was sub-Tenon injection. For cases which
      recur and progress to optic atrophy, optic nerve transplantation will be needed.
      Therefore, we have been studying the reconstruction of the optic nerve in Wister
      rats. We experimentally damaged the ganglion cells by causing ischemic retina
      with ligation of the ophthalmic artery and cutting the optic nerve just behind
      the eyeball. To prevent the apoptosis of ganglion cells, we injected various
      neurotrophic factors such as BDNF, GDNF, and HSP 27 into the vitreous. For
      effective injection of DNA, electropolation was applied and the best condition
      for avoiding apoptosis was chosen. Further, in Mx-c-fos transgenic mice, we found
      that regeneration of ganglion cells was inhibited. Based on the rescue study of
      the ganglion cells, optic nerve transplantation was performed using an artificial
      graft in which cultured Schwann cells from the ischiatic nerve, BDNF, CNTF,
      insulin, and forscolin were compound and bridged to the superior colliculus. The
      results showed a regeneration rate of the optic nerve axon of 15%. This rate was
      much higher than in other reports. Keratoplasty and intraocular lens implantation
      had a relatively long history of research before achieving clinical success. We
      believe that optic nerve transplantation will one day be successful in clinical
      treatment in the same way.

PMID- 11193942
TI  - [Gene expression and the eye].
AB  - We examined the role of the expression of the various genes in ocular tissues
      using knockout mice. In this paper, the results are described in three sections:
      development, physiology, and pathology. Regarding development, the IKK alpha in
      the development of the ocular surface and maf family genes in the development of
      the lens were examined. We clearly demonstrated that the deletion of some genes
      results in disorganization in the development according to the function of the
      genes. Regarding physiology, c-fos gene was expressed in the subpopulation of
      retinal neurons under a physiological light/dark cycle, and its expression is
      dependent on signal transduction system in the retinal cells. Regarding
      pathology, focal retinal injury of the retina induced the expression of c-fos
      mRNA in retinal Muller cells. There is a significant contribution of Jun N
      terminal phosphorylation to the induction of apoptosis of retinal ganglion cells
      after optic nerve transection. GLAST is required for normal signal transmission
      between photoreceptors and bipolar cells and both GLAST and GLT-1 play a
      neuroprotective role during ischemia in the retina. Blockage of the neurotrophin
      receptor p 75 rescue photoreceptor apoptosis induced by light exposure whereas
      the blockage of TrkC increased the photoreceptor cell death.

PMID- 11193943
TI  - [Treatment of exudative age-related macular degeneration].
AB  - I PROPHYLACTIC TREATMENT: We followed 75 eyes contralateral to eyes with
      exudative age-related macular degeneration (AMD), using indocyanine green
      angiography (IA), for more than one year. Hyperfluorescent areas in the late
      phase of IA were seen in 19 eyes at the initial examination, and in 25 eyes
      during follow-up. Exudative AMD developed in 9 of the 25 eyes. Using timetable
      analysis, we estimated that 11% of these 27 eyes developed AMD within one year
      and 55% within three years. The hyperfluorescent areas seen on IA appeared to be
      latent choroidal neovascularization (CNV) under the retinal pigment epithelium.
      We propose that photocoagulation aimed at hyperfluorescent areas should be
      considered in such cases. We performed prophylactic laser photocoagulation in 21
      eyes, which were then followed up for at least six months. These eyes all had 10
      or more serous drusen within 1,500 microns of the fovea and did not show
      hyperfluorescence, suggesting latent CNV in the late phase of IA. The majority or
      a small fraction of the serous drusen disappeared in 48% and 18% of the 21 eyes,
      respectively. CNV appeared adjacent to the laser scar in one eye (5%). Judging
      from these results, it is important to establish a method of definitively
      abolishing drusen and preventing the development of CNV. II TREATMENT OF CNV: Of
      229 eyes which showed occult CNV in fluorescein angiography (FA), 124 eyes (54%)
      showed classic CNV outside the fovea on IA. One hundred and two of the 124 eyes
      (45%) underwent laser photocoagulation. We evaluated indocyanine green guided
      laser photocoagulation of extrafoveal CNV in 139 eyes. The success rate was 81%
      at 3 months after laser photocoagulation. This was estimated using timetable
      analyses to have decreased to 78% at one year and 71% at three years. Eighty
      percent of successfully treated eyes showed maintained or improved visual acuity.
      These results did not differ significantly from those obtained with laser
      photocoagulation based on FA findings. When classic CNV is not detected on FA, IA
      is indicated and if classic CNV is detected outside the fovea, photocoagulation
      should be performed aggressively. We compared the histological findings of
      removed subfoveal CNV with the IA findings prior to removal. IA findings of CNV
      before removal were divided into four types. Types I and II showed numerous
      vascular lumina in von Willebrand factor staining. Prominent proliferation in
      types I and II was demonstrated with Ki-67. Vascular endothelial growth factor
      (VEGF) showed strong staining in types I, II and III. Therefore, CNV in eyes with
      types I, II and III, and especially type I, requires urgent treatment. We
      compared visual outcomes one year after treatment between 52 eyes that underwent
      removal and 56 eyes that underwent laser photocoagulation of subfoveal CNV. When
      CNV size was one disc diameter or less, mean visual acuity, the percentage of
      eyes with improved vision and with a visual acuity of 0.1 or more, was
      significantly greater in operated eyes than in coagulated eyes. Removal is
      therefore superior to photocoagulation in subfoveal CNV of one disc diameter or
      less in size. We evaluated preoperative factors influencing the best corrected
      visual acuity at least six months after removal of subfoveal CNV in 67 eyes.
      Factors influencing the best corrected visual acuity were IA findings, feeder
      vessel ingrowth sites and CNV sizes. Good indications for removal included types
      I, II and III IA findings, extra foveal location feeder vessel ingrowth sites,
      and small CNV. III LOW VISION CARE: We performed reading tests using the MN read
      J chart for 90 eyes with the scar stage of CNV. Reading speed profiles of the 90
      eyes were classified into two groups: 48 eyes showing a plateau with a relatively
      constant reading rate at the maximum level; and 42 eyes showing steadily
      increasing reading rate without a plateau. Eyes without a plateau had worse
      visual acuity, worse reading acuity, and slower reading speed. We evaluated
      newspaper reading performance by comparing conventional versus new methods based
      on the critical print size of the MN read J chart. Magnification power based on
      the critical print size were similar to those finally chosen as the best aid by
      the patients. On the other hand, magnification power was lower when conventional
      methods were used. The critical print size of the MN Read J chart appears to be
      valuable for determining low vision aids which facilitate reading by AMD
      patients.

PMID- 11193944
TI  - [New examination methods for macular disorders--application of diagnosis and
      treatment].
AB  - To establish a diagnosis or evaluate the efficacy of treatment for macular
      disorders, we need methods to evaluate the anatomical and functional changes of
      these disorders. In this article, we describe several studies that we have
      conducted for 2 years. In section 1, we report our new methods for making a
      diagnosis and evaluating visual function in macular disorders. In section 2, we
      describe our trials of these examination methods in treatment. Here is the
      summary of our results. In section 1, to examine the structures of the macular
      area, we used a retinal thickness analyzer (RTA), a confocal scanning laser
      ophthalmoscope (Heidelberg Retina Tomograph, HRT), and optical coherence
      tomography (OCT) to measure retinal thickness and assess retinal microstructures.
      We compared retinal imaging analysis of various macular diseases obtained with
      these three instruments. With the RTA, we obtained good three-dimensional macular
      images displayed on a retinal thickness map, but the retinal thickness map did
      not demonstrate the thickened retina with dense retinal hemorrhages, and high
      backscattering from hard exudates might obscure the vitreoretinal interface. The
      HRT three-dimensional topographic image clearly showed the undulation of the
      retinal surface. However, it took a relatively long time to obtain the HRT image,
      and we sometimes could not obtain good topographic images because of fixation
      movement. Examination with the OCT allows confirmation of the retinal cross
      sectional structures, such as retinoschisis or cystoid spaces and the
      vitreomacular interface, such as vitreous traction, that cannot be detected using
      other conventional methods with high resolution, but high reflectivity from dense
      hemorrhages obscured the deeper layers of the retinal structures. Measurement of
      retinal thickness obtained with both the RTA and OCT is highly reproducible, and
      there was significant correlation between the retinal thicknesses measured with
      the two instruments. We believe that these three instruments might contribute
      significantly to early, accurate diagnosis and better monitoring of the
      therapeutic effects of vitrectomy for macular diseases. In the future, if these
      fundus imaging analysis instruments can achieve higher resolution and can analyze
      three-dimensional retinal images, they will provide better information to
      clinically evaluate macular diseases. We demonstrated vitreous examination and
      examination from the retinal surface to the deeper retinal layer at the macular
      area using a scanning laser ophthalmoscope (SLO). The SLO examination with an
      argon laser and a large confocal aperture was useful for conducting kinetic
      examination of the vitreous opacity above the macula. With a diode laser and a
      ring aperture (dark-field mode), it was possible to examine the retina from the
      deeper retinal layer to the choroids. On the other hand, the SLO also allows us
      to conduct a functional examination of fixation. We demonstrated that the
      referred retinal locus of fixation may change during the follow-up period in
      patients whose central fixation is impaired due to macular disease, and we showed
      that the fixation behavior was related to the visual acuity. Therefore, the SLO
      is an ideal instrument for determining the visual field and the visual acuity
      before and after treatment in patients with macular disease, because of its
      precise localization of the examination point by directly observing the fundus
      and by monitoring fixation behavior. Our new program installed in the SLO allows
      us to complete the quantitative retinal sensitivity evaluation within 2 minutes,
      which is difficult to do using a conventional SLO program. Furthermore, we
      demonstrated for the first time that minute functional changes in the retina can
      be detected by the SLO under low background illuminance. Such changes cannot be
      detected under conventional conditions. In addition, the extrafoveal visual
      acuity of normal subjects and patients with macular disease was studied using
      this new SLO program. The iso-acuity lines could be illustrated by summarizing
      these results in normal subjects. The SLO acuity of the horizontal meridian is
      significantly better than that of the vertical meridian, and even in the nasal
      area adjacent to the optic disc, an acuity of better than 0.1 could be achieved.
      To evaluate macular function, we also investigated the blood flow of the choroid
      (CF), the retina (RF), and the choriocapillaris at the fovea (CCF). We
      investigated the CF in patients with age-related macular degeneration (AMD) using
      pulsatile ocular blood flow (POBF) measurements. In patients with exudative AMD,
      the POBF was significantly lower than in patients with nonexudative AMD or in
      control subjects. Decreased CF may play a role in the development of choroidal
      neovascularization in AMD. RF was measured using laser Doppler velocimetry (LDV).
      (ABSTRACT TRUNCATED)

PMID- 11193945
TI  - [Macular diseases--application of automated static perimetry and optical
      coherence tomography].
AB  - The usefulness of automated static perimetry and optical coherence tomography in
      the management of macular diseases has been described. Scotomata in eyes with
      central serous chorioretinopathy could be evaluated with central 10-degree
      automated static perimetry. The degree of visual field defects in eyes with the
      disease varied greatly with mean deviation of -10 dB or less in as many as 10% of
      the subjects. Although retinitis pigmentosa is a diffuse retinal dystrophy, eyes
      with a moderately advanced stage of retinitis pigmentosa should be managed as a
      macular disease, because the functioning retina is confined within the vascular
      arcade. The progressive nature in this stage of the disease could be demonstrated
      with a central 10-degree automated static perimetry measured once or twice a year
      and the use of univariate linear regression of mean deviation, in half of the
      patients with a mean follow-up period of 5 years. Functional recovery in eyes
      with exudative age-related macular degeneration after laser surgery or submacular
      surgery could be evaluated with central 10-degree automated static perimetry.
      Eyes with increased mean deviation in spite of reduced visual acuity after
      therapeutic intervention should also be evaluated. Macular function could also be
      evaluated using a color test. A newly developed color saturation discrimination
      test was applied to patients with age-related macular degeneration, retinitis
      pigmentosa, and cone dystrophy. The degree of dyschromatopsia was less in eyes
      with age-related macular degeneration than in those with retinitis pigmentosa or
      cone dystrophy with the same level of acuity loss. The highly protrusive nature
      of the orange-red nodule in eyes with idiopathic polypoidal choroidal
      vasculopathy was demonstrated with dimensional measurement with OCT. The degree
      of protrusion was greater than in eyes with serous pigment epithelial detachment,
      which suggests that the polypoidal lesion is covered with rigid tissues including
      Bruch's membrane. Parafoveal retinal sensitivity obtained with automated static
      perimetry was studied in correlation with retinal thickness measured using OCT in
      eyes with branch retinal vein occlusion showing macular edema without macular non
      perfusion or massive retinal hemorrhages. The increased retinal thickness due to
      macular edema is closely correlated with retinal sensitivity both at the fovea
      and in the parafoveal area. Eighty-nine phakic eyes of 46 patients with retinitis
      pigmentosa patients were studied to detect cystoid macular edema using OCT.
      Cystoid lesions were observed in the macula in 12 eyes in 6 (13%) of 46 patients.
      Some eyes with OCT-proven cystoid macular edema did not show dye pooling in the
      fluorescein angiogram. The width of the total area of cystoid lesions was
      positively correlated with best-corrected visual acuity but the thickness of the
      neurosensory retina at the center of the fovea was not. OCT findings of
      successfully repaired macular holes were categorized into 3 groups. Eyes with U
      type showed a normal foveal contour and a dark layer corresponding to the outer
      segment of photoreceptors. Eyes with V-type showed a notch in the surface of
      repaired neurosensory retina without a dark layer on the retinal pigment
      epithelium. Those with W-type showed a defect of the neurosensory retina, where
      the retinal pigment epithelium was exposed. The visual results were excellent in
      eyes with U-type, but poor in those with W-type.

PMID- 11193946
TI  - [Molecular cell biology on morphogenesis of the fovea and evolution of the
      central vision].
AB  - Since Charles Darwin wrote "On the Origin of Species by Means of Natural
      Selection", it had been assumed that various eye types, from the compound eye to
      the camera eye, had originated independently in at least 40-60 different phyletic
      lines. However, the finding of Pax 6, the master control gene for eye
      morphogenesis, and the fact that its sequence is highly conserved throughout the
      animal kingdom indicated that the prototype eye in a primitive animal originated
      only once in evolution, and various eye types arose from the same origin. We
      recently found a Pax 6 mutation in a pedigree with foveal hypoplasia. Thus, the
      Pax 6 that appeared in light sensory cells of a primitive animal in ancient times
      may play a role in morphogenesis of the fovea, the most highly developed visual
      receptor. The fovea first appeared in evolution in the temporal retina of fishes.
      Then, in birds, the nasal fovea and bifoveal system with nasal and temporal
      foveas developed. The fovea disappeared in primitive mammals, and reappeared in
      primates. A residue of the fovea is conserved in the visual streak, and the
      disappearance and reappearance of the fovea, in primitive mammals and primates
      respectively, correlates with degeneration and restoration of cone pigment genes
      in photoreceptors. Humans inherited the temporal fovea that had first originated
      in fish eyes. Pax 6 is expressed in the entire eyeball at an early stage of
      development, and is also expressed widely in the retina to determine its
      differentiation. To determine the position of the fovea, retinal cells are
      abundant in the visual streak, probably because expression of Pax 6 is regulated
      by patterning of the dorsoventral axis of the eyeball. Signaling molecules,
      discharged from the front of the face, also regulate Pax 6 expression, and
      determine position of the fovea, visual axis, angle gamma, growth of the eyeball,
      and shape of the visual field. Further investigation of nerve pathfinding system
      from the fovea to the central nervous system will clarify the origin of the
      central vision, and contribute to human welfare.

PMID- 11193948
TI  - Partnership for Health and Accountability. Unique statewide partnership breaks
      ground on health care accountability.

PMID- 11193949
TI  - Answering the call for increased accountability.

PMID- 11193950
TI  - Challenges to HHS "conditions of participation" may be initiated in federal
      court. National Association of Psychiatric Health Systems v. Shalala.

PMID- 11193951
TI  - State enjoined from enforcing new drug price control law. Pharmaceutical Research
      and Manufacturer's Association of America v. Commissioner.

PMID- 11193952
TI  - Royston-based health care system honors the real "Georgia peach".

PMID- 11193953
TI  - A matter of public trust.

PMID- 11193954
TI  - Lexical, syntactic, and stress-pattern cues for speech segmentation.
AB  - Many sources of segmentation information are available in speech. Previous
      research has shown that one or another segmentation cue is used by listeners
      under certain circumstances. However, it has also been shown that none of the
      cues are absolutely reliable. Therefore, it is likely that people use a
      combination of segmentation cues when listening to normal speech. This study
      addresses the issue of how young adults use multiple segmentation cues (lexical,
      syntactic, and stress-pattern) in combination to break up continuous speech.
      Evidence that people use more than one cue at a time was found. Furthermore, the
      results suggest that people can use segmentation cues flexibly such that
      remaining cues are relied upon more heavily when other information is missing.

PMID- 11193955
TI  - Verb and noun morphology in the spoken and written language of children with
      language learning disabilities.
AB  - The purpose of this study was to investigate the use of verb and noun morphology
      in school-age children's spoken and written language. Sixty children, with and
      without language learning disabilities (LLD), each produced 2 spoken and 2
      written language samples. The children's accuracy in using morphemes that mark
      verb finiteness (regular past tense, 3rd person singular present tense, copula,
      and auxiliary BE) was compared with their accuracy in using noun morphology
      (regular plural, possessive, articles). As would be expected, the typically
      achieving children, who were aged 7 to 12 years, had mastered the verb and noun
      morphology in spoken and written samples. The children with LLD, aged 10 to 12
      years, also showed high accuracy in the spoken samples. On the other hand, they
      showed substantial difficulty in the written samples with the regular past tense,
      with errors in 26% of obligatory contexts. However, the children with LLD also
      had difficulty with the regular plural, with errors in 12% of obligatory
      contexts. For both the regular past tense and plural, all errors were errors of
      omission. These results indicate that finiteness marking remains an area of
      relative difficulty, but perhaps not the only grammatical difficulty, for
      children with language impairments in the school years.

PMID- 11193956
TI  - Factors affecting young children's use of pronouns as referring expressions.
AB  - Most studies of children's use of pronouns have focused either on the morphology
      of personal pronouns or on the anaphoric use of pronouns by older children. The
      current two studies investigated factors affecting children's choice of pronouns
      as referring expressions-in contrast with their use of full nouns and null
      references. In the first study it was found that 2.5- and 3.5-year-old children
      did not use pronouns differentially whether the adult (a) modeled a pronoun or a
      noun for the target object or (b) did or did not witness the target event
      (although there was evidence that they did notice and take account of the adult's
      witnessing in other ways). In the second study it was found that children of this
      same age (a) do not use pronouns to avoid unfamiliar or difficult nouns but (b)
      do use pronouns differently depending on the immediately preceding discourse of
      the experimenter (whether they were asked a specific question such as "What did X
      do?" or a general question such as "What happened?"). In the case of specific
      questions, children prefer to use a null reference but use some pronouns as well
      (almost never using full nouns); in the case of the generic questions, children
      use pronouns even more often (and use nouns more as well). This finding was
      corroborated by some new analyses of children's use of pronouns in specific
      discourse situations in previously published studies. These findings suggest that
      children's choice of pronouns as referring expressions in early language
      development is influenced more by the immediately preceding discourse than other
      kinds of factors.

PMID- 11193957
TI  - Spoken language production in Huntington's and Parkinson's diseases.
AB  - The purpose of this study was to investigate the presence and nature of spoken
      language deficits in Huntington's (HD) and Parkinson's (PD) diseases.
      Specifically, the study examined whether (a) the spoken language abilities of
      patients with HD or PD differ from those of age-matched control participants with
      no brain damage, (b) HD and PD are associated with similar spoken language
      profiles, and (c) the spoken language abilities of patients with HD or PD are
      related to the severity of their motor speech deficits, cognitive impairments, or
      both. All participants completed picture description tasks and a battery of
      cognitive and motor speech tests. Syntactic, quantitative, and informativeness
      measures of spoken language were analyzed. In terms of syntax, patients with HD
      produced shorter utterances, a smaller proportion of grammatical utterances, a
      larger proportion of simple sentences, and fewer embeddings per utterance than
      their non-brain-damaged peers. The HD group also produced utterances that were
      shorter and syntactically simpler than those of the PD group, despite similar
      performances on the cognitive and motor speech tests. The only syntactic
      difference between the PD group and their control group was that patients with PD
      produced a smaller proportion of grammatical sentences. Although the patient and
      control participants tended to produce similar amounts of verbal output, less of
      what the patients said was considered informative. Correlations between language
      measures and test battery results suggested that the spoken language abilities of
      patients with HD or PD are related to a variety of neuropsychological and motor
      speech changes. The implications of these findings for the clinical management of
      HD and PD are discussed.

PMID- 11193958
TI  - Use of temporal envelope cues by children with developmental dyslexia.
AB  - This study evaluates the ability to process auditory temporal-envelope cues in a
      group of 6 children with dyslexia (mean age: 10;10 years;months). To address this
      issue, we measured (a) temporal modulation transfer functions (TMTFs), that is,
      the detection thresholds of sinusoidal amplitude modulation (SAM) applied to a
      white noise carrier, as a function of modulation frequency, fm (fm was 4, 16, 64,
      256, and 1,024 Hz) and (b) identification performance for vowel-consonant-vowel
      (VCV) stimuli over 5 sessions. VCV stimuli were either unprocessed or digitally
      processed to remove the original spectral information, resulting in a time
      varying speech envelope amplitude modulating a noise carrier. The same tests were
      conducted in 6 normal control children (mean age: 11;6 years;months) and 6 normal
      control adults (mean age: 24;8 years;months). SAM thresholds were similar in
      normal children and adults. For both normal groups, TMTFs were low pass in shape
      and showed low between-listener variability. TMTFs measured in children with
      dyslexia showed higher between-listener variability: TMTFs were band pass in 2
      children, flat in 1 child, and low pass in the 3 others. Overall, SAM thresholds
      were higher in children with dyslexia than in normal children at fm = 4 and 1,024
      Hz. Unprocessed-speech identification performance was nearly perfect in normal
      children and adults, and impaired in children with dyslexia. "Speech-envelope
      noise" identification performance was poorer in normal children and children with
      dyslexia than in normal adults. Performance improved across sessions in normal
      children and adults, but remained constant in children with dyslexia. Compared to
      normal children, children with dyslexia showed poorer reception of voicing,
      manner, and place of articulation for unprocessed speech and poorer reception of
      voicing for "speech-envelope noise." Taken together, these results support the
      hypothesis that some children with dyslexia may show abnormal auditory temporal
      envelope processing. Such a deficit, in turn, may explain the difficulties of
      children with dyslexia with speech perception.

PMID- 11193959
TI  - Multi-channel compression and speech intelligibility in industrial noise.
AB  - This study examined how various forms of compression affect speech
      intelligibility in moderately high levels of industrial noise. Thirteen listeners
      with high-frequency sensorineural hearing loss were fit with a digital hearing
      aid programmed to operate in three modes of compression: compression limiting,
      compression of low frequencies only (BILL), and compression of high frequencies
      only (TILL). For each of these conditions, listeners attempted to recognize CID W
      22 monosyllabic words delivered in a background of recorded industrial noise.
      Word recognition was also measured in quiet for the compression-limiting
      condition. The highest word identification scores were obtained in quiet (80.9%).
      Of the three conditions in which background noise was present, the mean score was
      highest for TILL compression (52.4%), and lowest for BILL (39.7%). Representative
      time-weighted average (TWA) exposures for each of the aided noise conditions were
      determined by means of a procedure outlined previously by the first author. The
      projected 8-hour amplified TWA with the hearing aid programmed to the TILL
      configuration was 94 dBA, whereas TWAs for the linear and BILL configurations
      were each 104 dBA. Thus, the highest intelligibility and lowest noise exposures
      were obtained with the aid in the TILL mode.

PMID- 11193960
TI  - Perception of voiceless fricatives by normal-hearing and hearing-impaired
      children and adults.
AB  - This study examined the perceptual-weighting strategies and performance
      audibility functions of 11 moderately hearing-impaired (HI) children, 11 age
      matched normal-hearing (NH) children, 11 moderately HI adults, and 11 NH adults.
      The purpose was to (a) determine the perceptual-weighting strategies of HI
      children relative to the other groups and (b) determine the audibility required
      by each group to achieve a criterion level of performance. Stimuli were 4
      nonsense syllables (see text). The vowel, transition, and fricative segments of
      each nonsense syllable were identified along the temporal domain, and each
      segment was amplified randomly within each syllable during presentation. Point
      biserial correlation coefficients were calculated using the amplitude variation
      of each segment and the correct and incorrect responses for the corresponding
      syllable. Results showed that for /see text/ and /see text/, all four groups
      heavily weighted the fricative segments during perception, whereas the vowel and
      transition segments received little or no weight. For /see text/, relatively low
      weights were given to each segment by all four groups. For /see text/, the NH
      children and adults weighted the transition segment more so than the vowel and
      fricative segments, whereas the HI children and adults weighted all three
      segments equally low. Performance-audibility functions of the fricative segments
      of /see text/ and /see text/ were constructed for each group. In general, maximum
      performance for each group was reached at lower audibility levels for /see text/
      than for /see text/ and steeper functions were observed for the HI groups
      relative to the NH groups. A decision theory approach was used to confirm the
      audibility required by each group to achieve a > or =90% level of performance.
      Results showed both hearing sensitivity and age effects. The HI listeners
      required lower levels of audibility than the NH listeners to achieve similar
      levels of performance. Likewise, the adult listeners required lower levels of
      audibility than the children, although this difference was more substantial for
      the NH listeners than for the HI listeners.

PMID- 11193961
TI  - Age-related improvements in auditory backward and simultaneous masking in 6- to
      10-year-old children.
AB  - This study investigated the development of auditory frequency and temporal
      resolution using simultaneous and backward masking of a tone by a noise. The
      participants were 6- to 10-year-old children and adults. On the measure of
      frequency resolution (the difference in the detection threshold for a tone
      presented either in a bandpass noise or in a spectrally notched noise), 6-year
      old children performed as well as adults. However, for the backward masking task,
      6-year-olds had, on average, 34 dB higher thresholds than adults. A negative
      exponential decay function fitted to the backward masking data for subjects of
      all ages indicated that adult-like temporal resolution may not be reached until
      about 11 years of age. These results show that, measured by masking, frequency
      resolution has reached adult-like performance by 6 years of age, whereas temporal
      resolution develops beyond 10 years of age. Six-year-old children were also
      assessed with tests of cognitive ability. Improvements in both frequency and
      temporal resolution were found with increasing IQ score.

PMID- 11193962
TI  - Changes in normal speech after fatiguing the tongue.
AB  - Detrimental effects of tongue fatigue on speech have been assumed to exist based
      on neuromotor speech disorders. However, to address whether fatigue is a
      contributing cause to impaired speech requires an experimental protocol with an
      uncomplicated population. This study induced tongue fatigue in eight
      neurologically normal persons and examined changes in speech perceptually and
      acoustically. The fatigue task consisted of repeated cycles of 6 s of sustained
      maximum voluntary contraction and 4 s of rest until 50% of maximum strength could
      not be achieved for three consecutive cycles. Participants then produced speech
      that was weighted heavily with lingual-palatal consonants. Perceptual analyses of
      the speech revealed a statistically significant deleterious effect of induced
      tongue fatigue on speech precision and an incomplete reversal of this effect
      after a recovery period. Acoustically, the first and third spectral moments (mean
      and skewness) of the spectral energy for /see text/, /see text/, and /see text/
      differed significantly after fatigue but in directions opposite to a priori
      predictions. Tendencies were found for decreased stop-closure duration and
      increased voice onset time for /see text/ after fatigue. Supplemental analyses
      revealed decreased second formant (F2) frequency for /see text/ and /see text/
      and flattened F2 transition for the diphthong /see text/ after fatigue. These
      results indicate disruption of tongue positioning and transitioning for lingual
      palatal consonants during speech after prolonged strenuous tongue exercises.

PMID- 11193963
TI  - Disfluency and time perception.
AB  - Stuttering is manifested as a disruption in speech timing, but it may stem from a
      more basic temporal disorder (R. D. Kent, 1984). We compared the ability of
      stuttering and nonstuttering adults to estimate protensity and to distinguish the
      relative lengths of short tones. We also examined whether there is a correlation
      between a person's degree of disfluency and the ability to measure protensity or
      judge the relative lengths of short tones. Twenty stuttering and 20 nonstuttering
      adults were given the Duration Pattern Sequence Test. They were also asked to
      estimate the lengths of 8 tones and silent intervals. A negative correlation was
      found between degree of disfluency and ability to determine the relative lengths
      of short tones. A positive correlation was found between degree of disfluency and
      length of protensity estimates.

PMID- 11193964
TI  - Treating stuttering in young children: predicting treatment time in the Lidcombe
      Program.
AB  - It is known that children may recover from stuttering without formal treatment
      during the first years after onset. Consequently, the timing of professional,
      early stuttering intervention is a pressing issue in speech-language pathology.
      This report presents data pertinent to this issue for 261 preschool-age children
      who received the Lidcombe Program of early stuttering intervention. Of these
      children, 250 completed the program and were considered by their clinicians to
      have been treated successfully. For the children who were treated successfully,
      logistical regression analyses were used to determine whether age, gender, period
      from onset to treatment, and stuttering severity related systematically to the
      time required for treatment. The present data confirmed previous reports that a
      median of 11 clinic visits was required to achieve zero or near-zero stuttering
      with the Lidcombe Program. Results were also consistent with a preliminary report
      of 14 children (C. W. Starkweather & S. R. Gottwald, 1993) showing a significant
      relation between stuttering severity and the time needed for treatment, with
      children with more severe stuttering requiring longer treatment times than
      children with less severe stuttering. However, results did not associate either
      increasing age or increased onset-to-treatment intervals with longer treatment
      times. This finding is not consistent with the Starkweather and Gottwald report,
      which linked advancing age with longer treatment time. In fact, the present data
      suggest that, for a short period after stuttering onset in the preschool years, a
      short delay in treatment does not appear to increase treatment time. An important
      caveat to these data is that they cannot be generalized to late childhood or
      early adolescence. The present findings are discussed in relation to natural
      recovery from stuttering.

PMID- 11193965
TI  - Perceptual-phonetic predictors of single-word intelligibility: a study of
      Cantonese dysarthria.
AB  - This study investigated the perceptual-phonetic predictors of intelligibility in
      Cantonese speakers with dysarthria. The speakers were 20 young adults with
      cerebral palsy. The listener group consisted of 12 native Cantonese speakers. A
      single-word intelligibility test was constructed, based on 17 phonetic contrasts.
      There were no significant differences in intelligibility for gender, age, or type
      of cerebral palsy. A regression analysis showed that intelligibility could be
      predicted with 97% accuracy by 5 out of the 6 most problematic contrasts. Three
      contrasts (glottal vs. null, final vs. null, and long vs. short vowel) predicted
      variation on an independent intelligibility measure obtained for the same
      speakers with 84% accuracy. Principal components analysis derived 4 components,
      which accounted for 81% of the variance in the 17 contrasts. Physiological
      explanations and language-specific contributions to speech disorder in this group
      of speakers are discussed.

PMID- 11193966
TI  - An acoustic study of coarticulation in dysarthric speakers with Parkinson
      disease.
AB  - Anticipatory vowel coarticulation in obstruent + vowel syllables was studied for
      9 dysarthric males with mild to moderate idiopathic Parkinson disease (PD) and a
      group of 10 healthy males. In addition to studying coarticulatory differences for
      speakers' habitual rate repetitions, a graded speaking rate task was used to
      investigate the effect of rate variation on coarticulation. The ratio of F2 onset
      frequency/F2 target frequency was used to infer coarticulation (i.e., ratios of
      1.0 indicate complete vowel harmony at vowel onset, and ratios greater than 1.0
      indicate relatively less coarticulation). Because F2 onset frequency is a
      relatively novel measure of coarticulation, a more common measure of anticipatory
      vowel coarticulation-fricative F2-was obtained for a subset of the speech stimuli
      and compared to F2 onset measures. Ratios of fricative F2/F2 target frequency
      also were computed to infer coarticulation and the results were compared to the
      F2 onset/F2 target ratios. The results indicated a modest relationship between F2
      onset frequency and fricative F2 for both speaking tasks and speaker groups, with
      a stronger relationship for the graded rate task. Regression analyses for the
      graded rate task further indicated that longer vowel durations were associated
      with larger ratios for both speaker groups. Thus, coarticulation tended to
      increase with faster rates and decrease with slower rates, although the
      relationship was more systematic for control speakers. Ratios for the habitual
      task tended to be smaller for speakers with PD, suggesting increased
      coarticulation relative to control speakers. This effect was not entirely
      attributable to the more rapid speaking rates for speakers with PD. Because
      habitual rate F2 onset/F2 target ratios tended to underestimate the extent to
      which coarticulation was increased for speakers with PD-compared to the fricative
      F2/F2 target ratios-measures other than F2 onset should be used to infer absolute
      differences in extent of coarticulation for speakers with PD and healthy
      controls.

PMID- 11193967
TI  - Motor strategy in rapid sequential swallowing: new insights.
AB  - This study examined the physiological properties and movement strategies of
      normal, rapid sequential swallowing during simultaneous videofluoroscopy (VFS)
      and submental surface electromyography (EMG). Ten subjects performed discrete (5
      and 15 cc) and sequential (150 cc in tilted and upright head postures) swallowing
      tasks. Analyses included VFS event timing, movement/bolus passage
      characteristics, EMG amplitude waveforms, and peak and offset EMG amplitudes.
      Results revealed that sequential swallows were significantly shorter than
      discrete swallows in several VFS event durations, but significantly longer in
      pharyngeal transit and stage transition times. The hyolaryngeal system exhibited
      a cyclical "rise and partial fall" movement pattern during sequential swallows on
      VFS, corresponding to a repetitive "activation and partial deactivation"
      characteristic on EMG. Greater peak EMG amplitude for sequential than discrete
      swallows was found in 6/10 subjects. Pharyngeal bolus merging, preparatory
      laryngeal gestures, and penetration without aspiration were also observed in some
      subjects on VFS. Intersubject differences were significant in timing measures and
      EMG amplitude. Our findings of individual variability and subject-specific
      strategies for task accommodation support the notion of built-in plasticity in
      the deglutitive motor complex.

PMID- 11193968
TI  - Multivariate statistical analysis of flat vowel spectra with a view to
      characterizing dysphonic voices.
AB  - The aim of this article is to show how dysphonic voices can be characterized by
      means of a multivariate statistical analysis of flat vowel spectra. The spectral
      contour was obtained by means of a wavelet transform of the logarithmic magnitude
      spectrum, which was subsequently flattened to remove interspeaker variability
      related to the excitation and vocal tract filter functions. The results of the
      statistical analysis of flat spectra were the following. Firstly, principal
      components analysis produced markers that separated noisy from clean spectra.
      Secondly, the heuristic search for harmonic peaks or interharmonic dips could be
      omitted. Thirdly, conventional spectral markers of noise appeared as special
      instances of the markers that were derived statistically. Fourthly, the levels of
      visually assigned hoarseness and the first two principal components were
      significantly correlated. The assignment of different levels of (visual)
      hoarseness to different vowel timbres could be explained by the variability
      associated with the spectral contour.

PMID- 11193969
TI  - A comparison of speech training methods with deaf adolescents: spectrographic
      versus noninstrumental instruction.
AB  - The effects of speech training with real-time spectrographic displays (SDs) were
      examined and compared to the effects of noninstrumental (NI) instruction (i.e.,
      training without computerized displays of speech) for deaf adolescents. A single
      case modified alternating-treatment experimental design with replication across
      subjects and speech targets was used to examine within-subject performance in
      establishing, maintaining, and generalizing target consonants. Comparisons
      between the two approaches were accomplished by determining how frequently each
      method resulted in improvement, maintenance of improvement, and generalization to
      untrained words. Each of the 4 subjects demonstrated improvement under both forms
      of instruction in a relatively short time. Maintenance of improvement was
      observed 6 weeks post-treatment for two NI-trained targets and one SD-trained
      target. Two subjects showed better generalization for their SD-trained target
      than their NI target. There was little difference in generalization scores for
      the remaining subjects. All subjects either regained their highest previous
      levels of acceptability or maintained high-level acceptability following brief,
      independent practice with SDs 10 weeks after training was discontinued. The
      expediency of independent practice with SDs was discussed.

PMID- 11193970
TI  - Variations in the relative speeds of orofacial structures with stuttering
      severity.
AB  - Stuttering can be characterized in part as a disorder in the coordination of
      different muscle systems. In light of basic aspects of orofacial physiology and
      development, the speeds of the lips and tongue relative to the jaw may be an
      important dimension for evaluating motor coordination among persons who stutter
      (PWS). To test this idea, an electromagnetic system was used to obtain measures
      of lip, tongue, and jaw speed in 38 adults (29 PWS and 9 normally fluent
      speakers, NFS) as they repeated a simple speech utterance at a normal rate. Using
      categorical ratings of stuttering severity, ratios of tongue speed to jaw speed
      were significantly greater in PWS rated as severe, compared to NFS and other PWS.
      Significant increases in lower lip-to-jaw and tongue-to-jaw speed ratios with
      stuttering severity were also reflected in correlation analyses relating speed
      ratios to a continuous measure of stuttering severity. These trends in speed
      ratio were related to increases in lower lip and tongue speed and decreases in
      jaw speed with stuttering severity. Sources of the speed differences are
      discussed in relation to underlying muscle activity, motor compensation processes
      in adults, and the development of orofacial motor control in children who
      stutter.

PMID- 11193971
TI  - Does the respiratory system function as an active pressure-flow source during
      experimental venting of oral air pressure? Comments on Finnegan, Luschei, and
      Hoffman (1999).

PMID- 11193972
TI  - Performing a quality semen analysis in the clinical laboratory.

PMID- 11193973
TI  - Nutrition assessment outcomes: a protocol for Native American hospitals.
AB  - The incorporation of visceral protein testing into nutrition assessment protocols
      can help all hospitals rapidly and accurately identify patients in need of
      restorative nutrition therapy. Reilly showed that a 3- to 5-day delay in
      identifying malnutrition has a direct variable cost of $1,500 per case. Studies
      by Brugler, Mears, and Reilly have demonstrated longer lengths of stay and
      increased care costs because of nosocomial complications (i.e., infections,
      pressure ulcers, wound dehiscence, dyspnea, system failures) related to
      malnutrition. Brugler showed that functionality--a measure of a patient's
      independence and ability to perform daily activities--both at admission and
      discharge, the number of care interventions, the occurrence of complications, the
      level of nutrition treatment needed, and the patient's discharge disposition were
      strongly associated with their admission albumin value. Conversely, nutrition
      restoration leads to improved patient outcomes, reduced costs, maximization of
      care reimbursement, and fulfillment of regulatory requirements. Adoption of this
      protocol by other hospitals should allow them to demonstrate comparable results,
      thereby justifying the incorporation of visceral protein testing into their
      nutrition assessment methods.

PMID- 11193974
TI  - Point-of-care testing.
AB  - Is POCT worth integrating into a facility? Despite its promise of speed and
      convenience, this technology requires careful evaluation of potential benefits,
      disadvantages, and challenges to the existing system. If the pros outweigh the
      cons, a step-by-step approach can ease the process of implementing a POCT
      program.

PMID- 11193975
TI  - Measuring ionized magnesium in complex physiological solutions.

PMID- 11193976
TI  - HIV's pharmacokinetics, pharmacodynamics, pharmacogenetics, and pharmacogenomics.

PMID- 11193977
TI  - Automated immunoassay of ANA and dsDNA autoantibodies in human serum samples.

PMID- 11193978
TI  - Use of a high-sensitivity C-reactive protein assay in evaluating cardiovascular
      disease risk.

PMID- 11193980
TI  - Laboratory results in real-time via the Web.

PMID- 11193979
TI  - Extending disease management: a home monitoring system for vital signs.

PMID- 11193981
TI  - An improved diabetes diagnostic kit with desiccant.

PMID- 11193982
TI  - Give families credit, access.

PMID- 11193983
TI  - Hill Physicians--the impact of the Internet on an IPA. Case study 2.

PMID- 11193984
TI  - Supply capitation. Proving ground.

PMID- 11193985
TI  - Herbal supplements.  Potion patrol.

PMID- 11193986
TI  - Scripps Health--using technology to reinvent itself. Case study 3.

PMID- 11193987
TI  - Reducing stroke deaths. Stroke of genius.

PMID- 11193988
TI  - Used medical equipment. Old stuff is us.

PMID- 11193989
TI  - E-ICU. Hands-off care.

PMID- 11193990
TI  - HIPAA is not Y2K.

PMID- 11193991
TI  - Consumers in control. How the Net will reshape health care.
AB  - Two trends are converging upon the health care landscape. And the collision of
      these two forces may change the health care system forever. Consumerism, a trend
      challenging every industry throughout the nation, is magnified in health care by
      simple demographics. The baby boomers, the most demanding consumers history has
      ever known, are entering the age of high health care use en masse. They will not
      be denied. Meanwhile, the development of the Internet--combined with the
      explosion in its use--has created a medium that has the force to change
      industries.

PMID- 11193992
TI  - Big ideas. Technology: crossed wires.

PMID- 11193994
TI  - Big ideas. Consumerism: who's buying it?

PMID- 11193993
TI  - Big ideas. Genomics: delayed reaction.

PMID- 11193995
TI  - Big ideas. Wild cards: surprises? You bet.

PMID- 11193996
TI  - Allina Health--a lesson in strategy. Case study 1.

PMID- 11193997
TI  - Kinder caring.

PMID- 11193998
TI  - Seroprevalence of Chlamydia pneumoniae infection in Thailand.
AB  - Chlamydia pneumoniae (C. pneumoniae) is an emerging infectious agent, with a
      spectrum of clinical manifestations, and it has recently been tentatively linked
      to atherosclerosis. In order to describe the seroprevalence of C. pneumoniae in
      Thailand, we evaluated 1,798 normal healthy subjects (aged 20-93 years) for anti
      C. pneumoniae IgG and IgA. Specific antibodies were measured by the fully
      automated ELISA method using elementary bodies of C. pneumoniae as an antigen.
      IgG antibodies against C. pneumoniae were presented in 55.16 per cent of men and
      41.63 per cent of women. Anti-C. pneumoniae IgA were presented in 31.50 per cent
      of men and 27.49 per cent of women. The prevalence of IgG antibody increased with
      age and reached 78 per cent in subjects between 51-93 years. The pattern of IgA
      antibody was a saddle shape, which indicated 2 peaks of chronic infection. Our
      results suggested that C. pneumoniae infection was common in Thailand. The high
      prevalence of evidence of exposure to C. pneumoniae may have implications for the
      prevention of cardiovascular disease if further study concludes that infection
      with this organism is a risk for cardiovascular disease.

PMID- 11193999
TI  - Comparison of parathyroid hormone in angiographically-demonstrated coronary
      artery disease patients and healthy Thais.
AB  - Parathyroid hormone (PTH) influences the calcium metabolism. The idea of
      cardiovascular effects of PTH is not new. Target cells for PTH are cardiomyocytes
      and smooth muscle cells. Evidence from previous studies suggest that many
      patients with heart disease have elevated PTH concentrations. Our objective was
      to determine PTH status in patients with coronary artery disease (CAD). We
      compared intact PTH levels in 109 CAD patients with 103 healthy people by
      electrochemiluminescence immunoassay. Mean values of PTH in healthy Thais and CAD
      patients were 37.4 +/- 17.9 and 40.2 +/- 21.8 respectively. No statistical
      difference was shown. In addition, we compared PTH levels among various numbers
      of coronary occlusion and also found no differences. We propose that intact PTH
      concentrations in CAD patients are not higher than in the healthy population.

PMID- 11194000
TI  - Limitation of transthoracic echocardiography in the diagnosis of congenital heart
      diseases.
AB  - Nowadays, it has been widely accepted that echocardiography is the most
      efficient, non invasive diagnostic tool to diagnose congenital heart diseases.
      However, cardiac catheterization remains the gold standard to diagnose and obtain
      hemodynamic data prior to cardiovascular surgery. In order to find out the
      accuracy of transthoracic echocardiography in relation to the anatomical
      diagnosis of congenital heart diseases, 175 consecutive patients who underwent
      diagnostic cardiac catheterization during January 1999 to December 1999 were
      reviewed. All of them had complete echocardiographic studies prior to the
      procedure. The male to female ratio was 1.06:1. The median age at the time of
      echocardiography was 3.36 (0.01-28.8) years old. The indications of the cardiac
      catheterization were to demonstrate cardiovascular anatomy 64 per cent, to obtain
      pulmonary artery pressure and pulmonary vascular resistance 13.7 per cent, and to
      get both information 22.3 per cent. Tetralogy of Fallot (23.4%) was the most
      frequent cardiac malformation, followed by complex congenital heart diseases
      (22.3%), simple left to right shunt (12%), pulmonary atresia with ventricular
      septal defect (8.6%), tricuspid atresia (5.7%), simple d-transposition of great
      arteries (4%), etc. From cardiac catheterization; 49 cases (28%) revealed
      additional data which were surgically important, 3 cases (1.7%) resulted in
      different diagnoses, and 3 cases (1.7%) revealed additional information which was
      not surgically important. Inadequate imaging technique (36 cases, 65.5%) and
      limitation of technique (19 cases, 34.5%) were the reasons for missing anatomical
      findings of transthoracic echocardiography. Age at the time of echocardiography
      was not a significant factor affecting the accuracy. Persistent left superior
      vena cava, multiple aorto-pulmonary collateral arteries, pulmonary artery
      anatomy, and coronary artery anatomy were the most frequent cardiac lesions
      misdiagnosed by transthoracic echocardiography that were somewhat surgically
      important. The incorrect echocardiographic diagnoses were aorto-pulmonary window,
      patent ductus arteriosus, and vascular ring. Thorough and extensive
      echocardiographic scanning coupled with cooperative or adequately sedated
      patients by an experienced operator using an efficient echocardiographic machine
      might improve the accuracy of transthoracic echocardiography in the diagnosis of
      congenital heart diseases.

PMID- 11194001
TI  - Comparison of supraventricular tachycardia from concealed bypass tract and Wolff
      Parkinson-White syndrome.
AB  - Supraventricular tachycardia (SVT) is a common problem. There are 2 types of
      accessory atrioventricular pathway (AP) causing SVT: one can conduct antegradely
      (WPW syndrome) and another can conduct only in a retrograde direction (concealed
      bypass tract or CBT). There are little data of the significance and difference of
      the two types in Thailand. The objectives of this study were to compare
      characteristics of patients, accessory pathways and outcome of radiofrequency
      catheter ablation (RFCA) between the 2 types of accessory pathways. We reviewed
      the electrophysiology report of patients with supraventricular tachycardia from
      the accessory pathway who were referred for RFCA. There were 74 males and 74
      females at a mean age of 37 years. CBT accounts for 44 per cent of SVT from AP.
      Compared to CBT, WPW syndrome was more in the right-sided location, more
      associated with heart disease, a higher number of accessory pathways, more
      inducible atrial fibrillation and more difficult to do ablation. However, the
      overall success rate of RFCA was similar. Although the recurrence rate was 8.4
      per cent, all patients with recurrence were successfully reablated. We concluded
      from this study that RFCA is a highly effective method for the treatment for both
      forms of accessory pathway although there are some differences between WPW
      syndrome and CBT.

PMID- 11194002
TI  - Effect of atenolol on symptomatic ventricular arrhythmia without structural heart
      disease.
AB  - Ventricular arrhythmia (VA) from right ventricular outflow tract (RVOT) is a
      common problem. Symptomatic patients are usually treated with beta-blockers.
      There is little data on the systematic evaluation of the drug efficacy. The
      objectives of this study were 1) To determine proportion of exercise induced
      ventricular arrhythmia among patients with symptomatic ventricular arrhythmia and
      2) to determine the response to beta blockers and the correlation between the
      response to betablockers and exercise induced VA. We prospectively studied 46
      consecutive patients with symptomatic ventricular arrhythmia. Patients recorded
      their symptom scores underwent exercise testing and 24-hour ambulatory monitoring
      before treatment and 1 month after atenolol. Exercise induced ventricular
      arrhythmia was demonstrated in 28 per cent of patients with symptomatic
      ventricular arrhythmia. Atenolol improves symptoms, decreases PVC count from
      ambulatory monitoring, increases exercise duration and suppresses malignant form
      of VA during exercise. These effects are at a similar extent in both groups of
      patients: those with and without exercise induced VA. However, the effect on
      ventricular arrhythmia suppression during exercise of atenolol was seen only in
      patients with increased PVC during exercise. In conclusion, atenolol is a good
      option in treating patients with symptomatic VA from RVOT regardless of the
      pattern of PVC response to exercise. Atenolol can suppress PVC during exercise
      testing better in patients with exercise induced VA compared to those without.

PMID- 11194003
TI  - Biochemical markers of bone turnover in angiographically-demonstrated coronary
      artery disease patients and healthy Thais.
AB  - The patients with coronary artery disease (CAD) were suffering from dyspnea.
      Physical activity of these patients was limited. Their lifestyle may be
      contributory factors for osteoporosis. Recent research has shown that biochemical
      markers may be used to predict future bone loss and identify individuals at risk
      for osteoporosis. Our objectives were to estimate reference ranges of bone
      markers in healthy Thais and to compare bone turnover between 105 healthy people
      and 118 CAD patients by using biochemical markers of bone formation and
      resorption. Mean values of bone markers in controls and patients were 22.9 +/-
      12.9, 21.6 +/- 16.2 respectively for N-Mid osteocalcin and 0.45 +/- 0.30, 0.47 +/
      0.37 respectively for beta-Crosslaps. There was no statistical difference of N
      Mid osteocalcin (p=0.50) and beta-Crosslaps (p=0.64) values between groups. Our
      data from this study suggested that that CAD patients have no higher risk for
      osteoporosis than healthy people.

PMID- 11194004
TI  - Reliability of Thai version of SF-36 questionnaire for the evaluation of quality
      of life in cardiac patients.
AB  - Quality of life is an important measurement of medical outcomes. Reliability of a
      Thai version of the SF-36 questionnaire has never been reported. The objective of
      this study was to determine the reliability of a Thai version of the SF-36
      questionnaire in cardiac patients. We developed a Thai version of the SF-36
      questionnaire and tested it in 212 cardiac patients. Reliability of the Thai
      version of the SF-36 questionnaire was assessed by internal consistency using
      Cronbach's Alpha statistic and inter-item correlation. We demonstrated that
      Cronbach's Alpha coefficient of every aspect of QOL exceeded 0.7, and all inter
      item correlation exceeded 0.4. In conclusion, the Thai version of the SF-36
      questionnaire is a valuable tool in assessing medical outcomes and medical
      research in Thai patients with cardiac disease. Whether it can be used in other
      diseases remains unknown.

PMID- 11194005
TI  - The use of cardiac magnetic resonance imaging in coronary artery disease.
AB  - A new noninvasive imaging technique, magnetic resonance imaging (MRI), has been
      developed that has the potential to assess anatomical and functional data of
      patients with coronary artery disease. None of the other cardiac investigations
      to date can combine all aspects of information. Cardiac MRI is a challenging task
      because of the motion of the structure during cardiac contraction and the motion
      with respiration. We reviewed the technique and the use of cardiac MRI in various
      aspects. The emerging area in cardiac MRI is the analysis of the plaque
      morphology information, and the use of the new contrast agents. Further
      investigation is needed in order for cardiac MRI to achieve a better image
      information within a shorter period of time.

PMID- 11194006
TI  - Impaired fasting glucose, diabetes mellitus and coronary risk factors.
AB  - The authors conducted a prevalence survey of impaired fasting glucose and
      diabetes mellitus in 3,615 Shinawatra employees, and we also determined various
      risk factors of coronary artery disease such as blood pressure level, body mass
      index and serum lipids. The prevalence of impaired fasting glucose and diabetes
      mellitus were 1.7 per cent and 0.8 per cent respectively. The prevalences were
      more common in males and increased with increasing age. Coronary risk factors
      were higher in impaired fasting glucose (IFG) and diabetes mellitus (DM) when
      compared with normal glucose levels. There were also significant differences
      between impaired fasting glucose and diabetes mellitus, except for pulse
      pressure, serum cholesterol level, LDL-cholesterol level and HDL-cholesterol
      level.

PMID- 11194007
TI  - Regular exercise and cardiovascular risk factors.
AB  - Physical inactivity has been counted as a risk factor for coronary artery
      disease. Regular exercise has also been reported to reduce risk of cardiovascular
      disease and its risk factors. We surveyed 3615 subjects for their conventional
      risk factors of coronary disease and for the frequency of their exercise. We
      found that subjects who had regular exercise were more likely to have lower
      triglyceride and resting heart rate. HDL cholesterol was higher in the group of
      subjects who had regular exercise. There was no difference in fasting plasma
      glucose, total cholesterol or blood pressure levels between those who had and
      those who did not have regular exercise.

PMID- 11194008
TI  - Electromagnetic interference of permanent pacemakers by mobile phones in
      Thailand.
AB  - The possible permanent pacemaker function interference by mobile telephones is
      concerned worldwide. Previous studies from the other countries with different
      mobile telephone systems and permanent pacemakers provided useful but indirect
      information. We in vitro studied the interaction between local mobile telephones
      and permanent pacemakers in Thailand. Seventeen mobile telephones from different
      systems and brands were tested in the laboratory with seven permanent pacemakers
      from different companies. We found no interference in the function of permanent
      pacemakers. The application of the information may be limited from the in vitro
      nature of the study. However this would be the useful reference for the future in
      vivo study.

PMID- 11194009
TI  - Are routine checkups necessary?: The Shinawatra's employee study.
AB  - The authors performed a survey in 3,615 Shinawatra employees aged 18-60 years to
      determine the abnormalities found with routine checkup. The annual checkup
      included: history taking. anthropometric measurement, physical examination,
      complete blood count, urine analysis, chest roentgenography, blood chemistry
      (fasting blood glucose, BUN, creatinine, uric acid, AST/ALT, cholesterol,
      triglyceride and HDL-cholesterol). The prevalence of abnormalities with
      management change detected by complete blood count, urine analysis was low and we
      did not recommend the routine use of complete blood count and urine analysis. The
      prevalence of hypertension was more common in males and the prevalence increased
      sharply after the age of 25 years in males and 40 years in females. The
      prevalence of abnormalities of BUN, creatinine (both males and females) and uric
      acid (in females) was very low. There was high prevalence of high AST/ALT which
      suggested hepatitis in our population, and the prevalence was more common in
      males beginning at a young age. Diabetes mellitus was more common in males
      especially after the age of 45 years. Chest roentgenography abnormalities were
      found in 9.4 per cent and the prevalence of abnormalities increased with age and
      was common after the age of 44 years. Most of the abnormalities found by chest
      roentgenography were pulmonary infiltration and cardiomegaly. The authors'
      findings did not recommend the routine use of complete blood count, urine
      analysis, fasting BUN and creatinine. We recommend routine blood pressure
      measurement in males aged 25 years or more and in females aged 40 years or more.
      We suggest routine blood cholesterol measurement in both sexes, blood
      triglyceride measurement in males aged 25 years or more and fasting blood sugar
      tests in males aged more than 44 years, chest roentgenography in males and
      females after the age of 45 years.

PMID- 11194010
TI  - Prevalence of new coronary risk factors in Thai population.
AB  - Many new cardiovascular biomarkers of atherosclerosis have recently been
      emerging. However, there is a paucity of these data in the Thai population. This
      study aims to determine the prevalence of these biomarkers of atherosclerosis and
      the relationship between these new risk factors and other conventional risk
      factors for atherosclerosis in the healthy Thai population. As a yearly check-up
      program, we surveyed 3,615 normal healthy populations for their conventional risk
      factors and some new cardiovascular biomarkers for atherosclerosis. The authors
      found hyperhomocysteinemia and high level of Lp(a) in 27 per cent and 32 per cent
      of the cases respectively. Prevalence of recent and past chlamydial infection was
      found in 30 per cent and 51 per cent respectively.

PMID- 11194011
TI  - Acute and follow-up results of laser angioplasty: single center experience.
AB  - Excimer laser angioplasty was used to treat total occluded coronary arteries and
      instent restenosis lesions with high success rate. To assess immediate and long
      term results of patients treated with excimer laser, we analyzed demographic
      information and the immediate results of 44 patients who underwent ELCA. The
      patients were followed up and assessed for clinical restenosis. The initial
      success rate of ELCA was 86.4 per cent which is comparable to plain balloon
      angioplasty performed during the same period. Clinical restenosis was 29 per
      cent. In conclusion, ELCA for patients with coronary artery disease can be
      performed with initial high success rate and reasonable long-term restenosis.

PMID- 11194012
TI  - The use of nonfluoroscopic catheter-based mapping system to perform
      radiofrequency ablation in complex ventricular tachycardia after cardiac surgery
      in congenital heart disease: a case report.
AB  - A nonfluoroscopic electroanatomical cardiac mapping system (CARTO) integrates
      anatomical and electrophysiological information to reconstruct a three
      dimensional activation map. Information from the CARTO system helps to reveal the
      mechanism and perform successful ablation in scar re-entry ventricular
      tachycardia after cardiac surgery. Three-dimensional activation and propagation
      mapping was performed in a patient with ventricular tachycardia after surgical
      correction of a double outlet right ventricle. The ventricular tachycardia
      appeared in two morphologies and were refractory to antiarrhythmic medication
      including amiodarone. Both ventricular tachycardias were re-entered using the
      ventriculotomy scar but rotated in different directions. Successful
      radiofrequency ablation was performed by creating a line of conduction block from
      the pulmonic valve to the ventriculotomy scar using entrainment mapping and the
      ablation lesion tagging technique. The CARTO system is useful in mapping and
      guiding the ablation of complex ventricular tachycardia after surgical correction
      in congenital heart disease

PMID- 11194013
TI  - Polymorphism of the gene encoding lipoprotein lipase in thai primary
      hyperlipoproteinemias.
AB  - Lipoprotein lipase (LPL) plays a central role in the clearance of very low
      density lipoprotein (VLDL) and chylomicrons from the circulation. It also affects
      the maturation of high density lipoprotein (HDL) and low density lipoprotein
      (LDL). LPL is an important candidate gene in determining the risk factor in
      metabolic disorders including primary hyperlipidemia. Our study is the first
      report from Thailand on the characterization of two common DNA polymorphisms, i.e
      Pvu II and Hind III at introns 6 and 8, respectively of the LPL gene in 94 Thai
      dyslipidemic subjects compared to 32 normolipidemic subjects using PCR-RFLP. It
      was observed that the frequencies of the cut and uncut alleles of Pvu II were
      0.67 and 0.33 in normolipidemic subjects. Such frequencies were 0.64 and 0.36 in
      hyperlipidemic subjects. Additionally, the frequencies of the cut and uncut
      alleles of Hind III were found to be 0.73 and 0.27 in normolipidemic subjects.
      They were 0.85 and 0.15 in hyperlipidemic subjects. The allele frequencies of the
      Hind III but not Pvu II polymorphism in hyperlipidemic subjects were
      significantly different from normolipidemic subjects (p<0.05). The relation
      between these polymorphisms and lipid traits was not statistically significant
      (p>0.05).

PMID- 11194014
TI  - Correlation of serum lipoprotein(a) with the clinical presentation of Thai
      coronary artery disease patients.
AB  - Elevated serum levels of lipoprotein(a) [Lp(a)] confer an increased risk of
      coronary artery disease (CAD) and have been confirmed as a strong and independent
      risk factor for this disease. This case-control study was to determine the
      significance of elevated Lp(a) levels for the existence of CAD by systematically
      recording cardiovascular risk factors in diagnostic coronary angiography in a
      group of patients. Two hundred thirty seven consecutive patients (175 men, 62
      women, aged 61+/-10 years) which comprised 24 acute myocardial infarction (AMI),
      76 unstable angina (UA) and 137 stable angina (SA) who underwent coronary
      angiography, were used as cases. One hundred seventy normal healthy volunteers
      (95 men, 75 women, and aged 58+/-15 years) were used as controls. Lp(a)
      concentration were measured by an immunoturbidimetric method (Roche Diagnostics,
      Switzerland). There was a significant difference between Lp(a) levels in UA
      compared with the control subjects (44.2+/-49.0 vs. 27.6+/-25.3 mg/dL, p =
      0.0006). When we compared SA and the control group (35.6+/-31.3 vs. 27.6+/-25.3
      mg/dL, p = 0.0139) there was a significant difference between these two groups.
      UA patients also had a significantly higher prevalence of abnormal Lp(a) (>30
      mg/dL) compared with the normal healthy control group (43.2% UA vs. 28.8%
      control, OR = 1.90, 95%CI = 1.08-3.32, p = 0.0248). SA patients also had the same
      finding as UA patients in a higher prevalence of abnormal Lp(a) when compared
      with the control group (45.2% SA vs. 28.8% control, OR = 2.04, 95%CI = 1.27-3.27,
      p = 0.0028). These data further support the role of Lp(a) in atherosclerotic
      coronary disease and the pathogenesis of acute coronary syndromes.

PMID- 11194015
TI  - Percutaneous transluminal coronary angioplasty in the young patients--Siriraj
      Hospital's experience.
AB  - The aim of this study was to follow-up immediate and long term results of
      patients aged less than 40 years with CAD treated by PTCA. Primary end points
      were to record major coronary events, incidence and timing of restenosis and
      requirement of repeated revascularization after initial PTCA. Data was collected
      retrospectively from records of patients aged less than 40 years who underwent
      PTCA from Jan 1996 to June 1998 in Her Majesty Cardiac Center, Siriraj Hospital.
      Patients were followed up and data was collected regarding recurrent angina,
      major coronary events and results of repeated coronary angiography and
      revascularization if available. Out of 830 procedures performed for 325 patients,
      30 patients (9%) were less than 40 years of age and comprised of 26 males (87%)
      and 4 females (13%). Eighteen patients (60%) had more than one risk factor. The
      most important risk factor was smoking (60%) followed by dyslipidaemia (47%) and
      family history of coronary artery disease (20%). DM was strikingly uncommon. 14
      patients had single vessel disease and 16 patients had multiple vessel disease.
      Initial stenosis was 87.5 +/- 9.8 and residual stenosis was 17.8 +/- 10.8. PTCA
      failed for 5 lesions, overall success rate was 89 per cent. Stent was used for 12
      lesions in 10 patients. There was no major complication during the procedure.
      Minor complications included non occlusive dissection in four cases and groin
      haematoma in three cases. The follow up ranged from 7-36 months with the median
      of 23 months. During follow up, there was no major cardiac event such as death,
      acute MI, congestive heart failure or cerebero-vascular accident. Eleven patients
      (37%) had sustained improvement without recurrent angina. Recurrent angina
      occurred in 19 patients (63%) after initial PTCA and second/third recurrent
      angina occurred in 5 patients. On repeated coronary angiography angiographic
      restenosis was seen in 10 patients (33%) after initial PTCA. Overall repeated
      revascularization was done twenty times for sixteen patients which included 4
      CABGs and 16 PTCA. Twenty one patients (70%) showed sustained improvement after
      repeated PTCA and medications. Follow up results of PTCA in young patients showed
      sustained improvement but achieved at high rate of repeated revascularization.

PMID- 11194016
TI  - Biosense mapping for ablation of ventricular tachycardia in cardiomyopathy.
AB  - Using conventional technology, radiofrequency ablation of ventricular tachycardia
      in cardiomyopathy is frequently unsuccessful because of hemodynamic instability,
      multiple foci and recurrences. The Biosense CARTO nonfluoroscopic mapping and
      navigation system, when used to locate the area of the scar or reentry circuit,
      has the potential to improve the successful ablation, and reduce the rate of
      recurrence. We report 2 cases here of ventricular tachycardia in cardiomyopathy
      in which Biosense mapping was useful to identify the area of scar in 1 case, and
      the area of microreentry circuits in another. Radiofrequency ablation was
      possible and successful, while the use of conventional mapping was impossible or
      had recurrence.

PMID- 11194017
TI  - Myocardial injury after radiofrequency catheter ablation.
AB  - Radiofrequency catheter ablation has been a good treatment option for various
      types of cardiac arrhythmia. However there is concern about myocardial injury
      associated with radiofrequency catheter ablation. We studied myocardial injury
      with biochemical markers and echocardiogram in 41 consecutive patients who
      underwent electrophysiology study (EP study) and radiofrequency catheter ablation
      (RFCA) at our institute from April to July 2000. The concentration of biochemical
      markers (CK-MB mass, troponin T and myoglobin) and result of the echocardiograms
      were analyzed with other characteristics. In 41 patients subjected to EP study
      with possible RFCA, abnormal levels of troponin T, CK-MB mass and myoglobin were
      found in 46 per cent, 15 per cent and 44 per cent immediately after procedure,
      which went up to 64 per cent, 22 per cent and 2 per cent at twenty four hours.
      Compare to the group with normal troponin T level, the patients with abnormal
      level at 24 hours after RFCA had a longer procedure time (119+/-44 min. vs 90+/
      22 min.), more frequent use of impedance ablation catheters (65% vs 27%), more RF
      applications (9+/-8 vs 18+/-16) and more ventricular ablation sites (69% vs 9%).
      The echocardiogram results showed no remarkable abnormality in any patients.
      Troponin T was the most sensitive marker to detect thermal myocardial injury
      associated with radiofrequency catheter ablation. Prolonged procedure time, RF
      applications, the use of impedance ablation catheter and ventricular ablation
      site were associated with elevated troponin T concentration after RFCA.

PMID- 11194018
TI  - The prevalence of left ventricular hypertrophy and associated factors in a Thai
      population.
AB  - Electrocardiographic left ventricular hypertrophy (LVH) has been a bad prognostic
      factor for cardiovascular morbidity and mortality. However the prevalence and
      prognostic value of LVH are varied among nationalities and populations. Several
      factors have been shown to associate with LVH. Some factors are treatable such as
      hypertension. We prospectively studied the prevalence of LVH and associated
      factors in selected group of Thai population. The study population was 1,606
      Shinawatra employees who were 30 year old or more. The prevalence of LVH was 13
      per cent (210) among study population. Hypertension, lower body weight and male
      sex were significantly associated factors. In the subjects with LVH, the
      prevalence of hypertension was 25.6 per cent, male ratio was 5:1 and mean body
      weight was 57.7 kg, compare to 9.8 per cent prevalence of hypertension, 2:1
      female ratio and mean body weight was 62.3 kg in the group without LVH.

PMID- 11194019
TI  - Radiofrequency catheter ablation: 5 years experience at Siriraj Hospital.
AB  - Between February 1995 to May 2000, 626 consecutive patients underwent
      radiofrequency catheter ablation for various types of cardiac arrhythmia. The
      mean age was 41 years, range 1-85 years. Mapping and ablation were guided by
      intracardiac electrogram and anatomical approaches. The initial success,
      compliction, recurrent and final success rates are shown below:- [table; see
      text] Conclusion, RFCA is an effective treatment and should be considered as
      first line treatment for certain tachyarrhythmia.

PMID- 11194020
TI  - Obesity and risk factors of coronary heart disease in healthy Thais: a cross
      sectional study.
AB  - Association between obesity and conventional risk factors for coronary artery
      disease is well established. Obesity is currently considered an independent risk
      for coronary artery disease. The relationship between body mass index (BMI) and
      fasting plasma lipids and glucose and blood pressures in non-obese subjects is
      not established. The authors studied relationships between BMI and lipids, and
      glucose, and blood pressure levels in healthy a population. The authors measured
      the weights and heights of 3,615 employees of a company during a routine yearly
      health examination. There were 1,250 males aged 31.3 +/- 6.6 and 2,365 females
      aged 29.3 +/- 4.9 years old. The average BMI for males and females were 23.5 +/-
      3.6 and 20.1 +/- 3.0 respectively. The levels of total cholesterol (Chol), LDL
      cholesterol, and triglyceride (TG), fasting plasma glucose (FPG) had a positive
      relationship with BMI (r = 0.22, 0.26, 0.41, 0.20; p < 0.001). HLD-cholesterol
      had a negative correlation with BMI (r = -0.36, p < 0.001). Both systolic (SBP)
      and diastolic (DBP) blood pressures had a positive correlation with BMI. The
      association persisted after all values were adjusted by age and sex. BMI has a
      significant positive relationship with the conventional risk factors for coronary
      artery disease and a negative relationship with HDL-cholesterol.

PMID- 11194021
TI  - Utility of intraoperative transesophageal echocardiogram in congenital heart
      disease.
AB  - Intraoperative transesophageal echocardiogram (TEE) has improved the
      perioperative outcome in adult patients. The purpose of the current study was to
      assess the benefit of intraoperative TEE in patients with congenital heart
      disease undergoing surgical correction (repair). The results of the patients who
      had consecutively undergone intraoperative TEE during their congenital heart
      surgery between January 1998 to June 2000 were reviewed. There were 104 patients
      (whose ages ranged from one week old to 50 years old (median 5 years old) and
      their weights from 3 kg to 79 kg (median 15 kg). A significant impact was said to
      have occurred if these findings prompted a change in surgical procedure following
      a prebypass study or rebypass for repair of a residual defect. Prebypass TEE had
      a significant impact in seven patients (6.7%). TEE could be used as a guide to
      help repair in three patients. The postbypass TEE examination had a significant
      impact in 15 patients (14.4%). Of these 15 patients, eight were detected
      primarily by TEE examination. The group of patients in whom TEE had the most
      significant impact was in patients who had surgery related to the repair of the
      atrioventricular valve (complete or partial atrioventricular (AV) canal repair,
      Ebstein's anomaly; 9 out of 22 patients; 41%). A less significant impact was
      found in surgery for other complex congenital defects (single ventricle or
      complete transposition of great arteries; eight out of 46 patients; 17.4%). TEE
      had limited impact in simple congenital lesion. Intraoperative TEE is valuable in
      the perioperative care of patients with congenital heart defects. We found the
      most benefit in patients with complete or partial AV canal and Ebstein's anomaly.

PMID- 11194022
TI  - Screening for a D9N common mutation in exon 2 of the LPL gene in Thai
      normolipidemic and hyperlipidemic subjects.
AB  - Lipoprotein lipase (LPL) is a multifunctional protein, playing a major role in
      the hydrolysis of triglyceride-rich lipoproteins. It also affects the maturation
      of high density lipoprotein (HDL) and low density lipoprotein (LDL). A D9N
      substitution is a frequent mutation found in exon 2 of the LPL gene. It is due to
      a G --> A transition causing a substitution of Asp by Asn at amino acid residue 9
      of the protein. This mutation was screened for in 94 Thai primary dyslipidemic
      (46 hypercholesterolemic and 48 combined hyperlipidemic) subjects compared to 32
      normal healthy subjects using PCR-RFLP. Such a mutation has not, yet, been
      detected in any of these Thai subjects.

PMID- 11194023
TI  - Analytical and clinical performance of two homogeneous assays for measuring of
      LDL-cholesterol.
AB  - A clinical laboratory currently estimates LDL-Cholesterol (LDL-C) concentration
      using the Friedewald calculation, which requires fasting specimens and is subject
      to error with increasing triglycerides levels. We evaluated the analytical and
      clinical performance of the direct LDL-C assay from two companies, Roche
      Diagnostics (LDL-C(Roche)) and Wako Pure Chemical (LDL-C(Wako)). Both methods
      meet current guidelines for precision with within-run coefficients of variation
      less than 3 per cent. The LDL-C(Roche) assay correlated well with the LDL-C from
      the Friedewald equation (LDL-C(Fried), r = 0.958, y = 0.85x + 17.08 mg/dL, n =
      422). The LDL-C(Wako) assay also correlated with the LDL-C(Fried) (r = 0.946, y =
      0.86x + 7.81 mg/dL, n = 422). In addition, at the medical decision cutoff points,
      LDL-C(Roche) assay and LDL-C(Wako) showed positive predictive values of 87.44 per
      cent and 69.67 per cent respectively. We conclude that the LDL-C(Roche) assay
      meets the currently established analytical and clinical performance, but LDL
      C(Wako) assay meets only analytical performance. Clinical performance needs
      further evaluation.

PMID- 11194024
TI  - Serum cardiac troponin T in unstable angina pectoris patients.
AB  - Cardiac troponin T (cTnT) is a regulatory contractile protein not normally found
      in blood. Its detection in the circulation has been shown to be a sensitive and
      specific marker for myocardial cell damage. In this study, we used a second
      generation enzyme immunoassay for cTnT to determine whether its presence in the
      serum of patients with unstable angina was a prognostic indicator. Thirty
      patients with unstable angina pectoris (UAP) and 30 patients with Q-wave acute
      myocardial infarction (AMI) were screened for serum CK-MB activity and cTnT at 6,
      12, 24 and 48 hours after the onset of chest pain, All of the mean concentrations
      of CK-MB activity determined in UAP patients were less than the upper limit of
      normal (25 U/L). Meanwhile, the mean concentration of cTnT at 6, 12, 24 and 48
      hours after onset of chest pain were higher than the cutoff values (0.1
      microg/L), We found that one third of UAP patients had serum cTnT at the time of
      admission more than 0.1 microg/L and that these groups of patients were
      associated with a high risk for cardiac events. Our results suggested that
      patients with elevated serum cTnT could be considered as high-risk patients for
      developing myocardial infarction, Patients with normal cTnT levels and a low or
      intermediate clinical risk could be stabilized and further stratified
      noninvasively.

PMID- 11194025
TI  - Screening for mutations in exon 4 of the LDL receptor gene in Thai subjects with
      primary hypercholesterolemia: detection of a novel mutation D151Y by PCR-CFLP.
AB  - A mutation in low density lipoprotein (LDL) receptor gene causes an autosomal
      codominant disorder namely familial hypercholesterolemia (FH). Mutations in the
      LDL receptor gene are very heterogeneous at the DNA levels, occurring in all 18
      exons of the gene. However, exon 4 has been found to be the hot spot for
      mutational events. In this study DNA from 45 Thai subjects with primary
      hypercholesterolemia was screened for mutations in the hot spot exon 4. The DNA
      samples were amplified by Polymerase Chain Reaction (PCR) and screened for
      mutation by Cleavase Fragment Length Polymorphism (CFLP) technique.
      Identification of mutation was performed by direct sequencing of PCR product.
      From this screening, one female patient was found to be heterozygous for a novel
      mutation which was due to a G to T transversion at nucleotide 514. This
      transversion would change the species-conserved amino acid at codon 151 from
      charged R group aspatic (GAC) to uncharged R group tyrosine (TAC), termed D151Y.
      From the same screening strategy, we found that this mutation was absent in 33
      healthy normolipidemic subjects. In this index subject, Arg 3500 Gln mutation in
      apo B-100 gene, causing hypercholesterolemia namely familial defective apo B-100
      (FDB), was not found. Therefore, hypercholesterolemia in this index subject was
      possibly caused by the D151Y mutation in the LDL receptor gene.

PMID- 11194026
TI  - Effect of Ava II and NcoI polymorphisms at the low density lipoprotein receptor
      gene on plasma lipid levels in a group of Thai subjects.
AB  - The contribution of common genetic variations at the LDL receptor gene in
      determining interindividual differences in plasma lipid levels in the general
      population has been observed in several studies. In this study, we employed the
      PCR-RFLP method to investigate such an effect of the common Ava II (exon 13) and
      Nco I (exon 18) polymorphisms at the low density lipoprotein (LDL) receptor gene
      locus in 54 normolipidemic Thai subjects. The mean LDL-C level was slightly
      higher in the Ava II (+/+) genotype than the other Ava II genotypes. This
      difference was significant at the 5 per cent level although there were only three
      homozygotes with Ava II (+/+) genotype. The average effect of Ava II (+) allele
      was to increase LDL-C level by 6.75 mg/dl. A gene-dosage effect was not observed
      for this polymorphism. In addition, the subjects with Ava II (+/+) genotype also
      tended to have high serum total cholesterol and triglyceride and low HDL-C
      levels. Nco I polymorphism revealed no statistically significant effect on lipid
      levels in these subjects. However, the subjects with (+) allele tended to have
      high levels of LDL-C, serum total cholesterol and triglyceride.

PMID- 11194027
TI  - Mutation analysis of exon 9 of the LDL receptor gene in Thai subjects with
      primary hypercholesterolemia.
AB  - The low density lipoprotein (LDL) receptor plays an important role in cholesterol
      homeostasis. A mutation in this gene causes an autosomal codominant disorder,
      namely familial hypercholesterolemia (FH). In this study, single strand
      conformation polymorphism (SSCP) analysis was used to screen for mutations in
      exon 9 of the LDL receptor gene in a group of 45 Thai patients (11 males and 34
      females) with primary hypercholesterolemia. The peptide encoded by exon 9 belongs
      to the epidermal growth factor (EGF) precursor homology domain which is highly
      conserved in the LDL receptor protein. An abnormal SSCP pattern was observed in
      one female patient. The same screening strategy was also used to screen DNA
      samples from 33 normolipidemic subjects. All of these samples showed normal SSCP
      pattern. By direct DNA sequencing, the underlying mutation in the DNA with
      abnormal SSCP pattern was identified. The index subject was heterozygous for a T
      to C transition at nucleotide 1235. This transition would cause a nonconservative
      substitution of a nonpolar side chain amino acid "methionine" at codon 391, with
      an uncharged polar side chain amino acid "threonine", note M391T. From multiple
      amino acid sequence alignment in six species, the amino acid at codon 391 and the
      others nearby are completely conserved. Such nonconservative substitution of an
      amino acid residue in a highly conserved region could consequently result in a
      functional and/or structural defect in the receptor protein. In conclusion, we
      propose that M391T is likely to be the cause of hypercholesterolemia in this
      index subject.

PMID- 11194028
TI  - Coarctation of the aorta in children at Siriraj Hospital.
AB  - A retrospective analysis of 33 children who were diagnosed to have coarctation of
      aorta at Siriraj Hospital between January 1989 and December 1998 was undertaken.
      There were 21 males (64%) and 12 females (36%). Their ages ranged from one day to
      11 years (median 2 months). The majority of the patients (78.8%) were presented
      early within the first year of life. The predominant clinical manifestations were
      congestive heart failure (69.6%), systemic hypertension of the upper extremities
      (36.3%) and decreased femoral pulses. Chest roentgenogram revealed cardiomegaly
      (70%) and increased pulmonary blood flow (84%), reflecting congestive heart
      failure and associated left-to-right shunting. Electrocardiogram showed normal
      pattern (33.3%), right ventricular hypertrophy (33.3%), left ventricular
      hypertrophy (22.2%) and biventricular hypertrophy (11.2%). The younger the
      patient is, the more right ventricular predominance is demonstrated. According to
      the echocardiogram and/or aortogram, juxtaductal type was found in 51.5 per cent,
      postductal type in 27.3 per cent and preductal type in 21.2 per cent. Medical
      management included prostaglandin E1 infusion in a newborn baby presented with
      low-cardiac output state, anticongestion and antihypertension, if indicated,
      followed by surgical correction. The result of coarctectomy with end-to-end
      anastomosis with or without arch augmentation was good. The operative mortality
      rate was 5 per cent. The overall mortality in the present study was 9 per cent.
      The most common causes of death were multiorgan failure and pulmonary infection.
      Residual coarctation was found in 5 per cent.

PMID- 11194029
TI  - A 5-year prospective study of conventional risk factors of coronary artery
      disease in Shinawatra employees: a preliminary prevalence survey of 3,615
      employees.
AB  - We conducted a prevalence survey of conventional risk factors of coronary artery
      disease in 3,615 Shinawatra employees and we planned to prospectively follow up
      this population to determine the impact of the risk factors in the development of
      coronary disease. The prevalence of hypertension, diabetes mellitus,
      hyperlipidemia, obesity, physical inactivity and smoking were 7.4 per cent, 1.4
      per cent, 21.1 per cent, 13.9 per cent, 76.3 per cent and 16.3 per cent
      respectively. The awareness of hypertension, diabetes mellitus and hyperlipidemia
      were 42.2 per cent, 78 per cent and 32.9 per cent respectively. The prevalence of
      the risk factors was more common in males and increased with increasing age.
      Dependent variables which were associated with hypertension included: excessive
      weight; male sex; increasing age; hypercholesterolemia and diabetes mellitus.
      Variables which were associated with diabetes mellitus were hypertriglyceridemia,
      hypertension, male sex, increasing age and excessive weight.. Variables which
      were associated with hypercholesterolemia were hypertriglyceridemia, high HDL
      cholesterol, increasing age, excessive weight and hematocrit level while
      overweight, hypercholesterolemia, low HDL-cholesterol, smoking, hematocrit level,
      low income and increasing age were associated with hypertriglyceridemia.
      Excessive weight was associated with hypertriglyceridemia, low HDL-Cholesterol,
      presence of hypertension, hypercholesterolemia, diabetes mellitus, increasing age
      and low education.

PMID- 11194030
TI  - Cell-mediated and humoral immunity and phagocytic ability in chicken Lines
      divergently selected for serum immunoglobulin M and G levels.
AB  - Humoral and cell-mediated immunities and phagocytic ability were examined at the
      third and fourth generations of selection in two pairs of chicken lines (at 10 wk
      of age) that were divergently selected for levels of high serum Ig M (HIM), low
      serum Ig M (LIM), high serum Ig G (HIG), and low serum Ig G (LIG). Cell-mediated
      immunity was examined by splenomegaly assay at 12 wk of age. At 20 and 23 wk of
      age, 20 birds from the respective lines were injected Brucella abortus (BA), and
      blood samples were collected at 7 and 14 d postprimary immunization (PPI) and
      postsecondary immunization (PSI). Phagocytic ability was measured by carbon
      clearance assay at 25 and 30 wk of age. The results showed that the LIG line had
      higher degree of splenomegaly indices than the HIG line in both generations. The
      HIM and HIG lines had significantly (P < 0.05) higher total antibody titers to BA
      than their low counterparts. Similarly, mercaptoethanol-resistant (MER) antibody
      titers to BA, as measured only in the fourth generation, were significantly (P <
      0.05) higher in the HIM and HIG lines than their low counterparts. In both
      generations, the HIM and HIG lines had significantly (P < 0.01) faster carbon
      clearance ability than the LIM and LIG lines. The results suggest that both pairs
      of selected lines exhibited divergence in immunocompetence, although they had
      been selected for serum Ig isotypes.

PMID- 11194031
TI  - Developmental instability in japanese quail genetically selected for contrasting
      adrenocortical responsiveness.
AB  - Differences in developmental instability were assessed with Japanese quail of two
      lines that had been genetically selected over several generations for reduced
      (low stress, LS) or exaggerated (high stress, HS) plasma corticosterone response
      to brief mechanical restraint. At 32 wk of age, three bilateral traits were
      selected for study in each quail line. The characteristics chosen were length of
      the metatarsus (shank length, SHL), diameter of the shank (SHD) perpendicular to
      the spur, and distance between the auditory canal and the nares (face length,
      FL). Significantly greater bilateral trait size variances were associated with
      the measurement of SHL (P < 0.0088) and FL (P < 0.0016) in the HS line than in
      the LS line. SHD variances did not differ (P = 0.22) in quail of the HS and LS
      lines. These findings suggest that developmental instability (i.e., fluctuating
      asymmetry, FA) is more pronounced in HS quail than in LS quail. Previous studies
      have shown that not only do quail of the HS line show greater adrenocortical
      responsiveness to a wide range of stressors but that they are also more easily
      frightened than LS birds. Therefore, the line differences in FA found here may
      reflect the birds' differential responsiveness to chronic social and physical
      environmental stressors. The present findings also support previous suggestions
      that measuring asymmetries in bilateral traits could be an additional and valid
      method of assessing stress and of comparing phenotypic stability in selected
      populations.

PMID- 11194032
TI  - A model for persistency of egg production.
AB  - The objectives of our study were to propose a new definition for persistency of
      egg production and to develop a mathematical model to describe the egg production
      curve, one that includes a new measure for persistency, based on the proposed
      definition, for use as a selection criterion to improve total egg production.
      Persistency of egg production is an important determining factor for total egg
      production. Hens with the same total production, however, can exhibit different
      egg production curves because of differences in persistency. We propose a new
      definition for persistency of egg production: the number of weeks during which a
      level of constant production is maintained. No egg production model exists that
      includes a measure of persistency in terms of duration of time or that allows
      this measure of persistency to be derived from model parameters. It was
      necessary, therefore, to develop a new model to describe an egg production curve
      for a flock: equation [see text] and for an individual: equation [see text] where
      y(t) = egg production at time t, t1 and t2 = times at transition, r = duration of
      transition, y(p) = level of constant production, b4 = rate of decline in
      production, and P = persistency of constant production. These parameters measure
      directly the important biological characteristics of an egg production curve. To
      illustrate the model, six data sets were used: two from flocks (one pullet flock
      and one hen flock) and four from two pairs of individuals. The proposed
      definition of persistency should be important for genetic selection because it
      might be desirable to select for increased persistency. The novel approach to the
      definition and measure of persistency presented here should provide a better
      understanding of the relationship between the new measure of persistency and
      other characteristics of egg production.

PMID- 11194033
TI  - The effect of storage and strain of hen on egg quality.
AB  - Eggs from 31-wk-old ISA-White and ISA-Brown hens were sampled immediately after
      lay and after periods of storage of 1, 3, 5, and 10 d at room temperature. Longer
      periods of storage resulted in lower albumen weight and albumen height and higher
      albumen pH. Eggs from ISA-Brown hens had more albumen and shell than those from
      ISA-White hens, likely due to differences in selection history rather than due to
      pleiotropic effects of eggshell color. Within each line and storage period, the
      egg weight was more closely associated with albumen weight than with yolk or
      shell weight. The albumen height of eggs from ISA-Brown hens was lower than that
      of ISA-White hens at all storage times, but the albumen pH was not affected by
      the strain. Albumen height and albumen pH were statistically unrelated in fresh
      eggs, but the association became larger as the storage period increased,
      suggesting that albumen height measures factors that are present when the egg is
      laid and changes during storage, whereas albumen pH measures only the effect of
      storage.

PMID- 11194034
TI  - Infection and immunity in broiler chicken breeders vaccinated with a temperature
      sensitive mutant of Mycoplasma gallisepticum and impact on performance of
      offspring.
AB  - A comparison of infection and immunity to Mycoplasma gallisepticum (MG) in
      broiler chicken breeders vaccinated with a temperature-sensitive mutant of MG
      versus nonvaccinated chickens, and the impact on the performance of their
      offspring was conducted. Infection and immunity in breeders were assessed by
      culture and enzyme-linked immunoassay, respectively. However, performance in
      their offspring was assessed by studying MG infection in embryos, occurrence of
      infection titers to MG in relation to mortality, and feed conversion in the
      broilers. Five out of 10 broiler chicken breeder flocks raised on the same
      multiple-age farm with a long history of mycoplasmosis were vaccinated
      intraocularly once with a temperature-sensitive MG mutant vaccine (ts-11) at an
      average age of 7.5 wk; another five breeder flocks were left as unvaccinated
      controls exposed to field MG. The average recoveries of ts-11 organisms from
      tracheas and infraorbital sinuses of 41-wk-old vaccinates were 88 and 84%,
      respectively. No field MG organisms were recovered from vaccinates between 15 and
      41 wk of age. The recovery of field MG organisms from tracheas and sinuses of
      nonvaccinated chickens increased to an average of 100% at 41 wk of age. A
      significant decrease (P < 0.05) in the average percentage of MG-seroconverted
      breeders occurred in ts-11-vaccinated flocks in comparison with nonvaccinated, MG
      infected flocks at 15, 20, 23, 29, 32, 36, and 41 wk of age. The average
      infection prevalence by MG in the vitelline membrane of 7-d-old embryos produced
      by the five unvaccinated breeder flocks peaked at 79% when their respective
      hatching eggs were collected at 36 wk of breeder's age. Embryos of ts-11
      vaccinated flocks had zero prevalence of MG infection at all times between 29 and
      57 wk of breeder's age. Seroconversion to MG (average of 17.7%) at 42 d of age
      was only present in sera of 10 offspring broiler flocks of the nonvaccinated
      breeders. However, a lack of seroconversion to MG occurred in 10, 42-d-old
      offspring broiler flocks of the five ts-11-vaccinated breeder flocks. This lack
      was associated with a lower, better average feed-conversion ratio (2.05) (P <
      0.05) and a lower average mortality percentage (5.3%) (P < 0.05) in comparison
      with those obtained in the offspring of the five unvaccinated, MG-infected
      breeder flocks. The results indicate that vaccination of broiler chicken breeders
      with a temperature-sensitive mutant of MG prevented infection by field MG in
      tracheas and infraorbital sinuses of these breeders and in the vitelline
      membranes of their embryos. In addition, the broiler offspring of the vaccinated
      breeders had a better production performance.

PMID- 11194035
TI  - Allelic complementation between MHC haplotypes B(Q) and B17 increases regression
      of Rous sarcomas.
AB  - Major histocompatibility (B) complex haplotypes B(Q) and B17 were examined for
      their effect on Rous sarcoma outcome. Pedigree matings of B(Q)B17 chickens from
      the second backcross generation (BC2) of Line UCD 001 (B(Q)B(Q)) mated to Line
      UCD 003 (B17B17) produced progeny with genotypes B(Q)B(Q), B(Q)B17, and B17B17.
      Six-week-old chickens were injected with subgroup A Rous sarcoma virus (RSV). The
      tumors were scored for size at 2, 3, 4, 6, 8, and 10 weeks postinoculation. A
      tumor profile index (TPI) was assigned to each bird based on the six tumor
      scores. Two experiments with two trials each were conducted. In Experiment 1,
      chickens (n = 84) were inoculated with 30 pock-forming units (pfu) RSV. There was
      no significant B genotype effect on tumor growth over time or TPI among the 70
      chickens that developed tumors. Chickens (n = 141) were injected with 15 PFU RSV
      in Experiment 2. The B genotype significantly affected tumor growth pattern over
      time in the 79 chickens with sarcomas. The B(Q)B17 chickens had the lowest TPI,
      which was significantly different from B17B17 but not B(Q)B(Q). The data indicate
      complementation because more tumor regression occurs in the B(Q)B17 heterozygote
      than in either B(Q)B(Q) or B17B17 genotypes at a 15 pfu RSV dose and
      significantly so compared to B17B17. By contrast, the 30 pfu RSV dose utilized in
      the first experiment overwhelmed all genotypic combinations of the B(Q) and B17
      haplotypes, suggesting that certain MHC genotypes affect the immune response
      under modest levels of viral challenge.

PMID- 11194036
TI  - Dietary polyunsaturated fatty acids alter lymphocyte subset proportion and
      proliferation, serum immunoglobulin G concentration, and immune tissue
      development in chicks.
AB  - The effects of fat source on immune response of the offspring of the Single Comb
      White Leghorn laying hens were investigated. The laying hens were fed for 6 wk
      with a wheat-soybean meal basal diet with added sunflower oil (SO), animal oil
      (AO), linseed oil (LO), or menhaden fish oil (FO) at 5% (wt/wt). Upon hatching,
      the chicks (30/group) were given the same types of diets for 8 wk. The dietary
      SO, AO, and LO provided different n-6 to n-3 polyunsaturated fatty acids (PUFA)
      ratios. The FO and LO had ratios of n-6 to n-3 PUFA that were close but had
      different components of n-3 PUFA. The results demonstrated that the chicks fed LO
      or FO had significantly lower (P < 0.05) splenocyte proliferative response to
      ConA than the chicks fed SO or AO at either 4 wk or 8 wk of age, with a stronger
      (P < 0.05) suppressive effect produced by LO at 4 wk. A significantly lower (P <
      0.05) splenocyte response to PWM was produced by the chicks fed AO, LO, and FO
      compared with the chicks fed SO at 8 wk. The thymus lymphocyte proliferation in
      response to ConA at 4 wk was lower (P < 0.05) in the chicks fed AO, LO, and FO
      than in the chicks fed SO. Both LO and FO elevated (P < 0.05) the proportion of
      IgM+ lymphocytes in spleen, but only FO increased (P < 0.05) the serum IgG
      concentration. The LO elevated (P < 0.05) the percentage of CD8+ T-lymphocytes
      but not the ratio of CD4+ to CD8+ cells (P > 0.05) in spleen. Growths of thymus,
      spleen, and bursa were impacted significantly (P < 0.05) by the amount of dietary
      PUFA, the ratio of n-6 to n-3 fatty acids, and n-3 PUFA components.

PMID- 11194037
TI  - Effects of dietary conjugated linoleic acid and linoleic:linolenic acid ratio on
      polyunsaturated fatty acid status in laying hens.
AB  - A study was conducted to determine the effects of dietary conjugated linoleic
      acid (CLA) and the ratio of linoleic:linolenic acid on long-chain polyunsaturated
      fatty acid status. Thirty-two 31-wk-old White Leghorn hens were randomly assigned
      to four diets containing 8.2% soy oil, 4.1% soy oil + 2.5% CLA (4.1% CLA source),
      4.1% flax oil + 2.5% CLA, or 4.1% soy oil + 4.1% flax oil. Hens were fed the
      diets for 3 wk before eggs and tissues were collected for the study. Lipids were
      extracted from egg yolk and tissues, classes of egg yolk lipids were separated,
      and fatty acid concentrations of total lipids, triglyceride,
      phosphatidylethanolamine, and phosphatidylcholine were analyzed by gas
      chromatography. The concentrations of monounsaturated fatty acids and non-CLA
      polyunsaturated fatty acids were reduced after CLA feeding. The amount of
      arachidonic acid was decreased after CLA feeding in linoleic acid- and linolenic
      acid-rich diets, but amounts of eicosapentaenoic acid and docosahexaenoic acid
      were increased in the linolenic-rich diet, indicating that the synthesis or
      deposition of long-chain n-3 fatty acids was accelerated after CLA feeding. The
      increased docosahexaenoic acid and eicosapentaenoic acid contents in lipid may be
      compensation for the decreased arachidonic acid content. Dietary supplementation
      of linoleic acid increased n-6 fatty acid levels in lipids, whereas linolenic
      acid increased n-3 fatty acid levels. Results also suggest that CLA might not be
      elongated to synthesize long-chain fatty acids in significant amounts. The effect
      of CLA in reducing the level of n-6 fatty acids and promoting the level of n-3
      fatty acids could be related to the biological effects of CLA.

PMID- 11194038
TI  - Prediction of the effect of enzymes on chick performance when added to cereal
      based diets: use of a modified log-linear model.
AB  - A previous study demonstrated that a log equation could be used to predict the
      relationship between the amount of a crude enzyme added to a diet and chick
      performance. The objective of the current study was to determine if a
      modification of the original equation, in conjunction with a computer program,
      would overcome some of its limitations. The modified equation was Y = A + B log
      (CX + 1), where Y is the estimated performance value; A is the intercept that
      represents the performance without enzyme supplementation; B, the slope of the
      equation (performance change per log unit of an enzyme in the diet), is a measure
      of an enzyme efficacy; C is an amplified factor; and X is the amount of enzyme in
      the diet. The results demonstrated that the new model more accurately predicted
      chick performance than that of the original equation with correlations (r)
      between chick performance and amount of different enzymes added to the diet
      ranging from r = 0.80 to 0.99 (P < 0.05). In addition, the same trends were found
      when the model was used to assess the efficacy of a given enzyme added to corn-,
      wheat-, barley-, and rye-based diets or for combinations of two dietary
      components (rye and wheat). The model proposed in this study provides a new means
      of assessing the overall efficacy of an enzyme preparation. This model could be
      routinely used by enzyme and livestock producers to establish the best
      combination of different cereals and enzymes so as to maximize net returns.

PMID- 11194039
TI  - The effects of enzyme addition to broiler diets containing high concentrations of
      canola or sunflower meal.
AB  - The effects of two commercial enzyme products on the nutritive value of canola
      meal (CM) and sunflower meal (SFM) were determined in a classical AME bioassay
      with special emphasis on the utilization of nonstarch polysaccharides (NSP). The
      enzymes were added to semi-purified broiler grower diets based on corn and casein
      containing 35% CM or 35% SFM, respectively. Feed intake, growth, and AME of the
      diets were significantly (P < 0.001) affected by type of oilseed meal included in
      the diet. Birds fed the SFM-based diets had a significantly (P < 0.001) higher
      growth rate and AME and a lower feed conversion ratio (FCR) than did birds fed
      the CM-based diets. The addition of enzymes to either CM- or SFM-based diets had
      no significant effects on growth performance and AME; however, the addition of
      enzymes to CM-based diets resulted in a significant reduction in the
      concentration of soluble NSP in the jejunum (Enzyme A) or a significant reduction
      of total NSP in the jejunum (Enzyme B). The AMEn was significantly lower in diets
      containing CM supplemented with Enzyme B. The addition of enzymes to SFM-based
      diets significantly improved NSP digestion in the jejunum and protein digestion
      in the ileum. The results of this study indicate that commercial enzyme products
      had some effects in diets containing high concentrations of CM or SFM. However,
      these effects could only be seen after detailed analyses of feed and digesta and
      did not result in significant improvement in growth performance of broilers.

PMID- 11194040
TI  - Effect of pressure processing on amino acid digestibility of meat and bone meal
      for poultry.
AB  - In the future, it may become desirable or required to process meat and bone meal
      (MBM) under pressure to reduce human health concerns associated with bovine
      spongiform encephalopathy (BSE). Therefore, three experiments evaluated the
      effects of different processing pressures on the digestibility of amino acids
      (AA) in MBM when the pressure processing was done after typical rendering
      (Experiments 1 and 2) or during the initial rendering process of raw materials
      (Experiment 3). Processing pressures varied from 0 to 60 psi in experimental or
      commercial feather meal cookers. Increasing pressure during processing reduced
      MBM Cys concentrations in Experiments 1 and 2. True digestibilities of most AA
      were significantly decreased by increasing pressures in Experiments 1 and 2, and
      reductions were generally largest for Cys and Lys, particularly Cys, and
      increased with severity as pressure increased. For example, in Experiment 1, Cys
      digestibility decreased from 65 to 50 to 15%, and Lys digestibility decreased
      from 76 to 68 to 41% as the MBM was processed at 0, 30, and 60 psi, respectively,
      for 20 min. When the pressure processing occurred during the initial rendering of
      the MBM raw material (Experiment 3), a significant reduction in digestibility of
      most AA was observed only at 60 psi, and the decrease was much less than that
      observed in Experiments 1 and 2. Our results indicate that pressure processing of
      MBM decreases the digestibility of AA for poultry. Thus, pressure processing of
      MBM to reduce potential BSE infectivity will likely decrease the nutritional
      value of the MBM.

PMID- 11194041
TI  - Isoleucine imbalance using selected mixtures of imbalancing amino acids in diets
      of the broiler chick.
AB  - Three experiments were conducted to determine the isoleucine requirement of a
      broiler from the time of hatch to 16 d of age. Chicks in the experiments were fed
      an isoleucine-limiting diet composed of wheat and peanut meal as the primary
      protein sources; this diet was used to investigate various mixtures of amino
      acids as imbalancing agents for isoleucine. The isoleucine requirement for
      maximum weight gain and feed efficiency was determined on the basis of broken
      line regression analysis to be 0.63 to 0.65% of the diet or 3.28 to 3.38% of
      dietary protein. A similar diet, marginally limiting in isoleucine, was used to
      investigate the response of chicks to the addition of various mixtures of amino
      acids to the diet. Chicks that received a 5% dietary addition of 11 amino acids
      consisting of equimolar concentrations of leucine, valine, histidine, methionine,
      phenylalanine, tryptophan, tyrosine, alanine, glycine, serine, and threonine had
      significantly lower weight gain and feed consumption and a higher feed conversion
      ratio than did chicks fed the basal diet. These adverse effects were only partly
      prevented by an isoleucine supplement. The large neutral amino acids, histidine,
      methionine, phenylalanine, tryptophan, and tyrosine, accounted for most of the
      effect of the mixture. No effect of a mixture of leucine and valine or a mixture
      of the small neutral amino acids (alanine, glycine, serine, and threonine) at the
      same concentrations as those in the mixture of the 11 amino acids was observed.
      Lysine and arginine were the only two indispensable amino acids not present in
      the mixture of 11 amino acids. A subsequent experiment demonstrated that these
      amino acids did not become co-limiting with isoleucine when the diet was
      imbalanced with the amino acid mixture. These results indicate that an isoleucine
      imbalance in chicks is readily precipitated by excessive dietary concentrations
      of large neutral amino acids in diets that are otherwise marginally adequate in
      isoleucine.

PMID- 11194042
TI  - Effect of dietary protein intake during the pullet-to-breeder transition period
      on early egg weight and production in broiler breeders.
AB  - The effects of CP intake on broiler breeder hen performance were evaluated. A
      flock of pullets was reared in floor pens from 0 d to 20 wk of age. At 20 wk of
      age, 96 pullets were randomly assigned to one of three feeding regimens with 14,
      16, or 18% dietary CP. Daily feed allocation from 20 to 29 wk of age was
      identical for all three treatments and was based on the BW of the birds fed the
      16% CP diet. Photostimulation occurred at 22 wk of age. At 29 wk of age, the hens
      were killed for determination of carcass characteristics. Dietary protein intake
      did not influence BW or BW gain throughout the trial. There were no differences
      in age at sexual maturity among treatments. From 25 to 28 wk of age, the hens on
      the 16 and 18% CP treatments had a significantly greater egg weight than did hens
      in the 14% CP group. The 14% CP treatment was unable to sustain as high a level
      of egg production as the other two treatments at 29 wk of age. The number of
      settable eggs was also lowest for the 14% CP treatment. The CP level in the diet
      did not affect the weights of the Pectoralis major or minor. Carcass composition
      was also not different among the treatments. Increased levels of CP in the prelay
      and early lay diets increased egg size and production rate although had minimal
      effect on carcass and ovarian parameters.

PMID- 11194043
TI  - Efficacy of sperm mobility assessment in commercial flocks and the relationships
      of sperm mobility and insemination dose with fertility in turkeys.
AB  - Our objectives were to evaluate: 1) the efficacy of the Sperm Mobility Test on
      commercial turkey farms, and 2) the influence of sperm mobility phenotype on
      fertility when insemination parameters are varied. In research flocks,
      differences in sperm mobility among toms are predictive of fertility. We wanted
      to test the efficacy of this sire selection test in practical, real-world
      situations, evaluating its usefulness in terms of assessing large numbers of
      toms, different strains of turkeys, and variable management practices. Utilizing
      field study results, controlled studies were then conducted to improve test
      parameters. For the field trials, semen from each of 405 breeder toms (11 strains
      or lines) was evaluated either in duplicate (n = 285) or in triplicate (n = 120).
      Sperm mobility was normally distributed among all toms tested, except for one
      strain. Because the sperm mobility indices for toms evaluated in these field
      trials were higher than those observed in research flocks, the Sperm Mobility
      Test was modified to increase the separation between high and low sperm mobility
      phenotypes by increasing the concentration of Accudenz. To determine the effects
      of sperm mobility and insemination dose on sustained fertility through time, hens
      from a research flock were inseminated twice before the onset of lay with sperm
      from toms classified as high-, average-, or low-mobility in concentrations of 25
      to 400 million sperm per artificial insemination dose, and egg fertility was
      evaluated over a 5-wk period. Toms with the high-mobility sperm phenotype
      maintained higher fertility (P < 0.05) over the 5-wk period at all insemination
      doses compared with toms with low-mobility sperm. Toms with high-mobility sperm
      sired equal numbers of poults in a sperm competition study in which numbers
      favored low-mobility toms by 3:1. These results demonstrate that the Sperm
      Mobility Test can be used for on-farm evaluation of semen quality of toms in
      commercial flocks and that sperm mobility influences fertility and sire fitness.

PMID- 11194044
TI  - The effects of methylxanthines on the mobility of stored turkey sperm.
AB  - The mobility of pooled turkey sperm following various storage regimens was
      assessed by objectively measuring the ability of sperm to penetrate a 2% Accudenz
      [5-(N-2,3-dihydroxypropylacetamido)-2,4,6-tri-iodo-N,N'-bis(2,3
      dihydroxypropyl)isophthalamide] solution at 41 C. When semen was diluted with
      Beltsville poultry semen extender and stored at 5 C with agitation at 150 rpm,
      sperm mobility declined as the storage interval increased (P < or = 0.05), with
      mobility scores (mean +/- SEM) of 0.440+/-0.029, 0.374+/-0.031, 0.282+/-0.011,
      0.202+/-0.019, and 0.130+/-0.019 for 0-, 3-, 6-, 24-, and 48-h storage,
      respectively. For a 10-wk fertility trial using the same storage method, sperm
      mobility and fertilizing capacity of semen were significantly reduced following
      24-h storage compared with values for unstored semen. The sperm mobility scores
      were 0.404+/-0.051 and 0.101+/-0.046 for unstored and 24-h stored semen,
      respectively, whereas the percentage of fertilized eggs was 95.9+/-5.1 for
      unstored semen and 48.0+/-5.1 for 24-h stored semen. When caffeine or
      pentoxifylline was added to semen at 2.5, 5, or 10 mM, no significant effect on
      sperm mobility was seen, regardless of whether these compounds were added to
      unstored semen, were present during 6-h storage, or were added following the 6-h
      storage interval. These studies demonstrate that sperm mobility and fertilizing
      capacity of pooled turkey semen declines with storage, and that addition of
      caffeine or pentoxifylline either during or after storage does not affect sperm
      mobility.

PMID- 11194045
TI  - Paternal influences on turkey embryonic growth in the absence of changes in egg
      weight and eggshell conductance.
AB  - The hypothesis was proposed that embryonic growth could be influenced paternally
      in the absence of changes in egg weight or eggshell conductance. Sire families
      were established by selecting 11 sires based on blood sampling of approximately
      50 commercial turkey males. Southern blot analysis was used to identify the most
      distantly related individuals in the subpopulation. Five hen siblings or half
      siblings of the males were randomly assigned to each male to randomize effects of
      egg size and eggshell conductance. Artificial inseminations were performed weekly
      for 17 wk, using each sire with the assigned hens. Fertilized eggs were collected
      and set in incubators at biweekly intervals. Offspring were observed at the time
      of hatching for sex, body weight, and blood glucose concentration. Significant
      differences among sires were observed at hatching for poult weights and blood
      glucose concentration, and a significant correlation between the BW and glucose
      concentration was noted. Progeny of sires with the highest and lowest BW and
      blood glucose concentrations were subsequently compared. Mean BW of poults from
      different sires differed by as much as 10 g, although they were hatched from eggs
      of the same weight. Elevated blood glucose was associated with heavier BW;
      heavier heart, liver, and muscle weights; a rapid utilization of glycogen at
      pipping; and increased gluconeogenesis as measured by plasma organic acids and
      glucose-6-phosphatase activity. We conclude that poult embryonic growth differs
      even when not mediated by egg size and functional characteristics.

PMID- 11194046
TI  - Correlation of body weight with hatchling blood glucose concentration and its
      relationship to embryonic survival.
AB  - The negative correlation between selection for rapid growth and embryonic
      survival was investigated. Embryonic growth was assessed with hatchling weights
      of a closed population of commercial turkey breeders. Hatchling weights were
      highly significantly (P < 0.0001) and positively correlated with blood glucose
      concentrations at hatching. This relationship existed for both tom and hen
      poults. Significant differences among dams for hatchling blood glucose were
      observed. Further experiments examined dams selected for producing poults
      hatching with high (High) or low (Low) blood glucose concentrations. The High
      embryos were in larger-sized eggs with the same eggshell conductance but with
      significantly lower conductance constants than the Low embryos, suggesting that
      Low had longer incubation periods. High embryos grew faster than Low embryos with
      elevated organ glycogen concentrations. Organic acid analysis indicated elevated
      plasma alpha-ketoglutarate, urate, and beta-hydroxy butyrate concentrations,
      suggesting a greater reliance on gluconeogenesis for the High group. Posthatch
      growth was significantly positively correlated with hatchling blood glucose
      concentrations in toms but not in hens. Tom poults hatching with elevated glucose
      were heavier than low glucose hatch mates until 22 wk of age, but hen poults
      displayed no differences until 16 wk when High hens weighed less than Low hens.
      These data suggest that the negative correlation between rapid growth and
      embryonic survival is related to egg-shell conductance constants and embryonic
      energy metabolism.

PMID- 11194047
TI  - Improvement of hatchability of chicken eggs injected by blastoderm cells.
AB  - In our first experiment, we studied the effect of injection method of blastoderm
      cells (BC) into the subgerminal cavity of White Leghorn embryos on hatchability
      of chicken chimeras. Freshly laid eggs were injected through a hole made in the
      equatorial plane of the eggshell (Method A). In Method B, eggs were stored
      pointed end down for 5 to 7 d prior to injection, and a hole was cut in the blunt
      end of the eggshell. An advantage of Method B was that the early embryonic
      mortality was reduced (P < or = 0.01) and resulted in higher hatchability (41.0%;
      43/105) than Method A (9.8%; 14/143). In the second experiment, we studied
      chicken hatchabililty as influenced by windowing (no hole, Group 1; hole in the
      equatorial plane, Group 2; hole in the blunt end of egg, Groups 3 and 4) and egg
      turning (Groups 1 and 4) or not (Groups 2 and 3) during incubation. The
      hatchability percentages were as follows: 67.9 (Group 1) 0.0, (Group 2) 23.3,
      (Group 3), and 56.8 (Group 4). A statistically significant difference (P < or =
      0.05) was noted between Group 1 or 4 and the other groups. We found no
      statistically significant differences in the weight changes (g) but did note
      certain differences in the egg weight loss (%) among different egg treatments. In
      the third experiment, we investigated the influence of origins of BC donors:
      Rhode Island Red (RIR), Barred Plymouth Rock (BPR), and Green-legged
      Partridgelike (GP) on hatchability of putative and somatic chimera chickens. The
      hatchability of chimeras was dependent on the adequate assortment of BC of the
      donor and ranged from 7.4% (RIR) to 56.1% (GP). In the case of BC injection of
      the GP breed, good hatchability was accompanied by very high percentage (86.9;
      20/23) of somatic chimeras.

PMID- 11194048
TI  - Biliary glutathione secretion in male single comb white leghorn chickens after
      inhibition of gamma-glutamyl transpeptidase.
AB  - The amount of hepatic export of glutathione into bile and the importance of gamma
      glutamyl transpeptidase (gammaGT) activity for catabolizing glutathione in the
      bile duct, have not been reported previously for domestic fowl. Therefore, the
      primary objective of this study was to establish baseline values of biliary
      glutathione, and a secondary objective was to investigate the effect of acivicin
      (AT-125; a gammaGT inhibitor) on biliary glutathione in the chicken. Cannulae
      were placed in the carotid artery (to measure blood pressure) and into the left
      bile duct of anesthetized male Single Comb White Leghorn (SCWL) chickens (n = 5;
      17 to 18 wk). The right bile duct was clamped between the liver and gall bladder.
      Bile samples were collected at 15-min intervals into microcentrifuge tubes (on
      ice) containing serine borate and iodoacetic acid to prevent glutathione
      oxidation. After two samples were obtained to establish baseline values,
      retrograde infusion of AT-125 (30 microLmol/kg BW) was given to inhibit gammaGT
      activity in the biliary tree. Systemic blood pressure of the birds remained above
      100 mm Hg throughout each experiment (90 to 120 min). Bile flow did not change
      significantly during the experiment and ranged between 0.15+/-0.03 and 0.20+/
      0.07 mL/15 min per kg BW. Baseline biliary secretion values of reduced
      glutathione (GSH), oxidized glutathione (GSSG), and total glutathione (TGSH) were
      4.6, 5.9, and 17 nmol/min per kg BW. After AT-125 infusion, biliary GSH levels
      increased from 15 to 31 nmol/min per kg BW, indicating that considerable gammaGT
      mediated catabolism of GSH occurred in the biliary tree of SCWL males. These
      results indicate that considerable turnover of GSH in the livers of domestic
      chickens is due to biliary excretion and that substantial recovery of GSH occurs
      through activity of gammaGT in the biliary tree.

PMID- 11194049
TI  - Mineral, amino acid, and hormonal composition of chicken eggshell powder and the
      evaluation of its use in human nutrition.
AB  - Chicken eggshell powder (ESP) might be an attractive source of Ca for human
      nutrition. To study its nutritional value, we analyzed minerals, amino acids, and
      hormones in commercially available Slovakian ESP. The mineral composition was
      compared with three Dutch ESP samples that differed in feed and housing, a
      Japanese ESP, refined CaCO3, and an oyster shell supplement. Chicken eggshell
      powder contains high levels of Ca (mean +/- SD/g EPS: 401+/-7.2 mg) and Sr (372+/
      161 microg) when compared with recommended or estimated daily intakes for humans
      51 to 70 yr of age. Levels of potentially toxic Pb, Al, Cd, and Hg were very low
      as were levels of V, B, Fe, Zn, P, Mg, N, F, Se, Cu, and Cr. Large differences in
      the levels of F, Se, Cu, Cr, and Sr in the Dutch and Slovakian ESP indicated a
      strong influence of feed and environment. The small protein fraction of ESP
      contains high levels of Gly and Arg. Furthermore, small amounts of transforming
      growth factor-beta1 (0.75 to 7.28 ng/g ESP), calcitonin (10 to 25 ng/g ESP), and
      progesterone (0.30 to 0.33 ng/g ESP) were detected. Estradiol-17beta and
      calcitriol were below the detection limit of the methods used. Compared with ESP,
      refined CaCO3 was found to contain increased levels of Cd, and the oyster shell
      supplement showed increased levels of Al and Cd. Therefore, ESP seems to have a
      beneficial composition with about 39% of elemental Ca, relevant amounts of Sr,
      and low levels of Al, Pb, Cd and Hg. It may be used as a Ca source in human
      nutrition.

PMID- 11194050
TI  - Surface finishes on stainless steel reduce bacterial attachment and early biofilm
      formation: scanning electron and atomic force microscopy study.
AB  - Three common finishing treatments of stainless steel that are used for equipment
      during poultry processing were tested for resistance to bacterial contamination.
      Methods were developed to measure attached bacteria and to identify factors that
      make surface finishes susceptible or resistant to bacterial attachment and
      biofilm formation. Samples of the treated surfaces (sand-blasted, sanded, and
      electropolished) were exposed to natural bacterial populations from chicken
      carcass rinses to allow growth of bacteria and development of biofilms on the
      surfaces. The kinetics of bacterial growth during surface exposure was followed
      by UV-visible spectrophotometry, and counts of bacteria and early biofilm
      formation were measured following scanning electron microscopy (SEM). The surface
      morphology of the samples was analyzed by atomic force microscopy (AFM) with
      samples from each of the batches of treatments used in the SEM studies. Relative
      differences in the surface morphology, including fractal dimensions, Z ranges,
      roughness, and other measurements corresponded by treatment with the differences
      in reduction of bacterial counts shown by SEM. The surface types varied in
      affinity for bacteria, and both physical and electrochemical treatments improved
      resistance of stainless steel to bacterial attachment. Electropolished stainless
      steel was the least rough surface and showed significantly fewer bacterial cells
      and beginning biofilm formations than the other treated surfaces. Food safety
      could be improved if bacterial populations could be reduced during processing by
      increasing the use of materials that are resistant to bacterial contamination.
      These findings will aid equipment manufacturers and processors in selecting
      materials and finishes that are most resistant to bacteria and biofilm formation.

PMID- 11194051
TI  - Effect of dry honey on oxidation in turkey breast meat.
AB  - The effect of adding dry honey to turkey breast meat on oxidative stability was
      measured using TBA, volatile headspace, and oxidative stability index. Ground
      turkey breast meat was mixed with different concentrations of dry honey (0, 1, 5,
      10, 15, and 20%) then cooked in polyethylene bags to 72 C. Oxidative stability
      measurements were taken for raw meat and cooked meat and for cooked meat after 48
      h of storage at 4 C. The proximate composition of the raw meat was 73.9%
      moisture, 23.2% protein, and 1.3% fat. Gas headspace analysis determined hexanal
      to be the most abundant volatile compound. Hexanal content decreased as the
      amount of added honey increased in both freshly cooked meat and in meat stored
      for 48 h at 4 C. The TBA values also decreased with increasing levels of added
      honey in the freshly cooked and 48-h-stored meats. The percentage inhibition of
      oxidation for the 5, 10, 15, and 20% samples increased from 50 to 76% for the
      freshly cooked meat and from 34 to 88% for the 48-h-stored meat. The oxidative
      stability index increased with increasing concentrations of honey from 0.28 h
      (control) to 7.73 h (20% honey). Addition of up to 15% honey inhibited the
      development of oxidative compounds in cooked turkey meat, with little further
      inhibition observed compared to 20% honey.

PMID- 11194052
TI  - Shelf life of ground poultry meat stored under modified atmosphere.
AB  - The shelf life of ground chicken and turkey meat packaged under a modified
      atmosphere containing O2 and a high level of CO2 (62% CO2, 8% O2, and 30% N2; gas
      1), or a gas mixture without O2 (20% CO2 and 80% N2; gas-2) was evaluated for 20
      d at 1 C. Meat packaged under gas-2 maintained a higher a* value (redness)
      throughout the experiment and generally had a more appealing color than the meat
      packaged using gas-1. Microbial populations were assessed after 8, 12, and 15 d
      of storage. Total aerobic mesophilic counts were higher in chicken meat than in
      turkey throughout storage. Coliforms and Escherichia coli counts were lower in
      meat packaged under gas-1. After 15 d of storage at 1 C, Brochothrix
      thermosphacta was detected only in ground chicken meat packaged using gas-2. Meat
      packaged under the gas mixtures tested had similar counts for presumptive
      pseudomonads, Staphylococcus aureus, and lactic acid bacteria. These results
      indicate that an appropriate gas mixture can maintain a desirable color in ground
      poultry meat but offers no guarantees with respect to the microbial profile of
      meat.

PMID- 11194053
TI  - Validation of thiosulfate for neutralization of acidified sodium chlorite in
      microbiological testing.
AB  - At low pH, acidified sodium chlorite (ASC) has antimicrobial activity against a
      variety of foodborne contaminants. To evaluate the antimicrobial efficacy of ASC
      at specific time points posttreatment, it is necessary to halt the action of the
      disinfectant by removing residual chlorite or by increasing the pH. In this
      study, thiosulfate was investigated at varying concentrations for its effect on
      microbial survival and was investigated at a concentration of 0.1% in the
      presence of ASC for its effect on the antimicrobial and chemical activity of the
      test solution. Additionally, sodium thiosulfate was tested in two buffering
      systems, buffered peptone water (BPW) and Butterfield's phopshate buffer (BPB),
      for its ability to inactivate ASC chemistry. The results of this study show that,
      at a concentration of 0.1%, sodium thiosulfate has no deleterious effect on
      Escherichia coli survival and is effective in halting the antimicrobial action of
      ASC by eliminating the production of residual chlorite. The BPW alone and BPB in
      combination with thiosulfate were found to be effective inactivators of ASC
      chemistry.

PMID- 11194054
TI  - HeartSaver VAD: a totally implantable ventricular assist device. Results of in
      vivo studies.
AB  - Currently, the most widely utilized ventricular assist devices (VADs) require
      percutaneous connections and are located either externally (e.g., Thoratec,
      Abiomed) or intra-abdominally (e.g., Novacor, TCI). These attributes have been
      implicated in a variety of complications (infection, thromboembolic,
      gastrointestinal, etc.). To address these concerns, a totally implantable VAD
      that requires no percutaneous connections and can be implanted in the left hemi
      thorax has been developed. The developed device has undergone in vivo evaluation
      as part of the design and development process. A total of 43 implants in the
      bovine model, with 5 device versions, have been conducted between July 1992 and
      February 2000. These studies successfully have demonstrated several important
      aspects of the developed device, including 1) feasibility of a totally
      implantable system; 2) capability of the device to support a dysfunctional heart;
      and 3) ability of the device to provide flows up to 10 L/min in a physiological
      setting. The studies to date have played a vital role in the design and
      development process as well as demonstrating the feasibility of a totally
      implantable intrathoracic VAD. Based on these studies, design optimization was
      conducted, resulting in the development of the pre-clinical version of the device
      in preparation for clinical trials.

PMID- 11194055
TI  - In vitro comparison of inhibitors of inducible nitric oxide synthase in a
      macrophage model.
AB  - Nitric oxide (NO) has been shown to decrease cardiac performance, induce global
      hypotension, and generate oxygen free-radicals. Nitric oxide is produced from the
      conversion of L-arginine to L-citrulline by inducible nitric oxide synthase
      (iNOS) and is a component of many cellular second messenger systems. It is not
      clearly understood if NO and iNOS are compensatory mechanisms or pathological
      processes in heart failure, and this study was designed to understand better
      inhibition of iNOS in a cell culture model. Inhibitors of iNOS were compared for
      in vitro capability of inhibiting the production of NO. Ethanol and S
      methylisothiourea (MITU) were applied to macrophage populations in 120 microM and
      1 microM, 100 and 10 nM for an 8-h incubation. Level of iNOS expression was
      measured in the ethanol-treated populations using an anti-iNOS primary antibody
      with a fluorescent labeled secondary antibody. Serum nitrites were measured in
      both treatment groups by the nonenzymatic Griess method to determine enzyme
      function. Our data indicate that ethanol demonstrates a stimulation and
      simultaneous inhibition of iNOS during an 8-h incubation. No dose-dependent
      correlation between amount of serum nitrites produced and ethanol treatment was
      observed. However, MITU demonstrated a clear inhibition of iNOS at 120 microM
      with a serum nitrite value of 25.7002 +/- 0.0647, with control values of 24.3421
      microM. Lower concentrations of MITU also demonstrated no correlation. Although
      both agents display inhibitory effects upon iNOS, MITU seems to have no apparent
      simultaneous stimulation and may hold more potential as a post-translational
      inhibitor of iNOS.

PMID- 11194056
TI  - Co-administration of aprotinin and epsilon-aminocaproic acid during
      cardiopulmonary bypass in a swine model.
AB  - Despite the beneficial effects of pharmacological interventions to prevent
      bleeding and to reduce the need for autogeneic blood, there are concerns that
      these agents induce a prothrombotic state. The purpose of this study was to
      examine the coagulation phenomena influenced by the coadministration of epsilon
      aminocaproic acid (EACA) and aprotinin during cardiopulmonary bypass (CPB). A
      swine model of CPB was utilized in this study. During 120 min of CPB, treatment
      animals (N = 5) received 6 x 10(6) Kiu of aprotinin and 30 grams of EACA;
      whereas, control animals (N = 3) received an equal volume of 0.9% saline. Indices
      of thrombogenicity included hematological variables, gross pathology, and circuit
      examination for the presence of thrombus. The application of both
      antifibrinolytics resulted in an increase use of heparin. Total heparin
      requirements were significantly different between treatment group (58,800 +/-
      3493 iu) versus control group (51,000 +/- 3464 iu). D-dimer concentration was
      also significantly higher in the control group (500-1000 ng mL-1) than in the
      treatment group (250-500 ng mL-1) at 5 and 30 min postprotamine. Other
      coagulation markers tested were not observed to be statistically significant
      between groups. Thromboelastographic (TEG) index decreased in the treatment group
      during the surgical procedure and bypass from 2.74 +/- 2.9 to -1.36 +/- 4.1 as
      compared to an increase from 2.62 +/- 2.9 to 4.05 +/- 0.4 in the control group.
      Pathologic analysis revealed occurrences of thrombus formation in small vessels
      in the lung and kidney glomeruli of treatment animals. The concurrent use of both
      aprotinin and EACA may induce a prothrombotic or coagulant state as determined by
      histological assessment.

PMID- 11194057
TI  - Technique for routine use of heparin bonded circuits with a reduced
      anticoagulation protocol.
AB  - The use of heparin-bonded cardiopulmonary bypass circuits (HBCs) with reduced
      anticoagulation protocol during cardiac surgery attenuates some of the adverse
      pathophysiologic responses to cardiopulmonary bypass (CPB). The strategies of how
      to maximize improvements in clinical outcomes using this technique are still
      debated. This article describes in detail a comprehensive approach to strategies
      developed at Boston Medical Center and the West Roxbury Veteran Affairs Medical
      Center in over 4000 cases in which HBC with a reduced anticoagulation protocol is
      used routinely. Important elements of this technique include elimination of
      cardiotomy reservoir during coronary artery bypass graft surgery (CABG),
      autologous blood priming, normothermic CPB, and precise heparin and protamine
      titration. Adaptation and variation in this technique to specific clinical
      situations is also highlighted.

PMID- 11194058
TI  - The effects of nitric oxide on coagulation during simulated extracorporeal
      membrane oxygenation.
AB  - Extracorporeal membrane oxygenation (ECMO) is associated with profound
      alterations in hemostasis, with platelet dysfunction often being implicated as a
      causative factor for transfusion. Nitric oxide (NO) has shown to be a rapid yet
      temporary inhibitor of platelet function. The purpose of this study was to
      evaluate the effects of NO on platelet number and function in an in vitro ECMO
      model. Eight silicone membrane oxygenators were primed with fresh, heparinized,
      bovine blood and allowed to circulate for 48 hours. The treatment group (NO)
      consisted of four oxygenators that had an end concentration of 20 ppm NO applied
      to the sweep gas. Platelet counts, methemoglobin levels, plasma-free hemoglobin
      levels, activated clotting times, and thromboelastographic (TEG) studies were
      performed at baseline, 1, 6, 12, and 24 h. Scanning electron microscopy (SEM) was
      performed on sample areas from each oxygenator. The treatment group maintained an
      average of 25% higher platelet counts than the control group (85.1 +/- 32.0, x
      10(3) versus 66.5 +/- 30.9 x 10(3)) although statistical significance was not
      achieved. Methemoglobin levels were significantly elevated in the treatment
      circuit at hours 12 and 24 (p < .05). This could be attributed to the lack of a
      biological interaction that would break down this toxic by-product. TEG indices
      steadily declined in both groups from baseline (-0.4 +/- 3.6) to (-17.2 +/- 3.3 p
      < .0007) treatment and (-20 +/- 4.5, p < .0001) control, with the treatment
      circuit maintaining only slightly improved indices over the most of the study.
      SEM data showed increased fibrin and cellular deposits in the control group (p =
      .05) when compared with the treatment group. NO added to the sweep gas of a
      simulated ECMO circuit at 20 ppm had little effect on the maintenance of platelet
      number and function.

PMID- 11194059
TI  - A cardiopulmonary bypass perfusion technique for the surgical repair of aortic
      type I dissections requiring the elephant trunk procedure.
AB  - The effect of cerebral and spinal cord protection by a modified perfusion
      technique during the elephant trunk procedure was assessed. Between 1997 and
      1998, six patients underwent selective cerebral perfusion (SCP) and lower half of
      the body perfusion (LBP), in which the right subclavian and left femoral arteries
      were separately cannulated and perfused by individual pump heads. Moderate
      systemic cooling was used (nasal temp. 20-30 degrees C; rectal temp. 23-26
      degrees C). The open distal aortic repair was performed using only the selective
      cerebral perfusion; while the aortic arch reconstruction was performed using both
      selective cerebral and lower half of the body simultaneous perfusion. Blood
      oxygen saturation of the left jugular vein (SjO2) and regional oxygen saturation
      cerebral (rSO2) in the front region of the brain, was monitored along with the
      pressure of the left temporal superficial and femoral artery. The mean
      cardiopulmonary bypass time was 136 minutes, with a mean arrest time of 92
      minutes. Mean duration of isolated selective cerebral perfusion was 23 minutes,
      with flow rates of 5-8 mL/kg/min; a left temporal superficial artery pressure of
      50 mmHg; SjO2 65-80%, and rSO2 58-72%. Mean duration of simultaneous selective
      cerebral and lower half of the body perfusion was 27 minutes; cerebral flow rates
      5-8 mL/kg/min; the left temporal superficial artery pressure of 45-50 mmHg; SjO2
      70-85% and rSO2 55-76%. At the same time, lower half of the body flow rates were
      maintained within 30-50 mL/kg/min; with a femoral artery pressure 50-80 mmHg.
      Mean extubation time was 28 hours; mean ICU time was 4.5 days. There were no
      neurologic complications in any patient. All patients survived the operation and
      were discharged from the hospital. This modified perfusion technique of SCP and
      LBP worked well and provided satisfactory cerebral and spinal cord protection.

PMID- 11194060
TI  - Cost-benefit of trained transport teams: estimates for head-injured children.
AB  - INTRODUCTION: Care during transport influences the outcome of head-injured
      children. Secondary adverse events, e.g., hypotension and hypoxia, worsen
      morbidity and mortality. Trained transport teams lower the incidence of such
      secondary "insults." OBJECTIVE: To estimate the cost-benefit of improved care
      from trained escorts. METHODS: The setting was a provincial air ambulance service
      during transition to trained pediatric escort paramedics. A retrospective review
      of transport and hospital records for a 12-month period was conducted. All
      children with head injuries (n = 43) transported to tertiary care [11 by
      untrained escorts (UE), 32 by trained escorts (TE)] were enrolled. Severity of
      injury was classified by Glasgow Coma Score (GCS); incidence of adverse events
      was counted and cost of change of severity resulting from preventable insults was
      estimated using published care costs. RESULTS: There were 13 preventable insults
      in six patients (55%) in the UE group and five preventable insults in four
      patients (12%) in the TE group (p<0.05). Among those in the UE group, two changed
      in severity from moderate to severe, one moderate worsened (decrease in GCS of 2
      or more), and two severe worsened. In the TE group, there were no changes >1.
      Cost-benefit estimates based on change in severity were $136,000 (median) to
      $238,000 (mean). CONCLUSION: Significant cost-benefit likely accrues from
      training escorts who transport children with significant head injuries to
      tertiary care.

PMID- 11194061
TI  - Patient status and time to intubation in the assessment of prehospital intubation
      performance.
AB  - Assessment of paramedic endotracheal intubation (ETI) performance often does not
      account for varied clinical conditions or the time required to complete the
      procedure. OBJECTIVE: To demonstrate the utility of patient status and time to
      intubation (TTI) for evaluating prehospital ETI performance. METHODS: Paramedic
      charts were reviewed for the period January-December 1998. Patient clinical
      status was defined as cardiac arrest (absence of perfusing rhythm) or non-cardiac
      arrest (presence of perfusing rhythm). Method, route, and success of ETI were
      noted. The TTI was determined as the elapsed time from on-scene arrival to
      securing of the endotracheal tube. Time elapsed from on-scene arrival to
      emergency department arrival was noted for instances of failed ETI. Statistical
      analysis was performed using chi-square and survival analysis (Kaplan-Meier
      estimator). RESULTS: Computer records were available for 26,026 patient contacts.
      Of 893 documented ETI attempts, 771 (86%) were successful. The ETI success rate
      was significantly higher (p<0.001) for cardiac arrests (551 of 591, 93.2%) than
      for non-cardiac arrests (220 of 302, 72.9%). Median TTIs were 5 minutes (95% CI:
      5, 5) for cardiac arrests and 17 minutes (95% CI: 14, 20) for non-cardiac
      arrests; this difference was significant (p<0.001). For non-cardiac arrests, ETI
      success was significantly (p = 0.002) higher for orotracheal intubation (OTI)
      (168 of 214, 78.5%) than for nasotracheal intubation (NTI) (52 of 88, 59.1%).
      Median TTIs were 15 minutes (95% CI: 13, 17) for OTI and 25 minutes (95% CI: 23,
      27) for NTI; this difference was significant (p = 0.002). For non-cardiac
      arrests, the difference i

PMID- 11194062
TI  - EMS dispatch.

PMID- 11194063
TI  - Which emergency medicine journals should EMS professionals read?

PMID- 11194064
TI  - Visits to home environments by emergency medical services: a statewide study.
AB  - Understanding out-of-hospital transport demographics would clarify the
      opportunities for injury surveillance and prevention. OBJECTIVE: To test the
      hypotheses that there are demographic differences in home vs. non-home emergency
      medical services (EMS) scene transports and that among age groups there are
      differences in demographics. METHODS: Data were extracted from the EMS State
      Ambulance Transport database of all reported during 1995. Transports from patient
      homes were compared with transports from all non-home scenes. Data extracted
      included age, gender, race, and type of complaint. Subgroup analysis was
      performed based on age groups in nonvehicular cases, safety problems, and
      interpersonal violence. Results were compared using a two-tailed chi-square with
      significance at p<0.05. Odds ratios (ORs) and 95% confidence intervals (95% CIs)
      were calculated for significant differences. RESULTS: The study included 118,131
      transported patients: 13% were children, 49% were adult between 18 and 64 years,
      and 38% were elder; 13% were African American, 82% were white, and 5% were other;
      47% were male and 53% were female. Fifty-eight percent of the transports were for
      safety problems, and 17% were for interpersonal violence. Of the 118,131
      transports, 56,812 (48%) were from patients' homes and 61,319 were not. Compared
      with EMS transports from non-home scenes, fewer home EMS transports were for
      injury (p<0.01, OR = 0.18, 95% CI = 0.17-0.19) and more home EMS transports were
      for illness (p<0.01, OR = 5.64, 95% CI = 5.49-5.79). There was no clinically
      significant difference in age, race, or gender. For all non-vehicular injury
      transports, the reason was more likely safety problems than interpersonal
      violence (58% vs. 17%); however, there was no difference in the percentages of
      type of call between the home and non-home transports. Home EMS transports were
      more likely interpersonal violence problems among adult patients less than 65
      years old; however, among the old and young, the problems were more likely to be
      safety-related. CONCLUSION: Forty-eight percent of all EMS transports are from
      the home. Only 18% of these EMS home transports are for injury-related problems.
      In general, EMS injury transports are more likely related to safety than to
      interpersonal violence. Among the home EMS transports, more than 50% of
      transports for young and old patients are safety-related. A large proportion of
      the home EMS transports for adults less than 65 years of age, however, are for
      interpersonal violence.

PMID- 11194065
TI  - Diversion of ALS ambulances: characteristics, causes, and effects in a large
      urban system.
AB  - OBJECTIVE: To characterize the reasons for and effects of diversions of advanced
      life support (ALS) ambulances in a large urban area with a high concentration of
      receiving hospitals. METHODS: A retrospective study was performed in a large
      urban region during a consecutive three-month period. Diversion was defined as
      the ALS transport of a patient to an emergency department (ED) other than the
      designated primary receiving facility. Case-matched concurrent cohorts of
      patients who were and were not diverted were studied to establish emergency
      medical services (EMS) time intervals, including total prehospital interval
      (TPI), on-scene interval (OSI), and patient transfer interval (PTI); age; gender;
      Glasgow Coma Score (GCS); ALS interventions; and insurance status. The reasons
      for diversion and the chief complaints of diverted patients were also studied.
      RESULTS: During the study period, 2,534 ALS runs occurred, of which 147 (5.8%)
      were diverted. Twenty-four (16.3%) diversions had incomplete run times, leaving
      123 (83.7%) for analysis. The most common chief complaints of diverted patients
      were shortness of breath (SOB), chest pain (CP), and altered mental status (AMS).
      The most common reason for diversion was special consideration (SC), defined as a
      diversion requested by a patient, family member, law enforcement officer, or
      private medical doctor. Diverted ambulances had significant increases in TPI,
      36.4 [95% confidence interval (95% CI) 35.1-37.7] vs. 33.4 [95% CI 32.13-34.7],
      and PTI, 10.3 [95% CI 9.4-11.2] vs. 7.9 [95% CI 7.2-8.6], compared with
      nondiverted ambulances. Further analysis demonstrated that SC diversions
      accounted for all of the increases in TPI (p<0.001) and PTI (p<0.001) when
      compared with other types of diversions and nondiverted transports. CONCLUSION:
      "Special consideration" was the most common reason for diversion in this study.
      Special consideration diversions increased TPI and PTI, causing delays in arrival
      to the ED and decreased ALS ambulance availability.

PMID- 11194066
TI  - The emotional content and cooperation score in emergency medical dispatching.
AB  - BACKGROUND: A common belief regarding scripted-protocol-driven emergency medical
      dispatch is that the caller is "too hysterical" or "too uncooperative" to allow a
      structured interrogation or to receive and act upon dispatch life support
      instructions. OBJECTIVES: To examine the emotional content and cooperation scores
      (ECCSs) of callers in more than 6,000 cases from two communication centers and to
      investigate the relationships between ECCS and caller party, incident nature,
      time of day, and geographical location. METHODS: The ECCS has five levels: 5,
      uncontrollable, hysterical; 4, uncooperative, not listening, yelling; 3,
      moderately upset but cooperative; 2; anxious but cooperative; and 1, normal
      conversational speech. The authors tabulated the ECCS as recorded during case
      review for a random sample of each center's ongoing quality assurance programs.
      Statistical tests were used to identify the presence of relationships between
      ECCS and caller party, arrest/nonarrest situations, time of day, and geographical
      location. RESULTS: Regardless of the caller party, the type of call, the time of
      day, or the geographical location, the mean ECCS of emergency callers is
      extremely low, indicating that most emergency callers are, in fact, very calm.
      The average ECCS computed from more than 3,000 cases from British Columbia was
      1.05; the average score from almost 3,500 cases from New York State was 1.21.
      CONCLUSION: While relationships between ECCS and the different parameters were
      noted, the differences were so small as to be of little or no use as additional
      information to assist with complaint triage. The low overall ECCS shows that the
      typical caller who requests emergency medical assistance is calm enough to be
      interrogated in a scripted and structured fashion, and is cooperative enough to
      be responsive to dispatch life support instructions.

PMID- 11194067
TI  - Utilization of air medical transport in a large urban environment: a
      retrospective analysis.
AB  - OBJECTIVE: To determine the utility of air medical transport in a large urban
      environment. METHODS: The authors conducted a retrospective analysis of all air
      medical transports of patients in the Fire Department of the City of New York EMS
      (emergency medical services) Command for the period of January 1, 1996, to
      December 31, 1999. These data were evaluated for frequency of air medical
      transport, patient condition at time of flight, and necessity of air evacuation.
      RESULTS: During the study period, some form of air medical transport was used 182
      times. Of this number, 32 were for transports of patients from a scene of an
      incident to a hospital within New York City; 18 for interfacility transport of
      patients from a hospital facility within New York City to another facility within
      New York City; 122 for interfacility transfers of patients from medical
      facilities outside of the New York City area to a facility in New York City; and
      ten for transport of patients from New York City medical facilities to facilities
      out of the area. CONCLUSION: The Fire Department of the City of New York EMS
      Command utilizes air medical evacuation for patient transports very infrequently.
      The parameters of New York City's large urban environment may not be conducive to
      air medical transport. These data seem to be consistent with experiences of other
      large urban cities.

PMID- 11194068
TI  - Prehospital rapid-sequence intubation.

PMID- 11194069
TI  - Performance of retrograde intubation in a multiple-trauma patient.

PMID- 11194070
TI  - The closing and evacuation of Flagler County, Florida: rapid emergency medical
      services system response to a unique problem.

PMID- 11194071
TI  - Acute coronary syndrome: pharmacotherapy.
AB  - Acute coronary syndrome (ACS) refers to the spectrum of cardiac disease, from
      unstable angina to ST-segment-elevation myocardial infarction. In the emergency
      medical services (EMS) setting, ACS may be more broadly thought to include
      patients with chest pain or other symptoms believed to have a cardiac origin who
      have evidence of ischemia or acute myocardial infarction on a 12-lead
      electrocardiogram, or symptomatic patients with a previous cardiac event or known
      cardiac disease. Pharmacologic management of these patients is based on the use
      of three primary classes of drugs: those that affect clotting, those that
      establish and maintain hemodynamic control, and those that relieve pain. Many of
      these agents have been evaluated in large clinical trials for in-hospital use,
      and a number of ongoing studies are assessing their efficacy in the prehospital
      setting. The appropriateness of prehospital use of specific agents within each
      class depends on proper patient selection, the necessity of immediate
      intervention, ease of use in the field, expertise of EMS personnel, and cost
      effectiveness of therapy. This consensus group reviewed agents from all three
      classes (including aspirin, GPIIb/IIIa inhibitors, unfractionated and low
      molecular-weight heparins, fibrinolytics, beta-adrenergic blockers, calcium
      antagonists, nitrates, and morphine) for their overall indication, applicability
      to the prehospital setting, and current prehospital use.

PMID- 11194072
TI  - Predicting survival in pediatric trauma patients receiving cardiopulmonary
      resuscitation in the prehospital setting.
AB  - OBJECTIVES: To determine survival in pediatric trauma patients receiving
      cardiopulmonary resuscitation (CPR) in the prehospital setting and to identify
      subgroups of patients who may have increased survival rates. METHODS: Records
      were obtained from the National Pediatric Trauma Registry on all pediatric trauma
      patients (age <19 years) over an 82-month period who received CPR at the scene of
      the injury. Data were recorded as to type of injury, need for additional CPR at
      the receiving hospital, and intubation in the field. Patient outcome was defined
      as: dead on arrival, dead at trauma center discharge, or alive at trauma center
      discharge. Univariate and logistic regression analyses were performed to identify
      statistical differences in survivors compared with nonsurvivors. RESULTS: Seven
      hundred twenty-nine patients were identified. The median age was 7.0 years, with
      a mean of 7.9 years; 62% were male, 37% were female, and 1% had no gender
      recorded. Age and gender distributions were not statistically different for the
      three outcomes. Eighty-seven patients (12%) were dead on arrival and an
      additional 458 (63%) were dead at trauma center discharge, while 184 (25%) were
      alive at trauma center discharge. Motor vehicle crashes accounted for 27% of
      admissions, and pedestrians struck by vehicle accounted for 23%. Intentional
      violence accounted for 18% of the accrued patients. Predictors of death in the
      patients who were alive at admission were penetrating injury (p = 0.001) and
      requirement of additional CPR at the trauma center (p = 0.001). Prehospital
      intubation was associated with decreased survival. Of the 641 patients who
      arrived at the hospital alive, 29% lived to trauma center discharge, but of the
      534/641 who received prehospital intubation, only 19% lived. The mean Functional
      Independence Measure (FIM) scores were 38.9 (range 18 to 126). CONCLUSIONS:
      Survival of pediatric trauma patients after receiving CPR in the prehospital
      setting is significantly higher than expected in adult patients. Penetrating
      trauma, the need for additional CPR at the trauma center, and prehospital
      intubation are all predictors of a worse outcome.

PMID- 11194073
TI  - Optimal prehospital cardiovascular care.
AB  - Optimal prehospital cardiovascular care may improve the morbidity and mortality
      associated with acute myocardial infarctions (AMIs) that begin in the community.
      Reducing the time delays from AMI symptom onset to intervention begins with
      maximizing effective patient education to reduce patient delay in recognizing
      symptoms and seeking assistance. Transportation delays can be minimized by
      appropriate use of 911 systems and improving technological 911 support. Patient
      triage to heart centers from the prehospital setting requires strict and
      comprehensive definition of the criteria for these centers by competent, unbiased
      clinical societies or governmental agencies. Prehospital 12-lead
      electrocardiograms and initiation of thrombolytic therapy can provide acute
      diagnosis and early treatment, thus facilitating faster processing and more
      directed in-hospital intervention. They also minimize over- and undertriage of
      patients to cardiac centers. Although evidence from investigational trials
      suggests that many of these procedures are effective, more research is required
      to ensure correct implementation and quality assurance at all emergency service
      levels.

PMID- 11194074
TI  - Concepts and application of prehospital ventilation.
AB  - Airway management and optimal ventilation are crucial aspects of managing out-of
      hospital medical emergencies. The goals in these situations are controlled
      ventilation and optimized inspiratory time, expiratory time, and airflow.
      Numerous techniques and devices are available to deliver oxygen-enriched air to
      patients during resuscitation. The bag-valve-mask (BVM) is one of the most common
      devices used to provide ventilation, although the American Heart Association
      ranks BVM devices lower in preference than other ventilation adjuncts, such as
      emergency and transport ventilators (ETVs) and pocket masks. The clearly
      documented limitations of BVM ventilation and its widespread use in the United
      States underscore the need to improve ventilation practices during care provided
      by emergency medical services (EMS) personnel. As part of that improvement, ETVs
      clearly have a role in the prehospital setting. These devices should be available
      on every ambulance, and the ability to use ETVs should be part of each EMS
      provider's skill set. Furthermore, all patients requiring emergency ventilation
      must be adequately monitored, including continuous monitoring of end-tidal carbon
      dioxide concentrations. As with any other skill, ventilation requires attention
      during initial training, continuing education and skill reinforcement, and
      quality review.

PMID- 11194075
TI  - Resuscitation in the out-of-hospital setting: medical futility criteria for on
      scene pronouncement of death.
AB  - The complete and irreversible cessation of life is often difficult to determine
      with complete confidence in the dynamic environment of out-of-hospital emergency
      care. As a result, resuscitation efforts often are initiated and maintained by
      emergency medical services (EMS) providers in many hopeless situations. Medical
      guidelines are reviewed here to aid EMS organizations with respect to decisions
      about: 1) initiating or waiving resuscitation efforts; 2) the appropriate
      duration of resuscitation efforts; and 3) recommended procedures for on-scene or
      prehospital pronouncement of death (termination of resuscitation). In cases of
      nontraumatic cardiac arrest, few unassailable criteria, other than certain
      physical signs of irreversible tissue deterioration, exist for determining
      medical futility at the initial encounter with the patient. Thus, the general
      medical recommendation is to attempt to resuscitate all patients, adult or child,
      in the absence of rigor mortis or dependent lividity. Conversely, wellfounded
      guidelines now are available for decisions regarding termination of resuscitation
      in such patients once they have received a trial of advanced cardiac life
      support. In practice, however, the final decision to proceed with on-scene
      pronouncement of death for these patients may be determined more by family and
      provider comfort levels and the specific on-scene environment. For patients with
      posttraumatic circulatory arrest, the type of injury (blunt or penetrating), the
      presence of vital signs, and the electrocardiographic findings are used to
      determine the futility of initiating or continuing resuscitation efforts. In
      general, patients who are asystolic on-scene are candidates for on-scene
      pronouncement, regardless of mechanism. With a few exceptions, blunt trauma
      patients with a clearly associated mechanism of lethal injury are generally
      candidates for immediate cessation of efforts once they lose their pulses and
      respirations. Regardless of the medical futility criteria, specialized training
      of EMS providers and targeted related testing of operational issues need to
      precede field implementation of on-scene pronouncement policies. Such policies
      also must be modified and adapted for local issues and resources. In addition,
      although the current determinations of medical futility, as delineated here, are
      important to establish for societal needs, the individual patient's right to live
      must be kept in mind always as new medical advances are developed.

PMID- 11194077
TI  - Liquid-based cytology for cervical screening.

PMID- 11194076
TI  - Spinal immobilization in the field: clinical clearance criteria and
      implementation.
AB  - Awareness of the health and financial repercussions of unnecessary immobilization
      has made cervical spinal immobilization controversial in out-of-hospital care.
      Clinical criteria for clearance of the cervical spine in the hospital based on
      mechanism of injury have been supported by many trauma centers. However,
      implementation of clinical criteria for cervical spinal clearance in out-of
      hospital settings is not as well validated by multicenter studies or accepted by
      many emergency departments. This consensus group recommends that clinical
      criteria to determine "low-risk" patients be available for use by emergency
      medical services providers in out-of-hospital settings; however, training,
      audits, quality management, integration into the medical community, and extent of
      program implementation should be decided based on individual emergency medical
      services systems.

PMID- 11194078
TI  - Cervical screening in England and Wales: its effect has been underestimated.
AB  - Opinions about cervical screening in the UK tend to follow one of two negative
      lines of thought. The first is that cervical cancer is a rare disease, and too
      much time and effort are spent on screening. The second is that it has been
      relatively ineffective, since incidence of invasive carcinoma did not fall until
      the NHS Cervical Screening Programme (NHSCSP) was introduced in 1988, although it
      fell by 40% since then. This paper presents publicly available data to
      demonstrate that neither of these views is true. Registrations of invasive
      carcinoma of the uterine cervix and carcinoma in situ in England and Wales
      between 1971 and 1996 show that a substantially increased risk of disease in
      women born since 1940 has been reversed, almost certainly by greatly improved
      screening. Cervical carcinoma is now a rare disease because most cases are
      prevented before they become invasive, mostly by screening young women, aged 20
      40, before the decade of life when symptomatic cervical carcinoma most frequently
      presents.

PMID- 11194079
TI  - Ethnic factors in the pathology of the uterine cervix cervical screening: a
      population at variance with national targets.
AB  - In recent years, it has been noted that the rate of detection of high-grade
      uterine cervical abnormalities by screening in the Newham and Tower Hamlets
      districts have been much lower than the national average. Whilst the national
      average for the detection rate of moderate and severe dyskaryosis has been around
      1.6%, the detection rate in Newham and Tower Hamlets has consistently been
      substantially lower, at 0.6-1.0%. This discrepancy may be explained on
      demographic grounds. The ethnic make up of the two districts differs from the
      national average. Newham has a mixed ethnic structure: Moslem (11%). Asian non
      Moslem (12%) and other groups (77%). The population of Tower Hamlets is made up
      of Moslem (23%), Asian non-Moslem ( 11%) and other groups (66%). In both
      districts, the rate of detection of moderate and severe dyskaryosis in these
      population subgroups between 1997 and 1999 was 0.57% for Moslem women, 0.52% for
      Asian non-Moslem women and 1.18% for other women. This study attempts to confirm
      the effects of social factors in the differences in rates of detection of
      cervical intraepithelial neoplasia (CIN) in Newham and Tower Hamlets.

PMID- 11194080
TI  - Survey of smear taking practice in the former North Thames region.
AB  - One hundred and seventy-seven doctors and 161 nurses from 230 clinics responded
      to a questionnaire on smear taking practice. The responses show that 66% of smear
      takers use the Aylesbury spatula and 30% use the Ayre spatula. A total of 53% use
      a cytobrush for selected cases. Training of smear takers and preparation of
      smears was satisfactory. Most (but not all) smear takers routinely record
      clinical information on the request form. Only 20 cytology laboratories in the
      North Thames region (70%) provide additional feedback to the smear takers about
      the quality of their smears apart from the information on the request form. Our
      study shows that feedback is an area where interaction between the laboratory and
      smear taker could be encouraged.

PMID- 11194081
TI  - Fine needle aspiration cytodiagnosis of secretory carcinoma of the breast.
AB  - Secretory carcinoma (SC) of the breast is a rare variant of breast malignancy and
      its cytological features in fine needle aspirates have only recently been
      described. In this communication, our experience with four cases of SC of the
      breast is presented in which the diagnosis was established on fine needle
      aspiration cytology (FNAC). In all cases, the samples were cellular and featured
      diffuse, prominent, intracytoplasmic vacuoles and secretion in malignant cells
      and occasional signet-ring like forms. The cytodiagnosis of SC in all the cases
      correlated with subsequent examination of cell blocks of the aspirate and tissue.
      Cytochemical stains showed diffuse positivity for mucin by alcian blue stain in
      the vacuolated cells which was periodic acid-Schiff positive and resistant to
      diastase digestion. Oil-red O staining was negative. Immunopositivity to
      carcinoembryonic antigen, cytokeratin (CAM 5.2), B72.3 and epithelial membrane
      antigen was found in malignant cells. The cytodiagnostic criteria for SC of the
      breast, characteristic cytological features which are useful in a correct FNAC
      diagnosis and differentiation from other pertinent breast carcinomas, are
      discussed.

PMID- 11194082
TI  - Validation of a decision support system for the cytodiagnosis of fine needle
      aspirates of the breast using a prospectively collected dataset from multiple
      observers in a working clinical environment.
AB  - We have used a 692 case dataset, collected retrospectively by a single observer,
      to develop decision support systems for the cytodiagnosis of fine needle
      aspirates of breast lesions. In this study, we use a 322 case dataset that was
      prospectively collected by multiple observers in a working clinical environment
      to test two predictive systems, using logistic regression and the multilayer
      perceptron (MLP) type of neural network. Ten observed features and the patient
      age were used as input features. The systems were developed using a training set
      and test set from the single observer dataset and then applied to the multiple
      observer dataset. For the independent test cases from the single observer
      dataset, with a threshold set for no false positives on the training set,
      logistic regression produced a sensitivity of 82% (95% confidence interval 73-91)
      and a predictive value of a positive result (PV +) of 98% (95-99), the values for
      the MLP were 79% (69-89) and 100%, respectively. However the performance on the
      prospective multiple observer dataset was much worse, with a sensitivity of 72%
      (65-80), and PV + of 97% (94-99) for logistic regression and 67% (60-75) and 91%
      (85-97) for the MLP. These results suggest that there is considerable
      interobserver variability for the defined features and that this system is
      unsuitable for further development in the clinical environment unless this
      problem can be overcome.

PMID- 11194083
TI  - Cytological findings in cystic hypersecretory ductal carcinoma of the breast: a
      potential pitfall in mammary cytology.

PMID- 11194084
TI  - Optimising FNA processing--a collection fluid allowing Giemsa, PAP and H & E
      staining, and facilitating thinprep, cytospin and direct smears and ancillary
      tests.

PMID- 11194085
TI  - The malpractice crisis.

PMID- 11194086
TI  - Influenza: a public health leadership meltdown.

PMID- 11194087
TI  - Medical care crisis looming in West Virginia.

PMID- 11194088
TI  - Breast cancer risks and prevention: implications of the Breast Cancer Prevention
      Trial results.
AB  - Breast cancer is a major health concern for women in the U.S. Several factors
      determine a woman's risk for developing breast cancer including age, genetics,
      hormonal exposure and others. It is possible to estimate a woman's risk for
      developing breast cancer by using a statistical model known as the Gail model.
      Using this model, the Breast Cancer Prevention Trial (BCPT) found that women at
      high risk for breast cancer could have their incidence of breast cancer reduced
      by 49% by taking tamoxifen. The serious side effects of tamoxifen therapy were
      almost exclusively seen in women over age 50. Women under 50 with a high risk of
      breast cancer are, therefore, most likely to benefit from taking tamoxifen for
      five years. Thus, a benefit-to-risk estimate should be made for each woman before
      advising her to take tamoxifen. A new trial (Study of Tamoxifen And Raloxifene,
      STAR) will compare tamoxifen with raloxifene for their effectiveness in reducing
      breast cancer and for side effects. West Virginia women participated in the BCPT
      and will be able to participate in the STAR trial through centers in Morgantown
      and Charleston.

PMID- 11194089
TI  - The STAR (Study of Tamoxifen and Raloxifene) trial in West Virginia.
AB  - Female breast cancer is a major medical problem with significant public health
      ramifications. In 1999, more than 170,000 women were diagnosed with breast cancer
      in the U.S. and more than 40,000 died from this disease. The STAR trial will
      determine if raloxifene (Evista) is either more or less effective than tamoxifen
      (Nolvadex in reducing the incidence of invasive breast cancer in postmenopausal
      women who are at increased risk for the disease. A secondary goal is to compare
      raloxifene and tamoxifen with regard to their side effects. Approximately 22,000
      postmenopausal women, 35 years of age or older, who are at increased risk for
      developing breast cancer will be randomly assigned in this double-blind trial to
      receive either 20 mg of tamoxifen plus a placebo or 60 mg of raloxifene plus a
      placebo, for five years. A substudy to evaluate the effect of raloxifene and
      tamoxifen therapy on study participants' quality-of-life will also be conducted.

PMID- 11194090
TI  - The West Virginia Coalition for Quality Health Care: reducing variation and
      improving care.

PMID- 11194091
TI  - Recent advances in end-of-life care.

PMID- 11194092
TI  - Intradural convexity chondroma: a case report and review of diagnostic features.
AB  - Intradural convexity chondromas are slow-growing tumors of young adults and
      children. Their symptoms are due to their size and degree of mass effect. They
      are extra-axial, avascular masses without peritumoral edema. CT and magnetic
      resonance resonance imaging of the head and cerebral angiography are helpful in
      diagnosis. Treatment is surgical resection.

PMID- 11194093
TI  - Estrogen-induced relaxation in bovine coronary arteries in vitro: evidence for a
      new mechanism.
AB  - Numerous studies have shown estrogen to be vasoactive in various circulations.
      Our objective was to determine the effect of estrogen on isolated bovine coronary
      arteries and the possible mechanism. Bovine coronary arteries, precontracted with
      thromboxane mimetic U46619 were given doses (0.01-30 microM) of 17B-estradiol in
      the presence and absence of endothelium and these inhibitors: 10 microM
      indomethacin (cyclooxygenase inhibitor), 10 microM methylene blue (inhibits
      soluble guanylate cyclase), 100 microM nitro-L-arginine (inhibits nitric oxide
      synthesis), 100 microM isobutylmethylxanthine (phosphodiesterase inhibitor) and
      30 microM mifepristone (Ru38486 steroid receptor antagonist). Our results
      indicated that, estrogen, in the highest concentration used (30 microM), elicited
      an acute dose-dependent relaxation of bovine coronary arteries from 4%-68% (n =
      15). No major difference in relaxation was observed between coronary arteries
      with or without endothelium, indicating that the mechanism was endothelium
      independent. Indomethacin, nitro-L-arginine and methylene blue did not alter this
      relaxation, suggesting that relaxant prostaglandins, l-arginine products and cGMP
      are not involved (n = 11-16), isobutylmethylxanthine enhanced relaxation from 20%
      40% (n = 15 p < 0.01), suggests a role for cAMP. Furthermore, mifepristone
      reduced the relaxation by more than 50% (n = 15 p < 0.05) consistent with the
      role for estrogen receptors. Based on our study, estrogen causes a dose-dependent
      relaxation of bovine coronary arteries that does not appear to utilize
      endothelium, prostaglandins, cGMP or arginine products, but may involve cAMP and
      estrogen receptors. This study may help justify treating myocardial ischemia with
      estrogen.

PMID- 11194094
TI  - Melanoma: latest diagnosis methods, surgical treatments and follow-up procedures.
AB  - Melanoma is a disease that is estimated will affect approximately 1 in 80
      Americans. It is a potentially lethal cutaneous malignancy that requires initial
      diagnosis by full thickness incisional or excisional biopsy followed by
      appropriate surgical care. Prospective randomized studies for adjuvant therapy
      with intermediate (0.76-4 mm. Breslow depth), and deeper (4 mm. or greater
      Breslow depth) lesions will be discussed. This paper outlines an algorithm for
      lifelong postoperative clinical follow-up.

PMID- 11194095
TI  - Heart rate and blood pressure changes with endurance training: the HERITAGE
      Family Study.
AB  - PURPOSE: The purpose of this study was to determine the magnitude of change in
      resting and exercise heart rate (HR) and blood pressure (BP), by race, sex, and
      age, after a 20-wk endurance training program in 507 healthy and previously
      sedentary subjects from the HERITAGE Family Study. METHODS: After baseline
      measurements, subjects exercised on cycle ergometers 3 d x wk(-1) for a total of
      60 exercise sessions starting at 55% of VO2max for 30 min x session(-1) and
      building to 75% of VO2max for 50 min x session(-1) for the last 6 wk. HR and BP
      at rest and during exercise (50 W, 60% of VO2max maximal exercise) were each
      determined in duplicate on two different days both before and after training
      (resting values at 24-h and 72-h posttraining). RESULTS: After the period of
      training, there was a small decrease in resting HR (-2.7 to -4.6 beats x min(-1)
      across groups at 72-h posttraining), and small changes (i.e., < 3 mm Hg) in
      resting systolic (SBP), diastolic (DBP), and calculated mean BP (MBP), which
      varied by race, sex, and age. During exercise at the same absolute work rate (50
      W), HR, SBP, DBP, and MBP were all significantly reduced, with greater reductions
      in HR in women compared with men, and greater reductions in BP in blacks and
      older subjects compared with whites and younger subjects, respectively. At the
      same relative work rate (60% VO2max), HR, DBP, and MBP were reduced, but SBP
      remained unchanged. Blacks had a greater reduction in DBP, but whites had a
      greater reduction in HR. Finally, at maximal exercise, there was a small decrease
      in HR, with men and whites decreasing more than women and blacks; an 8 mm Hg
      increase in SBP, with men increasing more than women; a 4 mm Hg decrease in DBP,
      with blacks decreasing more than whites; and no change in MBP. CONCLUSION: In
      conclusion, the reductions in resting HR and BP with training were generally
      small, but the reductions during exercise were substantial and clinically
      important, with the older and the black populations experiencing greater
      reductions.

PMID- 11194096
TI  - Deficits in eccentric versus concentric torque in children with spastic cerebral
      palsy.
AB  - PURPOSE: The purposes of this study were to determine whether ambulatory children
      with spastic cerebral palsy (CP) had abnormal isokinetic eccentric peak torque
      values at the knee and ankle, and to gain further insights on the influence of
      spasticity on voluntary force production in this population. METHODS: Twenty-four
      children with spastic CP (mean = 11.1+/-2.6 yr) and twenty children of comparable
      age with no neuromotor pathology (mean = 10.3+/-2.6 yr) participated in an
      isokinetic testing protocol on a Biodex dynamometer that measured eccentric and
      concentric peak torques of the knee extensors, knee flexors, ankle dorsiflexors,
      and ankle plantarflexors. Angular velocity of the eccentric trials was 30 degrees
      x s(-1) and of the concentric trials was 30 degrees x s(-1), 60 degrees x s(-1),
      and 120 degrees x s(-1). Peak torque values were normalized by body weight and
      compared across groups by using ANOVA procedures. Eccentric to concentric (E/C)
      peak torque ratios at 30 degrees x s(-1) were computed for each muscle and
      compared across groups. The torque values in CP were also expressed as a percent
      of the mean normalized value of the comparison group and compared across
      conditions using repeated measures ANOVA (P < 0.05). RESULTS: Children with CP
      demonstrated decreased eccentric and concentric peak torques for all muscle
      groups tested. The relative deficit in eccentric torque was less than the
      concentric torque and the decrement in concentric torque across speeds was
      greater in CP for all muscle groups except the ankle dorsiflexors. The E/C ratios
      for the knee extensors and flexors were also greater in CP. CONCLUSIONS: Children
      with CP have diminished eccentric as well as concentric peak torques at the knee
      and ankle. The influence of spasticity on voluntary force production can be
      inferred from the bias toward greater eccentric torque and the greater decrement
      in concentric torque across speeds in children with spastic CP.

PMID- 11194097
TI  - Effect of knee joint effusion on quadriceps and soleus motoneuron pool
      excitability.
AB  - PURPOSE: To examine changes in quadriceps and soleus MN pool activity resulting
      from knee joint effusion over a 4-h period and assess the relationship between
      the muscles. METHODS: A repeated measures before-after trial design was used for
      this study. Eight, neurologically sound volunteers (age 23.3+/-2.1 yr, height
      171.8+/-15.9 cm, mass 65.5+/-17.7 kg) participated in this study. An area
      superomedial to the patella was cleaned and anesthetized, and 30 mL of sterile
      saline was injected into the knee joint capsule to mimic mechanical joint
      effusion. The Hoffman reflex (H-reflex) was elicited by applying a percutaneous
      stimulus to the appropriate nerve and recording the response through surface
      electromyography. Soleus and vastus medialis H-reflex measures were collected
      from each volunteer before, at 30 min, 90 min, 150 min, and 210 min intervals
      over a 4-h period after knee effusion. RESULTS: All soleus H-reflex measures
      after effusion (30 min 5.89+/-0.92 V; 90 min 6.16+/-0.48 V; 150 min 6.59+/-0.50
      V; 210 min 6.70+/-0.56 V) were increased in relation to the preeffusion measure
      (5.01+/-0.79 V). All vastus medialis H-reflex measures after effusion (30 min
      4.23+/-0.94 V; 90 min 4.15 +/-1.11 V; 150 min 4.16+/-0.57 V; and 210 min 4.99+/
      1.23) were decreased in relation to the preeffusion measure (5.88+/-1.44 V; P <
      or = 0.05). CONCLUSIONS: Afferent activity from the knee joint capsule resulted
      in an inhibitory effect on the vastus medialis and a facilitatory effect on the
      soleus. Facilitation of the soleus in cooperation with other lower extremity
      musculature could be a mechanism for compensation of the inhibited quadriceps to
      maintain lower kinetic chain function.

PMID- 11194098
TI  - Knee biomechanics of the dynamic squat exercise.
AB  - PURPOSE: Because a strong and stable knee is paramount to an athlete's or
      patient's success, an understanding of knee biomechanics while performing the
      squat is helpful to therapists, trainers, sports medicine physicians,
      researchers, coaches, and athletes who are interested in closed kinetic chain
      exercises, knee rehabilitation, and training for sport. The purpose of this
      review was to examine knee biomechanics during the dynamic squat exercise.
      METHODS: Tibiofemoral shear and compressive forces, patellofemoral compressive
      force, knee muscle activity, and knee stability were reviewed and discussed
      relative to athletic performance, injury potential, and rehabilitation. RESULTS:
      Low to moderate posterior shear forces, restrained primarily by the posterior
      cruciate ligament (PCL), were generated throughout the squat for all knee flexion
      angles. Low anterior shear forces, restrained primarily by the anterior cruciate
      ligament (ACL), were generated between 0 and 60 degrees knee flexion.
      Patellofemoral compressive forces and tibiofemoral compressive and shear forces
      progressively increased as the knees flexed and decreased as the knees extended,
      reaching peak values near maximum knee flexion. Hence, training the squat in the
      functional range between 0 and 50 degrees knee flexion may be appropriate for
      many knee rehabilitation patients, because knee forces were minimum in the
      functional range. Quadriceps, hamstrings, and gastrocnemius activity generally
      increased as knee flexion increased, which supports athletes with healthy knees
      performing the parallel squat (thighs parallel to ground at maximum knee flexion)
      between 0 and 100 degrees knee flexion. Furthermore, it was demonstrated that the
      parallel squat was not injurious to the healthy knee. CONCLUSIONS: The squat was
      shown to be an effective exercise to employ during cruciate ligament or
      patellofemoral rehabilitation. For athletes with healthy knees, performing the
      parallel squat is recommended over the deep squat, because injury potential to
      the menisci and cruciate and collateral ligaments may increase with the deep
      squat. The squat does not compromise knee stability, and can enhance stability if
      performed correctly. Finally, the squat can be effective in developing hip, knee,
      and ankle musculature, because moderate to high quadriceps, hamstrings, and
      gastrocnemius activity were produced during the squat.

PMID- 11194099
TI  - Effects of walking poles on lower extremity gait mechanics.
AB  - PURPOSE: The purpose of this study was to determine whether walking with poles
      reduces loading to the lower extremity during level over ground walking. METHODS:
      Three-dimensional gait analysis was conducted on 13 healthy adults who completed
      10 walking trials using three different poling conditions (selected poles, poles
      back, and poles front) and without the use of poles (no poles). The inverse
      dynamics approach was used to calculate kinetic data via anthropometric,
      kinematic, and kinetic data. RESULTS: All walking with poles conditions increased
      walking speed (P = 0.0001-0.0004), stride length (P < 0.0001), and stance time (P
      < 0.0001) compared with the no poles condition. There also was a decrease in
      anterior-posterior GRF braking impulse (P = 0.0001), a decrease in average
      vertical GRF walking with poles (P < 0.0001-0.0023), and a decrease in vertical
      (compressive) knee joint reaction force (P < 0.0001-0.0041) compared with the no
      poles condition. At the knee, extensor impulse decreased a 7.3% between the no
      poles and selected poles conditions (P = 0.0083-0.0287) and 10.4% between the no
      poles and poles back conditions (P < 0.0001). The support moment was reduced
      between the no poles and poles back (P = 0.0197) and poles front (P = 0.0002)
      conditions. Ankle plantarflexor work (A2) was reduced in the poles-front
      condition (P = 0.0334), but no differences were detected in all other ankle, knee
      or hip power and work variables (P > 0.05). CONCLUSION: There were differences in
      kinetic variables between walking with and without poles. The use of walking
      poles enabled subjects to walk at a faster speed with reduced vertical ground
      reaction forces, vertical knee joint reaction forces, and reduction in the knee
      extensor angular impulse and support moment, depending on the poling condition
      used.

PMID- 11194100
TI  - Energy expenditure during 2 wk of an ultra-endurance run around Australia.
AB  - PURPOSE: For ultra-endurance athletes, whose energy expenditure is likely to be
      at the extremes of human tolerance for sustained periods of time, there is
      increased concern regarding meeting energy needs. Due to the lack of data
      outlining the energy requirements of such athletes, it is possible that those
      participating in ultra-endurance exercise are compromising performance, as well
      as health, as a result of inadequate nutrition and energy intake. To provide
      insight into this dilemma, we have presented a case study of a 37-yr-old ultra
      marathon runner as he runs around the coast of Australia. METHODS: Total energy
      expenditure was measured over a 2-wk period using the doubly labeled water
      technique. RESULTS: The average total energy expenditure of the case subject was
      6321 kcal x d(-1). Based on the expected accuracy and precision of the doubly
      labeled water technique the subject's total energy expenditure might range
      between 6095 and 6550 kcal x d(-1). The subject's average daily water turnover
      was 6.083 L over the 14-d period and might range between 5.9 L and 6.3 L x d(-1).
      CONCLUSIONS: This information will provide a guide to the energy requirements of
      ultra-endurance running and enable athletes, nutritionists, and coaches to
      optimize performance without compromising the health of the participant.

PMID- 11194101
TI  - Oligo-amenorrheic long-distance runners may lose more bone in spine than in
      femur.
AB  - PURPOSE: Strenuous training can be associated with amenorrhea leading to
      amenorrhea-related accelerated bone loss. Insufficient calorie energy, calcium,
      and/or protein intakes can also be frequently encountered in women with intense
      training, possibly contributing to bone loss. Long-distance runners with or
      without regular menses (age range 19-37 yr) were prospectively studied. METHODS:
      Changes in areal bone mineral density (BMD) were measured at 1-yr interval.
      RESULTS: Among 10 eumenorrheic, 11 oligo-amenorrheic, and 9 oral contraceptive
      users, there was no difference in energy, calcium, or protein intakes. Baseline
      BMD values were significantly lower in the oligo-amenorrheic group than in the
      two others at the level of lumbar spine (anteroposterior view: 0.941+/-0.039 in
      oligo-amenorrheic vs 1.077+/-0.029 or 1.051 +/-0.017 g x cm(-2), P < 0.005, in
      the eumenorrheic and contraceptive user groups, respectively) but not in weight
      bearing bone such as proximal and midshaft femur. Over a 1-yr interval, during
      which the three groups did not differ in terms of running distances and dietary
      intakes, oligo-amenorrheic women displayed a significant decrease in lumbar spine
      BMD in lateral view (-0.049+/-0.012 in oligo-amenorrheic vs -0.001+/-0.013 and
      0.014+/-0.012 g x cm(-2), p < 0.005, in the eumenorrheic and contraceptive user
      groups, respectively). We did not detect any significant change in femoral neck,
      trochanter, or midshaft BMD. CONCLUSIONS: Oligo-amenorrhea in long-distance
      runners, with adequate dietary intakes, was associated with a decrease in BMD
      affecting more the lumbar spine than the proximal and midshaft femur during a 1
      yr follow-up.

PMID- 11194102
TI  - Plasma lactate concentrations for self-selected maximal effort lasting 1 h.
AB  - PURPOSE: We determined the plasma lactate concentrations for 11 well-trained
      endurance cyclists or triathletes during a laboratory trial to measure maximal
      distance cycled in 1 h. METHODS: Subjects performed three distance trials,
      cycling as far as possible in 1 h. Blood samples were taken from a forearm vein
      every 10 min during the third trial (T). Samples were analyzed by
      spectrophotometer for plasma lactate concentrations ([La]). RESULTS: During T,
      subjects cycled 40.8+/-2.2 km at an average of 83+/-4% of their predicted maximum
      heart rate (HRmax). Minimum and maximum [La] for each subject was noted for
      minutes 10, 20, 30, 40, and 50. Minimum [La] ranged between 2.8 and 10.3 mmol x
      L(-1), and maximum [La] ranged between 5.8 and 13.6 mmol x L(-1). The average
      [La] from minute 10 to 50 was calculated for each subject and ranged from 5.0 to
      12.3 mmol x L(-1). This did not correlate with performance (distance covered in 1
      h). Therefore, there was a wide range of individual plasma lactate responses to
      the same laboratory test that simulated an actual race. The overall average [La]
      for all subjects was 7.6+/-2.1 mmol x L(-1). CONCLUSIONS: These data indicate
      first that the value of 4 mmol x L(-1), commonly referred to as OBLA, may often
      underestimate the upper limit of tolerance to lactate during a maximal endurance
      performance test lasting approximately 1 h. Second, during this type of work,
      intersubject differences in average plasma lactate concentration do not correlate
      with performance.

PMID- 11194103
TI  - Energy system contribution during 200- to 1500-m running in highly trained
      athletes.
AB  - PURPOSE: The purpose of the present study was to profile the aerobic and
      anaerobic energy system contribution during high-speed treadmill exercise that
      simulated 200-, 400-, 800-, and 1500-m track running events. METHODS: Twenty
      highly trained athletes (Australian National Standard) participated in the study,
      specializing in either the 200-m (N = 3), 400-m (N = 6), 800-m (N = 5), or 1500-m
      (N = 6) event (mean VO2 peak [mL x kg(-1)-min(-1)] +/- SD = 56+/-2, 59+/-1, 67+/
      1, and 72+/-2, respectively). The relative aerobic and anaerobic energy system
      contribution was calculated using the accumulated oxygen deficit (AOD) method.
      RESULTS: The relative contribution of the aerobic energy system to the 200-, 400
      , 800-, and 1500-m events was 29+/-4, 43+/-1, 66+/-2, and 84+/-1%+/-SD,
      respectively. The size of the AOD increased with event duration during the 200-,
      400-, and 800-m events (30.4+/-2.3, 41.3+/-1.0, and 48.1+/-4.5 mL x kg(-1),
      respectively), but no further increase was seen in the 1500-m event (47.1+/-3.8
      mL x kg(-1)). The crossover to predominantly aerobic energy system supply
      occurred between 15 and 30 s for the 400-, 800-, and 1500-m events. CONCLUSIONS:
      These results suggest that the relative contribution of the aerobic energy system
      during track running events is considerable and greater than traditionally
      thought.

PMID- 11194104
TI  - Field evaluation of energy expenditure from continuous and intermittent walking
      in women.
AB  - RATIONALE: Recent physical activity recommendations suggest that comparable
      amounts of prescribed physical activity, done as a single continuous bout or as a
      set of intermittent bouts, will produce equal amounts of energy expenditure (EE)
      during the prescribed activity as well as throughout the day. HYPOTHESES: In a
      field setting, we tested two hypotheses: (1) continuous and intermittent walking
      conditions will result in significantly greater total daily EE than a control
      condition, and (2) continuous and intermittent walking conditions will result in
      similar total daily METHODS: Thirty women (mean age [yr] = 43.7+/-5.8; mean body
      mass index [kg x m(-2)]= 24.7+/-4.0) participated in a repeated-measures design
      so that each woman participated in three walking conditions on successive days of
      the week: a single 30-min brisk walk (continuous): three 10-min brisk walks
      (intermittent); and no activity (control). Throughout the study protocol, women
      wore a TRITRAC-R3D accelerometer programmed to estimate EE in 2-min intervals.
      RESULTS: Mean total EE estimates (kcal) for the three walking conditions were as
      follows: continuous: 2181+/-308; intermittent: 2121+/-305; and control: 1948+/
      270. A repeated-measures analysis of variance omnibus test indicated that EE
      differed significantly by experimental condition [F(2,58) = 40.2, P < 0.001). To
      test the first hypothesis, contrasts were examined revealing that EE in the
      continuous and intermittent conditions was significantly greater than EE in the
      control condition [F(1,29) = 58.2, P < 0.001]. To test the second hypothesis,
      contrasts revealed that EE in the continuous condition was significantly greater
      than EE in the intermittent condition [F(1,29) = 7.0, P = 0.013]. CONCLUSION: For
      the purposes of total EE, selecting a continuous mode of walking may offer
      additional benefit over an intermittent mode, given the same total prescribed
      duration.

PMID- 11194105
TI  - Validity of lower extremity strength and power utilizing a new closed chain
      dynamometer.
AB  - PURPOSE: The purpose of this study was to compare selected variables measured on
      a traditional isokinetic dynamometer (Cybex II) with a new lower extremity,
      closed chain dynamometer (Omnikinetic, OmK). METHODS: Twelve subjects (6 male, 6
      female, age = 28+/-5 yr, mean +/- SD) performed Cybex II knee flexion and
      extension at 1.05, 3.14, and 5.23 rad x s(-1). A maximal effort of 10 repetitions
      of lower extremity concentric extension and eccentric flexion at 36% of subject's
      1-RM was performed on the OmK. Crank power and joint (ankle, knee, and hip)
      kinetics were recorded as a mean of 10 repetitions. RESULTS: t-Tests revealed
      right versus left leg differences (P < 0.05) for Cybex II peak torque flexion at
      5.23 rad x s(-1), and OmK knee and hip peak power and hip root mean square power
      (RMS) power. Cybex peak knee torques were related (Pearson r values 0.78-0.92, P
      < 0.01) to OmK peak knee torques. Cybex average power was related to OmK knee
      power (Pearson r values 0.71-0.96, P < 0.01) and OmK crank power (r = 0.62-0.94,
      P < .01). Correlations tended to be stronger comparing the OmK with the fastest
      (5.23 rad x s(-1)) Cybex II speed. CONCLUSIONS: These results suggest that the
      OmK knee and crank kinetic data are comparable to Cybex It isokinetic
      dynamometry. The ability to evaluate lower extremity joint exercise at a
      subject's maximal movement speed, in addition to the use of a closed-chain, multi
      joint motion, may allow for the OmK to provide a more global evaluation of lower
      extremity kinetics during seated concentric-extension, eccentric-flexion
      exercise.

PMID- 11194106
TI  - Exercise training with a heart device: a hemodynamic, metabolic, and hormonal
      study.
AB  - PURPOSE: The mechanisms of the training-induced improvements in left ventricular
      assist (LVAD) patients are unknown. METHODS: We measured the hemodynamic, gas
      exchange, and metabolic and hormonal effects of 6-wk exercise training in a
      cardiogenic shock patient who was assisted by an LVAD. RESULTS: After training,
      the peak power and VO2 increased by 166% and 56%, respectively (80 W and 16.1 mL
      x min(-1) x kg(-1)), whereas the ventilatory drive decreased. Although the LVAD
      output increased little with exercise, the systemic cardiac output rose
      (adequately for the VO2) from 5.91 and 4.90 L x min(-1) at rest to 9.75 and 9.47
      L x min(-1) at peak work rate, before and after training, respectively. Thus, the
      left ventricle ejected again through the aortic valve. Unloading and/or
      retraining resulted in a left ventricular filling pressure decrease. Although the
      right ventricular ejection fraction increased with exercise, it decreased again
      at the maximal load after training. For a given work rate the arterial lactate,
      the norepinephrine (NE) and epinephrine (E) concentrations fell after training,
      but the enhanced maximal work rate elicited higher NE and E concentrations (4396
      and 1848 pg x mL(-1), respectively). The lack of right ventricular unloading
      might have kept the atrial natriuretic peptide higher after training, but the
      blood cyclic GMP and endothelin were lower after training. CONCLUSION: In an LVAD
      patient, retraining returns the exercise capacity to the class III level by
      peripheral and left ventricular hemodynamic improvements, but the safety of
      maximal exercise remains to be proven in terms of right ventricular function and
      orthosympathetic drive.

PMID- 11194107
TI  - Effect of elbow joint angle on the magnitude of muscle damage to the elbow
      flexors.
AB  - PURPOSE: It has been shown that eccentric actions at a long muscle length result
      in a larger decrease in force and more muscle tenderness compared with those at a
      short muscle length. To further investigate the effect of elbow joint angle on
      the development of muscle damage, this study compared two maximal eccentric
      exercise regimens in which the starting position of the action was different, but
      the range of movement was the same. METHODS: One arm of 10 male students
      performed 24 maximal eccentric actions of the elbow flexors at the elbow joint
      angle from 0.87 to 2.27 rad (50-130 degrees: S condition) and the other arm at
      the elbow joint angle from 1.74 to 3.14 rad (100-180 degrees: L condition).
      Maximal isometric force, range of motion, muscle soreness, plasma creatine kinase
      activity, upper arm circumference, and B-mode ultrasound pictures of the elbow
      flexors (US) were measured before and for 5 d postexercise in both conditions.
      Magnetic resonance imaging (MRI) of the transverse scans of the upper arm was
      taken at 4 d after exercise. RESULTS: All measures changed significantly (P <
      0.01) after exercise for both conditions; however, significantly (P < 0.01)
      larger changes in the measures were found in the L condition compared with the S
      condition. MRI and US displayed that only the brachialis was damaged for the S
      condition but the biceps brachii was also damaged for the L condition.
      CONCLUSION: The greater development of muscle damage in the L condition compared
      with the S condition is likely to be associated with the elbow flexors muscles
      affected by the exercise.

PMID- 11194108
TI  - Habitual physical activity in children and adolescents with cystic fibrosis.
AB  - PURPOSE: This study was conducted to: 1) measure total physical activity levels,
      including the intensities of the various types of activities, in children and
      adolescents with CF compared with non-CF healthy control subjects; and 2)
      determine whether vigorous activity level was related to aerobic fitness and
      disease status in patients with CF. METHODS: Thirty patients with CF (18 male, 12
      female) and 30 control subjects (17 male, 13 female), 7-17 yr old, participated
      in this study. Habitual physical activity was measured using Kriska's Modifiable
      Activity Questionnaire (MAQ) and the past year's average of total hours, MET
      hours, and vigorous (VIG) hours (>6 METs) of activity per week were determined.
      Aerobic fitness was determined from peak oxygen uptake (VO2peak) obtained via
      maximal exercise testing on a cycle ergometer. Standard spirometry was used to
      measure pulmonary function. Body mass index (BMI) was determined from height and
      weight measurements. RESULTS: The CF and control groups were similar in age and
      gender distribution, but the patients were smaller (BMI, 98 vs 112% of predicted)
      and less aerobically fit (36.5 vs 41.4 mL x kg(-1) x min(-1)). Total and MET
      hours of physical activity did not differ between groups; however, the CF group
      participated in significantly fewer hours of vigorous activities than the control
      group (2 vs 3.7 h x wk(-1)). In patients with worse lung disease, VIG-h x wk(-1)
      were significantly related to VO2peak (r = 0.83). CONCLUSION: These results
      suggest that children with CF engage in less vigorous physical activities than
      their healthy non-CF peers, despite having good lung function. In view of the
      progressive nature of the disease, and the association between aerobic fitness
      and vigorous activity, patients should be encouraged to engage in more vigorous
      activities that promote aerobic fitness and may ultimately have an impact on
      survival.

PMID- 11194109
TI  - Treatment of exercise-induced muscle injury via hyperbaric oxygen therapy.
AB  - PURPOSE: This study examined the role of hyperbaric oxygen therapy (HBO) in the
      treatment of exercise-induced muscle injury. METHODS: 21 college-aged male
      volunteers were assigned to three groups: control, immediate HBO (iHBO), and
      delayed HBO (dHBO). All subjects performed 6 sets (10 repetitions per set) of
      eccentric repetitions with a load equivalent to 120% of their concentric maximum.
      HBO treatments consisted of 100-min exposure to 2.5 ATA and 100% oxygen with
      intermittent breathing of ambient air (30 min at 100% O2, 5 min at 20.93% O2).
      HBO treatments began either 2 (iHBO) or 24 h (dHBO) postexercise and were
      administered daily through day 4 postexercise. Forearm flexor cross-sectional
      area (CSA) and T2 relaxation time via magnetic resonance imaging (MRI) were
      assessed at baseline, 2, 7, and 15 d postinjury. Isometric strength and rating of
      perceived soreness of the forearm flexors were assessed at baseline, 1, 2, 3, 4,
      7, and 15 d postinjury. Serum creatine kinase (CK) was assessed on day 0 and on
      days 1, 2, 7, and 15 postinjury. RESULTS: Mean baseline CSA values were: 2016.3,
      1888.5, and 1972.2 mm2 for control, iHBO, and dHBO, respectively. All groups
      showed significant increases in CSA in response to injury (21% at 2 d, 18% at 7
      d) (P < 0.0001), but there were no significant differences between groups (P =
      0.438). Mean baseline T2 relaxation times were: 26.18, 26.28, and 27.43 msec for
      control, iHBO, and dHBO, respectively. Significant increases in T2 relaxation
      time were observed for all groups (64% at 2 d, 66% at 7 d, and 28% at 15 d) (P <
      0.0001), but there were no significant differences between groups (P = 0.692).
      Isometric strength (P < 0.0001), serum CK levels (P = 0.0007), and rating of
      perceived soreness (P < 0.0001) also indicated significant muscle injury for all
      groups, but there were no differences between groups (P = 0.459, P = 0.943, and P
      = 0.448, respectively). CONCLUSION: These results suggest that hyperbaric oxygen
      therapy was not effective in the treatment of exercise-induced muscle injury as
      indicated by the markers evaluated.

PMID- 11194110
TI  - Alcohol and college athletes.
AB  - PURPOSE: This study examines heavy episodic alcohol consumption and associated
      harms in collegiate athletes in the United States. The factors which may promote
      or deter such use are explored. METHODS: Randomly selected students in a
      nationally representative sample of 4-yr colleges in the United States completed
      self-report questionnaires in the spring of 1997. Athletes were defined as
      students who participated in one or more hours of intercollegiate athletics per
      day. Heavy episodic or "binge" drinking for men was defined as consuming five or
      more alcoholic drinks on at least one occasion in the past 2 wk and four or more
      for women. Athletes were compared with other students at their colleges. RESULTS:
      Athletes reported more binge drinking, heavier alcohol use, and a greater number
      of drinking-related harms. Athletes are more likely to exhibit the strong social
      ties found to be associated with binge drinking. Athletes, despite drinking more
      heavily than other students, report greater exposure to alcohol prevention
      efforts and possess unique motivations to limit their alcohol use. CONCLUSIONS:
      Athletes are a high-risk group for binge drinking and alcohol-related harms.
      Although special educational programs have targeted this group they have not
      sufficiently impacted the problem. Future prevention efforts targeted for
      athletes should address the unique social and environmental influences on
      athletes. Programs should also take advantage of motives of athletes for self
      limiting alcohol intake. Colleges, athletic departments, coaches, and sports
      medicine professionals are urged to act to help reduce athletes risk of alcohol
      related harms.

PMID- 11194111
TI  - Effect of swim taper on whole muscle and single muscle fiber contractile
      properties.
AB  - PURPOSE: To examine the changes in whole muscle function and single cell
      contractile properties of Type I and II muscle fibers from the deltoid muscle of
      highly trained swimmers before and after a 21-d reduction in training volume
      (taper). METHODS: Six college male swimmers (age, 20+/-1 yr; height, 187+/-2 cm,
      weight, 79+/-3 kg, fat, 7+/-1%) who had been, on average, swimming 6200 m x d(-1)
      for 5 months before the taper participated in this investigation. RESULTS: Whole
      muscle power increased (P < 0.05) 17% and 13% on the swim bench and swim power
      tests, respectively. Swim times improved by 4% (range: 3.0-4.7%; P < 0.05). There
      was no change in Type I fiber diameter, whereas Type IIa fibers were 11% larger
      (P < 0.05) after taper. Peak force (Po) of the Type I fibers was unaffected by
      the taper but increased (P < 0.05) from 0.63+/-0.02 to 0.82+/-0.05 mN in the IIa
      fibers. However, the specific force (Po/CSA) of the IIa fibers was unchanged.
      Shortening velocity (Vo) was 32% and 67% faster (P < 0.05) in the Type I and IIa
      fibers, respectively. Although Type I fiber power was unaltered, the IIa fibers
      increased 2.5-fold from 24.6+/-2.8 to 56.2+/-3.9 microN x FL x s(-1). When power
      was normalized for cell size, the power was still elevated twofold. CONCLUSIONS:
      These data suggest that tapering induces alterations in the contractile
      properties of single muscle fibers. Further, it appears that the Type IIa fibers
      are more affected than the Type I fibers by the taper. The increased size,
      strength, velocity, and power of the IIa fibers may be responsible for the
      improvements in whole muscle strength and power after the taper.

PMID- 11194112
TI  - Effects of light physical exercise on sleep regulation in rats.
AB  - PURPOSE: Acute physical exercise is known to enhance slow-wave sleep (SWS) and
      reduce paradoxical sleep (PS) in humans. In this study, we examined the effects
      of moderate physical exercise on sleep in rats. METHOD: Young adult Wistar rats
      underwent a 4-h baseline electroencephalographic (EEG) recording session. The
      following day, they were induced to walk (0.8 m x min(-1)) or run (4 m x min(-1))
      for 45 min in a rota-rod treadmill. Active control rats (ACR) were placed on the
      locked rota-rod for 45 min, whereas passive control rats (PCR) remained in their
      home cages. They were then left free to sleep for 4 h during which EEG activity
      was recorded. Rectal temperature (Tre) was monitored before and after exercise in
      ACR, walking and running rats (WR and RR, respectively) and at 45 min intervals
      in PCR. RESULTS: WR were able to walk for 45 min consecutively whereas in RR
      performances differed. Posttraining Tre was unchanged in ACR, PCR, and WR and
      resulted about 1.8 degrees C above baseline in RR. In both WR and RR after
      exercise i) length of SWS and PS, ii) intensity of SWS (spectral power density in
      1-4 Hz range), and iii) propensity for falling asleep were enhanced.
      Interestingly, there was a more conspicuous increment in PS than SWS. In ACR and
      PCR there were no changes in sleep. CONCLUSIONS: Due to the complexity of sleep
      regulation, the interaction of several factors might underlie the observed
      increment in SWS and PS. Nevertheless, it is interesting that light physical
      exercise favors sleep and above all a harmonic enhancement of both sleep phases.

PMID- 11194113
TI  - Creatine supplementation affects muscle creatine during energy restriction.
AB  - INTRODUCTION: Anaerobic performance and body protein may decrease with energy
      restriction practiced by some athletes for weight loss. METHODS: This
      investigation examined the effects of creatine (Cr) supplementation during energy
      restriction on muscle Cr, exercise performance (10 sprints of 6 s, with 30-s
      rest), nitrogen balance, and body composition in male resistance trainers.
      Creatine supplemented (CrS, 20 g x d(-1) of Cr) and those given a placebo (P1)
      consumed a formula diet of 75.3 kJ (18 kcal) x kg(-1) x d(-1) (54.7% C, 21.3% P,
      24% F) for 4 d. A control group was unsupplemented and continued their normal
      diet. There were no changes in body composition or performance of the control
      group. RESULTS: CrS and P1 demonstrated similar decreases in body weight and
      percent body fat. The percent change in fat-free mass was more for P1 (2.4+/-0.3%
      reduction) than CrS (1.4+/-0.4%), but urinary nitrogen losses were similar.
      Significant increases in muscle total Cr and CrP of 15-16% were demonstrated by
      CrS over the energy restriction period, whereas P1 had no changes in muscle Cr.
      Total work done during the sprints expressed per body weight tended to be 3.8%
      higher in CrS and 0.5% less in P1 after the energy restriction (P = 0.058).
      CONCLUSION: It was concluded that Cr supplementation increased muscle Cr during
      short-term energy restriction but did not affect body fat or protein loss. The
      change in muscle creatine was reflected in a tendency for higher total sprint
      work for the Cr group.

PMID- 11194114
TI  - The influence of diet and exercise on muscle and plasma glutamine concentrations.
AB  - PURPOSE: This study examined the relationship between muscle glutamine, muscle
      glycogen, and plasma glutamine concentrations over 3 d of high-intensity exercise
      during which dietary carbohydrate (CHO) intake varied. METHODS: Five endurance
      trained men completed two exercise trials in randomized order, over a 14-d
      period. Each trial required subjects to perform 50 min of high-intensity
      continuous and interval exercise on three consecutive days while consuming a diet
      that provided 45% of the energy as CHO or a diet in which CHO provided 70% of the
      total energy. Four days of inactivity and consumption of a 55% CHO diet separated
      the two randomized trials. Menus and food were provided for the subjects and all
      food and drink consumed were weighed and recorded for later analysis. Before
      exercise on the first day of each trial, at the start of exercise on day 3 and on
      completion of exercise on day 3, muscle was biopsied from the vastus lateralis
      for the analysis of glutamine and glycogen concentrations. Venous blood was
      sampled before and twice after exercise on each day for the analysis of plasma
      glutamine and cortisol concentrations. RESULTS: Mean plasma glutamine
      concentration was significantly higher during the 70% CHO exercise trial when
      compared with the 45% CHO trial (P < 0.05). Glycogen decreased by the same
      magnitude during both trials and there was no relationship between changes in
      plasma glutamine and changes in muscle glycogen concentration. Muscle glutamine
      concentration did not change in either trial. CONCLUSIONS: These data suggest
      that the influence of carbohydrate intake upon the concentration of plasma
      glutamine is not mediated through the concentration of intramuscular glycogen.

PMID- 11194115
TI  - Maximal exercise as a countermeasure to orthostatic intolerance after
      spaceflight.
AB  - Previous investigators have suggested that maximal exercise performed 24 h before
      the end of bed rest, a spaceflight analog, restores prebed rest plasma volume,
      baroreflex responses, and orthostatic tolerance. PURPOSE: In this case report, we
      examined the effect of a similar exercise protocol 24 h before a Shuttle landing
      on the orthostatic responses of four crewmembers (EX) after spaceflights of 8-14
      d. Four additional crewmembers (CON) served as controls and did not perform
      exercise during the final day of the flight. METHODS: Each crewmember performed a
      10-min stand test approximately 10 d before launch (L-10) and within 1-2 h of
      landing (R+0). Cardiac stroke volume was measured (Doppler ultrasound) supine and
      during each min of standing for three EX and three CON subjects. RESULTS:
      Preflight, all crewmembers completed the stand test and each group had similar
      heart rate and blood pressure responses. Postflight, all subjects also completed
      the 10-min stand test. Each group had similarly elevated supine and standing
      heart rates, elevated diastolic and mean arterial blood pressures, and reduced
      pulse pressures compared to L-10. However, postflight cardiac output, mean +/-
      SEM, (EX: 4.5+/-0.6 L x min(-1); CON: 3.1+/-0.3 L x min(-1)) and stroke volume
      (EX: 43+/-7 mL x beat; CON: 30+/-6 mL x beat) were higher after 10 min standing
      in the EX subjects compared to CON subjects. CONCLUSIONS: For these four
      crewmembers, maximal exercise performed 24 h before landing may have helped
      maintain stroke volume but did not maintain heart rate and blood pressure
      responses during standing compared to preflight.

PMID- 11194116
TI  - Vascular smooth muscle: integrator of vasoactive signals during exercise
      hyperemia.
AB  - The primary focus of this review is to discuss the importance of vascular smooth
      muscle function in mechanisms underlying exercise hyperemia in skeletal muscle.
      Important features of exercise hyperemia are presented and include: 1) the large
      magnitude of increase in blood flow, 2) the pattern of increased blood flow
      within and among skeletal muscle during exercise, 3) exercise hyperemia results
      from increases in vascular conductance produced by relaxation of vascular smooth
      muscle, 4) the increased blood flow is linked to the oxidative metabolism of the
      muscle, and 5) the increased blood flow occurs very rapidly with the initiation
      of exercise. A prevailing theme throughout this review is that vascular smooth
      muscle is a primary integrator of vasoactive signals that, in turn, regulate
      vascular resistance and muscle blood flow. Signal transduction pathways involved
      in vascular smooth muscle contraction and relaxation are discussed, with
      particular emphasis on the role of multiple and redundant signaling pathways for
      initiating a given contractile/relaxation response. We emphasize the concept that
      exercise hyperemia is a local phenomenon and that, during maximal exercise when
      most signals for vasoconstriction are still present, three primary control
      mechanisms are thought to regulate vasodilation and subsequent increases in
      vascular conductance: myogenic vascular control, metabolic vascular control, and
      endothelium-mediated vascular control. Experimental paradigms to test the
      relative importance of the predominant mechanisms thought to underlie exercise
      hyperemia are discussed and evaluated in light of the multiple and redundant
      control systems now known to contribute to control of blood flow in striated
      muscle tissue.

PMID- 11194117
TI  - An effective, economic way of monitoring menstrual cycle hormones in at risk
      female athletes.
AB  - PURPOSE: Female athletes, in response to intensive training, competition stress
      and a lean, athletic physique, are at increased risk of altered hypothalamic
      pituitary ovarian (HPO) axis function associated with menstrual cycle disturbance
      and reduced secretion of the ovarian hormones estrogen and progesterone. Because
      there is evidence suggesting possible detrimental effects on skeletal health
      associated with deficiencies in these hormones, a suitable means to asses ovarian
      hormone concentrations in at risk athletes is needed. The aim of this study was
      to evaluate a simple, economical means to monitor the ovarian hormone production
      in athletes, in the setting of intensive training. METHODS: Subjects comprised 14
      adolescent rowers, 12 lightweight rowers, and two groups of 10 matched control
      subjects. Ovarian function was monitored during the competition season by
      estimation of urinary excretion of estrone glucuronide (E1G) and pregnanediol
      glucuronide (PdG), enabling the menstrual cycles to be classified as ovulatory or
      anovulatory. RESULTS: Results indicated 35% and 75% of schoolgirl and lightweight
      rowers had anovulatory menstrual cycles, respectively. These findings were
      highlighted by significantly lower excretion of E1G and PdG during phases of
      intensive training in both the lightweight and schoolgirl rowers, compared with
      the control subjects. CONCLUSION: It was concluded that the urinary E1G and PdG
      assays were an effective means to assess the influence of intense training on
      ovarian hormone concentrations in at risk athletes. It is recommended that this
      technique be applied more widely as a means of early detection of athletes with
      low estrogen and progesterone levels, in an attempt to avoid detrimental
      influences on skeletal health.

PMID- 11194118
TI  - Exercise training increases creatine kinase capacity in canine myocardium.
AB  - INTRODUCTION: The creatine kinase (CK) energy shuttle of cardiomyocytes channels
      metabolic energy from the mitochondria to sites of energy utilization at
      contracting myofibrils and sarcolemmal and sarcoplasmic reticular ion pumps.
      Although plasticity of the myocardial CK system in response to hemodynamic
      overload has been repeatedly demonstrated, the effects of aerobic exercise
      training on myocardial CK are less well understood. This investigation tested the
      hypothesis that aerobic exercise training increases the capacity of the CK system
      in canine myocardium. METHODS: Mongrel dogs were conditioned by a 9-wk treadmill
      running program or cage-rested for 4 wk. Total CK activity was measured
      colorimetrically; CK(MB) was separated from other CK isoforms and measured by
      electrophoresis. RESULTS: Relative to sedentary controls, training increased left
      ventricular total CK activity 46% (P < 0.05) but did not alter total CK activity
      in right ventricular myocardium. Also in left ventricular myocardium, training
      increased CK(MB) isoenzyme activity 4.5-fold and the CK(MB) fraction of total CK
      threefold from 1.1+/-0.4 to 3.4+/-0.8% (P < 0.05). In contrast to left ventricle,
      CK(MB) activity and its fraction of total CK activity were not altered by
      training in right ventricular myocardium. CONCLUSIONS: Aerobic exercise training
      increases total myocardial CK activity and CK(MB) content in canine left
      ventricular myocardium, although CK(MB) remains a minor component of the
      myocardial CK system. The right ventricular CK system was not affected by
      training.

PMID- 11194119
TI  - Cardiac output and stroke volume changes with endurance training: the HERITAGE
      Family Study.
AB  - PURPOSE: The purpose of this study was to determine the magnitude of changes in
      cardiac output (Qc), stroke volume (SV), and arterial-mixed venous oxygen
      difference (a-vO2 diff) during submaximal exercise following a 20-wk endurance
      training program, with the primary focus on identifying differences in response
      by race, sex, and age. METHODS: The participants in this study (N = 631) were
      healthy and previously sedentary men (N = 277) and women (N = 354) of varying age
      (17-65 yr) and race (blacks, N = 217; whites, N = 414) who had completed the
      HERITAGE Family Study protocol. After baseline measurements, participants trained
      on cycle ergometers 3 d x wk(-1) for a total of 60 exercise sessions starting at
      the HR associated with 55% of maximal oxygen uptake (VO2max) for 30 min/session
      and building to the HR associated with 75% of VO2max for 50 min/session, which
      was maintained during the last 6 wk. HR, Qc (CO2 rebreathing), and SV (Qc/HR)
      were determined in duplicate at 50 W and at 60% of VO2max on two different days
      both before and after training. RESULTS: After training, there were significant
      decreases in HR and Qc, and significant increases in SV and a-vO2 diff at 50 W
      (except for no change in a-vO2 diff in black men). The changes in HR differed by
      sex and age, and the changes in SV, Qc, and a-vO2 diff differed by race. Qc
      decreased by 0.6 L x min(-1) at 50 W for the total sample, consistent with the
      decrease in VO2 at this power output. At 60% of VO2max HR decreased, and SV, Q,
      and a-VO2 diff increased. There were small differences in response by sex (HR and
      SV), race (HR), and age (HR and Qc). CONCLUSION: It is concluded that the
      cardiovascular systems of men and women, blacks and whites, and younger and older
      subjects are not limited in their ability to adapt to endurance training.

PMID- 11194120
TI  - Assessment of the Massachusetts Behavioral Health Program Year 6.
AB  - After a difficult transition from the previous vendor to the Massachusetts
      Behavioral Health Partnership (MBHP), Year 6 was a year of stability and
      incremental changes for the Massachusetts Behavioral Health Program. This
      assessment of Year 6 is based on interviews with key players, data provided by
      the MBHP, a survey of providers, as well as on the fifth year of an ongoing
      review of the program. Results indicate that enrollment grew, and new services
      were developed in response to identified needs. Providers considered access,
      utilization, and quality of care to be the same or better than a year earlier.
      Coordination improved, but was not optimal. Clinical and overall decisions with
      MBHP were collaborative or negotiated and less hierarchical in manner than the
      previous year. Providers rated MBHP better than other managed care organizations
      on quality of care and utilization review decisions, access, flexibility, and
      administration.

PMID- 11194121
TI  - Playing policy pinball: making policy analysis palatable.
AB  - The author presents a teaching tool to make policy analysis accessible to a wide
      range of audiences, especially those who might normally be reluctant to engage in
      policy discussions or debate. The tool has been used with good results in a
      variety of venues, and is presented with brief examples of how it can be used.

PMID- 11194122
TI  - The evolution of mental health parity in American politics.

PMID- 11194123
TI  - Trauma within the psychiatric setting: conceptual framework, research directions,
      and policy implications.

PMID- 11194124
TI  - Managed care and service capacity development in a public mental health system.
AB  - Developing a continuum of care is considered to be one of the first steps in the
      process of implementing managed care strategies. This study summarizes the
      results of a final survey that focused on the ability of Colorado community
      mental health centers (CMHCs) to build service capacity and create new programs
      as a result of Medicaid capitation financing. Capitated agencies, compared to
      those that remained fee-for-service during the study period, reported a much
      greater ability to develop services as a result of capitation. Decreases in
      services were minimal for all agencies. Some differences in managed care
      organizational models were noted, as were differences in the speed of
      implementation. Gaps in some services still remain. These findings point to
      important program implementation issues for publicly funded managed care.

PMID- 11194125
TI  - Enhancing inter-network cooperation among organizations providing mental health
      services to older persons.
AB  - The authors examine how organizations in several networks voluntarily cooperate
      to provide mental health services to older persons and recommend how
      organizational coordination and the delivery system can be improved. Information
      from mail surveys and in-depth interviews was analyzed. Little evidence of formal
      coordination across networks was found. Established organizations and agencies
      providing a larger number of services were more integrated. Providers recommended
      that organizational coordination be increased. Providers suggested that a more
      centralized delivery system and proactive education for clients and providers
      would be effective strategies to enhance service delivery.

PMID- 11194126
TI  - Performance measures of cultural competency in mental health organizations.
AB  - The authors utilized numerous documents created by advisory groups, expert panels
      and multicultural focus groups to develop performance measures for assessing the
      cultural competency of mental health systems. Competency was measured within
      three levels of organizational structure: administrative, provider network, and
      individual caregiver. Indicators, measures and data sources for needs assessment,
      information exchange, services, human resources, plans and policies, and outcomes
      were identified. Procedures for selection and implementation of the most critical
      measures are suggested. The products of this project are broadly applicable to
      the concerns of all cultural groups.

PMID- 11194127
TI  - Alosetron withdrawn from market.

PMID- 11194128
TI  - Needlestick prevention measures become law.

PMID- 11194129
TI  - Companies try different plans for same clotting factor product.

PMID- 11194130
TI  - Triple-drug tablet approved for HIV infection.

PMID- 11194131
TI  - Merck-Medco offers free generics to physicians.

PMID- 11194132
TI  - AHRQ assesses evidence for best management of COPD exacerbations.

PMID- 11194133
TI  - Opposing groups find common ground on health care coverage.

PMID- 11194134
TI  - Pharmacy and the e-train: time to get on board.

PMID- 11194135
TI  - Treatment strategies for recurrent oral aphthous ulcers.
AB  - The clinical features, etiology, and treatment of recurrent aphthous ulcers (RAU)
      are discussed. Aphthous ulcers are among the most common oral lesions in the
      general population, with a frequency of up to 25% and three-month recurrence
      rates as high as 50%. The ulcers, which usually occur on the nonkeratinized oral
      mucosa, can cause considerable pain and may interfere with eating, speaking, and
      swallowing. RAU is classified as minor, major, and herpetiform on the basis of
      ulcer size and number. The cause of RAU is idiopathic in most patients. The most
      likely precipitating factors are local trauma and stress. Other associated
      factors include systemic diseases and nutritional deficiencies, food allergies,
      genetic predisposition, immune disorders, the use of certain medications, and HIV
      infection. The primary goals of therapy for RAU are relief of pain, reduction of
      ulcer duration, and restoration of normal oral function. Secondary goals include
      reduction in the frequency and severity of recurrences and maintenance of
      remission. Topical medications, such as antimicrobial mouthwashes and topical
      corticosteroids, can achieve the primary goals but have not been shown to alter
      recurrence or remission rates. Systemic medications can be tried if topical
      therapy is ineffective. Levamisole has shown variable efficacy in reducing ulcer
      frequency and duration in patients with minor RAU. Oral corticosteroids should be
      reserved for severe cases of major RAU that do not respond to topical agents.
      Thalidomide is effective but, because of its toxicity and cost, should be used
      only as an alternative to oral corticosteroids. RAU can be effectively managed
      with a variety of topical and systemic medications.

PMID- 11194136
TI  - Validity and reliability of observational methods for studying medication
      administration errors.
AB  - The validity and reliability of observational methods for studying medication
      administration errors (MAEs) were studied. Between January and June 1998, two
      pharmacists observed consecutive drug administration rounds by nurses on two
      wards in a U.K. hospital and recorded all MAEs identified. The observers
      intervened in cases of potentially harmful errors. MAE records were audited to
      determine the percentage of omitted doses for which a corresponding reason was
      documented for the observation periods and for nonobservation periods. Error
      rates for each drug administration round were analyzed according to whether they
      were for the nurse's first, second, third (and so on) observed round. Error rates
      were calculated before and after the first intervention with nurses for whom an
      intervention was made. Observer reliability was calculated by comparing the rates
      of errors identified by the two observers. There was no difference between the
      observation and nonobservation periods in the percentage of omitted doses for
      which a reason was documented, and there was no change in the error rate with
      repeated observations. There was no difference in error rates before and after
      the first intervention for each nurse. There was also no difference in error
      detection between the two observers and no change with increasing duration of
      observation. Observation of nurses during drug administration at a U.K. hospital
      did not significantly affect the MAE rate; nor did tactful interventions by the
      observers. Observer reliability was high. Concerns about the validity and
      reliability of observational methods for identifying MAEs may be unfounded.

PMID- 11194137
TI  - The Institute of Medicine report on medical error: overview and implications for
      pharmacy.

PMID- 11194138
TI  - Pharmacists building a safer health system.

PMID- 11194139
TI  - Credentialing in pharmacy. The Council on Credentialing in Pharmacy.

PMID- 11194140
TI  - Centralized, pharmacist-managed anticoagulation service for a university-based
      health system.

PMID- 11194141
TI  - Of medication orders and deli sandwiches.

PMID- 11194142
TI  - Additional Novartis products available through assistance programs.

PMID- 11194143
TI  - Human tooth enamel as a record of the comparative lead exposure of prehistoric
      and modern people.
AB  - There is a considerable body of evidence to support the contention that the
      atmospheric Pb burden is now considerably greater than it was in the remote past.
      However, as there are a diversity of potential environmental pathways leading to
      Pb ingestion, it is not clear how atmospheric Pb levels relate to human exposure.
      It is necessary to establish a baseline for human exposure to Pb from natural
      sources in the pre-metallurgical past, with which contemporary exposure can be
      compared. This paper addresses this issue by comparing the Pb content of human
      dental enamel--an established proxy for Pb exposure--from modern and
      archaeological, pre-metallurgical individuals using thermal and plasma ionisation
      mass spectrometry. It is shown that mean Neolithic enamel Pb contents are
      approximately 0.31 +/- 0.04 ppm. These values are only one order of magnitude
      lower than previously reported data for the same tissues for modern juveniles,
      despite an established 400-fold increase in the atmospheric Pb burden. The
      results suggest that 'natural' exposure to Pb in food and water may have been
      higher than previously thought, and that the link between atmospheric Pb and
      human exposure warrants further investigation.

PMID- 11194144
TI  - Characterization of visibility and atmospheric aerosols in urban, suburban, and
      remote areas.
AB  - Visibility data from over the past four decades accumulated from urban areas of
      central Taiwan indicated that air pollutants have significantly degraded
      visibility in recent years. Currently, the annual average visibility in urban
      areas of the same region is approximately 8-10 km, while the visibility in remote
      areas is approximately 25-30 km. To understand how aerosols affect the visibility
      in this region, here we selected three sites in central Taiwan to measure the
      soluble ionic and carbonaceous species of PM(2.5) and PM(2.5-10) during 1997
      1998. A MOUDI cascade impactor was used to measure the size distributions of
      atmospheric sulfate, nitrate, and carbonaceous particles. The aerosol data were
      then analyzed together with meteorological and air quality data. Comparing the
      results obtained from urban, coastal suburban and remote sites revealed that
      sulfate, carbonaceous species and local wind speed significantly affected the
      visibility in the urban area. However, sulfate concentration and humidity
      influenced visibility in the coastal area of central Taiwan. The particulate
      concentration at the remote station was roughly one-fifth of that in the city.
      Regression analysis results indicated that humidity is a dominant factor
      affecting remote visibility.

PMID- 11194145
TI  - Study of the copper distribution in contaminated soils of hop fields by single
      and sequential extraction procedures.
AB  - Hop growing in Bavaria requires the use of copper containing fungicides against
      mildew, which results in an accumulation of copper in the upper soils to
      concentrations of up to approximately 450 mg kg(-1). The naturally occurring
      concentration of copper is approximately 10-15 times lower. Several single and
      sequential extractions were performed in parallel to the determination of total
      copper content after aqua regia digestion. By these means copper mobility and
      retention, its availability to plants as well as its distribution in soils was
      assessed. Three agricultural soils and two soils from fallow land have been
      analysed to elucidate whether the copper distribution changes in relation to
      agricultural activities and to predict environmental risks due to the high copper
      concentrations. This work also focuses on the difficulties arising from different
      results when using single and sequential extraction procedures. EDTA, acetic
      acid, deionised water, ammonium nitrate and calcium chloride were used as single
      extractants for the functionally defined speciation. EDTA and acetic acid can be
      regarded as extractants for the plant-available species, while deionised water,
      NH4NO3 and CaCl2 only release electrostatically weakly bound metals to estimate
      the mobile species. The extraction behaviour of copper in these procedures is
      discussed with respect to the quantities extracted from the contaminated and non
      contaminated soils. The studies indicate that no vertical copper translocation is
      observed in the ground, but the main amounts are highly available to plants.
      Sequential extraction procedures were used for operationally defined speciation,
      quantifying copper in specific soil phases. The 'five-step extraction scheme'
      first applied, suggested by the Standard Measurement and Testing Programme of the
      European Community, overestimated the amounts of copper bound to the residual
      phase. This was mainly due to the non-specific nature of the reagents for the
      organic/sulfidic and crystalline iron oxide fraction. A second reason could be
      the fact that this scheme was developed for sediment and not for soil analysis.
      Therefore, the sequential extraction has been applied using an adapted method of
      Zeien and Bruemmer, using different extractants for the two phases. The copper
      distribution was different, showing that approximately 40-50% of the total copper
      was bound to the organic fraction and approximately 15-30% could be extracted
      with the iron oxides. The amounts in the residual fraction were much lower. After
      comparing the results of the different extraction procedures the environmental
      behaviour of copper and its risks for plants, micro-organisms and groundwater is
      discussed in brief.

PMID- 11194146
TI  - Adsorption equilibriums of principal herbicides on paddy soils in Japan.
AB  - Herbicides used in paddy fields during the flooding season can easily cause
      pollution by run-off into rivers or by other routes. It is very important to know
      the adsorption characteristics that influence their fate in the soil. The
      adsorption equilibriums have often been expressed by Henry equations, and the
      values of equilibrium constant, Kd, are estimated from the adsorption constants,
      K(OC), based on organic carbon contents of soils. There is little information
      concerning the equilibrium values expressed by the Freundlich equations, and
      insufficient information on the actual concentration levels in the paddy field.
      Therefore, adsorption equilibriums of the five principal herbicides: esprocarb,
      mefenacet, pretilachlor, simetryn and thiobencarb, on five kinds of paddy soil in
      Japan were investigated. It was found that their equilibrium values were better
      expressed by the Freundlich equation for concentration levels for the paddy
      fields, and that the values for the adsorption coefficient, n, varied from 1.0 to
      1.6. Values for the coefficient, k, were in the range of 29-420 mg(1 - 1/n)
      l(1/n)/kg-dry, and the values were poorly related to solubilities in water or to
      the octanol-water partition coefficients of the herbicides. For each herbicide,
      except for simetryn, the values of k among the soils differed by 2-3 times, and
      no correlation could be found with the organic carbon contents, specific surface
      areas, pH, cation exchange capacity or major minerals of the soils. The
      adsorption equilibriums calculated from the values of adsorption constant Kd by
      the values of K(OC) in the literature were found to be very different from the
      experimental equilibriums. From the experimental values of coefficient k and n of
      the Freundlich equation, the maximum runoff concentrations of the herbicides were
      preliminarily estimated by a simple equilibrium model.

PMID- 11194147
TI  - Selenium and iodine in soil, rice and drinking water in relation to endemic
      goitre in Sri Lanka.
AB  - Endemic goitre has been reported in the climatic wet zone of south-west Sri Lanka
      for the past 50 years, but rarely occurs in the northern dry zone. Despite
      government-sponsored iodised salt programmes, endemic goitre is still prevalent.
      In recent years, it has been suggested that Se deficiency may be an important
      factor in the onset of goitre and other iodine deficiency disorders (IDD). Prior
      to the present study, environmental concentrations of Se in Sri Lanka and the
      possible relationships between Se deficiency and endemic goitre had not been
      investigated. During the present study, chemical differences in the environment
      (measured in soil, rice and drinking water) and the Se-status of the human
      population (demonstrated by hair samples from women) were determined for 15
      villages. The villages were characterised by low (< 10%), moderate (10-25%) and
      high (> 25%) goitre incidence (NIDD, MIDD and HIDD, respectively). Results show
      that concentrations of soil total Se and iodine are highest in the HIDD villages,
      however, the soil clay and organic matter content appear to inhibit the
      bioavailability of these elements. Concentrations of iodine in rice are low (< or
      = 58 ng/g) and rice does not provide a significant source of iodine in the Sri
      Lankan diet. High concentrations of iodine (up to 84 microg/l) in drinking water
      in the dry zone may, in part, explain why goitre is uncommon in this area. This
      study has shown for the first time that significant proportions of the Sri Lankan
      female population may be Se deficient (24, 24 and 40% in the NIDD, MIDD and HIDD
      villages, respectively). Although Se deficiency is not restricted to areas where
      goitre is prevalent, a combination of iodine and Se deficiency could be involved
      in the pathogenesis of goitre in Sri Lanka. The distribution of red rice
      cultivation in Sri Lanka is coincident with the HIDD villages. Varieties of red
      rice grown in other countries contain anthocyanins and procyanidins, compounds
      which in other foodstuffs are known goitrogens. The potential goitrogenic
      properties of red rice in Sri Lanka are presently unknown and require further
      investigation. It is likely that the incidence of goitre in Sri Lanka is multi
      factorial, involving trace element deficiencies and other factors such as poor
      nutrition and goitrogens in foodstuffs.

PMID- 11194148
TI  - Baseline metal concentration in the Asian periwinkle Littorina brevicula employed
      as a biomonitor to assess metal pollution in Korean coastal water.
AB  - Concentrations of Al, Fe, Mn, Cu, Zn, V, Ni, Co, Cr, Cd and Pb in the Asian
      periwinkle Littorina brevicula were determined from 39 sampling locations along
      the whole Korean coast. Metal concentrations in the periwinkle varied highly with
      sampling stations, but the variations could be well explained by the body size
      after eliminating the data exceeding the 'High' criteria. Among the stations
      exceeding the 'High' criteria corresponding to mean plus one standard deviation
      of the logarithms of the individual site mean, some stations exhibited values
      higher than expected from the relationship between metal body burden and body
      size, indicating that these locations were polluted with metals. However, several
      'High' stations followed the trends of the curve, suggesting that they resulted
      from the effect of their small body size, not from environmental contamination.
      Periwinkles of similar body sizes exhibited same range of metal concentrations in
      their body, independent of geographical position.

PMID- 11194149
TI  - The measurement of volatile constituents in Foray 48B, an insecticide prepared
      from Bacillus thuringiensis var. kurstaki.
AB  - Foray 48B, an insecticide prepared from Bacillus thuringiensis var. kurstaki
      (Btk), has been used for many years to combat infestations of Gypsy moths. Foray
      48B also contains a large number of 'inert ingredients' which are not disclosed
      by the manufacturer. Gypsy moths usually enter the country through marine- and
      airports in close proximity to urban areas, which consequently need to be
      sprayed. The population affected often demands more detailed information than
      what is available including the potential presence of volatile organic agents
      which could be released during spraying, posing a potential health hazard. Four
      different methods were investigated using GC/mass spectrometry regarding their
      ability to capture volatile agents associated with Foray 48B. It was found that
      solid phase micro-extraction was most efficient in capturing volatile agents from
      the head-space of Foray 48B. Separate trials using 95:5% ethanol/isopropanol
      mixture and toluene in an impinger configuration were much less efficient.
      Standard techniques using activated charcoal tubes in the laboratory setting as
      well as in a field trial did not capture any compounds. It was concluded that the
      volatile agents associated with Foray 48B did not appear to constitute a
      significant health hazard and no one agent was a likely candidate to serve as a
      tracer for Foray 48B exposure.

PMID- 11194150
TI  - Quantitative assessment of estrogenic activity in the water environment of Korea
      by the E-SCREEN assay.
AB  - In this study, the E-SCREEN assay was optimized and validated for the sensitive
      quantitative determination of the total estrogenicity in river samples. River
      water and sediment samples were collected and analyzed with the E-SCREEN. River
      water (10 l) was extracted using combined solid-phase extraction in static
      adsorption mode with Soxhlet extraction. Estrogenic pollutants adsorbed to the
      XAD-4 resin were recovered with 98.24 +/- 5.90% efficiency by elution with ethyl
      acetate and dichloromethane (1:9). The detection limit by 17beta-estradiol
      equivalent concentration (EEQ) of the E-SCREEN assay was 8.03 pg EEQ/l. Among the
      water samples, the estrogenic activity was observed to be higher downstream of
      the Kumho river (7.43 ng EEQ/l) and upstream of Kum river (2.05 ng EEQ/l) than in
      other samples. More than 3 mg of equivalent sediment samples from the Kumho
      river, Kum river and Miho stream showed partial agonistic effects, and the
      Mankyung river showed a partial agonistic effect with only 1.5 mg of sediment.
      The highest value of RPE was 83.34 downstream of the Kumho river, and the lowest
      value of RPE was 6.52 downstream of the Miho stream. Full estrogen agonistic
      activities were observed downstream of the Kumho river and upstream of the Kum
      river. The partial agonistic activity was observed in upstream of the Kumho
      river, downstream of the Mankyung river, and upstream of the Miho stream, and no
      agonistic action was observed downstream of the Kum river or Miho stream, or
      upstream of the Mankyung river. The total estrogenic activity in the river water
      and sediment samples was between 0.50 pg/L and 7.4 ng/L, 3.39 pg/g and 10.70
      pg/g.

PMID- 11194151
TI  - Determination of radionuclide exchangeability in freshwater systems.
AB  - Two freshwater sediments were spiked with 57Co, 85Sr and 134Cs and left for
      adsorption times ranging from 1 day to over 60 days. Following adsorption, the
      'exchangeable' pool of each radionuclide was measured using ammonium acetate
      extractions and a sequential leach procedure (Tessier et al., 1979), and the
      results were compared. Exchangeability was found to depend upon the sediment,
      radionuclide, sorption time and the identity of extracting agent. All three
      radionuclides showed a shift with increasing adsorption time from regular
      exchange sites to sites which are sterically hindered, but a fixation within the
      sediment was only observed for 57Co and 134Cs, with similar ammonium acetate
      extraction yields for both radionuclides. Misleading results were obtained during
      the sequential leach procedure due to redistribution and, therefore, the
      inclusion of a NH4+ leach after the MgCl2 extraction step was suggested. A
      mathematical model of element speciation was fairly successful at defining the
      'exchangeable' fraction, suggesting that the chemically- and mathematically
      defined fractions were similar.

PMID- 11194152
TI  - Algal biomass in a disturbed Atlantic river: water quality relationships and
      environmental implications.
AB  - Benthic algal biomass was determined at 38 sites along the Oria, a river with
      intense human activity on its watershed. Water temperature, total suspended
      solids and nutrient concentration affected algal biomass in different ways. Lower
      values of algal biomass [(chlorophyll-a concentration and ash-free dry weight
      (AFDW)] were found in the headwaters and forested tributaries, but also at sites
      receiving high deposition of solids (due to the outflow from paper mills and
      quarries). Higher values of algal biomass (both chlorophyll-a and AFDW) were
      common both in the main stretch of the river and in some tributaries receiving
      urban sewage outflows. Averages and ranges of temperature and dissolved oxygen
      concentration were compared for two continuously monitored stations. One of them
      (forested, nutrient-poor) had low algal biomass, while the second (open, nutrient
      rich) showed high chlorophyll-a concentration. Accumulation of algal biomass had
      environmental implications both in water quality and in the fish diversity of the
      Oria. Diel variations of dissolved oxygen were much higher (and reached hypoxia)
      at the site with higher biomass accumulation. The abundance of a fish community
      (dominated by cyprinids) more tolerant to hypoxia at that site can partly be
      attributed to the influence of algal biomass accumulation.

PMID- 11194153
TI  - Serum concentrations of organochlorines in men: a search for markers of exposure.
AB  - Analysis of single marker substances in serum could provide cost-effective
      assessment of human exposure to complex mixtures of organochlorines. We studied
      the serum concentrations of 10 polychlorinated biphenyl (PCB) congeners and 11
      chlorinated pesticides and some of their metabolites in samples collected from
      120 Swedish men (mean age 63 years, range 40-74 years) from the general Swedish
      population. The median concentrations of individual PCB congeners increased in
      the order PCB 52 < PCB 101 < or = PCB28 < PCB 105 < PCB 167 < PCB 156 < PCB 118 <
      PCB 138 < PCB 180 < PCB 153. The concentrations of o,p'-DDT, o,p'-DDE, p,p'-DDD,
      alpha-HCH and gamma-HCH were in most cases below the quantification limit (2-4
      ng/g lipid). Among the other chlorinated pesticides the median concentration
      increased in the order oxychlordane (12 ng/g lipid) < p,p'-DDT < trans-nonachlor
      < beta-HCH < HCB < p,p'-DDE (586 ng/g lipid). The observed concentrations of PCB
      and chlorinated pesticides were in the same range as those found in similar
      groups of men from Sweden and Norway, but lower than those found in male
      populations with recent occupational exposure or high environmental exposure.
      Strong relationships were found between the concentrations of single mono- and di
      ortho PCB congeners and groups of PCB congeners in serum. In our group of men PCB
      153 was a good marker substance for the concentration of sigma PCB and sigma di
      ortho PCB concentrations in serum. Moreover, among the mono-ortho PCB congeners
      analyzed, PCB 156 could be used as a marker for the sigma mono-ortho PCB TEQ
      concentrations in serum in the studied group. No useful marker substances were
      found among DDT compounds and other chlorinated pesticides and metabolites,
      except for trans-nonachlor which predicted the concentration of the metabolite
      oxychlordane fairly well.

PMID- 11194154
TI  - Minerals controlling arsenic and lead solubility in an abandoned gold mine
      tailings.
AB  - Numerous areas have been contaminated by heavy metals and metalloids due to
      industrial and mining activities. Studies investigating the behavior of such
      contaminants in the environment have identified speciation as a key factor
      controlling their mobility, availability and toxicity. Here we characterize As-
      and Pb-bearing phases resulting from the oxidation of sulfide-rich tailings of a
      former gold mine (La Petite Faye, France) in order to assess the risk for water
      quality. Elements were first pre-concentrated by granulometric fractionation
      (sedimentation in deionized water) and then investigated using X-ray diffraction
      and electron microprobe analyses. Two main As-Pb-bearing minerals were clearly
      identified: scorodite (FeAsO4 x 2H2O) and beudantite PbFe3(AsO4)(SO4)(OH)6. Minor
      amounts of As and Pb were dissolved in deionized water during granulometric
      fractionation, indicating the possible presence of other soluble Pb-sulfates
      which could be some of the primary metastable products of sulfide oxidation. This
      dissolution also provides information about the fate of these phases in the case
      of intensive leaching of the tailings. Scorodite may not be considered as a
      relevant candidate for As on-site immobilization, because its solubility largely
      exceeds drinking water standards whatever the pH. Since beudantite solubility has
      not yet been determined, an estimation of its solubility product was obtained
      using the Gibbs free energy of formation of plumbojarosite [Pb0.5Fe3(SO4)2(OH)6].
      This estimation suggests that beudantite should efficiently maintain low Pb
      concentration in waters. However, Pb dissolution in deionized water during the
      granulometric fractionation led to Pb concentrations much higher than the French
      and US drinking water standards (2.4 x 10(-7) mol l(-1)), which may be due to
      dissolution of the suspected metastable Pb-sulfates. Accurate determination of
      beudantite solubility is now required to improve the Pb risk assessment on such
      polluted sites.

PMID- 11194155
TI  - Determination of metals in plant samples by using a sector field inductively
      coupled plasma mass spectrometer.
AB  - The capability of pine needles to be used as bioindicators of trace metals in the
      environment is discussed. Samples were collected around the Instituto de
      Pesquisas Energeticas e Nucleares, the largest nuclear research center in South
      America and chosen to be the sampling target area. Results obtained for the
      elemental content of Th and U in samples collected nearby an uranium facility
      were, respectively, 0.072 and 0.042 mg kg(-1), while the results obtained for the
      La, Ce and Sm content in a sample collected in the vicinity of an extraction
      laboratory were, respectively, 0.22, 0.88 and 0.39 mg kg(-1). All these values
      are higher than the ones obtained with a reference sample (La 0.12; Ce 0.19, Th
      0.020 and U 0.012 mg kg(-1)), located far from the target area. Internal
      standardization was used to compensate the non-spectral interference of the
      different elements present in the sample solution matrix. The chemical elements
      bismuth (Bi) and indium (In) were chosen as internal standards. In order to
      control the accuracy of the chemical measurement process, certified samples of
      pine needles (NBS SRM 1575) were also analyzed. The results obtained show the
      capability of the investigated method in the determination of the relevant trace
      metals in the environment.

PMID- 11194156
TI  - The effect of surface coatings on the association of orthophosphate with natural
      colloids.
AB  - A new method has been utilised for the characterisation of natural particle
      surface coatings. The method involves the use of sedimentation field-flow
      fractionation (SdFFF), radiolabelling and inductively coupled plasma-high
      resolution mass spectrometry (ICP-HR MS) techniques to study the effect of
      colloidal surface coatings on the adsorptive behaviour of orthophosphate.
      Colloidal river sediment and soil samples were chemically treated in an attempt
      to selectively remove metal hydroxyoxides and natural organic matter. The samples
      were then radiolabelled with 33PO4(3-) and analysed by SdFFF to determine the
      surface adsorption density (SAD) of orthophosphate as a function of particle
      size. The SdFFF unit was directly coupled to an ICP-HR MS to determine the
      chemical composition of the colloidal samples as a function of particle size.
      Element concentration/UV detector signal and element atomic molar ratios were
      plotted against particle size, and the trends used in the interpretation of SAD
      distribution (SADD) changes for the samples were studied. In general, non
      constant trends in the orthophosphate SADDs were found, except for the river
      sediment treated with hydroxylamine hydrochloride. The results indicated that, in
      the soil sample studied, the Mn oxide coating was a dominant factor in
      determining phosphorus adsorption. This method could also be applicable to other
      industrial or similar samples.

PMID- 11194157
TI  - 16-year trends in elements of lichens at Theodore Roosevelt National Park, North
      Dakota.
AB  - An epiphytic lichen and a soil lichen in two very closely related genera
      (Parmelia sulcata and Xanthoparmelia chlorochroa, respectively) were sampled 16
      years apart at Theodore Roosevelt National Park in North Dakota and measured for
      their elemental content. Mercury and cadmium decreased approximately 30% over the
      time period in both species. Sulfur decreased 8% in the epiphytic species, but
      increased 20% in the soil lichen. Factor analysis revealed that soil elements
      were higher in the soil lichen, indicating there was some soil contamination in
      that species. A relationship between iron and titanium was found only in the soil
      lichen. Sulfur and mercury were highly enriched in both species relative to the
      soil, which suggests that the atmosphere is a contributing source of these
      elements. New baseline values were calculated, 22 elements for both species,
      although it is not recommended that the soil lichen be sampled in the future.

PMID- 11194158
TI  - Methane emission from a simulated rice field ecosystem as influenced by
      hydroquinone and dicyandiamide.
AB  - A simple apparatus for collecting methane emission from a simulated rice field
      ecosystem was formed. With no wheat straw powder amended all treatments with
      inhibitor(s) had so much lower methane emission during rice growth than the
      treatment with urea alone (control), which was contrary to methane emission from
      the cut rice-soil system. Especially for treatments with dicyandiamide (DCD) and
      with DCD plus hydroquinone (HQ), the total amount of methane emission from the
      soil system and intact rice-soil system was 68.25-46.64% and 46.89-41.78% of the
      control, respectively. Hence, DCD, especially in combination with HQ, not only
      increased methane oxidation in the floodwater-soil interface following
      application of urea, but also significantly enhanced methane oxidation in rice
      root rhizosphere, particularly from its tillering to booting stage. Wheat straw
      powder incorporated into flooded surface layer soil significantly weakened the
      above-mentioned simulating effects. Regression analysis indicated that methane
      emission from the rice field ecosystem was related to the turnover of ammonium-N
      in flooded surface layer soil. Diminishing methane emissions from the rice field
      ecosystem was significantly beneficial to the growth of rice.

PMID- 11194159
TI  - Ecological half-life of 137Cs in fish from a stream contaminated by nuclear
      reactor effluents.
AB  - Radiocesium (137Cs) concentrations were determined during 1974, 1981 and 1998 for
      seven species of fish inhabiting a stream (Steel Creek) contaminated by effluents
      from a nuclear reactor to examine the decline of this radionuclide in a natural
      ecosystem. Median 137Cs concentrations were highest in Micropterus salmoides
      (largemouth bass) during each year of the investigation (1974 = 6.67 Bq g(-1) dry
      wt. of whole body; 1981 = 3.72 Bq g(-1); 1998 = 0.35 Bq g(-1)), but no patterns
      of differences were observed among Aphredoderus sayanus (pirate perch), Esox
      americanus (redfin pickerel), Lepomis auritus (redbreast sunfish), L. gulosus
      (warmouth), L. punctatus (spotted sunfish), and Notropis cummingsae (dusky
      shiner). Results demonstrated a rapid decline in 137Cs within fish from Steel
      Creek during the 24-year period. For example, 137Cs concentrations in all fish
      species declined significantly among years, even after accounting for radioactive
      decay. The observed percent declines in 137Cs concentrations of individual
      species were 3-4 times greater between 1974 and 1981 compared to that expected by
      physical decay alone, and 2-3 times greater during 1981-1998. Ecological half
      lives (EHLs) of 137Cs in fish ranged from 4.43 years in A. sayanus to 6.53 years
      in L. gulosus. The EHL for 137Cs in all fish species combined was 5.54 years.
      Current levels of 137Cs in fish from Steel Creek (1.16 Bq g(-1) dry wt. of whole
      body to below detection limits) indicate that the consumption of fish from this
      ecosystem poses little risk to humans and sensitive wildlife species. These
      results demonstrate the importance of incorporating the concept of ecological
      half-life into determinations concerning the length and severity of potential
      risks associated with radiocontaminants.

PMID- 11194160
TI  - Comparison of atmospheric pesticide concentrations measured at three sampling
      sites: local, regional and long-range transport.
AB  - We present the comparison of atmospheric concentrations of eleven currently used
      pesticides (HCB, alpha-HCH, gamma-HCH, trifluraline, mecoprop, phosalone,
      atrazine, carbofuran, carbaryl, diuron and isoproturon) measured in remote
      (Aubure), rural (Colmar) and urban (Strasbourg) areas of Alsace and Vosges
      regions (cast France). Pesticides samples were collected simultaneously on two of
      the three sites during the summer season of 1993 and 1994, using a Hi-Vol sampler
      with Whatman filter paper and XAD-2 resin. The particle and gas phases were
      collected separately during 24 h. The relative importance of local emissions and
      local, regional and long distance transport on the contamination of the
      atmosphere in the three environments (remote, rural and urban) were investigated.
      To facilitate the interpretation of the results, the alpha/gamma-HCH ratio was
      used as a tracer of pesticide emissions.

PMID- 11194161
TI  - The long-term evolutions and the regional characteristics of atmospheric methane
      concentrations in Nagoya, 1983-1997.
AB  - This study provides information on the long-term evolutions of the atmospheric
      methane (CH4) concentrations in Nagoya City, Japan, which were analyzed by using
      the continuous monitoring data observed at the eight observatory stations for
      1983-1997. The 15-year records of the atmospheric CH4 concentrations were
      examined by means of a time-series analysis using a fast Fourier transform with a
      low-pass filter to elucidate the seasonal cycles and the long-term trends. The
      annual averages of the CH4 concentrations in Nagoya were 1.85 ppmv (parts per
      million by volume), 1.91 ppmv, and 1.90 ppmv in 1988, 1995 and 1997,
      respectively. Moreover, the annual average growth rate showed a drastic decrease
      from 17 ppbv (parts per billion by volume) year(-1) in 1992 to 2 ppbv year(-1) in
      1993, and further down to 7 ppbv year(-1) in 1997. Comparison of the atmospheric
      CH4 records in Nagoya with those in global air of the northern hemisphere
      observed at Mauna Loa observatory in Hawaii, USA, allows us to estimate the
      excess concentration of CH4 in the urban atmosphere of Nagoya, which was 0.17
      ppmv in 1988 and 0.15 ppmv in 1997. On a local scale, the atmospheric CH4
      concentrations in the northern part of Nagoya City increased until 1992 and then
      gradually decreased from 1993 to 1997, although those in the south-western urban
      areas constantly increased at the averaged growth rate of 13 ppbv year(-1) for
      1988-1997. The variation of the long-term trends of the CH4 concentrations in
      Nagoya may be ascribed to the emission changes from the CH4 sources due to the
      human activities such as waste dumping and landfills.

PMID- 11194162
TI  - Feasibility of assessing dermal exposure to PAHs of workers on gaswork sites--the
      SOLEX study.
AB  - Population exposure to pollutants in soil is an important public health concern.
      Difficult to measure, it is usually estimated using multimedia models. Modeling
      data predict that the skin surface is a predominant exposure route in roughly 15%
      of the US Superfund sites. Nonetheless, no study has confirmed these predictions.
      The SOLEX study was an opportunity to study the feasibility of estimating the
      cutaneous polycyclic aromatic hydrocarbons (PAHs: all 16 of the United States
      Environmental Protection Agency list) load of workers at three former
      manufactured gas sites, one of those being under remediation. Over two
      measurement periods (November 1997 and June 1998), 30 and 28 volunteers,
      respectively, were equipped for a single day work with five pads that collected
      soil particles and were placed at the neck, shoulder, wrist, groin, and ankle.
      Pad contamination was observed for six of the nine workers on the site being
      remediated but not on other sites. The wrist pad was most often affected,
      followed by the neck pad, these are, the exposed regions of the body. The PAHs
      most frequently identified were anthracene, fluoranthene, naphthalene,
      phenanthrene, and pyrene, at concentrations relatively high. In conclusion, this
      study showed that estimating skin exposure to soil pollutants is feasible.
      Secondly, it suggested that only subjects in close contact with the soil had a
      detectable exposure to PAHs. Extension of this approach to other exposure
      settings is warranted, especially among children playing in polluted public or
      private gardens, because their games lead to frequent contact with the soil.

PMID- 11194163
TI  - Seasonal and long-term variation of 210Pb concentration in air, atmospheric
      deposition rate and total deposition velocity in south Germany.
AB  - The activity concentration in air and atmospheric deposition rate of the long
      lived radon progeny 210Pb has been investigated at Munich-Neuherberg, south
      Germany, from 1972 (activity concentration) and from 1981 (atmospheric flux) to
      1999. For these periods, the continuous measurements yielded an average 210Pb
      activity concentration at ground level of 0.57 mBq m(-3) and an average total
      210Pb deposition rate to ground of 180 Bq m(-2) year(-1). The average total
      deposition velocity, which relates the total 210Pb deposition rate to the 210Pb
      activity concentration was calculated to be 1.0 cm s(-1). The variation of the
      data with time was studied by time-series analysis and distinct seasonal patterns
      were identified. Maximum 210Pb activity concentrations in air are observed in the
      autumn and winter months (October through February) of each year. By contrast,
      the maximum 210Pb deposition rate is observed during summer (June-August), i.e.
      in the months with the highest amount of rainfall at this site. Like the 210Pb
      deposition rate, the total deposition velocity exhibits a seasonal pattern with
      maximum values in summer. Due to the long observation period of 18 years, it was
      possible to observe for the first time a strong positive relationship between
      210Pb deposition and precipitation, especially for the months May and June and to
      a smaller extent for several other months. In the long-term, variations of
      approximately a factor of 2 were observed in the annual average 210Pb activity
      concentrations, the annual deposition sums and the annual average deposition
      velocities. Since around 1981 210Pb concentrations in air steadily decreased
      while 210Pb depositions increased. As a consequence of these significant trends,
      the time series of the total deposition velocity exhibits a trend of the data
      from approximately 0.7 cm s(-1) in 1981 to 1.7 cm s(-1) in 1999.

PMID- 11194164
TI  - Granulometry and the content of toxic and potentially toxic elements in vacuum
      cleaner collected, indoor dusts of the city of Warsaw.
AB  - Twenty-seven sites, together with 23 household dust sample sites, representing
      the home environment, and four public room dust sample sites, representing
      working environment (mainly offices) have been described in this paper. The
      latter were examined to obtain an approximate reference to the home environment
      data. All the samples were collected between May and July 1997 by a vacuum
      cleaner method, in the city of Warsaw, Poland. The granulometry of the dusts was
      determined by their separation into seven fractions in the range 8-500 microm.
      The concentrations of Cr, Ni, Cu, Zn, Pb, Br and Fe in the samples were
      investigated in fractions 8-32, 32-63 and 63-125 microm by the EDXRF technique.
      The results showed higher concentrations of these elements in finer fractions (8
      32 microm). The Pb content in the household dusts was found to be unexpectedly
      low, ranging from 120 microg g(-1) for the 63-125 microm fraction, up to 210
      microg g(-1) for the 8-32 microm fraction. Car exhausts could not be determined
      clearly as the main source of Pb in the indoor household dusts due to the lack of
      a Pb-Br intercorrelation. In these dusts, only Cr and Zn showed a remarkably high
      content of 90-100 and 1020-1070 (microg g(-1)), respectively. In the household
      dusts, strong intercorrelations were present in the three analysed fractions for
      the metal pairs: Pb-Zn, Pb-Cu, Fe-Cr, and Cu-Cr (weaker). The working environment
      rooms showed a higher degree of dustiness by 300%, as compared to the dwellings.
      The dusts collected in the working environment rooms showed slightly higher
      concentrations of Ni and by 50-100% higher concentrations of: Cu, Zn, Pb, Br than
      the analysed household dusts.

PMID- 11194165
TI  - Human impact on the environment in Japan and New Zealand: a comparison.
AB  - Because of its proximity to Asia, Japan has been populated by humans for a much
      longer time period than New Zealand and has a much higher population density. The
      similarity in geology and tectonic setting of the two island groups has forced
      both peoples to confront similar environmental hazards but this was achieved in
      different ways. During the Edo period (1600-1868) when contact with outside
      countries was limited, the Japanese adapted their agricultural practices to the
      environment and developed an agricultural system that corresponds closely to the
      ideals of sustainability. Indeed, it can be argued that the farming lifestyle of
      the Edo period was the most advanced way of life that can be adopted without
      depleting stock resources. Following the Meiji restoration in 1868, the policy of
      rapid industrialization led to many environmental mistakes, particularly after
      World War II. By the end of the 1960s, Japan was the world's most polluted
      country. The situation has subsequently improved greatly from this low point but
      much remains to be done. New Zealand was initially occupied by the Maori over
      1000 years ago. They did more environmental damage than was previously thought,
      particularly in burning off bush and destroying the bird life. However, it was
      the colonization of New Zealand by the Europeans after 1840 that led to the
      greatest environmental damage with their introduction of farming methods unsuited
      to the conditions. Although the need for better scientific planning of land use
      practices within New Zealand is recognized, sustainable management of the
      environment remains a distant goal. More detailed study of the agricultural
      methods and lifestyles adopted in Japan during the Edo period could help in
      defining the concept of sustainability.

PMID- 11194166
TI  - Polycyclic aromatic hydrocarbons in soil and plant samples from the vicinity of
      an oil refinery.
AB  - Soil samples, and samples of leaves of Plantago major (great plantain) and grass
      (mixed species) were collected from the vicinity of an oil refinery in Zelzate,
      Belgium, and analysed for seven polycyclic aromatic hydrocarbons (PAHs). The
      samples from the site adjacent to the refinery (site 1) contained very high total
      PAH-concentrations: namely 300, 8 and 2 microg/g dry wt. for soil, P. major and
      grass, respectively. Concentrations in samples from more remote sites (up to 4 km
      from the refinery) were a factor of 10-30 lower than those from site 1, but
      between them the differences were small. The PAH-profiles of the plant samples,
      in contrast with those of the soil samples, appeared to shift to higher
      contributions of gaseous PAHs with increasing distance from the refinery. This
      can be explained by particle-bound PAHs being deposited closer to the source than
      gaseous PAHs. It is suggested that particle-bound deposition is relatively more
      important for deposition to soil than to plants, due to blow-off and wash-off of
      the compounds from the leaves. The total PAH-concentrations in the leaves of P.
      major were higher than those measured in the grass samples, probably due to
      differences in aerodynamic surface roughness, leaf orientation and/or leaf age.
      However, the concentration ratios of P. major/grass were not constant for the
      different sites, varying from 1.2 to 8.8. Therefore, it appears that a precise
      prediction of PAH-concentrations for one plant species from known concentrations
      of another species is not possible. When errors in predicted concentrations need
      to be smaller than a factor of approximately 10, the sampling strategy has to be
      focussed on all species of interest.

PMID- 11194167
TI  - Population-based planning a popular tool for ASCs (ambulatory surgery centers).

PMID- 11194168
TI  - AMA launches partnership to lease physician database.
AB  - A joint venture is allowing the AMA to refine the physician data it sells to
      marketers. Physicians in the organization's heavily used database get some
      latitude in how information about them is distributed.

PMID- 11194169
TI  - Physicians go online for electronic medical records.
AB  - Frustrated with electronic health records systems on the market, a California
      physician took matters into his own hands. The result is an electronic medical
      records system in use by 9,000 physicians in about a dozen communities.

PMID- 11194170
TI  - Medical school consortium develops clinical protocols using Web-based strategy.

PMID- 11194171
TI  - HCIA-Sachs benchmarking study. Top-performing orthopedic hospitals have better
      outcomes despite higher acuity.

PMID- 11194172
TI  - Pharmacodynamic study of Hypericum perforatum L.
AB  - The effects of Hypericum perforatum L. (Hypericaceae) crude ethanol extract (A),
      ethyl acetate extract (B), aqueous extract (C) and infusion (I), on pentobarbital
      induced sleeping time, intestinal motility, and their analgesic activity, have
      been investigated. Extracts A and B exhibited significant stimulatory and
      antidepressant effects on the CNS. Both extracts prolonged sleep, increasing time
      up to more than 25 min. The antidepressive activity of extract A was also
      achieved by significant reduction of the myorelaxant activity of diazepam.
      Extract B exhibited strong analgesic activity reducing abdominal stretching
      induced by acetic acid by nearly 50 %. Extracts A, B and C exhibited spasmolytic
      activity, significantly reducing intestine motility.

PMID- 11194173
TI  - Oral bioavailability of active principles from herbal products in humans. A study
      on Hypericum perforatum extracts using the soft gelatin capsule technology.
AB  - The oral absorption of two known active principles of Hypericum perforatum,
      namely hyperforin and hypericin, was studied in an open, single dose, two-way,
      randomized, cross-over study involving 12 healthy subjects (six males and six
      females). Alcoholic Hypericum extract (300 mg, containing 5% hyperforin and 0.3 %
      hypericin) was administered in the morning after 12 hours fasting. The
      formulation was administered as softgel capsules containing, inter alia, soya oil
      together with the herbal extract. A second standard formulation in two piece hard
      gelatin capsules was also used for comparison purposes. Blood was sampled from
      the subjects at different times after drug administration and the plasma was
      analysed according to published analytical methods for the determination of
      hyperforin and hypericin. Peaks of plasma concentration, Cmax of hyperforin were
      168.35 ng/ml +/- 57.79 for the soft gelatin formulation (CV=34.32, n=12) and
      84.25 ng/ml +/- 33.51 for the hard gelatin capsule (CV=39.77, n=12). The Tmax
      values for hyperforin were 2.50 h +/- 0.83 for the soft gelatin formulation
      compared to 3.08 h +/- 0.79 for the reference formulation, whereas the total AUC
      were respectively 1482.7 h x ng/ml +/- 897.13 and 583.65 h x ng/ml +/- 240.29. As
      for hypericin, plasma levels were detectable in approximately half of the
      subjects treated. However also in this case the soft gelatin capsules exhibited a
      higher individual absorption when compared with the corresponding data for the
      hard gelatin capsules.

PMID- 11194174
TI  - Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an
      experimental study.
AB  - The roots of Withania somnifera (WS) are used extensively in Ayurveda, the
      classical Indian system of medicine, and WS is categorized as a rasayana, which
      are used to promote physical and mental health, to provide defence against
      disease and adverse environmental factors and to arrest the aging process. WS has
      been used to stabilize mood in patients with behavioural disturbances. The
      present study investigated the anxiolytic and antidepressant actions of the
      bioactive glycowithanolides (WSG), isolated from WS roots, in rats. WSG (20 and
      50 mg/kg) was administered orally once daily for 5 days and the results were
      compared by those elicited by the benzodiazepine lorazepam (0.5 mg/kg, i.p.) for
      anxiolytic studies, and by the tricyclic anti-depressant, imipramine (10 mg/kg,
      i.p.), for the antidepressant investigations. Both these standard drugs were
      administered once, 30 min prior to the tests. WSG induced an anxiolytic effect,
      comparable to that produced by lorazepam, in the elevated plus-maze, social
      interaction and feeding latency in an unfamiliar environment, tests. Further,
      both WSG and lorazepam, reduced rat brain levels of tribulin, an endocoid marker
      of clinical anxiety, when the levels were increased following administration of
      the anxiogenic agent, pentylenetetrazole. WSG also exhibited an antidepressant
      effect, comparable with that induced by imipramine, in the forced swim-induced
      'behavioural despair' and 'learned helplessness' tests. The investigations
      support the use of WS as a mood stabilizer in clinical conditions of anxiety and
      depression in Ayurveda.

PMID- 11194175
TI  - Hypocrellin and hypericin-induced phototoxicity of HL-60 cells: apoptosis or
      necrosis?
AB  - Hypericin and hypocrellin are potential antiviral and antineoplastic agents with
      multiple modes of light-induced biological activity connected with a production
      of singlet oxygen and/or excited-state proton transfer and consequent pH drop
      formation in the drugs environment. In present work light-induced cytotoxicity of
      hypericin and hypocrellin and mechansim of cell death (apoptosis or necrosis) on
      human leukemic cell line HL-60 was studied. As a mean for apoptosis detection we
      used poly (ADP-ribose) polymerase (PARP) as a sensitive marker of early stages of
      apoptosis. Our results show that exposition of HL-60 cells to hypericin (1 x 10(
      5) mol x l(-1)) for 4 hours has no effect on PARP cleavage. However, after 24 and
      48 hours of illumination there is evident that hypericin in this concentration
      cleaved PARP (116 kDa) into two fragments (85 and 25 kDa). Contrary to hypericin,
      hypocrellin in concentration 1 x 10(-5) mol x l(-1) after 4 hours of illumination
      cleaved PARP into two fragments typical for apoptosis. In lower concentration (1
      x 10(-6) mol x l(-1)) hypocrellin possess also significant cytotoxic activity.
      Because we detected no fragmentation of PARP in all observed time periods we
      suggest that cytotoxic effect of hypocrellin in this concentration is due to
      induction of necrosis. Our results support the hypotesis that the hypericin and
      hypocrellin has similar mechanism of action and illumination increases cytotoxic
      effect of both agents.

PMID- 11194176
TI  - Croton zehntneri essential oil: effects on behavioral models related to
      depression and anxiety.
AB  - Croton zehntneri (Cz), a popular plant used to treat "nervous disturbance",
      contains a complex mixture of compounds, including substances exhibiting central
      nervous system activity. The effects of Cz essential oil administration (p.o.) on
      the rat's central nervous system were studied in behavioral models used to
      evaluate anxiety and antidepressive drugs. The results showed that administration
      of Cz essential oil: 1) increased the immobility duration measured in the forced
      swimming test as compared to control group (control = 89.8 +/- 45.8; 1 microl =
      153.0 +/- 48.7; 3 microl = 157.4 +/- 45.3; 10 microl = 145.3 +/- 51.0); 2)
      reduced the locomotion frequency observed in the open field (control = 62.5 +/-
      22.7; 3 microl = 38.0 +/- 13.5; 10 microl = 39.2 +/- 22.2); 3) had no effect on
      the experimental group (1 microl) observed in open field; 4) had no effect on
      animals tested in social interactions, plus-maze and holeboard tests. These data
      suggest that Cz oil produced central depressor effects in rats without any
      anxiety alterations. These results may explain the popular use of this plant in
      Brazilian folk medicine for treating "nervous disturbances".

PMID- 11194177
TI  - Induction of cytotoxicity by chlorogenic acid in human oral tumor cell lines.
AB  - Millimolar concentrations of chlorogenic acid (CGA) showed higher cytotoxic
      activity against human oral squamous cell carcinoma (HSC-2) and salivary gland
      tumor (HSG) cell lines, as compared with that against human gingival fibroblast
      (HGF). The cytotoxic activity of CGA was significantly reduced by catalase or
      CoCl2, but not affected by FeCl3 or CuCl2. ESR spectroscopy showed that higher
      (millimolar) concentrations of CGA produced radicals under alkaline conditions,
      acting as a prooxidant, whereas lower concentrations of CGA scavenged superoxide
      and hydroxyl radical. CGA produced large DNA fragments (as identified by slightly
      faster migrating band of DNA on agarose gel electrophoresis) and nuclear
      condensation (as demonstrated by Hoechst (No. 33258) staining) in tumor cell
      lines. Activation of caspase was demonstrated by staining with M30 monoclonal
      antibody, which reacts with degradation products of cytokeratin 18. Contact with
      CGA for at least 6 h was necessary for irreversible cytotoxicity induction.
      Pretreatment of the cells with caspase 3 inhibitor partially inhibited the
      cytotoxic action of CGA. These date suggest that CGA induces cytotoxicity in oral
      tumor cell lines, possibly by hydrogen peroxide-mediated oxidation mechanism.

PMID- 11194178
TI  - Ampelopsis brevipedunculata (Vitaceae) extract inhibits a progression of carbon
      tetrachloride-induced hepatic injury in the mice.
AB  - Ampelopsis brevipedunculata (Maxim.) Trautv. (Vitaceae) has been used in Japanese
      herbal folk medicine to treat liver disease. The objective of this study is to
      evaluate the antihepatotoxic effect of A. brevipedunculata in the mice. An
      aqueous fraction was extracted by immersing the berries of the plant material in
      40% ethanol for six months, followed by removing ethanol. Daily free access to
      the aqueous extract as drinking water greatly reduced the severity of hepatic
      injury, characterized by centrilobular necrosis, cytoplasmic vacuolation,
      cellular swelling, inflammation, and fibrosis in the mice receiving a nonlethal
      dose of carbon tetrachloride twice weekly during nine weeks. In addition, such a
      feeding regimen decreased the elevated levels of plasma glutamate oxaloacetate
      transaminase and glutamate pyruvate transaminase in the carbon tetrachloride
      administered mice. These results suggest that the feeding regimen with A.
      brevipedunculata extract inhibited a progression of hepatic injury induced by
      carbon tetrachloride.

PMID- 11194179
TI  - Curative property of Withania somnifera Dunal root in the context of carbendazim
      induced histopathological changes in the liver and kidney of rat.
AB  - The liver and kidney of rat underwent severe histopathological lesions when
      treated with a single bolus dose of carbendazim, a fungicide, particularly
      affecting the hepatocytes and the renal corpuscles, respectively. The effects
      appear to be manifestations of the microtubule-disrupting activity of
      carbendazim. Treatment of carbendazim-treated rats with the powder of tuberous
      root of Withania somnifera (Ashwagandha) for 48 days resulted in complete cure of
      these organs. The results indicate that Withania somnifera would be an effective
      curative for carbendazim-induced histopathological changes in the liver and
      kidney.

PMID- 11194180
TI  - Anti-ulcer compound from Voacanga africana with possible histamine H2 receptor
      blocking activity.
AB  - Voacanga africana is used in Cameroonian ethnomedicine for the treatment of
      peptic ulcers. We have tested the cytoprotective, anti-secretory and ulcer
      healing actions of an alkaloid (TN) obtained from the fruit extract. Oral
      administration of TN (50-100 mg/kg) dose-dependently prevented ulcer formation by
      HCl/ethanol (36-75%), absolute ethanol (43-75%), HCl-ethanol/indomethacin (58
      84%), Pylorus ligation (31-100%), cold restraint stress (68-100%) and histamine
      (49-100%). The inhibitory effect at 50 and 100 mg/kg against HCl/ethanol was not
      suppressed by pre-treatment with indomethacin (20 mg/kg, i.p.). TN reduced Shay
      ligated gastric acid secretion from 77 mEq/l in the controls to 46 and 25 mEq/l
      for the 50 and 100 mg/kg doses. Augmented histamine-induced gastric acid
      secretion was reduced from 84 mEq/l in the controls to 45 and 21 mEq/l for the
      two doses of TN, with total inhibition of gastric and duodenal ulcers by the 50
      mg/kg dose. Healing rate of chronic acetic acid-induced ulcers was 62 and 83%,
      respectively, for the dose of 50 and 100 mg/kg of TN compared with the controls.
      TN has gastric anti-secretory effects similar to histamine receptor blockers. Its
      cytoprotective and ulcer healing properties are related to its ability to
      strengthen gastric mucosal defenses through enhanced gastric mucus production.

PMID- 11194181
TI  - Effects of Tarchonanthus camphoratus and Eriocephalus africanus on nociception in
      mice and pyrexia in rats.
AB  - The affects of water extracts of the leaves of T. camphoratus and E. africanus on
      acetic acid- and hotplate-induced nociception and lipopolysaccharide-induced
      pyrexia were investigated. The writhing induced by acetic acid was significantly
      attenuated by T. camphoratus (50-100 mg/kg, i.p.), and E. africanus (50-200
      mg/kg, i.p.). Similarly, the pain produced by the hot-plate was significantly
      antagonized by T. camphoratus (100 mg/kg, i.p.), and E. africanus (50-100 mg/kg,
      i.p.). T. camphoratus (100 mg/kg, i.p.), and E. africanus (100-200 mg/kg, i.p.)
      significantly attenuated the fever produced by the bacterial endotoxin
      (lipopolysaccharide, 50 microg/kg, i.m.). Paracetamol (500 mg/kg, i.p.), produced
      similar effect to T. camphoratus and E. africanus on acetic acid-induced writhes
      but did not affect the pain and the fever produced by the hot-plate and
      lipopolysaccharide respectively, to any significant extent. These results
      indicate that both T. camphoratus and E. africanus have analgesic and antipyretic
      properties.

PMID- 11194182
TI  - Interaction of Strychnos nux-vomica-products and iron: with reference to lipid
      peroxidation.
AB  - In this paper, it has been investigated that strychnine, the major active
      principle in the alcoholic extract of the seeds of Strychnos nux-vomica, is
      responsible for its antilipid peroxidative property. The mechanism of action of
      this drug is through the chelation of the free iron in the system. It has also
      been observed that strychnine does not have any pro-oxidant-property, because it
      does not convert Fe3+ to Fe2+ and vice versa in the reaction system, as has been
      observed with several other antioxidants.

PMID- 11194183
TI  - Investigation of topical application of procyanidin B-2 from apple to identify
      its potential use as a hair growing agent.
AB  - Procyanidin B-2 is a polyphenol compound we have identified in apple which acts
      as a hair-growing factor in the murine model both in vitro and in vivo. This
      report describes our investigation of the effects of 1% procyanidin B-2 tonic on
      human hair growth after sequential use for 6 months. A double-blind clinical test
      involving a total of 29 subjects was performed. Nineteen men in the procyanidin B
      2 group and 10 men in the placebo control group were subjected to analyses. No
      adverse side effects were observed in either group. The hair-growing effect was
      evaluated using a macrophotography technique combined with measurements of the
      hair diameter of clipped hairs. The increase in number of total hairs in the
      designated scalp area (0.5 cm square = 0.25 cm2 area) of procyanidin B-2 group
      subjects after the 6-month trial was significantly greater than that of the
      placebo control group subjects (procyanidin B-2, 6.68 +/- 5.53 (mean +/- SD)/0.25
      cm2; placebo, 0.08 +/- 4.56 (mean +/- SD)/0.25 cm2; P < 0.005, two-sample t
      test). The increase in number of terminal hairs, which are defined as hairs more
      than 60 microm in diameter, in the designated area (0.5 cm square = 0.25 cm2
      area) of the procyanidin B-2 group subjects after the 6-month trial was
      significantly greater than that of the placebo control group subjects
      (procyanidin B-2, 1.99 +/- 2.58 (mean +/- SD)/0.25 cm2; placebo, -0.82 +/- 3.40
      (mean +/- SD)/0.25 cm2; P < 0.02, two-sample t test). Procyanidin B-2 therapy
      shows potential as a safe and promising cure for male pattern baldness.

PMID- 11194184
TI  - The Korean version of the neuropsychiatric inventory: a scoring tool for
      neuropsychiatric disturbance in dementia patients.
AB  - The Neuropsychiatric Inventory (NPI) is a standardized, validated, and reliable
      tool to assess neuropsychiatric derangements in dementia patients. The aim of
      this study is to develop the Korean version of the NPI (K-NPI) and to test its
      reliability and usefulness in dementia patients. The subjects were 49 normal
      controls and 92 patients with Alzheimer's disease (43), vascular dementia (32),
      frontotemporal lobar degeneration (11), and other causes (6). Their caregivers
      familiar with the subjects' everyday behavior were interviewed with the K-NPI. In
      a subgroup (29/141) of the caregivers, the K-NPI was repeated for test-retest
      reliability, average of 23.1 days after the initial test. Prevalence rates of 12
      behavioral domains in dementia patients were comparable to those of the original
      NPI; apathy was the most common and hallucination was the least common behavior.
      Total K-NPI scores correlated positively with dementia severity assessed with the
      Korean Mini-Mental State Examination. Test-retest reliabilities of frequencies
      and severities of all subscales were significantly high. Depression, anxiety,
      apathy, irritability, night-time behavior, and eating change were identified at
      very low rates in normal controls and were significantly less than those in
      dementia patients (p<0.001). The K-NPI, whose reliability and competency are
      comparable to those of the original version, may be a reliable and useful tool
      for measuring neuropsychiatric disturbances in Korean dementia patients.

PMID- 11194185
TI  - Serotypes and antimicrobial susceptibility in clinical isolates of Haemophilus
      influenzae from Korean children in prevaccination era.
AB  - Fifty-five strains of Haemophilus influenzae recovered at a children's hospital
      in Korea from 1992 through 1997, were analyzed for serotype and antibiotic
      resistance. Antimicrobial susceptibility was tested by broth dilution method.
      Among the 55 strains, 26 were from normally sterile body fluids, of which 17 were
      from the immunocompetent children. Spectrum in the immunocompetent included
      meningitis (47%), bacteremic pneumonia (18%), and bacteremia without focus (35%).
      Three (12%) of 26 invasive infections were caused by non-type b: one type d and
      two type f. Nine of 29 non-sterile body fluid isolates belonged to one of
      encapsulted serotypes: four a, two c, one of each of b, d and e. Thirty two (58%)
      strains were resistant to ampicillin, and all of which produced beta-lactamase.
      All of the strains were highly susceptible to amoxicillin/clavulanate, cefixime,
      cefuroxime, azithromycin and ciprofloxacin, while 1 (2%), 7 (13%), 4 (7%) and 4
      (7%) strains were intermediate to cefprozil, cefaclor, loracarbef, and
      clarithromycin, respectively. The serotype distribution of H. influenzae in
      Korean children is similar to those in developed countries before the
      introduction of Hib conjugate vaccine, and ampicillin resistance rate is among
      the highest published to date.

PMID- 11194186
TI  - Serologic heterogeneity of HLA-A24 correlates with allelic types in the Korean
      population.
AB  - HLA-A24 is the second most frequently expressed HLA-A type in Koreans (GF 22.8%).
      Four different serologic reaction patterns were observed in Korean A24 positive
      samples using a commercial serologic typing kit. To clarify the nature of
      serologic heterogeneity, thirteen A24 positive DNA samples representing the four
      different serologic reaction patterns were subjected to DNA sequencing analysis
      of the amplified HLA-A genes from each sample. Four A*24 alleles (A*2402101,
      A*2403, A*2408, and A*2421) were associated with the four unique serologic
      reaction patterns. During this study, a novel allele, A*2421, was characterized.
      The new sequence is similar to A*2402101, differing at codon 127 (AAA-->AAC; K-
      >N). By comparing putative amino acid sequences and serologic reaction patterns
      of A*24 allelic products identified in this study, several crucial sites for A24-
      and A9-specific antibody binding were predicted: 127K for A24 antibody binding,
      and 62E-65G and 166D-167G for A9 antibody binding. This information will be
      helpful for accurately assigning HLA-A24 types by serology and for predicting
      serologic types of new alleles.

PMID- 11194187
TI  - Effectiveness of propofol pretreatment on the extent of deranged cerebral
      mitochondrial oxidative enzyme system after incomplete forebrain
      ischemia/reperfusion in rats.
AB  - It has been suggested that propofol has the protective effect on cerebral
      ischemia-reperfusion injury. The aim of this study is to evaluate the effect of
      propofol pretreatment on incomplete forebrain ischemia-reperfusion injury in
      rats. Thirty Sprague-Dawley rats were anesthetized with isoflurane in oxygen and
      randomly allocated into propofol group (n=13) and saline group (n=17). In
      propofol group, propofol was pretreated in a step-down scheme before inducing
      forebrain ischemia by occlusion of both common carotid arteries and arterial
      hypotension. After ischemia (20 min) and reperfusion (30 min), rats were
      decapitated. Brain was sliced to obtain coronal slices of 4-12 mm from frontal
      pole, which were reacted with 2% 2,3,5-triphenyl-2H-tetrazolium chloride (TTC)
      for 10 min to differentiate the damaged tissues from normal tissues. Median
      (interquartile range) values of the average percent infarct area were 0.0 (8.6)%
      and 20.1 (41.2)% in propofol and saline groups, respectively. There was
      significant difference between the groups. In conclusion, propofol may have a
      protective effect on incomplete forebrain ischemia-reperfusion injury.

PMID- 11194188
TI  - Presence of circulating autoantibodies against bronchial epithelia cell in
      patients with nonatopic asthma.
AB  - Allergic response to common environmental agents has been regarded as a main
      pathogenetic mechanism of bronchial asthma. However, allergic sensitization
      (atopy) can not be detected in a siginificant number of adult asthmatic patients.
      The etiology of nonatopic asthma has not yet been defined. To evaluate the
      possible involvement of autoimmune response against bronchial mucosa in the
      pathogenesis of nonatopic asthma, we performed indirect immunofluorescence
      staining of fresh frozen human bronchial mucosa tissue using serum samples from
      patients with atopic and nonatopic asthma, healthy controls, and patients with
      systemic lupus erythematosus. On immunostaining, circulating IgG autoantibodies
      against bronchial mucosa were detected in 2 (9.1%) of 22 patients with nonatopic
      asthma and in none of 22 patients with atopic asthma and of 22 healthy controls.
      IgG autoantibodies from the two patients with nonatopic asthma predominantly
      stained the cytoplasmic membrane of basal cells in bronchial epithelium. Serum
      samples from 10 patients with systemic lupus erythematosus immunostained the
      nucleus of epithelial cells in whole layer of bronchial epithelium. This study
      showed the presence of circulating IgG autoantibodies against the bronchial
      epithelial cell in a small portion of patients with nonatopic asthma. Further
      studies may be necessary to evaluate the possible involvement of autoimmune
      mechanism in the pathogenesis of nonatopic asthma.

PMID- 11194189
TI  - Change in activity of the sympathetic nervous system in diet-induced obese rats.
AB  - We investigated the change in activity of the sympathetic nervous system (SNS) in
      high-sucrose diet (HSD)-induced obese rats compared with controls. Power spectral
      analyses of R-R interval variability were performed to obtain the low frequency
      (LF, 0.04-0.699 Hz) and high frequency (HF, 0.7-3.0 Hz) powers. The percents of
      fat mass to body weight (%F/BW) and fat to muscle ratios (F/M) were significantly
      increased in HSD-fed rats. Plasma glucose, leptin, and triglyceride
      concentrations in rats fed with HSD were significantly increased. LF in
      normalized units (LFn), which represents both sympathetic and parasympathetic
      activities, was significantly increased whereas HF in normalized unit (HFn),
      which represents parasympathetic activity, was significantly decreased in HSD-fed
      rats. LF/HF, which represents sympathetic activity, was significantly increased
      in HSD-fed rats and was correlated with leptin (r=0.549, p<0.023), %F/BW
      (r=0.513, p<0.035), F/M (r=0.536, p<0.038), and triglyceride (r=0.497, p<0.042).
      When adjusted for leptin concentrations, however, LF/HF of HSD-fed rats was
      significantly decreased. In conclusion, HSD-induced obese rats showed increased
      LF/HF, which was significantly decreased by adjustment for leptin concentrations.
      We suggest that stimulating effect of leptin on SNS is reduced, which might play
      a role in induction of obesity by HSD.

PMID- 11194190
TI  - Relationship between normal heart size and body indices in Korean.
AB  - We provided a curve-fit equation to predict the normal heart weight (g) in
      Koreans by examining 422 autopsies (215 males and 207 females, from newborn to
      age 77 yr) who were relatively in good general condition. Heart weight was well
      correlated with body surface area (m2), body weight (kg), and body height (cm)
      but poorly with age in both sex. Heart weight progressively increased from birth
      to the earlier 3rd and 4th decades in male and female, respectively, and then
      gradually decreased; mean heart weight of all age group was greater in male than
      in female and significantly different from birth to 4th decade. In both sex,
      heart weight exponentially increased in accordance with the increase of body
      height, body weight, and body surface (in male, heart weight=0.00312 x body
      height(2.239), r2=0.750, p<0.0001; in female, heart weight=0.00443 x body
      height(2170), r2=0.781, p<0.0001; in male, heart weight=9.22 x body
      weight(0.853), r2=0.770, p<0.0001; in female, heart weight=9.00 x body
      weight0.855, r2=0.820, p<0.0001; in male, heart weight=155.18 x body surface
      area1.290, r=0.808, p<0.0001; in female, heart weight=124.13 x body surface
      area1.242, r=0.834, p<0.0001). These results indicate that heart weight is better
      correlated with body surface area than with body weight; however, body weight
      should be a better determinant of a predicted heart weight, since body surface
      area is entirely dependent on body height and body weight.

PMID- 11194191
TI  - Expression of progesterone receptor in human keratinocytes.
AB  - Despite the various responses of human skin to female sex hormones, cellular and
      subcellular targets and the mechanisms of action of estrogen and progesterone in
      human skin are not well understood. The detection of estrogen receptor (ER) and
      progesterone receptor (PR) in the skin is of great importance to understand the
      effect of estrogen and progesterone. In primary cultures of human keratinocytes,
      expression of ER and PR was monitored by immunocytochemistry and reverse
      transcriptase polymerase chain reaction (RT-PCR). Paraffin embedded skin tissues
      were stained with monoclonal antibodies to human ER and PR by
      immunohistochemistry. Cultured human keratinocytes expressed cytoplasmic PR
      protein and PR mRNA transcripts. By contrast, ER was detected only at the mRNA
      level. Suprabasal keratinocytes from samples of pruritic urticarial papules,
      plaques of pregnancy (PUPPP) and psoriasis were stained positively only for PR,
      while those from samples of erythema nodosum were negative for both ER and PR.
      Lesional epidermis of PUPPP showed positive PR immunoreactivity, while
      nonlesional epidermis did not. No other cells in the normal human skin were
      stained with ER and PR. The present study suggests that by expressing PR human
      keratinocytes act as targets for progesterone action.

PMID- 11194192
TI  - Prognostic significance of E-cadherin/catenin complex expression in gastric
      cancer.
AB  - Abnormal expression of E-cadherin/catenin complex in cancer has been associated
      with poor differentiation and acquisition of invasiveness, suggesting a possible
      role of this protein as an invasion suppressor. In this study, we conducted an
      immunohistochemical investigation of all components of the E-cadherin/catenin
      complex in 65 gastric cancer patients. Abnormal expression of E-cadherin and,
      alpha- and gamma-catenin occurred more frequently in diffuse than in intestinal
      type of gastric cancer, and correlated with poor differentiation. Abnormal
      expression of E-cadherin and beta-catenin correlated with poor survival. Abnormal
      expression of all four components of the complex was associated with poorly
      differentiated and diffuse-type carcinoma, and poor survival. In the multivariate
      analysis, abnormal expression of the E-cadherin/catenin complex was not an
      independent prognostic factor. These results suggest that the E-cadherin/catenin
      complex may be a useful marker of differentiation and prognosis in gastric
      cancer. Further studies are warranted to clarify the impact of the E
      cadherin/catenin complex on prognostic factor of gastric cancer.

PMID- 11194193
TI  - Topographic expression of p21WAF1/SDI1/CIP1, bcl2, and p53 is altered at the
      early stage of colorectal carcinogenesis.
AB  - We analyzed the expression of p21, bcl2, and p53 in normal and different
      pathologic mucosa of the human colorectum using immunohistochemistry and cold
      polymerase chain reaction-single strand conformation polymorphism. The topography
      of normal mucosa showed; bcl2 and p53 expression restricted to basal epithelial
      cells and p21 expressed only in superficial epithelial cells. This topographic
      expression was altered in hyperplastic polyps and adenomas. Hyperplastic polyps
      revealed absence of or weak bcl2 expression and strong p21 expression without
      topography. In adenomas, whereas bcl2 expression increased and extended to
      parabasal and superficial dysplastic epithelium, the increase of p21 expression
      was limited to surface dysplastic epithelium. p53 was weakly expressed throughout
      the full thickness of dysplastic epithelium. Bcl2 expression in adenomas was
      stronger than in carcinomas; p53 expression was converse and p21 expression was
      variable. In carcinomas, this topographic expression was largely abrogated but
      p53 mutation (36%) was more frequent than in adenomas (2%). In carcinomas, p21
      and p53 expression correlated inversely, but there was no relationship with bcl2.
      These results suggest that there is precisely ordered topographic pattern of p21,
      bcl2, and wild p53 expression in normal colorectal cells, but this becomes
      disordered during the early stage of colorectal carcinogenesis.

PMID- 11194194
TI  - Incidence pattern of colorectal cancer in Korea by subsite of origin.
AB  - It has been suggested that colorectal cancer might not be one homogenous disease
      entity, based on the distinctive characteristics of its subsite of origin.
      Incidence data on 4,987 colorectal cancer were obtained from the Seoul Cancer
      Registry between 1993 and 1995. Age, sex, and subsite-specific incidence rates
      were compared. The age-standardized annual incidence rates of total colorectal
      cancer were 26.1 and 18.0 per 100,000 for men and women, respectively. There were
      no appreciable difference in the rates of colon and rectal cancer for either sex
      (colon vs rectum: 12.8 vs. 13.2 for men, 9.3 vs. 8.6 for women). The incidence
      rate of right colon was slightly higher in men than in women, and this
      discrepancy became even greater in left colon (men vs women: 3.5 vs. 3.0 for
      right colon, 4.7 vs. 2.9 for left colon). When the incidence rate of right colon
      was compared with that of left colon, women had a higher rate in the right colon
      among the elderly, aged 60 yr and over and a lower rate at age 40 yr or less,
      while the opposite was observed for men. More analytic approaches are needed to
      identify which factors are related with these descriptive results in colorectal
      cancer incidence.

PMID- 11194195
TI  - A rat model for radiation-induced proctitis.
AB  - Radiation proctitis is a frequent acute complication encountered with pelvic
      irradiation. This study was aimed at establishing the optimal radiation dose for
      radiation-induced proctitis in rats. Female Wistar rats were used. The rectal
      specimens were examined morphologically at 5th and 10th day following 10-30 Gy
      irradiation in single fraction. With increasing dose, mucosal damage became
      worse, and there was a prominent reaction after > or =15 Gy. We selected 17.5 Gy
      as an optimal dose for radiation proctitis and examined specimens at day 1-14 and
      at week 4, 6, 8, and 12 after 17.5 Gy. The rectal mucosa revealed characteristic
      histological changes with time. An edema in lamina propria started as early as 1
      2 days after irradiation and progressed into acute inflammation. On day 7 and 8,
      regeneration was observed with or without ulcer. Four weeks later, all
      regeneration processes have been completed with end result of either fibrosis or
      normal appearing mucosa. This study showed that the radiation injury of the
      rectum in rat develops in dose-dependent manner as it has reported in previous
      studies and suggested that 17.5 Gy in single fraction is the optimum dose to
      evaluate the protective effect of various medications for radiation proctitis in
      face of the clinical situation.

PMID- 11194196
TI  - Association of serum lipids and glucose with the risk of colorectal adenomatous
      polyp in men: a case-control study in Korea.
AB  - Previous studies on life style for colorectal cancer risk suggest that serum
      lipids and glucose might be related to adenomatous polyps as well as to
      colorectal carcinogenesis. This case-control study was conducted to investigate
      the associations between serum lipids, blood glucose, and other factors and the
      risk of colorectal adenomatous polyp. Male cases with colorectal adenomatous
      polyp, histologically confirmed by colonoscopy (n=134), and the same number of
      male controls matched by age for men were selected in hospitals in Seoul, Korea
      between January 1997 and October 1998. Serum lipids and glucose levels were
      tested after the subjects had fasted for at least 12 hr. Conditional logistic
      regression showed that there was a significant trend of increasing adenomatous
      polyp risk with the rise in serum cholesterol level (Ptrend=0.07). Increasing
      trend for the risk with triglyceride was also seen (Ptrend=0.01). HDL-cholesterol
      and LDL-cholesterol had increasing trends for the risk, which were not
      significant. In particular, it was noted that higher fasting blood glucose level
      reduced the adenomatous polyp risk for men (Ptrend=0.001). This study concluded
      that both serum cholesterol and triglyceride were positively related to the
      increased risk for colorectal adenomatous polyp in Korea. Findings on an inverse
      relationship between serum glucose and the risk should be pursued in further
      studies.

PMID- 11194197
TI  - The significance of CD44 variants expression in colorectal cancer and its
      regional lymph nodes.
AB  - CD44 is a cell adhesion molecule with numerous isoforms created by mRNA
      alternative splicing. Expression of CD44 variants has been suggested to play a
      potential role in tumor progression and metastasis. We designed primers CD44V,
      CD44V6/7, CD44R1 and CD44V6-10 to analyze and compare the roles of each CD44
      variants. Expressions of CD44 variants were investigated in normal colonic
      mucosa, the lymph nodes which was histopathologically free of cancer cell, and
      cancer tissues of 44 human colorectal cancer patients by RT-PCR method. The
      expression of CD44V was observed in 28 out of 39 (71.8%) tumors and 7 out of 11
      (63.6%) N1 normal regional lymph nodes, and CD44V6/7 was observed in 28 out of 39
      (71.8%) tumors and 9 out of 11 (81.8%) N1 normal regional lymph nodes. The
      expressions of CD44V and CD44V6/7 were most frequently observed compared with any
      other CD44 variants. In normal colonic mucosa, the expression of CD44 variants
      are low but in cancer tissue and its regional lymph node, the expression of CD44V
      and CD44V6/7 were significantly higher and more frequent than any other CD44
      variants (p<0.05). These results suggest that CD44V and CD44V6/7 can be a
      molecular marker for colorectal cancer and its micrometastasis to the regional
      normal lymph node.

PMID- 11194198
TI  - Successful treatment in the patient with serum sodium level greater than 200
      mEq/L.
AB  - Hypernatremia developing in nonhospitalized adults is predominantly a disease of
      the elderly and mentally handicapped patients, possibly revealing inadequate
      nursing care of these patients. It has long been claimed that the duration of
      hypernatremia and its rate of correction are correlated with improvement in
      patients' neurologic status. Since there are only a handful of cases with serum
      sodium levels greater than 200 mEq/L until recently, it is not clear at what rate
      plasma sodium concentration can be safely normalized in severe hypernatremic
      patients. We report a case of severe hypernatremia with survival. This patient
      underwent rapid correction of serum sodium concentration during the management of
      this metabolic derangement using isotonic solution.

PMID- 11194199
TI  - Fungal discitis due to Aspergillus terreus in a patient with acute lymphoblastic
      leukemia.
AB  - We report a case of Aspergillus terreus discitis which developed in a patient
      with acute lymphoblastic leukemia following induction chemotherapy. A. terreus
      was isolated from sputum, one month earlier, but the physician did not consider
      it significant at the time. Magnetic resonance imaging study showed the
      involvement of L3-4, L4-5 and L5-S1 intervertebral discs. Etiology was
      established by means of histology and culturing a surgical specimen of disc
      materials. Our patient survived after a surgical debridement and amphotericin B
      administration with a total dose of 2.0 g. Discitis caused by Aspergillus terreus
      is a very rare event. A. terreus is one of the invasive Aspergillus species. The
      pathogenetic mechanism is discussed and the literature is reviewed.

PMID- 11194200
TI  - Toxic amebic colitis coexisting with intestinal tuberculosis.
AB  - A patient with a fulminant amebic colitis coexisting with intestinal tuberculosis
      had a sudden onset of crampy abdominal pain, mucoid diarrhea, anorexia, fever and
      vomiting with signs of positive peritoneal irritation. Fulminant amebic colitis
      occurring together with intestinal tuberculosis is an uncommon event and may
      present an interesting patho-etiological relationship. The diagnosis was proven
      by histopathologic examination of resected specimen. Subtotal colectomy including
      segmental resection of ileum, about 80 cm in length, followed by exteriorization
      of both ends, was performed in an emergency basis. Despite all measures, the
      patient died on the sixth postoperative day. The exact relationship of fulminant
      amebic colitis and intestinal tuberculosis is speculative but the possibility of
      a cause and effect relationship exists. Fulminant amebic colitis may readily be
      confused with other types of inflammatory bowel disease, such as idiopathic
      ulcerative colitis, Crohn's disease, perforated diverticulitis and appendicitis
      with perforation. This report draws attention to the resurgence of tuberculosis
      and amebiasis in Korea, and the need for the high degree of caution required to
      detect it.

PMID- 11194201
TI  - Extensive acute lung injury following limited thoracic irradiation: radiologic
      findings in three patients.
AB  - The aim of our study was to describe the radiologic findings of extensive acute
      lung injury associated with limited thoracic irradiation. Limited thoracic
      irradiation occasionally results in acute lung injury. In this condition, chest
      radiograph shows diffuse ground-glass appearance in both lungs and thin-section
      CT scans show diffuse bilateral ground-glass attenuation with traction
      bronchiectasis, interlobular septal thickening and intralobular smooth linear
      opacities.

PMID- 11194202
TI  - Intraoperative radiation therapy as an adjunctive therapy for huge and highly
      vascular parasagittal meningiomas.
AB  - This case presents a 34-year-old man who had a huge parasagittal meningioma.
      Initial treatment consisted of preoperative external carotid artery embolization
      and partial tumor resection. During the resection, we found that the tumor
      invaded the adjacent calvarium, and due to massive hemorrhage, total removal of
      the tumor was impossible. The patient was treated with intraoperative radiation
      therapy (IORT) (25 Gy via 16 MeV) as an adjunctive therapy. Eight months after
      IORT, we were able to remove the tumor completely without surgical difficulties.
      IORT can be considered an useful adjunctive therapy for the superficially
      located, huge, and highly vascular meningioma.

PMID- 11194203
TI  - Macular amyloidosis presented as poikiloderma: a case report.
AB  - We report a 51-year-old Vietnam War veteran with an unusual variant of macular
      amyloidosis presenting as poikilodermatous skin lesions. The extensive mottled
      brown pigmentation was checkered with small hypopigmented or normal skin-colored
      spots and intermingled with telangiectasia. Skin biopsy revealed subepidermal
      amyloid deposits. There was no evidence of extracutaneous involvements. This case
      could be easily confused with other true poikiloderma lesions.

PMID- 11194204
TI  - A sensible formulation of the significance test.
AB  - The conventional procedure for null hypothesis significance testing has long been
      the target of appropriate criticism. A more reasonable alternative is proposed,
      one that not only avoids the unrealistic postulation of a null hypothesis but
      also, for a given parametric difference and a given error probability, is more
      likely to report the detection of that difference.

PMID- 11194205
TI  - Using just noticeable differences to interpret test scores.
AB  - This study explored the value of obtaining a just noticeable difference (JND) for
      a test--the difference in scores needed before observers detect a difference in
      examinees' behavior--as a means of interpreting the practical meaning of scores.
      Classical psychophysical methods were adapted and applied to the scores of
      foreign teaching assistants (TAs) on an achievement test, the Test of Spoken
      English (TSE), and the ratings for English proficiency that the TAs received from
      their students. The JND for the TSE scores was substantial, as large as the
      standard deviation of the scores and much larger than the standard error of
      measurement and guidelines for the d index of effect size for mean differences,
      suggesting that both sets of standards may highlight score differences that are
      not practically significant. This study demonstrates the applicability of JNDs
      for evaluating scores on educational and psychologists' tests.

PMID- 11194206
TI  - The consequence of ignoring a nested factor on measures of effect size in
      analysis of variance.
AB  - Although the consequences of ignoring a nested factor on decisions to reject the
      null hypothesis of no treatment effects have been discussed in the literature,
      typically researchers in applied psychology and education ignore treatment
      providers (often a nested factor) when comparing the efficacy of treatments. The
      incorrect analysis, however, not only invalidates tests of hypotheses, but it
      also overestimates the treatment effect. Formulas were derived and a Monte Carlo
      study was conducted to estimate the degree to which the F statistic and treatment
      effect size measures are inflated by ignoring the effects due to providers of
      treatments. These untoward effects are illustrated with examples from
      psychotherapeutic treatments.

PMID- 11194207
TI  - Sample size and multiple regression analysis.
AB  - Despite the development of procedures for calculating sample size as a function
      of relevant effect size parameters, rules of thumb tend to persist in designs of
      multiple regression studies. One explanation for their persistence may be the
      difficulty in formulating a reasonable a priori value of an effect size to be
      detected. This article presents methods for calculating effect sizes in multiple
      regression from a variety of perspectives and also introduces a new method based
      on an exchangeability structure among predictor variables. No single method is
      deemed superior, but rather examples show that a combination of methods is likely
      to be most valuable in many situations. A simulation provides a 2nd explanation
      for why rules of thumb for choosing sample size have persisted but also shows
      that the outcome of such underpowered studies will be a literature consisting of
      seemingly contradictory results.

PMID- 11194208
TI  - A comparison of subset selection and analysis of covariance for the adjustment of
      confounders.
AB  - Two common methods for adjusting group comparisons for differences in the
      distribution of confounders, namely analysis of covariance (ANCOVA) and subset
      selection, are compared using real examples from neuropsychology, theory, and
      simulations. ANCOVA has potential pitfalls, but the blanket rejection of the
      method in some areas of empirical psychology is not justified. Assumptions of the
      methods are reviewed, with issues of selection bias, nonlinearity, and
      interaction emphasized. Advantages of ANCOVA include better power, improved
      ability to detect and estimate interactions, and the availability of extensions
      to deal with measurement error in the covariates. Forms of ANCOVA are advocated
      that relax the standard assumption of linearity between the outcome and
      covariates. Specifically, a version of ANCOVA that models the relationship
      between the covariate and the outcome through cubic spline with fixed knots
      outperforms other methods in simulations.

PMID- 11194209
TI  - Measurement and structural models for children's problem behaviors.
AB  - This article considers an analytic strategy for measuring and modeling child and
      adolescent problem behaviors. The strategy embeds an item response model within a
      hierarchical model to define an interval scale for the outcomes, to assess
      dimensionality, and to study how individual and contextual factors relate to
      multiple dimensions of problem behaviors. To illustrate, the authors analyze data
      from the primary caregiver ratings of 2,177 children aged 9-15 in 79 urban
      neighborhoods on externalizing behavior problems using the Child Behavior
      Checklist 4-18 (T. M. Achenbach, 1991a). Two subscales, Aggression and
      Delinquency, are highly correlated, and yet unidimensionality must be rejected
      because these subscales have different associations with key theoretically
      related covariates.

PMID- 11194210
TI  - Combining independent p values: extensions of the Stouffer and binomial methods.
AB  - The Stouffer z method, and other popular methods for combining p values from
      independent significance tests, suffer from three problems: vulnerability to
      criticisms of the individual studies being pooled, difficulty in handling the
      "file drawer problem," and vague conclusions. These problems can be reduced or
      eliminated by supplementing a test of combined probability with a variety of new
      analyses described here. Along with other advantages, these analyses provide a
      way to address the file drawer problem without making limiting assumptions about
      the nature of studies not included in the pooled analysis. These analyses can
      supplement a traditional meta-analysis, yielding conclusions not provided by
      widely used meta-analytic procedures.

PMID- 11194211
TI  - Promoting behavioral science research in diabetes.

PMID- 11194212
TI  - Relationship between electroneurographic changes and serum ubiquitin levels in
      patients with type 2 diabetes.
AB  - OBJECTIVE: The aim of the present study was to investigate any relationship
      between serum ubiquitin levels and electroneurographic changes in peripheral
      nerves for patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: The study
      involved 34 patients (19 men, 15 women; mean age 46 +/- 13 years) with type 2
      diabetes. Serum ubiquitin values were measured by sandwich enzyme-linked
      immunosorbent assay Measurement of nerve conduction velocity (NCV) was performed
      on three motor (median, tibial, and peroneal) and three sensory (median, ulnar,
      and sural) nerves. The value of motor compound muscle action potential (CMAP) was
      obtained from the sum of median, tibial, and peroneal motor nerve amplitudes, and
      sensory compound nerve action potential (CNAP) was computed as the sum of median
      and ulnar sensory nerve amplitudes. RESULTS: Patients with diabetes were divided
      into three groups: group 1 (n = 8) had normal electroneurography results, group 2
      (n = 8) had slowed NCV, and group 3 (n = 18) had low values of motor CMAP and/or
      sensory CNAP as well as slowed NCV. Mean ubiquitin level in group 3 (20.4 +/- 2.9
      ng/dl) was significantly higher than that in group 1 (11.2 +/- 1.1 ng/dl, t =
      11.5, P < 0.0001) and group 2 (13.2 +/- 2.7 ng/dl, t = 5.9, P < 0.0001). Serum
      ubiquitin levels were inversely correlated with motor CMAP (r = -0.68) and
      sensory CNAP (r = -0.61) values. CONCLUSIONS: The results of this study indicate
      that there could be a relationship between the diminished amplitudes of axons of
      the peripheral nerve and the increase in serum ubiquitin levels in patients with
      type 2 diabetes. Further studies are required to confirm this relationship.

PMID- 11194213
TI  - Involvement of peripheral polymorphonuclear leukocytes in oxidative stress and
      inflammation in type 2 diabetic patients.
AB  - OBJECTIVE: To determine the extent to which peripheral polymorphonuclear
      leukocytes (PMNs) contributed to oxidative stress (OS) and inflammation in type 2
      diabetic patients. RESEARCH DESIGN AND METHODS: PMNs and plasma were separated
      from blood withdrawn from 18 type 2 diabetic patients and 16 age- and sex-matched
      normal control subjects. The rate of superoxide release from phorbol 12-myristate
      13-acetate (PMA)-stimulated PMNs and the plasma glutathione (GSH) levels served
      as measures of OS. Inflammation was assessed by PMN recruitment, expressed by
      peripheral blood PMN counts, and the in vitro survival of PMNs, which reflects
      cell necrosis. RESULTS: PMA-stimulated PMNs from diabetes released superoxide
      significantly faster, and plasma-reduced GSH was lower in diabetic patients than
      in normal control subjects. The rate of superoxide release from diabetic PMNs
      showed no correlation with the plasma glucose concentrations, whereas a positive
      linear correlation with HbA1c was found. The in vitro survival of diabetic PMNs
      was lower than normal control PMNs when each was incubated in its own serum. The
      in vitro survival of normal control PMNs was reduced when incubated with diabetic
      serum, whereas normal control sera promoted the survival of diabetic PMNs.
      Peripheral PMN counts were higher in diabetic patients than in normal control
      patients. CONCLUSIONS: Type 2 diabetes is accompanied by a priming of PMNs,
      resulting in OS and increased self-necrosis. Necrosis starts a chain of
      inflammatory reactions that result in cell recruitment and in the long run, with
      OS, may result in endothelial dysfunction. Understanding the contribution of PMNs
      to OS and inflammation in diabetes may illuminate new mechanisms through which
      endothelial dysfunction evolves and causes angiopathy and atherosclerosis.

PMID- 11194214
TI  - Flexible meal-related dosing with repaglinide facilitates glycemic control in
      therapy-naive type 2 diabetes.
AB  - OBJECTIVE: This double-blind randomized placebo-controlled parallel group study
      assessed the efficacy and safety (with particular regard to body weight and
      hypoglycemia) of repaglinide when used in a flexible mealtime dosing regimen in a
      situation close to everyday clinical practice. RESEARCH DESIGN AND METHODS: A
      total of 408 patients with type 2 diabetes considered poorly controlled by diet,
      but without a history of previous antidiabetic medication, were randomized to
      receive 0.5 mg repaglinide at mealtimes (increased to 1 mg after 4 weeks
      depending on blood glucose response) or placebo for 16 weeks. Patients were free
      to choose a flexible meal pattern, adjusting the dosing schedule from two to four
      preprandial doses per day in accordance with a "one meal, one dose; no meal, no
      dose" principle. Additional snacks were not a requirement of the treatment
      schedule. RESULTS: Treatment with repaglinide significantly improved glycemic
      control with respect to baseline and placebo, reducing HbA1c by 1.14% from
      baseline and fasting plasma glucose by 1.8 mmol/l. Improvement in glycemic
      control was independent of the meal pattern adopted by patients, including those
      most commonly taking two or four meals daily, with no correlation between meal
      pattern and risk of hypoglycemia. The improvement in glycemic control was also
      independent of degree of obesity and age < or =65 or >65 years. There was no
      significant body weight increase in the repaglinide group. CONCLUSIONS: Mealtime
      dosing with repaglinide is effective in improving overall glycemic control in
      type 2 diabetic patients for which control is suboptimal using diet alone.
      Patients are able to vary their meal pattern from a conventional regimen of three
      meals daily without compromising control or increasing the risk of adverse
      events.

PMID- 11194215
TI  - Sodium sensitivity related to albuminuria appearing before hypertension in type 2
      diabetic patients.
AB  - OBJECTIVE: To find whether sodium sensitivity of blood pressure appears before
      hypertension and whether the sensitivity is related to diabetic nephropathy, we
      examined type 2 diabetic patients with normal levels of serum creatinine.
      RESEARCH DESIGN AND METHODS: A total of 32 patients were divided into three age
      matched groups: 11 patients had normoalbuminuria, 12 had microalbuminuria, and 9
      had macroalbuminuria. Patients stayed on a diet with ordinary sodium levels for 1
      week and a sodium-restricted diet for 1 week, in random order. Urinary excretion
      of sodium and albumin and systemic blood pressure were measured daily. A pressure
      natriuresis curve was drawn by linkage of the two datum points obtained in the
      steady state during the different diets. We calculated the sodium sensitivity
      index as the reciprocal of the slope of this curve. RESULTS: The median sodium
      sensitivity index and the mean blood pressure were higher in micro- and
      macroalbuminuric patients than in normoalbuminuric patients. Eighteen patients
      were without hypertension (<140/90 mmHg); of these, 10 had blood pressure
      readings <130/85 mmHg with ordinary sodium levels. Urinary albumin was correlated
      with the index but not with blood pressure. For these 10 patients, the index in
      those with albuminuria was higher than in those with normoalbuminuria. In such
      patients with albuminuria, sodium restriction decreased albuminuria and blood
      pressure. CONCLUSIONS: In type 2 diabetic patients with albuminuria but normal
      levels of serum creatinine, sodium sensitivity of blood pressure appears before
      hypertension and is related to albuminuria; sodium restriction is one treatment
      for diabetic nephropath, even without hypertension.

PMID- 11194216
TI  - Behavioral science research in diabetes: lifestyle changes related to obesity,
      eating behavior, and physical activity.
AB  - Lifestyle factors related to obesity, eating behavior, and physical activity play
      a major role in the prevention and treatment of type 2 diabetes. In recent years,
      there has been progress in the development of behavioral strategies to modify
      these lifestyle behaviors. Further research, however, is clearly needed, because
      the rates of obesity in our country are escalating, and changing behavior for the
      long term has proven to be very difficult. This review article, which grew out of
      a National Institute of Diabetes and Digestive and Kidney Diseases conference on
      behavioral science research in diabetes, identifies four key topics related to
      obesity and physical activity that should be given high priority in future
      research efforts: 1) environmental factors related to obesity, eating, and
      physical activity; 2) adoption and maintenance of healthful eating, physical
      activity, and weight; 3) etiology of eating and physical activity; and 4)
      multiple behavior changes. This review article discusses the significance of each
      of these four topics, briefly reviews prior research in each area, identifies
      barriers to progress, and makes specific research recommendations.

PMID- 11194217
TI  - Report of the health care delivery work group: behavioral research related to the
      establishment of a chronic disease model for diabetes care.
AB  - As one of four work groups for the November 1999 conference on Behavioral Science
      Research in Diabetes, sponsored by the National Institute on Diabetes and
      Digestive and Kidney Diseases, the health care delivery work group evaluated the
      status of research on quality of care, patient-provider interactions, and health
      care systems' innovations related to improved diabetes outcomes. In addition, we
      made recommendations for future research. In this article, which was developed
      and modified at the November conference by experts in health care delivery,
      diabetes and behavioral science, we summarize the literature on patient-provider
      interactions, diabetes care and self-management support among underserved and
      minority populations, and implementation of chronic care management systems for
      diabetes. We conclude that, although the quality of care provided to the vast
      majority of diabetic patients is problematic, this is principally not the fault
      of either individual patients or health care professionals. Rather, it is a
      systems issue emanating from the acute illness model of care, which still
      predominates. Examples of proactive population-based chronic care management
      programs incorporating behavioral principles are discussed. The article concludes
      by identifying barriers to the establishment of a chronic care model (e.g., lack
      of supportive policies, understanding of population-based management, and
      information systems) and priorities for future research in this area needed to
      overcome these barriers.

PMID- 11194218
TI  - Management of hyperglycemic crises in patients with diabetes.

PMID- 11194219
TI  - The Starr County Diabetes Education Study: development of the Spanish-language
      diabetes knowledge questionnaire.
AB  - OBJECTIVE: This study reports the psychometric properties of the 24-item version
      of the Diabetes Knowledge Questionnaire (DKQ). RESEARCH DESIGN AND METHODS: The
      original 60-item DKQ was administered to 502 adult Mexican-Americans with type 2
      diabetes who are part of the Starr County Diabetes Education Study. The sample
      was composed of 252 participants and 250 support partners. The subjects were
      randomly assigned to the educational and social support intervention (n = 250) or
      to the wait-listed control group (n = 252). A shortened 24-item version of the
      DKQ was derived from the original instrument after data collection was completed.
      Reliability was assessed by means of Cronbach's coefficient alpha. To determine
      validity, differentiation between the experimental and control groups was
      conducted at baseline and after the educational portion of the intervention.
      RESULTS: The 24-item version of the DKQ (DKQ-24) attained a reliability
      coefficient of 0.78, indicating internal consistency, and showed sensitivity to
      the intervention, suggesting construct validation. CONCLUSIONS: The DKQ-24 is a
      reliable and valid measure of diabetes-related knowledge that is relatively easy
      to administer to either English or Spanish speakers.

PMID- 11194220
TI  - American Diabetes Association 60th Scientific Sessions, 2000: thiazolidinediones,
      obesity, and related topics.

PMID- 11194221
TI  - Oxidative stress in families of type 1 diabetic patients: further evidence.

PMID- 11194222
TI  - Failure to develop hepatic injury from rosiglitazone in a patient with a history
      of troglitazone-induced hepatitis.

PMID- 11194223
TI  - Plasma lipoprotein subpopulation distribution in Caucasian and African-American
      women with gestational diabetes.

PMID- 11194224
TI  - Thyrotoxicosis masked by diabetic ketoacidosis: a fatal complication.

PMID- 11194225
TI  - Beta-cell autoimmunity, genetic susceptibility, and progression to type 1
      diabetes in unaffected schoolchildren.

PMID- 11194226
TI  - Type 1 diabetes and arterial dysfunction in asymptomatic Chinese adults.

PMID- 11194227
TI  - Lipoatrophy associated with lispro insulin in insulin pump therapy: an old
      complication, a new cause?

PMID- 11194228
TI  - Clinical evaluation of a newly designed compliant side port catheter for an
      insulin implantable pump: the EVADIAC experience. Evaluation dans le Diabete du
      Traitement par Implants Actifs.

PMID- 11194229
TI  - Efficacy of Tibetan medicine as an adjunct in the treatment of type 2 diabetes.

PMID- 11194230
TI  - Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in
      patients with type 2 diabetes.

PMID- 11194231
TI  - Environmental factors and type 1 diabetes.

PMID- 11194232
TI  - Efficacy of octreotide in the therapy of severe nonproliferative and early
      proliferative diabetic retinopathy: a randomized controlled study. Response to
      Grant et al.

PMID- 11194233
TI  - 4-g monofilament is clinically useful for detecting diabetic peripheral
      neuropathy.

PMID- 11194234
TI  - Applying the diabetes quality improvement project indicators in the Indian Health
      Service primary care setting.
AB  - OBJECTIVE: With publication of the Diabetes Quality Improvement Project (DQIP)
      measures, the Indian Health Service National Diabetes Program applied the DQIP
      format to its IHS Diabetes Care and Outcomes Audit for comparison and benchmarks.
      RESEARCH DESIGN AND METHODS: Since 1986 the IHS Diabetes Care and Outcomes Audit
      has been conducted by medical record review in >75% of IHS and tribal facilities.
      Each year systematic random sample of charts is drawn from local diabetes
      registries. Chart reviews are conducted by, trained professionals according to
      standard definitions and instructions. Abstracted data are entered into a
      microcomputer-based epidemiologic software package. Local, regional, and national
      rates are constructed for each item. During the period 1995-1997, 150 facilities
      submitted data for compilation, representing participation from all 12 IHS
      administrative regions. The IHS Diabetes Care and Outcomes Audit collected
      virtually all of the DQIP measures, with the exception of LDL cholesterol (which
      was added to the record review in 1998). RESULTS: In 1995, 1996, and 1997, a
      total of 9,557, 9,985, and 9,626 individuals, respectively, were included in the
      total IHS audit sample. The reviews for 1995, 1996, and 1997 revealed that of all
      subjects: 55, 65, and 80%, respectively, had more than one HbA1c test during the
      year (P < 0.001); 42, 38, and 34%, respectively; had a high-risk HbA1c (>9.5%) (P
      < 0.001); 83, 81, and 84%, respectively, were tested for macroproteinuria (P <
      0.11) and 16, 17, and 23%, respectively were tested for microproteinuria (P <
      0.001); total cholesterol was assessed in 80, 81, and 85%, respectively (P <
      0.001), and corresponding proportions of those with values <5.17 mmol/l were 48,
      50, and 52%, respectively; triglyceride values were measured for 75,75, and 80%,
      respectively (P < 0.001), and the corresponding median triglyceride levels were
      199, 198, and 193 mg/dl, respectively (P < 0.001); the proportion of clients with
      a blood pressure <140/90 mmHg was 64, 64, and 66%, respectively (P < 0.05); 55,
      56, and 55%, respectively, had a dilated eye exam (P < 0.053); and the proportion
      of clients who had a comprehensive foot exam were 59, 59, and 61%, respectively
      (P < 0.05). CONCLUSIONS: The DQIP accountability and quality improvement measures
      could be easily applied to the IHS Diabetes Care and Outcomes Audit, and the
      process can prove to be practical. However, data alone are not sufficient to
      effect change. Use of the measures to ensure that the quality of care improves
      must also be stressed, because measuring alone will not guarantee such
      improvement.

PMID- 11194235
TI  - Comparative analysis of organ-specific autoantibodies and celiac disease-
      associated antibodies in type 1 diabetic patients, their first-degree relatives,
      and healthy control subjects.
AB  - OBJECTIVE: In type 1 diabetes the coexistence with other endocrine diseases and
      organ-specific autoantibodies has been frequently reported leading to the concept
      of autoimmune polyendocrine syndrome (APS). In addition, an association of type 1
      diabetes with celiac disease has been described. These disorders share a similar
      genetic background, and first-degree relatives of type 1 diabetic patients may
      also be affected significantly. Screening for specific antibodies allows early
      diagnosis of these disorders. RESEARCH DESIGN AND METHODS: In the present cross
      sectional study, we analyzed sera from 197 recent-onset type 1 diabetic patients
      at the time of diagnosis, 882 first-degree relatives, and sera of 150 healthy
      control subjects for prevalence and co-occurence of the following antibodies
      (method): insulin autoantibodies (radioimmunoassay); GAD and IA-2 antibodies
      (radioligand assay); islet cell antibody, anti-adrenal cortex antibodies, and
      anti-gastric parietal cell antibodies (indirect immunofluorescence); anti
      thyroglobulin and anti-thyroid peroxidase antibodies; and gliadin IgG/A and
      tissue-transglutaminase IgA (enzyme-linked immunosorbent assay). RESULTS: The
      overall frequency of gastric patietal cell antibodies and adrenal antibodies did
      not differ significantly among groups. In contrast, type 1 diabetes-associated
      antibodies and thyroid antibodies were significantly more frequent both in recent
      onset type 1 diabetic patients and in the group of first-degree relatives (P <
      0.05). The prevalence of gliadin IgG/IgA and transglutaminase IgA was
      significantly higher in the group of recent-onset type 1 diabetic patients (P <
      0.05), but the difference between first-degree relatives and control subjects did
      not reach statistical significance. Focusing on the coexistence of antibodies,
      the group of recentonset type 1 diabetic patients presented with 27.4% of the
      subjects testing antibody-positive-specific for two or more of the envisaged
      disorders (i.e., type 1 diabetes, autoimmune thyroiditis, and celiac disease)
      compared with 3.1% in the group of first-degree relatives and 0 of 150 in the
      control population (P < 0.05). CONCLUSIONS: We conclude that, in an active case
      finding strategy, recent-onset type 1 diabetic patients should be routinely
      screened at least for concomitant autoimmune thyroid disease and additionally for
      celiac disease. Screening in their first-degree relatives should include at a
      minimum the search for thyroid autoimmunity in addition to screening for pre-type
      1 diabetes.

PMID- 11194236
TI  - Early failure of the diabetic heart.

PMID- 11194237
TI  - MICA polymorphism is associated with type 1 diabetes in the Korean population.
AB  - OBJECTIVE: Recent studies have demonstrated that MICA (major histocompatibility
      complex class I chain-related genes) on the short arm of the chromosome 6 are
      associated with susceptibility to various autoimmune diseases in Caucasians. The
      aim of our study was to investigate the role of MICA in type 1 diabetes
      susceptibility independent of the HLA DR-DQ polymorphism in genetically distinct
      Koreans. RESEARCH DESIGN AND METHODS: A total of 119 patients selected from
      Korean Seoul type 1 diabetes registry and 134 nondiabetic unrelated control
      subjects were typed for exon 5 polymorphism of MICA in addition to HLA DR-DQ
      typing. A total of 52 simplex families of type 1 diabetes were also studied.
      RESULTS: The MICA microsatellite allele consisting of six repetitions of GCT/AGC
      (A6) was present at a significantly lower frequency in the diabetic patient group
      (Pc < 0.01; Pc = P value after Bonferroni correction) than in the control
      population. The MICA microsatellite allele consisting of four repetitions (A4)
      was present at a higher frequency in diabetic patients (P < 0.05). This deviated
      distribution was not changed even after controlling for the HLA DRB1-DQB1
      haplotype. Transmission/disequilibrium test revealed significant deviation of
      transmission for alleles at the A6 polymorphism within the MICA gene (P < 0.05).
      CONCLUSIONS: We could assess that the MICA gene might be associated with type 1
      diabetes transracially independent of the HLA gene.

PMID- 11194238
TI  - Abnormal glucose tolerance and increased risk for cardiovascular disease in
      Japanese-Americans with normal fasting glucose.
AB  - OBJECTIVE: To compare the American Diabetes Association (ADA) fasting glucose and
      the World Health Organization (WHO) oral glucose tolerance test (OGTT) criteria
      for diagnosing diabetes and detecting people at increased risk for cardiovascular
      disease (CVD). RESEARCH DESIGN AND METHODS: Study subjects were 596 Japanese
      Americans. Fasting insulin, lipids, and C-peptide levels; systolic and diastolic
      blood pressures (BPs); BMI (kg/m2); and total and intra-abdominal body fat
      distribution by computed tomography (CT) were measured. Study subjects were
      categorized by ADA criteria as having normal fasting glucose (NFG), impaired
      fasting glucose (IFG), and diabetic fasting glucose and by WHO criteria for a 75
      g OGTT as having normal glucose tolerance (NGT), impaired glucose tolerance
      (IGT), and diabetic glucose tolerance (DGT). RESULTS: Of 503 patients with NFG,
      176 had IGT and 20 had DGT These patients had worse CVD risk factors than those
      with NGT . The mean values for NGT, IGT, and DGT, respectively, and analysis of
      covariance P values, adjusted for age and sex, are as follows; intra-abdominal
      fat area by CT 69.7, 95.0, and 101.1 cm2 (P < 0.0001); total CT fat area 437.7,
      523.3, and 489.8 cm2 (P < 0.0001); fasting triglycerides 1.40, 1.77, and 1.74
      mmol/l (P = 0.002); fasting HDL cholesterol 1.56, 1.50, and 1.49 mmol/l (P =
      0.02); C-peptide 0.80, 0.90, 0.95 nmol/l (P = 0.002); systolic BP 124.9, 132.4,
      and 136.9 mmHg (P = 0.0035); diastolic BP 74.8, 77.7, and 78.2 mmHg (P = 0.01).
      CONCLUSIONS: NFG patients who had IGT or DGT had more intra-abdominal fat and
      total adiposity; higher insulin, C-peptide, and triglyceride levels; lower HDL
      cholesterol levels; and higher BPs than those with NGT. Classification by fasting
      glucose misses many Japanese-Americans with abnormal glucose tolerance and less
      favorable cardiovascular risk profiles.

PMID- 11194240
TI  - Diastolic dysfunction in normotensive men with well-controlled type 2 diabetes:
      importance of maneuvers in echocardiographic screening for preclinical diabetic
      cardiomyopathy.
AB  - OBJECTIVE: Because a pseudonormal pattern of ventricular filling has never been
      considered in studies that reported a prevalence of left ventricular diastolic
      dysfunction (LVDD) between 20 and 40%, our aim was to more completely evaluate
      the prevalence of LVDD in subjects with diabetes. RESEARCH DESIGN AND METHODS: We
      studied 46 men with type 2 diabetes who were aged 38-67 years; without evidence
      of diabetic complications, hypertension, coronary artery disease, congestive
      heart failure, or thyroid or overt renal disease; and with a maximal treadmill
      exercise test showing no ischemia. LVDD was evaluated by Doppler
      echocardiography, which included the use of the Valsalva maneuver and pulmonary
      venous recordings to unmask a pseudonormal pattern of left ventricular filling.
      RESULTS: LVDD was found in 28 subjects (60%), of whom 13 (28%) had a pseudonormal
      pattern of ventricular filling and 15 (32%) had impaired relaxation. Systolic
      function was normal in all subjects, and there was no correlation between LVDD
      and indexes of metabolic control. CONCLUSIONS: LVDD is much more common than
      previously reported in subjects with well-controlled type 2 diabetes who are free
      of clinically detectable heart disease. The high prevalence of this phenomenon in
      this high-risk population suggests that screening for LVDD in type 2 diabetes
      should include procedures such as the Valsalva maneuver and pulmonary venous
      recordings to unmask a pseudonormal pattern of ventricular filling.

PMID- 11194239
TI  - How cost-effective is the treatment of dyslipidemia in patients with diabetes but
      without cardiovascular disease?
AB  - OBJECTIVE: Epidemiological studies have shown that the risk of myocardial
      infarction (MI) in diabetic patients without cardiovascular disease (CVD) is
      comparable to the risk of MI in patients with CVD. We used a validated Markov
      model to compare the long-term costs and benefits of treating dyslipidemia in
      diabetic patients without CVD versus treating CVD patients without diabetes in
      the U.S. The generalizability and robustness of these results were also compared
      across six other countries (Canada, France, Germany, Italy, Spain, and the U.K.).
      RESEARCH DESIGN AND METHODS: With use of the Cardiovascular Disease Life
      Expectancy Model, cost effectiveness simulations of simvastatin treatment were
      performed for men and women who were 40-70 years of age and had dyslipidemia. We
      forecast the long-term risk reduction in CVD events after treatment. On the basis
      of the Scandinavian Simvastatin Survival Study results, we assumed a 35%
      reduction in LDL cholesterol and an 8% rise in HDL cholesterol. RESULTS: In the
      U.S., treatment with simvastatin for CVD patients without diabetes was cost
      effective, with estimates ranging from $8,799 to $21,628 per year of life saved
      (YOLS). Among diabetic individuals without CVD, lipid therapy also appeared to be
      cost-effective, with estimates ranging from $5,063 to $23,792 per YOLS. In the
      other countries studied, the cost effectiveness of treating diabetes in the
      absence of CVD was comparable to the cost effectiveness of treating CVD in the
      absence of diabetes. CONCLUSIONS: Among diabetic men and women who do not have
      CVD, lipid therapy is likely to be as effective and cost-effective as treating
      nondiabetic individuals with CVD.

PMID- 11194241
TI  - Potential short-term economic benefits of improved glycemic control: a managed
      care perspective.
AB  - OBJECTIVE: There are limited data relating glycemic control to medical costs
      among patients with diabetes. The goal of this study was to examine the potential
      impact of improved glycemic control on selected short-term complications of
      diabetes and associated costs in a managed care setting. RESEARCH DESIGN AND
      METHODS: Using a retrospective cohort design and automated databases from January
      1994 to 30 June 1998, adult members of the Fallon Clinic who were diagnosed with
      diabetes were identified and assigned to one of three study groups based on each
      patient's mean HbA1c level: good control (<8%), fair control (8-10%), and poor
      control (> 10%) groups. Inpatient (hospital or skilled nursing facility)
      admissions for selected acute (short-term) complications, represented by selected
      infections, hyperglycemia, hypoglycemia, and electrolyte disturbances, and the
      associated medical charges were evaluated across the three HbA1c groups.
      Multivariate analyses were used to control for differences in several potential
      confounding factors among the study groups. All findings were expressed on a 3
      year basis. RESULTS: Of 2,394 patients with diabetes, approximately 10% (251) had
      at least one inpatient stay for a short-term complication, accounting for 447
      admissions. Over 3 years, the adjusted rate of inpatient treatment ranged from 13
      per 100 patients with good glycemic control to 16 per 100 patients with fair
      glycemic control and 31 per 100 patients with poor glycemic control (P < 0.05).
      The corresponding mean adjusted charges were approximately $970, $1,380, and
      $3,040, respectively Among the 30% of the study population with long-term
      diabetic complications, the results were more marked; the adjusted admissions per
      100 patients (mean charges) were estimated to be 30 ($2,610), 38 ($3,810), and 74
      ($8,320) over 3 years for patients with an HbA1c of <8, 8-10, and > 10%,
      respectively. CONCLUSIONS: In typical practice, better glycemic control is
      associated with a reduced rate of admission for selected short-term complications
      and, therefore, reduced medical charges for these complications over a 3-year
      period. The potential short-term economic benefits are important to consider when
      making decisions regarding the adoption and use of new interventions for the
      management of diabetes.

PMID- 11194242
TI  - All-cause mortality in the Canterbury (New Zealand) insulin-treated Diabetic
      Registry population.
AB  - OBJECTIVE: To establish all-cause death rates and life expectancies of and risk
      factors for mortality in insulin-treated diabetic individuals living in
      Canterbury, New Zealand. RESEARCH DESIGN AND METHODS: Insulin-treated diabetic
      subjects (n = 1,008) on the Canterbury Diabetes Registry were tracked over 9
      years, and their vital status was determined. Death rates were standardized using
      direct and indirect methods. Cox proportional hazard regression was used to model
      the effects of demographic and clinical covariates on survival time. RESULTS: At
      study entry, age ranged from 2.9 to 92.7 years, with mean 48.7 +/- 20.4 years;
      age at diagnosis was 0.2-88.9 years, mean 34.5 +/- 20.0 years; and duration of
      diabetes was 0.1-58.5 years, mean 14.0 +/- 10.6 years. There were 303 deaths in
      7,372 person-years of follow-up with a standardized mortality ratio (SMR) of 2.6
      (95% CI 2.4-3.0). Relative mortality was greatest for those aged 30-39 years (SMR
      9.2 [4.8-16.2]). The death rate for the diabetic cohort standardized against the
      Segi world standard population was 16.2 per 1,000. Attained age, sex, and
      clinical subtype were significant predictors of mortality The SMR for subjects
      with type 1 diabetes and age at onset <30 years was 3.7 (CI 2.7-5.0), 2.2 (1.8
      2.6) for those with onset > or =30 years, and 3.1 (2.5-3.7) for subjects
      suspected of having latent autoimmune diabetes in adulthood or insulin-treated
      type 2 diabetes. Life expectancy was reduced for both sexes at all ages.
      CONCLUSIONS: Mortality rates for insulin-treated diabetic individuals remain
      high, resulting in shortened life spans relative to the general population.
      Marked differences in mortality exist between clinical groups of subjects.
      Further research is needed to improve diabetes classification and to clarify
      differences in health outcomes.

PMID- 11194243
TI  - Impact of diabetes on employment and income in Manitoba, Canada.
AB  - OBJECTIVE: To compare employment and income of working-age (18-64 years) people
      with and without diabetes. RESEARCH DESIGN AND METHODS: We conducted a
      prospective population-based cohort study based in Manitoba, Canada, consisting
      of 25,554 individuals without diabetes and 608 with diabetes, of whom 242 had a
      complication of the disease. Adjusted odds ratios (ORs) of employment and income
      variables were determined. RESULTS: Diabetic individuals with complications were
      twice as likely not to be in the labor force (OR 2.07 [95% CI 1.49-2.87]) than
      nondiabetic individuals. This difference was not evident for diabetic individuals
      without complications (OR 1.20 [0.93-1.56]). Diabetic individuals without
      complications had incomes similar to those of nondiabetic individuals. The total
      income of diabetic individuals with complications was 72% of the income of
      nondiabetic individuals. When the analysis was limited to only those in the labor
      force, diabetic workers with complications still had only 85% the employment
      income of nondiabetic people. Diabetic individuals with complications received
      58% more social support income. In a separate analysis of aboriginal individuals,
      complicated diabetes was not associated with an increased likelihood of not
      working or a decrease in employment income. CONCLUSIONS: In general,
      complications of diabetes and the absence of the disease affect the ability to
      earn income in Manitoba, Canada. This effect was not identified in the aboriginal
      population of the province.

PMID- 11194244
TI  - Efficacy, safety, and pump compatibility of insulin aspart used in continuous
      subcutaneous insulin infusion therapy in patients with type 1 diabetes.
AB  - OBJECTIVE: The purpose of this study was to compare the efficacy, safety and pump
      compatibility of insulin aspart (a rapid-acting insulin analog) and buffered
      regular human insulin in patients with type 1 diabetes undergoing continuous
      subcutaneous insulin infusion (CSII) therapy. RESEARCH DESIGN AND METHODS: This
      was a single-center randomized open-label study Patients received CSII therapy
      with insulin aspart (n = 19) or buffered regular human insulin (n = 10) for 7
      weeks. Bolus doses of insulin aspart were administered immediately before meals
      and buffered regular human insulin 30 min before meals. RESULTS: Insulin aspart
      and buffered regular human insulin were both effective in controlling average
      daily blood glucose levels (8.2 +/- 1.9 and 8.5 +/- 2.1 mmol/l, respectively)
      (mean +/- SD) and maintaining serum fructosamine (343 +/- 25.7 and 336 +/- 27.4
      micromol/l) and HbA1c (6.9 +/- 0.6 and 7.1 +/- 0.6%) levels. Possible
      obstructions and set leakages were infrequently reported in both groups. Similar
      numbers of patients experienced hypoglycemia (blood glucose <2.5 mmol/l): 14
      (74%) insulin aspart patients versus 6 (60%) buffered regular human insulin
      patients. Patients receiving insulin aspart had fewer hypoglycemic events per
      patient (2.9) than those patients receiving buffered regular human insulin (6.2).
      There were no differences between the two insulins in the occurrence of
      hyperglycemic events (blood glucose >19 mmol/l) or in the number and type of
      adverse events. CONCLUSIONS: Insulin aspart and buffered regular human insulin
      were effective and well tolerated and provided similar pump compatibility when
      used in CSII therapy.

PMID- 11194245
TI  - Mealtime glucose regulation with nateglinide in healthy volunteers: comparison
      with repaglinide and placebo.
AB  - OBJECTIVE: This study was designed to compare the pharmacodynamic effects of
      single doses of nateglinide (A-4166), repaglinide, and placebo on mealtime
      insulin secretion and glycemic control in healthy subjects. RESEARCH DESIGN AND
      METHODS: Fifteen healthy volunteers participated in this open-label five-period
      crossover study. They received single 10-min preprandial doses of 120 mg
      nateglinide, 0.5 or 2 mg repaglinide, or placebo or 1 min preprandially of 2 mg
      repaglinide. Subjects received each dose only once, 48 h apart. Pharmacodynamic
      and pharmacokinetic assessments were performed from 0 to 12 h postdose. RESULTS:
      Nateglinide induced insulin secretion more rapidly than 2 and 0.5 mg repaglinide
      and placebo (10 min preprandial), with mean rates of insulin rise of 2.3, 1.3,
      1.15, and 0.8 microU x ml(-1) x min(-1), respectively, over the 0- to 30-min
      postmeal interval. After peaking, insulin concentrations decreased rapidly in the
      nateglinide-treated group and were similar to placebo within 2 h postdose. After
      2 mg repaglinide, peak insulin concentrations were delayed and returned to
      baseline more slowly than with nateglinide treatment. Nateglinide treatment
      produced lower average plasma glucose concentrations in the 0- to 2-h postdose
      interval than either dose of repaglinide and placebo (P < 0.05 vs. 0.5 mg
      repaglinide and placebo). Plasma glucose concentrations returned more rapidly to
      predose levels with nateglinide treatment than with either dose of repaglinide.
      Treatment with repaglinide produced a sustained hypoglycemic effect up to 6 h
      postdose. CONCLUSIONS: In this single-dose study in nondiabetic volunteers,
      nateglinide provided a more rapid and shorter-lived stimulation of insulin
      secretion than repaglinide, resulting in lower meal-related glucose excursions.
      If similar results are observed in diabetes, nateglinide may produce a more
      physiological insulin secretory response with the potential for a reduced risk of
      postabsorptive hypoglycemia.

PMID- 11194246
TI  - New ulceration, new major amputation, and survival rates in diabetic subjects
      hospitalized for foot ulceration from 1990 to 1993: a 6.5-year follow-up.
AB  - OBJECTIVE: To evaluate 1) the new ulceration, the new major amputation, and the
      survival rates of 115 diabetic subjects hospitalized for foot ulceration from
      1990 to 1993, with an average follow-up of 6.5 years, and 2) the demographic and
      clinical characteristics associated with these events. RESEARCH DESIGN AND
      METHODS: A total of 115 subjects, 31 women and 84 men, were monitored until 31
      December 1998. All subjects were provided with therapeutic shoes and received
      intense education. Data concerning new ulceration, new major amputation, and
      reamputation events and the date and cause of death were recorded for each
      patient. The prognostic factors for these events were then evaluated. RESULTS:
      The average follow-up was 78.3 +/- 15.3 months (range 60-106). During this time,
      13 homolateral and 12 contralateral episodes of new ulceration occurred. At
      univariate analysis, none of the variables considered were significantly
      associated with the new ulceration. There were three major amputations: two of
      the limb previously healed and one of the contralateral limb. Of the 115
      subjects, 51 (44.3%) died: 24 of the 31 women (77.4%) and 27 of the 84 men
      (32.1%). Ischemic cardiopathy was the most frequent cause of death (60.8%).
      Mortality concerned 20 of the 27 subjects (74.1%) undergoing major amputation
      from 1990 to 1993 and 31 of the 88 healed subjects (35.2%), with a significant
      difference (P < 0.0001). Multivariate analysis showed the independent role of the
      ankle-brachial index < or =0.5 (P = 0.005), age (P = 0.003), and female sex (P =
      0.027). CONCLUSIONS: We believe that the use of therapeutic shoes and intense
      educational training, including the education of the family, have contributed to
      the low incidence of new ulceration and major amputation in our study population.
      The high frequency of ischemic cardiopathy as a cause of death should, perhaps,
      lead to a more aggressive diagnostic and therapeutic attitude toward this
      pathology in diabetic subjects admitted to hospitals for foot ulceration.

PMID- 11194247
TI  - A comparison of two diabetic foot ulcer classification systems: the Wagner and
      the University of Texas wound classification systems.
AB  - OBJECTIVE: In this study the following two ulcer classification systems were
      applied to new foot ulcers to compare them as predictors of outcome: the Wagner
      (grade) and the University of Texas (LT) (grade and stage) wound classification
      systems. RESEARCH DESIGN AND METHODS: Ulcer size, appearance, clinical evidence
      of infection, ischemia, and neuropathy at presentation were recorded, and
      patients were followed up until healing or for 6 months. RESULTS: Of 194 patients
      with new foot ulcers, 67.0% were neuropathic, 26.3% were neuroischemic, 1.0% were
      ischemic, and 5.7% had no identified underlying factors. Median (interquartile
      range [IQR]) ulcer size at presentation was 1.5 cm2 (0.6-4.0). Lower-limb
      amputations were performed for 15% of ulcers, whereas 65% healed [median (IQR)
      healing time 5 (3-10) weeks] and 16% were not healed at study termination; 4% of
      patients died. Wagner grade (P < 0.0001), and UT grade (P < 0.0001) and stage (P
      < 0.001) showed positive trends with increased number of amputations. For UT
      stage, the risk of amputation increased with infection both alone (odds ratio
      [OR] = 11.1, P < 0.0001) and in combination with ischemia (OR = 14.7, P <
      0.0001), but not significantly with ischemia alone (OR = 4.6, P = 0.09). Healing
      times were not significantly different for each grade of the Wagner (P = 0.1) or
      the UT system (P = 0.07), but there was a significant stepwise increase in
      healing time with each stage of the UT system (P < 0.05), and stage predicted
      healing (P < 0.05). CONCLUSIONS: Increasing stage, regardless of grade, is
      associated with increased risk of amputation and prolonged ulcer healing time.
      The UT system's inclusion of stage makes it a better predictor of outcome.

PMID- 11194248
TI  - Insulin resistance and insulin secretory dysfunction are independent predictors
      of worsening of glucose tolerance during each stage of type 2 diabetes
      development.
AB  - OBJECTIVE: Although prospective studies indicate that insulin resistance and
      insulin secretory dysfunction predict type 2 diabetes, they provide limited
      information on the relative contributions of both abnormalities to worsening
      glucose tolerance at different developmental stages of the disease. We therefore
      assessed the predictive effect of insulin resistance and insulin secretory
      dysfunction separately for the progression from normal glucose tolerance (NGT) to
      impaired glucose tolerance (IGT) and from IGT to diabetes. RESEARCH DESIGN AND
      METHODS: Insulin-stimulated glucose disposal (M) (hyperinsulinemic clamp), acute
      insulin secretory response (AIR) (25-g intravenous glucose tolerance test), and
      body composition (hydrodensitometry or dual-energy X-ray absorptiometry) were
      measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT, who were
      then followed for 0.5-13 years. RESULTS: After follow-ups of 4.4 +/- 3.1 and 5.5
      +/- 3.4 years, 79 (31%) of the subjects with initial NGT had developed IGT, and
      64 (44%) of the subjects with initial IGT had developed diabetes. In proportional
      hazards analyses with adjustment for age, sex, and percent body fat, low M and
      low AIR were independent predictors of both the progression from NGT to IGT
      (relative hazards [95% CI] for 10th vs. 90th percentile: M 2.4 [1.2-4.7], P <
      0.02; AIR 2.1 [1.1-4.1], P < 0.04) and from IGT to diabetes (M 2.5 [1.3-5.0], P <
      0.01; AIR 1.8 [0.99-3.3], P = 0.055). CONCLUSIONS: During each stage of the
      development of type 2 diabetes, insulin resistance and insulin secretory
      dysfunction are independent predictors of worsening glucose tolerance and are,
      therefore, both targets for the primary prevention of the disease.

PMID- 11194249
TI  - Limited joint mobility in type 1 diabetic patients: associations with
      microangiopathy and subclinical macroangiopathy are different in men and women.
AB  - OBJECTIVE: To study the relationship of limited joint mobility (LJM) in type 1
      diabetic patients with microvascular complications, hypertension, and early
      atherosclerosis and to determine whether sex has an influence on possible
      associations. RESEARCH DESIGN AND METHODS: A total of 335 consecutive unselected
      patients (191 women and 144 men), aged 14-40 years, were studied for LJM,
      retinopathy, nephropathy (stages III and IV), and hypertension. Standard
      laboratory tests were performed; the intima-media thickness (IMT) of the carotid
      arteries, which reflects the extent of early atherosclerosis, was measured by
      high-resolution ultrasound, and plaques were identified. RESULTS: The frequency
      of LJM was 33.7% (29.8% in women and 38.9% in men). Subjects with LJM had a
      longer diabetes duration (P < 0.001) than those without (women 16.7 +/- 9.1 vs.
      10.3 +/- 6.0 years; men 15.0 +/- 9.0 vs. 9.4 +/- 6.3 years). Age, HbA1c, lipids,
      and systolic/diastolic blood pressure were not different between men and women
      with or without LJM. Men with LJM had a higher albumin excretion rate (37.1 vs.
      13.1 microg/min, P < 0.05) than those without LJM and showed a higher risk of
      proteinuria (odds ratio 1.8, 95% CI 1.2-2.7; P < 0.05), retinopathy (2.4, 1.7
      3.5; P < 0.001), and hypertension (1.7, 1.2-2.6; P < 0.05). The occurrence of
      these complications was not different between women with and without LJM, but
      only women with LJM had a greater IMT (0.59 +/- 0.13 vs. 0.55 +/- 0.10 mm, P <
      0.05) and a higher risk of plaques (odds ratio 2.1, 95% CI 1.3-3.4; P < 0.05)
      than women without LJM. In a multiple logistic regression analysis, adjusted for
      age and diabetes duration, male sex independently predicted the presence of LJM.
      Moreover, LJM proved to be an independent predictor of retinopathy in men only.
      CONCLUSIONS: LJM is an indicator of microvascular disease in men, and LJM is
      associated with early macrovascular disease in women.

PMID- 11194250
TI  - Inability of five-month-old infants to retrieve a contiguous object: a failure of
      conceptual understanding or of control of action?
AB  - Infants of 5 to 6 months of age can retrieve a free-standing object, but fail to
      retrieve the same object from atop a slightly larger object. The accepted
      explanation has been that the infants do not understand that an object continues
      to exist independently when placed upon another. Predictions based on that
      explanation were tested against the hypothesis that infants' problem consists of
      lack of precision in visually guided reaching and lack of ability to inhibit
      reflexive reactions to touch. Twelve infants each at 5 and 7 months of age were
      tested on 16 trials. More 5-month-olds succeeded, in less time, and with fewer
      touches to an edge of the base, on trials more forgiving of an imprecise reach
      than on less forgiving trials. Success in retrieving objects close in size and
      fully contiguous with their bases was seen even at 5 months when the demands on
      skill in reaching were reduced. It is proposed that when 5-month-old infants fail
      to retrieve one object placed upon another, it is not because of a lack of
      conceptual understanding, but because they lack the skill to reach to the top
      object without accidentally touching an edge of the base en route.

PMID- 11194251
TI  - Middle-school-age outcomes in children with very low birthweight.
AB  - Most previous studies of children with birthweight <750 g have focused on early
      childhood sequelae. To evaluate later outcomes, a regional sample of 60 <750-g
      birthweight children was compared at middle school age (M = 11 years) to 55
      children with birthweight 750-1,499 g and 49 term controls. The groups were
      matched on age, gender, and demographic variables at the time of an early-school
      age assessment (mean age 7 years). The <750-g birthweight group fared less well
      at middle school age than the term group on measures of cognitive function,
      achievement, behavior, and academic performance. In many instances, outcomes were
      less favorable for the <750-g children than for the 750 to 1,499-g group.
      Children in the <750-g group who were free of neurosensory disorders and global
      cognitive impairment performed more poorly on several tests than their term
      counterparts. Group differences in this subsample on tests of motor skills, math,
      and the ability to copy and recall a complex drawing remained significant even
      after controlling for IQ. Disparities between the <750-g and term groups
      increased with age for some measures. Despite favorable outcomes for many
      children in the <750-g group, this population is at risk for long-term
      developmental problems.

PMID- 11194252
TI  - Sibling differentiation in adolescence: implications for behavioral genetic
      theory.
AB  - The presence of sibling "differentiating processes"--defined as processes in
      which increased sibling similarity in environmental or genetic factors leads to
      differences in sibling outcomes-poses a challenge for standard behavioral genetic
      theory and research. The presence of differentiation processes may affect
      estimates of genetic and environmental parameters in ways that have not been
      fully recognized. Utilizing data from the Nonshared Environment and Adolescent
      Development project, this study examined whether differentiating processes
      existed for seven composite indices of positive and negative adolescent
      adjustment. The 720 sibling pairs in the study were broken down into groups by
      age difference (0-4 years) between siblings. The hypothesis that siblings close
      in age would demonstrate lower correlations on adjustment measures was generally
      supported at two time points, three years apart. However, siblings one year apart
      at Time 1 were more similar to each other than were siblings two years apart,
      suggesting that shared environmental influences counteract sibling
      differentiation processes for these siblings. The overall trend supporting
      sibling differentiation was found to be unrelated to measures of sibling
      positivity and negativity.

PMID- 11194253
TI  - Can young infants add and subtract?
AB  - Three experiments (N = 68), using Wynn's procedure, tested 5-month-old infants'
      looking time reactions to correct and incorrect results of simple addition and
      subtraction transformations. The aim was to investigate both the robustness and
      the parameters of infants' arithmetic competence. Experiments 1 and 2 (N = 44)
      were replications of Wynn's first two experiments in which infants were shown
      addition (1 + 1 = 1 or 2) and subtraction (2 - 1 = 1 or 2) requiring imprecise
      calculation. Experiment 3 (N = 24) was a subtraction counterpart (3 - 1 = 1 or 2)
      to Wynn's third experiment requiring precise calculation of addition (1 + 1 = 2
      or 3). Unlike Wynn, we found no systematic evidence of either imprecise or
      precise adding and subtracting in young infants. Our results, together with the
      mix of both positive and negative findings from other studies of infant
      arithmetic, suggest that infants' reactions to displays of adding and subtracting
      are variable and, therefore, that infants' numerical competencies are not robust.
      This conclusion is consistent with previous findings indicating that simple
      adding and subtracting develops gradually and continuously throughout infancy and
      early childhood.

PMID- 11194254
TI  - Findings of addition and subtraction in infants are robust and consistent: reply
      to Wakeley, Rivera, and Langer.
AB  - Findings showing numerical computation abilities in infants are considerably more
      robust and consistent than Wakeley, Rivera, and Langer suggest. All the interim
      replication attempts have successfully replicated my original findings. Possible
      reasons for Wakeley et al.'s failure to replicate are discussed.

PMID- 11194255
TI  - Predicting the outcomes of physical events: two-year-olds fail to reveal
      knowledge of solidity and support.
AB  - Two-year-olds' (N = 153) knowledge of solidity was tested in four search tasks
      adapted from infant looking-time experiments. In Experiment 1, 2-year-olds failed
      to search in the correct location for a falling ball after a hidden shelf that
      blocked its trajectory had been inserted in the apparatus. Experiment 2 extended
      this finding by showing that 2-year-olds failed to take into account the effects
      of either removing or inserting a shelf in their search for a toy dropped behind
      a screen. Experiment 3 examined sensitivity to the constraint provided by a solid
      barrier on horizontal motion. In all three experiments, 2-year-old children
      searched initially at the location where they saw the object during
      familiarization. Experiment 4, using multiple test trials but no familiarization
      to a pretest location, also showed that 2-year-olds failed to take the presence
      or absence of a barrier into account when planning where to search for a toy they
      had seen dropped behind a screen. In all of these studies, 2-year-olds showed no
      evidence of representing solidity and support constraints on the trajectories of
      falling objects. Experiments 1 and 3 also included 2 1/2-year-olds (N = 31), who
      succeeded on these search tasks. The implications of the poor performance of 2
      year-olds, in the face of success by very young infants on looking-time measures
      of sensitivity to similar constraints on object motion, are discussed.

PMID- 11194256
TI  - Children's attention to rigid and deformable shape in naming and non-naming
      tasks.
AB  - In four experiments with three-year-olds (N = 67), we investigate children's
      understanding of the differential importance of shape for categorization of solid
      rigid objects with fixed shapes and solid but deformable objects with shapes that
      can be changed. In a non-naming task we find that young children categorize rigid
      and deformable things differently and know that material is important for
      deformable things and shape for rigid things. In two naming tasks, however,
      children generalize names for both solid and deformable objects by shape
      similarity and disregard rigidity. To understand this pattern of results we
      examine a corpus of early-learned nouns and the kinds of rigid and nonrigid
      things named by nouns in that corpus. The results suggest that names for
      categories of solid, rigid objects in which instances are similar in shape
      dominate children's early noun vocabularies. We suggest that children's novel
      word generalizations for deformable things may be overgeneralizations of this
      dominant pattern.

PMID- 11194257
TI  - Word-learning skills of deaf preschoolers: the development of novel mapping and
      rapid word-learning strategies.
AB  - Word-learning skills of 19 deaf/hard-of-hearing preschoolers were assessed by
      observing their ability to learn new words in two contexts. The first context
      required the use of a novel mapping strategy (i.e., making the inference that a
      novel word refers to a novel object) to learn the new words. The second context
      assessed the ability to learn new words after minimal exposure when reference was
      explicitly established. The children displayed three levels of word-learning
      skills. Eleven children learned words in both contexts. Five were able to learn
      new words rapidly only when reference was explicitly established. Two children
      did not learn new words rapidly in either context. The latter seven children were
      followed longitudinally. All children eventually acquired the ability to learn
      new words in both contexts. The deaf children's word-learning abilities were
      related to the size of their vocabularies. The present study suggests that word
      learning strategies are acquired even when children are severely delayed in their
      language development and they learn language in an atypical environment.

PMID- 11194258
TI  - Effects of age and delay on the amount of information provided by alleged sex
      abuse victims in investigative interviews.
AB  - A total of 145 children of 4 to 5, 6 to 7, 8 to 9, and 10 to 12 years of age were
      interviewed within 3 days, 1 month, 1 to 3 months, or 5 to 14 months after
      allegedly experiencing a single incident of sexual abuse. The proportion of
      substantive investigative utterances eliciting new details from the children
      increased with age and decreased after delays of more than 1 month. Age (but not
      delay) was also associated with the length and richness of informative responses
      to individual investigative utterances of all types. Children were more likely to
      provide new details in response to option-posing and suggestive prompts. As in
      previous field studies, interviewers employed few open-ended prompts, and thus
      only 5% of the information obtained was elicited using free-recall prompts.

PMID- 11194259
TI  - Adolescents sex-typed friendship experiences: does having a sister versus a
      brother matter?
AB  - This study examines the connections between having a sister versus a brother and
      coming from a same-sex versus an opposite-sex sibling dyad and the degree of sex
      typing in adolescents' friendship experiences, including the qualities of their
      friendships (i.e., intimacy, control) and their friends' personal attributes
      (i.e., sex-typed leisure interests, expressive and instrumental personality
      qualities). Participants were 159 firstborn-secondborn adolescent sibling pairs
      (M = 14.94 years and M = 12.43 years, respectively) and a close friend of each
      sibling (N = 636, including siblings and friends). Data were collected during
      home visits with siblings and telephone interviews with friends of siblings. The
      results suggested that sisters may learn control tactics from their brothers that
      they apply in their friendships; boys, however, were less likely to model the
      emotional intimacy that characterized their sisters' experiences with friends. In
      addition, coming from an opposite-sex sibling dyad was linked to sex-typing in
      friends' personal attributes, particularly their masculine leisure interests and
      instrumental personality qualities. Sisters and brothers may provide unique
      opportunities to learn about sex-typed relationship experiences in early
      adolescence, a time when gender segregation in the peer context is pervasive.

PMID- 11194260
TI  - Sibling comparison of differential parental treatment in adolescence: gender,
      self-esteem, and emotionality as mediators of the parenting-adjustment
      association.
AB  - This study employs findings from social comparison research to investigate
      adolescents' comparisons with siblings with regard to parental treatment. The
      sibling comparison hypothesis was tested on a sample of 516 two-child families by
      examining whether gender, self-esteem, and emotionality-which have been found in
      previous research to moderate social comparison-also moderate sibling comparison
      as reflected by siblings' own evaluations of differential parental treatment.
      Results supported a moderating effect for self-esteem and emotionality but not
      gender. The sibling comparison process was further examined by using a structural
      equation model in which parenting toward each child was associated with the
      adjustment of that child and of the child's sibling. Evidence of the "sibling
      barricade" effect-that is, parenting toward one child being linked with opposite
      results on the child's sibling as on the target child-was found in a limited
      number of cases and interpreted as reflecting a sibling comparison process. For
      older siblings, emotionality and self-esteem moderated the sibling barricade
      effect but in the opposite direction as predicted. Results are discussed in terms
      of older siblings' increased sensitivity to parenting as well as the report of
      differential parenting reflecting the child's level of comfort and benign
      understanding of differential parenting, which buffers the child against
      environmental vicissitudes evoking sibling comparison processes.

PMID- 11194261
TI  - Mothers of anxious/ambivalent infants: maternal characteristics and child-care
      context.
AB  - A general model of the determinants of parenting was employed to explore the
      antecedents of the ambivalent attachment pattern in Israel. Specifically, three
      classes of variables were identified: maternal, infant, and child-care context.
      Participants were 98 mothers and their infants. This research was part of a
      longitudinal study on sleep patterns. Mothers filled out questionnaires and were
      observed with their infants in the Ainsworth Strange Situation laboratory
      procedure. Mothers of ambivalent infants showed lower education level, higher
      separation anxiety, and higher parenting stress than mothers of secure infants.
      Infants' perceived difficult temperament did not discriminate between the two
      groups. Longer hours spent at work and placement in group day-care were both
      associated with ambivalent attachment. The findings are discussed in light of the
      importance of considering distal factors such as maternal attitudes and general
      caregiving strategy in clarifying the antecedents of attachment patterns.

PMID- 11194262
TI  - Maternal regulation of sibling interactions in the preschool years: observational
      study in Japanese families.
AB  - Characteristics of three maternal regulating behaviors--(1) reference to one
      sibling's actions or emotional states toward the other sibling, (2) encouragement
      of sibling interactions, (3) distraction of one sibling's attention away from the
      other sibling-and their associations with children's positive and negative
      behaviors toward their siblings were investigated through semistructured home
      observations for 40 sibling pairs (1-4 years, 2-8 years) and their mothers in
      Japanese families. Maternal regulating behaviors were observed more frequently
      when the younger sibling was still in an early developmental stage in the
      preschool years, although the findings were modest. The older sibling's negative
      behaviors toward the younger sibling positively correlated with maternal
      distraction toward the younger; alternatively, the younger sibling's negative
      behaviors do not correlate with maternal distraction but do correlate with
      maternal encouragement directed toward the older sibling. Reliable associations
      were found between maternal regulating behaviors and prosocial exchanges between
      siblings; maternal reference to the younger sibling's actions or emotional states
      directed toward the older sibling was associated with the older sibling's
      positive behavior toward the younger sibling. Maternal regulating behaviors
      during mother-sibling triadic interactions were associated with the quality of
      sibling relationships.

PMID- 11194263
TI  - Interparental conflict and child adjustment: testing the mediational role of
      appraisals in the cognitive-contextual framework.
AB  - Children's appraisals of interparental conflict consistently have been associated
      with adjustment problems, but the processes that give rise to this association
      are not well understood. This paper proposes that appraisals of threat and self
      blame mediate the association between children's reports of interparental
      conflict and internalizing problems, and tests this mediational hypothesis in two
      samples of children, one drawn from the community (317 ten- to fourteen-year
      olds) and the other from battered women's shelters (145 ten- to twelve-year
      olds). Results indicate that perceived threat mediates the association between
      interparental conflict and internalizing problems for boys and girls in both
      samples, and self-blame mediates this association for boys in both samples and
      girls in the shelter sample. Perceived threat and self-blame do not mediate links
      with externalizing problems, and there is no evidence of a moderating effect of
      appraisals on the association between conflict and child adjustment. Implications
      for understanding the mechanism by which exposure to interparental conflict could
      lead to child maladjustment are discussed.

PMID- 11194264
TI  - Agents of change: pathways through which mentoring relationships influence
      adolescents' academic adjustment.
AB  - A conceptual model was tested in which the effects of mentoring relationships on
      adolescents' academic outcomes were hypothesized to be mediated partially through
      improvements in parental relationships. The parameters of the model were compared
      with those of an alternative, in which improved parental relationships were
      treated as an outcome variable rather than a mediator. The study included 959
      young adolescents (M age = 12.25 years), all of whom applied to Big Brothers Big
      Sisters programs. The adolescents were randomly assigned to either the treatment
      or control group and administered questions at baseline and 18 months later. The
      hypothesized model provided a significantly better explanation of the data than
      the alternative. In addition to improvements in parental relationships, mentoring
      led to reductions in unexcused absences and improvements in perceived scholastic
      competence. Direct effects of mentoring on global self-worth, school value, and
      grades were not detected but were instead mediated through improved parental
      relationships and scholastic competence. Implications of the findings for theory
      and research are discussed.

PMID- 11194265
TI  - Middle-class African American adolescents' and parents' conceptions of parental
      authority and parenting practices: a longitudinal investigation.
AB  - Conceptions of parental authority and ratings of parental rules and decision
      making were examined longitudinally among 82 middle-class African American
      adolescents and their parents (82 mothers and 52 fathers), who were divided into
      two groups according to family income. Adolescents were, on average, 13.14 years
      of age at Time 1 and 15.05 years of age at Time 2. Nearly all adolescents and
      parents affirmed parents' legitimate authority to regulate (and children's
      obligation to comply with) rules regarding moral, conventional, prudential,
      friendship, and multifaceted issues, but they were more equivocal in their
      judgments regarding personal issues. With age, adolescents increasingly judged
      personal issues to be beyond the bounds of legitimate parental authority, but
      judgments differed by family income. Adolescents from upper income families
      rejected parents' legitimate authority to regulate personal issues more at Time 1
      than did adolescents from middle income families, but no differences were found
      at Time 2. Authority to regulate adolescents' behavior did not extend to other
      adults or to schools, churches, and the law. With adolescents' increasing age,
      African American families became less restrictive in regulating prudential,
      friendship, multifaceted, and personal issues. Adolescents', mothers', and
      fathers' judgments demonstrated significant continuity over time, but few cross-
      or within-generation associations in judgments were found. Conceptions of
      legitimate parental authority at Time 1 were found to predict family rules at
      Time 2.

PMID- 11194267
TI  - [Federal committees wnat uniform continuing education certification. MMW readers
      will soon be able to earn federally valid continuing education points].

PMID- 11194268
TI  - [Drug therapy of backache. "We must distance ourselves from these guidelines"].

PMID- 11194266
TI  - Child development and evolutionary psychology.
AB  - Evolutionary developmental psychology involves the expression of evolved,
      epigenetic programs, as described by the developmental systems approach, over the
      course of ontogeny. There have been different selection pressures on organisms at
      different times in ontogeny, and some characteristics of infants and children
      were selected in evolution to serve an adaptive function at that time in their
      life history rather than to prepare individuals for later adulthood. Examples of
      such adaptive functions of immaturity are provided from infancy, play, and
      cognitive development. Most evolved psychological mechanisms are proposed to be
      domain specific in nature and have been identified for various aspects of
      children's cognitive and social development, most notably for the acquisition of
      language and for theory of mind. Differences in the quality and quantity of
      parental investment affect children's development and influence their subsequent
      reproductive and childcare strategies. Some sex differences observed in
      childhood, particularly as expressed during play, are seen as antecedents and
      preparations for adult sex differences. Because evolved mechanisms were adaptive
      to ancestral environments, they are not always adaptive for contemporary people,
      and this mismatch of evolved mechanisms with modern environments is seen in
      children's maladjustment to some aspects of formal schooling. We argue that an
      evolutionary perspective can be valuable for developing a better understanding of
      human ontogeny in contemporary society and that a developmental perspective is
      important for a better understanding of evolutionary psychology.

PMID- 11194269
TI  - [Not just tolerating chronic pain. Which analgesics for elderly patients?].
AB  - Some 25-50% of all elderly persons living at home suffer from chronic pain. Among
      nursing home residents, the figures are appreciably higher, ranging between 45%
      and 80%. The major causes of pain in old age are degenerative joint disease,
      lower back pain, cancer, osteoporosis and herpes zoster, polymyalgia rheumatica,
      and arterial occlusive disease. In many cases, chronic pain goes undiagnosed and
      is not properly treated. When a correct diagnosis is established, however, it is
      almost always possible to achieve adequate pain relief by a combination of non
      drug treatment and analgesics, and thus to improve the patient's quality of life.

PMID- 11194270
TI  - [Acute confusion in the elderly. Search for etiology and therapy].

PMID- 11194271
TI  - [Suicidality in the elderly. What to do when the patient is suicidal?].
AB  - The suicide rate shows a constant increase with age, and the reasons are
      multifactorial. In particular people with mental disturbances, especially
      depression, age-related multimorbidity and loneliness, have a tendency towards
      suicidal behavior. Therapeutic approaches are grounded in the early recognition
      of direct and indirect remarks indicative of suicidal tendencies, and in binding
      agreements on necessary therapeutic measures. For the future, there is an urgent
      need for further expansion of the cooperative effort between physicians and care
      providing and social services in multiprofessional teams that also involve
      relatives, together with training in crisis intervention in suicidal persons.

PMID- 11194272
TI  - [It's never too late to build muscle. How the elderly benefit from power
      training].

PMID- 11194273
TI  - [What to recommend and prescribe. When children have headaches].

PMID- 11194274
TI  - [Therapy control in respiratory tract diseases. Diagnostic series: evaluating
      lung function].

PMID- 11194275
TI  - [Antidepressive drug against nicotine. A method for smoking cessation].
AB  - Currently, two drugs are considered useful for those wishing to quit smoking in
      Germany--nicotine and bupropion. The mechanism of action appears to involve
      reuptake inhibition of the transmitters noradrenaline and/or dopamine by the
      brain. Treatment with a daily dose of 300 mg delayed release buproplon for 7 to 9
      weeks resulted in smoking cessation in 30.3% (buproplon) and 35.5% (bupropion
      plus nicotine patch) of the smokers at 12 months (placebo: 15.6%, nicotine patch:
      16.4%). A large number of the participants had had negative experience with
      nicotine preparations in previous attempts to stop smoking. Most side effects of
      bupropion involve the nervous system (disturbed sleep, trembling, loss of
      concentration, headache, dizziness, depression, restlessness, anxiety) and the
      gastrointestinal tract (dry mouth, nausea, vomiting, abdominal pain,
      constipation) and elevated temperature (> 1% of the treated subjects). It is
      suggested that, at present, bupropion should be used for this indication only in
      those smokers in whom treatment with nicotine has failed.

PMID- 11194276
TI  - [Diagnostic quiz. Tachycardia in lung disease. Sarcoidosis].

PMID- 11194277
TI  - [Drug therapy and prevention on unreliable footing. Stepchildren of migraine
      research].

PMID- 11194278
TI  - [The Netherlands permit active euthanasia. Physician as the angel of death?
      (interview by Dr. med. Julia Rautenstrauch)].

PMID- 11194279
TI  - [14. Coronary heart diseases: how the general practitioner can improve the
      prognosis].

PMID- 11194280
TI  - Influence of peripheral vascular occlusive disease on the morbidity and mortality
      of coronary artery bypass grafting.
AB  - The impact of peripheral vascular occlusive disease (PVD) on outcome for patients
      who have undergone coronary artery bypass grafting (CABG) was assessed by
      comparing preoperative and intraoperative patient characteristics and outcome in
      2 groups of patients who underwent CABG (patients with PVD, n=96; patients
      without PVD, n=593). Patients with PVD were significantly older (69+/-8.4 vs 63+/
      8.7; p<0.0001), and had a higher incidence of diabetes mellitus (48% vs 32%;
      p<0.01), hypertension (62% vs 46%; p<0.01), preoperative cerebral infarction (26%
      vs 12%; p<0.001) and chronic renal dysfunction (11% vs 4.4%; p<0.01) than those
      without PVD. Postoperative morbidity and mortality were assessed, after those
      risk factors were adjusted, using multivariate logistic regression analysis. The
      perioperative myocardial infarction (PMI) rate and in-hospital mortality rate
      were significantly higher in patients with PVD than in patients without PVD (9.4%
      vs 3.0%; p=0.0108, 17% vs 2.7%; p=0.0003, respectively). The odds ratio of PMI
      and in-hospital mortality were 3.4 (95% confidence intervals (CI): 1.3-8.6) and
      4.3 (95% CI: 2.0-9.5), respectively. Although the excess mortality rate was
      mainly the result of cardiac problems, such as low output syndrome or arrhythmia,
      in most of the cases, PVD, which may frequently prevent the use of the
      intraaortic balloon pump, also seemed to have a strong relation to postoperative
      morbidity and mortality.

PMID- 11194281
TI  - Extremely thickened media of small pulmonary arteries in fatal pulmonary
      hypertension with congenital heart disease--a morphometric and
      clinicopathological study.
AB  - There are patients with congenital heart disease and fatal pulmonary hypertension
      in whom the medial hypertrophy of the small pulmonary arteries is quite beyond
      the extent of ordinary cases of hypertension, a condition described as pulmonary
      hypertension with extremely thickened media of small pulmonary arteries (PH/ETM).
      Lungs from 6 infants, all younger than 2 years of age, who had congenital heart
      disease and fatal pulmonary hypertension, were analyzed by accurately measuring
      the media using Suwa's method. In PH/ETM, the media of the small pulmonary
      arteries was shown to be not only unusually thick, but extending toward the
      periphery, whereas the intimal changes were unexpectedly mild. In the PH/ETM
      group, the % wall thickness at a diameter of 50 microm (%Tw(50)), determined from
      regression analysis, was 23.2+/-1.3%, which was significantly higher than in
      either the control (10.3+/-1.2%) or ventricular septal defect group (18.9+/
      1.6%). In persistent pulmonary hypertension of the newborn (PPHN), it was 22.3+/
      1.8%, not significantly different from PH/ETM. The striking medial hypertrophy in
      PH/ETM and PPHN was apparently confined to small pulmonary arteries and in both
      conditions is likely to be the result of maldevelopment of these arteries.
      Surgical intervention may trigger a critical elevation of the pulmonary arterial
      resistance.

PMID- 11194283
TI  - Determination of left ventricular mass by echocardiography in normotensive
      diabetic patients.
AB  - Patients with Type 2 diabetes mellitus (DM) have excessive cardiovascular
      morbidity and mortality, even in the absence of hypertension. Left ventricular
      hypertrophy (LVH), which is an ominous prognostic sign and an independent risk
      factor for cardiac events, is often present in Type 2 DM patients. Forty-two Type
      2 DM patients without hypertension, all of whom had been diagnosed more than 10
      years ago, were examined in the present study. They had no evidence of renal
      dysfunction and had not received any anti-hypertensive drugs. Age-matched healthy
      normal subjects (n=47) were recruited as controls. All participants were
      classified according to the left ventricular mass index (LVMI) using M-mode
      echocardiography and their systolic function (fractional shortening) was
      examined. The systolic function was not significantly different between the Type
      2 DM and control groups. LVH can be seen even in the normotensive Type 2 DM
      patients, with these patients still having a higher LVMI than the normal control
      subjects. Although the plasma insulin levels were not significantly increased in
      the Type 2 DM patients, the LVMI significantly correlated with plasma insulin
      levels. However, the LVMI did not significantly correlate with plasma fasting
      glucose and hemoglobin A1c in the Type 2 DM patients. These results suggest that
      LVH in Type 2 DM patients without hypertension may be associated with elevated
      plasma insulin levels.

PMID- 11194282
TI  - Prognostic significance of cardiopulmonary exercise testing for 10-year survival
      in patients with mild to moderate heart failure.
AB  - Although a number of studies have investigated the prognostic significance of
      exercise variables, they have focused only on short-term prognosis in relatively
      severe heart failure. This study was carried out to determine whether the indices
      obtained during cardiopulmonary exercise testing have prognostic significance
      during a 10-year follow-up in mild to moderate heart failure. Three hundred and
      sixty-four consecutive patients with cardiac disease performed 4 min of 20-W warm
      up, followed by a symptom-limited incremental exercise test on a cycle ergometer.
      In addition to the measurements of peak oxygen uptake (VO2) and gas exchange
      (anaerobic) threshold, the time constant of VO2 kinetics during the onset of warm
      up exercise was calculated using a single exponential equation. Data on mortality
      were available for follow-up in 260 patients. After 3,331+/-610 days of follow
      up, 29 cardiovascular-related deaths occurred. The time constant of VO2 in the
      nonsurvivors was 76.7+/-43.3 s and was significantly prolonged compared with that
      of survivors (55.3+/-30.6 s, p=0.001). Peak VO2 and gas exchange threshold were
      both significantly lower in nonsurvivors than in survivors. Kaplan-Meier survival
      curves for 10 years of follow-up demonstrated a survival rate of 89.0% for
      patients with a normal VO2 time constant (< 80 s) and 71.7% for those with a
      longer time constant (> or = 80 s), showing a significant difference in survival
      (p=0.0028). Respiratory gas parameters obtained during exercise testing,
      particularly the time constant of VO2 kinetics, were found to be useful for
      predicting long-term prognosis in patients with chronic heart failure. These
      results suggest that cardiopulmonary exercise testing could be more applicable in
      ambulatory patients with minimal symptoms or minimal functional impairment.

PMID- 11194284
TI  - Causes of late mortality in patients with disabling intermittent claudication.
AB  - The long-term prognosis of patients suffering from intermittent ischemic
      claudication is reportedly worse than that of the normal population. The outcome
      of patients with ischemic claudication admitted to hospital was reviewed
      retrospectively to identify the causes of late death. The cumulative survival
      rates for patients with claudication were 94.6% at 1 year, 79.4% at 3 years,
      67.3% at 5 years and 37.4% at 10 years. The 3 major causes of death, that is,
      ischemic heart disease, malignancy, and cerebrovascular accident, were equally
      common. The younger patients tended to die of ischemic heart disease, whereas the
      older patients died of cerebrovascular accidents. Malignancies caused a similar
      number of late deaths in all age groups. These results suggest that specific care
      should be given to patients with intermittent claudication based on the age
      related causes of death.

PMID- 11194285
TI  - Diagnostic significance of the morphological change in the atrial electrogram
      during Para-Hisian pacing.
AB  - Para-Hisian pacing (PHP), a pacing method to differentiate between conduction
      occurring over an accessory pathway (AP) from that over the atrioventricular node
      (AVN), is assessed essentially by comparing the timing in the atrial electrogams.
      Morphological change in the atrial electrograms is often observed during PHP, but
      its significance has not been investigated. Prior to the catheter ablation
      procedure, PHP was performed in 52 patients with an AP and in 36 patients with AV
      nodal reentrant tachycardia (AVNRT). The morphological change in the atrial
      electrograms, which was retrospectively assessed between the His bundle and
      proximal right bundle branch (HB-RB) captured and non-captured beats, was
      identified in 15 of 52 patients with an AP and in 26 of 36 patients with AVNRT.
      The atrial electrogram in the 6 of these 15 AP patients changed its morphology
      without overlapping the ventricular electrogram. All 6 AP patients exhibited a
      PHP pattern with the presence of 2 retrograde conduction routes, an AP and the
      AVN. In the patients demonstrating no morphological change in the atrial
      electrogram, 33 of 37 AP patients and all 10 AVNRT patients had only one
      retrograde conduction route. Morphological change in the atrial electrogram
      without overlapping the ventricular electrogram seems to have diagnostic
      significance indicating the presence of both AP and AVN conduction.

PMID- 11194286
TI  - Clinical surveillance of a thin bipolar pacing lead.
AB  - A total number of 415 co-radial, bipolar pacing leads (189 atrial leads; 226
      ventricular leads) were implanted in 228 patients between November 1994 and July
      1999. Mean pacing thresholds at the implantation were normal at 0.6 V in the
      atrium and at 0.4 V in the ventricle with a pulse duration of 0.4-0.5 ms. Lead
      impedance was relatively low (337-447 ohms for atrial leads; 369-459 ohms for
      ventricular leads) at the implantation and during the follow-up periods. No
      definite failure in lead materials was observed in either atrial or ventricular
      leads (mean follow-up of 19.7 and 19.2 months, respectively: up to 52.9 months
      for both leads). Predicted clinical surveillance up to 10 years calculated
      statistically showed that the upper 95% confidence limit was a constant of 100%.
      The lower 95% confidence limits at 5, 7, and 10 years were estimated to be 98.0%,
      97.2%, and 96.0%, respectively. From the present study, the ThinLine lead is
      reliable for both sensing and pacing thresholds, and has excellent predicted lead
      longevity. Nevertheless, further observation is required regarding cost
      performance, such as early replacement of the pacemaker generator, because of the
      lower pacing lead impedance.

PMID- 11194287
TI  - Detecting viable hibernating myocardium in chronic coronary artery disease--a
      comparison of resting 201Tl single photon emission computed tomography (SPECT),
      99mTc-methoxy-isobutyl isonitrile SPECT after nitrate administration, and 201Tl
      SPECT after 201Tl-glucose-insulin infusion.
AB  - To identify and quantify the amount of viable hibernating myocardium in patients
      with chronic coronary artery disease, resting 201Tl single photon emission
      computed tomography (SPECT) was compared with 99mTc-methoxy-isobutyl isonitrile
      (MIBI) SPECT after nitrate infusion (nitrate-99mTc-MIBI) and 201Tl SPECT after
      201Tl with glucose-insulin-potassium infusion (201Tl-GIK) in 25 patients. Twenty
      one patients also underwent completely left ventriculography beforehand and 5+/-4
      months afterwards. SPECT images were divided into 9 segments and scored visually
      from 0 (normal uptake) to 3 (absent). The defect score was calculated as the
      summation of the total scores (TDS) in each patient. The TDS of nitrate-99mTc
      MIBI images (6.3+/-4.3) and 201Tl-GIK images (5.8+/-4.2) were significantly lower
      than the 7.4+/-4.3 of resting 201Tl images (p<0.01). Based on the improvement of
      wall motion after coronary revascularization, the sensitivity of 201Tl-GIK
      imaging (85%) was significantly higher (p<0.05), and that of nitrate-99mTc-MIBI
      imaging (79%) also tended to be higher (p=0.08), than that of 201Tl imaging (62%)
      in detecting viable myocardium. The specificity of the 3 methods was almost the
      same. The nitrate-99mTc-MIBI and 201Tl-GIK methods were more useful than the
      resting 201Tl method for evaluating viable hibernating myocardium. Furthermore,
      the 201Tl-GIK method may provide a more accurate estimate of the amount of viable
      myocardium than the nitrate-99mTc-MIBI method.

PMID- 11194288
TI  - Influence of age (body size) on the Fontan circulation--analysis by a theoretical
      model.
AB  - Among the original selection criteria for the Fontan operation, the recommended
      age at the time of surgery has been 4 years or older, but recent clinical data
      have indicated the feasibility of this procedure in younger patients. Because age
      may influence the properties of the systemic vascular bed, changes in systemic
      vascular resistance (Rs) and systemic vascular compliance (Cs) associated with
      physical development were quantified in 86 pediatric patients without known
      abnormalities of the systemic circulation, and the effects of age (body size) on
      Fontan circulation were then analyzed using an analytical model of the
      cardiovascular system. As the body surface area (BSA) of the patient decreased,
      Cs also decreased significantly (r=0.81, p<0.001). Based upon this relationship
      between BSA and Cs, the analytical model showed that the impedance (ventricular
      afterload) of the Fontan circulation significantly increased as Cs decreased with
      the decrease in BSA. Moreover, the increase in impedance in response to changes
      in heart rate or Rs was inversely proportional to the BSA. However, these
      findings were significant only when the BSA was below 0.3 m2. Small BSA, or a
      lower age, has minimal effects on the Fontan circulation until it comes close to
      the infant value, and thus the Fontan procedure may be feasible much earlier than
      formerly recommended when the hemodynamics are otherwise acceptable.

PMID- 11194289
TI  - Diagnostic usefulness of the post-exercise systolic blood pressure response for
      the detection of coronary artery disease in patients with diabetes mellitus.
AB  - Patients with diabetes mellitus (DM) often have a positive result on exercise
      testing despite a normal coronary arteriogram, which indicates that exercise
      induced ST depression is not always an accurate indicator of the presence of
      coronary artery disease (CAD) in such patients. The present study evaluated the
      usefulness of the post-exercise systolic blood pressure (SBP) response for the
      detection of CAD in 47 consecutive patients with DM. Significant stenotic lesions
      were detected by angiography in 25 patients; 18 of these had true positive (TP)
      exercise testing results, and 7 had false negative (FN) results. No significant
      stenotic lesions were detected in the remaining 22 patients and of these 10 had
      true negative (TN) exercise testing results, and 12 had false positive (FP)
      results. The SBP ratio (SBP after 3 min of recovery divided by the SBP at peak
      exercise) was significantly higher in patients with coronary stenoses than in
      those without. Analysis of the relative cumulative frequency revealed that a SBP
      ratio greater than 0.87 was associated with significant stenoses. The
      sensitivity, specificity, and accuracy of ST change combined with a SBP ratio
      greater than 0.87 for detecting stenoses in patients with DM were 68%, 82%, and
      74%, respectively. These results suggest that calculating the SBP ratio, in
      combination with monitoring for ST depression, improves the accuracy of treadmill
      exercise testing for the detection of CAD in patients with DM.

PMID- 11194290
TI  - Clinical characteristics and prognosis of hospitalized patients with congestive
      heart failure--a study in Fukuoka, Japan.
AB  - The clinical characteristics and prognosis of patients with congestive heart
      failure (CHF) have been described by a number of previous studies, but very
      little information is available on this issue in Japan. This study aimed to
      delineate the clinical characteristics and prognosis of Japanese patients
      hospitalized with CHF. Medical records were reviewed for 230 consecutive patients
      at 5 teaching hospitals in Fukuoka, Japan from January to December 1997 and the
      survival and hospital readmission were followed through December 1999 (mean
      follow-up, 2.4 years). The study population had a high mean age, contained a
      larger population of women especially in the older ages, and had a higher
      incidence of overt HF (48%) despite a relatively normal ejection fraction on
      echocardiography. Major causes of CHF were ischemic, valvular, and hypertensive
      heart diseases. The 1-year mortality rate was as low as 8.3% whereas rates of
      hospital readmission because of an exacerbation of CHF were as high as 40% during
      the follow-up period. Patients hospitalized with CHF in routine clinical practice
      in Japan have characteristics that differ from those in the population included
      in community-based studies or large clinical trials.

PMID- 11194291
TI  - Usefulness of transesophageal echocardiographic monitoring in transluminal
      endovascular stent-graft repair for thoracic aortic aneurysm.
AB  - The endovascular stent-graft has been devised for the treatment of thoracic
      aortic aneurysm (TAA) to reduce complications associated with conventional
      surgical repair. The present study assessed the usefulness of transesophageal
      echocardiography (TEE) for intra- and post-operative examinations in patients
      treated with transluminal endovascular stent-graft repair for TAA. Nine patients
      with TAA and 2 with chronic type B aortic dissection were studied. Immediately
      after stent-graft deployment, perigraft leakage was evaluated with both
      intraoperative TEE and aortography. In 9 of 11 patients, TEE and aortography
      immediately after stent-graft deployment revealed the same perigraft leakage
      results. TEE might therefore be useful for evaluating perigraft leakage and
      thrombus formation after stent-graft repair for TAA and could be an alternative
      to aortography, especially for patients with renal dysfunction who have the
      possibility of contrast agent-induced complications.

PMID- 11194292
TI  - Brain natriuretic peptide predicts chronic atrial fibrillation after ventricular
      pacing in patients with sick sinus syndrome.
AB  - Chronic atrial fibrillation (AF) is one of the main complications of sick sinus
      syndrome (SSS). As previously reported, plasma brain natriuretic peptide (BNP),
      reflects hemodynamic changes in different pacing modes, as does plasma atrial
      natriuretic peptide (ANP), so the present study investigated whether plasma BNP
      or ANP can predict chronic AF after single-chamber ventricular (VVI) pacemaker
      implantation in patients with SSS. Plasma ANP and BNP levels were measured before
      and 1-3 months after implantation in 99 SSS patients. Long-term follow-up was
      conducted with chronic AF as an endpoint. Chronic AF occurred in 19 patients
      during a mean follow-up of 5.1 years. Plasma ANP and BNP were significantly
      higher in the patients who developed chronic AF after implantation than in those
      who did not, despite similar ANP and BNP levels between the 2 groups before
      implantation. Post-implant high BNP and a history of paroxysmal AF were
      independent predictors of chronic AF by a multivariate Cox proportional hazards
      analysis. Plasma BNP can predict the development of chronic AF after VVI
      pacemaker implantation in patients with SSS because increased levels may reflect
      latent hemodynamic abnormalities, which may contribute to the development of AF
      after VVI pacemaker implantation.

PMID- 11194293
TI  - Adenosine-induced coronary flow reserve in Watanabe heritable hyperlipidemic
      rabbits.
AB  - The Watanabe heritable hyperlipidemic (WHHL) rabbit develops coronary
      atherosclerosis and hypercholesterolemia because of a genetic deficiency of low
      density lipoprotein receptors and is therefore a good animal model for studying
      the relationships of coronary atherosclerosis, hypercholesterolemia and coronary
      flow reserve. The aim of the present study was to assess myocardial perfusion at
      baseline and during adenosine infusion (0.2 mg x kg(-1) x min(-1)) in 8 WHHL
      rabbits (13.8+/-0.5 months) with 13N-ammonia, small-animal positron emission
      tomography (PET) and colored microspheres. Results were compared with those from
      6 age-matched Japanese white rabbits. Plaque distribution was also examined in
      the extramural coronary arteries. All 8 WHHL rabbits had coronary plaques, with 6
      showing multiple plaques. Mean global myocardial blood flow (ml x min(-1) x g(
      1)) did not differ significantly between control and WHHL groups both at baseline
      (3.67+/-0.72 vs 4.26+/-1.12 ml x min(-1) x g(-1), p=NS) and with adenosine
      (7.92+/-2.00 vs 9.27+/-2.91 ml x min(-1) x g(-1), p=NS), nor did coronary flow
      reserve (2.16+/-0.37 vs 2.18+/-0.41, p=NS). None showed evidence of regional
      perfusion abnormalities by visual and semiquantitative analyses of PET images. It
      was concluded that WHHL rabbits preserve adenosine-induced coronary flow reserve
      despite coronary atherosclerosis and hypercholesterolemia, suggesting that a
      compensatory mechanism develops in this animal model.

PMID- 11194294
TI  - Significance of pericardial cytokines in giant cell myocarditis in rats-
      pathological comparison to viral myocarditis in mice.
AB  - To investigate the precise disease progression in myocarditis, Lewis rats were
      injected with porcine cardiac myosin, and C3H/He mice were inoculated with
      coxsackievirus B3. Both were killed serially, and the hearts were stained with
      hematoxylin-eosin to compare their pathological characteristics. In viral
      myocarditis, viral replication in the myocardium resulted in myocardial necrosis
      with inflammation, and the lesions were distributed transmurally, as previously
      reported. On the other hand, in giant cell myocarditis, inflammatory lesions
      appeared at first around the capillaries in the epicardium, and thereafter spread
      transmurally. Pericardial effusion was noticed in all the rats with myocarditis
      in the fulminant stage. Levels of interleukin (IL) -1beta and IL-6 in the
      pericardial effusion were elevated compared with the serum cytokines at the peak
      of inflammation. However, interferon-gamma in both the pericardial effusion and
      serum was not elevated. The cause of the myocardial lesions that developed in
      rats with giant cell myocarditis may be some active inflammatory process via the
      pericardial effusion.

PMID- 11194295
TI  - Primary cardiac malignant fibrous histiocytoma in the right ventricular
      infundibulum treated with a cavo-pulmonary shunt and coronary embolization.
AB  - A 51-year-old woman presented with progressive right ventricular infundibular
      wall thickening and outflow obstruction. She had had an aorto-coronary bypass for
      left main coronary artery disease 1 year after radiation therapy for left mammary
      cancer. Enhanced computed tomography showed a mass in the right ventricular free
      wall with no connection to the mediastinum; the tumor extended into the main
      pulmonary artery, but there was no other evidence of a primary or metastatic
      tumor. A biopsy specimen was obtained and based on the microscopic and immuno
      histochemical findings (vimentin and Kp-1 positive) the diagnosis was primary
      cardiac malignant fibrous histiocytoma, which is very rare. A cavo-pulmonary
      artery connection lessened her symptoms, but embolization of the coronary artery
      to try and to reduce the mass had minimal effect. Four months after the tumor was
      diagnosed she died of extended pulmonary artery obstruction.

PMID- 11194296
TI  - Isolated coronary ostial stenosis associated with coronary vasospasm.
AB  - A 50-year-old woman was brought to the emergency room in a preshock condition. An
      emergency coronary angiogram revealed 90% ostial stenosis of the left coronary
      artery with delayed distal filling. After intracoronary nitrate, the degree of
      stenosis was reduced to 75%; no other coronary lesions were evident. The patient
      was found to have hyperthyroidism and she became euthyroid after a 2-month
      regimen of methimazole. A follow-up coronary angiogram showed that the left
      coronary artery had 50% ostial stenosis without delayed distal filling. At the
      same time, an aortogram showed complete occlusion of the right subclavian artery
      in its proximal site, a slight dilatation of the truncus brachiocephalic artery,
      and a diffuse wall irregularity of the abdominal aorta, suggestive of Takayasu's
      arteritis.

PMID- 11194297
TI  - Isolated left coronary ostial stenosis as a result of fibromuscular dysplasia in
      a young man.
AB  - A 28-year-old man was admitted to hospital for investigation of a 2-week history
      of angina occurring on exertion. Coronary angiography showed an isolated left
      coronary ostial stenosis and left main trunk plasty was performed 2 weeks later.
      The pathological diagnosis of the left coronary ostial stenosis was fibromuscular
      dysplasia, which makes this a rare case.

PMID- 11194298
TI  - Infective endocarditis with extensive calcified granulation of the mitral annulus
      and valve--a case report.
AB  - Mitral annular calcification, a degenerative process usually seen in the elderly
      or in chronic renal failure, is rarely seen in an extensive form. A 69-year-old
      man with no history of renal failure, rheumatic fever, or heart disease had
      mitral valve vegetation and regurgitation, together with extensive mitral annuls
      and valve calcification, which may or may not have been secondary to the
      infective endocarditis.

PMID- 11194299
TI  - Developments in Medicaid managed care.

PMID- 11194300
TI  - Staying the course: pursuing value in the Medicaid managed care era and beyond.

PMID- 11194301
TI  - Monitoring quality in Medicaid managed care: accomplishments and challenges at
      the year 2000.
AB  - This paper reviews the major developments during the late 1990s in quality
      monitoring for Medicaid managed care and offers an assessment of major challenges
      faced at the year 2000. We highlight the dramatic increase in activities to
      ensure and improve quality in Medicaid managed care. Prior to these developments,
      little was known about the actual level of quality of care. Thus, a major
      accomplishment of the late 1990s is that we now know more about quality, through
      some key indicators, and that states and plans have implemented activities and
      structures designed to improve quality. Despite this achievement, there is still
      a critical gap in our understanding about which activities and structures
      effectively improve the health of beneficiaries. There are also three operational
      challenges. First, as state quality assurance and improvement systems become
      increasingly comprehensive, states are challenged to keep them well coordinated
      and well targeted to key issues. Second, the dynamics of both plan turnover and
      enrollment-including steep drops in Medicaid enrollment-present a challenge for
      measuring and improving quality. A third challenge is to ensure that quality
      assurance and improvement programs work for enrollees with special health care
      needs. Finally, devoting sufficient resources to quality monitoring and
      improvement is a challenge for both states and plans since managed care programs
      are expected to save money as well as improve quality.

PMID- 11194302
TI  - Commercial managed care plans leaving the Medicaid managed care program in New
      York State: impact on quality and access.
AB  - To develop sufficient managed care capacity to accomplish the goal of
      transitioning Medicaid recipients into managed care, state policymakers have
      relied on commercial health maintenance organizations to open their panels of
      providers to the Medicaid population. However, while commercial health
      maintenance organization involvement in Medicaid managed care was high initially,
      since 1996 New York State has had 14 commercial plans leave the New York State
      Medicaid Managed Care Program. It has been speculated that the exodus of these
      commercial plans would have a negative impact on Medicaid enrollees' access and
      quality of care. This paper attempts to evaluate the impact of this departure
      from the perspective of quality and access measures and plan audit performance.
      Univariate and multivariate analyses were performed to evaluation the effect of
      commercial managed care plans leaving the Medicaid program. The overall
      performance of plans that remained in the program was compared to that of the
      plans that chose to leave for the two time periods 1996-1997 and 1998-2000.
      Access to care, quality of care, and annual audit performance data were analyzed.
      The departure of commercial health plans from the New York State Medicaid Managed
      Care Program has not had a statistically significant negative effect on the
      quality of care provided to Medicaid recipients as evaluated by standardized
      performance measures. In addition, there were no instances when there was a
      negative impact of the exit of the commercial plans on access to care. Managed
      care plans that chose to remain in Medicaid passed the Quality Assurance
      Reporting Requirements audit at a significantly (P < .01) higher rate than plans
      that chose to leave. CONCLUSIONS: A program consisting of health plans
      voluntarily participating and committed to Medicaid managed care can provide
      Medicaid recipients with appropriate access to high-quality health care. The
      exodus of commercial health plans from New York's Medicaid Managed Care Program
      during the time periods studied did not result in a detectable adverse impact on
      the quality of care for enrollees.

PMID- 11194303
TI  - Problems with quality monitoring for Medicaid managed care: perceptions of
      institutional and private providers in New York City.
AB  - The study objective was to examine quality oversight efforts by Medicaid managed
      care organizations (MCOs) for children in a sample of ambulatory care
      institutions and private practices in New York City. This was a cross-sectional
      study of quality assurance priorities and strategies of MCOs and their impact
      date in institutions in New York City. Data were from structured interviews
      administered in 1997 to medical directors in the eight largest MCOs; and medical
      directors, heads of ambulatory pediatrics, and institutional pediatricians in a
      random sample of 15 institutions and 20 private office-based providers. Medical
      directors in MCOs reported that their main priority areas were the preventive
      care measures (e.g., immunization and lead screening) that they must report to
      the state. Knowledge of these MCO priority areas and monitoring activities was
      high for medical directors in the random sample, but decreased from these medical
      directors to heads of ambulatory pediatrics to institutional pediatricians, with
      the differences between the medical directors and institutional pediatricians
      significant (P < .05). However, 96% of the institutional pediatricians reported
      knowing their own institution's priorities and monitoring activities. In
      contrast, most private pediatricians reported they knew MCO priorities and
      monitoring activities (80%). Less than 33% of any group reported activities as
      "very effective" or felt any incentive to improve performance. There was a high
      level of overlap in provider networks, with institutions and private providers
      having children in many MCOs, and MCOs having children in many sites.
      Conclusions. The current model of quality oversight is producing reports for the
      state, but is not translating into effective strategies at the provider level.
      The need to work through the leadership in institutions to influence quality is
      highlighted. The level of overlap in provider networks suggests the need for
      collaboration among MCOs in quality monitoring.

PMID- 11194304
TI  - A "best practices" strategy to improve quality in Medicaid managed care plans.
AB  - Medicaid managed care is delivered through organizations operating in very
      heterogeneous environments that confront similar barriers to success. Because
      Medicaid managed care is implemented differently in each state, health plans have
      been isolated from each other and have not had an opportunity to learn how others
      may have surmounted commonly encountered barriers. After interviewing Medicaid
      health plan medical directors, we developed a learning collaborative model based
      on shared categories of problems they would need to address before they could
      implement a successful improvement strategy in an important clinical area, birth
      outcome improvement. Under the Best Clinical and Administrative Practices
      initiative, we have brought together 12 Medicaid health plans to work together on
      strategies and specific objectives for overcoming obstacles to improvement.
      Evaluations by participants have been positive, and they appear to be making a
      number of specific organizational changes based on learning from the
      collaboratives. We will be employing this organizational development model to a
      series of clinically and administratively important topics over the next few
      years.

PMID- 11194305
TI  - Managed care for the Medicaid disabled: effect on utilization and costs.
AB  - The objective of this study was to describe the effect on health care utilization
      and costs of a program of managed care for the Medicaid disabled. The study was
      designed as a pre/post enrollment cohort comparison and was carried out in three
      Ohio counties. The subjects were disabled Medicaid-insured patients who
      voluntarily enrolled in a managed care program for at least 6 months between July
      1, 1995 and December 31, 1997, and who had (1) at least one Medicaid claim in the
      24-months pre-enrollment period and (2) overall satisfactory postenrollment
      encounter-level data. Ohio Medicaid provided claims and reimbursements (costs)
      for the pre-enrollment period and encounter-level data for the postenrollment
      period. Postenrollment costs were estimated by applying category-specific average
      pre-enrollment costs to postenrollment utilization data. We measured the
      following per patient-month: (1) trends in category-specific utilization and
      costs for up to 24 months before and after enrollment, (2) differences in overall
      and category-specific costs 1 year before and after enrollment, and (3) changes
      in the distribution of services 1 year before and after enrollment. Utilization
      categories included inpatient care, outpatient hospital (including emergency
      department) care, physician services, prescription medications, durable medical
      equipment and supplies, and home health care. We found that satisfactory
      encounter data were available in two of three counties. Of 1,179 enrollees, 592
      met all inclusion criteria. Before enrollment, utilization and costs were
      increasing significantly in four of six categories and were unchanging in two.
      Postenrollment, decreasing utilization was observed for three categories, one
      remained unchanged, and two were increasing, but from a lower "baseline." Except
      for physician services and home health care, there were lower utilization and
      estimated costs in all categories in the year after enrollment. Estimated
      inpatient and total costs declined by $155/patient-month (44.9%) and $210/patient
      month (37.1%), respectively. Findings were similar across sites. Inpatient care,
      outpatient hospital care, and prescription medications accounted for 97% of the
      reductions in estimated costs in the postenrollment period. Among patients
      voluntarily enrolled for at least 6 months, managed care for the Medicaid
      disabled was associated with striking decreases in health care utilization and
      estimated costs. The effect of managed care on these patients' satisfaction,
      access to specialized services, quality of care, and health outcomes are
      understood incompletely.

PMID- 11194306
TI  - Analysis of selection effects in New York City's Medicaid managed care population
      prior to mandatory enrollment.
AB  - It is becoming increasingly apparent that over the next several years the
      majority of Medicaid patients in many states will become enrolled in managed care
      plans, some voluntarily, but most as the result of mandatory initiatives. An
      important issue related to this development is the extent to which this movement
      to managed care is accompanied by serious selection effects, either across the
      board during the phase in or among individual plans or plan types with full-scale
      implementation. This paper examines selection effects in New York City between
      1993 and 1997 during the voluntary enrollment period prior to implementation of
      mandatory enrollment pursuant to a Section 1115 waiver. No substantial selection
      bias was documented between patients entering managed care and those remaining in
      the fee-for-service system among the largest rate groups, although some selection
      effect was found among plans and plan types (with investor-owned plans enrolling
      patients with lower prior utilization and expenses).

PMID- 11194307
TI  - Oil and water? Lessons from Maryland's effort to protect safety net providers in
      moving to Medicaid managed care.
AB  - Studies have highlighted the tensions that can arise between Medicaid managed
      care organizations and safety net providers. This article seeks to identify what
      other states can learn from Maryland's effort to include protections for safety
      net providers in its Medicaid managed care program--HealthChoice. Under
      HealthChoice, traditional provider systems can sponsor managed care
      organizations, historical providers are assured of having a role, patients can
      self-refer and have open access to certain public health providers, and
      capitation rates are risk adjusted through the use of adjusted clinical groups
      and claims data. The article is based on a week-long site visit to Maryland in
      fall 1998 that was one part of a seven-state study. Maryland's experience
      suggests that states have much to gain in the way of "good" public policy by
      considering the impact of their Medicaid managed care programs on the safety net,
      but states should not underestimate the challenges involved in balancing the need
      to protect the safety net with the need to contain costs and minimize the
      administrative burden on providers. No amount of protection can compensate for a
      poorly designed or implemented program. As the health care environment continues
      to change, so may the need for and the types of protections change. It also may
      be most difficult to guarantee adequate protections to those who need it most-
      among relatively financially insecure providers that have a limited management
      infrastructure and that depend heavily on Medicaid and the state for funds to
      care for the uninsured.

PMID- 11194308
TI  - A managed care/public health partnership: opportunities in New York City's
      Medicaid program.

PMID- 11194309
TI  - Evolution of federal policy on access to health care 1965 to 1980. 1983.

PMID- 11194310
TI  - The prevalence of homelessness among injection drug users with and without HIV
      infection.
AB  - Cross-sectional investigations of homelessness have many potential biases. Data
      from 2,452 individuals enrolled in a longitudinal cohort study of Baltimore,
      Maryland, residents recruited in 1988-1989 with a history of injection drug use
      were analyzed to identify the extent and determinants of homelessness.
      Proportions having ever experienced homelessness were compared across subgroups
      of injection drug users (IDUs) who were human immunodeficiency virus (HIV)
      negative, HIV positive, and HIV seroconverting. Logistic regression identified
      independent predictors of homelessness. In the cohort, 1,144 (46.7%) participants
      experienced homelessness during the course of the study. There were differences
      in prevalence of homelessness by serostatus: 42.4% (n = 621) of participants who
      remained HIV negative were ever homeless, while 50.6% (n = 346) of HIV-infected
      individuals and 58.9% (n = 178) of those who seroconverted during the study were
      ever homeless (P < .001). Participants who consistently denied active injection
      drug use during follow-up were unlikely to experience homelessness (19%).
      Independent predictors of homelessness were male sex, HIV seroprevalence, and HIV
      seroconversion. Following participants over time captures more experiences of
      homelessness than cross-sectional studies and more accurately identifies risk
      characteristics. Our data suggest that homelessness is a significant problem
      among IDUs, especially those with HIV/AIDS.

PMID- 11194311
TI  - Social costs of untreated opioid dependence.
AB  - Using cost-of-illness methodology applied to a comprehensive survey of 114 daily
      opiate users not currently in or seeking treatment for their addiction, we
      estimated the 1996 social costs of untreated opioid dependence in Toronto
      (Ontario, Canada). The survey collected data on social and demographic
      characteristics, drug use history, physical and mental health status, the use of
      health care and substance treatment services, drug use modality and sex-related
      risks of infectious diseases, sources of income, as well as criminality and
      involvement with the law enforcement system. The annual social cost generated by
      this sample, calculated at Canadian $5.086 million, is explained mostly by crime
      victimization (44.6%) and law enforcement (42.4%), followed by productivity
      losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100
      cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in
      Toronto yields a range of social cost between $43 and $69 per capita.

PMID- 11194312
TI  - Reasons given for disclosure of maternal HIV status to children.
AB  - The purpose of this investigation was to ascertain the reasons given by mothers
      diagnosed with AIDS (acquired immunodeficiency syndrome) for disclosing or not
      disclosing their HIV (human immunodeficiency virus) status to their children, a
      dilemma faced by most HIV-infected parents and those who counsel them. We
      interviewed 29 mothers residing in one of two New York City facilities that
      provide housing and medical treatment for adults with AIDS. The majority of these
      mothers do not live with their children, but all had recent face-to-face contact
      with them. The two reasons most frequently considered important for disclosing to
      children were that disclosure was the "right thing to do" and the need to make
      arrangements for children's future in case of maternal death or incapacity. The
      reason most frequently considered important for not disclosing was maternal
      concern about discussing death and dying with children. These findings have
      significant implications for counseling of HIV-positive parents.

PMID- 11194313
TI  - Maternal mortality in New York City: excess mortality of black women.
AB  - To assess maternal mortality in New York City, birth certificates and mortality
      records for New York City from 1988 through 1994 were linked and examined. During
      these 7 years, maternal mortality in New York City (defined by the International
      Classification of Diseases, 9th edition [ICD-9], as 630-676) per 100,000 live
      births significantly exceeded that of the country as a whole (20.2 vs. 8.2,
      respectively). Within New York City, an even greater variation of maternal
      mortality by race/ethnicity was noted, with the mortality ratio of whites,
      blacks, and Hispanics being 7.1, 39.5, and 14.4 per 100,000 live births,
      respectively. Socioeconomic characteristics such as educational attainment,
      marital status, and income influenced maternal mortality more in non-blacks than
      blacks. Analyses of cause-specific mortality revealed that, overall, ectopic
      pregnancy, embolism, and hypertension were the leading causes of death. However,
      the major factors explaining the excess maternal mortality among blacks were
      hypertension (mortality ratio of blacks to whites 5.57, 95% confidence interval
      2.30-13.39), ectopic pregnancy (4.78, 95% confidence interval 2.40-9.51), and
      abortion (4.58, 95% confidence interval 1.72-12.22). These findings confirm a
      persisting gap in maternal death between black and white women. Indeed, if all
      New Yorkers who became pregnant enjoyed the survival of the city's non-Hispanic
      white residents, the difference in maternal mortality between the city and the
      nation would be eliminated.

PMID- 11194314
TI  - The prevalence of asthma in children of elementary school age in western New
      York.
AB  - To determine the prevalence of caregiver-reported asthma in children 4 to 13
      years old in metropolitan western New York State, surveys were conducted during
      1997-1999 in the Buffalo, Niagara Falls, Iroquois, and Gowanda school systems.
      Questionnaires (3,889) were sent to the homes of elementary school children in
      nine schools in western New York. The caregivers were asked to complete a 13-item
      questionnaire for the child. Of the questionnaires, 60.5% (2,353/3,889) were
      completed. Of all children, 18% had physician-diagnosed asthma. Of children
      diagnosed with asthma, 86% were taking medication. Symptoms were consistent with
      suspected undiagnosed asthma for 13% of the children. Buffalo had the highest
      rate of diagnosed asthma (20%) for the age group. Gowanda had a prevalence of
      18%, Iroquois 16%, and Niagara Falls 15%. Variations were observed in asthma
      prevalence rates among different racial/ethnic groups. In general, boys had a
      significantly (P = .001) increased odds of being asthmatic compared with girls.
      Overall, African-Americans and Hispanic/Latino children had significantly (P =
      .012 and P = .005, respectively) higher asthma prevalence rates, two to five
      times those of their Caucasian peers. In Gowanda, the prevalence of diagnosed
      asthma among Native American children was 23%, compared to 15% among Caucasian
      children. Of diagnosed Native American children, 71% were female. In Gowanda, a
      significant association (P = .007) of asthma among children in split-grade
      classes was observed compared to nonsplit grades. Of Native American children in
      split grades, 60% were diagnosed asthmatics. These observations reveal a high
      prevalence of asthma in the age group of 4 to 13 year olds in western New York.
      Local variations in potential triggers of asthma need to be considered when
      advising asthmatics. The results suggest that some grades have a disproportionate
      amount of children with asthma. The implications of asthma for children's early
      education need to be examined further.

PMID- 11194315
TI  - Expanded syringe access demonstration program in New York State: an intervention
      to prevent HIV/AIDS transmission.

PMID- 11194316
TI  - New York State pharmacists' attitudes toward needle and syringe sales to
      injection drug users before implementation of syringe deregulation.
AB  - In May 2000, New York State passed legislation permitting the sale, purchase, and
      possession of up to 10 needles and syringes without a prescription. The law is
      intended to reduce the transmission of human immunodeficiency virus (HIV) and
      hepatitis among injection drug users (IDUs), their sexual partners, and their
      children. To obtain baseline information about the attitudes and likely practices
      of New York State pharmacists, we distributed a self-administered questionnaire
      to attendees of the state pharmacy association meeting in June 2000. Of 48 usable
      responses, 19% were from New York City and the rest from New York State. Of the
      48, 42% were unaware of the new law before the day of the survey, and 60% were
      somewhat or very willing to sell needles and syringes to an IDU. Of those who
      were not willing to sell to an IDU, 82% cited familiarity of the customer as a
      very important consideration in their decision making. Those who were not willing
      to sell to an IDU were more concerned about the detrimental impact of syringe
      sales on the community, were less likely to be aware of the new law, and were
      more likely to be concerned about legal liability for syringe sales. Over 80% of
      all pharmacists believed that syringe sales to IDUs are an important preventive
      health measure. The majority also favored learning more about the law. Compared
      to other state surveys of pharmacists, these preliminary data show a similar
      level of interest in becoming involved with syringe availability programs.

PMID- 11194317
TI  - New York City pharmacists' attitudes toward sale of needles/syringes to injection
      drug users before implementation of law expanding syringe access.
AB  - In May 2000, New York State passed legislation permitting the sale, purchase, and
      possession of up to 10 needles and syringes (hereafter "syringes") without a
      prescription, intended to reduce blood-borne pathogen transmission among
      injection drug users (IDUs). To obtain baseline data on pharmacists' attitudes
      and practices related to human immunodeficiency virus (HIV) prevention and IDUs,
      a telephone survey was administered to 130 pharmacists systematically selected in
      New York City. Less than half of pharmacists were aware of the new law; 49.6%
      were willing to or supported providing nonprescription sales of syringes to IDUs.
      Pharmacists in support tended to be less likely to consider customer appearance
      "very important." Managing and supervising pharmacists were more likely than
      staff pharmacists to support syringe sales to IDUs. Managing and supervising
      pharmacists who stocked packs of 10 syringes and personal sharps disposal
      containers, pharmacists who supported syringe exchange in the pharmacy, and
      pharmacists who were willing to sell syringes to diabetics without a prescription
      were more likely to support syringe sales to IDUs. Syringe disposal was a
      prominent concern among all pharmacists. Those not in support of syringe sales to
      IDUs tended to be more likely to believe the practice would increase drug use.
      These data suggest the need for initiatives to address concerns about syringe
      disposal and tailored continuing education classes for pharmacists on HIV and
      viral hepatitis prevention among IDUs.

PMID- 11194318
TI  - [Away from deficit orientation--emphasis on individual quality of life].

PMID- 11194319
TI  - [Hygiene on the way to the future].

PMID- 11194320
TI  - [Nosocomial infections are preventable].

PMID- 11194321
TI  - [Washing the patient--"do you think of body care?"].

PMID- 11194322
TI  - [Administration of nose drops: the best position is head down, legs up].

PMID- 11194323
TI  - [Working together as a team to reach a goal].

PMID- 11194324
TI  - [Introduction to the DGR system. I. The count-down runs relentlessly].

PMID- 11194325
TI  - [When the DRG come to Germany in the year 2003: the transition in the delivery of
      health care will gain in importance].

PMID- 11194326
TI  - [Regulations regarding costs of the nursing profession should be resumed].

PMID- 11194327
TI  - [Tasks of nursing experts have many sides].

PMID- 11194328
TI  - [Biographers need extensive knowledge about generations].

PMID- 11194329
TI  - [The human body and its nursing care].

PMID- 11194330
TI  - [Decubitus ulcer is always preventable].

PMID- 11194331
TI  - [Does nursing need its own ethics?].
AB  - In contrast to a medicine and medical ethics dominated by the physician, nurses
      claim more professional autonomy, domains of independent responsibility and
      recognition of their own moral judgment and ethical reflection. In my article I
      endorse these claims, but I object to the widespread opinion that their
      fulfillment requires a nursing ethics of its own, in the sense of a specific
      moral theory for nursing. Such a "special ethics" would be counterproductive to
      the concerns of nurses, and just as mistaken as a special medical or physicians
      ethics. Instead, a critique of medicine on the basis of a general ethics is
      required both for nurses and physicians. Part I presents arguments against
      mistaken conceptions of a special nursing ethics. Part II outlines elements of a
      general ethics for medicine and nursing. Part III explains my understanding of an
      ethical critique of medicine, which is founded upon the distinction of three
      conceptual dimensions of medicine: as science, institution and practice. This
      critique focuses the ethical attention on the life situation of the patient.
      Consequences for argumentative support and political fulfillment of the nurses'
      claims mentioned will thereby become evident.

PMID- 11194332
TI  - [Intuition as implicite knowledge].
AB  - The article relates the terms intuition, tacit knowledge and experience and
      describes their meaning for nursing. An empirical study with 16 experienced
      nurses is presented whereby the nurses had to deal with a simulated critical
      nursing situation. Basing on their actions a method for explication of action
      guiding tacit knowledge was developed so that a closer scrutinizing of this type
      of knowledge became possible. Results underline the assumption of many
      practitioners that intuition as a resource in nursing activities is not to
      underestimate. At the same time a warning is given: Intuition and tacit knowledge
      is not always and at all times to evaluate positively. Finally, this
      differentiated point of view is discussed regarding consequences for nursing
      practice.

PMID- 11194333
TI  - [Study on quality assurance in the prevention and therapy of decubitus ulcer by
      measuring the overlay pressure with test subjects on different prophylaxis
      systems].
AB  - The aim of this study on quality assurance in prevention and treatment of
      bedsores was to analyse the current state of treatment of pressure sores at the
      University Hospital in Marburg. Measurements of pressure exerted on the skin were
      taken of six soft storage systems and five alternating pressure systems. In
      addition, the study aimed to find out whether the applied method of pneumatic
      pressure measurement could be used with patients in every day nursing and whether
      reliable and valid data could be generated from patients who have already
      developed bedsores. In order to answer these questions measurements were taken on
      23/19 patients, including patients in lateral position, placing measuring
      instruments between the mattress/bed system and the body. The soft storage
      systems results prove a significant pressure reduction at all measuring points (p
      < 0.05), at the os coccygis even a highly significant pressure reduction (p <
      0.01). The alternating pressure systems results show that the average maximum
      pressure over 12 min lies between 56.39 mmHg and 38.94 mmHg with differing
      amplitudes (75.47 mmHg-5 mmHg) and alternating frequency (1.5 min-10 min).

PMID- 11194334
TI  - [The influence of nursing measures on incision pain and the use of opioids in the
      postoperative period].
AB  - This experimental study was designed to investigate the influence of a cognitive
      behavioural technique on elective abdominal-surgical and orthopaedic patients at
      seven different time points within the first 72 postoperative hours. It examines
      the effect of deep breathing relaxation on the anxiety, distress, and incisional
      pain levels of postoperative surgical patients. The results show that the
      cognitive behavioural technique positively affects postoperative perception of
      pain, energy level, relaxed state and strain within the experimental group. The
      technique did not influence the patients' postoperative state-anxiety and
      agitation. Postoperatively, patients from the experimental group in both surgical
      areas used more opioids than patients from the control group. Preoperatively
      assessed personality factors did not differ between both groups. Overall the
      findings suggest that the implementation of a deep breathing relaxation technique
      positively influences the postoperative course of elective abdominal-surgical and
      orthopaedic patients.

PMID- 11194335
TI  - [Families living with HIV and Aids--review of the literature].
AB  - This article presents the current state of the art regarding the concept of
      families living with HIV and Aids. The literature reflects a comprehensive view
      including families of origin, families of choice and partnerships. It is evident
      that family networks of homosexual men are most systematically described in the
      literature; to a lesser extent families with hemophilia and i.v. drug users and
      even fewer studies are found regarding families with a heterosexual transmission
      background and especially female family caregivers. This paper also focuses on
      the wide range of support offered by these family systems. The acute and mostly
      terminal infectious disease Aids, as observed in the 80 Dies, has now become a
      predominantly chronic-progressive illness. Since the mid 90 Dies, the new
      antiretroviral therapies have further decreased morbidity and mortality, leading
      to less personal care, high-tech nursing requirements and household support. This
      development places families in a position of providing more emotional and
      advocatory support and companionship over a considerably longer time span. The
      discussion identifies strengths and weaknesses of the current literature in order
      to define deficits in the Anglo-American as well as in the German speaking area.
      From a nursing science point of view, the characteristics of HIV/Aids care must
      be further acknowledged, described and systematically studied, and results must
      be made accessible. This is important because the knowledge acquired by studying
      families affected by HIV and Aids is of interest for other family systems dealing
      with chronically ill family members. Finally, research recommendations are listed
      regarding family-oriented care and future study designs.

PMID- 11194336
TI  - [Pain management and nursing care--results of a review of the literature].
AB  - Especially for patients with chronic conditions, the ability to cope with the
      experience of illness in their daily lives is essential for the quality of life.
      An analysis of the international literature, of German nursing textbooks and
      journals was carried out to determine the dissemination of the state of the art
      of pain management. International research findings indicate a wide gap between
      the state of the art and pain management practice. Multidisciplinary role model
      programs where nurses play a major role as change agents have proved to be an
      effective strategy to change the institutional practice of pain management. In
      Germany, pain therapy as a medical discipline as well as academic courses in
      nursing were only institutionalized in the last decade. As a consequence pain
      research and therapy remained the domain of medicine and psychology up to now.
      Enhancing knowledge and educative skills of nurses will not only promote the
      quality of care. It is a key concept of professionalization in nursing.

PMID- 11194338
TI  - [Endangered by narcotic gases in the operating room?].

PMID- 11194337
TI  - [Dr. Gustav Feldmann (1872-1947)--promoter of Jewish nursing in Germany].
AB  - The origins of Jewish nursing in Germany date back to the last part of the 19th
      Century. In the wake of national socialism tyranny (NS-Zeit), the existence of
      Jewish nursing was completely destroyed. Regarding establishment and solicitous
      development for Jewish women, owing to a Jewish doctor living in Stuttgart Dr.
      Gustav Feldmann (1872-1947) whose contribution to developing new profession in
      the first quarter of the 20th century was not without merit. Up to now, he was
      hardly recognized by medical history and historical research. The following
      contribution serves to get a better view of his life and activities; most
      importantly to introduce his published work to a wide readership.

PMID- 11194339
TI  - [Operating room nursing--continuing education or technical assistant?].

PMID- 11194340
TI  - [Diagnosis-related groups--a subject for nursing, or not?].

PMID- 11194341
TI  - [Mutual supervision by colleagues. A method of quality assurance in patient
      care].

PMID- 11194342
TI  - [Pain in old age].

PMID- 11194343
TI  - [Animals at the psychiatric hospital].

PMID- 11194344
TI  - [Basal stimulation in severe burns. Limits to be observed--resources used].

PMID- 11194345
TI  - [Minor amputation on the foot--ambulatory surgery under conduction anesthesia].

PMID- 11194346
TI  - ["Keyhole" surgery, even on the spine].

PMID- 11194347
TI  - [Managing suicidal patients in hospital].

PMID- 11194348
TI  - [Chronic wounds].

PMID- 11194349
TI  - [Is it logical or not? Understanding the logic of demented patients].

PMID- 11194350
TI  - [What is new in the treatment of diabetes mellitus?].

PMID- 11194351
TI  - [Understanding comes from observation. The DCM method (Dementia Care Mapping)].

PMID- 11194352
TI  - [Tegaserod].

PMID- 11194353
TI  - [Age-related macular degeneration (AMD)--a frequent cause of vision loss in the
      aged].

PMID- 11194354
TI  - [Photodynamic therapy with Vsudyne (Verteporfin)--an innovative therapy of age
      related macular degeneration].

PMID- 11194355
TI  - [Early Tamiflu therapy of influenza can reduce disease time by half].

PMID- 11194356
TI  - In vivo resistance of coronally induced bacterial ingress by an experimental
      glass ionomer cement root canal sealer.
AB  - The resistance of an experimental sealer (KT-308) to bacterial ingress was
      assessed in six beagle dogs. In four mandibular premolars per dog, canals were
      prepared, filled with condensed gutta-percha and either KT-308 or Roth 801 cement
      (n = 24 roots), and the pulp chambers inoculated with plaque. Two additional
      premolars per dog were similarly root-filled, but not inoculated (n = 12 and 11,
      respectively). One incisor per dog was inoculated, but not root-filled (n = 6).
      Dogs were terminated after 6 months, and jaw blocks were retrieved and processed
      for light microscopic examination of the periapical tissues. Inflammation about
      the inoculated roots was significantly lower (p < 0.03) for KT-308 (17%) than
      Roth 801 cement (46%). Inflammation about the noninoculated roots did not differ
      significantly between KT-308 (8%) and Roth 801 cement (36%). This study
      demonstrated a better functional efficacy of KT-308 than of Roth 801 cement, and
      validated this in vivo model for assessment of root filling materials.

PMID- 11194357
TI  - Characterization of reactive oxygen species generated from the mixture of NaClO
      and H2O2 used as root canal irrigants.
AB  - Characterization of a mixed solution of sodium hypochlorite (NaClO) and hydrogen
      peroxide (H2O2), which have been used as root canal irrigants, was investigated
      using electron spin resonance spectroscopy combined with a spin-trapping
      technique. In the solution, two kinds of reactive oxygen species, the superoxide
      anion radical (O2-.) and the hydroxyl radical (.OH), were detected. The pH
      changes and dissolved oxygen values in the NaClO-H2O2 reaction mixture were
      investigated. The pH influenced the generation of O2-. and .OH, and O2 was
      generated from H2O2. It is suggested that root canal irrigation with NaClO and
      H2O2 induces biological effects, such as tissue irritation (from the chemical
      reactions of O2-. and .OH) and physical effects, such as O2 bubbling.

PMID- 11194358
TI  - Identification of G-protein coupled receptor subunits in normal human dental
      pulp.
AB  - To respond appropriately to their environment, dental pulp cells must integrate
      informational input from multiple ligands, such as neuropeptides, growth factors,
      and vasoactive amines. These ligands act through multiple intracellular signaling
      pathways. G-protein coupled receptor subunits play a major role in this process,
      providing a mechanism for coordinated regulation of both messengers and
      effectors. Increasing number of neuropeptides have been found in pulpal tissue.
      However, there is no data about molecular identification of G-protein subunits in
      human dental pulp. To identify the postreceptor mechanism involved in dental pulp
      cell signal transduction, we performed a Western blot analysis of different G
      protein subunits. Biopsy specimens of human dental pulp were prepared and
      subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, followed
      by analysis with appropriate antibodies. We detected G alpha q/alpha 11, short
      and long forms of G alpha s, beta common, Gio-3, and Gil-2 antigens with a
      molecular weight approximately 42 kDa, 42 and 45 kDa, 36 kDa, 40 kDa, and 40 kDa,
      respectively. These results indicate that human pulp cells possess the cellular
      machinery to respond to sensory neuropeptides when they are released from the
      peptidergic nerve fibers. On this basis, the relationships of postdevelopmental,
      age-dependent, and pathophysiological disorders of G-proteins subunits in dental
      pulp could be studied.

PMID- 11194359
TI  - Suppression of bacterial adherence by experimental root canal sealers.
AB  - To prevent reinfection after root canal treatment, root filling materials should
      be antimicrobial. This study assessed the antimicrobial efficacy of KT-308, a
      modified glass ionomer cement sealer, and three formulations of ZUT, a
      combination of KT-308 and three different concentrations of a silver-containing
      zeolite. Discs prepared from the test materials and paper controls were incubated
      in Brain Heart Infusion broth for 12 wk. At 2-wk intervals, 18 discs from each
      group were inoculated with Enterococcus faecalis and incubated for periods of 1
      to 30 h. After further processing, a 200 microliters aliquot of the broth
      immersing each disc was plated on agar and assessed for bacterial growth. The
      remaining broth was measured for optical density. All ZUT discs demonstrated no
      bacterial growth after 15 h of interaction, in contrast to abundant growth with
      the KT-308 and paper discs. Thus ZUT effectively suppressed adherent E. faecalis
      after 15 h, irrespective of its concentration and age.

PMID- 11194360
TI  - Bleaching effect of sodium percarbonate on discolored pulpless teeth in vitro.
AB  - The purpose of this study was to evaluate the bleaching effect of sodium
      percarbonate on artificially stained pulpless teeth. Twenty extracted human
      mandibular premolars were stained by immersing them in human blood mixed with
      iron sulfide, and divided into three test groups and one control group. The
      following bleaching agents were used: sodium perborate mixed with 30% hydrogen
      peroxide (WB), sodium percarbonate mixed with distilled water (PW) or 30%
      hydrogen peroxide (PH). On days 5, 10, and 15, each pulp chamber was refilled
      with fresh bleaching paste. The L* (average lightness) of the midbuccal area of
      specimens was measured before and after staining, and on days 5, 10, 15, and 20
      by colorimeter. The bleaching effect was evaluated by the lightness recovery rate
      (LRR) calculated from L*. WB showed the highest LRR among all groups, and PW and
      PH showed significantly higher LRR when compared with the control group. PW and
      PH were not significantly different. Results showed that sodium percarbonate had
      an obvious bleaching effect without hydrogen peroxide and indicated that it could
      be a safe intracoronal bleaching agent.

PMID- 11194361
TI  - Leakage of amalgam, composite, and Super-EBA, compared with a new retrofill
      material: bone cement.
AB  - An in vitro leakage study was conducted to compare the root-end sealing ability
      of amalgam with cavity varnish, composite with dentin bonding agent, and Super
      EBA with a new retrofill material: bone cement. Eighty single-rooted teeth were
      instrumented and obturated with gutta percha, resected and retroprepared. The
      teeth were then randomly divided into 4 groups of 20, with each group receiving
      one of the previously mentioned retrofill materials. The bone cement group was
      either etched or unetched. The teeth were immersed in silver nitrate and
      developer for leakage assessment. The teeth were grooved and split longitudinally
      to measure leakage. Statistical analysis showed that amalgam leaked significantly
      less than Super-EBA and unetched bone cement; composite leaked significantly less
      than Super-EBA. Amalgam was not statistically different from composite or etched
      bone cement. No significant difference between composite and both bone cements
      was noted, nor between both bone cements and Super-EBA.

PMID- 11194362
TI  - Radiovisiography in the detection of periapical lesions.
AB  - The periapical areas of 16 teeth from 6 human mandibular jaw specimens were
      randomly examined by 3 observers using conventional radiography with Kodak E
      speed film and radiovisiography (with variable contrast and with fixed contrast).
      Each periapical area was examined preoperatively and after #2, #4, #6, and #8
      sized bur periapical lesions were created in the cortical bone. The three
      radiographic methods were compared by repeated-measures ANOVA of the accuracy
      scores for the 16 periapical lesions. Accuracy increased with size of lesion, but
      did not vary by method. Repeated-measures ANOVA of the accuracy scores of only
      the smallest and no lesion condition showed that conventional radiography and
      radiovisiography (variable contrast) have opposite strengths. Conventional
      radiography tended to be more accurate in the no lesion condition, whereas
      radiovisiography using variable contrast was somewhat more accurate in the
      smallest lesion condition. The accuracy of radiovisiography with fixed contrast
      was not significantly different from the other two methods.

PMID- 11194363
TI  - Three-dimensional reconstruction: a new method for the evaluation of apical
      microleakage.
AB  - The purpose of this study was the evaluation of a new method for studying apical
      microleakage by using a three-dimensional (3-D) reconstruction method. Fourteen
      human single-rooted mandibular teeth were used for this work. The canals were
      prepared with hand instruments by using the step-back technique. To supply a
      focus to the study of the method, the teeth were divided into two groups that
      were obturated using two different sealers. India ink was used for passive stain.
      Serial cross-sections 0.75 mm thick were taken from each specimen by using a
      special microtome. Each section was photographed under a stereoscopic microscope.
      Each photograph was digitized and processed to obtain a 3-D reconstruction of the
      external surface of the teeth, their corresponding prepared root canals, and
      their apical microleakage. Sample size and experimental methods were not designed
      to make valid groups; however, apical microleakage was observed in both groups
      ranging between 2.25 to 8.25 mm height. The 3-D reconstruction method has proved
      to be a useful tool in the study of apical microleakage.

PMID- 11194364
TI  - Interpretation of artificial and in vivo periapical bone lesions comparing
      conventional viewing versus a video conferencing system.
AB  - The purpose of this study was to compare the interpretation of conventional
      radiographs transmitted by a video teleconferencing system to conventional
      viewbox interpretation for both artificial and in vivo periapical bone lesions. A
      total of 30 radiographic images were used in this study: 20 radiographic images
      of artificial lesions and 10 radiographs from actual patients. Two endodontists
      evaluated the 30 images by giving a "yes" or "no" response when determining
      whether a periapical lesion was present on the radiograph. The study was
      conducted in two sessions, separated by a 6-wk interval to minimize evaluator
      recall. Results of the study revealed no statistical difference between the
      ability of the evaluator to identify periapical bone lesions using conventional
      radiographs on a viewbox and his ability to interpret the same images transmitted
      on a monitor screen.

PMID- 11194365
TI  - Comparison of nickel-titanium and stainless-steel spreader penetration and
      accessory cone fit in curved canals.
AB  - The purpose of this study was to compare nickel-titanium and stainless-steel
      spreader penetration in curved canals. Twenty prepared plastic blocks with a 30
      degrees curvature were used for each part of the study. In part 1, the force
      required to insert each spreader to within 1 mm of working length in an empty
      canal was measured. In part 2, the force required to insert each spreader to
      within 3 mm of working length was measured in a canal containing a master cone.
      In part 3, the depth of penetration of each spreader with a master cone in place
      using a 1.5 kg force was measured. Additionally, in part 3, the depth of
      penetration of the first accessory cone was measured. The results from part 1
      showed that a nickel-titanium spreader required significantly less force than a
      stainless-steel spreader (0.30 kg vs. 0.59 kg). In part 2, a nickel-titanium
      spreader required significantly less force than a stainless-steel spreader (1.56
      kg vs. 2.42 kg). In part 3, a nickel-titanium spreader penetrated significantly
      deeper than a stainless-steel spreader (15.0 mm vs. 14.0 mm). There was no
      significant difference in the depth of penetration of the first accessory cone
      used after either spreader (0.8 mm vs. 0.7 mm). Therefore, the potential for
      vertical root fracture in curved canals during lateral condensation may be
      minimized by using nickel-titanium spreaders.

PMID- 11194366
TI  - A supernumerary tooth fused to the facial surface of a maxillary permanent
      central incisor: case report.
AB  - A case of a supernumerary tooth fused to the facial surface of a maxillary
      permanent central incisor is reported. Root canal therapy on the maxillary
      central incisor was performed due to pulpal communication between the
      supernumerary tooth and the maxillary central incisor after removing the
      supernumerary tooth structure. The communication was sealed with mineral trioxide
      aggregate. The difference between fusion and gemination is discussed.

PMID- 11194367
TI  - An accident with a Gates Glidden drill in endodontic practice.
AB  - An unusual accident in clinical endodontic practice is described. The Gates
      Glidden drill is currently being used for establishing straight-line access in
      endodontic practice (1). One potential hazard in using the Gates Glidden drill is
      that it can separate within the canal (2). This article reports an accident
      involving a Gates Glidden drill separating in the elbow of a dentist during
      endodontic practice and to discuss the safety of using a Gates Glidden drill.

PMID- 11194368
TI  - Zebra. XVIII. Part 2. Adenoid cystic carcinoma.

PMID- 11194369
TI  - Effects of irrigation on debris and smear layer on canal walls prepared by two
      rotary techniques: a scanning electron microscopic study.
AB  - Debris and smear layer were evaluated in canals prepared with either Lightspeed
      (LS) or ProFile (PF) rotary instruments. Irrigants used were tap water (group A)
      or alternating 5.25% NaOCl and 17% EDTA (group B). Apical stops were prepared to
      size 52.5 in the LS and to size 6 (approximately ISO size 36) in the PF
      techniques. The roots were split longitudinally and examined at apical, middle
      and coronal levels for debris and the smear layer using a 5-step scale. Using
      only water, mean debris scores were similar for LS and PF. In contrast, with
      EDTA/NaOCl, LS- and PF-prepared canals had similar debris scores at the apical
      and coronal levels, but there was a significant difference at the middle level.
      Mean smear layer scores were similar in LS- and PF-shaped canals when water was
      the sole irrigant. In contrast, with NaOCl and EDTA, mean smear layer scores were
      significantly different at the apical and middle levels, but not at the coronal
      level. Neither technique was superior in removing debris, but larger canal
      preparations obtained in this study with LS instruments enabled a more effective
      removal of the smear layer in the EDTA-NaOCl group.

PMID- 11194370
TI  - Effectiveness of ProFile .04 taper rotary instruments in endodontic retreatment.
AB  - This study investigated the retreatment effectiveness of .04 Taper nickel
      titanium rotary ProFiles. Thirty extracted single-rooted anterior teeth were
      instrumented and obturated with gutta-percha/Roth's Sealer using lateral
      condensation. They were distributed into three groups of 10 each. Retreatment for
      group A was done using Profile alone, group B using Profile and chloroform, and
      group C using hand files with chloroform. The teeth were then split
      longitudinally into halves. The remaining gutta-percha/sealer on the root canal
      wall in the cervical, middle, apical thirds, and the whole canals were visually
      scored with the aid of light microscopes. The results showed that the mean scores
      in groups A and B were generally lower (better) than group C. Mean scores of the
      apical thirds tended to be higher (worse) than the middle and the cervical
      thirds, except in group A. ProFile with or without chloroform seemed to be a
      viable alternative retreatment method.

PMID- 11194371
TI  - Three-rooted maxillary second premolar.
AB  - The possibility of three canals in maxillary second premolars is quite small;
      however, it must be taken into account in clinical and radiographic evaluations
      during endodontic treatment. Many times their presence is noticed only after
      canal treatment, due to continuing postoperative discomfort. This article
      describes a clinical case of three-canal maxillary second premolars that are
      endodontically treated.

PMID- 11194372
TI  - Endodontic considerations of the nasopalatine duct region.
AB  - Although rare, anomalies of the nasopalatine region have been reported in the
      literature mimicking pathoses of endodontic origin. The purpose of this article
      is to present a case of a patent nasopalatine duct that was originally diagnosed
      as a sinus tract and referred for endodontic therapy. A review of the anatomy of
      the nasopalatine region is also discussed.

PMID- 11194373
TI  - Comparison of digital dental X-ray systems with self-developing film and manual
      processing for endodontic file length determination.
AB  - Human skulls were sectioned into 15 sextants. Teeth were then removed and 45
      canals were instrumented to their apical foramina. Endodontic files were glued in
      place at random distances from the apical foramina. Image geometry was maintained
      by a custom mounting jig. Images were captured with self-developing film,
      manually processed D-speed film, and a digital radiographic system (Dexis).
      Digital images were read on a conventional color monitor (cathode ray tube) and a
      laptop screen (active-matrix liquid crystal display). Fifteen dentists measured
      the distance from the file tip to the apical foramen of the tooth. Results showed
      that the measurement error was significantly less for the digital images than for
      the film-based images. It is likely that these statistical differences may not be
      of great clinical significance because the digital images could be measured in
      increments < 0.25 mm.

PMID- 11194374
TI  - Effect of rotational speed on the breakage of nickel-titanium rotary files.
AB  - Nickel-titanium 0.04-tapered rotary files were evaluated for breakage at
      different rotational speeds in semicircular bovine bone simulated root canals of
      identical size and radius for each file size group tested. The bovine bone canals
      had a radius of curvature of 5 mm and a canal width equivalent to the D1 diameter
      of the file plus 0.04 mm. Profile instrument #3, #4, and #5 were tested at 150,
      250, and 350 rpm. A contra-angle electric handpiece was mounted on an Instron
      machine that was set to deliver a constant downward speed of 5 mm/min. The
      electric handpiece and Instron machine were activated until the files broke. The
      amount of file tip penetration into the semicircular bovine bone canal was
      measured in degrees with a protractor from a radiographic image taken of the file
      inside the bone model. Greater degrees of tip penetration indicated greater
      resistance to breakage. Statistical analysis was done and the results indicated
      that there was a significant difference for all file sizes in the extent of file
      tip penetration before breakage. In the rotation range between 150 and 350 rpm
      the greatest extent of penetration occurred at 150 rpm. This study concluded that
      0.04 taper nickel-titanium rotary file breakage is less likely to occur if the
      files are rotated at lower speeds.

PMID- 11194376
TI  - Torsional properties of stainless-steel and nickel-titanium files after multiple
      autoclave sterilizations.
AB  - This study tested the hypothesis that multiple sterilizations of endodontic
      stainless-steel and nickel-titanium files will lead to a continuous decrease in
      the resistance of files to separation by torsion. One hundred stainless-steel and
      100 nickel-titanium #30 K-type files were divided into 20 groups of 10 and
      sterilized in increments of 10 cycles, using a full cycle and a fast cycle
      autoclave. These files were tested by twisting each of them in a clockwise
      direction until fracture (torque g-cm). Samples of the fractured files were
      embedded in an epoxy resin and polished for Knoop hardness tests. In addition,
      the samples were chemically etched to reveal changes in microstructure. The
      findings of this study indicate that neither the number of sterilization cycles
      nor the type of autoclave sterilization used affects the torsional properties,
      hardness, and microstructure of stainless-steel and nickel-titanium files.

PMID- 11194375
TI  - Effects of ultrasonic root-end preparation on microcrack formation and leakage.
AB  - Root-end preparations made with conventional ultrasonic (CUS) tips, diamond
      coated ultrasonic (DUS) tips, and high-speed stainless-steel burs (HSB) were
      compared for the incidence of microcracks and dye leakage. One hundred twenty
      incisors were instrumented, obturated, and had 3 mm resected from their apices.
      Sixty teeth were used for microcrack evaluation before and after root-end
      preparation with CUS, DUS, or HSB. Three types of microcracks were observed:
      intracanal, extracanal, and communicating. Four of the five cracks observed after
      root resection (before root-end preparation) were of the extracanal or intracanal
      type. After root-end preparation, 19 of the 41 new microcracks that developed
      were the communicating type. There was no significant difference among CUS, DUS,
      or HSB for the number or type of cracks. Of the remaining 60 resected teeth, 25
      were prepared with DUS, 25 with CUS, and 10 served as controls. All of the DUS
      and CUS teeth were filled with Super-EBA. Dye penetration was measured after
      immersion in Pelikan ink for 5 days. The dye penetration difference between DUS
      and CUS was not significant.

PMID- 11194377
TI  - Endothelial cell and stromal antigens in human periapical granulation tissue.
AB  - Periapical granulation tissue consists of vasculature of varying sizes and types,
      infiltrating cells, and other stromal elements. We examined the differential
      expression of endothelial and stroma antigens in this tissue to determine their
      tissue distribution in order to obtain hints on their functions. Some of the
      antigens examined were present only in the endothelial lining of vasculature,
      including high endothelial venules (e.g. CD31 and CD105), whereas others were
      more widely expressed by both vascular and stromal elements (e.g. CD29, CD63,
      CD44, and CD151). Immunohistochemical analysis using monoclonal antibodies
      specific to certain tissue compartments revealed the tissue architecture more
      precisely and the expression of certain antigens in the tissue suggested special
      roles for these antigens. Tissue distribution of CD63, CD143, CD147, and CD151 in
      periapical granulation tissue is first reported in the present study.

PMID- 11194378
TI  - Heat transfer to the periodontal ligament during root obturation procedures using
      an in vitro model.
AB  - It appears to be important to avoid thermal injury to the periodontal ligament
      when using heated guttapercha techniques such as "System B." An in vitro model
      was developed, consisting of an extracted human tooth rooted in an artificial
      periodontal ligament (PDL) and alveolar socket, which allowed us to measure the
      temperature transferred to the root surface. The teeth were instrumented and
      subsequently embedded in alginate to simulate the PDL. Medium gutta-percha points
      were fit, sealer was applied, and a fine Buchanan plugger was used for
      condensation. Temperature measurements were taken simultaneously at the apex and
      5 mm from the apex during obturation with two fine gauge thermocouples connected
      to a digital thermometer. The average temperature increase was approximately 1
      degree C at the apex and approximately 2 degrees C at the 5 mm mark. The
      resulting temperature increases appear to be lower than previously reported by
      other investigators (Hardie, 1986, 1987; Barkhordar et al., 1990; Weller et al.,
      1991; Lee et al., 1998), who did not allow for the heat disseminating effect of
      the PDL.

PMID- 11194379
TI  - Time course of the increase in trk A expression in trigeminal neurons after tooth
      injury.
AB  - Injury to tooth pulp often results in extensive sprouting of sensory nerve fibers
      at the site of wound repair due to local increases in nerve growth factor (NGF)
      concentration. NGF interacts with high-affinity binding sites, termed trk A
      receptors, located on the cell membranes of responsive neurons. If NGF induces
      wound repair and/or nociceptive responses in tooth pulp, then changes in
      expression of NGF receptors (trk A receptors) in response to dentin injury would
      be expected. To characterize the role of trk A receptors in mediating NGF-induced
      signals to sensory neurons, trigeminal ganglia from adult male rats were examined
      for changes in expression of trk A as a function of time after injury to
      maxillary molar dentin. In situ hybridization was performed with 35S-labeled
      riboprobes encoding the sense or antisense trk A sequences, and grain densities
      quantified over maxillary neurons. As early as 12 h after tooth injury, grain
      density counts increased by 71% above control level, indicating an increase in
      trk A receptor mRNA expression. Grain densities obtained from ganglia harvested
      at all time points through 168 h after injury remained elevated. At 336 h (14
      days) after injury, trk A receptor expression had decreased such that grain
      density counts were not different from preinjury levels. Thus our results suggest
      that NGF may be mediating repair and pain responses by the sustained upregulation
      of its cell surface receptor, trk A, in neurons of the trigeminal ganglia.

PMID- 11194380
TI  - Penetration of the pulp chamber by bleaching agents in teeth restored with
      various restorative materials.
AB  - It is thought that externally applied bleaching agents may penetrate into the
      pulp chamber. This study was conducted to evaluate the diffusion of peroxide
      bleaching agents into the pulp chamber of teeth restored with various restorative
      materials. Sixty-five human extracted anterior maxillary teeth were separated
      into the 13 groups containing 5 teeth. Five teeth (control group) were not
      subjected to any cavity preparation and restoration. Standardized class V
      cavities were prepared in the other 60 teeth and restored using composite resin
      (Charisma), polyacid modified composite resin (Dyract), or resin-modified glass
      ionomer cement (Vitremer). All teeth were sectioned 3 mm apical to the
      cementoenamel junction to remove the intracoronal pulp tissue, and the pulp
      chamber was filled with acetate buffer to absorb and stabilize any peroxide that
      might penetrate. Vestibular crown surfaces of teeth in the experimental groups
      were subjected to four different bleaching agents for 30 min at 37 degrees C,
      whereas the teeth in the control groups were exposed only to distilled water.
      Then the acetate buffer solution in the pulp chamber of each tooth was removed,
      and the pulp chamber of each tooth was rinsed with 100 ml of distilled water
      twice. Leukocrystal violet and enzyme horseradish peroxidase were added to the
      mixture of the acetate buffer and rinse water. The optical density of the
      resulting blue solution was determined spectrophotometrically and converted into
      microgram equivalents of hydrogen peroxide. Higher hydrogen peroxide
      concentrations resulted in a higher pulpal peroxide penetration. The highest
      pulpal peroxide penetration was found in resin-modified glass ionomer cement
      groups, whereas composite resin groups showed the lowest pulpal peroxide
      penetration.

PMID- 11194381
TI  - A histopathological and immunohistochemical study of dental pulp and pulpal nerve
      fibers in rats after the cavity preparation using Er:YAG laser.
AB  - The purpose of this study was to investigate histopathological changes in the
      dental pulp after Er:YAG laser irradiation compared with those after high-speed
      drill preparation. For evaluation, repair of nerve fibers was observed using an
      immunohistochemical technique. There was no significant difference between the
      remaining dentin thickness in either cases. (Mann-Whitney U test). In the Er:YAG
      laser group a marked fibroblast proliferation and the formation of reparative
      dentin were observed relative to the high-speed drill group. The time course of
      the increase and decrease in calcitonin gene-related peptide-immunoreactive
      fibers in the high-speed drill group was similar to that of previous reports. In
      the Er:YAG laser group an increase in calcitonin gene-related peptide
      immunoreactive fibers was seen earlier than in the high-speed drill group, and 7
      days after operation these fibers decreased to control level. The results
      suggested that the Er:YAG laser leads to pulpal repair earlier than the high
      speed drill.

PMID- 11194382
TI  - [Perioperative management with short-acting intravenous anesthetics].
AB  - Total intravenous anaesthesia (TIVA) with short-acting drugs is a standard
      procedure for day case surgery and is increasingly used for neurosurgical,
      cardiac surgical and paediatric surgical operations. The combination of propofol
      with alfentanil or remifentanil is frequently applied due to its favourable
      pharmacological properties. Propofol is characterized by a large volume of
      distribution at steady state and a relatively long elimination half time (t1/2
      beta). Because of a high metabolic clearance, the clinical effects of propofol
      decline rapidly even after prolonged intravenous drug infusion. In patients with
      increased age, obesity or liver or renal failure, decreased doses of propofol for
      induction of anaesthesia are recommended. The short-acting opioids alfentanil and
      remifentanil provide small volumes of distribution at steady state, a short blood
      brain equilibration time and decreased t1/2 beta. Remifentanil has unique
      pharmacological properties due to an ester binding and its elimination via
      extrahepatic hydrolysis by non-specific blood and tissue esterases. The context
      sensitive half time of remifentanil is significantly shorter than that of other
      opioids. Its analgetic potency is equal to fentanyl and 20 to 30 times higher
      than alfentanil. The advantages of total intravenous anaesthesia include fewer
      haemodynamic side-effects, a decreased incidence of postoperative nausea and
      vomiting and less neurohumoral stress response to surgery. Adequate pain therapy
      is mandatory after total intravenous anaesthesia with short-acting drugs.
      Continuous infusion of remifentanil for postoperative analgesia or
      supplementation of regional anaesthesia requires careful monitoring of vital
      functions. The economic aspects of TIVA remain to be determined.

PMID- 11194383
TI  - [Anesthesia with remifentanil combined with desflurane or sevoflurane in lumbar
      intervertebral disk operations].
AB  - Recovery characteristics, haemodynamic profile, analgesic requirement and costs
      were evaluated and compared in patients undergoing elective lumbar discectomy
      with remifentanil-based anaesthesia using either desflurane or sevoflurane as the
      volatile anaesthetic agent. Sixty-two patients (ASA I/II status) were randomly
      assigned to receive either desflurane and remifentanil or sevoflurane and
      remifentanil (in oxygen/air) for anaesthesia. After induction with 0.5
      microgram/kg/min remifentanil, 4 to 5 mg/kg thiopentone and 0.5 mg/kg atracurium,
      the patients received 0.25 microgram/kg/min remifentanil and 0.5 +/- 0.05 MAC of
      one of the volatile anaesthetic agents for further maintenance of anaesthesia. At
      the end of surgery, early emergence from anaesthesia was recorded by assessing
      the time to sufficient spontaneous respiration, eye opening and tracheal
      extubation. The total demand of piritramide in the postoperative period was
      determined using patient-controlled analgesia (PCA device). Quality of pain
      therapy was assessed via a verbal ranking scale (VRS). Side-effects such as
      postoperative nausea, vomiting or shivering were recorded in the postanaesthetic
      care unit. In both groups, the haemodynamic profile was nearly identical. Mean
      arterial pressure (-18%) and heart rate (-23%) were significantly reduced
      throughout anaesthesia in both groups. All recovery parameters were significantly
      shorter in the desflurane group in comparison with the sevoflurane group (e.g.
      time to tracheal extubation: 8.5 +/- 3.0 min vs. 11.9 +/- 4.6 min). No
      significant differences between the groups were observed concerning the amount of
      piritramide required, side-effects such as nausea and vomiting or the total cost
      of anaesthesia. In conclusion, both anaesthetic techniques provide adequate
      haemodynamic stability and postoperative pain control in a surgical procedure
      with minimal trauma. Incidence and severity of side-effects such as nausea,
      vomiting or shivering did not differ between the groups and were acceptable under
      clinical conditions. Costs for desflurane were significantly higher than those
      for sevoflurane, but total costs were not different between the groups.
      Concerning recovery profile, desflurane/remifentanil seems to have small
      advantages over sevoflurane/remifentanil in patients undergoing lumbar vertebral
      disc resection.

PMID- 11194384
TI  - [Continuous recording of cardiac output volume with the OptiQ system--experiences
      with clinical application].
AB  - This report discusses initial experiences with the clinical application of
      continuous cardiac output measurement (OptiQ SvO2/CCO-System). The system was
      used in 9 intensive care patients suffering either global cardiac insufficiency
      or systemic inflammatory response syndrome. Continuous cardiac output measurement
      was recorded during a period of stable blood pressure conditions and compared
      with the results of the conventional thermodilution method (bolus technique) in
      these patients. Regression analyses yielded r = 0.523 (r2 = 0.274) for the
      "urgent" mode, r = 0.943 (r2 = 0.889) for the "fast" mode, r = 0.953 (r2 = 0.907)
      for the "fast filter" mode and r = 0.990 (r2 = 0.980) for the "normal" mode. Mean
      differences between the continuous and the bolus technique were calculated as 
      0.13 +/- 1.81 l/min for the "urgent" mode, -0.42 +/- 0.51 l/min for the "fast"
      mode, -0.14 +/- 0.48 l/min for the "fast filter" mode and -0.08 +/- 0.19 l/min
      for the "normal" mode. After a period of two days, the costs of the conventional
      bolus technique significantly exceeded those of continuous measurement. The
      expenses for the conventional thermodilution technique are largely determined by
      the frequency of application and, hence, by the personnel and laboratory costs.
      In our experience, easy component handling and stable measuring properties make
      this new method of continuous cardiac output monitoring a valuable method in the
      diagnose and care of patients who are critically ill.

PMID- 11194385
TI  - Distance learning--an educational tool for developing countries.
AB  - Many anaesthetists in small hospitals and developing countries have poor access
      to educational materials. The use of electronic means of publication and
      distribution, combined with the concepts of distance learning, can lead to better
      levels of knowledge and clinical practice. A project based on these principles
      has been set up in Zimbabwe, and is proving helpful to both trainers and
      trainees. All District Hospitals have been visited, and trainees in them
      identified. A survey has been completed to identify the subject areas in which
      training is most necessary. Trainees have been provided with reference materials
      on CD-ROM which they can access by computer (each hospital has a computer).
      Specialist anaesthesiologists in the country are producing interactive tutorials
      which can be sent out by e-mail to every hospital, and these are backed up by a
      programme of regular visits, seminars and clinical teaching. The programme is
      proving helpful to both trainees and tutors, and has the potential to be used in
      the future in other developing countries.

PMID- 11194386
TI  - Outrageous II.

PMID- 11194387
TI  - Now is the time to observe and treat dental occlusion.

PMID- 11194388
TI  - Courts conflict over ERISA pre-emptions.

PMID- 11194389
TI  - Missing posterior teeth.

PMID- 11194390
TI  - Dental waterline filters.

PMID- 11194391
TI  - Alternate benefits.

PMID- 11194392
TI  - Proper terms.

PMID- 11194393
TI  - Parallel posts.

PMID- 11194395
TI  - Medication misuse is prevalent.

PMID- 11194394
TI  - Journal unveils new look, new features; prepares to go online.

PMID- 11194396
TI  - Home security in a broadband world.

PMID- 11194397
TI  - Macroesthetic elements of smile design.
AB  - BACKGROUND: Clinicians' expanding use of cosmetic restorative procedures has
      generated greater interest in the determination of esthetic guidelines and
      standards. The overall esthetic impact of a smile can be divided into four
      specific areas: gingival esthetics, facial esthetics, microesthetics and
      macroesthetics. In this article, the authors focus on the principles of
      macroesthetics, which represents the relationships and ratios of relating
      multiple teeth to each other, to soft tissue and to facial characteristics. CASE
      DESCRIPTION: The authors categorize macroesthetic criteria based on two reference
      points: the facial midline and the amount and position of tooth reveal. The
      facial midline is a critical reference position for determining multiple design
      criteria. The amount and position of tooth reveal in various views and lip
      configurations also provide valuable guidelines in determining esthetic tooth
      positions and relationships. CLINICAL IMPLICATIONS: Esthetics is an inherently
      subjective discipline. By understanding and applying simple esthetic rules, tools
      and strategies, dentists have a basis for evaluating natural dentitions and the
      results of cosmetic restorative procedures. Macroesthetic components of teeth and
      their relationship to each other can be influenced to produce more natural and
      esthetically pleasing restorative care.

PMID- 11194398
TI  - Ask the expert. Will ceramic restorations be challenged in the future?

PMID- 11194399
TI  - Clinical implications of sex in acute temporomandibular disorders.
AB  - BACKGROUND: Previous research on temporomandibular disorders, or TMDs, has been
      somewhat limited, with studies having low numbers of subjects, restricting the
      focus to women or looking at patients already diagnosed with chronic TMD. Because
      early intervention is beneficial, it is important to understand the symptoms that
      men and women have in the acute stage of TMD. METHODS: A total of 233 patients
      (161 women, 72 men) with acute TMD symptoms were assessed with a battery of
      biopsychosocial measures. Patients were diagnosed as having TMD on the basis of
      research diagnostic criteria, or RDC, or RDC, for TMD. After six months, patients
      were reassessed to determine whether they continued to have pain, thus
      classifying them as having chronic TMD. The authors found that 153 patients (47
      men, 106 women) had developed a chronic condition, while 80 patients (25 men, 55
      women) no longer reported pain (nonchronic). RESULTS: Female and male patients
      who developed chronic TMD differed significantly from patients who had acute
      symptoms that subsided. Women who developed chronic TMD exhibited significantly
      more psychosocial distress and impairment than women who did not develop chronic
      TMD, in terms of Diagnostic and Statistical Manual, Fourth Edition, or DSM-IV,
      diagnoses; Beck Depression Inventory, or BDI, scores; Minnesota Multiphasic
      Personality Inventory scores; Multidimensional Pain Inventory, or MPI, scores;
      and physical and psychological measures assessed with the RDC for TMD. Men who
      developed chronic TMD differed significantly from men who did not develop chronic
      TMD, in that they exhibited more impairment in terms of DSM-IV diagnoses and BDI
      and RDC measures. CONCLUSIONS: These findings provide evidence that significant
      differences exist between men and women in regard to acute TMD symptoms. CLINICAL
      IMPLICATIONS: The biopsychosocial differences between men and women suggest that
      some treatments may be more beneficial for women than for men.

PMID- 11194400
TI  - Potential health and environmental issues of mercury-contaminated amalgamators.
AB  - BACKGROUND: Dental amalgamators may become contaminated internally with metallic
      mercury. This contamination may result from mercury leakage from capsules during
      trituration or from the long-term accrual from microscopic exterior contaminants
      that result from the industrial assembly process. The potential health risk to
      dental personnel from this contamination is unknown. METHODS: The authors
      assessed used amalgamators from the federal service inventory for the amounts of
      mercury vapor levels, as well as the visual presence of mercury contamination.
      They evaluated these amalgamators for potential mercury vapor health risk, using
      established National Institute for Occupational Safety and Health methods and
      American Conference of Governmental Industrial Hygienists standards. RESULTS: Ten
      of the 11 amalgamators assessed had measurable mercury vapor levels. Four
      amalgamators were found to have internal static mercury vapor levels above
      Occupational Safety and Health Administration ceiling limit thresholds. During a
      simulated worst-case clinical use protocol, the authors found that no
      amalgamators produced mercury vapor in the breathing space of dental personnel
      that exceeded established time-weighted federal mercury vapor limits.
      CONCLUSIONS: Amalgamators may be contaminated internally with metallic mercury.
      Although the authors detected mercury vapor from these units during aggressive,
      simulated clinical use, dilution factors combined with room air exchange were
      found to keep health risks below established federal safety thresholds. CLINICAL
      IMPLICATIONS: Dental personnel should be aware that amalgamators may be
      contaminated with mercury and produce minute amounts of mercury vapor. These
      contaminated amalgamators may require disposal as environmentally hazardous
      waste.

PMID- 11194401
TI  - Perspectives of Maryland dentists on oral cancer.
AB  - BACKGROUND: Maryland's mortality rate for oral and pharyngeal cancer is seventh
      highest overall in the United States, sixth highest for men and third highest for
      African-American men. As part of a statewide needs assessment and in follow-up to
      a mail survey of Maryland general dentists, focus groups were conducted to obtain
      more in-depth information about why dentists do not provide a comprehensive oral
      cancer examination for most of their patients and how to solve this problem from
      a dentist's perspective. METHODS: A trained focus group moderator conducted two
      focus groups of general practice dentists in two locations in Maryland. Five
      major themes emerged from the two focus groups: inaccurate knowledge about oral
      cancer; inconsistency in oral cancer examinations; lack of confidence in when and
      how to palpate for abnormalities; lack of time to routinely provide oral cancer
      examinations; and recommendations to help resolve these issues. CONCLUSIONS: The
      focus groups provided a rich source of ideas on how to best provide dentists with
      continuing education about oral cancer prevention and early detection.
      Participants also provided opinions about the need to improve the public's
      awareness of oral cancer and its prevention. CLINICAL IMPLICATIONS: Dentists need
      to include comprehensive oral cancer examinations as part of their routine oral
      examinations for all appropriate patients.

PMID- 11194402
TI  - Using notched tray modification for accurate double-arch impressions.

PMID- 11194403
TI  - Utilization of library outreach services by dental school alumni, 1988-1998.
AB  - BACKGROUND: The University of Missouri-Kansas City School of Dentistry Library
      outreach service includes the Dental Reference Service, or DRS; Loansome Doc
      service, Career Opportunity Center, or COC; and the Instructional Resources
      Library, or IRL. The author reviewed usage of services for 1988-1998 to analyze
      use by alumni and nonalumni and to determine possible trends. METHODS: The author
      reviewed the UMKC School of Dentistry Library outreach service database from 1988
      1998 to determine the total number of contacts for all services, numbers of
      contacts for each service, overall number of items sent and the number of dental
      health professionals contacting the services. RESULTS: The author found that the
      COC received 55 percent of contacts for the years 1988-1998, while the DRS
      received 26 percent of the total contacts and the IRL service received 19
      percent. The DRS had the highest usage by alumni (80 percent); Loansome Doc
      service accounted for 11 percent of the DRS contacts. Total number of items sent
      in response to all requests was 34,325, of which 22,647 (66 percent) were to
      alumni. Alumni usage of all outreach services was consistent, ranging from 54 to
      63 percent of the total. CONCLUSIONS: It appears that UMKC School of Dentistry
      alumni are active information-seekers. Several questions, however, remain,
      indicating that additional research should be done in the area of dental
      informatics. PRACTICE IMPLICATIONS: Information-seeking behaviors are an
      important part of the active clinical practice and may become more important as
      evidenced-based dentistry becomes more prevalent.

PMID- 11194404
TI  - Ask the expert. What are the diagnostic protocols for oral cancer screenings?

PMID- 11194405
TI  - Dentists' attitudes and behaviors regarding domestic violence. The need for an
      effective response.
AB  - BACKGROUND: The authors examined the attitudes and behaviors of a national sample
      of dentists regarding domestic violence and the barriers dentists face in
      intervening to help victims. METHODS: The authors surveyed a national random
      sample of 321 dentists by mail from November 1997 to March 1998 about their
      attitudes and clinical practice behaviors related to domestic violence. Survey
      items were developed based on the domestic violence and health care literature.
      The authors used the Total Design Method to maximize the response rate and
      analyzed data to determine differences between dentists who had received domestic
      violence education and those who had not. RESULTS: Eighty-seven percent of
      responding dentists never screened for domestic violence; 18 percent never
      screened even when patients had visible signs of trauma on their heads or necks.
      Overall, respondents intervened only minimally to help patients whom they had
      identified as victims. Respondents reported that the major barriers to screening
      were the presence of a partner or children (77 percent), lack of training (68
      percent), concern about offending patients (66 percent) and their own
      embarrassment about bringing up the topic of abuse (51 percent). Respondents who
      had received domestic violence education were significantly more likely to screen
      for domestic violence and to intervene. CONCLUSIONS: Dentists face many barriers
      to identifying and helping patients who are abuse victims, yet these data suggest
      that education about domestic violence could help them overcome some of these
      barriers. CLINICAL IMPLICATIONS: We suggest that dentists follow the AVDR model
      when approaching abused patients in their practice: Ask about abuse, provide
      Validating messages, Document presenting signs and Refer victims to domestic
      violence specialists.

PMID- 11194407
TI  - Brain activity and cognitive processes: introduction to the special issue.

PMID- 11194406
TI  - Anticalculus efficacy of an antiseptic mouthrinse containing zinc chloride.
AB  - BACKGROUND: The authors undertook a controlled clinical study to determine the
      efficacy of a tartar-control antiseptic mouthrinse in inhibiting the development
      of supragingival dental calculus. METHODS: After undergoing a dental prophylaxis,
      334 subjects with a moderate rate of calculus formation were stratified and
      randomly assigned to one of three groups: positive control (using a tartar
      control toothpaste and an antiseptic rinse), negative control (using a regular
      toothpaste and an antiseptic mouthrinse) or experimental (using a regular
      dentifrice and a tartar-control mouthrinse). Subjects brushed and rinsed twice
      daily, unsupervised, for four months. The researchers assessed subjects' calculus
      levels using the Volpe-Manhold Index, or VMI, after 16 weeks. RESULTS: Using
      analysis of covariance, the authors found that both the experimental group (which
      used a tartar-control rinse containing zinc chloride) and the positive control
      group (which used a tartar-control dentifrice containing pyrophosphate)
      demonstrated statistically significantly lower VMI scores (P = .001) than the
      negative control group (which used a regular dentifrice and an antiseptic rinse).
      Both anticalculus agents provided a clinically relevant 21 percent reduction in
      calculus formation. CONCLUSION: An antiseptic mouthrinse containing 0.09 percent
      zinc chloride as the anticalculus agent provides a clinically relevant reduction
      in calculus formation in people with a moderate rate of such formation. CLINICAL
      IMPLICATIONS: A tartar-control mouthrinse with zinc chloride as the tartar
      control ingredient is clinically effective in reducing the formation of calculus.

PMID- 11194408
TI  - Cognitive neuroscience of episodic memory encoding.
AB  - This paper presents a cognitive neuroscientific perspective on how human episodic
      memories are formed. Convergent evidence from multiple brain imaging studies
      using positron emission tomography (PET) and functional magnetic resonance
      imaging (fMRI) suggests a role for frontal cortex in episodic memory encoding.
      Activity levels within frontal cortex can predict episodic memory encoding across
      a wide range of behavioral manipulations known to influence memory performance,
      such as those present during levels of processing and divided attention
      manipulations. Activity levels within specific frontal and medial temporal
      regions can even predict, on an item by item basis, whether an episodic memory is
      likely to form. Furthermore, separate frontal regions appear to participate in
      supplying code-specific information, including distinct regions which process
      semantic attributes of verbal information as well as right-lateralized regions
      which process nonverbal information. We hypothesize that activity within these
      multiple frontal regions provides a functional influence (input) to medical
      temporal regions that bind the information together into a lasting episodic
      memory trace.

PMID- 11194409
TI  - Individual differences in the functional neuroanatomy of verbal discrimination
      learning revealed by positron emission tomography.
AB  - Why do some people have better memory abilities than others? This issue has been
      of long-standing interest to scientists and lay people. However, using purely
      behavioral methods, psychologists have made little progress in illuminating it.
      Now that functional brain imaging techniques have become available to study
      mind/brain relations, there is a new promise of understanding individual
      differences in learning and memory in terms of corresponding differences in brain
      activity. In this paper, we will present a positron emission tomography (PET)
      study designed to examine individual differences in learning and memory
      abilities. The basic assumption is that different patterns of brain activity
      serve as strong predictors of memory performance. Two specific questions were
      addressed in this study: (i) Can PET illuminate the relations between memory
      processes and their neuroanatomical correlates among individual learners and
      rememberers? and (ii) if so, how are these relations affected by the stage of
      practice on a given memory task? Our PET study examined individual differences in
      the neuroanatomical correlates of multi-trial verbal discrimination learning in
      16 young healthy subjects. The results identified patterns of brain regions in
      which blood flow correlated with subjects' retrieval performance. However, these
      regions did not correlate with performance during all learning trials. Instead, a
      gradual shift was observed from one pattern of brain regions to another over the
      course of learning. These results suggest that individual differences in memory
      performance are related to differences in neural activity within specific brain
      circuits.

PMID- 11194410
TI  - Episodic encoding and recognition of pictures and words: role of the human medial
      temporal lobes.
AB  - In the present PET study, we examined brain activity related to processing of
      pictures and printed words in episodic memory. Our goal was to determine how the
      perceptual format of objects (verbal versus pictorial) is reflected in the neural
      organization of episodic memory for common objects. We investigated this issue in
      relation to encoding and recognition with a particular focus on medial temporal
      lobe (MTL) structures. At encoding, participants saw pictures of objects or their
      written names and were asked to make semantic judgments. At recognition,
      participants made yes-no recognition judgments in four different conditions. In
      two conditions, target items were pictures of objects; these objects had
      originally been encoded either in picture or in word format. In two other
      conditions, target items were words; they also denoted objects originally encoded
      either as pictures or as words. Our data show that right MTL structures are
      differentially involved in picture processing during encoding and recognition. A
      posterior MTL region showed higher activation in response to the presentation of
      pictures than of words across all conditions. During encoding, this region may be
      involved in setting up a representation of the perceptual information that
      comprises the picture. At recognition, it may play a role in guiding retrieval
      processes based on the perceptual input, i.e. the retrieval cue. Another more
      anterior right MTL region was found to be differentially involved in recognition
      of objects that had been encoded as pictures, irrespective of whether the
      retrieval cue provided was pictorial or verbal in nature; this region may be
      involved in accessing stored pictorial representations. Our results suggest that
      left MTL structures contribute to picture processing only during encoding. Some
      regions in the left MTL showed an involvement in semantic encoding that was
      picture specific; others showed a task-specific involvement across pictures and
      words. Together, our results provide evidence that the involvement of some but
      not all MTL regions in episodic encoding and recognition is format specific.

PMID- 11194411
TI  - Brain activation during episodic memory retrieval: sex differences.
AB  - Behavioral studies have shown a tendency for women to outperform men on episodic
      memory tasks. Here, data from a series of positron emission tomography (PET)
      studies were analyzed to examine sex differences in brain activity associated
      with episodic memory retrieval (yes/no recognition). A total of 17 women and 17
      men were included in the analyses. The strongest effect of the design was a
      retrieval-related increase in activity, involving right prefrontal and anterior
      cingulate regions, that was common to women and men. In addition, a significant
      task-by-sex interaction effect was observed which involved a distributed set of
      brain regions, including several frontal areas. These results suggest that while
      the neural correlate of episodic memory retrieval is largely the same for men and
      women, some differences do exist. Possible explanations for the observed
      differences are discussed, and it is concluded that biological and experiential
      factors jointly contribute to sex differences in brain activity.

PMID- 11194412
TI  - When, where, what: the electromagnetic contribution to the WWW of brain activity
      during recognition.
AB  - Recent findings from event-related potential (ERP) as well as hemodynamic studies
      have provided physiological evidence that recognition memory involves task
      related brain processes, notably episodic retrieval mode, and item-related brain
      processes, notably retrieval success or ecphory. The excellent time resolution of
      electromagnetic techniques allows to study the time course of these processes on
      a time range from milliseconds to several seconds. In a series of studies, the
      time scales within which task- and item-related processes are likely to operate
      were investigated. The results raise the possibility that both types of processes
      are further fractionable into short and longlasting components. The cognitive
      underpinnings of these components have yet to be determined.

PMID- 11194414
TI  - The cognitive neuroscience of signed language.
AB  - The present article is an assessment of the current state of knowledge in the
      field of cognitive neuroscience of signed language. Reviewed lesion data show
      that the left hemisphere is dominant for perception and production of signed
      language in aphasics, in a fashion similar to spoken language aphasia. Several
      neuropsychological dissociations support this claim: Non-linguistic visuospatial
      functions can be dissociated from spatial functions and general motor deficits
      can be dissociated from execution of signs. Reviewed imaging data corroborate the
      lesion data in that the importance of the left hemisphere is re-confirmed. The
      data also establish the role of the right hemisphere in signed language
      processing. Alternative hypotheses regarding what aspects of signed language
      processing are handled by the right hemisphere are currently tested. The second
      section of the paper starts by addressing the role that early acquisition of
      signed and spoken language play for the neurofunctional activation patterns in
      the brain. Compensatory cognitive and communicative enhancements have also been
      documented as a function of early sign language use, suggesting an interesting
      interaction between language and cognition. Recent behavioural data on sign
      processing in working memory--a cognitive system important for language
      perception and production suggest e.g. phonological loop effects analogous to
      those obtained for speech processing. Neuroimaging studies will have to address
      this potential communality.

PMID- 11194413
TI  - Lateralization of cognitive processes in the brain.
AB  - The lateralization of cognitive processes in the brain is discussed. The
      traditional view of a language-visuo/spatial dichotomy of function between the
      hemispheres has been replaced by more subtle distinctions. The use of magnetic
      resonance imaging (MRI) to study brain morphology has resulted in a renewed focus
      on the relationship between structural and functional asymmetry. Focus has been
      on the role played by the planum temporale area in the posterior part of the
      superior temporal gyrus for language asymmetry, and the possible significance of
      the larger left planum. The dichotic listening technique is used to illustrate
      the difference between bottom-up, or stimulus-driven laterality versus top-down,
      or instruction-driven laterality. It is suggested that the hemispheric dominance
      observed at any time is the sum result of the dynamic interaction between bottom
      up and top-down processing tendencies. Stimulus-driven laterality dominance is
      always monitored and modulated through top-down cognitive processes, like
      shifting of attention and changes in arousal. A model of top-down modulation of
      bottom-up laterality is presented with special reference to the understanding of
      psychiatric disorders.

PMID- 11194415
TI  - Functional brain imaging as a looking-glass into the degraded brain: reviewing
      evidence from Alzheimer disease in relation to normal aging.
AB  - Research on the real-time relationship between brain activity and mental
      performance is intense. However, relatively few studies have been devoted to
      patients with different diseases or lesions. Such studies may cast light on
      certain aspects of brain activity, such as plasticity. This review summarizes
      studies on Alzheimer's disease (AD) patients where the techniques to map brain
      activity in relation to mental performance have been utilized. Research findings
      suggest, that there is a spectrum of changes in AD patients that is distinct from
      that seen in healthy aging. These changes include: (i) loss of activated regions,
      (ii) reduced activation possibly due to brain degeneration typical of AD, (iii)
      the emergence of newly activated regions in order to compensate for minor brain
      deterioration (e.g., an enlargement of activated regions sometimes manifested as
      an increased bilaterality or a hemispheric shift of activation, and
      dedifferentiation), (iv) decreased level of activation, and (v) no change at all,
      which may occur in easy tasks or tasks that do not involve regions exposed to
      brain atrophy. In conclusion, the pattern of activation in AD depends on
      interactions between the clinical stage of patients, and the pattern of brain
      degeneration, as well as the task difficulty and specific networks necessary for
      solving the task.

PMID- 11194417
TI  - Noah's new ark. The imminent birth of a cloned gaur signals a new approach to
      preservation.

PMID- 11194416
TI  - The potent perils of a miracle drug.

PMID- 11194418
TI  - Feel no pain. What you need to know about the new rules for treating pain at
      hospitals and other facilities.

PMID- 11194419
TI  - The new biology and human reproduction.

PMID- 11194420
TI  - Antenatal transfer of rural women to perinatal centres. High Risk Obstetric and
      Perinatal Advisory Working Group.
AB  - The aim of this study was to describe antenatal transfers of rural women to
      perinatal centres, and among transferred women, to assess the use of selected
      evidence-based therapies and determine the predictors of preterm and imminent
      births. The clinical records of rural women antenatally transferred to perinatal
      centres in NSW and the ACT during 1997-1998 were reviewed. Of 453 rural antenatal
      transfers, 408 (90%) were emergency transfers. Increasing remoteness was
      associated with increased rates of antenatal transfer but not with a lower
      probability of giving birth. Of all transferred women, 64% delivered; 58% of
      preterm transfers delivered preterm and of those delivering preterm, 76%
      delivered within 7 days. Although the main reason for antenatal transfer was the
      possibility of preterm birth, women presenting with preterm contractions only
      were less likely to deliver preterm (OR = 0.2, 95% CI 0.1-0.4) or < or = 7 days
      (OR = 0.3, 95% CI 0.2-0.5) than women with any other presenting symptoms. The
      overall usage of effective interventions (antenatal steroids, antibiotics for
      PPROM and beta-mimetic tocolysis to delay birth) among antenatally transferred
      rural women was high, but there is room for increased uptake prior to transfer.

PMID- 11194421
TI  - Fetal growth charts for Aboriginal fetuses.
AB  - The study aimed to determine whether fetal growth parameters in Aboriginal
      pregnancies are such that separate fetal growth charts are necessary for their
      appropriate care. We designed a prospective study of a cohort of Aboriginal women
      presenting for antenatal care before 20 weeks gestation (ultrasound proven) and a
      reference cohort of Caucasian women. Four remote North Queensland communities
      served by the Far North Regional Obstetric and Gynaecological Service (FROGS) and
      the antenatal clinic at Cairns Base Hospital took part in the survey One hundred
      and four Aboriginal and 101 Caucasian women with no known medical factors
      affecting fetal growth or gestation were recruited, and 96 Aboriginal and 96
      Caucasian women completed the study Measurements took the form of longitudinal
      percentile charts of fetal biparietal diameter, abdominal circumference and femur
      length. Ultrasound measurements of fetal biparietal diameter, abdominal
      circumference and femur length were obtained 3 to 5 times during Aboriginal and
      Caucasian pregnancies, where the gestation was established by ultrasound before
      20 weeks gestation, and no known medical conditions which affect fetal growth
      were present in the mother. There were no statistical or clinically important
      differences in biparietal diameter, femur length and abdominal circumference of
      Aboriginal and Caucasian fetuses. We concluded that there is no reason to use
      separate fetal growth charts when examining Aboriginal fetal growth.

PMID- 11194422
TI  - The impact of nausea and vomiting on women: a burden of early pregnancy.
AB  - Nausea and vomiting are troublesome symptoms occurring in the first trimester of
      pregnancy. The aim of this study was to describe the impact these symptoms have
      on women in early pregnancy by interviewing, using a structured questionnaire,
      593 pregnant women presenting with nausea and vomiting in the first trimester of
      pregnancy. The women were asked to complete the Rhodes index of nausea and
      vomiting and the MOS 36 Short Form Health Survey (SF-36). Symptoms of nausea and
      vomiting started early in pregnancy. Nausea was the most troublesome symptom
      experienced by women, both in its duration and intensity. Low scores for the SF
      36 were found for all items, particularly physical functioning, energy and social
      functioning. The women described substantial effects on working, household duties
      and parenting activities. Findings from this study suggest nausea and vomiting in
      early pregnancy has a profound impact on women's general sense of well-being and
      day to day life activities.

PMID- 11194423
TI  - Preoperative diagnosis of dehiscence of the lower uterine segment in patients
      with a single previous Caesarean section.
AB  - Preoperative diagnoses were checked during surgery in 39 patients who underwent
      elective repeat Caesarean section with (n = 20) and without (as control, n = 19)
      a preoperative diagnosis of wall dehiscence (thinning) of the lower uterine
      segment (LUS). All patients were examined manually and by ultrasonography at 36
      weeks gestation before labour. A preoperative diagnosis of wall dehiscence was
      made when the wall thickness was less than 2 mm and/or the patient felt pain and
      tenderness in the LUS. Surgical findings of dehiscence were defined as a
      subperitoneal separation of the uterine scar in the LUS. The sensitivity and
      specificity of our ultrasonographic evaluations were found to be 100% and 83% (p
      < 0.05), respectively. On the other hand, there were no surgical findings of
      dehiscence in patients who felt pain and tenderness in the LUS with a wall
      thickness greater than 2 mm, nor among those in the control group.

PMID- 11194424
TI  - Perimortem Caesarean section: two case reports and a management protocol.
AB  - Perimortem Caesarean section is a rare clinical event. Two cases are reported.
      Both cases had poor outcomes. The impact of this was traumatic for the trainee
      specialists who managed the two cases. The relevant literature has been reviewed
      and a protocol for the management of this rare emergency is presented.

PMID- 11194425
TI  - Improving antenatal recognition of women at risk for postnatal depression.
AB  - The purpose of this study was to assess the effectiveness of a practical
      antenatal screen used at the Royal Women's Hospital, Brisbane, to identify women
      at risk for postnatal depression. It was a prospective, hospital-based, cohort
      study of 901 women (600 with and 301 without prenatal risk factors for postnatal
      depression). Depression was measured 16 weeks after the birth using the Edinburgh
      Postnatal Depression Scale. More of the women with a prenatal risk factor for
      depression (25.9%) scored above 12 on the Edinburgh Postnatal Depression Scale
      than those without any risk (10.9%) (p < or = 0.001). Low social support (p < or
      = 0.001), a personal history of mood disorder (p < or = 0.001) and a past history
      of postnatal depression ( p = 0.002) were all strongly associated with postnatal
      depression in this sample. Results indicate that an objective, psychosocial
      assessment during pregnancy improves recognition of women at risk for postnatal
      depression.

PMID- 11194426
TI  - Contemporary management of epilepsy in pregnancy.

PMID- 11194427
TI  - A randomised controlled trial of dietary energy restriction in the management of
      obese women with gestational diabetes.
AB  - A randomised controlled trial was designed to determine the effect of moderate
      30% maternal dietary energy restriction on the requirement for maternal insulin
      therapy and the incidence of macrosomia in gestational diabetes. Although the
      control group restricted their intake to a level similar to that of the
      intervention group (6,845 kiloJoules (kJ) versus 6,579 kJ), the resulting cohort
      could not identify any adverse effect of energy restriction in pregnancy. Energy
      restriction did not alter the frequency of insulin therapy (17.5% in the
      intervention group and 16.9% in the control group). Mean birthweight (3,461 g in
      the intervention group and 3,267 g in the control group) was not affected. There
      was a trend in the intervention group towards later gestational age at
      commencement of insulin therapy (33 weeks versus 31 weeks) and lower maximum
      daily insulin dose (23 units versus 60 units) which did not reach statistical
      significance. Energy restriction did not cause an increase in ketonemia.

PMID- 11194428
TI  - The utilisation of nuchal translucency as a prenatal marker of Down syndrome,
      1993-1999.
AB  - A sample of 6,038 obstetric ultrasound referrals and reports between January 1993
      and June 1999 in a single Melbourne private ultrasound practice was reviewed to
      determine whether the referral and reporting pattern for nuchal translucency (NT)
      measurement has changed. The proportion of both 10-14 week ultrasound scans and
      mid trimester fetal anatomy scan referrals increased significantly over the study
      period (p < 0.001 and p < 0.001, respectively). There was also a significant
      increase in NT reporting and the number of specific referrals for an NT
      measurement over the study period (p = 0.01 and p < 0.001, respectively). If
      current trends continue it is likely that the 10-14 week scan for NT measurement
      will become a routine component of antenatal care. Therefore, as a matter of
      urgency, it is imperative that the best and most cost-effective screening
      strategy for Down syndrome in an Australian population is defined.

PMID- 11194429
TI  - Parental decision-making differences between patients in two healthcare systems
      for choroid plexus cysts.
AB  - We evaluated the medical-sociological implications of parental perception of risk
      and decision-making choices for prenatally ascertained choroid plexus cysts (CPC)
      between two obstetric populations. The Wayne State University (WSU) Reproductive
      Genetics database and the Madigan Army Medical Center (MAMC) experience were
      reviewed to compare the rates of aneuploidy and invasive testing for cases with
      CPC. Aneuploidy rates were compared between those with isolated CPC, CPC with
      advanced maternal age (AMA), and CPC associated with multiple anomalies. In the
      WSU cohort 186 cases were identified, of whom 27 (15%) declined invasive fetal
      testing. In the remaining 159 cases, aneuploidy was present in 2/132 (1.5%)
      isolated CPC, 3/11 (27%) CPC with AMA, and 15/16 (93%) CPC with multiple
      anomalies. In the MAMC cohort 107 cases were identified, of whom 99 (92%)
      declined invasive fetal testing. No aneuploidy cases were found in the 3/12 AMA
      cases or 5/95 non-AMA cases that underwent amniocentesis. The two cases of
      aneuploidy with isolated CPC cannot be ignored, and provide an estimated
      attributable risk of at least 0.8%, a higher risk than 38 years of age. However,
      the parental sociologic context may be as important for decision-making as the
      genetic-prognostic risk.

PMID- 11194430
TI  - Management of vaginal agenesis: review of 10 years practice at a tertiary
      referral centre.
AB  - Vaginal agenesis is an uncommon congenital anomaly, and is often associated with
      agenesis of the uterus and fallopian tubes. Recent reports suggest that non
      surgical methods to create a neovagina offer advantages when assisted
      reproductive treatments are used in the adult life of these women. We have
      reviewed the management of 39 women with congenital vaginal agenesis to assess
      the outcomes of neovaginal creation. In 25 women with total Mullerian agenesis,
      creation of a neovagina using progressive perineal dilatation alone was very
      successful in women motivated by a sexual relationship.

PMID- 11194432
TI  - An experience with transvaginal sonography in gynaecologic tumour surveillance.
AB  - Surveillance of gynaecologic cancer patients treated with a curative intent
      involves frequent presentations by the patient for a targeted history, detailed
      general and pelvic examination, including Pap smear. One of the aims of such
      surveillance is to detect potentially curable recurrences early to allow the
      initiation of further therapy, hopefully to attain eradication of the recurrent
      tumour. Six cases are presented where the prudent use of transvaginal sonography
      (TVS) was found to be useful in the exclusion of recurrent tumour in patients
      with symptoms; early diagnosis in patients who were asymptomatic; confirmation of
      disease in those with symptoms; to evaluate patients with obliterated upper
      vaginas due to therapy, and follow-up of those with confirmed recurrence as a
      form of disease marker.

PMID- 11194431
TI  - Pain relief following day case laparoscopic tubal ligation with intra-peritoneal
      ropivacaine: a randomised double blind control study.
AB  - The aim of this study was to examine the effectiveness of ropivacaine
      administered by a simple intraperitoneal technique in relieving pain following
      laparoscopic application of Filshie clips. Nineteen patients were randomised to
      receive either ropivacaine (200 mg) or normal saline through the umbilical port
      following clip application. Using a visual analogue scale women receiving
      ropivacaine had significantly lower pain scores 2 hours post operatively (0.97 vs
      2.03 p < 0.05). The mean total postoperative fentanyl use was also significantly
      lower on the ropivacaine group (40 microg vs 104 microg p < 0.02). Only 10%
      (1/10) of the women in the ropivacaine group complained of nausea compared with
      44% (4/9) in the control group. Furthermore, 80% (8/10) of women in the
      ropivacaine group were either very or totally satisfied with their pain relief.
      Only 56% (5/9) of the women in the control group were very or totally satisfied
      with their pain relief. Ropivacaine administered by a simple intraperitoneal
      technique following laparoscopic sterilisation significantly reduces
      postoperative pain and parenteral analgesic requirements. It would be reasonable
      to consider this method as standard practice following laparoscopic tubal
      ligation.

PMID- 11194433
TI  - Body image and psychological well-being in pregnancy. A comparison of exercisers
      and non-exercisers.
AB  - This study compared the perceptions of body image and psychological well-being
      between exercising and non-exercising pregnant women. A prospective longitudinal
      study was conducted with 65 nulliparous women (mean age years = 30.3, range = 23
      39) who were allocated to 2 groups based on level of recreational exercise
      participation; 25 exercisers were compared with 18 non-exercisers. A self-report
      exercise history questionnaire and a 10 item Body Cathexis Scale were completed
      on two occasions during the pregnancy, at approximately 17 weeks and 30 weeks of
      gestation. The General Health Questionnaire (GHQ-28) was administered in late
      pregnancy. There was a significant difference between the exercise group and the
      non-exercise group in late pregnancy for some items on the Body Cathexis Scale.
      The exercise group had a lower level of probable caseness on the GHQ-28 with
      reduced frequency of somatic symptoms, anxiety and insomnia, and a higher level
      of psychological well-being.

PMID- 11194434
TI  - Changes in the plasma activities of protein C and protein S during pregnancy.
AB  - The objective of the study was to determine the changes in the plasma activities
      of protein C and protein S that occur during normal pregnancy In this prospective
      cross-sectional study, plasma activities of protein C and protein S were measured
      in 32 normal pregnant women in the first, second and third trimester and 6 weeks
      after delivery There was a significant fall in protein C and protein S activities
      during normal pregnancy compared with the post-puerperal period. The activities
      of protein C and protein S also gradually decreased throughout pregnancy (p <
      0.01). Increasing plasma volume during normal pregnancy and its dilutional effect
      might play some role in the low activities of protein S observed. The normal
      falls in protein S and protein C activities make it difficult to diagnose protein
      S and C deficiency during pregnancy. Based on our findings, if a woman has a
      thromboembolic event during pregnancy, testing for a definitive diagnosis of
      protein C or protein S deficiency or functional failure should be delayed until
      at least 6 weeks postpartum.

PMID- 11194435
TI  - Tissue kallikrein activity in pregnancy.
AB  - To determine tissue kallikrein (TK) activity in black African women with
      hypertensive disorders of pregnancy; 140 women were recruited and divided into
      the following groups: group A--35 preeclamptic women, group B--35 mild to
      moderate hypertensive pregnant women and group C--35 normotensive pregnant women,
      and group D--35 normotensive non-pregnant healthy women. The activity of tissue
      kallikrein was determined from a random untimed urine sample using a selective,
      synthetic chromogenic tripeptide substrate having the sequence H-D-Val-Leu-Arg
      pNA (S-2266). Urinary sodium and potassium levels was determined by flame
      photometry. Tissue kallikrein activity was decreased in women with preeclampsia
      (1.54 +/- 0.95 vs 3.05 +/- 0.83 ngTK/microg protein; p < 0.0001) and mild to
      moderate hypertensive group (2.03 +/- 0.76 vs 3.05 +/- 0.83 ngTK/microg protein;
      p < 0.0001) compared with normotensive pregnant women. There was also a
      significant difference in tissue kallikrein activity between the pregnancy groups
      (1.54 +/- 0.95 vs 2.03 +/- 0.76 ngTK/microg protein; p < 0.001). No difference in
      tissue kallikrein activity was observed between normotensive pregnant and
      normotensive non-pregnant healthy women (3.05 +/- 0.83 vs 3.14 +/- 0.88
      ngTK/microg protein; p = 0.51). There was no difference in the excretion of
      urinary sodium and potassium in pregnancy groups compared to normotensive
      pregnant group. Tissue kallikrein activity is decreased in hypertensive disorders
      of pregnancy.

PMID- 11194436
TI  - Oophorectomy at the time of surgery for moderate endometriosis: a survey of
      Australian gynaecologists.
AB  - The decision to perform bilateral oophorectomy at the time of surgery for
      endometriosis is dependent upon many factors, one of which is the opinion of the
      surgeon concerned. At present there is no consensus on this subject, and in an
      attempt to document current opinion, we performed a postal survey of all Fellows
      of RANZCOG living within Australia. The questionnaire presented the Fellow with a
      clinical scenario describing moderate endometriosis, and then asked him/her to
      select their preferred option for each of a number of anatomical areas. Out of
      1,050 questionnaires, 688 (65.5%) were returned. Analysis of these replies
      suggests that current opinion supports a conservative approach to surgery, with
      only 27.5% of Fellows electing to perform a hysterectomy in conjunction with
      bilateral oophorectomy.

PMID- 11194437
TI  - Ruptured tubal ectopic pregnancy associated with negative qualitative human
      chorionic gonadotrophin levels.

PMID- 11194438
TI  - Successful vaginal delivery in a woman with amyoplasia.
AB  - We report on the pregnancy management of a 22-year-old woman with amyoplasia, the
      commonest type of arthrogryposis multiplex congenita (AMC). Extrapolating from
      childhood and adult studies, the majority of cases are likely to be ambulatory
      and live independent lives as adults. Many females, therefore, would be expected
      to achieve a pregnancy. There have been several case reports on anaesthetic
      management for Caesarean section delivery in women with arthrogryposis, but no
      medical literature exists regarding the likelihood or management of vaginal
      delivery. This is the first reported case of conservative management of a woman
      with amyoplasia. A multi-disciplinary team was involved in her care. This
      involved careful assessment of her suitability for vaginal delivery, possible
      anaesthetic complications and potential difficulties in caring for an infant at
      home. Induction of labour at 37 weeks gestation resulted in the successful
      vaginal delivery of a liveborn healthy male.

PMID- 11194439
TI  - Spontaneous miscarriage of a cervical pregnancy and continuation of intra-uterine
      pregnancy following in vitro fertilisation and embryo transfer.

PMID- 11194440
TI  - Vaginal melanoma masquerading as adenocarcinoma based on cervical cytology: a
      case report and review of the literature.

PMID- 11194441
TI  - Self-inflicted penetrating abdominal injury in pregnancy.

PMID- 11194442
TI  - Carcinoid tumour of the ovary: a multidisciplinary approach?

PMID- 11194443
TI  - Multiple endocrine neoplasia type IIA (Sipple's syndrome) presenting in
      pregnancy.

PMID- 11194444
TI  - Birth of twins using in vitro matured oocytes and cryopreserved semen from a male
      with carcinoma of the penis.
AB  - Semen cryopreserved from a male prior to treatment for carcinoma of the penis was
      used for intra-cytoplasmic sperm injection (ICSI) of in vitro matured (IVM)
      oocytes, resulting in the birth of healthy, non-identical twin girls.

PMID- 11194445
TI  - It is possible to perform a sacrospinous colpopexy via the incision of an
      anterior vaginal repair alone if a posterior repair is not required.

PMID- 11194446
TI  - A new indication for breech extraction.

PMID- 11194447
TI  - New indication for breech extraction.

PMID- 11194448
TI  - Outcome after a pap smear report of low-grade abnormality: a longitudinal
      comparative study.

PMID- 11194449
TI  - The Chan et all retrospective study of vacuum versus forceps is really a study of
      difference of practice and not a study of different instruments.

PMID- 11194450
TI  - Urethral prolapse in a 7 year old girl.

PMID- 11194451
TI  - Inflammatory breast cancer survival: the role of obesity and menopausal status at
      diagnosis.
AB  - No previous studies have evaluated the effect of body size and menopausal status
      at diagnosis on survival from inflammatory breast cancer (IBC). We evaluated
      whether obesity and menopausal status had an impact on IBC survival in a cohort
      of 177 female IBC patients seen from 1974 to 1993 at The University of Texas MD
      Anderson Cancer Center. Survival time was defined as time from diagnosis until
      death or censorship at last date of contact. We categorized women by body size by
      using the National Institutes of Health/National Heart, Lung, and Blood
      Institute's definitions of obesity as body mass index ((BMI) = weight in
      kg/(height in m)2) > or = 30, overweight as 25 < or = BMI < 30kg/m2, and
      normal/lean as BMI < 25 kg/m2. Cox proportional hazards analysis, adjusting for
      axillary lymph node involvement and chemotherapy protocol, revealed a modifying
      effect of menopausal status at diagnosis on the association between obesity and
      IBC survival (P = 0.02). Relative to postmenopausal women, premenopausal women
      had significantly worse survival (hazard ratio (HR) = 1.51, 95% confidence
      interval (CI) = 1.03-2.22). After stratifying by menopausal status, premenopausal
      obese women had non-significantly better survival than their leaner premenopausal
      counterparts (HR = 0.63, 95% CI = 0.34-1.15) while postmenopausal obese women had
      significantly worse survival than their leaner counterparts (HR = 1.86, 95% CI =
      1.02-3.40). These findings suggest that factors associated with larger body size
      at diagnosis may contribute to shorter IBC survival among postmenopausal women
      but not premenopausal women, who were found to have poorer survival regardless of
      body size.

PMID- 11194452
TI  - Preliminary assessment of cognitive function in breast cancer patients treated
      with tamoxifen.
AB  - BACKGROUND: Tamoxifen is an anti-estrogen used in the treatment of breast cancer
      and to reduce the incidence of breast cancer in high risk women. Although the
      brain is an estrogen target organ and several studies have found a beneficial
      effect of estrogen on cognitive function, the effect of tamoxifen on cognition
      has not been reported. Therefore, we initiated a follow-up study of women who had
      participated in a study of breast cancer to assess the effect of tamoxifen
      treatment on cognitive function. METHODS: We recruited previously interviewed
      patients who were cases in a population-based case-control study of 2,653 women
      with primary breast cancer diagnosed between 1987 and 1996 at ages 55-72 years in
      Los Angeles County, California, USA. In November 1997, each case was mailed a
      follow-up questionnaire. Cognitive function was assessed by (1) clock drawing.
      (2) copying a box drawing, and (3) narrative writing to describe a pictured
      scene. Women reporting treatment with tamoxifen were categorized as standard-term
      users (4-5 years), short-term users (< 4 years) or long-term users (6 + years)
      and compared to never users. Tamoxifen users were also classified as past or
      current users. Differences in the mean cognitive test scores were tested after
      adjusting for age, age at diagnosis, stage of disease, radiation therapy,
      chemotherapy, race, education, marital status, previous use of oral
      contraceptives, type of menopause, age at last menstrual period, previous use of
      hormone replacement therapy, and depressive symptoms using analysis of
      covariance. All p-values for differences in the proportion of women who had
      errors on the tests are 2-sided and adjusted for age, stage of disease at
      diagnosis, and chemotherapy. FINDINGS: Information from 1,163 women aged 57-75
      years of age was analyzed; 710 had taken tamoxifen. There was little difference
      between women who had used tamoxifen for the standard five years and never users
      on the three cognitive tests. However, more women who had used tamoxifen for the
      standard term reported seeing their physician for memory problems than non-users
      (3.8% vs 1.5%, p = 0.04). This was especially true for current users of standard
      term (8.0%, p = 0.003). Current users also had a significantly lower mean
      complexity score (p = 0.03) on the narrative writing task. No differences were
      seen between past users and non-users. INTERPRETATION: Our study suggests that
      current use of tamoxifen may adversely effect cognition. Further study of
      tamoxifen and cognition is needed so that healthy women considering tamoxifen for
      the primary prevention of breast cancer have comprehensive information about the
      side effects of the treatment.

PMID- 11194453
TI  - Liarozole fumarate (R85246): in the treatment of ER negative, tamoxifen
      refractory or chemotherapy resistant postmenopausal metastatic breast cancer.
AB  - Three phase II studies were conducted to determine the efficacy and tolerability
      of liarozole fumarate (R85246; liarozole), a retinoic acid metabolism blocking
      agent (RAMBA) and aromatase inhibitor. Additionally, animal experiments in the
      MNU-induced rat mammary tumor model and in immature ovariectomized rats were
      conducted to further elucidate liarozole's mechanisms of action. Patients were
      postmenopausal with either: ER negative disease in first relapse (Group 1: 1n =
      16); ER positive or unknown disease refractory to tamoxifen (Group 2; n = 16); ER
      positive, negative or unknown disease resistant or refractory to chemotherapy
      (Group 3; n = 27). Treatment was liarozole (150-300mg) twice daily orally until
      disease progression. Response rates were: 25% in group 1 (95% CI 11.0-52.3%:
      median duration (MD) 20 months; range 2-36.5); 25% in group 2 (95% CI 11.0-52.3%;
      MD 6.5 months: range 3.5-38): 11% in group 3 (95% CI 4.2-29.2%; MD 7 months;
      range 3-8.5). No significant improvement in quality of life scores (FLI-C) was
      noted. Toxicities observed were predominantly dermatological (skin disorders:
      88%; dry mouth/eyes/lips: 69%). Plasma estradiol decreased from mean pre
      treatment levels of 72.7 pM (9.1-1,839 pM) to below detection (9.2 pM) after 1
      month. Liarozole, but not vorozole, partially inhibited estradiol induced uterine
      hypertrophy and demonstrated dose-dependent anti-tumor effects in the rats, only
      partially overcome by coadministration of estradiol. The clinical responses
      observed, together with our preclinical results, confirm liarozole's dual
      mechanism of action and provide a rationale for further evaluation of RAMBAs in
      the treatment of breast cancer.

PMID- 11194454
TI  - Polyadenylic-polyuridylic acid plus locoregional radiotherapy versus chemotherapy
      with CMF in operable breast cancer: a 14 year follow-up analysis of a randomized
      trial of the Federation Nationale des Centres de Lutte contre le Cancer (FNCLCC).
AB  - With a median follow-up of 14 years, the combination of polyadenylic-polyuridylic
      acid plus locoregional radiotherapy (257 patients) has significantly improved
      disease-free survival (p = 0.03) and significantly reduced the incidence of
      metastases (p = 0.04) when compared to CMF alone (260 patients), in women with
      operable breast cancer. The trial does not, however, permit an appreciation of
      the respective role of radiotherapy and PolyAU in these results.

PMID- 11194455
TI  - Selective decrease of serum immunoglobulin G1 as marker for early stages of
      invasive breast cancer.
AB  - The diagnostic value of the decrease in percentage of immunoglobulin G1 (%lgG1)
      in breast cancer was analyzed with special emphasis on early tumor stages. IgG1
      and total IgG were preoperatively measured in the sera of a total of 801
      individuals using a modified quantitative affinity chromatography. Group A
      consisted of 174 healthy individuals of both sexes, group B of 324 female
      patients with benign breast disease, and group C of 303 patients with invasive
      and non-invasive breast cancer. Within group C, 13 patients presented with
      intraductal carcinoma, and 22 patients with a pT1a-tumour (diameter less than 0.5
      cm). The %IgG1 values were compared among groups A, B and C. In addition,
      correlations were sought between %IgG1 values of group C and tumor size, stage
      (UICC), histopathological grade and oestrogen (ER) and progesteron receptor (PR)
      expression. The mean value of %IgG1 in group A was 63.3 +/- 0.5 s.e.m., in group
      B 57.75 +/- 0.4 s.e.m. and in group C 52.37 +/- 0.5 s.e.m. The differences of
      mean values were highly significant between all three groups. Sensitivity and
      specificity of %IgG1 to discriminate between group A and C were 75% and 87%, and
      between group B and C 62% and 63%, respectively. The significant decrease of
      %IgG1 in total serum IgG is able to distinguish patients with breast cancer of
      more than 5 mm in diameter from healthy controls and patients with benign breast
      diseases. Finally, calculated posterior probabilities revealed that within
      certain concentration limits %lgG1 may provide predictive information with high
      probabilities.

PMID- 11194456
TI  - Alcohol and breast cancer mortality in a cohort study.
AB  - Available epidemiological evidence indicates that alcohol intake is associated
      with a higher risk of developing breast cancer. Plausible biological pathways
      include its effect on levels of estrogens, cell membrane integrity and cell-to
      cell communication, inhibition of DNA repair, and congener effect. The present
      study evaluated the impact of alcohol on mortality from breast cancer, an area
      with relatively few studies in the literature. The subjects were participants in
      a Canadian prospective cohort study, the National Breast Screening Study (NBSS).
      Women were enrolled in the cohort from 1980 to 1985 to evaluate the efficacy of
      mammographic screening. Information on usual diet and alcohol intake at enrolment
      and other epidemiological variables was collected by means of a mailed, self
      administered questionnaire. Mortality from breast cancer during follow- up to 31
      December, 1993 was ascertained by record linkage to the Canadian Mortality Data
      Base maintained by Statistics Canada. During the follow-up period of 1980-1993
      (average 10.3 years), 223 deaths from breast cancer were identified for this
      analysis. The hazard ratios for the risk of death from breast cancer increased
      with intakes of total alcohol of 10-20 g/day (1.039, 1.009-1.071) and > 20 g/day
      ( 1.063, 1.029-1.098). This increase was contributed largely by the intake of
      wine, a 15% increase in risk at intakes higher than 10 g/day of alcohol from
      wine. Alcohol from spirits was associated with a small decrease in risk of death
      (hazard ratio at 10g/day, 0.945, 0.915-0.976). The effect of alcohol from beer
      was not significant in the two categories studied. Although our results were
      statistically significant, the magnitude of the change in risk was small.

PMID- 11194457
TI  - Inhibition of NF-kappaB activity enhances TRAIL mediated apoptosis in breast
      cancer cell lines.
AB  - Most breast cancer cell lines are resistant to TNF-related apoptosis inducing
      ligand (TRAIL) induced apoptosis. In sensitive breast cancer cell lines TRAIL
      rapidly induces the cleavage and activation of caspases leading to the subsequent
      cleavage of downstream caspase substrates. In contrast, there is no caspase
      activation in the resistant cell lines. The transcription factor NF-KB can
      inhibit apoptosis induced by a variety of stimuli including activation of death
      receptors. We investigated whether NF-kappaB contributes to the resistance of
      breast cancer cells to TRAIL induced apoptosis. All of the resistant breast
      cancer cell lines expressed NF-kappaB and had detectable NF-kappaB activity in
      nuclear extracts prior to treatment with TRAIL. Upon TRAIL treatment, a
      significant increase in NF-kappaB activity was seen in most of the cell lines. To
      directly test if NF-kappaB activity contributes to the resistance of these cell
      lines to TRAIL, we transiently transfected the resistant cell lines with an
      inhibitor of NF-kappaB (IkappaBdeltaN) and measured TRAIL induced apoptosis in
      control and transfected cells. All of the resistant cell lines tested showed an
      increase in TRAIL induced apoptosis when transfected with the IKBdeltaN. These
      results demonstrate that TRAIL resistant breast cancer cells fail to rapidly
      activate the apoptotic machinery but they do activate NF-kappaB. Inhibition of NF
      kappaB activity increases the sensitivity to TRAIL mediated apoptosis in
      resistant cells. These results suggest that agents which inhibit NF-kappaB should
      increase the clinical efficacy of TRAIL in breast cancer cells.

PMID- 11194458
TI  - PTP LAR expression compared to prognostic indices in metastatic and non
      metastatic breast cancer.
AB  - Several prognostic indices in breast cancer, including c-erbB2, epithelial growth
      factor receptors (EGFR), estrogen and progesterone receptors are signal
      transduction molecules. Recently, expression of another signal transduction
      molecule, the protein tyrosine phosphatase LAR, has been suggested to be
      increased in breast cancer. The objective of the current investigation was to
      examine the relationship between LAR expression and prognostic parameters in
      breast cancer. LAR expression was associated with metastatic potential in the
      well-characterized 13762NF rat mammary adenocarcinoma clones. The metastatic
      MTLn3 and MTLn2 clones expressed sizable amounts of LAR. The essentially non
      metastatic MTC clone had little LAR expression. C-erbB2 had highest expression in
      the highly metastatic MTLn3 clone, but c-erbB2 levels were sizeable in the weakly
      metastatic MTLn2 and non-metastatic MTC clone. EGFR expression had the strongest
      association with a clone's metastatic potential, being very high in MTLn3, weak
      in MTLn2, and undetectable in MTC. In human breast cancer specimens, LAR
      expression was strongly positive in 50% of metastatic cases but in only 21% of
      'non-metastatic' cases. As with the 13762NF-derived clones, c-erbB2 expression
      was strongly positive independent of metastatic phenotype. However, 46% (6/13) of
      cases that were strongly positive for c-erbB2 were strongly positive for LAR.
      Only 17% (2/11) of negative or weakly c-erbB2 positive samples were strongly
      positive for LAR. All ER+ positive tumors (n = 15) were positive for LAR and 53%
      of these tumors were strongly positive for LAR. In ER negative cases, only 1 of
      11 was strongly positive for LAR. While the current data indicate a strong
      association between ER and LAR expression in breast cancer tissue (p = 0.003),
      additional studies are warranted to further explore the relationship between LAR
      and prognostic indices of breast cancer progression.

PMID- 11194459
TI  - Australia maintains its capacity to fight and defeat any outbreak of foot &
      mouth.

PMID- 11194460
TI  - Media release hit the right targets.

PMID- 11194461
TI  - Perth and UK labs combine for PETS.

PMID- 11194462
TI  - AAHL also involved under PETS scheme.

PMID- 11194463
TI  - Dysplasia laxity.

PMID- 11194464
TI  - Caged hens--AVA misses welfare 'boat'.

PMID- 11194465
TI  - Conservative management of juvenile canine hip dysplasia.

PMID- 11194466
TI  - Triple pelvic osteotomy for juvenile canine hip dysplasia.

PMID- 11194467
TI  - Alternative surgical methods for treating juvenile canine hip dysplasia.

PMID- 11194468
TI  - Effects of an oral vasopressin receptor antagonist (OPC-31260) in a dog with
      syndrome of inappropriate secretion of antidiuretic hormone.
AB  - OBJECTIVE: The syndrome of inappropriate secretion of antidiuretic hormone is a
      rare disorder in dogs characterised by hypo-osmolality and persistent arginine
      vasopressin production in the absence of hypovolaemia and/or hypotension. The
      study describes the efficacy and safety of the nonpeptide selective arginine
      vasopressin V2 receptor antagonist OPC-31260 in a dog with the naturally
      occurring syndrome. DESIGN: The detailed case history of a dog with spontaneous
      syndrome of inappropriate secretion of antidiuretic hormone that received long
      term therapy with oral OPC-31260 is presented. Effects of the first dose of OPC
      31260 and of a dose administered after a continuous dosing period of 12 days are
      reported. PROCEDURE: Packed cell volume, plasma sodium, total protein, arginine
      vasopressin, renin activity, atrial natriuretic peptide, urine specific gravity,
      urine output, heart rate and body weight were monitored for 2 h before, and for 4
      h after, the first dose of OPC-31260. The same parameters plus plasma osmolality
      and urine osmolality were monitored when an identical dose was administered after
      12 days of therapy. RESULTS: Oral administration of OPC-31260 at 3 mg/kg body
      weight resulted in marked aquaresis with increased urine output and decline in
      urine specific gravity within 1 h. Corresponding increases in concentrations of
      plasma sodium, plasma osmolality and plasma renin activity were recorded over a 4
      h period. Arginine vasopressin concentration remained inappropriately elevated
      throughout the study. Results were similar when the trial procedure was repeated
      after a stabilisation period of 12 days. Long-term therapy with OPC-31260 at a
      dose of 3 mg/kg body weight orally every 12 h resulted in good control of
      clinical signs with no deleterious effects detected during a 3-year follow-up
      period. Despite sustained clinical benefits observed in this case, plasma sodium
      did not normalise with continued administration of the drug. CONCLUSIONS:
      Treatment of a dog with naturally occurring syndrome of inappropriate secretion
      of antidiuretic hormone with OPC-31260 at 3 mg/kg body weight orally every 12 h
      resulted in marked aquaresis and significant palliation of clinical signs with no
      discernible side-effects detected over a 3-year period. Thus, OPC-31260 appears
      to offer a feasible medical alternative to water restriction for treatment of
      dogs with syndrome of inappropriate secretion of antidiuretic hormone. Higher
      doses of OPC-31260 may be required to achieve and maintain normal plasma sodium
      in dogs with this syndrome.

PMID- 11194469
TI  - Evaluation of an insulin zinc suspension for control of naturally occurring
      diabetes mellitus in dogs.
AB  - OBJECTIVE: To evaluate duration of action of an insulin zinc suspension
      (Caninsulin, Intervet) in spontaneously occurring cases of canine diabetes
      mellitus and suitability of its use as a once daily administered insulin for
      treatment of this disease. DESIGN: Eight client-owned canine diabetics were
      included in a prospective pilot study. All dogs had been treated with Caninsulin
      for a minimum of 2 months and were considered on clinical grounds to be
      adequately stabilised. PROCEDURE: Dogs were hospitalised for 24 h and blood
      collected every 2 h via indwelling venous catheters for blood glucose
      determination. RESULTS: Once daily Caninsulin administration failed to maintain
      glycaemic control for greater than 13 h in five of eight dogs, but acceptable
      blood glucose concentrations were maintained for 22 h and greater than 24 h in
      two others. One dog became distressed during hospitalisation and the blood
      glucose curve did not show an identifiable response to the insulin. CONCLUSION:
      Most diabetic dogs may require twice daily administration of Caninsulin for
      satisfactory glycaemic control, but once daily administration may be adequate in
      some animals. More comprehensive investigation into duration of activity of
      Caninsulin is warranted.

PMID- 11194470
TI  - In vitro antimicrobial susceptibilities of three Porphyromonas spp and responses
      in the oral cavity of cats to treatment with selected antimicrobial drugs.

PMID- 11194471
TI  - The BSE inquiry and communication of risk.

PMID- 11194472
TI  - Effects of tail amputation and treatment with an albendazole controlled-release
      capsule on the health and productivity of prime lambs.
AB  - OBJECTIVE: To assess the effects of tail amputation and treatment with
      albendazole controlled-release capsule (CRC) on the health and productivity of
      prime lambs. DESIGN: Field trials on three farms. ANIMALS: About 551 Coopworth
      Poll Dorset cross, 588 Border Leicester-Merino-Poll Dorset cross and 575
      Corriedale-Poll Dorset cross lambs. PROCEDURE: On three farms, lambs with
      amputated tails were compared with an equal number of lambs with tails left
      entire. In both of these groups half the lambs were treated with an albendazole
      CRC 13 weeks after the start of lambing. Faecal soiling of the breech and
      flystrike of the breech were recorded. Lambs were weighed and body condition
      scored at each visit and carcase weights and fat score of each lamb at slaughter.
      Procedures on the slaughter chain were monitored to determine whether the
      retention of the tail caused any problems. RESULTS: There were no observed
      benefits of treatment with an albendazole CRC on the farms in the study. There
      was no strong evidence that tail amputation had any long-term effect on the
      growth rate of lambs or carcase traits. No detrimental effects were observed
      during processing of lambs with long tails in the abattoir. Lambs with entire
      tails had significantly greater mean dag scores than lambs with amputated tails.
      On one farm lambs with entire tails were at about twice the risk of requiring
      crutching and on another farm were at three times the risk of breech strike
      compared with lambs with amputated tails. CONCLUSION: This study provides
      evidence that amputating the tail is not an absolute requirement to maintain the
      health and welfare of prime lambs, but leaving the tail of prime lambs entire is
      likely to increase chemical usage to control flystrike, and to increase the
      frequency of crutching.

PMID- 11194473
TI  - Surveys in Papua New Guinea to detect the presence of Trypanosoma evansi
      infection.
AB  - OBJECTIVE: To confirm serological evidence that Trypanosoma evansi is present in
      Papua New Guinea. DESIGN: Three surveys were undertaken in PNG during 1997/1998.
      Animals were selected for sampling on the basis of convenience. Samples of blood
      were examined for the presence of T evansi by the haematocrit centrifugation
      technique (HCT) and mouse inoculation test (MI). Sera were tested in the field
      using the card agglutination test for trypanosomiasis/T evansi (CATT). Bovine
      sera were tested at James Cook University using an antibody-detection ELISA (Ab
      ELISA). Results from testing bovine sera with the Ab-ELISA and sera from
      wallabies with the CATT were analysed using FreeCalc to determine the probability
      that animals in these populations were infected with T evansi. RESULTS: A total
      of 545 serum samples were collected, during the three surveys of which 39 cattle,
      two pig and three agile wallaby samples were positive with the CATT. All bovine
      sera collected were negative when tested with an Ab-ELISA. T evansi was not
      isolated using the HCT or the MI from any of these animals. CONCLUSION: Based on
      the Ab-ELISA results it was concluded that T evansi infection was not present in
      cattle in villages around Balimo at a minimum expected prevalence of 10% (P <
      0.05) and, based on the CATT results, that infection was not present in wallabies
      on the Bula plain at a minimum expected prevalence of 10% (P < 0.1). These
      results indicate that it is unlikely that T evansi is endemic in PNG.

PMID- 11194474
TI  - Application of ERIC-PCR for the comparison of isolates of Haemophilus parasuis.
AB  - OBJECTIVE: To validate a polymerase chain reaction (PCR) based method.
      Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR), for the
      fingerprinting of Haemophilus parasuis strains and to use that method to
      differentiate isolates from apparently related outbreaks of Glasser's disease on
      three pig farms. DESIGN: ERIC-PCR was evaluated by comparing 15 different strains
      that represented all 15 recognised serovars in the Kielstein-Rapp-Gabrielson
      (KRG) scheme for serotyping H parasuis. Next, ERIC-PCR was used to examine 14
      Australian field isolates of H parasuis; 12 collected from three farms suffering
      apparently related outbreaks of Glasser's disease and two from two other farms
      with no known connection. RESULTS: The 15 serovar reference strains all gave
      unique, reproducible ERIC-PCR fingerprints. The 12 isolates from the three
      apparently related outbreaks all gave a single fingerprint, which was distinct
      from any seen in the 15 serovar reference strains and the two other Australian
      field isolates in the studied farms. The confirmation that all 12 isolates were
      the same strain allowed the development of a prevention and control program that
      has prevented the emergence of any further outbreaks of Glasser's disease on the
      three farms. CONCLUSION: ERIC-PCR is a suitable technique for the differentiation
      of unrelated strains of H parasuis. The finding that the 12 field isolates of H
      parasuis all shared the same fingerprint is strong evidence that there was a
      common source of infection on all three farms. This study has shown, for the
      first time, that ERIC-PCR is a suitable technique for the sub-typing of H
      parasuis and useful for studying the epidemiology of outbreaks of Glasser's
      disease.

PMID- 11194475
TI  - Sensitivity and specificity of two serological tests for the detection of ovine
      paratuberculosis.
AB  - OBJECTIVE: To determine the sensitivity and specificity of an absorbed ELISA and
      an AGID test for the detection of clinical and subclinical paratuberculosis in
      sheep. DESIGN: By testing a panel of sera from 1257 Australian Merino and
      crossbred sheep greater than 1 year of age, of which 1137 sheep were not infected
      with Mycobacterium avium subsp paratuberculosis and 120 sheep had
      paratuberculosis. PROCEDURE: Sera were collected from 457 sheep in Victoria and
      800 sheep in Western Australia. Presence of M a paratuberculosis infection in
      Victorian sheep was determined by histological examination of intestinal tissues,
      whereas sheep from Western Australia were presumed to be free of Johne's disease.
      The ability of an absorbed ELISA to discriminate between infected and uninfected
      sheep was described by test sensitivity and specificity, the distribution of
      ELISA OD, and the area under a receiver operating characteristic curve. RESULTS:
      The absorbed ELISA had a specificity of 98.2 to 99.5% (CI) and a sensitivity of
      35 to 54% (CI). In sheep from infected flocks in Victoria, the AGID test had a
      specificity of 99 to 100% (CI) and a sensitivity of 38 to 56% (CI). The
      sensitivity of serological tests was higher in sheep with a body condition
      representative of the lower quintile of their flock of origin. CONCLUSION: The
      AGID test and absorbed ELISA are useful tests for the detection of ovine
      paratuberculosis. Although the tests had a similar accuracy, they detected
      different subpopulations of infected sheep with only moderate overlap. The AGID
      test had a higher specificity than the absorbed ELISA.

PMID- 11194476
TI  - Effect of ephemeral fever of cattle on the appearance and contraction of blood
      clots.

PMID- 11194477
TI  - Pyogranulomatous enteritis in sheep due to penetrating seed heads of Dittrichia
      graveolens.

PMID- 11194478
TI  - [Report of the hospital discharge of the patient with myocardial infarct].

PMID- 11194479
TI  - [Opioids. Pharmacology, clinic, prospectives for an extensive use].

PMID- 11194480
TI  - [Deciding in conditions of uncertainty: the Delphi method and its use in the
      formulation of guidelines].
AB  - The purpose of this paper is to analyze one of the most powerful tools in the
      decision-making under conditions of uncertainty, the Delphi method, and to verify
      the related interest of scientific world, particularly, for formulation of
      guidelines. The method combines the expert opinion preventing biases due to
      institutional role, status or dominant personality. In the text we explain the
      methodology and the steps through which it is possible to realize the consensus;
      we schematized in a didactic manner all the phases for an operational approach of
      the reader. The search by the most diffused biomedical database (Medline)
      individualized 623 citations, 7 of which are guidelines (3 of remarkable
      importance). In conclusion, the Delphi method may be considered particularly
      interesting for its theoretical assumptions and it can be used as reference tool
      for assuming decisions in the formulation of clinical practice guidelines as
      objectively as possible.

PMID- 11194481
TI  - [Hyperthyroidism, therapy with erythropoietin, malnutrition and systolic function
      in hemodialysis: echocardiography study].
AB  - Secondary hyperparathyroidism is a frequent condition of dialysis patients.
      Endocrine derangements, with disturbance of calcium metabolism are complex,
      involving bone, heart (left ventricular hypertrophy-dilatation), bone marrow
      (anemia and erythropoietin resistance), muscle (increase of body fat mass) and
      insulin resistance. Aim of the study was to assess how these conditions are inter
      correlated in the same patients. 45 patients (m 20, f 25; years 61.8 +/- 11.6) in
      maintenance bicarbonate three-weekly hemodialysis since > 3 years were studied.
      Cardiac function was assessed by echocardiography (EF%: left ventricular ejection
      fraction), which showed an inverse correlation both with parathormone (iPTH vs
      EF%: r = -0.64; p < 0.001) and with erythropoietin (rHu-EPO vs EF%: r = -0.62; p
      < 0.001). This suggests the possibility of a multi-endocrine resistance in
      dialysis patients with chronic renal failure, secondary to the degree of
      malnutrition. Lower lean mass is correlated with hyperparathyroidism (iPTH vs fat
      mass%: r = 0.37; p < 0.01), with lower left ventricular systolic function (EF% vs
      fat mass%: r = -0.41; p < 0.005) and with rHu-EPO resistance. Moreover, patients
      with higher iPTH show a hypercatabolic disposition, assessed as protein catabolic
      rate (PCR/kg vs iPTH r = 0.54; p < 0.001). This pattern can be a consequence of
      chronic renal failure, but bio-compatibility of materials can be involved as
      well.

PMID- 11194483
TI  - [Intraparenchymal mycotic tonsillitis in childhood].

PMID- 11194482
TI  - [Pituitary pathology in elderly patients admitted in a division of internal
      medicine. Description of 3 cases].
AB  - Pituitary diseases are often unrecognized in the elderly, although if they can be
      at the basis of several pathological conditions. We report three clinical cases.
      Patient n. 1: 87 years old woman, in poor general condition. Thyroid function
      evaluation showed secondary hypothyroidism. Subsequent pituitary function
      evaluation demonstrated hypopituitarism with empty sella. The diagnosis was
      "hypopituitarism with secondary hypothyroidism and adrenocortical insufficiency,
      in empty sella" starting substitutive treatment with glucocorticoids and L
      thyroxine, with improvement in her clinical conditions. Patient n. 2: 74 years
      old woman, with severe congestive heart failure. Her clinical history revealed
      hypothyroidism. An endocrine evaluation (in absence of therapy) demonstrated
      panhypopituitarism with secondary hypothyroidism and adrenocortical insufficiency
      in presence of empty sella. The patients was started on substitutive treatment
      and her conditions improved. Patient n. 3: 74 years old man with several atrial
      fibrillation episodes and hyperthyroidism. Thyroid function evaluation suggested
      secondary hyperthyroidism confirmed by the presence of a pituitary macroadenoma.
      The patient underwent surgical adenomectomy by trans-sphenoidal route. The
      clinical conditions of the patient improved, but a slight secondary
      hyperthyroidism was still present caused by the persistence of residual
      pathological tissue in the right cavernous sinus region confirmed by octreoscan
      suggesting the presence of a lesion endowed with somatostatin receptors. The
      patient was started on long acting octreotide treatment, which is still in
      progress. In conclusion, pituitary diseases pass often unrecognized in the
      elderly. Their prompt recognition and treatment can resolve dangerous situations
      for the patients.

PMID- 11194484
TI  - [Genetic basis of sudden cardiac death].

PMID- 11194485
TI  - [High-dose chemotherapy in carcinoma of the breast. Sunshine and shadows].

PMID- 11194486
TI  - [The obesity problem, today].

PMID- 11194487
TI  - [Influenza].
AB  - Influenza outbreaks remain today among the most serious and intractable health
      problems owing to high rates of morbidity and high economic costs. Periodical
      epidemics and pandemics in temperate regions of the world are due to high genetic
      variability of influenza viruses, which concerns primarily haemagglutinin and
      neuraminidase antigens (antigenic drift and shift). Most influenza infections are
      self-limited, but they cause increased mortality in high-risk groups of
      population (such as the elderly and the subjects with chronic diseases) and
      increased morbidity in the general population, with loss of productivity and high
      health costs. During the past thirty years, efforts to control influenza have
      focused on the use of inactivated vaccines in high-risk groups and of two
      antiviral drugs, amantadine and rimantadine. However, the wide spread of
      influenza in all population groups and the limits of adamantane compounds induced
      to investigate novel approaches for prevention and control of flu. The new live
      attenuated, cold-adapted, trivalent intranasal vaccine was shown to be highly
      effective in children against influenza A (H3N2) and B viruses. The new antiviral
      drugs (zanamivir and oseltamivir), neuraminidase inhibitors, reduced the median
      time to alleviation of the major symptoms of influenza by 1-2 days. These
      advances in the last few years will certainly modify our approaches to influenza
      treatment and prevention.

PMID- 11194488
TI  - [Rhino-bronchial syndrome].
AB  - A close anatomical and functional relationship between superior and inferior
      airways is well documented. A typical example is offered by the close
      relationship between allergic rhinitis and asthma whose close connection is
      documented by epidemiological and pathological data. The mechanisms which can
      explain this phenomenon are not fully known but naso-bronchial reflexes, mouth
      breathing due to nasal obstruction and aspiration of nasal secretions seem all to
      be important. Moreover it has been recently proved that the treatment of rhinitis
      can improve the concomitant asthma thus confirming their relationship. Another
      less frequent association is between sinusitis and asthma. Such a connection
      seems to be frequent in patients suffering of atopic rhinitis but also in
      patients presenting a nasal obstruction of different nature such as deviations of
      the nasal septum, adenoid hypertrophy etc. Also in this case a correct medical or
      surgical treatment of sinusitis can improve asthma symptomathology. Finally a
      classic example of involvement of superior and inferior airways is represented by
      the syndrome of ASA intolerance. These patients in fact initially complain of
      rhinitis which afterwards is complicated by the onset of nasal polyposis and
      asthma which can prove clinically very severe. Nowadays, anyway, there is no
      evidence that the treatment of rhinitis or polypectomy can improve the clinical
      course of asthma. In conclusion, diseases of superior and inferior airways must
      be considered in strict connection and need the same global treatment.

PMID- 11194489
TI  - [Reye's syndrome: the death of a syndrome? (Or death by a syndrome?)].
AB  - Reye syndrome is characterized by acute encephalopathy and fatty degeneration of
      the liver almost exclusively in children. The onset is heralded by profuse
      vomiting and varying neurologic impairment from irritability to coma,
      decerebration and death. The encephalopathy must be associated with a greater
      increase in the levels of ammonia, or alanine amino-transferase and aspartate
      amino-transferase in serum; and with a fatty metamorphosis of the liver diagnosed
      by biopsy or at autopsy. The only characteristic universally accepted as
      diagnostic are the specific mithocondrial changes in the liver-biopsy specimen.
      Larger studies confirmed the association of aspirin with RS. The CDC of Atlanta
      cautioned physician and parents and a dramatic decline in case began at that
      time. Classic Reye syndrome is now so rare in the USA that when an apparent case
      is encountered in a child who has not taken aspirin, other diagnoses should be
      considered. After a brief survey of RS relative lack of specificity of case
      definition and of the polyhedric etiopathogenetic moments, the A. on the personal
      experience, point: a) the biological unicity of the man and the necessary
      coexistence of "constitutional" factors (metabolic and/or endocrine, and/or
      immunitary factors, the later almost never investigated), toxic, and infectious
      factors for the syndrome's deflagration; b) some aspects of the continued
      existence of therapeutic and diagnostic problems: the aspirin and/or salicilate
      use and the pharmacogenetic; the continued existence of other, generally similar
      conditions, such the drug and other known and unknown toxic mithocondrial factors
      that provoke this unusual response to common infections; and the inborn errors of
      metabolism; c) some practical aspects of diagnostic and therapeutic approach.

PMID- 11194490
TI  - [The use of erythropoietin alpha in programs of high-dose chemotherapy].
AB  - Epoetin (Epo) is physiologically present in the human body, stimulating
      erythropoiesis from bone marrow. Anemia is observed in cancer patients submitted
      to high-dose chemotherapy (HDCT), mainly caused by myelosuppression. Epoetin alfa
      has been widely used to treat the anemia that develops in the HDCT setting.
      Controlled studies in patients with hematologic malignancies or solid tumors who
      received Epo following HDCT have shown a decreased red blood cell transfusion
      requirement at least in patients receiving allogeneic bone marrow transplantation
      (BMT), while results in patients receiving autologous BMT have been
      disappointing. The administration of Epo before HDCT, in a period when bone
      marrow is still responsive to growth factors, may represent a new strategy aimed
      at decreasing the degree of anemia in these patients. A combination of
      granulocyte-colony stimulating factor and Epo has proved to be effective in
      mobilizing stem cell and committed myeloid/erythroid precursors.

PMID- 11194492
TI  - [Psychiatry of women: an new field of research in mental health].
AB  - This paper presents the state of the art of our current knowledge in the field of
      female psychiatry. This domain of mental health studies the particularities of
      psychological distress in women. It is a new concept, and its creation is
      subtended by some clinical and epidemiological realities. The creation of this
      very interesting field of research has been promoted on the one hand because of
      the existence of certain female-specific psychiatric disorders (premenstrual
      syndrome, post-partum psychopathologies, pseudocyesis, Ferjol's syndrome and
      menopause-related disorders) and on the other hand because the vast majority of
      mental diseases may be expressing major gender-related variations (prevalence,
      natural history of disease, symptomatology, prognosis and treatment outcome).
      Research in female psychiatry has numerous goals. First of all, the sex-based
      differences in the prevalence of mental disorders (e.g., depression,
      schizophrenia, anxiety, anorexia nervosa, personality disorders) has to be
      understood (are they artefacts, or the expression of hormonal or genetic
      influence, or a consequence of social factors, or even the result of brain
      development?). Second, the specific nature of some of these diseases is under
      investigation (e.g., is postnatal depression a classical major depressive
      disorder or a puerperal-specific disease?). And third, treatments must be adapted
      accordingly. Indeed, the study of female psychiatry attempts the integration of
      the gender-effect in order to improve the treatment modalities.

PMID- 11194491
TI  - [The importance of syndrome X in daily practice].
AB  - Metabolic syndrome X includes glucose intolerance or type 2 diabetes,
      dyslipidemia and arterial hypertension which are classical cardiovascular (CV)
      risk factors. In course of time, other CV risk factors have been added to the
      syndrome: rheological alterations, endothelial dysfunction, anomalies in the
      coagulation/fibrinolysis system, microalbuminuria and so on.... Insulin
      resistance is the cornerstone of metabolic syndrome X, with secondary
      hyperinsulinism. Upper body obesity is associated with metabolic syndrome X.
      Simple waist measurements can detect the subjects (10-15% of the population) at
      increased CV risk with a sensitivity of 70%. This is invaluable for such a simple
      and cheap test. Diet is the first step in treating these patients and reducing
      caloric intake is necessary in most of them. Saturated fats will be replaced by
      polyunsaturated and mono-unsaturated ones. Long-chain carbohydrates with low
      glycemic index will be suggested. Regular physical activity will be promoted. If
      these life style modifications fail, drugs can be added: biguanide and glitazone
      are good candidates. Orlistat has improved metabolic syndrome X on a long-term
      basis. Drugs that could increase insulin resistance are to be avoided.

PMID- 11194493
TI  - [Why radiation for the postmastectomy patient?].
AB  - We can identify a subgroup of patients with a high risk of loco-regional relapse
      after mastectomy. When those patients are irradiated, their absolute loco
      regional relapse risk drops for more than 10% with a relative risk reduction of
      66% (p < 0.0001). The severe complication rate is below 1%. With earlier
      radiotherapy techniques, there was an excess in long term cardiac mortality among
      irradiated patients. Even if the breast specific survival was improved with
      radiotherapy, the overall survival was not better. Three recent randomised trials
      have shown that postmastectomy radiotherapy adds 10% survival benefit to an
      adjuvant systemic treatment. The impact of radiotherapy on overall survival is
      more pronounced for less advanced tumors.

PMID- 11194494
TI  - [Reduction of perinatal transmission of HIV-1: antiretroviral prophylaxis and
      obstetrical interventions].
AB  - Incorporation of zidovudine prophylaxis (given to the mother during the third
      trimester of pregnancy and at delivery and to the newborn during the first 6
      weeks of life) in clinical practice has substantially reduced the perinatal
      transmission of HIV-1 and the number of pediatric AIDS cases in industrialized
      countries. Rates of transmission of +/- 1% have been observed with the
      combination of antiretroviral prophylaxis and elective caesarean delivery.
      Elimination of perinatal transmission of HIV is therefore a feasible goal in
      Europe and the United States. Recent studies have identified less complex and
      less expensive preventive therapies more applicable to developing countries.

PMID- 11194495
TI  - [Dopaminergic agonists in the treatment of Parkinson's disease].
AB  - After levodopa, dopaminergic agonists are the most powerful agents in idiopathic
      Parkinson's disease treatment. Used in monotherapy or rather in early combination
      with levodopa, they allow a dramatic reduction of long-term motor side effects of
      the latter: onset and peak-dose dyskinesias, early morning dystonias. Their
      gastro-intestinal (nauseas) and moreover psychiatric (confusion and
      hallucinations) side effects limit their use, notably in geriatric populations.
      Superiority of so-called "second generation" agonists (ropinirole, pramipexole)
      on "first generation" agonists (bromocriptine, pergolide) remains to be proved.

PMID- 11194496
TI  - [Medical teaching skills and basic science].

PMID- 11194497
TI  - [The quota system in Europe: its place in Belgium].

PMID- 11194498
TI  - [The quota system and its financial impact on the Erasmus Hospital].

PMID- 11194499
TI  - [Treatment of iatrogenic ureteral injuries].

PMID- 11194500
TI  - [A new method of scintigraphy].

PMID- 11194501
TI  - [Therapy of chronic inflammatory intestinal disease].

PMID- 11194502
TI  - [Colorectal cancer: importance of early diagnosis].

PMID- 11194503
TI  - [Differential diagnosis in hyperferritinemia].

PMID- 11194504
TI  - [7th Conference on Retroviruses and Opportunistic Infections].

PMID- 11194505
TI  - [Erasmus and medicine].

PMID- 11194506
TI  - [Workshop: immunosuppression in chickens].

PMID- 11194507
TI  - [Immunocastration is one step further in the castration of pigs].

PMID- 11194508
TI  - [Practical remarks in response to the question and answer about artificial
      insemination of the dog].

PMID- 11194509
TI  - [The importance of different pig diseases in the Netherlands].
AB  - As part of the project 'Clean pigs', IPG Institute for Pig Genetics BV made an
      inventory of the impact of different diseases on the Dutch pig industry. An
      expert panel assessed the importance of the different diseases with regard to
      public health, farm economy, the pig sector and export sales. The possibilities
      for the diagnosis of the different pathogens were listed and the goal for the
      next years, was set. Diseases were classified into three categories, according to
      their importance for the Dutch pig industry (Table 2). The diseases that can be
      eradicated are Salmonella (only specific strains), Pasteurella multocida DNT +
      PAR), Actinobacillus pleuropneumoniae, Haematopinus suis (lice) and Sarcoptes
      scabei (var. suis) (mange). National introduction of list A en most list B
      diseases of the OIE classification must be prevented.

PMID- 11194511
TI  - [KNMvD: banning some dog breeds will not solve the aggression problem].

PMID- 11194512
TI  - [The recognition rule in the practice].

PMID- 11194513
TI  - [Molecular effects and neuronal nets].

PMID- 11194514
TI  - [Neural mechanisms of anesthesia].
AB  - Positron emission tomography studies on volunteers showed that, at concentrations
      inducing the loss of consciousness, propofol, halothane and isoflurane reduce
      glucose metabolism of neocortical neurones by 20-50%. To find out whether these
      effects are caused by direct anaesthetic actions on cortical structures,
      experiments were carried out on isolated neocortical brain slices. In these
      investigations an excellent correlation was observed between anaesthetic
      concentrations causing a half-maximal depression of action potential firing in
      neocortical brain slices and anaesthetic blood concentrations monitored during
      awaking from anaesthesia in humans. Furthermore, it could be shown that, at
      concentrations approximately one half the MAC-value, isoflurane decreases the
      frequency of auditory evoked 30-40 Hz oscillations in the neocortex by 50%.
      Similar quantitative effects were observed on spontaneously occurring high
      frequency rhythms in neocortical brain slices. However, not all aspects of
      cerebral anaesthetic actions can be explained by direct effects on cortical
      neurones. The EEG synchronisation and the amplitude reduction of mid latency
      auditory evoked potentials are probably related to the inhibition of thalamic
      neurones. Halothane, isoflurane, enflurane and propofol reduced action potential
      firing of cortical neurones by enhancing GABAA receptor-mediated synaptic
      inhibition. This molecular mechanism seems also to be involved in depressing
      painful stimuli-induced motor responses. Nevertheless, there must be a difference
      between relevant anaesthetic mechanisms on the cerebral and spinal level. This
      follows from the observation that the relation between the concentration causing
      the loss of consciousness and the concentration that depresses movements
      considerably varies among different anaesthetic agents.

PMID- 11194515
TI  - [Invasive Candida infection in surgical patients: a valid clinical entity].
AB  - OBJECTIVE: Establishment of a case definition for invasive candidosis in
      postsurgical intensive care patients. METHODS: During the period of 1996-1999, 8
      cases of invasive candidosis were observed on a surgical intensive care unit.
      Patient records were evaluated with respect to diagnostic criteria and response
      to antimycotic therapy. RESULTS: Patients included 3 women and 5 men with a mean
      age of 62.7 (37-85) years. Candida peritonitis (n = 6) occurred after surgery or
      perforation of the intestinal tract, and Candida pneumonia was due to artificial
      ventilation (n = 3). C. albicans was isolated in all 8 cases, but mixed
      infections with other Candida spp. occurred in 3 cases. The Candida serum antigen
      test yielded a positive result in only 2/8 cases. I.v. therapy with fluconazole
      was successful in 7 cases, one patient with severe initial disease died with
      ongoing infection. With the exception of the lethal case, all patients showed a
      diagnostic serum antibody test, proving systemic candida infection. CONCLUSION:
      Based on the case descriptions, we propose the following definition of invasive
      candidosis: (1) Clinical signs of infection after surgery, (2) absence of
      bacterial pathogens and/or failure to respond to systemic antibiotics, (3)
      cultivation of Candida spp. from normally sterile sites or abundant growth in
      tracheal aspirate, (4) response to antimycotic therapy and (5) diagnostic serum
      antibody test. This definition proved to be valid for our patients and could be
      used as an inclusion criterion for future clinical studies of serodiagnosis of
      Candida infection or antimycotic chemotherapy.

PMID- 11194516
TI  - [Comparison of hydroxyethyl starch solutions derived from potato and corn starch]
      .
AB  - OBJECTIVE: The study was designed to investigate the effects of hydroxyethyl
      starch (HES) solutions derived from potato (p) compared to HES derived from corn
      (c) starch on the colloidosmotic pressure, plasma viscosity, and to measure the
      plasma and urine concentration. METHODS: After approval by the Ethics Committee,
      and having obtained informed consent, we recruited 20 patients undergoing lumbar
      disc surgery who received either 1000 ml of p-HES or c-HES (MW 200,000 DS 0.5) in
      a randomized, single-blind way. Colloidosmotic pressure, plasma viscosity and the
      plasma concentration were measured before and 30, 90, 240 min and one day after
      the infusion. Statistical analysis was performed using chi-square and Mann
      Whitney test. There were no differences between the two groups in regard to
      demographics and anesthesia. RESULTS: Plasma viscosity and colloidosmotic
      pressure did not change significantly during that time. There were no differences
      in plasma concentration and excretion of both solutions. The peak plasma
      concentration was reached after 30 min in both groups (8.57 +/- 3.92 g/l c-group
      and 7.67 +/- 4.68 g/l p-group) and declined thereafter. Within 6 h 38% (c-group
      23.0 +/- 3.2 g HES) and 28% (p-group 16.8 +/- 1.6 g HES) of the infused HES were
      found in the urine. 12 h later about 50% was excreted. CONCLUSION: The present
      study demonstrated that there was no clinically apparent effect on hematorheology
      and pharmacokinetics between these two solutions.

PMID- 11194517
TI  - [Value of reflecting disposable insulation (Thermodrape) in preventing
      perioperative hypothermia].
AB  - OBJECTIVE: The aim of the study was to evaluate the value of reflecting
      disposable insulation for the prevention of perioperative hypothermia. METHODS:
      After approval by the local ethics committee 36 patients undergoing long lasting
      urological intraabdominal surgery were studied. Anaesthesia was performed using
      etomidate, fentanyl, midazolam, pancuronium and succinylcholine. Patients were
      randomly assigned to 4 groups. These groups were treated as follows: Gr. 1:
      Infusion warmer (Hotline HL-90 with System L-70, Level 1 Technologies Inc.,
      Marshfield, USA) and standard O.R. draping with two layers of cotton drapes. Gr.
      2: Infusion warmer and reflecting disposable insulation (Thermadrape, O.R.
      Concepts Inc., Roanoke, USA) covering the legs, upper body, arms and head. Gr. 3:
      Infusion warmer and convective air warming with upper body blanket (WarmTouch,
      Mallinckrodt Medical, Hennef/Sieg, Germany). Gr. 4: Infusion warmer, convective
      air warming and reflecting disposable insulation. RESULTS: After 2 hours of
      surgery patients of groups 1 and 2 became hypothermic with core temperatures of
      35.1 and 35.6 degrees C respectively. No relevant difference could be found
      between the two groups. The combination of an infusion warmer and convective air
      warming was an effective method to prevent hypothermia in groups 3 and 4. After 2
      hours of surgery these patients had core temperatures of 36.6 and 36.4 degrees C
      respectively. Reflecting disposable insulation did not improve the effect of
      convective air warming. CONCLUSION: Reflecting disposable insulation was
      insufficient in the investigated operative setting.

PMID- 11194518
TI  - [Autologous phasmapheresis--from euphoria to rationality: practical handling of
      scientific knowledge. Part 3. Autologous plasmapheresis: valuable coagulation
      treatment or expansive volume replacement? Physiology and pharmacology].

PMID- 11194519
TI  - [Autologous plasmapheresis: ingenious coagulation treatment or expensive volume
      replacement?].

PMID- 11194520
TI  - [Hemoglobin solutions].

PMID- 11194521
TI  - [Autologous blood transfusion form the anesthesiologist's viewpoint].

PMID- 11194522
TI  - [Perspectives on autologous transfusion from the transfusion physician's
      viewpoint].

PMID- 11194523
TI  - Airway rescue with the intubating laryngeal mask in a patient with an
      unexpectedly large epiglottic cyst.
AB  - We report the successful use of the intubating laryngeal mask airway for rescue
      and intubation in an anaesthetised patient with an unexpectedly large epiglottic
      cyst. This case illustrates that airway rescue and intubation with the intubating
      laryngeal mask is possible and preoperative airway assessment does not always
      provide reliable information about airway management.

PMID- 11194524
TI  - [Perioperative treatment of a patient with hereditary angioedema (HAE) in a case
      of a young patient with osteosynthesis from a femoral fracture].
AB  - The following case report describes hereditary angioedema (HAE) in a juvenile
      male patient presenting with femoral fracture. The clinical characteristics,
      pathophysiological changes, diagnostics and management of anaesthesia for
      patients with hereditary angioedema will be discussed. Hereditary angioedema
      (HAE) is a rare autosomal dominant disorder, which is caused by congenital
      deficiency of functional C1-inhibitor (C1-INH). Patients are suffering from
      episodic and painless edema of the skin (face and limbs) and mucous membranes of
      the respiratory and gastrointestinal tracts (the latter causing abdominal cramps
      due to edema of the intestine). Life-threatening airway obstruction may occur
      when patients develop laryngeal edema. It is important to differentiate HAE from
      the more frequent allergic angioedema because of differences in the
      pharmacological treatment of acute attacks of HAE. C1-INH-concentrate is
      effective in both treatment of acute attacks and prevention of edema, especially
      in children, juveniles and young women.

PMID- 11194525
TI  - Nutrition in bone health revisited: a story beyond calcium.
AB  - Osteoporosis is a complex, multi-factorial condition characterized by reduced
      bone mass and impaired micro-architectural structure, leading to an increased
      susceptibility to fractures. Although most of the bone strength (including bone
      mass and quality) is genetically determined, many other factors (nutritional,
      environmental and life-style) also influence bone. Nutrition is important
      modifiable factor in the development and maintenance of bone mass and the
      prevention and treatment of osteoporosis. Approximately 80-90% of bone mineral
      content is comprised of calcium and phosphorus. Other dietary components, such as
      protein, magnesium, zinc, copper, iron, fluoride, vitamins D, A, C, and K are
      required for normal bone metabolism, while other ingested compounds not usually
      categorized as nutrients (e.g. caffeine, alcohol, phytoestrogens) may also impact
      bone health. Unraveling the interaction between different factors; nutritional,
      environmental, life style, and heredity help us to understand the complexity of
      the development of osteoporosis and subsequent fractures. This paper reviews the
      role of dietary components on bone health throughout different stages of life.
      Each nutrient is discussed separately, however the fact that many nutrients are
      co-dependent and simultaneously interact with genetic and environmental factors
      should not be neglected. The complexity of the interactions is probably the
      reason why there are controversial or inconsistent findings regarding the
      contribution of a single or a group of nutrients in bone health.

PMID- 11194526
TI  - American ginseng improves glycemia in individuals with normal glucose tolerance:
      effect of dose and time escalation.
AB  - OBJECTIVE: We studied the effect of escalating the dose and administration time
      of American ginseng (AG, Panax quinquefolius L.) in nondiabetic individuals to
      achieve further improvements in glucose tolerance seen previously when 3 g of AG
      was taken 40 minutes before a 25 g glucose challenge. METHODS: Ten nondiabetic
      individuals (6M:4F; mean +/- STD: age = 41 +/- 13 years, BMI = 24.8 +/- 3.5
      kg/m2, FBG = 4.5 +/- 0.1 mmol L(-1)) on 12 separate occasions, randomly received
      0 (placebo), 3, 6 or 9 g of ground AG root at 40, 80, or 120 minutes before a 25
      g oral glucose challenge. Capillary blood glucose was measured prior to ingestion
      of AG or placebo capsules and at 0, 15, 30, 45, 60 and 90 minutes from start of
      challenge. RESULTS: Compared with the placebo, 3, 6 and 9 g of AG reduced
      (p<0.05) postprandial incremental glucose at 30, 45 and 60 minutes; also, 3 and 9
      g of AG did so at 90 minutes. At 60 minutes, 9 g of AG reduced incremental
      postprandial glucose relative to 3 g of AG (p<0.05). All AG doses reduced
      (p<0.05) area under the incremental glucose curve (3 g, 26.6%; 6 g, 29.3%; 9 g,
      38.5%). AG taken at different times did not have an additional influence on
      postprandial glycemia. CONCLUSIONS: In nondiabetic individuals, 3, 6 or 9 g of AG
      taken 40, 80 or 120 minutes before a glucose challenge similarly improved glucose
      tolerance.

PMID- 11194527
TI  - Responses of plasma lipoproteins and sex hormones to the consumption of lean fish
      incorporated in a prudent-type diet in normolipidemic men.
AB  - OBJECTIVE: The effects of lean fish on plasma lipoproteins, postheparin plasma
      lipolytic activities and sex hormones were examined in 11 normolipidemic male
      subjects. METHODS: This study was a randomized crossover trial of two
      isoenergetic prudent-type diets, lean fish diet and beef, pork, veal, eggs and
      milk (nonfish) diet. Experimental diets provided approximately 11800 kJ--18% as
      proteins, 50% as carbohydrates, 32% as lipids [ratio of polyunsaturated to
      saturated fatty acids (P:S) of 1:1 compared with 0.5:1 in preexperimental diet],
      and 260 mg cholesterol/day. RESULTS: Compared with the nonfish diet, the lean
      fish diet induced higher plasma total and LDL apolipoprotein (apo) B and apo
      B:apo A-1 ratio, indicating that the substitution of lean fish for beef, veal,
      pork, eggs and milk provides little benefits with regard to plasma apo B
      concentrations in a low-fat high P:S diet. Moreover, triglycerides:apo B and
      cholesterol:apo B ratios of VLDL were lower following the lean fish diet than the
      nonfish diet, suggesting the presence of smaller very low-density lipoprotein
      (VLDL) particles following the consumption of lean fish. Higher plasma
      concentrations of sex hormone-binding globulin (SHBG), HDL2 cholesterol and
      HDL2:HDL3 cholesterol ratio were found with the lean fish diet compared with the
      nonfish diet. Negative correlations between plasma postheparin lipoprotein lipase
      (LPL) activity and VLDL triglycerides (n = 11, r = -0.53, p = 0.02), and between
      plasma postheparin LPL activity and VLDL triglycerides:apo B ratio (n = 11, r = 
      0.64, p = 0.02) were also observed following the lean fish diet. CONCLUSION:
      These results suggest that the effects of substituting lean fish for beef, veal,
      pork, eggs and milk on plasma lipoproteins may be partly associated with
      variations in plasma sex hormone status and plasma LPL activity in normolipidemic
      men.

PMID- 11194528
TI  - Dairy calcium is related to changes in body composition during a two-year
      exercise intervention in young women.
AB  - OBJECTIVE: Relationships between micronutrients and dairy product intake and
      changes in body weight and composition over two years were investigated. DESIGN:
      Two year prospective non-concurrent analysis of the effect of calcium intake on
      changes in body composition during a two year exercise intervention. SUBJECTS: 54
      normal weight young women, 18 to 31 years of age. MEASURES OF OUTCOME: Mean
      intakes of nutrients of interest were determined from three-day diet records
      completed at baseline and every six months for two years. The change in total
      body weight and body composition (assessed by dual x-ray absorptiometry) from
      baseline to two years was also determined. RESULTS: Total calcium/kilocalories
      and vitamin A together predicted (negatively and positively, respectively)
      changes in body weight (R2 = 0.19) and body fat (R2 = 0.27). Further, there was
      an interaction of calcium and energy intake in predicting changes in body weight,
      such that, only at lower energy intakes, calcium intake (not adjusted for energy)
      predicted changes in body weight. CONCLUSIONS: Regardless of exercise group
      assignment, calcium adjusted for energy intake had a negative relationship and
      vitamin A intake a positive relationship with two year changes in total body
      weight and body fat in young women aged 18 to 31 years. Thus, subjects with high
      calcium intake, corrected by total energy intake, and lower vitamin A intake
      gained less weight and body fat over two years in this randomized exercise
      intervention trial.

PMID- 11194529
TI  - Effect of meat replacement by tofu on CHD risk factors including copper induced
      LDL oxidation.
AB  - OBJECTIVE: To investigate the effect of replacing lean meat with a soy product,
      tofu, on coronary heart disease risk factors including serum lipoproteins,
      lipoprotein (a), factor VII, fibrinogen and in vitro susceptibility of LDL to
      oxidation. DESIGN: A randomized cross over dietary intervention study. SETTING:
      Free-living individuals studied at Deakin University. SUBJECTS: Forty-five free
      living healthy males aged 35 to 62 years completed the dietary intervention.
      Three subjects were non-compliant and excluded prior to analysis. INTERVENTIONS:
      A diet containing 150 grams of lean meat per day was compared to a diet
      containing 290 grams of tofu per day in an isocaloric and isoprotein
      substitution. Each dietary period was one month duration. RESULTS: Analysis of
      the seven-day diet record showed that diets were similar in energy, protein,
      carbohydrate, total fat, saturated and unsaturated fat, polyunsaturated to
      saturated fat ratio, alcohol and fiber. Total cholesterol and triglycerides were
      significantly lower, and in vitro LDL oxidation lag phase was significantly
      longer on the tofu diet compared to the meat diet. The hemostatic factors, factor
      VII and fibrinogen, and lipoprotein(a) were not significantly affected by the
      tofu diet. CONCLUSIONS: The increase in LDL oxidation lag phase would be expected
      to be associated with a decrease in coronary heart disease risk.

PMID- 11194530
TI  - The effect of lecithin supplementation on plasma choline concentrations during a
      marathon.
AB  - BACKGROUND: Previous studies have shown that plasma and urinary free choline
      concentrations decrease significantly during a marathon, and that these decreases
      may be associated with decreased performance. OBJECTIVE: In a pilot study, we
      sought to determine whether lecithin supplementation prior to a marathon would
      maintain plasma free and urinary choline concentrations and improve performance
      versus placebo. METHODS: 12 accomplished marathon runners, males (7) and females
      (5), 21 to 50 years of age were randomized to receive lecithin (4 capsules BID;
      PhosChol 900) or placebo beginning one day prior to the 2000 Houston-Methodist
      Health Care Marathon. The lecithin supplement provided approximately 1.1 g of
      choline on a daily basis (2.2 g total). Runners estimated finish time based on
      recent performance and training. Fasting, pre- and post-marathon plasma and a
      five-hour urine collection were analyzed for free choline and plasma for
      phospholipid-bound choline. Pre-race predicted, as well as the actual finish
      time, were recorded. RESULTS: All subjects completed the marathon. Plasma free
      choline decreased significantly in the placebo group and increased significantly
      in the lecithin group (9.6 +/- 3.6 to 7.0 +/- 3.6 nmol/mL vs. 8.0 +/- 1.2 to 11.7
      +/- 3.6 nmol/mL, p = 0.001 for the delta between groups). No significant changes
      in plasma phospholipid-bound choline concentration were observed. There was a non
      significant decrease in urine free choline in both groups. Actual finish time was
      256.3 +/- 46.3 minutes for the lecithin group vs. 240.8 +/- 62.0 for the placebo
      group and the actual:predicted time was 1.03 +/- 0.06 (lecithin) and 1.07 +/-
      0.08 (placebo), p = 0.36. CONCLUSION: Short-term lecithin supplementation prior
      to a marathon maintains normal plasma free choline concentration during the race,
      but failed to improve performance.

PMID- 11194531
TI  - Revisiting the picky eater phenomenon: neophobic behaviors of young children.
AB  - OBJECTIVES: To compare picky eater behaviors (food neophobia) of children as
      toddlers and at 42 to 84 months of age and to assess their mothers' neophobic
      behaviors. METHODS: In a follow-up study of toddlers' picky eater behaviors,
      trained interviewers conducted four in-home interviews with mothers (n = 71) when
      their children were 42, 60, 72 and 84 months of age. Mothers reported children's
      diets (1 weekend day and 2 week days, 12 days total) and their behaviors; weight
      and height were measured. An additional interview at 48 months involved only
      mothers' behaviors. Nutritionist IV software, correlations, t tests and repeated
      measures ANOVA were used to determine nutrient intake, behavioral relationships
      and differences by picky eater status. Mothers' descriptions of the children's
      food neophobia and bothersome behaviors were analyzed by qualitative methods.
      RESULTS: Mothers reported children's neophobic behaviors at all ages. Mothers'
      and children's behaviors were significantly and consistently correlated for
      number of attempts before deciding an unfamiliar food was disliked (p < 0.01) and
      trying unfamiliar foods away from home (p < 0.01). Other behavioral associations
      were significantly related for some ages but not for all the children's ages.
      There were no significant differences by picky eater status for nutrient intake
      or height and weight at any age. Mothers most frequently attempted unfamiliar
      entrees away from home because of social setting/relationships. About 20% of
      mothers attempted unfamiliar foods or new recipes just because they were
      different. CONCLUSIONS: Findings suggest that some neophobic behaviors of
      children did not improve with maturity. Mothers' perceptions about their
      children's picky eater status were inconsistent over time.

PMID- 11194532
TI  - Relative weight, weight loss efforts and nutrient intakes among health-conscious
      vegetarian, past vegetarian and nonvegetarian women ages 18 to 50.
AB  - OBJECTIVE: To compare relative weight, weight loss efforts and nutrient intakes
      among similarly health-conscious vegetarian, past vegetarian and nonvegetarian
      premenopausal women. METHODS: Demographic data, lifestyle practices and weight
      loss efforts (by questionnaire), body mass index (BMI;kg/m2) and dietary intake
      (via multiple-pass 24-hour diet recall) were compared in a convenience sample of
      90 current vegetarians, 35 past vegetarians and 68 nonvegetarians. RESULTS: Age
      (31.9 +/- 8.8), educational attainment, smoking status, alcohol use, physical
      activity and perceived health status were similar among the three groups of
      women. BMI did not differ by dietary pattern and averaged 23.7 +/- 4.7 for all
      women combined. Participants had intentionally lost > or = 10 pounds a mean of
      2.1 times, and 39% of women perceived themselves to be overweight; again, no
      differences were observed among dietary groups. Dietary intakes of vegetarians
      and current nonvegetarians were consistent with current recommendations for
      macronutrient composition (< 30% fat, < 10% saturates). Compared to current
      nonvegetarians, current vegetarians had lower intakes of protein, saturated fat,
      cholesterol, niacin, vitamins B12 and D, and higher fiber and magnesium intakes.
      Vegetarians' mean vitamin B12 and D intakes were well below recommendations.
      CONCLUSIONS: Relative weight and weight loss efforts do not differ by dietary
      pattern among similarly health-conscious vegetarian and nonvegetarian women. The
      only differences in nutrient intake with potential health implications were
      vitamins D and B12.

PMID- 11194533
TI  - Double-blind controlled study on the effects of dietary diacylglycerol on
      postprandial serum and chylomicron triacylglycerol responses in healthy humans.
AB  - OBJECTIVE: The effects of dietary diacylglycerol (DG) on postprandial lipemia in
      healthy humans were investigated. METHODS: Forty normolipidemic male volunteers
      ingested fat emulsions containing either DG oil or triacylglycerol (TG) oil, at
      different doses: 10 g (n = 13), 20 g (n = 10) and 44 g (n = 17). Two test
      emulsions were given at seven-days intervals in random order. Fatty acid
      compositions of the test oils had been adjusted to be equal. Fasting and
      postprandial serum lipid concentrations in each group and plasma lipoprotein
      lipids in the 20 g-fat ingestion group were measured during the postprandial
      intervals. RESULTS: When DG emulsion was ingested, serum TG concentrations were
      significantly lower (p < 0.05) in the late postprandial phase, i.e., 4 hours, 6
      hours as compared to the TG emulsion. The magnitude of postprandial lipemia (the
      area bounded by the curve above the fasting concentration) after ingestion of 44
      g-DG emulsion was significantly less than that of 44 g-TG emulsion (6.54 +/- 5.12
      and 8.45 +/- 7.54 mmol x h/L, mean +/- SD, respectively). Chylomicron TG,
      cholesterol, and phospholipid concentrations at 4 hours after ingestion of DG
      emulsion were significantly lower (p < 0.05) than those after the ingestion of TG
      emulsion at the same time point. No marked differences were observed for VLDL,
      LDL and HDL lipids between the test emulsions. CONCLUSION: In the usual range of
      fat intake (10-44 g), postprandial response after ingestion of DG emulsion was
      significantly less than that after ingestion of TG emulsion in healthy human
      subjects.

PMID- 11194534
TI  - Feeding tolerance in preterm infants: randomized trial of bolus and continuous
      feeding.
AB  - OBJECTIVE: To test the hypothesis that continuous gastric infusion (CGI) is
      better tolerated than intermittent gastric bolus (IGB) in small very low birth
      weight (VLBW) infants. DESIGN: Two-center, prospective, randomized, unmasked
      clinical trial. PATIENTS: 28 VLBW infants (birth weight <1250 g). A strict
      feeding protocol was followed. INTERVENTION: Patients were randomized to IGB or
      CGI. MAIN OUTCOME MEASURES: Time to reach full feeds (160 cc/kg/d)(by design and
      real), daily weight, caloric intake, residual gastric volume and type of feeding
      (formula vs. human milk vs. both). RESULTS: Five infants failed to complete the
      study because of death (n = 4) or protocol violation (n = 1). The two groups did
      not differ by birth weight or gestational age; infants fed via IGB reached full
      feeds earlier (p = 0.03) and had less delay in reaching full feeds than infants
      fed via CGI. CONCLUSION: Contrary to our hypothesis, gravity IGB is more
      effective than CGI in improving feeding tolerance in small VLBW infants.

PMID- 11194535
TI  - Development of a self-assessment instrument to determine daily intake and
      variability of dietary vitamin K.
AB  - OBJECTIVE: To develop and validate a brief, self-assessment instrument (K-Card)
      to determine daily variations in dietary vitamin K1 (phylloquinone) intake for
      use in patients receiving oral warfarin anticoagulant therapy. METHODS: The K
      Card was designed to include a checklist of selected common foods and beverages
      providing > or = 5 microg vitamin K per serving in American diets and items with
      lower vitamin K content typically consumed in quantities which contribute
      significantly to total vitamin K intake. The K-Card was validated against records
      of weighed food intake from thirty-six healthy volunteers, 20 to 40 and 60 to 80
      years of age, whose phylloquinone intakes and plasma concentrations had been
      previously measured by the Metabolic Research Unit, Jean Mayer USDA Human
      Nutrition Research Center on Aging, Tufts University, Boston, MA USA. Future use
      of the K-Card by patients was simulated by a single investigator using 108 one
      day weighed food records to estimate phylloquinone intakes. Dietary phylloquinone
      calculated from the K-Card was compared to the values of phylloquinone intake
      from the diet records collected on the same days, and to fasting plasma
      phylloquinone concentrations obtained from the same individuals on the following
      day. RESULTS: The mean dietary phylloquinone intake (+/- SEM) was 138.8 +/- 15.7
      microg for the K-Cards compared to 136.0 +/- 15.8 microg for the diet records (p
      = 0.067). Bland-Altman limits of agreement between quantities of dietary
      phylloquinone calculated from the K-Card and values obtained from the weighed
      food records were +/- 38 microg. CONCLUSION: In this simulation, the K-Card
      provided an accurate estimate of dietary phylloquinone intake and therefore
      deserves further testing for use by patients receiving coumarin-based
      anticoagulant therapy to determine whether variability in dietary patterns
      contributes to disruptions in anticoagulant drug efficacy and safety.

PMID- 11194536
TI  - Results of the Azizkhan procedure for long-term suprastomal tracheomalacia.
AB  - One of the reasons of failure to decannulate patients after airway surgery or
      long-term tracheostomy is suprastomal tracheomalacia. We present 7 cases with
      long-term tracheostomies treated by an anterior cricoid suspension described by
      Azizkhan in 1993. Prior to surgery, other causes of airway obstruction, as well
      as the presence of gastroesophageal reflux disease should be ruled out. All of
      them are decannulated. This procedure is a safe surgical technique, easily
      reproducible and with low costs.

PMID- 11194537
TI  - Surgery of subglottic stenosis in neonates and children.
AB  - The excellent management of patients in the different Intensive Care Units has
      decreased mortality but, as a side effect, we have to treat an increasing number
      of patients with airway problems secondary to prolonged intubation. The clinical
      records of patients diagnosed of acquired or congenital subglottic stenosis (SE)
      between 1990 and 1995 were retrospectively reviewed. Types of treatment included
      conservative, endoscopic, and open surgery: anterior cricoid split (ACS),
      anterior laryngotracheoplasty (ALTP) and anteroposterior laryngotracheoplasty
      (APLTP). 46 patients had SE: 7 congenital and 39 acquired. According to Cotton's
      classification 13 had grade I, 16 grade II, 12 grade III and none grade IV.
      Eleven of twelve cases treated conservatively did well (92%); one out of six
      patients managed endoscopically required further surgery (7%); good results were
      obtained in 5 of 7 cases treated by ACS (71 %); 8 out of 9 patients treated by
      ALTP did well (89%) and 7 out of 8 managed by APLTP had good results (87.5%). One
      iatrogenic suture dehiscence required further surgery. There is no statistical
      difference in the complication rate between patients treated conservatively and
      those treated by open surgery, while the mean hospital stay was higher in the
      latter (p < 0.05). An appropriate surgical technique should be offered to those
      patients with SE who do not do well with conservative management, since these
      techniques have yielded good results with a low rate of complications. Long-term
      follow-up shows the absence of recurrence.

PMID- 11194538
TI  - A new and successful chance in surgical treatment of gastrooesophageal reflux in
      severely neurologically impaired children: Bianchi's procedure.
AB  - AIM: Neurologically impaired (NI) children present with neuromuscular
      incoordination and severe gastroesophageal reflux (GER). In these cases, Bianchi
      has proposed total oesophagogastric dissociation (OGD) as a primary procedure and
      not only after failed fundoplication. METHODS: Anthropometric and laboratory
      data, incidence of respiratory symptoms, days of hospitalisation, time of
      feeding, stool frequency and quality of life were tested preoperatively and after
      OGD over a 12-month period in 13 severe NI patients. RESULTS: Results are shown
      in Table 1. We also recorded improvement in quality of life, based on
      communication by the person responsible for the care of the subject, and
      determined by psychological interviews. CONCLUSIONS: OGD is a successful and
      feasible procedure and can be included as a primary definitive surgical treatment
      in individualised nutritional rehabilitation planning for each severe NI child.

PMID- 11194539
TI  - Gastric electrical activity normalises in the first decade of life.
AB  - AIM: Electrogastrography (EGG) is emerging as a non-invasive modality for
      clinical investigation, especially in children. Yet the results of EGG are
      influenced by many factors, including age. The objective of this study was to
      establish the relationship between EGG parameters and age. METHODS: Fasting
      surface EGG (Digitrapper, Synectics) was recorded on 24 healthy boys. The data
      were analyzed using ANOVA, taking p < 0.05 as being statistically significant.
      RESULTS: The age of the boys studied ranged from 1.0 to 11 years (mean = 6.0
      years). The percentage of bradygastria was high, accounting for 34% of the
      recording. Normal rhythm increased (p = 0.013) and the bradygastria decreased
      with age (p = 0.026). The dominant frequency instability coefficient also
      decreased to a certain extent with age (p = 0.065). CONCLUSION: Compared to the
      adult population, bradygastria is common in children. The EGG progressively
      approaches adult pattern as the enteric development matures in the first decade
      of life. This justifies the conservative approach in managing conditions like
      gastro-oesophageal reflux in young children.

PMID- 11194540
TI  - Venoocclusive liver disease (VOD) as a complication of Wilms' tumour management
      in the series of consecutive 206 patients.
AB  - In 4 years (1993-1996) 206 pts. with nephroblastoma were treated. All children
      were treated according to SIOP 93-01 protocol. Overall survival was 92%. In 27
      cases hepatotoxic events occurred. In 10 cases, venoocclusive liver disease (VOD)
      was diagnosed. VOD is a syndrome associated with hepatomegaly, sudden weight gain
      or ascites and jaundice. It results from damage to the endothelium of hepatic
      venules and necrosis of central hepatocytes with subsequent proliferation of
      fibrous tissue and occlusion of the central hepatic veins. Dactinomycin is one of
      the drugs considered responsible for its development. Mean age of VOD patients
      was 4 yrs, however 3 of them were below 1 yr. In all cases, VOD occurred during
      postoperative chemotherapy (mean 16 th week of treatment). All patients received
      dactinomycin and vincristine. Five children with right kidney tumors underwent
      post-operative abdominal irradiation. Main VOD symptoms were hepatomegaly and
      ascites (80%). Hypertransaminasaemia, as well as, on ultrasound, gallbladder wall
      thickening and/or free abdominal fluid were observed. Median VOD duration was 27
      days and its course was usually temporary and self-limiting. However, in 2 cases
      recurrent VOD episodes were noted. All children received supportive treatment
      only. In 6 cases, VOD resulted in chemotherapy delay or drug reductions, while in
      4 others chemotherapy was completed preliminarily. Nevertheless it did not affect
      patients' outcome overall survival in VOD group was 90%. CONCLUSIONS: Total 5%
      VOD frequency is similar to other reports. Infants and children receiving
      abdominal irradiation seem to be at special risk of VOD development.

PMID- 11194541
TI  - Is there a correlation between organochlorine compounds and undescended testes?
AB  - Some pesticides and synthetic chemicals are known to act as hormonal modulators,
      often possessing oestrogenic activity (xenooestrogens). They are persistent and
      accumulate in fatty tissue. Aim of our study is to address the question, whether
      a selection of such compounds is to be found in the fatty tissue of children
      undergoing surgical procedures and whether there are differences in values
      obtained from patients with or without undescended testes. Fat samples of 48
      patients, 18 of whom had undescended testes, were examined by high-resolution gas
      chromatography and mass spectrometry for DDT and metabolites, polychlorinated
      biphenyls (PCB), toxaphenes, hexachlorocyclohexane (HCH), chlorinated cyclodienes
      and chlorinated benzenes. We were able to find accumulation of all substances in
      every patient. Statistical analysis revealed a highly significant difference
      between patients from the control group and those from the undescended testes
      group for two compounds, namely heptachloroepoxide (HCE) and hexachlorobenzene
      (HCB), increased values being found in the patients with undescended testes.
      Since the aetiology of this entity is unknown in most of the cases, prenatal
      exposure to exogenous oestrogens is an attractive and plausible hypothesis. In
      order to confirm this, some questions will have to be answered in further
      studies: effect of exposure to xenooestrogens during a specific period of
      development, probable role of other substances with proven or suspected hormonal
      activity, potential synergism of such compounds and differences in individual
      susceptibility.

PMID- 11194542
TI  - First Spanish Trauma Registry: analysis of 1500 cases.
AB  - OBJECTIVES: To develop the first Spanish Pediatric Trauma Registry to collect and
      evaluate infomation concerning aspects of injuries in our pediatric population.
      METHODS: From January 1995 to August 1998, 35,946 children younger than 16 years
      were treated in our hospital for acute injury: 1500 were admitted and included in
      our database. Our file registry consists of 108 data points including: patient
      identification, type, place and mechanism of injury, pre-hospital care,
      transport, assessment on admission, severity scores, diagnostic studies,
      injuries, treatment morbidity and mortality. RESULTS: Accidents were more
      frequent in males (68%) than in females. The predominant age group was 12-15
      years of age (34%). Accidents were more frequent in the street (35.1%) than at
      home (18.9%) or school (13%). Falls and traffic-related accidents were the
      leading cause of injury (39% and 21.2%, respectively). Two hundred and thirty
      five (15.7%) had a Pediatric Trauma Score < or = 8. Fifty of these sustained
      multiple trauma (33%) (Injury Severity Score > or = 15). Musculoskeletal and head
      trauma were the most frequent injuries (48.5% and 42.0%, respectively). Surgical
      or orthopedic procedures were performed in 906 patients (56.5%). The average
      length of stay was 4.5 days (range 1-93 days). Functional impairment in children
      older than 4 years of age was found in 413 children (33.3%). We encountered 7
      deaths in the 1500 patients, or an overall mortality of 0.5%. These 7 deaths were
      only seen in the I.S.S. > or = 15 group (50 patients) with 14% mortality.
      CONCLUSIONS: The goals of this Registry are to establish the epidemiology of our
      injured pediatric population, to review patient care, to develop prevention
      programs and to compare results with other centers so that potential deficiencies
      can be corrected.

PMID- 11194543
TI  - Elastic stable intramedullary nailing (ESIN) provides good long-term results in
      pediatric long-bone fractures.
AB  - The present study evaluates the long-term outcome of elastic stable
      intramedullary nailing (ESIN) in children with long-bone shaft fractures. 70
      patients were examined, the present mean age of patients was 12.7 (+/- 3.26)
      years, mean time interval since surgery was 3.1 (+/- 1.49) years. Following ESIN
      at the lower extremity (23 femur fractures, 14 tibia fractures), keloid formation
      was remarkable in one patient, range of motion (ROM) was adequate in all but one
      boy (extension deficit of the hip of 10 degrees). Overall leg length discrepancy
      was +4.1 mm (+/- 5.2 mm) following ESIN for femur fracture and +3.2 mm (+/- 6.4
      mm) following tibia fracture. Radiologically, all fractures had healed and no
      signs of avascular necrosis (AVN) could be detected. Malalignment was documented
      in one girl following tibia fracture (valgus of 12 degrees). Assessment of the
      upper extremity (28 forearm fractures, 5 humerus fractures) revealed keloid
      formation in 5 children. Impaired ROM was found in three children following ESIN
      for a forearm fracture (limited pro-/supination). Radiological controls detected
      one case of retrocurvation of the humerus (12 degrees, polytrauma patient) and
      one varus deviation of the radius in a 10-year old boy. Questioning the children
      about their opinion of the treatment, 93% considered the cosmetic results as good
      (6% fair), they judged the functional ability as perfect in 91% (9% fair) and 93%
      expressed great overall content (6% fair, 1% poor). In conclusion, ESIN provides
      good long-term results and can be a beneficial method for children with long-bone
      fractures.

PMID- 11194544
TI  - Small-bowel perforation in very low birth weight neonates treated with high-dose
      dexamethasone.
AB  - INTRODUCTION: Early postnatal treatment with high doses of corticosteroids may be
      effective in reducing the duration of mechanical ventilation in very low birth
      weight infants at risk for bronchopulmonary dysplasia. However, serious side
      effects may occur. MATERIAL AND METHODS: A retrospective study on 5 very low
      birth weight neonates, mean (+/- SEM): gestational age range 27.5 +/- 2 weeks,
      mean birth weight (+/- SEM): 836 g +/- 169 referred between April 1997 and
      October 1998 from a single academic neonatal intensive care unit to our tertiary
      pediatric surgical center with the diagnosis of intestinal perforation. During
      the same period, 60 very low birth weight infants have been treated in that unit
      following a standardized protocol including surfactant for respiratory distress
      syndrome and high-dose dexamethasone to prevent bronchopulmonary dysplasia.
      RESULTS: Pneumoperitoneum was diagnosed between 6 to 9 days after birth.
      Clinically, all babies remained surprisingly stable. An isolated ileal
      perforation, without sign of necrotizing enterocolitis, was found at laparotomy
      in each patient. A limited intestinal resection was performed, with primary end
      toend anastomosis (3 cases) or with transient ileostomies (2 cases). Surgical
      outcome was favorable in all patients. CONCLUSION: isolated intestinal
      perforation may be a complication of the preventive treatment of chronic lung
      disease with high-dose corticosteroids in very low birth weight infants.
      Conversely, corticosteroids may reduce the clinical signs and the multiple organ
      dysfunction associated with an abdominal drama, explaining the very good surgical
      prognosis of these newborns. Attention must be paid to an insidious
      pneumoperitoneum.

PMID- 11194545
TI  - Successful EXIT (ex utero intrapartum treatment) procedure in a fetus diagnosed
      prenatally with congenital high-airway obstruction syndrome due to laryngeal
      atresia.
AB  - Congenital high-airway obstruction syndrome (CHAOS) is due to rare malformations
      and has been reported previously in only few cases. If the diagnosis can be made
      prenatally, the ex utero intrapartum treatment (EXIT) procedure may be life
      saving. A healthy 28-year old nulli-para was referred because of isolated ascites
      found at gestational week 16 during routine ultrasound scan. Repeated scans
      showed overdistended hyperechogenic lungs with inverted diaphragm and a dilated
      trachea, which was interpreted as a CHAOS resulting from laryngeal atresia. The
      ascites eventually disappeared. An EXIT procedure was performed at 35 weeks of
      gestation. Anesthesia of the mother was induced with thiopental, succinylcholine
      and fentanyl followed by intubation, and maintained with isoflurane and nitrous
      oxide. A low abdominal midline incision was performed followed by a low
      transverse incision of the uterus. The fetal head, right arm and shoulder were
      delivered and intramuscular anesthesia was administered to the fetus. Immediate
      laryngoscopy confirmed the diagnosis and a tracheostomy was therefore performed.
      Surfactant was given after a few minutes of ventilation. Compliance improved and
      when the fetus was easy to ventilate, it was delivered. The baby is developing
      normally at 18 months of age. Surgical correction of the malformation will be
      performed after two years of age. It is concluded that some fetuses with a
      prenatal diagnosis of CHAOS can benefit from the EXIT procedure at delivery. This
      necessitates a multidisciplinary management team.

PMID- 11194546
TI  - Prophylactic thyroidectomy in the treatment of thyroid medullary carcinoma. Age
      for surgery?
AB  - Since the association of RET proto-oncogene mutations and medullary thyroid
      carcinoma in children there has been much discussion regarding timing of surgery.
      Our study group was formed from a brother and sister (8 and 5) and 3 brothers (9,
      13, 16) selected on the basis of a positive family history for thyroid medullary
      carcinoma. Histological examinations of the thyroidectomy specimens showed that
      the 8- and 9-year old had microinvasive carcinoma and the remaining three had C
      cell hyperplasia. Our recommendation is for prophylactic thyroidectomy for
      children with RET proto oncogene mutations at an early age, clearly before age 5.

PMID- 11194547
TI  - Spondylothoracic dysplasia with diaphragmatic defect: a case report with
      literature review.
AB  - Spondylothoracic dysplasia (Jarcho-Levin syndrome) is a syndrome of unknown
      etiology. We describe a new case with diaphragmatic eventration. Literature
      review for cases of Jarcho-Levin syndrome with diaphragmatic defects, which were
      six cases, revealed that renal affection increased when diaphragmatic defects
      associate the syndrome with pulmonary hypoplasia. Thus, the subgroup of
      spondylothoracic dysplasia with diaphragmatic defect is a more severe subgroup of
      the syndrome rather than the other forms of this syndrome. Relating the described
      anomalies in this case and that of the literature cases to the known
      embryological basis may point to a pivotal developmental link between lung,
      kidney and diaphragm, possibly the posterior mesenchyme.

PMID- 11194548
TI  - Neuroblastoma and bronchogenic cyst: a rare association.
AB  - A few of the known associations between paediatric cancer and congenital
      anomalies are attributable to contiguous-gene syndromes. Neuroblastoma (NB) has
      been linked with an excess of gastrointestinal malformations, but there is a
      significant scarcity of associated respiratory anomalies. We report on two
      children having an abdominal NB and a bronchogenic cyst diagnosed simultaneously
      and in different order of appearance. Both masses were removed in separated
      procedures, taking into account the priority and the time sequence of
      chemotherapy. Literature is reviewed, checking that the genetic basis for this
      association is supported by speculations about the oncogene RON.

PMID- 11194549
TI  - In vitro development of green fluorescent protein (GFP) transgenic bovine embryos
      after nuclear transfer using different cell cycles and passages of fetal
      fibroblasts.
AB  - Nuclear transfer using transfected donor cells provides an efficient new strategy
      for the production of transgenic farm animals. The present study assessed in
      vitro development of nuclear transfer embryos using green fluorescent protein
      (GFP) gene-transfected bovine fetal fibroblasts. In experiment 1, bovine fetal
      fibroblasts (BFF) were transfected with linearized pEGFP-N1 by electroporation,
      and the enucleated oocytes were reconstructed by nuclear transfer of transfected
      cells (BFF-GFP). The rates of blastocyst formation did not differ significantly
      between BFF and BFF-GFP (18.2% v. 15.6%). In experiment 2, before nuclear
      transfer, the donor cell stage was synchronized by serum deprivation or forming a
      confluent monolayer. The rates of cleavage (67.1% v. 71.8%) and blastocyst
      formation (15.8% v. 15.5%) did not differ between confluent and serum-starved
      cells after nuclear transfer. In experiment 3, the effects of different passages
      of donor fibroblast cells on the development of nuclear transfer embryos were
      investigated. Donor cells from 'early' (at passage 8-16) showed better blastocyst
      development (18.9%) than those from 'late' (at passage 17-32; 10.5%). In
      conclusion, this study suggests that transgenic somatic cell nuclei from early
      passages can be reprogrammed more effectively than those from late passages. In
      addition, GFP, a non-invasive selection marker, can be used to select transgenic
      nuclear transfer embryos.

PMID- 11194550
TI  - In situ pH measurements of the Syrian hamster uterus during early pregnancy to
      determine the role of pH in zona pellucida loss in vivo.
AB  - The mechanisms of zona pellucida (ZP) loss in peri-implantation hamster embryos
      in vivo versus in vitro are distinctly different. To investigate if ZP loss in
      vivo is the result of transient uterine pH changes, the luminal pH of the
      pregnant uterus was measured during the ZP loss period. Prior to ZP loss, pH was
      7.30 +/- 0.05 (mean +/- SE; left uterine horn) and 7.35 +/- 0.03 (right horn).
      During ZP loss, pH was 7.26 +/- 0.07 (left) and 7.35 +/- 0.03 (right), and after
      embryo attachment, 7.25 +/- 0.02 (left) and 7.27 +/- 0.02 (right). None of these
      values are statistically different. The pseudopregnant uterine pH was 7.30 +/-
      0.04 (left) and 7.31 +/- 0.04 (right), not statistically different from each
      other or from pregnant uteri. Blastocyst ZP loss in vitro (pH 3.0-8.5) occurred
      only at pH 3.0. Loss of ZP occurred in uterine flushings from pregnant or
      pseudopregnant hamsters, evidence that ZP loss is related to uterine factors.
      Complete ZP loss occurred at pH 6.8, but was incomplete at pH 6.6, 7.0 and 7.2.
      No ZP loss occurred in uterine flushings from non-mated females. In summary: (i)
      a change in uterine pH does not cause ZP loss in vivo in the Syrian hamster; (ii)
      a pH-sensitive factor in pregnant and pseudopregnant uterine fluid is responsible
      for ZP loss.

PMID- 11194551
TI  - Intrauterine insemination in sows with reduced sperm number.
AB  - Usually 2-3 x 10(9) sperm per insemination are used in pigs. In other species it
      has been shown that changing the site of insemination allows a reduction in the
      amount of sperm per insemination dose. The goal of this study was to determine
      the minimal number of sperm that can be used, without a reduction in either the
      pregnancy rate or the mean litter size, using surgical deep intrauterine
      insemination in sows after weaning. Three different sperm concentrations (5 x
      10(8), 1 x 10(8) and 1 x 10(7) sperm cells extended in 0.5 mL Androhep) were
      inseminated into the tip of each uterine horn. In addition two groups of control
      sows were inseminated once intracervically 24-32 h after the first signs
      ofoestrus with 1 x 10(9) and 3 x 10(9) sperm in 80 mL Androhep extender. Animals
      that became pregnant were allowed to farrow normally. No significant differences
      were observed between groups inseminated surgically with the three different
      sperm dosages with respect to pregnancy or farrowing rate. There was also no
      significant difference between the results of these groups and the results
      obtained from the non-surgically inseminated control groups. Neither the mean
      number of live-born nor stillborn piglets was significantly different between the
      surgically inseminated groups and the control groups. The total number of piglets
      born in each group was also not statistically different. The data show that the
      sperm number to be used for surgical insemination can be lowered without loss of
      the fertilization potential and may be used in the field as soon as a suitable
      insemination device is available.

PMID- 11194552
TI  - Development of reconstituted pig embryos by nuclear transfer of cultured cumulus
      cells.
AB  - This study tested the effects of oocyte collection method, activation protocol
      and maturational age of recipient oocytes on the in vitro development of nuclear
      transfer embryos reconstructed with cultured cumulus cells. Cumulus cells
      synchronized in G0/G1 phase by serum-starvation culture were transferred into
      enucleated oocytes that were collected by aspiration or dissection method and
      cultured for 33 or 44 h. Reconstituted embryos were activated with a combination
      of calcium ionophore A23187 or electric pulse and cycloheximide (CHXM), and
      cultured for 6 days. Oocyte collection methods, activation treatment in the
      presence of cytochalasin B and activation protocols did not affect the
      developmental rate of embryos reconstituted with 44-h-matured recipients.
      However, the development of embryos reconstituted with 33-h-matured recipients
      was significantly improved (P<0.05) by activation with the combination of
      electric pulse and CHXM. The present study shows that reconstituted porcine
      embryos derived from cultured cumulus cells can develop to the blastocyst stage,
      and that their development can be improved by reconstruction with young oocyte
      cytoplasts following activation with a combination of electric pulse and CHXM.

PMID- 11194553
TI  - Non-invasive monitoring of reproductive status in wild mongoose lemurs (Eulemur
      mongoz).
AB  - Endocrine profiles were investigated in wild and captive mongoose lemurs (Eulemur
      mongoz; Lemuridae) by analysing faecal progestagens and oestrogens. Oestrous
      cycle characterization was not possible, as most females appeared to conceive
      during the first oestrus of the breeding season. Conception was preceded by a
      pseudo-oestrus with no discernible luteal phase. Pseudo-oestrus and oestrus
      identification was possible by investigating the oestrogen:progestagen ratio.
      Pregnancy was reliably determined approximately 47 days after conception, when
      progestagen and oestrogen excretion increased above breeding season
      concentrations. Gestation was further characterized by high progestagen
      concentrations and a decline in oestrogen excretion 70-80 days after conception.
      Post partum, progestagens declined, but oestrogen excretion increased to exceed
      breeding season concentrations. In the wild group, a nulliparous daughter
      conceived while still a member of her natal group and aborted after 70-80 days of
      pregnancy at which time progestagens had declined but oestrogens remained high.
      Comparisons with other strepsirhine primates suggest that pseudo-oestrus followed
      by conception at first oestrus may be prevalent in lemurs. Gestational
      progesterone profiles vary between species, but a delayed increase in oestrogens
      during pregnancy could be common to all strepsirhines, although oestrogen levels
      during the final trimester of pregnancy differ between lemurs and lorises.
      Methodological investigations showed that prolonged storage of faeces in ethanol
      is viable and that the presence of undigested vegetable matter in the faecal
      pellets had no effect on the interpretation of hormone profiles.

PMID- 11194554
TI  - The viability of transferred sheep embryos after long-term cryopreservation.
AB  - The survival to term of 414 sheep embryos, thawed and transferred after
      conventional cryopreservation and storage for 13 years, was evaluated. A
      concurrent experiment involving the transfer of vitrified embryos to 91 ewes and
      artificial insemination of 51 ewes with frozen-thawed semen from sires of the
      long-term cryopreserved embryos provided forms of control treatments. The donor
      ewes had a mean ovulation rate of 10.9, and 7.1 embryos per ewe were
      cryopreserved. Each recipient ewe received two embryos and pregnancy was assessed
      at Day 18, Day 54 and term. The pregnancy rate was lower in the long-term embryo
      group than the artificial insemination group at Day 18 (P<0.01) and Day 54
      (P<0.05), although the difference at term (31% v. 49%) was not significant, with
      the vitrified embryo group being similar to the long-term group. Embryo survival
      to birth was 21%, with the majority of loss (80%) occurring by Day 18. The later
      stage of development and higher grade of transferred embryos and the older age of
      donor ewes resulted in a significantly higher (P<0.01) pregnancy rate at Day 54
      and term, and percentage of lambs born and weaned. Other effects of donor ewes
      (genotype, superovulation treatment, number of ovulations and embryos
      cryopreserved) were not significant. Implications for the design of genetic
      evaluation and germplasm conservation programmes using embryo cryopreservation
      technology are discussed.

PMID- 11194555
TI  - Protein synthesis and phosphorylation by elongating 13-15-day-old cattle
      blastocysts.
AB  - Most early embryonic loss in cattle occurs during the period of blastocyst
      formation and elongation. In this study de novo protein synthesis and
      phosphorylation by 13-15-day-old cattle blastocysts was determined. Blastocysts
      were classified by dimension into spherical, ovoid and elongated stages and
      cultured under oil for 4 h in drops of KSOM medium containing either 35S
      methionine or 32P-orthophosphate. Protein content increased with shape from
      spherical to ovoid to elongated. There were differences (P<0.05) within and among
      days in the percentage of radiolabel incorporated. Incorporation of 35S
      methionine increased with embryo protein content. However, incorporation of 35S
      methionine into TCA-insoluble material, expressed per microg of protein,
      decreased with shape (P<0.001) with more than a 10-fold difference between
      spherical and elongated 13-day-old blastocysts. Incorporation of 32P
      orthophosphate also tended to decrease with shape, with a 3-fold difference
      between spherical and elongated Day 13 blastocysts. It was concluded that, from
      Day 13, protein synthesis and phosphorylation, when expressed per unit of
      protein, decreased from a much higher level, which in the present study was
      around the time the blastocysts began to elongate.

PMID- 11194556
TI  - Pituitary responsiveness to diurnal and nocturnal GnRH pulses in melatonin
      treated ewe lambs.
AB  - It has been shown that oral administration of melatonin to Suffolk ewe lambs,
      from 10 weeks of age onwards, advances the onset of puberty compared with control
      lambs maintained under the same natural photoperiod. Luteinizing hormone (LH)
      pulse frequency at 20 and 26 weeks of age was unchanged by melatonin. However, LH
      pulse amplitudes greater than 1 ng mL(-1) were consistently observed in melatonin
      treated lambs, suggesting either a high responsiveness of the pituitary gland to
      endogenous gonadotrophin-releasing hormone (GnRH) pulses, or a large amount of
      GnRH released by each pulse. The purpose of the present study was to assess the
      pituitary responsiveness to six diurnal and six nocturnal exogenous pulses of
      GnRH (10 ng kg(-1) bodyweight) in melatonin-treated ewe lambs (3 mg melatonin
      daily at 1600 hours, from 10 weeks of age; n = 5) and control lambs of the same
      age (n = 5), born in the spring and kept under natural photoperiod. Pulses of
      GnRH were given intravenously at 60-min intervals by means of an indwelling
      jugular catheter from 0900 to 1400 hours and from 2100 to 0200 hours to ewe lambs
      of 20 and 26 weeks of age. Blood samples were collected at 10-min intervals using
      a contralateral jugular vein catheter from 1 h before and up to 1 h after the
      last GnRH pulse. The difference (delta) between plasma LH concentrations at 0 min
      and the greatest concentration of LH after each GnRH pulse was calculated and
      compared in the same group. The total area under the GnRH response curve (AUC)
      was also calculated and compared within and between the groups. The AUC of
      melatonin-treated lambs (66.1 +/- 5.94 and 52.24 +/- 7.42 ng mL(-1)/6 h, diurnal
      and nocturnal respectively) was greater than that of control lambs (39.42 +/-
      4.29 and 32.82 +/- 3.6 ng mL(-1)/6 h diurnal and nocturnal respectively; P<0.05)
      at 20 weeks of age. At 26 weeks of age, only the diurnal total AUC was greater in
      melatonin-treated lambs than in control lambs (60.17 +/- 7.98 and 29.8 +/- 5.02
      ng mL(-1)/6 h respectively; P<0.05). Delta LH concentrations in response to the
      first diurnal pulse of GnRH were greater than those in response to the fifth
      diurnal GnRH pulse (P<0.05) in melatonin-treated lambs of 20 weeks of age. Also,
      the delta LH concentrations in response to the first three diurnal GnRH pulses
      were greater than to the last three nocturnal pulses of GnRH (P<0.05). Delta LH
      concentrations were greater in response to the second diurnal pulse of GnRH than
      to the last three diurnal GnRH pulses, and greater than the responses to the
      first and the last four nocturnal GnRH pulses (P<0.05), at 26 weeks of age in
      melatonin-treated lambs. The response to nocturnal pulses of GnRH was similar. In
      control lambs, the responses to diurnal and nocturnal GnRH pulses were similar at
      20 and 26 weeks of age. These results suggest that melatonin enhances the
      pituitary responsiveness to GnRH pulses in ewe lambs.

PMID- 11194557
TI  - Characterization of the spermiation response, luteinizing hormone release and
      sperm quality in the American toad (Bufo americanus) and the endangered Wyoming
      toad (Bufo baxteri).
AB  - Spermiation and LH release in response to several methods of LHRH administration
      were assessed in the American toad (Bufo americanus), and the most successful
      method was tested in the endangered Wyoming toad (Bufo baxteri). Specific
      objectives were to: (1) compare spermiation responses and plasma LH concentration
      after invasive and non-invasive LHRH treatments; (2) evaluate sperm production in
      response to different LHRH dosages; (3) characterize the timing of sperm release
      post LHRH treatment; and (4) assess sperm quality (motility, viability,
      morphology and acrosomal status). Male American toads were administered 4 microg
      LHRH by one of four routes: (1) intraperitoneal injection (i.p.); (2)
      subcutaneous injection (s.q.); (3) dorsal dermis absorption (d.d.a.); and (4)
      ventral dermis absorption (v.d.a.). Aspermic urine only was collected from saline
      treated controls and d.d.a. animals. Several v.d.a. animals released spermic
      urine; however, all LHRH-injected toads released spermatozoa. I.p. animals
      produced higher sperm and LH concentrations than s.q. animals. The spermiation
      response in animals treated i.p. with 1 microg LHRH was similar to that in
      animals treated with 4 microg, but lower LHRH dosages tested produced inferior
      responses. Sperm production in responsive animals increased over time during the
      12-h sampling interval. Regardless of treatment, most American toad spermatozoa
      were motile, viable, and acrosome-intact. Endangered Wyoming toads were treated
      i.p. with 4 microg LHRH, and spermic urine was collected. Although most
      spermatozoa were viable and acrosome-intact, a considerable percentage possessed
      structurally abnormal heads. A single i.p. injection of LHRH appears to be a
      reliable and safe method for controlling spermiation in toads and may be useful
      for assisting endangered amphibian propagation.

PMID- 11194558
TI  - Polo-like kinase expression in normal human endometrium during the menstrual
      cycle.
AB  - The enzyme, polo-like kinase (PLK), is a mammalian serine/threonine kinase
      involved in cell cycle regulation. A great deal of evidence regarding the role of
      PLK in the cell cycle has been obtained through studies of cultured cells, though
      little is known about its function or even expression in vivo. The endometrium
      undergoes rapid proliferation and differentiation under ovarian steroid hormone
      control during the 28-day cycle. Thus, normal endometrium provides an excellent
      model in which to study the hormone dependency of PLK expression. In the present
      study, we examined the features of PLK expression in 20 samples of normal human
      endometrium during the menstrual cycle. The expression of Ki-67 and proliferating
      cell nuclear antigen (PCNA) were also examined as markers of proliferation.
      Immunohistochemical studies showed that PLK staining was detected in the basement
      membrane of many endometrial glands, stromal cells, and some endothelial cells.
      The number of PLK-positive endometrial gland cells was significantly higher in
      the late proliferative phase (19.16% +/- 4.98%) and the early secretory phase
      (19.28% +/- 4.99%) than in the early proliferative phase (2.60% +/- 2.33%) or the
      late secretory phase (5.76% +/- 2.16%) (P<0.0001). PLK expression seemed to be
      correlated with the expression of Ki-67 and PCNA in many endometrial glands and
      stromal cells particularly in the late proliferative phase, reflecting a role of
      PLK in cellular proliferation. Nevertheless, in the early secretory phase, at
      which point the expression of Ki-67 and PCNA decreased in endometrial glands, PLK
      was strongly expressed. This finding suggests that PLK may have some post-mitotic
      functions in certain specialized cell types. Although the highest expression of
      PLK was observed in the late proliferative and the early secretory phases, the
      expression drastically decreased in the late secretory phase. These findings,
      taken together, indicate that the expression of PLK in normal endometrium
      fluctuates over the course of the menstrual cycle, suggesting in turn that PLK is
      associated with hormone-dependent cellular proliferation and that hormone
      functions may be involved in its regulation.

PMID- 11194559
TI  - Influence of relative size at birth on growth and glucose homeostasis in twin
      lambs during juvenile life.
AB  - The effect of differences in size at birth on growth and glucose homeostasis
      between female twin lambs during juvenile life was examined. Twenty-six sets of
      twins were entered into the study, of which ten were used for organ sampling at
      birth and 16 were studied over the first year of life. Eleven sets were defined
      as being mismatched for birthweight as the weight difference between twins was
      >25%, with light lambs weighing 4.1 +/- 0.3 kg and heavy lambs weighing 5.1 +/-
      0.1 kg. All remaining twins were matched in bodyweight, weighing 4.6 +/- 0.5 kg.
      During the rapid period of juvenile growth (i.e. one, three and six months of
      age) and following stabilization of bodyweight (i.e. 12 months of age) glucose
      tolerance tests were performed by intravenously injecting 0.8 mg kg(-1)
      bodyweight glucose. This was followed the next day with an insulin tolerance
      test, performed by intravenously injecting 0.08 units kg(-1) bodyweight insulin.
      At birth there were no differences in organ weight as a fraction of total
      bodyweight between matched and mismatched twins, but the ratio of liver to brain
      weight was lower in light compared with heavy twins. Light lambs remained lighter
      than their twins up to six months of age, and crown-rump length was also shorter.
      At one and three months of age there were no differences in basal plasma glucose
      concentrations between the groups, but glucose tolerance was greater in light
      compared with heavy lambs at one and six months of age. Insulin tolerance was
      greater in light compared with matched lambs at one and six months of age. In
      conclusion, it has been shown that size at birth of one twin in relation to its
      co-twin is one factor determining glucose regulation during postnatal life. This
      not only affects glucose and insulin tolerance but also growth over the first six
      months of age.

PMID- 11194560
TI  - Vasoactive intestinal peptide influences hatching of ovine blastocysts.
AB  - Expanded blastocysts collected from superovulated Sarda ewes were divided at
      random into four groups for culture in a simple medium that does not support
      blastocyst hatching (CZB) or a complex medium that is permissive to hatching (TCM
      199), with or without vasoactive intestinal peptide (VIP), a known embryo
      mitogenic peptide. Plasminogen activator (PA) secretion after 24 h of culture,
      and the number of cells, diameter of blastocysts and hatching rate after 48 h of
      culture were compared. The results showed an increase in hatching rate (78.6 v.
      6.7%; P<0.01), diameter and number of cells (220.89 v. 210.44 microm, P<0.01 and
      246 v. 232, P<0.01 respectively) and caseinolytic areas (1.33 v. 0.92 cm, P<0.01)
      of blastocysts cultured in TCM 199 compared with those cultured in CZB.
      Supplementation of the culture media with VIP increased these parameters in CZB
      (P<0.01) and partially in TCM 199. In particular, cell number, diameter and PA
      activity were significantly higher (P<0.01) after culture with VIP in both media.
      Immunoneutralization of exogenous VIP in culture with anti-VIP antibody caused a
      decrease in the hatching rate (P<0.01) of embryos cultured in medium with VIP,
      similar to the rate in unsupplemented CZB (P<0.01). These results suggest a
      receptor-mediated response. In immunohistochemical studies, VIP was shown to bind
      receptors in hatched blastocysts demonstrating the VIP-receptor interaction, and
      VIP receptors of approximately 150 kDa were revealed by electrophoretic studies.
      In conclusion, ovine preimplantation embryos exhibit VIP receptors, providing a
      basis for a receptor-mediated influence of VIP in the hatching of ovine
      blastocysts.

PMID- 11194561
TI  - Tumour necrosis factor alpha up-regulates matrix metalloproteinase-2 activity in
      periovulatory ovine follicles: metamorphic and endocrine implications.
AB  - The collagenous matrix of the wall of periovulatory follicles is degraded and
      remodelled during ovulatory ovarian rupture and luteinization. Matrix
      metalloproteinase-2 (MMP-2) belongs to a family of zinc endopeptidases that
      cleave extracellular proteins; its primary substrate is the type IV collagen of
      basement membranes. Tumour necrosis factor alpha (TNFalpha) is a putative
      mediator of collagenolysis and ovulation. The objective of this investigation was
      to ascertain the regulatory role of TNFalpha on MMP-2 activity relevant to the
      folliculo-luteal transition in ewes. Luteal regression and the preovulatory surge
      of gonadotropins were induced by administration of prostaglandin F2alpha and
      gonadotropin-releasing hormone (GnRH) on Days 14 and 15.5 (= 0 h) of the oestrous
      cycle, respectively. Ovulation occurs from the dominant follicle approximately 24
      h after GnRH. An immunocapture-activity assay was used to measure MMP-2 in
      follicular extracts. Bioactive MMP-2 increased from 0 to 20 to 40 h after GnRH.
      Enzyme was immunolocalized at 40 h to the connective tissue framework that
      invades the parenchyma of the formative corpus luteum. Activity of MMP-2 was up
      regulated by incubation (20 h) of 0-h follicular explants with TNFalpha; this
      response was suppressed by the transcriptional inhibitor actinomycin D. Activity
      of MMP-2 was reduced when preovulatory follicular tissues were incubated (12-h
      explants for 6 h) with TNFalpha antiserum. Ovulation was blocked by
      intrafollicular injection of TNFalpha antiserum. Unruptured follicles luteinized,
      but were deficient in collagenous/vascularized trabeculae, and produced less
      progesterone than their control luteal counterparts. It is suggested that
      TNFalpha, via MMP-2 induction, contributes to the reorganization of an ovulatory
      follicle into a fully competent corpus luteum.

PMID- 11194562
TI  - Contraceptive effects of levonorgestrel implants in a marsupial.
AB  - The effect of subcutaneous levonorgestrel implants on reproduction in female
      tammar wallabies was investigated during the breeding and non-breeding season.
      Female tammars were given either a control or a levonorgestrel implant and their
      pouch young were removed to terminate embryonic diapause. Both the control and
      the levonorgestrel-implant animals treated during the months of May and June gave
      birth, demonstrating that levonorgestrel does not prevent the reactivation of the
      diapausing blastocyst or its subsequent development when given at these times.
      However, none of the levonorgestrel-treated animals mated post partum, whereas
      all of the control females that gave birth had a post partum oestrus and mated.
      Control animals gave birth again when the neonate was removed, and continued to
      breed normally during the following 36 months of the investigation. None of the
      levonorgestrel-treated animals gave birth again or mated during the next 36
      months. Animals given control implants during December did not reactivate or give
      birth until the normal start of the breeding season in late January. Animals
      treated with levonorgestrel implants during December did not reactivate with the
      control animals at the beginning of the breeding season and did not give birth
      during the next 36 months. There were no effects of levonorgestrel treatment on
      early lactation. Levonorgestrel implants were removed from six females and four
      of these animals resumed reproductive activity, confirming that the contraceptive
      effect of the implants is reversible. Levonorgestrel implants therefore provide a
      highly effective, reversible and long-term method of contraception for tammar
      wallabies. This contraceptive system appears to offer a method of population
      control for the management of overabundant captive and selected wild populations
      of macropodid marsupials.

PMID- 11194563
TI  - Fetal organ growth in response to oesophageal infusion of amniotic fluid,
      colostrum, milk or gastrin-releasing peptide: a study in fetal sheep.
AB  - The hypothesis of the present study was that the infusion of the biological
      fluids to which the developing gut is normally exposed (i.e. amniotic fluid,
      colostrum, milk) and a single growth factor (gastrin-releasing peptide), which is
      found in high concentrations in fetal fluids and milk, could ameliorate the
      altered growth induced by the elimination of swallowed input secondary to
      ligation of the oesophagus. At 108-110 days of gestation the fetal oesophagus was
      ligated and a catheter inserted towards the stomach (32 fetuses). At 117-119 days
      of gestation saline (n = 5), amniotic fluid (n = 5), colostral whey (n = 5), milk
      whey (n = 5) or gastrin-releasing peptide (3.6 nmol day(-1), n = 6), was infused
      for 7 days (4 x 20 mL day(-1)), or no infusion was given (ligated group, n = 6).
      A further 15 fetuses were not ligated (normal group, n = 15). All fetuses had
      carotid artery and/or jugular vein catheters implanted. At 124-126 days of
      gestation the fetus was delivered and fetal body and organ weights recorded.
      Analysing the results by ANOVA, there were no effects of either ligation alone or
      infusion after ligation on fetal weight, crown-rump length, or weight relative to
      bodyweight of heart, adrenal, pancreas, large intestine and cecum. There were
      significant differences between the infusion groups for lungs, kidney, pancreas,
      total gut, abomasum, small intestine, spleen, chest and neck thymus, and
      mesenteric lymph nodes. Ligation alone significantly reduced small intestinal
      growth and increased kidney and spleen growth. Colostrum infusion enhanced growth
      of most organs. Gastrin-releasing peptide significantly increased growth of all
      the immune organs studied. It was concluded that at an age when premature
      delivery could be encountered, the fetal gut is capable of significant adaptive
      growth, to varying degrees, depending on the enteral diet. Growth effects in
      organs distant to the gut suggest that either gastrointestinal uptake and
      transport of growth factors or altered nutrient uptake and/or availability can
      affect the growth of other major fetal organs.

PMID- 11194564
TI  - Maternal copper supplementation protects the neonatal rat lung against the
      adverse effects of maternal nicotine exposure.
AB  - Maternal nicotine exposure interferes with the extracellular formation of the
      connective tissue framework of the neonatal lung, a process that is dependent on
      copper-dependent lysyl oxidase. It has been shown that, during the phase of lung
      development associated with alveolarization, maternal nicotine exposure resulted
      in a reduction in the copper content and thus conceivably in the activity of
      lysyl oxidase of the neonatal lung. Therefore the aims of this study were (a) to
      determine the effects of maternal nicotine exposure during gestation and
      lactation on neonatal lung development, and (b) to establish whether maternal
      copper supplementation during gestation and lactation prevented the effect of
      maternal nicotine exposure on neonatal lung development. Pregnant rats were
      randomly divided into four groups: the control group received saline; the second
      group received 1 mg nicotine (kg bodyweight)(-1) day(-1) subcutaneously; the
      third group received 1 mg copper (kg bodyweight)(-1) day(-1); and the fourth
      group received both nicotine and copper in the same quantities as the previous
      two groups. Lung tissue of 14- and 42-day-old rat pups were processed for light
      microscopy. Maternal nicotine exposure during gestation and lactation resulted in
      (a) decreased alveolar number, (b) reduced internal surface area and (c)
      increased alveolar volume. Copper supplementation during gestation and lactation
      prevented the adverse effects of maternal nicotine exposure during gestation and
      lactation on the development of the alveolar region of the rat lung.

PMID- 11194565
TI  - NMR-based screening in drug discovery.

PMID- 11194566
TI  - Biophysical and biochemical investigations of RNA catalysis in the hammerhead
      ribozyme.

PMID- 11194567
TI  - Recent advances in the understanding of membrane protein assembly and structure.

PMID- 11194568
TI  - Prion propagation and molecular chaperones.

PMID- 11194569
TI  - Physicians' legal duties regarding the use of genetic tests to predict and
      diagnose Alzheimer disease.

PMID- 11194570
TI  - The physician profile database. Publishing malpractice information on the
      Internet.

PMID- 11194571
TI  - Regulation of medical devices in the European Union.

PMID- 11194572
TI  - To know or not to know. Legal perspectives on genetic privacy and disclosure of
      an individual's genetic profile.

PMID- 11194573
TI  - Asymptomatic rise in transaminase levels: clinician's dilemma and patient's
      concern.

PMID- 11194574
TI  - Iatrogenic hepatotoxicity.

PMID- 11194575
TI  - Gastroenterology and the Internet.
AB  - BACKGROUND: The Internet has come to play a significant role in health care
      across the world. Simple specific how-to-use information about the Internet for
      Gastroenterologists is lacking in the literature. AIM: To explain the origin,
      functions, use and impact of the Internet and to provide a list of important web
      site addresses related to Gastroenterology. METHODS: We undertook a detailed scan
      of the Internet and identified a large number of web sites pertaining to
      Gastroenterology. The sites were then thoroughly searched to evaluate their
      potential usefulness to Gastroenterology clinicians and researchers. A list of
      web site addresses were then compiled according to specific sub-areas of
      Gastroenterology. CONCLUSION: This overview of Internet and compliation of
      important web site addresses is expected to stimulate and instruct
      Gastroenterologists in the use of the Net in health care delivery and research.
      The list of web sites according to subspecialities provided in this article is
      expected to facilitate their search.

PMID- 11194576
TI  - Portal system thrombosis: a new dimension of high altitude illnesses.

PMID- 11194577
TI  - Effect of Giardia lamblia on duodenal disaccharidase levels in humans.
AB  - The study was conducted to detect the effect of giardiasis on human
      disaccharidase levels. Forty patients attending the medical outpatient department
      of PGIMER, Chandigarh were enrolled. Twenty patients, positive for Giardia
      lamblia comprised the study group while 20 patients negative for Giardia lamblia
      were taken as controls. Upper gastrointestinal endoscopy was performed in all
      patients. Estimation of lactase, sucrase, maltase and trehalase was done in
      biopsies. Histopathological investigation was carried out in all biopsy specimens
      after Haematoxylin and Eosin staining. Complaints of pain abdomen and bloating
      occurred commonly in giardiasis. Four biopsy samples in study group showed mild
      increase in lymphomononuclear infiltrate. Giardia lamblia was detected in 7
      biopsies. Lactase levels were decreased significantly (p < 0.05) in giardiasis.
      Rest of the enzymes were comparable to the controls. No differences in the enzyme
      activities were observed between males and females in either group and with the
      duration of symptoms.

PMID- 11194578
TI  - Evaluation of garlic oil as a contact dissolution agent for gallstones:
      comparison with monooctanoin.
AB  - AIM: To find a better contact solvent to dissolve gallstones we studied invitro
      use of garlic oil and compared it with monooctanoin. METHODS: In the first stage
      gall stones obtained from patients after cholecystectomy were subjected to
      dissolution in different concentrations of garlic oil. Then the rate of
      dissolution of gall stones in garlic oil was compared to that in monooctanoin in
      stage II. Efficacy of various concentration of garlic oil and monoocatanoin in
      dissolving gallstones in artificial gall bladder and common bile duct models were
      compared in stage III. RESULTS: Garlic oil dissolved the cholesterol gall stones
      in proportion to the concentration used. The gall stone fragmentation was faster
      [6 hours V/s 36 hours] and more [88.30% V/s 71.01%] by garlic oil in comparison
      to monooctanoin in test tubes and even in artificial gallbladder and common bile
      duct models. CONCLUSIONS: Garlic oil is a better contact dissolving agent of
      gallstones than monooctanoin.

PMID- 11194579
TI  - Gastric tuberculosis presenting as non-healing ulcer: case report.
AB  - Tuberculous infection of the stomach is uncommon and the diagnosis is often
      missed due to its non-specific presentation. We report a case of gastric
      tuberculosis which presented as a non-healing gastric ulcer.

PMID- 11194580
TI  - Angiographic detection and embolization of a Dieulafoy's lesion.

PMID- 11194581
TI  - Non-traumatic tracheoesophageal fistula in an adult.

PMID- 11194582
TI  - Primary malignant melanoma of the oesophagus: case report and review.
AB  - Primary malignant melanoma of the oesophagus [PMME] is a rare tumour. Worldwide,
      less than 200 cases have been reported to date. We report here a 72 year-old
      Saudi male who presented with abdominal pain and anorexia. On endoscopy a dark
      lesion was found in the oesophagus. Its histopathological features were
      consistent with malignant melanoma. There were no other melanotic lesions
      elsewhere. PMME occurs most frequently in the 7th and 8th decades of life with a
      male predominance. It is an aggressive tumour with the majority of patients dying
      in less than 2 years due to metastases to vital organs. Surgery is the treatment
      of choice. However, radiation may be useful as adjuvant therapy.

PMID- 11194583
TI  - Diffuse hepatic hemangiomatosis: case report.
AB  - Hemangiomas of the liver are often incidental findings on routine abdominal
      ultrasonography. Majority are single and asymptomatic. We report a patient with
      diffuse hemangiomatosis of the liver who presented with thrombocytopenia and
      congestive cardiac failure.

PMID- 11194584
TI  - Spontaneous neonatal gall bladder perforation.
AB  - A full term neonate was operated for diaphragmatic eventration through the chest.
      Postoperatively the baby developed gastric outlet obstruction. Ultrasonography
      and barium meal examination were suggestive of extrinsic compression in the
      region of the pylorus. At laparotomy a gall bladder perforation was found
      producing a biloma just abve the pylorus. Drainage of the bilioma and temporary
      cholecystostomy cured the gastric outlet obstruction.

PMID- 11194585
TI  - Infantile gastric teratoma.
AB  - Gastric teratoma is a rare tumour, comprising less than 1% of all teratomas in
      children. A 5 month old male child, who presented with an abdominal mass, fever
      and vomiting was diagnosed to have a gastric teratoma on ultrasonography, CT scan
      and serum alpha-feto protein. Complete excision of the tumour was performed. No
      chemotherapy was given. The histological examination revealed immature teratoma.
      The child is well 1 year after surgery.

PMID- 11194586
TI  - Hepatocyte isolation and transplantation in syngenic rats.
AB  - Refinement of techniques to isolate viable hepatocytes began in the late 1960's.
      It was established that perfusion of the intact liver as opposed to incubation of
      liver slices or chopped tissue increased the yield of cells. The present study
      aims to establish a simple, two-step, collagenase digestion method for hepatocyte
      isolation. A single inbred Fisher rat was used for hepatocyte isolation. The
      liver was perfused in-situ with perfusion buffer containing ethylene glycol bis
      N, N1, tetra acetic acid (EGTA), followed by the collagenase buffer. The liver
      was excised and gently minced. The tissue was resuspended in the collagenase
      buffer to complete dissociation. The cell suspension obtained was washed,
      centrifuged and filtered to complete the isolation procedure. The trypan blue
      exclusion test showed 80-85% cell viability. The isolated cells were transplanted
      into the splenic parenchyma of syngenic rats. Survival of the transplanted
      hepatocytes was confirmed by histological examination at the end of 90 days. This
      two step technique of in-situ liver perfusion gives a high yield of viable
      hepatocytes which show long term survival after transplantation.

PMID- 11194587
TI  - Review of a hospital experience of enterocutaneous fistula.
AB  - A retrospective analysis of records of 46 patients with enterocutaneous fistulas
      treated over a period of three and half years has been done. There were 28 males
      and 18 females, with 80% of patients being in age group of 25-35 years. Forty
      five patients were postoperative and in one patient fistula occurred
      spontaneously. Tuberculosis was the most common underlying pathology, seen in
      32.6% followed by enteric fever in 23.9%. The small intestine was the most common
      site for the origin of fistula, seen in 34 patients (73.9%). There were 22
      patients with high output fistula and 24 with low output. For high output
      fistulas, enteric fever was the most common cause (45%) and ileum was the most
      site of origin (82%). Low output fistulas were mainly of tubercular aetiology
      (62%) and involved ileum in 62% of cases. Nineteen out of 22 patients of high
      output fistulae had sepsis. Fourteen of these had generalised peritonitis (63%)
      and 5 had localized intra-abdominal collections (27%). Spontaneous closure
      occurred in 45.6% of patients on conservative management and 37% patients
      underwent surgical intervention. The overall mortality was 30.4%. High output
      fistulae had mortality figure of 54.5% and low output fistulas 8.4%. Mortality in
      relation to sepsis was 63%. No patient with sepsis and without surgical
      intervention survived. Following surgical intervention mortality was 50% in
      patients who showed evidence of sepsis. Early and effective control of sepsis is
      the most important factor determining outcome in patients of enterocutaneous
      fistula.

PMID- 11194588
TI  - Ruptured liver abscess with fulminant amoebic colitis: case report with review.
AB  - Amoebic liver abscess is the commonest extra intestinal manifestation of
      amoebiasis. Intraperitoneal rupture of liver abscess and fulminant necrotizing
      amoebic colitis are rare occurrences which complicate a severe form of invasive
      disease caused by Entamoeba histolytica. These complications are associated with
      a high morbidity and mortality. Synchronous pathological lesions in colon and
      liver are rare. Still rare is the occurrence of complicated colonic and hepatic
      invasive amoebiasis presenting as an acute abdomen. One such presentation of
      ruptured liver abscess and necrotizing amoebic colitis in a 70 year old male
      which was successfully managed is being reported.

PMID- 11194589
TI  - Oesophageal leiomyoma presenting as a mediastinal mass.
AB  - A 28 year old male presented with complaints of retrosternal pain, discomfort and
      dysphagia of 4 years duration. Barium swallow and oesophagoscopy were suggestive
      of extrinsic compression of thoracic oesophagus. CT scan of chest was suggestive
      of a large mediastinal lymph node mass. Thoracotomy and open biopsy showed a
      benign mesenchymal tumor on frozen section. A transthoracic oesophagectomy with
      gastric pull up and cervical oesophago-gastric anastomosis was performed. The
      postoperative course was uneventful and the patient discharged on the tenth
      postoperative day.

PMID- 11194590
TI  - Primary omental torsion: case report.
AB  - Primary omental torsion is a rare condition. It is confused with acute
      appendicitis. Presence of a normal appendix at surgery should raise the suspicion
      of omental torsion.

PMID- 11194591
TI  - Post cholecystectomy Mirizzi syndrome?

PMID- 11194592
TI  - Pacing in heart failure: improved ventricular interaction in diastole rather than
      systolic re-synchronization.
AB  - AIMS: To determine the mechanism by which left ventricular and biventricular
      pacing works. BACKGROUND: Pacing for congestive heart failure patients is
      employed in those with left bundle branch block on the basis that it will improve
      discoordinated contraction; however, the response is unpredictable. The authors
      propose that the mechanism of benefit is rather related to improvement of
      ventricular interaction in diastole (VID). VID is found in patients with a high
      left ventricular end-diastolic pressure (> 15 mmHg). Left ventricular pacing in
      these patients will delay right ventricular filling and allow greater left
      ventricular filling before the onset of VID. METHODS: The study group consisted
      of 18 congestive heart failure patients with an ejection fraction < 30% and with
      no more than Grade 1 mitral regurgitation. Group I comprised 10 patients with
      pulmonary capillary wedge pressure > 15 mmHg, four patients had a normal QRS
      duration and six had left bundle branch block. Group II comprised eight patients
      with pulmonary capillary wedge pressure < 15 mmHg, of whom five had a normal QRS
      duration. Haemodynamics were measured at baseline and during VDD pacing from
      either the left ventricle or right ventricle. RESULTS: The ratio of stroke
      volume/pulmonary capillary wedge pressure was calculated as an index of the
      relationship between left ventricular end-diastolic pressure and contractile
      function. This ratio was lower in group I than in group II patients (P = 0.005).
      In group I, haemodynamics were improved with left ventricular pacing (stroke
      volume/pulmonary capillary wedge pressure increased from 2.2 +/- 0.9 to 4.4 +/-
      3.6, P = 0.03). In group II there was no response to either left ventricular or
      right ventricular pacing. The improvement with left ventricular pacing was
      unrelated to QRS duration (r = 0.09). CONCLUSIONS: Left ventricular pacing
      acutely benefits congestive heart failure patients with pulmonary capillary wedge
      pressure > 15 mmHg irrespective of left bundle branch block. The present data
      suggest that the mechanism of response may be an improvement in left ventricular
      filling rather than ventricular systolic re-synchronization.

PMID- 11194593
TI  - Rate dependence of the effect of antiarrhythmic drugs delaying cardiac
      repolarization: an overview.
AB  - Prolongation of the cardiac action potential and refractoriness (class III
      effect) is a potentially beneficial electrophysiological mechanism of action.
      However, this effect may be diminished or eliminated at rapid heart rates, so
      called 'reverse rate dependence' of prolongation of repolarization. Action
      potential duration normally shortens as heart rate increases, due to increases in
      outward repolarizing currents, and/or decreases in inward depolarizing currents.
      The assessment of the effect of drugs on action potential duration is complicated
      by inter-species differences in ionic currents mediating repolarization,
      heterogeneity within the heart in repolarizing currents, and differential effect
      of drugs in different species, during differing experimental conditions, and at
      different rates of stimulation. In general, most drugs which predominantly block
      the IKr repolarizing current exhibit reverse rate-dependent effects on cardiac
      repolarization. Drugs or combinations of drugs which produce multiple ionic
      channel blocks and possibly those which block the IKs current, may be less prone
      to this potentially undesirable effect.

PMID- 11194594
TI  - Efficacy and tolerability of continuous overdrive atrial pacing in atrial
      fibrillation.
AB  - Overdrive right atrial pacing has been used to prevent atrial fibrillation, but
      its efficacy in atrial fibrillation prevention and the patient tolerability and
      quality of life during high rate pacing remain uncertain. The objective of this
      study was to test the effects of a consistent atrial pacing algorithm that
      automatically paced the atrium at 30 ms shorter than the sinus P-P interval for
      atrial fibrillation prevention. Fifteen patients with sick sinus syndrome
      implanted with a Thera DR (model 7940 or 7960, Medtronic Inc.) were randomly
      programmed to rate adaptive dual chamber pacing (DDDR) or DDDR + consistent
      atrial pacing mode, each for an 8-week study period. The efficacy of consistent
      atrial pacing was assessed by the number of automatic mode switching and the
      number of premature atrial complexes. Symptoms and quality of life were assessed
      by the SF-36 quality of life questionnaire and an atrial fibrillation symptom
      checklist. The percentage of atrial pacing increased from 57 +/- 32% to 86 +/-
      28%. Overall, there was no significant difference in the number of automatic mode
      switching episodes between DDDR and DDDR + consistent atrial pacing (47 +/- 90 vs
      42 +/- 87, P > 0.05), but a significant reduction in premature atrial complexes
      by 74.7% (P < 0.001). There was no undue increase in atrial rate by the DDDR +
      consistent atrial pacing mode versus DDDR (63 +/- 13 vs 70 +/- 7 bpm). There was
      no significant difference in quality of life scores and symptom severity on
      frequency between the two modes of pacing, but a trend towards a lower frequency
      of symptoms in the DDDR + consistent atrial pacing mode compared with baseline
      (29.5 +/- 10.2 vs 25.1 +/- 9.7, P = 0.07). An algorithm that provides consistent
      atrial overdrive pacing can suppress atrial fibrillation triggering premature
      atrial complexes without the need to increase the overall atrial rate compared
      with conventional pacing. The algorithm appears to be well-tolerated, but further
      studies are needed to address the clinical impact of this atrial fibrillation
      prevention algorithm.

PMID- 11194595
TI  - New onset atrial flutter termination by overdrive transoesophageal pacing:
      effects of different protocols of stimulation.
AB  - AIM: We evaluated the effect of different stimulation protocols on atrial flutter
      interruption by transoesophageal pacing. METHODS AND RESULTS: Eighty patients
      with new onset atrial flutter were randomized into four groups. Pacing was
      attempted under the following conditions: with short bursts (5 s), without
      treatment (group A) and after oral administration of propafenone 600 mg (group
      B); with prolonged bursts (30 s), without treatment (group C) and after oral
      administration of propafenone 600 mg (group D). Pacing interrupted atrial flutter
      in 20% of patients in A, 55% in B, 50% in C and 85% in D. The use of longer
      bursts gave better results both in patients without treatment (P < 0.05: C vs A)
      and in patients with propafenone (P < 0.05: D vs B). Comparing groups with the
      same stimulation protocol, we observed a better response in patients treated with
      propafenone (P < 0.05: B vs A and D vs C). In the groups without treatment the
      use of shorter bursts was associated with a lower induction of stable atrial
      fibrillation (three vs nine episodes), in the groups on propafenone no
      differences were observed (one vs one episode). CONCLUSIONS: We conclude that the
      association of propafenone with long bursts gives the best result for
      interruption of new onset atrial flutter by transoesophageal pacing.

PMID- 11194596
TI  - Long-term evaluation of autonomic tone in patients below 50 years of age with
      unexplained cerebral infarction: relation to atrial vulnerability.
AB  - Preliminary studies have described, in young patients with unexplained cerebral
      infarction, electrophysiological abnormalities similar to those observed in
      paroxysmal atrial fibrillation. Moreover, in young adults with 'normal' hearts,
      increased susceptibility to paroxysmal atrial fibrillation with autonomic
      abnormalities as assessed by heart rate variability analysis have been reported.
      METHODS: The long-term time and frequency domain measures of heart rate
      variability were analysed prospectively from 24-h Holter ECG recordings in 25
      patients (39 +/- 8 years) with unexplained cerebral infarction, and in 25 age-,
      sex- and cigarette-smoking-matched healthy control subjects. The day following
      the Holter ECG recordings, 9 +/- 4 months (mean) after the stroke, stroke
      patients underwent an electrophysiological study in order to analyse the
      electrical characteristics of their right atria and also to determine their
      vulnerability to atrial fibrillation. The correlations between autonomic tone
      parameters and electrophysiological findings were therefore assessed with linear
      regression analyses. RESULTS: All the measured components of heart rate
      variability either in time (SDNN, pNN50, SDANN/5, rMSSD) or frequency domains
      (total power, low-frequency, high-frequency power, low-frequency/high-frequency
      power ratio) were similar between stroke patients and controls. During
      electrophysiological study, atrial fibrillation was induced in 80% of stroke
      patients. Among these patients, atrial refractory periods were significantly
      shorter, local electrograms were longer, and latent atrial vulnerability index
      was markedly decreased when compared with patients having no inducible atrial
      fibrillation. Concerning heart rate variability analysis, no difference was found
      between patients with induced atrial fibrillation when compared with a matched
      subgroup of healthy control subjects. Furthermore, there was no statistically
      linear correlation between any of the measured autonomic tone parameters and any
      of the discovered atrial vulnerability markers. CONCLUSIONS: The long-term
      autonomic tone parameters of young patients presenting with a history of
      unexplained cerebral infarction are similar to those of healthy control subjects
      and are not correlated with atrial vulnerability parameters or atrial
      fibrillation inducibility.

PMID- 11194597
TI  - Electrophysiological determinants of atrial fibrillation in sinus node
      dysfunction despite atrial pacing.
AB  - AIMS: The effectiveness of atrial pacing in reducing the incidence of atrial
      fibrillation in patients with sinus node dysfunction is incomplete, and the
      correlation between electrophysiological atrial properties and the effect of
      permanent atrial pacing has been poorly investigated. Accordingly, the aim of the
      present study was to correlate electrophysiological data, in terms of atrial
      refractoriness, conduction parameters, and propensity to atrial fibrillation
      induction, and the likelihood of atrial fibrillation after DDD device
      implantation. METHODS AND RESULTS: The authors reviewed electrophysiological data
      of 41 patients with sinus node dysfunction (mean age 70 +/- 8 years, who were
      investigated free of anti-arrhythmic treatments before pacemaker implantation. At
      a drive cycle length of 600 ms, effective and functional refractory periods, S1
      A1 and S2-A2 latency, A1 and A2 width, and latent vulnerability index (effective
      refractory period [ERP] A2), were measured. Atrial fibrillation induction was
      tested with up to three extrastimuli in 34 patients. Induction of sustained
      atrial fibrillation (> 1 min) was considered as the end-point. P-wave duration on
      the surface ECG in lead II/V1 was also measured. Minimal atrial rate was
      programmed between 60 and 75 bpm (mean: 64 +/- 4 bpm). After implantation, the
      patients were followed-up for 28 +/- 17 months, and ECG-documented occurrence of
      atrial fibrillation was determined. Electrophysiological characteristics of
      patients with (n = 12) or without (n = 29) paroxysmal atrial fibrillation before
      implantation were similar. When comparing patients with (n = 11) or without (n =
      30) post-pacing atrial fibrillation occurrence, no differences were found in age,
      underlying heart disease, left atrial size, minimal pacing rate, and follow-up
      duration. Additionally, between the two former groups, there was no significant
      difference in terms of effective refractory periods (233 +/- 47 ms vs 239 +/- 25
      ms), functional refractory periods (280 +/- 48 ms vs 272 +/- 21 ms), S1-A1 (44 +/
      20 ms vs 37 +/- 13 ms) and S2-A2 latency (77 +/- 28 ms vs 66 +/- 22 ms), and A1
      duration (60 +/- 23 ms vs 53 +/- 16 ms). In contrast, in patients with post
      pacing atrial fibrillation occurrence, the P wave was more prolonged (116 +/- 22
      ms vs 98 +/- 13 ms; P < 0.01), A2 was longer (116 +/- 41 ms vs 87 +/- 27 ms; P <
      0.01), effective refractory periods/A2 was lower (2.1 +/- 0.4 cm vs 3.1 +/- 1.4
      cm; P < 0.05), and rate of atrial fibrillation induction was higher (8/11
      patients vs 8/23 patients; P < 0.05). Electrophysiological characteristics of
      patients free of post-pacing atrial fibrillation with associated (n = 6) or
      unassociated (n = 24) paroxysmal atrial fibrillation history before implantation
      were quite similar. In patients with post-pacing atrial fibrillation with
      associated (n = 6) or unassociated atrial fibrillation history (n = 5) before
      implantation, effective refractory periods was statistically different (207 +/-
      23 ms vs 264 +/- 46 ms; P < 0.05). Values of effective refractory periods < 220
      ms were significantly more frequent in patients with post-pacing atrial
      fibrillation than in patients without (4/11 patients vs 2/30 patients; P < 0.05).
      When comparing patients with post-pacing atrial fibrillation with effective
      refractory periods > or = 220 ms (n = 7) and < 220 ms (n = 4), A2 duration was
      remarkably prolonged (145 +/- 42 ms vs 90 +/- 11 ms; P < 0.05) in those with
      effective refractory periods > or = 220 ms. By contrast, between the two groups,
      effective refractory periods/A2 were identical (2.08 +/- 0.6 cm vs 2.15 +/- 0.3
      cm; P = n.s.). CONCLUSION: Prolonged atrial refractoriness, lesser degrees of
      conduction disturbance and a lower rate of atrial fibrillation induction seem to
      be predictive of stable sinus rhythm. In contrast, patients with persistence of
      atrial fibrillation despite pacing have a more abnormal and inhomogeneous atrial
      substrate, as well as a higher rate of atrial fibrillation induction. Prolonged P
      wave, shortened refractoriness, or remarkably abnormal conduction disturbances in
      the presence of prolonged refractoriness limit the effectiveness of standard
      atrial pacing in atrial fibrillation prevention. Identification of predictive
      criteria of failure of single-site atrial pacing may be used to consider dual
      site atrial pacing in such patients with sinus node dysfunction.

PMID- 11194598
TI  - Recording monophasic action potentials using a platinum-electrode ablation
      catheter.
AB  - AIMS: The monophasic action potential (MAP) is conventionally recorded using Ag
      AgCl electrodes which are not suitable for delivering radiofrequency currents. To
      be able to use the sharp MAP upstroke for identifying the local activation, as a
      step towards the development of a MAP-guided catheter ablation technique, the
      possibility of recording MAP via platinum electrodes of an ordinary ablation
      catheter was explored. METHODS AND RESULTS: One hundred and forty-two MAP
      recordings from the endocardium were obtained via an ablation catheter in 40
      patients undergoing electrophysiological study/catheter ablation. During sinus
      rhythm and pacing, 90% of the ventricular and 100% of the atrial MAPs had stable
      baselines. The amplitudes were 13 +/- 4.2 mV for ventricular and 2.4 +/- 0.8 mV
      for atrial MAPs. During mapping and ablation, MAPs and uni- and bipolar
      electrograms were recorded simultaneously using the same tip electrode in eight
      patients. The MAPs provided more distinct local activation than the electrograms.
      During 17 MAP recordings, additional MAPs were recorded simultaneously using an
      Ag-AgCl electrode catheter in the immediate vicinity of the ablation catheter.
      The MAPs taken with the ablation catheter had characteristics consistent with
      those taken with the Ag-AgCl catheter. CONCLUSIONS: (1) Platinum electrodes can
      be used for timely recording of MAPs in patients. (2) It is feasible to record
      MAPs and deliver radiofrequency currents via the same platinum-tip electrode.
      These findings suggest that MAP-guided catheter ablation is technically possible.

PMID- 11194599
TI  - Dose-related cardiac electrophysiological effects of intravenous magnesium. A
      double-blind placebo-controlled dose-response study in patients with paroxysmal
      supraventricular tachycardia.
AB  - AIMS: The role of magnesium as an antiarrhythmic drug is yet not conclusive.
      Therefore, we performed a double-blind, randomized, placebo-controlled dose
      response study of cardiac electrophysiological effects of intravenous magnesium.
      METHODS AND RESULTS: Thirty-six patients undergoing an electrophysiological
      evaluation for paroxysmal supraventricular tachycardia were randomized to one of
      the following dosages of intravenous magnesium (0, 5, 10 or 20 mmol).
      Conventional electrophysiological variables for sinus node function, atrial,
      atrioventricular node and ventricular conduction and refractoriness were measured
      before and after magnesium administration. Prolongation of the atrial-His
      interval was found at 5 mmol of magnesium compared with placebo and no further
      prolongation was observed at higher doses (-3 +/- 8, 11 +/- 9, 7 +/- 15, 11 +/-
      16, for the dosages of 0, 5, 10 and 20 mmol of magnesium, respectively, P <
      0.05). Measures of sinus node function, intra-atrial conduction and conduction
      through the Purkinje system were unaffected by magnesium. Male gender was
      associated with prolongation in atrial effective refractory period, in contrast
      to shortening in females: 2 +/- 43, 35 +/- 44, 36 +/- 33, 13 +/- 12 ms for males
      and 3 +/- 6, -12 +/- 11, -13 +/- 12, 0 +/- 23 ms for females, respectively (P <
      0.001). CONCLUSION: Atrioventricular node conduction was prolonged by 5 mmol
      intravenous magnesium and no further prolongation was observed at higher dosages.
      At dosages of 5 and 10 mmol magnesium the atrial effective refractoriness was
      prolonged in males and shortened in females.

PMID- 11194600
TI  - Ventricular fibrillation induced by rapid atrial rates in patients with
      hypertrophic cardiomyopathy.
AB  - AIMS: To describe the mechanisms of induction of ventricular fibrillation (VF) by
      rapid atrial rates in patients with hypertrophic cardiomyopathy (HCM). METHODS:
      Electrophysiological studies, management and follow-up in three patients with HCM
      with VF induced by atrial pacing. RESULTS: In one patient, spontaneous sinus
      tachycardia triggered VF. In another patient, VF occurred after verapamil
      infusion during rapid atrial fibrillation, and in the remaining patient there was
      no clinical VF. In all three patients, short runs of atrial pacing (cycle length
      272-380 ms) induced VF, and QRS widening preceded fibrillation in all patients.
      Marked ventricular electrogram fragmentation was documented in one patient during
      atrial pacing and in another patient during late ventricular extra-stimuli.
      Hypotension was associated with sinus tachycardia in one patient. The two
      patients developing clinical VF underwent atrioventricular (AV) junctional
      ablation; a ventricular defibrillator was implanted in one, and a mode-switching
      dual-chamber pacemaker in the other. No arrhythmic events occurred during 34- and
      35-month follow-up, respectively. In the other patient, postatrial fibrillation
      pauses caused syncope, and he is asymptomatic 52 months after implantation of a
      dual-chamber pacemaker. CONCLUSIONS: Rapid atrial rates can trigger VF in some
      patients with HCM, probably through a combination of electrophysiological and
      ischaemic mechanisms. AV junctional ablation may prevent VF in selected cases.

PMID- 11194601
TI  - The effects of orthostasis on the ventricular-evoked response.
AB  - AIMS: The effects of orthostasis on the morphology of the ventricular-evoked
      response were investigated. METHODS AND RESULTS: Seven patients (five females;
      74.9 +/- 4.6 years) with second- or third-degree atrioventricular block received
      DDD pacemakers Physios CTM 01 with fractal-coated ventricular leads (both
      Biotronik, Germany). At their 3-month follow-up sessions, these patients
      underwent tilt-table tests. Heart rate, mean arterial blood pressure and
      ventricular-evoked response were measured continuously. Signals were averaged
      over 15 consecutive beats. Coefficients of correlation between selected
      ventricular-evoked response parameters and heart rate or mean arterial blood
      pressure were calculated. Tilt upwards affected heart rate, mean arterial blood
      pressure and ventricular-evoked response extremes showed non-uniform, patient
      specific changes that were not related directly to other parameters. Heart rates
      significantly increased in six patients following tilt upwards. For all patients,
      ventricular-evoked response plateau amplitudes immediately increased with tilt
      upwards. Furthermore, repolarization times correlated with changes in heart rates
      (r = -0.78). CONCLUSIONS: Monitoring of the ventricular-evoked response during
      tilt-table testing revealed that the plateau amplitude of the ventricular-evoked
      response depends on the patient's position; ventricular-evoked response increased
      in the upright position and decreased in the supine position. Furthermore,
      repolarization time and heart rate correlated inversely; higher heart rates
      resulted in a shortening of the ventricular-evoked response.

PMID- 11194602
TI  - 'The Italian Protocol': a simplified head-up tilt testing potentiated with oral
      nitroglycerin to assess patients with unexplained syncope.
AB  - Head-up tilt testing potentiated by sublingual nitroglycerin (NTG), advocated by
      an Italian group, is a simple and safe but still not a standardized, diagnostic
      tool for the investigation of syncope. In fact, owing to its rapid spread, the
      original protocol received, often arbitrarily, many subsequent modifications. We
      now define the best methodology of the test on strictly evidence-based criteria
      as: stabilization phase of 5 min in the supine position; passive phase of 20 min
      at a tilt angle of 60 degrees; provocation phase of further 15 min after 400
      micrograms NTG sublingual spray. Test interruption is made when the protocol is
      completed in the absence of symptoms, or there is occurrence of syncope, or
      occurrence of progressive (> 5 min) orthostatic hypotension. We intend that this
      protocol, named by us as 'The Italian Protocol', will be accepted as the standard
      methodology of the tilt test potentiated by sublingual nitrates.

PMID- 11194603
TI  - Venous pooling during nitrate-stimulated tilt testing in patients with vasovagal
      syncope.
AB  - AIMS: To investigate the importance of venous pooling and variation in venous
      tone during nitrate-stimulated tilt testing in patients. METHODS: Ten patients
      with a history of vasovagal syncope underwent an upright tilt test after an
      injection of 99mTc-labelled albumin. A gamma camera was positioned at the level
      of the lower legs. The patients were tilted to 90 degrees for 30 min or until
      symptoms developed. In those subjects who did not show any symptoms before the
      end of the 30-min period, isosorbide dinitrate (ISDN) 5 mg was given sublingually
      and the test was prolonged for a maximum of 15 min. RESULTS: Nine of 10 patients
      needed nitrate stimulation to develop symptoms, and one patient remained symptom
      free following ISDN administration. Measurement of radioactivity revealed no
      significant increase in calf volume after nitrate stimulation (the mean volume
      increase was 77% before ISDN stimulation and a further 0.9% afterwards).
      CONCLUSIONS: The higher sensitivity for vasovagal syncope during upright tilt
      testing after administration of sublingual ISDN is not due to an increase in
      venous pooling in the lower extremities.

PMID- 11194604
TI  - Prevention of recurrent ventricular fibrillation by ventricular rate
      stabilization.
AB  - This report describes a post-infarct patient with recurrent ventricular
      fibrillation in the absence of acute ischaemia, in whom arrhythmia recurrences
      could be prevented by ventricular rate stabilization of a third-generation
      cardioverter defibrillator. Review of the literature and clinical implications
      are discussed.

PMID- 11194605
TI  - Ablation of idiopathic ventricular tachycardia by bipolar radiofrequency current
      application between the left aortic sinus and the left ventricle.
AB  - BACKGROUND: Failure to ablate idiopathic ventricular outflow tract tachycardia by
      radiofrequency current is not uncommon and suggests that non-standard approaches
      may be required to map and suppress idiopathic ventricular tachyarrhythmias in
      some patients. METHODS AND RESULTS: Left and right ventricular activation and
      pace mapping proved inadequate for radiofrequency application in a patient with
      idiopathic ventricular outflow tract tachycardia. Presystolic activity was
      recorded at the left aortic sinus of Valsalva, and the QRS complex recorded at
      this location during pacing showed few differences compared with that recorded
      during tachycardia. Radiofrequency current application at this site transiently
      suppressed the tachycardia. Following new mapping of the left ventricle outflow
      tract, radiofrequency application just below the aortic valve in close proximity
      to the previous aortic application site transiently abolished the arrhythmia.
      Finally, bipolar radiofrequency application between the distal electrode of the
      aortic catheter and the distal electrode of a second catheter placed in the left
      ventricular subaortic area permanently suppressed the tachycardia. CONCLUSION:
      Bipolar radiofrequency application between the aortic sinus of Valsalva and the
      left ventricle could be an alternative approach in occasional patients with
      idiopathic ventricular outflow tract tachycardia resistant to conventional left
      ventricular and aortic root unipolar radiofrequency application.

PMID- 11194606
TI  - 2000, Future of Arrhythmology: Lessons from the Past, Promises for Tomorrow.
      Maastricht, The Netheralands, 15-18 April 2000. Abstracts.

PMID- 11194607
TI  - Anterior cruciate ligament reconstruction with the Leeds-Keio artificial
      ligament.
AB  - The Leeds-Keio (L-K) artificial ligament, developed for knee ligament
      reconstruction, is made of polyester with a maximum tensile strength of 2200 N.
      This implant works not only as a ligament but also as a scaffold onto which
      natural tissue grows from synovium. In an animal experiment, each strand of the L
      K ligament was covered with new tissue by 2-3 weeks after anterior cruciate
      ligament reconstruction. Eight weeks postoperatively, abundant fibrous tissue
      with extensive vascularity covered the implant, which was still histologically
      immature. After 16 weeks, vascularization and tissue induction began to subside,
      and histologic analysis showed dense fibers running longitudinally and parallel.
      By 36 weeks, the new ligament looked like a natural anterior cruciate ligament,
      although histologically more cells could be seen than in the natural ligament.
      This maturation was observed only when the substitute was implanted under good
      tension. Clinically, the surgical procedure has been improved over the past 10
      years, to the current practice in which the tape-in-tube double L-K ligament
      employs a small piece of autogenous tissue to promote early tissue induction and
      maturation. Using this practice (n = 135), more than 85% of the patients were
      satisfied subjectively, objectively, and arthroscopically at the 5-year
      postoperative FU period. Few patients had joint effusion postoperatively.
      Sacrifice of autogenous tissue is minimal. The patient can return to activities
      of daily living within 2 weeks, and more than 50% of them to sports within 10
      weeks, and the new ligament is expected to keep its function for a long period as
      ingrowth completes the structure biologically.

PMID- 11194608
TI  - Clinical application of artificial ligament for ankle instability--long-term
      follow-up.
AB  - We have applied a reconstructive operation to patients with injury of the lateral
      ligament in the ankle joint using an artificial ligament made of polyester (Leeds
      Keio) since 1985. The operation was performed on 451 feet of 436 patients.
      Average follow-up period was 5 years and 8 months. Talar tilt and anterior drawer
      translation before and after the operation were improved from 16 degrees to 4
      degrees and from 11 mm to 4 mm, respectively. In this study, which has followed
      the same patients over an extended period, there were no cases with a decrease in
      the range of motion of the joint, with further development of osteoarthritis, or
      with a poorer result than those observed in our earlier study, which reported a
      short-term follow-up of the same patients. It may therefore be concluded that
      this reconstructive procedure of the lateral ligament of the ankle joint, using
      the artificial ligament, is also excellent after long-term follow-up.

PMID- 11194609
TI  - Long-term results of anterior cruciate ligament reconstruction using
      semitendinosus and gracilis tendons with Kennedy ligament augmentation device
      compared with patellar tendon autografts.
AB  - ACL reconstructions were postoperatively evaluated in 102 patients who underwent
      surgery using an arthroscopically assisted double-incision technique.
      Augmentation of the distally based semitendinosus and gracilis tendons was done
      either with the Kennedy ligament augmentation device (LAD) (Group 1 patients,
      mean follow-up of 108 months) or bone-patellar-tendon-bone graft (Group 2
      patients, mean follow-up of 109 months). At follow-up, serial KT-1000
      measurements showed < or = 5 mm side-to-side differences in 70% of Group 1 and
      90% of Group 2 patients. No differences were found among patients regarding
      postreconstruction complications such as loss in motion range, patellofemoral
      crepitus, osteoarthritis, and muscle disfunction.

PMID- 11194610
TI  - Follow-up study of Gore-Tex artificial ligament--special emphasis on tunnel
      osteolysis.
AB  - The Gore-Tex anterior cruciate ligament has been implanted in 123 patients at our
      institutions between 1984 and 1993. The Gore-Tex ligaments were totally ruptured
      in 26 cases. In the remaining 97 cases, 80 were followed up 5-11 years after
      operation. Graft loosening occurred in half of the cases, and osteoarthritic
      change was developed in 62% of the cases. Moreover, tibial and tunnel osteolysis
      was observed in most of the cases. Judging from these follow-up results, the Gore
      Tex ligament should not be used for anterior cruciate ligament reconstruction.

PMID- 11194611
TI  - Tissue expander: histological and histochemical study 6 months after transplant-
      our experience.
AB  - Implanting an expander in the subcutaneous layer causes gradual expansion and
      provides additional tissue for reconstruction of tissular defects. The force
      applied remodels the connective tissue and modifies dermis contractibility in
      additional tissue. Other authors confirm that parameters such as mitosis and
      hyaluronan influence the system in the tissue regeneration processes. We studied
      histochemical and morphological variations of tissue expanders before and 6
      months after transplant. Our histochemical data do not show any changes in dermis
      glycosaminoglycans of the expanded and transplant-expanded skin when compared to
      controls. Morphological data demonstrate reorganization of connective fibers and
      disappearance of the papillar layer. The latter is not yet formed in the expanded
      skin 6 months after transplant. This suggests that a long time is required for
      biological reconstruction of epidermal-dermal interactions after transplant.

PMID- 11194612
TI  - Biomechanical performance of silicone and latex external condom catheters.
AB  - Standard in vivo biomechanical performance tests and a pilot clinical study of
      latex external condom catheters (ECCs) and silicone ECCs demonstrated the
      superior performance of the silicone ECC over that of the latex ECC. The silicone
      ECC has a self-adhesive that binds more securely to human skin than the self
      adhesive of latex ECC. In addition, the moisture vapor transmission through
      silicone is significantly greater than through latex. The aggressive self
      adhesive of the silicone ECC significantly reduced ECC catheter pop-off compared
      to that of latex ECC. Silicone ECC removal can be facilitated by the application
      of a warm, wet cloth to the exterior surface of the silicone ECC, which
      significantly reduces its self-adhesive force. Constant, gentle traction is then
      applied to the silicone catheter outlet end to achieve atraumatic silicone ECC
      removal. On the basis of the results of these standardized tests and pilot study,
      the silicone ECC is recommended for incontinent men without obstructive uropathy.

PMID- 11194613
TI  - Routine practices and additional precautions for preventing the transmission of
      infection in health care.

PMID- 11194614
TI  - Infection prevention and control practices for personal services: tattoing,
      ear/body piercing, and electrolysis.

PMID- 11194615
TI  - Effect of seated posture on interface pressure in children who are able-bodied
      and who have myelomeningocele.
AB  - PURPOSE: The objective of this study was to investigate the relationship between
      sitting position and interface pressure distribution in seated children. METHOD:
      Fifteen able-bodied children and 15 children with myelomeningocele complete
      paraplegia, aged 7 to 18 years were included in the study. The body-seat
      interface pressure was measured with the QA pressure measurement system. Four
      sitting positions typically used to reduce body-seat interface pressure position
      (recline, tilt, combined and lean forward) were compared to a neutral position.
      RESULTS: Test/re-test Pearson correlation coefficients were greater than 0.94 for
      maximum pressure and greater than 0.88 for mean pressure at all test positions (p
      < 0.0001) and, for the risk area (defined as the percentage of sensors which
      recorded pressures greater than 40 mm Hg.) varied from 0.62 to 0.85 (p < 0.0005).
      Maximum pressures for the myelomeningocele group were significantly higher than
      those recorded for able-bodied subjects in the neutral, combined and lean forward
      positions (p < 0.001). For the able-bodied subjects, maximum pressures at the
      combined (p < 0.001), tilt (p < 0.05) and lean forward (p < 0.0001) positions
      were significantly lower than those measured at the neutral position. For the
      myelomeningocele subjects, maximum pressure at all tested positions was
      significantly lower than at the neutral position (p < 0.05). CONCLUSIONS: The
      results point to the importance of measuring body-seat interface pressure for
      each wheelchair user and of using the information to customize wheelchair
      utilization.

PMID- 11194617
TI  - How does spinal cord injury affect marital relationship? A story from both sides
      of the couple.
AB  - PURPOSE: To explore the impact of spinal cord injury (SCI) upon the family and
      marital relationship in Hong Kong. METHOD: Semi-structured interviews were
      conducted on 66 persons with SCI and 40 spouses. Qualitative information on
      family and marital relationships, life satisfaction, social functioning and
      leisure activities was transcribed and analysed. RESULTS AND CONCLUSION: It was
      found that the impact of the SCI was manifested in different but interrelated
      aspects onto the individuals and their spouses. However, many of the problems
      were due to the lack of communication between them. Rehabilitation professionals
      should then treat the couple as a single unit in order to facilitate mutual
      understanding and get rid of any distorted perception.

PMID- 11194616
TI  - A comparison of chronic pain patients and controls on traumatic events in
      childhood.
AB  - PURPOSE: The purpose was to examine the incidence of traumatic events in
      childhood, such as sexual and physical abuse, in a chronic pain group and a
      control group of hospital employees without chronic pain. METHOD: Ninety two
      patients with chronic pain, age range 20-62, were consecutively recruited from
      the outpatient clinics of a rehabilitation hospital and a general hospital.
      Ninety eight hospital employees, age range 20-62, were consecutively recruited
      from the employee health office of a rehabilitation hospital. All participants
      responded to nine questions related to sexual, physical and verbal abuse in
      childhood and completed the Childhood Traumatic Events Scale. A logistic
      regression with age, gender, sexual, physical, and verbal abuse, death of a
      family member, childhood illness, major upheaval before age 17, as independent
      variables were used to predict membership in the pain group contrasted with the
      control group. RESULTS: Child abuse was reported in the childhood history by
      54.4% of the chronic pain group, compared with 21.4% of the control group. A
      logistic regression showed that after adjusting for gender and age, sexual and
      verbal abuse were statistically significant predictors of being a member of the
      pain group. Odds ratios were sexual abuse: 2.67, p < 0.05, CI 1.00-7.14. Verbal
      abuse: 4.39, p < 0.001, CI 1.93-9.97. A logistic regression was modelled to
      predict child abuse when gender was taken into account. The results of the
      logistic regression showed that pain was a significant predictor for sexual abuse
      after adjusting for gender and age: odds ratio 4.37, p < 0.001, CI 1.80-10.60.
      Gender was not a statistically significant predictor for sexual abuse, after
      adjusting for pain and age: odds ratio 2.92, p < 0.072, CI 0.91-9.42.
      CONCLUSIONS: A history of physical, sexual and verbal abuse is more likely to
      occur in a chronic pain group than in a control group of hospital employees.
      Although child abuse is reported to be as high as 25% in the general American
      population, the statistics for chronic pain patients are twice as high as in the
      general population. The mechanisms for abuse include age, gender, and early
      family environment.

PMID- 11194618
TI  - Disability, coping and quality of life in individuals with muscular dystrophy: a
      prospective study over five years.
AB  - PURPOSE: The present study investigates progressive muscular dystrophy over a
      five year period. The purpose is twofold: to describe changes over time and to
      investigate relations between disability, coping and quality of life. METHOD: The
      study group comprised 45 adults (16 men and 29 women), with an average age of 44
      years. All were assessed in 1991 and 1996, with the following instruments: the
      ADL staircase, the Self-report ADL, the Mental Adjustment to Cancer scale, the
      Sickness Impact Profile and the Psychosocial well-being questionnaire (Kaasa).
      RESULTS: Increasing disability was accompanied by an increase in dependence on
      others and a significant deterioration of health-related quality of life and with
      regard to 'Satisfaction'. The predominant type of coping was 'Fighting spirit',
      whilst 'Fatalism' showed the greatest decline over time. 'Ambulation' and the ADL
      staircase correlated with 'Physical index' on the SIP. Correlations between
      disability, coping and quality of life were moderate. The results can serve as a
      basis for planning and evaluation of recurring rehabilitation for persons with
      MD.

PMID- 11194619
TI  - A comparison of the responsiveness of the Nottingham extended activities of daily
      living scale, London handicap scale and SF-36.
AB  - PURPOSE: Clinical trials require scales which are sensitive to the effects of
      intervention. This study examined the sensitivity to change of three generic
      health status measurement scales commonly used in evaluations of interventions in
      chronic, disabling disease. METHODS: Questionnaires comprising the SF-36, London
      Handicap Scale and Nottingham Extended Activities of Daily Living scale were
      administered to 81 patients before and after hip replacement. Changes were
      quantified as 'effect sizes'. RESULTS: Eighty nine per cent of patients reported
      improvements three months after surgery. The largest changes were seen on the SF
      36 pain scale (effect size 1.2 at three months, 1.5 at 6-12 months), physical
      function (1.1, 1.3) and role limitation--physical (0.8, 1.2) scales. The London
      Handicap Scale also measured large changes (effect sizes 0.6, 0.9), but the
      Extended Activities of Daily Living scale was insensitive to change (effect sizes
      0.1, 0.2). CONCLUSIONS: Some of the SF-36 dimensions were very sensitive to
      change. The London Handicap Scale was also reasonably responsive, and has the
      advantage of being a single, utility-based, score. The simpler Extended ADL score
      was poorly responsive.

PMID- 11194620
TI  - The mediation of disability by self efficacy in different samples of chronic pain
      patients.
AB  - PURPOSE: A path analytic model conceptualizing self efficacy as a mediator of
      disability was tested. This model could help explain the circumstances under
      which disability develops more in some chronic pain patients than in others.
      METHOD: Questionnaires from 479 chronic pain patients were collected prior to an
      initial consultative visit with a pain specialist at three pain clinics. These
      patients represented three separate samples. One sample from a tertiary care
      hospital (n = 226), one from a community-based clinic (n = 137) and a third
      sample from combined settings, but excluding patients with a history of
      depression prior to the onset of their pain (n = 116). Hypothesized and
      alternative models were tested to identify the model best fitting these data.
      RESULTS: Regression analysis supported self efficacy as a mediator of the
      relationship between pain intensity and disability (p < 0.001) in all three
      groups. This model was best supported in the group with no prior depression
      (accounting for 47% of the explained variance in disability). The 'no-prior
      depression' group was different than the other samples in that depression did not
      contribute to disability in this sample where prior depression was not controlled
      for. CONCLUSION: Self efficacy in an important variable contributing to the
      disability of chronic pain patients. Therefore, evaluating and bolstering the
      patient's belief in their own abilities may be an important component of therapy.

PMID- 11194621
TI  - An exploration of the Malawian perspective on children's everyday skills:
      implications for assessment.
AB  - PURPOSE: The aim of this study was to consider Malawian concepts of psychosocial
      development in children and to draw implications for the devising of an
      instrument to measure everyday skills in children. METHOD: Key informant
      interviews, focus groups and other interviews, video tapes and observations of
      children were undertaken in a rural village in Malawi, with a focus on 4-5-year
      olds. RESULTS: A well adapted child of this age is expected to show first of all
      understanding of social responsibilities, with regards respect, obedience,
      cooperation, ability to socialize with other children, ability to carry out
      'children's chores', to know people by names but more importantly how they are
      related to the child. The child should also show memory skills sufficient to
      carry messages. Such a child is described as intelligent/clever, characteristics
      important for survival. CONCLUSION: There are significant implications for the
      justification for the development of an instrument to measure everyday skills in
      African communities.

PMID- 11194622
TI  - Critical illness polyneuropathy: a summary of the literature on rehabilitation
      outcome.
AB  - PURPOSE: To evaluate the available literature on outcome of critical illness
      polyneuropathy (CIP) and to identify rehabilitation problems. METHODS OF STUDY
      SELECTION: A literature search in electronic databases. Primary articles on
      outcome in CIP using the classification of ICIDH or Quality of Life were enrolled
      in this study. Because of the types of study design, the lack of information
      regarding validity and the variability, a quantitative analysis was not possible.
      Instead, the overall results were evaluated in a qualitative approach. RESULTS:
      In the literature minimal attention was given to the rehabilitation aspects and
      long-term outcome of patients with CIP. Outcome measures were mainly used on the
      level of impairments and in lesser extent on the level of disabilities. One year
      after the onset of CIP, muscle weakness and decreased sensory function were
      frequently observed. Reported functional disabilities were dependency in
      Activities of Daily Living (ADL) and walking disabilities. CONCLUSION: The
      specific course and long-term outcome of CIP remains unclear. Research on the
      course and long-term functional outcome in CIP is necessary in order to identify
      rehabilitation problems and to formulate treatment strategies specifically
      directed towards the outcome of CIP.

PMID- 11194623
TI  - [Intravesical chemotherapy with mitomycin C after TUR for superficial bladder
      carcinoma].
AB  - Fifty-four patients mean aged 58.5 years (28 women and 26 men) undergo
      transurethral resection for superficial bladder carcinoma. Postoperatively 20 mg
      mitomycin is administered by instillation into the bladder for 8 weeks.
      Preoperative assessment includes: complete blood count, urea, creatinine, isotope
      nephrography, ultrasonography, excretory urography and CT scan of pelvis.
      Multifocal lesions are diagnosed in 22 patients (40.7%). In 36 cases (66.7%) it
      is a matter of solitary papillomas. The distribution of lesions is as follows:
      left bladder wall--12 patients (22.2%), right bladder wall--13 (24.07 per cent),
      trigone--18 (33.3%), and anterior bladder wall--11 (20.03 per cent).
      Postoperative check-ups: cytological assessment of urine and regular endoscopic
      study at 3-6 months. Recurrence rate amounts to 42.5% for the maximum follow-up
      period.

PMID- 11194624
TI  - [Serious infections associated with transurethral operations for lower urinary
      tract obstruction].
AB  - Serious urinary infections associated with transurethral surgery are a problem of
      current interest. The underlying causes of their occurrence and the therapeutic
      approach used are discussed. The study covers 139 patients treated over a two
      year period. The types of diseases giving rise to lower urinary tract obstruction
      and the transurethral operations performed--optic urethrotomy, laser
      photocoagulation and transurethral resection--are analyzed. In all patients
      sterile urine assessment is done before, during and after treatment.
      Identification of the bacterial strains and antimicrobial sensitivity testing are
      conducted with mini API system--Bio-Merieux, France. The frequency of microbical
      causing agents and their antibacterial resistance are studied. The tactics in
      selecting the most adequate drug is discussed. Pseudomonas aeruginosa is
      identified as urinary infection cause in 49.5 per cent. Good results are obtained
      in 118 patients (84.9%); among those without urethral catheter prior to operation
      -97.3 per cent, and in the group with urethral catheter--70.3 per cent.
      Conclusions are drawn concerning the necessity of microbiological study of the
      urine in transurethral operations, and undertaking treatment in due course.
      Retaining of the indwelling urethral catheter prior to intervention should be
      reduced to a minimum. The clinical efficacy of oral beta-lactams is lower by
      comparison with fluoroquinolines owing to the multiple resistance of strains. The
      tenets of picking out an antibiotic for handling significant urinary infections
      are outlined.

PMID- 11194625
TI  - [The most common complications associated with nephrectomy].
AB  - Access to the kidney and technical performance of nephrectomy should be related
      to the stage of the disease and degree of pathological process development (I.
      Viktorov 1983, S. Lambrev and T. Andreev 1961, T. Patrashkov 1982, F. S. Judy et
      al 1995). Advanced pathoanatomical changes in the kidney and pararenal space
      greatly interfere with the operation, especially in the event of adhesions to
      peritoneum and contiguous tissues (N. A. Lopatkina et al 1986, N. Minkov 1987, T.
      Patrashkov and H. Kumanov 1988). In the authors' reports presented are analyzed
      388 patients nephrectomized in the University Hospital "Alexandrovska", covering
      the period 1990 through 1995. All updated methods are used in diagnosing. The
      commonest intraoperative complications recorded in a series of 188 nephrectomies
      (48.45%) include: 1. Pus collections in the kidney--88 cases (46.80%). 2. Opening
      of peritoneum--64 (34.04%). 3. Decompressive puncture of the kidney--15 (7.97%).
      4. Neoplastic masses escaping from the renal parenchyma into the operative field-
      7 (3.72%). 5. Opening of pleura--5 (2.66%). 6. Purposeful opening of the tumor
      itself for decompression--3 (1.95%). 7. Kidney removal gives rise to diffuse
      bleeding necessitating inserting a tampon for hemorrhage control--2 (1.06%). 8.
      Splenectomy--1 (0.53%). 9. Because of advanced neoplastic process only biopsy is
      taken--1 (0.53%). 10. Hemicolectomy--1 (0.53%). 11. Injury to v cava inferior--1
      (0.53%). As shown by the experience gained, nephrectomy is a technically
      difficult operation, particularly in case of altered topoanatomical
      interrelations during secondary interventions on the kidney and ureter, or in
      case of concomitant pyelonephritis. Intraoperative complications are not life
      endangering provided treatment is undertaken in opportune time.

PMID- 11194626
TI  - [Mucinous breast carcinomas with neuroendocrine differentiation].
AB  - Mucinous breast carcinomas, denominated also gelatinous, mucoid and colloid
      (collomas), represent a heterogeneous group of neoplasms. More than half of them
      exhibit signs of neuroendocrine differentiation. Eighteen mucus producing
      carcinomas of the breast are subjected to morphological study. On the ground of
      demonstrating argyrophilia by the methods of Grimelius and Churukian--Shenk, and
      presence of secreting granules during electron microscopic study, they are
      assigned under the heading apudomas, i.e. tumors of the diffuse endocrine system,
      or the so-called APUD-system. The important practical implications of
      demonstrating neuroendocrine cells with a special reference to the biological
      patterns of this particular type of tumors are discussed.

PMID- 11194627
TI  - [Mammary gland carcinoma in men].
AB  - Over a 10-year period, a total of 403 patients with mammary gland carcinoma--398
      women (98.8%) and five men (1.2%)--are operated in the Clinic of Thoracic Surgery
      & Oncology at the Military Medical Academy. The mean age in men, as compared to
      that in women, is nearly 12 years older. In one patient tumorectomy is done for
      "cleanliness" on account of the seriously impaired general condition. In the
      remainder the operative intervention is radical mastectomy after Patey or
      Pirogov, with meticulous axillary lymph dissection. In all men operated on,
      gynecomastia concurrent to the underlying disease is found. The histological
      patterns of mammary gland cancer in male patients is identical to the
      histological picture in women.

PMID- 11194628
TI  - [Carotid body tumors - diagnosis and treatment].
AB  - Carotid body tumors are rare, with a tendency of slow but progressive growth,
      giving rise to external compression and/or involvement of the carotid arteries,
      craniofacial nerves and other neighbouring structures. They are adequately
      vascularized, with surgery being the treatment of choice. Localization and
      vascularity require comprehensive understanding of the anatomy, and most likely,
      vascular surgeons with carotid experience and neurosurgeons would make the best
      teams. In certain cases the participation of craniofacial surgeon is likewise
      needed. Over the period 1989 through 1999, in the Department of Vascular Surgery,
      six patients presenting carotid body tumor are treated. There is not a single
      case with bilateral involvement, and all have negative family history for carotid
      body tumor. Two of them are subjected to explorative surgery elsewhere. Two
      patients only are asymptomatic. In 3 patients CT of the neck, and in one--MRI are
      used as diagnostic modalities. Five patients undergo carotid artery
      ultrasonography, and three--angiography. Internal carotid clamping is
      necessitated in one case only, undergoing explorative surgery at another hospital
      and presenting a big tumor, stage III (Shamblin). Postoperatively, the patients
      complain of slight deviation of the tongue and slurred speech. The check-up
      carotid ultrasound shows hemodynamically relevant stenosis of the internal
      carotid artery, 1 cm distally to the carotid bifurcation, without flow into the
      external carotid being detected. On follow-up, all patients are alive and free of
      local recurrences or metastases.

PMID- 11194629
TI  - [Foreign bodies in the upper airways of children - problems relating to diagnosis
      and treatment].
AB  - The authors share their experience and systematic observations with regard to the
      correlation between "chronic pneumonia" and foreign bodies in the respiratory
      tract, based on a survey of 480 bronchoscopic examinations for a period of 10
      years. It was established that misdiagnosed foreign bodies in the lower
      respiratory tract account for 12.5% of all these cases. The percentage of
      undiagnosed bilateral foreign bodies is unusually high, as well as that of the
      left-sided foreign bodies, although to a smaller degree. The study also shows
      that very often in pediatric practice foreign bodies are wrongly diagnosed as
      bronchopneumonia and bronchial asthma.

PMID- 11194630
TI  - [Complications in Le Fort facial fractures combined with craniocerebral trauma].
AB  - The present research is based on the most frequent traumas and fractures in the
      middle zone of the face (second and third type by Rene le Fort) and the proceeded
      from them complications for a period of four years in the clinic of Neurosurgery
      in NIUMN "Pirogov". From the 280 patients that were studied the complications
      were observed in 54 of them. We worked up the received results statistically and
      presented them in drawing.

PMID- 11194631
TI  - [History of nephrectomy].
AB  - Following animal experiments (Combair 1803, Prevost and Dumas 1823) and
      accidental removal of the kidney in humans (Spillgellberg 1867, Peaslee 1868,
      Wolcott 1886), it has been established that elimination of a single kidney does
      not lead mandatorily to fatal outcome if the second functioning kidney is
      preserved. The chronology of nephrectomy development on a worldwide scale, and in
      Bulgaria as well, after the first routinely scheduled nephrectomy performed by
      Gustav Simon (2 Aug 1869), is presented. In 1897, almost 30 years later, Ivan
      Mikhaylovsky from the Plovdiv Hospital performed the first nephrectomy in this
      country. In the late 19th and early 20th century, nephrectomy becomes one of the
      most often used kidney operations (H Kumill, 1913--49.3 per cent), but gradually
      parallel to improving the diagnostic technique it is less frequently applied (W
      Lutzer et al, 1976--28 per cent) at the expense of organ-salvaging interventions.
      The last decade marks the introduction of laparoscopic nephrectomy (RV Clayman et
      al, 1991, AD Joce et al, 1992, JJ Rassweller et al, 1993, Sy Nakada et al, 1996,
      CC Abbou et al, 1998) which is a safe procedure even in patients with malignant
      renal pathology and adequately selected cases presenting various urological
      diseases.

PMID- 11194632
TI  - [Case of an adult female operated successfully for Boerhaave's syndrome].

PMID- 11194633
TI  - [Case reports on constrictive strictures of the esophagus].

PMID- 11194634
TI  - [A rare case of scrotal calculosis in a male presenting hydrocele].

PMID- 11194635
TI  - [Pseudolymphoma of the stomach].

PMID- 11194636
TI  - [Bile duct anomalies and variations of arterial blood supply to the liver and
      gall bladder].

PMID- 11194637
TI  - [Bladder neck reconstruction after radical prostatectomy].
AB  - Experience had with radical prostatectomy in patients presenting localized
      prostate carcinoma is shared. A modified technique for new bladder-neck formation
      contributing to continence preservation is used in five patients, yielding very
      good postoperative results. In four cases a full recovery of continence is
      achieved within 3 months of the operation without resorting to drug therapy. In
      one case medical treatment with parasympaticolytics and agonists of voluntary
      sphincter is applied. The final outcome is stress incontinence only and passage
      of urine in the event of micturition postponed with 3-3.5 hours.

PMID- 11194638
TI  - [Methods most frequently used in the diagnosis of renal diseases leading to
      nephrectomy].
AB  - In the past few years, the progress of science and technology, and introduction
      of new diagnostic and treatment methods (echography, isotope study, computerized
      axial tomography, renovasography, magnetic resonance imaging and others) have
      contributed greatly to early detection and timely treatment of pathological
      processes involving the kidney (ZK El-Zein, 1995). After practical implementation
      of new clinical methods of examination it becomes possible to gain better insight
      into the undelying causes and character of renal diseases (T. Patrashkov, 1982).
      The study covers 388 patients subjected to nephrectomy for various diseases of
      the kidneys and urether, diagnosed and treated in the Department of Urology
      University Hospital "Alexandrovska", over the period 1990 through 1995. The
      commonest diagnostic methods used to make diagnosis prior to nephrectomy include:
      1. Survey roentgenography of kidneys, urethers and urinary bladder (KUB)--364
      (93.81%). 2. Venous urography--320 (82.47%). 3. Echography--302 (77.83%).
      (Antegrade pyelography--2 (0.51%). 4. Isotope nephrogram (ING)--212 (54.63%). 5.
      Scintography of kidneys--126 (32.47%). 6. Computerized axial tomography (CAT)--82
      (21.13%)/(70.68%) among 116 renal tumor nephrectomies. 7. Renovasography--82
      (21.13%). 8. Retrograde pyelography--48 (12.37%). 9. Gamma-camera--10 (2.57%).
      10. Cystoscopy--6 (1.54%). 11. Ureterorenoscopy--2 (0.51%). Presumably, apart
      from the new "noninvasive" methods of study (computerized axial tomography--CAT
      and echography), the conventional venous urography has by no means lost its
      popularity.

PMID- 11194639
TI  - [Finite element analysis of an additional implant for intramedullary nailing].
AB  - In the surgical treatment of fractured femurs, the fracture is bridged by a
      medullary nail fixed in the bone with interlocking screws. Failure of bone
      substance in the region of the interlocking screws is the most common
      complication in the treatment of osteoporotic bone. With the aim of preventing
      this complication, an additional implant was developed. A finite element analysis
      of an ideal bone/implant system was carried out to investigate the role of the
      additional implant. Three defined finite element models were generated, and the
      associated stress situations compared. The first model is a standard fixation
      without the additional implant. In the second model, the additional implant is
      integrated within the bone/implant system. The third model uses a modified form
      of the additional implant. The results show that both additional implants reduce
      the stresses occurring, both in the bone substance and at the screws. The
      modified form of the additional implant proved to be the most favorable version.
      In the case of the original additional implant, the negative effect of the sharp
      edges of the thread was demonstrable.

PMID- 11194640
TI  - [Assessment of bone healing during callus distraction by an automatic torsional
      stiffness metering system].
AB  - The present article describes a newly developed device for the quantitative
      assessment of torsional in vivo stiffness of regenerating bone under callus
      distraction. Both the design and function of this device, and its use during bony
      consolidation are discussed. The device exhibited an accuracy of +/- 18% for
      stiffness under 0.1 Nm/degree, and +/- 5% stiffness above 0.1 Nm/degree. The
      average accuracy was +/- 14%. The data scatter for the stiffness measurement
      ranged between +/- 1.43% and +/- 7.68% (average: +/- 3.99%). The precision of a
      test machine was between +/- 0.01% and +/- 11.3% (average: +/- 3.65%). The method
      has the following advantages over existing methods for investigating healing: 1.
      no need to dismantle the external fixation for measurement; 2. preservation of
      the bone axis with minimal risk of misalignment during the bone healing process;
      3. minimal technical requirements, with easy, noninvasive measurement; 4. no
      exposure to X-radiation.

PMID- 11194641
TI  - [Standardized testing of bone implant surfaces with an osteoblast cell culture
      cyste. III. PVD hard coatings and Ti6Al4V].
AB  - The effect of titanium-based PVD coatings and a titanium alloy on the
      proliferation and differentiation of osteoblasts was investigated using a
      standardised cell culture system. Human fetal osteoblasts (hFOB 1.19) were
      cultured on titanium-niobium-nitride ([Ti,Nb]N), titanium-niobium-oxy-nitride
      coatings ([Ti,Nb]ON) and titanium-aluminium-vanadium alloy (Ti6Al4V) for 17 days.
      Cell culture polystyrene (PS) was used as reference. For the assessment of
      proliferation, the numbers and viability of the cells were determined, while
      alkaline phosphatase activity, collagen I and osteocalcin synthesis served as
      differentiation parameters. On the basis of the cell culture experiments, a
      cytotoxic effect of the materials can be excluded. In comparison with the other
      test surfaces, [Ti,Nb]N showed greater cell proliferation. The [Ti,Nb]N coating
      was associated with the highest level of osteocalcin production, while all other
      differentiation parameters were identical on all three surfaces. The test system
      described reveals the influence of PVD coatings on the osteoblast differentiation
      cycle. The higher oxygen content of the [Ti,Nb]ON surface does not appear to have
      any positive impact on cell proliferation. The excellent biocompatibility of the
      PVD coatings is confirmed by in vivo findings. The possible use of these
      materials in the fields of osteosynthesis and articular surfaces is still under
      discussion.

PMID- 11194642
TI  - [Simulator for migration processes and wear in the artificial hip acetabulum for
      radiologic measurement].
AB  - For assessing migration of cups, standard X-rays or stereo radiological images
      (SRI) are available. In addition, software is also available for measurements.
      The accuracies of the various systems are established statistically, in part
      combined with phantoms, and compared. To date, no known phantom is available for
      the simulation of acetabular cup migration with account being taken of the
      position of the pelvis in the X-ray beam. Such an appliance covering 8 different
      parameters has now been developed, the cup can be moved horizontally, vertically
      and in the loading direction. Angular accuracy is +/- 0.5 degree, and wear of a
      magnitude of 0.25 mm can be simulated. Two degree elevation of the pelvis, left
      or right, can be simulated. The position of the pelvis around the horizontal axis
      permits continuous variation. This appliance can simulate migratory movements of
      the acetabular cup within a pelvis, and wear within the cup. In addition, the
      spatial position of the pelvis can be varied. The X-ray images can be used to
      investigate the accuracy of evaluation strategies.

PMID- 11194643
TI  - [Survival rate of the cemented Charnley total hip endoprosthesis and modifying
      parameters].
AB  - AIM OF THE STUDY: To analyse survival of cemented Charnley prostheses, and
      influencing factors. MATERIAL AND METHODS: 539 patients (mean age: 62 years)
      undergoing 426 primary, and 200 revision Charnley hip arthroplasties, were
      examined. The indications for primary operation was idiopathic coxarthrosis in
      239 cases (56.1%), and rheumatic coxarthrosis in 56 cases (13.1%). Reasons for
      revision surgery included aseptic loosening in 123 cases (61.5%), septic
      loosening in 36 cases (18%), and prosthetic fracture in 13 cases (6.5%). RESULTS:
      After a mean follow-up of 4.4 years, patients were scored using the Merle
      d'Aubigne evaluation. The average postoperative score for primary operations was
      14.8 points, and for revision surgery 13.1 points. The respective pre-operative
      scores were 8.2 and 8.1. Radiographic investigation revealed peri-articular
      calcifications in 28.4% of the primary operations, and in 28.5% of the revisions.
      Radiolucent lines or protrusions were found in 29.8% of the primary, and in 42.0%
      of the revisions. At follow-up, 45 implants in 41 patients had been replaced.
      Kaplan-Meier survival rates for the primary group were 99.6% after one year,
      92.8% after five years, 78.3% after 10 years, and 45.9% after 15 years. The
      respective figures for the revision group were 98.2%, 85.3%, 59.7% and 31.3%. The
      largest difference was seen in the eleventh year. Patient age had no significant
      influence for the first 12 years. In the primary group, body mass index showed a
      significant influence only after 15 years. Analysis of the indications for
      surgery revealed a slightly higher survival rate in the arthrosis group (84%) vis
      a-vis the dysplasia group (83.3%), and a significantly higher rate vis-a-vis
      patients with rheumatoid arthritis (42%). CLINICAL RELEVANCE: Such factors as
      age, diagnosis and weight had an influence only over the long term. Significant
      differences between primary and revision operations were not found.

PMID- 11194644
TI  - [Ceramic acetabulum for hip endoprostheses. 8: Revisions].
AB  - For total hip replacement, ceramic femoral heads and acetabular liners are being
      used with success. However, reports of revision surgery necessitated by fractures
      or marked wear of ceramic components are still being published. The revision rate
      due to fracture is less than 0.01%, and much lower than for other complications.
      Nevertheless, improvement of safety remains a topic of discussion. This article
      reviews the results of investigations of explanted ceramic heads and liners, and
      discusses the problems caused by ceramic wear and chipping. Recommendations for
      revision surgery in such cases are given.

PMID- 11194645
TI  - [ESKA-Ceram--a new material in hip endoprosthetics].
AB  - ESKA-Ceram is a new material for use in hip endoprostheses, and comprises two
      thirds polyurethane and one-third Al2O3 ceramic powder. Its wear rates are of a
      similar low order of magnitude as those reported for metal-metal and ceramic
      ceramic combinations. A great advantage of the material is that it permits the
      production of asymmetrical inserts for acetabular cups.

PMID- 11194646
TI  - [Problems relating to vascular reconstruction in renal transplantation from a
      living donor].
AB  - We discuss vascular surgical problems in 59 kidney transplantations using alive
      donors. From April 96 till May 99 we harvested 59 kidneys from relatives (44
      women and 15 men), mean age 54.33 years. Those kidneys were transplanted to 37
      men (mean age 55.71 years), and 22 women (mean age 36.85 years). Preoperative
      dialysis was performed for a period of 5.015 years (mean). Thirty eight of the
      kidneys are right, and 21 of them are left. Six kidneys have two renal veins
      (10.16%), and 5 of them have two renal arteries (8.47%). We prefer end-to-end
      anastomosis between the donor renal artery and the recipient hypogastric artery.
      It ensures best regional hemodynamics, long-term patency and best positioning of
      the kidney avoiding vascular compression. The venous anastomosis is performed end
      to-side to the iliac vein of the recipient. In 7 cases of short renal artery of
      the donor kidney greater saphenous vein is used as arterial conduit to ensure
      tension-free anastomoses. Only 1 patient (1.74%) of 59 cases (71 venous
      anastomoses) suffered thrombosis of the iliac vein, which caused kidney rupture.
      We had 5 cases of postoperative bleeding (8.47%), three of them were from the
      kidney hilus, and two from exposure sites. After reexploration all of them have
      normal function. Vascular anomalies and/or vascular disease do not preclude the
      procedure. Atraumatic harvesting of the kidney is critical.

PMID- 11194647
TI  - [Our experience in the diagnosis and treatment of carotid-jugular fistulae].
AB  - We present our experience in treatment of patients with carotid-jugular fistulas
      for a three years period. Three of those patients had congenital fistulas and one
      had acquired (posttraumatic) fistula. Signs and symptoms include: pulsatile neck
      mass, systolic murmur, thrill, dilated superficial veins. Diagnosis was confirmed
      with Duplex ultrasonography and angiography. Patients were treated by open
      surgery (ligation and resection) and endovascular procedures (conventional and
      laser embolization). In cases of single A-V communication ligation and resection
      gives excellent results. In cases of multiple communications recurrence in the
      same or neighbouring vascular area is more likely and second stage surgery or/and
      endovascular procedures (embolization) may be needed.

PMID- 11194648
TI  - [Post-cystectomy derivations - a rule or control of technical skills?].
AB  - Limitations in gaining better understanding of bladder tumor responsiveness do
      exist, and accordingly the therapeutic interventions undertaken in diverse forms
      of the disease are conspicuous for discrepancies (M. J. Droller, 1990). E.
      Bricker in 1950 is the first to practically implement ileal conduit for urine
      derivation, and thus initiates the new and newest continent derivations. Over the
      period 1992-1998, in the Chair of Urology are performed 76 cystectomies with
      different urine derivations, using seven methods for the purpose: [table: see
      text] Also discussed are the conditions a derivation should mandatorily meet.
      Emphasis is laid on the fact that the choice of derivation is still largely
      dependent on the skill and experience of urologists.

PMID- 11194649
TI  - [Endoscopic treatment of upper urinary tract obstruction].

PMID- 11194650
TI  - [Therapeutic approach to upper urinary tract obstructions (UUTO) of gynecologic
      nature].
AB  - The existence of numerous treatment methods for upper urinary tract obstructions
      (UUTO) following gynecological interventions, taken alone demonstrates that it is
      a matter of a complex surgical problem, hardly lending itself to solution. There
      is no ideal operation, manipulation or procedure. It is precisely the role of the
      urologist to choose and implement in practice the most adequate therapeutic
      approach to each individual case. Urology is an interdisciplinary and extensive
      surgical speciality, disposing of both classical, well-tried operative
      procedures, and vast possibilities for performing minimum invasive interventions
      and manipulations. All treatment approaches to UUTO after gynecological
      operations used in the Chair of Urology are described and comprehensively
      discussed.

PMID- 11194651
TI  - [Long-term results of 516 transurethral resections of the prostate gland].

PMID- 11194652
TI  - [Duodenal decompression in the surgical management of complicated ulcers].
AB  - Operative duodenal decompression for correction of and prophylaxis against
      duodenostasis is discussed. The methods used for treating complicated pyloric or
      duodenal ulcers include: perforation suture according to Opel-Polykarpov,
      resection of the stomach after Billroth-Haberer-Finney, resection of the stomach
      after Billroth-Vitebsky. All procedures listed above are performed in conjunction
      with operative interventions aimed at duodenostasis decompression.

PMID- 11194653
TI  - [Hair transplantation with Calvitron - experience with 25 patients (preliminary
      report)].
AB  - Between 20 and 30% of the male and 5% of the female population is affected by
      baldness. This 'androgenic' alopecia is linked to a genetic and hormonal
      characteristic. The surgical options for the treatment of the alopecia are
      numerous, however none of it do not produced single solution that is applicable
      to all problems. In approximately 90% of the cases treated, the hair graft
      transplants comes to the forefront of the therapeutic methods. The method is
      applied in 25 patients and the Calvitron was used for the purpose. The patients
      were followed for 6 months after the implantation. From 300 to 620 grafts or 600
      to 1200 hair follicules were implanted in one section.

PMID- 11194654
TI  - [Complications in plastic surgery breast reconstruction with TRAM flap.
      Preventive methods and treatment modalities].
AB  - The breast reconstruction with the TRAM-flap is sophisticated and demanding
      procedure, requiring careful planning and technical proficiency. Despite these
      efforts, the outcome of the breast reconstruction can be compromised by factors
      such as vascular insufficiency, scar contraction, errors in planning of the flap,
      or in the technique of building the new breast. Preventing the problems and
      complications in breast reconstruction require careful preoperative study, proper
      patient selection, accurate analysis of the results and immaculate technical
      performance.

PMID- 11194655
TI  - [Combined and extended radical operations in colorectal carcinoma patients].
AB  - This is a report on radical operative interventions performed in 273/385 patients
      presenting complicated colorectal carcinoma, covering the period 1993 through
      1998. Fifty-four patients are subjected to combined and extended operations,
      distributed as follows: 31 combined and 23 extended. In fifteen patients with
      abdomino-perineal extirpation the combined interventions include: hysterectomy
      (6), ovariectomy (8), resection of vagina (7), prostate gland resection (3) and
      bladder resection (2). In case of resection of rectum after Hartmann, combined
      intervention is done in five patients--small intestine resection, ovariectomy,
      appendectomy and cyst extirpation from pelvis minor, respectively. Postoperative
      lethality amounts to 12.9 per cent, or 7/54 patients with complicated colorectal
      carcinoma undergoing combined and extended surgical interventions.

PMID- 11194656
TI  - [Orthotopic liver transplantation - recipient selection criteria].
AB  - In a great number of patients with progressive liver diseases whose terminal
      phases are cirrhosis and hepatic insufficiency, liver transplantation is the only
      feasible therapeutic alternative.  However,   the undertaking of liver
      transplantation is largely dependent on the availability of donor organs.  Hence,
      the process of selecting the most adequate recipient is of critical importance
      from both medicolegal view-point, and in terms of the likelihood of a successful
      outcome of transplantation.  The study is designed to asses the problems faced
      with a special reference to indications, contraindications and timing of liver
      transplantation.

PMID- 11194657
TI  - [Monitoring phagocytic activity in acute pancreatitis patients (mild and severe
      forms)].

PMID- 11194658
TI  - [Bilateral thoracotomy with transverse sternotomy in bilateral pulmonary
      echinococcosis].

PMID- 11194659
TI  - [Volvulus of the stomach].

PMID- 11194660
TI  - [Wegner granulomatosis with initial manifestation of bilateral granulomatous
      purulent necrotic mastitis].

PMID- 11194661
TI  - [Case report of combined variation of the branches of the subclavian and superior
      thyroid arteries].

PMID- 11194662
TI  - [Creation of an orthotopic urinary bladder from ileum - "St Anna's" procedure].

PMID- 11194663
TI  - [Therapeutic approach to postoperative dysphonia following thyroid gland
      surgery].
AB  - The recurrent nerve palsy, which is frequently expressed clinically by
      postsurgical dysphonia is quite often a complication in the thyroid surgery. The
      choice of therapeutic behaviour is based on the assessment of the clinical
      condition of the patient, in other words, whether the dysphonia is accompanied by
      dyspnoea or not. 32 patients with postsurgical dysphonias are included in the
      survey. All patients were operated for thyroid disease in the Clinic of Endocrine
      Surgery between August 1996 until May 1998 and surveyed for a follow-up period of
      3 to 21 months. The analysis of the results shows that the conservative treatment
      is appropriate for patients with functionally well compensated dysphonias,
      whereas the existence of high-level dyspnoea, whose morphologic substratum is
      most frequently a bilateral recurrent nerve palsy with median position of the
      vocal folds, necessitates surgical treatment.

PMID- 11194664
TI  - [Notes on some operative procedures in chest surgery].
AB  - Experience with some useful procedures in chest surgery, gained over a 35-year
      long clinical practice, is shared. The items discussed include: Lever assisted
      retraction of the intercostal space in thoracotomy. Preventive paravertebral
      excision of a rib in thoracotomy. Costal resection during thoracotomy. Hemostasis
      through aspiration electric cautery in thoracotomy and mediastinoscopy.
      Continuous running suture of bronchial stump and pulmonary parenchyma. Plastic
      bronchial stump hermetization. Pleural cavity drainage following inferior
      bilobectomy. Douche lavage for topical management of post-pulmonectomy empyema.
      The methods briefly outlined are addressed mainly to young chest surgeons in post
      graduate training.

PMID- 11194665
TI  - [Primary colorectal carcinoma as an underlying cause of obturation of the ileum].
AB  - This is a report on 169 patients presenting colorectal carcinoma with
      complication assuming the form of occlusive ileus, observed over the period 1993
      through 1998. Obturation is the commonest complication of colonic carcinoma
      (48.9%) with the left colon being more often involved (58.3%), recorded in a
      total of 108 patients. During the same period of time, occlusive ileus against
      the background of carcinoma of the rectum is diagnosed in 61 cases, representing
      37 per cent of complicated forms of this malignant neoplasm. The scope of
      operative management and the procedure used are largely determined by the
      location of primary malignancy. The timing of undertaking one or another
      operative intervention depends on the efficacy of preoperative preparation,
      degree of occlusive ileus progress, patient's age, concomitant diseases and the
      like. Failing to comply with or overlooking some of the aforementioned factors
      invariably exerts an unfavourable effect on the final outcome of treatment. In
      each patient presenting colorectal-carcinoma-induced occlusive ileus it is
      mandatory to precisely specify the scope of surgery, consistent with the
      patient's general condition, and eliminate the underlying cause jeopardizing his
      life.

PMID- 11194666
TI  - [Cosmetic rhinoplasty: open versus closed access. Results with 70 patients].
AB  - Because of its central location, the nose is an important element in facial
      aesthetics. The size and the shape is conditioned by the volume and the strength
      of the osteocartilaginous framework and the thickness of the soft-tissue cover.
      Rhinoplasty is a complex procedure requiring understanding of the anatomy and how
      each element contributes to the shape of the nose. In an attempt to obtain a
      pleasing aesthetic result and to have a satisfied patient 70 patients were
      operated. The results of open and closed approaches in rhinoplasty and the
      indications for the open approach are discussed.

PMID- 11194667
TI  - [Characteristic features of anesthesia in post-mastectomy mammary-gland
      reconstruction].

PMID- 11194668
TI  - [Current diagnosis of upper urinary tract obstructions (UUTO) of gynecologic
      origin].
AB  - Upper urinary tract obstructions represent a problem faced by urological
      specialists for many decades. Regardless of the updated methods of diagnosing and
      management, as well as the attempts at early detection of neoplastic diseases and
      their complications, there is a permanent tendency of the morbidity rate of
      carcinoma of the uterine neck and body to increase. What is more, age stratified
      morbidity most frequently demonstrates involvement of women in the 40-49 years
      age group. In the daily routine urological practice cases presenting UUTO are by
      no means rare, and not infrequently urologists confront a queer challenge
      necessitating to make exact diagnosis in opportune time. It is the purpose of the
      study to present a summed up assessment of the diagnostic methods most frequently
      used.

PMID- 11194669
TI  - [Obstruction of the upper urinary tract following gynecological interventions for
      neoplastic diseases of female genitalia].

PMID- 11194670
TI  - [Radical prostatectomy with broadened scope of indications - analysis of early
      experience].

PMID- 11194671
TI  - [Rupture of abdominal aortic aneurysm into inferior vena cava].

PMID- 11194672
TI  - [Combined surgical treatment of patients with huge aortic abdominal aneurysms
      associated with coronary artery lesions].
AB  - The objective of this study was to define the perioperative risk of simultaneous
      operations in patients with abdominal aortic aneurysm (AAA) associated with
      coronary artery disease (CAD). The hospital data of 30 patients with coexistent
      severe symptomatic AAA and significant CAD, who underwent one stage surgery of
      the abdominal aorta and the coronary arteries was retrospectively analysed. Most
      of the pts.--28 were male and only 2 female. The average age consisted 57.7
      years. Infrarenal AAA (diameter over 5 cm) was presented in 25 patients and
      suprarenal extension was in presented in 5 pts, while all patients with
      coexisting CAD had three vessels disease and significant impairment of left
      ventricular function (23 pts with ejection fraction (EF) < 50% and 10 pts < 30%
      EF). The resections of AAA in pts. undergoing simultaneous coronary artery
      procedure were performed on cardiopulmonary bypass (CPB) and moderate
      hypothermia. There were 2 early postoperative deaths (6.66%) and 5 major nonfatal
      postoperative complications (16.6%). Our experience with simultaneous surgery of
      coexistent huge AAA and CAD demonstrated that: a) Combined procedure can be
      performed safely in patients with significant AAA and CAD. b) The overall early
      operative mortality and morbidity after combined surgery compare favourably with
      the results after CABG of patients with impaired left ventricular function. c)
      Simultaneous operation seems to be more favourable in patients with coexistent
      AAA and CAD regarding the high risk of aneurysmal rupture, saving them also the
      potential morbidity and eventually fatal complications associated with the second
      procedure. d) Even the management of suprarenal and huge infrarenal AAA can be
      carried out easier and with less risk of complications under the protection of
      CPB.

PMID- 11194673
TI  - [Case of successful lung carcinoma surgery in a 78-year-old male patient].

PMID- 11194674
TI  - [Clinical and anatomical aspects of muscles within the deep anterior perineum of
      women].

PMID- 11194675
TI  - [Obturation of infrainguinal arteries - clinical picture and surgical
      management].

PMID- 11194676
TI  - Six sigma.

PMID- 11194677
TI  - A remote possibility.

PMID- 11194678
TI  - A veteran physician's view of the future.

PMID- 11194679
TI  - A community of physicians.

PMID- 11194680
TI  - The emergence of the acute care nurse practitioner.

PMID- 11194681
TI  - Hospitalists redefine the future of inpatient medicine.

PMID- 11194683
TI  - Small is beautiful, say independent physicians.

PMID- 11194682
TI  - Elections 2000: the future of health care.

PMID- 11194684
TI  - Health policy report. Health and health services utilization--what determines
      what?

PMID- 11194686
TI  - Chronic appendicitis: it does exist.

PMID- 11194685
TI  - Loss prevention case of the month. Costly error in judgment.

PMID- 11194687
TI  - Comparison between vaginal misoprostol and cervical dinoprostone for cervical
      ripening and labor induction.
AB  - OBJECTIVE: To compare the efficacy of intravaginal misoprostol (Cytotec) to
      intracervical dinoprostone (Prepidil) for pre-induction cervical ripening.
      METHODS: Sixty-one patients admitted for induction of labor, whose cervices were
      unfavorable (Bishop score: 4), were randomly assigned to either intravaginal
      placement of a 50 micrograms misoprostol tablet or intracervical administration
      of dinoprostone gel. RESULTS: Eighteen women (56%) in the misoprostol group and
      five (17%) in the dinoprostone group achieved cervical ripening within 12 hours
      (P = 0.007). Fewer doses of misoprostol were required to achieve cervical
      ripening, and the interval from induction of labor to delivery was shorter in the
      misoprostol group. Sixteen patients (50%) in the misoprostol group required
      oxytocin, whereas 26 (90%) in the dinoprostone group required oxytocin
      augmentation (P = 0.008). There was no significant difference in mode of delivery
      or neonatal outcome between the two groups. CONCLUSION: Vaginal misoprostol
      appears to be a more effective cervical ripening agent than cervical
      dinoprostone.

PMID- 11194688
TI  - Department of Health Report. Care coordination and Children's Special Services.

PMID- 11194690
TI  - Opportunities to improve Mississippi's quality of medical care.

PMID- 11194689
TI  - A therapeutic nightmare. (loss prevention case).

PMID- 11194691
TI  - Mineral starvation. 1913.

PMID- 11194692
TI  - Sources of medical information for patients at civilian and Navy primary care
      clinics in Pascagoula, Mississippi.

PMID- 11194693
TI  - The 1878 yellow fever epidemic in Memphis.

PMID- 11194694
TI  - Clustering of lifestyle behaviors: the relationship between cigarette smoking,
      alcohol consumption, and dietary intake.
AB  - PURPOSE: To examine relationships between cigarette smoking, alcohol use, and
      dietary intake. DESIGN: Respondents to the U.S. Department of Agriculture's
      Continuing Survey of Food Intakes by Individuals, a nationwide probability sample
      conducted from January 1994 through January 1997 (n = 23,602; response rate =
      80%), were selected. Adults ages 19 years and older were grouped according to
      their smoking and drinking habits. Selected demographic variables, food group
      servings, food energy, and densities of selected nutrients were compared.
      SETTING: In-home interviews were conducted in the 50 states and the District of
      Columbia. SUBJECTS: The selected sample (n = 6745) included 3229 nonsmokers, 1701
      former smokers, and 1808 current smokers, and 2284 abstainers, 2713 occasional
      drinkers, 1000 moderate drinkers, and 748 liberal drinkers. MEASURES: Responses
      to standard questionnaires were examined by Student's t-test, chi 2, one-way
      analysis of variance, and univariate and multivariate analyses of covariance.
      RESULTS: Men were more likely than women to be current smokers and liberal
      drinkers (64% vs. 40% and 62% vs. 38%). For both, the use of cigarettes and
      alcohol was closely related. An additive relationship was observed between
      smoking/drinking classification and lower food group servings and nutrient
      intakes. Although cigarette and alcohol use may have been underreported, these
      findings support previous ones showing poor food choices along with lower
      nutrient intakes as smoking and drinking increase. CONCLUSIONS: Smoking and
      drinking habits may alter individuals' food selections and nutrient intakes.
      Future interventions for health promotion may achieve greater success by
      targeting multiple risk factors simultaneously or sequentially.

PMID- 11194695
TI  - Implementing a dietary intervention in primary care practice: a process
      evaluation.
AB  - OBJECTIVES: Physicians acknowledge the need to advise their patients about
      dietary habits, but they may not have the training or tools to do this
      efficiently. In the context of a randomized trial, we investigated the
      feasibility of enlisting physicians to implement a dietary intervention in the
      primary care setting. METHODS: Physicians from 14 primary care practices were
      assigned via randomization to introduce a self-help booklet to promote dietary
      change at routine appointments. Delivery of the booklet was recorded by these
      intervention physicians at the clinic appointment; intervention participants were
      asked 3 months later in a telephone interview about whether they received and
      used the booklet. RESULTS: According to physician documentation, 95% of
      intervention participants who kept an appointment (n = 935) received the booklet;
      among participants completing a 3-month interview (n = 890), 96% reported the
      same. However, only about 50% of participants reported receiving the booklet from
      their physician; the remainder received the booklet from other clinic staff.
      Overall, 93% reported reading at least part of the booklet. Use of the booklet
      varied little whether it was delivered by a physician or staff person, but it was
      more likely to be read as time spent discussing the booklet increased.
      CONCLUSIONS: Physician cooperation and evidence of intervention effectiveness
      support the use of primary care for the delivery of interventions to change diet;
      training the entire health team and repeating dietary advice at subsequent visits
      may improve the success of such interventions.

PMID- 11194696
TI  - Increasing the reach of health sponsorship: using a "sponsorship kit" to promote
      health.
AB  - In Australia, a tobacco tax provides funding for Healthway, the Western
      Australian Health Promotion Foundation. Healthway provides sponsorships for the
      arts and racing and sporting events to replace funds previously provided by
      tobacco companies. These sponsorships provide visibility for Healthway and
      positive health messages. Normally, Healthway staff attends these events to help
      promote health messages. To reduce Healthway staff time spent helping event
      organizers promote health messages, Healthway developed a sponsor kit of
      promotional materials which communicate health messages without requiring
      Healthway staff to attend events. Recognition, awareness, comprehension, and
      acceptance of health messages was comparable at events that featured Healthway
      staff versus the sponsor kits, but the average cost of the sponsorship kits was
      only 40% of the cost when Healthway staff was featured.

PMID- 11194697
TI  - Patterns of health promotion programs for older adults in local health
      departments.
AB  - Questionnaires were sent to all 2561 members of the National Association of
      County Health Officers in 1996; only 492 (19.2%) responded. Almost all
      departments have health promotion or disease prevention programs available to
      older adults, but only three-fifths specifically target older adults with these
      programs. Most of those programs are clinical preventive services, including
      immunizations.

PMID- 11194698
TI  - Physical activity patterns and body mass index scores among military service
      members.
AB  - Questionnaires on exercise practices, reasons for exercising, factors that would
      increase exercise, and demographics were mailed to a stratified random sample of
      19,510 active duty personnel in all of the United States military services who
      were stationed at 38 large military installations and a number of remote
      locations. Responses were returned by 8,572 (55%). Approximately 63% exercised
      three times a week for 15-20 minutes, and 15% did not exercise at all. Mean BMI
      was 25.2. The top five reasons for exercising were to improve physical
      conditioning, have fun, manage weight, improve appearance and manage stress.

PMID- 11194699
TI  - The relationship between home smoking bans and exposure to state tobacco control
      efforts and smoking behaviors.
AB  - PURPOSE: To examine the relationship between home smoking bans and adult smokers'
      exposure to the statewide California Tobacco Control Program (TCP) and their
      cigarette smoking behavior. DESIGN: Cross-sectional survey that was part of the
      statewide Independent Evaluation of the California Tobacco Control, Prevention
      and Education Program. SETTING: Random telephone interviews within 18 California
      counties. SUBJECTS: A representative sample of 1315 adult smokers, aged 25 years
      and older. MEASURES: The telephone survey included questions about smoking
      behavior, quitting smoking, exposure to tobacco control program components, home
      smoking rules, and attitudes related to tobacco use and environmental tobacco
      smoke (ETS). RESULTS: Smokers with a home smoking ban were twice as likely (OR =
      2.29; 95% CI 1.22, 4.29) to have heard of TCP community programs and three times
      more likely (OR = 3.18; 95% CI 1.34, 7.57) to have seen and talked about the ETS
      media spot than smokers with no home smoking policy. Multivariate regression
      models indicated that having a home smoking ban was related to smoking fewer
      cigarettes per day and greater interest in quitting smoking compared with smokers
      with no smoking rules in the home (p < .05). CONCLUSIONS: These findings suggest
      that smokers reporting exposure to the California TCP were more likely to have
      restrictive home smoking policies and that more restrictive home smoking policies
      were associated with reduced smoking behavior.

PMID- 11194700
TI  - The social context of experimenting with cigarettes: American Indian "start
      stories".
AB  - Smoking rates among American Indians are higher than any other racial or ethnic
      group. Focus groups were conducted with 140 American Indian middle school
      students who were not living on reservations to explore the social context of
      smoking initiation. Most teens smoked their first cigarettes with friends,
      siblings or cousins, usually out of curiosity, or in response to peer
      encouragement. There was no indication of any link between smoking initiation and
      use of tobacco in traditional ceremonies. Overall, the social context for these
      teens was very similar to the social context of other teens in the United States.

PMID- 11194701
TI  - Stages of change and smoking cessation: a computer-administered intervention
      program for young adults.
AB  - Sixty-five college-student smokers were randomly assigned to a four-week computer
      administered, stage-based smoking control program or a four-week computer
      administered general health education control condition. At post-test, the
      percentage of students advancing to a higher stage of readiness to change was
      slightly higher among those in the stage-based program compared to the control
      condition. At seven month follow-up, both groups reported abstinence rates of
      approximately 30%. Continuous abstinence for 6 months was 19% for the stage-based
      group and 14% for the control group at the final follow-up.

PMID- 11194702
TI  - Impact of a telephone-based intervention on the reduction of health risks.
AB  - PURPOSE: Evaluate the long-term impact of telephone-based interventions that
      target high risk, ready-to-change individuals. DESIGN: Quasi-experimental design
      with pre/post comparisons of lifestyle-related health risks between participants
      and nonparticipants. SETTING: Six organizations from the private and public
      sectors. SUBJECTS: Subjects were 607 intervention participants who were compared
      with a control group of 1134 eligible nonparticipants. MEASURES: Health risk
      assessment at baseline and at an average of 2 years later measured risk in 13
      lifestyle areas. INTERVENTION: Programs were offered in seven areas: back care,
      cholesterol control, eating habits, exercise and activities, stress management,
      tobacco use, and weight control. Each program was conducted by a trained health
      educator who provided information and counseling to facilitate change in the area
      selected by the participant. All counseling was done by telephone and included
      three to five contacts over a 1-year period. RESULTS: Binary logistic regression
      models controlling for gender and age revealed both specific and general effects.
      Participants were 1.8 to 3.5 times as likely as nonparticipants to reduce the
      targeted risk in six of seven risk areas. In addition, participants were 1.7 to
      3.5 times as likely as nonparticipants to reduce their risks in nine of 13 areas
      not targeted by the intervention (i.e., general effect). Overall, participants
      significantly reduced their number of risks, whereas nonparticipants
      significantly increased their risk (difference of .85 risks). CONCLUSIONS:
      Results show that at-risk participants make long-term improvements in health
      risks directly related to the intervention in which they participate. Results
      also suggest that this intervention may help individuals develop behavior-change
      skills they can apply to other lifestyle issues.

PMID- 11194703
TI  - Delayed closure of epiphyseal cartilages induced by the aromatase inhibitor
      anastrozole. Would it help short children grow up?
AB  - Estrogens locally generated from androgen precursors due to the action of
      aromatase play a main role in epiphyseal cartilage fusion. Treatment with an
      aromatase inhibitor (anastrozole, 1 mg/day for 3 yr) in a boy previously operated
      on for a hamartoma causing precocious puberty and presenting with advanced bone
      maturation and nearly fused epiphyseal cartilages, slowed cartilage fusion
      consenting a higher final stature than expected (164.4 cm vs 158.4 cm). It is
      suggested that treatment with aromatase inhibitors, alone or in combination with
      rh-GH, may also be useful in children with constitutional short stature in order
      to delay epiphyseal closure and improve the final height.

PMID- 11194704
TI  - Neonatal and adult human heart tissues from normal subjects and patients with
      ischemic, dilated or hypertrophic cardiomyopathy express insulin-like growth
      factor binding protein-3 (IGFBP-3).
AB  - In the human fetus IGFBP-3 mRNA expression is most abundant in the skin, muscle
      and heart but circulating IGFBP-3 levels show age-related variations. In human
      heart tissues from controls and patients with either ischemic, dilated or
      hypertrophic cardiomyopathy (no.: 20, age-range from fetuses to elderly subjects)
      we determined the expression of cardiac IGFBP-3 mRNA by reverse transcriptase
      polymerase chain reaction (RT-PCR) and the protein by Western blotting. The same
      parameters were also determined in human livers. We detected IGFBP-3 mRNA in
      neonatal and adult as well as in fetal human heart tissues in both ventricles.
      Western blotting revealed the presence of IGFBP-3 in all the examined cardiac
      tissues. IGFBP-3 appeared to be more abundant in the heart than in the liver and
      in the failing hearts from patients with ischemic heart disease than in those
      with hypertrophic cardiomyopathy. Thus both normal and pathological human heart
      tissues express IGFBP-3 across lifespan and IGFBP-3 could play IGF-dependent
      and/or -independent actions at the myocardial level.

PMID- 11194705
TI  - Bone turnover in hyperthyroidism before and after thyrostatic management.
AB  - Hyperthyroidism is associated with enhanced osteoblastic and osteoclastic
      activity, and patients frequently have low bone mineral density and high bone
      turnover. The aim of this study was to examine the bone formation and resorption
      markers trend in 12 female patients, before and after normalization of thyroid
      activity. The following measurements were made at baseline and 1 and 6 months
      after hormone normalization induced by methimazole treatment: total alkaline
      phosphatase (ALP), bone alkaline phosphatase (BALP), collagen type C-terminal
      propeptide (PICP), osteocalcin (BGP), telopeptide (ICTP), urinary
      hydroxyproline/urinary creatinine (uOHP/uCreat), urinary calcium/urinary
      creatinine (uCa/uCreat) and deoxypyridinoline crosslinks (D-Pyr). Compared with
      controls, all of these parameters were significantly increased (ALP p = 0.014;
      BALP p = 0.0001; PICP p = 0.013; BGP p = 0.009; ICTP p = 0.0001; uOHP/uCreat p =
      0.002; uCa/uCreat p = 0.044; crosslinks p = 0.0001). After treatment the values
      of ALP, BALP and PICP in hyperthyroid patients showed an initial slight increase
      and then a significant downwards trend (ALP p = 0.008, BAP p = 0.001, PICP p =
      0.026). Furthermore, resorption markers showed a significant decrease (uOHP/
      uCreat p < 0.005 and D-Pyr p < 0.008). As regards lumbar BMD patients,
      measurements were significantly reduced in comparison with the control group (p =
      0.005). Six months after serum thyroid hormones level normalization, we observed
      a significant increase (p=0.014 vs baseline). Both neoformation and resorption
      markers are useful to assess pathological bone turnover and bone involvement in
      hyperthyroidism. They could also be employed to monitor the effect of antithyroid
      treatment on bone and to indicate if bone antiresorption therapy should be
      considered.

PMID- 11194706
TI  - Oxidative markers in diabetic ketoacidosis.
AB  - Oxidative stress has been implicated in the pathogenesis of the chronic
      complications of diabetes mellitus but little is known in diabetic ketoacidosis
      (DKA). The aim of this work was to determine whether lipid peroxidation, as
      assessed by measuring malondialdehyde (MDA, a prooxidant) and antioxidant status
      (TAS, an index of antioxidant defenses), is modified in DKA, and also whether any
      observed abnormalities were related to metabolic disturbances. METHODS: four
      groups of patients were studied, comprising 19 patients with DKA, massive
      ketonuria and plasma standard bicarbonate levels below 16 mmol/l (group 1); 20
      patients with poorly controlled diabetes, glycated hemoglobin (HbA1c) above 8%
      and plasma bicarbonate levels above 16 mmol/l (group 2); 11 patients with well
      controlled diabetes and HbA1c below 8% (group 3); and 10 non-diabetic, non-obese
      control subjects (group 4). Metabolic parameters, MDA levels and TAS were
      assessed in the plasma of the four groups of subjects. RESULTS: mean plasma MDA
      and TAS values were significantly different among the four groups (respectively p
      < 0.001 and p < 0.01). Mean plasma MDA value was significantly higher in group 1
      than in group 3 (p < 0.02) and group 4 (p < 0.001) but was not different from
      that in group 2. Mean plasma MDA value in group 2 was significantly lower than
      that in group 4 (p = 0.002). Mean plasma TAS value in group 1 was significantly
      lower than in groups 3 (p < 0.002) and 4 (p < 0.05). Mean plasma TAS value was
      significantly lower in group 2 than in group 4 (p<0.05). Plasma MDA values in the
      diabetic patients (groups 1+2+3) were not related to any clinical characteristics
      (BMI, age, duration of the disease) or metabolic parameters (glycemia, HbA1c
      bicarbonates, blood urea nitrogen, phosphatemia, lipids), while plasma TAS values
      correlated negatively with glycemia, osmolality and HbA1c. A significant
      relationship was also found between TAS and HbA1c in group 1 (p < 0.05) and
      between MDA and HbA1c in group 3 (p < 0.05). Correlations were also found between
      TAS and phosphatemia in group 1 (p < 0.01) and between MDA and phosphatemia in
      group 2 (p < 0.01). A positive relationship between MDA and cholesterol levels
      was found in group 1 (p < 0.01). In conclusion, MDA values are increased and TAS
      values decreased in DKA and poorly controlled diabetes, and tend to correlate
      more with markers of diabetic imbalance than with markers of acute metabolic
      disturbances of DKA.

PMID- 11194707
TI  - Growth promoting effect of human plasma ultrafiltrate bioactive fraction (TBP)
      for human non-functioning pituitary adenoma cells in vitro.
AB  - We described before that the chromatographically purified "human plasma
      ultrafiltrate bioactive fraction" (humoral factor tentatively denoted as tumor
      basic protein--TBP) regulates in vitro release of ACTH from pituitary adenomas
      stimulating the hormone release from the tumors showing low hormonal activity in
      vitro and inhibiting ACTH production in vitro by highly hormonally active
      pituitary tumors. In this study we describe growth promoting effects (determined
      by 3H-TdR incorporation assay) of TBP (5 microg/l, i.e. 10% w/v plasma equivalent
      concentration) for 10 non-functioning pituitary tumors. The effects of TBP
      appeared to negatively correlate with the in vitro growth abilities of the tumors
      that were otherwise dependent on the duration of the clinical symptoms of the
      tumor presence. Hence, similar to its effects on hormonal activity of the
      pituitary tumors, TBP stimulated the growth of the tumors which did not express
      high spontaneous 3H-TdR intensity, but did not stimulate the cells with high
      capacity of spontaneous 3H-TdR incorporation. Moreover, all the tumors that were
      stimulated by TBP were nononcocytic adenomas while oncocytoma cells were not
      stimulated at all. Thus, TBP shows activity of humoral (plasma) factor involved
      in the growth regulation of pituitary adenomas that might be used to define the
      growth abilities of these tumors, especially in case of null cell adenomas and
      oncocytomas as were the tumors used in this study.

PMID- 11194708
TI  - Pyridostigmine and metoclopramide do not restore the TSH response to TRH
      inhibited by L-thyroxine treatment in children with goiter.
AB  - To define the role of somatostatin and dopamine in TSH suppression induced by L
      thyroxine, 16 children (12 F, 4 M) on suppressive doses of L-thyroxine (3-4
      microg/kg/day) for endemic goiter were studied. Firstly a conventional TRH test
      was performed in all subjects, in order to evaluate TSH, PRL and GH (basal
      study). A week later a second TRH test was carried out; one hour before the test,
      however, group A (9 patients) was given 60 mg pyridostigmine bromide po
      (pyridostigmine study) and group B (7 patients) 10 mg metoclopramide po
      (metoclopramide study). In the basal study, TSH was suppressed in both groups and
      levels did not increase following TRH administration, while PRL increased
      significantly and GH levels remained stable. In the pyridostigmine study, TSH
      levels did not increase following TRH administration, while PRL and GH levels
      were both significantly raised. In the metoclopramide study, TSH and GH levels
      were not raised following TRH administration, while a significantly greater
      increase of PRL was observed. In conclusion, suppressive doses of L-thyroxine
      inhibit the TSH response to TRH, while they do not seem to affect GH and PRL
      secretion. Somatostatin and/or dopamine do not seem to play a significant role in
      the L-thyroxine-induced TSH suppression.

PMID- 11194709
TI  - Proteolytic processing of human growth hormone (GH) by rat tissues in vitro:
      influence of sex and age.
AB  - Although a wealth of evidence exists indicating that proteolytic cleavage can
      enhance the biological activity of the growth hormone (GH) molecule, the
      mechanisms responsible for the generation of GH fragments are not completely
      understood. In the present work we investigated the ability of different rat
      tissues to cleave 22 kDa GH, as well as the influence of sex and age, the two
      major physiological regulators of GH secretion on this process. Our results show
      that tissue homogenates obtained from rat liver, skeletal muscle or adipose
      tissue (three well-documented target organs for the hormone) are able to cleave
      22K-GH, while the hormone is resistant to cleavage by rat brain homogenates. This
      process is rather selective for 22K-GH, since the 20 kDa GH variant exhibits
      stability to degradation by all tissue homogenates investigated. Moreover, only a
      minor fraction of 22 kDa GH is cleaved under our experimental conditions,
      suggesting that GH microheterogeneity within the 22 kDa range may also determine
      hormone susceptibility. Finally, we also found that 22K-GH processing shows
      important age-related changes (the greatest intensity observed in 4-day-old
      pups), while no gender-related differences exist in any of the tissues
      investigated.

PMID- 11194710
TI  - A multimodality therapeutic approach in anaplastic thyroid carcinoma: study on 39
      patients.
AB  - The aim of this study was to investigate the role of multimodality treatment in
      patients with anaplastic thyroid carcinoma. From 1992 to 1999, 39 consecutive
      patients with a histologically or cytologically proven anaplastic thyroid
      carcinoma were referred to the Thyroid Center of Padua General Hospital. There
      were 28 females and 11 males with a median age of 69 years (range 39-88 years).
      About one-third of patients had a history of preceeding nodular goiter. Two
      patients had areas of differentiated thyroid carcinoma at histological
      examination. Local disease was present in 26 patients while distant metastases,
      mainly to the lung, were present in 22 at diagnosis or quickly developed during
      the observation period in all the others except one. Thirty-two patients were
      previously untreated: 9 of them were in good general condition, 1 had limited
      lung metastases, and the tumor mass was considered resectable by the surgeon.
      These 9 patients were treated with cisplatin once a week and radiotherapy (RT)
      36Gy in 18 fractions over three weeks, followed by total thyroidectomy (TT) and
      by further chemotherapy (CHT) with adriamycin and bleomycin in 4 patients. Seven
      patients, 3 with lung metastases at diagnosis, had undergone TT, followed by RT
      in 5, in another hospital and were subsequently referred to our center due to the
      presence of distant metastases. Therefore, a total of 16 patients (Group 1) was
      treated with TT, RT and CHT in various order. Nine patients with distant
      metastases at diagnosis (Group 2) received CHT; one of them had a disappearance
      of lung metastases and was then treated by TT and further CHT. Group 3 consisted
      of 14 elderly patients in poor general conditions; 4 of these received local RT,
      while the remaining did not receive any treatment. Four complete responses were
      seen in patients from Group 1, and 1 from Group 2. One patient without distant
      metastases at diagnosis is alive and free of disease 6 months after TT and
      adjuvant CHT, and 12 months after diagnosis. Three had long-term survival (14,
      24, 27 months) with a disease-free interval of 6-8-10 months. The patient from
      Group 2 who was treated in a second time by TT is alive without disease after 60
      months. Median survival rate was 11 months for Group 1, 5.7 months for Group 2
      and 4 months for Group 3. In some patients multimodality treatment (TT, RT and
      CHT) is associated with increased survival. Nine out of 16 patients, who
      underwent surgery and complementary treatment, had no local progression. In all
      but one distant metastases developed, mainly in the lung, during or after post
      surgical CHT. The best results were obtained in younger patients with less
      advanced disease. Early diagnosis is mandatory. Only a few patients responded to
      CHT, confirming that anaplastic thyroid carcinoma is often resistant to
      anticancer drugs. Our experience with combination modalities suggests that
      aggressive and appropriate combinations of RT, TT and CHT may provide some
      benefit in patients with anaplastic thyroid carcinoma. Preoperative CHT and RT
      may enhance surgical resectability of the primary tumor.

PMID- 11194711
TI  - Amyloid goiter in a case of systemic amyloidosis secondary to ankylosing
      spondylitis.
AB  - Infiltrative diseases of the thyroid include systemic sclerosis, hemochromatosis,
      sarcoidosis, chondrocalcinosis and amyloidosis. Only rarely does thyroid
      amyloidosis result in clinically palpable goiter. Classically, amyloidosis is
      associated with tuberculosis, rheumatoid arthritis, multiple myeloma or
      inflammatory bowel disease. Only rarely does clinical amyloidosis develop in the
      setting of ankylosing spondylitis. We describe a case of amyloid goiter in a
      patient with ankylosing spondylitis-associated amyloidosis.

PMID- 11194712
TI  - Use of the dopamine agonists bromocriptine and cabergoline in the management of
      risperidone-induced hyperprolactinemia in patients with psychotic disorders.
AB  - Risperidone is a novel antipsychotic agent that blocks both dopaminergic and
      serotonergic receptors. In several reports, clinically significant
      hyperprolactinemia has been reported in patients on this agent. However, the
      optimal management of risperidone-induced hyperprolactinemia has not been
      clarified. We reviewed the records of 5 patients with psychotic disorders who
      were evaluated for risperidone-induced hyperprolactinemia. There were 4 females
      and 1 male patient, aged 30-45 yr. All patients had significant
      hyperprolactinemia, with prolactin (PRL) levels ranging from 65.5 to 209
      microg/l. All but 1 of these patients had manifestations of hypogonadism. In
      these 4 patients, risperidone therapy was continued and the dopamine agonists
      bromocriptine or cabergoline were added. In 3 out of 4 patients, such additional
      therapy reduced the PRL level and alleviated hypogonadism. None of the patients
      treated with these agents had a worsening of psychosis. We conclude that
      risperidone can cause clinically significant hyperprolactinemia in patients
      treated with this drug. If risperidone therapy must be continued in such
      patients, addition of the dopamine agonists bromocriptine or cabergoline may
      successfully alleviate hyperprolactinemia and the associated manifestations
      without worsening psychotic symptoms.

PMID- 11194714
TI  - DHEA: A forgettable steroid?

PMID- 11194713
TI  - Occupational and environmental agents as endocrine disruptors: experimental and
      human evidence.
AB  - In the last few years great concern has arisen from the description of adverse
      endocrine effects of several occupational and environmental chemical agents on
      human and/or wildlife health. Such agents may exert their effects directly,
      specifically binding to hormone receptors, and/or indirectly, by altering the
      structure of endocrine glands and/or synthesis, release, transport, metabolism or
      action of endogenous hormones. Many studies have been focused on the outcomes of
      the exposure to those chemicals mimicking estrogenic or androgenic actions.
      Nonetheless, the disruption of other hormonal pathways is not negligible. This
      paper reviews the experimental and human evidence of the effects of occupational
      and environmental chemical agents on hypothalamus-pituitary unit, pineal gland,
      parathyroid and calcium metabolism and adrenal glands.

PMID- 11194715
TI  - Animal welfare and scientific evidence.

PMID- 11194716
TI  - Egg safety more important than hen housing.

PMID- 11194717
TI  - "Extreme upset"--AVA's welfare claims appalling.

PMID- 11194718
TI  - President started well but now seems 'lost'.

PMID- 11194719
TI  - Mastitis, polyarthritis and abortion caused by Mycoplasma species bovine group 7
      in dairy cattle.
AB  - OBJECTIVE: To report an outbreak of mastitis, polyarthritis and abortion caused
      by Mycoplasma sp bovine group 7 in three large, centrally-managed dairies and to
      review the relevant literature. DESIGN: Epidemiological, clinical and laboratory
      data were analysed, collated and reported. Multidisciplinary procedures were
      employed. These included clinical assessment and comprehensive laboratory
      investigations of affected calves, aborted foetuses and milk samples. Mycoplasma
      cultures and genetic analyses of isolates were undertaken to identify the
      aetiological agent. RESULTS: About 30% of 240 calves usually kept in a calf
      rearing facility developed severe polyarthritis as a result of Mycoplasma sp
      bovine group 7 infection between 2 and 3 weeks of age. Multiple abortions
      occurred on these farms. Mycoplasma sp bovine group 7 was recovered from the
      fibrinopurulent synovial exudates of four 14-day-old calves, from the stomach
      contents and lungs of two aborted foetuses, from 14 of 21 bulk milk and four of
      10 mastitic quarters. Three bulk colostrum samples cultured during the outbreak
      were negative for mycoplasma. CONCLUSION: Mycoplasma sp bovine group 7 caused
      significant economic losses as a result of polyarthritis, abortion and mastitis.
      The disease probably originated from udder infections with spread being
      facilitated by the decreased use of tetracycline in the treatment of mastitis.
      Neonatal calves were most likely infected by the consumption of milk contaminated
      with the organism. Abortions presumably resulted from mycoplasmaemia. This
      appears to be the first report in Australia of bovine abortion resulting from
      Mycoplasma sp infection.

PMID- 11194720
TI  - Physical, chemical and biological hazards in veterinary practice.
AB  - OBJECTIVE: To identify major occupational hazards encountered by veterinarians
      and their staff in practice in Australia. PROCEDURE: A literature search of
      Medical (MEDLINE), Occupational Health and Safety (OSHRAM) and Nursing and Allied
      Health (CINAHL) electronic data bases plus continual monitoring utilising the
      Uncover alerting system using the key words, 'occupational injury', 'occupational
      disease' and 'safety' linked with use of the word 'veterinarians' has found
      relevant articles. Personal communication with people who have undertaken studies
      on occupational safety in veterinarians elicited further information. CONCLUSION
      AND RECOMMENDATIONS: Veterinarians often sustain animal-related injuries, the
      most common of which are dog and cat bites, cat scratches and being hit or
      crushed by large animals. The most costly to treat include strains and back
      injuries. Most veterinarians treat themselves. There is no single reporting
      system for injuries or disease in veterinarians and reported cases may greatly
      underestimate the total. There is a need to assess accurately the occupational
      hazards in veterinary practice, to determine the actual occurrence of injuries
      and to develop strategies to prevent them.

PMID- 11194721
TI  - Characterisation of isolates of Haemophilus paragallinarum from Indonesia.
AB  - OBJECTIVE: To characterise 18 isolates of Haemophilus paragallinarum isolated
      from chickens in Indonesia. PROCEDURE: The isolates were identified to species
      level by traditional phenotypic methods. Six of the isolates were also identified
      by a species-specific polymerase chain reaction. Fourteen of the isolates were
      examined for resistance to a panel of seven antimicrobial agents using a disc
      diffusion method. All 18 isolates were serotyped according to the Page scheme
      using reference antisera in a haemagglutination inhibition test. RESULTS: Four of
      the 18 isolates were obtained from indigenous (kampung) chickens, with the
      remainder being from typical intensive poultry production systems. The 18
      isolates were obtained from 11 outbreaks that showed the typical clinical signs
      of infectious coryza and 11 of the isolates were obtained from chickens that had
      been vaccinated with infectious coryza vaccines. All 18 isolates were confirmed
      as H paragallinarum by biochemical testing and six isolates were also identified
      as H paragallinarum by the polymerase chain reaction test. Eleven isolates were
      resistant to erythromycin and streptomycin, 10 to neomycin, eight to
      oxytetracycline, five isolates to doxycycline, three to
      sulphamethoxazoltrimethoprim but only one to ampicillin. Seven isolates were Page
      serovar A, four were Page serovar B and seven were Page serovar C. CONCLUSION:
      The presence of all three Page serovars (A, B and C) has been confirmed for the
      first time in Indonesian chickens. As the majority of the infectious coryza
      vaccines in use in Indonesia contain only serovar A and C, the presence of
      serovar B in chickens indicates that the protection by these bivalent vaccines
      would be reduced. The use of trivalent infectious coryza vaccines that contain
      serovars A, B and C is recommended for use in Indonesia.

PMID- 11194722
TI  - A clinical trial to evaluate the effectiveness of antibiotic treatment of
      lactating cows with high somatic cell counts in their milk.
AB  - OBJECTIVE: To determine the effectiveness of treatment of lactating cows with
      high somatic cell counts in milk. DESIGN: Randomised clinical trial. METHODS:
      Single pooled quarter samples of milk were obtained from cows with somatic cell
      counts above 500,000 cells/mL on fifty farms. Milk samples were cultured for
      known mastitis bacterial pathogens. Cows were randomly allocated to treated and
      untreated groups. Treated cows received both intramammary cloxacillin and
      parenteral erythromycin. Single pooled quarter milk samples were obtained at 6
      weeks after treatment and were cultured for the presence of pathogenic bacteria.
      The percentage of samples with no growth at the post-treatment culture was used
      as an estimate of the bacteriological cures for each pathogen type and for each
      treatment group. Somatic cell counts of cows were compared between treatment
      groups and within pathogen group. The number of cows that completed a full
      lactation were compared between each treatment group and within each pathogen
      group. RESULTS: Treatment had no effect upon bacteriological cures, irrespective
      of pathogen present or the presence of bacteria during the previous lactation.
      There was no effect of treatment upon somatic cell count except for cows infected
      with Streptococcus dysgalactiae in which treatment caused a significant lowering
      of cell counts. This effect was not present in the subsequent lactation.
      Treatment of chronically infected cows did not alter the probability of a cow
      completing a full lactation but did improve the probability of newly infected
      cows being retained for the next lactation. Twenty-eight of 214 treated cows
      developed clinical mastitis in more than one quarter after treatment, thus
      indicating a poor technique by farmers for the insertion of intramammary
      antibiotics. CONCLUSIONS: Treatment during lactation of cows with high somatic
      cell counts in milk is ineffective in reducing bacterial infections and in
      reducing somatic cell counts to acceptable numbers.

PMID- 11194723
TI  - Prevalence of laryngeal paresis in dogs undergoing general anaesthesia.
AB  - OBJECTIVE: To estimate the prevalence of laryngeal paresis within a selected
      population of dogs and identify some of the distinguishing characteristics of
      affected dogs. DESIGN: A prospective study involving laryngoscopic examination of
      250 dogs. PROCEDURE: The laryngeal movements of 250 dogs undergoing general
      anaesthesia were observed. The severity of laryngeal paresis in these dogs was
      graded (0 = normal laryngeal movements, 4 = bilateral laryngeal paralysis). The
      following information was also recorded for each dog: age, sex, weight, breed,
      condition score, anaesthetic protocol, clinical suspicion of disease and
      observer. RESULTS: Twenty five percent of the dogs examined had some degree of
      laryngeal paresis. Affected dogs were significantly older than unaffected dogs (P
      < 0.001). There was a trend for the severity of laryngeal paresis to increase
      with age. There was no difference between the sexes. Dogs with laryngeal paresis
      were significantly heavier than normal animals (P < 0.02). Overweight animals had
      a significantly higher laryngeal grade than those with a normal condition score
      (P < 0.05). Labrador Retrievers and Rottweilers had a significantly higher risk
      of having laryngeal paresis (P < 0.05). Clinical suspicion was found to have high
      diagnostic value. An intra-class correlation coefficient for inter-rater
      reliability between the two observers was 0.95. CONCLUSIONS: Laryngeal paresis
      had a high prevalence in the animals surveyed and was strongly associated with
      age and breed. The results of this study are consistent with the concept of a
      progressive degenerative disease with a breed susceptibility. Clinical suspicion
      for the presence of the disease was a reliable indicator. The grading system used
      had a high degree of inter-observer agreement.

PMID- 11194724
TI  - Genetic screening for progressive retinal atrophy in the Australian population of
      Irish Setters.
AB  - OBJECTIVE: To determine whether the rcd-1 mutation causing progressive retinal
      atrophy (PRA) in Irish Setters is in the Australian breeding population. METHOD:
      DNA samples were tested for the mutation using the Polymerase Chain Reaction and
      specific primer nucleotides to amplify the phosphodiesterase gene followed by
      restriction enzyme cleavage and fragment size determination. RESULTS: No mutant
      alleles were found in 38 Irish Setters, representing over 80% of all major
      breeding stock in five Australian states. CONCLUSIONS: It is likely that the
      Australian population of Irish Setters is free of the rcd-1 form of PRA.

PMID- 11194725
TI  - Evaluation of brain damage resulting from penetrating and non-penetrating captive
      bolt stunning using lambs.
AB  - OBJECTIVE: To compare the brain damage in sheep resulting from penetrating and
      non-penetrating captive bolt stunning. DESIGN: The unrestrained heads of
      anaesthetised lambs were impacted in the temporal region with penetrating and non
      penetrating captive bolt pistols (humane stunners) using a constant charge. Two
      hours after head impact, brains were perfusion-fixed with 4% paraformaldehyde.
      Coronal sections were stained with haematoxylin and eosin and
      immunohistochemically for amyloid precursor protein, a sensitive marker of axonal
      and neuronal reaction in brains after trauma. Pathological changes in these
      brains were then quantified by morphometric analysis. RESULTS: The skull was
      fractured in 50% of lambs after a non-penetrating head impact and in all animals
      after a penetrating head wound. Impact contusions were present in 80% of lambs
      receiving a non-penetrating head injury and in all of those with a penetrating
      wound. Total contusion area was similar in both groups. Amyloid precursor protein
      positive axons and neurons, and haemorrhage, were widely distributed in the brain
      after both head impact types, but there was no statistically significant
      difference between the two groups. Multifocal necrosis of the cerebellar granular
      layer was found in all lambs with non-penetrating head injury, but in none with a
      penetrating injury. CONCLUSIONS: The structural brain damage, a mixture of focal
      and diffuse injury, produced by penetrating and non-penetrating captive bolt
      pistols was overall similar and of sufficient severity to suggest that both types
      of weapon are acceptable for euthanasia.

PMID- 11194726
TI  - Comparison of three serological tests and an interferon-gamma assay for the
      diagnosis of paratuberculosis in experimentally infected sheep.
AB  - OBJECTIVE: To compare the diagnostic performance of a complement fixation test,
      an agar gel immunodiffusion test, an enzyme-linked immunosorbent assay, and a
      whole-blood interferon-gamma assay for paratuberculosis in 14 sheep
      experimentally infected with Mycobacterium avium subsp paratuberculosis.
      EXPERIMENTAL DESIGN: Longitudinal study. RESULTS: The IFN-gamma assay detected
      more experimentally infected sheep, and earlier, than any of the serological
      tests. None of the antibody assays was able to detect all sheep with
      histologically confirmed paratuberculosis. CONCLUSIONS: The superior performance
      of the IFN-gamma assay in detecting infected sheep in this small experimental
      population warrants its further evaluation in a larger population of sheep
      naturally exposed to M a paratuberculosis.

PMID- 11194727
TI  - Improving the predictability of performance by prerace detection of dorsal
      metacarpal disease in thoroughbred racehorses.

PMID- 11194728
TI  - Bulk milk cell counts and bacterial dermatoses.

PMID- 11194729
TI  - Helicobacter pylori: changing patterns of ulcer disease and antibiotic
      resistance.

PMID- 11194730
TI  - Getting to grips with heroin and other opioid use.

PMID- 11194731
TI  - Lessons from the MONICA Project. MONItoring Trends and Determinants of
      CArdiovascular Disease.

PMID- 11194732
TI  - Domestic violence.

PMID- 11194733
TI  - Demographic and endoscopic characteristics of patients with Helicobacter pylori
      positive and negative peptic ulcer disease.
AB  - OBJECTIVE: To identify demographic and endoscopic characteristics of patients
      with Helicobacter pylori positive and negative chronic peptic ulcer disease.
      DESIGN: Cross-sectional study of peptic ulcer disease in prospectively recruited
      PATIENTS undergoing gastroscopy. PATIENTS: 277 consecutive patients referred for
      gastroscopy in 1996-1998. MAIN OUTCOME MEASURES: Rapid urease test, culture and
      histological examination for H. pylori infection; anti-H. pylori IgG antibodies
      in serum; demographic data, intake of non-steroidal anti-inflammatory drugs
      (NSAIDs) in the preceding 3 months, and size, number and location of ulcers.
      RESULTS: 54 patients (19%) had evidence of peptic ulcer disease (34 gastric
      ulcer, 14 duodenal ulcer and 6 both gastric and duodenal ulcer); 45 had active
      chronic peptic ulcer disease and were analysed in detail. H. pylori was present
      in 25 (56%) of these patients; 10 (22%) had used NSAIDs and 7 of the NSAID group
      also had H. pylori infection. Of the patients with gastric ulcers, those with non
      H. pylori, non-NSAID ulcers were significantly younger than both those with H.
      pylori-associated ulcers (mean age, 48 v. 65 years, P = 0.02) and those with
      NSAID-associated ulcers (mean age, 48 v 68 years, P = 0.02). The average size and
      number of gastric ulcers did not differ between patients with and without H.
      pylori infection. Of patients with duodenal ulcers, those with H. pylori
      infection had significantly fewer ulcers (1.1 v. 1.8, P = 0.04), although ulcer
      size was similar in the infected and uninfected groups. CONCLUSIONS: Gastric
      ulcers may now be more common than duodenal ulcers. Gastric ulcers associated
      with H. pylori infection and/or NSAID use occurred mostly in older people, while
      non-H. pylori, non-NSAID gastric ulcers were more common in younger patients. In
      the duodenum, single ulcers were associated with H. pylori infection, and
      multiple ulcers were more frequent in the non-H. pylori, non-NSAID group.

PMID- 11194734
TI  - Antibiotic resistance in Helicobacter pylori.
AB  - OBJECTIVE: To describe antibiotic resistance patterns in Helicobacter pylori.
      DESIGN: Culture and antibiotic sensitivity testing of antral and gastric body
      biopsy samples from patients having gastroscopy. PARTICIPANTS: Consecutive
      consenting patients aged 18 years or more presenting for gastroscopy from 1 July
      1998 to 30 June 1999. SETTING: An open-access gastroscopy service at an urban
      university tertiary hospital. MAIN OUTCOME MEASURES: Number of H. pylori isolates
      showing resistance to antibiotics; correlates of such resistance with demographic
      and clinical information. RESULTS: Of 1580 patients undergoing endoscopy, 434
      agreed to participate in the study. 108 (24.9%) had positive cultures for H.
      pylori, and 88 of these isolates (81%) were available for further testing.
      Resistance to metronidazole and clarithromycin was detected in 36% and 11%,
      respectively. No resistance was found to tetracycline or amoxycillin.
      Metronidazole resistance was commoner in younger patients (P = 0.0004) and
      macrolide resistance was commoner in those born outside Australia or New Zealand
      (P = 0.03). CONCLUSIONS: We found substantial resistance to metronidazole, and
      emerging clarithromycin resistance, but complete susceptibility to amoxycillin,
      tetracycline, gentamicin and cefaclor. These factors may influence the
      effectiveness of presently recommended eradication regimens.

PMID- 11194735
TI  - Trends in licit opioid use in Australia, 1984-1998: comparative analysis of
      international and jurisdictional data.
AB  - OBJECTIVES: To examine trends from 1984 to 1998 in licit opioids used in
      Australia compared with nine other developed countries, and in New South Wales
      compared with other Australian jurisdictions. DESIGN: Poisson regression analysis
      of annual rates of national and jurisdictional consumption of methadone, morphine
      and pethidine. MAIN OUTCOME MEASURES: All drug data were standardised to defined
      daily doses per 1000 population per day. RESULTS: Methadone consumption increased
      by, on average, 12% per year (RR, 1.12; 95% CI, 1.08-1.17), with Australia in the
      first rank of countries. Morphine use increased by 5% per year (RR, 1.05; 95% CI,
      1.02-1.09), with Australia ranking equal second with three other countries behind
      Denmark. Consumption of pethidine in all 10 countries was unchanged (RR, 0.99;
      95% CI, 0.97-1.00), with Australia equal first. In Australia, use of methadone
      syrup increased by 17% per year (RR, 1.17; 95% CI, 1.16-1.17) and by 11% per year
      for methadone tablets (RR, 1.11; 95% CI, 1.10-1.12). Consumption of methadone
      syrup in NSW was more than double that of any other jurisdiction. Consumption of
      methadone tablets was 2.4 times higher in South Australia (RR, 2.35; 95% CI, 2.09
      2.65) than NSW. The Northern Territory, Tasmania and Queensland also had
      significantly higher consumption than NSW. From 1991 to 1998, controlled-release
      morphine consumption increased by 27% per year nationally (RR, 1.27; 95% CI, 1.24
      1.30). The NT had 2.6 times more supply of morphine (RR, 2.63; 95% CI, 1.71-4.03)
      and Tasmania 58% more supply than NSW (RR, 1.58; 95% CI, 1.11-2.25). CONCLUSIONS:
      Australia's consumption of licit opioids ranked high internationally. There were
      diverse trends in the supply of licit opioids to Australia's jurisdictions,
      resulting in a heterogeneous pattern throughout the country.

PMID- 11194736
TI  - How many dependent heroin users are there in Australia?
AB  - OBJECTIVE: To estimate the prevalence of dependent or daily heroin users in
      Australia, and to compare the prevalence in Australia with that in other
      developed countries. DESIGN: We applied three different methods of estimation
      (back-projection, capture-recapture, and multiplier) to data on national opioid
      overdose deaths in Australia, first-time entrants to methadone maintenance
      treatment, and heroin-related arrests in New South Wales. We compared our
      estimates with estimates derived by similar methods in countries of the European
      Union. DATA SOURCES: Data on national opioid overdose deaths were obtained from
      the Australian Bureau of Statistics. Data on methadone entrants in NSW were
      extracted from a database maintained by the NSW Department of Health. Data on
      arrests for heroin-related offences were supplied by the NSW Police Service.
      RESULTS: The best estimates of the number of dependent heroin users in Australia
      in 1997-1998 from the three methods of estimation were between 67 000 and 92 000
      and the median estimate was 74 000. The population prevalence was 6.9 per 1000
      adults aged 15-54 years. The prevalence of heroin dependence in Australia is the
      same as that in Britain (7 per 1000) and within the range of recently derived
      estimates in the European Union (3-8 per 1000 adults aged 15-54 years).
      CONCLUSIONS: Although the exact figures need to be interpreted with caution, our
      estimates suggest that Australia has a substantial public health problem with
      dependent heroin use that is of a magnitude similar to that in comparable
      European societies.

PMID- 11194737
TI  - What can we do about domestic violence?
AB  - Domestic violence is a complex issue at both an individual and public health
      level. Barriers to disclosure often lie with the doctor rather than the victim. 
      Assessment of risk and devising a safety plan are important steps for the doctor
      to undertake with the victim. Recommendations for joint counselling or marriage
      guidance for the couple are usually not appropriate.  The efficacy of population
      screening for domestic violence has not yet been demonstrated. More limited
      opportunistic screening is recommended, especially in the emergency department,
      mental health and obstetric settings, and general practice.  Health professionals
      can be a bridge to resources within the community, but this requires knowledge of
      and liaison with those services.

PMID- 11194738
TI  - The rediscovery of methadone for cancer pain management.
AB  - Methadone is a potent synthetic opioid analgesic best known in Australia as
      maintenance therapy for narcotic addicts. Acceptance of methadone in cancer pain
      management is limited by a poor understanding of its pharmacokinetics and
      confusion about dosage. Many opioid conversion charts underestimate the potency
      of methadone, resulting in the risk of toxicity. Methadone is a valuable addition
      to the armamentarium of clinicians treating severe cancer pain, particularly
      neuropathic pain, that is poorly responsive to opioids or where opioid side
      effects are unacceptable.

PMID- 11194739
TI  - Forty years of combined oral contraception: the evolution of a revolution.
AB  - The combined oral contraceptive (COC) pill has become an integral part of
      fertility choice in almost every country since its introduction in 1960 in the
      United States. It was the first contraceptive method to provide sexual freedom of
      choice for women through reliable personal, private control of fertility. Modern,
      very low-dose pills have maintained a high degree of contraceptive efficacy, but
      the margin for error in pill-taking appears much smaller. These COCs have a much
      lower incidence of side effects and serious complications than early high-dose
      COCs. Serious health risks from venous thromboembolism are rare, and not
      measurably higher for pills containing third-generation compared with earlier
      progestogens. Most women feel very well taking modern COCs, but myths about these
      drugs still abound. Most non-contraceptive health benefits of COCs are still not
      widely appreciated in spite of much evidence. Controversy still persists over the
      association between COC use and breast cancer. Although slightly more breast
      cancers are detected in current COC users (relative risk 1.24; 95% CI, 1.15
      1.33), they are less advanced and less aggressive. Some women have pre-existing
      medical risk factors for COC use, and a detailed history for cardiovascular risk
      factors is one of the most important precautions.

PMID- 11194740
TI  - Depression: dispirited or spiritually deprived?
AB  - The 20th century has seen a widespread decline in mental health in Western
      society. One important factor may be the lack of meaning and spiritual fulfilment
      that is part of our increasingly secular and materialistic society. In medical
      education and practice, religious issues are often marginalised or
      'pathologised", despite consistent evidence from the literature of the protective
      effect of "religiosity" or "spirituality" on mental and physical health.

PMID- 11194741
TI  - Pituitary apoplexy: the importance of citing the differential diagnosis.

PMID- 11194742
TI  - Does cleansing the birth canal at delivery reduce postnatal infection rates?

PMID- 11194743
TI  - Amoxycillin resistance in an isolate of Helicobacter pylori from Melbourne.

PMID- 11194744
TI  - Epidemic of schizophrenia in children or inappropriate prescribing?

PMID- 11194745
TI  - Carotid sinus massage in the elderly: is it worth the risk?

PMID- 11194746
TI  - Managed care.

PMID- 11194747
TI  - Accidental paracetamol overdosing and fulminant hepatic failure in children.

PMID- 11194748
TI  - Possible steroid-sparing effect in asthma of lyprinol, a shellfish lipid extract.

PMID- 11194749
TI  - Overcrowding and infectious diseases--when will we learn the lessons of our past?

PMID- 11194750
TI  - Qualitative approaches in health research.

PMID- 11194751
TI  - Transposition of the great arteries: operative outcome in the current era.
AB  - AIMS: To assess the operative outcome, cardiac and neurodevelopmental sequelae in
      infants with transposition of the great arteries (TGA) undergoing the arterial
      switch operation (ASO). METHOD: Cross-sectional review of the 48 consecutive
      patients operated on in the calendar years 1995 and 1996 was undertaken to obtain
      recent cardiac, growth and neurodevelopmental parameters, and the mortality
      results were compared to the entire cohort of infants who underwent the ASO for
      definitive repair of TGA and double outlet right ventricle at Greenlane hospital
      between 1984 and 1998. RESULTS: Between January 1995 and December 1996, 48
      patients underwent the ASO. 96% were alive, and 88% alive and free from
      reoperation or significant neurological sequelae at a mean followup interval of
      sixteen months. Six (13%) had important residual cardiac lesions, of which supra
      valvular pulmonary stenosis was the most common. Growth parameters at follow-up
      were normal, as was the neurodevelopmental progress of all but two survivors
      (96%). CONCLUSION: In the current era, the ASO is a relatively safe procedure
      with excellent cardiac and neurodevelopmental outcome in the majority of infants.

PMID- 11194752
TI  - The sexual activity of 654 fourth form Hawkes Bay students.
AB  - AIMS: To describe the self reported patterns of sexual behaviour of 4th form High
      School Students from the Hawkes Bay region of New Zealand, in 1998. METHODS:
      Subjects completed a self administered written anonymous questionnaire in a
      supervised classroom situation. RESULTS: 654 4th form students, median age
      fourteen years, completed the questionnaire--45% male, 54% female. 39.4% of the
      sample reported having had sex/intercourse. Maori students were nearly three
      times (74.9%) as likely as European students (26.7%) to be sexually active (p <
      0.0001). 20.1% of these sexually active 4th formers report more than five
      partners. 11.9% of the total group and 30.2% of those who are sexually active,
      reported having first sex at age 12 or younger. CONCLUSIONS: The sexual activity
      of this sample of 4th form students is higher than reported previously in New
      Zealand, particularly so for Maori. Further research is needed to examine sexual
      behaviours and attitudes of young New Zealanders in the different communities to
      enhance the development and provision of geographically and culturally
      appropriate early sexuality education programmes and services. These should be
      designed to have particular relevance to the needs of young Maori.

PMID- 11194753
TI  - The effect on medical practice of disciplinary complaints: potentially negative
      for patient care.
AB  - AIM: To explore the personal and professional effect on general practitioners
      (GPs) of receiving a complaint against them to the (former) Medical Practitioners
      Disciplinary Committee, when the complaint did not proceed to a formal hearing.
      METHODS: Ten GPs were interviewed by telephone, following an enrollment procedure
      that protected identities from the interviewer. Qualitative (thematic) analysis
      of indepth interviews was used to categorise doctors' perceived effects of
      complaints on practice and to develop a theory on why such effects should occur.
      RESULTS: Receipt of a complaint had both short- and long-term effects on the
      doctor, and on their views of patients, society and the disciplinary process.
      There were immediate negative emotional responses that were sustained in the long
      term in a way that adversely effected doctor-patient relationships beyond the
      relationship with the original complainant. Doctors reported short-term changes
      in their practice of medicine, with reduced ability to work confidently and
      decisively. Doctors also reported altered practice in the long-term in the
      direction of defensive medicine, by withdrawing from providing some services and
      avoiding perceived at-risk activities. CONCLUSION: The impact of a complaint on
      the self of the doctor suggests a shame response. There may be a need for the
      relevant professional college to establish a rapid response 'crash team' to
      minimize the negative personal and professional effects of a complaint, even when
      the complaint does not proceed to a formal hearing.

PMID- 11194754
TI  - Frequency of microdeletions in the azoospermia factor region of the Y-chromosome
      of New Zealand men.
AB  - AIM: To determine the frequency of microdeletions in the azoospermic factor (AZF)
      genes on the Y-chromosome of New Zealand men attending the Fertility Centre.
      METHODS: World Health Organisation criteria were used to classify men as
      normospermic, oligozoospermic, severely oligozoospermic, and azoospermic.
      Microdeletions were detected from DNA of semen samples by the sequence-tagged
      site polymerase chain reaction. RESULTS: Microdeletions were detected in 20%
      (3/15) of azoospermic men, 4% (2/50) of severely oligozoospermic men, 3.2% (2/62)
      of oligozoospermic men, and 0.7% (1/141) normospermic men. One azoospermic man
      had multiple non-contiguous deletions. Overall, 5.5% of infertile men had at
      least one microdeletion in the long arm of the Y-chromosome. One severely
      oligozoospermic man and one oligozoospermic man had produced unassisted
      pregnancies. CONCLUSION: New Zealand men attending a Christchurch fertility
      centre have a similar frequency of microdeletions in the Y-chromosome to other
      populations. Azoospermic men have a higher frequency of microdeletions than men
      with less severe spermatogenic failure. Men with microdeletions can have reduced
      fertility, but are not necessarily sterile.

PMID- 11194755
TI  - Concealing clinical uncertainty--the language of clinicians.

PMID- 11194756
TI  - Blowing the whistle on bad practice.

PMID- 11194757
TI  - Retention of junior medical officers.

PMID- 11194758
TI  - Gastrogate.

PMID- 11194759
TI  - Getting health back on track.

PMID- 11194760
TI  - Getting health back on track.

PMID- 11194761
TI  - Health and the World Trade Organization.

PMID- 11194762
TI  - Does place of residence matter? Contextual effects and smoking in Christchurch.
AB  - AIM: To analyse the relationship between residential segregation and smoking and
      quit rates in Christchurch. METHOD: The study used a nested research design,
      which examines the extent to which variations in adult smoking rates at the
      meshblock level are, when holding socio-economic status constant, also influenced
      by the socio-economic profile of the census area units or wider communities
      within which they are located. RESULTS: Smoking and quit rates are not only
      related to levels of local neighbourhood (meshblock) deprivation, but also depend
      to a large extent on whether such neighbourhoods are located in socially
      segregated or more socially mixed parts of the city. The findings provide added
      support for the independent influence of contextual effects on smoking behaviour.
      CONCLUSION: The results suggest that attempts to further reduce smoking should
      target places as well as people.

PMID- 11194763
TI  - Utilisation rates in capitated primary care centres serving low income
      populations.
AB  - AIM: To measure utilisation rates in capitated primary care organisations serving
      low income populations with low or zero co-payments, and to examine the
      relationship between utilisation rates and organisation, age group, sex,
      ethnicity, community services card (CSC) holding rates, high use health card
      (HUHC) holding rates and deprivation of area of residence (NZDep96). METHODS:
      Data were collected during 1997/98, from eleven primary care organisations.
      Utilisation data were collected from practice computer information systems.
      RESULTS: 53.9% of registered patients were recorded as having consulted in a
      twelve-month period. Utilisation rates for doctor, nurse and midwife combined
      were higher amongst the young, elderly, and CSC holders. For males, they were
      higher amongst those living in the most socioeconomically deprived areas, but not
      for females. Utilisation rates were highest amongst the 'other' ethnic group, and
      lowest in the Pacific Island ethnic group. Organisation, age group, sex,
      ethnicity, CSC, HUHC and NZDep96 were independently predictive of total
      utilisation. CONCLUSIONS: Utilisation rates in capitated practices tended to be
      lower than those in fee-for-service practices. If equitable needs-based
      capitation funding formulas are to be developed, utilisation data from capitated
      practices in a range of cultural and socioeconomic settings is urgently required.

PMID- 11194764
TI  - "The view from the bottom of the cliff." Old age psychiatry services in New
      Zealand: the patients and the resources.
AB  - AIM: Despite the continual restructuring of New Zealand's health services in
      recent years, the development of mental health services for older people has been
      neglected as a strategic planning issue. METHODS: In 1998/9, the New Zealand
      branch of the Faculty of Psychiatry of Old Age (FPOA) of the Royal Australian and
      New Zealand College of Psychiatrists (RANZCP) initiated a national survey to
      obtain an overview of patient needs and national resources, with the aim of
      providing information to assist planning. Data were collected from eleven Old Age
      Psychiatry services nationwide, covering a total catchment of 2,800,000 New
      Zealanders. RESULTS: Patients were mostly over 70 years of age, female and with
      high co-morbidity for both medical and psychiatric illnesses. New Zealand
      resources directed to meet the needs are low by international standards.
      CONCLUSIONS: The results clarify the range of patient problems that Old Age
      Psychiatry services manage and the resources available. Most New Zealand services
      conform to World Health Organization recommendations.

PMID- 11194765
TI  - Distal forearm fractures in New Zealand children: annual rates in a
      geographically defined area.
AB  - AIMS: To estimate the annual incidence of distal forearm fractures in New Zealand
      children and to describe circumstances associated with this fracture. METHODS:
      The ages and dates of fracture of all girls and boys aged three to fifteen years
      with distal forearm fractures treated at Fracture Clinic, Dunedin Public Hospital
      in one calendar year were recorded. RESULTS: The age-standardised annual
      incidence rates for Dunedin girls and boys aged three to fifteen years were 10.4
      per 1000 (95% CI 8.3-12.4 per 1000), and 10.4 per 1000 (95% CI 8.3-12.6 per
      1000), respectively. The peak incidence in girls was observed at ten years of age
      (23.5 fractures per 1000) and for boys at thirteen years of age (25.3 fractures
      per 1000). Extrapolation of these rates to all New Zealand suggest that in
      children aged three to fifteen years, 3659 (95% CI 2906-4413) distal forearm
      fractures occur per year in girls, and 3845 (95% CI 3087-4603) per year in boys,
      representing about 20 fractures per day. Many of the fractures for the girls and
      boys resulted from apparently slight trauma (62.2% and 61.6%, respectively).
      CONCLUSIONS: Distal forearm fractures are very common events in New Zealand
      children and adolescents, and are usually caused by apparently slight trauma.

PMID- 11194766
TI  - Waiting for coronary bypass surgery. Observations from the sidelines.

PMID- 11194767
TI  - Whither the public health function?

PMID- 11194768
TI  - There is no place for a graduate entry medical course in New Zealand.

PMID- 11194769
TI  - Gastrogate.

PMID- 11194770
TI  - Getting the fat tax on the table.

PMID- 11194771
TI  - Pregnancies among New Zealand teenagers.

PMID- 11194772
TI  - Rickets in the welfare state.

PMID- 11194773
TI  - Re-using 'single-use' medical devices.

PMID- 11194774
TI  - Evolving concepts in the pathogenesis of chronic obstructive pulmonary disease.
AB  - It is arguable that more biologic insight has been gained from the study of COPD
      than from any other pulmonary disorder. A vast knowledge of the biology of
      extracellular matrix proteins, proteinases, and proteinase inhibitors has largely
      stemmed from the elastase:anti-elastase hypothesis for the pathogenesis of
      emphysema. An equally compelling case could be made that interest in, and funding
      for, COPD research has been woeful, and investigators have made no significant
      medical breakthroughs in the treatment of this disorder, which, unfortunately, is
      becoming epidemic worldwide. Indeed, it cannot be argued that physicians have
      very little treatment to offer to the many patients with COPD. Humankind is
      rapidly approaching a time when all human genes will be sequenced, and genetic
      engineering will allow determination of the function of these proteins in vivo.
      Expression profiling and bioinformatics will allow clinicians to assess the
      spectrum of genes and proteins regulated in biologic processes, no longer
      limiting study to naive candidate genes. These advances will allow investigators
      to decipher precise pathways of complex diseases, identify genetic and
      environmental interactions, and ultimately lead to specific (pre)diagnoses and
      rational treatment. Answers to the question as to why only a subset of smokers
      develop COPD will enhance the understanding of the disease process. Fortunately,
      there has been a resurgence of interest in COPD, led largely by the
      pharmaceutical industry, which has discovered the potential of this unmet need.
      Consequently, these state-of-the-art scientific techniques are being directly
      applied to COPD, lending hope for the future. Of even greater importance, the
      tide seems to be turning on the cigarette industry. Although difficult to
      imagine, perhaps cigarettes will disappear in this lifetime or at least the next
      generation won't be fooled by this deadly habit! Well ... the rational therapy
      thing could work.

PMID- 11194775
TI  - Genetic risk factors for chronic obstructive pulmonary disease.
AB  - Numerous epidemiologic studies have indicated that there is a genetic basis to
      COPD. This result suggests that COPD develops in genetically susceptible
      individuals after sufficient exposure to cigarette smoke. At present, most of the
      genes that contribute to the genetic component to COPD are unknown. alpha 1
      Antitrypsin deficiency is clearly a risk factor for COPD, but the other genetic
      associations with this disease must be considered as tentative. The key to
      establishing that a gene modifies the risk for a disease is replication of the
      association in different populations. This is a difficult task, however, because
      different genetic risk factors may be present in different populations. In
      addition, these genetic factors may interact with each other and with
      environmental risk factors, obscuring the effect of the gene on the phenotype.
      Apart from alpha 1-AT only the GST-M1, VDBP and CFTR genes have been implicated
      as risk factors in more than one population. Identification of other candidate
      genes awaits further understanding of the pathogenesis of COPD at the molecular
      level. There is good evidence that the propensity to smoke cigarettes and the
      likelihood of quitting smoking are influenced by genetic factors. This
      information may be useful in efforts directed toward cessation; however, most of
      the genetic studies so far have shown a rather small effect. The responses to
      hypoxia and hypercapnia also seem to be influenced by genetic factors.
      Identification of the genes involved could yield important insights into the
      pathogenesis of COPD and may highlight new targets for therapeutic intervention
      for this debilitating disease.

PMID- 11194776
TI  - Controversies in the use of spirometry for early recognition and diagnosis of
      chronic obstructive pulmonary disease in cigarette smokers.
AB  - Office spirometry used to detect COPD in smokers ages 44 and above with
      respiratory symptoms probably meets the criteria for a population-based screening
      test and for clinical case finding: If not detected early, COPD causes
      substantial morbidity or mortality, and smoking cessation is more effective when
      COPD is recognized before exertional dyspnea develops. Office spirometry is a
      feasible testing strategy and may be used to encourage smoking cessation efforts
      that change behavior in at least some patients. Office spirometry is relatively
      simple and affordable, is safe, and includes an action plan with minimal adverse
      effects. On the other hand, the false-positive and false-negative rates of office
      spirometry in the primary care setting may be higher than diagnostic spirometry
      performed during epidemiologic studies or in diagnostic pulmonary function
      laboratories, and the incremental benefit of office spirometry on smoking
      cessation rates is poorly established (when added to referral to an AHCPR-based
      smoking cessation program).

PMID- 11194777
TI  - Advances in radiologic assessment of chronic obstructive pulmonary disease.
AB  - Chest radiography allows detection of moderate and severe emphysema but does not
      allow quantitation of severity of disease or detection of mild emphysema. Chest
      radiography is helpful in assessing complications of emphysema such as
      pneumothorax or secondary infection of a bulla. HRCT provides a detailed image of
      emphysematous lung disease comparable to that of macroscopic pathologic
      appearance. The main role of HRCT in patients with COPD is in the preoperative
      assessment of patients being considered for bullectomy or LVRS.

PMID- 11194778
TI  - Peripheral muscle dysfunction in chronic obstructive pulmonary disease.
AB  - Peripheral muscle dysfunction is a common systemic complication of moderate to
      severe COPD and may contribute to disability, handicap, and premature mortality.
      In contrast to the lung impairment, which is largely irreversible, peripheral
      muscle dysfunction is potentially remediable with exercise training, nutritional
      intervention, oxygen, and anabolic drugs. Therapeutic success is often
      incomplete, however, and a better understanding of the mechanisms involved in the
      development of peripheral muscle dysfunction in COPD is needed to help develop
      innovative and more effective therapeutic strategies.

PMID- 11194779
TI  - Respiratory muscle function and drive in chronic obstructive pulmonary disease.
AB  - Respiratory, and particularly inspiratory, muscle function is altered in COPD.
      Many of these alterations are secondary to a mechanical disadvantage related to
      hyperinflation. Other factors, including corticosteroid therapy and nutritional
      depletion, are also deleterious to muscle function. In addition, the load imposed
      on the respiratory muscles is increased in COPD. Combined with the altered
      respiratory muscle function, this increase induces important changes in
      respiratory muscle drive and recruitment. Moreover, the imbalance between
      respiratory muscle function and load is an important determinant of dyspnea and
      hypercapnia. Because much of the lung and airway derangements are irreversible in
      COPD, the respiratory muscles appear to be an attractive target for therapeutic
      interventions.

PMID- 11194780
TI  - Mechanisms and measures of exercise intolerance in chronic obstructive pulmonary
      disease.
AB  - The mechanisms for exercise intolerance in chronic obstructive pulmonary disease
      are complex and multifaceted. Although ventilatory limitation caused by abnormal
      pulmonary function is a major contributor to this phenomenon, other factors may
      play an important role in limiting exercise. These other factors include
      depressed cardiac function, respiratory and peripheral muscle weakness,
      nutritional imbalances, and psychologic factors. The assessment of the pulmonary
      patient who complains of decreased functional status must include examination and
      consideration of all these variables. Only by addressing and treating the
      combination of these variables as they present in an individual patient will
      clinicians have the potential to impact that individual's functional status and
      quality of life.

PMID- 11194781
TI  - The chronic obstructive pulmonary disease exacerbation.
AB  - Chronic obstructive pulmonary disease is the only leading cause of death with a
      rising prevalence. The medical and economic costs arising from acute
      exacerbations of COPD are therefore expected to increase over the coming years.
      Although exacerbations may be initiated by multiple factors, the most common
      identifiable associations are with bacterial and viral infections. These are
      associated with approximately 50% to 70% and 20% to 30% of COPD exacerbations,
      respectively. In addition to smoking cessation, annual influenza vaccination is
      the most important method for preventing exacerbations. Controlled O2 is the most
      important intervention for patients with acute hypoxic respiratory failure.
      Evidence from randomized, controlled trials justifies the use of corticosteroids,
      bronchodilators (but not theophylline), noninvasive positive-pressure ventilation
      (in selected patients), and antibiotics, particularly for severe exacerbations.
      Antibiotics should be chosen according to the patient's risk for treatment
      failure and the potential for antibiotic resistance. In the acute setting,
      combined treatment with beta-agonist and anticholinergic bronchodilators is
      reasonable but not supported by randomized controlled studies. Physicians should
      identify and, when possible, correct malnutrition. Chest physiotherapy has no
      proven role in the management of acute exacerbations.

PMID- 11194782
TI  - Update on pharmacologic therapy for chronic obstructive pulmonary disease.
AB  - As described throughout this article, significant improvements continue to occur
      in the pharmacologic management of COPD. These improvements range from improved
      medication targeting to better understanding of mechanisms of action, to better
      delivery of medications, to lower side effects. New areas of pharmacologic
      intervention, if not ready for use today, hold great promise for the not-too
      distant future. In addition to the many agents described here, multiple mediator
      antagonists and anti-inflammatory agents are also under investigation for use in
      COPD. Interestingly, repair of alveolar tissue may be possible. Indeed,
      preliminary animal studies suggest that retinoic acid may be able to induce
      regeneration of lung alveoli. Overall, more effort is needed to broaden awareness
      and provide for the appropriate diagnosis of COPD, better explain pharmacologic
      therapies for COPD, simplify and disseminate guidelines, and highlight key
      differences between asthma and COPD, including their treatment strategies. As
      interest in COPD continues to grow, future updates on COPD management will
      continue to add new pharmacologic options for this devastating and preventable
      disease.

PMID- 11194783
TI  - Corticosteroids in chronic obstructive pulmonary disease. Clinical benefits and
      risks.
AB  - The use of systemic and inhaled corticosteroids for COPD has increased
      appreciably over the past 20 years. Clearer indications for corticosteroid
      therapy in COPD are beginning to emerge as the results from large clinical trials
      become available. Systemic corticosteroids are only modestly effective for acute
      COPD exacerbations, increase the risk for hyperglycemia, and should be given for
      no more than 2 weeks. The efficacy of long-term systemic corticosteroid therapy
      has not been adequately evaluated in this patient population. If longer term use
      of systemic steroids in COPD should be found to be useful, this conclusion would
      have to be weighed against the risk for serious adverse effects. High doses of
      inhaled corticosteroids cause a small sustained increase of the FEV1 in patients
      with mild and moderately severe COPD, but they do not slow the rate of FEV1
      decline. Based on analyses of secondary outcome, inhaled corticosteroids may
      improve the respiratory symptoms and decrease the number and severity of COPD
      exacerbations in patients with more advanced disease. Low doses of inhaled
      corticosteroids appear to be safe, but there is growing awareness that higher
      doses may not be so benign.

PMID- 11194784
TI  - Nutritional abnormalities and supplementation in chronic obstructive pulmonary
      disease.
AB  - Weight loss and muscle wasting commonly occur in patients with chronic
      obstructive pulmonary disease (COPD). A decreased dietary intake and elevated
      energy requirements underlie weight loss in these patients. Disturbances in
      intermediary metabolism caused by altered anabolic and catabolic mediators such
      as hormones, cytokines, and growth factors, and resulting in disproportionate
      muscle wasting have been described. Nutritional supplementation in combination
      with an anabolic stimulus (e.g. exercise) has been shown effective in improving
      functional capacity, health status, and mortality in most depleted patients.
      Nutritional or pharmacologic modulation of the catabolic response may further
      enhance the response in the near future.

PMID- 11194785
TI  - Exercise training in chronic obstructive pulmonary disease.
AB  - Exercise limitation is a common and disturbing manifestation of COPD. The
      exercise intolerance is often caused by multiple interrelated anatomic and
      physiologic disturbances. Importantly, exercise tolerance can be improved despite
      the presence of fixed structural abnormalities in the lung. Exercise training,
      undertaken alone or in the context of comprehensive PR, improves exercise
      endurance and, to a lesser degree, the maximal tolerated workload of patients
      with COPD. Pulmonary rehabilitation also improves dyspnea and QOL. Exercise
      training and PR should be considered for all patients lacking contraindications
      who experience exercise intolerance despite optimal medical therapy. Lower
      extremity training should be included routinely in the exercise prescription. The
      choice of type and intensity of training should be based primarily on the
      patient's individual baseline functional status, symptoms, needs, and long-term
      goals. When tolerated, high-intensity (continuous or interval) training may lead
      to greater improvements in aerobic fitness than low-intensity training but is not
      absolutely necessary to achieve gains in exercise endurance. Upper-extremity
      training should be undertaken when possible. Ventilatory muscle training should
      be considered for patients who continue to experience exercise limitation and
      breathlessness despite medical therapy and general exercise reconditioning.
      Exercise tolerance may improve following exercise training because of gains in
      aerobic fitness or peripheral muscle strength; enhanced mechanical skill and
      efficiency of exercise; improvements in respiratory muscle function, breathing
      pattern, or lung hyperinflation; as well as reduction in anxiety, fear, and
      dyspnea associated with exercise. Gains made in exercise tolerance can last up to
      2 years following a limited duration (6-12 week) rehabilitation program.

PMID- 11194786
TI  - Noninvasive ventilation in chronic obstructive pulmonary disease.
AB  - Over the past 15 years, numerous studies have explored the possibility that
      intermittent ventilatory assistance using noninvasive ventilation is beneficial
      in patients with severe stable COPD. The results are conflicting and no sustained
      beneficial action has been proven, although some improvement in respiratory
      muscle function may occur after short-term rest, and lengthening of the total
      duration of sleep has been shown in a few studies. Based on the observation that
      studies with favorable findings have generally had considerably higher PaCO2s
      than studies with negative findings, the current consensus view is that patients
      with severe CO2 retention (PaCO2 > 50-55 mm Hg) warrant a trial of NPPV. In
      addition, the Health Care Financing Agency that determines Medicare reimbursement
      policy in the United States has recently published guidelines for use of NPPV in
      patients with severe stable COPD that are based partly on the consensus view.
      There remains a deficiency of evidence supporting this application, however, and
      no study has confirmed any survival benefit or sustained improvement in
      functional status. Of note, several uncontrolled studies suggest that days of
      hospital use may be reduced after initiation of NPPV in these patients, but
      confirmatory studies are pending. If NPPV is to be initiated in patients with
      severe stable COPD, a more difficult adaptation process should be anticipated
      than for patients with neuromuscular disease. Great care must be taken in
      selecting a proper mask and optimal ventilator settings, and patients usually
      require considerable reassurance and encouragement. Potential problems should be
      anticipated and prevented, if possible. With a patient and supportive approach
      and a willingness to devote time to the process, clinicians can help optimize the
      likelihood of success, but failure rates are apt to remain higher than for other
      forms of chronic respiratory failure until the patient subpopulations with COPD
      most likely to benefit from NPPV are better defined and improvements in mask and
      ventilator technology enhance tolerance rates.

PMID- 11194787
TI  - Mechanical ventilation in chronic obstructive lung disease.
AB  - Exacerbations of COPD are a leading indication for MV in the intensive care unit.
      A thorough understanding of the pathophysiology of AVF in COPD is critical for
      physicians caring for these patients. In particular, physicians should understand
      DHI and use the ventilator and ancillary techniques to minimize its impact.
      Noninvasive positive-pressure ventilation should be considered strongly in
      relatively stable patients with an adequate mental status and manageable
      secretions. Once AVF resolves, patients should be removed from the ventilator as
      soon as is safe to do so to minimize the adverse effects of prolonged MV. An
      organized approach to weaning and identifying patients capable of independent
      breathing is crucial. Most patients with COPD and AVF benefit from MV and
      generally return to or approach their premorbid functional status. A significant
      subset, however, will not benefit from, or choose not to undergo, MV. Deciding
      upon appropriate therapeutic options for these patients relies heavily on
      effective communication between physician and patient. Comprehensive discussions
      before the development of AVF can assist decision-making after respiratory
      failure develops.

PMID- 11194788
TI  - Lung volume reduction surgery for emphysema.
AB  - Over the past decades, extensive literature has been published regarding surgical
      therapies for advanced COPD. Lung-volume reduction surgery would be an option for
      a significantly larger number of patients than classic bullectomy or lung
      transplantation. Unfortunately, the initial enthusiasm has been tempered by major
      questions regarding the optimal surgical approach, safety, firm selection
      criteria, and confirmation of long-term benefits. In fact, the long-term follow
      up reported in patients undergoing classical bullectomy should serve to caution
      against unbridled enthusiasm for the indiscriminate application of LVRS. Those
      with the worst long-term outcome despite favourable short-term improvements after
      bullectomy have consistently been those with the lowest pulmonary function and
      significant emphysema in the remaining lung who appear remarkably similar to
      those being evaluated for LVRS. With this in mind, the National Heart, Lung and
      Blood Institute partnered with the Health Care Finance Administration to
      establish a multicenter, prospective, randomized study of intensive medical
      management, including pulmonary rehabilitation versus the same plus bilateral (by
      MS or VATS), known as the National Emphysema Treatment Trial. The primary
      objectives are to determine whether LVRS improves survival and exercise capacity.
      The secondary objectives will examine effects on pulmonary function and HRQL,
      compare surgical techniques, examine selection criteria for optimal response,
      identify criteria to determine those who are at prohibitive surgical risk, and
      examine long-term cost effectiveness. It is hoped that data collected from this
      novel, multicenter collaboration will place the role of LVRS in a clearer
      perspective for the physician caring for patients with advanced emphysema.

PMID- 11194789
TI  - Lung transplantation for chronic obstructive pulmonary disease.
AB  - Lung transplantation is able to provide dramatic gains in pulmonary function to
      patients with advanced pulmonary emphysema. At the present time, however,
      transplantation is available to a strictly defined pool of candidates, and
      outcomes are limited by numerous respiratory and nonrespiratory postoperative
      complications. Further progress is needed in expanding the supply of donor lungs,
      minimizing perioperative complications, and optimizing postoperative immunologic
      management.

PMID- 11194790
TI  - Epidemiology of invasive and other pneumococcal disease in children in England
      and Wales 1996-1998.
AB  - The results of enhanced national surveillance of pneumococcal disease in children
      < 15 y of age in England and Wales are reported for the period 1996-1998. Of the
      1985 cases of laboratory-confirmed invasive disease (annual incidence 6.6 per
      100,000 overall and 39.7 per 100,000 in infants < 1 y of age), 485 (24%) were
      meningitis (annual incidence of 1.6 per 100,000 overall and 15.7 per 100,000 in
      infants <1 y of age). Fifty-nine deaths in children with invasive disease were
      identified-3% of the total reports. Thirty-one different serogroups/types were
      identified, with organisms in the 7-valent conjugate vaccine responsible for 69%
      of the infections in children < 5 y of age: this rose to 77% and 82%,
      respectively, for the 9-and 11-valent vaccines. Resistance to penicillin varied
      from 2.3% to 6.2% in different years, but erythromycin resistance remained
      constant at 17%. The vast majority of resistant isolates were in vaccine
      serotype/groups. Computerized hospital admission records for all children < 15 y
      of age with a discharge diagnosis code indicating probable pneumococcal disease
      were also analysed for 1997. The annual incidence for cases with a code
      specifically mentioning S. pneumoniae was 9.9 per 100,000 compared with 71.2 per
      100,000 for lobar pneumonia; the mean duration of stay for both was < 1 wk. The
      incidence of admission for pneumococcal meningitis (1.9 overall and 19.6 for
      infants < 1 y of age) was similar to that derived from laboratory reports and
      resulted in an average duration of stay of 2 wk. CONCLUSION: This surveillance
      has confirmed the substantial burden of morbidity attributable to pneumococcal
      disease in British children and the potential public health benefits that could
      be achieved by the use of pneumococcal conjugate vaccines.

PMID- 11194791
TI  - Epidemiology of pneumococcal disease in children in Germany.
AB  - Recently published and as yet unpublished data allow a reasonable estimate of the
      annual burden of pneumococcal disease in Germany. At least 277,000 episodes of
      otitis media and at least 2,000 episodes of sinusitis occur in children under the
      age of 5 y. Pneumococcal meningitis was found in 200 children under the age of 16
      y; the estimate for all age groups ranges from 450 to 1100 cases. Of
      approximately 150,000 cases of ambulatory pneumococcal pneumonia, at least 63,000
      105,000 patients are hospitalized each year. CONCLUSION: Further studies of
      pneumococcal epidemiology in Germany are needed, and continued surveillance will
      be necessary for a better understanding of the overall burden of pneumococcal
      disease in children as well as adults.

PMID- 11194792
TI  - Epidemiology of meningitis and bacteraemia due to Streptococcus pneumoniae in The
      Netherlands.
AB  - In The Netherlands, accurate data on the epidemiology of pneumococcal meningitis
      are available through a clinical microbiology laboratory-based national
      surveillance of cerebrospinal fluid isolates. The Netherlands Reference
      Laboratory for Bacterial Meningitis receives isolates of about 80% of all
      meningitis cases and about 40% of bacteraemic cases. The incidence of
      pneumococcal meningitis has increased slowly from 1.0/100,000 in 1990 to
      1.5/100,000 since 1996. The highest age-specific incidence of meningitis was
      observed in children < 5 y of age (8.2/100,000 in 1999). Of all isolates, 35%
      were from children < 5 y of age. The number of isolates from non-meningitis
      patients with bacteraemia increased considerably since the early 1990s,
      especially among the elderly. The highest incidence was found in 1996, probably
      owing to a relatively severe winter. During 1995-1999, pneumococcal meningitis in
      The Netherlands was caused mainly by serotypes 3, 6B, 7F, 9V, 14, 18C, 19F, and
      23F. Of the cases in children < 15 y, almost half were caused by serotypes 6B,
      14, 18C, and 19F. The serotypes present in the 23-valent polysaccharide and 7
      valent conjugate vaccines accounted for 87% and 47% of all meningitis cases,
      respectively. Pneumococcal resistance to penicillin in The Netherlands is still
      low, at about 1%. Genotypically, resistant strains belong to many clones.
      Horizontal transfer of capsular genes occurs among these isolates. In The
      Netherlands, 45% of cases of pneumococcal meningitis have severe predisposing
      factors. The case-fatality rate was significantly higher among patients with
      impaired immunity than among those with a break in the integrity of the dura.

PMID- 11194793
TI  - Epidemiology of pneumococcal infections in French children.
AB  - Since 1977, resistance to beta-lactams and other families of antibiotics among
      isolates of Streptococcus pneumoniae has increased alarmingly worldwide. France
      is particularly affected by this phenomenon; in 1997 the French National
      Reference Centre for Pneumococci reported that 44% of S. pneumoniae strains were
      penicillin non-susceptible (PNSS). Furthermore, resistance to macrolides (53%)
      and sulphonamides (37%) was comparable; in addition, >50% of PNSS had a high
      level of resistance to penicillin and were multiresistant. The highest frequency
      of resistance is observed in children, particularly those with acute otitis media
      (AOM). CONCLUSION: The clinical consequences of increasing antibiotic resistance
      are evident for meningitis and AOM, prompting clinicians to consider alternative
      agents such as high-dose cefotaxime (300 mg/ kg/d) or ceftriaxone (100mg/kg/d)
      plus vancomycin (60 mg/kg/d) for meningitis, and high-dose amoxicillin (> 80
      mg/kg/d) or ceftriaxone (50 mg/kg/d) for AOM.

PMID- 11194794
TI  - Epidemiology of invasive pneumococcal infections in children aged 0-6 years in
      Denmark: a 19-year nationwide surveillance study.
AB  - The impact of the new pneumococcal conjugate vaccines on invasive disease burden
      in Danish children was evaluated by analysing the results from the last 19 years
      of a nationwide surveillance of invasive pneumococcal infections. During 1981
      1999, the Streptococcus Unit at Statens Serum Institut, Copenhagen, received 1123
      invasive pneumococcal isolates from children aged 0-6 years. Nearly 72% (71.8%)
      of the pneumococcal isolates were from children aged <2 y. The median ages of
      children with pneumococcal meningitis and bacteraemia were 10.2 mo and 15.9 mo,
      respectively. The incidence of pneumococcal meningitis remained stable during the
      study period. The mean annual incidence rates of pneumococcal meningitis among
      children aged <1, <2, and <7 years were 17.4, 12.4, and 4.3 per 100,000,
      respectively, during 1981-1999 (overlapping age groups are used throughout this
      article to facilitate the comparison of incidence data from different countries
      or among different studies). The annual incidence of pneumococcal bacteraemia
      increased from 1981 to 1996, after which a slight fall was noted. During the last
      six years of the study period, the mean annual incidence rates of bacteraemia
      were 30.1, 32.5, and 14.0 per 100,000 children aged < 1, < 2, and < 7 years. In
      the 1990s, pneumococcal isolates with reduced sensitivity to penicillin (0-5%
      each year) and erythromycin (7.4% in 1999) emerged as a cause of invasive
      infections in children aged 0-6 years in Denmark. During 1981-1999, 10 serotypes
      (1, 4, 6A, 6B, 7F, 9V, 14, 18C, 19F, 23F) caused 82% of invasive infections in
      Danish children. Importantly, no significant temporal changes in overall serotype
      distribution or differences in serotype distributions between girls and boys
      could be documented during the study period. CONCLUSION: According to the Kaiser
      Permanente trial, the 7-, 9-, and 11-valent pneumococcal conjugate vaccines will
      probably cover around 60%, 70%, and 80%, respectively, of all invasive
      pneumococcal infections in Danish children aged 0-6y, corresponding to 12-14
      episodes of meningitis and 40-60 episodes of bacteraemia per year.

PMID- 11194795
TI  - Epidemiology of invasive childhood pneumococcal infections in Greece.
AB  - A retrospective study was conducted to identify the epidemiologic characteristics
      of invasive pneumococcal infections among children <14 y of age in our geographic
      region. During a 5-y period, from 1995 to 1999, 590 cases of invasive
      pneumococcal infection were identified in Aghia Sophia Children's Hospital,
      Athens, Greece. The male to female ratio was 1.4:1 and 64% of patients were
      younger than 5 y of age. The overall annual incidence rate was estimated as
      44/100,000 children <14y of age, whereas the incidence rate for children <5y of
      age was 100/100,000. The most common types of infections were pneumonia (472
      cases; 133 definite and 339 probable), bacteraemia without focus (79 cases), and
      meningitis (33 cases). A seasonal variation of invasive pneumococcal infections
      was noted, with two peaks--one during spring and the other during autumn. Only
      two cases with meningitis died and one developed permanent neurological sequelae,
      representing a case-fatality rate for meningitis of 6%. Serogroups 14, 19, 6, 18,
      23, 4 and 9 were the most prevalent, comprising 77% of 92 serotyped isolates.
      CONCLUSION: Invasive pneumococcal infections cause considerable morbidity in the
      paediatric population in the Athens metropolitan area. Sixty-six percent of the
      serotypes causing invasive pneumococcal disease in our region are included in the
      7-valent conjugate vaccine.

PMID- 11194796
TI  - Epidemiology of pneumococcal infections in Swedish children.
AB  - OBJECTIVE: This paper provides an overview of pneumococcal infections in Swedish
      children. METHOD: Data supplied by the Swedish Institute for Infectious Disease
      Control (SMI) provided information on invasive pneumococcal isolates and on
      isolates with reduced susceptibility to penicillin. Disease burden was estimated
      from data collected in northern Stockholm and Malmohus County. RESULTS: Only 3-6%
      of the total number of invasive pneumococcal isolates came from children 0-15
      years of age. Predominant serotypes in descending frequency were 7, 6, 14, and
      23. Strains from all sources with reduced sensitivity to penicillin (MIC > or =
      0.5 mg/l) were found in 3% of children and varied between 0.2% and 11%, with the
      highest value found in Southern Sweden (predominating strains were 9, 19, 15, 6,
      and 23). A 10-year review of all cases of meningitis in Northern Stockholm
      reflected an incidence of 10/100,000 (0-2 years) or 5.8/100,000 (0-5 years), with
      severe sequelae occurring in 20% of children. This information can be used to
      predict an annual incidence of 30 cases of meningitis in Sweden. CONCLUSION: The
      large proportion of serotype 7 among invasive isolates is distressing since this
      serotype is not represented in the present 7- and 9-valent protein-conjugated
      vaccines under development. However, the heptavalent vaccine, including serotypes
      4, 6B, 9V, 14, 18C, 19F, and 23F would (at a serotype level) provide coverage
      against 83% of the resistant isolates in Southern Sweden.

PMID- 11194797
TI  - Epidemiology of Streptococcus pneumoniae in Italian children.
AB  - In Italy, data regarding the aetiological role, antibiotic resistance, and
      serotype distribution of isolates of Streptococcus pneumoniae are scarce and
      based on very small population samples. We found that S. pneumoniae caused about
      30% of lower respiratory tract infections and 15% of acute otitis media
      infections in Italian children. The incidence of S. pneumoniae meningitis in
      subjects aged 0-4y was 1.1 x 100,000. In children <5 y of age with meningitis,
      the most common S. pneumoniae serotypes were, in rank order, 14, 6, 23, 1 and 4;
      among 53 nasopharyngeal carriers the most frequent serotypes were 6 and 19. The
      actual percentage of resistance of S. pneumoniae to penicillin is 10.2%, while
      for macrolides it reaches 25.5%. More data on the distribution of serotypes in
      Italian children are urgently needed in order to obtain a better understanding of
      the impact of the new pneumococcal vaccines.

PMID- 11194798
TI  - Streptococcus pneumoniae in children in Spain: 1990-1999.
AB  - This study analyses the serogroups/types (SGTs) and resistance to penicillin and
      erythromycin of 3921 strains isolated from 1990 to 1999 in children aged 0-14 y
      in Spanish hospitals of all the autonomous communities. Based on the age of the
      children, strains have been divided into five groups: 0-6 mo, > 6-1 y, > 1-2 y, >
      2-5 y and > 5 y. While only eight SGTs were responsible for 80% of the infections
      in children from 6 mo to 2 y of age, this number increased to 11 and 16 for the
      groups > 2-5 y and > 5-14 y, respectively. SGTs 6, 14 and 19 were prevalent in
      blood and otic exudates. SGTs 1, 4, 5, 12 and 18 were more frequent in invasive
      disease but serotype 3 was clearly associated with otitis. Serotypes I and 5 were
      quite significant in children of over 2 y of age, and this should be taken into
      account in future vaccine formulations. CONCLUSION: Although high, the rate of
      penicillin resistance in the paediatric population has remained stable in recent
      years. Conversely, erythromycin resistance is still increasing in our country.
      Coverage by the 7-valent vaccine was 78 and 81% for blood and otic isolates,
      respectively. These coverage levels would be increased by 9% and 3% if 9-valent
      (plus 1 + 5 serotypes) were used and by an additional 2.6% and 7.6% using the 11
      valent (plus 3 + 7) formulation.

PMID- 11194799
TI  - The 2000 presidential address. Back to the future: the ABA and burn prevention.

PMID- 11194800
TI  - The 2000 Everett Idris Evans Memorial Lecture. Burn prevention: a long way.

PMID- 11194801
TI  - The 2000 Clinical Research Award. Describing and predicting distress and
      satisfaction with life for burn survivors.
AB  - We investigated ratings of emotional distress and satisfaction with life at
      discharge from the hospital and at a 6-month follow-up in a multisite sample of
      295 adults hospitalized for the care of a major burn injury. Several psychosocial
      variables (history of alcohol abuse, marital status, and previous mental health)
      and some medical variables (days of intensive care, pulmonary complications, and
      hand burns) accounted for significant variance in the prediction of outcomes.
      Brief Symptom Inventory (distress) scores were higher and Satisfaction With Life
      Scale scores were significantly lower than those of a normative population at
      both measurement points. The results show the utility of biosocial models in
      which psychological and physical variables interact to influence adjustment and
      quality of life.

PMID- 11194802
TI  - The 2000 Moyer Award. The relevance of base deficits after burn injuries.
AB  - The relevance of an elevated base deficit (BD) during the fluid resuscitation of
      a thermally injured patient is not completely understood. After nonthermal
      trauma, early elevation of the BD represents insufficient cellular perfusion and
      is ultimately associated with a higher incidence of organ dysfunction and death.
      However, this relationship has not been completely examined after burn injuries.
      The purpose of this study was to determine if elevation of the BD during burn
      resuscitation was associated with potential consequences of malperfusion, such as
      systemic inflammatory response syndrome, acute respiratory distress syndrome, and
      multiple organ dysfunction. The records of 72 patients with burn injuries (mean
      age, 46 +/- 17 years; mean total body surface area burned, 44% +/- 18%) who
      required fluid resuscitation on admission to an adult regional burn center were
      analyzed. Patients with a mean BD of less than -6 mmol/L during the first 24
      hours were compared with patients with a mean BD of more than -6 mmol/L. Despite
      adequate resuscitation with good maintenance of urinary output, the patients in
      the group with a mean BD of less than -6 mmol/L had more florid systemic
      inflammatory response syndrome (P = .004), had more prevalent acute respiratory
      distress syndrome (P = .012), and experienced more severe multiple organ
      dysfunction (P < .001) compared with patients in the group with a mean BD of more
      than -6 mmol/L. The results suggest that abnormal elevation of the BD after burn
      injuries represents a malperfusion state, which may not be recognized if only
      "traditional" parameters, such as UO, are followed. Furthermore, this state
      appears to be related to the onset of more severe systemic inflammation and organ
      dysfunction.

PMID- 11194803
TI  - Multimodal versus progressive treatment techniques to correct burn scar
      contractures.
AB  - The treatment of burn scar contractures is a major emphasis in the rehabilitation
      of patients with burn injuries. Many treatment techniques have been used
      successfully but without a critical investigation of the best practice of care.
      In this study, we compared the outcomes for pediatric and adult patients treated
      with a multimodal therapy approach to treatment techniques that are considered to
      be progressive to determine if differences existed in the techniques. The medical
      records of 52 patients with documented burn scar contractures were reviewed for
      patient and rehabilitation treatment parameters. Included were population
      demographic information and type of treatment intervention used to correct the
      scar contracture. In particular, the postburn day when the contracture appeared,
      the percentage of range of motion deficit, the day when definitive treatment that
      eventually corrected the contracture was begun, and the days required to correct
      the contracture were noted. With equal range-of-motion deficits identified, the
      burn scar contractures of patients in the progressive treatment group were
      corrected in less than half the time of the burn scar contractures of the
      patients in the multimodal treatment group. This result occurred despite scar
      contractures that appeared significantly earlier and later initiation of
      definitive treatment.

PMID- 11194804
TI  - Sprayed keratinocyte suspensions accelerate epidermal coverage in a porcine
      microwound model.
AB  - Keratinocyte suspensions can potentially treat a variety of epidermal defects,
      but the mechanism of action has not been fully determined. We developed a porcine
      model to study the effect of sprayed cell suspensions delivered on small wounds
      within a meshed autograft. Paired full-thickness surgically excised wounds were
      covered with a fully expanded 3:1 meshed split-thickness autograft. A
      keratinocyte cell suspension was sprayed onto half of the wounds at a seeding
      density of 2.8 x 10(3) cells/cm2; the remaining wounds were sprayed with cell
      culture medium alone. Histologic analysis at days 5 and 8 showed an increase in
      average epidermal thickness, confluence, keratin cysts, and blood vessels in the
      keratinocyte cell suspension group compared with the cell culture medium control
      group. Wounds sprayed with the cell suspension showed faster and better quality
      of epithelialization than wounds sprayed with cell culture medium alone.

PMID- 11194805
TI  - The efficacy and safety of fentanyl for the management of severe procedural pain
      in patients with burn injuries.
AB  - Fentanyl has been shown to be effective for the management of intense pain of
      short duration. We have recently used intravenous fentanyl for burn wound
      procedures because of its rapid onset, high potency, and short duration. In this
      report, we reviewed our experience with fentanyl in a variety of procedural burn
      pain settings to develop specific recommendations about its effectiveness and
      safety for the treatment of pain in patients with burn injuries. The medical
      records of patients with burn injuries who received fentanyl for wound procedures
      over a 2-year period were retrospectively reviewed. Patient demographics, the
      amount of fentanyl administered, the level of analgesia achieved, and the
      incidence of adverse effects were analyzed. Fifty-five patients who were 9 months
      to 75 years old with burn wounds (range, 1%-90% of total body surface area)
      received 148 doses of fentanyl for the treatment of procedural pain. An average
      of 8.0 +/- 7.0 microg/kg of fentanyl (range, 0.7 to 38.0 microg/kg) was required
      for the first wound procedure with fentanyl. No correlation between dosage of
      fentanyl given and either age or percentage of total body surface area burned was
      observed. Transient respiratory depression was observed in 17 patients (31%). No
      patient required intubation or additional supplemental oxygen after the
      conclusion of the procedure. High doses of fentanyl are required to achieve
      adequate analgesia during some burn wound procedures. Respiratory depression
      associated with fentanyl use is transient but requires adequate preparation and
      trained personnel. Fentanyl may be effectively integrated into the pain control
      strategy for patients with burn injuries.

PMID- 11194806
TI  - A survey of gram-negative bacteria survival on hospital fabrics and plastics.
AB  - One critical factor for the transmission of microorganisms from person to person
      or from the environment to a person (patient or health care worker) is the
      ability of the microbe to survive on an environmental surface. The purpose of
      this study was to determine the length of survival of various gram-negative
      bacteria on fabrics and plastics commonly used in hospitals. Seven materials were
      tested: smooth cotton (clothing), cotton terry (towels), 60% cotton-40% polyester
      blend (scrub suits and lab coats), polyester (drapes), 75% nylon-25% spandex
      (pressure garments), polyvinyl (splash aprons), and polyurethane (keyboard
      covers). The following bacteria were tested: Pseudomonas aeruginosa, Escherichia
      coli, Klebsiella pneumoniae, Serratia marcescens, Proteus mirabilis,
      Acinetobacter species, and Enterobacter species. Swatches of the materials were
      inoculated with defined amounts of bacteria and assayed at regular intervals.
      Survival was dependent on the bacterium, its inoculum size, and the material
      tested. At 102 microorganisms per swatch, bacteria survived from less than 1 hour
      to 8 days. At 10(4) to 10(5) bacteria per swatch, survival ranged from 2 hours to
      more than 60 days. These findings emphasize the need for careful disinfection and
      conscientious contact control procedures in areas that serve immunosuppressed
      individuals, such as patients with burn injuries.

PMID- 11194807
TI  - Burn injuries in rats upregulate the gene expression of the ubiquitin-conjugating
      enzyme E2(14k) in skeletal muscle.
AB  - Burn injuries are associated with muscle cachexia, which mainly reflects protein
      breakdown in the ubiquitin-proteasome pathway. Ubiquitination of proteins
      degraded by this mechanism is regulated by multiple enzymes, including the 14-kd
      ubiquitin-conjugating enzyme, E2(14k). In this study, burn injuries in rats
      resulted in increased levels of the 1.2 kilobase E2(14k) transcript in the white,
      fast-twitch extensor digitorum longus muscle with no changes or only minor
      changes in the red, slow-twitch soleus muscle, liver, and kidney. The results
      provide the first evidence that burn injuries upregulate the gene expression of
      E2(14k) in skeletal muscle and suggest that ubiquitin-proteasome-dependent muscle
      protein breakdown after thermal injuries may, at least in part, be regulated by
      E2(14k).

PMID- 11194808
TI  - Cost-effective use of helicopters for the transportation of patients with burn
      injuries.
AB  - We performed a retrospective review to analyze the use of helicopters for the
      transportation of patients with burn injuries to determine whether a more cost
      effective approach could be developed without impairing the quality or delivery
      of health care. Charts were reviewed for all patients with burn injuries who were
      transported by helicopter to our hospitals during a 2-year period. Patients with
      inhalation injuries, with burn injuries received more than 24 hours before
      admission or more than 200 miles from our burn center, with more than 30% total
      body surface area (TBSA) burned, or with associated trauma injuries were
      excluded. Control patients with burn injuries who were transported by ambulance
      were identified and matched to the patients with burn injuries transported by
      helicopter for the percentage of TBSA burned, the percentage of third-degree
      burns, transport mileage, and age. The outcome was evaluated by comparison of
      length of stay, days on ventilator, and mortality rate. Comparisons were
      performed with Student t test. The transportation charge was determined for the
      patients transported by helicopter who we believed were eligible for transport by
      ambulance. Forty-seven of 85 patients transported by helicopter matched the
      inclusion criteria and had survived. There was no statistically significant
      difference between the percentage of TBSA burned, the percentage of third-degree
      burns, length of stay, days on ventilator, age, or transport mileage. There was,
      however, a significant difference in the time from the injury to admission to the
      hospital, as well as in the charge for transportation. Patients who had less than
      30% TBSA thermal cutaneous injuries without evidence of inhalation injury, and
      who are less than 200 miles from a burn center may be safely transported by
      ambulance. Ambulance transportation may take additional time; however, stricter
      protocols for helicopter transportation of patients with burn injuries will
      result in potentially substantial savings without affecting outcomes for
      patients.

PMID- 11194809
TI  - Analysis of hypertrophic and normal scar gene expression with cDNA microarrays.
AB  - Hypertrophic scar is one form of abnormal wound healing. Previous studies have
      suggested that hypertrophic scar formation results from altered gene expression
      of extracellular matrix molecules. A broadscale evaluation of gene expression in
      hypertrophic scars has not been reported. To better understand abnormalities in
      hypertrophic scar gene expression, we compared messenger RNA expression in
      hypertrophic scars, normal scars, and uninjured skin with the use of
      complementary (c)DNA microarrays. Total RNA was extracted from freshly excised
      human hypertrophic scars, normal scars, or uninjured skin and reverse transcribed
      into cDNA with the incorporation of [33P] deoxycytidine triphosphate. The
      resulting radioactive cDNA probes were hybridized onto cDNA microarrays of 4000
      genes. Hybridization signals were normalized and analyzed. In the comparison of
      tissue samples, mean intensities were calculated for each gene within each group
      (hypertrophic scars, normal scars, and uninjured skin). Ratios of the mean
      intensities of hypertrophic scars to normal scars, hypertrophic scars to
      uninjured skin, and normal scars to uninjured skin were generated. A ratio that
      was greater than 1 indicated upregulation of any particular gene and a ratio that
      was less than 1 indicated downregulation of any particular gene. Our data
      indicated that 142 genes were overexpressed and 50 genes were underexpressed in
      normal scars compared with uninjured skin, 107 genes were overexpressed and 71
      were underexpressed in hypertrophic scars compared with uninjured skin, and 44
      genes were overexpressed and 124 were underexpressed in hypertrophic scars
      compared with normal scars. Our analysis of collagen, growth factor, and
      metalloproteinase gene expression confirmed that our molecular data were
      consistent with published biochemical and clinical observations of normal scars
      and hypertrophic scars. cDNA microarray analysis provides a powerful tool for the
      investigation of differential gene expression in hypertrophic scar samples and
      either uninjured skin or normal scars. Our data validate the use of this
      technology for future studies on gene expression during repair processes of
      normal and abnormal wounds.

PMID- 11194810
TI  - The use of inhaled nitric oxide as adjuvant therapy in patients with burn
      injuries and respiratory failure.
AB  - Inhaled nitric oxide (NO) is a relatively new modality in the management of acute
      respiratory distress syndrome. The purpose of this study was to examine our
      experience with inhaled NO in 10 adult patients with burn injuries and acute
      respiratory distress syndrome-related oxygenation failure. The patients had a
      mean age of 50 +/- 19 years and a mean burn size of 41% +/- 20% of the total body
      surface area. Seven patients died and 3 survived. The survivors and nonsurvivors
      did not differ with respect to age, burn size, pre-NO ventilator settings, or
      indices of oxygenation including PaO2, oxygen saturation in arterial blood,
      PaO2/fraction of inspired oxygen (FIO2) ratio, and alveolar-arterial oxygen
      tension difference. The concentration of NO administered ranged between 5 ppm and
      30 ppm. PaO2, oxygen saturation in arterial blood, and the PaO2/FIO2 ratio
      increased in all patients. Although it was not statistically significant,
      survivors tended to have a more vigorous and sustained response than non
      survivors; this was best exemplified by the change in PFR. During the first hour
      of therapy, the PaO2/FIO2 ratio increased from 64.3 +/- 12.7 to 231.8 +/- 154.5
      in survivors and from 93.9 +/- 44.0 to 161.5 +/- 81.8 in the nonsurvivors. After
      12 hours of therapy, the PaO2/FIO2 ratio was 306.2 +/- 333.7 in the survivors and
      178.9 +/- 69.9 in the nonsurvivors. There were no complications associated with
      the use of inhaled NO. Although a stronger early response to NO seems to occur in
      survivors, we cannot definitely conclude that the early response pattern is
      predictive of recovery. Nonetheless, we believe that inhaled NO has a useful role
      in the treatment of patients with burn injuries and severe acute respiratory
      distress syndrome-related oxygenation failure.

PMID- 11194811
TI  - Palm computer demonstrates a fast and accurate means of burn data collection.
AB  - Manual biomedical data collection and entry of the data into a personal computer
      is time-consuming and can be prone to errors. The purpose of this study was to
      compare data entry into a hand-held computer versus hand written data followed by
      entry of the data into a personal computer. A Palm (3Com Palm IIIx, Santa, Clara,
      Calif) computer with a custom menu-driven program was used for the entry and
      retrieval of burn-related variables. These variables were also used to create an
      identical sheet that was filled in by hand. Identical data were retrieved twice
      from 110 charts 48 hours apart and then used to create an Excel (Microsoft,
      Redmond, Wash) spreadsheet. One time data were recorded by the Palm entry method,
      and the other time the data were handwritten. The method of retrieval was
      alternated between the Palm system and handwritten system every 10 charts. The
      total time required to log data and to generate an Excel spreadsheet was recorded
      and used as a study endpoint. The total time for the Palm method of data
      collection and downloading to a personal computer was 23% faster than hand
      recording with the personal computer entry method (P < 0.05), and 58% fewer
      errors were generated with the Palm method.) The Palm is a faster and more
      accurate means of data collection than a handwritten technique.

PMID- 11194813
TI  - How should endotension be defined? History of a concept and evolution of a new
      term.

PMID- 11194812
TI  - Burn injury in kitchen workers: a cause for prevention.
AB  - Preventable thermal injuries in professional kitchen workers have been
      identified, and we have introduced a protective garment. Because of the nature of
      their occupation, kitchen workers are prone to thermal injuries. It has been our
      experience that the majority of these injuries are scald injuries on the ankles
      and dorsum of the feet. We propose that a protective garment, such as a
      waterproof shoe and garter, could reduce the incidence of these injuries.

PMID- 11194814
TI  - Does successful embolization of endoleaks lead to aneurysm sac shrinkage?
AB  - PURPOSE: To determine whether embolization of endoleaks after endovascular repair
      of aortic aneurysms is associated with a decrease in the diameter of the
      aneurysm. METHODS: Fifteen patients (13 men; median age 76 years) demonstrated
      primary endoleaks persisting > or =3 months after endovascular abdominal aortic
      aneurysm repair with a variety of commercial endografts. In 8 patients, coil
      embolization failed to completely obliterate the leak, whereas embolotherapy
      proved successful in the remaining 7 patients. Surveillance of endoleaks and the
      effect of their embolization on aneurysm size were followed with serial computed
      tomographic (CT) scans. Follow-up after embolization extended for at least 12
      months. RESULTS: Patients with persistent leak exhibited a slight increase in
      mean aneurysm area from 21.41+/-4.25 to 22.47+/-6.70 cm2. Medians differed from
      20.03 (range 16.59-28.73) to 23.03 (range 14.14-33.69) cm2 (p = 0.0078, 95%
      confidence interval [CI] = 0.0075 to 0.0081). Successfully treated patients,
      however, showed a mean decrease from 20.58+/-3.63 (median 19.87) to 16.36+/-6.46
      cm2 (median 18.10) at 1 year (p = 0.0156, 95% CI = 0.0151 to 0.0160). The medians
      differed significantly between groups (p < 0.05). CONCLUSIONS: Persistent
      endoleaks after endovascular aortic aneurysm treatment led to an increase in the
      diameter of the aneurysm, whereas complete occlusion was associated with a
      significant decrease in aneurysm diameter.

PMID- 11194815
TI  - Aneurysm expansion and retroperitoneal hematoma after thrombolysis for stent
      graft limb occlusion caused by distal endograft migration.
AB  - PURPOSE: To describe a complication of thrombolytic therapy used to treat graft
      limb occlusion precipitated by distal migration and kinking of an abdominal
      aortic stent-graft. CASE REPORT: A 5.5-cm abdominal aortic aneurysm (AAA) in a 66
      year-old woman was treated with Vanguard bifurcated stent-graft. At the 1-year
      follow-up, she complained of left leg claudication. Computed tomography (CT)
      showed a 36% reduction in maximum AAA diameter, but the stent-graft had migrated
      distally approximately 5 mm, and the left graft limb was occluded. Thrombolysis
      was initiated, but after approximately 8 hours, abdominal pain began. Emergent CT
      scanning revealed rapid aneurysm expansion and a retroperitoneal hematoma.
      Thrombolytic treatment was stopped; transfusions and thrombogenic drugs were
      given to restore hemodynamic stability. The aneurysm began to decrease in size.
      The occluded graft limb had been reopened by the lytic therapy, uncovering a
      stenosis in the native artery distal to the graft limb. Stent placement restored
      outflow. The retroperitoneal hematoma resolved over time, and the aneurysm sac
      shrank to its prelytic diameter. The patient is well with a functioning endograft
      18 months after the occlusion (30 months after stent-grafting). CONCLUSIONS:
      Caution must be taken when using thrombolysis in patients with endovascular
      aortic grafts because unexpected bleeding complications might arise.
      Thrombectomy, femorofemoral bypass, or stent or stent-graft extensions might be
      safer alternatives for treating occluded stent-graft limbs.

PMID- 11194816
TI  - Role of duplex imaging in endovenous obliteration for primary venous
      insufficiency.
AB  - PURPOSE: To assess the role of duplex imaging in defining suitable pathological
      anatomy for endovenous obliteration and characterizing its treatment outcomes
      over time. METHODS: Eighteen lower limbs in 17 patients (12 women; mean age 48
      years; range 29-74 years) presenting with varicose greater saphenous veins (GSVs)
      were treated with endovenous obliteration without adjunctive high ligation.
      Duplex imaging was used as an intraprocedural guidance tool for vein access and
      catheter positioning and for preprocedural evaluation and serial surveillance
      after the procedures. RESULTS: In the 18 limbs, preprocedural duplex scanning
      defined reflux owing to incompetence of the terminal valve (n = 6), subterminal
      valve (n = 9), or truncal valve (n = 3). Duplex imaging facilitated percutaneous
      vein puncture and was essential in catheter positioning at the saphenofemoral
      junction (SFJ). At 1 week, the saphenous trunks of all 18 limbs were either
      shrunken and obliterated (n = 7) or occluded by thrombus without shrinkage (n =
      11). By 6 months, 7 GSVs were no longer sonographically visible, 10 were shrunken
      and obliterated, and 1 had a segmental partial recanalization. In the 15 limbs
      with terminal or subterminal valve incompetence at 1 week, 5 had total SFJ
      obliteration, 4 had > or =1 patent tributaries draining directly into the femoral
      vein through an open SFJ, and 6 had > or =1 patent tributaries draining into an
      open SFJ through a short (<2 cm) proximal saphenous trunk. By 6 months, only 1
      limb had total SFJ occlusion; the other 14 had at least 1 persistent or reopened
      tributary. CONCLUSIONS: Duplex scanning is indispensable for selecting patients,
      guiding the procedure, and defining the morphological maturation and hemodynamic
      changes that appear to characterize successful endovenous obliteration.

PMID- 11194817
TI  - A retrospective comparative study of open and endoscopic saphenous vein
      harvesting.
AB  - PURPOSE: To compare the operative variables, complications, and potential
      benefits of endoscopic saphenous vein harvesting (ESVH) with traditional open
      vein retrieval for coronary artery bypass grafting (CABG). METHODS: Data were
      collected retrospectively on 212 consecutive CABG patients from whom saphenous
      veins were harvested by one surgeon using either an open saphenous vein
      harvesting (OSVH) technique (n = 135) or ESVH (n = 77) performed with the ENDO
      SAPH Vein Harvest System. Fifty-three patients underwent a purely endoscopic
      procedure, whereas 24 patients had either a combined endo-open procedure (n = 13)
      or were converted to an open technique (n = 11) because of equipment failure or
      adverse anatomical characteristics. Harvest time was measured from initial leg
      incision to aortic cross-clamping. Leg wound complications were evaluated on the
      basis of progressive severity. RESULTS: Harvest and procedural times were longer
      for the ESVH group (111 and 313 minutes, respectively) than for the OSVH patients
      (63 and 252 minutes, respectively, p < 0.001). Mean length of stay was not
      appreciably different: 11.7+/-6.2 days (range 3-52) for the OSVH group, compared
      with 11.0+/-6.0 days (range 3-41) for the ESVH patients (p = 0.40). Fewer
      complications occurred in the ESVH group when a purely endoscopic procedure was
      performed (17% versus 35% for OSVH, p = 0.012). Infection occurred in 1 OSVH and
      in 4 ESVH patients, but 3 of the endoscopic patients had a combined procedure.
      Bivariate correlational analysis showed that an increased number of incisions (r
      = 0.29, p < 0.01), obesity (r = 0.18, p < 0.01), and short stature (r = -0.16, p
      < 0.05) were associated with leg wound complications, but hierarchial stepwise
      regression analysis determined only short stature to be a predictive variable
      (beta = 0.17, R2 = 0.03). CONCLUSIONS: Despite increased operating time, ESVH
      results in fewer complications when a purely endoscopic procedure is performed.

PMID- 11194818
TI  - Does prosthetic covering of nitinol stents alter healing characteristics or
      hemodynamics?
AB  - PURPOSE: To evaluate placement of polyester (Dacron) coverings on nitinol stents
      implanted in the canine aorta to determine the effect on cross-sectional lumen
      area, development of intimal hyperplasia, device endothelialization, and flow
      hemodynamics. METHODS: Ten polyester-covered and 10 uncovered nitinol stents (60
      mm length, 10- or 12-mm diameter) were deployed percutaneously in the normal
      infrarenal aorta of 20 adult mongrel dogs using random assignment. Angiography,
      intravascular ultrasound (IVUS), and duplex ultrasound performed at device
      deployment and before explantation at 6 weeks were used to measure aorta/device
      diameter and cross-sectional area. Pressure-perfusion-fixed aortic segments were
      compared for surface endothelialization (CD31 staining) and for thickness of
      neointimal formation. RESULTS: All 20 endoluminal devices were accurately
      positioned in the infrarenal aorta without early or delayed evidence of device
      thrombosis, significant lumen narrowing, or device deformity. IVUS and duplex
      scanning identified no anatomical stenosis in either the covered or the bare
      devices by duplex ultrasound; peak systolic velocity measurements were similar
      (106+/-25 cm/s in the covered stent versus 96+/-25 cm/s for bare stents, p >
      0.05). Mean neointimal thickness was significantly greater (p < 0.005) in the
      covered (326+/-145 microm) compared with the bare (219+/-62 microm) stents.
      Intima-to-media height ratios were greater in the covered stents (3.0+/-1.1
      compared with 1.1+/-0.2, p < 0.003). Mean surface area endothelialization in the
      proximal, middle, and distal sections of each device was similar (p > 0.05) in
      covered (59%, 56%, and 69%) and bare (59%, 65%, and 53%) stents. CONCLUSIONS:
      Deployment and balloon dilation of a covered nitinol stent in a nondiseased
      canine aorta increased neointimal development compared with an uncovered stent,
      but overall lumen cross-sectional area was preserved. No differences in device
      patency, intradevice thrombus formation, flow hemodynamics, or luminal
      endothelialization were demonstrated, despite a thicker intradevice neointima
      induced by the polyester covering.

PMID- 11194819
TI  - Differing morphological changes following endovascular AAA repair using balloon
      expandable or self-expanding endografts.
AB  - PURPOSE: To determine whether changes in aneurysm morphology after endovascular
      abdominal aortic aneurysm (AAA) repair differ according to the type of endograft
      (self-expanding versus balloon-expandable). METHODS: Among 88 patients with AAA
      treated with either homemade polytetrafluoroethylene (PTFE) aortomonoiliac
      endografts or Talent stent-grafts, 30 patients (24 males; mean age 73 years,
      range 55-93) were selected for this study based on a >2-year follow-up and
      freedom from endoleak or conversion. Of these, 12 had PTFE endografts and 18
      Talent devices. All patients had spiral computed tomographic angiography with 3
      dimensional reconstruction at 5 days posttreatment and 6-month intervals
      thereafter. Neck dimensions (length and diameters at 3 levels) were measured,
      along with volumes and maximal diameters of the sac and lengths of the aneurysm
      and endograft. Intra- and interobserver errors were <5% for linear and volume
      measurements. RESULTS: Both groups had an initial 20-mL increase in median volume
      (p = 0.02) followed, only in Talent patients, by marked shrinkage at 6 months (
      87.4 mL; p = 0.09). PTFE patients had no further changes in sac volume. Maximal
      sac diameters reflected volumes, but only after day 5. PTFE patients had an
      immediate increase (p = 0.03) in aneurysm neck diameters, which then remained
      stable. Talent patients had continuing increases in diameter to 6 months (p <
      0.05), with no change thereafter. Length changes were not significant in either
      group. PTFE patients had an increase in median aneurysm length at day 5 (+3.2 mm,
      p = 0.04) and again at 1.5 years (+6.4 mm, p = 0.03). Endograft length slowly
      increased (+18.7 mm) over 1.5 years (p = 0.02). Talent patients had no length
      changes in the device or aneurysm. CONCLUSIONS: Aneurysm morphology appeared to
      alter according to the type of endograft deployed. With PTFE endografts, aneurysm
      volume does not change, whereas impressive sac shrinkage occurs in conjunction
      with the Talent system. Aneurysm/graft lengths increase with unsupported stent
      grafts. Neck diameter increases immediately with balloon-expandable endografts
      and then remains constant. In the self-expanding models, neck diameter increases
      at 6 months but not thereafter.

PMID- 11194820
TI  - An endovascular model of carotid stenosis for the evaluation of thrombolysis and
      angioplasty.
AB  - PURPOSE: To develop a porcine carotid artery thrombosis model using a novel stent
      graft device to evaluate the efficacy of thrombolytic therapy and angioplasty
      procedures. METHODS: An endovascular device made from a tapered
      polytetrafluoroethylene graft inverted in a self-expanding nitinol stent was
      delivered to bilateral carotid arteries via a right femoral approach in 16 pigs.
      Carotid thrombotic occlusion ensued from flow stasis created by the intrastent
      stenosis. Via selective carotid catheterization from a femoral approach,
      urokinase (250,000 IU) was pulse-sprayed in one carotid artery while a control
      saline solution was infused in the contralateral vessel; delivery times were 1
      hour, 8 hours, 3 days, or 6 days after carotid occlusion (4 animals per time
      period). After thrombolysis, balloon angioplasty was performed to maintain
      carotid patency. Arteriography and intravascular ultrasound were used to evaluate
      the efficacy of thrombolysis. Light microscopy was used for histological analysis
      of the thrombus. RESULTS: Carotid artery occlusion occurred in 15+/-8 minutes
      after stent-graft placement in all animals. Urokinase was effective in
      recanalizing all occluded arteries in the 1-hour, 4-hour, and 3-day groups (100%)
      but was effective in only 2 of 4 animals in the 6-day group (p < 0.05). Overall
      thrombolytic efficacy was 78%+/-7%. Control saline solution showed no
      thrombolytic effect (p < 0.001). Angioplasty successfully restored normal luminal
      diameter in all fully lysed arteries (100%). Histological analysis showed fibrin
      predominant thrombus with a varying degree of platelet deposition. CONCLUSIONS:
      This endovascular approach, which creates a carotid stenosis using this novel
      stent-graft device, is reliable in producing carotid thrombosis. In our model,
      thrombolytic therapy was effective in restoring luminal patency, and the
      intraluminal stenosis is amenable to balloon angioplasty. The model is useful for
      the evaluation of antithrombotic therapy and adjunctive endovascular
      interventions.

PMID- 11194821
TI  - Does complete aneurysm exclusion ensure long-term success after endovascular
      repair?
AB  - PURPOSE: To examine whether complete aneurysm exclusion is a reliable marker for
      successful long-term endovascular abdominal aortic aneurysm (AAA) repair.
      METHODS: The medical records, computed tomographic (CT) scans, and duplex
      examinations of all the patients who underwent endovascular AAA repair at a
      single institution and had at least 12 months of follow-up were reviewed. Sixty
      seven patients (58 men; mean age 74 years, range 57-87) were identified. Complete
      aneurysm exclusion was defined by the absence of an endoleak at any time before
      an adverse event. The primary endpoint included all major adverse events that
      occurred during the postoperative period, including aneurysm expansion, acute
      symptoms referable to the AAA, late secondary procedures, ruptures, and deaths
      from ruptures and all other causes. RESULTS: There were 44 adverse events (8
      expanding aneurysms, 4 acute symptoms, 17 secondary procedures, and 15 deaths
      from other causes) in 28 (42%) patients. Among 36 (54%) patients who had initial
      complete aneurysm exclusion (no endoleak), 12 (33%) experienced adverse events,
      compared with 16 (52%) events in 31 patients who had endoleak (chi2 = 1.59, p =
      0.21). CONCLUSIONS: There was no statistically significant difference in adverse
      events based on the presence or absence of endoleak. Complete aneurysm exclusion
      as defined by absence of an endoleak does not indicate an event-free
      postoperative course. A better marker of clinical success of endovascular AAA
      repair is needed.

PMID- 11194822
TI  - Percutaneous stenting of an latrogenic superior mesenteric artery dissection
      complicating suprarenal aortic aneurysm repair.
AB  - PURPOSE: To report endovascular repair of an iatrogenic superior mesenteric
      artery (SMA) dissection caused by a balloon occlusion catheter. CASE REPORT: A 68
      year-old man with a suprarenal aortic aneurysm underwent conventional prosthetic
      replacement, during which visceral artery back bleeding was controlled with
      balloon occlusion catheters. Six hours postoperatively, the patient experienced
      an episode of bloody diarrhea with abdominal pain and tenderness and mild
      metabolic acidosis. Colonoscopy revealed colitis (grade I) without necrosis of
      the right and left colon. An emergent abdominal computed tomographic scan showed
      signs of mesenteric ischemia with bowel dilatation and SMA wall hematoma;
      angiography identified a dissection 1 cm distal to the SMA origin. An Easy
      Wallstent was deployed percutaneously, successfully reestablishing SMA patency.
      The postoperative course was uneventful, and the patient remains asymptomatic
      with a patent SMA stent and aortic graft at 1 year. CONCLUSIONS: latrogenic SMA
      dissection should be suspected after suprarenal aortic aneurysm repair if signs
      of mesenteric ischemia arise. Prompt and thorough imaging studies are necessary
      to confirm the diagnosis and assess the potential for an endoluminal treatment.

PMID- 11194823
TI  - Transseptal guidewire stabilization facilitates stent-graft deployment for
      persistent proximal ascending aortic dissection.
AB  - PURPOSE: To report endovascular repair of a DeBakey type I ascending aortic
      dissection. CASE REPORT: Five months after aortocoronary bypass grafting, a 56
      year-old woman demonstrated a persistent ascending aortic type I dissection whose
      entry tear proximal to the innominate artery spiraled down the descending
      thoracic aorta into the iliofemoral arteries. Repair was facilitated with a
      guidewire passed through a transseptal sheath in the right femoral vein. The
      guidewire traversed the right and left atria and the left ventricle and then
      exited into the ascending aorta and was exteriorized through the right femoral
      artery. A right brachial catheter aided contrast visualization of the innominate
      artery. Adenosine-induced elective cardiac arrest promoted precise placement of a
      customized polyester-covered balloon-expandable stent, which closed the aortic
      rent. CONCLUSIONS: A transseptal approach enables the guidewire to follow the
      curvature of the aortic arch, providing precise control of the stent-graft
      delivery system. This case illustrates the applicability of endovascular
      techniques to repair ascending aortic pathologies using readily available
      techniques, equipment, and drugs.

PMID- 11194824
TI  - Hybrid open-endoluminal technique for repair of thoracoabdominal aneurysm
      involving the celiac axis.
AB  - PURPOSE: To describe a technique combining endoluminal and open approaches for
      the repair of thoracoabdominal aneurysms involving the celiac axis. CASE REPORT:
      Two patients with type I thoracoabdominal aneurysm and suboptimal cardiac reserve
      underwent transluminal stent-graft implantation. To achieve satisfactory distal
      seal, the caudal end of the endograft was circumscribed with a Dacron band that
      was sutured to the aorta and endograft through a midline incision. The patent
      celiac artery in both patients was ligated to stop retrograde filling of the
      aneurysm sac. The patients developed no problems perioperatively, and exclusion
      of the aneurysms was confirmed by follow-up imaging. Three years after
      endografting, both patients had excluded aneurysms without evidence of endoleak
      or device migration. CONCLUSIONS: This combined approach is another treatment
      option for thoracic aneurysms that have an anatomically suitable proximal
      attachment zone with a compromised distal neck.

PMID- 11194826
TI  - Endograft surveillance: a priority for long-term device performance.

PMID- 11194825
TI  - Endoleaks and the need for a paradigm shift.

PMID- 11194827
TI  - A reply.

PMID- 11194828
TI  - Modulation of Th1/Th2 subsets by granulocyte-colony stimulating factor.

PMID- 11194829
TI  - Th1/Th2 lymphokine profile of T cells present in the blood of granulocyte-colony
      stimulating factor-treated stem-cell donors: up or down modulation.

PMID- 11194830
TI  - Clinical trial claims instructions issued.

PMID- 11194831
TI  - Customized patient bills can improve customer service.

PMID- 11194832
TI  - Health care access and use among low-income children: who fares best?
AB  - In this paper we assess how access to care and use of services among low-income
      children vary by insurance status. Although 40 percent of low-income children
      rely on private health insurance, little is known about how this coverage
      compares with Medicaid coverage in meeting their health care needs. We find that
      Medicaid and privately insured low-income children appear to have fairly
      comparable access but that Medicaid-covered children are more likely to receive
      services and to have more visits when they receive care. Expanding public
      coverage may not be sufficient to ensure that all low-income children have access
      to comprehensive and high-quality care. It may require improvements in preventive
      and dental care for children with private coverage, an area in which states have
      limited influence.

PMID- 11194833
TI  - Back to school: a health care strategy for youth.
AB  - School-based health centers (SBHCs) are a policy innovation designed to increase
      health care access among youth. The centers offer primary and acute care, often
      to underserved populations. We describe SBHCs, trace their history, and analyze
      the three great political challenges they face: moral opposition triggered by
      concern about reproductive health services in schools; funding in a managed care
      era; and partisan state politics. We show how the centers have been meeting these
      challenges. Finally, we consider the prospect of this innovation going to scale
      across the nation.

PMID- 11194834
TI  - A founder of quality assessment encounters a troubled system firsthand. Interview
      by Fitzhugh Mullan.

PMID- 11194835
TI  - HealthMarts, HIPCs (health insurance purchasing cooperatives), MEWAs (multiple
      employee welfare arrangements), and AHPs (association health plans): a guide for
      the perplexed.
AB  - This paper considers how pending proposals to authorize new forms of group
      purchasing arrangements for health insurance would fit and function within the
      existing, highly complex market and regulatory landscape and whether these
      proposals are likely to meet their stated objectives and avoid unintended
      consequences. Cost savings are more likely to result from increased risk
      segmentation than through true market efficiencies. Thus, these proposals could
      erode previous market reforms whose goal is increased risk pooling. On the other
      hand, these proposals contain important enhancements, clarifications, and
      simplification of state and federal regulatory oversight of group purchasing
      vehicles. Also, they address some of the problems that have hampered the
      performance of purchasing cooperatives. On balance, although these proposals
      should receive cautious and careful consideration, they are not likely to produce
      a significant overall reduction in premiums or increase in coverage.

PMID- 11194836
TI  - Have small-group health insurance purchasing alliances increased coverage?
AB  - We use data from 1993 and 1997 employer surveys to assess whether the three
      largest statewide small-group health insurance purchasing alliances--in
      California, Connecticut, and Florida--increased coverage in small business. They
      did not. Specifically, they did not reduce small-group market health insurance
      premiums, and they did not raise small-business health insurance offer rates. We
      explore and discuss some reasons why. Alliances do permit employers to offer much
      greater choice in the number and types of plans; employees are found to take
      advantage of this wider choice.

PMID- 11194837
TI  - Consumer-choice purchasing pools: past tense, future perfect?

PMID- 11194838
TI  - Shifting health insurance coverage, 1997-1999.

PMID- 11194839
TI  - How a changing workforce affects employer-sponsored health insurance.

PMID- 11194840
TI  - Generation vexed: age-cohort differences in employer-sponsored health insurance
      coverage.

PMID- 11194841
TI  - Communicating health information through the entertainment media.

PMID- 11194842
TI  - Prospects for improved decision making about medical necessity.

PMID- 11194843
TI  - Using and misusing anecdote in policy making.

PMID- 11194844
TI  - Out of the closet and into the legislature: breast cancer stories.

PMID- 11194845
TI  - Betwixt and between: targeting coverage reforms to those approaching Medicare.
AB  - Recent Medicare buy-in proposals agree on setting eligibility at age sixty-two
      but disagree on linking eligibility to loss of employer insurance or ability to
      pay. We examine arguments for targeting incremental coverage for older Americans
      in these ways. While access to retiree health insurance is declining, we question
      whether targeting loss of employer insurance can address many older Americans'
      insurance problems. Furthermore, focusing on persons ages sixty-two to sixty-four
      misses a large group of persons in poor health with limited resources. Efforts to
      improve coverage for older Americans should consider trade-offs between defining
      eligibility by age versus ability to pay.

PMID- 11194846
TI  - Covering the uninsured through TennCare: does it make a difference?
AB  - Tennessee created TennCare in 1994 to address the needs of "poor and uninsured
      citizens ... excluded from the health care system." Under TennCare, Tennessee
      implemented managed care in its Medicaid program and used savings anticipated
      from the switch to expand insurance coverage to uninsured and uninsurable adults
      and children. Our analysis of the expansion suggests that it improved access to
      care, reduced unmet need, and encouraged use of preventive services, particularly
      for children. These changes coincided with higher levels of satisfaction with
      care among TennCare beneficiaries.

PMID- 11194847
TI  - Patterns of insurance coverage within families with children.
AB  - This paper examines patterns of health insurance within families with children,
      using the 1996 Medical Expenditure Panel Survey (MEPS). Four and a half million
      families (14 percent) had insurance for some, but not all, family members. These
      partially insured families generally obtained coverage because of one of three
      situations: (1) A parent earned relatively higher wages and received the
      concomitant benefits of such jobs but could not afford dependent coverage; (2)
      the family had young children who were covered by Medicaid through more generous
      eligibility thresholds for children under age six, while other family members
      were ineligible; or (3) the family had a member who was eligible for public
      coverage because of a disability. Each of these situations offers the platform
      from which incremental policies might efficiently expand coverage to families.

PMID- 11194848
TI  - Left out: immigrants' access to health care and insurance.
AB  - Recent policy changes have limited immigrants' access to insurance and to health
      care. Fewer noncitizen immigrants and their children (even U.S.-born) have
      Medicaid or job-based insurance, and many more are uninsured than is the case
      with native citizens or children of citizens. Noncitizens and their children also
      have worse access to both regular ambulatory and emergency care, even when
      insured. Immigration status is an important component of racial and ethnic
      disparities in insurance coverage and access to care.

PMID- 11194849
TI  - Unfriendly shores: how immigrant children fare in the U.S. health system.
AB  - The proliferation of poor immigrant children in the United States raises concern
      about their high uninsurance rates and access to care. We examined the joint
      effects of health insurance status and place of birth on use of health services
      by children of the working poor. Of foreign-born children, 52 percent were
      uninsured and 66 percent had a regular care source, compared with 20 percent and
      92 percent, respectively, of native-born children. Foreign-born uninsured
      children were less likely than their native-born peers were to have a regular
      care source or to have sought care. Health insurance and immigration policies
      must act in concert to increase health care access for foreign-born children.

PMID- 11194850
TI  - Assessing the impact of health plan choice.
AB  - Many health policy researchers have argued that increased insurance plan choice
      will enhance the efficiency of the health care system. However, relatively little
      is known about plan choice and its association with insurance coverage and access
      to and satisfaction with health care. Using data from the 1996 Medical
      Expenditure Panel Survey, we find that 55 percent of workers had plan choice in
      that year. Approximately 26 percent of workers with choice obtained it through a
      family member. Controlling for other factors, plan choice is associated with
      higher levels of employment-based insurance coverage and a greater likelihood
      that workers are satisfied that their families' health care needs are being met.

PMID- 11194852
TI  - Use of antihypertensive drugs by Medicare enrollees: does type of drug coverage
      matter?
AB  - Research has demonstrated that Medicare beneficiaries with drug coverage consume
      more clinically essential drugs. However, generosity of coverage varies
      considerably across beneficiaries. This study examines the association between
      types of drug coverage and the consumption and cost per tablet of essential
      antihypertensive medications among beneficiaries with hypertension. The findings
      indicate that while both state- and employer-sponsored drug coverage are
      associated with greater consumption of antihypertensive drugs and lower out-of
      pocket costs per tablet, private supplemental coverage is not associated with
      greater use and is associated with only slightly lower out-of-pocket costs than
      among noncovered beneficiaries.

PMID- 11194851
TI  - Covering the low-income uninsured: the case for expanding public programs.

PMID- 11194853
TI  - Working with employers to increase SCHIP (State Children's Health Insurance
      Program) enrollment.

PMID- 11194854
TI  - Medicaid coverage for tobacco-dependence treatments.

PMID- 11194855
TI  - More on Medicare competitive pricing.

PMID- 11194856
TI  - Reorganizing HCFA: another look.

PMID- 11194857
TI  - HCFA reorganization: not a simple task.

PMID- 11194858
TI  - Medical professionalism: another view.

PMID- 11194859
TI  - Building a consensus for expanding health coverage.
AB  - Despite a flourishing economy and recent growth in employment-based health
      coverage, forty-three million Americans remain uninsured. Extending coverage to
      the uninsured is not an intractable public policy problem but could be addressed
      if the various health care stakeholders could only find common ground. We argue
      that to win broad-based support from across the ideological and political
      spectra, a meaningful proposal should achieve a balance between public- and
      private-sector approaches, focus attention on those who are most in need of
      assistance (low-income workers), and build on systems that work today. With the
      aim of pulling together a political coalition, we present a proposal specific
      enough to attract support but whose details will arise later, in the context of
      the legislative process.

PMID- 11194860
TI  - Window shopping: state health reform politics in the 1990s.
AB  - Throughout the 1990s states sought politically acceptable policies to reduce the
      ranks of the uninsured. Visions of comprehensive health reform and universal
      coverage yielded by mid-decade to more modest measures to repair private health
      insurance markets, and to these enactments were added several new public programs
      (state and federal) to expand coverage for lower-income children and, in some
      cases, adults. Because governments remain ill equipped to counter the power of
      business, insurers, and providers in conflicts fought on private turf, reform
      agendas have been more readily set, moved, and cleared in public-sector arenas.
      Although the number of uninsured rose steadily until 1999, "catalytic federalism"
      -the accelerating interplay between state and federal reform forces and funds-
      may be putting the programmatic foundations for broader coverage incrementally
      into place.

PMID- 11194861
TI  - Will new leadership address the issue of the uninsured?

PMID- 11194862
TI  - Increments toward what?
AB  - Incremental proposals to expand health insurance coverage, such as expansions of
      the State Children's Health Insurance Program (SCHIP) or creation of new tax
      credits, should be examined for the values that underlie them and for how they
      structure future options for additional incremental coverage expansions. This
      paper examines five design issues in incremental reform: who determines coverage
      options for the newly insured; what risk pool do they enter; what is the
      government's contribution toward their coverage; what barriers are created by
      efforts to encourage efficiency; and how are issues of federalism handled? Tax
      credits are a departure from past approaches, while an SCHIP expansion is a
      continuation of current policy directions.

PMID- 11194863
TI  - Expanding coverage: reflections on recent efforts.
AB  - This paper focuses on the major health care initiatives and proposals that
      policymakers have enacted or considered since 1980 and describes what we can
      learn from these efforts to expand coverage. Most proposals have focused on
      incremental strategies, through expansion of public programs or tax incentives
      for the purchase of private coverage, although universal proposals have also
      emerged. Incremental approaches, which seem more politically feasible, still
      involve complex policy trade-offs. Efforts to improve take-up rates of public and
      private insurance could greatly expand coverage as well.

PMID- 11194864
TI  - Expanding coverage via tax credits: trade-offs and outcomes.
AB  - In this paper we discuss various options for using refundable tax credits to
      reduce the number of uninsured persons. The effect of tax credits on the number
      of uninsured depends on the form of the credit scheme adopted. Moreover, since
      large subsidies for private insurance directed to low-income persons have never
      been implemented, there is considerable uncertainty about the effect of various
      tax credit proposals. We find that small credits will do little to reduce the
      number of uninsured but that credits covering about half of the premium for a
      benchmark policy might have a significant effect, especially if they take a fixed
      dollar form and can be used for policies with few restrictions. Finally, we
      discuss the normative issues surrounding the "costs" of these credits schemes,
      and the policy issues raised by the uncertainty of the effects.

PMID- 11194865
TI  - Medicaid for children: federal mandates, welfare reform, and policy backsliding.
AB  - The 1996 federal welfare reform law delinked Medicaid enrollment from welfare
      participation. This paper estimates the impact of welfare reform on children's
      Medicaid enrollment using a methodology that both adjusts for income and other
      demographic differences over time and across states, and provides income-specific
      estimates of enrollment. The results indicate large enrollment declines: Between
      1995 and 1998, enrollment probabilities for children in families with no income
      declined from 81 percent to 68 percent, while at half the poverty line, the
      decline was from 61 percent to 53 percent. This implies that 926,000 to 1.37
      million fewer children were enrolled after welfare reform. At the state level,
      Medicaid declines and welfare reform were strongly associated, with only a few
      states succeeding in preserving children's Medicaid coverage.

PMID- 11194866
TI  - Amplification methods for the immunolocalization of rare molecules in cells and
      tissues.
AB  - The needs to precisely assign macromolecules to specific locations and domains
      within tissues and cells and to reveal antigens which are present in low or even
      in trace amounts, led to the elaboration of a wide spectrum of immunocytochemical
      amplification procedures. These arise from the successive improvements of tissue
      preparation techniques, of antigen retrieval procedures and of immunological or
      non-immunological detection systems. Improvement of detection systems may be the
      most active in the development of amplification techniques. Since the early work
      of Coons, in which by the introduction of the indirect technique has started
      amplifying the signal, different systems have succeeded in increasing the
      sensitivity of antigens detection. Indeed, amplification techniques such as the
      multiple antibody layers, the multiple bridges, the enzyme complexes, the avidin
      biotin, the silver intensification, and the numerous variations and combinations
      among these have increased the sensitivity for the detection of scarce tissue
      antigens. However, as shown by the recent progress carried out with new
      approaches such as the catalyzed reporter deposition (CARD) and the enhanced
      polymer one-step staining (EPOS), more efficient methods are still needed. In
      electron microscopy, few techniques have reached the resolution afforded by the
      post-embedding immunogold approach. In spite of this and in order to further
      increase its sensitivity, new probes and novel approaches are allowing
      combination of the gold marker with the amplification capacity of enzymes
      afforded by the CARD technique. Immunogold amplification strategies, such as the
      multiple incubations with the primary antibody and the use of an anti-protein A
      antibody have also led to enhanced signals displaying the advantages in terms of
      resolution and possibilities of quantification inherent to the colloidal gold
      marker.

PMID- 11194867
TI  - Role of the nucleoid-associated protein H-NS in the synthesis of virulence
      factors in the phytopathogenic bacterium Erwinia chrysanthemi.
AB  - The ability of the enterobacterium Erwinia chrysanthemi to induce pathogenesis in
      plant tissue is strongly related to the massive production of plant-cell-wall
      degrading enzymes (pectinases, cellulases, and proteases). Additional factors,
      including flagellar proteins and exopolysaccharides (EPS), also are required for
      the efficient colonization of plants. Production of these virulence factors,
      particularly pectate lyases, the main virulence determinant, is tightly regulated
      by environmental conditions. The possible involvement of the protein H-NS in this
      process was investigated. The E. chrysanthemi hns gene was cloned by
      complementation of an Escherichia coli hns mutation. Its nucleotide sequence
      contains a 405-bp open reading frame that codes for a protein with 85% identity
      to the E. coli H-NS protein. An E. chrysanthemi hns mutant was constructed by
      reverse genetics. This mutant displays a reduced growth rate and motility but an
      increased EPS synthesis and sensitivity toward high osmolarity. Furthermore,
      pectate lyase production is dramatically reduced in this mutant. The hns mutation
      acts on at least two conditions affecting pectate lyase synthesis: induction of
      pectate lyase synthesis at low temperatures (25 degrees C) is no longer observed
      in the hns mutant and induction of pectate lyase production occurs in the late
      stationary growth phase in the hns background, instead of in the late exponential
      growth phase as it does in the parental strain. Moreover, the E. chrysanthemi hns
      mutant displays reduced virulence on plants. Taken together, these data suggest
      that H-NS plays a crucial role in the expression of the virulence genes and in
      the pathogenicity of E. chrysanthemi.

PMID- 11194868
TI  - Genetic identification of multiple biological roles associated with the capsid
      protein of satellite panicum mosaic virus.
AB  - Satellite panicum mosaic virus (SPMV), an 824-nucleotide, positive-sense, single
      stranded RNA virus, depends on Panicum mosaic virus (PMV) for replication and
      spread in host plants. Compared with PMV infection alone, symptoms are
      intensified and develop faster on millet plants infected with SPMV and PMV. SPMV
      encodes a 157 amino acid capsid protein (CP) (17.5 kDa) to encapsidate SPMV RNA
      and form T = 1 satellite virions. The present study identifies additional
      biological activities of the SPMV CP, including the induction of severe chlorosis
      on proso millet plants (Panicum miliaceum cv. Sunup or Red Turghai). Initial
      deletion mutagenesis experiments mapped the chlorosis-inducing domain to amino
      acids 50 to 157 on the C-terminal portion of the SPMV CP. More defined analyses
      revealed that amino acids 124 to 135 comprised a critical domain associated with
      chlorosis induction and virion formation, whereas the extreme C-terminal residues
      148 to 157 were not strictly essential for either role. The results also
      demonstrated that the absence of SPMV CP tended to stimulate the accumulation of
      defective RNAs. This suggests that the SPMV CP plays a significant role in
      maintaining the structural integrity of the full-length satellite virus RNA and
      harbors multiple functions associated with pathogenesis in SPMV-infected host
      plants.

PMID- 11194869
TI  - Uncoupling resistance from cell death in the hypersensitive response of Nicotiana
      species to cauliflower mosaic virus infection.
AB  - Cauliflower mosaic virus strain W260 elicits a hypersensitive response (HR) in
      leaves of Nicotiana edwardsonii, an interspecific hybrid derived from a cross
      between N. glutinosa and N. clevelandii. Interestingly, we found that N.
      glutinosa is resistant to W260, but responds with local chlorotic lesions rather
      than necrotic lesions. In contrast, N. clevelandii responds to W260 with systemic
      cell death. The reactions of the progenitors of N. edwardsonii to W260 infection
      indicated that each contributed a factor toward the development of HR. In this
      study, we present two lines of evidence to show that the resistance and cell
      death that comprise the HR elicited by W260 can indeed be uncoupled. First, we
      showed that the non-necrotic resistance response of N. glutinosa could be
      converted to HR when these plants were crossed with N. clevelandii. Second, we
      found that cell death and resistance segregated independently in the F2
      population of a cross between N. edwardsonii and N. clevelandii. We concluded
      that the resistance of N. edwardsonii to W260 infection was conditioned by a gene
      derived from N. glutinosa, whereas cell death was conditioned by a gene derived
      from N. clevelandii. An analysis of pathogenesis-related (PR) protein expression
      in response to W260 infection revealed that elicitation of PR proteins was
      associated with resistance rather than with the onset of cell death.

PMID- 11194870
TI  - Modulations in gene expression and mapping of genes associated with cyst nematode
      infection of soybean.
AB  - Infection of the soybean root by the soybean cyst nematode (SCN) (Heterodera
      glycines Ichinohe) induces a well-documented, yet poorly understood, response by
      the host plant. The plant response, involving the differentiation of a feeding
      structure, or "syncytium," facilitates the feeding and reproduction of the
      nematode to the detriment of the host. We used a genetic system involving a
      single dominant soybean gene conferring susceptibility to an inbred nematode
      strain, VL1, to characterize the nematode-host interaction in susceptible line PI
      89008. The restriction fragment length polymorphism marker pB053, shown to map to
      a major SCN resistance locus, cosegregates with resistance among F2 progeny from
      the PI 89008 x PI 88287 cross. Cytological examination of the infection process
      confirmed that syncytium development in this genetic system is similar to that
      reported by others who used noninbred nematode lines. Our study of infected root
      tissue in the susceptible line PI 89008 revealed a number of genes enhanced in
      expression. Among these are catalase, cyclin, elongation factor 1alpha, beta-1,3
      endoglucanase, hydroxy-methylglutaryl coenzyme A reductase, heat shock protein
      70, late embryonic abundant protein 14, and formylglycinamidine ribonucleotide
      synthase, all of which we have genetically positioned on the public linkage map
      of soybean. Formylglycinamidine ribonucleotide synthase was found to be tightly
      linked with a major quantitative trait locus for SCN resistance. Our observations
      are consistent with the hypothesis proposed by others that feeding site
      development involves the dramatic modulation of gene expression relative to
      surrounding root cells.

PMID- 11194871
TI  - Early symbiotic responses induced by Sinorhizobium meliloti iIvC mutants in
      alfalfa.
AB  - A mutation in the ilvC gene of Sinorhizobium meliloti 1021 determines a
      symbiotically defective phenotype. ilvC mutants obtained from different S.
      meliloti wild-type strains are able to induce root hair deformation on alfalfa
      roots and show variable activation of the common nodulation genes nodABC. All of
      these mutants are noninfective. The presence of extra copies of nodD3-syrM in an
      IlvC- background does not promote nod expression but allows the detection of low
      levels of Nod factor production. The sulphation of the Nod factor metabolites,
      however, is not affected. Furthermore, IlvC- strains induce a specific pattern of
      starch accumulation on alfalfa roots as well as of early nodulin expression.
      Hence, the pleiotropic action of the ilvC gene in S. meliloti may reveal novel
      complexities involved in the symbiotic interaction.

PMID- 11194872
TI  - Legume models strut their stuff.

PMID- 11194873
TI  - Functional screening yields a new beta-1,4-endoglucanase gene from Heterodera
      glycines that may be the product of recent gene duplication.
AB  - Clones with secreted cellulolytic activity were identified when a cDNA library
      constructed from poly A(+) RNA of preparasitic second-stage juveniles of
      Heterodera glycines, the soybean cyst nematode, was expressed in the Escherichia
      coli SOLR strain and overlaid with a carboxymethylcellulose (CMC) substrate.
      Twenty CMC-degrading clones were analyzed, and all were either identical or
      strongly similar to a beta-1,4-endoglucanase gene (HG-eng-2), previously isolated
      from H. glycines. A subgroup of identical "HG-eng-2-like" clones had considerable
      differences in the 5' untranslated region compared with HG-eng-2 and were
      designated HG-eng-3. One H. glycines genomic clone contained HG-eng-2 and HG-eng
      3 full-length genes, separated by a distance of approximately 8 kb, and a second
      genomic clone contained two copies of HG-eng-2, separated by approximately 6.5
      kb, suggesting the presence of endoglucanase gene clusters in H. glycines. The HG
      eng-2 and HG-eng-3 genes were in opposite transcriptional orientation, with
      considerable nucleotide differences in their 5' flanking regions. The highly
      conserved nucleotide sequence in the introns and exons and their close proximity
      within the genome suggest that HG-eng-2 and HG-eng-3 are the products of recent
      gene duplication and inversion.

PMID- 11194874
TI  - Molecular cloning of a cDNA encoding an amphid-secreted putative avirulence
      protein from the root-knot nematode Meloidogyne incognita.
AB  - Amplified fragment length polymorphism fingerprinting of three pairs of
      Meloidogyne incognita near-isogenic lines (NILs) was used to identify markers
      differential between nematode genotypes avirulent or virulent against the tomato
      Mi resistance gene. One of these sequences, present only in the avirulent lines,
      was used as a probe to screen a cDNA library from second-stage juveniles (J2s)
      and allowed cloning of a cDNA encoding a secretory protein. The putative full
      length cDNA, named map-1, encoded a 458 amino acid (aa) protein containing a
      predictive N-terminal secretion signal peptide. The MAP-1 sequence did not show
      any significant similarity to proteins deposited in databases. The internal part
      of the protein, however, was characterized by highly conserved repetitive motives
      of 58 or 13 aa. Reverse transcription polymerase chain reaction (RT-PCR)
      experiments confirmed that map-1 expression was different between avirulent and
      virulent NILs. In PCR reactions, map-1-related sequences were amplified only in
      nematode populations belonging to the three species against which the Mi gene
      confers resistance: M. arenaria, M. incognita, and M. javanica. Polyclonal
      antibodies raised against a synthetic peptide deduced from the MAP-1 sequence
      strongly labeled J2 amphidial secretions in immunofluorescence microscopy assays,
      suggesting that MAP-1 may be involved in the early steps of recognition between
      (resistant) plants and (avirulent) nematodes.

PMID- 11194875
TI  - Inhibition of fungal appressorium formation by pepper (Capsicum annuum) esterase.
AB  - A pepper esterase gene (PepEST) that is highly expressed during an incompatible
      interaction between pepper (Capsicum annuum) and the anthracnose fungus
      Colletotrichum gloeosporioides has been previously cloned. Glutathione-S
      transferase-tagged recombinant PepEST protein expressed in Escherichia coli
      showed substrate specificity for p-nitrophenyl esters. Inoculation of compatible
      unripe pepper fruits with C. gloeosporioides spores amended with the recombinant
      protein did not cause anthracnose symptoms on the fruit. The recombinant protein
      has no fungicidal activity, but it significantly inhibits appressorium formation
      of the anthracnose fungus in a dose-dependent manner. An esterase from porcine
      liver also inhibited appressorium formation, and the recombinant protein
      inhibited appressorium formation in the rice blast fungus, Magnaporthe grisea.
      Inhibition of appressorium formation in M. grisea by the recombinant protein was
      reversible by treatment with cyclic AMP (cAMP) or 1,16-hexadecanediol. The
      results suggest that the recombinant protein regulates appressorium formation by
      modulating the cAMP-dependent signaling pathway in this fungus. Taken together,
      the PepEST esterase activity can inhibit appressorium formation of C.
      gloeosporioides, which may result in protection of the unripe fruit against the
      fungus.

PMID- 11194876
TI  - Oxidative burst in alfalfa-Sinorhizobium meliloti symbiotic interaction.
AB  - Reactive oxygen species are produced as an early event in plant defense response
      against avirulent pathogens. We show here that alfalfa responds to infection with
      Sinorhizobium meliloti by production of superoxide and hydrogen peroxide. This
      similarity in the early response to infection by pathogenic and symbiotic
      bacteria addresses the question of which mechanism rhizobia use to counteract the
      plant defense response.

PMID- 11194877
TI  - Cloning and characterization of a bean UDP-glucosyltransferase cDNA expressed
      during plant-bacterial interactions.
AB  - A cDNA clone, which corresponds to an RNA transcript that accumulates in bean
      during the hypersensitive reaction, was isolated and designated Hra25 (for
      hypersensitive reaction associated). Hra25 is predicted to encode a UDP
      glucosyltransferase. Northern analysis was used to study Hra25 transcript
      accumulation in bean in response to incompatible and compatible strains of
      Pseudomonas syringae, an Hrp- mutant, and wounding. Our data suggest that the
      Hra25 transcript is activated in response to specific avr-derived signals as well
      as non-avr, general signals.

PMID- 11194878
TI  - Azorhizobium caulinodans ORS571 colonizes the xylem of Arabidopsis thaliana.
AB  - Improved conditions were used for the aseptic growth of Arabidopsis thaliana to
      investigate whether xylem colonization of A. thaliana by Azorhizobium caulinodans
      ORS571 might occur. When seedlings were inoculated with ORS571 (pXLGD4) tagged
      with the lacZ reporter gene, nearly all of the plants showed blue regions of
      ORS571 colonization at lateral root cracks (LRC). The flavonoids naringenin and
      liquiritigenin significantly stimulated colonization of LRC by ORS571. Blue bands
      of ORS571 (pXLGD4) bacteria were observed histochemically in the xylem of intact
      roots of inoculated plants. Detailed microscopic analysis of sections of primary
      and lateral roots from inoculated A. thaliana confirmed xylem colonization. Xylem
      colonization also occurred with an ORS571 nodC mutant deficient in nodulation
      factors. There was no significant difference in the percentage of plants with
      xylem colonization or in the mean length of xylem colonized per plant between
      plants inoculated with either ORS571 (pXLGD4) or ORS571::nodC (pXLGD4), with or
      without naringenin.

PMID- 11194879
TI  - Construction of a derivative of Agrobacterium tumefaciens C58 that does not
      mutate to tetracycline resistance.
AB  - Agrobacterium tumefaciens C58 mutates to tetracycline resistance at high
      frequency, complicating the use of many broad-host-range cloning and binary
      vectors that code for resistance to this antibiotic as the selection marker. Such
      mutations are associated with a resistant gene unit, tetC58, that is present in
      the genome of this strain. By deleting the tetC58 locus, we constructed NTL4, a
      derivative of C58 that no longer mutates to tetracycline resistance. The deletion
      had no detectable effect on genetic or physiological traits of NTL4 or on the
      ability of this strain to transform plants.

PMID- 11194880
TI  - DNA of nonhuman primates harbors hepatitis C-virus-specific sequences of its 5'
      non-coding region (5'-NCR).
AB  - The DNA from PBMCs of both hepatitis C virus (HCV)-positive patients and healthy
      HCV-negative human individuals tested thus far contains essential parts--up to
      272/341 nucleotides--of the HCV 5'-non-coding region (5'-NCR). These findings
      bring up the question of the possible evolutionary background of these sequences.
      Therefore, using the same methodology, we looked for the same sequences in
      animals closely related to man, i.e., in nonhuman primates (two chimpanzees, one
      orang-utan, one Debrazza monkey, two New World monkey species and a prosimian).
      The DNA from PBMCs of the studied animals belonging to nonhuman primates contains
      essential parts--up to 272/341 nucleotides--of the HCV 5'-non-coding region (5'
      NCR). A common sequence of 82 nucleotides is contained in the DNA of all the
      tested animals but only the chimpanzee's DNA harbors the same, longer sequence
      region of 272/341 nucleotides of the 5'-NCR found in human DNA. The results may
      provide a clue as to the possible origin of parts of the IRES containing sequence
      area of the HCV.

PMID- 11194881
TI  - Modified percutaneous endoscopic gastrostomy (PEG) with gastropexy--early
      experience with a new introducer technique.
AB  - OBJECTIVE: The Cliny PEG 13 has been available since 1999 for clinical use in the
      modified introducer technique in combination with endoscopically controlled
      gastropexy. Data on indication, insertion technique and safety have not yet been
      reported in the literature. METHODS: During the time period from January 1999 to
      June 2000, from a total of 457 patients receiving a PEG 27 (5.9%) subjects, in
      whom the insertion of a PEG by means of pull-through technique was impossible or
      only in combination with an intervention e.g. bougienage were included in this
      prospective study. Each patient received a Cliny PEG 13 by means of introducer
      technique with endoscopically controlled double gastropexy. Tumor patients with
      severe stenosis made up more than 90% of the cases. The insertion and 30 day
      follow-up were performed using a standardized protocol. Method-related and
      unrelated complications were recorded. RESULTS: PEG insertion was successful in
      all patients without additional intervention. We did not see any method-related
      complications. The peri-interventional local infection rate was 3.7%. One patient
      died during the 30-day follow-up period as a result of progression of the
      underlying disease. No further complications occurred in long term follow-up.
      CONCLUSIONS: Our results show that the Cliny PEG 13 is a safe technique and an
      alternative to other methods and surgical procedures in patients in whom a PEG
      was not applicable by means of the pull-through technique. Larger case numbers
      and the use in other patient collectives will have to prove these initial
      results.

PMID- 11194882
TI  - [Sonography: quo vadis?].

PMID- 11194883
TI  - [The ultrasound centre as a medically and economically relevant alternative--a
      report of the Regensburg experience].
AB  - In most medical centres, ultrasonography is performed independently by several
      departments. In october 1997, the University hospital of Regensburg founded an
      ultrasound centre, integrating surgical and medical departments as well as the
      institutes for radiology and nuclear medicine. The aims of this centre were the
      concentration of organization, machines, financial resources, manpower and know
      how, standardized training and quality, and strengthening of interdisciplinary
      cooperation in clinic, medical education and research. Booking, standardized
      reports and a joint archiving of reports are assisted by a collective computer
      system. Most examinations in the centre are performed by three all-day present
      gastroenterology, surgery and radiology residents who are supported by licensed
      sonographers of the other departments. Training is standardized, and the
      certification for ultrasound examinations is acquired after a test with
      theoretical and practical parts. The integration of various departments in the
      ultra-sound on-call service has led to significant savings. The pool of
      ultrasound machines is used jointly, department-specific resources for new
      machines have been put together. We are convinced that this way of a close
      interdisciplinary cooperation will result in improvements in quality, utilization
      of financial resources and clinical research.

PMID- 11194884
TI  - [Successful therapy of hepatorenal syndrome with norepinephrine].
AB  - A 39-year-old female with alcoholic cirrhosis was admitted with signs of an
      alcoholic hepatitis. Within one week a hepatorenal syndrome (HRS) (Creatinin 5.83
      mg/100 ml, Harnstoff 235 mg/100 ml) evolved in the absence of additional causes.
      She had a diminished water (urine volume 31 ml/h) and sodium excretion (10
      mmol/l). Urine flow was increased to 131 ml/h by plasma expansion with i.v.
      infusion of volume and albumin and with infusion of dopamine (3
      micrograms/kg/min) and, as there was no diuretic pretreatment and thus, no HRS
      secondary to diuretic treatment, furosemide (500 mg/24 h). However, impairment of
      renal function remained unchanged with this therapy. Therefore, norepinephrine
      (NE) therapy was initiated. A dosage of 0.1-0.12 microgram/kg/min was necessary
      to achieve the desired increase in the mean arterial pressure of 10-20 mm Hg.
      During the NE infusion the urine volume increased further to 231 ml/h, the sodium
      excretion raised to 44 mmol/l, and serum levels of creatinine and urea decreased
      to 1.91 mg/100 ml and 141 mg/100 ml, respectively. With recovering liver function
      the NE infusions could be discontinued after 5 days without recurrence of a HRS
      until discharge after 3 weeks. Beside the vasopressin analogon ornipressin, the
      combination of norepinephrine and dopamine seems to be useful for the therapy of
      HRS. Norepinephrine has the advantage of an easy accessibility in ICUs and seems
      to exert less side effects.

PMID- 11194885
TI  - [Pulmonal sarcoidosis: A rare side effect of interferon-alpha treatment for
      chronic hepatitis C infection].
AB  - This is a case report of a 44-year-old woman who received a 1-year-treatment with
      interferon-alpha for chronic hepatitis C virus infection. 3 months after
      cessation of the therapy she relapsed and was successfully retreated 12 months
      with a combination of interferon-alpha and ribavirin thereafter. During the
      treatment the patient developed a typical flue-like syndrome, dry cough with
      exertional dyspnea that was initially interpreted as a typical side effect of
      interferon-alpha treatment. Due to the persisting cough, further radiologic and
      histologic work up was done and results were significant for interstitial
      sarcoidosis. After interferon-treatment was stopped the pulmonary symptoms
      resolved completely while pathologic changes in radiographic imaging persisted.
      Interferon-alpha may have contributed to the development and progression of
      sarcoidosis by activation of cellular immunity. Although there are only few
      reports about pulmonary sarcoidosis associated with interferon-alpha treatment,
      this entity should be included in the differential diagnosis of putative side
      effects of interferon-alpha therapy.

PMID- 11194886
TI  - [Ulcers of the colon in association with nonsteroidal anti-inflammatory drugs
      (NSAID)--a rare cause of gastrointestinal bleeding? Report of 3 cases].
AB  - Although adverse side effects of nonsteroidal anti-inflammatory drugs (NSAID) can
      affect the whole gastrointestinal tract, most reports refer to upper
      gastrointestinal tract complications. We report on 3 patients with lower
      gastrointestinal bleeding (patient 1 and 2) respectively detectable fecal blood
      loss (patient 3) after the use of NSAID. Patient 1 and 3 were taking NSAID over
      at least 6 months for the treatment of rheumatic diseases while patient 2
      reported a single use of 2 g acetylsalicylic acid. Colonoscopy showed a single
      ulcer of the colon in patients 1 and 2. Due to acute bleeding patient 1 required
      interventional endoscopic treatment. Colonoscopy of patient 3 revealed multiple
      colonic ulcerations. Gastroduodenoscopy also detected adverse NSAID-effects on
      the upper gastrointestinal tract in patient 1 and 3 (ulcers of the stomach,
      erosive duodenitis). NSAID-medication was discontinued in all patients and,
      additionally, mesalazine was administered to patient 3. Consecutively, symptoms
      and lesions disappeared. Our cases stress the clinical importance of NSAID
      toxicity distal to the small intestine which may exist concomitantly to lesions
      of the upper gastrointestinal tract and is not obligatory dose-dependent.

PMID- 11194887
TI  - [Aminosalicylates and aspirin for colonic cancer: from anti-inflammatory to
      antineoplastic drugs?].
AB  - The aim of this article is to review potential antineoplastic properties of anti
      inflammatory compounds commonly used in various inflammatory diseases such as
      aminosalicylates, aspirin and other nonsteroidal drugs. Starting from
      experimental and epidemiologic evidence showing prophylaxis and/or tumor
      regression/suppression, specific antineoplastic actions especially the inhibition
      of cyclooxygenase-(COX)dependent and COX-independent steps including the role of
      transcription factor (NFkappaB) in the cell cycle regulation are reviewed. In
      addition other mechanisms by which these drugs may exert antitumor effects, also
      may be important such as induction of apoptosis of cancer cells and/or inhibition
      of potentially carcinogenic oxidative DNA damage. Based on this knowledge
      potential clinical implications are discussed.

PMID- 11194888
TI  - [Therapy of acute pancreatitis. Consensus guidelines].

PMID- 11194889
TI  - Stronger association with HLA-Cw6 than with corneodesmosin (S-gene) polymorphisms
      in Swedish psoriasis patients.
AB  - Psoriasis vulgaris is strongly associated with certain human leukocyte antigens,
      especially in early onset. The purpose of this study was to study the HLA-Cw6
      allele and its contribution to disease susceptibility in a set of 104 families
      with at least two affected siblings. A sequencing method was utilized to examine
      the two exons that build up the antigen binding site of the C locus receptor. DNA
      from patients homozygous for Cw6 based on haplotype information were sequenced.
      The results confirmed the identity of the Cw6 allele in affected individuals with
      the consensus sequence for Cw*0602. We screened the set of families for psoriasis
      patients homozygous for Cw6 and found 11 individuals with a mean age at onset of
      16.1 years. The corresponding figure for the Cw6 heterozygotes was 18.45 years
      and for the Cw6-negatives 22.36 years. This is indicative of a gene dose effect.
      We performed a transmission disequilibrium test (TDT) on the Cw6 allele per se,
      used as a biallelic marker. The analysis resulted in a P-value of 5.3 x 10(-17)
      (t167/nt45). This greatly exceeds our previous results of a TDT in the region,
      including microsatellite markers and single nucleotide polymorphisms (SNPs) in
      the coding part of the S gene (corneodesmosin), which is a suggested candidate
      gene in the region. The maximum nonparametric linkage (NPL) value was also
      reached using HLA-C as a marker. We conclude that Cw6 is the allele which shows
      the highest degree of association with psoriasis in our set of families and we
      propose that it directly influences the age at onset of the disease rather than
      increasing the genetic load in accordance with a polygenic theory.

PMID- 11194890
TI  - Polymorphisms in inflammation genes (angiotensinogen, TAP1 and TNF-beta) in
      psoriasis.
AB  - This study focused on the association between plaque psoriasis and polymorphisms
      of several inflammation genes. Included in the study were 142 Caucasian (Czech)
      patients with plaque psoriasis and 141 healthy subjects. The genotypes of the
      polymorphisms in angiotensinogen [M235T ATG, A(-6)G ATG], in transporters
      associated with antigen processing TAP1 (TAP1*0101, TAP*02011 and TAP1*0301) and
      in lymphotoxin alpha (TNFbeta) (NcoI in intron 1) were detected by polymerase
      chain reaction-based methods and restriction enzyme analysis. An increase in B1
      (less frequent) allele of NcoI TNFbeta polymorphism was found in psoriatic
      patients compared to healthy individuals (odds ratio = 1.6, 95% confidence
      interval 1.13-2.26, P = 0.006). A positive family history of psoriasis was
      associated with a higher B1 allele frequency in NcoI TNFbeta (P = 0.011). Hardy
      Weinberg disequilibrium was found in TAP1 polymorphism A-->G at nucleotide 1207
      in psoriatic patients. A case-control difference was found in the allelic
      concurrence of M235T and A(-6)G ATG polymorphisms. The most frequent population
      genotypes MMGG, MTAG and TTAA were observed in 92% of patients vs 74% of control
      subjects (odds ratio 0.29, 95% confidence interval 0.14-0.60, P = 0.0003). A
      positive history of tonsillitis and/or tonsillectomy was associated with a higher
      T allele frequency of the M235T ATG polymorphism (P = 0.037) as well as with a
      higher G allele frequency of the A(-6)G ATG polymorphism (P = 0.022).
      Polymorphisms in proinflammatory angiotensinogen and TNFbeta genes were
      associated with plaque psoriasis, a positive family history of psoriasis and with
      frequent tonsillitis in childhood.

PMID- 11194891
TI  - Animal model of sclerotic skin. III: Histopathological comparison of bleomycin
      induced scleroderma in various mice strains.
AB  - We have recently established a mouse model for scleroderma by repeated local
      bleomycin treatment. In this study, we compared the susceptibility to bleomycin
      in the development of dermal sclerosis among Balb/c, C3H/He, C57BL/6J, A/J,
      DBA/2, B10.BR, B10.A, and B10.D2 mouse strains. After either bleomycin or PBS
      treatment, skin from the injection site was histologically examined. Dermal
      sclerosis was induced by bleomycin treatment for 4 weeks in all of the strains
      examined. In particular, C3H/He, DBA/2, B10.D2 and B10.A mice developed intense
      dermal sclerosis characterized by deposition of homogeneous material in the
      dermis and thickened collagen bundles. Dermal thickness showed a more than
      twofold increase following bleomycin treatment, as compared with PBS treatment,
      except in C57BL/6J and DBA/2 mice. In A/J, C3H/He, B10.A, and B10.D2 mice, dermal
      thickness showed a more than 2.5-fold increase. Mast cell numbers in sclerotic
      skin were significantly greater than in PBS-treated skin in Balb/c and B10.A mice
      after 4 weeks of treatment. We also examined whether bleomycin treatment for 3
      weeks could induce dermal sclerosis in C3H mice. Histological examination
      revealed that epidermal thickness as well as dermal sclerosis was increased in
      C3H mice following bleomycin treatment for 3 weeks. Increased hydroxyproline
      content as well as mRNA expression of alpha1(I) collagen, as determined by
      Northern blot analysis, were observed following bleomycin treatment. Taken
      together, we conclude that C3H/He and B10.A mouse strains are bleomycin
      'susceptible', and these strains are considered to be a suitable experimental
      model of bleomycin-induced scleroderma.

PMID- 11194892
TI  - Targeted delivery of DNA encoding herpes simplex virus type-1 glycoprotein D
      enhances the cellular response to primary viral challenge.
AB  - Intravenous injection of plasmid DNA encoding herpes simplex virus type-1
      glycoprotein D (gD-1) complexed with asialoorosomucoid-poly-L-lysine (gD-ASOR)
      targets foreign DNA to the liver, leading to hepatic expression of gD-1. BALB/c
      mice were given two intravenous injections of gD-ASOR, pBK-ASOR (plasmid lacking
      the gD-1 gene but complexed with ASOR), or PBS. The skin was inoculated with 1 x
      10(4) PFU of HSV-1 or sham-inoculated, and analyzed for infectious virus and
      cellular infiltration 1, 3, and 5 days after inoculation. Prior immunization with
      gD-ASOR led to significantly lower (P < 0.05) viral titers in the skin 5 days
      after inoculation compared with controls. Infiltration of the skin at the site of
      inoculation by polymorphonuclear neutrophils (PMNs), T cells, B cells, dendritic
      cells, and macrophages was monitored immunohistochemically. Significantly higher
      numbers (P < 0.05) of CD4+ and CD8+ T cells, dendritic cells, and macrophages
      responded to HSV-1 challenge in mice immunized with gD-ASOR than in mice
      immunized with pBK-ASOR or PBS. The response by PMNs and B cells was
      indistinguishable among the treatment groups. These results suggest that BALB/c
      mice sensitized to gD-1 following gD-ASOR immunization develop an enhanced T-cell
      response to primary HSV-1 infection.

PMID- 11194893
TI  - Comparative inhibitory effects of vitamin D3 and an analogue on normal and
      psoriatic epidermis in organ culture.
AB  - Recently, there have been many vitamin D3 analogues synthesized and tried in the
      treatment of psoriasis. In the experiments reported here we observed and compared
      their effects on normal and psoriatic epidermis in organ culture in vitro. We
      employed a new vitamin D3 analogue, 22-oxa-calcitriol (OCT), the effect of which
      was compared with that of calcitriol (1,25-D3). Both caused suppression of
      proliferation of normal and psoriatic epidermis, dependent upon concentration and
      culture time. Histologically, in the presence of the agents, degeneration started
      from the top of the epidermis downwards. This is the first report of cell
      degeneration as a direct effect of vitamin D. The nature of the degeneration was
      evaluated by electron microscopy (EM) and by the in situ nick end labeling
      technique (TUNEL), and these studies revealed that the degeneration involved
      necrosis rather than apoptosis. This in vitro method may be useful to assess the
      effectiveness of newly synthesized vitamin D3 analogues in the treatment of
      psoriasis.

PMID- 11194894
TI  - Bleomycin increases steady-state levels of type I collagen, fibronectin and
      decorin mRNAs in human skin fibroblasts.
AB  - Bleomycin is a drug capable of inducing tissue fibrosis. In this study, the
      effects of bleomycin on gene expression of extracellular matrix encoding
      alpha1(I) collagen, fibronectin and decorin were determined in vitro in human
      dermal fibroblasts. Northern blot analysis showed that bleomycin upregulated
      alpha(I) collagen, fibronectin and decorin gene expression dose-dependently
      between 1 nM and 1 microM. Bleomycin at 100 nM upregulated alpha1(I) collagen,
      fibronectin and decorin mRNA expression with a peak at 6 h following stimulation
      in normal skin fibroblast monolayers. Bleomycin enhanced mRNA expression encoding
      these extracellular matrix proteins in both normal dermal and scleroderma
      fibroblasts. Concomitant stimulation with bleomycin and interferon-gamma (1,000
      U/ml), a representative antifibrotic cytokine, decreased alpha1(I) collagen mRNA
      expression. Bleomycin also mildly upregulated mRNA expression of transforming
      growth factor-beta (TGF-beta) and connective tissue growth factor (CTGF)
      coordinately in normal skin fibroblasts. Our results indicate that bleomycin
      modulates gene expression of extracellular matrix proteins in dermal fibroblasts,
      and this effect may be mediated by TGF-beta and CTGF.

PMID- 11194895
TI  - Vitamin B6 phototoxicity induced by UVA radiation.
AB  - We have previously reported that pyridoxine shows UVA-induced cytotoxicity. Four
      other vitamin B6 compounds (pyridoxal, pyridoxamine, pyridoxal phosphate, and
      pyridoxamine phosphate) are metabolically more important in vivo than pyridoxine.
      These compounds were examined for UVA phototoxicity to cultured human
      fibroblasts. The cytotoxicity was measured by post-UVA irradiation colony-forming
      ability. All the B6 compounds except pyridoxal phosphate showed cytotoxicity.
      Pyridoxamine phosphate, which is the most important form of vitamin B6 in vivo,
      had the strongest cytotoxic effect. To examine the involvement of reactive oxygen
      species in the phototoxicity, we performed an electron spin resonance study using
      the spin trapping agent, 5,5-dimethyl-1-pyrroline N-oxide, and
      diethylenetriaminepentaacetic acid. We failed to detect radicals derived from
      vitamin B6. The cytotoxic effect remained in UVA-irradiated solutions for at
      least 30 min after the end of UVA irradiation. Hydrogen peroxide was produced in
      the solution, but the amount was not enough to cause cytotoxicity. In addition,
      the cells from xeroderma pigmentosum patients who belong to group A or C showed
      survival curves similar to those of normal fibroblasts. This suggests that
      cyclobutane pyrimidine dimers or 6-4 photoproducts of DNA were not involved in
      this damage. These findings suggest that UVA-induced vitamin B6 cytotoxicity is
      caused by toxic photoproducts resulting from irradiated vitamin B6.

PMID- 11194896
TI  - Detection of clonal T cells in lichen planus.

PMID- 11194897
TI  - Immunohistochemical localization of sulfhydryl oxidase correlates with disulfide
      crosslinking in the upper epidermis of rat skin.

PMID- 11194898
TI  - The bulge is the source of cellular renewal in the sebaceous gland of mouse skin.

PMID- 11194899
TI  - Acne chlorina and acne vulgaris--casual likeness or casual homology?

PMID- 11194900
TI  - Direct contrast-enhanced 3D MR venography.
AB  - Non-enhanced two-dimensional (2D) time-of-flight (TOF) MRA is well established
      for imaging of the deep venous system. However, based on the acquisition of
      multiple axial images, it can be time-consuming and often fails to delineate
      small superficial and perforating veins. The presented low-dose, direct-contrast
      injection 3D MR venography technique allows rapid acquisition of high-quality MR
      venograms and can be employed for the display of the deep and superficial venous
      system of upper and lower extremity including pelvic and central thoracic veins.
      This article describes the employed technique and provides a comprehensive image
      based overview of the various indications for direct-infusion 3D MR venography
      such as post-/thrombotic changes, varicosities, and assessment of the greater
      saphenous vein prior to bypass surgery.

PMID- 11194901
TI  - Blunt trauma of the heart: CT pattern of atrial appendage ruptures.
AB  - Blunt trauma patients with myocardial ruptures rarely survive long enough to
      reach a trauma center; however, for the survivors, prompt diagnosis and surgery
      are mandatory and save up to 80% of patients. Preoperative diagnosis of
      myocardial ruptures is assessed by echocardiography or, more rarely, by
      angiocardiography. We report two cases of blunt trauma patients with an atrial
      appendage rupture which could be retrospectively identified on admission CT
      survey.

PMID- 11194902
TI  - Use of  half-dose gadolinium-enhanced MRI and magnetization transfer saturation
      in brain tumors.
AB  - The aim of this study was to search if half-dose gadolinium (Gd)-enhanced MR
      imaging with magnetization transfer saturation (MT) can replace standard-dose T1
      weighted spin echo (SE) without MT saturation in brain tumors. Thirty patients
      with a total of 33 brain tumors (14 gliomas, 13 meningiomas, 6 metastases) were
      prospectively studied using T1-weighted SE half-dose of Gd with MT, and T1
      weighted SE standard-dose Gd without MT. The contrast-to-noise ratio (CNR) of the
      two sequences was calculated and four radiologists reviewed qualitatively the
      images of the two sequences. There was no significant difference between both
      techniques for quantitative analysis (Wilcoxon test). However, there was a good
      agreement between sequences to evidence an intraclass correlation coefficient (r
      = 0.70) of all lesions. In cases of meningioma, the agreement was better (r =
      0.84). The results show a difference in the qualitative data between the two
      sequences, suggesting the use of the T1-weighted MR images with MT and half-dose
      of Gd with good results in the whole tested parameters except the lesional edema
      and the presence of artifacts. Half-dose T1-weighted SE with MT can replace
      standard-dose T1-weighted SE without MT with no loss of contrast enhancement in
      investigation of meningiomas and saving 50% of the contrast material.

PMID- 11194903
TI  - Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography.
AB  - The goal of this study was to assess the usefulness of spiral CT angiography
      (CTA) with three- dimensional reconstructions in defining intracranial aneurysms,
      particularly around the Circle of Willis. Two hundred consecutive patients with
      angiographic and/or surgical correlation were studied between 1993 and 1998, with
      CTA performed on a GE HiSpeed unit and Windows workstation. The following
      clinical situations were evaluated: conventional CT suspicion of an aneurysm;
      follow-up of treated aneurysm remnants or of untreated aneurysms; subarachnoid
      haemorrhage (SAH) and negative angiography; family or past aneurysm history; and
      for improved definition of aneurysm anatomy. Spiral CTA detected 140 of 144
      aneurysms, and an overall sensitivity of 97%, including 30 of 32 aneurysms 3 mm
      or less in size. In 38 patients with SAH and negative angiography, CTA found six
      of the seven aneurysms finally diagnosed. There was no significant artefact in 17
      of 23 patients (74%) with clips. The specificity of CTA was 86% with 8 false
      positive cases. Spiral CTA is very useful in demonstrating intracranial
      aneurysms.

PMID- 11194904
TI  - Multiple glioblastomas: CT and MR features.
AB  - The aim of this study was to analyze the CT and MR features of multiple
      glioblastomas, and to determine the best imaging modality for the initial
      diagnosis. The CT (four exams) and MR imaging (eight exams) of eight patients
      with proven multiple glioblastomas were reviewed by two neuroradiologists. The
      lesions were always hypo- or isodense on CT and hyperintense on T2-weighted
      images (100%). They were usually hypo- or isointense on T1-weighted images (90%).
      Edema and mass effect were very variable. After contrast media administration,
      the enhancement was mostly strong (71% on CT and 70% on MR), often either
      heterogeneous or ring-like. The different lesions of a patient often had a
      different pattern on MR (75% of cases). Meningeal or ventricular enhancement,
      suggestive of a possible way of dissemination, was rare. In case of multiple
      cerebral masses, multiple glioblastomas should be considered as a possible
      diagnosis in addition to the better known diagnosis of brain metastases,
      abscesses, or multifocal lymphomas. Moderate edema and mass effect on MR
      associated with strong and heterogeneous enhancement are suggestive of feature of
      multiple glioblastomas. Magnetic resonance allows rarely the visualization of a
      dissemination route.

PMID- 11194905
TI  - Robust processing of intracranial CT angiograms for 3D volume rendering.
AB  - The goal of this study was to develop a robust and simple technique for
      processing of cranial CT angiograms (CTA) in the clinical setting. The method
      described in this paper involves segmentation of the bone, then dilation of the
      skull by adding three or four layers of voxels. This dilated skull is subtracted
      from the vessels object on a voxel-by-voxel basis, allowing segmentation and
      subsequent display of the vessels only. For evaluation of the technique, three
      groups of operators processed one CTA, and the quality of the 3D views obtained
      and the times taken were compared. One group was given training by an expert and
      a "recipe" for guidance, the second was given only the "recipe," and the third
      group consisted of expert operators. All operators were able to produce good or
      acceptable shaded-surface displays when compared with digital subtraction
      angiography, within 10 min for experienced users, an average of 17 min for
      trained operators and 26 min for those using only the recipe sheet. Using a
      simple scoring system for the appearance of feeding vessels and draining veins,
      no significant differences were found between the three levels of training and
      experience. This technique simplifies the processing of CTAs and is quick enough
      to make such examinations part of a routine clinical service.

PMID- 11194906
TI  - Klippel-Feil syndrome in association with posterior fossa suboccipital dermoid
      cyst.
AB  - We present the second case of Klippel-Feil syndrome in association with a
      posterior fossa dermoid cyst extending through the occipital bone and presenting
      as a suboccipital subcutaneous mass. We describe its radiographic, CT, and MRI
      appearances as well as on MRI diffusion-weighted images. Posterior cranial fossa
      dermoid cysts and sinuses should be added to the list of congenital abnormalities
      which must be sought in patients with Klippel-Feil syndrome. Diffusion-weighted
      images of brain may differentiate these masses from cerebral spinal fluid
      collections.

PMID- 11194907
TI  - Middle cerebral arterial occlusion in a child with osteopetrosis major.
AB  - Osteopetrosis major (infantile autosomal recessive type) usually presents with
      pathological fractures, bone marrow failure and some neurological deficits due to
      remodelling defect of the bone and narrowed bonny channel of the blood supply.
      Herein we present a case of osteopetrosis major with neurological deficits not
      attributed to the narrowed carotid channel of the petrous bone, but due to middle
      cerebral arterial occlusion 2 cm distal to narrowed channel.

PMID- 11194908
TI  - The gamut of abdominal and pelvic cystic masses in children.
AB  - The gamut of abdominal and pelvic cystic masses in children is long with lesions
      affecting the urogenital tract and retroperitoneum, gastrointestinal tract and
      mesentery, hepatobiliary tract, and spleen. The goal of this pictorial review is
      to display the radiological manifestations of these disorders. The radiologist
      will learn, from this review of the differential diagnosis, how to reach a
      diagnosis after analyzing the characteristic findings using the appropriate
      imaging diagnostic studies among the various modalities available in his
      armamentarium, and the optimal management of these conditions.

PMID- 11194909
TI  - Prenatal thoracoabdominal tumor mimicking pulmonary sequestration: a diagnosis
      dilemma.
AB  - Thoracoabdominal masses are among the many congenital anomalies being detected in
      fetus. The differential diagnosis of such anomalies include cystic adenomatoid
      malformation, pulmonary sequestration, neuroblastoma, lymphangioma, congenital
      diaphragmatic hernia, and bronchial atresia. We report a fetal thoracoabdominal
      mass that proved to be an angioma that was treated by partial embolization.
      Complete regression was observed.

PMID- 11194910
TI  - Quiz case of the month. Osteomyelitis.

PMID- 11194911
TI  - Diuretic-enhanced gadolinium excretory MR urography: comparison of conventional
      gradient-echo sequences and echo-planar imaging.
AB  - The aim of this study was to investigate the utility of different gadolinium
      enhanced T1-weighted gradient-echo techniques in excretory MR urography. In 74
      urologic patients, excretory MR urography was performed using various T1-weighted
      gradient-echo (GRE) sequences after injection of gadolinium-DTPA and low-dose
      furosemide. The examinations included conventional GRE sequences and echo-planar
      imaging (GRE EPI), both obtained with 3D data sets and 2D projection images.
      Breath-hold acquisition was used primarily. In 20 of 74 examinations, we compared
      breath-hold imaging with respiratory gating. Breath-hold imaging was
      significantly superior to respiratory gating for the visualization of
      pelvicaliceal systems, but not for the ureters. Complete MR urograms were
      obtained within 14-20 s using 3D GRE EPI sequences and in 20-30 s with
      conventional 3D GRE sequences. Ghost artefacts caused by ureteral peristalsis
      often occurred with conventional 3D GRE imaging and were almost completely
      suppressed in EPI sequences (p < 0.0001). Susceptibility effects were more
      pronounced on GRE EPI MR urograms and calculi measured 0.8-21.7% greater in
      diameter compared with conventional GRE sequences. Increased spatial resolution
      degraded the image quality only in GRE-EPI urograms. In projection MR urography,
      the entire pelvicaliceal system was imaged by acquisition of a fast single-slice
      sequence and the conventional 2D GRE technique provided superior morphological
      accuracy than 2D GRE EPI projection images (p < 0.0003). Fast 3D GRE EPI
      sequences improve the clinical practicability of excretory MR urography
      especially in old or critically ill patients unable to suspend breathing for more
      than 20 s. Conventional GRE sequences are superior to EPI in high-resolution
      detail MR urograms and in projection imaging.

PMID- 11194912
TI  - MR imaging findings of uterine endometrial stromal sarcoma: differentiation from
      endometrial carcinoma.
AB  - Endometrial stromal sarcoma (ESS) is a rare malignant neoplasm of the uterus. We
      retrospectively analyzed pelvic MR imaging in 8 cases of ESS to determine the
      characteristic MR findings of ESS. Magnetic resonance images of 8 cases of ESS
      were evaluated for findings including the size, margin of the tumor, nodular
      lesions at the tumor margin, intramyometrial worm-like nodular extension,
      multiple nodular mass formation, hemorrhage, and necrosis in the tumor. The
      degree of contrast enhancement was also analyzed. The MR imaging findings of 21
      consecutive cases of endometrial carcinoma (EC) were also evaluated and compared
      with those of ESS. The mean and the standard deviation of the maximum diameter of
      ESS and EC were 8.80 +/- 4.99 and 3.93 +/- 2.47 cm, respectively. Increased
      enhancement in at least a part of the tumor was observed in five of the six
      analyzed ESS cases and in 2 of 12 analyzed EC cases. The irregular margin,
      nodular lesions at the margin, intramyometrial nodular extension, and multiple
      nodular mass formation were more frequently seen in cases of ESS than in cases of
      EC. Magnetic resonance imaging can play a role in both diagnosing ESS as well as
      in differentiating ESS from EC.

PMID- 11194913
TI  - Postoperative retroperitoneal hemorrhage due to a bleeding ureteric artery:
      treatment by transcatheter embolization.
AB  - We report a case of a postoperative retroperitoneal haemorrhage due to an
      iatrogenic perioperative injury of an ureteric artery. Transcatheter embolization
      using microparticles stopped the bleeding and the patient stabilized immediately.
      Ureteric artery injury is a very rare condition but can be managed successfully
      by percutaneous interventional techniques.

PMID- 11194914
TI  - Renal lymphangiomatosis during pregnancy: management with percutaneous drainage.
AB  - We report a unique case of exacerbation of renal lymphangiomatosis during
      pregnancy which was managed percutaneously until delivery. Renal
      lymphangiomatosis is a very rare benign disorder that might cause abdominal pain
      and rarely hypertension and hematuria. Surgical treatment options may result in
      nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be
      viewed as an efficient therapeutic option particularly when surgery is
      contraindicated.

PMID- 11194915
TI  - Present-day imaging of patients with renal colic.
AB  - In the past decade alternatives to urography have been proposed for the study of
      patients with renal colic. In 1992 it was suggested to replace urography with KUB
      and ultrasonography. In 1993 the combination of KUB and ultrasonography followed
      by urography in unresolved cases was proposed and, in 1995, it was suggested to
      replace urography with unenhanced helical CT (UHCT). This article illustrates the
      contribution of UHCT to the study of patients with renal colic and analyses
      advantages and shortcomings of the technique compared with other diagnostic
      approaches. Diagnostics of the patient with renal colic is based on the detection
      of direct and indirect signs which allow identification of not only the calculus,
      with a sensitivity of 94-100% and accuracy of 93-98% according different authors,
      but also other signs that can serve to guide patient management and evaluate long
      term prognosis. Unenhanced helical CT has the capability to detect extraurinary
      abnormalities which present with flank pain and mimic renal colic. The
      examination technique affects the quality of the images and therefore diagnostic
      accuracy as well as the dose to the patient. With regard to setting parameters,
      the choice of thickness and table feed should be guided by numerous factors.
      Multiplanar reconstruction is indicated in the study of the entire ureter course
      to identify the exact site of the calcification for the urologist to perform an
      evaluation similar to that obtained by urography. Many authors consider UHCT to
      be a valuable tool for suggesting the best therapeutic approach. Among these
      there are also urologists. The evaluation is based on the stone detection, its
      size and level in the urinary tract. Cost analysis shows that the cost of UHCT is
      equal to or inferior to the cost of urography. With regard to the dose, different
      data are reported in the literature. A high pitch (more than 1.5) and a thin
      collimation (3-mm thickness) are good compromise between quality and dose which
      can be compared to the dose of normal urography. What is to be done if helical CT
      is not available? If helical CT is not available, plain film plus ultrasonography
      should be considered. This approach does not solve all the cases; in unresolved
      cases urography is indicated. It should also be noted that US has a good
      sensitivity in detecting other conditions such as biliary lithiasis, acute
      pancreatitis, acute appendicitis and abdomino-pelvic masses which are responsible
      for pain that mimics renal colic. In conclusion, IVU should not have any more the
      priority in investigating the patients with renal colic. Helical CT should be the
      first choice in imaging a patient with renal colic. If this technique is not
      available, plain film and ultrasonography should be considered adding urography
      in unresolved cases.

PMID- 11194916
TI  - Virtual endoscopy of the middle ear.
AB  - Virtual endoscopy is a computer-generated simulation of fiberoptic endoscopy, and
      its application to the study of the middle ear has been recently proposed. The
      need to represent the middle ear anatomy by means of virtual endoscopy arose from
      the increased interest of otolarygologists in transtympanic endoscopy. In fact,
      this imaging method allows the visualization of middle ear anatomy with high
      detail, but it is evasive and is essentially used for surgical guidance. Virtual
      endoscopy provides similar perspectives of the tympanic cavity but does not
      require the tympanic perforation. In the study of the middle ear, specific
      attention is given to the retroperitoneum. This region contains elevations of the
      medial wall (pyramidal eminence and ridge, styloid eminence and ridge, subiculum,
      ponticulus) and depressions (sinus tympani, posterior sinus tympani, facial
      sinus, fossula of Grivot, oval window fossula), which can be effectively
      displayed by virtual endoscopy. Virtual endoscopy is foreseen as a useful tool in
      preoperative management of patients who are candidates for middle ear surgery,
      since it can predict with high detail the patient's specific anatomy by imaging
      perspectives familiar to otosurgeons.

PMID- 11194917
TI  - 2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal
      stenoses.
AB  - The aim of this study was to compare 2D and 3D CT imaging in the pre- and
      postoperative evaluation of complex benign larynges-tracheal airway stenoses with
      rigid endoscopy, considered as the gold standard. Six patients (aged 5-72 years)
      with a total of nine complex laryngo-tracheal stenoses underwent non-contrast
      helical CT scans (slice thickness 3 mm, pitch 1.3, reconstruction interval 1.5
      mm) before and after surgical resection. With prototype software, virtual
      endoscopy (VE) post-processing algorithms were applied to the imaging data sets.
      The VE and multiplanar 2D findings were compared with rigid endoscopy, considered
      as standard of reference. All nine stenoses were correctly identified on 3D
      images and their anatomical locations correctly assessed on 2D reconstructions.
      Artifacts were met when patients were unable to suspend their breath, leading to
      one false-positive result. Two-dimensional images and 3D VE of tracheal stenoses
      proved to be efficient and complementary to the rigid endoscopy, permitting a
      reliable endoluminal 3D view and evaluation of the surrounding anatomical
      structures. Limitations of this technique relate to the maximal spatial
      resolution of 1.5 mm, the lack of color, and the inability to assess the mucosa.
      Virtual endoscopy is for complex laryngo-tracheal stenoses an excellent
      complement for rigid endoscopy, remaining the method of reference, and may be
      indicated with complicated pathological structures.

PMID- 11194918
TI  - Sinochoanal polyp and its variant, the angiomatous polyp: MRI findings.
AB  - The angiomatous polyp corresponds to the vascular compromised nasochoanal part of
      a sinochoanal polyp. We describe the MRI characteristics of such lesions in four
      patients. All patients had an angiomatous polyp, in three cases as part of an
      antrochoanal polyp, and in one case as part of a sphenochoanal polyp. The
      unenhanced MR images depicted the typical appearance of a sinochoanal polyp,
      hypointense on T1-weighted and hyperintense on T2-weighted images. On gadolinium
      enhanced MR images, the sinusal part showed little or no peripheral enhancement;
      however, the nasochoanal part, corresponding to the angiomatous polyp, showed
      strong enhancement. An angiomatous polyp mimics a hypervascular mass lesion on
      enhanced MR studies. The anatomic location and association with a sinusal polyp
      allows the correct diagnosis.

PMID- 11194919
TI  - Detection of subtle pulmonary disease on CR chest images: monochromatic CRT
      monitor vs color CRT monitor.
AB  - To clarify the diagnostic efficacy of color soft-copy computed radiographic (CR)
      images of the chest in the detection of subtle pulmonary abnormalities. Twenty
      observers compared 87 soft-copy CR images on four types of CRT monitor
      (nonmagnified monochromatic CRT, magnified monochromatic CRT, nonmagnified color
      CRT, and magnified color CRT). Of 87 test images, 45 (including two identical
      sets of 12 images to test intraobserver variability) were abnormal and 42
      (including two identical sets of 12 images) were normal. Of the 45 abnormal
      images, 15 showed subtle abnormalities, 15 showed mild abnormalities, and 15
      showed obvious abnormalities. In the receiver operating characteristic (ROC)
      analyses, there were no statistically significant differences among the four
      types of CRT display formats in the detection of subtle abnormalities. Color CRT
      monitors can replace monochromatic CRT monitors without any loss in the ability
      to detect subtle interstitial lung disease.

PMID- 11194920
TI  - Clinically suspected pulmonary embolism: is it safe to withhold anticoagulation
      after a negative spiral CT?
AB  - The goal of this study was 3-month clinical outcome in nonanticoagulated patients
      with clinically suspected acute pulmonary embolism (PE) following a negative
      spiral CT. During a 6-month period 305 patients underwent spiral CT, of whom only
      8 also had a lung scintigraphy. In patients with a final CT report read as not
      positive for acute PE, all hospital records and answers to a patient
      questionnaire were analyzed for episodes of venous thrombembolism (VTE). Acute PE
      was diagnosed at spiral CT in 61 patients (20%). Twenty-six of the remaining 244
      patients were excluded from further analysis because of (a) long-term
      anticoagulation due to symptomatic acute deep venous thrombosis (n = 5),
      clinically diagnosed acute PE (n = 2), chronic recurrent VTE (n = 4), and cardiac
      disorders (n = 5); and (b) a normal perfusion scintigram (n = 4) or a negative
      pulmonary arteriogram (n = 6). Three patients were lost to follow-up. Among the
      remaining 215 patients only 10 had undergone a negative lower extremity venous
      study. Sixteen patients (7%) died during the follow-up period, 6 of whom
      underwent autopsy. Venous thrombembolism was diagnosed in three of the 215
      patients (1.4%, 95% confidence limits: 0.5-4.0%), one causing the patient's
      death. Two patients had advanced thoracic malignancies and the third severe
      chronic obstructive pulmonary disease (84 years old). A negative spiral CT may be
      able to exclude clinically significant acute PE with the same accuracy as a
      normal lung scintigraphy or a negative pulmonary arteriography.

PMID- 11194921
TI  - Venous hemangioma of the mediastinum.
AB  - Mediastinal hemangiomas are rare tumors. We present a case of venous hemangioma
      of the mediastinum. Computed tomography shows anterior mediastinal solid mass
      without enhancement effects. We believe that it is necessary to include a
      mediastinal hemangioma for differential diagnosis, when little or no enhancement
      effects are noted at early and delayed CT examination.

PMID- 11194922
TI  - Non-bronchial collateral supply from the left gastric artery in massive
      haemoptysis.
AB  - Two patients presented with recurrent, massive haemoptysis. Arteriography,
      including thoracoabdominal aortograms, revealed in both cases large non-bronchial
      collaterals arising from the left gastric artery. In the first case the non
      bronchial collateral supplied the upper left lobe and in the second case it
      supplied the middle right lobe. Percutaneous embolisation of bronchial and non
      bronchial collateral branches has become an accepted procedure in controlling
      massive or recurrent haemoptysis. Accurate identification of the non-bronchial
      collateral arterial feeders is essential for successful embolotherapy.

PMID- 11194923
TI  - Radiology of the spleen.
AB  - The spleen is generally not considered a challenge to the radiologist. Most often
      it poses a problem by anomalies or an irregular but normal contrast enhancement;
      however, a variety of inflammatory, infectious and neoplastic diseases may
      involve the spleen. CT and ultrasonography are screening modalities for the
      spleen. For problem solving, MR imaging can be helpful, especially due to its
      free choice of the imaging plane and because of the high resolution in contrast
      MR imaging. Splenic angiography as a diagnostic tool has generally been replaced
      by CT, ultrasound, or MR and is now used as an interventional method, e. g., in
      non-surgical management of patients with chronic idiopathic thrombocytopenia or
      in patients with splenic trauma. This article reviews the radiology of the
      spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction,
      cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of
      different imaging modalities and underlying gross and microscopic pathologic
      features leads to a better understanding of the radiologic findings.

PMID- 11194924
TI  - Left-sided omental torsion: CT appearance.
AB  - A 34-year-old male presented with exquisite left flank pain. Computed tomography
      showed a hyperdense vascular structure surrounded by whirling linear streaks
      situated in the greater omentum under the splenic flexure of the colon. Omental
      stranding extended caudally into the pelvis where part of the inflamed omentum
      entered a left inguinal hernia sac. Surgery revealed left-sided torsion of the
      greater omentum. Left-sided omental torsion is infrequent and pre-operative
      diagnosis is rarely established. The CT findings of an omental fatty mass with a
      whirling pattern is characteristic of omental torsion. Preoperative diagnosis is
      important because conservative management has been suggested.

PMID- 11194925
TI  - Hereditary angio-edema involving the gastrointestinal tract: CT findings.
AB  - We report a case of hereditary angio-edema in a young man presenting with
      recurrent abdominal pain for many years. The diagnosis was suspected on the basis
      of abdominal CT performed during an abdominal attack and was then confirmed by
      the measurement of serum concentration of C1 esterase inhibitor (C1-INH). To our
      knowledge, this is the first case reported of the hereditary form of angio-edema
      with isolated abdominal pain and in which the diagnosis was suggested by
      abdominal CT findings.

PMID- 11194926
TI  - Thiamine, beta-cell function and peripheral glucose utilization in thiamine
      responsive megaloblastic anemia (TRMA) syndrome.

PMID- 11194927
TI  - Plasma epinephrine and norepinephrine response to stimuli in autonomic neuropathy
      of type 2 diabetes mellitus.
AB  - The objective of this study was to examine epinephrine and norepinephrine plasma
      levels in patients with clinical type 2 diabetes mellitus, at different stages of
      autonomic neuropathy. Eighteen patients were classified in groups without (n = 6)
      and with early (n = 6), definite (n = 3) and severe (n = 3) neuropathy. Blood
      catecholamine levels were measured after the Valsalva maneuver, cold exposure and
      orthostatic tests. The norepinephrine basal levels were lower in patients with
      severe neuropathy (0.4 +/- 0.2 nmol/l), compared with the group with no
      neuropathy (1.3 +/- 0.5 nm/l, p = 0.034), or with early neuropathy (1.3 +/- 0.7
      nm/l, p = 0.035). After the Valsalva maneuver, no increase was found in the group
      with severe alteration. In patients without neuropathy, cold exposure induced a
      peak of norepinephrine at 5 min (delta = 1.9 +/- 1.6 nmol/l). The increase was
      lower in groups with definite and severe damage. In patients with definite or
      moderate neuropathy, the orthostatic test induced minimal or no response. The
      epinephrine response to the maneuvers was not significant, and no differences
      were found among the groups. Norepinephrine basal levels and cold responses are
      diminished in patients with definite and severe autonomic neuropathy. This
      provides further evidence on their impaired response to stress. The comparable
      epinephrine levels in patients with or without autonomic neuropathy indicates
      that adrenal medullar function is not significantly altered.

PMID- 11194928
TI  - Stress and coping behavior in patients with diabetes mellitus.
AB  - Diabetes mellitus is a disease which must be controlled over the lifetime of a
      patient. We investigated the issues of stress and coping for diabetes mellitus
      which may influence self-management. In addition, we examined the association of
      these factors with blood glucose control, in order to review self-management
      instructions for diabetes mellitus. The study included 153 patients with diabetes
      mellitus. The patients were divided into two subgroups: good-control group,
      comprising patients with glycohemoglobin (HbA1c) values less than 7.0%; and poor
      control group, comprising those with HbA1c values of 7.0% or more. All patients
      responded to a questionnaire regarding stress tolerance, Jalowiec and Power's
      coping scale and awareness of diabetes mellitus. Stress tolerance was not
      significantly different between the good-control and poor-control groups. No
      significant gender differences in coping score were evident for the good-control
      group. However, in the poor-control group, the coping score in men was
      significant higher than that in women. The problem-oriented coping score for men
      in the poor-control group was significantly higher than that for the good-control
      group (p < 0.01). In a comparison of awareness of diabetes mellitus, the
      proportion of patients who replied that they were rigidly following diabetes
      treatment was higher in the poor-control group than the good-control group.
      Patients with diabetes mellitus may have a knowledge of the disease and a strong
      will to resolve problems. This is especially true for male patients in that their
      will appeared to be stronger, but they may not have the resolve to establish
      appropriate behavior patterns. In the future, methods for evaluating self
      management should be included in diabetes education.

PMID- 11194929
TI  - Synergistic effect of arcuate and raphe nuclei graft to alleviate insulinemia and
      obesity in Zucker rats.
AB  - The arcuate nucleus (AN) of the hypothalamus is a key area in which endocrine
      messages are relayed to the brain, while midbrain raphe nucleus (RN) is the
      source of brain serotonin. Both nuclei contribute to the central mechanism of
      energy homeostasis. This experiment aimed to determine the impact of AN and RN
      grafts on insulinemia and obesity in diabetic rats. AN and RN were dissected from
      15-day (Fa/Fa) lean embryos and grafted separately or together into the third
      brain ventricle of obese (fa/fa) male Zucker rats. Histological analysis showed
      the functional maturity of grafts, which were vascularized, contained neurons
      reinnervating the periventricular hypothalamus and hypophysis, and expressed
      neuropeptide Y and enzymes for dopamine and serotonin synthesis. Three months
      after transplantation, the rats grafted with AN or RN had a lower body weight
      gain compared to sham-operated rats (19% and 17%, respectively). Rats grafted
      with AN together with RN gained significantly less body weight than rats grafted
      with AN or RN separately (31% vs. sham-operated rats), and showed a decreased
      plasma insulin concentration (132 +/- 33 microU/ml) vs. sham-operated rats (459
      +/- 108 microU/ml, p < 0.05). A synergistic effect on alleviating obesity and
      insulinemia by double AN and RN grafts suggests that both these nuclei are
      functionally interrelated in maintaining energy homeostasis, and normal
      functioning of both nuclei is altered during obesity.

PMID- 11194930
TI  - The effect of aminoguanidine on urinary heparan sulphate levels in experimental
      diabetes.
AB  - In the present study, we investigated whether the ameliorating effect of
      aminoguanidine on diabetes-related proteinuria and nephropathy is associated with
      glomerular basement membrane heparan sulphate contents. STZ-induced diabetic rats
      developed proteinuria (at the tenth week: diabetic rats, 713 +/- 418 mg protein
      per millimole creatinine; control rats, <30) and increased urinary heparan
      sulphate excretion (diabetic rats, 1,400 +/- 83 microg/mmol creatinine; control
      rats, 41 +/- 13; p < 0.001), suggesting loss of glomerular basement membrane
      charge. Aminoguanidine treatment of diabetic rats diminished urinary heparan
      sulphate levels (196 +/- 52), suggesting high incorporation of heparan sulphate
      associated charge into glomerular basement membrane. Aminoguanidine
      administration to diabetic rats also relatively improved proteinuria (456 +/-
      255). It is concluded that aminoguanidine treatment has a relative beneficial
      effect by restoring the diabetes-induced change in renal basement membrane
      heparan sulphate levels.

PMID- 11194931
TI  - Resting metabolic rate in Italians: relation with body composition and
      anthropometric parameters.
AB  - The objectives of this study were to obtain values for resting metabolic rate in
      Italians in relation to parameters of body composition, and to compare them to
      predicted values using the FAO/WHO/UNU equation. We performed a cross-sectional
      observational study of 131 healthy subjects (46 males and 85 females) at the
      Human Nutrition Unit, University Tor Vergata, Rome. Body composition was
      determined by dual energy X-ray absorptiometry (DXA) and resting metabolic rate
      was calculated using the Weir formula. Resting metabolic rate was 1,865 +/- 234
      kcal/day in males and 1,354 +/- 154 kcal/day in females. These values decreased
      slightly with age. The relationships with weight and age were stronger than that
      with lean mass from DXA as independent variables in multiple regression analysis.
      Mean resting metabolic rates predicted with FAO/WHO/UNU and Harris-Benedict
      formula were not significantly different from measured values except for the
      Harris-Benedict value for females (p < 0.01). Individual differences between
      measured and predicted values were notably high. The measured values were higher
      than those reported in the literature. The prediction of resting metabolic rate
      is more accurate with simple anthropometric parameters than with fat-free mass
      obtained by DXA. The individual error in the predicted values can be so high that
      for individual use a measured value is preferred over an estimated value.

PMID- 11194932
TI  - Acute effect of physiologic hyperinsulinaemia on serum leptin concentration in
      healthy young people.
AB  - This study aimed to identify the acute effect of a physiologic dose of insulin,
      enough to produce hyperinsulinaemia similar to that obtained in the postprandial
      state, on serum leptin concentrations in healthy young people. A randomised,
      single blind controlled clinical trial was performed in 45 healthy, non-obese,
      young volunteers. Serum leptin concentration, uric acid, creatinine levels and
      lipid profile were determined for all subjects. Insulin suppression test modified
      with octreotide, used to produce physiologic hyperinsulinaemia, or saline
      infusion as control, were performed. Steady state insulin (SSI) concentrations
      were calculated and they represented the hyperinsulinaemia state. Clinical
      characteristics and laboratory profiles were similar between groups. There was no
      significant difference between the effect of insulin or saline infusions on the
      serum leptin concentration. The acute effect of physiologic hyperinsulinaemia did
      not modify the serum leptin concentration in healthy young people.

PMID- 11194933
TI  - Serum concentrations of advanced glycation endproducts are associated with the
      development of atherosclerosis as well as diabetic microangiopathy in patients
      with type 2 diabetes.
AB  - We measured serum concentrations of advanced glycation endproducts (AGEs) in
      patients with type 2 diabetes, to elucidate the mechanisms underlying the
      elevated serum concentrations of AGEs and to clarify the relationship between
      serum AGE concentrations and the development of microangiopathy and
      macroangiopathy. Serum AGEs were significantly higher in diabetic patients than
      in age-matched control subjects (p < 0.0001). In diabetic patients, serum AGEs
      were positively correlated with HbAlc (r = 0.47, p < 0.0001), urinary albumin
      excretion (UAE) (r = 0.42, p < 0.0001), diabetes duration (r = 0.31, p = 0.0030),
      and fasting plasma glucose (r = 0.34, p = 0.0010). Multiple regression analysis
      disclosed that only the HbAlc and UAE levels independently correlated with serum
      AGE levels. Serum AGEs in diabetic patients with progressive retinopathy and
      overt nephropathy were significantly higher than in those with less severe
      retinopathy and nephropathy. Serum AGEs were significantly higher in the diabetic
      patients with coronary heart disease (CHD) than in those without CHD. These
      results suggest that the HbAlc and UAE levels are independent risk factors for
      increased serum AGE concentrations in type 2 diabetic patients, and that higher
      serum AGE concentrations are associated with increased severity of diabetic
      retinopathy and nephropathy. Serum AGE concentrations may be a useful marker not
      only for the severity of diabetic microangiopathy but also for the development of
      CHD in patients with type 2 diabetes mellitus.

PMID- 11194934
TI  - Significant association between a silent polymorphism in the neuromedin B gene
      and body weight in German children and adolescents.
AB  - Neuromedin B has been shown to exert an inhibiting effect on food consumption in
      rats. The corresponding gene NMB maps to chromosome 15q22.3-q23, a region
      expected to contain a gene for the Bardet-Biedl syndrome type 4 (BBS4). Based on
      its map position and the putative function of the encoded peptide, NMB can be
      considered as a candidate gene both for BBS4 and the development of human
      obesity. To examine its involvement in these phenotypes, we determined the
      genomic structure of human NMB, and performed a mutation screen in its coding
      region. In genomic DNA of six BBS4 patients and in a large population sample, two
      sequence variants were detected: a g.253C-->A transversion creating a P73T
      substitution and a g.401G-->A silent mutation changing the stop codon TGA into
      stop codon TAA. A case-control study with 92 extremely obese patients and 94
      underweight students revealed a significant association between the g.401G-->A
      polymorphism and body weight (adjustedp = 0.03), which was confirmed in a
      validation sample consisting of 95 extremely obese patients, and 95 normal weight
      and 48 underweight individuals (Mann-Whitney p = 0.02). These results suggest a
      contribution of NMB or a gene in its close vicinity to genetic weight control in
      humans.

PMID- 11194935
TI  - New temperature modification makes the Bielschowsky silver stain reproducible.
AB  - The Bielschowsky silver impregnation can be used as a single stain for the
      diagnosis of Alzheimer's disease. It impregnates both the amyloid and neuritic
      components of the senile plaques and it reliably stains neurofibrillary tangles.
      However, we find that the stain is highly sensitive to changes of the ambient
      temperature. Since the diagnostic criteria for Alzheimer's disease rely on a semi
      quantitative assessment of neuritic plaques and neurofibrillary tangles the
      reproducibility of the Bielschowsky stain is important. In this study we compare
      three different modifications of the Bielschowsky stain with the methenamine
      silver stain and with immunohistochemistry for the beta-amyloid and the
      hyperphosphorylated tau proteins. We found that the most reliable and easily
      reproducible modification of the Bielschowsky silver impregnation is the one that
      uses incubations at 5 degrees C.

PMID- 11194936
TI  - Cyclooxygenase expression in microglia and neurons in Alzheimer's disease and
      control brain.
AB  - Epidemiological studies suggest that non-steroidal anti-inflammatory drugs
      (NSAIDs) lower the risk of developing Alzheimer's disease (AD). Most NSAIDs act
      upon local inflammatory events by inhibiting the expression or activation of
      cylooxygenase (COX). In the present study the expression of COX-1 and COX-2 in AD
      and non-demented control temporal and frontal cortex was investigated using
      immunohistochemistry. COX-1 expression was detected in microglial cells, while
      COX-2 expression was found in neuronal cells. In AD brains, COX-1-positive
      microglial cells were primarily associated with amyloid beta plaques, while the
      number of COX-2-positive neurons was increased compared to that in control
      brains. No COX expression was detected in astrocytes. In vitro, primary human
      microglial and astrocyte cultures, and human neuroblastoma cells (SK-N-SH) were
      found to secrete prostaglandin E2 (PGE2), especially when stimulated. PGE2
      synthesis by astrocytes and SK-N-SH cells was stimulated by interleukin-1beta.
      Microglial cell PGE2 synthesis was stimulated by lipopolysaccharide only.
      Although astrocytes are used in studies in vitro to investigate the role of COX
      in AD, there are no indications that these cells express COX-1 or COX-2 in vivo.
      The different distribution patterns of COX-1 and COX-2 in AD could implicate that
      these enzymes are involved in different cellular processes in the pathogenesis of
      AD.

PMID- 11194937
TI  - Prenatal exposure to ethanol induces leptomeningeal heterotopia in the cerebral
      cortex of the rat fetus.
AB  - Pregnant rats were fed an ethanol-containing liquid diet between gestational day
      (GD) 10 and GD 21. Leptomeningeal heterotopias were observed in the cerebral
      cortex of ethanol-exposed fetuses. They appeared on the brain surface of the
      lateral cortical region near the rhinal fissure, and were found more numerously
      in the rostral than the caudal region. These abnormalities contained certain
      neuronal perikarya, microtubule-associated protein (MAP) 1b-positive neuronal
      processes, and Rat-401-positive radial glial fibers. Immunostaining for Rat-401
      revealed that the heterotopias protruded through breaches in the glia limitans.
      In adult rats exposed to ethanol prenatally, the heterotopias persisted in the
      lateral cortical region. We conclude that prenatal exposure to ethanol might
      induce defects in the glia limitans, resulting in the genesis of leptomeningeal
      heterotopias. These abnormalities may be related to mental retardation or the
      cognitive deficits associated with human fetal alcohol syndrome (FAS).

PMID- 11194938
TI  - Neuronal and glial advanced glycation end product [Nepsilon
      (carboxymethyl)lysine]] in Alzheimer's disease brains.
AB  - The cellular distribution of an advanced glycation end product [Nepsilon
      (carboxymethyl)lysine (CML)] in aged and Alzheimer's disease (AD) brains was
      assessed immunohistochemically. CML was localized in the cytoplasm of neurons,
      astrocytes, and microglia in both aged and AD brains. Glial deposition was far
      more marked in AD brains than in aged brains, and neuronal deposition was also
      increased. On electron microscopic immunohistochemistry, neuronal CML formed
      granular or linear deposits associated with lipofuscin, and glial deposits formed
      lines around the vacuoles. Neuronal and glial deposits were prominent throughout
      the cerebral cortex and hippocampus, but were sparse in the putamen, globus
      pallidus, substantia nigra, and cerebellum, with glial deposits being far more
      prominent in AD brains. The distribution of neuronal and glial deposits did not
      correspond with the distribution of AD pathology. The extent of CML deposits was
      inversely correlated with neurofibrillary tangle formation, particularly in the
      hippocampus. Most hippocampal pyramidal neurons with neurofibrillary tangles did
      not have CML, and most of the neurons with heavy CML deposits did not have
      neurofibrillary tangles. In the hippocampus, neuronal CML was prominent in the
      region where neuronal loss was mild. These observations suggest that CML
      deposition does not directly cause neurofibrillary tangle formation or neuronal
      loss in AD.

PMID- 11194939
TI  - Cortical neurons expressing calcium binding proteins are spared in dementia with
      Lewy bodies.
AB  - The consistent regional and laminar distribution of cortical Lewy bodies (LB) in
      brains of patients with dementia with Lewy bodies (DLB) suggests that only a
      certain subpopulation of neurons develops these alpha-synuclein-immunoreactive
      cytoplasmic inclusions. This study examined whether four non-overlapping neuronal
      subpopulations, defined by the expression of non-phosphorylated neurofilaments
      (SMI-32) and several calcium binding proteins (parvalbumin, calretinin and
      calbindin D28k), are vulnerable to LB formation. We performed peroxidase
      immunostaining to examine the distribution and to quantitate each neuronal
      subpopulation within the superior temporal sulcus (STS) area, and double-label
      immunohistochemistry to test for colocalization of alpha-synuclein and each
      neuronal marker in the STS and the entorhinal cortex. There were no significant
      differences between DLB brains and controls in the proportional quantity or
      laminar distribution of each neuronal subpopulation. Parvalbumin-immunoreactive
      neurons represented around 7%, calbindin D28k 8%, calretinin 10%, and SMI-32
      about 20% of the total neuronal population in the STS cortex. Neurons expressing
      parvalbumin and SMI-32 showed a widespread distribution across layers II to VI.
      Neurons expressing calretinin were present in superficial layers (II to IV), and
      calbindin D28k-immunoreactive neurons were mostly distributed within granular
      layers II and IV. None of the LB observed in the STS or the entorhinal cortex
      were located in neurons expressing calcium binding proteins; 25% of the LB were
      contained in SMI-32 immunoreactive neurons. In conclusion, cortical neurons
      expressing calcium binding proteins are spared in DLB, while SMI-32-positive
      neurons are affected in proportion to their density in the cortex. However, the
      majority of cortical LB develop in neurons not identified by any of these
      markers.

PMID- 11194940
TI  - Spinal tanycytic ependymomas.
AB  - Three cases of spinal tanycytic ependymoma are reported, a man aged 45 years and
      two women aged 36 and 55 years. Each patient developed gradual paraparesis over a
      few months prior to admission. Magnetic resonance imaging showed an enhancing,
      well-circumscribed tumor in the spinal cord in each case. Histologically, the
      tumors consisted of monotonous proliferation of long spindle cells with markedly
      eosinophilic cell processes; focally forming perivascular pseudorosettes. The
      tumor cells were strongly immunopositive for glial fibrillary acidic protein, S
      100 protein and vimentin. Ultrastructurally, in addition to massive intermediate
      filaments, many tumor cells showed abundant microtubules. Well-developed
      desmosomes and microvilli/cilia-lined microlumina were occasionally observed. The
      tumors were grossly totally removed and the patients remain recurrence free at 9,
      9, and 2 years postoperatively. Reviewing reported cases including our three
      cases, tanycytic ependymoma may occur frequently in spinal cord, especially in
      the cervical region of the spinal cord. Since histologically it resembles
      pilocytic astrocytoma and schwannoma, tanycytic ependymoma should be included in
      the differential diagnosis of benign spindle cell tumors of the central nervous
      system.

PMID- 11194941
TI  - Prion protein expression in senile plaques in Alzheimer's disease.
AB  - Prion protein (PrPC) is a glycolipid-anchored cell membrane sialoglycoprotein
      that localises in presynaptic membranes. Since synapses are vulnerable to
      Alzheimer's disease (AD), the present study examines PrPC expression in senile
      plaques, one of the major structural abnormalities in AD, by single- and double
      labelling immunohistochemistry. Punctate PrPC immunoreactivity is found in
      diffuse plaques, whereas isolated large coarse PrPC-positive granules reminiscent
      of dystrophic neurites are observed in neuritic plaques. Finally, PrPC deposition
      also occurs as dense filamentous and amorphous precipitates in amyloid cores of
      senile plaques, but not in the walls of blood vessels with amyloid angiopathy. In
      contrast to PrPC, betaA4-amyloid immunoreactivity is preserved and even enhanced
      following incubation of the tissue sections with proteinase K prior to
      immunohistochemistry, thus indicating no PrPC and betaA4-amyloid cross-reactivity
      in dense amyloid cores of senile plaques. Punctate PrPC deposition in diffuse
      plaques is similar to that of synaptophysin, a synaptic vesicle-associated
      protein, as already reported in other studies. Immunoprecipitation,
      electrophoresis and Western blot studies have shown that synaptophysin, amyloid
      precursor protein (APP) and betaA4 do not co-precipitate with PrP. These results
      suggest that synaptophysin, APP and betaA4 are likely not bound to PrP. PrPC
      accumulation in betaA4-amyloid dense cores may be the consequence of the release
      of PrP into the extracellular space. Whether PrPC accumulation in the
      extracellular space is the result of impaired endocytosis and subsequent
      hydrolysis in the endosomal compartment, in contrast to normal degradation of
      PrPC, resulting from or occurring in parallel to abnormal APP degradation,
      deserves further study.

PMID- 11194942
TI  - Primary involvement of the motor area in association with the nigrostriatal
      pathway in multiple system atrophy: neuropathological and morphometric
      evaluations.
AB  - To evaluate the changes that occur in the motor and supplementary motor cortices
      in cases of multiple system atrophy (MSA), we carried out morphological and
      morphometric studies in 7 cases of MSA and 11 age-matched controls.
      Neuropathological study revealed presence of glial cytoplasmic inclusions (GCIs)
      in the cortex and subcortical white matter of the motor and supplementary motor
      areas, loss of small to medium-sized pyramidal neurons, and astrocytosis in the
      motor cortex in all cases of MSA, showing a definite predilection in the cortical
      layers V and VI. The severity of neuronal loss in the motor cortex was highly
      correlated with the incidence of GCIs and the involvement of the nigrostriatal
      pathway. Morphometrically, significant reductions of both the thickness of motor
      cortical layers V and VI and the number of neurons were observed. In addition, a
      reduction in the number of neurons in the supplementary motor cortex was detected
      in three out of the seven MSA cases. The results of this study suggest that the
      motor area is a cardinal target in MSA, and that in association with the
      nigrostriatal pathway it forms a motor loop degeneration in this disease.

PMID- 11194943
TI  - Heme oxygenase-1 in lesions of human cerebral malaria.
AB  - Human cerebral malaria is a life threatening complication of Plasmodium
      falciparum infection. The cascades of signaling events resulting in tissue
      trauma, lesion formation, coma or resolution of lesions are only slowly becoming
      unraveled. Understanding the generation of local tissue protective cellular
      reactions might pave the way for generation of novel drugs limiting the formation
      of cerebral malaria lesions. Heme oxygenase-1 (HO-1) is an inducible enzyme
      degrading heme into the gaseous mediator carbon monoxide (CO) and biliverdin, a
      local antioxidant. Expression of HO-1 is considered a protective reaction against
      inflammatory and other insults to the brain. We have localized HO-1 to Durck's
      granulomas, typical lesions of advanced cerebral malaria. Here, activated
      monocytic cells and ramified microglia in direct vicinity to the lesions express
      HO-1. The striking association of HO-1 expression with areas of bleedings
      suggests that released hemoglobin and heme-- known inducers of HO-1--are mainly
      responsible for induction of monocytic HO-1 expression. HO-1 is expressed rather
      late to play a protective role in lesion formation and appears to have only a
      major role in Durck's granulomas. Further, generation of the gaseous mediator CO
      might contribute to the neurological derangements of advanced cerebral malaria.

PMID- 11194944
TI  - Autosomal recessive spastic paraplegia with hypoplastic corpus callosum,
      multisystem degeneration and ubiquitinated eosinophilic granules.
AB  - We report a 48-year-old woman with familial spastic paraplegia (FSP) showing
      mental retardation, amyotrophy and sensory disturbance. Her parents were second
      cousins and there were two other affected siblings in the family. Autopsy
      revealed degenerative lesions characterized by neuronal loss and gliosis in the
      upper and lower motor neuron systems, thalamus, lateral geniculate body, dentate
      nucleus and posterior column of the spinal cord. The remaining neurons often
      contained ubiquitinated lipofuscin granules. Although the corpus callosum was
      severely attenuated, it exhibited well-preserved myelination and only minimal
      gliosis. In the substantia nigra, the number of pigmented neurons was apparently
      low, but there was slight gliosis and no extraneuronal free melanin pigment in
      the background. The neurons in this brain region contained much smaller amounts
      of melanin pigment than might be expected for the patient's age. These findings
      suggest that this is an example of a family with autosomal recessive FSP with
      thin corpus callosum, and that maldevelopment of the corpus callosum and
      substantia nigra is a characteristic feature of the disease.

PMID- 11194945
TI  - Apoptotic muscle fiber degeneration in distal myopathy with rimmed vacuoles.
AB  - Rimmed vacuole formation, tubulofilamentous nuclear inclusions and muscle fiber
      atrophy are the characteristic pathological findings in distal myopathy with
      rimmed vacuoles (DMRV). Necrotic muscle fibers were few in number and did not
      appear to account for the muscle weakness, but the nuclear changes with
      myofibrillar degeneration followed by rimmed vacuole formation appeared to be the
      major reason for the muscle fiber atrophy in DMRV. To determine whether the
      nuclear change in DMRV was related to apoptosis, we examined 15 muscle biopsy
      specimens immunohistochemically, and 7 of them ultrastructurally. The
      characteristic tubulofilamentous nuclear inclusions were found in 4 and the
      typical fragmented apoptotic nuclei in 3 of the 7 muscle biopsy samples examined
      by electron microscopy. TUNEL-positive nuclei reflecting apoptotic DNA
      fragmentation were found in 13 of 15 biopsies ranging from a few to approximately
      1.5% of myonuclei. Apoptosis-specific protein was expressed in the sarcoplasm of
      atrophic fibers in 13 biopsies both with or without rimmed vacuoles. These
      findings suggest that the apoptotic process plays a crucial role in myofibrillar
      degeneration followed by autophagocytosis, i.e., rimmed vacuole formation, in
      DMRV.

PMID- 11194946
TI  - [Multidisciplinary approach in the treatment of localized forms of cancer of the
      prostate].
AB  - Localized prostate cancer can be treated by surgery, 3D conformal radiotherapy,
      brachytherapy: age, clinical stage, Gleason grade, baseline PSA,
      multidisciplinary approach enable physicians to tailor the therapeutic strategy.
      Patients are more informed of therapeutic morbidity and health related quality of
      life and want to give their feeling. Clinical research remains mandatory to set
      up the treatment policy with more objectivity.

PMID- 11194947
TI  - [Methods and results of radical prostatectomy for localized cancer of the
      prostate].
AB  - A radical prostatectomy for localized prostate cancer is indicated after
      evaluation of the disease (initial PSA, clinical stage, biopsy mapping, results
      of radiologic explorations with an endorectal MRI) and the patient (age,
      morbidity, life expectancy and wishes of potency conservation). The surgical
      approaches, retropubic or laparoscopic, depend on the surgeon's experience.
      Radical prostatectomy provides good disease-free survival for organ-confined
      disease close to the natural life expectancy. Post-radical prostatectomy
      morbidity is essentially represented by orthostatic incontinence (up to 6.8%),
      stress incontinence (up to 27%) and impotence (30 to 95%), depending on the
      published series and patient age.

PMID- 11194948
TI  - [Tridimensional conformal radiotherapy of cancer of the prostate].
AB  - 3D-conformal-radiation therapy is now available according to progress in imaging
      and treatment planning. It gives three advantages: better coverage of clinical
      target volume, decrease of dose in organs at risk and in some cases possibility
      of escalating the dose in the clinical target volume. These three theoretical
      advantages are demonstrated for localized prostate adenocarcinomas. An increase
      of clinical and biological cure rate was demonstrated with 3D-CRT compared with
      conventional technique for the same dose. A decrease of acute and late
      complications was observed with 3D-CRT in historical comparisons and in
      randomized clinical trials. The most exciting point were the results of studies
      of escalating dose (+10 or 15%). There was a relationship between dose and
      clinical and biological cure rate. The french study of escalated dose showed a
      probability of clinical and biological cure rate at 36 months of 50% for doses
      between 66 and 70 Gy and 85% for doses between 74 and 80 Gy. In conclusion, 3D
      CRT is becoming more and more important in the treatment of localized prostate
      carcinoma.

PMID- 11194949
TI  - The learning curve in prostate seed implantation.
AB  - OBJECTIVE: To describe the learning curve in prostate seed implantation,
      according to the experience with two groups of 100 patients. MATERIAL AND
      METHODS: A perineal, ultrasound-guided implantation technique with manual
      afterloading was used in all patients. Of a total of 255 patients treated over
      the period 1989 through 1998, the results of the first hundred patients were
      compared in relation to the last hundred patients. In the first group single
      seeds were used, while in the second group RAPID Strands were applied. RESULTS:
      Although there is a difference in the follow-up period, a significant difference
      is found in disease-free survival between the two groups. PSA progression was
      noticed in 39% of patients in the first group and in 12% in the other group. The
      strongest prognostic factor, however, is the initial PSA value. Toxicity is
      relatively low, though higher in the second group. CONCLUSIONS: The results
      obtained in the second hundred patients are in agreement with data from
      literature. Differences in outcome between the two groups are, however, not only
      explained by differences in technique, but also by selection and total number of
      implanted seeds.

PMID- 11194950
TI  - [Biomodulation and radiotherapy].
AB  - Recent improvement in the understanding of the mechanisms involved in the
      response to ionizing radiation have made it possible to identify new therapeutic
      targets to increase the anti-tumor efficacy or, alternatively, to decrease the
      effect on normal tissues. These approaches included targeting genes involved in
      the regulation of radio-induced DNA-repair and cell death as well as genes
      involved in the regulation of radio-induced apoptosis. Many other molecular
      targets have been recently identified to potentially interfere with the response
      to ionizing radiation, such as some cell membrane growth factor receptors (EGFr,
      TGFb) or molecules involved in intra-cellular signal transduction pathways, cell
      cycle regulation, etc. In addition, other promising ways to modulate radiation
      induced response concern extracellular or tissue factors such as hypoxia and
      angiogenesis.

PMID- 11194951
TI  - [Concomitant radiochemotherapy in cancer of the cervix uteri: modifications of
      the standards].
AB  - For a long time, combined external irradiation and brachytherapy has been
      considered as the standard treatment in patients with advanced cervical cancers.
      Recently, five clinical randomized trials assessing the role of cis-platin-based
      chemotherapy delivered concomitantly to radiotherapy have been conducted in the
      United States. Another clinical randomized trial assessing the role of epirubicin
      was conducted by the Queen Mary Hospital in Hong Kong. With more than 2,000
      enrolled patients, these studies showed converging results with an overall and
      disease-free survival improvement in the arms combining cis-platin and epirubicin
      based chemotherapy and irradiation. These combinations led to a significant
      decrease in loco-regional evolution or recurrence rates, or even in pulmonary
      metastases rates. The relative risk of recurrences was decreased by 50%. The
      relative risk of death was decreased by 40%. The differences, however, were less
      significant in patients with advanced stages III or IVA. Hematological and
      digestive acute toxicity was significantly higher in the radiochemotherapy
      groups, but long-term complications were comparable. The results of these
      randomized trials have led to a modification in the standard of treatment in
      these poor prognosis cervix cancers. Five of the randomized trials evidenced the
      superiority of cis-platin-based chemotherapy, but the optimal chemotherapeutic
      regimens remain to be defined.

PMID- 11194952
TI  - [Positron emission tomography in thoracic radiography].
AB  - The optimisation of the field of irradiation is the aim of the radiotherapist.
      Pet-Scan provides information revealing a better cartography of node involvement
      and allowing a better delineation of the tumour zone. In the follow-up of
      irradiated patients, PET-Scan provides information on the nature of residual
      lesions and a possible recurrence.

PMID- 11194953
TI  - [Ewing's sarcoma: towards a common protocol for adults and children].
AB  - Ewing sarcoma is an uncommon malignancy that has been frequently managed
      differently in childhood and adults. This is a review of the international
      experience that conducted to a common European study called Euro Ewing. This
      study was launched in 1999.

PMID- 11194954
TI  - [Brachytherapy in the treatment of vesicoprostatic rhabdomyosarcomas in
      children].
AB  - Brachytherapy has been widely used at the Institut Gustave-Roussy since 1972 in
      pediatric oncology. In genitourinary rhabdomyosarcoma, because of its ballistic
      and physical characteristics, it represents the optimal treatment whenever
      irradiation is required and brachytherapy feasible. Between 1976 and 1998, 23
      children with bladder or prostate rhabdomyosarcoma were treated with a protocol
      including brachytherapy, with five of them treated with a salvage brachytherapy.
      All but one brachytherapy was performed during the surgery. Among the 18
      brachytherapies performed as a first-line treatment, eight presented a tumoral
      evolution: five presented a local evolution, one a local and nodal evolution and
      two a nodal evolution. Brachytherapy allowed a conservative treatment among ten
      out of 11 children alive with no evidence of disease. Among the five patients
      with salvage brachytherapy, two presented a second recurrence. Sequelae were
      minimal, consisting of one grade I rectitis and one asymptomatic vesical and
      ureteral reflux. These results are consistent with the published data using more
      radical treatment. Brachytherapy can represent an alternative to radical surgery,
      when indications are clearly defined in bladder or prostate rhabdomyosarcoma.
      This type of treatment can be performed only integrated with other treatments,
      more particularly with surgery. This approach requires a close cooperation
      between the different specialists: pediatricians, surgeons and brachytherapists.

PMID- 11194955
TI  - [Innovations in the treatment of medulloblastoma].
AB  - Prognosis of medulloblastoma remains serious with a disease-free survival rate of
      70% at 5 years and severe sequelae in the majority of children. In order to
      improve this survival rate without unacceptable toxicity, various ways are
      currently under investigation. Among them, hyperfractionation and conformal
      therapy seem to be promising. Quality control of radiotherapy treatment could
      surely also play a major role on outcome.

PMID- 11194956
TI  - [A century of progress in the knowledge and treatment of nephroblastoma].
AB  - Since its initial description by Max Wilms over a century ago, nephroblastoma has
      benefited from considerable improvements both in terms of basic knowledge about
      it and management of it. Today, the majority of these very young patients can
      expect a long-term survival in excess of 90% at the price of a light therapy that
      combines surgical resection, chemotherapy based on ill-toxic agents, and in
      selected cases, radiotherapy of remarkably low toxicity. The contribution of
      large international studies will be emphasized here.

PMID- 11194957
TI  - [Cancer of the breast: results and toxicity of locoregional irradiation after
      mastectomy].
AB  - The locoregional control is a crucial step in the achievement of a cancer cure.
      After mastectomy, the locoregional irradiation clearly reduces the chest wall and
      nodal relapses, especially with initial lesions more than 5 cm or with nodal
      involvement and/or large lymphatic or vascular emboli. Two recent randomized
      trials confirmed the benefit of well-adapted locoregional irradiation. In the
      Danish trial, including premenopausal "high-risk" women treated by mastectomy and
      chemotherapy (CMF protocol), the radiotherapy reduced the locoregional relapses
      from 32 to 9% (P < 0.001) and increased the 10-year survival rates from 45 to 54%
      (P < 0.001). These results are now also confirmed in a postmenopausal group, with
      an increased 10-year survival rate of 36 to 45% (P < 0.001). In the Canadian
      trial, locoregional relapse rate decreased from 25 to 13% and 10-year survival
      rate increased from 56 to 65%. The meta-analysis published in 1995 by the Early
      Breast Cancer Trialist Collaborative Group (EBCTCG) showed only a modest benefit
      due to locoregional irradiation in breast cancer. However, when small trials and
      older trials started before 1970 are excluded due to imperfect methodologies and
      for inadequate irradiation techniques, the benefit of the "modern" radiotherapy
      appears significant in the 7,840 patients selected in this way. Thus, since the
      locoregional irradiation can avoid some metastatic evolutions developed only
      after "local" or "nodal" relapse, it must be integrated in a multidisciplinary
      strategy. Nevertheless, this treatment must be safe and this is possible by the
      use of new techniques, including the definition of anatomical volumes and
      previsional dosimetry. The most important point concerns the treatment of the
      internal mammary nodes, especially when previous chemotherapy including
      anthracyclines was performed. The use of a direct field, with at least 40% of the
      dose delivered by electrons in an alternating scheme, is recommended to ensure
      very good protection of the heart and lungs.

PMID- 11194958
TI  - [Patient positioning and its verification: justification, state of the art of the
      classical practices].
AB  - Patient immobilization is considered an important part of the quality control
      program in radiation therapy. The need for patient immobilization according to
      the symptoms, ensuring both reproducibility and comfort, is described in the
      recommendations for level 1 published by the SFPM (Societe francaise de physique
      medicale) and the SFRO (Societe francaise de radiotherapie oncologique). A
      customized device, associated with regular controls, is required for level 2.
      Customized procedures are mandatory in clinical practice for head and neck and
      brain treatments. Internal margins and movements of patients must be analyzed and
      controlled as deviations of CTV placement relative to the isocenter of linacs.
      They could be reduced with efficient positioning devices and accurate customized
      immobilization systems. Different devices could be used according to tumor
      locations. Except for subclavicular tumors, their efficacy remains controversial.

PMID- 11194960
TI  - [11th National Congress of the French Society of Oncologic Radiotherapy. Paris,
      France, 23-24 November 2000. Proceedings and abstracts].

PMID- 11194959
TI  - [Radiotherapy of cancer of the breast. Technical problems and new approaches].
AB  - Technical problems often arise during irradiation to the breast, chest wall, and
      regional lymph nodes. The following are among the most frequently encountered
      problems: avoidance of normal tissues (heart and lungs) during chest wall,
      internal mammary nodes, and large breast irradiations; dose heterogeneity in
      large breasts; under- or overdosage at field junctions (breast medial tangent and
      internal mammary fields in particular). Various technical solutions have been
      offered: modified treatment positions, field inclinations, and conformal
      irradiation. Many are currently under evaluation. These new technical approaches
      in breast cancer irradiation require modern facilities for imaging, simulation,
      and dosimetry, which help to individually design treatment planning.

PMID- 11194961
TI  - [Assessment of the use of electronic portal imaging].
AB  - Improvement in the accuracy of the positioning of the patient during external
      irradiation is one of the most important issues of the last decades, due to the
      detrimental impact of the misplacements on treatment outcome. Since 1990, the
      evolution of the technologic environment has led to a full integration of the
      portal imaging devices into linac technology. It offers a real on-line
      verification tool for "high-dose, high-accuracy" treatments. This overview based
      upon data from the literature describes the different types of imaging devices,
      the strategies of use and the results obtained. It also considers the use of
      imaging devices as an in vivo dosimeter.

PMID- 11194962
TI  - [Image fusion methods for the repositioning of the patient in radiotherapy].
AB  - Conformal radiotherapy requires the accurate and reproducible setup of the
      patient for each fraction delivery. Megavoltage imaging could enable this. This
      requires the development of image processing and data fusion algorithms. We
      describe an automated method based on the use of mutual information for
      registration. Such a method does not require any preliminary segmentation of the
      images. This method has been extensively tested on phantom as well as on some
      patient data. The obtained results demonstrated that this automated method for
      2D/2D registration is rapid, accurate and robust even in the case of blurred
      images for small treatment fields.

PMID- 11194963
TI  - [Is there a future for dosimetry control by portal imaging?].
AB  - This article deals with the potential benefits of portal imaging as a tool for
      the dosimetric control of a radiotherapy treatment. In the introduction the
      advantages of dosimetric control with portal imaging are described. Subsequently,
      the physical problem is considered between patient exit dose and dose at the
      level of the portal detector. Measurements with phantoms have shown that this
      relationship is complex: different algorithms have been developed by groups of
      researchers and some of them are summarised in this article. Finally, three
      examples of dosimetric control using portal imaging are presented: in vivo
      dosimetry on the beam axis, dosimetric profiles in two dimensions and portal
      dosimetry for intensity modulation.

PMID- 11194964
TI  - [The role of surgery in the treatment of glial tumors].
AB  - Indications for surgery in the management of glial tumors is twofold. Surgery
      provides a pathology-based diagnosis that is mandatory in every patient with a
      clinical diagnosis of glial tumor. However, its role in duration of survival is
      controversial. Total surgical removal is the best prognostic factor in grade 1
      glioma. For grade 2 to 4 gliomas, the results of surgery are variable. Surgical
      resection is undoubtedly associated with clinical improvement. Its impact on
      duration of survival is not firmly established, due to, on the one hand, the
      infiltrative pattern of these types of tumors and, on the other hand, to the
      inherent difficulty in evaluating their size either pre- or postoperatively.
      However, the sole clinical improvement related to surgical resection appears
      sufficient to justify patients' exposure to resective surgery. The surgical risk
      has dramatically decreased over the last few years mainly due to technical
      improvements.

PMID- 11194965
TI  - [Radiotherapy of brain astrocytomas and oligodendrogliomas of the adult].
AB  - Gliomas are moderately radiosensitive. The main prognostic factors are the
      anatomicopathological type and grade of glioma, the performance status, age of
      the patient and the extent of the surgery. According to data from the literature,
      high-grade gliomas should be given 60 Gy in five weekly fractions of 1.7 to 2 Gy
      in a volume including tumor or tumor bed, edema and a 2- to 3-cm margin. A dose
      of 45 Gy would be sufficient for low-grade gliomas, according to the results of a
      recent randomized EORTC trial. Brachytherapy and radiosurgery techniques may be
      indicated in selected cases.

PMID- 11194966
TI  - [Medical management of malignant gliomas].
AB  - The management of patients with malignant glioma aims at improving the duration
      and quality of life. It rests upon symptomatic (steroid therapy, anticonvulsants,
      etc.) and specific (chemotherapy, etc.) treatments. It also includes palliative
      care during the terminal phase of the disease. During the last 15 years,
      oligodendrogliomas have been demonstrated to be chemosensitive, leading to an
      improvement of their management; on the other hand, the treatment of glioblastoma
      multiforme remains disappointing. Development of new research pathways (gene
      therapy, immunotherapy, antiangiogenic drugs, etc.) feed new hopes for progress
      in the understanding and management of gliomas during the years to come.

PMID- 11194967
TI  - [Fractionated radiotherapy of intracranial meningiomas and neurinomas].
AB  - In most institutions, surgical excision remains the standard treatment of
      meningiomas and neurinomas; the aim of surgery is complete resection. However,
      total removal is not always feasible without significant morbidity and in some
      cases, the patient's condition contraindicates surgery. For incompletely excised
      tumors, recurrences will have consequences on neurological functions. There are
      now many reports in the literature confirming the fact that radiotherapy
      significantly decreases the incidence of recurrence of incompletely resected
      benign tumors and that it can replace surgery in some situations where an
      operation would involve considerable danger or permanent neurological damage:
      about 80 to 90% of such tumors are controlled with fractionated radiotherapy.
      Stereotaxic and three-dimensional treatment planning techniques increase local
      control and central nervous system tolerance so that the respective place of
      surgery and radiotherapy needs to be redefined, considering efficacy and
      morbidity of these two therapeutic means. In this article, we limit our remarks
      to fractionated radiotherapy and, after a review of the literature, we discuss
      the indications, volume evaluations and the techniques currently used.

PMID- 11194968
TI  - Combined ozonation and biodegradation for remediation of mixtures of polycyclic
      aromatic hydrocarbons in soil.
AB  - A study was conducted to investigate the feasibility of a combined treatment
      (i.e., ozonation and biodegradation) to overcome the inherent bacterial
      bioavailability limitation, and hence bioremediation limitation, of polycyclic
      aromatic hydrocarbons in soil. Ozonation was very efficient in the removal of
      naphthalene, fluorene, phenanthrene, and anthracene, but not for pyrene,
      chrysene, and benzo(a)pyrene from soil freshly spiked with the hydrocarbons. A
      similar result was obtained from coal tar-contaminated soil. Elimination of
      polycyclic aromatic hydrocarbons increased appreciably in sand containing 0.03%
      organic carbon, indicating the adverse effect of organic carbon on the efficiency
      of ozone treatment. In spiked and coal tar-contaminated soils, ozonation followed
      by biodegradation significantly increased the degradation of various polycyclic
      aromatic hydrocarbons including chrysene and benzo(a)pyrene which were not
      degraded by the test bacterial consortium alone. In particular, the effect of the
      combined treatment was more pronounced in coal tar-contaminated soil than in
      sterile soil spiked with hydrocarbons, probably due to the augmented biological
      activity of the introduced consortium. The results suggest that a combined
      treatment including ozonation and biodegradation may be a promising
      bioremediation technology in soil contaminated with mixtures of polycyclic
      aromatic hydrocarbons such as former manufactured gas plant sites.

PMID- 11194969
TI  - Formation of the metabolic intermediate 2,4,4-trimethyl-2-pentanol during
      incubation of a Sphingomonas sp. strain with the xeno-estrogenic octylphenol.
AB  - Degradation of branched octylphenol was studied in a bacterial culture of a
      Sphingomonas sp. strain. Octylphenol is considered to be the most stable
      degradation intermediate formed from the corresponding nonionic octylphenol
      polyethoxylates surfactants during biological wastewater treatment. Since
      octylphenol can exert estrogenic effects in wildlife, a detailed study of its
      biodegradation is warranted. The aerobic microbiological transformation of
      octylphenol was examined with and without the addition of the easily assimilable
      sodium acetate. In both cases the formation of the metabolite 2,4,4-trimethyl-2
      pentanol, representing the intact alkyl chain as a tertiary alcohol, was
      observed. Since the octylphenol degradation rate was not affected by the presence
      of acetate, this strain did not show any diauxic metabolic behaviour when
      incubated with octylphenol and sodium acetate as the sources of carbon and
      energy. As a result of the biotransformation of octylphenol, its estrogenic
      potency was removed because it is the phenolic moiety that interacts with the
      estrogen receptors. This feature opens perspectives for the use of this strain in
      the framework of an adequate treatment of wastewater with high levels of
      alkylphenol polyethoxylates.

PMID- 11194970
TI  - Influence of phenol on biodegradation of p-nitrophenol by freely suspended and
      immobilized Nocardioides sp. NSP41.
AB  - The effect of the presence of an alternate toxic compound (phenol) on the p
      nitrophenol (PNP)-degrading activity of freely suspended and calcium alginate
      immobilized Nocardioides sp. NSP41 was investigated. In the single substrate
      experiments, when the concentration of phenol and PNP was increased to 1400 mg l(
      1) and 400 mg l(-1), respectively, the initial cell concentrations in the freely
      suspended cell culture should be higher than 1.5 g dry cell weight l(-1) for
      complete degradation. In the simultaneous degradation experiment, when the
      initial concentration of phenol was increased from 100 to 400 mg l(-1), the
      specific PNP degradation rate at the concentration of 200 mg l(-1) was decreased
      from 0.028 to 0.021 h(-1). A freely suspended cell culture with a high initial
      cell concentration resulted in a high volumetric degradation rate, suggesting the
      potential use of immobilized cells for simultaneous degradation. In the
      immobilized cell cultures, although simultaneous degradation of PNP and phenol
      was maintained, the specific PNP and phenol degradation rate decreased. However,
      a high volumetric PNP and phenol degradation rate could be achieved by
      immobilization because of the high cell concentration. Furthermore, when the
      immobilized cells were reused in the simultaneous degradation of PNP and phenol,
      they did not lose their PNP- and phenol-degrading activity for 12 times in semi
      continuous cultures. Taken together, the use of immobilized Nocardioides sp.
      NSP41 for the simultaneous degradation of PNP and phenol at high concentrations
      is quite feasible because of the high volumetric PNP and phenol degradation rate
      and the reusability of immobilized cells.

PMID- 11194971
TI  - Distribution in the environment of degradative capacities for gasoline
      attenuation.
AB  - A methodology allowing the detailed assessment of the capacities of microflorae
      to degrade gasoline in aerobic conditions has been developed. It consisted in the
      determination of the degradation of a gasoline model mixture in liquid cultures
      in optimal conditions. The gasoline model mixture contained 23 representative
      hydrocarbons of gasoline (GM23). The kinetics and extent of biodegradation were
      evaluated by continuous overall monitoring of CO2 production and final
      chromatographic analysis (usually after about 30 days) of the consumption of each
      hydrocarbon. The methodology was used with soil and water samples from polluted
      and non polluted sites. The experimentation aimed at assessing the distribution
      of the degradative capacities in the environment and the prospects for natural
      attenuation of gasoline. Nine microflorae were tested. The intrinsic
      biodegradability (existence of mechanisms of biodegradation) appeared total for
      GM23 as shown by the results obtained with several microflorae. The degradative
      capacities of microflorae from non polluted samples were high (total degradation
      rates at least 85%). Incomplete degradation was observed essentially for
      trimethylalkanes (2,2,4-trimethylpentane and 2,3,4-trimethylpentane) and for
      cyclohexane. In several cases, samples from polluted sites exhibited more
      extensive degradative capacities, with total degradation of all hydrocarbons
      being observed for three out of the six samples.

PMID- 11194972
TI  - Investigating the specificity of regulators of degradation of hydrocarbons and
      hydrocarbon-based compounds using structure-activity relationships.
AB  - Microbial biosensors which have genes for bioluminescence coupled to genes that
      control hydrocarbon degradation pathways can be used as reporters on the
      specificity of regulation of those pathways. Structure-activity relationships can
      be used to discover what governs that specificity, and can also be used to
      separate compounds into different groups depending on mode of action. Published
      data for four different bioluminescent biosensors, reporting on toluene (two
      separate biosensors), isopropylbenzene, and octane, were analyzed to develop
      structure-activity relationships between biological response and
      physical/chemical properties. Good QSARs (quantitative structure-activity
      relationships) were developed for three out of the four biosensors, with between
      88 and 100 per cent of the variance explained. Parameters found to be important
      in controlling regulator specificity were hydrophobicity, lowest unoccupied
      molecular orbital energies, and molar volume. For one of the biosensors, it was
      possible to show that the biological response to chemicals tested fell into three
      separate classes (non-hydrocarbons, aliphatic hydrocarbons, and aromatic
      hydrocarbons). A statistically significant QSAR based on hydrophobicity was
      developed for the fourth biosensor, but was poor in comparison to the other three
      (44 per cent variance explained).

PMID- 11194973
TI  - Degradation of o-methoxybenzoate by a two-member consortium made up of a gram
      positive Arthrobacter strain and a gram-negative Pantotea strain.
AB  - Aromatic carboxylic acids substituted with methoxylated groups are among the most
      abundant products in "alpechin", the wastes resulting from pressing olives to
      obtain olive oil. Degradation of o-methoxybenzoate by an stable consortium made
      of a gram positive bacterium, Arthrobacter oxydans, and gram negative one,
      Pantotea agglomerans, was shown to mineralize this compound efficiently. The
      concerted action of both microorganisms was needed for the two first steps in the
      process, namely, the conversion of o-methoxybenzoate into salycilate, and the
      hydroxylation of the latter to gentisate. Gentisate was further degraded by the
      Arthrobacter strain.

PMID- 11194974
TI  - Anaerobic utilization of essential oils by denitrifying bacteria.
AB  - Plant volatile organic compounds are a major carbon source in nature. We studied
      the degradability of these substances by anaerobic microorganisms in enrichment
      cultures with representative essential oils as organic substrates and nitrate as
      electron acceptor. Lemon and pine needle oil supported microbial growth in the
      presence of pure oil, whereas parsley seed, camphor, sage, fennel, and mint oil
      supported growth only when the essential oils were dissolved in an overlying
      phase of 2,2,4,4,6,8,8-heptamethylnonane. Thyme oil did not support
      denitrification. Analyses of the microbially degraded oils revealed the
      disappearance of monoterpenes, of several monoterpenoids, and of methoxy-propenyl
      benzenes, including apiole and myristicin. Most-probable-number determinations
      for denitrifying communities in sewage sludge and forest soil yielded 10(6) to
      10(7) monoterpene-utilizing cells ml(-1), representing 0.7 to 100% of the total
      cultivable nitrate-reducing microorganisms. The utilization of essential oils
      together with the common occurrence of this metabolic trait are indications for
      an environmentally important, but currently unexplored anaerobic turnover of
      plant volatile organic compounds in soil.

PMID- 11194975
TI  - Enhancement of hydrocarbon waste biodegradation by addition of a biosurfactant
      from Bacillus subtilis O9.
AB  - A non-sterile biosurfactant preparation (surfactin) was obtained from a 24-h
      culture of Bacillus subtilis O9 grown on sucrose and used to study its effect on
      the biodegradation of hydrocarbon wastes by an indigenous microbial community at
      the Erlenmeyer-flask scale. Crude biosurfactant was added to the cultures to
      obtain concentrations above and below the critical micelle concentration (CMC).
      Lower concentration affected neither biodegradation nor microbial growth. Higher
      concentration gave higher cell concentrations. Biodegradation of aliphatic
      hydrocarbons increased from 20.9 to 35.5% and in the case of aromatic
      hydrocarbons from nil to 41%, compared to the culture without biosurfactant. The
      enhancement effect of biosurfactant addition was more noticeable in the case of
      long chain alkanes. Pristane and phytane isoprenoids were degraded to the same
      extent as n-C17 and n-C18 alkanes and, consequently, no decrease in the ratios n
      C17/pri and n-C18/phy was observed. Rapid production of surfactin crude
      preparation could make it practical for bioremediation of ship bilge wastes.

PMID- 11194976
TI  - Bacterial growth based on reductive dechlorination of trichlorobenzenes.
AB  - An anaerobic mixed bacterial culture was enriched for bacteria dechlorinating
      1,2,3- and 1,2,4-trichlorobenzene (TCB) to dichlorobenzenes by exclusive use of
      non-fermentable substrates and the application of vancomycin. Growth and
      dechlorination occurred in a purely synthetic medium with formate or hydrogen,
      acetate, and TCB. Neither acetogenesis nor methanogenesis was detected in the
      culture. Repeated subculturing maintaining high dechlorinating activities was
      also achieved when only hydrogen and TCB were supplied. This indicated that
      reductive dechlorination of TCB was the primary energy conservating process. The
      number of dechlorinating bacteria was strictly limited by the amount of TCB
      supplied in the medium. In addition, the dechlorinating activity could be
      maintained only in the presence of TCB. A most probable number analysis showed
      that the dechlorinating species amounted to at least 6 x 10(5) cells per ml at a
      total cell number of about 2 x 10(6) cells per ml. Vitamin B12 significantly
      stimulated the dechlorinating activity.

PMID- 11194977
TI  - [Propofol and remifentanil in day surgery].
AB  - BACKGROUND:  AIM OF THE STUDY: to compare AG versus MAC using propofol &
      remifentanil in a day surgery setting evaluating intra and postoperative clinical
      conditions and emergence times. METHODS: Propofol and remifentanil, either for
      general anesthesia (AG) then conscious sedation (MAC), have been administered to
      218 patients undergoing mainly plastic or proctologic surgery as day hospital. AG
      was induced with propofol 1.5-2 mg/kg followed by a continuous infusion of 10
      mg/kg/h and remifentanil infused at 10 micrograms/kg/h; MAC was started with
      propofol 3 mg/kg/h and remifentanil 4-5 micrograms/kg/h; during the maintenance
      phase of both AG and MAC, infusion rates of both drugs were adjusted according to
      clinical needs. Diazepam (0.05-0.06 mg/kg) and/or midazolam (2-3 mg) were given
      as premedication or coinduction as necessary. All patients received field
      infiltration with local anesthetics (lidocaine or mepivacaine); patients under GA
      were artificially ventilated with O2/air through IOT or LMA. Surgical and
      anesthesiological data were collected on specially designed records, with special
      attention to time intervals between anesthesia (FA) and surgery (FC) end and eyes
      opening (EO), orientation (OR), return of spontaneous breathing (SR), extubation
      (EST), sitting (SED), walking (CAMM), dressing (VEST) and discharge (DIM); data
      were analyzed with parametric and non parametric analysis of variance. RESULTS:
      All emergence intervals were longer under AG than under MAC: the earlier in the
      range of 4-5 vs 0.5-1 min; for the late intervals; FA-SED 24 +/- 18 vs 15 +/- 8,
      FA-PIED 65 +/- 48 vs 34 +/- 17, FA-VEST 69 +/- 58 vs 33 +/- 17, FA-CAMM 68 +/- 42
      vs 39 +/- 19. Discharge times (83 +/- 67 vs 73 +/- 60) were similar between the
      two groups. Drugs consumption under AG were roughly double than under MAC; total
      dose infused of propofol (mg/kg/min) 0.118 +/- 0.044 vs 0.06 +/- 0.036; total
      dose of remifentanil (microgram/kg/min): 0.106 +/- 0.049 vs 0.066 +/- 0.027. AG
      resulted in a higher % incidence of intraoperative hypotension and bradycardia:
      hypotension 61.7 vs 25.7 and bradycardia 30.3 vs 12.4. SaO2 decreased more
      commonly during MAC than AG (20.9% vs 10.1); intraoperative itching was referred
      in 20% of MAC patients. Conversions rate from MAC to AG was 2.8%. Psychomotor
      agitation was more frequent following AG (14%) than MAC (2%); nausea (1%),
      vomiting, shivering (12%), headache (2%), ortostatic hypotension (2%) were
      similar between the two groups. Diazepam and/or midazolam caused a significant
      prolongation of recovery intervals, for both AG and MAC with a mean delay of the
      order of 100-200%. CONCLUSIONS: Propofol- remifentanil gave excellent conditions
      for a wide variety of day surgery procedures, offering good anesthesia with quick
      emergence; the addition of bdz, even at low doses, prolongs significantly
      discharge times.

PMID- 11194978
TI  - Why anaesthesia is a good model to study respiratory system.

PMID- 11194979
TI  - Clinical comparison of either small doses of fentanyl or remifentanil for
      blunting cardiovascular changes induced by tracheal intubation.
AB  - BACKGROUND: To compare in a prospective, randomized study the effects on
      cardiovascular changes after tracheal intubation produced by small doses of
      either remifentanil or fentanyl. METHODS: With Ethical Committee approval, after
      intravenous midazolam premedication (0.05 mg.kg-1), 30 normotensive, ASA physical
      status I-II patients, without cardiovascular or respiratory diseases, and with a
      Mallampati score < 2, were randomly allocated to receive an intravenous bolus of
      either 3 micrograms.kg-1 fentanyl (n = 15) or 1 microgram.kg-1 remifentanil (n =
      15) infused over 60 sec and followed by a 0.15 microgram.kg-1.min-1 continuous
      intravenous infusion. General anesthesia was then induced with propofol (2 mg.kg
      1), followed by atracurium besilate (0.5 mg.kg-1) to facilitate tracheal
      intubation. Following intubation, the lungs were ventilated mechanically using a
      60% nitrous oxide in oxygen mixture with a 1% inspired fraction of sevoflurane.
      Arterial blood pressure and heart rate were recorded before anesthesia induction
      (baseline), one minute after induction of anesthesia, immediately after tracheal
      intubation and every minute for the first five minutes after intubation. RESULTS:
      Systolic arterial blood pressure values were significantly higher in the Fentanyl
      than in the Remifentanil group patients from 2 to 5 min after tracheal intubation
      (p < 0.01), while no differences were observed between the two groups in either
      diastolic arterial blood pressure or heart rate values. Four patients in the
      Remifentanil group (26%) but only one patient in the Fentanyl group (7%) showed
      systolic blood pressure values < 90 mmHg during the study period (p = not
      significant); however, the observed decreases in systolic arterial blood pressure
      values were transient and did not require treatment for any subject. CONCLUSION:
      We conclude that in healthy normotensive patients, the control of cardiovascular
      responses to tracheal intubation obtained with a 1 microgram.kg-1 loading dose of
      remifentanil is more effective than that provided by a 3 micrograms.kg-1 bolus of
      fentanyl, with the advantage of no risks for postoperative respiratory
      depression.

PMID- 11194980
TI  - [Non-invasive positive pressure mechanical ventilation in acute respiratory
      failure].
AB  - Known for two centuries, positive pressure non invasive mechanical ventilation
      (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the
      last ten years. The fact that VMNPP is able to improve gas exchange by avoiding
      endotracheal intubation and its complications is the most attractive aspect in
      both general and respiratory intensive care units and in the respiratory ward.
      Characteristics of VMNPP (interface, ventilator and modality of ventilation), the
      side where it is performed as well as severity of IRA, underlying disease, and
      the team's experience are important factors which influence outcome. The addition
      of VMNPP to conventional medical therapy reduces the need for IE, mortality and
      hospitalisation in a selected population of BPCO patients in IRA. As there are no
      available data for comparison between invasive mechanical ventilation (VMI) and
      VMNPP, the latter has not to be considered as an alternative to VMI but able to
      prevent it and, even if VMNPP fails, it may be used as a weaning technique. In
      IRA due to other than BPCO diseases VMNPP seems not to be more effective than
      standard treatment in avoiding IE but it may give efficient support with fewer
      complications as compared to VMI. Acute cardiogenic pulmonary edema and
      "terminal" diseases represent some of the most interesting application fields of
      VMNPP in non-BPCO patients. According to the latest literature data, in this
      review history, technique, advantages, limits, indications, nursing and cost of
      VMNPP are examined.

PMID- 11194981
TI  - [Systemic review of trials on the use of tramadol in the treatment of acute and
      chronic pain].
AB  - BACKGROUND: The purpose of the study was to verify the effectiveness of tramadol
      in the treatment of non-oncologic chronic pain, oncologic chronic pain and
      postoperative acute pain, applying the principles of meta-analytic analysis to
      randomized clinical trials (TCR). METHODS: I: Medline research of the TCR on the
      question in the period between 1989-1999, II: exclusion of single TCR through the
      question of Moore and Mcquay; calculation of the relative risk reduction (RRR),
      of the number needed to treat (NNT), of the odds ratio (OR) and of the typical
      odds ratio (TOR) of the trials which responded to characteristics of correct
      randomization and blindness, which expressed citation of the patients excluded
      from trial, and patients with measurable analgesic effectiveness (number of
      patients with reduction of the pain intensity 50%). RESULTS: 52 trials extracted
      from Medline: 10 on the treatment of non-oncologic chronic pain, 36 on the
      treatment of postoperative acute pain and 6 on the treatment of oncologic chronic
      pain. Responded fully to requirements: 8 studies (3 for non-oncologic chronic
      pain, 3 for postoperative acute pain and 2 for oncologic pain). The OR was 0.55 (
      0.31/1.41); 0.44 (1.04/1.92) and 0.98 (0.5/1.46); the RRR was 0.26 (-0.19/0.71),
      0.38 (0.15/0.61), 0.005 (0.19/0.20) and the NNT 6.6 (6.39/6.81), 5.26 (5.12/5.4),
      infinity in the 3 trials selected between those that concern the treatment of the
      nononcologic chronic pain (with TOR: 0.57 and confidence index: 0.23-0.9); the OR
      was 0.36 (1.06/1.78), 0.78 (-0.08/-1.64) and 1.12 (0.54/1.69); the RRR was 0.26 (
      0.18/0.7), 0.07 (-0.2/0.35), -0.01 (-0.09/0.07) and the NNT 4.7 (4.42/4.58), 20
      (19.8/20.20), infinity in the trials on the treatment of postoperative acute pain
      (with TOR: 0.4 and confidence index: -0.6-0.86); the OR was 0.53 (-0.67/1.73),
      0.27 (-0.71/1.12); the RRR was 0.19 (-0.33/0.72), 0.35 (0.02/0.68) and the NNT
      7.1 (6.78/7.42), 3.57 (3.37/3.76) in those that involved the treatment of
      oncologic chronic pain (with TOR: 0.49 and confidence index: 0.36-0.8).
      CONCLUSIONS: Although the short number of trials which can treated by the
      metanalytic technique the treatment with tramadol, compared comparison's to drugs
      (morphine, pentazocine, bupremorphine, etc.) determined a slight improvement in
      analgesic parameters or at least in analgesic effectiveness.

PMID- 11194982
TI  - European Committee for Hyperbaric Medicine (ECHM) to coordinate, promote and
      study the development of clinical hyperbaric medicine in Europe.

PMID- 11194983
TI  - Ketorolac for paediatric postoperative pain. A review.
AB  - Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) largely used in adults,
      deserves particular attention for postoperative pain therapy in children, even if
      it is not officially approved for paediatric use. We have examined a lot of
      studies about the use of ketorolac for paediatric postoperative pain, pointing
      out pharmacological and pharmacokinetic properties and side effects. There are
      significant differences in pharmacokinetic parameters, doses, routes of
      administration, length of treatment, side effects, usage precautions and
      pharmacological interactions between children and adults. Amongst the many drugs
      available, ketorolac seems to be particularly efficient for postoperative pain
      therapy in children too.

PMID- 11194984
TI  - Assessment of immunological status in the critically ill.
AB  - The systemic inflammatory response (SIRS) results from various types of injuries
      such as severe infection, trauma, ischemia-reperfusion and major surgery
      including cardiac surgery with cardio-pulmonary bypass. This response involves
      immune cell activation and a complex network of proinflammatory cytokines, which
      may induce multiple organ failure when uncontrolled. The monocyte plsys a central
      role in the response to infection with the release of TNF-alpha, IL-1 beta, and
      IL-12. In addition, monocytes present antigens to T lymphocytes. An optimal
      antigen presentation requires the expression of MHC class II HLA-DR on monocytes
      surface and of costimulatory molecules such as CD54 on monocytes and LFA-1 on
      lymphocytes. It has become increasingly apparent that the proinflammatory
      response is balanced by concomitant anti-inflammatory mechanisms that results in
      monocyte deactivation, characterized by a decrease in HLA-DR expression and the
      release of anti-inflammatory cytokines such as IL-10. This counterregulatory
      response, if prolonged or predominant, may predispose the patient to a higher
      risk of infection. Further studies need to be conducted to precise: i) the
      intensity of depression of the surface molocule expression assessing monocyte
      function, such as HLA DR and CD54; ii) the level of IL-10 and IL-12 release in
      patients with severe sepsis; iii) the immuno-modulating effects of frequently
      used treatments in these patients with severe sepsis and in surgical patients;
      iv) the time course of recovery; v) if the monitoring of HLA-DR, CD54, IL-10 and
      IL-12 will better predict the clinical outcome than clinical parameters.

PMID- 11194985
TI  - [Thrombotic thrombocytopenic purpura (TTP) or Moschowitz syndrome. Our
      experience].
AB  - AIM: The aim of this study was to report that Moschcowitz's syndrome was an
      inexorable cause of death in our Centre in the cases we observed, all of which
      failed to respond to the treatment used. This severe prognosis was attributed to
      the irreversible nature of the pathology when the patients were admitted to
      intensive care. METHODS: Three cases are described which were brought to our
      attention with this pathology. The following association was present in all
      cases: low platelet count, anemia with schistocytosis and indirect
      hyperbilirubinemia. Plasmapheresis was the main treatment used in all cases.
      SETTING: the intensive care unit of our Hospital is the regional reference centre
      where plasmapheresis is performed. PATIENTS: Three patients were studied: two
      females aged 62 and 42 respectively, and one male aged 63. All three patients
      came from this region and no special features were found in their long-term
      medical history. INTERVENTIONS: all patients underwent blood transfusion,
      plasmapheresis and received targeted antibiotic and corticosteroid treatment, and
      parenteral nutrition. RESULTS: All three cases died. CONCLUSIONS: The analysis of
      these cases highlights the need for an early diagnosis, even if this is not easy,
      in order to commence successful therapy.

PMID- 11194986
TI  - [Low backache: toward practice guidelines?].

PMID- 11194987
TI  - The role of arterial elastance in ventricular-arterial coupling in normal gravity
      and altered acceleration environments.
AB  - The role of physiological elastance (Ep) in maximizing external work (EW)
      transfer is not well understood and has not been investigated during microgravity
      and increased acceleration conditions. By better understanding this relationship,
      cardiovascular control mechanisms for meeting metabolic demands during normal
      gravity and altered acceleration stresses may be elucidated. Therefore, the
      objectives of this study were to determine the effect of Ep in maximizing EW of
      the left ventricle and to investigate this relationship during altered
      acceleration states. Ventricular and arterial parameters were estimated using
      established lumped parameter models from isolated beats of experimental data.
      These data were obtained during parabolic flight (0 and approximately 2 Gz) and
      centrifuge runs (approximately 1 to approximately 4 Gz) where acceleration was
      used to drive the cardiovascular system into a wide range of physiologic
      operating and coupling conditions. Parameter estimates at each Gz level were used
      in a series of computer simulations in which Ep was varied over a wide range to
      find the point of maximum EW for that coupling condition. Cardiac output and mean
      arterial pressure were maintained throughout the simulation process by adjusting
      heart rate. Results of the simulation showed that as arterial elastance decreased
      from its initially estimated (physiologic) value, external work increased
      slightly and as elastance increased, external work decreased. In particular, we
      found that the arterial elastance was set at a point near that which would
      produce maximal external work. In addition, it was found that altered Gz states
      may affect the Ep-EW relationship.

PMID- 11194988
TI  - The effects of age and sex on susceptibility to motion sickness.
AB  - BACKGROUND: The present investigation is concerned with the role of sex, age and
      experience in determining motion sickness susceptibility. HYPOTHESIS: Motion
      sickness susceptibility varies with sex and age, and may be related to the level
      of physical activity sustained by the individual. METHODS: Three surveys were
      conducted. The first included school age children (9-18 yr) and addressed motion
      experience and motion sickness on 13 forms of transport. The second questionnaire
      sought to determine whether these sex differences could be understood in terms of
      differential involvement in various forms of physical activity. The third survey
      addressed the role of age and sex effects in a college age population. RESULTS:
      The first study revealed significantly greater motion sickness for female as
      compared with male subjects on devices with which both groups were equivalent in
      terms of exposure history. The second study showed little relation between an
      individual's level of physical activity and susceptibility to motion sickness.
      The results of the third study were in essential agreement with the first survey
      and revealed no significant interactions between age and sex, suggesting that sex
      differences remain stable across this age range. CONCLUSION: Our conclusions
      regarding these surveys are that sex differences in motion sickness do not vary
      significantly with age and cannot be accounted for by differences in exposure to
      motion or physical activity. There was also little evidence for the notion that
      men are more reticent to report motion sickness.

PMID- 11194989
TI  - Positive end expiratory pressure (PEEP) slightly modifies ventilatory response
      during incremental exercise.
AB  - To clarify the ventilatory effects of a 5-cm H2O positive end expiratory pressure
      (PEEP) in healthy men during incremental exercise in normoxic conditions, 22
      subjects were subjected to a constant workload (0 W, 50 W, 100 W, 150 W and 200
      W) on a cycle ergometer for periods of 8 min each, both with and without 5-cm H2O
      PEEP. Results show that PEEP increases inspiratory (TI) and expiratory (TE)
      duration and tidal volume (VT) and decreases breathing frequency (fB) at rest (p
      < 0.05). During exercise, TI is higher at 50 W and 100 W (p < 0.05), but not at
      150 and 200 W. TE only increases at 50 W (p < 0.05). An increased VT (p < 0.05 at
      50, 100 and 150 W) and a decreased fB (p < 0.05 throughout the experiment) were
      observed. However, mean inspiratory flow (VT/T1) and duty cycle (TI/TT) were
      unaffected by PEEP. In conclusion, this study shows that a 5-cm H2O PEEP slightly
      modifies the ventilatory parameters in healthy subjects during incremental
      exercise in normoxic conditions.

PMID- 11194990
TI  - Energy cost of physical task performance in men and women wearing chemical
      protective clothing.
AB  - BACKGROUND: Chemical protective clothing (CPC) is required to perform certain
      occupations and is known to inhibit physical performance. Few data are available
      that quantify the physiological response of men and women during task performance
      while wearing CPC. HYPOTHESIS: The mobility of a task will have a significant
      effect on the change in energy cost. The energy cost of wearing CPC will be
      greater in women than men during physical task performance. METHODS: Energy cost
      (VO2) and the psychophysical scales, rating of perceived exertion (RPE) and
      respiratory distress (RD), were measured in 32 men and 26 women during the
      performance of 31 physical tasks. Tasks were categorized by mobility: stationary,
      intermittent or continuous. Between 6-12 men and 5-13 women conducted each task
      wearing 2 clothing conditions: battle-dress uniform (BDU, wt = 3.7 kg) and (CPC,
      wt = 9.3 kg). RESULTS: VO2 L x min(-1), was higher in CPC compared with BDU for
      the continuous task category for both genders. However, when VO2 (ml x kg(-1)
      clothed wt x min(-1)) was normalized for clothing weight, there remained a
      significant clothing effect for the continuous category, but there were no gender
      differences. VO2, expressed as a % VO2max, was significantly increased for BDU
      compared with CPC for the continuous task category only. This difference was
      significantly greater for women than men. Women exercised at a higher % VO2max
      and reported a higher RPE than men for all categories in both BDU and CPC. Both
      genders reported higher RD wearing CPC for the continuous task category only.
      CONCLUSIONS: There is an increase in energy cost wearing CPC during continuous
      tasks which can be attributed to both the clothing weight and the hobbling
      effect. Wearing CPC is more physiologically and psychologically demanding for
      women than men, especially when performing tasks of a continuous nature.

PMID- 11194991
TI  - Heat strain imposed by toxic agent protective systems.
AB  - This study evaluated physiological heat strain from two developmental toxic agent
      protective systems compared with the standard Toxicological Agent Protective
      (TAP) suit during exercise-heat stress. Eight subjects (six men, two women)
      completed three experimental trials, at 38 degrees C, 30% rh, wearing: 1) Self
      Contained Toxic Environment Protective Outfit (STEPO) with rebreather (STEPO-R);
      2) STEPO with tether (STEPO-T) or 3) the standard TAP. The STEPO systems provided
      effective body cooling of: STEPO-R, 200 +/- 36 W; and STEPO-T, 186 +/- 59 W. TAP
      had no cooling. All experimental trials used treadmill walking at 0.89 m x s(-1),
      0% grade at exercise/rest cycles of 20/10 min for 240 min. Metabolic rates for
      the treatments were: STEPO-R, 298 +/- 26 W; STEPO-T, 299 +/- 34 W; and TAP, 222
      +/- 40 W. Rate of heat storage was less (p < 0.05) in STEPO-R (37 +/- 8 W x m(
      2)) and STEPO-T (38 +/- 12 W x m(-2)) than in TAP (77 +/- 15 W x m(-2)). Sweating
      rate was less (p < 0.05) in STEPO-T (10.0 +/- 4.8 g x min(-1)) than in TAP (23.8
      x 11.4 g x min(-1)). There was no difference between STEPO-R (12.3 +/- 5.6 g min(
      1)) and the other two uniform systems. Subjects did not complete targeted
      exposure times of 240 min. Exposure time was longer (p < 0.05) in STEPO-R (83 +/-
      22 min) and STEPO-T (106 +/- 39 min) than in TAP (46 +/- 10 min). Predicted time
      to 39.0 degrees C was less (p < 0.05) in TAP (69 +/- 20 min) than in either STEPO
      R (226 +/- 124 min) or STEPO-T (244 +/- 170 min). The results of this study show
      that cooling in STEPO significantly reduced heat storage relative to TAP. The new
      generation toxic cleanup uniform systems effectively reduced heat stress and
      increased work capabilities compared with the standard TAP suit.

PMID- 11194992
TI  - Determination of lumbar muscular activity in helicopter pilots: a new approach.
AB  - BACKGROUND: Discomfort in the lumbar region is a frequent complaint of helicopter
      pilots. Two factors that helicopter crewmembers relate to back pain are exposure
      to vibration and poor posture during flight, because during flight the seat and
      controls force the pilot to adopt an asymmetric posture. Repeated exposure to
      these adverse flight conditions could cause pathological changes in the spine.
      The purpose of this study was to compare right and left sided lumbar muscular
      activity in helicopter pilots under real flight conditions, using surface
      electromyography (SEMG) to demonstrate the effects of asymmetrical posture on the
      musculoskeletal system. An attempt was also made to correlate lumbar muscular
      activity with environmental factors and such variables as type of flight, type of
      helicopter, duration of flight, age, physical fitness, and height. METHODS: Right
      and left-sided lumbar electrical activity were measured using two-channel SEMG
      during 35 flights in 2 types of helicopter and a cockpit mock-up. RESULTS: There
      was a statistically significant increase in right-sided lumbar activity when
      related to the duration of flight. CONCLUSIONS: The data showed that when the
      pilot used the manual controls during flight, he did not maintain a symmetrical
      posture and contracted one side more than the other. We think the relationship
      between the greatest right-sided contraction and flight duration is due to
      maintaining an asymmetric posture over a long period. We also noted a tendency
      towards greater right lumbar musculature activity in older pilots.

PMID- 11194993
TI  - Impact evaluation of the Royal Australian Air Force health promotion program.
AB  - BACKGROUND: In 1981, the Royal Australian Air Force (RAAF) introduced an
      intensive health promotion program (HPP), the purpose of which was to control
      preventable diseases, particularly cardiovascular disease (CVD), linked to
      lifestyle-related risk factors. However, the RAAF HPP's effectiveness had not
      been appropriately evaluated since its implementation. HYPOTHESIS: The RAAF HPP's
      interventions have reduced, beyond secular trends, the prevalence of lifestyle
      related CVD risk factors. METHODS: Retrospective cross-sectional risk factor
      prevalence surveys of randomly selected RAAF pilots and navigators were conducted
      for the years 1980, 1983 and 1989. The survey results for RAAF subjects were
      compared with the results obtained for demographically similar subjects
      participating in National Heart Foundation (NHF) Risk Factor Prevalence Study
      (RFPS) surveys for the same periods, using chi2 and Mantel-Haenszel (M-H) chi2
      tests, and 1-way and 2-way ANOVA. RESULTS: Over the survey periods, the
      prevalence of overweight and obesity decreased by 8% in RAAF subjects and
      increased by 7% in NHF subjects, and mean total serum cholesterol decreased by 8%
      in RAAF subjects while remaining static in NHF subjects. Participation in
      vigorous physical activity increased among RAAF, but not NHF, subjects. The
      results for most other risk factors showed significant differences between RAAF
      and NHF subjects, but trends were comparable over survey periods. CONCLUSIONS: On
      balance, reductions in the prevalence of overweight and obesity, and mean serum
      cholesterol in RAAF subjects were probable effects of the RAAF HPP. Other
      observed differences in CVD risk factors between RAAF and NHF groups were
      attributable to the RAAF aircrew selection process, or other RAAF-specific
      influences. The study thus provides qualified support for the hypothesis,
      although effects were less evident in older RAAF subjects.

PMID- 11194994
TI  - Factors associated with pilot error in aviation crashes.
AB  - BACKGROUND: The importance of pilot error in aviation crashes has long been
      recognized. However, understanding and preventing pilot error remains the
      foremost challenge in aviation safety. OBJECTIVE: This study aims to identify
      pilot characteristics and crash circumstances that are associated with the
      presence of pilot error in a large sample of aviation crashes. METHODS: Different
      data files compiled by the National Transportation Safety Board for 329 major
      airline crashes, 1,627 commuter/air taxi crashes, and 27,935 general aviation
      crashes for the years 1983-96 were merged; and the presence of pilot error was
      analyzed in relation to variables indicating the characteristics of the pilot-in
      command, crash circumstance, and aircraft. Multivariate logistic regression
      modeling was performed to assess the associations of individual variables with
      the likelihood of pilot error given a crash. RESULTS: Pilot error was a probable
      cause in 38% of the major airline crashes, 74% of the commuter/air taxi crashes,
      and 85% of the general aviation crashes. Among the factors examined, instrument
      meteorological condition and on-airport location were each associated with a
      significantly increased odds of pilot error. The likelihood of pilot error
      decreased as pilot certificate rating increased in commuter/air taxi and general
      aviation crashes. Neither pilot age nor gender was independently associated with
      the odds of pilot error. With adjustment for pilot characteristics and crash
      circumstances, flight experience as measured in total flight time showed a
      significant protective effect on pilot error in general aviation crashes.
      CONCLUSIONS: The prevalence and correlates of pilot error in aviation crashes
      vary with the type of flight operations. Adverse weather is consistently
      associated with a significantly elevated likelihood of pilot error, possibly due
      to increased performance demand.

PMID- 11194995
TI  - Age and risk-taking in French naval crew.
AB  - The purpose of this study was to evaluate the effects of age in French naval crew
      on risk-proneness. We tested 130 male navy personnel, age range 19-41 yr, with
      EVAR, a visual analog scale designed to rate risk-proneness and composed of 24
      items distributed among 5 factors: "self control," "danger-seeking" "energy,"
      "impulsiveness," and "invincibility." We observed a significant negative
      correlation between "energy" and age, whereas the other factors were not
      influenced by age. Risk-proneness change is limited and should not be a safety
      issue in the decision-making process if the age of navy crews is going to
      increase moderately.

PMID- 11194996
TI  - Louis H. Bauer, M.D., and the first civil U.S. aeromedical standards: his
      continuing legacy.
AB  - Louis Hopewell Bauer, M.D. (1888-1964) promulgated the first civil aviation
      medicine regulations for U.S. civil airmen on December 31, 1926. Major elements
      of these regulations are reflected in the current Federal Aviation Administration
      Civil Airman Medical Standards, these latter including modifications resulting
      from medical and aeronautical technical advances. Dr. Bauer's plans covering
      periodic examinations, waivers, and a system implemented through designated
      "Aviation Medical Examiners" are continued to this day. Dr. Bauer founded the
      progenitor of the present Aerospace Medical Association in 1929, the Aero Medical
      Association. Further, he founded the Journal of Aviation Medicine, the
      predecessor of the present Aviation, Space, and Environmental Medicine journal,
      the first issue published in March, 1930. Dr. Bauer's influence in medicine
      broadened to include the presidency of the American Medical Association (1952-3)
      and a long standing leadership role with the World Medical Association. His 1926
      textbook, Aviation Medicine, stands as an historic centerpiece in the evolution
      of aviation medicine. Bauer's leadership and contributions to civil aviation
      medicine came at the right time to enhance the development of U.S. civil aviation
      and civil aviation safety.

PMID- 11194997
TI  - The experience of nausea during sustained hyper-gravity flight with negligible
      angular velocity.

PMID- 11194998
TI  - Fatigue modeling.

PMID- 11195000
TI  - Operational physiology in the U.S. Navy.

PMID- 11194999
TI  - Brief exposure to -Gz reduces cerebral perfusion pressure during subsequent +Gz
      stress in rats.
AB  - INTRODUCTION: In humans, +Gz exposure immediately preceded by exposure to zero or
      -Gz can result in unexpected incapacitation ("push-pull" effect). Our goals were
      to establish whether this phenomenon exists in rats and to evaluate the
      importance of varying the duration of -Gz exposure on magnitude of the push-pull
      effect on cerebral perfusion pressure. METHODS: Eight conscious male rats were
      studied in the transition from +5 Gz to +10 Gz imposed by centrifugation. This
      was done with (push-pull) or without (control) 2 s exposure to -5 Gz applied
      using a counterbalanced design. Seven isoflurane anesthetized rats were studied
      in the transition from 0Gz (+1Gy) to + 1Gz imposed by tilting. This was done with
      (push-pull) or without (control) 0.5, 1, 3, or 9 s exposure to -1Gz imposed
      immediately prior to the transition applied using a counterbalanced designed.
      RESULTS: Exposure to 2 s of -5 Gz significantly (p < 0.01) reduced carotid artery
      pressure in the 4th through 8th s of exposure to +10 Gz by an average of 15 mmHg
      compared with control. In the tilt experiments, a push-pull effect was found with
      mild Gz exposure (+/-1Gz) with as little as 0.5 s -Gz exposure. Varying the head
      down dwell time did not alter the magnitude of the exaggerated hypotension
      induced by "push-pull" (p = 0.90). CONCLUSIONS: We conclude that rats express a
      "push-pull" effect similar to that observed in humans but that altering the
      duration of exposure to -Gz does not influence the magnitude of the "push-pull"
      effect.

PMID- 11195001
TI  - Tumour vaccines: a new immunotherapeutic approach in oncology.
AB  - Substantial progress has been made in vaccine development in recent years for the
      treatment of malignant diseases. New technologies have fostered the
      identification of potentially immunogenic tumour antigens that can be used to
      activate the patient's immune system to specifically recognize and destroy human
      tumour cells. More detailed insights into the process of intracellular protein
      degradation, processing and cell surface presentation have allowed immunogenic
      peptide domains to be identified that can be used in vaccine trials. Still a
      matter of intensive debate is the question of the most optimal presentation of
      tumour-derived proteins or peptides to the immune system to achieve a maximum
      response. In this area, major progress has been made by using dendritic cell or
      even naked DNA-based vaccines. The generation of new tools such as HLA-tetramer
      complexes now allows researchers to monitor more closely the expansion of peptide
      specific T cells under the process of vaccination. On the basis of these
      advances, a couple of vaccine trials have been performed that have increased our
      knowledge of vaccine development and provided indications that the concept of
      tumour-specific vaccination might be valid. However, we are still at the
      beginning of this process and should always remember that only well-designed,
      prospective clinical trials can define the optimal use of tumour vaccines in
      oncology.

PMID- 11195002
TI  - Effects of interferon-alpha2b treatment on ex vivo differentiation of mast cells
      from circulating progenitor cells in a patient with systemic mastocytosis.
AB  - Interferon (IFN)-alpha, a known inhibitor of myelopoiesis, is increasingly used
      to treat patients with systemic mastocytosis (SM). However, the mechanisms of IFN
      alpha effects on mast cell (MC) growth remain unknown, and the treatment
      responses may be variable. In the present study, factor-dependent ex-vivo
      differentiation of MCs from peripheral blood mononuclear cells (PBMNCs) was
      analyzed in a patient with SM treated with IFN-alpha2b (3 million U/day). The
      patient exhibited an extensive MC infiltration in his bone marrow (BM) and
      increasing serum total tryptase levels (spiking to > 1,400 ng/ml). PBMNCs were
      collected before and during IFN-alpha2b treatment and cultured in the presence or
      absence of stem cell factor (SCF, 100 ng/ml) for 42 days. In the absence of SCF,
      no MC growth was detectable. However, in the presence of SCF, MC containing
      tryptase appeared in the cultures. Treatment with IFN-alpha2b resulted in a time
      dependent decrease in SCF-inducible formation of MCs from PB progenitor cells in
      vitro. Also, during IFN-alpha2b treatment, blood histamine concentrations
      decreased. Serum total tryptase levels initially increased despite IFN-alpha2b
      treatment. However, after a latency period of a few months, tryptase
      concentrations declined and then reached a plateau. In healthy individuals, the
      SCF-induced in vitro growth of MCs from their progenitor cells was also
      inhibitable by the addition of IFN-alpha2b. In summary, our data show that IFN
      alpha2b can exhibit inhibitory effects on factor-dependent growth of MC
      progenitor cells. However, it still remains open which of the patients with
      mastocytosis can benefit from long-term IFN-alpha treatment.

PMID- 11195003
TI  - GP130 and c-kit signalling, initiated by the sIL-6R/IL-6 complex, is insufficient
      to expand the primitive adult bone marrow CD34+CD38- pre-CFU cell.
AB  - It has previously been shown that gp130 and c-kit signalling synergize for the ex
      vivo expansion of human cord blood (CB) CD34+ haematopoietic progenitor cells. We
      were interested in evaluating this synergy within an ontogenetically different
      haematopoietic tissue [i.e. adult bone marrow (BM)] and on a more primitive
      progenitor subset (i.e. CD34+ CD38-cells), which are highly enriched for pre
      colony forming unit (CFU) cells. These cells were plated out in a primary liquid
      culture supplemented with either interleukin (IL)-6+stem cell factor (SCF), IL-6+
      SCF+soluble IL-6 receptor (sIL-6R), IL-6+SCF+sIL-6R+IL3+IL-1 or SCF+IL-3+IL-6+IL
      1. Cell counting after liquid culture revealed an absolute expansion of 2.2-, 4.1
      , 89.5- and 65.7-fold compared with initial cell input for the four-cytokine
      combinations, respectively. The secondary read-out assay revealed that this cell
      expansion in the liquid culture also resulted in CFU generation, with absolute
      cloning efficiencies of 0.002, 0.024, 12.13 and 7.73 (per cell initially present)
      for the respective cytokine combinations. These results indicate that gp130 and c
      kit signalling alone (i.e. using IL6+SCF+sIL-6R), in terms of both cell number
      and CFU generation, insufficiently stimulate primitive adult BM CD34+CD38-
      haematopoietic cells in order to reach a CFU generation comparable with that
      obtained after multifactor stimulation. Adding sIL-6R to the multifactor
      stimulation and compared with this multifactor stimulation, a 1.7-fold synergy in
      terms of cell expansion and a 3.0-fold synergy in terms of CFU generation are
      obtained. The sIL-6R/IL-6 complex thus has a narrower spectrum of action on
      primitive adult BM CD34+CD38- cells than on CB CD34+ cells.

PMID- 11195004
TI  - Immunoelectron microscopic analysis of CD 54 surface distribution and its role in
      homotypic interaction on normal monocytes and blasts of acute myeloid leukemia.
AB  - The role of CD 54 in the homotypic interaction of normal monocytes and the blasts
      of five cases of acute myeloid leukemia (AML) was analyzed by immunoelectron
      microscopy (IEM). The cells were seeded on glass coverslips precoated with an
      electrontransparent melamine resin, which allowed their in situ labeling with
      monoclonal antibodies (MoAb) and subsequent analysis by whole mount
      immunoelectron microscopy (WM-IEM) or transmission immunoelectron microscopy
      (TIEM). Timed incubation of the cells in serum-free medium +/- interferon-gamma
      (IFN-gamma, 500 U/ml) induced a spreading of the monocytes and the blasts of four
      out of five leukemias, characterized by the development of numerous filopodia
      which led to initial cell-cell contacts. In parallel, an increase in CD 54
      surface density in four out of five leukemias could be detected, while no
      evidence of a CD 54 redistribution (capping) on single cells could be observed.
      WM-IEM studies detected no CD 54 molecules in the "early" cell-cell contacts,
      while "later" cell-cell contacts displayed strong CD 54 positivity. These data
      indicate that CD 54 is not involved in initial cell-cell contacts but is shifted
      secondarily to the cell contact sides and may thereby stabilize the adjacent
      membrane areas. The absence of spreading of the CD 54 negative blasts in one out
      of five leukemias and the blockade of the cellular migration by an anti-CD 54
      MoAb (Clone 84H10) in the remaining cases suggest that CD 54 expression is
      necessary for cellular locomotion. The observed inhibitory effect of the anti-CD
      54 MoAb probably mimics a negative circuit that serves to control cellular
      migration.

PMID- 11195005
TI  - Successful autologous bone marrow rescue in patients who failed peripheral blood
      stem cell mobilization.
AB  - We assessed autologous bone marrow (BM) harvest and hematologic recovery after
      high-dose chemotherapy (HDCT) in patients who failed to achieve peripheral blood
      stem cell (PBSC) mobilization. One hundred and ninety-three patients with germ
      cell tumor, malignant lymphoma, sarcoma or medulloblastoma were scheduled for
      HDCT. In 123 patients, PBSC were mobilized by disease-specific chemotherapy plus
      granulocyte colony-stimulating factor (G-CSF). In 110/ 123 patients (89%) with
      circulating CD34+ cell counts 2 > or = 10/microl, sufficient hematopoietic
      autografts were collected (group A). In 13/123 patients (11%) with peripheral
      CD34 + cell counts < 10/microl, PBSC harvesting was not performed (group B).
      These latter patients were classified as "poor mobilizers" and underwent second
      line BM harvest at a median of 46 (range 10-99) days after mobilization failure.
      Seventy patients with first-line BM harvest (group C) acted as historical
      controls. Ten patients from group B proceeded to HDCT and nine were evaluable for
      hematopoietic reconstitution. Recovery to neutrophils >0.5 x 10(9)/l was
      comparable with group C patients: 16 (range 9-34) days vs 13 (range 8-98) days.
      However, platelet (PLT) reconstitution >20 x 10(9)/l was significantly slower,
      with a median of 35 (range 13-50) days as compared with 19 (range 9-148) days (P
      = 0.0106) for control patients. Supportive care requirements, febrile days and
      length of hospital stay were not significantly different between the two groups
      of patients. We conclude that patients who fail to mobilize PBSC should be
      evaluated for second-line BM harvest. This approach may preserve the therapeutic
      option of HDCT for these patients.

PMID- 11195006
TI  - Plasma kinetics of an artificial emulsion resembling chylomicrons in patients
      with chronic lymphocytic leukemia.
AB  - Chylomicrons are the lipoproteins that transport dietary lipids in the blood.
      Although neoplastic diseases are often accompanied by alterations in lipid
      metabolism, chylomicrons are scarcely explored in cancer, despite their
      importance for the body's energy supply. Moreover, no data are available
      regarding chylomicron metabolism in chronic lymphocytic leukemia (CLL).
      Chylomicron metabolism in the bloodstream consists of lipolysis by lipoprotein
      lipase and uptake of remnants by the liver and is difficult to assess in the
      human body. Among the methods to evaluate this pathway, the determination of the
      plasma kinetics of triglyceride-rich emulsions that mimic chylomicrons is a
      practical and straightforward approach. A double-labeled chylomicron-resembling
      emulsion was injected into 10 patients with CLL and into 11 normolipidemic
      healthy subjects. The plasma kinetic curves of the emulsion 3H-triglyceride and
      14Ccholesteryl ester were determined in plasma samples collected over 30 min. The
      fractional clearance rate (FCR) of triglycerides in CLL was not changed compared
      with controls. The FCR of cholesteryl esters was also no different from controls.
      These results indicate that chylomicron lipolysis and remnant removal are not
      affected in CLL.

PMID- 11195007
TI  - Intracranial hemorrhage in children with immune thrombocytopenic purpura.
      Japanese Study Group on childhood ITP.
AB  - We sent questionnaires to hospitals in Japan in order to study the incidence and
      conditions of intracranial hemorrhage (ICH) in children with immune
      thrombocytopenic purpura (ITP). From 1980 to 1995, 11 cases of ICH were reported
      in eight patients with ITP at 35 institutions. One patient had ICH four times,
      but only one patient died of the condition. From 1990 through 1995, ICH occurred
      in four (0.52%) of 772 patients with ITP. None of the patients died. The platelet
      count when ICH occurred was 5.2 +/- 3.7 x 10(9)/l (mean +/- SD) (n = 11). Four of
      the eight patients (1980-1995) had received active treatment [e.g. intravenous
      immunoglobulin G (i.v. IgG)] immediately before ICH occurred. In seven cases
      (1980-1995), possible causes of ICH, including menstruation (n = 2) and viral
      infections (n = 3), were identified. Systemic lupus erythematosus (SLE) later
      developed in three patients. Although the incidence of ICH in children with ITP
      has not decreased compared with the rates in earlier studies, the mortality rate
      has decreased markedly. Our results suggest that menstruation, infection, and
      risk factors for progression to SLE may help to predict ICH in children with ITP.
      Large-scale prospective trials are needed to identify risk factors for ICH.

PMID- 11195008
TI  - Acute respiratory distress syndrome following intrathecal methotrexate
      administration: a case report and review of  literature.
AB  - Acute Respiratory distress syndrome (ARDS) is a rare complication following
      intrathecal (IT) injection of methotrexate (MTX) in adult acute lymphoblastic
      leukemia (ALL) patients. A 19-year-old man with ALL developed strikingly acute
      respiratory failure during central nervous system (CNS) prophylaxis with IT MTX
      administration and cranial irradiation. Histopathologic study of the lungs
      revealed a pattern of diffuse alveolar damage with interstitial cellular
      infiltration. His symptoms were relieved soon following treatment with
      corticosteroids and the pulmonary infiltrates resolved gradually. Pulmonary
      symptoms did not recur as he was continuously treated with oral corticosteroids.

PMID- 11195009
TI  - Lymphoma of bone with initial presentation as a calvarial mass.
AB  - A 21-year-old man was examined for a right frontal skull mass that had been
      present for 4 months. Excision biopsy of the mass revealed diffuse large B-cell
      lymphoma. Subsequent studies showed right preauricular lymphadenopathy but no
      systemic involvement. The patient was treated with six courses of CHOP
      (cyclophosphamide, adriamycin, vincristine, and prednisolone) with adjuvant whole
      brain irradiation and achieved a complete remission.

PMID- 11195010
TI  - Complete remission of generalized relapsed extranodal marginal zone B-cell
      lymphoma of mucosa-associated lymphoid tissue type of the gastrointestinal tract
      after high-dose chemotherapy and autologous peripheral stem cell transplantation.
AB  - Due to their homing properties, extranodal marginal zone B-cell lymphoma (MZBL)
      of mucosa-associated lymphoid tissue (MALT) type remain localized for long
      periods of time, and therefore have an excellent prognosis. However, if
      generalization and/or transformation into a diffuse large-cell lymphoma occurs,
      the prognosis deteriorates and no established treatment concepts are yet
      available. We report about a 57-year-old female patient with relapsed transformed
      stage-IV extranodal MZBL of MALT type of the entire gastrointestinal tract who
      was successfully treated using salvage chemotherapy followed by BEAM conditioning
      [BCNU 1,3-bis-2-(chloroethyl-1-nitrosourea), etoposide, cytosine arabinoside, and
      melphalan] and autologous peripheral stem cell transplantation. Follow-up
      revealed a sustained complete remission for 22 months.

PMID- 11195011
TI  - Treatment of supraventricular tachycardias in the new millennium--drugs or
      radiofrequency catheter ablation?
AB  - Supraventricular tachycardias are a cause of significant morbidity in children.
      Newer anti-arrhythmic drugs and the invention of radiofrequency catheter ablation
      have revolutionised anti-arrhythmic therapy in children. CONCLUSION: With the
      availability of these very effective therapeutic options, an improved knowledge
      of these methods and their indications is required.

PMID- 11195012
TI  - Cerebral spinal fluid flow, venous drainage and spinal cord compression in
      achondroplastic children: impact of magnetic resonance findings for decompressive
      surgery at the cranio-cervical junction.
AB  - In order to investigate the diagnostic properties of MRI of the brain and spine
      in achondroplastic children with regard to decompressive surgery, 25 patients
      were examined by conventional morphological and by "functional" imaging of CSF
      flow and magnetic resonance angiography (MRA) of the veins and sinuses at the
      cranial base following a special protocol. The results were compared to those
      from age-matched controls and were correlated with each other and retrospectively
      with the neurological findings. Measurements of distances and angulations at the
      cranio-cervical junction (CCJ) from MR scans showed similar values to those from
      conventional radiographs and CTs and thus can be used without correction for
      spatial distorsion. Signs of cervical medullary compression, myelomalacia and
      intramedullary cyst formation were found in six, seven and three children
      respectively. These alterations correlated significantly with each other (P <
      0.05). Semiquantitative evaluation of CSF flow demonstrated interruption of CSF
      pathways at the CCJ, which correlated with CCJ narrowing (P < 0.05). MRA showed a
      significant narrowing of the jugular foramina with a variable compensatory
      enlargement of the emissary veins and a significant reduction of the total
      outflow area (P < 0.01). There were no significant correlations between these MR
      changes and neurological deficits. CONCLUSION: Due to this unexpectedly poor
      correlation between magnetic resonance and clinical findings in achondroplastic
      children, the present role of magnetic resonance in the clinical setting is
      limited to the demonstration of spinal cord compression in individual cases. In
      three of our patients with prominent neurological abnormalities, the severe
      changes demonstrated by magnetic resonance imaging strongly supported the
      indication for surgical decompression.

PMID- 11195013
TI  - Effects of enzyme replacement therapy in thirteen Japanese paediatric patients
      with Gaucher disease.
AB  - To determine treatment effects in the unique and previously internationally
      unreported Japanese paediatric patient population with Gaucher disease (GD), we
      analysed six response parameters among 13 patients given enzyme replacement
      therapy (ERT). Also to obtain insights into optimising maintenance dosing,
      through subgroup analysis we retrospectively examined effects of three ERT dose
      reduction schedules from a starting regimen of 60 U/kg of body weight every 2
      weeks. Our patients included 11 males and two females, 11 individuals with
      possible type 1 and two individuals with type 3b GD, six individuals with the
      L444P/F2131 genotype and five with the L444P/L444P genotype, and five who had
      been splenectomised. Despite different mutation prevalence, Japanese patients
      with GD, like their counterparts from other ethnic groups, generally benefitted
      from ERT. However, early and marked ERT dose reduction (from 60 U/kg to 30 or 15
      U/ kg every 2 weeks within < or =6 months) was associated with insufficient
      improvement of mean haemoglobin level and relative height and with insufficient
      improvement or worsening of platelet count. Only the subgroup given 60 U/kg of
      ERT every 2 weeks for 36 months had significant improvement in mean haemoglobin,
      platelet count, angiotensin-converting enzyme and acid phosphatase levels and
      relative height at 36 months. CONCLUSION: These data suggest that long-term high
      dose enzyme replacement therapy may be required to obtain sufficient improvement
      to maintain health among paediatric patients with severe Gaucher disease.

PMID- 11195014
TI  - Clinical presentation of congenital sialidosis in a patient with a neuraminidase
      gene frameshift mutation.
AB  - Congenital sialidosis is a rare lysosomal storage disease caused by a primary
      neuraminidase deficiency which results from defects in the neuraminidase gene on
      chromosome 6p. The inheritance is autosomal recessive. Patients exhibit excessive
      urinary excretion of bound sialic acid and decreased or undetectable amounts of
      neuraminidase activity in various tissues. The clinical expression is variable,
      but ascites and hepatosplenomegaly are hallmarks of the disease. Skeletal
      abnormalities, facial dysmorphism and inguinal herniae have been described in
      most of the few reported cases. We describe a baby girl with biochemically proven
      sialidosis, who in addition to the above clinical features, had severely dilated
      coronary arteries, excessive retinal vascular tortuosity and an erythematous,
      macular rash. Homozygosity for a frameshift mutation at residue 623 of the
      neuraminidase cDNA was found. We speculate that the additional features found in
      our patient might be associated with the here described genotype of congenital
      sialidosis. CONCLUSION: Severely dilated coronary arteries, excessive retinal
      vascular tortuosity and an erythematous macular rash might be associated features
      of congenital sialidosis.

PMID- 11195015
TI  - Parental information needs in chronic renal failure and diabetes mellitus.
AB  - The information needs of parents of children with end stage renal failure (ESRF)
      or with insulin dependent diabetes mellitus (IDDM) were assessed by
      questionnaires over a 2-year period. Questionnaires were posted on seven
      occasions at 4-monthly intervals and were sent to both mothers and fathers. Most
      information needs were reported to be for detailed test results, for new
      information about the condition and about the child's future social development.
      Questions responsible for the three highest scores were concerned with the
      future: the child's fertility; their social, career and marriage prospects; and
      the hope for a new improved treatment. For the IDDM mothers, scores were
      significantly different depending on age of the child (P = 0.02). Change in
      treatment mode had no significant effect on the information needs of parents of
      children with ESRF (P = 0.81). Occupation was significantly associated with the
      mean general information needs scores for parents, with occupations of a lower
      socioeconomic status associated with higher information needs scores. There were
      no significant differences between the reported mean general information needs
      scores of parents of children with ESRF and of parents of children with IDDM (P =
      0.69) or between mothers and fathers mean general information needs scores (P =
      0.58). CONCLUSION: Multidisciplinary team members need to tailor information to
      the needs of the individual families and be sensitive to socioeconomic factors
      and communication issues.

PMID- 11195016
TI  - A major role of viruses in convulsive status epilepticus in children: a
      prospective study of 22 children.
AB  - A group of 22 previously healthy children with their first convulsive status
      epilepticus (SE), treated at Kuopio University Hospital, Finland, were
      prospectively studied. Eleven children had febrile and 11 afebrile SE. Polymerase
      chain reaction was used to detect specific DNA from CSF, enzyme immunoassays and
      immunofluorescence assays to detect specific antibodies in serum and CSF, viral
      cultures were obtained from CSF, throat and stool and antigen detection from
      throat specimens. Viral infection was identified in 10 of 11 children with
      febrile SE (91%) and in 7 of 11 with afebrile SE (64%). Human herpes virus 6
      infection was identified in 12 children (55%), and in at least six of them the
      infection was primary. Single cases of human herpes virus 7, parainfluenza 3,
      adenovirus 1, echovirus 22, rota, influenza A and Mycoplasma pneumoniae infection
      were diagnosed. CONCLUSION: Viruses, human herpes virus 6 in particular, seem to
      be major associated factors in convulsive status epilepticus, both febrile and
      afebrile. Human herpes virus 7 and Mycoplasma pneumoniae are novel agents
      associated with status epilepticus.

PMID- 11195018
TI  - Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective
      clinical study and review of the literature.
AB  - We performed a retrospective study of all children with Pierre Robin sequence
      (PRS), admitted to our hospital from 1981-1998 in order to evaluate diagnosis,
      treatment and prognosis. Patients were divided into two categories: isolated PRS
      (group 1) and PRS plus, i.e. PRS as part of a more complex syndrome (group 2). A
      total of 74 patients with PRS were found, 29 (39%) males and 45 (61%) females of
      whom 47 (63.5%) could be categorised as isolated PRS and 27 (36.8%) as PRS plus.
      The most frequent diagnoses in patients with PRS plus were Stickler syndrome and
      the velocardiofacial syndrome. Ophthalmological and fluorescent in situ
      hybridisation of chromosome 22 investigations should therefore be performed in
      all patients, as soon as the diagnosis of PRS is established. Some form of airway
      treatment was necessary in the majority of patients (52 of 74), most could be
      treated conservatively with prone/lateral positioning and close observation.
      Endotracheal intubation was necessary in one child from group 1 versus five from
      group 2. Tracheostomy was performed in three children from group 1 and two from
      group 2. Feeding problems occurred in about 25% of all PRS patients and stunted
      growth was seen especially in boys with isolated PRS before the age of 10 months.
      CONCLUSION: In our series, 33% of patients with Pierre Robin sequence plus had
      Stickler and velocardiofacial syndromes. Conservative airway management was a
      sufficient treatment for respiratory problems in the majority of patients.
      Feeding and growth need special attention in patients with Pierre Robin sequence.

PMID- 11195017
TI  - Gingival bleeding, epistaxis and haematoma three days after gastroenteritis: the
      haemorrhagic lupus anticoagulant syndrome.
AB  - A 3 year and 9 month-old girl presented with gingival bleeding, epistaxis, and
      multiple haematomas 3 days after an acute episode of gastroenteritis. Prothrombin
      time and activated partial thromboplastin time were prolonged with reduced
      clotting activity of factor II (< 10%), VIII (<1%), IX (3%), XII (10%) and
      evidence of a high titre inhibitor. Prothrombin (factor II) level was below the
      detection limit, both in a functional and immunological assay. It did not
      increase after administration of vitamin K or fresh frozen plasma. Further
      studies revealed presence of a strong lupus anticoagulant and a specific IgG
      antibody against prothrombin. Factor VIII antigen levels also were reduced (31%),
      but to a lesser extent than functionally determined factor VIII (<1%). Blood
      coagulation normalised following clinical recovery 6 weeks after admission. The
      pathophysiology of this acquired inhibitor phenomenon (accelerated clearance of
      complexes of clotting factors and phospholipids) is discussed. CONCLUSION: The
      haemorrhagic lupus anticoagulant syndrome (acquired hypoprothrombinaemia lupus
      anticoagulant syndrome) is a rare presentation of acquired bleeding diathesis in
      childhood. Since most cases in post-infectious children are asymptomatic, it
      might be underdiagnosed. In children with newly appearing bleeding symptoms or
      unclear prolonged prothrombin time or activated partial thromboplastin time, one
      has to consider this syndrome which could lead to relevant bleeding.

PMID- 11195019
TI  - Velofacial hypoplasia (Sedlackova syndrome): a variant of velocardiofacial
      (Shprintzen) syndrome and part of the phenotypical spectrum of del 22q11.2.
AB  - In 1955, a pattern of velar hypoplasia causing hypernasal speech and associated
      facial dysmorphism was observed in 26 children of Czech origin. Further cases
      with submucous cleft and/or cardiac anomalies were described. In 1978
      velocardiofacial syndrome (VCFS) was reported, a condition very similar to
      velofacial hypoplasia (Sedlackova syndrome) apart from overt clefts instead of
      velar hypoplasia. In 1990 it was suggested that both syndromes might be variants
      of the same clinical entity. To test this hypothesis we performed fluorescence in
      situ hybridisation using the DiGeorge/VCFS region specific probe D22S75 on 20
      patients originally classified as Sedlackova syndrome as well as molecular
      investigations for a subset of these patients. A 22q11.2 deletion was found in
      16/20 patients. Thus, our results confirm the aforementioned hypothesis and
      expand the long list of clinical diagnoses associated with del 22q11.2.
      CONCLUSION: Velofacial hypoplasia (Sedlackova syndrome) and velocardiofacial
      (Shprintzen) syndrome have a corresponding phenotype and are both associated with
      del 22q11.2.

PMID- 11195020
TI  - Deficiency of CD4+ lymphocytes due to intestinal loss after Fontan procedure.

PMID- 11195021
TI  - Liver abnormality in Turner syndrome.

PMID- 11195022
TI  - The relatively short duration that a child retains a pacifier in the mouth during
      sleep: implications for sudden infant death syndrome.
AB  - The relatively short duration that a child retains a pacifier in the mouth during
      sleep has implications when the mechanism(s) of the apparent prophylaxis effect
      of pacifier use against sudden infant death syndrome are considered.

PMID- 11195023
TI  - Caudal blockade as alternative therapeutic approach in neonatal arterial
      thrombosis.
AB  - Considering the high frequency of bleeding complications following fibrinolytic
      treatment, caudal blockade could be used in association with lower doses of
      tissue plasminogen activator as a possible new therapeutic approach in management
      of arterial thrombosis in neonates.

PMID- 11195024
TI  - Improvement of neurological symptoms by enzyme replacement therapy for Gaucher
      disease type IIIb.
AB  - Enzyme replacement therapy might improve chronic liver dysfunction and contribute
      to the resolution of basal ganglia lesions in patients with type 3b Gaucher
      disease.

PMID- 11195025
TI  - Incontinentia pigmenti: a report of ten cases.
AB  - A multidisciplinary approach is necessary in the care of patients with
      incontentia pigmenti (Bloch-Sulzberger syndrome).

PMID- 11195026
TI  - Successful treatment of acquired undescended testes with human chorionic
      gonadotropin.
AB  - Human chorionic gonadotrophin therapy may have its place in the management of
      acquired undescended testes and surgery should be reserved for those who fail to
      respond to therapy. Further studies are necessary to evaluate these preliminary
      results.

PMID- 11195027
TI  - Partial agenesis of the corpus callosum with partial seizures and bilateral
      congenital lacrimal duct atresia.
AB  - Patients with partial agenesis of the corpus callosum can be readily detected by
      magnetic resonance imaging.

PMID- 11195028
TI  - Impaired autonomic control of the heart by SOX10 mutation.
AB  - The autonomic nervous system plays an important role in the generation of complex
      heart rate dynamics that enable an organism to adapt to stress. Little is known
      about genes influencing the development of this autonomic control of the heart.
      We suggest the SOX10 gene to be a candidate for this process.

PMID- 11195029
TI  - Premature adrenarche, increased growth velocity and accelerated bone age in male
      patients with Prader-Labhart-Willi syndrome.
AB  - Premature adrenarche/pubarche in male patients with Prader-Labhart-Willi syndrome
      may be associated with increased growth velocity and bone age acceleration.

PMID- 11195030
TI  - Lipopolysaccharide-induced nasal cytokine response: a dose-response evaluation.
AB  - Information on the dose-response relationship is a prerequisite to defining the
      non-response threshold of exposure. We investigated whether nasal
      lipopolysaccharide (LPS) challenges induce an inflammatory response in a dose
      dependent way. In three settings nasal lavage was performed before, and 20 min,
      1, 6, 23, and 29 h after instillation of 0 microg, 10 microg, and 40 microg LPS
      for 10 s, in seven healthy subjects. Lavage fluids were analysed for
      concentrations of interleukin-6 (IL-6), IL-8, tumour necrosis factor-alpha (TNF
      alpha), histamine, and albumin. Symptoms were recorded by questionnaire and
      spirometric lung function was assessed after each lavage. The instillation of 40
      microg LPS caused a small increase in nasal symptoms. TNF-alpha was below the
      detection limit (0.5 pg/ml) in most subjects and, like IL-8 and albumin, showed
      no relation to the LPS challenge. IL-6 increased over twofold with 10 microg LPS
      and over 13-fold with 40 microg LPS, with a peak at 6 h after LPS provocation,
      and the repeated design ANOVA was significant for dose and for time. Six hours
      after the 40 microg LPS challenge the histamine level significantly increased
      compared to the saline treatment. We conclude that short-lasting instillation of
      LPS causes a dose-dependent IL-6 release in the upper airways and minor nasal
      symptoms.

PMID- 11195031
TI  - Spontaneous compressive orbital emphysema of rhinogenic origin.
AB  - We report the case of a young patient who developed spontaneous compressive
      orbital emphysema after an attack of coughing. At admission the patient presented
      left proptosis, diplopia, vision impairment and headache. Computer tomography
      showed air in the lateral part of left orbit compressing the eyeball and the
      optic nerve medially. It also revealed a sphenoid bone dysplasia with
      hyperpneumatization of the left greater wing and with two dehiscences in its
      wall. It was very intriguing to discover that this sphenoid dysplasia and the
      flap of mucosa covering one dehiscence were causing a ball-valve effect, allowing
      air to enter but not leave the orbit. Endoscopic sinus surgery was successfully
      used to treat this case.

PMID- 11195032
TI  - Effect of irrigation of the nose with isotonic salt solution on adult patients
      with chronic paranasal sinus disease.
AB  - In a prospective, randomized, controlled, double-blind trial we compared the
      effectiveness of endonasal irrigations with Ems salt solution to that with sodium
      chloride solution in the treatment of adult patients with chronic paranasal sinus
      disease. Subjects (n = 40) were randomly allocated to treatment either with
      isotonic Ems salt solution or with isotonic sodium chloride solution. The
      treatment consisted of endonasal irrigation twice daily and additional nasal
      spray as required. Nasal endoscopy, plain radiography of the paranasal sinuses,
      olfactometry, anterior rhinomanometry, and a saccharin-clearance test were
      carried out on days 1 and 7. Patients recorded rating scales of general
      discomfort, nasal airway obstruction, agreeableness of the irrigation, duration
      of improved nasal resistance after each irrigation, and the amount of additional
      nasal spray in a diary. Nasal air flow was not improved significantly. Subjective
      complaints, endonasal endoscopy, and radiography results revealed a significant
      improvement in both groups (P = 0.0001). In comparison, the two groups were not
      significantly different in outcome. Endonasal irrigations with salt solutions are
      effective in the treatment of chronic sinusitis, and a significant difference
      between Ems salt and sodium chloride was not observed.

PMID- 11195033
TI  - Composite hyoid-sternohyoid interposition graft in the surgical treatment of
      laryngotracheal stenosis.
AB  - This article reports six patients with severe laryngotracheal stenosis. The
      causes of stenosis were tracheotomy (two cases); prolonged endotracheal
      intubation (one case); laryngeal trauma (two cases); and surgery with
      postoperative chemo- and radiotherapy, addressing a thyroid gland follicular
      adenocarcinoma (one case). Two patients were already tracheotomized. The main
      postoperative complication was necrosis of the graft in a female patient who had
      previously undergone treatment for thyroid follicular adenocarcinoma. All
      patients were decannulated 6 months postoperatively. Five patients were then
      regularly followed up, but we lost contact with one patient. Comparison between
      pre- and postoperative pulmonary function testing revealed an increased maximum
      inspiratory flow (Vi max50) in five cases between 0.57 l/s and 2.18 l/s. A
      helical scan with 3-dimensional reconstruction of the cervical area in four
      patients confirmed the presence and preservation of the hyoid bone graft. Four
      patients remained satisfied with their postoperative voice quality, one patient
      was dissatisfied, and one patient was not followed up. This technique is
      effective in adults with severe laryngotracheal stenosis, restricted to the first
      tracheal rings, providing one takes into consideration the main contraindications
      of the procedure: past history of radiotherapy and thyroid surgery.

PMID- 11195034
TI  - Primary carcinoma of the subglottic larynx.
AB  - Primary cancer of the subglottic region is very rare and delay in diagnosis often
      leads to a poor prognosis. We retrospectively reviewed 49 patients with primary
      cancer of the subglottic larynx observed from 1969 to 1993 in the ORL Clinic of
      the University of Florence. This number constitutes 1.6% of all laryngeal cancers
      observed during this period. Four (8.2%) patients were stage T1, 13 (26.5%) T2,
      27 (55.1%) T3, and 5 (10.2%) T4. Forty-one patients were eligible for assessing
      the disease-free five-year survival rate, 17 of whom were treated with surgery
      alone, 6 with radiotherapy alone and 18 with combination therapy (surgery for the
      primary tumor and postoperative radiotherapy for cervical nodes). The five-year
      survival rate for the three treatment types was 47%, 0% and 83.3%, respectively.
      The overall survival rate was 56.1%. Combination therapy produced a significantly
      higher (P = 0.001) disease-free survival than surgery alone or radiotherapy
      alone.

PMID- 11195035
TI  - Fluorodeoxyglucose positron emission tomography, a new technique for increasing
      the detection rate of coincident thyroid cancer in head and neck oncology.
AB  - Clinically occult thyroid cancer is not uncommon and may occur in 1% to 10% of
      the population Since the first studies on the use of fluorodeoxyglucose positron
      emission tomography (FDG PET) in clinical oncology some reports have appeared on
      the detection of occult tumors using this imaging modality. According to these
      results, the number of patients with head and neck cancer and clinically occult
      coincident primary tumors at initial presentation may be expected to increase. In
      two of the four patients presented, the coincident tumor was detected with FDG
      PET. The possible role of this new imaging technique is discussed in correlation
      with treatment and clinical outcome.

PMID- 11195036
TI  - Schwannoma of the larynx: case report.
AB  - Neurogenous tumours of the larynx are extremely uncommon. We present a rare case
      of schwannoma of the larynx. Clinical findings are presented together with
      computed tomography (CT) and magnetic resonance images. The tumour was located in
      the right aryepiglottic fold of the larynx. CT showed a well defined and
      hypodense mass extending from the right aryepiglottic fold to the right vocal
      cord. The patient underwent an excision of the mass through a lateral thyrotomy
      and the tumour was completely removed. The diagnosis and treatment of this tumour
      are discussed.

PMID- 11195037
TI  - Merkel cell carcinoma of the auricle.
AB  - Merkel cell carcinoma is a rare, although increasingly recognized, malignant
      tumor of the skin. The most common site of occurrence is the head and neck (50%).
      Only five cases of this tumor on the auricle have been reported previously. We
      present a further such case. The incidence, clinical features, diagnosis,
      prognosis, and treatment of the Merkel cell carcinoma are discussed.

PMID- 11195038
TI  - Systematics in lymphatic tumor spread of carcinomas of the upper aerodigestive
      tract--a clinical study based on embryologic data.
AB  - BACKGROUND: The aim of this study was to assess the incidence and pattern of
      cervical lymph node (LN) metastases in carcinomas of the upper aerodigestive
      tract in relation to primary tumor (PT) invasion of the equivalents of pharyngeal
      arches (PhA) and occipital and cervical somites (OCS) in adults. METHODS: The
      pretherapeutic computed tomography scans and clinical findings in 729 patients
      with histologically proven carcinoma of the upper aerodigestive tract (112
      nasopharyngeal, 289 oropharyngeal, 252 laryngo-hypopharyngeal, and 76 oral cavity
      carcinomas, with LN involvement in 70% of the total) were analyzed in relation to
      PT invasion of equivalents of PhA and OCS. Tumors were recorded according to the
      infiltration of these equivalents. The metastatic involvement of the different
      cervical LN groups was analyzed and correlated to the pattern of PT invasion of
      equivalents of PhA and OCS by the chi-square test. RESULTS: The findings show
      that the pattern of cervical LN involvement depends on the location and extension
      of the PT and its invasion of equivalents of the PhA and OCS. Jugular LN
      metastases were found in tumors invading the equivalents of PhA 2-6.
      Submandibular LN metastases were evident in tumors invading tissues arising from
      the first PhA and the tongue. Retropharyngeal, spinal accessory and transversa
      colli LN metastases were found in tumors invading tissues arising from OCS. The
      frequency of LN metastases in the different LN chains decreased in the cranio
      caudal direction. Each neck hemisphere showed separate lymphatic drainage.
      CONCLUSIONS: Analysis of PT extension in relation to PhA and OCS equivalents
      allows patterns of LN involvement to be predicted.

PMID- 11195039
TI  - Long-term results in the treatment of obstructive sleep apnea.
AB  - No recent update is available on long-term results of the various types of
      treatment of obstructive sleep apnea (OSA) which can help the physician in
      evaluating the individually tailored treatment for patients with OSA in the long
      term. We arbitrarily defined "long-term" results as those after at least 3 years
      and reviewed the literature from the past 25 years for reports on conservative,
      apparative, and surgical therapy of OSA in children and adults. Another inclusion
      criterion was that the diagnosis was also confirmed by polysomnography before
      treatment and at follow-up. Only relatively few long-term studies meeting the
      criteria of 'evidence based medicine' were found, comparing the findings of these
      was difficult or impossible due to varying criteria for success. Long-term data
      were available about the effect of weight reduction, nasal ventilation therapy,
      oral devices, tonsillectomy, uvulopalatopharyngoplasty, maxillomandibular
      advancement osteotomies, and tracheotomy. After approx. 25 years many treatment
      modalities in sleep medicine are still experimental concerning the long-term use
      for the individual. In particular, randomized controlled trials in surgery are
      lacking. Late results show that at least 50% of patients with OSA can be treated
      effectively by one or a combination of treatments. Nasal continuous positive
      airway pressure, tracheotomy, maxillomandibular advancement osteotomy, and
      tonsillectomy are the most effective treatments of OSA.

PMID- 11195040
TI  - Virtual endoscopy of the nasal cavity in comparison with fiberoptic endoscopy.
AB  - PURPOSE: To apply virtual-endoscopic mode to display the nasal cavity and to
      evaluate clinical application of virtual endoscopy in comparison with nasal
      fiberoptic endoscopy. MATERIALS AND METHODS: Eleven patients were examined by
      virtual endoscopy after axial spiral computed tomography (CT) scanning was
      performed. In addition, 9 out of these 11 patients underwent fiberoptic
      endoscopy. Spiral CT scanning was performed with 1-mm collimation, 0.5- to 1-mm
      increment, 25-250 mA s, and pitch 1-2. Virtual endoscopy was performed by
      Explorer software package. RESULTS: Virtual endoscopy could clearly demonstrate
      anatomic structures in the nasal cavity, septal deviation, stenosis and
      obstruction of the middle meatus, turbinate hyperplasia, and pathological masses
      larger than 3 mm in diameter. However, "false adhesions" may appear in virtual
      endoscopy. The main limitation of virtual endoscopy was the inability to evaluate
      mucosa and its surface. CONCLUSION: Virtual endoscopy of the nasal cavity is a
      new and noninvasive method. It can demonstrate normal and pathological structures
      in the nasal cavity. Its ability to visualize is comparable with fiberoptic
      endoscopy except for evaluating mucosal surface and secretions. In the future,
      this method will probably be a basic instrument of computer-assisted surgery in
      the midfacial region.

PMID- 11195041
TI  - Research on renal endothelin in proteinuric nephropathies dictates novel
      strategies to prevent progression.
AB  - Proteinuria is one of the major risk factors for renal disease progression in
      patients with chronic nephropathies. Studies in disease models have helped to
      delineate mechanisms leading to renal structural damage as a result of persistent
      dysfunction of the glomerular barrier to proteins, even when the primary immune
      or non-immune insult to the kidney has ceased. From these preclinical studies, a
      role for endothelin in proteinuric chronic renal diseases has been suggested,
      thus providing the rationale for novel therapeutic approaches with endothelin
      receptor antagonists to maximize renoprotection so far achieved with blockade of
      the renin-angiotensin system by angiotensin-converting enzyme inhibition or
      angiotensin II receptor antagonism. Trials are needed to explore this potential
      area of clinical interest.

PMID- 11195042
TI  - Aldosterone in renal disease.
AB  - Blockade of the renin-angiotensin-aldosterone system has proved effective in
      retarding the progression of renal disease in the remnant kidney model, as well
      as other experimental diseases, and most importantly, in a range of progressive
      human renal diseases. Attention has focused on the role of angiotensin II in
      propagating progression both by its hemodynamic and non-hemodynamic actions.
      Recent evidence, predominantly in the remnant kidney model, indicates that the
      drugs used to block this hormone system, angiotensin-converting enzyme inhibitors
      and angiotensin II receptor blockers, also lower aldosterone levels. Aldosterone
      as well as angiotensin II thus appears to be instrumental in sustaining the
      hypertension and fibroproliferative destruction of the residual kidney.

PMID- 11195043
TI  - Angiotensin II type 1 receptor gene polymorphisms in humans: physiology and
      pathophysiology of the genotypes.
AB  - Many studies have attempted to relate genetic variants of components of the renin
      angiotensin system to complex diseases such as essential hypertension,
      cardiovascular disease and progressive renal failure. The angiotensin II type 1
      receptor (AT1R) gene is an important example of this approach. Many polymorphisms
      of the AT1R gene have been identified, but the A1166-->C polymorphism has been
      the most extensively studied. The physiological significance of this polymorphism
      is uncertain because of its location in the 3'-untranslated region of the gene.
      The present review summarizes association studies of the AT1R gene, focusing on
      clinical end-points and physiological responses.

PMID- 11195044
TI  - Bibliography. Current world literature. Hormones, autacoids, neurotransmitters
      and growth factors.

PMID- 11195046
TI  - Bibliography. Current world literature. Circulation and hemodynamics.

PMID- 11195045
TI  - Growing kidneys.
AB  - The number of kidney transplantations performed per year is restricted by the
      limited availability of donor organs. One possible solution to this shortage is
      the use of renal xenografts. However, the transplantation of xenografts is
      complicated by hyperacute and acute rejection. A second possible solution is to
      'grow a kidney' from a transplanted renal anlage. It has been postulated that the
      host immune response might be attenuated after the transplantation of such an
      anlage (metanephros) instead of a developed kidney. Transplanted metanephroi
      become chimeric organs in that their blood supply originates, at least partly,
      from the host. It is possible to transplant a developing metanephros, without the
      use of immunosuppression, from one rat to another. Transplanted metanephroi grow,
      differentiate, become vascularized, and function in host rats. 'Growing kidneys'
      via the transplantation of metanephroi may hold promise as a novel therapeutic
      approach to the treatment of chronic renal failure.

PMID- 11195047
TI  - CD2-associated protein and the kidney.
AB  - During the past 3 years there have been significant advances in our understanding
      of the biology of the glomerular podocyte. In particular, two proteins, CD2
      associated protein and nephrin, have been identified as critical podocyte
      proteins that are both required for normal glomerular filtration. In addition to
      supporting the idea that the slit diaphragm plays a crucial role in glomerular
      function, these results suggest novel insights into the pathogenesis of
      glomerular diseases. The present review addresses these recent advances and
      discusses the implications of the findings.

PMID- 11195048
TI  - Current advances in molecular genetics of autosomal-dominant polycystic kidney
      disease.
AB  - Autosomal-dominant polycystic kidney disease results from at least two causal
      genes, PKD1 and PKD2. The identical clinical phenotype in human patients and
      targeted Pkd1 and Pkd2 mutant mouse models provides evidence that both gene
      products act in the same pathogenic pathway. The discovery of direct PKD1 and
      PKD2 interactions implies that both gene products, polycystin-1 and polycystin-2,
      play a functional role in the same molecular complex. The spectrum of germ-line
      mutations in both genes and the somatic mutations identified from individual PKD1
      or PKD2 cysts indicate that loss of function of either PKD1 or PKD2 is the
      mechanism of cystogenesis in autosomal-dominant polycystic kidney disease. A
      novel mouse model, Pkd2WS25/-, has proved that loss of heterozygosity is the
      molecular mechanism of autosomal-dominant polycystic kidney disease. Recently,
      studies on the expression patterns of PKD1 and PKD2 in humans or mice indicate
      that polycystin 1 and polycystin 2 seem to have their own respective functional
      roles, even though most of the functions of these polycystins are parallel during
      human and mouse development. Pkd2-deficient mice have cardiac septum defects, but
      Pkd1 knockout mice do not have this phenotype. On the other hand, Pkd2 has a very
      low level of expression in the central nervous system when compared with Pkd1. In
      addition, the level of expression of Pkd1 is increased during mesenchymal
      condensation, whereas Pkd2 expression is unchanged. Preliminary data have shown
      that the PKD1/PKD2 compound trans-heterozygous has a more severe cystic phenotype
      in the kidney than that of an age-matched heterozygous type 1 or type 2 of
      autosomal-dominant polycystic kidney disease alone. This finding suggests that
      PKD1 may be a modifier of disease severity for PKD2, and vice versa. The
      characteristics of the contiguous PKD1/TSC2 syndrome phenotypes and the data from
      Krd mice imply that TSC2 and PAX2 may also serve as potential modifiers for the
      disease severity of autosomal-dominant polycystic kidney disease.

PMID- 11195049
TI  - The roles of cubilin and megalin, two multiligand receptors, in proximal tubule
      function: possible implication in the progression of renal disease.
AB  - Proteins that have not been retained by the glomerulus are reabsorbed in the
      proximal tubule by endocytosis, a process that involves binding at the apical
      pole of the tubule cell, vesicular internalization and subsequent lysosomal
      degradation. Data presented in this review indicate that the initial recognition
      step involves two high molecular weight proteins, megalin and cubilin, which have
      multiligand properties and can therefore account for the wide variety of proteins
      reabsorbed. Given the potential importance of transepithelial protein traffic in
      the induction of interstitial fibrosis, the identification of these receptors may
      have implications in the progression of acute or chronic renal disease and may
      provide a target for therapeutic intervention.

PMID- 11195051
TI  - Cytokines and hormones with anti-inflammatory effects: new tools for therapeutic
      intervention.
AB  - The inflammation that is involved in the development of glomerulonephritis is
      tightly regulated by the expression of anti-inflammatory factors. These include
      circulating hormones, such as glucocorticoids, and mediators that are produced by
      intrinsic cells and infiltrating leucocytes. The present review focuses on these
      anti-inflammatory factors, summarizing in particular their activities in existing
      models of glomerulonephritis. In addition, experimental evidence is presented
      that anti-inflammatory mediators are able to increase glucocorticoid binding or
      signalling in target cells. These data help to explain the in-vivo efficacy of
      anti-inflammatory mediators, and offer a promising new avenue for therapeutic
      intervention.

PMID- 11195050
TI  - Sodium reabsorption in aldosterone-sensitive distal nephron: news and
      contributions from genetically engineered animals.
AB  - The precise adaptation of renal sodium excretion to systemic needs is to a large
      extent achieved by the regulation of sodium re-absorption in the aldosterone
      sensitive distal nephron. Transcellular sodium re-absorption by the segment
      specific cells of the aldosterone-sensitive distal nephron (often called
      principal cells) is mainly controlled at the level of the expression and activity
      levels of the epithelial sodium channel, the apical amiloride-sensitive sodium
      influx pathway. Recent investigations have identified the first early aldosterone
      induced proteins that act on epithelial sodium channel function in expression
      systems. Indirect evidence suggests that one of these aldosterone-induced
      proteins, the serum- and glucocorticoid-inducible protein kinase SGK1, plays a
      central integratory role in the control of epithelial sodium channel surface
      expression and activity, also in the mammalian kidney. Gene-modified animals
      lacking epithelial sodium channel subunits or expressing mutant subunits have
      substantiated the central role of the epithelial sodium channel in sodium re
      absorption and blood pressure control, as well as for neonatal lung liquid
      clearance. Mice overexpressing or lacking specific hormones or their receptors
      have been used to study their role in sodium transport regulation, but the study
      of mouse physiology appears to lag behind the generation of gene-modified mice.
      Nonetheless, these new animal models have had a strong impact on research, by
      stimulating the integration of knowledge and techniques learned from
      reductionistic molecular approaches into tissue and animal studies, thus breaking
      down barriers and stimulating collaborations.

PMID- 11195052
TI  - Cytokine cross-talk between tubular epithelial cells and interstitial
      immunocompetent cells.
AB  - Immunostaining of renal biopsies of patients with interstitial rejection of
      allografts or other forms of interstitial inflammation has demonstrated the
      presence of activated T cells and monocytes/macrophages in the tubulointerstitial
      area. Cytokines that are produced by infiltrating cells are capable of activating
      tubular epithelial cells. In turn tubular epithelial cells can produce a wide
      variety of inflammatory mediators, including chemokines, which further regulate
      cellular influx. Interfering in this cross-talk between tubular epithelial cells
      and infiltrating cells might provide new options for therapeutic intervention.

PMID- 11195053
TI  - Implications from the Heart Outcomes Prevention Evaluation Study.

PMID- 11195054
TI  - Considerations for the evaluation of renal function in genetically engineered
      mice.
AB  - Transgenic and gene-targeting techniques have opened a new era of physiologic
      investigation: the field of functional genomics. The nearly exclusive use of the
      mouse in this discipline has necessitated the development and adaptation of
      sophisticated techniques for evaluating murine physiology at the cellular,
      tissue, organ and whole animal levels. Although many of the methodologies for
      exploring cardiorenal function have been successfully adapted from their use in
      the rat, there are important limitations and considerations that must be
      recognized when applying them in the mouse. Investigators have been successful in
      measuring a wide variety of functional variables at the whole kidney and even
      single nephron levels. Reviewed here are recent advances in the measurement of
      blood pressure, renal blood flow, whole kidney electrolyte excretion and
      clearance rates, single-nephron glomerular filtration rate and transport, and
      tubuloglomerular feedback.

PMID- 11195055
TI  - Do matrix metalloproteinases MMP-2 and MMP-9 (gelatinases) play a role in renal
      development, physiology and glomerular diseases?
AB  - Metalloproteinases MMP-2 and MMP-9 (also called gelatinases) are involved in cell
      invasion and in embryonic development and organogenesis. A growing number of
      reports suggest that MMP-2 and MMP-9 play some role in renal development, renal
      tubule physiology and glomerular pathophysiology. This editorial will focus on
      recent controversial data, especially those obtained from studies on MMP-9
      deficient mice, which shed new light on the functions of gelatinases in normal
      and diseased kidneys.

PMID- 11195056
TI  - Molecular genetics of essential hypertension: recent results and emerging
      strategies.
AB  - Efforts to identify hypertension-predisposition genetic loci have focused largely
      on candidate gene strategies, in which specific candidates have been tested for
      linkage and association with blood pressure or the diagnosis of hypertension. A
      variety of candidate genes have been investigated, including loci involving the
      renin-angiotensin-aldosterone system, sodium epithelial channel,
      catecholaminergic/adrenergic function, renal kallikrein system, alpha-adducin,
      and others involving lipoprotein metabolism, hormone receptors, and growth
      factors. These studies, and more recently, several genome-wide scans, have
      yielded highly promising results suggesting a number of potential candidate genes
      and genomic regions that may contribute to blood pressure variation. The results
      also point to the need for more robust phenotypes that are intermediate in the
      pathogenetic development of high blood pressure. Additional methods and
      strategies for improving genetic studies of human hypertension include
      comparative genomics, in which results from animal studies are used to target
      potential blood pressure loci, the use of newly developed quantitative tests of
      linkage and association, comprehensive single-nucleotide polymorphism discovery
      in candidate loci, and the use of single-nucleotide polymorphisms in
      cladistic/haplotype analyses and genome-wide searches.

PMID- 11195057
TI  - Cytochrome P450 metabolites of arachidonic acid in the control of renal function.
AB  - Recent studies indicate that arachidonic acid is primarily metabolized by
      cytochrome P450 enzymes of the 4A and 2C families in the kidney to 20
      hydroxyeicosatetraenoic acid (HETE), epoxyeicosatrienoic acids (EETs) and
      dihydroxyeicosatrienoic acids. These compounds play central roles in the
      regulation of renal tubular and vascular function. 20-HETE is produced by renal
      vascular smooth muscle (VSM) cells and is a potent constrictor that depolarizes
      VSM cells by blocking the calcium-activated potassium channel. Inhibition of the
      formation of 20-HETE blocks the myogenic response of isolated renal arterioles in
      vitro, and autoregulation of renal blood flow and tubuloglomerular feedback
      responses in vivo. EETs are products formed in the endothelium and are potent
      dilators that activate the calcium-activated potassium channel in renal VSM.
      Endothelial-dependent vasodilators stimulate the release of EETs, and these
      compounds appear to serve as an endothelial-derived hyperpolarizing factor. EETs
      and 20-HETE are produced in the proximal tubule. There, they regulate
      sodium/potassium-ATPase activity and serve as second messengers for the
      natriuretic effects of dopamine, parathyroid hormone and angiotensin II. 20-HETE
      is also produced in the thick ascending loop of Henle. It regulates sodium
      potassium-chloride transport in this nephron segment. The renal production of
      cytochrome P450 metabolites of arachidonic acid is altered in hypertension,
      diabetes, toxemia of pregnancy, and hepatorenal syndrome. Given the importance of
      cytochrome P450 metabolites of arachidonic acid in the control of renal function,
      it is likely that changes in this system contribute to the abnormalities in renal
      function that are associated with many of these conditions.

PMID- 11195058
TI  - Cyclooxygenase 2 and the kidney.
AB  - Cyclooxygenase metabolizes arachidonic acid to a family of bioactive fatty acids
      designated prostaglandins. Two isoforms of cyclooxygenase exist, designated COX1
      and COX2. These isoforms are expressed in distinct but important areas of the
      kidney. COX1 predominates in vascular smooth muscle and collecting ducts, whereas
      COX2 predominates in the macula densa and nearby cells in the cortical thick
      ascending limb. COX2 is also highly expressed in medullary interstitial cells.
      Whereas COX1 expression does not exhibit dynamic regulation, COX2 expression is
      subject to regulation by several environmental conditions, including salt intake,
      water intake, medullary tonicity, growth factors, cytokines, and adrenal
      steroids. Recently, COX2-selective non-steroidal anti-inflammatory drugs have
      become widely available. Many of the renal effects of non-selective non-steroidal
      anti-inflammatory drugs (including sodium retention, decreased glomerular
      filtration rate, and effects on renin-angiotensin levels) appear to be mediated
      by the inhibition of COX2 rather than COX1. Therefore, in contrast to the
      gastrointestinal-sparing effects of COX2-selective non-steroidal anti
      inflammatory drugs, when considering the kidney, the same caution must be applied
      when using COX2-selective inhibitors as has been used with traditional non
      selective non-steroidal anti-inflammatory drugs.

PMID- 11195059
TI  - Angiotensin type 2 receptors: potential importance in the regulation of blood
      pressure.
AB  - The angiotensin type 2 receptor is one of two major angiotensin II receptors that
      has been identified, cloned and sequenced. The other major receptor, the
      angiotensin type 1 receptor, is thought to mediate most of the biological
      responses to the peptide. The angiotensin type 2 receptor is expressed heavily in
      fetal tissues, but only at a low level in the adult. Documented angiotensin type
      2 receptor expression sites in the adult include kidney, heart and mesenteric
      blood vessels. The function of the angiotensin type 2 receptor is just beginning
      to be explored. Most of the evidence suggests that the angiotensin type 2
      receptor mediates a vasodilator signalling cascade that includes bradykinin,
      nitric oxide and cyclic guanosine 5-monophosphate. At least some of the
      beneficial actions of angiotensin type 1 receptor blockade, such as hypotension,
      are mediated by stimulation of the angiotensin type 2 receptor. Several recent
      papers suggest that angiotensin type 2 receptors, presumably located in systemic
      blood vessels, mediate vasodilation and hypotension. The angiotensin type 2
      receptor may be a new therapeutic target and candidate gene for the
      pathophysiology of hypertension.

PMID- 11195060
TI  - [Strategies for preoperative therapy of locoregional cancers: an opportunity for
      expanding current concepts].

PMID- 11195061
TI  - [Molecular markers as basis for chemotherapy?].
AB  - Although a majority of cancer patients show no response or minimal response to
      any given chemotherapy, all patients are nevertheless placed on standard therapy
      regimens because there has been no way to identify beforehand those patients who
      are destined not to respond. Determining the biochemical factors relevant to drug
      response in each patient's tumor cells prior to treatment should allow optimal
      therapy to be selected for each patient on a rational basis. In this paper, we
      summarize studies aimed at determining whether analysis of the quantitative
      expression levels of genes or proteins involved in cancer drug activity in
      clinical specimens of tumor tissue could predict the effect of the drug on a
      tumor. This hypothesis has been tested mostly in 5-fluorouracil (5-FU)-based
      regimens in colorectal cancer. In the case of 5-FU, the quantitative expression
      levels of thymidylate synthase, thymidine phosphorylase, and dihydropyrimidine
      dehydrogenase were found to be associated with tumor response. Using all three of
      these markers together resulted in very effective identification of responding
      patients. The salient results of these studies were that, using the PCR enhanced
      by newly developed methodology, gene expressions can be identified and measured
      in pretreatment biopsies that are quantitatively associated with either response
      or non-response to drugs that are used in treating colorectal cancer.

PMID- 11195062
TI  - [Confirmed preoperative therapy of rectal carcinoma].
AB  - Optimized surgical management is the most important factor influencing prognosis
      of patients suffering for rectal carcinoma. Oncologically radical surgical
      procedures with the intent of histologically complete resection should be
      performed, including excision of the tumour in total with sufficient margins in
      the oral and aboral directions. Total excision of the mesorectal tissue, at least
      in low-lying rectal tumours, is strongly recommended. Several retro- and
      prospective studies show that the surgeon him- or herself, using these adequate
      techniques, is the most important, statistically significant independent
      prognostic factor in patients with rectal carcinoma. In addition, adjuvant
      radiochemotherapy, given before or after surgery, decreases the local failure
      rates of high-risk patients (UICC stages II and III). Such radiochemotherapy is,
      to the great variety of different local failure rates in different surgical
      departments mandatory as recommended by the consensus conference of the German
      Cancer Society in July 1999. New and improved radiation techniques (conformal
      radiotherapy, intraoperative radiotherapy) could significantly decrease therapy
      related toxicity, and innovative schedules (continuous low-dose 5-FU) may show
      increased therapeutic benefit of adjuvant treatment. Combined radiochemotherapy
      prior to surgery seems to increase the rate of sphincter-preserving procedures in
      low-lying rectal cancer. Definitive results and a clear advantage of pre- over
      postoperative radiochemotherapy (currently being tested in a German multicenter
      study) are still pending.

PMID- 11195063
TI  - [New therapy approaches in tumors of the upper gastrointestinal tract (esophagus,
      stomach)].
AB  - Despite numerous phase-II and phase-III studies investigating neoadjuvant
      treatment in esophageal and gastric cancer, the value of multimodal therapy in
      these tumors is not clearly defined yet. One reason are the different study entry
      criteria and different staging modalities in the investigations published so far.
      Concerning esophageal cancer, neoadjuvant chemotherapy does not yet have a
      definite role after several phase-III studies. It may be that this treatment
      should only be inaugurated in innovative protocols. Furthermore, in esophageal
      cancer it is proven that chemoradiation is superior to radiation alone in the
      neoadjuvant setting. Following neoadjuvant chemoradiation, there is a distinct
      trend in favor of multimodal therapy. In the case of locally advanced squamous
      cell carcinoma of the esophagus, neoadjuvant chemoradiation offers 30%-60% of the
      patients the possibility for a complete resection (UICC-R0); however, this is
      accompanied by increased postoperative morbidity and mortality. In gastric
      cancer, neoadjuvant chemotherapy is still an experimental approach.
      Intraperitoneal chemotherapy has failed to show any benefit in Western trials.
      Clinically related research is concentrating on the problem of distinguishing
      responder from non-responder at the beginning of the therapy. First results
      indicate that with molecular markers, response might be predicted before therapy.
      Using 18-FDG PET, it could be possible that the response can be recognized after
      only 1 week of treatment, opening the door to early response evaluation. New
      therapeutics like monoclonal antibodies for adjuvant therapy, which is again
      under discussion in gastric cancer, are only in phase-I studies.

PMID- 11195064
TI  - [Evaluation of neoadjuvant therapy in breast carcinoma].
AB  - For 20 years preoperative chemotherapy has been the treatment of choice in
      inflammatory breast cancer. Adjuvant chemotherapy does not show any advantages
      over neoadjuvant systemic chemotherapy in terms of survival of patients with
      breast cancer. Reduction of the size of the tumor enables the surgeon to perform
      more breast-conserving surgery, but the long-term results for breast tumor to
      recur in these patients are not yet available. At our hospital, a tumor larger
      than 30 mm is an indication for mastectomy. In general, only 20.6% of all
      patients are suitable for neoadjuvant chemotherapy. Patients with lobular
      carcinoma or with tumors with an extensive ductal carcinoma in situ part will not
      benefit from such therapy. Tumor remission following neoadjuvant chemotherapy is
      of prognostic relevance. The rapid therapeutic effect of neoadjuvant therapy
      allows short-term evaluation of this treatment.

PMID- 11195065
TI  - [Differential indications for induction therapy of non-small-cell lung tumors].
AB  - Induction chemotherapy and induction chemo-radiotherapy have shown their
      efficiency and feasibility in many phase-II studies and have profen superior to
      operation alone in stage IIIa of NSCLC in several phase-III studies. Therefore it
      is justified to recommend this multimodal therapy in stage IIIa N2 disease within
      clinical studies. However, it is currently not justified to present this
      multimodal treatment modality as a generally agreed standard.

PMID- 11195066
TI  - [Minimally invasive parathyroidectomy with local anesthesia in conjunction with
      ultrasonography, sestamibi scintigraphy and intraoperative parathyroid hormone
      measurement].
AB  - INTRODUCTION: The standard procedure in patients with primary hyperparathyroidism
      (pHPT) includes cervical exploration and identification of all four enlarged
      parathyroid glands. New localization techniques, i.e., ultrasonography associated
      with color duplex sonography, 99mTc-sestamibi scintigraphy and the possibility of
      intraoperative parathormone (iPTH) measurement permit minimally invasive
      parathyroidectomy (MIP). Three different methods have been established: minimally
      invasive open parathyroidectomy, endoscopic parathyroidectomy and video-assisted
      parathyroidectomy. We present our experience with open MIP with the patient under
      local anesthesia (LA). METHODS: In 25 patients with pHPT the operation was
      started under local anesthesia. Preoperatively, ultrasonography and sestamibi
      scintigraphy were performed in each patient. iPTH measurement was carried out
      intraoperatively. RESULTS: In 23 patients (92%) the operation was done
      successfully in LA. There were no postoperative complications. During follow-up
      none of the patients developed hypercalcemia again. CONCLUSION: MIP in connection
      with ultrasonography, sestamibi scintigraphy and intraoperative PTH measurement
      offers a promising treatment for patients with pHPT.

PMID- 11195067
TI  - [Use of the heart-lung machine in extra-cardial carcinoma surgery].
AB  - The employment of the heart-lung machine to assisting the circulatory system for
      the resection of extracardial tumors is increasing because of their location,
      growth and infiltration. We report on three patients in whom the resection of the
      tumor was only possible with extracorporeal circulation (ECC). In the first
      patient sarcoma of the pulmonary artery and valve was resected under ECC. Artery
      and valve were replaced with a cryo-preserved valved bifurcation homograft. In
      the other patients ECC was used on the basis of tumorinfiltration of the inferior
      vena cava and tumor embolus of the pulmonary artery in a case of primary renal
      cell carcinoma, and tumor infiltration of the superior vena cava and right atrium
      in a case of follicular thyroid carcinoma. All patients had a good postoperative
      course and excellent long term survival.

PMID- 11195068
TI  - [Paraneoplastic hypoglycemia in localized fibrous tumors of the pleura].
AB  - Localized fibrous tumor of the pleura is a rare, slowly growing, benign tumor
      which originates from the submesothelial stem cells of the pleura visceralis.
      Most of these tumors clinically behave asymptomatically, although tumor
      associated hypoglycemia occurs in a few cases and can lead to hypoglycemic coma.
      Laboratory investigations show significant elevation of paraneoplastic IGF-II
      with a 2-3 times higher effect on the blood glucose level than insulin. Further,
      one finds reduced synthesis of IGFBP-3, which inhibits the action of IGF-II by
      inducing a complex with the paraneoplastic protein. As treatment, surgical
      resection of the tumor is recommended. We report on the case of a 72-year-old man
      with diabetes mellitus type II, who complained of recurrent hypoglycemic
      episodes. Diagnostic evaluation showed a fibrous tumor attached to the right
      diaphragm. After surgical treatment the hypoglycemic episodes disappeared.

PMID- 11195069
TI  - [Parathyroid gland carcinoma with postoperative encephalopathy].
AB  - We present a 78-year-old patient who suffered from symptomatic transitory
      psychotic syndrome after laparotomy. Persisting somnolence appeared with
      cardiopulmonary decompensation and gastrointestinal atony. Due to prolonged
      hypercalcemia primary hyperparathyreoidism was diagnosed. Resection of a large
      carcinoma of the parathyroids led to continuous clinical improvement.

PMID- 11195070
TI  - [Possible variations of free autogenous jejunum transplantation for differential
      reconstruction of the oropharynx].
AB  - INTRODUCTION: Resections of extensive tumours, recurrences and radiodermatitides
      at the neck cause complex defects. Free bowel transplantation enables one-stage
      reconstruction. PATIENTS AND METHODS: In 35 out of 57 interdisciplinarily treated
      patients, small-bowel transplantation was performed for reconstruction. Thirty
      patients received cylinder grafts, five jejunal patch plastics. In four patients
      neoglottis formations according to Ehrenberger were performed. To cover soft
      tissue defects, two patients received scapular free flaps, eight patients a
      jejunal segment, incised at the anti-mesenteric side, the mucosa stripped and
      covered by a split skin graft. RESULTS AND CONCLUSIONS: Thirty-four grafts were
      viable. One patient received a successful re-transplantation. One postoperative
      fistula at the hypo-pharyngojejunostomy was closed by a separated jejunal segment
      which was primarily used as monitor, two others by pectoral flaps. Separation of
      a jejunal graft into two or three segments enables restoration of swallowing,
      voice and covering soft tissue in a one-stage procedure. The whole reconstruction
      necessitates only one arterial and one venous microanastomosis at the neck.

PMID- 11195071
TI  - [Long-term follow up of bile duct injury by laparoscopic cholecystectomy and
      reconstruction with jejunum interposition].
AB  - The follow-up of patients with severe bile duct lesions after laparoscopic
      cholecystectomy often shows secondary complications. We report on a female
      patient suffering from long-lasting complications after bile duct injury and
      early reconstruction by end-to-end anastomosis via a T-tube drainage. More than 5
      years later and after multiple dilatation and stenting of the bile duct stenosis
      the patient was treated with an expanding metal stent. The severe cholangitis
      persisted. So the patient was operated on: bile duct and connected stent were
      resected. The reconstruction was performed with an isoperistaltic jejunal
      conduit. More than 24 months later the patient is healthy and at work again.

PMID- 11195072
TI  - [Endoscopic excision of extra-adrenal pheochromocytomas (paragangliomas)].
AB  - We describe the successful endoscopic removal of six extra-adrenal
      pheochromocytomas in three patients. One neoplasia was located retrocavally, two
      between the aorta and vena cava, two by the para-aortal, and one by the
      parailiacal. The tumors were removed by the posterior retroperitoneoscopic or by
      the anterior laparoscopic approach, respectively. The intraoperative and
      postoperative courses were uneventful.

PMID- 11195073
TI  - [Extramedullary hematopoiesis as differential mediastinal space-occupying lesion
      diagnosis].
AB  - Intrathoracic extramedullary hematopoiesis is a rare disease in the differential
      diagnosis of mediastinal masses. It is suggested that asymptomatic masses should
      not be treated. A correct diagnosis can thus help to avoid an operation. The aim
      of this case report is to draw attention to this phenomenon as a cause of
      mediastinal masses and to provide information about diagnostic facilities
      available. We report the case of a 53-year-old male patient with hereditary
      spherocytosis as well as the case of a 59-year-old male patient with pyruvate
      kinase deficiency who showed intrathoracic paravertebral masses, that were
      identified in the first case by video-assisted thoracoscopic intervention (VATS)
      and in the second case by thoracotomy as a region of extramedullary
      hematopoiesis.

PMID- 11195074
TI  - [Squamous epithelial carcinoma in a Zenker diverticulum].
AB  - Zenker's diverticulum is a common anomaly in the elderly patient. Carcinoma in
      such a diverticulum is a rare but recognized complication of a posterior
      pharyngeal pulsion diverticulum. We present a case of a 67-year-old patient with
      a long-standing symptomatic Zenker's diverticulum. The diagnosis of the neoplasm
      was only achieved intraoperatively. The patient underwent a proximal esophageal
      resection with lymphadenectomy. Reconstruction was done with a microvascular free
      jejunal transplant. The postoperative course was uneventful. Wide oncologic
      surgical resection is the therapy of choice in cases of carcinoma in a Zenker's
      diverticulum.

PMID- 11195075
TI  - [Laparoscopic cholecystectomy in isolated gallbladder metastasis of malignant
      melanoma].
AB  - Metastasized malignant melanomas can affect all organs of the human body.
      However, isolated metastatic spreading into the gallbladder is rare. We treated
      two asymptomatic patients who had undergone primary curative resection of a
      melanoma. Gallbladder structures suggesting the presence of tumors were noticed
      in the follow-up investigations. The two patients underwent laparoscopic
      cholecystectomy to clarify their pathological relevance. Histologically, the
      tumor was a metastasis of the malignant melanoma in each case. Surgery is
      indicated in stage IV in isolated metastatic spreading to the gallbladder in
      order to avoid symptoms or tumor complications. Since the vast majority of
      melanoma metastases of the gallbladder are located intraluminally and
      lymphadenectomy in the region of the hepatoduodenal ligament does not appear to
      be appropriate, the operation should be carried out laparoscopically. The value
      of postadjuvant chemoimmunotherapy after metastasis resection is being
      investigated in numerous studies at present.

PMID- 11195076
TI  - [Internet presence of surgical clinics in Germany. Current data and future
      prospects].
AB  - INTRODUCTION: The aim of this study was to obtain an overview of the use of the
      Internet by surgical departments in Germany as a presentation platform and
      information resource for their patients. METHODS: After a randomizing a total of
      1,760 surgical departments in Germany, 200 were chosen and asked about their
      Internet use. RESULTS: Most of the questionnaires (81.5%) were received and
      analyzed; 32.5% of the German surgical departments are represented on the
      Internet; 81.4% of the clinics without a homepage are planning to have one in the
      future. The hospitals represent themselves on average on two HTML documents.
      CONCLUSION: Approximately a third of the German surgical departments currently
      give information over the Internet with a wide and heterogeneous spectrum. In the
      near future approx. 80% of the German surgical departments will have online
      presence. Therefore, the increasing demand for medical information by the
      patients will be fulfilled. The professionalism and effectiveness of the home
      pages can be increased through registration with many search engines and the use
      of e-mail.

PMID- 11195077
TI  - [Comment on Ch. Konh"auser et a.: Operation method determines recurrence
      incidence of colorectal carcinomas].

PMID- 11195078
TI  - [Comment on P. Fricke et al.: Multiple metachronous metastases of renal cell
      carcinoma in the pancreas].

PMID- 11195079
TI  - [Comment on B. J. Leibl et al.: Laparoscopic inguinal hernia therapy as training
      operation].

PMID- 11195081
TI  - [Surgical endoscopy: as won, so lost?].

PMID- 11195080
TI  - [Benign diseases of the gallbladder and bile ducts].

PMID- 11195083
TI  - Urine stone formation during treatment with zonisamide.

PMID- 11195082
TI  - [Is there a "collective malpractice" for physicians?].

PMID- 11195084
TI  - Periventricular leukomalacia and tumor necrosis factor.

PMID- 11195085
TI  - cDermo-1 expression indicates a role in avian skin development.
AB  - Basic helix-loop-helix (bHLH) transcription factors have been shown to be
      important regulatory proteins for tissue determination and differentiation. We
      cloned the chicken homologue of the gene of the murine Twist-related bHLH protein
      Dermo-1, which we named cDermo-1, and analyzed its sequence and embryonic
      expression. Our sequence data suggest a decisive role of Dermo-1 proteins in the
      evolution of amniote skin. We present a detailed analysis of cDermo-1 expression
      during avian embryonic development. cDermo-1 is first expressed in a variety of
      mesodermal tissues of the chick embryo including the limb buds, but later becomes
      restricted to the subectodermal mesenchyme of the integument and the developing
      feather buds, indicating a role of cDermo-1 during avian skin and feather
      development.

PMID- 11195086
TI  - Okadaic acid-induced inhibition of protein phosphatase 2A enhances chondrogenesis
      in chicken limb bud micromass cell cultures.
AB  - The role of major cellular serine/threonine-specific protein phosphatases,
      protein phosphatase 1 and 2A, was investigated during chicken cartilage
      differentiation under in vitro conditions. Activity of protein phosphatase 2A
      decreased parallel to differentiation of chondrogenic cells, whereas activity of
      protein phosphatase 1 remained unchanged as assayed in the supernatants of the
      homogenised chicken limb bud micromass cell cultures. When okadaic acid, a potent
      inhibitor of protein phosphatase 1 and 2A was applied in 20 nM concentration for
      4 h during the second and third culturing days, it significantly increased the
      size of metachromatic cartilage areas measured in 6-day-old colonies. Following
      okadaic acid treatments, a significant inhibition in the activity of protein
      phosphatase 2A was found, while the activity of protein phosphatase 1 was
      unaffected as measured an days 2 and 3. TRITC-phalloidin labelling demonstrated
      that okadaic acid disorganised actin filaments and induced rounding of
      chondrogenic cells. This deterioration of actin filaments was reversible.
      Electron microscopy and biochemical analysis of colonies revealed that the
      ultrastructure and major components of cartilage matrix remained unchanged under
      the effect of okadaic acid. Okadaic acid-treatment applied to cultures containing
      predominantly differentiated chondrocytes (after day 4) did not influence the
      cartilage formation. 3H-thymidine and bromodeoxyuridine incorporation-assays
      demonstrated enhanced cell proliferation in the okadaic acid-treated colonies
      compared to that of the untreated ones. Our results indicate, for the first time,
      that protein phosphatase 2A is involved in the regulation of chondrogenesis.
      Inhibition of protein phosphatase 2A with okadaic acid may result in increased
      chondrogenesis via modulation of proliferation and cytoskeletal organisation, as
      well as via alteration of protein kinase A-signaling pathway of the chondrogenic
      cells.

PMID- 11195087
TI  - Ingrowth of sympathetic innervation occurs concomitantly with a decrease of ANP
      in the growing rat cardiac ventricles.
AB  - The relationship between the immunohistochemical expression of atrial natriuretic
      peptide and the occurrence of sympathetic nerve fibres, as visualized by staining
      for tyrosine hydroxylase, in the growing rat heart was evaluated. Rats were
      investigated at four different stages from birth to 21 days postnatally. The
      effects of chemical destruction of sympathetic nerve terminals in neonatal rats
      on the cardiac atrial natriuretic peptide content were furthermore examined by
      use of radioimmunoassay. There was in principle a reciprocal pattern of
      immunoreaction for atrial natriuretic peptide and tyrosine hydroxylase positive
      innervation in the ventricular myocardium, atrial natriuretic peptide reaction
      becoming less and less pronounced with the ingrowth of innervation positive for
      tyrosine hydroxylase. Furthermore, in the peripheral Purkinje fibre network,
      there was a marked atrial natriuretic peptide immunoexpression and scarce or no
      nerve fibres throughout the examination period. The radioimmunoassay measurements
      showed that chemical sympathectomy lead to elevated cardiac levels of atrial
      natriuretic peptide. The study shows that sympathetic innervation grows into the
      ventricular parts concomitantly with the occurrence of a decline in atrial
      natriuretic peptide expression during development of the heart. Furthermore, it
      is shown that a reversion of the in growth of sympathetic innervation by
      destruction of cardiac sympathetic nerves at an early stage leads to increased
      levels of atrial natriuretic peptide in the heart. The results give new evidence
      to the phenomenon that the atrial natriuretic peptide levels in the ventricular
      myocardium and the peripheral parts of the conduction system are under influence
      of the presence of sympathetic innervation.

PMID- 11195088
TI  - Wisteria floribunda agglutinin labeling patterns in the human cortex: a tool for
      revealing areal borders and subdivisions in parallel with immunocytochemistry.
AB  - Wisteria floribunda agglutinin (WFA) is a lectin that labels selectively N
      acetylgalactosamines beta 1 (GalNAc beta 1-3 Gal) residues of glycoproteins
      within the extracellular matrix of the neurons, and has been identified as a
      specific marker for functionally different cortical areas of the rodent brain.
      Here we report that WFA-binding sites can be used for the characterization of
      cortical areas and their subdivisions of the immersion-fixed human brain. WFA
      binding showed an area-specific distribution pattern within areas 1, and 3a-3b of
      the somatosensory cortex as well as in the primary motor areas 4a-4p. The WFA
      binding labeled stripes of 150-175 microm width at intervals of 800-1000 microm
      within the motor cortex but not in the somatosensory cortex. At the cellular
      level, differences in staining intensities among certain cell types were evident
      among WFA-positive glial cells. WFA binding seems to be a useful marker to reveal
      areal borders and function related intraareal specializations in combination with
      immunocytochemical techniques.

PMID- 11195089
TI  - Retarded myelination in the lumbar spinal cord of piglets born with spread-leg
      syndrome.
AB  - Piglets born with spread-leg syndrome, a congenital weakness of the hindlimb
      adductors, were investigated to determine the site of lesion leading to limb
      impairment. Histological and immunohistochemical studies of the motor neuron unit
      showed no alterations but quantitative analysis revealed a reduction of axonal
      diameter and myelin sheath-thickness of the fibres innervating the adductors of
      the affected limbs. In the lumbar spinal cord a lack of myelination was observed
      in the tracts descending to the lower motor neurons. Recovery from the syndrome
      was accompanied by a catching-up of myelination with that of the controls. The
      spread-leg syndrome is due to a nutritional deficiency in the sow; thus it is
      assumed that the deficient maternal substances, mainly choline and methionine,
      are essential for the normal myelin production by spinal white matter
      oligodendrocytes of the fetus.

PMID- 11195090
TI  - Distribution of somatostatin-28 (1-12) immunoreactivity in the diencephalon and
      the brainstem of the dog.
AB  - The term somatostatin refers to a family of peptides, mainly somatostatin-14,
      somatostatin-28 and somatostatin-28 (1-12), which are the cleavage products of a
      single 116 amino acid-long preprosomatostain molecule. The production of
      antibodies to these peptides allows their localization in a number of neuronal
      populations throughout the entire neuroaxis in many mammals. The dog has been
      pointed out as an extremely useful animal model for studying age-related
      cognitive dysfunction and other neuronal changes associated with aging in which
      somatostatin appears to be involved. However, only very scanty information is
      available with regard to the distribution of somatostatin in the brain of the
      dog. In the present work we have determined the pattern of the distribution of
      somatostatin-28 (1-12) immunoreactivity in the diencephalon and the brainstem of
      the dog. High to moderate densities of labeled perikarya were found in the
      anterior periventricular and arcuate hypothalamic nuclei, the reticular thalamic
      nucleus, in delimited parts of the nucleus of the brachium inferior colliculus,
      the retrorubral area, the dorsal raphe nucleus, the myelencephalic reticular
      formation and the dorsal motor nucleus of the vagus. Less dense population of
      somatostatin cells were localized in other diencephalic and brainstem nuclei. The
      distribution of labeled fibers was even broader as in addition to those above
      mentioned there were a number of areas that appeared devoid of labeled perikarya.
      Many of the findings were similar to those reported in earlier works while others
      underlined the existence of inconsistencies in the distribution pattern of this
      peptide in the brain of mammals.

PMID- 11195091
TI  - A primary culture system of rat olfactory bulb forming many synapses similar to
      intact ones and spontaneously generating synchronous intracellular calcium
      oscillations.
AB  - Previously, several studies attempting to analyze olfactory functions using
      dissociated culture systems of the olfactory bulb (OB) have been reported.
      Reciprocal dendrodendritic synapses between secondary neurons (mitral/tufted
      cells) and interneurons (periglomerular/granule cells) are considered to play the
      most important role in signal processing in the OB. However, it is unclear
      whether these reciprocal synapses are formed in vitro in the same way as they are
      in the intact OB. Thus, we synaptologically investigated the nature of cultured
      OB neurons. These neurons from embryonic rats were classified into four groups
      based on the size of their somata and their glutamic acid decarboxylase (GAD)
      immunoreactivity. At 14 days in vitro, most of the neurons synchronously showed
      spontaneous intracellular Ca2+ oscillations that were reversibly inhibited by
      application of D-APV and CNQX. Moreover, the frequency of the oscillations
      decreased and their amplitude became larger following application of bicuculline.
      These results suggest functional glutamatergic synaptic coupling and inhibitory
      GABAergic synaptic modulation. Immunocytochemical staining revealed many dot-like
      products (puncta) that were immunoreactive to GAD as well as to synaptophysin
      surrounding the cultured neurons. These results strongly indicate the presence of
      GABAergic synapses. The existence of synaptic contacts in OB neuron cultures was
      also confirmed by electron microscopy. Two types of synapses, symmetrical and
      asymmetrical, were morphologically recognizable. Moreover, we could also identify
      peculiar synapses resembling the in vivo reciprocal dendrodendritic synapses. The
      use of these primary culture systems will facilitate the elucidation of
      mechanisms underlying olfactory functions.

PMID- 11195092
TI  - Uptake of aflatoxin B1 and T-2 toxin by two mycotoxin bioassay microorganisms:
      Kluyveromyces marxianus and Bacillus megaterium.
AB  - Uptake of aflatoxin B1 (AFB1) and trichothecene T-2 toxin from growth medium by
      mycotoxin bioassay strains of Klutyveomyces marxianus and Bacillus megaterium was
      assessed by incubating, washing, and sonicating the cells, extracting samples
      with chloroform, and analysing the extracts by a combination of high-performance
      thin-layer chromatography (HPTLC) and fluorescence densitometry. Using cultures
      of K. marxianus, the entire AFB1 dose was recovered and no AFB1 metabolites were
      detected. Less than 1% of the AFB1 was recovered from the cells, and AFB1 did not
      inhibit growth. Methanol in the incubation medium had no significant effect on
      the levels of AFB1 associated with K. marxianus cells. The entire dose of T-2
      toxin was also recovered from K. marxianus cultures, and no metabolites were
      detected; again, less than 1% of T-2 toxin was cell-associated, but growth was
      completely inhibited. AFB1 partially inhibited the growth of B. megaterium;
      approximately 12% of the dose could not be recovered, and no AFB1-related
      metabolites were detected. Methanol increased the levels of recoverable AFB1
      associated with B. megaterium cells. In the case of T-2 toxin, around 8% of the
      dose was not recovered, and no metabolites were detected; growth of B. megaterium
      was stimulated. These results suggest irreversible binding of both toxins, or
      derivatives of them, to the cells of B. megaterium.

PMID- 11195093
TI  - The use of morphomutants to investigate septum formation and cell separation in
      Schizosaccharomyces pombe.
AB  - Cytokinesis in the fission yeast Schizosaccharomyces begins by formation of a
      medially placed actomyosin ring, continues by progressive development of a
      septum, and is completed by cleavage of the mature septum to bring about cell
      separation. The cytological analysis of the Schizosaccharomyces pombe
      morphomutants sph2-3 and sep1-1 presented here demonstrates that the medial
      actomyosin ring colocalizes to the leading edge of the centripetally growing
      septum, and cleavage of the septum is triggered by rupture of the mother cell
      wall at the septal basis.

PMID- 11195094
TI  - Characterisation of coupling products formed by biotransformation of biphenyl and
      diphenyl ether by the white rot fungus Pycnoporus cinnabarinus.
AB  - Cells of the white rot fungus Pycnoporus cinnabarinus grown in glucose were able
      to hydroxylate biphenyl and diphenyl ether, although growth was inhibited by
      these substrates at concentrations above 250 microM. 2- and 4-Hydroxybiphenyl
      were detected as products of biphenyl metabolism and 2- and 4-hydroxydiphenyl
      ether as products of diphenyl ether metabolism in the culture media. After
      addition of 2-hydroxydiphenyl ether and 2-hydroxybiphenyl to cell-free
      supernatants containing laccase as the only ligninolytic enzyme, different
      coloured precipitates were formed. HPLC analysis revealed the formation of
      additional hydrophobic metabolites with one major product per transformation.
      Mass spectrometric analysis of the methyl derivatives of the polymer mixture
      indicated dimers and trimers with different binding types. The main products were
      identified as dimers with carbon-carbon bonds in para-position to the hydroxyl
      group of the monomers by mass spectroscopy and nuclear magnetic resonance
      spectroscopy.

PMID- 11195095
TI  - The Myxococcus xanthus wbgB gene encodes a glycosyltransferase homologue required
      for lipopolysaccharide O-antigen biosynthesis.
AB  - Myxococcus xanthus is a gram-negative soil bacterium that initiates a complex
      developmental program in response to starvation. A transposon insertion (Tn5-lac
      omega109) mutant with developmental deficiencies was isolated and characterized
      in this study. A strain containing this insertion mutation in an otherwise wild
      type background showed delayed developmental aggregation for about 12 h and
      sporulated at 1-2% of the wild-type level. Tn5-lac omega109 was found to have
      disrupted the M. xanthus wbgB gene, which is located 2.1 kb downstream of the M.
      xanthus lipopolysacharide (LPS) O-antigen biosynthesis genes wzm wzt wbgA. The
      deduced polypeptide sequence of WbgB shares significant similarity with bacterial
      glycosyltransferases including M. xanthus WbgA. The wbgB::Tn5-lac omega109 mutant
      was found to be defective in LPS O-antigen synthesis by immunochemical analysis.
      Further mutational analysis indicated that the defects of the wbgB::Tn5-lac
      omega109 mutant were not the result of polar effects on downstream genes. Various
      motility assays demonstrated that the Tn5-lac omega109 mutation affected both
      social (S) and adventurous (A) gliding motility of M. xanthus cells. The
      pleiotrophic effects of wbgB mutations indicate the importance of LPS O-antigen
      biosynthesis for various cellular functions in M. xanthus.

PMID- 11195096
TI  - A stable archaeal pyruvate carboxylase from the hyperthermophile Methanococcus
      jannaschii.
AB  - The pyruvate carboxylase (PYC) of the hyperthermophilic, strictly
      hydrogenotrophic, autotrophic and marine methanarchaeon Methanococcus jannaschii
      was purified to homogeneity. Optimal activity was at pH 8.5, > or = 80 degrees C,
      and a KCl concentration of 0.175 M. This enzyme is the most thermophilic PYC so
      far studied. Unlike the Methanobacterium thermoautotrophicum enzyme, Mc.
      jannaschii PYC was expressed in cells grown without an external source of biotin
      and in the purified form was stable during storage at 4, -20 and -80 degrees C.
      However, it was rapidly inactivated at 80 degrees C. The enzyme was insensitive
      to aspartate and glutamate, mildly inhibited by alpha-ketoglutarate, and was
      strongly inhibited by ATP and ADP (apparent Km, for ATP, 0.374 +/- 0.039 mM;
      apparent Ki for ATP, 5.34 +/- 2.14 mM; Ki for ADP, 0.89 +/- 0.18 mM). It was also
      strongly inhibited when the Mg2+ concentration in the assay exceeded that of ATP.
      Thus, this stable PYC could serve as a model for mechanistic studies on archaeal
      PYCs. It was apparently an alpha4beta4-type PYC composed of a non-biotinylated
      55.5-kDa subunit (PYCA) and a 64.2-kDa biotinylated subunit (PYCB). The
      determined NH2-terminal sequences for these subunits provided additional support
      for our earlier proposal to rename the ORFs MJ1229 and MJ1231 in the NCBI Mc.
      jannaschii genome sequence database as PYCA and PYCB, respectively; even very
      recently, these have been misidentified as a subunit of acetyl-CoA carbxoylase
      (AccC) and the alpha-subunit of ion-pumping oxaloacetate decarboxylase
      (OADalpha), respectively.

PMID- 11195097
TI  - Hydrogen production by methanogens under low-hydrogen conditions.
AB  - Hydrogen production was studied in four species of methanogens
      (Methanothermobacter marburgensis, Methanosaeta thermophila, Methanosarcina
      barkeri, and Methanosaeta concilii) under conditions of low (sub-nanomolar)
      ambient hydrogen concentration using a specially designed culture apparatus.
      Transient hydrogen production was observed and quantified for each species
      studied. Methane was excluded as the electron source, as was all organic material
      added during growth of the cultures (acetate, yeast extract, peptone). Hydrogen
      production showed a strong temperature dependence, and production ceased at
      temperatures below the growth range of the organisms. Addition of polysulfides to
      the cultures greatly decreased hydrogen production. The addition of
      bromoethanesulfonic acid had little influence on hydrogen production. These
      experiments demonstrate that some methanogens produce excess reducing equivalents
      during growth and convert them to hydrogen when the ambient hydrogen
      concentration becomes low. The lack of sustained hydrogen production by the
      cultures in the presence of methane provides evidence against "reverse
      methanogenesis" as the mechanism for anaerobic methane oxidation.

PMID- 11195098
TI  - Isolation of human intestinal bacteria metabolizing the natural isoflavone
      glycosides daidzin and genistin.
AB  - Fecal bacteria from a healthy individual were screened for the specific bacteria
      involved in the metabolism of dietary isoflavonoids. Two strains of bacteria
      capable of producing primary and secondary metabolites from the natural
      isoflavone glycosides daidzin and genistin were detected. The metabolites were
      identified by comparison of their HPLC/mass, 1H NMR and UV spectra with those of
      standard and synthetic compounds. Both Escherichia coli HGH21 and the gram
      positive strain HGH6 converted daidzin and genistin to the their respective
      aglycones daidzein and genistein. Under anoxic conditions, strain HGH6 further
      metabolized the isoflavones daidzein and genistein to dihydrodaidzein and
      dihydrogenistein, respectively. The reduction of a double bond between C-2 and C
      3 to a single bond was isoflavonoid-specific by strain HGH6, which did not reduce
      a similar bond in the flavonoids apigenin and chrysin. Strain HGH6 did not
      further metabolize dihydrodaidzein and dihydrogenistein. This is the first study
      in which specific colonic bacteria that are involved in the metabolism of daidzin
      and genistin have been detected.

PMID- 11195099
TI  - Simulation of the conformation of the murein fabric: the oligoglycan, penta
      muropeptide, and cross-linked nona-muropeptide.
AB  - The structure and conformation of the sacculus of bacteria at a scale much larger
      than just the component disaccharide penta-muropeptide is not well known and is
      crucially important for the understanding of bacterial growth and cell wall
      function. By computer simulations, the minimal energy conformations and the
      energy needed for stretching the component parts were found. The oligosaccharide
      chain, modeled as (GlcNAc-MurNAc)8 when under no tension, can assumed a variety
      of nearly iso-energetic conformations. These included a variety of bends and
      kinks, with the chain forming an irregular random coil. In the most relaxed and
      minimal energy state, the D-lactyl groups of the MurNAc (N-acetyl muramic acid)
      residues protruded at about an angle of 90 degrees relative to the D-lactyl
      groups of their immediate MurNAc neighbors in the same chain. The cell wall penta
      muropeptide precursor is identical for Escherichia coli and Bacillus subtilis; it
      also adopted many conformations, each of an energy almost equal to the global
      minimum. The cross-bridged structure of the tail-to-tail linkage of disaccharide
      nona-muropeptide has a second type of association, in addition to the covalent
      cross-bridge, which has not been considered before. This is the ionic interaction
      between the free D-Ala and the free amino group of the m-A2 pm. In vivo, when the
      cross-bridge is stretched (in the computer to simulate growth), this pairing
      dissociates. The possible biological significance of this is that it exposes the
      underlying 'tail-to-tail' peptide bond to autolysis and will expose both the ends
      of the m-A2 pm and the D-AlaD-Ala groups that may then be able to react with
      nascent penta-muropeptides to form trimers. This suggests a new model for growth
      of the bacterial cell wall that depends on changes in the chemical conformation
      of the cross-bridge structure as it comes to bear stress.

PMID- 11195100
TI  - Acetobacterium tundrae sp nov, a new psychrophilic acetogenic bacterium from
      tundra soil.
AB  - A new psychrophilic, anaerobic, acetogenic bacterium from the tundra wetland soil
      of Polar Ural is described. The organism fermented H2/CO2, formate, methanol, and
      several sugars to acetate as the sole end-product. The temperature range for
      growth was 1-30 degrees C with an optimum at 20 degrees C. The bacterium showed
      no growth at 32 degrees C. Cells were gram-positive, oval-shaped, flagellated
      rods 0.7-1.l x 1.1-4.0 microm in size when grown at 1-20 degrees C. At 25-30
      degrees C, the cell size increased up to 2-3 x 10-15 microm due to a defect in
      cell division. The DNA G+C content of the organism was 39.2 mol%. Based upon 16S
      rDNA analysis and DNA-DNA reassociation studies, the organism was classified in
      the genus Acetobacterium as a new species, for which the name Acetobacterium
      tundrae sp. nov. is proposed. The type strain is Z-4493 (=DSM 9173T).

PMID- 11195101
TI  - Stable sulfur isotope fractionation during the reduction of thiosulfate by
      Dethiosulfovibrio russensis.
AB  - Stable sulfur isotope fractionation was investigated during reduction of
      thiosulfate by growing batch cultures of Dethiosulfovibrio russensis at a cell
      specific reduction rate of 2.4 +/- 0.72 fmol cell(-1) d(-1) (28 degrees C).
      Citrate was used as carbon and energy source. The hydrogen sulfide produced by
      this sulfur- and thiosulfate-reducing bacterium was depleted in 34S by 11%
      compared to total thiosulfate sulfur, in agreement with previous results observed
      for sulfate-reducing bacteria. This indicates the operation of a similar pathway
      for thiosulfate reduction in these phylogenetically different bacteria.

PMID- 11195102
TI  - Inducible expression and cellular location of AgrB, a protein involved in the
      maturation of the staphylococcal quorum-sensing pheromone.
AB  - AgrB has been suggested to be responsible for the posttranslational modification
      in staphylococci that leads to the production of the thiolactone-containing agr
      peptide pheromone. We demonstrate that AgrB is located in the cytoplasmic
      membrane. Vectors were constructed for the xylose-inducible overexpression of
      agrB, and of agrB and agrD together. A Staphylococcus epidermidis strain deleted
      for agr and containing these vectors was assayed for AgrB protein and pheromone
      production. The lack of adequate pheromone production suggests the involvement of
      additional factors in the production of the agr pheromone.

PMID- 11195103
TI  - A review of serious injuries and deaths among car occupants after motor vehicle
      crashes in Sweden from 1987 to 1994.
AB  - Car occupants injured in motor vehicle crashes (MVC) are a common problem in
      emergency departments. The aims of this study were to determine the incidence
      over time, according to the type of injury, age and sex distribution, mortality
      rate and geographical differences among all patients admitted to Swedish
      hospitals because of MVC injuries. Between 1987 and 1994, Swedish hospitals
      admitted 37,871 persons (51,348 admissions) who had been involved in MVC as
      drivers or passengers. There were 23,369 men and 14,502 women. The annual
      frequency of hospital admissions ranged from 5,943 to 7,175. There were 74.8
      injured persons admitted per 100,000 of the population each year. Males between
      16 and 24 years of age were more commonly involved. Injuries to the head and neck
      were particularly frequent (39%). Older persons, males, and passengers had a poor
      survival outcome. The incidence of injured car occupants was significantly higher
      in sparsly populated areas of Sweden.

PMID- 11195104
TI  - Anchor limited arthrodesis of the wrist.
AB  - We present a case of lunate dislocation with total disruption of all ligaments
      and, consequently, nutrient vessels. The injury was handled by fusion of the
      lunate with the scaphoid, capitate and triquetrum. This 'anchor fusion' has led
      to a very good long-term result.

PMID- 11195105
TI  - Glomangiopericytoma causing oncogenic osteomalacia. A case report with
      immunohistochemical analysis.
AB  - A 47-year-old woman suffered from gait disturbance due to back pain and muscle
      weakness. Laboratory data showed serum hypophosphatemia, elevated alkaline
      phosphatase, and a normal level of ionized calcium. Radiological examinations
      revealed multiple pathologic fractures in the ribs and pubic rami. She had had no
      episode of familial or any other notable disorder, and so she was initially
      treated with medication for adult-onset osteomalacia. However, 19 years later
      (when she was 66 years old), she noticed a soft-tissue tumor in her buttock. The
      tumor was excised. The histological features were those of glomangiopericytoma
      characterized by both glomus tumor-like and hemangiopericytoma-like structures.
      After removal of the tumor, her symptoms disappeared immediately. Laboratory data
      normalized 8 months later. To our knowledge, this is the first report of
      oncogenic osteomalacia caused by glomangiopericytoma.

PMID- 11195106
TI  - Synovial chondromatosis of the glenohumeral joint: a rare condition.
AB  - The case of a 22-year-old man with synovial chondromatosis (SC) of the shoulder
      joint is described. A literature review confirmed that SC of the glenohumeral
      joint is very rare and that the etiology of the disease is still unknown. The
      diagnosis is often delayed, and the preferred form of management remains
      controversial. We consider magnetic resonance imaging (MRI) a valuable tool in
      detecting SC at an early phase and estimating the intrasynovial extent of the
      disease. Shoulder arthroscopy today represents an elegant treatment option for
      removing the chondromas and performing a partial synovectomy. It might, however,
      be insufficent in cases of involvement of the bicipital tendon sheath and other
      recesses of the joint.

PMID- 11195107
TI  - Forty-two year survival with bilateral Judet hip prostheses.
AB  - In this case report, a 70-year-old man is presented who had begun to suffer from
      ankylosing spondylitis when he was 12 years old and had been operated on because
      of bilateral hip ankylosis at the age of 21 years. The interesting aspect of this
      case is that both hips were replaced with Judet type prostheses, which survived
      for 42 years.

PMID- 11195108
TI  - Presacral tumor associated with the Currarino triad in an adolescent.
AB  - A 17-year-old woman presented with pain over the sacral region. Plain radiographs
      of the sacrum demonstrated a bony deformity of the sacrococcygeal region in the
      shape of a scimitar. Magnetic resonance imaging showed a cystic mass of the
      presacral region which appeared to be continuous with the dural sac. An
      anteroposterior view myelogram revealed caudal elongation of the dural sac, and
      on the lateral view it was recognized as an anterior meningocele. At surgery, we
      confirmed a connection between the presacral mass and the rectum. In light of the
      combination of a sacral bony deformity, presacral mass including meningocele, and
      mass-rectum connection, we made the diagnosis of the Currarino triad, which is a
      rare complex of congenital caudal anomalies. The patient underwent excision of
      the presacral mass. Histologic examination of the resected specimen revealed
      features of an epidermoid cyst.

PMID- 11195109
TI  - Osteoid osteoma of olecranon process of ulna in subchondral location.
AB  - We present a case of a 15-year-old girl with osteoid osteoma in an unusual
      subchondral localization of the olecranon. Unspecific complaints and minimal X
      ray findings at the onset of the disease led to an incorrect diagnosis and more
      than 2 years of inefficient treatment.

PMID- 11195110
TI  - Osteoid osteoma of the carpal bones.
AB  - Osteoid osteoma is a benign bone tumor that rarely localizes in the hand or the
      carpal bones. We report two cases of osteoid osteoma localized in two different
      carpal bones. Unremitting wrist pain was a major clinical symptom. Surgical
      treatment including excision of the nidus was dramatically curative. In young
      patients, osteoid osteoma should be considered in the differential diagnosis of
      chronic wrist pain.

PMID- 11195111
TI  - Patellar tension band wiring: a revised technique.
AB  - Using a modified AO tension band wiring technique to treat a patellar fracture
      has become popular and has achieved a high success rate. However, the technique
      of Kirschner wire insertion has not been considered in detail, which may migrate
      and consequently introduce fragments loss of reduction. A revised technique
      involving bending both ends of the Kirschner wires was prospectively studied.
      Sixty-eight consecutive patients were so treated, and 62 patients were followed
      up for at least 2 years (range 2-6 years). All fractures healed with a union rate
      of 100% (62/62) and a union period of 2.5 +/- 0.5 months. Skin irritation was
      noted in 2 patients (3%). All patients achieved a satisfactory result. We
      therefore recommend this revised technique to treat all patellar fractures
      because of its high union rate and low complication rate.

PMID- 11195112
TI  - The role of mini-fragment screw fixation in volar dislocations of the proximal
      interphalangeal joint.
AB  - Palmar fracture-dislocations of the proximal interphalangeal (PIP) joint are
      uncommon injuries, which can be associated with long-term complications if sub
      optimally treated. We report two cases of palmar fracture-dislocations of the PIP
      joint treated by open reduction and internal fixation using a single mini
      fragment screw. The long term results of hand and finger function were excellent.

PMID- 11195113
TI  - Isola spinal instrumentation system for idiopathic scoliosis.
AB  - Since the definition of three-dimensional components of the scoliotic deformity,
      there have been important improvements in the surgical treatment of the problem.
      A derotation maneuver was proposed as a treatment option with CD instrumentation,
      but the reports of imbalance and decompensation with this system repopularized
      sublaminar wiring and translation as a corrective maneuver. Isola spinal
      instrumentation is one of the modern systems that utilizes vertebral translation
      instead of rod rotation. This study analyzes the results of 24 patients with
      idiopathic scoliosis who had been followed up for at least 2 years, and were
      surgically treated with titanium Isola Spinal Instrumentation in the Department
      of Orthopaedics and Traumatology, Ankara Social Security Hospital. Patients were
      grouped according to the King-Moe classification. Patients with type III, IV or V
      curves received only posterior instrumentation while this procedure followed
      anterior release and discectomy in the same session in patients with type I or II
      curves. A translation maneuver was utilized in the correction of scoliotic curves
      using the cantilever technique, either alone or supplemented by sublaminar wiring
      with Songer multifilament titanium cables. This study aimed to elucidate the
      effects of this technique in the frontal and sagittal plane curves and the trunk
      balance. The balance was analyzed clinically and radiologically by measurement of
      the lateral trunk shift (LT), shift of stable vertebra (SS), and shift of head
      (SH) in vertebral units (VU). The postoperative correction was significant in the
      frontal plane for all types of curves (p < 0.05). The postoperative correction
      was 80.9% +/- 9.5% in type III curves. Overall, the mean Cobb angle of the major
      curve value in the frontal plane was 66.9 degrees +/- 18.8 degrees, and it was
      corrected by 62.8% +/- 20.1%. The correction loss of Cobb angles in the frontal
      plane was 5.4 degrees +/- 5.5 degrees at the last follow-up visit. A normal
      physiologic thoracic contour (30 degrees - 50 degrees) was achieved in 83.3% of
      the patients and normal lumbar contour (40 degrees - 60 degrees) in 66.7% of the
      patients in the sagittal plane. The correction was found to be significant in all
      balance values (p < 0.05). The postoperative correction in LT values correlated
      with the correction of the Cobb angle values in the frontal plane. All patients
      had complete balance (SH: 0 VU and SS: 0 VU) or balanced curves (0 VU < SH, SS <
      0.5 VU).Finally, the study concluded that the translation maneuver, especially
      when used with the cantilever technique, resulted in high correction rates in the
      frontal plane. Additionally, the technique was also successful in obtaining
      normal sagittal contours and correcting balance values.

PMID- 11195114
TI  - The GSB total knee arthroplasty. A medium- and long-term follow-up and survival
      analysis.
AB  - From 1981 to 1987, 77 GSB-II total knee arthroplasties were implanted in 65
      patients. There were 23 men and 42 women aged on average 60 years old (range 30
      85 years). The diagnosis was osteoarthritis (OA) in 21 knees, rheumatoid
      arthritis (RA) in 44 knees, and other in 12 knees. A clinical and radiological
      follow-up was performed in two stages after a mean of 6.7 years (61 knees) and
      14.8 years (22 knees) to assess the medium- and long-term results and to
      determine if deterioration had occurred after mid-term follow-up. A survival
      analysis was done with two endpoints: (1) revision, and (2) revision, moderate or
      severe pain and lost to follow-up (worst-case scenario). At the last follow-up 36
      patients (44 knees) had died, 2 patients (2 knees) refused examination, and 3
      patients (3 knees) were lost to follow-up. Six knees had been revised for
      malposition (1.3%), septic (3.9%) and aseptic (2.6%) loosening. The mean Knee
      Society score after 6.7 and 14.8 years was 85 points (OA 82 points, RA 87
      points). Lateralisation, subluxation or dislocation of the patella was present in
      8 of 17 knees at the last follow-up. The 6- and 15-year survival rates with
      revision as the endpoint were 95% (CI 89%-100%) and 87% (CI 65%-100%),
      respectively. For the worst-case scenario, the 6- and 15-year survival rates were
      95% (CI 89%-100%) and 56% (CI 0%-100%), respectively. The medium- and long-term
      results of the GSB-II total knee arthroplasty were good, and a decline in the
      knee score did not occur beyond the mid-term follow-up. Patella complications
      were abundant, and a marked decrease in implant survival was noted when moderate
      or severe pain and lost to follow-up were included as endpoints.

PMID- 11195115
TI  - Fracture-dislocations of the elbow joint--strategy for treatment and results.
AB  - Between January 1993 and December 1996, 41 patients with fracture dislocation of
      the elbow joint were treated in our department. In 28 patients (median age 46
      years, range 15-77 years; 16 male, 12 female), a clinical and radiological follow
      up was obtained after median 34 months (range 12-59 months). In addition to the
      humero-ulnar dislocation, isolated fractures were present in 13 patients and
      combined fractures in 15 (all with involvement of the radial head). Primary
      neurological deficits were found in 7 and open fractures in 3 patients. In 7
      patients, primary definitive surgical therapy was carried out by open reduction
      and internal fixation. A two-step surgical management (initial closed reduction
      and immobilization, 5 patients with external fixator, 7 with plaster; secondary
      open surgical procedure) was performed in 12 and conservative treatment in 9
      patients. According to the Leipzig Elbow Score, taking subjective, clinical and
      radiological criteria into consideration, 4 patients achieved 'excellent' and 5
      patients a 'good' result. Ten patients were scored 'moderate' and 9 'poor'. The
      rate of secondary complications necessitating revision was 36%. Poor results were
      primarily caused by extensive initial soft-tissue damage, delayed definitive
      surgical therapy, and ectopic heterotopic ossification. In contrast, fracture
      localization and degree of arthrosis were not of significant importance for the
      final outcome. In fracture dislocations, the goal is a primary definitive
      surgical treatment aiming for early postoperative physiotherapy.

PMID- 11195116
TI  - Fifteen-year results of the Muller CoCrNiMo straight stem.
AB  - Between September 1980 and May 1982, 112 primary unilateral total hip
      arthroplasties with the original cemented M. E. Muller Straight stem
      (manufactured from Protasul-10, a CoCrNiMo alloy) were inserted in 109
      consecutive patients, all combined with non-cemented, non-coated polyethylene RM
      cups. Forty-three patients (40%) died during the follow-up period, all with the
      implant in place. Of the 66 surviving patients, 2 (1.8%) were lost to follow-up,
      and 7 (6.3%) were unable to attend the 15-year clinical and radiological follow
      up. Eight stems (7.3%) had to be revised for aseptic loosening and 3 stems
      (2.7%), for septic loosening. The 15-year survivorship of the Muller Straight
      stem regarding aseptic loosening is, therefore, 92.7%. Forty-six patients with 49
      total hip replacements could be evaluated clinically and radiologically after 15
      years. The mean duration of clinical follow-up for these 46 patients (42.2%) was
      14.8 years (range 12.8-16.5 years). There were 22 women (48%) and 24 men (52%).
      The mean age at the time of the operation was 62 years (range 38-80 years), and
      78 years (range 59-93 years) at the time of the latest follow-up. The mean Harris
      Hip Score at the latest follow-up evaluation of the 49 hip joints was 85 points
      (range 34-100 points). Of the 46 patients, 39 (85%) had a good or excellent
      clinical result. Radiographic follow-up was performed for 49 hips: 35 (70%) had
      linear or focal osteolysis in one or more zones of the stem, but only 4 (8%) had
      evidence of definitive loosening (linear radiolucency of over 2 mm all around the
      stem). Subsidence of over 2 mm was found in 20 hips (41%), 6 of them within the
      cement mantle. There was no correlation between subsidence and pain. The cause
      for the poor results is primarily the high rate of aseptic loosening of the non
      coated, non-cemented all-polyethylene RM cups, with a loosening rate of 63% and a
      revision rate of 25% after 15 years.

PMID- 11195117
TI  - Pelvic fracture among polytrauma decedents. Trauma-based mortality with pelvic
      fracture--a case series of 74 patients.
AB  - Pelvic fractures (PF) sustained from accidents are commonly believed to be a
      major cause of mortality in polytraumatized patients. The purpose of this paper
      is to determine whether PF are usually the primary cause or a contributing cause
      of mortality in these patients. A 10-year retrospective review was performed of
      all polytrauma patients with PF who were admitted to, and died, at a large, level
      I trauma center. The pelvic injury was graded according to Schatzker and Tile
      into stable (type A), partially stable (type B), and unstable (type C). The
      injury severity score (ISS), which incorporates associated injuries and their
      potential impact on mortality, was calculated for all patients. For each patient,
      a separate subjective designation of the probable cause of death was determined.
      We identified 74 decedents with PF following deceleration trauma. The pelvic
      fractures were classified as 12 type A (16%), 36 type B (49%), and 26 type C
      (35%). The mean ISS was extremely high, 40.6 +/- 1.4 (range 18-75), more than
      four times the score for simply a severe PF. The ISS was also not significantly
      different among the three pelvic fracture groups (P = 0.613). The records
      subjectively identified PF as the precipitating cause of death in only 13% of the
      patients. In this study, patients who died with PF had an ISS that implicated at
      least one or two additional major visceral injuries. These data do not support
      the hypothesis that PF, regardless of its complexity, is the usual primary cause
      or the major precipitating event of death in the polytraumatized patient. In
      these patients, mortality appears to be a function of the associated injuries
      based on the ISS calculation.

PMID- 11195118
TI  - A review of halo vest treatment of upper cervical spine injuries.
AB  - Thirty-five relevant studies involving in total 682 patients with 709 different
      types of injuries were evaluated in a review to determine the outcomes after
      immobilisation in a halo vest for various injuries to the upper cervical spine
      between 1962 and 1998. Studies were analysed according to the type of injury
      pattern and in terms of the treatment outcomes following primary treatment with a
      halo vest. The following types of injuries were evaluated: odontoid fractures (n
      = 420), hangman's fractures (n = 172), other axis fractures (n = 75), Jefferson
      fractures (n = 26), C1 arch fractures (n = 9), atlantooccipital (n = 2) and
      atlantoaxial dislocations (n = 5). The ligamentary atlantooccipital dislocations
      never healed. All isolated Cl ring fractures healed completely. The isolated C1
      arch fractures healed in 83% of the cases. The ligamentary atlantoaxial
      dislocations had a 60% rate of healing. Healing was noted in all isolated
      odontoid type I fractures, 85% of the isolated odontoid type II fractures, and
      67% of the odontoid type II fractures with combined injuries. The isolated
      odontoid type III fractures had a 97% healing rate. The non-classifiable odontoid
      fractures had a healing rate of 85%. The stable C2 arch fractures (hangman's
      fracture) healed consistently in 99%, and 90% success was found for other C2
      fractures. A halo vest can be recommended for patients with isolated Jefferson
      fractures, hangman's fractures, odontoid type III and type II fractures, with a
      low dislocation rate. The results of treatment with a halo vest were
      unsatisfactory with regard to combined injuries with an odontoid type II
      fracture. An overall healing rate of 86%, however, allows one to conclude that
      this treatment continues to be a good alternative to operative stabilisation of
      bone injuries to the upper cervical spine.

PMID- 11195119
TI  - Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis
      -a matched-pair analysis of 100 patients.
AB  - Conservative or operative treatment for rotator cuff calcifying tendinitis was
      investigated in 100 patients in a matched-pair analysis. They were examined
      clinically and ultrasonographically 35-60 months after the initial visit. The
      mean Patte score was 91.8 for the patients who underwent surgical treatment and
      81 for the ones who received conservative therapy (p < 0.004), while the age
      related Constant-score was 103.4 and 95, respectively. Ultrasonography showed 28%
      calcifications in the surgical group, 18% newly formed and 10% that did not
      resolve after surgery. In the conservatively treated group, 33% calcifications
      were seen, of which 67% resolved. The number of rotator cuff ruptures was
      significantly higher in the conservative group. In the surgical group, 2% of
      partial tears and in the conservative group 5% of partial and 4% of complete cuff
      ruptures were found. Conservative treatment for calcifying tendinitis leads to
      less favourable pain results in the long term than surgical treatment. Surgery
      shortens the painful period and may reduce the number of future rotator cuff
      ruptures. Finally, the subjective functional outcome is significantly better
      after surgery.

PMID- 11195120
TI  - A model for assessing the rotational stability of uncemented femoral implants.
AB  - Permanent secondary stability of the uncemented femoral stem of hip prostheses
      can only be achieved once primary rotational and axial stability has been
      ensured. Rotational stability means that the stem is resistant to the articular
      forces that induce rotation around the implant's longitudinal axis. The 10-year
      survival rates of two uncemented conical shaped stems with decisively different
      proximal shapes were significantly different (Schenker SK 63.9%, Zweymuller SL
      97.0%). The shapes were analyzed biomechanically by testing rotational stability
      in a silicone model. A reduction in the mediolateral height of the metaphyseal
      part by one-third led to a 20% smaller angle of ascent (P < 0.01), which
      indicated lower resistance. The proximally broader (mediolateral) prosthesis
      therefore proved to have better rotational stability. The study confirms that
      aseptic stem loosening is attributable to the design of the proximal part of the
      prosthesis.

PMID- 11195121
TI  - Effect of preoperative chemotherapy on the outcome of surgical treatment of
      vertebral tuberculosis: retrospective analysis of 434 cases.
AB  - A retrospective analysis of 434 patients with vertebral tuberculosis who were
      treated surgically was performed with special reference to the preoperative
      duration of chemotherapy. Of these, 376 underwent 4 weeks of a chemotherapy
      regimen with isoniazid, rifampin and ethamburol, and in 2 re-activation of the
      disease was observed. The remaining 58 underwent operation for neurological
      impairment with 6-18 h of the same chemotherapy regimen, and in no case did re
      activation occur. These results suggest a shorter duration of chemotherapy may be
      utilised in all patients undergoing surgical treatment for vertebral
      tuberculosis, providing a thorough debridement is performed, leaving no necrotic
      or infected tissue behind.

PMID- 11195122
TI  - Surgical treatment of tibial plateau fracture in elderly patients.
AB  - This retrospective study involves 22 patients with displaced tibial plateau
      fractures who were treated surgically from July 1993 to April 1996. All the
      patients were over 60 years old (mean 66.3 years old, range 61-80 years). All of
      the patients were treated by open reduction and internal fixation with AO/ASIF
      buttress plates (Synthes, Bochum, Switzerland). Additional small fragment plate
      or inter-fragmental screws were used in some of them as indicated. Two patients
      died during follow-up of causes unrelated to the fractures. The average follow-up
      time was 49.8 months (range 36-68 months). The other 20 patients were interviewed
      at the outpatient clinic, and radiographs of bilateral standing knees were taken.
      By comparison with the uninjured side on radiographs, condylar joint space
      depression was noted in 6 patients. However, joint depression greater than 4 mm
      was not found. Malalignment with varus or valgus greater than 5 deg was not
      demonstrated in any case. Their range of motion was restored in all patients,
      with more than 120 deg of flexion and without extension lag except for the one
      who suffered a superficial wound infection. No complication required further
      surgical management. During the period of follow-up, no accelerated degenerative
      change in the operated knee joint resulted in total knee arthroplasty. Two
      patients needed occasional medical treatment for residual knee joint pain. Only
      two patients needed canes for assistance during walking due to old age and minor
      stroke. The results justify surgical treatment for displaced tibial plateau
      fractures in elderly patients.

PMID- 11195123
TI  - The role of clinical examination and risk factors in the diagnosis of
      developmental dysplasia of the hip: a prospective study in 188 referred young
      infants.
AB  - In this prospective study, the role of clinical examination and risk factors in
      the diagnosis of developmental dysplasia of the hip (DDH) was analysed. For this
      purpose, 376 hips of 188 referred infants with an average age of 3.7 months
      (range 0-8 months) were clinically and ultrasonographically (Graf method)
      examined. Infants who had at least one risk factor for DDH had a three times
      higher occurence rate of DDH than those who didn't have any. Breech presentation
      and positive family history were the two most common risk factors associated with
      DDH. The rate of DDH was nearly 16 times higher in the hips with at least one
      abnormal clinical finding than in the ones without any. Ultrasonographically
      unstable hips (type IIc-unstable to type IV) were always detected during clinical
      examination. There was a risk of missing the diagnosis of hips with acetabular
      dysplasia alone. Limitation of abduction and asymmetry of the skin folds were the
      two most common clinical findings associated with DDH. Nearly two-thirds of the
      infants with at least one positive clinical finding and at least one risk factor
      had either an unilateral or bilateral dysplastic hip. It was concluded that a
      careful clinical examination was significantly more important than the coexisting
      risk factors in the detection of DDH.

PMID- 11195124
TI  - Ipsilateral fracture of the femoral neck and shaft, treatment by reconstruction
      interlocking nail.
AB  - This study involved nine patients with ipsilateral fractures of the neck and
      shaft of the femur. They were all male with an average age of 28.5 years. All of
      the fractures resulted from high-energy trauma. The neck fracture was initially
      missed in one case. All fractures were fixed by a Russell-Taylor reconstruction
      femoral nail. Surgery was delayed for an average of 6.6 days (range 2-21 days).
      The patients were followed up for an average of 2.1 years. All fractures healed;
      the average time of union for the neck fracture was 4.2 months (range 3-6 months)
      and for the shaft fracture, 6.9 months (range 4-18 months). A delay in surgery
      did not affect the union rate. There were no cases of avascular necrosis or non
      union of the femoral neck fracture. One hip healed into mild varus, one shaft
      fracture had a delayed union, and one developed a late infection of the femoral
      shaft. The use of the reconstruction nail offers superior stabilization over
      other currently used methods and is associated with fewer complications.

PMID- 11195125
TI  - Osteoporosis in patients with paralysis after spinal cord injury. A cross
      sectional study in 46 male patients with dual-energy X-ray absorptiometry.
AB  - In a cross-sectional study, 46 male patients with paralysis after spinal cord
      injury (average age 32 years; injuries sustained from 1 to 26 years ago; 33
      Frankel A, 13 Frankel B, C, D) were examined clinically and by dual-energy X-ray
      absorptiometry (DEXA). Their bone mineral density (BMD) values were compared with
      age-related controls and correlated to clinical parameters. BMD was reduced in
      the proximal femur (p < 0.05) and the distal forearm (p < 0.05), but not in the
      lumbar spine. Demineralisation was influenced in the proximal femur (Z-score 
      2.95) by immobilisation after surgical treatment. Patients suffering from
      complete lesions had significantly lower BMD in the lumbar spine (-1.47) compared
      with patients with incomplete lesions (+0.02). BMD was not significantly
      influenced by the level of the lesion and the ambulatory status. Long-term
      monitoring showed significant demineralisation in the proximal femur (r = -0.36)
      and the distal forearm (r = -0.4), but not in the lumbar spine (r = -0.21). By
      correlating BMD with clinical parameters, it can be deduced that, firstly,
      immobilisation after surgical treatment should be reduced to a minimum; secondly,
      that every effort must be expended to prevent turning an incomplete into a
      complete lesion; and finally, that rehabilitation treatment should be lifelong.

PMID- 11195126
TI  - Adaptation of Ilizarov ring fixator to the economic situation of developing
      countries.
AB  - Especially in countries with low per capita income, poor patients with open
      fractures and non-unions are unable to purchase modern, commercially produced
      surgical implants. To alleviate this situation, we initiated the production of a
      locally made ring fixator. The rings were cut from tubes cast from scrap
      aluminium. It was applied in 40 patients to test its utility for the typical
      indications for the Ilizarov technique. The fixator was tolerated well. All
      fractures united except in one case where there was refracture of the consolidate
      due to too early removal of the fixator. Two arthrodeses were successful. Bone
      transport showed adequate regeneration. A single radial non-union united
      successfully. Loosening occurred in 11 wires and breakage in 6. The subacute
      infections in 11 (27.5%) patients were not due to the fixator itself but to low
      standards of hygiene and the delay of treatment in the prehospital phase. Reusing
      the fixator at least three times reduces the cost for the individual patient to
      US$ 13.60. A locally made fixator is cost-effective and can be recommended for
      surgical treatment under similar economic situations.

PMID- 11195127
TI  - Treatment of stages 2 and 3 giant-cell tumor.
AB  - During the period from August 1986 to August 1992, we treated 23 patients with
      giant cell tumors stage 2 or 3, according to the classification by Campanacci et
      al.. We analyzed the therapeutic options, complications, local recurrence rate,
      and functional results after a mean follow-up of 56 months (range 31-89 months).
      Intralesional resections were performed in 15 and wide resections in 8 patients.
      The majority of intralesional resections were performed for stage 2 tumors and
      the majority of en-bloc resections for stage 3 tumors. The overall local
      recurrence rate was 8.7%, but we observed local recurrence only in intralesional
      resections. Our experiences suggest that a subtle surgical technique with respect
      to oncological requirements is the most important element in the avoidance of
      local recurrence. Stage 2 tumors associated with weight-bearing anatomical
      structures should be treated with intralesional curettage and bone cement. Stage
      3 tumors are limited as to their surgical options and are determined in some
      cases by their localization and the degree of bone destruction. Wide resections
      should be reserved mainly for stage 3 tumors.

PMID- 11195128
TI  - Early mobilization after sliding and Z-lengthening of heel cord: a preliminary
      experimental study in rabbits.
AB  - Sliding lengthening and Z-lengthening techniques are widely used in heel cord
      lengthening. Even though most surgeons performing these procedures apply a short
      leg cast after surgery, their postoperative immobilization intervals vary from 3
      to 7 weeks. Nather et al. showed that there was no need for immobilization after
      the musculotendinous lengthening of long, deep flexor tendons. In the present
      study, we aimed to show the healing process of heel cords lengthened by sliding
      and Z-plasty lengthening in rabbits that did not undergo any postoperative
      immobilization. We performed sliding lengthening in the right heel cords of the
      rabbits and Z-lengthening in the left heel cords. We compared these two
      techniques radiographically, biomechanically, and histopathologically. Even
      though the biomechanical study showed superior results in the sliding lengthening
      group on the 7th day, elongation of the tendons at both sites was seen
      radiographically. There was no statistically significant difference between the
      sites according to the biomechanical study done on the 28th day. We concluded
      that the ankle should be immobilized in the early healing phase and that both
      types of lengthening gain a similar level of strength by the 4th week.

PMID- 11195129
TI  - Septic arthritis of a lumbar facet joint due to pyonex.
AB  - We present a case of septic arthritis of a lumbar facet joint with an associated
      epidural abscess. A 13-year-old boy was hospitalized with acute severe back pain
      and fever after pyonex was done. The infection was precisely localized with
      magnetic resonance imaging, bone and gallium scintigraphy. He responded to
      antibiotic therapy. We suppose that the infection was caused by pyonex because
      the blood cultures were negative, and the patient had an abrupt onset of severe
      pain and fever 24 h after the acupuncture.

PMID- 11195130
TI  - Primary intramuscular hydatidosis of supraspinatus muscle.
AB  - Hydatid disease of the muscle is very rare and represents approximately 3% of all
      patients with hydatidosis. Since the infection closely resembles a soft-tissue
      tumor on clinical examination, the preoperative radiologic diagnosis is very
      important to avoid biopsy. We report an unusual case of primary intramuscular
      hydatidosis with its magnetic resonance imaging appearance, clinical and
      pathological findings.

PMID- 11195131
TI  - Flexor digitorum longus accessorius in the club foot of an infant with Nager
      syndrome.
AB  - The case of a male infant is reported who had club foot on the right side and pes
      adductus on the left side in combination with acrofacial dysostosis; he also
      demonstrated preaxial anomalies of the upper limbs indicative of Nager syndrome.
      In addition, an unusual aberrant muscle was discovered during surgical correction
      of the right club foot.

PMID- 11195132
TI  - Periscapho-lunate dislocation.
AB  - A case of a volar periscapholunate dislocation is reported. Treatment by closed
      reduction and Kirschner wire fixation gave a good clinical result.

PMID- 11195133
TI  - No neurological involvement for more than 40 years in Klippel-Feil syndrome with
      severe hypermobility of the upper cervical spine.
AB  - We report the case of a 42-year-old woman with Klippel-Feil syndrome, who showed
      severe hypermobility of the upper cervical spine without neurological involvement
      for more than 40 years. Radiographs revealed the presence of the odontoid bone
      and fusion of the atlas, odontoid bone, and occiput. Congenital fusion was
      present from the axis to C5 as a block vertebra. Lateral flexion-extension
      radiographs revealed severe hypermobility at the junction between the odontoid
      bone and the axis. Prophylactic surgical stabilization has been recommended in
      patients with severe hypermobility, but adjacent disc problems may possibly occur
      at the unfused levels in the future. We believe that early prophylactic
      stabilization should not be indicated for Klippel-Feil syndrome without
      neurological involvement only because of hypermobility.

PMID- 11195134
TI  - Alcohol drinking and cigarette smoking: a "partner" for gastric ulceration.
AB  - Alcohol consumption and cigarette smoking are two etiologic factors that have a
      close relationship with peptic ulcer diseases. Chronic active gastritis is
      reportedly associated with chronic alcohol ingestion. Nonetheless, the
      inflammatory changes are likely to be related to concurrent Helicobacter pylori
      infection that is common among alcoholics. Moreover, chronic alcoholism is also
      correlated with the presence of gastric metaplasia. Both clinically and
      experimentally, alcohol had been shown to affect the mucosal barrier and
      histology. These ulcerogenic effects play a crucial role in altering gastric
      mucosal defense mechanisms. Cigarette smoking is coupled with the initiation and
      prolongation of gastric ulcers. Epidemiologic data show that cigarette smoking
      increases both the incidence and relapse rate of peptic ulcer diseases and also
      delays ulcer healing in humans. Retrospective studies also indicate that
      cigarette smoking is a key factor in inducing ulcer diseases rather than a linked
      behavior. The general detrimental effects of cigarette smoking in the gastric
      mucosa include reduction of circulating epidermal growth factor, increase in
      tissue free radical production and the presence of free radicals in smoke,
      together with reduction of mucosal constitutive nitric oxide synthase activity.
      Furthermore, the alteration of normal gastric mucosal blood flow and angiogenesis
      and the suppression of cell proliferation contribute largely to the delay in
      ulcer healing in cigarette smokers. Concurrent consumption of alcohol and
      cigarette smoking significantly increases the risk of gastric ulcers. In animal
      experiments, cigarette smoking potentiated ethanol-induced gastric mucosal
      damage. The reduction of mucus secretion, increase in leukotriene B4 level,
      increased activities of inducible nitric oxide synthase, xanthine oxidase and
      myeloperoxidase, and the expression of adhesion molecules in the gastric mucosa
      accompanied such potentiating effects. Substances other than nicotine in
      cigarette smoke may also contribute to the above effects.

PMID- 11195135
TI  - Guided tissue regeneration with and without demineralized freeze-dried bone
      allografts for maxillary Class II furca invasions of rapidly progressive
      periodontitis.
AB  - BACKGROUND: Guided tissue regeneration (GTR) using an expanded
      polytetrafluorethylene (ePTFE) membrane is an established treatment modality for
      periodontal disease. This study was designed to compare the effects of ePTFE
      membranes with and without demineralized, freeze-dried bone allografts (DFDBA)
      for treating maxillary class II buccal furca invasions of rapidly progressive
      periodonitis. METHODS: Seven patients with pairs of maxillary class II buccal
      furca invasions comprised the study group. The clinical parameters investigated
      were probing depth, probing attachment level and marginal tissue recession. One
      defect from each pair of teeth was randomly selected for the ePTFE membrane and
      DFDBA group and the other tooth defect received ePTFE membrane treatment only.
      During the operation, horizontal probing depths at the buccal furcation areas
      were measured. The membrane was removed 6 weeks after insertion. All measurements
      were repeated 1 year later at surgical re-entry of the buccal furcation. The
      Wilcoxon ranked sum test was used to test the significance of the difference
      between the groups 1 year after treatment. RESULTS: In the ePTFE membrane and
      DFDBA group, the mean probing depth reduction was 2.1 +/- 0.8 mm. The probing
      attachment gain was 2.6 +/- 1.0 mm and the bone fill was 3.1 +/- 1.7 mm. There
      was no statistically significant difference between the groups for these
      parameters. The marginal tissue recession was reduced 0.4 +/- 0.7 mm in ePTFE
      membrane and DFDBA group but increased 0.9 +/- 0.6 mm in ePTFE membrane only
      group. This difference was statistically significant (p = 0.016). CONCLUSIONS:
      There was no difference in probing depth reduction, probing attachment gain or
      bone fill between the two treatment modalities for treating maxillary class II
      buccal furca invasion of rapidly progressive periodontitis. Marginal tissue
      recession can be significantly reduced with the treatment of combined ePTFE
      membrane and DFDBA.

PMID- 11195136
TI  - False positive molecular diagnosis of Leber's hereditary optic neuropathy.
AB  - BACKGROUND: The most common pathogenic mitochondrial DNA (mtDNA) mutation
      associated with Leber's hereditary optic neuropathy (LHON) is at the 11,778
      nucleotide (nt) position and is usually detected by loss of an Sfa NI restriction
      site. However, Sfa NI restriction site includes five nucleotides. Substitution of
      any of the five nucleotides leads to loss of the cutting site and causes a false
      positive result. We investigated the false-positive diagnosis of LHON by loss of
      the Sfa NI restriction site using Sfa NI restriction site analysis and single
      strand conformation polymorphism (SSCP) analysis. METHODS: Mae III restriction
      analysis for double confirmation of the Sfa NI restriction site and direct
      sequencing for final confirmation of SSCP analysis were performed. RESULTS: The
      sensitivity of Sfa NI test was 100% and the specificity of the Sfa NI test was
      97%. The false-positive rate of Sfa NI test was 3%. SSCP analysis showed 100%
      sensitivity. Direct sequencing showed 32 patients had a mutation at nt 11,778 of
      mtDNA and one patient had a silent mutation at nt 11,782 of mtDNA. CONCLUSIONS:
      These results suggest that restriction enzyme digestion analysis requires double
      confirmation to avoid a false-positive diagnosis and that DNA sequencing is
      needed for the confirmation of the mutation detected by SSCP.

PMID- 11195137
TI  - Review of pre-eclampsia in Taiwan: a multi-institutional study.
AB  - BACKGROUND: Because the reported frequency of pre-eclampsia in Taiwan varies
      significantly, the aims of this study were to measure the current incidence of
      pre-eclampsia and its correlated morbidity and mortality for both mothers and
      fetuses in Taiwan. METHODS: We retrospectively studied all reported cases of pre
      eclampsia and eclampsia from January 1, 1993 to December 31, 1997 in the 14
      tertiary medical centers and regional hospitals in Taiwan. Recruiting criteria
      were pregnancy-induced hypertension (systolic blood pressure > or = 140 mmHg or
      diastolic blood pressure > or = 90 mmHg) with proteinuria (> or = 300 mg of
      urinary protein per 24 hours) and independent part edema. RESULTS: There were
      4,193 patients with pre-eclampsia and eclampsia for a frequency of 2.03% of
      206,551 deliveries during the study period. Of these, 58.9% of patients were
      classified as having mild pre-eclampsia while 38.4% had severe pre-eclampsia.
      Advanced maternal age (> 35 years) (odds ratio [OR] = 4.56; 95% confidence
      interval [CI] = 4.23-4.90; p < 0.001), primiparity (OR = 1.71; 95% CI = 1.61
      1.82; p = 0.02) and twin pregnancy (OR = 1.92; 95% CI = 1.64-2.25; p = 0.01) were
      significant risk factors for developing pre-eclampsia. However, multivariate
      analysis showed that only advanced maternal age was a significant risk factor for
      pre-eclampsia (OR = 3.21; 95% CI = 2.95-3.50; p < 0.001). In contrast to mild pre
      eclampsia, severe pre-eclampsia resulted in significantly worse outcomes for both
      mothers and fetuses. Complications in patients with severe pre-eclampsia included
      placental abruption, acute renal failure, pulmonary edema, postpartum hemorrhage,
      pleural effusion, preterm labor, intrauterine growth retardation, stillbirth,
      neonatal mortality and low birth weight infants, all of which occurred
      significantly more frequently than in patients with mild pre-eclampsia (p <
      0.001). CONCLUSIONS: Pre-eclampsia remains a big challenge in modern obstetrics
      in Taiwan. Early diagnosis and management of patients with pre-eclampsia to
      prevent progression would significantly improve outcomes for mothers and fetuses.

PMID- 11195138
TI  - Krypton-81m ventilation and technetium-99m macroaggregated albumin perfusion
      scintigraphy for detection of pulmonary embolism: the first experience in Taiwan.
AB  - BACKGROUND: This study was designed to assess whether the self-made (Institute of
      Nuclear Energy Research, Taiwan) krypton (Kr)-81m could be used as a ventilation
      agent to detect patients with suspected pulmonary embolism (PE). In addition,
      xenon (Xe)-133 ventilation scintigraphy was also performed for comparison.
      METHODS: Forty patients with suspected PE were studied. Each patient received Kr
      81m ventilation, Xe-133 ventilation and technetium (Tc)-99m macroaggregated
      albumin (MAA) perfusion studies on the same day. Images were judged using the
      criteria of the modified Prospective Investigation of Pulmonary Embolism
      Diagnosis (PIOPED). For those with a high or intermediate probability of PE on
      lung scans and normal pulmonary function tests, anticoagulants were given and
      patients were monitored with Tc-99m MAA perfusion studies after treatment. The
      final diagnosis was based on chest radiography, pulmonary function tests and lung
      scans. RESULTS: All 40 patients successfully underwent lung scans. Of these, 11
      had PE. Ten of the 11 cases were detected using Kr-81m ventilation and Tc-99m MAA
      perfusion studies, resulting in a sensitivity of 91%. Seven of 11 cases were
      detected using Xe-133 ventilation and Tc-99m MAA perfusion studies, resulting in
      a sensitivity of 64%. Of the 11 patients with PE, four had PE alone; Kr-81m and
      Xe-133 results agreed in three patients, but Kr-81m detected PE in the remaining
      patient. Of the remaining seven patients who suffered from PE with obstructive
      airway disease, Kr-81m and Xe-133 agreed in four, but Kr-81m detected PE in
      another two patients and one case was missed by both studies. CONCLUSIONS: Self
      made Kr-81m was safe and effective for ventilation scintigraphy in humans. When
      Kr-81m was used for the detection of PE, it was particularly advantageous when PE
      occurred in small areas of the lungs or when the patient with PE had concurrent
      obstructive airway disease.

PMID- 11195140
TI  - Predictive efficacy of motion sickness history for airsickness.
AB  - BACKGROUND: Airsickness is a common problem in the early stage of flying
      training. It can be sufficiently severe to impair the student's flight
      performance and his ability to learn. Without adequate evaluation and
      rehabilitation, intractable airsickness symptoms will force student pilots to be
      permanently grounded. The purpose of this study was to evaluate the predictive
      efficacy of motion sickness history for airsickness of flight students. METHODS:
      A motion sickness history questionnaire with four different scores was used to
      predict airsickness of student pilots in the Air Force Academy. The questionnaire
      asked subjects questions about the severity and frequency of motion sickness
      symptom experienced in nine different motion sickness situations before and after
      12 years of age. The results were grouped to four different scores. Pearson
      correlation and Student's t-test methods were used to evaluate the correlations
      of the four different scores. RESULTS: A total of 76 flight students in the class
      of 1997 who had under gone their flight-training course were included in this
      study. They were all healthy males with a mean age of 22.2 years (range, 20-24
      years). The airsickness incidence of student pilots was 50%. The four different
      scores of motion sickness history questionnaire were highly correlated (r = 0.69
      0.86, p < 0.01). The "after 12 years-of-age actually sick" score key had greater
      predictive validity for airsickness than the other motion sickness history
      questionnaire score keys and so did the "before 12 years-of-age feels sick" and
      "after 12 years-of-age feels sick" for no airsickness. CONCLUSIONS: The motion
      sickness history questionnaire was an efficient method to predict airsickness
      among Air Force student pilots.

PMID- 11195139
TI  - Statistics in ophthalmic research: two eyes, one eye or the mean?
AB  - BACKGROUND: Ophthalmic data, while different among individuals, are usually
      similar between fellow eyes of the same individual. This study was designed to
      illustrate alternative approaches to account for the correlation between fellow
      eyes. This is important for making inferences using data from both eyes. METHODS:
      With the use of a real data set from a population-based study, we described the
      distribution of intraocular pressure (IOP) by estimating the mean and standard
      deviation (SD) and evaluated the potential risk factors of higher IOP based on
      the regression method. The units of observation studied were of both eyes, right
      eye only, left eye only, the eyes with higher IOP and the mean value of both
      eyes. Furthermore, the generalized estimating equation (GEE) method was used to
      account for the correlation between fellow eyes in the regression analysis.
      Results and inferences from the different approaches were compared. RESULTS: The
      analysis included all the eyes, providing the largest sample size and unbiased
      estimates of the mean and SDs. There were some discrepancies among different
      approaches in the regression analysis. The GEE method simultaneously evaluated
      the effects of both eyes, and increased precision and enhanced inferences.
      CONCLUSIONS: Inconsistent results among different ophthalmic studies result from
      variations in not only study design and courses but also statistical methods.
      Making the best use of appropriate statistical techniques, which account for
      between eye correlation, provides valid statistical inferences.

PMID- 11195141
TI  - Type III tympanoplasty with cartilage obliteration for cholesteatoma surgery.
AB  - BACKGROUND: The main objective of cholesteatoma surgery is complete eradication
      of the disease. Another goal is to preserve hearing acuity. We reviewed type III
      tympanoplasty with cartilage obliteration for cholesteatomatous ears. To evaluate
      the role of ossiculoplasty, the functional results of classic and modified type
      III tympanoplasties were compared. METHODS: Thirty-six cholesteatomatous ears
      undergoing type III tympanoplasty with cartilage obliteration were reviewed. The
      same operator performed these operations from 1984 until 1995. According to the
      CAO staging system, there were five early, 16 moderate and 15 advanced-stage
      cases of cholesteatoma. Using the anterior approach, all operations were canal
      wall-down type III tympanoplasties with "tailored" open cavity and cartilage
      obliteration. There were 24 classic and 12 modified type III tympanoplasties.
      RESULTS: The average follow-up duration was 7.2 years. Neither recidivistic
      cholesteatoma nor retraction pocket was observed postoperatively. There was an
      improvement in atelectatic score after surgery. The mean postoperative air-bone
      gap (ABG) was 15.8 +/- 10.7 dB and the mean closure of the ABG was 4.0 +/- 14.3
      dB. After the disease stage and preoperative hearing status were adjusted using
      regression analysis, there was no significant difference in hearing results
      between ears that underwent classic or modified type III tympanoplasties.
      CONCLUSIONS: We performed the canal-wall-down tympanoplasty with cartilage
      obliteration using the anterior approach for treatment of cholesteatoma. Such
      surgical techniques eradicate the cholesteatoma, prevent its recurrence and
      create a clean ear. Hearing reconstruction can also be accomplished in a single
      stage procedure offering a serviceable hearing acuity.

PMID- 11195142
TI  - [LII Annual Meeting of the Spanish Society of Neurology. Barcelona, 13-16
      December 2000. Abstracts].

PMID- 11195143
TI  - [Iron and cerebral infarct].

PMID- 11195144
TI  - Parkinson's disease: quantification of disability based on the Unified
      Parkinson's Disease Rating Scale.
AB  - OBJECTIVES: To develop a simple measure for quantification of the disability
      (dependency) due to Parkinson's disease (PD). METHODS:  PATIENTS: 65 nondemented
      PD outpatients, stage 1 to 5 of the Hoehn and Yahr Classification (HY).
      ASSESSMENT: HY, Schwab and England Scale, Northwestern University Disability
      Scale, Columbia University Rating Scale, Webster Scale, Barthel's Index, finger
      tapping, and timed "Up & Go" test. Six items from the ADL Section of the Unified
      PD Rating Scale (UPDRS)--as representative of the most basic ADL--were chosen to
      compose the UPDRS disability score (UDS), that was simultaneously rated by three
      observers. Global evaluations of disability by patient and physician were also
      recorded. STATISTICS: Descriptive, Cronbach alpha, kappa of Fleiss, Spearman rank
      correlation coefficients, Kruskal-Wallis test, and factor analysis. RESULTS:
      Internal consistency (Cronbach alpha = 0.86-0.87) and interobserver reliability
      (kappa = 0.84-0.98) were satisfactory. Convergent validity of the UDS with the
      applied PD rating scales (R = 0.76-0.92), global evaluations (R = 0.84-0.88), and
      timed tests (R = 0.47-0.65) was highly significant (all, p < 0.001). Distribution
      of UDS values across the HY categories showed significant trends (Kruskal-Wallis
      test, p < 0.001). A single factor explaining over 64% of the variance was
      identified. CONCLUSION: A simple and valid instrument for standardized evaluation
      of disability in PD is embedded in the UPDRS.

PMID- 11195145
TI  - [Prospective epidemiologic study of headache in ambulatory neurology service in
      the province of Palencia].
AB  - OBJECTIVES: To study demographic data about the first time consultations for
      headache in our neurologic clinic, its diagnostic distribution, its diagnostic
      and therapeutic management by the neurologist, its source, and the influence of
      the primary care doctors formation in their search of neurological consultation
      and therapeutic management in patients with headache. PATIENTS AND METHODS: A
      protocol with several demographic clinical and medical care data of the all first
      time visits for headache in our province was picked up, during 3 consecutive
      months. RESULTS: Headaches represent 21.5% of the first time consultations. The
      majority of the patients were women. The primary care doctors sent 93.6% of
      patients. The two more common diagnoses were tension-type headache (60%) and
      migraine (25.4%), reflecting their prevalences in the population. The more common
      treatments were the associations of two drugs. The general doctors sent more
      patients with headache (3.36 per thousand and year) than family doctors (1.84 per
      thousand and year). The approximation between initial diagnosis (primary care
      doctor) and final diagnosis (neurologist) was 26.4%, greater for family doctors
      (38.1%) than for general doctors (23.9%). CONCLUSIONS: Headaches represent the
      first cause of neurological consultation. The diagnostic distribution of the
      patients sent to our province shows the prevalences in the population. The family
      medicine formation is useful for a better selection of the patients sent to
      neurologists and a better diagnostic approach.

PMID- 11195146
TI  - [Molecular basis of spinal muscular atrophy: th SMN gene].
AB  - Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease
      characterized by degeneration and loss of motor neurons of the anterior horn of
      the spinal cord. The clinical manifestations include proximal symmetric weakness
      and progressive atrophy of muscle. SMA is classified by age of onset, severity of
      symptoms, and evolution in three groups: type I, severe or Werdnig-Hoffmann
      disease, type II or intermediate and type III, moderate-mild, Kugelberg-Welander
      disease. The identification of the SMN1 gene as determinant of SMA opened new
      alternatives to study the disease. Most of the patients have deletions and
      conversion of SMN1 and in a small number of cases, point mutations were detected.
      There is no obvious genotype-phenotype correlation because homozygous absence of
      SMN1 was associated to a wide spectrum of manifestations from congenital disease
      to non symptomatic cases. Modifier factors, such as the number of copies of SMN2,
      could influence the phenotype. Other possible modifier genes are under study. The
      SMN gene is expressed in various neuronal populations. However, only motor
      neurons are responsible for the manifestations of the disease. The SMN protein is
      part of a complex with various proteins involved in the splicing reaction. This
      apparent essential function for all cells could be critical in motor neurons.
      When SMN1 is absent or dysfunctional, the motor neurons could be more sensitive
      because they have an increased transcription activity. In this situation, other
      cells and tissues could be protected by genetic or cellular factors still
      undiscovered.

PMID- 11195147
TI  - From the Austrian Society of Neurology and Psychiatry to the Austrian Society of
      Neurology.

PMID- 11195148
TI  - [Bilateral polar infarct].

PMID- 11195149
TI  - [Schwannoma of the olfactory groove].
AB  - Solitary schwannomas arising from the olfatory groove are extremely rare. Only 15
      other cases have been reported so far. A case of olfatory groove schwannoma in a
      19-year-old man with seizures and without neurological deficits is described. CT
      scan and MRI showed a tumour in the left frontobasal region. Left frontal
      craniotomy and excision of the tumour revealed a tumour in the region of the
      olfatory groove attached to the cribiform plate. The pathology, origin, and
      clinical characteristics of olfatory groove schwannomas are reviewed.

PMID- 11195150
TI  - [Symptomatic cluster headache: presentation of 2 cases].
AB  - Cluster headache is a primary headache with well-defined diagnostic criteria.
      Nevertheless, in 3-5% of patients this syndrome is secondary to diverse cranial
      structural abnormalities. Atypical features which suggest a secondary or
      symptomatic origin include absence of periodicity and regular hourly recurrence,
      persistence of background pain among attacks, unsatisfactory response to
      treatment, and presence of neurological signs other than ptosis or miosis. We
      present two patients with symptomatic cluster-like headache. In one, the syndrome
      was associated with a fistula of the right superficial temporal artery. After
      embolization the pain attacks ceased. The second patient presented a ventricular
      xanthoma, located in the occipital horn; after surgical excision, the pain
      attacks did not recur. The progressive increase in frequency and absence of
      regularly hourly recurrence of pain episodes was a common feature in both cases.
      We comment and revise the pathophysiology of this syndrome, with emphasis on the
      case of the xanthoma, since we did not find a similar case described. If a
      secondary cluster-like headache is suspected, neuroimaging studies should be
      done.

PMID- 11195151
TI  - [Isolated sensory trigeminal neuropathy caused by a lateral pontine infarct]].
AB  - Lesion of cranial nerves due to vascular damage at pontine level generally
      associates affectation of near nerve tracts. Isolated fifth nerve palsy due to
      vascular pontine lesions has been scarcely reported. We present a hypertense 57
      year old woman who suffered from sudden paresthesias and hypoesthesia on the
      three divisions of trigeminal nerve without motor involvement and with
      preservation of corneal and masseter reflexes. Cranial magnetic resonance showed
      small dorsolateral pontine infarct over the right fifth cranial nerve entry.
      Isolated sensitive trigeminal neuropathy is a rare debut form of pontine infarct.

PMID- 11195152
TI  - [Stuttering as the only manifestation of a cerebral infarct].
AB  - A 53-year-old right-handed man acutely developed stuttering. On his examination
      there was blocks and repetitions exclusively on first syllables of words in
      conversational speech, improving in automatic tasks. There was neither aphasia,
      nor other neurological deficits. An MR imaging of the brain showed a
      circumscribed cortical infarct on the left precentral circunvolution. Cerebral
      angiography was consistent with atherosclerotic narrowing of the intracavernous
      segment of left internal carotid artery. Artery-to-artery embolism was the
      suggested mechanism for this stroke and the patient was treated with oral
      anticoagulants for six months. Stuttering improved progressively and the patient
      became asymptomatic a month after the stroke. Ictal acquired stuttering
      symptomatic of ischemic stroke without aphasia or other neurological deficit is
      exceptional. An small infarct on the left motor area as cause of isolated
      acquired stuttering adds new information about neural circuits involved in this
      phenomenon.

PMID- 11195153
TI  - [Acute dystonia secondary to treatment with betahistine].

PMID- 11195154
TI  - [Iatrogenic pneumocephalus caused by epidural analgesia].

PMID- 11195155
TI  - [Episodes of complete inversion of the visual image and protuberance infarct].

PMID- 11195156
TI  - Willingness to pay for long-term care insurance system in a municipality in
      Tokyo.
AB  - This study attempted to estimate the valuation of Long-term care (LTC) insurance
      system among the residents in a municipality in Tokyo by applying the Willingness
      to Pay (WTP) approach. The mean WTP for Group one (those aged 65 and over) and
      Group two (those aged between 40 and 64) was estimated to be 13,305 Japanese Yen
      and 8,722 Japanese Yen, respectively. Both amounts exceed the contribution
      estimated by the Ministry of Health and Welfare (2,500 Japanese Yen). The result
      reflects a high expectation for the system especially among those in Group one.
      It also suggests that those in Group one may be able to shoulder more financial
      responsibility for the system. Further research on WTP for LTC insurance system
      is deemed beneficial for its successful management.

PMID- 11195158
TI  - Mental health in the developing countries of the Asia Pacific region.

PMID- 11195157
TI  - Caries risk factors among three-year old children in Chiba, Japan.
AB  - In order to predict the factors which affect the occurrence of dental caries in
      children after the age 18-months, we analyzed the relationship between the
      increment of the decayed, missing, and filled teeth (dmft) in children from 18
      months to three-years of age and caries risk factors. Subjects were 392 infants
      who received both an 18-month-old check-up and a three-year-old check-up in Chiba
      city. Stepwise multiple logistic regression analyses were used to analyze the
      results with the increment of the dmft by various combinations of independent
      variables (sex, order of birth, sweets intake, beverage intake, tooth brushing
      and feeding). The most predictive factors for the increment of the dmft in upper
      anterior and molar were "breast feeding" and "bottle feeding" respectively. From
      these results, we concluded that bottle feeding and breast feeding were the risk
      factors for the increment of the dmft from the age of 18-months to three years.

PMID- 11195159
TI  - Depressive symptoms and cigarette smoking among Native Hawaiians.
AB  - The present study estimated the prevalence of depressive symptoms and cigarette
      smoking and examined the relationship between depressive symptoms and cigarette
      smoking among native Hawaiians. Cross-sectional data from 524 rural, native
      Hawaiian from the Native Hawaiian Health Research Project are presented.
      Depressive symptoms were measured using the self-report Centre for
      Epidemiological Studies--Depression Scale. Information on smoking behavior and
      sociodemographic variables was collected. The prevalence of depressive symptoms
      was 15%, and significantly higher among participants with lower educational
      attainment. The prevalence of current smokers was 32%, and significantly higher
      among younger adults and participants with lower educational attainment.
      Regression analyses reported a significant relationship between CES-D scores and
      smoking status as well as between CES-D scores and number of cigarettes smoked
      daily. However, when education and age were included in the regression models,
      the relationships were attenuated. The findings and implications of this study
      are discussed.

PMID- 11195160
TI  - Change in mortality and years of life lost attributable to tobacco in Japan, 1985
      and 1995.
AB  - Despite the secular trend of decreasing prevalence of smoking and consumption of
      tobacco in most industrialized countries, the prevalence of smoking in Japan
      continues to be one of the highest. Based on the alternative measure of
      population attributable fractions, the present study gives an estimate of the
      number of deaths and the years of life lost (YLLs) attributable to tobacco in
      Japan for both 1985 and 1995. This study shows a considerable increase in
      mortality from tobacco-related diseases over the decade, in particular from lung
      cancer and chronic obstructive pulmonary disease, a consequence of the
      intensified exposure to tobacco in the early 1960s. Although the period of the
      highest exposure to tobacco was in the late 1970s, prevalence of smoking is still
      considerably high in Japan and the burden from tobacco will persist if proper
      anti-smoking measures are not implemented immediately.

PMID- 11195161
TI  - Analysis of birth weight data from the Malaysian Family Life Survey II.
AB  - An analysis of birth weight was undertaken on secondary data derived from the
      Malaysian Family Life Survey II. A total of 1629 last singleton live birth
      infants was analysed with the aim of identifying from the variables available
      potential risk factors for low birth weight. Univariate and subsequently
      multivariate analyses were carried out for this purpose. The incidence of low
      birth weight was 11.8 percent. Race, parity and prematurity were found to be
      significantly associated with low birth weight after controlling of the other
      variables. The findings indicate that more work needs to be done to establish the
      underlying reasons for low birth weight in Malaysia.

PMID- 11195162
TI  - Association of lifestyle parameters with the prevention of hypertension in
      elderly Japanese men and women: a four-year follow-up of normotensive subjects.
AB  - To study the association of lifestyle parameters with the future risk of
      hypertension in normotensive subjects, a baseline questionnaire and a four-year
      follow-up were performed in 445 normotensive Japanese at 35 to 89 years of age.
      In 60 to 69 year old subjects, the changes of blood pressure during four years
      were negatively correlated with the amount of boiled rice intake in men and with
      Japanese tea intake in women. Multiple logistic regression analysis revealed that
      miso-soup intake at two bowls per day or over was protective against hypertension
      during follow-up (p < 0.05). These results indicate that food intake is important
      in the prevention of hypertension in the elderly.

PMID- 11195163
TI  - The health impacts of pesticide use on sugarcane farmers in Fiji.
AB  - A survey conducted among sugarcane farmers in Fiji found significant differences
      in the incidence of chronic illness and disease between users of pesticides and a
      nonuser control group. Though average production of sugarcane was markedly higher
      among pesticide users, average annual medical expenditures were also
      significantly higher. Advanced technological methods including chemical
      pesticides require a system of institutional support to provide, inter alia,
      information for an effective transition from traditional to modern agricultural
      practices. Without that support the ad hoc application of technology may result
      in inefficiency and, in the case of pesticides, increased health risks among the
      farm population. Besides practical handling and application advice farmers
      require information describing the chronic health impacts of pesticide exposure
      to allow their weighing of the full costs of pesticide use against the production
      benefits.

PMID- 11195165
TI  - Cost analysis of malaria patients in Taikkyi Township Myanmar.
AB  - A hospital and clinic-based study was conducted in one malaria endemic area,
      Taikkyi Township, Yangon Division, Myanmar, for analysis of cost incurred by
      different types of malaria cases and the factors influencing the cost of illness
      from July to October 1995. A total of 100 patients admitted to hospital and 100
      patients receiving ambulatory care from malaria clinics were interviewed using a
      structured questionnaire. Total cost of one episode of malaria was estimated to
      be kyats 559 for ambulatory care, kyats 2582 for an uncomplicated admitted case,
      kyats 4056 for one episode of cerebral malaria, kyats 4568 for one episode of
      other severe and complicated malaria and kyats 4758 for one episode of malaria
      with other disease. This study showed that the cost of illness for patients
      attending outpatient malaria clinics who received early diagnosis and prompt
      treatment was four to seven times cheaper than the cost of illness for
      hospitalized malaria cases. Multivariate analysis revealed the factors that
      contributed to high cost of care. Duration of illness before getting any type of
      treatment was the key factor that contributed to high or low cost of care. Long
      duration of illness before getting any type of treatment can lead to high malaria
      parasite density, long duration of actual illness and high total attendance cost.
      Therefore, it is recommended that people from malaria endemic areas should be
      informed to seek early treatment from health staff, and primary health care
      services should be made accessible to people who live in malaria endemic areas.
      The information obtained from this study will be useful in planning future
      malaria control programs and influencing policy makers to focus on timely and
      effective treatment of non-severe cases, which can save a large amount of
      economic loss due to treatment of severe malaria.

PMID- 11195164
TI  - High Toxoplasma seroprevalence associated with meat eating habits of locals in
      Nepal.
AB  - A serosurvey of Toxoplasma gondii infection in apparently healthy subjects (n =
      404) living in Achham (n = 215) and Dang (n = 189) districts in western Nepal was
      carried out. An interview with 249 participants, each representing a household,
      was also conducted. This interview pertained to their meat eating habits and the
      keeping of cats in their houses. Toxoplasma antibodies were detected by using the
      microlatex agglutination test. The overall seroprevalence was 65.3% with no
      significant difference in the two districts (Achham: 66.9% and Dang: 63.5%)
      included (p = 0.546). Females and the Indo-Aryan ethnic-group showed marginally
      higher prevalence compared with their male (p = 0.545) and Tibeto-Burman (p =
      0.075) counterparts. The majority of the infections was found to have occurred
      during childhood. The frequency of meat eating in western and eastern regions
      differed greatly (p = 0.000) with the people in the eastern region being frequent
      meat eaters than those in the western region. About one-third of the subjects,
      all Indo-Aryans, in the western region had the raw meat eating habit but none in
      the eastern region. Approximately 7.0% of households in both western and eastern
      regions kept cats. The present findings demonstrated a typical role of meat
      eating habits of people in the high Toxoplasma seroprevalence in Nepal.

PMID- 11195166
TI  - Airborne transmission of classical swine fever virus under experimental
      conditions.
AB  - Sixty-one pigs were housed in an isolation unit with three compartments and five
      pens. Each compartment had its own ventilation system resulting in air currents
      flowing from compartment A (pens 1 to 3) towards compartment B (pen 4), but not
      towards compartment C (pen 5). Classical swine fever virus was introduced by the
      experimental inoculation of one pig in the middle pen (pen 2) of compartment A.
      The virus infected the pigs in pen 4, following the prevalent air currents, and
      the compartmentalisation had only a retarding effect on the transmission of the
      virus. The absence of infection in the pigs in pen 5, which was not different
      from pen 4 except for the ventilation system, indicates that the spread of virus
      was affected by the air currents.

PMID- 11195167
TI  - Effects of a 1 per cent hydrocortisone conditioner on the prevention of immediate
      and late-phase reactions in canine skin.
AB  - Ten laboratory beagles were used to determine whether a 1 per cent hydrocortisone
      conditioner applied topically for three consecutive days would inhibit IgE
      mediated immediate and late-phase reactions induced in their skin. The trial was
      blinded, controlled with the product's vehicle and designed with a crossover. It
      consisted of three phases: one period without treatment (control phase) and two
      periods of treatment with either the active ingredient or the vehicle. Immediate
      and late-phase reactions were induced by the intradermal injection of rabbit anti
      canine IgE polyclonal antibodies. Twenty minutes after the intradermal challenge,
      the diameter of the wheal, but not the erythematous flares, were significantly
      reduced after the application of the active product. In contrast, IgE-mediated
      cutaneous late-phase reactions, evaluated by measurements of dermal thickness and
      eosinophil counts six hours after challenge and the numbers of dermal CD3
      positive T lymphocytes after 24 hours, were not reduced by its application.

PMID- 11195168
TI  - Talocalcaneal luxation with plantar displacement of the head of the talus in a
      dog and a cat.
AB  - A dog and a cat suffered talocalcaneal luxation with plantar displacement of the
      head of the talus. Each case was associated with luxation of the talocentral
      joint and subluxation of the calcaneoquartal joint. The collateral ligaments were
      not significantly disrupted and this made it technically difficult to reduce the
      luxations. However, after open reduction, the luxations were inherently stable
      and a positional screw provided long-term stability. Both animals returned to
      their previous level of activity with no detectable signs of lameness.

PMID- 11195169
TI  - Long-term follow up of the effect of a pheromone therapy on feline spraying
      behaviour.

PMID- 11195170
TI  - Prevalence of shiga toxin-producing Escherichia coli in healthy slaughter pigs in
      Switzerland.

PMID- 11195171
TI  - Pulex irritans infestation in dogs.

PMID- 11195172
TI  - Vaccination for avian influenza in Italy.

PMID- 11195173
TI  - Neutering of dogs.

PMID- 11195174
TI  - [Chlamydia pneumoniae and its relation with human atherosclerosis].

PMID- 11195175
TI  - [Transforming growth factor-beta (TGF-beta), keystone in diabetic nephropathy].

PMID- 11195176
TI  - [Viral C hepatitis in patients with end stage renal disease. II. Viral
      genotypes].
AB  - BACKGROUND: The hepatitis C virus infection is highly prevalent in patients on
      chronic dialysis. There are more than 10 variants of the hepatitis C virus, with
      55 to 72% of identity among them at the amino acid level. However, we do not know
      the specific genotype in dialysis patients in Mexico. Thus, the aim of the
      present study was to know the specific genotypes of the C virus in infected
      dialysis patients, to know the distribution of genotypes in the different
      dialysis techniques and to know the relation between genotype and hepatic disease
      stage. METHODS: We performed a prospective, transversal and comparative study in
      patients in dialysis in three hospital centers in the south of Mexico City. The
      presence of C-type hepatitis infection was assessed by ELISA II and qualitative
      RT-PCR in blood samples. The genotype of the hepatitis C virus was determined by
      analysis of the restriction pattern of the RT-PCR product using Mva I, Hinf I,
      BstU I and ScrF I restriction enzymes. Variables analyzed were: age, gender,
      etiology of renal failure, kind and time in substitutive therapy, transfusion and
      hepatitis history, liver function test, blood urea, serum creatinine and blood
      cell count. RESULTS: We studied 235 dialysis patients that were divided following
      their dialysis modality into: 132 in continue ambulatory peritoneal dialysis
      (CAPD), 17 in CAPD, but with history of hemodialysis (PD/HD) of at least one
      month and 86 on hemodialysis (HD). The hepatitis infection was detected in 24 of
      the 235 patients (CAPD = 4.5%, PD/HD = 41.1% and HD = 12.7%; p < 0.001). The most
      common genotype was 1B (12/24), followed by 1A and 2A (4/24 each one), and
      finally by 2B and 2C (2/24 each one). We detected no patients with genotypes 3 to
      6. The patients with 2A genotype were older than those infected with 1A (p <
      0.05). History of surgery, transfusions, and hepatitis was similar in all
      genotypes. Finally the time in dialysis was longer in patients with 2A genotype
      than others (2A = 60.5 +/- 71.5 months, vs. 1A = 11.5 +/- 11.3, 1B = 26 +/- 26.4
      y 2B/C = 17.5 +/- 13.4), but the difference did not reach statistical
      significance. The genotype distribution between dialysis techniques showed that
      1B genotype was the most frequent in all modalities. The 1A genotype was present
      in similar proportions in patients of the three dialysis groups, the 2C genotype
      was present only in patients with CAPD. Finally, the 2B was only found in
      hemodialysis patients. DISCUSSION: The assessment of viral genotype revealed that
      1B is the most common genotype in patients on chronic dialysis in Mexico City.
      The fact that the 1B and 1A genotypes were the most common types in our dialysis
      population suggest that transmission was similar to the general population, that
      is, probably by blood transfusions.

PMID- 11195177
TI  - Waldenstrom's macroglobulinemia is infrequent in Mexican Mestizos: experience of
      a hematological diseases referral center.
AB  - Along a 17-year period 7,373 patients were prospectively studied in a private
      practice Health facility; of these 11 were patients with Waldenstrom's
      macroglobulinemia; calculations from these data and previous publications show
      that this lymphoid malignancy represents in Mexico 0.18% of all hematologic
      malignancies, a figure 11 times lower than that described from caucasians. The
      median age was 65 years (range 31 to 84); there were 6 males and 5 females. Ten
      individuals were mexican mestizos, whereas one had a caucasian phenotype. The
      clinical features of the patients afflicted by the disease in Mexico were similar
      to those reported from caucasian populations. The median survival (SV) of the
      group of patients was 40 months, whereas the 42-month survival was 49%; the
      prognosis of the disease was relatively good despite the fact that complete
      remissions were unfrequent as a result of the treatment.

PMID- 11195178
TI  - [Non rheumatic pulmonary hemorrhage: case series description].
AB  - INTRODUCTION: Pulmonary hemorrhage (PH) is characterized by diffuse hemorrhage
      from the pulmonary microvasculature. Its main features are dyspnea, hemoptysis,
      diffuse bilateral alveolar infiltrate and sudden fall in hemoglobin. Because the
      conditioning causes can be both: rheumatic and non-rheumatic, early recognition
      of the precipitating causes aids in orienting specific therapy. OBJECTIVE: To
      identify the clinical and paraclinical features of non-rheumatic PH and determine
      the associated mortality. METHODS: The charts of all patients diagnosed with HP
      in this institution between 1987 and 1997 were reviewed. OPERATIVE DESCRIPTIONS
      (DEFINITION): HP was confirmed by bronchoscopy, pulmonary biopsy, necropsy or at
      least three of the following criteria: a.--Sudden dyspnea, b.--Hemoptysis, c.--Hb
      decrease of 1 g/dL or more, d.--Recent alveolar infiltrate in the chest X-ray.
      STATISTICAL ANALYSIS: Descriptive statistics. RESULTS: Nine cases of non
      rheumatic PH were identified. Median age of patients was 34 years. Six cases
      corresponded to men, chemotherapy was associated in three patients. The duration
      from diagnosis of the underlying disease to HP was one to 73 months. All the
      patients presented dyspnea, crepitant ates tachycardia, decrease in Hb (median 2
      g/dL), hypoxemia a mean of 53.4 mmHg. A diffuse interstitial pattern was evident
      in X rays of six cases; bronchoscopy was performed in three. Seven patients died,
      six because of massive pulmonary hemorrhage as the direct cause of death and one
      because of ARDS. CONCLUSIONS: PH occurs in hematological diseases accompanied by
      severe thrombocytopenia and progressive pulmonary infections. Because its
      associated with high mortality, early detection and treatment are of utmost
      importance.

PMID- 11195179
TI  - [Changes in brain serotonin biosynthesis in rats with diabetes mellitus induced
      by streptozocin: effect of insulin treatment].
AB  - OBJECTIVE: To investigate if the changes in the activity of the tryptophan-5
      hydroxylase and in brain serotonin synthesis provoked by diabetes mellitus
      persist or return to normal in the diabetic rats submitted to treatment with
      insulin. METHODS: Diabetes induced by the administration of streptozotocin in
      rats and their treatment with insulin was the paradigm used. At days 7, 14 and 21
      of evolution, the brain serotonergic biosynthetic activity was evaluated.
      RESULTS: The diabetic rats showed a significant decrease of body weight. Also,
      they showed a low concentration of I-tryptophan, as well as a diminution in the
      activity of the key enzyme tryptophan-5-hydroxylase and its product serotonin in
      the cerebral cortex and brainstem. Interestingly, the activity of the enzyme was
      higher in the brainstem from day 14, accompanied with an elevation of the
      neurotransmitter. The diabetic rats submitted to treatment with insulin showed a
      complete physical recovery and a return to normal of plasma and brain I
      tryptophan. The activity of the enzyme not only normalized but was elevated and
      with an increase of serotonin in the brainstem and cerebral cortex. CONCLUSION:
      The present findings confirm that diabetes mellitus produced a chronic anabolic
      deficit and a decrease in some brain regions of serotonin synthesis. Also,
      demonstrate that the diabetic rats under specific treatment with insulin had a
      complete physical recovery and a return to normal of the serotonin precursor in
      the blood and brain. However, the activity of the limiting enzyme TrpOH case was
      elevated with an increase of the neurotransmitter in all regions studied. Since
      the diabetic animal, insulin treated, does recover metabolically, the mechanism
      of activation of the serotonin biosynthetic path in the brain may not be
      dependent on the decreased availability of its precursor the free plasma I
      tryptophan. Instead, it might be due to a change in the kinetics of tryptophan-5
      hydroxylase, since its activity remains significantly increased in spite of
      plasma and brain normalization of its substrate. Altogether these changes in the
      biosynthesis of an important brain neurotransmitter may be of relevance in the
      pathophysiology of the psychoneurological complications in diabetic patients.

PMID- 11195180
TI  - [Circadian arterial blood pressure variation in non hypertensive type 2 diabetic
      patients].
AB  - OBJECTIVE: To determine the characteristics of the blood pressure circadian
      rhythm in non-hypertensive type 2 diabetic subjects. MATERIAL AND METHODS: Cross
      sectional study on 57 individuals with type 2 diabetes without hypertension (31
      women and 26 men) and 57 healthy subjects in a control group (29 women and 28
      men). High blood pressure, renal or hepatic diseases were exclusion criteria.
      Using patient activated semiautomatic portable blood pressure recorder (Omron
      Healthcare Inc., Vernon Hills, Ill 60061), self-measured blood pressure of 24-h
      was registered. Subjects who blood pressure measures were not appropriately
      recorded in equal or more than 10% of the lectures were not included. RESULTS:
      The average systolic and diastolic blood pressure of 24-h was similar between the
      groups studied. The percentage decrease in the nocturnal systolic/diastolic blood
      pressure was of 4.6%/1.2% and 3.8%/6.8% for the diabetic women and men
      respectively, and of 8.6%/9.9% and 6.8%/8.2% in the control women and men. For
      the last nocturnal and first diurnal hours the systolic/diastolic blood pressure
      of diabetic subjects showed a lower increase with a higher duration than that
      observed for the control group. CONCLUSIONS: Non hypertensive type 2 diabetic
      subjects shown both nocturnal blood pressure fall of less than 10% and a lower
      increase, with prolonged duration in the first diurnal hours, than that observed
      in healthy subjects.

PMID- 11195181
TI  - [Classification of acute leukemias according to the first latin-american
      consensus conference for the immunophenotyping of leukemias].
AB  - OBJECTIVE: To evaluate the recommendations of the First Latinamerican Consensus
      Conference for the Immunophenotyping of Acute Leukemia in untreated patients with
      de novo disease immunologically classified employing flow cytometry and an
      extended panel of monoclonal antibodies. MATERIAL AND METHODS: In that conference
      it was recommended the use of the following antibodies: cytoplasmic CD79a
      (cCD79a) and CD19 to define B-progenitor acute lymphoblastic leukemia (B-ALL);
      cCD3 and CD7 for T-cell ALL (T-ALL), and CD13, CD33 and myeloperoxidase (cMPO)
      for acute myeloblastic leukemia (AML). We analyzed the expression of these
      cellular antigens in 91 non-consecutive patients classified with the extended
      panel as: B-ALL 28 cases; T-ALL 7; B-T-ALL 2; AML 47; and mixed-lineage acute
      leukemia 7 cases. RESULTS: All 28 B-ALL cases were positive with each of the two
      recommended antibodies cCD79a and CD19, whereas in 24 AML cases (the expression
      of cCD79a was not assayed in 23 cases) and in 7 T-ALL patients both antigens were
      absent. cCD3 and CD7 antigens were identified in 71% and 100% of T-ALL,
      respectively. CD7 antigen was not detected in any of the 28 patients with B-ALL
      but it was expressed in 6 of 47 AML cases, while none of 75 B-ALL and AML cases
      were positive to cCD3. Forty nine percent of AML were positive for the three
      recommended markers: cMPO, CD13 and CD33, and 51% of AML cases reacted with one
      or two of these three monoclonal antibodies. Six out of 28 cases of B-ALL had
      aberrant expression of myeloid antigen (CD33 in 3 cases and CD13 in 3 cases).
      CONCLUSIONS: There was no difference in the definition of AL lineage between
      employing the extended antibody panel and that recommended by the Latinamerican
      consensus.

PMID- 11195182
TI  - [Thrombophilia, thromboembolism and the use of the unfractionated and low
      molecular-weight heparins].
AB  - An overview of the key concepts about detection of thrombophilic states,
      establishment of risk factors for thrombosis, the current strategies on diagnosis
      of thrombophilia, as well as an analysis of the current experience with the use
      of fractionated and unfractionated heparins, is presented. It is well known that
      thrombotic disease is multifactorial and that its treatment must be
      interdisciplinary and multidisciplinary in order to perform an opportune
      diagnosis and to establish an adequate prophylaxis and anti-thrombotic therapy.
      Even though several advantages are observed when low molecular weight heparins
      are used, unfractionated heparins still have some specific indications.
      Furthermore, under specific conditions, they can work synergistically to achieve
      a maximal effect on the thromboembolic states. We propose that every medical unit
      should establish its own criteria and diagnostic and therapeutic algorithms that
      allow to detect, to diagnose, and to treat the thrombotic events in the best way
      thus diminishing the morbidity and mortality associated with these thrombotic
      events.

PMID- 11195183
TI  - [Hepatitis C virus infection in patients with end stage renal disease].

PMID- 11195184
TI  - [Hyperhomocysteinaemia: physiopathology and medical implications].
AB  - Homocysteine is an intermediate aminoacid result of the conversion of methionine
      to cysteine. Homocystinuria or the hyperhomocysteinaemia are the most frequently
      related disorders of this aminoacid, being the former an autosomic recessive
      alteration, whereas the latter is conditioned by multiple factors, being the most
      important the genetic and nutritional factors. In the last years this alteration
      has regained special interest because of its increasing role in the thrombotic
      pathologies and the identification that hyperhomocysteinaemia represents an
      independent risk factor for the accelerated atherogenesis of multiple diseases.
      In this review physiopathological aspects and clinical implications of
      hyperhomocysteinaemia are mentioned as well as its diagnoses and treatment.

PMID- 11195185
TI  - [In search of prognostic factors in continuous ambulatory peritoneal dialysis].

PMID- 11195186
TI  - [Technology's fetishism].

PMID- 11195187
TI  - [Importance of risk of contamination from urine samples for diagnosis of urinary
      tract infection in a third level hospital].

PMID- 11195188
TI  - [Central neurogenic hyperventilation associated with a pontine infarction].
AB  - Central neurogenic hyperventilation in patients with a normal level of
      consciousness is uncommon. This condition occurs in bilateral pontine tegmental
      lesions, particularly tumors such as CNS lymphomas and glioma, as well as
      traumatic lesions. The physiopathological mechanisms are unknown and no there is
      no effective treatment for this entity. We report a case of central neurogenic
      hyperventilation associated to a unilateral basal pontine infarction.

PMID- 11195189
TI  - [The exercise of a more scientific clinical medicine].

PMID- 11195190
TI  - [Is tacit consent more efficient than informed consent in cadaveric organ
      donation for transplantation?].

PMID- 11195191
TI  - [A comparative study of antibacterial activity of ceftibuten, ceftazidime,
      cefuroxime and ampicillin against clinical isolates].
AB  - Ceftibuten is an orally active third generation new cephalosporin. Its
      antibacterial activity in vitro was tested to many clinical isolates and was
      compared to the activity of ceftazidime, cefuroxime and ampicillin, by twofold
      serial dilution method in Muller-Hinton agar--detection of minimum inhibitory
      concentrations (MIC) and by the disc-diffusion method of Kirby-Bauer. The new
      cephalosporin demonstrated great activity against the different clinical
      important strains. Many resistant strains to ampicillin were high susceptible to
      ceftibuten. The majority of Gram-negative organisms, including
      Enterobacteriaceae, the respiratory pathogens M.(B.) catarrhalis and H.
      influenzae are highly susceptible to Ceftibuten, however Pseudomonas,
      Acinetobacter are resistant. The majority of methicillin-susceptible strains of
      Staphylococcus are resistant too. New cephallosporin was also active against S.
      pyogenes (Streptococcus gr. A) and penicillin-susceptible pneumococci, but was
      inactive against S. agalactiae (Streptococcus gr. B), S. pneumoniae penicillin
      resistant strains and enterococci, similar to the other cephalosporins. The
      activity of ceftibuten was higher than that of ampicillin and cefuroxime against
      beta-lactamases positive strains of H. influenzae and M.(B) catarrhalis, also
      against tested strains of Enterobacteriaceae. The major priority of the new
      antibacterial agent over other cephalosporins and ampicillin is its stability to
      hydrolysis by the main broad-spectrum beta-lactamases producing E. coli and K.
      pneumoniae sp.

PMID- 11195192
TI  - [Cytokines and the liver in health and disease].
AB  - Cytokines are a group of proteins with autocrine, paracrine and endocrine
      activities which provide communication among hepatic cells and other cells and
      tissues of the man. Active in minute quantities, the cytokines activate and
      regulate homeostasis and cellular repair through effects on cell growth,
      differentiation and receptor expression and cell-mediated immunity. Cytokines--IL
      1, IL-2, IL-6, IL-8 IL-10, IL-12, TNF-alfa, PDGF and others, modulate liver
      metabolism in health and disease, physiological and pathologic liver functions
      and the evolution of liver inflammation and injury to hepatic fibrosis and liver
      cirrhosis. Data concerning the use of a recombinant form of Interleukin-10 and
      Interleukin-12 in the treatment of chronic liver disease (chronic viral
      hepatitis, fibrosis, cirrhosis, alcoholic liver disease) and cell-mediated
      immunity regulation are widely discussed in the review.

PMID- 11195193
TI  - [Treatment of primary biliary cirrhosis with ursodeoxycholic acid].
AB  - This study was undertaken to evaluate the efficacy of ursodeoxycholic acid (UDCA)
      in the treatment of primary biliary cirrhosis (PBC). Three patients with PBC
      (stage II) have been treated with UDCA (Ursofalk and Falk Pharma, Freiburg,
      Germany)--of 10 mg/kg daily dosage in the course of three years. Patients with
      well-defined PBC underwent complete history, physical examination, liver
      chemistries, ultrasonography and liver biopsy. Liver chemistries were determined
      every three months. A control liver biopsy was performed to one of the patient,
      an year after the beginning of the treatment. UDCA was well tolerated and showed
      no side effects. The most obvious benefit of UDCA was its favourable effect on
      serum biochemistries. Its use was associated with the delayed progression of the
      disease.

PMID- 11195194
TI  - [Consensus on the treatment of type 2 diabetes mellitus].
AB  - The outcome data from the United Kingdom Prospective Diabetes Study (UKPDS)
      showed that intensive drug treatment of diabetes mellitus-type 2 and the tight
      control of glycaemia and blood pressure are associated with lower incidence of
      chronic diabetic complications and mortality. The economical analysis showed out
      that money invested in the intensive drug treatment of diabetes and arterial
      hypertension resulted in less expenses for the treatment of diabetic
      complications. These data are the reason to suggest an algorythm for the
      treatment of diabetes mellitus type 2. The main aims are to achieve fasting blood
      glucose < or = 6 mmol/l, 2 hour postprandial glucose < or = 8 mmol/l and glycated
      haemoglobin (HbA1c) < or = 7.0%. The steps in the treatment include: non
      pharmacological treatment, monotherapy with an oral drug, combined oral
      treatment, insulin therapy, combined insulin and an oral drug therapy. The blood
      pressure control aims to achieve a figure below 140/85 mm Hg, using monotherapy
      or a combination of antihypertensive drugs from different pharmacological groups.

PMID- 11195195
TI  - [Nimesulide - a non-steroidal anti-inflammatory drug, a preferential
      cyclooxygenase-2 inhibitor].
AB  - Nimesulide (Aulin) refers to the class of sulphonanilides, which is unique among
      the non-steroidal antiinflammatory drugs (NSAIDs), being also the first drug on
      the market of pharmaceuticals, which preferentially inhibits the enzyme
      cyclooxygenase-2 (COX-2). This enzyme takes part in the synthesis of
      prostaglandin, which is produced in the course of the cascade of the inflammation
      process and has relation to the pathogenesis of pain, inflammation and fever,
      while the COX-1 enzyme forms prostaglandin, which projects the gastro-intestinal
      mucosis. Many newly found factors, together with the preferential inhibition of
      COX-2, are also contributing to the therapeutic effects of Nimesulide. The
      therapeutic concentration of non-combined active substance in blood-circulation
      reduces the following indicators: the activity of the myeloperoxidase; the
      release of cytokines; the histamine effects; the synthesis of stromelysin and
      collagenase, which pull down the proteoglicans and collagen. It is also
      characteristic of Nimesulide its antioxidant activity and suppression of: the
      synthesis of superoxidic ions from the neutrophils; also, the synthesis of
      platelet activating factor. Nimesulide shows good tolerability and is safe with
      patients having respiratory problems due to treatment with other NSAIDs.

PMID- 11195196
TI  - [Sodium in clinics and complications of liver cirrhosis].
AB  - The changes in sodium homeostasis most frequently are expression of water
      electrolyte balance disturbances in patients with liver cirrhosis. Hyponatremia
      of water excess is found in 35% of the patients with cirrhosis and ascites. This
      disturbance is most frequently connected with raised antidiuretic hormone
      (vasopressin) secretion and is realized by including of nonosmotic stimulating
      mechanisms. The vasopressin plays a leading role in pathogenesis of disturbed
      water metabolism in the liver cirrhosis. Some patients with hepatorenal syndrome
      are established with highest plasma vasopressin concentrations. Gene expression
      of the regulation of kidney vasopressin-sensitive water channels (aquaporin-2
      proteins) is also raised in the liver cirrhosis. Using in practice vasopressin
      type 2 (V-2) receptor antagonists gives hopeful results in medical treatment of
      water-electrolyte disturbances in patients with advanced liver cirrhosis.

PMID- 11195198
TI  - [Correlation between ventricular potentials and QT dispersion in patients with
      myocardial infarction].
AB  - We investigated QT dispersion (QTcd) and QT apex dispersion (QTad), corrected in
      relation to heart rate and the presence of ventricular late potentials (VLP) in
      27 patients with previous myocardial infarction. VLP were considered positive
      when two of following tree criteria were satisfied: 1. HF QRS > 114 ms; 2. RMS 40
      < 20 microV; 3. LAS > 38 ms. The patients were divided into two groups: group A-
      with VLP positive, 10 patients and group B--with VLP negative, 17 patients. Group
      A showed a significantly higher QTcd and QTad than group B (42 +/- 18.1 ms. v/s
      24.7 +/- 14.2 ms, p = 0.01 for QTcd and 41 +/- 20.2 ms. v/s 23.5 +/- 11.1 ms, p =
      0.007 for QTad). There is also a moderate expressed linear correlation between
      QTcd and HF QRS (r = 0.459). Our data suggest, that the presence of slowly
      conducting areas of myocardium, related to positive VLP is associated with
      expressed inhomogeneity of ventricular repolarisation pi. e. higher QTcd.

PMID- 11195199
TI  - [Diagnostic algorithm and software for assessment and follow-up of dyspnea].
AB  - Breathlessness is a common complaint among patients with lung and heart diseases.
      It is a complex, multidimensional symptom with descriptive and quantitative
      aspects. The aim of this study is to constitute a set of questionnaires and
      scales for adequate assessment of dyspnea and their combination in diagnostic
      algorithm with various ranges. In order to achieve this goal, we developed a
      software product DISKO with the following characteristics: Includes the basic
      instruments for assessing dyspnea in all dimensions--verbal (descriptive)
      characteristic, everyday activities and exercise dyspnea, as well as its impact
      on the patients' quality of life. Proposes minimal, optimal and comprehensive
      algorithm for assessment and follow up of dyspnea. Presents a convenient
      interface and an ability to configure a flexible data base easy for browsing and
      handling. Proposed tests and algorithm for dyspnea assessment make it easier for
      the physician to diagnose and follow up chronically ill patients whose major
      complaint is dyspnea. The software product DISKO is compliant with the modern
      requirements for medical software and can be utilized in the process of
      diagnostic, education and scientific research.

PMID- 11195200
TI  - Hemorheology in microcirculation: pathological changes. The 7th Tbilisi
      Symposium. Internet Virtual Symposium. Abstracts.

PMID- 11195201
TI  - Phylogenetic history of sifakas (Propithecus: lemuriformes) derived from mtDNA
      sequences.
AB  - The sifakas (Propithecus) include three species containing up to 10 described
      subspecies, whose evolutionary relationships remain contentious. In particular,
      it is unclear whether P. verreauxi deckeni and P.v. coronatus populations are
      differentiated at the subspecific level. Furthermore, the taxonomic status of the
      recently discovered P. tattersalli and its phylogenetic position also require
      further examination. About 2,400 bp of mitochondrial DNA sequence data from part
      of the COIII gene, together with complete genes for ND3, ND4L, ND4, and five
      tRNAs, were used to clarify relationships among Propithecus species and
      subspecies. All analyses group Avahi as the sister group to all sifakas. P.
      diadema is placed as a sister group to all other Propithecus. Among the remaining
      sifakas, one subclade is formed by Puv. coquereli and P. tattersalli, while P.v.
      verreauxi, P.v. deckeni, and P.v. coronatus form the second subclade. All
      analyses fail to resolve P.vu. coronatus and P.v. deckeni into separate
      monophyletic lineages. Based on pairwise distance comparisons and tree topology,
      we conclude that P. tattersalli does not represent a distinct species and that
      P.v. deckeni and P.v. coronatus do not deserve subspecific rank. On the other
      hand, our analyses indicate that P.v. coquereli may well represent a separate
      species.

PMID- 11195202
TI  - Age differences and developmental trends in alarm peep responses by squirrel
      monkeys (Saimiri sciureus).
AB  - Alarm calls can code for different classes of predators or different types of
      predatory threat. Acoustic information can also encode the urgency of threat
      through variations in acoustic features within specific alarm call types.
      Squirrel monkeys (Saimiri sciureus) produce an alarm call, known as the alarm
      peep, in highly threatening situations. Infant squirrel monkeys appear to have an
      innate predisposition to respond to alarm peeps but require experience to
      associate alarm peeps with the appropriate type of predatory threat [Herzog &
      Hopf, American Journal of Primatology 7:99-106, 1984]. Little is known about age
      related differences in the type or frequency of response to alarm peeps, or the
      development of alarm peep response in infants. The purpose of this study was to
      test experimentally the response strategies of different age classes of squirrel
      monkey to the playback of alarm peeps that were produced by infants, juveniles,
      or adults. Results suggest that infants, juveniles, and female subadults respond
      more frequently to alarm peeps than do adult females. Infant squirrel monkeys
      showed different behavioral strategies in response to alarm peeps as a function
      of age. Adult females differentiate between infant and adult alarm peeps by
      responding more frequently to the alarm peeps of adult females. These data
      demonstrate that squirrel monkeys use acoustic information to discern when to
      respond to the alarm peeps from conspecifics, and that infants gradually develop
      an adult-like response to alarm peeps over the first year of development.

PMID- 11195203
TI  - Effects of nonmaternal restraint on the vocalizations of infant rhesus monkeys
      (Macaca mulatta).
AB  - This study explored the effects of restraint by females other than the mother on
      the vocalizations of infant rhesus macaques (Macaca mulatta) in a captive social
      setting. In this species, females are very attracted to young infants and will
      frequently approach, groom, and hold the infant. Incompetent handling, abusive
      behavior, or extended periods away from the mother that prevent the infants from
      nursing represent potentially significant risks for infants. Vocal responses to
      such risky conditions appear to be the infants' only means to promote a return to
      their mothers. We examined the association between the severity of the threat
      posed to the infant and the nature of its vocal response to restraint, and
      whether the infants' calls influenced the behavior of their mothers or captors.
      The results suggest that situations posing greater risks for the infants, i.e.,
      longer periods of restraint, were associated with a greater use of noisy screams.
      Furthermore, mothers' responding was associated with a greater use of noisy
      screams as well. The mothers' reactions, however, could be described as cautious,
      and consisted mostly of closer monitoring; such tempered response might be
      related to the risk of injury to the infant that could result from a more
      forceful and direct attempt at retrieval.

PMID- 11195204
TI  - Immunobiology of the reproductive tract in a female baboon.
AB  - The aim of this study was to assess the suitability of various antihuman
      antibodies directed against immunocomponent cells to identify components involved
      in cellular and humoral immune responses in the immune organs of a female baboon,
      and to use these reagents to analyze the immunobiology of its reproductive tract.
      A female baboon of reproductive age was euthanized in the luteal phase of the
      menstrual cycle, and samples of spleen, intestines, tonsil, lymph nodes,
      Fallopian tube, uterus, cervix, and vagina were removed. Tissues were either
      fixed in 10% unbuffered formaldehyde, Bouin's fluid, or 95% ethanol containing 5%
      glacial acetic acid, and embedded in paraffin, or frozen unfixed. Frozen sections
      were then fixed in 100% acetone. Subsequently, tissue sections were reacted with
      the following antihuman antibodies directed against CD3, CD45RA, CD45RO, CD4,
      CD8, CD20, CD68, HLA-DR, CD57, CD103, CD15, and TIA-1: IgA, IgG, IgM, J-chain,
      secretory component, and neutrophil elastase, using routine immunohistology
      techniques. Human tissues (spleen, small intestine, lymph node, and tonsil) were
      used as positive controls. All antihuman antibodies crossreacted with baboon
      tissues, except neutrophil elastase, CD15, CD45RO, CD57, and CD1A. The
      distribution of immune cells in the reproductive tract of the female baboon was
      comparable to that in the human and offers the potential for this primate to be
      used as a model for the study of human reproductive immunology.

PMID- 11195205
TI  - [The 75th anniversary of the I. P. Pavlov Institute of Physiology of the Russian
      Academy of Sciences].

PMID- 11195206
TI  - [Specific and nonspecific cortical-subcortical mechanisms of behavior].
AB  - The paper presents data on comparative morphological study of afferent
      connections between the cat, dog, monkey brain basal ganglia with structures of
      the "motor" and "limbic" systems, neurophysiological data on specifics of
      involvement of the pre-frontal cortex, amygdala, caudate nucleus and thalamus in
      the processes of learning, perception and assessment of the stimuli significance,
      formation of short- and long-term memory's programs, decision making, programming
      the actions and assessment of the actions being performed, experimental data on
      the role of glutamatergic, dopaminergic, cholinergic, GABA-ergic systems of the
      cortex and a number of subcortical structures in the mechanisms of formation and
      implementation of the food and defence reflexes.

PMID- 11195207
TI  - [Muscarinic receptors in the neostriatum--participation in the operant behavior
      regulation in dogs].
AB  - Exposure of the dogs to signals, data collection and processing were accomplished
      using a special PC software. Bilateral microinjections of the muscarinic
      receptors agonists (oxotremorine) into the neostriatum enhanced the tonic
      component of instrumental movements, suppressed the phasic component and
      increased the postural component's amplitude. These changes were much more
      obvious in microinjections of the non-selective muscarinic receptor agonist
      carbachol due, probably, to its effect on both the M1 and M4 muscarinic receptors
      of the neostriatum efferent neurones.

PMID- 11195208
TI  - [Critical phases of the brain development].
AB  - Various effects were shown to act alter the proceeding of histogenetic processes
      in the embryonic neural tissue. Studies in mice revealed that, depending on the
      embryogenesis stage when a lack of serotonin occurred, the lack of this monoamine
      entails either death of the embryo or a teratogenic effect, or underdevelopment
      of brain structures. In the rat model of a shorten hypoxia, a disorder of neural
      tissue histogenesis in early stages of development, was found, as well as a
      reduction of its sensitivity to lack of oxygen by the end of embryogenesis.

PMID- 11195209
TI  - [Plasticity of the social behavior in Drosophila].
AB  - Original data illustrate self-starting classical conditioning to environmental
      factors in Drosophila, the factors serving as signals of a possible threat from
      other individuals and blocking initiation of activity. Instrumental conditioning
      resulting in reduction of an initially high level of activity in the group
      situation, helps a fly to avoid aggression from other flies and to use the food
      resources more efficiently. Classical conditioning makes it unnecessary for a fly
      to learn this instrumental task again and again: being faced with an analogous
      situation the fly automatically decreases its activity following presentation of
      the conditioned stimuli or the specific environment.

PMID- 11195210
TI  - [Corticoliberinergic mechanisms of the neostriatum in the neuroendocrine stress
      regulation].
AB  - Neostriatum and its dopaminergic mechanisms were shown to be involved in
      mediation of some adaptive effects of the CRH (corticotropin-releasing hormone),
      both behavioural and endocrine. The data obtained suggest that neostriatum
      contributes to a coping response by selecting an appropriate behavioural strategy
      in stressful situation.

PMID- 11195211
TI  - [Nociceptive system response to repetitive painful stimuli during chronic
      psychoemotional stress in humans].
AB  - Repeated nocigenic stimuli applied to the skin evoked a hyperalgesia in healthy
      subjects while in patients with neurasthenia which is a natural model of a
      chronic psychoemotional stress, they evoked a hyperalgesia accompanied by
      sensitization. The differences in the nociceptive system responses show
      particularities in reactivity (plasticity) of a wide dynamic range of the spinal
      neurons under chronic psychoemotional stress that is due to disorders in
      supraspinal descending modulation system of plasticity in the spinal nociceptive
      neurons.

PMID- 11195213
TI  - [The role of the prefrontal and parietal cortex in learning and memory in
      monkeys].
AB  - Removal of the 7th field of parietal cortex and sulcus principalis of prefrontal
      cortex did not affect learning processes for images with such properties as
      spatial frequency, orientation, geometrical form, but worsen learning
      characteristics in visual differentiation of spatial information making the
      learning processes unstable, longer and below the 85% level. Removal of sulcus
      principalis also affects learning of differentiation among various colour
      stimuli. The short-term memory in these monkeys are also much worse than in
      intact animals. A scheme of learning involving interacting sensory and cognitive
      processes controlled by motivation system, is proposed.

PMID- 11195212
TI  - [Effect of the transcranial electrical stimulation of the endorphinergic brain
      structures on the functional activity of hepatocytes after toxic exposure].
AB  - Biochemical events of the rat hepatocytes cytolysis and deterioration of their
      synthetic activity and detoxification ability, as well as morphological events of
      lipid degeneration after acute poisoning with dichloretane and CCl4, were
      significantly reduced by effects of transcranial stimulation (TES). Blockade of
      the TES effects with naloxone revealed its endorphinergic nature. Combined
      effects of the TES and Essenciale preparation were lower than separate those of
      these agents. The TES effects were clinically corroborated in treatment of toxic
      hepatitis.

PMID- 11195214
TI  - [Putative molecular mechanism of defensin interaction with the membrane of the
      sensory neuron].
AB  - NP-1 defensin decreased effective charge transfer in the activation gating system
      of TTX-resistant (slow) sodium channels in a dose-dependent manner. The
      dissociation constant and Hill coefficient values were KD = 2 pM and X--0.9.
      Geometry of the NP-1 defensin molecule was built using its primary structure with
      three S-S briges and fully optimised in the framework of molecular mechanics
      method. The data obtained explain experimental results of stechiometry 1:1 due to
      ligand-receptor interaction by the only outward directed carboxyl group of Glu 14
      which might form a hydrogen bond with a single binding site of non-identified
      defensin membrane receptor.

PMID- 11195215
TI  - [The mismatch negativity as an index of the perception of speech sounds by the
      human brain].
AB  - The present article outlines the contribution of the mismatch negativity (MMN),
      and its magnetic equivalent MMNm, to our understanding of the perception of
      speech sounds in the human brain. MMN data indicate that each sound, both speech
      and non-speech, develops its neural representation corresponding to the percept
      of this sound in the neurophysiological substrate of auditory sensory memory. The
      accuracy of this representation, determining the accuracy of the discrimination
      between different sounds, can be probed with MMN separately for any auditory
      feature or stimulus type such as phonemes. Furthermore, MMN data show that the
      perception of phonemes, and probably also of larger linguistic units (syllables
      and words), is based on language-specific phonetic traces developed in the
      posterior part of the left-hemisphere auditory cortex. These traces serve as
      recognition models for the corresponding speech sounds in listening to speech.

PMID- 11195216
TI  - [Control of the human and animal locomotor activity in the absence of supraspinal
      effects].
AB  - In patients deprived of supraspinal effects, electrical epidural stimulation of
      the spinal cord's dorsal surface at the level of 2nd lumbar segment induces step
      like movements accompanied by respective electromyographic activity of the leg's
      muscles. Triggering of the step-like movements occurs at certain parameters of
      the stimulation. The data obtained suggest that human spinal cord has networks of
      interneurons-generators of the step-like movements. A leading role of the spinal
      cord's propriospinal system in activation of spinal generators of stepping under
      epidural influences was shown in cats.

PMID- 11195217
TI  - [Visceral field of the rat insular cortex].
AB  - Structural-functional organisation of the cortical insular area relating to
      processes of the visceral functions control, was analysed. Representation of
      gastrointestinal, respiratory, and cardiovascular systems in the area, is given.
      Sites of respective neuronal groups and specifics of their spatial organisation
      within the area, were found. The data obtained suggest a scheme of the rat
      insular cortex's visceral field.

PMID- 11195218
TI  - [Effect of hypotension on the arterial system responsiveness].
AB  - The correlation analysis revealed no correlation within the range 110 to 80 mm Hg
      further transforming into a direct (within the range lower than 80 mm Hg)
      dependence of the pressure responses to mesatone on the reduction of initial mean
      arterial pressure under orthostatic hypotension in anaesthetised rats. Under
      paraverine hypotension a reverse correlation within the range 110-80 mm Hg
      transforming into a direct dependence (within the range lower than 80 mm Hg) of
      the responses to mesatone were observed. The dependence of cardiac shifts to
      mesatone on the initial arterial pressure was not occurred. The mechanisms of
      dependence of the systemic vascular responses on initial tone of arterial
      vessels, are discussed.

PMID- 11195219
TI  - [Metabolic/nutrition programming of the enzyme system in the offspring small
      intestine].
AB  - Protein deficiency in female rats diet during pregnancy and lactation resulted in
      changes of the intestine enzymes activity in posterity in early and late periods
      of ontogenesis. In the former period, deceleration of sucrase induction,
      acceleration of lactase suppression and maltase induction, and an earlier
      occurrence of the adult-type distribution of the intestine alkaline phosphatase,
      were found. At 2 to 4-month age a reduction of the latter enzyme activity was
      revealed in the doudenum, jejunum and ileum. The changes in the intestine enzymes
      activities led to a disorder in intermediary metabolism and to occurrence of
      "risk diseases".

PMID- 11195220
TI  - [The role of histamine in vagal and gastrin effects on the secretory function of
      the rat stomach].
AB  - In lumen-perfused stomachs of anaesthetized rat, acid and bicarbonate types of
      secretion were estimated on the basis of pH/PCO2 measurements. The data obtained
      reveal that, in anaesthetised rats, pentagastrin and cholinergic input affect
      acid secretion mainly indirectly via histamine release. Vagal effects on
      pepsinogen output are mediated partially via indirect histamine pathways. The
      direct action of pentagastrin, however, predominates. Bicarbonate production is
      subjected to cholinergic control alone.

PMID- 11195221
TI  - [The role of endogenous glucocorticoids in maintenance of the gastric mucosa
      integrity].
AB  - Effect of glucocorticoid deficiency on susceptibility to gastric mucosal injury
      by non-steroid anti-inflammatory drugs (NSAID) was studied in rats. The
      corticosterone production was inhibited by a single large dose of cortisol as
      well as by an adrenalectomy. The drop in the corticosterone production prompted
      gastric erosions induced by the NSAID. Replacing corticosterone prevented the
      effects of cortisol pretreatment of adrenalectomy on NSAID-induced gastric
      erosions. The data obtained reveal a gastroprotective effect of endogenous
      glucocorticoids.

PMID- 11195222
TI  - [History of the unique museum--apartment of Ivan Petrovich Pavlov in the I. P.
      Pavlov Institute of Physiology of the Russian Academy of Sciences].

PMID- 11195224
TI  - Quantifying infant respiratory variability: how to capture complexity.

PMID- 11195223
TI  - Overcoming surfactant inhibition with polymers.
AB  - Inhibition of the function of pulmonary surfactant in the alveolar space is an
      important element of the pathophysiology of many lung diseases, including
      meconium aspiration syndrome, pneumonia and acute respiratory distress syndrome.
      The known mechanisms by which surfactant dysfunction occurs are (a) competitive
      inhibition of phospholipid entry into the surface monolayer (e.g. by plasma
      proteins), and (b) infiltration and destabilization of the surface film by
      extraneous lipids (e.g. meconium-derived free fatty acids). Recent data suggest
      that addition of non-ionic polymers such as dextran and polyethylene glycol to
      surfactant mixtures may significantly improve resistance to inhibition. Polymers
      have been found to neutralize the effects of several different inhibitors, and
      can produce near-complete restoration of surfactant function. The anti-inhibitory
      properties of polymers, and their possible role as an adjunct to surfactant
      therapy, deserve further exploration.

PMID- 11195225
TI  - Familial aggregation and pain theory relating to recurrent pain experiences in
      children.

PMID- 11195226
TI  - What are the most effective means of promoting exclusive breastfeeding?

PMID- 11195227
TI  - Unnecessary water supplementation for babies: grandmothers blame clinics.
AB  - This study was designed to obtain policy-and programme-relevant data on exclusive
      breastfeeding in Lesotho at a time when global recommendations for exclusive
      breastfeeding were new. During both phases of field research, conducted in 1991
      and 1992, qualitative information was obtained through focus groups and
      individual interviews with mothers, grandmothers and nurses. This was
      complemented during the second phase with quantitative data collected through a
      clinic-based survey of mothers. The qualitative and the quantitative findings
      consistently converged, illustrating a culture of infant feeding in which
      breastfeeding was central, but exclusive breastfeeding was an unknown concept and
      not practised. Grandmothers seemed to be more in tune with the ideal of exclusive
      breastfeeding as they had given their young infants thin gruel only occasionally.
      Contemporary mothers, in contrast, were regularly giving their young infants
      water. Mothers and grandmothers frequently cited nurses as the source of advice
      for giving water. Grandmothers were adamant in pointing out that they had never
      given water to their own young infants and asserted that they avoided giving it
      to their grandchildren as they considered it unnecessary and harmful. According
      to the grandmothers, water supplementation was a new practice that had been
      introduced through the clinics. CONCLUSION: Efforts to discourage water
      supplementation and encourage exclusive breastfeeding in this setting need to be
      directed both at mothers and health providers.

PMID- 11195228
TI  - Residual pulmonary hypertension in children after treatment with inhaled nitric
      oxide: a follow-up study regarding cardiopulmonary and neurological symptoms.
AB  - Inhaled nitric oxide is a potent vasodilator in acute severe pulmonary
      hypertension and is increasingly used as rescue treatment in intensive care
      algorithms aiming at reducing severe hypoxaemia in neonates and children.
      Although the immediate effects may seem impressive, long-term outcome regarding
      residual pulmonary hypertension and other sequelae has been studied in only a
      very few patients. The aim of the present study was to evaluate residual
      pulmonary hypertension, cardiopulmonary or neurological symptoms in children
      after treatment with inhaled nitric oxide in severely hypoxaemic and/or pulmonary
      hypertensive mechanically ventilated children. The study was performed in four
      paediatric intensive care units in university hospitals in Sweden, Norway and
      Australia. Patients who had received inhaled nitric oxide as part of their
      intensive care treatment for severe hypoxaemia and/or pulmonary hypertension, and
      in whom 6 mo had elapsed since treatment, were included for evaluation. Thus 36
      paediatric or neonatal patients were examined for circulatory, respiratory or
      neurological disorders with clinical examination, echocardiography, chest X-ray
      and a capillary blood sample. Four patients with congenital heart disease had
      residual pulmonary hypertension. Nine patients were receiving bronchodilators.
      Sixteen patients had minor (n = 15) or moderate (n = 1) changes on a chest X-ray.
      One patient had a possible delay in psychomotor development. CONCLUSIONS: In
      spite of the severity of their primary illness, we found that the overwhelming
      majority of the surviving children were asymptomatic and doing well. The few
      residual circulatory and respiratory symptoms could be related to the initial
      condition.

PMID- 11195229
TI  - A study of breathing pattern and ventilation in newborn infants and adult
      subjects.
AB  - Experimentally modified breathing pattern in human subjects, by varying the
      inspired gas mixture or administering different neuromodulators, has been studied
      extensively in the past, yet unmodified breathing has not. Moreover, most data
      refer to infants during sleep and adults during wakefulness. We studied the
      baseline breathing pattern of preterm infants [n = 10; GA 30 (27-34) wk (median,
      range)]; term infants [n = 10; GA 40 (39-41) wk)], and adult subjects [n = 10;
      age 31 (17-48) y)] during quiet sleep. A flow-through system was used to measure
      ventilation. We found: (i) instantaneous ventilation was 0.273+/-0.006, 0.200+/
      0.003, and 0.135+/-0.002 L x min(-1) x kg(-1) in preterm, term infants, and adult
      subjects; the coefficients of variation were 39%, 25%, and 14% (p < 0.01). The
      greater coefficient of variation in neonates compared to adults related to
      increased variability in Vt (39% and 25% in preterm and term infants vs 14% in
      adults; p < 0.01) and f (39% and 22% vs 9%; p < 0.01). The major determinant of
      frequency in preterm infants was Te (81% variability), Ti varying less (25%
      variability); (ii) V(T)/Ti decreased and Ti/Ttot increased with age; (iii) the
      higher breath-to-breath variability in preterm infants was associated with larger
      changes in alveolar PCO2 and a larger variability in O2 saturation than later in
      life.

PMID- 11195230
TI  - HLA-DQA1*05-DQB1*0201 positivity predisposes to coeliac disease in Czech diabetic
      children.
AB  - The aims of this study were to estimate the prevalence of coeliac disease (CD) in
      Czech children with insulin dependent diabetes mellitus (IDDM), and to determine
      the contribution of HLA-DQA1 and DQB1 to CD susceptibility among diabetic
      children. We screened 345 children with IDDM (186 boys and 159 girls, aged 0 to
      18 y) for coeliac disease using the IgA endomysial antibodies (EMA) test. In all
      EMA-positive children, small bowel biopsy was performed to confirm CD. To
      determine the role of the HLA-DQA1*05-DQB1*0201 (DQ2) and the DQA1*03-DQB1*0302
      (DQ8) molecules in CD susceptibility among diabetic children, the HLA-DQA1-DQB1
      was genotyped in all EMA-positive, and in 186 of EMA-negative diabetic patients.
      EMA positivity was found in 15/345 (4.3%) diabetic children. The diagnosis of CD
      was established in 14/345 (4.1%) children based on a bioptic finding of villous
      atrophy, while the remaining EMA-positive patient had a normal bioptic finding,
      being diagnosed as a potential CD. The HLA DQA1*05-DQB1*0201 (DQ2) molecule
      conferred a significant risk of CD among diabetic children (odds ratio = 4.1, CI
      95% 1.1-15), being found more frequently in diabetic children with CD (80%) than
      in diabetic children without CD (49%). CONCLUSION: The high prevalence of CD
      (4.1%) found in Czech children with IDDM emphasizes the need for their regular
      screening. We suggest that this CD screening protocol may be individualized
      according to the DQA1*05-DQB1*0201 positivity.

PMID- 11195231
TI  - Elevated serum creatinine levels in infants with congenital hypothyroidism:
      reflection of decreased renal function?
AB  - The effects of hypothyroid status on renal function have been poorly studied in
      children. We assessed the renal function of hypothyroid infants detected during
      neonatal mass screening for congenital hypothyroidism (CH). Eighty hypothyroid
      infants and 20 age-matched normal infants for controls were enrolled. The 80
      patients, aged 1 mo, were divided into two groups based on the initial thyroid
      stimulating hormone (TSH) and free thyroxine (FT4) values: a mild-moderately
      hypothyroid (MHT) group (n = 64, 31M and 33F) and a severely hypothyroid (SHT)
      group (n = 16, 3M and 13F). Serum creatinine (SCr), TSH, FT4 and other chemicals
      were compared before and 2 mo after L-thyroxine (LT4) substitution therapy. The
      following results were obtained: SCr levels were significantly higher in the SHT
      group (33.2+/-10.0 micromol/L, p < 0.001) compared with the MHT group (20.6+/-6.4
      micromol/L) and normal control group (21.0+/-4.4 micromol/L). Two months after
      the LT4 replacement therapy, the elevated SCr levels in the SHT group decreased
      by 41.3% to the level (19.5+/-6.0 micromol/L) very close to that in the MHT group
      (18.8+/-5.1 micromol/L). No significant differences were noted among BUN levels
      in the three groups. Although serum creatinine kinase levels were significantly
      higher in the SHT group (230.3+/-102.3 U/L, p < 0.001) than in the MHT group
      (121.1+/-60.8 U/L), rhabdomyolysis was not considered to be responsible for the
      impaired renal function. CONCLUSION: From these results we conclude that serum
      creatinine levels are elevated in congenitally hypothyroid infants. This is a
      reversible change with thyroid hormone replacement therapy. The possibility of
      impaired renal functions should be kept in mind when treating hypothyroid
      infants.

PMID- 11195232
TI  - A multicenter collaborative study on the risk factors of cardiac sequelae due to
      Kawasaki disease: a one-year follow-up study.
AB  - OBJECTIVE: To measure the prevalence of cardiac sequelae 1 y after the onset of
      Kawasaki disease and determine the risk factors associated with these cardiac
      sequelae. MATERIAL AND METHODS: 1594 patients who initially visited one of the 87
      target hospitals in 1996 for Kawasaki disease participated. Selection of the
      target hospitals was based on a nationwide survey. The patients were followed-up
      and information concerning cardiac sequelae occurring within 1 y of onset was
      obtained by mail survey. RESULTS: The prevalence of cardiac sequelae 1 mo after
      onset was 10.2% and decreased to 4.2% in 1 y. The prevalence was higher among
      males than females and higher in patients less than 1 y and 5 ys or older than in
      1-4 year-olds. Of the patients with cardiac sequelae at 1 mo, the sequelae
      disappeared in 60.7% after 1 y. Analysis revealed low serum albumin as a risk
      factor related to the occurrence of cardiac sequelae 1 y after onset. Of the 1594
      patients, 10 had giant anuerysms and 3 had a fatal outcome. CONCLUSIONS:
      Approximately 60% of cardiac sequelae due to Kawasaki disease that developed
      within 1 mo after onset disappeared in 1 y. The odds ratio was significantly
      higher among patients with a low serum albumin level 1 y after onset.

PMID- 11195233
TI  - Dextran reduces surfactant inhibition by meconium.
AB  - We have previously shown that an addition of dextran to surfactant increases
      resistance to inactivation by albumin. The present study was designed to
      investigate whether dextran has a protective effect against inactivation of
      surfactant by meconium. The dynamic surface properties of various mixtures of
      modified natural surfactant (Curosurf), meconium and dextran were evaluated with
      the pulsating bubble technique. In the absence of meconium, an addition of
      dextran at 10 mg ml(-1) significantly shortened the surface adsorption time of
      Curosurf suspended in normal saline at a concentration of 5 mg ml(-1) from 1.6+/
      1.3 (mean +/- SD) sec to 0.4+/-0.4 sec (p < 0.05). Meconium at 5 mg ml(-1)
      increased the mean minimum surface tension (gammamin) after 3 min of pulsation
      from 2.1 mN m(-1) to 24 mN m(-1) (p < 0.05). An addition of dextran at 5 and 10
      mg ml(-1) to the meconium-surfactant mixture significantly reduced the gammamin
      to 6.4+/-4.5 mN m(-1) and 2.6+/-5.6 mN m(-1), respectively (p < 0.05 vs dextran 0
      mg ml(-1)). Meconium also increased the maximum surface tension (gammamax) of
      Curosurf from about 33 mN m(-1) to 53 mN m(-1). An addition of dextran at 5 and
      10 mg ml(-1) to the meconium-surfactant mixture reduced the gammamax to 41 and 39
      mN m(-1), respectively (p < 0.05 vs dextran 0 mg ml(-1)). There were significant
      negative correlations between dextran concentration and both gammamin and
      gammamax. We conclude that dextran reduces surfactant inhibition by meconium in a
      dose-dependent manner.

PMID- 11195234
TI  - Effect of low-dose cisapride on gastric emptying and QTc interval in preterm
      infants.
AB  - The aim of the study was a prospective survey of the effects of low-dose
      cisapride on gastric emptying and QTc interval in very low birthweight infants.
      Twenty low birthweight infants were studied: mean (SD) gestation 30.5 (2.2) wk;
      birthweight 1320 (150)g. Gastric emptying was assessed ultrasonically in 15 of
      these infants, in a randomized blind crossover study, following 24-h low-dose
      oral cisapride administration (0.1 mg/kg given 8 hourly), or placebo. The QTc
      interval was also determined in all 20 infants following a 7-d course of
      cisapride or placebo. CONCLUSIONS: Cisapride significantly shortened both gastric
      emptying time and QTc interval (p < 0.05) compared to placebo. All infants
      completed the study without any apparent adverse effects. In conclusion, low-dose
      cisapride administration significantly improves gastric emptying without
      increasing the QTc interval.

PMID- 11195235
TI  - Budesonide delivered by dosimetric jet nebulization to preterm very low
      birthweight infants at high risk for development of chronic lung disease.
AB  - We investigated the effect of an aerosolized corticosteroid (budesonide) on the
      oxygen requirement of infants at high risk for developing chronic lung disease
      (CLD) in a randomized, double-blind study. The study objective was to attain a
      30% decrease in FiO2 levels in the budesonide treatment group after 14 d of
      therapy. Thirty very low birthweight (VLBW) infants (median (range)) gestational
      age 26 wk (23-29) and birthweight 805 g (525-1227) were randomized. Inclusion
      criteria were mechanical ventilation on day 6 of life, or if extubated on nasal
      continuous positive airway pressure with FiO2 > or = 0.3. The budesonide
      (Pulmicort) dose was 500 microg bid, or placebo. The aerosol was delivered with a
      dosimetric jet nebulizer, with variable inspiratory time and breath sensitivity.
      Inhalations were started on day 7 of life. Twenty-seven patients completed the
      study. A significant lowering of the FiO2 levels at 21 d of life was not
      detected. Infants who received budesonide were more often extubated during the
      study period (7/8 vs 2/9) and had a greater relative change from baseline in
      their oxygenation index (budesonide decreased 26% vs placebo increased 60%).
      Subsequent use of intravenous dexamethasone or inhaled budesonide in the
      treatment group was significantly less. All patients required O2 supplementation
      on day 28 of life. At 36 wk postconceptual age, 61% of infants in the budesonide
      group needed supplemental O2 as opposed to 79% in the placebo group. No side
      effects on growth or adrenal function were observed. CONCLUSION: We conclude that
      inhaled budesonide aerosol via dosimetric jet nebulizer started on day 7 of life
      for infants at high risk for developing CLD decreases the need for mechanical
      ventilation similar to intravenous dexamethasone, but without significant side
      effects.

PMID- 11195236
TI  - Early motor development of premature infants with birthweight less than 2000
      grams.
AB  - The aim was to assess motor function during infancy in order to predict later
      function, mainly cerebral palsy. The neuromotor development of a population-based
      cohort of 209 of 236 (89%) survivors with a birthweight less than 2000 g was
      assessed using the Infant Neurological International Battery (INFANIB) and
      detailed neurological assessment. The infants were classified as being normal,
      dystonic, hypotonic or having suspected cerebral palsy (CP) at 4, 7, 13 and 18 mo
      corrected age if birthweight was less than 1500 g (n = 119) and at 7 and 13 mo if
      birthweight was 1500-1999 g (n = 90). Those with dystonia or suspected CP were
      followed until diagnosed as normal or as having CP after at least 36 mo of age.
      Fourteen (7%) finally developed CP. Motor function at 4 mo was inaccurate in
      predicting function at 7 mo and later. All who were normal at 7 mo remained
      normal in the follow-up period. Eight of 65 who were dystonic at 7 mo developed
      suspected CP, and three judged as suspected CP were eventually normal. The 14 who
      developed CP were judged as suspected CP (n = 5) or dystonic (n = 8) and one as
      hypotonic at 7 mo of age. CONCLUSIONS: The specificity of motor evaluation at 7
      mo corrected age regarding CP is unsatisfactory, since dystonia at this age is
      most often transient. A normal neuromotor assessment at 7 mo is highly predictive
      of subsequent normal motor function.

PMID- 11195237
TI  - Influence of the initial management regimen and family social situation on
      glycemic control and medical care in children with type I diabetes mellitus.
AB  - It is well known that social family factors are of importance in diabetes care,
      but it is not clear whether the initial management regimen can buffer these
      factors. In a prospective, randomized intervention study, 36 children with
      diabetes mellitus (type I) were followed, the aim being to study if a family
      psychosocial intervention at diagnosis could improve glycemic control and
      minimize hospital admissions. The control group was treated initially in a
      hospital ward, while the study group received problem-based learning and family
      therapeutic and social support in an out-hospital training apartment. A number of
      family social variables were evaluated at the time of diagnosis and 6, 12 and 24
      mo later. Family function was assessed using the self-estimated Family Climate
      Test at these same time-points. HbAlc values and information concerning in- and
      out-hospital visits to the pediatric clinic were collected for the 5-y period
      following diagnosis. We found no association between the offered management
      regimen and glycemic control or rate of readmission. In the study group only,
      both parents reported a significant improvement of the family climate. An
      increased risk for poor glycemic control was recorded in children living in one
      parent families (p = 0.03) or in families where the father had a low level of
      education (p = 0.04). Younger age (p = 0.05), a single-parent family (p = 0.05)
      and poor glycemic control (p = 0.02) were associated with more days of
      rehospitalization. The rate of divorce in the whole group was at least as high as
      in the normal population but, surprisingly, maternal dysfunction was associated
      with lower HbAlc value. The conclusion is that even with an initial management
      regimen designed to offer a family-individual care regimen based on accurate
      estimation of the psychological and pedagogical needs, the social family
      background is a most important factor for the glycemic control and need for
      readmission.

PMID- 11195238
TI  - Parents' perception of mental development and behavioural problems in 8 to 9-year
      old children.
AB  - A slow maturational rate may be an underlying antecedent of a psychiatric
      disorder. If this is correct, differences in behavioural problems could be
      related to the maturity level in children of the same chronological age. The aim
      of the study was to compare the parents' perceptions and assessments of their
      children's maturational status and behavioural problems. A population based on a
      nationwide sample from the Swedish twin-register of 8 to 9-y-old children (n =
      1079) was used. The parents completed a questionnaire including their views on
      their child's maturity level, the Swedish version of the Child Behaviour
      Checklist (CBCL) and an Attention Deficit Hyperactivity Disorder (ADHD) checklist
      based on the DSM-III-R criteria. Multivariate analyses showed a statistically
      significant relationship between immaturity reported by the parents and several
      behavioural problems reported on the CBCL: somatic complaints, anxious and
      depressed, social problems, thought problems, attention problems, behaviour
      problems and aggressive behaviour. There was also a statistically significant
      relationship between the maturity factor and the CBCL grouping of syndromes
      (internalizing, externalizing, total behaviour problems score) as well as between
      the maturity factor and ADHD. CONCLUSION: We conclude that at least from the
      parents' point of view the behaviour problems in their children may be related to
      maturity.

PMID- 11195239
TI  - Children of mothers abusing amphetamine: head circumference during infancy and
      psychosocial development until 14 years of age.
AB  - OBJECTIVE: To study the relationship between head circumference (HC) at birth
      (HO) and at 1 y of age (HI) and later outcome variables in children exposed to
      amphetamine during fetal life through maternal drug abuse. METHOD: Prospective
      longitudinal study of 65 children born to women abusing amphetamine. Potential
      bivariate and partial correlations between HC and outcome variables at 4, 8 and
      14 y of age were studied. In multivariate analyses on outcome variables, HC,
      maternal and perinatal factors were used as predictors. Analyses were performed
      for all children and separately for boys and girls. RESULTS: Head circumference
      at birth and 1 y of age were significant predictors for the level of achievement
      in Swedish language at 14 y. Head circumference at birth was a significant
      predictor for grades in mathematics in boys. Combined assessment of psychomotor
      development and psychosocial adjustment at 4 and 8 y correlated with HI in girls.
      CONCLUSION: Head circumference at birth and at 1 y of age correlated with school
      achievement at 14 y. HI also correlated with adjustment at 4 and 8 y in girls. A
      difference in vulnerability between girls and boys is important and should be
      considered in longitudinal studies of risk cohorts.

PMID- 11195240
TI  - Recurrent pain symptoms in children and parents.
AB  - Recurrent pain in five different areas (stomach, arms & legs, head, back and neck
      & shoulders) in a population of 348 school children and their parents has been
      investigated. The study presented here is restricted to 229 mother-father-child
      trios. Forty-four percent of the children reported pain in at least one area
      compared to 60% of the mothers and 51% of the fathers. Headache and pains in arms
      and legs were most common in boys. The most frequent pain sites for girls were
      head and back. Overall, girls complained more than boys. No significant
      associations between complaints in parents and their children were demonstrated,
      analysed by logistic regression analysis. Furthermore, there was no significant
      association between the reported pain in the mother and father. CONCLUSION:
      Children's pain did not associate with parental pain in this study. The results
      do not support previous hypotheses that recurrent pain clusters in families.

PMID- 11195241
TI  - Diagnosis and prognosis of wheezing disorders in young children in the city of
      Sao Paulo, Southeast Brazil.
AB  - Three-hundred-and-ninety-seven children aged 2-59 mo presenting to the paediatric
      emergency departments of five public hospitals in Sao Paulo, Brazil, with an
      acute episode of lower respiratory disease were examined. The children were
      classified into the following diagnostic categories: acute bronchitis, acute
      bronchiolitis, pneumonia, asthma, post-bronchiolitis wheezing and wheezing of
      uncertain aetiology. Three years after the initial study, the homes of the
      children diagnosed as asthmatic or as having wheezing of uncertain aetiology were
      visited to collect information on subsequent episodes of lower respiratory
      disease. This paper reports the proportional incidence of different categories of
      lower respiratory disease and the results of an analysis to investigate clinical
      features that might distinguish wheezing children between those with asthma and
      those with an infectious disease. The predictions made for children with wheezing
      of uncertain aetiology were then compared with the follow-up data. Recurrent
      wheezing disorders (asthma, post-bronchiolitis wheezing) were common in the study
      sample (47% of children). Thirty-six percent of children with an initial
      diagnosis of wheezing of uncertain aetiology were diagnosed as asthmatic by
      another doctor over the next 3 y. We were unable to identify any clinical
      features that were useful in identifying those children likely to be diagnosed
      subsequently as asthmatic. CONCLUSIONS: The use of a diagnostic category similar
      to that which we have called "wheezing of uncertain aetiology" might help to
      alert physicians early to the possibility of asthma without interfering in the
      management of the illness. Such a classification might also be useful in
      epidemiological investigations of the aetiology of lower respiratory diseases.

PMID- 11195242
TI  - Does maternal or paternal heredity affect carotid atherosclerosis in children
      with familial hypercholesterolaemia?
AB  - Maternal hypercholesterolaemia has recently been shown to increase the number of
      fatty streaks in the foetal aorta, as well as subsequent progression of fatty
      streaks to more advanced lesions. We compared carotid intima-media thickness by B
      mode ultrasonography in children who inherited familial hypercholesterolaemia
      from their mothers or fathers, hypothesizing that children whose mothers were
      hypercholesterolaemic during pregnancy had increased atherogenesis compared with
      children whose mothers did not have familial hypercholesterolaemia. We found that
      carotid intima-media thickness and prevalence of plaque did not differ between
      children with familial hypercholesterolaemia who inherited FH maternally or
      paternally.

PMID- 11195243
TI  - Clinical features, laboratory findings and differential diagnosis of benign acute
      childhood myositis.
AB  - We report clinical and laboratory data from 32 children with benign acute
      childhood myositis (BACM), children who presented with calf tenderness and gait
      abnormality. Laboratory evidence of a viral infection was evident in 23 patients,
      while serum creatine phosphokinase was uniformly increased (558 to 6800 U/L).
      Twenty-five patients (78.1%) were given a diagnosis other than BACM by their
      general practitioner or paediatrician. All patients made a rapid recovery within
      one week. We conclude that BACM should be encountered among the main causes of
      sudden-onset gait abnormality in young children.

PMID- 11195244
TI  - Sternal tuberculosis in a 9-month-old infant after BCG vaccination.
AB  - Tuberculosis osteitis is mainly observed as a late complication of the pulmonary
      infection. We describe a 9-mo-old Japanese infant who became infected with
      Mycobacterium tuberculosis even after receiving Bacillus Calmette-Guerin (BCG)
      vaccination at 3 mo of age. This is the first report that the sternum is the
      localization for tuberculous osteitis in infants. He developed a localized tumor
      in the sternum without any respiratory symptom. Mycobacterium tuberculosis
      complex was detected by means of nucleic acid amplification test. Gastric
      aspirates also yielded Mycobacterium tuberculosis. The source of the infection
      was unclear. CONCLUSION: Tuberculous osteitis should be excluded in infants with
      undiagnosed bone lesions, even if they have been vaccinated with BCG.

PMID- 11195245
TI  - Acyclovir-resistant varicella infection with atypical lesions in a non-HIV
      leukemic infant.
AB  - An HIV-negative infant presented with VZV primary infection during the
      maintenance therapy for megakaryoblastic leukaemia. The lesions were initially
      vesicular and necrotic but became verrucous and hyperkeratotic. A clinical
      resistance to acyclovir was suspected and confirmed by histologic and virologic
      studies. The patient was successfully treated by foscarnet. CONCLUSION:
      resistance of VZV to acyclovir may occur after a short treatment in a non-AIDS
      patient.

PMID- 11195246
TI  - Continuous veno-venous haemodiafiltration in an infant with a stage ivs
      neuroblastoma and acute renal failure.

PMID- 11195247
TI  - Coronary revascularization in seven-year-old boy with homozygous familial
      hypercholesterolaemia.

PMID- 11195248
TI  - Retrospective neuropsychological evaluation of 18 Romanian subjects with
      hyperphenylalaninaemia.

PMID- 11195249
TI  - Increase of serum prolactin during combined high-dose estrogen and progestin
      treatment in girls with constitutional tall stature.

PMID- 11195250
TI  - Urinary tract dysfunction in children with cerebral palsy.

PMID- 11195251
TI  - Preventing the transmission of bloodborne pathogens in health care and public
      service settings.

PMID- 11195252
TI  - An integrated protocol to manage health care workers exposed to bloodborne
      pathogens.

PMID- 11195253
TI  - Canadian contingency plan for viral hemorrhagic fevers and other related
      diseases.

PMID- 11195254
TI  - Guidelines for preventing the transmission of tuberculosis in Canadian Health
      Care Facilities and other institutional settings.

PMID- 11195255
TI  - Does risperidone have a place in the treatment of nonschizophrenic patients?
AB  - There is a now a substantial body of evidence that suggests the new antipsychotic
      agent, risperidone, may be safe and effective for treating psychotic, affective
      or behavioural symptoms associated with various disorders other than
      schizophrenia, schizophreniform disorder or schizo-affective disorder. These
      conditions include bipolar disorder, obsessive-compulsive disorder, Tourette's
      syndrome, dementia, Lewy body disease, mental retardation, Parkinson's disease,
      idiopathic segmental dystonia and organic catatonia. Although much of the data is
      anecdotal or in the form of open studies, there is now emerging a small number of
      well controlled investigations supporting efficacy for mania, dementia,
      behavioural disturbance in mental retardation and conduct disorder. Conventional
      antipsychotics have long been used, either in a primary capacity or as an adjunct
      to treat these disorders; however, they have limited benefit, pose significant
      risks of extrapyramidal side-effects, and may cause the potentially life
      threatening neuroleptic malignant syndrome. In contrast, risperidone at the
      recommended low doses may be efficacious and pose reduced risk of motor side
      effects. This article reviews the evidence that risperidone may be an effective
      new treatment for disorders other than schizophrenia.

PMID- 11195256
TI  - An open trial of citalopram in adolescents with post-traumatic stress disorder.
AB  - In this preliminary, 12-week open-label study, eight adolescents with moderate to
      severe post-traumatic stress disorder (PTSD) were treated with citalopram (the
      most selective of the selective serotonin reuptake inhibitors) in a fixed daily
      dose of 20 mg, and rated at 2-week intervals. The Clinician-Administered PTSD
      Scale (Child and Adolescent Version) was the primary measure used to assess
      treatment outcome. Core PTSD symptoms (re-experiencing, avoidance, and
      hyperarousal symptoms) showed statistically significant improvement at week 12 on
      the Clinician-Administered PTSD Scale (Child and Adolescent Version) (CAPS-CA),
      with a 38% reduction in total CAPS scores between baseline and endpoint.
      Citalopram failed to effect improvement on self-reported depressive symptoms. All
      seven adolescent completers were rated as much improved or very much improved on
      Clinical Global Impression Improvement scores. Citalopram was well-tolerated
      overall with reported adverse experiences being relatively benign. However,
      larger, controlled trials are needed to consolidate these preliminary results.

PMID- 11195257
TI  - Efficacy and tolerability of moclobemide in bulimia nervosa: a placebo-controlled
      trial.
AB  - A 6-week double-blind placebo-controlled trial was carried out to examine the
      efficacy and tolerability of moclobemide, a monoamine oxidase type A selective
      and reversible inhibitor, in the treatment of bulimia nervosa. Patients were
      admitted to the study even if they were unable to adhere to a tyramine-free diet.
      Fifty-two normal-weight women (age range 18-40 years) suffering from bulimia
      nervosa (DSM-IV criteria) completed the trial. Particular emphasis was placed on
      evaluating the incidence of hypertension and other side-effects in chronically
      treated patients. At the usual antidepressant dose of 600 mg, moclobemide was not
      significantly superior to placebo in the reducing the weekly number of binge
      eating episodes or in improving several measures of eating attitudes and
      behaviour (BITE, EDI, TFEQ) in normal-weight bulimia nervosa. The dropout rate
      was relatively low (29%), and the side-effects were limited and equally
      distributed between the two treatment groups. No patient experienced a
      hypertensive crisis during the study and no serious side-effect was detected. The
      study indicates that moclobemide 600 mg pro die is not efficacious in bulimia
      nervosa, but it can be safely administered, even to young subjects, at a very
      high risk of consuming large amounts of tyramine-rich foods without dietary
      restrictions.

PMID- 11195258
TI  - Relapses after discontinuation of drug associated with increased resistance to
      treatment in obsessive-compulsive disorder.
AB  - The aim of the present study was to determine whether obsessive-compulsive
      disorder (OCD) patients whose symptoms recur after drug discontinuation respond
      again when the same drug at the same daily dosage is reinstituted. Eighty-one
      patients who were responders to a previous 6-month, open-label, noncomparative,
      acute treatment phase with fixed doses of selective reuptake inhibitors (SRIs)
      and who relapsed within 6 months of drug discontinuation had the drug to which
      they responded in the acute phase reinstated at the same daily dose. The
      reinstitution trial lasted 24 weeks with monthly evaluations (Yale-Brown
      Obsessive-Compulsive Scale and Clinical Global Improvement). Data obtained in the
      reinstitution phase were analysed using Pearson's chi-squared test or Fisher's
      exact test when appropriate. The cumulative percentages of patients who responded
      in the second trial were compared to those of patients who responded in the acute
      treatment phase (for each treatment and for all SRIs together) across all
      evaluation times. When considering all patients together, a lower percentage of
      responders resulted when SRIs were reinstated: the difference in the cumulative
      percentage of responders appeared at month 4 and increased at months 5 and 6
      (Pearson chi-squared, P = 0.028, P = 0.009 and P < 0.001, respectively). When
      considering the patients separately according to the SRI used, no differences in
      the percentages of responders were found at any time. Our results indicate that
      patients whose symptoms recur after drug discontinuation respond again when the
      same drug used previously (at the same dosage used in the acute phase) is
      reinstated, but at a lower degree with respect to the acute treatment. Findings
      from our study, together with literature data indicating high relapse rates when
      discontinuing the treatment after the acute phase, support the idea of continuing
      the treatment in OCD over the long term.

PMID- 11195260
TI  - Depression in the community: results of the first Italian survey.
AB  - The 6-month prevalence of depression in the Italian community was evaluated by
      means of the modified-Mini-International-Neuropsychiatric Interview (MINI)
      administered with a computer-prompted interview to a representative panel of 3550
      individuals. Major depression and minor depression accounted for 8.0% and 2.9% of
      the cases, respectively. Major depression was 1.3 times as prevalent in females
      (compared to males), while minor depression was 1.6 times as prevalent in males.
      Prevalence of major depression was maximal (11.9%) in subjects aged 30-49 years,
      and minimal (4.1%) in subjects aged 60 years or older. These results confirm
      prevalence figures for depression in the community reported with the modified
      MINI for other European countries, and support the use of telematic data
      acquisition for health-related general population surveys.

PMID- 11195259
TI  - Hyperactivity in the hypothalamic-pituitary-adrenal axis in demented patients
      with delirium.
AB  - Occurrence of delirium is known to be related to, among other things, organic
      brain disorder, somatic disease and old age. It has been hypothesized that
      delirium is also associated with stress. Disturbances of the hypothalamic
      pituitary-adrenal (HPA) system have been found in delirious patients in various
      studies. The aim of the present study was to determine the activity in the HPA
      axis in demented patients to ascertain whether the stress regulating system was
      more disturbed in patients with delirium than in those without delirium. Demented
      inpatients with no acute medical illness were included in the study. Basal
      cortisol levels in serum were measured and dexamethasone suppression test (DST)
      was performed. The most important finding of the study was a strong relationship
      between delirium and DST pathology irrespective of age and severity of dementia.
      It is suggested that certain demented individuals have an impaired HPA system and
      a low delirium threshold and respond to stress with delirium.

PMID- 11195261
TI  - Olanzapine-induced leukopenia with human leukocyte antigen profiling.
AB  - Olanzapine is an atypical antipsychotic medication frequently used in the
      management of psychotic states. While it has proved to be safe compared to
      clozapine with regard to haematotoxicity, because it has only been available for
      a few years, full documentation of its haematological side-effects remains
      incomplete. We report a case of olanzapine-induced leukopenia with associated
      neutropenia. Since clozapine-induced haematotoxicity has been associated with
      characteristic human leukocyte antigen (HLA) groups, HLA typing was determined in
      this patient. Following failure with typical antipsychotic medication, the
      patient received 10 mg/day of olanzapine. Three weeks later, he developed fever
      and a significant decrease in leukocyte count. Olanzapine was immediately
      discontinued. HLA typing was determined. The white cell count returned to normal
      and the fever, most probably secondary to the low white cell count, subsided with
      antibiotic treatment. HLA typing results were: A1 24, B7, B35, DRB1*15, DRB1*11,
      DRB3*01-03, DRB5*01-02. Olanzapine may induce serious leukopenia and neutropenia.
      HLA typing in this single patient demonstrated a distinct haplotype compared to
      that previously observed in clozapine-induced haematoxicity.

PMID- 11195263
TI  - Psychiatric aspects of women's health.
AB  - A number of psychiatric disorders are present exclusively or more commonly in
      women. Furthermore, within a particular disorder there may be significant gender
      differences across demographic and clinical variables, and neurobiological
      fluctuations across women's menstrual and life cycles may affect the
      psychobiology of disorders and the pharmacokinetics of pharmacotherapies. Indeed,
      exploration of gender may serve as a useful heuristic for advancing the field as
      a whole and for integrating epidemiological and psychobiological data. In this
      supplement, we highlight three issues that fall under the rubric of 'women's
      mental health'; premenstrual dysphoric disorder, pharmacotherapy during pregnancy
      and lactation, and violent trauma and post-traumatic stress disorder in women.
      Although further work across the range of basic, clinical, and sociopolitical
      fronts is needed, advances in the pharmacotherapy of premenstrual dysphoric
      disorder, recent safety data on certain agents in pregnancy, and progress in the
      management of post-traumatic stress disorder provides cause for clinical

PMID- 11195262
TI  - Contribution of sodium valproate to the syndrome of inappropriate secretion of
      antidiuretic hormone.
AB  - We report the case of a 62-year-old man who was administered sodium valproate
      (VPA) and who subsequently developed the syndrome of inappropriate secretion of
      antidiuretic hormone (SIADH). He had been taking VPA for treatment of idiopathic
      generalized tonic-clonic convulsions since he was 56 years old. After
      substituting VPA with zonisamide, the serum sodium level returned to normal. We
      consider this episode of SIADH to be the result of a combination of factors
      including a weakness of the central nervous system and the long-term
      administration of VPA.

PMID- 11195264
TI  - Antidepressant drugs during pregnancy and lactation.
AB  - As depression is common in women during their childbearing years, many women will
      experience depression during pregnancy or postpartum. This paper reviews the
      latest scientific knowledge on the effects of antidepressant drugs during
      pregnancy and lactation. Information is presented on physical and behavioural
      teratogenic risks, impaired intrauterine growth, and neonatal toxicity,
      withdrawal, and death. Risk : benefit considerations, such as the effects of
      antidepressant drugs on the mother and foetus compared with the effects of
      untreated severe depression, are discussed to facilitate clinical decision
      making. Recent studies of the safety of antidepressant drugs during pregnancy and
      lactation are predominantly reassuring, and should guide and improve the care of
      depressed childbearing women and their infants.

PMID- 11195265
TI  - Trauma and post-traumatic stress disorder in women: a review.
AB  - In the aftermath of traumas such as combat or sexual assault, both men and women
      may experience similar symptoms, including post-traumatic stress disorder (PTSD).
      However, epidemiological studies have yielded higher rates of PTSD in women than
      in men in general populations, and there are also a number of gender differences
      in clinical presentation after trauma. Thus, in a study by the authors of
      patients presenting with physical trauma after interpersonal violence, women were
      more likely than men to have been previously assaulted, or to have sustained
      injury by a relative or someone known to them, but less likely to have used
      substances at the time of the assault or to require emergency surgery. A better
      understanding of the particular factors that contribute to higher rates of PTSD
      in women may ultimately shed light on the pathogenesis of this complex disorder.
      This article reviews gender differences in exposure to trauma and subsequent
      PTSD, emphasizing those features that characterize trauma and PTSD in women.

PMID- 11195266
TI  - Depression in Kenyan professional women.
AB  - This was a pilot study to document scores on a general measure of mental health,
      and to establish the relationship between perceived stress and social support, in
      Kenyan professional women. Subjects were identified through registered
      professional bodies, and were asked to self-administer several measures: the
      General Health Questionnaire, the Perceived Stress Scale, the Network Orientation
      Scale, and the Social Support Appraisal. Eighty-six out of 120 (71%) subjects
      responded, of which 22% reported depressive symptoms and 30% indicated that they
      were coping less well than usual. Increased perceived stress was significantly
      associated with lower network orientation and lower perceived social support.
      Further investigation is required in order to draw definitive conclusions.
      However, these data are of potential utility to Kenyan (and possibly other)
      professional organizations that intend to put in place systems for the promotion
      of women's mental health.

PMID- 11195267
TI  - Violence against women: an emerging health problem.
AB  - As well as being a violation of human rights, violence against women can be
      regarded as an 'emerging health problem' of the late twentieth century not
      because it is new, but because its prevalence and role in the aetiology of ill
      health has only recently been widely recognized. In this paper we discuss the
      epidemiology and health impact of violence against women, drawing particularly on
      data from research in South Africa. Here the prevalence of abuse is between 20%
      and 30%, which is in keeping with estimates for other countries and research has
      shown that 1% of women are raped each year. Gender-based violence is an
      appreciable cause of mortality from homicide and suicide. It is also associated
      with a range of other health problems, particularly injuries, HIV and sexually
      transmitted diseases, pregnancy complications and mental health problems.
      Available estimates suggest that it is associated with considerable costs to the
      health sector. Roles for the health sector in breaking cycles of abuse are
      increasingly being recognized and there is a need for appropriate interventions,
      based on screening, homicide and suicide risk assessment, documentation,
      information giving and referral to be implemented more widely in health
      facilities.

PMID- 11195268
TI  - Quality of life in cancer of the cervix patients.
AB  - Cancer of the cervix is one of the leading causes of death among female cancer
      patients in developing countries such as South Africa. Despite this, psychiatric
      morbidity, including impairment of quality of life, has not been well studied in
      such patients in this context. A total of 328 Zulu-speaking patients with
      cervical cancer were interviewed with a structured diagnostic instrument and with
      a quality of life measure (Quality of Life Index). Quality of life scores were
      numerically lower than published norms, and lower scores were associated with
      inpatient status, more advanced stage of the disease, lower Karnofsky physical
      performance scores, comorbid psychiatric disorder, and lower 'fighting spirit'
      and more 'helplessness/hopelessness'. The Quality of Life Index is a valuable
      instrument that can be used by clinicians in order to assess the negative impact
      of the

PMID- 11195269
TI  - Diagnosis and treatment of premenstrual dysphoric disorder: an update.
AB  - Premenstrual dysphoric disorder (PMDD) appears in the appendix of the DSM-IV
      under the heading 'depressive disorder not otherwise specified'. Yet, recently, a
      group of experts reached a consensus that PMDD is a distinct clinical entity with
      characteristic symptoms of irritability, anger, internal tension, dysphoria, and
      mood lability. PMDD is the more severe form of premenstrual symptomatology,
      whereas premenstrual syndrome (PMS) is milder and more prevalent and both must be
      differentiated from premenstrual magnification/exacerbation of an underlying
      major psychiatric disorder or a medical condition. Accurate assessment and
      diagnosis of significant premenstrual symptomatology is paramount and can be
      influenced by subjective perception, retrospective versus prospective reporting,
      and cultural context. The serotonergic system, which is in a close reciprocal
      relationship with the gonadal hormones, has been identified as the most plausible
      target for intervention. Results from randomized placebo-controlled trials in
      women with PMDD have clearly demonstrated that serotonin reuptake inhibitors
      (SSRIs), with daily or intermittent dosing, have excellent efficacy and minimal
      adverse effects and should be considered first-line treatment. Luteal phase only
      SSRI administration may offer an attractive treatment option for a disorder that
      is itself intermittent. Hormonal interventions, in particular the suppression of
      ovulation will eliminate premenstrual symptomatology; however, the benefits-risk
      ratio of these approaches should be carefully evaluated with the patient.

PMID- 11195270
TI  - Violent trauma among child and adolescent girls: current knowledge and
      implications for clinicians.
AB  - While the incidence and psychiatric correlates of violent trauma among children
      and adolescents have been well documented, there is less data on the specific
      ways in which girls are affected by violence. The present review examines current
      knowledge of the prevalence and effects of violent trauma on female children and
      adolescents. Domestic and community violence, sexual abuse and war trauma are
      included. Data on etiology and treatment are also reviewed. Current data indicate
      that violent trauma, particularly sexual victimization, is highly prevalent among
      child and adolescent girls. Furthermore, girls appear to be more vulnerable to
      post-traumatic stress reactions than boys. Some studies report that rates of
      posttraumatic stress disorder are six times higher in girls, possibly due to the
      sexual nature of girls' victimization. However, the nature of the exposure
      distress relationship and the role of protective factors both bear further
      research. The implications of current findings for clinical practice are
      discussed, in order to facilitate optimal assessment and treatment of young
      female victims of violence.

PMID- 11195271
TI  - Hand washing, cleaning, disinfection and sterilization in health care.

PMID- 11195272
TI  - Proceedings of the Consensus Conference on Infected Health Care Worker Risk for
      transmission of bloodborne pathogens.
AB  - The Laboratory Centre for Disease Control (LCDC) of Health Canada held a
      consensus conference on "Infected Health Care Workers: Risk for Transmission of
      Bloodborne Pathogens", on November 20-21, 1996. A wide range of opinion was
      sought (see Appendix 1 for a list of participants). This document represents the
      consensus achieved at that meeting as agreed upon by the participants at the
      final "consensus achieving" session.

PMID- 11195273
TI  - Preventing infections associated with indwelling intravascular access devices.

PMID- 11195274
TI  - Preventing the spread of vancomycin-resistant enterococci (VRE) in Canada.

PMID- 11195275
TI  - Foot care by health care providers.
AB  - These recommendations have been provided to assist health care providers in
      performing foot care with the intention of decreasing the transmission of
      pathogens and resulting infections. It is important that providers of foot care
      implement these recommendations into their daily practice so that infections
      associated with foot care can be prevented.

PMID- 11195276
TI  - Controlling antimicrobial resistance. An integrated action plan for Canadians.

PMID- 11195277
TI  - Deficiency of gustatory sensitivity to some deterrent compounds in "polyphagous"
      mutant strains of the silkworm, Bombyx mori.
AB  - Sawa-J, CSJ02 and N601 x C601 are selected mutant strains of Bombyx mori, which
      grow on various artificial diets or temporarily ingest various plant leaves. To
      examine the mechanisms mediating diet breadth of caterpillars, gustatory spike
      responses of the silkworms, called 'polyphagous" strains, were compared with
      normal strains, N137 x C146 and C02. There were notable differences in their
      feeding habits and in their sensitivity to salicin in deterrent cells in the
      maxillary medial styloconic sensilla and the epipharyngeal sensilla. By contrast,
      the deterrent cells of all strains responded similarly to strychnine nitrate in a
      dose-dependent manner. In additional comparisons of Sawa-J and N137 x C146, Sawa
      J maxillary deterrent cells were significantly less sensitive to phloridzin,
      amygdalin and arbutin, but responded to some alkaloids and 20-hydroxyecdysone
      with similar or even higher firing rate. These results suggest that the
      deficiency of the sensitivity to some deterrent compounds on the deterrent cell
      of the polyphagous strains may be caused by mutant genes and affects the diet
      breadth of caterpillars.

PMID- 11195278
TI  - Actions of neomycin on electrical light responses, Ca2+ release, and
      intracellular Ca2+ changes in photoreceptors of the honeybee drone.
AB  - Neomycin, known to inhibit phospholipase C-mediated IP3 formation, was applied in
      the bath or injected into cells and its effects on electrical light responses
      were analyzed. Neomycin effects on inositol 1,4,5-trisphosphate- and Ca2+-induced
      Ca2+ release from the endoplasmic reticulum and/or the light-induced Ca2+
      elevation were also studied. Neomycin (0.5 mmol x l(-1)) blocked inositol 1,4,5
      trisphosphate-, caffeine-, and Ca2+-induced Ca2+ release. Bath application of
      neomycin decreased the sensitivity to 20-ms light flashes by a factor of up to
      100 and slowed the kinetics of dim flash responses. Intracellularly injected
      neomycin desensitized the photoreceptors more than 1 log unit, increased the
      latency, and slowed the rate of rise of the light response. Neomycin (0.5 mmol x
      l(-1)) in the bath delayed and reduced the transient component of responses to 1
      s steps of light at intermediate intensities. It also decreased and slowed the
      light-induced, and it blocked the caffeine-induced intracellular Ca2+ elevation.
      The combined pharmacological effects of neomycin are suggested to decrease the
      Ca2+-mediated amplification of the phototransduction cascade and the Ca2+
      mediated acceleration of processes determining the kinetics of light responses.

PMID- 11195279
TI  - Combined kinematic and electromyographic analyses of proleg function during
      crawling by the caterpillar Manduca sexta.
AB  - The planta retractor muscles in the prolegs of Manduca sexta caterpillars are a
      frequently-used model system for investigating a number of problems in
      neurobiology. We have combined kinematic and electromyogram analysis of proleg
      movements during crawling to examine the roles of these muscles during normal
      behavior. We found that retractor muscle activity is highly stereotyped, and that
      the primary function of these muscles is to disengage the crochets at the tip of
      the proleg for the swing phase of crawling. The duration of activity of the
      muscles was tightly coupled to the phasing of crawling behavior. The stepping
      patterns of animals changed to accommodate variations in the substrate, but the
      relative timing of retractor muscle activity was unaffected. There were no clear
      correlations between the various properties of motoneuronal input to the muscle
      (duration of activity, number of spikes, peak frequency of spikes) and the
      resulting muscle length change. Perhaps because it functions partially as a
      hydrostat, this may represent a neuromuscular system in which a significant part
      of the control algorithm is embedded in its morphology.

PMID- 11195280
TI  - Context dependency of a limb withdrawal reflex in the caterpillar Manduca sexta.
AB  - The proleg withdrawal reflex in the caterpillar Manduca sexta is a robust, well
      characterized system for investigating the integration of sensory information
      with centrally patterned behavior. The reflex is evoked by stimulating
      mechanosensory hairs--planta hairs--located at the tip of each proleg. We studied
      the expression of this reflex by combining video recordings and electromyographic
      recordings from the main retractor muscles of the proleg, the principal and
      accessory planta retractor muscles. In intact animals, the nature of the response
      depended on the motor context of the animal. Animals which were standing quietly
      showed great variability in both the kinematic properties of proleg withdrawal,
      and the corresponding muscle electrical activity. Animals which were hanging
      upside down from a wooden dowel exhibited a much faster reflex, with retraction
      of the proleg occurring slightly faster than in standing animals, but re
      extension of the proleg to the substrate being considerably faster. In crawling
      animals, expression of the reflex depended on the phase of the crawling cycle
      during which stimulation occurred. The reflex in a given proleg was suppressed
      during stance phase of that proleg. During swing phase, however, planta hair
      stimulation evoked proleg withdrawal, resulting in an assistance reflex. In
      contrast. isolated abdomens showed much less variability in the reflex. A
      comparison of the relationship between retractor muscle activity and the
      resulting proleg movement showed significant correlations between both the
      duration of activity and the number of muscle spikes, and the size of the
      associated proleg withdrawal. This is a promising system in which to investigate
      how central neuronal circuits accomplish context-dependency of motor behavior.

PMID- 11195281
TI  - Calcium responses to pheromones and plant odours in the antennal lobe of the male
      and female moth Heliothis virescens.
AB  - In male moths, the primary olfactory integration centre, the antennal lobe,
      consists of two systems. The macroglomerular complex processes pheromone
      information, while the ordinary glomeruli process plant odour information.
      Females lack a macroglomerular complex. We measured the spatial representation of
      odours using in-vivo optical recording. We found that: (1) pheromone substances
      elicited activity exclusively in the MGC. No response was found in female
      antennal lobes. (2) Plant odours elicited combinatorial activity patterns in the
      ordinary glomeruli in both males and females. No response was found in the MGC of
      male moths. (3) A clean air puff often led to activity, in both males and
      females, suggesting that mechano-sensory information is also processed in the
      antennal lobe. (4) With an interstimulus interval of 5 or 10 s, strongly
      activated glomeruli were able to follow the temporal structure of the stimulus,
      while others lost their phase-locking. Some glomeruli showed "off" responses.
      These properties were odour dependent. This confirms and extends previous
      studies, showing the functional significance of the two subsystems for processing
      olfactory information. Pheromones are coded in a combinatorial manner within the
      macroglomerular complex, with each glomerulus corresponding to one information
      channel. Plant odours are coded in an across-glomeruli code in the ordinary
      glomeruli.

PMID- 11195282
TI  - Effects of signal duration on the recognition of masked communication signals by
      the grasshopper Chorthippus biguttulus.
AB  - The detection and recognition of acoustic communication signals masked by noise
      was investigated in a grasshopper (Chorthippus biguttulus) whose auditory system
      exhibits only poor spectral resolution and therefore has to operate in the time
      domain. The signals of this species consist of numerous identical subunits that
      enable the receiver, in principle, to make repetitive measurements. We aimed at
      determining the maximum integration time in this species by using stimuli of
      different durations under increasing noise levels. As a criterion for recognition
      the typical phonotactic turning response of the males was evaluated, which is
      reliably triggered by a female song, and thus is a sensitive indicator for
      recognition of conspecific signals. When confronted with a long signal (1000 ms)
      males tolerated a 2.4 dB higher noise level as compared to a short signal (250
      ms). Noise tolerance improved with increasing signal duration from 250 ms to 450
      ms. Beyond this signal duration, however, no further improvement was observed,
      indicating an upper limit for temporal integration that corresponds to only five
      song subunits. The gain in noise tolerance had a slope of 2.7 dB per doubling
      duration, which corresponds to the expectation derived from an energy detector
      model (3 dB per doubling duration) rather than to the value expected from signal
      detection theory (1.5 dB per doubling duration).

PMID- 11195283
TI  - Wavelength-dependent polarization orientation in Daphnia.
AB  - The ability to detect and use the polarization of light for orientation is
      widespread among invertebrates. Among terrestrial insects, the retinula cells
      that are responsible for polarization detection contain a single visual pigment,
      either ultraviolet or short (blue) wavelength sensitive. With the exception of a
      few aquatic insects, the visual pigments underlying polarization sensitivity in
      aquatic invertebrates have yet to be determined. Here we report that polarotaxis
      in Daphnia pulex, a freshwater crustacean, is wavelength dependent and most
      likely mediated by two visual pigments with absorbance maxima in the middle
      (green) and long wavelength (red) parts of the spectrum. This contrasts with the
      response of a closely related species, D. magna, in which polarotaxis is
      wavelength independent and based on a single middle wavelength visual pigment.
      The visual systems in Daphnia are the first among crustaceans shown to utilize a
      middle wavelength pigment for polarization detection and, in the case of D.
      pulex, the first shown to use more than one visual pigment for such a purpose.

PMID- 11195284
TI  - The critical period for caste determination in Bombus terrestris and its juvenile
      hormone correlates.
AB  - The critical period for caste determination and its juvenile hormone (JH III)
      correlates were studied in Bombus terrestris. Larvae of known age and instar were
      taken from young colonies, in which they would have been reared as workers, and
      placed into groups of queenless workers. Under these conditions the critical age
      for caste determination was 5 days, during the second instar. Endocrine
      correlates of caste determination were obtained by determining profiles of
      juvenile hormone titer and juvenile hormone biosynthesis, measured by chiral
      specific radioimmunoassay and the in vitro radiochemical assay, respectively. By
      the middle of the second instar prospective queen larvae had significantly higher
      rates of juvenile hormone biosynthesis and juvenile hormone titer than
      prospective worker larvae. Based on the coincidence of timing of both the
      critical period and the appearance of caste-specific juvenile hormone titer, we
      suggest that juvenile hormone plays a role in the mechanisms that control caste
      determination in B. terrestris.

PMID- 11195285
TI  - Stereocilium injury mediates hair bundle stiffness loss and recovery following
      intense water-jet stimulation.
AB  - Inner ear hair cells exhibit many pathologies following exposure to intense
      sound, and the hair bundle is a major site of damage. This paper measures in
      vitro hair bundle motion on chick cochlear hair cells after intense in vitro and
      in vivo stimulation to explore the nature of hair bundle injury. Hair bundle
      stiffness, as well as relative and asymmetric motion of individual stereocilia,
      is controlled largely by the extracellular tip links, and a change in hair bundle
      motion was used to assess tip-link destruction following overstimulation. Intense
      in vitro stimulation caused a loss in stiffness that fully recovered within 10
      min post-exposure. Relative and asymmetric stereocilia motion, however, were
      unchanged following the exposure, implying that tip links remained intact while
      the core or rootlet of the stereocilia were damaged and subsequently repaired.
      Intense and prolonged in vivo sound exposures produced stereocilia movements,
      measured in vitro, that were indicative of damage to stereocilia and tip links.
      Finally, the relative susceptibility of hair bundles to overstimulation was
      addressed by comparing stiffness loss with morphological features in the hair
      bundles. The loss of stiffness significantly increased as the amount of curvature
      in the hair bundle contour increased.

PMID- 11195286
TI  - Recent advances in the adjuvant therapy of breast cancer.

PMID- 11195287
TI  - [Sentinel lymphnode: surgical standard in breast cancer].
AB  - Evaluation of the sentinel lymph node (SLN) is capable of avoiding dissection in
      a high percentage of node negative patients (> 90). It is essential that
      "useless" treatment not be performed as the negative collateral effects are not
      justifiable and furthermore present financial laws do not reimburse dissections
      carried out in the absence of node disease. The intraoperative evaluation of the
      SL is an extremely expensive procedure, due both to the personnel required and to
      the time necessary for the patient to remain in the operating room awaiting
      histology results. In fact, it is far easier to retrieve the SLN in day hospital
      and to examine the specimen on fixed material and not frozen. Twenty three cases
      of deferred SLN were evaluated, the results of which were highly reliable because
      of these, only 3 dissections were performed after an average of 4 days from
      biopsy. As SL evaluation does not increase the "curability" of the disease but
      only reduces any eventual complications, we believe it should be restricted to
      extremely selected and specialistic institutions due to the great economical and
      organizational cost involved.

PMID- 11195288
TI  - Adjuvant therapy for patients with node negative breast cancer.

PMID- 11195289
TI  - [Metastatic breast cancer: what are the objectives?].
AB  - The medical approach to the treatment of metastatic breast cancer has changed in
      the last decade since the introduction of new drugs that demonstrate high
      activity and better tolerability profiles. The hormonal treatment, usually
      considered the first choice therapy for ER-positive metastatic breast cancer
      patients, has seen several improvements with the discovery of new selective
      aromatase-inhibitor agents and pure antiestrogens. New aromatase-inhibitors have
      shown higher activity and fewer side effects compared to megestrol acetate in
      second line treatment. The first line treatment has unchanged so far, but in the
      next future is possible that different agents, with lower toxicity, will replace
      tamoxifen since studies comparing this agent with pure antiestrogens or selective
      aromatase-inhibitors are ongoing. These new drugs would provide a better
      palliation of metastatic breast cancer in terms of higher clinical benefit,
      tolerability and quality of life. Chemotherapy is often used in ER-negative
      patients or in aggressive hormone refractory disease. Randomized trials have
      demonstrated that anthracyclin-containing regimens were more effective than
      combinations without anthracyclines. New cytotoxic drugs with high activity, such
      as taxanes (paclitaxel and docetaxel), vinorelbine, gemcitabine and capecitabine,
      have been introduced. Compared with older therapies, improved objective response
      rates and/or improved duration of response have been reported with these newer
      agents alone or in combination with other drugs. However, no clear improvement of
      overall survival has been shown so far. Taxanos alone or in combination are today
      considered the second line treatment of choice and studies are assessing the
      value of a taxane-anthracycline containing regimen in first line treatment. Some
      new agents (vinorelbine) showed, alone or in combination, an interesting cost
      effectiveness ratio with similar or higher "quality adjusted progression free
      survival" if compared to taxanes. Promising are also the results of agents that
      own low toxicity with comparable efficacy such as liposomal anthracycline.
      Attempts to improve overall survival with increased dose intensity or with high
      dose chemotherapy are disappointing. CONCLUSIONS: Since the goal of treatment of
      metastatic breast cancer is disease control rather than disease skill i.e.
      palliation of patients with complications of progressive cancer, the new agents
      have brought significant improvements (higher response rates, median time to
      progression, cost benefit and better tolerability). Future progresses for this
      disease, hopefully even in overall survival, will depend on the introduction of
      new therapies such as immunotherapy, inhibition of intracellular signaling,
      interference with tumor angiogenesis, gene-therapy and the development of
      vaccines.

PMID- 11195290
TI  - New perspectives in the treatment of non-small cell lung cancer. Introduction.

PMID- 11195291
TI  - Postoperative chemotherapy in non-small cell lung cancer.

PMID- 11195292
TI  - Treatment perspectives in advanced non-small cell lung cancer.

PMID- 11195293
TI  - Do we have good surrogate endpoints for survival in breast cancer studies?

PMID- 11195294
TI  - The evolution of surgery in non-small cell lung cancer.

PMID- 11195295
TI  - New drugs in non-small cell lung cancer.

PMID- 11195296
TI  - Neoadjuvant chemotherapy in non-small cell lung cancer: a standard approach?

PMID- 11195297
TI  - [Adjuvant therapy in gastric cancer].
AB  - In Western countries gastric cancer represents the third cause of death even if
      in the last twenty years the epidemiology of disease has changed. Surgery remains
      the treatment of choice and overall survival is still 7-15%. Survival data after
      curative resection are higher in Japan than in Western countries due to a
      substantial different surgical approach and "early" diagnosis. In both countries
      adjuvant treatment has been developed to increase the survival rate and different
      schedules and polipharmacological schemes have been tested. In Japanese trials a
      statistical significance in survival was observed with chemoimmunotherapy using
      chemotherapy as control arm. In Western countries data are not conclusive: most
      trial used surgery as control arm and sample size was not sufficient to show a
      significant difference between the two arms. The meta-analysis performed up to
      now have shown a trend of advantage in survival with adjuvant chemotherapy and
      many objections can be raised concerning the methodology of the same. In fact
      there are different types of meta-analyses according to whether they are based on
      the literature (MAL) or individual patient data (MAP or IPD meta-analysis). With
      an IPD meta-analysis a search is not only done in the literature for all relevant
      published trials, but also in the scientific community unpublished trials. For
      all trials, whether published or not, individual patient data on the endpoint of
      interest are obtained from the investigators. No meta-analysis performed up to
      now has adopted this methodology. Recently, combined therapy (CT/RT) has shown
      interesting results with an increase in DFS and OS. At the moment trials results
      are not sufficient to consider adjuvant chemotherapy the standard treatment:
      other large trials are required and a combined approach such as RT, IP
      chemotherapy, neoadjuvant plus adjuvant chemotherapy may be a future research
      possibility.

PMID- 11195298
TI  - [Combination of 5-Fluorouracil and folinic acid--is it still the standard therapy
      for advanced colorectal carcinoma?].
AB  - After a long period in which the only therapeutic approach for the management of
      colorectal cancer was the optimization of fluoropyrimidine-based chemotherapy,
      the last few years have seen the emergence of newly active chemotherapeutic
      agents endowed with novel mechanisms of action, such as oxaliplatin (OHP),
      irinotecan (CPT11), raltitrexed and oral 5-fluorouracil (5-FU) pro-drugs which
      can offer new therapeutic possibilities. The availability of these different
      classes of cytotoxic agents has introduced the possibility of combination
      chemotherapy. The most widely studied combinations are 5-FU/folinic acid
      (FA)/CPT11 and 5-FU/FA/OHP, both of which have been tested in two randomized
      studies. These trials consistently demonstrated that the addition of CPT11 or OHP
      to widely accepted infusional/bolus 5-FU/FA regimens is superior to the same 5
      FU/FA schedule alone in term of response rate (rate of about > 50%) and time to
      progression. It's worth nothing that both trials with the combination of 5
      FU/FA/CPT11 showed a significant survival benefit. Toxicity profiles were more
      pronounced with the combination therapies but the quality of life evaluation
      showed that the combinations had no negative impact on the evolution of the
      global health status over time. A current ongoing randomized study compares 5
      FU/FA/CPT11 with 5-FU/FA/OHP in order to identify the best first-line
      chemotherapy. Preliminary results in terms of objective response and toxicity are
      similar for both treatments. Raltitrexed is a thymidilate synthase inhibitor with
      activity comparable to 5-FU and a convenient administration schedule. In our
      institution, we performed a phase II single center trial to assess the efficacy
      of the combination of raltitrexed and CPT11. The principal aim of the study was
      the overall response rate. We observed a very promising 51% overall response
      rate. Most relevant side effects were diarrhea in about 20% of patients, asthenia
      and vomiting. Two recent studies have assessed the efficacy and tolerability of
      raltitrexed-OHP combination therapy. The results showed that the combination is
      active (ORR: 46-62%) and tolerable. Promising results have also been obtained in
      phase I studies with the OHP/CPT11 combination. All these data need to be
      confirmed in phase II-III clinical trials. In conclusion, combination therapy
      with CPT11 plus 5-FU/FA produces a 2-3 month survival advantage over 5-FU/FA
      alone and represents the new reference in the first-line chemotherapy of
      colorectal cancer. The association of 5-FU/FA and OHP improves response rates and
      progression-free survival. The increase in toxicity of these combinations is
      predictable and reversible and does not compromise quality of life. These
      important data suggest that there is now a limited role for single-agent first
      line chemotherapy of metastatic colorectal cancer.

PMID- 11195299
TI  - The new European gold standard treatment for rectum cancer.

PMID- 11195300
TI  - New perspectives in the treatment of gastrointestinal tumors. Introduction.

PMID- 11195301
TI  - Cancer vaccines.

PMID- 11195302
TI  - Allogeneic stem cell transplantation and non-myeloablative conditioning regimens.

PMID- 11195303
TI  - [Effectiveness of precautionary chemotherapy in gastric cancer].
AB  - Gastric cancer is a very aggressive disease. Surgery is the treatment of choice,
      with less than 30% 5-year survival for patients with complete resection. Although
      the incidence of gastric cancer in Western countries has declined progressively
      in recent decades, the prognosis of the disease has not changed in the last 30
      years, with 5-year global survival rates between 7 and 15%. The achievement of an
      increase in the rate of cure would be therefore an important goal, but the
      efficacy of adjuvant chemotherapy in this disease is still controversial. The aim
      of this overview is to document that postoperative chemotherapy may be effective
      in patients operated with curative intent for gastric cancer. We reviewed the
      results of randomized trials comparing adjuvant chemotherapy versus surgery
      alone, divided into those performed in the West and those performed in Asia, and
      according to publication period. We also reported the preliminary results of an
      intergroup randomized study of postoperative chemoradiation versus follow-up.
      Then, we summarized and discussed the results of the 3 meta-analyses, published
      respectively in 1993, 1999, and 2000, that evaluated the combined results from
      the over mentioned trials. Singular studies reported conflicting results and
      failed to show a clear indication for chemotherapy, but they were open to
      criticisms, due to methodological and therapeutical limitations. The meta
      analysis published by Hermans showed a non-significant trend in favor of adjuvant
      treatment. This analysis was later criticized, and, in response, the author
      published an update in 1994 in which he recalculated a significant odds ratio.
      Meta-analyses by Earle and Mari indicated that postoperative chemotherapy
      produces a small survival benefit in patients with curatively resected gastric
      carcinoma. Subgroup analyses produced some interesting findings. There was a
      partial evidence of better results with chemotherapy regimens containing
      anthracyclines, but it is possible that the results of the ongoing trials testing
      regimens including cisplatin will add more reliable information about the new
      regimens. Studies with longer follow-up maintained a trend towards benefit from
      adjuvant therapy, indicating that long-term survival may be afforded by
      treatment, as opposed to simply delaying relapse. Finally, there was a trend
      towards a larger magnitude of the effect when analyses were restricted to trials
      which included higher risk patients. In conclusion, the results of the 3 meta
      analyses suggest that adjuvant chemotherapy may be effective. However, other
      studies to confirm an effective treatment and to find new therapeutic combination
      or strategies in the field of adjuvant therapy for gastric carcinoma are
      warranted.

PMID- 11195304
TI  - The role of attention shifts in the categorization of continuous dimensioned
      stimuli.
AB  - Results of human category learning experiments, using stimulus dimensions with
      binary values, have implicated a rapidly acting mechanism of attention shifts.
      Theories of categorization desire that stimuli with binary, discrete and
      continuous valued dimensions should all be treated similarly. Theoretical
      analyses of attention shifting, however, have up to now only been developed for
      shifts between features, or shifts between entire dimensions, not shifts within
      dimensions. Here we present a model of how people learn to discriminate
      categories made up of stimuli with continuous-valued dimensions. The model uses
      rapid shifts in attention within stimulus dimensions to reduce errors during
      learning; the model generalizes J. K. Kruschke's (Psychological Review, 99, 22
      44, 1992) ADIT model. In an experiment in category learning, subjects were
      trained to discriminate four bivariate normal distributions that are presented
      with differential base rates. The base-rate manipulation produces several
      qualitative effects, for which the model accounts very well. With attention
      shifting turned off, the model fails to account for some aspects of the data,
      suggesting that attentions shifts are an important mechanism in the model.

PMID- 11195305
TI  - A shift of attention may be necessary, but it is not sufficient, for the
      generation of the Simon effect.
AB  - The Simon effect is the performance advantage for spatially corresponding,
      compared to non-corresponding, target-response ensembles when the location of the
      target is task irrelevant. In four experiments, we tested the predictions of the
      attention-shift account of the Simon effect. In all experiments, subject made
      choice responses with respect to the identity of a central target that followed a
      spatially non-informative peripheral precue. The first experiment showed a Simon
      effect away from the precue when the precue was a go/no-go signal: responses to
      spatially non-corresponding precue-response pairs were faster than responses to
      spatially corresponding precue-response pairs. The results of the second
      experiment suggested that this "reverse" Simon effect was not due to inhibition.
      In the third experiment, a secondary working memory task required the encoding,
      and later recall, of "oddball" precues. Although the Simon effect was absent,
      larger Simon effects towards the precue (i.e., responses were faster to spatially
      corresponding, compared to non-corresponding, precue-response ensembles) were
      correlated with poorer performance on the memory task. In the last experiment,
      the identity of completely non-informative precues was congruent, incongruent, or
      unrelated to the identity of the target. With precues that were unrelated to the
      identity of the target, there was a Simon effect towards the precues. Conversely,
      the Simon effect occurred away from the precue when the identity of the precue
      was related to that of the target. The findings suggest that a shift of attention
      alone is not sufficient to produce the Simon effect. Rather, the shift of
      attention must originate from an intentionally defined object. The results are
      discussed within a framework that integrates the attention-shift and referential
      coding hypotheses.

PMID- 11195306
TI  - Phase congruency: a low-level image invariant.
AB  - Phase congruency is a low-level invariant property of image features. Interest in
      low-level image invariants has been limited. This is surprising, considering the
      fundamental importance of being able to obtain reliable results from low-level
      image operations in order to successfully perform any higher level operations.
      However, an impediment to the use of phase congruency to detect features has been
      its sensitivity to noise. This paper extends the theory behind the calculation of
      phase congruency in a number of ways. An effective method of noise compensation
      is presented that only assumes that the noise power spectrum is approximately
      constant. Problems with the localization of features are addressed by introducing
      a new, more sensitive measure of phase congruency. The existing theory that has
      been developed for 1D signals is extended to allow the calculation of phase
      congruency in 2D images. Finally, it is argued that high-pass filtering should be
      used to obtain image information at different scales. With this approach, the
      choice of scale only affects the relative significance of features without
      degrading their localization.

PMID- 11195308
TI  - Subitizing and its subprocesses.
AB  - When people are presented with small sets of elements such as dots they can very
      easily determine their number. This ability has been called subitizing. The
      present paper reports results from four experiments. The discussion focuses on
      the question whether one or two psychological processes have to be assumed for
      this task of subitizing. Taken together our results support the two-process
      theories. In particular, a distinction between a process of separation and a
      process of enumeration is suggested. Experiments 3 and 4 support the canonical
      pattern hypothesis. Canonical patterns are processed substantially faster than
      noncanonical patterns. Furthermore, if a complex pattern can be broken down into
      small canonical patterns, then participants follow a partition and add strategy.

PMID- 11195307
TI  - The missing fundamental phenomenon in temporal vision.
AB  - Subjective flicker rates were measured for compound waveforms consisting of five
      harmonics without a fundamental component. It was found that observers perceived
      a rate at the fundamental frequency, although energy at this frequency was not
      included in the signals. In auditory pitch sensation this is called the missing
      fundamental phenomenon, and an analogous finding is known to occur in spatial
      vision. Moreover, observers perceived the flicker rates at the fundamental
      frequency even in the random-phase conditions, in which the period of the
      fundamental component is unclear in the real waveforms. The results indicate that
      the perceived flicker rates are not detected from the temporal waveforms per se.
      One possible mechanism for extracting such a periodicity in the signal is an auto
      correlation function to the real temporal waveforms.

PMID- 11195309
TI  - Perceptual inertia: spatial attention and warning foreperiod?
AB  - Perceptual inertia refers to a potential explanation for the observation that
      during a short period after stimulus onset, the visual system is insensitive to
      discriminatory detail. The present study attempted to replicate this empirical
      result in a simple one-item letter-identification task. The results provided
      little if any support for the construct of perceptual inertia. In the five
      experiments reported, evidence consistent with perceptual inertia was only
      obtained in Experiment 5. However, the Experiment 5 results can at least equally
      parsimoniously be explained in terms of two standard explanatory factors: an
      effect of precuing of the target position (selective attention) and foreperiod
      duration (general preparation).

PMID- 11195310
TI  - Selective cyclooxygenase-2 inhibitors: hope and facts.

PMID- 11195311
TI  - Usefulness of criteria for spondyloarthropathies.

PMID- 11195312
TI  - Contribution of arthroscopy and magnetic resonance imaging to the evaluation of
      painful knee osteoarthritis.
AB  - In knee osteoarthritis, arthroscopy provides valuable information that suggests
      an original approach to the disease. In combination with recent imaging study
      data, this information can be used to develop a novel concept of the evaluation
      of knee osteoarthritis. The main mechanisms responsible for flares of the disease
      seem to be synovitis, degenerative meniscal disease, and subchondral bone
      lesions. Treatments targeted at each of these mechanisms can be used as
      appropriate. Determination of the exact nature of the lesions can be difficult
      and relies at present on sophisticated investigations not readily available in
      everyday practice. Further work is needed to determine how a finer analysis of
      symptoms and signs in combination with simple investigations can differentiate
      between the various pathological patterns of knee osteoarthritis.

PMID- 11195313
TI  - Hypercalciuria.
AB  - Hypercalciuria is a biological syndrome defined as excretion in the urine of more
      than 0.1 mmol/kg/24 hours of calcium in the absence of dietary manipulation. A
      number of endocrine, renal, and bone diseases can cause hypercalciuria. Urinary
      calcium excretion is substantially influenced by dietary intakes of calcium,
      sodium, protein, carbohydrates, alcohol, and potassium: a poorly balanced diet
      can result in hypercalciuria. Recently, there has been a burst of interest in the
      molecular underpinnings of rare nephrolithiasis syndromes, which have been shown
      to result from mutations in the CLCN5 chloride channel gene. Mutations affecting
      the calcium-sensing receptor (CaSR) have been identified in other forms of
      hypercalciuria. Idiopathic hypercalciuria is defined as hypercalciuria that
      persists after correction of dietary imbalances and has no detectable cause. The
      classification suggested by Pak ("absorptive" hypercalciuria [with three types]
      and "renal" hypercalciuria) is controversial and of little assistance in clinical
      practice. Three mechanisms can be incriminated in idiopathic hypercalciuria:
      increased intestinal absorption of calcium, defective reabsorption of calcium by
      the renal tubule, and increased bone resorption. Overexpression of the vitamin D
      receptor (VDR) and deficiencies in renal tubule enzymes may also be involved.
      Bone mineral density is moderately decreased in idiopathic hypercalciuria,
      particularly in the renal type. The risk of vertebral fracture seems increased,
      however. Overproduction of calcitriol and cytokines that stimulate bone
      resorption have been incriminated in the bone loss. Treatment of the cause is
      essential in secondary hypercalciuria (dietary advice, treatment of an underlying
      disease, etc.). A diet low in sodium and meat and containing no more than 800 mg
      of calcium per day is advocated in idiopathic hypercalciuria. Hydrochlorothiazide
      therapy is warranted in patients with osteopenia and an inadequate response to
      dietary therapy.

PMID- 11195314
TI  - Can some cases of 'possible' spondyloarthropathy be classified as 'definite' or
      'undifferentiated' spondyloarthropathy? Value of criteria for
      spondyloarthropathies. Spanish Spondyloarthropathy Study Group.
AB  - OBJECTIVES: When evaluating patients for spondyloarthropathy, clinicians use the
      'possible spondyloarthropathy' category to indicate that they are unsure about
      the diagnosis. We sought to determine whether Amor's criteria or the European
      Spondyloarthropathy Study Group (ESSG) criteria could lift thi uncertainty.
      PATIENTS AND METHODS: During a Spanish study designed to validate criteria for
      spondyloar thropathies, 102 patients were classified in the 'possible
      spondyloarthropathy' category. We divided these patients into subgroups based on
      whether or not they met criteria for spondyloarthropathy. We compare baseline
      characteristics (N = 102) and five-year outcomes (N = 52) in these subgroups.
      RESULTS: The following features were significantly more common in the subgroups
      of patients who met Amor's criteria for spondyloarthropathy: oligoarthritis, heel
      pain, uveitis, balanitis, family history of spondyloarthropathy, an presence of
      the HLA B27 antigen. No differences were found for age at symptom onset, disease
      duration, buttock pain, gender, dactylitis, diarrhea, or psoriasis. Of the 52
      patients followed up for five years, 17 me Amor's criteria at baseline and 13
      were subsequently found to have definite spondyloarthropathy, whic was
      undifferentiated in six cases. There were only three cases of spondyloarthropathy
      among the 2 patients who did not meet Amor's criteria at baseline. Of the 28
      patients who met ESSG criteria at baseline, 13 had spondyloarthropathy versus
      three of the 17 patients who did not meet ESSG criteria at baseline CONCLUSION:
      Amor's criteria or the ESSG criteria allow early classification of most patients
      with 'possible spondyloarthropathy' and early identification of undifferentiated
      spondyloarthropathy corresponding to minimal-symptom or incipient disease. In
      this study, Amor's criteria performed better than the ESSG criteria.

PMID- 11195315
TI  - Altered bone mineral metabolism in patients with osteoarthritis.
AB  - OBJECTIVE: Investigation of the relationship between osteoarthritis (OA) and
      mineral density, and determination of any alteration in bone mineral, metabolism
      as assessed by biochemical markers of bone resorption and formation. METHODS:
      Forty females and 20 males were included in the study. Spinal OA as well as knee
      OA were defined from radiographs and graded according to Lane et al.'s and
      Spector et al.'s scoring systems. Bone mineral density (BMD) of the lumbar spine
      was measured by osteo CT. Bone turnover rates were estimated by measuring
      biochemical markers of bone resorption (urinary deoxypyridinoline) and bone
      formation (bone-specific alkaline phosphatase). Forty females and 20 males of the
      same age were studied as a control group. RESULTS: BMD was greater in women with
      spinal OA as compared to controls (P < 0.05). Also, males with OA had a non
      significantly higher BMD than controls. The bone resorption markers were higher
      than normal values. However, they were lower than the control group. Similarly,
      the bone formation markers were lower as compared to the control group.
      CONCLUSION: Spinal OA is associated with higher BMD. This protective effect of
      spinal OA against osteoporosis may be mediated through decreased rate of bone
      turnover.

PMID- 11195316
TI  - Acquired lumbar kyphosis caused in adults by primary paraspinal myopathy.
      Epidemiology, computed tomography findings, and outcomes in a cohort of 23
      patients.
AB  - Acquired lumbar kyphosis in adults, also called bent spine syndrome (BSS), is
      probably due to primary tardive myopathy affecting the paraspinal muscles.
      OBJECTIVES: To define family history and other factors associated with BSS, to
      score functional disability and pain in BSS using visual analog scales (VASs), to
      determine the pace of disease progression during follow-up, and to define
      computed tomography (CT) findings comparatively with age- and sex-matched
      controls. PATIENTS AND METHODS: Twenty-three patients (20 women and three men;
      mean age, 72.8 years) with a mean disease duration of 8.1 years at presentation
      and a mean follow-up of 3.5 years underwent a medical interview, a physical
      examination, and yearly CT scans with muscle density measurement at several
      vertebral levels (T4, T10, L1, L3, and L5). RESULTS: Mean age at BSS onset was
      64.6 years (range, 56-72). In 12 of the 23 cases, a family history of BSS was
      highly likely. Thirteen patients had performed heavy manual labor at some time
      during their lives. At completion of follow-up, the mean functional VAS score was
      74.5 mm, the mean Eifel score was 16/24, and the mean pain VAS score was 72.4 mm.
      Mean muscle density obtained by pooling measurements at all vertebral levels was 
      12.6 +/- 31 Hounsfield units (HU) in the patients and +36.9 +/- 21 HU in the
      controls. During the 3.5-year follow-up, the mean loss in muscle density was 6.9
      +/- 16 HU in the patients; in contrast, no muscle density difference was found
      between two groups of low back pain patients without BSS aged 65 years and 72
      years, respectively (36.2 +/- 15 HU vs 38.6 +/- 26 HU). CONCLUSION: BSS causes
      major functional disability and pain, which worsen over time. The decrease in
      paraspinal muscle density extends along the entire spine and becomes increasingly
      marked over time.

PMID- 11195317
TI  - Low back pain in hospital outpatients in Lome (Togo).
AB  - OBJECTIVE: To determine the patterns of low back pain and the conditions
      associated with this symptom in outpatients attending the rheumatology unit of
      the Lome Teaching Hospital. METHODS: Medical records of patients seen over a ten
      year period were studied retrospectively. RESULTS: Among the 9,065 patients seen
      during the study period, 3,204 (35.34%; 1,850 women and 1,354 men) had low back
      pain. Mean age at onset was 41 years, and mean duration of low back pain was
      three years. Diseases associated with low back pain were as follows: degenerative
      spinal disease, N = 3,054 (95.32%); spinal infections, N = 79 (2.47%);
      spondyloarthropathies, N = 44 (1.37%); and tumors, N = 27 (0.84%). The patterns
      of degenerative spinal disease included low back pain (N = 1,535, 47.91%), low
      back pain with nerve root pain suggestive of disk herniation (N = 1,108, 34.58%),
      and low back pain with nerve root pain and claudication suggestive of lumbar
      spinal stenosis (N = 411, 12.83%). Schober's index was abnormal in 831 of the
      1,408 patients (59%) with acute pain or disk herniation. Most patients with
      lumbar spinal stenosis were women (72.26%) and were aged 35 to 64 years. Findings
      suggestive of tuberculosis were present in 62 of the 79 patients with lumbar
      spinal infection. Among the 44 patients with spondyloarthropathies, 15 had
      ankylosing spondylitis and 11 had infection with the human immunodeficiency virus
      (HIV). Multiple myeloma was present in ten patients and metastatic tumors in
      eight. CONCLUSION: Low back pain seems to be as common in sub-Saharan Africa as
      in occidental countries, with a prevalence of one-third among rheumatology
      outpatients. Lumbar spinal stenosis seems more common than in the occident and is
      mainly observed in woman. Schober's index is not useful for measuring forward
      bending of the lumbar spine in Africans. The epidemiology of
      spondyloarthropathies in sub-Saharan Africa has been changed by the expanding HIV
      epidemic, despite the low prevalence of the HLA B27 phenotype.

PMID- 11195318
TI  - Weismann-Netter-Stuhl syndrome: first Brazilian case reports.
AB  - Weismann-Netter-Stuhl syndrome was first described in 1954 and is defined by an
      anterior curvature of the bones of the lower limbs, usually bilateral and
      symmetrical. Since its initial description, 82 cases were reported, including
      only 14 pediatric patients. The authors report two cases of this syndrome. One
      patient was an adult who presented with almost all the characteristic features of
      the disease. The second case was a 12-year-old girl who also presented with
      severe bone deformities of the upper limbs. Weismann-Netter-Stuhl syndrome is
      probably more common than previously reported and must be included in the
      differential diagnosis of rickets/osteomalacia, congenital syphilis and some
      cases of Paget's disease.

PMID- 11195319
TI  - Remitting asymmetrical pitting oedema in systemic lupus erythematosus: two cases
      studied with magnetic resonance imaging.
AB  - To our knowledge, only three cases of remitting symmetrical pitting oedema in
      systemic lupus erythematosus have been reported so far. This is the first report
      of two patients with asymmetrical pitting oedema and systemic lupus
      erythematosus. The first patient presented two consecutive episodes of unilateral
      oedema. The first episode involved the distal part of the right lower extremity
      and remitted spontaneously while the second involved the volar region of the left
      wrist and distal half of the forearm and promptly responded to steroids. Magnetic
      resonance imaging of the left wrist and forearm showed tenosynovitis of the
      flexor tendons and subcutaneous oedema. The second patient instead developed a
      single episode of pitting oedema of the distal part of the right lower extremity
      that resolved spontaneously. Magnetic resonance imaging of the right ankle and
      foot showed subcutaneous oedema without involvement of the tendon sheaths or
      osteoarticular and ligamental structures. These two cases suggest that pitting
      oedema in systemic lupus erythematosus may occasionally be asymmetric and
      associated or not with tenosynovitis.

PMID- 11195321
TI  - Uncommon arthritis as presenting manifestation of silent Crohn's disease.

PMID- 11195320
TI  - A possible association between Chlamydiae psittacci infection and temporal
      arteritis.
AB  - Some arguments are in favor of the role of Chlamydia in the pathogenesis of
      atherosclerosis and some vasculitis. Illustrating this possible relation, we
      report the case of a patient developing consecutively a Chlamydia psittacci
      infection and a temporal arteritis. A 73-year-old woman, with no significant
      medical history, was hospitalized for constitutional symptoms. Three weeks
      before, she had described fever and sore throat of two days' duration. Since that
      time, she had remained exhausted and developed a mild intermittent claudication
      of the jaws. Clinical examination was poor. A biological inflammatory syndrome
      was noticed. Chest X-ray revealed bilateral interstitial opacities. The titer of
      anti-C. psittaci antibodies was significant (positive 1g G at 1/2048). Soon after
      initiation of doxycycline, a temporal arteritis biopsy was performed, due to the
      persistence of clinical symptoms and high inflammatory syndrome, conclusive for
      the diagnosis of temporal arteritis. Corticotherapy was added to antibiotic
      therapy, resulting in the decrease of inflammatory syndrome and an improvement in
      the general status of the patient. X-ray opacities decreased in three weeks.
      Serological control after three months showed a decrease of the titer of anti-C.
      psittacci antibodies to 1/256, confirming the initial diagnosis of Chlamydia
      pneumopathy. Our observation could provide one more argument for the role of
      bacteria-like Chlamydia in the pathogenesis of vascular diseases. Prospective
      seroepidemiological and molecular biology studies could allow us to clarify the
      association between Chlamydia infections and inflammatory vasculitis-like
      temporal arteritis.

PMID- 11195322
TI  - Pathophysiology of osteoarthritis.

PMID- 11195323
TI  - The chondrocyte: from cell aging to osteoarthritis.

PMID- 11195324
TI  - Proinflammatory cytokines, prostaglandins, and the chondrocyte: mechanisms of
      intracellular activation.

PMID- 11195325
TI  - Interest of animal models in the preclinical screening of anti-osteoarthritic
      drugs.

PMID- 11195326
TI  - Gene therapy in osteoarthritis.

PMID- 11195327
TI  - Autologous chondrocyte implantation for cartilage defects: development and
      applicability to osteoarthritis.

PMID- 11195328
TI  - Reasonable osteoporosis prevention: hormone replacement therapy, SERM, or
      bisphosphonate?

PMID- 11195329
TI  - Rehabilitation therapy in chronic low back pain.

PMID- 11195330
TI  - Positron emission tomography: how useful is this new functional imaging tool in
      rheumatology?

PMID- 11195331
TI  - A genetic map of cucumber composed of RAPDs, RFLPs, AFLPs, and loci conditioning
      resistance to papaya ringspot and zucchini yellow mosaic viruses.
AB  - The watermelon strain of papaya ringspot virus (PRSV-W) and zucchini yellow
      mosaic virus (ZYMV) are potyviruses that cause significant disease losses in
      cucumber. Resistances have been identified primarily in exotic germplasm that
      require transfer to elite cultivated backgrounds. To select more efficiently for
      virus resistances, we identified molecular markers tightly linked to PRSV-W and
      ZYMV resistances in cucumber. We generated F6 recombinant inbred lines (RILs)
      from a cross between Cucumis sativus L. 'Straight 8' and a line from 'Taichung
      Mou Gua', TMG1 (susceptible and resistant, respectively, to both viruses), and
      studied the segregations of amplified fragment length polymorphism (AFLP)
      markers, randomly amplified polymorphic DNAs (RAPDs), restriction fragment length
      polymorphisms (RFLPs), and resistances to PRSV-W and ZYMV. A 353-point map of
      cucumber was generated, delineating 12 linkage groups at LOD 3.5. Linkage
      arrangements among RFLPs were consistent with previously published maps; however
      linkages among RAPDs in our map did not agree with a previously published map.
      Resistances to PRSV-W and ZYMV were tightly linked (2.2 cM) and mapped to the end
      of one linkage group. One AFLP cosegregated with resistance to ZYMV.

PMID- 11195332
TI  - The sex-determining gene doublesex in the fly Megaselia scalaris: conserved
      structure and sex-specific splicing.
AB  - The well-known sex-determining cascade of Drosophila melanogaster serves as a
      paradigm for the pathway to sexual development in insects. But the primary sex
      determining signal and the subsequent step, Sex-lethal (Sxl), have been shown not
      to be functionally conserved in non-Drosophila flies. We isolated doublesex
      (dsx), which is a downstream step in the cascade, from the phorid fly Megaselia
      scalaris, which is a distant relative of D. melanogaster. Conserved properties,
      e.g., sex-specific splicing, structure of the female-specific 3' splice site, a
      splicing enhancer region with binding motifs for the TRA2/RBP1/TRA complex that
      activates female-specific splicing in Drosophila, and conserved domains for DNA
      binding and oligomerization in the putative DSX protein, indicate functional
      conservation of dsx in M. scalaris. Hence, the dsx step of the sex-determining
      pathway appears to be conserved among flies and probably in an even wider group
      of insects, as the analysis of a published cDNA from the silkmoth indicates.

PMID- 11195333
TI  - Coevolution of A and B genomes in allotetraploid Triticum dicoccoides.
AB  - Data is presented on the coevolution of A and B genomes in allotetraploid wheat
      Triticum dicoccoides (2n = 4x = 28, genome AABB) obtained by genomic in situ
      hybridization (GISH). Probing chromosomes of T. dicoccoides with DNA from the
      proposed A/B diploid genome ancestors shows evidence of enriching A-genome with
      repetitive sequences of B-genome type. Thus, ancestral S-genome sequences have
      spread throughout the AB polyploid genome to a greater extent than have ancestral
      A-genome sequences. The substitution of part of the A-genome heterochromatin
      clusters by satellite DNA of the B genome is detected by using the molecular
      banding technique. The cause may be interlocus concerted evolution and (or)
      colonization. We propose that the detected high level of intergenomic invasion in
      old polyploids might reflect general tendencies in speciation and stabilization
      of the allopolyploid genome.

PMID- 11195334
TI  - DNA content, rDNA loci, and DAPI bands reflect the phylogenetic distance between
      Lathyrus species.
AB  - The nuclear DNA content, the proportion of A+T base pairs, the chromosomal
      positions of 5S and 25S rRNA genes, as well as of DAPI (4,6-diamidino-2
      phenylindole) bands are described for seven species belonging to three different
      sections of the genus Lathyrus. These data and chromosome measurements allowed to
      establish precise idiograms and to discriminate most of the chromosome pairs of
      the seven species. The karyotypic features correlate well with the phylogenetic
      distances between these species.

PMID- 11195335
TI  - Molecular contribution to selection of intergeneric hybrids between sugarcane and
      the wild species Erianthus arundinaceus.
AB  - Erianthus arundinaceus has great potential as a germplasm source for better
      ratoonability, vigour, tolerance to environmental stresses, and disease
      resistance in sugarcane. Many unsuccessful attempts have been made to introduce
      these characters into modern sugarcane cultivars. We report on significant
      progress made since molecular tools were implemented. Sequence-tagged PCR,
      revealing size variation in the 5S rDNA cluster, was performed on intact leaf
      tissue to identify genuine hybrids six weeks after germination. This early
      screening of seedlings avoids the loss of genuine hybrids due to competition with
      selfed progeny. Of 96 crosses made involving female Saccharum officinarum or
      sugarcane cultivars (Saccharum spp.) and male E. arundinaceus, 26 were fertile
      producing 1328 seedlings. Thirty-seven genuine hybrids were unequivocally
      identified but only 19 have survived. Genuine hybrids were produced from only
      three crosses, all involving S. officinarum as the female parent. Chromosome
      elimination was observed in all seven hybrids analyzed using genomic in situ
      hybridization (GISH). Very little cross-hybridization was observed between the
      genomes of the two species after GISH, confirming recent molecular studies which
      showed that E. arundinaceus is quite distant from the genus Saccharum. The major
      limitation in the introgression of E. arundinaceus resides now in the apparent
      sterility of the hybrids.

PMID- 11195336
TI  - Visualization of A- and B-genome chromosomes in wheat (Triticum aestivum L.) x
      jointed goatgrass (Aegilops cylindrica Host) backcross progenies.
AB  - Wheat (Triticum aestivum) and jointed goatgrass (Aegilops cylindrica) can cross
      with each other, and their self-fertile backcross progenies frequently have extra
      chromosomes and chromosome segments, presumably retained from wheat, raising the
      possibility that a herbicide resistance gene might transfer from wheat to jointed
      goatgrass. Genomic in situ hybridization (GISH) was used to clarify the origin of
      these extra chromosomes. By using T. durum DNA (AABB genome) as a probe and
      jointed goatgrass DNA (CCDD genome) as blocking DNA, one, two, and three A- or B
      genome chromosomes were identified in three BC2S2 individuals where 2n = 29, 30,
      and 31 chromosomes, respectively. A translocation between wheat and jointed
      goatgrass chromosomes was also detected in an individual with 30 chromosomes. In
      pollen mother cells with meiotic configuration of 14 II + 2 I, the two univalents
      were identified as being retained from the A or B genome of wheat. By using Ae.
      markgrafii DNA (CC genome) as a probe and wheat DNA (AABBDD genome) as blocking
      DNA. 14 C-genome chromosomes were visualized in all BC2S2 individuals. The GISH
      procedure provides a powerful tool to detect the A or B-genome chromatin in a
      jointed goatgrass background, making it possible to assess the risk of transfer
      of herbicide resistance genes located on the A or B genome of wheat to jointed
      goatgrass.

PMID- 11195337
TI  - Production and meiotic pairing behaviour of new hybrids of winter wheat (Triticum
      aestivum) x winter barley (Hordeum vulgare).
AB  - New winter wheat (Triticum aestivum L.) x winter barley (Hordeum vulgare L.)
      hybrids produced using cultivated varieties (wheat 'Martonvasari 9 krl'(Mv9 krl)
      x barley 'Igri', Mv9 krl x 'Osnova', 'Asakazekomugi' x 'Manas') were multiplied
      in tissue culture because of the high degree of sterility and then pollinated
      with wheat to obtain backcross progenies. Meiotic analysis of the hybrids Mv9 krl
      x 'Igri' and 'Asakazekomugi' x 'Manas' and their in vitro regenerated progenies
      with the Feulgen method revealed 1.59 chromosome arm associations per cell in
      both initial hybrids. The number of chromosome arm associations increased after
      in vitro culture to 4.72 and 2.67, respectively, in the two combinations.
      According to the genomic in situ hybridization (GISH) analysis, wheat-barley
      chromosome arm associations made up 3.6% of the total in the initial Mv9 krl x
      'Igri' hybrid and 6.6% and 16.5% of the total in in vitro regenerated progenies
      of the 'Asakazekomugi' x 'Manas' and Mv9 krl x 'Igri' hybrids, respectively. The
      demonstration by GISH of wheat-barley chromosome pairing in the hybrids and
      especially in their in vitro regenerated progenies proves the possibility of
      producing recombinants between these two genera, and thus of transferring useful
      characters from barley into wheat. In vitro conditions caused an increase in
      chromosome arm association frequency in both combinations and in fertility in
      some regenerants.

PMID- 11195338
TI  - A maize chromosome 3 addition line of oat exhibits expression of the maize
      homeobox gene liguleless3 and alteration of cell fates.
AB  - Maize chromosome addition lines of oat offer the opportunity to study maize gene
      expression in oat and the resulting phenotypes. Morphological examination of a
      maize chromosome 3 addition line of oat showed that this line exhibited several
      morphological abnormalities including a blade-to-sheath transformation at the
      midrib region of the leaf, a hook-shaped panicle, and abnormal outgrowth of
      aerial axillary buds. Dominant mutations in the maize liguleless3 (lg3) homeobox
      gene result in a blade (distal)-to-sheath (proximal) transformation at the midrib
      region of the leaf. Ectopic expression of the dominant mutant Lg3 allele is
      believed to cause the phenotype. Therefore, we suspected that the maize lg3 gene,
      which is located on maize chromosome 3, was involved in the phenotypes observed
      in the maize chromosome 3 addition line of oat. Genetic analyses of an oat BC1F2
      family segregating for maize chromosome 3 showed that the presence of a stable
      maize chromosome 3 was required for the expression of these cell fate
      abnormalities. RNA expression analysis of leaf sheath tissue from oat plants
      carrying maize chromosome 3 demonstrated that maize LG3 transcripts accumulated
      in oat, indicating that this expression is associated with the blade-to-sheath
      transformation, hook-shaped panicle and outgrowth of aerial axillary bud
      phenotypes. Our results demonstrate that the maize chromosome addition lines of
      oat are useful genetic stocks to study expression of maize genes in oat.

PMID- 11195339
TI  - DNA content, karyotypes, and chromosomal location of 18S-5.8S-28S ribosomal loci
      in some species of bivalve molluscs from the Pacific Canadian coast.
AB  - The DNA content of 10 species of bivalve molluscs from British Columbia coast was
      determined by image analysis, and the karyotypes of the horse clam Tressus capax,
      the bent-nose macoma Macoma nasuta, and the nuttall's mahogany clam Nuttallia
      nuttallii are described here for the first time. We also have analyzed the
      location of rDNA loci using a 28S-5.8S-18S probe in four of these species:
      Mytilus californianus, M. trossulus, Macoma nasuta and N. nuttallii. Results
      obtained report new data about cytogenetic characteristics of bivalve molluscs.

PMID- 11195340
TI  - Molecular characterization and chromosomal distribution of species-specific
      repetitive DNA sequences from Beta corolliflora, a wild relative of sugar beet.
AB  - Repetitive DNA sequences have been isolated from a Sau3AI plasmid library of
      tetraploid Beta corolliflora (2n = 4x = 36), a wild relative of sugar beet (B.
      vulgaris). The library was screened by differential hybridization with genomic
      DNA of B. corolliflora and B. vulgaris. When used as probes for Southern
      hybridization of genomic DNA, six clones were determined to represent highly
      repetitive DNA families present only in the B. corolliflora genome. Five other
      sequences were highly repetitive in B. corolliflora and low or single copy in B.
      vulgaris. The insert size varied between 43 bp and 448 bp. Two sequences pBC1279
      and pBC1944 displayed strong homology to a previously cloned satellite DNA from
      B. nana. With one exception, sequences are tandemly arranged as revealed by a
      typical ladder pattern after genomic Southern hybridization. The chromosomal
      distribution of five probes was determined by fluorescence in situ hybridization
      (FISH) of mitotic metaphases from B. corolliflora and a triploid hybrid between
      B. vulgaris and B. corolliflora. Three sequences were spread along all chromosome
      arms of B. corolliflora while one sequence was present on only six chromosomes.
      The chromosome-specific sequence pBC216 was found in close vicinity to the 5S
      rDNA located on B. corolliflora chromosome IV. This set of species-specific
      sequences has the potential to be used as probes for the identification of
      monosomic alien addition lines and for marker-assisted gene transfer from wild
      beet to cultivated beet.

PMID- 11195341
TI  - Physical localization of single-copy sequences on pachytene chromosomes in maize
      (Zea mays L.) by chromosome in situ suppression hybridization.
AB  - A new approach for locating single-copy DNA sequences on pachytene chromosomes of
      maize (Zea mays L.) was developed. A cosmid clone with homologous sequences to a
      molecular marker (umc105a) linked to a quantitative trait locus (QTL) for
      resistance against sugarcane borer (SCB) was physically mapped by fluorescence in
      situ hybridization (FISH) to the short arm of chromosome 9. The marker umc105a
      was genetically placed in the centromeric region. To suppress signals generated
      by maize repetitive DNA, competitive in situ suppression (CISS) hybridization was
      necessary to obtain specific signals from umc105a. A centromere specific DNA
      probe (CentC) was used in a double-labeling technique as a reference marker.
      Fluorescence signals generated by umc105a cosmid and CentC were specific and
      highly reproducible. Thus the single-copy DNA sequence of umc105a was physically
      localized on the short arm of chromosome 9 near the telomere. This is the first
      report of physical localization of single-copy DNA sequence by CISS hybridization
      to a maize pachytene chromosome.

PMID- 11195342
TI  - Different classes of retrotransposons in coniferous spruce species.
AB  - We have used the conservation of reverse transcriptase and integrase domains
      among retroelements to PCR-amplify three well-known types of these mobile genetic
      elements. Reverse transcriptase sequences from Ty1-copia were identified in
      spruce in this way, as well as integrase sequences from the Ty3-gypsy group.
      Using these sequences as probes against a Picea glauca genomic bank, individual
      members from the LTR (long terminal direct repeat) groups were obtained. A
      partial Ty1-copia-type element named Spcl was isolated along with a Ty3-gypsy
      type element named Spdl. Genomic Southern hybridizations revealed the complexity
      and high copy number of LTR retrotransposons in black and white spruce.

PMID- 11195343
TI  - Lineage sorting accounting for the disassociation between chloroplast and
      mitochondrial lineages in oaks of southern France.
AB  - Dumolin-Lapegue et al. (Mol. Biol. Evol. 15: 1321-1331. 1998) suggested that
      recurrent inversions of a 4-bp sequence of the mtDNA nad4-1/2 locus due to
      intramolecular recombination were responsible for the disassociation of
      chloroplast and mitochondrial genomes of French oaks. Based on their PCR-RFLP
      (PCR-restriction fragment length polymorphism) data obtained from three noncoding
      spacers, a minimum spanning network representing the phylogeny of the cpDNA was
      reconstructed. The mapping of alleles b and c of the mtDNA nad4-1/2 locus on the
      cpDNA network revealed a nonrandom distribution, which contradicted the expected
      patterns when repeated, and ongoing inversions had been occurring. The fact that
      polymorphisms (a mixed c + d type) were mostly restricted to the interior nodes
      of the network, which represented ancient haplotypes and geographically coincided
      with probable glacial refugia in southern Europe, agreed with a migrant-pool
      model. Evidence of a widespread pattern of polymorphism distribution indicated
      that mtDNA haplotypes were likely to be more ancient than the cpDNA haplotypes.
      Lineage sorting, due to relative age of cpDNA vs. mtDNA, plus the specific
      migratory mode, which recruited colonists from a random sample of resource
      populations during glacial expansion (thereby extending the lineage sorting
      period, LSP), may have resulted in the disassociation of chloroplast and
      mitochondrial genomes in oaks.

PMID- 11195344
TI  - Chromosome structure of Triticum timopheevii relative to T. turgidum.
AB  - The chromosome structure of four different wild populations and a cultivated line
      of Triticum timopheevii (2n = 28, AtAtGG) relative to Triticum turgidum (2n = 28,
      AABB) was studied, using genomic in situ hybridisation (GISH) and C-banding
      analysis of meiotic configurations in interspecific hybrids. Two wild accessions
      and the cultivated line showed the standard C-banding karyotype. The other two
      accessions are homozygous for translocation 5At/3G and translocations 1G/2G and
      5G/6G. GISH analysis revealed that all the T. timopheevii accessions carry
      intergenome translocations 6At/1G and 1G/4G and identified the position of the
      breakpoint in translocation 5At/3G. C-banding analysis of pairing at metaphase I
      in the hybrids with T. turgidum provides evidence that four species-specific
      translocations (6AtS/1GS, 1GS/4GS, 4GS/4AtL, and 4AtL/3AtL) exist in T.
      timopheevii, and that T. timopheevii and T. turgidum differ in the pericentric
      inversion of chromosome 4A. Bridge plus acentric fragment configurations
      involving 4AL and 4AtL were identified in cells at anaphase I. This result
      suggests that the paracentric inversion of 4AL from T. turgidum does not exist in
      T. timopheevii. Both tetraploid species have undergone independent and distinct
      evolutionary chromosomal rearrangements. The position, intercalary or subdistal,
      of the breakpoints in species-specific translocations and inversions contrasts
      with the position, at or close to the centromere, of intraspecific
      translocations. Different mechanisms for intraspecific and species-specific
      chromosome rearrangements are suggested.

PMID- 11195345
TI  - Linkage mapping and nucleotide polymorphisms of the 6-SFT gene of cool-season
      grasses.
AB  - Fructan plays an important role as an alternate carbohydrate and may contribute
      to drought and cold-stress tolerances in various plant species. The gene coding
      for sucrose:fructan 6-fructosyltransferase (6-SFT; EC 2.4.1.10), an enzyme that
      catalyzes the formation and extension of beta-2,6-linked fructans (levans), is
      important to fructan synthesis in many cool-season grasses, including cereal
      species. In this study, we compared a conserved sequence from the 6-SFT gene in
      barley with comparable sequences in 20 other cool-season grasses. We detected
      several DNA length polymorphisms, including variations in one simple-sequence
      repeat (SSR) in a 6-SFT intron of the barley cultivars Steptoe and Morex. Using
      the 'Steptoe' x 'Morex' doubled-haploid mapping population, the 6-SFT gene was
      genetically mapped to the distal region in the short arm of barley chromosome 1
      (7H), where it is closely linked with trait locus Rpg1. Primers designed from
      other conserved regions of the barley 6-SFT gene successfully amplified 351- or
      354-bp sequences of this gene from diverse cool season grass species. Sequence
      identities of the PCR products were greater than 80% among the 21 species.
      Phylogeny, as determined using these DNA sequences, is similar to that obtained
      from rDNA ITS sequences, and congruent with our current knowledge of genome
      relationships.

PMID- 11195346
TI  - Automictic parthenogenesis in the parasitoid Venturia canescens (Hymenoptera:
      Ichneumonidae) revisited.
AB  - Both arrhenotokous and thelytokous reproduction are known to occur in the
      parasitoid wasp Venturia canescens. The cytological mechanism of thelytoky was
      previously reported to involve the formation of a restitution metaphase after the
      reduction division, but the exact nature of the subsequent divisions, whether
      reductional or equational, remained unclear. We reinvestigated the cytological
      mechanisms in a thelytokous strain collected in France. Our observations confirm
      previous results, but an equational and not a reduction division was observed
      after restitution. This type of reproduction can be classified as central fusion
      automictic parthenogenesis. In two arrhenotokous strains the normal pattern of
      oogenesis and syngamy of Hymenoptera was observed. In addition, we used PCR
      amplification to show that thelytoky in V. canescens is not caused by Wolbachia
      bacteria. The results are discussed in relation to maintenance of heterozygosity
      and female sex.

PMID- 11195347
TI  - Organization of highly repeated sequences in surface-spread pachytene chromosomes
      of rye.
AB  - A method of preparing two-dimensional surface spreads of plant synaptonemal
      complexes (SCs) associated with fluorescence in situ hybridization (FISH) has
      been applied to analyze the location and organization of five different highly
      repeated DNA sequences in rye. Our observations indicate that, depending on the
      type of sequence, the chromatin displays different types of organization.
      Telomeric sequences were seen tightly associated with the SC while other
      repetitive DNA sequences were found to form loops that are associated with SCs
      only at their bases. On the contrary, the FISH signal of a centromeric satellite
      had a granular appearance, reflecting that the hybridization occurs only with
      parts of the chromatin loops.

PMID- 11195348
TI  - Reverse transcriptase can stabilize or destabilize the genome.
AB  - Telomeres, the eukaryotic chromosome termini, are deoxyribonucleoprotein
      structures that distinguish natural chromosome ends from broken DNA. In most
      organisms, telomeres are extended by a reverse transcriptase (RT) with an
      integrated RNA template, telomerase; in Drosophila melanogaster, however,
      telomere-specific retrotransposons, HeT-A and TART transpose specifically to
      chromosome ends. Whether telomeres are extended by a telomerase or by
      retrotransposons, an RT is a key component. RT has been studied extensively, both
      for its important role in converting RNA genomes to DNA, which has great
      evolutionary impact, and as a therapeutic target in human retroviral diseases.
      Here we discuss a few important aspects of RT usage during retrotransposition and
      telomere elongation.

PMID- 11195349
TI  - Structure, expression, and conserved physical linkage of mouse testicular cell
      adhesion molecule-1 (TCAM-1) gene.
AB  - Isolation and characterization were performed for cDNA encoding mouse testicular
      cell adhesion molecule-1 (TCAM-1) using 2908 bases coding for a protein having
      548 amino acids (60 kDa). Mouse TCAM-1 protein was found to consist of seven
      domains for signal sequence, five immunoglobulin (Ig) domains, and the
      transmembrane plus cytoplasmic domain. TCAM-1 gene and the region linking it to
      growth hormone (GH) gene located downstream from the TCAM-1 gene were then
      analyzed. The mouse TCAM-1 gene was 11.6 kb in length with 8 exons; the same as
      for the 12.0 kb rat gene. The distance from the TCAM-1 to GH gene was 12.5 kb in
      the mouse genome, and 7.6 kb in the rat. By Northern hybridization, 3.1-kb TCAM-1
      mRNA was detected in 17-day testis and would appear present in pachytene
      spermatocytes and round spermatids.

PMID- 11195350
TI  - Simple sequence repeats in Cucumis mapping and map merging.
AB  - Thirty-four polymorphic simple-sequence repeats (SSRs) were evaluated for length
      polymorphism in melon (Cucumis melo L.) and cucumber (Cucumis sativus L.). SSR
      markers were located on three melon maps (18 on the map of 'Vedrantais' and PI
      161375, 23 on the map of 'Piel de Sapo' and PI 161375, and 16 on the map of PI
      414723 and 'Dulce'). In addition, 14 of the markers were located on the cucumber
      map of GY14 and PI 183967. SSRs proved to be randomly distributed throughout the
      melon and cucumber genomes. Mapping of the SSRs in the different maps led to the
      cross-identification of seven linkage groups in all melon maps. In addition, nine
      SSRs were common to both melon and cucumber maps. The potential of SSR markers as
      anchor points for melon-map merging and for comparative mapping with cucumber was
      demonstrated.

PMID- 11195351
TI  - Genetic variation and relationship among and within Withania species as revealed
      by AFLP markers.
AB  - Withania somnifera is an important medicinal plant, and its anticancerous
      properties have been attributed to various classes of withanolide compounds. The
      objective of the present study was to investigate the inter- and intraspecific
      genetic variation present in 35 individuals of W. somnifera and 5 individuals of
      W. coagulans using AFLP (amplified fragment length polymorphism) marker
      technique. The information about genetic variation determined from AFLP data for
      40 individuals was employed to estimate similarity matrix value based on
      Jaccard's coefficient. The similarity values were further used to construct a
      phenetic dendrogram revealing the genetic relationships. The dendrogram generated
      by UPGMA (unweighted pair group method of arithmetic averages) distinguished W.
      somnifera from W. coagulans and formed two major clusters. These two main
      clusters shared a similarity coefficient of 0.3, correlating with the high level
      of polymorphism detected. The dendrogram further separated W. somnifera into
      three subclasses corresponding to Kashmiri and Nagori groups and an intermediate
      type. The AFLP profile of Kashmiri individuals was distinct from that of the
      Nagori group of plants. The intermediate genotype was distinct as it shared bands
      with both the Kashmiri and Nagori individuals, even though it was identified as a
      Kashmiri morphotype. Furthermore, the intermediate type shared a similarity
      coefficient of 0.8 with the Kashmiri individuals. The present work revealed low
      levels of variation within a population though high levels of polymorphism were
      detected between Nagori and Kashmiri populations. The ability of AFLP markers for
      efficient and rapid detection of genetic variations at the species as well as
      intraspecific level qualifies it as an efficient tool for estimating genetic
      similarity in plant species and effective management of genetic resources.

PMID- 11195352
TI  - In vitro binding of cattle PstI SINE with a 33-kDa nuclear protein.
AB  - A PstI family of SINEs (short interspersed elements) has been identified in some
      of the members of the family Bovidae, for example, cattle, buffalo and goat. In
      vitro DNA-protein interactions were studied to provide a better understanding of
      the function of these SINEs in the genome. Use of one such cattle PstI
      interspersed repeat sequence, as a probe in gel retardation assays, has lead to
      the identification of a repeat DNA-binding factor PIRBP (PstI interspersed repeat
      binding protein) from cattle liver nuclear extract. Southwestern analysis with
      liver nuclear extracts from cattle, goat, and buffalo revealed the presence of a
      PIRBP-like nuclear factor in all three species belonging to the family Bovidae.
      Deletion analysis localized the PIRBP binding site to an 80-bp (337-417 bp)
      region within the cattle PstI sequence. UV crosslinking and Southwestern analyses
      clearly indicated that PIRBP is a singular, small polypeptide of 33-kDa molecular
      mass. Homology search of the nucleic acids database revealed that the cattle PstI
      sequence was associated with many different genes of the family Bovidae, either
      in the 5' flanking region, 5' locus activating region, 3' UTR or in intervening
      sequences. The binding of the cattle PstI SINE by PIRBP and its association with
      the regulatory regions of the genes suggests that it plays an important role in
      the bovine genome.

PMID- 11195353
TI  - An integrated SSR and RFLP linkage map of Sorghum bicolor (L.) Moench.
AB  - We report the development, testing, and use (for genetic mapping) of a large
      number of polymerase chain reaction (PCR) primer sets that amplify DNA simple
      sequence repeat (SSR) loci of Sorghum bicolor (L.) Moench. Most of the primer
      sets were developed from clones isolated from two sorghum bacterial artificial
      chromosome (BAC) libraries and three enriched sorghum genomic-DNA (gDNA)
      libraries. A few were developed from sorghum DNA sequences present in public
      databases. The libraries were probed with radiolabeled di- and trinucleotide
      oligomers, the BAC libraries with four and six oligomers, respectively, and the
      enriched gDNA libraries with four and three oligomers, respectively. Both types
      of libraries were markedly enriched for SSRs relative to a size-fractionated gDNA
      library studied earlier. However, only 2% of the sequenced clones obtained from
      the size-fractionated gDNA library lacked a SSR, whereas 13% and 17% of the
      sequenced clones obtained from the BAC and enriched gDNA libraries, respectively,
      lacked a SSR. Primer sets were produced for 313 SSR loci. Two-hundred sixty-six
      (85%) of the loci were amplified and 165 (53%) of the loci were found to be
      polymorphic in a population composed of 18 diverse sorghum lines. (AG/TC)n and
      (AC/TG)n repeats comprised 91% of the dinucleotide SSRs and 52% of all of the
      SSRs at the polymorphic loci, whereas four types of repeats comprised 66% of the
      trinucleotide SSRs at the loci. Primer sequences are reported for the 165
      polymorphic loci and for eight monomorphic loci that have a high degree of
      homology to genes. Also reported are the genetic map locations of 113 novel SSR
      loci (including four SSR-containing gene loci) and a linkage map composed of 147
      SSR loci and 323 RFLP (restriction fragment length polymorphism) loci. The number
      of SSR loci per linkage group ranges from 8 to 30. The SSR loci are distributed
      relatively evenly throughout approximately 75% of the 1406-cM linkage map, but
      segments of five linkage groups comprising about 25% of the map either lack or
      contain few SSR loci. Mapping of SSR loci isolated from BAC clones located to
      these segments is likely to be the most efficient method for placing SSR loci in
      the segments.

PMID- 11195354
TI  - Positive meaning in amputation and thoughts about the amputated limb.
AB  - The majority of research conducted on the aftermath of amputation understandably
      concerns itself with its most distressing aspects. This research aimed to explore
      whether and how people think about their amputated limb, and whether and if they
      considered anything good had emerged from their amputation. One hundred and four
      (104) people completed the Trinity Amputation and Prosthesis Experience Scales
      (TAPES) and two open-ended questions. The majority of participants were young and
      had traumatic amputations. Fifty-six percent (56%) of people thought about their
      amputated limb. People with bilateral or a trans-femoral amputation were more
      likely to think about their amputated limb than people with a trans-tibial
      amputation. Forty-eight percent (48%) considered that something good had happened
      as a result of the amputation. Furthermore, finding positive meaning was
      significantly associated with more favourable physical capabilities and health
      ratings, lower levels of Athletic Activity Restriction and higher levels of
      Adjustment to Limitation. Future research and clinical implications are
      discussed.

PMID- 11195355
TI  - Prosthetic foot roll-over shapes with implications for alignment of trans-tibial
      prostheses.
AB  - Roll-over shape is introduced as a significant characteristic of prosthetic feet.
      The roll-over shapes of the Flexwalk, Quantum, SACH, and SAFE prosthetic feet
      were determined using three methods; two involving quasi-static loading and one
      dynamic loading. The results show that foot roll-over shape properties obtained
      by quasi-static and by dynamic methods are similar. Relationships between foot
      roll-over shape and the alignment of trans-tibial prostheses are introduced that
      suggest ways to align trans-tibial prostheses without walking trials and
      iterations. The relationships may explain what prosthetists attempt to accomplish
      when they dynamically align a trans-tibial limb. They also explain why prosthetic
      feet with different mechanical properties usually necessitate different
      alignments, and may explain why a number of gait studies of trans-tibial amputees
      do not show major gait differences when walking is executed on various kinds of
      prosthetic feet.

PMID- 11195356
TI  - Trans-tibial amputee gait: time-distance parameters and EMG activity.
AB  - Gait analysis of trans-tibial (TT) amputees discloses asymmetries in gait
      parameters between the amputated and sound legs. The present study aimed at
      outlining differences between both legs with regard to kinematic parameters and
      activity of the muscles controlling the knees. The gait of 14 traumatic TT
      amputees, walking at a mean speed of 74.96 m/min, was analysed by means of an
      electronic walkway, video camera, and portable electromyography system. Results
      showed differences in kinematic parameters. Step length, step time and swing time
      were significantly longer, while stance time and single support time were
      significantly shorter on the amputated side. A significant difference was also
      found between knee angle in both legs at heel strike. The biceps femoris/vastus
      medialis ratio in the amputated leg, during the first half of stance phase, was
      significantly higher when compared to the same muscle ratio in the sound leg.
      This difference was due to the higher activity of the biceps femoris, almost four
      times higher than the vastus medialis in the amputated leg. The observed
      differences in time-distance parameters are due to stiffness of the prosthesis
      ankle (the SACH foot) that impedes the normal forward advance of the amputated
      leg during the first half of stance. The higher knee flexion at heel strike is
      due to the necessary socket alignment. Unlike in the sound leg, the biceps
      femoris in the amputated leg reaches maximal activity during the first half of
      stance, cocontracting with the vastus medialis, to support body weight on the
      amputated leg. The obtained data can serve as a future reference for evaluating
      the influence of new prosthetic components on the quality of TT amputee's gait.

PMID- 11195357
TI  - Isokinetic strength and endurance of the knee extensors and flexors in trans
      tibial amputees.
AB  - Significant levels of muscular fatigue alter the co-ordination patterns and the
      ability to accomplish proper daily functions, especially in patients with initial
      low levels of strength. The purpose of this study was to evaluate the strength
      and endurance of the quadriceps and hamstring muscles in trans-tibial amputees.
      Concentric strength and endurance of the thigh muscles were measured bilaterally
      by an isokinetic dynamometer. The measured variables were torque and angle. For
      the endurance test, a fatigue index was calculated. Peak torque for extension and
      flexion was significantly higher in the sound limb (p<0.01). The fatigue index
      for extension was not significantly different in the sound limb from the
      amputated limb. The fatigue index for flexion is significantly higher in the
      sound limb (p<0.01). The finding may imply that from a metabolic point of view,
      the muscles of the amputated limb function properly. It is of great importance to
      reduce the bilateral deficit and the degree of atrophy as soon as possible in
      order to improve the level of performance. By choosing a correct strength and
      endurance training programme, one may expect to get a significant and good
      reaction from the muscles of the amputated limb as is expected from training the
      muscles of a sound limb.

PMID- 11195358
TI  - Ultrasound study of the motion of the residual femur within a trans-femoral
      socket during gait.
AB  - This study analyses the motion of the residual femur within a trans-femoral
      socket during gait using ultrasound data from two simultaneously transmitting
      transducers connected to two ultrasound scanners. Calibration tests accurately
      established the orientation of the two transducers mounted on the lateral wall of
      the socket. Relative positions of the ultrasound image of the femur were measured
      on video playback. Motion of the residual femur, relative to the lateral wall of
      the socket, at any instant during gait may be estimated, if the relative
      positions of the two transducers and the motion of the ultrasound image are
      known. A consistent pattern of femoral motion during 10 gait cycles is displayed
      graphically. The femoral motion in this paper is expressed as abduction/adduction
      or flexion/extension relative to the socket. However, without a full gait
      analysis study, the orientation of the socket relative to the ground or relative
      to the pelvis cannot be determined. Only one ultrasound scanner may be available
      for clinical use. Hence data collection may be restricted to only one transducer
      during gait. In order to simulate the single transducer mode, the ultrasound data
      recorded during the 10 previous gait cycles, was averaged at any instant of the
      gait cycle. The angular orientation of the femur was calculated based on the
      averaged data. Similar patterns of femoral motion were obtained irrespective of
      the technique adopted.

PMID- 11195359
TI  - A rear support walking frame for severely disabled children with cerebral palsy:
      initial development.
AB  - Ambulation for patients with total body involved cerebral palsy poses greater
      problems than those encountered in providing reciprocal walking for thoracic
      lesion paraplegic subjects. Experience with a prototype system showed that an
      orthosis which controls the movement of the lower limbs, in combination with a
      walking frame giving anterior support, enables such patients to walk. Despite
      shortcomings which restricted the use of the system to an indoor environment it
      provided a sound basis on which to examine walking frames to address the problems
      which had been identified. A review of these devices showed that the most
      effective means of achieving this aim is the use of a wheeled walking frame which
      provides vertical support and truncal alignment via a sprung pantograph mounted
      to the rear of the patient (rear support walking frames). Trials were conducted
      with two existing rear support walking frames. These indicated their potential
      for severely disabled patients, but also identified the need for higher stiffness
      in the structure and more sensitive control of vertical support to be achieved if
      effective ambulation in a wider range of environments was to be made possible for
      the target group. Prototypes based on an existing frame, which took account of
      the specification requirements, were produced for four new total body involved
      cerebral palsy patients with the same degree of walking dysfunction. Three of the
      patients were able to walk in a much wider variety of environments than any
      patient in the original system. A number of other issues related to transfer and
      steering were identified as requiring further development.

PMID- 11195360
TI  - Principal structural testing of trans-tibial prosthetic assemblies: specimen
      preparation.
AB  - A simple alignment apparatus and the method of transferring the offset test load
      to the prosthetic assembly through an aligned mandrel for the principal
      structural tests in accordance with ISO 10328 is presented. The new alignment
      apparatus was used to prepare test specimens consisting of traditional laminated
      prosthetic sockets, adaptors, shanks and foot blocks. The alignment apparatus
      proved useful in ensuring proper orientation and positioning of the components
      relative to one another as well as to the loading coordinate axes. The sockets
      and the other components achieved the maximum load specifications during the
      static failure tests and no failure of components was observed in the cyclic
      tests.

PMID- 11195361
TI  - Combined shock-absorbing shin and dynamic response.

PMID- 11195362
TI  - Fitting of electronic elbow on an elbow disarticulated patient by means of a new
      surgical technique.
AB  - Rehabilitation of trans-humeral amputees represents a challenge. One of the
      difficulties to overcome is prosthetic suspension. In the case of elbow
      disarticulation the presence of humeral condyles permits better suspension, but
      there is no room for elbow joints, particularly electronic ones, and the only
      available mechanisms are provided by external hinges. The purpose of this report
      is to present a case of a primarily elbow disarticulated patient, with indication
      for surgical revision due to bad skin coverage, neuroma and the wish to improve
      prosthetic fitting. The surgical plan outlined was to produce a shortening of the
      humerus, by means of an osteotomy just above the humeral condyles, preserving
      them for prosthetic suspension. This bone reduction was carried out with
      complementary shaping of bone segments with an indentation to enhance fixation.
      The operation was completed with neuroma resection, myodesis and removal of the
      skin grafted area. Preservation of the humeral condyles actually produced
      effective suspension. For final fitting a Utah Arm II was used, with wrist
      rotator, and interchangeable hand and Greifer for terminal devices. Good initial
      results and at nine months follow-up suggest this procedure should be considered
      in other elective situations.

PMID- 11195364
TI  - On being an Inorganic Chemistry Janus: looking back with thanks and ahead with
      excitement.

PMID- 11195363
TI  - A myoelectrically controlled shoulder-elbow orthosis for unrecovered brachial
      plexus injury.
AB  - Two myoelectrically controlled battery powered shoulder-elbow orthoses
      manufactured individually for two traumatic unilateral brachial plexus injury
      cases are reported. The first case was 24 years old and the other was 6 years
      old. Both patients had undergone unsuccessful microsurgical nerve repair
      procedures leaving them with elbow and shoulder paralysis and some residual hand
      motion. Manufactured orthoses were made of lightweight thermoplastic
      polyethylene. They stabilised the affected shoulder joint in the neutral
      position. Elbow extension and flexion were activated by a myoelectrically
      controlled battery powered orthosis, and the active range of motion of the elbow
      was between 60 and 140 degrees. These orthoses achieved elbow motions at a speed
      of 16 degrees per second. The rehabilitation time was 3 months in both patients.
      The older patient was rehabilitated using a 1 kg mass, and the younger one with
      0.5 kg mass, throughout the full range of active elbow motions. After 21 months
      it was found, in both cases, that the orthotic treatment had been successful and
      that the patients had been given the ability to engage in two-handed activities
      of daily living.

PMID- 11195365
TI  - Si extraction from silica in a basic polychalcogenide flux. Stabilization of
      Ba4SiSb2Se11, a novel mixed selenosilicate/selenoantimonate with a polar
      structure.
AB  - An unusual compound, Ba4SiSb2Se11, was discovered from a reaction of Ba/Th/Sb/Se.
      It is assumed that Si was extracted from the silica reaction tube. It forms as
      silver needlelike crystals in the polar space group Cmc2(1) with a = 9.3981(3) A,
      b = 25.7192(7) A, c = 8.7748(3) A, and Z = 4. A rational synthesis has been
      devised at 600 degrees C. The compound is composed of Ba2+ ions stabilized
      between infinite one-dimensional [SiSb2Se11]8- chains running parallel to the a
      axis. Each chain is composed of a [SbSe2]- infinity backbone with [SiSe4]4-
      tetrahedra chelating every other Sb atom from the same side of the backbone. The
      V-shaped triselenide groups, (Se3)2-, are attached to the rest of the Sb atoms in
      the chain through one of their terminal Se atoms. The compound has a band gap of
      1.43 eV. The Raman spectrum shows a broad shift at 247 cm-1 and a shoulder around
      234 cm-1, which are related to the Se-Se vibration of the triselenide groups
      and/or the Si-Se vibrations of the [SiSe4]4- groups. The compound decomposes at
      522 degrees C.

PMID- 11195366
TI  - Preparations, characterizations, and structures of
      (biimidazole)dihalobis(triphenylphosphine)rhenium(III) salts: strong ion-pairing
      and acid-base properties.
AB  - Two-electron reduction occurs when the Re(V) precursors ReOX3(PPh3)2 and
      ReO(OEt)X2(PPh3)2 are reacted with biimidazole (biimH2) in boiling chloroform,
      affording rhenium(III) cationic complexes of the type cis,trans
      [ReX2(PPh3)2(biimH2)]X with X = Cl, Br, and I. Crystal structures are determined
      for the compounds with the three halogens, as well as for the
      [ReCl2(PPh3)2(biimH2)](benzoate) salt. In all cases, the counterion is attached
      to the complex cation via hydrogen bonding with the N-H groups of coordinated
      biimidazole. Variable-temperature 1H NMR spectroscopy shows that a mixture of
      [ReCl2(PPh3)2(biimH2)](benzoate) and [ReCl2(PPh3)2(biimH2)]Cl is in slow exchange
      below -50 degrees C in CD2Cl2, indicating that ion pairing is retained in
      solution. Both N-H groups can be deprotonated with sodium methoxide, and their
      acidities are evaluated from UV-visible spectra. Competition between
      monodeprotonated [ReCl2(PPh3)2(biimH)] and various carboxylic acids reveals that
      the acidity of the first N-H proton corresponds to that of acetic acid (pKa(aq)
      approximately 4.8). By a similar competitive reaction between bis-deprotonated
      [ReCl2(PPh3)2(biim)]- and phenols, the second acidity is estimated to be close to
      that of phenol (pKa(aq) approximately 9.8).

PMID- 11195367
TI  - Structural and electronic properties of Co-corrole, Co-corrin, and Co-porphyrin.
AB  - A quantitative study of the structure and electronic properties of Co-corrole, Co
      corrin, and Co-porphyrin, using density functional theory, is reported. The
      structure of each macrocycle is optimized, with no symmetry constraints, by
      considering different spin states. The ground-state structures and spin states (S
      = 1 for Co-corrole, S = 0 for Co-corrin and S = 1/2 for Co-porphyrin) are in good
      agreement with the experimental data available. The trends in the sizes of the
      coordination cavities upon varying the inner metal atom and/or the macrocycle are
      analyzed and compared with those for the Fe-porphyrin we studied previously. Our
      results reveal that most of the distortion of the Co-corrin core in the B12
      coenzyme is due to the inherent properties of Co-corrin. Quite different
      behaviors are found between corrinoids and porphyrins upon varying the spin
      state. While an increase in the metal-nitrogen (M-N) distance with spin state
      occurs in the porphyrins, the corrinoids show little variation in the M-N
      distance and, in some cases, undergo small structural changes in the ring
      structure. These results aid in understanding the often discussed question of why
      nature has chosen corrin/porphyrin for carrying out the particular biological
      functions identified in the B12 coenzyme.

PMID- 11195368
TI  - Molecule-based magnets formed by bimetallic three-dimensional oxalate networks
      and chiral tris(bipyridyl) complex cations. The series
      [ZII(bpy)3][ClO4][MIICrIII(ox)3] (ZII = Ru, Fe, Co, and Ni; MII = Mn, Fe, Co, Ni,
      Cu, and Zn; ox = oxalate dianion).
AB  - The synthesis, structure, and physical properties of the series of molecular
      magnets formulated as [ZII(bpy)3][ClO4][MIICrIII(ox)3] (ZII = Ru, Fe, Co, and Ni;
      MII = Mn, Fe, Co, Ni, Cu, and Zn; ox = oxalate dianion) are presented. All the
      compounds are isostructural to the [Ru(bpy)3][ClO4][MnCr(ox)3] member whose
      structure (cubic space group P4(1)32 with a = 15.506(2) A, Z = 4) consists of a
      three-dimensional bimetallic network formed by alternating MII and CrIII ions
      connected by oxalate anions. The identical chirality (lambda in the solved
      crystal) of all the metallic centers determines the 3D chiral structure adopted
      by these compounds. The anionic 3D sublattice leaves some holes where the chiral
      [Z(bpy)3]2+ and ClO4- counterions are located. These compounds behave as soft
      ferromagnets with ordering temperatures up to 6.6 K and coercive fields up to 8
      mT.

PMID- 11195369
TI  - Lithium amidohydridoaluminates.
AB  - The amidohydridometalates [Li(THF)4][HAl(NPh2)3] (1), [Li(DME)3][HAl(N(CH2Ph)2)3]
      (2), and [((THF)3Li)-(H2Al(NcHex2)2)].0.5toluene (3.0.5toluene; cHex = C6H11)
      have been prepared by reaction of the corresponding amines with LiAlH4 in THF.
      For 2 recrystallization from DME is required to obtain crystals, suitable for X
      ray diffraction. The new compounds have been characterized by elemental analyses,
      IR, NMR, and MS techniques, and X-ray structure analyses. According to this the
      anions of 1, 2, and 3x0.5toluene possess distorted tetrahedral coordination
      spheres. In 3x0.5toluene a Li...H contact of 184(4) pm was detected to complete
      the tetrahedral coordination of the Li+ center.

PMID- 11195370
TI  - Synthesis, characterization, solid-state molecular structures, and deprotonation
      reactions of cationic alcohol complexes of osmium nitrosyl porphyrins.
AB  - New alkoxide (OEP)Os(NO)(OR) (OEP = 2,3,7,8,12,13,17,18-octaethylporphyrinato
      dianion; R = ethyl, isopropyl, hexyl, cyclohexyl) compounds and alcohol
      [(OEP)Os(NO)(HOR)]+ complexes (R = methyl, ethyl, isopropyl, hexyl, cyclohexyl)
      have been prepared in high yields and have been fully characterized by IR, 1H
      NMR, and UV-vis spectroscopy, and by elemental analyses. The (OEP)Os(NO)(OEt)
      compound was characterized by single-crystal X-ray crystallography. The cationic
      aqua and alcohol [(OEP)Os(NO)(HOR)]+ complexes (R = ethyl, isopropyl, hexyl)
      complexes were also characterized by single-crystal X-ray crystallography, and
      the latter represent the first osmium alcohol structures to be reported. The
      electrophilic [(OEP)Os(NO)]+ cation in the [(OEP)Os(NO)(HOR)]+ complexes renders
      the coordinated alcohol ligands susceptible to deprotonation by pyridine to
      produce the corresponding alkoxide (OEP)Os(NO)(OR) derivatives. A one-pot
      reaction sequence for the preparation of new (OEP)Os(NO)(OR) complexes from
      (OEP)Os(NO)(OEt) was developed, which was based on (i) initial protonation of the
      ethoxide compound to give [(OEP)Os(NO)(HOEt)]+, (ii) alcohol substitution by ROH
      to give [(OEP)Os(NO)(HOR)]+, and (iii) deprotonation of the latter by pyridine to
      give (OEP)Os(NO)(OR).

PMID- 11195371
TI  - Biphasic behavior of the high-spin-->low-spin relaxation of [Fe(btpa)](PF6)2 in
      solution (btpa = N,N,N',N'-tetrakis(2-pyridylmethyl)-6,6'-bis(aminomethyl)-2,2'-
      bipyridine).
AB  - The light-induced high-spin-->low-spin relaxation for the Fe(II) spin-crossover
      compounds [Fe(btpa)](PF6)2 and [Fe(b(bdpa))](PF6)2 in solution, where btpa is the
      potentially octadentate ligand N,N,N',N'-tetrakis(2-pyridylmethyl)-6,6'
      bis(aminomethyl)-2,2'-bipyridine and b(bdpa) is the analogous hexadentate ligand
      N,N'-bis(benzyl)-N,N'-bis(2-pyridylmethyl)-6,6'-bis(aminomethyl)-2,2'-
      bipyridine, respectively, has been studied by temperature-dependent laser flash
      photolysis. [Fe(b(bdpa))](PF6)2 shows single-exponential 5T2-->1A1 relaxation
      kinetics, whereas [Fe(btpa)](PF6)2 exhibits solvent-independent biphasic
      relaxation kinetics. The fast process of [Fe(btpa)](PF6)2 with a rate constant,
      kHL, of 2.5 x 10(7) s-1 at 295 K and an activation energy, Ea, of 1294(26) cm-1
      in methanol can be assigned to the 5T2-->1A1 relaxation as well. The slow process
      with a kHL(295 K) of 3.7 x 10(5) s-1 and a Ea of 2297(32) cm-1 in methanol--which
      is the slowest light-induced relaxation process observed so far for an Fe(II)
      spin-crossover complex in solution--is assigned to a coupling of the 5T2-->1A1
      relaxation process to a geometrical rearrangement within the pendent pyridyl
      arms.

PMID- 11195372
TI  - Heteroleptic lanthanide compounds with chalcogenolate ligands: reduction of
      PhNNPh/PhEEPh (E = Se or Te) mixtures with Ln (Ln = Ho, Er, Tm, Yb). Thermolysis
      can give LnN or LnE.
AB  - Lanthanide metals reduce mixtures of azobenzene and PhEEPh (E = Se or Te) in
      pyridine to give the bimetallic compounds [(py)2Ln(EPh)(PhNNPh)]2 (E = Se, Ln =
      Ho (1), Er (2), Tm (3), Yb (4); E = Te, Ln = Ho (5), Er (6), Tm (7), Yb (8)). The
      structures of [(py)2Er(mu-eta 2-eta 2-PhNNPh)(SePh)](2).2py (2) and [(py)2Ho(mu
      eta 2-eta 2-PhNNPh)(TePh)](2).2py (5) have been determined by low-temperature
      single-crystal X-ray diffraction, and the nearly identical unit cell volumes of
      the remaining compounds indicate they are most likely isomorphous to 2 or 5. In
      all compounds, the Ln(III) ions are bridged by a pair of mu-eta 2-eta 2-PhNNPh
      ligands that, from the N-N bond length, have clearly been reduced to dianions.
      Charge is balanced by the single terminal EPh ligand on each Ln, and the
      coordination sphere is saturated by two pyridine donors to give seven coordinate
      metal centers. Thermal decomposition of 5 gives HoTe, 8 gives a mixture of YbN
      and YbTe, and 1 does not give a crystalline solid-state product. Crystal data (Mo
      K alpha, 153(2) K) are as follows: 2, monoclinic group P2(1)/n, a = 11.864(3) A,
      b = 14.188(2) A, c = 17.624(2) A, beta = 91.62(2) degrees, V = 2965(1) A3, Z = 4;
      5, triclinic space group P1, a = 10.349(2) A, b = 17.662(4) A, c = 17.730(8) A,
      alpha = 75.82(3) degrees, beta = 74.11(3) degrees, gamma = 89.45(2) degrees, V =
      3016(2) A3, Z = 2.

PMID- 11195373
TI  - New molecular assemblies of redox isomers, [CrIII(X4SQ)3-n(X4Cat)n]-n (X = Cl and
      Br; n = 0, 1, and 2), with metallocenium cations, [MIIICp2]+ (M = Co and Fe): X
      ray crystal structures and physical properties.
AB  - A series of redox isomers of [CrIII(X4SQ)(X4Cat)2]2-, [CrIII(X4SQ)2(X4Cat)]-, and
      [CrIII(X4SQ)3]0 (X = Cl and Br, SQ = semiquinonate, and Cat = catecholate) have
      been synthesized and characterized as charge-transfer (CT) compounds with
      metallocenium cations: (CoIIICp2)2[CrIII(Cl4SQ)(Cl4Cat)2] (1),
      (CoIIICp2)2[CrIII(Br4SQ)(Br4Cat)2] (2), (FeIIICp2)[CrIII(Cl4SQ)2(Cl4Cat)].C6H6
      (4), (FeIIICp2)[CrIII(Br4SQ)2(Br4Cat)].CS2 (5), and
      (FeIIICp2)[CrIII(Cl4SQ)2(Cl4Cat)][CrIII(Cl4SQ)3] (6). First, the oxidation states
      of the chromium complexes are strongly dependent on the redox potentials of the
      metallocenes used. The CoIICp2, exhibiting stronger reduction power than FeIICp2,
      is useful for two-electron reduction of the [CrIII(X4SQ)3]0, affording
      [CrIII(X4SQ)(X4Cat)2]2- (1 and 2), which are first isolated and
      crystallographically characterized in the solid state. In contrast the reaction
      with FeIICp2 affords only [CrIII(X4SQ)2(X4Cat)]- (4 and 5). Second, solvents
      influence crystal structures of these compounds. The solvent set of C6H6/CS2
      gives 1:1:C6H6 compound 4 with unique charged anions, [CrIII(Cl4SQ)2(Cl4Cat)]-,
      while the other set, n-C6H12/CS2, affords 1:2 compound 6 including the two redox
      isomers, [CrIII(Cl4SQ)2(Cl4Cat)]- and [CrIII(Cl4SQ)3]0. The
      [CrIII(X4SQ)(X4Cat)2]2- anions in 1 and 2 show no significant interconnection
      between them (discrete type), while the [CrIII(X4SQ)2(X4Cat)]- anions in 4-6 show
      one-dimensional column-type structures with the aid of intermolecular stacking
      interactions of the ligand moieties. The anions in 4 show additional stacking
      interaction with the [FeIIICp2]+ to form one-dimensional ...[D][A][S][D][A]... (D
      = [FeIIICp2]+, A = [CrIII(Cl4SQ)2(Cl4Cat)]-, and S = C6H6) type mixed-stack
      arrangements similar to that of previously reported
      (CoIIICp2)[CrIII(Cl4SQ)2(Cl4Cat)].C6H6 (3). Compound 6 forms a two-dimensional
      sheet structure where the two redox isomers, [CrIII(Cl4SQ)2(Cl4Cat)]- and
      [CrIII(Cl4SQ)3]0, are included. The sheet is regarded as a mixed-valence
      molecular assembly. Two types of the anions, [CrIII(X4SQ)(X4Cat)2]2- (1 and 2)
      and [CrIII(X4SQ)2(X4Cat)]- (4-6), exhibiting an intramolecular mixed-valence
      state, show intramolecular intervalence CT transition (IVCT) from the Cat to the
      SQ at near 5800 and 4300 cm-1, respectively, both in the solution and in the
      solid states. The intermolecular mixed-valence state of 6 was characterized by
      absorption spectroscopy, electric conductivity, and SQUID magnetometry.
      Interestingly, this mixed-valence state of the chromium module is dependent on
      the redox active nature of the coordinated ligands.

PMID- 11195374
TI  - Photon upconversion properties of Ni2+ in magnetic and nonmagnetic chloride host
      lattices.
AB  - Near-infrared to visible upconversion luminescence in Ni2+:CsCdCl3, Ni2+:CsMnCl3,
      and Ni2+:RbMnCl3 is presented and analyzed. In all three materials upconversion
      occurs via a sequence of ground-state absorption/excited-state absorption
      processes, which are both formally spin-forbidden transitions. Consequently, in
      the diamagnetic Ni2+:CsCdCl3 they are weak, and the efficiency of the
      upconversion process is relatively low. This is in clear contrast to the
      isostructural Ni2+:RbMnCl3 where the spin selection rule relaxes because of
      Ni(2+)-Mn2+ exchange interactions, leading to an intensity enhancement of the
      spin-flip transitions involved in the Ni2+ upconversion mechanism. This results
      in an exchange-induced enhancement of the upconversion rate in Ni2+:RbMnCl3
      relative to Ni2+:CsCdCl3 by 2 orders of magnitude after two-color excitation into
      the maxima of the ground-state and excited-state absorption bands. In
      Ni2+:CsMnCl3 the Ni(2+)-Mn2+ exchange interaction does not play a significant
      role. This is due to the different Ni(2+)-Cl(-)-Mn2+ bridging geometry relative
      to Ni2+:RbMnCl3. In contrast to Ni2+:CsCdCl3 and Ni2+:RbMnCl3 where the
      upconversion luminescence occurs from Ni2+, in Ni2+:CsMnCl3 the upconverted
      energy is emitted from Mn2+ in the visible spectral region. This leads to an
      enhanced visible upconversion luminescence in Ni2+:CsMnCl3, relative to the other
      two samples where Ni2+ near-infrared inter-excited-state emissions compete with
      the visible upconversion luminescence.

PMID- 11195375
TI  - Copper(I) chemistry of bis(pyrazolyl)diphenylborate ligands: formation of a
      heterocycle by Cu-mediated acetonitrile addition.

PMID- 11195376
TI  - Synthesis and dehydrative condensation of monomeric hydroxoruthenium complexes
      with hydrotris(3,5-diisopropylpyrazolyl)borate ligand, TpiPr2Ru(L2)-OH (L2 =
      dppe, bipy).

PMID- 11195377
TI  - The molecular structure of (PSH+)(nido-7,8-C2B9H12-) determined by neutron
      diffraction (PS = proton sponge, 1,8-bis(dimethylamino)naphthalene).

PMID- 11195378
TI  - A NdIIICuII molecular material with a honeycomb-like structure.

PMID- 11195379
TI  - Mass and FTIR spectroscopic investigations of gaseous manganese tetrafluoride.

PMID- 11195380
TI  - Modeling the active sites of metalloenzymes. 4. Predictions of the unready states
      of [NiFe] Desulfovibrio gigas hydrogenase from density functional theory.
AB  - Density functional theory has been used to predict the structures of a variety of
      active site models for the unready states, Ni-A and Ni-SU, of the [NiFe]
      hydrogenase from Desulfovibrio gigas. By comparing available experimental results
      on Ni-A, Ni-SU, and Ni-SI with the computational results on these model
      complexes, we have been able to identify the most likely formulas and structures
      for the active sites of Ni-A and Ni-SU. Ni-A is predicted to be a Ni(III)-Fe(II)
      species with the bridging hydroxo ligand, rather than the expected oxo ligand,
      while Ni-SU is predicted to be a Ni(II)-Fe(II) species with a water molecule
      coordinated to the Fe center. Both have one of the terminal S atoms (cysteines)
      protonated.

PMID- 11195381
TI  - Synthesis and characterization of the diruthenium(III) complexes
      Ru2(F4Oap)2(F5ap)2 and Ru2(F4Oap)(F4NCNap)(F5ap)2 where F4Oap is the 2-(3,4,5,6
      tetrafluoro-2-oxoanilino)pyridinate anion, F4NCNap is the 2-(3,4,5,6-tetrafluoro
      2-cyanamidoanilino)pyridinate anion, and F5ap is the 2-(2,3,4,5,6
      pentafluoroanilino)pyridinate anion.

PMID- 11195382
TI  - Preparation and crystal structure of tetraphenylphosphonium triiodotetrabromide
      [PPh4][I3Br4].
AB  - Tetraphenylphosphonium triiodotetrabromide [PPh4][I3Br4] is obtained by the
      reaction of tetraphenylphosphonium bromide with iodine monobromide. It is the
      first example of an iodine rich, seven-membered polybromide. [PPh4][I3Br4]
      crystallizes triclinic in the space group P1 with a = 10.947(1) A, b = 11.945(1)
      A, c = 12.896(1) A, alpha = 66.80(1) degrees, beta = 77.21(1) degrees, gamma =
      85.73(1) degrees, and two formula units per unit cell. The final R indices [I > 4
      sigma(I)] are R1 = 0.0362 and wR2 = 0.0944.

PMID- 11195383
TI  - Hydrothermal syntheses, structures, and properties of [Cu3Cl2CN(pyrazine)] and
      copper(I) halide pyrazine polymers.
AB  - Crystals of copper halide and pseudohalide compounds with pyrazine are
      synthesized under hydrothermal conditions. The title compound, [Cu3Cl2CNPz] (1)
      (Pz = pyrazine), is a new copper compound exhibiting an unusual -(Cu3Cl2)-
      polymeric stair structural motif and three-coordinate cyanide. Compound 1
      crystallizes in the monoclinic space group P2(1)/m, with a = 3.6530(7) A, b =
      17.160(3) A, c = 6.9800(14) A, beta = 90.58(3) degrees, and Z = 2. In addition,
      the series of complexes [Cu2X2Pz] for X = Cl (2), Br (3), and I (4) are also
      crystallized under hydrothermal conditions. The inorganic polymer [Cu2Br2Pz] (3)
      belongs to the triclinic space group P1, with a = 6.9671(14) A, b = 7.849(2) A, c
      = 8.099(2) A, alpha = 71.69(3) degrees, beta = 70.71(3) degrees, gamma = 85.43(3)
      degrees, and Z = 2. The structure of 3, is similar to the recently reported
      structure for [Cu2Cl2Pz] (2) (Kawata, S.; Kitagawa, S.; Kumagai, H.; Iwabuchi,
      S.; Katada, M. Inorg. Chim. Acta 1998, 267, 143). The third member of the series,
      [Cu2I2Pz], is found to be isostructural on the basis of X-ray powder diffraction
      results. The lattice parameters are refined from indexed reflections to a =
      7.115(10) A, b = 8.321(19) A, c = 8.378(17) A, alpha = 71.1(3) degrees, beta =
      67.3(1) degrees, and gamma = 83.0(2) degrees. Electronic spectra show that
      compounds 1-4 have optical band gaps in the range 2.2-2.4 eV. The infrared and
      Raman spectra as well as the thermal properties of all compounds are presented.

PMID- 11195384
TI  - Crystal structure of CF3I(Cl)F.
AB  - In addition to CF3IF2 and CF3ICl2, CF3I(Cl)F is the only known example of the
      (trifluoromethyl)iodine dihalides. CF3I(Cl)F is even at low temperatures not
      stable in solution and decomposes by symmetrization. It crystallizes in the
      orthorhombic space group Cmca with a = 6.898(1) A, b = 7.310(1) A, c = 20.127(1)
      A and eight formula units per unit cell. The final R indices [I > 2 sigma(I)] are
      R1 = 0.0372 and wR2 = 0.0981.

PMID- 11195386
TI  - Synthesis of a vinylene-bridged ferrocene-hydroquinone complex and its unusual
      structural change originated by proton-coupled electron transfer.

PMID- 11195385
TI  - Mutual interdependence of spin crossover and metal-metal bond formation in
      M2Cl9(3-) (M = Fe, Ru, Os).
AB  - Broken-symmetry density functional theory is used to examine the coupling between
      metal ions in the face-shared bioctahedral complexes M2Cl9(3-), M = Fe, Ru, Os.
      In the ruthenium and osmium systems, the metal ions have low-spin configurations,
      and strong coupling results in the formation of a metal-metal sigma bond. In
      contrast, the iron system contains two weakly coupled high-spin FeIII centers,
      the different behavior being due to the high spin-polarization energy in the
      smaller Fe atom. At Fe-Fe separations shorter than 2.4 A, however, an abrupt
      transition occurs and the ground state becomes very similar to that for the
      heavier congeners (i.e., strongly coupled low-spin FeIII). The intrinsic link
      between high-spin/low-spin transitions on the individual metal centers and the
      onset of metal-metal bond formation is traced to the spin-polarization energy,
      which plays a central role in both processes.

PMID- 11195387
TI  - Structural characterization and magnetic properties of sandwich-type
      tungstoarsenate complexes. Study of a mixed-valent VIV2/VV heteropolyanion.
AB  - Complexes K11Na1[As2W18(Mn(H2O))3O66]x27H2O (1) and
      Na12[As2W18(Co(H2O))3O66]x34H2O (2) have been characterized. 1 crystallizes in
      the orthorhombic space group Pnma, with a = 30.6484(4) A, b = 14.9946(2) A, and c
      = 19.17080(10) A (Z = 4), while 2 crystallizes in the monoclinic space group
      C2/c, with a = 14.124(2) A, b = 23.294(3) A, c = 32.247(3) A, and beta =
      98.935(10) degrees (Z = 4). Structures of the anions of 1 and 2 are similar, the
      divalent metals adopting a square pyramidal environment.
      K11[As2W18(VO)3O66]x23H2O (3) crystallizes in the orthorhombic space group Pnma,
      with a = 30.6240(5) A, b = 14.9861(2) A, and c = 19.2651(3) A (Z = 4). The
      structure has revealed a disorder on two of the three metals linking the [alpha
      AsW9O33]9- parts. For these two vanadium atoms, the V=O bonds are directed
      alternatively toward the inside or the outside of the [alpha-AsW9O33]9- cavity.
      The remaining vanadium shows a V=O bond always directed toward the outside of the
      cavity. Titration of VIV by CeIV revealed that 3 is the mixed-valent VIV2VV
      species. Magnetic measurements are in agreement with this formulation. The high
      temperature molar magnetic susceptibility of a powdered sample of 3 clearly
      confirms the presence of two d1 centers. The two VIV are antiferromagnetically
      coupled, with J = -2.9 cm-1 and g = 1.93. Crystallographic data do not permit the
      location of the two VIV to be distinguished from the location of the VV. As
      expected, the Mn(II) are very weakly antiferromagnetically coupled in compound 1.
      The complex Na8[Ni(H2O)6]2[As2W18(Ni(H2O))3O66]x20H2O (4) has been synthesized.
      The anion crystallized with two octahedral [Ni(H2O)6]2+ as counterions. Magnetic
      data have been fitted assuming that the only exchange-coupled centers are the
      nickels of the polyanion. 4 exhibits an antiferromagnetic coupling with J = -1.7
      cm-1, g = 2.27, and theta = -1.5 K.

PMID- 11195388
TI  - Aqueous solution speciation of Fe(III) complexes with dihydroxamate siderophores
      alcaligin and rhodotorulic acid and synthetic analogues using electrospray
      ionization mass spectrometry.
AB  - Aqueous solutions of Fe3+ complexes of cyclic (alcaligin) and linear
      (rhodotorulic acid) dihydroxamate siderophores and synthetic linear eight-carbon
      chain and two-carbon-chain dihydroxamic acids ([CH3N(OH)C=O)]2(CH2)n; H2Ln; n = 2
      and 8) were investigated by electrospray ionization mass spectrometry (ESI-MS).
      Information was obtained relevant to the structure and the speciation of various
      Fe(III)-dihydroxamate complexes present in aqueous solution by (1) comparing
      different ionization techniques (ESI and FAB), (2) altering the experimental
      parameters (Fe3+/ligand ratio, pH, cone voltage), (3) using high-stability
      hexacoordinated Fe(III) siderophore complex mixtures (ferrioxamine B/ferrioxamine
      E) as a calibrant to quantify intrinsically neutral (H+ clustered or protonated)
      and intrinsically charged complexes, and (4) using mixed-metal complexes
      containing Fe3+, Ga3+, and Al3+. These results illustrate that for all
      dihydroxamic acid ligands investigated multiple tris- and bis-chelated mono- and
      di-Fe(III) species are present in relative concentrations that depend on the pH
      and Fe/L ratio.

PMID- 11195389
TI  - Synthesis and characterization of novel trigonal bipyramidal technetium(III)
      mixed-ligand complexes with SES/S/P coordination (E = O, N(CH3), S).
AB  - Five-coordinate oxotechnetium(V) mixed-ligand complexes [TcO(SES)(S-p-C6H4-OMe)],
      where SES is a tridentate dithiolato fragment of the type -S(CH2)2E(CH2)2S- (E =
      O, 1; E = S, 2; E = NMe, 3) are converted via reduction-substitution reactions in
      the presence of PMe2Ph into the corresponding five-coordinate Tc(III) complexes
      [Tc(SES)(S-p-C6H4-OMe)(PMe2Ph)] (E = O, 4; E = S, 5; E = NMe, 6). Rearrangement
      of the original square pyramidal "3 + 1" oxo species to the trigonal bipyramidal
      "3 + 1 + 1" Tc(III) complexes occurs by placing the three thiolate donors on the
      basal plane, the phosphine phosphorus, and the heteroatom of the tridentate
      ligand at the apexes of the bipyramid. These Tc(III) complexes are diamagnetic
      species, thereby allowing multinuclear NMR characterization in solution, which
      confirm their structures to be identical to those observed in the solid state via
      X-ray determinations.

PMID- 11195390
TI  - Extended X-ray absorption fine structure analysis of the bipyridine copper
      complexes in atom transfer radical polymerization.

PMID- 11195391
TI  - Electrochemical synthesis and structural and physical characterization of one-
      and two-electron-reduced forms of [SMo12O40]2-.
AB  - Isolation of a soluble [NHex4]+ salt has allowed a detailed electrochemical study
      of the anion alpha-[SMo12O40]2- to be undertaken. Four reversible one-electron
      reduction processes are observed in CH2Cl2 solution. Controlled potential
      electrolysis led to isolation of tetraalkylammonium salts of the one-electron
      reduced anion alpha-[SMo12O40]3- and the two-electron-reduced anion alpha
      [SMo12O40].4- [SMo12O40]3- is stable to disproportionation in dry solvents (Kdis
      = 10(-7.4). EPR and magnetic susceptibility data indicate that [SMo12O40]3- is a
      simple paramagnet (S = 1/2) while [SMo12O40]4- is paramagnetic with the mu eff
      values decreasing at low temperatures. Solutions of the two-electron-reduced
      species are EPR silent, but microcrystalline powders show very weak signals. The
      crystal structure of alpha-[NBu4]3[SMo12O40] has been determined (triclinic P1; a
      = 13.840(3) A; b = 15.587(4) A; c = 19.370(3) A; alpha = 94.82(2) degrees; beta =
      93.10(1) degrees; gamma = 91.05(2) degrees; Z = 2). There is disorder around the
      C2 axis of the central SO4(2-) tetrahedron. In the presence of aqueous HClO4
      (0.045 M) in thf/H2O or MeCN/H2O (98/2 v/v), [SMo12O40]2- exhibits five two
      electron-reduction processes. Under these conditions, [SMo12O40]3- protonates and
      disproportionates into [SMo12O40]2- and the (2e-, 2H+)-reduced anion
      [H2SMo12O40]2-.

PMID- 11195392
TI  - Synthesis of nickel sulfides in aqueous solutions using sodium dithionite.
AB  - Reaction of nickel chloride with sodium dithionite in aqueous solutions at
      ambient temperature has been investigated systematically to obtain nickel
      sulfides. The products are characterized by X-ray diffraction, thermogravimetric
      analysis, and electrical resistivity and magnetic susceptibility measurements. It
      is found that the compositions and structures of the products are controlled by
      the reaction pH and the amount of the reactants. While reactions under highly
      acidic (pH < or = 2) and basic (pH > or = 7) conditions yield crystalline sulfur
      and amorphous or poorly crystalline NiySx, respectively, those at intermediate 3
      < or = pH < or = 6 give crystalline NiySx. Both crystalline Ni3S2 (heazlewoodite
      structure) and Ni3S4 (spinel structure) have been obtained at room temperature.
      Additionally, NiS (millerite structure) is obtained by carefully heating Ni3S4 at
      200 degrees C in a mixture of 90% Ar and 10% H2. Ni3S4 is found to be metastable,
      and it begins to disproportionate above 100 degrees C. Both Ni3S2 and Ni3S4 show
      metallic behavior. While Ni3S2 exhibits temperature-independent magnetic
      susceptibility, Ni3S4 shows ferrimagnetic ordering below 20 K.

PMID- 11195393
TI  - EPR spectroscopic studies of the reduction of chromium(VI) by methanol in the
      presence of peptides. Formation of long-lived chromium(V) peptide complexes.
AB  - The synthesis and characterization of the first Cr(V) complexes with non-sulfur
      containing peptides, which may mimic the chemistry of the intermediates in the
      formation of Cr-induced peptide-DNA cross-links in vivo, are reported. The
      reduction of Cr(VI) with methanol in the presence of a number of non-sulfur
      containing peptides produced relatively stable Cr(V)-peptide complexes, which
      were characterized by EPR spectroscopy and electrospray mass spectrometry. The
      reaction of Cr(VI) with methanol alone (in the absence of peptide ligands)
      resulted in the formation of two Cr(V)-methanol intermediates, with giso values
      of 1.9765 and 1.9687. The methanol reduction of Cr(VI) in the presence of the
      glycine peptides, triglycine, tetraglycine, and pentaglycine resulted in the
      formation of both Cr(V)-methanol and Cr(V)-peptide intermediates, while only the
      Cr(V)-peptide complexes were detected in the reactions with the alanine peptides
      trialanine, tetraalanine, and pentaalanine. Similar EPR signals were observed for
      all of the Cr(V)-peptide complexes with giso values between approximately 1.986
      and approximately 1.979, and AN values of (2.1-2.6) x 10(-4) cm-1.

PMID- 11195394
TI  - Bimetallic cyanide-bridged complexes based on the photochromic nitroprusside
      anion and paramagnetic metal complexes. Syntheses, structures, and physical
      characterization of the coordination compounds
      [Ni(en)2]4[Fe(CN)5NO]2[Fe(CN)6]x5H2O, [Ni(en)2][Fe(CN)5NO]x3H2O, [Mn(3
      MeOsalen)(H2O)]2[Fe(CN)5NO], and [Mn(5-Brsalen)]2[Fe(CN)5NO].
AB  - The synthesis, crystal structure, and physical characterization of the
      coordination compounds [Ni(en)2]4[Fe(CN)5NO]2[Fe(CN)6]x5H2O (1),
      [Ni(en)2][Fe(CN)5NO]x3H2O (2), [Mn(3-MeOsalen)(H2O)]2[Fe(CN)5NO] (3), and [Mn(5
      Brsalen)]2[Fe(CN)5NO] (4) are presented. 1 crystallizes in the monoclinic space
      group P2(1)/n (a = 7.407(4) A, b = 28.963(6) A, c = 14.744(5) A, alpha = 90
      degrees, beta = 103.26(4) degrees, gamma = 90 degrees, Z = 2). Its structure
      consists of branched linear chains formed by cis-[Ni(en)2]2+ cations and
      ferrocyanide and nitroprusside anions. The presence of two kinds of iron(II)
      sites has been demonstrated by Mossbauer spectroscopy. 2 crystallizes in the
      monoclinic space group P2(1)/c (a = 11.076(3) A, b = 10.983(2) A, c = 17.018(5)
      A, alpha = 90 degrees, beta = 107.25(2) degrees, gamma = 90 degrees, Z = 4). Its
      structure consists of zigzag chains formed by an alternated array of cis
      [Ni(en)2]2+ cations and nitroprusside anions. 3 crystallizes in the triclinic
      space group P1 (a = 8.896(5) A, b = 10.430(5) A, c = 12.699(5) A, alpha =
      71.110(5) degrees, beta = 79.990(5) degrees, gamma = 89.470(5) degrees, Z = 1).
      Its structure comprises neutral trinuclear bimetallic complexes in which a
      central [Fe(CN)5NO]2- anion is linked to two [Mn(3-MeOsalen)]+ cations. 4
      crystallizes in the tetragonal space group P4/ncc (a = 13.630(5) A, c = 21.420(8)
      A, Z = 4). Its structure shows an extended 2D neutral network formed by cyclic
      octameric [-Mn-NC-Fe-CN-]4 units. The magnetic properties of these compounds
      indicate the presence of quasi-isolated paramagnetic Ni2+ and Mn3+. Irradiated
      samples of the four compounds have been studied by differential scanning
      calorimetry to detect the existence of the long-lived metastable states of
      nitroprusside.

PMID- 11195395
TI  - [CoII(4-terpyridone)2]X2: a novel cobalt(II) spin crossover system [4-terpyridone
      = 2,6-bis(2-pyridyl)-4(1H)-pyridone].

PMID- 11195396
TI  - A three-dimensional extended Sb network in the metallic antimonides (M',Ti)5Sb8
      (M' = Zr, Hf, Nb, Mo).
AB  - (M',Ti)5Sb8 was prepared from the melt by arc-melting suitable mixtures of Ti,
      TiSb2, and M'Sb2, respectively. This phase exists at least with M' = Zr, Hf, Nb,
      and Mo. A significant phase range for Zr delta Ti5 - delta Sb8 was found to be
      within 1.10(8) < or = delta < or = 3.9(3). All (M',Ti)5Sb8 representatives
      investigated occur in the same, yet hitherto unknown structure type, as
      determined by single-crystal analyses. E.g., the lattice dimensions of Zr delta
      Ti5 - delta Sb8 range from a = 654.49(3) pm, c = 2662.4(2) pm for delta = 1.10(8)
      to a = 671.06(6), c = 2679.7(4) pm for delta = 3.9(3) (space group I4(1)22, No.
      98, Z = 4). The three chemically inequivalent metal sites are statistically
      occupied by different mixtures of the M atoms M' and Ti, included in a three
      dimensional network of Sb atoms on 6- to 8-fold Sb coordinated positions. Sb-Sb
      bonds of intermediate lengths occur in addition to the predominating
      heteronuclear M-Sb bonds. Physical property measurements of (Zr,Ti)5Sb8 reveal
      these phases being metallic exhibiting specific resistances of several m omega.cm
      and a small Seebeck coefficient at room temperature, in agreement with the
      results of the electronic structure calculations on the LMTO and extended Huckel
      levels. The calculations indicate a possible change to semiconducting properties
      by heavy doping.

PMID- 11195397
TI  - [The effect of exogenous nitric oxide on endothelial dysfunction in two-kidney,
      one-clip renovascular hypertensive rats].
AB  - Previous studies have shown that hypertension causes endothelial dysfunction. To
      study the influence of exogenous nitric oxide(NO) on endothelial dysfunction
      produced by hypertension, we administered a non-depressor dose of nipradilol to
      two-kidney, one-clip renovascular hypertensive rats(2K1C). Sprague-Dawley rats
      underwent either sham surgery(G-1) or clipping of the left renal artery. From day
      seven, 2K1C were randomized into 3 groups, placebo treatment(G-2), nipradilol
      treatment(G-3,) and propranolol treatment(G-4). Urinary NO2- + NO3-(NOx)
      excretion (UNOx V) was measured 4 weeks after clipping, and then,
      acetylcholine(Ach), A23187, or sodium nitroprusside(SNP)-induced relaxation were
      measured in the aorta. Blood pressure was increased in G-2, G-3, and G-4 compared
      to G-1. UNOx V was lower in G-2, G-3, and G-4 compared to G-1, but UNOx V was
      higher in G-3 compared to G-2 and G-4. Although Ach or A23187-induced relaxation
      was significantly decreased in isolated artery from G-2, G-3, and G-4 compared
      with those from G-1. Ach- or A23187-induced relaxation was improved in G-3. SNP
      induced relaxation did not differ among the 4 groups. These results suggest that
      exogenous NO from nipradilol reduces the endothelial dysfunction caused by
      hypertension without changing the blood pressure.

PMID- 11195398
TI  - [Ambulatory blood pressure monitoring in hypertensive CAPD patients].
AB  - The periodic structure of 24-hour blood pressure variation(circadian rhythm of
      blood pressure by ambulatory blood pressure monitoring(ABPM) in hypertensive CAPD
      patients was investigated by a new method of analysis based upon the maximum
      entropy method(MEM). In addition, this method allows the adequacy of
      antihypertensive therapies to be evaluated in such patients. The results were as
      follows; 1) The frequency of non-dipper type hypertension was 88%(36/41 cases),
      and the remaining 12% (5/41) were dipper type hypertension patients. The rise in
      morning blood pressure(morning surge: MS) was noted in 64% of the former. 2)
      Night time systolic blood pressure(182 +/- 22 mmHg, n = 36) was higher in
      patients with non-dipper type hypertension than in those with the dipper type(151
      +/- 17 mmHg, n = 5, p < 0.01). 3) The standardized level of systolic blood
      pressure(SLSBP) calculated by MEM analysis in patients with non-dipper type
      hypertension(177 +/- 7 mmHg) was comparable with that in those with dipper type
      hypertension(168 +/- 13 mmHg, ns). 4) Treatment with long-acting Ca antagonist
      alone significantly reduced both SLSBP and the area over the SLSBP from 188 +/-
      18 mmHg to 160 +/- 7 mmHg(p < 0.01, n = 8), and area over the SLSBP from 2,735 +/
      340 mmHg.hr to 1,945 +/- 298 mmHg.hr(p < 0.01, n = 8). 5) In addition to long
      acting Ca antagonist, administration of alpha 1-blocker given at bed time was
      significantly efficacious in reducing the rise in morning blood pressure, MS. The
      present study using MEM analysis of ABPM suggests that the blood pressure profile
      of hypertensive CAPD patients is characterized by a non-dipper type dominance and
      a frequent morning surge. Furthermore, the combined therapy with long-acting Ca
      antagonist and alpha 1-blocker was substantially effective both in reducing the
      overall blood pressure level, and in inhibiting the MS. This combined
      antihypertensive therapy may be potentially useful to prevent CAPD patients from
      the future development of cardiovascular complications.

PMID- 11195399
TI  - [The effects of ACE inhibitor treatment and ACE gene polymorphism on
      erythropoiesis in chronic hemodialysis patients].
AB  - Aggravation of anemia in chronic renal failure patients by angiotensin-converting
      enzyme inhibitors (ACEIs) has been attributed to the inhibition of angiotensin II
      which facilitates erythropoietin(Epo) production. This study was aimed at
      evaluating whether ACEIs aggravate anemia in maintenance hemodialysis patients
      and to investigate the influence of ACE gene polymorphism on erythropoiesis in
      these patients. Ninety-one hemodialysis patients were divided into 2 groups,
      based on whether or not they were administered ACEIs, into the ACEI group(n = 24)
      and the non-ACEI group(n = 67), and comparisons were made of the doses of
      recombinant human Epo(rHuEpo) administered, the hematocrit(Hct) and the plasma
      Epo concentrations. Among the patients in the non-ACEI group, only 17 did not
      receive rHuEpo, while all of the patients in the ACEI group received rHuEpo. The
      average dose of rHuEpo was 102.7 +/- 45.4 IU/kg/week in the ACEI group and 57.8
      +/- 55 IU/kg/week in the non-ACEI group and the difference between the two groups
      was statistically significant. A statistically significant difference in the Hct
      was also observed between the two groups: the mean Hct in the ACEI group was 28.7
      +/- 2.9% while that in the non-ACEI group was 31.1 +/- 3.7%. The plasma Epo
      concentrations were significantly lower in the ACEI group than in the non-ACEI
      group. No significant differences in the rHuEpo dose and Hct were observed
      between the three ACE genotype classes in either the ACEI or the non-ACEI group,
      however, there was a significant difference among the three genotypes in the non
      ACEI group in regard to the plasma Epo concentrations; patients with the DD
      genotype had higher concentrations than those with the DI or II genotypes. These
      data suggest that anemia in maintenance hemodialysis patients is worsened by
      ACEIs as a result of the suppression of Epo production. Although it has been
      suggested that the endogenous Epo concentrations in maintenance hemodialysis
      patients are associated with ACE gene polymorphism, no significant influence of
      the ACE genotype on the rHuEpo dose or Hct was evident. Therefore, it is possible
      that exacerbation of anemia by ACEIs in the patients receiving rHuEpo is a result
      of an inhibited bone marrow response to Epo.

PMID- 11195400
TI  - [A case of high-age minimal change nephrotic syndrome relapse after 18-year
      remission and effective treatment with steroid and cyclosporin combined therapy].
AB  - We describe the clinical course of a 69-year-old woman, who suffered from minimal
      change nephrotic syndrome(MCNS) after long-term remission. In 1979, she was
      admitted to Kanazawa University Hospital due to MCNS verified by renal biopsy and
      was treated with oral prednisolone(initially 40 mg/day) for two years. She
      suffered from edema again in 1999 with massive proteinuria. Renal biopsy revealed
      minor glomerular abnormality without any deposition of immunoglobulins or
      complements. Electron microscopic findings showed extensive foot process
      effacement. Therefore, we diagnosed this case as a recurrence of MCNS. She was
      treated with the combination of methylprednisolone pulse therapy(500 mg, 3 days),
      oral prednisolone(20 mg/day) and cyclosporin(CyA, 3 mg/kg/day), which could
      induce earlier complete remission. These results suggest that recurrence after
      long-term remission could occur in adult-onset MCNS and that the combination
      therapy of prednisolone and CyA may be effective for the induction of early
      remission in MCNS.

PMID- 11195402
TI  - NCCN outcomes research database: data collection via the Internet.
AB  - Since 1997, the National Comprehensive Cancer Network (NCCN) outcomes database
      has successfully collected and reported patterns of care and outcomes data in the
      oncology setting. Breast cancer was the first cancer site chosen for this
      outcomes study, with non-Hodgkin's lymphoma targeted as the next site. Quarterly
      reports of the data are compiled and distributed to all participating centers.
      The results for each institution are given to the Principal Investigator at the
      respective institution. At present, the NCCN database contains more than 100,000
      records of longitudinal data on more than 5,000 women with breast cancer.
      Extending data collection to the community setting is a goal.

PMID- 11195401
TI  - [Three cases of severe hyponatremia under taking selective serotonin reuptake
      inhibitor (SSRI)].
AB  - The association between selective serotonin reuptake inhibitors(SSRIs) and
      hyponatremia has been documented throughout the world. In Japan, since SSRIs have
      recently come into use for patients with depression, there are only a few reports
      of hyponatremia associated with SSRIs. We present here three cases of the
      syndrome of inappropriate secretion of antidiuretic hormone(SIADH) associated
      with the administration of fluvoxamine for depression. They were admitted to our
      hospital because of deep coma, and revealed severe hyponatremia. Their serum
      sodium levels were 103-112 mEq/l, serum osmolalities were 227-241 mmol/kg, urine
      sodium levels were 38-107 mEq/l, and urine osmolalities were 352-781 mmol/kg.
      These patients were started on fluvoxamine 3 days-3 months previously. The
      diagnosis of SIADH in these patients was made based on hyponatremia, and low
      serum and high urine osmolalities. The fluvoxamine treatment was discontinued,
      and hypertonic saline was infused. Their serum sodium levels and osmolalities
      were subsequently normalized. None of the other known causes of hyponatremia,
      including diuretic therapy, tumors, and respiratory and central nervous system
      diseases, were present. High plasma AVP levels observed in the two cases suggest
      that SSRIs stimulate AVP secretion, thereby causing SIADH. Many reports have
      shown that people older than 70 years were at a particularly high risk of
      developing hyponatremia when SSRIs were used. In the future, since the use of
      SSRIs will be increasing, the water and electrolyte balance of elderly patients
      should be monitored carefully during SSRIs therapy.

PMID- 11195403
TI  - Using tumor registry resources in analyzing concordance with guidelines and
      outcomes.
AB  - Collection and analysis of standardized multi-institutional outcomes data is a
      labor-intensive process. As the National Comprehensive Cancer Network (NCCN)
      seeks to expand its Outcomes Database to include multiple primary tumor types,
      the amount of time and effort required for detailed data abstraction and
      transmission will become an obstacle for many primary institutions. In addition,
      as the NCCN Guidelines become more widely distributed and adopted in the oncology
      community, it would be appealing to evaluate guideline concordance and quality of
      care in community hospitals and community-based physician practices vs major
      cancer centers. However, methods for case finding and collection of detailed
      outcomes data in the community setting are not well established. Most cancer
      centers and community hospitals have already set aside resources for maintaining
      a local tumor registry that includes limited information on demographics,
      diagnosis, staging, treatment, and survival for all new cancer patients treated
      at the specific institution. One strategy that can be used to facilitate a global
      outcomes program within the NCCN community calls for capitalizing on existing
      local database resources and experienced coding and data management staff.

PMID- 11195404
TI  - The managed-care perspective for improving quality.
AB  - The role of managed-care organizations (MCOs) is to determine the existence of a
      benefit and how it is to be covered. Clinical guidelines and evidence-based
      medicine are critical parts of those decisions, and help drive much of the
      medical policies of MCOs. The goal is to identify and support medically
      appropriate and cost-effective interventions, and not cover treatments that do
      not have those characteristics. This will become increasingly important as more
      payers move to defined contribution plans, which place added responsibility for
      care decisions on the medical care consumer. Improving quality, creating
      consistency, and establishing the credibility of MCOs and their guidelines are
      imperative for integrating evidence-based medicine into coverage decisions. The
      ultimate outcome sought by MCOs and payers is improvement of the health of the
      populations they serve.

PMID- 11195405
TI  - NCCN Practice Guidelines for Prostate Cancer.
AB  - Systemic therapies for prostate cancer are likely to improve, and as they do,
      they will have enormous impact on the treatment of high-risk and locally advanced
      cancers. Further technical improvements in radiotherapy and alternative local
      modalities, such as cryoablation, are also likely, and will bring even more
      options for local control. It is certain these guidelines will continue to
      evolve.

PMID- 11195406
TI  - New developments in the treatment of acute myeloid leukemia.
AB  - Curative therapy for acute myeloid leukemia (AML) remains unsatisfactory.
      However, three recent advances may play an important role in determining how AML
      is treated in the near future. First, the development of targeted antibody
      therapy using the anti-CD33-calicheamicin conjugate (gemtuzumab ozogamicin,
      Mylotarg) represents a novel targeted approach to the killing of leukemia cells.
      Second, modern molecular methods have improved our ability to identify minimal
      residual disease (MRD) in patients who appear to be in remission. These methods
      will allow physicians to tailor therapy, offering, for example, more intensive
      therapy to patients who harbor MRD. Lastly, the development of microarray gene
      expression technology allows for the simultaneous study of thousands of genes.
      With this technology, we may determine the genes responsible for the biological
      properties of treatment response and relapse in leukemia patients.

PMID- 11195408
TI  - NCCN Practice Guidelines for Cancer-Related Fatigue.
AB  - These guidelines propose a treatment algorithm in which patients are evaluated
      regularly for fatigue, using a brief screening instrument, and are treated as
      indicated by their fatigue level. The algorithm's goal is to identify and treat
      all patients with fatigue that causes distress or interferes with daily
      activities or functioning. Management of fatigue begins with primary oncology
      team members who perform the initial screening and either provide basic education
      and counseling or expand the initial screening to a more focused evaluation for
      moderate or higher levels of fatigue. At this point the patient is assessed for
      the five primary factors known to be associated with fatigue: pain, emotional
      distress, sleep disturbance, anemia, and hypothyroidism. If any of these
      conditions are present, it should be treated according to practice guidelines,
      and the patient's fatigue should be reevaluated regularly. If none of the primary
      factors is present or the fatigue is unresolved, a more comprehensive assessment
      is indicated--with referral to other care providers as appropriate. The
      comprehensive assessment should include a thorough review of systems, review of
      medications, assessment of comorbidities, nutritional/metabolic evaluation, and
      assessment of activity level. Management of fatigue is cause-specific when
      conditions known to cause fatigue can be identified and treated. When specific
      causes, such as infection, fluid and electrolyte imbalances, or cardiac
      dysfunction, cannot be identified and corrected, nonpharmacologic and
      pharmacologic treatment of the fatigue should be considered. Nonpharmacologic
      interventions may include a moderate exercise program to improve functional
      capacity and activity tolerance, restorative therapies to decrease cognitive
      alterations and improve mood state, and nutritional and sleep interventions for
      patients with disturbances in eating or sleeping. Pharmacologic therapy may
      include drugs such as antidepressants for depression or erythropoietin for
      anemia. A few clinical reports of the use of corticosteroids and psychostimulants
      suggest the need for further research on these agents as a potential treatment
      modalities in managing fatigue. Basic to these interventions, the effective
      management of cancer-related fatigue involves an informed and supportive oncology
      care team that assesses patients' fatigue levels regularly and systematically and
      incorporates education and counseling regarding strategies for coping with
      fatigue (Johnson, 1999), as well as using institutional fatigue management
      experts for referral of patients with unresolved fatigue.

PMID- 11195407
TI  - NCCN Practice Guidelines for Cancer Pain.
AB  - The overall approach to pain management encompassed in these guidelines is
      comprehensive. It is based on objective pain assessments, utilizes both
      pharmacologic and nonpharmacologic interventions, and requires continual
      reevaluation of the patient. The NCCN Cancer Pain Practice Guidelines Panel
      believes that cancer pain can be well controlled in the vast majority of patients
      if the algorithms presented are systematically applied, carefully monitored, and
      tailored to the needs of the individual patient.

PMID- 11195409
TI  - NCCN Practice Guidelines for Head and Neck Cancers.

PMID- 11195410
TI  - Oncology business update.
AB  - This article explores a variety of environmental factors that influence the
      delivery of oncology care in both academic and community settings. These factors
      include fragmentation of the managed-care process, increased backlash to managed
      care organizations, greater federal and state intervention, and new technologies,
      medicines, and procedures. The author also discusses continued consolidation of
      managed-care organizations, as well as how physicians and hospitals are being
      compensated for oncology services. Other topics explored include the progress of
      case rate and capitation as an alternative to fee-for-service medicine, the
      latest events in insurer coverage of clinical trials, and the progress of
      oncology disease management. In addition, the author discusses the interest of
      national payers in the management of oncology services and delivery mechanisms
      for highly specialized oncology services.

PMID- 11195411
TI  - NCCN Practice Guidelines for Colorectal Cancer.
AB  - The NCCN Colorectal Cancer Guidelines panel believes that a multidisciplinary
      approach is necessary for the management of the patient with colorectal cancer.
      The panel endorses the concept that treatment of patients in a clinical trial has
      priority over standard or accepted therapy. The recommended surgical procedure
      for resectable colon cancer is an en bloc resection; laparoscopic surgery should
      be done only in the context of a clinical trial. For patients with stage III
      disease, 5-FU-based adjuvant therapy is recommended. A patient who has metastatic
      disease in the liver or lung should be considered for surgical resection if he or
      she is a candidate for surgery and if surgery can extend survival. Surgery should
      be followed by adjuvant chemotherapy. The panel advocates a conservative post
      treatment surveillance program for colon and rectal carcinoma patients. Serial
      CEA determinations are appropriate if the patient is a candidate for aggressive
      surgical resection, should recurrence be detected. Abdominal and pelvic CT scans
      should be utilized only when there are clinical indications of possible
      recurrence. Patients whose disease progresses during 5-FU-based therapy should be
      treated with irinotecan or encouraged to participate in a phase I or phase II
      clinical trial.

PMID- 11195412
TI  - The NCCN/American Cancer Society partnership.
AB  - The National Comprehensive Cancer Network (NCCN) partnered with the American
      Cancer Society two years ago in an effort to translate the NCCN Practice
      Guidelines for professionals into guidelines for patients. The response from
      patients to the first two guidelines was overwhelmingly positive. The following
      panel discussion provides some background information on this alliance and
      discusses the development and highlights of their latest collaboration, the
      Colorectal Cancer Patient Guidelines.

PMID- 11195413
TI  - Novel therapeutic approaches for metastatic colorectal cancer.
AB  - More than 4 decades after its discovery, 5-FU remains an important part of the
      treatment of colorectal cancer. However, the advent of new agents and the
      discovery of novel molecular targets have opened a new era in the treatment of
      this disease. Recent trials of combinations of 5-FU, leucovorin, and either
      irinotecan or oxaliplatin have produced exciting results that warrant
      consideration of these regimens as front-line therapies for colorectal cancer.
      Having produced consistent improvements in response rate, progression-free
      survival duration, and overall survival duration, the combination of 5-FU,
      leucovorin, and irinotecan is rapidly becoming the standard against which newer
      regimens will be compared. Nevertheless, the improvements in survival achieved so
      far have remained relatively small. Whenever possible, patients should be
      encouraged to participate in well-designed clinical trials of new regimens.
      Despite the impressive advances of the past few years, advanced colorectal cancer
      remains a highly lethal disease.

PMID- 11195414
TI  - General guidelines for the management of older patients with cancer.
AB  - Because aging is highly individualized, the best guide to treatment of the older
      patient with cancer may be provided by a comprehensive assessment that evaluates
      such diverse areas as functional status, comorbidity, socioeconomic conditions,
      nutrition, polypharmacy, and the presence or absence of geriatric syndromes.
      Aging is further associated with important pharmacologic changes that involve
      pharmacokinetics, pharmacodynamics, and the toxicity profile of the drugs. These
      changes increase the risk of therapeutic complications partly because of the
      different behavior of the disease in an older patient population and partly
      because of a decreased tolerance to treatment in some older patients.

PMID- 11195415
TI  - NCCN Practice Guidelines for Chronic Myelogenous Leukemia.

PMID- 11195416
TI  - Role of oral chemotherapy in colorectal cancer.
AB  - Despite the long clinical history of 5-FU in gastrointestinal cancer, the
      development of oral agents has been a productive endeavor, and oral
      fluoropyrimidine agents are likely to play an important role in the management of
      colorectal cancer. Results of recent trials in advanced/metastatic colorectal
      cancer have shown equivalence of response rates, time to disease progression, and
      median survival and reduced rates of neutropenia and stomatitis with oral
      capecitabine (Xeloda) or UFT/leucovorin compared with standard fluorouracil (5
      FU)/leucovorin regimens. Evaluation of these oral agents in adjuvant therapy, in
      combination chemotherapy, and in combination with radiation therapy is ongoing.

PMID- 11195417
TI  - The NCCN guidelines development process and infrastructure.
AB  - A major task of the National Comprehensive Cancer Network (NCCN) is to develop
      pathways reflecting the major step-by-step management decisions required to
      provide care for patients with cancer. The determination of what is appropriate
      care involves assessing the balance between the sum of the benefits compared to
      the sum of the risks. The guidelines are composed of recommendations based on the
      best evidence available at the time they are derived. Each guideline is reviewed
      annually and once revisions have been uniformly accepted, the new version becomes
      the official NCCN guideline for that year.

PMID- 11195418
TI  - NCCN Practice Guidelines for Breast Cancer.
AB  - The therapeutic options for patients with noninvasive or invasive breast cancer
      are complex and varied. In many situations, the patient and physician have the
      responsibility to jointly explore and ultimately select the most appropriate
      option from among the available alternatives. With rare exception, the
      evaluation, treatment, and follow-up recommendations contained within these
      guidelines were based largely on the results of past and present clinical trials.
      However, there is not a single clinical situation in which the treatment of
      breast cancer has been optimized with respect to either maximizing cure or
      minimizing toxicity and disfigurement. Therefore, patient and physician
      participation in prospective clinical trials allows patients not only to receive
      state-of-the-art cancer treatment but also to contribute to the improvement of
      treatment of future patients.

PMID- 11195419
TI  - NCCN Practice Guidelines for Acute Myelogenous Leukemia.

PMID- 11195420
TI  - Oncology legislative update.
AB  - This article reviews current legislative and regulatory issues of importance to
      the oncology community. Topics include patient protection, Medicare support of
      clinical trials, research data protection, the Medical Innovation Tax Credit,
      National Cancer Institute appropriations, and medical record privacy issues.
      Other topics discussed included funding for stem-cell research, genetic therapy
      oversight, and coverage for uninsured patients.

PMID- 11195421
TI  - Contribution of anemia to fatigue in the cancer patient.
AB  - One of the goals of the proposed National Comprehensive Cancer Network Practice
      Guidelines for Cancer-Related Fatigue is outlining a systematic approach to the
      evaluation, intervention, and assessment of outcome in the treatment of fatigue.
      Anemia has been characterized as a major contributor to fatigue, and a review of
      patients receiving cancer therapy showed that the majority developed anemia. The
      current data support the value of returning hemoglobin levels to the normal range
      in terms of maximizing improvements in quality of life related to anemia. The
      potential impact of anemia in terms of treatment outcome is under investigation.

PMID- 11195422
TI  - Considerations in the management of myeloma.
AB  - Multiple myeloma remains an incurable cancer. In recent years, progress in
      different drug classes has improved outcomes, but management has become more
      complicated. Areas such as prognostic classification, the increased use of high
      dose chemotherapy with autologous stem-cell rescue, and a wider array of
      ancillary drugs must be integrated into recommendations for a consolidated
      treatment plan. Estimating prognosis is dependent on both clinical features and a
      growing list of laboratory tests. Autologous transplantation has been applied to
      an increasing proportion of patients, at different points in the disease process.
      Besides the age cut-off issue, there are still significant treatment choices to
      be made within the transplant technique. Newer drugs, most recently, thalidomide
      (Thalomid), may offer benefits independent of conventional cytotoxic drugs or
      steroids. Use of ancillary drugs, such as bisphosphonates, interferon, P
      glycoprotein blockers, antibiotics, and growth factors, are also discussed. For
      the future, immunotherapy in the posttransplant setting appears promising.
      Ultimately, basic research must identify intracellular targets for the
      development of specific new-generation drugs.

PMID- 11195423
TI  - Managed care companies and the practice of medicine.
AB  - One of the major issues pertaining to the pending legislation for Patient's Bill
      of Rights is the potential of liability health care plans, particularly when they
      decline coverage they consider not medically necessary. We call these contracts
      "managed health care" plans. But, realistically, when is it managing? When is it
      medicine? When, if at all, does management undermine medicine? And if it does,
      should managed care organizations--and their representatives--be held legally
      liable for medical decisions that go wrong? A panel of seven experts examines
      these questions from medical, payment, patient, legal, insurance, and governing
      viewpoints.

PMID- 11195424
TI  - National Cancer Policy Board Report.
AB  - While collecting information for a consumer pamphlet to assist cancer patients in
      navigating through the medical system, the National Cancer Policy Board
      discovered the data that were available were critically insufficient. In
      response, the turned their attention to analyzing our ability to assess quality
      of cancer care. Their findings along with ten recommendations were published in
      April 1999. In particular, their conclusions concerning data collection and
      volume outcomes surprised many in the oncology community. These comments along
      with five of their recommendations--high-volume settings, standard guidelines,
      the elements of quality care, measuring and monitoring quality care, and end-of
      life care--are presented in this panel discussion.

PMID- 11195425
TI  - Influence of benzyl benzoate as oil core on the physicochemical properties of
      spray-dried powders from polymeric nanocapsules containing indomethacin.
AB  - To prepare spray-dried powders of poly(D,L-lactic acid) (PLA) or poly-epsilon
      caprolactone (P epsilonC) from colloidal suspensions containing indomethacin
      (IND) using benzyl benzoate (BnB), nanocapsules (NC) were prepared by
      nanoprecipitation. To select the best NC formulations, increasing drug
      concentrations were tested (1.0, 1.5, or 2.0 mg/mL). The particle size was
      measured by Nanosizer. Spray-dried powders (SDP) were prepared by addition of
      Aerosil 200 into suspensions of NC. IND was assayed by HPLC. Free IND was
      determined using an Ultrafree. NC-SPD were examined under SEM. The particle sizes
      of all formulations are in the sub-300 nm range and are IND-associated, with drug
      recovery close to 100%. After 1 month, the formulations with highest drug content
      (2.0 mg/mL) showed a decline of total quantity of IND. After spray-drying, IND
      recovery for SDP presented values above 100%, indicating that the drug was
      concentrated from loss of mass during the process. To verify the relationship of
      oil phase with this loss of mass, similar NC (IND 1.5 mg/mL) prepared with
      Miglyol 810 (MI) were spray-dried, and SEM analysis showed nanostructures
      adsorbed onto SiO2. Similar nano-structures were not visualized for NC samples
      prepared with BnB. A swelling experiment showed the complete dissolution of both
      polymer by the BnB, whereas for MI the polymer masses remained unchanged. In
      conclusion, BnB is a solvent for PLA and P epsilonC and this ester is entrained
      during spray-drying. Despite the use of BnB in formulations of NC, PLA, or P
      epsilonC, colloidal suspensions prepared with BnB could be micelles instead of
      nanocapsules.

PMID- 11195426
TI  - Pluronic F127-based ocular delivery system containing biodegradable
      polyisobutylcyanoacrylate nanocapsules of pilocarpine.
AB  - The objectives of our study were to prepare a biodegradable
      polyisobutylcyanoacrylate (PIBCA) colloidal particulate system of pilocarpine, to
      incorporate it into a Pluronic F127(PF127)-based gel delivery system, and to
      evaluate its ability to prolong the release of pilocarpine.
      Polyisobutylcyanoacrylate nanocapsules (PIBCA-NC) of pilocarpine were prepared by
      interfacial polymerization. Physicochemical characterization of the colloidal
      dispersion of PIBCA-NC of pilocarpine was performed by measuring drug loading,
      particle size analysis, and scanning electron microscopy. Results indicated that
      approximately 13.5% of pilocarpine was loaded onto the PIBCA-NC, the nanocapsules
      ranged from 370 to 460 nm, the distribution was narrow, and there was no
      significant effect of stirring speed on particle size. The PIBCA-NC dispersion of
      1% pilocarpine alone (I) and after incorporation into the Pluronic F127 gel
      delivery system (II) were compared against 1% pilocarpine incorporated into a
      PF127 gel containing 5% methylcellulose (PF127MC) alone (III) by measuring the
      miotic response in the albino rabbit eye. Statistical analysis indicated a rank
      order for both the duration and intensity of miosis of II > III >> I, with all
      differences being significant (p < 0.05). Thus, it appears that II increases the
      contact time of pilocarpine with the absorbing tissue in the eye, thereby
      improving ocular bioavailability. The PIBCA-NC of pilocarpine dispersed in the
      PF127MC gel delivery system has considerable potential for achieving a prolonged
      delivery for such drugs as pilocarpine and other more hydrophobic drugs.

PMID- 11195427
TI  - Targeting of liposomal andrographolide to L. donovani-infected macrophages in
      vivo.
AB  - Despite the rapid development in medicinal and pharmaceutical technology, the
      targeting of drugs to phagocytic cells in macrophage-related diseases still
      remains a major unsolved problem. By using the mannosyl-fucosyl receptors on
      macrophages, attempts were made to target antileishmanial drugs encapsulated in
      mannosylated or fucosylated liposomes to treat experimental leishmaniasis in the
      hamster model. Mannosylated liposomes were found to be more potent in delivering
      antileishmanial drugs to phagocytic cells. Liposomes loaded with an indigenous
      drug, andrographolide, a labdane diterpenoid isolated from Indian medicinal plant
      Andrographis paniculata, were prepared and tested against experimental
      leishmaniasis in a hamster model. Mannosylated liposomes loaded with the drug
      were found to be most potent in reducing the parasitic burden in the spleen as
      well as in reducing the hepatic and renal toxicity. In addition, mannosylated
      drug-loaded liposome-treated animals showed a normal blood picture and splenic
      tissue histoarchitecture when compared with those treated with free drug or
      regular liposomal drug. Such a drug-vehicle formulation may be considered for
      clinical trials.

PMID- 11195428
TI  - Effect of nanoparticles on digitoxin uptake and pharmacologic activity in rat
      glomerular mesangial cell cultures.
AB  - Our experiments analyzed the uptake of free and nanoparticles (NP)-associated
      digitoxin (DGT) by rat glomerular mesangial cells. NP were prepared by the
      nanoprecipitation method using the biodegradable polyester, polycaprolactone
      (PCL). Prior to in vitro experiments, the systems were characterized by means of
      spectrofluorimetry, dynamic light scattering, and size exclusion chromatography
      (SEC). The loading efficiency was 80.30 +/- 1.03% of the initial DGT amount in
      the preparation, and the average particle size was 176 +/- 8 and 161 +/- 6 nm for
      DGT-NP and "empty" NP, respectively. SEC studies revealed noncovalent
      interactions among the different chemical compounds in the formulation. In vitro
      experiments were conducted at 37 degrees C and pH 7.5 by incubating "empty" NP,
      free DGT or DGT-NP (10 microg PCL/mL; 100 ng DGT/mL) with glomerular mesangial
      cells for 30 and 60 min. Uptake of DGT by the cells was favored by its
      incorporation into PCL-NP and showed time dependency. After 30 min of incubation,
      no significant differences of drug uptake were seen between free DGT (13.1 +/-
      2.8%) or DGT-NP (17.4 +/- 4.9%); however, the uptake of DGT, when it was
      associated to the polymeric carrier, increased by approximately 2-fold (37.8 +/-
      5.7%) at 60 min, whereas no significant changes were observed for free drug (20.0
      +/- 6.8%). The pharmacologic activity of the drug was evaluated by measuring the
      planar cell surface area (PCSA). "Empty" NP, free drug, or DGT-NP did not produce
      significant variations on the PCSA as compared with control cells after a 30-min
      incubation. Nonetheless, DGT-NP reduced the PCSA to 82.51 +/- 8.42% of control
      values when the incubation lasted 60 min. The ability of cells to exclude the
      trypan blue dye and the leakage of lactate dehydrogenase into the medium revealed
      no signs of increased toxicity from incorporation of DGT into PCL-NP. Therefore,
      PCL-NP improved drug uptake by the cells without altering the pharmacologic
      activity and toxicity of the drug. Thus, they can be a useful approach to target
      drugs to the kidneys or the heart.

PMID- 11195429
TI  - Development and evaluation of nasal formulations of ketorolac.
AB  - Ketorolac tromethamine is a potent non-narcotic analgesic with moderate anti
      inflammatory activity. Clinical studies indicate that ketorolac has a single dose
      efficacy greater than morphine for postoperative pain and has excellent
      applicability in the emergency treatment of pain. Due to incomplete oral
      absorption of ketorolac, several approaches have been tried to develop a nonoral
      formulation in addition to injections, especially for the treatment of migraine
      headache. The aim of our study was to develop a nasal formulation of ketorolac
      with a dose equivalent to the oral formulation. A series of spray and lyophilized
      powder formulations of ketorolac were administered into the nasal cavity of
      rabbits, and their pharmacokinetics profiles were assessed. The spray and powder
      formulations were compared through their pharmacokinetics parameters and absolute
      bioavailability. Drug plasma concentration was determined using solid phase
      extraction, followed by an HPLC analysis. Nasal spray formulations were
      significantly better absorbed than powder formulations. A nasal spray formulation
      of ketorolac tromethamine showed the highest absorption with an absolute
      bioavailability of 91%. Within 30 min of administration, the plasma concentration
      was comparable to that resulting from an intravenous injection. The absolute
      bioavailability of a solution of ketorolac acid was 70%. Apparently, the
      dissolution of ketorolac acid into the mucous layer limits its absorption. There
      were no significant differences in absorption between different powder
      formulations. Even the reduction of particle size from 123 microm to 63 microm
      did not indicate better absorption of ketorolac tromethamine from powder
      formulations. Interestingly, the absolute bioavailability of ketorolac
      tromethamine from a powder formulation is only 38%, indicating that the drug may
      not be totally released from the polymer matrix before it is removed from nasal
      epithelium by mucociliary clearance.

PMID- 11195430
TI  - Effect of nicotinic acid conjugated to DNA-transfecting complexes targeted at the
      transferrin receptor of HeLa cells.
AB  - A conjugate consisting of streptavidin (biotinylated transferrin)-biotinylated
      polylysine for DNA delivery to cells was modified by partial nicotinylation of
      the polylysine component of the conjugate and used for transfection studies. A
      conjugate of biotin10-nicotinyl60-polylysine250 containing 60 weakly basic
      nicotinyl (pyridine-3-carboxyl) residues was prepared. The design of the modified
      polylysine was directed to the possible binding of H+ ions in the endosome
      lysosomal vesicles (pH 5-6) by the nicotinyl groups, thus circumventing the use
      of chloroquine. The results obtained, however, while showing a 5- to 6-fold
      increase in luciferase transfection activity still necessitated an absolute
      requirement for chloroquine. A further polylysine conjugate containing a larger
      number of nicotinyl residues, biotin10-nicotinyl120-polylysine250, also was
      prepared and studied. This macromolecule stimulated luciferase activity to a
      small extent and was also dependent on chloroquine. Smaller biotinylated
      polylysine100 conjugates containing nicotinyl groups were also prepared. These
      were biotin10-nicotinyl30-polylysine100, and biotin10-nicotinyl60-polylysine100,
      respectively. Both substances, however, gave opaque, hazy aqueous solutions with
      precipitates on standing and could not be used for further experimental work. The
      results indicate that the introduction of weakly basic nicotinyl (pyridine-3
      carboxyl) groups onto polylysine250 give conjugates that are unable to replace
      the lysosomotrophic agent chloroquine in the HeLa cell sysem studied. A 5- to 6
      fold increase in luciferase activity, however, was found with biotin10
      nicotinyl60-polylysine250.

PMID- 11195431
TI  - Positively charged gelatin microspheres as gastric mucoadhesive drug delivery
      system for eradication of H. pylori.
AB  - Gastric mucoadhesive drug delivery systems are very promising for eradication of
      Helicobacter pylori (H. pylori), a spiral bacterium that resides in the gastric
      mucus layer and at the mucus-epithelial cell interface. New positively charged
      biodegradable microspheres were prepared using aminated gelatin by surfactant
      free emulsification in olive oil, followed by a cross-linking reaction with
      glutaraldehyde. The amino group contents of the modified gelatin and the
      microspheres were determined using a 2,4,6-trinitrobenzenesulfonic acid method.
      With the increase of glutaraldehyde concentration, the amino group content of the
      microspheres decreased accordingly. The influence of glutaraldehyde
      concentration, cross-linking reaction time, drug-loading patterns, and type of
      release media on the in vitro release characteristics of amoxicillin from the
      microspheres was investigated. Amoxicillin release rate from the modified gelatin
      microspheres was significantly reduced compared with that from gelatin
      microspheres. Furthermore, the release was decreased with the increase of
      glutaraldehyde concentration and/or cross-linking time. On the other hand, a
      faster release was observed in a lower pH release medium and/or using a lower pH
      solution for amoxicillin loading. The gastric mucoadhesive properties of the
      microspheres were evaluated using RITC-labeled microspheres in an isolated rat
      stomach. The gastric mucoadhesion of the modified gelatin microspheres was
      markedly improved compared with that of gelatin microspheres. The modified
      gelatin microsphere proves to be a possible candidate delivery system for the
      effective eradication of H. pylori.

PMID- 11195432
TI  - Repeat efforts pay off for cardiovascular initiative.

PMID- 11195433
TI  - Hospital finds nutrition care pays off on all counts, cutting costs,
      complications, mortality.
AB  - Identifying and treating malnutrition early reduces hospital stays,
      complications, and mortality. St. Francis Healthcare Services in Wilmington, DE,
      reports a two-year cost avoidance of $2.4 million from the reduced length of stay
      attributed to its malnutrition program. The program includes a screen to identify
      patients at high-risk of developing malnutrition and an algorithm for aggressive
      restorative care.

PMID- 11195435
TI  - Late-night, on-site radiologist reduces X-ray errors in the ER.
AB  - Hospital supports after-hours' radiologist with competitors' business. St.
      Elizabeth Health Partners in Covington, KY, pools readings from four other
      facilities to provide enough work to lure radiologists into evening shifts. With
      radiologists now reading X-rays on-site in the ER at night, return visits due to
      misinterpreted exams have been almost eliminated.

PMID- 11195434
TI  - Sending PharmD candidates to patients' homes can avert potential medication
      problems.
AB  - Pharmacists' home visits avert outpatient medication troubles. Crozer-Keystone
      Health System in Springfield, PA, has pharmacy students evaluate patients at home
      to address risk factors that could send the patients back to the hospital. The 3
      year-old program has prevented at least five hospitalizations.

PMID- 11195436
TI  - Pharmacy expenses generally less than $10 million in 1998.
AB  - Data Benchmarks: According to the American Society of Health-System Pharmacists'
      1999 survey, 57% of hospital pharmacies had operating expenses of $1 million to
      $9 million in fiscal 1998, with hospitals in the Northeast and West leading the
      pack.

PMID- 11195437
TI  - [Rh-prophylaxis or not? Recommendations are wanted].

PMID- 11195438
TI  - [Alarming increase of esophageal cancer. Is antireflux surgery an efficient
      prevention?].

PMID- 11195439
TI  - [Rh-prophylaxis or not? Obstetric departments should make decisions if there are
      medical reasons which justify the treatment].
AB  - In order to find out whether or not the incidence rate of RhD-immunization has
      increased in pregnant women who were not given antenatal prophylaxis a survey was
      carried out comprising 620 women. It was evident that the number of new
      immunizations had decreased, both in absolute numbers and in relation to the
      number of births during the years 1991-1998. Hence prophylactic anti-D seems not
      to be indicated, neither for this group of women nor for women who have had a
      spontaneous abortion.

PMID- 11195440
TI  - [Fireworks explosion in Enschede in May 2000. The course, rescue work and
      consequences].

PMID- 11195441
TI  - [To be mentally disabled is popular in California--consequences of the new Three
      strikes and you're out law].

PMID- 11195442
TI  - [The "filling-in-trap". Our sences deceive us].
AB  - We use various strategies in order to attain a complete knowledge of reality. One
      of these is using "filling-in". What is and is not filling-in is discussed. The
      brain may process light which reaches the retina in two fundamentally different
      ways. The conclusion is that many a patient with perimetrically verifiable visual
      field defects with each eye separately experiences a complete image of his total
      surrounding. The quality of this image correlates to the neuronal capacity of the
      retina in question. What generally has been assumed to be due to filling-in is in
      this specific instance a newly discovered faculty in the system consisting of eye
      and brain naively, we have walked straight into the trap of blaming this faculty
      on filling-in.

PMID- 11195443
TI  - [Did Saint Birgitta suffer from epilepsy?].

PMID- 11195444
TI  - [Scrutiny of alternative medicine. "Distant healing"--a special kind of
      telemedicine].

PMID- 11195445
TI  - [The neglected inside of human beings. Lack of competence among personnel when it
      comes to patients' needs of existential and spiritual talks].

PMID- 11195446
TI  - [The Santa lives dangerously].

PMID- 11195447
TI  - [Cosmas and Damianos. Altruistic twin physicians who were used by rich ruling
      dynasty].

PMID- 11195448
TI  - [Psychiatric clinics--closed or moved? Significant part of current around-the
      clock care is now invisible].

PMID- 11195449
TI  - [Physicians--future leaders?].

PMID- 11195450
TI  - [Sjonell and Stahle give misleading information on mammography screening].

PMID- 11195451
TI  - [Reply: the factual matter is the most important].

PMID- 11195452
TI  - [Is work-related stress the primary cause of sudden death?].

PMID- 11195453
TI  - [Is it always a matter of fact to prevent HIV transmission to the fetus/child?].

PMID- 11195454
TI  - [An important contribution on increased mortality among anesthesiologists should
      initiate a debate].

PMID- 11195455
TI  - [Evidence-based discussion on therapeutic strategies for dyspepsia is valuable].

PMID- 11195456
TI  - Transgenic mouse models for lung cancer.
AB  - Transgenic technology allows the ability to target regulatory genes to the lungs
      in a cell-specific fashion. Using this technology, we have generated a model to
      investigate the phenotypic consequences of targeting oncogenes to particular cell
      types in the lungs and are developing a second model for the regulated expression
      of oncogenes in the lung. The transgenic model involves the constitutive
      expression of simian virus 40 large T antigen in the Clara cells of mouse lungs.
      This model has been used to investigate changes in expression of cell cycle
      regulatory genes in the Clara cells during the transformation process, as well as
      the expression of the transcription factors regulating the expression of Clara
      cell differentiation markers. The second model we are developing investigates the
      regulated expression of the genes in the lungs. This system is based on the
      establishment of two types of transgenic lines. The regulator line consists of a
      chimeric transcriptional factor placed under the control of a lung-specific SPC
      (surfactant protein C) promoter. This chimeric regulator is composed of a
      transcription activation domain, the GAL4 DNA-binding domain, and a truncated
      progesterone receptor that is responsive to RU 486, but not to endogenous
      progesterone. The second transgenic mouse line contains the silent target
      transgene under the control of a minimal promoter with upstream activating
      sequences (UAS) that are recognized by the regulator transgene. Upon breeding
      these two lines, the resulting bitransgenic mice can then be induced to express
      the target transgene only with the administration of RU 486. Two generations of
      regulators have been evaluated on their ability to regulate the expression of a
      growth hormone reporter gene. This system demonstrated the inducible expression
      of the reporter genes in the distal airways of the lungs.

PMID- 11195457
TI  - Use of p53 transgenic mice in the development of cancer models for multiple
      purposes.
AB  - The tumor suppressor gene p53 is perhaps the most commonly mutated gene in human
      cancer, being mutated in a high percentage of colon, breast, skin, bladder, and
      many cancers of the aerodigestive tract. Individuals with Li-Fraumeni syndrome,
      who routinely have a germline mutation in the p53 tumor suppressor gene, are at
      high risk for lung cancer, confirming its intimate role in lung tumorigenesis in
      humans. In contrast, the majority of chemically induced or spontaneous cancers in
      rodents do not contain mutations in p53. Therefore, we examined a transgenic
      mouse that contains a dominant negative mutation (Arg135Val) in the p53 gene
      placed under the control of its own endogenous promoter. The resulting mice have
      3 copies of the mutated transgene as well as 2 normal p53 alleles. In the
      chemical carcinogenesis studies, we employed mice containing the mutated p53 gene
      to examine for carcinogen susceptibility. We found that mice with the p53
      mutation, on an A/J F1 background, were more susceptible to a number of potential
      lung carcinogens, including N-methyl-N-nitrosourea (MNU) and the known tobacco
      carcinogens 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and
      benzo(a)pyrene (BP). Mice with a mutant p53 developed larger tumors and roughly 3
      times as many tumors, emphasizing the potential effects of a p53 mutation both on
      tumor initiation and progression. In addition, we examined 2 nonlung carcinogens,
      1,2-dimethylhydrazine (DMH), a colon carcinogen, and N-butyl-N-(4-hydroxybutyl)
      nitrosamine (OHBBN), a bladder carcinogen. Interestingly a germline p53 mutation
      increased the incidence of DMH-induced colon, lung, hepatic, and uterine tumors,
      while having limited effects on OHBBN-induced bladder tumors. Because of its
      heightened susceptibility we are examining the use of this model in smoke-induced
      tumorigenesis in A/J mice as well. Employing the lung adenomas induced by NNK, we
      found that mice with or without a p53 mutation were equally susceptible to the
      chemopreventive effects of dexamethasone plus myo-inisitol and green tea. These
      tumors, which arise in a highly reproducible manner in p53 transgenic mice
      following carcinogen treatment, have mutations in both p53 and the K-ras
      oncogene. Thus, this model appears useful for examining for potential
      chemotherapeutic agents. p53-mutated or wild-type mice were equally susceptible
      to the therapeutic effects of Taxol or Adriamycin. Interestingly, piroxicam was
      similarly effective in inhibiting colon tumor formation by DMH in mice with or
      without a mutation in the p53 tumor suppressor gene. In contrast, lung and
      uterine tumors developing in these mice were not susceptible to the
      chemopreventive effects of piroxicam. In summary, mice with mutations in the p53
      tumor suppressor gene appear to be particularly applicable for basic mechanistic
      studies, for screening for potential carcinogens, and for screening for
      chemopreventive or chemotherapeutic agents.

PMID- 11195458
TI  - Morphometric analysis of CC10-hASH1 transgenic mouse lung: a model for
      bronchiolization of alveoli and neuroendocrine carcinoma.
AB  - Constitutive expression of human achaete-scute homolog-1 (hASH1) alone or in
      combination with Simian virus 40 (SV40) large T antigen (TAg) under the Clara
      cell 10-kDa secretory protein (CC10) promoter results in bronchiolization of
      alveoli and enhanced tumorigenesis, respectively. A novel morphometric system
      composed of series of fixed distance concentric rings originating at the
      bronchioloalveolar junction was used to determine spatial growth patterns. hASH1
      mice exhibited progressive airway epithelial hyperplasia near this junction, and
      minimal changes further away in the alveolar compartment. TAg animals shared this
      increase, but exhibited variable distance-dependent growth. By 2 months TAg/hASH1
      animals showed highly increased growth at all points measured. Remarkably,
      TAg/hASH1 animals expressed both CC10 and extensive neuroendocrine
      differentiation in airways and tumors. The results suggest that these transgenic
      mice provide a useful model with many similarities to human lung carcinogenesis,
      which originates in airway epithelium, and often reveals neuroendocrine
      differentiation.

PMID- 11195459
TI  - Polygenic resistance to mouse pulmonary adenomas.
AB  - Susceptibility to urethan-induced pulmonary adenomas (PA) in mice is under
      polygenic control. To analyze these traits in detail, we generated a set of
      recombinant inbred (RI) mouse strains, called SMXA, from an intercross between PA
      susceptible A/J and resistant SM/J, and established a strain distribution pattern
      (SDP) table of 158 marker loci for SMXA RI strains. From the SDP table, it was
      possible to estimate the allele for 4 known PA susceptibility (Pas) loci in all
      members of SMXA RI strains. We compared combinations of Pas loci alleles with the
      data of number of PA induced by urethan. One of the RI strains, SMXA24, showed
      extremely low PA numbers, whereas they had the A/J-derived alleles at all 4 Pas
      loci. F1 hybrids of SMXA24 and A/J developed as few PA as SMXA24 on exposure to
      urethan. To confirm the hypothesis that SMXA24 has dominant PA resistance
      gene(s), we examined a backcross generation to A/J for multiplicity of PA. A
      preliminary genome scan followed by quantitative trait locus analysis revealed
      two resistance loci, one on mouse chromosome 11 (MMU11) (logarithm of odds [LOD]
      score 4.35) and another on MMU12 (LOD score 6.47). They were named Par1 and Par3,
      respectively. Both loci were epistatic to Pas1, the major susceptibility loci on
      MMU6. We next asked if such dominant resistance loci play some role in human lung
      cancer by studying possible loss of heterozygosity (LOH) at syntenic chromosomal
      segments in 79 human lung cancers, including 30 adenocarcinomas, 25 squamous cell
      carcinomas (SQ), and 24 small cell carcinomas (SCC). The map positions of Par1
      and Par3 correspond to human 17q11-23 and 14q11-24. Of 30 adenocarcinomas, LOH
      was found in 53% at 17q and in 30% at 14q. For both SQ and SCC, LOH in 17q were
      about 10%, but LOH in 14q was about 30% to 42%. Therefore, a gene in 17q seemed
      to be selective for adenocarcinomas, probably at the level of the target cell. In
      contrast, another gene in 14q affected all 3 types of lung carcinomas, suggesting
      it is related to the progression of lung tumors in general. A comparative
      approach may provide useful information for understanding human cancers.

PMID- 11195460
TI  - Fine mapping and characterization of candidate lung tumor resistance genes for
      the Par2 locus on mouse chromosome 18.
AB  - In a number of recent studies, a lung tumor resistance locus designated either
      Par2 or Pas7 was mapped to distal chromosome 18 in crosses between susceptible
      A/J and more resistant BALB/c mice. This locus is important in that it accounts
      for as much as 60% of the difference in lung tumor susceptibility between the A/J
      and BALB/c mice, both of which contain the susceptible allele of Kras2, a marker
      and strong candidate for the major lung tumor susceptibility gene on mouse
      chromosome 6. We have now fine-mapped the Par2 locus by using congenic mice that
      were constructed by placing part of chromosome 18 from the susceptible A/J onto
      the genetic background of lung tumor-resistant BALB/c mice. After 7 generations
      of backcrossing, N7 mice that carried 28 cM of the A/J quantitative trait locus
      (QTL) region were crossed to the BALB/c to generate the N8 generation. Congenic
      strains (N8) that contain various QTL regions were generated. N9 mice, generated
      from N8 males x 3 BALB/c females, were genotyped in the region of the Par2 locus
      and treated with an initiating dose of urethane and allowed to form lung tumors
      over 6 months. The mice were killed and the lung tumors counted. With this cross
      the Par2 locus was narrowed to a 6-cM region. Potential candidate genes in this
      region include Smad4, Smad2, and Dcc. Previously, we excluded Smad4 and Smad2 as
      candidates for Par2 based on the lack of functional polymorphism(s) and
      differential expression in lungs from A/J and BALB/c mice. In this study, no
      polymorphism of the coding sequence of Dcc was observed between A/J and BALB/c
      mice. Further fine mapping and positional cloning are required for the
      identification of the Par2 gene.

PMID- 11195461
TI  - Fine mapping of quantitative trait loci using advanced intercross lines of mice
      and positional cloning of the corresponding genes.
AB  - High-resolution mapping of quantitative trait loci (QTLs) is an essential step
      towards positional cloning and identification of the corresponding genes. Most
      QTL detection and mapping studies in mice have been carried out using F2
      intercross and backcross populations. As a consequence of the limited number of
      recombination events in small chromosomal regions, this has generally permitted
      mapping to only relatively large confidence intervals of 20 to 40 cM. A number of
      population designs have been proposed to increase recombination level in crosses.
      This includes advanced intercross lines (AIL) described by Darvasi and Soller
      [Genomics. 1995; 141: 1199-1207]. In this report demonstration of the utility of
      the AIL approach for fine mapping of QTL, which previously had been mapped with
      95% confidence interval to 20 to 40 cM in a F2 intercross, will be presented. The
      methodological approaches to go from the fine-mapped QTL to the identification of
      the actual genes and mutations are discussed.

PMID- 11195462
TI  - Detection of genetic alterations in mouse lung adenocarcinomas by two-dimensional
      gel electrophoresis.
AB  - DNA from 14 mouse lung adenocarcinomas and 7 normal lungs were examined by 2
      dimensional gel electrophoresis (2-DGE) for genetic alterations. 2-DGE profiles
      from tumor samples were compared with those profiles from normal lung tissues
      through a computer-assisted color overlay system. Compared to the profiles in
      normal lung DNA, 6 spots were amplified and 16 spots were partially reduced in
      their intensity in tumors. Two spots were detectable only in tumor tissues. These
      altered spots indicate genetic changes in mouse lung tumor development. The
      identification of these genetic alterations is probably important in
      understanding mouse lung carcinogenesis.

PMID- 11195463
TI  - K-ras p21 expression and activity in lung and lung tumors.
AB  - Although K-ras is mutated in many human and mouse lung adenocarcinomas, the
      function of K-ras p21 in lung is not known. We sought evidence for the prevalent
      hypothesis that K-ras p21 activates raf, which in turn passes the signal through
      the extracellular signal regulated kinases (Erks) to stimulate cell division, and
      that this pathway is upregulated when K-ras is mutated. Results from both mouse
      lung tumors and immortalized cultured E10 and C10 lung type II cells failed to
      substantiate this hypothesis. Lung tumors did not have more total K-ras p21 or K
      ras p21 GTP than normal lung tissue, nor were high levels of these proteins found
      in tumors with mutant K-ras. Activated K-ras p21-GTP levels did not correlate
      with proliferating cell nuclear antigen. Special features of tumors with mutant K
      ras included small size of carcinomas compared with carcinomas lacking this
      mutation, and correlation of proliferating cell nuclear antigen with raf-1. In
      nontransformed type II cells in culture, both total and activated K-ras p21
      increased markedly at confluence but not after serum stimulation, whereas both
      Erk1/2 and the protein kinase Akt were rapidly activated by the serum treatment.
      Reverse transcriptase-polymerase chain reaction (RT-PCR) assays of K-ras mRNA
      indicated an increase in confluent and especially in postconfluent cells.
      Together the findings indicate that normal K-ras p21 activity is associated with
      growth arrest of lung type II cells, and that the exact contribution of mutated K
      ras p21 to tumor development remains to be discovered.

PMID- 11195464
TI  - Mechanisms of aflatoxin B1 lung tumorigenesis.
AB  - Although aflatoxin B1 (AFB1) is best known as a hepatocarcinogen, the respiratory
      system can also be a target of this mycotoxin. In isolated lung cells from
      rabbits and mice, AFB1 is bioactivated by cytochromes P450, primarily in
      nonciliated bronchiolar epithelial (Clara) cells. However, mutagenesis
      experiments suggest that the DNA-binding AFB1 epoxide metabolite can leave the
      cells of origin, and potentially interact with other cell types. Consistent with
      DNA adduct studies, AFB1-induced AC3F1 mouse lung tumors contain point mutations
      at guanine residues in K-ras, with the anticipated bias for the A/J allele.
      Furthermore, following AFB1 treatment but prior to tumor development, K-ras
      mutations occur preferentially in mouse Clara cells. However, in contrast to
      findings with other carcinogens, AFB1-induced mouse lung tumors demonstrate
      frequent, but heterogeneously distributed, overexpression of p53 protein as well
      as p53 point mutations, suggesting a carcinogen-specific response. Unlike lung
      tissue from mice and rabbits, human peripheral lung bioactivates AFB1 primarily
      by prostaglandin H synthase--and/or lipoxygenase-catalyzed cooxidation, with
      activity concentrated in macrophages. In addition, although glutathione S
      transferase M1-1 has high specific activity for AFB1 epoxide conjugation, lung
      tissues from GSTM1-null individuals do not demonstrate diminished rates of
      conjugation, compared to tissues from GSTM1-positive individuals. In summary,
      AFB1 tumorigenesis in mice demonstrates unique properties, and processes of
      bioactivation show significant species differences.

PMID- 11195465
TI  - Transforming growth factor-beta 1 and its receptors in human lung cancer and
      mouse lung carcinogenesis.
AB  - The transforming growth factor-betas (TGF-beta s) are multifunctional proteins
      that inhibit the proliferation of many epithelial cells through a set of cell
      protein receptors that includes the TGF-beta type I (RI) and type II (RII)
      receptors. Loss of growth inhibition by TGF-beta is thought to contribute to the
      development of many types of tumors. In the present study, we have examined
      expression of the proteins and mRNAs for TGF-beta 1, TGF-beta RI, and TGF-beta
      RII in normal human lung, well-characterized non-small cell lung cancer (NSCLC)
      cell lines, and primary NSCLC specimens. Immunohistochemical staining for TGF
      beta 1, TGF-beta RI, and TGF-beta RII using specific antibodies in normal human
      lung showed expression of the 3 proteins in the epithelium of bronchi and
      bronchioles as well as in alveoli. Differential expression of TGF-beta RI and TGF
      beta RII proteins was detected in 5 NSCLC cell lines using Western blot analysis,
      with reduced levels in 3 cell lines. A panel of 45 formalin-fixed and paraffin
      embedded NSCLC specimens showed positive immunostaining for TGF-beta 1, TGF-beta
      RI, and TGF-beta RII, with reduced TGF-beta RII in poorly differentiated
      adenocarcinomas and squamous cell carcinomas and some moderately differentiated
      adenocarcinomas. In situ hybridization studies conducted with specific riboprobes
      for TGF-beta 1, TGF-beta RI, and TGF-beta RII showed corresponding localization
      of expression of the mRNAs in the specimens that showed positive immunostaining
      for the proteins. To investigate the roles of TGF-beta 1, TGF-beta RI, and TGF
      beta RII in chemically induced mouse lung tumorigenesis, we examined the
      expression of their proteins and mRNAs in 2 mouse model systems. Whereas
      expression of the proteins and mRNAs for TGF-beta 1 and TGF-beta RI was
      comparable in lung adenomas and bronchioles of A/J mice treated with
      benzo(alpha)pyrene, decreased immunostaining and hybridization for TGF-beta RII
      protein and mRNA was detected in 50% of lung adenomas in these mice.
      Interestingly, expression of TGF-beta 1 and the TGF-beta receptor proteins was
      similar to that of bronchioles in C57B1/6 mice and their littermates heterozygous
      for deletion of the TGF-beta 1 gene treated with diethylnitrosamine. These data
      show that reduced levels of expression of TGF-beta RII occur in some, but not
      all, human and mouse lung tumors. This suggests that different mechanisms of
      action, some of which may involve the TGF-beta signaling pathway, may contribute
      to the progression of lung tumorigenesis.

PMID- 11195466
TI  - Differential sensitivity to lung tumorigenesis following transplacental exposure
      of mice to polycyclic hydrocarbons, heterocyclic amines, and lung tumor
      promoters.
AB  - Research conducted by this laboratory over the past decade has demonstrated the
      high susceptibility of the fetus to lung tumor formation following in utero
      exposure of the resistant C57BL/6 and DBA/2N strains of mice to 3
      methylcholanthrene (MC). In this review, we describe our more recent studies on
      the effects of MC and cotreatment with the lung tumor promoter, butylated
      hydroxytoluene (BHT), on lung tumor formation in the intermediately susceptible
      BALB/c strain of mice, and the determination of the potential carcinogenicity of
      the heterocyclic amine, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) in resistant
      mouse strains. BALB/c mice showed a similar incidence of lung tumors, both in
      terms of percentage of mice with tumors and number of tumors per mouse, as found
      in the resistant [D2 x B6D2F1]F2 mice. Ki-ras point mutations were found in 56%
      (20/36) of BALB/c lung lesions compared with an incidence of 79% in [D2 x
      B6D2F1]F2 mice. BALB/c lung lesions demonstrated a similar association of Ki-ras
      mutations with tumor stage. Interestingly, a strain-dependent difference was
      observed in the mutational spectrum, where 62% and 38% of the lesions in BALB/c
      mice exhibited G-->C and G-->T transversions, respectively, in contrast with the
      16% and 84% incidences observed in [D2 x B6D2F1]F2 mice. BHT had no statistically
      significant effect on tumor incidence, multiplicity, or Ki-ras mutational
      spectrum in BALB/c mice treated in utero with MC, although a trend toward
      increased tumor multiplicity was observed. Finally, experiments initiated to
      assess the transplacental carcinogenicity of IQ in D2B6F1 mice demonstrated that
      1 year after birth, no macroscopically or microscopically visible liver, lung, or
      colon tumors were found in the transplacentally treated offspring, nor was
      induction of Cyp1a1, Cyp1b1, or glutathione S-transferases (GSTs) in fetal lung
      and liver tissues observed. This implies that at least under these experimental
      conditions, IQ may not be an important transplacental carcinogen. Overall, these
      data demonstrate that mutagenic damage to Ki-ras is a critical early event
      mediating murine lung tumorigenesis in both sensitive and resistant strains.
      Strain-dependent differences in the Ki-ras mutational spectrum may be associated
      with their differential susceptibility to lung tumor initiation.

PMID- 11195467
TI  - Inhibition of COX-2 and induction of apoptosis: two determinants of nonsteroidal
      anti-inflammatory drugs' chemopreventive efficacies in mouse lung tumorigenesis.
AB  - Recent studies suggested that nonsteroidal anti-inflammatory drugs (NSAIDs)
      inhibit lung tumorigenesis under conditions that are immunosuppressive. We
      hypothesized that this inhibition of mouse lung tumorigenesis requires induction
      of apoptosis and inhibition of COX (cyclooxygenase)-1, COX-2, and the incidence
      of K-ras mutation. The NSAIDs used in this study include acetylsalicylic acid
      (ASA) that is anti-inflammatory with COX-1 and COX-2 inhibition and N-[2
      (cyclohexyloxy)-4-nitrophenyl]-methanesulfonamide (NS398) that is a specific COX
      2 inhibitor. We have previously demonstrated that ASA (147 and 294 mg/kg diet)
      and NS398 (7 mg/kg diet) inhibited lung tumorigenesis by 31%, 44%, and 34%,
      respectively, in 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-treated A/J
      mice. No difference in the incidence and types of K-ras mutations was found
      between the lung tumors treated with NNK and those treated with NNK/ASA and
      NNK/NS398. In NNK-treated mice, ASA (394 mg/kg diet) or NS398 significantly
      increased the apoptotic index, from 0.07 to 0.30 or to 0.33, respectively. ASA
      (294 mg/kg diet) and NS398 also inhibited the expression of COX-2. Finally,
      modulation of gene expression by NS398 and ASA (294 mg/kg diet) was determined
      using Atlas cDNA expression arrays. Expression of cyclin B2 was decreased and
      expression of Fas-L and BAD were increased in lung tissues treated with both
      NS398 and ASA. Treatment with NS398 also increased expression of p57kip2 and
      myosin. These genes modulated by NSAIDs may play a role in mediating the observed
      chemopreventive effects of the NSAIDs in the mouse lung. Our results demonstrate
      that lung tumor prevention with NSAIDs involve both the induction of apoptosis
      and the inhibition of COX-2 expression.

PMID- 11195468
TI  - Successful and not so successful chemoprevention of tobacco smoke-induced lung
      tumors.
AB  - Strain A/J mice underwent whole body exposure for 6 hours a day, 5 days a week,
      for 5 months to a mixture of cigarette sidestream and mainstream smoke (89%-11%;
      total suspended particulates 80-150 mg/m3), then were kept for another 4 months
      in air before being killed for scoring of lung tumors. In 7 independent
      experiments, lung tumor multiplicity was significantly increased in all 7 trials
      and lung tumor incidence in 5. When animals were kept for 9 months in smoke, lung
      tumor multiplicity was not significantly higher than in controls, although lung
      tumor incidence was. The following chemopreventive agents were evaluated: green
      tea, phenethyl isothiocyanate (PEITC), acetylsalicylic acid (ASA), N
      acetylcysteine (NAC), p-XSC (1,4-phenylenebis[methylene]selenocyanate), d
      limonene (DL), and a mixture of PEITC and BITC (benzyl isothiocyanate). In
      animals exposed to tobacco smoke, none of these agents reduced lung tumor
      multiplicity or incidence. As a control, the effects of the same agents were
      examined in A/J mice initiated with 4-(methylnitrosamino)-1-(3pyridyl)-1-butanone
      (NNK) or urethane. In mice injected with NNK, green tea and ASA did not reduce
      lung tumor multiplicities and NAC had no effect on urethane-induced lung tumors,
      whereas PEITC, p-XSC and DL reduced NNK-induced tumor multiplicities to 20% to
      50% of control values. On the other hand, dietary mixture of myoinositol and
      dexamethasone was not only highly protective against NNK, but reduced lung tumor
      multiplicities and incidence in smoke-exposed animals to control values. This
      effect was also seen when the animals were fed the myo-inositol-dexamethasone
      mixture once they were removed from smoke. It is concluded that in animal studies
      it might be preferable to evaluate the effectiveness of putative chemopreventive
      agents against full tobacco smoke rather than against selected model compounds.
      The observations made with myo-inositol-dexamethasone suggest that people who
      have recently quit smoking might benefit the most from active chemoprevention.

PMID- 11195469
TI  - Chemoprevention of vinyl carbamate-induced lung tumors in strain A mice.
AB  - The ability of potential chemopreventive agents to prevent vinyl carbamate
      induced lung tumors was determined in 2 different experiments. Female strain A
      mice administered intraperitoneally either a single injection of 60 mg/kg vinyl
      carbamate that induced 24.0 +/- 1.72 tumors/mouse at 24 weeks or 2 injections of
      16 mg/kg vinyl carbamate each (32 mg/kg total dose) that induced 43.2 +/- 3.2
      tumors/mouse at 20 weeks. Lung carcinomas were found as early as 16 weeks.
      Dexamethasone and piroxicam provided in the diet were found to significantly
      inhibit lung tumors induced by 60 mg/kg vinyl carbamate at 24 weeks whereas myo
      inositol also provided in the diet, did not significantly inhibit tumor
      formation. In animals given 6 16-mg/kg doses of vinyl carbamate, tumor
      multiplicity was reduced roughly 25% by alpha-difluoromethylornithine and green
      tea and reduced 50% by dexamethasone and piroxicam. Combinations of these agents
      were also tested using a total dose of 32 mg/kg of vinyl carbamate. Although
      alpha-difluoromethylornithine and green tea did not result in a significant
      inhibition of lung tumor formation if used alone, the combination of alpha
      difluoromethylornithine and green tea resulted in a significant reduction of
      tumor multiplicity. The combinations of alpha-difluoromethylornithine or green
      tea with either dexamethasone or piroxicam or the combination of dexamethasone
      and piroxicam did not decrease tumor multiplicity greater than achieved by
      dexamethasone and piroxicam alone. In summary, selected chemopreventive agents
      previously shown to inhibit lung tumors by other chemical carcinogens also
      inhibited vinyl carbamate-induced lung tumors.

PMID- 11195470
TI  - Chemopreventive efficacy of promising farnesyltransferase inhibitors.
AB  - The studies presented were designed to test the efficacy of farnesyltransferase
      inhibitors (FTIs) as potential chemopreventive compounds in the mouse lung tumor
      model, and in tumor cell lines. The compounds included manumycin, gliotoxin,
      dihydroepiandrosterone (DHEA), perillyl alcohol (POH), and FTI-276. Each of these
      compounds had the potential, based on in vitro and limited in vivo evidence, to
      inhibit mouse lung tumorigenesis. In vitro studies were conducted with both K-ras
      transformed NIH-3T3 cells and mouse lung tumor epithelial cell lines. We utilized
      2 primary mouse lung tumor models that reliably produce lung tumors with an
      oncogenic K-ras mutation when induded by 4-(methylnitrosoamino)-1-(3-pyridyl)-1
      butanone (NNK). Manumycin, gliotoxin, DHEA, and POH were administered 3 times per
      week peritoneally (i.p.), starting 1 week prior to carcinogen treatment, and
      throughout the test period (4.5 months). FTI-276 was delivered daily for 4 months
      by a time-release pellet method. Both the manumycin and gliotoxin treatment
      groups demonstrated 100% incidence and an increase in tumor multiplicity over
      control, of 66% and 58% increase respectively (P < .05). Although DHEA showed no
      significant chemopreventive effect, POH treatment demonstrated a 22% reduction in
      tumor incidence (P < .05) and a 58% reduction in tumor multiplicity (P < .05).
      Finally, FTI-276 reduced both the tumor multiplicity by 41.7% (P < .005), and the
      total tumor volume/burden per mouse by 79.4% (P < .0001). The apoptotic index in
      FTI-276-treated tumors showed an increase of 77% over control tumors (P < .05).
      In vitro, all compounds demonstrated growth inhibition at a dose-response manner;
      however, manumycin, gliotoxin, and DHEA demonstrated an initial increase in
      growth rate at lower doses. In summary, we have shown that POH and FTI-276 are
      chemopreventive in a primary mouse lung tumor model. In contrast, DHEA was not
      significantly chemopreventive at the dosage utilized, and treatment of an
      immunocompetent host with manumycin or gliotoxin demonstrated a significant
      increase in tumorigenicity over carcinogen control.

PMID- 11195471
TI  - Is the combination of ibuprofen and caffeine effective for the treatment of a
      tension-type headache?

PMID- 11195472
TI  - What is the most cost-effective screening regimen for colon cancer?

PMID- 11195473
TI  - Are antidepressants effective in the treatment of fibromyalgia, and is this
      effect independent of depression?

PMID- 11195474
TI  - Clinical inquiries. What is a reasonable initial approach to the patient with
      fatigue?

PMID- 11195475
TI  - Clinical inquiries. Is surgery effective for reducing symptoms in adults with
      obstructive sleep apnea?

PMID- 11195476
TI  - Does the family APGAR effectively measure family functioning?
AB  - BACKGROUND: The Family APGAR has been widely used to study the relationship of
      family function and health problems in family practice offices. METHODS: Data
      were collected from 401 pediatricians and family physicians from the Pediatric
      Research in Office Settings network and the Ambulatory Sentinel Practice Network.
      The physicians enrolled 22,059 consecutive office visits by children aged 4 to 15
      years. Parents completed a survey that included the Family APGAR and the
      Pediatric Symptom Checklist. Clinicians completed a survey that described child
      psychosocial problems, treatments initiated or continued, and specialty care
      referrals. RESULTS: Family dysfunction on the index visit often differed from
      dysfunction at follow-up (kappa=0.24). Only 31% of the families with positive
      Family APGAR scores at baseline were positive at follow-up, and only 43% of those
      with positive scores at follow-up had a positive score at the initial visit.
      There were many disagreements between the Family APGAR and the clinician. The
      Family APGAR was negative for 73% of clinician-identified dysfunctional families,
      and clinicians did not identify dysfunction for 83% of Family APGAR-identified
      dysfunctions (kappa=0.06). CONCLUSIONS: Our data do not support the use of the
      Family APGAR as a measure of family dysfunction in the primary care setting.
      Future research should clarify what it does measure.

PMID- 11195477
TI  - The common cold in patients with a history of recurrent sinusitis: increased
      symptoms and radiologic sinusitislike findings.
AB  - BACKGROUND: We evaluated whether the symptoms and signs and radiologic findings
      during a common cold are similar in patients who have and have not suffered from
      recurrent sinusitis. METHODS: We recruited 2 series of volunteer cases from
      February 1, 1996, to December 31, 1996. Twenty-three adults who claimed to have
      suffered from recurrent sinusitis and 25 who had never had sinusitis were
      examined during the period of a self-diagnosed cold of 48 to 96 hours' duration
      and again after 21 days. Symptom scores were recorded, nasoendoscopy and computed
      tomography scans were performed, and viral and bacterial specimens were taken.
      RESULTS: The patients with a history of sinusitis had significantly higher
      symptom scores than the control patients (P=.04) and had radiologic sinusitislike
      changes more often (65% [15] vs 36% [9]; difference 29% [95% confidence interval,
      2%-56%]; P=.04). The viral etiology of the common cold (verified in 67% of the
      episodes) was similar in both groups. Pathogenic bacteria were isolated from the
      middle meatus in 24% (6) of the control patients and only 9% (2) of the sinusitis
      prone patients (P=.15). On the basis of the symptomatology, radiologic findings,
      and bacterial cultures only 2 patients in the sinusitis-prone group should have
      been treated with antimicrobials. CONCLUSIONS: Some patients are susceptible to
      both sinusitislike symptoms and radiologic findings during viral common colds.
      This may cause them to consult their physicians earlier and more often during
      viral colds, which may result in unnecessary antibiotic treatments.
      Nasopharyngeal bacteriological cultures may prove to be useful in ruling out
      bacterial sinusitis.

PMID- 11195478
TI  - Use and perceptions of antibiotics for upper respiratory infections among college
      students.
AB  - BACKGROUND: Upper respiratory infections (URIs) are mainly viral in nature,
      rendering antibiotics ineffective. Little is known about what college students
      believe concerning the effectiveness of antibiotics as a treatment for URIs.
      METHODS: Students (n=425) on 3 college campuses were surveyed using a survey
      describing 3 variations in presentation of an uncomplicated URI. Participants
      were questioned about their likelihood of using a variety of treatments for the
      URI and about their likelihood of seeking a physician's care. RESULTS: The
      percentage of students endorsing antibiotic use differed significantly by symptom
      complex. Likelihood of seeking medical care also differed significantly across
      symptom groups, with greater endorsement in the discolored nasal discharge and
      low-grade fever scenarios. Stepwise multiple regression analysis revealed that
      belief in antibiotic effectiveness for cold symptoms decreased with tic and
      Therapeutic increasing years of higher education. Likelihood of antibiotic use
      across different scenarios increased with age. Likelihood of seeking care across
      different scenarios was related to type of health insurance and belief in
      antibiotic effectiveness. CONCLUSIONS: Undergraduate college students show poor
      recognition of typical presentations of the common cold and have misconceptions
      about effective treatment. Although increasing years of college correlated with
      decreasing belief in antibiotics' effectiveness for a cold, more health education
      at the college level is recommended.

PMID- 11195479
TI  - Acute rhinosinusitis: a diagnostic and therapeutic challenge.

PMID- 11195480
TI  - Mental illness, functional impairment, and patient preferences for collaborative
      care in an uninsured, primary care population.
AB  - OBJECTIVE: Our goal was to compare the prevalence of mental illness and its
      impact on functional status in an indigent uninsured primary care population with
      a general primary care sample. We also hoped to assess patient preferences about
      mental health and medical service integration. STUDY DESIGN: We compared a survey
      of consecutive primary care adults in April and May 1999 with a 1997-98 survey of
      3000 general population primary care patients. Both studies used the Primary Care
      Evaluation of Mental Disorders Patient Health Questionnaire and the 20-question
      Medical Outcomes Study Short Form. POPULATION: The patients were from a private
      nonprofit primary care clinic in Grand Junction, Colorado, that served only low
      income uninsured people. We approached a total of 589 consecutive patients and
      enrolled 500 of them. MAIN OUTCOME MEASURE: The main outcomes were the prevalence
      of psychiatric illnesses and the relationship with functional impairment. We
      compared our findings with a more generalizable primary care population. RESULTS:
      This low-income uninsured population had a higher prevalence of 1 or more
      psychiatric disorders (51% vs 28%): mood disorders (33% vs 16%), anxiety
      disorders (36% vs 11%), probable alcohol abuse (17% vs 7%), and eating disorders
      (10% vs 7%). Having psychiatric disorders was associated with lower functional
      status and more disability days compared with not having mental illness. Patients
      indicated a preference for mental health providers and medical providers to
      communicate about their care. CONCLUSIONS: This low-income uninsured primary care
      population has an extremely high prevalence of mental disorders with impaired
      function. It may be important in low-income primary care settings to include
      collaborative care designs to effectively treat common mental disorders, improve
      functional status, and enhance patient self-care.

PMID- 11195481
TI  - Becoming an information master: using "medical poetry" to remove the inequities
      in health care delivery.
AB  - In response to the spiraling costs, the US populace, for now, has chosen to
      ration health care by choosing who can receive it rather than what services are
      provided. Changing this approach will require an organized national policy and
      will be difficult. Clinicians must accept that providing minimally beneficial but
      not absolutely necessary care to their patients increases cost without
      significantly improving quality, and results in more people who lack adequate
      health care. The public must accept that exclusively focusing health care
      decisions on individuals places patients in conflict with their community, their
      family, and, eventually, themselves. Effectively using valid Patient-Oriented
      Evidence that Matters (POEMs) will give family physicians the tools necessary to
      improve the value of health care services. Family physicians are in the unique
      position to guide the necessary changes in health care delivery to resolve these
      conflicts and to be leaders in this process.

PMID- 11195482
TI  - The evaluation and treatment of adults with gastroesophageal reflux disease.
AB  - Gastroesophageal reflux disease (GERD) is defined as symptoms or tissue damage
      that results from the abnormal reflux of gastric contents into the esophagus. A
      systematic review of population-based studies estimates that heartburn or
      regurgitation symptoms occur in 21% to 59% of the population during a given year.
      The frequency of GERD in specific populations is provided in Table 1. Although
      only 1 in 5 patients with upper intestinal symptoms that occur at least weekly
      seeks medical attention, nearly 1% of all visits to a family physician's office
      are for GERD or related conditions. GERD significantly affects the quality of
      patients' lives. In a survey of patients presenting for upper endoscopy with
      symptoms of at least 3 months' duration, those with a diagnosis of GERD reported
      low scores at baseline for general well-being. Fortunately, follow-up data
      reported 4 weeks after treatment note improvement in gastrointestinal symptoms,
      general well-being, general health, vitality, and depression.

PMID- 11195483
TI  - Does use of an instant hand sanitizer reduce elementary school illness
      absenteeism?

PMID- 11195484
TI  - Is the sweeping of membranes a useful intervention in conjunction with induction
      of labor in term pregnancy?

PMID- 11195485
TI  - Can a clinical rule accurately predict whether a patient has strep throat?

PMID- 11195486
TI  - Is budesonide or nedocromil superior in the long-term management of mild to
      moderate asthma in children?

PMID- 11195487
TI  - Smoking, hypertension, and erectile dysfunction.

PMID- 11195489
TI  - Old stone face.

PMID- 11195488
TI  - Preventing acute mountain sickness.

PMID- 11195490
TI  - Can vaginal misoprostol be administered 1 to 3 days after mifepristone without
      loss of efficacy or an increase in adverse events?

PMID- 11195491
TI  - Surface plasmon resonance imaging measurements of DNA and RNA hybridization
      adsorption onto DNA microarrays.
AB  - Surface plasmon resonance (SPR) imaging is a surface-sensitive spectroscopic
      technique for measuring interactions between unlabeled biological molecules with
      arrays of surface-bound species. In this paper, SPR imaging is used to
      quantitatively detect the hybridization adsorption of short (18-base) unlabeled
      DNA oligonucleotides at low concentration, as well as, for the first time, the
      hybridization adsorption of unlabeled RNA oligonucleotides and larger 16S
      ribosomal RNA (rRNA) isolated from the microbe Escherichia coli onto a DNA array.
      For the hybridization adsorption of both DNA and RNA oligonucleotides, a
      detection limit of 10 nM is reported; for large (1,500-base) 16S rRNA molecules,
      concentrations as low as 2 nM are detected. The covalent attachment of thiol-DNA
      probes to the gold surface leads to high surface probe density (10(12)
      molecules/cm2) and excellent probe stability that enables more than 25 cycles of
      hybridization and denaturing without loss in signal or specificity. Fresnel
      calculations are used to show that changes in percent reflectivity as measured by
      SPR imaging are linear with respect to surface coverage of adsorbed DNA
      oligonucleotides. Data from SPR imaging is used to construct a quantitative
      adsorption isotherm of the hybridization adsorption on a surface. DNA and RNA 18
      mer oligonucleotide hybridization adsorption is found to follow a Langmuir
      isotherm with an adsorption coefficient of 1.8 x 10(7) M(-1).

PMID- 11195492
TI  - Electrochemically actuated mercury pump for fluid flow and delivery.
AB  - This paper describes the development of a prototype pumping system with the
      potential for incorporation into miniaturized, fluid-based analytical
      instruments. The approach exploits the well-established electrocapillarity
      phenomena at a mercury/electrolyte interface as the mechanism for pump actuation.
      That is, electrochemically induced changes in the surface tension of mercury
      result in the pistonlike movement of a mercury column confined within a
      capillary. We present herein theoretical and experimental assessments of pump
      performance. The design and construction of the pump are detailed, and the
      potential attributes of this design, including the generated pumping pressure,
      flow rate, and power consumption, are discussed. The possible miniaturization of
      the pump for use as a field-deployable, fluid-delivery device is also briefly
      examined.

PMID- 11195493
TI  - Continuous cell introduction for the analysis of individual cells by capillary
      electrophoresis.
AB  - Instrumentation for high-throughput analysis of single cells by capillary
      electrophoresis is described. A flow-based interface that uses electroosmotic
      flow (EOF) provides continuous injection of intact cells through an introduction
      capillary into a cell lysis junction and migration of the resulting cell lysate
      through a separation capillary for analysis. Specifically, two capillaries were
      coupled together with 5-mm-long Teflon tubing to create a approximately 5-microm
      gap, and the junction was immersed in a buffer reservoir. High voltage was
      applied across both capillaries so that cells were continuously pumped into the
      first capillary by EOF. Individual cells were lysed on-column at the junction
      without detergents, presumably owing to mechanical disruption caused by a
      dramatic change in flow properties at the gap. After each cell was lysed at the
      junction, the major proteins hemoglobin and carbonic anhydrase were separated by
      capillary electrophoresis and the resultant analyte zones were detected by laser
      induced native fluorescence using 275-nm excitation. The detection limits of
      hemoglobin and carbonic anhydrase were 37 and 1.6 amol, respectively, which
      correlate well with the literature. The instrumentation was evaluated with intact
      red blood cells. The averaged time for complete analysis (i.e., continuous
      injection, lysis, separation, and detection) of one human erythrocyte was less
      than 4 min with this capillary-based setup. Moreover, this instrumentation
      simplifies the introduction of individual, intact cells without the use of a
      microscope.

PMID- 11195494
TI  - Selected reaction monitoring LC-MS determination of idoxifene and its
      pyrrolidinone metabolite in human plasma using robotic high-throughput,
      sequential sample injection.
AB  - The generation of large numbers of samples during early drug discovery has
      increased the demand for rapid and selective methods of analysis. Liquid
      chromatography-tandem mass spectrometry (LC-MS-MS), because of its sensitivity,
      selectivity, and robustness, has emerged as a powerful tool in the pharmaceutical
      industry for many analytical needs. This work presents a high-throughput selected
      reaction monitoring LC-MS bioanalytical method for the determination of
      idoxifene, a selective estrogen receptor modulator, and its pyrrolidinone
      metabolite in clinical human plasma samples. The described method uses short,
      small-bore columns, high flow rates, and elevated HPLC column temperatures to
      perform LC separations of idoxifene and its metabolite within 10 s/sample.
      Sequential injections were accomplished with a 215/889 multiple probe liquid
      handler (Gilson, Inc.), which aspirates eight samples simultaneously and performs
      its rinse cycle parallel to sample injection, resulting in minimum lag time
      between injections. This high-throughput method was applied to the determination
      of idoxifene and its metabolite in clinical human plasma samples. Sample
      preparation employed liquid/liquid extraction in the 96-well format. Method
      validation included determination of intra- and interassay accuracy and precision
      values, recovery studies, autosampler stability, and freeze-thaw stability. The
      LOQ obtained was 10 ng/mL for idoxifene and 30 ng/mL for the metabolite. Using
      idoxifene-d5 as an internal standard, idoxifene showed acceptable accuracy and
      precision values at QC level 1 (QC1, 15 ng/mL), level 2 (QC2, 100 ng/mL), and
      level 3 (QC3, 180 ng/mL) (85.0% accuracy +/- 12.0% precision, 95.1 +/- 4.9%, and
      90.3 +/- 4.7%, respectively). The pyrrolidinone metabolite also showed acceptable
      accuracy and precision values (using no internal standard for quantitation) at
      QC1 (60 ng/mL), QC2 (100 ng/mL), and QC3 (180 ng/mL) (104.9 +/- 14.4%, 91.1 +/-
      13.0%, and 90.8 +/- 12.2%, respectively). The validated method was applied to the
      analysis of 613 human clinical plasma samples. An average run time of 23 s/sample
      (approximately 37 min/ 96-well plate or over 3,700 sample/day) was achieved. The
      successful validation presented indicates that rapid methods of analysis can
      efficiently and reliably contribute to the fast sample turnaround required for
      high sample number generating processes.

PMID- 11195495
TI  - Mercury micropumps.

PMID- 11195496
TI  - Microfluidic device for combinatorial fusion of liposomes and cells.
AB  - We describe an electrofusion-based technique for combinatorial synthesis of
      individual liposomes. A prototype device with containers for liposomes of
      different compositions and a fusion container was constructed. The sample
      containers had fluid contact with the fusion container through microchannels.
      Optical trapping was used to transport individual liposomes and cells through the
      microchannels into the fusion container. In the fusion container, selected pairs
      of liposomes were fused together using microelectrodes. A large number of
      combinatorially synthesized liposomes with complex compositions and reaction
      systems can be obtained from small sets of precursor liposomes. The order of
      different reaction steps can be specified and defined by the fusion sequence.
      This device could also facilitate single cell-cell electrofusions (hybridoma
      production). This is exemplified by fusion of transported red blood cells.

PMID- 11195497
TI  - "Four-decay" DNA sequencing.

PMID- 11195498
TI  - Diffusion-based calibration for SPME analysis of aqueous samples.
AB  - When an SPME fiber is exposed for a short period of time to a flowing fluid
      sample, the amount of extracted analyte depends on its diffusion coefficient in
      the matrix medium, and it can be correlated to its concentration using a simple
      mathematical model. This work discusses the extension of this approach, already
      validated for gaseous samples and SPME fibers coated with strong adsorbent
      coatings, to the diffusion-based quantification of analytes present in aqueous
      samples. Dilute aqueous solutions of aromatic hydrocarbons were used as model
      samples and vials were modified to use conventional magnetic agitation with
      controlled tangential flow of the test solution around the fiber. It was
      demonstrated that, with proper selection of the stirring speed and sampling time,
      the same diffusion-based quantitative model used for gas samples could be
      employed. Under optimal conditions, the concentrations of the evaluated aromatic
      hydrocarbons were estimated with relative standard deviations between 0.8 and
      3.6% and without deviation from the expected values within this precision range.
      Considering the extraction times involved, between 30 and 60 s, the approach here
      presented is the fastest possible technique for direct extraction of analytes
      from liquid samples.

PMID- 11195499
TI  - Argentometric titration for the determination of liquid chromatographic injection
      reproducibility.
AB  - The reproducibility of autosamplers for high-performance liquid chromatography
      can be checked by the injection of a sodium chloride solution without an
      installed column. The dispensed chloride plug is analyzed quantitatively by
      argentometric titration. If the titration can be performed with high enough
      precision, the autosampler performance is investigated without additional
      effects. Experiments with a 20-microL loop were performed. We found the following
      repeatabilities (relative standard deviations): titration, 0.07%; 10-microL "pull
      loop" injection (partial filling of the loop), 0.6%; and 20-microL "full loop"
      injection, 0.1%. In contrast to these data, the relative standard deviations
      obtained from chromatographic peaks include the steps of injection, separation,
      detection, and integration without any knowledge of the individual contributions.
      Such values are higher; we found for chromatographic peak areas of parabens 2%
      under pull loop conditions and 0.17% by full loop. The titration approach allows
      the determination of the contribution of the injection to the uncertainty budget
      of a liquid chromatographic analysis.

PMID- 11195500
TI  - Chip-based mosaic immunoassays.

PMID- 11195501
TI  - Trace atmospheric gases on a shoestring.

PMID- 11195502
TI  - Phosphopeptide/phosphoprotein mapping by electron capture dissociation mass
      spectrometry.
AB  - Of methods for dissociation of multiply charged peptide and protein ions,
      electron capture dissociation (ECD) has the advantages of cleaving between a high
      proportion of amino acids, without loss of such posttranslational modifications
      as glycosylation and carboxylation. Here this capability is successfully extended
      to phosphorylation, for which collisionally activated dissociation (CAD) can
      cause extensive loss of H3PO4 and HPO3. As shown here, these losses are minimal
      in ECD spectra, an advantage for measuring the degree of phosphorylation. For
      phosphorylated peptides, ECD and CAD spectra give complementary backbone
      cleavages for identifying modification sites. For a 24-kDa heterogeneous
      phosphoprotein, bovine beta-casein, activated ion ECD cleaved 87 of 208 backbone
      bonds that identified a phosphorylation site at Ser-15, and localized three more
      among Ser-17,-18, -19, and -22 and Thr-24, and the last among four other sites.
      This is the first direct site-specific characterization of this key post
      translational modification on a protein without its prior degradation, such as
      proteolysis.

PMID- 11195503
TI  - Calixarenes: designer ligands for chemical sensors.

PMID- 11195504
TI  - A method for determination of ion distribution within electrosprayed droplets.
AB  - A simplified method for determination of ion distribution within electrospray
      ionization droplets has been developed. The method is based on an electrospray
      ionization mass spectrometry equilibrium partitioning model recently developed by
      Enke (Enke, C. G. Anal. Chem. 1997, 69, 4885-4893). This "simple" method required
      only two samples to be analyzed at each solution composition compared to the
      method previously reported. Furthermore, as the same m/z value is monitored in
      both experiments, possible effects of the mass-dependent ion transmission in the
      quadrupole were eliminated. Tetra-alkylammonium compounds with variable
      hydrophobicity were used as model compounds and the effect of methanol-water
      composition in the electrosprayed solution was studied. It was found, as
      expected, that the signal optimized at a high content of methanol in the
      electrosprayed solution. The distribution coefficient for analyte ions between
      the droplet surface and bulk solution maximize, however, at a lower content of
      methanol in the electrosprayed solution.

PMID- 11195506
TI  - Microwave-enhanced chemistry.

PMID- 11195505
TI  - Analysis of protein phosphorylation by capillary liquid chromatography coupled to
      element mass spectrometry with 31P detection and to electrospray mass
      spectrometry.
AB  - A method for phosphopeptide identification by capillary liquid chromatography
      (muLC) interfaced alternatively to element mass spectrometry (inductively coupled
      plasma mass spectrometry, ICPMS) and to electrospray ionization mass spectrometry
      (ESI-MS) is described. ICPMS is used for 31P detection and ESI-MS provides the
      corresponding molecular weight information. Alignment of the two separate muLC
      runs is performed using the baseline distortion at the elution front, which shows
      up in both muLC-ICPMS and muLC-ESI-MS. Both a quadrupole and a magnetic sector
      field mass analyzer were used in combination with ICP. The detection limit
      achieved for the muLC-ICP-HRMS runs is approximately 0.1 pmol of phosphopeptide
      injected. Without any further precautions, contamination by phosphate-containing
      compounds at this level was found to be uncritical. The method is demonstrated
      for the analysis of a complex mixture of synthetic phosphopeptides and a set of
      tryptic digests of three phosphoproteins. These include beta-casein, activated
      human MAP kinase ERK1, and protein kinase A catalytic subunit. The tryptic
      phosphopeptides of these proteins could all be detected and identified by our new
      strategy. Analysis of three fractions of protein kinase A catalytic subunit with
      different phosphorylation status gives direct access to the order in which the
      phosphorylation of the four phosphorylation sites occurs. The two most important
      aspects of using muLC-ICPMS with 31P detection for phosphopeptide identification
      are (i) that a high selectivity is achieved and (ii) that the signal intensity is
      independent of the chemical form of phosphorus and directly proportional to the
      molar amount of 31P in the muLC eluate. Thus, muLC-ICPMS with 31P detection is
      introduced as a new, robust, and specific method in phosphoproteomics.

PMID- 11195507
TI  - Determination of alkylbenzyldimethylammonium chlorides in river water and sewage
      effluent by solid-phase extraction and gas chromatography/mass spectrometry.
AB  - This study presents a modified method to analyze alkylbenzyldimethylammonium
      chlorides (ABDACs) in river water and sewage effluent. The method involves mixed
      samples with linear alkylbenzenesulfonates (LAS) as a counterion to enhance the
      extraction of ABDAC residues from an RP-18 solid-phase cartridge by formation of
      hydrophobic ion-pair complexes. The ABDACs were then eluted with methanol-ethyl
      acetate (1:1, v/v) and formed to their corresponding alkyldimethylamines by the
      Hofmann degradation with potassium tert-butoxide. The alkyldimethylamines were
      then identified and quantitated by gas chromatograph/mass spectrometry (GC/MS).
      The results indicate that, in the presence of LAS, debenzylation of ABDACs occurs
      selectively at a temperature higher than 90 degrees C to produce the
      corresponding nonionic alkyldimethylamines. The method proposed herein provides a
      high precision and sensitivity for ABDACs, to quantitation at < or =0.1 microg/L
      in 500 mL of the water samples. The average recovery of ABDAC spiked water
      samples was 95% with relative standard deviations (RSD, n = 7) of 9%. The RSDs of
      three replicate environmental sample analyses ranged from 5 to 11%. Direct HPLC
      method was applied to evaluate the GC/MS method, and compatible results were
      observed.

PMID- 11195508
TI  - Mixing electrochemistry with microscopy.

PMID- 11195509
TI  - Determination of mycophenolic acid and mycophenolate mofetil by high-performance
      liquid chromatography using postcolumn derivatization.
AB  - An efficient method to lower the optical detection limit is described using the
      displacement of an absorption and emission band of an analyte after a polarity
      change in different solvents. This solvatochromic effect was used in a RP-HPLC
      assay for the fluorescence detection of mycophenolic acid (6-(4-hydroxy-6-methoxy
      7-methyl-3-oxo-5-phthalanyl)-4-methyl-4-hexenoic acid, MPA) and the prodrug
      mycophenolate mofetil (MMF), the N-(2-hydroxyethyl)morpholino ester of MPA. The
      rational to use fluorescence detection is based on the behavior of MMF and MPA,
      which fluoresce in a basic medium (pH >9.5). Following a simple protein
      precipitation, the analytes were separated in an isocratic RP-HPLC system. The
      postcolumn generation of the phenolate anions of MPA and MMF was achieved by
      addition of an aqueous sodium hydroxide solution regulated by a newly developed
      continuous-flow liquid control system. MPAG, not directly accessible for
      fluorescence detection, was analyzed after enzymatic deglucuronidation to MPA.
      Compared to published quantification limits for MPA and MMF by UV detection, this
      method is more than 100-fold more sensitive, with a lower limit of quantification
      of 45 fmol for both MPA and MMF.

PMID- 11195510
TI  - The limits of written tests.

PMID- 11195511
TI  - Sampling and analysis of airborne particulate matter and aerosols using in-needle
      trap and SPME fiber devices.
AB  - A needle trap device (NTD) and commercial poly(dimethylsiloxane) (PDMS) 7-microm
      film thickness solid-phase microextraction (SPME) fibers were used for the
      sampling and analysis of aerosols and airborne particulate matter (PM) from an
      inhaler-administered drug, spray insect repellant, and tailpipe diesel exhaust.
      The NTD consisted of a 0.53-mm o.d. stainless steel needle having 5 mm of quartz
      wool packing section near the needle tip. Samples were collected by drawing air
      across the NTD with a Luertip syringe or via direct exposure of the SPME fiber.
      The mass loading of PM was varied by adjusting the volume of air pulled through
      the NTD or by varying the sampling time for the SPME fiber. The air volumes
      ranged from 0.1 to 50 mL, and sampling times varied from 10 s to 16 min.
      Particulates were either trapped on the needle packing or sorbed onto the SPME
      fiber. The devices were introduced to a chromatograph/mass spectrometer (GC/MS)
      injector for 5 min desorption. In the case of the NTD, 10 microL of clean air was
      delivered by a gas-tight syringe to aid the introduction of desorbed analytes.
      The compounds sorbed onto particles extracted by the SPME fiber or trapped in the
      needle device were desorbed in the injector and no carry-over was observed. Both
      devices performed well in extracting airborne polycyclic aromatic hydrocarbons
      (PAHs) in diesel exhaust, triamcinolone acetonide in a dose of asthma drug and
      DEET in a dose of insect repellant spray. Results suggest that the NTDs and PDMS
      7-microm fibers can be used for airborne particulate sampling and analysis,
      providing a simple, fast, reusable, and cost-effective screening tool. The
      advantage of the SPME fiber is the open-bed geometry allowing spectroscopic
      investigations of particulates; for example, with Raman microspectroscopy.

PMID- 11195512
TI  - Polypyrrole-coated capillary coupled to HPLC for in-tube solid-phase
      microextraction and analysis of aromatic compounds in aqueous samples.
AB  - In-tube solid-phase microextraction (SPME) based on a polypyrrole (PPY)-coated
      capillary was investigated for the extraction of aromatic compounds from aqueous
      solutions. The PPY-coated capillary was coupled on-line to HPLC that was
      programmed with an autosampler to achieve automated in-tube SPME and HPLC
      analysis. Three groups of aromatics, including both polar and nonpolar compounds,
      were examined. The results demonstrated that the PPY coating had a higher
      extraction efficiency than the currently used commercial capillary coatings,
      especially for polycyclic aromatic compounds and polar aromatics due to the
      increasing pi-pi interactions, interactions by polar functional groups, and
      hydrophobic interactions between the polymer and the analytes. In addition to the
      functional groups in the PPY coating, which contributed to the higher extraction
      efficiency and selectivity toward analytes, the coating's porous surface
      structure,which was revealed by electron microscopy experiments, provided a high
      surface area that allowed for high extraction efficiency. It was found that the
      extraction efficiency and selectivity could be tuned by changing the coating
      thickness. The preliminary study of the extraction mechanism indicated that
      analytes were extracted onto the PPY coating mainly by an adsorption mechanism.
      The method was used for the extraction and analysis of both polar and nonpolar
      aromatics in aqueous samples.

PMID- 11195513
TI  - Short-wave near-infrared spectroscopy of biological fluids. 1. Quantitative
      analysis of fat,  protein, and lactose in raw milk by partial least-squares
      regression and band assignment.
AB  - The present study has aimed at providing new insight into short-wave near
      infrared (NIR) spectroscopy of biological fluids. To do that, we analyzed NIR
      spectra in the 800-1,100-nm region of 100 raw milk samples. The contents of fat,
      proteins, and lactose were predicted by partial least-squares (PLS) regression
      and band assignment in that region was investigated based upon PLS loading plots
      and regression coefficients. For the fat prediction, the whole set of samples was
      divided into two groups and the fat concentration was predicted for the samples
      that were not included in the calibration procedures. The correlation coefficient
      and root-mean-square error of prediction (RM-SEP) in the better prediction run
      were found to be 0.996 and 0.087 wt %, respectively. Assignment of the bands due
      to fat was proposed based upon the regression coefficients and PLS loading
      weights, and the importance of a pretreatment in the prediction was discussed.
      Milk proteins also yielded sufficient correlation coefficients and RMSEP although
      the contributions of protein bands to the milk spectra were much smaller than
      those of the fat bands. The sizes of the calibration models for protein
      prediction were considered. This is the first time that good correlation
      coefficients and RMSEP of proteins have ever been obtained for the short-wave NIR
      spectra of milk. For lactose, noisy regression coefficients with limited
      prediction ability were obtained. Band assignment was investigated also for bands
      due to proteins and lactose. We propose the detailed band assignment for the
      short-wave NIR region useful for various biological fluids. The results presented
      here demonstrate that the short-wave NIR region is promising for the fast and
      reliable determination of major components in biological and biomedical fluids.

PMID- 11195514
TI  - An approach for analysis of protein toxins based on thin films of lipid mixtures
      in an optical biosensor.
AB  - Biological membrane-like lipid films were deposited on the sensing surface in an
      optical biosensor instrument. The membranes were mixtures of biologically
      occurring lipids. Eight surfaces were prepared, some of which contained various
      glycolipids as minor components. One was supplemented with membrane proteins. The
      binding of six protein toxins (cholera toxin, cholera toxin B subunit, diphtheria
      toxin, ricin, ricin B subunit, staphylococcal enterotoxin B) and of bovine serum
      albumin at pH 7.4 and pH 5.2 to each of the sensor surfaces was studied. Each of
      the seven proteins gave a distinct binding pattern. The assay is rapid and
      simple, with no need for reagents. The lipid sensor surface is readily
      regenerated after binding and very stable. The concept with mixed lipid layers
      and assays at different pHs gives numerous combinations and could be applicable
      for developing a sensor for protein toxins.

PMID- 11195515
TI  - Micromosaic immunoassays.
AB  - Immunoassays are widely used for medical diagnostics and constitute the principal
      method of detecting pathogenic agents and thus of diagnosing many diseases. These
      assays, which are most often performed in well plates, would be greatly improved
      by a practical method to pattern a series of antigens on a flat surface and to
      localize their binding to many analytes. But no obvious method exists to expose a
      planar surface successively to a series of antigens and analytes. Here, we
      present miniaturized mosaic immunoassays based on patterning lines of antigens
      onto a surface by means of a microfluidic network (muFN). Solutions to be
      analyzed are delivered by the channels of a second muFN across the pattern of
      antigens. Specific binding of the target antibodies with their immobilized
      antigens on the surface results in a mosaic of binding events that can readily be
      visualized in one screening using fluorescence. It is thus possible to screen
      solutions for antibodies in a combinatorial fashion with great economy of
      reagents and at a high degree of miniaturization. Such mosaic-format immunoassays
      are compatible with the sensitivity and reliability required for immunodiagnostic
      methods.

PMID- 11195516
TI  - Selectivity behavior and multianalyte detection capability of voltammetric
      ionophore-based plasticized polymeric membrane sensors.
AB  - The current response features ofvoltammetric ion-selective polymeric membranes
      doped with neutral ionophores in view of practical sensor development are
      elucidated. The membranes are designed to extract ions only under applied
      external potentials and interrogated by normal-pulse voltammetry and pulsed
      amperometry. They contain two polarizable interfaces to avoid loss of lipophilic
      ions at the sample side and to maximize the available potential window. A simple
      theoretical model is developed that describes the observed current at the end of
      an uptake pulse to the applied membrane potential, which is the sum of both
      boundary potentials (at the sample and inner electrolyte side) and the membrane
      internal iR drop. The results describe how the selectivity of the resulting
      sensor must be dependent on the applied potential. Evidently, the role of the
      applied potential is akin to incorporating lipophilic cationic and anionic sites
      with potentiometric ionophore-based membranes, which are well known to
      considerably affect membrane selectivity and to define the charge type of the
      assessed ions. This has important implications for sensor design, as the applied
      cell potential can be used to tune sensor selectivity. Theory also explains the
      role of the inner electrolyte on sensor behavior. A maximum measuring range is
      expected with ions in the inner electrolyte that are difficult to extract into
      the membrane. This corresponds to Kihara's experimental results and contrasts to
      common ion-selective electrode practice, where a salt of the analyte ion is
      normally present in the inner electrolyte. Separate and mixed solution
      experiments with membranes containing the sodium-selective ionophore tert-butyl
      calix[4]arene tetramethyl ester and the lithium ionophore ETH 1810 agree very
      well with theoretical expectations. Multianalyte detection capability with a
      single sensing membrane is demonstrated in a selectivity-modifying pulsed
      amperometric detection mode, where each applied voltage yields a different
      practical selectivity of the sensor. The sensor is altered from being sodium to
      potassium selective as the magnitude of the applied potential is repetitively
      varied within the pulse sequence. The sensors show high long-term stability under
      continuous measuring conditions over 15 h.

PMID- 11195517
TI  - Liposomes labeled with biotin and horseradish peroxidase: a probe for the
      enhanced amplification of antigen--antibody or oligonucleotide--DNA sensing
      processes by the precipitation of an insoluble product on electrodes.
AB  - Liposomes labeled with biotin and the enzyme horseradish peroxidase (HRP) are
      used as a probe to amplify the sensing of antigen-antibody interactions or
      oligonucleotide-DNA binding. The HRP-biocatalyzed oxidation of 4-chloro-1
      naphthol (1) in the presence of H2O2, and the precipitation of the insoluble
      product 2 on electrode supports, are used as an amplification route for the
      sensing processes. The anti-dinitrophenyl antibody (DNP-Ab) is sensed by a
      dinitrophenyl-L-cysteine antigen monolayer associated with an Au electrode. A
      biotinylated anti-IgG-antibody (Fc-specific) is linked to the antigen-DNP-Ab
      complex, and the biotin-labeled HRP-liposomes associate with the assembly through
      an avidin bridge. The biocatalyzed precipitation of 2 on the electrode increases
      the electron-transfer resistances at the electrode-solution interface or the
      electrode resistance itself. The binding events of the different proteins on the
      electrode and the biocatalyzed precipitation of 2 on the conductive support are
      followed by Faradaic impedance spectroscopy or constant-current
      chronopotentiometry. DNP-Ab concentrations as low as 1 x 10(-11) g x mL(-1) can
      be detected by this method. The labeled liposomes were also used for the
      amplified detection of DNA 3. The oligonucleotide 4, complementary to a part of
      the target DNA 3 that is a model nucleic acid sequence for the Tay-Sachs genetic
      disorder, is assembled on an Au electrode. Hybridization of the analyte 3
      followed by the association of the biotin-tagged oligonucleotide 5 yields a three
      component double-stranded assembly. Sensing of the analyte 3 is amplified by the
      association of avidin, the labeled liposomes, and the subsequent biocatalyzed
      precipitation of 2 on the electrodes. The DNA 3 is detected with a sensitivity
      that corresponds to 6.5 x 10(-13) M. Faradaic impedance spectroscopy and
      chronopotentiometry were employed to follow the stepwise assembly of the systems
      and the electronic transduction of the detection of the analyte DNA 3.

PMID- 11195518
TI  - Low-affinity complexes.

PMID- 11195519
TI  - An investigation of the etiology of a mild diarrhea observed in a group of
      grower/finisher pigs.
AB  - An investigation into a mild diarrhea in a group of grower/finisher pigs was
      carried out in order to determine the etiology. A tiamulin injection and a
      carbadox-medicated ration were given to pens of pigs in a 2 x 2 factorial
      experimental design. Pens of pigs were assessed a score, based on the consistency
      of the feces in the pen, each week. The clinical investigation looked for the
      intestinal pathogens Brachyspira pilosicoli, B. hyodysenteriae, Lawsonia
      intracellularis, Salmonella spp., Yersinia spp., transmissible gastroenteritis
      virus, and rotavirus. Despite a rigorous investigation, the diarrhea was not
      attributed to any pathogen. A mild colitis was noted among pigs necropsied while
      affected with diarrhea. Improved diagnostic tools may allow a more effective
      response to an outbreak of mild disease, while at the same time reducing the
      amount of antimicrobials used in swine production.

PMID- 11195521
TI  - A survey of the prevalence of Giardia in dogs presented to Canadian veterinary
      practices.
AB  - Fecal samples (1216) were collected from dogs presented to 15 veterinary
      practices across Canada and tested for Giardia by ELISA for group-specific
      antigen. If positive, the presence of Giardia was confirmed by microscopy. Eighty
      eight submissions tested positive by ELISA and microscopy. The overall prevalence
      rate of Giardia was 7.2%.

PMID- 11195520
TI  - Evaluation of a strategic deworming program in dairy heifers in Quebec based on
      the use of moxidectin, an endectocide with a long persistency.
AB  - Two different deworming strategies based on the use of moxidectin, a broad
      spectrum endectocide with persistency against Ostertagia ostertagi, were
      evaluated in grazing dairy heifers. Eighty-four heifers unexposed to parasitic
      infection were randomly allocated to 3 different groups: untreated (Group 1),
      treated at 3 and 10 weeks after turnout with 0.5 mg/kg/body weight (BW) of
      topical moxidectin (Group 2), or treated at turnout and 10 weeks later with 0.5
      mg/kg/BW of topical moxidectin (Group 3). The heifers were turned out on June 6
      (Day 0) to a naturally contaminated pasture divided into 3 sections by an
      electrical fence. Each group of heifers was put on a different section of
      pasture. The trial ended when they were housed on October 29 (Day 143). The
      results of this experiment confirmed the beneficial effect of 2 strategic
      treatments with moxidectin pour-on under field conditions in Quebec. The
      parasitological parameters showed a statistical difference in terms of mean fecal
      egg counts between treated and control groups (ANOVA, P < or = 0.006). After
      turnout, pasture larval counts were consistently higher for Group 1 compared with
      counts for Group 2 or 3. All heifer groups gained weight during the trial period,
      but the weight gain profile of both treated groups was significantly higher than
      that of the untreated controls (ANOVA, P < 0.03). During the trial period, Group
      2 and Group 3 gained 77.7 kg BW and 73.2 kg BW, respectively, while Group 1
      gained only 57.9 kg BW, despite the fact that heifers of Group 1 received a
      greater quantity of supplementary feed while on pasture.

PMID- 11195522
TI  - Predictive variables for the occurrence of early clinical mastitis in primiparous
      Holstein cows under field conditions in France.
AB  - Holstein heifers from 47 dairy herds in France were enrolled in a field study to
      determine predictors for clinical mastitis within the first month of lactation.
      Precalving and calving variables (biochemical, hematological, hygienic, and
      disease indicators) were collected. Early clinical mastitis (ECM) predictive
      variables were analyzed by using a multiple logistic regression model (99 cows
      with ECM vs. 571 without clinical mastitis throughout the first lactation). Two
      variables were associated with a higher risk of ECM: a) difficult calving and b)
      medium and high white blood cell (WBC) counts in late gestation. Two prepartum
      indicators were associated with a lower ECM risk: a) medium and high serum
      concentrations of immunoglobulin G1 (IgG1) and b) high percentage of eosinophils
      among white blood cells. Calving difficulty and certain biological blood
      parameters (IgG1, eosinophils) could represent predictors that would merit
      further experimental studies, with the aim of designing programs for reducing the
      risk of clinical mastitis in the first lactation.

PMID- 11195523
TI  - The interpretation of "scientific".

PMID- 11195524
TI  - Estimating the cost of sea lice to salmon aquaculture in eastern Canada.
AB  - Parasitic sea lice are serious problems in aquaculture. The true cost of these
      parasites is unknown. We demonstrate the economic burden imposed by sea lice, so
      that researchers, aquatic specialists, and policy makers can approximate the
      economic cost of this problem and work towards developing alternative control
      methods.

PMID- 11195525
TI  - A survey of demographics and information demands of dairy producers.
AB  - Survey responses from 75 randomly selected dairy producers on Prince Edward
      Island were summarized to obtain a demographic picture of the dairy industry in
      this province and to determine information management practices and demands for
      the future. The results indicate a preparedness for dairy production in the
      future.

PMID- 11195526
TI  - Are dry cat foods contributing to the increased occurrence of certain feline
      diseases?

PMID- 11195527
TI  - Causes of sudden and unexpected death in cats: a 10-year retrospective study.

PMID- 11195528
TI  - Hypertrophic osteodystrophy in a Great Dane puppy.
AB  - An intact male, Great Dane puppy was evaluated for weakness, lethargy, reluctance
      to move, and inability to stand. Hypertrophic osteodystrophy was diagnosed based
      on clinical and radiographic findings. Clinical signs, radiographic lesions,
      gross pathology, histopathology, etiology, and treatment of the disease are
      discussed.

PMID- 11195529
TI  - An ethicist's commentary on the producer who is unwilling to euthanize sick pigs.

PMID- 11195530
TI  - [Migraine: dynamics of psychophysiologic pattern].
AB  - 85 patients with migraine without aura and 20 healthy individuals were examined
      between the attacks, before the attack, during and after it (1-2 days). The
      examination included clinical-neurological analysis; psychological Spilberger's
      and Beck's tests, scale of alexithymia and complex algesic questionnaire;
      recording of the conditional negative wave; determination of nociceptive flexor
      reflex; recording of trigeminal evoked potentials; spectral analysis of the
      heart's rhythms; polysomnographic study. Psychophysiologic pattern characteristic
      for all the patients was established. Psychological and neurophysiological
      parameters changed synchronously in the periods before the attack, during and
      after it. Before the migraineous attack a specific pathologic integration
      increased and presented maximally (the activity of antinociceptive system weakens
      anxiety increased, tension of catecholaminergic systems grew, hyperactivity in
      trigeninal sphere elevated, tolerance to the pain decreased). A clear tendency to
      the reversibility of these changes was observed after an attack. A dynamics
      revealed in the psychophysiological pattern could serve as a predictor of a
      migraineous attack and open some perspectives for prophylaxis of the algesic
      attack.

PMID- 11195531
TI  - [Psychological factors of chronic pain].
AB  - To investigate psychological factors, involved in formation of chronic algesic
      syndrome, 70 patients (50 women, 20 men, mean age--33.5 years) with panic
      disorder (PD) were examined. The patients were divided into 3 groups: with PD
      combined with chronic ache (CA) (26 patients); with PD combined with episodical
      ache (EA) (19 cases); PD without ache (25 individuals). Algesic phenomena were
      estimated according to "Algesic anamnesis of life" questionnaire; depression
      level was estimated according to Back's and Hamilton's Rating tests; the level of
      reactive and personality anxiety--according to Spilberger's inventory test.
      Severity of psychopathologic syndromes was estimated according to SCL Rating
      Scale. It was demonstrated that patients with CA and PD have a more significant
      role of depression in course of the disease as compared with anxiety; prevalence
      of functional-neurological symptoms in clinical pattern of PD (atypicalness);
      high level of somatization and a lot of algesic stresses in their life. Factors
      that prevent chronization of the ache were the following ones: degree of
      manifestation and the significance of phobic anxiety in the course of the
      disease, restricting behavior, atypical PD and less number of pain episodes in
      life.

PMID- 11195532
TI  - [A specific form of headache with neuralgia-like manifestations (SUNCT
      syndrome)].
AB  - A recently described SUNCT is a rare head ache syndrome characterized by
      shortlasting, unilateral, neuralgia-like headache attack with conjunctival
      injection and tearing; 26 cases of SUNCT-syndrome have been reported in medical
      literature. The authors observed the described symptoms in 3 cases (among 86
      patients with trigeminal paroxysmal manifestations). Clinical features of SUNCT
      syndrome are presented. In addition, the authors discuss possible etiologic
      factors and treatment as well as a differential diagnosis of SUNCT-syndrome, from
      trigeminal neuralgia, cluster headache, chronic paroxysmal hemicrania and
      combined syndromes.

PMID- 11195533
TI  - [Aspects of the development in dysphagia and its functional dynamics].
AB  - 100 patients (88 women, 12 men) of 16-64 years of age with functional dysphagia
      were examined. In all the cases the disease develops under the influence of
      stress in individuals with high anxiety, easy formation of dysthymic, obsessive
      phobic reactions in the situation of frustration. Functional dysphagia arises
      most frequently at the age of 20-40 years. 4 stages pass in the course of the
      disease: a stage of reactive (neurotic) depression; psychosomatic reactions;
      psychosomatic cycles (mono- and polysomic); psychopathization. Psychopathization
      manifests pathologic (psychosomatic) development of personality observed usually
      in long-term course of dysphagia.

PMID- 11195534
TI  - [Imovan in therapy of sleep disorders in patients with cerebral stroke].

PMID- 11195535
TI  - [Organic neuroses as psychosomatic problem].
AB  - To study a role of psychogenic and somatogenic factors in the development of
      organic neuroses, 302 patients were examined: 199 with cardioneurosis and 103
      with irritable-bowel syndrome (IBS) with mental and subclinical somatic pathology
      or without it. Two types of organic neuroses were distinguished: a conversive one
      -somatized hysteria (psychogenically determined subsyndromal hysterohypochondriac
      phobic or affective reactions with clear difference of algesic and autonomic
      disorders from symptoms of the somatic pathology, with polymorphism of the
      involved organic systems); and autonomic neurosis that is a central link in the
      structure of psychosomatic correlations, which, on the one hand, was overdone by
      clinical manifestations of the somatic pathology (mitral prolapse--35%,
      ventricular extrasystoles--12%, etc. in cardioneurosis, lymphoid hyperplasia of
      colonic mucosa--100%, dysbiopsis--10%, etc. in IBS); on the other hand, autonomic
      neurosis is a somatopsychic component of psychopathologic disorders of anxious
      phobic, affective and hypochondriac sphere (panic disorder--59%, generalized
      anxiety--15%, anxious depression--18% in cardioneurosis, melancholic or
      hypochondriac cyclothymic depressions--76%, hypochondriac development--24% in
      IBS). Psychosomatic correlations were considered in autonomic neurosis in the
      context of some continuum, where somatic disorders amplified by functional
      disorders are on the one pole and true mental pathology including somatoautonomic
      disorders--on the other pole. Recommendations have been formulated on therapy of
      organic neuroses with anxiolytics, antidepressants and atypical neuroleptics in
      combination with somatotropic drugs.

PMID- 11195536
TI  - [Application of phototherapy in children with headache].
AB  - The paper presents an analysis of the influence of 10 sessions of phototherapy
      (exposure to bright white light, 3300 lux) in 9 children with episodic headache
      of tension (EHAT), in 21 children with chronic headache of tension (CHAT) and in
      10 children with migraine. Clinical complaints, mood, autonomic status, blood
      levels of thyroid hormones, hydrocortisone, prolactin, excretion of
      catecholamines with daily urine were analysed. A course of phototherapy resulted
      in improvement of the mood, a decrease in the number of the complaints, a
      tendency to normalization of autonomic homeostasis, an increase in the levels of
      hydrocortisone and prolactin, a decrease of the high initial level of urine
      adrenaline and noradrenaline as well as elevation of initially low one in 92.5%
      of children from all the groups. The most pronounced positive effect was observed
      after phototherapy in children with CHAT, weaker effect was found in children
      with migraine. The conclusion is made about optimizing and modulating influence
      of phototherapy on the levels of stress-realizing hormones and autonomic
      homeostasis, that improves adaptation of a child's organism.

PMID- 11195537
TI  - [The influence of alpha-dihydroergocryptine derivatives on psychomotor
      manifestations in Parkinson disease].
AB  - The paper presents the results of administration of alpha-dihydroergocryptine
      preparation (vasobral) to parkinsonic patients. It was prescribed to 20 patients
      with parkinsonism together with the specific therapy. Clinical state as well as
      the level of anxiety and depression was estimated using standard scales both
      before and after treatment. A high efficiency of vasobral was found as regards
      such symptoms as disorders of memory, headache, vertigo, a noise in ears and
      head, asthenic state. In some patients functional activity increased, in 4
      patients a dose of dopaminergic preparations was successfully decreased by 25%.
      An important aspect of vasobral activity was also a decrease of anxious
      depressive symptoms. A conclusion was made about efficiency of vasobral in
      combined treatment of parkinsonic patients.

PMID- 11195538
TI  - [Efficiency of new forms of madopar in Parkinson's disease].
AB  - The paper presents estimation of the efficiency of some new forms of madopar
      (madopar dispergative--Mad-Dis, Mad-HBS) in 26 patients with Parkinson's disease
      by methods of motor potential, autonomic tests. A good tolerance of Mad-HBS was
      found. Its administration neither causes changes of autonomic indices nor
      aggravates symptomatology of cardiovascular disease. A single dose of Mad-Dis may
      serve as a predictor for a positive result of DOPA-containing preparations in a
      certain group of patients with Parkinson's disease.

PMID- 11195539
TI  - [Disorder of eating behavior and comorbid syndromes in obesity and methods of
      their correction].
AB  - Eating behavior and comorbid syndromes were investigated in 40 women with
      obesity. A frequent combination of obesity with disorders of eating behavior,
      with emotional-personality, psychoautonomic and algesic disorders as well as with
      appearance of affective disorders during dietetic nutrition ("dietetic
      depression") required their correction. As a result of insufficiency of
      serotoninergic system of brain in pathogenesis of such disorders, fluoxetine
      (prozac)-a selective inhibitor of serotonine reuptake--was used for treatment of
      eating disorders. Heterogeneity in the structure of the obesity is shown.
      Disorders of eating behavior were combined with pronounced anxiety, depression,
      algesic and psychoautonomic syndromes. Therapy with prozac during 3 months in
      dose of 20 mg daily resulted in decrease of weight. Normalization of eating
      pattern, decrease of anxiety, depression, reaction to the external stimuli,
      increase of stress-resistance of patients, alterations in eating liking, decrease
      of severity of disorders comorbid to obesity were observed. A conclusion is made
      that prozac is indicated for patients in whom pathology of eating behavior plays
      a significant role in pathogenesis of obesity.

PMID- 11195540
TI  - [The possibility of the use of several clinical, genetic and MRI characteristics
      for the prognosis of effects of beta-interferon-1beta treatment in multiple
      sclerosis].
AB  - Recently, beta-interferons have become the first line medicine of pathogenic
      treatment of multiple sclerosis (MS). 75 MS patients from Moscow received the
      treatment with beta-interferon-1b (betaferon). Clinical, genetic and MRI data on
      48 of them were included in detailed statistical analyses. High basic frequency
      of relapses, absence of atrophy of the brain at the first MRI scans and the
      presence of HLA-DRB1*15 (less significant DRB1*0301 and DRB1*04) were associated
      with better clinical effects of one year Betaferon course--decrease of relapses
      frequency and delay in EDSS progression.

PMID- 11195541
TI  - [Botox in combined treatment of cerebral palsy in children].
AB  - Ten patients with cerebral palsy (CP) were treated with botox (botulinum toxin,
      type A). The next forms of the disease were observed in the patients: a spastic
      dysplegia, a spastic hemiplegia, a spastic-hyperkinetic form of CP. Botox was
      injected into the damaged muscles in a dose of 100-300 Units. Therapeutical
      effect was found in 90% of the patients, an average duration of the medical
      effect was 6-12 months. Because of the small cohort of the patients treated with
      botox there was made a preliminary conclusion about the high efficiency and
      safety of botox for CP treatment. The need of further clinical observations was
      emphasized.

PMID- 11195542
TI  - [Fluvoxamine (fevarin) in the treatment of depression].
AB  - 30 patients of 23-73 years old with endogenic and reactive depressions were
      treated with fevarin. The clinical state of the patients was estimated by means
      of Hamilton Depression Rating Scale (Ham-D). Fevarin was administrated in daily
      dose of 100-300 mg; the course of the treatment was equal to 4-8 weeks. The
      anxiolytic and antidepressive effects of fevarin were developed from the 5-7 days
      of the therapy: an anxiety disappeared completely by the end of the 3-d week. The
      most pronounced antidepressive effect was found for the classic depression with
      melancholy. A mild simulative effect and a normalization of a sleep were also
      observed. An improvement of the mental state was found in the all the patients by
      the end of the treatment: in 60% it was significant (a complete remission); in
      40%--a considerable improvement was observed with the reduction of all clinical
      components of the depressive state. Fluvoxamine was found to be the high
      effective preparation for both endogenic and reactive depressions.

PMID- 11195543
TI  - [Relative drug resistance as a result of an erroneous approach to patient care].

PMID- 11195544
TI  - [Peculiar lexicon in hysteria].
AB  - A psycholinguistic association experiment was used to examine 19 hysterical
      patients with different functional-neurological motor disorders, such as
      unilateral or bilateral pseudopareses, pseudoataxia and 9 healthy individuals (a
      control group). The method included three tests: a free associative experiment
      and different types of the directed associative experiment (grammatically
      mediated or semantically mediated). According to these tests verbal activity was
      significantly decreased in the patients as compared with controls and patients
      with left-sided pseudoparesis as compared with the right-sided one. In addition,
      there were correlations of verbal activity with the degree of paresis (a positive
      correlation) and with the level of demonstrability of personality (a negative
      one).

PMID- 11195545
TI  - [The use of the instrument for the control of statistic hypotheses for the
      analysis of patient population in mental hospitals].
AB  - To reveal homogeneous groups of old-age patients in psychiatric hospitals, a
      classic method of mathematical statistics chi 2 criterion of Pearson for the
      contingency tables was used. The general sample of patients (655 individuals) was
      from hospitals of Moscow (281 persons), Tver (250 individuals) and Kalyazin (124
      patients). Description of the patients was made by means of sets including 44
      signs from three blocks: demographic, social and clinical. The pattern of
      homogeneous and heterogeneous groups was presented for each separate sign that
      was quite important for practical activity of psychiatrists-gerontologists.

PMID- 11195546
TI  - [The systemic analysis of the predictors of clinico-social prognosis in
      schizotypic pseudoneurotic disorder].
AB  - By means of the systemic analytic approach (a correlation-regression analysis)
      author estimated prognostic significance of clinical characteristics of
      premorbid, initial period and manifestations of schizotypic pseudoneurotic
      disorders in terms of the level of social adaptation. 232 patients were observed
      after the fist hospitalization during 10 years. Criteria of both favorable and
      unfavorable prognosis of the disease were determined. The best prognosis took
      place in 7.6% of the patients, moderate--in 53.4% and the worst (maladaptation)-
      in 38.8% of the cases. A favorable prognosis correlated with poorly
      differentiated (nonspecific for endogenic diseases) disorders and with lack of
      personal changes. Meanwhile, an unfavorable prognosis correlated with disorders
      typical for slow-progredient schizophrenia (polymorphic neurosis-like and
      affective disorders, deficient changes of the personality and cognitive
      disorders).

PMID- 11195547
TI  - [Family form of hemiplegic migraine].

PMID- 11195548
TI  - [Antiphospholipid syndrome with choreic manifestations].

PMID- 11195549
TI  - [Family cases of syringomyelia and Arnold-Chiari anomalies].

PMID- 11195550
TI  - Diatheses and stressors in borderline pathology of childhood: the role of
      neuropsychological risk and trauma.
AB  - OBJECTIVE: To determine the relative contributions of neuropsychological deficits
      and psychosocial stressors to the presence of borderline pathology in children.
      METHOD: The subjects were 86 school-age children (75 males, 11 females) referred
      for psychiatric day treatment. Thirty-five of the children met criteria for
      borderline pathology. Data on psychosocial risk factors were obtained for each
      child from a questionnaire completed by members of the child's clinical team and
      were based on interviews with parents and children, as well as reports from
      schools and social agencies. Neuropsychological measures included computerized
      versions of the Wisconsin Card Sorting Test and the Continuous Performance Test.
      RESULTS: Both deficits in executive function and psychological trauma made
      significant and independent contributions to the variance in borderline
      pathology. Inclusion of both sets of risk factors produced a model that explained
      48% of the variance in borderline diagnosis. CONCLUSIONS: Both environmental
      risks and neurobiological vulnerability should be taken into account to
      understand the etiology of borderline pathology in children.

PMID- 11195551
TI  - Latent class analysis of child behavior checklist anxiety/depression in children
      and adolescents.
AB  - OBJECTIVE: Comorbidity of psychiatric problems such as anxiety and depression
      poses challenges to treatment and research. This study tested whether problem
      items from the Anxious/Depressed scale of the Child Behavior Checklist (CBCL) can
      be separated into distinct anxiety and depression classes or are continuously
      distributed throughout a population. METHOD: A CBCL was completed by a parent or
      guardian of each of 1,987 children and adolescents selected to represent
      nonreferred children in the United States, as well as by a parent or guardian of
      each of a demographically matched sample of 1,987 clinically referred children
      and adolescents. Problem items from the Anxious/Depressed scale of the CBCL were
      subjected to latent class analysis. RESULTS: Analyses revealed three levels of
      problem presentation in both samples. Children in the nonreferred sample were
      classified as having no problems, mild problems, or moderate anxiety/depression
      problems. Children and adolescents in the referred group were classified as
      having mild, moderate, or severe levels of problems. No pure anxiety or
      depression classes were found, only classes containing a mixture of both anxiety
      and depressive problems. Age, gender, and sample differences were found in class
      groupings, with nonreferred adolescent girls showing elevated levels of problems.
      CONCLUSIONS: Results suggest that the comorbid conditions of anxiety and
      depression, as assessed by the CBCL anxiety/depression problem items, can be
      thought of as part of the same continuum of problems. Implications for assessment
      and treatment utilization are discussed.

PMID- 11195552
TI  - When is an assessment an intervention? Parent perception of infant intentionality
      and language.
AB  - OBJECTIVE: To determine whether the process of having parents rate their infant's
      intentionality and language using parent-report questionnaires influences
      parents' tendency to view infants as intentional or linguistic. METHOD: The
      Infant Intentionality Questionnaire (IIQ) and the MacArthur Communicative
      Development Inventories (CDI) were administered to three groups of mothers. Forty
      mothers completed the interviews longitudinally when their infants were 8, 10 and
      12 months old. A group of 20 mothers completed the interviews longitudinally when
      their infants were 10 and 12 months old. A third group of 20 mothers completed
      the interviews at 12 months only. RESULTS: IIQ scores increased across age but
      also were higher if parents had more experience with the questionnaire. CDI
      scores increased with age, but there was no effect of repeated testing.
      CONCLUSIONS: Previous experience with the IIQ seems to have enhanced the tendency
      to perceive intentionality. In contrast, repeated testing with the CDI did not
      alter parent perception of child language. These results suggest that some parent
      report instruments (e.g., the IIQ) can alter the test-taker's awareness and thus
      could serve as an intervention. Parent-report instruments that tap something that
      is salient, familiar, and easily observable (e.g., the child's language) are less
      likely to alter the parent's perception.

PMID- 11195553
TI  - A therapeutic approach to children and adolescents with anxiety disorders and
      associated comorbid conditions.

PMID- 11195554
TI  - Genetics of childhood disorders: XXII. ADHD, Part 6: The dopamine D4 receptor
      gene.

PMID- 11195555
TI  - Maternal depression and comorbidity: predicting early parenting, attachment
      security, and toddler social-emotional problems and competencies.
AB  - OBJECTIVE: To examine relations between maternal depression (in pure and comorbid
      forms) and mother-infant interactions, infant attachment, and toddler social
      emotional problems and competencies. A second objective was to explore sex
      differences. METHOD: Sixty-nine mother-infant dyads were followed from pregnancy
      to 30 months postpartum. Depression was measured at multiple times with self
      report and interview assessments. Play was assessed at 4 months and attachment
      status at 14 months postpartum. At 30 months, mothers completed the Child
      Behavior Checklist and Infant-Toddler Social and Emotional Assessment. RESULTS:
      Lifetime maternal depression predicted less optimal mother-infant interactions
      and insecure infant attachment. However, this "depression effect" was accounted
      for by mothers with comorbid diagnoses, who had less optimal interactions, and
      infants with higher rates of insecurity than either mothers with depression only
      or mothers with no psychopathology. Prenatal and postpartum depressive symptoms
      were associated with problem behaviors and lower competencies for boys. In
      contrast, quality of early interactions predicted problem behaviors in girls.
      CONCLUSIONS: It is important to examine the context of maternal depression with
      respect to additional psychopathology and environmental risks. Maternal
      depression in the presence of other psychopathology confers risk to the mother
      child dyad. Consistent with previous work, risk pathways appear to differ for
      boys and girls. Early identification and prevention efforts are warranted.

PMID- 11195556
TI  - Victimization of children.

PMID- 11195557
TI  - Effectiveness of mental health services.

PMID- 11195558
TI  - Diagnoses and interactive patterns of infants referred to a community-based
      infant mental health clinic.
AB  - OBJECTIVES: To describe the distribution of symptoms and diagnoses in a community
      based infant mental health clinic and to compare play and feeding interactions of
      referred and nonreferred infants. METHOD: The Diagnostic Classification of Mental
      Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3) was
      used to diagnose 113 referred infants (60% were boys). Thirty additional dyads
      were matched with 30 nonreferred dyads. Feeding, play interactions, and home
      environment were compared. RESULTS: Two peaks of referral were found: 0 to 6 and
      12 to 18 months. The main reasons for referral were eating problems, sleep
      problems, aggressive behavior, irritability, and maternal depression. The most
      common DC 0-3 diagnosis was a combination of primary infant disorder, parent
      child relationship disorder, and parental psychopathology. Mothers of referred
      children provided lower levels of sensitivity, support, and structuring of the
      interaction, and less optimal home environment. The dyadic relationship showed a
      lower degree of mutuality and higher negative exchanges. Feeding interactions
      elicited more negative interactions than play. CONCLUSIONS: Infants referred by
      community health workers showed less optimal mother-infant interactions and had
      less optimal environment, compared with nonreferred dyads. Symptoms of emotional
      distress in infancy are best apprehended when assessed in multi-institutional
      contexts and formulated in a multiaxial approach.

PMID- 11195559
TI  - Infant and toddler pathways leading to early externalizing disorders.
AB  - OBJECTIVE: To examine pathways leading to specific types of early externalizing
      disorders. METHOD: Longitudinal data were collected on 310 low-income, male
      subjects followed from infancy until age 6 years. RESULTS: Support across
      informants was found for the importance of the caregiving environment during
      infancy in relation to the development of externalizing disorders at school
      entry. Support was also found for the significance of early child factors, but
      this was limited to child behavior at home. CONCLUSIONS: The results are
      consistent with social learning and attachment models, which suggest that severe
      conduct problems in early childhood are the result of deficits in the caregiving
      environment. Support was also found for Moffitt's hypothesis that children with
      the comorbid attention-deficit/hyperactivity disorder-oppositional defiant
      disorder/conduct disorder pattern experience multiple child and psychosocial risk
      factors that begin during infancy.

PMID- 11195560
TI  - Factitious disorder by proxy.

PMID- 11195561
TI  - Disruptive behavior in young children: what does it mean?
AB  - OBJECTIVE: To examine how the Diagnostic Classification of Mental Health and
      Developmental Disorders of Infancy and Early Childhood (DC 0-3) primary
      diagnoses, Parent-Infant Relationship Global Assessment Scale, and Child Behavior
      Checklist/2-3 (CBCL/2-3) externalizing and internalizing symptoms augment the DSM
      III-R/IV and guide treatment. METHOD: 82 children aged 18 to 47 months, who
      presented with disruptive behavior to an early childhood psychiatry clinic, were
      diagnosed using DSM-III-R/IV, DC 0-3, and the CBCL/2-3. RESULTS: Children with
      DSM-III-R/IV disruptive disorders or attention-deficit/hyperactivity disorder
      were diagnosed with DC 0-3 regulatory disorders, disorders of affect, and
      traumatic stress disorder. Clinically significant externalizing and internalizing
      symptoms co-presented in 45.1% of the children. Of children with disorders of
      affect, 41.2% had relationships categorized as disordered, contrasting with 21.1%
      of those with traumatic stress disorder and 10.3% of those with regulatory
      disorders. Increasingly disordered relationships were significantly correlated
      with externalizing and internalizing symptoms, and children with disordered
      relationships were 3.6 times more likely to have clinically significant levels of
      internalizing symptoms. CONCLUSION: In these children with disruptive behaviors,
      co-presentation of externalizing and internalizing symptoms is most common. Those
      with increased relational risk had more externalizing and internalizing symptoms
      and more disorders of affect.

PMID- 11195562
TI  - Paxil and self-scratching.

PMID- 11195563
TI  - Toward establishing procedural, criterion, and discriminant validity for PTSD in
      early childhood.
AB  - OBJECTIVE: To explore several key aspects of the diagnosis and assessment for
      posttraumatic stress disorder (PTSD) in infants and young children. METHOD:
      Fifteen traumatized, clinic-referred children, and a comparison sample of 12 at
      risk children, all younger than 48 months of age, were assessed with a
      standardized procedure and a semistructured diagnostic interview. The assessments
      were videotaped and reviewed by two blind raters for scoring DSM-IV PTSD criteria
      and an alternative set of PTSD criteria for young children. Raters were debriefed
      and consensus ratings were used to make best-estimate diagnoses. RESULTS: The
      investigation of procedural validity showed that 12% of the diagnostic criteria
      present in these children could be detected by a clinician through direct
      observation or interaction with the children. The remainder of criteria were
      apparent only through caregiver report. Problematic aspects of parental reporting
      were most evident for the avoidance/numbing of responsiveness criteria. The
      traumatized subjects showed significantly more alternative criteria of PTSD than
      DSM-IV criteria of PTSD. The main sources of rater disagreement are described.
      CONCLUSIONS: Additional sources of information would complement the
      multidimensional assessment of PTSD in young children. The set of alternative
      criteria appears to show greater criterion validity than the DSM-IV criteria.

PMID- 11195564
TI  - Pineal germinoma and psychosis.

PMID- 11195565
TI  - Classification of young children's sleep problems: a pilot study.
AB  - OBJECTIVES: This study examines videotaped sleep in infancy in an attempt to
      predict the development of disturbed sleep during toddlerhood. In addition, a
      tentative classification scheme that quantifies night waking and sleep onset
      problems in young children is proposed. METHOD: The sleep patterns of 33 children
      were assessed at two points in time. At 12 months of age (time 1), sleep was
      videotaped on two consecutive nights. A self-soothing/signaling index for 12
      month-olds was constructed. At time 2 (mean age = 39 months), a follow-up
      telephone interview assessed current sleep patterns and the presence or absence
      of sleep problems. RESULTS: The data suggest that the self-soothing/signaling
      index obtained at 12 months of age predicts night waking approximately 2 years
      later. CONCLUSIONS: The preliminary classification scheme for night waking and
      sleep onset problems in young children warrants further study. Night waking in
      toddlers might be predictable from sleep behaviors at 1 year of age.

PMID- 11195566
TI  - Temperamental contributions to social behavior: the moderating roles of frontal
      EEG asymmetry and gender.
AB  - OBJECTIVES: Infant temperament is thought to provide one of the fundamental bases
      for social and emotional development. Few studies have examined the direct and
      indirect influences of early temperament and physiological disposition on later
      development. METHOD: This article presents results of a longitudinal study that
      took place between the years 1989 and 1996 in which the relations between
      maternal reports of negative reactivity at 9 months of age and maternal ratings
      and laboratory observations of social wariness and sociability at 4 years of age
      (n = 97) were examined. Also examined were the moderating roles of (1) frontal
      electroencephalogram (EEG) asymmetry as assessed at 9 months of age and (2) the
      child's gender. RESULTS: Negative reactivity predicted social wariness for
      infants with right frontal EEG asymmetry, but not for those with left frontal EEG
      asymmetry and for boys but not girls. The only significant predictor of
      sociability was gender. Specifically, at 4 years of age girls were rated higher
      on the measure of sociability than were boys. CONCLUSION: The findings are
      discussed in terms of the roles of frontal EEG asymmetry and gender in moderating
      the impact of temperamental negative reactivity on later social behavior.

PMID- 11195567
TI  - Fourteen-year follow-up of speech/language-impaired and control children:
      psychiatric outcome.
AB  - OBJECTIVE: To examine the association between early childhood speech and language
      disorders and young adult psychiatric disorders. METHOD: In a longitudinal
      community study conducted in the Ottawa-Carleton region of Ontario, Canada,
      interviewers administered structured psychiatric interviews to age 19
      participants who were originally identified as speech-impaired only, language
      impaired, or nonimpaired at age 5. The first stage of the study took place in
      1982 when participants were 5 years old, and the latest stage of the study took
      place between 1995 and 1997 when participants had a mean age of 19 years. This
      report examines the association between early childhood speech/language status
      and young adult psychiatric outcome. RESULTS: Children with early language
      impairment had significantly higher rates of anxiety disorder in young adulthood
      compared with nonimpaired children. The majority of participants with anxiety
      disorders had a diagnosis of social phobia. Trends were found toward associations
      between language impairment and overall and antisocial personality disorder
      rates. Males from the language-impaired group had significantly higher rates of
      antisocial personality disorder compared with males from the control group. Age
      of onset and comorbidity did not differ by speech/language status. The majority
      of participants with a disorder had more than one. CONCLUSIONS: Results support
      the association between early childhood speech and language functioning and young
      adult psychiatric disorder over a 14-year period. This association underscores
      the importance of effective and early interventions.

PMID- 11195568
TI  - Introduction--Assessment of infant and toddler mental health: advances and
      challenges.

PMID- 11195569
TI  - Natural course of alcohol use disorders from adolescence to young adulthood.
AB  - OBJECTIVES: To examine the course of alcohol use disorder (AUD) and determine the
      extent to which AUD in adolescence is a risk factor for AUD and other
      psychopathology in young adulthood. METHOD: Nine hundred forty participants from
      a large community sample in western Oregon were interviewed twice during
      adolescence (14-18 years of age the first assessment; between 1987 and 1991) and
      once at age 24 (1993-1999). Between 1995 and 1998, parents were assessed for
      lifetime AUD. Participants were classified into nonproblematic use (NON), problem
      drinker (PROB) (symptoms of AUD but no diagnosis), and AUD groups. RESULTS:
      Adolescent AUD significantly predicted AUD, substance use disorder, depression,
      and elevated levels of antisocial and borderline personality disorder symptoms by
      age 24. Compared with the NON group, adolescents in the PROB group were at
      increased risk for AUD, substance use disorder, depression, and antisocial
      personality disorder symptoms. However, the PROB group had lower rates of future
      AUD and antisocial personality disorder symptoms than the adolescent AUD group.
      Gender interactions were nonsignificant. Daily smoking and conduct/oppositional
      defiant disorders predicted future AUD, when adolescent AUD and other disorders
      were controlled. Paternal, but not maternal, AUD was associated with greater risk
      of future AUD. CONCLUSIONS: For the majority of adolescents, AUD are not benign
      conditions that resolve over time. Assessment, treatment, and prevention
      recommendations are discussed.

PMID- 11195570
TI  - Cognitive risk factors and suicide attempts among formerly hospitalized
      adolescents: a prospective naturalistic study.
AB  - OBJECTIVE: To examine the relationship between cognitive variables and time until
      suicide attempts among 180 adolescents who were monitored for as much as 6.9
      years after discharge from an inpatient psychiatry unit. METHOD: In a prospective
      naturalistic study, adolescents were assessed at the time of their psychiatric
      hospitalization and semiannually thereafter. Suicidal behavior at index
      hospitalization and over the follow-up period was assessed with semistructured
      psychiatric diagnostic interviews. At hospitalization, cognitive risk factors
      were assessed with a problem-solving task and with questionnaires assessing
      hopelessness, expectations for posthospitalization suicidal behavior, reasons for
      living, and dysfunctional attitudes. RESULTS: Expectations about future suicidal
      behavior were related to posthospitalization suicide attempts. Among youths with
      previous suicide attempts, higher levels of hopelessness were associated with
      increased risk, and greater survival and coping beliefs were associated with
      decreased risk for posthospitalization suicide attempts. Hopelessness and
      survival and coping beliefs were not related to posthospitalization attempts
      among adolescents without prior suicidal behavior, and hopelessness was not
      predictive after controlling for overall severity of depression. CONCLUSIONS:
      Expectations for suicidal behavior, hopelessness, and survival and coping beliefs
      provide important prognostic information about later suicidal behavior and should
      be targeted in interventions with suicidal youths.

PMID- 11195571
TI  - [Use of data from DNA-DNA hybridization and analysis of 16S rRNA genes for
      resolving taxonometric problems using the order Haloanaerobiales as an example].
AB  - In this review, the validity of evolutionary conclusions inferred from the
      quantitative estimates of the similarity between bacterial genes is evaluated
      using the order Halonanaerobiales as an example. The haloanaerobic phenotype is
      briefly characterized, as are some specific features that allow the order
      Haloanaerobiales to serve as a reference taxon. Phylogenetic analysis provides a
      set of standard quantitative criteria for ranking bacterial taxa, from species to
      families. Recommendations for the use of these standard criteria are given.

PMID- 11195572
TI  - [Organization and regulation of polyhydroxybutyrate/valerate biosynthesis in
      bacteria].
AB  - Recent data on the biosynthesis of poly(3-hydroxybutyrate) (PHB) and poly(3
      hydroxybutyrate-co-3-hydroxyvalerate) (PHB/V) and its regulation in bacteria are
      reviewed, with special emphasis on the properties and regulation of the relevant
      enzymes and their genes. Some conditions promoting the synthesis of PHB and PHB/V
      by natural, mutant, and recombinant producers are considered.

PMID- 11195573
TI  - [Facultative and obligate aerobic methylobacteria synthesize cytokinins].
AB  - The presence and expression of genes controlling the synthesis and secretion of
      cytokinins by the pink-pigmented facultative methylotroph Methylobacterium
      mesophilicum VKM B-2143 with the serine pathway and nonpigmented obligate
      methylotroph Methylovorus mays VKM B-2221 with the ribulose monophosphate pathway
      of C1 metabolism were shown using the polymerase chain reaction (PCR) and reverse
      transcription-PCR methods. The presence of the corresponding mRNA in M.
      mesophilicum cells grown on methanol or succinate suggests that the expression of
      these genes is constitutive. The cytokinin activity of culture liquid and its
      fractions was determined by a biotest with Amarantus caudatus L. seedlings. Using
      enzyme-linked immunosorbent analysis, we detected zeatin (riboside) in the
      culture liquid of both bacteria studied. The data obtained show that the aerobic
      methylobacteria are phytosymbionts that are able to utilize the single- and
      polycarbon compounds secreted by symbiotic plants and to synthesize cytokinins.

PMID- 11195574
TI  - [Use of poly-beta-oxybutyric acid by Yersinia pseudotuberculosis and Listeria
      monocytegenes bacteria at various temperatures].
AB  - A comparative investigation of the intracellular content of poly-beta
      hydroxybutyric acid showed that Yersinia pseudotuberculosis strains accumulated,
      on the average, lower amounts of this reserve substance than Listeria
      monocytogenes strains. The intracellular pool of poly-beta-hydroxybutyric acid
      was responsible for the growth of the bacteria at low temperatures (4-6 degrees
      C) in the absence of any exogenous carbon and energy source.

PMID- 11195575
TI  - [Production of proteinases associated with Bifidobacterium adolescentis 94-BIM
      cell wall].
AB  - Bifidobacterium adolescentis 94-BIM was found to produce cell-wall bound
      proteolytic enzymes active at acidic, neutral, and alkaline pH values. The
      solubilization of proteinases with 0.5% Triton X-100 substantially improved the
      yield of the enzymes. The most active accumulation of cell-bound proteinases was
      observed in the third hour of cultivation at rates of 156.7, 179.5, and 111.1
      U/(mg h), measured at pH 2.5, 7.0, and 9.0, respectively. It is suggested that
      the cell-wall bound proteinases of B. adolescentis 94-BIM are the precursors of
      the enzymes secreted into the medium.

PMID- 11195576
TI  - [Biosynthesis of Proteus mirabilis nuclease].
AB  - The culture liquid and periplasm of Proteus mirabilis contained nuclease, an
      enzyme with DNase and RNase activities. The nuclease was most actively
      synthesized in the early exponential and stationary growth phases. Nuclease
      synthesis was regulated by nucleic acids (induction by substrate) and inorganic
      phosphate (end-product inhibition). The synthesis and secretion of nuclease by P.
      mirabilis was induced by mitomycin C, an inducer of the SOS functions of cells.
      This suggests the involvement of SOS-response proteins in the regulation of
      nuclease synthesis.

PMID- 11195577
TI  - [Degradation of phenanthrene by mutant strains--naphthalene degraders].
AB  - Five naphthalene- and salicylate-utilizing Pseudomonas putida strains cultivated
      for a long time on phenanthrene produced mutants capable of growing on this
      substrate and 1-hydroxy-2-naphthoate as the sole sources of carbon and energy.
      The mutants catabolize phenanthrene with the formation of 1-hydroxy-2-naphthoate,
      2-hydroxy-1-naphthoate, salicylate, and catechol. The latter products are further
      metabolized by the meta- and ortho-cleavage pathways. In all five mutants,
      naphthalene and phenanthrene are utilized with the involvement of plasmid-borne
      genes. The acquired ability of naphthalene-degrading strains to grow on
      phenanthrene is explained by the fact that the inducible character of the
      synthesis of naphthalene dioxygenase, the key enzyme of naphthalene and
      phenanthrene degradation, becomes constitutive.

PMID- 11195578
TI  - [Composition of lipids from yeast-like and mycelial cells of the fungus Mucor
      hiemalis, grown in the presence of 4-chloroaniline].
AB  - The fungus Mucor hiemalis, which is commonly thought to be monomorphic, produced
      two types of cells, yeastlike and mycelial, during growth in a medium containing
      4-chloroaniline. Among the polar lipids of yeastlike cells,
      diphosphatidylglycerol was dominant, while phosphatidylcholine and
      phosphatidylethanolamine were present in minor amounts. Conversely, mycelial
      cells mainly contained phosphatidylcholine and phosphatidylethanolamine, whereas
      the content of diphosphatidylglycerol was low. The neutral lipids of yeastlike
      cells were dominated by diacylglycerides, sterols, and fatty acids. The content
      of triacylglycerides and sterol esters was low. Yeastlike cells contained higher
      amounts of saturated fatty acids and lower amounts of unsaturated fatty acids
      than the mycelium. The content of stearic acid in the fatty acids of the mycelium
      grown in the presence of 4-chloroaniline was as high as 25.3-29.9%.

PMID- 11195579
TI  - [Characterization of a new strain of Bacillus thuringiensis, a producer of an
      endotoxin against coleoptera].
AB  - A new strain of Bacillus thuringiensis 2-7 was found to belong to the serotype
      H8. Cells of this strain contained irregular and flat crystalline inclusions and
      two large plasmids. The gene responsible for crystal formation is most likely
      located on the large plasmid greater than 105 MDa in size. Comparison of the cry
      gene of B. thuringiensis 2-7 and the cryIIIA gene of B. thuringiensis subsp.
      tenebrionis showed that their nucleotide sequences are identical.

PMID- 11195580
TI  - [A new species of psychrophilic basidiomycetes yeast Leucosporidium fasciculatum
      sp. Nov].
AB  - A psychrophilic yeast with a basidiomycetous developmental cycle and properties
      corresponding to the genus Leucosporidium Fell et al. was isolated from the
      fruiting body of the edible spring mushroom Gyromitra esculenta Pers. picked near
      Moscow. However, the isolate differed from all Leucosporidium species described
      to date in a number of characteristics. The results of the study of the
      developmental cycle and of the cultural, morphological, physiological, and
      biochemical properties of the new isolate, strain KBP Y-3696, allow it to be
      assigned to a new species of the genus Leucosporidium.

PMID- 11195581
TI  - [Growth of Escherichia coli cell culture and frequency of mutation, induced by N
      methyl-N'-nitro-N-nitrosoguanidine].
AB  - The rate of Escherichia coli mutation with N-methyl-N'-nitro-N-nitrosoguanidine
      was found to depend on the age of the culture and the pH value of the incubation
      medium. The mutability of late-logarithmic cells was higher than that of mid
      logarithmic cells. Rifampicin, a transcription inhibitor, enhanced the mutagenic
      action of MNNG on cells from the late logarithmic and early stationary phases
      suspended in a medium with a pH of 7.4, and on cells from the mid-logarithmic
      phase suspended in a medium with a pH of 6.5. Conversely, streptomycin decreased
      the frequency of induced mutations in cells from the late logarithmic and early
      stationary phases suspended in the medium with a pH of 7.4, and in cells from the
      mid-logarithmic and early stationary phases suspended in the medium with a pH of
      6.5. These data were interpreted as showing that the repair of premutational DNA
      lesions induced by MNNG depends on the level of DNA transcription and
      translation.

PMID- 11195582
TI  - [Assimilation of carbon dioxide and oxidation of methane in various zones of the
      Rainbow hyperthermophilic field zones].
AB  - Rates of carbon dioxide assimilation and methane oxidation were determined in
      various zones of the Rainbow Hydrothermal Field (36 degrees N) of the Mid
      Atlantic Ridge. In the plume above the hydrothermal field, anomalously high
      methane content was recorded; the microbial population density (up to 10(5)
      cells/ml) was an order of magnitude higher than the background values; and the
      CO2 assimilation rate varied from 0.01 to 1.1 micrograms C/(1 day). Based on the
      data on CO2 assimilation, the production of organic carbon due to bacterial
      chemosynthesis in the plume was calculated to be 930 kg/day or 340 tons/year
      (about 29% of the organic carbon production in the photic zone). In the black
      smoke above active smokers, the microbial population density was as high as 10(6)
      cells/ml; the rate of CO2 assimilation made up 5-10 micrograms C/(1 day); the
      methane oxidation rate varied from 0.15 to 12.7 mu/(1 day); and the methane
      concentration ranged from 1.05 to 70.6 mu/l. In bottom sediments enriched with
      sulfides, the rate of CO2 assimilation was at least an order of magnitude higher
      than in oxidized metal-bearing sediments. At the base of an active construction
      site, whitish sediment was found, which was characterized by a methane high
      content (92 mu/dm3) and a high rate of oxidation (1.7 mu/(dm3 day)).

PMID- 11195583
TI  - [Microbiological study of the northern part of the Barentz Sea at the onset of
      winter].
AB  - The total number of microorganisms and rates of microbial processes of the carbon
      cycle were determined in snow, sea ice, water, and seafloor sediments of the
      northern part of the Barents Sea from September to October, 1998. The
      explorations were carried out in two areas: along the trajectory from Franz Josef
      Land to Victoria Island and along the continental slope region covered with solid
      ice at latitude 81 degrees-82 degrees N and longitude 37 degrees-39 degrees E. At
      the time of study, the ice cover was represented by thick one-year old ice (up to
      1.2 m), perennial ice (up to 1.85 m), and pack ice. The number of bacteria in the
      snow cover, sea ice, and seawater was 12 to 14, 50 to 110, and 10 to 240 x 10(3)
      cells/ml, respectively. Rates of CO2-assimilation in the absence of light,
      glucose utilization, and methane oxidation by bacteria were determined. The
      highest rate of microbial processes was found in samples of the lowermost newly
      formed sea ice. The lowest level of activity for all processes was observed from
      melted snow water. A direct relation was shown between the concentration of Corg,
      the bacterial biomass, and the values of delta 13Corg in mixtures of melted snow
      and ice. The number of microorganisms and rates of microbial processes in
      seafloor sediments measured at the stations on the continental slope are
      comparable to those in the central part of the Barents Sea and the northern part
      of the Kara Sea.

PMID- 11195584
TI  - [Microbiological processes of the carbon and sulfur cycle in cold methane seeps
      in the North Atlantic].
AB  - Functioning of microbial communities in surface sediments of the Haakon Mosby
      underwater mud volcano (lat. 72 degrees N) and in gas seepage fields of the
      Vestnesa Ridge was investigated using Mir-1 and Mir-2 deep-sea submersibles
      during the 40th expedition of the research vessel Academician Mstislav Keldysh.
      Large areas of sedimentary deposits of the Haakon Mosby mud volcano (HMMV) and
      pockmarks of the Vestnesa Ridge (VR) are covered with bacterial mats 0.1 to 0.5
      cm thick. The microbial community making up bacterial mats of the HMMV was
      predominated by large filamentous bacteria with filaments measuring up to 100
      microns in length and 2 to 8 microns in width. The occurrence of rosettes allowed
      the observed filamentous bacteria to be referred to the morphologically similar
      genera Leucothrix or Thiothrix. Three morphological types of filamentous bacteria
      were identified in bacterial mats covering VR pockmarks. Filaments of type one
      are morphologically similar with representatives of the genera Thioploca or
      Desmanthos. Type two filaments had numerous inclusions of sulfur and resembled
      representatives of the genus Thiothrix. The third morphological type was
      constituted by single filaments made up of tightly connected disk-like cells and
      can, apparently, be assigned to the genus Beggiatoa. The rates of methane
      oxidation (up to 1570 microliters C/(dm3 day)) and sulfate reduction (up to 17 mg
      S/(dm3 day)) measured in surface sediments of HMMV and VR were close to the
      maximum rates of these processes observed in badly polluted regions of the
      northwestern shelf of the Black Sea. High rates of microbiological processes
      correlated with the high number of bacteria. The rate of methane production in
      sediments studied was notably lower and ranged from 0.1 to 3.5 microliters
      CH4/(dm3 day). Large areas of the HMMV caldera were populated by pogonophoras,
      represented by the two species, Sclerolinum sp. and Oligobrachia sp. The mass
      development of Sclerolinum sp. in the HMMV caldera was by the activity of aerobic
      methane-oxidizing bacteria localized inside the cells of these animals. Bacterial
      cells were also found in the trophosome tissue of Oligobrachia sp., but in cells
      of these bacteria, we did not observe the membrane structures typical of
      methanotrophs. The localization pattern of pogonophoras on the surface of reduced
      sediments suggests that the predominant bacteria in Oligobrachia tissues are
      sulfur-oxidizing endosymbionts.

PMID- 11195585
TI  - [Effect of sodium salicylate on the population dynamics of a rhizospheric strain
      of Pseudomonas aureofaciens in soil and on wheat roots].
AB  - The effect of sodium salicylate on the population dynamics of the rhizobacterium
      Pseudomonas aureofaciens BS1393 and its variant bearing the naphthalene
      biodegradation plasmid pBS216 was studied in the wheat rhizoplane and adjacent
      soil. Optimum salicylate concentration for the maintenance of the plasmid-bearing
      strain and for the normal growth of wheat was found to be 250 micrograms/g soil.
      When the soil was supplemented with salicylate, the population of P. aureofaciens
      BS1393(pBS216) in the wheat rhizoplane and adjacent soil was, respectively, 4-
      and 20-fold higher than that of the parent strain lacking the plasmid.

PMID- 11195586
TI  - [Effect of Trichoderma species fungi on soil micromycetes, causing infectious
      conifer seedling lodging in Siberian tree nurseries].
AB  - Soils in the tree nurseries studied were characterized by a lower species
      diversity of fungi than adjacent virgin soils. In particular, the relative
      abundances of representatives of the genera Mucor, Chaetomium, and Trichoderma in
      the nursery soil were two times lower than in adjacent virgin soils. On the other
      hand, the nursery soil exhibited greater abundances of fungi of the genus
      Fusarium, which are causative agents of many diseases of conifer seedlings. To
      appreciate the efficiency of biocontrol of the infectious diseases of conifer
      seedlings, we introduced several indigenous Trichoderma strains into the nursery
      soil and found that this affected the species composition of soil microflora
      considerably. Changes in the species composition of mycobiota beneficially
      influenced the phytosanitary state of soils and reduced the infectious lodging of
      conifer seedlings.

PMID- 11195587
TI  - [Chromatic adaptation of ancient viable cyanobacteria from Arctic permafrost].

PMID- 11195588
TI  - [The phylogenetic position of aerobic, moderately-thermophilic bacteria of the
      Sulfobacillus species, oxidizing Fe2+, S(0) and sulfide minerals].

PMID- 11195589
TI  - [Monoclonal antibodies as an instrument to study fibrin polymerization].
AB  - Examples of using monoclonal antibodies (MAb) for studying the fibrin
      polymerization mechanism are considered. MAb with epitopes situated in the fibrin
      polymerization sites or in the recognition sites of enzymes thrombin,
      plasminogen, and factor XIII, which are the functional partners of fibrin, are
      primarily discussed. The MAb to epitopes in various regions of A alpha, B beta,
      and gamma polypeptide chains of the functionally important E, D, and alpha C
      domains of fibrin are successively described.

PMID- 11195590
TI  - [Phytoecdysteroids: structure, sources and biosynthetic pathways in plants].
AB  - Data on the content of ecdysteroids in plant sources are given and the
      ecdysteroid biosynthesis and role in plants are discussed.

PMID- 11195591
TI  - [Synthetic peptide designs based on immunoactive fragments of the VP1 protein of
      the foot-and-mouth disease virus strain A22].
AB  - Peptide constructs consisting of 44-53 aa were synthesized on the basis of
      sequences 135-159, 170-190 and 197-213 of VP1 from the foot-and-mouth disease A22
      strain. Immunogenic and protective properties of the peptide constructs were
      studied in guinea pigs and mice of three lines. The constructs were shown to
      induce higher levels of antibodies and exhibit higher protective effects than the
      separate peptides. The most active among the peptides studied was the construct
      involving the VP1 fragments 135-160 and 170-190: it protected pigs from the
      experimental infection by the foot-and-mouth disease virus.

PMID- 11195592
TI  - [The chromosomal genes for black widow spider neurotoxins do not contain
      introns].
AB  - The overlapping fragments of the chromosomal DNA from black widow spider
      Latrodectus mactans carrying genes for high-molecular-mass protein neurotoxins,
      alpha- and delta-latroinsectotoxins (alpha-LIT and delta-LIT) and alpha
      latrotoxin (alpha-LTX), were PCR-amplified and cloned. Restriction analysis of
      the PCR products showed that the distribution and sizes of the restriction
      fragments coincided with those deduced from the earlier sequencing of cDNAs of
      the corresponding genes. It thus followed that the alpha-LIT and delta-LIT genes
      are intronless. Along with our data on the structure of the alpha
      latrocrustotoxin (alpha-LCT), this implies that the lack of introns is a common
      feature of the black widow spider genes encoding high molecular mass neurotoxins.

PMID- 11195593
TI  - [Oligomerization of DNA-(adenine-N6)-methyltransferase from phage T4 and its
      effect on the catalytic characteristics of the enzyme].
AB  - The structural and catalytic properties of the phage T4 DNA-(adenine-N6)
      methyltransferase (EC 2.1.1.72) were studied at different enzyme-substrate
      concentration ratios by chemical cross-linking of the protein subunits and by
      measuring the presteady state kinetics of the reactions. Various structural
      states of the methyltransferase were correlated with its catalytic activity, and
      it was shown that the oligomeric forms of the enzyme are catalytically active but
      are characterized by the reaction parameters different from those of the monomer.

PMID- 11195594
TI  - Perspectives. It's lonely in the middle of the road: big story is compromises not
      agreed to.

PMID- 11195595
TI  - Bold new Medicaid model encourages DM innovation.

PMID- 11195596
TI  - Seeking a DM approach to diagnosis, treatment of ADHD in adults.
AB  - Get a handle on diagnosis and treatment of ADHD in adults. Mental health
      practitioners are beginning to recognize that adults, too, can have ADHD, but a
      large percentage of them are falling through the cracks, often with devastating
      consequences. Further complicating the problem is the fact that there is
      widespread practice variation in how the disorder is diagnosed and treated. Now
      some experts are developing standardized assessment tools, and while the science
      to back up such efforts is admittedly lacking, it is clear that progress is being
      made.

PMID- 11195597
TI  - Use your data to efficiently monitor chronic illnesses.
AB  - Internet-based approach streamlines the work of case managers. Phone based follow
      up programs can work well in monitoring chronically ill patients, but they are
      labor intensive. To get around this problem, a Colorado provider has teamed up
      with an application service provider to automate the collection of important data
      on a real-time basis. The result is an Internet-based system of alerts which
      tells case managers who they need to call and when.

PMID- 11195598
TI  - Web-based 'early warning' predictive modeling system enhances preventive care.
AB  - Shifting the focus of disease management from treatment to prevention. There is
      nothing new about the concept of health risk assessment. Most of these tools seek
      to identify people with chronic disease so that interventions can be employed.
      But a cadre of DM firms think that approach does not go far enough. See how one
      firm is trying to move the focus from treatment to prevention of disease in the
      first place.

PMID- 11195599
TI  - Diabetes, hypertension, and cardiovascular disease.

PMID- 11195600
TI  - Significance of circulatory epinephrine levels in exercise-induced neurally
      mediated syncope.
AB  - BACKGROUND AND HYPOTHESIS: Previous research has failed to document temporal
      changes in epinephrine levels in patients with neurally mediated syncope
      associated with exercise. The purpose of this study was to investigate the role
      of circulatory catecholamines in exercise-induced neurally mediated syncope,
      specifically focusing on epinephrine levels. METHODS: The present study deals
      with temporal changes of circulatory catecholamine levels during head-up tilt
      tests (40 min, 80 degree tilt) in 62 patients with syncope of unknown origin, 7
      of whom had syncope associated with exercise (exercise-induced group, 19+/-3
      years). Data were compared with 10 control subjects (control group, 45+/-23
      years). Of the 55 patients with syncope not associated with exercise, 32 tested
      positive for the head-up tilt tests (positive group, 31+/-16 years) and 23
      patients tested negative (negative group, 46+/-19 years). Blood samples for
      circulatory catecholamine assay were obtained from the antecubital vein in the
      baseline supine position 2 min after the tilt started, every 10 min during tilt,
      and at the time of the onset of symptoms or the end of tilt. Levels of
      norepinephrine and epinephrine were determined using the high-pressure liquid
      chromatography (HPLC) method (pg/ml). RESULTS: Plasma norepinephrine levels among
      the four groups were similar at the supine position and during tilt testing. In
      contrast, patients in the exercise-induced group had significantly higher maximum
      epinephrine levels during head-up tilt testing than the other three groups (288+/
      191 vs. 148+/-117, 66+/-31, and 54+/-27 pg/ml, respectively, p < 0.05). Patients
      in the positive group had higher maximum epinephrine levels than those in the
      negative group (p <0.05). Also, patients in the exercise-induced group and those
      in the positive group had a significantly shorter tilt-testing time than patients
      in the negative and control groups. CONCLUSIONS: A marked increase of epinephrine
      was observed during head-up tilt testing in patients with neurally mediated
      syncope associated with exercise. The present findings further accelerate the
      identification of the role of epinephrine in the mechanisms behind neurally
      mediated syncope associated with exercise.

PMID- 11195601
TI  - Right ventricular involvement in hypertrophic cardiomyopathy: a case report and
      literature review.
AB  - Although hypertrophic cardiomyopathy (HCM) is classically considered a disease of
      the left ventricle, right ventricular (RV) abnormalities have also been reported.
      However, involvement of the right ventricle in HCM has not been extensively
      characterized. The literature regarding prevalence, genetics, patterns of
      involvement, histologic findings, symptoms, diagnosis, and treatment of RV
      abnormalities in HCM is reviewed. To highlight the salient points, a case is
      presented of apical HCM with significant RV involvement, with an RV outflow tract
      gradient and near obliteration of the RV cavity, in the absence of a left
      intraventricular gradient. Right ventricular involvement in HCM appears to be as
      heterogeneous as that of the left ventricle. The spectrum extends from mild
      concentric hypertrophy to more unusual severe, obstructive disease. While in some
      cases the extent of RV involvement correlates with left ventricular (LV)
      involvement, predominant RV disease can be seen as well. While the genetics of RV
      involvement have not been well characterized, histologic findings appear to be
      similar to those in the left ventricle, suggesting similar pathogenesis.
      Significant RV involvement may result in RV outflow obstruction and/or reduced RV
      diastolic filling, with potentially increased incidence of severe dyspnea,
      supraventricular arrhythmias, and pulmonary thromboembolism. The optimal
      treatment for patients with significant RV disease is unknown. Medical and
      surgical therapies have been attempted with variable success; experience with
      newer techniques such as percutaneous catheter ablation has not been reported.
      Further characterization of RV involvement in HCM is necessary to elucidate more
      clearly the clinical features and optimal treatments of this manifestation of
      HCM.

PMID- 11195602
TI  - Myocardial viability in patients with thrombolyzed myocardial infarction: is it
      assessable by predischarge exercise electrocardiography test?
AB  - BACKGROUND: Most studies concerning exercise electrocardiography (ECG) testing
      after acute myocardial infarction (AMI) were carried out in the prethrombolytic
      era. ST-segment elevation in the infarction area during exercise has usually been
      interpreted as indicating the presence of dyskinesia as a result of extensive
      left ventricle damage. HYPOTHESIS: This study was undertaken to evaluate the
      contributions of exercise-induced ST-segment elevation and T-wave
      pseudonormalization to the assessment of myocardial viability in patients with
      thrombolyzed myocardial infarction (MI), compared with low-dose dobutamine
      echocardiography. METHODS: The study comprised 52 consecutive patients with AMI
      treated with thrombolysis. All patients underwent low-dose dobutamine
      echocardiography and symptom-limited exercise testing before discharge. RESULTS:
      Nineteen patients showed ST-segment elevation (Group 1), 9 showed isolated T-wave
      pseudonormalization (Group 2), and 24 patients did not exhibit either of these ST
      T segment changes (Group 3). Low-dose dobutamine echocardiography revealed
      evidence of viability in 16 patients (84%) in Group I (p = 0.01), 5 (56%) in
      Group 2 (p = NS), and 11 patients (46%) in Group 3 (p = NS). CONCLUSION: Exercise
      induced ST-segment elevation may contribute to the evaluation of myocardial
      viability in patients with AMI treated with thrombolysis. However, in the absence
      of exercise-induced ST-segment elevation, further noninvasive studies might be
      indicated to assess myocardial viability.

PMID- 11195603
TI  - Screening for carotid artery disease before cardiac surgery: is current clinical
      practice evidence based?
AB  - BACKGROUND: There is no clear consensus as to the correct screening procedure to
      identify patients undergoing cardiac surgery and who are at greatest risk of
      stroke because of the presence of significant carotid artery stenosis. Such
      screening is important because some patients benefit from combined carotid and
      cardiac surgery and, regardless of this, the information gained puts the cardiac
      surgeon in a position to provide an accurate assessment of surgical risk. Our
      objective was to examine current clinical practice of carotid artery
      investigation prior to urgent cardiac surgery and to review this illustrative
      practice in the context of the world literature. HYPOTHESIS: The study aimed to
      establish that current typical practice for screening cardiac surgical patients
      for carotid artery disease is illogical according to the evidence in the world
      literature. METHODS: The study consisted of a retrospective assessment of all
      patients undergoing urgent cardiac surgery and a Medline-derived literature
      review, and included all patients undergoing urgent cardiac surgery at a tertiary
      cardiothoracic center between January 1 and December 31, 1997. RESULTS: Of 529
      patients undergoing urgent cardiac surgery, 44 (8%) were screened preoperatively
      by duplex Doppler ultrasonography for carotid disease. The indications for
      screening were asymptomatic carotid bruit in 24 patients, history of stroke or
      transient ischemic attack (TIA) in 12 patients, and neither stroke, TIA, or bruit
      in 7 patients. The tests were requested either by the attending cardiologists or
      by the cardiac surgeon to whom they were referred. One patient had already been
      diagnosed as having carotid artery disease in the past. Thirteen patients
      underwent additional carotid investigations. Eleven patients were demonstrated to
      have internal carotid artery stenosis > or = 60% and 3 patients underwent
      combined cardiac and carotid surgery. Review of the literature revealed the
      following groups to be at increased risk of future stroke unrelated to surgery,
      and of postoperative stroke: those with a history of stroke or TIA, those with
      carotid bruits, and, of importance, all patients with significant carotid
      stenosis. Recent data suggest that symptomatic patients and the elderly are at
      greatest risk. CONCLUSIONS: Only 8% of patients undergoing urgent cardiac surgery
      in a 1-year period were screened for carotid artery disease. We suggest that
      screening should definitely be performed in all patients with a history of stroke
      or TIA, all patients with a bruit, and all patients aged > 65 years. The
      literature suggests, however, that significant reductions in stroke rate could be
      achieved by screening the whole cardiac surgical population, although there is a
      paucity of data that are specifically pertinent to this patient subgroup. Further
      data are therefore required for the construction of a scientifically valid and
      medicolegally sound policy.

PMID- 11195604
TI  - Electrocardiographic criteria for predicting total occlusion of the proximal left
      anterior descending coronary artery in anterior wall acute myocardial infarction.
AB  - BACKGROUND: Patients with occlusion of the left anterior descending coronary
      artery (LAD) proximal to both the first septal branch and the first diagonal
      branch may benefit most from early reperfusion therapy due to extensive area at
      risk. HYPOTHESIS: The aim of the study was to examine whether 12-lead
      electrocardiograms (ECGs) in the acute phase of acute myocardial infarction (AMI)
      could identify total occlusion of the LAD proximal to both the first septal and
      the first diagonal branch. METHODS: A 12-lead electrocardiogram was recorded on
      admission in 128 patients with anterior AMI within 12 h from symptom onset.
      Patients were divided into three groups according to the culprit lesion: 33
      patients had total occlusion of the LAD proximal to both the first septal
      perforator and the first diagonal branch (Group P), in 51 it was proximal to
      either the first septal perforator or the first diagonal branch (Group D-a), and
      in 44 it was distal to both the first septal perforator and the first diagonal
      branch (Group D-b). RESULTS: Sensitivity and specificity of a greater degree of
      ST-segment depression in lead III than that of ST-segment elevation in lead aVL
      were 85 and 95%, respectively, which was better than the results derived by all
      other ECG criteria (p< 0.001). CONCLUSIONS: We conclude that a greater degree of
      ST-segment depression in lead III than that of ST-segment elevation in lead aVL
      is a useful predictor of proximal LAD occlusion in patients with anterior AMI.

PMID- 11195605
TI  - Influence of age on left atrial appendage function in patients with nonvalvular
      atrial fibrillation.
AB  - BACKGROUND: Age is an independent risk factor for thromboembolism in nonvalvular
      atrial fibrillation (NVAF). An association between low left atrial appendage
      (LAA) Doppler velocities and thromboembolic risk in NVAF has been reported.
      HYPOTHESIS: The study was undertaken to identify age-related differences in LAA
      function that may explain the higher thromboembolic rates in older patients with
      NVAF. METHODS: Forty-two consecutive patients (age 69+/-2 years [range 42-92], 24
      [57%] men) with NVAF underwent transthoracic and transesophageal
      echocardiography. The following were compared in 22 patients younger and 20 older
      than 70 years: left ventricular (LV) diameter, mass and ejection fraction, left
      atrial (LA) diameter and volume, LAA area and volume, LAA peak emptying (PE) and
      peak filling (PF) velocities, presence and severity of spontaneous echo contrast
      (SEC) and mitral regurgitation (MR). RESULTS: Left atrial diameter (4.6+/-0.1 vs.
      4.5+/-0.2 cm), LA volume (105+/-10 vs. 92+/-8 ml), LAA area (6.8+/-0.6 vs. 5.2+/
      0.8 cm2), and LAA volume (5.6+/-0.9 vs. 3.9+/-1.0 ml) were similar (p>0.05) in
      both groups. Older patients had lower LAA PE (26+/-2 vs. 34+/-3 cm/s, p = 0.02)
      and PF (32+/-2 vs. 41+/-4 cm/s, p = 0.04) velocities, lower LV mass (175+/-13 vs.
      234+/-21 gm, p = 0.02), higher relative wall thickness (0.52+/-0.02 vs. 0.43+/
      0.03, p = 0.02), smaller LV diastolic diameter (4.3+/-0.1 vs. 5.2+/-0.2 cm, p <
      0.001), and higher LV ejection fraction (62+/-2 vs. 55+/-2%, p = 0.025).
      Frequency and severity of SEC and MR were similar in both groups. Multivariate
      analysis identified older age as the only significant predictor of reduced LAA
      velocities. CONCLUSION: Compared with younger patients, older patients with NVAF
      have lower LAA velocities despite higher LV ejection fraction, smaller LV size,
      and similar LA and LAA volumes. These findings may explain the higher
      thromboembolic rates in older patients with NVAF.

PMID- 11195606
TI  - Silent ischemic interval on exercise test is a predictor of response to drug
      therapy: a randomized crossover trial of metoprolol versus diltiazem in stable
      angina.
AB  - BACKGROUND AND HYPOTHESIS: There is no method available to predict the relative
      antianginal efficacy of beta blockers and calcium-channel antagonists. The
      present study was undertaken to assess the role of silent ischemic interval (SII)
      on exercise treadmill test (ETT) as a predictor of response to therapy with
      metoprolol and diltiazem in patients with stable angina. METHODS: Thirty-four
      patients with stable angina were divided into two groups depending upon the
      presence or absence of an SII gap of at least 1 min between onset of ST
      depression and appearance of angina on ETT. Metoprolol (50-100 mg twice daily)
      and diltiazem (60-120 mg three times daily) were randomly assigned for 6 weeks to
      patients in each group, and then patients were crossed over for further 6 weeks
      after a washout period of 2 weeks. Antianginal efficacy was assessed by clinical
      and exercise parameters. RESULTS: In patients with SII, the clinical responder
      rate was better with metoprolol than with diltiazem (90 vs. 60%, respectively),
      and on ETT, metoprolol produced significant improvement in the total exercise
      time (p< 0.01), time to 1 mm ST depression (p <0.01), time to angina (p <0.01),
      and a significant decrease in peak rate-pressure product (p<0.001), whereas
      diltiazem had no significant effect on exercise parameters. However, in patients
      without SII, metoprolol and diltiazem had a similar clinical responder rate
      (57%), and both produced a significant increase in total exercise time (p <
      0.01), time to 1 mm ST depression (p < 0.01), and time to angina (p < 0.01). In
      addition, metoprolol had a significant effect on peak rate-pressure product (p <
      0.001). CONCLUSION: Silent ischemic interval on ETT can be a predictor of
      response to antianginal therapy in stable angina, as patients with SII respond
      better to metoprolol and those without SII respond equally to both metoprolol and
      diltiazem.

PMID- 11195607
TI  - Association between calcific aortic stenosis and hypercholesterolemia: is there a
      need for a randomized controlled trial of cholesterol-lowering therapy?
AB  - BACKGROUND: Calcific aortic stenosis may have common etiological factors with
      atherosclerosis. HYPOTHESIS: In this retrospective, case-control study, we aimed
      to determine whether there is an association between hypercholesterolemia and
      calcific aortic valve stenosis. METHODS: Consecutive patients undergoing single
      aortic or mitral valve replacement in a regional cardiothoracic surgical center
      were reviewed and preoperative patient characteristics were recorded:
      demographics, comorbidity (including coronary artery disease and associated risk
      factors), serum total cholesterol, lipid-lowering therapy, and serum creatinine.
      RESULTS: Serum total cholesterol concentrations were significantly higher in
      patients with calcific aortic stenosis than in controls (6.2+/-1.1 vs. 5.3+/-1.1
      mmol/l; p < 0.001). The significant difference in serum cholesterol
      concentrations remained following correction for gender and body mass index (p =
      0.02) and when patients with coronary artery disease were excluded (6.3+/-1.1 vs.
      5.3+/-1.4 mmol/l; p<0.001). Subgroup analysis demonstrated that the association
      between elevated serum cholesterol concentrations and calcific aortic stenosis
      was particularly strong in patients with tricuspid aortic valves (6.4+/-1.2 vs.
      5.3+/-1.1 mmol/l; p < 0.001) compared with those with bicuspid valves (5.9+/-1.1
      vs. 5.3+/-1.1 mmol/l; p = 0.06). CONCLUSIONS: We conclude that
      hypercholesterolemia is associated with calcific aortic stenosis and may be
      implicated in its pathogenesis and progression. We believe that there is now a
      need for a randomized, controlled trial of cholesterol-lowering therapy in
      patients with calcific aortic stenosis.

PMID- 11195608
TI  - Length of stay and procedure utilization are the major determinants of hospital
      charges for heart failure.
AB  - BACKGROUND: Most of the 10 billion dollars spent annually on heart failure (HF)
      management in this country is attributed to hospital charges. There are
      widespread efforts to decrease the costs of treating this disorder, both by
      preventing hospital admissions and reducing lengths of stay (LOS). HYPOTHESIS:
      The objective of this study was to identify the major determinants of hospital
      charges for an acute hospitalization for HF among a large, diverse group of
      patients. METHODS: Administrative information on all 1995 New York State hospital
      discharges assigned ICD-9-CM codes indicative of HF in the principal diagnosis
      position were obtained. Bivariate and multivariate statistical analyses were
      utilized to determine those patient- and hospital-specific characteristics which
      had the greatest influence on hospital charges. RESULTS: In all, 43,157 patients
      were identified. Mean hospital charges were $11,507+/-15,995 and mean hospital
      LOS was 9.6+/-14.5 days. With multivariate analyses, the most significant
      independent predictors of higher hospital charges were longer LOS, admission to a
      teaching hospital, treatment in an intensive care unit, and the utilization of
      cardiac surgery, permanent pacemakers, and mechanical ventilation. Age, gender,
      race, comorbidity score, and medical insurance, as well as treatment by a
      cardiologist and death during the index hospitalization were not among the most
      significant predictors. CONCLUSIONS: We conclude that LOS and procedure
      utilization are the major determinants of hospital charges for an acute episode
      of inpatient HF care. Reducing LOS and other initiatives to restructure hospital
      based HF care may reduce total health care costs for HF.

PMID- 11195609
TI  - Combination treatment with telmisartan and hydrochlorothiazide in black patients
      with mild to moderate hypertension.
AB  - BACKGROUND: Hydrochlorothiazide (HCTZ) is commonly used to treat black patients
      with hypertension. To avoid the metabolic disturbances associated with high-dose
      HCTZ, blood pressure control may be achieved by combining low doses with another
      antihypertensive. HYPOTHESIS: The study was undertaken to assess the tolerability
      and antihypertensive dose-response efficacy of telmisartan and HCTZ and their
      combination in black patients with mild to moderate hypertension (mean supine
      blood pressure 140/95-200/114 mmHg). METHODS: Following a 4-week, single-blind,
      placebo run-in period, 222 black patients were randomized to once-daily treatment
      with one of 20 different double-blind combinations of telmisartan (0, 20, 40, 80,
      160 mg) and HCTZ (0, 6.25, 12.5, 25 mg) for 8 weeks. Blood pressure was measured
      at baseline and after 2, 4, and 8 weeks. RESULTS: Telmisartan 80 mg/HCTZ 12.5 mg
      reduced supine trough diastolic blood pressure (DBP)--primary efficacy parameter-
      by 13.3 mmHg, and supine trough systolic blood pressure (SBP) by 21.5 mmHg. These
      reductions represented benefits of 13.7/8.7 mmHg over telmisartan 80 mg and
      12.3/8.1 mmHg over HCTZ 12.5 mg (p < 0.01). Telmisartan 40 mg/HCTZ 12.5 mg
      reduced supine trough SBP/DBP by 14.3/10.0 mmHg, amounting to 12.3/3.3 mmHg more
      than telmisartan 40 mg and 5.1/4.8 mmHg more than HCTZ 12.5 mg. This reached
      significance for the comparisons with telmisartan 40 mg for SBP and HCTZ 12.5 mg
      for DBP (p<0.05). A response surface analysis and therapeutic response rates
      confirmed the additive antihypertensive effects of telmisartan and HCTZ. All
      treatments were well tolerated, with side-effect profiles comparable with
      placebo. Adverse events were mainly transient and of mild to moderate severity.
      CONCLUSIONS: Telmisartan 80 mg combined with HCTZ 12.5 mg is effective and well
      tolerated in black patients with mild to moderate hypertension, providing greater
      antihypertensive activity than the corresponding monotherapies.

PMID- 11195610
TI  - Heart rate-lowering and -regulating effects of once-daily sustained-release
      diltiazem.
AB  - BACKGROUND: Epidemiologic evidence suggests that an elevated heart rate (HR) is
      an adverse and independent prognostic factor in arterial hypertension and other
      cardiovascular diseases. Although diltiazem is characterized as an HR-lowering
      calcium antagonist, no studies have quantified the magnitude of HR changes in
      patients with angina or hypertension. HYPOTHESIS: The study was undertaken to
      explore the magnitude of proportional HR reduction at varying levels of resting
      HR with the sustained-release formulation of diltiazem (SR diltiazem) at the
      usual clinical doses of 200 or 300 mg once daily. METHODS: This meta-analysis was
      conducted on six comparative double-blind studies including 771 patients with
      angina or hypertension in which SR diltiazem 200-300 mg once daily was compared
      either with placebo or with other agents known not to influence HR (angiotensin
      converting enzyme inhibitors, diuretics). Sustained-release diltiazem decreases
      elevated baseline HR, with an increasing effect at higher initial rates. RESULTS:
      Multiple comparisons by baseline HR category showed a significant difference
      between both groups for baseline HR of 74-84 beats/min and > or = 85 beats/min (p
      = 0.001). Sustained-release diltiazem had no significant HR-decreasing effect on
      baseline HR < or =74 beats/min but appears to have a genuine regulating effect on
      HR: it reduces tachycardia without inducing excessive bradycardia. These findings
      are in contrast to those with dihydropyridine calcium antagonists, which tend to
      increase HR and have been associated with an adverse outcome in acute
      cardiovascular conditions. At the same time, there is evidence to suggest that HR
      lowering calcium-channel blockers decrease cardiovascular event rates following
      myocardial infarction. CONCLUSION: When calcium antagonists are indicated for use
      in patients with angina or hypertension, an HR-lowering agent, that is, diltiazem
      rather than dihydropyridine, should be recommended.

PMID- 11195611
TI  - Homocysteine: a new cardiac risk factor?
AB  - Elevated plasma homocysteine levels have recently been implicated as a new risk
      factor for coronary artery disease. In this article, homocysteine metabolism,
      secondary causes of elevated plasma homocysteine, and the potential mechanism of
      vascular damage in hyperhomocysteinemia are briefly reviewed. The current
      clinical evidence implicating hyperhomocysteinemia as a risk factor for coronary
      artery disease, as well as the data regarding the effects of B vitamin
      supplementation on homocysteine concentrations, are also reviewed. The current
      recommendation of the authors is to treat patients with known coronary artery
      disease or those who are considered to be at high risk for coronary artery
      disease with 400 microg of folate supplementation. Until prospective clinical
      trial data become available, this approach appears to be a safe and effective way
      to approach this patient population.

PMID- 11195621
TI  - Percutaneous retrieval of a large peripherally inserted central catheter remnant
      from the pulmonary arteries.

PMID- 11195622
TI  - Which fasting triglyceride levels best reflect coronary risk? Evidence from the
      Turkish Adult Risk Factor Study.
AB  - BACKGROUND: Association between raised low-density lipoprotein cholesterol (LDL
      C) levels and high risk for coronary heart disease (CHD) is well established and
      taken into account in guidelines on coronary prevention. HYPOTHESIS: The
      relationship between risk for coronary heart disease (CHD) and the levels of
      fasting plasma triglycerides was studied in the cohort of the Turkish Adult Risk
      Factor Study, a representative random sample of an adult population. METHODS: In
      829 men and 907 women aged > or =27 years (mean 48.5+/-11), plasma lipids and
      lipoproteins were measured by the enzymatic dry method in the postabsorptive
      state. A sample of values was validated in a reference laboratory. Apoliprotein
      (apo) A-I and B were measured by the turbidimetric immunoassay using commercial
      kits in part of the cohort. Blood pressure and anthropometric measurements were
      made. Criteria for the diagnosis of CHD were based on history, cardiovascular
      examination, and Minnesota coding of resting electrocardiograms. Coronary heart
      disease was diagnosed in about 7% of the subjects. Participants were divided into
      four categories depending on their triglyceride levels: I = < 100 mg/dl (282 men,
      400 women), II = 100-139 mg/dl (204 men, 228 women), III = 140-212 mg/dl (188
      men, 180 women), and IV = > or = 212 mg/dl (155 men, 99 women). RESULTS: After
      adjustment for age, high-density lipoprotein (HDL) and low-density lipoprotein
      (LDL) cholesterol, smoking, and body mass index by logistic regression analysis,
      and after assigning the CHD risk of 1 to Category I, the relative risk for men
      and women combined rose to 1.42 in Category III (p<0.045) while it diminished to
      0.94 in Category IV (p = 0.79). In women, the odds ratio (OR) rose gradually up
      to 1.78 (p< 0.025) in Category III, only to decline in Category IV. The OR in men
      was slightly, insignificantly, and equally elevated in Categories III and IV.
      Patients with CHD in Category III were not distinguished from those in Category
      IV by the studied risk parameters. It was suggested that high risk for CHD-
      particularly in subjects with slightly elevated or normal cholesterol levels-is
      often not reflected by extreme increases of fasting triglycerides but best by
      modest elevations (140-212 mg/dl), which serve better as a marker of triglyceride
      rich lipoprotein particles. This knowledge may prove to be of value in population
      screening and individual risk assessment.

PMID- 11195623
TI  - Single left coronary artery with origin of the right coronary artery from distal
      circumflex.
AB  - We report two very unusual cases of agenesis of the right coronary ostium with
      continuation of the left circumflex artery as the right coronary artery. The
      recognition of the anomaly in the first case lead to a better understanding of
      this finding in the second case, which translated into shorter procedure time,
      less contrast volume, and fewer catheter manipulations.

PMID- 11195624
TI  - John Collins Warren.

PMID- 11195625
TI  - Molecular characterization of an infectious bronchitis virus strain isolated from
      an outbreak in vaccinated layers.
AB  - An infectious bronchitis virus (IBV) strain CT/7852/97 was isolated from a
      commercial layer flock experiencing decreased egg production and poor egg
      quality. Reciprocal virus neutralization test demonstrated that the isolate was
      closely related to Massachusetts, Arkansas, and JMK. With the use of both reverse
      transcription-polymerase chain reaction-restriction fragment length polymorphism
      and multiplex polymerase chain reaction methods, results consistently showed that
      CT/7852/97 isolate was Massachusetts serotype specific only. The nucleotide
      sequence of S1 polypeptide coding region of CT/7852/97 was determined and
      compared with the published sequences of 12 IBV strains from North America. The
      highest nucleotide homology with H120 (97%) and the least homology (62%) with
      Delaware (De/072/92) were observed. Massachusetts 41 and Beaudette shared 94% and
      93%, respectively, nucleotide similarity with CT/7852/97, and Connecticut, JMK,
      and Arkansas 99 had 94%, 83%, and 78%, respectively, nucleotide similarity with
      CT/7852/97. Furthermore, no possible recombination site on S1 gene among
      Massachusetts 41, Arkansas 99, and JMK was detected in the isolate.

PMID- 11195626
TI  - Analysis of semen quality from each testis/duct system of a turkey with a
      duplicated cloaca and vent.
AB  - A case is described wherein a turkey male (tom) possessed two vent areas with
      duplicated cloacae served by one large intestine. Both cloacae were functional in
      that feces were excreted and semen could be collected from each. The left vas
      deferens and ureter emptied into the left cloaca, and the right vas deferens and
      ureter emptied into the right cloaca. This allowed semen from each testis/duct to
      be collected separately from the corresponding cloaca. Thus, a unique opportunity
      was presented to collect semen separately from the left and right testis/duct
      system for semen analysis and fertility determination. Sperm concentration and
      percentage of dead sperm were not significantly different when semen from left
      vs. right reproductive tract were compared. The concentrations of spermiophages
      in semen from both reproductive tracts fell into the range reported for normal
      semen (0-8 x 10(5)/ml); however, semen from the right side had consistently
      higher spermiophage concentrations than that from the left side. On the basis of
      observations from one male made possible by an anatomic anomaly, it appears that
      the fecundities of the left and right testis/duct systems of the turkey male do
      not significantly differ and that recruitment of spermiophages into one tract
      (because of immunologic challenge, etc.) does not necessarily mean that the
      opposite testis/ducts will respond similarly.

PMID- 11195627
TI  - Diagnosis of eastern equine encephalitis by immunohistochemistry in two flocks of
      Michigan ring-neck pheasants.
AB  - The diagnosis of eastern equine encephalitis (EEE) virus infection in avian
      species is relatively difficult when compared with other species. There are no
      characteristic histologic lesions in the avian brain that would serve to
      distinguish EEE from infections with, for example, Newcastle disease or highly
      pathogenic avian influenza virus. Traditionally, virus isolation (VI) and/or
      hemagglutination inhibition (HI) has been used for a definitive diagnosis of EEE
      in birds. Recently, we developed an immunohistochemistry (IHC) technique for
      confirmatory diagnosis of EEE infection in equine brain. This test also detected
      EEE virus in formalin-fixed avian brain. VI confirmed IHC finding in two cases of
      EEE in ring-neck pheasants. IHC is a rapid, sensitive test for confirming and
      differentiating a histopathologic diagnosis of EEE in avian species and should be
      considered as an alternative test to VI or HI.

PMID- 11195628
TI  - Infection of turkeys with Ornithobacterium rhinotracheale and Mycoplasma
      synoviae.
AB  - Within 1 mo, two separate outbreaks of respiratory disease occurred in two flocks
      on the multiage market turkey farm in Slovenia. More severe dinical signs and
      higher mortality were observed in male birds. Ornithobacterium rhinotracheale
      (ORT) was isolated in pure culture from tracheas of the affected birds in both
      outbreaks. Commercial enzyme-linked immunosorbent assay test showed the presence
      of antibodies to ORT in sera of birds from both clinically affected flocks and
      also in two flocks of younger birds without clinical sings. Immunoblotting with
      ORT culture isolated during the outbreak as an antigen confirmed the presence of
      antibodies to ORT in sera of turkeys of all four flocks examined. In addition,
      three different serologic assays also detected antibodies to Mycoplasma synoviae
      (MS) in three out of four flocks. The concomitant infection with MS did not show
      an obvious effect on mortality rates nor on the antibody response against ORT.
      Younger birds appeared to be less susceptible to ORT pathogenicity because in
      those flocks the infection was subclinical.

PMID- 11195629
TI  - Experimental Escherichia coli respiratory infection in broilers.
AB  - This study determined optimal conditions for experimental reproduction of
      colibacillosis by aerosol administration of avian pathogenic Escherichia coli to
      2-to-4-wk-old broiler chickens. The basic model for reproducing disease was
      intranasal administration of approximately 10(4) mean embryo infectious dose of
      infectious bronchitis virus (IBV) followed by aerosol administration of an 02 or
      an 078 strain of E. coli in a Horsfall unit (100 ml of a suspension of 10(9)
      colony-forming units/ml over 40 min). Scores were assigned to groups of infected
      chickens on the basis of deaths; frequency and severity of lesions in the air
      sacs, liver and heart; and recovery of the challenge E. coli 6 days post-E. coli
      infection. An interval of 4 days between the IBV and E. coli challenges was best
      whether the chickens received the IBV at 8 or 20 days of age. Typically, 50%-80%
      of the chickens developed airsacculitis and 0 to 29% of the chickens developed
      pericarditis or perihepatitis, with little or no mortality. Escherichia coli
      alone resulted in no deaths and 0 to 20% airsacculitis, but these percentages
      increased to 0 to 5% and 52%-60% when the E. coli aerosol was administered
      through a cone-shaped chamber. Administration of IBV alone failed to induce
      lesions. Recovery of the challenge E. coli from chickens did not correlate well
      with lesions. On the basis of these data, administration of IBV to 20-day-old
      chickens followed 4 days later by exposure to an avian pathogenic E. coli
      reproduces avian colibacillosis with the low mortality, high percentage of
      airsacculitis, and low percentage of septicemic lesions characteristic of the
      conditions seen in the natural disease.

PMID- 11195630
TI  - Development of a quantitative-competitive polymerase chain reaction assay for
      serotype 1 Marek's disease virus.
AB  - We have developed a quantitative-competitive (QC) polymerase chain reaction (PCR)
      for the detection of Marek's disease virus (MDV) DNA. The assay utilizes a
      competitor DNA that differs from the viral DNA of interest by having a small
      insertion. The competitor DNA acts as an internal standard for the estimation of
      viral DNA in an unknown sample. The amount of viral DNA in a sample is
      quantitated by coamplification in the presence of a known amount of competitor
      DNA. The same PCR primers that amplify the viral DNA also amplify the competitor
      DNA. When the amount of competitor is equal to the amount of viral DNA in a
      sample, there is equal amplification of the competitor and the virus. Thus, we
      are able to quantitate the viral DNA in an unknown sample. To establish the
      utility of this assay, in vivo correlations between virulence and virus
      replication were studied. Our data demonstrated that a more virulent strain of
      MDV (648A) replicated better in thymus during cytolytic infection than did a less
      virulent strain (GA). However, no differences in virus titer were observed when
      these two viruses were propagated in tissue culture. Our data are consistent with
      the generally held idea that "hot" strains of MDV replicate earlier and better in
      birds. Thus, QC-PCR is extremely specific and sensitive to measure MDV DNA over a
      wide range and can be applied to in vivo studies of viral pathogenesis.

PMID- 11195631
TI  - Interaction of Marek's disease virus and Cryptosporidium baileyi in
      experimentally infected chickens.
AB  - Histocompatible B13/B13 white specific-pathogen-free leghorn chickens were used
      to investigate the effect of coinfection with Cryptosporidium baileyi and the
      HPRS 16 strain of Marek's disease virus (MDV) in chickens and to assess the
      pathogenicity of C. baileyi when MDV is given before or after the parasite.
      Groups of chickens concurrently infected with C. baileyi orally inoculated at day
      (D)4 and MDV inoculated at hatching (C4M0 group) or at D8 (C4M8 group) were
      compared with relevant control groups inoculated with only C. baileyi at D4 (C4
      group), only MDV at hatching (M0 group) or at D8 (M8 group), and an uninoculated
      control group (UC group). The chickens were kept in isolator units until the end
      of the experiment at D62. Our results showed a considerable synergistic effect in
      concurrently infected chickens and more severe consequences when chickens
      received MDV before C. baileyi infection. In fact, except for a slight transitory
      weakness, the chickens in C4 group remained free of overt clinical signs and
      there was no mortality. However, coinfection with both pathogens induced more
      lasting or permanent oocyst shedding. Severe clinical cryptosporidiosis with
      weakness, anorexia, depression, growth retardation, and chronic and severe
      respiratory disease causing death occurred in all chickens in the C4M0 group
      between D12 and D43 and in 67% of the chickens in the C4M8 group between D17 and
      D57. Eighty-two percent and 33%, respectively, died before the development of
      specific Marek's disease lesions. Mortality rates were 27% and 33% in the M0 and
      M8 groups, respectively. The presence of MDV enhanced the establishment of more
      lasting cryptosporidial infection in the respiratory tract, esophagus, crop,
      proventriculus, and kidneys (only in C4M0 group) as well as in bursa of
      Fabricius, ceca, and cloaca. Serologic analysis showed that chickens with chronic
      cryptosporidiosis in the C4M8 group had an increased level of C. baileyi-specific
      immunoglobulin A. Our results may explain some cases of mortality in chickens
      naturally infected with MDV and Cryptosporidium.

PMID- 11195632
TI  - Nonspecific innate immunity against Escherichia coli infection in chickens
      induced by vaccine strains of Newcastle disease virus.
AB  - The objective was to test the hypothesis that vaccine strains of Newcastle
      disease virus (NDV) induce nonspecific immunity against subsequent infection with
      Escherichia coli. White leghorn chickens at 5 wk of age were vaccinated with a
      NDV vaccine at various days before challenge exposure with O1:K1 strain of E.
      coli via an intra-air sac route. Immunity was determined on the basis of the
      viable number of E. coli in the spleen 24 hr after the infection. Roakin strain
      induced significant (P < 0.05) immunity against E. coli at 4, 6, and 8 days, and
      La Sota strain at 2, 4, and 8 days, postvaccination. Secondary NDV vaccination
      administered 14 days later failed to induce immunity against E. coli when
      chickens were infected 1 or 5 days after the vaccination. Significant (P < 0.05)
      suppression of this nonspecific immunity was observed in birds treated with
      corticosterone, 40 mg/kg in feed, given for three consecutive days immediately
      prior to the bacterial exposure but not in those treated prior to the period. The
      results indicate that innate immunity induced by the primary NDV vaccination may
      significantly suppress the multiplication of E. coli in chickens for a period of
      2-8 days postvaccination. The NDV-induced immunity was inhibited by
      corticosterone, which is known to mediate physiological responses to stress.

PMID- 11195633
TI  - Susceptibility of broiler chicks to infection by avian pneumovirus of turkey
      origin.
AB  - In this paper we present the results of studies on the infectivity of an isolate
      of avian pneumovirus (APV) from turkeys to broiler chickens. Two-week-old broiler
      chicks free of antibodies to APV were exposed either by oculonasal or oral route
      with a cell cultured APV of turkey origin. Chickens from both APV-inoculated
      groups exhibited clinical signs that included coughing, sneezing, nasal
      discharge, and watery eyes during 2-8 days postinoculation. Tissue samples from
      birds in the APV-inoculated group were positive for APV by polymerase chain
      reaction (PCR) up to 9 days postinoculation. Samples of blood from both
      oculonasally and orally infected chickens were positive for APV. Intestinal
      samples from chickens infected with APV orally were positive for the presence of
      APV on PCR up to 9 days postinoculation. APV was reisolated from samples taken
      from chickens in both groups inoculated orally and oculonasally. Sera from birds
      exposed by the oculonasal or by the oral route showed the presence of APV
      specific antibodies.

PMID- 11195634
TI  - Evaluation of chicken infectious anemia virus and associated risk factors with
      disease and production losses in broilers.
AB  - A case-control study was performed to determine the significance of chicken
      infectious anemia virus (CIAV) as a risk factor associated with secondary disease
      in commercial broilers and to identify the significance of production losses
      associated with CIAV. The study also examined the relationship between bursal and
      thymic atrophy and the presence of CIAV. Cases were defined as submissions to the
      Alabama Veterinary Diagnostic Laboratories with a history of clinical disease and
      with a diagnosis of coccidiosis, gangrenous dermatitis, or respiratory disease.
      Controls were selected from submissions with neither a history of disease nor
      evidence of disease on necropsy. CIAV was detected in fresh tissues by polymerase
      chain reaction. Both thymic atrophy and the detection of CIAV were significantly
      associated with a disease case (P < 0.05). Bursal atrophy was a significant risk
      factor associated with the detection of CIAV in a submission (P < 0.05). Whereas
      CIAV was associated with disease cases that showed production losses in both
      percentage of livability and percentage of condemnations (P < 0.05), detection of
      CIAV alone was not associated with detectable losses in production or flock
      performance.

PMID- 11195635
TI  - Induction of vitamin A deficiency in turkeys.
AB  - The objective of this study was to determine the relationship between the hepatic
      vitamin A (VitA) level and the pathologic changes in the oropharynx and esophagus
      of VitA-deficient turkeys. Study turkeys were provided with a diet sufficient
      (11,000 IU/kg) or deficient (2750 IU/kg) in VitA from 4 to 17 wk of age. Body
      weight, bacterial culture, and tissues from internal organs were collected at
      weekly intervals. VitA deficiency causes epithelial tissue damage in poultry.
      This epithelial damage was seen grossly as white plaques in the oropharynx and
      esophagus and histologically as squamous metaplasia of mucosal glands and
      keratinization of epithelium. No significant difference in body weights was seen
      among the groups. Moreover, no pathogenic bacteria was isolated during sampling
      periods. Liver VitA levels declined significantly after consumption of low VitA
      diet for 3 wk and were depleted after 5 wk. Squamous metaplasia due to VitA
      deficiency developed in the esophagus after 3 wk and in the oropharynx after 4 wk
      of consuming a VitA-deficient diet.

PMID- 11195636
TI  - The effect of hypovitaminosis A on the pathogenesis of Pasteurella multocida in
      turkeys.
AB  - It has been proposed that Pasteurella multocida can invade the host tissues via
      the mucous membrane. Vitamin A (VitA) deficiency has been associated with mucous
      membrane damage, such as squamous metaplasia. The objective of this study was to
      determine the early stages in the pathogenesis of P. multocida in VitA-deficient
      turkeys and clinically healthy turkeys. Fifteen-week-old VitA-deficient and
      clinically healthy turkeys were inoculated with P. multocida P-1059, a virulent
      strain, and the portal of entry, invasion, and localization of P. multocida were
      studied by microbial examination of the trachea, liver, and lung and histologic
      examinations of internal organs. Higher mortality was found in VitA-deficient
      turkeys. Pasteurella multocida was first reisolated from the trachea, secondarily
      from the liver and blood, and finally from the lung in both groups. Invasion of
      P. multocida into tissues occurred between 3 hr and 24 hr postinoculation in both
      groups. Our findings suggest that altered membrane integrity in VitA-deficient
      birds did not appear to change the time course of the systemic spread of P.
      multocida infection in turkeys and that the increased mortality seen in the VitA
      deficient turkeys may be associated with immune system impairment.

PMID- 11195637
TI  - Reticuloendotheliosis virus (REV) long terminal repeats incorporated in the
      genomes of commercial fowl poxvirus vaccines and pigeon poxviruses without
      indication of the presence of infectious REV.
AB  - Because of reticuloendotheliosis virus (REV) contamination in commercial poultry
      vaccines, polymerase chain reaction (PCR) assays have been described to increase
      the sensitivity of biological assays used to detect REV in vaccines. The PCR
      assay designed to amplify the long terminal repeat (LTR) region of REV identified
      REV LTRs in many of the commercial fowl poxvirus (FPV) vaccines evaluated. These
      commercial vaccines were not thought to be contaminated with replicating REV
      because of the lack of REV outbreaks, the lack of in vitro amplification, and
      lack of a serologic response to REV. As previously described, the FPV S vaccine
      strain is known to carry infectious integrated proviral REV, whereas FPV M
      vaccine strain and its derivatives carry integrated LTRs or remnants of REV
      proviral DNA inserted into the FPV genome. Another PCR assay designed to amplify
      the envelope gene of REV was used to verify that the envelope proviral gene was
      not present in REV LTR PCR-positive samples. Southern blot analysis with REV LTR
      probes hybridized to the 9-kb EcoRI genomic fragment of all FPV and pigeon
      poxviruses evaluated, whereas the envelope probe did not hybridize to any
      poxvirus genome. Sequence analysis of the 9-kb EcoRI fragment indicated that an
      integrated REV LTR exists in the 9-kb EcoRI of some poxvirus genomes. A new PCR
      assay designed to amplify integrated REV LTRs in the 9-kb EcoRI fragment
      identified complete and incomplete integrated REV LTRs in all FPV and pigeon
      poxvirus genomes evaluated.

PMID- 11195638
TI  - Viral pathogenesis in chicken embryos and tumor induction in chickens after in
      ovo exposure to serotype 1 Marek's disease virus.
AB  - We examined the susceptibility of late-stage chicken embryos to infection with
      oncogenic serotype 1 Marek's disease virus (MDV 1). Intravenous inoculation of
      MDV 1 at embryonic day (ED) 16 resulted in significant replication of the virus
      in embryonic tissues. Within 5 days of virus exposure, pp38 viral antigen (pp38)
      was detected in embryonic bursae and MDV 1 was isolated by plaque assay from the
      spleens, thymuses, and bursae of embryos. The pathogenesis of MDV 1 after
      intravenous inoculation at ED 16 was similar to that in chicks exposed to MDV 1
      after hatching. In contrast to the response of the embryo to intravenous
      inoculation, embryos exposed to MDV 1 by the amniotic route did not develop
      detectable pp38, nor could the virus be isolated from the embryonic tissues by
      plaque assay. These results show that the route of inoculation of MDV 1 in the
      embryos is critical for allowing the virus to come in contact with target cells.

PMID- 11195639
TI  - Survival of Salmonella typhimurium and Escherichia coli O157:H7 in poultry manure
      and manure slurry at sublethal temperatures.
AB  - Exponential inactivation was observed for Salmonella typhimurium and Escherichia
      coli O157:H7 in poultry manure with decimal reduction times ranging from half a
      day at 37 C to 1-2 wk at 4 C. There was no material difference in inactivation
      rates between S. typhimurium and E. coli O157:H7. Inactivation was slower in
      slurries made by mixing two parts of water with one part of manure; decimal
      reduction times (time required for 90% destruction) ranged from 1-2 days at 37 C
      to 6-22 wk at 4 C. Escherichia coli O157:H7 consistently exhibited slightly
      slower inactivation than S. typhimurium. Log decimal reduction time for both
      strains was a linear function of storage temperature for manure and slurries.
      Chemical analysis indicated that accumulation of free ammonia in poultry manure
      was an important factor in inactivation of the pathogens. This finding was
      experimentally confirmed for S. typhimurium by adding ammonia directly to peptone
      water or to bovine manure, which was naturally low in ammonia, and adjusting pH
      to achieve predetermined levels of free ammonia.

PMID- 11195640
TI  - The effect of eukaryotic expression vectors and adjuvants on DNA vaccines in
      chickens using an avian influenza model.
AB  - Vaccination of poultry with naked plasmid DNA has been successfully demonstrated
      with several different poultry pathogens, but the technology needs to be further
      developed before it can be practically implemented. Many different methods can
      conceivably enhance the efficacy of DNA vaccines, and this report examines the
      use of different eukaryotic expression vectors with different promoters and
      different adjuvants to express the influenza hemagglutinin protein. Four
      different promoters in five different plasmids were used to express the
      hemagglutinin protein of an H5 avian influenza virus, including two different
      immediate early cytomegaloviruses (CMVs), Rous sarcoma virus, chicken actin, and
      simian virus 40 promoters. All five constructs expressed detectable hemagglutinin
      protein in cell culture, but the pCI-neo HA plasmid with the CMV promoter
      provided the best response in chickens when vaccinated intramuscularly at 1 day
      of age on the basis of antibody titer and survivability after challenge with a
      highly pathogenic avian influenza virus at 6 wk postinoculation. A beneficial
      response was observed in birds boostered at 3 wk of age, in birds given larger
      amounts of DNA, and with the use of multiple injection sites to administer the
      vaccine. With the use of the pCI-neo construct, the effects of different
      adjuvants designed to increase the uptake of plasmid DNA, including 25% sucrose,
      diethylaminoethyl dextran, calcium phosphate, polybrene, and two different
      cationic liposomes, were examined. Both liposomes tested enhanced antibody titers
      as compared with the positive controls, but the other chemical adjuvants
      decreased the antibody response as compared with the control chickens that
      received just the plasmid alone. The results observed are promising for continued
      studies, but continued improvements in vaccine response and reduced costs are
      necessary before the technology can be commercially developed.

PMID- 11195641
TI  - Relationship between antigen release and antibody response of infectious coryza
      water-in-oil-in-water emulsion vaccines.
AB  - The relationship between the antigen release from formulations in vitro and the
      antibody response after administration of water-in-oil-in-water (W/O/W) emulsion
      vaccines containing Haemophilus paragallinarum (Hpg) was studied in chickens.
      Increases of sorbitan sesquioleate volume in the formulation led to slower
      antigen release and tended to induce higher hemagglutination-inhibition (HI)
      antibody titers. In addition, the vaccines prepared with internal aqueous
      phase:oil phase:external aqueous phase (A:O:A) ratios of 3:4:3 and 3:3:4 also
      showed slower release of antigen and higher HI antibody titer compared with those
      of an A:O:A ratio of 3:2:5. Vaccines prepared with polyoxyethylene (POE)(10)
      hydrogenated castor oil or POE(40) hydrogenated castor oil instead of sorbitan
      sesquioleate showed higher release and lower antibody HI titers. As a result, HI
      antibody titers at 6 wk after vaccination were inversely related to antigen
      release, as determined by the release test. The correlation coefficient was
      0.942. In infectious coryza W/O/W emulsion vaccines, the slow release of antigen
      from the formulation induced and maintained high HI antibody titers of Hpg.

PMID- 11195642
TI  - Antibody titers to infectious bursal disease virus in broiler chicks after
      vaccination at one day of age with infectious bursal disease virus and Marek's
      disease virus.
AB  - The effect of day-of-age vaccination with infectious bursal disease virus (IBDV)
      alone or in combination with Marek's disease virus (MDV) in broiler chicks was
      investigated. One-day-old commercial broiler progeny obtained from IBDV-immunized
      breeder flocks were vaccinated subcutaneously according to the manufacturer's
      directions with live-attenuated commercially available vaccines as follows: IBDV
      alone, MDV alone, IBDV + MDV, and unvaccinated control. IBDV was not detected
      after vaccination by reverse transcriptase/polymerase chain reaction in any of
      the bursal, thymic, and splenic tissues tested. Serum IBDV antibody levels, as
      monitored by enzyme-linked immunosorbent assay (ELISA), showed similar rates of
      decline among the four groups, and, by day 28 postinoculation, serum antibody
      levels in all groups were below detectable limits. IBDV-specific neutralizing
      maternal antibody (MA) titers in the IBDV + MDV and control groups, as monitored
      by the virus neutralization assay (VN), remained higher and declined more slowly
      throughout the experiment as compared with VN titers in the IBDV- and the MDV
      vaccinated groups. In a second experiment, groups of one-day-old broiler chicks
      were vaccinated as in Experiment 1. Serum IBDV antibody detected by ELISA and VN
      assay declined parallel to those observed in Experiment 1. Histopathologic
      lesions characteristic of IBDV were not observed in any of the groups.
      Vaccination with MDV alone was associated with increased rates of IBDV
      neutralizing MA decline similar to those caused by vaccination with IBDV alone,
      whereas concurrent vaccination with IBDV + MDV was not associated with increased
      rates of IBDV neutralizing MA decline over that of nonvaccinated controls.
      Results of these studies indicate that IBDV vaccination at 1 day of age does not
      cause accelerated IBDV-specific MA decline as detected by ELISA but does appear
      to cause an accelerated decline in neutralizing IBDV-specific MA. Furthermore,
      vaccination with IBDV at 1 day of age appeared to slow the accelerated rate of
      IBDV neutralizing antibody decline caused by MDV vaccination.

PMID- 11195643
TI  - Hematologic and clinical chemistry reference values in red lories (Eos spp.).
AB  - We established reference ranges for three hematologic and 15 clinical chemistry
      parameters of 40 clinically healthy birds of the genus Eos. The following species
      were included to the study: Eos histrio (n = 19), Eos squamata (n = 8), Eos bomea
      (n = 5), Eos reticulata (n = 4), Eos cyanogenia (n = 4). Detailed information
      concerning methodology, which is often missing in papers dealing with reference
      values, is included. As far as possible, data are compared with literature, and
      some thoughts on obvious deviations are given. The problem of establishing
      reference values in rare species is reviewed.

PMID- 11195644
TI  - Alterations in levels of various host antioxidant factors in turkey knockdown
      syndrome.
AB  - Five components (selenium, glutathione peroxidase, copper, superoxide dismutase,
      and vitamin E) of the antioxidant system of turkey poults were examined to
      determine if they play any role in the knockdown (KD) syndrome. All flocks were
      provided with feed formulated to contain monensin at 54-60 g/ton. Flock data were
      analyzed as a case-control study with three treatment groups (KD-affected and
      unaffected turkey poults from a KD flock and poults from an unaffected flock
      [control]). Affected turkey poults had lower (P < 0.001) serum vitamin E levels
      compared with unaffected poults from KD flocks or poults from unaffected flocks.
      No significant differences were observed for the other parameters evaluated but
      there was a trend towards lower copper and superoxide dismutase values in
      affected birds. It appears that serum vitamin E concentrations in turkey poults
      may play a significant role in susceptibility to or protection against KD
      syndrome. Other components of the antioxidant system may also be involved, and
      complex interactions among several body systems may be critical.

PMID- 11195645
TI  - Ornithobacterium rhinotracheale, a primary pathogen in broilers.
AB  - Field strains of Ornithobacterium rhinotracheale were tested on their virulence
      in different chicken breeds. Ornithobacterium rhinotracheale was able to induce
      lesions after aerosol challenge without a previous priming with virus, and thus
      O. rhinotracheale was proven to be a primary pathogen. The virulence of Dutch
      strains, isolated between 1995 and 1998, did not increase, but the Dutch isolates
      and a South African strain were more pathogenic compared with an American strain
      of O. rhinotracheale. White specific-pathogen-free leghorns were less susceptible
      to O. rhinotracheale infection than broilers, whereas there was no difference in
      susceptibility between commercial broilers and specific-pathogen-free broilers.

PMID- 11195646
TI  - In vitro effect of ethylenediaminetetraacetic acid-Tris on the efficacy of
      hatchery disinfectants.
AB  - Solutions of ethylenediaminetetraacetic acid (EDTA)-Tris showed synergistic or
      additive effects on gram-negative bacteria when combined with hatchery
      disinfectants consisting of phenol and detergent (Magnaphen-100), quaternary
      ammonium compound (QAC) and glutaraldehyde (Synergize), QAC (BioSentry 904), and
      hydrogen peroxide. The gram-positive bacteria reacted less favorably, with
      reaction mixtures showing all three levels of potentiation (synergistie,
      additive, and antagonistic). Combinations of EDTA-Tris and a commercial
      glutaraldehyde solution (Glutracide), when mixed with the test organisms, showed
      mostly antagonistic effects. Solutions of EDTA-Tris decreased the concentration
      of hatchery disinfectants required for bacterial killing by 75% in those
      situations in which synergistic potentiation occurred. EDTA-Tris is nontoxic to
      12-day-old embryos. Serial passage of the test organisms in solutions of EDTA
      Tris did not result in the development of resistant forms.

PMID- 11195647
TI  - Genotyping Campylobacter jejuni strains isolated from the gut and oviduct of
      laying hens.
AB  - Campylobacter jejuni frequently colonizes the avian intestine. Recent evidence
      suggests that this organism can also colonize the oviduct of laying hens.
      However, the source and role of this colonization are unknown. Isolates from the
      ceca, cloacae, and oviducts of 11 laying hens in three intensive egg-producing
      flocks were genotyped by Fla typing with the restriction fragment length
      polymorphism of the polymerase chain reaction product of the flaA and flaB genes
      (fla typing) and pulsed-field gel electrophoresis (PFGE). A diversity in fla
      types and PFGE types was observed within and between flocks. Individual birds
      could be colonized by different genotypes at various intestinal and oviduct
      sites. However, the oviduct of individual birds appeared to be colonized by only
      one genotype at the time of sampling. In two birds, matching isolates
      investigated from the intestinal and reproductive tracts were genotypically
      identical but different from those oviduct isolates found in other birds in the
      same flock. Interestingly, not all cecal isolates appeared to be equally able to
      colonize the oviduct. These results suggest that oviduct colonization may result
      from ascending infection via the cloaca and that some strains of C. jejuni may be
      better adapted than others to oviduct colonization.

PMID- 11195648
TI  - Avian leukosis virus subgroup J infection profiles in broiler breeder chickens:
      association with virus transmission to progeny.
AB  - Profiles of infection with avian leukosis virus subgroup J (ALV-J) and factors
      that predict virus transmission to progeny were studied. Eggs from an infected
      broiler breeder flock were hatched at the laboratory. The flock was reared in a
      floor pen, transferred to laying cages at 22 wk, and inseminated to produce
      fertile eggs. A cohort of 139 chickens was tested at frequent intervals over a 62
      wk period for virus, viral antigens, or antibodies in plasma, cloacal swabs, egg
      albumen, and embryos. Virus was detected in 7% of chicks at hatch but spread
      rapidly so that virtually all chicks became infected between 2 and 8 wk of age.
      Mortality due to myeloid leukosis and related tumors was 22%. Over 40% of the
      chicks developed persistent infections, whereas the remainder experienced
      transient infections. Five types of infection profiles were recognized. Novel
      responses included hens that were positive for virus intermittently or started
      late in life to shed viral antigens into the cloaca. ALV-J was isolated from 6%
      of 1036 embryos evaluated between 26 and 62 wk. However, over 90% of the virus
      positive embryos were produced between 29 and 34 wk of age. Of 80 hens that
      produced embryos, 21 produced at least one infected embryo and were identified as
      transmitters. All but one transmitter hen would have been detected by a
      combination of viremia, cloacal swab, and albumen tests conducted between 18 and
      26 wk. However, virus was transmitted to embryos from hens that were not
      persistently viremic or that rarely shed viral group-specific antigen into the
      albumen of their eggs. Intermittent patterns of both antigen shedding and virus
      transmission to embryos were observed in some hens. These results validate
      current screening procedures to identify potential transmitter hens and provide
      some suggestions for improvement but also show that identification of all
      transmitter hens by such procedures is unlikely. Thus, eradication programs based
      solely on dam testing may be less effective than those where dam testing is
      combined with procedures to mitigate early horizontal transmission in progeny
      chicks.

PMID- 11195649
TI  - Pathogenicity of West Nile virus for turkeys.
AB  - In the fall of 1999, West Nile virus (WNV) was isolated during an outbreak of
      neurologic disease in humans, horses, and wild and zoological birds in New York,
      Connecticut, and New Jersey. Turkeys could potentially be a large reservoir for
      WNV because of the high-density turkey farming and the presence of large wild
      turkey populations in the eastern seaboard of the United States. Little is known
      about the pathogenicity of WNV in domestic or wild turkeys. Specific-pathogen
      free 3-wk-old turkeys were inoculated subcutaneously with 10(3.3) mean tissue
      culture infective doses of a WNV strain isolated fromthe index case in a New York
      crow. No clinical signs were observed in the turkeys over the 21 days of the
      experiment. One turkey died abruptly at 8 days postinoculation (DPI). Many
      turkeys developed viremia between 2 and 10 DPI, but the average level of virus
      was very low, less than needed to efficiently infect mosquitos. Low levels of WNV
      were detected in feces on 4 and 7 DPI, but no virus was isolated from
      oropharyngeal swabs. WNV wasnot transmitted from WNV-inoculated to contact
      exposed turkeys. All WNV-inoculated poults seroconverted on 7 DPI. In the turkey
      that died, WNV was not isolated from intestine, myocardium, brain, kidney, or
      cloacal and oropharyngeal swabs, but sparse viral antigen was demonstrated by
      immunohistochemistry in the heart and spleen. Turkeys in contact with WNV
      inoculated turkeys and sham-inoculated controls lacked WNV specific
      antibodies,and WNV was not isolated from plasma and cloacal and oropharyngeal
      swabs. These data suggest that WNV lacks the potential to be a major new disease
      of turkeys and that turkeys will not be a significant amplifying host for
      infecting mosquitos.

PMID- 11195650
TI  - A multiplex reverse transcription-polymerase chain reaction assay for Newcastle
      disease virus and avian pneumovirus (Colorado strain).
AB  - Newcastle disease virus (NDV) and avian pneumovirus (APV) cause Newcastle disease
      and rhinotracheitis respectively, in turkeys. Both of these viruses infect the
      respiratory system. A one-tube, multiplex, reverse transcription-polymerase chain
      reaction (RT-PCR) assay for the detection of both NDV and Colorado strain of APV
      (APV-Col) was developed and evaluated. The primers, specific for each virus, were
      designed from the matrix protein gene of APV-Col and the fusion protein gene of
      NDV to amplify products of 631 and 309 nucleotides, respectively. The multiplex
      RT-PCR assay, for detecting both viruses simultaneously, was compared with the
      single-virus RT-PCR assays for its sensitivity and specificity. The specific
      primers amplified products of predicted size from each virus in the multiplex as
      well as the single-virus RT-PCR assays. The multiplex RT-PCR assay was determined
      to be equivalent to the single-virus RT-PCR assays for detecting both NDV and APV
      Col. This multiplex RT-PCR assay proved to be a sensitive method for the
      simultaneous and rapid detection of NDV and APV-Col. This assay has the potential
      for clinical diagnostic applications.

PMID- 11195651
TI  - Characterization of Mexican strains of avian infectious bronchitis isolated
      during 1997.
AB  - Ten infectious bronchitis virus (IBV) isolates were recovered from broiler
      chickens in the states of Queretaro and Guanajuato in Mexico. The viruses were
      isolated from trachea, lung, kidney, and cecal tonsils of birds that showed
      respiratory signs in spite of vaccination with Massachusetts (Mass) and
      Connecticut strains of IBV. Each isolate was identified by an accession number
      from 1 to 10. Six of the isolates were neutralized by Mass monoclonal antibodies,
      whereas the other four were not. In addition, these four isolates did not produce
      lesions in embryos in the first five to seven passes. These four isolates were
      further characterized by the reverse transcriptase-polymerase chain reaction and
      restriction fragment length polymorphism techniques. The electrophoretic patterns
      for the four isolates were identical but were different from other known IBV
      isolates.

PMID- 11195652
TI  - Maintenance of a captive flock of house finches free of infection by Mycoplasma
      gallisepticum.
AB  - Since the beginning of an epidemic of conjunctivitis in wild house finches caused
      by Mycoplasma gallisepticum (MG), all captive colonies established by capturing
      free-ranging house finches from the eastern population have also either been
      infected at the time of capture or developed infection shortly after capture. In
      an attempt to avoid this infection in captive flocks being maintained for studies
      of the finches' behavior and ecology, we compared two different flock management
      strategies and were able to prevent the development of mycoplasmal conjunctivitis
      with one of the strategies. Single-sex flocks were built by introducing only
      seronegative wild-caught birds showing no clinical signs of conjunctivitis and
      covering their outdoor flight cages with netting to prevent interaction with
      other wild birds although only the female flocks were initially treated with a 6
      wk course of tylosin tartrate (0.3 mg/ml). The female flocks never developed
      conjunctivitis although the disease did develop in the male flocks. Furthermore,
      serologic assessments of the healthy flock by serum plate agglutination assays
      for MG indicated that the females remained free of MG infection in the final 7 wk
      of the study, during which they were unmedicated. We conclude that any low-level
      MG infection not diagnosed by the initial test for seroconversion was cleared by
      the prolonged drug treatment.

PMID- 11195653
TI  - Health status of northern bobwhite quail (Colinus virginianus) in eastern Kansas.
AB  - The health status of wild northern bobwhite quail (Colinus virginianus) from Lyon
      County, Kansas, was evaluated by conducting comprehensive health assessments on
      25 birds. Gross lesions indicative of avian pox, ulcerative enteritis, and quail
      bronchitis were not present. Serologic tests for antibodies to Salmonella
      pullorum, Salmonella gallinarum, Pasteurella multocida, Mycoplasma gallisepticum,
      Mycoplasma synoviae, and avian adenoviruses were all negative. Intestinal
      coccidia (Eimeria spp.) were found in 36% of the birds. Only three species of
      helminth parasites were found: Dispharynx nasuta in two birds, Cyrnea colini in
      one bird, and larval Physaloptera sp. in four birds. Arthropod parasites (ticks,
      lice, mites, and/or chiggers) were present on 96% of the birds examined. Compared
      with wild bobwhite populations in the southeastern United States, the diversity,
      prevalence, and intensities of microbial and parasitic agents were low.

PMID- 11195654
TI  - Outer membrane proteins for serologic detection of Ornithobacterium
      rhinotracheale infection in turkeys.
AB  - Ornithobacterium rhinotracheale (ORT) is a bacterium responsible for a
      respiratory disease in turkeys and chickens and has been identified as one of the
      emerging respiratory bacterial pathogens. The clinical signs and lesions caused
      by ORT are very similar to those caused by other respiratory infectious agents;
      therefore, an accurate diagnostic test is necessary to identify the infection. In
      this study, we have investigated the use of outer membrane proteins of ORT in an
      indirect enzyme-linked immunosorbent assay (ELISA) to detect the exposure to ORT
      infection. Outer membrane proteins of ORT were extracted and used as an antigen
      in ELISA to detect infection in turkeys exposed to different serotypes of ORT.
      The ELISA results were compared with the conventional serum plate agglutination
      test. The agglutination test detected specific antibodies for ORT in 65% of
      experimentally infected turkeys during the first 2 wk of infection. The ELISA
      detected up to 100% of infected birds for 8 wk postinfection. The results suggest
      that ELISA is able to detect the exposure to ORT in later stages of the infection
      and this assay can be used in serologic surveillance of ORT infection for poultry
      in the field.

PMID- 11195655
TI  - Presence of fluoroquinolone-resistant coliforms in poultry litter.
AB  - Litter was collected from four turkey farms (eight houses) with a history of
      fluoroquinolone (FQ) treatment failure, 10 adult broiler breeder chicken farms
      (43 houses) with one having a history of FQ treatment, and 30 broiler chicken
      farms (110 houses) with 24 having a history of FQ treatment. In the turkey
      litter, the percentage of nalidixic acid-resistant (at 100 microg/ml)
      coliforms/total number of coliforms ranged from 0.6% to 61.9%. Two of the four
      farms had houses containing coliforms resistant to the two FQs, enrofloxacin (1
      microg/ml) and sarafloxacin (1 microg/ml). There was also multiple resistance to
      other antimicrobials on all four turkey farms (ampicillin, tetracycline,
      chloramphenicol, kanamycin). The level of total coliforms from the adult broiler
      breeder litter was low, and there were no nalidixic acid-resistant isolates from
      any of the 10 farms. In the broiler chickens, 7 of 91 houses with a history of FQ
      usage contained coliforms resistant to nalidixic acid; however, 2 of the 19
      houses on farms with no history of FQ usage had nalidixic acid-resistant
      coliforms. All of the broiler farms with nalidixic acid-resistant isolates were
      also resistant to the FQ sarafloxacin, whereas only 3 of the 24 treatment history
      farms and 1 of the no-treatment history farms exhibited enrofloxacin-resistant
      coliforms in the litter.

PMID- 11195656
TI  - Some safety aspects of salmonella vaccines for poultry: distribution and
      persistence of three Salmonella typhimurium live vaccines.
AB  - The purpose of this study was to analyze the safety characteristics of three
      commercially available live Salmonella vaccine strains (vacT, Zoosaloral, and
      X3985) in relation to their persistence in individual animals but also within a
      flock and in the environment. In a first experiment, the digestive and systemic
      distributions in chickens were followed for 10 days in individually reared
      chickens that were orally inoculated at 1 day of age. Strain X3985 quickly
      disappeared from the digestive tract but remained in the liver until the end of
      this experiment, whereas strains vacT and Zoosaloral colonized the liver as well
      as the gut for 10 days. In the second trial, behavior of the vaccine strains was
      studied in groups of 20 chickens during 10 wk after a single oral administration
      to individual birds. Strain vacT remained in the environment of inoculated
      animals for 4-5 wk. Six weeks after the inoculation, vacT was not recovered from
      internal organs such as liver and spleen, and vacT disappeared from the digestive
      tract between the sixth and the 10th weeks. Comparatively, both Zoosaloral and
      X3985 vaccine strains persisted longer in the environment (8 wk at least). Of the
      vaccine strains, X3985 showed the greatest colonization of both systemic and
      digestive organs.

PMID- 11195657
TI  - Lack of antigenic relationship between French and recent North American non-A/non
      B turkey rhinotracheitis viruses.
AB  - Twelve turkey rhinotracheitis viruses (TRTVs) including the Colorado isolate and
      two French non-A/non-B viruses were serologically compared. Six enzyme-linked
      immunosorbent assay (ELISA) antigens derived from subgroup A, subgroup B, a
      French non-A/non-B, and the Colorado TRTVs were used. Virus neutralization (VN)
      tests were performed with four Ma-104-adapted viruses derived from subgroup A,
      subgroup B, a French non-A/non-B, and the Colorado viruses. French strains
      isolated since 1995 were assigned to subgroup B in both ELISA and VN, whereas
      those isolated in 1985 and 1986 appeared more diverse: two strains belonged to
      subgroup B, one to subgroup A, and two others appeared antigenically different
      from both the A and B subgroups and are classified as non-A/non-B. The Colorado
      strain appeared different from these three groups of TRTVs. Assignment to
      subgroup A or B was confirmed by reverse transcription-polymerase chain reaction,
      but neither the French non-A/non-B strains nor the Colorado virus could be
      classified with the subgroup-specific G-based primers. These results suggest that
      at least three antigenically different viruses were present in France in 1985-86
      and that the Colorado strain is different from all European TRTVs. Further
      serologic and phylogenic studies will be necessary to evaluate their actual
      prevalences and relationships.

PMID- 11195658
TI  - Sequential spread of Campylobacter infection in a multipen broiler house.
AB  - Generally, colonization with Campylobacter jejuni is first detected in broilers 2
      3 wk after hatching. Once introduced into a flock, this infection spreads very
      rapidly. The sources and routes of transmission of C. jejuni in broilers remain
      debatable. In this study, the spread of infection was monitored in a commercial
      multipen broiler house in which birds were contained in discrete groups and
      sampled sequentially. Colonization was monitored in two broiler flocks up to
      slaughter. Serotyping and fla typing methods were applied to differentiate all
      the C. jejuni strains isolated. In flock 1, colonization was first detected at 32
      days of age in birds located at the rear of the house. By 40 days, nearly all the
      birds were infected with the same strain (fla type 1.9). However, at 46 days of
      age, a second strain (fla type 3.7) was detected in some of the birds. These
      birds were also located toward the rear of the house. In flock 2, infection was
      detected at 5 wk of age. This infection was once again first detected in birds
      located at the rear of the house. In this flock, only a single fla type (1.1) was
      isolated throughout. A survey of the broiler house relative to the location of
      first point of infection indicated the use of an entrance door unprotected by
      boot dips. However, securing this door during the second flock study did not
      prevent infection.

PMID- 11195659
TI  - Serologic survey of slaughter-age ostriches (Struthio camelus) for antibodies to
      selected avian pathogens.
AB  - Serum samples from 163 slaughter-age ostriches (Struthio camelus) in Ohio and
      Indiana were tested for antibodies to avian influenza virus (AIV), Newcastle
      disease virus (NDV), paramyxovirus (PMV) 2, PMV3, PMV7, infectious bursal disease
      virus (IBDV), Bordetella avium, Mycoplasma synoviae, Mycoplasma gallisepticum,
      Ornithobacterium rhinotracheale, Salmonella pullorum, Salmonella gallinarum, and
      Salmonella typhimurium. One ostrich had antibodies to AIV H5N9, 57% of the
      ostriches had antibodies to NDV, four ostriches had antibodies to both NDV and
      PMV2, and one ostrich had antibodies to NDV, PMV2, PMV3, and PMV7. None of the
      ostriches had antibodies to IBDV, B. avium, M. synoviae, M. gallisepticum, O.
      rhinotracheale, S. pullorum, S. gallinarum, and S. typhimurium. This is the first
      report of antibodies to avian influenza and PMV7 in ostriches in the United
      States.

PMID- 11195660
TI  - National surveillance of Campylobacter in broilers at slaughter in Denmark in
      1998.
AB  - A surveillance study for thermophilic Campylobacter spp. in broiler flocks was
      carried out for the year 1998 in Denmark. The study included examinations of 4286
      broiler flocks comprising samples from 57,000 birds. Overall, a flock prevalence
      of 46.0% was recorded. The species distribution was Campylobacter jejuni 86%,
      Campylobacter coli 11%, Campylobacter lari 1%, other not further diagnosed
      species 2%. The prevalence was significantly higher in the period from June to
      October (3.2 < odds ratio [OR] <1.8, P < 0.0002) and was significantly associated
      with abattoir (OR < 2.8, P < 0.0001) and the length of the period the broiler
      houses were left empty between flocks (download period; 6 days or more) (OR =
      1.6, P < 0.0198). No association between Campylobacter colonization and the age
      at slaughter was found. Separating the flocks into batches for slaughter elevated
      the flock prevalence from 0.41 after the first batch had been slaughtered to 0.46
      after all batches had been slaughtered.

PMID- 11195661
TI  - Suicide among gay and lesbian adolescents and young adults: a review of the
      literature.
AB  - This paper explores the issue of suicide among gay and lesbian adolescents and
      young adults, as well as provides information to guide clinicians in working
      effectively with this population. The theoretical perspectives on homosexual
      identity development by Troiden, Cass, and Lewis are discussed in connection with
      Durkheim's Suicide Theory and various theoretical risk factors, as well as
      implications for social work practice. This paper is intended to be utilized as a
      tool during the assessment phase of treatment with an adolescent or young adult
      who may be questioning his or her sexuality.

PMID- 11195662
TI  - Museums, friends, and lovers in the New South: Laura's Web, 1909-1931.
AB  - Laura Bragg, a member of the first graduating class at Simmons College, journeyed
      to Charleston as a New Woman in 1909. As the first woman director of a major
      scientific museum in the United States, Bragg transformed the Charleston Museum
      into a public education institution and became an innovative leader in museum
      education. This article documents Bragg's contributions within the context of
      antebellum culture where the Southern Belle was placed on a Victorian pedestal
      and Boston marriages were an unknown phenomenon. Using extensive and hitherto
      unpublished correspondence, the authors detail Bragg's lesbian relationships and
      describe her network within the homosexual male community during the era of the
      Charleston Renaissance.

PMID- 11195663
TI  - Recent scholarship on homosexuality in the Greco-Roman world.

PMID- 11195664
TI  - GLBT campuslife on the Web.

PMID- 11195665
TI  - What is the Word at Logos College? Homosocial ritual or homosexual denial in Don
      Delillo's End Zone?
AB  - "What Is the Word at Logos College? Homosocial Ritual or Homosexual Denial in Don
      Delillo's End Zone?" investigates the homoerotic desire that, despite being
      culturally repressed, periodically surfaces in foothall. Given the highly
      closeted nature of American foothall, it is necessary to look at the puns,
      allusions, and interactions between the players to see how Don DeLillo has
      created a text that subtly exposes the homoerotics of male sport. In order to
      strengthen the connection between homoeroticism and football, I will show how
      football's invention and organization in America coincides with the construction
      of the homosexual subject. Football and other arenas for male-male play become
      enforced at the same time as desire begins to express itself; thus, football is
      the logical place in America to look for unresolved (and resolved) male
      homosexuality, and DeLillo does this skillfully.

PMID- 11195666
TI  - The evolution of homoerotic behavior in humans.
AB  - This paper presents a theoretical model for the evolution of same-sex sexual
      behavior, or homoerotic behavior, in humans. Contrary to the traditional study of
      the topic, the emphasis is on homoerotic behavior itself, irrespective of sexual
      orientation. It is an inferential model drawn from cross-species evidence, cross
      cultural evidence, and current evolutionary theory. It is posited that humans
      evolved a disposition for homoerotic behavior because it increased same-sex
      affiliation among peripheralized hominids and indirectly influenced rates of
      survival and reproductive success. The implications for the conceptualization of
      same-sex sexual behavior and future research are indicated.

PMID- 11195667
TI  - The romantic sexology of John Addington Symonds.
AB  - This paper examines a radical text by the English Classicist and homosexual, John
      Addington Symonds (1840-1893). Through a close study of an unpublished and long
      concealed manuscript, "A Problem in Modern Ethics" (1891), Symonds's political
      vision and the odd form of writing it takes is revealed as romantic in character.
      Symonds polemicizes against the pathologization of homosexuals in the legal
      medical discourses of the time and advocates on behalf of a latent homosexual
      ethics, shunned from modern Western society, but continuing to hold forth a
      promise for the civic and moral renewal of Western countries. Against the
      positions of Krafft-Ebing and others, Symonds argues for the acceptance of "manly
      love," in the spirit of the ancients, as a source of moral inspiration for a
      declining Europe. Where Symonds is often read by historians of homosexual
      radicalism as a precursor to the radical tradition of the 20th century, romantic
      acceptance of the untimeliness of his moral vision, indicates less a politically
      progressive than a romantically fatalistic enterprise.

PMID- 11195668
TI  - [Puncture-drainage sanation of abdominal abscesses: is it sufficient treatment?].
AB  - Some anatomical grounds of postoperative extravisceral abscess formation, methods
      and results of their treatment, therapeutic policy in abscesses of parenchymatous
      organs are presented. 681 patients with abdominal abscess of various location
      were examined. Detailed analysis of ultrasonic and computed tomographic semiotics
      of postoperative extravisceral suppurative focus was carried out in 164 patients.
      The risk zones of extravisceral abscess formation in the conditions of changed
      visceral syntopy and destroyed ligamentic structures were determined. The
      efficiency of puncture-drainage treatment in different variants of
      subdiaphragmatic abscess was 89.4%, in abscess of omental bursa--83.3%.
      Intracavital prolonged proteolysis by immobilized proteinases (imosimase) was
      applied. The injection of imosimase in abscess cavity led to its content lysis,
      including the thick products of inflammation, improving their secretion through
      the drainage. In the majority of the patients, the puncture-drainage treatment of
      abscesses of various etiology and pathogenesis is an adequate method of sanation.

PMID- 11195670
TI  - [Laparoscopic cholecystectomy].
AB  - The results of more than 1000 laparoscopic cholecystectomies are analyzed.
      Significant improvement of main parameters (mean hospital stay, postoperative
      lethality, postoperative complications rate) is demonstrated, including cases of
      acute destructive cholecystitis. The conception of emergency laparoscopic
      cholecystectomy is proposed. It is shown that the percentage of severe
      complications and lethality are significantly lower in laparoscopic operations
      than in the open operations. The widespread opinion of frequent damage of
      extrahepatic bile ducts is not confirmed. The development of laparoscopic surgery
      justifies more active policy in acute cholecystitis.

PMID- 11195669
TI  - [Role of prolonged intraarterial catheter therapy in general peritonitis].
AB  - The analyses of treatment results in 82 patients with general purulent
      peritonitis are presented. In these patients long-term intraarterial catheter
      therapy (IACT) was included in the complex of postoperative treatment after
      elimination of infection source. Postoperative peritonitis was in 66 patients, 52
      patients of them underwent reoperations for persisting general peritonitis. Use
      of IACT promoted arrest of abdominal inflammatory process and polyorganic
      insufficiency due to high concentration of antibiotics in the affection focus,
      improvement of regional circulation, reduced number of postoperative
      complications and a sharp fall of lethality of 8.5%.

PMID- 11195671
TI  - [Gastrostomy as a stage of esophagoplasty].
AB  - The description of a modified technique of gastrostoma formation on small flexure
      is presented. Indications for this operation in patients with tumor and
      cicatrical esophageal strictures, planned for gastric esophagoplasty are
      formulated. The are authors regard a correctly created gastrostoma as the first
      stage of esophagoplasty. The main mistakes in gastrostoma creation that donTt
      permit to use the stomach for esophagus replacement are noted. The main
      principles and techniques of stoma creation on small flexure are described. The
      presented method is recommended for use in specialized esophageal departments and
      in general surgical hospitals.

PMID- 11195672
TI  - [Laparoscopy in diagnosis and treatment of acute abdominal diseases in children].
AB  - 2765 children with abdominal pains were observed in the clinic of pediatric
      surgery from 1995 to 1999. During the observation period the abdominal pains
      persisted in 85 children. As it was not possible to resect the acute abdominal
      diseases, these children underwent diagnostic laparoscopy. Destructive changes in
      the appendix were revealed in 12 patients, 73 patients have avoided unnecessary
      laparotomy and appendectomy. It is concluded that diagnostic potential of
      laparoscopy is not inferior to diagnostic laparotomy. Moreover laparoscopy has
      advantage as a method of final diagnosis.

PMID- 11195673
TI  - [Treatment of giant postoperative hernias].
AB  - Modified hernial ring plasty leading to significant improvement of treatment
      result was used in 48 patients. Lethality was 2.1%, suppuration of the
      postoperative wound was seen in 16.6% patients. There was the relapse (in 3-5
      years) in 9% patients. Positive result of the above method compared with other
      Sapezhko's plasty modifications is explained by good blood supply in sutured
      tissues due to absence of their excessive tension, by location of the sutures
      between peritoneal layers and contact of similar tissues as a result of tamponade
      of space between displaced flaps of scar tissues and internal sutures with
      duplication of fibrous tissue layer.

PMID- 11195674
TI  - [Transpubic approach in radical prostatectomy].
AB  - Surgical interventions in prostate apex and urethral membranous part are
      difficult because these structures are in the depth of the small pelvis.
      Transpubic approach permits easy manipulations in this area. There are the
      following variants of this approach: symphysotomy, pubectomy, resection of
      superior horizontal rami of pubic bones, resection of inferior horizontal rami of
      pubic bones, clinoid resection of pubic bones. The simplicity, adequacy and
      convenience of different surgical manipulations are the advantages of transpubic
      approach. The clinoid resection of pubic bones is the optimal variant of this
      approach. In provides an adequate approach to operated organs, the integrity of
      pelvic ring is saved, as a result of which there are no severe orthopedic
      disorders in the nearest and remote postoperative periods. For determination of
      indications to transpubic approach, the comparative study of the transpubic and
      low-median approaches in radical prostatectomy was carried out in 50 male
      cadavers according to parameters proposed by Sozon-Yaroshevich in 1954. The type
      of constitution, height of symphysis, size and shape of the prostate
      puboprostatic ligaments, adhesion of ligaments to prostate, prostate position
      against symphysis, size of small pelvis venous vessels were taken into account.
      It was established that the angle of surgical action in wound in low-medium
      approach was 35-50 degrees, in transpubic approach--by 25-30 degrees more.
      Incline angle of surgical manipulation axis, which reflect the correspondence of
      surgical section to exposed organ's disposition, is very important in case of
      organ's immobile position. This angle in low-medium approach was 40 +/- 5
      degrees, in transpubic--80-90 degrees. Dorsal venous plexus and urethrals
      membranous part are approachable if the prostate size is small, but if the
      prostate volume is more than 30 cm3 and symphysis is high (> 7 cm), it is very
      difficult to manipulate in this zone in low-medium approach. Transpubic approach
      warrants thorough and careful prostatectomy. Methods leading to disturbance of
      pelvic ring integrity (symphysotomy, pubectomy) have no advantages. Clinoid
      resection ensures the optimum view of operative field and satisfy the main
      requirements of surgical approach.

PMID- 11195675
TI  - [Ultrasonic diagnosis of complications after bypass operations in lower
      extremities arteries].
AB  - After reconstructive vascular operations the patients need dynamic control and
      non-invasive monitoring. The purpose of the study was to reveal the potential of
      duplex scanning (DS) in assessment of bypasses function and diagnosis of
      postoperative complications. 148 patients after aorto-femoral and femoro
      popliteal bypass, including patients with late postoperative complications (shunt
      thrombosis, stenosis or spurious aneurysm of anastomosis) were examined. Energy
      colored DS was performed in scans "Toshiba" SSH-140 and "Acuson" Sequoia-512. In
      ultrasonic diagnosis the vascular graft was imaged as a tube structure with
      hyperechogenic walls and distinct pulse; it was easy to detect the material of
      vascular graft. In examination of distal anastomosis the initial portions of
      efferent arteries were usually imaged distinctly. In satisfactory distal vascular
      bed, the shunt's blood flow did not differ from normal blood flow. In patients
      with multifocal lesions the spectrum of shunt's blood flow was similar to main
      changed blood flow. Substantial change of blood velocity was revealed in
      complications (aneurysm or stenosis of anastomosis). Spurious aneurysm was imaged
      as a hypoechogenic pulsating formation. Thrombotic masses in aneurysm's cavity
      were distinctly detected at DS, unlike at angiography. In case of anastomosis
      insufficiency, the suture's disrupted filaments and free branch's ends could be
      imaged. Stenosis of anastomosis was characterized by visible lumen's stenosis,
      local thickening and unevenness of wall, spectrum's change and blood velocity
      increase. In shunt's thrombosis the DS permitted to follow the thrombed graft's
      path, to reveal the cause of thrombosis and to detect the condition of outflow
      tract. The authors regard DS as a method of choice in dynamic control for state
      of bypasses and arteries in patients after reconstructive operations in lower
      extremities arteries.

PMID- 11195677
TI  - [Atypical approach with allogenous vein for hemodialysis].

PMID- 11195676
TI  - [Opportunity of operative traumatism decrease in patients with complicated
      tricuspid valve defect].
AB  - This study examined the results of surgical trivalve of 44 patients with trivalve
      heart defect. In all the patients the heart defect was combined with two and more
      complicating factors: advanced III-degree calcinosis of the valves, cardiomegaly,
      cardiac fibrillation, left atrium thrombosis, high pulmonary hypertension. In 20
      patients the operative intervention on the heart was repeated. The analysis of
      the results allowed to recommend some surgical techniques which allowed to
      decrease surgical traumatism in patients with complicated trivalve heart defect.
      Low traumatism was possible because of incomplete removal of the calcium masses
      extending on the fibrotic ring and outside, use of two-row counter U-suture on
      linings for the prosthesis fixing, transdoubleatrial approach without isolation
      of the heart from the adhesions in dense pericardial obliteration, correction
      even insignificant trivalve heart defect or relative valve incompetence.

PMID- 11195678
TI  - [Right-sided hemihepatectomy for hepatic abscess complicated by recurrent profuse
      bleeding].

PMID- 11195679
TI  - [Use of electrographic method for detection of catheter position in the aorta].
AB  - Electrographic method has permitted to detect the position of aorta catheter's
      end in 5 patients. This method is most available for intensive care departments
      of city hospital, because it doesn't require special equipment and additional
      staff, is easy to master, may be directly used during catheterisation, is safe
      for patients and staff and is cost effective.

PMID- 11195680
TI  - [Intraoperative ultrasonic examination in diagnosis of surgical diseases].

PMID- 11195681
TI  - [Efficacy of obesity surgical treatment in diabetes mellitus type II].

PMID- 11195682
TI  - [Endobronchial laser therapy in the preoperative preparation of patients with
      lungs surgical diseases].

PMID- 11195683
TI  - [Clinical variants and treatment of gastrointestinal fistulas].
AB  - The experience of 411 patients treatment, aged from 15 to 78 years with
      gastrointestinal tract fistulas are summarized. Depending on clinico-anatomical
      picture, fistulas are divided in 5 types. There were 110 (26.8%) patients with
      fistula type I, 36 (8.7%)--type II, 70 (17.03%)--type III, 29 (7.5%)--type IV, 66
      (40.4%)--type V. Treatment policy was developed for each group. Necessity of
      urgent relaparotomy in patients with fistula type I, early relaparotomy in
      fistula type II, late relaparotomy and elective operations in fistula types III,
      IV and V were substantiated. At usage of this treatment 102 (24.8%) from 411
      patients died.

PMID- 11195684
TI  - Recreational pharmaceuticals.

PMID- 11195685
TI  - Your A to Z guide to the year in medicine.

PMID- 11195686
TI  - Don't pass the salt.

PMID- 11195687
TI  - Buzzing about safety. The latest studies say there is no cell-phone risk, but
      many users are making their own decisions about taking precautions.

PMID- 11195688
TI  - Lost on the campus.

PMID- 11195689
TI  - The future of drugs.

PMID- 11195690
TI  - Brave new pharmacy.

PMID- 11195691
TI  - AIDS. Still no vaccine, but better antiviral drugs are on the way.

PMID- 11195692
TI  - Cancer. Smart bombs for targeting deadly tumors.

PMID- 11195693
TI  - Mental illness. Probing the chemistry of the brain.

PMID- 11195694
TI  - Autoimmune diseases. New ways to intervene when the body attacks itself.

PMID- 11195695
TI  - Obesity. Healthy genes could mean smaller jeans.

PMID- 11195696
TI  - Alzheimer's disease. New insights into its cause lead to new drug strategies.

PMID- 11195697
TI  - Heart disease. Rethinking treatments for the heart.

PMID- 11195698
TI  - Parkinson's disease. Lubricating gummed-up brains.

PMID- 11195699
TI  - The antibiotics crisis. We're in the midst of an escalating arms race with the
      microbe, and we may be losing.

PMID- 11195700
TI  - Beyond needles and pills. Drug reactions kill tens of thousands of patients each
      year. Part of the problem is how the medicine is being delivered.

PMID- 11195701
TI  - Potions from poisons.

PMID- 11195702
TI  - [SSRI antidepressants and alcoholism].
AB  - It seems that SSRI (moreover than being antidepressant) may reduce alcohol
      consumption by decreasing desire, craving and liking for alcohol. The 5-HT
      reuptake inhibitors may be helpful for the treatment of alcoholism by reducing
      relapse frequency and severity. Moreover, if depression or anxiety is present, it
      should be effective to give them immediately because of the frequent association
      between these pathologies and alcoholism.

PMID- 11195703
TI  - [How I investigate...a burning mouth].
AB  - Burning mouth is a symptom typical for the oral mucosa. In contrast, pruritus is
      absent at this site. The situation which is the reverse on the skin can be
      explained by microanatomical differences in the sensorial innervation and by a
      different balance between neuromediators. Burning mouth sensation calls for the
      search of a series of diseases. However, it is most often a monosymptomatic
      expression of a minimal lichenoid stomatitis.

PMID- 11195704
TI  - [Pharma-clinics. The drug of the month. Levofloxacin (Tavanic)].
AB  - Levofloxacin, the (-)-(S)-enantiomer isolated from the racemate ofloxacin, is
      launched by Aventis under the trade name of Tavanic. This new oral and parenteral
      antibiotic belongs to the fluoroquinolone family and exerts a bactericidal
      activity upon a large spectrum of microorganisms, including Gram negative and
      Gram positive bacilli (among which Streptococcus pneunomiae), and atypical
      respiratory pathogens. It also has interesting pharmacokinetic properties.
      Besides the classical indications of other fluoroquinolones (especially
      complicated urinary tract infections, including pyelonephritis, and severe skin
      and soft tissue infections), levofloxacin is indicated for the treatment of acute
      sinusitis, acute exacerbations of chronic bronchitis and community-acquired
      pneumonia.

PMID- 11195705
TI  - [Info-congress. COPERNICUS and Val-HEFT studies].

PMID- 11195706
TI  - [Image of the month. Malignant fibrous histiocytoma].

PMID- 11195707
TI  - [How I treat... refractory multiple myeloma with thalidomide].
AB  - Despite the use of high-dose chemotherapy with autologous hematopoietic stem cell
      transplantation, multiple myeloma remains largely uncurable. Indeed complete
      remission rate is about 50% and median survival reaches 5 years without plateau.
      Recently thalidomide has been identified as a promising agent. We report the
      clinical story of 2 patients with refractory myeloma that we treated successfully
      with thalidomide.

PMID- 11195708
TI  - [Clinical case of the month. Disseminated fusariosis in a immunocompromised
      patient].
AB  - Fusarium spp are ubiquitous soil saprophytes and occasional plant pathogens.
      Fusariosis in humans is usually limited to superficial mycoses. We report the
      case of a disseminated fungal infection due to Fusarium spp in an
      immunosuppressed patient suffering from acute lymphoblastic leukemia. This report
      and review of the recent literature suggest that Fusarium spp are emerging fungal
      pathogens in immunosuppressed patients.

PMID- 11195709
TI  - [Primary hyperparathyroidism: etiology, diagnosis and treatment].
AB  - Primary hyperparathyroidism is a not so infrequent disease that is often
      overlooked by physicians. Its incidence is estimated to be about 28 in 100.000
      subjects, mainly women over seventy years old. Three to four percents of women
      over seventy are affected. Hyperparathyroidism can be isolated or be a component
      of a more complex syndrome like multiple endocrine neoplasms (MEN). Patients can
      be asymptomatic or present with symptoms like asthenia, hypertension or
      nephrolithiasis. The biological investigation requires the combined measurements
      of plasmatic ionized calcium and parathormone. In some cases, more specific
      explorations like calcium loading tests have to be performed in order to confirm
      the diagnosis.

PMID- 11195710
TI  - [Idiopathic pulmonary fibrosis: a new histopathologic classification and clinical
      aspects].
AB  - Idiopathic pulmonary fibrosis (IPF) comprises different interstitial lung
      diseases of unknown origin. They are classified into four groups based on
      pathologic criteria: UIP, DIP, AIP and NSIP. This classification helps in terms
      of prognosis and treatment. In addition to history, physical examination and
      common investigations (chest X ray, pulmonary function testing), a
      bronchoalveolar lavage (BAL), a high-resolution CT scan and ideally a open-lung
      biopsy are needed to establish a precise diagnosis. The patients are usually
      treated by immunosuppressive agents, and mainly by corticoids. However, in UIP,
      lung transplantation is the only way to improve survival.

PMID- 11195711
TI  - [Fibromyalgia in the year 2000].
AB  - Musculoskeletal pain is common in the population. Several pathologies like
      fibromyalgia (FM), chronic fatigue syndrome (CFS) or spasmophilia are associated
      with functional myalgia. The etiology of FM remains elusive, but the diagnosis is
      well established. The criteria for the classification are widespread pain
      combined with tenderness at 11 or more of the 18 specific tender points sites.
      The prevalence is 2% in the general population. This article reviews recent data
      on the pathophysiology and treatment of FM.

PMID- 11195712
TI  - [Urban and rural mycozoonoses].
AB  - The main mycozoonoses are due to specific dermatophytes which are pathogens for
      man and animals. Contamination occurs most often after close contact with the
      animal showing clinical lesions or with inapparent carriage only. The
      contaminated environment also participates to the mycozoonotic epidemics.
      Interhuman transmission is more rarely encountered. Young children before puberty
      are most receptive to the disease. The main urban mycozoonosis is due to
      Microsporum canis transmitted by dogs and cats. Rural mycozoonoses due to
      Trichophyton ochraceum can be contracted from bovines. Zoophilic dermatophytes
      induce lesions which are most often quite inflammatory in humans.

PMID- 11195713
TI  - Information processing during sleep onset and sleep.
AB  - This Special Section examines the extent of information processing during sleep
      onset and sleep itself. It is generally agreed that, stimulus input is markedly
      inhibited during sleep, thus preventing conscious awareness of the external
      environment. Overt behavioural responses are rarely made within sleep. Two
      neurophysiological measures are therefore often used. The electrical activity of
      the brain (the EEG) can be employed to distinguish waking (conscious) from
      sleeping (unconscious) states. It is also possible to quantify the EEG prior to
      and following a detection (or a failure of a detection) of a stimulus. Such
      measures can thus be used to predict conscious awareness. A second measure that
      frequently has been employed is the brain's response to an external stimulus (the
      evoked potential). Different components of the evoked potential can be used to
      trace the extent of information processing during the different states of
      consciousness. Some are associated with a preconscious detection while others are
      associated with conscious awareness. Other evoked potentials may be unique to
      sleep.

PMID- 11195714
TI  - The mismatch negativity to frequency deviants during the transition from
      wakefulness to sleep.
AB  - This study examines the changes in the Mismatch Negativity during the transition
      from a waking, conscious state to one of sleep and unconsciousness. Auditory
      event-related potentials were recorded from eight participants during the sleep
      onset period. A 1,000 Hz-standard stimulus was presented every 600 ms. At random,
      on 20% of the trials, the standard was changed to either a large 2,000-Hz or a
      small 1,100-Hz deviant. During wakefulness, the large deviant elicited a larger,
      long-lasting MMN than the small deviant. Following the large deviant during
      relaxed wakefulness and Stage 2 sleep, the MMN continued to be elicited although
      it was reduced in amplitude. No significant MMN was recorded for either deviant
      in Stages 1 and slow wave sleep. The loss of consciousness therefore appears to
      have a marked effect on the MMN.

PMID- 11195715
TI  - The impact of prestimulus EEG frequency on auditory evoked potentials during
      sleep onset.
AB  - Auditory evoked potentials were recorded during wakefulness, Stage 1, and Stage 2
      non-REM sleep using a three-tone auditory oddball paradigm. Stage 1 sleep was
      divided into trials preceded by alpha and those preceded by theta. A negative
      wave peaking at about 100 ms, N1, displayed a significant decrease in amplitude
      with the onset of Stage 2 sleep. A later N2 peaked at about 250 ms in the waking
      state. This changed into a sleep-specific negative wave peaking at 300 ms (N300)
      at the alpha-theta transition within Stage 1. The P300 displayed a similar shift
      to become a P450 in Stage 2 sleep. N550 was specific to Stage 2, and was larger
      in response to rare, rather than frequent stimuli. There was no evidence of any
      enhancement to relevant rare stimuli compared with irrelevant rare stimuli.

PMID- 11195716
TI  - EEG characteristics prior to and following the evoked K-Complex.
AB  - This study was designed to determine if the K-Complex reflects an arousal from
      sleep or a sleep protection mechanism. Ten participants were presented auditory
      stimuli every 20 s while asleep. Trials were sorted according to the presence or
      absence of a K-Complex. A fast Fourier Transformation of the data was computed on
      EEG segments prior to and following stimulus onset. The log power of activity in
      delta, theta, alpha, sigma, and beta bandwidths was computed. When a K-Complex
      was elicited, there were no differences in EEG activity prior to and following
      the stimulus. However, during slow wave sleep, when a K-Complex was not elicited,
      there was a significant overall increase in theta, alpha, sigma, and beta
      activity following stimulus. These results tend to support the notion that the K
      Complex appears to prevent arousal.

PMID- 11195717
TI  - Awareness during drowsiness: dynamics and electrophysiological correlates.
AB  - During drowsy periods, performance on tasks requiring continuous attention
      becomes intermittent. Previously, we have reported that during drowsy periods of
      intermittent performance, 7 of 10 participants performing an auditory detection
      task exhibited episodes of non-responding lasting about 18 s (Makeig & Jung,
      1996). Further, the time patterns of these episodes were repeated precisely in
      subsequent sessions. The 18-s cycles were accompanied by counterbalanced power
      changes within two frequency bands in the vertex EEG (near 4 Hz and circa 40 Hz).
      In the present experiment, performance patterns and concurrent EEG spectra were
      examined in four participants performing a continuous visuomotor compensatory
      tracking task in 15-20 minute bouts during a 42-hour sleep deprivation study.
      During periods of good performance, participants made compensatory trackball
      movements about twice per second, attempting to keep a target disk near a central
      ring. Autocorrelations of time series representing the distance of the target
      disk from the ring centre showed that during periods of poor performance marked
      near-18-s cycles in performance again appeared. There were phases of poor or
      absent performance accompanied by an increase in EEG power that was largest at 3
      4 Hz. These studies show that in drowsy humans, opening and closing of the gates
      of behavioural awareness is marked not by the appearance of (12-14 Hz) sleep
      spindles, but by prominent EEG amplitude changes in the low theta band. Further,
      both EEG and behavioural changes during drowsiness often exhibit stereotyped 18-s
      cycles.

PMID- 11195718
TI  - Norms of subjective frequency of use and imagery for a sample of 1,916 French
      nouns.
AB  - Norms of rated subjective frequency of use and imagery on seven-point scales are
      reported for 1,916 French nouns. Subjective frequency was defined as the rated
      frequency of occurrence of words in spoken French, and imagery was defined as the
      rated case with which a word aroused a mental image. The mean, standard
      deviation, and percentile rank of the frequency and imagery ratings for each item
      are presented in the Appendix together with their objective frequency of
      occurrence in Baudot's (1992) dictionary. Interjudge reliability was assessed by
      calculating the correlation between the mean ratings of items repeated in the
      booklet, between the mean ratings obtained from odd-numbered and even-numbered
      respondents, and by computing the Cronbach alpha statistic for each page of the
      booklet. These reliability estimates were equal to or greater than .92 for
      frequency and for imagery, confirming the high level of interjudge consistency.
      Although the estimates provided by female and male participants were highly
      correlated (r = .97), the former gave a slightly higher frequency rating to the
      word sample but a slightly lower imagery rating than the latter did. Moreover,
      female respondents gave slightly more extreme ratings on the frequency and
      imagery scales. An analysis of the absolute difference between female and male
      ratings revealed a discrepancy of one half point or more on 20% of the word
      sample for frequency and 13% for imagery. On both scales, the mean absolute
      difference between male and female ratings was larger than that obtained by
      chance alone. This finding highlights the possibility that some words may not be
      equally familiar to women and men or may not evoke imagery with the same ease in
      these groups. Validity estimates for the frequency and imagery ratings were
      derived from correlations with scale values drawn from other normative studies.
      These correlation coefficients were equal to or greater than .78 for frequency
      and .86 for imagery, confirming the high level of consistency between this and
      other studies. An analysis of the relationship between subjective frequency and
      imagery ratings indicated that these variables are generally uncorrelated but
      exceptions occur. In the present study the coefficient of the correlation between
      subjective frequency and imagery was .24. However, when items with extreme mean
      frequency were excluded from the calculation, the correlation coefficient dropped
      to .04 and was no longer significant. Imagery ratings from five independent
      studies were all positively and significantly correlated with Vikis-Freibergs's
      (1974) frequency estimates, which were obtained from a free-association task.
      This finding suggests that word association, as a form of cued recall, may be
      influenced by several stimulus attributes including prior frequency of
      association and imagery-evoking value. The pattern of correlation between imagery
      ratings and text-based frequency estimates is not coherent. It reveals
      significant correlations only in select cases and no consistent polarity of
      linear relationship. The main contribution of this research is to provide
      reliable estimates of subjective frequency and imagery value for a word sample
      that is larger than those included in previous studies. A close examination of
      the linear relationship among the various sources of frequency and imagery data
      underscores the risk of confounding these variables in the selection of lexical
      stimuli for research.

PMID- 11195719
TI  - On the role of eye movements and saccade preparation in generating auditory
      inhibition of return.
AB  - In three experiments, listeners were required to either localize or identify the
      second of two successive sounds. The first sound (the cue) and the second sound
      (the target) could originate from either the same or different locations, and the
      interval between the onsets of the two sounds (Stimulus Onset Asynchrony, SOA)
      was varied. Sounds were presented out of visual range at 135 azimuth left or
      right. In Experiment 1, localization responses were made more quickly at 100 ms
      SOA when the target sounded from the same location as the cue (i.e., a
      facilitative effect), and at 700 ms SOA when the target and cue sounded from
      different locations (i.e., an inhibitory effect). In Experiments 2 and 3,
      listeners were required to monitor visual information presented directly in front
      of them at the same time as the auditory cue and target were presented behind
      them. These two experiments differed in that in order to perform the visual task
      accurately in Experiment 3, eye movements to visual stimuli were required. In
      both experiments, a transition from facilitation at a brief SOA to inhibition at
      a longer SOA was observed for the auditory task. Taken together these results
      suggest that location-based auditory IOR is not dependent on either eye movements
      or saccade programming to sound locations.

PMID- 11195720
TI  - Acculturation attitudes and sociocultural adjustment of sojourner youth in
      Israel.
AB  - Among 300 Jewish sojourner youth (age range: 15-18 years) from the Russian
      Federation, the authors investigated associations of acculturation attitudes,
      measures of sociocultural adjustment, and length of the encounter with the host
      society, Israel. All the youth were participating in a 1-3-year program of high
      school studies in Israel. In the light of J. W. Berry's (1997) acculturation
      model, the authors examined the assumptions that the participants' adjustment to
      Israeli society would require readiness to abandon some of their previous
      identity and to adopt elements of a new identity characteristic of the host
      society. Lower degrees of separation and higher degrees of integration were
      positively linked with measures of sociocultural adjustment. The adjustment
      scores tended to decrease over time spent in Israel.

PMID- 11195721
TI  - Motivation in person perception: role of the other's perspective.
AB  - In previous studies (G. Steins & R. A. Wicklund, 1993, 1996, 1997; R. A. Wicklund
      & G. Steins, 1996), perspective-taking depended on the interplay between 2
      variables--(a) press (the relationship intensity between perceiver and perceived
      person) and (b) conflict. In the absence of conflict, perspective-taking was
      positively related to press; in the presence of conflict, perspective-taking was
      negatively related to press. In the present 3 studies, involving samples of
      German students, the author conducted a detailed exploration of the motivational
      impact of press on perspective-taking: In the 1st study, she measured press via
      the participant's wish to deal with the other person; in the 2nd study, via the
      perceiver's preoccupation with the target; and in the 3rd study, she defined
      press as a general tendency of some participants to become absorbed in other
      individuals. All 3 studies included elements of conflict. The results further
      supported the perspective-taking model and improved the understanding of the
      influence of motivation in person perception.

PMID- 11195722
TI  - Sensation-seeking and differentially arousing television commercials.
AB  - The authors predicted (a) that disinhibited consumers would react more favorably
      to advertising that was high in arousal and (b) that inhibited consumers would
      react more favorably to advertising that was low in arousal. They tested these
      predictions by having U.S. college students evaluate both the commercial and the
      product being marketed in 1 of 2 beer commercials. The prospective buyers then
      completed a measure of dispositional sensation-seeking tendencies. Although the
      participants who differed in disinhibition reacted differently to the 2
      commercials, the nature of their responses was more complex than predicted.

PMID- 11195723
TI  - Crowding effects of density and personal space requirements among older people:
      the impact of self-control and social support.
AB  - The authors examined the effects of self-control and social support among a
      representative sample of 300 older people, 150 in high-density and 150 in low
      density households in India. The Self-Control Schedule (M. Rosenbaum, 1980), the
      Comfortable Interpersonal Distance Test (M. Duke & S. Nowicki, 1972), the Social
      Support Questionnaire, and the Judgement of Environmental Quality Scale (I. G.
      Sarason, H. M. Levine, R. B. Basham, & B. R. Sarason, 1983) were the measures. A
      2 x 2 x 2 (Density x Social Support x Self-Control) analysis of variance for
      perceptions of home environment and personal space requirements revealed that the
      Self-Control x Social Support interaction moderated the crowding effects of
      density: The participants in high-density households evaluated their home
      environments more positively and reduced their personal space requirements.

PMID- 11195724
TI  - Chinese implicit leadership theory.
AB  - In a 1st attempt to identify an implicit theory of leadership among Chinese
      people, the authors developed the Chinese Implicit Leadership Scale (CILS) in
      Study 1. In Study 2, they administered the CILS to 622 Chinese participants from
      5 occupation groups, to explore differences in perceptions of leadership. Factor
      analysis yielded 4 factors of leadership: Personal Morality, Goal Efficiency,
      Interpersonal Competence, and Versatility. Social groups differing in age,
      gender, education level, and occupation rated these factors. Results showed no
      significant gender differences, and the underlying cause for social group
      differences was education level. All groups gave the highest ratings to
      Interpersonal Competence, reflecting the enormous importance of this factor,
      which is consistent with Chinese collectivist values.

PMID- 11195725
TI  - Perceived job image among police officers in Singapore: factorial dimensions and
      differential effects.
AB  - The authors examined the perceived job image of police officers in Singapore and
      its differential effects on their work-related attitudes (e.g., job satisfaction,
      organizational commitment, and intention to quit). The authors obtained data from
      questionnaire surveys and focus-group interviews. Perceived job image consisted
      of 4 dimensions: (a) prestige, (b) integrity, (c) competence, and (d) nonroutine
      job nature. Results of hierarchical regression analyses suggested that the first
      2 dimensions of the perceived job image construct were salient in affecting the
      police officers' work-related attitudes.

PMID- 11195726
TI  - Coping style following acute stress in competitive sport.
AB  - The purpose of this study was to ascertain coping styles among competitive
      athletes in response to various acute stressors. Specifically, the authors used a
      134-item survey to measure approach and avoidance coping styles, with task
      focused and emotion-focused coping tendencies nested hierarchically as
      subdimensions under each. Australian and U.S. college-aged participants indicated
      the extent to which they used approach, avoidance, task-focused, and emotion
      focused coping strategies (a 4-factor model) in response to selected acute
      stressors experienced during sport competition. The authors computed confirmatory
      factor analysis to test the theoretically driven model. The criterion loading of
      .30 and above for each of the factors reduced the survey to 65 items. Findings
      indicated stronger links between the 2 approach constructs of task- and emotion
      focused coping than between the 2 avoidance constructs of those subdimensions.
      The goodness-of-fit indices for the 4-factor model were 0.58 and 0.57 for
      Australian and U.S. samples, respectively, and .71 overall. Concomitant low
      correlations between the 2 approach (0.18) and the 2 avoidance dimensions (0.43)
      reflected relatively high residuals between stressors. In general, psychometric
      analyses suggest that coping style may be more prevalent in some situations than
      others, lending partial support for the transactional model of coping.

PMID- 11195727
TI  - Affectionate same-sex touch: the influence of homophobia on observers'
      perceptions.
AB  - The author extended the proposition (V. J. Derlega, R. J. Lewis, S. Harrison, B.
      A. Winstead, & R. Costanza, 1989) that the fear of being seen as homosexual
      accounts for the common finding that U.S. women engage in more same-sex touch
      than do U.S. men. The author proposed a theoretic model positing that the
      magnitude of homophobia's influence on behavior and on reactions to behavior is
      proportional to the likelihood that the behavior is sexual in nature. An
      experiment involving reactions to same-sex embraces demonstrated that, although
      homophobia was negatively related to evaluations of same-sex affectionate touch,
      the magnitude of the relationship covaried with the probability that the touch
      was sexual. The implications of these findings for longer range theory
      development are discussed.

PMID- 11195728
TI  - Education and career aspirations of Palestinian and U.S. youth.

PMID- 11195729
TI  - Management of abdominal pain.

PMID- 11195730
TI  - Clinical aspects of recurrent abdominal pain.

PMID- 11195731
TI  - The role of motility in functional abdominal disorders in children.

PMID- 11195732
TI  - Biopsychosocial issues in functional abdominal pain.

PMID- 11195733
TI  - Gastroesophageal reflux and other causes of abdominal pain.

PMID- 11195734
TI  - Chronic abdominal pain: inflammatory bowel disease and eosinophilic
      gastroenteropathy.

PMID- 11195735
TI  - Management of abdominal pain. Resident's column.

PMID- 11195736
TI  - A fictitious case of runaway abdominal pain.

PMID- 11195737
TI  - Laser pneumatic retinopexy for repair of recurrent retinal detachment after
      failed scleral buckle--ten years experience.
AB  - BACKGROUND: Although pneumatic retinopexy was introduced for the repair of
      primary retinal detachments, we have had excellent long-term success in employing
      this technique along with laser photocoagulation following failure of routine
      scleral buckle surgery in nonvitrectomized eyes over the last 10 years. PATIENTS
      AND METHODS: We categorized a consecutive series of 40 eyes that failed primary
      scleral buckling surgery and had at least six months follow-up. Eyes were
      separated into two groups: those with 1) subretinal fluid persisting or
      developing during the first 14 days after surgery or 2) those accumulating
      subretinal fluid at least 14 days after initially successful anatomic
      reattachment of the retina. RESULTS: In these groups, 36 of the 40 eyes (90%)
      were successfully reattached using outpatient pneumatic retinopexy alone.
      Complications were limited to the production of new retinal breaks in 5 patients.
      The 4 pneumatic retinopexy failures were all subsequently treated successfully
      with either scleral buckle revision or vitrectomy. CONCLUSION: We believe that
      laser pneumatic retinopexy repair of recurrent retinal detachments following
      scleral buckle and without significant proliferation vitreoretinopathy (PVR)
      should be considered ahead of conventional surgical intraoperative techniques.
      Laser pneumatic retinopexy may be a very successful procedure for the treatment
      of recurrent retinal detachments after failed scleral buckle surgery. In a
      consecutive series of 40 eyes with recurrent retinal detachment, we were able to
      repair 36 with pneumatic retinopexy alone.

PMID- 11195738
TI  - Iris neovascularization after vitrectomy combined with phacoemulsification and
      intraocular lens implantation for proliferative diabetic retinopathy.
AB  - PURPOSE: To analyze the incidence of iris neovascularization after vitrectomy
      combined with phacoemulsification and intraocular lens (IOL) implantation using a
      small incision in the treatment of proliferative diabetic retinopathy (PDR).
      PATIENTS AND METHODS: We studied a consecutive series of 46 eyes in which
      vitrectomy combined with phacoemulsification and IOL implantation had been
      performed, and compared the surgical results with a prior series of 40 eyes in
      which vitrectomy alone had been performed. RESULTS: Postoperative iris and angle
      neovascularization was found in 6 eyes (15%) treated by vitrectomy alone, but in
      only 1 eye (2%) treated by combined vitrectomy (P<0.05). Final visual acuity
      improved by two or more lines in 23 eyes (57%) in the vitrectomy alone group, and
      in 35 eyes (76%) in the combined vitrectomy group. CONCLUSIONS: The incidence of
      postoperative rubeosis iridis was significantly lower, and the visual results
      were satisfactory with vitrectomy combined with phacoemulsification and IOL
      implantation for PDR. These findings suggest that combined vitrectomy for PDR is
      a useful surgical procedure.

PMID- 11195739
TI  - Ocular penetration of cefepime following systemic administration in humans.
AB  - OBJECTIVE: To investigate the penetration of cefepime (a fourth generation
      cephalosporin) into the aqueous humor after single-dose intravenous
      administration in humans. PATIENTS AND METHODS: Before receiving cataract
      surgery, 30 patients received randomly 1 g (group 1, 15 patients) and 2 g (group
      2, 15 patients) single intravenous injection of cefepime before surgery. Samples
      of aqueous humor and serum were obtained at 0.5, 1, 2, 4, and 12 hours after
      injection. Three patients were sampled each time for 1 g and 2 g of cefepime.
      Samples were assayed for cefepime concentrations with high performance liquid
      chromatography (HPLC). RESULTS: All the patients had detectable cefepime in their
      aqueous humor and serum measurable by HPLC. A mean peak aqueous humor level was
      5.16 +/- 0.88 microg/mL in group 1 and 5.87 +/- 1.64 microg/mL in group 2 at 0.5
      hour after injection. The mean level of cefepime in aqueous humor decreased after
      0.5-hour measurements in both groups and was measured as 0.82 +/- 0.21 microg/mL
      in group 1 and 2.04 +/- 0.30 microg/mL in group 2 at 12 hours after injection.
      CONCLUSION: Aqueous humor levels of cefepime after single IV injection were above
      the minimum inhibitory concentration (MIC90) for most ocular pathogens, but the
      duration of exposure to an antibiotic was not sufficient for therapeutic effect.

PMID- 11195740
TI  - Excimer laser photorefractive keratectomy for hyperopia.
AB  - BACKGROUND AND OBJECTIVE: Photorefractive keratectomy (PRK) has been extensively
      evaluated for the correction of myopia. This study was undertaken to assess the
      safety, efficacy, and reliability of PRK in the correction of hyperopia. PATIENTS
      AND METHODS: There were 28 eyes with refractions of +1 to +7.75 D treated for
      hyperopia with the Chiron Technolas 217-C excimer laser. Thorough visual
      assessments were made before treatment and at regular follow-up to 18 months.
      Complications and patient satisfaction were noted. RESULTS: At 18 months the mean
      subjective refraction was +0.46+/-1.00 D with 26 eyes (92.8%) within 1 D of
      emmetropia. Thirteen eyes (46.4%) achieved uncorrected visual acuity (UCVA) of
      20/20 or better and all patients had an UCVA of > or = 20/32 or better. Best
      corrected visual acuity (BCVA) remained unchanged in 26 eyes (92.8%) and improved
      in 2 eyes (7.2%). On the seventh day from treatment, 17 eyes (25%) had a loss of
      2 or more lines of BCVA. At 15 days this was reduced to 8 eyes (14.3%) and at one
      month to 3 eyes (3.6%). There were no cases of loss of 2 or more lines of BCVA at
      18 months of follow-up. All patients expressed a high degree of satisfaction.
      CONCLUSIONS: Photorefractive keratectomy safely and effectively reduced hyperopia
      in the patients studied. The technique was reliable and still offered good
      results at 18 months of follow-up.

PMID- 11195741
TI  - The effect of pterygium surgery on corneal topography.
AB  - OBJECTIVE: The aim of this prospective randomized clinical study was to evaluate
      the effect of pterygium surgery on the corneal topography using a computerized
      corneal topography system. PATIENTS AND METHODS: Computerized corneal topography
      was performed on 27 patients with primary pterygium before and after pterygium
      excision surgery. The topographical changes that occurred following surgery were
      evaluated using paired and unpaired two-tailed t-test and Pearson coefficient of
      correlation analyses. Simulated keratometric astigmatism at the central 3 mm and
      the total mean refractive powers of the whole cornea were measured before and
      after surgery. Following surgery, flattened or steepened corneal areas were
      determined. RESULTS: Simulated keratometric astigmatism at 3 mm was found to be
      2.30 +/- 2.08 D (0.2 - 7.63) preoperatively and 0.82 +/- 0.74 D (0.06 - 2.79)
      postoperatively. The difference between these two values was statistically
      significant (t = -3.46, P = 0.002). Total mean refractive power of the whole
      cornea was found to be 42.26 +/- 0.63 (40.80 - 43.64) preoperatively and 43.69 +/
      0.88 (41.50 - 44.90) postoperatively and the difference was 1.42 +/- 0.87. There
      was a statistically significant high difference (t = 28.36, P < 0.001). When
      preoperative and postoperative corneal topographies were compared, the whole
      cornea was found steeper at the postoperative period except a little region in
      the superior nasal quadrant. CONCLUSION: We believe that corneal topographical
      changes caused by the pterygium are almost reversible after surgical treatment,
      and postoperatively the cornea becomes steeper.

PMID- 11195742
TI  - Fat-conserving aesthetic lower blepharoplasty.
AB  - OBJECTIVE: To evaluate a variation on lower eyelid fat-conserving blepharoplasty
      as a treatment for several facets of periorbital aging, especially eyelid fat
      protrusion and skeletonization of the inferior orbital rim. PATIENTS AND METHODS:
      Retrospective review of 14 consecutive patients at an academic center who
      underwent fat-conserving lower blepharoplasty over an 8-month period. Independent
      evaluation of surgical success was performed by two experienced surgeons.
      RESULTS: Fat-conserving blepharoplasty corrected skeletonization of the inferior
      orbital rim in 13 of 14 cases, and was moderately effective at correction of
      lower eyelid fat protrusion and wrinkles. There were no complications.
      CONCLUSION: Fat-conserving lower blepharoplasty is a safe and effective surgical
      technique for reduction of visibility of the bony orbital rim and can complement
      other procedures used to improve signs of aging in the periorbital region.

PMID- 11195743
TI  - The treatment of lacrimal apparatus obstruction with the use of an inner canthal
      Jones tube insertion via a transcaruncular route.
AB  - BACKGROUND AND OBJECTIVE: To evaluate the clinical utility of the lacrimal bypass
      surgery using Bowman's probe in treatment of obstruction of the lacrimal
      apparatus. PATIENTS AND METHODS: This study evaluated 124 cases of obstruction of
      the lacrimal passage systems with mean epiphora of 2.7 years. An incision was
      made on the side of the caruncle, and the lacrimal bone was penetrated between
      the lacrimal sac and the nasal mucosa by Bowman #0. Insertion of a Jones tube was
      made at the new lacrimal pathway, a puctum dilator or scissors was introduced
      through the caruncle and dilated across the lacrimal bone into the nasal cavity.
      The Jones tube was introduced over the probe into the nasal cavity, and fixed at
      the caruncle with nonabsorbable suture material. RESULTS: Complete resolution of
      epiphora was accomplished in 120 (96.8%) of 124 eyes; only 4 (3.2%) eyes failed
      during a mean of 17.1 months of follow-up. CONCLUSION: This procedure is simple
      and safe with no facial scarring, short operation time, high success rate, and
      can be performed under local anesthesia. Therefore, the clinical utility of this
      procedure seems to be of value in treatment of complicated obstruction of the
      lacrimal apparatus.

PMID- 11195744
TI  - Quantitative analysis of hydroxyl radicals in the anterior optic nerve of the cat
      following transient ischemia.
AB  - PURPOSE: Ischemic insults in the optic nerve are relatively common ocular
      disorders. This study provides quantitative data on the generation of hydroxyl
      radicals in the anterior optic nerve of the cat during the early reperfusion
      phase following 90 minutes of ischemia. MATERIALS AND METHODS: Cats were injected
      intravenously with sodium salicylate that by acting as an hydroxyl radical trap,
      forms 2,3-dihydroxybenzoic acid (2,3-DHBA). Ischemia was achieved by intraocular
      pressure (IOP) elevation via cannulation of the anterior chamber. Ischemia was
      maintained for 60 minutes in 6 eyes and 90 minutes in 12 eyes, followed by 5
      minutes of reperfusion. In an additional 6 eyes, ischemia was maintained for 90
      minutes without reperfusion. RESULTS: After 90 minutes of ischemia and
      reperfusion, mean normalized levels of 2,3-DHBA (ie, ng 2,3-DHBA/microg
      salicylate/mg protein) that represent the levels of hydroxyl radicals were 2.47
      times (at least) higher in the anterior optic nerves than in the fellow sham
      operated controls (P = 0.03). These levels were 3.9 times (at least) greater than
      in the corresponding levels after 90 minutes of ischemia without reperfusion (P=
      0.005). CONCLUSION: This study provides a quantitative analysis and evidence for
      the generation of hydroxyl radicals in the optic nerve of the cat following
      transient ischemia. A quantitative analysis may provide an important tool to
      detect even relatively small levels of free radicals in the tissues, and to
      evaluate the relative efficacy of various therapeutic agents in the inhibition of
      free radical generation following ischemia and reperfusion.

PMID- 11195745
TI  - Diode laser photocoagulation for retinopathy of prematurity: a histopathologic
      study.
AB  - Laser photocoagulation has largely supplanted cryotherapy as an effective
      treatment for retinopathy of prematurity. This case describes the ocular
      histopathologic findings of a pair of eyes in a severely premature male infant
      treated with diode laser photocoagulation for bilateral stage 3 retinopathy of
      prematurity (ROP) for 360 degrees in zone 1 with severe plus disease. The right
      eye responded to treatment; the left eye developed persistent vitreous hemorrhage
      and total retinal detachment. The histopathologic examination of laser burns in
      the right eye disclosed segmental areas of chorioretinal scarring with retinal
      atrophy and gliosis, loss of RPE and extensive atrophy of the choroid and its
      vasculature, which involved both the choriocapillaris and larger vessels. The
      left eye had iris neovascularization, a chronic organized vitreous hemorrhage and
      a totally detached retina. The histopathologic findings in an eye of a premature
      infant with threshold ROP treated with diode laser photocoagulation resembled
      those reported after transsceral cryotherapy. Diode laser photocoagulation may
      produce less severe chorioretinal damage.

PMID- 11195746
TI  - Progressive outer retinal necrosis in a patient with nephrotic syndrome.
AB  - Progressive outer retinal necrosis syndrome (PORN) is a variant of necrotizing
      herpetic retinopathy and the majority of the described cases were related to
      acquired immunodeficiency syndrome. We present a patient who is HIV negative with
      nephrotic syndrome and prednisolone use for 4 months who showed clinical features
      of PORN. Low CD4 counts and lymphocytopenia suggested immunosuppression. In the
      left eye, tractional retinal detachment at the posterior pole followed by
      incomplete posterior vitreous detachment developed. In addition to intravenous
      administration of acyclovir, vitreous surgeries including stripping of the
      posterior hyaloid and silicone-oil tamponade were successfully performed to
      repair the retinal detachment in the left eye and to prevent it in the right eye.

PMID- 11195747
TI  - The effect of tissue plasminogen activator on premacular hemorrhage.
AB  - BACKGROUND AND OBJECTIVE: Early vitrectomy is recommended for eyes with
      premacular hemorrhage, which causes fibrovascular proliferation and macular
      traction. The purpose of this study was to investigate the therapeutic effects of
      tissue plasminogen activator (tPA) on premacular hemorrhage, and the clearing of
      hemorrhage from the macula. PATIENTS AND METHODS: The authors injected tPA (25
      37.5 microg) into the vitreous cavity of 13 eyes with premacular hemorrhage. The
      causes of premacular hemorrhage were diabetic retinopathy in 11 eyes and
      traumatic injuries in 2 eyes. Prior to tPA injection, 4 eyes had complete
      posterior vitreous detachment (PVD) and 9 eyes had no PVD. RESULTS: After tPA
      injection, the hemorrhages in 10 eyes were completely absorbed. They were
      absorbed partially in 2 eyes and were not absorbed at all in 1 eye. Absorption of
      hemorrhage in the 4 eyes with complete PVD took an average of 5.5 days, and in
      the 6 eyes with no PVD, it took an average of 12.7 days (P=0.002). After tPA
      injection, visual acuity improved in 9 eyes, remained stable in 3 eyes, and
      worsened in 1 eye. In 5 eyes, pars plana vitrectomy (PPV) was required after tPA
      injection because of recurrent vitreous hemorrhage, macular traction or
      nonabsorbed premacular hemorrhage. CONCLUSION: TPA seems to be a good alternative
      method of treatment for premacular hemorrhage, especially in eyes with complete
      PVD. It appears to improve vision and defer the need for PPV.

PMID- 11195748
TI  - A traumatic macular hole secondary to a high-energy Nd:YAG laser.
AB  - A case is reported of a traumatic macular hole caused by a high-energy Nd:YAG
      laser. The initial ocular examination revealed an explosive, crater-shaped, full
      thickness macular hole surrounded by local edema and detachment. By the 12th day
      after the injury, the hole had shrunk progressively and was covered by a thin
      fibrin-like membrane. A thick epiretinal membrane covered the injured area 1
      month after the injury. Nine months after the injury, the macular hole closed
      spontaneously with a partially detached epiretinal membrane. This case
      demonstrates one of the natural healing processes of a traumatic macular hole.
      Although the hole finally closed, the patient did not regain his vision because
      of the severe damage to the photoreceptors, retinal pigment epithelium, and
      choroid.

PMID- 11195749
TI  - Lipemia retinalis.

PMID- 11195750
TI  - Subconjunctival cephalosporin anaphylaxis.
AB  - This case describes a patient who developed a systemic anaphylactic reaction to a
      subconjunctival injection of cephalosporin. The patient did well, but required
      intensive therapy, including airway intubation. She had a history of penicillin
      allergy. Even 50 mg of cephalosporin antibiotic injected locally can produce a
      life threatening anaphylactic reaction.

PMID- 11195751
TI  - Quantitative CMV antigenemia correlated with ophthalmoscopic screening for CMV
      retinitis in AIDS patients.
AB  - To assess the efficacy of the cytomegalovirus (CMV) antigen test in detecting the
      clinical presence of CMV retinitis. A retrospective chart review was conducted on
      86 HIV positive patients who underwent dilated fundus exams for CMV retinitis.
      All patients had a CMV antigen assay performed within three months of their
      retinal exam. At a level of 45, the antigen test has a sensitivity of 96% in
      correctly detecting CMV retinitis and a specificity of 90.2%. The negative and
      positive predictive values of the antigen test were 98.2% and 80%, respectively.
      CMV antigen blood test provides a useful screening tool in detecting the presence
      or absence of CMV retinitis. An antigen level less than 45 strongly suggests the
      absence of retinitis.

PMID- 11195752
TI  - A simple closed chamber technique for repair of traumatic iridodialysis in phakic
      eyes.
AB  - A surgical technique was developed for traumatic iridodialysis repair using a
      small partial-thickness scleral flap and a 24-gauge disposible hypodermic needle.
      This procedure is a "direct iridodialysis-site approach" closed chamber technique
      with minimal surgical trauma that can be used in phakic, pseudophakic, or aphakic
      eyes.

PMID- 11195753
TI  - Subretinal hemorrhage from a retinal arterial macroaneurysm simulating a
      choroidal melanoma.

PMID- 11195754
TI  - Anxiety sensitivity in social phobia: comparison between social phobics with and
      without panic attacks.
AB  - The current study examines levels of anxiety sensitivity among social phobic
      patients with and without panic attacks. Two-hundred fourteen individuals with a
      primary diagnosis of social phobia completed the Anxiety Sensitivity Index (ASI)
      prior to treatment. Social phobics who experienced panic attacks reported higher
      levels of anxiety sensitivity than those without panic attacks. Patterning of
      response to ASI items differed between panicking and non-panicking patients, with
      the panicking patients reporting greater fear of catastrophic consequences of
      bodily sensations. Individuals with an additional diagnosis of panic disorder did
      not differ from those with exclusively situational panic attacks. The findings
      suggest the importance of examining differences between anxiety-disordered
      individuals who experience panic attacks and their non-panicking counterparts.

PMID- 11195755
TI  - Generalization of social anxiety to sporting and athletic situations: gender,
      sports involvement, and parental pressure.
AB  - Although researchers have documented that social anxiety may occur in a wide
      range of interpersonal and performance situations, little attention has been paid
      to the potential influence of social anxiety on participation in athletics or
      physical activity. The performance demands of sport and potential social
      evaluative nature of exercise make it likely that social anxiety would generalize
      to these situations. Given the physical and psychological benefits of engaging in
      regular physical activity, avoidance of such activities by socially anxious
      individuals may have profound health consequences. One-hundred and eighty
      undergraduate university students completed a battery of standardized social
      anxiety measures, and a series of 5-point Likert-type questions examining fear
      and avoidance of sporting and athletic situations. Results indicated that social
      anxiety and fear of negative evaluation were generally related to social
      evaluative fears in sporting or athletic situations, particularly for women.
      Furthermore, social anxiety was positively correlated with avoidance of
      individual sporting activities, but not with avoidance of team activities.
      Further analyses revealed social anxiety did not differ by competition level.
      However, for men, familial pressure to play sports during high school was
      associated with higher fear of negative evaluation. Implications for the
      assessment and treatment of social anxiety disorder are discussed.

PMID- 11195756
TI  - Attention to bodily sensations: a test of the cognitive-attentional model of
      panic.
AB  - This paper describes a study designed to test the cognitive-attentional model of
      panic. This model suggests that attention to internal sensations is likely to
      increase misinterpretation of them as representing a serious threat to health,
      which in turn might increase anxiety. In the present study, instructions for
      internal attentional focus were predicted to increase symptom reporting, anxiety,
      and catastrophic symptom attributions. Two groups, patients diagnosed with panic
      disorder with agoraphobia (PDA) and normal controls, watched a stressful film;
      half of each group was asked to attend to their internal sensations while
      watching, and the other half to focus on the film. In the normal controls, the
      manipulation was effective in modifying attentional focus, and the self-focused
      attention group became more anxious, reported more symptoms, and made more
      negative symptom attributions. However, in the PDA group, attentional focus was
      high in both conditions, and perhaps for this reason the intervention had no
      effect on mood, symptoms, catastrophic cognitions, or symptom attribution.

PMID- 11195757
TI  - Perception of emotions in anxious and learning disabled children.
AB  - This study examined differences in the ability to perceive others' emotions in
      anxious and learning disabled children, as these differences may contribute to
      these children's unique socio-emotional difficulties and therapeutic needs. Forty
      six children ages 8 to 12 with either anxiety disorders (ANX), language-based
      learning disabilities (LD), both conditions, or neither condition (clinical
      controls) were compared on the DANVA, a standardized measure of auditory and
      visual perception of emotion. Group results were then compared to normative data.
      Using multivariate analyses, significant group differences were found on the
      auditory portion of the DANVA but not on the visual portion. LD and comorbid
      children scored lower on several auditory stimuli, especially when presented at
      low emotional intensity, while ANX and comorbid children showed high accuracy for
      auditory sadness. Comorbid children also had lower auditory DANVA scores than the
      normative sample. No interactive effects between ANX and LD were found. ANX and
      LD each appear to have distinct effects on the auditory perception of others'
      emotions. Children with both conditions show both effects and differ from normal
      children in this domain. Replication using larger samples is required.

PMID- 11195758
TI  - Generalized anxiety disorder in older adults: examining the relation between
      clinician severity ratings and patient self-report measures.
AB  - Generalized anxiety disorder (GAD) is the most prevalent of the chronic anxiety
      disorders for older adults. Although a variety of self-report measures are
      beginning to be utilized to assess anxiety and related symptoms in older adults,
      there is a paucity of data regarding the convergence of self-report measures with
      clinician ratings of symptom severity. This situation is problematic in that
      interpretability of assessment data is limited, as is our broader understanding
      of the construct of GAD in an older adult population. To address these issues, we
      examined convergence across assessment modalities among 64 older adults who met
      diagnostic criteria for GAD. In addition to two Anxiety Disorders Interview
      Schedule for DSM-IV (ADIS-IV) interviews conducted by independent raters,
      participants completed four self-report measures (Penn State Worry Questionnaire
      [PSWQ], Worry Scale [WS], State-Trait Anxiety Inventory [STAI], Beck Depression
      Inventory [BDI]) as part of a more extensive pretreatment assessment battery.
      Results revealed significant correlations between clinician-rated GAD severity
      and the BDI, STAI, and PSWQ. Regression analyses indicated that the BDI (r2 =
      .15) and the PSWQ (r2 = .07) were particularly useful predictors of clinician
      rated GAD severity. A comorbid mood disorder, however, was identified as an
      important mediator of these relations. Specifically, presence of coexistent
      depression accounted for 17% of the variance in clinician severity ratings (CSR;
      P < .01), with individuals diagnosed with a comorbid mood disorder receiving
      higher clinician severity ratings. The only self-report measure that accounted
      for additional significant variance was the PSWQ (7%). The study highlights the
      need to address coexistent psychological conditions when examining convergence
      between assessment modalities, and expands upon the relatively neglected area of
      anxiety assessment in older individuals. Specifically, the BDI and the PSWQ are
      identified as particularly useful screening instruments that may be helpful in
      conceptualizing GAD severity within an older adult population.

PMID- 11195759
TI  - Age effects on the social interaction test in early adulthood male rats.
AB  - The effects of age on active and passive social interaction were studied in
      Wistar rats using the social interaction test (S.I.T.). Individual behaviors such
      as ambulation, rearing, and defecation were also studied. Despite the widespread
      use of the S.I.T. in anxiety research, the effects of age on the S.I.T. have not
      been studied thoroughly. Male Wistar rats of 75, 135, and 180 days old were used.
      Our results showed age effects on active social contact, passive social contact,
      ambulation, rearing, and defecation. At 135 days old, animals presented the
      lowest scores on active social behavior and the highest scores on defecation.
      Moreover, exploratory behavior measured by ambulation and rearing decreased with
      age. These results suggest that age could be a relevant variable in the social
      interaction test.

PMID- 11195760
TI  - Comorbidity in chronic shyness.

PMID- 11195761
TI  - Acute onset and remission of obsessions and compulsions following medical
      illnesses and stress.
AB  - Obsessive Compulsive Disorder (OCD) is generally chronic. Episodic OCD with
      complete remission has been rarely reported. Two cases of brief, episodic
      obsessions and compulsions that appeared for the first time following
      psychological stress and in the context of medical illness are reported. The
      possibility of brief episodes of OCD precipitated by stress is illustrated.
      Exploration of this phenomenon may help us learn more about OCD in general.

PMID- 11195762
TI  - Obstetric care in patients with HIV disease.
AB  - Appropriate management of pregnant patients who have human immunodeficiency virus
      (HIV) disease can have a major impact on maternal and infant health. The goals of
      therapy are to properly manage the pregnancy, treat the maternal HIV infection
      and minimize the risk of vertical transmission of HIV. Early detection of HIV
      through aggressive screening programs is necessary to initiate timely therapy.
      Zidovudine therapy given antepartum and intrapartum to the mother and after birth
      to the newborn has been shown to decrease the risk of vertical transmission.
      Evidence suggests that more aggressive antiretroviral therapy for the mother,
      which allows suppression of viral loads to undetectable levels, may be safe and
      may provide significant additional benefits. However, treatment needs to be
      individualized, weighing the possible teratogenic risks against the benefits of
      decreased transmission. Multiple prospective cohort studies support elective
      cesarean section as an additional means to decrease vertical transmission, but
      its role in relation to other therapies has not been determined. As in
      nonpregnant patients infected with HIV, prevention of opportunistic infections
      and adequate psychosocial support are essential.

PMID- 11195763
TI  - Photo quiz. Nodules in a linear distribution.

PMID- 11195764
TI  - The 2001 recommended childhood immunization schedule.

PMID- 11195765
TI  - A patient seeking disability.

PMID- 11195766
TI  - Office laboratory medicine. American Academy of Family Physicians.

PMID- 11195767
TI  - Spiritual assessment in medical practice.

PMID- 11195768
TI  - Spirituality and medical practice: a look at the evidence.

PMID- 11195769
TI  - Providing basic spiritual care for patients: should it be the exclusive domain of
      pastoral professionals?

PMID- 11195770
TI  - New insights into mental illness.

PMID- 11195771
TI  - Family physicians and end-of-life care.

PMID- 11195772
TI  - Adult rhinosinusitis: diagnosis and management.
AB  - Rhinosinusitis can be divided among four subtypes: acute, recurrent acute,
      subacute and chronic, based on patient history and a limited physical
      examination. In most instances, therapy is initiated based on this
      classification. Antibiotic therapy, supplemented by hydration and decongestants,
      is indicated for seven to 14 days in patients with acute, recurrent acute or
      subacute bacterial rhinosinusitis. For patients with chronic disease, the same
      treatment regimen is indicated for an additional four weeks or more, and a nasal
      steroid may also be prescribed if inhalant allergies are known or suspected.
      Nasal endoscopy and computed tomography of the sinuses are reserved for
      circumstances that include a failure to respond to therapy as expected, spread of
      infection outside the sinuses, a question of diagnosis and when surgery is being
      considered. Laboratory tests are infrequently necessary and are reserved for
      patients with suspected allergies, cystic fibrosis, immune deficiencies,
      mucociliary disorders and similar disease states. Findings on endoscopically
      guided microswab culture obtained from the middle meatus correlate 80 to 85
      percent of the time with results from the more painful antral puncture technique
      and is performed in patients who fail to respond to the initial antibiotic
      selection. Surgery is indicated for extranasal spread of infection, evidence of
      mucocele or pyocele, fungal sinusitis or obstructive nasal polyposis, and is
      often performed in patients with recurrent or persistent infection not resolved
      by drug therapy.

PMID- 11195773
TI  - Spirituality and medical practice: using the HOPE questions as a practical tool
      for spiritual assessment.
AB  - The relationship between spirituality and medicine has been the focus of
      considerable interest in recent years. Studies suggest that many patients believe
      spirituality plays an important role in their lives, that there is a positive
      correlation between a patient's spirituality or religious commitment and health
      outcomes, and that patients would like physicians to consider these factors in
      their medical care. A spiritual assessment as part of a medical encounter is a
      practical first step in incorporating consideration of a patient's spirituality
      into medical practice. The HOPE questions provide a formal tool that may be used
      in this process. The HOPE concepts for discussion are as follows: H--sources of
      hope, strength, comfort, meaning, peace, love and connection; O--the role of
      organized religion for the patient; P--personal spirituality and practices; E-
      effects on medical care and end-of-life decisions.

PMID- 11195774
TI  - Management of ankle sprains.
AB  - Without adequate care, acute ankle trauma can result in chronic joint
      instability. Use of a standardized protocol enhances the management of ankle
      sprains. In patients with grades I or II sprains, emphasis should be placed on
      accurate diagnosis, early use of RICE (rest, ice, compression and elevation),
      maintenance of range of motion and use of an ankle support. Sprains with complete
      ligament [corrected] tears (grade III) may require surgical intervention.
      Although early motion and mobility are recommended, ligamentous strength does not
      return until months after an ankle sprain.

PMID- 11195775
TI  - Complementary medicine: viable models.
AB  - Complementary medicine has had a quiet, consumer-based, grassroots evolution,
      generally spearheaded by individual champions. In this article, McGrady describes
      six models of complementary medicine and details specific practitioners who have
      implemented these models. Solo practitioners, physician-based practices, academic
      and research initiatives, wellness centers, provider networks, and hospital-based
      initiatives are discussed to display the diversity of options for complementary
      medicine. In addition, the author touches upon the legalities and credentialing
      of practitioners, as well as the financial considerations that health systems
      must face.

PMID- 11195776
TI  - Complementary and alternative medicine: an opportunity for reform.
AB  - Healthcare in the United States is in the midst of a grassroots consumer movement
      as the use of complementary and alternative medicine (CAM) continues to increase.
      Traditional health providers find themselves in the unenviable and challenging
      position of being late entrants into a market that in theory could provide some
      ready cash at a time when reimbursement is scarce. This article first takes a
      look at the numbers involved in CAM, and from that foundation predicts future
      trends involving CAM, discusses the challenge presented to providers and
      insurers, and offers up the opportunities for systems providing CAM to consumers.
      While the task of incorporating CAM into the traditional healthcare system may
      seem daunting, systems that bring CAM into their continuum of care can take heart
      that millions of people and billions of dollars are just waiting for a new
      approach that adds value to health and quality to life.

PMID- 11195777
TI  - Observations from a bottom-line-oriented true believer.
AB  - While it is difficult to find two people who agree on the definition of
      complementary medicine, the McGrady and Freshley and Carlson articles help
      substantially in creating a common definition. This information should help to
      move providers and practitioners to a better understanding of complementary
      medicine and its inevitable presence on the American healthcare scene. In the
      post-Balanced Budget Act era, healthcare executives and physicians recognize that
      a business-as-usual approach to the delivery of healthcare services is not an
      option. Cultivating new sources of revenue and having a retail rather than a
      reimbursement mindset of new ventures is essential. The $13.7 billion dollars
      being spent annually on complementary medicine is money hospitals can no longer
      afford to leave on the table. If complementary medicine is approached with the
      proper philosophical and leadership commitment, and is truly accepted as an
      important component in the continuum of care, financial success will follow.

PMID- 11195778
TI  - We are a nation of lonely molecules.

PMID- 11195779
TI  - Alternatives that work--an insurer's path to integrated healthcare.

PMID- 11195780
TI  - Characterization of the 5'-flanking region of the rat TIS11 gene.
AB  - To understand the mechanism underlying the transcriptional regulation of the
      immediate early gene TIS11, we characterized the 5'-flanking region of the rat
      TIS11 gene. When fused to the luciferase reporter gene, the 5.3-kb 5'-flanking
      region of the rat TIS11 gene exhibited functional promoter activity in
      pheochromocytoma PC12 and hepatoma H4IIE cells. 5'-Deletion analyses indicated
      that multiple negative and positive regulatory regions were present in the 5'
      flanking region, and that some of these regions functioned in a cell type
      specific manner. Promoter activity of the rat TIS 11 gene was enhanced by phorbol
      12-myristate 13-acetate (PMA) in both cell lines, and the PMA-responsiveness
      resided within the 5'-flanking region. The induction of promoter activity by PMA
      was completely blocked by GF109203X or PD98059, inhibitors of protein kinase C
      and mitogen-activated protein (MAP) kinase kinase, respectively. These results
      suggested that induction of the rat TIS 11 promoter by PMA is mediated by
      activation of the protein kinase C/MAP kinase cascade.

PMID- 11195781
TI  - The type of DNA attachment sites recovered from nuclear matrix depends on
      isolation procedure used.
AB  - A large variety of DNA sequences have been described in nuclear matrix attachment
      regions. It could be most likely a result of the different methods used for their
      isolation. The idea about how different types of known DNA sequences (strongly
      attached to the nuclear matrix, weakly attached, or not attached) directly
      participate in anchoring DNA loops to the nuclear matrices isolated by different
      experimental procedures was tested in this study. Matrix-attached (M) and matrix
      independent or loop (L) fractions as well as nuclear matrices were isolated using
      extractions of nuclei with 25 mM lithium 3,5-diiodosalicylate (LIS), 2 M NaCl,
      0.65 M ammonium sulphate containing buffers followed by DNase I/RNase A
      digestion, or according to so designated conventional method. Using PCR-based and
      in vitro binding assays it was established that LIS and ammonium sulphate
      extractions gave similar results for the type of attachment of sequences
      investigated. The harsh extraction with 2 M NaCl or the conventional procedure
      led to some rearrangements in the attachment of DNA loops. As a result a big part
      of matrix attached sequences were found detached in the loop fractions. However,
      the in vitro binding abilities of the MARs to the nuclear matrices isolated by
      different methods did not change.

PMID- 11195782
TI  - Alpha-1 adrenergic signaling in a cardiac murine atrial myocyte (HL-1) cell line.
AB  - Activation of alpha-1 adrenergic receptors in the heart has been shown to result
      in increased contractile activity, cardiac fetal gene re-expression, and myocyte
      hypertrophy. Three alpha-1 adrenergic receptors have been identified through
      molecular cloning. Due to the limited selectivities of the currently available
      alpha-1 adrenergic receptor antagonists, the signaling pathways activated by
      specific subtypes in the heart remain unresolved. To resolve this dilemma, we
      have used a molecular approach to identify the signaling pathways and downstream
      genes that are engaged in response to activation of individual alpha-1 adrenergic
      subtypes in cardiac cells. We have transfected constitutively active alpha-1
      adrenergic receptors (alpha1a-S290/293-AR [1] or the alpha1b-S288/294-AR [2])
      subtypes into the cardiac murine myocyte cell line (HL-1) and studied the signal
      transduction pathway(s) and cardiac gene(s) activated by them. In this study, we
      demonstrate that the alpha1a-S290/293 -AR [1] subtype preferentially couples to
      cardiac-specific atrial natriuretic factor (ANF) gene expression, while the
      alpha1b-S288/294-AR preferentially couples to activation of mitogen-activated
      protein kinase (MAPK), Ets-like transcription factor-1 (Elk1) and serum response
      element (SRE) signaling pathways. Endogenous alpha-1 adrenergic receptors are
      expressed, and stimulate phosphatidylinositol-hydrolysis upon activation with the
      alpha-1 agonist, phenylephrine.

PMID- 11195783
TI  - Protein nitration.
AB  - Various proteins/enzymes obtained commercially were tested for the presence of
      endogenously nitrated tyrosine by Western blot analysis omitting reducing agent
      in the step of SDS-PAGE. Histones II-S and VIII-S, IgG, cAMP-dependent protein
      kinase (PKA), phosphorylase b, and phosphorylase kinase exhibited strong
      immunoreactive bands. Histone VI-S, glycogen synthase, lactate dehydrogenase,
      actin, thyroglobulin, and macroglobulin exhibited moderate immunoreactivity.
      Histone III-S, casein, acetyl cholinesterase, DNase I, and lipase had only
      traceable immunoreactivity. Whereas histone VII-S, pyruvate kinase, trypsin,
      pepsin, chymotrypsin, protease IV, and protease XIII, and glutathione S
      transferase lacked immunoreactivity. A variation of immunoreactivity between
      hypertensive and normaltensive rat hearts was found in the histone-agarose
      fractions of crude extracts. Additionally, nitrotyrosine immunoreactivity was
      observed in non-mammalian organisms including Eschericia coli, Saccharomyces
      cerevisiae and Triticum vulgaris. Upon the treatment of 15 microM peroxynitrite
      (PN), strong oxidant derived from nitric oxide (NO), the apparent Km of PKA for
      cAMP increased from approximately 10(-8) to 10(-6) M. The results imply that the
      varied nitration of tyrosine residues in proteins/enzymes may occur as a post
      translational modification in vivo, and such discriminative nitration may be
      vital in PN/NO-regulated signal transduction cascade.

PMID- 11195786
TI  - Vascular endothelial growth factor is increased following coronary artery
      occlusion in the dog heart.
AB  - Vascular endothelial growth factor (VEGF) is a hypoxia-inducible factor expressed
      into several molecular forms in mammalian tissues of which VEGF 120, VEGF 164,
      and VEGF 188 are the major isoforms. While VEGF 164 is the predominant isoform in
      most tissues, VEGF 188 has been reported to be dominant in cardiac tissues such
      as that in guinea pig, rat, and mouse. In the dog heart, an important model for
      studies of myocardial ischemia and angiogenesis, the expression of VEGF remains
      to be established. We investigated the expression of the various isoforms of VEGF
      in normal and ischemic dog heart tissues using Reverse transcription-Polymerase
      chain reaction, Ribonuclease Protection Assay and Western blotting. The
      nucleotide sequences of the major isoforms of VEGF were also determined using
      homology cloning techniques. Our study showed that the nucleotide sequences of
      dog VEGF were highly homologous to human VEGF especially in the c-terminal region
      spanning exons 58. A single amino acid-deletion (Glu5 in human VEGF), similar to
      that reported in other animal species, was observed in the major isoforms
      resulting in monomers of 120, 164, and 188 amino acids. A novel splice site
      similar to that in human VEGF183 was also identified in the dog heart, resulting
      in the 182 amino acid-containing isoform (VEGF 182). Moreover, VEGF 164 was
      expressed at a higher level as compared with VEGF 182 or VEGF 188 in both normal
      and ischemic tissues. The identification of the nucleotide sequences of VEGF
      isoforms in the dog heart should prove useful in investigating the molecular
      expression of VEGF in canine tissues.

PMID- 11195785
TI  - Lysosome lipid storage disorder in NCTR-BALB/c mice: spleen and lung lysosomes
      store unesterified cholesterol but differ in their phospholipid composition.
AB  - A strain derived from a colony of BALB/c mice at the National Center for
      Toxicological Research, Jefferson, AR, USA (NCTR-BALB/c) suffers from an
      autosomal recessive disorder characterized by proliferation of secondary
      lysosomes with accumulation ofunesterified cholesterol in several tissues. The
      unesterified cholesterol content of spleens and lungs from the affected mice were
      elevated 8- and 3-fold respectively over age- and sex-matched controls.
      Postnuclear supernatants of tissue homogenates were fractionated by sucrose
      density gradient centrifugation and the fractions were analyzed for unesterified
      cholesterol, protein and marker enzyme activities for lysosomes (N-acetyl-beta-D
      glucosaminidase, beta-D-glucuronidase), plasma membrane (alkaline
      phosphodiesterase I), endoplasmic reticulum (glucose-6-phosphatase) and
      mitochondria (cytochrome oxidase). The enzyme distribution profile showed that
      lysosomes of affected tissues floated at low density regions (density 1.05-1.08)
      of the gradient and contained substantial amount of tissue unesterified
      cholesterol. These low density lysosomes were purified about 17-fold (58% yield)
      from spleen and about 6-fold (32% yield) from lungs with minimal contamination by
      other organelles They were mostly intact as judged by high latency for N-acetyl
      beta-D-glucosaminidase activity (70-100%). Lysosomes of control tissues were not
      found at the low density regions. The distribution profiles for other organelles
      were similar between affected and control tissues. Phospholipid composition of
      low density lysosomes were distinctly different from their respective tissue
      homogenates. Spleen and lung lysosomes were enriched in sphingomyelin and
      phosphatidylcholine respectively. The results suggest that these lysosomes
      acquire their low densities due to accumulation of unesterified cholesterol, the
      retention of which may be aided by sphingomyelin and phosphatidylcholine content
      of the lysosomes.

PMID- 11195787
TI  - Effect of ethylisopropyl amiloride, a Na+ - H+ exchange inhibitor, on
      cardioprotective effect of ischaemic and angiotensin preconditioning.
AB  - The present study is designed to investigate the role of Na+ -H+ exchanger in the
      cardioprotective effect of ischaemic and angiotensin (Ang II) preconditioning.
      Isolated perfused rat heart was subjected to global ischaemia for 30 min followed
      by reperfusion for 120 min. Coronary effluent was analysed for LDH and CK release
      to assess the degree of cardiac injury. Myocardial infarct size was estimated
      macroscopically using TTC staining. Left ventricular developed pressure (LVDP)
      and dp/dt were recorded to evaluate myocardial contractility. Four episodes of
      ischaemic or Ang II preconditioning markedly reduced LDH and CK release in
      coronary effluent and decreased myocardial infarct size. 5-(N-ethyl-N
      isopropyl)amiloride (EIPA), a Na+ - H+ exchange inhibitor, produced no marked
      effect on ischaemic preconditioning and Ang II preconditioning induced
      cardioprotection. On the other hand, EIPA administration prior to global
      ischaemia produced a similar reduction in myocardial injury as was noted with
      ischaemic preconditioning or Ang II preconditioning. On the basis of these
      results, it may be concluded that inhibition of Na+ - H+ exchanger protects
      against ischaemia-reperfusion induced myocardial injury whereas activation of Na+
      - H+ exchanger may not mediate the cardioprotective effect of ischaemic and Ang
      II preconditioning.

PMID- 11195784
TI  - Modification of beta-adrenoceptor signal transduction pathway by genetic
      manipulation and heart failure.
AB  - The beta-adrenoceptor (beta-AR) mediated signal transduction pathway in
      cardiomyocytes is known to involve beta1- and beta2-ARs, stimulatory (Gs) and
      inhibitory (Gi) guanine nucleotide binding proteins, adenylyl cyclase (AC) and
      cAMP-dependent protein kinase (PKA). The activation of beta1- and beta2-ARs has
      been shown to increase heart function by increasing Ca2+ -movements across the
      sarcolemmal membrane and sarcoplasmic reticulum through the stimulation of Gs
      proteins, activation of AC and PKA enzymes and phosphorylation of the target
      sites. The activation of PKA has also been reported to increase phosphorylation
      of some myofibrillar proteins (for promoting cardiac relaxation) and nuclear
      proteins (for cardiac hypertrophy). The activation of beta2-AR has also been
      shown to affect Gi-proteins, stimulate mitogen activated protein kinase and
      increase protein synthesis by enhancing gene expression. Beta1- and beta2-ARs as
      well as AC are considered to be regulated by PKA- and protein kinase C (PKC)
      mediated phosphorylations directly; both PKA and PKC also regulate beta-AR
      indirectly through the involvement of beta-AR kinase (betaARK), beta-arrestins
      and Gbeta gamma-protein subunits. Genetic manipulation of different components
      and regulators of beta-AR signal transduction pathway by employing transgenic and
      knockout mouse models has provided insight into their functional and regulatory
      characteristics in cardiomyocytes. The genetic studies have also helped in
      understanding the pathophysiological role of PARK in heart dysfunction and
      therapeutic role of betaARK inhibitors in the treatment of heart failure. Varying
      degrees of defects in the beta-AR signal transduction system have been identified
      in different types of heart failure to explain the attenuated response of the
      failing heart to sympathetic stimulation or catecholamine infusion. A decrease in
      beta1-AR density, an increase in the level of G1-proteins and overexpression of
      betaARK are usually associated with heart failure; however, these attenuations
      have been shown to be dependent upon the type and stage of heart failure as well
      as region of the heart. Both local and circulating renin-angiotensin systems,
      sympathetic nervous system and endothelial cell function appears to regulate the
      status of beta-AR signal transduction pathway in the failing heart. Thus
      different components and regulators of the beta-AR signal transduction pathway
      appears to represent important targets for the development of therapeutic
      interventions for the treatment of heart failure.

PMID- 11195788
TI  - Protein kinase C is involved in cardioprotective effects of ischemic
      preconditioning on infarct size and ventricular arrhythmia in rats in vivo.
AB  - Protein kinase C (PKC) has been known to play an important role in ischemic
      preconditioning (IP). This study was designed to examine whether the
      translocation of PKC is associated with the cardioprotective effects of IP in
      vivo on infarct size and ventricular arrhythmias in a rat model. Using
      anesthetized rats, heart rate, systolic blood pressure, infarct size and
      ventricular arrhythmias during 45 min of coronary occlusion were measured. PKC
      activity was assayed in both the cytosolic and cell membrane fraction. Brief 3
      min periods ofischemia followed by 10 min ofreperfusion were used to precondition
      the myocardium. Calphostin C was used to inhibit PKC. Infarct size was
      significantly reduced by IP (68.1 (2.5)%, mean (S.E.) vs. 45.2 (3.4)%, p < 0.01).
      The reduction in infarct size by IP was abolished by pretreatment with calphostin
      C. The total number of ventricular premature complex (VPC) during 45 min of
      coronary occlusion was reduced by IP (1474 (169) beats/45 min vs. 256 (82)
      beats/45 min, p < 0.05). The reduction the total number of VPC induced by IP was
      abolished by the administration of calphostin C before the episode of brief
      ischemia. The same tendency was observed in the duration of ventricular
      tachycardia and the incidence of ventricular fibrillation. PKC activity in the
      cell membrane fraction transiently increased immediately after IP (100 vs. 142%,
      p < 0.01) and returned to baseline 15 min after IP. Pretreatment with calphostin
      C prevented the translocation of PKC. The translocation of PKC plays an important
      role in the cardioprotective effect of IP on infarct size and ventricular
      arrhythmias in anesthetized rats.

PMID- 11195789
TI  - Calpain-mediated proteolytic cleavage of troponin I induced by hypoxia or
      metabolic inhibition in cultured neonatal cardiomyocytes.
AB  - While ischemic damage to myofibrillar proteins is thought to be responsible in
      part for depressed cardiac function, the relation between myofilament protein
      breakdown and chronic hypoxia has not been defined. We previously characterized a
      chemical hypoxia model of neonatal cardiomyocytes mediated by 1 mM azide that
      exhibits features of calpain activation (Mol Cell Biochem 178:141-149, 1998). We
      here show that both hypoxia and azide-mediated metabolic inhibition induced heme
      oxygenase-1 expression, and caused cell death associated with lipid peroxidation.
      While blocking calcium influx or inhibiting calpain activity efficiently
      attenuated hypoxia-induced cell injury, it failed to prevent cell injury caused
      by adenoviral overexpression of the tumor suppressor protein p53. Inhibitors of
      caspases, on the other hand, suppressed cell injury caused by p53 overexpression.
      Hypoxia caused selective cleavage of troponin I (TnI), which could be suppressed
      by either nifedipine or calpeptin. Other myofilament proteins such as troponin T,
      myosin heavy chain, and actin appeared to remain largely intact. p53-mediated
      cell injury exhibited proteolysis of the caspase protein substrate lamin B
      without appreciable breakdown of TnI. We suggest that calpain-induced TnI
      breakdown may constitute a unique biochemical marker associated with chronically
      hypoxic cardiomyocytes.

PMID- 11195790
TI  - Effect of sex and bezafibrate on incorporation of blood borne palmitate into
      lipids of rat liver nuclei.
AB  - The aim of the present study was to investigate whether lipid metabolism in the
      nuclei is affected by changes in the metabolism of free fatty acids in the liver.
      The experiments were carried out on 3 groups of rats: 1 - control-male, 2 -
      female, and 3 - male, treated with bezafibrate (a peroxisome proliferator). The
      rats received 14C-palmitic acid intravenously. Thirty min later liver samples and
      blood from the abdominal aorta were taken. The liver nuclei were isolated in
      sucrose gradient. Lipids were extracted from the nuclei and the liver homogenate
      and subsequently separated into the following fractions: phospholipids, mono, di-
      and triacylglycerols, free fatty acids, cholesterol and cholesterol esters. The
      radioactivity of each fraction was counted. Furthermore, the content of free
      fatty acids and the fatty acid binding proteins was measured. It was found that
      radioactivity was present in each lipid fraction obtained from the liver
      homogenate and from the nuclei. In the female group, the total radioactivity of
      lipids in the liver homogenate was lower, whereas in the nuclei it was higher in
      comparison to the male group. The reduction in the radioactivity in the liver was
      mostly accounted for by decreased radioactivity in the fraction
      oftriacylglycerols and phospholipids. In the nuclei, the radioactivity of the
      fraction of phospholipids, free fatty acids and diacylglycerols was elevated.
      Bezafibrate did not affect the total radioactivity of lipids in the liver and
      reduced it in the nuclei. In the liver, the drug increased radioactivity mostly
      in the fraction of phospholipids and reduced it mainly in the fraction of
      triacylglycerols. In the nuclei, the radioactivity of each lipid fraction
      examined was reduced. The content of the fraction of free fatty acids in the
      liver and in the nuclei in the female and in the bezafibrate-treated groups did
      not differ from the respective value in the control group. The content of fatty
      acid binding proteins in the nuclei of the female and bezafibrate-treated groups
      increased in parallel to the elevation in their content in the cytosol. It is
      concluded that the female sex hormones and bezafibrate influence the transport of
      selected lipids into the nuclei. The effects seem to be a consequence of the
      action of these factors directly on the nucleus.

PMID- 11195791
TI  - Evidence that the TRP-1 protein is unlikely to account for store-operated Ca2+
      inflow in Xenopus laevis oocytes.
AB  - The role of the TRP-1 protein, an animal cell homologue of the Drosophila
      transient receptor potential Ca2+ channel, in store-operated Ca2+ inflow in
      Xenopus laevis oocytes was investigated. A strategy involving RT-PCR and 3' and
      5' rapid amplification of cDNA ends (RACE) was used to confirm and extend
      previous knowledge of the nucleotide and predicted amino acid sequences of
      Xenopus TRP-1 (xTRP-1). The predicted amino acid sequence was used to prepare an
      anti-TRP-l polyclonal antibody which detected the endogenous oocyte xTRP-1
      protein and the human TRPC-1 protein expressed in Xenopus oocytes. Ca2+ inflow
      (measured using fura-2) initiated by 3-deoxy-3-fluoroinositol 1,4,5-trisphosphate
      (InsP3F) or lysophosphatidic acid (LPA) was completely inhibited by low
      concentrations of lanthanides (IC50 = 0.5 microM), indicating that InsP3F and LPA
      principally activate store-operated Ca2+ channels (SOCs). Antisense cRNA or
      antisense oligodeoxynucleotides, based on different regions of the xTRP-1 cDNA
      sequence, when injected into Xenopus oocytes, did not inhibit InsP3F-, LPA- or
      thapsigargin-stimulated Ca2+ inflow. Oocytes expressing the hTRPC-1 protein,
      which is 96% similar to xTRP-1, exhibited no detectable enhancement of either
      basal or InsP3F-stimulated Ca2+ inflow and only a very small enhancement of LPA
      stimulated Ca2+ in-flow compared with control oocytes. It is concluded that the
      endogenous xTRP-1 protein is unlikely to be responsible for Ca2+ inflow through
      the previously-characterised Ca2+ -specific SOCs which are found in Xenopus
      oocytes. It is considered that xTRP-1 is likely to be a receptor-activated non
      selective cation channel such as the channel activated by maitotoxin.

PMID- 11195792
TI  - Three dimensional atomic model and experimental validation for the ATP-Regulated
      Module (ARM) of the atrial natriuretic factor receptor guanylate cyclase.
AB  - Atrial natriuretic factor (ANF) receptor guanylate cyclase (ANF-RGC) is a single
      chain transmembrane-spanning protein, containing both ANF binding and catalytic
      activities. ANF binding to the extracellular receptor domain activates the
      cytosolic catalytic domain, generating the second messenger cyclic GMP.
      Obligatory in this activation process is an intervening transduction step, which
      is regulated by the binding of ATP to the cyclase. The partial structural motif
      of the ATP binding domain of the cyclase has been elucidated and has been termed
      ATP Regulatory Module (ARM). The crystal structures of the tyrosine kinase
      domains of the human insulin receptor and haematopoietic cell kinase were used to
      derive a homology-based model of the ARM domain of ANF-RGC. The model identifies
      the precise configuration of the ATP-binding pocket in the ARM domain, accurately
      represents its ATP-dependent features, and shows that the ATP-dependent
      transduction phenomenon is a two-step mechanism. In the first step, ATP binds to
      its pocket and changes its configuration; in the second step, via an unknown
      protein kinase, it phosphorylates the cyclase for its full activation.

PMID- 11195793
TI  - Influence of extracellular potassium on the antiarrhythmic effect of global
      preconditioning in isolated perfused rat hearts.
AB  - The objective of this study was to investigate if a variation in extracellular-K+
      concentrations alters the effects of global pre-conditioning on ischemia-induced
      arrhythmias. Rat hearts were Langendorff-perfused with Krebs-Henseleit solution
      and randomised in 8 groups (n = 12/group): four control groups (K+: 2, 4, 6, or 8
      mmol/L) which underwent 30-min coronary artery occlusion and four preconditioned
      groups (K+: 2, 4, 6, or 8 mmol/L) in which the 30-min regional ischemia was
      preceded by 2 cycles of 3 min global ischemia. In the presence of low K+ (2
      mmol/L), there were no differences between control and preconditioning groups in
      the number of ventricular premature beats (VPBs): 194 +/- 64 vs. 217 +/- 81, the
      incidence of ventricular tachycardia (VT): 100% vs. 100% and of ventricular
      fibrillation (VF): 100% vs. 100%. In the presence of normal K+ concentration (4
      mmol/L), ischemic preconditioning reduced the number of VPBs from 88 +/- 26 to 25
      +/- 10, (p < 0.05), the incidence of VT from 100 to 50% (p < 0.05), and of VF
      from 67 to 16% (p < 0.05). In the condition of higher K+ concentration (6 mmol/
      L), VPBs (34 +/- 8 vs. 11 +/- 4), the incidence of VT (100% vs. 25%; p < 0.05 )
      and VF (25% vs. 8%) were further reduced in preconditioned hearts. In the
      condition of K+ concentration (8 mmol/L), there were no differences in VPBs (11
      +/- 3 vs. 7 +/- 2), the incidence of VT (8% vs. 0%) and VF (8% vs. 0%) between
      control and preconditioned hearts. Our data show that ischemic preconditioning
      affords protection against arrhythmias during coronary artery occlusion in the
      isolated rat heart and that hypokalemia abolishes the antiarrhythmic effects of
      global preconditioning.

PMID- 11195794
TI  - Alteration of the levels of the M-type 6-phosphofructo-1-kinase mRNA isoforms
      during neonatal maturation of heart, brain and muscle.
AB  - During muscle, heart, and brain neonatal maturation, the capacity to utilize
      glucose in energy metabolism is directly related to the extent of accumulation of
      the 6-phosphofructo-1-kinase (PFK) M-type subunit. Neonatal development of other
      organs, such as liver and kidney, which are not characterized by large increases
      in the capacity to use glucose do not exhibit large increases in the M-type
      subunit protein. The presence of the M-type subunit in a PFK isozyme pool fosters
      a higher affinity utilization of carbohydrate and increased responsiveness to the
      levels of regulatory metabolites. To better appreciate this phenomenon, which is
      vital for normal development, the different isoforms of the M-type subunit mRNA's
      and alteration of their levels during maturation have been examined. Further, the
      potential promoter regions, i.e., the regions upstream from the sites of
      initiation of transcription, which are involved in expression of the different M
      type subunit mRNA isoforms have been isolated, sequenced, and examined for
      possible transcription factor interaction sites. Using cDNA libraries produced
      from adult rat brain or skeletal muscle RNA, two primary forms of rat M-type
      subunit cDNA's were detected. Although the translated regions of these mRNA's
      were essentially identical, the 5'-untranslated region (5'-UTR) exhibited
      different lengths (90 or 59 bp) and sequences. Each M-type subunit cDNA had 10
      common nucleotides immediately upstream from the initiator ATG, and the remaining
      5'-UTR's had insignificant identity. A genomic fragment which interacted with
      probes complimentary to the sequences of the 5'-UTR of each M-type subunit mRNA
      isoform was isolated and sequenced by primer walking. It was discovered that the
      5'-UTR of one of the mRNA's (proximal mRNA) was located immediately upstream from
      exon I and was apparently transcribed without splicing. Subsequently, the initial
      bp in the sequence of the other mRNA isoform (distal mRNA) was located 4010 bp
      upstream from the ATG in exon 1. Employing Reverse Transcription-Polymerase Chain
      Reaction using total RNA and scanning densitometry, the relative levels of the
      proximal and distal mRNA's during neonatal maturation of brain, heart, and muscle
      were measured. In these tissues, both forms of M-type subunit mRNA's were
      present, and during maturation tissue-specific differences were noted.

PMID- 11195795
TI  - Methionine 156 in the immunodominant domain of CD36 contributes to define the
      epitope recognized by the NL07 MoAb.
AB  - CD36 is a membrane glycoprotein expressed by several cell types, and play a role
      as a receptor for different physiological and pathological ligands. An
      immunodominant domain of CD36 has been described in the amino acidic region 155
      183, where many ligands and monoclonal antibodies (MoAbs) react. MoAbs against
      CD36 have proved useful in structural as well as functional studies. One of these
      antibodies, MoAb NL07, recognizes a conformational epitope that is acquired in
      the late steps of the CD36 maturation. The NL07 epitope appears to be
      functionally relevant and blocks CD36-mediated binding to red blood cells
      infected with the malaria parasite Plasmodium falciparum (IRBC). In this work a
      mutant COS-7 clone expressing NL07-negative CD36 molecules on the cell surface
      was investigated. In the mutant, the methionine in position 156 of the wild type
      CD36 sequence was replaced by a valine. It was determined that methionine 156 was
      essential for NL07 reactivity, mapping the NL07 epitope to the vicinity of the
      functionally important immunodominant domain (aa 155-183) of CD36. Although
      methionine 156 is located in this region, the CD36V156 mutated molecule was
      apparently functional and able to bind IRBC and oxidized LDL.

PMID- 11195797
TI  - Multiple sclerosis.

PMID- 11195796
TI  - Stimulatory effect of genistein and daidzein on protein synthesis in osteoblastic
      MC3T3-E1 cells: activation of aminoacyl-tRNA synthetase.
AB  - The effect of genistein and daidzein on protein synthesis in osteoblastic MC3T3
      E1 cells in vitro was investigated to determine a cellular mechanism by which the
      isoflavones stimulate bone formation. Cells were cultured for 48 h in alpha
      minimal essential medium containing either vehicle, genistein (l0(-7) - 10(-5) M)
      or daidzein (10(-7) - 10(-5) M). The 5,500 g supernatant of cell homogenate was
      used for assay of protein synthesis with [3H]leucine incorporation in vitro. The
      culture with genistein or daidzein caused a significant elevation of protein
      synthesis in the cell homogenate. The effect of genistein ( 10(-5) M) or daidzein
      ( 10(-5) M) in elevating protein synthesis was significantly prevented, when
      cells were cultured for 48 h in a medium containing either actinomycin D (10(-7)
      M) or cycloheximide (10(-6) M) in the absence or presence of isoflavones.
      Moreover, when genistein (10(-7) 10(-5) M) or daidzein (10(-6) and 10(-5) M) was
      added to the reaction mixture containing the cell homogenate obtained from
      osteoblastic cells cultured without isoflavone, protein synthesis was
      significantly raised. This increase was markedly blocked by the addition of
      cycloheximide (10(-7) M). In addition, [3H]leucyl-tRNA synthetase activity in the
      cytosol of osteoblastic cells was significantly increased by the addition of
      genistein (10(-6) and 10(-5) M) or daidzein (10(-5) M) into the enzyme reaction
      mixture. The present study demonstrates that genistein or daidzein can stimulate
      protein synthesis in osteoblastic MC3T3-E1 cells. The isoflavones may have a
      stimulatory effect on osteoblastic bone formation due to increasing protein
      synthesis.

PMID- 11195798
TI  - Multiple sclerosis.

PMID- 11195799
TI  - Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus
      nephritis.

PMID- 11195800
TI  - Exercise-induced premature ventricular depolarizations.

PMID- 11195801
TI  - Treatment of ectopic pregnancy.

PMID- 11195802
TI  - Repair of large bone defects with the use of autologous bone marrow stromal
      cells.

PMID- 11195803
TI  - Transmission of glomerular permeability factor from a mother to her child.

PMID- 11195804
TI  - 4th International Workshop on Pore-Forming Toxins. 14-17 September 2000, Trento,
      Italy. Abstracts.

PMID- 11195805
TI  - Bovine welfare spotlighted at annual forum.

PMID- 11195806
TI  - Drug compounding position statement adopted.

PMID- 11195807
TI  - Innovator in bovine housing standards gains welfare award.

PMID- 11195808
TI  - Natural bovine behavior key to evaluating management practices.

PMID- 11195809
TI  - Raising contented cattle makes welfare, production sense.

PMID- 11195810
TI  - Livestock shows a lesson in ethics, animal care.

PMID- 11195811
TI  - Welfare of animals integral part of professional rodeos.

PMID- 11195812
TI  - Assessing the state of the cattle slaughter industry.

PMID- 11195813
TI  - Feels acupuncture lacks scientific evidence.

PMID- 11195814
TI  - Opinions regarding the ECFVG program.

PMID- 11195815
TI  - Opinions regarding the ECFVG program.

PMID- 11195816
TI  - Opinions regarding the ECFVG program.

PMID- 11195817
TI  - AVAR defends accuracy of references.

PMID- 11195818
TI  - Believes aggression is more common in some dog breeds.

PMID- 11195819
TI  - Views on insurance and veterinary economics.

PMID- 11195820
TI  - Views on insurance and veterinary economics.

PMID- 11195821
TI  - Views on insurance and veterinary economics.

PMID- 11195822
TI  - Information on parasitic gastrointestinal tract infections in cats.

PMID- 11195823
TI  - Preparing today's veterinarians for a nontraditional future.

PMID- 11195824
TI  - Theriogenology question of the month. Endometrial cups.

PMID- 11195825
TI  - Steroidogenic response of adrenal tissues after administration of ACTH to dogs
      with hypercortisolemia.
AB  - OBJECTIVE: To evaluate adrenal sex hormone concentrations in neutered dogs with
      hypercortisolemia. DESIGN: Case series. ANIMALS: 11 neutered dogs with
      hypercortisolemia. PROCEDURE: Serum samples obtained before and 1 hour after
      administration of ACTH were evaluated for concentrations of cortisol,
      progesterone, testosterone, dehydroepiandrosterone sulfate or androstenedione or
      both, and 17-hydroxyprogesterone. RESULTS: For all dogs, concentrations of 1 or
      more adrenal sex hormones were substantially greater than reference range values
      before or after administration of ACTH. Testosterone concentration was not
      greater than reference range values in any of the dogs. CONCLUSIONS AND CLINICAL
      RELEVANCE: Results emphasize the importance of ruling out hypercortisolemia
      before measuring adrenal sex hormone concentrations as a means of diagnosing
      adrenal hyperplasia syndrome (alopecia X) in dogs.

PMID- 11195826
TI  - Long-term outcome of gonadectomy performed at an early age or traditional age in
      dogs.
AB  - OBJECTIVE: To determine long-term results and complications of gonadectomy
      performed at an early age (prepubertal) or at the traditional age in dogs.
      DESIGN: Cohort study. ANIMALS: 269 dogs from animal shelters. PROCEDURE: Dogs
      that underwent gonadectomy were allotted to 2 groups on the basis of estimated
      age at surgery (traditional age, > or =24 weeks old; prepubertal, < 24 weeks
      old). Adoptive owner information was obtained from shelter records, and telephone
      interviews were conducted with owners to determine physical or behavioral
      problems observed in the dogs since adoption. Follow-up information was obtained
      from attending veterinarians for dogs with complex problems or when owners were
      uncertain regarding the exact nature of their dog's problem. RESULTS: Prepubertal
      gonadectomy did not result in an increased incidence of behavioral problems or
      problems associated with any body system, compared with traditional-age
      gonadectomy, during a median follow-up period of 48 months after gonadectomy.
      Rate of retention in the original adoptive household was the same for dogs that
      underwent prepubertal gonadectomy as those that underwent traditional-age
      gonadectomy. Infectious diseases, however, were more common in dogs that
      underwent prepubertal gonadectomy. CONCLUSIONS AND CLINICAL IMPLICATIONS: With
      the exception of infectious diseases, prepubertal gonadectomy may be safely
      performed in dogs without concern for increased incidence of physical or
      behavioral problems during at least a 4-year period after gonadectomy.

PMID- 11195827
TI  - Comparison of in-hospital versus 24-hour ambulatory electrocardiography for
      detection of ventricular premature complexes in mature Boxers.
AB  - OBJECTIVE: To evaluate the use of in-hospital electrocardiography (ECG) for
      detection of ventricular premature complexes (VPC), compared with 24-hour
      ambulatory ECG. DESIGN: Original study. ANIMALS: 188 Boxers > 9 months old; 31
      had a history of syncope, and 157 were healthy (no history of syncope).
      PROCEDURE: In-hospital ECG was performed on all Boxers for at least 2 minutes.
      Within 7 days after the in-hospital ECG was completed, 24-hour ambulatory ECG was
      performed. RESULTS: The specificity of in-hospital ECG was 100% for the detection
      of at least 50 VPC in a 24-hour period in dogs with syncope and 93% in healthy
      dogs. In-hospital ECG had poor sensitivity, although sensitivity increased as the
      number of VPC per 24 hours increased. CONCLUSIONS AND CLINICAL RELEVANCE: Use of
      in-hospital ECG is highly specific for detection of at least 50 VPC during a 24
      hour period. However, in-hospital ECG is insensitive, and a lack of VPC does not
      suggest that the dog does not have a substantial number of VPC during that same
      period. The use of in-hospital ECG appears to be inadequate for screening
      purposes and therapeutic evaluations in mature Boxers with ventricular arrhythmic
      disease.

PMID- 11195828
TI  - Suspected caffeine and ephedrine toxicosis resulting from ingestion of an herbal
      supplement containing guarana and ma huang in dogs: 47 cases (1997-1999).
AB  - OBJECTIVE: To describe the clinical signs following ingestion of an herbal
      supplement containing guarana and ma huang in dogs, estimate minimum dose at
      which clinical signs of toxicosis and death were reported, and evaluate treatment
      options. DESIGN: Retrospective study. ANIMALS: 47 dogs with evidence of ingestion
      of an herbal supplement containing primarily guarana and ma huang. PROCEDURE:
      Records of dogs that had ingested an herbal supplement containing ma huang and
      guarana between July 1997 and October 1999 were retrieved from the National
      Animal Poison Control Center database. Data were retrieved and reviewed regarding
      signalment, dose ingested, clinical signs, laboratory test results, treatment,
      and final outcome. Cases were assessed by staff veterinarians as toxicosis or
      suspected toxicosis on the basis of strength of evidence supporting a diagnosis.
      RESULTS: Most dogs (80%) developed clinical signs of toxicosis within 8 hours of
      ingestion, and clinical signs persisted for up to 48 hours. Hyperactivity,
      tremors, seizures, and behavior changes were reported in 83% of dogs; other signs
      included vomiting (47%), tachycardia (30%), and hyperthermia (28%). Seventeen
      percent of the dogs died or were euthanatized. Estimated doses of guarana and ma
      huang ranged from 4.4 to 296.2 mg/kg (1.98 to 133.2 mg/lb) and 1.3 to 88.9 mg/kg
      (0.58 to 40.0 mg/lb) of body weight, respectively; minimum dose at which death
      was reported was 19.1 mg of guarana/kg (8.7 mg/lb) and 5.8 mg of ma huang/kg (2.6
      mg/lb). CONCLUSIONS AND CLINICAL RELEVANCE: Accidental ingestion of herbal
      supplements containing primarily guarana and ma huang in dogs can lead to a
      potentially lethal condition that may require prompt detoxification and
      supportive treatment for several days. Most dogs recovered with supportive
      treatment.

PMID- 11195829
TI  - Radiographic patterns of periodontitis in cats: 147 cases (1998-1999).
AB  - OBJECTIVE: To determine patterns of alveolar bone loss (periodontitis) and other
      lesions evident on full-mouth survey radiographs of cats. DESIGN: Retrospective
      study. ANIMALS: 147 cats. PROCEDURE: Full-mouth radiographs were evaluated for
      evidence and severity of alveolar bone loss, odontoclastic resorption lesions
      (ORL), retained roots, missing teeth, signs of endodontic disease secondary to
      periodontitis, and apical resorption. RESULTS: 106 (72%) cats had some degree of
      periodontitis, 100 (68%) were missing teeth, 98 (67%) had ORL, 78 (53%) had
      expansion of the buccal alveolar bone at 1 or more canine teeth, 75 (51%) had
      retained roots, 48 (33%) had apical resorption, and 12 (8%) had signs of
      endodontic disease secondary to periodontitis. Cats < 4 years old were not
      significantly more likely than the general population to have normal alveolar
      bone height. Prevalence of ORL increased with age, but cats > or =13 years old
      were less likely than the general population to have moderate or severe
      generalized periodontitis. Purebred cats were not significantly more likely to
      have periodontitis or ORL than mixed-breed cats. CONCLUSIONS AND CLINICAL
      RELEVANCE: Results suggest that periodontitis is common in cats and that
      horizontal bone loss is the most common radiographic pattern of alveolar bone
      loss. Purebred cats were not more likely than mixed-breed cats to have ORL or
      periodontitis, but when they did have periodontitis, it was more likely to be
      moderate to severe. Cats with ORL were less likely than cats without ORL to have
      normal alveolar bone height and more likely to have severe focal vertical bone
      loss.

PMID- 11195830
TI  - Intermittent hypoglycemia in a horse with anaplastic carcinoma of the kidney.
AB  - Clinically apparent hypoglycemia is rare in adult horses. Hypoglycemia is a well
      recognized paraneoplastic syndrome in humans and dogs with non-insulin-secreting
      tumors and may occur in horses as well. Hypoglycemia associated with non-insulin
      secreting tumors is believed to result from production of an abnormal form of
      insulin-like growth factor II. Neoplasia should be considered in the differential
      diagnosis for adult horses with hypoglycemia.

PMID- 11195831
TI  - Outbreaks of clinical mastitis caused by Trichosporon beigelii in dairy herds.
AB  - Trichosporon beigelii is widely distributed in nature and is classically
      associated with white piedra, a mycosis that may involve the hair of the human
      body. Intramammary infections caused by T beigelii may be fatal in cows; the
      prevalence in affected dairy herds may be high. Affected cows may have
      hyperthermia, swelling of the udder, and substantially decreased milk production
      or agalactia. Intramammary infections caused by yeast, including T beigelii, may
      also be associated with high bacterial counts in bulk-tank milk.

PMID- 11195832
TI  - Propylene glycol toxicosis in a llama.
AB  - Propylene glycol toxicosis in llamas can result from overzealous administration
      of propylene glycol-containing gels formulated and labeled for use in cattle.
      Treatment of ketosis in llamas requires re-establishment of stomach flora and
      stimulation of appetite.

PMID- 11195833
TI  - Use of medetomidine and ketamine for immobilization of free-ranging giraffes.
AB  - OBJECTIVE: To develop a dosage correlated with shoulder height (SH) in
      centimeters for effective immobilization of free-ranging giraffes, using a
      combination of medetomidine (MED) and ketamine (KET) and reversal with
      atipamezole (ATP). DESIGN: Prospective study. ANIMALS: 23 free-ranging giraffes.
      PROCEDURE: The drug combination (MED and KET) was administered by use of a
      projectile dart. Quality of induction, quality of immobilization, and time to
      recovery following injection of ATP were evaluated. Physiologic variables
      measured during immobilization included PaO2, PaCO2, oxygen saturation, end-tidal
      CO2, blood pH, indirect arterial blood pressure, heart and respiratory rates, and
      rectal temperature. RESULTS: Sixteen giraffes became recumbent with a dosage
      (mean +/- SD) of 143 +/- 29 microg of MED and 2.7 +/- 0.6 mg of KET/cm of SH.
      Initially, giraffes were atactic and progressed to lateral recumbency. Three
      giraffes required casting with ropes for data collection, with dosages of 166 +/-
      5 microg of MED and 3.2 +/- 0.6 mg of KET/cm of SH. Four giraffes required
      administration of etorphine (n = 2) or were cast with ropes (2) for capture but
      remained dangerous to personnel once recumbent, precluding data collection. In
      giraffes successfully immobilized, physiologic monitoring revealed hypoxia and
      increased respiratory rates. Values for PaCO2, end-tidal CO2, and heart rate
      remained within reference ranges. All giraffes were hypertensive and had a slight
      increase in rectal temperature. Atipamezole was administered at 340 +/- 20
      microg/cm of SH, resulting in rapid and smooth recoveries. CONCLUSIONS AND
      CLINICAL RELEVANCE: Medetomidine and KET was an effective immobilizing
      combination for free-ranging giraffes; however, at the dosages used, it does not
      induce adequate analgesia for major manipulative procedures. Quality of induction
      and immobilization were enhanced if the giraffe was calm. Reversal was rapid and
      complete following injection of ATP.

PMID- 11195834
TI  - Multifocal pyogranulomatous osteomyelitis resembling chronic recurrent multifocal
      osteomyelitis in a lemur.
AB  - Chronic recurrent multifocal osteomyelitis is a rare inflammatory bone disease of
      children and adolescents that is characterized by localized swelling and pain in
      the clavicles and long bones of the limbs. Diagnosis of chronic recurrent
      multifocal osteomyelitis is made from clinical signs, characteristic radiographic
      and histopathologic findings, and negative results of microbial cultures.
      Treatment of chronic recurrent multifocal osteomyelitis in humans includes
      administration of nonsteroidal anti-inflammatory drugs or immune modulators,
      which may be effective in lemurs.

PMID- 11195835
TI  - [Urinary tract infections in the elderly].
AB  - DEFINITIONS: Age over 65 years is generally used to define the elderly
      population. Urinary tract infections are increasingly frequent after this age.
      Comorbidity and living conditions in the elderly have a particular incidence on
      the clinical expression and the bacterial flora involved. Besides these elements,
      altered cognitive capacity and abnormal urinary function prior to the infection
      and lead to an atypical clinical presentation. ASYMPTOMATIC BACTERIURIA:
      Systematic screening has produced a large body of literature on asymptomatic
      bacteriuria. Our review of the literature leads to the conclusion that systematic
      bacteriology tests are not warranted in the elderly population in general due to
      the subsequent risk of germ selection and erroneous diagnosis. PRACTICAL
      ATTITUDE: The diagnosis of urinary infection must be evidence-based, taking into
      account the patient's history and ruling out other diagnoses. In all cases,
      antibiotics must be carefully adapted to the patient's situation and titrated to
      kidney function.

PMID- 11195836
TI  - [Anti-epilepsy drugs and their use in the elderly].
AB  - RISING INCIDENCE AND PREVALENCE: The frequency of epilepsy after the age of 60
      years is increasing, a particularly important point in light of the rise in this
      age group. Incidence is estimated to exceed 100 cases per 100,000 subjects over
      the age of 60, reaching 160 per 100,000 in subjects aged 80 to 84 years.
      Prevalence exceeds 7 per 1000 in the 55 to 64 age group and 12 per 1000 in the 85
      to 94 age group. CLINICAL FEATURES IN THE ELDERLY: Partial complex seizures are
      particularly frequent. Some patients experience seizure-related confusion states
      or slowly regressive neurological deficits. THERAPEUTIC STRATEGY: Excepting acute
      seizures induced by aggressive cerebral events, treatment should be aimed at the
      triggering factor. Anti-epilepsy drugs are warranted in patients who experience 2
      or more seizures and for whom no amendable triggering factor can be identified.
      For stroke patients, long-term treatment should be reexamined after the acute
      phase. DRUG PRESCRIPTION: Benzodiazepines have proven efficacy when the objective
      is to achieve rapid control of frequent seizures. However, for elderly subjects,
      the risk of sedation and known adverse effects must be carefully assessed for
      these drugs. All anti-epilepsy agents are active: choosing the right drug for
      elderly subjects depends basically on patient tolerance and risk of drug
      interaction. Special attention should be given to the effect on cognitive
      function.

PMID- 11195837
TI  - [Diabetes in the elderly patient].
AB  - EPIDEMIOLOGY: Diabetes mellitus in the elderly population is a major public
      health challenge. The aging population (over 65 years) now makes up 26.83% of the
      overall population in France and the prevalence of diabetes mellitus in this
      population is an estimated 10.3 to 20%. PATHOPHYSIOLOGY: The pathophysiology of
      diabetes is complex and mainly involves age-related insulin resistance. Changes
      in body fat, nutrition, and hormone secretions (insulin growth factor,
      dehydroepiandrosterone) also play an important role. Chronic hyperglycemia alone
      is pathogenic. COMPLICATIONS: Most are severe and induce not only dramatic
      vascular complications, diabetic foot, retinopathy, and neuropathy, but also, in
      association with age-induced illnesses and frail homeostasis, produce a high rate
      of disablement and decay of quality of life. MANAGEMENT: Current management of
      diabetes in the elderly population can be greatly improved. Systematic follow-up
      is essential, with special care to preserve self-independence. Education and self
      monitoring play an important role. Large diet allowances are recommended.
      Available drug therapies for the elderly (basically insulin, short half-life
      sulfamides, metformine if renal function in normal, and exceptionally alpha
      glucosidase inhibitors) must be examined in light of the specific situation of
      this frail population and the age-related changes in metabolism. Blood glucose
      control can be improved without risking unacceptable levels of hypoglycemia.

PMID- 11195838
TI  - [Treatment of arthroses in the elderly patient].
AB  - BACKGROUND: Elderly subjects with osteoarthritis are treated with analgesic
      drugs, non-steroidal antiinflammatory drugs (NSAID) and intra-articular
      corticosteroid injections as well as symptomatic slow acting drugs in
      osteoarthritis (Sy-SADOA). BASIC REGIMENS: Initial treatment for osteoarthritis
      pain should be paracetamol, followed by NSAID if necessary, especially in the
      elderly, because of their adverse effects. EFFICACY: Sy-SADOA are effective on
      pain and function with a persistent effect, allowing the reduction of analgesic
      and NSAID dosage.

PMID- 11195839
TI  - [Dr. Watson's principle].

PMID- 11195840
TI  - [Controlling pain in the elderly patient: efficacy and safety].

PMID- 11195841
TI  - [Assessing nutritional status in the elderly: a different approach from assessing
      general health status].

PMID- 11195842
TI  - [Protein-energy malnutrition. Diagnostic methods and epidemiology].
AB  - EPIDEMIOLOGY: Protein-calorie malnutrition (PCM) is highly prevalent among
      elderly persons living in the community (4%), hospitalized in acute care units or
      geriatric rehabilitation units (50%), or in long-term care facilities (30-40%).
      PCM is the first predictor of poor prognosis in the elderly. DIAGNOSIS:
      Parameters used to establish the diagnosis of PCM and identify its
      pathophysiology are both simple and inexpensive: body mass index, plasma albumin
      and CRP, arm circumference and skin fold thickness. CONSEQUENCES: Because of its
      frequency and consequences on morbidity and mortality in the elderly, PCM is an
      important public health problem in industrialized countries.

PMID- 11195843
TI  - [Influence of nutrition and physical activity on muscle in the very elderly].
AB  - AGE-RELATED LOSS IN MUSCLE MASS: Aging is associated with a progressive decline
      in muscle mass (sarcopenia). Age-related sarcopenia results in a 50% decrease in
      muscle fiber area, especially type II fiber area. There are many consequences
      related to this reduction in muscle mass including decline in muscle strength and
      function and impaired functional capacity. PROTEIN INTAKE: Sarcopenia also
      results in a reduction in the body's major protein pool. Adequate dietary protein
      to replace obligatory nitrogen loss and to support protein turnover is essential
      for maintaining muscle mass. It is usually suggested that protein requirements in
      older subjects are above 1 g/kg/d. PHYSICAL EXERCISE: Sedentary lifestyle may
      contribute to loss of skeletal mass in elderly people. Exercise can help reverse
      this deficit and may improve the regeneration potential of muscle fibers.

PMID- 11195844
TI  - [Malnutrition in the elderly. Clinical consequences].
AB  - A COMMON PROBLEM: Undernutrition occurs when nutrient intake does not meet
      nutritional needs. Selective food intake induced micronutrient deficits (moderate
      undernutrition) and can later lead to protein calorie malnutrition (PCM). PCM is
      often discovered during acute illness (increased nutritional needs). PCM is
      observed in 30 to 50% of the institutionalized population and in 2-4% of the
      elderly living at home. Micronutrient deficits are far more frequent and concern
      4 million elderly persons in France. AGE-RELATED CHANGES: Decreased smell and
      taste capacities and the inability to modify eating habits in stress conditions
      are mainly responsible for low food intake. Low intake leads to immunodeficiency,
      and subsequent frailty. Any intercurrent illness aggravates both undernutrition
      and immunodeficiency, creating a disease-to-disease spiral (undernutrition
      immunodeficiency) that is difficult to inverse. SIGNS OF PCM: Early signs of
      protein-calorie malnutrition are nonspecific: fatigue, apathy, decline in muscle
      strength. It is important to diagnose undernutrition at this stage before more
      specific symptoms develop: anorexia, weight loss, infection. Metabolic disorders
      occur at a later stage, generally during an acute illness, leading to overt PCM
      with perturbed glucose metabolism, recurrent infection, dehydration, impaired
      wound healing and calcium bone loss. The length of refeeding therapy depends on
      the intensity of the clinical signs, weight loss, dehydration, glucose metabolism
      disorder and/or on the severity of clinical complications such as infection or
      bone fractures. PRACTICAL ATTITUDE: Under nutrition must be recognized early at
      the stage of nonspecific clinical expression. Practitioners must be constantly
      aware of the risk of undernutrition and search for nonspecific signs in the
      elderly.

PMID- 11195845
TI  - [Nutritional support in elderly malnourished patients].
AB  - ASSESSMENT OF NUTRITIONAL STATUS: Protein-calorie malnutrition is frequent and
      often severe in fragile hospitalized or institutionalized elderly subjects.
      Underdiagnosis and undertreatment is commonplace. Since under- or malnutrition is
      more difficult to correct in the elderly than in the young subject, a careful
      assessment of the nutritional status must be made in order to recognize any
      nutritional disorder early and initiate proper treatment early. NUTRITIONAL
      ASSISTANCE: High-protein oral supplementation and complementary enteral nutrition
      can improve the clinical status of certain under- or malnourished elderly
      subjects. It is particularly important to initiate nutritional assistance early
      and provide effective treatment for any recognized surgical or medical cause of
      malnutrition. Patient cooperation is crucial. EXPECTED RESULTS: Associated early
      with rehabilitation therapy, nutritional assistance can be expected to improve
      the functional independence of the elderly patient. Treatment efficacy and
      patient tolerance must be evaluated regularly to adapt nutritional assistance to
      the patient's particular clinical situation. Intensive enteral nutrition is not
      appropriate for elderly patients with severe malnutrition whose quality of life
      is compromised by motor, psycho-cognitive, or sensorial handicaps.

PMID- 11195846
TI  - Involvement of type I and type II mechanisms in the linoleic acid peroxidation
      photosensitized by tiaprofenic acid.
AB  - Analysis of the photomixtures resulting from irradiation of aqueous solutions of
      linoleic acid sensitized by tiaprofenic acid (TPA) or its major photoproduct
      (DTPA) by HPLC has shown the formation of all the four possible conjugated dienic
      hydroperoxides. According to laser flash photolysis experiments the rate
      constants for hydrogen abstraction from linoleic acid by the excited triplet
      states of TPA and DTPA are 2 x 10(5) and 3.2x 10(5) M(-1) s(-1), respectively.
      These data, together with the known rate constants for oxygen quenching of
      triplet (D)TPA and for the reaction of singlet oxygen with linoleic acid, show
      that the mechanism is mixed type I/type II. Finally, typical radical scavengers
      such as BHA and singlet oxygen quenchers such as DABCO and sodium azide are
      efficient quenchers of the triplet excited state of DTPA. This shows the risk of
      assigning mechanisms based on indirect 'evidences' using 'specific' additives.

PMID- 11195847
TI  - Photobinding of carprofen to protein.
AB  - Carprofen is a non-steroidal antiinflammatory drug with marked photosensitising
      properties. In order to elucidate the mechanisms underlying the phenomenon of
      drug-protein photobinding, mixtures of the drug and human serum albumin were
      irradiated under different experimental conditions. After irradiation and
      subsequent gel-filtration chromatography of the photomixture, the eluting protein
      fraction was analysed by means of fluorescence spectroscopy. The formation of
      drug-protein photoadducts could be evidenced by the characteristic emission
      properties of the carbazole chromophore. The photobinding of the drug to human
      serum albumin appears to involve the formation of aryl radicals resulting from
      carbon-halogen photocleavage. This mechanistic interpretation is supported by the
      observed variations in the intensity of the fluorescence spectra, which can be
      correlated with the lower quantum yield emission of chlorocarbazoles as compared
      to non-halogenated analogues. The results from laser flash photolysis studies are
      also in agreement with this proposal.

PMID- 11195848
TI  - Damage to mitochondria of cultured human skin fibroblasts photosensitized by
      fluoroquinolones.
AB  - The phototoxic fluoroquinolones ofloxacin, lomefloxacin, norfloxacin,
      ciprofloxacin and BAYy 3118 have ionizable groups with pKa values close to
      neutrality. Different ionic species of these fluoroquinolones, therefore,
      partition in various compartments and organelles of living cells according to
      their ionic equilibria. While all these fluoroquinolones accumulate in lysosomes,
      they more or less stain the rest of the cytoplasm of living HS 68 fibroblasts. As
      a result, photosensitized damage to other cytoplasmic sites than lysosomes can
      also be expected. Using microfluorometry and rhodamine 123 (Rh 123) as a specific
      fluorescent probe which is released from mitochondria by light absorption, we
      show that under ultraviolet A (UVA) irradiation norfloxacin and ciprofloxacin
      readily damage mitochondrial membranes. as evidenced by the UVA dose-dependent
      strongly accelerated release of Rh 123 from mitochondria in cells treated with
      norfloxacin and ciprofloxacin. Damages are already noticeable at UVA doses as low
      as 2 J/cm2. By contrast, no such photoinduced damage can be observed with
      ofloxacin, lomefloxacin and BAYy 3118, the latter being the most phototoxic
      derivative towards HS 68 fibroblasts. The initial photodamage induced by
      norfloxacin and ciprofloxacin can then propagate after the irradiation as shown
      by the strongly increased rate of release of Rh 123 from mitochondria of cells
      that have been incubated with these two fluoroquinolones and left in the dark
      after a pre-irradiation with 18 J/cm2 of UVA. Interestingly, the same pre
      irradiation after cells have been treated with BAYy 3118 and lomefloxacin induces
      similar post-irradiation effects, although they have no apparent immediate
      photosensitizing action on mitochondria.

PMID- 11195849
TI  - The phototumorigenic fluoroquinolone, lomefloxacin, photosensitises p53
      accumulation and transcriptional activity in human skin cells.
AB  - The fluoroquinolone antibiotic, lomefloxacin, is phototoxic in human skin exposed
      to UVA radiation, photosensitises DNA strand breaks and pyrimidine dimers in
      human keratinocytes in vitro, and is phototumorigenic in mouse skin. The p53
      tumour suppressor protein is activated by a variety of cellular insults including
      UV radiation, to become a transcription factor for downstream markers such as the
      cyclin-kinase inhibitor p21CIP1/WAF1 or cause caspase transactivation which
      cleaves poly ADP ribose polymerase (PARP) as an early step in apoptosis. We have
      investigated these molecular defence responses in human skin cells treated with
      lomefloxacin and UVA radiation in vitro. Western blots revealed that lomefloxacin
      photosensitised the stabilisation of p53 protein in human fibroblasts.
      Lomefloxacin also photosensitised p53 transcriptional activity in amelanotic
      melanoma cells expressing wild-type p53 and stably transfected with a construct
      containing a beta-galactosidase reporter gene downstream from a p53 consensus
      binding sequence. Neither photosensitised production of H2O2 nor the resultant
      DNA strand breaks, appeared to be involved in this effect. Interestingly,
      p21CIP1/WAFI protein was upregulated by lomefloxacin in the dark by a p53
      independent mechanism. Lomefloxacin also photosensitised the degradation of
      nuclear PARP, suggestive of caspase mediated, early apoptotic events.

PMID- 11195850
TI  - Photoreactivity of tiaprofenic acid and suprofen using pig skin as an ex vivo
      model.
AB  - The skin is repeatedly exposed to solar ultraviolet radiation. Photoreaction of
      drugs in the body may result in phototoxic or photoallergic side effects. Non
      steroidal anti-inflammatory drugs, such as tiaprofenic acid (TPA) and the closely
      related isomer suprofen (SUP) are frequently associated with photosensitive
      disorders; they may mediate photosensitised damage to lipids, proteins and
      nucleic acids. Using ex vivo pig skin as a model, we investigated the
      photodegradation of TPA and SUP, and photobinding of these drugs to protein by
      means of HPLC analysis and drug-directed antibodies. Both with keratinocytes,
      which were first isolated from the pig skin and thereafter exposed to UVA and
      with keratinocytes which were isolated from pig skin after the skin was UVA
      exposed, time-dependent photodegradation of TPA and SUP was found, beside
      photoadduct formation to protein. The results of this work show that: (a) TPA and
      SUP were photodecomposed with similar efficiency; major photoproducts detected
      were decarboxytiaprofenic acid (DTPA) and decarboxysuprofen (DSUP), respectively.
      (b) Both drugs form photoadducts, as concluded from recognition by drug-specific
      antibodies. Pig skin appears to be a good model for studying the skin
      photosensitising potential of drugs.

PMID- 11195851
TI  - Photobinding of ketoprofen in vitro and ex vivo.
AB  - Ketoprofen (KP), a non-steroidal anti-inflammatory drug of the 2-aryl propionic
      class, has been shown to produce photoallergic side effects as well as cutaneous
      photosensitizing properties that induce other phototoxic effects. In the present
      study we investigated photobinding of ketoprofen to both human serum albumin
      (HSA), a model protein, and to ex vivo pig skin and its photodegradation. Results
      demonstrate that photoadduct formation and photodegradation progressively
      increased with irradiation time where they reach a maximum. Maximum photobinding
      to the viable layer of the epidermis was about 7-8% of the initial radiolabelled
      KP added, in the region of 15-30 min UV irradiation. These results were
      comparable to in vitro results that were seen with photobinding of KP to HSA; in
      this case, the quantity of covalently bound material was approximately 10% of the
      initial, after a maximum of 18 min irradiation. It was found by HPLC analysis
      that the KP decrease is accompanied by an increase of the corresponding
      photoproduct, decarboxylated ketoprofen (DKP). The yield of DKP reaches a maximum
      at around 15 min. DKP appears to play an important role in vitro and ex vivo,
      being the major photoproduct and responsible for the photobinding process. Using
      micro-autoradiographical techniques we investigated the penetration and
      distribution of ketoprofen in ex vivo pig skin in greater detail. It was apparent
      that percutaneous absorption was taking place and that most of the ketoprofen was
      predominately localised in fibroblasts in the papillary dermis. No other specific
      localisation within the skin architecture was identified. Although there were
      differences in the quantities of bound ketoprofen within the different layers of
      the skin, these levels did not appear to correlate with irradiation time.

PMID- 11195852
TI  - Analyses of cutaneous fluoroquinolones photoreactivity using the integrated model
      for the differentiation of skin reactions.
AB  - Currently available test models for the differentiation of photoallergic and
      photoirritant reactions are extremely time consuming and the protocols are very
      heterogeneous. In vitro tests are of proven value in predicting irritant or toxic
      effects, but these tests fail to predict chemical-induced allergic side effects.
      We developed test systems for this endpoint which is not easily detected by
      existing assays. In a previous publication we were able to discriminate between a
      contact sensitizer and a skin irritant with a combination of primary ear swelling
      analysis and cell counting of the ear-draining lymph nodes [Toxicol. Appl. Pharm.
      153 (1998) 83; Arch. Toxicol. 73 (2000) 501]. This combination of tests was
      called the Integrated Model for the Differentiation of chemical-induced allergic
      and irritant Skin reactions (IMDS). In addition, it had been shown before that
      inclusion of UV irradiation in the local lymph node assay enables discrimination
      of photoallergic from photoirritant reactions after dermal application
      [Photodermatol. Photoimmunol. Photomed. 10 (1994) 57]. Because of the fact that
      fluoroquinolones are known to induce photoreactions after oral but not dermal
      treatment, the aim of the present study was to apply the IMDS for the fast and
      reliable differentiation of photoreactions due to fluoroquinolones after oral
      treatment. Enoxacin, lomefloxacin, ofloxacin, sparfloxacin and BAY y 3118 were
      tested in this system. We found a good correlation between the results of UV
      light-irradiated IMDS and a guinea pig model with the quinolones as far as
      photoirritancy was concerned. This holds true also for the photoallergic standard
      olaquindox and the photoirritant standard 8-methoxypsoralen. However, in contrast
      to the guinea pig assays the IMDS is fast and extremely predictive for the risk
      of both photosensitization and photoirritancy depending on the route of exposure.
      Thus, the UV light-irradiated IMDS turned out to be a good tool for the
      preclinical risk assessment procedure in terms of discriminating photoreactions.
      In addition, flow cytometric analyses were used to underline the fact that
      antigen-independent activation occurred after the induction of photoirritant
      reactions.

PMID- 11195853
TI  - Development of an expert system rulebase for the prospective identification of
      photoallergens.
AB  - Relationships between the structure and properties of chemicals can be programmed
      into knowledge-based systems such as DEREK (an acronym for 'Deductive Estimation
      of Risk from Existing Knowledge'). The DEREK knowledge-based computer system
      contains a sub-set of over 50 rules describing chemical substructures
      (toxophores) responsible for skin sensitization. This rulebase, based originally
      on Unilever historical in-house guinea pig maximisation test data, is largely
      complete and is undergoing refinement as the next stage of its development. As
      part of an ongoing program of validation and testing, the predictive ability of
      the sensitization rule set was assessed by processing the structures of over 100
      chemical substances in the list of contact allergens identified by the BgVV
      (German Federal Institute for Health Protection of Consumers). The exercise
      highlighted areas of chemistry where further development of the rulebase was
      required, either by extension of the scope of existing rules or by generation of
      new rules where a sound mechanistic rationale for the biological activity could
      be established. Several chemicals likely to be acting as photoallergens were
      identified and rules for photoallergenicity were written covering three classes
      of chemicals. This paper describes work to extend the DEREK rules for
      photoallergenicity as part of the European Phototox Project.

PMID- 11195854
TI  - Photochemical decomposition of lomefloxacin in vitro and in vivo.
AB  - To obtain an idea of the photostability of Lomefloxacin (Lom) under in vivo
      conditions the compound was exposed to UV-A (310-360 nm) in PBS buffer pH 7.4.
      Exposure of 10 microg/ml of Lom in PBS pH 7.4 led to more than 50% decomposition
      within 10 min. Loss of the fluorine atom at C-8 and partial breakdown of the
      piperazine ring occurred. The only two photoproducts formed under these
      conditions were AEA, 1-ethyl-6-fluoro-1,4-dihydro-7-(2-aminoethyl-amino)-4-oxo-3
      quinolinecarboxylic acid, and APA, 1-ethyl-6-fluoro-1,4-dihydro-7-(2-aminopropyl
      amino)-4-oxo-3-quinolinecarboxylic acid. When Lom was exposed in whole blood in
      vitro, the same photochemical decomposition was observed in the plasma as in PBS
      buffer: APA and AEA were the only products. During UV-A exposure, Lom was shown
      to be taken up by the leukocytes. This process appeared to be less rapid during
      UV-A exposure than in the dark. As soon as UV-A exposure commenced, AEA and APA
      were found. As in the plasma, the total amount of Lom and the two photoproducts
      in the leukocytes was not significantly different from the amount of Lom found in
      unexposed cells at the same time point. The erythrocytes did not take up Lom, but
      exposure of whole blood to Lom and UV-A under the above conditions led to more
      than 7% haemolysis. Treatment of rats with a combination of Lom and UV-A
      demonstrated photodecomposition of Lom in vivo. In urine produced during exposure
      and by the irradiated rats during the twilight period after exposure, a
      considerable amount of AEA and APA was found. The blood plasma from rats exposed
      simultaneously to UV-A and Lom proved to contain AEA and APA and, in the
      leukocytes, APA. This was not the case with animals kept in twilight.

PMID- 11195855
TI  - Clinical trials results of a unique monoclonal antibody in asthma.
AB  - IgE binds to high affinity receptors (Fc epsilon RI) on mast cells, basophils,
      alveolar macrophages, and antigen-presenting cells. This results in the
      degranulation of effector cells and the release of mediators, such as histamine,
      leukotrienes, cytokines, that are causally linked to the pathophysiology of
      allergic asthma. It made for an attractive target for the development of a unique
      humanized monoclonal antibody, rhuMAb-E25 (E25). E25 offers a novel strategic
      approach to allergy treatment, it is expected that using E25 to significantly
      decrease IgE levels will result in improved control of allergic asthma.

PMID- 11195856
TI  - Targets for asthma therapy.
AB  - Most asthma is allergic in origin, the disease involves four distinct phases of
      response: the sensitization phase and the activation phase, followed by the
      effector phase, initiated by the release of pharmacologically active agents, the
      growth and repair phase, characterized by proliferation of tissues as
      "remodeling" of the airway wall, altering structure and function.

PMID- 11195857
TI  - Varicose symptoms without varicose veins: the hypotonic phlebopathy, epidemiology
      and pathophysiology. The Acireale project.
AB  - Ever since 1982 the authors have been interested in varicose symptoms without
      varicose veins. Carrying out several pilot studies with infrared
      photoplethysmography (PPG) and strain gauge plethysmography they suggest that the
      pathophysiology of this behaviour could be caused by the reduction of the venous
      wall tone. They propose the name of Hypotonic Phlebopathy (HP). The diagnosis
      criteria are focused by symptoms (heavy legs in upright position, restless leg
      syndrome, sub-oedema and/or evening oedema) and signs detected by PPG, s.g
      plethysmography and duplex scanning (reduction of the muscle-venous calf pump and
      increase of the venous wall compliance). Epidemiology, assessed between 1989 and
      1992 (Acireale Project), showed a 15.90% morbidity, with higher prevalence in
      females; the most important risk factors are pregnancy and family history. HP is
      not rare in males; the principal risk factor is work involving standing for long
      periods. These behaviours have been independently confirmed by two studies
      carried out in France in 1992, which showed a 15% prevalence in a similar group
      of subjects with functional venous insufficiency. The authors suggest the
      introduction of the term of Hypotonic Phlebopathy, the symptoms of which are
      significantly improved by phlebotonic drugs, especially when they are stronger.
      CEAP classification: C(0-S); E(P); A(0); P(unclassifiable); Clinical score (1-2);
      Anatomical score (0); Disability score (1).

PMID- 11195858
TI  - [Vascular pathology of surgical interest in drug addicts].
AB  - The incidence of vascular complications due to drug abuse is at present
      increasing due to new types of drugs and to the different ways of intake of such
      substances. The vascular complications related to drug abuse may affect venous,
      arterious and lymphatic districts and in particular: ischemia following intra
      arterial injections, arterious and venous pseudoaneurysm, vasculitis, aneurysms,
      aortic dissections, abscesses complicated by erosions of vessels, arteriovenous
      fistulas, compartment syndrome, superficial and deep venous thrombosis, septic
      trombophlebitis, puffy hand syndrome. The scientific knowledge in this matter is
      incomplete because of the new pathological cases and the lack of information
      regarding the efficacy of different treatments. The authors report four patients
      affected by vascular pathologies due to drug abuse. In one case, a heroin addict
      has undergone multiple fasciotomies for compartimental syndrome arising because
      the patient maintained an innatural posture for several hours during an overdose
      coma. In a second case, a segmental right subclavear deep venous thrombosis has
      been treated by pharmacological therapy with satisfactory functional recovery of
      the arm. A third patient has been successfully submitted to intra-arterial
      pharmacological vasodilatation for generalised lower limbs vasospasm caused by
      drug abuse. In the last case, the voluntary swallowing of a great dose of cocaine
      caused the patient's death after multiple ischemic and hemorrhagic cerebral
      episodes. After the description of these cases, a review of the recent literature
      and some observations on this topic are presented. A better knowledge of vascular
      complications due to drug abuse should improve the therapeutical approach of
      these patients.

PMID- 11195859
TI  - [Harmonic echocardiography of tissue in the diagnosis of aneurysms of the
      interatrial septum. Study of 550 consecutive ambulatory patients].
AB  - BACKGROUND: It has been assessed whether echocardiographic harmonic imaging
      improves the detection of atrial septal aneurysm (ASA) compared with fundamental
      imaging. METHODS: We studied consecutively, using fundamental and harmonic
      imaging, 550 patients (with or without cardiopathy; 300 females and 250 males) in
      an outpatients' department (age 23-76 years, mean 50 years). We used a
      multifrequency transthoracic probe transmitting at 2 Mhz and receiving at 4 Mhz.
      The ASA was classified in three types according to Hanley et al. Type 1A,
      protruding into the right atrium without oscillation; Type 1B protruding into the
      right atrium with oscillation, and Type 2, protruding into the left atrium with
      oscillation. We compared atrial septal aneurysm definition in fundamental and
      harmonic mode, and assessed the interobserver agreement in the diagnosis of ASA.
      The echocardiographic images were recorded on magneto-optical disk and analysed
      by two blinded observer. With Pearson test we assessed the interobserver
      concordance in the ASA study; so we quantified the advantage of harmonic imaging
      as reduction of the inter-observer variability. RESULTS: Among 550 consecutive
      subjects in the echocardiographic study population, ASA was diagnosed in 8
      (1.45%) and 15 (2.72%) patients using fundamental and harmonic methods
      respectively. A significant reduction of the inter-observer variability in the
      ASA diagnosis was found with harmonic imaging (harmonic imaging: r = 0.96;
      fundamental imaging: r = 0.70). CONCLUSIONS: The harmonic methods drastically
      improves echocardiographic imaging of ASA, it may be used routinely and reduces
      the need for more invasive technique such as transesophageal echocardiography.

PMID- 11195860
TI  - [Use of colchicine in chronic pericardial effusion. Presentation of 2 clinical
      cases and review of the literature].
AB  - Colchicine was introduced in 1987 for the treatment of recurrent pericarditis. Up
      to the present, papers have been published on a total of 117 patients treated
      with colchicine after the failure of treatment with FANS, corticosteroids and
      repeated pericardiocentesis. Here two cases of chronic pericardial effusion, one
      secondary to pericardiotomy, the second idiopathic, are reported. Both were
      recalcitrant to conventional therapy. Both patients were treated with 2 mg/die
      colchicine for 1 month followed by 1 mg/die for a further 5 months, without
      recurrence of the effusion after follow-up of 12 and 24 months respectively. No
      side-effects were observed. Colchicine is an anti-inflammatory drug which, by
      inhibiting various leukocyte functions, depresses the action of the leukocytes
      and of the fibroblasts at the site of the inflammation. We conclude that
      colchicine is effective in post-pericardiotomic and idiopathic chronic
      pericardial effusion as already reported in cases of recurrent pericarditis.
      Given the lack of side-effects, it could be considered as a drug of choice
      alternatively to FANS and corticosteroids.

PMID- 11195861
TI  - Thrombosis of mechanical valve prosthesis: thrombolysis vs surgical treatment.
      Report of two cases, personal experience and review of the literature.
AB  - We report the cases of two patients, previously operated for mitral mechanical
      valve replacement who developed thrombosis of the prosthesis. The two patients
      were successfully treated with pharmacological thrombolysis with no recurrence.
      One patient developed late peripheral embolization most probably due to late
      mobilisation of a thrombotic fragment. Our experience with surgical management is
      reported (39 mitral and 5 aortic prosthetic thrombosis from 1982 to 1999 among 89
      patients with prosthetic malfunction). Average time interval between surgery and
      thrombus formation is 26 months (max 204, min 1 month). Rate of mitral thrombosis
      is 3.9% and aortic 0.25%. Clinical presentation spreads from almost asymptomatic
      patients to critically ill patients with pulmonary oedema or frank cardiogenic
      shock. Temporary suspension of anticoagulant therapy (83% in our study group) to
      rule out minor surgery, appears to be the most frequent cause of thrombosis.
      Transthoracic or better transoesophageal echo-cardiography and Doppler are by far
      the most accurate diagnostic tools that can entirely replace angiographic
      assessment. Operative mortality was 64% in the prosthetic mitral thrombosis and
      20% in the aortic one. Thrombolytic treatment may be affected by minor to
      relevant complications such as peripheral or central embolization but in our
      experience and according to the literature it seems much less hazardous than re
      do surgery. Thrombolytic treatment is advocated for critical patients unless
      emergency institution of cardio pulmonary bypass is required and/or indicated. Re
      do surgery remains indicated for all other cases of prosthetic malfunction.

PMID- 11195862
TI  - Osteochondroma of the tibia and popliteal artery stenosis.
AB  - In our department, an osteochondroma of the tibia in a young girl with
      intermittent claudication of the right leg was treated. Many instrumental
      examinations were performed in order to exclude an arterial disorder. As the
      patient shows signs of arterial compression, an operative procedure to remove the
      exostosis was performed.

PMID- 11195863
TI  - Anaemia, osteogenesis imperfecta and valve diseases. The preoperative treatment
      with epoetin-alpha to increase haematocrit and haemoglobin levels in patients
      with high risk of perioperative bleeding.
AB  - The case of a patient with Osteogenesis imperfecta is reported who underwent
      surgery for mitral valve replacement. Osteogenesis imperfecta is a hereditary
      disease of the connective tissue, associated with bone fragility, bluish
      colouring of the sclerae, loss of hearing and dental anomalies. Osteogenesis
      imperfecta is included in a group of hereditary pathologies with Ehlers-Danlos
      syndrome, Hurler syndrome, pseudoxanthoma elasticum and Marfan syndrome. In the
      literature there are few cases of patients with osteogenesis imperfecta operated
      for mitral valve disease secondary to such disease. The patient also has a
      positive family history and a severe anaemia: this was treated with epoetin-alpha
      and ferrous sulphate during the three weeks before surgery. The response to
      epoietin treatment was good while clinical outcome was poor due to rupture of the
      posterior ventricular wall in the 12th postoperative hour. The use of epoietin
      alpha is discussed.

PMID- 11195864
TI  - Treatment of deep underlying reticular veins by Nd:Yag laser and IPL source.
AB  - BACKGROUND: The purpose of this paper is to estimate the efficacy of Nd:Yag laser
      and IPL combined action for the treatment of deep (up to 5 mm) and large (up to 3
      mm in diameter) reticular varicosity of the lower extremity. METHODS: A group of
      38 subjects (2 male and 36 female) aged from 34 to 65 years were treated for deep
      reticular varicosity of the legs. All patients underwent various clinical
      analyses in order to evaluate and exclude pre-existing cardiovascular pathology,
      coagulation disorders as well as pathology due to saphena incontinence. Also, for
      the first three months they underwent ambulatory specialistic treatments at 21
      days intertreatment interval. RESULTS: A reduction of venous network of 80-90%
      after 2 treatment sessions with Nd:Yag laser was obtained in 84% of subjects.
      Successive 3 treatment sessions with IPL have achieved complete vanishing of the
      treated venous network in 36 patients (95%). CONCLUSIONS: A combined action of
      Nd:Yag laser and IPL has demonstrated its particular efficacy in non-invasive
      treatment of deep and extensive reticolar varicosity of the lower extremity,
      considering also that it is well tolerated by patients and applicable in each
      single case on out patient basis.

PMID- 11195865
TI  - Bone-inductive efficacy of recombinant human bone morphogenetic protein-2
      expressed in Escherichia coli: an experimental study in rat mandibular defects.
AB  - Because to our knowledge the efficacy of prokaryotically expressed recombinant
      human bone morphogenetic proteins (rhBMP) to promote orthotopic osteogenesis has
      not previously been investigated, our aim was to test the efficacy of rhBMP-2
      produced in Escherichia coli to promote bone healing in a standardised
      experimental bone healing model in rat mandibles. Different doses of rhBMP-2 were
      delivered in an absorbable collagen sponge carrier, and microporous barrier
      membranes were placed over half the number of defects in each treatment group,
      thereby making intraosseous cells the only recruitment source for new osteogenic
      cells. Results were evaluated by computerised image analysis after 12 and 24
      days. The relative efficacy of rhBMP-2 preparations of different purity was also
      compared. E coli-produced rhBMP-2 stimulated bone healing, but its efficacy was
      estimated to be about one order of magnitude less than that of rhBMP-2 expressed
      in eukaryotic cells. We conclude that bacterially expressed rhBMP-2 is osteogenic
      in vivo, although higher doses will be required than of rhBMP-2 expressed in
      mammalian cell lines.

PMID- 11195866
TI  - Transfer of platelet-derived growth factor-BB gene by gene gun increases
      contraction of collagen lattice by fibroblasts in diabetic and non-diabetic human
      skin.
AB  - We have used an in vitro model of wound contraction, the fibroblast-populated
      collagen lattice, to examine the effect of platelet-derived growth factor BB
      (PDGF-BB) and PDGF-BB gene transfer by gene gun on the contraction of lattices
      composed of either diabetic or non-diabetic human fibroblasts. The area of
      collagen lattice and DNA synthesis were measured in 12 specimens. There were
      significant increases in lattice contraction with increasing doses of PDGF-BB and
      fibroblasts transfected with the PDGF-BB gene compared with control (p < 0.01).
      DNA synthesis of the non-diabetic and diabetic fibroblast lattices showed
      significantly increased incorporation of tritiated thymidine with increasing
      doses of PDGF-BB and fibroblasts transfected with the PDGF-BB compared with
      controls (p < 0.05). The effect of PDGF-BB gene transfer on diabetic and non
      diabetic fibroblasts was similar to that of 20 ng/ml or less of PDGF-BB.

PMID- 11195867
TI  - Scalding injuries in immigrant families.
AB  - From 1990 to 1996, 214 patients aged up to 6 years were treated at our inpatient
      burns unit. Ages ranged from 3 to 70 months. Scalding was the cause in 186 cases.
      The median size of the burned areas was 5.0% (range 0.5%-40%). One hundred and
      nine were deep dermal burns that required surgical treatment, but this was
      refused in seven instances. Duration of hospital stay was 11 days (2-45). The
      number of follow-up visits ranged from 0 to 17. Secondary reconstructions for
      scarring have been done for seven children so far. Ninety-eight (46%) came from
      immigrant families, mostly from the Middle East and the Balkans. Of the 186
      scalded children, 94 (51%) were immigrants, and they also had a tendency to have
      more severe injuries. Explanations might be that they were more likely to cook
      with water and oil, they were unfamiliar with Swedish safety standards and
      measures, and they had difficulty in communicating (language) and a limited
      social network. The ensuing scar also may disturb or delay the child's adaptation
      to the new environment. Our preventive work is now based on a model that states
      that frequency, type, and severity of injury is dictated by the variables: risk,
      personality, supervision, and education.

PMID- 11195868
TI  - Wound closure by dermatotraction after fasciotomy for acute compartment syndrome.
AB  - Intramuscular pressure (IMP) was measured in 16 patients during secondary wound
      closure by dermatotraction with external tissue extension (ETE). Secondary wound
      closure was done 4-16 days after fasciotomy for acute compartment syndrome. The
      traction between wound edges was 2.5 N in the first six patients and 3.5 N in the
      following 10 patients. Mean (SD) IMP was 6.9 (3.5) mmHg before wound closure. It
      increased to 12.3 (1.4) mmHg in the 2.5 N group and to 24.7 (7.0) mmHg in the 3.5
      N group when dermatotraction was applied. Mean (SD) leg perfusion pressure in the
      2.5 N group decreased by 7% to 69.3 (10.9) mmHg and in the 3.5 N group by 23% to
      62.2 (7.4) mmHg. None of the patients needed a skin graft. We conclude that
      dermatotraction by ETE raises IMP intraoperatively sufficiently to preserve
      adequate limb perfusion pressures.

PMID- 11195869
TI  - Dermabrasion of large congenital melanocytic naevi in neonates.
AB  - We describe our findings in a series of 12 patients with large congenital
      melanocytic naevi treated with dermabrasion between the first and fourteenth week
      of life. Postoperative follow-up ranged from 1-16 years. In all but two cases
      dermabrasion resulted in an appreciable and stable reduction of the
      hyperpigmentation, possibly by reducing the number of pigmented cells in the
      epidermis. In six of our 12 patients, reconstruction using grafts and flaps was
      done to improve the aesthetic result. Seven years after dermabrasion, one patient
      developed a minimal deviation melanoma in the treated area, but his subsequent
      clinical course has been uneventful.

PMID- 11195870
TI  - The lateral thoracodorsal flap in breast reconstruction: a comparison between two
      plastic surgical centres.
AB  - In a retrospective study the results of breast reconstruction with 146 lateral
      thoracodorsal flaps operated on during the period 1991-94 at the Departments of
      Plastic Surgery at the Sahlgrenska University Hospital in Goteborg and the
      Stockholm Soder Hospital were evaluated. The median age of the 135 patients was
      51 years (range 37-74). About two thirds of the patients were also operated on on
      the opposite side at the same time; and this was done more often in Stockholm,
      which partly explains the longer operating time in Stockholm. Perioperative
      bleeding (median 100 ml, range 25-400) was similar in both groups. Median
      postoperative bleeding, which was measured only in Stockholm, was 300 ml (range
      30-1000). Seromas were seen only in Goteborg where postoperative drains were
      rarely used. The rate of early complications (infection and partial necrosis)
      were higher in Stockholm where more flaps were raised in irradiated tissue. We
      conclude that the results were similar in the two centres, and the thoracodorsal
      flap gives good results. The incidence of early morbidity could be reduced by
      excluding patients who had been irradiated, by inserting drains, and by giving
      antibiotic prophylaxis.

PMID- 11195871
TI  - Clinical follow up of the lateral thoracodorsal flap in breast reconstruction:
      comparative evaluation from two plastic surgical centres.
AB  - A follow up study that compared the results from two plastic surgical centres
      comprised 95 patients after breast reconstruction with the lateral thoracodorsal
      (LTD) flap combined with either a smooth or textured saline-filled implant. It
      was conducted a median of 39 months (range 15-67) after the reconstruction. We
      investigated the size of the reconstructed breast and LTD flap, symmetry of the
      breasts, orientation of the mastectomy scar, and the rate of capsular
      contracture, which were similar in the two centres. However, according to the
      modified Baker classification and applanation tonometry reconstructions with
      smooth-surfaced implants and drainage of the implant pocket resulted in softer
      breasts (p = 0.03). The LTD flap technique in breast reconstruction was a good
      choice, particularly for women who required a minor breast reconstruction, and
      the technique can be recommended for suitable patients.

PMID- 11195872
TI  - Should sensory function after median nerve injury and repair be quantified using
      two-point discrimination as the critical measure?
AB  - Two-point discrimination (2PD) is widely used for evaluating outcome from
      peripheral nerve injury and repair. It is the only quantifiable measure used in
      the British Medical Research Council (MRC) classification that was developed by
      Highet in 1954. This paper reports the results of a study of 41 patients with
      complete median nerve lacerations to the wrist or forearm. Two-point
      discrimination thresholds were assessed together with locognosia (locognosia is
      the ability to localise a sensory stimulus on the body's surface), tactile
      gnosis, and touch threshold. Using the MRC classification 29 (71%) patients had a
      result of S2 or below, 11 (27%) were S3, and only one scored S3+. Patients scored
      much better on the other tests and showed progressive recovery. It remains too
      difficult for patients to obtain a measurable threshold value on 2PD and the test
      therefore lacks responsiveness. The rating of outcome from peripheral nerve
      repair should not be based solely on 2PD testing and must include other tests of
      tactile sensibility.

PMID- 11195873
TI  - Osseointegrated proximal interphalangeal joint prostheses with a replaceable
      flexible joint spacer--long-term results.
AB  - Osseointegrated proximal interphalangeal joint prostheses with a replaceable
      joint spacer were used in 25 joints in 19 patients (five men and 14 women) aged
      45 (16-67) years. Indications for surgery were post-traumatic arthrosis (nine
      joints in eight patients), primary osteoarthrosis (10 joints in eight patients),
      and rheumatoid arthritis (six joints in three patients). A silicone joint spacer
      was attached to titanium fixtures by short titanium stems that extended from the
      spacer and fitted into a central canal in the screws. The arthroplasty was done
      in one stage, which included resection of the joint followed by grafting of
      marrow and cancellous bone from the iliac crest into adjacent medullary cavities
      before insertion of the titanium fixture. Follow up at 8.5 (5-11) years showed
      that 47 out of 50 fixtures (94%) had successfully osseointegrated while 17 of 25
      joint spacers (68%) had fractured. However, because of the design of the
      prostheses fractured joint spacers could easily be replaced and a new spacer
      could be connected to already osseointegrated screws. The joint spacer was
      replaced in 11 fingers once or several times. Range of movement (ROM) in the
      whole series (four fusions excluded) was 41 (0-85) degrees with an extension
      defect of 15 (0-55) degrees. In eight joints with permanently intact joint
      spacers the ROM was 39 (0-60) degrees with extension defects of 16 (0-40)
      degrees. In six joints in which the spacer was replaced once the ROM was 43 (0
      85) degrees with an extension defect of 16 (0-55) degrees. Our data confirm good
      long-term osseointegration of titanium fixtures and that a joint spacer, if
      needed, can be replaced by a new spacer that can be attached to already
      osseointegrated screws without jeopardizing the ROM.

PMID- 11195874
TI  - Triceps to biceps transfer to restore elbow flexion in three patients with
      brachial plexus palsy.
AB  - Between April 1994 and April 1998, triceps to biceps transfers were done for
      three men with post-traumatic lesions of the brachial plexus and consequent loss
      of elbow flexion. Their mean age at the time of their accidents was 33 years
      (range 19-41) and at the time of muscle transfer 40 years (28-46), with a mean
      observation period of 21 months (12-31). The transfer resulted in active elbow
      flexion in all patients with a mean of 113 degrees (90 degrees-130 degrees) and a
      degree of strength 4-5 (contraction against resistance) with no remaining deficit
      of passive extension. Two patients were satisfied with the result of the
      operation and the other was content. No complications were noted. The transfer of
      the triceps muscle to the tendon of the biceps muscle on loss of elbow flexion
      resulted in adequate movement and degree of strength. The triceps to biceps
      transfer involves operating close to the elbow joint and minimal complications,
      is cosmetically satisfactory, and is particularly suitable for co-contraction of
      triceps and biceps.

PMID- 11195875
TI  - Radial nerve palsy after simple fracture of the humerus.
AB  - Radial nerve palsy is a common complication of simple fracture of the humerus.
      The aim of this retrospective study was to assess the degree of spontaneous
      recovery and the need for exploration and repair of the nerve. The study included
      26 patients with radial nerve palsy after simple fracture of the humerus. The
      male:female ratio was 3:1 and the median age was 21 years (range 9-79). Three
      patients had early exploration of the radial nerve in connection with
      osteosynthesis, and no appreciable damage to the nerve was found. Two other
      patients were explored later because they failed to recover. This exploration
      showed damage to the nerve which required further operation. Twenty-one patients
      were treated conservatively and all recovered well. None needed later operation.
      Because of the low incidence of nerve lesions we recommend an expectant policy
      initially.

PMID- 11195876
TI  - Effect of manual lymph drainage as described by Vodder on oedema of the hand
      after fracture of the distal radius: a prospective clinical study.
AB  - The aim of this study was to evaluate the efficacy of manual lymph drainage, as
      described by Vodder, in reducing oedema in the hand after a traumatic injury.
      During a period of 10 months in 1996-7, a total of 26 consecutive patients with a
      fracture of the distal radius that was treated by external fixation were included
      in the study. Patients were randomised into an experimental (n = 12) and a
      control group (n = 14). Treatment started 11 days after application of the
      external fixator. All patients had the same conventional treatment with
      exercises, movement, oedema control, and education. The experimental group was
      given 10 treatments of manual lymph drainage in addition. Oedema was measured
      four times with the volumeter, and the injured hand was always compared with the
      uninjured one. The first measurement was made three days after removal of the
      external fixation. The difference in hand volume showed that the experimental
      group had significantly less oedema in the injured hand. This result indicates
      that manual lymph drainage is a useful method for reducing post-traumatic oedema
      in the hand.

PMID- 11195877
TI  - Carpal tunnel syndrome in patients on long-term haemodialysis.
AB  - The purpose of this study was to describe the pathophysiology of carpal tunnel
      syndrome (CTS) in patients on long-term haemodialysis. We examined 110 patients,
      who had been having haemodialysis for chronic renal failure and had CTS, to
      clarify the clinical features and electrophysiological changes in peripheral
      nerves. There was a significant correlation between the incidence of CTS and the
      duration of haemodialysis. Compared with idiopathic CTS, CTS caused by long-term
      haemodialysis had relatively limited postoperative improvement. Symptoms recurred
      postoperatively in 11 patients (19%) of those with CTS caused by long-term
      haemodialysis. Electrophysiological measurements of sensory nerve conduction
      velocity showed that it was slower in distal segments of the median nerve in
      patients on haemodialysis compared with normal volunteers. Nerve conduction
      velocity in the carpal tunnel was significantly delayed (p < 0.05) in the
      patients with CTS on long-term haemodialysis. N9-13 interpeak latencies were
      significantly longer (p < 0.05) in subjects who had had haemodialysis for at
      least 10 years. All the patients with advanced destructive spondyloarthropathy
      had longer N9-13 interpeak latency. These results suggest that CTS in patients on
      long-term haemodialysis has its basis in neuropathy. The clinical course of CTS
      in these patients is different from that of patients with idiopathic CTS, because
      the neuropathy involves not only the carpal tunnel region, but also the proximal
      part of the median nerve both diffusely and progressively.

PMID- 11195878
TI  - Natural skin reduction and breast recovery using a tissue expander after
      enucleation of a giant breast tumour.
AB  - We report a new use of the tissue expander for reshaping a breast after resection
      of a giant tumour. After resection of giant fibroadenomas, two patients had
      expanders inserted into the tissue defect and gradually reduced in size over five
      months. This facilitated healing and natural skin shrinkage and resulted in a
      natural shape and size.

PMID- 11195879
TI  - Reconstruction of defects of the dorsum of the nose with bilateral transposition
      flaps. Case report.
AB  - Transposition flaps are old but are the method of choice in reconstruction of
      defects of the dorsum of the nose. Eleven consecutive patients with such defects
      were treated with 22 transposition flaps. The nasal defects resulted from tumour
      (n = 9), trauma (n = 1), and keratoacanthoma (n = 1). The dissection is rapid,
      easy and the complication rate is low.

PMID- 11195880
TI  - Hypertrophic branchial myopathy with uniform predominance of type 1 fibres. Case
      report.
AB  - A 17-year-old Japanese girl presented with left masseteric hypertrophy. She had a
      habit of chewing only on the affected side. Histochemical study of the masseter
      muscle showed myopathic changes characterised by uniform type 1 fibres with gross
      hypertrophy, increases of internal nuclei and split fibres, and endomysial
      fibrous tissue. This condition could be compatible with hypertrophic branchial
      myopathy, because it was confined to the masseter muscle and so cannot be
      classified into any known type of systemic myopathy.

PMID- 11195881
TI  - Giant cell tumour of the hamate. Case report.
AB  - We report the case of a 31-year-old woman who had had the distal end of the ulna
      resected for a giant cell tumour five years before presenting with a further one
      in the hamate. The medullary cavity of the hamate was curetted and cancellous
      bone grafted from the distal radius. Her symptoms resolved, and 26 months
      postoperatively the cortex of the hamate was fully restored.

PMID- 11195882
TI  - Median nerve injury caused by missed foreign body. Case report.
AB  - A 56-year-old woman sustained a delayed median nerve division after a penetrating
      injury of the right wrist by a piece of wood had gone unnoticed. There was no
      neurological damage at the time of the injury. The foreign body spread the median
      nerve apart, which subsequently reduced the sensitivity in the index finger.
      Removal of the wood resulted in complete recovery.

PMID- 11195883
TI  - Idiopathic tumoral calcinosis of the index finger. Case report.
AB  - Tumoral calcinosis of the hand is rare, and we present a case report of
      idiopathic tumoral calcinosis of the index finger, which posed a diagnostic
      problem as it looked like an infection. We successfully removed the calcific
      deposit and there had been no recurrence one year after the operation.

PMID- 11195884
TI  - Expressions of positive emotion in women's college yearbook pictures and their
      relationship to personality and life outcomes across adulthood.
AB  - To test hypotheses about positive emotion, the authors examined the relationship
      of positive emotional expression in women's college pictures to personality,
      observer ratings, and life outcomes. Consistent with the notion that positive
      emotions help build personal resources, positive emotional expression correlated
      with the self-reported personality traits of affiliation, competence, and low
      negative emotionality across adulthood and predicted changes in competence and
      negative emotionality. Observers rated women displaying more positive emotion
      more favorably on several personality dimensions and expected interactions with
      them to be more rewarding; thus, demonstrating the beneficial social consequences
      of positive emotions. Finally, positive emotional expression predicted favorable
      outcomes in marriage and personal well-being up to 30 years later. Controlling
      for physical attractiveness and social desirability had little impact on these
      findings.

PMID- 11195885
TI  - Sociocognitive self-regulatory mechanisms governing transgressive behavior.
AB  - This longitudinal research examined a structural model of the self-regulatory
      mechanisms governing transgressive conduct. Perceived academic and self
      regulatory efficacy concurrently and longitudinally deterred transgressiveness
      both directly and by fostering prosocialness and adherence to moral self
      sanctions for harmful conduct. The impact of perceived social self-efficacy was
      mediated through prosocialness. Moral disengagement and prosocialness affected
      transgressiveness through the mediating influence of irascible affectivity and
      hostile rumination. Ruminative affectivity, in turn, both concurrently and
      longitudinally affected transgressiveness. Moral disengagement also contributed
      independently to variance in transgressiveness over time. This pattern of
      relations was obtained after controlling for prior transgressiveness. The
      structural model was replicated across gender and provided a better fit to the
      data than did several alternative models.

PMID- 11195886
TI  - Age-related differences and change in positive and negative affect over 23 years.
AB  - Positive and negative affect, measured by the Bradburn Affect Balance Scale, were
      studied in a longitudinal sample spanning from 1971 to 1994. The sample (N =
      2,804) represented 4 generations of families. Linear trend analyses compared
      generations over time for positive and negative affect and also examined the
      possible influences of neuroticism and extraversion on initial levels of affect
      and patterns of change in affect. Negative affect decreased with age for all
      generations, although the rate was attenuated among the oldest adults. Higher
      neuroticism scores also attenuated the decrease in negative affect across time.
      For positive affect, the younger and middle-aged adults showed marked stability,
      but the older group evidenced a small decrease over time. Higher levels of
      extraversion were related to more stability in positive affect.

PMID- 11195887
TI  - Self-concordance, goal attainment, and the pursuit of happiness: can there be an
      upward spiral?
AB  - Two studies used the self-concordance model of healthy goal striving (K. M.
      Sheldon & A. J. Elliot, 1999) to examine the motivational processes by which
      people can increase their level of well-being during a period of time and then
      maintain the gain or perhaps increase it even further during the next period of
      time. In Study 1, entering freshmen with self-concordant motivation better
      attained their 1st-semester goals, which in turn predicted increased adjustment
      and greater self-concordance for the next semester's goals. Increased self
      concordance in turn predicted even better goal attainment during the 2nd
      semester, which led to further increases in adjustment and to higher levels of
      ego development by the end of the year. Study 2 replicated the basic model in a 2
      week study of short-term goals set in the laboratory. Limits of the model and
      implications for the question of how (and whether) happiness may be increased are
      discussed.

PMID- 11195888
TI  - Extending the bases of subjective attitudinal ambivalence: interpersonal and
      intrapersonal antecedents of evaluative tension.
AB  - Researchers have conceptualized ambivalence as resulting from the conflicting
      positive and negative thoughts and feelings that a person holds toward an
      attitude object (intrapersonal discrepancy). The authors investigated the
      hypothesis that perceived interpersonal attitudinal discrepancies can also
      contribute to feelings of subjective ambivalence beyond that determined by
      intrapersonal discrepancy. Study 1 revealed that the perception of attitudinal
      discrepancy with one's parents was associated with greater feelings of
      ambivalence. Studies 2 and 3 found increased ambivalence as a function of
      manipulated interpersonal discrepancies. Study 4 replicated and reversed the
      effect, revealing that interpersonal attitudinal discrepancy with a disliked
      other was associated with less ambivalence. Together, these studies provide
      support for the proposition that, because of balance processes, interpersonal
      relationships influence feelings of subjective ambivalence.

PMID- 11195889
TI  - Being accepted for who we are: evidence that social validation of the intrinsic
      self reduces general defensiveness.
AB  - Three studies examined the possibility that being liked intrinsically by others-
      for who one is--reduces self-esteem defense, whereas being liked for what one has
      achieved does not. All 3 studies contrasted the effects on self-esteem defense of
      liking based on intrinsic or achievement-related aspects of self. Study 1 showed
      that thoughts of being liked intrinsically reduced defensive bias toward downward
      social comparison. Study 2 demonstrated that being liked for intrinsic aspects of
      self reduced participants' tendency to defensively distance themselves from a
      negatively portrayed other. Study 3 revealed that being liked for intrinsic
      aspects of self encouraged a preference for upward over downward counterfactuals
      for a negative event. In all 3 studies, similar reductions in defensiveness were
      not found when liking was based on achievements. Discussion focuses on
      implications for understanding the functional value of different bases of self
      worth.

PMID- 11195890
TI  - Promotion and prevention focus on alternative hypotheses: implications for
      attributional functions.
AB  - Five studies examined hypothesis generation and discounting in causal attribution
      from the perspective of regulatory focus theory (E. T. Higgins, 1997, 1998).
      According to this theory, a promotion focus is associated with generating more
      and simultaneously endorsing multiple hypotheses, whereas a prevention focus is
      associated with generating only a few hypotheses and selecting 1 hypothesis from
      a given set. Five studies confirmed these predictions for both situationally
      induced and chronic individual differences in regulatory focus. In Studies 1, 2,
      and 3, individuals in a promotion focus generated more hypotheses than
      individuals in a prevention focus. In Studies 4 and 5, individuals in a promotion
      focus discounted explanations in light of alternatives less than individuals in a
      prevention focus. Study 5 also found that in a promotion focus, person
      explanations were generalized across situations less than in a prevention focus.

PMID- 11195891
TI  - Emotional distress regulation takes precedence over impulse control: if you feel
      bad, do it!
AB  - Why do people's impulse controls break down during emotional distress? Some
      theories propose that distress impairs one's motivation or one's ability to exert
      self-control, and some postulate self-destructive intentions arising from the
      moods. Contrary to those theories, Three experiments found that believing that
      one's bad mood was frozen (unchangeable) eliminated the tendency to eat fattening
      snacks (Experiment 1), seek immediate gratification (Experiment 2), and engage in
      frivolous procrastination (Experiment 3). The implication is that when people are
      upset, they indulge immediate impulses to make themselves feel better, which
      amounts to giving short-term affect regulation priority over other self
      regulatory goals.

PMID- 11195892
TI  - Emotions in collectivist and individualist contexts.
AB  - A theory of cultural differences in emotions was tested in a questionnaire study.
      Hypotheses about the differences between emotion in individualist and
      collectivist contexts covered different components of emotion: concerns and
      appraisals, action readiness, social sharing, and belief changes. The
      questionnaire focused on 6 types of events that were rated as similar in meaning
      across cultures. Participants were 86 Dutch individualist respondents and 171
      Surinamese and Turkish collectivist respondents living in the Netherlands. As
      compared with emotions in individualist cultures, emotions in collectivist
      cultures (a) were more grounded in assessments of social worth and of shifts in
      relative social worth, (b) were to a large extent taken to reflect reality rather
      than the inner world of the individual, and (c) belonged to the self-other
      relationship rather than being confined to the subjectivity of the self.

PMID- 11195893
TI  - The forced-choice paradigm and the perception of facial expressions of emotion.
AB  - The view that certain facial expressions of emotion are universally agreed on has
      been challenged by studies showing that the forced-choice paradigm may have
      artificially forced agreement. This article addressed this methodological
      criticism by offering participants the opportunity to select a none of these
      terms are correct option from a list of emotion labels in a modified forced
      choice paradigm. The results show that agreement on the emotion label for
      particular facial expressions is still greater than chance, that artifactual
      agreement on incorrect emotion labels is obviated, that participants select the
      none option when asked to judge a novel expression, and that adding 4 more
      emotion labels does not change the pattern of agreement reported in universality
      studies. Although the original forced-choice format may have been prone to
      artifactual agreement, the modified forced-choice format appears to remedy that
      problem.

PMID- 11195894
TI  - Anger and advancement versus sadness and subjugation: the effect of negative
      emotion expressions on social status conferral.
AB  - Four studies examined status conferral (decisions about who should be granted
      status). The studies show that people confer more status to targets who express
      anger than to targets who express sadness. In the 1st study, participants
      supported President Clinton more when they viewed him expressing anger about the
      Monica Lewinsky scandal than when they saw him expressing sadness about the
      scandal. This effect was replicated with an unknown politician in Study 2. The
      3rd study showed that status conferral in a company was correlated with peers'
      ratings of the workers' anger. In the final study, participants assigned a higher
      status position and a higher salary to a job candidate who described himself as
      angry as opposed to sad. Furthermore, Studies 2-4 showed that anger expressions
      created the impression that the expresser was competent and that these
      perceptions mediated the relationship between emotional expressions and status
      conferral.

PMID- 11195895
TI  - Interindividual-intergroup discontinuity reduction through the anticipation of
      future interaction.
AB  - Consistent with the role of a long-term perspective in reducing the tendency of
      intergroup relations to be more competitive than interindividual relations in the
      context of noncorrespondent outcomes, an experiment demonstrated that anticipated
      future interaction reduced intergroup but not interindividual competitiveness.
      Further results indicated that the effect was present only for groups composed of
      members high in abstractness (Openness-Intellect on the Big 5 Inventory and
      Intuition on the Myers-Briggs Type Inventory) who trusted their opponents.

PMID- 11195896
TI  - Suboptimal dialysis initiation in a retrospective cohort of predialysis patients-
      predictors of in-hospital dialysis initiation, catheter insertion and one-year
      mortality.
AB  - OBJECTIVE: Previous investigations using univariate study designs have reported
      that delayed referral to predialysis clinics is associated with adverse outcomes
      at the time of dialysis initiation. However, the independent effect of delayed
      referral is poorly defined. Moreover, the optimal time at which to refer patients
      to predialysis programs remains unclear. The aim of this study was to identify
      independent predictors of dialysis initiation requiring hospitalization.
      MATERIALS AND METHODS: A retrospective cohort of 201 predialysis patients was
      investigated using multivariate logistic regression analysis. RESULTS:
      Multivariate analysis selected advanced age (odds ratio (OR) 1.038,95% confidence
      interval (CI) 1.011-1.065), history of congestive heart failure (OR 2.877, 95% CI
      1.205-6.871), and shorter predialysis follow-up time (OR 0.945, 95% CI 0.920
      0.971) as independent predictors of in-hospital dialysis initiation. The risk of
      in-hospital dialysis initiation increased by 5.5% for every month lost due to
      late referral. CONCLUSION: Patients should be referred to predialysis programs as
      early as 24 months before anticipated dialysis initiation in order to minimize
      the risk of future adverse outcomes.

PMID- 11195897
TI  - Comparison of BTA stat and NMP22 tests in the detection of bladder cancer.
AB  - OBJECTIVE: This study aimed to compare the BTA (bladder tumour antigen) stat and
      urinary nuclear matrix protein (NMP22) tests in the detection of bladder cancer.
      MATERIAL AND METHODS: The office-based qualitative BTA stat and the laboratory
      based quantitative NMP22 tests were studied in the same urine samples obtained
      from 49 patients with a high suspicion of bladder cancer and 20 healthy subjects.
      RESULTS: A tumour was identified in 36 patients after the cystoscopy. BTA stat
      demonstrated a sensitivity of 89%, which was superior to the sensitivity of 66.6%
      with the NMP22 test in detecting the bladder cancer (p < 0.02). The sensitivities
      for grade I tumours with BTA stat and NMP22 were 55.5% and 33.3%, respectively.
      The sensitivity of BTA stat was 100% for tumour categories except for the pTa and
      grade I tumours. No positive result was observed with both tests among the
      healthy subjects. The specificities for BTA stat and NMP22 were 78.7% and 69.6%,
      respectively. CONCLUSIONS: The BTA stat test was significantly more sensitive
      than the NMP22 test in the detection of bladder cancer. Although the sensitivity
      of BTA stat was not sufficient to replace cystoscopy, its ease and low cost may
      play a role in reducing the number of control cystoscopies, especially in
      patients with low risk of progression.

PMID- 11195898
TI  - Evaluation of human leukocyte antigen expression in patients with prostate
      cancer.
AB  - OBJECTIVE: The aim of this prospective study was to evaluate the possible
      relationship between human major histocompatibility antigens [human leukocyte
      antigen (HLA)] and prostatic adenocarcinoma. MATERIAL AND METHODS: This clinical
      study was performed in 30 patients with histologically proven prostatic
      adenocarcinoma and 102 healthy men. HLA A, B and DR groups were evaluated in all
      patients. RESULTS: Of the HLAs examined, A2, A10, A28, A14, DR6, DR7 and DR9 were
      found to be accumulated significantly in patients with prostatic cancer in
      comparison with the healthy subjects. Apart from HLA A2 and DR7, the relative
      risk has been found to be over 2 in patients demonstrating these antigens.
      CONCLUSIONS: Although there was a statistically significant difference with
      respect to HLA accumulation between patients with prostate cancer and healthy
      subjects, larger series of patients including other parameters are needed.

PMID- 11195899
TI  - The use of betamethasone and hyaluronidase injections in the treatment of
      Peyronie's disease.
AB  - OBJECTIVE: The aim of this study was to assess the effect of local injections of
      betamethasone, hyaluronidase and lidocaine in patients with Peyronie's disease.
      MATERIAL AND METHODS: A total of 112 men who had a palpable plaque at the penis
      and suffered from painful erection and bending of penis was treated with a total
      of 12 injections containing betamethasone, hyaluronidase and lidocaine. Patients
      were classified into groups according to the duration of the disease (<6 months,
      6-12 months or >12 months) as well as the size of the plaque (<10 mm, 10-20 mm or
      >20 mm). Pretreatment evaluation of patients and assessment of outcome were based
      on subjective criteria as well as measurement of the size of the plaque by means
      of ultrasound. Results were correlated to patients' characteristics. RESULTS: The
      overall response rate was 86%. Cure or improvement was noticed in 31% and 55% of
      patients respectively. Most of the patients (83%) had a duration of disease less
      than 12 months. Painful erection, bending of penis and plaque were absent in 97%,
      32% and 31% of patients, respectively, after treatment. No severe complications
      were observed. The effect of treatment was strongly related to the duration of
      disease and the size of the plaque. CONCLUSIONS: The method is safe, well
      tolerated by patients and characterized by a high response rate in patients with
      a history of less than 12 months and a plaque not exceeding 20 mm.

PMID- 11195900
TI  - Effect of ultrasound in the treatment of primary nocturnal enuresis.
AB  - OBJECTIVE: This study aimed to determine the efficacy of ultrasound therapy in
      patients with primary nocturnal enuresis. MATERIAL AND METHODS: Thirty-five
      patients with enuresis were included the study. Patients were divided into two
      groups: 27 patients with enuresis were treated with ultrasound with irradiation
      and heating, and eight patients with enuresis were treated with ultrasound
      without irradiation or heating (placebo group). Ultrasound therapy was performed
      using the Therasonic 350 machine. The ultrasound therapy was applied to the skin
      of lumbosacral region. A treatment course of ultrasound comprised 10 sessions of
      0.8 W/cm2 intensity applied daily for 8 min. Symptoms were evaluated I week, and
      3, 6 and 12 months after the treatment. RESULTS: Twenty-two (81.5%) patients
      responded to the ultrasound therapy at the first week after the treatment. The
      effect of ultrasound started immediately after the treatment and continued during
      the 12 months of the follow-up period. CONCLUSION: Ultrasound therapy seems to be
      effective in the treatment of primary nocturnal enuresis in the 1 year follow-up
      period.

PMID- 11195901
TI  - First Scandinavian experience of electrical sacral nerve stimulation in the
      treatment of the overactive bladder.
AB  - OBJECTIVE: This study aimed to evaluate the efficacy of electrical sacral nerve
      stimulation (SNS) in the treatment of urinary incontinence and urinary retention
      refractory to conservative treatment, and to assess the impact of urodynamic
      abnormalities and electrode position. MATERIAL AND METHODS: Thirty patients (10
      men, 20 women) with a mean age of 59 years (range 21-79 years), all of whom had
      longstanding symptoms ranging from 2 to 46 years (mean 12.4 years), were
      subjected to a percutaneous test stimulation. Ten patients responded well,
      resulting in a permanent implant in nine patients. Electrode positions were
      determined by plain X-ray and computed tomography. RESULTS: Radiologically, a
      variety of positions of the temporary electrodes was seen. In the implanted
      patients, long-term symptom reduction varied over time, ranging from total relief
      to partial or total recurrence of symptoms. CONCLUSIONS: SNS is a new promising
      option for the treatment of urge incontinence. Refined instruments for proper
      patient selection and the optimal way to position the electrode remain to be
      developed.

PMID- 11195902
TI  - Testicular seminoma in a man with bilateral microlithiasis and a history of
      cryptorchidism.
AB  - A case is presented of a young man with a history of bilateral cryptorchidism who
      presented with infertility. On investigation he was noted to have bilateral
      microlithiasis and left testicular seminoma. The possible association between
      microlithiasis and seminoma in patients with a history of cryptorchidism is
      discussed.

PMID- 11195903
TI  - An unusual case of duplex ureteropyelocystoplasty.
AB  - Ileocystoplasty is associated with electrolyte disturbances, mucus production and
      gastrointestinal tract disruption. An unusual case is presented of duplex
      ureteropyelocystoplasty with an excellent postoperative result. This technique
      avoids the complications associated with the use of ileum in the urinary tract.

PMID- 11195904
TI  - Erroneous diagnosis of chronic urinary retention in three women with pelvic
      cysts.
AB  - Three cases are presented where pelvic masses were originally misdiagnosed as
      cases of chronic urinary retention. In all cases the erroneous diagnosis was made
      at outpatient assessment, where postmicturition ultrasound scan measurement of
      residual urine volume had been performed. This investigation, while a useful
      tool, must be viewed in the context of other clinical findings.

PMID- 11195905
TI  - Rare earth elements--a new generation of growth promoters for pigs?
AB  - The present study which includes two feeding experiments was performed to
      investigate a possible performance enhancing effect of rare earth elements (REF)
      in piglets. This performance enhancing effect has been described in the Chinese
      literature for a long time, however, it was never tested under "western
      conditions". In the first feeding experiment 72 piglets at a mean BW of 7.3 kg
      were allotted to a control and to 4 REE groups at different levels of lanthanum
      chloride or an REE mixture containing mainly chlorides of lanthanum, cerium and
      praseodymium. The experimental period lasted 5 weeks. Positive effects of REE
      were found on body weight gain as well as on feed conversion ratio of the
      piglets. Compared to the control group, the daily weight gain was improved by 2
      to 5% and feed conversion was better by up to 7%. These effects were, however,
      not significant. In the second feeding experiment, piglets (mean BW 17.3 kg) were
      fed for 8 weeks with a similar REE mixture. Significant positive effects of REE
      were found on both body weight gain and on feed conversion ratio by 19% and 10%,
      respectively. This is the first time that a performance enhancing effect of REE
      in pigs under western feeding conditions has been shown. Since the use of
      antibiotics as growth promoters in animal feed has been restricted in the
      European Union recently, rare earth elements might be of interest as new, safe
      and inexpensive alternative performance enhancers.

PMID- 11195906
TI  - Dietary carbohydrates affect caecal fermentation and modify nitrogen excretion
      patterns in rats. II. Studies with diets differing in protein quality.
AB  - In 2 two-factorial experiments, each conducted on 80 growing male rats, the
      effects of substituting 10% raw potato starch (PS), pectins (PEC), or cellulose
      (CEL) for wheat starch (WS) and the addition of tannic acid to WS (WSTA) were
      studied using diets differing in protein quality. Casein unsupplemented or
      supplemented with DL-methionine and gluten unsupplemented or supplemented with
      lysine, methionine and tryptophan were used as protein sources in Experiment 1
      and 2, respectively. Parameters indicative of caecal fermentation intensity (pH,
      acetic, propionic and butyric acid contents, digesta and tissue weight) and of
      protein metabolism (urea blood concentration, faecal and urinary nitrogen
      excretion) were determined. Ten-day balance experiments were preceded by a 10-day
      adaption period to respective carbohydrates given in a diet containing balanced
      protein. In both experiments the type of carbohydrates affected the caecal
      concentration of individual and total SCFA and other parameters of fermentation
      intensity. Pectins and potato starch were fermented more intensively than
      cellulose. Faecal N excretion was increased by all carbohydrates substituted for
      cereal starch, and by tannic acid. Urinary excretion was greater on CEL than on
      PEC and WSTA containing casein and on other diets containing gluten. In both
      experiments urinary N excretion was the lowest on PEC diets. Protein quality had
      the greatest effect on apparent biological value and net protein utilization but
      all indices of protein utilization were also affected by carbohydrates. It is
      concluded that not only the amount of N excreted in faeces but also in urine is
      affected by the type and fermentability of carbohydrates.

PMID- 11195907
TI  - Comparative studies on the in vitro properties of phytases from various microbial
      origins.
AB  - The physical and chemical properties of six crude phytase preparations were
      compared. Four of these enzymes (Aspergillus A, Aspergillus R, Peniophora and
      Aspergillus T) were produced at commercial scale for the use as feed additives
      while the other two (E. coli and Bacillus) were produced at laboratory scale. The
      encoding genes of the enzymes were from different microbial origins (4 of fungal
      origin and 2 of bacterial origin, i.e., E. coli and Bacillus phytases). One of
      the fungal phytases (Aspergillus R) was expressed in transgenic rape. The enzymes
      were studied for their pH behaviour, temperature optimum and stability and
      resistance to protease inactivation. The phytases were found to exhibit different
      properties depending on source of the phytase gene and the production organism.
      The pH profiles of the enzymes showed that the fungal phytases had their pH
      optima ranging from 4.5 to 5.5. The bacterial E. coli phytase had also its pH
      optimum in the acidic range at pH 4.5 while the pH optimum for the Bacillus
      enzyme was identified at pH 7.0. Temperature optima were at 50 and 60 degrees C
      for the fungal and bacterial phytases, respectively. The Bacillus phytase was
      more thermostable in aqueous solutions than all other enzymes. In pelleting
      experiments performed at 60, 70 and 80 degrees C in the conditioner, Aspergillus
      A, Peniophora (measurement at pH 5.5) and E. coli phytases were more heat stable
      compared to other enzymes (Bacillus enzyme was not included). At a temperature of
      70 degrees C in the conditioner, these enzymes maintained a residual activity of
      approximately 70% after pelleting compared to approximately 30% determined for
      the other enzymes. Incubation of enzyme preparations with porcine proteases
      revealed that only E. coli phytase was insensitive against pepsin and pancreatin.
      Incubation of the enzymes in digesta supernatants from various segments of the
      digestive tract of hens revealed that digesta from stomach inactivated the
      enzymes most efficiently except E. coli phytase which had a residual activity of
      93% after 60 min incubation at 40 degrees C. It can be concluded that phytases of
      various microbial origins behave differently with respect to their in vitro
      properties which could be of importance for future developments of phytase
      preparations. Especially bacterial phytases contain properties like high
      temperature stability (Bacillus phytase) and high proteolytic stability (E. coli
      phytase) which make them favourable for future applications as feed additives.

PMID- 11195908
TI  - Lactational and metabolic effects in cows of lysine and methionine added to a
      ration deficient according to the I.N.R.A. method.
AB  - The effects of adding lysine and/or methionine to a ration of calculated
      deficiency in these amino acids of 10% and 20%, respectively, were studied in 24
      Brown Swiss cows. The mixed rations (27% grass silage, 19% maize silage, 5% hay
      and 49% concentrate on DM basis) contained 14.5% CP on average. Lysine supply was
      selectively elevated by adding fish meal in exchange for other concentrate
      ingredients. Methionine was supplied in a rumen-protected form. Milk protein
      content was elevated whereas fat amount decreased by adding both amino acids.
      Lactose content increased without additional lysine from fish meal. Live weight,
      milk yield, milk fat content and protein amount remained unaffected by any
      variation of amino acids supply. Also nutrient digestibility and nitrogen balance
      were not changed by the treatments. Blood plasma concentrations confirmed the
      assumed variation in metabolic lysine and, less clear, methionine supply. Effects
      on plasma concentrations of other amino acids were relatively small. Most plasma
      hormones and enzymes, and metabolites in plasma, urine and milk did not respond
      to the variation in amino acid supply. Lysine addition via fish meal increased
      aspartate amino transferase and decreased urinary allantoin concentration.
      Additional methionine elevated plasma ornithine. Overall lysine and methionine
      appear to have been only marginally deficient in the unsupplemented ration fed
      for 3 weeks despite the deficiency of 10% to 20% as calculated by the I.N.R.A.
      method.

PMID- 11195909
TI  - Research note: is starch utilization for fat deposition in man different from
      that in animals?
AB  - Utilization of starch for fat deposition in humans was investigated by means of
      the nitrogen-carbon-balance method in a respiration chamber using the difference
      principle with a basal and a supplemental period. The basal diet was designed to
      maintain an adequate energy balance of the volunteer and to meet the maintenance
      requirements of protein, minerals and vitamins. The dietary fat content was
      minimized to 2.7% of DM. The digestibility of starch energy was determined to be
      97%. The estimated efficiency of ME utilization of starch for energy deposition
      in humans amounted to 75.8%, which was in accordance with former results in pigs
      and rats. This suggests that in case of an intake of diets rich in carbohydrates
      and low in fat the utilization of carbohydrates for lipogenesis in humans is
      similar to that in monogastric mammal animals.

PMID- 11195910
TI  - Understanding ambiguous words in biased sentences: evidence of transient
      contextual effects in individuals with nonthalamic subcortical lesions and
      Parkinson's disease.
AB  - A cross-modal priming experiment was used to investigate lexical ambiguity
      resolution during sentence processing in individuals with nonthalamic subcortical
      lesions (NSL) (n = 10), compared to matched normal controls (n = 10), and
      individuals with cortical lesions (CL) (n = 10) and Parkinson's disease (PD) (n =
      10). Critical sentences biased towards the dominant or subordinate meaning of a
      sentence-final lexical ambiguity were presented auditorily, followed after a
      short interstimulus-interval (ISI) (0 msec) or a long ISI (1000 msec), by the
      presentation of a visual target which was related to the dominant or subordinate
      meaning, or was an unrelated control word. Subjects made speeded lexical
      decisions on the targets. At the short ISI, lexical activation for the
      neurological patient groups appeared influenced by contextual information to a
      greater extent than in normal controls, which may indicate delayed lexical
      decision making or disturbed automatic lexical activation. At the long ISI, only
      the PD and NSL individuals failed to selectively activate the contextually
      appropriate meaning, suggesting a breakdown in the attention-based control of
      semantic activation through contextual integration. This finding may implicate
      disruptions to proposed frontal-striatal mechanisms which mediate attentional
      allocation and strategy formation.

PMID- 11195911
TI  - Emotional and physiological responses to false feedback.
AB  - The relationship between autonomic-visceral arousal and emotional experience is
      unclear. The attribution or cognitive-arousal theory of emotional experience
      posits that emotional experience is dependent on both visceral-autonomic nervous
      system feedback and the cognitive interpretation of the stimulus that induced
      this visceral activation. The finding that false cardiac feedback can alter
      emotional experience suggests that it may be the conscious perception that one is
      aroused, together with the cognitive interpretation of the stimulus that are
      important in developing emotional experience. Because the right hemisphere
      appears to play a special role in modulating arousal and interpreting emotional
      stimuli, it is possible that right hemisphere damage may interfere with
      developing the computations needed for emotional experience. To test this
      hypothesis we exposed men, both neurologically intact and those with right and
      left hemisphere lesions, to emotionally provocative pictures that were paired
      with false cardiac feedback, and examined the effects of this false feedback on
      their ratings of attractiveness of these pictures and their cardiac reactivity to
      this information. Subjects with left hemisphere damage, but not right hemisphere
      damage, showed significant changes in their emotional rating whereas control
      subjects showed marginal reactivity in their emotional ratings. Subjects with
      left hemisphere damage also showed significant changes in their cardiac
      reactivity. This finding is consistent with prior reports that indicate, when
      compared to right hemisphere damaged patients and normal controls, patients with
      left hemisphere lesions have an increased visceral-autonomic response to stimuli.
      These findings further provide support for the postulate that it is the cognitive
      interpretation of perceived physiological arousal together with the cognitive
      interpretation of the stimulus that is important in the development of emotional
      judgment and experience. These results do not support the approach-left
      hemisphere/avoidance-right hemisphere dichotomy, but instead suggest that left
      hemisphere damage increases reactivity to false feedback, and that the intact
      right hemisphere function integrates the cognitive interpretation of the
      emotional information and perceived arousal that lead to that emotional judgment.
      That these subjects showed no consistent relationship between their measures of
      cardiac reactivity and their ratings of attractiveness detracts from the James
      Lange and attribution theories. These subjects also showed no consistent
      relationship between their knowledge of affective physiological reactivity and
      their ratings of attractiveness, or between their knowledge of physiological
      reactivity and actual measures of cardiac reactivity, suggesting that other
      neuropsychological factors are involved in making an emotional judgment.

PMID- 11195912
TI  - An ecological approach to planning dysfunction: script execution.
AB  - Planning, which concerns many activities in everyday life, is a two-stage
      process. The first one predetermines a course of actions aimed at achieving some
      specific goals. It is founded on managerial knowledge or overlearned sequences of
      events and may be tested by script generation. The second stage entails
      monitoring and guiding the execution of the plan to a successful conclusion. It
      must take into account environmental contingencies and may be tested by script
      execution. If the frontal lobes intervene not only in managerial knowledge
      (Grafman, 1989) but also in binding the plan with contextual environment
      (Damasio, Tranel and Damasio, 1991; Shallice and Burgess, 1991), script execution
      would be more sensitive than script generation to planning deficits. To test this
      hypothesis, script execution and script generation were compared in 11 patients
      with a dysexecutive syndrome and 10 matched controls, using three scripts of
      daily life activities: (1) 'shopping for groceries'; (2) 'cooking'; (3)
      'answering a letter and finding the way to post the reply'. Two way ANOVAs showed
      more errors in execution than in generation, more errors in patients than in
      controls, and a greater difference between execution and generation in patients
      than in controls. Furthermore, 'context neglect' and 'environmental adherence'
      were the two types of errors that best differentiated patients from controls.
      Finally, the total number of errors in execution correlated with the score on
      behavioral questionnaires answered by occupational therapists. These results
      confirm our hypothesis and suggest that script execution may be a valid
      ecological approach to estimate the severity of deficits in daily life
      activities.

PMID- 11195913
TI  - Orientation bias in unilateral neglect: representational contributions.
AB  - Left-neglect patients bisect horizontal lines to the right of true center. Longer
      lines are bisected further to the right than shorter lines. This line-length
      effect might be explained by an increase in the rightward bias of attention
      because longer lines extend further ipsilesionally. Alternatively, neglect
      patients might be limited in their abilities to internally represent horizontal
      magnitudes. Patients might orient further rightward with longer lines because
      these lines have longer representations. If the line-length effect occurs on
      lines of identical objective length but they are represented differently, then
      central mechanisms must contribute to the orientation bias. We constructed two
      types of lines that were perceived by normal subjects as having different
      lengths, but were of identical extents. Three neglect patients bisected lines
      perceived as longer, further to the right than lines perceived as shorter. These
      results demonstrate that relative magnitudes of internal representations
      contribute to the degree of bias in neglect patients.

PMID- 11195914
TI  - Predicting hand preference with performance on motor tasks.
AB  - Handedness may be defined as preference or hand-differences in task performance.
      The strength and significance of the relationship between hand preference and
      hand performance asymmetries have been contested. To evaluate this relationship,
      we administered the Edinburgh Handedness Inventory and measured asymmetries in
      finger tapping, Purdue Pegboard, and grip strength in 30 subjects who prefer
      their right hand and 30 subjects who prefer their left hand. Hand asymmetries in
      finger tapping, Purdue Pegboard, and grip strength each predicted hand preference
      scores. However, a multiple regression equation best predicted hand preference by
      using performance of each task. Hand asymmetries in finger tapping correlated
      strongly with asymmetries in Purdue Pegboard performance, but neither of these
      asymmetries correlated strongly with asymmetries in grip strength. These findings
      indicate that hand preference and asymmetries in motor proficiency are strongly
      related, but suggest that preference and proficiency for different aspects of
      motor performance may be independently lateralized.

PMID- 11195915
TI  - The role of the left hemisphere in verbal and spatial reasoning tasks.
AB  - Laterality of reasoning processes have long been a source of investigation.
      Differing formats of verbal and spatial reasoning tasks have meant it has not
      been possible to extricate true performance level from artefacts of input and
      output modalities. The Verbal and Spatial Reasoning Test (VESPAR) offers this
      opportunity, by virtue of matched sets of verbal and spatial inductive reasoning
      problems. Two series of 40 patients with unilateral left and right hemisphere
      lesions were tested on two verbal and two spatial subtests of the VESPAR,
      together with a battery of baseline tests. The performance of the left and right
      hemisphere lesion cases was compared with a normal standardisation sample.
      Whereas only the left hemisphere group failed the verbal sections, both left and
      right hemisphere groups failed the spatial sections. The influence of aphasia on
      spatial reasoning was considered to be an incomplete explanation for the failure
      of the left hemisphere group on the spatial sections. It is concluded that this
      investigation provides firmer evidence of a crucial role for the left hemisphere
      in both verbal and spatial abstract reasoning processes.

PMID- 11195916
TI  - Alzheimer patients' ability to read words with irregular stress.
AB  - The TIB, an Italian version of the National Adult Reading Test (NART), requires
      the subject to read out a list of Italian words with a dominant (regular) and a
      less frequent (irregular) stress pattern. It was given to a group of 45 patients
      with a diagnosis of dementia of Alzheimer type (DAT) and to a matched control
      group. Both the NART and the TIB are based on the assumption that the ability to
      translate orthography into phonology is relatively unimpaired in DAT patients.
      Despite the different language characteristics on which the two tests are based,
      the present results largely replicate those found for the NART. Patients with
      mild and moderate DAT did not perform differently from matched controls on the
      TIB, while they were impaired on the NART. Patients with severe dementia,
      however, also failed in the TIB test.

PMID- 11195917
TI  - Asymmetries of visuospatial attention are modulated by viewing distance and
      visual field elevation: pseudoneglect in peripersonal and extrapersonal space.
AB  - Many factors influence the degree of leftward error (pseudoneglect) that typifies
      the line bisection performance of normal subjects. We find that viewing distance
      also exerts a modulating influence on spatial attention in normal subjects, as it
      appears to do in neglect syndrome. Using forced-choice tachistoscopic line
      bisection, 38 right-handed subjects (15 male, 23 female) bisected horizontal
      lines (13.7 degrees w x 0.24 degrees h) presented in the midsagittal plane as a
      function of line elevation (- 3.6 degrees, 0 degrees, and 3.6 degrees relative to
      horizontal midline) and viewing distance (45 and 90 cm). We find a significant
      main effect of viewing distance, F (1, 37) = 10.04, p = .003, where pseudoneglect
      is larger in peripersonal (45 cm) than in extrapersonal (90 cm) space. We
      replicate an effect of line elevation, F (2, 74) = 4.40, p = .016, where
      pseudoneglect is greatest in the superior visual field (McCourt and Jewell,
      1999). The interaction was not significant, p > .05. Thus, we find evidence for
      independent spatiotopic (viewing distance) and retinotopic (line elevation)
      effects on line bisection performance in normal observers, suggesting that the
      allocation of visuospatial attention is modulated within multiple frameworks.

PMID- 11195918
TI  - Semantic category dissociations, familiarity and gender.
AB  - We carried out four experiments to assess the extent to which familiarity with
      certain objects in everyday life is related to gender and can account, at least
      partially, for the semantic category dissociation observed in a few brain-damaged
      patients. In the first experiment, 210 normal subjects, half males and half
      females, were given the names of 60 stimuli from the Snodgrass and Vanderwart's
      set, 30 belonging to living categories and 30 to non-living categories. The task
      was to rate their familiarity, based on the frequency with which one (i) thinks
      or speaks of a given item, (ii) sees it represented in the media, and (iii) is
      confronted with real exemplars. The three indices were highly correlated and
      their average value was, therefore, used. Females gave higher familiarity ratings
      to fruit, vegetables and furniture and males to tools. The second experiment was
      aimed to verify whether the gender difference was responsible for the category
      dissociation found following brain damage. A male patient with greater impairment
      for living categories and a female patient with greater impairment for non-living
      categories were requested to name the same 60 stimuli and their scores were
      analysed, partialling out the familiarity effect, measured both with the non
      gender specific index of Snodgrass and Vanderwart and with the new gender
      specific index. In either case, the category dissociation remained significant.
      To determine if the mean general population familiarity index was valid for the
      single subject, we studied whether a cohabitant first degree relative was able to
      predict a normal subject's familiarity better than the population index. Contrary
      to expectations, the better predictor was the population index. The test-retest
      reliability of each subject's familiarity ratings was satisfactory, but not
      higher than the correlation between the personal judgement of each subject and
      the population index.

PMID- 11195919
TI  - Cinema seating in right, mixed and left handers.
AB  - Two hundred and sixty four right-handed, 246 mixed-handed and 360 left-handed
      students were requested to indicate on five maps of cinema halls what place they
      would choose. All three handedness groups showed a preference for the right and a
      corresponding directional bias towards the left space. However, they differed
      significantly from each other on the magnitude of this bias which was most
      pronounced in right and less in left handers. It is assumed that lateralized
      mechanisms underlying such biases have developed evolutionarily and serve right
      handed persons best. Non-dextrality considerably reduces their phenotypic
      expressions, but even left-handedness does not reverse the directional bias
      towards the left. It is also hypothesized that right, mixed and left handers
      differ in a large number of behavioral choices and strategies, modeled by
      cerebrally lateralized mechanisms and that the cinema seating preference is only
      one of them.

PMID- 11195920
TI  - [Risk management in the surgical practice: recovered serenity].

PMID- 11195921
TI  - [Role of somatostatins in the preventin of pancreatic fistulae and the treatment
      of digestive fistulae].
AB  - Somatostatin and analogues exert an extraordinary range of inhibitory effects
      which eventually may have a variety of therapeutic applications. Treatment of
      intestinal and pancreatic fistula are the main targets in general and digestive
      surgery. The perioperative and prophylactic application of somatostatin or
      octreotide in patients who undergo major pancreatic surgery reduces the
      postoperative complication rate. This prevention seems indicated following
      Whipple procedure in patients with soft pancreatic tissue. The efficacy of
      somatostatin or analogues in the treatment of intestinal or pancreatic fistulae
      is still in debate. Fistula output frequently decreases but closure rate, healing
      time and complications rate are not reduced. The treatment and care of patients
      with high output fistulae may be simplified by somatostatin or analogues if a
      positive effect on output is obvious in the first days of treatment.

PMID- 11195922
TI  - [French randomized trials in general and digestive surgery in the last decade].
AB  - STUDY AIM: To study the characteristics of randomized trials published by general
      and digestive French surgeons over the last decade. MATERIAL AND METHODS: An
      extensive electronic and manual literature search was performed. Trials published
      as original articles compared two surgical techniques or a surgical procedure
      with a nonsurgical treatment. The characteristics of the trials and their
      methodology were assessed. At the same time, a survey was conducted among authors
      to assess the impact of application of the Huriet-Serusclat law (ethics related
      to the protection of individuals subjected to bioclinical research) on the
      conduct of the trial. RESULTS: Forty trials (including 22 multicentre trials)
      were found. Twelve trials (30%) addressed a key-question and twenty (50%)
      addressed a particular step of the procedure (anastomosis, drainage, etc). Most
      trials (83%) were published in English language journals. The 18 trials with a
      good methodological quality mainly had a multicentre design (n = 16). The survey
      showed that 10 trials were conducted prior to the publication of Huriet-Serusclat
      law and that 14 trials were conducted in compliance with this law. CONCLUSION:
      This study revealed the large number of well designed multicentre trials in
      France. But most trials assessed technical steps of the surgical procedures.
      Application (without prerequisite) of the Huriet-Serusclat law could probably
      explain the rarity and the difficulties of conducting trials comparing two
      different procedures or a surgical with a medical treatment.

PMID- 11195923
TI  - [Laparoscopic treatment of solid and cystic tumors of the liver. Study of 33
      cases].
AB  - AIM OF THE STUDY: Laparoscopic liver surgery is still in its early stages. The
      aim of this study was to report our experience in the laparoscopic management of
      solid and cystic liver tumours. PATIENTS AND METHODS: From April 1991 to December
      1999, 32 patients with various lesions of the liver underwent laparoscopic liver
      surgery. One group of patients presented with cysts (n = 15) (11 giant solitary
      cysts and 4 polycystic liver diseases) and one group of patients presented with
      solid tumours (n = 18): focal nodular hyperplasia (n = 8), haemangioma (n = 6),
      adenoma (n = 2), isolated metastasis from a colonic cancer (n = 1) and
      hepatocellular carcinoma (n = 1). Fifteen cyst fenestrations and eighteen liver
      resections were performed via a laparoscopic approach including 1 right
      lobectomy, 5 left lateral segmentectomies, 2 subsegmentectomies IVb, 1
      segmentectomy III and 9 non-anatomical resections. RESULTS: Conversion to
      laparotomy was performed in one case (3%) at the end of the operation (patient
      who had successfully undergone left lateral segmentectomy for hepatocellular
      carcinoma) to check the resection margins and surgical transection had been
      performed in healthy parenchyma. Mean diameter of solid tumours was 6.5 cm and
      15.7 cm for solitary cysts. The mean operating time for hepatic resections was
      232 minutes. There was no postoperative mortality. Complications occurred in one
      case for each group and consisted in intestinal stricture through a port site
      requiring intestinal resection. Mean postoperative hospital stay was 5.6 days for
      solid tumours and 7.5 days for cystic lesions. In the group of cystic lesions,
      the recurrence rate was 50% with a 5.5-months follow-up. CONCLUSION: Laparoscopic
      liver surgery can be safely performed, but requires a good experience in open
      hepatic surgery and laparoscopic surgery. The laparoscopic approach is indicated
      in patients with symptomatic or atypical benign solid tumour, giant solitary cyst
      and polycystic liver disease, located anteriorly on the liver. Indications for
      malignant lesions have not been clearly defined and require further information.

PMID- 11195924
TI  - [Assessment of quality of life after antireflux surgery].
AB  - AIM OF THE STUDY: To assess the quality of life (QoL) of patients operated for
      gastroesophageal reflux disease (GERD). PATIENTS AND METHODS: This prospective
      study included 82 consecutive patients submitted to antireflux surgery between
      October 1998 and January 1999. A new questionnaire was used to assess their QoL:
      the Gastrointestinal Quality of Life Index (GIQLI) that includes 36 items
      concerning 5 dimensions: symptoms, vitality, emotions, social relations and
      medical treatment. The series consisted of 44 men and 38 women with a mean age of
      47 years (range: 18-78). QoL was assessed before and 6 months after surgery; the
      follow-up rate was 94% (77/82). The pre- and postoperative GIQLI scores of the
      study group and the GIQLY score of a control group of 110 healthy patients were
      compared. RESULTS: Before surgery, the GIQLI score (90 +/- 23) was greatly
      impaired compared to the score (123 +/- 13) observed in the control group (p <
      0.001). After surgery, the GIQLI score (110 +/- 23) increased significantly (p <
      0.001), but remained statistically lower than the score of the control group (p <
      0.001). The postoperative score recorded in the symptoms dimension was lower than
      the control group score: 55 +/- 11 versus 66 +/- 6 (p < 0.001), while no
      significant difference was observed in the other 4 dimensions. Univariate
      statistical analysis revealed that the postoperative GIQLI score (y) was
      correlated with the preoperative GIQLI score (x) according to the formula: y =
      0.43 x + 71 (p < 0.001) and the sex of the patients, as the postoperative GIQLI
      score was higher in male patients (115 +/- 19) than in female patients (103 +/-
      23) (p < 0.02). CONCLUSION: The QoL of the patients was greatly improved after
      antireflux surgery, but remained lower than that of a control group of healthy
      subjects. Better patient selection should improve the results. In our series,
      male patients or patients with a high preoperative GIQLI score were the best
      candidates for antireflux surgery.

PMID- 11195925
TI  - [Pickrell intervention in children for anal incontinence secondary to anorectal
      malformation].
AB  - STUDY AIM: The aim of this study was to report the results of unilateral Pickrell
      procedure in children with fecal incontinence secondary to anal atresia. PATIENTS
      AND METHOD: Twenty three children were operated between 1975 and 1997. The mean
      age at the time of the operation was 8.5 years. Functional results were
      systematically evaluated by Kelly's clinical score and by anal sphincter
      electromyography and anal manometry for some patients. RESULTS: There was no
      postoperative mortality. One colostomy was performed for recurrent local sepsis.
      The functional result with a mean follow-up of 6 years was estimated to be good
      in 25%, intermediate in 45% and poor in 30%. Clinical improvement of continence
      was obtained in 70% of cases. CONCLUSION: The improvement of continence after
      Pickrell procedure essentially depends on the patient selection criteria, pre-
      and postoperative rehabilitation and regular enemas. In the case of poor results,
      the authors propose bilateral Pickrell procedure which improved the results in
      eight out of nine children in this group.

PMID- 11195926
TI  - [Intravagal parathyroid ectopia].
AB  - AIM OF THE STUDY: The presence of an ectopic parathyroid gland is the commonest
      cause of persistent hyperparathyroidism (HPT). High cervical ectopic glands
      represent 0.21 to 9% of these cases. Only 3 cases of high intravagal sites have
      been described. The authors report two new cases of persistent HPT caused by an
      intravagal parathyroid gland. PATIENTS AND METHOD: In a series of 1,712 cases of
      HPT operated over the last 25 years (1,307 primary HPT and 405 secondary or
      tertiary HPT), two cases (0.12%) of persistent HPT were caused by a high
      intravagal parathyroid gland. One case corresponded to primary HPT and the other
      case corresponded to tertiary HPT. One patient underwent three operations and the
      other patient underwent four operations. CONCLUSION: Intravagal thyroid tissue
      may cause HPT. This very rare site must be considered among the other high
      cervical ectopic sites in the pre- and intraoperative assessment of
      hyperparathyroidism, particularly in cases of persistent or recurrent
      hyperparathyroidism.

PMID- 11195927
TI  - [Mature teratome of the mediastinum].
AB  - STUDY AIM: The aim of this retrospective study was to report a series of 12 cases
      of mature teratoma of the mediastinum operated during a 10-year period in the
      same center. PATIENTS AND METHOD: From 1990 to 2000, 12 patients (7 females and 5
      males with a mean age of 32 years) were operated for mature mediastinal teratoma.
      Chest pain was present in 10 cases; cough, dyspnea and septic episodes were
      present in 5 cases and X-ray detected the mediastinal tumor in 10 cases. CT scan
      showed a tumor with liquid and fatty components and calcifications in 5 out of 9
      cases. Tumors were resected via a posterolateral thoracotomy in 11 cases and an
      anterior thoracotomy in one case, associated with pneumonectomy in 1 case, basal
      segmentectomy in 1 case and thymectomy in 1 case. RESULTS: There were no
      postoperative deaths. Morbidity included 2 phrenic nerve palsies, 1 pyothorax
      after pneumonectomy, 1 case of bleeding and 1 pleural effusion. No recurrences
      have been observed with a follow-up of 5 to 87 months. Nine of the 10 tumors
      reviewed by pathologist contained multiple tissue components and one only
      contained a single tissue. CONCLUSION: Mature teratomas are usually detected in
      young patients: they are usually located in the middle part of the anterior
      mediastinum and are only diagnosed by pathologic examination of the specimen.
      They have an excellent prognosis when tumor resection is complete and in the
      absence of immature tissue in the tumor.

PMID- 11195928
TI  - [Filling of bone defects with tricalcium phosphate beta in traumatology].
AB  - AIM OF STUDY: Synthetic bone substitutes like calcium phosphate ceramics have
      been used in orthopaedic surgery for several years. The aim of this study was to
      assess the results of the use of tricalcium phosphate beta for filling bone
      defects in trauma cases. PATIENTS AND METHOD: beta tricalcium phosphate was used
      in 24 trauma cases. The GESTO classification (Association pour l'etude des
      Greffes et Substituts Tissulaires en Orthopedie) and a qualitative scale were
      used to estimate the integration. RESULTS: With a mean follow-up of 20 months,
      integration was excellent in 41.2%, good in 29.2% and moderate in 17.4%. No
      fibrous encapsulation was observed around the implants in any case. Sepsis
      occurred in 3 cases with open fractures. CONCLUSION: beta-Tricalcium phosphate
      seems in our experience to be an excellent bone substitute for filling bone
      defects in trauma cases.

PMID- 11195929
TI  - [Use of the vacuum-assisted closure system for the treatment of perineal gangrene
      involving the abdominal wall].
AB  - The vacuum-assisted closure (VAC) system is used for the treatment of complicated
      wounds and large tissular dehiscences. The study aim was to report a case of
      perineal gangrene extended to the abdominal wall in a 53-year old woman. After
      several extensive surgical debridments, using of the VAC was followed by a good
      and rapid healing of the wound.

PMID- 11195930
TI  - [Primary malignant melanoma of the esophagus].
AB  - Primary malignant melanoma of the esophagus is a rare but aggressive tumor that
      accounts for less than 0.1-0.2% of all esophageal malignancies. The aim of this
      study was to report a case of primary malignant melanoma of the esophagus in a 72
      year-old woman. The diagnosis was histologically proven, but the patient died
      despite extensive surgical resection.

PMID- 11195931
TI  - [Germain Pichaut de Lamartiniere. Eulogy presented to the Royal Academy of
      Surgery during the public session on April 22, 1784].
AB  - G. Pichaut de Lamartiniere (1696-1783) accompanied the king during his campaigns
      and, in 1747, then succeeded La Peyronie as first surgeon to the king and
      President of the Royal Academy of Surgery. "He devoted his talent as an organizer
      in favour of surgeons. He did everything to proclaim the independence of surgery
      and to protect it from the tyranny of the Faculty of Medicine of Paris". He did
      not leave behind any scientific or academic works.

PMID- 11195932
TI  - The nuclear chloride ion channel NCC27 is involved in regulation of the cell
      cycle.
AB  - NCC27 is a nuclear chloride ion channel, identified in the PMA-activated U937
      human monocyte cell line. NCC27 mRNA is expressed in virtually all cells and
      tissues and the gene encoding NCC27 is also highly conserved. Because of these
      factors, we have examined the hypothesis that NCC27 is involved in cell cycle
      regulation. Electrophysiological studies in Chinese hamster ovary (CHO-K1) cells
      indicated that NCC27 chloride conductance varied according to the stage of the
      cell cycle, being expressed only on the plasma membrane of cells in G2/M phase.
      We also demonstrate that Cl- ion channel blockers known to block NCC27 led to
      arrest of CHO-K1 cells in the G2/M stage of the cell cycle, the same stage at
      which this ion channel is selectively expressed on the plasma membrane. These
      data strongly support the hypothesis that NCC27 is involved, in some as yet
      undetermined manner, in regulation of the cell cycle.

PMID- 11195933
TI  - Regulation kinetics of Na+-Ca2+ exchange current in guinea-pig ventricular
      myocytes.
AB  - To investigate the regulation of native cardiac Na+-Ca2+ exchange by cytoplasmic
      Na+ (Na+i) and Ca2+ (Ca2+i), we recorded the Na+-Ca2+ exchange current (INa-Ca)
      from inside-out 'macro patches' excised from intact guinea-pig ventricular cells.
      The half-maximal concentration (Kh) of Ca2+i required to induce an inward INa-Ca
      was 7 microM. The Kh of Na+i required to induce an outward INa-Ca was 21 mM, and
      tended to decrease at the steady state of Na+-dependent inactivation. The time
      constant (tau) of Na+-dependent inactivation was approximately 1.5 s at 100 mM
      Na+i and 1 microM Ca2+i. The Kh for Na+i was 14 mM. Ca2+i augmented the peak
      outward INa-Ca (Kh = 0. 2 microM) and attenuated Na+-dependent inactivation (Kh =
      2.2 microM). The outward INa-Ca was activated by 5 microM Ca2+i with a half-time
      to reach steady state (t1/2) of approximately 0.4 s. This activation was composed
      of two exponential processes. Deactivation of the current upon Ca2+i removal also
      consisted of two exponential processes and had a t1/2 of approximately 0.5 s. A
      Na+-Ca2+ exchange model, consisting of one consecutive 4Na+:1Ca2+ exchange cycle
      and two inactive states, well mimicked the experimental data with regard to ion
      dependencies and regulation kinetics. These data provide detailed information on
      the kinetics of the Na+i- and Ca2+i-dependent regulation of native Na+-Ca2+
      exchange. They also indicate that the regulation kinetics operate faster in macro
      patches than in the giant membrane patch from cardiac 'blebs', or in Xenopus
      oocytes expressing a cloned exchanger (NCX1.1).

PMID- 11195934
TI  - A genetic algorithm with adaptive mutations and family competition for training
      neural networks.
AB  - In this paper, we present a new evolutionary technique to train three general
      neural networks. Based on family competition principles and adaptive rules, the
      proposed approach integrates decreasing-based mutations and self-adaptive
      mutations to collaborate with each other. Different mutations act as global and
      local strategies respectively to balance the trade-off between solution quality
      and convergence speed. Our algorithm is then applied to three different task
      domains: Boolean functions, regular language recognition, and artificial ant
      problems. Experimental results indicate that the proposed algorithm is very
      competitive with comparable evolutionary algorithms. We also discuss the search
      power of our proposed approach.

PMID- 11195935
TI  - Short-term prediction of chaotic time series by using RBF network with regression
      weights.
AB  - We propose a framework for constructing and training a radial basis function
      (RBF) neural network. The structure of the gaussian functions is modified using a
      pseudo-gaussian function (PG) in which two scaling parameters sigma are
      introduced, which eliminates the symmetry restriction and provides the neurons in
      the hidden layer with greater flexibility with respect to function approximation.
      We propose a modified PG-BF (pseudo-gaussian basis function) network in which the
      regression weights are used to replace the constant weights in the output layer.
      For this purpose, a sequential learning algorithm is presented to adapt the
      structure of the network, in which it is possible to create a new hidden unit and
      also to detect and remove inactive units. A salient feature of the network
      systems is that the method used for calculating the overall output is the
      weighted average of the output associated with each receptive field. The superior
      performance of the proposed PG-BF system over the standard RBF are illustrated
      using the problem of short-term prediction of chaotic time series.

PMID- 11195936
TI  - Kernel and nonlinear canonical correlation analysis.
AB  - We review a neural implementation of the statistical technique of Canonical
      Correlation Analysis (CCA) and extend it to nonlinear CCA. We then derive the
      method of kernel-based CCA and compare these two methods on real and artificial
      data sets before using both on the Blind Separation of Sources.

PMID- 11195937
TI  - Features selection and architecture optimization in connectionist systems.
AB  - In this paper, we propose a features selection measure and an architecture
      optimization procedure for Multi-Layer Perceptrons (MLP). The algorithm presented
      in this contribution employs a heuristic measure named HVS (Heuristic for
      Variable Selection). This new measure allows us to identify and select important
      variables in the features space. This can be achieved by eliminating redundant
      features and those which do not contain enough relevant information. The proposed
      measure is used in a new procedure aimed at selecting the "best" MLP architecture
      given an initial structure. Application results for two generic problems:
      regression and discrimination, demonstrates the proposed selection algorithm's
      effectiveness in identifying optimized connectionist models with higher accuracy.
      Finally, an extension of HVS, named epsilonHVS, is proposed for discriminative
      features detection and architecture optimization for Time Delay Neural Networks
      models (TDNN).

PMID- 11195938
TI  - Assessing rbf networks using DELVE.
AB  - In this paper, different methods for training radial basis function (RBF)
      networks for regression problems are described and illustrated. Then, using data
      from the DELVE archive, they are empirically compared with each other and with
      some other well known methods for machine learning. Each of the RBF methods
      performs well on at least one DELVE task, but none are as consistent as the best
      of the other non-RBF methods.

PMID- 11195939
TI  - Content-based image retrieval system using neural networks.
AB  - An effective image retrieval system is developed based on the use of neural
      networks (NNs). It takes advantages of association ability of multilayer NNs as
      matching engines which calculate similarities between a user's drawn sketch and
      the stored images. The NNs memorize pixel information of every size-reduced image
      (thumbnail) in the learning phase. In the retrieval phase, pixel information of a
      user's drawn rough sketch is inputted to the learned NNs and they estimate the
      candidates. Thus the system can retrieve candidates quickly and correctly by
      utilizing the parallelism and association ability of NNs. In addition, the system
      has learning capability: it can automatically extract features of a user's drawn
      sketch during the retrieval phase and can store them as additional information to
      improve the performance. The software for querying, including efficient graphical
      user interfaces, has been implemented and tested. The effectiveness of the
      proposed system has been investigated through various experimental tests.

PMID- 11195940
TI  - Effects of background noise on audiometric thresholds during positron emission
      tomography: passive and active noise-reduction.
AB  - Position emission tomography (PET) is used to assess the functional activity of
      the human auditory brain; however, the activity detected by PET could be affected
      by ambient acoustic noise from the PET equipment. To evaluate these effects, we
      compared behavioural thresholds in the PET camera with those measured in an
      audiometric sound booth. Thresholds were measured with: (i) ER2 earphones, (ii)
      ER2 earphones + Cabot earmuffs, (iii) ER2 earphones + Bose Series II Aviation
      Headset with active noise-reduction off, and (iv) ER2 earphones + Bose Series II
      Aviation Headset with active noise-reduction on. Overall ambient noise level in
      the camera was 73 dB SPL and the maximum octave-band SPL was 68 dB SPL at 250 Hz.
      Threshold elevations in the PET camera were greatest with ER2 (17 dB, 125 Hz)
      earphones and lowest with ER2 earphones + Bose Series II Aviation Headset (8 dB
      at 250 Hz) with active noise-reduction. Thus, PET scanner noise had little or no
      effect on threshold when stimuli were presented through ER2 earphones covered
      with an activated Bose Series II Aviation Headset.

PMID- 11195941
TI  - Use of the 400 Hz period evoked potential in the prediction of loudness
      discomfort levels in normal hearing adults.
AB  - This study investigated normally-hearing adult subjects to establish whether the
      400 Hz Period Evoked Potential (PEP) can be used to predict Loudness Discomfort
      Level (LDL). Parameter-intensity functions were obtained using the response
      measures (400 Hz components) of amplitude, phase, magnitude squared coherence
      (MSC) and phase coherence (PC). The best predictor of the subjective LDL was
      found to be the gradient of the individual's amplitude-intensity function for
      significant (MSC > 0.264 and/or PC > 0.525) responses only. In this case 82% are
      predicted within 10 dB and there is a maximum error of 15 dB.

PMID- 11195942
TI  - Multifrequency multicomponent tympanometry in normal and otosclerotic ears.
AB  - A multifrequency multicomponent admittance meter was used to evaluate 70 ears of
      patients affected by fenestral otosclerosis (Os ears), monolateral (16 cases) or
      bilateral (27 cases). The 16 contralateral ears of the patients with monolateral
      otosclerosis who presented a pure-tone air-bone gap less than 10 dB were
      evaluated separately (Cos ears). A group of 48 ears belonging to 24 otologically
      normal subjects (N ears), with hearing thresholds better than or equal to 10dB HL
      in the frequencies between 250 and 8000 Hz served as a control group. The purpose
      of the study was to evaluate the acoustic admittance characteristics of the three
      groups of ears, with particular regard to the parameters represented by the
      resonance frequency (RF), the acoustic conductance value (G) at RF and the
      individual interaural differences in these two parameters in the N and Cos
      groups. The degree to which fenestral otosclerosis can influence variations of RF
      and the correlation between the value of RF and conductive hearing loss in
      patients with clinically confirmed pictures and in the controlateral ears in the
      cases where the disease was clinically unilateral were also investigated. The
      study reveals statistically significant differences between the RF means in the N
      group (1085 +/- 244Hz) vs the Os group (1264 +/- 320 Hz) (p < 0.001) and between
      the G means in the N group (5.33 +/- 1.72 mmhos) vs the Os group (4.46 +/- 2.54
      mmhos) (p = 0.04) and N group vs Cos group (3.42 +/- 2.27 mmhos) (p < 0.001). No
      correlation was found between the value of RF and conductive hearing loss. This
      study also shows how prognostic value may also be attributed to conductance at
      middle-ear pressure balancement: extremely low values for this parameter at RF
      are indicative of initial otosclerotic involvement of the oval window.

PMID- 11195943
TI  - Symptoms, disability and handicap in unilateral peripheral vestibular disorders.
      Effects of early presentation and initiation of balance exercises.
AB  - The aim of this study was to obtain a profile of disability and handicap in
      patients with unilateral peripheral vestibular disorders presenting to a
      specialist tertiary care unit. Two validated questionnaires were sent to patients
      who had a unilateral peripheral vestibular disorder as defined by strict
      criteria. Some patients still suffered moderate handicap and disability 5 years
      after the initial symptoms related to a unilateral vestibular disorder, although
      the duration of symptoms (onset to questionnaire completion) did not correlate
      with severity of disability and handicap, as judged by questionnaire scores.
      However, patients presenting to the unit within 6 months of onset of vertigo
      commenced balance exercises significantly earlier and had significantly lower
      disability scores than patients presenting later. A high proportion of non
      compliance with, and delay in initiation of, vestibular rehabilitation exercises
      was noted in the total patient sample, while compliance with, and early
      initiation of, Cooksey Cawthorne exercises were significantly correlated with low
      disability and questionnaire scores. These findings suggest that early referral
      to a specialist balance unit for patients with persistent dizziness is associated
      with better outcome.

PMID- 11195944
TI  - Auditory function among young occupational divers: a 3-year follow-up study.
AB  - Auditory function was measured in a 3-year follow-up study of 54 young
      occupational divers divided into high-exposure (n = 23) and low-exposure (n = 31)
      groups. The divers performed open-sea dives with a median number of 132 dives
      (range 44-766) during follow-up. At the start of follow-up, hearing in the high
      exposure group was reduced compared with that in the low-exposure group. During
      the follow-up period, the total group experienced a significantly reduced hearing
      ability at 4 kHz in the left ear. No difference in change between the last and
      the first measurement for both ears combined was found when the two groups were
      compared. A regression analysis of measurements at the end of follow-up shows an
      association between the loss of hearing in the left ear at 6 and 8 kHz and the
      total number of years of diving. This indicates that diving may contribute to
      hearing impairment.

PMID- 11195945
TI  - Effect of frequency content on categorical loudness normalization.
AB  - In this study, increases in loudness with increases in bandwidth, termed loudness
      summation, were derived from loudness growth functions estimated using a loudness
      scaling procedure. The results revealed that at equal loudness category,
      categorical loudness summation was generally larger in normal-hearing than in
      hearing-impaired subjects; furthermore, the increase in loudness summation at
      intermediate loudness levels observed in the former, was absent in the latter.
      These results, in broad agreement with recent data from the literature, can be
      explained in the light of physiological data on cochlear compression. One
      implication of these results regarding hearing aid fitting was that channel-by
      channel loudness normalization was effective only when the incoming sound was
      closed in bandwidth to one of the test stimuli.

PMID- 11195946
TI  - Interrater agreement on tympanometry in infants.
AB  - Two-hundred and forty-two tympanograms of infants were interpreted according to a
      standard operating procedure independently by an audiologist and ten study
      doctors from the Finnish Otitis Media Vaccine Trial. The interrater agreement
      among the study doctors according to Kappa index was excellent (kappa = 0.80).
      The agreement was significantly better on curves taken during pre-scheduled
      healthy visits than during sick visits due to respiratory infection (p < 0.001).
      In addition concurrent knowledge of the clinical ear status significantly
      improved the agreement on abnormal curves (flat B-curves and failed F-curves, p <
      0.001). The clinical differences between the groups were minor. The age of the
      infant had no effect on interpretation. The agreement between the audiologist and
      the study doctors was also excellent (kappa = 0.77). Excellent agreement can be
      achieved in infant tympanometry through adequate instruction and training.

PMID- 11195947
TI  - Severe-profound hearing impairment and health-related quality of life among post
      lingual deafened Swedish adults.
AB  - Health-related quality of life (HRQL) was measured with the Nottingham Health
      Profile (NHP) in 311 Swedish adults suffering from severe-profound hearing
      impairment (sensorineural hearing loss in the better ear of > or = 70 dB HL at a
      frequency of 1.0 kHz) for comparisons with a normal-hearing population. The
      subjects completed NHP and a questionnaire regarding bio-psycho-social status.
      Generally, subjects with profound hearing loss reported lower HRQL. Significant
      differences were obtained for lack of energy, emotional reactions and social
      isolation. Females with profound impaired hearing tended overall to have lower
      HRQL than the males. The persons with severe-profound hearing impairment working
      full-time reported higher HRQL than those with a partial or full disablement
      pension and were comparable with the hearing population. Severe-profound hearing
      impairment is associated with an impact on HRQL of the sufferers, especially
      their emotional and social coping and energy resources. The profound hearing
      impaired persons seem to constitute a risk group for worse psychosocial
      adjustment and need greater attention and support.

PMID- 11195948
TI  - Speech perception after multichannel cochlear implantation in Finnish-speaking
      postlingually deafened adults.
AB  - This study was done to examine the short-term and long-term effects of
      multichannel cochlear implantation on speech perception in Finnish-speaking
      adults. The subjects comprise 20 adults. Pure-tone thresholds (0.125-8kHz),
      discrimination of phoneme quantity, sentence recognition, word recognition,
      phoneme recognition and listening performance were studied before and after
      implantation. After switch-on of the implant, the median pure-tone threshold
      values in the sound field were comparable to the level of mild hearing
      impairment. Most improvement in sentence recognition took place during the 6
      months after the switch-on (mean score 74%). In word recognition, most
      improvement took place during the 12 months after the switch-on (mean score 66%),
      and clear improvement was noted even thereafter. In phoneme recognition, the
      performance of the subjects improved over the entire follow-up period, and 24
      months after the switch-on the mean score was 52%. Individual variation was seen
      in the performance of the subjects. With 3 months of listening experience, all
      subjects were able to recognize some speech without speechreading, and they
      gained good functional benefit from the implant. The use of speech recognition
      tests with different degrees of difficulty is essential for the follow-up of
      adult cochlear implant subjects.

PMID- 11195949
TI  - Sun Protection is Fun! A skin cancer prevention program for preschools.
AB  - Children and their caregivers are prime candidates for intervention to curb the
      rising incidence of skin cancer in the United States. Preschools provide a unique
      opportunity to influence the sun protection practices of parents and teachers on
      behalf of young children. Sun Protection is Fun!, a comprehensive skin cancer
      prevention program developed by The University of Texas M. D. Anderson Cancer
      Center in collaboration with The University of Texas-Houston Health Science
      Center School of Public Health, was introduced to preschools in the greater
      Houston area. The program's intervention methods are grounded in Social Cognitive
      Theory and emphasize symbolic modeling, vicarious learning, enactive mastery
      experiences, and persuasion. Program components include a curriculum and
      teacher's guide, videos, newsletters, handbooks, staff development, group
      meetings designed to encourage schoolwide changes to support the program, and
      sunscreen. The intervention map, including objectives for program development,
      implementation, and evaluation, is discussed.

PMID- 11195950
TI  - Project SOAR: a training program to increase school counselors' knowledge and
      confidence regarding suicide prevention and intervention.
AB  - School counselors are often the lead individuals in school suicide prevention
      programs. All school counselors in Dallas, Texas, receive training through
      Project SOAR (Suicide, Options, Awareness, and Relief), a suicide prevention
      program. This study assessed Dallas school counselors' knowledge of suicidal risk
      factors and perceived ability to initiate appropriate steps when confronted with
      a suicidal student. A two-page, 44-item survey was distributed to all Dallas
      school counselors attending a mandatory meeting in spring 1999. A total of 186
      school counselors (75%) responded. Most had been a school counselor for less than
      10 years and one-half received initial SOAR training less than four years ago.
      The majority strongly agreed that they could recognize suicidal warning signs,
      assess a student's risk for suicide, and offer support to a suicidal student. In
      addition, most knew the intervention steps to take when a student assessed at
      high suicidal risk. When compared to school counselors nationwide, these
      counselors reported increased confidence in identifying students at suicidal
      risk.

PMID- 11195951
TI  - Analysis of a bi-state, multi-district, school-based hepatitis B immunization
      program.
AB  - A descriptive correlational research design assessed factors influencing
      participation and completion rates, and to determine vaccine administration
      costs, in a school-based Hepatitis B vaccination program. Of 18,046 students in
      public and private schools in the metropolitan Kansas City, Mo., area, 12,986
      (73.4%) participated with approximately 75% of these students completing the
      vaccine series. Larger schools reported decreased participation and completion
      rates. Both rates were highest in schools providing educational interventions.
      Schools with a large population of commercially insured students reported low
      participation rates (65%), but high completion rates (85%). Schools with a high
      number of Medicaid-eligible students had high participation rates (97%), but low
      completion rates (67%). The vaccine cost $5.06 per dose to administer.

PMID- 11195952
TI  - A meta-analysis examining effects of school sexuality education programs on
      adolescents' sexual knowledge, 1960-1997.
AB  - This study analyzed and synthesized findings from selected studies conducted from
      1960 through 1997 regarding effects of school sexuality education on adolescents'
      sexual knowledge. This purpose was achieved using meta-analysis. Sixty-seven
      studies that met the selection criteria were included in the meta-analysis. The
      67 studies reported 72 outcomes regarding sexual knowledge, which were grouped
      into six independent variables related to knowledge about sexuality. A weighted
      effect size method developed by Hedges and Olkin was calculated using all
      studies. For all studies, 97% of weighted effect sizes were positive. The
      weighted average effect size on sexual knowledge across all studies of 0.41 was
      statistically significant, indicating a significant difference occurred between
      control and experimental groups' mastery of objectives related to sexual
      knowledge. It was concluded that sexuality education programs positively affect
      overall sexual knowledge.

PMID- 11195953
TI  - Who wants to be healthy?

PMID- 11195954
TI  - Implications of growing up digital.

PMID- 11195955
TI  - [Effect of blood concentrations of preovulatory estradiol on the quality of eggs
      and pre-embryos in patients treated with fertilization in vitro].
AB  - The objective was to investigate if the preovulatory estradiol concentrations
      obtained during controlled ovarian hyperstimulation (COH) have effect on
      reproductive outcome. The study included a total of 198 in vitro fertilization
      (IVF) cycles. Patients were divided into four groups according to serum
      preovulatory estradiol concentrations. In low responder patients was observed
      significantly decreased oocyte and preembryo quality compared with normal or high
      responders (P < 0.01). In this work high response do not have effect on IVF
      outcome. The clinical results indicate that low estradiol levels the day of hCG
      administration are apparently correlated with poor oocyte and embryo quality.

PMID- 11195956
TI  - [Comparative study between estradiol valerate combined with cyproterone acetate,
      and conjugated equine estrogens combined with medroxyprogesterone acetate as
      hormone replacement therapy in climacteric].
AB  - OBJECTIVE: To compare the effectiveness in the control of climacteric symptoms,
      the tolerability and the uterine bleeding pattern between two types of hormone
      replacement therapy. MATERIAL AND METHODS: 81 postmenopausal women between 40 and
      60 years age with vasomotor symptoms were studied. Randomly it was administered:
      I. Conjugated equine estrogens (CEE)-Medroxyprogesterone acetate (MPA): 21
      tablets with 0.625 mg of CEE and 10 tablets with 5 mg of MPA which were taken
      with the last ten tablets of CEE in each cycle (n = 3 7). II. E2V-CPA: 11 tablets
      with 2 mg of E2V and 10 tablets with 2 mg of E2V and 1 mg of CPA (n = 44). Each
      cycle comprised 28 days. The treatments were compared with squared Chi and Mann
      Whitney U test. RESULTS: The hot flushes presence was significantly greater in
      the group with CEE-MPA (p < 0.03). Severe throbs at the end of the study had a
      trend to be more frequent in the group with EC-MPA (p < 0.06). At the end of the
      study there was a greater frequency of breast tenderness in the group with CEE
      MPA (P = 0.009). CONCLUSIONS: Both treatments have good effectiveness,
      tolerability and same bleeding pattern. Only the frequency of hot flushes, the
      presence of severe throbs and breast tenderness were lower in the group with E2V
      CPA, that makes this preparation an option that can have a better acceptance by
      the women.

PMID- 11195957
TI  - [Prenatal steroids for fetal maturation in preterm birth. Experience at an
      institution].
AB  - INTRODUCTION: Prenatal steroids have been proved useful in the prevention of
      respiratory distress syndrome (RDS) and other complications in premature infants.
      OBJECTIVE: To analyze retrospectively the impact of prenatal steroids in
      premature infants < 34 weeks. MATERIAL AND METHODS: Two hundred nineteen
      premature infants were divided into two groups: Group I (n = 145) without
      prenatal steroids and Group II (n = 74) with steroids. Maternal age, prenatal
      control, gestational age, gender, weight, Apgar score at 1 and 5 minutes,
      duration of neonatal hospital care, the presence or absence of RDS,
      intraventricular haemorrhage (IVH), necrotising enterocolitis (NEC), chronic lung
      disease (CLD) and neonatal death were analyzed. Chi square test and OD ratios
      were calculated. RESULTS: Significant statistical difference were found in
      maternal age, prenatal control, and birth weight. Gestational age, gender and
      Apgar score at 1 and 5 minutes showed no significant difference. RDS and CLD
      incidence proved to be lower in group II (with prenatal steroids) showing a
      significant statistical of X2 = 31.32; p < 0.01 and X2 = 5.42; p < 0.01
      respectively. Intraventricular difference (X2 = 5.02; p < 0.1), NEC (X2 = 1.47; p
      < 0.1), duration of neonatal hospital care and neonatal death showed no
      significant difference. DISCUSSION: As reported by other authors, RDS incidence
      in premature infants is reduced by the use of prenatal steroids, and secondarily
      the incidence of CLD. No effect was found in the presence of IVH even though the
      OD ratio showed a protective effect. No beneficial effect nor an increase in the
      frequency of NEC was demonstrated. It is necessary to incorporate strategies at
      different levels that have the objective of preventing premature births and its
      complications.

PMID- 11195959
TI  - [Breast angiosarcoma].
AB  - OBJECTIVE: To report the case of a female with Mammary Angiosarcoma. SETTING:
      Breast Unit of Oncology Service from Hospital General de Mexico. CASE REPORT: A
      28 year old female patient was noted to have a left painless breast mass with
      reddish-violaceous macular lesions in the overlaying skin in upper quadrants,
      which she had initially discovered 2 years previously. The patient described a
      progressive breast enlargement. Mammography showed dense tissue without focal
      mass. A contrast-enhanced Magnetic Resonance of left breast was performed, and
      10.5 x 8.5 cm enhancing vascular mass with irregular borders that occupied the
      entire superior portion of the breast was identified, the mass extended to the
      pectoral fascia but no evidence of muscle invasion. An incisional Biopsy of the
      breast mass was performed and the biopsy was interpreted as low grade Mammary
      Angiosarcoma. Left Simple Mastectomy with partial pectoral resection was
      performed; and final histopathologic result was intermediate grade Mammary
      Angiosarcoma. Immunohistochemistry was positive for Factor VIII, Anti Ulex
      Europeaus and CD 31. CONCLUSION: High index suspect is mandatory for an opportune
      diagnosis and treatment of Angiosarcoma. Magnetic resonance has a potential role
      in guiding clinical management.

PMID- 11195958
TI  - [Comparative assessment of efficacy and safety of assisted vaginal delivery with
      forceps and with vacuum extractor].
AB  - We performed a prospective, controlled, randomized trial to compare de safety and
      efficacy between the vaginal assisted delivery with vacum extractor forceps. We
      included a control group of primigravidae. We use the ACOG application criteria
      for operative obstetrics. We measured the differences in regard to indication for
      operative delivery, obstetric trauma and the general characteristics of the
      patients. A total of 210 patients were included which were distributed in three
      groups. In the first group we included the patients of vacum extractor, the
      second group of forceps and the third the control group. In our results we found
      no statistically significant differences among three groups in regard to the
      general characteristics and obstetric trauma. In the vacum extractor group we
      found six cefalohematomas (8.5%), two newborns with skin laceration (2.8%) and
      four newborns with cerebral edema (5.7%). In the forceps group we had two
      newborns diagnosed with cefalohematomas (2.8%), seven newborns with cerebral
      edema (10%) and scalp laceration on four newborns (6%). In the control group we
      found one cefalohematoma (1.4%) and cerebral edema in four newborns (5.7%). We
      did not find statistically significant differences when we compared the group of
      the vacum and the forceps. CONCLUSION: With this information we concluded that
      both instruments are equal in regard to efficacy and safety when they are use by
      experimented hands and following the application criteria. Nevertheless, there is
      a high incidence of vaginal injuries and obstetric trauma in the newborn in the
      operative delivery compared with the control group without an important increase
      in the perinatal mortality.

PMID- 11195960
TI  - [Use captopril and estradiol-medroxyprogesterone in premenopausal hypertensive
      patients].
AB  - INTRODUCTION: The premenopause period is that which precedes the actual
      menopause, when a decrease of the ovarian hormones is present, leading to
      cardiovascular diseases as arterial hypertension, acute myocardial infarction and
      cerebrovascular diseases. OBJECTIVE: We evaluated the antihypertensive response
      of the estradiol-medroxyprogesterone, to reduce arterial pressure in the
      premenopausal patient. MATERIAL AND METHODS: In a clinical trial from March 1997
      to September 1998, 106 patients with systemic hypertension, symptoms
      hypoestrogenism and estradiol levels less than 30 pg/mL were evaluated. They were
      randomized at a trial in two groups with pursuit of 6 months. Group A: 53 with
      captopril, Group B: 53 with estradiol-medroxyprogesterone. The arterial pressure,
      cholesterol, triglycerides and symptoms hypoestrogenism were analyzed before and
      after the treatment. The statistical analysis was performed with Student T.
      RESULTS: A decrease of arterial pressure was observed with estradiol, the same as
      with captopril with a p < 0.05. Decrease of cholesterol and triglycerides were
      more significant in the estradiol group with a p < 0.05. A bigger attenuation of
      symptoms of the hypoestrogenism existed in the estradiol group. CONCLUSIONS: The
      antihypertensive response with estradiol was the same as with captopril in the
      premenopausal patient with systemic hypertension.

PMID- 11195961
TI  - [Maternal risk factors associated with anencephaly].
AB  - INTRODUCTION: Anencephaly has factors of risk genetics, environmental and
      maternal. OBJECTIVE: Identify maternal factors of risk for anencephaly. DESIGN:
      Case-control study. SETTING: Department of Gyneco-Obstetrics and Pediatrics;
      second level Social Security Hospital. PARTICIPANTS: 69 pregnant patients
      attended in their delivery, 23 cases and 46 controls. INTERVENTIONS: We applied a
      questionnary with questions about factors of risk to each patient with
      anencephaly children (cases), and to two mothers with healthy children
      (controls). MEASUREMENTS: The data were analyzed and in boards 2 x 2 resisting
      differentiates them with x2 test, and the association was measured with odds
      ratio (OR). Results greater than 1.5 with IC95% by above 1 were significant.
      RESULTS: Incidence of anencephaly is 2.82/1,000 live births. Association with
      maternal age, pregnancy, gestational pathology, exposition to high temperatures,
      mother occupation, exposition to chemical or physical agents, was not found.
      Protective effects associated, with drug administration during gestation, mainly
      multivitamin preparations, was found. CONCLUSIONS: The incidence is high, it is a
      public health problem. During pregnancy probability of anencephaly was less
      frequent in mothers receiving multivitamin preparations.

PMID- 11195962
TI  - [Acute fatty liver of pregnancy. Report of a case and review of the literature].
AB  - Acute Fatty Liver of Pregnancy. The acute fatty liver of pregnancy (AFLP) is an
      uncommon entity, potentially fatal, which affects women during the last quarter
      of pregnancy. It is characterized by a prodromic period of symptoms followed by
      jaundice, hepatic failure, clotting disorders and fatty infiltration of the
      liver, evident through hepatic biopsy. The incidence ranks from 1 to 20 thousand
      births, and it is more frequent among women with multiple pregnancies. We report
      the case of a 29-year-old patient, with multiple pregnancy 33 to 34 weeks of
      gestation, blood pressure values of 140/90 mmHg, 160,000/dL platelets, PT 25.6
      seconds, TPT 64.7 seconds, blood glucose 52 mL/dL, creatinine 2.1 mg/dL, uric
      acid 11.9 mg/dL, lactic dihydrogenase 1063 U/l, GPT 220 U/l, AF 1172 U/l, total
      bilirubin 8.4 mg/dL, proteinuria 30 mg/dL. A cesarean section was practiced after
      correcting the coagulation disorders. The first twin was a male with birth weight
      of 2,070 g, APGAR 8-9; the second twin was a female fetal death weighting 2,050
      g. Hepatic biopsy confirmed the diagnosis. The cause of AFLP is unknown. The
      frequency among multiple pregnancies is higher. Almost half of the cases have
      hypertension and proteinuria. There are also high levels of both transaminases,
      phosphatase and bilirubins and hypoglycemia. The prothrombin time is enlarged.
      The differential diagnostic between pre-eclampsia and AFLP is not crucial since
      the obstetric management is the same. The main treatment is promptly deliverance
      and general measures. The obstetrician must be aware of this hepatic disease.

PMID- 11195963
TI  - [Intrahepatic cholestasis of pregnancy, an unpredictable fetal risk: report of a
      case and review of the literature].
AB  - This is a clinical case of intrahepatic cholestasis of pregnancy that developed
      fetal death few hours after a reactive non-stress test. A 35 year old woman who
      suffered intrahepatic cholestasis in two previous pregnancies with good outcome.
      In her last pregnancy she had again intrahepatic cholestasis with abnormal liver
      tests. The clinical evolution, as well as electronic fetal heart monitoring and
      ultrasonographic evolution were all normal except for the fetal growth that was
      restricted, but symmetric. At 35 4/7 weeks of gestation she developed prodromic
      uterine contractions and a non-stress test was normal. However, 8 hours later the
      patient returned for reexamination and the fetus was found dead and at birth was
      a symmetrically small male baby. The fetus' genetic study and placenta's
      histological study were both normal. The patient cholestasis was resolved few
      weeks later.

PMID- 11195964
TI  - Influenza in Canada--1999-2000 season.

PMID- 11195965
TI  - Two serologically non-groupable Neisseria meningitidis strains from clinical
      specimens identified by molecular method as serogroup B meningococci.

PMID- 11195966
TI  - Isolation, purification, and characterization of glutathione S-transferase from
      oat (Avena sativa) seedlings.
AB  - Glutathione S-transferase (GST) from oat seedlings was purified by ammonium
      sulfate precipitation and glutathione (GSH) affinity chromatography. Sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis revealed the presence of two
      major protein subunits with molecular masses of 29 and 31 kDa, respectively.
      Isoelectric focusing revealed a major band with pI of 3.43 and a minor band with
      pI of 7.42. Kinetic analysis with respect to 1-chloro-2,4-dinitrobenzene (CDNB)
      as substrate revealed a Km of 1.18 mM and Vmax of 0.94 micromol/min and a
      specific activity of 17.96 micromol/min/mg. Inhibition studies indicated that oat
      GST is strongly inhibited by chlorophyllin, hemin, and anthocyanin and only
      weakly by bilirubin and biliverdin.

PMID- 11195967
TI  - Native fluorescence and mag-indo-1-protein interaction as tools for probing
      unfolding and refolding sequences of the bovine serum albumin subdomain in the
      presence of guanidine hydrochloride.
AB  - Changes in the fluorescence spectrum of tryptophans Trp 134 and Trp 212 in bovine
      serum albumin (BSA) and of Trp 214 of human serum albumin in the presence of the
      chaotropic agent guanidine hydrochloride (Gnd) were studied. A detailed analysis
      of the fluorescence spectrum of native BSA yielded the fluorescence spectrum for
      each tryptophan of BSA. Modifications in the binding of Mag-indo-1 to BSA, which
      results in a specific quenching of the fluorescence spectrum of Trp 134
      associated with an energy transfer from Trp 134 to the protein-bound Mag-indo-1,
      were also investigated. Changes occurring when the Gnd concentration is decreased
      stepwise cover a larger concentration scale of Gnd than the reverse protocol,
      allowing one to suggest that the resulting conformational changes in the
      subdomain IA of BSA involve at least three different steps.

PMID- 11195968
TI  - Construction of a ferritin reactor: an efficient means for trapping various heavy
      metal ions in flowing seawater.
AB  - An apparatus consisting of two pumps, a mixer, a ferritin reactor, and a
      spectrophotometer was constructed to study the ability to trap various heavy
      metal ions (M2+) and the dynamics of a reconstituted ferritin reactor in flowing
      seawater. Reconstituted pig spleen ferritin (PSFr) is assembled from apo-protein
      shell to form a reconstituted iron core. The main components of the PSFr are its
      core, which contains an Fe2+:Pi stoichiometry of 6.0 +/- 0.5, reconstituted from
      pig spleen apoferritin (apo PSF), Fe2+, inorganic phosphate (Pi), and O2 (0.6
      atm). The Fe3+-Pi clusters within the PSFr core exhibit resistance to salt
      ranging from 1% to 6% NaCl. The ferritin reactor consists of PSFr and an
      oscillating bag. Using the reactor, M2+ ions such as Cd2+, Zn2+, Co2+, and Mn2+
      are directly trapped by the ferritin. We found a 1:2 +/- 0.2 stoichiometry of the
      trapped M2+ to the released iron as measured by chemical analysis or atomic
      absorption spectrometry; nontransient elements such as Na+, K+, Ca2+, etc., were
      scarcely trapped by the reactor. This study provides basic conditions for
      establishing a ferritin reactor and a convenient means for monitoring the
      pollution of heavy metal ions in seawater.

PMID- 11195969
TI  - Chaperone-mediated refolding of recombinant prochymosin.
AB  - It has been verified that prochymosin is characterized by a two-stage refolding:
      dilution of unfolded protein into pH 11 buffer followed by neutralization at pH
      8; the high-pH step is indispensable. Here we demonstrate that one-stage
      refolding around pH 8 can be achieved when GroE or 10-fold molar excess (rather
      than catalytic concentration) of protein disulfide isomerase (PDI) over
      prochymosin is present. The helping effect varies with the oxidation states of
      prochymosin. GroE and PDI increase the reactivation of the unfolded, partially
      reduced and the unfolded, oxidized prochymosin from 5% to 40% and from 50% to
      100%, respectively. For the unfolded and fully reduced prochymosin, GroE does not
      have a positive effect, whereas PDI promotes renaturation from 2% to 28%. Based
      on our previous and present observations, we propose that at pH 8 there may be
      two kinds of incorrect interactions within and between prochymosin polypeptides
      leading to unproductive pathways: one prevents disulfide rearrangement, which can
      be avoided by high pH; the other interferes with acquisition of native
      conformation, which can be relieved by GroE and PDI.

PMID- 11195970
TI  - Amino acid sequences of hemoglobin from guinea fowl (Numida meleagri) and
      California quail (Lophortyx californica) with phylogenetic analysis of major
      groups of Galliformes.
AB  - We determined the complete amino acid sequences of the hemoglobin of two species,
      guinea fowl and California quail, in Galliformes from intact globin chain and
      chemical cleavage fragments in order to analyze the molecular evolution of
      hemoglobin for the classification of Galliformes. Galliformes have two types of
      hemoglobin components, HbA and HbD, which consist of identical beta chain and
      different alpha chains. The sequences are similar to globin chains of Galliformes
      reported previously. These sequences were compared with those of other
      Galliformes (Phasianidae, Meleagrididae) using duck and goshawk as out-groups.
      The phylogenetic tree of major groups of Galliformes based on hemoglobin was
      similar to the tree model produced based on the amino acid sequence of lysozyme
      c.

PMID- 11195971
TI  - Effects of Ca2+ on the activity and stability of methanol dehydrogenase.
AB  - The effects of exogenously added Ca2+ on the enzymatic activity and structural
      stability of methanol dehydrogenase were studied for various Ca2+ concentrations.
      Methanol dehydrogenase activity increased significantly with increasing
      concentration of Ca2+, approaching saturation at 200 mM Ca2+. The effect of Ca2+
      on the activation of MDH was time dependent and Ca2+ specific and was due to
      binding of the metal ions to the enzyme. Addition of increasing concentration of
      Ca2+ caused a decrease of the intrinsic tryptophan fluorescence intensity in a
      concentration-dependent manner to a minimum at 200 mM, but with no change in the
      fluorescence emission maximum wavelength or the CD spectra. The results revealed
      that the activation of methanol dehydrogenase by Ca2+ occurred concurrently with
      the conformational change. In addition, exogenously bound Ca2+ destabilized MDH.
      The potential biological significance of these results is discussed.

PMID- 11195972
TI  - Light chain of botulinum A neurotoxin expressed as an inclusion body from a
      synthetic gene is catalytically and functionally active.
AB  - Botulinum neurotoxins, the most potent of all toxins, induce lethal neuromuscular
      paralysis by inhibiting exocytosis at the neuromuscular junction. The light
      chains (LC) of these dichain neurotoxins are a new class of zinc-endopeptidases
      that specifically cleave the synaptosomal proteins, SNAP-25, VAMP, or syntaxin at
      discrete sites. To facilitate the structural and functional characterization of
      these unique endopeptidases, we constructed a synthetic gene for the LC of the
      botulinum neurotoxin serotype A (BoNT/A), overexpressed it in Escherichia coli,
      and purified the gene product from inclusion bodies. Our procedure can provide
      1.1 g of the LC from 1 L of culture. The LC product was stable in solution at 4
      degrees C for at least 6 months. This rBoNT/A LC was proteolytically active,
      specifically cleaving the Glu-Arg bond in a 17-residue synthetic peptide of SNAP
      25, the reported cleavage site of BoNT/A. Its calculated catalytic efficiency
      kcat/Km was higher than that reported for the native BoNT/A dichain. Treating the
      rBoNT/A LC with mercuric compounds completely abolished its activity, most
      probably by modifying the cysteine-164 residue located in the vicinity of the
      active site. About 70% activity of the LC was restored by adding Zn2+ to a Zn2+
      free, apo-LC preparation. The LC was nontoxic to mice and failed to elicit
      neutralizing epitope(s) when the animals were vaccinated with this protein. In
      addition, injecting rBoNT/A LC into sea urchin eggs inhibited exocytosis
      dependent plasma membrane resealing. For the first time, results of our study
      make available a large amount of the biologically active toxin fragment in a
      soluble and stable form.

PMID- 11195973
TI  - Steady-state kinetic analysis of human ubiquitin-activating enzyme (E1) using a
      fluorescently labeled ubiquitin substrate.
AB  - We report the synthesis of fluorescently labeled ubiquitin (Ub) and its use for
      following ubiquitin transfer to various proteins. Using Oregon green (Og)
      succinimidyl ester, we prepared a population of Ub mainly labeled by a single Og
      molecule; greater than 95% of the Og label is associated with Lys 6 of Ub. We
      demonstrate that Og-Ub is efficiently accepted by Ub-utilizing enzymes, such as
      the human ubiquitin-activating enzyme (E1). We used this fluorescent substrate to
      follow the steady-state kinetics of human E1-catalyzed Ub-transfer to the
      ubiquitin-carrier enzyme Ubc4. In this reaction, E1 uses three substrates: ATP,
      Ubc4, and Ub. The steady-state kinetics of Og-Ub utilization by E1 is presented.
      We have also used analytical ultracentrifugation methods to establish that E1 is
      monomeric under our assay condition (low salt) as well as under physiological
      condition (150 mM NaCl).

PMID- 11195974
TI  - Kinetic characterization of the double mutant R148A/E182S of glycogen
      phosphorylase kinase catalytic subunit: the role of the activation loop.
AB  - Many protein kinases are activated by phosphorylation in a highly conserved
      region of their catalytic subunit, termed activation loop. Phosphorylase kinase
      is constitutively active without the requirement for phosphorylation of residues
      in the activation loop. The residue which plays an analogous role to the
      phosphorylatable residues in other protein kinases is Glu182, which makes
      contacts to a highly conserved Arg148. In turn, Arg148 adjacent to the catalytic
      Asp149, enabling information to be transmitted from the activation loop to the
      catalytic machinery. The double mutant R148A/E182S has been kinetically
      characterized. The mutation resulted in an approximate 16- to 22-fold decrease in
      the kcat/Km value of the enzyme. The kinetic data, discussed in the light of the
      structural data from previously determined complexes of the enzyme, lead to the
      suggestion that the activation loop has a major role in substrate binding but
      also in correct orientation of the groups participating in catalysis.

PMID- 11195975
TI  - Effects of denaturing and stabilizing agents on the inhibitory activity and
      conformational stability of Schizolobium parahyba chymotrypsin inhibitor.
AB  - The conformational stability of the Schizolobium parahyba chymotrypsin inhibitor
      (SPCI) was investigated based on conformational changes and inhibitory activity
      in the presence of chaotropic and stabilizing agents. At 90 degrees C, the half
      lifetime of SPCI was 154 min, while in the presence of 1 M KCl and 20% PEG
      20,000, it was drastically reduced to 6 and 3 min, respectively. In contrast, at
      90 degrees C, the SPCI structure remained unaltered with the addition of 1 mM DTT
      and 56% glycerol. The reduction of the two disulfide bonds caused conformational
      changes in the SPCI without altering the inhibitory activity, suggesting that
      disulfide bonds are irrelevant to the maintenance of SPCI conformation. Unfolded
      structures were formed in the presence of 6 M GdnHCl, while in the presence of 8
      M urea, destabilization was due to peptide bond rupture. These results suggest
      that the thermal inactivation of SPCI involves conformational changes and that
      hydrophobic and electrostatic interactions play a significant role, while the
      disulfide bonds are of secondary importance in maintaining the high thermal
      stability of SPCI.

PMID- 11195977
TI  - Binding study of riboflavin-binding protein with riboflavin and its analogues by
      differential scanning calorimetry.
AB  - Thermal unfolding parameters of hens' egg-white riboflavin-binding-protein (RBP)
      were measured by differential scanning calorimetry. Thermal denaturation scans of
      apoRBP and RBP complexes with riboflavin and its analogues (FMN, N10 DL-glyceryl
      isoalloxazine, and N10 omega-hydroxypentyl isoalloxazine) have been measured. It
      was found that ligand binding causes increase of RBP thermal stability, as
      manifested by a change of denaturation temperature from 60.8 degrees C for apoRBP
      to 72.8 degrees C for RBP-Rf complex. For RBP-FMN complex, the denaturation
      temperature of 73.0 degrees C was even higher than for the RBP-Rf complex. The
      other two flavin analogues showed transition temperatures in between 66.9 degrees
      C and 68.8 degrees C, respectively. Analysis of excess heat capacity data showed
      that the best fit was the sum of two independent thermal transitions. One of the
      transitions, which contributed approximately 70% to the total heat effect, has
      transition temperature in the broad range of 60.5-73.2 degrees C; the other
      transition temperature is in the narrower range of 65.4-71.1 degrees C. The
      observed transitions can be related to RBP domains.

PMID- 11195976
TI  - Purification and characterization of a trypsin-like enzyme with fibrinolytic
      activity present in the abdomen of horn fly, Haematobia irritans irritans
      (Diptera: Muscidae).
AB  - This work describes the purification and characterization of a trypsin-like
      enzyme with fibrinolytic activity present in the abdomen of Haematobia irritans
      irritans (Diptera: Muscidae). The enzyme was purified using a one-step process,
      consisting of affinity chromatography on SBTI-Sepharose. The purified protease
      showed one major active proteinase band on reverse zymography with 0.15% gelatin,
      corresponding to a molecular mass of 25.5 kDa, with maximum activity at pH 9.0.
      The purified trypsin-like enzyme preferentially hydrolyzed synthetic substrates
      with arginine residue at the P1 position. The Km values determined for three
      different substrates were 1.88 x 10(-4), 1.28 x 10(-4), and 1.40 x 10(-4) M for H
      alpha-benzoyl-Ile-Glu-Gly-Arg-p-nitroanilide (S2222), DL-Ile-Pro-Arg-p
      nitroanilide (S2288), and DL-Phe-Pip-Arg-p-nitroanilide (S2238), respectively.
      The enzyme was strongly inhibited by typical serine proteinase inhibitors such as
      SB

PMID- 11195978
TI  - Conformational studies of a melittin-inhibitor complex.
AB  - The conformation of a melittin-inhibitor complex was studied by solution NMR,
      solid-state NMR, and circular dichroism. In solution, binding was studied by
      titrating inhibitor against melittin in dimethyl sulfoxide, methanol, aqueous
      buffer, and dodecylphosphocholine micelles. The change in chemical shift of Trp19
      resonances and the formation of a precipitate at 1:1 molar ratio indicated that
      the inhibitor was bound to melittin. Solid-state NMR also showed a change in
      chemical shift of two labeled carbons of melittin near Pro14 and a change in 1HT1
      relaxation times when complexed with inhibitor. Rotational resonance experiments
      of melittin labeled in the proline region indicated a change in conformation for
      melittin complexed with inhibitor. This observation was also supported by
      circular dichroism measurements, indicating a reduction in alpha-helical
      structure for increasing ratios of inhibitor bound to melittin.

PMID- 11195979
TI  - Temperature, pH, and solvent isotope effects on cytochrome c peroxidase mutant
      N82A studied by proton NMR.
AB  - The mutant of baker's yeast cytochrome c peroxidase-CN with Ala82 in place of
      Asn82, [N82A]CcPCN, exhibits a complex solution behavior featuring dynamic
      interconversion among three enzyme forms that so far have only been detected by
      NMR spectroscopy. Proton NMR studies of [N82A]CcPCN reveal resonances from each
      of the three enzyme forms and show that the interconversion among forms is
      controlled by the pH, temperature, and isotope composition (H2O vs. D2O) of the
      buffer solution. No evidence for a key hydrogen bond between His52 and heme
      coordinated cyanide is found in any of the enzyme forms, indicating that
      disruption of the extensive distal hydrogen bonding network is the source of this
      phenomenon.

PMID- 11195980
TI  - The interaction between impulsivity and neighborhood context on offending: the
      effects of impulsivity are stronger in poorer neighborhoods.
AB  - This research blends 2 traditions of theorizing on the causes of crime, one
      focused on the role of individual differences and the other focused on structural
      and contextual variables. Two related studies examined the relations among
      impulsivity, neighborhood context, and juvenile offending. The first, cross
      sectional study uses a large sample of 13-year-old inner-city boys, whereas the
      second, longitudinal study offers a conceptual replication using 17-year-old
      inner-city boys who are a subset of the original sample. Across both studies,
      results indicate that the effects of impulsivity on juvenile offending are
      stronger in poorer neighborhoods. Furthermore, nonimpulsive boys in poor
      neighborhoods were at no greater risk for delinquency than nonimpulsive boys in
      better-off neighborhoods.

PMID- 11195981
TI  - Perceptual organization in schizophrenia: the processing of symmetrical
      configurations.
AB  - The hypothesis that the perceptual organization dysfunction of patients with poor
      premorbid schizophrenia is due to a deficit in global visual sensory store
      processing was tested by assessing their ability to process symmetrical
      configurations that develop early and have strong prepotent structures. Two same
      different judgment tasks in which performance varies as a function of the
      symmetrical organization and task demands were administered to participants with
      good and poor premorbid schizophrenia, those with mood disorders, and normal
      controls. Like the other groups, poor premorbid schizophrenics' latency and error
      response patterns closely paralled the a priori model of adequate processing. The
      results support their competence in perceptually processing symmetrical
      configurations and disconfirm the hypothesis that their input deficiencies
      represent a general deficiency in all forms of perceptual organization. The
      implications for specifying their early input dysfunction are discussed.

PMID- 11195982
TI  - Vulnerability to depression: cognitive reactivity and parental bonding in high
      risk individuals.
AB  - Although various conceptual proposals have suggested that disruptions in
      childhood bonding processes may be linked to the origins of these cognitive
      structures, little research has tested these proposals. This study assessed the
      information processing of vulnerable individuals and its relationship to
      childhood bonding. Formerly depressed (vulnerable) and never depressed
      (nonvulnerable) individuals participated in a mood induction task followed by an
      attentional allocation task. Results indicated that vulnerable individuals
      uniquely diverted attention toward negative stimuli when they were in a negative
      mood. Furthermore, level of maternal caring was found to be associated with
      performance on this task for vulnerable individuals in this mood state. These
      data support the idea that cognitive variables form a pathway between troublesome
      parental-child/adolescent interactions and depression.

PMID- 11195983
TI  - Phobia-relevant illusory correlations: the role of phobic responsivity.
AB  - The authors investigated the role of phobic responsivity in the generation of
      phobia-relevant illusory correlations. As a means of disentangling the
      contributions of prior fear and elicited fear responses, half of a group of
      phobic women received 1 mg alprazolam (n = 21), and half received a placebo (n =
      22). A group of nonfearful women (n = 24) was included to control for prior fear
      per se. Participants were exposed to slides of spiders, weapons, and flowers that
      were randomly paired with a shock, a siren, or nothing. Postexperimental
      covariation estimates and on-line outcome expectancies were assessed.
      Irrespective of both prior and elicited fear, participants postexperimentally
      overassociated spiders and shock. Yet, only women with spider phobia displayed a
      persisting fear-confirming expectancy bias. This bias was similar for the placebo
      and alprazolam groups. Thus, the bias appeared to be due to preexisting
      phobogenic beliefs, whereas phobic responsivity played a negligible role.

PMID- 11195984
TI  - Induced emotional interpretation bias and anxiety.
AB  - Five experiments are reported showing that the interpretation of personally
      relevant emotional information can be modified by systematic exposure to
      congruent exemplars. Participants were induced to interpret ambiguous information
      in a relatively threatening or a benign way. Comparison with a baseline condition
      suggested that negative and positive induction had similar but opposing effects.
      Induction of an interpretative bias did not require active generation of
      personally relevant meanings, but such active processing was necessary before
      state anxiety changed in parallel with the induced interpretative bias. These
      findings provide evidence consistent with a causal link between the deployment of
      interpretative bias and anxiety and reveal something of the processes underlying
      this association.

PMID- 11195985
TI  - Psychological and physiological predictors of response to carbon dioxide
      challenge in individuals with panic disorder.
AB  - Past studies in nonclinical samples have found that suffocation fear, but not a
      behavioral index of carbon dioxide (CO2) sensitivity (i.e., breath-holding
      duration), predicts anxious response to CO2 challenge. These associations were
      examined in individuals with panic disorder while adding more sensitive indices
      of CO2 sensitivity. Consistent with the earlier studies, the authors found that
      suffocation fear predicted anxious responding to CO2 challenge but breath-holding
      duration did not. However, highly precise measures of CO2 sensitivity, not
      included in earlier studies, did predict anxious challenge responding. These
      findings support the predictive value and possible etiological relevance of both
      specific psychological variables and physiological CO2 sensitivity in panic
      vulnerability. Further work is still needed to determine whether the findings are
      specific to panic disorder.

PMID- 11195986
TI  - Posttraumatic stress disorder and retrospectively reported stressor exposure: a
      longitudinal prediction model.
AB  - There has been recent concern about the degree to which posttraumatic stress
      disorder (PTSD) symptomatology influences reports of prior exposure to highly
      stressful life events. In this longitudinal study of 2,942 male and female Gulf
      War veterans, the authors documented change in stressor reporting across 2
      occasions and the association between change and PTSD symptom severity. A
      regression-based cross-lagged analysis was used to examine the relationship
      between PTSD symptom severity and later reported stressor exposure. Shifts in
      reporting over time were modestly associated with PTSD symptom severity. The
      cross-lagged analysis revealed a marginal association between Time 1 PTSD symptom
      severity and Time 2 reported stressor exposure for men and suggested that later
      reports of stressor exposure are primarily accounted for by earlier reports and
      less so by earlier PTSD symptomatology.

PMID- 11195987
TI  - Evidence for a genetic etiology of early-onset delinquency.
AB  - Age at onset of antisocial behavior discriminates persistent and transitory
      offenders. The authors proposed that early-onset delinquency has an underlying
      genetic influence that manifests in problems related to inhibition, whereas late
      onset delinquency is more environmentally mediated. To test these notions, they
      selected 36 early starters, 86 late starters, and 25 nondelinquent controls from
      a large sample of 11-year-old twins and compared them on several measures related
      to inhibition and a peer group measure. As expected, early starters had more
      psychological, behavioral, and emotional problems related to inhibition than late
      starters and controls. A longitudinal analysis indicated an increase an
      antisocial behavior among peers of late starters shortly before their delinquency
      onset. Family history data and a twin analysis provided evidence of greater
      genetic influence on early-onset than late-onset delinquency.

PMID- 11195988
TI  - Psychosocial predictors of the short-term course and outcome of major depression:
      a longitudinal study of a nonclinical sample with recent-onset episodes.
AB  - Three variables have been hypothesized to play important roles in prolonging the
      course of depressive episodes: a ruminative response style, significant
      interpersonal relationships, and childhood adversity. The authors examined
      whether these variables predicted the short-term course of major depressive
      disorder (MDD). Participants (n = 84) were college students with a recent-onset
      major depressive episode. Assessments included several interview and self-report
      measures, and data on interpersonal relationships were obtained from close
      confidants. Follow-up interviews were conducted 6 months later. After controlling
      for baseline severity, harsh discipline in childhood significantly predicted mean
      level of depression across the follow-up and level of depression at follow-up.
      Harsh discipline was also significantly associated with relapse but not with
      recovery. After controlling for baseline severity, rumination and the
      interpersonal variables did not predict the outcome of MDD.

PMID- 11195989
TI  - Are the discrepancies between self- and others' appraisals of competence
      predictive or reflective of depressive symptoms in children and adolescents: a
      longitudinal study, Part II.
AB  - Two cohorts of children and adolescents (who started 6th grade in 1993 and 1996),
      parents, teachers, and peers participated in a 4-wave, 2-year, longitudinal study
      of perceived competence and depressive symptoms. The authors assessed children's
      tendencies to underestimate their competence (discrepant self-appraisals)
      relative to the appraisals of significant others. We also assessed the degree to
      which self-appraisals reflected the evaluations of others (reflective self
      appraisals). Domains of competence were academic competence, physical appearance,
      behavioral conduct, social acceptance, and athletic competence. Cross-sectional
      analyses indicated that depressive symptoms correlated with reflective and
      discrepant self-appraisals. Longitudinal analyses revealed that reflective and
      discrepant self-appraisals predicted subsequent depressive symptoms and that
      depressive symptoms predicted discrepant but not reflective self-appraisals.
      Clinical implications of the findings are discussed.

PMID- 11195990
TI  - Memory illusions: false recall and recognition in adults with Asperger's
      syndrome.
AB  - As persons on the autistic spectrum are known not to use semantic features of
      word lists to aid recall, they might show diminished susceptibility to illusory
      memories that typically occur with lists of associated items. Alternatively,
      since such individuals also have poor source monitoring, they might show greater
      susceptibility. The authors found that adults with Asperger's syndrome (n = 10)
      recalled similar proportions of a nonpresented strong associate of the study list
      items, compared with controls (n = 15). In Experiment 2, rates of true and false
      recognition of study list associates did not differ significantly between
      Asperger (n = 10) and control (n = 10) participants. Moreover, the Asperger
      participants made fewer remember and more know judgments than controls for
      veridical but not for false recognitions. Thus, deficits found in some aspects of
      memory in people with Asperger's syndrome do not affect their susceptibility to
      memory illusions.

PMID- 11195991
TI  - Realism of confidence in obsessive-compulsive checkers.
AB  - The study examined whether obsessive-compulsive (OC) checkers have reduced
      confidence in their knowledge. OC checkers were compared with panic disorder (PD)
      patients and nonpatient controls using a calibration-of-knowledge procedure.
      Participants completed a general knowledge questionnaire, rated their confidence
      in each answer, and estimated the total number of correct answers. These
      responses were converted to 2 measures of confidence relative to performance-
      over/underconfidence and over/underestimation. OC checkers had lower scores than
      nonpatients did on both measures, whereas the PD patients did not differ from
      either group. For the OC checkers, relative confidence was inversely related to
      the severity of obsessions. The authors speculate that confidence may depend on a
      confirmation bias in testing hypotheses and that the reduced confidence in OC
      checkers may reflect a disconfirmation bias in this population.

PMID- 11195992
TI  - Prospective analysis of comorbidity: tobacco and alcohol use disorders.
AB  - Alcohol use disorders (AUD) and tobacco use disorders (TD) frequently co-occur.
      The authors examined AUD-TD comorbidity over time using a state-trait (ST) model.
      The ST model represents variance in AUD/TD as a traitlike factor that spans
      measurement occasion and identifies distinct sources of variance in AUD-TD
      comorbidity. The ST model was evaluated on 450 young adults (baseline age = 18.5
      years; 51% with family history of alcoholism) assessed 5 times over 7 years. The
      ST model demonstrated superior fit over a first-order autoregressive model. The
      tendency to diagnose with AUD and TD was partially explained by family history of
      alcoholism; this relationship was mediated by childhood stressors, alcohol
      expectancies, and behavioral undercontrol. Results supported a common third
      variable influence (vs. directional) model of comorbidity. The ST model is an
      important conceptual and methodological approach to the prospective study of
      comorbidity in general.

PMID- 11195993
TI  - Biases in eye movements to threatening facial expressions in generalized anxiety
      disorder and depressive disorder.
AB  - The study investigated biases in selective attention to emotional face stimuli in
      generalized anxiety disorder (GAD) and depressive disorder, using a modified
      probe detection task. There were 4 face types: threatening, sad, happy, and
      neutral. Measures of attentional bias included (a) the direction and latency of
      the initial eye movement in response to the faces and (b) manual reaction time
      (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results
      showed that individuals with GAD (without depressive disorder) were more likely
      to look first toward threat faces rather than neutral faces compared with normal
      controls and those with depressive disorder. They also shifted their gaze more
      quickly toward threat faces, rather than away from them, relative to the other
      two groups. There were no significant findings from the manual RT data.
      Implications of the results for recent theories of clinical anxiety and
      depression are discussed.

PMID- 11195994
TI  - Impaired positive inferential bias in social phobia.
AB  - People with social phobia report anticipatory and retrospective judgments about
      social situations that appear consistent with a negative interpretative bias.
      However, it is not at all clear that biased interpretative inferences are made
      "on-line;" that is, at the time that ambiguous information is first encountered.
      In a previous study, volunteers who were anxious about interviews were found to
      lack the positive on-line inferential bias that was characteristic of nonanxious
      controls but also failed to show a bias favoring threatening inferences (C. R.
      Hirsch & A. Mathews, 1997). This finding was confirmed in the present study, in
      which social phobic patients showed no evidence of making on-line emotional
      inferences, in contrast with socially nonanxious controls who were again clearly
      biased in favor of positive inferences. The authors concluded that nonanxious
      individuals are characterized by a benign on-line inferential bias, but that this
      is impaired in people with social phobia.

PMID- 11195995
TI  - Implicit memory bias for threat-relevant information in individuals with
      generalized social phobia.
AB  - The authors used a noise judgment task to investigate implicit memory bias for
      threat in individuals with generalized social phobia (GSP). Participants first
      heard neutral sentences (e.g., "The manual tells you how to set up the tent.")
      and social-threat sentences (e.g., "The classmate asks you to go for drinks.").
      Implicit memory for these sentences was then tested by asking participants to
      rate the volume of noise accompanying the presentation of these "old" sentences
      intermixed with "new" sentences that had not been previously presented. Implicit
      memory for old sentences is revealed when participants rate the noise
      accompanying old sentences as less loud than the noise accompanying new
      sentences. Those with GSP demonstrated an implicit memory bias for social-threat
      sentences, whereas controls did not. This differential priming effect suggests
      that information about threat may be automatically accessed in GSP.

PMID- 11195997
TI  - Aberrant semantic and affective processing in people at risk for psychosis.
AB  - Semantic and affective processing were examined in people at risk for psychosis.
      The participants were 3 groups of college students: 41 people with elevated
      Perceptual Aberration and Magical Ideation (PerMag) scores, 18 people with
      elevated Social Anhedonia (SocAnh) scores, and 100 control participants.
      Participants completed a single-word, continuous presentation pronunciation task
      that included semantically related words, affectively valenced words, and
      semantically unrelated and affectively neutral words. PerMag participants
      exhibited increased semantic priming and increased sensitivity to affectively
      valenced primes. SocAnh participants had increased sensitivity to affectively
      valenced targets.

PMID- 11195996
TI  - Increases in manic symptoms after life events involving goal attainment.
AB  - Bipolar disorder has been conceptualized as an outcome of dysregulation in the
      behavioral activation system (BAS), a brain system that regulates goal-directed
      activity. On the basis of the BAS model, the authors hypothesized that life
      events involving goal attainment would promote manic symptoms in bipolar
      individuals. The authors followed 43 bipolar I individuals monthly with
      standardized symptom severity assessments (the Modified Hamilton Rating Scale for
      Depression and the Bech-Rafaelsen Mania Rating Scale). Life events were assessed
      using the Goal Attainment and Positivity scales of the Life Events and
      Difficulties Schedule. As hypothesized, manic symptoms increased in the 2 months
      following goal-attainment events, but depressed symptoms were not changed
      following goal-attainment events. These results are congruent with a series of
      recent polarity-specific findings.

PMID- 11195998
TI  - Borderline personality: traits and disorder.
AB  - Although the 5-factor model (FFM) has been advocated as an alternative to
      representing the construct of borderline personality, some argue that this
      diagnosis carries essential information that is not well captured by the FFM. The
      present study examined antecedent, concurrent, and predictive markers of
      construct validity in a sample of 362 patients with personality disorders. The
      results indicated that neuroticism best distinguished borderline and
      nonborderline patients, whereas the FFM as a whole captured a sizable proportion
      of the variance in the borderline diagnosis. However, the residual of the
      borderline diagnosis that was not explained by the FFM was found to be
      significantly related to childhood abuse history, family history of mood and
      substance use disorders, concurrent symptoms, and 2-year and 4-year outcomes.
      Thus, some elements of the borderline diagnosis may not be fully captured in a 5
      factor representation.

PMID- 11196000
TI  - The paradox of normal neuropsychological function in schizophrenia.
AB  - Mounting evidence suggests that compromised neurocognitive function is a core
      feature of schizophrenia. However, some studies have found neuropsychologically
      normal schizophrenia patients. To address this apparent contradiction, we blindly
      rated individual neuropsychological profiles of 75 schizophrenia patients and 91
      control participants on the basis of methods developed by L. J. Seidman, S. V.
      Faraone, W. S. Kremen, J. R. Pepple, M. J. Lyons, and M. T. Tsuang (1993). Almost
      one-quarter of the patients were classified as neuropsychologically within normal
      limits (WNL). Despite significantly worse neuropsychological performance, WNL
      patients had higher estimated premorbid ability than did controls. Compared to a
      subset of controls matched on overall neuropsychological function, WNL patients
      had higher estimated premorbid ability and current IQs. Our results favor the
      view that even neuropsychologically normal schizophrenia patients have
      compromised cognitive function relative to their presumed expected or premorbid
      level of intellectual ability.

PMID- 11195999
TI  - Naltrexone's effects on reactivity to alcohol cues among alcoholic men.
AB  - The mechanisms of naltrexone's effects on urges to drink during abstinence are
      unclear. Naltrexone may suppress either urges to drink specifically or appetitive
      responses in general. The effects of naltrexone on cue reactivity to alcoholic
      and sweet nonalcoholic beverages were investigated. Alcohol-dependent men (N =
      53) in treatment received naltrexone (50 mg) or placebo. Four hours later, they
      received baseline assessment, exposure to fruit juice, and exposure to their
      usual alcoholic beverage in 3-min trials. Naltrexone reduced urge to drink and
      self-reported attention to the alcohol cues, not at the initial exposure but
      after repeated exposures to alcohol cues. Naltrexone reduced negative affect
      across baseline and alcohol trials. No effects of naltrexone on responses to the
      nonalcoholic appetitive beverage cues were found, suggesting that general
      appetite suppression does not mediate the effects of naltrexone on urges.

PMID- 11196001
TI  - Self-perceived competence and the relation between life events and depressive
      symptoms in adolescence: mediator or moderator?
AB  - In a 2-wave longitudinal study, 9th-grade students (N = 468) completed self
      report measures of stressful life events, depressive symptoms, and 5 domains of
      self-perceived competence (i.e., academic competence, social acceptance, physical
      appearance, behavioral conduct, and athletic competence). Teachers and peers also
      reported about the participants' depressive symptoms. In longitudinal analyses,
      negative (but not positive) events related to depressive symptoms. Results
      suggested that self-perceived competence served as a mediator (but not a
      moderator) of this relation. Negative events predicted changes in self-perceived
      competence. Self-perceived competence predicted changes in depressive symptoms.
      Also, the direct effect of negative events on depressive symptoms diminished
      after controlling for self-perceived competence.

PMID- 11196002
TI  - Contextual insensitivity in schizophrenic language processing: evidence from
      lexical ambiguity.
AB  - The authors investigated whether contextual failures in schizophrenia are due to
      deficits in the detection of context or the inhibition of contextually irrelevant
      information. Eighteen schizophrenia patients and 24 nonpsychiatric controls were
      tested via a cross-modal semantic priming task. Participants heard sentences
      containing homonyms and made lexical decisions about visual targets related to
      the homonyms' dominant or subordinate meanings. When sentences moderately biased
      subordinate meanings (e.g., the animal enclosure meaning of pen), schizophrenia
      patients showed priming of dominant targets (e.g., paper) and subordinate targets
      (e.g., pig). In contrast, controls showed priming only of subordinate targets.
      When contexts strongly biased subordinate meanings, both groups showed priming
      only of subordinate targets. The results suggest that inhibitory deficits rather
      than context detection deficits underlie contextual failures in schizophrenia.

PMID- 11196003
TI  - Dysfunctional thinking in major depressive disorder: a deficit in metacognitive
      monitoring?
AB  - Speed of response to attitudinal statements has predictive behavioral
      significance and reflects the relative contributions of "automatic" access to
      precomputed schematic representations and slower "controlled" on-line processing.
      Latencies to Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) and
      neutral statements were measured in 30 depressed patients and 30 nondepressed
      controls. For controls, responses incompatible with functional schemas were
      markedly slowed. This pattern of latencies is consistent with the operation of
      metacognitive monitoring of potential dysfunctional responses, dependent on
      limited controlled processing resources. For patients, there was no evidence of
      selective slowing for these or any other form of response. Results suggest that
      depressed patients have a deficit of metacognitive monitoring of dysfunctional
      cognitive products.

PMID- 11196004
TI  - Stressful life events, bipolar disorder, and the "kindling model".
AB  - A common misconception is that bipolar disorder is an endogenous process.
      However, previous research suggests a role for life events in the onset of and
      recovery from bipolar episodes. Yet, there remains some question as to whether
      the relationship between life events and onset changes over the course of the
      disorder as a result of the number of episodes an individual has experienced.
      Using a rigorous interview measure of stressful life events, the current study
      tested the kindling model (R. M. Post, 1992), which theorizes that major life
      events play a diminishing role over the course of illness in bipolar patients.
      Analyses revealed that the number of episodes experienced does not appear to have
      a significant effect on bipolar 1 patients' reactivity to external stressors. In
      addition, the results suggest that a more complex relationship exists among age,
      stress, and onset of new episodes than can be adequately explained by the
      kindling model.

PMID- 11196005
TI  - A comparison of two life stress assessment approaches: prospective prediction of
      treatment outcome in recurrent depression.
AB  - Research on life stress has been characterized by inconsistent results, which
      some researchers attribute to different assessment methodologies. Generally,
      studies have used either self-report checklists or investigator-based interviews.
      To test whether different results are derived from these approaches, the authors
      compared information from a self-report measure of life stress with the
      additional data available from a follow-up investigator-based measure in
      prospectively predicting the outcome of treatment for recurrent major depression.
      The 2 approaches produced different results, with investigator-based life events
      predicting lower probability of remission and self-report life events either
      predicting increased likelihood of remission or not predicting at all. The
      results demonstrated that methodology may account for some of the inconsistencies
      in the life stress literature.

PMID- 11196006
TI  - Expressed emotion and attributions in the relatives of bipolar patients: an
      analysis of problem-solving interactions.
AB  - Among the relatives of schizophrenic and depressed patients, high expressed
      emotion (EE) attitudes are associated with "controllability attributions" about
      the causes of patients' symptoms and problem behaviors. However, previous studies
      have judged EE attitudes and causal attributions from the same assessment
      measure, the Camberwell Family Interview (CFI; C. E. Vaughn & J. P. Leff, 1976).
      The authors examined causal attributions among relatives of 47 bipolar patients,
      as spontaneously expressed to patients in family problem-solving interactions
      during a postillness period. Relatives rated high EE during the patients' acute
      episode (based on the CFI) were more likely than relatives rated low EE to
      spontaneously attribute patients' symptoms and negative behaviors to personal and
      controllable factors during the postillness interactional assessment. Thus, the
      EE-attribution linkage extends to the relatives of bipolar patients evaluated
      during a family interaction task.

PMID- 11196007
TI  - Electroencephalographic asymmetries in adolescents with major depression:
      influence of comorbidity with anxiety disorders.
AB  - This study examined whether adolescents with major depressive disorder (MDD)
      display the abnormal electroencephalographic (EEG) alpha asymmetries found in
      depressed adults. Resting EEG was recorded in 25 right-handed female outpatients
      (19 with MDD, 11 of whom also had a current anxiety disorder; 6 with anxiety
      disorders only) and 10 non-ill controls. In contrast to the non-ill controls,
      adolescents having MDD but no anxiety disorder showed alpha asymmetry indicative
      of less activation over right than over left posterior sites. Within the MDD
      patient group, comorbid anxiety disorders reduced the posterior alpha asymmetry,
      supporting the potential importance of evaluating anxiety in studies of regional
      brain activation in adolescent MDD. These preliminary findings are similar to
      those from adult studies that suggest that MDD is associated with right
      parietotemporal hypoactivation.

PMID- 11196008
TI  - Psychiatric disorders and dissatisfaction with social relationships: does type of
      relationship matter?
AB  - The specificity of the association between 9 Axis I psychiatric disorders and
      quality of the relationship with spouse, relatives, and friends was evaluated for
      married participants who completed the Ontario Health Survey Mental Health
      Supplement (N = 4,933). When the authors controlled for the quality of other
      social relationships, not getting along with one's spouse was related to 6
      disorders, with the strongest associations found for generalized anxiety
      disorder, major depression, panic, and alcohol problems; 4 associations remained
      significant when they controlled for comorbid disorders. Not getting along with
      relatives and friends was generally unrelated to psychiatric disorders when they
      controlled for the other social relationships. Results indicate that the
      association between marital quality and psychiatric disorders is not an artifact
      of general social dissatisfaction and that this association is significant for
      several disorders.

PMID- 11196009
TI  - Child development after maternal tocolysis with beta-sympathomimetic drugs.
AB  - The psycho-social development of both preterm and term children whose mothers
      reported tocolytic treatment was assessed at the ages of 2, 4.5, and 8 years.
      Term children exposed to tocolysis showed a higher rate of psychiatric disorders
      as well as poorer cognitive and motor performance than controls. In the preterm
      children no adverse impact of tocolysis could be found. The results are discussed
      concerning possible ways in which tocolytic treatment may influence child
      development. Restrictions because of the preliminary character of this study and
      the need of further prospective studies to clarify the developmental impact of
      tocolysis are also considered.

PMID- 11196010
TI  - Risk factors in childhood that lead to the development of conduct disorder and
      antisocial personality disorder.
AB  - With juvenile crime on the rise, understanding and preventing juvenile
      delinquency is one of the greatest challenges facing mental health professionals
      today. Recognizing early signs of conduct disorder (CD) can be difficult, but
      identifying risk factors is an important step in preventing a child's progression
      to CD or Antisocial Personality Disorder (APD). This paper focuses on various
      risk factors for CD and APD, such as intrinsic individual differences,
      psychosocial/environmental factors, genetic and neurochemical factors. Early
      recognition and intervention may prevent the progression from aggressive and
      maladaptive behaviors to CD and later APD.

PMID- 11196011
TI  - Trauma and personality correlates in long-term pediatric cancer survivors.
AB  - To explore the relationship between PTSD and trauma-spectrum symptoms, including
      personality and functional correlates, in long term pediatric cancer survivors (N
      = 40), we assessed these constructs with a structured interview for PTSD, a
      clinical interview, and self-report questionnaires. Thirty-five out of 40
      participants (88%) currently met at least one trauma symptom at a functionally
      significant level. These survivors demonstrate high levels of restraint and low
      levels of distress, representative of a repressive adaptive style. After more
      than 5 years since treatment completion, the relatively high levels of current
      trauma-spectrum symptoms may reflect the long-term deleterious impact of
      childhood cancer.

PMID- 11196012
TI  - Implications of aggressive children's positively biased relatedness views for
      future relationships.
AB  - The present study examined the tendency of aggressive children to generalize the
      positive bias in their perceptions of relatedness across different interpersonal
      relationships. Secondly, it examined the implications of distorted perceptions of
      relatedness for quality of aggressive children's future relationships. Subjects
      included 62 second and third grade children nominated and rated by teachers as
      aggressive. Self- and others' appraisals of relationship quality were gathered
      across four interpersonal domains (i.e., mother, teacher, mentor, and peer).
      Children's positively biased perceptions of social relatedness were concordant
      across adult relationship domains but not across the peer domain, suggesting that
      children's relationships with adults and peers represent somewhat distinct
      socialization contexts. As expected, children who inflate levels of social
      relatedness establish less close relationships with novel partners (mentors). The
      findings emphasize the need for clinicians to focus on mental representations
      while planning interventions with aggressive children.

PMID- 11196013
TI  - Spatial orientation adjustments in children with autism in Hong Kong.
AB  - Abnormal spatial orientation and body postures in children with autism often
      interfere with visual abilities to attend tasks and social interactions. Twenty
      four children diagnosed with autism from Kowloon, Hong Kong were assessed for
      spatial orientation and spatial management abilities. Positive changes in spatial
      orientation were evident when the children wore ambient prism lenses and included
      changes in posture from slanted to erect. Adjustments in spatial management were
      evident in improved ball catching ability, a task requiring visual tracking and
      eye-hand coordination. The findings suggest that alterations to the sensory
      systems may lead to behavioral change in some children.

PMID- 11196014
TI  - Associated health risks of adolescents with disordered eating: how different are
      they from their peers? Results from a high school survey.
AB  - In this study, we compare health risks of adolescents with disordered eating to
      those of their peers without disordered eating. A self-report health survey from
      a community sample of 1769 high school students was used to compare emotional,
      medical, and social behaviors of these two groups. Risk data for disordered
      eating students was compared within and across genders. Adolescents with
      disordered eating are at increased risk for emotional and physical health
      problems compared to their peers. Overall health risks for boys and girls with
      disordered eating are quite similar. However, boys with disordered eating develop
      associated health risk profiles that differentiate them from male peers by having
      increased mental health, sexual and physical abuse, and general health problems.
      Girls with disordered eating have associated health risks for substance use and
      sexual risk-taking that distinguished them from their female peers.

PMID- 11196015
TI  - N232S, G741R and D778G beta-cardiac myosin mutants, implicated in familial
      hypertrophic cardiomyopathy, do not disrupt myofibrillar organisation in cultured
      myotubes.

PMID- 11196016
TI  - Give a dog a bad name--the story of DDT.

PMID- 11196017
TI  - 1999 HIV surveillance result--little grounds for pessimism.

PMID- 11196018
TI  - Registry: unusual HIV transmission in children under the age of 10 years.

PMID- 11196019
TI  - Russian and Cape health partners.

PMID- 11196020
TI  - Discrimination beyond the grave.

PMID- 11196021
TI  - Commitment more than skin deep.

PMID- 11196022
TI  - Mabasa leads a new struggle.

PMID- 11196023
TI  - Prevention of vertical transmission of human immunodeficiency type 1 virus in a
      managed care setting.

PMID- 11196024
TI  - Re-use of single-use disposable instrumentation.

PMID- 11196025
TI  - The Jaipur paradigm--a conceptual framework for understanding social
      susceptibility and vulnerability to HIV.

PMID- 11196026
TI  - Another unfortunate interpretation of section 7(2) of the Employment Equity Act.

PMID- 11196027
TI  - Emerging glycopeptide resistance in gram-positive organisms.

PMID- 11196028
TI  - The role of clinical assessment in the prevention of osteoporotic fractures.

PMID- 11196029
TI  - Chronic glucocorticoid therapy and osteoporosis--an under-recognised problem in
      South Africa.

PMID- 11196030
TI  - Vancomycin-resistant Staphylococcus aureus occurs in South Africa.

PMID- 11196031
TI  - A case of vancomycin-resistant enterococcal endocarditis.

PMID- 11196032
TI  - Ewart's sign in tuberculous pericarditis.

PMID- 11196033
TI  - Prevalence of nasopharyngeal antibiotic-resistant pneumococcal carriage in
      children attending private paediatric practices in Johannesburg.
AB  - OBJECTIVES: To determine the nasopharyngeal carriage rate, serogroups/types, and
      antibiotic resistance of Streptococcus pneumoniae in children attending
      paediatric practices in the private sector in Johannesburg and to relate patterns
      of resistance to antimicrobial exposure and other demographic characteristics in
      individual children. DESIGN: A total of 303 children aged from 1 month to 5 years
      were recruited from eight private paediatric practices in northern Johannesburg.
      Nasopharyngeal samples were taken and parent interviews were conducted. RESULTS:
      Pneumococci were isolated from 121 children (40%). The most common serotypes were
      6B, 19F, 6A, 23F, 14, and 19A. Carriage was significantly associated with prior
      hospital admission (odds ratio 1.89) and day care attendance (odds ratio 2.31)
      and was negatively associated with antibiotic use within the previous 30 days.
      Antibiotic resistance was found in 84 isolates (69.4%); 45 (37.2%) were multiply
      resistant. One-third of the pneumococci showed intermediate level resistance to
      penicillin and 12.4% were highly resistant. There was a high level erythromycin
      resistance in 38% of the isolates. A total of 94/214 children (42%) had recently
      used antibiotics and were four times more likely to carry antibiotic-resistant
      pneumococci (P < 0.05). CONCLUSION: Pneumococcal resistance was significant in
      this group of children with easy access to paediatric services and antibiotic
      use. The implication of such high resistance for the treatment of pneumococcal
      diseases is that high-dose amoxicillin is the preferred empirical oral therapy
      for treatment of otitis media. Ceftriaxone or cefotaxime should be used in
      combination with vancomycin for the treatment of meningitis until a cephalosporin
      resistant pneumococcal cause is excluded. Intravenous penicillin or ampicillin
      will successfully treat pneumococcal pneumonia in this population. Antimicrobial
      resistance among pneumococci colonising children in the private sector has
      increased dramatically in recent years.

PMID- 11196034
TI  - Perimenopausal wrist fracture--an opportunity for prevention and management of
      osteoporosis.
AB  - OBJECTIVE: Review of Medscheme's administrative databases to study the
      relationship between hip fracture and previous wrist fracture in peri- and
      postmenopausal women. DESIGN: Retrospective analysis of 1995-1998 data for women
      aged 50 and above hospitalised for management of wrist fracture. Those identified
      were subjected to further review to establish rates of osteoporosis and/or hip
      fracture. Osteoporosis and/or hip fracture rates were also determined for a
      control population. MAIN OUTCOME MEASURES: Osteoporosis investigation and
      management rates in controls v. subjects who had experienced a previous wrist
      fracture. RESULTS: A total of 701 subjects was admitted to hospital for
      management of a wrist fracture between 1995 and 1998; and compared with 1,385
      similarly aged controls. Diagnosis of osteoporosis and admission for hip fracture
      were more common in women who had experienced a previous wrist fracture (relative
      risk (RR) 1.55; 95% confidence interval (CI) 1.19-2.03 for osteoporosis, and RR
      3.32; 95% CI 1.16-9.69 for hip fracture). Of 10 hip fractures which occurred in
      the wrist fracture group, 9 were in women not diagnosed as having, or treated
      for, osteoporosis. CONCLUSION: While women with a history of wrist fracture are
      more likely than controls to be tested and treated for osteoporosis, it
      nevertheless appears that insufficient attention is being paid to this
      premonitory event.

PMID- 11196035
TI  - Monitoring and management of bone status in patients on chronic glucocorticoid
      treatment--the Medscheme experience.
AB  - OBJECTIVE: Review of administrative databases to gain insight into the
      investigation, management and sequelae of bone disease in patients on long-term
      glucocorticoid treatment. DESIGN: Retrospective analysis of 1998 pharmaceutical
      and clinical claims data for +/- 2 million lives administered by Medscheme. Data
      were extracted for members registered with the chronic medication programme as
      eligible for chronic glucocorticoid treatment. Those identified were subjected to
      further review for evidence of osteoporosis and/or hip fracture. Subgroup
      analysis of peri- and postmenopausal women was carried out and compared against a
      control group. MAIN OUTCOME MEASURES: Osteoporosis investigation and treatment
      rates in males and females; frequency of hip fractures; prescribing profiles;
      role of underlying disease, glucocorticoid route, gender and age in development
      of osteoporosis. RESULTS: A total of 1,614 subjects (54% females) was registered
      for chronic glucocorticoid treatment. Osteoporosis was diagnosed in 14.1% of
      females and 5.9% of males across a broad age range. Hip fractures were recorded
      for one female and three males. The subgroup analysis showed that osteoporosis
      was +/- 1.5 times more common in women receiving glucocorticoids than in peri-
      and postmenopausal controls, and that there was greater use of vitamin D and
      calcium supplementation and bisphosphonates in those exposed to glucocorticoids.
      Multivariate analysis showed overall that female gender, increasing age and oral
      glucocorticoids were significantly related to osteoporosis. CONCLUSION: Reference
      to UK and US data suggests that while local practitioners are aware of the effect
      of glucocorticoids on bone, the level of awareness is probably suboptimal,
      especially with regard to male patients.

PMID- 11196036
TI  - Empiric treatment based on Helicobacter pylori serology cannot substitute for
      early endoscopy in the management of dyspeptic rural black Africans.
AB  - BACKGROUND: Evidence that chronic gastric Helicobacter pylori (HP) infection is
      an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and
      lymphoma has led to the suggestion that all serologically positive dyspeptic
      patients should be treated empirically with antibiotics to eradicate the
      infection, without endoscopic diagnosis. The following study was performed to
      determine whether such a policy would prove to be of benefit in rural Africa,
      where endoscopic facilities are lacking and infection rates high. METHODS: Four
      district clinics were visited and 97 consecutive patients with persistent upper
      gastro-intestinal symptoms studied. After history-taking and physical
      examination, a blood sample was taken for HP serology (IgG anti-HP EIA) and
      endoscopy was performed. RESULTS: In comparison with similar studies in
      westernised countries HP was considerably more common (80%), and similar to that
      reported for the background population (83-86%), but peptic ulceration (17%) and
      gastric cancer (1%) were not. HP status and antibody levels failed to predict the
      presence of serious disease; patients with 'alarm' signs (78%), cancer (78%) and
      peptic ulcers (81%) had similar seropositivity rates to patients with non-ulcer
      dyspepsia (81%). Interestingly, many patients with distal oesophagitis were
      seronegative (40%). Haemoglobin concentrations and nutritional status were
      similar in HP-positive and negative patients. On the basis of published decision
      analysis strategies, empiric treatment of HP-positive patients with uncomplicated
      dyspepsia could be expected to produce symptomatic relief in 50% of cases, but
      would have delayed the diagnosis of 3 cases of cancer if patients over the age of
      45 were included. CONCLUSION: The lack of association between HP serology and
      upper gastro-intestinal disease indicates that serological investigation cannot
      substitute for endoscopy in the management of black Africans with dyspepsia, and
      that empiric anti-HP therapy cannot be justified.

PMID- 11196037
TI  - Nutritional status of patients in a long-stay hospital for people with mental
      handicap.
AB  - OBJECTIVE: To investigate the general nutritional status of patients in Alexandra
      Hospital, Cape Town, and to determine whether dietary copper deficiency was
      causing anaemia in hospital patients. DESIGN: Descriptive and cross-sectional
      analytical studies. SETTING: A long-stay hospital for people with mental
      handicap. SUBJECTS: Information was obtained from the total hospital population.
      In addition, groups of 15 patients were selected from each of two specific wards,
      one with active and the other inactive patients. To determine whether copper
      deficiency was causing anaemia, a sample of 30 patients, divided into three
      groups (a hypochromic microcytic, a normochromic anaemic and a non-anaemic group)
      was studied. MAIN OUTCOME MEASURES: Body mass indices (BMI) and daily dietary
      intakes were compared with Recommended Daily Allowance (RDA) values. Serum copper
      and serum caeruloplasmin levels were used to detect possible copper deficiency.
      RESULTS: A considerable number of patients were found to be underweight (32% of
      males and 26% of females had BMIs < 20). A smaller number were obese (6% of males
      and 17% of females had BMIs > 30). Poor nutrition was more common in severely
      handicapped patients and those with acquired causes of their mental handicap.
      Subjects with Down syndrome were generally well nourished and occasionally obese.
      Poor dietary intakes of biotin, pantothenic acid, vitamin D and copper were
      encountered. The serum copper and caeruloplasmin values were found to be within
      normal limits. Patients with hypochromic, microcytic anaemia had higher serum
      copper and caeruloplasmin levels than those with normochromic anaemia and the
      control group. CONCLUSIONS: A number of nutritional problems among the inpatient
      population were found. Many were undernourished, while a smaller number of
      patients were overweight. In both the active and inactive wards macronutrient
      intakes were generally within normal limits. However, some micronutrient
      nutritional deficiencies were encountered. We were unable to establish that
      dietary copper deficiency was the cause of anaemia in our patients. Elevated
      serum copper and caeruloplasmin levels found in hypochromic, microcytic patients
      were thought to result from the existence of low-grade infection, associated with
      elevation of the acute-phase protein, caeruloplasmin.

PMID- 11196038
TI  - Critically ill obstetric and gynaecological patients in the intensive care unit.
AB  - OBJECTIVES: To document mortality among critically ill obstetric and
      gynaecological patients requiring intensive care unit (ICU) admission and to
      investigate whether any poor prognostic features could allow for earlier and more
      aggressive intervention. STUDY DESIGN: A retrospective study of all obstetric and
      gynaecological patients admitted to the ICU of Johannesburg Hospital between 1985
      and 1996. Sixty-one patients were analysed both as a group and as two subgroups-
      those with incomplete abortions and those with other pregnancy-related diagnoses.
      RESULTS: Derangements in platelet counts, serum creatinine levels and prothrombin
      international normalised ratio (INR) were present in all patients on the day of
      admission to hospital. In the group with incomplete abortions absolute levels of
      these parameters may be used to identify those patients with a worse outcome. The
      mortality rate was 38%. CONCLUSION: Early ICU admission and aggressive surgical
      intervention are strongly recommended in patients with septic incomplete
      abortions presenting with more than a single organ dysfunction.

PMID- 11196039
TI  - Motorcycle taxi drivers and sexually transmitted infections in a Peruvian Amazon
      City.
AB  - BACKGROUND: In Iquitos, Peru, motorcycle taxis are a common form of public
      transportation used both by residents and visitors. GOAL: To evaluate the
      prevalence of factors associated with sexually transmitted disease risk and of
      Neisseria gonorrhoeae and Chlamydia trachomatis infections among motorcycle taxi
      drivers working in Iquitos, Peru. STUDY DESIGN: A convenience sample of
      motorcycle taxi drivers was recruited through street outreach. Participants were
      confidentially interviewed and provided urine specimens for gonococcal and
      chlamydial infection testing. RESULTS: A history of sexually transmitted disease
      (62%) or symptoms in the past year (35%) and of referral of clients to commercial
      sex workers (60%) was common. The prevalence of gonococcal or chlamydial
      infection was 3.5%. CONCLUSIONS: Motorcycle taxi drivers are a major means of
      public transportation in Iquitos, Peru, have high personal risks for sexually
      transmitted disease, and interface often with at-risk persons.

PMID- 11196040
TI  - Patterns of chlamydia and gonorrhea infection in sexual networks in Manitoba,
      Canada.
AB  - BACKGROUND: The use of sexual network analysis has the potential to further our
      understanding of sexually tranmitted disease (STD) epidemics and contribute to
      the development of more effective targeted control strategies. GOAL: To use
      sexual network analysis to study transmission patterns of chlamydia and gonorrhea
      in Manitoba, Canada. STUDY DESIGN: Routinely collected case/contact information
      gathered by public health nurses was used to construct the sexual network.
      RESULTS: Components within the sexual network ranged in size from 2 to 82 people.
      Two types of components, designated radial and linear, were described. Large
      linear components resembled the theoretical structure of STD core groups.
      Geographic analysis of the largest components demonstrated the potential for STD
      transmission between isolated rural communities and within different areas of an
      urban center. CONCLUSIONS: The application of sexual network analysis on a
      provincial basis demonstrated the importance of a centralized, coordinated
      approach to STD control. The analysis highlights the need for a greater
      understanding of the causative factors promoting the formation of different
      component types, the homogeneity and heterogeneity of behaviors within and
      between components, and the temporal stability of these patterns.

PMID- 11196041
TI  - Networks and pathogens.

PMID- 11196042
TI  - An unusual transmission of Neisseria meningitidis: neonatal conjunctivitis
      acquired at delivery from the mother's endocervical infection.
AB  - BACKGROUND: Primary meningococcal conjunctivitis is assumed to be due to the
      direct inoculation of Neisseria meningitidis into the conjunctival sac from an
      exogenous source. According to a literature review, no case of neonatal
      conjunctivitis infection acquired at delivery from maternal endocervicitis has
      been published. GOAL: To report a case of meningococcal neonatal conjunctivitis
      acquired at delivery because of the mother's endocervical infection and cross
      transmission of the strain with her partner. STUDY DESIGN: Strains were
      characterized by bacteriologic and serologic methods including grouping
      (agglutination), typing, and subtyping (enzyme-linked immunoabsorbent assay).
      Molecular analysis was done by pulsed-field gel electrophoresis. RESULTS: The
      three strains (newborn infant, mother, partner) were of the same antigenic
      formula (C:NT:P1.NT) and exhibited similar NheI and SpeI pulsed-field gel
      electrophoresis patterns. CONCLUSION: The identical phenotypic and genomic
      analysis of strains is the evidence for N meningitidis transmission at delivery
      from a maternal endocervical infection to the newborn infant and cross
      transmission between sexual partners.

PMID- 11196043
TI  - Unsuspected gonorrhea and chlamydia in patients of an urban adult emergency
      department: a critical population for STD control intervention.
AB  - BACKGROUND: Urban emergency departments (EDs) providing services to patients at
      high risk for sexually transmitted infection may be logical sites for
      intervention. GOAL: To determine the prevalence of gonorrhea (GC) and chlamydia
      (CT) in an adult ED patient population, and to assess risk factors for infection.
      STUDY DESIGN: Cross-sectional study of patients aged 18 to 44 in an urban ED,
      seeking care of any medical nature. Main outcome was positive for GC or CT by
      urine ligase chain reaction assay. RESULTS: Test results for GC and/or CT were
      positive in 13.6% of 434 18 to 31 year-olds and in 1.8% of 221 32 to 44 year
      olds. Of 63 infected individuals identified by the study, 15 (23.8%) were treated
      at the ED visit. Age < or =31 detected 88% of infections. Among 18- to 31-year
      old patients, predictive risk factors by multivariate analysis included age <25,
      >1 sex partner in the past 90 days, and a history of sexually transmitted
      disease. CONCLUSION: This study identified a high prevalence of GC and CT in
      patients seeking ED services. Many of these infections were clinically
      unsuspected. These data demonstrate that the ED is a high-risk setting and may be
      an appropriate site for routine GC and CT screening in 18- to 31-year-old
      patients.

PMID- 11196044
TI  - Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless
      adolescent population.
AB  - BACKGROUND: High rates of unprotected intercourse and illegal drug use have been
      reported among homeless adolescents. As a transient population with the potential
      to act as disease vectors from one location to another, incidence and prevalence
      of sexually transmitted infections in this population are of particular concern.
      GOAL: To assess a homeless adolescent population for incidence and prevalence of
      Chlamydia trachomatis, herpes simplex virus type 2, hepatitis B virus, hepatitis
      C virus, HIV, and psychosocial correlates of the acquisition of sexually
      transmitted infections. STUDY DESIGN: Longitudinal with assessments at baseline,
      3 months, and 6 months (n = 536; 319 males and 217 females). RESULTS: Baseline
      prevalence of C trachomatis was 4.17% for males and 6.30% for females. Prevalence
      of herpes simplex virus type 2 was 5.73% for males and 12.50% for females.
      Hepatitis B virus and hepatitis C virus prevalences were 3.60% and 5.0%,
      respectively. HIV seroprevalence was 0.3%. The incidence of sexually transmitted
      infections was significantly higher among females than among males (16.7% versus
      9.8%) and was associated with inconsistent condom use and, for females, number of
      partners and sex with older partners. Incident hepatitis B virus and hepatitis C
      virus infection rates were 3.44% and 6.61%, respectively; both were associated
      with injection drug use. CONCLUSIONS: Among females, the incidence of herpes
      simplex virus type 2 (> 25%) and C trachomatis (12%) was relatively high.
      Inconsistent condom use was the primary factor associated with a significantly
      greater risk of incident sexually transmitted infections. This was especially
      true for females with multiple partners. Homeless adolescents also are at high
      risk for hepatitis B virus and hepatitis C virus infection, primarily associated
      with self-reported injection drug use.

PMID- 11196045
TI  - Are emergency departments the next frontier for sexually transmitted disease
      screening?

PMID- 11196046
TI  - Implementation of a screening program for chlamydial infection in incarcerated
      adolescents.
AB  - BACKGROUND: In collaboration with the Houston Department of Health and Human
      Services, the authors implemented and evaluated a urine-based chlamydia screening
      program in incarcerated youth in Harris County, Texas, and assessed predictor
      variables for infection. GOAL: To implement and evaluate chlamydia screening in
      incarcerated youth. STUDY DESIGN: The authors determined prevalence of chlamydial
      infection, treatment rates, and predictor variables in 589 youth and repeated the
      measures 6 months later in 975 additional youth. RESULTS: Initially, the
      prevalence of infection was 9.6% in males and 28.1% in females; 88% of infected
      youth were treated while incarcerated. White males had a significantly lower
      prevalence of chlamydial infection; however, consistent condom use was not
      associated with a lower prevalence of chlamydia. In the 6-month assessment of
      chlamydia prevalence in 975 youth, prevalence and treatment rates remained high
      and predictor variables were similar. CONCLUSION: The authors instituted a
      screening program for chlamydial infection in incarcerated youth that was
      performing well at reassessment 6 months later.

PMID- 11196047
TI  - Herpes simplex virus type 2 seroepidemiology in Spain: prevalence and
      seroconversion rate among sexually transmitted disease clinic attendees.
AB  - BACKGROUND: Only limited data on the seroprevalence of herpes simplex virus type
      2 (HSV-2) are available from European countries. Until recently, serologic tests
      for HSV-2 serotyping have been hampered by cross-reactivity to type-common
      antigens. The present study aims at providing data on the prevalence of HSV-2
      infection in a group of STD clinic attendees using a reliable type-specific
      immunoassay. GOAL: To evaluate the seroprevalence of HSV-2 and the accumulated
      incidence of clinical genital herpes infection in a sample of Spanish sexually
      transmitted disease (STD) clinic attendees. STUDY DESIGN: The study consisted of
      two parts. First, a cross-sectional study of HSV-2 seroprevalence was conducted
      in patients with STDs. Second, a prospective cohort study was undertaken to
      evaluate the accumulated incidence of infection by HSV-2 and of clinical episodes
      of genital herpes in HSV-2-negative patients included in the first study during a
      follow-up period of 6 to 18 months. RESULTS: Of the 374 patients (129 men, 245
      women) studied, 25% were seropositive for HSV-2 (12% of men, 30% of women).
      Antibodies to HSV-2 were related to female gender (odds ratio, 2.7; P < 0.001)
      and to the number of sexual partners (odds ratio, 4.1; P < 0.001). Fifty-two
      percent of patients (145 of 281 patients) who were initially seronegative
      returned to the clinic for a second serologic testing, of whom 1% (2 of 145
      patients) had seroconverted. None of the patients developed genital herpes during
      the follow-up period. CONCLUSION: The relatively high seroprevalence (25%) and
      the low rate (4%) of HSV-2 previously reported in the general population in Spain
      suggest that the virus circulation may be restricted to certain risk groups.
      Therefore, future healthcare measures may target specific groups, such as
      patients with STDs.

PMID- 11196048
TI  - Slow diffusion of home HIV-specimen collection: provider concerns at odds with
      client preferences.
AB  - BACKGROUND: Home specimen collection and telephone counseling (HSCTC) may be a
      convenient new method for detection of HIV infection among cohorts at high-risk
      for HIV. GOAL: To evaluate attitudes about HSCTC among participants, HIV
      counselors, and community advisory board members associated with a national
      multisite study of persons at high risk for HIV. STUDY DESIGN: Twelve focus
      groups and surveys were conducted at six sites among 126 counselors, community
      advisory board members, and cohort participants. RESULTS: Staff and community
      advisory board members raised concerns about the acceptability, feasibility,
      safety, and effectiveness of HSCTC. In contrast, participants (92%) reported a
      willingness to collect blood and oral samples on a frequent basis, and preferred
      telephone (73%) to office-based counseling. CONCLUSION: Home specimen collection
      and telephone counseling appear to be preferred by study participants at high
      risk of HIV infection. Staff and community advisory board members had stronger
      reservations than prospective users.

PMID- 11196049
TI  - Curable sexually transmitted infections among the clientele of a family planning
      clinic in Istanbul, Turkey.
AB  - BACKGROUND: Integrating screening and treatment of sexually transmitted
      infections into existing family planning programs can be a good way to fight this
      problem. Also, the number of studies on the prevalence of certain sexually
      transmitted infections in this population in Turkey is limited. GOAL: To find out
      the prevalence of the most common sexually transmitted infections among the
      clients of an urban family planning clinic and to evaluate demographic
      characteristics and clinical signs related to sexually transmitted infections.
      STUDY DESIGN: Samples for Chlamydia trachomatis, Neisseria gonorrhoeae, and
      Trichomonas vaginalis were collected from 569 women who attended the clinic from
      December 15, 1997 to March 31, 1998. RESULTS: No case of N gonorrhoeae was found
      among the samples. The prevalence of C trachomatis infection was 1.9%, whereas
      the prevalence of of T vaginalis was 2.6%. None of the demographic
      characteristics or clinical signs was related to these infections. CONCLUSION:
      Larger studies using more sensitive laboratory tests are needed to determine the
      prevalence of chlamydial infections in family planning clinics in Turkey.

PMID- 11196050
TI  - [Evaluation of cognitive disorders and screening of delirium in cancer patients
      receiving morphine. Comparison of the use of the Elementary Test of
      Concentration, Orientation and Memory (TELECOM)and of the Mini-Mental State
      Examination (MMSE)].
AB  - OBJECTIVE: The Mini Mental State Examination (MMSE) is the gold standard
      cognitive test for screening delirium in cancer patients on opioids. But the MMSE
      is long and requires writing, reading and drawing from patients with various
      degrees of physical inability. Age and educational level affect the MMSE score.
      The Blessed Orientation-Memory-Concentration (BOMC) test is strictly oral and
      brief. This six item test is not affected by age or educational level. PATIENTS
      AND METHODS: We conducted a validation study of BOMC for screening delirium in
      cancer patients taking opioids. One physician examined 25 advanced cancer
      patients 34 times with MMSE and BOMC. Diagnosis of delirium was made by the same
      examiner according to the DSM IV criteria. The MMSE score was used for diagnosis
      of cognitive failure. RESULTS: Seventy-six percent of the patients completed the
      MMSE and 100% the BOMC. Scores of the two tests were correlated (0.71). An
      average 4 min 12 sec was gained with BOMC compared with MMSE. For a 10/11 cutoff,
      the BOMC had 83% sensitivity and 95% specificity for delirium diagnosis. Positive
      and negative predictive values were 91%. The time for the BOMC was correlated
      with BOMC score (0.6). A BOMC time of 3 min 20 sec had 91% sensitivity and
      specificity for delirium diagnosis. CONCLUSION: BOMC is more applicable than MMSE
      for screening delirium in cancer patients. The relationship between BOMC time and
      delirium deserves further investigations.

PMID- 11196051
TI  - [Facial diplegias during pregnancy].
AB  - BACKGROUND: Facial diplegia is a rare event, most commonly of unknown origin. We
      report the case of a woman who presented bilateral Bell's palsy a few days after
      a normal delivery. CASE REPORT: Five days after the delivery of gemellary
      pregnancy, a 34-year old woman developed complete bilateral facial palsy. No
      treatment was initially prescribed. She was first seen in our department two
      weeks after the onset of her illness. The diagnostic work-up was negative and we
      considered that our patient had bilateral Bell's palsy. Treatment with
      methylprednisolone and intravenous acyclovir, initiated since admission, have had
      very limited effect. DISCUSSION: As has already been shown for facial palsy,
      idiopathic facial diplegia, although exceptional, seems to be more frequent
      during the last trimester of pregnancy and in the early puerperium. Seven cases
      have been reported in the literature over the last 30 years. We discuss here the
      pathophysiology.

PMID- 11196053
TI  - [A new sign of chronic stomach volvulus in an elderly patient: an anterior gait
      desequilibrium].

PMID- 11196052
TI  - [Reversible pulmonary hypertension in Basedow's disease].
AB  - BACKGROUND: An association between pulmonary hypertension and hyperthyroidism has
      been described. An autoimmune mechanism is usually advocated but a direct effect
      thyroid hormones on the pulmonary vascular system is also suggested. CASE REPORT:
      A 49-year-old woman with a history of Graves' disease was admitted for sudden
      dyspnea. There was no evidence of ischemic stroke and the electrocardiogram and
      cardiac enzymes were normal. The lung scintiscan did not show any sign of
      pulmonary embolism. The chest computed tomography was normal. Doppler
      echocardiography found pulmonary hypertension with systolic pulmonary artery
      pressure of 68.7 mmHg. Thyroid function tests showed hyperthyroidism with
      recurrent Graves' disease. Pulmonary hypertension markedly decreased after the
      euthyroid state was achieved with antithyroid therapy. DISCUSSION: This patient
      had pulmonary hypertension associated with hyperthyroidism due to Graves'
      disease. The rapid reversibility of pulmonary hypertension in this case after the
      achievement of the euthyroid state suggest a pathogenic link between these two
      disorders and a possible direct effect of thyroid hormones on the pulmonary
      vascular system.

PMID- 11196054
TI  - [Gastrointestinal and thyroid localizations of a MALT lymphoma].

PMID- 11196055
TI  - [Broncho-pulmonary colonization by Enteromonas hominis in gastroesophageal
      reflux].

PMID- 11196056
TI  - [Dietary fiber or calcium supplementation does not prevent the recurrence of
      colonic adenomas].

PMID- 11196057
TI  - [Concerning the creation of neurovascular units].

PMID- 11196058
TI  - [Cannabis arteriopathy].

PMID- 11196059
TI  - [An innocent speed selector].

PMID- 11196060
TI  - [A virus called HTLV-1. Virological and molecular aspects].
AB  - A VIRAL PATHOGEN: HTLV-1, the first oncogenic retrovirus discovered in man
      carries, in addition to the genes coding for its structural protein, genes for
      capside and matrix (gag), reverse transcriptase and integrase (pol), protease and
      envelope (env), a unique region (termed pX) of about 2 kb situated at the
      position 3' of the env gene that encodes for Tax and Rex regulator proteins. TAX
      AND REX: These two proteins play a role in the viral cycle. Rex acts at the post
      transcriptional level; Its capacity to modulate Tax expression could allow the
      virus to establish a chronic infection with little expression. Tax stimulates
      viral transcription and also plays a fundamental role in leukecernogenesis by
      modifying the expression of several genes crucial for cell survival and
      proliferation. GENETIC STABILITY: The HTLV-1 genome sequence appears to be very
      stable. Specifically leukernogeneic or neurotrophic strains are unlikely to
      exist. However, despite this genetic stability, there are molecular variants
      related to the geographical origin of the virus.

PMID- 11196061
TI  - [A virus called HTLV-1. Epidemiological aspects].
AB  - GEOGRAPHIC DISTRIBUTION AND TRANSMISSION: HTLV-1 is not an ubiquitous virus. 15
      to 25 million subjects are estimated to be infected. Endemic areas are recognized
      in southern Japan, tropical Africa, the Caribbean, some areas in Central and
      South America, and in few regions of the Middle East and Melanesia. In these
      endemic zones, 0.5 to 50% of the population, depending on age and gender, have
      specific antibodies against HTLV-1 antigens. Interhuman transmission can occur
      from mother to child by prolonged breast feeding, from men to women by sexual
      intercourse, and from blood exposure via infected lymphoid cells. MOLECULAR
      EPIDEMIOLOGY: Molecular epidemiology studies have evidenced several molecular
      types or genotypes of HTLV-1 linked to the geographical origin of the infected
      population rather than to the associated pathology (leukemia versus
      neuromyelopathy). The high stability of the HTLV-1 genome is probably related to
      clonal expansion of infected cells conjugated to the minimal use of the reverse
      transcriptase. This low variability has been used as a molecular tool to better
      understand the origin, the evolution and the dissemination of this retrovirus.
      The current distribution of HTLV-1, and its simian homologue STLV-1, results from
      at least 4 events: transmission of STLV-1 between different monkey species,
      transmission of STLV-1 to humans, persistence of HTLV-1 in isolated human
      populations, and finally global and more recent distribution of HTLV-1 (mainly
      the cosmopolite subtype) subsequent to migration of virus-infected populations.

PMID- 11196062
TI  - [Recommendations for the creation of neurovascular units. French Neurovascular
      Society].

PMID- 11196063
TI  - Eye movements and lexical access in spoken-language comprehension: evaluating a
      linking hypothesis between fixations and linguistic processing.
AB  - A growing number of researchers in the sentence processing community are using
      eye movements to address issues in spoken language comprehension. Experiments
      using this paradigm have shown that visually presented referential information,
      including properties of referents relevant to specific actions, influences even
      the earliest moments of syntactic processing. Methodological concerns about task
      specific strategies and the linking hypothesis between eye movements and
      linguistic processing are identified and discussed. These concerns are addressed
      in a review of recent studies of spoken word recognition which introduce and
      evaluate a detailed linking hypothesis between eye movements and lexical access.
      The results provide evidence about the time course of lexical activation that
      resolves some important theoretical issues in spoken-word recognition. They also
      demonstrate that fixations are sensitive to properties of the normal language
      processing system that cannot be attributed to task-specific strategies.

PMID- 11196064
TI  - Priming in sentence processing: intralexical spreading activation, schemas, and
      situation models.
AB  - A series of eye-tracking experiments investigated priming in natural language
      understanding. Intralexical spreading activation accounts of priming predict that
      the response to a target word will be speeded (i.e., primed) when strong
      associates appear prior to the target. Schema-based priming accounts predict that
      priming will occur when the target word is a component of an activated schema or
      script. Situation model accounts predict that priming will occur when a target
      word can be integrated easily into an evolving discourse representation. In
      separate experiments, we measured the effect of associated words, synonyms, and
      identity primes on processing times for subsequently encountered target words.
      Our designs crossed prime type (e.g., synonyms vs. unassociated words) with
      semantic plausibility (i.e., the target word was a plausible vs. an implausible
      continuation of the sentence). The results showed that identity primes, but not
      associates or synonyms, primed target words in early measures of processing like
      first fixation and gaze duration. Plausibility effects tended to emerge in later
      measures of processing (e.g., on total reading time), although some evidence was
      obtained for early effects of semantic plausibility. We propose that priming in
      naturalistic conditions is not caused by intralexical spreading activation or
      access to precompiled schemas.

PMID- 11196065
TI  - One frog, two frog, red frog, blue frog: factors affecting children's syntactic
      choices in production and comprehension.
AB  - Two experiments are reported which examine children's ability to use referential
      context when making syntactic choices in language production and comprehension.
      In a recent on-line study of auditory comprehension, Trueswell, Sekerina, Hill,
      and Logrip (1999) examined children's and adults' abilities to resolve temporary
      syntactic ambiguities involving prepositional phrases (e.g., "Put the frog on the
      napkin into..."). Although adults and older children used the referential context
      to guide their initial analysis (pursuing a destination interpretation in a one
      frog context and a modifier interpretation in a two-frog context), 4 to 5-year
      olds' initial and ultimate analysis was one of destination, regardless of
      context. The present studies examined whether these differences were attributable
      to the comprehension process itself or to other sources, such as possible
      differences in how children perceive the scene and referential situation. In both
      experiments, children were given a language generation task designed to elicit
      and test children's ability to refer to a member of a set through restrictive
      modification. This task was immediately followed by the "put" comprehension task.
      The findings showed that, in response to a question about a member of a set
      (e.g., "Which frog went to Mrs. Squid's house?"), 4- to 5-year-olds frequently
      produced a definite NP with a restrictive prepositional modifier (e.g., "The one
      on the napkin"). These same children, however, continued to misanalyze put
      instructions, showing a strong avoidance of restrictive modification during
      comprehension. Experiment 2 showed that an increase in the salience of the
      platforms that distinguished the two referents increased overall performance, but
      still showed the strong asymmetry between production and comprehension. Eye
      movements were also recorded in Experiment 2, revealing on-line parsing patterns
      similar to Trueswell et al.: an initial preference for a destination analysis and
      a failure to revise early referential commitments. These experiments indicate
      that child-adult differences in parsing preferences arise, in part, from
      developmental changes in the comprehension process itself and not from a general
      insensitivity to referential properties of the scene. The findings are consistent
      with a probabilistic model for uncovering the structure of the input during
      comprehension, in which more reliable linguistic and discourse-related cues are
      learned first, followed by a gradually developing ability to take into account
      other more uncertain (or more difficult to learn) cues to structure.

PMID- 11196066
TI  - Locality and parsing complexity.
AB  - Two experiments, an off-line acceptability judgment study and an on-line self
      paced reading experiment, were conducted to tackle the question of locality-based
      preferences in sentence processing. The material consisted of German verb-final
      sentences containing a relative clause that was either host adjacent or
      extraposed. While the off-line data seem to reflect locality based integration
      cost, the on-line data revealed a highly different picture. It is argued that, in
      the present constructions at least, locality is relevant for production rather
      than perception. In perception, heads can be anticipated through incremental
      integration of their arguments.

PMID- 11196067
TI  - Wide-coverage probabilistic sentence processing.
AB  - This paper describes a fully implemented, broad-coverage model of human syntactic
      processing. The model uses probabilistic parsing techniques, which combine phrase
      structure, lexical category, and limited subcategory probabilities with an
      incremental, left-to-right "pruning" mechanism based on cascaded Markov models.
      The parameters of the system are established through a uniform training
      algorithm, which determines maximum-likelihood estimates from a parsed corpus.
      The probabilistic parsing mechanism enables the system to achieve good accuracy
      on typical, "garden-variety" language (i.e., when tested on corpora).
      Furthermore, the incremental probabilistic ranking of the preferred analyses
      during parsing also naturally explains observed human behavior for a range of
      garden-path structures. We do not make strong psychological claims about the
      specific probabilistic mechanism discussed here, which is limited by a number of
      practical considerations. Rather, we argue incremental probabilistic parsing
      models are, in general, extremely well suited to explaining this dual nature-
      generally good and occasionally pathological--of human linguistic performance.

PMID- 11196068
TI  - Evaluation of a highly specific functional test for the detection of factor V
      Leiden.
AB  - In the present study, a new functional test for the detection of increased
      resistance of coagulation factor V to degradation by activated protein C (factor
      V Leiden mutation) was evaluated. The STA-STACLOT APC-R Test (Diagnostica Stago,
      Asnieres, France) is based on the specific activation of factor X by Crotalus
      viridis helleri snake venom. The results are given as clotting time in seconds of
      the patient's plasma in the presence of venom and activated protein C. The intra
      assay coefficient of variation was 2.17% (n=20) for samples within the normal
      range, and 1.70% and 1.42% (n=20) for the plasma of a heterozygous or a
      homozygous carrier of the factor V Leiden mutation, respectively. The inter-assay
      coefficient of variation (n=10) was 7.75% for the plasma of a healthy donor,
      5.05% for the plasma of a heterozygous carrier and 3.38% for the plasma of a
      homozygous individual. The normal range (5th-95th percentile) of 136.4 s-174.7 s
      was derived from the clotting time of the plasma of 38 healthy controls. Values
      below 136 s were found in every sample from patients carrying the factor V Leiden
      mutation (n=52), whereas no patient with protein C (n=11) or protein S deficiency
      (n=10) had reduced clotting times. Homozygous carriers of the factor V Leiden
      mutation had clotting times shorter than 66.0 s and heterozygous carriers had
      clotting times longer than 80.0 s. Thus, based upon the individual clotting time,
      patients homozygous for factor V Leiden mutation could easily be distinguished
      from normals or heterozygous individuals. The influence of coagulation factor X,
      V, or II deficiency on the STACLOT APC-R Test was evaluated and revealed
      prolonged clotting times at factor V activities below 50%. In the presence of
      lupus anticoagulant the specificity of the STA-STACLOT APC-R Test was clearly
      decreased. In the present study, we clearly show that the STA-STACLOT APC-R Test
      is able to discriminate carriers of the factor V Leiden mutation from healthy
      controls or patients with protein C or protein S deficiency.

PMID- 11196069
TI  - The mechanism of action of angiotensin II is dependent on direct activation of
      vascular smooth muscle carbonic anhydrase I.
AB  - Our previous studies have shown that angiotensin II increases carbonic anhydrase
      activity both in vitro and in vivo. In this study we investigated in vitro the
      effect of angiotensin II on carbonic anhydrase I and II from erythrocytes and on
      arteriolar vascular smooth muscle carbonic anhydrase I. We also studied in vitro
      and in vivo the effect of angiotensin II receptor blockers (irbesartan and
      candesartan) on purified carbonic anhydrase I and II, on vascular smooth muscle
      carbonic anhydrase I and on arterial blood pressure in humans and in animals. In
      vitro results showed that angiotensin II is a direct and stronger activator of
      carbonic anhydrase I than II. Angiotensin II receptor blockers reduced mainly
      carbonic anhydrase I activity and completely antagonized the activating effect of
      angiotensin II both on purified and on vascular smooth muscle carbonic anhydrase
      I. Our in vivo experiments showed that irbesartan and candesartan are powerful
      inhibitors of carbonic anhydrase I both in erythrocytes (in humans) and in
      vascular smooth muscles (in animals). In humans, irbesartan and candesartan
      progressively reduce arterial blood pressure in hypertensive subjects, in
      parallel with progressive reduction of erythrocyte carbonic anhydrase I activity.
      We believe that angiotensin II could have a dual mechanism of action: (1)
      angiotensin interacting with its receptor to form a stimulus-receptor complex;
      (2) the same stimulus directly acts on the carbonic anhydrase I isozyme (which
      might be coupled with angiotensin II receptors), ensuring an adequate pH for
      stimulus-receptor coupling for signal transmission into the cell and hence
      vasoconstriction.

PMID- 11196070
TI  - Nitric oxide production during bacterial and viral meningitis in children.
AB  - Nitric oxide is very likely to play a role in physiopathological mechanisms of
      bacterial meningitis. As shown by in vitro studies, nitric oxide is toxic to
      endothelial cells, as well as to neurones, and thus may be responsible for
      neurological sequelae in bacterial meningitis. Increased level of nitric oxide
      can also inhibit mitochondrial respiration, enhancing anaerobic glycolysis.
      Twenty-seven children with documented bacterial meningitis, 73 with viral (mumps
      and enteroviral) meningitis, and 51 controls were studied. All children with
      bacterial meningitis were given cefotaxime (200 mg/kg per day). Glucose and
      protein concentrations and cerebrospinal fluid cell counts were determined
      routinely, as well as nitrite and nitrate levels. The levels of nitrite and
      nitrate in cerebrospinal fluid on admission were higher in patients with
      bacterial meningitis than in controls or in children with viral meningitis. In 10
      patients, dexamethasone therapy (0.4 mg/kg every 12 h for 2 days) was started
      about 10 min before the first antibiotic dose. A significantly lower nitrite
      concentration was observed after 24-48 h of treatment compared with non-steroid
      treated patients. Significant positive correlations between the nitrite and
      granulocyte counts and the protein concentration in cerebrospinal fluid were
      found in all patients with meningitis. Increased nitric oxide production in
      cerebrospinal fluid during the acute phase of bacterial meningitis may result
      from the inflammatory process and tissue injury. Dexamethasone administered
      before the first parenteral antibiotic dose seems to reduce nitric oxide
      production in the cerebrospinal fluid during bacterial meningitis.

PMID- 11196071
TI  - Oxidized low-density lipoprotein is localized in the ventricles of hearts from
      patients with coronary heart disease.
AB  - The present study was designed to investigate whether oxidized low-density
      lipoprotein is accumulated in the left and right ventricular walls of patients
      with coronary heart disease (n=10) compared with patients with dilated
      cardiomyopathy (n=9) or healthy heart donors (controls, n=5). Sections from both
      ventricles of explanted hearts and coronary arteries of the same patients were
      analyzed by semiquantitative immunohistochemistry for the presence of oxidized
      low-density lipoprotein. Oxidized low-density lipoprotein was enriched in the
      left and right ventricular walls from coronary heart disease patients compared
      with patients with dilated cardiomyopathy (P=0.0012 for left ventricle and
      P=0.103 for right ventricle) or controls (P=0.0012 for the left ventricle and
      P<0.05 for the right ventricle). The accumulation of oxidized low-density
      lipoprotein was higher in the left than in the right ventricles in all three
      groups. Positive immunoreactivity for oxidized low-density lipoprotein was mainly
      identified in the endocardium and the subendocardial areas of the ventricles and
      co-localized with macrophages. Accumulation of oxidized low-density lipoprotein
      in the ventricles significantly correlated with the enrichment in the respective
      coronary arteries, whereas only poor correlations were observed between various
      hemodynamic parameters and ventricular oxidized low-density lipoprotein
      accumulation. Ventricular accumulation of oxidized low-density lipoprotein seems
      to be a generalized pathophysiological process which does not exclusively involve
      the coronary arteries. Higher oxidative stress in combination with impaired
      oxygen supply in the endocardium could have favored low-density lipoprotein
      deposition and oxidation.

PMID- 11196072
TI  - Serum lipoprotein profile in patients with cancer. A comparison with non-cancer
      subjects.
AB  - The association of cancer with low serum total cholesterol is well established.
      Less clear is the relationship of cancer with the cholesterol distribution among
      the different lipoprotein classes. Conflicting results have been reported on low
      density lipoprotein cholesterol, high-density lipoprotein cholesterol and serum
      triglyceride levels in different types of tumor. Total serum cholesterol, low
      density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and serum
      triglycerides were analyzed in 530 patients with newly diagnosed cancer (97 with
      hematological malignancies, 92 with tumor of the lung, 108 of the upper digestive
      system, 103 of colon, 32 of breast, and 98 of the genitourinary system) and in
      415 non-cancer subjects. Anthropometric (body mass index) and biochemical (serum
      albumin) indices of nutritional status were also determined in all subjects.
      Total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein
      cholesterol, serum albumin, and body mass index were significantly lower in
      cancer than in non cancer-subjects. The lowest values of total cholesterol, low
      density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were
      recorded in patients with hematological malignancies and the highest in patients
      with breast tumor. All the cancer groups, with the exception of women with breast
      cancer, showed significantly lower total cholesterol, low-density lipoprotein
      cholesterol and high-density lipoprotein-cholesterol than age- and sex-matched
      non-cancer subjects. Multiple regression analysis with low-density lipoprotein
      cholesterol, high-density lipoprotein-cholesterol, and triglycerides as dependent
      variables and sex, age, body mass index, albumin, and cancer (dummy variable) as
      independent variables, showed that cancer was independently associated with low
      levels of low-density lipoprotein-cholesterol and high-density lipoprotein
      cholesterol and with high values of serum triglycerides. Total cholesterol, low
      density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, serum
      triglycerides, body mass index and serum albumin were significantly lower in
      patients with metastatic than in patients with non-metastatic solid tumor. The
      significant difference in low-density lipoprotein-cholesterol and serum
      triglycerides between patients with metastatic and non-metastatic cancer was lost
      when lipoprotein cholesterol and serum triglyceride levels were adjusted for
      nutritional variables. The lipid profile in cancer patients is characterized by
      low low-density lipoprotein-cholesterol, low high-density lipoprotein-cholesterol
      and relatively high serum triglycerides. The abnormality is a common feature of
      both hematological and solid tumors and is not entirely explained by poor
      nutrition.

PMID- 11196073
TI  - Role of platelets in tissue factor expression by monocytes in normal and
      hypercholesterolemic subjects. In vitro effect of cerivastatin.
AB  - Thrombosis is a complication of atherosclerosis and monocytes play a determinant
      role either in the progression of atherosclerotic plaque or in blood coagulation
      by way of tissue factor expression. Platelets play a direct role in thrombosis
      and a hyperfunctional state has been described in hypercholesterolemic subjects.
      Moreover, platelets seem to be able to enhance monocyte activity. Cholesterol
      lowering molecules (statins) are reported to reduce cardiovascular risk, either
      by decreasing the circulating level of cholesterol or by non-lipidic actions such
      as the reduction of monocyte and platelet activity. The aim of our study was to
      investigate the influence of platelets on the expression of tissue factor by
      monocytes and the effect induced by cerivastatin. We measured tissue factor
      levels by ELISA and the procoagulant activity of stimulated monocytes by a
      clotting assay on cellular preparations and whole blood in 40
      hypercholesterolemic subjects (22 male, 18 female, mean age 52.7 +/- 12 years,
      total cholesterol 251.6 +/- 19.9 mg/dl) before and after cerivastatin addition.
      Tissue factor expression was enhanced in hypercholesterolemic subjects compared
      with normal subjects (31.6 +/- 7.6 vs. 23 +/- 5.8 pg/cells, P < 0.01). The
      presence of platelets increased the amount of tissue factor (55.3 +/- 7.3
      pg/cells, P < 0.001) and cerivastatin reduced the expression of tissue factor in
      isolated monocytes, in the mixed cellular system, and in whole blood (19.6 +/-
      4.1 pg/cells, P < 0.001). In conclusion, tissue factor expression by monocytes is
      enhanced in hypercholesterolemic subjects compared with normal controls.
      Platelets enhance monocyte production of tissue factor, and cerivastatin is able
      to counteract this prothrombotic mechanism.

PMID- 11196074
TI  - Responses of the skin microcirculation to acetylcholine and to sodium
      nitroprusside in chronic uremic patients.
AB  - The aim of the present study was to assess the endothelial function of the
      microcirculation in chronic renal failure. We investigated the responses of the
      cutaneous blood flow to locally delivered acetylcholine and sodium nitroprusside
      in uremic patients. The study included 60 chronic uremic patients: 40 patients
      with a creatinine clearance of 4-25 ml/min were on conservative treatment and 20
      patients were on maintenance hemodialysis. The changes in skin blood flow
      following iontophoretic delivery of acetylcholine (an endothelium-dependent
      vasodilator) and sodium nitroprusside (an endothelium-independent vasodilator)
      were measured by laser Doppler flowmetry. Acetylcholine induced a progressive
      increase in blood flow in both groups, reaching approximately 100% of the maximal
      hyperemic response obtained by sodium nitroprusside delivery. The percent
      increase in blood flow from baseline was lower in hemodialysis patients than in
      patients on conservative treatment, after both acetylcholine (550 +/- 44 vs. 718
      +/- 61%, P < 0.05) and sodium nitroprusside (553 +/- 46 vs. 735 +/- 69%, P <
      0.05) delivery. In the hemodialysis group, the hyperemic responses to
      acetylcholine and sodium nitroprusside did not improve after the hemodialysis
      session. Hence, the hyperemic responses of the skin microcirculation are lower in
      hemodialysis patients than in patients on conservative treatment, and did not
      ameliorate after hemodialysis. It seems to be independent of endothelial
      dysfunction, and associated with the severity of uremia and with the maintenance
      hemodialysis treatment. This microcirculatory abnormality is in keeping with the
      arterial stiffness and vascular wall damages described in dialysis patients,
      which contribute to the cardiovascular morbidity of chronic uremia.

PMID- 11196075
TI  - Pulmonary effects of inhaled ultrafine particles.
AB  - INTRODUCTION AND OBJECTIVES: Recent epidemiological studies have shown an
      association between increased particulate urban air pollution and adverse health
      effects on susceptible parts of the population, in particular the elderly with
      pre-existing respiratory and cardiovascular diseases. Urban particles consist of
      three modes: ultrafine particles, accumulation mode particles (which together
      form the fine particle mode) and coarse mode particles. Ultrafine particles
      (those of < 0.1 micron diameter) contribute very little to the overall mass, but
      are very high in number, which in episodic events can reach several hundred
      thousand/cm3 in the urban air. The hypothesis that ultrafine particles are
      causally involved in adverse responses seen in sensitive humans is based on
      several studies summarized in this brief review. METHODS AND RESULTS: Studies on
      rodents demonstrate that ultrafine particles administered to the lung cause a
      greater inflammatory response than do larger particles, per given mass. Surface
      properties (surface chemistry) appear to play an important role in ultrafine
      particle toxicity. Contributing to the effects of ultrafine particles is their
      very high size-specific deposition when inhaled as singlet ultrafine particles
      rather than as aggregated particles. It appears also that ultrafine particles,
      after deposition in the lung, largely escape alveolar macrophage surveillance and
      gain access to the pulmonary interstitium. Inhaled low doses of carbonaceous
      ultrafine particles can cause mild pulmonary inflammation in rodents after
      exposure for 6 h. Old age and a compromised/sensitized respiratory tract in
      rodents can increase their susceptibility to the inflammatory effects of
      ultrafine particles significantly, and it appears that the aged organism is at a
      higher risk of oxidative stress induced lung injury from these particles,
      compared with the young organism. Results also show that ultrafine particle
      effects can be significantly enhanced by a gaseous co-pollutant such as ozone.
      CONCLUSIONS: The studies performed so far support the ultrafine particle
      hypothesis. Additional studies are necessary to evaluate mechanistic pathways of
      responses.

PMID- 11196076
TI  - A follow-up study on occupational exposure to inhaled anaesthetics in Eastern
      European surgeons and circulating nurses.
AB  - OBJECTIVE: Although no dose-response relationship exists for the health risks
      associated with the occupational exposure to inhaled anaesthetics, public health
      authorities recommend threshold values. The aim of the present study was to
      assess whether and to what extent these threshold values are exceeded in surgeons
      and circulating nurses of an Eastern European university hospital, before and
      after measures had been taken to reduce occupational exposure. METHODS: At nine
      workplaces, occupational exposure to nitrous oxide and the volatile anaesthetic
      used (halothane or isoflurane) was measured within the breathing zones of
      surgeons and circulating nurses by means of photoacoustic infrared spectrometry.
      The measurements were carried out in 1996 and were repeated in 1997 after the
      installation of active scavenging devices at five workplaces, and an air
      conditioning system at one workplace. RESULTS: Occupational exposure to nitrous
      oxide and halothane or isoflurane was lower in 1997 compared with that of 1996.
      In 1996, 89% of the nitrous oxide values were above the European threshold value
      of 100 ppm, whereas in 1997 approximately 50% were above this limit. In 1996 the
      majority of the measurements for the volatile anaesthetics were already below 5
      ppm halothane and 10 ppm isoflurane and the number of measurements exceeding
      these limits was further reduced in 1997. CONCLUSION: The measures taken were
      effective in reducing waste gas exposure. Nevertheless, further efforts are
      necessary, especially for nitrous oxide, to reach Western European standards and
      to minimise possible health risks. These efforts comprise the installation of
      (active) scavenging devices, air-conditioning systems and new anaesthesia
      machines at all workplaces, the use of low-flow anaesthesia, the replacement of
      inhaled anaesthetics by intravenous anaesthetics and an appropriate working
      technique.

PMID- 11196077
TI  - Gender differences in upper extremity musculoskeletal complaints in the working
      population.
AB  - OBJECTIVES: This study analysed the association between gender and upper
      extremity musculoskeletal complaints, among the general working population and in
      various occupational groups. The hypothesis was tested whether the higher risk
      for women in the general working population for these complaints could partly be
      explained by differences in the distribution of men and women in occupations with
      different risks for the onset of upper extremity musculoskeletal complaints.
      METHODS: The data for this study came from cross-sectional questionnaire data
      from 16,874 employees categorised in 21 different occupational classes.
      Associations between gender and complaints of the upper extremities were analysed
      for the total study sample and for each occupational class separately. An
      adjustment was made for the variable 'occupational class' in the final model in
      order to study the impact of occupational gender segregation on gender
      differences in upper extremity complaints in the working population. RESULTS: In
      the total study sample, significantly higher risks of complaints of the neck,
      shoulder, elbow, and wrist among the women were observed. Within many
      occupational classes, women reported significantly higher risks than did men, in
      particular for complaints of the neck and shoulder. Adjustment for occupational
      class showed increased risks for female workers for complaints of the neck,
      shoulder, elbow, and wrist, hence, rejecting our hypothesis on occupational
      gender segregation as an explanation for the higher risks for upper extremity
      complaints among women in the general working population. CONCLUSIONS: This study
      confirmed the presence of gender differences in upper extremity musculoskeletal
      complaints among the working population and in many occupational classes, with
      female workers having the higher risk. The results, however, do not lend support
      to a differential occupational exposure theory as an explanation for the higher
      risks for these complaints among women in the general working population. Careful
      consideration of gender influence in ergonomic epidemiological studies is
      recommended.

PMID- 11196078
TI  - Biological monitoring of workers exposed to ethylbenzene and co-exposed to
      xylene.
AB  - OBJECTIVE: Ethylbenzene is an important constituent of widely used solvent
      mixtures in industry. The objective of the present study was to provide
      information about biological monitoring of occupational exposure to ethylbenzene,
      and to review the biological limit values corresponding to the threshold limit
      value of ethylbenzene. METHODS: A total of 20 male workers who had been exposed
      to a mixture of ethylbenzene and xylene, through painting and solvent mixing with
      commercial xylene in a metal industry, were recruited into this study.
      Environmental and biological monitoring were performed during an entire week. The
      urinary metabolites monitored were mandelic acid for ethylbenzene and
      methylhippuric acid for xylene. Correlations were analyzed between urinary
      metabolites and environmental exposure for ethylbenzene and xylene. The
      interaction effects of a binary exposure to ethylbenzene and xylene were also
      investigated using a physiologically based pharmacokinetic (PBPK) model. RESULTS:
      The average environmental concentration of organic solvents was 12.77 ppm for
      xylene, and 3.42 ppm for ethylbenzene. A significant correlation (R2 = 0.503) was
      found between environmental xylene and urinary methylhippuric acid. Urinary level
      of methylhippuric acid corresponding to 100 ppm of xylene was 1.96 g/g creatinine
      in the worker study, whereas it was calculated as 1.55 g/g creatinine by the PBPK
      model. Urinary level of mandelic acid corresponding to 100 ppm of ethylbenzene
      was found to be 0.7 g/g creatinine. PBPK results showed that the metabolism of
      ethylbenzene was highly depressed by co-exposure to high concentrations of xylene
      leading to a non-linear behavior. CONCLUSIONS: At low exposures, both
      methylhippuric acid and mandelic acid can be used as indicators of commercial
      xylene exposures. However at higher concentrations mandelic acid cannot be
      recommended as a biological indicator due to the saturation of mandelic acid
      produced by the co-exposure to xylene.

PMID- 11196079
TI  - Occupational exposure to low concentrations of carbon disulfide as a risk factor
      for hypercholesterolaemia.
AB  - OBJECTIVE: The objective of this study was to investigate the effect of
      occupational exposure to carbon disulfide (CS2) concentrations below threshold
      limit value (TLV)-time-weighted average (TWA) (31 mg/m3) on total cholesterol,
      blood pressure and the prevalence of coronary heart disease (CHD). METHODS: A
      cross-sectional study involving 141 viscose rayon workers (64 men), and 141 age-
      and gender-matched controls without occupational contact with noxious chemicals,
      was carried out. The probability for CHD was determined by means of the WHO
      questionnaire and was 12-lead electrocardiography-coded using Minnesota criteria.
      Blood pressure was measured by the standardized method of the WHO and blood was
      examined for total cholesterol. A cumulative exposure index (CS2 index) was
      calculated for each worker by multiplying the number of years held in a
      particular job, by the CS2 concentrations in that job-environment. According to
      the CS2 index, the exposed workers were distributed into two groups: group 1 (CS2
      index < 100) and group 2 (CS2 index > or = 100). RESULTS: Depending on the job
      and specific work place the CS2 concentrations were between 1 and 30 mg/m3.
      Cholesterol levels were significantly higher in the exposed group (4.9 +/- 0.7)
      compared with the controls (4.6 +/- 0.7). Adjustment for age, smoking, body-mass
      index (BMI) and gender showed the significant effect of the CS2 index on the
      total cholesterol (P < 0.001). The prevalence of hypercholesterolaemia was
      significantly higher in the exposed group (42.6%), compared with the controls
      (26.2%); odds ratio (OR) (adjusted for potential confounders) was 2.56, 95% CI
      1.47-4.46. Logistic regression showed a significantly increased risk for elevated
      cholesterol in group 2 (OR 5.52; 95% CI 2.81-10.83). No significant effect of CS2
      index on blood pressure and CHD prevalence was found. CONCLUSIONS: The results of
      our study show that occupational exposure to CS2 concentrations below 31 mg/m3
      and a CS2 index > 100 may increase total cholesterol. Our results imply that even
      the CS2 concentrations below TLV-TWA may produce morbid changes, and suggest the
      mechanism of the effect of CS2, leading to lipid metabolism disturbances and
      acceleration of atherosclerosis.

PMID- 11196080
TI  - Acute effects on the human EEG after an external exposure to 200 ppm methanol.
AB  - OBJECTIVES: Even low concentrations of organic solvents may cause acute effects
      on the human central nervous system. The German MAK (threshold limit value) of
      methanol is 200 ppm. The aim of this study was to investigate whether acute
      exposure to 200 ppm methanol causes adverse effects, measured by EEG, and
      moreover, whether it is possible to differentiate between sedative and excitatory
      effects with this method. METHODS: Twelve healthy subjects were exposed for 4 h
      to 200 ppm and to 20 ppm (control) in an exposure chamber in a cross-over design.
      The EEG was recorded before (reference) and at the end of each exposure with, the
      subject's eyes closed and opened and during a choice reaction test (color word
      stress test). Spectral power was calculated by fast Fourier transformation.
      Subjective symptoms and effects of blinding with 20 ppm methanol were assessed by
      questionnaires. RESULTS: The study was a single-blind one. During subjects'
      exposure to 200 ppm, their scores for prenarcotic and irritating symptoms were
      not different from controls. In the closed-eye condition of subjects, the
      spectral power of the theta-band and of some electrodes of the delta-band was
      significantly less at the end of exposure to 200 ppm, than that of controls. In
      the open-eye condition and during the color word stress test no significant
      changes were found. CONCLUSION: The changes in the theta-band suggest a slight
      excitatory effect of 200 ppm methanol. The effect was weak, as scores of acute
      symptoms did not change. With respect to our results, it is not necessary for the
      MAK value to be decreased.

PMID- 11196081
TI  - Performance assessment of a passive sampler in industrial atmospheres.
AB  - In this work we investigate the performances of a passive sampler (GABIE badge)
      in industrial atmospheres, in accordance with the general specifications of the
      EN 838 standard. The field experiment was carried out in a paint-manufacturing
      factory producing a large number of pollutants at the workplaces. A comparison
      was performed between the results obtained by passive sampling and the
      conventional tube/pump method (reference method) on nine solvents usually
      encountered in the different workshops: n-butanol, isobutanol, toluene,
      ethylbenzene, m-xylene, methylisobutylketone, methylethylketone (MEK), ethyl
      acetate, butyl acetate. Results were compared by use of the distribution of the
      relative difference between badge "passive sampling" and tube "active sampling"
      results (with the latter considered as the reference method). In general, results
      revealed good agreement between passive and active sampling (except in the case
      of MEK) and confirmed the accuracy of sampling rates determined for the GABIE
      sampler. Bias was generally low and variability could be considered to be
      satisfactory (generally < 20% with a maximum of 30% for ethylbenzene). For MEK,
      strong bias was noted together with probable underestimation of the tube results.
      Additional results lead us to suggest that this phenomenon could be due to poor
      desorption of the SKC tubes by carbon disulphide (CS2); (quantitative recovery
      for MEK is in fact possible using other desorption solvents).

PMID- 11196082
TI  - Factors affecting FEV1 in workers with potroom asthma after their removal from
      exposure.
AB  - OBJECTIVE: In this study the relationship has been studied between exposure time
      and potential prognostic factors and FEV1 percent predicted (FEV1-% pred) in
      workers with potroom asthma, after their transfer from exposure to exposure-free
      departments. METHODS: Between 1970 and 1990 in a Dutch aluminium-production
      plant, 179 workers had been diagnosed as having potroom asthma. We carried out a
      follow-up study (n = 122) in the population still present at the factory 5 years
      after their relocation to an exposure-free department. In this study population,
      we examined the relationship between FEV1-% pred at follow-up, and exposure time:
      the time interval between start of exposure and diagnosis. To correct for
      confounding factors, we included age, pre-employment FEV1-% pred, allergy,
      medical treatment, and smoking in the analysis. RESULTS: The mean FEV1-% pred at
      follow-up was within the normal range (90.3, SD 13.5). Long exposure time was
      significantly associated with a low FEV1-% pred at follow-up (P = 0.0046).
      Adjustment was necessary for pre-employment FEV1-% pred and current smoking as
      confounding factors. CONCLUSION: Long duration of exposure is a factor affecting
      FEV1 in workers with potroom asthma. The results of this study give support for
      additional preventive measures to be taken, such as early recognition of work
      related respiratory complaints and repeated education.

PMID- 11196083
TI  - Urinary 1-hydroxypyrene and 2-naphthol concentrations in male Koreans.
AB  - OBJECTIVE: Urinary 1-hydroxypyrene (1-OHP) has been used as a biological marker
      of exposure to polycyclic aromatic hydrocarbons (PAHs), and urinary 2-naphthol is
      suggested as a new marker for route-specific exposure to airborne PAHs. We
      analyzed urinary 1-OHP and 2-naphthol concentrations in 292 male Koreans (129
      university students and 163 shipyard workers) to define the distribution pattern
      in Koreans with no or low occupational exposure to PAHs. METHOD: Histories of
      cigarette smoking and the eating of PAH-containing foods were obtained by a self
      administered structured questionnaire. Urine samples were collected and urinary 1
      OHP and 2-naphthol concentrations were measured using high-performance liquid
      chromatography (HPLC). RESULTS: The arithmetic (geometric) means of urinary 1-OHP
      and 2-naphthol concentrations for all students, expressed as micromoles per mole
      of creatinine, were 0.04 (0.04) and 3.12 (2.22), for non-smokers 0.03 (0.03) and
      1.78 (1.30) and for smokers 0.05 (0.03) and 4.36 (3.62), respectively. Among
      shipyard workers, the arithmetic (geometric) means of urinary 1-OHP and 2
      naphthol concentrations were 0.69 (0.31) and 4.37 (2.62) for all, 0.27 (0.18) and
      2.46 (1.16) for nonsmokers, and 0.97 (0.44) and 5.60 (4.44) for smokers,
      respectively. Mean urinary 1-OHP and 2-naphthol concentrations differed
      significantly between nonsmokers and smokers both in students and in shipyard
      workers. In smokers, some variables related to smoking habit were positively
      correlated with urinary 1-OHP and with 2-naphthol concentrations. The latter
      showed better correlations with the variables related to smoking amount than the
      former. None of the food-related factors was significantly correlated with
      urinary 1-OHP or 2-naphthol concentration. CONCLUSION: These results suggest that
      urinary 2-naphthol concentration is more sensitively affected by smoking status
      than urinary 1-OHP concentration and that urinary 2-naphthol is a sensitive
      marker for low-level inhalation of PAHs.

PMID- 11196084
TI  - Adjustment to concentration-dilution of spot urine samples: correlation between
      specific gravity and creatinine.
AB  - OBJECTIVE: Spot urine samples were investigated to determine correlations between
      urinary creatinine and specific gravity, and intra- and inter-day variations
      other than gender- and age-dependence of urinary concentrations. METHODS: Urinary
      creatinine concentrations and specific gravity were determined in 534 spot
      samples (385 from men and 149 from women). Subjects' ages ranged between 18 and
      68 years. Spot urine samples were also collected from 14 male subjects before and
      after a 1-week work-shift for the evaluation of intra- and inter-day variations
      of creatinine and specific gravity. RESULTS: In spot samples, creatinine
      concentrations ranged between 0.16 and 4.36 g/l and specific gravity between
      1.002 and 1.037. A high correlation (r = 0.82, P < 0.001) was observed between
      creatinine and specific gravity; male subjects showed significantly higher values
      of creatinine (P < 0.001) than did female subjects (1.90 +/- 0.74 and 1.41 +/-
      0.72 g/l, respectively) and specific gravity (1.023 +/- 0.006 and 1.020 +/-
      0.007, respectively). In addition, creatinine but not specific gravity
      significantly decreased (P < 0.02) in subjects older than 50 years, compared with
      those under 40. CONCLUSIONS: Results confirm the gender-dependence of creatinine
      concentrations in spot specimens and also show age-dependence, indicating the
      need for these aspects to be considered when the range of acceptable samples is
      to be set. No significant intra- or inter-day variations were observed for the
      two parameters. Lastly, the possibility of a comparison of differently adjusted
      values was indicated by a conversion formula derived from adjustments to
      creatinine and the corresponding specific gravity of a hypothetical urinary
      value, as follows: specific gravity adjusted values = 1.48 x creatinine adjusted
      values.

PMID- 11196085
TI  - Evaluation of occupational health service systems in small- and medium-sized
      industries in Korea.
AB  - OBJECTIVES: To establish a system of analytical methodology that can be used to
      evaluate an occupational health service system, to evaluate the performance of
      different types of the system in small- and medium-sized industries using the
      evaluation model, and to identify factors which influence the performance of an
      occupational health service system. METHODS: The input-output-outcome aspects of
      two different systems, capitation-based Group health services and fee-for-service
      based Individual health services, were examined, based on a causal model. Each
      causal relationship in the model was tested for its statistical significance by
      the linear regression technique based on the ordinary least square method. Data
      from 16 enterprises in the Group-type, 17 enterprises in the Individual-type, and
      32 enterprises in the Transitional Group-type were used in the analyses. RESULTS:
      In the Group model, enterprises utilized fewer resources for occupational
      services, their workers were provided with more services when services such as
      medical examinations were supplied directly by the system, and they had worse
      outcome measures of health and industrial injuries. The latter was the result of
      less input and fewer services, the supply of which was not within the direct
      control of the system, such as compliance with the recommendation to install
      machine safety devices and the proper maintenance and operation of these devices.
      CONCLUSIONS: Although study results revealed problem areas in the performance of
      the Group system, the study found a potential for an effective and efficient
      system in the Group-type with efforts geared to the better follow-up of work
      environment problems.

PMID- 11196087
TI  - [Value of chemotherapy in curative therapy of head and neck therapy].

PMID- 11196088
TI  - [Reports from the annual meeting of the German Society of Otorhinolaryngology,
      Head and Neck Surgery in Berlin].

PMID- 11196086
TI  - Mechanism of refractory ceramic fiber- and rock wool-induced cytotoxicity in
      alveolar macrophages.
AB  - OBJECTIVES: Man-made vitreous fibers (MMVFs) can induce cytotoxicity in a way
      similar to that of other particles, including silica and asbestos fibers.
      However, as yet the mechanism of MMVF-induced cytotoxicity is still not clear.
      This report aims to clarify the mechanism of MMVF-induced cytotoxicity in the
      alveolar macrophage (AM). In this mechanism, an attempt to prove the involvement
      of the adenosine triphosphate (ATP) generation system and the polyinosinic acid
      inhibitable scavenger receptors was made. METHODS: Several parameters were
      observed for cytotoxicity, such as cell viability, the release of lactic
      dehydrogenase (LDH) and ATP levels in rat AM's that were treated with refractory
      ceramic fibers (RF2) and rock wool (RW1). A specially designed ATP generation
      system was used to determine the effect of MMVF on ATP generation. A scavenger
      receptor ligand was applied to evaluate the relationship between scavenger
      receptors and MMVF-induced ATP depletion. RESULTS: A 3-(4,5-dimethylthiazol)-2,5
      diphenyl tetrazolium bromide (MTT) assay indicated that both RF2 and RW1 caused a
      decrease in cell viability and this decrease was concentration-dependent. RF2 and
      RW1 increased the release of LDH with increasing fiber concentration. From these
      parameters, RF2 was shown to exhibit greater cytotoxicity than did RW1. Both
      fibers decreased the intracellular ATP content and this decrease was
      concentration-dependent. The decrease was more pronounced in RW1 than in RF2 at
      all fiber concentrations. These fibers suppressed succinate-triggered oxygen
      consumption. Polyinosinic acid, a ligand of the scavenger receptor, inhibited the
      MMVF-induced decrease in ATP concentration. CONCLUSION: These results suggest
      that RF2 and RW1 can induce cytotoxicity and ATP depletion in the AM through the
      polyinosinic acid-inhibitable scavenger receptor. ATP depletion was the important
      factor in MMVF cytotoxicity, especially by RW1.

PMID- 11196089
TI  - [Congenital hearing disorders in children. 1: Acquired hearing disorders].
AB  - The results of international investigations on connatally acquired hearing loss
      are compared with the data of the German Registry on Childhood Hearing Loss (4058
      cases). The connatal hearing disorders have shown a notable change in the last
      years regarding to aetiology and prevalence. In contrast to countries of the
      third world in developed nations the prevalence of permanent childhood hearing
      loss has been reduced down to 1 in 1.000 births. The results let assume a
      prevalence of approximately 1:1.200 births in Germany. For instance the number of
      rubella embryopathia decreased effectively. In contrast CMV infections and
      alcohol fetopathia are playing an increasing role. In the patients of the German
      Registry on Childhood Hearing Loss the percentage of certainly progressive
      hearing loss is 10.3 within the 4058 children with permanent hearing impairment.
      Diagnostic procedures first of all for the early diagnosis of CMV but also of
      toxoplasmosis are considerable because these infections may result in treatable
      hearing loss. Also consequent hearing tests are demanded in children with alcohol
      fetopathia.

PMID- 11196090
TI  - [An assessment of tinnitus retraining therapy].
AB  - Based on the neurophysiological model of tinnitus developed by Jastreboff and
      Hazell [39] there have been some important developments in understanding and
      therapy of tinnitus over the last decade. The clinical applications of this model
      are known as "tinnitus retraining therapy", which has the objective of reducing
      both the distress associated with tinnitus and the tinnitus perception itself. As
      a form of systematic, repeated and skilled counselling over a long period of up
      to 2 years supported by sound therapy (hearing aid or noise generator) the
      evidence for their high degree of effectiveness is overwhelming. On the basis of
      a "German concept" of tinnitus retraining therapy developed and proposed by the
      ADANO (Arbeitsgemeinschaft deutschsprachiger Audiologen und Neurootologen) the
      current status of this treatment will be briefly reviewed including some actual
      studies of Goebel et al. [14] that confirm the world wide critical comments on
      the recent developments in the management of tinnitus especially with regard to
      tinnitus retraining therapy [79].

PMID- 11196091
TI  - [Quality assurance in ENT tumor surgery].
AB  - BACKGROUND AND OBJECTIVE: Quality control is of special importance in head and
      neck oncology since the quality of medical care constitutes a vital parameter for
      the diseased patient. In contrast to other medical specialties, no quality
      assurance program for head and neck cancer patients has yet been established in
      Germany. Therefore, a survey was conducted to assess the quality assurance
      instruments that are in use today in otorhinolaryngology-head and neck (ORL-HNS)
      centers. PATIENTS AND METHODS: In a nationwide survey, questionnaires were sent
      out to 146 German ORL-HNS departments (the return rate was 75%). RESULTS: 56% of
      all departments apply dedicated quality assurance processes, and 38% have
      appointed a formal quality assurance officer. Interdisciplinary oncological
      conferences are held in the vast majority of all departments with the
      participation of radiation oncologists in 86 (78%), medical oncologists in 84
      (76%), diagnostic radiologists in 82 (74%), and pathologists in 73 (66%).
      Morbidity-mortality conferences are held in seven departments (6%). A
      standardized follow-up of oncological patients is carried out in 95 units (86%),
      and 53 departments use computer-assisted data bases to organize their follow-up
      data (48%). A wide variety of documentation systems is in use throughout the
      country: 78 units (71%) offer formal follow-up to their oncological patients.
      CONCLUSIONS: This survey documents a wide-spread interest in quality assurance
      procedures. Many individual efforts are being undertaken. However, no uniform
      quality assurance or auditing system is currently in use in Germany nor is a
      commonly accepted data base available. The ability to offer oncological follow-up
      within the national social security system is generally considered indispensable
      for the maintenance of high-quality oncological care in ORL-HNS departments.

PMID- 11196092
TI  - [Morphological connections between the Hypoglassal and facial nerve in the brain
      stem of the rat].
AB  - BACKGROUND AND OBJECTIVE: The perfect coordination and synchronization of
      hypoglossal and facial muscles during chewing, swallowing, breathing, and
      vocalization requires particular concomitant activities of the facial muscles. In
      contrast, no direct connection between the facial and hypoglossal nucleus on the
      level of the brain stem has been detected until now. PATIENTS/METHODS: Facial and
      hypoglossal nuclei of rats were identified on the basis of their antidromic field
      potential recorded after peripheral stimulation of the corresponding nerves.
      Stereotactically single or double fluorescence tracer injections (Biotin-Dextran,
      Fluorescine-Dextran, Rhodamine-Dextran, Fluoro Gold) were placed into the nuclei.
      RESULTS: Retrograde tracer injections into the facial nucleus consistently
      labeled small neurons in the hypoglossal nucleus. In reverse experiments the
      injection of anterograde tracers into the hypoglossal nucleus labeled fine
      caliber varicose nerve fibers, but no somata in the facial nucleus. Synchronous
      injections of different tracers into the facial and hypoglossal nucleus produced
      a small, but constant number of double-labeled cells in the parvocellular
      reticular formation. CONCLUSIONS: Both, hypoglossal interneurons projecting to
      the facial nucleus and neurons of the parvocellular reticular formation double
      projecting to the facial and hypoglossal nucleus might play an important role in
      coordinated orofacial movements. Moreover, both populations of neurons might be
      responsible for the excellent postoperative results after hypoglossal-facial
      anastomosis.

PMID- 11196093
TI  - [Pharyngolaryngoscopic findings in patients with obstructive sleep apnea syndrome
      and primary snoring].
AB  - BACKGROUND AND OBJECTIVE: The localization of an upper airway collapse in snorers
      and patients suffering from obstructive sleep apnea was a subject frequently
      discussed in the last few years. Pharyngolaryngoscopy during sleep or drug
      induced sleep allows evaluation of upper airway conditions. PATIENTS/METHODS: A
      total of 324 patients suffering from snoring or obstructive sleep apnea underwent
      flexible pharyngolaryngoscopy while awake and under propofol-induced sedation in
      the course of routine diagnostic procedures in the sleeping lab. In this study,
      the results of pharyngolaryngoscopy are compared to results of the Muller
      maneuver and polysomnographic recordings. The therapeutic consequences of this
      additional investigation are discussed. RESULTS: In 95% of cases snoring was
      observed during drug-induced sleep. A significant discrepancy was seen between
      results of the endoscopy while being awake (Muller maneuver) and during drug
      induced sleep. The degree of collapse differed significantly in the area of the
      base of the tongue. Severe collapse was seen much more often with pharyngoscopy
      during drug-induced sleep compared to the results during the Muller maneuver.
      CONCLUSIONS: The collapsibility in the area of the base of the tongue correlated
      with higher results in the RDI (respiratory disturbance index) registered with
      standard polysomnography. Snoring and upper airway collapse were easily surveyed,
      and the pharyngolaryngoscopy during propofol-induced sleep proved to be a simple,
      safe, readily controllable and effective supplementary diagnostic device for the
      diagnosis and treatment of obstructive sleep apnea and snoring.

PMID- 11196094
TI  - [Significance of the SISI test within the scope of expert assessment of noise
      induced hearing loss].
AB  - BACKGROUND AND OBJECTIVE: Proof of cochlear hearing loss is an essential
      prerequisite for the diagnosis of noise deafness. For this purpose, the
      Konigsteiner instruction leaflet (Konigsteiner Merkblatt) recommends among other
      items the SISI test. PATIENTS/METHODS: The results of the SISI test at 1 and 4
      kHz were analysed for 100 expert opinions of noise (200 ears). RESULTS: 10% of
      the subjects showed at 1 and 4 kHz a positive and 44% a negative result. At 1
      kHz, 46% indicated a negative result and at 4 kHz a positive result. In the group
      with a negative SISI test at both frequencies, 74% demonstrated characteristics
      of pseudohypacusis. There was no correlation between a retrocochlear hearing
      disorder and a negative SISI test. CONCLUSIONS: Our analysis demonstrated that
      the negative SISI test is more often evidence of pseudohypacusis rather than a
      retrocochlear disorder. Consequently, the validity of a negative SISI test is
      limited.

PMID- 11196095
TI  - [Value of a nutrition score in patients with advanced carcinomas in the area of
      the head and neck].
AB  - BACKGROUND AND OBJECTIVE: Patients with advanced head and neck cancer often
      suffer from malnutrition even before the start of therapy. Hence, the demand for
      nutritional support increases particularly before and during radiochemotherapy.
      Though nutritional therapy has been shown to substantially improve individual
      outcome, neither the criteria for patient candidacy nor the indications for
      therapeutic intervention have been established. We performed a retrospective
      analysis to determine the indications for nutritional support and < 0 evaluate
      the benefits of measures actually taken against malnutrition before and during
      radiochemotherapy as well as perioperatively. PATIENTS/METHODS: Data taken from a
      prospective study for the evaluation of oral mucositis during radiochemotherapy
      was analysed retrospectively. To calculate the indication for nutritional
      support, a nutritional scoring system (Hackl) was employed for the first time,
      which contained biochemical and anthropometric parameters as well as the period
      of starvation. The results were then compared to a nutritional support program
      implemented by the subjective examinations of the attending physician. RESULTS:
      Changes in body weight and body mass index (BMI) remained the most impressive
      parameters. Catabolic metabolism developed preoperatively and a significant loss
      of whole-body protein followed surgical therapy. Clinically, the results of the
      nutritional score correlated with the observation of malnutrition. Furthermore,
      our findings suggest that nutritional therapy was commonly delayed until late in
      the clinical course. CONCLUSION: The results indicate the necessity of objective
      and reproducible diagnosis and control of malnutrition. The scoring system used
      may provide a useful and yet simple tool for assessing individual indications for
      timely nutritional support.

PMID- 11196096
TI  - [Objective measurement of normal nasality in the Saxony dialect].
AB  - In the United States of America, the nasometer was developed by Fletcher as an
      objective method for measuring nasality. There are no accepted normal values for
      comparable test materials regarding the German language. The aim of this study
      was the examination of the auditively normal nasality of Saxon-speaking people
      with the nasometer. The nasalance of 51 healthy Saxon-speaking test persons with
      auditively normal nasality was measured with a model 6200 nasometer (Kay
      Elemetrics, U.S.A.). The text materials used were the vowels "a", "e", "i", "o",
      and "u", the sentences "Die Schokolade ist sehr lecker" ("The chocolate is very
      tasty") and "Nenne meine Mama Mimi" ("Name my mama Mimi"), and the texts of
      "North wind and sun", "A children's birthday", and an arbitrary selection from
      Strittmatter. The mean nasalance for the vowels was 17.7%, for the sentence
      containing no nasal sounds 13.0%, and for the sentence containing many nasal
      sounds 67.2%. The mean value of the texts was 33-41%. The results for the texts
      agreed well with the results of Reuter (1997), who examined people from the state
      of Brandenburg. A range from 20% to 55% is suggested as the normal value for
      nasalance in the German-speaking area.

PMID- 11196097
TI  - [Danger from exploding fireworks and blank firearms].
AB  - Explosive amusement and deterrent articles such as New Year's Eve cannons and
      rockets, toy pistols, and blank guns are not at all harmless items. Their
      potential dangerousness is often extremely underestimated. Two damaging
      mechanisms are important: during explosions, high pressures and temperatures
      develop and a considerable sound pressure level can be measured. If the explosion
      happens near the human body (intentionally or inadvertently), not only
      superficial lesions can occur, but also (mainly due to contact shots) serious,
      deep-seated tissue damage, especially in the head and neck region with its
      endangered sense organs such as eye and ear, the vessels and nerves supplying the
      brain, the speech- and voice-forming apparatus, and in particular the face, can
      be the consequence. Their mutilation can lead to serious and extensive
      interpersonalchanges. Accidents are published in the relevant otological and
      forensic medical papers, but nevertheless it seems important to us to point out
      the dangerousness of these readily available items.

PMID- 11196098
TI  - [Tumor oxygenation in combined whole body hyperthermia and polychemotherapy.
      Studies exemplified by recurrent carcinoma of the mouth cavity].
AB  - BACKGROUND AND OBJECTIVE: Previous studies have reported synergistic effects of
      combined hyperthermia and chemotherapy and/or irradiation. The response to
      irradiation and chemotherapy of well-oxygenated and vascularized tumors generally
      is better than that of hypoxic tumors. Therefore, tumor oxygenation is recognized
      as an important predictive factor in the therapy of malignant tumors. In
      practice, the head and neck area remains outside of the hyperthermia chamber
      during whole-body hyperthermia. It was the aim of this study to evaluate if the
      head and neck region receives sufficient warmth and, if so, if tumor oxygenation
      increases accordingly. PATIENTS/METHODS: Whole-body hyperthermia, as heat
      radiation (Enthermics Medical Systems RHS-7500), was applied to the narcotised 60
      year-old male patient with a local recurrence tumor pT3 pN2b M0 squamous cell
      carcinoma of the oral cavity. Tumor oxygenation and temperature were measured by
      LICOX catheters via one-point measurement during the entire hyperthermia
      treatment (3.5 h). Parallelly, chemotherapy (ifosfamide/Carboplatin) was given in
      four cycles (one cycle/month). RESULTS: With a latency of 10 min the increase of
      intratumoral temperature was comparable to temperatures achieved in the
      esophagus. The maximum intratumoral temperature was 41.8 degrees C. The average
      increase in tumor oxygenation was more than 100%. The clinical outcome in the
      case presented was a partial tumor remission (PR). CONCLUSIONS: During combined
      whole-body hyperthermia and polychemotherapy, tumor oxygenation is also
      significantly improved in the head and neck area, despite the fact that the head
      and neck area remained outside the hyperthermia chamber. The intratumoral
      temperature was comparable to esophageal and rectal temperatures.

PMID- 11196099
TI  - [Determining the optimal position for snoring splints. Forced mandibular advance
      is not always required].

PMID- 11196100
TI  - [Chronic pain at the base of the tongue. Projectile of an air rifle as a foreign
      body].

PMID- 11196101
TI  - [Mucotympanum in cleft lip].

PMID- 11196102
TI  - [Digital photo- and video-documentation].

PMID- 11196103
TI  - Treating glucosphingolipid disorders by chemotherapy: use of approved drugs and
      over-the-counter remedies.
AB  - The accumulation of a glucosphingolipid (GSL) in individuals lacking an adequate
      level of hydrolase activity could be minimized by chemotherapeutic measures that
      slow the formation of the GSL and stimulate the defective hydrolase. By achieving
      a balance in the rates of formation and breakdown, one should be able to
      alleviate the symptoms of excess storage and achieve a satisfactory
      accommodation. While several drugs seem to be specifically suitable for this
      purpose, only one of these has been approved for human use. However, less
      effective drugs and over-the-counter substances are available for human use and
      may prove satisfactory for a few years until better ones are made available. The
      proposed materials and the evidence behind the recommendations are presented in
      this paper.

PMID- 11196104
TI  - Mutations in the low-density-lipoprotein receptor gene in German patients with
      familial hypercholesterolaemia.
AB  - Familial hypercholesterolaemia (FH) is an autosomal dominant disorder of lipid
      metabolism characterized by elevated low-density lipoproteins (LDL), the
      formation of tendon and skin xanthomata and the development of premature coronary
      atherosclerosis. It is caused by a defect in the receptor-mediated hepatic uptake
      of LDL due to mutations in the LDL receptor. In 25 FH families with a total of
      160 members and in two individuals without available relatives, all of German
      origin, we identified LDL receptor mutations by a multiplex-PCR-based single
      strand conformation polymorphism method followed by direct sequencing. Of the 24
      mutations found, 15 are missense mutations, 2 are nonsense mutations, 4 are small
      deletions or insertions leading to frameshifts, 2 are an in-frame insertion and
      deletion, respectively, and one is a splice site mutation. Propositi carrying
      mutations that are known to completely abolish receptor function (nonsense and
      frameshift mutations, missense mutation V480M) had significantly higher untreated
      total and LDL-cholesterol levels compared to those patients carrying missense and
      in-frame insertion mutations of unknown functional consequence, which may lead to
      either reduced or completely abolished receptor function (11.30+/-1.64 vs 9.76+/
      1.50 mmol/L, and 9.39+/-1.23 vs 7.99+/-1.45 mmol/L, respectively). These results
      confirm the clinical and molecular heterogeneity of FH and the influence of
      different functional classes of mutations on lipid values.

PMID- 11196106
TI  - Branched-chain L-amino acid metabolism in classical maple syrup urine disease
      after orthotopic liver transplantation.
AB  - We characterized the effect of orthotopic liver transplantation on the catabolism
      of branched-chain L-amino acids in a female patient with classical form of maple
      syrup urine disease. Transplantation was performed at the age of 7.4 years due to
      a terminal liver failure triggered by a hepatitis A infection. Since then, the
      patient is on an unrestricted diet and plasma concentrations of branched-chain L
      amino and 2-oxo acids are stable, yet at moderately increased levels (2- to 3
      fold of control). L-Alloisoleucine concentrations, however, remained remarkably
      elevated (> 5-fold of control). In vivo catabolism was investigated by measuring
      the metabolic L-alloisoleucine clearance and whole-body leucine oxidation in the
      postabsorptive state. In an oral loading test with 580 micromol alloisoleucine
      per kg body wt, the L-alloisoleucine elimination rate constant (0.067 h(-1)) was
      in the normal range (0.069+/-0.012 h(-1), n = 4). In an oral L-[1-13C]leucine
      load (38 micromol/kg body wt), 19.5% of the tracer dose applied was recovered in
      exhaled 13CO2 versus 18.9+/-3.6% in healthy subjects (n = 10). Thus, the patient
      exhibited obviously normal whole-body catabolic rates although branched-chain L
      amino acid oxidation was confined to the liver transplant. Most likely, the
      enhanced substrate supply from extrahepatic sources led to an elevation of the
      plasma concentrations and thus induced a compensatory enhancement of the
      metabolic flux through the branched-chain 2-oxo acid dehydrogenase complex in the
      intact liver tissue.

PMID- 11196105
TI  - Hepatocellular carcinoma despite long-term survival in chronic tyrosinaemia I.
AB  - Tyrosinaemia I (fumarylacetoacetate hydrolase deficiency) is an autosomal
      recessive inborn error of tyrosine metabolism that produces liver failure in
      infancy or a more chronic course of liver disease with cirrhosis, often
      complicated by hepatocellular carcinoma, in childhood or early adolescence. We
      studied a 37-year-old woman with tyrosinaemia I whose severe liver disease in
      infancy and rickets during childhood resolved with dietary therapy. From 14 years
      of age she resumed an unrestricted diet with the continued presence of the
      biochemical features of tyrosinaemia, yet maintained normal liver function. In
      adult years she accumulated only small amounts of succinylacetone. Despite this
      evolution to a mild biochemical and clinical phenotype, she eventually developed
      hepatocellular carcinoma. Her fumarylacetoacetate hydrolase genotype consists of
      a splice mutation, IVS6-1g>t, and a novel missense mutation, Q279R. Studies of
      resected liver demonstrated the absence of hydrolytic activity and of
      immunological expression of fumarylacetoacetate hydrolase in liver tumour. In
      nontumoral areas, however, 53% of normal hydrolytic activity and immunologically
      present fumarylacetoacetate hydrolase was found. This case demonstrates the high
      risk of liver cancer in tyrosinaemia I even in a seemingly favourable biological
      environment.

PMID- 11196107
TI  - Tyrosine hydroxylase deficiency unresponsive to L-dopa treatment with unusual
      clinical and biochemical presentation.
AB  - Tyrosine hydroxylase (TH) deficiency is generally considered as a cause of the
      autosomal recessive form of dopa-responsive dystonia, also known as Segawa
      disease. Clinical hallmarks comprise parkinsonian and other extrapyramidal
      symptoms. Biochemically the defect leads to the defective synthesis of
      catecholamines, in particular dopamine. The diagnosis relies on a characteristic
      pattern of biogenic amine metabolites exclusively in the CSF and can be confirmed
      by establishing a mutation in the TH gene. Here we present a patient meeting all
      diagnostic criteria, including a new homozygous mutation (926T > C) with
      confirmed parental heterozygosity, extrapyramidal symptoms, but atypical other
      symptoms with periodic neurological episodes observed every 4 days and
      unresponsive to dopa treatment. The CSF biochemical abnormalities were severe.
      Uncharacteristically, a strongly abnormal urinary catecholamine metabolite
      pattern was also consistently observed. The atypical presentation of this patient
      shows that the clinical and metabolic phenotype of TH deficiency is more variable
      than formerly thought, and that the condition should no longer be considered as a
      treatable disorder per se.

PMID- 11196108
TI  - Trifunctional protein deficiency: three families with significant maternal
      hepatic dysfunction in pregnancy not associated with E474Q mutation.
AB  - We report five families with trifunctional protein deficiency in which, during
      pregnancy, three mothers experienced significant hepatic disease when carrying an
      affected fetus. Diagnoses were based on increased levels of long-chain
      hydroxyacylcarnitines and deficiencies of 3-hydroxyacyl-CoA dehydrogenase (LCHAD)
      and 3-ketoacyl-CoA thiolase activity in fibroblasts. All affected infants lacked
      the common E474Q mutation associated with isolated LCHAD deficiency. This
      mutation is thought to be a predisposing factor for maternal hepatic disease in
      pregnancy. Our findings suggest that other defects in this enzyme complex might
      be responsible for maternal hepatic complications in pregnancy.

PMID- 11196109
TI  - Plasma creatinine assessment in creatine deficiency: A diagnostic pitfall.
AB  - Guanidinoacetate methyltransferase (GAMT) deficiency (creatine deficiency
      syndrome) is a recently discovered inborn error of creatine biosynthesis.
      Affected patients have elevated concentrations of guanidino-acetate, the
      metabolic precursor of creatine, in urine, plasma and cerebrospinal fluid. In
      addition, urinary creatinine excretion and plasma creatinine concentration are
      decreased. For biochemical evaluation of patients suspected to suffer from GAMT
      deficiency, correct quantification of creatinine in plasma is important. Here we
      report our experience with different quantification techniques. We found that
      creatinine in plasma from two GAMT-deficient patients appeared normal when
      measured by the Jaffe method but was decreased when measured enzymatically or by
      HPLC. The apparently normal levels of creatinine as measured by the Jaffe method
      were not caused by guanidinoacetate. In urine, the Jaffe method and the enzymatic
      method gave similar results, indicating that in urine no false elevations of
      creatinine can be expected. As the Jaffe method is still widely used for routine
      plasma creatinine measurements, it is important to realize it cannot be used to
      exclude GAMT deficiency.

PMID- 11196110
TI  - Neuroleptic malignant syndrome in a patient with citrullinaemia.

PMID- 11196111
TI  - Ornithine carbamoyltransferase deficiency presenting with chorea in a female.

PMID- 11196112
TI  - Holocarboxylase synthetase deficiency: urinary metabolites masked by gross
      ketosis.

PMID- 11196113
TI  - Hyperprolinaemia in patients with deletion (22)(q11.2) syndrome.

PMID- 11196114
TI  - Prolactin, a marker for cerebral dopamine deficiency in patients suffering from
      phenylketonuria (PKU)?

PMID- 11196115
TI  - A novel mutation in the glucose-6-phosphatase gene in Korean twins with glycogen
      storage disease type Ia.

PMID- 11196116
TI  - A novel mitochondrial transfer RNA proline mutation.

PMID- 11196117
TI  - Age-related scattered hypofluorescent spots on late-phase indocyanine green
      angiograms.
AB  - PURPOSE: Scattered hypofluorescent spots may be seen on indocyanine green (ICG)
      angiograms of regions that do not show abnormalities when viewed with an
      ophthalmoscope. Hypofluorescent spots are found in several pathologic conditions,
      typically in inflammatory diseases. In this report, we describe hypofluorescent
      spots in normal fundi and show that such spots can be age-related. METHODS: Video
      fundus camera ICG angiograms of 115 eyes of 109 patients aged 12 to 85 years with
      normal fundi or with only age-related maculopathy were reviewed. The relation
      between age and scattered hypofluorescent spots, and between age-related
      maculopathy and spots was examined utilising regression analysis. RESULTS:
      Scattered hypofluorescent spots were seen throughout the posterior pole in 24
      eyes of 23 patients and in a portion of the posterior pole in 30 eyes of 29
      patients. The hypofluorescent spots were noted between 26 and 37 minutes after
      dye injection. Patient age ranged from 51 to 80 years, and regression analysis
      showed that the frequency of hypofluorescent spots increased significantly with
      aging (p < 0.05). However, age-related maculopathy did not show a significant
      relation to the spots. CONCLUSION: Scattered hypofluorescent spots seen in the
      posterior pole during the late-phase of ICG angiograms can apparently be due to
      aging of the fundus.

PMID- 11196118
TI  - Parafoveal arteriolar obstruction after ocular trauma in a patient with systemic
      lupus erithematosus.
AB  - BACKGROUND: Retinal arterial obstruction after ocular trauma is a rarely
      described entity which presents a still controversial pathogenesis. However,
      intravascular leucoembolization in response to activation of complement factor 5
      (C5a) has now been hypothesized as a possible cause of arterial embolization
      after severe trauma. Coincidentally, the pathogenesis of vascular lesions seen in
      active systemic lupus erithematosus is also related to the activation of the same
      complement factor. METHODS: We present the case of a 32-year-old man with active
      systemic lupus erithematosus who received a blunt trauma in his right eye and
      immediate developed severe visual loss. RESULTS: Ophthalmoscopy of the affected
      eye revealed a cherry-red spot macula, small hemorrhages and edema of the
      posterior pole. Fluorescein-angiography showed obstructions and staining of small
      branches of arterioles in the parafoveal region. After 2 months of follow-up, the
      ophthalmoscopic picture evolved to optic atrophy and the visual acuity remained
      severely reduced. CONCLUSION: We hypothesize that patients with complement
      mediated diseases are predisposed to retinal arteriolar obstruction after ocular
      trauma.

PMID- 11196119
TI  - Late Horner's syndrome following the bite of a black widow spider.
AB  - In this paper, we report on the case of a 23-year-old man who presented with a
      ptosis of the right upper lid and a miosis 1 month after being bitten in his
      right hand by Latrodectus revivenis. A positive cocaine test confirmed a
      diagnosis of Homer's syndrome.

PMID- 11196120
TI  - The antibacterial effect of topical anesthetic proparacaine on conjunctival
      flora.
AB  - PURPOSE: To investigate the antibacterial effect of topical anesthetic
      proparacaine on conjunctival flora. METHODS: One hundred and forty-four eyes of
      72 patients awaiting cataract surgery were included in the study. A commercially
      available solution of proparacaine, preserved with benzalkonium chloride 0.01%,
      was instilled in one eye of all subjects while the vehicle solution, including
      the same concentration of preservative in aqueous solution, was administered to
      the other eye. Conjunctival cultures were taken from all eyes before and 15
      minutes after the instillation of proparacaine and the vehicle. RESULTS: Of the
      144 eyes, 76 (52.8%) had positive-conjunctival cultures with the most commonly
      isolated organisms being coagulase-negative staphylococci in each group. Of the
      76 culture-positive eyes, 40 (52.6%) received proparacaine and 36 (47.4%) the
      vehicle preparation. Fifteen minutes after the instillation of proparacaine and
      the vehicle eyedrops, four eyes (10%) and 12 eyes (33.3%) had culture-positive
      conjunctival smears, respectively. Proparacaine significantly reduced the number
      of culture-positive eyes (p = 0.0003), in contrast to the vehicle (p = 0.21).
      CONCLUSION: A topical anesthetic, proparacaine, demonstrates antibacterial
      effects on the conjunctival flora.

PMID- 11196121
TI  - Evolution of ocular clinical and electrophysiological findings in pediatric
      Bardet-Biedl syndrome.
AB  - Bardet-Biedl syndrome (BBS) is a hereditary autosomal-recessive disorder,
      characterized by mental retardation, obesity, pigmentary retinopathy, polydactyly
      and, only in males, hypogenitalism. Even though genetic studies have revealed
      five different forms of BBS correlated to distinct loci on different chromosomes,
      a diagnosis of BBS is still primarily based on clinical data. The present study
      discusses the evolution of clinical ophthalmological and electrophysiological
      characteristics of BBS patients in developmental age. The main results obtained
      on a sample of 13 pediatric patients are the following: * progressive loss of
      visual acuity arised early in the first decade of life * ophthalmoscopic signs of
      pigmentary retinopathy were present only in 46% of the children studied *
      striking anomalies in the electroretinogram were also detected in the cases
      without pigmentary retinopathy * the electroretinographic results, when
      detectable, suggested a greater involvement of the photopic system as against the
      scotopic system.

PMID- 11196122
TI  - A comparative study on the effects of apraclonidine and timolol on the ophthalmic
      blood flow velocity waveforms.
AB  - PURPOSE: To evaluate the effects of topical timolol and apraclonidine on
      retrobulbar blood flow velocity waveforms in a group of healthy volunteers.
      METHODS: Apraclonidine 1% and timolol maleate 0.5% single dose administrations
      were crossed over double masked in 12 healthy volunteers. The intraocular
      pressure measurements were followed by Doppler examination of the ophthalmic
      artery and the central retinal artery. RESULTS: Intraocular pressure was reduced
      significantly on both treated and fellow eyes after timolol (p = 0.003, p = 0.04
      respectively) and after apraclonidine (p = 0.002, p = 0.01 respectively). After
      apraclonidine administration end diastolic velocity, mean velocity decreased and
      pulsatility index increased in the ophthalmic artery of both treated and fellow
      eyes. Resistivity index increased and peak systolic velocity decreased only in
      the ophthalmic artery of treated eyes. All Doppler indices remained
      nonsignificant for central retinal artery of both eyes. After timolol
      administration there were no significant changes of the Doppler indices in the
      ophthalmic artery and central retinal artery of the treated and fellow eyes.
      CONCLUSION: Topical timolol and apraclonidine significantly reduced the
      intraocular pressure. Single dose administration of apraclonidine 1% increased
      the vascular impedance distal to the ophthalmic artery. On the other hand,
      timolol 0.5% had no effect on vascular impedance.

PMID- 11196123
TI  - Pseudoexfoliation and glaucoma in eyes with retinal vein occlusion.
AB  - PURPOSE: To evaluate pseudoexfoliation (PE) and pre-existent glaucoma in eyes
      with branch retinal vein occlusion (BRVO) and central retinal vein occlusion
      (CRVO). METHODS: Consecutive eyes with a diagnosis of BRVO (73 eyes of 70
      patients) and CRVO (53 eyes of 49 patients) examined between July and December
      1998 comprised the study eyes. Age-matched control group consisted of 384 eyes of
      192 outpatients. The prevalence of PE and glaucoma were determined and
      appropriate statistical tests were performed. RESULTS: PE was present in six of
      73 eyes with BRVO (8.2%), 11 of 53 eyes with CRVO (20.8%) and 20 of 384 control
      eyes (5.2%). Two of 73 eyes with BRVO (2.7%) and 10 of 53 eyes with CRVO (18.9%)
      had glaucoma. Compared with the control eyes, PE was significantly more common in
      eyes with CRVO and coexistent glaucoma was significantly more common both in eyes
      with CRVO and in eyes with BRVO. CONCLUSION: While glaucoma seems to be a risk
      factor both for BRVO and CRVO, PE is a likely risk factor for CRVO.

PMID- 11196124
TI  - Effect of oral felodipine on ocular circulation.
AB  - PURPOSE: To evaluate the effects of felodipine, a calcium channel blocker, on
      ocular circulation. METHODS: In a double blind, randomized, crossover design, 10
      volunteers received placebo or felodipine on 2 separate days. Bidirectional laser
      Doppler velocimetry (BLDV), laser Doppler flowmetry (LDF), and monochromatic
      fundus photography (MFP) were employed to assess retinal, choroidal, and optic
      nerve rim circulatory parameters. Measurements were obtained at baseline, 1.5,
      and 3 hours after dosing. Blood pressure, intraocular pressure (IOP), and heart
      rate were monitored, and perfusion pressure (PP) was calculated. RESULTS: In
      comparison to placebo, significant average percentage decreases in diastolic
      blood pressure (BPd; p = 0.001), mean blood pressure (BPm; p = 0.003), and
      perfusion pressure (PP; p = 0.003) were observed 1.5 hours following felodipine.
      No significant differences were observed following placebo. Retinal, choroidal
      and optic nerve rim circulatory parameters showed no significant changes after
      placebo or felodipine. A significant positive correlation between BPd and optic
      nerve velocity (ONve1) was observed 3 hours following felodipine (R = +0.654; p =
      0.040). In contrast, no significant correlation between BPd and ONve1 was noted
      (R = +0.198; p = 0.583) following placebo. CONCLUSIONS: No significant change in
      retinal, optic nerve rim, or foveolar choroidal blood flow were observed, a
      factor that may be important in the treatment of systemic hypertension in
      patients with glaucoma.

PMID- 11196125
TI  - Visual recovery in unilateral traumatic pediatric cataracts treated with
      posterior chamber intraocular lens and anterior vitrectomy in Pakistan.
AB  - PURPOSE: To evaluate visual recovery in unilateral traumatic cataracts in
      children treated with posterior chamber intraocular lens implantation and
      anterior vitrectomy. METHODS: Sixteen children with unilateral traumatic cataract
      between ages 3-10 years (mean, 5 years 8 months) were treated with posterior
      chamber intraocular lens implantation and anterior vitrectomy. Surgery was
      performed between 2 weeks and 7 months (mean, 7.75 weeks) after injury. Follow up
      was between 9 and 29 months (mean, 17.9 months). RESULTS: The most common
      postoperative complication was fibrinous uveitis, which developed in 4 children
      (25%). All eyes had a clear visual axis postoperatively; none required
      capsulotomy. The mean postoperative refraction was +0.9 diopters (range, +3.50 to
      -2.75 diopters). Three eyes (18.75%) had visual acuity of 6/9, 8 eyes (50%) had
      visual acuity of 6/12 or better, and 11 eyes (68.75%) had visual acuity of 6/18
      or better. The cause of poor visual acuity was cystoid macular edema in one eye,
      macular scars in two eyes, and amblyopia in one eye. CONCLUSIONS: Unilateral
      traumatic cataracts in children in whom aphakia is corrected with posterior
      chamber lens implantation combined with anterior vitrectomy result in good visual
      outcome, and we recommend this treatment modality in traumatic cataract in
      children.

PMID- 11196126
TI  - The effect of latanoprost on aqueous humor PGF2alpha levels in glaucoma patients.
AB  - AIM: The purpose of this study is to evaluate the effect of the PGF2alpha
      isopropyl ester analogue, Latanoprost which is a new ocular hypotensive topical
      agent, on the aqueous humor PGF2alpha levels in open-angle glaucoma patients.
      METHODS: Patients diagnosed with either capsular or primary open-angle glaucoma
      and scheduled for trabeculectomy, were consecutively enrolled in the study. Group
      1 represented the control group (n = 17) and Group 2 represented the Latanoprost
      treatment group (n = 9). All the topical drugs were stopped 10 days
      preoperatively and only systemic carbonic anhydrase inhibitors were continued if
      necessary. Group 2 patients received topical 0.005% Latanoprost once daily for 5
      10 days preoperatively. During trabeculectomy operation, aqueous samples were
      taken through paracentesis from the patients. Aqueous humor levels of PGF2alpha
      and its metabolite 13,14-dihydro-15-keto-PGF2alpha were measured using enzyme
      immunoassay. RESULTS: The mean PGF2alpha levels were 24.38 +/- 5.79 pg/ml in the
      control group and 10.99 +/- 4.11 pg/ml in the Latanoprost group, the difference
      of which was statistically significant (p < 0.05). In the Latanoprost group,
      there was a positive correlation between levels of PGF2alpha, and its metabolite
      (p < 0.05). CONCLUSION: Pretreatment with PGF2alpha isopropyl ester analogue,
      Latanoprost topically decreased PGF2alpha levels in the aqueous humor of
      glaucomatous eyes, probably due to its uveoscleral outflow increasing effect. The
      clinical importance and application of this result has to be determined.

PMID- 11196127
TI  - 360 Degrees of epibulbar granulation tissue thirteen years after silicone circle
      buckle operation.
AB  - To demonstrate a granulomatous reaction to silicone buckel thirteen years after
      retinal detachment surgery. We report on a 71-year-old man who developed a 360
      degrees of epibulbar granulation tissue due to silicone circle buckel. The
      granulation tissue was demonstrated by a computer tomography and histologically.
      A granulomatous reaction to silicone circle buckel can be found many years from
      the first operation. Biopsy is always necessary to establish a definitive
      diagnosis. Treatment of 360 degrees of epibulbar granulation tissue causing
      ocular dysfunction is by surgical excision.

PMID- 11196128
TI  - Correlation between high-pass resolution perimetry and standard threshold
      perimetry in subjects with glaucoma and ocular hypertension.
AB  - PURPOSE: To evaluate the correlation between High-Pass Resolution Perimetry (HRP)
      and standard threshold perimetry in patients with glaucoma or ocular
      hypertension. METHODS: 31 glaucomatous patients and 37 ocular hypertension
      subjects with previous perimetric examination experience were consecutively
      recruited and only one eye for each patient was selected at random. Glaucomatous
      patients were classified as having primary open angle glaucoma when they had an
      abnormal visual field and/or an abnormal optic nerve head (ONH)/retinal nerve
      fiber layer (RNFL) typical of glaucoma, open angle at gonioscopy and no
      clinically apparent secondary cause for their glaucoma. Ocular hypertension
      subjects were defined as having intraocular pressure >21 mm Hg on no treatment,
      normal visual field, normal ONH and RNFL, elevated intraocular pressure without
      any treatment. All the subjects were examined with Humphrey Field Analyzer (HFA)
      640, 'program central 30-2' (Humphrey Systems, San Leandro, CA, USA) and with
      High-Pass Resolution Perimeter (HRP), Ophthimus version 2.4,'ring program' (Nikon
      HighTech Vision, Goteborg, Sweden). Visual field indices were obtained with both
      systems: for HFA mean deviation (MD), corrected pattern standard deviation (CPSD)
      and short term fluctuation (SF), while for HRP global deviation (GD), local
      deviation (LD), form index (FI) and neural capacity (NC). The data were analyzed
      by descriptive analysis, Student's t test with Bonferroni's correction or Mann
      Whitney non-parametric test and Pearson or Spearman's correlation coefficient.
      RESULTS: A significant correlation was found between MD and GD (r = -0.81), CPSD
      and LD (r = 0.87), PSD and LD (r = 0.72). NC was significantly correlated with MD
      (r = 0.76), GD (r = -0.94). FI was significantly correlated with PSD (r = -0.58),
      CPSD (r = -0.72), LD (r = -0.56). When the same data were analyzed for the
      glaucomatous group only, similar results were found; in the ocular hypertensive
      group no significant correlation was found except between NC and MD (r = 0.52).
      CONCLUSION: HRP indices vary comparably with HFA indices. Parameters as NC and FI
      were significantly correlated with standard visual field indices of both HFA and
      HRP. Although the clinical applications for FI are not clear yet, NC could detect
      both early glaucomatous damage and age related changes.

PMID- 11196129
TI  - Cytogenetics of donkey chromosomes: nomenclature proposal based on GTG-banded
      chromosomes and depiction of NORs and telomeric sites.
AB  - With the expansion of comparative genome analysis across different mammals, there
      is an increasing need to have well-defined banded karyotypes for the species
      chosen for investigation. In this context, the steadily growing gene mapping data
      in the donkey urgently require a framework whereby alignment/comparison of
      genetic information can be readily made with equids and other mammalian species.
      Hence a GTG-banded karyotype of the donkey (Equus asinus; EAS) is presented,
      along with schematic drawings and nomenclature of the banded chromosomes. In
      addition, the most characteristic features of individual chromosomes are
      described and their relative size estimated. Using the FISH approach, the
      location of nucleolous organizer regions (NORs) and telomeric repeat sequences
      (TTAGGG) were detected. Where possible, information on asine chromosomes is
      supplemented with known/likely equine and human homologues. The study thus
      primarily aims to provide an appropriate cytogenetic basis for the donkey
      chromosomes, so that research focused on gene mapping and comparative genomics in
      this species can be reported under a common format.

PMID- 11196130
TI  - Meiotic metaphase I pairing behavior of a 5BL recombinant isochromosome in wheat.
AB  - A recombinant isochromosome i5BLrec of wheat was developed with one arm and the
      proximal 36% of the other arm of Chinese Spring (CS) origin and the distal 64% of
      the recombined arm of Triticum turgiduM subsp. dicoccoides origin. The i5BLrec
      provides an unusual opportunity to analyze the role of the centromere or arm
      heterozygosity in chromosome prealignment and synapsis during meiosis. In
      monosomic condition, the i5BLrec formed a ring univalent in 86.8% of the pollen
      mother cells (PMCs) at meiotic metaphase I. In the disomic condition, the two
      i5BLrec preferentially paired as a normal bivalent in 74.8% of the PMCs, which
      differed significantly (p <0.01) from the normal bivalent pairing of 51% observed
      in diisosomic 5BL chromosomes of the CS (Di5BL(CS)) control plants. In plants
      with one i5BLrec and a normal 5B(CS), the long arm of 5B(CS) paired with the
      homologous arm of i5BLrec in 54.4% of the PMCs, and 40.4% of the PMCs had a
      5B(CS) univalent and a i5BLrec ring univalent. The implications of the i5BLrec
      pairing data on the mechanism of Ph1 gene action are discussed.

PMID- 11196131
TI  - Analysis of replication timing at the FRA10B and FRA16B fragile site loci.
AB  - The molecular basis for the cytogenetic appearance of chromosomal fragile sites
      is not yet understood. Late replication and further delay of replication at
      fragile sites expressing alleles has been observed for FRAXA, FRAXE and FRA3B
      fragile site loci. We analysed the timing of replication at the FRA10B and FRA16B
      loci to determine whether late replication is a feature which is shared by all
      fragile sites and, therefore, is a necessary condition for chromosomal fragile
      site expression. The FRA10B locus was located in a transitional region between
      early and late zones of replication. Fragile and non-fragile alleles exhibit a
      similar replication pattern proximal to the repeat but fragile alleles are
      delayed relative to non-fragile ones on the distal side. Although fragility at
      FRA10B appears to be caused by expansion of an AT-rich repeat in the region,
      replication time near the repeat was similar in fragile and non-fragile alleles.
      The FRA16B locus was late replicating and appeared to replicate even later on
      fragile chromosomes. While these observations are compatible with the hypothesis
      that delayed replication may play a role in fragile site expression, they suggest
      that replication delay may not need to occur at the expanded repeat region itself
      in order to be permissive for fragility.

PMID- 11196132
TI  - Robertsonian polymorphism, B chromosomes variation and sex chromosomes
      heteromorphism in the african water rat Dasymys (Rodentia, Muridae).
AB  - Chromosome banding analysis (G- and C-bands) of Dasymys rufulus from Senegal,
      Mali and the Ivory Coast, and D. cf. incomtus from Eastern and South-western
      Ethiopia was carried out. The diploid numbers (2N) in the former species range
      between 36 and 39 due to the presence of 0-3 small biarmed heterochromatic B
      chromosomes, resulting in a corresponding variation of the number of autosomal
      arms (NFa) between 44 and 50. The basic autosomal set was, however, constant and
      identical in these specimens. The karyotypes of D. cf. incomtus from Eastern and
      Western Ethiopia were found to be different (2N = 40 and 38, respectively).
      Comparison of G-banding patterns of the species studied revealed that they differ
      from each others by 1-2 Rb fusions/fissions, one paracentric inversion and
      heteromorphous sex chromosomes resulting from addition/deletion of
      heterochromatic blocks (X) and pericentric inversion (Y). In the light of the
      available chromosome banding data, the significance of intraspecies karyotypic
      variability within D. cf. incomtus and its relevance to the systematics of the
      genus are discussed.

PMID- 11196133
TI  - The human autoantigen MCP1 is required during early stages of DNA replication.
AB  - Metaphase chromosome protein 1 (MCP1) is a nuclear autoantigen that is associated
      with condensed chromosomes throughout mitosis. During interphase, this antigen
      shows a speckle distribution in the nucleus, excluding the nucleolus.
      Additionally, MCP1 binds tightly to the scaffold/matrix component of nuclei and
      isolated chromosomes. In order to determine the in-vivo localization of the
      antigen, we have expressed MCP1 fused to EGFP in tissue culture cells. The
      results demonstrate that MCP1 is located in the nucleus during interphase and
      during mitosis associates tightly to condensed chromosomes. Furthermore,
      microinjection of specific antibody confirms these results. We have used a
      specific monoclonal antibody (mAb 402) against MCP1 to assess the function of
      this antigen during cell cycle progression. HeLa and Ptk-2 cells that were
      microinjected into the nucleus and/or cytoplasm at G1/S and very early S phase
      were not able to progress and complete DNA replication. However, injection of mAb
      402 at mid or late S phase does not prevent completion of DNA replication and
      subsequent progression into mitosis. Microinjection of mAb 402 in Ptk-2 cells
      synchronized in mitosis did not interfere with progression of mitosis and cells
      divided. Our results suggest that MCP1 is required at the G1/S transition and
      during early S phase.

PMID- 11196134
TI  - Stability of transferred human chromosome fragments in cultured cells and in
      mice.
AB  - Chromosome fragments represent feasible gene delivery vectors with the use of
      microcell-mediated chromosome transfer. To test a prerequisite for a gene
      delivery vector, we examined the stability of human chromosome fragments (hCFs)
      in cultured cells and in trans-chromosomic (Tc) mice. Fragments of human
      chromosomes 2 (hCF(2-W23)), 11 (hCF-11) and 14 (hCF(SC20)) tagged with neo were
      introduced into the TT2F mouse ES cells, and retention of the hCFs was examined
      by FISH during long-term culture without selection. In contrast to the gradual
      loss of hCF(2-W23) and hCF-11, hCF(SC20) remained stable over 70 population
      doublings in the ES cells. The hCF(SC20) was also stable in cultured human tumor
      cells and chicken DT40 cells. We have previously generated chimeric mice using
      the ES cells harboring the hCF(2-W23) or hCF(SC20), followed by production of Tc
      mice. Although both the hCF(2-W23) and hCF(SC20) persisted in cells of Tc mice as
      an additional chromosome and were transmitted to offspring, the hCF(SC20) was
      more stable than the hCF(2-W23) in F1 and F2 mice. The present study shows that
      the stability of hCFs in Tc mice differs with tissue types and with genetic
      background used for successive breedings. Thus, the hCF(SC20), which was
      relatively stable in both mouse and human cells, may be a promising candidate for
      development as a gene delivery vector.

PMID- 11196135
TI  - Comparative FISH mapping of the ancestral fusion point of human chromosome 2.
AB  - It is known that human chromosome 2 originated from the fusion of two ancestral
      primate chromosomes. This has been confirmed by chromosome banding and
      fluorescence in-situ hybridization (FISH) with human chromosome-2-specific DNA
      libraries. In this study, the order of 38 cosmid clones derived from the human
      chromosome region 2q12-q14 was exactly determined by high-resolution FISH in
      human chromosome 2 and its homologous chromosomes in chimpanzees (Pan
      trogrodydes, 2n=48) and cynomolgus monkeys (Macacafascicularis, 2n = 42). This
      region includes the telomere-to-telomere fusion point of two ancestral ape-type
      chromosomes. As a result of comparative mapping, human chromosome region 2q12-q14
      was found to correspond to the short arms of chimpanzee chromosomes 12 and 13 and
      cynomolgus monkey chromosomes 9 and 15. It is noted that no difference was
      detected in the relative order of the cosmid clones between human and chimpanzee
      chromosomes. This suggests that two ancestral ape-type chromosomes fused tandemly
      at telomeres to form human chromosome 2, and the genomic organization of this
      region is thought to be considerably conserved. In the cynomolgus monkey,
      however, the order of clones in each homologue was inverted. In addition to
      cosmid mapping, two chromosome-2-specific yeast artificial chromosome (YAC)
      clones containing the fusion point were identified by FISH.

PMID- 11196136
TI  - Gene density in the Giemsa bands of human chromosomes.
AB  - The human genome is formed by isochores belonging to five families, L1, L2, H1,
      H2 and H3, that are characterized by increasing GC levels and gene
      concentrations. In-situ hybridization of DNA from different isochore families
      provides, therefore, information not only on the correlation between isochores
      and chromosomal bands, but also on the distribution of genes in chromosomes.
      Three subsets of R(everse) bands were identified: H3+, H3* and H3-, that contain
      large, moderate, and no detectable amounts, respectively, of the gene-richest H2
      and H3 isochores, and replicate very early and early, respectively, in S phase of
      the cell cycle. Here, we investigated the GC levels, replication timings and DNA
      compaction of G(iemsa) bands. We showed that G bands comprise two different
      subsets of bands, one of which is predominantly composed of L1 isochores,
      replicates at the end of the S phase, has a higher DNA compaction relative to H3+
      bands and corresponds to the darkest G bands of Francke (1994). In contrast, the
      other subset is composed of L2 and H1 isochores, has less-extreme properties in
      replication and composition and corresponds to the less-dark G bands of Francke.

PMID- 11196137
TI  - Chromosome mapping of GABRB3 and PML loci in macaca and cercopithecus indicates
      the mechanism of evolution of human chromosome 15.

PMID- 11196138
TI  - [Dental agenesis. Results of a prospective study of 30 cases].
AB  - OBJECTIVE: We conducted a prospective study to determine the types of bone
      anomalies observed in different types of dental agenesia. PATIENTS AND METHOD:
      This prospective series included 30 patients who attended our pluridisciplinary
      clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of
      syndromal agenesia. Patients consulted for a variety of reasons, no specific sign
      was found. The diagnosis was based on the panoramic x-ray and confirmed at the
      genetic consultation. RESULTS: Results were systemized by localization of the
      agenesia. In all cases, the height of the bone crest was preserved compared with
      the adjacent teeth. In the anterior part of the maxillary, the bone crest was
      thin showing a water drop aspect. In the posterior maxillary, there was a
      decrease in the subsinusal height due to invagination of the floor of the sinus.
      In the anterior part of the mandible, the crest had a knife blade aspect but no
      loss of height and in the posterior part, a preserved distance between the
      residual crest rim and the dental canal. DISCUSSION: In 60% of the solitary
      agenesias in the anterior part of the maxillary, augmentation was not required. A
      sinus graft was required in all cases involving the posterior maxillary. Multiple
      anterior or lateral agenesias were treated with a parietal graft.

PMID- 11196139
TI  - [Maxillary distraction and implantology].
AB  - Vertical alveolar distraction can be a useful surgical technique in preprosthetic
      reconstructive surgery, especially after failed autogenous onlay bone grafting.
      The main advantage of this technique is to allow expansion of both the bone and
      soft tissue. Through a case of vertical alveolar reconstruction by distraction
      osteogenesis and implant rehabilitation in a patient who had undergone two
      previously unsuccessful interposition bone graft procedures, this report
      illustrate the advantages of alveolar ridge augmentation by distraction
      osteogenesis.

PMID- 11196140
TI  - [Mandibular atrophy and a screw-retained implant-supported prosthesis].
AB  - Prosthetic care for mandibular atrophy has raised many difficult problems,
      particularly in the most severe cases. The solution to most of these problems
      lies in the use of osteointegrated implants. Good results were obtained by using
      a small number of implants associated with adjustable overdenture prostheses or,
      alternatively, by using a larger number of implants (5 or 6) associated with a
      screw fixed prosthesis with posterior cantilever. Cantilever prostheses can
      provide support for the mental foramen zones and the posterior zones of the
      mandibular body where bone resorption is important after application of
      adjustable plates to the fibromucosa.

PMID- 11196141
TI  - [Evaluation of mandibular propulsion appliances in children. A study of 18
      cases].
AB  - PURPOSE: Mandibular propulsion appliances are used currently in the treatment of
      class II malocclusion. The purpose of this study was to evaluate their effects on
      facial development to formulate specific indications. PATIENTS AND METHODS:
      Eighteen children (mean age 9-12) treated with a propulsion device for a class II
      division 1 malocclusion with a minimum of 4 mm overjet were included in a
      retrospective study over a 4 year period. We compared maxillomandibular and
      dentoalveolar position before and after treatment using Delaire computer software
      cephalometric analysis and superpositions. RESULTS: Statistically significant
      effects on molar discrepancy (p = 0.0002), overjet (p = 0.0003), sagittal
      mandibular position (p = 0.0040 for FM-Me/theoretical and p = 0.0010 for NP-FM
      Me), mandibular length (p = 0.004 for FM-Me/theoretical), mandibular corpus
      length (p = 0.0286 for Go-Me/theoretical), upper incisors palatal version (p =
      0.0002), and on lower incisors lip version (p = 0.0436) were assessed. No action
      on maxillary growth (p = 0.7274 for FM-NP/theoretical), ramus length (p = 0.9651
      for Cp-Go/theoritecal), lower facial height (p = 0.7045 for ENA-Me/theoretical)
      or translation of the alveolar arches (p = 0.9571 for A-Pti'/ENA-Pti and p =
      0.1564 for B-Pa'/B-Pa) could be confirmed. CONCLUSIONS: An increase in mandibular
      corpus development and no effect on alveolar arches suggests a basal mandibular
      action for this device. This concludes that retromandibular position and
      brachycorpus with upper incisor lip version, without lower incisors lip version
      are the best indications for mandibular propulsion appliances. Prospective
      studies should be carried out to confirm this hypothesis.

PMID- 11196142
TI  - [Indications and implications of surgical maxillary expansion in orthodontic
      surgery].
AB  - Surgically assisted rapid maxillary expansion is an accepted method for
      correction of transverse skeletal and dental discrepancies. The surgical
      technique includes a Lefort I osteotomy with medial palatine osteotomy. The
      maxillary must be totally released to achieve the desired expansion. There are
      several advantages: bone apposition in osteotomy sites, reduced risk of dental
      version or extrusion compared with orthopedic care, secondary surgical cure of
      complex dysmorphism requiring fewer segmentary osteotomies. Finally, we examined
      skeletal side effects induced by surgically assisted rapid maxillary expansion in
      the vertical and sagittal dimension of the face.

PMID- 11196143
TI  - [Peroperative use of a silicone occlusal block for palatal and lingual support in
      orthognathic surgery].
AB  - We present an alternative to acrylic occlusal wafers in orthognatic surgery. We
      propose using a silicone wafer that is easier to position preoperatively.

PMID- 11196144
TI  - [Success and failure in orthodontic maxillofacial treatment with superelastic
      shape-memory nickel-titanium wires. Apropos of 4 examples].
AB  - We present four clinical cases to show the usefulness of superelastic shape
      memory NiTi alloy wires in orthodontics. Martensitic and austenitic states of the
      alloy facilitate wire insertion in the bracket slot, creating a gently continuous
      force to move the tooth whatever the deformation of the wire. Use of a more
      physiological force lessens the risk of therapeutic errors due to misevaluated
      dysfunction and/or underlying dysmorphism.

PMID- 11196145
TI  - [Semi-rigid bracket splinting of teeth after traumatic luxation].
AB  - We describe a non-rigid procedure using brackets for splinting teeth after
      traumatic avulsion. This type of appliance preserves alveolodental ligament
      physiology and enables immediate mastication without occlusal obstruction.
      Installation is easy, except when severe bleeding or alveolar fracture occurs.

PMID- 11196146
TI  - Protection against 2-hydroxyamino-1-methyl-6-phenylimidazo[4,5-b]pyridine
      cytotoxicity and DNA adduct formation in human prostate by glutathione S
      transferase P1.
AB  - The prostate has been identified as a target for 2-amino-1-methyl-6
      phenylimidazo[4,5-b]pyridine (PhIP)-induced carcinogenesis. Humans are exposed to
      PhIP through ingestion of well-done cooked meats, and there is evidence from
      epidemiological studies that implicates red meat consumption in prostate
      carcinogenesis. The alpha and pi class isoforms of glutathione S-transferases
      (GSTs) have been shown to inhibit adduction of activated PhIP metabolites to DNA
      in cell-free systems. In humans, silencing of GST pi(GSTP1) through CpG island
      hypermethylation is found in nearly all prostate carcinomas and is believed to be
      an early event in prostate carcinogenesis. We hypothesized that suppressed GSTP1
      expression in prostate cells would increase their vulnerability to cytotoxicity
      and DNA adduct formation mediated by activated PhIP metabolites. To test this
      hypothesis, the human prostate adenocarcinoma cell line, LNCaP, which contains a
      silenced GSTP1 gene, was genetically modified to constitutively express high
      levels of GSTP1. Both LNCaP and LNCaP-GSTP1 cells exposed to N-OH-PhIP, but not
      parent PhIP, for 24 h showed a dose-dependent decrease in cell viability. GSTP1
      overexpressing cells had LC50s 30-40% higher than cells transfected with the
      vector alone. PhIP-DNA adducts isolated from LNCaP-derived cells and primary
      human prostate tissue cultures exposed to N-OH-PhIP were analyzed by liquid
      chromatography/electrospray ionization mass spectrometry. Primary cultures of
      human prostate tissue and LNCaP-GSTP1 cells had approximately 50% lower adduct
      levels than parental LNCaP and vector control cells. Bioactivation assays using
      LNCaP cytosols showed that enzymatic activation of N-OH-PhIP to a DNA binding
      species was dependent on ATP and could be inhibited by recombinant human GSTP1 in
      the presence of glutathione. This evidence confirms that N-OH-PhIP can be
      bioactivated to a DNA binding species in human prostate and human prostate
      derived cells. These observations provide the basis for using LNCaP and LNCaP
      GSTP1 cells as a model system for studying the role of this enzyme in protection
      against N-OH-PhIP induced DNA damage in prostate carcinogenesis. Loss of GSTP1
      expression in human prostate may, therefore, enhance its susceptibility to
      carcinogenic insult by compounds such as N-OH-PhIP. Conversely, induction of GSTs
      in early-stage prostate carcinogenesis may be a useful protective strategy.

PMID- 11196147
TI  - Synthesis and evaluation of 18F-labeled choline as an oncologic tracer for
      positron emission tomography: initial findings in prostate cancer.
AB  - The up-regulation of rates of choline uptake and phosphorylation in certain
      malignancies has motivated the development of positron-labeled choline analogues
      for noninvasive detection of cancer using positron emission tomography (PET). The
      choline analogue, no-carrier-added [18F]fluoromethyl-dimethyl-2-hydroxyethyl
      ammonium (FCH), was synthesized through the intermediate [18F]fluorobromomethane.
      FCH was evaluated in relationship to 2-[18F]fluoro-2-deoxyglucose (FDG) as an
      oncological probe in cultured PC-3 human prostate cancer cells, a murine PC-3
      human prostate cancer xenograft model, and in PET imaging studies of patients
      with prostate cancer. FCH was synthesized in 20-40% radiochemical yield and >98%
      radiochemical purity. Accumulation of FCH and FDG were comparable in cultured
      prostate cancer cells, whereas only FCH was inhibited (90%) by hemicholinium-3, a
      specific inhibitor of choline transport and phosphorylation. FCH showed similar
      biodistribution to [14C]choline in the tumor-bearing mouse, with prominent renal
      and hepatic uptake. Tumor uptake of FCH was similar to choline and FDG in the
      mouse model, although tumor:blood ratios were moderately higher for FCH. Initial
      PET imaging studies in prostate cancer patients showed high uptake of FCH in
      advanced prostate carcinoma and detection of osseous and soft tissue metastases.
      FCH uptake by tumors was markedly reduced in patients rescanned during androgen
      deprivation therapy. It is concluded that FCH closely mimics choline uptake by
      normal tissues and prostate cancer neoplasms. FCH is potentially useful as a PET
      tracer for detection and localization of prostate cancer and monitoring effects
      of therapy.

PMID- 11196148
TI  - (+)-Catechin inhibits intestinal tumor formation and suppresses focal adhesion
      kinase activation in the min/+ mouse.
AB  - Colorectal cancer is sensitive to dietary influences. Epidemiological data
      linking high intake of fruits and vegetables to decreased cancer risk have
      prompted the search for specific plant constituents implicated in tumor
      prevention. This task is difficult because of the complex chemical composition of
      plant foods and the multifactorial nature of carcinogenesis. Researchers are
      aided in this effort by the C57BL/6J-Min/+ (Min/+) mouse, an animal bearing a
      germline defect in Apc that is similar to the initiating genetic event in the
      majority of human colorectal cancers. In this study, we treated Min/+ mice with
      (+)-catechin, a phenolic antioxidant abundant in certain fruits. Administration
      of (+)-catechin in an AIN-76A diet at doses of 0.1 and 1% decreased the
      intestinal tumor number by 75 and 71%, respectively. Mechanistic studies linked
      this effect to (+)-catechin-induced changes in integrin-mediated intestinal cell
      survival signaling, including structural alteration of the actin cytoskeleton and
      decreased focal adhesion kinase (FAK) tyrosine phosphorylation. Immunoblot
      analysis of small intestine scrapings from Min/+ mice and Apc+/+ wild-type
      C57BL/6J littermates together with excised Min/+ adenomas showed increased
      expression of phosphorylated FAK in the macroscopically normal enterocytes of
      untreated Min/+ mice and adenomas. Confirming the relevance of this signaling
      pathway, treatment of Min/+ mice with (+)-catechin reduced the expression of
      phosphorylated FAK to a level similar to the wild-type littermate controls. Thus,
      the natural abundance and favorable bioavailability of (+)-catechin make it a
      promising addition to the list of potential colorectal cancer chemopreventive
      agents.

PMID- 11196149
TI  - Estrogens reduce and withdrawal of estrogens increase risk of microsatellite
      instability-positive colon cancer.
AB  - There are sex differences in the occurrence of microsatellite instability (MSI)
      in colon tumors. Taken together with the epidemiological evidence that hormone
      replacement therapy (HRT) and, less consistently, parity, are inversely
      associated with colon cancer, it has been hypothesized that estrogens are
      associated with MSI. The purpose of this study was to evaluate sex-specific
      differences in the prevalence of MSI in colon tumors and to determine whether
      reproductive history and hormonal exposures are associated with MSI. Using data
      from a population-based case-control study of 1836 cases with MSI data and 2410
      population-based controls, we evaluated sex, reproductive factors, and hormone
      exposure in relation to the presence or absence of MSI in tumors. MSI was
      evaluated by a panel of 10 tetranucleotide repeats, the noncoding mononucleotide
      repeat BAT-26, and the coding mononucleotide repeat in transforming growth factor
      beta receptor type II (TGFbetaRII). Exposure data on reproduction, hormone use,
      obesity, and physical activity were obtained from an interviewer-administered
      questionnaire. Women were less likely then men to have MSI+ tumors at a young age
      and more likely to have unstable tumors at an older age; we observed a
      significant interaction (P < 0.01) between age, sex, and MSI. Evaluation of
      reproductive factors showed that women who had ever been pregnant had half the
      risk of MSI+ tumors compared with women who had never been pregnant. In
      complementary fashion, total ovulatory months were associated with an increased
      risk of MSI+ tumors [odds ratio (OR), 2.1; 95% confidence interval (CI), 1.1-4.0
      comparing MSI+ versus MSI- tumors]. Age at first and last pregnancy did not
      influence the association. The observed associations were strongest among women
      <60 years of age at the time of diagnosis. Having used oral contraceptives was
      associated with a lower risk of MSI+ tumors (OR, 0.7; 95% CI, 0.4-1.2); recent
      users of HRT were at a reduced risk of MSI+ tumors (OR, 0.8; 95% CI, 0.5-1.4);
      and women who were former HRT users were at an increased risk of MSI+ tumors (OR,
      1.8; 95% CI, 1.1-3.0). Obesity and lack of physical activity were associated with
      an elevated risk of both MSI+ (OR, 1.7; 95% CI, 0.7-3.3) and MSI- (OR, 2.2; 95%
      CI, 1.7-3.) tumors in men, but only with MSI- (OR, 1.5; 95% CI, 1.1-2.2) tumors
      in women. The excess of MSI+ tumors in women is explained by the excess of MSI+
      tumors at older ages. Our data suggest that estrogen exposure in women protects
      against MSI, whereas the lack of estrogen in older women increases risk of
      instability. HRT in these older women may, again, reduce the risk of unstable
      tumors. A model for the way in which estrogens (endogenous, exogenous, and
      obesity-associated) modify the risk of MSI+ tumors is proposed.

PMID- 11196150
TI  - Characterization of the antitumor effects of the selective farnesyl protein
      transferase inhibitor R115777 in vivo and in vitro.
AB  - R115777 [(B)-6-[amino(4-chlorophenyl)(1-methyl-1H-imidazol-5-yl)-methyl]-4-(3
      chlorophenyl)-1-methyl-2(1H)-quinolinone] is a potent and selective inhibitor of
      farnesyl protein transferase with significant antitumor effects in vivo
      subsequent to oral administration in mice. In vitro, using isolated human
      farnesyl protein transferase, R115777 competitively inhibited the farnesylation
      of lamin B and K-RasB peptide substrates, with IC50s of 0.86 nM and 7.9 nM,
      respectively. In a panel of 53 human tumor cell lines tested for growth
      inhibition, approximately 75% were found to be sensitive to R115777. The majority
      of sensitive cell lines had a wild-type ras gene. Tumor cell lines bearing H-ras
      or N-ras mutations were among the most sensitive of the cell lines tested, with
      responses observed at nanomolar concentrations of R115777. Tumor cell lines
      bearing mutant K-ras genes required higher concentrations for inhibition of cell
      growth, with 50% of the cell lines resistant to R115777 up to concentrations of
      500 nM. Inhibition of H-Ras, N-Ras, and lamin B protein processing was observed
      at concentrations of R115777 that inhibited cell proliferation. However,
      inhibition of K-RasB protein-processing could not be detected. Oral
      administration b.i.d. of R115777 to nude mice bearing s.c. tumors at doses
      ranging from 6.25-100 mg/kg inhibited the growth of tumors bearing mutant H-ras,
      mutant K-ras, and wild-type ras genes. Histological evaluations revealed
      heterogeneity in tumor responses to R115777. In LoVo human colon tumors,
      treatment with R115777 produced a prominent antiangiogenic response. In CAPAN-2
      human pancreatic tumors, an antiproilferative response predominated, whereas in
      C32 human melanoma, marked induction of apoptosis was observed. The heterogeneity
      of histological changes associated with antitumor effects suggested that R115777,
      and possibly farnesyl protein transferase inhibitors as a class, alter processes
      of transformation related to tumor-host interactions in addition to inhibiting
      tumor-cell proliferation.

PMID- 11196151
TI  - Expression of a truncated first exon BCR sequence in chronic myelogenous leukemia
      cells blocks cell growth and induces cell death.
AB  - We have shown that a deletion mutant form of Bcr [Bcr(64-413)] is a strong
      inhibitor of the tyrosine kinase of Bcr-Abl in vitro and also inhibits its
      oncogenic growth effects (Liu et al., Cancer Res., 56: 5120-5124, 1996). To
      determine the effects of this Bcr-Abl kinase inhibitor on chronic myelogenous
      leukemia (CML) cells, we cloned BCR(64-413) into a recombinant, replication
      defective adenovirus to express useful quantities of Bcr(64-413) in a wide
      variety of cells in culture. Infection of Cos1 cells with plaque-purified virus
      at a multiplicity of infection of 20-40 induced high expression of Bcr(64-413) as
      detected by Western blotting. Infection of hematopoietic cells at modest
      multiplicities of infection (20-40) required special conditions involving
      shifting cycling cells to a nongrowing condition involving serum starvation and
      cell crowding. Under these conditions, both Bcr-Abl-positive and -negative
      hematopoietic cells can be efficiently infected by adenovirus, as demonstrated by
      5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside staining of cells infected by
      beta-galactosidase (beta-GAL) adenovirus. We found that expression of Bcr(64-413)
      in Bcr-Abl-positive K562 and BV-173 cells, but not Bcr-Abl-negative SMS-SB cells,
      increased cell-cell clumping and inhibited cell growth. In contrast to the
      effects of the Bcr(64-413) adenovirus, the beta-GAL adenovirus, despite infecting
      both types of cells, did not block growth or increase cell-cell clumping of Bcr
      Abl-positive and -negative hematopoietic cells. Expression of Bcr(64-413) protein
      in primary cultures of cells from CML patients with active disease interfered
      with cell growth, induced apoptosis (as measured by annexin staining), and
      increased cell-cell clumping, whereas the beta-GAL adenovirus and mock-infected
      cells lacked these effects. In contrast, normal marrow cells did not exhibit
      these effects on infection with Bcr(64-413) adenovirus. We conclude from these
      findings that Bcr(64-413) interferes with the oncogenic effects of Bcr-Abl and
      therefore has the potential for use in therapy of CML.

PMID- 11196152
TI  - Usefulness of repeated direct intratumoral gene transfer using hemagglutinating
      virus of Japan-liposome method for cytosine deaminase suicide gene therapy.
AB  - To investigate the feasibility of repeated gene transfection in suicide gene
      therapy against human solid tumors by a combination of 5- fluorocytosine (5-FC)
      and its converting enzyme, cytosine deaminase (CD), we repeatedly transfected the
      yeast CD gene into the human pancreatic cancer cell line BXPC3 using the
      hemagglutinating virus of Japan-liposome in a new gene transfer method. The in
      vivo growth of the s.c. transplanted BXPC3 tumor in nude mice given CD-gene
      transfection was significantly suppressed by i.p. injection of 5-FC when compared
      with tumors treated with the control vector. Furthermore, the tumor transfected
      with the CD gene during a 7-day interval was suppressed much more than that of a
      single transfection. These results suggest that repeated transfection of the
      suicide gene together with the combination of 5-FC and the yeast CD gene using
      the hemagglutinating virus of Japan-liposome gene transfer method may be useful
      for the treatment of human solid tumors, including pancreatic cancer.

PMID- 11196153
TI  - Mitochondrial dysfunction after aerobic exposure to the hypoxic cytotoxin
      tirapazamine.
AB  - Tirapazamine (TPZ) is a bioreductive drug that exhibits a high degree of
      selective toxicity toward hypoxic cells, and at doses that are used clinically,
      little or no cell killing is observed in aerobic cells. Nonetheless, the effects
      of TPZ on aerobic tissues are still responsible for the dose limitations on the
      clinical administration of this drug. Clinical side effects include fatigue,
      muscle cramping, and reversible ototoxicity. We have investigated TPZ-induced
      changes in the mitochondria in aerobically exposed cells as a potential mediator
      of these side effects. Our data show that aerobic administration of TPZ at
      clinically relevant doses results in a profound loss in the mitochondrial
      membrane potential (MMP). We show that loss in the MMP occurs in a variety of
      cell lines in vitro and also occurs in muscle tissues in vivo. The loss in MMP is
      temporary because recovery occurs within 2 h. TPZ is directly metabolized within
      mitochondria to a DNA-damaging form, and this metabolism leads to both the cell
      killing effects of TPZ on aerobic cells at high doses and to the loss in MMP at
      clinically relevant doses. Using cell lines derived from genetically modified
      mice with a targeted deletion in manganese superoxide dismutase, we have further
      distinguished the phenotypic effects of TPZ in mitochondria at high toxic doses
      versus those at clinically relevant doses. We have investigated several potential
      mechanisms for this TPZ-induced loss in MMP. Our results indicate no change in
      the rate of cellular respiration in TPZ-treated cells. This implies that the loss
      in MMP results from an inability of the inner mitochondrial membrane to sustain a
      potential across the membrane after TPZ treatment. Incubation of cells with an
      inhibitor of the mitochondrial permeability transition suggests that the loss of
      MMP may result from the regulated opening of a large mitochondria channel.

PMID- 11196154
TI  - In situ expression of soluble B7-1 in the context of oncolytic herpes simplex
      virus induces potent antitumor immunity.
AB  - In vivo delivery of immunomodulatory genes is a promising strategy for solid
      tumor vaccination. A drawback is that it necessitates induction of a large effect
      from transgene expression in a small percentage of tumor cells. Although the B7
      family is known to be the most potent of the costimulatory molecules, gene
      transduction of B7 alone has not been effective in inducing antitumor immunity in
      nonimmunogenic tumors by ex vivo methods, much less in vivo. We have developed a
      novel approach where a gene encoding soluble B7-1, a fusion protein of the
      extracellular domain of murine B7-1 and the Fc portion of human IgG1, is
      delivered to tumor cells in vivo in the context of an oncolytic replication
      competent herpes simplex virus, and the gene product is secreted by tumor cells
      rather than expressed on the cell surface. Defective herpes simplex virus vectors
      containing the B7-1-immunoglobulin (B7-1-Ig) fusion transgene (dvB7Ig) were
      generated using G207 as a helper virus and tested in the poorly immunogenic
      murine neuroblastoma, Neuro2a, in syngeneic A/J mice. Intraneoplastic inoculation
      of dvB7Ig/G207 at a low titer successfully inhibited the growth of established
      s.c. tumors, despite the expression of B7-1-Ig being detected in only 1% or fewer
      of tumor cells at the inoculation site, and prolonged the survival of mice
      bearing intracerebral tumors. Immunohistochemistry of dvB7Ig/G207-inoculated
      tumors revealed a significant increase in CD4+ and CD8+ T-cell infiltration
      compared with control tumors inoculated with defective vector expressing alkaline
      phosphatase (dvAP/G207). The antitumor effect of dvB7Ig/G207 was not manifested
      in athymic mice. In vivo depletion of immune cell subsets in A/J mice further
      revealed that CD8+ T cells, but not CD4+ T cells, were required. Animals cured of
      their tumors by dvB7Ig/G207 treatment were protected against rechallenge with a
      lethal dose of Neuro2a cells but not SaI/N cells. The results demonstrate that
      the use of soluble B7-1 for immune gene therapy is a potent and clinically
      applicable means of in situ cancer vaccination.

PMID- 11196155
TI  - Tumor cell vaccine elicits potent antitumor immunity after allogeneic T-cell
      depleted bone marrow transplantation.
AB  - Allogeneic bone marrow transplantation (BMT) is currently restricted to
      hematological malignancies because of a lack of antitumor activity against solid
      cancers. We have tested a novel treatment strategy to stimulate specific
      antitumor activity against a solid tumor after BMT by vaccination with irradiated
      tumor cells engineered to secrete granulocyte-macrophage colony-stimulating
      factor (GM-CSF). Using the B16 melanoma model, we found that vaccination elicited
      potent antitumor activity in recipients of syngeneic BMT in a time-dependent
      fashion, and that immune reconstitution was critical for the development of
      antitumor activity. Vaccination did not stimulate antitumor immunity after
      allogeneic BMT because of the post-BMT immunodeficiency associated with graft
      versus-host disease (GVHD). Remarkably, vaccination was effective in stimulating
      potent and long-lasting antitumor activity in recipients of T-cell-depleted (TCD)
      allogeneic bone marrow. Recipients of TCD bone marrow who showed significant
      immune reconstitution by 6 weeks after BMT developed B16-specific T-cell
      cytotoxic, proliferative, and cytokine responses as a function of vaccination. T
      cells derived from donor stem cells were, therefore, able to recognize tumor
      antigens, although they remained tolerant to host histocompatibility antigens.
      These results demonstrate that GM-CSF-based tumor cell vaccines after allogeneic
      TCD BMT can stimulate potent antitumor effects without the induction of GVHD, and
      this strategy has important implications for the treatment of patients with solid
      malignancies.

PMID- 11196156
TI  - Simultaneous treatment with 1-beta-D-arabinofuranosylcytosine and daunorubicin
      induces cross-resistance to both drugs due to a combination-specific mechanism in
      HL60 cells.
AB  - We have established a human myelogenous leukemia cell line (HL60/AD) that is 10
      fold cross-resistant to both 1-beta-D-arabinofuranosylcytosine (ara-C) and
      daunorubicin; the cell line was isolated from HL60 by simultaneous treatment with
      these two agents at low drug concentrations attainable in clinical trials.
      HL60/AD was found to have multiple resistance mechanisms. With regard to ara-C,
      HL60/AD cells showed decreased deoxycytidine kinase activity but did not show
      elevation of cytidine deaminase activity or a decrease in ara-C influx. With
      regard to daunorubicin, a decrease in topoisomerase II activity was found. A
      decrease in intracellular accumulation of daunorubicin was also found. P
      glycoprotein was not detected, but the multidrug resistance-associated protein
      was expressed. Furthermore, an increase of total cellular glutathione (GSH)
      content was found. Interestingly, the resistance of HL60/AD cells not only to
      daunorubicin but also to ara-C was markedly reversed by treatment with L
      buthionine-(S,R)-sulfoximine (BSO), a potent inhibitor of GSH synthesis. After
      exposure of HL60/AD to ara-C, mitochondrial membrane potential and reactive
      oxygen intermediates showed no significant change, but a considerable loss of
      mitochondrial membrane potential and an increase in reactive oxygen intermediate
      generation were caused by pre-incubation with BSO. Neither elevation of GSH nor
      reversal of resistance by BSO was found in ara-C-resistant HL60 cells that were
      selected only with ara-C. These findings suggest that in addition to the
      summation of the mechanisms of resistance to each agent reported previously, an
      increased level of GSH plays an important role in the cross-resistance induced in
      HL60/AD cells by simultaneous exposure to both drugs.

PMID- 11196157
TI  - Induction of differentiation of acute promyelocytic leukemia cells by a cytidine
      deaminase-resistant analogue of 1-beta-D-arabinofuranosylcytosine, 1-(2-deoxy-2
      methylene-beta-D-erythro-pentofuranosyl)cytidine.
AB  - Since the establishment of all-trans retinoic acid (ATRA) differentiation
      therapy, the prognosis of acute promyelocytic leukemia (APL) has improved, and
      APL has become a curable subtype of acute myelocytic leukemia. Complete remission
      can be achieved with ATRA alone, but disease-free survival is still too short
      because of relapse. To overcome this drawback, ATRA has been used in combination
      with chemotherapeutic agents such as 1-beta-D-arabinofuranosylcytosine (araC) and
      daunorubicin. However, growth of the APL cell lines NB4 and HT93 is less
      sensitive to araC than to that of other myeloid leukemia cell lines such as HL-60
      and U937. ATRA effectively induced granulocytic differentiation of NB4 and HT93
      cells, whereas araC did not, even in a high concentration. A cytidine deaminase
      resistant analogue of araC, 1-(2-deoxy-2-methylene-beta-D-erythro
      pentofuranosyl)cytidine (DMDC), inhibited the growth of NB4 and HT-93 cells and
      was also effective on HL-60 and U937 cells. The promyelocytic cell lines were
      induced to differentiate by DMDC and other cytidine deaminase-resistant
      analogues. Among them, DMDC was the most potent in inducing differentiation and
      inhibiting the growth of NB4 cells. The ATRA-induced differentiation of NB4 cells
      was not augmented by araC, whereas combined treatment with ATRA and DMDC had more
      than additive effects in inducing the differentiation of NB4 cells. Similar
      results were observed in a primary culture of leukemia cells that had been
      freshly isolated from APL patients. These results suggest that DMDC may play a
      role in the treatment of APL.

PMID- 11196158
TI  - Adenovirus-mediated Bax overexpression for the induction of therapeutic apoptosis
      in prostate cancer.
AB  - Using adenoviral technology, we overexpressed the proapoptotic molecules pro
      caspase-3, pro-caspase-7, and Bax to induce therapeutic apoptosis of prostate
      cancer cell lines growing in vitro and in vivo. Because overexpressed pro-caspase
      3 did not undergo autocatalytic activation in any of the five prostate cancer
      cell lines evaluated, this strategy was unable to engage any component of the
      apoptotic pathway. Overexpressed pro-caspase-7 was proteolytically cleaved in
      LNCaP and LnCaP-Bcl-2 cells but not in PC-3, DU-145, or TsuPr(1) cells. Cleavage
      was associated with engagement of many components of the apoptotic pathway,
      including DEVDase activity, cleavage of intracellular caspase targets such as the
      DNA fragmentation factor and the proapoptotic Bid, release of cytochrome c from
      the mitochondria to the cytoplasm, and terminal deoxynucleotidyl transferase
      mediated nick end labeling. No apoptosis was observed in the cells where caspase
      7 did not undergo autocatalytic activation. Searching for an approach that would
      more reliably induce therapeutic apoptosis of prostate cancer cell lines, we used
      a binary adenoviral system to overexpress the proapoptotic molecule Bax. Bax was
      dramatically overexpressed and caused apoptosis of every cell line infected by
      engaging the mitochondrial pathway, including proteolytic cleavage and catalytic
      activation of the caspases, cleavage of caspase substrates, release of cytochrome
      c from the mitochondria, and DNA fragmentation. Furthermore, three injections of
      the Bax overexpression system into PC-3 cell tumors in nude mice in vivo caused a
      25% regression in tumor size corresponding to a 90% reduction relative to
      continued tumor growth in animals that received injections with the control
      binary system expressing Lac-Z. These experiments show that adenovirus-mediated
      Bax overexpression is capable of inducing therapeutic programmed cell death in
      vitro and in vivo by activating the mitochondrial pathway of apoptosis. On the
      basis of these studies, we conclude that manipulation of Bax expression is an
      attractive new gene therapy approach for the treatment of prostate cancer.

PMID- 11196159
TI  - More frequent beta-catenin exon 3 mutations in gallbladder adenomas than in
      carcinomas indicate different lineages.
AB  - To clarify the contribution of beta-catenin, which is related to cell adhesion
      and intranuclear transcription, to gallbladder carcinogenesis, we investigated
      its expression using immunohistochemistry, and beta-catenin exon 3 mutations by
      DNA direct sequencing, in 18 gallbladder adenomas and 82 adenocarcinomas.
      Membranous expression was significantly lower in moderately and poorly
      differentiated than in well-differentiated adenocarcinoma cases (P < 0.001). The
      gallbladder adenomas showed significantly stronger expression in the cytoplasm
      and the nucleus than carcinomas (P < 0.05 and P < 0.001, respectively), and exon
      3 mutations were observed in 62.5% (10 of 16) of adenomas, but only 4.8% (1 of
      21) of carcinomas. With beta-catenin as a molecular marker, the adenoma-carcinoma
      sequence can be considered to be a minor pathway in gallbladder carcinogenesis.

PMID- 11196160
TI  - Immunological and viral factors associated with the response of vulval
      intraepithelial neoplasia to photodynamic therapy.
AB  - Topical 5-aminolevulinic acid-based photodynamic therapy (PDT) has produced
      complete response rates of >90% for nonmelanoma skin carcinomas, which are mostly
      human papillomavirus (HPV) negative. Using a similar treatment protocol, we
      observed a short-term response in only one third (10 of 32) of high-grade vulval
      intraepithelial neoplasia (VIN 2-3) lesions. Unifocal lesions were found more
      responsive than multifocal and pigmented lesions. Animal model studies have
      suggested that long-term PDT response involves an immune reaction in which CTLs
      play a crucial role. In this study, we have assessed: (a) HPV infection; (b) HLA
      expression; and (c) immune infiltrating cells in VIN biopsies from responders and
      nonresponders to determine whether these factors may limit response to topical 5
      aminolevulinic acid-based PDT. Tissues from normal vulva (n = 9), vulval
      carcinoma (n = 11), and VIN (32 patients from which 19 pre- and 43 post-PDT
      biopsies were taken) were investigated for immune cell infiltration and HLA class
      I expression by immunohistochemistry and HPV infection by PCR. There was a
      greater likelihood of HPV positivity associated with a lack of response of VIN to
      PDT (P = 0.002), and VIN nonresponders were more likely to show HLA class I loss
      compared with responders (P = 0.030). HLA class I down-regulation was
      significantly greater in the carcinomas (82%, total loss) than the VIN (28%, 19%,
      total loss; and 9%, allele loss; P = 0.004). None of the cases with class I down
      regulation responded to PDT, whereas 3 of 6 (50%) of cases that showed total
      class I loss subsequently developed superficial invasion. Compared with normal
      vulval skin, VIN lesions showed increased infiltration by CD4 (T-helper) and CD68
      (macrophages) but not CD1a (Langerhans cells) or CD8 (CTLs). There was, however,
      a significant increase of CD8 infiltration in posttreatment VIN responders
      compared with nonresponders (P = 0.0001). These data clearly support the
      contention that high-risk HPV infection and lack of cell-mediated immunity may
      play a role in the observed poor response of lower genital lesions to topical
      PDT.

PMID- 11196161
TI  - A retrogen strategy for presentation of an intracellular tumor antigen as an
      exogenous antigen by dendritic cells induces potent antitumor T helper and CTL
      responses.
AB  - Induction of an effective antitumor response requires CD4+ helper T (Th) cells to
      recognize antigens on the same dendritic cells (DCs) that cross-present CTL
      antigens. Such cross-presentation is difficult to achieve by current tumor
      vaccine strategies. Here, we develop a novel "Retrogen" strategy for DCs to
      efficiently cross-present an intracellular tumor antigen, MAGE-3, to both MHC
      class I and MHC class II in a cognate manner. Specifically, the MAGE-3 gene was
      linked to a leader sequence at its NH2 terminus for secretion and to a cell
      binding domain at its COOH terminus for receptor-mediated internalization. DCs
      transduced with the modified MAGE-3 gene produced and secreted MAGE-3 proteins,
      which were efficiently taken up by DCs via receptor-mediated internalization and
      presented as exogenous antigens to class I and class II molecules. Immunization
      of mice with the transduced DCs expressing the MAGE-3 fusion protein, termed
      "Retrogen" for its retrograde transport/internalization after secretion,
      efficiently induced all arms of the adaptive antitumor immune responses. Thus,
      this retrogen strategy of using a unifying mechanism for DCs to cross-present an
      intracellular tumor antigen in a cognate manner could be generally used to
      improve the efficacy of tumor vaccines and immunotherapies.

PMID- 11196162
TI  - Histone deacetylase-targeted treatment restores retinoic acid signaling and
      differentiation in acute myeloid leukemia.
AB  - Histone deacetylase (HDAC)-dependent transcriptional repression of the retinoic
      acid (RA)-signaling pathway underlies the differentiation block of acute
      promyelocytic leukemia. RA treatment relieves transcriptional repression and
      triggers differentiation of acute promyelocytic leukemia blasts, leading to
      disease remission. We report that transcriptional repression of RA signaling is a
      common mechanism in acute myeloid leukemias (AMLs). HDAC inhibitors restored RA
      dependent transcriptional activation and triggered terminal differentiation of
      primary blasts from 23 AML patients. Accordingly, we show that AML1/ETO, the
      commonest AML-associated fusion protein, is an HDAC-dependent repressor of RA
      signaling. These findings relate alteration of the RA pathway to myeloid
      leukemogenesis and underscore the potential of transcriptional/differentiation
      therapy in AML.

PMID- 11196163
TI  - Granulocyte/macrophage-colony stimulating factor produced by recombinant avian
      poxviruses enriches the regional lymph nodes with antigen-presenting cells and
      acts as an immunoadjuvant.
AB  - Recombinant avian poxviruses [fowlpox and canarypox (ALVAC)], restricted for
      replication in nonavian cell substrates and expressing granulocyte/macrophage
      colony stimulating factor (avipox-GM-CSF), were evaluated for their ability to
      enrich an immunization site with antigen-presenting cells (APCs) and, in turn,
      function as biological vaccine adjuvants. Avipox-GM-CSF administered as a single
      s.c. injection significantly enhanced the percentage and absolute number of APCs
      in the regional lymph nodes that drain the injection site. Both the magnitude and
      duration of the cellular and phenotypic increases within the lymph nodes induced
      by the avipox-GM-CSF viruses were significantly (P < 0.05) greater than those
      measured in mice treated with four daily injections of recombinant GM-CSF
      protein. Temporal studies revealed that the APC enrichment of regional lymph
      nodes was sustained for 21-28 days after injection of the recombinant avipox
      virus expressing GM-CSF and, moreover, three injections of the recombinant virus
      could be given without any appreciable loss of in vivo bioactivity. Mice
      expressing human carcinoembryonic antigen (CEA) as a transgene (CEA.Tg) developed
      CEA-specific humoral and cell-mediated immunity after being immunized with avipox
      CEA. The coadministration of recombinant avipox viruses expressing CEA and GM-CSF
      significantly enhanced CEA-specific host immunity with an accompanying
      immunotherapeutic response in tumor-bearing CEA.Tg mice. The optimal use of
      avipox-GM-CSF, in terms of dose and dose schedule, especially when used with
      different immunogens, remains to be determined. Nonetheless, the present findings
      demonstrate: (a) the effective delivery of GM-CSF to an immunization site using a
      recombinant avian poxvirus; (b) the compatibility of delivering an antigen and GM
      CSF in replication-defective viruses to enhance antigen-specific immunity; and
      (c) the combined use of recombinant avipox viruses expressing CEA and GM-CSF to
      generate antitumor immunity directed at a self tumor antigen.

PMID- 11196164
TI  - Persistence of immunogenic pulmonary metastases in the presence of protective
      anti-melanoma immunity.
AB  - We have developed a murine melanoma model that allows us to investigate the
      mechanisms by which spontaneous, immunogenic melanoma metastases escape
      immunological destruction in syngeneic mice. In the current study, we tested the
      hypothesis that loss of immunogenicity is an obligatory step in the persistence
      of pulmonary metastases. Fragments of syngeneic K1735-M2 tumor were implanted in
      the outer edge of one pinna per C3H/HeN mouse, and the growing tumors were
      removed 2-3 weeks later. Two weeks after removal of the tumors, the mice
      demonstrated effective T-cell-mediated immunity to s.c. challenge with K1735-M2
      cells. However, lung metastases appeared in 23% of the immunized mice within 9-12
      weeks after the initial tumor implantation. The expression of protective immunity
      to s.c. tumors required the presence of both CD4+ and CD8+ T cells. The immunized
      mice had specific CTLs capable of killing both K1735-M2 melanoma cells and the
      cells of nine independently derived melanoma metastases. Furthermore, K1735-M2
      immunization protected these mice from s.c. tumor challenge with all nine
      metastatic cell lines. Our results demonstrate that the persistence of these
      metastases within the lung was not attributable to emergence of antigen-loss
      variants in immunized hosts. Our model provides an approach to investigate other
      mechanisms by which spontaneous metastases escape from immunological control and
      an opportunity to improve immunotherapy of melanoma metastases.

PMID- 11196165
TI  - Human heat shock protein 70 peptide complexes specifically activate antimelanoma
      T cells.
AB  - Members of the heat shock protein 70 (HSP70) family display a broad cellular
      localization and thus bind a repertoire of chaperoned peptides potentially
      derived from proteins of different cellular compartments. In this report, we show
      that HSP70 purified from human melanoma can activate T cells recognizing melanoma
      differentiation antigens in an antigen- and HLA class I-dependent fashion. HLA
      class I-restricted anti-melanoma T cells were susceptible to MHC-restricted,
      HSP70-dependent stimulation, indicating that HSP70 complexed peptides were able
      to gain access to the class I HLA presentation pathway. In addition, MHC matching
      between the melanoma cells used as a source of HSP and the responding T cells
      were not required, indicating that HSP70 activation may occur across MHC
      barriers. Besides the MHC-restricted and peptide-dependent activation pathway,
      HSP70 with no endogenous complexed peptides or HSP70 purified from antigen
      negative cells was also able to induce IFN-gamma release by antimelanoma T cells
      by a MHC-independent mechanism. In this case, however, higher doses of HSP70 were
      required. The capacity to activate class I-restricted, antitumor T cells as well
      as antigen-presenting cells, together with the finding that the HSP70 chaperoned
      peptide repertoire includes melanoma-shared epitopes, holds promise for a HSP70
      based cancer vaccine.

PMID- 11196166
TI  - Local administration of dendritic cells inhibits established breast tumor growth:
      implications for apoptosis-inducing agents.
AB  - Dendritic cells (DCs) can efficiently acquire foreign antigen(s) from apoptotic
      cells and induce MHC class I-restricted, antigen-specific CTLs. An accumulation
      of DCs within solid tumor masses in situ has been associated indirectly with a
      more favorable prognosis. Therefore, DCs may offer an efficient means for
      triggering immune responses within tumors, particularly in those masses
      containing significant apoptosis. We examined whether delivery of DCs could,
      alone, impact on the progressive growth of a tumor with a relatively high
      apoptotic index. We detected significant early apoptosis within the mass of a
      s.c. growing murine MT-901 breast carcinoma. DCs could efficiently engulf MT-901
      tumor apoptotic cells in vitro. Intratumoral injections of syngeneic but not
      allogeneic DCs resulted in significant inhibition of MT-901 tumor growth.
      Histological examination of the tumor revealed intense mononuclear cell
      infiltration during and after DC injections. Tumor growth inhibition was
      relatively radiosensitive and dependent on host-derived CD8+ T cells. The
      baseline level of tumor apoptosis could be increased substantially by tumor
      necrosis factor alpha administration, leading to a greater DC-mediated antitumor
      effect. The antitumor effect could also be enhanced by first pulsing DCs with the
      foreign helper protein, keyhole limpet hemocyanin, prior to intratumoral delivery
      and combining it with the systemic administration of interleukin 2. Splenocytes
      from treated animals showed heightened levels of specific CTL activity and
      production of cytokines. The level of in situ tumor apoptosis appears to play a
      critical role in DC-mediated antitumor effects. The potential implication of
      these findings in DC-based tumor therapy strategies is discussed.

PMID- 11196167
TI  - Alterations of the double-strand break repair gene MRE11 in cancer.
AB  - MRE11 plays a role in DNA double-strand break repair. Hypomorphic mutations of
      MRE11 have been demonstrated in ataxia-telangiectasia (AT)-like disorder. ATM
      mutations play a causal role in AT and have been demonstrated in lymphoid
      malignancies in patients without AT histories. By analogy with the relationship
      of ATM to lymphoid malignancies, it is probable that alterations of MRE11 are
      associated with tumor formation. We performed a mutation analysis of MRE11 in 159
      unselected primary tumors. Three missense mutations at conserved positions were
      found in breast and lymphoid tumors. Additionally, an aberrant transcript without
      genomic mutation was found in a breast tumor. These findings suggest an
      occasional role for MRE11 alterations in the development of primary tumors.

PMID- 11196168
TI  - A novel role of metalloproteinase in cancer-mediated immunosuppression.
AB  - Depressed immune responses have been observed frequently in cancer patients. In a
      variety of human malignancies, the expression of interleukin-2 receptor alpha (IL
      2R alpha) on activated tumor-infiltrating lymphocytes was down-regulated. Because
      IL-2R alpha plays a pivotal role in the development and propagation of functional
      T cells, its depressed expression may result in poor function of tumor-reactive
      cytotoxic lymphocytes. For elucidating the mechanism responsible for down
      regulation of IL-2R alpha, a coculture model of in vitro mixed autologous
      lymphocytes and tumor cells was established. Kinetic analysis showed that
      cervical cancer cells down-regulated IL-2R alpha expression on encountered T
      cells. The amount of IL-2R alpha mRNA in tumor-infiltrating lymphocytes-derived
      CD8+ T cells was compatible with that in the corresponding activated CD8+ T
      cells. Additional evidence showed that cervical cancer cells could induce the
      release of soluble IL-2R alpha expression on encountered T cells. By using
      protease inhibition assays we demonstrated that tissue inhibitors of
      metalloproteinase abrogated the cancer-mediated IL-2R alpha proteolytic process
      and restored the T-cell proliferation function. Immunohistochemical stainings
      further revealed prominent metalloproteinase (MMP) expressions, including MMP-1,
      MMP-2, and MMP-9, in cervical cancer tissues. Additional in vitro studies showed
      that MMP-9 mediates cleavage of IL-2R alpha and down-regulates the proliferative
      capability of cancer-encountered T cells. Our findings suggest a new role of MMPs
      in tumor-mediated immunosuppression and provide a possible therapeutic potential
      for patients with cervical cancer.

PMID- 11196169
TI  - The chemotherapeutic drug 5-fluorouracil induces apoptosis in mouse thymocytes in
      vivo via activation of the CD95(APO-1/Fas) system.
AB  - The CD95/CD95 ligand (CD95L) system has been shown to mediate chemotherapeutic
      drug-induced apoptosis in vitro. However, the contribution of the CD95 pathway to
      drug-induced apoptosis is controversial. We have shown previously that 5
      fluorouracil (5-FU) induces apoptosis in vitro via the activation of the
      CD95/CD95L system. To study the effects of the chemotherapeutic drug 5-FU and the
      contribution of the CD95 system to 5-FU-induced apoptosis in vivo, we gave mice
      an i.p. injection of 5-FU. Apoptotic cell death peaked in thymocytes at 18 h
      after administration of 5-FU. Total organ weight and cell number in the thymus
      were reduced by approximately 40%. This cell loss was due to apoptosis, as
      measured in cell suspensions by measuring hypodiploid DNA content and by terminal
      deoxynucleotidyl transferase-mediated nick end labeling staining of tissue
      sections. The number of apoptotic cells correlated with the extent of weight loss
      and cell attrition of the organs. Furthermore, in the thymi of 5-FU-treated
      animals, CD95L was strongly up-regulated. Apoptosis of thymocytes was blocked in
      vivo with neutralizing anti-CD95L antibodies. In addition, cell loss in the
      thymus was negligible in lpr mice in comparison with wild-type mice. Thus, a
      significant portion of apoptosis of thymocytes in vivo on treatment with 5-FU is
      mediated via the CD95/CD95L pathway. Our findings therefore contribute to the
      understanding how chemotherapeutic drugs exert their effects in vivo.

PMID- 11196170
TI  - Aberrant promoter methylation of multiple genes in non-small cell lung cancers.
AB  - Aberrant methylation of CpG islands acquired in tumor cells in promoter regions
      is one method for loss of gene function. We determined the frequency of aberrant
      promoter methylation (referred to as methylation) of the genes retinoic acid
      receptor beta-2 (RARbeta), tissue inhibitor of metalloproteinase 3 (TIMP-3),
      p16INK4a, O6-methylguanine-DNA-methyltransferase (MGMT), death-associated protein
      kinase (DAPK), E-cadherin (ECAD), p14ARF, and glutathione S-transferase P1
      (GSTP1) in 107 resected primary non-small cell lung cancers (NSCLCs) and in 104
      corresponding nonmalignant lung tissues by methylation-specific PCR. Methylation
      in the tumor samples was detected in 40% for RARbeta, 26% for TIMP-3, 25% for
      p16INK4a, 21% for MGMT, 19% for DAPK, 18% for ECAD, 8% for p14ARF, and 7% for
      GSTP1, whereas it was not seen in the vast majority of the corresponding
      nonmalignant tissues. Moreover, p16INK4a methylation was correlated with loss of
      p16INK4a expression by immunohistochemistry. A total of 82% of the NSCLCs had
      methylation of at least one of these genes; 37% of the NSCLCs had one gene
      methylated, 22% of the NSCLCs had two genes methylated, 13% of the NSCLCs had
      three genes methylated, 8% of the NSCLCs had four genes methylated, and 2% of the
      NSCLCs had five genes methylated. Methylation of these genes was correlated with
      some clinicopathological characteristics of the patients. In comparing the
      methylation patterns of tumors and nonmalignant lung tissues from the same
      patients, there were many discordancies where the genes methylated in
      nonmalignant tissues were not methylated in the corresponding tumors. This
      suggests that the methylation was occurring as a preneoplastic change. We
      conclude that these findings confirm in a large sample that methylation is a
      frequent event in NSCLC, can also occur in smoking-damaged nonmalignant lung
      tissues, and may be the most common mechanism to inactivate cancer-related genes
      in NSCLC.

PMID- 11196171
TI  - Transforming growth factor-beta-induced growth inhibition in a Smad4 mutant colon
      adenoma cell line.
AB  - Transforming growth factor-beta (TGF-beta) inhibits growth and induces apoptosis
      of colon epithelial cells. Binding of TGF-beta to its receptor induces
      phosphorylation of the Smad proteins Smad2 and Smad3, which then form heteromeric
      complexes with Smad4, translocate to the nucleus, and activate gene
      transcription. Smad4 function has been considered an obligate requirement for TGF
      beta signaling, and Smad4 mutations present in some cancers have been considered
      sufficient to inactivate TGF-beta signaling. In this work, we describe studies
      with a nontransformed human colon epithelial cell line that is mutant for Smad4
      but remains growth-inhibited by TGF-beta. The colon cell line VACO-235 has lost
      one of its Smad4 alleles via a chromosome 18q deletion. The remaining allele
      bears two missense point mutations located in regions important for Smad4 trimer
      formation, which is thought necessary for Smad4 function. As expected, pSBE4
      BV/Luc, a Smad4-activated transcriptional reporter, was inactive in VACO-235.
      Nonetheless, VACO-235 demonstrated 80% growth inhibition in response to TGF-beta,
      as well as retention of some TGF-beta-mediated activation of the p3TP-Lux
      transcriptional reporter. Transient transfection of the VACO-235 Smad4 mutant
      allele into a Smad4-null cell line confirmed that this allele is functionally
      inactive as assayed by both the pSBE4-BV and p3TP-Lux reporters. The simplest
      explanation of these results is that there is a non-Smad4-dependent pathway for
      TGF-beta-mediated signaling and growth inhibition in VACO-235 cells.

PMID- 11196172
TI  - A role for CCAAT/enhancer binding protein beta-liver-enriched inhibitory protein
      in mammary epithelial cell proliferation.
AB  - The transcription factor, CCAAT/enhancer binding protein beta (C/EBPbeta),
      regulates the expression of genes involved in proliferation and terminal
      differentiation. Dimerization of the dominant-negative C/EBPbeta-liver-enriched
      inhibitory protein (LIP) isoform with the C/EBPbeta-liver-enriched activating
      protein (LAP) isoform inhibits the transcriptional activation of genes involved
      in differentiation. Consequently, an increase in LIP levels may inhibit terminal
      differentiation and lead to proliferation. C/EBPbeta-LIP and LAP are crucial for
      mammary gland development (G. W. Robinson et al., Genes Dev., 12: 1907-1916,
      1998; T. N. Seagroves et al., Genes Dev., 12: 1917-1928, 1998) and are also
      overexpressed in breast cancer (B. Raught et al., Cancer Res., 56: 4382-4386.
      1996; C. A. Zahnow et al., J. Natl. Cancer Inst., 89: 1887-1891, 1997); however,
      little is known about how these isoforms differentially regulate cell cycle
      progression. To address this question, C/EBPbeta-LIP was overexpressed in both
      the mammary glands of transgenic mice and in cultured TM3 mammary epithelial
      cells. Here we report that the involuted mammary glands from transgenic mice
      overexpressing C/EBPbeta-LIP contain both focal and diffuse alveolar hyperplasia
      and, less frequently, contain mammary intraepithelial neoplasias (high grade) and
      invasive and noninvasive carcinomas. Likewise, cultured TM3 cells, stably
      expressing C/EBPbeta-LIP, showed an increase in proliferation and foci formation
      attributable to a reentry into S-phase during cellular confluence. These results
      demonstrate that C/EBPbeta-LIP can induce epithelial proliferation and the
      formation of mammary hyperplasias and suggest that a C/EBPbeta-LIP-initiated
      growth cascade may be susceptible to additional oncogenic hits, which could
      result in the initiation and progression of neoplasia.

PMID- 11196173
TI  - Lack of telomerase RNA gene hTERC expression in alternative lengthening of
      telomeres cells is associated with methylation of the hTERC promoter.
AB  - The immortal phenotype of most human cancers is attributable to telomerase
      expression. However, a number of immortal cell lines and tumors achieve telomere
      maintenance in the absence of telomerase via alternative mechanisms known as ALT
      (alternative lengthening of telomeres). Here we show that the promoter of the
      telomerase RNA gene (hTERC) is methylated in three of five ALT cell lines and is
      associated with a total absence of hTERC expression in the three lines. Treatment
      with 5-azacytidine in combination with trichostatin A resulted in partial
      demethylation of the hTERC promoter and expression of the gene. Partial
      methylation was detected in tumors (5%) and in immortal cell lines (27%). Cell
      lines with partial methylation express hTERC. Only in ALT cell lines does there
      appear to be a strong correlation between hTERC promoter hypermethylation and
      lack of hTERC expression.

PMID- 11196174
TI  - Nonhomologous end-joining of ionizing radiation-induced DNA double-stranded
      breaks in human tumor cells deficient in BRCA1 or BRCA2.
AB  - Mutations in the BRCA1 or BRCA2 genes predispose to a wide spectrum of familial
      cancers. The functions of the proteins encoded by BRCA1 and BRCA2 remain to be
      elucidated, but their interaction and colocalization with hRAD51 suggest a role
      in homologous recombination and DNA double-strand break (DSB) repair. The role of
      BRCA1 and BRCA2 in the rejoining of ionizing radiation (IR)-induced DNA DSBs,
      which may represent a step in the overall process of repair, remains uncertain
      because recent reports provide conflicting results. Because elucidation of the
      role of these proteins in DNA DSB rejoining is important for their functional
      characterization, we reexamined this end point in cells with mutations in either
      BRCA1 or BRCA2. We show that two pancreatic carcinoma cell lines known to have
      either wild-type (BxPC3) or mutant forms (Capan-1) of BRCA2 rejoin IR-induced DNA
      DSBs to a similar extent following biphasic kinetics characterized by a fast and
      a slow component. Importantly, inactivation of DNA-dependent protein kinase (DNA
      PK) by wortmannin generates similar shifts from the fast to the slow component of
      rejoining in BRCA2-proficient and BRCA2-deficient cells. This suggests that the
      functioning of either the fast, DNA-PK-dependent component or the slow, DNA-PK
      independent component of rejoining is not affected by mutations in BRCA2. Also, a
      human breast cancer cell line with mutated BRCA1 shows normal rejoining of IR
      induced DNA DSBs and levels of inhibition by wortmannin commensurate with the
      degree of DNA-PK inhibition. These observations fail to confirm a direct role for
      BRCA1 or BRCA2 in the rejoining of IR-induced DSBs in the genome of human tumor
      cells and, as a result, an involvement in nonhomologous end-joining. They are in
      line with similar observations with mutants deficient in genes implicated in
      homologous recombination and support the view that the radiosensitivity to
      killing of cells deficient in BRCA1 or BRCA2 derives from defects in this repair
      pathway.

PMID- 11196175
TI  - Mutant E-cadherin breast cancer cells do not display constitutive Wnt signaling.
AB  - Participation of E-cadherin in the Wnt signaling pathway was suggested because of
      the dual role of beta-catenin in cell adhesion and the Wnt signaling cascade.
      Whereas beta-catenin interacts at the cell membrane with the cell adhesion
      protein E-cadherin, in the nucleus it activates Wnt target genes through
      formation of transcriptionally active complexes with members of the Tcf/Lef
      family of transcription factors. Here, we analyzed by PCR and direct cycle
      sequencing 26 human breast cancer cell lines for alterations in the E-cadherin
      gene. Genetic alterations were identified in eight cell lines. Five cell lines
      had truncating mutations, whereas three cell lines had in-frame deletions in the
      gene transcript and expressed mutant E-cadherin proteins at the cell membrane.
      Involvement of E-cadherin in the Wnt pathway was evaluated through determination
      of the activity of a Tcf reporter gene, which had been transiently transfected
      into 15 breast cancer cell lines. None of six E-cadherin mutant cell lines and
      four cell lines that exhibit transcriptional silencing of the E-cadherin gene
      showed Tcf-mediated transcriptional activation. E-cadherin wild-type cell line
      DU4475 exhibited constitutive Tcf-beta-catenin signaling activity and was found
      to express truncated APC proteins. These results indicate that if cellular
      transformation occurred through mutation of E-cadherin, it is not mediated via
      constitutive activation of the Wnt signaling pathway.

PMID- 11196176
TI  - High resolution allelotype of nonfunctional pancreatic endocrine tumors:
      identification of two molecular subgroups with clinical implications.
AB  - A high resolution allelotype for nonfunctional pancreatic endocrine tumors (NF
      PETs) has been generated by microsatellite analysis of DNA from 16 frozen cases,
      each probed with 394 markers. Two subgroups of NF-PETs were found. Seven cases
      showed frequent, large allelic deletions [loss of heterozygosity (LOH)] with an
      average fractional allelic loss (FAL) of 0.55, whereas nine cases showed a small
      number of random losses with a FAL of 0.15. Designated high or low FAL,
      respectively, these genetic phenotypes showed correlation with the ploidy status:
      high-FAL tumors were aneuploid, low-FAL were diploid. Chromosomes 6q and 11q
      showed LOH in >60% of cases. About 50% of cases had losses on 11p, 20q, and 21.
      Selected LOH analysis on an additional 16 paraffin-embedded NF-PETs confirmed the
      high frequency of 6q and 11q LOH. The allelotype of NF-PET is markedly different
      from that of either ductal or acinar tumors of the pancreas as well as from that
      of functional-PETs. Moreover, whereas deletions involving chromosome 11 also are
      a feature of functional-PETs, the involvement of chromosome 6q is characteristic
      of NF-PETs. Survival analysis showed that none of the single chromosomal
      alterations was associated with outcome, whereas ploidy status is an independent
      factor adding prognostic information to that furnished by the proliferative index
      measured by Ki-67 immunohistochemistry.

PMID- 11196177
TI  - Five novel hormone-responsive cell lines derived from murine mammary ductal
      carcinomas: in vivo and in vitro effects of estrogens and progestins.
AB  - We have developed an experimental model of mammary carcinogenesis in which the
      administration of medroxyprogesterone acetate (MPA) to female BALB/c mice induces
      progestin-dependent ductal metastatic mammary tumors with high levels of estrogen
      receptor (ER) and progesterone receptor (PR). Through selective transplants in
      untreated mice, we have obtained progestin-independent variants, still expressing
      high levels of ER and PR. Primary cultures of the MPA-induced carcinomas C4-HD
      and C7-HI were set up, and after 3-4 months, several different cell lines were
      obtained. Four of these, MC4-L1, MC4-L2, MC4-L3, and MC4-L5 were established from
      C4-HD and a fifth, MC7-L1, from C7-HI. All cells were of epithelial origin, as
      demonstrated by electron microscopy and by immunocytochemical identification of
      cytokeratin and cadherin. In vitro MC4-L1, MC4-L3, and MC4-L5 showed a typical
      epithelial morphology; when transplanted in vivo, they originated metastatic
      carcinomas with different degrees of differentiation. MC4-L2 and MC7-L1 deviated
      from the standard epithelial picture; they disclosed a spindle-shaped morphology
      in vitro and in vivo gave rise to a biphasic spindle cell/tubular carcinoma and
      an anaplastic carcinoma, respectively; both lines gave rise to metastases. This
      differential morphology correlated with a higher degree of aggressiveness, as
      compared with MC4-L1, MC4-L3, and MC4-L5. ERs and PRs were detected by binding,
      immunocytochemistry, and Western blot. In vitro, MC4-L2 and MC7-L1 were
      stimulated by MPA (nM to microM) and 17beta-estradiol (nM and 10 nM); no
      significant stimulation was observed in MC4-L1, MC4-L3, and MC4-L5 under the same
      experimental conditions. In vivo, MPA significantly stimulated tumor growth in
      all epithelioid lines but not in MC4-L2 and MC7-L1. A progestin-dependent growth
      pattern was confirmed for MC4-L1, MC4-L3, and MC4-L5 in successive transplants,
      whereas MC4-L2 and MC7-L1 behaved as progestin independent. This is the first
      description of mouse mammary carcinoma cell lines expressing ER and PR. The
      different in vitro hormone responses as compared with in vivo and the
      differential effects of 17beta-estradiol in the parental tumors and in cell lines
      render these lines useful tools for the in vitro and in vivo study of hormone
      regulation of tumor growth and metastases.

PMID- 11196178
TI  - Expression of cyclooxygenase 2 in human malignant melanoma.
AB  - Cyclooxygenase (COX)-2 is an inducible enzyme involved in production of
      prostaglandins in inflammatory processes. There is now increasing evidence that a
      constitutive expression of COX-2 plays a role in development and progression of
      malignant epithelial tumors. In the present study we investigated expression and
      function of COX-2 in malignant melanoma. Expression of COX-2 was determined by
      immunohistochemistry in 28 cases of primary skin melanoma and 4 benign nevi. We
      show that COX-2 was expressed in 26 cases (93%) of melanomas, with a moderate to
      strong expression in 19 cases (68%). Benign nevi as well as normal epithelium
      were negative in all cases. A constitutive expression of COX-2 mRNA and protein
      was found in five melanoma cell lines (A375, MeWo, SK-Mel-13, SK-Mel-28, and IGR
      37) by using Northern blot as well as immunoblotting. All melanoma cell lines
      produced prostaglandin (PG) E2 between 468 and 3500 pg/ml as determined by ELISA.
      Treatment with NS-398 (50 microM), a specific inhibitor of COX-2, suppressed PGE2
      production of all melanoma cell lines by 50-96%. The IC50 for inhibition of PGE2
      production by NS-398 was determined as 4 microM, indicating that NS-398 acts via
      inhibition of the COX-2 isoenzyme. We could show that proliferation of melanoma
      cell lines was not influenced by treatment with NS-398 in concentrations up to
      100 microM. However, NS-398 reduced Matrigel invasion of all five malignant
      melanoma cell lines by 50-68%. Our results indicate that COX-2 is expressed in
      malignant melanomas and may be involved in regulation of melanoma invasion. It
      remains to be investigated whether selective inhibitors of COX-2 might be useful
      for prevention or treatment of malignant melanoma.

PMID- 11196179
TI  - Modulation of tumor angiogenesis by conditional expression of fibroblast growth
      factor-2 affects early but not established tumors.
AB  - Fibroblast growth factor-2 (FGF2) is a pleiotropic heparin-binding growth factor
      endowed with a potent angiogenic activity in vitro and in vivo. To investigate
      the impact of the modulation of FGF2 expression on the neovascularization at
      different stages of tumor growth, we generated stable transfectants (Tet-FGF2)
      from the human endometrial adenocarcinoma HEC-1-B cell line in which FGF2
      expression is under the control of the tetracycline-responsive promoter (Tet-off
      system). After transfection, independent clones were obtained in which FGF2 mRNA
      and protein were up-regulated compared with parental cells. Also, the conditioned
      medium of Tet-FGF2 transfectants caused proliferation, urokinase-type plasminogen
      activator up-regulation, migration, and sprouting of cultured endothelial cells.
      A 3-day treatment of Tet-FGF2 cell cultures with tetracycline abolished FGF2
      overexpression and the biological activity of the conditioned medium without
      affecting their proliferative capacity. Tet-FGF2 cells formed tumors when nude
      mice received s.c. injections. The administration of 2.0 mg/ml tetracycline in
      the drinking water before cell transplantation, continued throughout the whole
      experiment, inhibited FGF2 expression in Tet-FGF2 tumor lesions. This was
      paralleled by a significant decrease in the rate of tumor growth and
      vascularization to values similar to those observed in lesions generated by
      parental HEC-1-B cells. Tetracycline administration 20 days after tumor cell
      implant, although equally effective in reducing FGF2 expression and inhibiting
      tumor vascularity, only minimally impaired the growth of established Tet-FGF2
      tumors. The results indicate that FGF2 expression deeply affects the initial
      tumor growth and neovascularization of HEC-1-B human endometrial adenocarcinoma
      in nude mice. On the contrary, the growth of established tumors appears to be
      independent of the inhibition of FGF2 expression and decreased vascular density.
      The possibility that a significant reduction of angiogenesis may not affect the
      progression of large tumors points to the use of antiangiogenic therapy in early
      tumor stage.

PMID- 11196180
TI  - Antiapoptotic role of endogenous nitric oxide in human melanoma cells.
AB  - The role of endogenous NO on cell survival was investigated in human melanoma
      cells and melanocytes. Inducible NO synthase (iNOS) was always expressed in a
      panel of melanoma cell lines from metastatic lesions and in normal adult
      melanocytes. iNOS was also detected by immunohistochemistry in melanoma cells
      from metastases. Release of NO by tumor cells and melanocytes was inhibited by a
      specific iNOS inhibitor, aminoguanidine (AMG). Inhibition of endogenous NO
      synthesis did not affect cell cycle progression of melanoma cells but led to cell
      death by apoptosis, as indicated by Annexin V/propidium iodide and terminal
      deoxynucleotidyltransferase-mediated dUTP nick end labeling assays. By contrast,
      iNOS inhibition by AMG did not promote apoptosis in normal adult melanocytes. A
      mitochondrial pathway was involved in melanoma apop tosis, as indicated by
      altered mitochondrial membrane potential (delta psi(m)) and down-regulation of
      Bcl-2 protein level after iNOS inhibition. AMG treatment triggered release of
      caspase-1, enzymatic activation of caspase-3, and degradation of poly(ADP-ribose)
      polymerase, one of the main caspase-3 substrates. Melanoma cell apoptosis induced
      by iNOS inhibition was completely blocked by peptide inhibitors of caspase-1 and
      caspase-3 (Ac-DEVD-CHO and AC-YVAD-CHO) or by an exogenous NO donor, sodium
      nitroprusside, or by addition of serum. Finally, comparison of control and AMG
      treated melanoma cells by pathway-specific gene array analysis indicated that
      inhibition of NO synthesis led, before induction of apoptosis, to up-regulation
      of mRNA levels of genes involved in the apoptosis pathway such as Bax, caspase-1,
      caspase-3, caspase-6, gadd45beta, mdm2, and TRAIL. Taken together, these results
      indicate that melanoma cell survival is regulated by endogenous NO resulting from
      iNOS activity.

PMID- 11196181
TI  - p53 induction and apoptosis in response to radio- and chemotherapy in vivo is
      tumor-type-dependent.
AB  - The p53 protein rapidly accumulates in cells in response to DNA damage, which can
      trigger apoptosis. This pathway is hypothesized to be important for tumor
      suppression by p53, as well as for the response of tumors to chemo- or
      radiotherapy. Implicit in these ideas is that the p53 induction-apoptosis pathway
      is active in tumor cells in vivo. Because tumor suppression by p53 in mice is
      markedly tissue-type-dependent, we tested the activity of the pathway in tumors
      in vivo by inducing tumors in six different tissues and treating tumor-bearing
      mice with DNA damaging cancer therapeutic agents. In response to treatment, cells
      from T-cell lymphomas, intestinal adenomas, and mammary tumors rapidly induced
      p53 and underwent apoptosis. In squamous cell papillomas, p53 was constitutively
      expressed and was further induced by the treatments, but apoptotic cells were
      only rarely observed. In treated mice bearing lung or liver adenomas, minimal or
      no p53 accumulation or apoptosis was observed in the tumor cells. Thus, there is
      marked variation in the intrinsic ability of autochthonous tumor cells to
      accumulate p53 and undergo apoptosis. This variation provides one explanation for
      the tissue specificity of tumor suppression by p53. It also indicates that the
      role of apoptosis in the response of tumors to therapy varies significantly among
      tumor types.

PMID- 11196182
TI  - Specific p53 mutations detected in plasma and tumors of hepatocellular carcinoma
      patients by electrospray ionization mass spectrometry.
AB  - Hepatocellular carcinoma (HCC), a common cause of cancer deaths worldwide, has
      several major etiological risk factors, including infection with the hepatitis
      viruses and exposure to aflatoxin B1. A specific missense mutation resulting from
      a guanine to thymine transversion at the third position of codon 249 in the p53
      tumor suppressor gene has been reported in 10-70% of HCCs from areas of high
      dietary exposure to aflatoxin B1. Short oligonucleotide mass analysis was
      compared with DNA sequencing in 25 HCC samples for specific p53 mutations.
      Mutations were detected in 10 samples by short oligonucleotide mass analysis in
      agreement with DNA sequencing. Analysis of another 20 plasma and tumor pairs
      showed 11 tumors containing the specific mutation, and this change was detected
      in six of the paired plasma samples. Four of the plasma samples had detectable
      levels of the mutation; however, the tumors were negative, suggesting possible
      multiple independent HCCs. Ten plasma samples from healthy individuals were all
      negative. This molecular diagnostic technique has implications for prevention
      trials and for the early diagnosis of HCC.

PMID- 11196183
TI  - Apoptosis: an early event in metastatic inefficiency.
AB  - Whereas large numbers of cells from a primary tumor may gain access to the
      circulation, few of them will give rise to metastases. The mechanism of
      elimination of these tumor cells, often termed "metastatic inefficiency," is
      poorly understood. In this study, we show that apoptosis in the lungs within 1-2
      days of introduction of the cells is an important component of metastatic
      inefficiency. First, we show that death of transformed, metastatic rat embryo
      cells occurred via apoptosis in the lungs 24-48 h after injection into the
      circulation. Second, we show that Bcl-2 overexpression in these cells inhibited
      apoptosis in culture and also conferred resistance to apoptosis in vivo in the
      lungs 24-48 h after injection. This inhibition of apoptosis led to significantly
      more macroscopic metastases. Third, comparison between the extent of apoptosis by
      a poorly metastatic cell line to that by a highly metastatic cell line 24 h after
      injection in the lungs revealed more apoptosis by the poorly metastatic cell
      line. These results indicate that apoptosis, which occurs at 24-48 h after
      hematogenous dissemination in the lungs is an important determinant of metastatic
      inefficiency. Although prior work has shown an association between apoptosis in
      culture and metastasis in vivo, this work shows that apoptosis in vivo
      corresponds to decreased metastasis in vivo.

PMID- 11196184
TI  - Laminin isoforms 8 and 10 are primary components of the subendothelial basement
      membrane promoting interaction with neoplastic lymphocytes.
AB  - To determine whether subendothelial laminins (LNs) could be implicated in the
      extravasation of neoplastic lymphocytes, we have examined the distribution of a
      number of LN isoforms in human vascular structures of adult individuals and have
      assayed the ability of the isolated LN molecules to promote adhesion of lymphoma
      and leukemic cells in vitro using a novel cell adhesion assay, CAFCA, Centrifugal
      Assay for Fluorescence-based Cell Adhesion (E. Giacomello et al., Biotechniques,
      26: 758-762, 1999; P. Spessotto et al., Methods Mol. Biol., 139: 321-343, 2000).
      The use of previously characterized LN chain-specific antibodies showed that the
      vast majority of the smaller vascular compartments, known to correspond to sites
      of lymphocyte transmigration, expressed the subunits involved in the structuring
      of 9 of the 12 LN isoforms known to date. Eight LN isoforms (i.e., LN-1, -2, -4, 
      5, -8, -9, -10, and -11) and four naturally occurring LN complexes were isolated
      from various tissues and cultured cells by combined gel filtration, ion exchange,
      and immunoaffinity chromatographies, and the identity/composition of the isolated
      LNs/LN complexes was asserted by immunochemical means and amino-acid sequencing.
      Notwithstanding the widespread colocalization of LN isoforms, a panel of
      neoplastic B- and T-cell lines and lymphocytes isolated from patients affected by
      chronic lymphocytic B-cell leukemia attached preferentially and with high avidity
      to purified LN-8, purified LN-10, and LN-10-containing protein complexes, whereas
      lymphocytes derived from patients diagnosed with acute lymphocytic leukemia
      failed to bind to these LNs. All of the tested neoplastic lymphocytes failed to
      adhere to the isolated LN-1, LN-4, LN-9, and LN-11 and attached moderately well
      to purified LN-2 and LN-5. The interaction of transformed lymphocytes with LNs
      was cation-dependent and interchangeably mediated by the alpha3beta1 and
      alpha6beta1 integrins. The degree of engagement of the two LN receptors was
      dependent upon their relative levels of cell surface expression, whereas,
      irrespective of the phenotype, lymphocytes deprived of either of these receptors
      were incapable of LN binding. The findings suggest that LN-8 and LN-10 may act in
      an independent or complementary fashion as primary components of the endothelial
      basement membrane favoring the interaction of extravasating neoplastic
      lymphocytes. Thus, our results would demonstrate that different LN isoforms may
      evoke diverse cellular responses in different cell types and that this divergence
      may be the basis for the redundancy of LN distribution in a number of vascular
      structures.

PMID- 11196185
TI  - Reconstitution of caspase 3 sensitizes MCF-7 breast cancer cells to doxorubicin-
      and etoposide-induced apoptosis.
AB  - MCF-7, a breast cancer-derived cell line, is deficient of caspase 3 and
      relatively insensitive to many chemotherapeutic agents. To study the association
      of caspase 3 deficiency and chemotherapeutic resistance, we reconstituted caspase
      3 in MCF-7 cells and characterized their apoptotic response to doxorubicin and
      etoposide. Western blots demonstrated that caspase 3 was constitutively expressed
      in the reconstituted MCF-7 cells. Both morphological observation and survival
      assays showed that caspase 3 reconstitution significantly sensitized MCF-7 cells
      to both drugs. Remarkably increased activation of caspases 3, 6, and 7, cleavage
      of cellular death substrates, and DNA fragmentation were detected in the
      reconstituted MCF-7 cells after drug treatment. Together, these data demonstrated
      a specific role for caspase 3 in chemotherapy-induced apoptosis and in activation
      of caspases 6 and 7. Our results also suggest that caspase 3 deficiency may
      contribute to chemotherapeutic resistance in breast cancer.

PMID- 11196186
TI  - Cytogenetic analysis of multifocal bladder cancer supports a monoclonal origin
      and intraepithelial spread of tumor cells.
AB  - Bladder cancer is often characterized by a multifocal growth pattern. This
      observation has given rise to the hypothesis of "field cancerization," predicting
      a polyclonal origin of multiple tumors rising from an area of independently
      transformed mucosa cells. On the other hand, genetic studies suggested a
      monoclonal origin. To address these contradictory hypotheses, we performed
      comparative genomic hybridization (CGH) on 32 tumors originating from six bladder
      cystectomy specimens. All tumors derived from the same patient showed a set of 7
      13 identical chromosomal aberrations and additional individual alterations. Most
      striking were the findings of 17p losses in all (32 of 32) tumors of the six
      cystectomy specimens and 20p gains in all tumors of four bladders, as well as an
      unexpected high number of chromosomal changes (20.4 alterations per tumor on
      average). To clarify a possible role of the TP53 tumor suppressor gene on 17p13,
      we applied immunohistochemistry and sequence analysis on the tumors and
      additional 52 mucosa samples. Identical TP53 mutations and protein overexpression
      was found in individual tumors only as well as in mucosa samples from continuous
      areas. Our results not only provide further evidence for a monoclonal origin of
      multifocal bladder cancer but also point at intraepithelial migration of tumor
      cells carrying specific chromosomal aberrations.

PMID- 11196187
TI  - Frameshift mutations at coding mononucleotide repeats of the hRAD50 gene in
      gastrointestinal carcinomas with microsatellite instability.
AB  - Microsatellite instability (MSI) and frameshift mutations in genes containing
      nucleotide repeats have been reported in a subset of colorectal and gastric
      carcinomas. This study describes the analysis of MSI-positive colorectal (39
      cases) and gastric carcinomas (36 cases) for the presence of frameshift mutations
      of the six genes known to be involved in DNA repair and containing mononucleotide
      repeats in their coding region. Our mutational study of the 75 MSI-positive
      tumors revealed frequent mutations in hRAD50 (23 cases, 31%), BLM (16 cases,
      21%), and hMSH6 (16 cases, 21%); rare mutations in BRCA1 (1 case, 1%) and ATM (3
      cases, 4%); and no mutation in NBS1. In contrast, no frameshift mutation was
      found in 60 MSI-negative colorectal and gastric carcinomas. The mutation of
      hRAD50, a gene that is involved in the response to cellular DNA damage and forms
      a complex with hMRE11 and NBS1, has not been reported previously. Our results
      suggest that frameshift mutations of hRAD50, BLM, and hMSH6 are selected and play
      a role in the tumorigenesis of colorectal and gastric carcinomas with MSI. The
      MSI targeting of the hRAD50 and BLM genes represents an additional link between
      MSI and DNA repair because alteration of these genes could accelerate defective
      DNA repair.

PMID- 11196188
TI  - Neuroblastoma-derived gangliosides inhibit dendritic cell generation and
      function.
AB  - Neuroblastoma (NB), a tumor of the sympathetic nervous system, is the most common
      extracranial solid tumor in children. NB-derived gangliosides inhibit the
      functional activity of T and natural killer cells, contribute to tumor-induced
      bone marrow suppression, and cause multiple alterations of hematopoiesis,
      resulting in pancytopenia. However, the role of gangliosides in the regulation of
      dendritic cell (DC) generation (dendropoiesis) has not been studied. Using murine
      and human NB cell lines, we demonstrated that coincubation of murine bone marrow
      progenitors or human CD34+ progenitor cells with NB cells resulted in a
      significant inhibition of dendropoiesis in vitro up to 90%. The number of DCs was
      assessed by FACScan determination of CD83+ or CD11c+ cells coexpressing MHC class
      II and CD86 molecules. In addition, inhibition of antigen-presenting properties
      of DCs cultured in the presence of NB cells was observed in allogeneic mixed
      leukocyte reaction (33,508 +/- 1,613 cpm for control DCs versus 17,428 +/- 152
      cpm for NB-treated DCs; P < 0.05). Treatment of NB cells with 10 microM DL-threo
      1-phenyl-2-decanolylamine-3-morpholino-1-propanol HCl, an inhibitor of
      glucosylceramide synthase, markedly abrogated ganglioside synthesis and was
      accompanied by blockade of NB ability to inhibit dendropoiesis. Furthermore,
      purified gangliosides added to DC cultures significantly inhibited DC generation.
      The percentage of CD83+ cells decreased from 51.8 +/- 6.1% in the control group
      to 12.9 +/- 2.7% in cultures treated with GD2 (P < 0.05). Thus, our results
      demonstrate that NB-derived gangliosides inhibit the generation of functionally
      active DCs and may play a role in tumor-induced immunosuppression and subsequent
      tumor escape from immune recognition and elimination.

PMID- 11196189
TI  - Specifically targeted killing of carcinoembryonic antigen (CEA)-expressing cells
      by a retroviral vector displaying single-chain variable fragmented antibody to
      CEA and carrying the gene for inducible nitric oxide synthase.
AB  - The generation of retroviral vectors that infect specific cell types through
      recognition of cell surface antigens is a promising and effective approach to
      targeted gene therapy of cancer. Carcinoembryonic antigen (CEA), a highly
      characterized, cell surface glycoprotein overexpressed by various tumor cells,
      provides a specific tool for tumor tissue-specific targeting by retroviral
      vectors. The conventional suicidal gene delivery systems need additional drugs
      other than their gene products. The inducible nitric oxide synthase (iNOS) gene
      product yields nitric oxide (NO), which directly induces autocytotoxicity and
      cytolysis of bystander cells. In the present study, we have developed a novel
      bifunctional Moloney murine leukemia virus-based recombinant retroviral vector
      that displays a chimeric envelope protein containing a single-chain variable
      fragmented (scFv) antibody to CEA and carries the iNOS gene in the genome. The
      resultant bifunctional retroviral vector showed a specific delivery of the iNOS
      gene to human CEA-expressing carcinoma cells, resulting in the direct and
      efficient killing of CEA-expressing carcinoma cells by induction of apoptosis.
      This is the first report of successful killing of CEA-expressing cells by
      specific targeting of the iNOS gene. This approach may offer a one-step procedure
      for effective gene therapy of CEA-expressing tumors.

PMID- 11196190
TI  - Matrix metalloproteinase 2 in tumor cell-induced platelet aggregation: regulation
      by nitric oxide.
AB  - A correlation exists between the ability of tumor cells to aggregate platelets
      and their tendency to metastasize. Tumor cell-induced platelet aggregation
      (TCIPA) facilitates the embolization of the vasculature with tumor cells and the
      formation of metastatic foci. It is well documented that matrix
      metalloproteinases (MMPs) play an integral part in tumor spread and the
      metastatic cascade. Therefore, we have examined the role of MMPs during TCIPA and
      its regulation by nitric oxide (NO) in vitro. Human HT-1080 fibrosarcoma and A549
      lung epithelial cancer cells induced TCIPA in a concentration-dependent manner
      that was monitored by aggregometry. This aggregation resulted in the release of
      MMIP-2 from platelets and cancer cells, as measured by zymography. HT-1080 cells
      released significantly more MMP-2 than A549 cells and were more efficacious in
      inducing TCIPA. Inhibition of MMP-2 with phenanthroline (1-1000 microM), a
      synthetic inhibitor of MMPs, and by neutralizing anti-MMIP-2 antibody (10
      microg/ml) reduced TCIPA induced by HT-1080 cells. TCIPA was abolished by
      simultaneous inhibition of platelet function with acetylsalicylic acid (100
      microM; thromboxane pathway inhibitor), apyrase (250 microg/ml; ADP pathway
      inhibitor), and phenanthroline. NO donors such as S-nitroso-n-acetylpenicillamine
      and S-nitrosoglutathione (both at 0.01-100 microM) inhibited TCIPA and MMP-2
      release from platelets and tumor cells. The inhibitory actions of S-nitroso-n
      acetylpenicillamine and S-nitrosoglutathione were reversed by 1H
      [1,2,4]oxadiazole[4,3]quinoxalin-1-one (0.01-30 microM), a selective inhibitor of
      the soluble guanylyl cyclase. We conclude that (a) human fibrosarcoma cells
      aggregate platelets via mechanism(s) that are mediated, in part, by MMP-2; (b) NO
      inhibits TCIPA, in part, by attenuating the release of MMP-2; and (c) these
      effects of NO are cGMP-dependent.

PMID- 11196191
TI  - Interleukin 6 inhibits proliferation and, in cooperation with an epidermal growth
      factor receptor autocrine loop, increases migration of T47D breast cancer cells.
AB  - Interleukin (IL)-6, a multifunctional regulator of immune response,
      hematopoiesis, and acute phase reactions, has also been shown to regulate cancer
      cell proliferation. We have investigated IL-6 signaling pathways and cellular
      responses in the T47D breast carcinoma cell line. The IL-6-type cytokines, IL-6
      and oncostatin M, simultaneously inhibited cell proliferation and increased cell
      migration. In T47D cells, IL-6 stimulated the activation of Janus-activated
      kinase 1 tyrosine kinase and signal transducers and activators of transcription
      (STAT) 1 and STAT3 transcription factors. Expression of dominant negative STAT3
      in the cells strongly reduced IL-6-mediated growth inhibition but did not prevent
      IL-6-induced cell migration. IL-6 treatment led to activation of the mitogen
      activated protein kinase (MAPK) and the phosphatidylinositol 3'-kinase (PI3K)
      pathways. Inhibition of MAPK or PI3K activity reversed IL-6- and oncostatin M
      stimulated migration. Because cross-talk between cytokine receptors and members
      of the ErbB family of receptor tyrosine kinases has been described previously, we
      have examined their interaction in T47D cells. Down-regulation of ErbB receptor
      activity, through the use of specific pharmacological inhibitors or dominant
      negative receptor constructs, revealed that IL-6-induced MAPK activation was
      largely dependent on epidermal growth factor (EGF) receptor activity, but not on
      ErbB-2 activity. Using a monoclonal antibody that interferes with EGF receptor
      ligand interaction, we have shown that in T47D cells, IL-6 cooperates with an EGF
      receptor autocrine activity loop for signaling through the MAPK and PI3K pathways
      and for cell migration. Both the tyrosine phosphatase SHP-2 and the
      multisubstrate docking molecule Gab1, which are potential links between IL-6 and
      the MAPK/PI3K pathways, were constitutively associated with the active EGF
      receptor. On IL-6 stimulation, SHP-2 and Gab1 were recruited to the gp130 subunit
      of the IL-6 receptor and tyrosine phosphorylated, allowing downstream signaling
      to the MAPK and PI3K pathways. Thus, in T47D breast carcinoma cells, IL-6 acts in
      synergy with EGF receptor autocrine activity to signal through the MAPK/PI3K
      pathways. Cooperation between IL-6 and the EGF receptor in T47D breast carcinoma
      cells illustrates how a combination of multiple stimuli, either exogenous or
      endogenous, may result in synergistic cellular responses.

PMID- 11196192
TI  - Vascular endothelial growth factor receptor-2-blocking antibody potentiates
      radiation-induced long-term control of human tumor xenografts.
AB  - Antiangiogenic therapy can enhance radiation-induced tumor growth inhibition.
      However, the effects of combined antiangiogenic and radiation therapy on long
      term tumor control and normal tissue response have not been reported. We treated
      mice bearing two different human tumor xenografts with anti-vascular endothelial
      growth factor receptor-2 antibody (DC101) and five dose fractions of local
      radiation and followed them for at least 6 months. DC101 significantly decreased
      the dose of radiation necessary to control 50% of tumors locally. The decrease
      was 1.7- and 1.3-fold for the moderately radiosensitive small cell lung carcinoma
      54A and the highly radioresistant glioblastoma multiforme U87, respectively. In
      contrast to tumors, no increase in skin radiation reaction by the antibody was
      detected. Surprisingly, 44% of mice bearing 54A tumor developed clear ascites
      after DC101 treatment at its highest dose; this was fatal to 20% of mice. This
      adverse effect was seen only in mice that received whole-body irradiation 1 day
      before tumor implantation. The encouraging results on two human tumor xenografts
      suggest that vascular endothelial growth factor receptor-2 blockade merits
      further investigation to assess its potential as an enhancer of radiation therapy
      in the clinic.

PMID- 11196193
TI  - D-24851, a novel synthetic microtubule inhibitor, exerts curative antitumoral
      activity in vivo, shows efficacy toward multidrug-resistant tumor cells, and
      lacks neurotoxicity.
AB  - N-(pyridin-4-yl)-[1-(4-chlorbenzyl)-indol-3-yl]-glyoxyl-amid (D-24851) is a novel
      synthetic compound that was identified in a cell-based screening assay to
      discover cytotoxic drugs. D-24851 destabilizes microtubules and blocks cell cycle
      transition specifically at G2-M phase. The binding site of D-24851 does not
      overlap with the tubulin binding sites of known microtubule-destabilizing agents
      like vincristine or colchicine. In vitro, D-24851 has potent cytotoxic activity
      toward a panel of established human tumor cell lines including SKOV3 ovarian
      cancer, U87 glioblastoma, and ASPC-1 pancreatic cancer cells. In vivo, oral D
      24851 treatment induced complete tumor regressions (cures) in rats bearing
      Yoshida AH13 sarcomas. Of importance is that the administration of curative doses
      of D-24851 to the animals revealed no systemic toxicity in terms of body weight
      loss and neurotoxicity in contrast to the administration of paclitaxel or
      vincristine. Interestingly, multidrug-resistant cell lines generated by
      vincristine-driven selection or transfection with the Mr 170,000 P-glycoprotein
      encoding cDNA were rendered resistant toward paclitaxel, vincristine, or
      doxorubicin but not towards D-24851 when compared with the parental cells.
      Because of its synthetic nature, its oral applicability, its potent in vitro and
      in vivo antitumoral activity, its efficacy against multidrug-resistant tumors,
      and the lack of neurotoxicity, D-24851 may have significant potential for the
      treatment of various malignancies.

PMID- 11196195
TI  - Tumor progression is associated with a significant decrease in the expression of
      the endostatin precursor collagen XVIII in human hepatocellular carcinomas.
AB  - Endostatin inhibits angiogenesis and tumor growth in mice. The role of its
      endogenous precursor collagen XVIII in human cancer is unknown. In normal
      tissues, two variants of collagen XVIII, namely, the short and long forms
      regulate tissue specificity, the long form being almost exclusively expressed by
      hepatocytes in the liver. We analyzed RNA arrays from 57 hepatocellular
      carcinomas (HCCs) with common and variant-specific probes and investigated the
      relationships between collagen XVIII expression and angiogenesis by measuring the
      CD34-positive microvessel density. Low collagen XVIII expression by tumor
      hepatocytes was associated with large tumor size (r, -0.63; P < 0.001) and
      replacement of trabeculae with pseudoglandular-solid architecture (chi2, 28; P <
      0.001), which indicate tumor progression. Tumors expressing the highest collagen
      XVIII levels were smaller and had lower microvessel density (P = 0.01) than those
      expressing moderate levels; and HCCs with the lowest collagen XVIII levels
      approached a plateau of microvessel density, which indicated that a decrease in
      collagen XVIII expression is associated with angiogenesis in primary liver
      cancer. HCCs recurring within 2 years of resection showed 2.2-fold lower collagen
      XVIII mRNA than nonrecurring ones (P = 0.02). The findings relied on the
      hepatocyte-specific long form. Thus, the endogenous expression of the endostatin
      precursor decreases along with tumor progression in HCCs.

PMID- 11196194
TI  - Heregulin regulation of urokinase plasminogen activator and its receptor: human
      breast epithelial cell invasion.
AB  - Heregulin-beta1, which binds human epidermal growth factor receptors 3 and 4,
      promotes motility and invasiveness of breast cancer cells. Considering the
      established role of urokinase plasminogen activator (uPA) and its receptor (uPAR)
      in invasion, this study was undertaken to explore the role of heregulin-beta1 in
      regulating uPA and uPAR in breast cancer invasion. The stimulation by heregulin
      beta1 of noninvasive human breast cancer MCF-7 cells induced the expression of
      uPA mRNA, protein, and its plasminogenic activity. This uPA mRNA expression was
      blocked by a transcriptional inhibitor, actinomycin D, and does require de novo
      protein synthesis for its optimal induction in MCF-7 cells, but not in mouse
      mammary epithelial HC11 cells. Heregulin-beta1 also induced the expression of
      uPAR mRNA and protein in an actinomycin D-sensitive manner and cycloheximide
      superinduced the uPAR mRNA. Heregulin-beta1-stimulated signaling initiated the
      transcription from uPA- and uPAR-promoters. These results suggest that heregulin
      beta1 regulation of breast cancer cell invasion may be mediated in part through
      the up-regulation of uPA and uPAR.

PMID- 11196196
TI  - Highly elevated ultraviolet-induced mutation frequency in isolated Chinese
      hamster cell lines defective in nucleotide excision repair and mismatch repair
      proteins.
AB  - We have isolated N-methyl-N'-nitro-N-nitrosoguanidine-resistant cell lines from
      43-3B Chinese hamster ovary cells, which are deficient in the ERCC1 gene involved
      in nucleotide excision repair. By Western blotting analysis, we found cell lines
      that are deficient or decreased in the amount of MSH6, or PMS2, or MSH2 proteins.
      Cell extracts of these cell lines show reduced efficiency of G:T mismatch repair
      activity. Compared with 43-3B, these cell lines exhibit highly elevated UV
      induced mutation rates, indicating that mammalian mismatch repair can suppress UV
      induced mutagenesis and may play a role in the fidelity of DNA replication at the
      sites of UV damage.

PMID- 11196197
TI  - Topoisomerase I-mediated cytotoxicity of N-methyl-N'-nitro-N-nitrosoguanidine:
      trapping of topoisomerase I by the O6-methylguanine.
AB  - Alkylating agents such as N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) are known
      to covalently link alkyl groups at the position 6 of guanines (O6MG) in DNA. O6
      alkylguanine-DNA alkyltransferase (AGT) specifically removes the methyl group of
      the O6MG. Using purified human topoisomerase I (Top1), we found an 8-10-fold
      enhancement of Top1 cleavage complexes when O6MG is incorporated in
      oligonucleotides at the +1 position relative to a unique Top1 cleavage site. Top1
      poisoning by O6MG is attributable to a decrease of the Top1-mediated DNA
      religation as well as an increase in the enzyme cleavage step. Increased cleavage
      is probably linked to a change in the hydrogen bonding pattern, such as in the
      case of the 8-oxoguanine, whereas inhibition of religation could be attributed to
      altered base pairing, such as abasic sites or base mismatches, because
      incorporation of a 6-thioguanine did not affect Top1 activity. Top1-DNA covalent
      complexes are also induced in MNNG-treated CHO cells constitutively lacking the
      AGT enzyme. Conversely, no increase could be detected in CHO cells transfected
      with the wild-type human AGT. Moreover, we show that yeasts overexpressing the
      human Top1 are more sensitive to MNNG, whereas knock-out Top1 strain cells
      display some resistance to the drug. Altogether, these results suggest a role for
      Top1 poisoning by alkylated bases in the antiproliferative activity of alkylating
      agents as well as in the DNA lesions resulting from endogenous and carcinogenic
      DNA modifications.

PMID- 11196198
TI  - The partial nontandem duplication of the MLL (ALL1) gene is a novel rearrangement
      that generates three distinct fusion transcripts in B-cell acute lymphoblastic
      leukemia.
AB  - A partial nontandem duplication (PNTD) of mixed lineage leukemia (MLL) gene is
      described in B-cell acute lymphoid leukemia without structural cytogenetic
      abnormalities at 11q23 and 9p22. A duplicated portion of MLL is interrupted by
      the insertion of a region of 9p22 that includes the 3'-end of the AF9 gene. The
      PNTD encodes: (a) a PNTD transcript; (b) a partial tandem duplication of MLL; and
      (c) a chimeric transcript fusing MLL to the 3'-end of AF9, mimicking the
      t(9;11)(p22;q23) and expressed 1024-fold higher than the other two. The MLL PNTD,
      therefore, contributes toward leukemogenesis through simultaneous production of
      fusion transcripts that are otherwise encoded by three distinct genetic defects.

PMID- 11196199
TI  - Human homologue of yeast Rad23 protein A interacts with p300/cyclic AMP
      responsive element binding (CREB)-binding protein to down-regulate
      transcriptional activity of p53.
AB  - The tumor suppressor protein p53 regulates various cellular responses to DNA
      damage and plays a significant role in DNA repair. The nuclear p300/cyclic AMP
      responsive element binding (CREB)-binding protein (CBP) proteins act as
      coactivators in supporting the transcription function of p53. We examined the
      role of the human homologue of yeast Rad23 protein A (hHR23A), one of the two
      human homologues of the Saccharomyces cerevisiae nucleotide excision repair gene
      product Rad23, in the p300/CBP-associated regulation of p53 activity.
      Overexpression of wild-type hHR23A inhibits the p53 transcriptional activity and
      results in a decreased steady-state protein level of cellular p53. The inhibitory
      effect of hHR23A can be overcome by the concomitant expression of p300, CBP, and
      p300 segments harboring C/H1 domain and neutralized by the coexpression of HIV
      accessory protein Vpr, which binds COOH terminus of hHR23A/B. Additionally,
      hHR23A was shown to interact in vitro and in vivo with p300 segments harboring
      C/H1 domain. These studies provide evidence for the involvement of hHR23A in the
      regulation of p53 activity through p300/CBP. Although the precise direct role of
      hHR23 proteins in regulation of p53 and DNA repair remains to be elucidated, our
      data suggest that the interaction between hHR23A and p300/CBP has important
      implications in cross-talk between the p53 pathway and DNA repair.

PMID- 11196200
TI  - Intact nitric oxide synthase II gene is required for interferon-beta-mediated
      suppression of growth and metastasis of pancreatic adenocarcinoma.
AB  - Previous studies have shown that enforced expression of IFN-beta suppressed tumor
      growth and metastasis. In this report, we determined whether the induction of
      nitric oxide synthase II (NOS II) gene is required for IFN-beta-mediated
      antitumor activity using syngeneic mice with intact (NOS II+/+) or genetically
      disrupted (NOS II-/-) NOS II gene. PANC02-H7 highly metastatic murine pancreatic
      adenocarcinoma cells were transfected with an IFN-beta expression vector or a
      control pcDNA3 vector. The parental PANC02-H7, control vector-transfected, and
      IFN-beta-transfected cells were orthotopically implanted into the pancreas of
      syngeneic NOS II+/+ and NOS II-/- C57BL/6J mice. In NOS II+/+ C57BL/ 6J, both
      parental and control vector-transfected cells grew progressively in pancreas and
      produced numerous liver metastases and a large amount of malignant ascites,
      whereas IFN-beta-secreting cells did not. In NOS II-/- C57BL/6J mice, however,
      IFN-beta-secreting cells grew much more aggressively. Higher NO induction was
      detected in NOS II+/+ mice that received injections with IFN-beta-secreting cells
      than with the control cells, but it was not detected in NOS II-/- mice. These
      data suggested that IFN-beta secreted from tumor cells stimulates NO production
      by host cells and suppresses tumor growth and metastasis.

PMID- 11196201
TI  - Proteomic analysis reveals that 14-3-3sigma is down-regulated in human breast
      cancer cells.
AB  - The class of molecular chaperones known as 14-3-3 is involved in the control of
      cellular growth by virtue of its apparent regulation of various signaling
      pathways, including the Raf/mitogen-activated protein kinase pathway. In breast
      cancer cells, the sigma form of 14-3-3 has been shown to interact with cyclin
      dependent kinases and to control the rate of entry into mitosis. To test for a
      direct role for 14-3-3 in breast epithelial cell neoplasia, we have quantitated
      14-3-3 protein levels using a proteomic approach based on two-dimensional
      electrophoresis and matrix-assisted laser desorption/ionization mass spectrometry
      (MALDI-TOF). We show here that 14-3-3sigma protein is strongly down-regulated in
      the prototypic breast cancer cell lines MCF-7 and MDA-MB-231 and in primary
      breast carcinomas as compared with normal breast epithelial cells. In contrast,
      levels of the alpha, beta, delta, or zeta isoforms of 14-3-3 were the same in
      both normal and transformed cells. The data support the idea that 14-3-3sigma is
      involved in the neoplastic transition of breast epithelial cells by virtue of its
      role as a tumor suppressor; as such, it may constitute a robust marker with
      clinical efficacy for this pathology.

PMID- 11196202
TI  - Evidence for the development of p53 mutations after cytotoxic therapy in a
      neuroblastoma cell line.
AB  - p53 mutations are rare in neuroblastomas at diagnosis perhaps accounting for
      their initial response to therapy, but advanced neuroblastoma frequently
      relapses, and it is possible that p53 mutations develop later. Two neuroblastoma
      cell lines derived from the same patient before [SKNBE(1n)] and after [SKNBE(2c)]
      cytotoxic therapy were analyzed for the presence of chromosome 17 and p53 genes
      by fluorescent in situ hybridization, p53 mutations by DNA sequencing, and p53
      function after irradiation by studying the transcription of p53-regulated genes,
      cell cycle arrest, and induction of apoptosis. The SKNBE(1n) cell line was wild
      type for p53, had two p53 genes, two copies of chromosome arm 17p and showed
      functional p53 after irradiation. The SKNBE(2c) cell line derived from the same
      patient 5 months later at relapse had loss of an entire chromosome 17, resulting
      in hemizygosity for the p53 locus on 17p and a missense p53 mutation in exon 5,
      and p53 was not functional after irradiation. The appearance of a p53 mutation in
      a cell line derived from a relapsed neuroblastoma suggests that this may be a
      mechanism of resistance to therapy. If p53 mutations develop frequently in
      relapsed neuroblastoma, cytotoxic agents more sensitive to mutant p53 might be
      more effective at relapse.

PMID- 11196203
TI  - A three-dimensional and temporo-spatial model to study invasiveness of cancer
      cells by heregulin and prostaglandin E2.
AB  - To study the temporal expression of motile structures and protease activity
      during colon cancer cell invasion by heregulin-beta1 (HRG) and prostaglandin E2
      (PGE2), we have developed a three-dimensional spatial model system. HRG and PGE2
      each induced the formation of well-organized, three-dimensional structures with
      empty spaces in the center and stimulated the expression of urokinase plasminogen
      activator (uPA) with differential localization of membrane-bound uPA at the focal
      adhesion points and leading edges of the motile cells. A specific cyclooxygenase
      2 inhibitor blocked the formation of three-dimensional luminal glandular
      structures induced by HRG but did not block those induced by PGE2. A specific
      antagonist of uPA receptor completely blocked the formation of these luminal
      glandular structures induced by PGE2 and HRG. These findings suggest that HRG
      mediated increased invasiveness of colon cancer cells is augmented at least in
      part by induction of PGE2 and uPA, and this augmentation may involve the
      formation of three-dimensional invasive structures via the uPA pathway. In
      addition, the three-dimensional model system presented here may have a wider
      application to screen the effects of therapeutic compounds and biomolecules on
      different spatial aspects of colonic biology, including cell growth, motility,
      invasion, survival, and apoptosis.

PMID- 11196204
TI  - p53 modulates base excision repair activity in a cell cycle-specific manner after
      genotoxic stress.
AB  - To elucidate the nature of the cross-talk between the p53 protein and the DNA
      repair machinery, we have investigated the relationship between the two
      throughout the cell cycle. Base excision repair (BER) was analyzed in cell cycle
      phase-enriched populations of lymphoid cells expressing wild-type p53. Our study
      yielded the following novel findings: (a) BER exhibited two distinct peaks of
      activity, one associated with the G0-G1 checkpoint and the second with the G2-M
      checkpoint; (b) although the overall BER activity was reduced after exposure of
      cells to 400R, there was an augmentation of the G0-G1-associated BER activity and
      a reduction in the G2-M-associated BER activity; and (c) modulations in these
      patterns of BER after genotoxic stress were found to be p53 regulated. p53
      protein levels induced after gamma-irradiation were distributed evenly in the
      various cell cycle populations (analyzed by the PAb-248 anti-p53 monoclonal
      antibody). However, both the dephosphorylation of serine 376 of p53 (contained in
      the PAb-421 epitope) and the specific DNA binding activity, as well as apoptosis,
      were enhanced toward the G2-M populations. Furthermore, inactivation of wild-type
      p53, mediated by mutant p53 expression, abolished the alterations in the BER
      pattern and showed no induction of a G2-M-associated apoptosis after gamma
      irradiation. These results suggest that after genotoxic stress, stabilized p53
      enhances the G0-G1-associated BER activity, whereas it predominantly reduces BER
      activity at the G2-M-enriched populations and instead induces apoptosis. After
      genotoxic stress, p53 functions as a modulator that determines the pattern of BER
      activity and apoptosis in a cell cycle-specific manner.

PMID- 11196205
TI  - Progesterone receptor B gene inactivation and CpG hypermethylation in human
      uterine endometrial cancer.
AB  - The expressions of two isoforms of human progesterone receptor (PR) are under the
      control of the two different promoters. Recent studies revealed differences
      between these isoforms, PRA and PRB, in their expression and function in
      endometrial cells. Aberrant methylation of normally unmethylated CpG islands has
      been associated with inactivation of several genes in human cancers. In this
      study, we investigated the methylation status and the expression of the two
      different PR isoforms, PRA and PRB, in uterine endometrial carcinoma (UEC) using
      methylation-specific PCR (MSP), reverse transcription-PCR (RT-PCR), the 5' rapid
      amplification of cDNA ends method (5'RACE), and immunohistochemical staining. The
      results of RT-PCR and 5'RACE suggest that only PRB is inactivated, although PRA
      is activated in all UEC cell lines. Treatment with a demethylating agent, 5-aza
      2'-deoxycytidine, restored PRB expression in all cell lines, suggesting that
      inactivation of this gene is through methylation. By MSP and direct DNA
      sequencing, PRB was methylated, whereas PRA was unmethylated in all of the cell
      lines. To determine the methylation status of PRB in UEC patients, we
      investigated 83 cancerous and 33 normal samples. Sixty-two of 83 cancer samples
      had only methylated alleles of PRB, although all cancer samples had only
      unmethylated PRA alleles. Seventy-one of 83 cancer samples were negative for PRB
      expression. All 62 cancer samples that had only methylated PRB alleles were
      negative for PRB expression. No significant changes were observed in PRA
      methylation status or immunohistochemistry positivity in normal and cancer
      samples. To determine whether de novo methylation of PRB occurred in UEC
      patients, we studied 32 pairs of cancer and normal samples from the same patient.
      Twenty of 32 cancer samples had only methylated PRB alleles, although all 32
      normal samples had only unmethylated PRB alleles. The loss of unmethylated
      alleles was well correlated with negativity in immunohistochemical staining for
      PRB. This is the first report of the selective methylation and the subsequent
      silencing of PRB in uterine endometrial cancer.

PMID- 11196206
TI  - [Classification of idiopathic macular ruptures].
AB  - Based on comprehensive examinations making use of optic coherent tomography,
      idiopathic macular ruptures were classified (by severity) as pre-ruptures,
      lamellar and perforating ruptures. A 10-point scale is proposed for quantitative
      analysis of ruptures. Regularities in retinal changes characteristic of each type
      of ruptures are detected. This helps accurately evaluate the rupture, choose
      treatment strategy, and evaluate its results.

PMID- 11196207
TI  - [Clinical picture of isolated retinal vasculitis].
AB  - Clinical picture of isolated retinal vasculitis (IRV) in 43 patients (25 men and
      18 women) aged 22-42 years is analyzed. IRV was bilateral in 88.4% cases and
      involved the veins. Two forms of disease were distinguished: peripheral (in 75%)
      and central-peripheral (25%). Both forms were characterized by a high hemorrhagic
      activity, occlusion of vessels, ischemic zones and neovascularization of the
      retina and optic disk, but these signs were more frequent in central peripheral
      form of IRV. IRV is a grave disease leading to poor vision or blindness in 18%
      cases. The onset is poorly manifest with floating spots and blurred vision; the
      main symptom is vitreous hemorrhage. Visual acuity was significantly decreased in
      patients with occlusive IRV in comparison with those without occlusions (0.32 +/-
      0.37 vs. 0.77 +/- 0.28). The earliest changes can be detected mainly in the
      peripheral parts of the retina. This necessitates special attention of
      ophthalmologist to seemingly negligible complaints of patients and thorough
      examination of the fundus oculi, particularly of its peripheral sections, which
      can be performed only on condition of adequate mydriasis. Only timely diagnosis
      and early pathogenetic therapy can decrease the probability of such complications
      as hemophthalmos, retinal neovascularization, detachment of retina, and
      neovascular glaucoma, and prevent disability.

PMID- 11196208
TI  - [Treatment of experimental corneal injuries by dioxidine and urotropin
      solutions].
AB  - The efficiency of 1% dioxidine and 5% urotropin solutions in suppurative
      penetrating corneal wounds was studied in 2 experimental series on 54 rabbits. In
      series A toxic effects of these drugs on eyeball tissues were studied on 6 rats,
      in series B drug effects were studied on a model of suppurative penetrating
      corneal wounds. A 21-day course of therapy with these drugs (instillations and
      subconjunctival parabulbar injections) caused no toxic changes in ocular tissues.
      Therapy with 1% dioxidine and 5% urotropin accelerated clinical cure by 4-6 days
      in comparison with other methods of treatment. Clinical cure was observed 3-5
      days sooner after combined use of both drugs in comparison with their individual
      application, during during combined use their antibacterial effect was
      synergistic. Hence, a combination of 1% dioxidine and 5% urotropin solutions is
      an effective method for treating suppurative penetrating wounds of the cornea.

PMID- 11196209
TI  - [Comparative study of tears protein composition in patients after photorefractive
      keratectomy and laser specialized keratomileusis].
AB  - Changes in the protein spectrum of the lacrimal fluid, resultant from refraction
      ocular surgery (photorefraction keratectomy, PRK, and laser specialized
      keratomileusis, LASIK) were evaluated. Lacrimal fluid was collected before
      operation and in various terms after it in 28 patients (48 eyes) subjected to PRK
      and in 34 patients (59 eyes) subjected to LASIK. Biochemical analysis of the
      lacrimal fluid was performed on a mass spectrometer. After PRK the greatest
      changes in the protein spectrum occurred immediately after the operation before
      reepithelialization. Changes after LASIK were negligible. Refraction laser
      operations cause changes in the protein composition of tears, LASIK being more
      physiological than PRK from viewpoint of intactness of the protein composition of
      tears.

PMID- 11196210
TI  - [Evaluation of various methods effectiveness for aphakia correction in patients
      with myopic refraction and glaucoma].
AB  - The efficiency of various methods for correcting postoperative aphakia was
      evaluated in 113 patients (118 eyes) with medium and high myopia and glaucoma. In
      group 1 (44 eyes) extraocular correction of aphakia was planned after cataract
      extraction, in group 2 (33 eyes) intraocular lenses were implanted, in group 3
      (21 eyes) combined interventions were performed (cataract extraction with
      antiglaucoma component), and in group 4 (20 eyes) cataract extraction was
      performed simultaneously with sinusotrabeculectomy and intraocular correction of
      aphakia. The number of patients with visual acuity higher than 0.1 was
      significantly more in groups 2 and 4 after implantation of intraocular lenses
      than in groups 1 and 3, who needed extraocular correction of aphakia: 59.1% in
      group 1, 42.9% in group 3, 78.8% in group 2, and 60% in group 4. Intraocular
      correction of aphakia in patients with glaucoma and myopia helps attain the
      maximum possible visual acuity even in patients with far-advanced stages of the
      disease with residual visual field. Individual approach to estimation of optic
      force of implanted intraocular lens helps reduce the myopic refraction of the
      operated eye.

PMID- 11196211
TI  - [Cosmetic results of posttraumatic eyeball subatrophy surgical treatment using
      "alloplant" biomaterials with subsequent use of prostheses].
AB  - A complex of surgical operations making use of Alloplant biomaterials, performed
      in 47 patients with initial posttraumatic subatrophy and 79 patients with well
      developed and far advanced stages of this condition, helped preserve the eye as
      anatomical organ in 97.5% patients, with enlargement of the eyeball in two-thirds
      of patients and stabilization in one-third. Optic reconstructive operations were
      later performed and visual acuity improved in patients with the initial stage of
      subatrophy. Use of allotransplant for eyeball bandage in order to create a
      carcass for the sclera helped conceal the cicatricial deformation of the sclera
      and repair the shape and volume of the eyeball in patients with initial
      subatrophy, due to which a good cosmetic result was attained. In well-developed
      and far advanced subatrophy use of biomaterial for bandage created optimal
      conditions for thin-wall cosmetic prostheses, ruled out the irritating effect of
      the prosthesis in cases when corneal sensitivity was retained and/or there were
      coarse corneaoscleral cicatrices, and thus extended the indications for cosmetic
      prostheses of subatrophic eyes.

PMID- 11196212
TI  - [Indications, terms and classification of reconstructive interventions based on
      penetrating keratoplasty with implantation of posterior chamber intraocular
      lens].
AB  - Based on analysis of 750 reconstructive operations on the anterior segment of the
      eye, the authors classify simultaneous reconstructive interventions based on
      perforating keratoplasty with implantation of posterior chamber intraocular lens
      (IOL). Indications, terms, and technological features of such operations are
      defined with due consideration for the etiology of involvement of the anterior
      segment of the eye, corneal status, presence of the lens, and intactness of the
      lenticular posterior capsule. Disk posterior chamber IOLs with intracapsular
      fixation are preferred (in case of an intact capsule sac, with suturing to the
      posterior surface of the cornea) in the absence of the posterior capsule of the
      lens. As a result of surgery, improvement of visual acuity by 0.04-0.8 was
      attained in 720 patients.

PMID- 11196213
TI  - [Experience of garasone use in surgical practice].
AB  - The efficiency of garasone (Schering-Plau) in preoperative and postoperative
      treatment was evaluated in 50 patients. Controls (48 pts) were treated by
      combinations of antibiotics (0.25% levomycetin and 20% sodium sulfacyl solutions)
      and antiinflammatory drugs (0.1% dexamethasone and maxidex). The postoperative
      inflammatory reaction ceased much sooner in the patients treated with garasone
      than in the controls. Conjunctival edema, corneal edema, and descemetitis
      completely disappeared on days 4-5 after the operation in the study group and
      only on day 6 in the control. Higher efficiency of garasone can be attributed to
      the advantages of its components: wide-spectrum gentamicin and its high
      bioavailability for the eyeball tissues and an effective steroid betamethasone.
      One more advantage of garasone is that it is convenient to use (a single flask,
      no need in repeated instillations). The results recommend garasone for wide use
      for prevention and treatment of postoperative inflammatory diseases of the eyes.

PMID- 11196214
TI  - [Ophthalmodynamography in studies of ocular hemodynamics in normal subjects of
      different age with different arterial pressure].
AB  - Computer-aided ophthalmodynamographer for studies of hemodynamics in the orbital
      artery has been elaborated at research and production firm All-Russian Institute
      of Medical Engineering--Optimed. A total of 292 healthy subjects (542 eyes) aged
      28-77 years with systolic pressure 100-170 mm Hg were examined. Main hemodynamic
      parameters in the orbital artery were determined: systolic, diastolic, mean
      ophthalmic, perfusion pressure, and systolic increment in pulse volume. Ocular
      hemodynamic parameters, except systolic increment in pulse volume, directly
      depend on systemic arterial pressure but not on age. Normal parameters of
      systolic, diastolic, mean ophthalmic, and perfusion pressure in the orbital
      artery at certain levels of systemic arterial pressure were determined.

PMID- 11196215
TI  - [Efficiency of removing a transparent lens in high myopia].
AB  - Results of removal of a transparent lens in high myopia are analyzed. The
      operation was performed in two stages according to V. S. Belyaev and T. S.
      Ilyina. The second stage of the operation (lens extraction) was performed by the
      extracapsular method, which prevented vitreous prolapse into the anterior chamber
      in all cases and ruled out the possibility of detachment of the posterior plate
      of the vitreous and retina. Simple technique of the operation, good remote
      results, no need in expensive instruments or equipment recommend this operation
      for any ophthalmological department performing extracapsular cataract
      extractions.

PMID- 11196216
TI  - [Immunopathological process in retina during development of diabetic
      retinopathy].

PMID- 11196217
TI  - [Remote results of high myopia surgical correction by tunnel keratoplasty ].
AB  - Remote results evidence high refraction efficiency of tunnel keratoplasty, stable
      results being observed for up to 15 years. A total of 104 operations (58
      patients) were analyzed for a period of observation of more than 10 years. The
      patients' ages varied from 17 to 52 years, there were 34 women and 24 men. The
      main advantage of interlamellar refraction meridional keratoplasty is easiness of
      operation. At present it is the operation of choice for dosed reduction of eye
      refraction aimed at correction of high myopia and astigmatism. The possibility of
      correcting residual myopia after keratotomy and repair of refraction
      abnormalities resultant from perforating keratoplasty is particularly
      interesting. The possibility of regulating the corrective effect in remote
      periods by replacing the implants also deserves attention. Hence, low traumatism,
      high efficiency, and stability of the refraction effect once more confirm our
      recommendation to use tunnel keratoplasty in clinical practice.

PMID- 11196218
TI  - [Potentialities of conservative and surgical treatment of patients with
      congenital microphthalmia and anophthalmia].
AB  - Congenital anophthalmia and microphthalmia were responsible for 1.7-1.8% cases of
      all cases treated at laboratory of plastic surgery and ocular prostheses.
      Clinical picture of the condition is described. The philosophy of rehabilitation
      of patients with congenital anophthalmia and microphthalmia is as follows: 1) no
      operations during the first years of life; 2) early staged fitting with
      prostheses; 3) surgical treatment in older age, when the resources of
      conservative extension of the cavity are exhausted. The authors emphasize that
      active conservative treatment should be preferred. Method for nonsurgical
      extension of the conjunctival cavity by staged insertion of prostheses is
      described. Positive and negative aspects of surgical treatments are discussed.
      The authors emphasize that surgical activity in early age is extremely harmful.
      Results of surgical treatment of 27 patients are presented. The patients were
      divided into 2 groups differing by the tasks of surgery: repair of consequences
      of previous operations (59.2% cases) and typical correction of the eye lids
      (40.8%). Clinical examples are offered.

PMID- 11196219
TI  - Towards an alternative approach to personhood in the end of life questions.
AB  - Within the Western bioethical framework, we make a distinction between two
      dominant interpretations of the meaning of moral personhood: the naturalist and
      the humanist one. While both interpretations of moral personhood claim to promote
      individual autonomy and rights, they end up with very different normative views
      on the practical and legal measures needed to realize these values in every day
      life. Particularly when we talk about the end of life issues it appears that in
      general the arguments for euthanasia are drawn from the naturalist interpretation
      of moral personhood while the arguments against euthanasia, for their part, are
      derived from the idealist and/or humanist understanding of the same concept. This
      article focuses on examining the metaphysical assumptions and internal
      contradiction found behind the opposing arguments presented by two prominent
      philosophers of these two traditions: Peter Singer and Ludger Honnefelder. The
      author claims that neither side of the debate succeeds in defending its normative
      position without reconsidering how to take the social aspects of moral personhood
      into account. The author holds that, despite our need to set individual's
      decision making into social context, the current communitarian narrative concept
      of personhood fails to offer a convincing alternative. Instead of merely trying
      to replace psychological and atomistic view of personhood with a collective
      understanding of an individual's moral identity, we need to discuss the normative
      relation between the concept of 'moral personhood' and the demand for respect of
      individual autonomy in Western bioethics within a wider philosophical
      perspective.

PMID- 11196220
TI  - 'Watching' medicine: do bioethicists respect patients' privacy?
AB  - Agich has identified 'watching' --the formal or informal observation of the
      medical setting-- as one of the four main roles of the clinical bioethicist. By
      an analysis of a case study involving a bioethics student who engaged in watching
      at an HIV/AIDS clinic as part of his training, I raise questions about the
      ethical justification of watching. I argue that the invasion of privacy that
      watching entails makes the activity unacceptable unless the watcher has received
      prior consent from the patients who are being observed. I conclude that, even
      though it is important for bioethics students to understand the complexities of
      actual medical practice, watching should play a prominent role in bioethics
      education only if the privacy problems in it can be resolved.

PMID- 11196221
TI  - The biomedical disciplines and the structure of biomedical and clinical
      knowledge.
AB  - The relation between biomedical knowledge and clinical knowledge is discussed by
      comparing their respective structures. The knowledge of a disease as a biological
      phenomenon is constructed by the interaction of facts and theories from the main
      biomedical disciplines: epidemiology, diagnostics, clinical trial, therapy
      development and pathogenesis. Although these facts and theories are based on
      probabilities and extrapolations, the interaction provides a reliable and
      coherent structure, comparable to a Kuhnian paradigma. In the structure of
      clinical knowledge, i.e. knowledge of the patient with the disease, not only
      biomedical knowledge contributes to the structure but also economic and social
      relations, ethics and personal experience. However, the interaction between each
      of the participating "knowledges" in clinical knowledge is not based on mutual
      dependency and accumulation of different arguments from each, as in biomedical
      knowledge, but on competition and partial exclusion. Therefore, the structure of
      biomedical knowledge is different from that of clinical knowledge. This
      difference is used as the basis for a discussion in which the place of
      technology, evidence-based medicine and the gap between scientific and clinical
      knowledge are evaluated.

PMID- 11196222
TI  - Dualism and its importance for medicine.
AB  - Cartesian dualism has been viewed by medical theorists to be one of the chief
      causes of a reductionist/mechanistic treatment of the patient. Although I aver
      that Cartesian dualism is one culprit for the misapprehension of the genuine
      treatment of patients in terms of both mind and body, I argue that interactive
      dualism which stresses the interaction of mind and body is essential to treat
      patients with dignity and compassion. Thus, adequate medical care that is
      humanistic in nature is difficult (if not impossible) to achieve without
      physicians adhering to a dualistic framework in which the body and person is
      treated during illness.

PMID- 11196223
TI  - Generalised chronic musculoskeletal pain as a rational reaction to a life
      situation?
AB  - While the biomedical model is still the leading paradigm within modern medicine
      and health care, and people with generalised chronic musculoskeletal pain are
      frequent users of health care services, their diagnoses are rated as having the
      lowest prestige among health care personnel. An epistemological framework for
      understanding relations between body, emotions, mind and meaning is presented. An
      approach based on a phenomenological epistemology is discussed as a supplement to
      actions based on the biomedical model. Within the phenomenological frame of
      understanding, the body is viewed as a subject and carrier of meaning, and
      therefore chronic pain can be interpreted as a rational reaction to the totality
      of a person's life situation. Search for possible hidden individual meanings in
      painful muscles presupposes meeting health personnel who view the person within a
      holistic frame of reference.

PMID- 11196224
TI  - Dying in America.

PMID- 11196225
TI  - [Proposal for a classification of Class II Division 1: contribution of Delaire's
      analysis].
AB  - Class II division 1 dental malocclusions are present in various forms depending
      on the site, direction and degree of discrepancy between the arches. The ability
      to recognize the origin of the malocclusion is essential to decide how, and when
      it is necessary to treat. In this study, the Delaire's analysis was performed for
      111 individuals with a Class II division I malocclusion; a classification of
      these cases is proposed, according to the presence or the absence of a skeletal
      discrepancy. In 87% of the cases, a Class II division 1 dental malocclusion was
      associated with a Class II skeletal discrepancy (50% maxillary prognathism, 23.5%
      normal maxillary relationship and 13.5% maxillary retrognathism). The lines of
      the cranial base, the shape and size of the mandible varied considerably. In only
      6% of cases, the dental malocclusion was associated with a skeletal Class I
      relationship, and in 7% of cases with a Class III relationship: it was often
      related to retruded mandibular teeth. It was shown that Class II division 1
      dental malocclusions may result from differing causes: therefore, the
      identification of their etiology seems essential to provide the best possible
      treatment, at the right period in time.

PMID- 11196226
TI  - [Body posture and craniofacial morphology].
AB  - The body posture has been studied according to the craniofacial morphology. A
      cephalometric analysis (lateral cephalometric radiographs) and a stabilometric
      recording of the posture with a vertical force platform have been done for 45
      individuals: 17 boys and 28 girls aged 9 to 16 years. Cephalometric sagittal and
      transverse variables show no correlation with the sagittal position of the center
      of foot pressure. It seems that mild to moderate dentofacial deformities do not
      reflect on the posture of the body as a whole.

PMID- 11196227
TI  - [Influence of saggital inclination of the teeth and the orientation of the
      occlusal plane on mesial drift in the dental arch].
AB  - As a rule, the occlusal plane in man is not flat but curved in the three
      dimensions. This curved organization is related to a specific phenomena: the
      continuity of the dental arch without diastema. The Page's proposal of the
      tangent law explains the sagittal organization of the mandibular teeth by
      geometrical analyses. A cephalometric analysis of 485 subjects, in natural
      dentition, is the basis for the present statistical study of the mandibular teeth
      sagittal inclination, related to the direction of the tangent. Mandibular
      incisors follow the tangent law, but the long axis of the posterior mandibular
      teeth exhibits a postero-anterior and progressive differential angle with the
      direction of the tangent: 15 degrees, 20 degrees, 25 degrees, 28 degrees. The
      differential angle with the direction of vertical strength during closure
      movement generates an horizontal strength component, with a tendency to create a
      forward tooth movement. This horizontal component of force is tightening the
      proximal contacts, maintaining the continuity of the dental arch: it also
      originates the mesial "drift" and mandibular incisor crowding.

PMID- 11196228
TI  - [A device for mandibular advancement in respiratory disorders of sleep. Clinical
      study].
AB  - This study describes the technical steps for the making of a mandibular
      advancement device for sleep disordered patients (apnea index < 10). In a second
      part of the study, a group of 21 patients with sleep disordered breathing treated
      successfully with a mandibular advancement device is compared to a homologous
      control group. The experimental group showed cephalometric characteristics
      approaching those seen in patients with sleep apnea syndrome. The mandibular
      advancement device moved the mandibule forward (SNB angle increases by 1.7
      degrees) and downward (mandibular plane angle increases by 3 degrees, which can
      be related to the 7.4 mm anterior vertical height increase). The hyoid bone
      adopted a more distant position from the cervical vertebrae. Important individual
      variations were seen among the patients for the optimal repositioning of the
      mandible.

PMID- 11196229
TI  - [Functional and esthetic rhinoplasty in orthognathic surgery].
AB  - The author presents a surgical rhinoplasty, aiming at functional and aesthetic
      purposes, in dentofacial orthopedics.

PMID- 11196230
TI  - [Excellence in orthodontics. Interview by M. G. Choukroun and O. Sorel].
AB  - "Excellence is not an act, it is a daily exercise", is a sentence quoted by B.
      Zachrisson and is the cornerstone of his approach. He explains how, by a careful
      inspection and an analysis of the facial bone structure, using the patient's
      movement, he can establish a diagnosis and set the treatment's objectives. He
      defines the key points of a balanced smile, the rules and guidelines for enamel
      reproximation, the methods of bonding and the rules governing the stability of
      orthodontic treatments.

PMID- 11196231
TI  - [Growth and choices in orthopedic or orthodontic therapy].
AB  - Although the clinical aspects of the skeletal Class II can be numerous, in most
      cases an insufficient sagittal development of the mandible can be identified.
      Besides the functional disorder caused by the sagittal skeletal problem, the
      aesthetic appearance is damaged. To provide an efficient orthodontic or
      orthopedic treatment, the practitioner must consider this aesthetic prejudice,
      while correcting the functional disorder. One of the main goal when correcting
      skeletal Class II relationships is to improve the sagittal development of the
      mandibular growth. The sagittal impact is greater for the horizontal growth and
      will improve the aesthetic appearance. In addition, the treatment will be easier,
      shorter and therefore less traumatic because of the spontaneously natural self
      correction. Finally, the correction will be more stable because the functions
      such as breathing and swallowing will be easily rehabilitated. To obtain
      convenient aesthetic and functional corrections of skeletal Class II
      relationships, four essential rules must be taken care of: finding the best
      therapeutic choice, choosing the best moment to start treatment, initiating an
      efficient unlocking, providing an overall treatment.

PMID- 11196232
TI  - [Trends in orthodontic biomaterials: metals and ceramics].
AB  - While the beginning of orthodontics was marked by an acute scarcity in materials,
      the modern clinician has to face a large array of devices made of metals,
      plastics, ceramics and combinations thereof. Each of these materials have been
      developed for other purposes than orthodontics, and then transplanted "as is" in
      a field which has its own demands. During the years, theses devices, as well as
      the materials these are made of, have been modified most of time to the benefit
      of both the patient and the clinician, and some time to that of the manufacturer
      who has tried to save, or bypass limiting patients. Among the latter are the
      harder, but less corrosion resistant steels, the efficient but corrosion prone
      brazing, the inexpensive but weaker molded attachments, the aesthetic but fragile
      ceramics. Understanding the trends and basics of materials science should help
      the clinician to avoid being sued iatrogenic inflicted affections.

PMID- 11196233
TI  - [Comparative study of mandibular growth and rotation in two sample groups treated
      according to the "Distal Active Concept" or the Edgewise technique].
AB  - The "Distal Active Concept" therapy, favours an immediate repositioning of the
      mandible and introduces new therapeutic sequences which allow an easy correction
      of the Class II molar relationship, enhancing the mandibular growth
      simultaneously. The "Distal Active Concept" therapy is a combined treatment which
      induces the correction of the Class II malocclusion without extractions and
      without headgear. The dento-alveolar unit is used as a functional matrix to free,
      then enhance the mandibular growth and induce its counter-clockwise rotation. 35
      patients treated with the "Distal Active Concept" therapy are compared to 33
      patients, treated with the extraction of four bicuspids and in Edgewise therapy,
      in order to visualize the mandibular growth and the counterbalancing rotation
      described by Dibbets.

PMID- 11196234
TI  - [Synthesis and evaluation of the clinical approach to growth].
AB  - A critical reflection based on literature is presented to the lectures given at
      the symposium "A clinical approach to growth" at the 73rd Reunion Scientifique of
      the Societe Francaise d'Orthopedie Dento-Faciale in Deauville, France, on may
      13th, 2000. Uncertainty is expressed about the long-term effects on the growth
      pattern after early surgery in children. It is apparent that conventional
      dentofacial orthopedics have a limited long-term effect on the growth pattern.
      Surgical as well as non-surgical (orthopedic) approaches are plagued by
      complications and relapse. The need for unbiased clinical research and
      standardized, complete documentation and analysis--also on how/why clinical
      decisions were taken--seems of utmost importance for a balanced future
      development of conventional and newly introduced techniques.

PMID- 11196235
TI  - [Xenotransplantation: utopia or clinical reality?].
AB  - Xenotransplantation, i.e. the transplantation of organs (tissues, cells) from
      animals into humans has been a major question in medicine for many years. Based
      on the ever increasing shortage of suitable donor organs, the research of
      xenotransplantation grew more intensive than ever before. The problems associated
      with xenotransplantation can be divided into four categories: i./ immunological,
      ii./ physiological, iii./ infectious-microbiological, iv./ ethical. In this study
      the author attempts to summarize the possibilities of xenotransplantation, the
      problems associated with it, and their possible solutions.

PMID- 11196236
TI  - [Long-chain polyunsaturated fatty acids in the early development of the human
      nervous system].
AB  - The role of long-chain polyunsaturated fatty acids (LCPUFA) in the early
      development of the human nervous system was put forward by the better cognitive
      development observed in breast-fed than in formula fed infants in parallel with
      the presence of LCPUFA in human milk but not in formula. The role of LCPUFA in
      early human neurodevelopment can be investigated by comparing data obtained in
      formula fed infants randomly assigned to receive formula with or without LCPUFA.
      Investigations in preterm infants indicate that the presence of LCPUFA in the
      formula offers benefits for the early postnatal development of visual and
      cognitive functions. The unequivocal results obtained in preterm infants led to
      the recommendation of LCPUFA supplementation to formulae for preterm infants. In
      several studies in full-term infants, enhanced dietary intake of LCPUFA was
      accompanied with better visual acuity and better results in various cognitive
      tests. However, other studies did not show visual or cognitive differences
      between full-term infants fed formula with or without LCPUFA. It is a question
      under current debate whether supplementation of LCPUFA to formulae for full-term
      infants is required to lessen the difference between the intellectual development
      of breast-fed and formula fed infants.

PMID- 11196238
TI  - [Meta-analysis of therapeutic and preventive clinical trials].
AB  - The paper surveyes the principles and the models of meta-analysis and gives the
      basic statistical formulae. For evaluation of data of clinical trials two
      illustrative examples are presented: 1. evaluation of association and homogeneity
      in fixed and random models of the common standardized treatment effects measured
      by continuous variable with known sample sizes, means and standard deviations; 2.
      evaluation of association and homogeneity in fixed model of: the common
      InRelative-Risk and Risk-Difference ot treatment effects determined by
      dichotomous variable categorized in 2 x 2 tables and completed with Stouffer and
      Fisher methods combining z and p values of percentage differences of the
      treatment effects. It is demonstrated that the presented two illustrative
      examples, as models of meta-analysis provide objective statistical methods for
      data summarization of clinical trials. Evidence based medicine applies also the
      methods of meta-analysis.

PMID- 11196237
TI  - [Serum eosinophil cationic protein (sECP) level after cow's milk challenge test
      in allergic children].
AB  - The eosinophil cationic protein (ECP) level in the sera is higher in allergic
      diseases. The change of the ECP level in the sera of patients with cow milk
      allergy was examined during the cow's milk challenge test after a long cow's milk
      free diet period. The sECP level of 35 milk sensitive patients was determined by
      a fluoroimmunoassay (Pharmacia CAP System ECP FEIA) before the milk challenge
      test, as well as 2 and 24 hours after it. The average age of the patients was 16
      (6-49) months. The basic sECP level of cow's milk allergic patients was
      significantly higher (12.2 micrograms/l vs. 7.0 micrograms/l, p < 0.05) than that
      of the control group (n = 20). The sECP level significantly decreased 2 hours
      after the milk challenge test (12.2 micrograms/l vs. 9.2 micrograms/l, p = 0.01),
      24 hours after the challenge it was again on the basic level (11.2 micrograms/l,
      p = 0.26). Out of the 35 allergic children ten had positive clinical reactions
      after the milk challenge test (positive group), while 25 had no reaction after it
      (negative group). Comparing the sECP level of these two groups, no significant
      difference was found in the sECP level either before the milk challenge test or
      after it. The significant decrease of the sECP level 2 hours after the beginning
      of milk challenge test might be explained by the fact that this toxic protein is
      secreted into the bowel.

PMID- 11196239
TI  - [Hypophosphatemic oncogenic osteomalacia].
AB  - The first case of oncogen osteomalacia in Hungary is reported, to draw the
      attention of the medical profession to it and to present the new data about its
      pathomechanism. Pathological hip fracture caused by hypophosphataemic
      osteomalacia due to isolated renal phosphate wasting was found in a previously
      healthy 19 years old sportsman. In spite of daily 1.5 micrograms calcitriol
      treatment and phosphate supplementation, hypophosphataemia persisted for 13 years
      and he needed regular indometacin medication for his bone pain. During that time
      an 1.5 cm gingival tumour was found and radically removed. The serum phosphate
      level returned to normal in a few hours after the operation (preoperative 0.51,
      after 2, 4 and 8 hours 0.61, 0.68 and 0.79 mmol/l respectively), and remained
      normal without calcitriol. The histological examination showed epulis with
      fibroblast and vascular cell proliferation, which has never been previously
      reported in connection with oncogenic osteomalacia. The pain resolved after 3
      months and the bone density became normal in one year. Oncogenic osteomalacia
      must be considered in every case presenting with atypical hypophosphataemic
      osteomalacia. Careful dental examination is needed also in the course of search
      for the underlying tumour. Every tumour-like growth, even the common epulis, has
      to be operated radically and serum phosphate monitored in the postoperative
      period in all such cases.

PMID- 11196240
TI  - [Faulty calculations of drug costs by the Hospital Association].

PMID- 11196241
TI  - [Assessing the extent of alcohol consumption].

PMID- 11196242
TI  - [Zoltan Vamossy, Editor of the Medical Weekly and Antal Tiszamarti].

PMID- 11196243
TI  - Bibliography. Current world literature. Leukemia.

PMID- 11196244
TI  - Bibliography. Current world literature. Endocrine tumors.

PMID- 11196245
TI  - Bibliography. Current world literature. Cancer biology.

PMID- 11196246
TI  - Enuresis--background and treatment.
AB  - Nocturnal urinary continence is dependent on 3 factors: 1) nocturnal urine
      production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms.
      Any child will suffer from nocturnal enuresis if more urine is produced than can
      be contained in the bladder or if the detrusor is hyperactive, provided that he
      or she is not awakened by the imminent bladder contraction. Urine production is
      regulated by fluid intake and several interrelated renal, hormonal and neural
      factors, foremost of which are vasopressin, renin, angiotensin and the
      sympathetic nervous system. Detrusor function is governed by the autonomic
      nervous system which under ideal conditions is under central nervous control.
      Arousal from sleep is dependent on the reticular activating system, a diffuse
      neural network that translates sensory input into arousal stimuli via brain stem
      noradrenergic neurons. Disturbances in nocturnal urine production, bladder
      function and arousal mechanisms have all been firmly implicated as pathogenetic
      factors in nocturnal enuresis. The group of enuretic children are, however,
      pathogenetically heterogeneous, and two main types can be discerned: 1) Diuresis
      dependent enuresis - these children void because of excessive nocturnal urine
      production and impaired arousal mechanisms. 2) Detrusor-dependent enuresis -
      these children void because of nocturnal detrusor hyperactivity and impaired
      arousal mechanisms. The main clinical difference between the two groups is that
      desmopressin is usually effective in the former but not in the latter. There are
      two first-line therapies in nocturnal enuresis: the enuresis alarm and
      desmopressin medication. Promising second-line treatments include anticholinergic
      drugs, urotherapy and treatment of occult constipation.

PMID- 11196247
TI  - Sex offender testimony: junk science or unethical testimony?

PMID- 11196248
TI  - Illegal behaviors in problem gambling: analysis of data from a gambling helpline.
AB  - Problem gambling behaviors, particularly the most severe form, which is
      pathological gambling (PG), represent an emerging public health problem. Compared
      with the general population, individuals with problem gambling are more likely to
      have reports of legal issues, including commission of crimes, arrest, and
      incarceration. The goal of the present study is to examine the characteristics of
      individuals seeking help for gambling problems with regard to reports of illegal
      behavior secondary to gambling. Individuals with gambling problems were
      identified through use of a 24-hour gambling helpline, and information regarding
      the identified problem gambler was investigated with respect to reported presence
      or absence of gambling-related illegal behaviors. Identified gamblers with
      reported gambling-related illegal behaviors compared with those without such
      behaviors appeared to experience more severe gambling-related problems. Despite
      being on average younger, gamblers with acknowledged gambling-related illegal
      behaviors were more likely to have reports of having problems with multiple forms
      of gambling, debts to acquaintances, been suicidal secondary to gambling, used
      alcohol or drugs excessively, and received mental health treatment. Secondary
      analyses of the subgroup of gamblers with gambling-related illegal behaviors
      revealed that those with reports of arrest or incarceration secondary to gambling
      compared with those with gambling-related illegal behaviors but without arrest or
      incarceration secondary to gambling were more likely to have features similar to
      those described for individuals with antisocial personality disorder (ASPD). That
      is, the gambler with reported arrest or incarceration secondary to gambling was
      more likely to be male, unemployed, single, and have reports of problems with
      excessive drug or alcohol use. In contrast, the gamblers acknowledging gambling
      related illegal behaviors but not arrest or incarceration secondary to gambling
      were predominantly female and more likely to have reports of problems with non
      strategic forms of gambling (e.g., slot machine), owing money to legitimate
      sources of borrowing, having filed for bankruptcy, and having family problems
      related to gambling. The findings indicate: (1) individuals with reported legal
      problems secondary to gambling represent a more ill subpopulation of problem
      gamblers; and (2) there exist separate subgroups of gamblers with gambling
      related illegal behaviors (i.e., those with or without reported arrest or
      incarceration secondary to gambling) with strikingly different characteristics
      and possibly different treatment needs. The results of the present study
      highlight the importance of the identification and treatment of individuals with
      gambling problems with respect to legal issues.

PMID- 11196249
TI  - Commentary: types, lotteries, and substance abuse among problem gamblers.

PMID- 11196250
TI  - All God's children: religion, divorce, and child custody.
AB  - Many young Americans, married and marriageable, are turning to more traditional
      or fundamentalist religions. Religiosity and ultra-strict morality often leads to
      attitudes that alter decision-making in marriage, divorce, and the disposition of
      the children of divorce. Judgmental pastoral counseling may affect these
      decisions even more. This paper discusses these issues, emphasizing the need for
      forensic psychiatrists involved in the custody arena to be aware of the
      religious, spiritual, irreligious, or even anti-religious feelings of the
      battling partners. It also presents detailed information about the four major
      American religions (Roman Catholicism, traditional Judaism, Mormonism, and Islam)
      that have specific doctrine, protocols, or customs affecting decisions in
      marriage, divorce, and child custody and visitation. This information is
      presented from the viewpoint of a child advocate. Mental health experts
      consulting in child custody must understand the backgrounds of the battling
      parents, including the religious pressures that well may adversely affect their
      interspousal disputes, particularly those over child custody. The experts must
      also recognize the attitudes of the religious communities in which the custodial
      parent may reside after divorce. Those attitudes may be rejecting of the children
      as well as of the divorced parent(s). Mental health experts may have a better
      chance to reach agreement between the battling parents if the experts reverse the
      historic reluctance of psychiatrists to evaluate and discuss the religious
      feelings and beliefs of their forensic evaluatees.

PMID- 11196251
TI  - Commentary: religiously enlightened consultation for child custody disputes.

PMID- 11196252
TI  - Survey of forensic psychiatrists on evaluation and treatment of prisoners on
      death row.
AB  - Psychiatrists have debated their role in evaluating prisoners accused of capital
      crimes and in treating prisoners on death row when restoration of competence
      would result in execution. Despite debate, there are no previous surveys of
      psychiatrists' opinions on this issue. We sent an anonymous questionnaire to all
      board-certified forensic psychiatrists in the United States. Of the 456 forensic
      psychiatrists identified, 290 (64%) returned the survey. Most respondents
      supported a role, in at least some cases, for psychiatric evaluation of prisoners
      accused of capital crimes. Respondents were divided on whether or not
      psychiatrists should treat incompetent death row prisoners if restoration of
      competence would result in execution. Attitudes about the ethical acceptability
      of capital punishment were associated with views about the psychiatrists' role
      but were not determinative in every case.

PMID- 11196253
TI  - Licensure requirements for out-of-state forensic examinations.
AB  - Forensic clinicians, including psychiatrists, are sometimes asked to perform
      solely forensic (e.g., court- or litigation-related) assessments or interviews
      outside states in which they are licensed. A short survey was sent to all U.S.
      state medical licensing agencies asking whether or not a psychiatrist licensed in
      another state must also be licensed in the surveyed state before performing a
      purely forensic interview or examination. Of the 45 states responding, 21 said
      that no additional "local" license would be required; 6 gave unclear responses;
      and 18 said a local license would generally be required. At least 7 of the 18
      states that generally require a local license accept unlicensed out-of-state
      physicians when they are requested by or consulting to an in-state physician. The
      state's definition of "medical practice" figured heavily in many responses. No
      pattern of state size (area), population density, or geographic location was
      discerned. The materials received, comments by board staff and attorneys, and
      interpretations or assumptions by the author are not to be construed as
      "official" for any state.

PMID- 11196254
TI  - Actuarial risk assessment models: a review of critical issues related to violence
      and sex-offender recidivism assessments.
AB  - Risk assessment in the area of identification of violence has been dichotomized
      by several prominent researchers as the "clinical approach" versus the "actuarial
      method". The proponents of the actuarial approach argue for actuarially derived
      decisions to replace existing clinical practice. The actuarial method requires no
      clinical input, just a translation of the relevant material from the records to
      calculate the risk score. A risk appraisal approach based upon a sole actuarial
      method raises several questions: those of public safety, peer-accepted standards
      of practice, liability issues, and concordance with evidence-based medicine
      practice. We conclude that the sole actuarial approach fails to satisfy these
      critical issues.

PMID- 11196255
TI  - "Telling tales out of court": a pilot study of experts' disclosures about
      opposing experts.
AB  - A pilot questionnaire surveyed forensic psychiatrists and psychologists about
      information they would feel it appropriate to disclose to their retaining
      attorneys about an opposing expert witness. A spectrum of hypothetical
      disclosures was offered, varying in their relevance to the case at hand and in
      their degree of "public" versus "personal" information. Respondents agreed
      significantly that "public" information could be disclosed to one's attorney, but
      responses about disclosing "personal" information varied widely. The findings and
      their implications are briefly discussed.

PMID- 11196256
TI  - Criminal responsibility, diminished capacity, and the gay panic defense.

PMID- 11196257
TI  - Canadian landmark case: L.C. and the Attorney General for Alberta v. Brian Joseph
      Mills.

PMID- 11196258
TI  - Troxel, et vir, Petitioners v. Granville: grandparents' rights or parental
      autonomy?

PMID- 11196259
TI  - Dangerous severe personality disorder: extension of the use of civil commitment
      in the United Kingdom.

PMID- 11196260
TI  - Mental health court: promises and limitations.

PMID- 11196261
TI  - Re: "Terrorist on trial: the context of political crime".

PMID- 11196262
TI  - Disease outcome may be predicted by molecular detection of minimal residual
      disease in bone marrow in advanced neuroblastoma: a pilot study.
AB  - PURPOSE: This pilot study focussed on whether sequential molecular detection of
      minimal residual disease (MRD) in bone marrow (BM) could predict the outcome of
      patients with advanced neuroblastoma. PATIENTS AND METHODS: Bone marrow samples
      from 21 patients older than age 12 months with stage IV neuroblastoma were
      sequentially examined for tumor cell contamination by detecting tyrosine
      hydroxylase (TH) messenger ribonucleic acid (mRNA) using reverse transcription
      polymerase chain reaction (RT-PCR). Twenty patients received myeloablative
      therapy with hematopoietic stem cell transplantation after achieving complete
      remission. RESULTS: All BM samples of patients except that of one patient was
      cytologically positive for neuroblastoma cells at diagnosis, and they became
      negative for neuroblastoma cells within 3 months by cytologic examination. By RT
      PCR analysis, BM samples of all patients were positive for TH mRNA at diagnosis,
      and samples of 19 patients became negative for TH mRNA 1 to 13 months after the
      start of chemotherapy. Six patients whose BM samples became negative for TH mRNA
      within 4 months after the start of chemotherapy remained alive without evidence
      of disease (median 76 mos, range 36-91). In contrast, out of 15 patients whose BM
      samples remained positive, 10 patients had relapse develop and 9 patients died
      from disease (median 15 mos, range 10-25). There was a statistically significant
      difference in disease-free survival between the two groups (P < 0.05).
      CONCLUSION: Persistence of MRD in BM may predict poor prognosis in advanced
      neuroblastoma.

PMID- 11196263
TI  - Posttransplant lymphoproliferative disease in children: correlation of histology
      to clinical behavior.
AB  - PURPOSE: To determine whether the morphologic features of posttransplant
      lymphoproliferative disease (PTLD) correlated to a response to therapy. PATIENTS
      AND METHODS: We reviewed our experience with PTLD in the pediatric population. We
      identified 32 patients with a total of 36 episodes of PTLD. The diagnosis was
      confirmed by tissue examination and classified according to the degree of
      monomorphic features of the lesion. Thirty-four of 36 episodes were managed with
      immunosuppression reduction, and the patients were assessed for their response to
      this strategy. Chemotherapy was used to treat 10 of 15 patients who had
      progressive disease, and their subsequent course was also analyzed. RESULTS:
      Sixteen of 17 (94%) patients with polymorphic morphology responded to
      immunosuppression reduction compared with only 5 of 17 (29%) patients with
      monomorphic features (P < 0.001). All of the patients with progressive disease
      who did not receive additional therapy died. Standard chemotherapy regimens for
      lymphoma were administered to 10 patients with progressive disease, with a high
      response rate (90%), durable remissions, and acceptable toxicity. CONCLUSIONS: We
      conclude that the morphologic characteristics of PTLD provide information to
      potentially help guide treatment strategies in the management of this disease.
      Standard chemotherapy regimens for malignant lymphoma appear to be a viable
      treatment option for patients with progressive disease, although further
      investigation is needed.

PMID- 11196264
TI  - Impact of pharmacy practices on the cost of colony-stimulating factor use in
      pediatric stem cell transplantation: an institution-based analysis.
AB  - PURPOSE: An evaluation of colony-stimulating factor (CSF) use in pediatric stem
      cell transplantation (SCT) was conducted to identify potential cost-efficiencies
      while preserving institutional standards of patient care. METHODS: Clinical and
      pharmacy records of the 55 SCTs performed during fiscal year 1995 were reviewed.
      Material costs per vial and per microgram, exclusive of preparation or overhead
      costs, were used. The best costing strategy was defined as the least expensive
      stocking and dispensing practice to deliver the drug actually used during the
      study period. RESULTS: CSFs were used in 35 of 55 transplants; 68% of usage was
      protocol-mandated to enhance engraftment; the remainder was associated with life
      threatening complications of SCT. All use was consistent with published evidence
      based guidelines. Changes in stocking and dispensing practices would result in an
      overall annual savings of $48,162 (fiscal year 1995 dollars), a 39% decrease in
      cost without a change in clinical application. CONCLUSIONS: Our analysis
      demonstrates that stocking and dispensing practices place significant fiscal
      burden in the care of pediatric-aged patients and must be carefully considered.
      This analysis presents a model for evaluating all components of drug cost from a
      global perspective, highlighting a need for examination of pharmacy and
      manufacturing as well as clinical practices.

PMID- 11196265
TI  - Myelopoietic growth factors after stem cell transplantation: does it pay.

PMID- 11196266
TI  - Abundance of apoptotic neoplastic cells in diagnostic biopsy samples is not a
      prognostic factor in childhood primitive neuroectodermal tumors of the central
      nervous system.
AB  - PURPOSE: To assess if the abundance of apoptotic tumor cells is an independent
      prognostic factor in primitive neuroectodermal tumors (PNET) of the central
      nervous system. PATIENTS AND METHODS: Formalin-fixed paraffin-embedded tumor
      tissue sections from 78 clinically well-characterized children with PNET were
      evaluated by terminal deoxytransferase-mediated deoxyuridinie-5'-triphosphate
      (dUTP) nick-end labeling (TUNEL). Apoptotic indices (AI) were determined by
      counting TUNEL-positive tumor cells either in the highest staining region (AI hot
      spot) or in at least 15 randomly chosen fields (AI random). The AI hot spot and
      AI random were then correlated with clinical variables and survival outcome.
      RESULTS: AI hot spot (median 0.56%; range 0%-6.54%) and AI random (median 0.30%;
      range 0%-3.21%) showed considerable intertumor variability. Moreover, 53% of the
      evaluated PNET showed a more than two-fold difference between AI hot spot and AI
      random, showing important intratumoral variability of the abundance of apoptotic
      cells in a subset of the evaluated PNET. No significant associations were found
      between AI hot spot and AI random with clinical variables or survival outcome.
      CONCLUSION: The apoptotic index does not predict survival outcome and is not
      specifically associated with clinical variables of prognostic significance in
      childhood PNET.

PMID- 11196267
TI  - Prospective randomized trial between two doses of granulocyte colony-stimulating
      factor after ifosfamide, carboplatin, and etoposide in children with recurrent or
      refractory solid tumors: a children's cancer group report.
AB  - PURPOSE: The objectives of this study were: 1) to compare the time to hematologic
      recovery (absolute neutrophil count [ANC] > or = 1,000/mm3 and platelet count >
      or = 100,000/mm3) in a randomized prospective study of two doses of granulocyte
      colony-stimulating factor (G-CSF) (5.0 vs. 10.0 microg/kg per day) after
      ifosfamide, carboplatin, and etoposide (ICE) chemotherapy; and 2) to determine
      the response rate (complete response [CR] + partial response [PR]) of ICE in
      children with refractory or recurrent solid tumors. PATIENTS AND METHODS: From
      June 1992 until November 1994, 123 patients with recurrent or refractory
      pediatric solid tumors were treated with ifosfamide (1,800 mg/m2 per day x 5),
      carboplatin (400 mg/m2 per day x 2), and etoposide (100 mg/m2 per day x 5) and
      randomized to receive either 5.0 microg/kg per day or 10.0 microg/kg per day of G
      CSF subcutaneously until recovery of ANC to > or = 1,000/mm3. RESULTS: The
      incidence of grade 4 neutropenia during the first course was 88%. Median time
      from the start of chemotherapy to ANC > or = 1,000/mm(-3) for all patients during
      courses 1 and 2 was 21 and 19 days, respectively. The incidence of developing
      platelet count < or = 20,000/mm3 during course 1 was 82%. The median time from
      the start of the course of chemotherapy to platelet recovery > or =100,000/mm3
      for all patients during courses 1 and 2 was 27 days. There was no significant
      difference in the median time of ANC recovery, platelet recovery, or incidence of
      grade 4 neutropenia; and in the median days of fever and the incidence of
      infections requiring hospitalization and intravenous antibiotics during courses 1
      and 2, there was no significant difference between the two doses of G-CSF. One
      hundred eighteen patients were evaluated for response to ICE. The overall
      response rate (CR + PR) in this study was 51% (90% confidence interval, 43%-59%).
      The CR rate for all diagnostic categories was 27%. The Kaplan-Meier estimates of
      1-year and 2-year survival probabilities for all patients were 52% and 30%,
      respectively. CONCLUSION: In summary, this combination of chemotherapy (ICE) was
      associated with a high CR rate (27%) in children with recurrent or refractory
      solid tumors, but also with a high incidence of grade 4 neutropenia and
      thrombocytopenia. Doubling the dose of G-CSF from 5.0 to 10.0 microg/kg per day
      after ICE chemotherapy did not result in an enhancement of neutrophil or platelet
      recovery or the incidence of grade 4 neutropenia developing.

PMID- 11196268
TI  - Osteogenic sarcoma associated with Diamond-Blackfan anemia: a report from the
      Diamond-Blackfan Anemia Registry.
AB  - PURPOSE: Diamond-Blackfan anemia (DBA) is a congenital pure red cell aplasia,
      usually presenting in infancy or early childhood. A review of the literature
      strongly supports a predisposition to hematopoietic malignancy. Recently, solid
      tumors have been reported, some attributable to hemosiderosis and/or androgen
      therapy. Two cases of osteogenic sarcoma have also been documented. An analysis
      from the Diamond-Blackfan Anemia Registry was performed to evaluate the cancer
      risk in patients with DBA. METHODS: The Diamond-Blackfan Anemia Registry of North
      America (DBAR) is a comprehensive database of patients with DBA enrolled, after
      informed consent, through outreach to pediatric hematologists and family groups.
      The patients and/or their families complete a detailed questionnaire, and a
      review of medical records and telephone interviews are performed to complete and
      clarify the information provided. RESULTS: Of the 354 patients registered in the
      DBAR, there were six patients meeting the accepted diagnostic criteria for DBA
      who were found to have malignancies. Three patients had osteogenic sarcoma
      diagnosed, one with myelodysplastic syndrome, one with colon carcinoma, and one
      with a soft tissue sarcoma. CONCLUSION: There appears to be an association of
      osteogenic sarcoma with DBA. A young age at presentation may be a feature of DBA
      associated osteogenic sarcoma. Because of the immaturity of the database, the
      actuarial risk for osteogenic sarcoma and other cancers in individuals with DBA
      cannot be ascertained. Speculation is made regarding the nature of the molecular
      defect leading to the association of DBA and osteogenic sarcoma.

PMID- 11196269
TI  - Chemotherapy-induced unconjugated hyperbilirubinemia caused by a mutation of the
      bilirubin uridine-5'-diphosphate-glucuronosyltransferase gene.
AB  - Chemotherapy for malignant neoplasms sometimes causes unconjugated
      hyperbilirubinemia in the absence of liver dysfunction. We analyzed the
      association of chemotherapy-induced hyperbilirubinemia with mutations of the
      bilirubin uridine-5'-diphosphate (UDP)-glucuronosyltransferase gene (UGT1A1) from
      two leukemic patients in whom chemotherapy resulted in a hyperbilirubinemic
      response. We isolated genomic DNA from peripheral blood samples and amplified
      UGT1A1 by polymerase chain reaction. The amplified DNA fragments were analyzed by
      direct sequencing. The genes of the two patients revealed an identical
      heterozygous missense mutation in exon 1 (211G-->A: G71R). This UGT1A1 mutation
      may be the basis of chemotherapy-induced unconjugated hyperbilirubinemia.

PMID- 11196270
TI  - Secondary myelodysplasia with monosomy 7 arising after treatment for acute
      lymphoblastic leukemia in childhood.
AB  - Monosomy 7 is recognized as a characteristic, clonal abnormality associated with
      acquired myelodysplasia (MDS) or acute myeloid leukemia (AML). It can occur as a
      late complication of cytotoxic therapy and is usually associated with exposure to
      alkylating agents or radiation therapy. We report two patients with therapy
      related myelodysplasia (t-MDS) associated with monosomy 7 occurring in children
      after completion of therapy for acute lymphoblastic leukemia (ALL). Both children
      were noted to have t-MDS with monosomy 7 at the time of cessation of
      chemotherapy. Neither child had received an alkylating agent or radiation therapy
      during treatment. One child had a unique dicentric marker chromosome that was
      shown by fluorescent in situ hybridization to be derived from chromosome 7. This
      report emphasizes the need to identify and minimize therapy-related side effects
      without compromising cure rates.

PMID- 11196271
TI  - Successful treatment of disseminated relapsed medulloblastoma in an infant by
      primary radiotherapy.
AB  - An infant who experienced disseminated relapse of medulloblastoma while receiving
      chemotherapy is described. He was subsequently treated with radiation therapy.
      Seven and one-half years from diagnosis, he is currently disease-free and enjoys
      a relatively normal life. We emphasize the importance of considering radiation as
      one of the treatment modalities for young children with relapsed medulloblastoma.

PMID- 11196272
TI  - Treatment of Langerhans cell histiocytosis with pamidronate.
AB  - A 14-year-old boy with longstanding multisystem Langerhans cell histiocytosis
      (LCH) had multifocal bone pain unresponsive to chemotherapy, corticosteroids,
      anti-inflammatories, and narcotic analgesics. He responded to two cycles of
      intravenous pamidronate, each 90 mg per day on three consecutive days. Two
      subsequent episodes of deterioration also responded to treatment. The
      pathophysiology of his bone pain and the likely mechanisms of biphosphonate
      action are discussed, with emphasis on the molecular and cellular basis of LCH.

PMID- 11196273
TI  - Clearance of TT virus after allogeneic bone marrow transplantation.
AB  - A 10-year-old girl with thalassemia underwent bone marrow transplantation. Before
      transplantation, she had persistent TT virus (TTV) DNAemia for at least 18
      months. Interestingly, the viral DNAemia was cleared soon after transplant and
      remained undetectable at the latest follow-up at 28 months. The early clearance
      of TTV that had occurred before engraftment or initiation of any antiviral
      therapy, together with the absence of TTV DNA from the results of the liver
      biopsy performed before transplantation, led us to hypothesize that the
      hematologic compartment could have been the site for viral persistence. Thus, the
      conditioning regimen may have depleted the hemic cells and the hematologically
      compartmentalized TTV. The potential of hemic tropism of TTV and its role in
      hematologic diseases need to be considered.

PMID- 11196274
TI  - Extracutaneous Sweet syndrome involving the gastrointestinal tract in a patient
      with Fanconi anemia.
AB  - Acute febrile neutrophilic dermatosis, or Sweet syndrome, is a cutaneous eruption
      characterized clinically by the appearance of painful red plaques and nodules and
      histologically by an intense dermal neutrophilic infiltrate. Extracutaneous
      manifestations are rare. We report a patient in whom otherwise typical cutaneous
      Sweet syndrome was accompanied by an extracutaneous manifestation in the ileum.

PMID- 11196275
TI  - Congenital dyserythropoietic anemia type 1 with fetal onset of severe anemia.
AB  - We report a patient with congenital dyserythropoietic anemia type 1 with
      characteristic anomalies and two novel clinicopathologic presentations:
      intrauterine onset of severe anemia resulting in cardiac failure and relatively
      mild dyserythropoietic features on bone marrow aspiration in contrast to severity
      of anemia. After repeated transfusions and a trial of erythropoietin
      administration, the patient died from respiratory infection at age 7 months.
      Autopsy revealed characteristic dyserythropoietic features of the bone marrow by
      light microscopy and electron microscopy, which confirmed a diagnosis of
      congenital dyserythropoietic anemia type 1.

PMID- 11196276
TI  - An infant with homozygous hemoglobin D-Iran.
AB  - Hemoglobin D-Iran (Hb D-Iran, beta 22 Glu-->Gln) is a beta-chain variant that was
      first described in 1973. Hb D-Iran in combination with normal Hb A (Hb D-Iran
      trait) is a benign condition. Hb D-Iran has also been described in combination
      with sickle hemoglobin and beta thalassemia, but never as a homozygous mutation.
      The authors describe a case of homozygous Hb D-Iran in an infant of Pakistani
      descent. The hematologic values, hemoglobin electrophoresis, peripheral blood
      smear, and clinical course to date suggest that homozygous Hb D-Iran is a
      relatively benign condition with mild microcytic anemia, poikilocytosis, and
      minimal hemolysis.

PMID- 11196277
TI  - Treatment of hemolytic disease of the newborn caused by anti-Kell antibody with
      recombinant erythropoietin.
AB  - Recent data suggest that antibody-mediated suppression of erythroid progenitors
      may contribute to the anti-Kell-induced alloimmune hemolytic disease of the
      newborn (HDN). A 32-week-old girl who was positive for Kell was born to a mother
      who was negative for Kell but known to have anti-Kell antibodies. After birth,
      the baby had HDN and hyperbilirubinemia develop (peak bilirubin 21 mg/dL at day 9
      of life). which was treated with phototherapy. Although the hyperbilirubinemia
      resolved, she became progressively anemic (hematocrit 22%) with an
      inappropriately low reticulocyte response (1.1%) and erythropoietin (EPO) level
      (20 mU/mL). To avoid the need for a blood transfusion, she was treated with
      recombinant erythropoietin (rEPO) and oral iron supplements. One week after
      starting EPO, the reticulocyte count increased to 9.1%. Erythropoietin therapy
      was continued for a total of 9 weeks, with resolution of her anemia at the end of
      therapy (hematocrit 35%). Thus, we were able to successfully treat the anemia
      with rEPO with avoidance of blood transfusion. This patient demonstrates that the
      antibody-mediated erythroid suppression in Kell alloimmune anemia can be overcome
      by rEPO. Recombinant erythropoietin should therefore be considered in the
      management of infants with severe or hypoproliferative anti-Kell-associated
      anemia.

PMID- 11196278
TI  - Treatment of Epstein-Barr virus-associated posttransplant lymphoproliferative
      disorders.

PMID- 11196279
TI  - Unusual complication of sickle cell crisis.

PMID- 11196280
TI  - Vincristine-induced fever in a child with rhabdomyosarcoma: cellular
      hypersensitivity to vincristine demonstrated by leukocyte migration test.

PMID- 11196281
TI  - The myth of informed consent.

PMID- 11196282
TI  - Smoking status in pregnant women assessment of self-report against carbon
      monoxide (CO).
AB  - Smoking according to self-report and to carbon monoxide (CO) were examined in
      7,405 pregnant women who agreed to complete a breath test and questionnaire. The
      sensitivity and specificity of self-report against CO, and predictors of a high
      CO among reported nonsmokers, were examined. The prevalence of reported smoking
      was 23% (95% CI: 19.4-26.4), and 20% had a CO of 9 or more (95% CI: 17.0-23.1).
      The sensitivity and specificity against CO were 87% (95% CI: 83.1-91.6) and 93%
      (95% CI: 91.9-94.6). The positive predictive value was 76% (95% CI: 73.2-79.8),
      reflecting CO's inability to detect light smoking. The negative predictive value
      was 97% (95% CI: 95.6-97.8). The best predictors of high CO among reported
      nonsmokers were being divorced/separated (9.8% had high CO), quitting during
      pregnancy (8.5% had high CO), being third trimester, and high passive exposure.
      Some pregnant women may report inaccurately despite validation. Difficulties
      remain in determining the contributions of passive exposure and inaccurate report
      to inconsistencies between biochemical and self-report measures.

PMID- 11196283
TI  - A family study of homeland Korean alcohol use.
AB  - Survey data were obtained from 199 homeland Korean families consisting of 199
      sets of parents, and 300 college-age sons (162) and daughters (138). Data were
      obtained regarding quantity and frequency of alcohol consumption by users and of
      judgments of what constituted "normal" and "problem" alcohol use, flushing
      status, symptoms experienced following alcohol use, reasons for drinking given by
      users, and reasons for abstaining given by abstainers. Fathers and sons differed
      little in use status, but daughters were abstainers far less often than their
      mothers. Female users drank a good deal less than males, fathers and sons
      differed slightly, while daughters drank considerably more than their mothers.
      Own use was substantially correlated with judgments of the nature of normal use
      and far less related judgements of problem use. There was a significant
      difference in fast versus slow skin flushing. with a higher proportion of females
      being fast flushers. Fast flushers drank less than slow flushers and also judged
      lower amounts of consumption as being "normal." Fast flushers experienced more
      physical symptoms than slow flushers; persons who drank more experienced fewer
      symptoms. Males more than females, slow flushers more than fast flushers, and
      heavy more than light users of alcohol are more likely to endorse a variety of
      reasons for drinking. Reasons for not drinking differ little across family
      membership groups. Contemporary homeland Koreans drink less than would have been
      expected on the basis of prior research, even though there is a substantial
      generational difference among females, with daughters being less frequently
      abstainers and drinking more, and more often than their mothers.

PMID- 11196285
TI  - Behavioral characteristics related to substance abuse and risk-taking, sensation
      seeking, anxiety sensitivity, and self-reinforcement.
AB  - Given the multitude of negative outcomes associated with substance abuse and
      other risk-taking behaviors, the current study sought to investigate sensation
      seeking, anxiety sensitivity, and self-reinforcement as they relate to
      participation in high-risk behaviors with 155 undergraduate students. The
      measures were the Reckless Behavior Questionnaire, Sensation Seeking Scale,
      Anxiety Sensitivity Index, Heiby Self-Reinforcement Questionnaire, and a sample
      of items from the treatment factor of the Substance Abuse Attitude Survey.
      Significant multivariate effects were attributable to sensation seeking and
      anxiety sensitivity. Sensation seeking and anxiety sensitivity were significant
      predictors of substance abuse. The model significantly predicted risky sexual
      behavior with a positive relationship between sensation seeking and risky sexual
      behavior. High anxiety-sensitivity scores were associated with a greater reported
      incidence of high-risk sexual practices. Participants highest in sensation
      seeking were most likely to engage in reckless driving, with male incidence being
      greater than for females. An unexpected finding was that anxiety sensitivity
      negatively correlated with substance abuse.

PMID- 11196284
TI  - Correlates of mental health service utilization and unmet need among a sample of
      male adolescents.
AB  - The authors sought to identify the correlates of mental health services
      utilization and unmet need for these services among a sample of adolescent males.
      We hypothesized that our findings would replicate and extend those of the recent
      Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA)
      study, which found that parental factors play a major role in their children's
      unmet mental health care needs. Our study involved an evaluation of mental health
      service utilization and unmet need during the prior 2 years, as reported by the
      subjects at a follow-up assessment at age 16. Four factors were found to predict
      increased mental health services utilization, including attention deficit
      hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) among the
      adolescent males, the father's alcohol use disorder, and the mother's amphetamine
      use disorder. One factor was found to predict decreased utilization, the father's
      cannabis use disorder. Four factors significantly predicted unmet treatment need,
      including conduct disorder, the mother's amphetamine use disorder, a higher
      number of siblings, and a parental history of having had a childhood anxiety
      disorder. The results of this study suggest that parental psychopathology,
      parental substance abuse, the presence of conduct disorder, and an increased
      number of siblings act as barriers to adequate mental health treatment among
      adolescents. These findings confirm the crucial role that parental factors play
      in the treatment utilization and the unmet treatment need of their children, and
      also suggest that an increased number of siblings can also be associated with
      unmet treatment need.

PMID- 11196286
TI  - Processes of changing gambling behavior.
AB  - Recovered problem gamblers (N = 37) described the processes used in overcoming
      their gambling problem using a modified version of the Processes of Change
      Questionnaire (J. O. Prochaska, W. F. Velicer, C. C. DiClemente, & J. S. Fava,
      1988). The most frequently used processes were cognitive-experiential in nature
      and included self-reevaluation, environmental reevaluation, dramatic relief, and
      self-liberation. The least-used processes were reinforcement management and
      social liberation. Individuals who had sought gambling treatment reported greater
      use of most processes, in particular cognitive-experiential ones, compared with
      self-changers. The processes reported by participants were similar to those
      elicited through open-ended questions, but the results for problem gamblers
      differ from results of studies of other types of behavior change.

PMID- 11196287
TI  - Effect of current tobacco use and history of an alcohol problem on health status
      in hospitalized patients.
AB  - This prospective study assessed the relationship between current tobacco use and
      history of an alcohol problem to health status in hospitalized patients. Factors
      associated with current tobacco use and history of an alcohol problem were also
      evaluated. Data were collected using a self-administered survey distributed by
      nursing staff to adult inpatients registered on April 27, 1994 at the Mayo
      Clinic, Rochester, Minnesota affiliated hospitals. Respondents (N = 589, 45%
      female) were classified into 4 subgroups based on current tobacco use status and
      history of an alcohol problem: (a) current tobacco use only (n = 94, 16%); (b)
      history of an alcohol problem only (n = 30, 5%); (c) both (n = 27, 5%); or (d)
      neither (n = 438, 74%). Patients with both current tobacco use and an alcohol
      problem history reported markedly lower scores on health status measures of
      general and mental health compared to the other three subgroups. Moreover,
      current tobacco use and history of an alcohol problem were each associated with
      increased psychological distress. Current tobacco use was predictive of a history
      of an alcohol problem and vice versa.

PMID- 11196288
TI  - Concurrent prediction of drug use among high-risk youth.
AB  - Correlates of drug use were examined in a continuation high school sample (n =
      1.315), using canonical correlation analysis. Fourteen demographic,
      attitudes/belief, and psychosocial pressure/ anxiety-type variables were included
      as concurrent predictors. Eight drug-use-related measures were also placed into
      the analysis as outcome variables. Two factors were revealed. White ethnicity,
      not being Latino, all attitude/belief measures, and family conflict and
      depression showed relatively high loadings on the first predictor factor, and
      were associated with all drug-use measures. Latino ethnicity and being relatively
      unacculturated (i.e., tending to speak Spanish), most of the attitude/belief
      measures (but not sensation seeking or spirituality), and perceived peer approval
      to use drugs, trait anxiety, and depression showed relatively high loadings on
      the second predictor factor, and were associated with the hard-drug-use measures.
      These results suggest that there is a subgroup of unacculturated Latino youth who
      are anxious, who perceive they will achieve peer approval by using drugs, and who
      tend to use hard drugs. Indicated drug abuse prevention strategies may need to be
      tailored to this subgroup when developing and implementing programming.

PMID- 11196289
TI  - Individual change amid stable smoking patterns in polydrug users over 3 years.
AB  - The pattern of stability/change in smoking status was examined annually in 254
      community-dwelling polydrug users over 3 years. Respondents' smoking status was
      classified as nonsmoker, intermittent smoker, or "everyday" smoker. Results
      showed that the typical probability of retaining the same smoking status across
      any two consecutive assessments was: 0.77 for nonsmokers (never smokers and
      former smokers combined), 0.82 for everyday smokers, and 0.16 for intermittent
      smokers. The transition matrix proved stable across three observations; the
      predicted equilibrium distribution matched well with observed distributions.
      Fifty-five percent of intermittent smokers converted to everyday smoking within a
      year, but 29% converted to former-smoker status in the same period. No other
      transition exceeded 12%. Considerable flux in individual smoking status,
      particularly among intermittent smokers, was observed despite stable prevalence
      of smoking status in this population. Intermittent smoking status appeared to be
      a temporary "way station" between the two more stable everyday smoker and
      nonsmoker classifications. Results challenge current assumptions about
      "occasional" or "chipper" smokers.

PMID- 11196290
TI  - Smoking status and psychosocial variables in type 1 diabetes mellitus.
AB  - While depression, anxiety, and negative affect are associated with smoking and
      smoking cessation outcomes in healthy individuals, these associations have not
      been established in smokers with chronic diseases such as diabetes mellitus, a
      condition which greatly increases cardiovascular disease risk. Other psychosocial
      variables such as stress and locus of control may also be associated with smoking
      but are seldom reported. We examined stress, affect, and locus of control by
      smoking status in patients with type 1 diabetes mellitus. Results indicated that
      current smokers reported significantly higher levels of perceived stress, a more
      negative affect, and higher powerful others locus of control compared with
      nonsmokers. These findings indicate that those patients who have diabetes and who
      smoke are at greater risk for depressive symptoms. This knowledge may aid
      clinicians in their attempts to help these patients quit smoking.

PMID- 11196291
TI  - The context-specific positive alcohol outcome expectancies of university women.
AB  - Alcohol outcome expectancies are subjective beliefs about the psychological and
      physical effects of alcohol consumption. The primary purpose of the present study
      was to determine whether the types and strengths of university women's positive
      alcohol outcome expectancies differ across three typical student drinking
      contexts. Seventy-eight female undergraduates completed three versions of the
      Expectancy Context Questionnaire (ECQ) depicting Social, Sexual, and Tension
      drinking contexts, respectively, and then prospectively self-monitored their own
      drinking behavior. Respondent's total positive expectancies were strongest,
      overall, in the Sexual context and weakest in the Tension context. Consistent
      with hypothesis, the strengths of certain specific alcohol expectancies varied
      significantly across contexts: Arousal expectancies were strongest in the Sexual
      context and weakest in the Social context; Social/Sexual Enhancement expectancies
      were strongest in the Sexual context and weakest in the Tension context; and
      Global Positive Affect expectancies were strongest in the Social context and
      weakest in the Tension context. Drinking levels over the week of self-monitoring
      were significantly predicted by Global Positive Affect and Relaxation
      expectancies in the Social Context, and by Social/ Sexual Enhancement, Arousal,
      and Relaxation expectancies in the Sexual Context. The theoretical and clinical
      importance of identifying drinking context when examining alcohol expectancies is
      discussed.

PMID- 11196292
TI  - Drug-use behavior and correlates in people with schizophrenia.
AB  - This study examined how illicit drugs were accessed, reasons for drug use,
      prevalence of emotional, physical, and sexual abuse, psychiatric symptomatology,
      level of functioning, and the relationship of these factors to substance use in
      25 schizophrenia outpatients. To identify unique substance-use behaviors or
      correlates, this information was compared to 25 substance-abusing outpatients
      with major affective disorders, and 30 people with schizophrenia alone. Patients
      largely financed their drug habits with money given by immediate family members,
      and reported using drugs primarily for social reasons. While all three groups
      reported high levels of physical, sexual, and emotional abuse, a relationship
      between emotional abuse and substance use was observed only for people with
      schizophrenia. There were no differences between the two schizophrenia groups in
      psychiatric symptoms or level of functioning. The treatment implications of these
      findings are discussed.

PMID- 11196293
TI  - Co-occurrence of alcohol and cigarette use among adolescents.
AB  - Concurrent use of alcohol and cigarettes among adolescents is a serious public
      health issue. Trends in concurrent use of alcohol and cigarettes were determined
      using data from three comparable large statewide samples of 7-12th-grade students
      in New York State, from surveys conducted in 1983, 1990, and 1994. The prevalence
      of use of alcohol and cigarettes decreased from 1983 (23%) to 1990 (19%), and
      increased by 1994 (22%). Logistic regression analysis showed that these trends
      are highly significant, and that the probability of use of alcohol and cigarettes
      is higher for females than males, increases with age, and is lower for most
      ethnic minorities than for Whites. In the 1990s, Blacks, Hispanics, and Asians
      increased in their probability of concurrent use more than did Whites. Users of
      both alcohol and cigarettes are at increased risk of personal and social
      problems, as well as increased risk of delinquency. Drinking and smoking show
      synergistic effects on illicit drug use and drug problems.

PMID- 11196294
TI  - Sources of motivation for abstinence: a replication analysis of the reasons for
      quitting questionnaire.
AB  - The Reasons for Quitting Questionnaire (RFQ) as modified by McBride and
      colleagues (C. M. McBride et al., 1994) for use with substance users other than
      tobacco smokers, was administered to individuals approved for public-sector
      addiction treatment. Four motivation dimensions, similar to those found by
      McBride et al., were identified: self-concept issues, health concerns, legal
      issues, and social influence. A forced two-component solution yielded dimensions
      interpretable as intrinsic and extrinsic motivation. Self-concept issues provided
      the highest levels of motivation for abstinence in this sample, with moderate
      levels provided by health concerns, and the lowest levels provided by legal and
      social influence components. Intrinsic motivation was higher than extrinsic
      motivation. Logistic regression models, with adjustment for total motivation,
      tested the association of successful abstinence during a follow-up period with
      baseline extrinsic and intrinsic motivation, and with the difference between
      intrinsic and extrinsic levels. All three associations were significant:
      intrinsic motivation (positive association), extrinsic motivation (negative
      association), and the difference score (positive association). The results
      suggest the usefulness of the 20-item modified RFQ in evaluating motivation for
      abstinence among treatment seekers exhibiting severe negative consequences of
      addiction. Testing with samples varying in severity of addiction consequences is
      recommended.

PMID- 11196295
TI  - Interest in different forms of self-help in a general population sample of
      drinkers.
AB  - The study investigates: (1) the level of interest in self-help services for
      drinkers, and (2) the predictors of interest in these services. A representative
      sample of 1,557 Ontario respondents participated in a telephone survey. Current
      drinkers (n=1,247) were asked about their interest in getting: (a) a telephone
      call from a therapist to help them evaluate their drinking, (b) a self-help book,
      and (c) a computerized summary comparing their drinking to that of other
      Canadians. Bivariate comparisons of demographic and drinking-related variables
      were made between those interested and not interested in each of the offered
      services. Logistic regression analysis was used to find the best predictors of
      interest. The results revealed that 16% were interested in a telephone call, 26%
      in a self-help book, and 39% in computerized normative feedback. Negative
      consequences of drinking and indicators of lower societal resources increased
      interest in self-help services. Computerized feedback and self-help books serve
      as cheap and nonintrusive ways to provide incentive for change to early-stage
      problem drinkers due to the interest they raise in the intended target
      population.

PMID- 11196296
TI  - Brave new monkey.

PMID- 11196297
TI  - The ultimate diet plan. Don't eat so much.

PMID- 11196298
TI  - Seeing a virtual shrink.

PMID- 11196299
TI  - Hybridization screening of very short PCR products for paleoepidemiological
      studies of Chagas' disease.
AB  - Single strands of very short PCR products can be covalently immobilized to a
      slide and then easily detected by probe hybridization. In this work, the PCR
      product was a 70-nucleotide segment of ancient DNA, representing a portion of
      repeat mini-circle DNA from the kinetoplast of Trypanosoma cruzi, the infectious
      agent of Chagas' disease (American Trypanosomiasis). The target segment was
      initially established to be present in soft tissue samples taken from four
      "naturally" mummified Andean bodies using PCR followed by cloning and sequencing.
      Hybridization screening of the covalently immobilized PCR products positively
      identified products from 25 of 27 specimens of different tissues from these four
      mummies. The method appears to be ideal for the purpose of screening a large
      number of specimens when the target PCR product is very short.

PMID- 11196300
TI  - Spreadsheet-based program for the analysis of DNA methylation.
AB  - Methylation of DNA in CpG dense regions of gene promoters (CpG islands) is
      important for transcriptional inactivation of selective genes in normal and
      neoplastic cells. Here, we present a spreadsheet-based program adapted from
      Microsoft Excel that is useful for identifying CpG islands and for assisting in
      the laboratory analysis of DNA methylation of these regions. Upon execution of
      the program, a customized workbook analyzes an entered DNA sequence for the total
      number and percentage cytosine and guanine nucleotides, the total number and
      percentage of CpG sites, and a CpG:GpC ratio. The program also displays the
      distribution of CpG sites in a visual format as well as in two different
      graphical formats. Finally, the program assists in laboratory studies of DNA
      methylation that employ bisulfite modification of DNA by displaying methylation
      dependent effects of bisulfite treatment on DNA sequences.

PMID- 11196301
TI  - Microsoft Word macro for analysis of cytosine methylation by the bisulfite
      deamination reaction.
AB  - Cytosine methylation at CpG dinucleotides is an important control mechanism in
      development, differentiation, and neoplasia. Bisulfite genomic sequencing and its
      modifications have been developed to examine methylation at these CpG
      dinucleotides. To use these methods, one has to (i) manually convert the sequence
      to that produced by bisulfite conversion and PCR amplification, taking into
      account that cytosine residues at CpG dinucleotides may or may not be converted
      depending on their methylation status, (ii) identify relevant restriction sites
      that may be used for methylation analysis, and (iii) conduct similar steps with
      the other DNA strand since the two strands of DNA are no longer complementary
      after bisulfite conversion. To automate these steps, we have developed a macro
      that can be used with Microsoft Word. This macro (i) converts genomic sequence to
      modified sequence that would result after bisulfite treatment facilitating primer
      design for bisulfite genomic sequencing and methylation-sensitive PCR assay and
      (ii) identifies restriction sites that are preserved in bisulfite-converted and
      PCR-amplified product only if cytosine residues at relevant CpG dinucleotides are
      methylated (and thereby not converted to uracil) in the genomic DNA.

PMID- 11196302
TI  - Conversion of capillary electrophoresis microchip genotyping data for analysis
      with Genetic Profiler software.
AB  - The collection and conversion of 4-color fluorescent genotyping data from
      capillary array electrophoresis microchip devices and its conversion to a format
      easily and rapidly analyzed by Genetic Profiler genotyping software is presented.
      Microchip fluorescence intensity data are acquired and stored as 4-color tab
      delimited text. These files are converted to electrophoretic signal data (ESD)
      files using a utility program (TEXT-to-ESD) written in C. TEXT-to-ESD generates
      an ESD file by converting text data to binary data and then appending a 632-byte
      ESD-file trailer. Up to 96 ESD files are then assembled into a run folder and
      imported into Genetic Profiler, where data are reduced to 4-color
      electropherograms and analyzed. In this manner, DNA fragment sizing data acquired
      with our high-speed electrophoretic microchip devices can be rapidly analyzed
      using robust commercial software. Additionally, the conversion program allows
      sizing of data with Genetic Profiler that have been preprocessed using other
      third-party software, such as BaseFinder.

PMID- 11196303
TI  - MouseBank: a database application for managing transgenic mouse breeding
      programs.

PMID- 11196304
TI  - Labeling DNA with stable isotopes: economical and practical considerations.
AB  - Labeling DNA with stable isotopes to measure cell proliferation can be a
      technique as effective as 3H-thymidine labeling without the limitations imposed
      by using radioisotopes. Here, we investigated the relative efficiency of four
      nonradioactive precursors to DNA: [1-13C]-glycine, [1,2-13C2]-glycine, [U-13C]
      glucose, and [U-13C, 15N]-thymidine. The efficiency of incorporation for each of
      these labeled precursors in HEP G2 cells in culture has been studied. When
      considering the actual costs of in vivo experiments in which large doses of
      labeled material are needed, economical constraints may play an important role in
      defining a practical method. Therefore, the economics of this process were also
      considered. Using the enrichment per dollar for whichever nucleoside had the
      highest incorporation in a given experiment, glycine is about five times more
      economical as a label than thymidine and eight times more economical than glucose
      in these cells.

PMID- 11196305
TI  - Detection of small sequence differences using competitive PCR: molecular
      monitoring of genetically improved, mercury-reducing bacteria.
AB  - A quantitative PCR approach is presented to detect small genomic sequence
      differences for molecular quantification of recombinant DNA. The only unique
      genetic feature of the mercury-reducing, genetically improved Pseudomonas putida
      KT2442::mer73 available to distinguish it from its native mercury-resistant
      relatives is the DNA sequence crossing the border of the insertion site of the
      introduced DNA fragment. The quantification assay is a combination of specific
      PCR amplification and temperature gradient gel electrophoresis (TGGE). Gene
      quantification is provided by a competitively co-amplified DNA standard
      constructed by point mutation PCR. After computing the denaturation behavior of
      the target DNA stretch, a single base difference was introduced to achieve
      maximum migration difference in TGGE between the original target DNA and the
      modified standard without altering the PCR amplification efficiency. This
      competitive PCR strategy is a highly specific and sensitive way to detect small
      sequence differences and to monitor recombinant DNA in effluxes of
      biotechnological plants.

PMID- 11196306
TI  - Quantitative detection of Chlamydia spp. by fluorescent PCR in the LightCycler.
AB  - Quantitative detection of intracellular bacteria of the genus Chlamydia by the
      standard cell culture method is cumbersome and operator dependent. As an
      alternative, we adapted hot-start PCR to the glass capillary quantitative PCR
      format of the LightCycler. The optimized PCR was consistently more efficient than
      commercially available pre-assembled PCRs. Detection by quantitative PCR of as
      few as single copies of DNA of Chlamydia spp. was accomplished by SYBR Green
      fluorescence of the dsDNA product and by fluorescence resonance energy transfer
      (FRET) hybridization probes. The PCRs were 15-fold more sensitive than the cell
      culture quantitative assay of C. psittaci B577 infectious stock. The number of
      chlamydial genomes detected by C. psittaci B577 FRET PCR correlated well with
      cell culture determination of inclusion forming units (IFUs) (r = 0.96, P <
      0.0008). When infected tissue samples were analyzed by cell culture and PCR, the
      correlation coefficient between IFUs and chlamydial genomes was higher with C.
      psittaci B577 FRET PCR (r = 0.90, P < 0.0004) than with Chlamydia omp1 SYBR Green
      PCR (r = 0.85, P < 0.002).

PMID- 11196307
TI  - Use of SMART-generated cDNA for gene expression studies in multiple human tumors.
AB  - We demonstrate here that SMART PCR-amplified cDNAs arrayed on a nylon membrane
      are suitable for high-throughput tissue expression profiling when starting
      biological materials are limited. We show that SMART cDNA accurately reflects
      gene expression patterns found in total RNA by comparing the expression level of
      several target genes in SMART PCR-amplified cDNAs and their corresponding total
      RNAs. We also arrayed cDNAs from 68 matched tumor and normal samples on a nylon
      membrane to determine whether SMART PCR-amplified cDNA could be used for
      detecting differentially expressed genes in these tissues. These arrays
      containing normalized tumor and normal cDNAs were hybridized with probes for
      glutathione peroxidase and gelsolin. The hybridization results revealed cancer
      related and patient-specific gene expression differences between tumor and normal
      tissues for these genes. These studies show that SMART PCR-amplified cDNAs
      maintain the complexity of the original mRNA population and are thus suitable for
      high-throughput studies to compare the relative abundance of target genes and to
      detect differentially expressed genes in a wide variety of tissues
      simultaneously.

PMID- 11196308
TI  - Genes to drugs.

PMID- 11196309
TI  - Current concepts in cancer vaccine strategies.
AB  - Cancer vaccines are entering a new phase of popularity, in part because of the
      recognition of when a therapeutic vaccine is most effective and the
      identification of appropriate target antigens. New technologies, most notably
      gene transfection into dendritic cell and DNA vaccination approaches, have
      spurred further clinical evaluations. While many researchers consider humoral
      responses as not being viable for large tumors, these responses may play a role
      in regulating micrometastases (i.e., adjuvant setting). The recent approval of
      antibodies as therapeutics for cancer treatment has lent to the viability of this
      therapy concept. The success of carbohydrate-conjugate vaccines in bacterial
      systems has also renewed interest in developing such vaccines for cancer
      immunotherapy. Carbohydrates can be further converted into peptide/protein
      mimetics with several of these mimetics in clinical trials. These mimetic forms
      can be manipulated into DNA vaccine types that may be combined into DNA cassettes
      that contain CTL-associated epitopes to further define a novel strategy for
      future vaccine development.

PMID- 11196311
TI  - Improved methylation protection-based DNA footprinting to reveal structural
      distortion of DNA upon transcription factor binding.

PMID- 11196310
TI  - Generation and characterization of recombinant vascular targeting agents from
      hybridoma cell lines.
AB  - Vascular targeting agents (VTAs) can be produced by linking antibodies or
      antibody fragments directed against endothelial cell markers to effector
      moieties. So far, it has been necessary to produce the components of VTAs
      (antibody, antibody fragment, linker, and effector) separately and, subsequently,
      to conjugate them by biochemical reactions. We devised a cloning and expression
      system to allow rapid generation of recombinant VTAs from hybridoma cell lines.
      The VTAs consist of a single chain Fv antibody fragment as a targeting moiety and
      either truncated Pseudomonas exotoxin (resulting in immunotoxins) or truncated
      human tissue factor (resulting in coaguligands) as effectors. The system was
      applied to generate recombinant immunotoxins and coaguligands directed against
      endoglin, vascular endothelial growth factor (VEGF):VEGF receptor (VEGFR) complex
      and vascular cell adhesion molecule 1 (VCAM-1). The fusion proteins exhibited
      similar functional activity to analogous biochemical constructs. This is the
      first report to describe the generation and characterization of recombinant
      coaguligands.

PMID- 11196312
TI  - Maximization of signal derived from cDNA microarrays.
AB  - Microarray technology is a powerful tool for generating expression data on a
      large number of genes simultaneously. However, as for any assay, it must be
      reproducible to give confidence in the results. Using a classical statistical
      method--the factorial design of experiments--we have assessed the effects of
      different experimental factors in our system. Significant effects on signal were
      seen when the standard components were substituted with a different enzyme,
      fluorescent label, or RNA purification method. This has led to the implementation
      of an improved procedure that maximizes signal without affecting the variability
      of the system, thus increasing the signal-to-noise ratio. In addition, we were
      able to quantify the variability between microarrays and replicates within
      microarrays.

PMID- 11196313
TI  - Genotools SNP manager: a new software for automated high-throughput MALDI-TOF
      mass spectrometry SNP genotyping.
AB  - Analysis of single nucleotide polymorphisms (SNPs) is a rapidly growing field of
      research that provides insights into the most common type of differences between
      individual genomes. The resulting information has a strong impact in the fields
      of pharmacogenomics, drug development, forensic medicine, and diagnostics of
      specific disease markers. The technique of matrix-assisted laser
      desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) has been
      shown to be a highly suitable tool for the analysis of DNA. It supplies a very
      versatile method for addressing a high-throughput SNP genotyping approach. Here,
      we present the Bruker genotools SNP MANAGER, a new software tool suitable for
      highly automated MALDI-TOF MS SNP genotyping. The genotools SNP MANAGER
      administers the sample preparation data, calculates masses of allele-specific
      primer extension products, performs genotyping analysis, and displays the
      results. In the current study, we have used the genotools SNP MANAGER to perform
      an automated duplex SNP analysis of two biallelic markers from the promoter of
      the gene encoding the inflammatory mediator interleukin-6.

PMID- 11196314
TI  - Background activity of reverse transcriptases.

PMID- 11196315
TI  - Development and use of a plasmid encoding green fluorescent protein in multiple
      antibiotic-resistant Salmonella.

PMID- 11196316
TI  - Large-scale colony screening and insert orientation determination using PCR.

PMID- 11196317
TI  - Cost-efficient quantification of enzyme-linked immunospot.

PMID- 11196318
TI  - Microplate assay for the measurement of hydroxyproline in acid-hydrolyzed tissue
      samples.

PMID- 11196319
TI  - Use of DAPI staining for quantitation of cell chemotaxis.

PMID- 11196320
TI  - Molecular modeling on the Web.

PMID- 11196321
TI  - System for cleavable Fc fusion proteins using tobacco etch virus (TEV) protease.
AB  - We describe a novel Fc fusion protein system that can be cleaved by tobacco etch
      virus (TEV) protease. This system is desirable because it takes advantage of the
      high specificity of TEV protease and its activity at 4 degrees C. We produced two
      TEV-Fc fusion proteins that contain the first three Ig domains and all six Ig
      domains of the cell adhesion molecule L1. Both proteins were efficiently cleaved
      by TEV protease at 4 degrees C. Functional analysis of the cleavage products in
      neurite outgrowth assays showed they had similar activities to their parental Fc
      fusion proteins. Therefore, TEV-Fc fusion proteins may increase the utility and
      flexibility of the Fc fusion protein system.

PMID- 11196322
TI  - Promoter methylation analysis on microdissected paraffin-embedded tissues using
      bisulfite treatment and PCR-SSCP.
AB  - Methylation-sensitive single-strand conformation analysis (MS-SSCA) is a new
      method of screening for DNA methylation changes. The combination of bisulfite
      modification and PCR results in the conversion of unmethylated cytosines to
      thymines, whereas methylated cytosines remain unchanged. This sequence conversion
      can lead to methylation-dependent alterations of single-strand conformation,
      which can be detected by SSCA. An analysis of mixtures of methylated and
      unmethylated DNA at known ratios revealed that the relative intensities of the
      corresponding bands following MS-SSCA were maintained. MS-SSCA was applied for
      methylation analysis of human p16 promoter region using genomic DNA obtained from
      either frozen, fixed, or microdissected fixed tissue sections. MS-SSCA is a
      rapid, specific, and semiquantitative approach that allows the detection of
      methylation of the p16 gene promoter. In reconstruction experiments, the method
      permits the detection of 10% or less of cells harboring a methylated p16
      promoter. We have been successful in analyzing by MS-SSCA almost all (96%) tumor
      samples microdissected from archival paraffin-embedded fixed tissue sections and
      obtaining reproducible results. In addition, when microdissection was performed,
      the clonality of this genetic alteration could be identified.

PMID- 11196323
TI  - Preparation of a low molecular weight polyethylenimine for efficient cell
      transfection.
AB  - Polyethylenimines (PEIs) of a molecular weight between 25 and about 800 kDa have
      successfully been used for in vitro and in vivo gene delivery approaches. Recent
      publications indicated that PEI molecules of lower molecular weight and a small
      molecular weight range are also efficient transfection reagents with a much lower
      cytotoxicity compared to high molecular weight PEIs. Here, we describe the
      application of a molecular sieve chromatography to fractionate a commercially
      available 25-kDa PEI. We generated three pools of PEIs with molecular weight
      ranges of 70-360 (I), 10-70 (II), and 0.5-10 kDa (III), respectively. We show
      that, in comparison with the 25-kDa PEI, pool III increased the expression of
      luciferase up to 100-fold and the number of transfected cells 2-3 fold. In
      addition, the kinetics of reporter gene expression was also much faster in pool
      III, compared with the 25-kDa PEI or with pools I or II. Finally, pool III showed
      the lowest cytotoxicity in comparison with the other PEI preparations. Thus, we
      provide a one-step processing of a 25-kDa PEI, resulting in a more effective and
      also less cytotoxic transfection reagent.

PMID- 11196324
TI  - Acetylcholinesterase assay for rapid expression screening in liquid and solid
      media.
AB  - The synaptic enzyme acetylcholinesterase (AChE), which is the target of many
      insecticides and potential warfare agents, is implied in Alzheimer's disease and
      is a good potential candidate to be used in biosensors. This promotes a strong
      demand for production of recombinant AChE to be used in various studies. A
      promising expression system is the yeast Pichia pastoris, but the expression
      efficiency needs to be improved. Optimization studies require a rapid and
      efficient screening test to detect positive yeast colonies after transformation.
      Using indoxylacetate as a substrate, we designed a chromogenic test that is not
      interfered with by the culture media background color and, thus, is suitable for
      microplate screening. Moreover, it was possible to adapt the test for direct on
      plate detection of AChE-expressing colonies.

PMID- 11196325
TI  - Preparation of DNA suitable for PCR amplification from fresh or fixed single
      dinoflagellate cells.
AB  - A method is described to prepare total DNA from single cells of dinoflagellates,
      which can be used for PCR amplification. As model organisms, we used a stock
      strain of Alexandrium catenella and cells of Dinophysis acuminata harvested from
      the Atlantic Ocean. Fresh grown cells or cells maintained in different
      preservatives were tested as sources for DNA preparation. The method used to
      prepare DNA combines physicochemical and enzymatic procedures on cells embedded
      in agarose plugs or beads. The agarose pieces containing the DNA were used to
      perform PCR amplification of a fragment of DNA containing a 5.8S rRNA gene and
      the flanking internal transcribed spacers (ITS1 and ITS2).

PMID- 11196327
TI  - Rehabilitation after amputation.
AB  - The principles of amputee rehabilitation, from preamputation to reintegration
      into the work force and community, are reviewed. The authors discuss exercise
      techniques, training programs, and environmental modifications that have been
      found to be helpful in the rehabilitation of the amputee. The exercise programs
      presented here are divided into four main components: flexibility, muscle
      strength, cardiovascular training, and balance and gait. The programs include
      interventions by the physical, occupational, and recreational therapist under the
      supervision and guidance of a physician.

PMID- 11196326
TI  - cDNA library screening using the SOS recruitment system.
AB  - The SOS recruitment system (SRS), a recently developed method for detecting
      protein-protein interactions, provides an attractive alternative to identify
      biologically important protein interactions. In SRS, the protein-protein
      interactions take place in the cytoplasm instead of the nucleus, as is the case
      in the conventional two-hybrid system. Although the SRS has overcome some of the
      disadvantages of the conventional two-hybrid system, it still has several
      problems and limitations. Here, we describe a new protocol for SRS library
      screening. A new combination of growth media to avoid the tedious step of replica
      plating greatly increases the number of independent colonies in a single library
      screening. Furthermore, we designed a pair of ras-specific primers and a one-step
      simple PCR to rule out the most abundant false positive, the mammalian ras cDNA,
      in SRS library screening.

PMID- 11196328
TI  - Primary-care interventions for the population at risk for amputation.
AB  - The care of patients at risk for amputation includes the identification of at
      risk patients, appropriate follow-up and treatment, and the anticipation of
      possible complications. Education and long-term follow-up are vital for
      management of the patient at risk for amputation.

PMID- 11196329
TI  - Differentiation and treatment of phantom sensation, phantom pain, and residual
      limb pain.
AB  - This article defines the three major forms of postamputation sensation: 1)
      phantom sensation, 2) phantom pain, and 3) residual-limb pain. Proposed
      etiologies for phantom pain are discussed. The literature on current diagnoses
      and treatments for each of the three postamputation sensations is reviewed.

PMID- 11196330
TI  - Use of prostheses and footwear in 110 inner-city partial-foot amputees.
AB  - The number of partial-foot amputations performed is increasing, and many
      recommendations have been made regarding the use of prostheses and footwear
      designed to prevent higher-level amputations in this population. The present
      study investigated the use of prostheses and shoe inserts and the types of
      footwear worn by partial-foot amputees in the inner city to determine whether
      previous recommendations are being followed as well as whether new prosthetic
      styles are being used. The study surveyed 110 patients (73 men and 37 women) with
      a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of
      all levels. The results showed that about one-half of all patients wore a shoe
      insert orthosis. Although 54% wore some form of special footwear to accommodate
      and protect the residual foot, no patient in this study wore a shoe with a rocker
      bottom sole. Only one patient with a transmetatarsal amputation used a brace and
      only one patient in the entire study wore a modern cosmetic foot prosthesis.

PMID- 11196331
TI  - Subtotal pedal amputations. Biomechanical and intraoperative considerations.
AB  - Proper treatment for the compromised diabetic foot often requires surgical
      correction and subtotal pedal amputation. This article discusses various levels
      of amputation of the human foot, including digital, ray, transmetatarsal,
      midfoot, and Syme amputations. Surgical techniques and biomechanical
      considerations are presented in order to assist the surgeon in planning for the
      most functional outcome of the patient. A review of the literature and the
      experiences of the authors are presented.

PMID- 11196332
TI  - Why I chose to be 'Dr. Beyond'.

PMID- 11196333
TI  - For coughs and colds, older patients need alternatives to PPA products.

PMID- 11196334
TI  - Once-a-week alendronate for postmenopausal osteoporosis is as effective as once
      daily dosing.

PMID- 11196335
TI  - NIH modifies trial as ACE inhibitors slow renal disease in African Americans.

PMID- 11196336
TI  - Prostate cancer. When to offer screening in the primary care setting.
AB  - Prostate cancer is the second-leading cause of cancer death in American men over
      age 50. Even so, consensus is lacking on whom to screen, when to screen, and what
      to do if cancer is discovered. The two most commonly used screening methods are
      digital rectal examination and serum prostate-specific antigen (PSA). PSA misses
      18 to 25% of prostate cancers and provides false-positive results some 60% of the
      time. PSA test refinements are improving its sensitivity and specificity and
      therefore the early, accurate detection of prostate cancer. Whether routine
      screening of all men is cost-effective remains controversial--especially for men
      age 75 and older--but the value of screening to the individual patient is the
      concern of the primary care physician.

PMID- 11196337
TI  - Successful aging. How increased life expectancy and medical advances are changing
      geriatric care.
AB  - If the unprecedented increase in life expectancy has a downside, it is the
      exposure of risk to chronic age-related disorders. As clinicians work to foster
      healthy aging, we must also seek ways to prevent the disabling disorders that
      keep many older persons from enjoying their longevity. The high prevalence of
      chronic illness and functional limitation among older persons underscores the
      need for strategically directed health and social services. Successful patient
      management must extend beyond diagnosis and disease treatment and include
      promotion of function and prevention of decline. Achieving this goal requires a
      seamless continuum of management and interdisciplinary caregiving. There also
      must be a focus on improving the understanding of the science of aging. New
      treatment approaches for managing aging may one day include cognitive enhancers,
      designer hormones, telomerase, antioxidants, and gene therapy.

PMID- 11196338
TI  - Influenza in the older adult. Indications for the use of vaccine and antiviral
      therapy.
AB  - Each year, the influenza virus is responsible for 20,000 to 40,000 deaths and up
      to 300,000 hospitalizations in the United States. Although children and younger
      adults experience more cases of influenza, older individuals who are infected
      with the virus experience greater morbidity and mortality. The most effective
      means of influenza prevention for older adults is the influenza vaccine.
      Antivirals are used as adjuvant therapy, but they are not intended as primary
      prevention except for at-risk patients who are allergic to the vaccine. The
      neuroaminidase inhibitors may cause fewer side effects than the older antivirals
      and therefore may be a useful alternative in the treatment of influenza symptoms
      in older adults.

PMID- 11196339
TI  - Serotonin syndrome. A common but often unrecognized psychiatric condition.
AB  - This case illustrates that compliance with the basic principles of geriatric
      pharmacology (start low, go slow, and avoid polypharmacy) might have prevented a
      clinical syndrome that could have caused serious complications. Fortunately,
      serotonin syndrome was recognized early, the offending agents were discontinued,
      and supportive treatment was provided. The patient was ultimately treated with
      mirtazapine, an antidepressant not associated with serotonergic effects.

PMID- 11196340
TI  - Measurement of the bioavailability of aescin-containing extracts.
AB  - OBJECTIVE: In horse chestnut seed extracts (HCSE), the triterpene saponin mixture
      aescin is considered the active principle. The bioavailability and
      pharmacokinetics of different HCSE preparations have been studied under single
      and repeated applications using a radioimmunological method (RIA) developed to
      identify beta-aescin, one of the pharmacologically active fractions of the
      saponin mixture. In this paper, the available pharmacokinetic data are reviewed
      and the observed heterogenicity between comparable studies is discussed. DATA
      SOURCES: Pharmacokinetic data from 5 single- and 4 multiple-dose bioequivalence
      studies with HCSE-containing products, were measured by the same analytical
      laboratory using the same RIA. EVALUATION: In studies where procedures were
      identical the pharmacokinetic data of beta-aescin show high variations. Even
      under steady-state conditions a considerable variability for the same HCSE
      product is obtained. CONCLUSION: Formal reasons like study design and medications
      can be ruled out as a source of pharmacokinetic variation. In extracts of herbal
      drugs like HCS, the relative concentration of the individual saponin fractions
      can considerably differ from batch to batch. For immunological methods,
      identification of such antigens with intermolecular variability, e.g., the
      structural aescin analogs, is of unknown validity. Therefore the shape of the
      concentration-time curve would only show an approximation of the time course but
      not for the absolute concentrations. A specific validation procedure for the RIA
      must be developed, otherwise a LC-MS/MS-method of sufficient sensitivity should
      be elaborated.

PMID- 11196341
TI  - Weighting function used for adjustment of multiple-bolus drug dosing.
AB  - This paper presents a new method for the adjustment of the multiple-bolus dosing
      of a drug. The method is based on the weighting function of the system describing
      the behavior (absorption, distribution and elimination) of the drug in the
      patient, identified employing a test dose administration of the drug to a
      patient. This method can be employed for the adjustment of the multiple-bolus
      dosing of the drugs whose behavior in the patient can be sufficiently described
      by linear time invariant models. The method allows to estimate loading and
      maintenance bolus doses of the drug, necessary to reach and maintain prescribed
      trough levels of the drug in a patient at desired time-points, both (the levels
      and time-points) specified by treatment requirements. The method is particularly
      suitable for the adjustment of multiple-bolus dosing of drugs with narrow
      therapeutical windows or of very expensive products such as the clotting factors.
      The method is exemplified by the adjustment of the multiple-bolus dosing of
      factor VIII in postoperative treatment of hemophilia A.

PMID- 11196342
TI  - Prooxidant role of histidine in hypoxic stressed mice and Fe(3+)-induced lipid
      peroxidation.
AB  - An attempt was made to study the effect of histidine on reactive oxygen species
      in a rodent model of hypoxic stress and in Fe(3+)-ascorbic acid-induced lipid
      peroxidation in mouse brain homogenates. The latency for onset of hypoxic stress
      induced convulsions was decreased in histidine-treated animals with a concomitant
      rise in brain lipid peroxidation levels. In vitro, histidine potentiated Fe(3+)
      ascorbic acid-induced lipid peroxidation in mouse brain homogenates while other
      antioxidants like B-HT and U-74500A inhibited the same. Moreover, Fe(3+)
      histidine-induced lipid peroxidation could not be inhibited by preincubation of
      the system with high concentrations of ascorbic acid. Thus, it is concluded that
      histidine acts as a strong prooxidant potentiating the genesis of reactive oxygen
      species during hypoxic stress as well as during Fe(3+)-ascorbic acid-induced
      lipid peroxidation.

PMID- 11196343
TI  - Xylazine, an alpha 2-adrenergic agonist, modulates proliferation of rat
      thymocytes in vivo and in vitro.
AB  - The effect of xylazine, an alpha 2-adrenergic agonist, on proliferation of rat
      thymocytes in vivo and in vitro was examined. It was found that the agonist
      administered to rats in vivo at doses of 2.5 mg/kg and 5 mg/kg stimulated
      thymocyte proliferation to suboptimal (0.625 microgram/ml) concentrations of
      concanavalin A (Con A). A similar effect was confirmed in vitro when lower
      concentrations of xylazine (5 microM) were added to cultures of thymic cells from
      intact animals in the presence of both suboptimal and optimal (2.5 micrograms/ml)
      Con A concentrations. Higher doses in vivo (25 mg/kg) and in vitro (50 microM,
      100 microM and 250 microM) significantly inhibited proliferation of thymocytes to
      Con A. The phenomenon was followed by a decrease in interleukin-2 (IL-2)
      production (in vivo and in vitro) and down-regulation of IL-2 receptor alpha (IL
      2R alpha) expression (in vitro). The exogenous IL-2 completely restored the
      inhibitory effect of xylazine in vivo on thymocyte proliferation. However, a
      minimal influence of the cytokine on the xylazine-inhibited thymocyte
      proliferation in vitro was observed. Stimulatory effect of xylazine on
      proliferation of thymocytes was probably mediated through alpha 2-adrenoreceptors
      since it was blocked by yohimbine, an alpha 2-adrenoreceptor antagonist. It seems
      that the pathways involved in inhibition of thymocyte proliferation by xylazine
      are more complex because the xylazine-suppressed thymocyte proliferation was
      potentiated by yohimbine.

PMID- 11196344
TI  - Cardioprotective effects of citrulline in ischemia/reperfusion injury via a non
      nitric oxide-mediated mechanism.
AB  - The effects of L-citrulline, the byproduct of nitric oxide (NO) synthesis, and
      its stereoisomer D-citrulline were studied in a polymorphonuclear leukocyte (PMN)
      dependent isolated perfused rat heart model consisting of 20 min of global
      ischemia and 45 min of reperfusion. Ischemic hearts reperfused with either D- or
      L-citrulline (20 nM) exhibited a marked preservation of left ventricular
      developed pressure and of maximal rate of development of left ventricular
      developed pressure, compared to hearts perfused without either D- or L-citrulline
      (both p < 0.001). In addition, both D- and L-citrulline significantly attenuated
      PMN accumulation in the post-reperfused myocardium from 288 +/- 33 PMNs/mm2 in
      untreated hearts to 89 +/- 10 and 76 +/- 6 PMNs/mm2, respectively (both p <
      0.001). In isolated rat aortic rings, neither D- or L-citrulline induced any
      vasodilation or release of nitric oxide from the vascular endothelium. However,
      expression of P-selectin on the coronary vascular endothelium was markedly
      attenuated in hearts perfused with either D- or L-citrulline compared to ischemic
      reperfused hearts without citrulline (both p < 0.001). These results provide
      evidence that D- or L-citrulline significantly attenuates PMN-induced cardiac
      contractile dysfunction in the isolated perfused rat heart subjected to
      ischemia/reperfusion via a non-NO-mediated mechanism.

PMID- 11196345
TI  - Renal functional responses to centrally administered ouabain in anesthetized
      rabbits.
AB  - The effects of intracerebroventricularly administered ouabain on renal function
      were studied in rabbits. Ouabain, when given intracerebroventricularly in doses
      ranging from 0.1 to 10 micrograms/kg, dose-dependently produced antidiuretic,
      antinatriuretic and antikaliuretic effects, along with decreases in renal
      perfusion and glomerular filtration rate. Systemic blood pressure also increased
      significantly in a dose-related fashion. No increase in free water reabsorption
      was noted. Intravenously administered ouabain (10 micrograms/kg) caused less
      pronounced antidiuresis and antinatriuresis, with the renal hemodynamics tending
      slightly to decrease. No significant increment of systemic blood pressure with
      intravenous ouabain was observed. In rabbits with one kidney denervated and the
      contralateral left intact, ouabain 10 micrograms/kg i.c.v. produced the typical
      renal effects on the intact kidney, while the denervated kidney responded with
      prominent natriuresis and diuresis, showing the maximal response in the second 10
      min period after administration. Renal nerve activity increased significantly
      upon administration of ouabain 10 micrograms/kg i.c.v. and reached a peak at
      around 10 to 20 min after drug administration, a period in which the most
      remarkable antidiuresis and antinatriuresis is produced by i.c.v. ouabain. These
      observations suggest that the antidiuresis and antinatriuresis elicited by
      centrally administered ouabain results mainly from the decrease of renal
      hemodynamics, which is caused by the increased renal nerve activity.

PMID- 11196346
TI  - Effect of clarithromycin on the pharmacokinetics of carbamazepine in rhesus
      monkeys.
AB  - Clarithromycin, an advanced-generation macrolide antimicrobial, is less prone to
      drug interactions as compared to erythromycin. Based on two case reports in which
      increased carbamazepine (CBZ) plasma concentrations were observed in patients
      receiving clarithromycin, a crossover multiple dose study was designed to find
      out the pharmacokinetic interaction between CBZ and clarithromycin in rhesus
      monkeys. CBZ (46 mg/kg/d) was administered to the monkeys alone and along with
      clarithromycin (20 mg/kg/d). Blood samples were collected from 0-24 h. Plasma
      concentrations of CBZ were measured by HPLC technique. Pharmacokinetic data
      revealed an increase in plasma concentrations, AUC(0-24) and t1/2e of CBZ when
      coadministered with clarithromycin, but the increase was not statistically
      significant. These findings suggest careful administration and plasma monitoring
      of CBZ concentrations when coadministered with clarithromycin.

PMID- 11196348
TI  - Depleted credibility. Did U.S. weapons make Italian soldiers sick?

PMID- 11196347
TI  - Double-blind, randomized, placebo-controlled pilot study with anapsos in senile
      dementia: effects on cognition, brain bioelectrical activity and cerebral
      hemodynamics.
AB  - The aim of this study was to evaluate the effects of two doses of anapsos in
      comparison with placebo on cognitive performance, brain bioelectrical activity
      pattern and cerebral hemodynamic parameters in patients with mild to moderate
      senile dementia of vascular type and Alzheimer type. Forty-five patients (age
      73.8 +/- 7.6 years; range 56-89 years) with mild to moderate senile dementia
      (Global Deterioration Scale: stages 3-5) of the vascular (VD; n = 22) or the
      Alzheimer type (AD; n = 23) were included in a double-blind randomized placebo
      controlled clinical trial. After a 2-week period of drug washout, patients were
      treated with placebo (n = 15; age 72.7 +/- 7.5 years), 360 mg/day of anapsos (n =
      15; age 75.5 +/- 7.2 years), or 720 mg/day of anapsos (n = 15; age 73 +/- 7.7
      years) for 4 weeks (28 days). At baseline and after the 4-week period of double
      blind treatment, cognitive performance, brain bioelectrical activity power and
      blood flow hemodynamics in the middle cerebral arteries were evaluated with
      ADAScog, brain mapping and transcranial Doppler ultrasonography, respectively.
      Patients receiving 360 mg/day of anapsos showed a significant improvement in
      cognitive performance after treatment (ADAScog scores: p < 0.05) that was not
      observed in patients treated with placebo or 720 mg/day of anapsos. As compared
      to placebo, anapsos (360 mg/day) induced a significant improvement in ADAScog
      scores in mild senile dementia patients (p < 0.01) and in the subset of patients
      with AD (p < 0.05). Anapsos (360 mg/day) also increased cerebral blood flow
      velocities in left and right middle cerebral arteries in the subgroup of AD
      patients, whereas with the dose of 720 mg/kg this increase was only observed in
      the left side. Patients treated with anapsos (360 mg/day) showed a decrease in
      relative delta power and an increase in relative theta and alpha brain
      bioelectrical activity frequencies, indicating an acceleration of the EEG
      pattern. The present results show that anapsos (360 mg/day) improves cognitive
      performance, cerebral blood perfusion and brain bioelectrical activity in
      patients with senile dementia. These effects of anapsos were more marked in
      demented patients with mild mental deterioration and/or with dementia of the
      Alzheimer type.

PMID- 11196349
TI  - When healers kill. Could better monitoring have stopped a homicidal doctor?

PMID- 11196350
TI  - Monkeying with nature. A genetically altered primate could aid the study of human
      disease.

PMID- 11196351
TI  - The ABCs of vitamin A. Veggies revisited.

PMID- 11196352
TI  - Optical cylinder designs to increase the field of vision in the osteo-odonto
      keratoprosthesis.
AB  - BACKGROUND: The single optical cylinders used in the osteo-odonto
      keratoprosthesis (OOKP) are known to produce very small visual fields. Values of
      40 degrees are typically quoted. The purpose of this paper is to present designs
      for new optical cylinders that significantly increase the field of view and
      therefore improve the visual rehabilitation of patients having an OOKP. METHODS:
      Computer ray-tracing techniques were used to design and analyse improved one- and
      two-piece optical cylinders made from polymethyl methacrylate. All designs were
      required to have a potential visual acuity of 6/6 before consideration was given
      to the visual field and optimising off-axis image quality. Aspheric surfaces were
      used where this significantly improved off-axis image quality. RESULTS: Single
      optical cylinders, with increased posterior cylinder (intraocular) diameters,
      gave an increase in the theoretical visual field of 18% (from 76 degrees to 90
      degrees) over current designs. Two-piece designs based on an inverted telephoto
      principle gave theoretical field angles over 120 degrees. Aspheric surfaces were
      shown to improve the off-axis image quality while maintaining a potential visual
      acuity of at least 6/6. This may well increase the measured visual field by
      improving the retinal illuminance off-axis. CONCLUSIONS: Results demonstrate that
      it is possible to significantly increase the theoretical maximum visual field
      through OOKP optical cylinders. Such designs will improve the visual
      rehabilitation of patients undergoing this procedure.

PMID- 11196353
TI  - True exfoliation of the lens capsule following uveitis.
AB  - PURPOSE: To report a rare case of true exfoliation of the lens capsule following
      panuveitis, with slit-lamp photographs before and following the development of
      the true exfoliation. METHODS: Case report. Review of the history and clinical
      features of a 70-year-old woman who developed true exfoliation during the
      treatment for panuveitis. RESULTS: After 7 months of treatment for bilateral
      panuveitis with topical steroid and tropicamide, the patient developed a thin,
      transparent membrane arising on the lens surface in the right eye. A diagnosis of
      true exfoliation of the lens capsule was made. CONCLUSIONS: True exfoliation of
      the lens capsule following uveitis may occur due to the weakening of the anterior
      capsule by metabolic disorder caused by uveitis and precipitated by repeated
      mydriasis.

PMID- 11196354
TI  - Retinal blood flow changes in diabetic retinopathy measured with the Heidelberg
      scanning laser Doppler flowmeter.
AB  - BACKGROUND: Investigation of retinal blood flow in patients with and without
      diabetic retinopathy (DR). Retinal blood flow is measured with the non-invasive
      Heidelberg Retinal Flowmeter (HRF). The clinical suitability of the HRF in
      patients with diabetes mellitus is investigated, and measured blood flow is
      compared with blood flow in a group of non-diabetic persons. METHODS: Cross
      sectional study of retinal capillary perfusion in eighty diabetic patients and
      forty-nine control persons, non-invasively measured with the Heidelberg scanning
      laser Doppler flowmeter. RESULTS: In the control group, HRF measurements could be
      performed in all subjects. In the diabetes group some patients had media
      opacities or were not able to maintain stable fixation. Therefore HRF measurement
      was only possible in 79%, 75% and 60% of the subjects for the nasal, papillo
      macular and foveal areas respectively. Retinal blood flow as measured in the
      perifoveal and nasal areas was associated with the level of diabetic retinopathy.
      In patients with proliferative DR (levels 4 and 5) the blood flow was reduced, in
      comparison with that of the patients with exudative or non-proliferative DR
      (levels 1 and 2) and preproliferative DR (level 3). Blood flow was not correlated
      with age, systemic blood pressure, intra-ocular pressure and perfusion pressure
      in either group. A significant negative correlation with the actual blood glucose
      level was found in the perifoveal area (R = -0.585, P = 0.0001). CONCLUSIONS: The
      HRF offers an interesting non-invasive method for measurement of retinal blood
      flow. In this cross-sectional study variations in retinal blood flow could be
      detected in various stages of DR in relation to clinically visible funduscopic
      changes.

PMID- 11196355
TI  - Phacoemulsification following treatment of choroidal melanoma.
AB  - BACKGROUND: Little is known about the risks, effects and results of
      phacoemulsification following treatment with different modalities of choroidal
      melanoma. METHODS: In a retrospective study, records were evaluated of 72
      patients who underwent cataract surgery after treatment of choroidal melanoma (35
      were treated with iodine-125 plaques, 27 with ruthenium-106 plaques, eight by
      tumor excision, and two with proton beam irradiation). The data were analyzed
      with respect to complications, effects on postoperative tumor care and visual
      outcome. RESULTS: Phacoemulsification was performed at a mean interval of 21.5
      months after primary tumor therapy. An intraocular lens (IOL) was implanted in
      93% of the cases. The mean postoperative follow-up time was 16.2 months.
      Preoperative problems were rubeosis iridis (30.5%), secondary glaucoma (34.7%)
      and posterior synechiae (41.6%). Intraoperatively, defects of the posterior
      capsule occurred in 12.5%. Visual acuity equal to or better than preoperative
      vision was found in 95.8% of the patients as the best postoperative measurement
      and in 72.2% at the last follow-up measurement. A deterioration of more than two
      lines in visual acuity was observed in 4.2% as the best postoperative vision and
      in 27.8% at the last documented examination. Phacoemulsification was not the
      cause of deterioration in any of the cases. After cataract surgery, tumor
      retreatment was necessary in 19.4%. Treatment of radiation retinopathy was
      performed for the first time in 13.8%. Metastases developed in six patients
      (8.3%). CONCLUSION: Phacoemulsification following treatment for choroidal
      melanoma is both possible and advisable. The majority of patients have enhanced
      visual acuity. No decrease of vision occurred as a result of cataract extraction.
      The postoperative care of intraocular tumors and the treatment of radiation
      retinopathy is improved by timely cataract surgery.

PMID- 11196356
TI  - The sensitivity and specificity of direct ophthalmoscopic optic disc assessment
      in screening for glaucoma: a multivariate analysis.
AB  - BACKGROUND: Previous studies have shown that the cup:disc (C/D) ratio has limited
      sensitivity and specificity. Improved sensitivity and specificity has been found
      with combinations of disc parameters using stereophotography or disc imaging, but
      the extent to which these studies reflect what can be achieved by direct
      assessment is unclear. The purpose of this paper is to report the sensitivities
      and specificities of a range of disc parameters, both in isolation and in
      combination, as graded during clinical examination with direct ophthalmoscopy.
      METHODS: Sixty-seven patients with newly diagnosed primary open angle glaucoma
      and 145 non-glaucomatous subjects were examined by direct ophthalmoscopy. The
      following features of the optic disc were graded: vertical and horizontal C/D
      ratios (uncorrected for disc size), narrowest rim width, presence/absence of disc
      haemorrhage, focal pallor of the neuroretinal rim, parapapillary atrophy,
      steepness of the cup-edge and presence/absence of baring of the lamina cribrosa.
      Subjects were validated as glaucomatous/non-glaucomatous on the basis of visual
      fields, independently of the results of optic disc gradings. Multiple logistic
      regression modelling was used to evaluate the effectiveness of combinations of
      disc parameters. RESULTS: Sensitivities and specificities are limited for all
      features when considered in isolation. The 'cupping' parameters have the highest
      sensitivities and specificities but no single cut-off criterion for these
      parameters has both high sensitivity and specificity. Multiple logistic
      regression modelling indicated that two disc parameters in combination, narrowest
      rim width and parapapillary atrophy, were independently associated with glaucoma
      and achieved best prediction. Combining information from these parameters
      achieved a sensitivity of 81% (95% CI = 69-89%) and a specificity of 90% (95% CI
      = 84-95%), a level of discrimination that is not significantly better than
      narrowest rim width alone in terms of area under the receiver operator
      characteristic (ROC) curve. CONCLUSION: Disc assessment during clinical
      examination with direct ophthalmoscopy can achieve comparable sensitivities and
      specificities with those previously reported for stereophotographic assessment or
      visual fields screening. However, since the diagnostic accuracy of disc
      assessment in isolation is inadequate for screening, a combined test strategy is
      necessary.

PMID- 11196357
TI  - Light-induced damage of the retina through slit-lamp photography.
AB  - BACKGROUND: I report on two patients who suffered severe loss of visual acuity
      after slit-lamp photography of the anterior eye segment. METHODS: Both patients
      were pseudophakic and pictures were taken to document the degree of posterior
      capsule opacification via retroillumination with dilated pupils. Both patients
      had excellent visual acuity at the time of photography was taken and experienced
      reduction of to hand movement afterwards. A Zeiss 75 SL device was used for the
      slit-lamp photography. In cooperation with Carl Zeiss Jena the slit lamp was
      investigated. RESULTS: Ophthalmoscopy and angiography after photography
      discovered a central macular defect, similar to a photocoagulation. The visual
      acuity did not recover. CONCLUSION: Under certain circumstances slit-lamp
      photography of the anterior eye segment can lead to severe light-induced damage
      of the retina.

PMID- 11196358
TI  - Changes of retinal capillary blood flow in age-related maculopathy.
AB  - BACKGROUND: To investigate retinal capillary blood flow characteristics in
      patients with age-related maculopathy (ARM). METHODS: Retinal capillary blood
      volume (VOL), blood flow (FLOW), and velocity (VEL) were measured in four macular
      sectors (I, II, III, IV) and in two areas beyond the temporal superior and
      inferior major vessel arcades (V and VI) in: 10 eyes with early ARM (drusen > or
      = 63 microns and/or atrophy of the retinal pigment epithelium, RPE, < 175 microns
      and/or proliferation of RPE), 13 with late ARM (exudative), 10 with late ARM
      (fibrotic), 14 normal eyes of 14 children of patients with ARM, and in 4 age- and
      sex-matched control groups using the Heidelberg retinal flowmeter (HRF).
      Statistical analysis was performed with the exact Wilcoxon test using an
      additional adjustment procedure by Bonferroni-Holm. RESULTS: As compared to the
      control group, there was no significant change of VOL, FLOW, and VEL in patients
      with early ARM. In patients with late ARM (exudative), there was a significant
      higher FLOW in sectors I, II, and IV and a higher VOL and VEL in sectors III and
      IV. The group with late ARM (fibrotic) showed a reduction of VOL and FLOW in
      sectors I-IV and of VEL in sectors II and IV. In children of ARM patients, VOL,
      FLOW, and VEL of sectors I-VI did not differ from the control group. CONCLUSION:
      HRF measurements in patients with ARM indicate an increased macular retinal
      capillary blood flow in patients with the exudative form of late ARM and a
      decreased macular perfusion in those with the fibrotic form.

PMID- 11196359
TI  - Longitudinal nerve fibre layer thickness change in normal-pressure glaucoma.
AB  - PURPOSE: To investigate longitudinal retinal nerve fibre layer (RNFL) thickness
      change in patients with normal-pressure glaucoma (NPG) and to assess how this may
      be related to visual fields. METHODS: NPG patients and normal subjects who had
      had serial GDx nerve fibre layer Analyzer II imaging and Humphrey visual fields
      performed at least 18 months apart were selected for study. These measurements
      were compared between groups at baseline and at subsequent follow-up, for change
      over time. RESULTS: Seventy-five NPG patients and 35 normal subjects were
      studied. Significant differences in RNFL thickness were found between NPG
      patients and normal controls at baseline (P < or = 0.001). Over the same time,
      there was greater RNFL thinning in NPG patients than in normal subjects (P < or =
      0.0001). RNFL thinning in NPG was negatively correlated with visual field log MD
      at baseline (P < 0.001) and change in MD over time (P < 0.001). CONCLUSION:
      Reduction of RNFL thickness over time was significantly greater in NPG patients
      than in normal subjects, indicating that NPG patients' RNFL had thinned at a
      faster rate. NPG patients with initially better visual fields had a greater
      reduction in RNFL thickness than did those with initially more advanced visual
      field defects, suggesting that more RNFL change may be observed when glaucoma is
      at an earlier stage. There was a direct relationship between RNFL thinning and
      visual field deterioration.

PMID- 11196360
TI  - Morphological study on rupture of posterior capsule in RLC mouse lens.
AB  - PURPOSE: To clarify the causative factor underlying rupture of the posterior
      capsule of the RLC mouse lens as a recessive trait around the 50th postnatal day.
      METHODS: The lenses of the RLC mouse were removed in the period from birth to
      50th postnatal day. Some specimens were observed by light microscopy and
      transmission and scanning electron microscopy. Others were examined as flat
      preparations of the lens epithelium. RESULTS: There was an abnormal arrangement
      of lens fibers at the newborn stage, and lens fibers of the perinuclear zone
      ended almost vertical in relation to the posterior capsule. Consequently, the
      posterior suture was not formed in this mouse lens. On the 10th postnatal day,
      the ends of the lens fibers that terminated in the posterior capsule became
      swollen, and the posterior capsule at the posterior polar region became thin. On
      the 20th day, the area of swollen fibers was so large at the center of the
      posterior capsule that a vacuolated area was observed under the dissecting
      microscope. On the 30th day, the posterior cortical fibers in this area showed
      marked swelling, and the posterior capsule became extremely thin. On the 40th
      day, the anterior cortex became unusually thick, and the lens nucleus was
      dislocated towards the posterior capsule. On the 50th day, the posterior capsule
      ruptured. At this time the lens fibers from the perinuclear zone constituted the
      central area of rupture, and the cortical fibers from the equator formed the
      protruded area outside the lens. CONCLUSION: The findings revealed that the RLC
      mouse lens has an abnormal lens fiber arrangement from the early period of lens
      development, that the lens fibers from the perinuclear zone cause swelling
      without forming the posterior suture, and that the thin capsule is ruptured by
      pushing out of the nucleus by thickening of the anterior cortex.

PMID- 11196361
TI  - Transplantation of iris pigment epithelium into the choroid slows down the
      degeneration of photoreceptors in the RCS rat.
AB  - BACKGROUND: Trophic factors [e.g. basic fibroblast growth factor (bFGF)] released
      by transplanted retinal pigment epithelial (RPE) cells are able to slow down the
      hereditary degeneration of the retina in the Royal College of Surgeons rat in
      sites distant from the site of transplantation where rod outer segment (ROS)
      phagocytic activity is not reconstituted by the transplants. METHODS: To
      investigate whether iris pigmented epithelial (IPE) cells are also able to
      generate this rescue by trophic factors, we transplanted IPE cells from Long
      Evans rats into the choroid and subretinal space of 17 young RCS rats. The eyes
      were enucleated after 6 months and prepared for light microscopy. Six age-matched
      RCS rats served as controls. Light microscope sections from the whole choroid,
      healthy choriocapillaris, transplanted cells and the maximum thickness of the
      choroid, and outer nuclear layer parameters were analyzed by computer-assisted
      morphometry. RESULTS: In transplanted animals photoreceptor cells were rescued
      from degeneration although the majority of the transplanted IPE cells were
      located in the choroid. In the non-transplanted group photoreceptors were absent.
      CONCLUSIONS: Transplantation of IPE cells slows down degeneration of the
      photoreceptors in the RCS rat. This photoreceptor-sparing effect by the IPE cells
      was observed even when the transplants were predominantly located within the
      choroid. The beneficial effect observed may be related to trophic factors
      possibly secreted by the transplanted IPE cells.

PMID- 11196362
TI  - Alterations of sensory retinal explants exposed to choroidal melanoma cells ex
      vivo.
AB  - BACKGROUND: Cultures of retinal explants have been established as a useful tool
      to investigate effects of pathogenic agents in vitro. We used such cultures as a
      model to study the effects of choroidal melanoma on retinal organisation and
      function. METHODS: Rabbit retinal explants were co-cultured with human choroidal
      melanoma cells, or exposed to supernatants from choroidal melanoma cell cultures,
      for various periods from 1 day to 10 days. The retinal explants were then studied
      by histology and immunocytochemistry for glial fibrillary acidic protein (GFAP)
      and vimentin. The release of the pro-inflammatory interleukins IL-6 and IL-8 into
      the media was measured by enzyme-linked immunosorbent assay. RESULTS: Both in the
      co-cultures and after treatment with choroidal melanoma cell supernatants for
      more than 1 week, the layered structure of the retinae became disorganised.
      Retinal glial (Muller) cells displayed gliosis as indicated by increased GFAP
      immunoreactivity and decreased immunoreactivity for vimentin. Additionally, the
      secretion of cytokines, particularly of IL-8, was significantly modulated. The
      retinal explants produced much less IL-8 than the melanoma cells in separate
      cultures but increased their IL-8 release significantly after a few days'
      exposure to melanoma cell-conditioned medium. CONCLUSION: The results show that
      in cases of choroidal melanoma, the well-known morphological and inflammatory
      alterations of the retina are accompanied by glial cell reactivity and up
      regulated retinal cytokine secretion, and may be caused by soluble factors
      secreted and induced by the melanoma.

PMID- 11196363
TI  - Transforming growth factor-beta: a growth factor inducing alpha B-crystallin
      expression in ciliary muscle cells.
AB  - BACKGROUND: In a recent study we showed that, in vitro, transforming growth
      factor-beta 2 (TGF-beta 2) induces alpha B-crystallin expression in cultured
      trabecular meshwork (TM) cells, but not in cultured fibroblasts. We assumed that
      alpha B-crystallin can be induced by TGF-beta 2 only if the cells are already
      expressing a basal level of the protein. In the present study we therefore
      treated cultured ciliary muscle (CM) cells constitutively expressing alpha B
      crystallin and investigated the effect of TGF-beta on expression of alpha B
      crystallin and the corresponding mRNA in these cells. MATERIAL AND METHODS:
      Monolayer cultures of third-passage CM cells from eyes of five human donors (12
      73 years), being confluent for 7 days, were treated with 1.0 ng/ml TGF-beta 1 or
      TGF-beta 2. Induction of alpha B-crystallin and the related mRNA was investigated
      by immunofluorescence and by western and northern blot analysis. RESULTS: An
      increase in alpha B-crystallin mRNA was observed following treatment with TGF
      beta. Actinomycin blocked the induction of alpha B-crystallin by the cytokine TGF
      beta. Using western blotting the increase in alpha B-crystallin expression in CM
      cells was only small. CONCLUSION: These results confirm our assumption that
      induction of alpha B-crystallin by the cytokine TGF-beta depends on basal levels
      of the protein and its mRNA constitutively present within the cells. Comparison
      of the increase in alpha B-crystallin mRNA and protein expression indicate that
      post-transcriptional regulation mechanisms are responsible for these findings in
      CM cells.

PMID- 11196364
TI  - Neurotransmitter contents in the retina of RCS rat.
AB  - BACKGROUND: Retinitis pigmentosa is a hereditary disease characterized by
      gradually developing degeneration of photoreceptors. The Royal College of
      Surgeons (RCS) rat is an experimental model of retinitis pigmentosa. However,
      there is a paucity of information concerning neurotransmitter contents in the
      retina of RCS rats. Thus, we determined the retinal contents of neurotransmitters
      in RCS rats at 4 and 23 weeks postnatally and in age-matched congenic control
      rats. METHODS: Dopamine (DA) and acetylcholine (ACh) were electrochemically
      measured by high-performance liquid chromatography (HPLC). Neuroactive amino
      acids, including gamma-aminobutyric acid (GABA) and taurine, were determined by
      means of an HPLC-precolumn derivatization method. RESULTS: Contents of DA, ACh,
      glutamate, aspartate and GABA in the retina of RCS rats 4 weeks postnatally were
      within normal ranges. At 23 weeks, the retinal contents of DA, glutamate and
      aspartate in the RCS rats were significantly lower than in the age-matched
      control rats, while the contents of ACh and GABA were unaffected even at this
      later stage. On the other hand, the retinal content of glycine in the RCS rats at
      23 weeks was significantly higher than that in the age-matched control rats. It
      is interesting to note that the content of taurine in the RCS rats had already
      decreased at 4 weeks postnatally and the decrease was more marked at 23 weeks.
      CONCLUSION: The decrease in taurine content is probably the first sign of
      degeneration revealed by the retinal neurotransmitters of RCS rats.

PMID- 11196365
TI  - [Is knee osteotomy still indicated in knee osteoarthritis?].
AB  - This study was undertaken to investigate whether high tibial osteotomy (HTO)
      still had a role in the treatment of osteoarthritis of the knee joint. The author
      has performed photoelasticity studies which confirmed abnormal stress
      distribution over the joint, as soon as its mechanical axis was deviated and the
      joint line had an obliquity over 10 degrees. High tibial osteotomy to correct
      varus or valgus deformity restores a symmetrical stress distribution and
      represents the only etiological treatment of secondary osteoarthritis of the
      knee. Two hundred and fifty HTO's were performed between 1971 and 1985 for
      osteoarthritis of the knee. The short-term result was good or very good in 75%,
      fair in 20% and poor in 5%. Fair and poor results were related to insufficient
      correction, to infection or mostly to incorrect indications. In 152 cases with a
      good or very good short term result, a further evaluation was made between 8
      years and 15 years after operation. It was noted that osteoarthritis had been
      arrested in 105 cases (69%) whereas it had deteriorated in 47 cases. The main
      factors associated with further deterioration were insufficient correction and
      persistence of joint line obliquity. Provided on optimal correction is achieved
      (3 degrees to 6 degrees hypercorrection in valgus osteotomy, 0 degree in varus
      osteotomy) and provided a horizontal joint line is restored, HTO performed in
      good indications (Ahlback grade I or II) may provide good results for at least 10
      to 15 years.

PMID- 11196367
TI  - [The role of arthroscopy in subacromial pathology. Retrospective study of a
      series of arthroscopic acromioplasties].
AB  - The authors report the results of a retrospective study of 59 arthroscopic
      acromioplasties. Objective shoulder assessment was made following the relative
      Constant score and UCLA rating scale. Subjective satisfaction of the patient was
      assessed on an analogic scale. The patients were divided into 3 groups, according
      to the subacromial pathology treated. The first group (27 shoulders in 23
      patients) included patients with subacromial impingement without a complete
      rotator cuff tear. The objective result, between 80 and 90%, was close to results
      in others series reported. Distinction between patients with no tear or partial
      tear of the cuff showed better results for patients with partial tears. This
      surprising finding may be at least partially explained by the fact that these
      patients were older than those without a cuff tear. The results of this study,
      and the review of the literature, confirmed the value of subacromial
      decompression as a treatment for impingement without complete cuff tear resistant
      to at least 6 months of conservative treatment; comparison between surgical and
      arthroscopic series showed similar results. The second group (19 shoulders in 19
      patients) included patients with impingement and complete cuff tear. The
      objective results and the literature review led us to specify indications.
      Subacromial decompression with debridment of the tear has given excellent results
      in older patients--over 60 for most authors--when the tear was limited. In our
      study, the function of the shoulder at revision was good when the tear was
      limited to the supraspinatus and part of the infraspinatus. The third group (13
      shoulders in 10 patients) included patients with calcifying tendinitis.
      Arthroscopic acromioplasty was performed in every case; excision of the
      calcification was performed in less than half of the cases and did not influence
      the final result. The calcifications had disappeared at revision in all cases.
      This may suggest that the treatment of the associated impingement was the most
      important procedure in these cases.

PMID- 11196366
TI  - The CINCA syndrome: a rare cause of chronic arthritis and multisystem
      inflammatory disorders.
AB  - Chronic infantile neurological cutaneous articular (CINCA) syndrome is a rare
      disorder with neonatal onset characterised by a chronic progressive inflammatory
      process with skin rash, articular and central nervous system involvement. This
      primary systemic inflammatory disorder should be distinguished from juvenile
      rheumatoid arthritis (JRA). Although the articular findings are characteristic
      features of CINCA syndrome, there is a certain degree of variability in the
      articular involvements which are not always symmetrical nor is the degree of
      severity uniform. The etiology of CINCA syndrome remains unknown. No single
      treatment has been found to be effective. This syndrome is known in the American
      medical literature as infantile onset multisystem inflammatory disease (IOMID).

PMID- 11196368
TI  - Lateral epicondylalgia: treatment by manipulation under anaesthetic and steroid
      injection and operative release.
AB  - A retrospective study of 112 cases of lateral epicondylalgia treated between
      April 1995 and April 1998 was conducted. The treatment modalities included
      manipulation under anaesthetic and operative release. A questionnaire was used to
      assess the outcome. The patients who were unresponsive to conservative treatment
      either had manipulation under anaesthetic and a steroid injection or had an
      operative release. Those who had manipulation under anaesthetic and injection had
      33.3% satisfactory outcome for pain and function at 17.2 months mean follow-up.
      Among those who had operative release, 69% had satisfactory outcome for pain and
      function at 17.2 months mean follow-up. The results of manipulation under
      anaesthetic and steroid injection are not good enough for this treatment to be
      recommended in the management of tennis elbow. It is more effective to treat the
      patients unresponsive to conservative treatment with open release.

PMID- 11196369
TI  - Clinical relevance of acetabular erosion in young patients with a bipolar hip
      prosthesis.
AB  - In elderly patients bipolar hip prostheses are often used for intracapsular
      fractures of the femoral neck and are often complicated by pain after a few
      years; this pain is frequently related to acetabular erosion seen on xray. In
      this study 18 bipolar hip prostheses were used in the treatment of a proximal
      femoral sarcoma in a young patient population (mean age: 39.6 years). Their
      quality of life was evaluated by TESS and MSTS scores, after a mean follow-up of
      81.8 months (range 8-171 months). A radiologic grading system was used to assess
      acetabular erosion on plain xrays. The patients did not report significant pain,
      they enjoyed a very good quality of life, and they did not show any obvious
      acetabular erosion. The use of a bipolar implant appears as a good alternative to
      total hip replacement in the treatment of relatively young patients who have to
      undergo proximal femoral tumor resection procedures and have a normal acetabulum.

PMID- 11196370
TI  - Impaction grafting for acetabular deficiency in total hip arthroplasty for
      developmental hip dysplasia.
AB  - The pathological anatomy in neglected developmental dysplasia of the hip often
      demands some sort of reconstructive surgery to augment the acetabular bone stock
      during total hip arthroplasty. We have reviewed 11 hips in 10 patients with
      osteoarthritis secondary to developmental hip dysplasia who underwent cemented
      total hip arthroplasty using impaction grafting of the acetabulum with a
      morselized femoral head autograft, to bring the socket down to the anatomical hip
      center. The mean age at the index procedure was 43.4 years (ranging from 29 to 60
      years) and the mean follow-up period was 3.8 years (ranging from 2 to 7 years).
      Postoperative functional evaluation according to the Merle d'Aubigne and Postel
      score modified by Charnley revealed very satisfactory results. Radiographic
      review showed incorporation of all grafts. One socket is radiographically loose.
      No major complications have been encountered. There have been no reoperations. We
      believe that acetabular impaction grafting is a valuable alternative in dealing
      with osteoarthritic hips secondary to developmental hip dysplasia.

PMID- 11196372
TI  - Conservative or surgical management of distal femoral fractures. A retrospective
      study with a minimum five year follow-up.
AB  - We report the outcome of conservative and surgical management in 50 skeletally
      mature patients (average age 64.6 years, 36 females patients) with 51
      supracondylar femoral fractures treated in our unit between June 1991 and
      December 1993. Thirty-six fractures were caused by low-energy trauma, and 15 were
      due to high-energy trauma. Open fractures occurred in 5 patients. Of the 34
      patients (35 fractures) treated conservatively, 15 (46%) achieved a satisfactory
      result. Of the 16 patients treated by internal fixation, 10 (62%) reached a
      satisfactory outcome. Osteoporosis, severe comminution of the fracture,
      involvement of the knee joint, and soft tissue injury in open fractures were
      associated with unsatisfactory results. Conservative management of these
      fractures is associated with a lesser chance of achieving a good functional
      result. With the advent of new fixation devices and our experience that
      conservative management can actually lead to many complications, the proportion
      of patients operated upon is likely to increase.

PMID- 11196371
TI  - Failure of total hip arthroplasty with Boneloc bone cement.
AB  - Early failure of Boneloc cemented total hip arthroplasty is well documented.
      However, information regarding the long term prognosis is scanty. The aim of this
      study was therefore to assess the long term failure rate of total hip replacement
      with Boneloc bone cement. Between January 1991 and March 1992, Boneloc bone
      cement (Polymers Recontructive A/S, Farum, Denmark) was used in 42 consecutive
      total hip replacements in 42 patients. The average age of the patients was 75
      years. There were 25 women and 17 men. The diagnosis at operation was
      osteoarthritis in all cases. A cemented Muller Taperloc femoral stem was used
      with a cemented Muller acetabular cup (Biomet, Warsaw, USA). The follow-up time
      was 9 years. All patients underwent radiographic control the first postoperative
      year and annually after 1995. To date 21 patients have been revised for aseptic
      loosening at a mean of 5 years (range: one year to 8 years). Three other patients
      have definite radiographic evidence of loosening. The overall failure rate is
      therefore 24/42 = 57%. Our results confirm the previously reported poor results
      of Boneloc bone cement for hip arthroplasty and support the recommendation of
      indefinite follow-up for surviving prostheses. New prosthesis designs and new
      cements should have documentation, including laboratory tests and randomized
      clinical studies with radiostereometric evaluation. However, the ethical
      responsibility rests heavily on the shoulders of the clinician to make a correct
      analysis of the need for a new product before he begins to use it.

PMID- 11196373
TI  - Anterograde femoral nailing with a reamed interlocking titanium alloy nail.
AB  - Intramedullary nailing has become the gold standard for treatment of femoral
      diaphyseal fractures. Between March 1995 and December 1998 we performed 40
      intramedullary nailings using the ACE femoral nail (De Puy). The patients were
      followed for an average of 27.9 months (range: 6-54 months). The mean age was
      33.2 years (range: 17-87 years); the sex distribution was 33 males and 7 females.
      All fractures were unilateral (right 18, left 22). Most of the fractures were
      caused by traffic accidents (35), the others originated from sports, work and
      gunshot (1). Thirty-five fractures were closed and 5 were open: 1 was grade I, 2
      were grade II and 2 grade IIIa according to Gustilo's classification. According
      to the AO classification 18 fractures were type A, 13 type B and 9 type C. The
      majority of patients had associated injuries: neurotrauma 2, chest trauma 2, and
      other fractures e.g. of the clavicula, lumbar spine, patella, tibia. Immediate
      surgery was performed in 34 cases, delayed surgery in 6 cases. All fractures were
      treated on a fracture table, with closed reduction, reaming of the intramedullary
      canal, proximal and distal locking and intraoperative control of rotation and
      length. The mean time to healing was 17.85 weeks (range: 18-50 weeks). The
      following complications were observed: 3 delayed unions, which united after
      dynamisation, one malunion, which required corrective osteotomy, and one
      nonunion, which healed after exchange nailing. We encountered no rotational
      deformity and no clinically relevant shortening. Six nails were removed due to
      irritation by locking screws. These results are comparable with those of larger
      series in the literature with other types of interlocking nails. The union rate
      in this series was 97.5%.

PMID- 11196374
TI  - Ganglion cysts associated with cruciate ligaments of the knee: a possible cause
      of recurrent knee pain.
AB  - Intraarticular ganglia of the knee are uncommon; however, these ganglion cysts
      may produce knee discomfort without a clear etiology. We present the cases of 10
      patients with ganglion cysts arising from cruciate ligaments of the knee joint
      who underwent arthroscopic excision after MR examination. The MR findings,
      clinical features and arthroscopic findings were evaluated comparatively.
      Diagnoses were confirmed by means of a histological study after arthroscopic
      excision. The cysts were fluid-filled, with low T1-weighted signal intensity and
      high T2-weighted signal intensity. Except for two patients with recent accidents,
      the remaining eight presented chronic pain without any history of trauma. Pain
      was the most frequent clinical sign. It was associated with knee extension in 3
      cases and with flexion in 3 cases. In 7 cases, cysts were exclusively associated
      with the anterior cruciate ligament (ACL). Only in one case was a cyst associated
      with an ACL rupture. Four patients presented meniscal lesions. All ganglia
      appeared solitary in each knee. Postarthroscopy evolution was painless in 8
      patients. Histologic diagnoses corresponded to ganglion cysts. The tissues from
      the patient with the ACL rupture presented a fibrous reaction with myxoid
      degeneration forming intraligamentary ganglion cysts.

PMID- 11196375
TI  - Surgical risk factors in Larsen's syndrome.
AB  - The authors report on a child with typical Larsen's syndrome with some rare
      findings such as mixed-type hearing loss and with some potentially fatal
      operative risks including laryngomalacia and cervical instability. A few deaths
      with Larsen's syndrome have been reported associated with various fatal risks
      such as spinal instability. Therefore, laryngomalacia and several other
      potentially fatal risks are presented in this report as awareness may prove
      essential to orthopedic surgeons.

PMID- 11196376
TI  - Congenital bilateral short femur complicated by stress fracture. A case report.
AB  - Congenital malformation of the femur is an uncommon but complex problem. Short
      femur with proximal deficiency (Kalamchi type III) is part of this congenital
      anomaly. If the precautions associated with progressive coxa vara and bowing in
      the femoral shaft are not taken, stress fractures may occur in the femoral neck
      and the femoral shaft. We report on a 38-year-old female with type III-A
      congenital malformation of both femurs who presented the complications mentioned
      and had not been treated before. This case is instructive because it illustrates
      the complications developed in patients who have not been treated.

PMID- 11196377
TI  - Extradigital glomus tumor causing para-Achilles tendon pain. A case report.
AB  - A 48-year-old woman with a 15-year history of a painful nodule in the para
      Achilles tendon area was evaluated by clinical examination, magnetic resonance
      imaging and ultrasonography, then treated by simple surgical excision of the
      nodule. Pathology revealed a glomus tumor, which is extremely rare in the para
      Achilles tendon area. This is the first report of a glomus tumor in this
      location.

PMID- 11196378
TI  - High-grade metachronous osteosarcoma. A case report over a 23-year period.
AB  - This is a case report on the remarkable 23-year course of a metachronous
      osteogenic sarcoma in a 31-year-old man. Histology invariably showed the features
      of a high-grade osteogenic sarcoma with predominantly chondroblastic cells.
      During the observed period the patient developed nine osseous metastases. The
      quiescent clinical course of some metastases was in sharp contrast to the
      histological pattern. The patient finally died from symptoms of increasing
      cervical spinal cord compression without ever developing lung metastases.

PMID- 11196379
TI  - [Traumatic luxation of the posterior tibialis tendon].
AB  - Anterior dislocation of the tibialis posterior tendon is a traumatic lesion,
      which is rarely suspected following ankle trauma. It seems to be promoted by
      hypoplasia of the retromalleolar sulcus. Surgical treatment is easy and
      reportedly gives excellent results, but the diagnosis is difficult and absence of
      diagnosis may result in functional instability of the foot requiring more
      invasive surgical treatment.

PMID- 11196380
TI  - [Isolated traumatic luxation of the distal radio-ulnar joint. A case report].
AB  - The author reports a case of isolated traumatic volar dislocation of the ulnar
      head in the distal radioulnar joint. This fairly uncommon injury is seldom
      accurately diagnosed at first presentation because there is no distinct deformity
      at the wrist and extension-flexion is normal and painless. However pronation is
      always restricted and painful. A dislocation of this joint may be simple or
      complex and the treatment varies accordingly. Because the dislocation in this
      patient had occurred more than two months previously, surgical reduction failed
      and resection of the distal ulna using Darrach's procedure was performed.

PMID- 11196381
TI  - [Donation and transplantation in Spain at the end of the 20th century].

PMID- 11196382
TI  - [Stromal tumor of the rectum and leiomyosarcoma of the prostate as a cause of
      urinary syndrome attributable to BPH].
AB  - OBJECTIVE: To discuss the classifications of patients with lower urinary tract
      symptoms ascribed to BPH, in order to define the indication for treatment for
      patients with similar features but of a different etiology. The literature is
      also reviewed. METHODS/RESULTS: Two patients, aged 62 and 63 years, diagnosed as
      having BPH were found to have a gastrointestinal stromal tumor (GIST) and a
      leiomyosarcoma of the prostate, respectively. The first patient had undergone
      retropubic resection. Frozen section analysis revealed a GIST. The second patient
      had undergone TURP twice. A perineal biopsy at the last medical examination
      showed a leiomyosarcoma of the prostate. This patient finally underwent pelvic
      tumorectomy. The international classification of BPH is discussed: PQSF (P:
      prostatic weight determined by transrectal US or DRE; Q: quality of life
      assessment; S: international prostate symptom score (IPSS); F: maximum urinary
      flow rate by uroflowmetry--Qmax). CONCLUSIONS: The classifications are practical,
      but should be improved. In our view, details useful in orienting the diagnosis
      could be lost by oversimplification.

PMID- 11196383
TI  - [Deletion of ABH antigens in urine sediment cells from patients with prostatic
      adenoma].
AB  - OBJECTIVE: This study was conducted to analyze ABH antigenic expression in
      urinary sediment of patients with benign prostatic hyperplasia (BPH) before and
      after deobstructive surgery. METHODS/RESULTS: The agglutination inhibition
      technique was utilized to determine the ABH antigenic expression in urinary
      sediments of 30 healthy subjects and 34 patients with BPH. The presence of
      neoplastic cells was also determined in urinary sediments of the patients by
      Papanicolaou's stain. These studies were performed before and 12 months after
      surgery. Membrane antigen expression was found in 100% of the healthy subjects
      and in only 50% of the patients with BPH before surgery. Only 25 patients
      returned for control evaluation after surgery. Of these, 17 were positive and of
      the remaining 8 patients who were negative preoperatively, only one continued to
      be negative. Urine cytology demonstrated progression to malignancy in this
      patient. CONCLUSIONS: Determination of ABH antigenic expression appears to be
      able to identify premalignant conditions and could be a useful complementary
      diagnostic method to cytology.

PMID- 11196384
TI  - [Usefulness of PSA-complex in the diagnosis of prostatic carcinoma].
AB  - OBJECTIVE: Since its discovery as a marker for prostate cancer, there have been
      many attempts to enhance the diagnostic efficacy of the prostate specific antigen
      (PSA). Among these are the studies that analyze the behavior of different forms
      of serum PSA bound to different antiproteases, such as alpha-1-antichymotrypsin,
      which forms the complexed PSA (PSA-c). This study analyzed the utility of PSA-c
      to enhance specificity without altering sensitivity in comparison to total PSA
      (PSA-t). METHODS: From September 1998 to March 1999, blood samples were obtained
      from 96 patients that had undergone a prostate biopsy due to a suspicion of
      prostate cancer. PSA-c, PSA-t (Technicon Immunol system, Bayer) and PSA-c/PSA-t
      ratio were analyzed in these patients. RESULTS: ROC curves were plotted and the
      optimal cutoffs were found for which the specificity was higher for PSA-c (44.6%
      [CI 95%, 32-57]) versus PSA-t (35.4% [CI 95%, 25-49]) and the PSA-c/PSA-t ratio
      (38.5% [CI 95%, 27-51]) while maintaining a similar sensitivity index (90%). PSA
      c showed similar results for other values of sensitivity. CONCLUSIONS: PSA-c was
      found to improve specificity in comparison to PSA-t and PSA-c/PSA-t ratio. PSA-c
      determination could avoid unnecessary biopsies without altering sensitivity;
      i.e., the same number of prostate cancers will be detected.

PMID- 11196385
TI  - [Significance of random biopsies of healthy mucosa in superficial bladder tumor].
AB  - OBJECTIVE: To analyze the characteristics of the random biopsies of normal
      appearing mucosa taken during TUR of superficial bladder tumors and to correlate
      them with the outcome and characteristics of the superficial tumor. METHODS:
      Multiple random biopsy specimens from normal-appearing areas of 300 TUR
      procedures for primary or recurrent superficial urothelial carcinoma were
      analyzed. Preoperative cytologies were obtained in most of the patients and tumor
      number, localization, size, stage and grade according to the WHO classification
      were determined. In patients with multiple tumors, the stage, size and grade of
      the worst tumor were utilized. Patients who showed a risk of recurrence during
      follow-up received intravesical therapy postTUR of the bladder. The site and
      characteristics of recurrence were analyzed and compared with the random biopsy
      findings. RESULTS: In 38 superficial tumors (12.7%), significant histological
      changes were found in the random biopsies of normal-appearing mucosa taken during
      resection. A significant difference was found between patients with and without
      positive random biopsies only for tumor stage. Statistically significant
      differences were found when comparing the primary and recurrent tumors, due to
      the greater number of high and moderate grade tumors in the primaries. There were
      significant differences in regard to the positive preoperative cytologies between
      the patients with negative and those with positive random biopsies. No
      statistical correlation was found between the localization of the superficial
      tumor and a positive biopsy or between the latter and the site of tumor
      recurrence. There were 126 recurrences (42%); mean time to recurrence was 13.5
      months (median 9.5 months). No significant difference was found (log-rank) for
      time to recurrence in patients with positive or negative random biopsies, but
      significant differences were found when we analyzed the number of superficial
      tumors and the use of intravesical therapy, but not for the type of therapy.
      CONCLUSIONS: Multiple random biopsies permit a better categorization of the tumor
      and complete staging. The outcome and the decision to administer intravesical
      therapy following TUR of the bladder are influenced by the foregoing. The
      practical results of random biopsies, however, are scanty, since the prognostic
      significance of the histological changes found in these biopsies is not worse
      than that of the superficial tumor resected. There are, however, a few cases with
      a higher risk of recurrence and/or progression than the superficial tumor.
      Preoperative cytology is useful in the selection of these patients. Furthermore,
      since the proportion of high grade tumors is higher in primary tumors, performing
      multiple biopsies is mandatory in these cases if previous urine cytology is not
      available.

PMID- 11196386
TI  - [Epidermoid carcinoma of the penis].
AB  - OBJECTIVE: To analyze our series and review the prognostic factors in the
      treatment of epidermoid carcinoma of the penis. METHODS: Age, time to
      consultation, circumcision, form of presentation, local treatment, tumor stage
      and grade, lymph node involvement and outcome were analyzed in 27 cases of
      carcinoma of the penis diagnosed at our hospital from 1981 to 1999. RESULTS: The
      incidence rate was 1.8 cases/100,000 men/year. No patient had been circumcised,
      except one who was circumcised in the adult age. The median time to consultation
      was 24 months (interquartile range: 60-7.75). The median follow-up was 37 months
      (interquartile range: 84-12). All patients with pT1GI-II and pT2G-II primary
      tumor (n = 21; 78% of the series) and with no lymphadenopathy were disease-free
      at 6 months' minimum follow-up [17 of the 21 patients (81%) had more than 32
      months' follow-up]. Only one patient with pT1-GII tumor, but with a vertical
      growth pattern, had positive inguinal lymph nodes (pN2). The remaining patients
      with lymph node involvement showed infiltration of the erectile tissue and
      moderately or poorly differentiated tumors. Only two prophylactic lymphadenectomy
      procedures were performed (pN0). Regardless of treatment, 5 of the 6 patients
      with lymph node involvement died within one year after diagnosis. CONCLUSIONS:
      Given the demonstrated relationship between carcinoma of the penis and hygiene,
      and phimosis which makes hygiene difficult, circumcision should be performed in
      childhood. Furthermore, circumcision at this age has been demonstrated to have a
      prophylactic value that disappears in the adult age.

PMID- 11196387
TI  - [Partial nephrectomy in lithiasis].
AB  - OBJECTIVE: To analyze our series of patients with renal lithiasis who underwent
      partial nephrectomy from 1980-1999. METHODS: 28 patients who underwent partial
      nephrectomy were analyzed (22 females; mean age 48.09 years, and 6 males; mean
      age 60 years). Surgery for lithiasis had been previously performed in 5 renal
      units. Nine patients had previously undergone ESWL (more than 3 sessions), all of
      whom subsequently developed multiple residual calculi. Twelve patients had a
      microbiologically confirmed positive urine culture. The renal lithiasis amenable
      to treatment by partial nephrectomy was frequently localized in the lower calyces
      (17 cases). RESULTS: Histopathological analysis of the nephrectomy specimen
      showed a prevalence of signs of chronic parenchymal atrophy (25 cases). Three
      cases showed segmental renal dysplasia (those in whom a superior heminephrectomy
      was performed for duplex excretory system). Fifty percent of the stone fragments
      analyzed showed calcium phosphocarbonate. Eight patients had postoperative
      complications; the most important were two cases of renal cutaneous fistula and
      one subphrenic abscess. At 9 1/2 years' mean follow-up, renal function is normal
      in 25 patients. Lithiasis developed in the contralateral unit in 6 cases and in
      the same renal unit in one case. CONCLUSIONS: Partial nephrectomy continues to be
      a therapeutic option for lithiasis. Its indication depends on the morphological
      and functional characteristics of the compromised renal unit, especially in those
      cases in whom renal preservation can be obviated due to its scanty significance.

PMID- 11196388
TI  - [Treatment of erectile dysfunction with vacuum devices].
AB  - OBJECTIVE: To analyze the results achieved with vacuum devices in the treatment
      of erectile dysfunction. METHODS: A telephone survey was conducted on 150
      patients undergoing treatment with a vacuum device. Of these, 89 responded; 79 of
      which were considered valid for the study. The duration and frequency of use,
      side effects and degree of patient and partner satisfaction were analyzed. Mean
      follow-up was 59.5 months. RESULTS: There were 14 dropouts early in the course of
      treatment. The remaining 65 patients used the device for a mean duration of 34.6
      months, 3.7 times monthly. 63.3% of the patients achieved erection in more than
      half of the attempts. The most frequent side effects were pain (27 patients) and
      ecchymosis (7 patients). Forty-eight patients discontinued treatment at 10.8
      months' mean follow-up. The most common causes for discontinuing treatment were
      lack of efficacy, refusal of the partner and pain. CONCLUSIONS: Treatment of
      erectile dysfunction with the vacuum constriction device should be utilized as an
      alternative to intracavernosal drug-induced erection therapy when oral therapy
      fails or is contraindicated. A male with a stable partner and impotence arising
      from venous leakage or mild cavernous artery insufficiency is the ideal
      candidate.

PMID- 11196389
TI  - [Scrotal invasive angiomyofibroblastoma. First reported case].
AB  - OBJECTIVE: To report a case of locally invasive angiomyofibroblastoma of the
      scrotum. To our knowledge, this is the first case of invasive scrotal
      angiomyofibroblastoma reported in the literature. METHODS: A case of invasive
      angiomyofibroblastoma of the scrotum is presented. The literature is reviewed
      with special reference to the etiopathogenesis, clinical features, diagnosis and
      treatment of this rare soft tissue tumor. RESULTS/CONCLUSIONS: The case described
      herein shows that angiomyofibroblastoma can be invasive.

PMID- 11196390
TI  - [Foreign body as renal pseudotumor in a patient with renal polycystic kidney].
AB  - OBJECTIVE: To report a case of granuloma due to a retained surgical sponge that
      mimicked a pseudotumor in a patient with autosomal dominant polycystic kidney
      disease. The appearance of retained surgical sponges on diagnostic imaging is
      reviewed. METHODS: Patient evaluation included renal ultrasound, magnetic
      resonance imaging (MRI) and arteriography. RESULTS: MRI provides characteristic
      features that permit preoperative diagnosis. CONCLUSIONS: In the presence of a
      mass or abscess in patients who have previously undergone surgery, a retained
      surgical sponge should be included in the differential diagnosis. MRI permits
      preoperative diagnosis.

PMID- 11196391
TI  - [Bilharziasis, clinical course of the disease: acute and chronic phase. Two
      clinical cases].
AB  - OBJECTIVE: To report two cases of bilharziasis and review the literature with
      special reference to treatment according to the stages of the disease.
      METHODS/RESULTS: Two patients that had previously visited endemic areas consulted
      for hematuria and renal colic, respectively. One patient was in the acute stage
      of the disease. Diagnosis was made on the demonstration of eggs of the
      schistosome in urine. Good response was achieved by medical treatment. The other
      patient was in the chronic stage. No eggs were demonstrated in urine and
      diagnosis was based on the anatomopathological findings: This patient required
      reconstructive surgery. CONCLUSIONS: Although bilharziasis is uncommon in our
      setting, its incidence is rising due to increasing migration and travel. The
      disease has different clinical manifestations depending on its stage and
      therefore different diagnosis and treatment. Recognizing the disease in the early
      stage prevents progression to the chronic stage and the morbidity and mortality
      of the late stage of the disease, as well as more aggressive treatment.

PMID- 11196392
TI  - [Bladder metastasis of signet-ring cell adenocarcinoma from the stomach].
AB  - OBJECTIVE: To describe an additional case of metastatic bladder tumor from
      gastric signet-ring cell adenocarcinoma. METHODS/RESULTS: Local recurrence was
      demonstrated by gastrointestinal endoscopy and biopsy in a 52-year-old female who
      underwent total gastrectomy for signet-ring cell gastric adenocarcinoma two years
      earlier. A CT scan showed bilateral hydronephrosis and diffuse thickening of the
      bladder wall. Bladder biopsy demonstrated signet-ring cell adenocarcinoma.
      Palliative treatment with ureteral catheterization was instituted. CONCLUSIONS:
      Signet-ring cell adenocarcinoma of the bladder is usually a primary tumor.
      Metastatic signet-ring cell adenocarcinoma to the urinary bladder is uncommon.

PMID- 11196393
TI  - [Basal cell carcinoma of the penis].
AB  - OBJECTIVE: To report an uncommon case of basal cell carcinoma of the penis.
      METHODS: A case of basal cell carcinoma of the penis is presented. This has been
      the only case of this tumor type detected in our setting. The literature is
      briefly reviewed. RESULTS/CONCLUSIONS: Basal cell carcinoma of the penis is rare.
      To date only 20 cases have been reported in the literature. To our knowledge, no
      case of distant metastasis has been documented. Diagnosis by gross examination
      may be difficult due to the broad polymorphism of this lesion and must be
      confirmed by histological analysis.

PMID- 11196394
TI  - [Lipoma of spermatic cord; report of a case].
AB  - OBJECTIVE: To report an additional case of lipoma of the spermatic cord, an
      uncommon, silent tumor. METHODS: A case of lipoma of the spermatic cord is
      described. The patient had presented with an enlarged scrotum with no symptoms.
      The literature on lipoma of the spermatic cord is briefly reviewed, with special
      reference to its diagnosis, forms of presentation and treatment. RESULTS: US
      evaluation demonstrated a mass adhered to the epididymis. An epididymal tumor was
      suspected and surgical exploration by the inguinal approach was performed.
      CONCLUSIONS: Lipoma is the most common tumor of the spermatic cord. Its etiology
      is unknown. It frequently appears in the fourth and fifth decades of life and
      usually involves the left hemiscrotum. It is silent and is detected by
      enlargement of the scrotum. The diagnosis is histological supported by US, which
      offers a reliability of 80%-100%. Treatment is by surgery in all cases.

PMID- 11196395
TI  - [Non-functional renal paraganglioma associated with carotid paraganglioma and
      appendicular mucocele].
AB  - OBJECTIVE: A case of nonfunctional renal paraganglioma associated with
      appendicular mucocele and metachronic carotid paraganglioma is presented.
      METHODS/RESULTS: A 68-year-old patient consulted for abdominal pain. Patient
      evaluation with US, CT and opague enema showed an elongated mass that compromised
      the cecum and a solid mass in the right kidney. The patient underwent
      appendectomy and radical right nephrectomy. The anatomopathological findings
      showed an appendicular mucocele and renal paraganglioma. The postoperative
      hormone analyses were normal. A carotid paraganglioma was removed 8 months later.
      CONCLUSIONS: Renal tumors arising from neural crest cells are uncommon. To our
      knowledge, this is the third case of nonfunctional renal paraganglioma reported
      in the literature. The associated appendicular mucocele was an incidental
      finding.

PMID- 11196396
TI  - Comparison of the efficacy of fluoxetine alone vs. fluoxetine plus local
      lidocaine ointment in the treatment of premature ejaculation.
AB  - OBJECTIVE: The present study compares the efficacy and side effects of fluoxetine
      alone vs. fluoxetine plus local lidocaine ointment in the treatment of premature
      ejaculation. METHODS: Forty-three patients suffering from premature ejaculation
      were studied. The exclusion criteria were erectile dysfunction, loss of libido,
      alcohol and substance abuse, mental retardation, diabetes mellitus, thyroid
      disease, hypotension, previous use of these drugs and urogenital infections. The
      patients' ages ranged from 19 to 48 years (mean age 28 +/- 1.6). They had regular
      sexual lives. They had normal psychiatric consultation and the Glombock Rast
      Sexual Satisfactory Test (GRISS) psychiatric test were in accordance with
      premature ejaculation. RESULTS: The patients were assigned to two groups. Twenty
      six patients, aged 21 to 36 years (mean age 27), received only fluoxetine 20
      mg/day (1 capsule) for a week which was later increased to 40 mg/day (2
      capsules). Seventeen patients, aged 19 to 48 years (mean age 31), were given
      fluoxetine 20 mg/day plus local application of lidocaine ointment. The patients
      and partners were re-evaluated 8 weeks after the treatment. The results were
      classified as unsuccessful, improvement and cure. The chi-square test was used
      for statistical analysis. In the fluoxetine group, 8 (30.8%) patients cured, 11
      (42.2%) showed improvement and there were 7 failures (26.9%). In the combination
      treatment group, 9 (52.9%) patients cured, improvement was observed in 5 (29.4%)
      and failure in 3 (17.6%). Side effects in group I were observed in 6 patients
      (23%) and in 5 (29.4%) in group II. There were no statistical differences between
      the two groups according to the side effects (p > 0.01). No patients were
      excluded from the study due to side effects. CONCLUSION: The combination of
      fluoxetine plus local application of lidocaine ointment was found to be more
      effective than fluoxetine alone in the treatment of premature ejaculation.
      However, the results should be confirmed in further studies with a placebo group
      to rule out the placebo effect.

PMID- 11196397
TI  - Associations between thoracic kyphosis, head posture, and craniofacial morphology
      in young adults.
AB  - The aim of the present study was to investigate associations between thoracic
      hyper- and hypokyphosis, head posture, and craniofacial morphology in young
      adults. Using forward bending test and spinal pantographic measurements, 31
      subjects, 16 with thoracic hyper- and 15 with hypokyphosis, were selected from a
      population-based cohort of 430 young adults. Lateral roentgen-cephalograms were
      taken in natural head posture and craniofacial and postural angular measurements
      were calculated. Any statistically significant differences between the groups
      thoracic hyperkyphosis and thoracic hypokyphosis--were analysed using Student's t
      test. Subjects with thoracic hyperkyphosis had a larger atlantocervical angle
      (At/ CVT, P < 0.01) than subjects with thoracic hypokyphosis. However, head
      position (NSL/VER) was similar in both groups, probably owing to the visual
      perception control of craniovertical relation. There was no statistically
      significant difference in craniofacial morphologyy between the groups.

PMID- 11196398
TI  - Oral health behavior and attitudes of adults in Lithuania.
AB  - In Lithuania, the oral health system is currently in transition and systematic
      data are needed for public oral health care planning. The objectives of this
      study were (i) to describe the self-assessment of oral health status in
      Lithuanian adults, the oral hygiene practices, and dental visiting habits; (ii)
      to assess the attitudes towards teeth and oral health, dental care and oral
      health services; (iii) to determine whether oral health attitudes and behavior
      are affected by socio-economic factors; and (iv) to analyse the association
      between self-care practices and use of oral health services. The study comprised
      random samples of 35-44-year-olds (n = 381) and 65-74-year-olds (n = 302). Data
      were collected during 1997 98 by means of self-administered questionnaires and
      the response rate was 53%. Nearly all persons of ages 35-44 had natural teeth,
      whereas 14% of 65-74-year-olds were edentulous. Among the dentate persons, 45% of
      the young adults against 36% of the elderly claimed having poor teeth, and 66%
      and 55%, respectively, had experience of pain from teeth or mouth during the past
      year. At ages 35-44, 33% of participants reported toothbrushing at least twice a
      day and this was the case for 21% of 65-74-year-olds. Dental visits within the
      past year were indicated by 60% of young adults and 43% of the elderly; 83% of
      all participants reported that their last visit to the dentist was due to acute
      oral symptoms. In general, the participants had positive dental knowledge and
      attitudes; however, 56% were unaware of any effect of fluoride. The bivariate
      analyses showed that perceived oral health status and oral self-care practices
      were related to use of dental services. The multivariate analyses of dental
      visiting habits revealed the effects of gender, urbanization, presence of natural
      teeth, experience of dental problems, attitudes to dental care and dentists, and
      education. In conclusion, preventive dental services should be introduced and the
      establishment of community-based oral health promotion programs is urgently
      needed for Lithuania.

PMID- 11196399
TI  - Immunolocalization of interleukin-8 and proliferating cell nuclear antigen in
      gingival keratinocytes in patients with periodontitis.
AB  - The aim of this study was to investigate the relation between local expression of
      IL-8 and the localization of neutrophilic granulocytes, using CD16 as a marker of
      neutrophils. We also investigated the correlation between IL-8 and epithelial
      proliferation using proliferating cell nuclear antigen (PCNA) as a marker of
      proliferation. The distribution of IL-8, CD16 and PCNA/cyclin was determined by
      immunocytochemical techniques. We used cryostat-cut sections from gingival
      biopsies harvested from 5 subjects with and 5 subjects without periodontitis. Our
      histological examination demonstrated that the localization of neutrophilic
      granulocytes in gingival tissue from patients with periodontitis did not
      correlate with the expression of IL-8. In all tissue sections from patients and
      controls, the inflammatory cells accumulated near the pocket epithelium and only
      a few leukocytes deviated from this pattern. In the patient group, keratinocytes
      not belonging to the pocket or junctional epithelium expressed IL-8 without any
      evidence of a chemoattractant effect on neutrophils. The marker of proliferation,
      PCNA/cyclin, was expressed in keratinocytes in the basal cell layer. The
      expression was less pronounced in the control group. Our finding that IL-8 was
      expressed in proliferating cells suggests that IL-8 may have a role in
      keratinocyte proliferation.

PMID- 11196400
TI  - Avoidance of dental visits: the predictive validity of three dental anxiety
      scales.
AB  - The purpose of this study was to determine the sensitivity, specificity, positive
      and negative predictive values for Corah's Dental Anxiety Scale (DAS) and two
      modified versions of it (MDAS; MDAS/4). A questionnaire was mailed to a simple
      random sample of 1,190 25-year-old residents in the west of Norway in 1997. Half
      the sample received DAS, the other half MDAS. The response rate after one
      reminder was 62%. The respondents completed the scales, gave demographic
      particulars and answered one question about dental visiting habits during the
      last 5 years plus an open-ended question about reasons for non-attendance. Using
      the answers to the latter question as validating criterion, it was found that,
      for all scales, sensitivity decreased while specificity improved when changing
      from a liberal to a stringent cut-off point. The scales gave low positive
      predictive values (< or = 0.26), but high negative predictive values (> or =
      0.98). Since DAS and MDAS/4 gave almost identical findings, the two samples were
      combined. At a cut-off point > or = 13 sensitivity was 0.83, specificity 0.84,
      positive predictive value 0.18 and negative predictive value 0.99. The
      corresponding estimates when the cut-off point was > or = 15 were 0.67, 0.90,
      0.22 and 0.98. It is concluded that, in this test, DAS and the two versions of
      MDAS gave acceptable, or near acceptable sensitivity, specificity and negative
      predictive values, but far too low positive predictive values to be useful for
      prediction at the individual level.

PMID- 11196401
TI  - Trends in dental and medical research and relevance of randomized controlled
      trials to common activities in general dentistry.
AB  - The aim was to study publication trends in dental and medical research as well as
      the proportion of randomized controlled trials in dental research (RCT-Ds) of
      relevance to common activities in general dentistry. The study was based on
      Medline searches, 1969 99 (MeSH terms). Data from Public Dental Services (county
      of Ostergotland, Sweden) were used to find the most common activities in the
      practice of general dentistry,. In dental research the annual number of
      publications had decreased from 5,900 in 1969 to 4,400 in 1999, corresponding to
      9,100 and 14,000, respectively, in medical research. Clinical trials in dental
      research had increased to 7% and RCT-Ds to 5% of all dental research during 1969
      99. In medicine, clinical trials and randomized controlled trials had increased
      to 2% and 1%, respectively. In dental and medical research, meta-analyses (MAs)
      totalled 0.1-0.2% in 1994 and 1999. One out of 200 dental research publications
      in 1979 99 was an RCT-D of relevance to the most common activities in general
      dentistry. These activities contributed to more than 80% of the dental care of
      children and adolescents and to more than 60% of the dental care of adults in
      1999.

PMID- 11196402
TI  - Hyposalivation and iron stores among individuals with and without active dental
      caries.
AB  - The aims of the study were to investigate frequencies of low unstimulated whole
      saliva (UWS) levels and low serum ferritin (S-f) levels among individuals with
      active dental caries (ADC) and dental caries inactive (DCI) individuals and to
      compare the relationship between UWS and S-f levels. In this descriptive study,
      48 ADC patients and 48 DCI individuals were compared. The two groups were matched
      regarding age and sex (30 females and 18 males in each group, age range 15-40
      years). In the ADC group, 32 individuals (67%) had low (< or = 0.20 ml/min) UWS
      levels compared with 13 individuals (27%) in the DCI group. This difference was
      statistically significant (P < 0.001). The mean values of UWS were significantly
      lower in the ADC group compared to the DCI group (mean ml/min +/- SD) 0.20 +/-
      0.13 and 0.33 +/- 0.24, respectively (P = 0.002). There were significant
      differences for females but not for males when comparing frequencies of low UWS
      levels (P < 0.001) and mean UWS levels (P = 0.002). There was no difference in S
      f levels between the two groups. Neither was any correlation between UWS and S-f
      found. In conclusion, the significant negative relationship found between UWS and
      ADC indicates that a suppressed defense for dental caries activity could play a
      more important role in ADC than previously presumed, especially among females.
      The absence of a correlation between UWS and S-f might indicate that saliva
      secretion will not be stimulated by iron supplementation.

PMID- 11196403
TI  - Changes in TMD signs and in mandibular movements from 10 to 15 years of age in
      relation to articulatory speech disorders.
AB  - This study is part of a longitudinal study on the associations between different
      orofacial dysfunctions. The aim was to determine changes in signs of
      temporomandibular disorders (TMD) and in mandibular movement capacity in subjects
      with articulatory speech disorders and in controls by re-examining a sample of
      187 previously studied children from 10 to 15 years of age. Articulatory speech
      disorders were diagnosed by a phoniatrician. Mandibular movement capacity, signs
      of TMD, occlusal contacts/ interference and slide between retruded and
      intercuspal positions were recorded by a dentist. The follow-up results showed
      that mandibular mobility mainly increased up to the age of 15, but there was a
      decrease in protrusion capacity in almost half of the cases. This fluctuation
      probably reflects the normal changes in growth pattern. Signs of TMDs proved to
      be inconsistent in nature, especially among the controls. With age, girls in the
      control group, more so than boys, were prone to new signs of TMD, but no gender
      difference was found in the group of subjects with misarticulations of speech.
      The findings indicate that in adolescence different orofacial dysfunctions are
      related.

PMID- 11196404
TI  - Sealants and xylitol chewing gum are equal in caries prevention.
AB  - Sealants and xylitol have been demonstrated to prevent dental decay, but their
      effect has never been compared in the same study. Regular use of xylitol chewing
      gum during 2 or 3 school years was compared with application of occlusal sealants
      in a randomized study. The reliability of the clinical observations was
      controlled by examining the presence of dental decay in the same teeth from
      bitewing radiographs in a blind study. After 5 years, no statistically
      significant differences between the sealant and xylitol groups were found. The
      results were in line with the results from separate studies with sealants or
      xylitol. There were no great differences between the costs of the measures. The
      selection between the compared preventive measures has to be made on the basis of
      practical aspects such as caries occurrence, availability of personnel and other
      resources, opportunity costs, cooperation with schools, and other local
      conditions.

PMID- 11196405
TI  - Efficacy of a slow-release device containing fluoride, xylitol and sorbitol in
      preventing infant caries.
AB  - A novel slow-release administration device, the "Fall-Asleep Pacifier" (FAP), was
      studied as a prophylactic measure against mutans streptococcal oral infection and
      dental caries in a risk group of 1-year-old children by comparing the test (T, n
      = 34) and control (C, n = 88) groups in a prospective cohort study. In the T
      group the children received their fluoride tablets (Fludent, containing NaF
      corresp. 0.25 mg F0- , xylitol 159 mg and sorbitol 153 mg) in the evenings in
      FAP. In the C group the children received the same dose of Fludent crushed in
      food in the evenings. The proportion of children, whose plaque samples from the
      upper incisors were mutans streptococcus positive at the age of 24 months, was
      significantly (P < 0.05) greater in group C (25%) than in group T (9%). The
      children in the T group developed significantly (P < 0.001) less (none) new
      dentinal carious lesions in their primary dentitions than the children in the C
      group between 2 and 3 1/2 years of age. Fifty-four percent of the children to
      whom the FAP was offered complied with regular use of it. The beneficial effect
      observed in the T group compared with the C group was apparently mostly due to
      the administration mode via FAP, which could prolong the intra-oral
      bioavailability of the prophylactic preparation.

PMID- 11196406
TI  - The outcomes of mandibular third molar removal and non-removal: a study of
      patients' preferences using a multi-attribute method.
AB  - The aim was to study patients' preferences about outcomes of mandibular third
      molar removal and non-removal using multi-attribute utility (MAU) methodology.
      The study comprised three stages. Stage 1: Elicitation of domains, i.e. main
      areas of patients' lives which could be affected by third molar removal and non
      removal. Stage 2a: Interdomain weighting was obtained by relative weighting of
      the domains elicited in Stage 1. Stage 2b: Intradomain weighting obtained by
      patients' designation of values for different health states of each domain. Stage
      3: Rating of outcomes. The patients were asked to imagine experiencing a variety
      of outcomes of mandibular third molar removal and non-removal, described in 19
      short vignettes. The numbers of patients interviewed for the three stages were
      30, 78, and 55, respectively. Five domains were identified. The mean relative
      weightings were approximately equal for the domains "Home and social life" and
      "General health and well-being", followed in order of importance by 'Job and
      studies" and "Health and comfort of mouth, teeth and gums". "Your appearance"
      received the lowest mean relative weighting. The vignette, which described the
      presence of a fluid-filled sac and suggested that this tooth must be removed,
      received the highest mean preference (least effect on patients' lives). The
      lowest mean preference (most effect on patients' lives) was generated by the
      vignette, which stated that the jaw was broken and that the teeth must be wired
      together for 6 weeks. We conclude that, from the patient's perspective, outcomes
      of non-removal were preferable to outcomes of mandibular third molar removal.

PMID- 11196407
TI  - Growth hormone and cortisol in serum and saliva.
AB  - Salivary diagnosis is a developing area in clinical chemistry and dentistry.
      Cortisol analyses from saliva have been used in pediatric practice and as doping
      tests. Growth hormone (hGH), also a stress hormone, has not been analyzed from
      saliva. We studied the serum and saliva of 51 healthy subjects. The samples were
      taken at 8:00 in the morning after 12 h fasting. Cortisol concentrations were
      analyzed using RIA. An immunoradiometric assay was applied for analyzing serum
      and salivary hGH. The validity of this method developed in our laboratory was
      found to be good. The results showed correlation of salivary cortisol with that
      of serum (r = 0.47, P < 0.001). Salivary hGH concentrations were 1000-fold lower
      than the respective values in serum, but a clear correlation was found between
      salivary and serum hGH levels (r = 0.59, P < 0.001).

PMID- 11196408
TI  - Steroidogenic factor 1 is a monomeric orphan, but does not work alone.

PMID- 11196409
TI  - The activation function of steroidogenic factor-1 is impaired in ACTH-resistant
      Y1 mutants.
AB  - This study explores the basis for the altered function of steroidogenic factor-1
      (SF1) in a family of ACTH-resistant Y1 adrenal cell mutants. As determined in
      electrophoretic mobility shift assays, the DNA binding activity of SF1 was not
      impaired in the mutant clones. Instead, the ability of SF1 to interact with the
      coactivator, GRIP1 was affected as determined in a modified mammalian 2-hybrid
      assay. These findings indicate that the mutants harbor a defect affecting the
      activation function of SF1.

PMID- 11196410
TI  - Baboon cytochrome P450c11 is encoded by more than one gene.
AB  - Two P450c11 genes, sharing 99% homology, were cloned from Cape baboon adrenal
      tissue using RT-PCR. The cDNAs showed 96% and 94.6% sequence identity to human
      P450c11 and aldosterone synthase, respectively. One of the gene sequences
      contained a termination codon in exon one. The cloned cDNAs were expressed in COS
      1 cells and the metabolism of deoxycorticosterone to corticosterone investigated.
      The expressed enzyme exhibited 1 beta hydroxylase activity, but no aldosterone
      synthase activity.

PMID- 11196411
TI  - Expression of three negative regulators of CYP17 gene transcription in
      adrenocortical cells.
AB  - The expression of negative regulators of CYP17 gene expression: DAX-1, COUP-TF
      and N-CoR was investigated in bovine adrenocortical cells in primary culture. The
      cells were incubated for 6 hours in a defined medium, containing ACTH (10 nM) or
      forskolin (25 microM). Total RNA was isolated, the concentration of CYP17 gene
      transcript was determined by hybridization analysis, and polyA RNA was reverse
      transcribed to obtain cDNA. Fragments of CYP17, DAX-1, COUP-TF, N-CoR and beta
      actin cDNA were amplified by PCR and the amplified cDNAs were analyzed by agarose
      gel electrophoresis followed by densitometry. It was found that DAX-1 and COUP-TF
      mRNA levels were unaffected by treatment with ACTH or forskolin. On the contrary,
      both compounds enhanced the level of mRNA encoding N-CoR. Under the same
      conditions, ACTH or forskolin substantially stimulated CYP 17 mRNA accumulation.
      Our results suggest that in the adrenocortical cells in culture, the expression
      of DAX1 and COUP-TF is constitutive, whereas N-CoR expression might be inducible.

PMID- 11196412
TI  - Regulation of CYP11B2 gene expression by protein kinase C.
AB  - Bisindolylmaleimide, a protein kinase C (PKC) inhibitor, was shown to stimulate
      the hamster CYP11B2 promoter activity in transfected NCI-H295 cells. In this
      study we have found that TPA, an activator of PKC, also inhibited the hamster
      CYP11B2 promoter activity. DAG-dependent PKC alpha and PKC epsilon, and atypical
      PKC zeta were detected in hamster adrenal zona glomerulosa, whereas the isoforms
      alpha, epsilon, zeta and theta were found in NCI-H295 cells. CYP11B2 promoter
      activity was inhibited in cells co-transfected with constitutively active PKC
      alpha and epsilon mutants, whereas it was increased with the constitutively
      active PKC zeta mutant. Dominant negative PKC alpha, epsilon and zeta mutants
      stimulated the promoter activity. Go6976, a specific inhibitor of classical PKCs,
      enhanced promoter activity, providing further evidence that PKC alpha, the only
      classical PKC revealed in hamster adrenal and NCI-H295 cells, was involved in the
      promoter inhibition.

PMID- 11196413
TI  - Transcriptional regulation of steroid receptor coactivator-1 (SRC-1) in
      glucocorticoid action.
AB  - Diverse mechanisms of steroid receptor action have been clarified in recent
      years, as a consequence of the discovery of multiple coactivators. Among them,
      steroid receptor coactivator-1 (SRC-1) is a member of the p160 coactivator
      families, which are 160 kDa proteins that interact with steroid receptors in a
      hormone-sensitive manner. Since coactivators function as transcriptional power
      boosters, subtle changes in coactivator expression levels in certain cells
      markedly change of receptor-mediated transcriptional activity. Expression of the
      glucocorticoid receptor (GR) has been shown to be autoregulated in glucocorticoid
      action, i.e., GR is downregulated by its cognate ligand, indicating that this
      autoregulation of GR may protect target cells against excessive hormone action.
      In the present study, we examined whether coactivator expression levels are also
      regulated by glucocorticoids. Among several coactivators, the SRC-1 mRNA level
      was downregulated by dexamethasone treatment in rat tissues, such as liver,
      heart, kidney, stomach, and cerebrum, in vivo. We also demonstrated dexamethasone
      mediated downregulation of SRC-1 mRNA and its protein levels in rat renal
      mesangial cells in vitro. These results suggest that ligand-mediated
      downregulation of SRC-1 is crucial in the physiology of glucocorticoid action.

PMID- 11196415
TI  - Transcriptional regulation of the gene encoding the StAR protein in the human
      adrenocortical cell line, H295R by cAMP and TGFbeta1.
AB  - In the present work, we have analyzed the transcriptional regulation of StAR
      expression in the human adrenocortical cell line H295R. We observed that StAR
      mRNA levels rapidly increased in response to forskolin, starting after 2 h of
      treatment and reaching a maximum by 12 h. Deletion analysis of the human StAR
      promoter demonstrated that the first 150 bp upstream of the transcription start
      were sufficient for both basal and cAMP-induced expression of a reporter gene. We
      demonstrate that out of the three binding sequences for the steroidogenic factor
      1 (SF-1) only the central one (-105 to -96) is implicated in both basal and cAMP
      induced StAR expression. In addition, another important regulatory element for
      both basal and cAMP-induced StAR expression is present between -62 and -24
      upstream of the transcription start. We also show that TGF1beta1 inhibits StAR
      expression at the transcriptional level. We found that the TGFbeta-inhibitory
      element lies between -150 and -85 upstream of the transcription start and that
      the SF-1 binding sites are not implicated in TGFbeta1 regulation.

PMID- 11196414
TI  - Orphan receptors COUP-TF and DAX-1 as targets in disordered CYP17 expression in
      adrenocortical tumors.
AB  - CYP17 gene transcription is activated by SF-1 binding to a cyclic AMP-responsive
      sequence within the promoter region of the gene, and its transcription is
      inhibited by COUP-TF binding to the sequence. Another orphan receptor, DAX-1, is
      shown to act as a suppressor of SF-1-mediated transcription. We examined the
      expression level of these orphan receptors in adrenocortical tumors and compared
      the results with CYP17 expression. CYP17 was highly expressed in cortisol
      producing adenomas, whereas COUP-TF and DAX-1 expression levels were very low. In
      deoxycorticosterone-producing adenomas, on the other hand, CYP17 expression was
      extremely low, whereas DAX-1 was highly expressed and SF-1 expression was
      slightly decreased. In conclusion, the reciprocal expression of CYP17 and the
      transcriptional repressors COUP-TF and DAX-1 indicates that these orphan
      receptors have a pathophysiologic role in the excessive hormone production in
      cortisol- and deoxycorticosterone-producing adrenocortical tumors.

PMID- 11196416
TI  - Pituitary-adrenal axis regulation in CRH-deficient mice.
AB  - Corticotropin-releasing hormone (CRH)-deficient (knockout (KO)) mice demonstrate
      severely impaired adrenal responses to restraint, ether, and fasting, and lack
      the normal diurnal glucocorticoid (GC) rhythm. Here, we summarize recent studies
      determining the role of CRH in augmenting plasma adrenocorticotrophic hormone
      (ACTH) concentration after glucocorticoid withdrawal and pituitary-adrenal axis
      stimulation in the context of inflammation. Even though GC insufficient, basal
      pituitary proopiomelanocortin (POMC) mRNA, ACTH peptide content within the
      pituitary, and plasma ACTH concentrations are not elevated in CRH KO mice. POMC
      mRNA content in CRH KO mice increases following adrenalectomy, and this increase
      is reversed by GC, but not aldosterone, replacement. In marked contrast to the
      increase in POMC mRNA, plasma ACTH does not increase in the CRH KO mice following
      adrenalectomy. Administration of CRH to adrenalectomized CRH KO mice results in
      acute, robust ACTH secretion. Thus, loss of GC feedback can increase POMC gene
      expression in the pituitary, but CRH action is essential for increased secretion
      of ACTH into the circulation. While GC secretion is impaired in CRH KO mice after
      most stimuli, we have found near-normal GC responses to inflammation and systemic
      immune challenge. Studies in mice with CRH and IL-6 deficiency reveal that IL-6
      is essential for activation of the pituitary-adrenal axis during inflammatory and
      other stressors in the absence of CRH.

PMID- 11196418
TI  - Requirement of WT1 for gonad and adrenal development: insights from transgenic
      animals.
AB  - Development of the gonad and adrenal gland occurs in close proximity and it has
      been proposed that they share a common primordium. Recent knockout and transgenic
      studies in mice have demonstrated that besides the orphan nuclear receptor SF1,
      the Wilms' tumor suppressor gene WT1 is important for gonad and adrenal gland
      development. WT1 is a complex gene with at least 24 isoforms produced from its
      locus. Although the role of each isoform is not yet understood, biochemical
      studies and analyses of human patients suggest that they do serve different
      functions in the cell. Here we present our current view of the part WT1 may play
      in the development of the gonad and discuss its possible role in the formation of
      the adrenal primordium.

PMID- 11196417
TI  - Approaches to define the role of SF-1 at different levels of the hypothalamic
      pituitary-steroidogenic organ axis.
AB  - Targeted gene disruption has produced knockout mice globally deficient in the
      orphan nuclear receptor steroidogenic factor 1 (SF-1). These SF-1 knockout mice
      lacked adrenal glands and gonads and consequently exhibited adrenocortical
      insufficiency and sex reversal of their internal and external genitalia. They
      also had impaired expression of gonadtropins in the anterior pituitary
      gonadotropes and agenesis of the ventromedial hypothalamic nucleus (VMH),
      confirming roles of SF-1 at all three levels of the hypothalamic-pituitary
      steroidogenic organ axis. Ongoing experiments are directed at using evolving
      techniques for tissue-specific gene inactivation to define the roles of SF-1
      within discrete sites of the hypthalamic-pituitary-steroidogenic organ axis.

PMID- 11196419
TI  - Fetal hypothalamic-pituitary adrenal (HPA) development and activation as a
      determinant of the timing of birth, and of postnatal disease.
AB  - Birth in most animal species is triggered by the fetus through activation of the
      fetal hypothalamic-pituitary-adrenal (HPA) axis. Preterm birth, may be associated
      with precocious activation of fetal HPA function, reflecting the fetal response
      to an adverse intrauterine environment. There is a progressive and concurrent
      increase of ACTH1-39 and cortisol (F) in the circulation of fetal sheep during
      the last 15-20 days of pregnancy (term, day 145-150) associated with increased
      expression of hypothalamic CRH pituitary POMC and adrenal ACTH receptor and
      steroidogenic enzymes, particularly P450 C17. Similar changes occur with fetal
      hypoxemia. Negative feedback is ameliorated by decreased pituitary and
      hypothalamic glucocorticoid receptor, increased CBG, and altered fetal pituitary
      11B-hydroxysteroid dehydrogenase type 1. Repeated fetal hypoxemia, diminishes the
      fetal-pituitary ACTH response, but increases fetal adrenal responsiveness.
      Fetuses exposed to maternal glucocorticoid in late gestation are growth
      restricted with altered postnatal HPA responsiveness and glycemic responses that
      reproduce the insulin resistance of type 2 diabetes. We conclude that the level
      of fetal HPA activity is crucial not only for determining gestation length, but
      also predicts pathophysiologic adjustment in later life.

PMID- 11196420
TI  - DHEA replacement in women with adrenal insufficiency--pharmacokinetics,
      bioconversion and clinical effects on well-being, sexuality and cognition.
AB  - Standard replacement for adrenal insufficiency (AI) consists of glucocorticoids
      and mineralocorticoids while DHEA deficiency is routinely ignored. Thus, AI
      represents the ideal pathophysiological model of isolated DHEA deficiency. We
      investigated the effects of DHEA replacement in 24 women with primary and
      secondary AI employing a double blind, placebo-controlled, randomized crossover
      design. A DHEA dose of 50 mg/d was chosen based on preceding single-dose
      pharmacokinetics and bioconversion studies. Each patient received four months of
      treatment with DHEA and four months placebo, with a one-month washout period.
      Measurements included serum steroid hormones, somatotropic parameters and
      psychometric assessment of well-being, mood, cognition and sexuality. Treatment
      with DHEA raised the initially low serum concentrations of DHEA, DHEAS,
      androstenedione, and testosterone into the normal range. DHEA induced a slight
      increase in serum IGF-I, but only in patients with primary AI, suggesting a
      growth hormone-mediated effect. DHEA treatment significantly improved overall
      wellbeing as well as scores for depression, anxiety, and their physical
      correlates. Furthermore, DHEA significantly increased both sexual interest and
      the level of satisfaction with sex. DHEA replacement had no influence on the
      cognitive performance, which was already on a high level at baseline. In
      conclusion, DHEA replacement improves well-being and sexuality in women with
      adrenal insufficiency. If this is due to a direct effect of DHEA on the brain, an
      indirect effect via increased androgen synthesis, or both, remains to be
      elucidated. Long-term studies in patients of both sexes are needed to further
      define the role of DHEA in standard replacement for adrenal insufficiency.

PMID- 11196421
TI  - The HPA axis and the stress response.

PMID- 11196422
TI  - Gene dosage effects of steroidogenic factor 1 (SF-1) in adrenal development and
      the stress.

PMID- 11196423
TI  - The localization of DHEA sulfotransferase in steroidogenic and steroid
      metabolizing tissues of the adult rhesus macaque monkey.
AB  - Dehydroepiandrosterone sulfate is a major secretory product of the human adrenal
      cortex during intrauterine development as well as during adulthood. There are few
      animal experimental models that share this characteristic pattern of adrenal
      cortical steroidogenesis, which probably accounts for the relative paucity of
      information about the control of development and function of the adrenal androgen
      secretory apparatus. Adrenal androgen production in the rhesus macaque shares
      many similarities with that of the human. We sought to determine the tissue
      distribution of the enzyme DHEA sulfotransferase (DST) in the rhesus. Tissues
      were harvested at the time of autopsy from 7 adult monkeys (5 M, 2 F) ranging
      from 8-15 yrs old, and were fixed in 4% paraformaldehyde, embedded in paraffin,
      and sectioned at 5 mu thickness. Tissue sections were immunostained for DST with
      an anti-human liver DST antibody. DST was not detected in the testis or ovary. In
      the liver, immunoreactive DST was detected only in hepatocytes and in the kidney,
      DST was found only in the epithelial cells lining the collecting tubules. In the
      adrenal, DST was present in the cells of the zona reticularis but was not found
      in the cells of the medulla, zona fasciculata or in the very prominent zona
      glomerulosa. DST was most prominent in cells that were closest to the reticularis
      medullary border. In most adrenals evaluated, the immunopositive cells were
      scattered, rather than forming a continuous band of cells around the medulla. The
      tissue distribution of DST in the adult rhesus macaque is qualitatively similar
      that observed in the adult human. These data aresuggestive that the rhesus might
      be an excellent model for the exploration of factors that regulate adrenal
      androgen production during development, aging, and in response to illness and
      stress, all of which have been found to be associated with variations in DHEA and
      DHEA sulfate production in the human.

PMID- 11196424
TI  - N-proopiomelanocortin (1-77) suppresses expression of steroidogenic acute
      regulatory protein (StAR) mRNA in the adrenal gland of the fetal sheep.
AB  - In the sheep, there is a rapid increase in fetal adrenal growth and
      steroidogenesis during the last 10-15 days gestation. Recently, we have shown
      that infusion of POMC (1-77) increases fetal adrenal growth and expression of
      CYP17 mRNA but does not significantly alter fetal plasma cortisol concentrations
      [1]. We therefore investigated the effects of infusion of bovine POMC (1-77) and
      its biosynthetic derivative POMC (1-49) on adrenal StAR mRNA expression. At 136d
      gestation, POMC (1-77) (n=5 fetuses; 2microg/ml/h), POMC (1-49) (n=5 fetuses,
      2microg/ml/h) or Saline (n=5 fetuses, 1ml/h) was infused for 48h. At 138d, fetal
      adrenal glands were collected and frozen in liquid N2 until RNA was extracted.
      Northern blot analyses demonstrated a major transcript for StAR mRNA at 3.0kb in
      fetal adrenal glands from all treatments. The membrane was stripped and re-probed
      with a P-labelled rat 18S rRNA oligo-probe to verify equal RNA loading. Infusion
      of POMC (1-77), but not POMC (1-49), resulted in a suppression of fetal adrenal
      StAR mRNA:18S rRNA when compared to adrenal StAR mRNA:18S rRNA from saline
      infused controls. Our data suggest POMC (1-77) may act via separate mechanisms to
      increase fetal adrenal growth and to limit adrenal steroidogenesis through
      suppression of StAR mRNA.

PMID- 11196425
TI  - Corticosteroid production by fetal rat hippocampal neurons.
AB  - 11beta-hydroxylase and aldosterone synthase catalyse the final stages of
      corticosterone and aldosterone synthesis respectively. Previously, we established
      that they are expressed in the rat brain, particularly the cerebellum and the
      hippocampus. Primary cultures of fetal rat neurons were studied. RT-PCR and
      immunohistochemistry established that neurons express 11beta-hydroxylase and
      aldosterone synthase mRNAs and protein. After incubating the cells with 10microM
      DOC for 24 hours, medium was analysed for aldosterone and corticosterone. Median
      % conversion of DOC to corticosterone was 7.6% compared to 0.4% in controls.
      Median % conversion of DOC to aldosterone was 6.2% compared to 0.06% in controls.
      Corticosteroids mediate a number of functions of mammalian brain, including blood
      pressure homeostasis, salt appetite and neuronal excitability. Local production
      of these steroids could have significant effects on these processes.

PMID- 11196426
TI  - Chronic stress effects on the rat adrenal cortex.
AB  - Under the influence of a chronic permanent stress, the adrenal function as well
      as the entire hypothalamic-pituitary-adrenal axis (HPAA) suffered an adaptation
      process that resulted in the normalization of the studied stress hormones (ACTH,
      corticosterone and aldosterone) with the exception of plasma renin activity which
      first diminished and at the end increased. ACTH receptors exhibited a dual
      response since after 14 days of permanent stress MC2-R showed a slight reduction
      while MC5-R was still up-regulated.

PMID- 11196427
TI  - Functional expression of the human ACTH receptor gene.
AB  - The ACTH receptor is the type 2 (MC2R) among the melanocortin receptor family and
      is expressed almost exclusively in the adrenal cortex. The human MC2R (hMC2R) was
      very difficult to express in heterologous cell lines. We have succeeded in
      transient and stable expression of hMC2R using the M3 melanoma cells. Moreover,
      we have found that the expressed hMC2R in M3 cells showed similar ACTH binding
      affinity and coupling to adenylate cyclase as the MC2R of normal human adrenal
      cells, contrarily to most of the other expression cell models. In these
      conditions, we have been able to test several mutant hMC2R described in patients
      with the familial glucocorticoid deficiency syndrome (FGD) using this cell line.

PMID- 11196428
TI  - Activation and phosphorylation of angiotensin AT1 and AT2 receptors.

PMID- 11196429
TI  - Hypophysectomy results in a loss of connexin gap junction protein from the
      adrenal cortex.
AB  - To test the hypothesis that gap junctions are dependent on the tropic state of
      the adrenal gland, the effect of hypophysectomy on connexin 43 (alpha1-Cx43) gap
      junction protein occurrence and distribution was examined in mice. Gap junction
      protein occurrence was assessed with immunohistochemical techniques. In the
      adrenal gland from intact animals, alpha1-Cx43 gap junction protein was detected
      in the zonae fasciculata(ZF) and reticularis (ZR) while only a few alpha1-Cx43
      gap junction plaques were found connecting zona glomerulosa(ZG) cells.
      Hypophysectomy led to a profound atrophy of the cortex which was more marked in
      the inner zones (zonae fasciculata and reticularis) than in the zona glomerulosa.
      There was a time dependent loss of alpha1-Cx43 gap junction protein in the
      adrenal cortex after hypophysectomy. At 33 day following hypophysectomy there was
      a two fold decrease in gap junctions in the zona fasciculata while the average
      gap junction plaque size was not different than the size seen in control animal
      adrenal glands.. ACTH (1U/gm body weight) treatment in hypophysectomized animals
      increased the number of gap junction plaques in the zona fasciculata.
      Hypophysectomy led to diminished alpha1-Cx43 gap junction expression in the zona
      fasciculata which could be restored by ACTH treatment. Because altering the
      tropic state of the adrenal glands via hypophysectomy leads to a reduction in gap
      junction number, it can be suggested that control of gap junction expression in
      the adrenal gland is hormone dependent and linked to adrenal gland function.

PMID- 11196430
TI  - Neuroendocrine regulation by the Agouti/Agrp-melanocortin system.

PMID- 11196431
TI  - Isolation of a full length ovine angiotensin II type-1 receptor (AT1-R) cDNA.
AB  - A full-length ovine AT1-R cDNA (2358 bases: Genebank AF254119) was isolated from
      ovine adrenal cortex using 3'-RACE. While homology of the 5'-untranslated region
      to human sequence was low (34.2%), the beginning of both human exon 1 and human
      exon 5 (encoding the end of the 5'-untranslated sequence/complete protein coding
      region/3'-untranslated sequence) were exceptionally conserved and in context. The
      intervening untranslated sequence showed lower homology to human sequence, but
      still contained four additional ATG sequences close to corresponding "in frame"
      TGA Stop codons shown in human to impair AT1-R translation in vitro. The putative
      protein coding sequence was >99% identical to the previous reported ovine genomic
      sequence. The predicted amino acid sequence in turn encoded a protein with the
      properties of a seven alpha-helix transmembrane receptor sharing closest homology
      (99.1%) to the bovine receptor and lowest to the rat Type la (90.5%). The 3'
      untranslated region showed relatively high homology to the porcine and bovine
      receptor cDNA, but did not share the additional 643 bases found only in the
      bovine 3'-untranslated region. The ovine 3'-sequence included a polyadenylation
      signal as well as three AUUUA destabilization sequences observed in most other
      species including human. Thus ovine AT1-R mRNA stability may be short lived, and
      control of degradation may be an additional mechanism for regulation of ovine AT1
      R expression.

PMID- 11196432
TI  - A role for the p42/44 isoforms of MAPK in the regulation of steroid secretion
      from Y1 mouse adrenocortical cells.

PMID- 11196433
TI  - Effect of serotonin4 (5-HT4) receptor agonists on aldosterone secretion in
      idiopathic hyperaldosteronism.
AB  - Serotonin (5-HT) stimulates aldosterone secretion in man through 5-HT4 receptors
      positively coupled to adenylyl cyclase. In particular, it has been shown that
      oral administration of a single dose of the 5-HT4 receptor agonist cisapride
      induces a significant increase in plasma aldosterone levels (PAL) in healthy
      volunteers. Idiopathic hyperaldosteronism (IH) is a rare disorder characterized
      by hypertension, hypokalemia and bilateral adrenal hypersecretion of aldosterone.
      In patients with IH, administration of the 5-HT precursor 5-hydroxytryptophan (5
      HTP) is followed by a significant increase in PAL. 5-HTP-induced aldosterone
      secretion has been attributed to the activation of central serotonergic pathways.
      The aim of the present study was to evaluate the effect of the oral
      administration of a single dose of cisapride (10 mg) on aldosterone secretion in
      15 patients with IH, in a simple blind fashion versus placebo. Cisapride induced
      a significant increase in PAL but did not affect renin, cortisol and potassium
      levels. The present study demonstrates that 5-HT4 receptor agonists are able to
      stimulate aldosterone secretion in patients with IH. These data also indicate
      that hyperplastic glomerulosa tissue, like normal glomerulosa cells, expresses a
      functional 5-HT4 receptor. Therefore, 5-HT4 receptor antagonists may represent a
      new approach in the treatment of primary hyperaldosteronism.

PMID- 11196434
TI  - Induction of nitric oxide synthase activity in adrenal cells.
AB  - The induction of nitric oxide synthase (NOS) II by bacterial lypopolysaccharide
      (LPS) was studied in a steroidogenic mouse tumor adrenal cell line (Y1).
      Conditioned media from LPS-stimulated peritoneal macrophages induced an increase
      in NOS II expression as shown by western and northern blot analysis. Accordingly,
      in the presence of conditioned media an increase in nitrite levels was observed.
      In addition, steroid production was significantly decreased. In conclusion, NOS
      II expression could be induced in steroidogenic cells with a concomitant
      inhibition of steroid production.

PMID- 11196435
TI  - Rat glomerulosa cells express functional 5-HT7 receptors.
AB  - It has been previously demonstrated that serotonin (5-HT) is a potent stimulator
      of aldosterone secretion in amphibians and mammals. The aim of the present study
      was to characterize the type of serotonergic receptor involved in the action of 5
      HT on rat glomerulosa cells. The effects of 10 serotonergic receptor agonists and
      12 receptor antagonists on aldosterone secretion from perifused rat
      adrenocortical slices were investigated. Correlation analysis between the
      potencies of the different compounds in our model and those previously reported
      for transfected 5-HT receptors showed that the rat adrenal 5-HT receptor exhibits
      the pharmacological profile of the 5-HT7 receptor. RT-PCR amplification with
      specific primers for the 5-HT7 receptor confirmed the presence of 5-HT7 receptor
      mRNA in the adrenal cortex. Western blot analysis using antibodies against the 5
      HT7 receptor revealed the occurrence of a protein with an apparent molecular mass
      of 66 kDa in the zona glomerulosa. In glomerulosa cells, 5-HT induced a
      concentration-dependent increase of cAMP formation. These data demonstrate that
      rat adrenal glomerulosa cells express functional 5-HT7 receptors positively
      coupled to adenylyl cyclase.

PMID- 11196436
TI  - Effects of cellular mediator agonists on cortisol and steroid acute regulatory
      (StAR) protein in bovine zona fasciculata (ZF) cells.
AB  - Primary cultures of bovine ZF cells were incubated for 1 h or 6h with the
      agonists 8-bromo-cyclic AMP (8-Br-cAMP) an activator of protein kinase A (PKA),
      the phorbol ester phorbol 12-myristate 13-acetate (PMA) a protein kinase C (PKC)
      activator, the Ca2+ ionophore, A23187, or the L-type Ca2+ channel agonist Bay
      K8644. Both cortisol secretion (determined by radioimmunoassay of cell medium)
      and cellular StAR protein levels (quantified by western blotting) were
      significantly increased at 6h, by all agonists. However, while all agonists
      stimulated cortisol secretion at 1h, StAR protein levels remained unchanged by
      these treatments. We conclude that in bovine ZF cells, StAR protein synthesis can
      be regulated by mechanisms involving activation of PKA, PKC and Ca2+ influx.
      However, a net increase in cellular StAR protein does not appear to be essential
      for the initiation for the first stage of acute steroidogenesis.

PMID- 11196437
TI  - An ACTH-activated protein tyrosine phosphatase (PTP) is modulated by PKA-mediated
      phosphorylation.
AB  - In adrenal cortex, ACTH regulation of steroidogenesis depends on PKA-dependent
      serine/threonine phosphorylation and also on the activity of protein tyrosine
      phosphatases (PTPs). In addition, ACTH increases total PTPs involving at least
      three soluble PTPs (50, 82 and 115 kDa). Serine/threonine phosphorylation of
      these enzymes themselves could be a regulatory mechanism of their activity since
      the increase of total PTP activity is dependent on PKA-activation. In this report
      we analyzed the effect of in vitro phospho-dephosphorylation processes on the
      activity displayed by the ACTH-activated PTP of 115 kDa. Using an in-gel PTP
      assay we demonstrate that dephosphorylation catalyzed by potato acid phosphatase
      (PAP) reduces the activity of the 115 kDa PTP present in ZF from ACTH-treated
      animals and PKA-mediated phosphorylation reverses this effect.

PMID- 11196438
TI  - Calcium signal and mitochondrial metabolism in steroid producing cells.

PMID- 11196439
TI  - Inhibition of protein tyrosine phosphatase activity blocks shape change &
      steroidogenesis in Y1 cells.
AB  - Y1 adrenocortical cells respond to forskolin stimulation with increases in
      steroid secretion and change of shape. The rapid rounding of flat, adherent cells
      which occurs is known to involve dephosphorylation of the focal adhesion protein,
      paxillin. We have investigated the effects of a tyrosine phosphatase inhibitor,
      calpeptin (CP) on steroidogenesis and shape change in Y1 cells. Forskolin
      treatment (FSK, 2 microM) caused marked rounding of Y1 cells (FSK = 76.3 +/- 1.5%
      cells rounded after 30 minutes, untreated = 2.9 +/- 0.7 % rounded); calpeptin
      pretreatment (CP; 100 ug/ml) had little effect on shape (9.6 +/- 2.4% rounded)
      but blocked the rounding response to FSK (32.1 +/- 2.1% rounded. Calpetin also
      eliminated the steroidogenic response to FSK ( FSK = 242 +/- 14% control ; FSK +
      CP = 113 +/- 18% control ) without affecting production of steroid from membrane
      permeant 22R-OH-cholesterol. The results support the view that dephosphorylation
      of paxillin is important in the rounding response and provide evidence for the
      involvement of tyrosine-phosphatase activity in cyclic AMP-stimulated
      steroidogenesis in Y1 cells.

PMID- 11196440
TI  - Evidence that StAR and MLN64 act on the outer mitochondrial membrane as molten
      globules.
AB  - StAR increases the flow of cholesterol from the outer to inner mitochondrial
      membrane (OMM to IMM), but its mechanism of action remains unclear. MLN64 is a
      445 amino acid protein of unknown function that has four N-terminal transmembrane
      domains and whose C-terminal domain from 218-445 is 37% identical to StAR. N-62
      StAR is as active as wild-type StAR, and N-234 MLN64 has 1/3 to 1/2 of StAR's
      activity. N-62 StAR lacks a mitochondrial leader and is confined to the
      cytoplasm, indicating that it acts on the OMM. Bacterially expressed N-62 StAR
      and N-218 MLN64 are active with isolated MA-10 cell mitochondria, indicating the
      proteins were properly folded. Far-UV CD spectroscopy, unfolding in urea, and
      fluorescence spectroscopy indicate that StAR undergoes a pH-dependent transition
      to a molten globule (retained secondary structure, partially lost tertiary
      structure) and stabilizes in mildly acid conditions. Far-UV CD data indicate that
      MLN64 undergoes a much less pronounced transition. Western blotting shows that
      normal human placenta has abundant N-terminally-cleaved 30 kDa MLN64. Partial
      proteolysis followed by mass spectrometry shows that the C-termini of StAR and
      MLN64 are sensitive to proteolysis, indicating looser folding. Our model of StAR
      action is that the protease-resistant domain unfolds slowly during normal
      mitochondrial entry, keeping StAR in contact with the OMM longer, increasing
      activity. The transition to the molten globule may be related to interaction with
      the OMM. These data are consistent with the recent crystallographic structure of
      N-216 MLN64 in which MLN64 binds cholesterol one molecule at a time, but are not
      consistent with the suggestion that StAR/MLN64 must reside in the
      intramembraneous space to transfer cholesterol form the OMM to the IMM.

PMID- 11196441
TI  - Roles of scavenger receptor BI and APO A-I in selective uptake of HDL cholesterol
      by adrenal cells.
AB  - Adrenal cells obtain cholesterol for steroid production via the selective uptake
      of cholesteryl ester (CE) from HDL particles, a process in which CE is
      transferred to the plasma membrane without degradation of the HDL particle.
      Although this process has been studied for two decades, only recently have the
      receptor and the HDL ligand been identified. Scavenger class B, type I, (SR-BI)
      is regulated by ACTH in adrenocortical cells in parallel with steroid production.
      Antibody to SR-BI blocks the uptake and utilization of HDL CE for steroid
      production in Y1-BS1 adrenal cells. The adrenal glands of SR-BI knockout mice are
      depleted in cholesterol providing complementary evidence that SR-BI is
      responsible for HDL CE accumulation in adrenal cells. SR-BI-mediated HDL CE
      selective uptake is a two-step process in which SR-BI first interacts with
      multiple sites in apoA-I with the amphipathic inverted alpha-helical repeat units
      of apoA-I serving as recognition motifs. This is followed by efficient CE
      transfer down its concentration gradient to the plasma membrane, a process
      requiring the extracellular domain of SR-BI. Other scavenger receptors bind HDL
      but do not afford the CE transfer step. Adrenal glands from apoA-I knockout mice
      lack CE stores, indicating that apoAI is essential for HDL selective uptake in
      vivo. ApoA-I knockout HDL particles bind normally to SR-BI but do not permit
      efficient CE transfer to the cell. These findings suggest that apoA-I has an
      important role in the transfer of HDL CE that goes beyond its function as a
      ligand for interaction with SR-BI.

PMID- 11196442
TI  - Regulation of arachidonic acid release in steroidogenesis: role of a new acyl-CoA
      thioestrase (ARTISt).
AB  - It has been well established that arachidonic acid (AA) and its metabolism to
      leukotrienes plays an obligatory role in steroid production. The release of AA is
      regulated by hormone stimulation and protein phosphorylation. We have cloned a
      cDNA of a phosphoprotein with a molecular mass of 43 kDa (p43), purified from the
      cytosol of stimulated adrenal glands. This protein acts as intermediary in the
      stimulation of steroid synthesis through AA release, and has been found to be a
      member of a recently described acyl-CoA thioesterase family. In view of the
      mandatory role of this protein in the activation of AA-mediated steroidogenesis,
      the term Arachidonic acid-Related Thioesterase Involved in Steroidogenesis
      (ARTISt), is proposed for p43. The present study describes the production of the
      recombinant protein by cDNA expression in Escherichia coli and its functional
      characterization. Recombinant acyl-CoA thioesterase was capable to release AA
      from the respective acyl-CoA, and this activity was affected by well-recognized
      inhibitors of AA release and metabolism: 4-bromophenacyl bromide (BPB) and
      nordihydroguariaretic acid (NDGA). In addition, the inhibition of acyl-CoA
      thioesterase activity by NDGA correlates with the inhibition of steroid synthesis
      produced by this compound in adrenal cortex cells. Moreover, the recombinant
      protein was phosphorylated in vitro by PKA. These results provide the first
      evidence linking acyl-CoA thioesterases with the regulation of steroidogenesis,
      and support a regulatory role for acyl-CoA thioesterases in steroidogenic
      tissues, suggesting an alternative pathway for AA release in signal transduction.

PMID- 11196443
TI  - Relationship of StAR expression to mitochondrial cholesterol transfer and
      metabolism.
AB  - Experiments in Y-1 and primary adrenal cells have established that basal StAR
      mRNA is sufficient for maximum cAMP-stimulated cholesterol metabolism providing
      that newly synthesized p37 StAR precursor is phosphorylated, transferred to the
      matrix and proteolytically cleaved to pp30. This form is active at the inner
      membrane. The majority of mitochondrial StAR redistributes, perhaps with
      cholesterol, to matrix vesicles but no longer facilitates intermembrane transfer
      even when appropriately phosphorylated. MA10 cells utilize a similar to Y01 cells
      mechanism, but sustain a higher rate of cholesterol metabolism at comparable StAR
      levels and exhibit much higher maximum rates. In Y-1 adrenal cells cholesterol
      metabolism is fully activated prior to increased StAR expression which then does
      not affect the rate. Thus factors other than StAR are at least as important in
      determining overall rates of cholesterol delivery. Following cAMP stimulation
      StAR is predominantly expressed as the 3.5kb form which arises from alternative
      polyadenylation following transcription of an extended exon 7. This form contains
      an AU-rich regulatory element at the 3'-end that potentially mediates the
      relatively rapid turnover of this form. The 1.6kb form is more stable and reaches
      a steady state at later time points. Turnover of both forms is coupled tightly to
      ongoing transcription and translation. In addition to enhanced transcription cAMP
      appears to direct enhanced turnover of the 3.5kb form. StAR participation in
      cholesterol metabolism functions at very low levels of mRNA and high efficiency
      at each step.

PMID- 11196444
TI  - Post-translational regulation of steroidogenic acute regulatory protein by cAMP
      dependent protein kinase A.
AB  - Adrenal steroid production is stimulated by adrenocorticotropin hormone
      activation of the cAMP-dependent protein kinase A (PKA) signaling pathway and
      subsequent induction of Steroidogenic Acute Regulatory (StAR) protein expression.
      Herein we have compared StAR mRNA and protein levels in 8-Br-cAMP-treated mouse
      adrenocortical Y1 and the derived PKA mutant Kin-8 cell lines to evaluate the PKA
      requirement in StAR expression. StAR mRNA was induced by 8-Br-cAMP-treatment of
      both Y1 and Kin-8 cells with maximal expression levels in Kin-8 cells
      approximately 50% of that observed in Y1 cells. StAR protein levels, as detected
      by Western analysis, were concomitantly increased in Y1 cells but were not
      detected in the Kin-8 cells. StAR mRNA colocalized with the active polysome
      fractions in both 8-Br-cAMP-treated Y1 and Kin-8 cells, indicating translation
      was not blocked in Kin-8 cells. Consistent with this data, a 2-fold increase in
      incorporation of [35S]methionine into StAR was also observed after 8-Br-cAMP
      treatment of both cell lines. Since StAR protein levels were not sufficient to
      detect by Western analysis, these data indicate that PKA functions at the post
      translational level to regulate StAR expression and we propose that
      phosphorylation of StAR by PKA contributes to protein stability.

PMID- 11196445
TI  - Probing structural and functional domains of human P450c17.
AB  - Human P450c17 performs at least six chemical transformations, but this spectrum
      of activity is differentially regulated by structural changes and by redox
      partner proteins. Furthermore, P450c17 isoforms from different species with
      approximately 90% amino acid identity exhibit markedly different relative rates
      for these transformations. Although this phenomenology has been recognized for
      nearly 20 years, the underlying chemistry and structural basis for these effects
      are poorly understood. We have constructed a structural model of human P450c17
      using computational chemistry to understand informative, naturally occurring
      human mutations and to provide a rational basis for designing alterations in
      P450c17 that probe functional domains of the protein. We have mapped with
      considerable confidence key residues involved in the interaction with redox
      partner proteins, including K89, R347, and R358, which form positive charges on
      the "proximal" surface of P450c17. Neutralization of these charges selectively
      impairs 17, 20-lyase activity without large reductions in 17alpha-hydroxylase
      activity or 17alpha-hydroxypregnenolone binding. We are now directing our efforts
      to the identification of key residues in the active site that mediate the
      substrate specificity and catalytic selectivity of human P450c17.

PMID- 11196446
TI  - Role of arachidonic acid metabolism in ACTH-stimulated cortisol secretion by
      bovine adrenocortical cells.
AB  - We have studied the effects of inhibitors of arachidonic acid (AA) metabolism,
      nordihydroguaiaretic acid (NDGA), a lipoxygenase (LPX) inhibitor, and
      indomethacin (INDO), a cyclooxygenase (COX) inhibitor, on cortisol secretion and
      StAR protein in primary cultures of bovine adrenal zona fasciculata (ZF) cells.
      NDGA inhibited cortisol secretion in response to both 10(-12) M and 10(-8) M
      ACTH. AA (10(-4) M) partially reversed the inhibition of cortisol secretion by
      NDGA at 10(-12) M ACTH but not at 10(-8) M ACTH. On the other hand, INDO
      potentiated the cortisol response to 10(-12) M ACTH. Neither NDGA nor INDO
      significantly affected StAR protein levels. These results suggest a StAR protein
      independent role for the LPX and COX pathways in acute cortisol secretion, and
      support the hypothesis that LPX products of AA metabolism are key cellular
      signals when bovine ZF cells are acutely stimulated by physiological
      concentrations of ACTH (10(-12) M).

PMID- 11196447
TI  - The role of 11 beta-hydroxysteroid dehydrogenase in central obesity and
      osteoporosis.
AB  - Both central obesity and osteoporosis are common findings in states of
      glucocorticoid excess. In many tissues, including adipose tissue, hydroxysteroid
      dehydrogenase type 1 (11beta-HSD1) catalyses the inter-conversion of active
      glucocorticoid, cortisol (F) and inactive cortisone (E) and regulates exposure to
      the glucocorticoid receptor. As such, factors which regulate 11beta-HSD1 are
      likely to have an important role in adipose tissue and bone physiology. Using
      primary cultures of human adipose stromal cells we have investigated the effect
      of various factors present within the adipocyte microenvironment for their
      effects on 11beta-HSD1 expression. IGF-1 caused a dose dependant inhibition of
      11beta-HSD1 activity in both subcutaneous and omental stromal cells.
      Additionally, TNFalpha treatment increased 11beta-HSD1 reductase activity and
      mRNA expression. In adult human bone, 11beta-HSD1, but not 11beta-HSD2,
      expression was demonstrated using enzyme activity studies, RT-PCR and
      immunohistochemistry. In contrast to liver and adipose tissues, where reductase
      activity predominates, both reductase and dehydrogenase activities of 11beta-HSD1
      were evident in bone chips and primary cultures of human osteoblasts. The action
      of growth factors and cytokines on glucocorticoid sensitive tissues such as
      adipose tissue and bone may be mediated by modulation of local glucocorticoid
      metabolism at a pre-receptor level.

PMID- 11196448
TI  - Molecular modeling of the hamster adrenal P450C17.
AB  - The cytochrome P450C17 (C17) is the steroidogenic enzyme responsible for the
      conversion of pregnenolone and progesterone to dehydroepiandrosterone (DHEA) and
      delta4-androstenedione (AD) respectively. This conversion is achieved by two
      enzymatic activities, 17alpha-hydroxylase and 17,20-lyase, located at the same
      active site. In man, the adrenal C17 basically only produces DHEA. We have shown
      that the hamster adrenal C17 produces DHEA as well as AD. Moreover, the hamster
      like man produces cortisol as its major glucocorticoid. We can thus compare the
      hamster and human adrenal C17, and use their differences in order to elaborate a
      strategy for structure-function studies. We have thus engineered hamster adrenal
      C17 mutants which possess modified enzymatic activities. We also proceeded to
      elaborate a three-dimensional model of the hamster C17 to visualise the
      structural impact of these mutations. This model demonstrates that the mutations
      created are not localised at the active site, but rather in surrounding regions.
      These could affect the conformation of the active site, in turn, modulating the
      17alpha-hydroxylase and 17,20-lyase activities. For example, the mutation T202N
      is located next to Val 482 and Val 483 which compose the roof of the active site.
      This mutation decreased both 17alpha-hydroxylase and 17,20-lyase activities,
      indicating the importance of the roof of the active site for general
      functionality of the C17.

PMID- 11196449
TI  - Inhibition of cytochrome P450c11 by biogenic amines and an aziridine precursor, 2
      (4-acetoxyphenyl)-2-chloro-N-methyl-ethylammonium chloride.
AB  - The interaction of several biogenic amines and Compound A (2-(4-acetoxyphenyl)-2
      chloro- N-methyl-ethylammonium chloride), an analogue of the active substance in
      a HPLC fraction isolated from the shrub, Salsola tuberculatiformis Botsch., with
      cytochrome P450c11 was investigated. Noradrenaline, octopamine and Compound A
      inhibited the type I DOC induced difference spectrum of P450c11 and elicited a
      type II difference spectrum when added alone. The Ks-values for noradrenaline,
      octopamine, and Compound A were 0.8 mM, 0.16 mM and 0.36 mM, respectively.
      Dopamine, adrenaline and synephrine did not interact with, or inhibit, P450c11.
      Further investigation of Compound A indicated that it is a mixed inhibitor of
      sheep P450c11 with a stronger competitive (Kic = 106-110 microM) than
      uncompetitive (Kiu = 667-737 microM) element, and that it inhibits the conversion
      of deoxycorticosterone to corticosterone by human 11beta-hydroxylase and
      aldosterone synthase with EC50 values of 97 microM and 190 microM, respectively,
      in fetal calf serum.

PMID- 11196450
TI  - Properties of an adrenal medullary protein immunorelated to steroid acute
      regulatory (StAR) protein.
AB  - Immunohistochemistry using a StAR peptide antiserum had previously revealed
      strong staining in rat and bovine adrenal medulla, suggesting the presence of a
      protein immunogenically related to StAR. Western blots of bovine medulla tissue
      homogenates showed the principal adrenal medullary immuno-reactive species to
      have a higher molecular weight (50 kDa) compared to StAR protein (30 kDa).
      Subcellular fractionation localised the 50 kDa species principally to the medulla
      cytosol. StAR peptide antiserum binding to both the 30 kDa and 50 kDa species
      could be specifically competed by the peptide antigen. These data suggest that
      the adrenal medullary immuno-reactive species and StAR protein are distinct
      entities, which share some features in common.

PMID- 11196451
TI  - Triple A syndrome--clinical aspects and molecular genetics.
AB  - The triple A syndrome or Allgrove syndrome (MIM*231550) is characterized by
      adrenocorticotropic hormone (ACTH) resistant Adrenal insufficiency, Achalasia of
      the cardia and Alacrima. In addition to the main features, patients frequently
      suffer from neurological disturbances. Dermatological abnormalities such as
      palmoplantar hyperkeratosis as well as other signs like short stature,
      microcephaly and osteoporosis point to the multisystemic character of the
      disorder. The molecular defect of the autosomal recessively inherited triple A
      syndrome is not known. We initially performed a systematic genome linkage scan in
      eight triple A families and were able to map the syndrome to a 6 cM interval on
      human chromosome 12q13 near the type II keratin gene cluster. A refinement of the
      triple A critical region was achieved by detailed haplotype analysis in a further
      37 families from different ethnic backgrounds. There was no indication of genetic
      heterogeneity. The achalasia-alacrima (AA) syndrome which has been defined as a
      distinct clinical entity (MIM 200440) is most likely a variant of the triple A
      syndrome as shown by haplotype analysis in three AA families. We constructed a
      high-resolution BAC/PAC-based transcript map of the region which will greatly
      facilitate the identification of the triple A syndrome gene. The considerable
      intra- and interfamilial variability of the severity of the disorder implies a
      variable expression of an impaired pleiotropically acting gene.

PMID- 11196452
TI  - A new insight into the molecular basis of 3beta-hydroxysteroid dehydrogenase
      deficiency.
AB  - Classical 3beta-hydroxysteroid dehydrogenase/delta5-delta4 isomerase (3beta-HSD)
      deficiency is a rare form of congenital adrenal hyperplasia that impairs
      steroidogenesis in both the adrenals and gonads resulting from mutations in the
      HSD3B2 gene, causing varying degrees of salt-loss in both sexes and incomplete
      masculinization of the external genitalia in genetic males. To date a total of 34
      mutations (including 5 frameshift, 4 nonsense, 1 in-frame deletion, 1 splicing
      and 23 missense mutations) have been identified in the HSD3B2 gene. Results from
      functional charaterization studies of the mutant proteins agrees with the
      prediction that no functional type II 3beta-HSD isoenzyme is expressed in the
      adrenals and gonads of the patients with the severe salt-losing form, whereas the
      nonsalt-losing form causes an incomplete loss in enzymatic activity, thereby
      leaving sufficient enzymatic activity to prevent salt loss. Recent studies have
      highlighted the fact that various mutations appear to have a drastic effect upon
      the stability of the protein, therefore providing molecular evidence of a new
      mechanism involved in classical 3beta-HSD deficiency. Finally, the functional
      characterization of the missense mutations known to be involved in this autosomal
      recessive disorder provides valuable information concerning the structure
      function relationships of the 3beta-HSD enzyme superfamily.

PMID- 11196453
TI  - Genotype-phenotype correlations of mutations and polymorphisms in HSD11B2, the
      gene encoding the kidney isozyme of 11beta-hydroxysteroid dehydrogenase.
AB  - Mutations in the HSD11B2 gene encoding the kidney (11-HSD2) isozyme of 11beta
      hydroxysteroid dehydrogenase cause the syndrome of apparent mineralocorticoid
      excess, a form of salt-sensitive hypertension. Enzymatic activities of mutant
      enzymes measured in cultured cells are correlated with several parameters of
      clinical severity including urinary steroid product:precursor ratios, age at
      diagnosis, birth weight and potassium levels, but not with blood pressure. In
      normals or in subjects with essential hypertension, sensitivity of blood pressure
      to salt loading is correlated with activity of renal 11-HSD2, as measured by an
      increase in the ratio of urinary free cortisol/urinary free cortisone (UFF/UFE),
      and also correlated with length of a CA repeat polymorphism in the first intron
      of HSD11B2. A functional explanation for these associations remains to be
      elucidated.

PMID- 11196454
TI  - New molecular genetic defects causing 11beta-hydroxylase deficiency (CAH).

PMID- 11196455
TI  - Cortisol producing adrenal adenoma--a new manifestation of Gardner's syndrome.
AB  - INTRODUCTION: Familial adenomatous polyposis (FAP) is an autosomal dominant
      disorder which typically presents with colorectal cancer in early adult life
      secondary to extensive adenomatous polyps of the colon. Gardner's syndrome is a
      variant of FAP in which desmoid tumors, osteomas and pigmented retinal lesions
      occur together with intestinal manifestations. The APC gene (adenomatous
      polyposis coli) at 5q21 is a tumor suppressor gene which is mutant in FAP.
      PATIENT: A 36 year old woman presented with a history of polyposis ventriculi,
      ovarian desmoid cysts, and disseminated desmoid tumors. Her familial history was
      unremarkable. On admission she complained weight gain, secondary amenorrhea, and
      episodes of hypertension followed by paroxysmal headache. RESULTS: Elevated
      urinary free cortisol (878 microg/24h), suppressed basal ACTH (< 5 pg/ml) and
      insuppressible serum cortisol after low dose dexamethasone (189 ng/ml) revealed
      adrenal Cushing's syndrome. Abdominal NMR showed an adrenal mass two centimeter
      in diameter with inhomogeneous contrast enhancement. Unilateral adrenalectomy was
      performed and an adrenal adenoma was diagnosed by histological criteria. For
      mutational detection DNA from peripheral blood leucocytes was extracted. A
      protein truncation test was performed, which revealed a termination mutation
      between codon 1099 and 1623 of the APC gene. Direct sequencing showed a point
      mutation in exon 15 of the APC gene at position 1542 (CAG --> TAG). This region
      is known to be altered in patients with extraintestinal manifestation of FAP.
      CONCLUSION: In patients with Gardner's syndrome adrenal tumors leading to
      hormonal excess should be considered. Whether mutations in the APC gene have
      implications in sporadic adrenal tumorigenesis needs to be proven.

PMID- 11196456
TI  - Risk factors associated with persistent postoperative hypertension in Cushing's
      syndrome.
AB  - The aim of the present study was to assess the long-term results of adrenalectomy
      and to evaluate potential risk factors for the persistence or recurrence of
      hypertension. Forty-five patients with Cushing's syndrome caused by benign
      cortisol-producing adrenocortical adenomas were evaluated before and for a period
      of 1 year after surgical cure. When the patients were classified into two groups
      according to whether their preoperative BP was more (HBP group) or less (NBP
      group) than 140/90 mmHg, the BP level was found to be continuously higher in the
      HBP group than in the NBP group during the year after surgery. This finding
      suggests that the preoperative BP level in Cushing's syndrome may be a
      determinant factor for persistent hypertension after surgery (P<0.05). In
      addition, a correlation was found between postoperative BP level and duration of
      hypertension (P<0.05), but no relationships were found between postoperative BP
      levels and other factors, including age, BMI, tumor size, serum cortisol,
      aldosterone, potassium, total cholesterol, or glucose levels. The above findings
      indicate that intensive control of preoperative BP to maintain it below 140/90
      mmHg with antihypertensive medication is a very important means of improving
      prognosis for postoperative BP. Immediate diagnosis and surgical treatment to
      reduce the duration of hypertension are also crucial for the long-term BP
      prognosis.

PMID- 11196457
TI  - Two novel mutations in splice donor sites of CYP11B1 in congenital adrenal
      hyperplasia due to 11beta-hydroxylase deficiency.
AB  - We present an in vivo and in vitro study of congenital adrenal hyperplasia in a
      patient with 11beta-hydroxylase deficiency. Genetic analysis showed two new base
      substitutions of CYP11B1, a conservative transition at the last base of exon 5,
      and a IVS8+4A-->G transition in intron 8. Difficulties with suppressive therapy
      resulted in severe hypertension. A laparoscopic adrenalectomy was decided which
      lead to normalization of blood pressure. In vitro, steroidogenesis by adrenal
      cells showed no measurable 11beta-hydroxylase activity. Analysis of CYP11B1 mRNA
      by RT-PCR and sequencing showed expression of a mRNA which lacked exon 8,
      presumably resulting from the intron 8 mutation. In addition a highly truncated
      mRNA was detected corresponding to exons 1, 2, 8, 9, with the loss of exons 3-7,
      presumably related to the exon 5 mutation. Western blot analysis showed a shorter
      CYP11B immunoreactive band of 43 kDa, consistent with truncation of exon 8. Thus
      adrenalectomy in this patient allowed effective treatment of severe hypertension
      and helped to understand the mechanisms of two novel mutations responsible for
      aberrant splicing of CYP11B1.

PMID- 11196458
TI  - The application of high density microarray for analysis of mitogenic signaling
      and cell-cycle in the adrenal.
AB  - Angiotensin II (AII) binds to specific G-protein coupled receptors and is
      mitogenic in adrenal, liver epithelial, and vascular smooth muscle cells. The
      H295R human adrenocortical cell line, which expresses AII receptors predominantly
      of the AT1 subclass, proliferates in response to treatment with AII. The
      induction and maintenance of cellular proliferation involves a precisely
      coordinated induction of a variety of genes. As the human genome sequencing
      projects near completion a variety of high throughput technologies have been
      developed in order to create dynamic displays of genomic responses. One high
      throughput method, the gridded cDNA microarray has been developed in which
      immobilised DNA samples are hybridized on glass slides for the identification of
      global genomic responses. For this purpose high precision robotic microarrayers
      have been developed at AECOM. The cyclin D1 gene, which encodes the regulatory
      subunit of the cyclin D1-dependent kinase (CD1K) required for phosphorylation of
      the retinoblastoma protein (pRB), was induced by AII in H295R cells. Abundance of
      the cyclin D1 gene is rate-limiting in G1 phase progression of the cell-cycle in
      a variety of cell types. AII induced cyclin D1 promoter activity through a c-Fos
      and c-Jun binding sequence at -954 bp. Theabundance of c-Fos within this complex
      was increased by AII treatment. Analysis of AII signaling in adrenal cells by
      cDNA microarray demonstrated an induction of the human homologue of Xenopus XPMC2
      (HXPMC2). The cDNA for XPMC2 was previously shown to rescue mitotic catastrophe
      in mutant S. Pombe defective in cdc2 kinase function. Further studies are
      required to determine the requirement for cyclin D1 and XPMC2H in AII-induced
      cell-cycle progression and cellular proliferation in the adrenal.

PMID- 11196459
TI  - Signal transduction in G0/G1-arrested mouse Y1 adrenocortical cells stimulated by
      ACTH and FGF2.
AB  - In G0/G1 cell cycle arrested mouse Y1 adrenocortical tumor cells ACTH39, a weak
      mitogen and strong anti-mitogenic agent, blocks FGF2 mitogenic activity at G1
      phase, keeping untouched ERK-MAPK activation and c-Fos protein induction. Here we
      report two anti-mitogenic mechanisms initiated in ACTH receptors and mediated by
      cAMP/PKA: a) post-transcriptional down regulation of c-Myc protein; b)
      dephosphorylation of AKT/PKB. In Y-1 cells the activity of the Mad/Max/Myc
      network of transcription factors seems to be regulated by c-Myc levels. FGF2
      induces c-myc gene and stabilizes c-Myc protein by a process dependent on ERK
      MAPK (PD98059 sensitive), but not on PI3K (Wortmannin resistant). ACTH39, on the
      other hand, causes rapid decrease in c-Myc levels induced by FGF2 in wild type Y1
      cells, but not in PKA-deficient Y1 clones. The ACTH inhibition of DNA synthesis
      stimulated by FGF2 is reversed by transient transfection and induction of the
      MycER chimera (fusion of c-Myc and estrogen-receptor), suggesting that c-Myc down
      regulation is an efficient anti-mitogenic mechanism activated by ACTH. Y1 cells
      display high constitutive levels of AKT/PKB, that is dependent on elevated Ras x
      GTP. FGF2 up regulates Ras x GTP, PI3K and AKT/PKB. ACTH antagonizes this
      mitogenic effect of FGF2, promoting rapid dephosphorylation of AKT/PKB.

PMID- 11196460
TI  - Neurotransmitters and neuropeptides in the differential regulation of
      steroidogenesis in adrenocortical-chromaffin co-cultures.
AB  - Adrenocortical steroidogenesis is regulated in addition to a central regulation
      via the hypothalamus-pituitary-adrenal axis by intra-adrenal mechanisms involving
      the adrenal medulla. We could previously show that adrenocortical steroidogenesis
      is stimulated by co-culturing bovine adrenocortical cells with medullary
      chromaffin cells. This stimulation was due to soluble factors released from the
      chromaffin cells under basal, unstimulated conditions and involved the increased
      expression of P450 enzymes, StAR and de novo protein synthesis. In the present
      study we analyzed the differential regulation of the three cortical zones and
      characterized secretagogues involved in this stimulation. While cortisol and
      androstenedione release were increased 10 fold by incubation with chromaffin cell
      conditioned medium, aldosterone secretion was not influenced. 80% of the
      stimulation proved to be due to adrenomedullary epinephrine, norepinephrine,
      ACTH, PACAP and PG-dependent mechanisms. Other adrenomedullary secretory
      products, serotonin, Met-enkephalin, Leu-enkephalin, galanin, CGRP, substance P,
      VIP or NPY did not stimulate steroidogenesis in this system. Our data show that
      adrenomedullary cells differentially regulate the three adrenocortical zones.
      This stimulation predominantly depended on epinephrine, norepinephrine, PACAP,
      and ACTH released from the chromaffin cells and prostaglandin-dependent
      mechanisms such as interleukin-1.

PMID- 11196461
TI  - Paracrine control of the adult adrenal cortex vasculature by vascular endothelial
      growth factor.
AB  - The extensive vascular network that irrigates the adult adrenal cortex is
      essential for both the delivery of oxygen and nutrients to glandular
      steroidogenic cells and for the rapid and efficient export of corticosteroid
      products from these cells into the blood flow. During experimental and
      pathological changes in adrenal cortex size caused by ACTH overproduction or
      deficiency, the vasculature evolves in a coordinated manner with the mass of
      glandular cells so that blood vessel formation/regression and cortical
      gowth/atrophy are respectively synchronized. In addition to its previously
      reported expression in human fetal adrenocortical cells, the angiogenic factor
      VEGF-A appears also to be strongly expressed by both glomerulosa and fasciculata
      cells of the adult bovine adrenal cortex, when the endothelium is quiescent.
      Moreover, the expression of the two major transcripts encoding the 121 and the
      165 amino acid-long isoforms of VEGF-A was observed to be rapidly (within 2-4 h)
      up-regulated (2-3 fold) by ACTH in primary cultures of bovine fasciculata and
      glomerulosa cells. The expression of the signalling VEGF receptors R1 (flt-1) and
      R2 (flk-1) was restricted to the endothelial cells of the cortex whereas
      neuropilin-1 was expressed by both endothelial and steroidogenic cells. This
      suggests that, under the control of the pituitary hormone ACTH, VEGF exerts a
      paracrine control over the vasculature of the adult adrenal cortex. Given its
      known effects as an anti-apoptotic agent and an inducer of endothelial
      fenestration, VEGF is likely to play a role in the maintenance of the dense and
      fenestrated vascular bed of the adrenal cortex. The vasculature thus appears as
      an important secondary target of ACTH action in the physiological control of
      adrenal cortex homeostasis.

PMID- 11196462
TI  - Expression and regulation of BCL-2 family genes in human adrenocortical adenomas
      in comparison with adrenal hyperplasia of Cushing's disease.
AB  - The significance of increases in the expression of apoptosis-suppressing genes
      such as bcl-2 and mcl-1/EAT in human adrenal tumors has not yet been fully
      elucidated. Furthermore the roles of these genes in cell proliferation may
      involve interaction with steroidogenesis in the tumors via intracellular second
      messengers. Cyclic AMP (cAMP) caused human adrenocortical H295R cells to
      overexpress hCYP17 resulting in hypersecretion of cortisol. At the same time,
      however, expression of bcl-2, which has a cAMP response element (CRE), was not
      affected. Furthermore, in vivo Bcl-2 protein analysis showed its down-regulation
      in adrenal hyperplasia of Cushing's disease despite ACTH stimulation. Exogenous
      addition of glucocorticoid did not affect the expression of bcl-2 family genes.
      Expressions of Mcl-1/EAT and Bax did not differ markedly among human adrenal
      glands affected by various pathologies. In conclusion the down-regulation of Bcl
      2 in Cushing's disease did not agree with no induction of this gene by cAMP in
      H295R cells, suggesting that expression of Bcl-2 protein was not regulated mainly
      by cAMP-protein kinase (PKA) pathways in human adrenal hyperplasia.

PMID- 11196463
TI  - p53 and Ki67 in adrenocortical tumors.
AB  - The p53 tumor-supressor gene has been reported as the most frequent genetic
      abnormality seen in human malignancies. Here we studied immunohistochemically the
      expression of p53 in a large series of adrenocortical tumors. The proliferative
      activity was assessed by the expression of Ki67. Tumor material consisted of 60
      adrenocortical adenomas and 27 adrenocortical carcinomas. A tumor was scored as
      positive for p53 if more than 10% of the cells showed nuclear staining. All
      adrenocortical adenomas were negative for p53 and the percentage of Ki67 positive
      cells was mostly 1-2% but never exceeded 5%. Hormonal activity did not reflect
      the proliferation index. Adrenocortical carcinomas, however, behaved differently
      depending on hormonal activity. 10/13 of non-functional , 0/3 Conn's, 3/7
      Cushing's and 3/4 virilizing carcinomas were positive for p53. The proliferative
      activity was also higher in non-fuctional carcinomas compared with hormonally
      active tumors. Our data show that majority of adrenocortical carcinomas are
      positive for p53, whereas all adenomas are negative. Hormonal activity of
      carcinomas reflects both p53 status and proliferation index. Thus,
      immunohistochemical levels of p53 and Ki67 are higher in hormonally inactive
      adrenocortical carcinomas.

PMID- 11196464
TI  - Expression of vascular endothelial growth factor in human adrenals.
AB  - Angiogenesis is an important component in many biological processes and also in
      pathologic conditions including neoplastic diseases. Vascular endothelial growth
      factor (VEGF) is a secreted endothelial cell-specific growth factor, which is
      induced by tissue hypoxia and is angiogenic in vivo. Adrenal gland is a well
      vascularized organ, and the roles of VEGF in normal adrenal and in adrenal
      tumorigenesis is not well characterized. We therefore investigated VEGF mRNA
      expression in normal human adrenals and in cultured adrenocortical cells. VEGF
      mRNA was constantly expressed in normal adrenals as well as in cultured
      adrenocortical cells. The mRNA levels were increased after 24h stimulation with
      either ACTH or cAMP. The effect of cAMP was dose-dependent. This suggests that
      ACTH-induced VEGF mRNA expression is mediated via protein kinase A dependent
      pathway.

PMID- 11196465
TI  - Role of ERK/MAP kinase in mitogenic interaction between ACTH and FGF2 in mouse Y1
      adrenocortical tumor cells.
AB  - In G0/G1 cell cycle-arrested Y1 adrenocortical cells FGF2 is a strong mitogen,
      whereas ACTH39 can be a weak mitogen or a strong anti-mitogenic agent.
      Phosphorylated ERK1/2-MAP kinases are undetectable by Western and
      immunocitochemistry assay in G0/G1-arrested Y1 adrenal cells. Cell entry into S
      phase linearly correlates with migration of phosphorylated ERK to nucleus. FGF2
      rapid and strongly triggers transient phosphorylation of ERK1/2, whereas ACTH39
      is a poor ERK1/2 activator. But, the MEK1 inhibitor, PD98059 (50microM), inhibits
      cFos and cyclin D1 induction and DNA synthesis stimulation by both ACTH39 and
      FGF2, suggesting that ERK1/2 activation mediates the strong and the weak
      mitogenic effect of, respectively, FGF2 and ACTH39. In addition, ACTH39
      antagonizes the FGF2 mitogenic effect keeping untouched ERK1/2 activation, c-Fos
      and cyclin D1 induction.

PMID- 11196466
TI  - Regulation of MAPK activity in response to dietary sodium in the rat adrenal
      gland.
AB  - Stimulation of aldosterone biosynthesis by angiotensin II (AII) is thought to be
      mediated via the PLC, IP3 and intracellular calcium signalling pathway. MAPK
      (p42/p44) is involved in cell proliferation, and is also activated by AII, but
      its role in the adrenal response to dietary sodium is unclear. To study the
      relationship between AII receptor (ATR), MAPK and PKC isoforms, PKCalpha and
      PKCepsilon, mature Wistar rats were maintained on low or high sodium diets for 1
      week. In adrenals from animals on a sodium deplete diet, total ligand binding to
      both ATR subtypes decreased in the zona glomerulosa (ZG). Under these conditions,
      active MAPK in the ZG decreased paralleling a decrease in active PKCalpha. In the
      inner zones (IZ), largely reflecting medullary events, low sodium did not affect
      MAPK activity. However active PKCalpha decreased. In adrenals from sodium-loaded
      animals, type 2 ATR (AT2R) binding was reduced in the ZG, while type 1 ATR (AT1R)
      increased in the IZ. Active MAPK increased in ZG, as did active PKCalpha and
      PKCepsilon. In IZ, ERK, PKCalpha and PKCepsilon were unchanged. These results
      suggest that in the ZG and IZ, two different modes of MAPK regulation may exist,
      utilising different PKC isoforms.

PMID- 11196467
TI  - Adrenal tumorigenesis targeted by the corticotropin-regulated promoter of the
      aldo-keto reductase AKR1B7 gene in transgenic mice.
AB  - Studies of ACTH functions in adrenal steroidogenesis have been facilitated by the
      availability of immortalized mouse adrenocortical Y1 cells. In order to obtain
      alternative cell lines with a more differentiated zona fasciculata (ZF) phenotype
      we used targeted tumorigenesis strategy. We have generated transgenic mice
      expressing the SV40 T antigen under the control of the ACTH-dependent promoter
      for the AKR1B7/MVDP gene (aldo-keto reductase 1B7/mouse vas deferens protein),
      which encodes an enzyme responsible for detoxifying isocaproaldehyde, the product
      of side-chain cleavage of cholesterol generated by steroidogenesis. Our previous
      data indicated that in the mouse adrenal, AKR1B7 expression was restricted to the
      ZF and that a 0.5-kb promoter region was able to target specific adrenal
      expression in transgenic mice. In situ hybridization analyses indicate that
      AKR1B7 expression during fetal and post-natal periods paralleled the onset of
      glucocorticoid synthesis and the development of ZF. In transgenic mice, ACTH
      control and developmental programming of the CAT gene driven by the 0.5-kb
      promoter followed endogenous gene regulation. Then transgenic mice harboring the
      0.5-kb/SV40 T antigen construct were generated and two founders out of three
      developed adrenal tumors. Cells derived from the tumor of founder 1 (ATC1) were
      grown in presence of forskolin to maintain ACTH receptor expression and were
      tested for ACTH responsiveness by immunocychemistry and northern blot analyses.
      Even after several passages, the ACTH induced AKR1B7 and P450c11beta mRNAs
      accumulations were similar to that observed in mouse primary adrenocortical cell
      cultures. Our findings suggest that ATC1 cells have conserved essential features
      of ZF cells. In order to achieve complete characterization of these cells further
      analyses are currently performed to investigate their steroidogenic activity.

PMID- 11196468
TI  - Daily regeneration of rat adrenocortical cells: circadian and zonal variations in
      cytogenesis.
AB  - Daily regeneration of rat adrenocortical cells were investigated in terms of
      circadian and zonal variations by following the cells at the DNA-synthesizing
      stage. An S-phase was assessed by 5-bromo-2'-deoxyuridine (BrdU) incorporation
      into the cell-nuclei and/or by visualizing proliferating cell nuclear antigen.
      The BrdU-positive cells were observed throughout the day mainly in two regions of
      the adrenal cortex, i.e. the innermost portion of the zona glomerulosa and the
      outermost portion of the zona fasciculata. Cells only in a latter region showed a
      distinct circadian rhythm of cell proliferation with a peak at 3-4 a.m. A
      remarkable rise in the plasma adrenocorticotropin (ACTH) concentration preceded
      such an increase in the cell proliferation by about 4 hours. This phenomenon
      could be mimicked by raising the plasma ACTH concentration by the administration
      of Cortrosyn Z or metyrapone. Angiotensin II-stimuli induced by Na-deficiency
      increased the proliferation of zona glomerulosa cells in the former region at 6
      7p.m without significant effects on that of the zona fasciculata cells in the
      latter region. Thus at least two sites, which respond differentially to the
      day/night cycle and circulating hormone levels, exist in rat adrenal cortex being
      responsible for the cytogenesis in this endocrine organ.

PMID- 11196469
TI  - Transforming growth factor beta1: implications in adrenocortical tumorigenesis.
AB  - TGFbeta1, a multifunctional growth modulator, inhibits the proliferation of
      epithelial cells. TGFbeta1 signaling is dependent on the heterodimerization of
      the TGFbeta1 receptor II (TGFbeta1RII) with the TGFbeta1 receptor I (TGFbeta1RI).
      The cytoplasmic proteins Smads are the mediators of the TGFbeta1 signal. TGFbeta1
      regulates adult and fetal adrenal growth and function. Previously we have shown
      by Northern analysis that TGFbeta1mRNA was well expressed in normal adrenal and
      in adrenocortical adenomas but reduced in carcinomas. To investigate whether
      TGFbeta1 receptors may act as tumor suppressors of adrenal tumorigenesis, 16
      adenomas and 12 carcinomas were studied. We have used SSCP analysis to scan for
      inactivating mutations in carcinomas. All tumor samples were negative for somatic
      alterations of both genes. A competitive RT-PCR system was developed to compare
      the levels of expression of TGFbeta1, TGFbeta1R-I and TGFbeta1R-II, Smad-2 and
      Smad-4 genes in all tumors. In our study, we confirmed the presence of reduced
      levels of TGFbeta1 in carcinomas. On the contrary, Smad-4 gene levels were
      elevated in carcinomas when compared to that of adenomas. No significant
      differences were observed in gene expression of TGFbeta1RI and Smad-2. Our
      results suggest that mutations of TGFbeta1 receptors appear not to be involved in
      adrenal tumorigenesis. Adrenal carcinomas showed a significant reduction of the
      TGFbeta1 mRNA levels but on the contrary Smad 4 mRNA levels were significantly
      increased.

PMID- 11196470
TI  - ACTH inhibits A Ras-dependent anti-apoptotic and mitogenic pathway in mouse Y1
      adrenocortical cells.
AB  - Mouse Y1 adrenocortical tumor cells harbor amplified and overexpressed c-Ki-ras
      gene, displaying relatively high constitutive levels of Ras x GTP. Here we report
      that Y1 cells also constitutively display high levels of phosphorylated AKT/PKB,
      that are dependent on Ras x GTP and PI3K. ACTH rapidly causes dephosphorylation
      of AKT/PKB in a cAMP/PKA dependent maner. This ACTH inhibition of the anti
      apoptic and mitogenic AKT/PKB pathway is likely to be relevant in ACTH growth
      inhibitory effects in Y-adrenocortical cells.

PMID- 11196471
TI  - Mechanisms of epigenetic silencing of the c21 gene in Y1 adrenocortical tumor
      cells.
AB  - We utilized Y1 adrenocortical carcinoma cell line as a model system to dissect
      the events regulating epigenomic gene silencing in tumor cells. We show here that
      the chromatin structure of c21 gene is inactive in Y1 cells and that it could be
      reconfigured to an active form by either expressing antisense mRNA to DNA
      methyltransferase 1 (dnmt1) or an attenuator of Ras protooncogenic signaling
      hGAP. Surprisingly however, the known inducer of active chromatin structure the
      histone deacetylase inhibitor trichostatin A TSA fails to induce expression of
      c21. These results suggest that the primary cause of c21 gene silencing is
      independent of histone deacetylation. We present a model to explain the possible
      roles of the different components of the epigenome and the DNA methylation and
      demethylation machineries in silencing c21 gene expression.

PMID- 11196472
TI  - Transplantation of normal and genetically modified adrenocortical cells.
AB  - Cell transplantation techniques have been applied to the study of the biology of
      the adrenal cortex and to adrenocortical cell proliferation, differentiation, and
      senescence. Primary bovine adrenocortical cells, primary human adrenocortical
      cells and genetically modified bovine adrenocortical cells have been
      transplanted. Successful methods include transplantation of cells beneath the
      kidney capsule and several subcutaneous cell transplantation procedures. In
      successful transplants the cells form a functional vascularized tissue structure
      that allows the host animals to survive adrenalectomy. We show here that
      subcutaneous cell transplantation does not depend on embedding cells in collagen
      gel before introduction into the host animal. Subcutaneous transplants secrete
      both cortisol and aldosterone. However, the variability of plasma aldosterone
      levels indicates that the factors that determine glomerulosa-type and fasciculata
      type cell function in transplant tissues are not well understood.

PMID- 11196474
TI  - Adrenocortical and gonadal differentiation regulated by transcription factors,
      Ad4BP/SF-1 (NR5A1) and Dax-I (NROB1).

PMID- 11196473
TI  - Regulation of human CYP11B2 and CYP11B1: comparing the role of the common CRE/Ad1
      element.
AB  - In humans, the final steps in corticosteroid production results from the activity
      of aldosterone synthase in the glomerulosa and 11beta-hydroxylase in the
      fasciculata. The regional expression of these isozymes is believed to result from
      transcriptional regulation of the aldosterone synthase (CYP11B2) and 11beta
      hydroxylase (CYP11B1) genes. Previous studies suggest that the primary cis
      element needed for agonist enhanced transcription of the CYP11B genes shares high
      sequence similarity to a consensus cAMP Response Element (CRE). Here the role of
      the CRE/Adl was studied. Reporter constructs prepared with the 5'flanking DNA of
      hCYP11B2 and hCYP11B1 were transfected into NCI-H295R (H295R) adrenocortical
      tumor cells. Both hCYP11B2 and hCYP11B1 driven reporter constructs responded in a
      similar manner to treatment with angiotensin II, potassium, dbcAMP, or forskolin.
      Mutation of the hCYP11B1 CRE/Adl element decreased basal reporter expression and
      decreased response to agonist. Mutation of the hCYP11B2 CRE/Adl element caused a
      loss of basal expression but retained response to agonist suggesting a role for
      other cis-elements in hormonal regulation of hCYP11B2. In addition, both cis
      elements were able to form complexes with in vitro prepared CRE binding (CREB)
      protein, activating transcription factor (ATF)-1 and ATF-2 in mobility shift
      assays. However, only the ATF-2 complex migrated similarly to a complex seen
      using H295R nuclear extract. Taken together these data suggest that the CRE/Adl
      element plays an important role in the transcriptional regulation of both hCYP11B
      genes but does not play an important role in the regional distribution of the two
      isozymes within the adrenal.

PMID- 11196475
TI  - The AT2 receptor of angiotensin II and apoptosis in human fetal adrenal gland.

PMID- 11196476
TI  - Adrenocortical expression of MnSOD.
AB  - The mitochondrial matrix antioxidant manganese superoxide dismutase (MnSOD) is
      part of a cascade of components that protects the cell from cytotoxic reactive
      oxygen species (ROS) and previous investigations have predominately concentrated
      on this role. However, recent studies on the roles of redox state and ROS suggest
      that they may have a role in cellular regulation. Using a cDNA clone we
      generated, northern blot analysis localised the expression of MnSOD predominantly
      to the zona fasciculata and reticularis (zfr) in rat adrenals. To test whether
      this correlated with MnSOD activity, assays were conducted on adrenal tissue from
      rats maintained on a low sodium diet or betamethasone treated and compared with
      that of untreated controls. MnSOD activity was enhanced in zfr adrenal
      mitochondria from rats that were ACTH treated or on a low sodium diet.
      Betamethasone had no effect, and cytosolic/membrane SOD activities were unchanged
      by all of the treatments. The identification of MnSOD as a hormone inducible
      component in the adrenal cortex is consistent with the concept that the redox
      state and/or ROS are involved in the specific regulation of zfr function.

PMID- 11196477
TI  - Captopril effects on the rat adrenal cortex.

PMID- 11196478
TI  - Zonal differentiation in the rat adrenal cortex.
AB  - The factors that establish and maintain adrenocortical zonation are poorly
      understood. The capsular adrenal gland of the rat has been shown to develop into
      a functionally zoned tissue in autotransplanted glands in vivo. To examine this
      in vitro, capsular gland preparations (largely glomerulosa (zg) with some
      fasciculata (zf) were cultured in vitro in Eagles MEM (3.6mM K+) for 14 days.
      Zonal differentiation was determined by immunocytochemical localisation of inner
      zone antigen (IZA, zf/reticularis specific) and Pref-1 (zg specific). In the
      absence of further additions these preparations invariably maintained a good
      zonal arrangement of zg and zf over the whole period, though without significant
      cellular proliferation. Neither the daily addition of the stimulants, maximally
      8.3mM potassium, 1nM ACTH, or 100nM angiotensin II (AII), or the AII type 1
      receptor antagonist losartan (10microM) had any significant effect on the glands
      intrinsic capacity to maintain zonation in vitro. Aldosterone output declined
      rapidly under control conditions (3.6mM K+), but was stimulated by AII, or high
      K+ reaching a maximum after 7 days, and thereafter declined. However at higher K+
      conditions (5.6mM) aldosterone was not supported by angiotensin II.
      Corticosterone secretion increased autonomously after 2 days in 3.6mM K+ then
      declined. At higher K+ conditions corticosterone rapidly declined. The factors
      studied had no effect on the inherent property of the adrenal gland to express
      the zg or zf phenotype. However the functional steroidogenic capacity of the
      adrenocortical cells was affected in a highly specific and complex manner by the
      added stimulants.

PMID- 11196479
TI  - Neural modulation of regenerating adrenal transplants.

PMID- 11196480
TI  - Role of phosphorylation, gene dosage and Dax-1 in SF-1 mediated steroidogenesis.
AB  - The mechanisms by which SF-1 (Steroidogenic Factor-1) and Dax-1 (Dosage-sensitive
      sex reversal-Adrenal hypoplasia congenita critical region on the X chromosome)
      dictate adrenal-specific transcriptional programs are the focus of this
      laboratory. SF-1-mediated transcription is upregulated by phosphorylation of
      serine 203 located in the hinge region of SF-1. An SF-1S203A mutant attenuates SF
      1 activation, while substitution of S203 with a charged aspartate (SF-1S203D)
      results in a dose dependent increase in SF-1 mediated transcription. Ser203
      serves as a substrate for Erk2 in vitro and is critical for activation of SF-1 by
      multiple components of the MAPK pathway. Isoelectric focusing demonstrates
      multiple immuno-reactive SF-1 species in mouse adrenal and NCI-H295A cell
      extracts. We propose that differential phosphorylation of SF-1 by various
      mitogens serves to couple extracellular signals to adrenal-specific
      transcriptional programs. Mouse studies utilizing SF-1 heterozygous mice explore
      the in vivo role of SF-1 levels, SF-1 phosphorylation and SF-1 interaction with
      Dax-1 in adrenal steroidogenesis. SF-1 heterozygous mice exhibit a marked
      decrease in baseline and post-stress corticosterone with a concomitant increase
      in ACTH. The role of Dax-1 in these SF-1 dependent processes is explored in
      compound SF-1 (+/-)/Dax-1 KO mice that exhibit an increase in basal
      corticosterone and a decrease in basal ACTH compared to simple SF-1 (+/-) mice.
      These finding are consistent with an inhibitory role for Dax-1 in SF-1 mediated
      transcription. Mice that express epitope tagged SF-1 (wild type, SF-1S203A and SF
      1S203D) are being used to rescue the heterozygous adrenal phenotype and to
      determine the in vivo role of SF-1 phosphorylation in adrenal function.

PMID- 11196481
TI  - SIK (Salt-inducible kinase): regulation of ACTH-mediated steroidogenic gene
      expression and nuclear/cytosol redistribution.
AB  - Possible involvement of salt-inducible kinase (SIK), a serine/threonine protein
      kinase first cloned from high K+-diet treated rat adrenal glands, in the
      regulation of steroidogenesis was investigated. Y-1 cells, when treated with
      ACTH, underwent a rapid change in SIK's mRNA content. It reached the maximum
      within a few hours and returned to the base after 8 h. In contrast, the levels of
      mRNAs for CYP11A and StAR protein reached the maxima after 8 h. The SIK's mRNA
      induction failed to occur in ACTH-, forskolin- or 8-Br-cAMP-treated Kin-7 cells,
      a mutant cell line of Y-1 with defective cAMP-dependent protein kinase A (PKA). Y
      1 cells that overexpress SIK, when treated with ACTH, had significantly repressed
      levels of mRNAs for CYP11A and StAR protein. Therefore, SIK might have a negative
      effect on the CYP11A- and StAR protein-gene expression in the early phase of ACTH
      mediated steroidogenesis. To further explore the mechanisms underlying this
      phenomenon, we examined intracellular distribution of the green fluorescence
      protein (GFP)-tagged SIK. When GFP-SIK was introduced into HeLa cells, the
      fluorescent signals were detected in the nucleus. In Y-1 cells GFP-SIK was
      detected both in the nucleus and cytosol, and the signal in the former moved to
      the latter after ACTH-treatment. The nuclear/cytosol re-distribution of GFP-SIK
      was also observed in forskolin- or 8-Br-cAMP-treated Y-1 cells, but not in Kin-7
      cells. These results suggest that the intracellular re-distribution of SIK in Y-1
      cells may depend on the cAMP/PKA signaling pathway and has an important
      regulatory role in the ACTH-mediated steroidogenic gene expression.

PMID- 11196482
TI  - Farewell to polio in the Western Pacific.

PMID- 11196483
TI  - The challenges of doing more against malaria, particularly in Africa.

PMID- 11196484
TI  - Roll back malaria--what are the prospects?

PMID- 11196485
TI  - Combination therapy for malaria in Africa: hype or hope?
AB  - The development of resistance to drugs poses one of the greatest threats to
      malaria control. In Africa, the efficacy of readily affordable antimalarial drugs
      is declining rapidly, while highly efficacious drugs tend to be too expensive.
      Cost-effective strategies are needed to extend the useful life spans of
      antimalarial drugs. Observations in South-East Asia on combination therapy with
      artemisinin derivatives and mefloquine indicate that the development of
      resistance to both components is slowed down. This suggests the possibility of a
      solution to the problem of drug resistance in Africa, where, however, there are
      major obstacles in the way of deploying combination therapy effectively. The
      rates of transmission are relatively high, a large proportion of asymptomatic
      infection occurs in semi-immune persons, the use of drugs is frequently
      inappropriate and ill-informed, there is a general lack of laboratory diagnoses,
      and public health systems in sub-Saharan Africa are generally weak. Furthermore,
      the cost of combination therapy is comparatively high. We review combination
      therapy as used in South-East Asia and outline the problems that have to be
      overcome in order to adopt it successfully in sub-Saharan Africa.

PMID- 11196486
TI  - Comparison of house spraying and insecticide-treated nets for malaria control.
AB  - The efficacies of using residual house spraying and insecticide-treated nets
      against malaria vectors are compared, using data from six recent comparisons in
      Africa, Asia and Melanesia. By all the entomological and malariological criteria
      recorded, pyrethroid-treated nets were at least as efficacious as house spraying
      with dichlorodiphenyltrichloroethane (DDT), malathion or a pyrethroid. However,
      when data from carefully monitored house spraying projects carried out between
      the 1950s and 1970s at Pare-Taveta and Zanzibar (United Republic of Tanzania),
      Kisumu (Kenya) and Garki (Nigeria) are compared with recent insecticide-treated
      net trials with apparently similar vector populations, the results with the
      insecticide-treated nets were much less impressive. Possible explanations include
      the longer duration of most of the earlier spraying projects and the use of non
      irritant insecticides. Non-irritant insecticides may yield higher mosquito
      mortalities than pyrethroids, which tend to make insects leave the site of
      treatment (i.e. are excito-repellent). Comparative tests with non-irritant
      insecticides, including their use on nets, are advocated. The relative costs and
      sustainability of spraying and of insecticide-treated net operations are briefly
      reviewed for villages in endemic and epidemic situations and in camps for
      displaced populations. The importance of high population coverage is emphasized,
      and the advantages of providing treatment free of charge, rather than charging
      individuals, are pointed out.

PMID- 11196487
TI  - Spatial targeting of interventions against malaria.
AB  - Malaria transmission is strongly associated with location. This association has
      two main features. First, the disease is focused around specific mosquito
      breeding sites and can normally be transmitted only within certain distances from
      them: in Africa these are typically between a few hundred metres and a kilometre
      and rarely exceed 2-3 kilometres. Second, there is a marked clustering of persons
      with malaria parasites and clinical symptoms at particular sites, usually
      households. In localities of low endemicity the level of malaria risk or case
      incidence may vary widely between households because the specific characteristics
      of houses and their locations affect contact between humans and vectors. Where
      endemicity is high, differences in human/vector contact rates between different
      households may have less effect on malaria case incidences. This is because
      superinfection and exposure-acquired immunity blur the proportional relationship
      between inoculation rates and case incidences. Accurate information on the
      distribution of malaria on the ground permits interventions to be targeted
      towards the foci of transmission and the locations and households of high malaria
      risk within them. Such targeting greatly increases the effectiveness of control
      measures. On the other hand, the inadvertent exclusion of these locations causes
      potentially effective control measures to fail. The computerized mapping and
      management of location data in geographical information systems should greatly
      assist the targeting of interventions against malaria at the focal and household
      levels, leading to improved effectiveness and cost-effectiveness of control.

PMID- 11196488
TI  - Molecular entomology and prospects for malaria control.
AB  - During the past decade, the techniques of molecular and cell biology have been
      embraced by many scientists doing research on anopheline vectors of malaria
      parasites. Some of the most important research advances in molecular entomology
      have concerned the development of sophisticated molecular tools for procedures
      such as genetic and physical mapping and germ line transformation. Major advances
      have also been made in the study of specific biological processes such as insect
      defence against pathogens and the manner in which malaria parasites and their
      anopheline hosts interact during sporogony. One of the most important highlights
      of this research trend has been the emergence during the past year of a formal
      international Anopheles gambiae genome project, which at present includes
      investigators in several laboratories in Europe and the USA. Although much of
      this molecular research is directed towards the development of malaria control
      strategies that are probably many years from implementation, there are some
      important areas of molecular entomology that may have a more near-term impact on
      malaria control. We highlight developments over the past decade in three such
      areas that we believe can make important contributions to the development of near
      term malaria control strategies. These areas are anopheline species
      identification, the detection and monitoring of insecticide
      susceptibility/resistance in wild anopheline populations and the determination of
      the genetic structure of anopheline populations.

PMID- 11196489
TI  - Entering the post-genomic era of malaria research.
AB  - The sequencing of the genome of Plasmodium falciparum promises to revolutionize
      the way in which malaria research will be carried out. Beyond simple gene
      discovery, the genome sequence will facilitate the comprehensive determination of
      the parasite's gene expression during its developmental phases, pathology, and in
      response to environmental variables, such as drug treatment and host genetic
      background. This article reviews the current status of the P. falciparum genome
      sequencing project and the unique insights it has generated. We also summarize
      the application of bioinformatics and analytical tools that have been developed
      for functional genomics. The aim of these activities is the rational, information
      based identification of new therapeutic strategies and targets, based on a
      thorough insight into the biology of Plasmodium spp.

PMID- 11196490
TI  - Using a geographical information system to plan a malaria control programme in
      South Africa.
AB  - INTRODUCTION: Sustainable control of malaria in sub-Saharan Africa is jeopardized
      by dwindling public health resources resulting from competing health priorities
      that include an overwhelming acquired immunodeficiency syndrome (AIDS) epidemic.
      In Mpumalanga province, South Africa, rational planning has historically been
      hampered by a case surveillance system for malaria that only provided estimates
      of risk at the magisterial district level (a subdivision of a province). METHODS:
      To better map control programme activities to their geographical location, the
      malaria notification system was overhauled and a geographical information system
      implemented. The introduction of a simplified notification form used only for
      malaria and a carefully monitored notification system provided the good quality
      data necessary to support an effective geographical information system. RESULTS:
      The geographical information system displays data on malaria cases at a village
      or town level and has proved valuable in stratifying malaria risk within those
      magisterial districts at highest risk, Barberton and Nkomazi. The conspicuous
      west-to-east gradient, in which the risk rises sharply towards the Mozambican
      border (relative risk = 4.12, 95% confidence interval = 3.88-4.46 when the
      malaria risk within 5 km of the border was compared with the remaining areas in
      these two districts), allowed development of a targeted approach to control.
      DISCUSSION: The geographical information system for malaria was enormously
      valuable in enabling malaria risk at town and village level to be shown. Matching
      malaria control measures to specific strata of endemic malaria has provided the
      opportunity for more efficient malaria control in Mpumalanga province.

PMID- 11196491
TI  - The fate of sporozoites.

PMID- 11196492
TI  - Demonstration of a persisting exo-erythrocytic cycle in Plasmodium cynomolgi and
      its bearing on the production of relapses. 1948.

PMID- 11196493
TI  - Malaria control stymied in 2010, mastered in 2025.

PMID- 11196495
TI  - Malaria--first, roll back expectations.

PMID- 11196494
TI  - Roll back malaria in sub-Saharan Africa?

PMID- 11196496
TI  - Roll back malaria: technically feasible or just politically correct?

PMID- 11196497
TI  - Roll back malaria is unarguably both necessary and possible.

PMID- 11196498
TI  - Estimating the number of helminthic infections in the Republic of Cameroon from
      data on infection prevalence in schoolchildren.
AB  - INTRODUCTION: The prevalence of infection with helminths is markedly dependent on
      age, yet estimates of the total number of infections are typically based on data
      only from school-aged children. Such estimates, although useful for advocacy,
      provide inadequate information for planning control programmes and for
      quantifying the burden of disease. Using readily available data on the prevalence
      of infection in schoolchildren, the relation between the prevalence of infection
      in school-aged children and prevalence in the wider community can be adequately
      described using species-specific models. This paper explores the reliability of
      this approach to predict the prevalence infection in the community and provides a
      model for estimating the total number of people infected in the Republic of
      Cameroon. METHODS: Using data on the prevalence of helminthic infection in school
      aged children in Cameroon, the prevalence of infection in pre-school children and
      adults was estimated from species-specific linear and logistic regression models
      developed previously. The model predictions were then used to estimate the number
      of people infected in each district in each age group in Cameroon. RESULTS: For
      Cameroon, if only the prevalence of infection in schoolchildren is used, the
      number of people infected with each helminthic species will be overestimated by
      up to 32% when compared with the estimates provided by the species-specific
      models. The calculation of confidence intervals supports the statistical
      reliability of the model since a narrow range of parameter estimates is evident.
      Furthermore, this work suggests that estimation of national prevalence of
      infection and the number infected will be enhanced if data are stratified by age;
      this model represents a useful planning tool for obtaining more accurate
      estimates. Estimates based on data aggregated from three geographical levels
      (district, regional, and national) show that summarizing prevalence data at the
      national level will result in biases of up to 19%. Such biases reflect
      differences in the geographical distribution for the prevalence of each species.
      DISCUSSION: Developing more accurate estimates requires a better understanding of
      the differences in the spatial heterogeneity of each species and also better
      methods of incorporating this information when making estimates.

PMID- 11196499
TI  - Safety of community drinking-water and outbreaks of waterborne enteric disease:
      Israel, 1976-97.
AB  - Waterborne disease remains a major public health problem in many countries. We
      report findings on nearly three decades of waterborne disease in Israel and the
      part these diseases play in the total national burden of enteric disease. During
      the 1970s and 1980s, Israel's community water supplies were frequently of poor
      quality according to the microbiological standards at that time, and the country
      experienced many outbreaks of waterborne enteric disease. New regulations raised
      water quality standards and made chlorination of community water supplies
      mandatory, as well as imposing more stringent guidelines on maintaining water
      sources and distribution systems for both surface water and groundwater. This was
      followed by improved compliance and water quality, and a marked decline in the
      number of outbreaks of waterborne disease; no outbreaks were detected between
      1992 and 1997. The incidence of waterborne salmonellosis, shigellosis, and
      typhoid declined markedly as proportions of the total burden of these diseases,
      but peaked during the time in which there were frequent outbreaks of waterborne
      disease (1980-85). Long-term trends in the total incidence of reported infectious
      enteric diseases from all sources, including typhoid, shigellosis, and viral
      hepatitis (all types) declined, while the total incidence of salmonellosis
      increased. Mandatory chlorination has had an important impact on improving water
      quality, in reducing outbreaks of waterborne disease in Israel, and reducing the
      total burden of enteric disease in the country.

PMID- 11196500
TI  - Treatment of human African trypanosomiasis.

PMID- 11196501
TI  - UK report urges screening for "mad sheep" disease.

PMID- 11196502
TI  - The Uganda Ebola outbreak--not all negative.

PMID- 11196503
TI  - Malaria drug resistance gene identified.

PMID- 11196504
TI  - First countries to be recipients of GAVI funds.

PMID- 11196505
TI  - Doctors' first strike in Republic of Korea likely to end.

PMID- 11196506
TI  - WHO's plan for Internet health domain halted.

PMID- 11196507
TI  - A second WHO region declared polio-free.

PMID- 11196508
TI  - Crawling through the Web: what do our patients find?

PMID- 11196509
TI  - Factors associated with low bone mineral density in female patients with systemic
      lupus erythematosus.
AB  - OBJECTIVE: To study risk factors for low bone mineral density (BMD, g/cm) in
      patients with systemic lupus erythematosus (SLE). METHODS: Ninety-two consecutive
      patients with SLE followed by rheumatology faculty between 1997 and 1999
      completed a questionnaire regarding lifestyle during the clinic visit, a chart
      review was performed, and data were collected for the time of the first dual
      energy x-ray absorptiometry (DXA) examination. Univariate and multivariate
      statistical analyses were used to assess relationships between various risk
      factors and BMD. RESULTS: Ninety-eight percent of patients had received
      prednisone, 51% were postmenopausal (9 of whom received hormone replacement
      therapy), 68% had received hydroxychloroquine, and 15% were osteoporotic. The
      following factors were found to be significantly related to lower BMD by
      univariate analysis: Caucasian race, older age at diagnosis, higher age at the
      time of the first DXA, longer disease duration, higher cumulative corticosteroid
      dose, higher SLE Damage Index score, and postmenopausal status. In the
      multivariate analysis only the following factors were significant: Caucasian
      race, increased number of pregnancies, postmenopausal status, higher SLE Damage
      Index, and higher cumulative corticosteroid dose. An unexpected finding was that
      taking hydroxychloroquine was the only factor associated with higher BMD of the
      hip and spine in the univariate analysis, and it remained predictive of higher
      BMD of the hip and spine in the multivariate analysis. CONCLUSION:
      Hydroxychloroquine appears to protect against low BMD in corticosteroid treated
      patients with SLE.

PMID- 11196510
TI  - Systemic vasculitis in patients with hepatitis C.
AB  - OBJECTIVE: To analyze the main characteristics of patients infected with
      hepatitis C virus (HCV) presenting with different types of vasculitis syndrome.
      METHODS: We retrospectively compared 2 groups of patients with HCV presenting
      with systemic vasculitis: 10 with biopsy proven polyarteritis nodosa-type
      systemic vasculitis (PAN, Group 1) and 7 with mixed cryoglobulinemia syndrome
      (MC, Group 2). RESULTS: Patients of Group 1 presented with different features
      than Group 2: life threatening systemic vasculitis (10 vs 0; p < 0.01), severe
      multifocal sensorimotor mononeuropathies versus distal moderate sensory
      polyneuropathies, malignant hypertension (5 vs 0; p = 0.04), cerebral angiitis (2
      vs 0), ischemic abdominal pain (2 vs 0), kidney and liver microaneurisms (2 vs
      0), increased erythrocyte sedimentation rate and C-reactive protein (7 vs 0; p <
      0.01), renal insufficiency (5 vs 0; p = 0.04), HCV genotype 1b (3 vs 6; p =
      0.06), and lower activity of chronic hepatitis (p = 0.02). Neuromuscular biopsies
      showed lesions of vasculitis in all patients, but the type of vasculitis was
      different in Group 1 compared to Group 2: medium size artery involvement (7 vs 0;
      p < 0.01), necrotizing vasculitis (10 vs 0; p < 0.01), and mononuclear cell
      infiltrate in perivascular areas (0 vs 7; p < 0.01). Using prednisone, plasma
      exchanges, and interferon-alpha, complete recovery was obtained in all PAN-type
      patients except one. In Group 2 patients, interferon-alpha did not have any
      effect on the peripheral neuropathy. CONCLUSION: HCV infection may be associated
      with different types of systemic vasculitis, i.e., polyarteritis nodosa or mixed
      cryoglobulinemia. Because of differences in clinical and pathological features
      and therapeutic strategy, PAN-type vasculitis should be distinguished from MC
      type vasculitis in HCV patients.

PMID- 11196511
TI  - Abnormal responses to endothelial agonists in Raynaud's phenomenon and
      scleroderma.
AB  - OBJECTIVE: To further specify the site of vascular dysfunction in patients with
      Raynaud's phenomenon (RP) and scleroderma. METHODS: Ten patients with RP and
      scleroderma and 11 healthy control subjects received brachial artery infusions of
      sodium nitroprusside, an endothelium independent vasodilator, bradykinin, and
      substance P while bilateral finger blood flow was measured with venous occlusion
      plethysmography. RESULTS: Both groups showed vasodilation to sodium
      nitroprusside. However, in response to the endothelium dependent compounds
      bradykinin and substance P, the controls showed vasodilation, whereas the
      patients showed vasoconstriction. CONCLUSION: The vascular defect in RP and
      scleroderma does not lie at the site of the muscarinic receptor, but possibly in
      a distal signaling mechanism.

PMID- 11196512
TI  - Interleukin 16 expression in relation to disease activity in rheumatoid
      arthritis.
AB  - OBJECTIVE: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown
      etiology characterized by an infiltration of CD4+ T lymphocytes within the
      rheumatoid synovium. Cytokines have been shown to play a modulatory role in the
      pathogenesis of RA. We analyzed the expression of a T cell derived cytokine.
      interleukin 16 (IL-16), in relation to disease activity to characterize its
      biologic function in RA. METHODS: Secreted IL-16 was measured by enzyme
      immunoassay in sera and synovial fluids (SF) from 25 patients with RA in
      comparison to 20 control samples from patients with osteoarthritis (OA). IL-16
      expression in peripheral blood mononuclear cells (PBMC) was characterized by flow
      cytometric analysis after intracellular cytokine staining for IL-16. In synovial
      tissue specimens, IL-16 mRNA expression was analyzed by real-time quantitative
      reverse transcriptase polymerase chain reaction (RT-PCR). In parallel, expression
      of IL-16 was localized in synovial tissues by in situ hybridization and
      immunohistochemistry. Results were analyzed in relation to disease activity.
      RESULTS: IL-16 was detected at significantly higher levels in sera and SF of
      patients with RA in comparison to OA (p < 0.001). Flow cytometry of PBMC showed
      that a great proportion of both CD4+ and CD8+ T cells constitutively expressed
      the IL-16 protein. In synovial tissues, IL-16 mRNA levels were significantly
      elevated in comparison to OA controls (p < 0.001). In situ hybridization for IL
      16 producing cells revealed a predominant accumulation of IL- 16 positive cells
      within the inflammatory infiltrates. A significant correlation between IL- 16
      expression and local inflammatory activity could not be established (r = 0.27, p
      = 0.19) by microscopic analysis of the synovial cell infiltrate. In addition, no
      significant association was observed between serum, SF, and synovial tissue
      expression of IL-16 and clinical disease activity in RA. CONCLUSION: These data
      suggest IL-16 might play a role in the pathogenesis of chronic inflammation in
      RA. The lack of significant correlation between IL-16 expression, clinical
      disease activity, and local inflammatory activity suggests a regulatory rather
      than a proinflammatory function for IL-16 in the pathogenesis of chronic synovial
      inflammation in RA.

PMID- 11196513
TI  - Seronegative rheumatoid arthritis in elderly and polymyalgia rheumatica have
      similar patterns of HLA association.
AB  - OBJECTIVE: To examine whether polymyalgia rheumatica (PMR) and late onset
      rheumatoid arthritis have identical or similar HLA-DRB1 genetic associations.
      METHODS: Seventy five PMR cases without evidence of giant cell arteritis were
      available for study. One hundred seven RA cases were investigated, of which 62
      had disease onset after age 60 years. All cases were compared with 145 ethnically
      matched controls. All cases and controls originated from Lugo, NW Spain. HLA-DRB1
      typing was performed on DNA samples using PCR based molecular methods. RESULTS:
      Early onset RA (< or =40 yrs) was strongly associated with DRB1*04 (DRB1*0401 and
      *0404). In contrast late onset RA (> or = 60 yrs) was not associated with DRB1*04
      but was associated with DRB1*01. Stratification of late onset RA cases by
      rheumatoid factor status revealed that DRB1*01 was only increased in seropositive
      RA cases. Late onset seronegative RA cases exhibited increased frequency of
      DRB1*13/*14; this was also observed in PMR cases where coexistence of GCA had
      been excluded. CONCLUSION: These data indicate that (1) HLA associations with RA
      differ with respect to age at disease onset; and (2) seronegative late onset RA
      and "isolated" PMR have a similar HLA-DRB1 association and may have an identical
      etiological basis.

PMID- 11196514
TI  - Clinicopathological findings consistent with primary Sjogren's syndrome in a
      subset of patients diagnosed with chronic fatigue syndrome: preliminary
      observations.
AB  - OBJECTIVE: Some patients diagnosed with chronic fatigue syndrome (CFS) have
      symptoms commonly observed in Sjogren's syndrome (SS), particularly xerophthalmia
      and xerostomia, leading to speculation that some patients with CFS might have
      primary SS or that the 2 disorders share common pathophysiological features. We
      investigated the prevalence of symptoms of mucosal dryness, salivary gland
      pathology, lacrimal hyposecretion, and autoantibodies (antinuclear antibody,
      SSA/SSB) among patients diagnosed with CFS. METHODS: Twenty-five subjects with
      CFS and 18 healthy control subjects were interviewed and examined, had a Schirmer
      test and fluorescein tear dilution, and underwent minor salivary gland (MSG)
      biopsy. Antibody to nuclear antigen as well as anti-La (SSA) and anti-Ro (SSB)
      antibody were available for subjects with CFS. Pathologists unaware of the
      subject group assignment examined labial salivary gland biopsy specimens and
      calculated a standard MSG score for each specimen. RESULTS: Mucosal dryness was
      reported by 13/25 (52%) subjects with CFS, of which 8 (32%) also had MSG score,
      low Schirmer test value, and symptoms consistent with primary SS (p = 0.05). No
      control subject met diagnostic criteria for primary SS. MSG focus scores < or =1
      were common among both groups (CFS 14/25; controls 15/18). MSG results without
      pathological alteration were rare, seen in only one control and no CFS patients.
      Low Schirmer values were found in 10/25 (40%) CFS patients and 1/18 (6%) control
      (p = 0.01). CONCLUSION: A subset of patients with CFS may have primary SS.

PMID- 11196515
TI  - The psychometric properties of patient preferences in osteoporosis.
AB  - OBJECTIVE: Osteoporosis is a chronic disease manifested by wrist, vertebral, and
      hip fractures that results in significant morbidity and burden to society. About
      30% of postmenopausal women have osteoporosis according to the WHO criteria.
      Women with one vertebral fracture have a 4-fold increased risk of a subsequent
      fracture. The goal of treatment is to prevent fractures and improve quality of
      life. Preferences or utilities are now recommended for incorporating quality of
      life into evaluations of the cost effectiveness of new therapeutic interventions.
      We evaluated the psychometric properties of preference based measures in
      osteoporosis. METHODS: Preference scenarios were constructed with a health state
      classification system. The reliability and validity of the feeling thermometer
      and the standard gamble was assessed by interviewing 42 women from 4 different
      patient groups. The sensitivity to change of the feeling thermometer and standard
      gamble was compared with the Health Utilities Index Mark 2 (HUI2) and SF-36. All
      subgroups were reassessed about 2 months after their first interview. RESULTS:
      Preference measurement was feasible in women of different age groups. The
      reliability coefficients for health states ranged from 0.65 to 0.87. The
      preference scores for the marker states demonstrated content validity. Convergent
      validity of the feeling thermometer was supported by a significant correlation
      with the HUI2 (r = 0.38, p < 0.05) and the physical health summary of the SF-36
      (r = 0.56, p < 0.005). The standard gamble did not correlate with the HUI2 (r =
      0.15) or the feeling thermometer (r = 0.09), but correlated with 2 domains of the
      SF-36. The preference measures were sensitive to change, with the efficiency
      scores ranging from 0.78 to 1.0. CONCLUSION: Preference measurements in the
      evaluation of osteoporosis are feasible. The feeling thermometer and standard
      gamble appear to be related to different aspects of health related quality of
      life. Both instruments were sensitive to change over a 2 month period.

PMID- 11196516
TI  - Bone mineral density in patients with psoriatic arthritis.
AB  - OBJECTIVE: Little information is available concerning bone mass in patients with
      psoriatic arthritis (PsA): the existence of less severe periarticular
      osteoporosis is considered possible, but there are no data concerning the
      existence of systemic osteoporosis. We investigated bone mineral density (BMD) in
      patients with PsA. METHODS: We studied 186 patients with non-axial PsA and 100
      healthy subjects, equally divided into 3 groups: women of child-bearing age,
      women in menopause, and men. No patient had previously received steroid
      treatment. In all patients, evaluation was made of disease duration, inflammation
      indices (erythrocyte sedimentation rate, C-reactive protein), functional indices
      (Steinbrocker scale), and the Health Assessment Questionnaire (HAQ). BMD was
      measured by fan-beam x-ray densitometry of the lumbar spine, femur, and total
      body (evaluating the whole skeleton, as well as the spine, trunk, and upper and
      lower limbs). Ultrasound densitometry of the heel was also performed. RESULTS:
      BMD was significantly lower in the arthritic than in the healthy subjects
      regardless of sex, menopausal status, or age, as expressed in g/cm2 (lumbar spine
      1.112 vs 1.326; femoral neck 0.870 vs 1.006; total body 1.125 vs 1.203) or by T
      and Z scores (lumbar T = -1.36, Z = -0.98; femoral neck T = -1.12, Z = -0.83;
      total body T = -1.09, Z = -0.65). Ultrasound densitometry of the heel was
      similarly altered (stiffness 96 vs 77; T -1.78; Z -1.29). Among the PsA patients,
      demineralization in at least one skeletal region was observed in 67% of
      premenopausal women (marked in 11%), 100% of postmenopausal women (marked in
      47%), and 80% of the men (marked in 29%). In premenopausal women,
      demineralization did not correlate with the disease variables; in postmenopausal
      women and the men, it correlated with a decline in the functional indices and the
      HAQ score. This was confirmed by analysis of the relative risk of osteoporosis
      expressed in odds ratios (HAQ: 1.6; age: 1.4; years since menopause: 1.7).
      CONCLUSION: Demineralization was observed in more than 2/3 of our PsA patients
      without axial involvement. This demineralization was not related to the indices
      of inflammation or disease duration, but there is a delayed correlation with HAQ
      score, as well as age and the number of years since menopause.

PMID- 11196517
TI  - Clinical and radiological amelioration of refractory peripheral spondyloarthritis
      by pulse intravenous pamidronate therapy.
AB  - OBJECTIVE: To examine the potential therapeutic properties of an
      aminobisphosphonate, pamidronate, using clinical and laboratory outcome variables
      together with dynamic magnetic resonance imaging (MRI) and gadolinium
      augmentation in patients with spondyloarthropathy (SpA) refractory to
      nonsteroidal antiinflammatory drugs (NSAID). METHODS: We studied 9 patients (7
      male, 2 female) of mean age 27.9 years (range 19-38) and mean disease duration of
      5.5 years (range 0.5-20). Five had ankylosing spondylitis (AS), 3 had
      undifferentiated SpA, and one had reactive arthritis. Seven were HLA-B27
      positive. Two had inflammatory bowel disease. Pamidronate (60 mg) was given
      intravenously on Days 1, 2, 14, 28, and 56, over 4 h in 500 ml of 5% dextrose.
      Clinical outcome assessments included the BASDAI (disease activity), BASFI
      (function), BASGI (global well being) composite visual analog instruments, and
      swollen and tender joint count. Laboratory variables included the erthrocyte
      sedimentation rate (ESR) and C-reactive protein (CRP). Dynamic MRI with
      gadolinium augmentation of synovium and bone was performed at baseline and at Day
      84 in the first 6 patients enrolled in the study. RESULTS: All patients completed
      the study and there was a significant improvement in all clinical and laboratory
      variables assessed. Mean swollen and tender joint count decreased by 93.8% (p =
      0.017) and 98.2% (p = 0.012), respectively, and complete clinical resolution of
      synovitis was noted in 5 patients. BASDAI decreased by 44.2% (p = 0.028), BASFI
      by 47.3% (p = 0.015), and BASGI by 42.2% (p = 0.011). ESR and CRP declined by
      49.4% (p = 0.012) and 66.9% (p = 0.008), respectively. Acute lymphopenia
      accompanied by elevated CRP levels was noted in 8 patients in the 48 h after
      first pamidronate infusion. Maximal rate and magnitude of enhanced MRI signal
      after gadolinium augmentation decreased after pamidronate therapy, especially in
      the bone marrow. CONCLUSION: Preliminary data from uncontrolled studies support
      the efficacy of pamidronate therapy for NSAID refractory SpA and warrant further
      evaluation in controlled trials.

PMID- 11196518
TI  - Physical therapy is effective for patients with osteoarthritis of the knee: a
      randomized controlled clinical trial.
AB  - OBJECTIVE: To assess the effectiveness of physical therapy, given either as an
      individually attended treatment or in a small group format, in terms of pain,
      physical function, and health related quality of life for patients with
      osteoarthritis (OA) of the knee. METHODS: After 2 baseline assessments, 126
      patients were randomized into one of 3 allocation arms: individual treatments (n
      = 43), small group format program (n = 40), and waiting list control (n = 43).
      After reassessment at 8 weeks, patients allocated to waiting list control were
      randomized into one of the 2 active treatment arms. Assessments included both
      self-report measures (WOMAC, SF-36) and objective measures of physical
      performance (gait analysis and muscle strength). RESULTS: Both physical therapy
      treatment allocations resulted in significant improvements in pain, physical
      function, and health related quality of life above the control group
      (standardized response mean 0.36 to 0.65). Improvements in the self-report
      measures were substantiated by significant correlated improvements in knee
      extensor strength and fast walking speed (rho 0.36-0.42). There were no
      significant differences in effectiveness between the 2 physical therapy
      allocations for any of the measured outcomes. Improvements gained were maintained
      for at least 2 months. Responsiveness to treatment was modified by loss of medial
      joint space width, the interaction being significant for physical function, gait,
      and knee extensor strength. CONCLUSION: Physical therapy, either as an
      individually delivered treatment or in a small group format, is an effective
      intervention for patients with knee OA. Responsiveness to this 8 week
      intervention was modified by loss of medial joint space width.

PMID- 11196519
TI  - Improvements following short term home based physical therapy are maintained at
      one year in people with moderate to severe rheumatoid arthritis.
AB  - OBJECTIVE: We previously demonstrated the efficacy of a 6 week home based
      physical therapy (PT) intervention for people with moderate to severe rheumatoid
      arthritis (RA). This followup study determined if short term improvements were
      maintained to one year. METHODS: Participants in the short term study were
      randomly assigned to receive a PT intervention (education, exercise, and pain
      relief modalities) delivered by physiotherapists with advanced rheumatology
      training (Weeks 0 to 6) or to a wait list control group. The control group
      received the intervention between Weeks 6 to 12. Outcome measures included the
      Stanford Arthritis Self-Efficacy Scale (SES), the Arthritis Community Research
      and Evaluation Unit Rheumatoid Arthritis Knowledge Questionnaire (KQ), and a
      visual analog scale for pain. Disease activity measures (tender joints, grip
      strength, and morning stiffness) were also included. MANOVA was used to compare
      within-subject scores at baseline and at 12 and 52 weeks. Paired t tests were
      used to determine if 12 week changes were maintained at 52 weeks. RESULTS: Of the
      127 protocol completers, 117 (92.1%) were available for the one year followup.
      For those measures that showed significant improvement in the randomized
      controlled trial (SES, KQ, morning stiffness), improvements at 12 weeks were
      maintained at 52 weeks (p > 0.010). CONCLUSION: Subjects who participated in a
      short term home based PT intervention delivered by specially trained therapists
      reported improved outcomes following treatment, and these improvements were
      maintained at one year followup. Future studies need to explore the relative
      contributions of education, exercise, home based care, therapist training, and
      reinforcement strategies in improving longterm outcomes in RA.

PMID- 11196520
TI  - Comparative study of osteoarthritis of the contralateral knee joint of male
      amputees who do and do not play volleyball.
AB  - OBJECTIVE: To assess the prevalence of osteoarthritis (OA) of the contralateral
      knee of men with traumatic amputation who do and do not participate in regular,
      vigorous physical activity. METHODS: Three groups of patients were assessed.
      Group 1 consisted of 8 male amputee volleyball players. Group 2 consisted of 24
      male amputees who do not play volleyball, and Group 3 was made up of 24 healthy
      controls matched by age and weight to Group 2. The prevalence of contralateral
      knee OA in Groups 1 and 2 was assessed by questionnaire, physical examination,
      and radiographs, and was compared with findings for Group 3. RESULTS: The rate of
      OA in all amputees (Groups 1 and 2 together) was 65.6%, which was significantly
      higher than among the controls (p < 0.05). The most common findings among the
      amputees were patellar and medial osteophytosis of the tibiofemoral joint, with a
      tendency to medial narrowing of the tibiofemoral joint space. CONCLUSION:
      Traumatic amputees have a higher prevalence of OA in the knee of the nonamputated
      leg than matched healthy controls.

PMID- 11196521
TI  - Chondroitin sulfate in osteoarthritis of the knee: a prospective, double blind,
      placebo controlled multicenter clinical study.
AB  - OBJECTIVE: To assess the efficacy and safety of chondroitin sulfate (CS) 1 g/day
      per os compared to placebo, in a double blind, randomized, parallel group study,
      with 3 months treatment followed by a 3 month posttreatment period, in patients
      with femorotibial osteoarthritis (OA). METHODS: The main criterion was the
      functional handicap assessed by Lequesne's algofunctional index (AFI). Secondary
      efficacy criteria were: self-assessed pain with activity and at rest, self
      assessed impact of OA on daily living, patient and physician assessed overall
      change in patient state since the previous visit, and daily NSAID and analgesic
      consumption, all evaluated monthly. The main analysis was performed on the intent
      to-treat (ITT) population at treatment endpoint compared to baseline (Day 0).
      RESULTS: The ITT efficacy data set comprised 130 patients (63 in CS group and 67
      in placebo group). At treatment endpoint, the AFI showed greater but
      nonsignificant improvement in the CS than in the placebo group. Improvement
      became significant (p = 0.02) in the completer population (n = 114). In the ITT
      population, all variables tended towards greater improvement in the CS than the
      placebo group. In the completer population, pain at rest also significantly
      decreased in the CS group compared to the placebo group (p = 0.03), and, one
      month after treatment, CS had a significantly higher persistent effect than
      placebo on the AFI (p = 0.01), pain with activity (p = 0.001), physician assessed
      patient state (p = 0.05), and most other efficacy criteria. Adverse event rates
      did not differ significantly. CONCLUSION: We observed a trend towards efficacy of
      CS 1 g/day compared to placebo with good tolerability after 3 month treatment,
      and persistent efficacy one month posttreatment. Further investigations are
      required to confirm this trend.

PMID- 11196522
TI  - Single and multiple dose pharmacokinetics of acetaminophen (paracetamol) in
      polymedicated very old patients with rheumatic pain.
AB  - OBJECTIVE: To determine whether multiple dosing of acetaminophen would result in
      drug accumulation in polymedicated elderly patients with rheumatic pain. METHODS:
      Twelve inpatients (11 women), aged 89 +/- 4 years, weight 59 +/- 10 kg, receiving
      3 to 8 concomitant medications, entered the study. Their creatinine clearance
      according to the Cockroft-Gault formula was 42 +/- 12 ml/min. The
      pharmacokinetics of 1 g acetaminophen was evaluated after the first dose (D1) and
      after the last dose (D7) during a 3 times daily regimen of 1 g for 5 consecutive
      days. RESULTS: The plasma pharmacokinetic profile of acetaminophen did not change
      significantly at D7 compared to D1. No significant within-patient differences
      were observed, especially with respect to plasma elimination half-life (2.74 +/-
      0.48 and 2.77 +/- 0.32 hours, respectively), area under the concentration-time
      curve (82.5 +/- 21.1 and 90.1 +/- 15.2 microg x h/ml, respectively), and apparent
      oral clearance (3.68 +/- 0.85 and 3.28 +/- 0.52 ml/min/kg, respectively).
      CONCLUSION: No drug accumulation occurred during multiple dosing with
      acetaminophen in these very old subjects. On the basis of pharmacokinetic data
      alone, a dose regimen of acetaminophen 1 g tid seems to be appropriate in such
      patients.

PMID- 11196523
TI  - Surfing the Net--information on the World Wide Web for persons with arthritis:
      patient empowerment or patient deceit?
AB  - OBJECTIVE: In the past few years access to the Internet has become readily
      available. Patients are increasingly seeking and obtaining health information
      through the Internet, most often the World Wide Web (WWW). We assessed the
      content, authorship, and scope of the information available on WWW in relation to
      rheumatoid arthritis. METHODS: In an attempt to replicate use by the average
      person, a broad search of the Internet was conducted for the phrase "rheumatoid
      arthritis" using WebCrawler, a commonly used search engine. All the "hits" were
      critically assessed after visiting and collecting information from the respective
      Web sites in relation to relevance, scope, authorship, type of publication, and
      financial objectives. RESULTS: The search returned 537 hits. We evaluated 531-2
      did not exist, 2 could not be contacted, one was not in English, and one required
      a membership to access. The 531 hits originated from 388 Web sites. Only 198
      (51%) were considered to be relevant and 7 (2%) were of doubtful relevance.
      Thirty-four (17%) were posted by an individual, 57 (28%) by a nonprofit
      organization, 104 (51%) by a profit industry, and 10 (5%) by universities. Ninety
      one (44%) promoted alternative therapies, the most common including cetyl
      myristoleate, colloidal minerals, Pycnogenol, shark cartilage, and Tahitian Noni.
      Of the 107 sites with financial interests, 76 (71%) promoted alternative
      medicine. The first 100 hits only identified about a third of the nonprofit
      organizations or university owned Web pages. CONCLUSION: Many sites easily
      accessed by consumers appear to be profit based companies advertising an
      alternative product claimed to be effective for many conditions. These findings
      emphasize the need for critical evaluation of Web site contents.

PMID- 11196524
TI  - The arthritis of inflammatory childhood myositis syndromes.
AB  - OBJECTIVE: Arthritis has been an associated finding in juvenile dermatomyositis
      (JDM), but its prevalence, course, and response to therapy has not been well
      described. We investigated the frequency, course, and clinical and radiographic
      features in a large cohort of patients with JDM. METHODS: The charts of 94
      patients with idiopathic myositis (1984-99) were reviewed: 80 JDM, 3 juvenile
      polymyositis (JPM), 5 amyopathic JDM, and 6 overlap myositis syndromes. Compiled
      data included demographics, clinical features, a detailed description of the
      arthritis, investigations (radiographs, autoantibodies), course, and response to
      therapy. All radiographs were independently reviewed by a single radiologist.
      RESULTS: Sixty-one percent (95% CI 50-72%) of patients with JDM had arthritis.
      The arthritis was reported a median 4.5 mo (range -73.6 to 76.6 mo) after the JDM
      onset. When compared to patients with no arthritis, the occurrence of arthritis
      was not significantly related to sex, race, positive antinuclear antibody or
      rheumatoid factor, calcinosis, nodules, vasculitis, or Raynaud's phenomenon. The
      initial involvement was pauciarticular in 67% and polyarticular in 33%. In the
      pauci group, asymptomatic knee effusions were the predominant finding (n = 19,
      58%), and in 18 patients may have been the result of steroid therapy. Two
      patients evolved from a pauci onset to a polyarticular course. All responded to
      therapy (corticosteroids; 47 were taking other medications) with remission of the
      arthritis within a median of 2.0 mo (range 0.1-64.5 mo). However, the arthritis
      recurred in 39% as the corticosteroids were tapered. Four patients with JDM
      eventually required corticosteroid wrist injections, with resolution of the
      arthritis. The arthritis was nonerosive in all cases. No patient with JPM had
      arthritis. Three of 5 patients with amyopathic JDM and 4 of 6 with overlap
      myositis syndrome had a nonerosive polyarthritis. CONCLUSION: Nonerosive
      arthritis involving the knees, wrists, elbows, and fingers is a frequent
      manifestation of JDM and other idiopathic childhood myositis. The arthritis is
      seen early in the course of JDM and often responds to treatment. However, the
      arthritis may recur with tapering of corticosteroids despite remission of the
      JDM. In a significant proportion of JDM cases, arthritis is the major sequela and
      may warrant further medical therapy or intraarticular corticosteroid injections.

PMID- 11196525
TI  - Evidence for immune activation against oxidized lipoproteins in inactive phases
      of juvenile chronic arthritis.
AB  - OBJECTIVE: Oxidative stress contributes to joint inflammation and damage in
      rheumatoid arthritis. In a mobile inflamed joint, exercise induced multiple
      cycles of hypoxia-reperfusion injury may lead to the creation of a redox
      environment in which oxido-reductase systems, by NADPH mechanisms, produce highly
      reactive chemical species (i.e., oxygen free radicals). We investigated 2
      endproducts of lipid peroxidation, malonildialdehyde (MDA) and diene conjugates
      (DC), and the formation of antibodies against oxidized low density lipoproteins
      (Ab oxLDL) in juvenile chronic arthritis (JCA), and assessed the role of
      oxidative phenomena in different phases and subsets of this disease. METHODS: To
      assess the role of oxidative stress in JCA, we measured the endproducts of lipid
      peroxidation, MDA and DC, by the increase of absorbance at 586 nm and 234 nm,
      respectively, and the levels of Ab oxLDL by ELISA in the sera of 58 patients with
      JCA and 21 healthy controls. Due to crossreactivity between Ab oxLDL and
      anticardiolipin antibodies (aCL), the sera were also tested by a standard ELISA
      for IgG-aCL. The patients were divided into 3 subsets: 29 with pauciarticular
      (pauci), 15 with polyarticular (poly), and 14 with systemic (sys) onset disease,
      and then were subdivided, according to different variables appropriate to each
      subset, reflecting active and inactive disease, into 30 active (14 pauci, 8 poly,
      8 sys) and 28 inactive (15 pauci, 7 poly, 6 sys). RESULTS: Levels of Ab oxLDL
      were significantly increased in the whole group of patients (566.6 +/- 263.0 vs
      206.6 +/- 136.3 mU/ml; p < 0.001) and in each of the type of onset (pauci 660.8
      +/- 272.1, p < 0.001; poly 341.3 +/- 134.7, p < 0.01; sys 497.8 +/- 114.8, p <
      0.001) compared to controls. Ab oxLDL were higher in the inactive than in the
      active group (743.5 +/- 231.9 and 404.4 +/- 169.9; p < 0.001). MDA and DC levels
      were not increased significantly in patients' sera. No patient was positive for
      IgG-aCL. CONCLUSION: These findings suggest that MDA and DC cannot be considered
      major markers of oxidative stress in JCA and that the Ab oxLDL may represent a
      delayed sign of oxidative stress previously induced by the inflammatory process
      in patients with JCA.

PMID- 11196526
TI  - Isolated tuberculous monoarthritis mimicking oligoarticular juvenile rheumatoid
      arthritis.
AB  - Isolated monoarthritis caused by Mycobacterium tuberculosis in the absence of
      clinical pulmonary disease is extremely rare in North America. After decades of
      consistent declines in incidence, a remarkable resurgence of tuberculosis (TB) is
      occurring in North America. It must always be considered in the differential
      diagnosis of chronic monoarthritis if devastating sequelae are to be avoided. We
      describe 2 cases of tuberculous arthritis in young children presenting with
      monoarthritis of the knee. The presumptive diagnosis in each case was
      oligoarticular onset juvenile rheumatoid arthritis (JRA). Each had an atypical
      course for JRA, with lack of response to intraarticular corticosteroid. The
      diagnosis of TB arthritis was made only with synovial biopsy.

PMID- 11196527
TI  - Central nervous system vasculitis as a complication of refractory
      dermatomyositis.
AB  - We describe a 47-year-old woman with refractory dermatomyositis (DM) who
      developed progressive cognitive dysfunction. Magnetic resonance imaging showed a
      large cerebral infarction, and the diagnosis of central nervous system (CNS)
      vasculitis was confirmed by both angiogram and brain biopsy. Her DM and CNS
      vasculitis responded promptly to the institution of daily cyclophosphamide, and
      her previously refractory disease entered remission.

PMID- 11196528
TI  - Self-injection of gold and methotrexate.

PMID- 11196529
TI  - Radiographic diagnosis of sacroiliitis--are sacroiliac views really better?

PMID- 11196530
TI  - Disappointing longterm result with disease modifying antirheumatic drugs.

PMID- 11196531
TI  - Nocardia pleural empyema complicating anti-Jo1 positive polymyositis during
      immunoglobulin and steroid therapy.

PMID- 11196532
TI  - Hemodynamics in vasculitides.

PMID- 11196533
TI  - Multifocal Staphylococcus aureus infection originating from the sacroiliac joint
      in a patient with rheumatoid arthritis.

PMID- 11196534
TI  - Stromelysin-1 (MMP-3) in synovial fluid of patients with rheumatoid arthritis has
      potential to cleave membrane bound Fas ligand.
AB  - OBJECTIVE: To investigate the relationship between matrix metalloproteinases
      (MMP) and the soluble form of Fas ligand (sFasL) in the synovial fluid (SF) of
      patients with rheumatoid arthritis (RA), and to determine which MMP have a major
      role in cleaving FasL. METHODS: The concentrations of sFas and sFasL in SF from
      48 patients with RA and 43 patients with osteoarthritis (OA) were measured using
      specific ELISA. The levels of different MMP (MMP-1, 2, 3, 7, 9) in SF were also
      measured by ELISA. The active forms of gelatinases were detected by gelatin
      zymogram. Human FasL-expressing transfected cells (hFasL/L5178Y) were used to
      investigate whether FasL is cleaved from membrane bound FasL. RESULTS:
      Significantly higher levels of MMP-1, 3, and 9 were found in SF from RA patients
      compared to OA patients, but MMP-7 was not detectable in either group. The
      concentrations of sFas and sFasL in SF were also higher in RA than in OA
      patients. However, there was no relationship between the concentration of sFas
      and sFasL. Among MMP, MMP-3 concentrations in SF were closely correlated with the
      level of sFasL and with disease activity of RA. Enzymatic cleavage assay
      indicated that MMP-3 has potential to cleave the FasL expressed on hFasL/L5178Y
      cells and to produce sFasL. CONCLUSION: There was significant correlation between
      the concentration of sFasL and MMP-3 in SF of patients with RA. In addition, our
      data indicate that the shedding of FasL may be regulated by MMP-3 in the joint of
      patients with RA.

PMID- 11196535
TI  - Systemic onset juvenile idiopathic arthritis: a retrospective study of 80
      consecutive patients followed for 10 years.

PMID- 11196536
TI  - Autoantibodies to CTLA-4 enhance T cell proliferation.

PMID- 11196537
TI  - Adverse reactions to rifabutin.

PMID- 11196538
TI  - Association between insulin-like growth factor status and physical activity
      levels in rheumatoid arthritis.
AB  - OBJECTIVE: To determine if the altered insulin-like growth factor (IGF) status in
      rheumatoid arthritis (RA) is due to inflammation, altered body composition, or
      lack of exercise. METHODS: Subjects included 73 patients with RA, 54 patients
      with other rheumatic diseases, both inflammatory and noninflammatory, and 28
      healthy, physically active controls. Serum levels of IGF-I, IGF-II, and IGF
      binding protein-3 (IGFBP-3) were measured by radioimmunoassay. Body composition
      was estimated by bioelectrical impedance analysis, and habitual exercise level
      approximated by questionnaire. Statistical analysis was performed by 2 and 3 way
      ANOVA and moderated hierarchical regression. RESULTS: Serum IGF-I (p < 0.001),
      IGFBP-3 (p < 0.001), and the BP-3:total IGF molar ratio (p < 0.001) were
      depressed in both patient groups relative to controls. In contrast, IGF-II levels
      were depressed only in patients with RA (p < 0.01). Differences in the IGF
      proteins between patients and controls could not be attributed to inflammation.
      Habitual exercise level, but not body composition, was shown to be a significant
      predictor for IGF-I, IGFBP-3, and BP-3:total IGF molar ratio (p < 0.001).
      CONCLUSION: Our results indicate that the reduction in circulating IGF proteins
      observed in our patients is more related to their sedentary lifestyle than to the
      inflammatory process. This conclusion is in agreement with reports that show that
      highly active individuals typically exhibit higher levels of systemic IGF
      proteins than age matched sedentary controls.

PMID- 11196539
TI  - Genetic studies of psoriatic arthritis: dissecting joints and skin.

PMID- 11196540
TI  - Magnetic resonance imaging: a valuable method for the detection of synovial
      inflammation in rheumatoid arthritis.
AB  - OBJECTIVE: Clinical assessment of rheumatoid arthritis (RA) based on pain and
      swelling and physical examination is limited by observer error and
      interpretation. We compared magnetic resonance imaging (MRI) and clinical
      examination to detect synovitis in RA. METHODS: Twelve patients with active RA
      were assessed according to Ritchie index, swollen joint count and score, swollen
      joint count of hands and wrists [2 wrists, 10 metacarpophalangeal (MCP), 10
      proximal interphalangeal (PIP)], morning stiffness, pain intensity, Disease
      Activity Score (DAS), erythrocyte sedimentation rate, and C-reactive protein. MR
      images of hands and wrists were obtained with an adapted device, on T1 weighted
      (T1W) spin echo (SE) coronal images before and after gadolinium DTPA, TIW SE
      axial images with gadolinium DTPA, T2* gradient echo recall coronal and axial
      sequences, and assessed by 2 radiologists (O = no synovitis, 1 = synovitis).
      RESULTS: The swollen joint count on hands and wrists was 59 on clinical
      examination (mean 5.08 +/- 3.15 per patient; 20/24 wrists, 7/120 MCP, 32/120 PIP)
      and 162 on MRI (mean 13.50+/- 5.65; 22/24 wrists, 70/120 MCP, 70/120 PIP).
      Statistically significant correlations were found between MRI synovitis count and
      swollen joint count (p = 0.015) and score (p = 0.019), Ritchie Index (p = 0.035),
      DAS (p = 0.02) and morning stiffness (p = 0.07). MRI revealed synovitis
      significantly more often than clinical examination (162 vs 59; p = 0.00002) [2
      fold in PIP (70/32) and 10-fold in MCP (70/7)]. Clinical examination and MRI were
      concordant for 157/264 joints (59.5%). The association of normal MRI with
      synovitis on clinical examination was observed in 2 cases, the opposite in 105.
      CONCLUSION: MRI is more sensitive than clinical examination to detect synovitis
      of hands and wrists in RA, especially for MCP and PIP joints, and is valuable for
      assessment of inflammation in hands and wrists in RA.

PMID- 11196541
TI  - Plasma monocyte chemoattractant protein 1 is a marker for joint inflammation in
      rheumatoid arthritis.
AB  - OBJECTIVE: Monocyte chemoattractant protein 1 (MCP-1) level in plasma is
      described as a marker for joint inflammation in rheumatoid arthritis (RA).
      METHODS: MCP-1 in plasma and synovial fluid (SF) was quantified by ELISA in 36 RA
      patients with synovitis of the knee at Day 1 and 30. Disease activity was
      assessed by the swollen joint count, Ritchie Articular Index (RAI), global
      assessment, pain on visual analog scale, Health Assessment Questionnaire,
      erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). RESULTS: By
      linear regression analysis plasma MCP-1 levels correlated significantly with the
      swollen joint count (Day 1: R = 0.47, p = 0.005; Day 30: R = 0.53, p < 0.001) and
      the RAI (Day 1: R = 0.37, p = 0.03; Day 30: R = 0.41, p = 0.01). The correlations
      of swollen joint count and RAI with ESR and CRP were significant only on Day 30
      for the ESR (R = 0.40, p = 0.02). No association was found between plasma MCP-1
      levels and the ESR/CRP levels. MCP-1 levels in plasma in RA patients were
      elevated compared to controls (p < 0.001) and MCP-I levels in SF were higher than
      in plasma (p < 0.001). No correlation was found between SF MCP-1 levels and in
      vitro migration of mononuclear cells towards SF. MCP-1 appears to participate in
      the disease process in RA, and plasma MCP-1 may be useful in monitoring joint
      inflammation.

PMID- 11196542
TI  - Epstein-Barr virus, methotrexate, and lymphoma in patients with rheumatoid
      arthritis and primary Sjogren's syndrome: case series.
AB  - OBJECTIVE: Rheumatoid arthritis (RA) and primary Sjogren's syndrome (SS) are
      associated with an increased risk of lymphoma. Epstein-Barr virus (EBV), a
      ubiquitous herpes virus, has been linked etiologically to lymphoma in patients
      with RA and primary SS. Recently, methotrexate (MTX) has also been linked to the
      development of these lymphomas. We investigated the frequency of EBV in lymphoma
      tissue of patients with RA and primary SS and the association of MTX with
      lymphomagenesis. METHODS: Twenty-three patients with RA and 9 with primary SS
      with a history of lymphoma were identified by writing to all Arthritis Foundation
      member rheumatologists in Washington State. Formalin fixed, paraffin embedded
      tissue blocks were then requested from pathology laboratories. Lymph nodes from 5
      RA patients without lymphoma were also studied. In situ hybridization using a
      biotinylated EBER-1 oligonucleotide probe was used to detect EBV in tissue
      sections. Positive and negative laboratory controls were used to ensure
      procedural integrity. RESULTS: Specimens from 21 RA patients were obtained, with
      2 subsequently excluded due to specimen quality. Specimens from 6 patients with
      primary SS were obtained. In situ hybridization for EBV was positive in 5/19
      (26%) RA patients and 1/6 patients with primary SS. In the nonmalignant lymph
      nodes no patient showed EBV. One primary SS and 12 RA patients were known to be
      taking MTX at the time of lymphoma diagnosis. Of the EBV positive RA lymphoma
      patients, 4/5 were receiving MTX at the time of diagnosis. These results show
      that EBV is present in lymphoma tissue of some patients with RA and very few with
      primary SS. CONCLUSION: EBV is over-represented in the lymphomas of patients with
      RA, but whether MTX plays a role in predisposing patients with RA and primary SS
      to the development of lymphoma, perhaps by influencing behavior of EBV, remains
      unclear.

PMID- 11196543
TI  - Becoming a disability pensioner with rheumatoid arthritis in Norway 1971-1990.
AB  - OBJECTIVE: Physically demanding occupations have been associated with becoming a
      disability pensioner with rheumatoid arthritis (DPRA), but not with the disease
      of RA. The association with becoming DPRA probably reflects that patients with RA
      have difficulties in maintaining employment in a physically demanding occupation.
      However, the attitudes of the employers concerning employment of persons with RA
      might vary. For example, the patient's age may influence the strength of the
      association between a physically demanding occupation and becoming DPRA. We
      assessed whether the association between the predictors and becoming DPRA was
      stronger for the youngest or the oldest age group. METHODS: The study was
      prospective with data on persons in Norway 30-56 years old either in the census
      of 1970 or 1980. All new cases of DPRA during the 2 followup periods 1971-80 and
      1981-90 were identified and analyzed by logistic regression. RESULTS: For women
      the predictors employment, low level of education, and period ( 1981-90 compared
      to 1971-80) were more strongly associated with becoming DPRA for the youngest
      compared to the oldest persons, while manual work and part time work were not
      predictors of becoming DPRA. For men, all the predictors in the study were more
      strongly associated with becoming DPRA for the youngest compared to the oldest
      age group. CONCLUSION: The higher risk of becoming DPRA was associated with most
      predictors for persons aged 30-39 years than the group aged 50-56 years. Our
      results appear to indicate that the consequences of having RA in the labor market
      are greater for the youngest age group.

PMID- 11196544
TI  - Opioid therapy for osteoarthritis of the hip and knee: use it or lose it?

PMID- 11196545
TI  - Carpal tunnel sonography by the rheumatologist versus nerve conduction study by
      the neurologist.
AB  - OBJECTIVE: To determine the value of sonography (SG) performed by the
      rheumatologist to diagnose carpal tunnel syndrome (CTS). METHODS: Sixty-three
      patients with clinical signs of CTS according to the neurologist, based on
      patient history and clinical examination, were studied. In the 6 weeks prior to
      surgery, SG was performed by a rheumatologist and nerve conduction study (NCS)
      was assessed. Improvement of initial complaints of 90% or more 3 months after
      surgery was considered to be the post-hoc gold standard for the diagnosis of CTS.
      RESULTS: After surgery, 47 patients (75%) experienced > or = 90% relief of
      complaints. Mean cross sectional area of the median nerve for patients with CTS
      was 11.3 mm2 compared to 6.1 mm2 in the control group. The sensitivity to detect
      CTS was 0.70 for SG and 0.98 for NCS, and specificity was 0.63 for SG and 0.19
      for NCS. Positive predictive value was 0.85 for SG and 0.78 for NCS; negative
      predictive value was 0.42 for SG and 0.75 for NCS. Accuracy was 0.68 for SG and
      0.78 for NCS. CONCLUSION: CTS can be identified by SG less sensitively but more
      specifically than by NCS.

PMID- 11196546
TI  - Incidence of elbow involvement in rheumatoid arthritis. A 15 year endpoint study.
AB  - OBJECTIVE: To evaluate the incidence of involvement and cause of destruction of
      humeroulnar (HU) and humeroradial (HR) joints in a prospectively followed cohort
      of 74 patients with seropositive and erosive rheumatoid arthritis (RA). METHODS:
      At the 15 year followup standard anteroposterior and lateral radiographs of 148
      elbow joints were evaluated, and the grade of destruction was assessed by the
      Larsen method. RESULTS: Erosive involvement (Larsen grade 2) was observed in
      75/148 (51%) elbows in 45/74 (61%) patients; 30 patients had bilateral and 15
      unilateral involvement. The incidence of mild erosions (Larsen grade 2) was
      49/148 (33%), and severe erosions (Larsen 3-5) 26/148 (18%). The 13 most severely
      involved (Larsen grade 4-5) joints were seen in 8 (11%) patients. Erosions were
      most often observed on the capitellum (64 joints) and the lateral epicondyle (58
      joints) of the humerus (AP view) or on the olecranon of the ulna (52 joints). The
      Larsen score (0-100) for peripheral joints correlated significantly with the
      elbow joint Larsen grade on both sides: right, r = 0.53 (95% CI 0.34 to 0.68);
      left, r = 0.53 (95% CI 0.34 to 0.68). CONCLUSION: After 15 years more than half
      of the elbows and almost 2 of 3 patients with RA showed definite involvement of
      the elbow joint. Erosions were most often located on the capitellum and the
      lateral epicondyle of the humerus or the olecranon of the ulna. Severe
      destruction was most often bilateral.

PMID- 11196547
TI  - Analysis of leukemia inhibitory factor, type 1 and type 2 cytokine production in
      patients with eosinophilic fasciitis.
AB  - OBJECTIVE: Eosinophilic fasciitis (EF) is a scleroderma-like disease of unknown
      etiology characterized by skin induration, elevated immune globulins, and
      peripheral eosinophilia. The hallmarks of the chronic cutaneous involvement in
      this syndrome are inflammation and fibrosis of the fascia. To determine how the
      inflammatory process in EF may be regulated, we investigated the spontaneous and
      mitogen induced [lipopolysaccharide (LPS), phytohemagglutinin (PHA) or both
      LPS+PHA] syntheses of interleukins (IL)-2, 5 and 10, interferon-gamma (IFN
      gamma), and leukemia inhibitory factor (LIF) cytokines by peripheral blood
      mononuclear cells (PBMC) from 4 patients with active EF and compared them to
      those of 10 healthy individuals. METHODS: We used a short term whole blood assay
      and culture supernatants were collected after 24 h to measure the IL-2 and IFN
      gamma contents and after 48 h to evaluate IL-5, IL-10, and LIF. Supernatant
      cytokine concentrations were determined by ELISA. RESULTS: All 4 patients had
      similar patterns of cytokine secretion. Cytokine production did not differ
      between patients and controls under basal conditions or when LPS was added to the
      cultures. In contrast, under PHA or LPS+PHA stimulation, significantly higher
      amounts of all 5 cytokines were detected in samples from patients compared to
      those from controls. CONCLUSION: Overall, our data suggest that EF is
      characterized by an increased capacity of PBMC to produce IL-5 and IL-10,
      possibly leading to eosinophilia and immune globulin overexpression. In this
      context, the simultaneous elevations of type 1 cytokines (IL-2 and IFN-gamma) and
      LIF production by the same cells may be an attempt by the immune system to limit
      the exacerbation of a type 2 dominant response.

PMID- 11196548
TI  - Detection of nucleosome particles in serum and plasma from patients with systemic
      lupus erythematosus using monoclonal antibody 4H7.
AB  - OBJECTIVE: To develop a monoclonal antibody reagent that would react with
      nucleosomes but not directly with constituent double stranded DNA (dsDNA) or with
      histones. METHODS: Mice were immunized with highly purified chicken
      mononucleosomes and hybridomas employed to produce Mab that did not react with
      dsDNA or histones but still showed reactivity with nucleosomes. RESULTS: Murine
      monoclonal IgG antibody 4H7, generated from a mouse immunized with highly
      purified chicken erythrocyte nucleosomes, showed no direct ELISA reactivity with
      either dsDNA or isolated histones or with Sm and RNP antigens or combinations of
      any of these components. Mab 4H7 did show strong ELISA reactivity for chicken
      erythrocyte and calf thymus nucleosomes as well as for human leukocyte
      nucleosomes. The Mab did show strong ELISA reactions with peptides 1-25 of
      histone H2B and 1-21 of H3, which correspond to sequences known to be located at
      the surface of nucleosomes. We then measured relative serum levels of 4H7
      reactive nucleosome antigen in 140 patients with systemic lupus erythematosus
      (SLE) in parallel with 50 non-SLE patients with other types of connective tissue
      disease and 92 healthy subjects. Occasional low levels of serum nucleosomal
      antigen were seen in 4 of 92 controls, but many patients with SLE (66/140) showed
      marked elevations of serum nucleosomal antigen. No difference was observed when
      serum or plasma samples were studied. A marked correlation (R = 0.401, p <
      0.0001) was noted when disease activity score (SLEDAI) was plotted against
      optical density value measured with 4H7 in ELISA. Further, the levels of
      circulating nucleosomes were raised in SLE patients with very active central
      nervous system and renal involvement. CONCLUSION: Presence of nucleosome related
      antigen in sera from patients with SLE may provide insight into the sequence of
      disease related antigenic stimuli in active SLE.

PMID- 11196549
TI  - Phase I clinical trial of a monoclonal antibody against CD40-ligand (IDEC-131) in
      patients with systemic lupus erythematosus.
AB  - OBJECTIVE: To investigate the safety and pharmacology of a humanized monoclonal
      antibody against CD40-ligand (IDEC-131) in patients with systemic lupus
      erythematosus (SLE). METHODS: Cohorts of 3 to 5 patients with symptomatic lupus
      each received 0.05, 0.25, 1.0, 5.0, or 15.0 mg/kg of IDEC-131 as a single
      intravenous infusion. Patients were followed for 3 months to evaluate toxicity
      and pharmacokinetics. RESULTS: This phase I, single dose, dose-escalating study
      was conducted in 23 patients at a single institution. All patients experienced at
      least 1 adverse event (AE) during a 3 month followup period, although 58 AE in 17
      patients were considered possibly or probably related or of unknown relationship
      to treatment. No dose relationship in the distribution of AE was apparent. No
      infusion related cytokine-release syndrome was observed; no infusions were
      interrupted, and all patients completed treatment. Eight mild (grade 1 or 2)
      infections were reported in 8 patients. All infections were considered unrelated
      to drug administration and all resolved uneventfully. No patient developed
      detectable antibodies to IDEC-131. Flow cytometry revealed no apparent treatment
      related depletion of lymphocyte subsets. Pharmacokinetic analysis indicated that
      the maximum serum concentration and the area under the concentration curve of
      IDEC-131 were proportional to the dose administered. At doses between 1.0 and
      15.0 mg/kg, the serum half-life ranged from 299 to 320 h. Efficacy was not
      formally evaluated in this single dose study. CONCLUSION: IDEC-131 (humanized Mab
      against CD40L) administered in a single intravenous infusion at doses of 0.05
      15.0 mg/kg is safe and well tolerated in patients with SLE.

PMID- 11196550
TI  - Localization of arrhythmogenic triggers of atrial fibrillation.
AB  - INTRODUCTION: Mapping procedures to identify triggers of atrial fibrillation from
      pulmonary veins (PVs) are not well established. We sought to determine the value
      of multipolar recordings from the coronary sinus (CS) and crista terminalis (CT)
      for identifying the origin of paced and atrial premature depolarizations (APDs)
      initiating atrial fibrillation from left versus right PVs. METHODS AND RESULTS:
      Fifteen patients with paroxysmal atrial fibrillation refractory to medications
      had decapolar catheters (5-mm electrode, 2-mm interelectrode spacing) placed in
      the CS and posterior medial to the CT. Bipolar electrograms were recorded at each
      site. Electroanatomic left atrial endocardial maps were created in sinus rhythm,
      and each PV was identified and paced. During spontaneous APDs initiating atrial
      fibrillation and PV pace maps, the atrial activation and the earliest electrogram
      at CS and CT were compared. PV sites were designated as sites of origin of APDs
      when (1) intracardiac electrograms in the CS and CT during arrhythmogenic APDs
      matched those of PV pace maps, (2) local activation preceded CS and CT recordings
      by at least 40 msec (all sites), and (3) atrial depolarizations were eliminated
      by application of radiofrequency energy (24/26 sites). Pacing from each of the 30
      right PV sites resulted in proximal to distal CS activation and later recordings
      at the CS than the CT (earliest CS-CT activation range: -15 to -58 msec, mean -32
      +/- 12). In contrast, pacing from the left PV sites typically (28/30 sites)
      activated the CS from the distal to proximal poles and demonstrated simultaneous
      or earlier (CS-CT range: -14 to +54 msec, mean 13 +/- 17) recordings of the CS
      than the CT (P < 0.0001). For 13 APDs mapped to the right PVs, CS minus CT
      activation was -17 to -49 msec (mean -31 +/- 8). For 13 APDs localized to the
      left PVs, the CS minus CT activation time ranged from -8 to +28 msec (mean 14 +/-
      15). CONCLUSION: Activation sequence mapping from multipolar catheters placed in
      the CS and along the posterior medial CT rapidly differentiates right and left PV
      sites of origin of atrial depolarization.

PMID- 11196551
TI  - How to find the fibrillating site? Brain exercise versus fancy mapping tools.

PMID- 11196552
TI  - Importance of the atrial channel for ventricular arrhythmia therapy in the dual
      chamber implantable cardioverter defibrillator.
AB  - INTRODUCTION: Performance of dual chamber implantable cardioverter defibrillator
      (ICD) systems has been judged based on functioning of the ventricular
      tachycardia:supraventricular tachycardia (VT:SVT) discrimination criteria and DDD
      pacing. The purpose of this study was to evaluate the use of dual chamber
      diagnostics to improve the electrical and antiarrhythmic therapy of ventricular
      arrhythmias. METHODS AND RESULTS: Information about atrial and ventricular rhythm
      in relation to ventricular arrhythmia occurrence and therapy was evaluated in 724
      spontaneous arrhythmia episodes detected and treated by three types of dual
      chamber ICDs in 41 patients with structural heart disease. Device programming was
      based on clinically documented and induced ventricular arrhythmias. In ambulatory
      patients, sinus tachycardia preceded ventricular arrhythmias more often than in
      the hospital during exercise testing. The incidence of these VTs could be reduced
      by increasing the dose of a beta-blocking agent in only two patients. In five
      patients in whom sinus tachycardia developed after onset of hemodynamic stable
      VT, propranolol was more effective than Class III antiarrhythmics combined with
      another beta-blocking agent with regard to the incidence of VT and pace
      termination. In all but three cases, atrial arrhythmias were present for a longer
      time before the onset of ventricular arrhythmias. During atrial arrhythmias, fast
      ventricular rates before the onset of ventricular rate were observed more often
      than RR irregularities and short-long RR sequences. Dual chamber diagnostics
      allowed proper interpretation of detection and therapy outcome in patients with
      different types of ventricular arrhythmia. CONCLUSION: The advantages of the dual
      chamber ICD system go further than avoiding the shortcomings of the single
      chamber system. Information from the atrial chamber allows better device
      programming and individualization of drug therapy for ventricular arrhythmia.

PMID- 11196553
TI  - Effect of sodium channel blockers on ST segment, QRS duration, and corrected QT
      interval in patients with Brugada syndrome.
AB  - INTRODUCTION: Brugada syndrome is characterized by an ST segment elevation in
      leads V1-V3 and a high incidence of ventricular fibrillation (VF). A mutation in
      a cardiac Na+ channel gene, SCN5A, has been linked to Brugada syndrome, and
      sodium channel blockers have been shown to be effective in unmasking the syndrome
      when concealed. The aim of this study was to examine the effects of Na+ channel
      blockers on ST segment elevation, QRS, corrected QT (QTc) interval, and
      ventricular arrhythmias in patients with Brugada syndrome. METHODS AND RESULTS:
      We examined the effects of three different Na+ channel blockers (flecainide,
      disopyramide, and mexiletine) on the amplitude of the ST segment 20 msec after
      the end of QRS (ST20), QRS duration, QTc interval measured from 12-lead ECG, and
      ventricular arrhythmias in 12 Brugada and 10 control patients. Maximum ST20
      observed in the V2 or V3 leads under baseline conditions was greater in the
      Brugada patients than in control patients, whereas QRS duration and maximum QTc
      interval were no different between the two groups. Flecainide and disopyramide,
      but not mexiletine, significantly increased maximum ST20 and QRS duration in both
      groups, although these effects were much more pronounced in the Brugada patients.
      The increases in ST20 and QRS duration with flecainide were significantly larger
      than those with disopyramide. An increase of 0.15 mV in ST20 with flecainide
      separated the two groups without overlap. Ventricular premature complexes
      developed only with flecainide in Brugada patients (3/12) displaying a marked ST
      elevation but not widening of QRS. CONCLUSION: Our findings suggest that Na+
      channel blockers amplify existing I(Na) and possibly other ion channel defects,
      with a potency inversely proportional to the rate of dissociation of the drug
      from the Na+ channel, thus causing a prominent elevation of the ST segment and,
      in some cases, prolongation of QRS duration in patients with Brugada syndrome.

PMID- 11196554
TI  - ST segment elevation and sudden cardiac death: from the Brugada syndrome to acute
      myocardial ischemia.

PMID- 11196555
TI  - Continuous telemetry from a chronic canine model of sudden cardiac death.
AB  - INTRODUCTION: We sought to develop a continuously telemetered animal model of
      sudden cardiac death (SCD) to study the role of existing infarcts and acute
      ischemia in fatal arrhythmias. METHODS AND RESULTS: A telemetry system capable of
      recording eight channels of electrophysiologic data continuously and chronically
      has been developed. To demonstrate the use of this technology in an animal model
      of sudden death, 12 anesthetized dogs were instrumented with eight electrodes
      located in endocardium of the right side of the heart, epicardium of the left
      ventricle (LV), or in the subcutaneous tissues. The left anterior descending
      (LAD) coronary artery was occluded for 90 minutes and reperfused to produce LV
      infarction. A copper wire was placed in the left circumflex (LCX) coronary artery
      to cause intimal injury in a second arterial bed. The telemetry unit recorded
      deaths in seven animals between 19 to 64 hours after surgery. Five animals that
      did not experience SCD by the fifth postoperative day served as controls. There
      were three modes of SCD: complex ventricular ectopy that degenerated into
      ventricular fibrillation (VF, n = 4); normal sinus rhythm that suddenly
      degenerated into VF (n = 1); and bradycardia (RR intervals >1,000 msec) that
      lasted >3 minutes and preceded VF (n = 2). ST segment changes were significantly
      greater in the LCX-bed electrograms for tachyarrhythmic compared to
      bradyarrhythmic deaths (mean +/- SD; 4.0 +/- 3.4 mV and 0.2 +/- 0.8 mV,
      respectively). Fast Fourier transform showed the peak frequency of VF 10 seconds
      after onset was significantly higher in the five dogs with initial
      tachyarrhythmias compared with the VF that followed profound bradycardia (6.5 +/-
      3.1 Hz and 3.7 +/- 0.6 Hz, respectively). Computer-assisted planimetry of
      postmortem heart slices revealed that infarcts in the two dogs with bradycardic
      events were larger (19.7% +/- 2.2% of the LV and septal mass) than in the five
      dogs with tachyarrhythmias (7.7% +/- 2.4%) or in the five control dogs (11.9% +/-
      8.1%). CONCLUSION: It is possible to record via telemetry the events leading to
      SCD in an animal model. Continuous telemetry monitoring demonstrated that both
      tachyarrhythmias and bradyarrhythmias ultimately resulted in VF in an animal
      model of SCD. Animals with tachyarrhythmic deaths had greate ischemia in the LCX
      bed, smaller preexisting infarcts, and higher VF peak frequency than animals with
      bradyarrhythmic deaths.

PMID- 11196556
TI  - Long-term monitoring of animal models of sudden death.

PMID- 11196557
TI  - Colocalization of tenascin and sympathetic nerves in a canine model of nerve
      sprouting and sudden cardiac death.
AB  - INTRODUCTION: Sympathetic nerve sprouting after myocardial infarction (MI) may
      contribute significantly to the occurrence of ventricular arrhythmia and sudden
      cardiac death. Tenascin-X (TnX), a matrix protein known to be associated with
      nerve growth in central and peripheral nerves, also may play a role in cardiac
      nerve sprouting after MI. METHODS AND RESULTS: Immunocytochemical staining
      techniques were used to identify nerves in 5-microm serial sections from 6 normal
      dogs and 11 dogs with MI. Among the dogs with MI, 4 also received nerve growth
      factor infusion to the left stellate ganglion. The time between MI to tissue
      harvest averaged 35.7 +/- 14.4 days. Tyrosine hydroxylase (TH) stain was used to
      identify sympathetic nerves, and growth-associated protein-43 (GAP-43) was used
      to identify growing nerves. Polyclonal antibody was obtained for use in
      identifying TnX. Nerves were evident in both the infarcted and noninfarcted
      areas. Many nerves were found around blood vessels. A total of 181 nerves in 69
      slides were examined: 89 were from noninfarcted myocardium, 4 from infarct, 13
      from infarct border zone, and 75 from perivascular regions. Except in normal
      dogs, all nerves stained positive for TH also stained positive for GAP-43,
      indicating sympathetic nerve sprouting after MI. In all dogs, the nerves that
      stained positive for TH also stained positive for TnX. CONCLUSION: There is a
      colocalization of TnX, GAP-43, and TH in sprouted cardiac nerves. These results
      suggest that TnX is important not only in the existing normal myocardial nerve
      cells but also in cardiac sympathetic nerve sprouting after MI.

PMID- 11196558
TI  - Mechanisms of sympathetic neural regeneration after myocardial infarction: more
      questions than answers.

PMID- 11196559
TI  - Is all ventricular fibrillation the same? Influence of mode of induction on
      characteristics of ventricular fibrillation.
AB  - INTRODUCTION: Little information is available on the relationship between the
      mode of induction of ventricular fibrillation (VF) to VF characteristics. METHODS
      AND RESULTS: VF was induced from the anterior left ventricle by programmed
      electrical stimulation, burst pacing, alternating current (AC), high current S2
      at a site remote from S1, T wave shock, and intersecting wavefronts in seven
      normal dogs and seven dogs with chronic myocardial infarction. Using two
      electrode arrays, 112 electrograms were recorded from the anterior and lateral
      wall. Cycle lengths were analyzed and activation vectors were created by summing
      orthogonally recorded bipolar electrograms. The magnitude of the vector loops was
      integrated over time to produce an "ensemble vector" index (EVI) whose magnitude
      is high when beat-to-beat activation direction is consistent and low when
      activation direction is variable. T wave shock-induced VF had a significantly
      longer cycle length 1 to 5 seconds after VF onset than other modes of induction
      (P < 0.05). The frequency-corrected EVI was significantly larger for AC current
      and T wave shock-induced VF as opposed to all other modes of VF induction in
      early VF (P < 0.0001). After 10 seconds of VF, these differences persisted only
      on the anterior wall. CONCLUSION: VF induced in animals by T wave shock and AC
      current had different characteristics than VF induced by other methods. These
      findings may have implications for our understanding of VF pathophysiology.

PMID- 11196560
TI  - Fibrillation is more complex in the left ventricle than in the right ventricle.
AB  - INTRODUCTION: The mechanisms that maintain ventricular fibrillation (VF) are not
      completely understood. It has been proposed that increased ventricular wall
      thickness destabilizes VF wavefronts and therefore is an important determinant of
      VF activation patterns. We hypothesized that if this is the case, then VF
      patterns on the thin-walled right ventricle (RV) should be simpler than those on
      the thick-walled left ventricle (LV). METHODS AND RESULTS: In seven open chest
      pigs, we mapped VF simultaneously from two epicardial recording arrays, one on
      the RV and one on the LV. Each array contained 504 unipolar electrodes (in a 21 x
      24 grid) spaced by 2 mm. We used specialized pattern analysis methods to compute
      quantitative descriptors of RV and LV activation patterns. Our data show that VF
      is more organized in the RV than the LV, containing fewer, larger wavefronts that
      follow fewer distinct pathways and are less likely to fragment or collide with
      other wavefronts. The incidence, size, and cycle length of reentrant circuits
      were similar in the two ventricles, but RV reentry persisted for more cycles.
      These results are not predicted by the differences in electrophysiologic
      properties between LV and RV that have been reported in mammalian hearts.
      CONCLUSION: The geometry of the ventricular wall, particularly wall thickness, is
      an important determinant of VF activation patterns.

PMID- 11196561
TI  - Understanding ventricular fibrillation by quantifying the complexity of
      activation patterns.

PMID- 11196562
TI  - Profibrillatory effects of verapamil but not of digoxin in the goat model of
      atrial fibrillation.
AB  - INTRODUCTION: Verapamil and digoxin have been shown to modulate tachycardia
      induced atrial electrical remodeling. The goal of the present study was to
      determine the direct effects of verapamil and digoxin on atrial fibrillation
      (AF), before and after electrical remodeling. METHODS AND RESULTS: In six goats
      we measured the AF cycle length (AFCL) and duration of AF (DurAF) of 50
      consecutive induced paroxysms, before (t = 0) and after 24 hours (t = 24) of
      electrical remodeling. During AF, conduction velocity (CV(AF)), refractory period
      (RP(AF)), and type of AF (I, II, III) were determined. Verapamil was administered
      at a loading dose of 0.1 mg/kg, followed by a continuous (2-hour) infusion of 5
      microg/kg/min. Digoxin was given intravenously as a single 0.02 mg/kg bolus. At t
      = 0 and t = 24, digoxin and verapamil caused a significant slowing of the
      ventricular rate of >40%. Digoxin had no effect on DurAF, AFCL, CV(AF), or
      RP(AF). Infusion of verapamil had a direct proarrhythmic effect. Both at t = 0
      and t = 24, AFCL and RP(AF) were shortened by about 15%. During acute AF,
      verapamil prolonged the average duration of AF paroxysms from 7 to 16 seconds.
      After 24 hours of AF, the proarrhythmic effect was much stronger. Shortly after
      starting infusion (6 +/- 2 min), verapamil converted paroxysmal AF into sustained
      AF. As long as verapamil infusion was maintained, AF no longer terminated in any
      of the goats. This effect was associated with an increase in AF fragmentation
      from type I to type II-III. CONCLUSION: Verapamil shortens AFCL and RP(AF) in the
      presence and absence of electrical remodeling. After 24 hours, it exerted a
      marked proarrhythmic effect and converted paroxysmal (type I) into sustained
      (type III) AF. In contrast, digoxin had no effect on the rate or stability of AF.

PMID- 11196563
TI  - Termination of spiral waves with biphasic shocks: role of virtual electrode
      polarization.
AB  - INTRODUCTION: This simulation study seeks to extend the virtual electrode
      polarization (VEP) theory for defibrillation to explain the success and failure
      of biphasic shocks. The goals of the study are to (1) provide insight into why
      optimal biphasic shocks have a lower voltage defibrillation threshold than
      monophasic shocks, (2) examine the mechanisms of biphasic shock failure and to
      determine whether they differ from those of monophasic shocks, and (3) study how
      the timing of biphasic shock delivery to a spiral wave affects voltage
      defibrillation threshold. METHODS AND RESULTS: A spiral wave is initiated in a
      bidomain representation of a 2-cm x 2-cm sheet of ventricular myocardium. The
      model incorporates nonuniform fiber curvature, membrane kinetics suitable for
      high-strength shocks, and electroporation. A spatially uniform extracellular
      field is delivered by line electrodes. The shock establishes VEP that dictates
      the postshock activity in the tissue. Our results demonstrate that the second
      phase of biphasic shocks leaves the tissue with substantially smaller postshock
      excitable gap, thus eliminating the majority of the substrate for reinitiation of
      reentrant activity. Further, the occurrence of break excitations for weaker
      biphasic shocks indicates that the mechanisms for biphasic shock failure are more
      complex than for monophasic shocks. Biphasic voltage defibrillation thresholds
      range from 8 to 16 V/cm, depending on the position of the spiral wave. An
      increase in the amount of preshock excitable gap leads to an increase in voltage
      defibrillation threshold. CONCLUSION: This study demonstrates the importance of
      VEP and its interaction with preshock activity in the success and failure of
      biphasic defibrillation shocks.

PMID- 11196564
TI  - Time course of left atrial mechanical recovery after linear lesions: normal sinus
      rhythm versus a chronic atrial fibrillation dog model.
AB  - INTRODUCTION: The extent of left atrial (LA) mechanical function recovery after
      creation of linear lesions using the loop catheter has not been determined.
      METHODS AND RESULTS: LA mechanical function was assessed before and after linear
      lesions using transthoracic two-dimensional and Doppler echocardiography in two
      groups: (1) normal, which consisted of eight healthy dogs in normal sinus rhythm
      (NSR); and (2) atrial fibrillation (AF), which consisted of nine dogs in
      spontaneous AF for 6 months following rapid pacing-induced AF. NSR was restored
      with linear lesions in all AF dogs. All animals were in NSR 5 months after linear
      lesions. In the normal dogs, the maximal velocity of the transmitral flow "A"
      wave was reduced by 42% during the first week postablation and by 24% at 5 months
      versus preablation. At 5 months, no differences in LA function were noted between
      the normal and the AF group for all measured Doppler parameters. At 5 months, the
      LA systolic area in AF dogs was reduced by 40% (preablation 12.9 +/- 2.9 cm2,
      postablation 7.6 +/- 1.2 cm2; P < 0.01) and in the normal dogs by 21%
      (preablation 10.0 +/- 0.9 cm2, postablation 7.8 +/- 1.2 cm2; P < 0.02), being the
      same in both groups within 3 months of recovery. CONCLUSION: The creation of
      linear lesions with the loop catheter does not result in LA expansion. In normal
      dogs, LA mechanical activity is reduced for 3 weeks postablation. The time course
      of LA mechanical function recovery is the same for the AF and the NSR dogs, and
      it is complete at 3 months postablation. At 5 months, LA systolic function
      parameters in both groups are reduced by 24% versus the preablation values of the
      normal dogs. Linear lesions result in a significant reduction in LA size.

PMID- 11196565
TI  - In atrial fibrillation, size does matter.

PMID- 11196566
TI  - Endocardial noncontact activation mapping of idiopathic left ventricular
      tachycardia.
AB  - Idiopathic left ventricular tachycardia with a right bundle, left-axis deviation
      is thought to originate from posterior fascicles. Recently, there has been
      considerable interest in the anatomic and mechanistic basis of this arrhythmia.
      We report our experience with a 26-year-old man in whom new noncontact mapping
      technology was used to acquire detailed data from the left ventricle, identify
      the mid-diastolic potential and part of the ventricular tachycardia circuit, and
      perform successful ablation. This information helped define the physiologic
      aspects of this unique tachycardia.

PMID- 11196567
TI  - Long QT syndrome: cellular basis and arrhythmia mechanism in LQT2.
AB  - LQT2 is one form of the congenital long QT syndrome. It results from mutations in
      the human ether-a-go-go-related gene (HERG), and more than 80 mutations, usually
      causing single amino acid substitutions in the HERG protein, are known. HERG
      encodes the ion channel pore-forming subunit protein for the rapidly activating
      delayed rectifier K+ channel (I(Kr)) in the heart. This review summarizes current
      findings about mutations causing LQT2, the mechanisms by which mutations may
      cause the clinical phenotype of a reduction in I(Kr) and a prolonged QT interval,
      and how this may be involved in the generation of ventricular arrhythmias.

PMID- 11196568
TI  - An electrocardiographic masquerade.
AB  - A 60-year-old woman underwent successful pulmonary embolectomy for a massive
      pulmonary embolism. On postoperative day 2, while receiving intravenous dopamine
      for hypotension, she developed the tachycardia, and a 12-lead ECG was obtained
      (Fig. 1). Figure 2 shows the 12-lead ECG obtained on the previous day, when she
      was in sinus rhythm with frequent premature

PMID- 11196569
TI  - Prolonged atrioventricular block during AAI pacing for sick sinus syndrome.

PMID- 11196571
TI  - Asymmetric photolysis with elliptically polarized light.
AB  - Previous investigations have shown the efficacy of right-(RCPL) and left-(LCPL)
      circularly polarized light in promoting the asymmetric photolysis of racemic
      organic substrates and producing measurable enantiomeric excesses (e.e.s) when
      photolysis is incomplete. Synchrotron radiation, polychromatic and having out-of
      plane components which are elliptically and ultimately circularly polarized, has
      been suggested as a universal source of RCPL and LCPL on a cosmic scale. The more
      prevalent right-(REPL) and left-(LEPL) elliptically polarized components have
      never been investigated for similar capabilities. The present study, using a
      212.8 nm laser beam to mimic the synchtrotron radiation, explores the potential
      of REPL and LEPL in this context and finds a qualitative trend indicating that
      each induces asymmetric photolysis in the same sense as RCPL and LCPL, but to a
      lesser degree.

PMID- 11196570
TI  - Nonenzymatic template-directed condensation of short-chained oligouridylates on a
      poly(A) template.
AB  - An oligouridylate with chain-length of more than three was condensed on a
      polyadenylate [poly(A)] template with 1-ethyl-3-(3
      dimethylaminopropyl)carbodiimide (EDAC) in imidazole buffer. The condensation
      reaction proceeds via the phosphorimidazolide of the oligouridylate as an
      intermediate. Pentauridylate [(pU)5] was converted to decauridylate [(pU)10] in
      10% yield at 0 degree C for 7 days in the presence of the poly(A) template, while
      no coupling product was obtained in the absence of the poly(A) template. The
      resulting linkage of the (pU)10 was mainly 2'-5' linkage.

PMID- 11196572
TI  - Synthesizing oligomers from monomeric nucleotides in simulated hydrothermal
      environments.
AB  - Dimers and trimers of adenosine monophosphate (AMP) were synthesized from AMP in
      environments simulating hot vents on the sea floor of the primitive Earth. The
      simulated environments were made in the flow reactor, in which an aqueous
      solution of reactants was circulated from the hot to the cold region repeatedly.
      The oligomerization proceeded most significantly when the hot reaction solution
      at about 110 degrees C was abruptly ejected into the cold environment maintained
      at about 0 degree C.

PMID- 11196573
TI  - Hydrothermal circulation of seawater through hot vents and contribution of
      interface chemistry to prebiotic synthesis.
AB  - Synthesizing oligopeptides from glycine and alanine in a flow reactor, which
      stimulates constant hydrothermal circulation of seawater through hot vents on the
      primitive Earth, demonstrated that an exponential growth of the products is
      possible. The initial rapid growth of the product is a consequence of using the
      products formed in one cycle as the starting materials for the cycle of
      synthesis.

PMID- 11196574
TI  - Prebiotic methylation and the evolution of methyl transfer reactions in living
      cells.
AB  - An hypothesis is presented for the prebiotic origin of methyl groups and the
      evolution of methyl transfer reactions in living cells. This hypothesis,
      described in terms of prebiotic and early biotic chemical evolution, is based on
      experimental observations in our lab and in those of others, and on the
      mechanisms of enzymatic methyl transfer reactions that occur in living cells. Of
      particular interest is our demonstration of the reductive methylation of
      ethanolamine and glycine in aqueous solution by excess formaldehyde. These
      reactions, involving prebiotic compounds and conditions, are mechanistically
      analogous to the de novo origin of methyl groups in modern cells by reduction of
      methylene tetrahydrofolate. Furthermore, modern cellular methyl transfers from S
      adenosylmethionine to amine nitrogen may involve formaldehyde as an intermediate
      and subsequent reductive methylation, analogous to the prebiotic chemistry
      observed herein.

PMID- 11196575
TI  - Formation of peptide bonds from metastable versus crystalline phase: implications
      for the origin of life.
AB  - Formation of peptide bonds was attempted by thermal activation of dry amino acids
      from aqueous solution that simulated prebiotic evaporative environments. The
      evaporation trend of amino acids solutions shows a bifurcation and can lead to
      either a crystalline phase (near equilibrium) or a metastable non-crystalline
      phase (far from equilibrium). Only amino acids in this metastable phase are able
      to form peptide bonds by thermal activation at temperatures that are generated by
      solar radiation today. We suggest that this metastable phase is the ideal initial
      material to trigger amino acid assemblage with protein-like structure because
      provide the driving force (supersaturation) for an intense interaction between
      monomers of different amino acids and allows activation of these monomers in
      plausible prebiotic conditions.

PMID- 11196576
TI  - Abiotic synthesis of guanine with high-temperature plasma.
AB  - The origin of guanine has been unknown, though there are some reports concerning
      its abiotic synthesis. We show here that guanine, as well as uracil and cytosine,
      are synthesized from a 90%N2-10%CO-H2O gas mixture via a complex organic product
      produced with the high-temperature and rapid quenching technique. This result
      implies that a large amount of complex organic matter including precursors of
      bioorganic compounds might have been produced on the primitive earth after
      cometary impacts.

PMID- 11196577
TI  - Fine structure of fossilized bacteria in Volyn kerite.
AB  - Ultrathin sectioning and cryofracture of fibrous kerite, sampled from 1.8-1.75
      billion year old Volyn sediments (Ukraine), revealed in bacteria-like bodies the
      presence of structures similar to sheath, cell wall, periplasm, cytoplasm,
      septum, membranes, intramembrane particles, poly-beta-hydroxybutyrate inclusions.
      On the strength of these data and also the fatty acid profiles of these
      microfossils, we concluded that fibrous kerites are biogenic formations, namely
      fossilized bacterial mats.

PMID- 11196578
TI  - [Intracellular calcium: physiology and physiopathology].
AB  - Many important aspects of our life are regulated by the free cytosolic Ca2+
      concentration. The intracellular Ca2+ signal is regulated both in space,
      frequency and amplitude. Each cell chooses a unique set of Ca2+ signals to
      control its function. Ca2+ signal transduction is based on rises in free
      cytosolic Ca2+ concentration. Ca2+ can come from the extracellular space or be
      released from intracellular stores. Extracellular Ca2+ enters the cell through
      various types of plasma-membrane Ca2+ channels and leaves the cell using Ca2+
      pumps and Na+/Ca(2+)-exchangers. Ca2+ is accumulated in intracellular stores by
      means of Ca2+ pumps and is released via inositol 1,4,5-trisphosphate (IP3) and
      ryanodine receptors. Mutations or abnormalities in one of the above mentioned
      Ca(2+)-transporting proteins can lead to disease. Skeletal-muscle pathology can
      be caused by abnormal ryanodine receptors (malignant hyperthermia, porcine stress
      syndrome, central core disease), plasma-membrane Ca2+ channels (hypokalemic
      periodic paralysis, muscular dysgenesis mice, paraneoplastic Lambert-Eaton
      myasthenia syndrome) or Ca2+ pumps (Brody disease). Neurologic disorders can be
      related to altered function of plasma-membrane Ca2+ channels (episodic ataxia
      type 2, spinocerebellar ataxia type 6, familial hemiplegic migraine, glutamate
      excitotoxicity, tottering, leaner, lethargic and stargazer mice), IP3 receptors
      (Lowe's oculocerebrorenal syndrome, manic depression, Alzheimer's disease,
      opisthotonos mice) and Ca2+ pumps (deafwaddler mouse and wriggle mouse sagami).
      Two skin diseases are caused by Ca(2+)-pump mutations (Darier disease and Hailey
      Hailey disease). Incomplete X-linked congenital stationary night blindness is
      caused by a mutation in the plasma-membrane Ca2+ channels in rods and cones.

PMID- 11196579
TI  - [Intra- and intercellular Ca(2+)-signal transduction].
AB  - Calcium is one of the most universal signal-transduction elements in a large
      variety of cells ranging from bacteria to specialized neurons. Ca2+ acts as a
      second messenger controlling such processes as secretion, cell differentiation or
      signal transmission. In order to be able to execute their specific functions and
      to react in a coordinated way to stimuli, multicellular organs need a precise
      orchestration of cellular functions. For this purpose cells have developed
      different forms of intercellular communication (IC). In this study we
      investigated a number of mechanisms of intracellular propagation and IC using
      experiments with fluorescent Ca(2+)-indicators, confocal microscopy and digital
      imaging techniques. In ROS 17/2.8 osteoblasts, retinal pigment epithelial cells
      (RPE) and CPAE endothelial cells, a small mechanical deformation of the plasma
      membrane results in a transient increase of free cytoplasmic Ca2+ concentration
      ([Ca2+]i). This Ca(2+)-rise starts at the site of stimulation and propagates
      concentrically to neighboring cell layers. The intracellular Ca(2+)-wave in RPE
      and ROS cells is caused by Ca(2+)-influx followed by Ca(2+)-release from the
      intracellular stores and by intercellular propagation of the Ca(2+)-wave. The
      [Ca2+]i-transient upon mechanical stimulation of LLC-PK1 epithelial cells, C6
      glioma cells and MLO-Y4 osteocytes was limited and/or variable. In CPAE cells
      only the intracellular release is important for evoking the Ca(2+)-transient, and
      is followed by IC. IC can occur via gap junctions (GJ) consisting of membrane
      spanning proteins, connexins (Cx). It was demonstrated that IC and GJ in RPE and
      ROS cells can be reversibly blocked by gap-junction inhibitors such as heptanol
      or halothane. We demonstrated important differences in modulation of gap
      junctional communication between these cell types. While in RPE cells stimulation
      of PKC activity was able to inhibit IC, this was not the case in ROS cells. We
      screened LE-RPE cDNA via PCR using specific primers for different connexins and
      found no effect of high glucose solutions, which cause decreased intercellular
      communication, on the Cx-isoforms expressed. Cx43 is the only Cx-isoform present
      at the protein level for which Western blot analysis revealed the presence of
      different forms corresponding to different phosphorylated states. Increased
      phosphorylation of Cx43 was only seen after direct PKC activation by PMA, but not
      by indirect PKC activation by high glucose levels. The decreased communication by
      high glucose concentrations was however associated by a decreased expression of
      cellular Cx43 to about 3/4 of the level in control conditions. High glucose
      concentrations therefore decrease Cx43 at the protein level via a PKC effect that
      appears to be independent of the direct activation of PKC by phorbolesters.
      Mechanical stimulation did not evoke intercellular Ca(2+)-waves in LLC-PK1
      epithelial cells, C6 glioma cells and MLO-Y4 osteocytes. In CPAE-endothelial
      cells, the contribution of gap junctions to IC following mechanical stimulation
      is negligible, and modulation of gap junctions via phosphorylation or high
      glucose solutions is absent. Perfusion experiments and pharmacological studies
      demonstrated that IC following mechanical stimulation of these cells occurs via
      release of an extracellular mediator. Our experiments provide strong evidence in
      favor of purinergic agonists as mediators, such as ATP but mainly ADP. In
      conclusion we can say that cells contain a wide spectrum of mechanisms for intra-
      and intercellular communication, and that widely different mechanisms can evoke
      the same phenomenon of intra- and intercellular Ca(2+)-waves.

PMID- 11196580
TI  - [Antisense constructs, therapeutics of the future?].
AB  - Two lines of research were followed to obtain an adequate antisense effect.
      Natural oligonucleotides can degrade their mRNA targets catalytically, but are
      prone to enzymatic instability. Therefore, we looked for the minimal molecular
      modification, which would yield nuclease stable constructs, which can be taken up
      sufficiently to exert a selective antiproliferative effect. Small aliphatic diols
      conjugated at the 3'-end yielded such constructs, enabling selective tumor growth
      inhibition in an experimental in vivo situation. Further studies with complexing
      agents which increase their stability as well as uptake are ongoing. Another
      strategy aimed at obtaining strongly binding analogs, which would allow mRNA
      translation inhibition by steric interference. Hexitol nucleic acids (HNA) by
      virtue of their high and selective affinity for RNA, are therefore a prime
      candidate. When targeting the translation initiation regions, and using a
      lipofection protocol, nice activities were obtained at inhibiting Plasmodium,
      ICAM-1 and Ha-ras mRNA expression. Therefore, uptake should not be a limiting
      factor for the development of HNA as antisense therapeutics.

PMID- 11196582
TI  - Turing instabilities in general systems.
AB  - We present necessary and sufficient conditions on the stability matrix of a
      general n(> or = 2)-dimensional reaction-diffusion system which guarantee that
      its uniform steady state can undergo a Turing bifurcation. The necessary
      (kinetic) condition, requiring that the system be composed of an unstable (or
      activator) and a stable (or inhibitor) subsystem, and the sufficient condition of
      sufficiently rapid inhibitor diffusion relative to the activator subsystem are
      established in three theorems which form the core of our results. Given the
      possibility that the unstable (activator) subsystem involves several species
      (dimensions), we present a classification of the analytically deduced Turing
      bifurcations into p (1 < or = p < or = (n - 1)) different classes. For n = 3
      dimensions we illustrate numerically that two types of steady Turing pattern
      arise in one spatial dimension in a generic reaction-diffusion system. The
      results confirm the validity of an earlier conjecture [12] and they also
      characterise the class of so-called strongly stable, matrices for which only
      necessary conditions have been known before [23, 24]. One of the main
      consequences of the present work is that biological morphogens, which have so far
      been expected to be single chemical species [1-9], may instead be composed of two
      or more interacting species forming an unstable subsystem.

PMID- 11196581
TI  - Asymptotics of the total net direct pharmacological effect for large drug doses.
AB  - The direct pharmacological effect E is described by the Emax model relating E to
      the drug plasma concentration Cp. The area under the effect vs. time curve (AUCE)
      is used as the measurement of the total net pharmacological effect. The drug
      plasma concentrations are solutions of compartmental systems of ordinary
      differential equations with the input terminated after a finite time and
      controlled in a proportional manner by a single dose-like parameter. The
      asymptotics of the time derivative of Cp for large doses are derived and used as
      conditions which have to be satisfied by functions for which the asymptotics of
      the integral defining AUCE are derived. The AUCE is proportional to the time TC >
      EC50 for which the drug concentration stays above the threshold level EC50. The
      threshold EC50 denotes the drug plasma concentration which elicits 50% of the
      maximum effect. The parameter TC > EC50 is proportional to the logarithm of drug
      dose for large doses and its asymptotics is calculated up to the order o(1) as
      dose increases to infinity. The results are applied to basic pharmacokinetic
      systems.

PMID- 11196583
TI  - Analysis of clustered firing patterns in synaptically coupled networks of
      oscillators.
AB  - Oscillators in networks may display a variety of activity patterns. This paper
      presents a geometric singular perturbation analysis of clustering, or alternate
      firing of synchronized subgroups, among synaptically coupled oscillators. We
      consideroscillators in two types of networks: mutually coupled, with all-to-all
      inhibitory connections, and globally inhibitory, with one excitatory and one
      inhibitory population of oscillators, each of arbitrary size. Our analysis yields
      existence and stability conditions for clustered states, along with formulas for
      the periods of such firing patterns. By using two different approaches, we derive
      complementary conditions, the first set stated in terms of time lengths
      determined by intrinsic and synaptic properties of the oscillators and their
      coupling and the second set stated in terms of model parameters and phase space
      structures directly linked to parameters. These results suggest how biological
      components may interact to produce the spindle sleep rhythm in thalamocortical
      networks.

PMID- 11196584
TI  - A new explicit stability criterion for human periodic breathing.
AB  - The aim of this paper is to carry out a stability analysis for periodic breathing
      in humans that incorporates the dynamic characteristics of ventilation control. A
      simple CO2 model that takes into account the main elements of the respiratory
      system, i.e. the lungs and the ventilatory controller with its dynamic
      properties, is presented. This model results in a three-dimensional non-linear
      delay differential system for which there exists a unique equilibrium point. Our
      stability analysis of this equilibrium point leads to the definition of a new
      explicit stability criterion and to the demonstration of the existence of a Hopf
      bifurcation. Numericall simulations illustrate the influence of physiological
      parameters on the stability of ventilation. and particularly the major role of
      the dynamic characteristics of the respiratory controller.

PMID- 11196585
TI  - Stochastic epidemics in dynamic populations: quasi-stationarity and extinction.
AB  - Empirical evidence shows that childhood diseases persist in large communities
      whereas in smaller communities the epidemic goes extinct (and is later
      reintroduced by immigration). The present paper treats a stochastic model
      describing the spread of an infectious disease giving life-long immunity, in a
      community where individuals die and new individuals are born. The time to
      extinction of the disease starting in quasi-stationarity (conditional on non
      extinction) is exponentially distributed. As the population size grows the
      epidemic process converges to a diffusion process. Properties of the limiting
      diffusion are used to obtain an approximate expression for tau, the mean
      parameter in the exponential distribution of the time to extinction for the
      finite population. The expression is used to study how tau depends on the
      community size but also on certain properties of the disease/community: the basic
      reproduction number and the means and variances of the latency period, infectious
      period and life-length. Effects of introducing a vaccination program are also
      discussed as is the notion of the critical community size, defined as the size
      which distinguishes between the two qualitatively different behaviours.

PMID- 11196586
TI  - [Vasculitis: are we talking about the same thing?].

PMID- 11196587
TI  - [Respiratory complications in hematopoietic stem cell transplantation. What does
      radiology contribute?].
AB  - OBJECTIVE: To determine the incidence of respiratory complications and their
      manifestations in both conventional radiology and high-resolution computerized
      tomography (HRCT) in a series of patients who had undergone blood progenitor cell
      transplantation (BPCT). The objective was to evaluate whether the radiological
      findings associated with post-transplantation time can be useful for establishing
      the differential diagnosis. PATIENTS AND METHODS: A study was undertaken of a
      total of 108 consecutive patients who had undergone BPCT and were alive one year
      after; from these patients a selection was made of those who had some respiratory
      complications during the first year after transplantation. Complications were
      classified in three different groups on the basis of time elapsed since
      transplantation (early, intermediate, and late stages). Chest X-ray films of each
      patient were examined and in 17 cases the study was completed with HRCT. These
      findings were correlated with both definitive diagnosis and time elapsed since
      BPCT. The following procedures were useful for diagnostic confirmation: blood
      culture, sputum culture, fibrobronchoscopy with bronchoalveolar lavage or lung
      biopsy, biopsy by other methods, necropsy, or clinical course after empirical
      therapy. RESULTS: Thirty-three out of the 108 patients undergoing BPCT had some
      form of respiratory complication during the first year after transplantation. The
      most common radiological pattern both in the chest X-ray and in HRCT was alveolar
      consolidation. Other findings included ground-glass appearance, interstitial
      pattern, pulmonary nodules, and pleural effusion. The diagnoses in relation to
      the different stages of transplantation were: a) early stage: three cases of
      heart failure, two cases of alveolar hemorrhage, two cases of pulmonary
      aspergillosis and three cases of undocumented complications; b) intermediate
      stage: four cases of cytomegalovirus pneumonia, one case of pulmonary
      aspergillosis, two cases of bacterial pneumonia, and two cases of undocumented
      pneumonitis; c) late stage: four cases of bacteriologically documented pneumonia,
      two cases of pneumonitis with an unidentified agent, two cases of graft-versus
      host disease, one case of pulmonary aspergillosis and two complications without
      established diagnosis. CONCLUSIONS: The relationship between radiological
      findings and time elapsed since transplantation of blood precursor cells is very
      useful for establishing the diagnosis of pulmonary complications. High resolution
      computerized tomography is useful for detecting unnoticed lesions in conventional
      X-ray, and for diagnosing bronchiolitis obliterans and some fungal lesions.

PMID- 11196588
TI  - [Churg-Strauss syndrome. Our experience in 2 decades].
AB  - BACKGROUND: Since 1951, the year when the Churg-Strauss syndrome was reported,
      several isolated cases have been reported in the literature but works containing
      a high number of cases are exceptional. The features of the syndrome as well as
      diagnostic criteria have not been contrasted in large series. We therefore tried
      to analyze these parameters in 16 patients diagnosed of Churg-Strauss syndrome at
      our hospital. METHODS: A retrospective analysis was made of 16 patients diagnosed
      of Churg-Strauss syndrome at Hospital Universitario La Paz from 1978 at 1998.
      Data regarding personal antecedents, clinical manifestations, analytical
      parameters, histology and clinical course were collected. Also, the main
      diagnostic criteria reported in the literature were applied to each case.
      RESULTS: Of the 16 cases, thirteen (81%) were women, six were diagnosed at an age
      between 21 and 40 years; other six cases from 51 to 70 years. All patients had
      antecedents of bronchial asthma. Among clinical manifestations, 60% had fever and
      50% a general syndrome. The main involved organs by decreasing frequency were
      lung (100%), nervous system (63%), and heart (44%). The mean eosinophilic count
      was 7,640/mm3. The histological diagnosis was obtained in 14 out of the 16
      patients (88%). The most efficient biopsies corresponded to muscle and nerve.
      After therapy, no relapse was noted of vasculitis although bronchial asthma
      persisted in most patients (12). Twelve cases (75%) fulfilled the Lanham
      diagnostic criteria. CONCLUSIONS: Churg-Strauss syndrome affects mainly women
      with severe eosinophilia. Electromyogram and muscle and peripheral nerve biopsy
      are useful tools for diagnosis. The Lanham criteria lead to the diagnosis in most
      patients.

PMID- 11196589
TI  - [Collagenous colitis: an entity with diverse therapeutic options].
AB  - Collagenous colitis is a disorder which has been diagnosed with increasing
      frequency in the last few years, probably due to the routine obtention of colon
      biopsy specimens in the study of patients with chronic diarrhoea. Good responses
      have been reported with a number of therapies, although only a scarce number of
      clinical trials have been performed, partly because of the small number of
      patients studied. Two cases of collagenous colitis with different therapeutic
      approaches are here reported. All medical therapy options for this interesting
      disorder are reviewed.

PMID- 11196590
TI  - [Colorectal cancer: inducing circumstances (etiology) and pathogenic paths
      (pathogenesis].

PMID- 11196591
TI  - [Diarrhea of nosocomial origin in an adult population].

PMID- 11196592
TI  - [Vaccinations in the patient infected with the human immunodeficiency virus].

PMID- 11196593
TI  - [Indications for the pharmacologic treatment of hyperlipidemias].

PMID- 11196594
TI  - [Diagnostic management of syncope].

PMID- 11196595
TI  - [A patient with dyspnea and pain in the right thigh].

PMID- 11196596
TI  - [Progressively appearing hyperpigmented macules in a patient treated with
      furosemide].

PMID- 11196597
TI  - [Exanthema in a patient infected with the human immunodeficiency virus after
      starting antiretroviral treatment].

PMID- 11196598
TI  - [Necrotic plaques in a patient with chronic renal insufficiency].

PMID- 11196599
TI  - [Prostatic infiltration by non-Hodgkin's lymphoma: report of a case].

PMID- 11196600
TI  - [Human myiasis caused by Sarcophagidae sp. (Diptera) in a post-irradiation
      ulcerative lesion after treatment for an axillary epidermoid carcinoma].

PMID- 11196601
TI  - [Diffuse large cell B lymphoma presenting as clinicohistologic lymphadenopathy].

PMID- 11196602
TI  - [Abrupt decrease in visual acuity in the course of acute pancreatitis].

PMID- 11196603
TI  - [Isolation of human herpesvirus type 6 in the blood of patients receiving a renal
      transplant].

PMID- 11196604
TI  - Is the university-industrial complex out of control?

PMID- 11196605
TI  - Scepticism greets claims that uranium shells cause leukaemia.

PMID- 11196606
TI  - Dye dispute leans Amersham's way.

PMID- 11196607
TI  - Overseas investors plan six 'world class' universities in India.

PMID- 11196609
TI  - Canadian astronomers mount lobby effort.

PMID- 11196608
TI  - Bush targets space-based missile defence system.

PMID- 11196610
TI  - Scientists unimpressed by Australia's funding plan.

PMID- 11196611
TI  - US to take temperature of mercury threat.

PMID- 11196612
TI  - Hunt for Earth-like planets edges towards launch pad.

PMID- 11196613
TI  - Moderate takes key science role in Congress.

PMID- 11196614
TI  - Biologists crusade for evolution.

PMID- 11196615
TI  - Save our swamp.

PMID- 11196616
TI  - Sensitive development could protect Amazonia instead of destroying it.

PMID- 11196617
TI  - How electricity could power the car of today.

PMID- 11196618
TI  - Did agriculture reduce human lifespan?

PMID- 11196619
TI  - You can't have it all.

PMID- 11196621
TI  - The dark cradles of stars.

PMID- 11196620
TI  - Food, song and speciation.

PMID- 11196622
TI  - Haemoglobin scavenger.

PMID- 11196623
TI  - Cancer. Death and methylation.

PMID- 11196624
TI  - Earth science. In the beginning...

PMID- 11196625
TI  - Cardiovascular biology. Small cells, big issues.

PMID- 11196626
TI  - Climatology. Glacial hiccups.

PMID- 11196627
TI  - An enzymic 'latch' on a global carbon store.

PMID- 11196628
TI  - Cross-modal plasticity and cochlear implants.

PMID- 11196629
TI  - Networks of nanotubes and containers.

PMID- 11196630
TI  - Worms start the reef-building process.

PMID- 11196631
TI  - Rapid changes of glacial climate simulated in a coupled climate model.
AB  - Abrupt changes in climate, termed Dansgaard-Oeschger and Heinrich events, have
      punctuated the last glacial period (approximately 100-10 kyr ago) but not the
      Holocene (the past 10 kyr). Here we use an intermediate-complexity climate model
      to investigate the stability of glacial climate, and we find that only one mode
      of Atlantic Ocean circulation is stable: a cold mode with deep water formation in
      the Atlantic Ocean south of Iceland. However, a 'warm' circulation mode similar
      to the present-day Atlantic Ocean is only marginally unstable, and temporary
      transitions to this warm mode can easily be triggered. This leads to abrupt warm
      events in the model which share many characteristics of the observed Dansgaard
      Oeschger events. For a large freshwater input (such as a large release of
      icebergs), the model's deep water formation is temporarily switched off, causing
      no strong cooling in Greenland but warming in Antarctica, as is observed for
      Heinrich events. Our stability analysis provides an explanation why glacial
      climate is much more variable than Holocene climate.

PMID- 11196632
TI  - Internal structure of a cold dark molecular cloud inferred from the extinction of
      background starlight.
AB  - Stars and planets form within dark molecular clouds, but little is understood
      about the internal structure of these clouds, and consequently about the initial
      conditions that give rise to star and planet formation. The clouds are primarily
      composed of molecular hydrogen, which is virtually inaccessible to direct
      observation. But the clouds also contain dust, which is well mixed with the gas
      and which has well understood effects on the transmission of light. Here we use
      sensitive near-infrared measurements of the light from background stars as it is
      absorbed and scattered by trace amounts of dust to probe the internal structure
      of the dark cloud Barnard 68 with unprecedented detail. We find the cloud's
      density structure to be very well described by the equations for a pressure
      confined, self-gravitating isothermal sphere that is critically stable according
      to the Bonnor-Ebert criteria. As a result we can precisely specify the physical
      conditions inside a dark cloud on the verge of collapse to form a star.

PMID- 11196633
TI  - Quantum metallicity in a two-dimensional insulator.
AB  - One of the most far-reaching problems in condensed-matter physics is to
      understand how interactions between electrons, and the resulting correlations,
      affect the electronic properties of disordered two-dimensional systems. Extensive
      experimental and theoretical studies have shown that interaction effects are
      enhanced by disorder, and that this generally results in a depletion of the
      density of electronic states. In the limit of strong disorder, this depletion
      takes the form of a complete gap in the density of states. It is known that this
      'Coulomb gap' can turn a pure metal film that is highly disordered into a poorly
      conducting insulator, but the properties of these insulators are not well
      understood. Here we investigate the electronic properties of disordered beryllium
      films, with the aim of disentangling the effects of the Coulomb gap and the
      underlying disorder. We show that the gap is suppressed by a magnetic field and
      that this drives the strongly insulating beryllium films into a low-temperature
      'quantum metal' phase with resistance near the quantum resistance RQ = h/e2,
      where h is Planck's constant and e is the electron charge.

PMID- 11196634
TI  - The relationship between fragility, configurational entropy and the potential
      energy landscape of glass-forming liquids.
AB  - Glass is a microscopically disordered, solid form of matter that results when a
      fluid is cooled or compressed in such a manner that it does not crystallize.
      Almost all types of materials are capable of glass formation, including polymers,
      metal alloys and molten salts. Given such diversity, general principles by which
      different glass-forming materials can be systematically classified are
      invaluable. One such principle is the classification of glass-formers according
      to their fragility. Fragility measures the rapidity with which a liquid's
      properties (such as viscosity) change as the glassy state is approached. Although
      the relationship between the fragility, configurational entropy and features of
      the energy landscape (the complicated dependence of energy on configuration) of a
      glass-former have been analysed previously, a detailed understanding of the
      origins of fragility is lacking. Here I use simulations to analyse the
      relationship between fragility and quantitative measures of the energy landscape
      for a model liquid whose fragility depends on its bulk density. The results
      reveal that fragility depends on changes in the vibrational properties of
      individual energy minima in addition to their total number and spread in energy.
      A thermodynamic expression for fragility is derived, which is in quantitative
      agreement with kinetic fragilities obtained from the liquid's diffusivity.

PMID- 11196635
TI  - Observation of shear-induced nematic-isotropic transition in side-chain liquid
      crystal polymers.
AB  - Flow-induced phase transitions are a fundamental (but poorly understood) property
      of non-equilibrium systems, and are also of practical importance for tuning the
      processing conditions for plastics, petroleum products, and other related
      materials. Recognition that polymers may exhibit liquid crystal properties has
      led to the discovery of the first tailored side-chain liquid crystal polymers
      (SCLCPs), which are formed by inserting a spacer between the main polymer chain
      and the lateral mesogen liquid-crystalline graftings. Subsequent research has
      sought to understand the nature of the coupling between the main polymer chain
      and the mesogens, with a view to obtaining better control of the properties of
      these tailored structures. We show here that the parallel or perpendicular
      orientation of the mesogens with respect to the main chain can be reversed by the
      application of an external field produced by a shear flow, demonstrating the
      existence of an isotropic nematic phase transition in SCLCPs. Such a transition,
      which was theoretically predicted for low-molecular-weight liquid crystals but
      never observed, is shown to be a general property of SCLCPs too. We expect that
      these SCLCPs will prove to be good candidate systems for the experimental study
      of these non-equilibrium phenomena.

PMID- 11196636
TI  - An abrupt climate event in a coupled ocean-atmosphere simulation without external
      forcing.
AB  - Temperature reconstructions from the North Atlantic region indicate frequent
      abrupt and severe climate fluctuations during the last glacial and Holocene
      periods. The driving forces for these events are unclear and coupled atmosphere
      ocean models of global circulation have only simulated such events by inserting
      large amounts of fresh water into the northern North Atlantic Ocean. Here we
      report a drastic cooling event in a 15,000-yr simulation of global circulation
      with present-day climate conditions without the use of such external forcing. In
      our simulation, the annual average surface temperature near southern Greenland
      spontaneously fell 6-10 standard deviations below its mean value for a period of
      30-40 yr. The event was triggered by a persistent northwesterly wind that
      transported large amounts of buoyant cold and fresh water into the northern North
      Atlantic Ocean. Oceanic convection shut down in response to this flow,
      concentrating the entire cooling of the northern North Atlantic by the colder
      atmosphere in the uppermost ocean layer. Given the similarity between our
      simulation and observed records of rapid cooling events, our results indicate
      that internal atmospheric variability alone could have generated the extreme
      climate disruptions in this region.

PMID- 11196637
TI  - Evidence from detrital zircons for the existence of continental crust and oceans
      on the Earth 4.4 Gyr ago.
AB  - No crustal rocks are known to have survived since the time of the intense meteor
      bombardment that affected Earth between its formation about 4,550 Myr ago and
      4,030 Myr, the age of the oldest known components in the Acasta Gneiss of
      northwestern Canada. But evidence of an even older crust is provided by detrital
      zircons in metamorphosed sediments at Mt Narryer and Jack Hills in the Narryer
      Gneiss Terrane, Yilgarn Craton, Western Australia, where grains as old as
      approximately 4,276 Myr have been found. Here we report, based on a detailed
      micro-analytical study of Jack Hills zircons, the discovery of a detrital zircon
      with an age as old as 4,404+/-8 Myr--about 130 million years older than any
      previously identified on Earth. We found that the zircon is zoned with respect to
      rare earth elements and oxygen isotope ratios (delta18O values from 7.4 to 5.0%),
      indicating that it formed from an evolving magmatic source. The evolved
      chemistry, high delta18O value and micro-inclusions of SiO2 are consistent with
      growth from a granitic melt with a delta18O value from 8.5 to 9.5%. Magmatic
      oxygen isotope ratios in this range point toward the involvement of supracrustal
      material that has undergone low-temperature interaction with a liquid
      hydrosphere. This zircon thus represents the earliest evidence for continental
      crust and oceans on the Earth.

PMID- 11196638
TI  - Oxygen-isotope evidence from ancient zircons for liquid water at the Earth's
      surface 4,300 Myr ago.
AB  - Granitoid gneisses and supracrustal rocks that are 3,800-4,000 Myr old are the
      oldest recognized exposures of continental crust. To obtain insight into
      conditions at the Earth's surface more than 4 Gyr ago requires the analysis of
      yet older rocks or their mineral remnants. Such an opportunity is presented by
      detrital zircons more than 4 Gyr old found within 3-Gyr-old quartzitic rocks in
      the Murchison District of Western Australia. Here we report in situ U-Pb and
      oxygen isotope results for such zircons that place constraints on the age and
      composition of their sources and may therefore provide information about the
      nature of the Earth's early surface. We find that 3,910-4,280 Myr old zircons
      have oxygen isotope (delta18O) values ranging from 5.4+/-0.6% to 15.0+/-0.4%. On
      the basis of these results, we postulate that the approximately 4,300-Myr-old
      zircons formed from magmas containing a significant component of re-worked
      continental crust that formed in the presence of water near the Earth's surface.
      These data are therefore consistent with the presence of a hydrosphere
      interacting with the crust by 4,300 Myr ago.

PMID- 11196639
TI  - Fossil that fills a critical gap in avian evolution.
AB  - Despite the discoveries of well-preserved Mesozoic birds, a key part of avian
      evolution, close to the radiation of all living birds (Aves), remains poorly
      represented. Here we report on a new taxon from the Late Cretaceous locality of
      Ukhaa Tolgod, Mongolia, that offers insight into this critically unsampled
      period. Apsaravis and the controversial alvarezsaurids are the only avialan taxa
      known from the continental deposits at Ukhaa Tolgod, which have produced hundreds
      of fossil mammals, lizards and other small dinosaurs. The new taxon, Apsaravis
      ukhaana, is the best-preserved specimen of a Mesozoic ornithurine bird discovered
      in over a century. It provides data important for assessing morphological
      evolution across Avialae, with implications for, first, the monophyly of
      Enantiornithes and Sauriurae; second, the proposition that the Mesozoic sister
      taxa of extant birds, as part of an 'ecological bottleneck', inhabited
      exclusively near-shore and marine environments; and third, the evolution of
      flight after its origin.

PMID- 11196640
TI  - Correlated evolution of morphology and vocal signal structure in Darwin's
      finches.
AB  - Speciation in many animal taxa is catalysed by the evolutionary diversification
      of mating signals. According to classical theories of speciation, mating signals
      diversify, in part, as an incidental byproduct of adaptation by natural selection
      to divergent ecologies, although empirical evidence in support of this hypothesis
      has been limited. Here I show, in Darwin's finches of the Galapagos Islands, that
      diversification of beak morphology and body size has shaped patterns of vocal
      signal evolution, such that birds with large beaks and body sizes have evolved
      songs with comparatively low rates of syllable repetition and narrow frequency
      bandwidths. The converse is true for small birds. Patterns of correlated
      evolution among morphology and song are consistent with the hypothesis that beak
      morphology constrains vocal evolution, with different beak morphologies
      differentially limiting a bird's ability to modulate vocal tract configurations
      during song production. These data illustrate how morphological adaptation may
      drive signal evolution and reproductive isolation, and furthermore identify a
      possible cause for rapid speciation in Darwin's finches.

PMID- 11196641
TI  - Nitrogen limitation of microbial decomposition in a grassland under elevated CO2.
AB  - Carbon accumulation in the terrestrial biosphere could partially offset the
      effects of anthropogenic CO2 emissions on atmospheric CO2. The net impact of
      increased CO2 on the carbon balance of terrestrial ecosystems is unclear,
      however, because elevated CO2 effects on carbon input to soils and plant use of
      water and nutrients often have contrasting effects on microbial processes. Here
      we show suppression of microbial decomposition in an annual grassland after
      continuous exposure to increased CO2 for five growing seasons. The increased CO2
      enhanced plant nitrogen uptake, microbial biomass carbon, and available carbon
      for microbes. But it reduced available soil nitrogen, exacerbated nitrogen
      constraints on microbes, and reduced microbial respiration per unit biomass.
      These results indicate that increased CO2 can alter the interaction between
      plants and microbes in favour of plant utilization of nitrogen, thereby slowing
      microbial decomposition and increasing ecosystem carbon accumulation.

PMID- 11196642
TI  - Regulation of the gain of visually guided smooth-pursuit eye movements by frontal
      cortex.
AB  - In studies of the neural mechanisms giving rise to behaviour, changes in the
      neural and behavioural responses produced by a given stimulus have been widely
      reported. This 'gain control' can boost the responses to sensory inputs that are
      particularly relevant, select among reflexes for execution by motoneurons or
      emphasize specific movement targets. Gain control is also an integral part of the
      smooth-pursuit eye movement system. One signature of gain control is that a brief
      perturbation of a stationary target during fixation causes tiny eye movements,
      whereas the same perturbation of a moving target during the active state of
      accurate pursuit causes large responses. Here we show that electrical stimulation
      of the smooth-pursuit eye movement region in the arcuate sulcus of the frontal
      lobe ('the frontal pursuit area', FPA) mimics the active state of pursuit. Such
      stimulation enhances the response to a brief perturbation of target motion,
      regardless of the direction of motion. We postulate that the FPA sets the gain of
      pursuit, thereby participating in target selection for pursuit.

PMID- 11196643
TI  - A role for ghrelin in the central regulation of feeding.
AB  - Ghrelin is an acylated peptide that stimulates the release of growth hormone from
      the pituitary. Ghrelin-producing neurons are located in the hypothalamus, whereas
      ghrelin receptors are expressed in various regions of the brain, which is
      indicative of central-and as yet undefined-physiological functions. Here we show
      that ghrelin is involved in the hypothalamic regulation of energy homeostasis.
      Intracerebroventricular injections of ghrelin strongly stimulated feeding in rats
      and increased body weight gain. Ghrelin also increased feeding in rats that are
      genetically deficient in growth hormone. Anti-ghrelin immunoglobulin G robustly
      suppressed feeding. After intracerebroventricular ghrelin administration, Fos
      protein, a marker of neuronal activation, was found in regions of primary
      importance in the regulation of feeding, including neuropeptide Y6 (NPY) neurons
      and agouti-related protein (AGRP) neurons. Antibodies and antagonists of NPY and
      AGRP abolished ghrelin-induced feeding. Ghrelin augmented NPY gene expression and
      blocked leptin-induced feeding reduction, implying that there is a competitive
      interaction between ghrelin and leptin in feeding regulation. We conclude that
      ghrelin is a physiological mediator of feeding, and probably has a function in
      growth regulation by stimulating feeding and release of growth hormone.

PMID- 11196644
TI  - Identification of the haemoglobin scavenger receptor.
AB  - Intravascular haemolysis is a physiological phenomenon as well as a severe
      pathological complication when accelerated in various autoimmune, infectious
      (such as malaria) and inherited (such as sickle cell disease) disorders.
      Haemoglobin released into plasma is captured by the acute phase protein
      haptoglobin, which is depleted from plasma during elevated haemolysis. Here we
      report the identification of the acute phase-regulated and signal-inducing
      macrophage protein, CD163, as a receptor that scavenges haemoglobin by mediating
      endocytosis of haptoglobin-haemoglobin complexes. CD163 binds only haptoglobin
      and haemoglobin in complex, which indicates the exposure of a receptor-binding
      neoepitope. The receptor-ligand interaction is Ca2+-dependent and of high
      affinity. Complexes of haemoglobin and multimeric haptoglobin (the 2-2 phenotype)
      exhibit higher functional affinity for CD 163 than do complexes of haemoglobin
      and dimeric haptoglobin (the 1-1 phenotype). Specific CD163-mediated endocytosis
      of haptoglobin-haemoglobin complexes is measurable in cells transfected with
      CD163 complementary DNA and in CD163-expressing myelo-monocytic lymphoma cells.

PMID- 11196645
TI  - Identification of the platelet ADP receptor targeted by antithrombotic drugs.
AB  - Platelets have a crucial role in the maintenance of normal haemostasis, and
      perturbations of this system can lead to pathological thrombus formation and
      vascular occlusion, resulting in stroke, myocardial infarction and unstable
      angina. ADP released from damaged vessels and red blood cells induces platelet
      aggregation through activation of the integrin GPIIb-IIIa and subsequent binding
      of fibrinogen. ADP is also secreted from platelets on activation, providing
      positive feedback that potentiates the actions of many platelet activators. ADP
      mediates platelet aggregation through its action on two G-protein-coupled
      receptor subtypes. The P2Y1 receptor couples to Gq and mobilizes intracellular
      calcium ions to mediate platelet shape change and aggregation. The second ADP
      receptor required for aggregation (variously called P2Y(ADP), P2Y(AC), P2Ycyc or
      P2T(AC)) is coupled to the inhibition of adenylyl cyclase through Gi. The
      molecular identity of the Gi-linked receptor is still elusive, even though it is
      the target of efficacious antithrombotic agents, such as ticlopidine and
      clopidogrel and AR-C66096 (ref. 9). Here we describe the cloning of this
      receptor, designated P2Y12, and provide evidence that a patient with a bleeding
      disorder has a defect in this gene. Cloning of the P2Y12 receptor should
      facilitate the development of better antiplatelet agents to treat cardiovascular
      diseases.

PMID- 11196646
TI  - Inactivation of the apoptosis effector Apaf-1 in malignant melanoma.
AB  - Metastatic melanoma is a deadly cancer that fails to respond to conventional
      chemotherapy and is poorly understood at the molecular level. p53 mutations often
      occur in aggressive and chemoresistant cancers but are rarely observed in
      melanoma. Here we show that metastatic melanomas often lose Apaf-1, a cell-death
      effector that acts with cytochrome c and caspase-9 to mediate p53-dependent
      apoptosis. Loss of Apaf-1 expression is accompanied by allelic loss in metastatic
      melanomas, but can be recovered in melanoma cell lines by treatment with the
      methylation inhibitor 5-aza-2'-deoxycytidine (5aza2dC). Apaf-1-negative melanomas
      are invariably chemoresistant and are unable to execute a typical apoptotic
      programme in response to p53 activation. Restoring physiological levels of Apaf-1
      through gene transfer or 5aza2dC treatment markedly enhances chemosensitivity and
      rescues the apoptotic defects associated with Apaf-1 loss. We conclude that Apaf
      1 is inactivated in metastatic melanomas, which leads to defects in the execution
      of apoptotic cell death. Apaf-1 loss may contribute to the low frequency of p53
      mutations observed in this highly chemoresistant tumour type.

PMID- 11196647
TI  - The protein-protein interaction map of Helicobacter pylori.
AB  - With the availability of complete DNA sequences for many prokaryotic and
      eukaryotic genomes, and soon for the human genome itself, it is important to
      develop reliable proteome-wide approaches for a better understanding of protein
      function. As elementary constituents of cellular protein complexes and pathways,
      protein-protein interactions are key determinants of protein function. Here we
      have built a large-scale protein-protein interaction map of the human gastric
      pathogen Helicobacter pylori. We have used a high-throughput strategy of the
      yeast two-hybrid assay to screen 261 H. pylori proteins against a highly complex
      library of genome-encoded polypeptides. Over 1,200 interactions were identified
      between H. pylori proteins, connecting 46.6% of the proteome. The determination
      of a reliability score for every single protein-protein interaction and the
      identification of the actual interacting domains permitted the assignment of
      unannotated proteins to biological pathways.

PMID- 11196648
TI  - Crystal structures of SarA, a pleiotropic regulator of virulence genes in S.
      aureus.
AB  - Staphylococcus aureus is a major human pathogen, the potency of which can be
      attributed to the regulated expression of an impressive array of virulence
      determinants. A key pleiotropic transcriptional regulator of these virulence
      factors is SarA, which is encoded by the sar (staphylococcal accessory regulator)
      locus. SarA was characterized initially as an activator of a second virulence
      regulatory locus, agr, through its interaction with a series of heptad repeats
      (AGTTAAG) within the agr promoter. Subsequent DNA-binding studies have revealed
      that SarA binds readily to multiple AT-rich sequences of variable lengths. Here
      we describe the crystal structure of SarA and a SarA-DNA complex at resolutions
      of 2.50 A and 2.95 A, respectively. SarA has a fold consisting of a four-helix
      core region and 'inducible regions' comprising a beta-hairpin and a carboxy
      terminal loop. On binding DNA, the inducible regions undergo marked
      conformational changes, becoming part of extended and distorted alpha-helices,
      which encase the DNA. SarA recognizes an AT-rich site in which the DNA is highly
      overwound and adopts a D-DNA-like conformation by indirect readout. These
      structures thus provide insight into SarA-mediated transcription regulation.

PMID- 11196649
TI  - Projection structure of a ClC-type chloride channel at 6.5 A resolution.
AB  - Virtually all cells in all eukaryotic organisms express ion channels of the ClC
      type, the only known molecular family of chloride-ion-selective channels. The
      diversity of ClC channels highlights the multitude and range of functions served
      by gated chloride-ion conduction in biological membranes, such as controlling
      electrical excitability in skeletal muscle, maintaining systemic blood pressure,
      acidifying endosomal compartments, and regulating electrical responses of GABA
      (gamma-aminobutyric acid)-containing interneurons in the central nervous system.
      Previously, we expressed and purified a prokaryotic ClC channel homologue. Here
      we report the formation of two-dimensional crystals of this ClC channel protein
      reconstituted into phospholipid bilayer membranes. Cryo-electron microscopic
      analysis of these crystals yields a projection structure at 6.5 A resolution,
      which shows off-axis water-filled pores within the dimeric channel complex.

PMID- 11196650
TI  - Enabling the chemistry of life.
AB  - Enzymes are the subset of proteins that catalyse the chemistry of life,
      transforming both macromolecular substrates and small molecules. The precise
      three-dimensional architecture of enzymes permits almost unerring selectivity in
      physical and chemical steps to impose remarkable rate accelerations and
      specificity in product-determining reactions. Many enzymes are members of
      families that carry out related chemical transformations and offer opportunities
      for directed in vitro evolution, to tailor catalytic properties to particular
      functions.

PMID- 11196652
TI  - Improving enzymes by using them in organic solvents.
AB  - The technological utility of enzymes can be enhanced greatly by using them in
      organic solvents rather than their natural aqueous reaction media. Studies over
      the past 15 years have revealed not only that this change in solvent is feasible,
      but also that in such seemingly hostile environments enzymes can catalyse
      reactions impossible in water, become more stable, and exhibit new behaviour such
      as 'molecular memory'. Of particular importance has been the discovery that
      enzymatic selectivity, including substrate, stereo-, regio- and chemoselectivity,
      can be markedly affected, and sometimes even inverted, by the solvent. Enzyme
      catalysed reactions in organic solvents, and even in supercritical fluids and the
      gas phase, have found numerous potential applications, some of which are already
      commercialized.

PMID- 11196651
TI  - Enzymes for chemical synthesis.
AB  - New catalytic synthetic methods in organic chemistry that satisfy increasingly
      stringent environmental constraints are in great demand by the pharmaceutical and
      chemical industries. In addition, novel catalytic procedures are necessary to
      produce the emerging classes of organic compounds that are becoming the targets
      of molecular and biomedical research. Enzyme-catalysed chemical transformations
      are now widely recognized as practical alternatives to traditional (non
      biological) organic synthesis, and as convenient solutions to certain intractable
      synthetic problems.

PMID- 11196653
TI  - Modular enzymes.
AB  - Although modular macromolecular devices are encountered frequently in a variety
      of biological situations, their occurrence in biocatalysis has not been widely
      appreciated. Three general classes of modular biocatalysts can be identified:
      enzymes in which catalysis and substrate specificity are separable,
      multisubstrate enzymes in which binding sites for individual substrates are
      modular, and multienzyme systems that can catalyse programmable metabolic
      pathways. In the postgenomic era, the discovery of such systems can be expected
      to have a significant impact on the role of enzymes in synthetic and process
      chemistry.

PMID- 11196654
TI  - Combinatorial and computational challenges for biocatalyst design.
AB  - Nature provides a fantastic array of catalysts extremely well suited to
      supporting life, but usually not so well suited for technology. Whether
      biocatalysis will have a significant technological impact depends on our finding
      robust routes for tailoring nature's catalysts or redesigning them anew.
      Laboratory evolution methods are now used widely to fine-tune the selectivity and
      activity of enzymes. The current rapid development of these combinatorial methods
      promises solutions to more complex problems, including the creation of new
      biosynthetic pathways. Computational methods are also developing quickly. The
      marriage of these approaches will allow us to generate the efficient, effective
      catalysts needed by the pharmaceutical, food and chemicals industries and should
      open up new opportunities for producing energy and chemicals from renewable
      resources.

PMID- 11196655
TI  - Industrial biocatalysis today and tomorrow.
AB  - The use of biocatalysis for industrial synthetic chemistry is on the verge of
      significant growth. Biocatalytic processes can now be carried out in organic
      solvents as well as aqueous environments, so that apolar organic compounds as
      well as water-soluble compounds can be modified selectively and efficiently with
      enzymes and biocatalytically active cells. As the use of biocatalysis for
      industrial chemical synthesis becomes easier, several chemical companies have
      begun to increase significantly the number and sophistication of the biocatalytic
      processes used in their synthesis operations.

PMID- 11196656
TI  - The AT-rich region between -54 to -66 is important for the promoter activity of
      interleukin-10 in Epstein-Barr virus positive Burkitt's lymphoma cells.
AB  - IL-10 is an important regulatory cytokine. The recent characterization of the 5'
      flanking region of IL-10 led to the identification of the promoter region. The
      infection of B cells with EBV induces IL-10 production which may contribute to
      EBV-induced transformation. In the present report, IL-10 promoter elements
      involved in the constitutive expression of IL-10 in EBV-positive lymphoma cells
      are described. The AT-rich region between -54/-66 from the transcriptional start
      site was found to be important for IL-10-promoter activity in BL36. A point
      mutation at position -60 (T/A) was associated with over 90% reduction of
      luciferase activity in the cell lines BL36 and BL74. The conversion of A/T at
      position -57 led to enhanced promoter activity. In addition the AT-rich region
      could serve as an enhancer for the beta-globin basic promoter. In BJAB cells (EBV
      negative), sequences between -205/-139 rather than the AT-rich region were
      involved in IL-10 promoter regulation. This underlines the importance of the AT
      rich region for EBV-associated IL-10 promoter regulation. Our results further the
      understanding of how the IL-10 gene could be regulated in B cell lymphomas.

PMID- 11196657
TI  - Allelic variants in the interleukin-6 gene and essential hypertension in Japanese
      women.
AB  - Genes that can be implicated in hypertension in experimental animals are
      plausible candidates in the pathogenesis of human hypertension. A recent genome
      wide search for quantitative-trait loci (QTL) in hypertensive rats revealed a
      strong correlation between the interleukin-6 (IL-6) locus on rat chromosome 4 and
      systolic, diastolic, and mean arterial pressure in this mammalian species. To
      investigate a possible association between genetic variations of the IL-6 gene
      and hypertension in humans, we identified two novel single-nucleotide sequence
      variations, a C/G substitution at -634 in the promoter region and a G/A
      substitution at 4391 in a 3' non-coding portion of exon 5, and a previous
      reported sequence variant, an A/T variation in the composition of the AnTn tract
      around -447 in the promoter region (Fishman D et al. J Clin Invest 1998; 102:
      1369-1376), within a test population of 96 Japanese subjects. Allelic
      associations involving these variations were analyzed in 150 hypertensive and 143
      normotensive Japanese women. The distribution of alleles of the three
      polymorphisms, as well as a dinucleotide repeat present at the IL-6 locus, was
      similar in the two groups. Therefore, the IL-6 gene appears to play a minimal
      role in the genetic etiology of essential hypertension in Japanese women.

PMID- 11196658
TI  - Taxonomic hierarchy of HLA class I allele sequences.
AB  - The markedly high levels of polymorphism present in classical class I loci of the
      human major histocompatibility complex have been implicated in infectious and
      immune disease recognition. The large numbers of alleles present at these loci
      have, however, limited efforts to verify associations between individual alleles
      and specific diseases. As an approach to reduce allele diversity to hierarchical
      evolutionarily related groups, we performed phylogenetic analyses of available
      HLA-A, B and C allele complete sequences (n = 216 alleles) using different
      approaches (maximum parsimony, distance-based minimum evolution and maximum
      likelihood). Full nucleotide and amino acid sequences were considered as well as
      abridged sequences from the hypervariable peptide binding region, known to
      interact in vivo, with HLA presented foreign peptide. The consensus analyses
      revealed robust clusters of 36 HLA-C alleles concordant for full and PBR sequence
      analyses. HLA-A alleles (n = 60) assorted into 12 groups based on full nucleotide
      and amino acid sequence which with few exceptions recapitulated serological
      groupings, however the patterns were largely discordant with clusters prescribed
      by PBR sequences. HLA-B which has the most alleles (n = 120) and which unlike HLA
      A and -C is thought to be subject to frequent recombinational exchange, showed
      limited phylogenetic structure consistent with recent selection driven retention
      of maximum heterozygosity and population diversity. Those allele categories
      recognized offer an explicit phylogenetic criterion for grouping alleles
      potentially relevant for epidemiologic associations, for inferring the origin of
      MHC genome organization, and for comparing functional constraints in peptide
      presentation of HLA alleles.

PMID- 11196659
TI  - Genetic polymorphism of murine tissue plasminogen activator associated with
      antiphospholipid syndrome.
AB  - In a subset of patients with systemic lupus erythematosus (SLE), antiphospholipid
      syndrome characterized by thrombocytopenia, thrombosis, recurrent abortion and
      antiphospholipid antibodies develops. Male (NZW x BXSB) F1 mice are widely used
      as a model for SLE-associated antiphospholipid syndrome. Our earlier genetic
      studies showed that one susceptibility allele for thrombocytopenia and associated
      IgG platelet-binding autoantibodies in male (NZW x BXSB) F1 mice was linked to
      the BXSB-type polymorphic microsatellite D8Mit96, located in proximity to the
      gene Plat for tissue-type plasminogen activator (t-PA). In the present studies,
      sequence analyses for structural and promoter regions of Plat revealed a single
      nucleotide polymorphism encoding a catalytic domain of t-PA, with an amino acid
      substitution of anionic Glu366 in NZW for a cationic Lys in BXSB. Progeny studies
      using NZW x (NZW x BXSB) F1 male backcross mice showed that the BXSB Plat allele
      was significantly associated with high levels of both platelet-binding antibodies
      and thrombocytopenia. Furthermore, these two traits appeared to be regulated by a
      complementary effect of two BXSB alleles; one is linked to Plat and the other to
      the H-2 complex and the gene for plasminogen. Thus, the BXSB-type Plat may be one
      susceptibility allele for the multigenic antiphospholipid syndrome seen in (NZW x
      BXSB) F1 mice. Potential mechanisms are discussed.

PMID- 11196660
TI  - Variation in immunoregulatory genes determines the clinical phenotype of common
      variable immunodeficiency.
AB  - Variation in clinical phenotype is a hallmark of many complex diseases. The cause
      of this clinical heterogeneity is unknown, but it may be determined by genetic
      factors distinct from those conferring disease susceptibility. Common variable
      immunodeficiency (CVID) is a complex disease of unknown aetiology and diverse
      clinical manifestations. We have developed a unified polymerase chain reaction
      and sequence-specific primer (PCR-SSP) method to simultaneously genotype multiple
      polymorphisms under identical conditions, and have used this method to test the
      hypothesis that the clinical phenotype of CVID is determined by immunoregulatory
      gene polymorphism. Twenty-three polymorphisms in 13 genes were studied in 163
      CVID patients. Vitamin D receptor and IL-6 alleles were associated with
      immunophenotypic abnormalities characteristic of more severe disease; and tumour
      necrosis factor and IL-10 alleles conferred susceptibility to the granulomatous
      form of CVID in an interacting fashion. These findings demonstrate that different
      clinical features of a disease may have unique pathogenetic abnormalities,
      determined by multiple interacting genetic factors. The ease of application of
      this efficient, robust genotyping technique to polymorphisms throughout the
      genome will make it a powerful tool in the investigation of the genetic basis of
      phenotypic variability in a wide variety of diseases.

PMID- 11196661
TI  - Chromosome 17q22-q24 and multiple sclerosis genetic susceptibility. American
      French Multiple Sclerosis Genetic Group.
AB  - Recently, genome-wide searches for multiple sclerosis (MS) susceptibility genes
      have suggested that the chromosome 17q22-q24 region might contain susceptibility
      genes in two sets of families of different ethnic backgrounds (Finnish and
      British). Therefore, we decided to test this region in two sets of families of
      different ethnic backgrounds (American and French), but collected according to
      the same diagnostic criteria. All lod-score values were non-significant.
      Moreover, we could exclude that the 17q22-24 region might contain a gene
      increasing the sibling recurrence risk of MS over 1.4, rendering the existence of
      such a gene very unlikely, at least in the group of tested families.

PMID- 11196662
TI  - Microsatellite alleles and single nucleotide polymorphisms (SNP) combine to form
      four major haplotype families at the human interleukin-10 (IL-10) locus.
AB  - Interleukin-10 (IL-10) is a pivotal immunoregulatory cytokine, influencing many
      aspects of the immune response. The IL-10 gene is located on chromosome 1 at 1q31
      32 and is highly polymorphic. One microsatellite and three single nucleotide
      polymorphisms (SNPs) have been recorded within the 1.2 kb immediately upstream of
      the gene, with an additional microsatellite present at 4 kb upstream. The
      relationship between these two classes of polymorphism is poorly defined in the
      IL-10 gene. Haplotypes have been presented comprising alleles from the two
      microsatellite loci, and independently from the three SNPs, but these have not
      yet been brought together to define unified halpotypes. In the present report we
      describe the 29 IL-10 haplotypes found in 56 Dutch European families and show
      that they fall into four major haplotype groups, each of which spans the 4 kb
      upstream of the IL-10 gene and has a different distribution of IL10.G alleles. In
      addition, we describe three novel single nucleotide polymorphisms in the human IL
      10 gene and suggest how they relate to these four haplotype families.

PMID- 11196663
TI  - Two polymorphisms within interleukin-3 (hIL3) gene detected by mismatch PCR/RFLP.
AB  - Two alleles of IL-3 have been reported to GenBank (GenBank M14743, M20137). The
      sequence difference between these two alleles is at the first nucleotide of the
      27th codon (the 131st nucleotide from the initiation site): thymine and cytosine,
      and leading the amino acid difference: proline and serine (Pro27Ser). The other
      allelism, thymine and cytosine, was also observed at position -16 of the IL-3
      upstream promotor region (GenBank L10616, M60870). We clarified that these
      substitutions were frequent polymorphisms in the Japanese population by using the
      mismatch-PCR (polymerase chain reaction)/RFLP (restriction fragment length
      polymorphism) method.

PMID- 11196664
TI  - A highly polymorphic CA repeat marker at the interleukin-11 locus.
AB  - The interleukin-11 (IL-11) stimulates T cell-dependent development of
      immunoglobulin-producing B cells and collaborates with IL-3 in supporting murine
      megakaryocyte colony formation. The interleukin-11 (IL-11) also stimulates
      osteoclast formation and inhibits osteoclast function in vitro and has been
      implicated in estrogen deficiency-induced bone loss. We isolated a polymorphic
      dinucleotide (CA) repeat sequence from a genomic clone containing the IL-11 gene
      located at 19q13.3-q13.4. High heterozygosity (0.81) makes this polymorphism a
      useful marker in genetic study of disorders affecting immune response and bone
      metabolism.

PMID- 11196665
TI  - Identification of novel single nucleotide polymorphisms in intron 1B and exon 1C
      of the human interleukin-1 receptor type I (IL-1RI) gene.
AB  - We have identified two novel single nucleotide polymorphisms in the 5' region of
      the human IL-1RI gene: (1) A-->G at position 52 in intron 1B (GenBank accession
      number AF146426), which creates an Mspl restriction endonuclease site. Allele
      frequencies in a Caucasian population were 0.1 (A allele) and 0.9 (G allele). (2)
      A-->T at position 140 in exon 1C (GenBank accession number AF146427). Allele
      frequencies in a Caucasian population were 0.27 (A allele) and 0.73 (T allele).

PMID- 11196666
TI  - A bi-allelic VNTR in the human TNFR2 (p75) gene promoter.
AB  - We describe a bi-allelic VNTR polymorphism within a 42 bp region in the promoter
      of the tumour necrosis factor receptor 2 gene (TNFR2). Within this region there
      are one (Allele 1) or two (Allele 2) repeats of a 15 bp sequence, 5'-GCCGGGC
      AGGTGGAG-3'. Allele frequencies observed in a Caucasian population were 0.3
      (Allele 1) and 0.7 (Allele 2).

PMID- 11196667
TI  - A novel single nucleotide polymorphism and five probable haplotypes in the 5'
      flanking region of the IL-6 gene in African-Americans.
AB  - In order to identify novel single nucleotide polymorphisms (SNPs), we sequenced a
      940 bp region of the 5' flanking region of the IL-6 gene in 63 normal African
      Americans. We identified a biallelic (G/C) SNP at position -573 relative to the
      transcription start site (-573C allele frequency 0.095). This SNP, together with
      SNPs at -598 and -174, allows identification of five probable haplotypes.
      Haplotypes containing the -174C allele, which has been associated with lower
      plasma IL-6 levels, were uncommon (4%). These haplotypes may influence IL-6 gene
      transcription and thus may contribute to racial differences in the prevalence of
      inflammatory diseases.

PMID- 11196668
TI  - Association of the TNF +489 polymorphism with susceptibility and radiographic
      damage in rheumatoid arthritis.
AB  - Multiple genetic factors contribute to susceptibility to rheumatoid arthritis
      (RA). The extent of variability in disease presentation in RA may be related to
      genetic heterogeneity. In this study we investigated the association of the TNF
      gene polymorphism at position +489 with susceptibility to and severity of RA.
      Analysis of the frequency of the +489 A and G alleles in a group of 293
      consecutive RA patients and 138 healthy controls revealed a significant decrease
      of the A allele. The +489 GA patients had a 3.9 times decreased chance of having
      erosive disease than +489 GG patients. These results were confirmed in a
      prospective study using a cohort of 112 patients who were followed for 12 years.
      The progression rate of the erosion score over 12 years expressed as Sharp score
      for X-rays of hands and feet was 3.4 per year for the GA-genotyped patients and
      12.1 for the GG-genotyped patients. These associations were independent of
      rheumatoid factor and HLA-shared epitope positivity. In conclusion, these data
      suggest that the intron TNF +489 polymorphism is associated with susceptibility
      to and disease severity of RA independently of HLA-shared epitope-positive
      alleles.

PMID- 11196669
TI  - New variations of human CC-chemokine receptors CCR3 and CCR4.
AB  - CCR3 and CCR4 are the members of CC chemokine receptor family expressed on Th2
      type CD4+ T cells. In this study, variation screening of the entire coding
      regions of CCR3 and CCR4 was performed, and possible association with several
      autoimmune diseases was tested, using the genomic DNA from 304 Japanese healthy
      individuals and 272 Japanese patients with rheumatic diseases. One non-synonymous
      substitution was identified in CCR3 gene, whereas in CCR4 gene, two non
      synonymous and two synonymous substitutions were detected. Among the synonymous
      substitutions, CCR4 1014(C-->T) was observed in 7.2% of the healthy individuals
      and 6.6% of the patients, and was considered as a single nucleotide polymorphism.
      All other variations were observed in only one or two individuals. No significant
      association was observed between any of the variations and any of the rheumatic
      diseases. Among these variations, CCR3-C218S substitution coded by 652(T-->A)
      substitution was localized in the region conserved among the G protein coupled
      receptor family. Reactivity of eosinophils to the monoclonal antibody against
      CCR3 and the chemotaxis to eotaxin were slightly reduced in this patient as
      compared with healthy controls or a patient with Behcet disease homozygous for
      the common allele, while CCR3 mRNA level was not different. These findings
      suggest that CCR3-C218S substitution may lead to the reduced function of CCR3 at
      the protein level. Further study will be of interest to test whether CCR3-C218S
      variation or any of the CCR4 variations has a significant role in rendering
      susceptibility to immunological diseases or resistance to HIV infection.

PMID- 11196670
TI  - The major histocompatibility complex-encoded class I-like HFE abrogates
      endocytosis of transferrin receptor by inducing receptor phosphorylation.
AB  - The major histocompatibility complex-encoded gene, Hfe, has been implicated to
      play a pivotal role in hereditary hemochromatosis, a common autosomal recessive
      disorder of iron metabolism. The recent finding that a physical interaction
      between HFE and transferrin receptor establishes a functional link between HFE
      and transferrin receptor-mediated iron metabolism in the pathophysiology of
      hereditary hemochromatosis. To elucidate the underlying mechanisms by which HFE
      interacts with and affects transferrin receptor function, we have systematically
      investigated the consequences of the HFE-transferrin receptor interaction in
      cellular iron homeostasis. Herein we show that in HFE-expressing cells, the
      amount of intracellular transferrin is decreased by approximately 28%, despite a
      approximately 40% increase in surface-expressed transferrin receptor. Kinetic
      analysis of receptor-bound transferrin endocytosis reveals that HFE expression
      not only reduces transferrin binding but also abrogates transferrin receptor
      endocytosis. As a result, HFE expression leads to an accumulation of non
      functional transferrin receptors at the cell surface, and a decrease in iron
      uptake. Moreover, HFE expression induces hyper-serine phosphorylation of the
      transferrin receptor. Taken together, these results suggest that HFE negatively
      modulates cellular iron uptake by impairing transferrin receptor endocytosis via
      HFE-induced receptor phosphorylation.

PMID- 11196671
TI  - Interethnic studies of TNF polymorphisms confirm the likely presence of a second
      MHC susceptibility locus in ankylosing spondylitis.
AB  - The objective of this study was to investigate TNF promoter region polymorphisms
      for association with susceptibility to ankylosing spondylitis (AS). The TNF -238
      and -308 polymorphisms were genotyped in 306 English AS cases and 204 ethnically
      matched healthy B27-positive controls, and 96 southern German AS cases, 58 B27
      positive and 251 B27-negative ethnically matched controls. Additionally, the TNF 
      376 polymorphism was genotyped in the southern German cases and controls. In the
      southern German AS patients a significant reduction in TNF -308.2 alleles was
      seen, compared with B27 positive controls (odds ratio 0.4, P = 0.03, 95%
      confidence interval 0.2-0.9), but no difference in allele frequencies was
      observed at TNF -238. Significant association between AS and both TNF -238 and
      TNF -308 was excluded in the English cases. These results confirm previous
      observations in the southern German population of association between TNF
      promoter region polymorphisms and AS, but the lack of association in the English
      population suggests that these polymorphisms themselves are unlikely to be
      directly involved. More likely, a second, non-HLA-B, MHC locus is involved in
      susceptibility to AS in these two populations.

PMID- 11196672
TI  - Genetic influence on peripheral blood T lymphocyte levels.
AB  - T lymphocytes are a major component of the adaptive immune system. CD4 positive T
      cell subpopulations regulate B cell and macrophage effector function while CD8
      positive T cells are largely responsible for anti-viral cytotoxic activity. The
      degree of natural variation in the levels and ratios of the various T cell
      subpopulations is a possible risk factor for the development of autoimmune
      disease, infectious disease and cancer. There is some evidence from studies of
      inbred strains of mice and humans which suggests that variation in T cell
      subpopulations is genetically influenced. However, family studies alone cannot
      distinguish between common environmental and shared genetic influences and
      provide less robust estimates of the heritability than twin studies. To
      comprehensively examine genetic influences on a selection of important T cell
      phenotypes, we investigated variation in levels of total lymphocytes, CD3+, CD4+,
      CD8+, CD3+CD4+, CD3+CD8+ lymphocytes and in CD4:CD8 ratio as a proportion of
      lymphocytes and of T cells using the classical twin model approach. Healthy
      female twin pairs were sampled from the St. Thomas' UK Adult Twin Registry. A
      maximum of 103 monozygotic (MZ) and 186 dizygotic (DZ) twins aged 18-80 years
      participated in the study. Whole blood samples were analysed for T cell subsets
      by flow cytometry. The relative genetic contribution to these phenotypes was
      estimated using a variance components model-fitting approach. Heritability
      estimates were calculated of 65% for CD4:CD8 T cell and lymphocyte ratios, around
      50% for absolute lymphocyte, CD3+ and CD4+ counts, and 56% for CD8+ numbers.
      Unique (rather than shared) familial environment explains the remainder of the
      variance. Genetic factors have a major influence on the variation in peripheral T
      cell subset numbers. Polymorphism dictating such variation should be taken into
      account when assessing risk factors for T cell immune-mediated disease with a
      genetic background.

PMID- 11196673
TI  - New polymorphisms of human CD80 and CD86: lack of association with rheumatoid
      arthritis and systemic lupus erythematosus.
AB  - The crucial role of costimulatory molecules, CD28, CTLA-4, CD80 and CD86, for T
      cell activation and inhibition has been established. In the previous study, we
      reported the results of a polymorphism screening of human CTLA-4 gene. In this
      study, we screened for polymorphisms of human CD28, CD80 and CD86 genes, and
      detected that polymorphisms were tested for the association with rheumatoid
      arthritis (RA) and systemic lupus erythematosus (SLE). Variations were identified
      in the coding regions of CD80 (452G/A, 614C/G and 864A/G) and CD86 (1057A/G),
      while no variation was observed in the coding region of CD28. The variations at
      CD80 position 452 and CD86 position 1057 were present in a substantial proportion
      of the Japanese population, and were considered to be single nucleotide
      polymorphisms within the coding sequence (cSNPs). CD80 864 (G-->A) leads to the
      amino acid substitution N186D, and CD86 1057 (A-->G) results in A304T
      substitution. Furthermore, in the analysis of CD80 5'-flanking region, six SNPs, 
      454C/A, -387T/C, -232G/A, -79G/C, -7T/C and /A, and one insertion, -558ins
      (CATGA), were identified. The combination of these variations was found to
      constitute four promoter alleles of CD80. None of the observed variations was
      significantly associated with RA or SLE. Further studies will be of particular
      interest to examine the functional difference of the promoter alleles for the
      transcriptional activity of CD80, as well as the evolutionary pathway of the four
      alleles.

PMID- 11196674
TI  - Human genetic factors related to susceptibility to mild malaria in Gabon.
AB  - Several human genetic factors, including red blood cell polymorphisms (ABO blood
      group, sickle-cell trait, G6PD deficiency) as well as point mutations in the
      mannose binding protein (MBP) and in the promoter regions of both the TNF-alpha
      and NOS2 genes, influence the severity of disease due to infection with
      Plasmodium falciparum. We assessed their impact on mild P. falciparum malaria, as
      part of a longitudinal investigation of clinical, parasitological and
      immunological parameters in a cohort of 300 Gabonese schoolchildren. We found the
      following frequencies: blood group O (0.54), sickle-cell trait (0.23), G6PD
      deficiency (0.09), MBP gene mutations (0.34), TNF-alpha promoter mutations (at
      positions -238: 0.17 and -308: 0.22) and NOS2 promoter mutation (0.18). Blood
      group O or hemoglobin AA were associated with protection against higher
      parasitemia. Girls with normal G6PD enzyme activity were protected against
      clinical malaria attacks. In addition, we demonstrated for the first time that
      the mutation at position -238 of the gene coding for the promoter region of TNF
      alpha was positively correlated with the level of the antibody response specific
      for epitopes of the antigens MSA-2 and RAP-1 of P. falciparum.

PMID- 11196675
TI  - Cloning, expression and initial characterization of interleukin-19 (IL-19), a
      novel homologue of human interleukin-10 (IL-10).
AB  - Interleukin-10 (IL-10) is a pleiotropic cytokine with important immunoregulatory
      functions whose actions influence activities of many of the cell-types in the
      immune system. We report here identification and cloning of a gene and
      corresponding cDNAs encoding a novel homologue of IL-10, designated IL-19. IL-19
      shares 21% amino acid identity with IL-10. The exon/intron structure of IL-19 is
      similar to that of the human IL-10 gene, comprising five exons and four introns
      within the coding region of the IL-19 cDNA. There are at least two distinct IL-19
      mRNA species that differ in their 5'-sequences, suggesting the existence of an
      intron in the 5'-sequences of coding portion of the IL-19 gene. The longer 5'
      sequence contains an alternative initiating ATG codon that is in-frame with the
      rest of the coding sequence. The expression of IL-19 mRNA can be induced in
      monocytes by LPS-treatment. The appearance of IL-19 mRNA in LPS-stimulated
      monocytes was slightly delayed compared to expression of IL-10 mRNA: significant
      levels of IL-10 mRNA were detectable at 2 h post-stimulation, whereas IL-19 mRNA
      was not detectable until 4 h. Treatment of monocytes with IL-4 or IL-13 did not
      induce de novo expression of IL-19, but these cytokines did potentiate IL-19 gene
      expression in LPS-stimulated monocytes. In addition, GM-CSF was capable of
      directly inducing IL-19 gene expression in monocytes. IL-19 does not bind or
      signal through the canonical IL-10 receptor complex, suggesting existence of an
      IL-19 specific receptor complex, the identity of which remains to be discovered.

PMID- 11196676
TI  - Allele associations reveal four prominent haplotypes at the human interleukin-6
      (IL-6) locus.
AB  - We have examined four polymorphic elements in the human interleukin-6 (IL-6)
      locus and described their allele distribution in 73 unrelated, healthy
      individuals from the West-of-Scotland. These comprised three single nucleotide
      polymorphisms (SNP) in the 5' promoter region of the gene and one VNTR in the 3'
      region of IL-6. A statistical consideration of the relationship between alleles
      at each locus was carried out. Of a total of 12 possible haplotypes observed in
      the population, the analysis suggested that four were prominent. These accounted
      for 41.1%, 28.1%, 14.4% and 3.4% respectively; in total, 87% of the haplotypes
      present. Frequently, these proposed haplotypes were supported by homozygosity
      across all four loci within individuals. We propose that these haplotypes be
      identified as IL6.0103, IL6.0204, IL6.0207 and IL6.0307, in recognition of their
      frequency in this population and the alleles that they contain.

PMID- 11196677
TI  - Linkage analysis of a candidate region in Scandinavian sib pairs with multiple
      sclerosis reveals linkage to chromosome 17q.
AB  - To date, four genome screens have been completed in the demyelinating autoimmune
      disease multiple sclerosis (MS). Although these screens failed to identify any
      loci with major effects on susceptibility, several novel regions of potential
      linkage were suggested, including the long arm of chromosome 17. In order to
      further pursue this promising region we have investigated six highly polymorphic
      microsatellite markers in 115 Scandinavian families with MS affected sib pairs.
      Multipoint linkage analysis revealed a peak maximum likelihood score (MLS) of 0.9
      in the region of marker D17S787. Stratifying the results on the basis of HLA-DR2
      status showed that the linkage was not limited to families segregating for the
      HLA-DR2 allele as has previously been suggested. In conclusion, our results
      further support the proposal that a multiple sclerosis susceptibility locus is
      contained on chromosome 17q.

PMID- 11196678
TI  - High-resolution analysis of IL-6 minisatellite polymorphism in Sardinian multiple
      sclerosis: effect on course and onset of disease.
AB  - A minisatellite polymorphism located in the 3' flanking region of the interleukin
      6 (IL-6) gene was analysed in 192 Sardinian simplex families with multiple
      sclerosis (MS). By applying a high-resolution sizing approach, 9 alleles were
      identified. None of these were associated with in globo susceptibility to MS as
      shown by transmission disequilibrium testing. Analysis of clinically different
      groups showed that the A5 allele was associated with a benign (P = 0.007) but not
      with a malignant (P = 0.45) course of disease. In particular, the frequency of
      the A5/A5 genotype was significantly higher in patients with benign MS (P =
      0.002). In addition, carriage of any of the larger alleles (A6-->A9) was
      associated with accelerated onset of disease (P = 0.025). Our results suggest
      that allelic variations in the IL-6 gene may predispose to alterations in the
      course and initial onset of MS.

PMID- 11196679
TI  - Mannose binding lectin (MBL) gene mutation is not a risk factor for systemic
      lupus erythematosus (SLE) and rheumatoid arthritis (RA) in Japanese.
AB  - Mannose binding lectin (MBL) deficiency may be associated with increased
      susceptibility to infection and autoimmune disorders, such as systemic lupus
      erythematosus (SLE) and rheumatoid arthritis (RA). In the present study, we
      performed for the first systematic search for mutations in all the four exons of
      the MBL gene using polymerase chain reaction (PCR)/single-strand conformation
      polymorphism (SSCP) analysis. Of 49 healthy Japanese individuals studied, only
      the previously reported mutation at the codon 54 (substitution from Gly to Asp;
      G54D) was identified. The allele frequencies of G54D in 105 healthy Japanese
      individuals, 95 SLE patients and 59 RA patients, were 0.233, 0.226 and 0.178,
      respectively, which were not significantly different. In addition, two
      polymorphisms at positions of -550 and -221 in the promoter region were not
      associated with SLE and RA. It is unlikely that MBL deficiency plays a major role
      in the pathogenesis of SLE and RA in Japanese.

PMID- 11196680
TI  - Independent contribution of HLA-DRB1 and TNF alpha promoter polymorphisms to the
      susceptibility to Crohn's disease.
AB  - Although a number of studies reported the association of HLA-DRB1 and Crohn's
      disease (CD), the actual alleles associated with CD are considerably variable
      among populations. On the other hand, the relevance of tumor necrosis factor
      alpha (TNF alpha) in the pathogenesis of CD is established through experimental
      as well as clinical studies, raising the possibility that TNFA polymorphism is
      primarily or independently contribute to the association of HLA region genes with
      CD. New polymorphisms which may affect the transcriptional activity were recently
      reported within the upstream promoter region of TNFA gene. In the present study,
      we compared HLA-DRB1, TNFA promoter and TNF receptor 2 (TNFR2) genotypes in 154
      Japanese patients with CD and 265 unrelated healthy controls to evaluate the
      individual contribution of these genes to the genetic predisposition to CD.
      Significant positive association was observed in HLA-DRB1*0405 (P = 0.001, odds
      ratio (OR) = 2.02) and 0410 (P = 0.002, OR = 4.79). Among the TNFA promoter
      haplotypes, TNFA-U03 (-1031C, -863A, -857C) was significantly increased (P =
      0.008, OR = 1.64), while TNFA-U04 (-1031C, -863C, -857C) was significantly
      decreased (P = 0.014, OR = 0.12), in CD. The association with TNFA-U03 was
      independent of that with DRB1*0405 and 0410, and apparent additive or
      multiplicative effect was not observed between these susceptibility alleles. No
      association was observed between TNFR2-196M/R polymorphism and CD. These results
      indicated that both of HLA-DRB1 and TNFA promoter polymorphisms contribute to the
      susceptibility to CD in an independent manner.

PMID- 11196681
TI  - Evidence for recent selection of the CCR5-delta 32 deletion from differences in
      its frequency between Ashkenazi and Sephardi Jews.
AB  - Recent studies have shown higher frequencies of the CCR5-delta 32 allele and the
      CCR5-delta 32/delta 32 genotype, which confers protection against HIV infection,
      in northern Europe as compared to Mediterranean countries. Here, we analyse the
      prevalence of CCR5-delta 32 in 922 HIV seronegative blood donors in Israel to
      verify its frequency in Jews of Ashkenazi and Sephardi origin. A significant
      difference (P < 0.001) was found between the CCR5-delta 32 allele frequency in
      Ashkenazi (13.8%) vs (4.9%) Jews. In contrast, no significant difference was
      observed in the frequency of the CCR2-641 mutation between Ashkenazi (9.2%) and
      Sephardi (13.4%) Jews. Using the Island model we calculate that a minimal genetic
      migration rate of 3% per generation would have been necessary if the higher CCR5
      delta 32 prevalence in Ashkenazi is to be fully explained by mixing with the
      indigenous north-European populations. This putative migration rate is 20-fold
      higher than that currently estimated from other genes, and would correspond to a
      non-realistic minimal current admixture of 80%. Thus, our results suggest that a
      positive selection process for CCR5-delta 32 should have occurred in northern
      Europe at most a 1000 years ago, after the Ashkenazi Jews separated from their
      Sephardi kin and moved to north Europe.

PMID- 11196682
TI  - No evidence for linkage in the promoter region of the inducible nitric oxide
      synthase gene (NOS2) in a Danish type 1 diabetes population.
AB  - Exposure of human pancreatic islets to a mixture of cytokines induces expression
      of inducible nitric oxide synthase (iNOS), impairs beta-cell function and induces
      apoptosis. Exposing human islets to high amounts of NO from chemical NO-donors
      causes DNA strand breaks and mitochondrial damage, suggesting that NO is
      deleterious to human beta-cells. Hence, we consider the gene encoding iNOS in
      beta-cells, NOS2, a candidate gene for type 1 diabetes in humans. In the present
      study we have tested three identified polymorphisms within the promoter sequence
      of the human NOS2 gene in a type 1 diabetic family material comprising 154
      affected sib-pair families and 103 affected simplex families (1143 individuals in
      total). PCR-based amplification of the polymorphic loci were established. Linkage
      analysis was performed using the extended transmission disequilibrium testing
      (ETDT). A Bsal RFLP was found not to be polymorphic in 20 type 1 diabetic
      patients and 14 healthy control subjects and was not analysed further. In
      affected cases a nine allele CCTTT repeat and a bi-allelic TAAA repeat revealed
      allelewise Petdt of 0.52 and 0.60, respectively. ETDT applied to (TAAA)n;
      (CCTTT)n haplotypes demonstrated random transmission from heterozygous parents to
      affected offspring. In conclusion, the tested polymorphisms within the NOS2 gene
      promoter did not show evidence for linkage to type 1 diabetes in a Danish family
      material.

PMID- 11196683
TI  - Lack of association between the polymorphism at the heat-shock protein (HSP70-2)
      gene and systemic lupus erythematosus (SLE) in the Mexican mestizo population.
AB  - Major histocompatibility complex (MHC) alleles have been recognized as genetic
      factors for developing systemic lupus erythematosus (SLE). In the present study
      we analyzed whether a heat-shock protein gene (HSP70-2) is involved in
      determining susceptibility to develop SLE in a Mexican Mestizo population. A
      HSP70-2 Pst I polymorphism was detected by a restriction fragment length
      polymorphism analysis of polymerase chain reaction (PCR-RFLP) in 107 SLE patients
      and 158 healthy controls. No statistically significant differences were observed
      in the HSP70-2 allele distribution between patients and healthy controls. HLA-DR
      analysis showed an increased frequency of HLA-DR3 allele in the patients group (P
      < 0.05, OR = 2.26, EF = 6.0%). On the other hand, when we analyzed HSP70-2
      polymorphism in relation to HLA-DR3 allele, we could only detect an increased
      frequency of AB genotype in the DR3 negative patients (pC < 0.05, RR = 2.6, EF =
      11.3%). Linkage disequilibrium was observed for three haplotypes: HLA-DR3-HSP70
      2A (D = 0.03, D' = 0.67, P < 0.01); HLA-DR1-HSP70-2A (D = 0.03, D' = 0.86, P <
      0.01) and HLA-DR8-HSP70-2B (D = 0.02, D' = 0.46, P = 0.02). Our data indicate
      that HSP70-2 gene polymorphism as opposed to the other ethnic groups does not
      appear to be relevant in SLE susceptibility in Mexican patients and that the
      distribution of the different alleles depend on the frequency of HLA alleles
      associated with them.

PMID- 11196684
TI  - P-glycoprotein (encoded by multidrug resistance genes) is not required for
      interleukin-2 secretion in mice and humans.
AB  - P-glycoprotein (encoded by multidrug resistance genes), a member of the ATP
      binding cassette transporter protein superfamily, has been shown to play a role
      in the secretion of cytokines. This conclusion was based upon the inhibition of
      cytokine secretion by anti-P-gp monoclonal antibodies. In this study, we show
      that anti-CD3-stimulated lymphocytes from wild-type, mdr1a knock out and mdr1ab
      double knock out mice produce similar amounts of IL-2, IFN-gamma, IL-4, and IL
      10. In addition, Jurkat T cells that lack P-gp and MDR1-transfected Jurkat T
      cells (JurkatP-gp) as well as purified human peripheral blood CD4+ P-gp+ and CD4+
      P-gp- and CD8+ P-gp+ and CD8+ P-gp- T cell subsets produced comparable amounts of
      IL-2. These data show that P-gp is not required for secretion of IL-2, IFN-gamma,
      IL-4, and IL-10 secretion in mice and IL-2 secretion in humans.

PMID- 11196685
TI  - Association analysis with microsatellite and SNP markers does not support the
      involvement of BCL-2 in systemic lupus erythematosus in Mexican and Swedish
      patients and their families.
AB  - We have described suggestive linkage between microsatellite markers within the
      cytogenetic region 18q21-23 and SLE, a region where linkage with other autoimmune
      diseases has also been detected. The Bcl-2 gene located within this region, is a
      candidate gene because of its role in apoptosis, a physiological mechanism that
      could be deregulated in autoimmune disease. Furthermore, several studies have
      found abnormalities of Bcl-2 expression in SLE patients. We therefore sought to
      determine if the Bcl-2 gene is involved in SLE by studying members of a large
      cohort of Mexican SLE patients (n = 378) and 112 Swedish simplex families. Using
      a microsatellite marker and two single nucleotide polymorphisms located within
      the gene, we were unable to detect association between Bcl-2 and SLE in either
      population. We also tested whether combinations of alleles of the Bcl-2 and IL
      10.G microsatellites would increase the risk for SLE. Our results do not support
      such hypothesis. Our findings suggest that linkage between SLE and the 18q21-23
      region is due to a gene other than Bcl-2.

PMID- 11196686
TI  - Tumor necrosis factor gene polymorphisms in patients with cirrhosis from chronic
      hepatitis C virus infection.
AB  - Pro-inflammatory cytokines including tumour necrosis factor (TNF) mediate the
      pathogenesis of hepatitis C virus (HCV) infection. The distribution of TNF gene
      polymorphisms was examined among cirrhotic and non-cirrhotic patients infected
      with HCV. Thirty Caucasians with cirrhosis due to chronic HCV infection and 114
      HCV-infected patients histopathologically free of cirrhosis were genotyped for
      genetic variants in TNF, lymphotoxin alpha and TNF-receptor type I using PCR
      based techniques. Variability in the progression of HCV-related cirrhosis was
      assessed in a multivariate model including genetic and non-genetic factors such
      as gender, estimated duration of infection, alcohol consumption, and viral
      genotype. Viral genotype and non-genetic host features were not independently
      related to the occurrence or rate of development of cirrhosis in the patient
      population. In contrast, the TNF promoter variants TNF2 (-238A) and TNF3 (-308A)
      conferred a 3.2-fold and 5.1-fold risk of cirrhosis respectively (P = 0.03 for
      both). Reciprocal effects were observed with several TNF alleles and haplotypes
      defined by the -238G/A and -308G/A dimorphic sequences. Polymorphisms in the TNF
      alpha promoter appear to be associated with variability in the histological
      severity of chronic hepatitis C infection.

PMID- 11196687
TI  - Spatial, a gene expressed in thymic stromal cells, depends on three-dimensional
      thymus organization for its expression.
AB  - Although the importance of thymic stroma in thymopoiesis has been recognized, the
      underlying molecular details regarding stromal cell biology remain obscure. To
      study this area, we have cloned genes expressed in thymic stromal cells. Spatial
      is alternatively spliced to generate two mRNAs in thymus and lymph node (LN) but
      it is not expressed in the spleen. In mouse embryos, the short form begins
      expression at day 10 while the long form is not detected until day 12. Both mRNAs
      encode proline rich proteins and their closest homology is to homeobox and POU
      domain transcription factors. Spatial is not expressed in thymocytes, but it is
      expressed in 2-deoxyguanosine-treated day 14 fetal thymic organ culture (FTOC)
      and in reaggregated FTOC. These data suggest that a normal three-dimensional
      organization of stromal cells is required for Spatial expression. An antiserum
      raised against a C-terminal peptide detected proteins of 38 and 32 kDa in Western
      blots of total thymus proteins. In frozen thymus sections, subcapsular epithelial
      cells were stained with the anti-Spatial antiserum. Paracortical subcapsular
      cells of unknown function were also stained in the LN. Both forms of Spatial
      fused to the green fluorescent protein (GFP) localize to the nucleus in
      transfected cells.

PMID- 11196688
TI  - Dinucleotide repeat polymorphism in the interleukin-10 gene promoter (IL-10.G)
      and genetic susceptibility to early-onset periodontal disease.
AB  - Emerging evidence suggests that certain genetic polymorphisms are associated with
      various sub-groups of early-onset periodontal diseases (EOP). We determined the
      genotype with respect to a (CA)n dinucleotide repeat polymorphism in the promoter
      region of the interleukin-10 gene (IL-10.G) in 72 patients with EOP and in 73
      healthy individuals in order to test for possible disease associations. Some
      differences between the frequency of individual IL.10.G alleles in the patients
      groups as compared to the healthy controls were detected. For example the
      frequency of the IL-10.G9 allele in a clinical sub-group of the EOP patients with
      localised disease (L-EOP, n = 21) was 64.3% as compared to 41.8% in the controls.
      However, statistical analysis (Monte Carlo simulation) revealed that the
      differences in IL-10.G allele distribution between the healthy controls and both
      the EOP group and the L-EOP group were not statistically significant. We conclude
      that this study provides no evidence for a role of IL-10.G alleles in genetic
      susceptibility to EOP.

PMID- 11196689
TI  - The common functional C(-159)T polymorphism within the promoter region of the
      lipopolysaccharide receptor CD14 is not associated with sepsis development or
      mortality.
AB  - Sepsis is characterised by a systemic inflammatory response to bacterial products
      during infection, which interestingly both in humans and animal models is gender
      associated with a higher susceptibility of males than females. The CD14 receptor
      is involved in activation of cells by lipopolysaccharides released from Gram
      negative bacteria and, as recently shown, also by products of Gram-positive
      bacteria (e.g., peptidoglycans and lipoteichoic acid). The functional relevance
      of a C(-159)T CD14 polymorphism recently has been shown based on correlation of
      the T allele to higher plasma levels of soluble CD14, and higher membrane
      expression on monocytes. We, therefore, now analysed this CD14 polymorphism in
      204 patients with severe sepsis and 247 controls. No significant difference of
      allele frequencies was observed between sepsis patients and controls neither for
      males nor females. Mortality also was not associated with the polymorphism
      studied. This may suggest that other mechanisms for lipopolysaccharide
      recognition, such as the recently described Toll-like receptors are important for
      inflammatory cell activation in sepsis.

PMID- 11196690
TI  - Immuno- and genetic therapy in autoimmune diseases.
AB  - Animal models of autoimmune disease have been developed that mimic some aspects
      of the pathophysiology of human disease. These models have increased our
      understanding of possible mechanisms of pathogenesis at the molecular and
      cellular level and have been important in the testing, development and validation
      of new immunotherapies. The susceptibility to develop disease in the majority of
      these models is polygenic as is the case in humans. The exceptions to this rule
      are gene knock outs and transgenic models of particular genes which, in
      particular genetic backgrounds, have also contributed to the understanding of
      single gene function and their possible contribution to pathogenesis. Gene
      therapy approaches that target immune functions are being developed with
      encouraging results, despite the polygenic nature of these diseases. Basically
      this novel immuno-genetic therapy harnesses the knowledge of immunology with the
      myriad of biotechnological breakthroughs in vector design and delivery.
      Autoimmune disease is the result of genetic dysregulation which could be
      controlled by gene therapy. Here we summarize the genetic basis of these human
      diseases as well as some of the best characterized murine models. We discuss the
      strategies for their treatment using immuno- and gene therapy.

PMID- 11196691
TI  - Targeting the mucosa: genetically engineered vaccines and mucosal immune
      responses.
AB  - The discovery that inoculation of DNA leads to strong and long lasting immune
      responses generated enthusiasm to assess the efficacy of various genetically
      engineered vaccines against mucosally acquired infections. Various techniques
      have been used to generate the most suitable DNA vaccines, ranging from
      immunization with naked DNA to utilizing genetically engineered recombinant
      viruses and bacteria to deliver the DNA. Different DNA vaccine modalities and
      mucosal immune responses to them have been discussed. It has been shown that even
      though intramuscular and intradermal immunization with these vaccines generates
      strong systemic responses, mucosal responses are not induced. It has been
      proposed that the site of immunization determines mucosal immune responses and
      that primed lymphocytes preferentially accumulate at sites where they have been
      induced thus generating the strongest cellular and antibody responses at the site
      of vaccination. The impact of the site of induction on mucosal immune responses
      to vaccines is discussed. It is possible to enhance desired vaccine effects in
      the mucosa and to modify the undesirable side effects. Cytokines such as IL-2, IL
      12, IL-15 and IL-18 have been used to enhance CTL activity while IL-5, IL-6 and
      the chemokine MIP-1 alpha have shown the capacity to increase IgA responses to
      vaccines.

PMID- 11196692
TI  - The new genetics of bone marrow transplantation.
AB  - There is now little doubt that functional immune polymorphism exists and can
      exert a significant effect on the severity of immunologic disease. Studies in
      this area are driven by the belief that an understanding of the influence of
      immune polymorphism on immunologic disease will improve our ability to predict
      disease occurrence and severity. The usefulness of this information is
      necessarily limited, however, by the fact that an individual has a fixed genome.
      If an individual has an allele which predisposes to increased disease severity,
      there is little we can do, other than treat the disease in that individual in a
      more aggressive manner or attempt to find preventative therapies. There is,
      however, one unique immunologic disorder that is an exception to this rule. Graft
      versus-host disease (GVHD), the major complication of bone marrow
      transplantation, is an immunologic reaction mediated, in large part, by donor T
      cells. It is unique in that it is the only immunologic disorder in which we can
      choose the genetics of the immune system causing the disorder. In this disease,
      more than any other, an understanding of the role of immune polymorphism is
      essential since we could hypothetically use this information to choose a donor
      whose T cells will not mediate GVHD of life-threatening severity. In this review,
      I argue that there is highly suggestive evidence that allelic polymorphism in non
      MHC genes encoding mediators of the immune response exerts a very significant
      effect on the severity of GVHD and that typing for such allelic polymorphisms
      will in future be as important as MHC-typing in choosing an appropriate donor for
      bone marrow transplantation.

PMID- 11196693
TI  - Interleukin-10 gene promoter polymorphism in English and Polish healthy controls.
      Polymerase chain reaction haplotyping using 3' mismatches in forward and reverse
      primers.
AB  - A polymerase chain reaction with sequence-specific primers (PCR-SSP) system using
      primers with mismatches at the 3' ends was developed to determine polymorphisms
      in IL-10 promoter region. Three previously described biallelic polymorphisms in
      IL-10 were linked in a 12 reaction PCR-SSP system and the method used to provide
      genotype data on 233 UK and 166 Polish controls. There are eight possible
      polymorphic combinations in IL-10 promoter gene but only three were observed in
      both control groups. Population frequencies of IL-10 genotypes show, in contrast
      to HLA, that UK and Polish frequencies are remarkably similar.

PMID- 11196694
TI  - Identification of complement receptor one (CR1) polymorphisms in west Africa.
AB  - Complement receptor one (CR1) is a ligand for the rosetting of Plasmodium
      falciparum infected red cells with uninfected cells. Since CR1 exhibits three
      known polymorphisms, we studied European-Americans (n = 112) and African
      Americans (n = 330) and Malians (n = 158) to determine if genetic differences
      existed in an area endemic for malaria that could offer a survival advantage. The
      frequencies of Knops blood group phenotypes McC(b+) and Sl(a-) were greatly
      increased in Africans vs Europeans. Although the frequency of McC(b+) was similar
      between Africans from the USA or Mali, the Sl(a-) phenotype was significantly
      higher in Mali (39% vs 65%, respectively). There was an increased frequency of
      the largest size (250 kD) of CR1 in Mali, but this did not differ significantly
      from the USA (P = 0.09). Both cohorts of Africans had higher expression of red
      cell CR1 than European-Americans but this showed little difference between the
      USA and Mali groups. Thus, the most important CR1 polymorphism relevant to
      rosetting of malaria infected cells appears to be the Knops blood group.

PMID- 11196695
TI  - Single nucleotide polymorphisms in the coding regions of human CXC-chemokine
      receptors CXCR1, CXCR2 and CXCR3.
AB  - Chemokines and their receptors have critical roles in inflammatory and
      immunological responses, and thus their genetic contribution to various human
      disorders needs investigation. In this study, systematic variation screening of
      the entire coding regions of CXCR1 (IL8RA), CXCR2 (IL8RB) and CXCR3 was carried
      out, using genomic DNA from a large number of Japanese healthy individuals and
      patients with rheumatic diseases. In addition to the previously reported
      variations in CXCR1 and in CXCR2, two non-synonymous, two synonymous
      substitutions and one nonsense mutation of CXCR1, one non-synonymous and two
      synonymous substitutions of CXCR2, two non-synonymous substitutions of CXCR3 were
      newly identified. The common single nucleotide polymorphisms (SNPs) at CXCR1
      codon 827 and CXCR2 codon 786 were in strong linkage disequilibrium. In addition,
      familial analysis indicated that human CXCR3 is located on chromosome X. No
      significant association was observed between the variations and the tested
      rheumatic diseases. However, CXCR variations identified in this study will
      provide valuable information for the future studies in medical sciences as well
      as in human genetics.

PMID- 11196696
TI  - IL-6 promoter polymorphisms in rheumatoid arthritis.
AB  - We investigated the possible association between the IL-6 promoter polymorphisms,
      at positions -622 and -174, and susceptiblity to, and/or outcome of, rheumatoid
      arthritis (RA). A total of 163 patients with RA and 157 healthy controls were
      genotyped for IL-6 using a PCR-RFLP method. The -622 and -174 alleles were in
      complete linkage disequilibrium. No difference was observed in the distribution
      of IL-6 promoter genotype or allele frequencies between RA patients and controls.
      However, a significant difference in the mean age at disease onset between IL-6
      genotypes was observed. The present data appear to rule out an important role of
      IL-6 promoter polymorphisms in the susceptibility to RA. However, IL-6 genotypes
      may contribute to the pathogenesis of the disease by influencing the age at
      disease onset.

PMID- 11196697
TI  - Identification of four novel interleukin-13 gene polymorphisms.
AB  - The development of allergic asthma is thought to involve environmental and
      inherited genetic components and has pathophysiological features reflecting in
      part the activity of T cell cytokines. Interleukin-13, a product primarily of
      activated lymphocytes, is considered to be a critical effector molecule in
      allergic airway response and has been found to be overexpressed in the airways of
      patients with asthma. The IL-13 gene is located on chromosome 5q31, one of the
      major loci to be linked to asthma susceptibility, and amongst a cluster of genes
      which dominate the immunopathology of allergic disease. Recently, an IL-13
      promoter polymorphism was found to be associated with allergic asthma. In the
      present study we report the identification of four novel biallelic polymorphisms
      in the IL-13 gene, two intronic and two exonic, one of which results in a basic
      to hydrophilic amino acid change. We characterised the frequencies of these four
      biallelic polymorphisms and the frequencies of the haplotypes, resulting from the
      combination of these four biallelic polymorphisms, in a population of 196 UK
      Caucasoid healthy individuals.

PMID- 11196698
TI  - Polymorphisms in the MBL2 promoter correlated with risk of HIV-1 vertical
      transmission and AIDS progression.
AB  - We investigated the polymorphisms of the promoter region of the MBL2 gene, which
      codifies for the Mannose-binding protein (MBP). The study population included 90
      children with vertically acquired HIV-infection, further divided on the basis of
      the disease rate, 27 HIV exposed-uninfected children, and 74 healthy control
      subjects matched for ethnic origin to evaluate the MBP involvement in the risk of
      HIV-1 infection and to assess the role of the MBP promoter in AIDS progression. A
      region of 380 bp in the promoter of the MBL2 gene was analysed by PCR and direct
      sequencing of both DNA strands. We found that the polymorphism at position -550
      influences the risk of HIV-infection and AIDS progression. Also a 6 bp deletion
      at position -328 was correlated with HIV-1 infection. This study indicates that
      the promoter of the MBL2 gene influences vertical transmission of HIV and the
      course of perinatal infection.

PMID- 11196699
TI  - A novel PCR-RFLP assay for the detection of a polymorphism in the 3' of STAT6
      gene.
AB  - We have identified a novel single nucleotide polymorphism at position 2964 (G/A)
      in the 3' untranslated region of the human STAT6 gene (GeneBank Accession No.
      U16031). A novel PCR-RFLP method has been devised for this polymorphism using the
      amplification-created restriction site (ACRS) method. Allele frequencies in the
      UK Caucasian population were found to be 0.33 for allele A and 0.67 for allele G.

PMID- 11196700
TI  - Ku autoantigen (DNA helicase) is required for interleukins-13/-4-induction of 15
      lipoxygenase-1 gene expression in human epithelial cells.
AB  - As reported previously in human monocytes, a human lung epithelial cell line,
      A549, showed de novo induction of 15-Lipoxygenase-1 (15-LO-1) in response to
      interleukins-13 (IL-13) and -4 (IL-4). In this cell line, 15-LO-1 expression, by
      RT-PCR and western blotting, was observed following 6 and 24 h of exposure to
      human IL-13 (ED50 5 ng/ml) and IL-4 (ED50 0.2 ng/ml). We have previously shown
      that no cis-acting regulatory elements exist within the 15-LO-1 promoter region.
      To define IL-13 and IL-4 responsive trans-acting elements, we identified a region
      (DP2: -353 to -304 bp site) within the 15-LO-1 promoter (by footprinting
      experiments) to which IL-13-responsive elements (or factors) bind specifically
      (Kelavkar et al, 1998, Mol Biol Rep 25, 173-182). To further delineate this
      region, we constructed (by site-directed mutagenesis) several deletion mutants in
      the 'LOPB5' region containing the 29 bp within the -353 to -304 bp of the DP2
      core element. These were: DP3 (site totally deleted), DP4 (5 bp deleted at the
      center of the site), DP5 (8 bp at the 5'-end of the site) and DP6 (13 bp at the
      3'-end of the site). Cotransfection of these deletion constructs (driving
      luciferase reporter genes) was associated with 90% (DP4, DP5 and DP6) or 100%
      (DP3) abrogation of promoter activity at 24 h. Purification of nuclear protein
      extracts from IL-13 and IL-4-stimulated A549 cells, using a DP2 core containing
      affinity column, identified a 150 kDa protein under non-denaturing conditions,
      and two, 70 and 85 kDa proteins under denaturing conditions. These were not
      detectable by Coomassie blue staining in control nuclear protein extracts. Matrix
      assisted laser desorption ionization mass spectrometry (MALDI-MS) of the tryptic
      digests of these proteins, identified one as the 86 kDA Lupus KU autoantigen
      protein P86 and the second as the 70 kDa Lupus KU autoantigen protein P70. Gel
      shift and supershift experiments using monoclonal antibodies toward Ku antigen
      and its individual subunits, and utilizing DP2 and other mutant oligonucleotides
      with purified nuclear protein extracts from control and cytokine-treated A549
      cells, confirmed our findings. Furthermore, electroporation of neutralizing anti
      Ku70, Ku 80 and Ku70/80 antibodies into A549 cells totally suppressed IL-13 and
      IL-4-stimulated 15-LO-1 induction in these cells. Further, immunoprecipitation
      experiments data suggests that IL-4 and IL-13 activate Ku antigens and 15-LO-1
      expression through distinct signaling events. In summary, in A549 cells, Ku
      antigen is induced in response to the cytokines, IL-13 and -4, and a 29 bp region
      within the -353 to -304 bp region of the 15-LO-1 promoter is required for its
      binding and subsequent induction of 15-LO-1 gene expression. The findings may
      provide an important link between the established dysregulated function of Ku
      antigen in auto-immune diseases, such as systemic lupus erythematosus and
      thyroiditis, and the increasingly recognized 'anti-inflammatory' role of 15-LO-1.

PMID- 11196701
TI  - Genetic control of susceptibility to UV-induced immunosuppression by interacting
      quantitative trait loci.
AB  - Ultraviolet B radiation (290-320 nm) initiates a dose and wavelength dependent
      down-regulation of cell-mediated immunity which is critical in experimental
      ultraviolet radiation (UV) carcinogenesis, preventing immune attack on highly
      antigenic UV-induced tumors. UV-induced immunosuppression has been demonstrated
      in humans and may be a risk factor for skin cancer. In this study, we have
      investigated genetic linkage of the autosomal loci controlling this trait.
      Previously, we had derived a model describing control of susceptibility to UV
      induced immunosuppression in inbred mice by unlinked interacting autosomal and X
      linked loci. A genome-wide scan using MIT microsatellite markers was carried out
      on 100 backcross (BALB/c x (BALB/c x C57BL/6) F1) mice derived from the inbred
      strains BALB/c (low susceptibility) and C57BL/6 (high susceptibility) and tested
      for systemic UV-induced immunosuppression of a contact hypersensitivity response.
      The values for % suppression for each animal and the genotype data were used to
      investigate genetic linkage by multiple regression analysis. Significance was
      assessed using the permutation test. Both main effects and interactive effects
      were investigated, first with each genotype marker singly, and secondly, in a
      novel approach using markers pairwise. A joint model was derived in which all
      loci and pairs of loci identified were included simultaneously in a multiple
      regression model. This model indicates four quantitative trait loci (QTLs) with
      significant main effects, one on chromosome 10 which decreased susceptibility to
      UV-induced immunosuppression and QTLs on chromosomes 6, 17 and 1 which increased
      susceptibility. Additionally, loci on chromosomes 14 and 19 showed significant
      interaction with the locus on chromosome 1. Further investigation indicated a
      potential three-way interaction involving the loci on chromosomes 1, 14 and 19.

PMID- 11196702
TI  - Linkage of human tumor necrosis factor-alpha to human osteoporosis by sib pair
      analysis.
AB  - Osteoporosis as well as osteopenia are common human conditions considered to
      result from the interplay of multiple genetic and environmental factors. Twin and
      family studies have yielded strong correlation between measures of bone mass and
      a number of genetic factors. Certain genes (e.g., cytokines such as interleukin
      1, interleukin-6, or tumor necrosis factor-alpha) are capable of regulating
      metabolism, formation, and resorption of bone; all processes that determine bone
      mass. We tested 192 sib-pairs of adult Japanese women from 136 families for
      genetic linkage between osteoporosis and osteopenia phenotypes and allelic
      variants at the tumor necrosis factor-alpha (TNFA) locus, using a dinucleotide
      repeat polymorphism located near the gene. The TNFA locus showed evidence for
      linkage to osteoporosis, with mean allele sharing of 0.478 (P = 0.30) in
      discordant pairs and 0.637 (P = 0.001) in concordant affected pairs. Linkage with
      osteopenia was also significant in concordant affected pairs (P = 0.017).
      Analyses limited to the post-menopausal women in our cohort showed similar or
      even stronger linkage for both phenotypes. The results provide evidence that
      genetic variations within the TNFA locus or adjacent genes affect regulation of
      mineral metabolism in bone and some of them confer risk for osteoporosis in adult
      women.

PMID- 11196703
TI  - Characterization and genomic sequence of the murine 60 kD Ro gene.
AB  - Autoantibodies binding 60 kD Ro (or SS-A) are commonly found in patients with
      systemic lupus erythematosus and Sjogren's syndrome. While many studies have
      examined the autoimmune response directed against this RNA-protein, its function
      is still uncertain. As part of a broad effort to better understand animal models
      of anti-Ro autoimmunity we have characterized the murine 60 kD Ro gene. Southern
      blot analysis of mouse genomic DNA suggests that the 60 kD Ro gene is a single
      copy gene. The complete sequence of the gene was determined from three
      overlapping genomic lambda phage clones (GenBank accession number AF065398). The
      murine 60 kD Ro gene spans approximately 23 kb and consists of 8 or 9 exons. DNA
      sequence analysis revealed the presence of multiple B1 repetitive units. It maps
      in synteny with the human 60 kD Ro gene. Therefore, the isolation and
      characterization of the 60 kD Ro gene will be instrumental for future studies on
      protein function and the role this protein plays in the development of autoimmune
      responses.

PMID- 11196704
TI  - TNF-alpha-induced apoptosis in neonatal lymphocytes: TNFRp55 expression and
      downstream pathways of apoptosis.
AB  - Previously we have shown decreased Fas-mediated apoptosis in cord blood
      lymphocyte subsets. In this study, we compared tumor necrosis factor (TNF)-alpha
      induced apoptosis in T lymphocytes and their subsets between cord blood and
      peripheral blood from healthy young controls. The expression of TNF receptor I
      (TNFR-I) was assessed by flow cytometry and quantitative RT-PCR. The expression
      of adapter molecules TNF receptor-associated death domain (TRADD), Fas-associated
      death domain (FADD) and TNF-associated factor-2 (TRAF-2) and caspase 3 was
      analyzed by Western blotting. The activity of caspase 3 and caspase 8 was
      measured by colorimetric assay. The susceptibility of CD4+ and CD8+ T cells to
      TNF-alpha-induced apoptosis was measured by terminal deoxytidyl transferase
      mediated dUTP nick end labelling (TUNEL) assay. Both CD4+ and CD8+ T cell subsets
      from cord blood demonstrated decreased susceptibility to TNF-alpha-induced
      apoptosis that was associated with decreased activation of both caspase 8 and
      caspase 3 as compared to T cell subsets in peripheral blood. Furthermore,
      expression of TNFR-I, TRADD and caspase 3 was decreased in cord blood lymphocytes
      as compared to peripheral blood lymphocytes. The significance of these
      observations is discussed.

PMID- 11196705
TI  - The centromeric part of the human NK gene complex: linkage of LOX-1 and LY49L
      with the CD94/NKG2 region.
AB  - The natural killer (NK) gene complex is a genomic region containing lectin-type
      receptor genes. We have established a contig of PAC and BAC clones comprising
      about 1 Mb of the centromeric part of the NK gene complex. This region extends
      from the LOX-1 gene, which encodes a receptor for oxidized LDL and was found
      within 100 kb telomeric of the STS marker D12S77, contains the CD94 and NKG2 NK
      receptor genes and reaches beyond D12S852 on the proximal side. In this part we
      have mapped the human LY49L gene, a homologue of the rodent Ly49 genes, which
      encode important MHC class I receptors for the regulation of NK cell activity in
      rodents. The LY49L gene is localized 100 to 200 kb centromeric of the NKG2 gene
      cluster and 300 to 400 kb telomeric of the STS marker D12S841. Genomic sequencing
      of the complete gene including promoter and intron sequences confirmed that the
      structure is similar to the mouse Ly49 genes. Screening of several cDNA libraries
      did not detect any transcripts of putative additional human LY49 genes. In
      addition, in the course of these studies several EST sequences were localized in
      the region, one immediately upstream of the LY49L gene.

PMID- 11196706
TI  - CCR5 (chemokine receptor-5) DNA-polymorphism influences the severity of
      rheumatoid arthritis.
AB  - Chemokines are critical for the inflammatory process in autoimmune diseases such
      as rheumatoid arthritis (RA). The chemokine receptor-5 (CCR5) mediates chemotaxis
      by CC-chemokines and is expressed by lymphocytes with the Th1 phenotype and
      monocyte/macrophages. A 32 bp deletion in the CCR5 (CCR5-delta 32 allele)
      abolishes receptor expression in homozygotes, while CCR5-delta 32 carriers would
      express less receptor than wild-type homozygotes. This polymorphism is related to
      the resistance to HIV-1 infection and progression towards AIDS. We hypothesized
      that the CCR5-delta 32 allele may modulate the severity of disease in RA. A total
      of 160 RA-patients (71 and 89 with severe and non-severe phenotypes,
      respectively) and 500 healthy individuals from the same Caucasian population
      (Asturias, northern Spain) were genotyped. Carriers of the CCR5-delta 32 allele
      were at a significantly higher frequency (P = 0.012) in non-severe compared to
      severe patients (17% vs 4%). Our results suggest that the CCR5-delta 32
      polymorphism is a genetic marker related to the severity of RA.

PMID- 11196707
TI  - Lack of association between the interferon regulatory factor-1 (IRF1) locus at
      5q31.1 and multiple sclerosis in Germany, northern Italy, Sardinia and Sweden.
AB  - Interferon regulatory factor-1 (IRF-1) is a transcriptional inducer of the
      interferon-beta (IFN-beta) gene and other interferon-stimulated genes. A GT
      repeat polymorphism in the 7th intron of the IRF-1 gene was used as a marker to
      test for association with multiple sclerosis (MS) in a case-control study
      including individuals from Germany, Northern Italy and Sweden. In none of these
      populations, did we find any significant allelic association with disease. This
      lack of association was confirmed by testing transmission disequilibrium of
      individual IRF1 alleles in a representative sample of Sardinian simplex MS
      families. No deviation of the expected 50% transmission rates was seen.
      Therefore, our work does not provide evidence in favor of IRF1 being a candidate
      for conferring genetic susceptibility to, or protection against, MS in Europe.

PMID- 11196708
TI  - A new polymorphism in the promoter region of the human interleukin-16 (IL-16)
      gene.
AB  - Interleukin 16 (IL-16) is a chemotactic cytokine which binds to CD4 and affects T
      cell activation. Here we report a novel single nucleotide polymorphism, T to C,
      in the promoter region of the IL-16 gene in two distinct Asian populations,
      Japanese and Thai. This mutation occurs at an allele frequency of approximately
      22% and 18%, respectively. Although IL-16 potently suppresses replication of
      human immunodeficiency virus type 1 (HIV-1), we observed no significant
      difference in the allele frequency of this polymorphism between HIV-1-infected
      and non-HIV-1-infected individuals in both Asian populations. Since differential
      IL-16 levels have been reported to be associated with inflammatory diseases such
      as systemic lupus erythematosus, atopic dermatitis and allergic asthma, it would
      be of interest to analyze the allele frequency of this mutation in patients with
      these autoimmune and allergic diseases.

PMID- 11196709
TI  - CTLA-4 in autoimmune diseases--a general susceptibility gene to autoimmunity?
AB  - For most autoimmune disorders, the pattern of inheritance is very complex. The
      major histocompatibility complex (MHC) gene complex has been implicated as the
      major genetic component in the predisposition to these diseases but other genes
      are likely to be involved. Based on function and experimental data, the gene
      encoding cytotoxic T lymphocyte-associated antigen 4 (CTLA4) has been suggested
      as a candidate gene for conferring susceptibility to autoimmunity. In this
      review, we critically evaluate the evidence for pathogenetical involvement of
      CTLA-4 in the different autoimmune diseases with focus on the possible role of
      genetic variation of the CTLA4 locus.

PMID- 11196710
TI  - Cytokine (TNF alpha, LT alpha and IL-10) polymorphisms in inflammatory bowel
      diseases and normal controls: differential effects on production and allele
      frequencies.
AB  - The influence of biallelic polymorphisms in the tumour necrosis factor-alpha (TNF
      alpha), lymphotoxin-alpha (LT alpha) and interleukin-10 (IL-10) genes on
      stimulated TNF alpha and IL-10 production was studied in ulcerative colitis (UC)
      patients, Crohn's disease (CD) patients and in healthy controls. A polymerase
      chain reaction sequence-specific primer (PCR-SSP) system was developed to type
      nine biallelic polymorphisms, three in each of the TNF alpha, LT alpha and IL-10
      genes. Production of the TNF alpha and IL-10 was measured by ELISA in
      lipopolysaccharide (LPS) stimulated whole blood. Four haplotypes of the TNF alpha
      gene, three haplotypes of LT alpha and three haplotypes of IL-10 were identified.
      No significant differences in haplotype frequencies were found between patients
      and controls overall. On subgroup analysis however, haplotype TNF-2 was more
      frequent in women with extensive colitis compared to distal colitis (31% vs 12%;
      P = 0.028). This difference was even greater for the combined TNF-2-LT alpha-2
      haplotype (56% vs 21%; P = 0.0007). The TNF-2 and LT alpha-2 haplotypes were
      associated with higher TNF alpha production in CD patients, and the TNF-4
      haplotype was associated with lower TNF alpha production in UC patients. The A
      allele in the IL-10 promoter region at position -1082 was associated with
      decreased IL-10 production in CD patients and controls (P = 0.005, P = 0.015
      respectively). These data provide evidence that the effect of TNF alpha, LT alpha
      and IL-10 gene polymorphisms on cytokine production differ in CD, UC patients and
      controls.

PMID- 11196711
TI  - SPLASH (PLA2IID), a novel member of phospholipase A2 family, is associated with
      lymphotoxin deficiency.
AB  - Lymphotoxin (LT) deficient mice have profound defects in the splenic
      microarchitecture associated with defective expression on certain gene products,
      including chemokines. By using subtraction cloning of splenic cDNA from wild-type
      and LT alpha or TNF/LT alpha double deficient mice we isolated a novel murine
      gene encoding a secretory type phospholipase A2, called SPLASH. The two major
      alternative transcripts of SPLASH gene are predominantly expressed in lymphoid
      tissues, such as spleen and lymph nodes. SPLASH maps to the distal part of
      chromosome 4, to which several cancer-related loci have been also mapped.

PMID- 11196712
TI  - Susceptibility to Leishmania major infection in mice: multiple loci and
      heterogeneity of immunopathological phenotypes.
AB  - Susceptibility as opposed to resistance of mouse strains (e.g., BALB/c vs
      C57BL/6) to Leishmania major has been attributed to a defective Th1 and a
      predominant Th2-response, resulting in increased IL-4 and IgE production, and
      decreased interferon gamma (IFN gamma) production, macrophage activation and
      elimination of parasites. Here we report dissection of genetic and functional
      aspects of susceptibility to leishmaniasis using two contrasting inbred strains
      BALB/cHeA (susceptible) and STS/A (resistant) and a resistant Recombinant
      Congenic (RC) Strain, CcS-5/Dem, which carries a random set of 12.5% of genes
      from the strain STS and 87.5% genes from the susceptible strain BALB/c. Linkage
      analysis of F2 hybrids between the resistant RC strain CcS-5 and the susceptible
      strain BALB/c revealed five loci affecting the response to the infection, each
      apparently associated with a different combination of pathological symptoms and
      immunological reactions. The correlation between Th2-type immune reactions and
      the disease in the F2 mice was either absent, or it was limited to mice with
      specific genotypes at loci on chromosomes 10 and 17. This suggests that the
      resistance vs susceptibility is influenced by mechanisms additional to the
      postulated antagonistic effects of Th1 and Th2 responses, and that the host's
      genotype affects the development of leishmaniasis in a complex way.

PMID- 11196713
TI  - Is interleukin-6 important in inflammatory bowel disease?
AB  - The IL-6 gene maps to an area of chromosome 7 known to be significant for
      susceptibility to inflammatory bowel disease. The functional effects of
      interleukin-6 (IL-6) polymorphisms in the 4th intron and in the 3' flanking
      region of IL-6 gene were studied in 192 inflammatory bowel disease patients and
      healthy subjects. A polymerase chain reaction with sequence-specific primers (PCR
      SSP) was used to determine a G to A polymorphism (* at position 4470 in intron 4
      of IL-6 gene). Four alleles in the 3' flanking region were studied using a
      variable number of tandem repeats PCR (VNTR-PCR) amplification. Production of IL
      6 was measured in lipopolysaccharide (LPS) stimulated whole blood samples by an
      enzyme-linked immunosorbent assay (ELISA). A modest increase in the frequency of
      the IL-6*G allele was noted in Crohn's disease (CD) patients (50%) and ulcerative
      colitis (UC) patients (46.1%) as compared to controls (39.8%, P = 0.025). We were
      unable to find any significant functional effect of the IL-6 polymorphisms tested
      on IL-6 protein production. We postulate that the IL-6 polymorphisms investigated
      here may be in linkage disequilibrium with a susceptibility gene and that they
      may be utilised as genetic markers.

PMID- 11196714
TI  - Eosinophilia is attenuated in experimental colitis induced in IL-5 deficient
      mice.
AB  - Tissue eosinophilia is a feature of idiopathic inflammatory bowel disease and
      other forms of colonic inflammation but it is not clear whether the role of
      eosinophils in the disease process is to contribute to tissue damage. Interleukin
      5 (IL-5) stimulates production and activation of eosinophils in vitro and
      enhances immunoglobulin A (IgA) production. As very little is known about the
      function of IL-5 in the colon, the aim of this study was to assess its role in
      colonic inflammation. IL-5 deficient mice were studied using the dextran sulphate
      sodium (DSS)-induced colitis model and the results compared to a congenic IL-5+/+
      strain. The absence of IL-5 resulted in reduction of tissue eosinophilia (P <
      0.0001) but was not reflected in differences in the severity of the disease (P >
      0.5) or in the extent of tissue damage in this model of colitis. Numbers of
      immunoglobulin-containing cells in IL-5 deficient mice were similar to those in
      the IL-5+ mice. We conclude that the main role of IL-5 in DSS-induced colonic
      inflammation is to attract a population of eosinophils which do not appear to
      contribute significantly to the initiation or development of tissue damage in
      this model of colitis.

PMID- 11196715
TI  - Genetic polymorphism of IL-12 p40 gene in immune-mediated disease.
AB  - Understanding of the genetic basis of autoimmune diseases is currently
      incomplete. Cytokine gene polymorphisms warrant consideration as factors
      explaining variation in the human immune and inflammatory responses and as
      candidate susceptibility genes for related pathological states. Interleukin 12
      (IL-12) is a key regulator of the polarisation of immune responses to T helper 1
      or 2 categories and plays a role in autoimmune and infectious diseases. Using a
      bioinformatic strategy, we aligned cDNA and expressed sequence tag sequences to
      identify putative polymorphic regions of the IL-12 p40 gene. Position 1188 in the
      3' untranslated region (UTR) was polymorphic with the frequency of the common
      allele around 80% in healthy UK Caucasoids. PCR genotyping of multiple Caucasoid
      groups and an African group showed significant population variation. In a case
      control design, the polymorphism was not associated with rheumatoid arthritis,
      Felty's syndrome or large granular lymphocyte syndrome with arthritis or multiple
      sclerosis. A nonsignificant increase in the B allele frequency was observed in
      the rare large granular lymphocyte syndrome without arthritis (odds ratio 2.02
      95% CI 0.95-4.3). This new genetic marker could be useful in anthropological
      studies and should be investigated in other autoimmune, allergic, inflammatory
      and infectious diseases.

PMID- 11196716
TI  - A TNFR2 3' flanking region polymorphism in systemic lupus erythematosus.
AB  - The role of pro-inflammatory cytokines in systemic lupus erythematosus (SLE)
      remains somewhat controversial. Several studies have shown increased production
      of TNF alpha and IL-6 in patients with SLE. Increased production of IL-6, TNF
      alpha, and IL-1 soluble receptors have also been reported. This finding is
      provocative because the soluble receptors have the capacity to act as
      antagonists. Several other inflammatory disorders are also associated with
      increased production of soluble TNF alpha receptors suggesting that this may be a
      general compensatory mechanism designed to down-regulate inflammation. The recent
      identification of an SLE disease susceptibility locus near the TNFR2 locus (TNFR
      p75) suggested the hypothesis that genetically driven differences in soluble
      TNFR2 production could play a role in the genetic susceptibility to SLE. We
      therefore characterized the frequency of a genetic polymorphism in the 3'
      untranslated region of the TNFR2 gene in Caucasoid SLE patients and
      geographically matched controls. No difference in the gene frequency of the two
      base-pair polymorphism in SLE patients compared to controls was found, nor was
      there any association with any particular clinical phenotype.

PMID- 11196717
TI  - A polymorphic microsatellite marker in the human p55 TNF receptor, CD120a.
AB  - We provide characterization of a highly polymorphic dinucleotide repeat in the
      human TNF-receptor 1 gene (TNFR1, TNFRp55, CD120a). We have observed 11 alleles
      at this locus in individuals from the West of Scotland. In a panel of healthy,
      unrelated individuals from the West of Scotland (n = 143), the overall
      heterozygosity was 68%, indicating the potential usefulness of these markers in
      immunogenetic studies.

PMID- 11196718
TI  - New polymorphisms in the IL-10 promoter region.
AB  - Interleukin-10 (IL-10) is an important immunoregulatory cytokine. We searched for
      new sequence variations in the 5' flanking region of the IL-10 gene by denaturing
      high performance liquid chromatography. A 3996 bp region spanning position -3934
      to +61 was amplified in 12 polymerase chain reaction (PCR) fragments and each
      fragment was screened for variations in 23 Italian individuals. The following
      eight sequence variations all consisting of single base pair substitutions were
      identified: -3533A/T, -2769A/G, -2739A/G, -2013A/G, -1349A/G, -1255C/T, -851A/G, 
      657A/G. The new polymorphisms were analysed in an additional panel of random
      Italian individuals. The same samples were also tested for the IL10.G and IL10.R
      microsatellites, and for the two previously described single nucleotide
      polymorphisms (SNPs) at positions -1082 and -592. Highly significant pairwise
      linkage disequilibria were observed between alleles at most SNPs. Three major
      haplotypic combinations of alleles at multiple SNP sites were observed.

PMID- 11196719
TI  - A Bsr BI polymorphism in exon 1C of the human interleukin-1 receptor type I (IL
      1RI) gene.
AB  - We have identified a single nucleotide polymorphism in the 5' region of the human
      interleukin-1 receptor type I (IL-1RI) gene, a C-->A transversion at position 52
      in exon 1C (GenBank accession number AF172151) which creates a Bsr BI restriction
      endonuclease site. Allele frequencies in a Caucasian population were 0.72 (C
      allele) and 0.28 (A allele).

PMID- 11196720
TI  - Biliary complications associated with laparoscopic cholecystectomy--an analysis
      of common misconceptions.
AB  - BACKGROUND: Several views are expressed by surgeons on biliary complications
      following laparoscopic cholecystectomy as follow: most are caused by trainees;
      complications occur in the presence of difficult anatomy/pathology; injuries
      occur more proximally than at open cholecystectomy; most injuries are recognised
      immediately and most can be managed non-operatively. The aim of our study was to
      determine if these views are substantiated in clinical practice. METHODS: The
      mode of presentation, management and outcome of thirty-two patients referred to a
      hepatobiliary unit over a seven year period were analysed. RESULTS: In 72% of
      cases the initial operator was a consultant. Five of the 32 complications (16%)
      occurred in the presence of difficult anatomy/pathology. Two patients had
      proximal biliary tree injuries, the only mortalities (two) occurring in this
      group. Only 41% of injuries were detected immediately; 87% required surgical
      intervention, hepaticojejunostomy being the most common procedure performed
      (75%). CONCLUSION: Our study shows that the majority of bile duct injuries are
      not caused by trainees, do not occur because of unusual anatomy/pathology, do not
      occur in the proximal biliary tree and are not recognised at the time of
      operation. Most injuries ultimately require major reconstructive surgery for
      definitive management.

PMID- 11196721
TI  - Proximal femoral fracture in Northern Ireland between 1985-1997--trends and
      future projections.
AB  - The aims of this study were to identify changing trends with time of the
      incidence of proximal femoral fracture and to enable future number of hip
      fractures to be projected. Hospital theatre records in Northern Ireland were
      surveyed in 1985, 1991, 1994 and 1997 to establish the number of surgical
      procedures for proximal femoral fracture. The age and sex specific rates for
      males and females aged 50+ years were calculated. Analysis of age and sex
      specific incidence rates was undertaken using linear regression and Poisson
      regression. A 1.6% increase per annum (95% CI 1.0-2.2) was noted in males and
      females from 1985 to 1997. Projected increases in rates of proximal femoral
      fracture were calculated using population projection for 2001, 2006, 2011 and
      2016. Modelling (a) assuming the age standardised rates in 1997 remain static and
      continue predicted a 55% fracture increase in males and a 29% increase in females
      by 2016, (b) assuming the secular increases continued predicted a 93% fracture
      increase in males and a 67% increase in females and (c) assuming further linear
      growth on a log-scale predicted a fracture increase in males of 135% and 99% in
      females. The number of proximal femoral fractures in Northern Ireland is
      increasing faster than that anticipated due to demographic changes alone,
      supporting a secular increase which was evident throughout the period of time
      studied, in contrast to that reported from other regions in the United Kingdom.

PMID- 11196722
TI  - Periprosthetic femoral fractures in Northern Ireland.
AB  - Twenty-five patients with periprosthetic femoral fractures were admitted to the
      Ulster Hospital between August 1998 and May 2000. Average age was 77 years
      (range, 42-96 years) with a female to male ratio of 2:1. Twenty-four of the
      fractures occurred following primary joint arthroplasty on average 7.6 years from
      insertion of the primary prosthesis. One patient sustained an intraoperative
      fracture during revision surgery. In the majority (80%), the periprosthetic
      femoral fracture was associated with a traumatic event. On average, two days
      elapsed from the time of injury until admission to our unit. Time from admission
      to surgery was on average 4 days. All patients were treated by open fracture
      fixation. Duration of stay in the fracture unit was on average 20 days. Prior to
      their fracture 92% of patients were living at home and 84% were mobile either
      unaided or with the use of a stick. At most recent review, 72% are back living at
      home and 60% are mobile either unaided or with the use of a stick. We emphasise
      that there is the likelihood of an increase in periprosthetic femoral fractures
      due to the increasing number of primary arthroplasties being performed on a more
      active, ageing population. Preventative measures and cost implications are also
      discussed.

PMID- 11196723
TI  - Drugs for dementia: the first year. An audit of prescribing practice.
AB  - In March 1998 the Department of Health and Social Services issued prescribing
      guidelines for the use of drugs for dementia. A criterion based audit of 202
      consecutive cases was undertaken over one year which showed that the prescribing
      guidelines in general were being followed. A small number of patients, 3, were
      prescribed the drugs outside the guidelines and most failures, 10, were due to
      poor recording of data in the clinical record. Despite the recommendation of the
      DHSS no agreed shared care protocols have been implemented but this does not seem
      to have affected access to these drugs. As a result of this audit changes have
      been made with regard to documentation of patient assessments and suggestions
      made to review Clinical Resource Efficiency Support Team (CREST) guidelines.

PMID- 11196724
TI  - Non-small cell lung cancer and CHART (continuous hyperfractionated accelerated
      radiotherapy)--where do we stand?
AB  - This paper reviews the use of hyperfractionated and/or accelerated radiation
      therapy in the curative treatment of non-small cell lung cancer, and explains the
      scientific rationale behind the development of these regimes. The indications,
      practicalities and economics of introducing them routinely are addressed. Novel
      radiotherapy techniques are further discussed in the context of current
      developments and on-going clinical trials.

PMID- 11196725
TI  - Renal replacement therapy in Ireland--the Belfast experience. Based on the 2nd J
      Creery Ferguson Memorial Lecture of the Royal College of Physicians of Ireland on
      the occasion of the bicentenary of the Royal Victoria Hospital--7th March 1997.

PMID- 11196726
TI  - Airway management in a patient with a nail-gun injury to the floor of the mouth.

PMID- 11196727
TI  - Curative surgery following failure of vancomycin therapy: a case report of
      methicillin resistant staphylococcal endocarditis on a native mitral valve.

PMID- 11196728
TI  - Conservative management of major liver trauma.

PMID- 11196729
TI  - Cystic tumours of the pancreas--the importance of correct diagnosis and
      treatment.

PMID- 11196730
TI  - Volvulus of the gallbladder.

PMID- 11196731
TI  - The delivery of the first babies conceived using testicular sperm in Northern
      Ireland.

PMID- 11196732
TI  - Twin pregnancy with a living fetus and coexisting complete hydatidiform mole.

PMID- 11196733
TI  - Acute bilateral anterior dislocations of the shoulders.

PMID- 11196734
TI  - An unusual case of patellar dislocation. A case report and literature review.

PMID- 11196735
TI  - Aspirin-related small bowel diaphragm disease identified during emergency
      laparotomy.

PMID- 11196736
TI  - The declining autopsy rate and clinicians' attitudes.
AB  - The autopsy rate has been declining worldwide for decades. This study determined
      the overall and differential autopsy rates for the Royal Victoria Hospital,
      Belfast for the years 1997-1999 inclusive. Trends were examined by comparison
      with previously collected data for the years 1990, 1991 and 1993. Reasons for the
      decline in autopsy rates as perceived by hospital clinicians were assessed by
      means of a questionnaire. Over the last decade, there has been a steady decline
      in the overall autopsy rate from 30.4% in 1990 to 18.4% in 1999. This is due to a
      decrease in the hospital autopsy rate from 21.6% in 1990 to 7.9% in 1999. The
      coroner's autopsy rate has remained comparatively unchanged at around 11%. The
      decline in the overall and hospital autopsy rates involves all of the principal
      bedholding directorates, but is most dramatic in medicine, surgery and intensive
      care, where hospital autopsy rates are currently 7% or less. The main reasons for
      this decline as perceived by clinicians are difficulty in obtaining consent from
      relatives and advances in modern diagnostic techniques. The findings of this
      enquiry are in keeping with trends elsewhere, despite repeated studies which
      clearly demonstrate the continuing value of the autopsy in clinical practice.
      Recent publicity concerning the retention of organs can only have an adverse
      affect. Pathologists and clinicians who value the autopsy must become actively
      engaged in both public and medical education. Renewed emphasis must be placed on
      the importance of the autopsy in teaching, training and clinically relevant
      research, and as a means of medical audit.

PMID- 11196737
TI  - Paediatric renal transplantation in Northern Ireland (1984-1998).
AB  - Over the last 20 years a comprehensive paediatric nephrology service has been
      developed in Northern Ireland, based in the academic medical unit at the Royal
      Belfast Hospital for Sick Children (RBHSC). In the 15 years 1984-1998 a total of
      77 renal transplants have taken place in patients aged 18 years and under.
      Initially transplants were only considered in children over five years of age but
      in the past eight years children as young as two years have successfully received
      kidneys. Aggressive nutritional support combined with peritoneal dialysis has
      enabled survival to a size when transplantation is feasible. The 5 year graft
      survival was 64%, with two children dying following transplantation. The
      complexity of managing this age group is reflected by the fact that a total of 10
      transplants (13%) failed in the first 30 days. These figures compare favourably
      with statistics reported by similar paediatric centres from across the United
      Kingdom and Republic of Ireland, and with local results in adult patients. This
      demonstrates that a successful end stage renal replacement programme for children
      is achievable in a relatively small population, which is geographically isolated.

PMID- 11196738
TI  - Multiple sclerosis in Northern Ireland: a historical and global perspective.
AB  - The uneven worldwide distribution of multiple sclerosis has been of interest to
      epidemiologists, neurologists and statisticians for over a century, prevalence
      rates for the disease apparently being determined by variations in age, gender,
      geography, race and ethnic group. Northern Ireland has been recognised as an area
      of high MS prevalence since the truly seminal work of Allison and Millar almost
      50 years ago. The most recent study in Northern Ireland was undertaken in 1996
      and involved the neighbouring districts of Coleraine, Ballymena, Ballymoney and
      Moyle (population, 151,000). Overall, 254 definite and probable cases were
      identified (prevalence: 168.2/100,000) with a further 34 suspected cases (overall
      prevalence: 190.7/100,000). Females predominated (ratio, 2.1:1) and the average
      age at onset was 31.6 years. The highest age specific prevalence rate for females
      was in the 35-44 years old age group (519.6/100,000) and for males was in those
      aged 55-64 (292.3/100,000). The spectrum of disability was broad and 20% could be
      considered to have relatively "benign" disease. These figures sadly confirm that
      Northern Ireland has one of the highest and rising MS prevalence rates in the
      world and implies an enormous potential for societary costs.

PMID- 11196739
TI  - Discovery of the Rett syndrome gene and its function.

PMID- 11196740
TI  - Neonatal tetanus in the southeast of Turkey: risk factors, and clinical and
      prognostic aspects. Review of 73 cases, 1990-1999.
AB  - Although neonatal tetanus (NT) can be prevented by immunization of expectant
      mothers and by good hygiene and asepsis during delivery, it is still a common
      cause of neonatal mortality in developing countries. The objective of this study
      was to determine indicators in NT. We reviewed the clinical records of 73
      neonates admitted to the Pediatric Infectious Diseases Ward of Dicle University
      Hospital, Diyarbakir, Turkey, with the diagnosis of NT. Delivery had occurred at
      home by untrained traditional birth attendants in all cases. None of the mothers
      had immunization with tetanus toxoid during pregnancy. The median age of infants
      at presentation was 7.3 days and the mean age at onset of symptoms was 5.6 +/-
      2.8 days. The overall mortality was found to be 52 percent. Mortality was
      significantly associated with an incubation period of 4.3 days or less and fever.
      The incidence of NT in Turkey is on the decline due to widespread tetanus toxoid
      use in pregnant women, but in some regions, especially in the so-called rural
      poor areas, there is still risk of preventable diseases. Hygienic deliveries and
      immunization of pregnant women are very important for the prevention of NT
      deaths, and universal prenatal care, including education programs on appropriate
      perinatal and cord care, can significantly reduce NT incidence and mortality in
      developing countries.

PMID- 11196741
TI  - Reactogenicity and immunogenicity of a new measles-mumps-rubella vaccine
      containing RIT 4385 mumps virus strain in healthy Turkish children.
AB  - A total of 44 children aged between 15-18 months were randomly vaccinated either
      with a new measles-mumps-rubella (MMR) vaccine (Priorix, SmithKline Beecham) or a
      commercially available MMR vaccine (MMR-II, Merck) to compare the reactogenicity
      and immunogenicity. No local symptoms or fever was reported. Seroconversion rates
      of the study vaccine were 100, 95 and 100 percent for measles, mumps and rubella,
      respectively. The seroconversion rates for the control vaccine were 100, 94.7 and
      95.5 percent, respectively. The geometric mean titers (GMT's) for the study and
      control groups were 1695, 95, 58; and 2198, 1183 and 47; respectively. In
      conclusion, the new MMR vaccine containing RIT 4385 mumps strain derived from the
      Jeryl Lynn strain was shown to be immunogenic and safe in healthy Turkish
      children. Further post-marketing surveillance should be conducted.

PMID- 11196742
TI  - Carnitinuria in rickets due to vitamin D deficiency.
AB  - In this study, we measured the serum-urine total carnitine levels and PTH levels
      before and after treatment in 18 patients with nutritional rickets. The urine and
      blood samples were taken on the first (pretreatment) and the 15th day of the
      study (post-treatment). The total carnitine levels of serum and urine samples,
      serum PTH and serum-urine creatinine concentrations were determined. We found
      that the levels of carnitine excreted in the urine on the first (pre-treatment)
      and on the 15th day (post-treatment) were higher than the reference levels.
      Decrease in carnitine excretion on the 15th day seemed to be correlated with
      decrease in aminoaciduria at that time. The study showed a significant
      correlation between urinary carnitine excretion and serum PTH levels. In our
      study we did not find any significant difference between the serum total
      carnitine levels on the first (pre-treatment) and the 15th day (post-treatment),
      and both values were lower than the reference values for the same age group. We
      observed that the total serum carnitine levels did not change on the 15th day of
      the post-treatment period in spite of a decrease in urinary carnitine excretion.
      The results of the present study indicated that carnitine metabolism is disturbed
      in nutritional rickets. Further evaluation of rickets cases and new studies will
      probably lead to a better understanding of carnitine metabolism in nutritional
      rickets.

PMID- 11196743
TI  - The relationship between osteocalcin levels and sexual stages of puberty in male
      children.
AB  - Osteocalcin is a specific and reliable marker which increases with rapid bone
      turnover and gives data about bone metabolism. The pubertal growth spurt is also
      known as a good example of rapid bone turnover. The aim of this study was to
      determine whether osteocalcin is a useful marker for the pubertal growth spurt
      period. In this study, osteocalcin levels in male adolescents were examined in
      relation to their sexual maturation stage and age. The osteocalcin levels and
      alkaline phosphatase levels were compared during the pubertal growth spurt. Serum
      osteocalcin and alkaline phosphatase levels were evaluated in 100 eligible
      healthy male children and adolescents (aged 10 to 17 years). Five groups (n: 20
      each) of children and adolescents were formed according to their sexual
      maturation stages. Finally, the subjects were divided into three main groups in
      relation to the pubertal growth spurt and sexual maturation stages. Data were
      evaluated and compared among these three groups: First group = Stage 1
      (prepuberty) + Stage 2 (early puberty) consisted of 40 (20 + 20) children and
      adolescents. Their mean osteocalcin value was 17.2 +/- 6.3 ng/ml and alkaline
      phosphatase 573.8 +/- 143.9 IU/L. Second group: Stage 3 + Stage 4 consisted of 40
      (20 + 20) children and adolescents. These groups were known as the pubertal
      growth spurt groups. Their mean osteocalcin value was 29.4 +/- 10.6 ng/ml and
      alkaline phosphatase 728.4 +/- 233.9 IU/L. Third group: In this group, there were
      20 children and adolescents who reached Stage 5 of sexual maturation and whose
      pubertal growth spurt was slowing. Their mean osteocalcin value was 15.3 +/- 5.8
      ng/ml and alkaline phosphatase 435.8 +/- 184.8 IU/L. During the pubertal growth
      spurt, there is a relationship between bone remodelling and increasing
      osteocalcin and alkaline phosphatase levels. When sexual maturation reaches Stage
      4 at 14 years old, osteocalcin and alkaline phosphatase levels make a peak,
      associated with the rapid growth in height. As sexual maturation reaches Stage 5,
      osteocalcin and alkaline phosphatase levels gradually decrease with growth
      maturation and their levels decline to the level of adults at the completion of
      this period. Our study showed that osteocalcin and alkaline phosphatase levels
      can be used as markers for evaluation of the growth spurt period.

PMID- 11196744
TI  - Analysis of 2017 Holter records in pediatric patients.
AB  - Holter monitoring (HM) is widely used in arrhythmic disorders of adult patients;
      however, studies in the pediatric age group are limited. This study aims to
      determine the value of HM in diagnosis and treatment of disorders related to
      arrhythmias in pediatric patients. We examined 2,017 Holter records of 1,500
      children who applied to our institution between November 1994 and October 1998.
      The age ranged from 0-24 years (52% male, 48% female). The indications for HM
      were screening for arrhythmic symptoms (palpitation, chest pain, syncope) in 67
      percent, monitoring dysrhythmic therapy in 17 percent, postoperative control in
      five percent, and pacemaker control in four percent. Palpitation is the leading
      presenting symptom, with more frequent findings of supraventricular extrasystole
      (SVE), supraventricular tachycardia (SVT), ventricular extrasystole (VE) and
      complete heart block (CHB) when compared to other symptoms. Only 5.3 percent of
      the patients had arrhythmic symptoms during monitoring and asymptomatic patients
      had more frequent arrhythmias. SVT, VE, and CHB are more frequent findings in the
      abnormal heart with previous cardiac operations. The diagnostic yield is low with
      arrhythmic symptoms in the pediatric age group; however, HM enables cumulative
      evaluation of heart rhythm and rhythm variability, which is important in
      diagnosing silent arrhythmias in high risk groups (abnormal heart, postoperative
      heart).

PMID- 11196745
TI  - Complications of pediatric cardiac catheterization: 18-month study.
AB  - Pediatric cardiac catheterization may be indicated under certain conditions, but
      is associated with some risk. The purpose of the study was to evaluate the
      complications associated with diagnostic and interventional catheterization
      procedures done over an 18-month period in our laboratory. Of the 230 cardiac
      catheterizations, 204 were solely diagnostic in nature. Eleven percent were
      interventional catheterizations including aortic and pulmonary valvuloplasties
      and balloon atrial septostomy. Six percent of the patients constituted grown-up
      congenital heart disease (GUCH). The median age was 34 months excluding the GUCH
      group. There was one death below one year of age (0.4% mortality) occurring six
      hours after the diagnostic catheterization; it was attributed to the underlying
      disease. There were eight complications (3.4%) that we would consider serious,
      including atrial flutter, ventricular tachycardia, severe hypercyanotic spell,
      seizure, transient complete heart block, peripheral vascular injury which
      resulted in pseudoaneurysm formation of the femoral artery requiring surgical
      intervention, and transient pulse loss. When catheterization is necessary, it
      should be carried out as efficiently as possible with awareness of conditions
      that probably increase the risk of a clinically important event. Although
      patients undergoing cardiac catheterization are now younger and have more complex
      cardiac abnormalities, the procedure seems to have become safer when compared to
      previous literature.

PMID- 11196746
TI  - Thymic enlargement in childhood.
AB  - Thymic masses constitute one of the least common mediastinal masses in childhood.
      While producing symptoms of airway compromise, they also raise the suspicion of
      malignancy when detected. Radiological, operative and pathological findings of
      patients that have been operated for thymic masses in our institution is
      presented in this paper. Nine patients were operated in our institution during a
      12-year-period between 1985-1997 for thymic masses. Ages of the patients ranged
      from four months to 13 years. With the exception of one, who was diagnosed with a
      routine chest x-ray, all the patients had respiratory complaints. All the
      patients had been evaluated with computed tomography preoperatively. In total,
      seven sternotomies and four thoracotomies were performed to reach the anterior
      mediastinum. The distribution of masses was as follows two malignant thymomas,
      three thymic hyperplasia, one lymphocyte-rich thymoma, one epithelial thymoma,
      one cystic thymoma and one lymphoblastic lymphoma. Although rare, thymic
      enlargement may be a cause of intractable respiratory complaints in childhood.
      Because of the high incidence of primary malignancy of the mediastinal neoplasms
      in childhood, thymic enlargement requires accurate pathological diagnosis and
      treatment. Median sternotomy with intensive anesthetical care allows proper
      tumoral exposure.

PMID- 11196747
TI  - The clinical outcome of childhood masturbation.
AB  - This study was performed to investigate the clinical outcome of childhood
      masturbation. For this purpose 50 children (mean age = 48.7 +/- 24.5 months, 34
      girls females and 16 boys males) with masturbation symptoms were examined at
      first visit to the Department of Child Psychiatry and two years thereafter with
      psychiatric interviews. The mean masturbation frequency at the initial interview
      was significantly decreased after two years. It was noted that 39 children (78%)
      were completely recovered and 11 children (22%) continued to masturbate after two
      years. Children who did not recover were significantly younger, began to
      masturbate earlier and masturbated more frequently than others at the time of
      initial evaluation. It was concluded that the findings about the beneficial
      effect of sedative drugs in combination with parental guidance, education and
      means for behavior modification were promising.

PMID- 11196748
TI  - Neonatal morbidity and mortality associated with maternal HELLP syndrome.
AB  - The syndrome of hemolysis, elevated liver enzymes and low platelet count (HELLP
      syndrome) is a severe form of preeclampsia and eclampsia. To compare the impact
      of HELLP syndrome and hypertension in pregnancy (HIP) on neonatal morbidity and
      mortality, 11 infants born to mothers with HELLP syndrome were recruited between
      1993 and 1997 from neonatal records. They were compared to 11 infants born to
      mothers with HIP and 11 control infants born to healthy mothers matched for
      gestational age, postnatal age and gender. Cesarean section rate was higher in
      the HELLP group than in the controls (p < 0.05). HELLP group infants had lower
      Apgar scores (54.5% < 1 at 5th min), than controls (9.1%) (p < 0.05). Both HELLP
      and HIP group infants showed a higher incidence of intrauterine growth
      retardation (63.6% and 54.5%, respectively) than the controls (9.1%) (p < 0.05).
      The incidence of respiratory distress syndrome (RDS) was similar in HELLP and HIP
      groups and was greater than that in controls (p = NS). Additionally, the neonatal
      death rate was the highest in the HELLP group (p = NS).

PMID- 11196749
TI  - Clinicopathological conference: an 11-year-old boy with recurrent infections,
      hypertension, skin rash, and nephritic syndrome.
AB  - In this clinicopathological conference, an 11-year old boy who presented with
      recurrent pyogenic infections, hypertension, malar rash, various skin lesions and
      nephritic syndrome since five years of age is discussed. He was hospitalized for
      clinical investigation with skin and renal biopsies at 10 years of age. Using
      clinicopathological data obtained from his last admission, a clinical diagnosis
      was reached, and the disorders of the complement system causing patients to show
      these signs or symptoms are emphasized. At the end of the discussion, a
      clinicopathological correlation is given for making the diagnosis.

PMID- 11196750
TI  - Triosephosphate isomerase deficiency with elevated sweat chloride test: report of
      a case.
AB  - A 15-month-old girl with severe hemolytic anemia and progressive respiratory
      failure is presented. She was well until the age of six months when she developed
      a pulmonary infection. During the next six months, she had frequent respiratory
      infections and her paleness became evident. At the age of 12 months, she was
      observed to have easy fatigability and muscle weakness, and she received her
      first blood transfusion. She was referred to our hospital at the age of 15
      months. The physical examination revealed a malnourished girl with hypotonia,
      nystagmus, generalized muscle weakness and severe breathing difficulty requiring
      ventilatory support The hemoglobin (Hb) was 9.7 g/dl; hematocrit (Hct) 29%, mean
      corpuscular volume (MCV) 101 fl and reticulocyte count 15%. Peripheral blood
      smear revealed macrocytosis and stomatocytosis (30% of the red cells) and
      polychromasia. Sweat chloride test was 90 and 94 mEq/L on two separate occasions.
      The serum vitamin E level was 0.26 mg/dl (N: 0.44-0.68). She was found to be
      heterozygous for factor V Leiden mutation. Although malnutrition, low serum
      vitamin E and elevated sweat chloride test were suggestive of cystic fibrosis,
      this diagnosis failed to account for all the findings in the patient. A search
      for a red cell enzyme deficiency revealed that the red cell triosephosphate
      isomerase (TPI) activity was low. DNA analysis showed the 315 G-C (105 Glu-Asp)
      TPI mutation, thus confirming the diagnosis of TPI deficiency.

PMID- 11196751
TI  - Familial mullerian agenesis.
AB  - Mullerian agenesis is characterized by the absence of the fallopian tubes, uterus
      and internal portion of the vagina. Patients have normal female phenotype and
      genotype, with normal secondary sex characteristics but with amenorrhea. We
      report a family in which mullerian agenesis was diagnosed in three siblings and
      their two paternal aunts. This family was ascertained when the proband was
      evaluated for primary amenorrhea. She had normal secondary sexual development.
      Her karyotype was 46, XX. Ultrasound examination and magnetic resonance imaging
      of the pelvis revealed absence of the uterus and vagina. The proband had three
      sisters and two of them showed similar physical and radiological findings. Two of
      the proband's paternal aunts had no uterus. Although the pathogenesis of
      mullerian agenesis is well understood, the etiology and genetics are still
      unknown. Various forms of inheritance patterns have been suggested by several
      authors. In conclusion, it would appear that mullerian agenesis is influenced by
      multifactorial inheritance and polygenic and familial factors.

PMID- 11196752
TI  - Dilatation of a restrictive interatrial communication using a balloon angioplasty
      catheter.
AB  - Balloon atrioseptostomy is a life-saving procedure palliating certain congenital
      heart defects like transposition of the great arteries, right or left
      atrioventricular valve atresia, hypoplastic left heart syndrome, and pulmonary
      hypertension. Occasionally the Rashkind balloon septostomy technique may be
      ineffective in creating an adequate interatrial communication. We performed
      balloon dilatation of a restricted atrial septal defect using a balloon
      angioplasty catheter in a three-month-old infant.

PMID- 11196753
TI  - Pseudomonas sepsis with neutrophagocytosis in a premature newborn.
AB  - Secondary hemophagocytic syndrome may develop during certain severe infections
      commonly due to viral infections, but is rarely associated with bacterial
      infections, and its appearance in a premature newborn is uncommon. We present a
      case of hemophagocytosis during Pseudomonas aeruginosa septicemia in a premature
      infant. After sepsis treatment with imipenem-cilastatin and aminoglycoside,
      remission of hemophagocytosis was achieved.

PMID- 11196754
TI  - Double meningocele. Case report.
AB  - The coexistence of two distinct meningoceles of the spine is a very unusual
      event. We report a three-day-old boy with double meningoceles at the thoracic and
      lumbar levels. The connection between the stalk of the thoracic meningocele and
      the spinal cord, as seen on magnetic resonance imaging, showed a neurological
      involvement in this lesion. Our case is only the third without association of
      congenital anomalies or neurofibromatosis to be reported to date.

PMID- 11196755
TI  - Congenital generalized infantile myofibromatosis and neonatal hemochromatosis. An
      autopsy case report.
AB  - An autopsy case of congenital infantile myofibromatosis and neonatal
      hemochromatosis is reported. A thirty-six-hour-old baby girl had multiple
      subcutaneous nodules in addition to multiple visceral involvement of heart,
      lungs, pharynx, larynx, stomach, small bowel, large bowel, pancreas, kidneys,
      spleen, thyroid, adrenal glands, lymph nodes, peripheral nerves, meninges and
      soft tissues. In these tumoral nodules, three types of histological patterns were
      observed: 1-hemangiopericytoma-like, 2-mixed, and 3-pure spindle cell. Tumor
      cells were immunohistochemically positive for actin, and negative for desmin,
      muscle-specific antigen, and estrogen, related protein. The histological and
      immunohistochemical findings of the case suggested that a close relationship may
      exist between infantile myofibromatosis and infantile hemangiopericytoma. In
      addition to infantile myofibromatosis, neonatal hemochromatosis characterized by
      iron deposition in parenchymatous organs such as liver, pancreas, lungs, thyroid,
      and adrenal glands was another important characteristic of the case.

PMID- 11196756
TI  - Congenital sick sinus syndrome with breath holding and severe syncope episodes
      during infancy. A case report.
AB  - Sick sinus syndrome is a rare cause of bradycardia in children without structural
      heart disease. A case of profound sinus bradycardia, sinus arrest with junctional
      escape, and pauses in a two-year-old infant with breath-holding and syncope
      episodes is presented. As a result of these clinical symptoms and
      electrocardiographic findings, the patient with sick sinus syndrome underwent
      implantation of transvenous ventricular pacemaker. He has been well and
      asymptomatic since the insertion of the pacemaker. In the differential diagnosis
      of an infant with breath-holding and syncope episodes, when these symptoms in
      particular cannot be explained by other common reasons, sick sinus syndrome
      should be kept in mind. This case also illustrates the importance of
      electrocardiographic studies for the diagnosis.

PMID- 11196757
TI  - Intraabdominal lymphangiomyoma in an infant with protein-losing enteropathy and
      hemihypertrophy.
AB  - Lymphangiomyoma is an extremely rare tumor occurring exclusively in women of
      reproductive age. The tumor is characterized by proliferation of immature smooth
      muscle along the lymphatic vessels of the abdomen, thorax and lung. Although
      lymphangiomyoma has been reported in a young girl and a girl infant, none has
      been reported in boys. We report herein a case of lymphangiomyoma in a two-year
      old boy. The unusual presentation in this patient was that the tumor arose from
      the small bowel mesentery without any evidence of lung involvement. The tumor was
      extirpated and lymphangiomyomatosis was confirmed pathologically.

PMID- 11196758
TI  - Polysplenia syndrome with hepatic artery of superior mesenteric artery origin and
      a circumaortic renal vein.
AB  - An 8 1/2-month-old girl with biliary atresia and polysplenia syndrome having
      multiple vascular anomalies without cardiac anomalies is reported. Interruption
      of the inferior vena cava with azygous continuation, which is a common anomaly,
      was seen in conjunction with origin of the common hepatic artery from the
      superior mesenteric artery and with a circumaortic renal vein. The case has
      particular importance in that no hepatic artery or renal vein variations have
      been described with biliary atresia and polysplenia syndrome in the literature
      thus far to our knowledge. The anomalies were shown using different radiological
      examinations including computed tomography, echocardiography, angiography,
      venography and magnetic resonance imaging.

PMID- 11196759
TI  - Preoperative diagnosis of bronchial atresia presenting with recurrent respiratory
      symptoms in an infant.
AB  - Bronchial atresia (BA) is a rare respiratory malformation that may be diagnosed
      from infancy to adulthood. A typical feature of the disease is involvement of the
      left upper lobe and a mass-like lesion surrounded by a hyperlucent and
      nondeflating zone. We present a six-month-old male infant who was diagnosed by
      contrast-enhanced spiral computed tomography (CT) with three-dimensional (3D)
      technology, and by Tc-99m-macroalbumin aggregate (Tc99m-MAA) radionuclide
      scintigraphy. We stress that early diagnosis of BA can be made noninvasively
      using contrast-enhanced spiral CT and radionuclide scintigraphy. 3D computed
      tomographic reformation allows a more accurate diagnosis as well as a more
      specific approach to management and follow-up.

PMID- 11196760
TI  - Are ferric compounds useful in treatment of iron deficiency anemia?
AB  - The effect of ferric compounds in therapy of iron deficiency anemia is doubtful;
      however, the absorption of iron is not affected negatively by food or drugs. In
      our Well Baby Clinic, ferric polymaltose (6 mg/kg/d) was given to 59 infants
      (Group 1) and ferrous sulphate (same doses) was given to 64 infants (Group 2) (74
      +/- 9 d, 70 +/- 7 d, respectively). These infants had iron deficiency anemia, and
      their therapy was continuous. Ferric polymaltose was not as effective as ferrous
      sulphate, although it increased hemoglobin and serum iron. Mean corpuscular
      volume and serum ferritin were not significantly changed after therapy. For this
      reason, we prefer to use only ferrous salts in therapy.

PMID- 11196761
TI  - Synthesis and magnetic and structural characterization of the first homoleptic
      lanthanide beta-ketoiminate.

PMID- 11196762
TI  - Dual pathways for TiO2 sensitization by Na2[Fe(bpy)(CN)4].

PMID- 11196763
TI  - Ligand-centered near-infrared luminescence from lanthanide complexes with
      chelating nitronyl nitroxide free radicals.

PMID- 11196764
TI  - Syntheses and characterization of anti-inflammatory dinuclear and mononuclear
      zinc indomethacin complexes. Crystal structures of [Zn2(indomethacin)4(L)2] (L =
      N,N-dimethylacetamide, pyridine, 1-methyl-2-pyrrolidinone) and
      [Zn(indomethacin)2(L1)2] (L1 = ethanol, methanol).
AB  - The syntheses and spectral and structural characterizations of Zn(II)
      indomethacin [1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1H-indole-3-acetic acid =
      IndoH] complexes, as different solvent adducts, have been studied. The complexes
      are unusual in that both monomeric and dimeric complexes are formed and that this
      is the first example of the same carboxylato ligand binding via both carboxylate
      oxygen atoms in monomeric and dimeric Zn(II) complexes. The crystal structures of
      Zn-Indo complexes with N,N-dimethylacetamide (DMA), pyridine (Py), 1-methyl-2
      pyrrolidinone (NMP), EtOH, and MeOH as solvent ligands, [Zn2(Indo)4(DMA)2].2DMA,
      1, [Zn2(Indo)4(Py)2].2H2O, 2b, [Zn2(Indo)4(NMP)2], 3, cis-[Zn(Indo)2(EtOH)2], 4,
      and cis-[Zn(Indo)2(MeOH)2], 5, were determined. Complexes 1, 2b, and 3
      crystallize in the triclinic space group P1 (No. 2): a = 13.628(2) A, b =
      17.462(2) A, c = 11.078(1) A, alpha = 99.49(1) degrees, beta = 108.13(1) degrees,
      gamma = 110.10(1) degrees for 1; a = 13.347(3) A, b = 16.499(5) A, c = 10.857(1)
      A, alpha = 99.48(2) degrees, beta = 108.25(2) degrees, gamma = 106.24(2) degrees
      for 2; a = 14.143(3) A, b = 14.521(2) A, c = 11.558(2) A, alpha = 109.07(1)
      degrees, beta = 90.80(2) degrees, gamma = 116.40(1) degrees for 3. The three
      complexes exhibit dinuclear paddle-wheel structures with a Zn...Zn distance of
      2.9686(6) A, Zn-ORCOO distances of 2.035(2)-2.060(2) A, and a Zn-ODMA distance of
      1.989(2) A in 1, a Zn...Zn distance of 2.969(1) A, Zn-ORCOO distances of 2.020(3)
      2.049(3) A, and a Zn-NPy distance of 2.036(3) A in 2, and a Zn...Zn distance of
      2.934(1) A, Zn-ORCOO distances of 2.009(3)-2.051(3) A, and a Zn-ONMP distance of
      1.986(3) A in 3. In these cases, the zinc ions are offset along the z direction
      such that the L-Zn...Zn-L moiety is nonlinear, unlike the Cu analogues. Each Zn
      has a square-pyramidal geometry bridged by four carboxylato ligands in the basal
      plane with the solvent ligands containing an O- or N-donor atom at the apex.
      Complexes 4 and 5 are isostructural, with space group C2/c (No. 15). For 4, a =
      30.080(2) A, b = 5.3638(6) A, c = 24.739(2) A, beta = 90.342(7) degrees, and for
      5, a = 29.419(2) A, b = 5.320(2) A, c = 24.461(2) A, beta = 90.840(4) degrees.
      The Zn resides on a 2-fold axis and the complexes have a distorted cis octahedral
      structure with Zn-ORCOO bond lengths of 2.183(3) and 2.169(3) A, a Zn-OEtOH bond
      length of 2.015(3) A in 4, Zn-ORCOO bond lengths of 2.195(2) and 2.151(2) A, and
      a Zn-OMeOH bond length of 2.022(3) A in 5.

PMID- 11196765
TI  - Reactivity of [RuHCl(PiPr3)2]2 with functionalized vinyl substrates. The H2
      ligand as a sensitive probe of electronic structure.
AB  - Reaction of [RuHClL2]2 (L = PiPr3) with 2-vinylpyridine gives L2ClRu(eta 2
      CH=CHC5H4N) with liberation of H2. Reaction of [RuHClL2]2 with a range of olefins
      D(H)C=CR(EWG) substituted by electron-donating (D) and -withdrawing (EWG) groups
      occurs by oxidative addition of a vinyl C-H bond to give the metallacycles
      L2ClHnRu(eta 2-(++)C(D)=CR(EWG)). The 13C chemical shift of ++C and the fate of
      the "Hn" unit (decoordination, binding as H2, or binding as two hydrides) are
      strongly correlated, depend on the donating and withdrawing power of D and EWG,
      and can be used to decide whether ++C binds to Ru as a carbene or as a vinyl.
      These results emphasize the reducing power of Ru(II) when pi-acid ligands such as
      CO are absent.

PMID- 11196766
TI  - A new class of electron-rich unsaturated molecules: Ru2HnX4-n(PiPr3)4, X = anion.
AB  - Synthesis, spectroscopic, and X-ray structural characterization of Ru2HnCl4-nL4
      (n = 2, 3) and Ru2H2F2L4 (L = PiPr3) are reported. The structure of Ru2HCl3L4 is
      also reported. These are dinuclear species containing two five-coordinate,
      approximately square-pyramidal metal atoms. Halides, not hydrides, preferentially
      occupy bridging sites, and the RuXL2 terminal moiety shows limited fluxionality,
      but hydrides do not migrate between metals. The limited steric protection
      provided by PiPr3 is evident from the dimerization observed and from the fact
      that all these structures have rather small [symbol: see text]P-Ru-P
      (approximately 105 degrees). Also reported are RuHXL2 species with X =
      acetylacetonate, phenoxide, O3SCH3, and O3SCF3. Several examples of coordinated
      olefin to complexed carbene conversions are used to test the influence of anion X
      on reactivity.

PMID- 11196767
TI  - Tuning charge recombination rate constants through inner-sphere coordination in a
      copper(I) donor-acceptor compound.
AB  - The coordination compounds [Cu(bpy-MV2+)(PPh3)2](PF6)3, where bpy-MV2+ is the 1
      (4-(4'-methyl-2,2'-bipyridin-4-yl)butyl)-1'-methyl-4, 4'-bipyridinediium(2+)
      cation, and [Cu(dmb)(PPh3)2](PF6), where dmb is 4,4'-dimethyl-2,2'-bipyridine,
      have been prepared and characterized. Visible light (417 nm) excitation of
      [Cu(bpy-MV2+)(PPh3)2]3+ at room temperature leads to rapid intramolecular
      electron transfer, kcs > 1 x 10(8) s-1, to form a charge-separated state with an
      electron localized on the pendant viologen group and a copper(II) metal center,
      abbreviated [CuII-bpy-MV.+]. This state recombines to ground-state products with
      first-order rate constants that can be tuned with solvent over a approximately
      10(7)-10(5) s-1 range. The activation parameters were determined from temperature
      dependent electron-transfer data with Arrhenius analysis. A model is proposed
      wherein a solvent molecule is coordinated to Cu(II) in the charge-separated
      state, [(S)CuII-bpy-MV.+]. Visible light excitation of [Cu(dmb)(PPh3)2](PF6) in
      argon-saturated dichloromethane produces long-lived photoluminescent excited
      states, tau = 80 ns, that are dynamically quenched by the addition of Lewis basic
      solvents. The measured quenching constants each correlate well with the lifetime
      of the charge-separated state measured after excitation of [Cu(bpy
      MV2+)(PPh3)2]3+ in the corresponding solvent.

PMID- 11196768
TI  - Oxalato-bridged dinuclear complexes of Cr(III) and Fe(III): synthesis, structure,
      and magnetism of [(C2H5)4N]4[MM'(ox)(NCS)8] with MM' = CrCr, FeFe, and CrFe.
AB  - A new series of homo- and heterometallic oxalato-bridged dinuclear compounds of
      formulas [Et4N]4[MM'(ox)(NCS)8] ([Et4N]+ = [(C2H5)4N]+; ox = C2O4(2-)) with MM' =
      Cr(III)-Cr(III) (1), Fe(III)-Fe(III) (2), and Cr(III)-Fe(III) (3) is reported.
      They have been structurally characterized by infrared spectra and single-crystal
      X-ray diffraction. The three compounds are isostructural and crystallize in the
      orthorhombic space group Cmca with Z = 8, a = 16.561(8) A, b = 13.481(7) A, and c
      = 28.168(8) A for 1, a = 16.515(2) A, b = 13.531(1) A, and c = 28.289(4) A for 2,
      a = 16.664(7) A, b = 13.575(6) A, and c = 28.386(8) A for 3. The structure of 3
      is made up of a discrete dinuclear anion [CrFe(ox)(NCS)8]4- and four disordered
      [Et4N]+ cations, each of them located on special positions. The anion, in a
      crystallographically imposed C2h symmetry, contains metal cations in distorted
      octahedral sites. The Cr(ox)Fe group, which is planar within 0.02 A, presents an
      intramolecular metal-metal distance of 5.43 A. Magnetic susceptibility
      measurements indicate antiferromagnetic pairwise interactions for 1 and 2 with J
      = -3.23 and -3.84 cm-1, respectively, and ferromagnetic Cr-Fe coupling with J =
      1.10 cm-1 for 3 (J being the parameter of the exchange Hamiltonian H = -2JS1S2).
      The ESR spectra at different temperatures confirm the magnetic susceptibility
      data.

PMID- 11196770
TI  - Importance of multiple-scattering phenomena in XAS structural determinations of
      [Ni(CN)4]2- in condensed phases.
AB  - A quantitative analysis of the XAS spectra of the tetracyanonickelate complex
      [Ni(CN)4]2- has been carried out. The simultaneous study of the EXAFS and XANES
      regions yielded complementary information regarding the geometric and electronic
      structures of the complex. XANES spectra were modeled by applying recently
      developed self-consistent, full multiple-scattering algorithms in the FEFF8 code
      (version 8 x 34). XANES spectra for clusters of different sizes (from 9 to 125
      atoms) were computed and compared with experimental spectra. This region of the
      spectra was proportional to a broadened Ni p-density of states diagram above the
      Fermi level. Although the main features of the XANES spectra were reasonably
      reproduced by computations, the weak dependence of the theoretical spectra on
      cluster size contrasts with the close similarity between the experimental spectra
      of the solid and solution systems. Because of the special geometry of the
      complex, calculations with polarized light parallel and perpendicular to the
      molecular plane were carried out, yielding a reasonable reproduction of the
      experimental data from another report for cluster sizes equal to or higher than
      45 atoms. The highly symmetric square planar structure of the complex was found
      to be responsible for the unusual amplitude of the multiple-scattering (MS)
      contributions to the EXAFS spectra. Spectra in this region were fitted using the
      FEFFIT EXAFS analysis program, taking into account only the MS paths that
      simultaneously have both a high amplitude, as calculated with the ab initio code
      FEFF, and a small Debye-Waller factor, as estimated by the independent-vibration
      approximation model. Fitting results yielded very similar structures for the Ni2+
      complex in the solid state and in solution, though the larger Debye-Waller
      factors found for the solid suggest higher static disorder in this state.

PMID- 11196769
TI  - Ligand substitution behavior of a simple model for coenzyme B12.
AB  - The ligand substitution reactions of trans-[CoIII(en)2(Me)H2O]2+, a simple model
      for coenzyme B12, were studied for cyanide and imidazole as entering
      nucleophiles. It was found that these nucleophiles displace the coordinated water
      molecule trans to the methyl group and form the six-coordinate complex trans
      [Co(en)2(Me)L]. The complex-formation constants for cyanide and imidazole were
      found to be (8.3 +/- 0.7) x 10(4) and 24.5 +/- 2.2 M-1 at 10 and 12 degrees C,
      respectively. The second-order rate constants for the substitution of water were
      found to be (3.3 +/- 0.1) x 10(3) and 198 +/- 13 M-1 s-1 at 25 degrees C for
      cyanide and imidazole, respectively. From temperature and pressure dependence
      studies, the activation parameters delta H++, delta S++, and delta V++ for the
      reaction of trans-[CoIII(en)2(Me)H2O]2+ with cyanide were found to be 50 +/- 4 kJ
      mol-1, 0 +/- 16 J K-1 mol-1, and +7.0 +/- 0.6 cm3 mol-1, respectively, compared
      to 53 +/- 2 kJ mol-1, -22 +/- 7 J K-1 mol-1, and +4.7 +/- 0.1 cm3 mol-1 for the
      reaction with imidazole. On the basis of reported activation volumes, these
      reactions follow a dissociative mechanism in which the entering nucleophile could
      be weakly bound in the transition state.

PMID- 11196771
TI  - Hydrothermal synthesis of (C6N2H14)2(UVI2UIVO4F12), a mixed-valent one
      dimensional uranium oxyfluoride.
AB  - A new hybrid organic-inorganic mixed-valent uranium oxyfluoride,
      (C6N2H14)2(U3O4F12), UFO-17, has been synthesized under hydrothermal conditions
      using uranium dioxide as the uranium source, hydrofluoric acid as mineralizer,
      and 1,4-diazabicyclo[2.2.2]octane as template. The single-crystal X-ray structure
      was determined. Crystals of UFO-17 belonged to the orthorhombic space group Cmcm
      (no. 63), with a = 14.2660(15) A, b = 24.5130(10) A, c = 7.201(2) A, and Z = 4.
      The structure reveals parallel uranium-containing chains of two types: one type
      is composed of edge-sharing UO2F5 units; the other has a backbone of edge-sharing
      UF8 units, each sharing an edge with a pendant UO2F5 unit. Bond-valence
      calculations suggest the UF8 groups contain UIV, while the UO2F5 groups contain
      UVI. EXAFS data give results consistent with the single-crystal X-ray structure
      determination, while comparison of the uranium LIII-edge XANES of UFO-17 with
      that of related UIV and UVI compounds supports the oxidation-state assignment.
      Variable-temperature magnetic susceptibility measurements on UFO-17 and a range
      of related hybrid organic-inorganic uranium(IV) and uranium(VI) fluorides and
      oxyfluorides further support the formulation of UFO-17 as a mixed-valent UIV/UVI
      compound.

PMID- 11196772
TI  - Single-crystal polarized optical absorption spectroscopy of the one-dimensional
      ferrimagnet MnIICuII(pba)(H2O)3.2H2O (pba = 1,3-propylenebis(oxamato)).
AB  - Powder and single-crystal optical absorption of the ferrimagnet
      MnIICuII(pba)(H2O)(3).2H2O (denoted MnCu) and the Mn-doped compound
      Mn0.1Mg0.9Cu(pba)(H2O)(3).2H2O (denoted Mn0.1Mg0.9Cu) with pba standing for 1,3
      propylenebis(oxamato) was investigated in the 10-300 K range. The crystal
      structure of MnCu was previously reported, and consists of bimetallic chains with
      octahedral MnII and square pyramidal CuII ions linked by oxamato bridges, MnCu
      and Mn0.1Mg0.9Cu being isostructural. The spectra of both MnCu and Mn0.1Mg0.9Cu
      show an important dichroism along the chain direction, due to the strong
      polarization of the CuII band at around 16,000 cm-1 in this direction. They
      exhibit narrow and intense spin-forbidden MnII transitions in the 24,000-25,000
      cm-1 range, which are activated by an exchange mechanism. The polarization and
      thermal dependence of the 6A1g-->4A1g, 4Eg(G) MnII transitions were recorded. The
      polarization along the chain axis was interpreted in the framework of the pair
      mechanism first introduced by Tanabe and co-workers. A theoretical expression for
      the thermal dependence of the intensity was derived by considering the CuII spin
      as a quantum spin and the MnII spin as a classical spin, and compared with the
      experimental data. The interaction parameter between the local ground states has
      been found to be J = -25 cm-1 using the spin Hamiltonian H = -J sigma
      i(SMn,iSCu,i + SMn,i+1SCu,i). The spectra of Mn0.1Mg0.9Cu showed cold and hot
      bands, whose energy difference is directly related to J and the interaction
      parameter J* between the CuII ion in its ground state and the MnII ion in its
      spin-flip excited state. J* has been estimated to be +40 cm-1. These results have
      been compared to those obtained with other MnIICuII compounds. The
      complementarity between optical and magnetic properties has been discussed.

PMID- 11196773
TI  - Synthesis and structures of heterocyclic azidogallanes [(CH3)ClGaN3]4 and
      [(CH3)BrGaN3]3 en route to [(CH3)HGaN3]x: an inorganic precursor to GaN.
AB  - The synthesis of [(CH3)ClGaN3]4 (1) with a heterocyclic cyclooctane-like
      structure and [(CH3)BrGaN3]3 (2) with a trimeric structure has been demonstrated.
      X-ray structural determinations reveal that 1 and 2 consist of Ga4N4 eight
      membered rings and Ga3N3 six-membered rings, respectively, in which the Ga atoms
      are bridged by the alpha nitrogens of the azide groups. [(CH3)ClGaN3]4
      crystallizes in the tetragonal space group P42(1)c with a = 11.017(4) A, c =
      8.699(7) A, and Z = 8. [(CH3)BrGaN3]3 crystallizes in the triclinic space group
      P1 with a = 8.1080(10) A, b = 9.9390(13) A, c = 10.4439(13) A, alpha = 86.069(3)
      degrees, beta = 86.771(3) degrees, gamma = 80.829(2) degrees, and Z = 6. The
      reaction of 1 and 2 with LiGaH4 yields [(CH3)HGaN3]x, which is a new low
      temperature source of GaN.

PMID- 11196774
TI  - 1:1 complexes of dimethylthio- and ethylenedithio-tetrathiafulvalenothioquinone
      1,3-dithiolemethides with CuBr2 as a new type of pi/d molecular system.
AB  - The reaction of dimethylthio- (1) and ethylenedithio
      tetrathiafulvalenothioquinone-1,3-dithiolemethides (2) with CuBr2 gave 1:1
      complexes between the donors and CuBr2, 1.CuBr2 and 2.CuBr2, in which the Cu atom
      of CuBr2 binds to the thiocarbonyl S atom in 1 and 2. The electrical conductivity
      (sigma) of 1.CuBr2 at room temperature was ca. 10(-5) S cm-1, while a
      comparatively high value of 4.0 S cm-1 was obtained for 2.CuBr2, whose
      temperature dependence of sigma exhibited, however, semiconducting behavior with
      a very small activation energy of 0.18 eV. The observed paramagnetic
      susceptibilities (chi p's) of the Cu complexes were composed of both a component
      due to the localized Cu spins obeying the Curie-Weiss law and a temperature
      independent chi p due to the conducting pi electrons on the 1- or 2-stacked
      columns. From the Curie constants obtained, the degrees of intramolecular
      electron transfer from 1 and 2 to CuBr2 moieties were estimated at ca. 90% and
      60%, respectively. The small, negative Weiss temperature suggest very weak
      antiferromagnetic interactions among the Cu spins on the CuBr2 moieties.

PMID- 11196775
TI  - Structure and reactivity of aquacarbonylruthenium(II) complexes. An X-ray and
      oxygen-17 NMR study.
AB  - The water exchange on [Ru(CO)(H2O-eq)4(H2O-ax)](tos)2 (1), [Ru(CO)2(H2O-eq)2(H2O
      ax)2](tos)2 (2), and [Ru(CO)3(H2O)3](ClO4)2 (3), the 17O exchange between the
      bulk water and the carbonyl oxygens have been studied by 17O NMR spectroscopy,
      and the X-ray crystallographic structures of 1 and 2 have been determined. The
      water exchange of equatorially and axially coordinated water molecules on 1 and 2
      follow an Id mechanism and are characterized by keq298 (s-1), delta H++ (kJ/mol),
      and delta S++ (J/(mol K)) of (2.54 +/- 0.05) x 10(-6), 111.6 +/- 0.4, and 22.4 +/
      1 (1-eq); (3.54 +/- 0.02) x 10(-2) and 81 (1-ax); (1.58 +/- 0.14) x 10(-7),
      120.3 +/- 2, and 28.4 +/- 4 (2-eq); and (4.53 +/- 0.08) x 10(-4), 97.9 +/- 1, and
      19.3 +/- 3 (2-ax). The observed reactivities correlate with the strength of the
      Ru-OH2 bonds, as expressed by their length obtained by X-ray studies: 2.079 (1
      eq), 2.140 (1-ax), 2.073 (2-eq), and 2.110 (2-ax) A. 3 is strongly acidic witha
      pKa of -0.14 at 262 K. Therefore, the acid-dependent water exchange can take
      place through 3 or Ru(CO)3(H2O)3OH+ with an estimated keq298 of 10(-4)/10(-3) s-1
      and kOH262 of 0.053 +/- 0.006 s-1. The 17O exchange rate between the bulk water
      and the carbonyl oxygens increases from 1 to 2 to 3. For 1 an upper limit of 10(
      8) s-1 was estimated. For 2, no acid dependence of kRuCO between 0.1 and 1 m Htos
      was observed. At 312.6 K, in 0.1 and 1 m Htos, kRuCO = (1.18 +/- 0.03) x 10(-4).
      For the tricarbonyl complex, the exchange can proceed through 3 or
      Ru(CO)3(H2O)2OH+ with kRuCO and kRuOHCO of, respectively, 0.003 +/- 0.002 and
      0.024 +/- 0.003 s-1, with a ruthenacarboxylic acid intermediate.

PMID- 11196777
TI  - A dimeric titanium-containing polyoxometalate. Synthesis, characterization, and
      catalysis of H2O2-based thioether oxidation.
AB  - The previously unknown titanium(IV)-containing mu-hydroxo dimeric
      heteropolytungstate (Bu4N)7[(PTiW11O39)2-OH] (TBA salt of H1) has been
      synthesized, starting from H5PTiW11O40, and characterized by elemental analysis,
      multinuclear (31P, 17O, 183W) NMR, IR, FAB-MS, cyclic voltammetry, and
      potentiometric titration. 31P NMR reveals that H1 (delta -12.76) readily forms in
      MeCN from the Keggin monomer (POM), PTiW11O40(5-) (2, delta -13.34), upon the
      addition of 1.5 equiv of H+, via the protonated species, P(TiOH)W11O39(4-) (H2,
      delta -13.44). The ratio of H1, 2, and H2, which are present in equilibrium in
      MeCN solution at 25 degrees C, depends on the concentration of both H+ and H2O.
      The Ti-O-Ti linkage readily reacts with nucleophilic reagents, such as H2O and
      ROH, to yield monomeric Keggin derivatives. mu-Hydroxo dimer H1 shows higher
      catalytic activity than 2 for thioether oxidation by hydrogen peroxide in
      acetonitrile. The reaction proceeds readily at room temperature and affords the
      corresponding sulfoxide and sulfone in ca. quantitative yield. The addition of
      H2O2 to H1 or H2 results in the formation of a peroxo complex, most likely the
      hydroperoxo complex P(TiOOH)W11O39(4-) (I), which has 31P NMR resonance at -12.43
      ppm. The rate of the formation of I is higher from H2 than from H1. When H1 is
      used as a catalyst precursor, the rates of the thioether oxidation and peroxo
      complex formation increase with increasing H2O concentration, which favors the
      cleavage of H1 to H2. H2O2 in MeCN slowly converts 2 to another peroxotitanium
      complex, P(TiO2)W11O39(5-) (II), which has 31P NMR resonance at -12.98 ppm.
      Peroxo complexes I and II differ in their protonation state and interconvert fast
      on the 31P NMR time scale. Addition of 1 equiv of H+ completely converts II to I,
      while 1 equiv of OH- completely converts I to II. 31P NMR confirms that I is
      stable under turnover conditions (thioether, H2O2, MeCN). Contrary to two-phase
      systems such as dichloroethane/aqueous H2O2, no products resulting from the
      destruction of the Keggin POM were detected in MeCN in the presence of H2O2 (a
      500-fold molar excess). The reactivity of I, generated in situ from II by adding
      1 equiv of H+, toward organic sulfides under stoichiometric conditions was
      confirmed using both 31P NMR and UV-vis spectroscopy. This is a rare
      demonstration of the direct stoichiometric oxidation of an organic substrate by a
      titanium peroxo complex.

PMID- 11196776
TI  - Structural characterization of the picket fence (TpivPP) porphyrins Co(TpivPP),
      Co(TpivPP)(NO2)(1-MeIm), and Co(TpivPP)(NO2)(1,2-Me2Im).
AB  - The compounds Co(TpivPP) (1), Co(TpivPP)(NO2)(1-MeIm) (2), and
      Co(TpivPP)(NO2)(1,2-Me2Im) (3) have been synthesized (TpivPP = meso
      tetrakis(alpha, alpha, alpha, alpha-o-pivalamidophenyl)porphyrinato dianion), and
      their structures have been determined with single-crystal X-ray diffraction
      methods. 1: a = 17.578(1) A, b = 17.596(1) A, c = 20.639(1) A, beta = 115.03(1)
      degrees, P2(1)/c, Z = 4, T = -120 degrees C. 2: a = 18.522(4) A, b = 18.942(4) A,
      c = 18.177(4) A, beta = 90.68(3) degrees, C2/c, Z = 4, T = -70 degrees C. 3: a =
      18.998(4) A, b = 19.187(4) A, c = 18.000(4) A, beta = 90.96(3) degrees, C2/c, Z =
      4, T = -120 degrees C. Compounds 2 and 3 have crystallographically imposed 2-fold
      axes. In 2 and 3, which represent R-state (relaxed) and T-state (tense) models,
      respectively, for hemoglobin, the NO2 ligand is bound on the "picket" side to the
      Co atom, and either 1-MeIm (for 2) or 1,2-Me2Im (for 3) is bound to the Co atom
      at the sixth coordination site on the sterically unhindered side of the molecule.
      The average deviations of atoms from the 24-atom porphyrin core are 0.031, 0.129,
      and 0.117 A for 1, 2, and 3, respectively. The Co atom is -0.043(1) A out of the
      mean 24-atom porphyrin plane toward the 1-MeIm ligand in 2 and -0.089(1) A out of
      the plane toward the 1,2-Me2Im ligand in 3. The bonds of both axial ligands in
      the R-state model 2, 1.898(4) A for Co-N(O2) and 1.995(4) A for Co-N(base), are
      shorter than the corresponding bonds in the T-state model 3, 1.917(4) A for Co
      N(O2) and 2.091(4) A for Co-N(base).

PMID- 11196778
TI  - Synthesis, characterization, and crystal structure of alpha-[Ru(azpy)2(NO3)2]
      (azpy = 2-(phenylazo)pyridine) and the products of its reactions with guanine
      derivatives.
AB  - The synthesis and characterization of alpha-[Ru(azpy)2(NO3)2], 1, are reported
      (azpy is 2-(phenylazo)pyridine; alpha indicates the isomer in which the
      coordinating pairs ONO2, N(py), and N(azo) are cis, trans, and cis,
      respectively). The solid-state structure of 1 has been determined by X-ray
      crystallography. Crystal data: orthorhombic a = 15.423(5) A, b = 14.034(5) A, c =
      10.970(5) A, V = 2374(2) A3, space group P2(1)2(1)2(1) (No. 19), Z = 4, Dcalc =
      1.655 g cm-3. The structure refinement converged at R1 = 0.042 and wR2 = 0.118
      for 3615 unique reflections and 337 parameters. The octahedral complex shows
      monodentate coordination of the two nitrate ligands. The Ru-N(azo) bond distances
      (2.014(4) and 1.960(4) A), slightly shorter than the Ru-N(py) bonds (2.031(4) and
      2.059(4) A), agree well with the pi-back-bonding ability of the azo groups. The
      binding of the DNA-model bases 9-ethylguanine (9egua) and guanosine (guo) to 1
      has been studied and compared with previously obtained results for the binding of
      model bases to the bis(bipyridyl)ruthenium(II) complex. The ligands 9egua and guo
      appear to form monofunctional adducts, which have been isolated as alpha
      [Ru(azpy)2(9egua)Cl]PF6, 2, alpha-[Ru(azpy)2(9egua)(H2O)]-(PF6)2, 3, alpha
      [Ru(azpy)2(guo)(H2O)](PF6)2, 4, and alpha-[Ru(azpy)2(guo)Cl]Cl, 5. The
      orientations of 9egua and guo in these complexes have been determined in detail
      with the use of 2D NOESY NMR spectroscopy. In 2 and 5, H8 is directly pointed
      toward the coordinated Cl, whereas, in 3 and 4, H8 is wedged between the pyridine
      and phenyl rings. The guanine derivatives in the azpy complexes can have more
      orientations than found for related cis-[Ru(bpy)2Cl2] species. This fluxionality
      is considered to be important in the binding of the alpha-bis(2
      (phenylazo)pyridine)ruthenium(II) complex to DNA. In complex 1, ruthenium is the
      chiral center and in the binding to guanosine, two diastereoisomers each of
      adducts 4 and 5 have been clearly identified by NMR spectroscopy.

PMID- 11196779
TI  - Magnetic coupling through the carbon skeleton of malonate in two polymorphs of
      ([Cu(bpy)(H2O)][Cu(bpy)(mal)(H2O)])(ClO4)2 (H2mal = malonic acid; bpy = 2,2'
      bipyridine).
AB  - Two polymorphic malonato-bridged copper(II) complexes of formula
      ([Cu(bpy)(H2O)][Cu(bpy)(mal)(H2O)])-(ClO4)2 (1 and 2) (bpy = 2,2'-bipyridine and
      mal = malonate dianion) have been prepared and their structures solved by X-ray
      diffraction methods. Compound 1 crystallizes in the monoclinic space group
      P2(1)/a, with a = 23.743(3) A, b = 9.7522(5) A, c = 27.731(2) A, beta =
      114.580(10) degrees, and Z = 4. Compound 2 crystallizes in the orthorhombic space
      group Pbcn, with a = 23.700(5) A, b = 25.162(5) A, c = 9.693(5) A, and Z = 4. The
      structures of 1 and 2 are made up of uncoordinated perchlorate anions and
      malonate-bridged zigzag copper(II) chains grouped in an isosceles triangle
      running parallel to the b (1) and c (2) axes. These chains are built by a
      [Cu(bpy)(mal)(H2O)] unit acting as bis-monodentate ligand toward two
      [Cu(bpy)(H2O)] adjacent units through its OCCCO skeleton in an anti-anti
      conformation, whereas the OCO carboxylate bridges exhibit the anti-syn
      conformation. Compounds 1 and 2 contain four crystallographically independent
      copper(II) atoms, but the environment of all of them is distorted square
      pyramidal: the axial position is occupied by a water molecule, whereas the
      equatorial plane is formed by a chelating bpy and either a bidentate malonate or
      two carboxylate oxygens from two malonate groups. The equatorial Cu-O(mal)
      (1.911(4)-1.978(4) (1) and 1.897(5)-1.991(4) A (2)) and Cu-N(bpy) (1.983(4)
      2.008(5) (1) and 1.971(6)-2.007(6) A (2)) bonds are somewhat shorter than the
      axial Cu-O(w) one (2.257(5)-2.524(5) (1) and 2.236(5)-2.505(6) A (2)). The angles
      subtended at the copper atom by the chelating bpy vary in the ranges 80.9(2)
      81.8(2) degrees (1) and 80.4(2)-82.1(2) degrees (2), values which are somewhat
      smaller than those of the chelating malonate (80.4(2)-82.1(2) degrees (1) and
      93.0(2)-93.6(2) degrees (2)). The intrachain copper-copper separations through
      the OCCCO fragment are 8.227(1) (1) and 8.206(2) A (2), whereas those through the
      OCO bridging unit are 4.579(1)-5.043(1) (1) and 4.572(2)-5.040(2) A (2). The
      magnetic behavior of 1 and 2 in the temperature range 2.0-290 K is very close,
      and it corresponds to an overall ferromagnetic coupling, the chi MT versus T
      curve exhibiting a maximum at 18 K. The analysis of the magnetic data through a
      numerical expression derived for the real topology of 1 and 2, that is, chains of
      isosceles triangles with two intrachain exchange pathways J1 (exchange coupling
      through the OCO carboxylate) and J2 (exchange coupling through the OCCCO
      malonate), indicates the occurrence of ferro- (J1 = +4.6 cm-1) and
      antiferromagnetic couplings (J2 = -4.2 cm-1). The magnetic coupling through these
      exchange pathways is further analyzed and substantiated by density functional
      theory calculations on a malonate-bridged trinuclear copper(II) model system.

PMID- 11196780
TI  - Synthesis, spectroscopic, and structural studies on transition metal complexes
      involving homoleptic tripodal selenoether and telluroether coordination.
AB  - The reaction of [MCl2(NCMe)2] (M = Pd or Pt) with 2 molar equiv of MeC(CH2ER)3 (E
      = Se, R = Me; E = Te, R = Me or Ph) and 2 molar equiv of TlPF6 affords the bis
      ligand complexes [M(MeC(CH2ER)3)2][PF6]2. The crystal structure of
      [Pt(MeC(CH2SeMe)3)2][PF6]2 (C16H36F12P2PtSe6, a = 12.272(10) A, b = 18.563(9) A,
      c = 15.285(7) A, beta = 113.18(3) degrees, monoclinic, P2(1)/n, Z = 4) confirms
      distorted square planar Se4 coordination at Pt(II), derived from two bidentate
      tripod selenoethers with the remaining arm not coordinated and directed away from
      the metal center. Solution NMR studies indicate that these species are fluxional
      and that the telluroether complexes are rather unstable in solution. The
      octahedral bis tripod complexes [Ru(MeC(CH2SMe)3)2][CF3-SO3]2 and
      [Ru(MeC(CH2TePh)3)2][CF3SO3]2 are obtained from [Ru(dmf)6][CF3SO3]3 and tripod
      ligand in EtOH solution. The thioether complex (C18H36F6O6RuS8, a = 8.658(3) A, b
      = 11.533(3) A, c = 8.659(2) A, alpha = 108.33(2) degrees, beta = 91.53(3)
      degrees, gamma = 106.01(2) degrees, triclinic, P1, Z = 1) is isostructural with
      its selenoether analogue, involving two facially coordinated trithioether ligands
      in the syn configuration. NMR spectroscopy confirms that this configuration is
      retained in solution for all of the bis tripod Ru(II) complexes. These low-spin
      d6 complexes show unusually high ligand field splittings. The hexaselenoether
      Rh(III) complex [Rh(MeC(CH2SeMe)3)2][PF6]3 was obtained by treatment of
      [Rh(H2O)6]3+ with 2 molar equiv of MeC(CH2SeMe)3 in aqueous MeOH in the presence
      of excess PF6- anion, while the iridium(III) analogue [Ir(MeC(CH2SeMe)3)2][PF6]3
      was obtained via the reaction of the Ir(I) precursor [IrCl(C8H14)2]2 with the
      selenoether tripod in MeOH/aqueous HBF4. NMR studies reveal different invertomers
      in solution for both the Rh and Ir species. The Cu(I) complexes
      [Cu(MeC(CH2ER)3)2]PF6 were obtained from [Cu(NCMe)4]PF6 and tripod ligand in
      CH2Cl2 solution. The corresponding Ag(I) species [Ag(MeC(CH2TeR)3)2]CF3SO3 (R =
      Me or Ph) were obtained from Ag[CF3SO3] and tripod telluroether. In contrast, a
      similar reaction with 2 molar equiv of MeC(CH2SeMe)3 afforded only the 1:1
      complex [Ag(MeC(CH2SeMe)3)]CF3SO3. The structure of this species
      (C9H18AgF3O3SSe3, a = 8.120(3) A, b = 15.374(3) A, c = 14.071(2) A, beta =
      93.86(2) degrees, monoclinic, P2(1)/n, Z = 4) reveals a distorted trigonal planar
      geometry at Ag(I) derived from one bidentate selenoether and one monodentate
      selenoether. These units are then linked to adjacent Ag(I) ions to give a one
      dimensional linear chain cation.

PMID- 11196781
TI  - Sterically encumbered systems for two low-coordinate phosphorus centers.
AB  - Tetraarylphenyls of the form 2,3,5,6-Ar4C6 (Ar = p-tert-butylphenyl) are
      investigated as sterically demanding ligands for the syntheses of compounds
      having two p-phenylene-bridged phosphorus centers. The precursor to such
      materials, 1,4-diiodo-2,3,5,6-tetrakis(p-tert-butylphenyl)benzene (1), is readily
      obtained via a one-pot procedure in 68% yield. Compound 1 is then used to provide
      the bis(dichlorophosphine) 1,4-bis(dichlorophosphino)-2,3,5,6-tetrakis(p-tert
      butylphenyl)benzene (2) and the derived bis(phosphine) 1,4-bis(phosphino)-2,3,5,6
      tetrakis(p-tert-butylphenyl)benzene (3) in yields of 56 and 94% respectively.
      These materials provide access to novel materials containing two low-coordinate
      phosphorus centers bridged by a sterically encumbered phenylene unit. Compound 2
      reacts with benzaldehyde and 2,6-dichlorobenzaldehyde in the presence of excess
      trimethylphosphine and zinc to produce the new pale yellow crystalline
      bis(phosphaalkenes) (E,E)-PhC(H)=PAr4C6P=C(H)Ph (4a; 42%) and (E,E)
      Ar'C(H)=PAr4C6P=C(H)Ar' (4b; 46%; Ar' = 2,6-dichlorophenyl). The crystal
      structure of 4a shows a P=C bond length of 1.676(5) A. Compound 2 is also used to
      provide the unusual red-orange bis(diphosphene) DmpP=PAr4C6P=PDmp (5; 55%; Dmp =
      2,6-Mes2C6H3). Compound 5 is structurally characterized, and a P=P bond length of
      2.008(2) A is ascertained.

PMID- 11196782
TI  - The flash-quench technique in protein-DNA electron transfer: reduction of the
      guanine radical by ferrocytochrome c.
AB  - Electron transfer from a protein to oxidatively damaged DNA, specifically from
      ferrocytochrome c to the guanine radical, was examined using the flash-quench
      technique. Ru(phen)2dppz2+ (dppz = dipyridophenazine) was employed as the
      photosensitive intercalator, and ferricytochrome c (Fe3+ cyt c), as the oxidative
      quencher. Using transient absorption and time-resolved luminescence
      spectroscopies, we examined the electron-transfer reactions following
      photoexcitation of the ruthenium complex in the presence of poly(dA-dT) or
      poly(dG-dC). The luminescence-quenching titrations of excited Ru(phen)2dppz2+ by
      Fe3+ cyt c are nearly identical for the two DNA polymers. However, the spectral
      characteristics of the long-lived transient produced by the quenching depend
      strongly upon the DNA. For poly(dA-dT), the transient has a spectrum consistent
      with formation of a [Ru(phen)2dppz3+, Fe2+ cyt c] intermediate, indicating that
      the system regenerates itself via electron transfer from the protein to the
      Ru(III) metallointercalator for this polymer. For poly(dG-dC), however, the
      transient has the characteristics expected for an intermediate of Fe2+ cyt c and
      the neutral guanine radical. The characteristics of the transient formed with the
      GC polymer are consistent with rapid oxidation of guanine by the Ru(III) complex,
      followed by slow electron transfer from Fe2+ cyt c to the guanine radical. These
      experiments show that electron holes on DNA can be repaired by protein and
      demonstrate how the flash-quench technique can be used generally in studying
      electron transfer from proteins to guanine radicals in duplex DNA.

PMID- 11196783
TI  - Syntheses, structures, and reactivities of heteroleptic magnesium amide
      thiolates.
AB  - The syntheses and characterizations of a family of novel heteroleptic magnesium
      amide thiolates are presented. The compounds are synthesized by ligand
      redistribution chemistry involving reactions of equimolar amounts of magnesium
      amides and magnesium thiolates. Utilization of the smaller thiolates [Mg(SPh)2]n
      and [Mg(S-2,4,6-iPr3C6H2)2]n results in the isolation of dimeric species,
      [Mg(THF)(N(SiMe3)2)(mu-SR)]2 (R = Ph (1), 2,4,6-iPr3C6H2 (2)), with four
      coordinate metal centers and bridging thiolate functions. The sterically more
      encumbered thiolate S-2,4,6-tBu3C6H2 induces the formation of the four
      coordinate, monomeric species Mg(THF)2(N(SiMe3)2)(S-2,4,6-tBu3C6H2) (3)). Careful
      choice of reaction conditions allows the successful syntheses of pure
      heteroleptic compounds; however, it remains difficult to obtain the compounds in
      high yields, since a tendency toward product symmetrization and ligand
      redistribution under re-formation of the starting materials is prevalent. One of
      these symmetrized products is also included in this report: the dimeric, four
      coordinate magnesium thiolate [Mg-(THF)(S-2,4,6-tBu3C6H2)(mu-S-2,4,6-tBu3C6H2)]2
      (4), isolated as the product of the reaction between [Mg-(N(SiMe3)2)2]2 and
      Mg(THF)2(S-2,4,6-tBu3C6H2)2. All compounds were characterized by NMR and IR
      spectroscopy, elemental analyses, and X-ray crystallography. Crystal data
      obtained with Mo K alpha (lambda = 0.710 73 A) radiation are as follows. 1:
      C16H31MgNOSSi2, a = 11.2100(1) A, b = 17.4512(3) A, c = 11.2999(2) A, beta =
      97.952(1) degrees, V = 2189.32(6) A3, Z = 4, monoclinic, space group P2(1)/n, R1
      (all data) = 0.0934. 2: C25H49MgNOSSi2, a = 11.1691(1) A, b = 11.0578(1) A, c =
      26.0671(4) A, beta = 99.906(1) degrees, V = 3171.44(6) A3, Z = 4, monoclinic,
      space group P2(1)/c, R1 (all data) = 0.0557. 3: C36H71MgNO3SSi2, a = 42.8293(16)
      A, b = 10.9737(5) A, c = 16.8305(7) A, beta = 98.755(3) degrees, V = 7818.1(6)
      A3, Z = 8, monoclinic, space group C2/c, R1 (all data) = 0.1331. 4:
      C80H132Mg2O2S4, a = 18.8806(2) A, b = 19.3850(2) A, c = 27.3012(4) A, beta =
      97.250(1) degrees, V = 9912.4(2) A3, Z = 4, monoclinic, space group P2(1)/n, R1
      (all data) = 0.1023.

PMID- 11196784
TI  - Interaction of oxo-bridged vanadium(III) phenanthroline and bipyridine dimers
      with DNA.
AB  - Cationic mu-oxo V(III) dimers of the type [V2OL4Cl2]2+ (L = 1,10-phenanthroline,
      3,4,7,8-tetramethyl-1,10-phenanthroline, 4,7-diphenyl-1,10-phenanthroline; or
      2,2'-bipyridine) are shown to interact very strongly with DNA and to lead
      ultimately to its degradation. Spectroscopic binding studies, electrophoreses,
      DNA melting temperature experiments, and other tests on the parent 1,10
      phenthroline complex all yield results consistent with tight binding. However,
      the exact nature of the binding--i.e., intercalative, groove binding,
      electrostatic, or covalent--remains unclear. Resonance Raman spectroscopy is
      found to be a powerful method for studying the interaction of these mu-oxo V(III)
      dimers with DNA and shows that in frozen aqueous solution, the parent complex
      [V2O(phen)4Cl2]2+ undergoes initial aquation, followed by the reaction of the
      aquated species with the DNA. Once the V(III) dimer is bound to the DNA, redox
      takes place, leading to the formation of alkaline-sensitive lesions. Hydrogen
      peroxide is implicated as a partner in this redox event, based on the effects of
      the enzymes SOD and catalase.

PMID- 11196785
TI  - Adduct formation or metathesis reactions of silver complexes containing the
      fluorinated ligands [HB(3,5-(CF3)2Pz)3]- and [CF3SO3]-: formation of silver
      adducts containing unsupported silver-germanium bonds.
AB  - A mixture of [HB(3,5-(CF3)2Pz)3]Ag(eta 2-toluene) and [(Me)2ATI]GeCl in CH2Cl2,
      rather than undergoing metathesis, formed a 1:1 adduct [HB(3,5-(CF3)2Pz)3]Ag<-
      GeCl[(Me)2ATI] (1, where [HB(3,5-(CF3)2Pz)3] = hydrotris(3,5
      bis(trifluoromethyl)pyrazolyl)borate and [(Me)2ATI] = N-methyl-2
      (methylamino)troponiminate) featuring a silver-germanium bond. Solutions of 1 (in
      CH2Cl2 or toluene) did not precipitate AgCl even after several days. However, it
      easily underwent metathesis with CF3SO3Ag, leading to the chloride-free product
      [HB(3,5-(CF3)2Pz)3]Ag<--Ge(OSO2CF3)[(Me)2ATI] (2). Compounds 1 and 2 were
      characterized by X-ray crystallography. The Ag-Ge bond distances of 1 and 2 are
      2.4215(9) and 2.4116(10) A, respectively.

PMID- 11196786
TI  - Copper and silver complexes containing organic azide ligands: syntheses,
      structures, and theoretical investigation of [HB(3,5-(CF3)2Pz)3]CuNNN(1-Ad) and
      [HB(3,5-(CF3)2Pz)3]AgN(1-Ad)NN (where Pz = pyrazolyl and 1-Ad = 1-adamantyl).
AB  - Treatment of [HB(3,5-(CF3)2Pz)3]Na(THF) with CF3SO3Cu followed by 1
      azidoadamantane affords [HB(3,5-(CF3)2Pz)3]CuNNN(1-Ad) in 65% yield. The solid
      state structure shows that the copper atom is coordinated to the terminal
      nitrogen atom (NT) of the azidoadamantane ligand. The related silver(I) adduct
      can be prepared in 80% yield by the treatment of [HB(3,5-(CF3)2Pz)3]Ag(THF) with
      1-azidoadamantane. However, [HB(3,5-(CF3)2Pz)3]AgN(1-Ad)NN shows a different
      bonding mode where the silver atom coordinates to the alkylated nitrogen atom
      (NA) of the azidoadamantane ligand. Asymmetric stretching bands of the azido
      group for copper and silver adducts appear at 2143 and 2120 cm-1, respectively.
      Theoretical investigation shows that steric effects do not play a dominant role
      in determining the bonding mode of the azide ligand in these two metal complexes.
      Although the copper(I) ion affinity for the two coordinating sites NT and NA is
      nearly identical, copper-azide back-bonding interactions favor the copper-NT mode
      of bonding over the copper-NA mode. Silver (a very poor back-bonding metal)
      prefers the NA site for coordination. The NA site has a significantly higher
      proton affinity and slightly higher sodium ion affinity. Important structural
      parameters for [HB(3,5-(CF3)2Pz)3]CuNNN(1-Ad) and [HB(3,5-(CF3)2Pz)3]AgN(1-Ad)NN
      are as follows: Cu-NT 1.861(3) A, NT-N 1.136(4) A, N-NA 1.219(4) A, NT-N-NA
      173.1(3) degrees; Ag-NA 2.220(5) A, NT-N 1.143(12) A, N-NA 1.227(10) A, NT-N-NA
      176.8(12) degrees. Overall, the azidoadamantane ligand does not undergo any
      significant changes upon coordination to Cu(I) or Ag(I) ions.

PMID- 11196787
TI  - Symmetry of metal chelates.
AB  - Is a metal chelate symmetric, with the motion of the metal described by a single
      well potential, or is it asymmetric, in a double-well potential? For hydrogen,
      this is the familiar question of the symmetry of a hydrogen bond. The molecular
      symmetry of MLn complexes (M = Li, Na, K, Al, Pd, Rh, Si, Sn, Ge, Sb, etc.; L is
      the anion of 3-hydroxy-2-phenylpropenal) in solution is now probed with the
      method of isotopic perturbation of equilibrium. A statistical mixture of 3
      hydroxy-2-phenylpropenal-d0, -1-d, and -1,3-d2 was synthesized and converted to
      various metal complexes. Some complexes show two aldehydic signals, which means
      that their ligands are monodentate. For LiL, NaL, and KL, the 13C NMR isotope
      shifts, delta CH(D) - delta CH(H), for the aldehydic CH groups are small and
      negative, consistent with L- being a resonance hybrid. They are small and
      positive for AlL3, PdL2, Rh(CO)2L, SiX3L, SiL3+X-, (CF3)3GeL, SbCl4L, (EtO)4TaL,
      and (EtO)4NbL. The positive isotope shifts are unusual, but since they are small
      and temperature independent, they are intrinsic and indicate that these metal
      chelates are symmetric, as expected. Large positive isotope shifts, up to 400
      ppb, are observed for Ph3GeL, Me3GeL, Ph2GeL2, Bu3SnL, and Ph4SbL. However, it is
      likely that these are monodentate complexes undergoing rapid metal migration, as
      judged from the X-ray crystal structures of Ph3SnL and Ph4SbL. NMR experiments
      indicate an intermolecular mechanism for exchange, which may be a biomolecular
      double metal transfer. It is remarkable that the isotope shifts in these five
      complexes demonstrate that they are asymmetric structures, even though they
      appear from other NMR evidence to be symmetric chelates.

PMID- 11196788
TI  - Resonance Raman and semiempirical electronic structure studies of an odd-electron
      dinickel tetraiminoethylenedimacrocycle complex.
AB  - Resonance Raman studies of Ni2TIED3+ (TIED = tetraiminoethylenedimacrocycle)
      reveal that many modes couple to the intense electronic transition centered at
      725 nm, a feature that is nominally similar to the intense delocalized
      intervalence absorption bands observed in the same region for Fe2(TIED)L4(5+) and
      Ru2(TIED)L4(5+) (L is any of several axial ligands). Time-dependent spectral
      modeling of the Raman and absorption spectra for the nickel compound was
      undertaken to understand the electronic transition. We were unable to model the
      Raman and absorption spectra successfully with a single electronic transition,
      suggesting that the absorption band is made up of two overlapping transitions.
      Semiempirical electronic structure calculations corroborate the suggestion.
      Additionally, these calculations indicate that the transitions are in fact ligand
      localized transitions, with little metal involvement and no charge-transfer
      character. Furthermore, the ground-state electronic structure is best described
      as an identical pair of NiII centers bridged by a radical anion rather than a
      three-site mixed-valence assembly. Previous EPR studies (McAuley and Xu, Inorg.
      Chem. 1992, 31, 5549) had indicated primarily ligand character for the radical.
      The assignments are consistent with the resonance Raman results where the
      dominant modes coupled to the transitions are assigned as totally symmetric
      bridge vibrations.

PMID- 11196790
TI  - The first mixed-valence fluorotin alkoxides: new sol-gel precursors of fluorine
      doped tin oxide materials.

PMID- 11196789
TI  - Crystal structures and solution behavior of paramagnetic divalent transition
      metal complexes (Fe, Co) of the sterically encumbered tridentate macrocycles
      1,4,7-R3-1,4,7-triazacyclononane: coordination numbers 5 (R = i-Pr) and 6 (R = i
      Bu).
AB  - The coordination chemistry of the sterically hindered macrocyclic triamines,
      1,4,7-R3-1,4,7-triazacyclononane (R = i-Pr, i-Pr3tacn, and R = i-Bu, i-Bu3tacn)
      with divalent transition metals has been investigated. These ligands form a
      series of stable novel complexes with the triflate salts MII(CF3SO3)2 (M = Fe,
      Co, or Zn) under anaerobic conditions. The complexes Fe(i-Pr3tacn)(CF3SO3)2 (2),
      [Co(i-Pr3tacn)(SO3CF3)(H2O)](CF3SO3) (3), [Co(i-Pr3tacn)(CH3CN)2](BPh4)2 (4),
      Zn(i-Pr3tacn)(CF3SO3)2 (5), [Fe(i-Bu3tacn)(CH3CN)2(CF3SO3)](CF3SO3) (6), Fe(i
      Bu3tacn)-(H2O)(CF3SO3)2 (7), and Co(i-Bu3tacn)(CF3SO3)2 (8) have been isolated.
      The behavior of these paramagnetic complexes in solution is explored by their 1H
      NMR spectra. The solid-state structures of four complexes have been determined by
      X-ray single-crystal crystallography. Crystallographic parameters are as follows.
      2: C17H33F6FeN3O6S2, monoclinic, P2(1)/n, a = 10.895(1) A, b = 14.669(1) A, c =
      16.617(1) A, beta = 101.37(1) degrees, Z = 4. 3: C17H35CoF6N3O7S2, monoclinic,
      P2(1)/c, a = 8.669(2) A, b = 25.538(3) A, c = 12.4349(12) A, beta = 103.132(13)
      degrees, Z = 4. 6: C24H45F6FeN5O6S2, monoclinic, P2(1)/c, a = 12.953(6) A, b =
      16.780(6) A, c = 15.790(5) A, beta = 96.32(2) degrees, Z = 4. 7:
      C20H41F6FeN3O7S2, monoclinic, C2/c, a = 22.990(2) A, b = 15.768(2) A, c =
      17.564(2) A, beta = 107.65(1) degrees, Z = 8. The ligand i-Pr3tacn leads to
      complexes in which the metal ions are five-coordinate, while it's isobutyl
      homologue affords six-coordinate complexes. This difference in the
      stereochemistries around the metal center is attributed to steric interactions
      involving the bulky alkyl appendages of the macrocycles.

PMID- 11196791
TI  - Synthesis of bis-thiolato-bridged ru(III) dimers. The crystal structure of
      [Ru(H2edta)(mu-SC6H5)]2.

PMID- 11196792
TI  - Synthesis and characterization of chelating triamide complexes of bismuth and
      antimony.

PMID- 11196793
TI  - A new structural class of lanthanide carbonates: synthesis, properties, and X-ray
      structure of the one-dimensional chain complex [Co(NH3)6]6[K2(H2O)10]
      [Nd2(CO3)8](2)20H2O.

PMID- 11196794
TI  - Oxidative additions of cyclo-octasulfur and cyclo-octaselenium to the cobalt(II)
      complex of 1,3-bis(dimethylphosphino)propane (dmpp): crystal structures and
      spectroscopic properties of [Co(S2O)(dmpp)2]PF6 and [Co(Se2)(dmpp)2]BF4.

PMID- 11196795
TI  - Bimetallic Pt/Ru complexes as catalysts for the electrooxidation of methanol.

PMID- 11196796
TI  - Neutral macrocycles via halide-induced ring opening of binuclear condensed
      intermediates.

PMID- 11196797
TI  - Preparation of a chiral, 2-dimensional network containing metallacrown and copper
      benzoate building blocks.

PMID- 11196798
TI  - Novel biomimetic calix[6]arene-based copper(II) complexes.

PMID- 11196799
TI  - Novel photoisomerization behavior of Rh binuclear complexes involving an
      azobenzene-bridged bis(terpyridine) ligand. Strong effects of counterion and
      solvent and the induction of redox potential shift.

PMID- 11196800
TI  - (Tetrakis(2-pyridylmethyl)ethylenediamine)iron(II) perchlorate. Study of density
      functional methods.
AB  - On the basis of the data obtained by X-ray diffraction, the properties of two
      independent crystallographic subsystems in the [Fe(tpen)](ClO4)2.2/3H2O complex
      are studied in detail with the density functional method B3LYP. The energies of
      singlet, triplet, and quintet states at different temperatures are obtained, the
      influences of geometry on energy changes are analyzed, the regularity of the spin
      state interconversions is investigated, and the effect of the triplet and action
      of the anion on spin crossover are discussed. This investigation demonstrates
      that (1) the energy difference between the high-spin state and singlet state
      decreases as the Fe-N distance and geometric distortion increase, (2) the spin
      equilibrium system is predominantly in low-spin form below room temperature and
      the proportion of high-spin state rapidly increases above room temperature, (3)
      one of the two cation sites has a greater presence of the high-spin content, (4)
      the triplet state may be responsible for the fast rate of spin-state
      interconversions, and (5) the B3LYP method proves to be very adequate to study
      the spin-state transition of this complex.

PMID- 11196801
TI  - Infrared and Raman spectroscopic investigations of the Nb(V) fluoro and oxofluoro
      complexes in the LiF-NaF-KF eutectic melt with development of a diamond IR cell.
AB  - A vacuum-tight cell for infrared spectroscopic investigations of extremely
      corrosive melts, e.g., molten fluorides, has been constructed and tested up to
      750 degrees C. The cell has a gold-lined sample chamber and a diamond window
      transparent for the infrared light. It can be furnished with a gold piston that
      enables the recording of short-path-length FTIR spectra of liquid samples.
      Solutions of Nb(V) in LiF-NaF-KF eutectic (FLINAK) with and without oxide
      additions have been investigated by FTIR and Raman spectroscopy. The presence of
      NbF7(2-), NbOF5(2-), and NbO2F4(3-) complexes was established in the molten state
      at 600 degrees C. After solidification NbF7(2-) was still the only Nb(V) all
      fluoro complex present. Three oxofluoro complexes, NbOF6(3-), NbOF5(2-), and
      NbO2F4(3-), have been identified in the solid state. Typical frequency regions
      for the different complexes are established. Finally, it was shown that K2NbF7
      can be used as an indicator to determine the oxide content of the sample melts.

PMID- 11196802
TI  - Mixed-addenda vanadium-substituted polyfluorooxometalates: synthesis,
      characterization, and catalytic aerobic oxidation.
AB  - For the first time, mixed-addenda vanadium-substituted polyfluorooxometalates,
      PFOMs, have been synthesized. Depending on the workup procedure used, two types
      of compounds were prepared. The first PFOM was a quasi Wells--Dawson type
      compound, [H2F6NaVVW17O56]8-, and the second a mixture of vanadium-substituted
      polyfluorooxometalates of the Keggin structure, XVIVW11FnO40 - n (X = H2, V, W; n
      = 1-4). From the X-ray diffraction analysis, [H2F6NaVVW17O56]8- has an elliptic
      (egg) shape with a central sodium atom surrounded by six fluorine atoms in a
      trigonal prism coordination. One may differentiate between two types of addenda
      atoms to be found in belt and capped positions. According to 1H, 19F, and 51V NMR
      analysis, it is concluded that vanadium is isomorphically substituted in both the
      belt and capped position of [H2F6NaVVW17O56]8-. The mixture of vanadium
      substituted PFOMs of the Keggin structure was shown, by HPLC and ESR, to contain
      at least two species of different charge and of a different vanadium environment.
      The [H2F6NaVVW17O56]8- PFOM was active for the catalytic aerobic oxidation of
      alkyl aromatic compounds in biphasic (water-catalyst and substrate) media. The
      reaction selectivity (autoxidation versus oxydehydrogenation) depended on the
      substrate and reaction conditions such as temperature and oxygen pressure. The
      selectivity to oxydehydrogenation was significantly higher compared to the
      prototypical cobalt acetate catalytic system.

PMID- 11196803
TI  - Determination of metal-ligand stoichiometries for inorganic complexes using total
      reflection X-ray fluorescence.
AB  - The methods usually used to determine the ratio metal-ligand in inorganic
      complexes require a set of solutions with different concentrations for both the
      ligand and metal. We propose a new method using the total reflection X-ray
      fluorescence technique, in which the ratio between metal and ligand is determined
      precisely, easily, and quickly. Experimental results provide evidence that for
      different chemical complexes, the ligand-metal ratio determined by this technique
      deviates at most from stoichiometric values by 6%. The technique is restricted
      usually to elements with Z above 14, and its detection limit is on the order of
      10(-8) g/g.

PMID- 11196804
TI  - NMR and EPR investigations of iron corrolates: iron(III) corrolate pi cation
      radicals or iron(IV) corrolates?
AB  - The chloroiron corrolates of 2,3,7,8,12,13,17,18-octamethyl- and 7,13-dimethyl
      2,3,8,12,17,18-hexaethylcorrole ([(Me8C)FeCl] and [(7,13-Me2Et6C)FeCl],
      respectively) and their bisimidazole complexes have been investigated by NMR
      spectroscopy as a function of temperature, and by EPR spectroscopy at 4.2 K.
      Magnetic susceptibilities were measured by the modified Evans method. It is found
      that the electron configuration of the chloroiron corrolates is that of a S = 3/2
      Fe(III) center coupled to a corrolate pi radical, where one electron has been
      removed from the pi system of the corrolate. This pi radical is
      antiferromagnetically coupled to the unpaired electrons of the iron to yield an
      overall S = 1 complex, as evidenced by the very large positive shifts of the meso
      H resonances (183 and 172 ppm). That this antiferromagnetic coupling is very
      strong is supported by the near-Curie behavior of the 1H chemical shifts. For the
      chloroiron corrolates in the presence of imidazole, imidazole-d4, and N
      methylimidazole at temperatures of -50 degrees C and below, the mono- and
      bisligand complexes are formed. The NMR spectra can be assigned on the basis of
      chemical exchange between the chloroiron(III) parent complex and the bisligand
      complex at -30 degrees C, and between the bisligand complex and the monoligand
      complex at -50 degrees C. The bisimidazole complexes show pyrrole CH2 and CH3
      resonances characteristic of low-spin Fe(III) centers (S = 1/2), but with
      strongly upfield-shifted meso-H resonances (delta values of -95 and -82.5 ppm for
      the octamethyl complex and -188 and -161 ppm for the dimethylhexaethyl complex at
      203 K) characteristic of the presence of a macrocycle-centered unpaired electron.
      The magnetic moments of these bisligand complexes are somewhat lower than
      expected for overall S = 1 systems, and decrease as the temperature is lowered.
      The lower apparent magnetic moments (2.0-1.8 mu B between -50 and -90 degrees C)
      are believed to be caused by a combination of weak or no magnetic coupling
      between the metal and macrocycle electrons and decreasing solubility of the
      complex as the temperature is lowered. The non-Curie behavior of the 1H chemical
      shifts observed in the low-temperature (-50 to -90 degrees C) NMR spectra likely
      arises from a combination of the effects of weak antiferromagnetic coupling of
      metal and macrocycle spins, a low-lying electronic excited state, and ligand
      binding/loss equilibria at the highest temperatures studied (-50 degrees C).

PMID- 11196805
TI  - Crystal structures of a family of silver cyanide complexes of thiourea and
      substituted thioureas.
AB  - The syntheses and crystal structures of a family of silver cyanide complexes of
      thiourea and substituted thioureas are reported. The sulfur ligands include
      thiourea (tu), 1-methyl-2-thiourea (mtu), 1,3-dimethyl-2-thiourea (dmtu), 1,1,3,3
      tetramethyl-2-thiourea (tmtu), and 2-imidazolidinethione (N,N'-ethylenethiourea,
      etu). Synthesis was effected by dissolving AgCN in an aqueous solution of ligand.
      Two different complexes were obtained by the reaction of AgCN with tu. Complex
      1a: (AgCN)(tu), monoclinic, P2(1)/c, a = 9.3851 (6) A, b = 8.2782 (5) A, c =
      7.1178 (5) A, beta = 94.591 (1) degree, and Z = 4. Complex 1b: (AgCN)(tu)2,
      triclinic, P1, a = 7.9485 (14) A, b = 9.431 (2) A, c = 12.771 (2) A, alpha =
      85.695 (3) degrees, beta = 81.210 (4) degrees, gamma = 77.987 (2) degrees, and Z
      = 4. Complex 2: (AgCN)(mtu), triclinic, P1, a = 4.113 (2) A, b = 9.472 (4) A, c =
      9.679 (4) A, alpha = 113.918 (5) degrees, beta = 98.188 (6) degrees, gamma =
      97.725 (6) degrees, and Z = 2. Complex 3 (AgCN)2(dmtu)2, monoclinic, P2(1)/m, a =
      7.1482 (7) A, b = 14.776 (2) A, c = 7.3366 (7) A, beta = 92.418 (2) degrees, and
      Z = 2. Complex 4: (AgCN)(tmtu), orthorhombic, P2(1)2(1)2(1), a = 8.823(6) A, b =
      10.209 (2) A, c = 10.362 (2) A, and Z = 4. Complex 5: (AgCN)2(etu)2, triclinic,
      P1, a = 6.8001 (2) A, b = 8.6154 (1) A, c = 13.4747 (3) A, alpha = 71.720 (1)
      degree, beta = 79.906 (1) degree, gamma = 75.885 (2) degrees, and Z = 2. All of
      the structures involve either one- or two-dimensional polymeric arrays held
      together by bridging S and CN groups. There is, however, no similarity between
      any two of the arrays. Four of the five ligands used also form similar complexes
      with CuCN. For one ligand, tmtu, the structures are isomorphous. For the other
      three, not only are the structures not isomorphous, the m/n ratio in (MCN)mLn
      when M is Ag is different from that when M is Cu.

PMID- 11196806
TI  - Vanadium complexes of the N(CH2CH2S)3(3-) and O(CH2CH2S)2(2-) ligands with
      coligands relevant to nitrogen fixation processes.
AB  - Vanadium(III) and vanadium(V) complexes derived from the tris(2
      thiolatoethyl)amine ligand [(NS3)3-] and the bis(2-thiolatoethyl)ether ligand
      [(OS2)2-] have been synthesized with the aim of investigating the potential of
      these vanadium sites to bind dinitrogen and activate its reduction. Evidence is
      presented for the transient existence of (V(NS3)(N2)V(NS3), and a series of
      mononuclear complexes containing hydrazine, hydrazide, imide, ammine, organic
      cyanide, and isocyanide ligands has been prepared and the chemistry of these
      complexes investigated. [V(NS3)O] (1) reacts with an excess of N2H4 to give,
      probably via the intermediates (V(NS3)(NNH2) (2a) and (V(NS3)(N2)V(NS3) (3), the
      V(III) adduct [V(NS3)(N2H4)] (4). If 1 is treated with 0.5 mol of N2H4, 0.5 mol
      of N2 is evolved and green, insoluble [(V(NS3))n] (5) results. Compound 4 is
      converted by disproportionation to [V(NS3)(NH3)] (6), but 4 does not act as a
      catalyst for disproportionation of N2H4 nor does it act as a catalyst for its
      reduction by Zn/HOC6H3Pri2-2,6. Compound 1 reacts with NR1(2)NR2(2) (R1 = H or
      SiMe3; R2(2) = Me2, MePh, or HPh) to give the hydrazide complexes
      [V(NS3)(NNR2(2)] (R2(2) = Me2, 2b; R2(2) = MePh, 2c; R2(2) = HPh, 2d), which are
      not protonated by anhydrous HBr nor are they reduced by Zn/HOC6H3Pri2-2,6.
      Compound 2b can also be prepared by reaction of [V(NNMe2)(dipp)3] (dipp =
      OC6H3Pri2-2,6) with NS3H3. N2H4 is displaced quantitatively from 4 by anions to
      give the salts [NR3(4)][V(NS3)X] (X = Cl, R3 = Et, 7a; X = Cl, R3 = Ph, 7b; X =
      Br, R3 = Et, 7c; X = N3, R3 = Bu(n), 7d; X = N3, R3 = Et, 7e; X = CN, R3 = Et,
      7f). Compound 6 loses NH3 thermally to give 5, which can also be prepared from
      [VCl3(THF)3] and NS3H3/LiBun. Displacement of NH3 from 6 by ligands L gives the
      adducts [V(NS3)(L)] (L = MeCN, nu CN 2264 cm-1, 8a; L = ButNC, nu NC 2173 cm-1,
      8b; L = C6H11NC, nu NC 2173 cm-1, 8c). Reaction of 4 with N3SiMe3 gives
      [V(NS3)(NSiMe3)] (9), which is converted to [V(NS3)(NH)] (10) by hydrolysis and
      to [V(NS3)(NCPh3)] (11) by reaction with ClCPh3. Compound 10 is converted into 1
      by [NMe4]OH and to [V(NS3)NLi(THF)2] (12) by LiNPri in THF. A further range of
      imido complexes [V(NS3)(NR4)] (R4 = C6H4Y-4 where Y = H (13a), OMe (13b), Me
      (13c), Cl (13d), Br (13e), NO2 (13f); R4 = C6H4Y-3, where Y = OMe (13g); Cl
      (13h); R4 = C6H3Y2-3,4, where Y = Me (13i); Cl (13j); R4 = C6H11 (13k)) has been
      prepared by reaction of 1 with R4NCO. The precursor complex [V(OS2)O(dipp)] (14)
      [OS2(2-) = O(CH2CH2S)2(2-)] has been prepared from [VO(OPri)3], Hdipp, and OS2H2.
      It reacts with NH2NMe2 to give [V(OS2)(NNMe2)(dipp)] (15) and with N3SiMe3 to
      give [V(OS2)(NSiMe3)(dipp)] (16). A second oxide precursor, formulated as
      [V(OS2)1.5O] (17), has also been obtained, and it reacts with SiMe3NHNMe2 to give
      [V(OS2)(NNMe2)(OSiMe3)] (18). The X-ray crystal structures of the complexes 2b,
      2c, 4, 6, 7a, 8a, 9, 10, 13d, 14, 15, 16, and 18 have been determined, and the
      51V NMR and other spectroscopic parameters of the complexes are discussed in
      terms of electronic effects.

PMID- 11196807
TI  - Solid-state and solution structure of lanthanide complexes of a new nonadentate
      tripodal ligand containing phenanthroline binding units.
AB  - The new nonadentate tripodal ligand trenphen (tris[(1,10-phenanthroline-2
      carboxamido)-ethyl]amine) has been synthesized by condensation of tren [tris(2
      aminoethyl)amine] with an excess of 1,10-phenanthroline-2-carboxylic acyl
      chloride. The ligand trenphen and its lanthanide complexes (Sm, Nd, Eu, Tb, and
      Lu) have been structurally characterized by single-crystal X-ray diffractometry.
      Crystals of trenphen.H2O.CH3CN, 1, are monoclinic, space group P2(1)/n, a =
      14.9923(8) A, b = 17.4451(10) A, c = 17.1880(10) A, beta = 114.8290(10) degrees,
      V = 4079.9(4) A3, Z = 4. The solid-state crystal structures of the isostructural
      [Ln(trenphen)](OTf)3.yH2O.xEt2O.zCH3CN (OTf = CF3SO3) (Ln = Nd, y = 0.5, x = 1, z
      = 3 (2); Ln = Sm, y = 0.5, x = 1, z = 3 (3); Ln = Eu, y = 0.5, z = 3 (4); Ln =
      Tb, y = 0.5, x = 1, z = 1.5 (5); Ln = Lu, y = 0.5, x = 1, z = 1.5 (6)) (trigonal,
      P-3, Z = 2) show that the covalent tripod trenphen undergoes a rearrangement in
      the presence of lanthanide ions yielding three tridentate binding units which
      encapsulate the nine-coordinated lanthanide ion with a slightly distorted,
      tricapped, trigonal prismatic coordination geometry. The correlation observed
      between the decrease of Ln-N distances and the metal ionic radius indicates that
      trenphen, although containing rigid bidentate phenanthroline units, is
      sufficiently flexible to self-organize without steric constraints around
      lanthanide ions of different size. Solution-state NMR studies show that complexes
      2-6 exist in acetonitrile solution as discrete rigid C3-symmetric species
      retaining the triple-helical structure observed in the solid state. NMR and ES-MS
      titration show the formation of bimetallic and trimetallic species in the
      presence of an excess of metal, whereas mononuclear bistrenphen complexes are
      obtained in the presence of an excess of ligand.

PMID- 11196808
TI  - Synthesis and Mossbauer spectroscopic studies of chemically oxidized
      ferrocenyl(phenyl)phosphines.
AB  - The electrochemical potentials of Fc3-xPPhx, (1-3, x = 0-2) and (FcPPh)n (4)
      indicate that iodine should oxidize ferrocenyl(phenyl)phosphines. The molar
      conductivity of solutions of 1-3 increases sharply when the solutions are
      titrated with iodine, leveling off after the addition of > 2 equiv of oxidant,
      consistent with formation of 1:1 electrolytes. Diamagnetic salts 6-9 are observed
      upon addition of a benzene solution of iodine to a benzene solution of 1-4 at
      ambient temperature in ratios of I2/metallocene ranging from 1:1 to 2:1. Well
      resolved 1H and 31P NMR spectra are obtained for 6-8. Absorptions assigned to the
      I3- anion dominate the UV-vis spectrum of 6-8, whereas characteristic absorptions
      for [Fc][I3] are absent. Mossbauer spectra of 7-9 reveal isomer shifts consistent
      with low-spin iron(II) in ferrocene derivatives rather than those in ferricenium
      ions. Small amounts of low-spin FeIII appear to be present in 6. Taken together,
      the results suggest that 6-9 are iodophosphonium salts and not ferricenium salts.
      Diferrocenyl(phenyl)phosphine oxide (5) reacts with iodine to produce a
      diamagnetic, dark solid 10. Low-spin FeII is observed at 77 and 293 K in the
      Mossbauer spectra of 10 with no evidence for oxidation of FeII to FeIII. Compound
      10 is proposed to be a neutral complex between 5 and I2. Reactions between 5 and
      2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) yield [Fc2P(=O)][DDQ]2 (11).
      Mossbauer spectroscopy of 11 indicates the presence of a mixture of low-spin FeII
      and low-spin FeIII at 77 K, suggesting that some electron transfer occurs from 5
      to DDQ. The fraction of low-spin FeIII increases at room temperature.

PMID- 11196809
TI  - Pentadentate terpyridine-catechol linked ligands and their cobalt(III) complexes.
AB  - A series of novel pentadentate terpyridine-catechol linked ligands were prepared,
      in which the terpyridine and catechol moieties were linked together by (CH2)n
      chains of different lengths (n = 4-6). Together with 1-methylimidazole, these
      ligands formed low-spin, six-coordinate Co(III) complexes. Two of the complexes
      (n = 4, 5) were characterized by X-ray crystallography [n = 4, monoclinic,
      P2(1)/c, a = 14.957(7) A, b = 10.585(9) A, c = 23.033(7) A, beta = 106.01(3)
      degrees, V = 3505(3) A3, Z = 4, R = 0.063; n = 5, monoclinic, P2(1)/c, a =
      8.848(7) A, b = 15.78(1) A, c = 25.455(7) A, beta = 93.90(5) degrees, V = 3544(3)
      A3, Z = 4, R = 0.056], which revealed similar structures around the Co(III)
      centers but different conformations for the (CH2)n linkers. The (CH2)4 linker
      showed a straight, symmetric conformation whereas the (CH2)5 linker showed a
      curved conformation that allowed the accommodation of one extra CH2 unit,
      suggesting that the (CH2)4 linker presents the "best-fit" length for these
      complexes.

PMID- 11196810
TI  - Effects of substituents on the thermodynamic and kinetic stabilities of HCGeX (X
      = H, CH3, F, and Cl) isomers. A theoretical study.
AB  - The effect of substitution on the potential energy surfaces of HC identical to
      GeX (X = H, CH3, F, and Cl) were explored using density functional theory (B3LYP)
      and QCISD methods. The theoretical findings suggest that (H)(X)C = Ge: is the
      minimum on the singlet potential energy surface, regardless of the substituents
      (X) used. On the other hand, HC identical to GeX and XC identical to GeH are
      found to be local minima on the surface, but they are neither kinetically nor
      thermodynamically stable.

PMID- 11196812
TI  - Syntheses and electronic spectroscopy of [PtL(L')][ClO4] complexes (HL = 6-phenyl
      2,2'-bipyridine; L' = pyridine, 4-aminopyridine, 2-aminopyridine, and 2,6
      diaminopyridine).
AB  - Four cyclometalated Pt(II) complexes, [PtL(L')][ClO4] [HL = 6-phenyl-2,2'
      bipyridine; L' = pyridine (1), 4-aminopyridine (2), 2-aminopyridine (3), 2,6
      diaminopyridine (4)], were designed and synthesized to probe intramolecular
      N...Pt interactions. The crystal structures of the compounds show that the
      pyridine ligands are almost perpendicular to the planes of the molecules. In
      addition, the pendant NH2 groups of the 2-aminopyridine and 2,6-diaminopyridine
      ligands are close to the metal centers in complexes 3 and 4, with the Pt-N(H2)
      distances (3.065(3)-3.107(3) A) significantly shorter than the sum of the van der
      Waals radii of Pt and N. These compounds were also studied by electronic
      spectroscopy. All the complexes display intense intraligand pi-->pi* transitions
      at 200-340 nm (epsilon = 10(4)-10(3) M-1 cm-1) and moderately intense (epsilon
      approximately 10(3) M-1 cm-1) metal (Pt)-to-ligand (pi*) charge-transfer (MLCT)
      transitions. For 1 and 2, the MLCT transitions occur at approximately 390 nm, but
      the MLCT transition of 4 is exceptionally low in energy (492 nm). The low
      temperature emission spectra of the complexes in frozen EMD glass indicate that 3
      pi pi* is the emissive excited state for 1 and 2 but the emission of 3 is from a
      3MLCT excited state. On the basis of the spectroscopic results, the order of
      energy of the MLCT excited states is established as 1 approximately 2 > 3 > 4. It
      is proposed that the red shifts of the MLCT transitions in 3 and 4 are due to
      increased electron-donating abilities of the ancillary pyridine ligands and
      intramolecular interactions between the orbitals of amine nitrogen lone pairs.
      Crystal data for the complexes are as follows. 1: triclinic P1, Z = 2, a =
      8.7917(2) A, b = 10.6398(3) A, c = 11.9592(3) A, alpha = 107.130(1) degrees, beta
      = 92.522(1) degrees, gamma = 111.509(1) degrees. 2.CH3CN: triclinic P1, Z = 2, a
      = 7.0122(4) A, b = 12.9653(8) A, c = 14.0283(9) A, alpha = 107.3100(10) degrees,
      beta = 102.7640(10) degrees, gamma = 91.6320(10) degrees. 3.CH3CN: triclinic P1,
      Z = 2, a = 7.6459(1) A, b = 10.8433(1) A, c = 14.8722(2) A, alpha = 99.383(1)
      degrees, beta = 93.494(1) degrees, gamma = 101.385(1) degrees. 4.CH3CN: triclinic
      P1, Z = 2, a = 7.862(2) A, b = 10.977(3) A, c = 14.816(5) A, alpha = 99.34(2)
      degrees, beta = 92.64(2) degrees, gamma = 104.11(2) degrees.

PMID- 11196811
TI  - pH-controlled change of the metal coordination in a dicopper(II) complex of the
      ligand H-BPMP: crystal structures, magnetic properties, and catecholase activity.
AB  - The dinucleating ligand 2,6-bis[(bis(2-pyridylmethyl)amino)methyl]-4-methylphenol
      (H-BPMP) has been used to synthesize the three dinuclear Cu(II) complexes
      [Cu2(BPMP)(OH)][ClO4](2).0.5C4H8O (1), [Cu2(BPMP)(H2O)2](ClO4)(3).4H2O (2), and
      [Cu2(H-BPMP)][(ClO4)4].2CH3CN (3). X-ray diffraction studies reveal that 1 is a
      mu-hydroxo, mu-phenoxo complex, 2 a diaqua, mu-phenoxo complex, and 3 a binuclear
      complex with Cu-Cu distances of 2.96, 4.32, and 6.92 A, respectively.
      Magnetization measurements reveal that 1 is moderately antiferromagnetically
      coupled while 2 and 3 are essentially uncoupled. The electronic spectra in
      acetonitrile or in water solutions give results in accordance with the solid
      state structures. 1 is EPR-silent, in agreement with the antiferromagnetic
      coupling between the two copper atoms. The X-band spectrum of powdered 2 is
      consistent with a tetragonally elongated square pyramid geometry around the
      Cu(II) ions, in accordance with the solid-state structure, while the spectrum in
      frozen solution suggests a change in the coordination geometry. The EPR spectra
      of 3 corroborate the solid-state and UV-visible studies. The 1H NMR spectra also
      lead to observations in accordance with the conclusions from other
      spectroscopies. The electrochemical behavior of 1 and 2 in acetonitrile or in
      water solutions shows that the first reduction (Cu(II)Cu(II)-Cu(II)Cu(I) redox
      couple) is reversible and the second (formation of Cu(I)Cu(I) irreversible. In
      water, 1 and 2 are reversibly interconverted upon acid/base titration (pK 4.95).
      In basic medium a new species, 4, is reversibly formed (pK 12.0), identified as
      the bishydroxo complex. Only 1 exhibits catecholase activity (oxidation of 3,5-di
      tert-butylcatechol to the corresponding quinone, vmax = 1.1 x 10(-6) M-1 s-1 and
      KM = 1.49 mM). The results indicate that the pH dependence of the catalytic
      abilities of the complexes is related to changes in the coordination sphere of
      the metal centers.

PMID- 11196813
TI  - Dimolybdenum bis((S,S,S)-triisopropanolaminate(3-)): a blue compound with an
      unusual Mo-Mo triple bond.
AB  - Mo2(OtBu)6 and Mo2(NMe2)6 each react with (S,S,S)-triisopropanolamine (2 equiv)
      in benzene to yield dimolybdenum bis((S,S,S)-isopropanolaminate(3-)), Mo2[(OC-(S)
      HMeCH2)3N]2 (M identical to M), as a blue crystalline solid. Cell parameters at 
      160 degrees C: a = 17.389(6) A, b = 10.843(3) A, c = 10.463(3) A, beta =
      125.28(1) degrees, Z = 2 in space group C2. The molecular structure involves an
      Mo2 unit inside an O6N2 distorted cubic box. The Mo2 axis is disordered about
      three positions with occupancy factors of ca. 45%, 45%, and 10%. Despite this
      disorder, the molecular structure is shown to contain a central Mo identical to
      Mo unit of distance 2.15(3) A coordinated to two triolate ligands which each have
      two chelating arms and one that spans the Mo identical to Mo bond. The local
      Mo2O6N2 moiety has approximate C2h symmetry, and the Mo-N distances are long, 2.4
      A. The 1H and 13C(1H) NMR spectra recorded in benzene-d6 are consistent with the
      geometry found in the solid-state structure. The blue color arises from weak
      absorptions, epsilon approximately 150 dm3 mol-1 cm-1, at 580 and 450 nm in the
      visible region of the electronic absorption spectrum. Raman spectra recorded in
      KCl reveal pronounced resonance effects with excitation wavelengths of 488.0,
      514.5, and 568.2 nm, particularly for the 322 cm-1 band, which can probably be
      assigned to nu(Mo identical to Mo). The electronic structure of this compound is
      investigated by B3LYP DFT calculations, and a comparison is made with the more
      typical ethane-like (D3d) Mo2(OR)6 compounds is presented. The distortion imposed
      on the molecule by the triisopropanolaminate(3-) ligands removes the degeneracy
      of the M-M pi molecular orbitals. The HOMO and SHOMO are both M-M pi and M-O
      sigma* in character, while the LUMO is M-M pi* and the SLUMO is predominantly M-O
      sigma* with metal sp character. The calculated singlet-singlet transition
      energies are compared with those implicit in the observed electronic spectrum.

PMID- 11196814
TI  - Surface-enhanced Raman scattering and surface-enhanced resonance Raman scattering
      excitation profiles of Ag-2,2'-bipyridine surface complexes and of [Ru(bpy)3]2+
      on Ag colloidal surfaces: manifestations of the charge-transfer resonance
      contributions to the overall surface enhancement of Raman scattering.
AB  - Excitation profiles of SERS (surface-enhanced Raman scattering) and/or SERRS
      (surface-enhanced resonance Raman scattering) spectral bands of two forms of a Ag
      bpy (bpy = 2,2'-bipyridine) surface complex and of [Ru(bpy)3]2+ on Ag
      nanoparticle (hydrosol) surfaces were determined from the spectra excited in the
      458-600 nm region and are reported together with the FT-SERS spectra of the Ag
      bpy surface complex and FT Raman spectra of [Ru(bpy)3] Cl2. Seven of the observed
      11 fundamentals as well as their first overtones and combination bands are
      selectively enhanced in SERS of the Ag-bpy surface complex formed in the Ag
      colloid/HCl/bpy system. The profiles of these bands show a common maximum at
      approximately 540 nm. The selectively enhanced bands of the Ag-bpy surface
      complex have nearly the same wavenumbers as those enhanced in the SERRS and
      resonance Raman spectra of [Ru(bpy)3]2+ upon excitation close to the 453 nm
      maximum of its MLCT absorption band. Moreover, the intensity patterns of the bpy
      vibrations of the two species match both in resonance (541 nm excitation for Ag
      bpy, 458 nm for [Ru(bpy)3]2+) and in off-resonance (458 and 1064 nm for Ag-bpy,
      1064 nm for [Ru(bpy)3]2+). The distinct band shapes of the excitation profiles of
      the selectively enhanced vibrational modes of the Ag-bpy surface complex, as well
      as the observation of overtones and combination bands in the SERS spectra upon
      excitation into this "band", are interpreted in terms of a charge-transfer
      resonance contribution to the overall SERS enhancement. In view of the near
      coincidence of the vibrational modes coupled to the resonant electronic
      transition of Ag-bpy with those coupled to the MLCT transition of [Ru(bpy)3]2+,
      the resonant electronic transition is tentatively assigned to a Ag metal to bpy
      (pi*) CT transition.

PMID- 11196815
TI  - Synthesis and structural characterization of luminescent trinuclear gold(I)
      complexes with dithiocarbamates.
AB  - We have synthesized a series of trinuclear gold(I) complexes, namely, [Au3(mu
      dpmp)(S2CNR2)nCl3-n] (n = 0-3; R = Me, CH2Ph), [Au3(mu-dpmp)(mu
      S2CNR2)Cl](CF3SO3) (R = Me, CH2Ph), and [Au3(mu-dpmp)(mu-S2CNMe2)(C6F5)]X (X =
      Cl, CF3SO3), containing the triphosphine dpmp
      [bis(diphenylphosphinomethyl)phenylphosphine] and varying amounts of
      dithiocarbamate. NMR experiments show fluxional behavior in solution for most of
      these derivatives because several arrangements of the ligands are possible. The
      crystal structure of [(mu-dpmp)(AuCl)3] has been determined by X-ray diffraction
      studies; the molecule displays mirror symmetry and involves an angular
      arrangement of the gold atoms [Au-Au-Au 119.603(14) degrees, Au-Au 3.3709(4) A].
      We have studied the optical properties of these derivatives in the solid state,
      finding a red shift as a function of the dithiocarbamate number and, for some
      derivatives, wavelength-dependent emission spectra at low temperature.

PMID- 11196816
TI  - Electrophilic substitution of (diamine)tetrahydroxoplatinum(IV) with carboxylic
      anhydrides. Synthesis and characterization of (diamine)platinum(IV) complexes of
      mixed carboxylates.
AB  - A novel series of (diamine)platinum(IV) complexes of mixed carboxylates have been
      synthesized by electrophilic substitution of the tetrahydroxoplatinum(IV) complex
      (dach)Pt(OH)4 (dach = trans-(+/-)-1,2-diaminocyclohexane) with three different
      carboxylic anhydrides, pivalic, acetic, and trifluoroacetic anhydrides.
      Consecutive two-step acylations with two different carboxylic anhydrides in
      acetone or dichloromethane gave the mixed carboxylate complexes
      (dach)Pt(O2CR)x(O2CR')4 - x (R = C(CH3)3 or CF3, R' = CH3, x = 1-4) including all
      the possible stereoisomers, which could be separated and identified by means of
      HPLC, column chromatography, 1H NMR, and X-ray crystallography. From analysis of
      the reaction products we have found that the positions of electrophilic
      substitution of (dach)Pt(OH)4 were influenced by the kinds of carboxylic
      anhydrides exhibiting different electrophilicity or steric effects. The initial
      substitution by the first reactant occurs more favorably on axial OH, but in the
      case of pivalic anhydride, equatorial substitution is favored probably because of
      the bulkiness of the pivalate group. Such a result seems to be related to their
      stereochemical factors rather than to differences in electrophilicity. The
      lipophilicity of the title complexes was affected not only by the carbon numbers
      of substituents but also by the conformation of the resulting compound.

PMID- 11196817
TI  - Syntheses and structures of rhenium(IV) and rhenium(V) complexes with
      ethanedithiolato ligands.
AB  - A novel dimeric rhenium(IV) complex, [Re2(SCH2CH2S)4], and a monomeric
      methyloxorhenium(V) complex, [CH3ReO(SCH2CH2S)PPh3], were synthesized from
      methyloxorhenium(V) complexes and characterized crystallographically. The
      structure of [Re2(SCH2CH2S)4], the formation reaction of which showed surprising
      demethylation conceivably through the homolytic cleaveage of the rhenium-carbon
      bond, features distorted trigonal prismatic coordination of sulfurs around the
      metal center and a rhenium-rhenium triple bond. A revised structure,
      [Tc2(SCH2CH2S)4], is proposed for a related technetium complex, originally
      identified as [Tc2(SCH2CH2S)2(SCH=CHS)2] (Tisato et al. Inorg. Chem. 1993, 32,
      2042). Additionally, a new compound, CH3Re(O)(SPh)2PPh3, was prepared.

PMID- 11196818
TI  - Detection of the EPR spectra of NO. in ruthenium(II) complexes.
AB  - The EPR of NO. can be detected in the liquid and solid states when crystal fields
      are sufficient to remove the axial symmetry and separate the (pi*)x and (pi*)y
      orbitals by a few hundred reciprocal centimeters. The theory of the EPR spin
      Hamiltonian of bound NO. is reviewed, further developed, and then applied to the
      observed frozen-liquid spectra of NO. bound to Ru(II) obtained from RuIINO+
      complexes by reduction. Comparisons to earlier reports on the observation of the
      EPR spectra of NO. are made.

PMID- 11196819
TI  - Synthesis and structural characterization of highly chlorinated, brominated,
      iodinated, and methylated carborane anions, 1-H-CB9X9-, 1-NH2-CB9X9- (X = Cl, Br,
      I), and 1-H-CB9(CH3)9-.
AB  - The highly chlorinated, brominated, and iodinated carborane anions 1-R-CB9X9- (R
      = H, NH2; X = Cl, Br, I) were prepared in high yields by treatment of [Me3NH][1-R
      CB9H9] with excess ICl, Br2/triflic acid, and I2/triflic acid, respectively, in
      sealed tubes at 180-240 degrees C. With the aid of a Pd catalyst, B-I bonds could
      be converted into the B-Me bonds by treatment with excess MeMgBr, which led to
      the preparation of the permethylated species 1-H-CB9Me9- in good yield. These new
      anions were fully characterized by 1H, 13C, and 11B NMR, IR, and negative-ion
      MALDI MS spectroscopy. Some were further characterized by single-crystal X-ray
      analyses. The weakly coordinating nature of these new anions was probed by 29Si
      chemical shifts.

PMID- 11196820
TI  - Mono- and dinuclear ruthenium(II) and osmium(II) polypyridine complexes built
      around spiro-bridged bis(phenanthroline) ligands: synthesis, electrochemistry,
      and photophysics.
AB  - Two new dyads have been synthesized in which terminal Ru(II) and Os(II)
      polypyridine complexes are separated by sterically constrained spiro bridges. The
      photophysical properties of the corresponding mononuclear complexes indicate the
      importance of the decay of the lowest-energy triplet states localized on the
      metallo fragments through the higher-energy metal-centered excited states. This
      effect is minimized at 77 K, where triplet lifetimes are relatively long, and for
      the Os(II)-based systems relative to their Ru(II)-based counterparts.
      Intramolecular triplet energy transfer takes place from the Ru(II)-based fragment
      to the appended Os(II)-based unit, the rate constant being dependent on the
      molecular structure and on temperature. In all cases, the experimental rate
      constant matches surprisingly well with the rate constant calculated for Forster
      type dipole-dipole energy transfer. As such, the disparate rates shown by the two
      compounds can be attributed to stereochemical factors. It is further concluded
      that the spiro bridging unit does not favor through-bond electron exchange
      interactions, a situation confirmed by cyclic voltammetry.

PMID- 11196821
TI  - Analysis of the spin exchange interactions in the three phases of vanadium
      pyrophosphate, (VO)2P2O7, in terms of spin-orbital interaction energy.
AB  - The spin exchange interactions in the ambient-pressure orthorhombic (APO), high
      pressure orthorhombic (HPO), and ambient-pressure monoclinic (APM) phases of the
      vanadium pyrophosphate, (VO)2P2O7, were analyzed by calculating the spin-orbital
      interaction energies delta e-delta e0 of their spin dimers. The anisotropy of the
      spin exchange interactions in the HPO phase is well explained by the delta e
      delta e0 values. For the APO phase, the reported crystal structure does not
      provide accurate enough delta e-delta e0 values to conclude unambiguously which
      of the V1-V2 and V3-V4 chains has a larger spin gap and which of the bridged and
      edge-sharing spin dimers has a stronger spin exchange interaction in the V1-V2
      and V3-V4 chains. The APM phase is predicted to exhibit essentially two spin
      gaps, with a large spin gap for the V8-V5-V7-V6 chain and a very small one for
      the V4-V2-V3-V1 chain.

PMID- 11196822
TI  - Stabilization of high-valent metals by corroles:
      oxo[tris(pentafluorophenyl)corrolato]chromium(V).
AB  - The aerobic reaction of Cr(CO)6 with tris(pentafluorophenyl)corrole (H3(TpFPC))
      in toluene gives the dark red oxochromium(V) compound (TpFPC)Cr(O), which has
      been characterized by X-ray crystallography, electrochemistry, and EPR
      spectroscopy. Short Cr-N (1.927-1.943 A) bonds as well as relatively large 14N
      and small 53Cr coupling constants suggest that sigma (N-->Cr) donation is
      responsible for the unusual stability of chromium(V) in this complex. The CrV/IV
      reduction potential (0.11 V vs Ag/AgCl) is 0.65 V below that of
      oxo(tetramesitylporphinato)chromium(V).

PMID- 11196823
TI  - Countercomplementarity and strong ferromagnetic coupling in a linear mixed mu
      acetato, mu-hydroxo trinuclear copper(II) complex. Synthesis, structure, magnetic
      properties, EPR, and theoretical studies.
AB  - The structural and magnetic data of the trinuclear compound
      [Cu3(L)2(CH3COO)2(OH)2(dmf)2] (HL = N-(2-methylpyridyl)toluensulfonylamide) are
      reported. The compound crystallizes in the monoclinic system, space group P2(1)/n
      (no. 14), with a = 11.6482(6) A, b = 13.5772(6) A, c = 13.5306(7) A, alpha = 90
      degrees, beta = 92.859(5) degrees, gamma = 90 degrees, and Z = 2. The three
      copper atoms form an exact linear arrangement. Neighboring coppers are connected
      by a hydroxo bridge and a bidentate syn-syn carboxylato group. The coordination
      spheres of the terminal copper atoms are square pyramidal with a dmf molecule as
      the apical ligand. The central copper has a regular square planar geometry. The
      mixed bridging by a hydroxide oxygen atom and a bidentate carboxylato group leads
      to a noncoplanarity of the adjacent basal coordination planes with a dihedral
      angle of 51.96(9) degrees. Susceptibility measurements (2-300 K) reveal a strong
      ferromagnetic coupling, J = 93(6) cm-1, in the mixed-bridged moiety leading to a
      quartet ground state that is confirmed by the EPR spectra. The ferromagnetic
      exchange coupling is discussed using DFT calculations on model compounds that
      have shown a countercomplementary effect of the hydroxo and acetate bridges.

PMID- 11196824
TI  - Single-molecule magnets: a new class of tetranuclear manganese magnets.
AB  - The preparation, X-ray structure, and detailed physical characterization are
      presented for a new type of single-molecule magnet [Mn4(O2CMe)2(pdmH)6](ClO4)2
      (1). Complex 1.2MeCN.Et2O crystallizes in the triclinic space group P1, with cell
      dimensions at 130 K of a = 11.914(3) A, b = 15.347(4) A, c = 9.660(3) A, alpha =
      104.58(1) degree, beta = 93.42(1) degree, gamma = 106.06(1) degree, and Z = 1.
      The cation lies on an inversion center and consists of a planar Mn4 rhombus that
      is mixed-valent, MnIII2MnII2. The pdmH- ligands (pdmH2 is pyridine-2,6
      dimethanol) function as either bidentate or tridentate ligands. The bridging
      between Mn atoms is established by either a deprotonated oxygen atom of a pdmH-
      ligand or an acetate ligand. The solvated complex readily loses all acetonitrile
      and ether solvate molecules to give complex 1, which with time becomes hydrated
      to give 1.2.5H2O. Direct current and alternating current magnetic susceptibility
      data are given for 1 and 1.2.5H2O and indicate that the desolvated complex has a
      S = 8 ground state, whereas the hydrated 1.2.5H2O has a S = 9 ground state.
      Ferromagnetic interactions between MnIII-MnII and MnIII-MnIII pairs result in
      parallel spin alignments of the S = 5/2 MnII and S = 2 MnIII ions. High-frequency
      EPR spectra were run for complex 1.2.5H2O at frequencies of 218, 328, and 436 GHz
      in the 4.5-30 K range. A magnetic-field-oriented polycrystallite sample was
      employed. Fine structure is clearly seen in this parallel-field EPR spectrum. The
      transition fields were least-squares-fit to give g = 1.99, D = -0.451 K, and B4
      degrees = 2.94 x 10(-5) K for the S = 9 ground state of 1.2.5H2O. A molecule with
      a large-spin ground state with D < 0 can function as a single-molecule magnet, as
      detected by techniques such as ac magnetic susceptibility. Out-of-phase ac
      signals (chi'' M) were seen for complexes 1 and 1.2.5H2O to show that these
      complexes are single-molecule magnets. A sample of 1 was studied by ac
      susceptibility in the 0.4-6.4 K range with the ac field oscillating at
      frequencies in the 1.1-1000 Hz range. A single peak in chi'' M vs temperature
      plots was seen for each frequency; the temperature of the chi'' M peak varies
      from 2.03 K at 995 Hz to 1.16 K at 1.1 Hz. Magnetization relaxation rates were
      evaluated in this way. An Arrhenius plot gave an activation energy of 17.3 K,
      which, as expected, is less than the 22.4 K value calculated for the
      thermodynamic barrier for magnetization direction reversal for an S = 8 complex
      with D = -0.35 K. The 1.2.5H2O complex with an S = 9 ground state has its chi'' M
      peaks at higher temperatures.

PMID- 11196825
TI  - Catecholate/salicylate heteropodands: demonstration of a catecholate to
      salicylate coordination change.
AB  - While iron release from enterobactin-mediated iron transport occurs primarily via
      an esterase that destroys the siderophore, other catechol siderophores that are
      not susceptible to hydrolysis act as bacterial growth factors. Elucidating the
      structures of protonated ferric enterobactin may reveal the pathway by which
      synthetic analogues fulfill bacterial iron requirements. In order to more
      completely model this potential delivery pathway for ferric iron, as well as to
      understand the pH dependent structural dynamics of ferric enterobactin, two
      ligands, (2-hydroxybenzoyl-2-aminoethyl)-bis(2,3-dihydroxybenzoyl-2
      aminoethyl)amine (TRENCAMSAM) and (2-hydroxy-3-methoxybenzoyl-2-aminoethyl)
      bis(2,3-dihydroxybenzoyl-2- aminoethyl)amine (TRENCAM(3M)SAM), have been
      synthesized as models for monoprotonated enterobactin. The coordination chemistry
      of these ligands with Fe3+ and Al3+ has been investigated. Fe[TRENCAMSAM]2-
      crystallizes in the triclinic space group P1: Z = 1, a = 11.3307(6) A, b =
      12.5479(7) A, c = 15.5153(8) A, alpha = 94.513(1) degree, beta = 105.867(1)
      degree, gamma = 94.332(1) degree. The structure is a two-metal two-ligand dimer
      supported by mu-oxo bridges from two catecholate moieties. Al[TRENCAMSAM]2-
      crystallizes in the triclinic space group P1: Z = 2, a = 9.1404(2) A, b =
      13.3570(1) A, c = 15.5950(1) A, alpha = 95.711(1) degree, beta = 104.760(1)
      degree, gamma = 92.603(1) degree. The complex is a monomer with a five
      coordinate, square-pyramidal aluminum cation. Al[TRENCAM(3M)SAM]2- crystallizes
      in the monoclinic space group C2/m: Z = 8, a = 34.244(2) A, b = 11.6206(6) A, c =
      21.9890(12) A, beta = 101.478(1) degree. The complex is also a monomer, but with
      a highly distorted five-coordinate, square-pyramidal aluminum cation coordination
      sphere. At high pH these complexes do not display a salicylate mode of binding;
      however, at low pH Al[TRENCAMSAM]2- converts to protonated Al[H3TRENCAMSAM]+,
      which is a six-coordinate, tris-salicylate complex. Al[H3TRENCAMSAM]+
      crystallizes in the triclinic space group P1: Z = 2, a = 11.5475(4) A, b =
      12.1681(4) A, c = 12.5094(4) A, alpha = 109.142(1) degree, beta = 104.327(1)
      degree, gamma = 103.636(1) degree. This is the first catecholamide enterobactin
      analogue that has been structurally characterized in both a catecholate and
      salicylate mode of coordination.

PMID- 11196826
TI  - Band deconvolution analysis of the absorption and magnetic circular dichroism
      spectral data of a planar phthalocyanine dimer.
AB  - The electronic absorption and magnetic circular dichroism spectral data of a
      phthalocyanine dicopper complex that is deduced to be very planar and to share a
      common benzene ring have been studied by band deconvolution analysis. The results
      were compared with those of the molecular orbital (MO) calculations within the
      framework of the Pariser-Parr-Pople (PPP) approximation. The results of the band
      deconvolution analysis are in good agreement with those of the PPP calculations,
      allowing many bands to be reasonably assigned on the basis of the MO
      calculations. The validity of the PPP method for the MO calculation of large
      molecules is also emphasized.

PMID- 11196828
TI  - Mesogenic palladium complexes with pincer ligands derived from dipicolinic acid.
AB  - 4-Substituted pyridine-2,6-dicarboxylic acids, (E)-dipicH2, and 4-substituted
      pyridine-2,6-bis(thiocarboxylic) acids, (E)-pdtcH2, (E = OCnH2n + 1, SCnH2n + 1)
      have been synthesized and used as O,N,O- and S,N,S-pincer ligands with palladium.
      In the fourth coordination site the complexes bear 4-decyloxy-4'-stilbazole (L1),
      4-decyloxy-N-(4-pyridylmethylene)anilines (L2), decyl 4-pyridinecarboxylate (L3),
      4-(4'-decyloxyphenyl)pyridinecarboxylate (L4), 4-(3',4',5'
      tridecyloxybenzyl)pyridinecarboxylate (L5), 4-isocyano-1-decyloxybenzene (L6), or
      4-isocyano-4'-decyloxybiphenyl (L7). Thermotropic mesomorphism is observed for
      the (E)-dipic complexes with L5 and n = 12, which display columnar phases. The
      complexes with S,N,S-pincers show an important depression in the melting point
      compared to their O,N,O homologues and this change gives rise to mesomorphic
      materials (SC). However, in the case of L5 the mesomorphic behavior observed for
      the O,N,O derivative is lost in its S,N,S analogue. The alkylsulfanyl compounds
      exhibit lower transition temperatures and wider mesophase ranges than their
      alkoxy analogues.

PMID- 11196827
TI  - Structural and photophysical studies of Cu(NN)2+ systems in the solid state.
      Emission at last from complexes with simple 1,10-phenanthroline ligands.
AB  - For a variety of reasons, relating the photophysical properties of a copper
      phenanthroline to a structure in solution is problematic. To elucidate some of
      the issues involved, in this paper we describe the crystal and molecular
      structures of a series of Cu(NN)2(+)-containing systems along with spectral data
      obtained from the solids themselves. The NN ligands investigated are tmp (3,4,7,8
      tetramethyl-1,10-phenanthroline), dpdmp (2,9-diphenyl-4,7-dimethyl-1,10
      phenanthroline), dptmp (2,9-diphenyl-3,4,7,8-tetramethyl-1,10-phenanthroline),
      and dipp (2,9-diisopropyl-1,10-phenanthroline). The results show that a
      flattening distortion can have a large impact on the spectroscopic properties of
      a Cu(NN)2+ system, whereas a typical rocking distortion has comparatively little
      effect. The reflectance spectra of orange or orange-red salts that have
      approximately perpendicular phenanthroline ligands exhibit absorption bands in
      the neighborhood of 460 nm along with a shoulder at longer wavelength. In the
      other limit, when a pronounced flattening distortion occurs and the dihedral
      angle between ligands is 20 degrees or more off perpendicular, the reflectance
      spectrum exhibits two distinct visible bands with intense absorption occurring at
      525 nm or even longer wavelength. If the phenanthroline ligand lacks bulky
      substituents in the 2,9 positions, the compound may even be purple, depending on
      the counterion. Cu(NN)2+ complexes that contain phenyl substituents in the 2,9
      positions and exhibit long-wavelength absorption in solution probably adopt a
      flattened structure in the ground electronic state. In most other systems ground
      state flattening is a solid-state effect induced by lattice forces. However, a
      flattening distortion is an intrinsic attribute of the emissive excited state,
      although intra- or intermolecular forces can inhibit the effect. In the case of
      the Cu(dptmp)2+ system, intramolecular steric interactions oppose flattening
      because the methyl groups in the 3,8 positions control the torsion angles of the
      neighboring phenyl groups. In the case of [Cu(tmp)2]BPh4, packing interactions
      induce a small flattening in the crystal, but they also constrain the degree of
      distortion that can occur in the excited state. As a consequence [Cu(tmp)2]BPh4
      exhibits a weak photoluminescence in the solid phase (tau = 15 ns). This is the
      first report of emission from a bis(phenanthroline)copper(I) system that does not
      have bulky substituents in the 2 and/or 9 positions of the ligand. The
      [Cu(tmp)2]BPh4 system crystallizes in space group P2(1)/n with a = 17.4883(4) A,
      b = 9.86860(10) A, c = 26.3747(6) A, alpha = 90 degrees, beta = 97.7021(8)
      degrees, gamma = 90 degrees, V = 4510.8(3) A3, and Z = 4. For 12,948 unique data
      with Fo2 > 2 sigma(Fo2), R = 6.5%. The [Cu(dpdmp)2]PF6 system crystallizes in
      space group P2/n with a = 16.0722(13) A, b = 8.1100(7) A, c = 16.8937(10) A,
      alpha = 90 degrees, beta = 93.947(5) degrees, gamma = 90 degrees, V = 2196.8(5)
      A3, and Z = 2. For 2833 unique data with Fo2 > 2 sigma(Fo2), R = 6.0%. The
      [Cu(dptmp)2]PF6.THF system crystallizes in space group P1 with a = 12.8486(4) A,
      b = 13.7341(1) A, c = 15.1678(3) A, alpha = 99.5819(14) degrees, beta =
      96.7263(13) degrees, gamma = 97.3311(12) degrees, V = 2591.3(2) A3, and Z = 2.
      For 13,753 unique data with Fo2 > 2 sigma(Fo2), R = 7.4%. Finally, the
      [Cu(dipp)2]TFPB system crystallizes in space group P1 with a = 14.2523(3) A, b =
      16.0496(4) A, c = 17.5801(3) A, alpha = 112.4150(13) degrees, beta = 105.7480(13)
      degrees, gamma = 99.6078(11) degrees, V = 3408.7(3) A3, and Z = 2. For 8774
      unique data with Fo2 > 2 sigma(Fo2), R = 9.3%.

PMID- 11196829
TI  - N-porphyrinylamino and -amido compounds by addition of an amino or amido nitrogen
      to a porphyrin meso position.
AB  - This report describes the synthesis and characterization of a series of
      octaethylporphyrin derivatives in which the porphyrin pi-network is connected to
      phenyl, 3-fluoranthenyl, or 1-pyrenyl aromatic systems through a meso amino or
      amido nitrogen. Metal-free bases and zinc(II) and iron(III) complexes have been
      obtained. These compounds represent the first examples of linkages between
      porphyrins and extended pi-networks through a nitrogen atom directly attached to
      a porphyrin meso position. 1H NMR studies of the metal-free bases and zinc
      complexes showed that in the amido-linked adducts, the plane containing the aryl
      substituent was oriented perpendicular to the plane of the porphyrin. Linkage
      through the secondary amino nitrogen, however, allowed the aryl plane to rotate
      toward coplanarity with the porphyrin plane, resulting in conjugation of the
      highest occupied aryl and porphyrin molecular orbitals through the nitrogen lone
      pair. In developing routes to the amino-linked compounds, the facile formation of
      fused azaaryl chlorins via an oxidative intramolecular cycloaddition was
      observed. An aryl carbon ortho to the meso linkage attacked the beta-carbon of an
      adjacent pyrrole ring, accompanied by 1,2-migration of a pyrrole beta-ethyl
      substituent and a two-electron oxidation of the initially formed macrocycle. The
      resulting structures are analogous to benzochlorins. The electronic spectra of
      the metal-free bases are characterized by intense, long-wavelength bands in the
      visible region. Molecular structures of the chloroferric complexes of the
      azabenzofluorantheno- and azabenzpyrenoporphyrin macrocycles (derived from fusion
      of the fluoranthenyl and pyrenyl substituents, respectively) were obtained by X
      ray diffraction. The porphyrin moiety in the azabenzofluoranthenoporphyrin
      adopted a gable structure, with a 22 degrees fold along a diagonal including the
      pyrrole-ring C4 and C16 alpha-carbons. By contrast, the azabenzpyrenoporphyrin
      was virtually planar.

PMID- 11196830
TI  - Definitive assignment of the g tensor of [Fe(OEP)(NO)] by single-crystal EPR.
AB  - Single-crystal EPR measurements have been performed on the triclinic form of
      [Fe(OEP)(NO)] (Ellison, M. K.; Scheidt, W. R. J. Am. Chem. Soc. 1997, 119, 7404)
      and on the isomorphous cobalt derivative [Co(OEP)(NO)] (Ellison, M. K.; Scheidt,
      W. R. Inorg. Chem. 1998, 37, 382) which has been doped with [Fe(OEP)(NO)].
      Principal values of the g tensor determined at room temperature are gmax = 2.106,
      gmid = 2.057, and gmin = 2.015. The principal direction associated with the
      minimum g value lies 8 degrees from the Fe-N(NO) direction, 2 degrees from the
      normal to the heme plane, and 42 degrees from the N-O direction. The direction
      associated with the maximum g value lies 9 degrees from the normal to the Fe-N-O
      plane. The fact that the direction of gmin is near the Fe-N(NO) direction is
      consistent with the dominant role of spin-orbit coupling at the iron atom in
      determining the g tensor and with the picture of the electronic structure of the
      compound from restricted calculations, which makes the half-filled orbital mostly
      dz2 on the iron atom. The hyperfine tensor is nearly isotropic and was only
      resolved in the doped samples. Principal values of the A tensor determined at
      room temperature are 40.9, 49.7, and 42.7 MHz. Principal values of the g tensor
      determined from the doped samples at 77 K are gmax = 2.110, gmid = 2.040, and
      gmin = 2.012. Principal values of the A tensor are 42.5, 52.8, and 44.1 MHz at 77
      K. The small change in g values with temperature is in contrast to the large
      temperature dependence on g values observed in samples of MbNO (Hori et al. J.
      Biol. Chem. 1981, 256, 7849).

PMID- 11196831
TI  - meso-Aryl smaragdyrins: novel anion and metal receptors.
AB  - An easy synthesis of core-modified meso-aryl smaragdyrins containing oxygen and
      sulfur in addition to pyrrole nitrogens has been achieved through an alpha-alpha
      coupling involving modified tripyrrane and dipyrromethane. The complexation
      behavior of these macrocycles toward anions (Cl-, F-, AMP-) and metal cations
      (Rh(I), Ni(II)) is reported. Specifically, it has been shown that the Rh(I) and
      Ni(II) ions bind to the smaragdyrin skeleton in its free base form. X-ray
      structural studies of Rh(I) complex 1 indicate an eta 2-type coordination
      involving only one imino and one amino nitrogen of the dipyrromethane unit.
      However, all four bipyrrole nitrogens participate in the coordination with the
      Ni(II) ion. Furthermore, Ni(II) coordination oxidizes the ligand, and the complex
      is formulated as the pi-cation radical of nickel(II) smaragdyrin. The anion
      complexation is followed in both the solid and solution phases. Solution studies
      reveal that the binding constants of the ions with the protonated form of
      smaragdyrin vary as F- > AMP- > Cl-. The X-ray structure of the chloride anion
      complex reveals that the chloride ion is bound above the cavity of the
      smaragdyrin macrocycle through three N-H...Cl hydrogen bonds. Crystal data with
      Mo K alpha (lambda = 0.710,73 A) are as follows: 1, C41H27N4O3Rh, a = 11.836(8)
      A, b = 12.495(9) A, c = 12.670(2) A, alpha = 69.09(6) degrees, beta = 78.78(6)
      degrees, gamma = 77.02(5) degrees, V = 1692.1(17) A3, Z = 2, triclinic, space
      group P-1, R1 (all data) = 0.0471; 4.HCl, C41H29N4O1Cl, a = 11.878(2) A, b =
      17.379(4) A, c = 16.015(3) A, beta = 109.546(10) degrees, V = 3115.47(11) A3, Z =
      4, monoclinic, space group P2(1)/c, R1(all data) = 0.0850.

PMID- 11196832
TI  - Syntheses and structures of the arylaluminum chalcogenides (ArAlE)2 (Ar = 2
      (NEt2CH2)-6-MeC6H3, E = Se; Ar = 2,6-(NEt2CH2)2C6H3, E = Se, Te).
AB  - Two intramolecular stabilized arylaluminum dihydrides, (2-(NEt2CH2)-6-MeC6H3)AlH2
      (1) and (2,6-(NEt2CH2)2C6H3)AlH2 (2), were prepared by reducing the corresponding
      dichlorides with an excess of LiAlH4 in diethyl ether. Reactions of 1 and 2 with
      elemental selenium afforded the dimeric arylaluminum selenides [(2-(NEt2CH2)-6
      MeC6H3)AlSe]2 (3) and [(2,6-(NEt2CH2)2C6H3)AlSe]2 (4). Reaction of 2 with
      metallic tellurium gave the dimeric arylaluminum telluride [(2,6
      (NEt2CH2)2C6H3)AlTe]2 (5). The possible reaction pathway is discussed, and
      molecular structures determined by single-crystal X-ray analyses are presented
      for 3 and 5.

PMID- 11196833
TI  - Raman study of the hexafluoroaluminate ion in solid and molten FLINAK.
AB  - Raman spectra have been obtained for matrix-isolated AlF6(3-) in an LiF/NaF/KF
      (FLINAK) eutectic mixture. Three Raman bands characteristic of the
      hexafluoroaluminate ion were identified in the solids formed from FLINAK melts
      which contained small amounts (5-11 mol%) of either AlF3 or Na3AlF6. The three
      allowed Raman-active bands of the matrix-isolated octahedral complex ion, nu
      1(A1g), nu 2(Eg), and nu 5(F2g), were observed at 560.5, 380, and 325 cm-1,
      respectively, for the solid sample at 25 degrees C. Wavenumbers and relative
      intensities were similar to those of Na3AlF6 (cryolite), K3AlF6, and K2NaAlF6
      (elpasolite) and other crystals known to contain discrete, octahedral AlF6(3-)
      ions. Peak positions, half-widths, and relative intensities for the bands were
      measured for samples at temperatures different from room temperature through the
      melting transition and into the molten state. The transition from high
      temperature solid to molten salt at about 455 degrees C occurred gradually
      without perceptible change in the peak positions, half-widths, or relative
      intensities. For a sample in molten FLINAK at 455 degrees C, the nu 1(A1g), nu
      2(Eg), and nu 5(F2g) modes of the AlF6(3-) ion were observed at 542, 365, and 324
      cm-1, respectively. Raman depolarization experiments were consistent with these
      assignments, and the low value of the depolarization ratio of the nu 1(A1g) mode
      at 542 cm-1 indicated that the sample was molten above 455 degrees C.
      Differential thermal analysis also indicated that the FLINAK samples melted at
      about 455 degrees C. Raman measurements were performed for samples at
      temperatures from 25 to 600 degrees C in a silver dish, on a hot stage, in an
      argon-filled atmosphere, under a microscope. Additional Raman experiments were
      performed on samples at temperatures from 25 to 750 degrees C in a conventional
      graphite windowless cell, in an argon-filled quartz tube, in a standard furnace.
      Over the concentration range 4.8-11 mol% AlF3 (CR 23-8.0) in FLINAK, only bands
      due to the AlF6(3-) ion were detected. There was no evidence to support the
      presence of other aluminum complexes in these melts.

PMID- 11196835
TI  - Ortho-linked polyaryloxide ligands and their titanium complexes.
AB  - Ortho-linked polyphenols, quaterphenol L(OH)4, and moderately hindered terphenol
      PhL(OH)3 are developed as new multidentate polyaryloxide ligands for transition
      metal chemistry. The polyphenols are synthesized using ortho-metalation and metal
      catalyzed cross-coupling methodologies; the synthetic routes allow for facile
      electronic and steric modification of the basic ligand design. The Ti(IV)
      coordination chemistry of these ligands reveals a diverse collection of bridged
      structures: dimeric [Ti(mu-PhLO3)(OiPr)]2 (P2(1)/n, a = 12.2699(5) A, b =
      11.7957(5) A, c = 21.238(1) A, beta = 94.551(1) degrees, Z = 2, T = 170(2) K),
      dimeric [Ti2(mu-PhLO3)2(mu-Cl)(Cl)(THF)] (P1, a = 11.212(1) A, b = 14.165(1) A, c
      = 22.447(2) A, alpha = 90.440(4) degrees, beta = 93.345(4) degrees, gamma =
      111.164(4) degrees, Z = 2, T = 170(2) K), and trimeric [Ti3(mu,mu'-LO4)(mu
      OiPr)2(OiPr)6] P2(1)/n, a = 11.1022(5) A, b = 18.7015(9) A, c = 24.409(1) A, beta
      = 95.369(2) degrees, Z = 4, T = 170(2) K). The reaction of TiCl3(THF)3 with
      [PhLO3]3- results in oxidation of Ti(III) to Ti(IV) and formation of the oxo
      dimer [Ti(PhLO3)(THF)]2(mu-O) (P1, a = 10.8649(6) A, b = 12.1882(7) A, c =
      14.3349(9) A, alpha = 65.602(3) degrees, beta = 84.390(3) degrees, gamma =
      86.582(3) degrees, Z = 1, T = 200(2) K); the oxo group presumably originates from
      the THF solvent. The titanium centers in these environments are either 5- or 6
      coordinate, with distorted square pyramidal/trigonal bipyramidal and distorted
      octahedral geometries, respectively; the polyphenoxide chelate ligands are
      capable of bridging multiple oxophilic titanium sites.

PMID- 11196834
TI  - Electronic and resonance Raman spectra of [Au2(CS3)2]2-. Spectroscopic properties
      of a "short" Au(I)-Au(I) bond.
AB  - The anion [Au2(CS3)2]2- has an unusually short Au-Au distance (2.80 A) for a
      binuclear Au(I) complex. We report detailed Raman studies of the nBu4N+ salt of
      this complex, including FT-Raman of the solid and UV/vis resonance Raman of
      dimethyl sulfoxide solutions. All five totally symmetric vibrations of the anion
      have been located and assigned. A band at delta nu = 125 cm-1 is assigned to nu
      (Au2). The visible-region electronic absorption bands (384 (epsilon 30,680) and
      472 nm (epsilon 610 M-1 cm-1)) are attributable to CS3(2-) localized transitions,
      as confirmed by the dominance of nu sym(C-Sexo) (delta nu = 951 cm-1) in RR
      spectra measured in this region. An absorption band at 314 nm (22,250 M-1 cm-1)
      is assigned as the metal-metal 1(d sigma*-->p sigma) transition, largely because
      nu sym(C-Sexo) is not strongly enhanced in RR involving this band. Observation of
      the expected strong resonance enhancement of nu (Au2) was precluded as a result
      of masking by intense solvent Rayleigh scattering in the UV.

PMID- 11196836
TI  - Solvothermal construction of a coordination polymer around in situ generated
      pyroglutamic acid: preparation, crystal structure, and magnetic behavior of
      [Mn(C5H6NO3)2]infinity.

PMID- 11196837
TI  - Model complexes for the active form of galactose oxidase. Physicochemical
      properties of Cu(II)- and Zn(II)-phenoxyl radical complexes.

PMID- 11196838
TI  - Reactivity of organometallic molybdate toward lanthanide cations. Synthesis and
      structure of polynuclear lanthanide-molybdate complexes.

PMID- 11196840
TI  - Conjugation involving nitrogen lone-pair electrons: can it lead to stable
      multiply charged cations?

PMID- 11196839
TI  - Synthesis and molecular structure of (TTP)Ti(1,2-eta 2-PhC identical to C-C
      identical to CPh).

PMID- 11196841
TI  - Nitrosyl transfer from manganese to iron in tropocoronand complexes.

PMID- 11196842
TI  - Ethylene oxide and propylene sulfide complexes of silver(I): synthesis and
      characterization of [HB(3,5-(CF3)2Pz)3]Ag(OC2H4) and [HB(3,5
      (CF3)2Pz)3]Ag(SC3H6).

PMID- 11196843
TI  - A dichromium(II,II) compound with a strong antiferromagnetic coupling but little
      or no Cr-Cr bonding.

PMID- 11196844
TI  - The propionate of heme binds N4O2 Schiff base antimalarial drug complexes.

PMID- 11196845
TI  - Influencing the size of giant rings by manipulating their curvatures:
      Na6[Mo120O366(H2O)48H12(Pr(H2O)5)6](approximately 200H2O) with open shell metal
      centers at the cluster surface.

PMID- 11196846
TI  - Supramolecular coordination chemistry in aqueous solution: lanthanide ion-induced
      triple helix formation.
AB  - The self-assembly of dinuclear triple helical lanthanide ion complexes
      (helicates), in aqueous solution, is investigated utilizing laser-induced,
      lanthanide luminescence spectroscopy. A series of dinuclear lanthanide (III)
      helicates (Ln(III)) based on 2,6-pyridinedicarboxylic acid (dipicolinic acid,
      dpa) coordinating units was synthesized by linking two dpa moieties using the
      organic diamines (1R,2R)-diaminocyclohexane (chxn-R,R) and 4,4'
      diaminodiphenylmethane (dpm). Luminescence excitation spectroscopy of the Eu3+
      7F0-->5D0 transition shows the apparent cooperative formation of neutral triple
      helical complexes in aqueous solution, with a [Eu2L3] stoichiometry. Eu3+
      excitation peak wavelengths and excited-state lifetimes correspond to those of
      the [Eu(dpa)3]3- model complex. CD studies of the Nd(III) helicate Nd2(dpa-chxn
      R,R)3 reveal optical activity of the f-f transitions, indicating that the chiral
      linking group induces a stable chirality at the metal ion center. Molecular
      mechanics calculations using CHARMm suggest that the delta delta configuration at
      the Nd3+ ion centers is induced by the chxn-R,R linker. Stability constants were
      determined for both ligands with Eu3+, yielding identical results: log K = 31.6
      +/- 0.2 (K in units of M-4). Metal-metal distances calculated from Eu3+-->Nd3+
      energy-transfer experiments show that the complexes have metal-metal distances
      close to those calculated by molecular modeling. The fine structure in the Tb3+
      emission bands is consistent with the approximate D3 symmetry as anticipated for
      helicates.

PMID- 11196847
TI  - Mechanistic studies of (porphinato)iron-catalyzed isobutane oxidation.
      Comparative studies of three classes of electron-deficient porphyrin catalysts.
AB  - We report herein a comprehensive study of (porphinato)iron [PFe]-catalyzed
      isobutane oxidation in which molecular oxygen is utilized as the sole oxidant;
      these catalytic reactions were carried out and monitored in both autoclave
      reactors and sapphire NMR tubes. In situ 19F and 13C NMR experiments, coupled
      with GC analyses and optical spectra obtained from the autoclave reactions have
      enabled the identification of the predominant porphyrinic species present during
      PFe-catalyzed oxidation of isobutane. Electron-deficient PFe catalysts based on
      5,10,15,20-tetrakis(pentafluorophenyl)porphyrin [(C6F5)4PH2], 2,3,7,8,12,13,17,18
      octabromo-5,10,15,20-tetrakis(pentafluorophenyl) porphyrin [Br8(C6F5)4PH2], and
      5,10,15,20-tetrakis(heptafluoropropyl) porphyrin [(C3F7)4PH2] macrocycles were
      examined. The nature and distribution of hydrocarbon oxidation products show that
      an autoxidation reaction pathway dominates the reaction kinetics, consistent with
      a radical chain process. For each catalytic system examined, PFeII species were
      shown not to be stable under moderate O2 pressure at 80 degrees C; in every case,
      the PFeII catalyst precursor was converted quantitatively to high-spin PFeIII
      complexes prior to the observation of any hydrocarbon oxidation products. Once
      catalytic isobutane oxidation is initiated, all reactions are marked by
      concomitant decomposition of the porphyrin-based catalyst. In situ 17O NMR
      spectroscopic studies confirm the incorporation of 17O from labeled water into
      the oxidation products, implicating the involvement of PFe-OH in the catalytic
      cycle. Importantly, Br8(C6F5)4PFe-based catalysts, which lack macrocycle C-H
      bonds, do not exhibit augmented stability with respect to analogous catalysts
      based on (C6F5)4PFe and (C3F7)4PFe species. The data presented are consistent
      with a hydrocarbon oxidation process in which PFe complexes play dual roles of
      radical chain initiator, and the species responsible for the catalytic
      decomposition of organic peroxides. This modified Haber-Weiss reaction scheme
      provides for the decomposition of tert-butyl hydroperoxide intermediates via
      reaction with PFe-OH complexes; the PFeIII species responsible for hydroperoxide
      decomposition are regenerated by reaction of PFeII with dioxygen under these
      experimental conditions.

PMID- 11196848
TI  - Molecular mechanics calculations of 10-vertex boron cage compounds.
AB  - The model proposed earlier for molecular mechanics calculations of 7- and 12
      vertex boranes, carboranes, and metallocarboranes has been extended to the case
      of 10-vertex borane cage compounds. To use the MM3 program with the standard
      connectivity file, and to avoid program alterations, the 10-vertex cages of the
      molecules were presented as a superposition of four formally independent
      fragments. Interactions between the fragments were described with a Hill-like
      potential, with the parameters adjusted for valence interactions. Standard values
      for the bond lengths and bond angles in the 10-vertex boron cage have been found
      by statistical analysis of X-ray data on borane cage compounds stored in the
      Cambridge Structural Database. Several substituted neutral molecules and anions
      have been considered, and good agreement of the calculated and experimental data
      has been obtained. Using the approach developed, the unknown structure of the [mu
      B20H16O(CH2)4O(CH2)2CH(CH3)2]3- ion has been calculated.

PMID- 11196849
TI  - Encapsulating bis(beta-ketoiminato) polyethers. Volatile, fluorine-free barium
      precursors for metal-organic chemical vapor deposition.
AB  - The synthesis, characterization, and incorporation in volatile metal-organic
      chemical vapor deposition (MOCVD) precursors of a new class of linked beta
      ketoiminate-polyether-beta-ketoiminate ligands is presented. These ligands are
      designed to encapsulate alkaline-earth cations having low charges and large ionic
      radii. Barium complexes having the general formula Ba[(RCOCHC(R')N)2(R")] (R =
      tert-butyl or CF3; R' = tert-butyl, methyl, or CF3; R" = -(CH2CH2O)4CH2CH2- or 
      (CH2CH2O)5CH2CH2)-) were prepared and characterized by 1H and 13C NMR
      spectroscopy, elemental analysis, and mass spectrometry. Single-crystal X-ray
      diffraction analysis of 2,2,5,25,28,28-hexamethyl-9,12,15,18,21-pentaoxa-4,25
      diene-6,24- diimino-3,27-pentacosadionatobarium(II) reveals a monomeric, nine
      coordinate, tricapped trigonal prismatic coordination geometry. Single-crystal X
      ray structural analysis of 1,1,1,24,24,24-hexafluoro-4,21-ditrifluoromethyl
      8,11,14,17- tetraoxa-3,21-diene-5,20-diimino-2,23
      tetracosadionatobarium(II).2DMSO reveals a monomeric, ten-coordinate, distorted
      tetracapped trigonal prismatic coordination geometry. Volatility data are
      presented for these barium complexes, demonstrating viability as MOCVD
      precursors. In addition, it is demonstrated that thin epitaxial films of BaTiO3
      can be grown on (001) MgO by low-pressure MOCVD techniques using one of these
      barium complexes and Ti(dipivaloylmethanate)2(isopropoxide)2 as precursors.

PMID- 11196850
TI  - Luminescent chains formed from neutral, triangular gold complexes sandwiching TlI
      and AgI. Structures of (Ag([Au(mu-C2,N3-bzim)]3)2)BF4.CH2Cl2, (Tl([Au(mu-C2,N3
      bzim)]3)2)PF(6).0.5THF (bzim = 1-benzylimidazolate), and (Tl([Au(mu
      C(OEt)=NC6H4CH3)]3)2)PF6.THF, with MAu6 (M = Ag+, Tl+) cluster cores.
AB  - It has been found that several trinuclear complexes of AuI interact with silver
      and thallium salts to intercalate Ag+ and Tl+ cations, thereby forming chains.
      The resulting sandwich clusters center the cations between the planar trinuclear
      moieties producing structures in which six AuI atoms interact with each cation in
      a distorted trigonal prismatic coordination. The resultant (B3AB3B3AB3)infinity
      pattern of metal atoms also shows short (approximately 3.0 A) aurophilic
      interactions between BAB molecular centers. These compounds display a strong
      visible luminescence, under UV excitation, which is sensitive to temperature and
      the metal ion interacting with the gold. X-ray crystal structures are reported
      for Ag([Au(mu-C2,N3-bzim)]3)2BF4CH2Cl2 (P1, Z = 2, a = 14.4505(1) A; b =
      15.098(2)A; c = 15.957(1)A; alpha = 106.189(3) degrees; beta = 103.551(5)
      degrees; gamma = 101.310(5) degrees); Tl([Au(mu-C2,N3-bzim)]3)2PF(6)05C4H8O (P1,
      Z = 2, a = 15.2093(1)A; b = 15.3931(4)A; c = 16.1599(4)A; alpha = 106.018(1)
      degrees; beta = 101.585(2) degrees; gamma = 102.068(2) degrees); and Tl([Au(mu
      C(OEt)=NC6H4CH3)]3)2PF6.C4H8O (P2(1)/n, Z = 4, a = 16.4136(3)A; b = 27.6277(4)A;
      c = 16.7182(1)A; beta = 105.644(1) degrees). Each compound shows that the
      intercalated cation, Ag+ or Tl+, coordinates to a distorted trigonal prism of six
      AuI atoms. The counteranions reside well apart from the cations between the
      cluster chains.

PMID- 11196851
TI  - Through-ring bonding in edge sharing dimers of octahedral complexes.
AB  - A study of the preferred structures for the M2X2 rings in the binuclear complexes
      of types [M2(mu-XR2)2L8] and [M2(mu-XR3)2L8] is presented, based on qualitative
      orbital arguments supported by extended Huckel calculations on Cr compounds. The
      main conclusions are confirmed by DFT calculations on key compounds of Cr and Mn
      and agree well with the results of a structural database analysis. With the
      simplified electron counting scheme deduced, complexes with six or four electrons
      available for bonding of the M2X2 framework are predicted to have two possible
      minimum energy structures, with either a short M-M or X-X distance, whereas
      compounds with eight framework electrons are expected to present no short through
      ring distance. Such a behavior is consistent with the framework electron rules
      reported earlier for compounds with different coordination spheres and provides a
      general description of the structure and bonding in a variety of compounds with
      M2X2 diamonds. Metal-metal bonding across the ring can be equally predicted
      taking into account only the bonding characteristics of the t2g-like orbitals for
      the XR2- but not for the XR3-bridged complexes. In addition, the framework
      electron counting scheme has the advantage of being independent of the formal
      oxidation state assigned to the metal atom.

PMID- 11196852
TI  - Syntheses, structures, and physical properties of LnAsTe (Ln = La, Pr, Sm, Gd,
      Dy, Er).
AB  - Six rare-earth arsenic tellurides have been synthesized by the reactions of the
      rare-earth elements (Ln) with As and Te at 1123 K. LaAsTe (a = 7.8354(11) A, b =
      4.1721(6) A, c = 10.2985(14) A, T = 153 K), PrAsTe (a = 7.728(2) A, b =
      4.1200(11) A, c = 10.137(3) A, T = 153 K), SmAsTe (a = 7.6180(16) A, b =
      4.0821(9) A, c = 9.991(2) A, T = 153 K), GdAsTe (a = 7.5611(15) A, b = 4.0510(8)
      A, c = 9.920(2) A, T = 153 K), DyAsTe (a = 7.4951(13) A, b = 4.0246(7) A, c =
      9.8288(17) A, T = 153 K), and ErAsTe (a = 7.4478(1) A, b = 4.0078(1) A, c =
      9.7552(2) A, T = 153 K) crystallize with four formula units in the orthorhombic
      space group D2h16-Pnma. These compounds are isostructural and belong to the beta
      ZrSb2 structure type. In each compound, the Ln atoms are coordinated by a
      tricapped trigonal prism of four As atoms and five Te atoms. The entire three
      dimensional structure is built up by the motif of the LnAs4Te5 tricapped trigonal
      prisms. Infinite nonalternating zigzag As chains are found along the b axis, with
      As-As distances in these compounds ranging from 2.5915(5) to 2.6350(9) A.
      Conductivity measurements in the direction of these As chains indicate that
      PrAsTe is metallic whereas SmAsTe and DyAsTe are weakly metallic.
      Antiferromagnetic transitions occur in SmAsTe and DyAsTe at 3 and 9 K,
      respectively. DyAsTe above 9 K follows the Curie-Weiss law.

PMID- 11196853
TI  - Water adsorption and hydrolysis on molecular transition metal oxides and
      oxyhydroxides.
AB  - Addition of water to molecular transition metal oxides (TiO2(g) and CrO3(g)) and
      oxyhydroxides (ScO(OH)(g), VO2(OH)(g), and MnO3(OH)(g)) was studied by means of
      quantum chemistry. In the investigated reactions, each reaction step comprised
      the breaking of one M=O bond and the formation of two OH groups. Exothermicity
      was observed when the product had tetrahedral or lower oxygen coordination. The
      reactions were found to involve stable water complexes as intermediates. The
      stabilities of such complexes were accentuated in the addition reaction
      Sc(OH)3(g) + H2O(g), in which the formation of a tetrahedral complex was found
      exothermic. For VO(OH)3(g), CrO2(OH)2(g), and MnO3(OH)(g), water addition to the
      remaining M=O bonds was found endothermic, whereas the formation of water
      complexes, using hydrogen bonds and preserving the oxyhydroxide kernel, was
      preferred. Thus, the sequence of such kernels for water clustering in the
      investigated reactions was found to be Sc(OH)3.H2O(g), Ti(OH)4(g), VO(OH)3(g),
      CrO2(OH)2(g), and MnO3(OH)(g). These stability considerations are important, as
      CrO2(OH)2(g) is believed to be the product of water-induced degradation of the
      protective chromium oxide scale on stainless steel at elevated temperatures.

PMID- 11196854
TI  - Hydrolysis on transition metal oxide clusters and the stabilities of M-O-M
      bridges.
AB  - Water addition to molecular single, double and triple M-O-M bridges (M = Sc, Ti,
      V, Cr, and Mn) were considered, and the stabilities toward stepwise hydrolysis of
      the oxygen bridges were studied by means of quantum chemistry. The M-O bond
      distances for the studied systems were compared to experiment for demonstration
      of the applicability of the B3LYP functional to the investigated systems. While
      substantial exothermicities were found for the hydrolysis of double and triple M
      O-M bridges, addition of water to a single bridge was generally found to be
      slightly endothermic. The lack of enthalpy drive for the (OH)yOxM-O-MOx(OH)y +
      H2O-->2MOx-1(OH)y+2 reaction was taken to suggest that entropy increase and the
      formation of mononuclear water complexe, would be decisive factors for the
      dissociation. A mechanism was proposed for the observed erosion of the protective
      chromium oxide scale on high-temperature alloys at elevated temperatures and high
      humidities, based on the formation of CrO2(OH)2(g).

PMID- 11196855
TI  - Selective imidazolidine ring opening during complex formation of iron(III),
      copper(II), and zinc(II) with a multidentate ligand obtained from 2
      pyridinecarboxaldehyde N-oxide and triethylenetetramine.
AB  - The condensation of 2-pyridinecarboxaldehyde N-oxide and triethylenetetramine
      yields a product with two imidazolidine rings, as proven by a solid-state X-ray
      structure analysis as well as by NMR solution spectra. This ligand, L1, undergoes
      a ring-opening reaction on complex formation with Cu(II), yielding [CuL2]2+ where
      L2 functions as a pentadentate ligand, containing only one imidazolidine ring. On
      complexation with Zn(II) and Fe(III), both rings are opened and the complexes
      [ZnL3]2+ and [FeL3]3+ with a hexadentate L3 ligand are formed. The
      recrystallization of [ZnL3]2+ from DMSO solution results in the complex
      [ZnL1(DMSO)2]2+ in which L1 behaves as a tetradentate ligand. Thus L1, L2, and L3
      are structural isomers with two, one, or no imidazolidine rings, as confirmed by
      X-ray structure analyses. The intramolecular ring formation is the result of the
      nucleophilic addition of the N(amino) group to the electrophilic sp2-hybridized 
      HC delta+=N site. Owing to the absence of the chelate effect on the sp3
      hybridized carbon atom belonging to the imidazolidine ring, the ring opening is
      facilitated and readily observed upon complex formation with Cu(II), Zn(II), and
      Fe(III).

PMID- 11196856
TI  - Reactivity of "Eu(OiPr)2" with phenols: formation of linear Eu3, square pyramidal
      Eu5, cubic Eu8, and capped cubic Eu9 polymetallic europium complexes.
AB  - The direct reaction of europium with 2-propanol and phenols has been investigated
      under a variety of conditions. The reaction of europium metal with 2,6
      dimethylphenol and 2,6-diisopropylphenol in 2-propanol at reflux revealed that
      polymetallic europium complexes could be generated by this method.
      Hx[Eu8O6(OC6H3Me2-2,6)12(OiPr)8], 1, and H5[Eu5O5(OC6H3iPr2-2,6)6(NCCH3)8], 2,
      were isolated by recrystallization in the presence of hexanes and acetonitrile,
      respectively, and characterized by X-ray crystallography. Complex 1 has a cubic
      arrangement of europium ions with face-bridging mu 4-O donor atoms, edge-bridging
      mu-O(phenoxide/phenol) ligands, and terminal O(isopropoxide/2-propanol) ligands.
      Complex 2 is mixed valent and has a square pyramidal europium core with four
      Eu(II) ions at the basal positions and one Eu(III) ion at the apex. Since these
      reactions gave complicated mixtures of products from which 1 and 2 could only be
      obtained in low yields, direct reactions under less forcing reaction conditions
      were investigated. Europium reacts slowly at room temperature to form arene
      soluble divalent [Eu(OiPr)2(THF)x]n, 3. Complex 3 reacts with 2,6-dimethylphenol
      to form the arene-insoluble complex (H[Eu(OC6H3Me2)2(OiPr)])n, 4.
      Recrystallization of 4 in the presence of THF results in the crystallographically
      characterizable divalent trimetallic complex [Eu(OC6H3Me2-2,6)2(THF)2]3, 5, which
      has an unusual linear metal geometry. In the presence of HOiPr at ambient
      conditions in the glovebox, crystals of 5 slowly convert to the mixed valent
      H10[Eu8O8(OC6H3Me2-2,6)10(OiPr)2(THF)6], 6, which was found to have a cubic
      arrangement of europium atoms similar to 1 by X-ray crystallography. Complex 4,
      upon heating under vacuum, followed by reaction with THF, forms the arene-soluble
      divalent complex H18([Eu9O8(OC6H3Me2-2,6)10(THF)7][Eu9O9(OC6H3Me2-2,6)10(THF)6]),
      7, which contains two types of capped cubic arrangements of europium ions in the
      solid state.

PMID- 11196857
TI  - Magnetic coupling in end-to-end azido-bridged copper and nickel binuclear
      complexes: a theoretical study.
AB  - The influence of structural parameters on the exchange coupling J between metal
      atoms in end-to-end azido-bridged binuclear complexes of Cu(II) and Ni(II) has
      been studied by means of density functional calculations. For the case of double
      bridged Cu(II) compounds, four ideal pentacoordinate models have been employed in
      which the coordination spheres of the two metal atoms are either a trigonal
      bipyramid or a square pyramid, connected through equatorial or axial bridges. The
      distortion from those ideal geometries along a Berry pathway has also been
      analyzed. For the hexacoordinate Ni(II) compounds, models with two or one
      bridging ligands have been studied. The effect of the bridging M-N-N bond angles
      on the exchange coupling has been analyzed for both the Cu(II) and Ni(II)
      complexes.

PMID- 11196858
TI  - A hydrothermal investigation of the 1/2V2O5-H2C2O4/H3PO4/NH4OH system: synthesis
      and structures of (NH4)VOPO(4).1.5H2O, (NH4)0.5VOPO(4).1.5H2O,
      (NH4)2[VO(H2O)3]2[VO(H2O)][VO(PO4)2](2).3H2O, and (NH4)2[VO(HPO4)]2(C2O4).5H2O.
AB  - The 1/2V2O5-H2C2O4/H3PO4/NH4OH system was investigated using hydrothermal
      techniques. Four new phases, (NH4)VOPO(4).1.5H2O (1), (NH4)0.5VOPO(4).1.5H2O (2),
      (NH4)2[VO(H2O)3]2[VO(H2O)][VO(PO4)2]2.3H2O (3), and (NH4)2[VO(HPO4)]2(C2O4).H2O
      (4), have been prepared and structurally characterized. Compounds 1 and 2 have
      layered structures closely related to VOPO(4).2H2O and A0.5VOPO4.yH2O (A = mono-
      or divalent metals), whereas 3 has a 3D open-framework structure. Compound 4 has
      a layered structure and contains both oxalate and phosphate anions coordinated to
      vanadium cations. Crystal data: (NH4)VOPO(4).1.5H2O, tetragonal (I), space group
      I4/mmm (No. 139), a = 6.3160(5) A, c = 13.540(2) A, Z = 4;
      (NH4)0.5VOPO(4).1.5H2O, monoclinic, space group P2(1)/m (No. 11), a = 6.9669(6)
      A, b = 17.663(2) A, c = 8.9304(8) A, beta = 105.347(1) degrees, Z = 8;
      (NH4)2[VO(H2O)3]2[VO(H2O)][VO(PO4)2]2.3H2O, triclinic, space group P1 (No. 2), a
      = 10.2523(9) A, b = 12.263(1) A, c = 12.362(1) A, alpha = 69.041(2) degrees, beta
      = 65.653(2) degrees, gamma = 87.789(2) degrees, Z = 2;
      (NH4)2[VO(HPO4)]2(C2O4).5H2O, monoclinic (C), space group C2/m (No. 12), a =
      17.735(2) A, b = 6.4180(6) A, c = 22.839(2) A, beta = 102.017(2) degrees, Z = 6.

PMID- 11196859
TI  - Formation of a tetranuclear copper (II) cluster assembled by metal-assisted
      hydrolysis and desulfurization of bis(3,5-dimethylpyrazolyl)methylphosphine
      sulfide, MeP(S)(3,5-Me2Pz)2.
AB  - The reaction of methylphosphine sulfide, MeP(S)(3,5-Me2Pz)2, 1, with anhydrous
      CuCl2 affords a tetranuclear copper cluster[Cu2Cl2(3,5-Me2Pz)3(MePO3)]2, 2, and a
      dinuclear compound Cu2Cl4(3,5-Me2Pz)4, 3. This reaction involves a metal-assisted
      desulfurization along with concomitant hydrolysis of P-N bonds. The X-ray
      structures of 1-3 have been determined, and the crystal parameters for these are
      the following. 1: space group = C2/c, a = 15.2552(1) A, b = 8.7364(2) A, c =
      21.4490(3) A, beta = 93.349(1) degrees, V = 2853.74(8) A3, and Z = 8. 2: space
      group = P2(1)/n, a = 12.5964(4) A, b = 15.7773(4) A, c = 13.9781(4) A, beta =
      116.6280(10) degrees, V = 2483.32(12) A3, and Z = 2. 3: space group = P2(1)/c, a
      = 8.7137(8) A, b = 13.5493(14) A, c = 11.8847(12) A, beta = 106.179(2) degrees, V
      = 1347.6(2) A3, and Z = 2. The structure of 2 shows that it comprises two
      dinuclear copper cores bridged together by two tripodal methylphosphinate, MePO3,
      ligands. 2 is weakly antiferromagnetically coupled, as revealed by variable
      temperature magnetic susceptibility measurements.

PMID- 11196860
TI  - Self-propagating metathesis routes to metastable group 4 phosphides.
AB  - Group 4 phosphides, which are typically prepared at high temperatures (> 800
      degrees C) over several days, are synthesized in self-propagating metathesis
      (exchange) reactions in seconds. These reactions produce cubic forms of zirconium
      phosphide (ZrP) and hafnium phosphide (HfP) which are normally made at
      temperatures greater than 1425 degrees C and 1600 degrees C, respectively. To
      test whether the high temperatures reached in the metathesis reactions are
      responsible for the formation of the cubic phases, inert salts are added to lower
      the maximum reaction temperatures. The lower temperature reactions still result
      in cubic phosphides, although smaller crystallites form. Further experiments with
      phosphorus addition indicate that the phosphorus content is not responsible for
      cubic phase formation. Templating is ruled out using lattice mismatched KCl and
      hexagonal ZnS as additives. Therefore, the direct synthesis of the high
      temperature cubic phase in metathesis reactions appears to be caused by
      nucleation of the metastable cubic form that is then trapped by rapid cooling.
      Heating the cubic phase of either ZrP or HfP to 1000 degrees C for 18 h, or
      carrying out metathesis reactions in sealed ampules at 1000 degrees C, results
      only in the hexagonal phase.

PMID- 11196861
TI  - Peroxo and ferryl intermediates detected by 1H NMR spectroscopy during the
      oxygenation of iron(II) porphycene.
AB  - The iron(III) 2,7,12,17-tetra-n-propylporphycene (TPrPc)FeIIICl is reduced using
      aqueous sodium dithionite or zinc amalgam to produce (TPrPc)FeII. The 1H NMR
      spectrum of (TPrPc)FeII (293 K; delta (ppm): pyrrole, -37.52; meso, 71.56; alpha
      CH2, 27.47; beta-CH2, 8.92; gamma-CH3, 5.55) can be accounted for by the planar
      unligated iron(II) porphycene with an S = 1 ground electronic state. Introduction
      of dioxygen into a toluene-d8 solution of (TPrPc)FeII at 203 K results in the
      formation of the (mu-peroxo)diiron(III) porphycene (TPrPc)FeIII-O-O-FeIII(TPrPc).
      The value of the chemical shift of the pyrrole resonances (17.99 ppm at 203 K) of
      this species and its distinct non-Curie behavior imply strong antiferromagnetic
      iron(III)-iron(III) coupling via a mu-peroxo bridge. The (TPrPc)FeIII-O-O
      FeIII(TPrPc) intermediate is stable at 203 K, but it converts into the (mu
      oxo)diiron complex (TPrPc)FeIII-O-FeIII(TPrPc) upon warming above 203 K. Reaction
      of (TPrPc)FeIII-O-O-FeIII(TPrPc) with a nitrogen bases (B: pyridine-d5, 1
      methylimidazole) results in a homolytic cleavage of the mu-peroxo bridge to form
      the ferryl porphycene complex B(TPrPc)FeIVO (1H NMR (223 K), delta (ppm):
      pyrrole, -1.32; meso, 11.80). B(TPrPc)FeIVO reacts with triphenylphosphine at 223
      K to yield triphenylphosphine oxide.

PMID- 11196862
TI  - Structural influences of organonitrogen ligands on vanadium oxide solids.
      Hydrothermal syntheses and structures of the terpyridine vanadates
      [V2O4(terpy)2]3[V10O28], [VO2(terpy)][V4O10], and [V9O22(terpy)3].
AB  - Hydrothermal reactions of the V2O5/2,2':6':2"-terpyridine/ZnO/H2O system under a
      variety of conditions yielded the organic-inorganic hybrid materials
      [V2O4(terpy)2]3[V10O28].2H2O (VOXI-10), [VO2(terpy)][V4O10] (VOXI-11), and
      [V9O22(terpy)3] (VOXI-12). The structure of VOXI-10 consists of discrete
      binuclear cations [V2O4(terpy)2]2+ and one-dimensional chains [V10O28]6-,
      constructed of cyclic [V4O12]4- clusters linked through (VO4) tetrahedra. In
      contrast, the structure of VOXI-11 exhibits discrete mononuclear cations
      [VO2(terpy)]1+ and a two-dimensional vanadium oxide network, [V4O10]1-. The
      structure of the oxide layer is constructed from ribbons of edge-sharing square
      pyramids; adjacent ribbons are connected through corner-sharing interactions into
      the two-dimensional architecture. VOXI-12 is also a network structure; however,
      in this case the terpy ligand is incorporated into the two-dimensional oxide
      network whose unique structure is constructed from cyclic [V6O18]6- clusters and
      linear (V3O5(terpy)3) moieties of corner-sharing vanadium octahedra. The rings
      form chains through corner-sharing linkages; adjacent chains are connected
      through the trinuclear units. Crystal data: VOXI-10, C90H70N18O42V16, triclinic
      P1, a = 12.2071(7) A, b = 13.8855(8) A, 16.9832(10) A, alpha = 69.584(1) degrees,
      beta = 71.204(1) degrees, gamma = 84.640(1) degrees, Z = 1; VOXI-11,
      C15H11N3O12V5, monoclinic, P2(1)/n, a = 7.7771(1) A, b = 10.3595(2) A, c =
      25.715(4) A, beta = 92.286(1) degrees, Z = 4; VOXI-12, C45H33N9O22V9, monoclinic
      C2/c, a = 23.774(2) A, b = 9.4309(6) A, c = 25.380(2) A, beta = 112.047(1)
      degrees, Z = 4.

PMID- 11196863
TI  - Oxidative scission of a Mo-Mo quadruple bond.
AB  - Two compounds containing the cations Mo2(DPhIP)4n+, n = 1 or 2 and DPhIP = the
      anion of 2,6-diphenyliminopiperidine, have been obtained by oxidation of the
      quadruply-bonded Mo2(DPhIP)4 species. The first oxidation process conserves the
      structure but results in a slight increase of the Mo-Mo distance from 2.114(1) to
      2.136(2) A in [Mo2(DPhIP)4](PF6).2CH2Cl2 (1.2CH2Cl2). However, the second
      oxidation process breaks the dimolybdenum bond, giving a bioctahedral complex,
      [Mo2(DPhIP)4](BF4)2.5CH3CN.Et2O (2.5CH3CN.Et2O), with Mo...Mo separation of
      2.9954(7) A. Crystallographic data for 1.2CH2Cl2 are space group C2/c, a =
      17.1891(9) A, b = 17.807(1) A, c = 24.210(2) A, beta = 106.403(4) degrees, Z = 4;
      for 2.5CH3CN.Et2O, space group P2(1)/n, a = 16.523(5) A, b = 27.418(5) A, c =
      18.163(3) A, beta = 93.48(2) degrees, Z = 4.

PMID- 11196864
TI  - Preparations, structures, and electrochemical studies of aryldiazene complexes of
      rhenium: syntheses of the first heterobinuclear and heterotrinuclear derivatives
      with bis(diazene) or bis(diazenido) bridging ligands.
AB  - The mono- and binuclear aryldiazene complexes [Re(C6H5N=NH)(CO)5-nPn]BY4 (1-5)
      and [(Re(CO)5-nPn)2-(mu-HN=NAr-ArN=NH)](BY4)2 (6-12) [P = P(OEt)3, PPh(OEt)2,
      PPh2OEt; n = 1-4; Ar-Ar = 4,4'-C6H4-C6H4, 4,4'-(2-CH3)C6H3-C6H3(2-CH3), 4,4'-C6H4
      CH2-C6H4; Y = F, Ph) were prepared by reacting the hydride species ReH(CO)5-nPn
      with the appropriate mono- and bis(aryldiazonium) cations. These compounds, as
      well as other prepared compounds, were characterized spectroscopically (IR; 1H,
      31P, 13C, and 15N NMR data), and 1a was also characterized by an X-ray crystal
      structure determination. [Re(C6H5N=NH)(CO)(P(OEt)3)4]BPh4 (1a) crystallizes in
      space group P1 with a = 15.380(5) A, b = 13.037(5) A, c = 16.649(5) A, alpha =
      90.33(5) degrees, beta = 91.2(1) degrees, gamma = 89.71(9) degrees, and Z = 2.
      The "diazene-diazonium" complexes [M(CO)3P2(HN=NAr-ArN identical to N)](BF4)2 (13
      15, 17) [M = Re, Mn; P = PPh2OEt, PPh2OMe, PPh3; Ar-Ar = 4,4'-C6H4-C6H4, 4,4'
      C6H4-CH2-C6H4] and [Re(CO)4(PPh2OEt)(4,4'-HN=NC6H4-C6H4N identical to N)](BF4)2
      (16b) were synthesized by allowing the hydrides MH(CO)3P2 or ReH(CO)4P to react
      with equimolar amounts of bis(aryldiazonium) cations under appropriate
      conditions. Reactions of diazene-diazonium complexes 13-17 with the metal
      hydrides M2H2P'4 and M2'H(CO)5-nP"n afforded the heterobinuclear bis(aryldiazene)
      derivatives [M1(CO)3P2(mu-HN=NAr-ArN=NH)M2HP'4](BPh4)2 (ReFe, ReRu, ReOs, MnRu,
      MnOs) and [M1(CO)3P2(mu-HN=NAr-ArN=NH)M2'(CO)5-nP"n](BPh4)2 (ReMn, MnRe) [M1 =
      Re, Mn; M2 = Fe, Ru, Os; M2' = Mn, Re; P = PPh2OEt, PPh2OMe; P',P" = P(OEt)3,
      PPh(OEt)2; Ar-Ar = 4,4'-C6H4-C6H4, 4,4'-C6H4-CH2-C6H4; n = 1, 2]. The
      heterotrinuclear complexes [Re(CO)3(PPh2OEt)2(mu-4,4'-HN=NC6H4
      C6H4N=NH)M(P(OEt)3)4(mu-4,4'-HN=NC6H4- C6H4N=NH)Mn(CO)3(PPh2OEt)2](BPh4)4 (M =
      Ru, Os) (ReRuMn, ReOsMn) were obtained by reacting the heterobinuclear complexes
      ReRu and ReOs with the appropriate diazene-diazonium cations. The heterobinuclear
      complex with a bis(aryldiazenido) bridging ligand [Mn(CO)2(PPh2OEt)2(mu-4,4'
      N2C6H4-C6H4N2)Fe(P(OEt)3)4]BPh4 (MnFe) was prepared by deprotonating the
      bis(aryldiazene) compound [Mn(CO)3(PPh2OEt)2(mu-4,4'-HN=NC6H4-C6H4N=NH)Fe(4-
      CH3C6H4CN)(P(OEt)3)4](BPh4)3. Finally, the binuclear compound
      [Re(CO)3(PPh2OEt)2(mu-4,4'-HN=NC6H4-C6H4N2)Fe(CO)2(P(OPh)3)2](BPh4)2 (ReFe)
      containing a diazene-diazenido bridging ligand was prepared by reacting
      [Re(CO)3(PPh2OEt)2(4,4'-HN=NC6H4-C6H4N identical to N)]+ with the
      FeH2(CO)2(P(OPh)3)2 hydride derivative. The electrochemical reduction of mono-
      and binuclear aryldiazene complexes of both rhenium (1-12) and the manganese, as
      well as heterobinuclear ReRu and MnRu complexes, was studied by means of cyclic
      voltammetry and digital simulation techniques. The electrochemical oxidation of
      the mono- and binuclear aryldiazenido compounds Mn(C6H5N2)(CO)2P2 and
      (Mn(CO)2P2)2(mu-4,4'-N2C6H4-C6H4N2) (P = PPh2OEt) was also examined.
      Electrochemical data show that, for binuclear compounds, the diazene bridging
      unit allows delocalization of electrons between the two different redox centers
      of the same molecule, whereas the two metal centers behave independently in the
      presence of the diazenido bridging unit.

PMID- 11196865
TI  - Synthesis of monohalogeno derivatives of closo-[B9H9]2-. Crystal structures of
      (Ph4P)2[1-XB9H8].CH3CN (X = Cl, Br, I).
AB  - By reaction of Na2[B9H9] with the appropriate N-halogenosuccinimide, the
      monohalogenated anion [1-XB9H8]2- (X = Cl, Br, or I) is formed. The X-ray
      diffraction analyses performed on single crystals of (Ph4P)2[1-XB9H8].CH3CN (X =
      Cl, Br, I) reveal that the tricapped trigonal prismatic geometry of the cluster
      is retained after substitution in the 1-position. Crystallographic data are as
      follows for (Ph4P)2[1-XB9H8].CH3CN. X = Cl, Br: monoclinic, space group P2(1), a
      = 10.7 A, b = 32.9 A, c = 13.8 A, beta = 96 degrees, Z = 4, R1 = 0.038 and R1 =
      0.036, respectively. X = I: monoclinic, space group P2(1)/n, a = 10.5 A, b = 13.6
      A, c = 33.4 A, beta = 94 degrees, Z = 4, R1 = 0.094. The compounds have been
      characterized by vibrational and 11B NMR spectroscopy as well.

PMID- 11196866
TI  - Diazo complexes of rhenium: preparations and crystal structures of the
      bis(dinitrogen), [Re(N2)2(PPh(OEt)2)4][BPh4] and methyldiazenido
      [ReCl(CH3N2)(CH3NHNH2)(PPh(OEt)2)3][BPh4] derivatives.
AB  - Depending on experimental conditions and the nature of the hydrazine, the
      reactions of ReCl3P3 [P = PPh(OEt)2] with RNHNH2 (R = H, CH3, tBu) afford the
      bis(dinitrogen) [Re(N2)2P4]+ (2+), dinitrogen ReClN2P4 (3), and methyldiazenido
      [ReCl(CH3N2)(CH3NHNH2)P3]+ (1+) derivatives. In contrast, reactions of ReCl3P3 [P
      = PPh(OEt)2, PPh2OEt] with arylhydrazines ArNHNH2 (Ar = Ph, p-tolyl) give the
      aryldiazenido cations [ReCl(ArN2)(ArNHNH2)P3]+ (4+) and [ReCl(ArN2)P4]+ (7+) and
      the bis(aryldiazenido) cations [Re(ArN2)2P3]+ (5+, 6+). These complexes were
      characterized spectroscopically (IR; 1H and 31P NMR), and the BPh4 complexes 1,
      2, and 7 were characterized crystallographically. The methyldiazenido derivative
      [ReCl(CH3N2)(CH3NHNH2)(PPh(OEt)2)3][BPh4] (1) crystallizes in space group P1 with
      a = 15.396(5) A, b = 16.986(5) A, c = 11.560(5) A, alpha = 93.96(5) degrees, beta
      = 93.99(5) degrees, gamma = 93.09(5) degrees, and Z = 2 and contains a singly
      bent CH3N2, group bonded to an octahedral central metal. One methylhydrazine
      ligand, one Cl- trans to the CH3N2, and three PPh(OEt)2 ligands complete the
      coordination. The complex [Re(N2)2(PPh(OEt)2)4][BPh4] (2) crystallizes in space
      group Pbaa with a = 23.008(5) A, b = 23.367(5) A, c = 12.863(3) A, and Z = 4. The
      structure displays octahedral coordination with two end-on N2 ligands in mutually
      trans positions. [ReCl(PhN2)(PPh(OEt)2)4][BPh4] (7) crystallizes in space group
      P2(1)/n with a = 19.613(5) A, b = 20.101(5) A, c = 19.918(5) A, beta = 115.12(2)
      degrees, and Z = 4. The structure shows a singly bent phenyldiazenido group trans
      to the Cl- ligand in an octahedral environment. The dinitrogen complex ReClN2P4
      (3) reacts with CF3SO3CH3 to give the unstable methyldiazenido derivative
      [ReCl(CH3N2)P4][BPh4]. Reaction of the methylhydrazine complex
      [ReCl(CH3N2)(CH3NHNH2)P3][BPh4] (1) with Pb(OAc)4 at -30 degrees C results in
      selective oxidation of the hydrazine, affording the corresponding methyldiazene
      derivative [ReCl(CH3N=NH)(CH3N2)P3][BPh4] (8). In contrast, treatment with
      Pb(OAc)4 of the related arylhydrazines [ReCl(ArN2)(ArNHNH2)P3][BPh4] (4) [P =
      PPh(OEt)2] gives the bis(aryldiazenido) complexes [Re(ArN2)2P3][BPh4] (5).
      Possible protonation reactions of Bronsted acids HX with all diazenides, 1, 4, 5,
      6, and 8, were investigated and found to proceed only in the cases of the
      bis(aryldiazenido) complexes 5 and 6, affording, with HCl, the octahedral
      [ReCl(ArN=NH)(ArN2)P3][BPh4] or [ReCl(Ar(H)NN)(ArN2)P3][BPh4] (10) (Ar = Ph; P =
      PPh2OEt) derivative.

PMID- 11196867
TI  - Syntheses, structures, and properties of tetrakis(mu-acetato)dirhodium(II)
      complexes with axial pyridine nitrogen donor ligands with or without assistance
      of hydrogen bonds.
AB  - Eight adducts of Rh2(O2CCH3)4 with axial pyridine derivatives that contain
      hydrogen-bonding amino and/or steric methyl substituents in the 2- and 6
      positions have been prepared and examined by electronic absorption and 1H NMR
      spectroscopy in solution and by elemental, IR, thermogravimetric, and X-ray
      diffraction analyses in the solid state. The results indicated that strong
      hydrogen bonding interactions between Rh2(O2CCH3)4 and axially coordinated
      pyridine derivatives with a 2- or 6-amino group occur in both solution and the
      solid state and contribute to the higher thermal stability of the molecular
      assembly of dirhodium complexes. It was demonstrated that such a combination of
      coordinate and hydrogen bonds is useful as a building tool in designing and
      constructing new organic-inorganic hybridized compounds and supramolecular
      architectures.

PMID- 11196868
TI  - Synthesis and characterization of water-soluble silver(I) complexes with L
      histidine (H2his) and (S)-(-)-2-pyrrolidone-5-carboxylic acid (H2pyrrld) showing
      a wide spectrum of effective antibacterial and antifungal activities. Crystal
      structures of chiral helical polymers [Ag(Hhis)]n and ([Ag(Hpyrrld)]2)n in the
      solid state.
AB  - Two water-soluble, silver(I) complexes showing a wide spectrum of effective
      antibacterial and antifungal activities, i.e., ([Ag(Hhis)].0.2EtOH)2 (1; H2his =
      L-histidine) and [Ag(Hpyrrld)]2 (3; H2pyrrld = (S)-(-)-2-pyrrolidone-5-carboxylic
      acid) were prepared. In aqueous solution 1 and 3 were present as dimers, whereas
      in the solid state they were polymers. Crystallization of 1 by slow evaporation
      and/or vapor diffusion gave water-insoluble crystals of [Ag(Hhis)]n (2) showing
      modest antimicrobial activities. The complex 1 in the solid state is a polymer
      formed by intermolecular hydrogen-bonding interactions between dimeric
      [Ag(Hhis)]2 cores, while 2 is a different polymer without a core complex. X-ray
      crystallography revealed that 2 was a left-handed helical polymer consisting of a
      bent, 2-coordinate silver(I) atom bonding to the Namino atom of one Hhis- ligand
      and the N pi atom of a different Hhis- ligand. Of particular note is the fact
      that Ocarboxyl atoms do not participate in the coordination. X-ray
      crystallography also revealed that 3 was a left-handed helical polymer formed by
      self-assembly of dimeric [Ag(Hpyrrld)]2 cores with an intramolecular metal(I)
      metal(I) interaction (Ag-Ag distance, 2.9022(7) A). The FT-IR and the solid-state
      13C and 15N NMR spectra showed that the dimeric core of 1 was formed through Ag-N
      bonds, while that of 3 was formed through Ag-O bonds. The molecular ions of 1 and
      3 were detected by the positive-ion electrospray ionization (ESI) mass
      spectrometry. For 1-3, characterization by elemental analysis, TG/DTA, FT-IR, and
      variable-temperature solid-state 13C NMR and room-temperature 15N NMR
      measurements was performed, and for 1 and 3, that by solution molecular weight
      measurements and solution (109Ag, 1H, and 13C) NMR spectroscopies was also
      carried out. The antibacterial and antifungal activities of 1 and 3 were
      remarkable and comparable to those of the previous silver(I)-N-heterocycle
      complexes.

PMID- 11196869
TI  - Corroles with group 15 metal ions. Synthesis and characterization of
      octaethylcorroles containing As, Sb, and Bi ions in +3, +4, and oxidation states.
AB  - The synthesis, spectroscopic characterization, and electrochemistry of As, Sb,
      and Bi corroles are reported. The investigated complexes are represented by
      [(OEC)AsV(CH3)]+ClO4- and (OEC)M where M = As(III), Sb(III), or Bi(III) and OEC
      is the trianion of octaethylcorrole. The products of each redox reaction are
      characterized by UV-vis and ESR spectroscopy. The first one-electron oxidations
      of (OEC)As and (OEC)Sb are metal-centered and result in the formation of
      [(OEC)AsIV]+ and [(OEC)SbIV]+. A second one-electron oxidations generates
      [(OEC)AsV]2+ and [(OEC.)SbIV]2+, the latter of which is slowly converted to a
      Sb(V) corrole, [(OEC)SbV]2+. The first one-electron oxidation of (OEC)Bi leads
      only to the Bi(III) pi-cation radical, but a second one-electron oxidation is
      proposed to give a Bi(IV) complex, [(OEC)Bi]2+. The first reduction of
      [(OEC)AsV(CH3)]+ClO4- is accompanied by loss of the sigma-bonded methyl ligand
      and formation of an As(III) complex.

PMID- 11196870
TI  - Synthesis and characterization of the layered vanadium borophosphate
      (imidazolium)3.8(H3O)1.2[(VO)4(BO)2(PO4)5].0.3H2O.
AB  - The first layered vanadium borophosphate
      (imidazolium)3.8(H3O)1.2[(VO)4(BO)2(PO4)5].0.3H2O (1) has been synthesized
      hydrothermally and characterized by chemical analysis, infrared and Raman
      spectroscopy, and thermogravimetric and magnetic measurements. The compound
      crystallizes in the monoclinic space group C2/c, a = 9.4737 (5) A, b = 22.1444
      (12) A, c = 17.2192 (13) A, beta = 105.936 (1) degrees, Z = 4. The structure
      contains a novel borophosphate secondary building unit, [B2P5O22], in which two
      BP2O10 trimers are linked by an additional PO4 tetrahedron. These units are
      connected by V(IV)2O8 dimers and V(IV)O5 square pyramids to form layers. The
      space between the layers is filled by disordered imidazolium and hydronium
      cations and water molecules that form a complex network of hydrogen bonds. A
      model for the interlayer disorder is proposed.

PMID- 11196871
TI  - Syntheses, characterizations, and single-crystal X-ray structures of soluble
      titanium alkoxide phosphonates.
AB  - Reactions of Ti(OiPr)4 with different phosphonic acids RPO3H2 (R = Ph, 4-CNPh,
      Me, tBu) in organic solvents have been investigated. In the presence of small
      amounts of water, the new molecular titanium oxide alkoxide phosphonates [Ti4(mu
      3-O)(OiPr)5(mu-OiPr)3(RPO3)3].DMSO [R = Ph (1), Me (2), tBu (3), 4-CNPh (4)] were
      isolated. The single-crystal X-ray structure analyses of 1 and 2 revealed
      hexacoordinated titanium atoms and a connectivity of (111) for each phosphonate.
      Under rigorous exclusion of water, the reaction of Ti(OiPr)4 with tert
      butylphosphonic acid in toluene gave the titanium phosphonate tetramer
      [Ti(OiPr)2(tBuPO3)]4 (5). A single-crystal X-ray structure analysis of 5 revealed
      a 5 + 1 coordination of the titanium atoms as a result of the (112) connectivity
      of each phosphonate; such a coordination mode has never been reported for a
      titanium phosphate, phosphonate, or phosphinate. Compounds 1-5 were characterized
      by FT-IR, 31P MAS NMR, and solution multinuclear NMR (1H, 13C(1H,) 31P(1H))
      spectroscopies. 13C CP MAS NMR experiments were carried out on arylphosphonates 1
      and 4. Solution NMR experiments were also used to investigate the exchange
      reaction between 1 and 2 and the conversion of 5 to [Ti4(mu 3-O)(OiPr)5(mu
      OiPr)3(tBuPO3)3].iPrOH by partial hydrolysis in the presence of Ti(OiPr)4. The
      phosphonate clusters 1-5 are soluble in organic solvents and are likely
      intermediates in the sol-gel processing of inorganic-organic hybrids based on
      titanium oxide and phosphonate groups that we are currently developing.

PMID- 11196872
TI  - Synthesis and characterization of sulfide, sulfide-sulfonium, and bissulfide
      derivatives of [B12H12]2-. Additivity of Me2S and MeS- substituent effects in 11B
      NMR spectra of disubstituted icosahedral boron clusters.
AB  - The 1,2-, 1,7-, and 1,12-isomers of (Me2S)2B12H10 (O, M, and P) react with
      potassium phthalimide in DMF or EtSNa in CH3CN/EtOH upon reflux producing the
      corresponding isomers of [(MeS)(Me2S)B12H10]- (O1-, M1-, P1-). If excess of
      either nucleophile is used, [Me2SB12H11]- (1) and O, M, P can be converted into
      dianions [MeSB12H11]2- (2) and [(MeS)2B12H10]2- (O2-, M2-, P2-). The use of EtSNa
      is recommended since it facilitates the isolation of products compared to the
      potassium phthalimide method. When 1 or O, M, P are treated with an excess of an
      alkali metal (Na, K) in liquid ammonia at -40 degrees C, sulfide 2 or bissulfide
      dianions O2-, M2-, P2- are obtained cleanly and almost instantly. While both the
      nucleophilic substitution and alkali metal reduction methods are useful for the
      synthesis of dianions 2, O2-, M2-, and P2-, only the former method is suitable
      for the synthesis of the sulfide-sulfonium anions O1-, M1-, P1-. The analysis of
      the 11B NMR spectra of 1, O, M, P and anions derived from them demonstrated that
      the spectra of the disubstituted species can be predicted qualitatively, keeping
      in mind the simple substituent effects obtained from the spectra of
      monosubstituted anions 1 and 2. Some evidence is found for small partial double
      bond character of the B-SMe bonds in anions. [MePPh3]+ salts of [MeSB12H11]2- (2)
      and [1-(MeS)-7-(Me2S)B12H10]- (M1-) are structurally characterized by single
      crystal X-ray diffraction analysis. Crystal data: [MePPh3]2[MeSB12H11], P2(1)
      (No. 4), a = 9.243(1) A, b = 18.272(1) A, c = 12.548(1) A, beta = 103.17(1)
      degrees, Z = 2; [MePPh3][1-(MeS)-7-(Me2S)B12H10], P1 (No. 2), a = 9.278(2) A, b =
      12.003(5) A, c = 14.819(7) A, alpha = 112.18(4) degrees, beta = 105.61(3)
      degrees, gamma = 92.91(3) degrees, Z = 2.

PMID- 11196873
TI  - Copper(II) and copper(I) complexes with an open-chain N4 Schiff base ligand
      modeling CuZn superoxide dismutase: structural and spectroscopic characterization
      and kinetics of electron transfer.
AB  - The structure of the complex [CuII(PuPy)](ClO4)2 (PuPy = L = 1,8-bis(2-pyridyl)
      2,7-diazaoctadiene-1,7) and the structure of the corresponding copper(I) complex
      were determined. In CuIIL(ClO4)2, a model compound with CuZnSOD activity, the
      unit CuIIL2+ has a tetrahedrally distorted square-planar N4 coordination
      geometry. The copper(I) complex with L was found to be dimeric,
      (CuIL)2(ClO4)2.DMF (DMF = N,N-dimethylformamide). The binuclear unit (CuIL)2(2+)
      has a helical structure with two ligands L bridging the two copper atoms to
      provide tetrahedral N4 coordination of each copper(I). In solutions of
      (CuIL)2(ClO4)2.DMF, solvent-dependent dissociation occurs according to D
      reversible 2M (D = (CuIL)2(2+); M = CuILSx+; S = solvent). Stopped-flow
      spectrophotometry was used to determine the rate constants for the dissociation
      of the dimer D (kM) and dimerization of the monomer M (kD) for S = acetonitrile
      and DMF. Equilibrium constants Kdim = kM/kD were determined
      spectrophotometrically. In aqueous solution, the oxidation of the dimer
      (CuIL)2(2+) by CoIII(NH3)5Cl2+ and cis- and trans-CoIII(en)2Cl2+ follows a second
      order rate law, rate = kox[(CuIL)2(2+)][Co(III)]. Data for rate constant kox and
      for the activation parameters delta H++ and delta S++ are presented. In DMF, the
      oxidation of (CuIL)2(2+) by CoIII(NH3)5Cl2+ occurs via the monomer CuIL(DMF)x+
      and the dissociation of (CuIL)2(2+) becomes rate-controlling. The reduction of
      CuIIL2+ by RuII(edta)H2O2- was found to be too fast to be resolved by stopped
      flow spectrophotometry. The kinetic results are discussed mechanistically in
      terms of the redox switch aspects of the system.

PMID- 11196874
TI  - Synthesis, characterization, and spontaneous resolution of chiral nickel(II)
      complexes with the tripod ligand tris[2-(((2-phenylimidazol-4
      yl)methylidene)amino)ethyl]amine.
AB  - The chiral nickel(II) complexes of a tripod-type ligand with the chemical
      formulas [Ni(H3L)](NO3)2.MeOH (1), [Ni(H3L)](ClO4)2.MeOH (2), and
      [Ni(H3L)](C6H5COO)2.6H2O (3) were synthesized and characterized (H3L = tris[2
      (((2-phenylimidazol-4-yl)methylidene)amino)ethyl]amine). The crystal structures
      of 1-3 were determined by their single-crystal X-ray analyses. 1, C37H40N12O7Ni:
      orthorhombic, P2(1)2(1)2(1); a = 14.198(2) A, b = 22.422(2) A, c = 12.019(2) A, Z
      = 4. 2, C37H40N10O9Cl2Ni: orthorhombic, P2(1)2(1)2(1); a = 14.206(2) A, b =
      22.735(3) A, c = 12.696(3) A, Z = 4. 3, C50H58N10O10Ni: triclinic, P1; a =
      14.191(5) A, b = 16.048(4) A, c = 13.692(4) A, alpha = 115.25(2) degrees, beta =
      111.07(3) degrees, gamma = 64.75(2) degrees, Z = 2. Each complex has an
      octahedral coordination environment for the nickel(II) ion, formed by the six
      nitrogen donor atoms, and is either a delta (clockwise) or a lambda
      (anticlockwise) enantiomorph, depending on the screw arrangement of the tripod
      type ligand around the nickel(II) ion. The circular dichroism (CD) spectrum of a
      powdered sample of a crystal of 1 showed a positive and a negative peak at 915
      and 630 nm, respectively, and that of another crystal showed an enantiomeric
      pattern. The observation of the Cotton effect and the crystal structure provided
      evidence for spontaneous resolution of the chiral complex molecule.

PMID- 11196875
TI  - 1,2-bis(pyridine-2-carboxamido)benzenate(2-), (bpb)2-: a noninnocent ligand.
      Syntheses, structures, and mechanisms of formation of [(n-Bu)4N][FeIV2(mu
      N)(bpb)2(X)2] (X = CN-, N3-) and the electronic structures of [MIII(bpbox1)(CN)2]
      (M = Co, Fe).
AB  - The well-known tetradentate ligand 1,2-bis(pyridine-2-carboxamido)benzenate(2-),
      (bpb)2-, and its 4,5-dichloro analogue, (bpc)2-, are shown to be "noninnocent"
      ligands in the sense that in coordination compounds they can exist in their
      radical one- and diamagnetic two-electron-oxidized forms (bpbox1)- and (bpbox2)0
      (and (bpcox1)- and (bpcox2)0), respectively. Photolysis of high-spin [(n
      Bu)4N][FeIII(bpb)(N3)2] and its (bpc)2- analogue in acetone solution at room
      temperature generates the diamagnetic dinuclear complex [(n-Bu)4N][FeIV2(mu
      N)(bpb)2(N3)2] and its (bpc)2- analogue; the corresponding cyano complex [(n
      Bu)4N][FeIV2(mu-N)(bpb)2(CN)2] has been prepared via N3- substitution by CN-.
      Photolysis in frozen acetonitrile solution produces a low-spin ferric species (S
      = 1/2) which presumably is [FeIII(bpbox2)(N)(N3)]-, as has been established by
      EPR and Mossbauer spectroscopy. The mononuclear complexes [(n
      Bu)4N][FeIII(bpb)(CN2)] (low spin), [Et4N][CoIII(bpb)(CN)2] and Na[CoIII(bpc)
      (CN)2].3CH3OH can be electrochemically or chemically one-electron-oxidized to
      give [FeIII(bpbox1)(CN)2]0 (S = 0), [CoIII(bpbox1)(CN)2]0 (S = 1/2), and
      [CoIII(bpcox1)(CN)2]0 (S = 1/2). All complexes have been characterized by UV-vis,
      EPR, and Mossbauer spectroscopy, and their electro- and magnetochemistries have
      been studied. The crystal structures of [(n-Bu)4N][FeIII(bpb)(N3)2].1/2C6H6CH3,
      Na[FeIII(bpb)(CN)2], Na[CoIII(bpc)(CN)2].3CH3OH, [(n-Bu)4N][FeIV2(mu
      N)(bpb)2(CN)2], and [(n-Bu)4N][FeIV2(mu-N)(bpb)(N3)2] have been determined by
      single-crystal X-ray diffraction.

PMID- 11196876
TI  - Reactivity of mu-hydroxodizinc(II) centers in enzymatic catalysis through model
      studies.
AB  - The stable dinuclear complex [Zn2(BPAM)(mu-OH)(mu-O2PPh2)](ClO4)2, where BPAN =
      2,7-bis[2-(2-pyridylethyl)-aminomethyl]-1,8-naphthyridine, was chosen as a model
      to investigate the reactivity of (mu-hydroxo)dizinc(II) centers in
      metallohydrolases. Two reactions, the hydrolysis of phosphodiesters and the
      hydrolysis of beta-lactams, were studied. These two processes are catalyzed in
      vivo by zinc(II)-containing enzymes: P1 nucleases and beta-lactamases,
      respectively. The former catalyzes the hydrolysis of single-stranded DNA and RNA.
      beta-Lactamases, expressed in many types of pathogenic bacteria, are responsible
      for the hydrolytic degradation of beta-lactam antibiotic drugs. In the first step
      of phosphodiester hydrolysis promoted by the dinuclear model complex, the
      substrate replaces the bridging diphenylphosphinate. The bridging hydroxide
      serves as a general base to deprotonate water, which acts as a nucleophile in the
      ensuing hydrolysis. The dinuclear model complex is only 1.8 times more reactive
      in hydrolyzing phosphodiesters than a mononuclear analogue, Zn(bpta)(OTf)2, where
      bpta = N,N-bis(2-pyridylmethyl)-tert-butylamine. Hydrolysis of nitrocefin, a beta
      lactam antibiotic analogue, catalyzed by [Zn2(BPAN)(mu-OH)(mu-O2PPh2)](ClO4)2
      involves monodentate coordination of the substrate via its carboxylate group,
      followed by nucleophilic attack of the zinc(II)-bound terminal hydroxide at the
      beta-lactam carbonyl carbon atom. Collapse of the tetrahedral intermediate
      results in product formation. Mononuclear complexes Zn(cyclen)-(NO3)2 and
      Zn(bpta)(NO3)2, where cyclen = 1,4,7,10-tetraazacyclododecane, are as reactive in
      the beta-lactam hydrolysis as the dinuclear complex. Kinetic and mechanistic
      studies of the phosphodiester and beta-lactam hydrolyses indicate that the
      bridging hydroxide in [Zn2(BPAN)(mu-OH)(mu-O2PPh2)](ClO4)2 is not very reactive,
      despite its low pKa value. This low reactivity presumably arises from the two
      factors. First, the briding hydroxide and coordinated substrate in [Zn2(BPAN)(mu
      OH)(substrate)]2+ are not aligned properly to favor nucleophilic attack. Second,
      the nucleophilicity of the bridging hydroxide is diminished because it is
      simultaneously bound to the two zinc(II) ions.

PMID- 11196877
TI  - Synthesis and characterization of (R-C5H14N2)2[Ga4(C2O4)(H2PO4)2(PO4)4].2H2O, a
      layered gallium phosphatooxalate containing a chiral amine.
AB  - The first metal phosphatooxalate containing a chiral amine, (R
      C5H14N2)2[Ga4(C2O4)(H2PO4)2(PO4)4].2H2O, has been synthesized hydrothermally and
      characterized by single-crystal X-ray diffraction and 31P MAS NMR spectroscopy.
      It crystallizes in the monoclinic space group P2(1) (No. 4) with a = 8.0248(4) A,
      b = 25.955(1) A, c = 9.0127(5) A, beta = 100.151(1) degrees, and Z = 2. The
      structure consists of GaO6 octahedra and GaO4 tetrahedra connected by
      coordinating C2O4(2-) and phosphate anions to form anionic sheets in the ac plane
      with charge-compensating diprotonated R-2-methylpiperazinium cations and water
      molecules between the layers. There is a good correlation between the NMR
      spectrum and the structure.

PMID- 11196878
TI  - An electron paramagnetic resonance study of Mn2(H2O)(OAc)4(tmeda)2 (tmeda =
      N,N,N',N'-tetramethylethylenediamine): a model for dinuclear manganese enzyme
      active sites.
AB  - The complex Mn2(H2O)(OAc)4(tmeda)2 (tmeda = N,N,N',N'-tetramethylethylenediamine)
      is a model for the active site of hydrolase enzymes containing acetate-bridged
      dimanganese cores. The two high-spin Mn(II) ions are antiferromagnetically
      coupled, as determined by previous magnetic susceptibility studies (Yu, S.-B;
      Lippard, S. J.; Shweky, I; Bino, A. Inorg. Chem. 1992, 31, 3502-3504) to yield a
      spin "ladder" with total spin S = 0, 1, 2, ..., 5 in increasing energy. In this
      study, the complex was characterized by Q-band and X-band EPR spectroscopy in
      frozen solution. Analysis of the temperature dependence of these EPR spectra
      indicates that the primary spectral contribution is from the S = 2 manifold. The
      EPR spectra were simulated using a full spin Hamiltonian for this manifold of a
      coupled spin system, which provided the fit parameters J = -2.9 cm-1, g = 2.00,
      and D2 = -0.060 +/- 0.003 cm-1. An additional multiline EPR signal is observed
      which is proposed to arise from the total spin S = 5/2 ground state of a Mn(II)
      trimer of the type Mn3(OAc)6(tmeda)2.

PMID- 11196879
TI  - Cation disorder in Ga1212.
AB  - Substitution of calcium for strontium in LnSr2-xCaxCu2GaO7 (Ln = La, Pr, Nd, Gd,
      Ho, Er, Tm, and Yb) materials at ambient pressure and 975 degrees C results in
      complete substitution of calcium for strontium in the lanthanum and praseodymium
      systems and partial substitution in the other lanthanide systems. The calcium
      saturation level depends on the size of the Ln cation, and in all cases, a
      decrease in the lattice parameters with calcium concentration was observed until
      a common, lower bound, average A-cation size is reached. Site occupancies from X
      ray and neutron diffraction experiments for LnSr2-xCaxCu2GaO7 (x = 0 and x = 2)
      confirm that the A-cations distribute between the two blocking-layer sites and
      the active-layer site based on size. A quantitative link between cation
      distribution and relative site-specific cation enthalpy for calcium, strontium,
      and lanthanum within the gallate structure is derived. The cation distribution in
      other similar materials can potentially be modeled.

PMID- 11196880
TI  - Cooperative diastereoselectivity of palladium- and platinum-promoted
      intramolecular [4 + 2] Diels-Alder cycloaddition reactions of 3,4-dimethyl-1
      phenylphosphole.
AB  - The complexes [(DMPP)2M(CH3CN2)]X2 (DMPP = 3,4-dimethyl-1-phenylphosphole; M =
      Pd, Pt; X = BF4-, NO3-, ClO4-) react with 2 equiv of the dienophiles N,N
      dimethylacrylamide (DMAA), 2-vinylpyridine (VyPy), and diphenylvinylphosphine
      (DPVP) to form bis-[4 + 2] Diels-Alder cycloaddition products. The
      [M(DMPP)2(DMAA)2]2+ and [M(DMPP)2(VyPy)2]2+ complexes form exclusively as the cis
      geometric isomers, whereas for [M(DMPP)2(DPVP)2]2+, both cis- and trans-geometric
      isomers are formed. The two Diels-Alder cycloadditions occur sequentially, and
      the absolute configuration of the first reaction influences the absolute
      configuration of the second. In all cases, recemic mixtures of the (R,R) and
      (S,S) diastereomers are formed; none of the meso (R,S) diastereomer is observed.
      New complexes were characterized by elemental analyses, physical properties,
      infrared spectroscopy, 1H, 1H(31P), 13C(1H), and 31P(1H) NMR spectroscopy, and,
      in most cases, X-ray crystallography.

PMID- 11196881
TI  - Similarities and differences between cobalamins and cobaloximes. Accurate
      structural determination of methylcobalamin and of LiCl- and KCl-containing
      cyanocobalamins by synchrotron radiation.
AB  - The accurate crystal structure determinations of MeCbl (1), CNCbl.2LiCl (2), and
      CNCbl.KCl (3), based on synchrotron diffraction data collected at 100 K and using
      high-quality single crystals, are reported. Refinements gave R1 indices of 0.0834
      (1), 0.0434 (2), and 0.0773 (3). The influence of the water of crystallization
      and ion content on the crystal packing of these and other cobalamins (XCbl) is
      discussed, and a relationship between the crystal packing and the corrin side
      chain conformations is presented. An analysis of the bond lengths within the
      corrin moiety, based on 13 accurate structures with several X groups, shows that
      the trend of the C-C and C-N distances can be interpreted in terms of electronic
      and steric factors. The variation in structural, NMR and IR spectroscopic, and
      electrochemical properties are compared with those of cobaloximes, the B12 model,
      when X is varied. This comparison indicates that the pi-back-donation from metal
      to the CN axial ligand and the transmission of the trans influence of the X
      ligand are more effective in cobalamins than in cobaloximes. These findings are
      consistent with a significantly greater availability of electron charge on Co in
      cobalamins, and, hence, a semiquantitative evaluation of the electronic
      difference between the cobalt centers in the two systems is allowed.

PMID- 11196882
TI  - Linear trichromium complexes with the anion of 2,6-di(phenylimino)piperidine.
AB  - The anion of 2,6-di(phenylimino)piperidine (DPhIP) has been found to support
      linear chains of three metal atoms. Three new compounds,
      [Cr3(DPhIP)4Cl]Cl.(1).5CH2Cl2.0.5H2O (1.1.5CH2Cl2.0.5H2O), [Cr3(DPhIP)4(CH3CN)]-
      (PF6)2.H2O.4CH3CN (2.H2O.4CH3CN), and [Cr3(DPhIP)4(F)(CH3CN)](BF4)2.5CH3CN
      (3.5CH3CN), have been synthesized and characterized by X-ray crystallography.
      Compound 1 has a linear chain of three chromium atoms arranged in an
      unsymmetrical fashion, with two of them forming a quadruply bonded unit (Cr-Cr
      distance 1.932(2) A) and the third being a non-metal-metal-bound 5-coordinate
      unit (Cr...Cr distance 2.659(2) A). The fifth coordination site is occupied by a
      chloride ion, and another chloride ion is located in the interstices of the
      crystal. The trimetal unit in compound 2 is structurally similar to that in
      compound 1 except that the axial ligand in 2 is a CH3CN molecule. Compound 3 is
      an oxidation product prepared by reaction of 1 with AgBF4. Here, a square
      pyramidal CrIII unit, FCrN4, and a Cr-Cr quadruply bonded (Cr-Cr distance
      1.968(2) A) unit, with an axially coordinated acetonitrile molecule, form the
      trichromium chain. The CrIII...CrII separation of 2.594(2) A in 3 is too long to
      be considered a bonding interaction.

PMID- 11196883
TI  - Straightforward conversion route to nanocrystalline monothiooxides of rare earths
      through a high-temperature colloid technique.

PMID- 11196884
TI  - Synthesis of arene-soluble dizirconium nonaisopropoxide lanthanide cations
      involving divalent ytterbium.

PMID- 11196885
TI  - Synthesis, characterization, and properties of a lithium 21-thiaporphyrin
      complex.

PMID- 11196886
TI  - On the failure to observe isotropic electron paramagnetic resonance spectra for
      certain chromium(I) carbonyl complexes.

PMID- 11196887
TI  - XAS investigation of the nickel active site structure in Escherichia coli
      glyoxalase I.

PMID- 11196888
TI  - Elemental solvothermal reaction to produce ternary semiconductor CuInE2 (E = S,
      Se) nanorods.

PMID- 11196889
TI  - Strong differences in the in vitro cytotoxicity of three isomeric dichlorobis(2
      phenylazopyridine)ruthenium(II) complexes.

PMID- 11196890
TI  - Involvement of multiply bonded dirhenium complexes in mixed-metal assemblies.
      Isolation and characterization of a new type of Re4Pd2 cluster.

PMID- 11196891
TI  - Synthesis and structural characterization of quaternary thorium selenophosphates:
      A2ThP3Se9 (A = K, Rb) and Cs4Th2P5Se17.
AB  - Single crystals of A2ThP3Se9 (A = K (I), Rb (II)) and Cs4Th2PsSe17 (III) form
      from the reaction of Th and P in a molten A2Se3/Se (A = K, Rb, Cs) flux at 750
      degrees C for 100 h. Compound I crystallizes in the triclinic space group P1 (No.
      2) with unit cell parameters a = 10.4582(5) A, b = 16.5384(8) A, c = 10.2245(5)
      A, alpha = 107.637(1); beta = 91.652(1); gamma = 90.343(1) degrees, and Z = 2.
      Compound II crystallizes in the triclinic space group P1 (No. 2) with the unit
      cell parameters a = 10.5369(5) A, b = 16.6914(8) A, c = 10.2864(5) A, alpha =
      107.614(1) degrees, beta = 92.059(1) degrees, gamma = 90.409(1) degrees, and Z =
      2. These structures consist of infinite chains of corner-sharing [Th2Se14] units
      linked by (P2Se6)4- anions in two directions to form a ribbonlike structure along
      the [100] direction. Compounds I and II are isostructural with the previously
      reported K2UP3Se9. Compound III crystallizes in the monoclinic space group
      P2(1)/c (No. 14) with unit cell parameters a = 10.238(1) A, b = 32.182(2) A, c =
      10.749(1) A; beta = 95.832(1) degrees, and Z = 4. Cs4Th2P5Se17 consists of
      infinite chains of corner-sharing, polyhedral [Th2Se13] units that are also
      linked by (P2Se6)4- anions in the [100] and [010] directions to form a layered
      structure. The structure of III features an (Se2)2- anion that is bound eta 2 to
      Th(2) and eta 1 to Th(1). This anion influences the coordination sphere of the 9
      coordinate Th(2) atom such that it is best described as bicapped trigonal
      prismatic where the eta 2-bound anion occupies one coordination site. The
      composition of III may be formulated as Cs4Th2(P2Se6)5/2(Se2) due to the presence
      of the (Se2)2- unit. Raman spectra for these compounds and their interpretation
      are reported.

PMID- 11196892
TI  - Model investigations of vanadium-protein interactions: novel vanadium(III) and
      oxovanadium(IV) compounds with the diamidate ligand 1,2-bis(2
      pyridinecarboxamide)benzene (H2bpb).
AB  - Novel vanadium(III) and oxovanadium(IV) compounds with the diamidate ligand 1,2
      bis(2-pyridinecarboxamide)benzene (H2bpb) were synthesized and structurally
      characterized. H2bpb is capable of binding to vanadium in either its anionic
      (dianionic-monoanionic) or its neutral form, resulting in complexes of various
      geometries and stoichiometries. The dianionic form (bpb2-), in NHEt3(trans
      [VCl2(bpb)]) (1) and [VO(bpb)(H2O)]05dmso036CH3OH013H2O
      (6x05dmsox036CH3OHx013H2O), acts as a planar tetradentate bis[N-amidate-N
      pyridine] equatorial ligand. The monoanionic form (Hbpb-) behaves as an (Npy,Oam)
      or (Npy,Nam) chelator in [V(Hbpb)3]2CHCl3 (22CHCl3) as well as a mu 2-bridging
      eta 4-(Npy,Oam-Npy,Nam) in [VOCl(Hbpb)](2)x2CH3NO2 (3x2CH3NO2), while the neutral
      H2bpb behaves as a mu 2-bridging-eta 4-bis(Npy,Oam) in
      [VOCl(H2bpb)](2)x104CH3OHx123thfx074H2O (4x104CH3OH123thf074H2O). Compound
      4x104CH3OHx123thfx074H2O crystallizes in the triclinic system P1, with (at 25
      degrees C) a = 9140(2) A, b = 11058(2) A, c = 14175(2) A, alpha = 99013(5)
      degrees, beta = 104728(7) degrees, gamma = 102992(7) degrees, V = 13149(4) A3, Z
      = 1, while compound 605dmso036CH3OH013H2O crystallizes in the monoclinic space
      group P2(1)/n with (at 25 degrees C) a = 11054(5) A, b = 11407(5) A, c = 16964(7)
      A, beta = 932(1) degrees, V = 2136(2) A3, Z = 4. Variable temperature magnetic
      susceptibility studies of the dimeric compounds 3x2CH3NO2 and 4x104CH3OH show g
      values for the V(IV) centers that are slightly smaller than 20 (as expected for
      d1 ions) and indicate small antiferromagnetic coupling between the two
      vanadium(IV) centers. Ab initio calculations were also carried out, providing
      results concerning the effect of the relative strength and the deformation energy
      involved in the eta 2-(Npy,Nam) and eta 2-(Npy,Oam) bonding modes in the ligation
      of Hbpb- to vanadium.

PMID- 11196893
TI  - A systematic evaluation of molecular recognition phenomena. 1. Interaction
      between phosphates and nucleotides with hexaazamacrocyclic ligands containing m
      xylylic spacers.
AB  - The host-guest interactions between ortho- (Ph), pyro- (Pp), and tripolyphosphate
      (Tr) anions together with ATP (At), ADP (Ad), and AMP (Am) nucleotides and the
      hexaazamacrocyclic ligand 3,7,11,19,23,27-hexaazatricyclo[27311(13,17)]triaconta-
      1(32),13,15,17(34),29(33),30-hexaene (Bn) have been investigated by
      potentiometric equilibrium methods. Ternary complexes are formed in aqueous
      solution as a result of hydrogen bond formation and Coulombic attraction between
      the host and the guest. Formation constants for all the species obtained are
      reported. The selectivity of the Bn ligand with regard to the phosphate and
      nucleotide substrates is discussed and illustrated with species distribution
      diagrams. A comparison of the present results with those obtained for the similar
      but smaller macrocyclic ligand 3,6,9,17,20,23-
      hexaazatricyclo[23311(11,15)]triaconta-1(29),11(30),12,14,25,27-hexaene (Bd) is
      also discussed. It is found that the competition of the Bd and Bn ligands for the
      formation of ternary species with a specific substrate is strongly dependent on
      the p[H]. The crystal structure of the compound [(H6Bn)(H2PO4)6]2H2O with
      empirical formula C28H68N6O26P6 has been solved by means of X-ray diffraction
      analysis. The compound belongs to the triclinic P1 space group with Z = 1, a =
      8892(2) A, b = 9369(4) A, c = 16337(8) A, alpha = 7372(4) degrees, beta = 8301(4)
      degrees, and gamma = 6481(3) degrees. The phosphate counterions are found to
      bridge adjacent layers of macrocyclic molecules through an extensive hydrogen
      bonding network

PMID- 11196894
TI  - A systematic evaluation of molecular recognition phenomena. 2. Interaction
      between phosphates and nucleotides with hexaazamacrocyclic ligands containing
      diethylic ether spacers.
AB  - The host-guest interactions between ortho- (Ph), pyro- (Pp), and tripolyphosphate
      (Tr) anions together with ATP (At), ADP (Ad), and AMP (Am) nucleotides and the
      two hexaazamacrocyclic ligands 1,15-dioxa-4,8,12,18,22,26-hexaazacyclooctacosane
      (Pn) and 1,13-dioxa-4,7,10,16,20,24-hexaazacyclohexacosane (Op) have been
      investigated by potentiometric equilibrium methods. Ternary complexes are formed
      in aqueous solution as a result of hydrogen bond formation and Coulombic
      attraction between the host and the guest. Formation constants for all the
      species obtained are reported. The selectivity of the Pn and Op ligands with
      regard to the different phosphate and nucleotide substrates is discussed and
      illustrated with total species distribution diagrams. A comparison is also
      carried out, with the results obtained in this work and those obtained previously
      with three other closely related hexaazamacrocyclic ligands. This comparison
      manifests the importance of ligand basicity, rigidity, and pi-stacking capability
      in order to understand their binding and selectivity.

PMID- 11196895
TI  - "Bridging hydroxide effect" on mu-carboxylato coordination and electrochemical
      potentials of bimetallic centers: Mn2(II,II) and Mn2(III,III) complexes as
      functional models of dimanganese catalases.
AB  - Synthesis, solution structures, and electrochemistry of several dinuclear
      Mn2(II,II) complexes (1-4) and Mn2(III,III) complexes (6 and 8), derived from a
      functional catalase mimic [(L1,2)Mn2(II,II)(mu 13-O2CCH3)]2+ (1) are described
      that enable testing of the role of intramolecular hydroxide ligands on the redox
      properties. Addition of 1 equiv of hydroxide to 1 or 3 forms [(L1,2)Mn2(II,II)(mu
      13-O2CCH3)(mu- OH)]+ (7A or 7B, respectively), possessing two six-coordinate
      Mn(II) ions bridged by hydroxide and acetato ligands. Two-electron oxidation of 7
      with O2 occurs by forming [(L1,2)Mn2(III,III)(mu 1,3-O2CCH3)(mu-OH)]3+ (8) and
      H2O2 with no ligand rearrangements in methanol. Reaction of 8 with 2-3 equiv
      hydroxide forms [(L1,2)Mn2(III,III)(mu-O)(OH)(O2CCH3)]+ in which deprotonation of
      mu-OH- to yield mu-O2- favors subsequent addition of a terminal hydroxide ligand,
      accommodated by a bridging-to-terminal "carboxylate-shift". Preservation of six
      coordinate Mn(II) ions throughout all hydroxide-induced transformations is
      observed, including oxidation by O2. Cyclic voltammetry reveals that addition of
      mu-OH- converts the two-electron redox couple II,II/III,III for complexes 1-4 to
      sequential one-electron couples at lower reduction potentials, yielding
      substantial stabilization of the II,III and III,III oxidation states by delta E =
      440 and 730 mV, respectively. Binding of a second OH- to 7A or 7B forms
      (L1,2)Mn2(II,II)(mu 13-O2CCH3)(OH)2, containing two six-coordinate Mn(II) ions
      with two terminal hydroxides and a mu 1,3-bridging acetato. Electrochemistry
      reveals that displacement of the bridging hydroxide to a terminal site upon
      addition of the second OH- restores a two-electron redox couple II,II/III,III but
      now at a higher reduction potential with considerable loss of the electrochemical
      stabilization energy provided by the mu-OH- (delta E = 250 and 350 mV loss for
      Mn2(II,II) and Mn2(III,III), (respectively). These results indicate a
      considerably stronger influence of bridging vs terminal hydroxide ligands in
      stabilizing the higher oxidation states and separating the one-electron redox
      potentials of bimetallic centers. By contrast, in the absence of mu-OH- bridges
      the longer separation with the mu 1,3-carboxylato bridge in dimanganese(II,II)
      complexes leads to nearly complete uncoupling of the Mn(II) oxidation potentials,
      thus yielding a two-electron redox transition to (III,III). We hypothesize that
      this "bridging hydroxide effect" may be due to both greater screening of the
      repulsive intermetallic electric potential energy and increased resonance
      stabilization of the mixed-valence (II,III) oxidation state by charge
      delocalization . These data provide a physicochemical basis for interpretation of
      the catalase activity of these complexes and of dimanganese catalase enzymes (see
      the following manuscript).

PMID- 11196896
TI  - Mechanism of hydrogen peroxide dismutation by a dimanganese catalase mimic:
      dominant role of an intramolecular base on substrate binding affinity and rate
      acceleration.
AB  - Several modifications of the manganese coordination environment and oxidation
      states of a family of synthetic dimanganese complexes have been introduced in
      search of the structural features that promote high rates of hydrogen peroxide
      dismutation (catalase activity). The X-ray structure of reduced catalase (T
      thermophilus) reveals a dimanganese(II,II) site linked by three bridges: mu 13
      glutamate-, mu-OH-, and mu-OH2. The roles of a bridging hydroxide vs mu-aqua and
      the carboxylate have been examined in the reduced Mn2(II,II) complexes,
      [(L1,2)Mn2(mu-O2CCH3)(mu-X)]2+ for X- = OH- (7A) or X = H2O (1-4), and their
      oxidized Mn2(III,III) analogues, [(L1,2)Mn2(mu-O)(O2CCH3)(OH)]+ (6) (L1 is
      N,N,N',N'-tetrakis(2-methylenebenzamidazolyl)-1,3-diaminopropan- 2-ol, and L2 is
      the tetrakis-N-ethylated analogue of L1, which has all amine protons replaced by
      ethyl groups). The steady-state catalase rate is first-order in concentration of
      both substrate and reduced catalyst and saturates at high peroxide concentrations
      in all cases, confirming peroxide/catalyst complex formation. No catalyst
      decomposition is seen after > 2000 turnovers. Catalysis proceeds via a ping-pong
      mechanism between the Mn2(II,II/III,III) redox states, involving complexes 6 and
      7A/7A'. The Mn2(III,IV) oxidation state was not active in catalase activity.
      Replacement of the mu-aqua bridge by mu-hydroxide eliminates a kinetic lag phase
      in production of the O2 product, increases the affinity for substrate peroxide in
      the rate-limiting step as seen by a 5-fold. decrease in the Michaelis constant
      (KM), and accelerates the maximum rate (kcat) by 65-fold The kinetic and
      spectroscopic data are consistent with substrate deprotonation by the hydroxide
      bridge, yielding a hydroperoxyl bridge coordinated between the Mn ions (mu, eta 2
      geometry, "end-on") as the basis for catalysis: mu-OH- + H2O2-->mu-O2H- + H2O.
      Binding of a second hydroxide ion to 7A causes a further increase in kcat by 4
      fold with no further change in substrate affinity (KM). By contrast, free
      (noncoordinating) bases in solution have no effect on catalysis, thus
      establishing intramolecular sites for both functional hydroxide anions. Solution
      structural studies indicate that the presence of 2-5 equiv of hydroxide in
      solution leads to formation of a bishydroxide species, [(L1,2)Mn2(mu 13
      O2CCH3)(OH)2], which in the presence of air or oxygen auto-oxidizes to yield
      complex 6, a Mn2(III,III)(mu-O) species. Complex 6 oxidizes H2O2 to O2 without a
      kinetic lag phase and is implicated as the active form of the oxidized catalyst.
      A maximum increase by 240-fold in catalytic efficiency (kcat/KM = 700 s-1 M-1) is
      observed with the bishydroxide species versus the aquo complex 1, or only 800
      fold less efficient than the enzyme. Deprotonation of the amine groups of the
      chelate ligand L was shown not to be involved in the hydroxide effects because
      identical results were obtained using the catalyst with tetrakis(N-ethylated)-L.
      Uncoupling of the Mn(II) spins by protonation of the alkoxyl bridge (LH) was
      observed to lower the catalase activity. Comparisons to other dimanganese
      complexes reveals that the Mn2(II,II)/Mn2(III,III) redox potential is not the
      determining factor in the catalase rate of these complexes. Rather, rate
      acceleration correlates with the availability of an intramolecular hydroxide for
      substrate deprotonation and with binding of the substrate at the bridging site
      between Mn ions in the reductive O-O bond cleavage step that forms water and
      complex 6.

PMID- 11196897
TI  - Binding of pi-acceptor ligands to (triamine)iron(II) complexes.
AB  - A series of (Me3TACN)FeII derivatives with soft coligands have been investigated,
      where Me3TACN is N,N',N"-trimethyl-1,4,7-triazacyclononane. Treatment of Me3TACN
      with FeCl2 afforded a compound with the empirical formula (Me3TACN)FeCl2 (1).
      Compound 1, which is a versatile precursor reagent, was shown by single-crystal X
      ray diffraction to be the salt [(Me3TACN)2Fe2Cl3][(Me3TACN)FeCl3], containing
      isolated [(Me3TACN)2Fe2Cl3]+ and [(Me3TACN)FeCl3]- subunits. Treatment of 1 with
      NaBPh4 gave the known [(Me3TACN)2Fe2Cl3]BPh4, while the addition of Me3TACN to
      FeCl4(2-) gave [(Me3TACN)FeCl3]-. Oxygenation of 1 afforded [(Me3TACN)FeCl2]2(mu
      O), which was shown crystallographically to be centrosymmetric with a pair of
      distorted octahedral Fe centers. The Fe-N bond trans to the Fe-O bond is
      elongated by 02 A relative to the other Fe-N distances. Solutions of 1 and
      thiolates absorb CO to give [(Me3TACN)Fe(SPh)(CO)2]BPh4 and
      (Me3TACN)Fe(S2C2H4)(CO) (nu CO = 1896 cm-1). Treatment of 1 with excess CN-
      afforded [(Me3TACN)Fe(CN)3]-, isolated as its PPh4+ salt 5. Crystallographic and
      spectroscopic studies show that 5 is low spin with a C3v structure; its Fe-N
      distances contracted by 023 A relative to those in [(Me3TACN)FeCl3]-. Aqueous
      solutions of 1 bind CO upon the addition of CN- to produce (Me3TACN)Fe(CN)2(CO)
      (6) Analogous to 6 is (Me3TACN)Fe(CN)2(CNMe), prepared by methylation of 5. The
      metastable dicarbonyl [(Me3TACN)FeI(CO)2]I was prepared by treatment of FeI2(CO)4
      with Me3TACN and was crystallographically characterized as its BPh4- salt. Values
      of E1/2 for [(Me3TACN)FeCl3]-, 5, and 6 are -0409, -0640, and 0533 V vs Fc/Fc+,
      respectively.

PMID- 11196898
TI  - Syntheses and structures of heterobicyclic bis(tert
      butylamido)cyclodiphosph(III)azane compounds having phosphorus(III) and
      arsenic(III) centers.
AB  - Syntheses and single-crystal X-ray diffraction studies of heterobicyclic
      cyclodiphosphazanes having central phosphorus(III) and arsenic(III) atoms are
      described. Interaction of PCl3 or AsCl3 with cis-[(tBuNP)2(tBuNLixTHF)2] produced
      the isomorphous ([(tBuNP)2(tBuN)2]ECl); E = P(1), As(4), respectively. These Cs
      symmetric molecules crystallize with two molecules in the monoclinic space group
      P2(1)/m. Unit cell dimensions of 1 are (293 K) a = 9.777(1) A, b = 11.745(1) A, c
      = 9.986(2) A, and beta = 97.44(1) degrees; those of 4 are (213 K) a = 9.688(3) A,
      b = 11.873(3) A, c = 9.975(3) A, and beta = 97.80(3) degrees. When
      ([(tBuNP)2(tBuN)2]PCl) was treated with NaN3 or LiN(SiMe3)2,
      ([(tBuNP)2(tBuN)2]PN3)(2) and ([(tBuNP)2(tBuN)2]PN(SiMe3)2)(3), respectively,
      were obtained. Compound 2 crystallizes in the monoclinic space group P2(1)/m and
      has until-cell dimensions (213 K) of a = 9496(7) A, b = 12455(7) A, c = 10043(6)
      A, and beta = 9723(4) degrees, Z = 2.

PMID- 11196899
TI  - Structurally diverse copper(II)-carboxylato complexes: neutral and ionic
      mononuclear structures and a novel binuclear structure.
AB  - The copper complexes with the commercial auxin herbicides MCPA, 2,4-D, and 2,4,5
      T in the presence of a nitrogen donor heterocyclic ligand, phen or bipyam, were
      prepared and characterized. The available evidence supports a dimeric structure
      for the 2,4-D complex in the presence of bipyam while phen leads to monomeric
      forms. The EPR spectrum of Cu2(2,4-D)4(bipyam)2 at 4 K in the solid state
      exhibits an axial signal which corresponds to almost isolated S = 1/2 magnetic
      ions. Magnetic data for the dimer show a weak antiferromagnetic interaction
      between the two metal ions with J = -08 cm-1. The crystal structures of
      tetrakis[(2,4-dichlorophenoxy)acetato]bis(2,2'-bipyridylamine)dicopper(II), 1,
      bis(1,10-phenanthroline)[(2,4,5-trichlorophenoxy)acetato]copper(II) chloride, 2,
      and aqua(1,10-phenanthroline)bis[((2-methyl-4-chlorophenoxyacetato]copper(II), 3,
      were determined and refined by least-squares methods using three-dimensional MoK
      alpha data. 1 crystallizes in space group P1, in a cell of dimensions a =
      10813(1) A, b = 12138(1) A, c = 11909(1) A, alpha = 86448(3) degrees, beta =
      80127(3) degrees, and gamma = 63982(3) degrees, and V = 13837(2) A3, with Z = 1 2
      crystallizes in space group I2/a, in a cell of dimensions a = 29958(9) A, b =
      11342(3) A, c = 21196(7) A, beta = 10794(1) degrees, and V = 68522(4) A3, with Z
      = 8 3 crystallizes in space group P1, in a cell of dimensions a = 87419(8) A, b =
      12512(1) A, c = 14598(1) A, alpha = 110737(1) degrees, beta = 95742(2) degrees,
      gamma = 103286(2) degrees, V = 14241(2) A3, with Z = 2.

PMID- 11196900
TI  - Supramolecular complex of cytochrome c with lariat ether: solubilization, redox
      behavior and catalytic activity of cytochrome c in methanol.
AB  - A variety of lariat ethers were employed to solubilize water-soluble cytochrome c
      in methanol, in which alcohol, ether, ester, amine, and amide functionalities
      were attached as cation-ligating side arms to 18-crown-6, 15-crown-5, and 12
      crown-4 rings. Among these lariat ethers, the alcohol-armed 18-crown-6 derivative
      offered the highest solubilization efficiency for cytochrome c via supramolecular
      complexation. The resulting cytochrome c-lariat ether complexes were
      electrochemically and spectroscopically characterized and confirmed to have redox
      active heme structures of 6-coordinate low-spin population in methanol. Some of
      them catalyzed the oxidation of pinacyanol chloride with hydrogen peroxide in
      methanol and exhibited higher activities than unmodified cytochrome c and its
      poly(ethylene glycolated) derivative. Since the supramolecular complexation
      between lariat ether and cytochrome c includes extremely simple procedures, it
      provides a facile preparation method of effective biocatalysts working in organic
      solvents from metalloproteins.

PMID- 11196901
TI  - Isothermal titration calorimetry measurements of Ni(II) and Cu(II) binding to
      His, GlyGlyHis, HisGlyHis, and bovine serum albumin: a critical evaluation.
AB  - The binding of Ni(II) and Cu(II) to histidine, to the tripeptides GlyGlyHis and
      HisGlyHis, and to the protein bovine serum albumin has been studied by isothermal
      titration calorimetry (ITC) to determine the experimental conditions and data
      analysis necessary to reproduce literature values for the binding constants and
      thermodynamic parameters. From analysis of the ITC data, we find that there are
      two major considerations for the use of this method to accurately quantify metal
      ion interaction with biological macromolecules. First, to determine true pH
      independent binding constants, ITC data must be corrected for metal ion
      competition with protons by accounting for the experimental pH and pKa values of
      the metal-binding residues. Second, metal interaction with the buffer (stability
      and enthalpy of formation of metal-buffer complex(es)) must be included in the
      analysis of the ITC data to determine the binding constants and the change in
      enthalpy. While it may be possible to use a buffer that forms only weak, and
      therefore negligible, complexes with the metal, a buffer that has a strong and
      well-characterized interaction has the benefit of suppressing metal ion
      hydrolysis and precipitation, and of allowing the quantification of high-affinity
      metal-binding sites on biological macromolecules. This study has also quantified
      the contribution of the N-terminal imidazole of HisGlyHis to the stability of the
      Cu(II) and Ni(II) complexes of this protein sequence and has provided new insight
      about Cu(II) binding to albumin.

PMID- 11196902
TI  - New linear tricobalt complex of di(2-pyridyl)amide (dpa),
      [Co3(dpa)4(CH3CN)2][PF6]2.
AB  - Reaction of the linear tricobalt compound Co3(dpa)4Cl2 (1) (dpa = di(2
      pyridyl)amide) with silver hexafluorophosphate in acetonitrile yields
      [Co3(dpa)4(CH3CN)2][PF6]2 (2). Two crystalline forms are obtained from the same
      solution, namely, a monoclinic (P2(1)) form 2xCH3CNx2Et2O and a triclinic (P1)
      form, 2x3CH3CN. The tricobalt units in both crystals are essentially symmetrical,
      though this is not required by crystal symmetry, with Co-Co distances in the
      range 2298-2304 A. Each of the two terminal Co atoms is coordinated to an
      acetonitrile molecule with Co-N distances in the range 2068-2111 A at 213 K. The
      spiral arrangement of ligands gives an overall idealized D4 point group symmetry
      for the cation [Co3(dpa)4(CH3CN)2]2+ . Chiral crystals of both delta and lambda
      configurations in the P2(1) form have been isolated. The absolute configurations
      were determined by X-ray crystallography and their mirror-image circular
      dichroism spectra measured. The D4 symmetry of the cation appears to be preserved
      in solution as judged by the presence of only five proton resonance signals in
      the 1H NMR spectrum. Magnetic susceptibility measurements in the solid state
      indicates that 2 has a doublet ground state and exhibits an increase of the
      effective moment at high temperature (approximately 160 K) due to a spin
      crossover process.

PMID- 11196903
TI  - Synthesis, structure, and multi-NMR studies of (Me4N)[A(M(SC(O)Ph)3)2] (A = Na, M
      = Hg; A = K, M = Cd or Hg).
AB  - The compounds (Me4N)[A(M(SC(O)Ph)3)2] (A = K, M = Cd (2); A = Na, M = Hg (3); and
      A = K, M = Hg (4)) were synthesized by reacting the appropriate metal chloride
      with A+PhC(O)S- and Me4NCl in the ratios 1:3:1 and 2:6:1. The structures of these
      compounds were determined by single-crystal X-ray diffraction methods. All the
      compounds are isomorphous, isostructural, and crystallized in the space group P1
      with Z = 1. Single-crystal data for 2: a = 106670(2) A, b = 111522(2) A, c =
      119294(2) A, alpha = 71782(1) degrees, beta = 85208(1) degrees, gamma = 69418(1)
      degrees, V = 126140(4) A3, Dcalc = 1528 g cm-3. Single-crystal data for 3: a =
      10840(2) A, b = 10946(4) A, c = 12006(3) A, alpha = 7218(2) degrees, beta =
      8675(2) degrees, gamma = 6743(2) degrees, V = 12493(6) A3, Dcalc = 1756 g cm-3.
      Single-crystal data for 4: a = 104780(1) A, b = 112563(2) A, c = 119827(2) A,
      alpha = 71574(1) degrees, beta = 85084(1) degrees, gamma = 70705(1) degrees, V =
      126523(3) A3, Dcalc = 1755 g cm-3. In the [A(M(SC(O)Ph)3)2]- anions, each M(II)
      atom is bonded to three thiobenzoate ligands through sulfur atoms, giving a
      trigonal planar MS3 geometry. The carbonyl oxygen atoms from the two
      [M(SC(O)Ph)3]- anions are bonded to the alkali metal atom, providing an
      octahedral environment. Solution metal NMR studies showed the concentration
      dependent dissociation of the alkali metal ions in the trinuclear anions.

PMID- 11196904
TI  - Mechanism and molecular-electronic structure correlations in a novel series of
      osmium(V) hydrazido complexes.
AB  - Reaction between the Os(VI) nitrido (OsVI identical to N+) complexes
      [OsVI(L3)(Cl)2(N)]+ (L3 is 2,2':6',2"-terpyridine (tpy) or tris(1
      pyrazolyl)methane (tpm)) and secondary amines (HN(CH2)4O = morpholine,
      HN(CH2)4CH2 = piperidine, and HN(C2H5)2 = diethylamine) gives Os(V)-hydrazido
      complexes, [OsV(L3)(Cl)2(NNR2)]+ (NR2 = morpholide, piperidide, or diethylamide).
      They can be chemically or electrochemically oxidized to Os(VI) or reduced to
      Os(IV) and Os(III). The Os-N bond lengths and Os-N-N angles in the structures of
      these complexes are used to rationalize the bonding between the dianionic
      hydrazido ligand and Os. The rate law for formation of the Os(V) hydrazido
      complexes with morpholine as the base is first order in [OsVI(L3)(Cl)2(N)]+ and
      second order in HN(CH2)4O with ktpy(25 degrees C, CH3CN) = (581 +/- 12) M-2 s-1
      and ktpm(25 degrees C, CH3CN) = 2683 +/- 40 M-2 s-1. The proposed mechanism
      involves initial nucleophilic attack of the secondary amine on the Os(VI) nitrido
      group to give a protonated Os(IV)-hydrazido intermediate. It is subsequently
      deprotonated and then oxidized by OsVI identical to N+ to Os(V). The extensive
      redox chemistry for these complexes can be explained by invoking a generalized
      bonding model. It can also be used to assign absorption bands that appear in the
      electronic from the visible-near-infrared spectra including a series of d pi-->d
      pi interconfigurational bands at low energy.

PMID- 11196905
TI  - Synthesis, structure, and bonding of A5Cd2Tl11, A = Cs, Rb. Naked pentagonal
      antiprismatic columns centered by cadmium.
AB  - A new anionic thallium cluster chain 1 infinity[Cd2Tl11(5-)] has been discovered
      in the A-Cd-Tl systems for A = Cs, Rb. The compounds are synthesized by direct
      fusion of the elements at 700 degrees C and equilibration of the quenched product
      at 200 degrees C for 1 month. The thallides crystallize in the orthorhombic space
      group Amm2, Z = 2, a = 56107(7) and 55999(6) A, b = 18090(3) and 17603(3) A, c =
      13203(3) and 12896(2) A for A = Cs and Rb, respectively, and contain chains of
      face-sharing pentagonal Tl10 antiprisms embedded in a matrix of alkali metal
      cations. Cadmium atoms occupy the center of the antiprisms and donate electrons
      to the anionic chain. Additional four-bonded Tl atoms on one side of the chain
      make the structure acentric. The compounds are diamagnetic (chi 296 = -08, -40 (x
      10(-4) emu/mol, respectively) and metallic (10-20 mu omega cm at 275 K), and the
      indirect band gap energy of both compounds is close to zero according to extended
      Huckel calculations on the isolated chain.

PMID- 11196906
TI  - Synthesis and structures of new ternary aluminum chalcogenides: LiAlSe2, alpha
      LiAlTe2, and beta-LiAlTe2.
AB  - The synthesis and crystal structures of new ternary aluminum chalcogenides,
      LiAlSe2, alpha-LiAlTe2, and beta-LiAlTe2, are reported. These compounds are
      synthesized by solid-state reaction at 800 degrees C. The single-crystal X-ray
      structures of these compounds have been determined. LiAlSe2: a = 68228(9) A, b =
      8266(1) A, c = 65236(7) A, Pna2(1) (No 33, Z = 4) alpha-LiAlTe2: a = 65317(4) A,
      c = 116904(9) A, I42d (No 122, Z = 4) beta-LiAlTe2: a = 44810(6) A, c = 7096(1)
      A, P3m1 (No 156, Z = 1). These ternary compounds are formed by fusion of AlQ4 (Q
      = Se, Te) tetrahedra. LiAlSe2 shows beta-NaFeO2 structure type, which can be
      viewed as a wurtzite superstructure. alpha-LiAlTe2 adopts chalcopyrite structure
      type. In LiAlSe2 and alpha-LiAlTe2, AlQ4 (Q = Se, Te) tetrahedra share four
      corners to build three-dimensional structures and Li atoms are located in the
      tetrahedral sites between the chalcogen layers. beta-LiAlTe2 has polar layers
      formed by three-corner shared AlTe4 tetrahedra, and Li cations are in the
      distorted antiprisms between the layers. 7Li MAS NMR studies show that chemical
      shifts of Li in these ternary chalcogenides are nearly identical regardless of
      different chemical environments.

PMID- 11196907
TI  - Time-resolved infrared spectroscopic study of reactive acyl intermediates
      relevant to cobalt-catalyzed carbonylations.
AB  - Time-resolved infrared spectroscopic studies have been used to characterize the
      reactive intermediate CH3C(O)Co(CO)2PPh3 (ICo), which is relevant to the
      mechanism of the catalysis of alkene hydroformylation by the phosphine-modified
      cobalt carbonyls. Step-scan FTIR and (variable) single-frequency time-resolved
      infrared detection on the microsecond time scale were used to record the spectrum
      of ICo and to demonstrate that the principal photoproduct of the subsequent
      reaction of this species at PCO = 1 atm is the methyl cobalt complex
      CH3Co(CO)3PPh3 (MCo). At higher PCO the trapping of ICo with CO to re-form
      CH3C(O)Co(CO)3PPh3 (ACo) (rate = kCO[CO][ICo]) was shown to become competitive
      with the rate of acetyl-to-cobalt methyl migration to give MCo (rate = kM[ICo]).
      Activation parameters for the competing pathways in benzene were determined to be
      delta H++CO = 57 +/- 04 kJ mol-1, delta S++CO = -91 +/- 12 J mol-1 K-1 and delta
      H++M = 40 +/- 2 kJ mol-1, delta S++M = -19 +/- 5 J mol-1 K-1. The effects of
      varying the solvent on the competitive reactions of ICo were also explored, and
      the mechanistic implications of these results are discussed.

PMID- 11196908
TI  - Time-resolved IR studies of [Re(LL)(CO)4]+.

PMID- 11196909
TI  - Monodentate-bridged phosphodiester and sulfate complexes: structural insights
      into the biological activation of phosphodiesters, sulfate, and sulfate esters.

PMID- 11196910
TI  - Varying coordination modes and magnetic properties of copper(II) complexes with
      diazamesocyclic ligands by altering additional donor pendants on 1,5
      diazacyclooctane.
AB  - A series of new diazamesocyclic ligands based on a diazamesocycle, 1,5
      diazacyclooctane (DACO), functionalized by additional donor groups--1,5-bis(N-1
      methylimidazol-2-ylmethyl)-1,5- diazacyclooctane (L1), 1-(2-hydroxybenzyl)-1,5
      diazacyclooctane (HL2), 1,5-bis(2-hydroxybenzyl)-1,5-diazacyclooctane (H2L3), and
      1-(N-1-methylimidazol-2-ylmethyl)-1,5-diazacyclooctane (L4)--and their Cu(II)
      complexes have been synthesized and characterized. Single-crystal X-ray
      diffraction analysis of the four Cu(II) complexes revealed that L1 forms a five
      coordinate mononuclear complex, HL2 a N3- mu-bridged binuclear complex, H2L3 an
      oxygen mu-bridged trinuclear complex, and L4 a one-dimensional zigzag
      coordination polymeric complex with Cu(II). [CuL1ClO4](ClO4) (I): a = 12.194(2)
      A, b = 13.351(3) A, c = 14.473(3) A, beta = 107.10(3) degrees, Z = 4. [CuL2(N3)]2
      (II): a = 8.1864(6) A, b = 18.141(2) A, c = 9.3307(7) A, beta = 103.662(6)
      degrees, Z = 2. [Cu3(L3)2Cl2] (III): a = 10.7296(13) A, b = 13.7707(17) A, c =
      13.5523(17) A, beta = 106.350(3) degrees, Z = 2. ([CuL4Cl]2ClO4) infinity (IV): a
      = 7.279(1) A, b = 23.695(5) A, c = 19.308(4) A, beta = 100.28(3) degrees, Z = 8.
      All four complexes crystallize in the monoclinic crystal system with the P2(1)/c
      space group, and each Cu(II) center coordinated with DACO is pentacoordinated
      with a distorted square-pyramidal or trigonal-bipyrimidal coordination
      environment. In complex IV, the binuclear cation unit [CuL4Cl]2(2+) constitutes
      the fundamental building block of an infinite alternating zigzag chain structure,
      and the binuclear unit contains two types of geometries around the Cu(II)
      centers: the Cu(1) center is a distorted square-pyramidal environment, while the
      Cu(2) is a distorted trigonal-bipyramidal coordination environment. To the best
      of our knowledge, this is the first Cu(II) complex of a diazamesocyclic ligand
      with an infinite polymeric structure. The magnetic properties of complexes II,
      III, and IV have been investigated by variable-temperature magnetic
      susceptibility measurements in the solid state. The obtained parameters are 2J =
      2.06 cm-1 (II), -345.56 cm-1 (III), and -2.60 cm-1 (IV), which differ greatly
      from ferromagnetic to weak and strong antiferromagnetic coupling. These results
      unequivocally indicate that the nature of the pendant arms is a key factor
      governing the structure and properties of the complexes; therefore, the
      coordination modes and properties of the metal complexes of a diazamesocycle can
      be controlled by altering the pendant donors on it. Magneto-structural
      correlation has been precisely analyzed, and the solution properties of these
      complexes have also been described.

PMID- 11196911
TI  - Electronic structures of M21S8 (M = Nb, Zr) and (M,M')21S8 (M, M' = Hf, Ti; Nb,
      Ta) phases and reasons for variations in the metal site occupations.
AB  - The electronic structures of binary M21S8 (M = Nb, Zr) and isostructural ternary
      (M,M')21S8 (M, M' = Hf, Ti; Nb, Ta) phases have been studied by means of extended
      Huckel tight-binding band structure calculations. For the valence electron
      concentration in the binary group 5 metal phase Nb21S8, metal-metal bonding is
      optimized whereas, in the isostructural group 4 metal phase Zr21S8, metal-metal
      bonding levels exist above the Fermi level. However, the electronic structure
      analysis suggests a stable structure for M21S8 phases with group 4 metals and
      that (M,M')21S8 phases with mixed group 4 and group 5 metals, even if not yet
      reported, could well exist. In the ternary phase Nb6.9Ta14.1S8, a linear
      relationship exists between the magnitude of the metal-metal bonding capacity (as
      expressed by the total metal-metal Mulliken overlap population) of each
      crystallographically independent metal site and the occupation of the site with
      the heavier metal (i.e., the element with the greater bonding capability). The
      situation is quite more complex in Hf7.5Ti13.5S8, where the metal-metal bonding
      capacity of each site, differences in electronegativity between Ti and Hf, and
      site volume arguments must be taken into account to understand the metal site
      occupation.

PMID- 11196912
TI  - Ab initio study of rearrangements on the (CH)2(BR)2, R=H, and NH2 potential
      energy surfaces.
AB  - A comprehensive survey of the (CH)2(BH)2 potential energy surface was carried out
      at the [MP4/6-311 + G(d,p)]//MP2/6-31G(d) level. Many of the classical and
      nonclassical isomers of the carborane surface are separated by high activation
      barriers, which explains why derivatives of most isomers could be prepared as
      stable compounds at room temperature. The transition states are grouped into two
      types, hydrogen migration (terminal-to-bridge and bridge-to-terminal) and group
      migration (BH, CH, and CH2). The rearrangement of 1,3-diamino-1,3-diboretene (1
      NH2) to 1,2-diamino-1,2-diboretene (2-NH2) was computed and compared to the
      rearrangement in the parent (1-->2). The effect of the amino group is to
      substantially increase the barrier height and stabilize the product, 2-NH2.

PMID- 11196913
TI  - Synthesis and characterization of mixed-ligand oxorhenium complexes with the SNN
      type of ligand. Isolation of a novel ReO[SN][S][S] complex.
AB  - A new series of mixed-ligand oxorhenium complexes 4-9, with ligands 1-3 (L1H2)
      containing the SNN donor set and monodentate thiols as coligands (L2H), is
      reported. All complexes were synthesized using ReOCl3(PPh3)2 as precursor. They
      were isolated as crystalline products and characterized by elemental analysis and
      IR and NMR spectroscopy. The ligands 1 and 2 (general formula RCH2CH2NHCH2CH2SH,
      where R = N(C2H5)2 in 1 and pyrrolidin-1-yl in 2) act as tridentate SNN chelates
      to the ReO3+ core, leaving one open coordination site cis to the oxo group. The
      fourth coordination site is occupied by a monodentate aromatic thiol which acts
      as a coligand. Thus, three new "3 + 1" [SNN][S] oxorhenium complexes 4-6 (general
      formula ReO[RCH2CH2NCH2CH2S][SX], where R = N(C2H5)2 and X = phenyl in 4, R =
      N(C2H5)2 and X = p-methylphenyl in 5, and R = pyrrolidinlyl and X = p
      methylphenyl in 6) were prepared in high yield. Complex 4 adopts an almost
      perfect square pyramidal geometry (tau = 0.07), while 6 forms a distorted square
      pyramidal geometry (tau = 0.24). In both complexes 4 and 6, the basal plane is
      formed by the SNN donor set of the tridentate ligand and the S of the monodentate
      thiol. On the other hand, the ligand 3, [(CH3)2CH]2NCH2CH2NHCH2CH2SH, acts as a
      bidentate ligand, probably due to steric hindrance, and it coordinates to the
      ReO3+ core through the SN atoms, leaving two open coordination sites cis to the
      oxo group. These two vacant positions are occupied by two molecules of the
      monodentate thiol coligand, producing a novel type of "2 + 1 + 1" [SN][S][S]
      oxorhenium mixed-ligand complexes 7-9 (general formula
      ReO[[(CH3)2CH]2NCH2CH2NHCH2CH2S][SX][SX], where X = phenyl in 7, p-methylphenyl
      in 8, and benzyl in 9). The coordination sphere about rhenium in 7 and 8 consists
      of the SN donor set of ligand 3, two sulfurs of the two monodentate thiols, and
      the doubly bonded oxygen atom in a trigonally distorted square pyramidal geometry
      (tau = 0.44 and 0.45 for 7 and 8, respectively). Detailed NMR assignments were
      determined for complexes 5 and 8.

PMID- 11196914
TI  - Mercury(I) molybdates and tungstates: Hg2WO4 and two modifications of Hg2MoO4.
AB  - The high-temperature (beta-) modification of Hg2MoO4 was prepared by solid-state
      reaction of HgO with MoO2 at 400 degrees C. Well-crystallized samples of the low
      temperature (alpha-) modification of Hg2MoO4 and isotypic Hg2WO4 were obtained by
      hydrothermal recrystallization of the microcrystalline powders at 180 degrees C.
      The crystal structures of these transparent yellow compounds were determined by
      single-crystal X-ray diffractometry. beta-Hg2MoO4: P2(1)/c, Z = 4, a = 511.31(6)
      pm, b = 901.83(7) pm, c = 1086.0(1) pm, beta = 101.01(3) degrees. alpha-Hg2MoO4
      and Hg2WO4: C2/c, Z = 4, a = 873.52(6) and 873.0(1) pm, b = 1155.19(7) and
      1147.6(3) pm, c = 493.05(3) and 493.24(6) pm, beta = 115.196(5) degrees and
      114.86(1) degrees, respectively. In beta-Hg2MoO4 the molybdenum atoms are
      tetrahedrally coordinated by oxygen atoms and the MoO4 tetrahedra are linked via
      Hg2 dumb-bells, thus forming infinite zigzag chains. The low-temperature (alpha
      )modification of Hg2MoO4 contains MoO6 octahedra, which are linked via common
      edges to form zigzag chains, which are further linked via Hg2 dumb-bells,
      resulting in puckered two-dimensionally infinite sheets. Bonding between adjacent
      sheets is achieved only via weak (secondary) Hg-O bonds of 254.8 pm, while the
      strong Hg-O bonds of the nearly linear O-Hg-Hg-O groups within the sheets have a
      length of 214.8 pm. The Hg-Hg bond lengths are practically the same in the three
      compounds with 252.3(1), 253.49(7), and 253.3(1) pm in beta-Hg2MoO4, alpha
      Hg2MoO4, and Hg2WO4, respectively. The average Mo-O distances within the MoO4
      tetrahedra and the MoO6 octahedra are 176.2, and 196.5 pm, respectively. The
      structural chemistry of these compounds is discussed together with that of
      previously reported mercury I and II molybdates and tungstates.

PMID- 11196915
TI  - Preparation and oxygenation of (flavonolato)copper isoindoline complexes with
      relevance to quercetin dioxygenase.
AB  - Mesitylcopper reacts with flavonol (flaH) in the presence of 1,3-bis(2
      pyridylimino)isoindoline (indH) to yield the diamagnetic complex CuI(fla)(indH),
      which on reaction with molecular oxygen undergoes oxidative splitting of the C2
      C3 bond of the pyranone ring of the flavonolate ligand to give CuI(indH)(O-bs) (O
      bs = O-benzoylsalicylate) (orthorhombic, P1, a = 8.048(7) A, b = 8.969(9) A, c =
      19.240(2) A, alpha = 85.69 degrees, beta = 80.24(7) degrees, gamma = 77.87(7)
      degrees, V = 1337(2) A3, Z = 2) and carbon monoxide. The reaction of
      [CuI(CH3CN)4]ClO4, flaH, and indH with dioxygen at room temperature affords the
      paramagnetic complex [CuII(fla)(indH)]ClO4 (mu = 2.10 mu B), and after
      elimination of HClO4, CuII(fla)(ind) (orthorhombic, Pbca, a = 8.888(2) A, b =
      19.169(7) A, c = 33.614(10) A, alpha = beta = gamma = 90 degrees, V = 5727(3) A3,
      Z = 8) with mu = 1.86 mu B is formed. The latter undergoes cleavage of the
      pyranone ring on oxygenation at 80 degrees C to give CuII(ind)(O-bs) (mu = 1.87
      mu B, nu(CO) = 1742 cm-1, and nu(CO2) = 1581, 1387 cm-1) and carbon monoxide.
      CuII(fla)(ind) and [CuII(fla)(indH)]ClO4 serve as good catalysts for the
      oxygenation of flavonol to O-benzoylsalicyclic acid.

PMID- 11196916
TI  - New antitumor-active azole-bridged dinuclear platinum(II) complexes: synthesis,
      characterization, crystal structures, and cytotoxic studies.
AB  - Three new derivatives of the cytotoxic azole-bridged dinuclear platinum(II)
      complex [(cis-Pt(NH3)2)2(mu-OH)(mu-pz)][NO3]2 (1) have been prepared and
      structurally characterized. Their formulas are [(cis-Pt(NH3)2)2(mu-OH)(mu-1,2,3
      ta)][NO3]2 (2) (1,2,3-ta = 1,2,3-triazolate), [(Pt(R,R-dach))(mu-OH)(mu
      pz)(Pt(S,S- dach))][NO3]2 (3) (dach = 1,2-diaminocyclohexane, pz = pyrazolate),
      and [(Pt(R,R-dach))(mu-1,2,3- ta)2(Pt(S,S-dach))][NO3]2 (4). The compounds were
      characterized by 1H, 13C, and 195Pt NMR spectroscopy, and elemental analysis, and
      their crystal structures were determined. Relevant data for 2: triclinic, space
      group P1, a = 8.5225(15) A, b = 9.1977(18) A, c = 9.9771(7) A, alpha = 66.988(10)
      degrees, beta = 75.423(9) degrees, gamma = 67.321(13) degrees, Z = 2. 3:
      orthorhombic, space group Pca2(1), a = 17.7653(3) A, b = 12.4076(3) A, c =
      10.7091(3) A, Z = 4. 4: orthorhombic, space group Pbca, a = 13.8944(1) A, b =
      17.8668(1) A, c = 20.7647(2) A, Z = 8. In the crystal structures of 2, and 3, the
      intramolecular distances between the two Pt atoms are 3.4411(6) and 3.4873(5) A,
      and the dihedral angles between the platinum coordination planes are 14.1(3) and
      9.3(4) degrees, respectively. In 2, an intramolecular hydrogen bond is observed
      between N9 of the ammine ligand and the noncoordinated nitrogen atom (N3) of the
      triazole ring (N9...N3: 2.962(10) A). 4 has a boat-form structure, and the two
      coordination planes cross at 83.64(10) degrees. A cytotoxicity assay of these
      dinuclear platinum(II) compounds on human tumor cell lines was performed. In most
      of the cell lines, 1 and 2 showed much higher cytotoxicity than those of
      cisplatin. On the other hand, 3 was found to be moderately active, and 4 was
      found only marginally cytotoxic. Implications of these findings are discussed in
      the context of a structure-activity relationship.

PMID- 11196917
TI  - Synthesis of SnSe in various alkaline media under mild conditions.
AB  - The synthesis of SnSe was systematically investigated in various alkaline media
      and at various temperatures with SnCl2.2H2O and selenium as source materials. The
      basicity of the alkaline media and the reaction temperature are two key factors
      considered in our process. The synthesis of SnSe in sodium hydroxide solution and
      aqueous ammonia is limited to a narrow temperature range, while the synthesis in
      hydrazine hydrate and ethylenediamine proceeds over a wider range. The final
      products were characterized by X-ray diffraction pattern (XRD), energy dispersive
      X-ray (EDX), and transmission electron microscopy (TEM). TEM results showed a
      variation of crystal morphology of SnSe obtained in different media. Two simple
      chemical mechanisms for the formation of SnSe are presented.

PMID- 11196918
TI  - Bis(mercaptoimidazolyl)(pyrazolyl)hydroborato complexes of zinc, cadmium, and
      cobalt: structural evidence for the enhanced tendency of zinc in biological
      systems to adopt tetrahedral M[S4] coordination.
AB  - The bis(2-mercapto-1-methylimidazolyl)(pyrazolyl)hydroborato derivatives
      [pzBmMe]2Zn, [pzBmMe]2Co, and [pzBmMe]2Cd have been isolated and structurally
      characterized by X-ray diffraction. Despite their common [pzBmMe]2M composition,
      each of these complexes adopts a different structure. Thus, (i) the zinc complex
      exhibits a tetrahedral Zn[S4] structure in which only the sulfur donors
      coordinate to zinc, (ii) the cobalt complex exhibits a trigonal-bipyramidal
      Co[S3NH] structure in which one of the pyrazolyl groups and one of the B-H groups
      coordinate to cobalt, and (iii) the cadmium complex exhibits a six-coordinate
      Cd[S4H2] structure in which both B-H groups interact with the cadmium center.
      These comparisons emphasize that zinc has a greater preference for tetrahedral
      M[S4] coordination than does either cobalt or cadmium, an observation that is in
      accord with the prevalent role of zinc in the structural sites of enzymes.

PMID- 11196919
TI  - The OsO4F-, OsO4F2(2)-, and OsO3F3- anions, their study by vibrational and NMR
      spectroscopy and density functional theory calculations, and the X-ray crystal
      structures of [N(CH3)4][OsO4F] and [N(CH3)4][OsO3F3].
AB  - The fluoride ion acceptor properties of OsO4 and OsO3F2 were investigated. The
      salts [N(CH3)4][OsO4F] and [N(CH3)4]2[OsO4F2] were prepared by the reactions of
      OsO4 with stoichiometric amounts of [N(CH3)4][F] in CH3CN solvent. The salts
      [N(CH3)4][OsO3F3] and [NO][OsO3F3] were prepared by the reactions of OsO3F2 with
      a stoichiometric amount of [N(CH3)4][F] in CH3CN solvent and with excess NOF,
      respectively. The OsO4F- anion was fully structurally characterized in the solid
      state by vibrational spectroscopy and by a single-crystal X-ray diffraction study
      of [N(CH3)4][OsO4F]: Abm2, a = 7.017(1) A, b = 11.401(2) A, c = 10.925(2) A, V =
      874.1(3) A3, Z = 4, and R = 0.0282 at -50 degrees C. The cis-OsO4F2(2-) anion was
      characterized in the solid state by vibrational spectroscopy, and previous claims
      regarding the cis-OsO4F2(2-) anion are shown to be erroneous. The fac-OsO3F3-
      anion was fully structurally characterized in CH3CN solution by 19F NMR
      spectroscopy and in the solid state by vibrational spectroscopy of its N(CH3)4+
      and NO+ salts and by a single-crystal X-ray diffraction study of
      [N(CH3)4][OsO3F3]: C2/c, a = 16.347(4) A, b = 13.475(3) A, c = 11.436(3) A, beta
      = 134.128(4) degrees, V = 1808.1(7) A3, Z = 8, and R = 0.0614 at -117 degrees C.
      The geometrical parameters and vibrational frequencies of OsO4F-, cis-OsO4F2(2-),
      monomeric OsO3F2, and fac-OsO3F3- and the fluoride affinities of OsO4 and
      monomeric OsO3F2 were calculated using density functional theory methods.

PMID- 11196920
TI  - Ruthenium(II) complexes of redox-related, modified dipyridophenazine ligands:
      synthesis, characterization, and DNA interaction.
AB  - The synthesis, spectral characterization, and electrochemical properties of
      [Ru(phen)2(qdppz)]2+, which incorporates a quinone-fused dipyridophenazine ligand
      (naphtho[2,3-a]dipyrido[3,2-h:2',3'-f]phenazine-5,18-dione, qdppz), are described
      in detail. Chemical or electrochemical reduction of [Ru(phen)2(qdppz)]2+ leads to
      the generation of [Ru(phen)2(hqdppz)](2+)--a complex containing the hydroquinone
      form (hqdppz = 5,18-dihydroxynaphtho[2,3-a]-dipyrido[3,2-h:2',3'-f]phenazine) of
      qdppz. Absorption and viscometric titration, thermal denaturation, topoisomerase
      assay, and differential-pulse voltammetric studies reveal that
      [Ru(phen)2(qdppz)]2+ is an avid binder of calf-thymus DNA due to a strong
      intercalation by the ruthenium-bound qdppz, while [Ru(phen)2(hqdppz)]2+ binds to
      DNA less strongly than the parent "quinone"-containing complex. DNA-photocleavage
      efficiencies of these complexes also follow a similar trend in that the MLCT
      excited state of [Ru(phen)2(qdppz)]2+ is more effective than that of
      [Ru(phen)2(hqdppz)]2+ in cleaving the supercoiled plasmid pBR 322 DNA (lambda exc
      = 440 +/- 5 nm), as revealed by the results of agarose gel electrophoresis
      experiments. The photochemical behaviors of both the quinone- and hydroquinone
      appended ruthenium(II) complexes in the presence of DNA not only provide valuable
      insights into their modes of binding with the duplex but also lead to detailed
      investigations of their luminescence properties in nonaqueous, aqueous, and
      aqueous micellar media. On the basis of the results obtained, (i) a photoinduced
      electron transfer from the MLCT state to the quinone acceptor in
      Ru(phen)2(qdppz)]2+ and (ii) quenching of the excited states due to proton
      transfer from water to the dipyridophenazine ligand in both complexes are invoked
      to rationalize the apparent lack of emission of these redox-related complexes in
      the DNA medium.

PMID- 11196921
TI  - Ruthenium(II) complexes of 6,7-dicyanodipyridoquinoxaline: synthesis,
      luminescence studies, and DNA interaction.
AB  - The hexaflurophosphate and chloride salts of a series of ruthenium(II) complexes
      incorporating a new dipyridophenazine-based ligand, dicnq (6,7
      dicyanodipyrido[2,2-d:2',3'-f]quinoxaline), are synthesized in good-to-moderate
      yields. These mono ([Ru(phen)2(dicnq)]2+; phen = 1,10-phenanthroline), bis
      ([Ru(phen)(dicnq)2]2+), and tris ([Ru(dicnq)3]2+) complexes are fully
      characterized by elemental analysis, infrared, FAB-MS, 1H NMR, and cyclic
      voltammetric methods. Results of absorption titration and thermal denaturation
      studies reveal that these complexes are moderately strong binders of calf-thymus
      (CT) DNA, with their binding constants spanning the range (1-3) x 10(4) M-1. On
      the other hand, under the identical set of experimental conditions of light and
      drug dose, the DNA (pBR 322)-photocleavage abilities of these ruthenium(II)
      complexes follow the order [Ru(phen)2(dicnq)]2+ > [Ru(phen)(dicnq)2]2+ >>
      [Ru(dicnq)3]2+, an order which is the same as that observed for their MLCT
      emission quantum yields. Steady-state emission studies carried out in nonaqueous
      solvents and in aqueous media with or without DNA reveal that while
      [Ru(dicnq)3]2+ is totally nonemissive under these solution conditions, both
      [Ru(phen)2(dicnq)]2+ and [Ru(phen)(dicnq)2]2+ are luminescent and function as
      "molecular light switches" for DNA. Successive addition of CT DNA to buffered
      aqueous solutions containing the latter two complexes results in an enhancement
      of the emission in each case, with the enhancement factors at saturation being
      approximately 16 and 8 for [Ru(phen)2(dicnq)]2+ and [Ru(phen)(dicnq)2]2+,
      respectively. These results are discussed in light of the relationship between
      the structure-specific deactivations of the MLCT excited states of these
      metallointercalators and the characteristic features of their DNA interactions,
      and attempts are made to compare and contrast their properties with those of
      analogous dipyridophenazine-based complexes, including the ones reported in the
      preceding paper.

PMID- 11196922
TI  - 2-D interwoven and 3-D 5-fold interpenetrating silver(I) complexes of 1
      (isocyanidomethyl)-1H-benzotriazole and 1,3-bis(dicyanomethylidene)indan.
AB  - This paper presents novel and distinctive organosilver polymers with intriguing
      structure motifs, constructed from iodoacetonitrile (L1), 1-(isocyanidomethyl)-1H
      benzotriazole (L2), 1,3-bis(dicyanomethylidene)indan (L3), and silver(I) salts,
      respectively. Treatment of L1 with AgClO4 generated [Ag(L1)(ClO4)]n (1), whose X
      ray determination revealed a 2-D wavy sheet structure with square grids. Reaction
      of L2 with AgPF6 gave rise to a novel 2-D wavy interwoven network,
      ([Ag(L2)(PO2F2)0.5])n (2). The complex [Ag2(L3)2]n (3) obtained by reaction of
      AgClO4 with L3 can be regarded as unprecedented 3-D 5-fold interpenetrating nets
      with columnar aromatic stacks and indicates semiconductive behavior. The IR, ESR
      spectroscopic results, conductivities, and structural features of the complexes
      are discussed, respectively. The present findings may provide insight into the
      coordination versatility of silver(I) and polynitrile ligands and an inspiration
      for the self-assembly of novel supramolecular networks with multifunctional
      ligands. Crystal data: 1, C2H2AgINClO4, orthorhombic, Pca2(1) (No. 29), a =
      14.503(1) A, b = 5.104(2) A, c = 10.2019(9) A, Z = 4; 2, C8H6AgN4PF4O,
      orthorhombic, Pnna (No. 52), a = 12.2705(3) A, b = 21.150(1) A, c = 10.040(1) A,
      Z = 8; 3, C30H10Ag2N8, triclinic, P1 (No. 2), a = 14.920(2) A, b = 11.896(2) A, c
      = 7.400(4) A, alpha = 86.55(2) degrees, beta = 80.87(2) degrees, gamma = 74.47(1)
      degrees, Z = 2.

PMID- 11196923
TI  - Synthesis, structure, luminescence, and theoretical studies of tetranuclear gold
      clusters with phosphinocarborane ligands.
AB  - Treatment of the tetranuclear gold cluster [Au4((PPh2)2C2B9H10)2(AsPh3)2] (1),
      which contains the nido-carborane-diphosphine [7,8-(PPh2)2C2B9H10]-, with various
      tertiary phosphines leads to derivatives [Au4((PPh2)2C2B9H10)2-(PR3)2] (PR3 =
      PPh3 (2), P(4-MeC6H4)3 (3), P(4-OMeC6H4)3 (4)). The X-ray crystal structure of
      complex 4 shows a tetrahedral framework of gold atoms, two of which are chelated
      by the diphosphine, and two are coordinated to one monophosphine ligand each.
      These compounds are very stable and are obtained in high yield. MP2 calculations
      suggest that the two types of chemically nonequivalent gold atoms can be formally
      assigned as Au(I) (those attached to the arsines or phosphines) and Au(0) (those
      bonded to the anionic diphosphine) and emphasize the role of correlation in the
      gold-gold interactions. The compounds are luminescent. The emission is assigned
      to a gold-centered spin-forbidden transition; the assignment of the oxidation
      state of the gold centers on this basis leads to results coincident with those
      obtained by theoretical calculations.

PMID- 11196924
TI  - Kinetics and mechanism for reversible chloride transfer between mercury(II) and
      square-planar platinum(II) chloro ammine, aqua, and sulfoxide complexes.
      Stabilities, spectra, and reactivities of transient metal-metal bonded platinum
      mercury adducts.
AB  - The Hg2+aq- and HgCl+aq-assisted aquations of [PtCl4]2- (1), [PtCl3(H2O)]- (2),
      cis-[PtCl2(H2O)2] (3), trans-[PtCl2(H2O)2] (4), [PtCl(H2O)3]+ (5), [PtCl3Me2SO]-
      (6), trans-[PtCl2(H2O)Me2SO] (7), cis-[PtCl(H2O)2Me2SO]+ (8), trans
      [PtCl(H2O)2M32SO]+ (9), trans-[PtCl2(NH3)2] (10), and cis-[PtCl2(NH3)2] (11) have
      been studied at 25.0 degrees C in a 1.00 M HClO4 medium buffered with chloride,
      using stopped-flow and conventional spectrophotometry. Saturation kinetics and
      instantaneous, large UV/vis spectral changes on mixing solutions of platinum
      complex and mercury are ascribed to formation of transient adducts between Hg2+
      and several of the platinum complexes. Depending on the limiting rate constants,
      these adducts are observed for a few milliseconds to a few minutes. Thermodynamic
      and kinetics data together with the UV/vis spectral changes and DFT calculations
      indicate that their structures are characterized by axial coordination of Hg to
      Pt with remarkably short metal-metal bonds. Stability constants for the Hg2+
      adducts with complexes 1-6, 10, and 11 are (2.1 +/- 0.4) x 10(4), (8 +/- 1) x
      10(2), 94 +/- 6, 13 +/- 2, 5 +/- 2, 60 +/- 6, 387 +/- 2, and 190 +/- 3 M-1,
      respectively, whereas adduct formation with the sulfoxide complexes 7-9 is too
      weak to be observed. For analogous platinum(II) complexes, the stabilities of the
      Pt-Hg adducts increase in the order sulfoxide << aqua < ammine complex,
      reflecting a sensitivity to the pi-acid strength of the Pt ligands. Rate
      constants for chloride transfer from HgCl+ and HgCl2 to complexes 1-11 have been
      determined. Second-order rate constants for activation by Hg2+ are practically
      the same as those for activation by HgCl+ for each of the platinum complexes
      studied, yet resolved contributions for Hg2+ and HgCl+ reveal that the latter
      does not form dinuclear adducts of any significant stability. The overall
      experimental evidence is consistent with a mechanism in which the accumulated
      Pt(II)-Hg2+ adducts are not reactive intermediates along the reaction coordinate.
      The aquation process occurs via weaker Pt-Cl-Hg or Pt-Cl-HgCl bridged complexes.

PMID- 11196925
TI  - Formation of one-, two-, and three-dimensional open-framework zinc phosphates in
      the presence of a tetramine.
AB  - Five new open-framework zinc phosphates, encompassing the entire hierarchy of
      open-framework structures, have been synthesized hydrothermally in the presence
      of triethylenetetramine. The structures include one-dimensional ladders, two
      dimensional layers, and three-dimensional structures as well as a zinc phosphate
      where the amine acts as a ligand. [C6N4H22]0.5[Zn(HPO4)2] (I): monoclinic, space
      group P2(1)/c (no. 14), a = 5.2677(1) A, b = 13.3025(1) A, c = 14.7833(1) A, beta
      = 96.049 degrees, Z = 4. [C6N4H22]0.5[Zn2(HPO4)3] (II): triclinic, space group P1
      (no. 2), a = 7.515(1) A, b = 8.2553(1) A, c = 12.911(1) A, alpha = 98.654(1)
      degrees, beta = 101.274(1) degrees, gamma = 115.791(1) degrees, Z = 2.
      [C6N4H22]0.5[Zn2P2O8] (III): triclinic, space group P1 (no. 2), a = 8.064(1) A, b
      = 8.457(1) A, c = 9.023(1) A, alpha = 111.9(1) degrees, beta = 108.0(1) degrees,
      gamma = 103.6(1) degrees, Z = 2. [C6N4H22]0.5[Zn3(PO4)2(HPO4)] (IV): triclinic,
      space group P1 (no. 2), a = 5.218(1) A, b = 8.780(1) A, c = 16.081(1) A, alpha =
      89.3(1) degrees, beta = 83.5(1) degrees, gamma = 74.3(1) degrees, Z = 2.
      [C6N4H20]0.5[Zn4P4O16] (V): monoclinic, space group P2(1)/c (no. 14), a =
      9.219(1) A, b = 15.239(1) A, c = 10.227(1) A, beta = 105.2(1), Z = 4. The
      structure of I is composed of ZnO4 and HPO4 tetrahedra, which are edge-shared to
      form four-membered rings, which, in turn, form a one-dimensional chain (ladder).
      In II, these ladders are fused into a layer. The structures of III and IV
      comprise networks of ZnO4 and PO4 tetrahedra forming three-dimensional
      architectures. In V, the amine molecule coordinates to the Zn and acts as a
      pillar supporting the zinc phosphate layers, which possess infinite Zn-O-Zn
      linkages. The 16-membered one-dimensional channel in IV and the ZnO3N pillar,
      along with infinite Zn-O-Zn linkages in V, are novel features. The structure of
      the open-framework zinc phosphates is found to depend sensitively on the relative
      concentrations of the amine and phosphoric acid, with high concentrations of the
      latter favoring structures with lower dimensions.

PMID- 11196926
TI  - Influence of hydrogen bonding on the assembly of six-membered vanadium
      borophosphate cluster anions: synthesis and structures of
      (NH4)2(C2H10N2)6[Sr(H2O)5]2[V2P2BO12](6)10H2O,
      (NH4)2(C3H12N2)6[Sr(H2O)4]2[V2P2BO12](6)17H2O, and (NH4)3(C4H14N2)4
      5[Sr(H2O)5]2[Sr(H2O)4][V2P2BO12]6 10H2O.
AB  - Three new strontium vanadium borophosphate compounds,
      (NH4)2(C2H10N2)6[Sr(H2O)5]2[V2P2BO12]6 10H2O (Sr-VBPO1) (1),
      (NH4)2(C3H12N2)6[Sr(H2O)4]2[V2P2BO12]6 17H2O (Sr-VBPO2) (2), and
      (NH4)3(C4H14N2)4.5[Sr(H2O)5]2[Sr(H2O)4][V2P2BO12]6 10H2O (Sr-VBPO3) (3) have been
      synthesized by interdiffusion methods in the presence of diprotonated
      ethylenediamine, 1,3-diaminopropane, and 1,4-diaminobutane. Compound 1 has a
      chain structure, whereas 2 and 3 have layered structures with different
      arrangements of [(NH4) [symbol: see text] [V2P2BO12]6] cluster anions within the
      layers. Crystal data: (NH4)2(C2H10N2)6[Sr(H2O)5]2[V2P2BO12]6 10H2O, monoclinic,
      space group C2/c (no. 15), a = 21.552(1) A, b = 27.694(2) A, c = 20.552(1) A,
      beta = 113.650(1) degrees, Z = 4; (NH4)2(C3H12N2)6[Sr(H2O)4]2[V2P2BO12]6 17H2O,
      monoclinic, space group I2/m (no. 12), a = 15.7618(9) A, b = 16.4821(9) A, c =
      21.112(1) A, beta = 107.473(1) degrees, Z = 2;
      (NH4)3(C4H14N2)4.5[Sr(H2O)5]2[Sr(H2O)4] [V2P2BO12]6 10H2O, monoclinic, space
      group C2/c (no. 15), a = 39.364(2) A, b = 14.0924(7) A, c = 25.342(1) A, beta =
      121.259(1) degrees, Z = 4. The differences in the three structures arise from the
      different steric requirements of the amines that lead to different amine-cluster
      hydrogen bonds.

PMID- 11196927
TI  - Ligand influences of the structures of molybdenum oxide networks.
AB  - The influence of organonitrogen ligands on the network structure of molybdenum
      oxides was examined by preparing three new molybdenum oxide phases [MoO3(4,4'
      bpy)0.5] (MOXI-8), [HxMoO3(4,4'-bpy)0.5] (MOXI-9), and [MoO3(triazole)0.5] (MOXI
      32). The structure of [MoO3(4,4'-bpy)0.5) consists of layers of corner-sharing
      MoO5N octahedra, buttressed by bridging 4,4'-bipyridyl ligands into a three
      dimensional covalently bonded organic-inorganic composite material. Partial
      reduction of [MoO3(4,4'-bpy)0.5] yields the mixed-valence material [HxMoO3(4,4'
      bpy)0.5] (x approximately 0.5). The most apparent structural change upon
      reduction is found in the Mo-ligand bond lengths of the MoO5N octahedra, which
      exhibit the usual (2 + 2 + 2) pattern in [MoO3(4,4'-bpy)0.5] and a more regular
      (5 + 1) pattern in [HxMoO3(4,4'-bpy)0.5]. Substitution of triazole for 4,4'
      bipyridine yields [MoO3(triazole)0.5], which retains the layer motif of corner
      sharing MoO5N octahedra but with distinct sinusoidal ruffling in contrast to
      planar layers of [MoO3(4,4'-bpy)0.5] and [HxMoO3(4,4'-bpy)0.5]. The folding
      reflects the ligand constraints imposed by the triazole ligand that bridges
      adjacent Mo sites within a layer. MOXI-8, C5H4NMoO3: monoclinic P2(1)/c, a =
      7.5727(6) A, b = 7.3675(7) A, c = 22.433(3) A, beta = 90.396(8) degrees, Z = 8.
      MOXI-9, C5H4.5NMoO3: monoclinic I2/m, a = 5.2644(4) A, b = 5.2642(4) A, c =
      22.730(2) A, beta = 90.035(1) degrees, Z = 4. MOXI-32, C2H3N3Mo2O6: orthorhombic
      Pbcm, a = 3.9289(5) A, b = 13.850(2) A, c = 13.366(2) A, Z = 4.

PMID- 11196928
TI  - Multiple-path dissociation mechanism for mono- and dinuclear
      tris(hydroxamato)iron(III) complexes with dihydroxamic acid ligands in aqueous
      solution.
AB  - Linear synthetic dihydroxamic acids ([CH3N(OH)C=O)]2(CH2)n; H2Ln) with short (n =
      2) and long (n = 8) hydrocarbon-connecting chains form mono- and dinuclear
      complexes with Fe(III) in aqueous solution. At conditions where the formation of
      Fe2(Ln)3 is favored, complexes with each of the two ligand systems undergo [H+]
      induced ligand dissociation processes via multiple sequential and parallel paths,
      some of which are common and some of which are different for the two ligands. The
      pH jump induced ligand dissociation proceeds in two major stages (I and II) where
      each stage is shown to be comprised of multiple components (Ix, where x = 1-3 for
      L2 and L8, and IIy, where y = 1-3 for L2 and y = 1-4 for L8). A reaction scheme
      consistent with kinetic and independent ESI-MS data is proposed that includes the
      tris-chelated complexes (coordinated H2O omitted for clarity) (Fe2(Ln)3,
      Fe2(L2)2(L2H)2, Fe(LnH)3, Fe(L8)(L8H)), bis-chelated complexes (Fe2(Ln)2(2+),
      Fe(LnH)2+, Fe(L8)+), and monochelated complexes (Fe(LnH)2+). Analysis of kinetic
      data for ligand dissociation from Fe2(Ln)(LnH)3+ (n = 2, 4, 6, 8) allows us to
      estimate the dielectric constant at the reactive dinuclear Fe(III) site. The
      existence of multiple ligand dissociation paths for the dihydroxamic acid
      complexes of Fe(III) is a feature that distinguishes these systems from their
      bidentate monohydroxamic acid and hexadentate trihydroxamic acid counterparts and
      may be a reason for the biosynthesis of dihydroxamic acid siderophores, despite
      higher environmental molar concentrations necessary to completely chelate
      Fe(III).

PMID- 11196929
TI  - Chemistry of metal-bound anion radicals. A family of mono- and bis(azopyridine)
      chelates of bivalent ruthenium.
AB  - The reaction of the dihydride [RuII(H)2(CO)(PPh3)3], 3, with excess azo-2,2'
      bipyridine (abp) in boiling dry benzene has afforded the diradical bischelate
      [RuII(abp.-)2(CO)(PPh3)], 4, and the hydridic monochelate monoradical [RuII(abp.
      )(H)(CO)(PPh3)2], 5. A similar reaction between 3 and 2-(p
      chlorophenylazo)pyridine (Clpap) did not yield a bischelate, but the hydridic
      monoradical [RuII(Clpap.-)(H)(CO)(PPh3)2], 6, has been isolated. Upon treatment
      of 4-6 with NH4PF6 in a wet dichloromethane-acetonitrile medium, the one-electron
      oxidized salts 4+PF6-, 5+PF6-, and 6+PF6- are isolated, H+ being the oxidizing
      agent. The X-ray structures of 4+PF6-.CH2Cl2, 5+PF6-.H2O, and 6+PF6- have been
      determined. In the monoradical 4+ the azo N-N bond lengths in the two chelate
      rings are 1.284(6) and 1.336(6) A, showing that the radical electron is localized
      in the latter ring. The half-filled extended Huckel HOMO is indeed found to be so
      localized, and it has a large azo character. Complexes 4-6 display radical redox
      couples with E1/2 in the range -0.5 to +0.10 V vs SCE. The E1/2 values
      qualitatively correlate with corresponding vco values (1900-2000 cm-1). The
      monoradicals (S = 1/2) 4+, 5, and 6 uniformly display a strong EPR signal near g
      = 2.00. Metal-mediated magnetic interaction makes the EPR-silent diradical 4
      strongly antiferromagnetic with J = -299 cm-1. Crystal data are as follows:
      (4+PF6-.CH2Cl2, C40H33Cl2F6N8-OP2Ru) monoclinic, space group P2(1)/c (no. 14), a
      = 14.174(6) A, b = 16.451(4) A, c = 18.381(4) A, beta = 98.00(3) degrees, Z = 4;
      (5+PF6-.H2O, C47H41F6N4O2P3Ru) monoclinic, space group P2(1)/n (no. 14), a =
      9.433(2) A, b = 38.914(17) A, c = 13.084(3) A, beta = 103.47(2) degrees, Z = 4;
      (6+PF6-, C48H39ClF6N3OP3Ru) monoclinic, space group P2(1)/n (no. 14), a =
      10.496(5) A, b = 22.389(8) A, c = 19.720(6) A, beta = 90.53(3) degrees, Z = 4.

PMID- 11196930
TI  - Mixed hydroxypyridinonate ligands as iron chelators.
AB  - New ligands based on hydroxypyridinonate (HOPO) and other bidentate ligands are
      explored as iron(III) sequestering agents. These are based on the N,N',N"-tris[(3
      hydroxy-1-methyl- 2-oxo-1,2-didehydropyrid-4-yl)-carboxamidoethyl]amine (TREN-Me
      3,2-HOPO) platform in which one Me-3,2-HOPO ligand group is substituted with
      either a 2-hydroxyisophthalamide (TREN-Me-3,2-HOPOIAM) or a 2,3
      dihydroxyterephthalamide (TREN-Me-3,2-HOPOTAM) moiety. The ferric complexes have
      been prepared and structurally characterized by X-ray diffraction: Fe[TREN-Me-3,2
      HOPOIAM] crystallizes in the monoclinic space group C2/c with cell parameters a =
      18.1186(3) A, b = 17.5926(2) A, c = 25.0476(2) A, beta = 98.142(1) degrees, Z =
      8. Fe[TREN-Me-3,2-HOPOTAM]- crystallizes in the monoclinic space group C2/c with
      cell parameters a = 31.7556(12) A, b = 14.0087(6) A, c = 22.1557(9) A, beta =
      127.919(1) degrees, Z = 8. The aqueous coordination chemistry of these ligands
      with both the ferric and ferrous redox states of iron has been examined using
      spectroscopic and electrochemical methods, giving log formation constants of
      26.89(3) (beta 110), 31.16(6) (beta 111) for the ferric TREN-Me-3,2-HOPOIAM
      complexes and 33.89(2) (beta 110), 38.45(2) (beta 111) for the ferric TREN-Me-3,2
      HOPOTAM complexes. For the reduced (ferrous) complexes values of 10.03(9) (beta
      110) and 13.7(2) (beta 110) were observed for the Fe[TREN-Me-3,2-HOPOIAM]- and
      Fe[TREN-Me-3,2-HOPOTAM]2- complexes, respectively. These data provide a complete
      description of metal-ligand speciation as a function of pH and of redox activity.
      The ligands described in this work are part of a new class of heteropodate
      ligands which exploit the various chelating properties of several binding units
      within a single tripodal ligand and allow for systematic variation of the
      properties for medical or other applications.

PMID- 11196931
TI  - Synthetic models for the zinc sites in the methionine synthases.
AB  - The syntheses and molecular structures of a series of tetrahedral zinc complexes
      designed to model the active sites in Escherichia coli methionine synthases are
      reported. [PhTttBu]ZnBr (PhTttBu = phenyltris((tert-butylthio)-methyl)borate) was
      prepared and characterized crystallographically to provide entry into [S3]ZnX
      complexes. Metathesis with KSPh yielded the phenylthiolato complex,
      [PhTttBu]Zn(SPh), which represents a structural mimic of the homocysteine ligated
      form of the enzyme. Alternatively, [S2N]ZnX (X = Br, CH3, SPh) species were
      prepared using the new mixed-donor ligands, [Ph(pz)BttBu]
      (phenyl(pyrazolyl)bis((tert-butylthio)methyl)borate) and [Ph(pztBu)BttBu]
      (phenyl(3-tert-butylpyrazolyl)bis((tert- butylthio)methyl)borate). Protonolysis
      of [Ph(pztBu)-BttBu]Zn(CH3) by PhSH in toluene yielded [Ph(pztBu)BttBu]Zn(SPh), a
      synthetic analogue of the homocysteine ligated form of cobalamin-independent
      methionine synthase (Met E). The average Zn-S bond distance in [Ph
      (pztBu)BttBu]Zn(SPh) of 2.37 A compares well with the EXAFS-derived distance of
      2.31 A found in the homocysteine-bound form of Met E.

PMID- 11196932
TI  - Heterogeneous electron-transfer rate constants for M2(O2CR)4(0)/+, where M = Mo,
      W, Ru, or Rh and R = alkyl or aryl.
AB  - By the use of Nicholson's method, the heterogeneous electron-transfer rate
      constants (ks) for the oxidation of a series of M2(O2CR)4 complexes have been
      determined in benzonitrile, where the metal M = Mo, W, Ru, or Rh and R = alkyl or
      aryl. For R = tBu, the values of ks follow the order M = Mo > W > Ru > Rh. No
      simple influence of R on ks was observed, although added ligands that are known
      to reversibly bind to the dinuclear center were shown to influence the E1/2
      values in order of their basicity and to suppress the rate of electron transfer.
      The reported data are compared with those obtained for Cp2Fe0/+, Cp2*Fe0/+, and
      Ru(bpy)2(2)+/3+ and with earlier work on dirhenium multiply bonded compounds.

PMID- 11196933
TI  - Synthesis, structure, and H2O2-dependent catalytic functions of disulfide-bridged
      dicopper(I) and related thioether-copper(I) and thioether-copper(II) complexes.
AB  - A disulfide-bridged dicopper(I) complex, [Cu2(Py2SSPy2)](ClO4)2 (1) (Py2SSPy2 =
      bis(2-[N,N-bis(2-pyridylethyl)-amino]-1,1- dimethylethyl)disulfide), a thioether
      copper(I) complex, [Cu(iPrSPy2)](ClO4) (2) (iPrSPy2 = N-(2-isopropylthio-2
      methyl)propyl-N,N-bis-2-(2-pyridyl)ethylamine, and a thioether-copper(II)
      complex, [Cu-(PheSPy2)(H2O)](ClO4)2 (3) (PheSPy2 = N-(2-methyl-2
      phenethylthio)propyl-N,N-bis-2-(2- pyridyl)ethylamine), were newly synthesized by
      the reactions of Cu(ClO4)2.6H2O with a thiol ligand of Py2SH (N,N-bis[2-(2
      pyridyl)-ethyl]-1,1-dimethyl-2- mercaptoethylamine) and thioether ligands of
      iPrSPy2 and PheSPy2, respectively. For complexes 1 and 2, X-ray analyses were
      performed. Complex 1 crystallizes in the triclinic space group P1, and complex 2
      crystallizes in the orthorhombic space group Pbca with the following unit cell
      parameters: for 1, a = 15.165 (3) A, b = 22.185 (4) A, c = 14.989 (3) A, alpha =
      105.76 (1) degrees, beta = 90.82 (2) degrees, gamma = 75.23 (1) degrees, and Z =
      2; for 2, a = 17.78 (2) A, b = 17.70 (1) A, c = 15.75 (1) A, and Z = 8. Complex 1
      is the first structurally characterized example obtained by the redox reaction
      Cu(II) + RSH-->Cu(I) + RSSR and has two independent structures (1a, 1b) which
      mainly differ in S-S bond distances, Cu(I)...Cu(I) separations, and C-S-S-C
      dihedral angles of the disulfide units. The S-S bond distances of 2.088(7) A in
      1a and 2.070(7) A in 1b are indicative of significant activation of the S-S bonds
      by the dicopper centers. Fragment molecular orbital (FMO) analyses and molecular
      orbital overlap population (MOOP) analyses based on the extended Huckel method
      clarify the preferable formation of the disulfide S-S bond in 1 rather than the
      formation of a thiolate-copper(II) complex within the Py2S- ligand framework.
      Catalytic functions of complexes 1-3 were investigated with peroxides (H2O2 and
      tBuOOH) as oxidants. Complex 1 catalyzed the selective oxidation of cyclohexane
      to cyclohexanol and mediated the cyclohexene epoxidation in the presence of H2O2.
      A transient dark green intermediate observed in the reaction of 1 with H2O2 is
      characterized by UV-vis, EPR, and resonance Raman spectroscopies, identifying it
      as a Cu(II)-OOH species, 1(OOH). The resonance Raman features of the nu(O-O)
      bands at 822 and 836 cm-1, which are red-shifted to 781 and 791 cm-1,
      respectively, upon introduction of H2(18)O2, are indicative of formation of two
      kinds of Cu-OOH species rather than the Fermi doublet and the significant
      weakening of the O-O bonds. These mechanistic studies demonstrate that by virtue
      of the electron-donating ability of the disulfide unit the Cu-OOH species can be
      actually activated for one-electron oxidation, which has been reported so far
      unfavorable for other vibrationally characterized Cu-OOH species.

PMID- 11196934
TI  - Synthesis and crystal structure determination of a new pressure-induced iridium
      ditelluride phase, m-IrTe2, and comparison of the crystal structures and relative
      stabilities of various IrTe2 polymorphs.
AB  - The new monoclinic IrTe2 phase m-IrTe2 was synthesized under pressure, and its
      structure was determined by X-ray powder diffraction. The relative stabilities of
      the three known and three hypothetical IrTe2 polymorphs were discussed on the
      basis of tight binding electronic band structure calculations. m-IrTe2 exhibits
      structural features of both CdI2- and pyrite-type IrTe2 phases and is expected to
      be nearly as stable as that of the CdI2-type IrTe2. The hypothetical IrS2- and
      ramsdellite-type IrTe2 phases are predicted to be more stable than the CdI2-type
      IrTe2.

PMID- 11196935
TI  - Synthesis and characterization of a novel asymmetric ferrocene alkoxycarboxylate
      of titanium, Ti4O2(OiPr)6(eta 5-O2CC5H4)Fe(eta 5-C5H5))6.

PMID- 11196936
TI  - Interaction of [Pt(en)(phen)]2+ and [Pt(en)(phi)]2+ with the hexanucleotide
      d(GTCGAC)2: evidence for minor groove binding.

PMID- 11196937
TI  - Hydrothermal evolution of the thiourea-cerium(III) nitrate system: formation of
      cerium hydroxycarbonate and hydroxysulfate.

PMID- 11196938
TI  - Structural, electronic, and magnetic properties of (Fe[HC(3,5-Me2pz)3]2)(BF4)2
      (pz = pyrazolyl): observation of unusual spin-crossover behavior.

PMID- 11196939
TI  - An isolable, oxygen-coordinated silver(I) complex of dimethyl diazomalonate:
      synthesis and characterization of [HB(3,5-(CF3)2Pz)3]Ag[OC(OCH3)]2CN2 (where Pz =
      pyrazolyl).

PMID- 11196940
TI  - Calixarenes as scaffolds: introduction of tridentate rare earth metal binding
      units into calix[4]arene.
AB  - The reactions of various derivatives of chelidamic acid (4-hydroxypyridine-2,6
      dicarboxylic acid) with p-tert-butylcalix[4]arene have produced several new mono-
      and difunctionalized derivatives of the calixarene in which tridentate functional
      groups suitable for the binding of rare earth metal cations have been
      incorporated. Single-crystal X-ray structure determinations have been performed
      on two difunctionalized calixarenes found to adopt different "cone" and "1,2
      alternate" conformations, as well as on a complex of europium(III) with the
      phenoxide form of a monofunctionalized ligand, this structure confirming that
      charge factors are dominant in determining the site of lanthanide metal binding
      in these ligands.

PMID- 11196941
TI  - Synthesis, structural characterization, and Monte Carlo simulation of the
      magnetic properties of two new alternating MnII azide 2-D honeycombs. Study of
      the ferromagnetic ordered phase below 20 K.
AB  - Reaction of MnII and pyridine derivatives such as 4-methylpyridine (4-Mepy) and 4
      ethylpyridine (4-Etpy) led to the new two-dimensional systems trans-[Mn(4
      Mepy)2(N3)2]n (1) and trans-[Mn(4-Etpy)2(N3)2]n (2). Compound 1 crystallizes in
      the triclinic system, P1 group (a = 9.269(2) A, b = 9.635(3) A, c = 18.860(4) A,
      Z = 4), and compound 2 crystallizes in the monoclinic system, P2(1)/c group (a =
      14.416(3) A, b = 8.515(2) A, c = 15.728(4) A, Z = 4). The two compounds show
      honeycomb structures based on dinuclear Mn-(mu-N3)2-Mn subunits linked to the
      four nearest-neighbor similar subunits by four end-to-end single azido bridges,
      but whereas the subunits of compound 1 show the end-to-end Mn-(mu 1,3-N3)2-Mn
      kind of bridges, compound 2 prefers the end-on Mn-(mu 1,1-N3)2-Mn fragment.
      Magnetically, compound 1 is an alternating 2-D system with two different
      antiferromagnetic interactions, whereas compound 2 corresponds to a two
      dimensional ferro-antiferromagnetic system showing spin canting and permanent
      magnetization below 20 K. The coupling constant parameters J1 = -10.1 cm-1, J2 = 
      4.7 cm-1, and g = 2.019 for 1 and J1 = -5.3 cm-1, J2 = 2.9 cm-1, and g = 2.016
      for 2 have been obtained from calculations using the Monte Carlo method based on
      the Metropolis algorithm.

PMID- 11196942
TI  - Reactions of M(CO)5X (M = Mn, Re; X = Cl, Br) with (Ph2PCH2)3CCH3 (P3) and
      (Ph2P(CH2)2)3P (P3P'): synthetic, spectroscopic, electrochemical, and
      electrospray mass spectrometric studies.
AB  - The reactions of M(CO)5X (M = Mn, Re; X = Cl, Br) with (Ph2PCH2)3CCH3 (P3) and
      (Ph2P(CH2)2)3P (P3P') are investigated, and the products are characterized by IR,
      NMR (31P and 13C), and electrospray mass spectrometric (ESMS) techniques. With
      P3, the major products are fac-M(CO)3(eta 2-P3)X (syn and anti isomers) and
      cis,fac-M(CO)2(eta 3-P3)X, and with P3P', the major product for each metal is
      cis,mer-M(CO)2(eta 3-P3P')X, but cis-[M(CO)2(eta 4-P3P')]X and fac-[Re(CO)3(eta 3
      P3P')]X are also characterized. Addition of MeI to those complexes containing
      pendant phosphine groups produces the corresponding phosphonium cations without
      affecting the remainder of the molecule. On the voltammetric time scale,
      electrochemical oxidation of cis,fac-Mn(CO)2(eta 3-P3)X yields the corresponding
      17e cation cis,fac-[Mn(CO)2(eta 3-P3)X]+, but on the longer time scale of
      exhaustive electrolysis or chemical oxidation, the product is fac-[Mn(CO)3(eta 3
      P3)]+. In contrast, the rhenium cation cis,fac-[Re(CO)2(eta 3-P3)X]+ is stable on
      the synthetic time scale, but upon oxidation of cis,fac-Re(CO)2(eta 3-P3)X with
      NOBF4, the final product is the 18e [Re(CO)(NO)(eta 3-P3)X]+. cis,mer-Mn(CO)2(eta
      3-P3P')X is reversibly oxidized to cis,mer-[Mn(CO)2(eta 3-P3P')X]+ on the
      voltammetric time scale, but on the longer synthetic time scale, the product
      isomerizes to trans-[Mn(CO)2(eta 3-P3P')X]+, which can be reduced to trans
      Mn(CO)2(eta 3-P3P')X. Upon voltammetric oxidation, the corresponding rhenium
      complexes show an initial irreversible response associated with the pendant
      phosphine group prior to the reversible oxidation of the metal on the synthetic
      time scale; spectroscopic data indicate formation of cis,mer-Re(CO)2(eta 3
      P3P'O)X. The complex cis,mer-[Re(CO)2(eta 3-P3P'Me)X]+ shows only the reversible
      metal oxidation response. ESMS data are obtained directly for the methylated
      cationic complexes, and neutral complexes are either oxidized or adducted with
      sodium ions to produce cationic species.

PMID- 11196943
TI  - Main-group-element calix[4]arenes: variable coordination and conformational
      isomerism at phosphorus and silicon.
AB  - Treatment of calix[4]arene (1b) with trichloromethylsilane yields two conformers
      of calix[4]SiMe(OH), the cone 2b-C and the partial cone 2b-PC. These are isolated
      and structurally characterized, and their thermodynamic activation parameters are
      determined in solution [Ea = 117(3) kJ/mol, delta H = 5(4) kJ/mol]. Similar
      parameters are found for the p-tert-butylcalix[4]arene analogues 2a-C and 2a-PC.
      Deprotonation of 2b with butyllithium yields calix[4]SiMe(OLi) (8b). The
      structure of 8b is solvent dependent: 8b contains a five-coordinate silicon in
      THF and a four-coordinate silicon in benzene. Similar behavior is found for the p
      tert-butylcalix[4]arene analogues. The five-coordinate phosphorus analogue of the
      anion in 8, p-tert-butylcalix[4]PMe (11a), is synthesized from the phosphonium
      triflate salt p-tert-butylcalix[4]PMe(OH)OTf (10a(OTf)) via treatment with
      butyllithium. The structure of 11a shows the geometry around phosphorus to be
      very close to a pure trigonal bipyramid. The X-ray structure of 10a(OTf) cannot
      be obtained, but its iodide analogue 10a(T) is synthesized and structurally
      characterized. The cation in 10a(I) adopts the partial cone conformation in the
      solid state, similar to 2b-PC. Treatment of 8b with methyl
      trifluoromethanesulfonate yields the methyl phenyl ether calix[4]SiMe(OMe) (3b).
      This species and its p-tert-butyl analogue 3a are structurally characterized.
      Both adopt the partial cone conformation. The SiMe group in 3b can be removed via
      treatment with fluoride to yield the monomethylated calix[4]arene 4b in 50-60%
      overall yield based on 1b.

PMID- 11196944
TI  - Yttrium calix[4]arene complexes. Silylation and silylamine elimination reactions
      on model oxo surfaces.
AB  - The synthesis and the spectroscopic and structural characterization of lower-rim
      silylated and rare-earth-metalated calix[4]arenes are presented.
      Hexamethyldisilazane, HN(SiMe3)2, reacted in a selective manner with [p-tert
      buttylcalix[4]arene]H4 (1) in refluxing mesitylene to give the 1,3-silylated
      product [p-tert-butylcalix[4]arene(SiMe3)2]H2 (2) in high yield. The molecular
      structure of compound 2, as revealed by X-ray crystallography, shows the pinched
      cone conformation of the calixarene bowl, featuring hydrogen bonding between the
      phenylsilyl ether and phenolic oxygen atoms (O...O, 2.838 A). From the reaction
      of the sterically more crowded tetraphenyldimethyldisilazane, HN(SiMePh2)2, only
      starting material could be recovered. In contrast, tetramethyldisilazane,
      HN(SiHMe2)2, afforded the tetrakis-silylated product [p-tert
      butylcalix[4]arene(SiHMe2)4] (3) in hexane solution at ambient temperature. A
      single-crystal X-ray diffraction study of compound 3 established the 1,2
      alternate conformation, which is also present in solution, as indicated by 1H NMR
      spectroscopy. The yttrium complex Y[N(SiHMe2)2]3(THF)2 (4) exchanged all of its
      silylamide ligands when treated with an equimolar amount of 1 in toluene at
      ambient temperature to yield compound 5, as indicated by IR and NMR spectroscopy.
      The molecular structure of 5 revealed a centrosymmetric dimer of composition [Y(p
      tert-butylcalix[4]arene(SiHMe2)(THF)]2. Three of the deprotonated phenolic oxygen
      atoms of the calixarene bowl bind to the metal center, two as terminal ligands
      and one in a bridging mode, while the fourth undergoes in situ silylation
      (nu(SiH) 2127 cm-1). The distorted-trigonal-bipyramidal coordination geometry is
      completed by a THF molecule. Bis-silylated 2 reacted with 4 to form the
      heteroleptic complex (Y[p-tert-butylcalix[4]arene(SiMe3)2][N(SiHMe2)2]) (6).
      Crystal data: C50H72O4Si2 (2), triclinic, P1, a = 12.8914(3) A, b = 14.9270(5) A,
      c = 15.1652(4) A, alpha = 77.293(2) degrees, beta = 65.019(2) degrees, gamma =
      72.234(2) degrees, Z = 2; C52H80O4Si4 (3), triclinic, P1, a = 10.1774(2) A, b =
      14.1680(2) A, c = 18.7206(2) A, alpha = 95.8195(8) degrees, beta = 95.5294(8)
      degrees, gamma = 98.1098(7) degrees, Z = 2; C100H132O10Si2Y2, 2(C6H6) (5),
      triclinic, P1, a = 13.2625(4) A, b = 14.5894(3) A, c = 17.0458(5) A, alpha =
      65.0986(14) degrees, beta = 77.8786(8) degrees, gamma = 85.5125(13) degrees, Z =
      1.

PMID- 11196945
TI  - Polyhedral members of the Mg2nP2m family derived from dimeric magnesium
      trialkylsilylphosphandiide.
AB  - The magnesiation of tri(tert-butyl)silylphosphane in THF yields tetrameric
      (tetrahydrofuran-O)magnesium tri(tert-butyl)silylphosphandiide 1. The central
      moiety is a slightly distorted Mg4P4 cube with tetracoordinate magnesium and
      phosphorus atoms. The reaction of dibutylmagnesium with H2PSitBu3 in toluene
      gives tetramagnesium tetrakis[mu-tri(tert-butyl)silylphosphanide] bis[mu 4
      tri(tert-butyl)silylphosphandiide] 2. The central fragment is a Mg4P2 octahedron
      with the phosphorus atoms in a trans position. The Mg...Mg edges are bridged by
      the phosphanide substituents. Crystallographic data of 1: C68H148Mg4O5P4Si4,
      monoclinic, P2(1)/c, a = 13.454(1) A, b = 26.123(1) A, c = 24.539(2) A, beta =
      96.53(1) degrees, Z = 4; crystallographic data of 2: C72H166Mg4P6Si6, monoclinic,
      P2(1)/n, a = 13.951(1) A, b = 14.269(1) A, c = 24.209(2) A, beta = 102.415(1)
      degrees, Z = 2.

PMID- 11196946
TI  - Matrix-isolated Al2OF6(2-) ion in molten and solid LiF/NaF/KF.
AB  - A Raman spectrum consistent with that expected from an Al2OF6(2-) ion was
      observed when Na2O was dissolved in a eutectic LiF/NaF/KF (FLINAK) melt at 500
      degrees C, which contained a low concentration of either AlF3 or Na3AlF6.
      Furthermore, it was possible to trap the Al2OF6(2-) ion in the frozen solid and
      to measure its Raman and IR spectra at 25 degrees C. A number of bands have been
      detected; among those, the two most characteristic bands of the Al2OF6(2-) ion at
      494 (polarized) and 265 cm-1 in the FLINAK melt at 500 degrees C, and those at
      509 and 268 (Raman) and approximately 780 to approximately 900 (IR) cm-1 for the
      compound matrix isolated in solid FLINAK at 25 degrees C. In the absence of added
      oxide, the dissolved aluminum fluoride was in the form of the octahedral AlF6(3-)
      ion, which has characteristic Raman bands at 542 and 325 cm-1 in the FLINAK melt
      at 500 degrees C. Whereas alumina, Al2O3, was found to be essentially insoluble
      in FLINAK melts, it was possible to dissolve sufficient amounts of Na2O to
      convert most of the AlF6(3-) to the oxyfluoroaluminate, Al2OF6(2-). These
      solutions appeared to be metastable with respect to formation of insoluble
      alumina at higher temperatures. The present results can be compared to previous
      measurements on alumina dissolved in pure molten cryolite at much higher
      temperatures, where alumina solubility is low and broad bands due to oxide
      species are difficult to detect due to overlap with bands from AlF6(3-) and AlF4
      .

PMID- 11196947
TI  - Crucial role of Cu-S bonding for structural changes accompanying the reversible
      CuI/CuII transition in an unrestrained Cu(N[symbol: see text]S)2 coordination
      arrangement. An experimental and DFT study.
AB  - The structure of reversibly oxidizable [Cu(mmb)2](BF4) with 1-methyl-2
      (methylthiomethyl)-1H-benzimidazole (mmb) as bidentate N,S-donor ligand has been
      determined and compared with that of the copper(II) species [Cu(mmb)2(eta 1
      ClO4)](ClO4). In the complex ions of the equilibrium [CuI(mmb)2](+) + ClO4-
      reversible e- + [CuII(mmb)2-(eta 1-ClO4)]+ the almost linear N-Cu-N backbone is
      invariant whereas the bonds to the thioether sulfur centers and especially the
      changing S-Cu-S angle (145.18(5) degrees for the CuII species, 109.33(3) degrees
      for the CuI form) reflect the metal oxidation state. In contrast to the
      perchlorate coordinating copper(II) species, [CuI(mmb)2](BF4) contains a cation
      with a very large vacant site at the metal center, resulting in elliptical
      channels within the crystal. DFT calculations on [CuI(mb)2]+, [CuII(mb)2]2+, and
      [CuII(mb)2(OClO3)]+ with mb = 2-methylthiomethyl-1H-benzimidazole confirm the
      essential role of the metal-sulfur bonds in responding to the reversible CuI/II
      electron transfer process, even in the absence of electronically stronger
      interacting thiolate sulfur centers or sophisticated oligodentate ligands.

PMID- 11196948
TI  - Organic-inorganic hybrids based on polyoxometalates. 6. Syntheses, structure, and
      reactivity of the bis(tert-butylsilyl)decatungstophosphate [(gamma-PW10O36)(t
      BuSiOH)2]3-.
AB  - Bis(tert-butylsilyl)decatungstophosphate (n-Bu4N)3[(gamma-PW10O36)(t-BuSiOH)2]
      (1) has been synthesized through phase-transfer conditions, by reaction of t
      BuSiCl3 with Cs7[(gamma-PW10O36)].xH2O. This new hybrid anion has been
      characterized by elemental analysis, X-ray crystallography, multinuclear solution
      and solid-state NMR, and infrared spectroscopy. Crystals of 1 are monoclinic,
      space group C2/c, with lattice constants a = 44.762(10) A, b = 19.032(4) A, c =
      22.079(8) A, beta = 98.9(2) degrees, and Z = 8. Anion 1 has nominal Cs symmetry
      and displays an "open structure" with two t-BuSiOH groups anchored to the (gamma
      PW10O36) framework. The two t-BuSiOH units are nonequivalent as confirmed by 29Si
      CP-MAS NMR and by diffuse reflection infrared spectroscopy. The two OH groups are
      linked through one H-bond (dO-O = 2.63 A). According to 29Si and 183W NMR, 1
      adopts a more symmetrical conformation (C2v) in solution. Anion 1 reacts cleanly
      in homogeneous conditions with Me2SiCl2 to yield (n-Bu4N)3[(gamma-PW10O36)(t
      BuSiO)2(SiMe2)] (2). The structure of 2 has been inferred from multinuclear NMR
      and infrared spectroscopy. The hybrid "closed-structure" anion 2 consists of the
      (gamma-PW10O36) framework on which is grafted a heterosilylated network composed
      of a capping fragment, Si(CH3)2, linked to the t-BuSi groups through two siloxane
      bridges.

PMID- 11196949
TI  - Synthesis and structural characterization of Sm(II) and Yb(II) complexes
      containing sterically demanding, chelating secondary phosphide ligands.
AB  - Metathesis between [(Me3Si)2CH)(C6H4-2-OMe)P]K and SmI2(THF)2 in THF yields
      [([Me3Si]2CH)(C6H4-2-OMe)P)2Sm(DME)(THF)] (1), after recrystallization. A similar
      reaction between [(Me3Si)2CH)(C6H3-2-OMe-3-Me)P]K and SmI2(THF)2 yields
      [([Me3Si]2CH)(C6H3-2-OMe-3-Me)P)2Sm(DME)].Et2O (2), while reaction between
      [(Me3Si)2CH)(C6H4-2-CH2NMe2)P]K and either SmI2(THF)2 or YbI2 yields the five
      coordinate complex [([Me3Si]2CH)(C6H4-2-CH2NMe2)P)2Sm(THF)] (3) or the solvent
      free complex [([Me3Si]2CH)(C6H4-2-CH2NMe2)P)2Yb] (4), respectively. X-ray
      crystallography shows that complex 2 adopts a distorted cis octahedral geometry,
      while complex 1 adopts a distorted pentagonal bipyramidal geometry (1, triclinic,
      P1, a = 11.0625(9) A, b = 15.924(6) A, c = 17.2104(14) A, alpha = 72.327(2)
      degrees, beta = 83.934(2) degrees, gamma = 79.556(2) degrees, Z = 2; 2,
      monoclinic, P2(1), a = 13.176(4) A, b = 13.080(4) A, c = 14.546(4) A, beta =
      95.363(6) degrees, Z = 2). Complex 3 crystallizes as monomers with a square
      pyramidal geometry at Sm and exhibits short contacts between Sm and the ipso
      carbon atoms of the ligands (3, monoclinic, C2/c, a = 14.9880(17) A, b =
      13.0528(15) A, c = 24.330(3) A, beta = 104.507(2) degrees, Z = 4). Whereas
      preliminary X-ray crystallographic data for 4 indicate a monomeric structure in
      the solid state, variable-temperature 1H, 13C(1H), 31P(1H), and 171Yb NMR
      spectroscopies suggest that 4 undergoes an unusual dynamic process in solution,
      which is ascribed to a monomer-dimer equilibrium in which exchange of the
      bridging and terminal phosphide groups may be frozen out at low temperature.

PMID- 11196950
TI  - Role of cyclometalation in controlling the rates of ligand substitution at
      platinum(II) complexes.
AB  - The rates of chloride for triphenylphosphine substitution have been measured in
      dichloromethane for a series of cyclometalated [Pt(N-N-C)Cl] complexes containing
      a number of terdentate N-N-C anionic ligands, derived from deprotonated alkyl-,
      phenyl-, and benzyl-6-substituted 2,2'-bipyridines. These rates have been
      compared with those of the corresponding [Pt(N-N)(C)Cl] (N-N = 2,2'-bipyridine; C
      = CH3 or C6H5) complexes having the same set of donor atoms but less constrained
      arrangements of the ligands. The reactions of the cyclometalated compounds occur
      as a single-stage conversion from the substrate to the ionic pair [Pt(N-N
      C)(PPh3)]Cl products. There is no evidence by 1H and 31P(1H) NMR spectroscopy for
      the formation of other Pt(II) species or of concurrent ring-opening processes. In
      contrast, in the monoalkyl- or monoaryl-2,2'-bipyridine complexes, chloride
      substitution is followed by subsequent slower processes which involve the
      detachment of one arm of the chelated 2,2'-bipyridine, fast cis to trans
      isomerization of the cis-[Pt(PPh3)2(eta 1-bipy)(R)]+ transient intermediate, and,
      eventually, the release of free bipy, yielding trans-[Pt(PPh3)2(R)Cl] (R = Me or
      Ph). All reactions are first-order with respect to complex and phosphine
      concentration, obeying the simple rate law kobsd = k2[PPh3]. The values of the
      second-order rate constant k2 do not seem particularly sensitive to the nature of
      the bonded organic moiety (alkyl or aryl), to its structure (cyclometalated or
      not), to the size of the ring, or to the number of alkyl substituents on it. The
      effects are those foreseen on the basis of an associative mode of activation. The
      only exception to this pattern of behavior is constituted by the complex [Pt(bipy
      phi-H)Cl] (bipy phi = 6-phenyl-2,2'-bipyridine), which features a significant
      rate enhancement with respect to the analogue [Pt(bipy)(Ph)Cl] complex. The
      results of this work, together with those of a previous paper, suggest that there
      is not a specific role of cyclometalation in controlling the reactivity, unless
      an in-plane aryl ring becomes part of the pi-acceptor system of the chelated 2,2
      bipyridine, behaving as a cyclometalated analogue of the nitrogen terdentate
      2,2':6',2"-terpyridine.

PMID- 11196951
TI  - Covalent metal-organic networks: pyridines induce 2-dimensional oligomerization
      of (mu-OC6H4O)2Mpy2 (M = Ti, V, Zr).
AB  - Treatment of M(OiPr)4 (M = Ti, V) and [Zr(OEt)4]4 with excess 1,4-HOC6H4OH in THF
      afforded [M(OC6H4O)a(OC6H4OH)3.34-1.83a(OiPr)0.66-0.17a(THF)0.2]n (M = Ti, 1-Ti;
      V, 1-V, 0.91 < or = a < or = 1.82) and [Zr(1,4-OC6H4O)2-x(OEt)2x]n (1-Zr, x =
      0.9). The combination of of 1-M (M = Ti, V, Zr) or M(OiPr)4 (M = Ti, V), excess
      1,4- or 1,3-HOC6H4OH, and pyridine or 4-phenylpyridine at 100 degrees C for 1 d
      to 2 weeks afforded various 2-dimensional covalent metal-organic networks: [cis
      M(mu 1,4-OC6H4O)2py2] infinity (2-M, M = Ti, Zr), [trans-M(mu 1,4-OC6H4O)2py2.py]
      infinity (3-M, M = Ti, V), solid solutions [trans-TixV1-x(mu 1,4-OC6H4O)2py2.py]
      infinity (3-TixV1-x, x approximately 0.4, 0.6, 0.9), [trans-M(mu 1,4-OC6H4O)2(4
      Ph-py)2] infinity (4-M, M = Ti, V), [trans-Ti(mu 1,3-OC6H4O)2py2] infinity (5
      Ti), and [trans-Ti(mu 1,3-OC6H4O)2(4-Ph-py)2] infinity (6-Ti). Single-crystal X
      ray diffraction experiments confirmed the pleated sheet structure of 2-Ti, the
      flat sheet structure of 3-Ti, and the rippled sheet structures of 4-Ti, 5-Ti, and
      6-Ti. Through protolytic quenching studies and by correspondence of powder XRD
      patterns with known titanium species, the remaining complexes were structurally
      assigned. With py or 4-Ph-py present, aggregation of titanium centers is
      disrupted, relegating the building block to the cis- or trans-(ArO)4Tipy2 core.
      The sheet structure types are determined by the size of the metal and the
      interpenetration of the layers, which occurs primarily through the pyridine
      residues and inhibits intercalation chemistry.

PMID- 11196952
TI  - Crystal structure of (difluoro)methoxyoxo iodine(V) IF2(O)OCH3.
AB  - (Difluoro)methoxyoxo iodine(V) (IF2(O)OCH3), the methyl ester of the unknown
      difluoro iodic acid (IF2(O)OH), was obtained by the reaction of methoxytrimethyl
      silane with iodine pentafluoride. IF2(O)OCH3 crystallizes orthorhombic in the
      space group Pbca with a = 7.605(1) A, b = 7.360(1) A, c = 15.017(1) A, and eight
      formula units per unit cell. The final R indices [I > 2 sigma(I)] are R1 = 0.0264
      and wR2 = 0.0516. Additionally, IF2(O)OCH3 was characterized by its vibrational
      spectra and quantum mechanical calculations were performed.

PMID- 11196953
TI  - Kinetic origin of the chelate effect. Base hydrolysis, H-exchange reactivity, and
      structures of syn,anti-[Co(cyclen)(NH3)2]3+ and syn,anti-[Co(cyclen)(diamine)]3+
      ions (diamine = H2N(CH2)2NH2, H2N(CH2)3NH2).
AB  - The synthesis of syn,anti-[Co(cyclen)en](ClO4)3 (1(ClO4)3) and syn,anti
      [Co(cyclen)tn](ClO4)3 (2(ClO4)3) is reported, as are single-crystal X-ray
      structures for syn,anti-[Co(cyclen)(NH3)2](ClO4)3 (3(ClO4)3). 3(ClO4)3:
      orthorhombic, Pnma, a = 17.805(4) A, b = 12.123(3) A, c = 9.493(2) A, alpha =
      beta = gamma = 90 degrees, Z = 4, R1 = 0.030. 1(ClO4)3: monoclinic, P2(1)/n, a =
      8.892(2) A, b = 15.285(3) A, c = 15.466(3) A, alpha = 90 degrees, beta = 91.05(3)
      degrees, gamma = 90 degrees, Z = 4, R1 = 0.0657. 2Br3: orthorhombic, Pca2(1) a =
      14.170(4) A, b = 10.623(3) A, c = 12.362(4) A, alpha = beta = gamma = 90 degrees,
      Z = 4, R1 = 0.0289. Rate constants for H/D exchange (D2O, I = 1.0 M, NaClO4, 25
      degrees C) of the syn and anti NH protons (rate law: kobs = ko + kH[OD-]) and the
      apical NH, and the NH3 and NH2 protons (rate law: kobs = kH[OD-]) in the 1, 2,
      and 3 cations are reported. Deprotonation constants (K = [Co(cyclen
      H)(diamine)2+]/[Co(cyclen)(diamine)3+][OH-]) were determined for 1 (5.5 +/- 0.5 M
      1) and 2 (28 +/- 3 M-1). In alkaline solution 1, 2, and 3 hydrolyze to
      [Co(cyclen)(OH)2]+ via [Co(cyclen)(amine)OH)]2+ monodentates. Hydrolysis of 3 is
      two step: kobs(1) = kOH(1)[OH-], kobs(2) = ko + kOH(2)[OH-] (kOH(1) = (2.2 +/-
      0.4) x 10(4) M-1 s-1, ko = (5.1 +/- 1.2) x 10(-4) s-1, kOH(2) = 1.0 +/- 0.1 M-1 s
      1). Hydrolysis of 2 is biphasic: kobs(1) = k1K[OH-]/(1 + K[OH-] (k1 = 5.0 +/- 0.2
      s-1, K = 28 M-1), kobs(2) = k2K2[OH-]/(1 + K2[OH-]) (k2 = 3.5 +/- 1.2 s-1, K2 =
      1.2 +/- 0.8 M-1). Hydrolysis of 1 is monophasic: kobs = k1k2KK2[OH-]2/(1 + K[OH
      1])(k-1 + k2K2[OH-]) (k1 = 0.035 +/- 0.004 s-1, k-1 = 2.9 +/- 0.6 s-1, K = 5.5 M
      1, k2K2 = 4.0 M-1 s-1). The much slower rate of chelate ring-opening in 1,
      compared to loss of NH3 from 3, is rationalized in terms of a reduced ability of
      the former system to allow the bond angle expansion required to produce the SN1CB
      trigonal bipyramidal intermediate.

PMID- 11196954
TI  - Structure and bonding of transition metal-boryl compounds. Theoretical study of
      [(PH3)2(CO)ClOs-BR2] and [(PH3)2(CO)2ClOs-BR2] (BR2 = BH2, BF2, B(OH)2,
      B(OCH=CHO), Bcat).
AB  - Quantum chemical DFT calculations using the B3LYP functionals have been carried
      out for the electronically unsaturated 16 VE five-coordinate osmium boryl
      complexes [(PH3)2(CO)ClOs-BR2] and the 18 VE six-coordinate complexes
      [(PH3)2(CO)2ClOs-BR2] with BR2 = BH2, BF2, B(OH)2, B(OHC=CHO), and Bcat (cat =
      catecholate O2C6H4). The bonding situation of the Os-BR2 bond was analyzed with
      the help of the NBO partitioning scheme. The Os-B bond dissociation energies of
      the 16 VE complexes are very high, and they do not change very much for the
      different boryl ligands. The 18 VE complexes have only slightly lower bond
      energies than the 16 VE species. The Os-B bond in both classes of compounds is
      provided by a covalent sigma-bond which is polarized toward osmium and by strong
      charge attraction. Os-->B pi-donation is not important for the Os-B binding
      interactions, except for the Os-BH2 complexes. The stability of the boryl
      complexes [Os]-BR2 comes mainly from B<--R pi-donation, which is clearly higher
      than the Os-->B pi-donation. The intraligand charge distribution of the BR2 group
      changes little when the Os-B bond is formed, except for BH2. The CO ligand in
      [(PH3)2(CO)2ClOs-BR2] which is trans to BR2 has a relatively weak bond to the
      osmium atom.

PMID- 11196955
TI  - Experimental and theoretical studies of the d8-d10 interaction between Pd(II) and
      Au(I): bis(chloro[(phenylthiomethyl)diphenylphosphine]gold(I))-
      dichloropalladium(II) and related systems.
AB  - The reaction between thioether phosphine gold(I) precursors such as
      [AuCl(Ph2PCH2SPh)], 1, or [Au(Ph2PCH2SPh)2]CF3SO3 and PdCl2(NCPh)2 affords the
      new compounds [(AuCl(Ph2PCH2SPh)2PdCl2], 2, and [AuPdCl2(Ph2PCH2SPh)2]CF3SO3, 3.
      The crystal structure of complex 2 has the sterically unhindered Pd(II) and Au(I)
      at a distance of 314 pm. Quasirelativistic pseudopotential calculations on
      [AuPdCl3(PH2CH2SH)(SH2)] models give short Au-Pd distances at the second-order
      Moller-Plesset (MP2) level and long Au-Pd distances at Hartree-Fock (HF) level. A
      detailed analysis of the Au-Pd interaction shows dominant dispersion, some ionic
      contributions, and no net charge transfer between the metals.

PMID- 11196956
TI  - Structural characterization and formation mechanism of sitting-atop (SAT)
      complexes of 5,10,15,20-tetraphenylporphyrin with divalent metal ions. Structure
      of the Cu(II)-SAT complex as determined by fluorescent extended X-ray absorption
      fine structure.
AB  - The UV-vis absorption spectra and the formation kinetics of sitting-atop (SAT)
      complexes (M(H2tpp)2+) of 5,10,15,20-tetraphenylporphyrin (H2tpp) with a series
      of divalent metal ions (M2+ = Mn2+, Fe2+, Co2+, Ni2+, Cu2+, and Zn2+) in
      acetonitrile have been investigated. The structural characteristics of the SAT
      complexes for a series of M2+ ions are discussed on the basis of the UV-vis
      absorption spectra. The structure parameters around Cu2+ in the Cu(II)-SAT
      complex were determined by a fluorescent EXAFS method: the coordination number is
      6 with three kinds of Cu-N interactions having bond lengths of 2.05, 1.98, and
      2.32 A for pyrrolenine nitrogens of H2tpp, acetonitrile nitrogens at equatorial
      sites, and acetonitrile nitrogens at axial sites, respectively. The rate
      constants at 25 degrees C for the formation of the SAT complex in acetonitrile
      are as follows: kf/mol-1 kg s-1 = 3.4 x 10(2) for Mn2+, 0.18 for Co2+, 1.6 x 10(
      3) for Ni2+, and 61 for Zn2+. The finding that the variation trends in the rate
      constants for a series of M2+ ions for the SAT complex formation and the solvent
      exchange reaction in various solvents are very similar indicates that the rate
      determining step for the SAT complex formation is the interchange between the
      coordinating nitrogen of a bound acetonitrile and the pyrrolenine nitrogen of
      H2tpp. The fact that the values of kf are smaller by 4-6 orders of magnitude in
      comparison with those of the solvent exchange suggests that there is a large
      energetic loss due to the fast preequilibria prior to the rate-determining step,
      such as deformation of a porphyrin ring and outer-sphere encounter formation due
      to an electrostatic interaction between M2+ and the local negative charge on the
      pyrrolenine nitrogens. We observed the subsequent formation of the corresponding
      metalloporphyrins by deprotonation of the SAT complex and oxidation of the M2+
      center, of which the dynamic behavior was significantly different for the
      different M2+ ions.

PMID- 11196957
TI  - Ion-pair interactions of lanthanide(III) complexes in aqueous solutions.
AB  - The formation of ion-pair adducts between the cationic complex La(THP)3+ (THP =
      1,4,7,10-tetrakis(2-hydroxypropyl)-1,4,7,10-tetraazacyclododecane) and the
      anionic complexes Tm(DOTA)- (DOTA = 1,4,7,10-tetraazacyclododecane-N,N',N",N"'
      tetraacetate), Tm(DTPA)2- (DTPA = diethylenetriamine-N,N,N',N",N"-pentaacetate),
      Tm(TTHA)3- (TTHA = triethylenetetraamine-N,N,N',N",N"',N"'-hexaacetate), and
      Tm(DOTP)5- (DOTP = 1,4,7,10-tetraazacyclododecane-N,N',N",N"'
      tetrakis(methylenephosphonate)) is examined by 13C NMR spectroscopy. The induced
      13C shifts of the La(THP)3+ complex are followed by titration of the Tm(III)
      complexes of DOTA, DTPA, and TTHA at pH 7. From these data, the stability
      constants are calculated to be beta 1 = 64 M-1 (1:1), beta 1 = 296 M-1 (1:1), and
      beta 2 = 26,000 M-2 (2:1) for the ion pairs of La(THP)3+, with Tm(DOTA)-,
      Tm(DTPA)2-, and Tm(TTHA)3-, respectively. The La(THP)3+,Tm(DOTP)5- system elicits
      chiral resolution of the rapidly interconverting Tm(DOTP)5- isomers.

PMID- 11196958
TI  - Kinetics and mechanism of oxygen transfer to methyloxo(dithiolato)rhenium(V)
      complexes.
AB  - The kinetics and mechanism of the reactions of the dimeric and monomeric
      methyloxo(dithiolato)rhenium(V) complexes [(o-SC6H4CH2S)Re(O)CH3]2 and [(o
      SC6H4CH2S)PyRe(O)CH3] (Py = pyridine) with XO, sulfoxides, and pyridine N-oxides
      are studied. In these reactions, an oxygen atom from XO is transferred to
      rhenium, from which it later removed. A reaction scheme is proposed to interpret
      the kinetic data. This scheme features the formation of a monomeric (sulfoxide)-
      or (pyridine N-oxide)(dithiolato)methyloxorhenium(V) complex followed by its
      bimolecular oxidation in a rate-controlling step. Several sulfoxides (methyl,
      methyl phenyl, and substituted diphenyl) all react at similar rates. Activation
      parameters are determined for dimethyl sulfoxide and di-4-tolyl sulfoxide from
      temperature-dependent studies. The reactions with pyridine N-oxides show
      autocatalysis in which the catalyst is confirmed to be pyridine formed in the
      reactions.

PMID- 11196959
TI  - Preparation and properties of cyclopentadienyl- and pentamethylcyclopentadienyl
      titanium(IV) complexes with the C8H4S8 ligand, electrical conductivities of their
      oxidized species, and X-ray crystal structure of Ti(C5Me5)2(C8H4S8).
AB  - Ti(C5H5)2(C8H4S8) (1), Ti(C5Me5)2(C8H4S8) (2), [NMe4][Ti(C5H5)(C8H4S8)2] (3), and
      [NMe4][Ti(C5Me5)(C8H4S8)2] (4) [C8H4S8(2-) = 2-(4,5-ethylenedithio)-1,3-dithiole
      2-ylidene)-1,3-dithiole-4,5- dithiolate(2-)] were prepared by reaction of
      Ti(C5H5)2Cl2, Ti(C5Me5)2Cl2, Ti(C5H5)Cl3, or Ti(C5Me5)Cl3 with Li2C8H4S8 or
      [NMe4]2[C8H4S8] in THF. They were oxidized by iodine, the ferrocenium cation, or
      TCNQ (7,7,8,8-tetracyano-p-quinodimethane) in CH2Cl2 or in acetone to afford one
      electron-oxidized and over-one-electron-oxidized species, [Ti(C5H5)2(C8H4S8)].I3,
      [Ti(C5H5)2(C8H4S8)][PF6], [Ti(C5Me5)2(C8H4S8)].I3, [Ti(C5Me5)2(C8H4S8)][PF6],
      [Ti(C5H5)(C8H4S8)2].I0.9, [Ti(C5H5)(C8H4S8)2][TCNQ]0.3,
      [Ti(C5Me5)(C8H4S8)2].I2.4, and [Ti(C5Me5)(C8H4S8)2][TCNQ]0.3, with the C8H4S8
      ligand-centered oxidation. They exhibited electrical conductivities of 1.6 x 10(
      1) to 7.6 x 10(-4) S cm-1 measured for compacted pellets at room temperature. The
      crystal structure of 2 was clarified to consist of isolated dimerized units of
      the molecules through some sulfur-sulfur nonbonded contacts: monoclinic, P2(1)/c,
      a = 9.534(2) A, b = 18.227(2) A, c = 17.775(2) A, beta = 94.39(1) degrees, Z = 4.

PMID- 11196960
TI  - Unprecedented stabilization of cobalt(II) in a tetrahedral S2O2 environment: the
      use of a redox-noninnocent ligand.
AB  - The reaction of Zn(II) and Co(II) with thiosalicylic acid, o-HSC6H4COOH, and its
      methyl ester has led to the following complexes: [Zn(SC6H4COO)] (1),
      (NEt4)Na[Zn(SC6H4COO)2].H2O (2), (NEt4)2Na[Co(SC6H4COO)3].2H2O (3),
      (NEt4)3Na3[(Co(SC6H4COO)3)2].6MeOH (4), [Zn(SC6H4COOMe)2] (5), and
      [Co(SC6H4COOMe)n], n = 2 (6), 3 (7). These ligands have not allowed stabilization
      of Co(II) in a sulfur-oxygen coordination environment. The structures of
      complexes 2-4 and 7 have been determined crystallographically. Those of 2-4 show
      significant similarities such as the behavior of the -SC6H4COO- anion as
      chelating ligand and the involvement of sodium ions as a structural element.
      Thus, the structure of the [Na(Zn(SC6H4COO)2)(H2O)]- anion in complex 2 can be
      described as infinite chains of consecutive [Zn(SC6H4COO)2]2- metalloligands
      linked by [Na(H2O)]+ centers, that of the [Na(Co(SC6H4COO)3(H2O)2)]2(4-) anion in
      3 as a centrosymmetric tetranuclear Co2Na2 dimer with a (CoIII(S[symbol: see
      text]O)3)Na(mu-H2O)2Na(CoIII(S[symbol: see text]O)3) core, and that of the
      pentanuclear [Na3(Co(SC6H4COO)3)2(MeOH)6]3- anion in 4 as two dinuclear
      [(CoIII(S[symbol: see text]O)3)Na(MeOH)3] fragments linked to a central sodium
      ion, which appears to be the first structurally characterized example of a NaS6
      site. The use of the o-HSC6H4COOMe ligand allowed the synthesis of
      [Co(SC6H4COOMe)2] (6) but not its full structural characterization. Instead,
      [Co(SC6H4COOMe)3] (7) was obtained and structurally characterized. It consists of
      mononuclear molecules containing an octahedral CoIIIS3O3 core. The selection of
      2,2-diphenyl-2-mercaptoacetic acid as ligand with reductive properties has
      afforded the first mononuclear complex containing a CoIIS2O2 core and thus an
      unprecedented model for Co(II)-substituted metalloproteins containing tetrahedral
      MS2O2 active sites. The synthesis and full structural characterization of the
      isostructural complexes (NEt4)2[Zn(Ph2C(S)COO)2] (8) and (NEt4)2[Co(Ph2C(S)COO)2]
      (9) show that they consist of discrete [M(Ph2C(S)COO)2]2- anions, with a
      distorted tetrahedral coordination about the metal. In addition, the stability
      conferred by the ligand on the CoIIS2O2 core has allowed its characterization in
      solution by paramagnetic 1D and 2D 1H NMR studies. The longitudinal relaxation
      times of the hyperfine-shifted resonances and NOESY spectra have led to the
      assignment of all resonances of the cobalt complex and confirmed that it
      maintains its tetrahedral geometry in solution. Magnetic measurements (2-300 K)
      for complex 9 and 9.2H2O are in good agreement with distorted tetrahedral and
      octahedral environments, respectively.

PMID- 11196961
TI  - ((Fluoroformyl)imido)(trifluoromethyl)sulfur fluoride, FC(O)N = S(F)CF3:
      unexpected conformational properties.
AB  - The geometric structure and conformational properties of
      ((fluoroformyl)imido)(trifluoromethyl)sulfur fluoride, FC(O)N = S(F)CF3, are
      investigated by gas electron diffraction (GED) experiments, IR (gas)
      spectroscopy, and quantum chemical calculations (HF, MP2, and B3LYP with 6-31G*
      basis sets). The GED intensities are reproduced best with a mixture of 79(12)%
      trans-syn and 21(12)% cis-syn conformers. "Trans/cis" describes the orientation
      around the S=N double bond (FC(O) group relative to sulfur substituents), and
      "syn" refers to the orientation of the C=O bond relative to the S=N bond. From
      the intensities of the C=O bands in the IR (gas) spectrum, a composition of
      86(8)%:14(8)% is derived. These ratios correspond to delta G0(GED) = 0.79(36) and
      delta G0(IR) = 1.09(35) kcal mol-1. The preference of a trans structure, around
      the S=N double bond is unexpected, since all imidosulfur compounds studied thus
      far possess a cis configuration. The conformational properties are reproduced
      qualitatively correctly by all theoretical calculations. The predicted energy
      differences delta E(HF) = 2.41, delta E(MP2) = 0.64, and delta E(B3LYP) = 0.28
      kcal mol-1 are larger or slightly smaller than the experimental values.
      Additional theoretical calculations (B3LYP) for several imidosulfur compounds
      reveal that only FC(O)N=S(F)CF3, with mixed substitution at sulfur and the FC(O)
      group bonded to nitrogen, prefers the trans structure.

PMID- 11196962
TI  - Reaction of (carbonylimido)sulfur(IV) derivatives with TAS-fluoride,
      (Me2N)3S+Me3SiF2-.
AB  - In the reaction of TAS-fluoride, (Me2N)3S+Me3SiF2-, with carbonyl sulfur
      difluoride imides RC(O)NSF2 (R = F, CF3), C-N bond, cleavage is observed, and
      TAS+RC(O)F2- and NSF are the final products. From TASF and RC(O)NS(CF3)F, the
      salts TAS+RC(O)NS(CF3)F2- (R = F (14), CF3 (15)), with psi-pentacoordinate sulfur
      centers in the anions, are formed. An X-ray structure investigation of 14 shows
      that the fluorine atoms occupy axial positions and CF3, NC(O)F, and the sulfur
      lone pair occupy equatorial positions of the trigonal bipyramid. The -C(O)F group
      lies in the equatorial plane with the CO bond synperiplanar to the SN bond.
      According to B3LYP calculations, this structure corresponds to a global minimum
      and the expected axial orientation of the -C(O)F group represents a transition
      state. Calculations for the unstable FC(O)NSF3- anion show a different geometry.
      The -C(O)F group deviates 40 degrees from axial orientation, and the equatorially
      bonded fluorine is, in contrast to the -CF3 group in 14, syn positioned.

PMID- 11196963
TI  - Formation of mono-, bi-, tri-, and tetranuclear Ag(I) complexes of C3-symmetric
      tripodal benzimidazole ligands.
AB  - The C3-symmetric tripodal ligand tris(2-benzimidazolylmethyl)amine (ntb) and its
      alkyl-substituted derivatives tris(N-R-benzimidazol-2-ylmethyl)amine (R = methyl,
      Mentb; R = ethyl, Etntb; R = propyl, Prntb) react with various silver(I) salts to
      afford mononuclear [Ag(Prntb)(CF3SO3)].0.25H2O, 1, binuclear
      [Ag2(Mentb)2](CF3SO3)2.H2O, 2, trinuclear [Ag3(Etntb)2](ClO4)3.CH3OH, 3, and
      tetranuclear [Ag4(ntb)2(CH3CN)2(CF3CO2)2](CF3CO2)2.2H2O, 4. All four complexes
      have been characterized by elemental analyses, IR spectroscopy, and X-ray
      crystallography. The Ag(I) ion in 1 is coordinated to the three imine nitrogen
      atoms of the Prntb ligand and one oxygen atom of the trifluoromethanesulfonate
      anion in a distorted tetrahedral environment. Dinuclear 2 has C2 symmetry with
      each Ag(I) atom trigonally coordinated by two arms of one Mentb and one arm of
      another. Trinuclear 3 has C3 symmetry with a Ag3 regular triangle sandwiched
      between a pair of Etntb ligands such that one arm of each ligand is involved in
      linear coordination about an Ag(I) atom. In the tetranuclear complex 4, two
      linearly coordinated Ag(I) atoms lying on the molecular C2 axis are bridged by a
      pair of ntb ligands and the remaining pendant arm of each ntb ligand is attached
      to another Ag(I) atom whose tetrahedral coordination sphere is completed by an
      acetonitrile molecule and a chelating trifluoroacetate anion. Complexes 2 and 3
      may be regarded as an aggregation of two tridentate ligands by a silver dimer and
      a trinuclear cluster with weak Ag...Ag interactions, respectively, while in 4 the
      aggregation of two tripodal ligands by four Ag(I) ions affords a multicomponent
      internal cavity. The packing modes of complexes 1-3 are dominated by weak
      supramolecular pi...pi and CH...pi interactions. Hexagonal or square channels are
      generated in 1 and 2, and a honeycomb layer structure is formed in 3 with solvate
      molecules and counteranions occupying the voids. The crystal structure of 4
      consists of a three-dimensional network consolidated by NH...O and OH...O
      hydrogen bonds.

PMID- 11196964
TI  - Structure and photochemistry of dicyanocobalt(III) tetraphenylporphyrin.
      Photochromic reaction caused by photodissociation of axial ligand.
AB  - Chlorocobalt(III) tetraphenylporphyrin, (Cl)CoIIITPP, reacts with potassium
      cyanide in dichloromethane or benzene containing 18-crown-6 to give a green
      solution of [crown-K+][(CN)2CoIIITPP-]. The molecular structure of [crown
      K+][(CN)2CoIIITPP-] is identified by X-ray crystallography. In methanol,
      (Cl)CoIIITPP plus KCN also gives a green solution of [(CN)2CoIIITPP-]. The green
      methanol solution containing 1.4 x 10(-4) M KCN turns orange by continuous
      photolysis with a 250-W mercury lamp for 5 min. The orange solution returns to
      green when it is kept in the dark for 5 min. The kinetic study suggests that
      [(CN)2CoIIITPP-] dissociates CN- by continuous photolysis, giving rise to the
      formation of the orange species, (CH3OH)(CN)CoIIITPP. The photoproduct,
      (CH3OH)(CN)CoIIITPP, regenerates the green species, [(CN)2CoIIITPP-], by reaction
      with CN-. The laser photolysis study of [(CN)2CoIIITPP-] in methanol demonstrates
      that photodissociation of CN- takes place within 20 ns after the 355-nm laser
      pulse, resulting in the formation of two transients, I (short-lived) and II (long
      lived). The absorption spectra of both transients are similar to that of
      (CH3OH)(CN)CoIIITPP. These transients eventually return to [(CN)2CoIIITPP-]. The
      decay of species I follows first-order kinetics with a rate constant k. = 2 x
      10(6) s-1, independent of the concentration of KCN. Species II is identified as
      (CH3OH)(CN)CoIIITPP, which is observed with the continuous photolysis of the
      solution. The laser photolysis of [crown-K+][(CN)2COIIITPP-] in dichloromethane
      gives the transient species, which goes back to the original complex according to
      first-order kinetics with a rate constant k = 5 x 10(6) s-1. [crown
      K+][(CN)2CoIIITPP-] is concluded to photodissociate the axial CN- to form [crown
      K+CN-][(CN)CoIIITPP] in which an oxygen atom of the crown moiety in [crown-K+CN-]
      is coordinated to the cobalt(III) atom of [(CN)CoIIITPP] at the axial position.
      The intracomplex reverse reaction of [crown-K+CN-][(CN)CoIIITPP] leads to the
      regeneration of [crown-K+][(CN)2CoIIITPP-]. The structure and the reaction of the
      transient species I observed for [(CN)2CoIIITPP-] in methanol are discussed on
      the basis of the laser photolysis studies of [crown-K+][(CN)2CoIIITPP-] in
      dichloromethane.

PMID- 11196965
TI  - Coordination of lanthanide triflates and perchlorates with N,N,N',N'
      tetramethylsuccinamide.
AB  - Compounds formed from the reaction of N,N,N',N'-tetramethylsuccinamide (TMSA)
      with trivalent lanthanide salts possessing the poorly coordinating counteranions
      triflate (CF3SO3-) and perchlorate (ClO4-) have been prepared and examined.
      Structural features of these Ln-TMSA compounds have been studied in the solid
      phase by thermogravimetric analysis, infrared spectroscopy, and, in selected
      cases, by single-crystal X-ray diffraction and in solution by infrared
      spectroscopy. Eight-coordinate compounds, [Ln(TMSA)4]3+, derived from
      coordination of four succinamide ligands to the metal ion could be formed with
      all lanthanides examined (Ln = La, Pr, Nd, Eu, Yb, Lu). Structural analyses by
      single-crystal X-ray diffraction were performed for the lanthanide triflate salts
      Ln(C8H16N2O2)4(CF3SO3)3: Ln = La, compound 1, monoclinic, P2(1)/n, a = 11.0952(2)
      A, b = 19.2672(2) A, c = 24.9759(3) A, beta = 90.637(1) degrees, Z = 4, Dcalcd =
      1.586 g cm-3; Ln = Nd, compound 2, monoclinic, C2/c, a = 24.6586(10) A, b =
      19.3078(7) A, c = 11.1429(4) A, beta = 90.450(1) degrees, Z = 4, Dcalcd = 1.603 g
      cm-3; Ln = Eu, compound 3, monoclinic, C2/c, a = 24.4934(2) A, b = 19.3702(1) A,
      c = 11.1542(1) A, beta = 90.229(1) degrees, Z = 4, Dcalcd = 1.617 g cm-3; Ln =
      Lu, compound 5, monoclinic, C2/c, a = 24.2435(4) A, b = 19.6141(2) A, c =
      11.2635(1) A, beta = 90.049(1) degrees, Z = 4, Dcalcd = 1.626 g cm-3. X-ray
      analysis was also carried out for the perchlorate salt: Ln = Eu, compound 4,
      triclinic, P1, a = 10.9611(2) A, b = 14.6144(3) A, c = 15.7992(2) A, alpha =
      106.594(1) degrees, beta = 91.538(1) degrees, gamma = 90.311(1) degrees, Z = 2,
      Dcalcd = 1.561 g cm-3. In the presence of significant amounts of water, 7
      coordinate compounds with mixed aquo-TMSA cation structures [Ln(TMSA)3(H2O)]3+
      (Ln = Yb) and [Ln(TMSA)2(H2O)3]3+ (Ln = La, Pr, Nd, Eu, Yb) have been isolated
      with structural determinations by single-crystal X-ray diffraction obtained for
      the following species: Yb(C8H16N2O2)3(H2O)(CF3SO3)3, compound 6, monoclinic,
      P2(1)/n, a = 8.9443(3) A, b = 11.1924(4) A, c = 44.2517(13) A, beta = 93.264(1)
      degrees, Z = 4, Dcalcd = 1.735 g cm-3; Yb(C8H16N2O2)3(H2O)(ClO4)3, compound 7,
      monoclinic, Cc, a = 19.2312(6) A, b = 11.1552(3) A, c = 19.8016(4) A, beta =
      111.4260(1) degrees, Z = 4, Dcalcd = 1.690 g cm-3; Yb(C8H16N2O2)2(H2O)3(CF3SO3)3,
      compound 8, triclinic, P1, a = 8.6719(1) A, b = 12.2683(2) A, c = 19.8094(3) A,
      alpha = 75.815(1) degrees, beta = 86.805(1) degrees, gamma = 72.607(1) degrees, Z
      = 2, Dcalcd = 1.736 g cm-3. Unlike in the analogous nitrate salts, only bidentate
      binding of the succinamide ligand to the lanthanide metal is observed. IR
      spectroscopy studies in anhydrous acetonitrile suggest that the solid-state
      structures of these Ln-TMSA compounds are maintained in solution.

PMID- 11196966
TI  - Key factors determining the course of methyl iodide oxidative addition to
      diamidonaphthalene-bridged diiridium(I) and dirhodium(I) complexes.
AB  - The course of methyl iodide oxidative addition to various nucleophilic complexes,
      [Ir2(mu-1,8-(NH)2naphth)(CO)2(PiPr3)2] (1), [IrRh(mu-1,8
      (NH)2naphth)(CO)2(PiPr3)2] (2), and [Rh2(mu-1,8-(NH)2naphth)(CO)2(PR3)2] (R =
      iPr, 3; Ph, 4; p-tolyl, 5; Me, 6), has been investigated. The CH3I addition to
      complex 1 readily affords the diiridium(II) complex [Ir2(mu-1,8
      (NH)2naphth)I(CH3)(CO)2(PiPr3)2] (7), which undergoes slow rearrangement to give
      a thermodynamically stable stereoisomer, 8. The reaction of the Ir-Rh complex 2
      gives the ionic compound [IrRh(mu-1,8-(NH)2naphth)(CH3)(CO)2(PiPr3)2]I (10). The
      dirhodium compounds, 3-5, undergo one-center additions to yield acyl complexes of
      the formula (Rh2(mu-1,8-(NH)2naphth)I(COCH3)(CO)(PR3)2] (R = iPr, 12; Ph, 13; p
      tolyl, 14). The structure of 12 has been determined by X-ray diffraction. Further
      reactions of these Rh(III)-Rh(I) acyl derivatives with CH3I are productive only
      for the p-tolylphosphine derivative, which affords the bis-acyl complex [Rh2(mu
      1,8-(NH)2naphth)(CH3CO)2I2(P(p-tolyl)3)2] (15). The reaction of the PMe3
      derivative, 6, allows the isolation of the bis-methyl complex [Rh2(mu-1,8
      (NH)2naphth)(mu-I)(CH3)2(CO)2(PMe3)2]I (16a), which emanates from a double one
      center addition. Upon reaction with methyl triflate, the starting materials, 1,
      2, 3, and 6, give the isostructural cationic methyl complexes 9, 11, 17, and 18,
      respectively. The behavior of these cationic methyl compounds toward CH3I,
      CH3OSO2CF3, and tetrabutylamonium iodide is consistent with the role of these
      species as intermediates in the SN2 addition of CH3I. Compounds 18 and 17 react
      with an excess of methyl triflate to give [Rh2(mu-1,8-(NH)2naphth)(mu
      OSO2CF3)(CH3)2(CO)2(PMe3)2][CF3SO3] (19) and [Rh2(mu-1,8
      (NH)2naphth)(OSO2CF3)(COCH3)(CH3)(CO)(PiPr3)2][CF3SO3] (20), respectively. Upon
      treatment with acetonitrile, complexes 17 and 18 give the isostructural cationic
      acyl complexes [Rh2(mu-1,8-(NH)2naphth)(COCH3)(NCCH3)(CO)(PR3)2][CF3SO3] (R =
      iPr, 21; Me, 22). A kinetic study of the reaction leading to 21 shows that
      formation of these complexes involves a slow insertion step followed by the fast
      coordination of the acetonitrile. The variety of reactions found in this system
      can be rationalized in terms of three alternative reaction pathways, which are
      determined by the effectiveness of the interactions between the two metal centers
      of the dinuclear complex and by the steric constraints due to the phosphine
      ligands.

PMID- 11196967
TI  - Columnar mesomorphism of bi- and trinuclear Ni(II), Cu(II), and VO(II) cis
      enamonoketone complexes with low symmetry.
AB  - New enaminoketone tetradentate bi- and trinuclear complexes creating columnar
      mesophases are reported. Various combinations of nickel, copper, or vanadyl ions
      were applied as metallic centers. Because of the bowlike structure of chelating
      centers and the low molecular symmetry (Cs) the bivanadyl complexes form two
      diastereoisomers, which were separated. The superexchange coupling of the
      electron spins of paramagnetic centers copper-copper and vanadyl-vanadyl was
      found for binuclear complexes in ESR studies.

PMID- 11196968
TI  - Preparation and characterization of oxorhenium(V) complexes with 2,2'
      biimidazole: the strong affinity of coordinated biimidazole for chloride ions via
      N-H...Cl- hydrogen bonding.
AB  - N,N'-Dimethylbiimidazole and bipyridine (N-N) react with ReOCl3(OPPh3)(Me2S) to
      give mer-ReOCl3(N-N) compounds. Nonmethylated biimidazole forms a trans-O,O
      [ReOCl2(OPPh3)(biimH2)]+ cation, which is tightly associated with the Cl-
      counterion via N-H...Cl- hydrogen bonding. Hydrolysis of ReOCl3(biimMe2) in wet
      acetone (5% water) leads to the linear oxo-bridged dinuclear species
      [(OReCl2(biimMe2)2(mu-O)] containing chelated biimMe2. Acetone solutions
      containing only 1% water yield the bent oxo-bridged dinuclear species
      [(OReCl2)2(mu-O)(mu-biimMe2)2], where each Re center retains the ReO2Cl2N2
      coordination but the biimMe2 ligands are bridging. The linear oxo-bridged
      [(OReCl2(biimH2)2(mu-O)] complex obtained with nonmethylated biimidazole includes
      two Cl- ions held via N-H...Cl- hydrogen bonds, leading to a dianionic
      [(OReCl2(biimH2...Cl)2(mu-O)]2- unit in the crystals of the PPh4+ salt. The
      compounds are characterized by IR and NMR spectroscopies, and the structures of
      [ReOCl2(OPPh3)(biimH2)]Cl, [(OReCl2(biimH2)2(mu-O)](PPh4Cl)(2).2H2O, and
      [(OReCl2)2(mu-O)(mu-biimMe2)2].acetone are determined by X-ray diffraction.

PMID- 11196969
TI  - Copper(II) benzoate nitroxide dimers and chains: structure and magnetic studies.
AB  - Copper(II) benzoate dimers and linear chains have been synthesized and exhibit
      very different magnetic behaviors. The benzoate dimers, 1a, show typical dimeric
      singlet-triplet transitions and strong antiferromagnetic coupling (JST = -206 K (
      143 cm-1); H = -2JSTSa.Sb). The bromobenzoate dimer can be converted into linear
      chains of hydrogen-bonded monomers, showing 1-D ferromagnetic coupling (6a, theta
      = +9 K). Copper(II) sites can also be bridged by nitroxide-substituted benzoates,
      1b and 1c, that is, 2-(4'-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-3-oxide-1
      oxyl (NNBA, 3a), with JST = -216 K (-150 cm-1), with comparable interactions
      between the nitroxide and triplet Cu(II) spins, theta T = -157 K. A 1-D chain
      similar to the bromobenzoate monomers can also be produced with NNBA, also
      exhibiting ferromagnetic coupling (6b, theta = +0.67 K), albeit much weaker.
      Other nitroxides have been introduced into the Cu(II) dimer system by capping
      copper(II) acetate with the polydentate 2-(4'-pyridyl)-4,4,5,5
      tetramethylimidazoline-3-oxide-1-oxyl (PYNN, 3b), which exhibits almost no
      coupling to the copper centers when both ends of the dimer are capped (1d, theta
      = -5.8 K). In contrast, strong coupling is observed when only one PYNN is used
      (2, theta = -300 K), which is the result of direct coordination of the nitroxide
      to the copper centers, producing a chain of the dimer units.

PMID- 11196970
TI  - Oxo complexes of osmium(IV) formed via dioxygen activation. X-ray structures of
      [OsX(dcpe)2]PF6 (X = Cl, Br), [OsCl(eta 2-O2)(dcpe)2]BPh4, and
      [OsCl(O)(dcpe)2]BPh4 (dcpe = 1,2-bis(dicyclohexylphosphino)ethane).
AB  - Dioxygen addition to the 16-electron complexes [OsX(P-P)2]+ (3) gives the
      dioxygen adducts [OsCl(eta 2-O2)(P-P)2]+ (3), which in turn react with HCl gas to
      give the novel osmium(IV) oxo complexes trans-[OsX(O)(P-P)2]+ (5) (X = Cl, Br; P
      P = 1,2-bis(dicyclohexylphosphino)ethane (dcpe), 1,2-bis(diethylphosphino)ethane
      (depe), 1,2-bis((2R,5R)-2,5-dimethylphospholano)benzene (Me-duphos)). The
      complexes [OsX(dcpe)2]+ (X = Cl, Br) (3) are studied by X-ray crystallography and
      are shown to have a "Y-shaped" coordination geometry in the equatorial plane. The
      X-ray structural analysis of [OsCl(eta 2-O2)(dcpe)2]+ (4a) reveals an
      exceptionally short O-O bond (1.315(5) A). trans-[OsCl(O)(dcpe)2]+ (5a), the
      first oxo complex of osmium(IV) investigated crystallographically, exhibits a
      long Os-O distance of 1.834(3) A. The reactivity of 4 and 5 as oxidants is
      described. The dioxygen complex 4a transfers one oxygen atom to PPh3 (to give
      Ph3PO) or oxidizes iodide ions to triiodide ions in the presence of anhydrous
      HCl. In both reactions, the corresponding oxo species 5a is quantitatively formed
      as the only metal-containing product. Oxo complexes 5 are surprisingly stable and
      unreactive toward standard reducing agents such as phosphines.

PMID- 11196971
TI  - Copper(II) complexes of pyridyl-appended diazacycloalkanes: synthesis,
      characterization, and application to catalytic olefin aziridination.
AB  - As part of an ongoing effort to rationally design new copper catalysts for olefin
      aziridination, a family of copper(II) complexes derived from new tetradentate
      macrocyclic ligands are synthesized, characterized both in the solid state and in
      solution, and screened for catalytic nitrene transfer reactivity with a
      representative set of olefins. The pyridylmethyl-appended diazacycloalkane
      ligands L6(py)2, L7(py)2, and L8(py)2 are prepared by alkylation of the
      appropriate diazacycloalkane (piperazine, homopiperazine, or diazacyclooctane)
      with picolyl chloride in the presence of triethylamine. The ligands are metalated
      with Cu(ClO4)(2).6H2O to provide the complexes [(L6(py)2)Cu(OClO3)]ClO4 (1),
      [(L7(py)2)Cu(OClO3)]ClO4 (2), and [(L8(py)2)Cu](ClO4)2 (3), which, after
      metathesis with NH4PF6 in CH3CN, afford [(L6(py)2)Cu(CH3CN)](PF6)2 (4),
      [(L7(py)2)Cu(CH3CN)](PF6)2 (5), and [(L8(py)2)Cu](PF6)2 (6). All six complexes
      are characterized by X-ray crystallography, which reveals that complexes
      supported by L6(py)2 and L7(py)2 (1, 2, 4, 5) adopt square-pyramidal geometries,
      while complexes 3 and 6, ligated by L8(py)2 feature tetracoordinate, distorted
      square-planar copper ions. Tetragonal geometries in solution and d(x2 - y2),
      ground states are confirmed for the complexes by a combination of UV-visible and
      EPR spectroscopies. The divergent flexibility of the three supporting ligands
      influences the Cu(II)/Cu(I) redox potentials within the family, such that the
      complexes supported by the larger ligands L7(py)2 and L8(py)2 (5 and 6) exhibit
      quasi-reversible electron transfer processes (E1/2 approximately -0.2 V vs
      Ag/AgCl), while the complex supported by L6(py)2 (4), which imposes a rigid
      tetragonal geometry upon the central copper(II) ion, is irreversibly reduced in
      CH3CN solution. Complexes 4-6 are efficient catalysts (in 5 mol % amounts) for
      the aziridination of styrene with the iodinane PhINTs (in 80-90% yields vs
      PhINTs), while only 4 exhibits significant catalytic nitrene transfer reactivity
      with 1-hexene and cyclooctene.

PMID- 11196972
TI  - Selective tin-carbon bond cleavage reactions of trimethylstannylzirconocene
      dichloride with electrophiles.
AB  - The reaction of 5,5-bis(trimethylstannyl)cyclopentadiene with CpZrCl3 (Cp = eta 5
      C5H5) affords the monostannylated metallocene complex (eta 5-Me3SnC5H4)CpZrCl2
      (1), accompanied by variable amounts of (eta 5-ClMe2SnC5H4)CpZrCl2 (2). The
      complex (1) reacts with BCl3 or with ICl to afford 2 (Sn-CH3 cleavage), but with
      HCl, Cp2ZrCl2 is obtained instead (Sn-Cp cleavage). Depending on the reaction
      conditions, treatment of either 1 or 2 with BBr3 affords (eta 5
      BrMe2SnC5H4)CpZrBr2 (3) or (eta 5-Br2MeSnC5H4)CpZrBr2 (4). The reaction of 1 with
      excess I2 affords the iodostannylated complex (eta 5-IMe2SnC5H4)CpZrCl2 (5). Two
      of the complexes (2.2C6H5CH3 and 4.THF) are crystallographically characterized.
      The adduct 4.THF has a distorted trigonal bipyramidal geometry about tin with a
      long O-Sn distance of 2.655 A. We find overall that Me3Sn substituents undergo
      electrophilic halodemethylation much more readily than corresponding Me3Si
      substituents, whereas the reactivities of the halostannylated complexes toward
      nucleophiles such as airborne moisture are much lower than those of their
      halosilylated counterparts.

PMID- 11196973
TI  - New inorganic/organic coordination polymers generated from bidentate Schiff-base
      ligands.
AB  - The coordination chemistry of the long conjugated bidentate Schiff-base ligands
      1,4-bis(3-pyridyl)-2,3-diaza-1,3-butadiene (L1) and 2,5-bis(3-pyridyl)-3,4-diaza
      2,4-hexadiene (L2) with cadmium and cobalt nitrate hydrates is investigated. Four
      new coordination polymers are prepared by solution reactions and fully
      characterized by infrared spectroscopy, elemental analysis, thermogravimetric
      analysis, and single-crystal X-ray diffraction. [Cd(NO3)2(L1)(1.5).0.5(L1)]n (1;
      monoclinic, P2(1)/c; a = 7.7729(16) A, b = 19.049(4) A, c = 17.865(4) A, beta =
      93.13(3) degrees, Z = 4) is obtained by combination of L1 with Cd(NO3)(2).4H2O in
      a benzene/methanol or THF/methanol mixed-solvent system. The structure features
      two-dimensional brick wall sheets that are cross-linked by weak noncovalent pi-pi
      interactions (alternating face-to-face stacking of coordinated and uncoordinated
      L1 molecules) to generate a novel three-dimensional network.
      [Co(NO3)2(L1)(1.5).H2O]n (2; orthorhombic, Ccca; a = 19.031(4) A, b = 33.627(7)
      A, c = 14.299(3) A, Z = 4) is generated from the reaction of L1 with
      Co(NO3)(2).6H2O in a benzene/ethanol mixed-solvent system. It forms with a unique
      three-dimensional framework that can be considered a new polymeric motif based on
      the 1:1.5 metal-to-ligand composition M(L)1.5. The Cd(II) and Co(II) centers in 1
      and 2, which lie in seven-coordinate environments, generate two new types of
      building blocks. The topologies of these two new building blocks are distinctly
      different from the common "T-shaped" building block generated from the same
      (MN3O4) coordination environment reported previously. Cd(L2)2(NO3)2 (3) and
      Co(L2)2(NO3)2 (4) are obtained by combination of L2 with Cd(NO3)(2).4H2O and
      Co(NO3)(2).6H2O, respectively. Compounds 3 and 4 are isostructural, crystallizing
      in the monoclinic space group P2(1)/n, with a = 8.5802(17) A, b = 17.506(4) A, c
      = 10.443(2) A, beta = 96.59(3) degrees, and Z = 2 for 3 and a = 8.5283(17) A, b =
      17.408(4) A, c = 10.229(2) A, beta = 97.05(3) degrees, and Z = 2 for 4. 3 and 4
      adopt a novel one-dimensional chain structural motif, consisting of M2(L2)2 (M =
      Cd, Co) ringlike units. O...H-C hydrogen-bonding interactions in both 3 and 4
      play a significant role in aligning the polymer strands in the solid state.

PMID- 11196974
TI  - Ternary early-transition-metal palladium pnictides Zr3Pd4P3, Hf3Pd4P3, HfPdSb,
      and Nb5Pd4P4.
AB  - Several ternary palladium pnictides of the early transition metals have been
      prepared by arc-melting of the elemental metals and the binary pnictides ZrP,
      HfP, HfSb2, or NbP, and their structures have been determined by X-ray
      diffraction methods. The phosphides M3Pd4P3 (M = Zr, Hf) adopt a new structure
      type (Pearson symbol oP40), crystallizing in the orthorhombic space group Pnma
      with Z = 4 and unit cell parameters of a = 16.387(2), b = 3.8258(5), and c =
      9.979(1) A for Zr3Pd4P3 and a = 16.340(2), b = 3.7867(3), and c = 9.954(1) A for
      Hf3Pd4P3. The antimonide HfPdSb was identified by powder X-ray diffraction
      (orthorhombic, Pnma, Z = 4, a = 6.754(1) A, b = 4.204(1) A, and c = 7.701(2) A)
      and confirmed to be isostructural to ZrPdSb, which adopts the TiNiSi-type
      structure. The phosphide Nb5Pd4P4 adopts the Nb5Cu4Si4-type structure,
      crystallizing in the tetragonal space group I4/m with Z = 2, a = 10.306(1) A, and
      c = 3.6372(5) A. Coordination geometries of pentacapped pentagonal prisms for the
      early transition metal, tetracapped distorted tetragonal prisms for Pd, and
      tricapped trigonal prisms for the pnicogen are found in the three structures;
      tetracapped tetragonal prisms for Nb are also found in Nb5-Pd4P4. In common with
      many metal-rich compounds whose metal-to-nonmetal ratio is equal or close to 2:1,
      the variety of structures formed by these ternary palladium pnictides arises from
      the differing connectivity of pnicogen-filled trigonal prisms. Pnicogen-pnicogen
      bonds are absent in these structures, but metal-metal bonds (in addition to metal
      pnicogen bonds) are important interactions, as verified by extended Huckel band
      structure calculations on Zr3Pd4P3.

PMID- 11196975
TI  - Recognition of DNA base pair mismatches by a cyclometalated Rh(III) intercalator.
AB  - Two cyclometalated complexes of Rh(III), rac-[Rh(ppy)2chrysi]+ and rac-[Rh(ppy)2
      phi]+, have been synthesized and characterized with respect to their binding to
      DNA. The structure of rac-[Rh(ppy)2 phi]Cl.H2O.CH2Cl2 has been determined by X
      ray diffraction (monoclinic, P2(1)/c, Z = 4, a = 18.447(3) A, b = 9.770(1) A, c =
      17.661(3) A, beta = 94.821(11) degrees, V = 3172.0(8) A3) and reveals that the
      complex is a distorted octahedron with nearly planar ligands, similar in
      structure to the DNA mismatch recognition agent [Rh(bpy)2chrysi]3+. The 2
      phenylpyridyl nitrogen atoms are shown to be in the axial positions, as a result
      of trans-directing effects. This tendency simplifies the synthesis and
      purification of such complexes by limiting the number of possible isomers
      generated. The abilities of [Rh(ppy)2chrysi]+ and [Rh(ppy)2 phi]+ to bind and,
      with photoactivation, to cleave DNA have been demonstrated in assays on duplex
      DNA in the absence and presence of a single CC mismatch. [Rh(ppy)2chrysi]+ was
      shown upon photoactivation to cleave DNA selectively at the base pair mismatch
      whereas [Rh(ppy)2 phi]+ cleaves B-DNA nonspecifically. The reactivity of
      [Rh(ppy)2chrysi]+ was also compared to that of the known mismatch recognition
      agent [Rh(bpy)2chrysi]3+. Competitive photocleavage studies revealed that a 14
      fold excess of [Rh(ppy)2chrysi]+ was required to achieve the same level of
      binding as that of [Rh(bpy)2chrysi]3+. However, the ratio of damage induced by
      [Rh(bpy)2chrysi]3+ to that induced by [Rh(ppy)2chrysi]+ is considerably greater
      than this value, indicating that decreased photoefficiency for the cyclometalated
      complex must contribute to its significantly attenuated photoreactivity. These
      cyclometalated intercalators provide the starting points for the design of a new
      family of metal complexes targeted to DNA.

PMID- 11196976
TI  - Copper(II) and nickel(II) complexes of binucleating macrocyclic
      bis(disulfide)tetramine ligands.
AB  - Novel macrocyclic bis(disulfide)tetramine ligands and several Cu(II) and Ni(II)
      complexes of them with additional ligands have been synthesized by the oxidative
      coupling of linear tetradentate N2S2 tetramines with iodine. Facile demetalation
      of the Ni(II) oxidation products affords the free 20-membered macrocycles meso-9
      and rac-9 and the 22-membered macrocycle 16, all of which are potentially
      octadentate N4S4 ligands. X-ray structure analyses reveal distinctly different
      conformations for the two isomers of 9; meso-9 shows a stepped conformation in
      profile with the disulfide groups corresponding to the rise of the step, whereas
      rac-9 exhibits a V conformation with the disulfide groups near the vertex of the
      V. No metal complexes of rac-9 have been isolated. Crystallographic studies of
      three Cu(II) complexes reveal that depending upon the size of the macrocyclic
      ligand and the nature of the additional ligands (I-, NCO-, and CH3CN), the Cu(II)
      coordination geometry shows considerable variation (plasticity), with substantial
      changes in the Cu(II)-disulfide bonding. Thus, a diiodide salt contains six
      coordinate Cu(II) to which all four bridging disulfide sulfur atoms form strong
      equatorial bonds. In contrast, isocyanato complexes of the 20- and 22-membered
      macrocycles exhibit trigonal-bipyramidal Cu(II) and distorted cis-octahedral
      Cu(II) geometries, respectively, having only one and no short equatorially bound
      sulfur atoms. The coordination geometry of the latter complex can also be
      described as four-coordinate seesaw with two semicoordinated S(disulfide)
      ligands. Disulfide-->Cu(II) ligand-to-metal charge transfer absorptions of both
      isocyanato-containing Cu(II) species appear too weak to observe, probably because
      of poor overlap of the sulfur orbitals with the Cu(II) d-vacancy. The dual
      disulfide-bridged Ni(II) units of the crystallographically characterized
      octahedral Ni(II) complex of meso-9 with axial iodide and acetonitrile ligands
      promote substantial antiferromagnetic coupling (J = -13.0(2) cm-1).

PMID- 11196977
TI  - Allosteric manipulation of photoexcited state relaxation in
      (bpy)2RuII(binicotinic acid).
AB  - The emission spectrum and luminescent lifetime of (bpy)2RuII(binicotinic acid) is
      affected by the presence of heavy metal ions in solution. As little as 1 microM
      Pb2+ causes a red shift in emission, an increase in the emission quantum yield,
      and an increase in the room-temperature lifetime. A smaller red shift is observed
      in the 4,4'-dicarboxy analogue in the presence of large quantities of lead;
      however, the emission lifetime and intensity are diminished. An X-ray
      determination of the ground-state geometry shows that the bipyridine rings of the
      binicotinic acid are twisted along the 2,2' bond by 19.3 degrees. The interaction
      between lead and the binicotinic acid complex was modeled by molecular mechanics
      and extended Huckel calculations. The calculations show that interaction with
      lead flattens the bridged ring system of the binicotinic acid ligand, which
      affects the pi* energy levels of the ligand, the d-orbital energies of the
      Ru(II), and the vibrational modes available to the substituted bipyridine ligand.
      The inverse energy gap law behavior observed in the binicotinic acid complex is
      explained in terms of an allosteric interaction between lead and the binicotinic
      acid complex.

PMID- 11196979
TI  - Reversible and site-specific reduction of the ligand sides in a molecular
      rectangle with up to eight electrons.

PMID- 11196978
TI  - Kinetics of metal-mediated one-electron oxidation of guanine in polymeric DNA and
      in oligonucleotides containing trinucleotide repeat sequences.
AB  - The oxidation of guanines in DNA by Ru(III) is investigated by catalytic
      electrochemistry and stopped-flow spectrophotometry. The reactions of calf thymus
      DNA (20% guanine) and herring testes DNA (25% guanine) with Ru(bpy)3(3+) (bpy =
      2,2'-bipyridine) show biexponential decays in stopped-flow spectrophotometric
      experiments with the fast and slow components in 2:1 ratios and average rate
      constants in 880 mM NaCl of <k> = 18,700 M-1 s-1 for calf thymus DNA and <k> =
      24,600 M-1 s-1 for herring testes DNA. The higher rate constant for the more
      guanine-rich DNA is possibly due to a higher density of electron-rich guanine
      multiplets. The observation of a biexponential decay is incorporated into digital
      simulations of the catalytic voltammograms observed for Ru(bpy)3(2+) in the
      presence of DNA. For both DNAs, the rates observed by voltammetry are somewhat
      slower than those observed by stopped-flow spectrophotometry and the dependence
      of the rate constants on scan rate using the biexponential model is less
      pronounced than when only one decay is treated, supporting the notion that the
      scan rate dependence arises from the multiphasic decay. At low salt
      concentrations, where binding of the metal complex to DNA increases the effective
      catalytic rate constant, rates can be measured by stopped-flow spectrophotometry
      only with a less oxidizing complex, Fe(bpy)3(3+/2+), which yields trends in the
      rate constants similar to those observed for the case of Ru(bpy)3(3+/2+) at high
      ionic strength. Oligonucleotides based on the trinucleotide repeat sequences
      (AGT)n and (GAA)n produce significant catalytic currents, which are readily
      interpreted in terms of the guanine concentration and the secondary structure
      discerned from gel electrophoresis experiments. These experiments may provide a
      basis for sensing secondary structures and repeat numbers in biologically
      relevant DNAs.

PMID- 11196980
TI  - Dimeric bridged and chelated alkali metal (Li and Na)
      bis(iminophosphorano)methanide complexes with contrasting structures.

PMID- 11196981
TI  - Synthesis and structure of (H3NC2H4NH3)2Co7(PO4)6: a novel open framework cobalt
      phosphate.

PMID- 11196982
TI  - ESEEM and mims ENDOR spectroscopies of cis,trans-(L-N2S2)MoVO(SCH2Ph): detection
      of the two benzylthiolate alpha protons.

PMID- 11196983
TI  - Pictures of Charles Darwin.

PMID- 11196984
TI  - Founders of American Geology. Meeting: History of Geologic Pioneers, Troy, New
      York, USA; 3-5th August, 2000.

PMID- 11196985
TI  - The use of colours on the the seventeenth century royal warship Vasa.
AB  - The seventeenth-century Swedish Royal warship Vasa was painted and decorated with
      almost 500 figure sculptures and many carved ornaments. It is probably the most
      extensive sculptural work in wood to have been preserved from this period in
      European history. The ship's decorations are of particular importance given the
      scarcity of knowledge of how sculptures in general, and large ships in
      particular, were painted in Northern Europe during this period. About 20
      different pigments have been characterized and it has been possible to
      reconstruct the appearance of many of the sculptures and to extend this knowledge
      to the ship's original appearance.

PMID- 11196986
TI  - The mathematical and military sciences in Renaissance England.
AB  - The Renaissance saw the evolution of troop management, fortification and
      artillery into 'mathematical' sciences and those who practiced these tasks into
      'mathematical practitioners'. These terms have been allowed to imply that these
      areas were deeply theoretical, whereas they varied from theoretical to simply
      numerical. Gunnery, in particular, tended towards the latter. Practitioners of
      the simpler mathematics, however, gained by being able to connect their action to
      the more impressive study of 'the mathematicks'. Future work must recognize more
      critically the distinction inherent in the term 'mathematical' when applied to
      the arts of the Renaissance.

PMID- 11196987
TI  - Diffusion of astronomy in the ancient world.
AB  - Astronomical techniques, calendars and devices were developed independently in
      many places around the world. However, there was much cross-cultural exchange of
      technology over the centuries. The cultures of Egypt, Greece, India and China
      influenced each others' astronomy and each cannot be treated in isolation.

PMID- 11196988
TI  - Humphry Davy: science and social mobility.
AB  - Humphry Davy (1778-1829) was one of the first professional scientists, earning
      his living and rising spectacularly from an impoverished upbringing in Cornwall
      to be President of the Royal Society and a baronet. He owed his rise to patronage
      as well as to his range of abilities: as a lecturer, as a chemical theorist and
      as a very early applied scientist. But his exalted position brought him little
      happiness, for he could not satisfy all the hopes put upon him as the successor
      to Sir Joseph Banks. Admired rather than loved, he became unpopular and was seen
      as haughty. In his last two years, spent wandering lonely and sickly in Italy and
      the Alps, he sought to make sense of his life, writing dialogues as his bequest
      to the new generation.

PMID- 11196989
TI  - Elegant hypothesis and inelegant fact in developmental biology.
AB  - The relationship between theoretical and experimental approaches to the problem
      of pattern generation during embryonic development has often been uneasy. This
      stems at least in part from the different emphases that have typically been used
      in the two approaches. The spectacular success of modern genetic techniques in
      uncovering developmental mechanisms has led to a widespread belief that theory is
      no longer very relevant. However, recent examples of data-driven modelling point
      to new roles for theoretical approaches in exploring important issues such as the
      robustness and evolution of pattern-forming mechanisms.

PMID- 11196990
TI  - Applications of laser desorption and electrospray ionization mass spectrometry at
      the transition between clusters and colloids.

PMID- 11196991
TI  - A homologous series of redox-active, dinuclear cations with the bridging ligand 2
      (2-pyridyl)-1,8-naphthyridine.

PMID- 11196992
TI  - Mechanistic role of benzylic bromides in the catalytic autoxidation of
      methylarenes.
AB  - Different pathways for benzylic bromide transformations were examined under
      conditions of cobalt-bromide catalysis in acetic acid. It has been shown that
      benzylic bromides participate in the catalytic cycle through their catalyzed and
      noncatalyzed oxidation, through their reaction with Co(III), and through
      cobalt(II)-catalyzed solvolysis. The rates of the direct reduction of Co(III) by
      several benzylic bromides were measured under an argon atmosphere; the reaction
      occurs by a mechanism involving two forms of Co(III). The same reaction under an
      oxygen atmosphere initiates the cobalt-bromide-catalyzed oxidation of benzyl
      bromide, thus leading to the regeneration of inorganic bromide and the fast
      reduction of Co(III). Solvolysis of benzylic bromides plays only a minor role in
      the regeneration of inorganic bromide in glacial acetic acid.

PMID- 11196993
TI  - Aminopyridine iron catecholate complexes as models for intradiol catechol
      dioxygenases. Synthesis, structure, reactivity, and spectroscopic studies.
AB  - Four new Fe(III) catecholate complexes, [(bispicMe2en)FeIII(DBC)]+,
      [(bispicCl2Me2en)FeIII(DBC)]+, [(trispicMeen)FeIII(DBC)]+, and
      [(BQPA)FeIII(DBC)]+, which all contain aminopyridine ligands, were synthesized.
      The structure of [(bispicMe2en)FeIII(DBC)]+ was determined by X-ray diffraction.
      It crystallizes in the triclinic space group P1 with a = 10.666(3) A, b =
      13.467(5) A, c = 17.685(2) A, alpha = 93.46(2) degrees, beta = 93.68(2) degrees,
      gamma = 109.0(3) degrees, V = 2387.4 A3, and Z = 2. All of these complexes were
      found to be active toward oxidation of catechol by O2 in DMF at 20 degrees C to
      afford intradiol cleavage products. The catechol was quantitatively oxidized,
      mainly (90%) into 3,5-di-tert-butyl-5-(carboxymethyl)-2-furanone. Reaction rates
      were measured, and for the first three (topologically similar) complexes, a
      correlation of the second-order kinetic constants k with the optical parameters
      of the two LMCT O(DBC)-->Fe(III) bands was found. In particular, k increases with
      the epsilon max of the charge-transfer bands. The k value of the complex
      [(BQPA)FeIII(DBC)]+, containing a tripodal ligand, is smaller than expected on
      the basis of these correlations. This discrepancy could be related to steric
      hindrance induced by the BQPA ligand. However, the much lower activity of the
      bispicen-Fe(III)-type complexes compared to that of the [(TPA)FeIII(DBC)]+
      complex synthesized by Jang et al. (J. Am. Chem. Soc. 1991, 113, 9200-9204),
      despite similar epsilon max values, shows that a knowledge of optical and NMR
      parameters values is not sufficient to explain the dioxygenase activity rate. In
      their study of protocatechuate 3,4-dioxygenase, Orville et al. (Biochemistry
      1997, 36, 10052-10066) suggested that asymmetric chelation of the catecholate to
      Fe(III) is of great importance in the efficiency of the intradiol dioxygenase
      reaction. Indeed, a comparison of the X-ray structures of [(TPA)FeIII(DBC)]+ and
      [(bispicMe2en)FeIII(DBC)]+ shows that the Fe(III)-O bonds differ by 0.019 A in
      the former and are identical in the latter. Asymmetry could also play a role in
      the model complexes. An alternative explanation is the possible existence of a
      low-spin state for [(TPA)FeIII(DBC)]+, as recently identified in
      [(TPA)FeIII(cat)]+ by Simaan et al.

PMID- 11196994
TI  - Synthesis and structural characterization of configurational isomers of tungsten
      palladium complexes with bridging diphenyl(dithioalkoxycarbonyl)phosphine as a
      ligand and phosphine transfer from tungsten to palladium.
AB  - Treatment of the complex [W(CO)5[PPh2(CS2Me)]] (2) with [Pd(PPh3)4] (1) affords
      binuclear complexes such as anti-[(Ph3P)2Pd[mu-eta 1,eta 2-(CS2Me)PPh2]W(CO)5]
      (3), syn-[(Ph3P)2Pd[mu-eta 1,eta 2-(CS2Me)PPh2]W(CO)5] (4), and trans
      [W(CO)4(PPh3)2] (5). In 3 and 4, respectively, the W and Pd atoms are in anti and
      syn configurations with respect to the P-CS2 bond of the
      diphenyl(dithiomethoxycarbonyl)phosphine ligand, PPh2(CS2Me). Complex 3 undergoes
      extensive rearrangement in CHCl3 at room temperature by transfer of a PPh3 ligand
      from Pd to W, eliminating [W(CO)5(PPh3)] (7), while the PPh2CS2Me ligand
      transfers from W to Pd to give [[(Ph3P)Pd[mu-eta 1,eta 2-(CS2Me)PPh2]]2] (6). In
      complex 6, the [Pd(PPh3)] fragments are held together by two bridging PPh2(CS2Me)
      ligands. Each PPh2(CS2Me) ligand is pi-bonded to one Pd atom through the C=S
      linkage and sigma-bonded to the other Pd through the phosphorus atom, resulting
      in a six-membered ring. Treatment of Pd(PPh3)4 with [W(CO)5[PPh2[CS2(CH2)nCN]]]
      (n = 1, 8a; n = 2, 8b) in CH2Cl2 affords syn-[(Ph3P)2Pd[mu-eta 1,eta 2
      [CS2(CH2)nCN]PPh2]W(CO)5] (n = 1, 9a; n = 2, 9b). Similar configurational
      products syn-[(Ph3P)2Pd[mu-eta 1,eta 2-(CS2R)PPh2]W(CO)5] (R = C2H5, C3H5,
      C2H4OH, C3H6CN, 11a-d) are synthesized by the reaction of Pd(PPh3)4 with
      [W(CO)5[PPh2(CS2R)]] (R = C2H5, C3H5, C2H4OH, C3H6CN, 10a-d). Although complexes
      11a-d have the same configuration as 9a,b, the SR group is oriented away from Pd
      in the former and near Pd in the latter. In these complexes, the
      diphenyl(dithioalkoxycarbonyl)phosphine ligand is bound to the two metals through
      the C=S pi-bonding and to phosphorus through the sigma-bonding. All of the
      complexes are identified by spectroscopic methods, and the structures of
      complexes 3, 6, 9a, and 11d are determined by single-crystal X-ray diffraction.
      Complexes 3, 9, and 11d crystallize in the triclinic space group P1 with Z = 2,
      whereas 6 belongs to the monoclinic space group P2/c with Z = 4. The cell
      dimensions are as follows: for 3, a = 10.920(3) A, b = 14.707(5) A, c = 16.654(5)
      A, alpha = 99.98(3) degrees, beta = 93.75(3) degrees, gamma = 99.44(3) degrees;
      for 6, a = 15.106(3) A, b = 9.848(3) A, c = 20.528(4) A, beta = 104.85(2)
      degrees; for 9a, a = 11.125(3) A, b = 14.089(4) A, c = 17.947(7) A, alpha =
      80.13(3) degrees, beta = 80.39(3) degrees, gamma = 89.76(2) degrees; for 11d, a =
      11.692(3) A, b = 13.602(9) A, c = 18.471(10) A, alpha = 81.29(5) degrees, beta =
      80.88(3) degrees, gamma = 88.82(1) degrees.

PMID- 11196995
TI  - Synthesis and characterization of Rhodium(III) dichloro complexes with
      unsymmetrically bound salen-type ligands.
AB  - We have synthesized a series of novel octahedral Rh(III) salen-type complexes
      where the salen ligand is unsymmetrically bound to the Rh(III) dichloride center.
      This mode of bonding left one intact phenol group coordinating to the rhodium
      center and has never before been observed in salen-metal chemistry. These
      remarkably stable complexes possess unique coordination geometry and represent
      the first time that Rh(III) salen complexes have been successfully isolated from
      the direct combination of RhCl(3).3H2O and the salen ligand in the absence of a
      nucleophilic base. The (salen)Rh(III) dichloride complex can be converted to the
      analogous monochloride complex by reaction with metal carbonate salts.

PMID- 11196996
TI  - Synthesis, characterization, and structure of macrocyclic mono- and C2-symmetric,
      binuclear nickel calixsalen complexes.
AB  - Mono- (3a,b) and binuclear (4a,b) tetradentate NiII complexes of a series of 26
      membered macrocyclic salen dimers, [salen(CH2)]2, are prepared in good yield by
      solvent-controlled reaction with Ni(OAc)2. The mononuclear complex 3b
      crystallizes in the trigonal space group 3P1(#144), a = 18.2566(2) A, c =
      15.9244(2) A, V = 4596.57(8) A3, and Z = 3. Refinement converged with R = 0.054
      and Rw = 0.049 for 6852 reflections with I > 2.003 sigma(I). The NiII in complex
      3b coordinates in an approximate square planar geometry to one of the two
      available tetradentate salen sites. Complex 4b crystallizes in the orthorhombic
      space group P2(1)2(1)2(1)(#19), a = 19.531(2) A, b = 22.891(3), c = 13.373(1) A,
      V = 5960(1) A3, and Z = 4. The refinement converged with R = 0.067 and Rw = 0.065
      for 3752 reflections with I > 2.003 sigma(I). Complex 4b coordinates two
      distorted square planar, cofacially oriented NiII-salen units held 7.1 A apart by
      a rigid, syn-folded macrocyclic structure. The solution spectroscopic data and
      solid-state crystallographic data of 3b and 4b demonstrate the presence of a
      molecular-sized cavity which shows host-guest properties. Reaction of the
      flexible 32-membered disalen macrocycle [salen(OCH2CH2O)]2 with Ni(OAc)2 resulted
      in formation of a binuclear complex, 5. Complex 5 crystallizes in the triclinic
      space group P1(#1), a = 10.366(4) A, b = 12.170(3) A, c = 10.021(2) A, alpha =
      106.29(2) degrees, beta = 91.69(2) degrees, gamma = 68.63(2) degrees, V =
      1126.3(5) A3, and Z = 1. The refinement converged with R = 0.052 and Rw = 0.053
      for 2385 reflections with I > 2.003 sigma(I). The binuclear complex 5 contains
      two cofacially oriented, square planar NiII-salen groups lying 3.5 A apart in an
      anti-folded macrocyclic structure.

PMID- 11196997
TI  - Ligand binding inside the cavities of lacunar and saddle-shaped cyclidene
      complexes: molecular mechanics and molecular dynamics studies.
AB  - Cobalt(II) complexes with tetradentate macrocyclic cyclidene ligands are known to
      coordinate one additional axial base molecule, leaving the sixth vacant
      coordination site at the metal ion available for small ligand (e.g., O2) binding.
      Molecular mechanics and molecular dynamics simulations provide a microscopic view
      of 1-methylimidazole (MeIm) binding within the cavities of several lacunar
      (bridged) and saddle-shaped (unbridged) cyclidenes and uncover the roles of the
      bridges and the walls of the clefts in steric protection of the cobalt(II)
      coordination site. Short bridges (C3 and C6) prevent inside-the-cavity MeIm
      binding because of severe ligand distortions leading to high-energy penalties (58
      and 25 kcal/mol, respectively), while long bridges (C8 and C12) flip away from
      the MeIm binding site, allowing for penalty-free MeIm inclusion. In the unbridged
      saddle-shaped complex, there is no energy difference between inside- and outside
      the-cavity MeIm binding. The preferential existence of the coordinatively
      unsaturated, five-coordinate species Co(unbrCyc)(MeIm)2+ should therefore be
      explained by electronic, rather than steric, factors. Molecular dynamics and free
      energy simulations reveal the presence of a weak (ca. 4 kcal/mol in the gas phase
      and ca. 2 kcal/mol in methanol solution) noncovalent MeIm binding site at the
      entrance of the cleft of cobalt(II) unbridged cyclidene, at a distance of about 4
      A from the metal ion. The macrocycle geometry remains undistorted at such large
      Co-N(MeIm) separations, while the cavity opens up by 0.9 A upon covalent MeIm
      binding (Co-N(MeIm) distance of 2 A). An increase in macrocycle strain energy
      upon MeIm inclusion is compensated by favorable nonbonded interactions between
      the incoming base and the walls of the unbridged cyclidene.

PMID- 11196998
TI  - Fluoride ion donor properties of TcO2F3 and ReO2F3: X-ray crystal structures of
      MO2F3.SbF5 (M = Tc, Re) and TcO2F3.XeO2F2 and Raman and NMR spectroscopic
      characterization of MO2F3.PnF5 (Pn = As, Sb), [ReO2F2(CH3CN)2][SbF6], and
      [Re2O4F5][Sb2F11].
AB  - The fluoride ion donor properties of TcO2F3 and ReO2F3 toward AsF5, SbF5, and
      XeO2F2 have been investigated, leading to the formation of TcO2F3.PnF5 and
      ReO2F3.PnF5 (Pn = As, Sb) and TcO2F3.XeO2F2, which were characterized in the
      solid state by Raman spectroscopy and X-ray crystallography. TcO2F3.SbF5
      crystallizes in the monoclinic system P2(1)/n, with a = 7.366(2) A, b = 10.441(2)
      A, c = 9.398(2) A, beta = 93.32(3) degrees, V = 721.6(3) A3, and Z = 4 at 24
      degrees C, R1 = 0.0649, and wR2 = 0.1112. ReO2F3.SbF5 crystallizes in the
      monoclinic system P2(1)/c, with a = 5.479(1) A, b = 10.040(2) A, c = 12.426(2) A,
      beta = 99.01(3) degrees, V = 675.1(2) A3, and Z = 4 at -50 degrees C, R1 =
      0.0533, and wR2 = 0.1158. TcO2F3.XeO2F2 crystallizes in the orthorhombic system
      Cmc2(1), with a = 7.895(2) A, b = 16.204(3) A, c = 5.198(1) A, beta = 90 degrees,
      V = 665.0(2) A3, and Z = 4 at 24 degrees C, R1 = 0.0402, and wR2 = 0.0822. The
      structures of TcO2F3.SbF5 and ReO2F3.SbF5 consist of infinite chains of
      alternating MO2F4 and SbF6 units in which the bridging fluorine atoms on the
      antimony are trans to each other. The structure of TcO2F3.XeO2F2 comprises two
      distinct fluorine-bridged chains, one of TcO2F3 and the other of XeO2F2 bridged
      by long Tc-F...Xe contacts. The oxygen atoms of the group 7 metals in the three
      structures are cis to each other and to two terminal fluorine atoms and trans to
      the bridging fluorine atoms. The 19F NMR and Raman spectra of TcO2F3.PnF5 and
      ReO2F3.PnF5 in SbF5 and PnF5-acidified HF solvents are consistent with
      dissociation of the adducts into cis-MO2F2(HF)2+ cations and PnF6- anions. The
      energy-minimized geometries of the free MO2F2+ cations and their HF adducts, cis
      MO2F2(HF)2+, have been calculated by local density functional theory (LDFT), and
      the calculated vibrational frequencies have been used as an aid in the assignment
      of the Raman spectra of the solid MO2F3.PnF5 adducts and their PnF5-acidified HF
      solutions. In contrast, ReO2F3.SbF5 ionizes in SO2ClF solvent to give the novel
      Re2O4F5+ cation and Sb2F11- anion. The 19F NMR spectrum of the cation is
      consistent with two ReO2F2 units joined by a fluorine bridge in which the oxygen
      atoms are assumed to lie in the equatorial plane. The [ReO2F2(CH3CN)2][SbF6] salt
      was formed upon dissolution of ReO2F3.SbF5 in CH3CN and was characterized by 1H,
      13C, and 19F NMR and Raman spectroscopies. The ReO2F2(CH3CN)2+ cation is a
      pseudooctahedral cis-dioxo arrangement in which the CH3CN ligands are trans to
      the oxygens and the fluorines are trans to each other.

PMID- 11196999
TI  - Structures and magnetism of two novel heptanuclear lanthanide-centered trigonal
      prismatic clusters: [LnCu6(mu 3-OH)3(HL)2(L)4](ClO4)2.25H2O (Ln = La, Tb; H2L =
      iminodiacetic acid).
AB  - The new heteronuclear iminodiacetic acid (H2L) complexes [LnCu6(mu 3
      OH)3(HL)2(L)4](ClO4)(2).25H2O with Ln = La (1) and Tb (2) have been prepared in
      aqueous solution and characterized by single-crystal X-ray diffraction to be
      isomorphous (crystallographic data for 1 and 2: hexagonal, P63/m; a = b =
      12.6425(14) A, c = 24.541(5) A, Z = 2 (1); a = b = 12.5802(9) A, c = 24.285(4) A,
      Z = 2 (2)). Ln3+ was found to be located in the center of the trigonal prismatic
      cage formed by six Cu2+ ions, with a tricapped trigonal prismatic coordination
      environment of nine O atoms. The magnetic properties of complexes 1 and 2 have
      been studied. The results indicate the presence of ferromagnetic couplings
      between Tb3+ and Cu2+ in compound 2.

PMID- 11197000
TI  - Studies of the synthesis and thermochemistry of coordinatively unsaturated
      chelate complexes (eta 5-C5Me5)IrL2 (L2 = TsNCH2CH2NTs, TsNCH2CO2, CO2CO2).
AB  - A comparative synthetic, structural, and thermochemical study on a series of
      chelate complexes containing the fragment (eta 5-C5Me5)Ir [(eta 5
      C5Me5)Ir(TsNCH2CH2NTs) (1), (eta 5-C5Me5)Ir(TsNCH2CO2) (2), (eta 5
      C5Me5)Ir(CO2CO2) (3)] was performed to clarify the roles of carboxylato and
      sulfonamido ligands. Whereas 1 and 2 are monomeric in solution and in the solid
      state, 3 appears to exist as an oligomer or polymer, (3)n, which can be broken up
      by addition of a ligand L such as a phosphine, CO, or 2-methoxypyridine to form
      (eta 5-C5Me5)Ir(L)(CO2CO2) (6). The synthesis of (3)n from [(eta 5-C5Me5)IrCl(mu
      Cl)]2 required the use of silver oxalate in CH3CN, but if other solvents were
      used, the bridging oxalato complex (eta 5-C5Me5)IrCl(mu-eta 2-eta 2-C2O4)ClIr(eta
      5-C5Me5) (7) was obtained and identified by X-ray diffraction. Enthalpies for
      reaction of THF-soluble monomers 1 and 2 with PMe3 were determined to be 
      28.7(0.5) and -28.5(0.4) kcal mol-1, respectively. The oligomerization behavior
      of 3 may be a result of reduced sigma- or pi-donation of carboxylato ligands
      compared to N-tosylamido ligands, because the values for nu CO in oxalato and
      bissulfonamido complexes 6-CO and (eta 5-C5Me5)Ir(CO)(TsNCH2CH2NTs) (4-CO) were
      2064 and 2042 cm-1, respectively.

PMID- 11197001
TI  - Automated solid-phase synthesis and photophysical properties of
      oligodeoxynucleotides labeled at 5'-aminothymidine with Ru(bpy)2(4-m-4'-cam
      bpy)2+.
AB  - A facile and automated procedure for the incorporation of a derivatized
      Ru(bpy)3(2+) in an oligodeoxynucleotide is reported. The Ru(bpy)3(2+)-thymidine
      phosphoramidite is synthesized, and then incorporated in DNA using a standard
      protocol on an automated DNA solid-phase synthesizer. The structure of the DNA
      duplex is not altered after labeling with Ru(bpy)3(2+). Photophysical studies of
      the novel ruthenium trisdiimine thymidine complex as well as the corresponding
      labeled oligodeoxynucleotides demonstrate that the favorable properties
      associated with the ruthenium complex are retained after covalent attachment to
      the nucleoside and oligodeoxynucleotide.

PMID- 11197002
TI  - Polylithiated tetraaminosilanes: synthesis and characterization of
      (Et2O.Li)4[Si(Nnaph)4] and X-ray structure of (THF.Li3[Si(NiPr)3(NHiPr)])2.
AB  - The treatment of SiCl4 with 4 equiv of Li2(Nnaph) (naph = 1-naphthyl) in diethyl
      ether gives (Et2O.Li)4[Si(Nnaph)4] (4), which, upon reaction with excess tBuNH3Cl
      or MeO3SCF3, generates Si[N(H)naph]4 (5) or Si[N(Me)naph]4 (6), respectively. The
      centrosymmetric dimer (THF.Li3[Si(NiPr)3(NHiPr)])2 (7), formed via trilithiation
      of Si[N(H)iPr]4 with n-butyllithium, consists of a bis-THF-solvated Li6(NiPr)6
      cyclic ladder bicapped by two SiN(H)iPr units. Crystal data for 7:
      C32H74Li6N8O2Si2, monoclinic, P2(1)/n, a = 10.661(7) A, b = 16.964(5) A, c =
      12.405(4) A, beta = 93.22(4) degrees, V = 2239.9(15) A3, and Z = 2.

PMID- 11197003
TI  - Synthesis of stable crystals of a self-assembled centered icosahedral samarium
      cluster formed by bis(L-prolinato)nickel(II) ligands.
AB  - A centered icosahedral 12-coordinate samarium cluster formed by six bis(L
      prolinato)nickel(II) ([Ni(pro)2]) ligands, [Sm(Ni(pro)2)6]3+, was prepared. The
      reaction of Sm with [Ni(pro)2] in a small excess (a 2-fold excess) and also in a
      large excess (even a 10-fold excess) of the latter produced the cluster.
      Therefore, this system is a self-assembly. In the cluster, each nickel atom is
      surrounded by six atoms: two amino nitrogens, two carboxylate oxygens which form
      chelate rings with the nitrogen atoms, and two carboxylate oxygen atoms which
      link the neighboring nickel atoms. The samarium atom is coordinated by six
      [Ni(pro)2] ligands, and the metal is in an icosahedral environment formed by 12
      oxygen atoms. The icosahedral geometry is almost ideal. Crystals of
      [Sm(Ni(pro)2)6](ClO4)3.6MeOH, which were prepared from a methanol solution,
      immediately decompose after filtration because of loosely trapped MeOH molecules
      in the crystal lattice. Therefore, crystals without MeOH molecules, which must be
      stable, were prepared by recrystallization from acetonitrile with
      tetramethylammonium perchlorate (TMAP). According to the X-ray crystal analysis,
      the cluster is TMA[Sm(Ni(pro)2)6](ClO4)4, cubic of space group F23, with a =
      21.273(9) A, V = 9626(1) A3, and Z = 4; R = 0.053 (Rw = 0.049) for 1296
      reflections. In addition, several crystals of cluster salts that have different
      counteranions, i.e., tetrafluoroborate (BF4-), hexafluorophosphate (PF6-), iodide
      (I-), and nitrate (NO3-), were prepared. The order of increasing ease of
      crystallization of the cluster salts was I- > PF6- approximately ClO4- > BF4- >>
      NO3-. The cluster structure is retained in alcohol and acetonitrile solutions;
      the UV-vis spectra of the solutions are perfectly consistent with the powder
      diffuse reflection spectrum. Cyclic voltammograms of [Sm(Ni(pro)2)6]3+ in
      acetonitrile proved that the structure of [Sm(Ni(pro)2)6]3+ is retained in the
      redox process and that the nickel atoms electrochemically interact with one
      another. Thermal analysis of the cluster salts with different counteranions was
      investigated. The results imply that the cluster is very stable until bis(L
      prolinato)nickel(II) ligands, which form the cage structure, disintegrate and
      that the thermal decomposition processes of the cluster salts depend on their
      counteranions.

PMID- 11197004
TI  - Electron paramagnetic resonance and spectroscopic characteristics of
      electrogenerated mixed-valent systems [(eta 5-C5Me5)M(mu-L)M(eta 5-C5Me5)]+ (M =
      Rh, Ir; L = 2,5-diiminopyrazines) in relation to the radicals [(eta 5
      C5Me5)ClM(mu-L)MCl(eta 5-C5Me5)]+ and [(eta 5-C5Me5)M(mu-L)MCl(eta 5-C5Me5)]2+.
AB  - Electrochemical reduction of the dinuclear [(eta 5-C5Me5)ClM(mu-L)MCl(eta 5
      C5Me5)]2+ ions (M = Rh, Ir; L = 2,5-bis(1-phenyliminoethyl)pyrazine (bpip) and
      2,5-bis[1-(2,6-dimethylphenyl)iminoethyl]pyrazine (bxip)) proceeds via the
      paramagnetic intermediates [(eta 5-C5Me5)ClM(mu-L)MCl(eta 5-C5Me5)]+ (L = bpip)
      or [(eta 5-C5Me5)M(mu-L)MCl(eta 5-C5Me5)]2+ (L = bxip) and [(eta 5-C5Me5)M(mu
      L)M(eta 5-C5Me5)]+. Whereas the first is clearly a radical species with a small g
      anisotropy, the chloride-free cations are distinguished by structured
      intervalence charge transfer (IVCT) bands in the near-infrared region and by
      rhombic electron paramagnetic resonance features between g = 1.9 and g = 2.3,
      which suggests considerable metal participation at the singly occupied MO.
      Alternatives for the d configuration assignment and for the role of the
      bisbidentate-conjugated bridging ligands will be discussed. The main difference
      between bpip and bxip systems is the destabilization of the chloride-containing
      forms through the bxip ligand for reasons of steric interference.

PMID- 11197005
TI  - Ferromagnetism in an extended three-dimensional, diamond-like copper(II) network:
      a new copper(II)/1-hydroxybenzotriazolato complex exhibiting soft-magnet
      properties and two transitions at 6.4 and 4.4 K.
AB  - The use of the substituted benzotriazole ligand btaOH (1-hydroxybenzotriazole) in
      copper(II) chemistry has yielded a structurally and magnetically very interesting
      complex. The [Cu2(O2CMe)4(H2O)2]/btaOH.H2O/aqueous NH3 (1:4:4, 1:3:3, 1:2:2)
      reaction system in MeOH gives dark brown-green [Cu(btaO)2(MeOH)]n (4) in
      approximately 80% yield. 4 crystallizes in the tetragonal space group P4(3)2(1)2
      with (at 25 degrees C) a = 9.915(1) A, b = 9.915(1) A, c = 14.715(2) A, and Z =
      4. The structure consists of a 3D, diamond-like copper(II) lattice. The CuII atom
      has a square pyramidal geometry with four btaO- ligands at the basal plane. The
      btaO- ion functions as a bidentate bridging ligand, with N(3) and the
      deprotonated oxygen being the ligating atoms. Dc and ac magnetic susceptibility
      measurements, together with low-field (10 G) and high-field (up to 5000 G)
      magnetization data, are consistent with ferromagnetic interactions on the scale
      of the crystal lattice with two critical temperatures: 6.4 and 4.4 K. The former
      critical temperature could correspond to a transition from a paramagnetic to a
      ferromagnetic state; the latter one, to a transition from a ferromagnetically
      ordered state to its 3D ordering. The magnetic data, along with the field
      dependence of the magnetization and the EPR data, are also in line with a soft
      magnet. Moreover, the EPR studies performed on 4 reveal unique features reported
      for the first time in the field of molecular magnetism.

PMID- 11197006
TI  - 19F NMR study of the equilibria and dynamics of the Al3+/F- system.
AB  - A careful reinvestigation by high-field 19F NMR (470 MHz) spectroscopy has been
      made of the Al3+/F- system in aqueous solution under carefully controlled
      conditions of pH, concentration, ionic strength (I), and temperature. The 19F NMR
      spectra show five distinct signals at 278 K and I = 0.6 M (TMACl) which have been
      attributed to the complexes AlFi(3-i)+(aq) with i < or = 5. There was no need to
      invoke AlFi(OH)j(3-i-j)+ mixed complexes in the model under our experimental
      conditions (pH < or = 6.5), nor was any evidence obtained for the formation of
      AlF6(3-)(aq) at very high ratios of F-/Al3+. The stepwise equilibrium constants
      obtained for the complexes by integration of the 19F signals are in good
      agreement with literature data given the differences in medium and temperature.
      In I = 0.6 M TMACl at 278 K and in I = 3 M KCl at 298 K the log Ki values are
      6.42, 5.41, 3.99, 2.50, and 0.84 (for species i = 1-5) and 6.35, 5.25, and 4.11
      (for species i = 1-3), respectively. Disappearance of the 19F NMR signals under
      certain conditions was shown to be due to precipitation. Certain 19F NMR signals
      exhibit temperature- and concentration-dependent exchange broadening. Detailed
      line shape analysis of the spectra and magnetization transfer measurements
      indicate that the kinetics are dominated by F- exchange rather than complex
      formation. The detected reactions and their rate constants are AlF2(2+) + *F-
      reversible AlF*F2+ + F- (k02 = (1.8 +/- 0.3) x 10(6) M-1 s-1), AlF3(0) + *F-
      reversible AlF2*F0 + F- (k03 = (3.9 +/- 0.9) x 10(6) M-1 s-1), and AlF3(0) + H*F
      reversible AlF2*F0 + HF (kH03 = (6.6 +/- 0.5) x 10(4) M-1 s-1). The rates of
      these exchange reactions increase markedly with increasing F- substitution. Thus,
      the reactions of AlF2+(aq) were too inert to be detected even on the T1 NMR time
      scale, while some of the reactions of AlF3(0)(aq) were fast, causing large line
      broadening. The ligand exchange appears to follow an associative interchange
      mechanism. The cis-trans isomerization of AlF2+(aq), consistent with octahedral
      geometry for that complex, is slowed sufficiently to be observed at temperatures
      around 270 K. Difference between the Al3+/F- system and the much studied Al3+/OH-
      system are briefly commented on.

PMID- 11197007
TI  - Uranium(VI) sulfilimine complexes: a new class of nitrogen analogues of the
      uranyl ion.
AB  - The compound tetraphenylphosphonium tetrachlorooxo-S,S
      diphenylsulfiliminatouranium, [Ph4P][UOCl4(NSPh2)], has been prepared in high
      yield from [Ph4P][UOCl5] and [Ph2S=NSiMe3]. An X-ray structure of this compound
      shows that the uranium atom has a pseudooctahedral geometry with oxygen and
      nitrogen atoms in trans positions. The structure of the analogous phosphoriminato
      complex [Ph4P][UOCl4(NPPh3)] has been determined for comparison. Derivatization
      of the sulfide group shows that only a limited range of functionalization confers
      stability toward reduction. The emission spectrum of the first electronic excited
      state reveals a greatly reduced energy compared with that of the uranyl ion. This
      red shift in the transition is consistent with the weakening of the U-N bond
      relative to the U-O bond.

PMID- 11197008
TI  - Synthesis, structure, and single-crystal EPR study of [Cp(t-Bu3PN)Ti(mu-Cl)]2.
AB  - The reduction of CpTi(NPt-Bu3)Cl2 with Mg powder in benzene proceeds slowly to
      give [CpTi(NPt-Bu3(mu-Cl)]2 (1). An X-ray crystallographic study confirmed 1 is a
      centrosymmetric chloro-bridged dimer in the solid state. A single-crystal EPR
      study of 1 permitted the determination of the best-fitted values for the diagonal
      spin Hamiltonian parameters. This appears to be the first EPR single-crystal
      study of a Ti(III)-Ti(III) dimer. The implications of these data are considered
      and discussed in light of extended Huckel molecular orbital calculations.

PMID- 11197009
TI  - Preparation, characterization, and X-ray crystal structures of helical and
      syndiotactic zinc-based coordination polymers.
AB  - The reactions of (facac)2Zn.2H2O (facac = 1,1,1,5,5,5-hexafluoroacetylacetonate)
      with 2,5-bis(4-ethynylpyridyl)furan (1) and 1,2-bis(4-ethynylpyridyl)benzene (2)
      yield, upon crystallization, coordination polymers. The former polymer,
      ((facac)2Zn.1)n, has an isotactic, helical structure in the solid state
      [monoclinic space group P2(1)/n; a = 11.0374(3) A, b = 24.2179(10) A, c =
      14.3970(4) A, beta = 92.880(2) degrees; Z = 4]. The latter polymer,
      ((facac)2Zn.2)n, adopts a syndiotactic structure in the solid state [monoclinic
      space group P2(1)/n; a = 9.1344(1) A, b = 21.7985(5) A, c = 16.0322(4) A, beta =
      99.6680(11) degrees; Z = 4]. The solution structures of the corresponding
      oligomers have been studied by low-temperature 1H and 19F NMR spectroscopy.
      Chiral polymers were prepared using the fragment [(+)-tfc]2Zn ((+)-tfc = 3
      ((trifluoromethyl)hydroxymethylene)-(+)-camphorate). A linear, zigzag structure
      was found for ([(+)-tfc]2Zn.1)n [triclinic space group P1; a = 7.4833(2) A, b =
      14.1563(5) A, c = 21.21230(5) A, alpha = 78.4440(15) degrees, beta = 81.5644(15)
      degrees, gamma = 76.4976(13) degrees; Z = 1]. Reaction with tris(4
      pyridyl)methanol (3) yielded a homochiral, helical polymer, ([(+)-tfc]2Zn.3)n
      [monoclinic space group C2; a = 25.0633(12) A, b = 11.8768(7) A, c = 17.1205(9)
      A, alpha = 90 degrees, beta = 117.954(3) degrees, gamma = 90 degrees; Z = 4].

PMID- 11197010
TI  - Synthesis, characterization, and redox behavior of new selenium coronands and of
      copper(I) and copper(II) complexes of selenium coronands.

PMID- 11197011
TI  - Synthesis, structure, and magnetic properties of two new
      ferromagnetic/antiferromagnetic one-dimensional nickel(II) complexes.
      Magnetostructural correlations.
AB  - Two new one-dimensional nickel(II) complexes were synthesized and characterized:
      [Ni(N,N-dimethylethylenediamine)(N3)2] (1) and [Ni(2-aminoethylpyridine)(N3)2]
      (2). The crystal structures of 1 and 2 were solved. Complex 1 crystallizes in the
      monoclinic system, space group P2(1)/n with a = 10.569(2) A, b = 7.331(4) A, c =
      12.9072(8) A, beta = 111.324(10) degrees, and Z = 4. Complex 2 crystallizes in
      the monoclinic system, space group P2(1)/c with a = 12.299(5) A, b = 14.307(2) A,
      c = 12.604(3), beta = 106.72(2) degrees, and Z = 4. The two complexes are similar
      and may be described as one-dimensional systems with double-azido-bridged ligands
      in end-to-end and end-on coordination alternatively. The end-on moiety is almost
      identical for 1 and 2, but the end-to-end moiety is different in each structure:
      for 1 this part is almost planar but for 2 is nonplanar. In both cases the Ni
      atoms are situated in similar distorted octahedral environments. The magnetic
      properties of the two compounds were studied by susceptibility measurements vs
      temperature. The chi M vs T plots for 1 and 2 show a global antiferromagnetic
      behavior with a maximum near room temperature for 1 and at very low temperature
      for 2. J values for 1 and 2 were deduced from the spin Hamiltonian 
      sigma(J1SiSi+1 + J2Si+1Si+2). The computational method was based on the numerical
      solution for finite systems of increasing size. J values for 1 were J1 = -187 cm
      1 and J2 = +77 cm-1 and for 2 J1 = -28 cm-1 and J2 = +73 cm-1. The positive
      values correspond to end-on azido ligands and the negative values to end-to-end
      azido ligands. Since the geometries of the [Ni(N3)]2 moieties involving the end
      on azido ligands are almost the same in the two structures, the ferromagnetic
      coupling is nearly identical in the two compounds, while the significantly
      different antiferromagnetic couplings reflect the near planarity of the end-to
      end Ni2(N3)2 fragment in 1 and its twisted geometry in 2.

PMID- 11197012
TI  - Unusual 9-->10 rearrangement of the substituted cage carbon in the
      ferratricarbollide series. Synthesis of the isomeric complexes [2-eta 5-(C5H5)-10
      X-closo-2,1,7,10-FeC3B8H10] (where X = H2N, MeHN, Me2N, and ButHN).
AB  - Treatment of the zwitterionic amine tricarbollides of general formula 7-L-nido
      7,8,9-C3B8H10 (1) (where L = Me2HN (1c) and ButH2N (1d)) with [(eta 5
      C5H5)Fe(CO)2]2 in refluxing mesitylene resulted in the formation of a mixture of
      the known compounds [2-(eta 5-C5H5)-9-X-closo-2,1,7,9-FeC3B8H10] (2) (where X =
      H2N (2a), Me2N (2c), and ButHN (2d)) and a series of new, isomeric
      ferratricarbollylamines [2-(eta 5-C5H5)-10-X-closo-2,1,7,10-FeC3B8H10] (3) (where
      X = H2N (3a), Me2N (3c), and ButHN (3d)) in moderate yields. Complexes of type 3
      (where X = H2N (3a), MeHN (3b), Me2N (3c), and ButHN (3d)) were also obtained
      readily by heating complexes of type 2 (where X = H2N (2a), MeHN (2b), Me2N (2c),
      ButHN (2d), and Bu(t)(Me)N (2e)) at ca. 300 degrees C for 10 min. All the
      complexes of type 3 contain reactive amine functions in meta positions with
      respect to the metal center. The observed 9-->10 rearrangement of the substituted
      cluster carbon is quite unexpected and is believed to result from higher
      thermodynamic stability of the 10-substituted isomers. The structures of all
      compounds of type 3 were established by high-field NMR spectroscopy and mass
      spectrometry, and that of 3d was determined by an X-ray diffraction study.

PMID- 11197013
TI  - Completion of the series of M2(hpp)4Cl2 compounds from W to Pt: the W, Os, and Pt
      compounds.
AB  - The series of M2(hpp)4Cl2 complexes (hpp is the anion of 1,3,4,6,7,8-hexahydro-2H
      pyrimido[1,2-a]pyrimidine) from M = W to M = Pt has been completed by the
      preparation and characterization of those with M = W, Os, and Pt. W(hpp)4Cl2 (1)
      has a W-W distance of 2.250(2) A, is diamagnetic, and can be assigned a W-W
      triple bond based on a sigma 2 pi 4 electron configuration. Os2(hpp)4Cl2 (2) has
      an Os-Os distance of 2.379(2) A and displays a temperature-independent
      paramagnetism. It can be assigned a sigma 2 pi 4 delta 2 delta*2 configuration.
      Pt2(hpp)4Cl2 has a Pt-Pt distance of 2.440(1) A and is diamagnetic. A bond order
      of 1, based on a configuration in which only the sigma* orbital is empty, is
      consistent with these data.

PMID- 11197014
TI  - Lowest electronic excited states of platinum(II) diimine complexes.
AB  - Absorption and emission spectra of Pt(diimine)L2 complexes (diimine = 2,2'
      bipyridine (bpy) or 4,4'-dimethyl-2,2'-bipyridine (dmbpy); L = pyrazolate (pz-),
      3,5-dimethylpyrazolate (dmpz-), or 3,4,5-trimethylpyrazolate (tmpz-)) have been
      measured. Solvent-sensitive absorption bands (370-440 nm) are attributed to spin
      allowed metal-to-ligand charge-transfer (1MLCT) transitions. As solids and in 77
      K glassy solution, Pt(bpy)(pz)2 and Pt(dmbpy)(pz)2 exhibit highly structured
      emission systems (lambda max approximately 494 nm) similar to those of the
      diprotonated forms of these complexes. The highly structured bands (spacings 1000
      1400 cm-1) indicate that the transition originates in a diimine-centered 3(pi-
      >pi*) (3LL) excited state. The intense solid-state and 77 K glassy solution
      emissions from 3MLCT[d(Pt)-->pi*(bpy)] excited states of complexes with dmpz- and
      tmpz- ligands occur at longer wavelengths (lambda max = 500-610 nm), with much
      broader vibronic structure. These findings are consistent with increasing
      electron donation of the pyrazolate ligands, leading to a distinct crossover from
      a lowest 3LL to a 3MLCT excited state.

PMID- 11197015
TI  - Polysulfide anions II: structure and vibrational spectra of the S4(2-) and S5(2-)
      anions. Influence of the cations on bond length, valence, and torsion angle.
AB  - The influence of the cations on bond length, valence, and torsion angle of S4(2-)
      and S5(2-) anions was examined in a series of solid alkali tetra- and
      pentasulfides by relating their Raman spectra to their known X-ray structures
      through a force-field analysis. The IR and Raman spectra of BaS4.H2O and the
      Raman spectra of (NH4)2S4.nNH3, gamma-Na2S4, and delta-Na2S5 are presented. The
      similarity of spectra of gamma-Na2S4 with those of BaS4.H2O suggests similar
      structures of the S4(2-) anions in these two compounds with a torsion angle
      smaller than 90 degrees. The variations of SS bond length, SSS valence angle, and
      dihedral angle of Sn2- anions are related to the polarization of the lone pair
      and electronic charge of the anion by the electric field of the cations. A
      correlation between the torsion angle and the SSS valence angle is shown as that
      previously reported between the length of the bond around which the torsion takes
      place and the dihedral angle value. These geometry changes are explained by the
      hyperconjugation concept and the electron long-pair repulsion.

PMID- 11197016
TI  - Binding and redox properties of iron(II) bonded to an oxo surface modeled by
      calix[4]arene.
AB  - The syntheses of the parent compounds [(p-Bu(t)-calix[4]-(O)2(OR)2)Fe-L] [R = Me,
      L = THF, 5; R = Bu(n), L = THF, 6; R = PhCH2, L = THF, 7; R = SiMe3, L = none, 8]
      have been performed by reacting the protonated form of the dialkylcalix[4]arene
      with [Fe2Mes4] [Mes = 2,4,6-Me3C6H2]. All of them undergo one-electron oxidative
      functionalization. By use of different oxidizing agents, the following iron(III)
      derivatives have been obtained: [(p-Bu(t)-calix[4]-(O)2(OR)2)Fe-X] [X = Cl, R =
      Me, 9; X = I, R = Me, 10] and [(p-Bu(t)-calix[4]-(O)2(OR)2)2Fe2(mu-X] [X = O, R =
      Me, 11; X = O, R = Bu(n), 12; X = S, R = Me, 13], 9 and 10 being particularly
      appropriate for a further functionalization of the metal. The last three display
      typical antiferromagnetic behavior [J = -78.6 cm-1, 11; J = -64.1 cm-1, 13]. In
      the case of 7 and 8, the reaction with O2 led to the dealkylation of one of the
      alkoxo groups, with the formation of a dimeric iron(III) derivative ([mu-p-Bu(t)
      calix[4]-(O)3(OR))2Fe2] [R = PhCH2, 14; R = SiMe3, 15] [J = -9.8 cm-1]. The
      reaction of the parent compounds with ButNC and diazoalkanes led to the formation
      of [Fe=C] functionalities supported by a calix[4]arene oxo surface. The following
      compounds have been isolated and characterized: ([p-Bu(t)-calix[4]
      (O)2(OR)2)Fe=CNBut] [R = SiMe3, 16, nu CN = 2175 cm-1], ([p-Bu(t)-calix[4]
      (O)2(OR)2)Fe=CPh2] [R = Me, 17; R = PhCH2, 18; R = SiMe3, 19]. The three carbene
      complexes 17-19 display quite an unusual high-spin state, which is a consequence
      of the formation of a weak pi interaction between the metal and the carbene
      carbon, as confirmed by the extended Huckel calculations. The carbene
      functionality has been removed from the iron center in the reaction with O2 and
      HCl. The proposed structures have been supported by X-ray analyses of complexes
      8, 9, 12, 14, 16, 17, and 19.

PMID- 11197017
TI  - General-acid-catalyzed reactions of hypochlorous acid and acetyl hypochlorite
      with chlorite ion.
AB  - The rate of oxidation of ClO2- by HOCl is first order in each reactant and is
      general-acid catalyzed. In the initial steps of the proposed mechanism, a steady
      state intermediate, HOClOClO-, forms (k1 = 1.6 M-1 s-1) and undergoes general
      acid (HA)-catalyzed reactions (k2HA) to generate a metastable intermediate,
      ClOClO. Values of k2HA/k-1 are 1.6 x 10(4) M-1 (H3O+), 20 M-1 (HOAc), and 8.5 M-1
      (H2PO4-). Subsequent competitive reactions of ClOClO with ClO2- (k3) to give
      2ClO2 and with OH- (k4OH) and other bases (k5B) to give ClO3- are very rapid. The
      relative yields of these products give k4OH/k3 = 1.3 x 10(5), k5HPO4/k3 = 0.20,
      and k5OAc/k3 = 0.06. At low pH and low buffer concentrations, the apparent yield
      of ClO2, based on 2ClO2 per initial HOCl, reaches 140%. This anomaly is
      attributed to the induced disproportionation of ClO2- by ClOClO to give ClO3- and
      additional HOCl. A highly reactive intermediate, ClOCl(O)OClO-, is proposed that
      can undergo Cl-O bond cleavage to give 2ClO2 + Cl- via one path and ClO3- + 2HOCl
      via another path. The additional HOCl recycles in the presence of excess ClO2- to
      give more ClO2. Ab initio calculations show feasible structures for the proposed
      reaction intermediates. Acetic acid has a second catalytic role through the
      formation of acetyl hypochlorite, which is much more reactive than HOCl in the
      transfer of Cl+ to ClO2- to form ClOClO.

PMID- 11197018
TI  - An EPR and 1H NMR active mixed-valence manganese (III/II/III) trinuclear
      compound.
AB  - A mixed-valence Mn(III)-Mn(II)-Mn(III) trinuclear complex of stoichiometry
      MnIIIMnIIMnIII(Hsaladhp)2(Sal)4.2CH3CN (1), where H3saladhp is a tridentate
      Schiff-base ligand, has been structurally characterized with X-ray
      crystallography. The Mn(III)Mn(II)Mn(III) angles are strictly 180 degrees as
      required by crystallographic inversion symmetry. The complex is valence-trapped
      with two terminal Mn(III) ions in a distorted square pyramidal geometry. The
      Mn(III)...Mn(II) separation is 3.495 A. The trinuclear complex shows small
      antiferromagnetic exchange J coupling. The magnetic parameters obtained from the
      fitting procedure in the temperature range 10-300 K are J1 = -5.7 cm-1, g = 2.02,
      zJ = -0.19 cm-1, and R = 0.004. The EPR spectrum was obtained at 4 K in CHCl3 and
      in tetrahydrofuran glasses. The low-field EPR signal is a superposition of two
      signals, one centered around g = 3.6 and the other, for which hyperfine structure
      is observed, centered around g = 4.1 indicating an S = 3/2 state. In addition,
      there is a 19-line signal at g = 2.0. The multiline signal compares well with
      that observed for the S2 or S0* states of the oxygen-evolving complex. 1H NMR
      data reveal that the trinuclear compound keeps its integrity into the CHCl3
      solution. Crystal data for complex 1: [C54H52N4O18Mn3], M = 1209.82, triclinic,
      space group P1, a = 10.367(6) A, b = 11.369(6) A, c = 13.967(8) A; alpha =
      112.56(1) degree, beta = 93.42(2) degrees, gamma = 115.43(1) degree, Z = 1.

PMID- 11197019
TI  - New calcium germanium nitrides: Ca2GeN2, Ca4GeN4, and Ca5Ge2N6.
AB  - We report three new calcium germanium nitrides synthesized as crystals from the
      elements in sealed niobium tubes at 760 degrees C using liquid sodium as a growth
      medium. Black Ca2GeN2 is isostructural with the previously reported strontium
      analogue. It is tetragonal P4(2)/mbc (no. 135) with a = 11.2004(8) A, c =
      5.0482(6) A, and Z = 8. It contains GeN2(4-) units which have 18 valence
      electrons, and consequently are bent, like the isoelectronic molecule SO2. In
      contrast, clear, orange Ca4GeN4 with fully oxidized germanium contains isolated
      GeN4(8-) tetrahedra and is monoclinic P2(1)/c (no. 14) with a = 9.2823(8) A, b =
      6.0429(5) A, c = 11.1612(9) A, beta = 116.498(6) degrees, and Z = 4. Clear,
      colorless Ca5Ge2N6, also with fully oxidized germanium, contains infinite chains,
      1 infinity[GeN2N2/2(5-)], of corner-sharing tetrahedra similar to those found in
      pyroxenes. However, the precise structure of this latter phase has not yet been
      determined because of twinning problems.

PMID- 11197020
TI  - Lanthanide chalcogenolate complexes: synthesis and crystal structures of the
      isoleptic series [Sm(TpMe,Me)2ER] (E = O, S, Se, Te; TpMe,Me = tris-3,5
      dimethylpyrazolylborate).
AB  - A series of lanthanide complexes containing a chalcogenolate ligand supported by
      two TpMe,Me (tris-3,5-dimethylpyrazolylborate) groups has been prepared and
      crystallized and provides direct comparisons of bonding to hard and soft ligands
      at lanthanide centers. Reaction of [Sm(TpMe,Me)2Cl] with NaOR (R = Ph, Ph-Bu(t))
      gives [Sm(TpMe,Me)2OR] (1a and 1b, respectively) in good yields. Reductive
      cleavage of dichalcogenides by samarium(II) was used to prepare the heavier
      congeners. Complexes of the type [Sm(TpMe,Me)2ER] for E = S, R = Ph (2a), E = S,
      R = Ph-4-Me (2b), E = S, R = CH2Ph (2c), E = Se, R = Ph (3a), E = Se, R = Ph-4
      Bu(t) (3b), E = Se, R = CH2Ph (3c), and E = Te, R = Ph (4) have been prepared
      together with the corresponding complexes with TpMe,Me,4-Et as ancillary. The X
      ray crystal structures of 1b, 2b, 3a, 3b, and 4 have been determined. The crystal
      of 1b (C40H57B2N12OSm.C7H8) was monoclinic, P2(1)/c, a = 10.6845(6) A, b =
      18.5573(11) A, c = 24.4075(14) A, beta = 91.616(2) degrees, Z = 4. The crystal of
      2b (C37H51B2N12SSm) was monoclinic, P2(1)/n, a = 15.0154(9) A, b = 13.1853(8) A,
      c = 21.1254(13) A, beta = 108.628(2) degrees, Z = 4. The crystal of 3a
      (C36H49B2N12SeSm.C7H8) was triclinic, P1, a = 10.7819(6) A, b = 19.3011(10) A, c
      = 23.0235(12) A, alpha = 79.443(2) degrees, beta = 77.428(2) degrees, gamma =
      89.827(2) degrees, Z = 4. The crystal of 3b (C40H57B2N12SeSm) was triclinic, P1,
      a = 10.1801(6) A, b = 10.2622(6) A, c = 23.4367(14) A, alpha = 88.313(2) degrees,
      beta = 86.268(2) degrees, gamma = 62.503(2) degrees, Z = 2. The crystal of 4
      (C36H49B2N12TeSm.C7H8) was monoclinic, P2(1)/c, a = 18.7440(10) A, b = 10.3892(6)
      A, c = 23.8351(13) A, beta = 94.854(2) degrees, Z = 4. The compounds form an
      isoleptic series of seven-coordinate complexes with terminal chalcogenolate
      ligands. Examination of 1b and other crystallographically characterized
      lanthanide alkoxides suggests that there is little correlation between bond angle
      and bond length. The structures of 3a and 3b, however, contain molecules in which
      one of the pyrazolylborate ligands undergoes a major distortion arising from
      twisting around a B-N bond so as to give an effectively eight-coordinate complex
      with pi-stacking of the phenyl group with one pyrazolyl ring. These distortions
      shed light on the fluxionality of these systems.

PMID- 11197021
TI  - M+(12-crown-4) supramolecular cations (M+ = Na+, K+, Rb+, and NH4+) within Ni(2
      thioxo-1,3-dithiole-4,5-dithiolate)2 molecular conductor.
AB  - Monovalent cations (M+ = Na+, K+, Rb+, and NH4+) and 12-crown-4 were assembled to
      new supramolecular cation (SC+) structures of the M+(12-crown-4)n (n = 1 and 2),
      which were incorporated into the electrically conducting Ni(dmit)2 salts (dmit =
      2-thioxo-1,3-dithiole-4,5-dithiolate). The Na+, K+, and Rb+ salts are
      isostructural with a stoichiometry of the M+(12-crown-4)2[Ni(dmit)2]4, while the
      NH4+ salt has a stoichiometry of NH4+(12-crown-4)[Ni(dmit)2]3(CH3CN)2. The
      electrical conductivities of the Na+, K+, Rb+, and NH4+ salts at room temperature
      are 7.87, 4.46, 0.78, and 0.14 S cm-1, respectively, with a semiconducting
      temperature dependence. The SC+ structures of the Na+, K+, and Rb+ salts have an
      ion-capturing sandwich-type cavity of M+(12-crown-4)2, in which the M+ ion is
      coordinated by eight oxygen atoms of the two 12-crown-4 molecules. On the other
      hand, the NH4+ ion is coordinated by four oxygen atoms of the 12-crown-4
      molecule. Judging from the M(+)-O distances, thermal parameters of oxygen atoms,
      and vibration spectra, the thermal fluctuation of the Na+(12-crown-4)2 structure
      is larger than those of K+(12-crown-4)2 and Rb+(12-crown-4)2. The SC+ unit with
      the larger alkali metal cation gave a stress to the Ni(dmit)2 column, and the SC+
      structure changed the pi-pi overlap mode and electrically conducting behavior.

PMID- 11197022
TI  - Synthesis of a ligand based upon a new entry into the 3-hydroxy-N-alkyl-2(1H)
      pyridinone ring system and thermodynamic evaluation of its gadolinium complex.
AB  - The synthesis of a new, more water soluble derivative of TREN-Me-3,2-HOPO
      (tris[(3-hydroxy-1-methyl-2-oxo-1,2- didehydropyridine-4-carboxamido)ethyl]amine)
      is presented. The synthesis starts with the condensation reaction of (N
      methoxyethylamino)acetonitrile hydrochloride and oxalyl chloride to give 3,5
      dichloro-N-(methoxyethyl)-2(1H)-pyrazinone. The 3-position is readily substituted
      with a benzyloxy group, and the pyrazinone is converted to ethyl 3-(benzyloxy)-N
      (methoxyethyl)-2(1H)-pyridinone-4-carboxylate by a Diels-Alder cycloaddition with
      ethyl propiolate. Basic deprotection of the ester followed by activation,
      coupling to tren, and acidic deprotection of the benzyl groups gives the ligand
      TREN-MOE-3,2-HOPO (tris[(3-hydroxy-1-(methoxyethyl)- 2-oxo-1,2-didehydropyridine
      4-carboxamido)ethyl]amine). The gadolinium complex of TREN-MOE-3,2-HOPO was
      prepared by metathesis, starting from gadolinium chloride. The solubility of the
      new metal complex is significantly enhanced. The four protonation constants
      (determined by potentiometry) for TREN-MOE-3,2-HOPO (log Ka1 = 8.08, log Ka2 =
      6.85, log Ka3 = 5.81, log Ka4 = 4.98) are virtually identical to those reported
      for the parent ligand. The stability constants for the gadolinium complex of TREN
      MOE-3,2-HOPO determined by potentiometry (log beta 110 = 19.69(2), log beta 111 =
      22.80(2)) and by spectrophotometry (log beta 110 = 19.80(1), log beta 111 =
      22.88(1), log beta 112 = 25.88(1)) differ slightly from those for the parent
      ligand; this follows from a change in the complexation model in which a new
      diprotonated species, [Gd(TREN-MOE-3,2-HOPO)(H)2]2+, was included. The presence
      of this extra species was demonstrated by factor analysis, comparison of spectral
      data, and nonlinear least-squares refinement. Significant formation of this
      species is observed between pH 3 and pH 1.5.

PMID- 11197023
TI  - Kinetics of silicate exchange in alkaline aluminosilicate solutions.
AB  - In strongly alkaline aqueous KOH solutions containing SiIV in large excess over
      AlIII, the kinetics of exchange of monomeric silicate with small acyclic
      aluminosilicate solute species is much more rapid than with either cyclic
      aluminosilicates or any all-silicate anions. Selective inversion recovery 29Si
      NMR studies of homogeneous solutions of stoichiometric composition 3.0 mol kg-1
      of SiO2, 0.1 mol kg-1 of Al2O3, and 8.0 mol kg-1 of K2O in 60-75% D2O gave rate
      constants of 2.0 +/- 0.2 kg mol-1 s-1 and 17 +/- 4 s-1 for the forward and
      reverse reactions of monomeric silicate with (HO)3AlOSiOn(OH)(3-n)(n+1)- (n = 2
      or 3) at 0 degree C. These rate constants are more than 10(4)-fold faster than
      those extrapolated from 60 to 90 degrees C for comparable reactions of silicate
      anions. The greater lability of acyclic aluminate centers relative to silicate is
      ascribed partly to the availability of HO- groups for condensation reactions on
      Al and mainly to the ease of expansion of the coordination number of AlIII beyond
      4. The latter attribute is diminished when AlIII is constrained to be tetrahedral
      in cyclic structures. With respect to the mechanism of formation of zeolites from
      alkaline aqueous media, it is suggested that small, labile AlOSi units add
      rapidly to growing zeolitic structures "on demand", whereas the more kinetically
      inert cage or ring structures cannot. This would explain why a silicate or
      aluminosilicate structure that is dominant among solute species at equilibrium in
      the presence of a particular cation may bear little or no geometric relation to
      the zeolitic framework promoted kinetically by that same cation.

PMID- 11197024
TI  - EPR and ligand field studies of iron superoxide dismutases and iron-substituted
      manganese superoxide dismutases: relationships between electronic structure of
      the active site and activity.
AB  - The problem of metal selectivity of iron/manganese superoxide dismutases (SODs)
      is addressed through the electronic structures of active sites using electron
      paramagnetic resonance and ligand field calculations. Studies of wild-type
      iron(III) SOD (FeSOD) from Escherichia coli and from Methanobacterium
      thermoautotrophicum and iron-substituted manganese(III) SOD (Fe(sub)MnSOD) from
      E. coli and from Serratia marcescens are reported. EPR spectroscopy of wild-type
      enzymes shows transitions within all three Kramers doublets identified by their g
      values. From the temperature dependence of the observed transitions, the zero
      field splitting is found to be negative, D = -2 +/- 0.2 cm-1. The electronic
      structure is typical of a distorted trigonal bipyramid, all the EPR features
      being reproduced by ligand field analysis. This unique and necessary electronic
      structure characterizes wild-type enzymes whatever their classification from the
      amino acid sequence into iron or manganese types, as E. coli FeSOD or M.
      thermoautotrophicum FeSOD. In iron-substituted manganese SODs, reduced catalytic
      activity is found. We describe how inhomogeneity of all reported substituted
      MnSODs might explain the activity decrease. EPR spectra of substituted enzymes
      show several overlapping components. From simulation of these spectra, one
      component is identified which shares the same electronic structure of the wild
      type FeSODs, with the proportion depending on pH. Ligand field calculations were
      performed to investigate distortions of the active site geometry which induce
      variation of the excitation energy of the lowest quartet state. The corresponding
      coupling between the ground state and the excited state is found to be maximum in
      the geometry of the native SODs. We conjecture that such coupling should be
      considered in the electron-transfer process and in the contribution of the
      typical electronic structure of FeSOD to the activity.

PMID- 11197025
TI  - Reactions of the dirhenium(II) complexes Re2X4(mu-dppm)2 (X = Cl, Br; dppm =
      Ph2PCH2PPh2) with isocyanides. 21. A comparison with the complexes Re2Cl4(mu
      dppE)2 and Re2Cl4(mu-dcpm)2 (dppE = Ph2PC(=CH2)PPh2; dcpm = Cy2PCH2PCy2) and the
      structural characterization of complexes of the types Re2Cl4(mu-LL)2(CNR),
      Re2Cl4(mu-LL)2(CNR)2, and [Re2Cl3(mu-LL)2(CNR)3]+ (LL = dppm, dppE, dcpm; R = t
      Bu, Xyl).
AB  - A study of the reactions between the triply bonded dirhenium(II) complexes
      Re2Cl4(mu-LL)2, where LL = Ph2PCH2PPh2 (dppm), Ph2PC(=CH2)PPh2 (dppE), or
      Cy2PCH2PCy2 (dcpm), with the isocyanides t-BuNC and XylNC (Xyl = 2,6
      dimethylphenyl) show that complexes of the type Re2Cl4(mu-LL)2(CNR), Re2Cl4(mu
      LL)2(CNR)2, and [Re2Cl3(mu-LL)2(CNR)3]+ are formed sequentially. Several of these
      have been structurally characterized by X-ray crystallography: Re2Cl4(mu
      dppm)2(CNXyl) (2), Re2Cl4(mu-dcpm)2(CNXyl) (11), Re2Cl4(mu-dppE)2(CN-t-Bu)2 (6),
      Re2Cl4(mu-dcpm)2(CN-t-Bu)2 (12), and [Re2Cl3(mu-dppE)2(CN-t-Bu)3]Cl (7). Complex
      2 has an A-frame-like structure with a single mu-Cl bridging ligand, whereas for
      11 the structure is like that of 2 but without this bridge, viz., Cl2Re(mu
      dppm)2ReCl2(CNXyl) with a Re-Cl bond approximately collinear with Re identical to
      Re. The symmetrical complexes 6 and 12 are essentially isostructural and have an
      anti-arrangement of the two t-BuNC ligands. Complex 7 has the open bioctahedral
      structure [(t-BuNC)2ClRe(mu-dppE)2ReCl2(CN-t-Bu)]+, which is quite different from
      that of the edge-sharing bioctahedron found in salts of the [Re2Cl3(mu
      dppm)2(CNXyl)3]+ cation and its neutral congener Re2Cl3(mu-dppm)2(CNXyl)3;
      preliminary crystallographic data for the latter compound show the structure to
      be (XylNC)ClRe(mu-Cl)(mu-CNXyl)(mu-dppm)2ReCl(CNXyl) with an all-cis arrangement
      of XylNC ligands. The Re-Re bond distances of 2, 6, 7, 11, and 12 occur in the
      range 2.289-2.380 A and are consistent in all instances with the retention of a
      Re identical to Re bond, albeit weakened by some degree of Re-->CNR(pi*) back
      bonding.

PMID- 11197026
TI  - Self-assembling molecular wires of halogen-bridged platinum complexes in organic
      media. Mesoscopic supramolecular assemblies consisting of a mixed valent
      Pt(II)/Pt(IV) complex and anionic amphiphiles.
AB  - A novel class of supramolecular assemblies in organic media consisting of a
      molecular wire of a halogen-bridged platinum complex [Pt(en)2][PtCl2(en)2]4+ (en
      = 1,2-diaminoethane) and anionic amphiphiles is developed. When double-chained
      phosphates or sulfonates are employed, the resultant [Pt(en)2][PtCl2(en)2](4+)
      lipid complexes displayed intervalence charge transfer (CT) absorption bands in
      the crystalline state. They are soluble in organic solvents because of the
      amphiphilic superstructure, in which the solvophobic one-dimensional platinum
      complex is surrounded by solvophilic alkyl chains. CT absorption bands of halogen
      bridged linear complexes are maintained in organic media, with varied colors that
      depend on the chemical structure of constituent amphiphiles. Monoalkylated
      phosphates failed to form colored, halogen-bridged ternary complexes probably
      because of their coordination to the axial position of PtII(en)2. Formation of
      mesoscopic supramolecular assemblies in organic media was confirmed for the
      [Pt(en)2][PtCl2(en)2] complexes by electron microscopy. Interestingly, a
      supramolecular complex consisting of dihexadecyl sulfosuccinate and
      [Pt(en)2][PtCl2(en)2]4+ displayed clear, indigo solutions that are distinct from
      the yellow color observed for those of [Pt(en)2][PtCl2(en)2]/dialkyl phosphate
      complexes. The indigo color of the former complex disappeared upon heating the
      solution to 60 degrees C, whereas it reappeared reversibly by cooling the
      solution to room temperature. In electron microscopy, rodlike nanostructures with
      a minimum width of 18 nm and lengths of 700-1700 nm were observed after cooling,
      though not at elevated temperatures. Apparently, the lipid
      [Pt(en)2][PtCl2(en)2]4+ complex undergoes reversible dissociation and reassembly
      processes in chloroform, and it becomes better dispersed after the reassembling
      process. The present finding opens a general route to solution chemistry of low
      dimensional inorganic complexes and enables rational design and control of self
      assembling inorganic molecular wires.

PMID- 11197027
TI  - Crystal structure of the molecular addition compound
      diphenylchloroborane.tetrahydrofuran.

PMID- 11197028
TI  - Synthesis and characterization of a homoleptic thiolate complex of titanium(IV).

PMID- 11197029
TI  - Unusual redox state dependent fermi resonances in the infrared spectra of
      trinuclear ruthenium clusters with isocyanide ligands.

PMID- 11197030
TI  - Self-association in gold chemistry: a tetragold(I) complex linked by both
      aurophilic and hydrogen bonding.

PMID- 11197031
TI  - Neighborhood views on the definition and etiology of child maltreatment.
AB  - OBJECTIVE: The purpose of this study, as part of a larger study on neighborhoods
      and child maltreatment, was to determine how parents residing in neighborhoods
      with differing profiles of risk for child maltreatment reports defined child
      abuse and neglect and viewed its etiology. METHOD: Parents (n = 400) were
      systematically selected from neighborhoods (n=20) with different profiles of risk
      for child maltreatment report rates. As part of a larger interview, parents were
      asked to generate lists of behaviors that they would define as child abuse and
      neglect and to rate 13 etiological factors on a 10 point scale as to their
      contribution to the occurrence of child maltreatment. RESULTS: While there were
      differences in definitional emphases, with African-American parents including
      behaviors of neglect and European-American parents including behaviors of
      physical abuse, there was marked congruence on the catalogue of behaviors that
      parents would define as child abuse and neglect. Four factors were identified
      that explained almost two-thirds of the variance in parents' etiological
      explanations: poverty and family disruption, substance abuse and stress; lack of
      moral and family values; and individual pathology. These factors were related to
      neighborhood conditions, individual perceptions of neighborhood and individual
      characteristics. CONCLUSIONS: Community-based programs aimed at preventing or
      ameliorating child maltreatment must have at their very core an understanding of
      how populations being served define child maltreatment and why they believe that
      it occurs.

PMID- 11197032
TI  - Disciplining children: characteristics associated with the use of corporal
      punishment.
AB  - OBJECTIVE: To evaluate the Social Situational Model of Family Violence through an
      examination of characteristics associated with the use of ordinary and severe
      corporal punishment as measured by the Parents-Child Conflict Tactics Scales.
      METHOD: Logistic Regression used to examine the validity of the model using data
      from a national sample conducted by the Gallup Organizations. RESULTS: Those with
      fewer resources (lower income, lower educational attainment) were more likely to
      be use severe corporal punishment. In addition, those who had been more likely to
      be socialized into the use of violence were also more likely to use severe
      corporal punishment. CONCLUSIONS: The social situational model of family violence
      was supported suggesting that increased efforts be made to give these parents the
      resources they need to implement alternative discipline strategies.

PMID- 11197033
TI  - Maternal infanticides in Fiji.
AB  - OBJECTIVE: This essay contributes to the cross-cultural literature on childhood
      homicides by examining 16 infanticidal homicides that occurred in Fiji over an 11
      year period. The results are compared with infanticide studies conducted in other
      societies. METHOD: Official police data recorded in a Homicide and Manslaughter
      register are analyzed. These are supplemented by newspaper reports of
      infanticides and semi-structured interviews conducted with key criminal justice
      and medical personnel intimately associated with infanticide cases. RESULTS: The
      findings show that most infanticide defendants were young, poor, Fijian, with
      little formal education, living with nonparental kin at the time of the crime.
      The infanticides were precipitated by unwanted pregnancies brought on by
      nonmarital and extramarital sex. Pregnancy is carried to full gestation without
      knowledge of family, friends and neighbors of offenders and the infant is killed
      immediately following birth. CONCLUSIONS: The current findings demonstrate that
      the patterns of maternal infant killings in Fiji are congruous in many
      significant ways with those in advanced industrialized societies. It is concluded
      that additional research in non-Western, nonindustrialized nations is imperative
      to contribute to the development of sound conclusions about, and remedies for
      infanticide.

PMID- 11197034
TI  - [Psychosocial aspects of infanticide in black Africa: the case of Senegal].
AB  - OBJECTIVE: Following the example of Senegal, this study had two main objectives.
      First: Ring the alarm bell about the large number of infanticides in a country
      where people usually consider a child as a treasure. Second: Highlight the deep
      motivations which may induce an African woman to kill her child. METHOD: The
      author examined psychiatric experts reports about crimes and varied offenses
      acquired from Fann University Hospital in Dakar during a 27 year period, from
      January 1968 to December 1994. RESULTS: For a total number of 164 reports, 33 or
      20% concerned infanticides. This underlines the importance of the phenomenon.
      Mental pathology appeared in two cases (3%) but 97% were supposed to be mentally
      healthy. CONCLUSION: These results suggest that social and cultural reasons more
      than medical ones explain the occurrence of infanticides. It seems that it is
      under the pressure of social and cultural motivations that women and especially
      young mothers, depreciate becoming a mother.

PMID- 11197035
TI  - Children involved in bullying at elementary school age: their psychiatric
      symptoms and deviance in adolescence. An epidemiological sample.
AB  - OBJECTIVE: This study investigated psychiatric symptoms and deviance at the age
      of 15 years among children involved in bullying at the age of 8 years or at the
      age of 12 years. Furthermore, the relationships between involvement in bullying
      at the age of 8 years, concurrent psychiatric deviance, and later psychiatric
      deviance were studied. METHOD: Questionnaires filled in by the parents, teachers
      and children themselves were used to reveal psychiatric symptoms and deviance.
      RESULTS: Children involved in bullying, in particular those who were bully
      victims at early elementary school age and those who were victims in their early
      teens, had more psychiatric symptoms at the age of 15 years. The probability of
      being deviant at the age of 15 years was higher among children involved in
      bullying at the age of 8 or 12 years than among non-involved children. When
      concurrent psychiatric deviance was taken into account, involvement in bullying
      increased the probability of teacher-defined deviance at the age of 15 years.
      CONCLUSION: Bullying experiences are connected not only to concurrent psychiatric
      symptoms but also to future psychiatric symptoms. Furthermore, the probability of
      being deviant in adolescence is increased if the child has been involved in
      bullying at elementary school age.

PMID- 11197036
TI  - Sexual abuse during childhood and adolescence among Nicaraguan men and women: a
      population-based anonymous survey.
AB  - AIMS: The objective was to describe experiences of sexual abuse occurring before
      19 years of age among men and women in Leon, Nicaragua and to explore the
      possible association to later sexual risk behavior. METHOD: A sub-sample of
      literate urban men and women 25-44 years of age was selected from a
      representative sample of households in Leon. After an invitation to a public
      health event, 154 men (53% of the invited) and 213 women (66% of those invited)
      participated in giving written answers to an anonymous questionnaire. RESULTS:
      Twenty percent of men and 26% of women reported that they had experienced sexual
      abuse. Women had been victims of attempted or completed rape twice as often as
      men, 15% as compared to 7%. Thirty-three percent of the abuse towards boys and
      66% of the abuse towards girls was committed by family members. Women who had
      experienced attempted or completed rape were more likely to later have had a
      higher number of sexual partners compared to non-abused or moderately abused
      women. CONCLUSIONS: Sexual abuse of children and adolescents of both sexes is
      common in Nicaragua. The results underscore the urgent need to address this
      serious problem more openly, and to make more resources available for the
      prevention of sexual abuse and for support to victims.

PMID- 11197037
TI  - Child on child sexual abuse: psychological perspectives.
AB  - OBJECTIVE: This study describes the emotional and behavioral responses of
      children who have been sexually victimized by juveniles (CC) 17 years of age and
      younger compared to child victims of adults (CA) 18 years of age and older.
      METHOD: A total sample of N = 194 children and adolescents participated in the
      study, with 26% (n = 51) comprising CC and 74% (n = 143) encompassing CA. The
      mother/caretaker was administered a demographic form, Achenbach's Child Behavior
      Checklist (CBCL), and the Family Assessment Measure (FAM-P). The child was given
      the Family Assessment Measure (FAM-C) and the Trauma Symptom Checklist for
      Children (TSCC). The clinician completed the Parental Reaction to Incest
      Disclosure Scale (PRIDS). RESULTS: No differences were found between the two
      groups for the type of sexual abuse, penetration, or the use of force. CC were
      younger and more likely to be males who were abused in a school setting, home, or
      a relative's home by a sibling or a non-related male. CC endorsed clinically
      significant sexual preoccupations and manifested borderline clinically
      significant symptomatology. CONCLUSIONS: Children victimized by other children
      manifested elevated levels of emotional and behavioral problems and were not
      significantly different from those who had been sexually abused by adults.

PMID- 11197038
TI  - The use of telemedicine in child sexual abuse evaluations.
AB  - OBJECTIVE: To describe the advantages, disadvantages and current status of child
      abuse consultations conducted through telemedicine networks. METHOD: The results
      of a telephone survey of seven statewide telemedicine networks are reported and
      discussed with respect to goals, funding, technical support and expertise,
      infrastructure, and extent of use. Quality assurance and liability issues
      concerning telemedicine child abuse consultations are also reviewed. RESULTS: The
      goals of telemedicine networks in child abuse are to provide (1) expertise to
      less experienced clinicians primarily in rural areas; (2) a method for peer
      review and quality assurance to build consensus of opinions particularly in
      sexual abuse cases; and (3) support for professionals involved in an emotionally
      burdensome area of pediatrics. Problems encountered by existing networks include:
      (1) funding for equipment and reimbursement for consultation; (2) consistent
      technical support: (3) clinician lack of technical expertise, knowledge, or
      motivation; and (4) lack of network infrastructure. Legal considerations include
      licensure exemptions for consulting across state lines, potential for
      malpractice, patient confidentiality and security of images forwarded over modem
      lines, and liability of the equipment, consulting site, and the consultant in
      criminal proceedings. CONCLUSIONS: Telemedicine consultations offer a unique
      opportunity to raise the standard of care in child abuse evaluations, but success
      depends on clinician motivation, appropriate infrastructure, and ongoing funding
      and technical support.

PMID- 11197039
TI  - Emotional responses to child sexual abuse: a comparison between police and social
      workers in Hong Kong.
AB  - OBJECTIVE: Research on specific emotional responses of professionals to child
      sexual abuse (CSA), other than the overwhelming feeling, is currently lacking in
      the child welfare literature. This study examines the initial responses to CSA of
      police and social workers in Hong Kong. METHOD: Based on their recall of the
      first child sexual abuse incident, 28 police officers and 86 social workers from
      10 training sessions on child sexual abuse in Hong Kong indicated how strong they
      felt about their emotions in 10 categories of 37 responses. RESULTS: Among the 37
      emotional responses, police and social workers showed significant differences in
      only seven responses: (1) embarrassment with the perpetrator; (2) ambivalence
      about rescuing the child or preserving the family; (3) fear of being inadequate
      in handling the situation; (4) titillation in response to our involuntary
      physiological responses to words and descriptions of sex acts; (5) feelings of
      revenge because the behavior was bad or immoral; (6) empathy with the child's
      condition; and (7) ambivalence about helping or punishing the perpetrator. In
      both groups, "anger at the perpetrator" and "empathy with the child's condition"
      were the most strongly felt emotions. CONCLUSIONS: Although these two
      professional groups were not significantly different in most of the emotional
      responses to their first child sexual abuse incidents, police were more likely to
      have ambivalent and revenge feelings, while social workers were more likely to
      have discomfort feelings. Limitations of this research project include sampling
      procedure, self-report biases, and effect of training.

PMID- 11197040
TI  - Childhood disciplinary experiences reported by adults with craniofacial
      anomalies.

PMID- 11197041
TI  - Enhancing children's narratives in investigative interviews.
AB  - OBJECTIVE: To illustrate the amount of detail that can be elicited from alleged
      abuse victims using open-ended prompts by closely examining forensic interviews
      of a 5-year-old and a 15-year-old. METHOD: Interview prompts in the substantive
      sections of two forensic interviews were characterized as invitations, cued
      invitations. directive or option-posing, and the number of details they each
      elicited was tabulated. RESULTS: In both interviews, open-ended prompts
      predominated and were distributed throughout the substantive phases of the
      interviews. Most of the information obtained was elicited using open-ended
      prompts, which remained equivalently effective throughout the interviews.
      Reconstruction of the children's accounts illustrated how successive prompts
      continued to elicit information. CONCLUSION: Well-framed open-ended prompts,
      including those that use details provided by the child as cues, elicit narrative
      accounts from children of all ages. Because such information is more likely to be
      accurate, investigators are urged to rely more extensively on open-ended prompts.

PMID- 11197042
TI  - Community acquired acute Helicobacter pylori gastritis.

PMID- 11197043
TI  - Chronic hepatitis B virus infection in Asian countries.
AB  - Of the estimated 50 million new cases of hepatitis B virus (HBV) infection
      diagnosed annually, 5-10% of adults and up to 90% of infants will become
      chronically infected, 75% of these in Asia where hepatitis B is the leading cause
      of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). In Indonesia,
      4.6% of the population was positive for HBsAg in 1994 and of these, 21% were
      positive for HBeAg and 73% for anti-HBe; 44% and 45% of Indonesian patients with
      cirrhosis and HCC, respectively, were HBsAg positive. In the Philippines, there
      appear to be two types of age-specific HBsAg prevalence, suggesting different
      modes of transmission. In Thailand, 8-10% of males and 6-8% of females are HBsAg
      positive, with HBsAg also found in 30% of patients with cirrhosis and 50-75% of
      those with HCC. In Taiwan, 75-80% of patients with chronic liver disease are
      HBsAg positive, and HBsAg is found in 34% and 72% of patients with cirrhosis and
      HCC, respectively. In China, 73% of patients with chronic hepatitis and 78% and
      71% of those with cirrhosis and HCC, respectively, are HBsAg positive. In
      Singapore, the prevalence of HBsAg has dropped since the introduction of HBV
      vaccination and the HBsAg seroprevalence of unvaccinated individuals over 5 years
      of age is 4.5%. In Malaysia, 5.24% of healthy volunteers, with a mean age of 34
      years, were positive for HBsAg in 1997. In the highly endemic countries in Asia,
      the majority of infections are contracted postnatally or perinatally. Three
      phases of chronic HBV infection are recognized: phase 1 patients are HBeAg
      positive with high levels of virus in the serum and minimal hepatic inflammation;
      phase 2 patients have intermittent or continuous hepatitis of varying degrees of
      severity; phase 3 is the inactive phase during which viral concentrations are low
      and there is minimal inflammatory activity in the liver. In general, patients who
      clear HBeAg have a better prognosis than patients who remain HBeAg-positive for
      prolonged periods of time. The outcome after anti-HBe seroconversion depends on
      the degree of pre-existing liver damage and any subsequent HBV reactivation.
      Without pre-existing cirrhosis, there may be only slight fibrosis or mild chronic
      hepatitis, but with pre-existing cirrhosis, further complications may ensue.
      HBsAg-negative chronic hepatitis B is a phase of chronic HBV infection during
      which a mutation arises resulting in the inability of the virus to produce HBeAg.
      Such patients tend to have more severe liver disease and run a more rapidly
      progressive course. The annual probability of developing cirrhosis varies from
      0.1 to 1.0% depending on the duration of HBV replication, the severity of disease
      and the presence of concomitant infections or drugs. The annual incidence of
      hepatic decompensation in HBV-related cirrhosis varies from 2 to 10% and in these
      patients the 5-year survival rate drops dramatically to 14-35%. The annual risk
      of developing HCC in patients with cirrhosis varies between 1 and 6%; the overall
      reported annual detection rate of HCC in surveillance studies, which included
      individuals with chronic hepatitis B and cirrhosis, is 0.8-4.1%. Chronic
      hepatitis B is not a static disease and the natural history of the disease is
      affected by both viral and host factors. The prognosis is poor with decompensated
      cirrhosis and effective treatment options are limited. Prevention of HBV
      infection thorough vaccination is still, therefore, the best strategy for
      decreasing the incidence of hepatitis B-associated cirrhosis and HCC.

PMID- 11197044
TI  - Evaluation of miniature manometric techniques for the measurement of esophageal
      body pressure waves.
AB  - BACKGROUND AND AIMS: Perfused miniature manometric assemblies with lumina of 0.4
      0.5 mm i.d. have been developed. Reduced luminal size offers the advantages of
      reduced assembly bulk and increased assembly complexity with greater numbers of
      lumina and lower manometric infusion volumes because of a slower perfusion rate.
      This study investigated the recording fidelity of miniature manometric assemblies
      in the measurement of esophageal peristalsis. METHODS: Four miniature manometric
      assemblies, each containing manometric lumina of either 0.4 or 0.5 mm i.d., were
      evaluated at 100 and 180 cm lengths. The fidelity of miniature manometric luminal
      recordings were evaluated in vivo during esophageal peristalsis by using a
      simultaneous comparison with the standard lumina and an intraluminal strain
      gauge. RESULTS: During esophageal peristalsis, miniature manometric lumina
      recorded the peak amplitude of pressure waves, with an accuracy at perfusion
      rates of 0.04 mL/min (0.4 mm, i.d.) and 0.15 mL/min (0.5 mm, i.d.). CONCLUSION:
      Miniature manometric assemblies of lengths that are practical for use in humans
      are suitable for recording esophageal peristalsis.

PMID- 11197045
TI  - Histological analysis of gastritis and Helicobacter pylori infection in patients
      with early gastric cancer: a case-control study.
AB  - BACKGROUND AND AIMS: Infection with Helicobacter pylori is associated with an
      increased risk of gastric adenocarcinoma. However, most patients with H. pylori
      infection will not develop gastric cancer. The aims of the present study were to
      examine which histological features, including H. pylori infection, would
      increase the risk of gastric cancer using a case-control study. METHODS: Three
      gastric biopsy specimens were taken from 72 patients with early gastric cancer
      and 72 age- and sex-matched control subjects. The grade of gastritis was examined
      according to the updated Sydney System. The presence of H. pylori infection was
      determined by serology and histology. Odds ratio (OR) of developing gastric
      cancer was calculated for H. pylori positivity and histological features using
      conditional logistic regression. For patients with H. pylori infection,
      histological features in cancer patients and control subjects were compared.
      RESULTS: The OR of the presence of mononuclear cell infiltration in the corpus
      and intestinal metaplasia in the angulus were significantly elevated. The grade
      of mononuclear cell infiltration in the corpus and antrum was significantly
      higher in both types of cancer patients than controls. Glandular atrophy and
      intestinal metaplasia were increased in patients with intestinal-type cancer in
      the angulus and antrum. Bacterial density in the corpus and polymorphonuclear
      cell infiltration in the antrum were increased in patients with diffuse-type
      cancer. CONCLUSIONS: Severe chronic gastritis induced by H. pylori infection
      seems to be associated with diffuse-type gastric cancer. Glandular atrophy and
      intestinal metaplasia, which occur in gastric mucosa with chronic inflammation,
      are significantly associated with intestinal-type cancer.

PMID- 11197046
TI  - A short-term eradication therapy for Helicobacter pylori acute gastritis.
AB  - BACKGROUND AND AIMS: Acute gastritis, caused by an initial infection of
      Helicobacter pylori (H. pylori), may resolve spontaneously, but the infection
      sometimes becomes chronic. We examined the efficacy of a short-term H. pylori
      eradication therapy on acute gastritis. METHODS: Among the 15 patients with
      hemorrhagic acute gastritis who were randomly allocated to group A (eradication
      therapy) or group B (Lansoprazole, LPZ), 10 of them started to receive treatment
      within 1 day after the disease onset. The other five patients began the
      eradication therapy 4-6 days after disease onset (group C). Eradication therapy
      consisted of a daily oral administration of each of 30 mg lansoprazole (LPZ),
      once a day; 400 mg clarithromycin, twice a day; 1000 mg amoxicillin, twice a day;
      and 300 mg rebamipide, three times a day, for one week. If the endoscopy was
      normal, medication was stopped for the following 4 weeks before gastric endoscopy
      was performed again in order to assess H. pylori eradication. RESULTS: All group
      A patients were cured after the 1-week treatment and therefore, they became H.
      pylori negative. Group B and C patients had erosions or ulcers after the 1-week
      treatment and so received an additional 3-week administration of LPZ. Four weeks
      later, their gastritis was cured and except for one group B patient, they became
      H. pylori-negative. CONCLUSION: In patients with acute gastritis, caused by an
      initial H. pylori infection, eradication therapy was efficacious in achieving
      early healing. This therapy should be started as soon as possible after disease
      onset.

PMID- 11197047
TI  - Helicobacter pylori infection among Japanese children.
AB  - BACKGROUND: In Japan, there are few reports describing Helicobacter pylori
      infection among young children. The aim of the present study was to identify risk
      factors associated with H. pylori in school-aged children. METHODS: Subjects were
      first-grade students of three elementary schools (n = 310) and second-grade
      students of a junior high school (n = 300). Personal information, such as
      student's medical history, parent's history, family size, sibshipsize and
      household pets, was collected from guardians using a questionnaire. Saliva
      samples and personal information were collected twice (1995 and 1996). By using
      the saliva samples, H. pylori IgG antibody was measured using a commercial kit.
      To analyze the risk factors for H. pylori infection, sex- and age-adjusted odds
      ratios (OR) were calculated using a multiple logistic model. RESULTS: Among the
      children, factors related to Helicobacter antibody in saliva included spending a
      longer period of time in a nursery school or kindergarten (OR = 4.0) and a
      maternal history of stomach disease (OR = 2.8). Birth order (OR = 2.2), sleeping
      situation (OR = 2.3) and sibshipsize (OR = 1.6) were not factors that were
      significantly related to Helicobacter antibody in the saliva. Chewing food for
      the infant, family size, rooms in the household, sharing a bedroom during
      childhood, pets, a past history and a paternal history were not related to
      positivity. CONCLUSIONS: The results indicate that transmission is person-to
      person, mainly through close contact with other children and intrafamilial
      infection. Helicobacter pylori infection seems to occur frequently early in life,
      probably before 6 years of age.

PMID- 11197048
TI  - Non-steroidal anti-inflammatory drugs with different cyclooxygenase inhibitory
      profiles that prevent aberrant crypt foci formation but vary in acute
      gastrotoxicity in a rat model.
AB  - BACKGROUND: Standard non-steroidal anti-inflammatory drugs (NSAIDs) reduce the
      risk of colorectal cancer; however, their use as preventive agents is limited by
      their inherent toxicity. Drugs that selectively inhibit cyclooxygenase-2 (COX-2)
      may be useful in this setting as they are supposedly less toxic. No study has
      directly compared the ability of standard NSAIDs and selective COX-2 inhibitors
      to inhibit colorectal cancer at clinically relevant doses. METHODS: Aberrant
      crypt foci (ACF) were induced in Sprague-Dawley rats by using 1,2
      dimethylhydrazine (DMH). Test agents or vehicle were then administered for 3
      weeks, twice daily through orogastric gavage. At the end of this period, the
      number and multiplicity of ACF were determined. The agents tested at equivalent
      anti-inflammatory doses were: sulindac and indomethacin (standard NSAIDs),
      meloxicam (selective COX-2 inhibitor), celecoxib (specific COX-2 inhibitor) and
      sulindac sulfone (no known COX activity). Acute gastrotoxicity of NSAID in rats
      was compared by using quantitative histology. RESULTS: All test agents reduced
      the number of ACF. There was a 42% reduction with indomethacin, 46% with
      sulindac, 46% with meloxicam, 22% with celecoxib and 36% with sulindac sulfone.
      Only the COX-2 inhibitors caused no significant gastrotoxicity in rats.
      CONCLUSIONS: Cyclooxygenase-2 inhibitors are potentially ideal chemopreventive
      agents as they inhibit ACF and are not gastrotoxic.

PMID- 11197049
TI  - Overexpression of c-H-ras p21 is correlated with vascular endothelial growth
      factor expression and neovascularization in advanced gastric carcinoma.
AB  - BACKGROUND AND AIMS: ras Gene and its product (p21) have been reported to be
      associated with vascular endothelial growth factor (VEGF), which is one of the
      most important angiogenic factors, and tumor-associated angiogenesis. We tried to
      evaluate the correlation between the expression of c-H-ras gene product p21 and
      angiogenesis in advanced gastric carcinoma. METHODS: Immunohistochemical
      expression of c-H-ras p21 and VEGF was examined in 49 advanced gastric
      adenocarcinomas. In addition, double immunohistochemical staining was performed
      using anti-CD34 and anti-Ki-67 antibodies, and the intratumoral microvessel
      densities and their endothelial proliferative labeling indices were then counted
      to evaluate the degree of angiogenesis. RESULTS: The expression of c-H-ras p21
      was demonstrated in 43 out of 49 gastric adenocarcinomas (87.8%). It did not
      correlate with histologic type, depth of invasion or metastasis. However, the
      degree of c-H-ras p21 expression was correlated with VEGF. In addition, the
      degree of c-H-ras p21 expression was correlated with increased intratumoral
      microvascular density and endothelial proliferative activity. CONCLUSIONS: We
      suggest that c-H-ras oncogene product p21 contributes to the upregulation of
      tumor-associated angiogenesis by the increased production of VEGF in advanced
      gastric carcinomas. Therefore, treatment involving the targeting of ras oncogene
      could inhibit solid tumor growth by suppressing tumor-associated angiogenesis.

PMID- 11197050
TI  - Decreased anti-Saccharomyces cerevisiae antibody titer by mesalazine in patients
      with Crohn's disease.
AB  - BACKGROUND: Saccharomyces cerevisiae may contribute to the pathophysiology of
      Crohn's disease. We determined serum anti-Saccharomyces cerevisiae antibody
      (ASCA) levels in patients with inflammatory bowel disease. METHODS AND RESULTS:
      Immunoglobulin G (IgG) ASCA was measured by using an ELISA in serum samples from
      19 patients with ulcerative colitis, 18 patients with Crohn's disease and 7
      healthy controls. The ASCA level was significantly higher in patients with
      ulcerative colitis and patients with Crohn's disease than in controls, and was
      significantly higher in patients with Crohn's disease compared with patients with
      ulcerative colitis. Age, gender, disease activity, extent of disease and small
      bowel involvement each did not affect ASCA levels. The use of elemental or
      polymeric diet therapy for Crohn's disease and administration of corticosteroids
      to patients with inflammatory bowel disease also did not affect ASCA levels. The
      ASCA titer was significantly lower in patients with Crohn's disease taking
      mesalazine than in those not taking it, although, serum IgG levels did not differ
      between these two groups, which might imply a suppression of IgG production by
      mesalazine at the intestinal level. CONCLUSIONS: The finding of increased serum
      ASCA titers in patients with inflammatory bowel disease suggests that
      Saccharomyces cerevisiae may play a role in the pathophysiology of this
      condition.

PMID- 11197051
TI  - Status and natural course of GB virus C/hepatitis G virus infection among high
      risk groups and volunteer blood donors in Taiwan.
AB  - BACKGROUND: Hemophilia, thalassemia and uremia patients are at risk of
      parenterally transmitted infectious agents. The status and nature of the course
      of GB virus C/hepatitis G virus (GBV-C/HGV) infection among these groups and
      blood donors in Taiwan was investigated. METHODS: Serum GBV-C HGV-RNA and
      antibodies to GBV-C/HGV envelope-2-protein (anti-E2) were determined in 500 blood
      donors and in 44 hemophilia, 37 thalassemia and 85 uremia patients. Phylogenetic
      analysis was performed. RESULTS: The prevalence of GBV-C/HGV-RNA and anti-E2,
      respectively, was 38.6 and 27.3% in hemophilia patients, 27.0 and 27.3% in
      thalassemia patients, 14.1 and 10.6% in uremia patients and 3.4 and 7.2% in blood
      donors. The prevalence of GBV-C HGV exposure was 59.1 and 51.4% in hemophilia and
      thalassemia patients, respectively, which was significantly higher than that for
      uremia patients (22.4%; P < 0.01) and blood donors (10.2%; P < 0.001). The anti
      E2 seroconversion rate was 66.7% in blood donors and 47.4, 36.8 and 34.6% in
      thalassemia, uremia (P < 0.05 compared with blood donors) and hemophilia (P <
      0.01 compared with blood donors) patients, respectively. Discrepancies in the
      prevalence of GBV-C HGV and hepatitis C virus infection were found among the
      three risk groups. Phylogenetic analysis showed that 51 of 56 GBV-C HGV isolates
      clustered in group 3; the remaining five were of group 2a. Twelve of 39 viremic
      patients in the risk groups cleared the virus during the 4 year follow-up period;
      seven developed concomitant anti-E2 reactivity. CONCLUSIONS: GB virus C hepatitis
      G virus infection is epidemic among risk groups and GBV-C HGV group 3 is the
      major strain in Taiwan. In the risk groups, approximately 18% of infections
      resolve with concomitant anti-E2 seroconversion within 4 years.

PMID- 11197052
TI  - Chronic hepatitis C is mild in menstruating women.
AB  - BACKGROUND AND AIMS: Women with chronic hepatitis C may have a slower rate of
      disease progression than men. We have previously demonstrated a relationship
      between hepatic iron concentration and liver fibrosis in patients with chronic
      hepatitis C. Our aim was to compare hepatic histologic findings, iron status and
      other factors putatively capable of determining the severity of chronic hepatitis
      between menstruating women and men of comparable age. METHODS: We studied 21
      consecutive hepatitis C virus (HCV)-RNA positive menstruating women and 24
      consecutive HCV-RNA positive men of comparable age, who underwent liver biopsy
      for chronic hepatitis C. Alcohol intake was recorded and blood tests, HCV
      genotyping, serum iron, unsaturated iron binding capacity, serum ferritin,
      hepatic iron concentration, and liver histology were evaluated. RESULTS:
      Menstruating women showed lower grading (2.7 +/- 1.5 vs 3.6 +/- 2, P = 0.09) and
      significantly lower staging (1.38 +/- 1.11 vs 2.42 +/- 1.64, P = 0.037) scores
      than men of comparable age. Among the factors putatively capable of determining
      the severity of chronic hepatitis, only the hepatic iron concentration correlated
      with the hepatic histologic staging in a multivariate analysis. Iron-depleted
      women (transferrin saturation < 20% and/or serum ferritin < 9 micrograms/L)
      showed significant lower hepatic histologic grading (1.75 +/- 0.7 vs 3.23 +/-
      1.55, P = 0.027) and staging (0.75 +/- 1.03 vs 1.77 +/- 1.01, P = 0.026) scores
      than women with normal iron status. CONCLUSIONS: Menstruating women with chronic
      hepatitis C may have a milder disease compared to men of comparable age, possibly
      because of menstrual blood loss and lower hepatic iron concentration. Women with
      chronic hepatitis C and iron deficiency have a milder disease compared to women
      with normal iron status, suggesting that iron deficiency results in a slower rate
      of disease progression.

PMID- 11197053
TI  - Efficacy of consensus interferon in the treatment of chronic hepatitis C.
AB  - BACKGROUND AND AIMS: Consensus interferon (CIFN) is a newly developed type I
      interferon. The aim of this study was to investigate the safety and efficacy of
      CIFN in the treatment of patients with chronic hepatitis C and to determine the
      predictors for sustained response. METHODS: Patients were randomized to receive 3
      micrograms or 9 micrograms CIFN three times a week for 24 weeks, followed by 24
      weeks of observation. Efficacy was assessed by normalization of serum
      transaminase levels and disappearance of serum hepatitis C virus (HCV)-RNA at the
      end of treatment and at 24 weeks after stopping treatment. Histologic response
      was defined as a decrease of at least two points in the Knodell necroinflammatory
      score at week 48 and was compared with baseline. RESULTS: There were no serious
      adverse effects related to CIFN therapy. Overall, 44% of patients receiving 3
      micrograms and 48% of patients receiving 9 micrograms had normalization of serum
      transaminase levels and disappearance of HCV viremia at the end of treatment. At
      24 weeks after stopping treatment, 16% of patients in receiving 9 micrograms and
      12% of patients receiving 3 micrograms had sustained responses. The histologic
      responses in patients receiving 9 micrograms and those receiving 3 micrograms
      were 60% and 36%, respectively. The necroinflammatory score was significantly
      reduced from baseline to week 48 in both groups. In addition, bodyweight < 60 kg
      and pretreatment serum HCV-RNA level < 0.5 MEq/mL can serve as predictors for
      sustained response to CIFN treatment. CONCLUSIONS: These findings suggest that 9
      micrograms CIFN is safe and effective in the treatment of patients with chronic
      hepatitis C.

PMID- 11197055
TI  - Gastrointestinal: double pylorus.

PMID- 11197054
TI  - Renovascular resistance assessed by color Doppler ultrasonography in patients
      with chronic liver diseases.
AB  - BACKGROUND AND AIMS: Renal arterial vasoconstriction is known to be related to
      renal hemodynamic derangement in patients with liver cirrhosis. Using color
      Doppler ultrasonography in patients with chronic liver diseases, abnormal
      resistance in the renal artery was examined non-invasively both cross-sectionally
      and longitudinally to clarify the relationship between renal vascular resistance
      and liver function to neurohumoral factors. METHODS: The study comprised 118
      patients with cirrhosis, 23 patients with chronic hepatitis, and 35 healthy
      controls. Pulsatility and resistive indices that were derived from renal artery
      velocity analysis were used as parameters of renal arterial resistance. RESULTS:
      Both the pulsatility and resistive indices were significantly higher in cirrhotic
      patients (1.29 +/- 0.37, P < 0.001 and 0.69 +/- 0.07, P < 0.001, respectively)
      compared to controls (1.00 +/- 0.12 and 0.62 +/- 0.05, respectively) and compared
      to patients with chronic hepatitis (0.97 +/- 0.13 and 0.60 +/- 0.05,
      respectively). Both indices showed significant correlation with increased Child
      Pugh grade. Each correlated significantly with plasma renin activity and plasma
      aldosterone and norepinephrine levels. Multivariate analysis of the relationship
      between neurohumoral factors and renal arterial resistance disclosed that plasma
      renin activity was a significant independent predictor. The longitudinal change
      in pulsatility index, resistive index and neurohumoral factors were examined in
      the cirrhotic patients who were followed-up for longer than 6 months. Pulsatility
      and resistive indices increased according to the deterioration of liver function
      and the changes in both indices were closely related to the change in plasma
      renin activity. CONCLUSIONS: Pulsatility index and resistive index as measured by
      color Doppler ultrasonography were closely related to the severity of cirrhosis
      and to the levels of neurohumoral factors, especially plasma renin activity, in
      this cross-sectional and longitudinal study. Therefore, they are useful indices
      for assessing renal hemodynamics in patients with cirrhosis.

PMID- 11197056
TI  - Hepatobiliary and pancreatic: small liver tumor. Small hepatocellular carcinoma
      with fatty changes.

PMID- 11197057
TI  - A balanced 5:1 carbohydrate:protein diet: a new method for supplementing protein
      to patients with chronic liver disease.
AB  - BACKGROUND AND AIMS: Protein malnutrition in patients with chronic liver disease
      contributes to bone and muscle weakness and compromises immune function and
      survival. In contrast, high-protein diets may induce or exacerbate hepatic
      encephalopathy. The aim of the present study was to test whether increased
      amounts of protein, balanced by dietary carbohydrate in a 1:5 ratio, may be given
      to chronic liver disease patients in order to minimize postprandial increases in
      plasma amino acid (AA) concentrations. METHODS: Eight patients with chronic liver
      disease were studied. Each received, in a randomized order, three different diets
      of 2510 kJ of either high protein (37:50:28, carbohydrate:protein:fat), high
      carbohydrate (126:10:6) or a balanced 5:1 carbohydrate:protein diet (105:21:11).
      All patients were followed for plasma AA, glucose and insulin levels, as well as
      for cognitive and behavioral changes. RESULTS: Following the high protein diet,
      AA concentrations were significantly increased. In contrast, after the balanced
      diet, AA levels were practically constant enabled. All diets was well tolerated
      and no cognitive or behavioral changes appeared. CONCLUSION: The administration
      of a balanced 5:1 carbohydrate:protein diet may enable patients with chronic
      liver disease to tolerate increased amounts of dietary protein, without altering
      plasma amino acid concentrations.

PMID- 11197058
TI  - Parathyroid hormone-related peptide producing cholangiocellular carcinoma with a
      marked psammoma formation.
AB  - Humoral hypercalcemia caused by parathyroid hormone-related peptide (PTHrP),
      associated with cholangiocellular carcinoma (CCC), has rarely been documented.
      There have been no reports of CCC associated with extensive calcification of the
      tumor with psammoma body formation. A 66-year-old man was admitted with a large
      calcified tumor in the liver detected on an abdominal X-ray. An ultrasound-guided
      fine needle biopsy specimen of the liver tumor showed evidence of adenocarcinoma.
      He had hypercalcemia with an elevated PTHrP level. The patient died because of
      disseminated intravascular coagulation and progressive hepatic failure. A
      postmortem examination revealed a large poorly differentiated CCC in the liver.
      Immunohistochemical examination showed the presence of PTHrP-positive tumor
      cells. The calcified lesion consisted of a number of accumulated psammoma bodies.
      We present a case of PTHrP producing CCC with a marked psammoma formation.

PMID- 11197059
TI  - Advanced hepatocellular carcinoma with distant metastases, successfully treated
      by a combination therapy of alpha-interferon and oral tegafur/uracil.
AB  - We report a case of advanced hepatocellular carcinoma (HCC), successfully treated
      by a combination therapy of alpha-interferon (IFN-alpha) and tegafur/uracil
      (UFT). A 44-year-old Japanese man who underwent a partial hepatectomy for HCC
      developed tumor recurrence in the liver 10 months after surgery. Transcatheter
      arterial chemoembolization (TAE) was performed twice within 7 months, but was
      ineffective. Later, multiple metastatic lesions appeared in the liver, lung and
      spine. Following the third TAE, a combination therapy of IFN-alpha (10 x 10(6)
      units, i.m., t.i.w.) and UFT (300 mg, p.o.d.) was started. The treatment resulted
      in a fall in serum PIVKA-II (protein induced by vitamin K antagonism) levels from
      906 mAU to normal levels and a complete resolution of all lung nodules within 6
      months. At the latest follow up 24 months after the initiation of combination
      treatment, the patient was working full-time and showed no evidence of tumor
      relapse. A combination therapy of IFN-alpha and UFT may be promising for the
      treatment of advanced HCC.

PMID- 11197060
TI  - A multimodal intervention for grandparents raising grandchildren: results of an
      exploratory study.
AB  - This article describes the results of an exploratory study of a multimodal, home
      based intervention designed to reduce psychological stress, improve physical and
      mental health, and strengthen the social support and resources of grandparents
      raising grandchildren. The six-month intervention included home visits by
      registered nurses, social workers, and legal assistants; the services of an
      attorney; and monthly support group meetings. The intervention resulted in
      improved mental health scores, decreased psychological distress scores, and
      increased social support scores. Participants also experienced improvement in the
      level of public benefits received and in their legal relationships with their
      grandchildren. Implications of these findings for practice are highlighted.

PMID- 11197061
TI  - Helping foster parents cope with separation, loss, and grief.
AB  - Major changes in planning for children in foster care have resulted in
      significant changes in the roles of and expectations for foster parents,
      accompanied by even less attention to the issues of foster families' grief and
      loss. This article focuses on (1) the many ways foster parents encounter loss and
      grief on a continuous basis; (2) factors that affect the intensity of the loss
      and the healthy expression and resolution of grief; (3) problems that can result
      when the grief of foster parents is not adequately addressed; and (4) ways in
      which professionals can be helpful to these caregivers around loss and grief.

PMID- 11197062
TI  - How soon is too soon? Addiction recovery and family reunification.
AB  - This article describes the addiction recovery process and its impact on parenting
      behaviors-information needed by child welfare workers involved in decisionmaking
      regarding family reunification. Two models of recovery-from alcoholism and from
      cocaine addiction-are reviewed, along with issues encountered in recovery,
      particularly for women. Case examples and discussion demonstrate how child
      welfare workers can apply these models in determining the appropriateness of
      reunification.

PMID- 11197063
TI  - The postadoption experience: child, parent, and family predictors of family
      adjustment to adoption.
AB  - Eighteen to 24 months after they adopted children in state custody, 159 parents
      were surveyed regarding their postadoption experiences. Most children remained
      with their new families, with parents reporting the adoption experience to be
      "about as hard as expected," and rating the past year of caring for the child as
      being more "smooth" than "stressful." Parents saw how the child contributed
      positively to their lives, were less positive about available social supports,
      and expressed dissatisfaction with the speed of the adoption, the availability of
      community supports, and the ability to link with supports. Children's special
      needs (e.g., older age at adoption) were predictive of postplacement adjustment.

PMID- 11197064
TI  - Effects of clofibrate and indocyanine green on the hepatobiliary disposition of
      acetaminophen and its metabolites in male CD-1 mice.
AB  - 1. The effects of clofibrate (CFB) and indocyanine green (ICG) on the biliary
      excretion of acetaminophen (APAP) and its metabolites were investigated. 2. Male
      CD-1 mice were pretreated with 500 mg CFB/kg, i.p. for 10 days. Controls received
      corn oil vehicle only. After overnight fasting, common bile duct-cannulated mice
      were challenged with a non-toxic dose of APAP (1 mmol/kg, i.v.). 3. CFB
      pretreatment did not affect bile flow rate, nor did it affect the cumulative
      biliary excretion of APAP and its conjugated metabolites. 4. Additional CFB or
      corn oil pretreated mice were given 30 mumol indocyanine green (ICG)/kg, i.v.,
      immediately before APAP dosing. ICG is a non-metabolizable organic anion that is
      completely excreted into the bile through a canalicular transport process for
      organic anions. 5. ICG significantly decreased the bile flow rate and biliary
      concentration of APAP-glutathione, APAP-glucuronide and APAP-mercapturate within
      the first hour after dosing without affecting the biliary concentration of APAP.
      6. The results indicate that CFB pretreatment does not affect the total amount of
      APAP and its metabolites excreted in bile. They also suggest that the biliary
      excretion of several conjugated metabolites of APAP share the same excretory
      pathway with the organic anion ICG.

PMID- 11197065
TI  - In vitro identification of the cytochrome P450 isoform responsible for the
      metabolism of alpha-dihydroergocryptine.
AB  - 1. The in vitro metabolism of alpha-dihydroergocryptine (DHEC, Almirid), an ergot
      derived dopamine agonist for the treatment of Parkinson's disease, has been
      studied in cultured cell lines following incubation with DHEC. Human hepatocytes
      as well as two sets of metabolically competent cell lines expressing one single
      human cytochrome P450 (1A1, 1A2, 1B1, 2A6, 2C8, 2C9, 2C18, 2C19, 2D6, 2E1, 3A4)
      were used. 2. Mono- and dihydroxy metabolites of DHEC could only be detected in
      the culture media of the cell line expressing human cytochrome CYP3A4. The same
      metabolites were found in the media of cultured human hepatocytes derived from
      three different donors. After 24-h incubation with 1 microM DHEC, approximately
      60% mono- and approximately 20% dihydroxy metabolites were detected, i.e.
      approximately 80% of DHEC was metabolized. Further, DHEC demonstrated an
      inhibitory effect on CYP3A4-mediated testosterone metabolism and additionally
      could induce CYP3A4 and CYP2E1 mRNA when added at 10 microM to cultured human
      hepatocytes. 3. The data suggest that DHEC metabolism in humans is primarily
      mediated by the CYP3A4 isoform. The results are in accordance with findings
      derived from other ergot alkaloids.

PMID- 11197066
TI  - Glucuronidation of resveratrol, a natural product present in grape and wine, in
      the human liver.
AB  - 1. Resveratrol, a polyphenolic compound present in grape and wine, has beneficial
      effects against cancer and protective effects on the cardiovascular system. It
      has been shown that the compound is sulphated in human liver and the aims of the
      present investigation were to study resveratrol glucuronidation in human liver
      microsomes and to determine whether flavonoids inhibit resveratrol
      glucuronidation. 2. A simple and reproducible radiometric assay for resveratrol
      glucuronidation was developed. The assay employed uridine-5'-diphosphoglucuronic
      acid-[14C] and unlabelled resveratrol. Resveratrol-glucuronide was isolated by
      TLC. The intra- and interassays variabilities were 1 and 1.5%, respectively. 3.
      The rate of resveratrol glucuronidation was measured in 10 liver samples. The
      mean +/- SD and median of resveratrol glucuronidation rate were 0.69 +/- 0.34 and
      0.80 nmol/min/mg, respectively. Resveratrol glucuronosyl transferase followed
      Michaelis-Menten kinetics and the Km and Vmax (mean +/- SD; n = 5) were 0.15 +/-
      0.09 mM and 1.3 +/- 0.3 nmol/min/mg, respectively. The intrinsic clearance was 11
      +/- 4 x 10(-3) ml/min.mg. 4. The flavonoid quercetin inhibited resveratrol
      glucuronidation and its IC50 (mean +/- SD; n = 3) was 10 +/- 1 microM. Myricetin,
      catechin, kaempferol, fisetin and apigenin (all at 20 microM) inhibited
      resveratrol glucuronidation and the percent of control ranged between 46%
      (catechin) to 72% (apigenin). 5. The present results show that resveratrol is
      glucuronated in the human liver. Glucuronidation may reduce the bioavailability
      of this compound however, flavonoids inhibit resveratrol glucuronidation and such
      an inhibition might improve the bioavailability of resveratrol.

PMID- 11197067
TI  - Metabolism of 26,27-hexafluoro-1 alpha,25-dihydroxyvitamin D3 and 26,27
      hexafluoro-1 alpha,23(S)25-trihydroxyvitamin D3 in ROS17/2.8 cells transfected
      with a plasmid expressing CYP24.
AB  - 1. To clarify the possibility that the metabolism of 26,27-hexafluoro-1 alpha,25
      dihydroxyvitamin D3 [F6-1,25(OH)2D3] to 26,27-hexafluoro-1 alpha,23(S),25
      trihydroxyvitamin D3 [F6-1,23,25(OH)3D3 and that of F6-1,23,25(OH)3D3 to 26,27
      hexafluoro-23-oxo-1 alpha,25-dihydroxyvitamin D3 [F6-23-oxo-1,25(OH)2D3] are
      catalysed by 25-hydroxyvitamin D3 24-hydroxylase (CYP24), ROS17/2.8 cells
      transfected with a plasmid expressing CYP24 [pSVL-CYP24(+)] and a corresponding
      blank plasmid [pSLV-CYP24R(-)] were used. 2. Incubation of [1 beta-3H]-F6
      1,25(OH)2D3 for 2 and 5 days with ROS17/2.8 cells transfected with pSVL-CYP24(+)
      generated a metabolite that co-migrated with authentic F6-1,23,25(OH)3D3 in both
      normal phase and reversed-phase HPLC systems. 3. Incubation of [1 beta-3H]-F6
      1,23,25(OH)3D3 for 5 days with pSVL-CYP24(+)- transfected ROS 17/2.8 cells
      generated a metabolite that co-migrated with authentic F6-23-oxo-1,25(OH)2D3. In
      contrast, the metabolites F6-1,23,25(OH)3D3 or F6-23-oxo-1,25(OH)2D3 were not
      generated in the cells transfected with pSVL-CYP24R(-). 4. The results indicate
      that CYP24 catalyses the conversion of F6-1,25(OH)2D3 to F6-1,23,25(OH)3D3 and
      that of F6-1,23,25(OH)3D3 to F6-23-oxo-1,25(OH)2D3.

PMID- 11197068
TI  - Isolation and cultivation of Ca2+ tolerant cardiomyocytes from the adult rat:
      improvements and applications.
AB  - 1. Primary cultures of cardiomyocytes provide a valuable tool for the study of
      the pharmacological and toxicological properties of drugs and chemicals, but for
      several technical reasons cardiomyocytes from adult animals are not routinely
      used in long-term culture. Because of significant advances in cardiovascular
      research, tissue engineering and cell transplantation, the need to isolate
      primary cells from adult animal and/or human tissue is likely to increase in the
      future. 2. The most common protocols for the isolation and cultivation of
      cardiomyocytes have been reviewed and the various approaches have been compared.
      The recent advances in cell culture techniques and the use of the cytoprotective
      agent, e.g. 2,3-butanedione monoxime greatly increases cell yield and cell
      viability of isolated and cultured cardiomyocytes. New concepts emerge that
      enabled an assessment of cellular differentiation in cultured cardiomyocytes and
      certain specific nuclear transcription factors may play a pivotal role in this
      process.

PMID- 11197069
TI  - Skeletal muscle kinetics of propofol in anaesthetized sheep: effect of altered
      muscle blood flow.
AB  - 1. The kinetics of propofol were studied in vivo in a skeletal muscle bed of the
      hindlimb of the anaesthetized sheep at normal and low rates of blood flow. 2.
      Propofol kinetics in muscle were determined during and after a 20-min i.v.
      infusion of propofol (10 mg min-1) via paired arteriofemoral venous blood
      sampling. One-and-a-half hours later, the study was repeated but with a
      concurrent left femoral artery infusion of adrenaline (0.004 mg min-1) to lower
      the muscle blood flow by vasoconstriction. 3. Muscle blood flow in the low flow
      state was 28% of that in the normal state. The kinetics were poorly described by
      a single flow-limited compartment model, but were better described by a model
      with a flow-limited component and a deeper distribution component. There were no
      significant differences in muscle retention of propofol between normal and low
      flow states. 4. There was an apparent arteriovenous shunt of approximately 24% of
      total muscle blood flow for the low flow state, but not for the normal blood flow
      state.

PMID- 11197070
TI  - Mass spectrometric and NMR characterization of metabolites of roxifiban, a potent
      and selective antagonist of the platelet glycoprotein IIb/IIIa receptor.
AB  - 1. The methyl ester prodrug roxifiban is an orally active, potent and selective
      antagonist of the platelet glycoprotein GPIIb/IIIa receptor and is being
      developed for the prevention and treatment of arterial thrombosis. 2. Roxifiban
      was rapidly hydrolyzed to the zwitterion XV459 in vivo and by liver slices from
      the rat, mouse and human and by intestinal cores from dog. XV459 was metabolized
      to only a small extent in vitro and in vivo. 3. Studies with rat and dog given
      radiolabelled roxifiban showed limited oral absorption with the majority of the
      radiolabel being excreted in faeces. After i.v. doses of 14C-roxifiban, most of
      the radioactivity was recovered in the urine of rat whereas the dog excreted
      significant amounts of radioactivity in bile and urine. 4. XV459 could be
      metabolized extrahepatically by dog gut flora to produce an isoxazoline ring
      opened metabolite. In vitro hepatic metabolism of XV459 was mainly by
      hydroxylation at the prochiral and chiral centres of the isoxazoline ring. These
      hydroxylated metabolites were not detected in the urine and plasma of human
      volunteers administered roxifiban. 5. Initial LC/MS identification of metabolites
      was achieved by dosing the rat with an equimolar mixture of d0:d4 roxifiban and
      detecting isotopic clusters of pseudomolecular ions. Unequivocal characterization
      of these metabolites was achieved by LC/MS, LC/NMR and high-field NMR techniques
      using synthetic standards of the metabolites. 6. The synthesis of one
      hydroxylated metabolite enabled the assignment of the correct stereochemistry of
      the substituted hydroxyl group on the isoxazoline ring.

PMID- 11197071
TI  - Transdermal delivery of the potent analgesic dihydroetorphine: kinetic analysis
      of skin permeation and analgesic effect in the hairless rat.
AB  - Dihydroetorphine is an extraordinarily strong opioid analgesic. To assess its
      effectiveness after topical application in hairless rats we have examined the
      kinetic analysis of skin permeation through excised skin and the in-vitro
      reservoir effect of skin, and have investigated the predictability of plasma
      concentration and analgesic effect following in-vivo transdermal application.
      Dihydroetorphine was moderately permeable from an aqueous suspension through
      excised hairless rat skin. Dihydroetorphine flux from drug-dispersed pressure
      sensitive adhesive tape was threefold that from the applied aqueous suspension.
      The fluxes through the abdominal and the dorsal skin during tape application
      fitted the Fickian diffusion equation well after the tape was removed peeling off
      the outer layer of the stratum corneum. The relationship between the plasma
      concentration and the analgesic effect was examined for four different rates of
      infusion of dihydroetorphine. A non-linear pharmacokinetic disposition was
      observed. Following abdominal (0.28 cm2, 20 microg) and dorsal (0.50 cm2, 35
      microg) applications of the dihydroetorphine tape, plasma concentration (0.2-0.8
      ng mL(-1)) and analgesic effect were maintained at a suitable level, for more
      than 8 h, until removal of the tape. These profiles were predictable using the
      combined equation for percutaneous absorption, disposition and the analgesic
      effect, but the analgesic effect was slightly lower than the predicted value. The
      results show that it was possible to control the plasma concentration and the
      analgesic effect of dihydroetorphine by topical application of the analgesic
      using pressure-sensitive adhesive tape in the hairless rat. It was possible to
      predict the result using mathematical modelling.

PMID- 11197072
TI  - Sustained release of 5-fluorouracil from polymeric nanoparticles.
AB  - The use of biodegradable nanoparticles loaded with 5-fluorouracil was
      investigated as a potential means to sustain the release of this drug.
      Nanoparticles prepared from four biodegradable polymers were loaded with 5
      fluorouracil using three loading concentrations of drug and three different
      concentrations of added polymer. Washing particles using a centrifugation/re
      suspension with ultrasound protocol was found to dislodge the majority of drug,
      resulting in an over-estimation of incorporation efficiency and low levels of
      strongly entrapped drug. Increasing the initial 5-fluorouracil concentration
      before polymer/monomer addition increased the drug loading in both washed and
      unwashed particles. Increasing the amount of polymer used to make nanoparticles
      did not increase loadings, but did produce increased amounts of unusable polymer
      waste. Drug release from nanoparticles was evaluated using a Franz cell diffusion
      apparatus, which showed an initial burst effect followed by a slower release
      phase over 24 h. Indeed, nanoparticles prepared from poly(lactide-co-glycolide)
      released 66% of their 5-fluorouracil payload over this period. It was concluded
      that 5-fluorouracil-loaded nanoparticles could be readily included into a
      hydrogel-based delivery system to provide sustained drug release for trans
      epithelial drug-delivery applications.

PMID- 11197073
TI  - Enhancement of anti-metastatic activity of pentoxifylline by encapsulation in
      conventional liposomes and sterically stabilized liposomes in murine experimental
      B16F10 melanoma model.
AB  - Pentoxifylline has been shown to exhibit anti-metastatic activity by inhibiting
      homing of B16F10 melanoma cells in the murine experimental metastasis model. In
      this study, the effect of encapsulation of pentoxifylline in conventional and
      sterically stabilized liposomes on its anti-metastatic activity in the murine
      experimental metastasis model was investigated. After a single intravenous dose
      (10, 20 or 40 mg kg(-1)), pentoxifylline solution, as well as conventional
      pentoxifylline liposomes, significantly reduced the number of pulmonary nodules
      compared with the untreated control group. Conventional pentoxifylline liposomes
      showed significantly higher inhibition (69%) of pulmonary tumour nodule formation
      at a dose of 20mg kg(-1) as compared with pentoxifylline solution (49%) at the
      same dose. Encapsulation of pentoxifylline in sterically stabilized liposomes
      prepared by incorporation of monomethoxypolyethyleneglycol (5000)-cholesteryl
      ester further enhanced the inhibition of pulmonary nodule formation (77%) at a
      dose of 20 mg kg(-1) as compared with conventional pentoxifylline liposomes.
      Overall, the results suggest that encapsulation of pentoxifylline in conventional
      liposomes enhanced its anti-metastatic activity. Steric stabilization of
      pentoxifylline liposomes also resulted in a two-fold increase in anti-metastatic
      activity (at dose of 10 mg kg(-1)) as compared with conventional liposomes.

PMID- 11197074
TI  - Pharmacokinetics and bioavailability of tacrolimus in rats with experimental
      renal dysfunction.
AB  - The effects of renal failure on the pharmacokinetics and bioavailability of
      tacrolimus were investigated in rats. Experimental renal dysfunction was induced
      by intraperitoneal injection of cisplatin (5 mg kg(-1)) into rats. The blood
      concentration of tacrolimus was measured after intravenous and intra-intestinal
      administration of the drug. The blood concentration of tacrolimus after
      intravenous administration (1 mg kg(-1)) was slightly increased (up to 1.3 fold)
      by induction of renal dysfunction. In contrast, the peak tacrolimus concentration
      after intra-intestinal administration (1 mg kg(-1) or 3 mg kg(-1)) in rats with
      renal failure was about 2-fold higher than that in normal controls. The
      bioavailability was increased by about 35% in rats with impaired renal function
      as compared with normal controls. These results suggested that the
      bioavailability of tacrolimus, which is mainly metabolized in the liver and
      intestine after oral administration, is also influenced by renal function.

PMID- 11197075
TI  - Different effects of amitriptyline and imipramine on the pharmacokinetics and
      metabolism of perazine in rats.
AB  - The aim of this study was to search for possible effects of imipramine and
      amitriptyline on the pharmacokinetics and metabolism of perazine at steady state
      in rats. Perazine (10 mg kg(-1), i.p.) was administered to rats twice daily for
      two weeks, alone or jointly with imipramine or amitriptyline (10 mg kg(-1) i.p.).
      Concentrations of perazine and its two main metabolites (5-sulphoxide and N
      desmethylperazine) in the plasma and brain were measured at 30 min (Cmax), 6h and
      12h (slow disposition phase) after the last dose of the drugs. Liver microsomes
      were prepared 24 h after withdrawal of the drugs. Amitriptyline increased the
      plasma and brain concentrations of perazine (up to 300% of the control) and N
      desmethylperazine, while not affecting those of 5-sulphoxide. Imipramine only
      tended to increase the neuroleptic concentration in the plasma and brain. Studies
      with control liver microsomes showed that amitriptyline and imipramine added to
      the incubation mixture in-vitro, competitively inhibited N-demethylation (Ki
      (inhibition constant) = 16 microM and 164 microM, respectively) and 5
      sulphoxidation (Ki = 57 microM and 86 microM, respectively) of perazine,
      amitriptyline being a more potent inhibitor of perazine metabolism, especially
      with respect to N-demethylation. Studies with microsomes of rats treated
      chronically with perazine or tricyclic antidepressants, or both, did not show
      significant differences in the rate of perazine metabolism between perazine- and
      perazine+antidepressant-treated rats. The data obtained were compared with the
      results of analogous experiments with promazine and thioridazine. It was
      concluded that elevations of perazine concentration were caused by direct
      inhibition of the neuroleptic metabolism by the antidepressants. Similar
      interactions, possibly leading to exacerbation of the pharmacological action of
      perazine, may be expected in man. Since the interactions between phenothiazines
      and tricyclic antidepressants may proceed in two directions, reduced doses of
      both the neuroleptic and the antidepressant are recommended when the drugs are
      administered jointly.

PMID- 11197076
TI  - Effect of buthionine sulphoximine, glutathione and methimazole on the renal
      disposition of cisplatin and on cisplatin-induced nephrotoxicity in rats:
      pharmacokinetic-toxicodynamic analysis.
AB  - The aim of this study was to classify the protective mechanisms of DL-buthionine
      (S,-R)-sulphoximine, glutathione and methimazole on cisplatin-induced
      nephrotoxicity in rats. An Emax model was used to study the effect of these
      compounds on the pharmacokinetics of cisplatin, especially renal handling and
      intra-renal biotransformation. Cisplatin (5 mg kg(-1)) was administered as an
      intravenous bolus to rats treated with either 0.9% NaCl (control), buthionine
      sulphoximine, glutathione or methimazole. The blood urea nitrogen level was
      monitored to estimate cisplatin-induced nephrotoxicity. To estimate renal
      handling of cisplatin, cisplatin was infused intravenously to rats treated with
      0.9% NaCl, buthionine sulphoximine, glutathione or methimazole. The
      concentrations of unchanged cisplatin in plasma, urine and kidney were determined
      by a post-column derivatization HPLC method. The relationship between the
      pharmacokinetics and toxicodynamics of cisplatin was analysed using a sigmoid
      Emax model. All compounds studied ameliorated significantly the nephrotoxicity of
      cisplatin. The renal accumulation of cisplatin was reduced significantly by
      pretreatment with buthionine sulphoximine but not by either glutathione or
      methimazole. Although glutathione treatment did not affect the renal accumulation
      of cisplatin, it significantly decreased the binding of cisplatin to the
      intrarenal organelle and the decreased binding was well correlated to the
      decrease of the blood urea nitrogen level. In summary, pharmacokinetic
      toxicodynamic analysis will be useful for classifying the protective mechanism of
      cisplatin-induced nephrotoxicity.

PMID- 11197077
TI  - Determination of tissue spaces of the isolated hindlimb of the rat using
      netilmicin as an extracellular space indicator.
AB  - The kinetic behaviour of drugs in extracellular space is of interest as it
      influences the drug's access to, and permanence in, those areas of the body upon
      which drugs exert pharmacological or toxicological actions. A series of
      experiments was carried out to characterize the vascular, interstitial and
      cellular spaces of the isolated hindlimb of the rat. Certain specific
      experimental conditions were met: body weight was under 230 g to avoid fat tissue
      in the preparations; a perfusion flow rate of 3 mL min(-1); and 3% of bovine
      albumin in the perfusate supplied at 25 degrees C to the tissues. The isolation
      of the hindlimb followed the method described by Ruderman with some modifications
      to restrict the perfusion to the right hindlimb. Tritiated water, netilmicin and
      methylene blue were injected separately and efferent fluid samples were collected
      for 15 min after solute injection. Analysis of the efferent curves was performed
      to calculate the statistical moments (AUC, area under concentration-time curve;
      MTT, mean transit time; VTT, variance of mean transit times) and solute
      distribution volumes, which were subsequently used to estimate the tissue spaces
      of the isolated hindlimb. The results revealed that methyl blue and netilmicin
      can be respectively used as alternatives to radiolabelled indicators of the
      vascular and extracellular spaces of tissues included in the rat isolated
      hindlimb.

PMID- 11197078
TI  - Time-dependent nephrotoxicity associated with daily administration of cisplatin
      in mice.
AB  - The chronopharmacokinetics and chronopharmacodynamics of cisplatin were studied
      in a mouse model to reveal the mechanisms of dosing time-dependent nephrotoxicity
      induced by daily administration. Chronotoxicity was tested by daily
      intraperitoneal injections of cisplatin (6mg kg(-1)) for 5 days at four time
      points (04:00, 10:00, 16:00 and 22:00h) in BALB/c mice (n = 6 in each group).
      After following the changes in body weight, serum concentrations of blood urea
      nitrogen (BUN) and creatinine obtained on day 6 were compared. The results showed
      diurnal variations in cisplatin toxicity, with the 04:00 and 16:00h time points
      the best and the worst, respectively. We then measured platinum concentrations in
      blood, liver and kidney and compared the results of the 04:00 and 16:00 h groups
      (n = 4 in each group). Kidney sensitivity to cisplatin alone, lipopolysaccharide
      (LPS) alone, cisplatin with LPS and saline (control) were also measured using a
      tissue culture system (a measurement system of interleukin-6 (IL-6) production)
      between the 04:00 and the 16:00 h groups (n = 4 in each group). These results
      showed no significant difference in platinum accumulation between the two groups.
      IL-6 production was higher in the 16:00 h group than in the 04:00 h group after
      saline injection alone (P < 0.05). Cisplatin treatment alone did not increase IL
      6 production. However, IL-6 levels were markedly augmented by cisplatin with LPS.
      In conclusion, chrononephrotoxicity induced by daily cisplatin administration
      does not only depend on cisplatin accumulation, but might also depend on kidney
      sensitivity to diurnal variations in inflammatory reaction without direct
      cisplatin toxicity.

PMID- 11197079
TI  - Dammarane derivatives protect cultured rat cortical cells from glutamate-induced
      neurotoxicity.
AB  - We previously reported that ginsenosides Rb1 and Rg3, dammarane glycosides, of
      Panax ginseng C. A. Meyer (Araliaceae), significantly attenuated glutamate
      induced neurotoxicity in primary cultures of rat cortical cells. To seek more
      potent neuroprotective compounds, we attempted to modify the chemical structure
      of dammarane glycosides and obtained six derivatives, MA-11, PT-11, PT-111, POA
      101, POA-111 and N-001. The neuroprotective activity of these dammarane
      derivatives were evaluated employing primary cultures of rat corticoid cells. The
      glutamate-induced neuronal cell damage was significantly reduced by a pre
      treatment with protopanaxadiol, MA-11 or PT-11 at concentrations ranging from 100
      nM to 10 microM. Both MA-11 and PT-11, preserved the levels of catalase and
      inhibited decreases in glutathione reductase in glutamate-injured cells.
      Furthermore, the dammarane derivatives reduced the content of intracellular
      peroxide in glutamate-intoxicated cells. Finally, they inhibited the formation of
      malondialdehyde, a compound produced during lipid peroxidation, in glutamate
      insulted cells. These results show that the dammarane derivatives, MA-11 and PT
      11, exert significant neuroprotective effects on cultured cortical cells by a
      mechanism seemingly distinct from that afforded by ginsenosides Rb1 and Rg3. As
      such, the dammarane derivatives may be efficacious in protecting neurons from
      oxidative damage caused by exposure to excess glutamate.

PMID- 11197080
TI  - Effects of Ba2+ on F&F 96365-sensitive sustained contraction of rat pulmonary
      artery.
AB  - The effects of Ba2+ on receptor-mediated sustained contraction of rat pulmonary
      artery and guinea-pig oesophageal muscularis mucosae were studied in-vitro. In
      rat isolated pulmonary artery, sustained contraction induced by noradrenaline (1
      microM) was resistant to nicardipine (1 microM), but this same sustained
      contraction was completely inhibited by SK&F 96365 (30 microM), a blocker of
      voltage-dependent L-type Ca2+ channels and receptor-activated Ca2+ influx. The
      SK&F 96365-sensitive sustained contraction induced by noradrenaline (1 microM)
      may be due primarily to Ca2+ influx through receptor-activated Ca)+ channels
      resistant to nicardipine. Cumulatively applied BaCl2 (0.1 - 10 mM) increased the
      noradrenaline (1 microM)-induced sustained contraction of the pulmonary arterial
      preparation in the absence of nicardipine, but in the presence of nicardipine (1
      microM), BaCl2 (0.1 - 3 mM) did not affect this contraction. A higher
      concentration of BaCl22 (10 mM), however, weakly inhibited the noradrenaline (1
      microM)-induced tone. In addition, BaCl2 (3-10 mM) increased the tone induced by
      KCl (60 mM), and the BaCl2-elevated KCl tone was markedly inhibited by
      nicardipine (1 microM) treatment. In the guinea-pig isolated oesophageal
      muscularis mucosae, sustained contraction induced by acetylcholine (3 microM) was
      resistant to nicardipine (1 microM) but was returned to its basal level by SK&F
      96365 (30-60 microM). The SK&F 96365-sensitive, acetylcholine-induced sustained
      contraction of the oesophageal muscularis mucosae is also likely to link with
      receptor-activated Ca2+ channels resistant to nicardipine. In contrast to the rat
      pulmonary artery, cumulatively applied BaC12 (0.3 - 10 mM) inhibited the
      acetylcholine (3 microM)-induced sustained contraction of the oesophageal
      muscularis mucosae in a concentration-dependent manner in the presence of
      nicardipine (1 microM). In conclusion, Ba2+ presumably activates voltage
      dependent Ca2+ channels by depolarizing plasma membrane and also passes through
      voltage-dependent Ca2+ channels to contract the pulmonary artery in the absence
      of nicardipine, and Ba2+ also has a minor effect on the nicardipine-resistant,
      SK&F 96365-sensitive sustained contraction induced by noradrenaline in rat
      isolated pulmonary artery.

PMID- 11197081
TI  - Effect of dimethylglycine on gastric ulcers in rats.
AB  - Dimethylglycine is an anti-stress nutrient with antioxidant properties. Recently,
      studies have implicated the generation of oxygen-derived free radicals and lipid
      peroxidation as one of the mechanisms in the pathogenesis of gastric ulcer.
      Hence, we evaluated the antiulcer activity of dimethylglycine in various rat
      models of ulcer and also investigated the probable antioxidant mechanism of the
      anti-ulcer effect. Dimethylglycine at a dose of 25 and 35 mg kg(-1) significantly
      reduced ulcer number, ulcer size and ulcer index in pyloric-ligation-, ibuprofen-
      and stress-induced ulcers. The 35 mg kg(-1) dose was more effective than 25 mg
      kg(-1) and was comparable to famotidine. Dimethylglycine did not produce any
      significant change in acid secretion, unlike famotidine. There was a significant
      increase in plasma and tissue malondialdehyde levels in pyloric-ligated rats but
      these levels fell following dimethylglycine treatment. Also, there was a
      significant reduction in glutathione levels after dimethylglycine treatment. The
      results suggest that the gastroprotective effect of dimethylglycine could be
      mediated by its free radical scavenging activity and cytoprotection of gastric
      mucosa.

PMID- 11197082
TI  - Clonidine attenuates the carbachol-induced contractile and phosphatidylinositol
      responses of rat trachea.
AB  - Although clonidine is known to affect vascular smooth muscle, its effects on
      airway smooth muscle are not fully understood. This study was designed to examine
      the effects of clonidine on carbachol-induced contractile and
      phosphatidylinositol responses of rat trachea. Clonidine, at a dose of 100 microM
      or greater, attenuated carbachol-induced contraction and the accumulation of
      carbachol-induced inositol monophosphate (IP1). Clonidine also attenuated the
      accumulation of aluminium fluoride-induced IP1. The concentration-effect
      relationship of IP1 accumulation was similar to that of carbachol-induced
      contraction; r = 0.797, P < 0.001. These results suggest that clonidine
      attenuates contractile responses, at least in part, through the inhibition of
      phospholipase C (coupled with G-proteins) in phosphatidylinositol responses.

PMID- 11197083
TI  - AL-3138 antagonizes FP prostanoid receptor-mediated inositol phosphates
      generation: comparison with some purported FP antagonists.
AB  - The aim of this study was to pharmacologically characterize the antagonist
      properties of a novel prostaglandin F2alpha (PGF2alpha) analogue (11-deoxy-16
      fluoro PGF2alpha; AL-3138) using a variety of second-messenger assays of
      prostaglandin receptor subtypes. A detailed comparison was made between AL-3138
      and some purported FP receptor antagonists such as PGF2alpha dimethylamine,
      PGF2alpha dimethylamide, glibenclamide and phloretin using the FP receptor
      mediated phosphoinositide turnover assay in A7r5 rat thoracic aorta smooth muscle
      cells and mouse Swiss 3T3 fibroblasts. The potency and efficacy of AL-3138 as an
      FP receptor agonist were: EC50 = 72.2 +/- 17.9 nM (Emax = 37%) (n = 3) in A7r5
      cells and EC50 = 20.5 +/- 2.8 nM (Emax = 33%) (n = 5) in 3T3 cells. Being a
      partial agonist, the antagonist potency of AL-3138 against fluprostenol in A7r5
      cells was determined to be: Ki = 296 +/- 17 nM (n = 3) and Kb = 182 +/- 44 nM (n
      = 5) (-log Kb = 6.79 +/- 0.1). AL-3138 exhibited very minimal or no antagonistic
      effects at EP2, EP4, DP and TP prostaglandin receptors. Both PGF2alpha
      dimethylamide and PGF2alpha dimethylamine were inactive as FP receptor
      antagonists, whereas phloretin and glibenclamide were very weak and had -log Kb
      values of 5.28 +/- 0.09 (n = 3) and 3.58 +/- 0.32 (n = 3), respectively. However,
      phloretin antagonized functional responses of EP2 and DP prostanoid receptors,
      and also the V1-vasopressin receptor. AL-3138 competed for [3H]PGF2alpha binding
      to FP receptors with a relatively high affinity (IC50high = 312 +/- 95 nM)
      matching its functional antagonist potency. In conclusion, AL-3138 is a more
      potent and selective FP receptor antagonist than glibenclamide, phloretin,
      PGF2alpha dimethylamide and PGF2alpha dimethylamine and is therefore a unique and
      novel pharmacological tool to help characterize FP receptor-mediated functions.

PMID- 11197085
TI  - Electron-microscopic study of the bactericidal effect of OPB-2045, a new
      disinfectant produced from biguanide group compounds, against methicillin
      resistant Staphylococcus aureus.
AB  - The bactericidal effect of OPB-2045, a new disinfectant produced from biguanide
      group compounds, against methicillin-resistant Staphylococcus aureus (MRSA), MRSA
      IID 1677, was investigated by transmission electron microscopy. OPB-2045 showed
      strong bactericidal activity against MRSA. The minimum inhibitory concentration
      (MIC) and the minimum bactericidal concentration (MBC) of OPB-2045 against the
      test strain were 0.78 and 1.56 microg mL(-1), respectively. The test bacteria
      were incubated in the presence of OPB-2045 at 1/2 MIC (0.39 microg mL(-1)), 1 MIC
      (0.78 microg mL(-1)), 2 MIC (1 MBC, 1.56 microg mL(-1)), 4 MIC (2 MBC, 3.13
      microg mL(-1)) or 10 MIC (5 MBC, 7.8 microg mL(-1)) at 37 degrees C for 30 s, 3
      min, 30 min or 6h. The morphology of the cells was examined by transmission
      electron microscopy. The cell damage observed after 30-min or 6-h incubation in
      the presence of OPB-2045 at 1/2 or 1 MIC was the same as that at 2, 4 or 10 MIC.
      The numbers of damaged MRSA cells increased according to the increase in
      concentration of added disinfectant, and the image of bacteriolysis was observed,
      too. After treatment at 1/2 or 1 MIC, a few leaking cells were recognized, but no
      destroyed cells were found. No morphological changes were observed after
      treatment at 1 or 2 MIC for 30 s, 3 min or 30 min. When the incubation time was
      extended to 6 h, morphological changes in the MRSA cells treated at 1 or 2 MIC
      were observed. When examining the relationship between the numbers of surviving
      bacteria and the MIC (MBC) values in soybean casein digest broth, no decrease in
      MRSA cell numbers was recognized in the untreated control or at 1/2 MIC, but a
      marked decrease in MRSA cell numbers was recognized as the OPB-2045 concentration
      was increased. The new disinfectant OPB-2045 would make a useful contribution to
      the medical field for the prevention of infections caused by pathogenic bacteria
      such as MRSA.

PMID- 11197084
TI  - Recombinant human lactoferrin is effective in the treatment of Helicobacter felis
      infected mice.
AB  - Recombinant human lactoferrin possesses in-vitro antibiotic and anti-inflammatory
      activity similar to the native form. It was tested for in-vivo activity in mice
      infected with the gastritis-inducing bacterium Helicobacter felis. A two-week
      course of treatment with lactoferrin was sufficient to partially reverse both
      infection-induced gastritis and the infection rate, and fully reverse gastric
      surface hydrophobicity changes. A comparison of lactoferrin with amoxicillin and
      standard triple therapy revealed no differences in infection rate. These results
      show that recombinant human lactoferrin is effective in a mouse model of
      Helicobacter infection, and support further testing of this promising agent for
      this application.

PMID- 11197086
TI  - Effects of Uncaria tomentosa total alkaloid and its components on experimental
      amnesia in mice: elucidation using the passive avoidance test.
AB  - The effects of Uncaria tomentosa total alkaloid and its oxindole alkaloid
      components, uncarine E, uncarine C, mitraphylline, rhynchophylline and
      isorhynchophylline, on the impairment of retention performance caused by amnesic
      drugs were investigated using a step-down-type passive avoidance test in mice. In
      this test, the retention performance of animals treated with the amnesic and test
      drugs before training was assessed 24 h after training. Uncaria tomentosa total
      alkaloid (10-20 mg kg(-1), i.p.) and the alkaloid components (10-40 mg kg(-1),
      i.p.), as well as the muscarinic receptor agonist oxotremorine (0.01 mg kg(-1),
      i.p.), significantly attenuated the deficit in retention performance induced by
      the muscarinic receptor antagonist scopolamine (3 mg kg(-1), i.p.). The effective
      doses of uncarine C and mitraphylline were larger than those of other alkaloid
      components. Uncarine E (20 mg kg(-1), i.p.) also blocked the impairment of
      passive avoidance performance caused by the nicotinic receptor antagonist
      mecamylamine (15 mg kg(-1), i.p.) and the N-methyl-D-aspartate (NMDA) receptor
      antagonist (+/-)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP; 7.5
      mg kg(-1), i.p.), but it failed to affect the deficit caused by the
      benzodiazepine receptor agonist diazepam (2 mg kg(-1), i.p.). Rhynchophylline
      significantly reduced the mecamylamine-induced deficit in passive avoidance
      behaviour, but it failed to attenuate the effects of CPP and diazepam. These
      results suggest that Uncaria tomentosa total alkaloids exert a beneficial effect
      on memory impairment induced by the dysfunction of cholinergic systems in the
      brain and that the effect of the total alkaloids is partly attributed to the
      oxindole alkaloids tested. Moreover, these findings raised the possibility that
      the glutamatergic systems are implicated in the anti-amnesic effect of uncarine
      E.

PMID- 11197087
TI  - Baicalin, the predominant flavone glucuronide of scutellariae radix, is absorbed
      from the rat gastrointestinal tract as the aglycone and restored to its original
      form.
AB  - When baicalin was orally administered to conventional rats, it was detected in
      their plasma for 24 h after administration, but baicalein, the aglycone of
      baicalin, was not detected. However, when baicalin was given to germ-free rats,
      only a small amount of baicalin was detected in their plasma within 2 h after the
      administration, its AUC0-lim (the area under the concentration-time curve from 0
      to last determination time) being 12.0% of that in conventional rats.
      Subsequently, a considerable amount (55.1 +/- 6.2%) of baicalin was recovered
      from the gastrointestinal tract even 4 h after administration. When baicalein was
      orally administered to conventional rats, however, baicalin appeared rapidly in
      their plasma at an AUC0-lim value similar to that obtained after oral
      administration of baicalin, despite the absence of baicalein in plasma. When
      intestinal absorption was evaluated by the rat jejunal loop method, baicalein was
      absorbed readily, but only traces of baicalin were absorbed. Moreover, in
      conventional rats a small amount (13.4 +/- 3.1%) of baicalin and an appreciable
      amount (21.9 +/- 3.4%) of baicalein were recovered from the gastrointestinal
      tract even 4 h after oral administration of baicalin, but only a small amount
      (3.93 +/- 1.43%) of baicalein was detected in the intestinal tract 1 h after
      administration of baicalein. Baicalin was transformed to baicalein readily by the
      rat gastric and caecal contents. When baicalin was administered orally to
      conventional rats, an appreciable amount of baicalein was recovered in their
      gastrointestinal tracts. Moreover, baicalein was efficiently conjugated to
      baicalin in rat intestinal and hepatic microsomes. These results indicate that
      baicalin itself is poorly absorbed from the rat gut, but is hydrolysed to
      baicalein by intestinal bacteria and then restored to its original form from the
      absorbed baicalein in the body.

PMID- 11197088
TI  - Obesity-related hospitalization costs to the U.S. Navy, 1993 to 1998.
AB  - The objective of this work was to estimate the cost to the U.S. Navy for obesity
      related hospital admissions by examining (1) inpatient utilization associated
      with obesity; (2) the rank order, probability, and total facility costs of
      obesity-related diagnosis-related groups (DRGs); and (3) expected inpatient
      expenses. The frequency and probability of inpatient events in the Navy's active
      duty population were derived from the Department of Defense's Retrospective Case
      Mix Analysis System. Medicare-based facility costs per DRG were estimated. These
      measures were combined in a decision-analytic model. Expected facility costs per
      obesity-related admission for active duty Navy personnel increased by age group
      from $3,328 for 18 to 24 year olds to $5,746 for 45 to 64 year olds. The annual
      avoidable inpatient cost for the Navy was estimated to be $5,842,627 for the top
      10 obesity-related DRGs. Improvements to the Navy Physical Readiness Program and
      other interventions that may reduce obesity, obesity-related health care use, and
      the public economic burden should be pursued.

PMID- 11197089
TI  - The cost-saving potential of prevaccination antibody tests when implementing a
      mass immunization program.
AB  - A seroprevalence study of hepatitis A virus (HAV), hepatitis B virus (HBV), and
      varicella-zoster virus (VZV) was carried out among Saudi Arabian National Guard
      soldiers with the objective of determining the cost-saving potential of
      prevaccination antibody tests when implementing an immunization program for the
      soldiers. A systematic sampling of 450 blood samples from 1,350 soldiers who
      donated blood at our hospital was carried out. Antibody tests were performed
      using the enzyme-linked immunosorbent assay method. The seropositivity rates for
      antibodies to HAV, HBV, and VZV were 97.5, 17.8, and 88.5%, respectively.
      Comparing the cost of prevaccine screening with that of universal vaccination, it
      was estimated that savings of 76 and 32% could be effected for HAV and VZV.
      Conversely, screening for HBV before immunization could increase the cost of
      vaccinating against the disease by 49%. A seroprevalence study could be a useful
      cost-saving approach to a mass immunization program against endemic, natural
      immunity-conferring diseases.

PMID- 11197090
TI  - A comparison of health needs and personal health goals of Army Reserve Military
      and civilian employees.
AB  - Army active and reserve component personnel must be ready for rapid mobilization
      as world conflicts increase in number and intensity. Department of Defense
      civilian employees also need to be available to work long hours to maintain troop
      support. Healthy lifestyles are key to the physical and mental readiness demanded
      by this kind of work. The purpose of this descriptive study was to assess health
      and readiness by examining the health needs, identified through health risk
      appraisals, and personal health goals of military personnel and civilians (N =
      90) employed at a large Army Reserve command headquarters located in the southern
      part of the country. Prominent health needs included reducing the number of
      saturated fats found in the diets of military personnel and increasing the
      frequency of exercise for civilian employees. Weight loss constituted the primary
      personal health goal for 53% of all employees. Initial health promotion
      activities should incorporate assessment information into the design of command
      sponsored programs. Focusing on health needs as well as personal health goals may
      enhance the early success of such programs.

PMID- 11197091
TI  - The effect of "mentored" relationships on satisfaction and intent to stay of
      company-grade U.S. Army Reserve nurses.
AB  - This study examined the strategic implications of mentoring relationships
      perceived by company-grade U.S. Army Reserve nurses. The effects of mentorship on
      professional socialization, job satisfaction, and intent to stay were examined
      using the adapted framework of Hunt and Michael. The study population consisted
      of U.S. Army Reserve nurses from all three components of the ready reserve. One
      hundred nurses from each category were randomly selected and provided a
      questionnaire. The questionnaire combined Dreher's Mentoring Scale, Price's
      Intent-to-Stay Scale, and Hoppock's Job Satisfaction Scale. The overall response
      rate was 57%. Seventy-two of the 171 respondents reported at least one mentored
      experience. Findings indicate that mentored nurses report more satisfaction and
      have a higher intent to stay than nonmentored nurses. Continued research and
      encouragement of mentoring are recommended.

PMID- 11197092
TI  - Mentoring experiences among Navy midshipmen.
AB  - Previous research suggests that mentor relationships are facilitative of career
      success, career satisfaction, and retention in organizations. Yet, little
      research has been done to explore the prevalence or function of mentor
      relationships in military populations. In this study, preliminary data were
      collected regarding the prevalence of mentor relationship experiences among 576
      third year midshipmen at the U.S. Naval Academy. Only 40% of respondents had ever
      experienced a mentor relationship. Most mentors were senior military personnel,
      and 87% were male. Most relationships were mutually initiated, and they tended to
      last for several years. Although both career and psychosocial mentor functions
      were present in these relationships, psychosocial functions were most notable and
      most highly correlated with positive appraisals of mentor relationships.
      Midshipmen viewed mentoring as extremely important and rated their own mentor
      relationships as extremely positive. Implications for further research on
      mentoring are discussed.

PMID- 11197093
TI  - Gender differences in the utilization of a military ship's medical department.
AB  - Civilian studies show roughly a three-fold higher use of medical resources by
      females of childbearing age than males. Significantly higher use of medical
      services by females would be important information when staffing and supplying
      U.S. Navy ships to accommodate female crew members. In this light, visits to the
      medical department on a ship with a mixed-gender crew were reviewed for a 6-month
      period. Total visits were counted by gender, and female visits were categorized.
      Females were seen at a rate 9.2 times that of males (6.44 vs. 0.70 visits per
      year). Gender-specific problems accounted for a minority of female visits (39%),
      whereas gender-neutral problems yielded a female-to-male visit ratio of nearly
      6:1. At this rate, the work load of a ship's medical department will increase
      substantially when integrating women into an all-male crew.

PMID- 11197094
TI  - Operational medicine experience integrated into a military internal medicine
      residency curriculum.
AB  - The optimal training of physicians should prepare them for the environment in
      which they will practice. During the past several years, the practice of internal
      medicine has shifted from a focus on the inpatient setting to one that includes
      an emphasis on the ambulatory clinic. Military internists must be further
      prepared to practice medicine with forward units, at field hospitals, and in
      other operational settings. Community-based teaching programs that reflect
      present and future practice are increasingly recognized as essential, yet details
      on the structure and implementation of such programs, especially those designed
      to teach field and operational medicine, are lacking. The Internal Medicine
      Residency Program at Walter Reed Army Medical Center has developed and
      implemented an operational medicine curriculum that includes a field medical
      training exercise. The program is driven by the residents and chief resident and
      requires little additional funding. Resident research continues to increase,
      morale remains high, and the first class to complete the 3-year operational
      curriculum achieved a 100% pass rate on the American Board of Internal Medicine
      certification examination. We describe our 3-year experience of implementing this
      program, with an emphasis on curriculum design and execution, qualitative
      assessment, and initial lessons learned.

PMID- 11197095
TI  - A longitudinal subspecialty experience for internal medicine residents.
AB  - OBJECTIVE: Market and technology innovations have greatly changed the teaching
      and practice of medicine in the past 10 years. This report describes an
      innovation in the ambulatory education of internal medicine residents: a
      subspecialty continuity clinic. METHODS: A subspecialty continuity clinic was
      developed to improve the training of internal medicine residents in caring for
      complex ambulatory patients. The clinic structure is discussed from the
      perspective of patients, residents, and subspecialists. Logistical challenges and
      solutions are described. RESULTS: Two and one-half years into the program,
      feedback from residents and subspecialists has been positive. In-training
      examination scores are relatively higher in the involved specialties, and
      residents are managing illnesses they rarely saw in an outpatient setting before
      this program. CONCLUSION: This experience suggests that a subspecialty continuity
      clinic is worthwhile and practical in educating primary care residents.

PMID- 11197096
TI  - Attack on Koreyni-Both's article.

PMID- 11197097
TI  - Evaluation of psychopathological factors and origins of suicides committed by
      soldiers, 1989 to 1998.
AB  - Research and scientific observations indicate that, in the armed forces, some
      individuals tend to experience strong feelings of solitude and harm and do not
      always have opportunities to receive help. The inability to solve and
      successfully cope with problems may lead to adaptive difficulties and provoke
      reckless reactions, including suicide attempts. The aim of this project was a
      retrospective analysis of the origins and factors leading to successful suicide
      attempts undertaken by soldiers from 1989 to 1998, with special emphasis on
      psychopathological determinants. The study examined all cases of successful
      suicides in the Polish Armed Forces: 163 professional soldiers (military service
      was their job) and 274 privates (obligatory military service group). The most
      common reason for suicides in the analyzed group was the combination of
      psychiatric disorders and psychosocial factors. Among privates, most of the
      suicides occurred during the first 12 months of service, whereas professional
      soldiers committed most suicides between their 11th and 15th years of service.
      The results suggest the urgent introduction of a suicide prevention program.

PMID- 11197099
TI  - Prevalence and contributing factors of eating disorder behaviors in active duty
      service women in the Army, Navy, Air Force, and Marines.
AB  - Eating disorders continue to be studied among civilian women. Gross disturbances
      in eating behaviors characterize the condition of anorexia nervosa (AN),
      currently seen among 1 to 2% of non-active duty women. Bulimia nervosa (BN) is
      prevalent among 2% of the female population, and both disorders have a female-to
      male ratios of 10:1. Another category of eating disorders known as not otherwise
      specified (NOS) occurs in 3 to 35% of individuals in the reported literature.
      This study examined the prevalence of AN, BN, and NOS among a large sample of
      active duty women currently serving in the Army, Navy, Air Force, and Marines.
      Multiple military, professional, and behavioral variables were analyzed to
      provide an increased understanding and awareness of these disorders among all
      active duty service women. This descriptive, correlational study of 3,613 service
      women targeted females from the total population of three major medical centers
      (Army, Navy, and Air Force) and the total population of Marine women serving in
      Okinawa, Japan, at the time of the study. Anonymous survey return was obtained at
      34% (N = 1,278). The study revealed an overall prevalence of 1.1% for AN, 8.1%
      for BN, and 62.8% for NOS among all service women. However, AN, BN, and NOS were
      found at significantly higher rates (p = 0.000) among women in the Marines, who
      reported AN at 4.9%, BN at 15.9%, and NOS at 76.7%. Use of laxatives, diuretics,
      diet pills, vomiting, and fasting for standards increased during the body
      measurement and fitness periods for all services, but year-round use of many of
      these behaviors occurred at significantly higher rates among Marines (p = 0.000).
      Multiple logistic regression analysis predicted several factors associated with
      the manifestation of eating disorders in this population of active duty women.

PMID- 11197098
TI  - Community meetings on a military inpatient psychiatric unit: a question of
      balance.
AB  - Community meetings are a mainstay of any inpatient psychiatric unit. Although
      they differ in frequency, attendance, leadership, and size, they all maintain a
      similar purpose of acculturating the members to the values of the ward and
      encouraging responsible behavior and effective communication. The military
      inpatient psychiatric unit is no different, although it does have several unique
      factors that affect the management of the community meeting. Specifically, these
      factors are the inherent military rank structure, which often conflicts with the
      rank of staff and other patients, the incorporation of a civilian population into
      a military culture, and a greater focus on patient transitions from military to
      civilian society. We describe and discuss the common variables of community
      meetings, elucidate how the military aspects affect the meeting, and offer
      potential suggestions for the management of this unique large dynamic group.

PMID- 11197100
TI  - Organization and work of the war hospital in Tomislavgrad during the war in
      Bosnia and Herzegovina from 1992 to 1995.
AB  - The work of the War Hospital in Tomislavgrad during the war in Bosnia and
      Herzegovina from 1992 to 1995 is described. The War Hospital in Tomislavgrad was
      one of the first medical institutions organized in Bosnia and Herzegovina, with
      the intention of providing surgical treatment and care to soldiers, local
      civilians, and refugees who found shelter in this part of the country. It was
      located on the main communication route connecting Bosnia and Herzegovina and the
      south part of Croatia. During the 4-year period, 23,191 examinations, of which
      8,341 were first-time examinations, and 1,547 surgical operations were performed.
      The hospital provided a high level of surgical and anesthesiology service in an
      area where none existed before the war. All patients were treated regardless of
      their nationality or religion, thus mitigating the consequences of the war.

PMID- 11197101
TI  - Vision readiness of the reserve forces of the U.S. Army.
AB  - In 1996 and 1997, the Army conducted an exercise to assess the ability to rapidly
      mobilize the reserve forces. In accordance with Army requirements, each soldier
      was evaluated to determine if he or she met vision and optical readiness
      standards. Of the 1,947 individuals processed through the optometry section, 40%
      met vision requirements without correction and 32% met vision requirements with
      their current spectacles. The remaining 28% required examination. A major
      impediment to processing reserve units for deployment is the lack of vision and
      optical readiness. In the mobilization for the Persian Gulf War, significant
      delays were incurred because of the time required to perform eye examinations and
      fabricate eyewear. However, as a result of this exercise, current prescriptions
      will be available in the event of mobilization. To ensure readiness, all units
      should perform such exercises periodically.

PMID- 11197102
TI  - Ocular injuries caused by mustard gas: diagnosis, treatment, and medical defense.
AB  - Sulfur mustard has been used as a vesicant chemical warfare agent. To investigate
      the ocular damage it causes, we studied the effects on chemical casualties in the
      Iran-Iraq War. The patient population consisted of more than 5,000 chemical
      casualties, both military and civilian. The range of ocular damage was wide. The
      most common ocular effects were conjunctivitis and photophobia. Patients with
      significant corneal involvement are at risk for corneal ulceration and rarely for
      anterior chamber scarring and neovascularization, any of which would result in
      prolonged disability. In conclusion, the eye is the organ most sensitive to
      sulfur mustard vapor. Ocular injuries generally heal completely. In severe cases,
      blindness may occur. The need for corneal transplantation is rare.

PMID- 11197103
TI  - Initial 67th Combat Support Hospital Optometry Services in Taszar, Hungary,
      during Operation Joint Endeavor.
AB  - BACKGROUND: Existing U.S. Army personnel and equipment authorization documents do
      not recognize the need for optometry services at deployed combat support
      hospitals (CSHs). The specific hospital tasked with the mission of supporting
      Operation Joint Endeavor from a support base in Taszar, Hungary, did not have any
      documentation authorizing the assignment of ophthalmology assets. Current Army
      doctrine stipulates the presence of an area support medical battalion, with
      assigned optometry assets, to deploy and operate near a CSH. However, in the
      winter of 1995, when Operation Joint Endeavor began, there were no area support
      medical battalions staffed in Europe, and none deployed to the Taszar support
      base. Therefore, the 67th CSH's mission to provide comprehensive inpatient and
      outpatient care on a contingency basis to all personnel in the area of operations
      did not have a doctrinal means of supporting an eye care requirement. OBJECTIVE:
      To meet this eye care shortfall between doctrinal policy and actual operational
      needs or requirements, the optometry staff of the 67th CSH scavenged two
      optometry field sets from old Operation Desert Storm war stock and deployed with
      the main body of hospital personnel to Taszar, Hungary, on December 18, 1995. In
      doing so, the Table of Organization and Equipment was thus supplemented with
      extra equipment and personnel, beyond doctrinal guidelines, to accomplish the
      assigned mission. METHOD: This report is a prospectively gathered summary of the
      eye care provided from December 18, 1995, to September 15, 1996. RESULTS: A total
      of 1,471 patients were examined and treated, averaging 7 patients per day. Less
      than half of the case load was medical in nature, with the remaining being
      refractive in nature or for periodic examination. The most common pathologies
      seen were soft contact lens complications, non-contact lens corneal pathology,
      conjunctivitis (bacterial, viral, and adenoviral), and ocular trauma (foreign
      bodies, chemical splashes, blunt injury). Refractive cases during the entire
      deployment involved primarily myopes requiring increased correction. However,
      close to half of the refractive cases in the first month involved habitually
      uncorrected low hyperopes and early presbyopes. CONCLUSIONS: Based on the
      productivity presented by the case load demand of this CSH's area medical support
      mission, an eye care need was clearly met, adding to the overall mission success
      of the 67th CSH.

PMID- 11197104
TI  - A comparison of morbidity in the Australian Defence Force with Australian general
      practice.
AB  - This study was designed to examine morbidity patterns among Australian Defence
      Forces members and to compare them with civilian general practice. The study was
      conducted in the outpatient departments of the Royal Australian Air Force (RAAF)
      No. 6 Hospital, Melbourne, Australia. The patients studied were male and female
      members of the RAAF (66%), Army (25%), and Navy (9%). The problems managed at all
      primary care consultations during 1993 and 1994 were coded using the Ninth
      Revision of the International Classification of Diseases (Clinical Modification).
      The codes were grouped and compared against a major study of Australian general
      practice. In the 6 Hospital study, 21,910 problems were managed at 19,909
      consultations. The main differences found between the two studies were that
      service personnel had more medical examinations, more musculoskeletal and
      respiratory problems, and fewer psychological and cardiovascular problems. Most
      of the differences observed may reflect the Defence Force's recruitment selection
      criteria and the emphasis on physical fitness and diet.

PMID- 11197105
TI  - Proposed technique for evaluation of endotracheal tube fixation and comparison of
      four fixation methods.
AB  - BACKGROUND: The fixation of an endotracheal tube must be rapid in conditions
      involving numerous casualties, such as a chemical warfare (CW) situation. The
      tube also should be fixed and strong to prevent unplanned extubations. METHODS:
      We developed a technique for the evaluation of fixation methods. This technique
      was used to evaluate four methods. Three commercial fixators were compared with
      the fixation method used today in the Israeli Defense Forces (IDF) and commonly
      used in different out-of-hospital settings. The exercises were performed on adult
      intubation mannequins with and without CW protective gear. The fixations were
      timed, and their quality was evaluated by the participants and inspectors.
      RESULTS: The time score for the method used today in the IDF was significantly
      higher compared with the commercial fixation methods. The quality scores for the
      Thomas fixator and the IDF method were significantly higher than for the fixators
      by VBM and Rusch. The CW protective gear significantly prolonged the time but did
      not affect the quality of the fixation. CONCLUSIONS: With this technique, a good
      estimation of the time and quality of fixation can be achieved.

PMID- 11197106
TI  - Periodontal disease and its association with systemic disease.
AB  - Periodontal diseases are oral disorders characterized by inflammation of the
      supporting tissues of the teeth. Usually, periodontitis is a progressively
      destructive loss of bone and periodontal ligament (loss of the attachment
      apparatus of the teeth). Periodontitis has documented risk factors, including but
      not limited to specific plaque bacteria, smoking, and diabetes mellitus.
      Initially, the link between systemic disease and periodontal diseases was thought
      to be unidirectional. Currently, there is increasing evidence that the
      relationship between these entities may be bidirectional. Recent case-control and
      cross-sectional studies indicate that periodontitis may confer a 7-fold increase
      in risk for preterm low birth weight infants and a 2-fold increase in risk for
      cardiovascular disease. These early reports indicate the potential association
      between systemic and oral health. Additionally, these studies support the central
      hypothesis that periodontal disease involves both a local and a systemic host
      inflammatory response. This knowledge of disease interrelationships may prove
      vital in intervention strategies to reduce patient risks and prevent systemic
      disease outcomes. Based on the current evidence of the periodontal-systemic
      disease connection, the purpose of this report is to help establish the
      groundwork for closer communication between physicians and periodontists in the
      military health care setting.

PMID- 11197107
TI  - Surgical care in the isolated military hospital.
AB  - BACKGROUND: To maintain the health of service members and their families
      throughout the world, the Department of Defense has established several isolated
      military hospitals (IHs). The operational environment of IHs is such that illness
      and traumatic injury requiring surgical intervention is common. This study sought
      to examine the general and orthopedic surgical experience at an IH to determine
      whether surgical care could be provided in an effective and safe manner. METHODS:
      All patients evaluated by the general and orthopedic surgeon at Guantanamo Bay
      Naval Hospital from October 1, 1998, to April 1, 1999, were included in this
      study. The following data were retrospectively reviewed: patient demographic
      data, diagnosis, initial and follow-up care, medical evacuation data, operative
      procedures, and complications. RESULTS: There were 336 patients who presented for
      surgical evaluation, resulting in 660 follow-up appointments during the study
      period. There were 31 medical evacuations (3 emergent). The surgical services
      performed 122 major operative procedures. There were 58 inpatient admissions.
      There was 1 death, and surgical complications occurred in 2 patients, for an
      overall morbidity and mortality of 1.4% and 0.7%, respectively. CONCLUSION: Our
      data show that an IH is capable of providing surgical care, including care for
      traumatic injuries, in a safe manner. This is the first study that provides
      objective evidence that general and orthopedic surgery at an IH can be provided
      within the standard of care.

PMID- 11197108
TI  - Heat stroke.

PMID- 11197109
TI  - Poliomyelitis: the role of military in the final campaign.

PMID- 11197110
TI  - Radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates: a new
      method in the treatment of chronic nasal obstruction.
AB  - Twenty-two Caucasians (16 male and 6 female) with chronic bilateral nasal
      obstruction due to hypertrophic inferior turbinates were followed up over a three
      month period. They were assessed by clinical examination, as active anterior
      rhinometry, and acoustic rhinometry before and after topical decongestion,
      preoperatively and three months after surgery. All patients were treated by
      application of radiofrequency-volumetric-tissue reduction (RFVTR, or somnoplasty)
      to both inferior turbinates. Initial postoperative edematous response disappeared
      during the first week after RFVTR. Three months postoperatively 20 of 22 patients
      (91%) reported subjective improvement of nasal patency. The average cross
      sectional area for both sides of the nasal cavity (measured at the head of the
      inferior turbinate (C-Notch) before decongestion) increased in 15 of 22 patients
      (68.2%). This means a significant improvement from 1.24 to 1.49 cm2 for both
      sides of the nasal cavity (p = 0.0054). We conclude that RFVTR can safely reduce
      turbinate volume in a precise manner in patients with nasal obstruction due to
      hypertrophic inferior turbinates.

PMID- 11197111
TI  - Stereotactic computer-assisted navigational sinus surgery: accuracy of an
      electromagnetic tracking system with the tissue debrider and when utilizing
      different headsets for the same patient.
AB  - The InstaTrak system by Visualization Technologies, Inc. (Woburn, MA) has
      recently introduced attachments that can be utilized to localize the tip of the
      XPS Straightshot debrider (Xomed Industries, Jacksonville, FL) during image
      guided surgery. The accuracy of these newer attachments has not been objectively
      tested in a clinical setting. Our primary objective was to compare the actual
      instrument (XPS debrider tip) location with its computer screen location in the
      coronal, sagittal, and axial views. This was considered to be the "accuracy" of
      the instrument being tested. We secondarily compared its accuracy with the
      accuracy of the 0 degree and 45 degrees curved localizing aspirators in a
      prospective study. The manufacturer also recommends that the same headset used
      during scanning be utilized during surgery. A second objective therefore was to
      determine if a headset other than the one used during CT scanning could be used
      intraoperatively with an acceptable level of accuracy. Accuracy of the
      instruments between the patients' own headset (used during CT scanning) and a
      generic or research headset (not used during scanning) was compared
      intraoperatively. The third and final objective was to determine if the same
      headset could be used repeatedly with an acceptable level of accuracy. Generic
      "research" headsets were therefore utilized for a total of five surgeries per
      headset and visual accuracy between the multiply utilized research headsets and
      the patients' own headsets was recorded and compared. Anatomic localization
      accuracy was 1.06 mm for the XPS debrider, 0.89 mm for the 0 degree aspirator,
      and 1.05 mm for the 45 aspirator when the patients own headset was utilized. When
      the research (generic) headset was utilized the respective values were 0.69 mm
      for the debrider, 0.77 mm for the 0 degree aspirator, and 0.99 mm for the 45
      degrees aspirator. With multiple utilization of a single headset, there was no
      significant loss in accuracy. In conclusion, the accuracy of the newly marketed
      attachment for the debrider was found to be comparable to the standard
      aspirators. Accuracy remained acceptable when a headset other than the one used
      during CT scanning was used intraoperatively. No loss in accuracy was noted when
      a headset was utilized more than once.

PMID- 11197112
TI  - Interleukin-1 beta, interleukin-5, interleukin-6, interleukin-8, and tumor
      necrosis factor-alpha in chronic sinusitis: response to systemic corticosteroids.
AB  - Recently, the role of various cytokines in the pathogenesis of chronic
      rhinosinusitis has come under investigation. Various studies have reported
      increased levels of interleukin-3, interleukin-4, interleukin-5, interleukin-13,
      and granulocyte macrophage-colony stimulating factor in the sinonasal mucosa of
      patients with chronic rhinosinusitis. The present study investigated the levels
      of pro-inflammatory cytokines, including interleukin-1 beta (IL-1 beta),
      interleukin-5 (IL-5), interleukin-6 (IL-6) interleukin-8 (IL-8), and tumor
      necrosis factor-alpha (TNF-alpha), in the sinonasal mucosa of patients with
      chronic rhinosinusitis, and evaluated the response of these cytokines to oral
      corticosteroids. Chronic rhinosinusitis subjects (n = 15) and control subjects (n
      = 9) underwent nasal endoscopy and biopsy of the sinonasal mucosa. Chronic
      rhinosinusitis subjects were subsequently treated with a 10-day tapering dose of
      prednisone followed by a second sinonasal endoscopic exam and biopsy. Mucosal
      biopsy specimens were immunostained for IL-1 beta, IL-5, IL-6, IL-8, and TNF-a.
      In chronic rhinosinusitis subjects, mucosal levels of IL-1 beta, IL-6, IL-8, and
      TNF-alpha were significantly elevated when compared with control subjects, and
      levels of IL-5 demonstrated a strong trend toward elevation. In posttreatment
      chronic rhinosinusitis subjects, levels of IL-6 were significantly decreased when
      compared with pretreatment levels, and TNF-alpha levels demonstrated a
      significant trend toward reduction. These findings support the hypothesis that
      the inflammatory response in chronic rhinosinusitis is associated with elevated
      levels of pro-inflammatory cytokines, and suggest that oral corticosteroids may
      exert a beneficial effect by significantly reducing the levels of IL-6 and TNF
      alpha.

PMID- 11197113
TI  - Nasal mucociliary transport in pregnancy.
AB  - Using the saccharin method, we performed tests of mucociliary function four times
      during pregnancy and once one month after delivery in 27 women. As the transport
      distance for saccharin varied from 37 to 65 mm, we used the transport speed for
      evaluation. Pregnancy rhinitis affects at least 20% of pregnancies. The
      mucociliary transport speed was higher in the group of women with pregnancy
      rhinitis, and was reduced during pregnancy in the group of women without that
      condition. We found no significant correlation between mucociliary transport
      speed and objectively registered nasal peak expiratory flow index. The
      pathophysiology of pregnancy rhinitis is not known, but is possibly
      multifactorial. The changes occurring in the nasal mucociliary transport system
      during normal pregnancy and in pregnancy rhinitis need further studies.

PMID- 11197114
TI  - Endoscopic sinus surgery in patients with cystic fibrosis: an analysis of
      complications.
AB  - The application of endoscopic sinus surgery (ESS) for the management of paranasal
      sinus disease in patients with cystic fibrosis (CF) has been well described. Due
      to underlying medical issues such as acquired coagulopathies and advanced
      pulmonary disease, perioperative morbidity is assumed to be higher in this group.
      The incidence and type of complications associated with CF patients undergoing
      ESS has not been previously described. We reviewed 52 consecutive endoscopic
      procedures in 41 patients with CF performed by a single surgeon over a 34-month
      period. This review focused on perioperative and postoperative complications.
      Additional clinical data gathered included estimated blood loss, length of
      procedure, coagulation laboratory studies, the presence of nasal polyposis, the
      use of nasal packing, pulmonary function status, and average hospitalization
      time. A total of six complications were identified--four immediate and two
      delayed. The perioperative or immediate complications included two cases of
      epistaxis, one case of periorbital ecchymosis, and one case of pulmonary
      hemorrhage. Delayed complications include one case of epistaxis and one case of
      intranasal scarring. In two of these six patients, length of hospitalization was
      prolonged for management of the associated complications. No study has
      specifically addressed complications of ESS in the CF patient. Our review
      demonstrates a complication rate of 11.5%, which compares favorably with the non
      CF ESS complication rates of 0-17% reported in the literature. Critical to
      successful management of these patients is coordinated care delivered by the
      pediatrician or internist, the pulmonary specialist, the anesthesia team, and the
      otolaryngologist. In addition to a review of current literature, we discuss the
      overall management approach adopted at our institution and highlight elements
      thought to minimize morbidity.

PMID- 11197115
TI  - Acanthamoeba rhinosinusitis: characterization, diagnosis, and treatment.
AB  - Nasal and paranasal sinus manifestations are among the most common presentations
      of the acquired immunodeficiency syndrome (AIDS). Several studies cite that as
      many as 70% of patients with this disease have symptoms referable to the head and
      neck, including a 30% prevalence of sinusitis. Although the bacteriology of
      sinusitis in this population is largely considered comparable to that of
      immunocompetent patients, several opportunistic pathogens have been identified,
      particularly when T-cell counts are low. This report identifies Acanthamoeba as a
      potentially fatal cause of rhinosinusitis in immunosuppressed patients. The
      pathogenesis, diagnosis, and treatment of this rare entity will be discussed and
      the literature reviewed.

PMID- 11197116
TI  - Frontal sinus surgery: endoscopic technique and preliminary results.
AB  - Endoscopic frontal sinus surgery, once the last frontier in the evolution of
      endoscopic sinus surgery, is considered difficult, risky to the patient, and
      likely to result in a high failure rate. We clarify the surgical anatomy for
      frontal sinus surgery that, based on a review of our data, provides safe and
      predictable access to the frontal sinus. We studied 200 consecutive patients with
      respect to indications, endoscopic and radiographic findings, results, and
      complications. The study will describe the technique in detail, including the
      following points: 1) computed tomography identification of the superior
      attachment of the uncinate process; 2) complete removal of the uncinate process,
      including its superior attachments, by using the microdebrider; 3) removal of the
      agger nasi cell, if present; and 4) verification of an open frontal sinus by a
      transillumination or image-guided system. Postoperative assessment of patients'
      symptoms and the confirmation of a patent frontal sinus by office endoscopy and
      transillumination indicated a 90% patency for short-term follow-up (average 12.2
      months). There were no major complications. Postoperative complications included
      frontal recess stenosis, polypoid mucosa occluding the frontal recess, and middle
      turbinate lateralization. All of these situations may lead to recurrence of
      infection and symptoms. In-depth understanding of anatomic variations of the
      uncinate process and precise surgical removal of its superior attachments provide
      surgical access to the frontal sinus that is based on the natural ostia and is,
      therefore, more likely to remain patent.

PMID- 11197117
TI  - Effect of topical nasal pharmaceuticals on sodium and chloride transport by human
      airway epithelia.
AB  - The human airway epithelium lines the respiratory tract from the nasal mucosa to
      the bronchioles. Electrolyte transport by these epithelia is crucial in
      maintaining the appropriate volume and salt composition of the airway surface
      fluid. When this epithelium becomes functionally impaired, the airways are more
      prone to respiratory infections. We studied the effect of six common topical
      agents that are commonly used to treat rhinorrhea and nasal inflammation on the
      transepithelial resistance, sodium, and chloride transport of primary cultures of
      human airway epithelia grown at the air-liquid interface. The pharmaceuticals
      fluticasone propionate, cromolyn sodium, ipratropium bromide, azelastine,
      oxymetazoline, and normal saline were used and the electrical function of the
      epithelia was studied in Ussing chambers. Azelastin and ipratropium bromide
      treated epithelia were found to have a significant decrease in transepithelial
      resistance. Both normal saline and fluticasone propionate resulted in significant
      increases in amiloride-sensitive short circuit currents that reflect sodium
      transport. Finally, normal saline resulted in a significant increase in
      bumetanide-sensitive short circuit current that reflects chloride transport
      across the epithelia. The data presented may explain a mechanism by which some
      topical pharmaceuticals help reduce rhinorrhea, and may point to some unwanted
      side effects of some pharmaceuticals on the electrolyte transport of the airway
      epithelia. In summary, several of the common topical nasal agents alter the
      electrolyte transport of the nasal airway epithelia. The in vivo significance of
      these findings is to be determined.

PMID- 11197118
TI  - Subacute effects of ozone exposure on cultivated human respiratory mucosa.
AB  - This study was designed to investigate subacute effects of long-term exposure of
      both healthy and chronically inflamed human respiratory mucosa to ozone.
      Functional and metabolic effects on ciliary beat frequency (CBF), release of
      interleukin 8 (IL-8), interleukin 4 (IL-4), and gamma interferon (g-INF), as well
      as cellular viability and cytotoxicity, were monitored. Cell cultures of 60
      specimens (healthy mucosa: n = 30, inflamed mucosa: n = 30) were exposed to
      synthetic air and to ozone-enriched synthetic air in different concentrations of
      100, 500, and 1000 micrograms/m3. Continuous expositions were performed using an
      air/liquid interface cell culture technique for a period of 4 weeks. CBF was
      monitored using video-interference contrast microscopy and cytokine release was
      quantified by enzyme immunoassays. Cellular viability and cytotoxicity were
      controlled by measuring lactate dehydrogenase activity, cytosolic activity of
      esterases, and by staining of nuclear DNA. Synthetic air had no influence on CBF
      during the 4 weeks of exposure. IL-8 release was continuously diminished in
      unaffected and in chronically inflamed mucosa. Within the first week of
      continuous exposure with any ozone concentration neither CBF nor release of IL-8
      were affected in healthy or in inflamed mucosa. During the second and the
      following weeks of exposure CBF and the release of IL-8 were reduced in both
      tissues. Release of IL-4 or g-INF were not detectable at any time during the 4
      weeks of ozone exposure. At higher ozone concentrations of 500 and 1000
      micrograms/m3 there was an increase of cytotoxicity which was greater in
      chronically inflamed than in healthy mucosa. In conclusion, ozone had no
      measurable effect on those parameters measured in human upper respiratory
      epithelium after one week of in vitro exposure to different concentrations, but
      did after longer periods of exposure. Chronically inflamed mucosa had a tendency
      toward a higher susceptibility to intermediate and high concentrations of ozone
      that did not reach a level of statistical significance under the conditions used
      in this study.

PMID- 11197119
TI  - Biologic characteristics of paragangliomas of the nasal cavity and paranasal
      sinuses.
AB  - Paragangliomas of the nasal cavity and paranasal sinuses are extremely rare. This
      study was conducted to investigate the biologic characteristics of these lesions
      on different molecular levels and to estimate their biologic behavior. Operative
      specimens of three patients who underwent surgery for a paraganglioma of the
      nasal cavity (one case) or paranasal sinuses (two cases) were investigated by
      routine histology, quantitative DNA analysis, and immunohistochemical assessment
      of proliferation markers (i.e., Proliferating Cell Nuclear Antigen, PCNA; Ki67
      MIB-1), the expression of cell-surface antigens, which reflect the tumor-stroma
      interaction (i.e., CD 44 v0.4/5 and 6, CD 54, CD 106), oncogene products (nm-23;
      p53), and bcl-2 as a marker of apoptosis. Histologically, two tumors were
      paragangliomas of the adenomatous subtype, one lesion was classified as
      angiomatous. According to DNA analysis, aneuploid cells were detected in all
      tumors. Two of three paragangliomas were classified as a DNA type III pattern,
      implying a high percentage of aneuploid cells and an aggressive behavior.
      Immunohistochemically, paragangliomas of the nasal cavity showed increased scores
      for both proliferation markers tested, indicating a rapid growth pattern.
      According to the expression of cell-surface markers and oncogene products, these
      tumors displayed an aggressive behavior and an infiltrating growth pattern. The
      highest value for the parameters of quantitative DNA analysis and highest
      proliferation scores were found in a tumor of a patient who developed multiple
      tumor recurrences after radical excision of the lesion with clear margins, and
      finally died of disease. In conclusion, paragangliomas of the nasal cavity and
      paranasal sinuses examined in this study should be regarded as suspicious
      concerning their biologic and clinical behavior. Radical excision, and in cases
      with highly aggressive biology, postoperative radiation therapy are recommended.
      Tumor biologic examinations can help to recognize high-risk patients for
      developing recurrences and possibly lesions with a malignant behavior and to
      enhance our understanding of the biology of these extremely rare tumors of the
      nasal cavity and paranasal sinuses.

PMID- 11197120
TI  - Malignant fibrous histiocytoma of the nasal cavity and paranasal sinuses.
AB  - Malignant fibrous histiocytomas are uncommon in the head and neck, the sinonasal
      tract being the most common location. This report describes 5 cases in this area:
      two in the nasal cavity, two in the maxillary sinus, and one in the frontal
      sinus. Four were primary cases and one was secondary to previous irradiation. All
      patients received surgical treatment, one of them with postoperative irradiation.
      All five patients experienced local recurrences and three also experienced
      distant metastases. Only one of these recurrences was successfully salvaged and
      the patient is alive and free of disease 3 years after resection. A summary of
      knowledge about the entity is reviewed.

PMID- 11197121
TI  - Inheritance and variation in eggshell patterning in the great tit Parus major.
AB  - The inheritance of patterns on avian eggshells is central to understanding the
      evolution of traits such as egg mimicry (e.g. in cuckoos). Yet little is known
      about the inheritance, or indeed function, of eggshell patterns. It has long been
      believed that the evolution of eggshell pattern mimicry required that patterns be
      determined by genes situated on the female-specific W chromosome. However, it has
      never been demonstrated for any bird that egg pattern traits (rather than ground
      colour) are female sex linked, or indeed that they are inherited. We studied the
      inheritance of three measures of egg-pigment patterns in a wild great tit
      population. Egg patterns were female specific but unrelated to female attributes
      such as age or condition and showed only weak environmental effects. Eggs of
      daughters resembled those of both their mothers and maternal grandmothers, but
      not of their paternal grandmothers. We conclude that this is the first
      demonstration of female sex-linked inheritance of avian eggshell patterning, so
      raising the probability that such a system operates in egg mimics and their
      hosts.

PMID- 11197122
TI  - Cryptic genetic variation and paraphyly in ravens.
AB  - Widespread species that are morphologically uniform may be likely to harbour
      cryptic genetic variation. Common ravens (Corvus corax) have an extensive range
      covering nearly the entire Northern Hemisphere, but show little discrete
      phenotypic variation. We obtained tissue samples from throughout much of this
      range and collected mitochondrial sequence and nuclear microsatellite data. Our
      study revealed a deep genetic break between ravens from the western United States
      and ravens from throughout the rest of the world. These two groups, the
      'California clade' and the 'Holarctic clade' are well supported and over 4%
      divergent in mitochondrial coding sequence. Microsatellites also reveal
      significant differentiation between these two groups. Ravens from Minnesota,
      Maine and Alaska are more similar to ravens from Asia and Europe than they are to
      ravens from California. The two clades come in contact over a huge area of the
      western United States, with mixtures of the two mitochondrial groups present in
      Washington, Idaho and California. In addition, the restricted range Chihuahuan
      raven (Corvus cryptoleucus) of the south-west United States and Mexico is
      genetically nested within the paraphyletic common raven. Our findings suggest
      that the common raven may have formerly consisted of two allopatric groups that
      may be in the process of remerging.

PMID- 11197123
TI  - Waiting time to parapatric speciation.
AB  - Using a weak migration and weak mutation approximation, I studied the average
      waiting time to parapatric speciation. The description of reproductive isolation
      used is based on the classical Dobzhansky model and its recently proposed
      multilocus generalizations. The dynamics of parapatric speciation are modelled as
      a biased random walk performed by the average genetic distance between the
      residents and immigrants. If a small number of genetic changes is sufficient for
      complete reproductive isolation, mutation and random genetic drift alone can
      cause speciation on the time-scale of ten to 1,000 times the inverse of the
      mutation rate over a set of loci underlying reproductive isolation. Even
      relatively weak selection for local adaptation can dramatically decrease the
      waiting time to speciation. The actual duration of the parapatric speciation
      process (that is the duration of intermediate forms in the actual transition to a
      state of complete reproductive isolation) is shorter by orders of magnitude than
      the overall waiting time to speciation. For a wide range of parameter values, the
      actual duration of parapatric speciation is of the order of one over the mutation
      rate. In general, parapatric speciation is expected to be triggered by changes in
      the environment.

PMID- 11197124
TI  - Molecular and morphological evidence on the phylogeny of the Elephantidae.
AB  - The African and Asian elephants and the mammoth diverged ca. 4-6 million years
      ago and their phylogenetic relationship has been controversial. Morphological
      studies have suggested a mammoth Asian elephant relationship, while molecular
      studies have produced conflicting results. We obtained cytochrome b sequences of
      up to 545 base pairs from five mammoths, 14 Asian and eight African elephants. A
      high degree of polymorphism is detected within species. With a dugong sequence
      used as the outgroup, parsimony and maximum-likelihood analyses support a mammoth
      African elephant clade. As the dugong is a very distant outgroup, we employ
      likelihood analysis to root the tree with a molecular clock, and use bootstrap
      and Bayesian analyses to quantify the relative support for different topologies.
      The analyses support the mammoth African elephant relationship, although other
      trees cannot be rejected. Ancestral polymorphisms may have resulted in gene trees
      differing from the species phylogeny Examination of morphological data,
      especially from primitive fossil members, indicates that some supposed
      synapomorphies between the mammoth and Asian elephant are variable, others
      convergent or autapomorphous. A mammoth African elephant relationship is not
      excluded. Our results highlight the need, in both morphological and molecular
      phylogenetics, for multiple markers and close attention to within-taxon variation
      and outgroup selection.

PMID- 11197125
TI  - Axial and appendicular pneumaticity in Archaeopteryx.
AB  - From the time of its discovery in 1860 to this day Archaeopteryx has been
      essential to our understanding of avian evolution. Despite the great diversity of
      plesiomorphic avialan (sensu Gauthier 1986) taxa discovered within the last
      decade, Archaeopteryx remains the most basal avialan taxon. A very unusual
      feature of extant birds is their lung structure, in which air diverticulae
      penetrate the bones. This has previously been reported in Archaeopteryx as well,
      in the cervical vertebrae of the Berlin specimen and in an anterior thoracal
      vertebra of the Eichstatt specimen. This indicates the presence of a cervical air
      sac. We show that the London specimen also has pneumatized anterior thoracal
      vertebrae, and, thus, that this feature was present in the most archaic avialans,
      as the London and Eichstatt specimens are different species. Furthermore, the
      pelvis of the London specimen shows clear signs of the presence of an abdominal
      air sac, indicating that at least two of the five air sacs present in modern
      birds were also present in Archaeopteryx. Evidence of pubic pneumaticity was also
      found in the same position in some extant ratites.

PMID- 11197126
TI  - Are avian blood parasites pathogenic in the wild? A medication experiment in blue
      tits (Parus caeruleus).
AB  - The Hamilton and Zuk hypothesis on haemoparasite-mediated sexual selection and
      certain studies of reproductive costs are based on the assumption that avian
      blood parasite infections are detrimental to their hosts. However, there is no
      experimental evidence demonstrating harmful effects of blood parasites on fitness
      in wild populations, it even having been suggested that they may be non
      pathogenic. Only an experimental manipulation of natural blood parasite loads may
      reveal their harmful effects. In this field experiment we reduced through
      medication the intensity of infection by Haemoproteus majoris and the prevalence
      of infection by Leucocytoazoon majoris in blue tits (Parus caeruleus), and
      demonstrated detrimental effects of natural levels of infection by these common
      parasite species on host reproductive success and condition. The fact that some
      of the costs of infection were paid by offspring indicates that blood parasites
      reduce parental working capacity while feeding nestlings. Medicated females may
      be able to devote more resources to parental care through being released from the
      drain imposed upon them by parasites and/or through a reduced allocation to an
      immune response. Therefore, this work adds support to previous findings relating
      hosts' life-history traits and haematozoan infections.

PMID- 11197127
TI  - Antigenic role of the endosymbionts of filarial nematodes: IgG response against
      the Wolbachia surface protein in cats infected with Dirofilaria immitis.
AB  - Filarial nematodes harbour intracellular endosymbiotic bacteria, which have been
      assigned to the genus Wolbachia. These bacteria appear to play an important role
      in the pathogenesis of filarial diseases through their lipopolysaccharides. In
      view of the presence of Wolbachia endosymbionts in the body of filarial
      nematodes, one might also expect that proteins from these bacteria play an
      antigenic role in humans and animals affected by filariases. To test this
      hypothesis, we produced in recombinant form the surface protein WSP and a portion
      of the cell-cycle protein FTSZ from the Wolbachia of Dirofilaria immitis. Western
      immunoblot assays were then performed using cat sera to test the immunogenicity
      of these proteins. Sera were collected from owners' cats, which were either sero
      negative or sero-positive for D. immitis and from cats before and after
      experimental infection with D. immitis. FTSZ was recognized in Western blots by
      sera from both positive and negative cats and from both uninfected and
      experimentally infected cats. WSP was recognized only by sera from positive cats
      and from cats experimentally infected with D. immitis; this protein was not
      recognized by sera from negative cats and from cats before experimental infection
      with D. immitis. The results of Western blot assays on WSP thus support the
      hypothesis that infection with filarial nematodes induces the production of
      antibodies against Wolbachia proteins.

PMID- 11197128
TI  - Intraspecific phylogenetic congruence among multiple symbiont genomes.
AB  - Eukaryotes often form intimate endosymbioses with prokaryotic organisms. Cases in
      which these symbionts are transmitted cytoplasmically to host progeny create the
      potential for co-speciation or congruent evolution among the distinct genomes of
      these partners. If symbionts do not move horizontally between different
      eukaryotic hosts, strict phylogenetic congruence of their genomes is predicted
      and should extend to relationships within a single host species. Conversely, even
      rare 'host shifts' among closely related lineages should yield conflicting tree
      topologies at the intraspecific level. Here, we investigate the historical
      associations among four symbiotic genomes residing within an aphid host: the
      mitochondrial DNA of Uroleucon ambrosiae aphids, the bacterial chromosome of
      their Buchnera bacterial endosymbionts, and two plasmids associated with
      Buchnera. DNA sequence polymorphisms provided a significant phylogenetic signal
      and no homoplasy for each data set, yielding completely and significantly
      congruent phylogenies for these four genomes and no evidence of horizontal
      transmission. This study thus provides the first evidence for strictly vertical
      transmission and 'co-speciation' of symbiotic organisms at the intraspecific
      level, and represents the lowest phylogenetic level at which such coevolution has
      been demonstrated. These results may reflect the obligate nature of this intimate
      mutualism and indicate opportunities for adaptive coevolution among linked
      symbiont genomes.

PMID- 11197129
TI  - A mechanistic link between parasite resistance and expression of a sexually
      selected trait in a damselfly.
AB  - This paper examines a field-based insect system in which a signal trait and an
      immune effector system responsible for parasite resistance rely on the same
      melanin-producing enzyme cascade (phenoloxidase, PO). Observations and
      experiments on males of the calopterygid damselfly Calopteryx splendens
      xanthostoma revealed that resistance to the prevalent parasite in the study
      system (a eugregarine protozoan infecting the mid-gut) was correlated with
      quantitative aspects of the sexually dimorphic melanized wingspot of males, a
      trait that is produced and fixed before the host comes into contact with the
      sporozsoites of the parasite. Regulation of PO during experimental immune
      challenge showed that males with dark, homogenous melanin distribution in their
      wings showed no change in PO levels 24 h after challenge. By contrast males with
      lighter and/or more heterogenous melanin distribution in their wings tended to
      show higher PO levels 2-h after immune challenge. The changes in PO levels occur
      despite the lack of a relationship between wing-pigment distribution and the
      cellular encapsulation response. These results suggest a shared, limiting
      resource may form the mechanistic basis of the trade-off between a condition
      dependent signal trait and immune function in this system.

PMID- 11197130
TI  - Human fertility variation, size-related obstetrical performance and the evolution
      of sexual stature dimorphism.
AB  - In several animal species, change in sexual size dimorphism is a correlated
      response to selection on fecundity. In humans, different hypotheses have been
      proposed to explain the variation of sexual dimorphism in stature, but no
      consensus has yet emerged. In this paper, we evaluate from a theoretical and an
      empirical point of view the hypothesis that the extent of sexual dimorphism in
      human populations results from the interaction between fertility and size-related
      obstetric complications. We first developed an optimal evolutionary model based
      on extensive simulations and then we performed a comparative analysis for a total
      set of 38 countries worldwide. Our optimization modelling shows that size-related
      mortality factors do indeed have the potential to affect the extent of sexual
      stature dimorphism. Comparative analysis using generalized linear modelling
      supports the idea that maternal death caused by deliveries and complications of
      pregnancy (a variable known to be size related) could be a key determinant
      explaining variation in sexual stature dimorphism across populations. We discuss
      our results in relation to other hypotheses on the evolution of sexual stature
      dimorphism in humans.

PMID- 11197131
TI  - 'Sloppy' sperm mixing and intraspecific variation in sperm precedence (P2)
      patterns.
AB  - Sperm precedence patterns are typically highly variable within (and between)
      species. Intraspecific variation in sperm precedence (measured as P2, the
      proportion of progeny fathered by the last male to mate' is frequently seen as a
      candidate for adaptive interpretation through either male effects (e.g. body
      size), female effects (e.g. cryptic female choice) or an interaction between the
      two. Here we show, using computer simulation, that if ejaculates divide into a
      number of 'packets' and packets from two males mix randomly, then a variety of
      patterns of sperm precedence may result. We term this process 'sloppy' mixing. If
      ejaculates break into a small number of packets, bimodal P2 distributions are
      predicted. As the number of packets is increased, then a complex series of
      changes through multimodal and flat to unimodal distributions results. Sloppy
      mixing can thus result in many of the observed P2 distributions. Sloppy mixing is
      unlikely to change the predictions of adaptive models of sperm competition.

PMID- 11197132
TI  - Extra-pair paternity as the result of reproductive transactions between paired
      mates.
AB  - Transactional ('optimal skew' or concessions') models of social evolution
      emphasize that dominant members of society can be favoured for donating parcels
      of reproduction to same-sexed subordinates in return for cooperation by the
      latter. We developed a mathematically similar model in which extra-pair paternity
      in broods receiving biparental care is viewed as emerging from a reproductive
      transaction between the paired mates. The model quantitatively predicted the
      maximum paternity that a male mate can demand before its female mate is favoured
      to break the pair bond and caring solitarily for a brood sired entirely by a
      neighbouring male. The model predicts that extra-pair paternity results when the
      neighbouring male is of sufficiently higher quality than the male mate. In such
      cases, the exact amount of extra-pair paternity will vary directly with the
      difference in quality between the two males and inversely with the value (fitness
      impact) of the male mate's parental care. Importantly, the transactional model
      provided a unified explanation for experimental and observational evidence that
      extra-pair paternity rises with decreasing quality of the male mate, increasing
      genetic variability among breeding males, increasing breeding density, increasing
      availability of food and decreasing involvement of the male mate in parental
      care.

PMID- 11197133
TI  - Male-male competition and parental care in collared flycatchers (Ficedula
      albicollis): an experiment controlling for differences in territory quality.
AB  - Females are known to benefit from mate choice in several different ways but the
      relationship between these benefits has received little attention. The quality of
      resources provided by males, such as nest sites, and paternal care are often
      assumed to covary positively However, because the location of the nest affects
      the cost of parental care, these two benefits from mate choice can easily be
      confounded. To investigate the provisioning ability of successful competitors
      while controlling for differences in territory quality we removed early-settled
      pairs of collared flycatchers (Ficedula albicollis) and allowed replacement by
      later-arriving males or floaters (i.e.'poor competitors'). A control group of
      early-settled males (i.e. 'good competitors') had their females removed. Females
      paired to good competitors enjoyed a significantly higher reproductive success
      and tended to receive more parental assistance from their mates compared with
      females mated to poor competitors. Thus, some males seem able not only to compete
      successfully over resources but also to feed their offspring at a relatively
      higher rate. An alternative explanation, that poor competitors invested less in
      offspring quality in response to a lower share of paternity, could be rejected.
      The rate of extra-pair paternity did not differ between the two treatment groups.
      Our results suggest that male- male competition can sometimes facilitate female
      choice of superior care-givers. Thus, a female's benefit from choosing a
      competitive male may not be restricted to the quality of the resource he defends
      but can also include superior paternal care.

PMID- 11197134
TI  - Early exposure leads to repeatable preferences for male song in female zebra
      finches.
AB  - This study addressed the question of how early learning processes in females
      influence later preferences for a male trait. I tested whether exposure to song
      alone (of a male other than the father) was sufficient for inducing a stable
      (repeatable) preference in female zebra finches (Taeniopygia guttata) by limiting
      early exposure to tape tutoring. A group of controls heard no songs before also
      being tested in adulthood. Repeated tests for preferences for tutor or unfamiliar
      song were made, interspersed with additional tests involving new songs.
      Preferences were tested in an operant task where pecking of response keys led to
      song playback. Most females significantly preferred one of the two songs in a
      given test. In the first test, the relative preference for the tutor song was
      significantly higher for the tutored than for the control females. Subsequently,
      tutored females' preferences for the tutor song remained higher on average, but
      the two groups did not differ significantly. However, tutored, but not untutored
      females' preferences were highly repeatable between tests, suggesting that early
      exposure to song might lead to a consolidation ol choice behaviour, a previously
      unknown effect of early exposure to song in female songbirds.

PMID- 11197136
TI  - Protecting your records in an online world.

PMID- 11197135
TI  - Attentional diversion during adaptation affects the velocity as well as the
      duration of motion after-effects.
AB  - The effects of diverting attention on early motion processing in human vision
      were studied with a selective adaptation technique. The velocity of motion after
      effects (MAEs) produced on a stationary test grating after prolonged exposure to
      drifting luminance-modulated gratings was measured by matching MAE velocity with
      that of another physically moving grating. Initial MAE velocities decreased and
      their rate of decay increased with the distance of the adapting and test gratings
      from the fixation point. When attention was diverted from the adapting grating,
      by having subjects process the intermittently changing digit which formed the
      fixation point, initial MAE velocities were reduced and rate of decay increased,
      with the largest effect of diversion being found for gratings near the fixation
      point. The effects of varying attention mimic those of varying adapting duration,
      rather than adapting contrast or velocity, and appear to reflect a genuine change
      in motion-processing mechanisms.

PMID- 11197137
TI  - Searching the Web. The power of portals.

PMID- 11197138
TI  - Drug ads on TV: pretty, but perplexing.

PMID- 11197139
TI  - Wintertime common sense: how much do you have?

PMID- 11197140
TI  - Why are our children getting fat?

PMID- 11197141
TI  - St. John's Wort for wintertime blues.

PMID- 11197142
TI  - Winter sledding tips.

PMID- 11197143
TI  - Paying for prescriptions: programs that can help.

PMID- 11197144
TI  - Caring for a child with asthma.

PMID- 11197145
TI  - Necessity of monitoring HPLC by a X-R control chart on measurement of serum fat
      soluble vitamins.
AB  - In epidemiologic studies, many serum samples obtained from a large population
      have to be processed for measurement of fat-soluble vitamins. Quantification
      results by a high performance liquid chromatography (HPLC) should be stable in
      both intra- and inter-run, and a quality control may be performed by a X-R
      control chart. The present study shows that serum retinol, alpha-tocopherol,
      alpha-carotene, beta-carotene, and lycopene could be measured simultaneously, by
      1) use of photodiode-array (POD) detector, 2) selection of some optimal
      analytical conditions (e.g. column, mobile phase, column temperature), 3)
      applying 2 internal standards, and 4) monitoring by a X-R control chart. The
      present procedure yielded relatively low coefficients of variations (CVs)
      compared to some reported figures. However, determination of CVs only does not
      ensure the accuracy and precision of an assay system, and application of a X-R
      control chart may be necessary for a good quality control of measurement, such as
      serum fat-soluble vitamins.

PMID- 11197146
TI  - Thoracoscopic lung biopsy for diffuse infiltrative lung disease.
AB  - Thoracoscopic lung biopsy is becoming the procedure of first choice for the
      diagnosis of many localized and diffuse lung diseases. We have performed
      thoracoscopic lung biopsy for 17 patients with diffuse infiltrative lung disease,
      in Kurume University Hospital. There were 13 females and 4 males with a mean age
      of 48 years (range: 19-71 years). Thoracoscopic surgical biopsy was performed in
      the right lung in 12 and in the left lung in 5. Adequate lung tissue from each
      case was obtained for pathological examination. The mean surgical biopsy time was
      49 min (range: 25-72 min) and bleeding was negligible. The mean duration for
      chest tube drainage was 2.6 days. No postoperative complication such as prolonged
      air leakage occurred. A specific diagnosis from the biopsy was achieved in 13
      (76.4%) of the 17 cases. In only 6 (35.2%) of the 17 cases, the pathological
      diagnosis was the same as that from the thoracoscopic biopsy. In these 6 cases,
      the same diagnosis was obtained only in those with idiopathic interstitial
      pneumonitis or diffuse panbronchitis. Thoracoscopic lung biopsy was safe and
      useful for diagnosis for diffuse infiltrative lung disease.

PMID- 11197147
TI  - Plasma beta-phenylethylamine in Parkinson's disease.
AB  - Plasma beta-phenylethylamine (PEA) levels were determined in 27 patients with
      Parkinson's disease (PD) in order to evaluate its relation with the severity or
      clinical course of PD. The plasma PEA concentrations in PD patients were
      significantly lower (mean +/- SD, 862 +/- 554 pg/ml) than those in the control
      group (1765 +/- 790 pg/ml) (p < 0.0001). The concentrations of PEA in plasma did
      not correlate with Hoen and Yahr stage. However, in serial measurements of the
      PEA of 5 patients in the progressive group of the clinical course of PD, the
      plasma PEA levels revealed a downward trend after one or two years. On the other
      hand, in 3 patients of non-progressive group, the plasma PEA remained at the same
      level. This study suggests that plasma PEA level might reflect nigrostriatal
      degeneration in patients with PD.

PMID- 11197148
TI  - Shedding of herpes simplex virus type 1 into tears and saliva in healthy Japanese
      adults.
AB  - It is well known that asymptomatic viral shedding is one of the forms of
      reactivation of herpes simplex virus type-1 (HSV-1). Although there have been
      some long-term investigations of viral shedding into tears and saliva in healthy
      subjects in the U.S.A, there have previously been no investigation study in
      Japan. Racial differences in the incidence of reactivation of HSV-1 have been
      pointed out, and it has been considered that reactivation is found less often
      among Japanese people than among Westerners. In the present study, we selected 10
      healthy adults (7 males and 3 females) to isolate HSV-1 from tears and saliva 3
      times a week over 6 months, and the results were compared with the results of
      other studies conducted in the U.S.A. It was found that the virus was isolated in
      5 (3 males and 2 females) of 10 subjects and of the 5 subjects, the virus was
      isolated from saliva in 4 and from tears in 1. The number of specimens was 1,742
      for tears and 871 for saliva with isolation of 1 and 4, respectively. The
      duration of shedding was only 1 day in all of the 5 subjects in whom the virus
      was isolated. The isolation frequency was significantly lower among Japanese
      people than among American people when our results were compared with the results
      of studies conducted in the U.S.A. It was clear that the reactivation rate was
      lower for Japanese people in terms of asymptomatic shedding.

PMID- 11197149
TI  - Effectiveness of an educational trial to encourage sufficient calcium intake in
      women college students.
AB  - An educational trial to encourage sufficient calcium (Ca) intake was conducted on
      women college students who entered the college for dietitian either in 1993 or in
      1994. The trial's effectiveness was assessed by a prospective cohort study. Two
      hundred and fifteen 18- or 19-year-old students were assigned into two cohorts,
      i.e., a control cohort (CC) and an educated cohort (EC). Both groups received 3
      surveys, i.e., at baseline, 1 week after, and 1 year after the Ca education,
      which was given only to the EC at baseline to encourage sufficient Ca intake. The
      amount of Ca taken by the CC did not significantly change in the 3 surveys. The
      EC took a significantly larger amount of Ca 1 week after and maintained
      relatively larger amount of Ca 1 year after the Ca education. These results
      suggest some effectiveness of Ca education on the women college students.

PMID- 11197150
TI  - Effect of facial affect stimuli on auditory and visual P300 in healthy subjects.
AB  - This study investigated whether or not P300 components are influenced by
      emotional affect such as sadness and pleasure in twenty healthy subjects and
      whether or not the P300 effects of facial affect stimuli are influenced by
      auditory and visual stimulus modalities. Written informed consent was taken from
      each subject before the study. Each subject was asked to stare at a simple
      picture of a facial expression (crying or smiling faces) during the auditory and
      visual oddball tasks. P300 amplitude and area were significantly larger when
      viewing a crying face (sadness) than a smiling face (pleasure) under both
      conditions with auditory and visual stimulus. P300 latency was significantly
      longer while viewing sadness than while viewing pleasure only with auditory
      stimuli. Reaction time was not changed by facial stimuli. Amplitude and area of
      P300 were significantly larger in women than men in their modalities, but the
      effects of facial affect on P300 amplitude and area in women were similar to
      those in men. These results suggest that amplitude and area of P300 with both
      modalities recorded while viewing sadness may induce larger attentional resource
      than pleasure. Gender was a less potent influence of facial expression on P300
      parameters. The influence of facial emotion may be important to investigate the
      recognition processes of subjects.

PMID- 11197151
TI  - Comparison of the inpatients admitted during the recent 5 years (January 1994
      December 1998) with those admitted during the previous 5 years (January 1989
      December 1993): a clinico-statistical study.
AB  - As society ages, the composition of the diseases that occur within it changes
      accordingly. With that in mind, we examined the characteristics and trends in the
      recent inpatients and compared these recent inpatients with those of a previous
      report to identify the changes that accompany the aging of society. Subjects were
      1,534 cases (men 56.9%, female 43.1%, average age 47.1 years) who were
      hospitalized at Kurume University Hospital for treatment during the 5-year period
      from January 1st, 1994 through December 31st, 1998. The ratio of inpatients over
      65 years old was about 1.8 times higher than in the previous study, showing a
      clear trend toward an increased overall age of inpatients. As for the types of
      disease observed, the most common malignancies were epithelial tumor, followed by
      other benign tumors, as well as 76 cases which included diseases resembling tumor
      (epulis and exostosis etc.). A majority of the patients (55.6%) were directed to
      the Hospital by their dentist, a finding similar to that of the previous report.
      As for geographical distribution, 93.3% of the inpatients lived within 40 km of
      the center of Kurume City where our oral surgery is located, an increase of about
      10% from the last report. In other words, our results showed a reduction in the
      sphere of treatment distribution.

PMID- 11197152
TI  - Profiles of herpes simplex virus type 1 antibodies in primary herpetic infections
      of the maxillofacial regions.
AB  - Changes in the aspects of primary infection of herpes simplex virus type 1 in the
      maxillofacial region have been observed due to the increase in the number of
      adult cases. To elucidate the possibility of serologic diagnosis in primary
      infectious patients and the influence of virucide on antibody production, we
      evaluated changes in serum antibodies (neutralizing antibody, IgM, and IgG
      antibody) in pair serum in 35 primary infectious patients using a micro-plate
      method and ELISA. At the first examination, 31 (89%) of 35 patients did not have
      neutralizing antibodies, and 23 of the 31 patients showed significant increases
      of neutralizing antibody titer more than four times at the second examination.
      Three of the 4 patients that had neutralizing antibodies showed significant
      increases at the second examination; therefore, 26 (74.3%) of the 35 patients
      could be diagnosed as having primary infection only by neutralizing antibodies.
      Regarding 9 patients who did not show significant increases in neutralizing
      antibodies, 5 of the 9 patients showed increases in IgG antibody titer more than
      two times at the second examination, and at the first examination, IgM antibody
      titer in 3 of the remaining 4 patients was more than 0.2 that is the cut-off
      value; therefore, it was possible to diagnose the 8 patients as having primary
      infection. We evaluated the influence of the use of virucide, gender, age, period
      between onset and the first examination, and period between onset and the second
      blood collection on antibody production; however, there were no differences
      observed except that significant increases in antibody were observed in 4
      children aged below 10 years, although they used virucide. These results revealed
      that it was not possible to serologically diagnose whether there was primary or
      recurrent infection only by neutralizing antibody titer.

PMID- 11197153
TI  - Histomorphological investigation regarding to malignant transformation of
      pleomorphic adenoma (so-called malignant mixed tumor) of the salivary gland
      origin: special reference to carcinosarcoma.
AB  - Pleomorphic adenoma is the best-recognized tumor among those of salivary gland
      origin that also has the highest incidence. However, it is not uncommon for it to
      become malignant, and it has been noted that the frequency of malignancy
      increases as a result of the tumor persisting without being treated following the
      onset of adenoma. Carcinomatous components demonstrate various histological
      appearances, and in particular, there have been sporadic reports of
      carcinosarcoma in which malignant findings are not only observed in epithelial
      components, but in mesenchymal components as well. We conducted a
      histopathological study on cases of malignant-transformed pleomorphic adenoma,
      namely so-called malignant mixed tumor observed in our department. The subject
      cases consisted of a total of 19 cases registered in the diagnostic files of our
      department and included 12 males and 7 females. Age ranged from 46 to 87 (average
      67.7) years old. The sites of occurrence consisted of the parotid gland in 17
      cases, and palatal and buccal minor salivary glands in one case each.
      Histological types consisted of 7 cases of adenocarcinoma not otherwise
      specified, 3 cases of squamous cell carcinoma, 3 cases of salivary duct
      carcinoma, and one case each of polymorphous low-grade adenocarcinoma and
      epithelial-myoepithelial carcinoma, while the remaining were 2 cases of
      sarcomatoid carcinoma and 2 carcinosarcoma. We described herein their
      histological characteristics, discussed diagnostic problems in various instants
      in which each phenotype on this setting, and reviewed the literature, especially
      as to carcinosarcoma in contrast with those derived from other organs.

PMID- 11197154
TI  - Advanced gastric cancer with liver metastasis effectively treated by intra
      hepatic arterial infusion of 5-FU, MMC and peroral administration of 5-FU: a case
      report.
AB  - We have experienced a case of advanced gastric cancer with liver metastasis
      effectively treated by intra-hepatic arterial infusion of 5-fluorouracil (5-FU),
      mitomycin C (MMC) and peroral administration of 5-FU. The patient was a 48-year
      old male diagnosed as having advanced gastric cancer with multiple liver
      metastasis in the bilateral lobes of the liver. This patient was treated by intra
      hepatic arterial infusion of 5-FU (250 mg/2 days x 8 doses), MMC (20 mg x 1 dose,
      6 mg/2 weeks x 6 doses) and peroral administration of 5-FU (200 mg/day). At 14
      weeks later, a CT revealed that the metastatic liver tumors had disappeared.
      However, at 7 months after the therapy, the patient eventually died of liver and
      brain metastasis. These results suggested that intra-hepatic arterial infusion of
      5-FU and MMC was an effective therapy for metastatic tumors in the liver, but we
      need to perform intra-hepatic arterial infusion using a new prolonged regimen to
      treat the liver metastasis.

PMID- 11197155
TI  - Multiple carcinoids in the stomach with hypergastrinemia and type A gastritis: a
      case report.
AB  - We have experienced a case of the stomach with hypergastrinemia and type A
      gastritis with multiple carcinoids in a 37-year-old woman. An upper
      gastrointestinal series revealed multiple minute polyps in the upper body of the
      stomach. All polyps were diagnosed as carcinoid using endoscopic biopsies. She
      had neither symptom or signs of typical carcinoid disease. The serum gastrin
      level was as high as 725 pg/ml. Total gastrectomy was performed, and the
      diagnosis of multiple gastric carcinoids (sm, no) with type A gastritis was
      histologically confirmed. After the operation, the serum gastrin level returned
      to normal, and the patient has been doing well and is disease-free to date at 7
      years after the operation. This case suggested that multiple gastric carcinoid
      lesions may be precipitated by chronic atrophic gastritis accompanying
      hypergastrinemia. In the treatment of multiple gastric carcinoids with type A
      gastritis, total gastrectomy with lymph node dissection should be standard
      operative procedure, in order to resect the fundic gland area completely which
      could be the origin of carcinoids and endocrine cell micronest.

PMID- 11197156
TI  - Separation of N2-ethyl-2'-deoxyguanosine-5'-monophosphate and four native
      deoxyribonucleoside monophosphates using capillary zone electrophoresis with
      polyethylene glycol as buffer additive.
AB  - We investigated the separation of five deoxyribonucleoside monophosphates: 2'
      deoxyguanosine-5'-monophosphate (dGMP), 2'-deoxyadenosine-5'-monophosphate
      (dAMP), 2'-deoxycytosine-5'-monophosphate (dCMP), 2'-deoxythymidine-5'
      monophosphate (dTMP) and a dGMP adduct possessing N2-ethyl-guanine, which has
      been noted in relation to mutagenesis of alcohol, using capillary zone
      electrophoresis (CZE). The concentration of polyethylene glycol (PEG) as a
      modifier and the pH of the running solutions can efficiently control the observed
      separation. Interaction of PEG with analytes was quantitatively evaluated. PEG
      worked effectively as a hydrophobic selector in these separations. The values of
      pKa of the acidic-NH-groups in the base moieties of dGMP, dTMP, and the dGMP
      adduct are close to that of boric acid used as buffer of the running solutions.
      The control of their charge was facilitated, enabling improved separations. A
      more sufficient and fast separation was achieved by both optimization of pH of
      the running solutions and PEG concentration compared with that obtained by pH
      control alone. On-line concentration using a stacking method followed by the PEG
      assisted CZE was briefly studied.

PMID- 11197157
TI  - Evaluation of norbornene- beta-cyclodextrin-based monomers and oligomers as
      chiral selectors by means of nonaqueous capillary electrophoresis.
AB  - Norbornen-5-yl carboxylic acid and norbornen-5-ylmethylsilyl ether-based beta
      cyclodextrins (beta-CDs) containing up to three norbornene ester and up to five
      norbornene silyl ether units have been prepared from beta-CD and norbornen-5
      carboxylic chloride and norbornen-5-ylmethyldichlorosilane, respectively.
      Oligomers (n = 2-4) were prepared therefrom using ring-opening metathesis
      polymerization (ROMP). Monomeric and oligomeric substituted beta-CDs were
      evaluated as chiral selectors in nonaqueous capillary zone electrophoresis using
      35 mM sodium bicarbonate in N-methylformamide (NMF) as background electrolyte.
      Both monomeric and oligomeric norbornene ester- and norbornene silyl ether-type
      selectors showed good enantioresolution for dansylated (DNS-) amino acids using
      concentrations of the chiral selector of up to 4% w/v. A significant improvement
      in resolution was observed upon the introduction of up to five norbornene silyl
      ether units into a beta-CD molecule, whereas higher degrees of substitution with
      norbornen-5-yl-carboxyl groups lead to a reduction in enantioresolution of DNS
      amino acids. Thus, pentakis(norbornen-5-ylmethylhydroxysiloxyl)-beta-CD turned
      out to be superior to mono(norbornen-5-ylmethylhydroxysiloxyl)-beta-CD in terms
      of enantioresolution. Moreover, norbornene silyl ether-type selectors were found
      to be more efficient than norbornene ester-type selectors. Finally, oligomeric
      selectors were found to possess superior or at least comparable
      enantioselectivity in the separation of DNS-amino acids compared to the parent
      monomers. A maximum in enantioresolution was obtained with
      oligo(pentakis(norbornen-5-ylmethylhydroxysiloxyl)beta-CD).

PMID- 11197158
TI  - Comparison of binding of tetraphenylborate and tetraphenylphosphonium ions to
      cyclodextrins studied by capillary electrophoresis.
AB  - Binding constants for tetraphenylborate and tetraphenylphosphonium ions (Ph4B-
      and Ph4P+) to cyclodextrins (CDs) to give 1:1 host-guest complexes have been
      measured using capillary electrophoresis. Mobilities of the ions as a function of
      gamma-CD concentration give binding constants, K, of 1.08 x 10(5) M-1 for Ph4B-
      and 0.6 x 10(1) M-1 for Ph4P+. This dramatic difference of four orders of
      magnitude in binding constants is not seen with beta-CD (K = 7.7 x 10(1) M-1 for
      Ph4B- and 3.7 x 10(1) M-1 for Ph4P+) or dimethyl (DM)-beta-CD (K = 46 x 10(1) M-1
      for Ph4B-1 and 7.7 x 10(1) M-1 for Ph4P+). The crystal and hydrodynamic radii of
      the ions, the latter calculated from their absolute mobilities, indicate that
      Ph4B- is smaller than the gamma-CD cavity, whereas Ph4P+ is approximately the
      gamma-CD cavity size. Results suggest that Ph4B- fits exactly into a gamma-CD
      cavity, with hydrophobic contacts involving several of the phenyl rings, whereas
      Ph4P+ is too large to enable these multiple contacts to be made. When only a
      single phenyl ring can fit into the CD cavity, binding strengths are in the order
      DM-beta-CD > beta-CD > gamma-CD and Ph4B- > Ph4P+. Measurement of electrophoretic
      mobilities of the complexes shows that their hydrodynamic radii are in the order
      gamma-CD < beta-CD approximately DM-beta-CD for Ph4B- and gamma-CD > beta-CD
      approximately DM-beta-CD for Ph4P+.

PMID- 11197159
TI  - Expression of alpha-amylase gene in rat liver: liver-specific amylase has a high
      affinity to glycogen.
AB  - The reactivity of rat liver alpha-amylases with maltotriose (G3), maltopentose
      (G5) and glycogen has been investigated. Liver amylases were found to be
      glycosylated and to have a molecular mass of 50 kDa by Western blotting using an
      anti-human salivary amylase antibody. The glycosylated liver amylases were found
      to be capable of G3- and G5-hydrolysis and of glucose formation, as demonstrated
      by thin-layer chromatography. When the amylase preparation was exposed to
      different concentrations of glycogen and run on a cellulose acetate membrane, the
      mobilities of rat liver amylases significantly decreased with tailing directly
      from the point of origin. In contrast, rat salivary amylases were not so much.
      These results indicate that rat liver amylases have a strong affinity to
      glycogen. We confirmed the expression of liver-specific amylases in rat liver by
      reverse transcriptional-polymerase chain reaction (RT-PCR); PCR products showed
      one band of an expected size of 474 bp using primers tested in the present study.
      A partial nucleotide sequence was then determined. When compared with the gene of
      mouse liver amylase, the substitution of 26 bases out of 434 bases was
      elucidated. The present data demonstrate the presence of liver-specific amylases
      in rats.

PMID- 11197160
TI  - Chiral analysis of baclofen by alpha-cyclodextrin-modified capillary
      electrophoresis and laser-induced fluorescence detection.
AB  - An enantioselective method for baclofen (4-amino-3-p-chlorophenylbutyric acid)
      based on capillary electrophoresis (CE) separation and laser-induced fluorescence
      (LIF) detection has been developed. Naphthalene-2,3-dicarboxaldehyde (NDA) was
      used for precolumn derivatization of the nonfluorescent drug. alpha-Cyclodextrin
      (alpha-CD) was included in the buffer as a chiral selector for the separation of
      NDA-labeled S-(+)- and R-(-)-baclofen. Optimal resolution and detection were
      obtained with an electrophoretic buffer of 50 mM sodium borate (pH 9.5)
      containing 7 mM alpha-CD and a He-Cd laser (lambda ex = 442 nm, lambda em = 500
      nm). Combined with a simple cleanup procedure, this method can be applied to the
      analysis of baclofen enantiomers in human plasma. The relative standard deviation
      (RSD) values on peak areas of a plasma sample containing 1.0 microM racemic
      baclofen were 6.4 and 4.9% (n = 8) for the S-(+)- and R-(-)-enantiomer,
      respectively. The RSD value on migration times of both enantiomers was 0.5% (n =
      8). Calibration graphs for S-(+)- and R-(-)-baclofen in plasma showed a good
      linearity (r > or = 0.999) in the concentration range of 0.1-2.0 microM. The
      limit of detection of baclofen in plasma was about 10 ng/mL.

PMID- 11197161
TI  - Monitoring human serum transferrin by capillary zone electrophoresis with end
      column amperometric detection.
AB  - Capillary zone electrophoresis was employed for the determination of human serum
      transferrin using end-column amperometric detection with a carbon fiber
      microelectrode at a constant potential of 1.9 V vs. saturated calomel electrode
      (SCE). The optimum conditions of separation and detection are 7.5 x 10(-4) mol/L
      Tris-3.44 x 10(-4) mol/L HCl for the buffer solution, 20 kV for the separation
      voltage, 5 kV and 10 s for the injection voltage and the injection time,
      respectively. The limit of detection is 6.7 x 10(-8) mol/L or 440 amol (S/N = 2).
      The relative standard deviations are 0.67% for the migration time and 1.5% for
      the electrophoretic peak current. The method was applied to the determination of
      transferrin in human serum. The recovery is between 93-104%.

PMID- 11197162
TI  - Simultaneous determination of doxorubicin, daunorubicin, and idarubicin by
      capillary electrophoresis with laser-induced fluorescence detection.
AB  - The separation and simultaneous determination of doxorubicin, daunorubicin and
      idarubicin was investigated using capillary electrophoresis with laser-induced
      fluorescence detection. Because the three anthracycline antibiotics were similar
      in structure and mass, careful manipulation of the electroosmotic flow and
      electrophoretic mobilities was required. A buffer consisting of 100 mM borate,
      adjusted to pH 9.5, containing 30% acetonitrile was found to provide a very
      efficient and stable electrophoretic system for the analysis of the three
      anthracyclines. The method was applied to the determination of three
      anthracyclines in serum samples. Responses were linear in the range of 10-500
      ng.mL-1 and the detection limits were lower than 0.9 ng.mL-1.

PMID- 11197163
TI  - Separation of cold medicine ingredients by capillary electrophoresis.
AB  - This study demonstrates the separation of cold medicine ingredients (e.g.,
      phenylpropanolamine, dextromethorphan, chlorpheniramine maleate, and paracetamol)
      by capillary zone electrophoresis and micellar electrokinetic chromatography.
      Factors affecting their separations were the buffer pH and the concentrations of
      buffer, surfactant and organic modifiers. Optimum results were obtained with a 10
      mM sodium dihydrogen-phosphate-sodium tetraborate buffer containing 50 mM sodium
      dodecyl sulfate (SDS) and 5% methanol (MeOH), pH 9.0. The carrier electrolyte
      gave a baseline separation of phenylpropanolamine, dextromethorphan,
      chlorpheniramine maleate, and paracetamol with a resolution of 1.2, and the total
      migration time was 11.38 min.

PMID- 11197164
TI  - Determination of nucleosides in natural Cordyceps sinensis and cultured Cordyceps
      mycelia by capillary electrophoresis.
AB  - Cordyceps sinensis is a well-known traditional Chinese medicine, and some of the
      active components are nucleosides. The analysis of nucleosides in Cordyceps
      material has been performed by reversed-phase high-performance liquid
      chromatography (HPLC) with gradient elution or by spectrometry. Here, we have
      explored the possibility of using capillary electrophoresis to determine the
      content of three major nucleosides (adenosine, guanosine and uridine) in
      Cordyceps. Capillary electrophoresis needs no gradients, and it provides a better
      separation due to its higher efficiency. In order to optimize the resolution, the
      separation of adenosine, guanosine and uridine was determined in Cordyceps with
      respect to the variation of buffer concentration, pH, temperature, and voltage.
      By using the calibrated electrophoresis system, the separation was achieved for
      the three nucleosides in less than 10 min with a background electrolyte
      consisting of 0.2 M boric acid-sodium hydroxide buffer, pH 8.5. The nucleoside
      contents of various types of natural Cordyceps and cultured Cordyceps mycelia
      were determined and compared. There was a great variation of nucleoside content
      in different sources of Cordyceps; the cultured Cordyceps mycelia, however,
      contains a much higher concentration than the natural Cordyceps.

PMID- 11197165
TI  - Determination of synthesized alpha-vitamin E by micellar electrokinetic
      chromatography.
AB  - We developed a micellar electrokinetic chromatography method (MEKC) for the
      direct determination of the content of synthesized alpha-vitamin E. It was found
      that under the optimum separation conditions 7 mM borate + 14 mM phosphate + 15
      mM sodium dodecyl sulfate (SDS) + 10 mM sodium cholate (NaCh) + 8% acetonitrile
      (pH 9.2) with UV detection wavelength at 214 nm, 16 kV constant voltage, and 26
      degrees C constant temperature, alpha-vitamin E and its isomers can be baseline
      separated and alpha-vitamin E was quantitatively analyzed. In addition, the
      sample recovery, the limit of detection and the repeatability of the method were
      investigated. The influence of various parameters on the separation such as SDS
      concentration, NaCh concentration, buffer pH and acetonitrile percentage were
      also discussed.

PMID- 11197166
TI  - Identification of a phosphoprotein that is downregulated in immortalized human
      fibroblasts.
AB  - Many lines of evidence indicate that the immortalization step is critical for the
      neoplastic transformation of normal human cells. Once normal human cells have
      been immortalized, they are relatively easily transformed into neoplastic cells.
      In order to understand these phenomena, patterns of protein phosphorylation in
      proliferating normal human fibroblast cell strains and their immortalized cell
      lines were compared by using two-dimensional polyacrylamide gel electrophoresis.
      It was found that the expression and phosphorylation levels of the human heat
      shock protein 27 (HSP27) were predominantly downregulated in the immortalized
      cells compared with those in their normal counterparts. In the normal cells,
      HSP27 expression and phosphorylation were markedly increased by physiological and
      nonphysiological stresses, such as serum addition, treatment with a carcinogenic
      agent like 4-nitroquinoline-1-oxide, and a high osmotic pressure. This may be a
      normal defense against acute changes of cellular environment and cytotoxic
      effects. However, these stresses had no effects on the expression and
      phosphorylation of HSP27 in the immortalized cells. These results suggest that an
      abnormal regulation of HSP27 expression and phosphorylation may be one of the
      reasons for easy neoplastic transformation of the immortalized cells by the
      treatment with carcinogenic agents.

PMID- 11197167
TI  - Nondenaturing two-dimensional electrophoretic analysis of loop-sheet
      polymerization of serpin, squamous cell carcinoma antigen-2.
AB  - Two homologous serine proteinase inhibitors (serpins), squamous cell carcinoma
      (SCC) antigen-1 and -2 were separated by nondenaturing two-dimensional
      electrophoresis combined with immunostaining to acquire further information on
      these proteins under physiological conditions. Polymers of SCC antigen-2 were
      detected in cytosolic extracts prepared from tumor tissues. The polymer formation
      of SCC antigen-2 was apparently decreased and the SCC antigen-2-synthetic peptide
      binary complexes were newly formed by the addition of synthetic peptide with
      sequences corresponding to residues from P14 to P2 in the reactive center loop of
      SCC antigen-2. On the other hand, the incubation with synthetic peptides having
      the sequence of the reactive center loop of SCC antigen-1 or antithrombin had no
      effect on polymerization of SCC antigen-2. These data suggest that the
      polymerization of SCC antigen-2 may occur spontaneously in vivo by the loop-sheet
      mechanism of serpin.

PMID- 11197168
TI  - Reduced proteolysis of surfactant protein A and changes of the bronchoalveolar
      lavage fluid proteome by inhaled alpha 1-protease inhibitor in cystic fibrosis.
AB  - In cystic fibrosis (CF), the chronic neutrophilic inflammation of the airways
      results in proteolytic degradation of lung tissue early in the course of the
      disease. Inhalation of alpha 1-protease inhibitor (alpha 1-PI) may restore the
      protease-antiprotease imbalance and thus lead to less tissue damage. To monitor
      its impacts on bronchoalveolar lavage (BAL) fluid protein pattern (proteome) and
      on surfactant protein A (SP-A), eight young adults with CF inhaled 100 mg of
      alpha 1-PI twice daily over eight weeks. BAL fluids were obtained before and
      after inhalation. Total protein, the number and amount of proteins with a
      molecular mass < 20 kDa were reduced compared to pretreatment values. Degradation
      products of SP-A were shown by immunoblotting, being reduced after alpha 1-PI
      treatment. This pilot study demonstrates that inhalation of alpha 1-PI is
      associated with biochemical changes consistent with reduced proteolysis. The
      display of the BAL proteome by two-dimensional electrophoresis may be helpful to
      quantify the overall molecular changes associated with proteolytic or other lung
      injuries and offers the possibility to monitor directly therapeutic
      interventions.

PMID- 11197169
TI  - Changes of voltage-dependent anion-selective channel proteins VDAC1 and VDAC2
      brain levels in patients with Alzheimer's disease and Down syndrome.
AB  - Voltage-dependent anion-selective channel proteins (VDACs) are pore-forming
      proteins found in the other mitochondrial membrane of all eukaryotes and in brain
      postsynaptic membranes. VDACs regulate anion fluxes of a series of metabolites
      including ATP, thus regulating mitochondrial metabolic functions. We determined
      protein levels of VDACs in individual post-mortem brain regions of patients with
      Down Syndrome (DS) and Alzheimer's disease (AD) using two-dimensional
      electrophoresis (2-DE) and matrix-assisted laser desorption/ionization-mass
      spectroscopy (MALDI-MS). VDAC1 (SWISS-PROT accession number P21796) and VDAC2
      (P45880) were unambiguously identified and quantified, but VDAC3 was not found.
      The spots representing VDAC1 were separated with different p/s (p/7.5, 8.5, and
      10.0) probably caused by post-translational modifications as, e.g.,
      phosphorylation. In DS cerebellum, total VDAC1 protein was elevated significantly
      whereas VDAC2 did not show any significant alterations. In AD brains, VDAC1
      p/10.0 was significantly reduced in temporal, frontal, and occipital cortex with
      the p/7.5 form elevated in occipital cortex. Total VDAC1 was significantly
      decreased in frontal cortex and thalamus. VDAC2 was significantly elevated in
      temporal cortex only. The biological meaning of our results may be derangement of
      voltage-dependent anion-selective channel function and reflecting impaired
      glucose, energy, and intermediary metabolism as well as apoptotic mechanisms.

PMID- 11197170
TI  - Contribution of blotting techniques to the study of rapeseeds (Brassica napus L.)
      lipases.
AB  - A recent advance in the study of plant lipases involving immunological techniques
      is presented. In an attempt to characterize lipases of cotyledons from
      germinating rapeseed seedlings and to investigate an eventual cross-reactivity
      with animal lipases, we have prepared anti-porcine pancreatic lipase antibodies
      raised in rabbit. It is shown by enzyme-linked immunosorbent assay and dot
      blotting that these antibodies react with lipases in the rapeseed crude extract
      and in the different cellular fractions obtained by differential centrifugation.
      Preincubation of the antiserum with the rapeseed crude extract affects the amount
      of antibodies binding to the porcine pancreatic lipase. We demonstrate
      immunochemical cross-reactivity between rapeseed and porcine pancreatic lipase.
      Using the immunoblotting procedure, it is found that antibodies bind specifically
      to a single polypeptide with a molecular mass of about 55 kDa. Rapeseed lipase
      activity decreased after immunoprecipitation suggesting that antibodies were
      bound to some catalytic site residues. We conclude from the data obtained in this
      study that the two different lipase species present close similarities in amino
      acid sequence and antigen characteristics.

PMID- 11197171
TI  - Controversies over heteroplasmy.

PMID- 11197172
TI  - Hundredfold productivity of genome analysis by introduction of microtemperature
      gradient gel electrophoresis.
AB  - Genome profiling, which employs temperature-gradient gel electrophoresis (TGGE)
      for DNA analysis, has recently been developed in identifying species by genotype.
      However, the performance of this technology like the general applications of TGGE
      was, though highly informative, limited in its ability due to methodological
      reasons. This study demonstrates that minimization of the gel for TGGE, to around
      one-tenth of its conventional size (approximately 2 cm), can be successfully
      introduced, resulting in a hundredfold higher performance (total evaluation of
      time, cost, and degree of parallel operations) than that of the conventional.
      Reproducibility was evaluated from the measures of the pattern similarity scores
      (PaSS) between band patterns (genome profiles) obtained with the conventional
      TGGE, and that with micro-TGGE (microTGGE) developed here, after extracting a set
      of featuring points from genome profiles. Size minimization, which leads to the
      reduction of the amount of samples required (cost-saving), is another great
      advantage, enhancing the employment of multicolor fluorescence technology. Since
      the further development of microbe-related fields such as epidemiology and
      microbial ecology inevitably require knowledge based on the identification of a
      great number of species and strains, microbe-related fields will receive the most
      optimal benefits from the technological improvements attained here.

PMID- 11197173
TI  - Multiple voltage-gradient gel electrophoresis system.
AB  - A new device, based on the principle of voltage-gradient gel electrophoresis, was
      developed in order to enhance differentiation of the distance across the range of
      molecular masses in the electrophoretic fractionation of nucleic acids in an
      agarose matrix. The apparatus has a series of modular parallel plates, placed
      slantwise to allow reiteration of the voltage gradient effect along the gel. This
      subjects DNA fragments of variable length to differential runnings according to
      their original position in the gel. Both the number of slantwise plates and the
      distance between them can be changed to modify operating performance. Our system
      allows better fractionations as compared to conventional electrophoresis, since
      it forms gel areas in which distancing between the ranges of molecular masses is
      enhanced.

PMID- 11197174
TI  - Heparan sulfate, heparin, and heparinase activity detection on polyacrylamide gel
      electrophoresis using the fluorochrome tris(2,2'-bipyridine) ruthenium (II).
AB  - The paper shows the ability of the fluorochrome tris(2,2'-bipyridine) ruthenium
      (II) (Rubipy) to detect heparan sulfate, heparin, and heparinase activity of M3
      murine mammary adenocarcinoma cells as well as bacterial heparinases I, II, and
      III in native polyacrylamide gel electrophoresis (PAGE). The technique is based
      on the electrophoretic mobility of high molecular weight heparins and subsequent
      staining with Rubipy (50 micrograms/mL). The minimum content of heparin detected
      by fluorescence in a UV transilluminator was 25-50 ng. The number of Rubipy
      molecules bound to heparin, determined in relationship to the number of
      disaccharide units (DU), showed that two to six heparin disaccharide units are
      bound by each fluorochrome molecule. Scatchard plot analysis showed one Rubipy
      binding site (Kd = (8.56 +/- 2.97) x 10(-5) M). Heparinase activity was
      determined by densitometric analysis of the fluorescence intensity of the heparin
      containing band of the gel. While heparinase I (EC 4.2.2.7.) degraded heparin
      and, to a lower degree, partially N-desulfated N-acetylated heparin (N-des N-Ac),
      heparinase II (no EC number) could efficiently degrade heparan sulfate (HS) and
      partially N-des N-Ac heparin. Finally, heparinase III (EC 4.2.2.8.) degraded HS
      almost exclusively. Only heparin and N-des N-Ac heparin were substrates for M3
      tumor cell heparinases. We describe a qualitative, sensitive and simple method to
      detect heparinase activity and determine its substrate specificity using Rubipy
      fluorescence with heparin and heparan sulfate in multiple biological samples
      tested in parallel.

PMID- 11197175
TI  - An approach to the sensitivity of temperature-gradient gel electrophoresis in the
      detection of clonally expanded T-cells in cutaneous T-cell lymphoma.
AB  - Detection of T-cell clonality by polymerase chain reaction (PCR) and high
      resolution electrophoresis facilitates differentiation of early stages of
      cutaneous T-cell lymphoma (CTCL) from benign T-cell-rich dermatoses. However,
      data regarding the sensitivity of the various electrophoresis techniques differ
      remarkably. In the present study, the capacity of heteroduplex (HD)-loaded
      temperature-gradient gel electrophoresis (TGGE) to detect clonally expanded T
      cells was assessed systematically and modifications to the procedure were
      defined. Using our standard protocol, HD-TGGE detected clonal T-cell receptor
      (TCR)-gamma PCR products, generated from the Jurkat cell line, down to a total of
      2 ng/microL (14 ng) DNA. However, slowly migrating single strands of the clonal
      PCR product reduced the amount of the clonality indicating homoduplices. To
      overcome this single-strand formation, thus decreasing the detection limit, the
      urea concentration in the gel and the temperature ramp for the HD-formation were
      altered, as well as the temperature gradient in the gel. Application of the
      modified protocol resulted in a tenfold lower detection limit of 0.15 ng/microL
      (1.05 ng) DNA in the clonal band. The sensitivity of the adapted HD-TGGE was
      investigated by dilution experiments using the well established T-cell lines
      Jurkat, Molt-4, MyLa and SeAx. By these approaches clonal PCR products diluted in
      nonclonal PCR products were detectable down to concentrations of 5-10%.
      Comparably, in the case of mixtures of clonal in nonclonal DNA the detection
      limit reached 5-10% clonal DNA. However, by dilution of clonal cells in nonclonal
      peripheral blood mononuclear cells, which corresponds to in vivo conditions, a
      lower detection limit of approximately 1-5% was observed.

PMID- 11197176
TI  - Electric light scattering from single-stranded DNA in linear polyacrylamide
      solutions.
AB  - The electric light scattering (ELS) of ssDNA (calf thymus, 10 kbp, 55
      micrograms/mL) in denaturing polyacrylamide (PAA) solutions was studied as a
      function of applied sinusoidal electric field and polymer concentration. Electric
      fields of strengths up to 300 V/cm and of frequencies between 100 and 5000 Hz
      were applied. It was found that the ELS effect increases with the field strength
      and decreases at high frequencies. The dependence of the ELS effect of ssDNA on
      polymer concentration passes through a maximum at 1% PAA. The relaxation times of
      decay of the ELS effect increase with increasing polymer concentrations. It was
      demonstrated that ELS is a useful method for investigation of ssDNA behavior in
      the course of pulse-field electrophoresis in polymer solutions.

PMID- 11197177
TI  - Deficient brain snRNP70K in patients with Down syndrome.
AB  - The small nuclear ribonucleoprotein 70K (snRNP 70K; U1-70 kDa) is an integral
      part of the spliceosome, a large RNA-protein complex catalyzing the removal of
      introns from nuclear pre-mRNA. snRNP is one of the best-studied essential
      subunits of snRNPs, is highly conserved and its inactivation was shown to result
      in complete inhibition of splicing. Applying subtractive hybridization, we found
      a sequence with 100% identity to snRNP absent in fetal Down syndrome (DS) brain.
      This observation made us determine snRNP-mRNA steady-state levels and protein
      levels in brains of adult patients with DS. snRNP-mRNA and protein levels of five
      individual brain regions of DS and controls each, were determined by blotting
      techniques. snRNP-mRNA steady state levels were significantly decreased in DS
      brain. Performing Western blots with monoclonal and human antibodies, snRNP
      protein levels were decreased in several regions of DS brain, although one
      monoclonal antibody did not reveal different snRNP-immunoreactivity. Although
      decreased snRNP-protein could be explained by decreased mRNA-steady state levels,
      another underlying mechanism might be suggested: snRNP is one of the death
      substrates rapidly cleaved during apoptosis by interleukin-1-beta-converting
      enzyme-like (ICE) proteases, which was well-documented by several groups. As
      apoptosis is unrequivocally taking place in DS brain leading to permanent cell
      loses, decreased snRNP-protein levels may therefore reflect decreased synthesis
      and increased apoptosis-related proteolytic cleavage.

PMID- 11197178
TI  - A novel catalase mutation detected by polymerase chain reaction-single strand
      conformation polymorphism, nucleotide sequencing, and western blot analyses is
      responsible for the type C of Hungarian acatalasemia.
AB  - Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP)
      screening was used for searching mutations of the catalase gene in two Hungarian
      hypocatalasemic families. A syndrome-causing mutation was found in a PCR product
      containing exon 7 and its boundaries. Nucleotide sequence analyses detected a G
      to T substitution at position 5 of intron 7. The effect of this splice site
      mutation was confirmed by Western blot analyses demonstrating a decreased
      catalase protein level in these patients. These findings represent a novel type
      (C) of catalase mutations in the Hungarian acatalasemic/hypocatalasemic patients.

PMID- 11197179
TI  - pH-independent large-volume sample stacking of positive or negative analytes in
      capillary electrophoresis.
AB  - In capillary electrophoresis, the short optical path length associated with on
      column UV detection imposes an inherent detection problem. Detection limits can
      be improved using sample stacking. Recently, large-volume sample stacking (LVSS)
      without polarity switching was demonstrated to improve detection limits of
      charged analytes by more than 100-fold. However, this technique requires
      suppression of the electroosmotic flow (EOF) during the run. This necessitates
      working at a low pH, which limits using pH to optimize selectivity. We
      demonstrate that LVSS can be performed at any buffer pH (4.0-10.0) if the
      zwitterionic surfactant Rewoteric AM CAS U is used to suppress the EOF.
      Sensitivity enhancements of up to 85-fold are achieved with migration time,
      corrected area, and peak height reproducibility of 0.8-1.6%, 1.3-3.7%, and 0.8
      4.9%, respectively. Further, it is possible to stack either positively or
      negatively charged analytes using zwitterionic surfactants to suppress the EOF.

PMID- 11197180
TI  - pH-mediated field-amplified sample stacking of pharmaceutical cations in high
      ionic strength samples.
AB  - Capillary electrophoretic separation of samples of physiological origin typically
      have both poor resolution and efficiency due to destacking. We have previously
      reported a stacking method for concentration of catecholamines in artificial
      dialysate, or Ringer's solution. However, pH-mediated sample stacking of other
      cations has not been investigated. In this report, pH-mediated stacking has been
      extended to eletripan, dofetilide, doxazosin, sildenafil, UK-103,320, UK-202,581,
      and CP-122,288. These compounds were chosen without prior structural screening
      except that they were cationic at the pH of our background electrolyte (BGE).
      Capillary electrophoretic behavior of samples in BGE is compared with those of
      samples in Ringer's solution with and without pH-mediated acid stacking. Results
      indicate that the peak heights and efficiencies for acid-stacked samples are
      increased compared to the unstacked samples in Ringer's solution or BGE. For
      example, the peak efficiencies for 5 s injections of eletriptan in BGE and
      Ringer's solution are 138,000 and 72,000 plates, respectively. In contrast, a 10
      s injection of eletriptan followed by acid injection for 16 s produces a peak
      with 246,000 plates. Evaluation of the stacking effect was performed by
      comparison of the peak height at similar peak efficiencies for samples in
      Ringer's solution with and without stacking. Using this method, pH-mediated acid
      stacking provides a 10- to 27-fold sensitivity enhancement for the seven cations.

PMID- 11197181
TI  - Discrimination between peak spreading in capillary zone electrophoresis of
      proteins due to interaction with the capillary wall and due to protein
      microheterogeneity.
AB  - Our study attempts to find an approach to distinguishing between the contribution
      to peak spreading in capillary zone electrophoresis (CZE) due to protein
      microheterogeneity and that due to interaction with the capillary wall, by
      analyzing correlations between observed peak spreading and peak asymmetry. The
      peak asymmetry was measured as ln[(tm-t1)/(t2-tm)] where tm, t1, and t2 are
      migration times at the mode of the peak and at the intersection of the peak width
      at half-height with the ascending and descending limbs, respectively. Two
      isoforms of recombinant green fluorescent protein (GFP-1 and GFP-2, 27 kDa
      molecular mass), glucose-6-phosphate dehydrogenase (GPD, 104 kDa), and the
      naturally fluorescent protein R-phycoerythrin (PHYCO, 240 kDa) were subjected to
      CZE in polyacrylamide-coated fused-silica capillaries of 50 and 100 microns
      diameters under varying conditions of protein concentration, field strength, and
      the initial zone length. Under conditions such that contributions to peak
      spreading from axial diffusion, thermal effects, and electrophoretic dispersion
      are negligible, the analysis of the interrelations between peak width and peak
      asymmetry was found to allow a conclusion as to the cause of peak spreading in
      CZE of protein. It appears that the peak width of GFP-2 originates mostly in
      protein microheterogeneity while that of GFP-1 is due to protein-capillary wall
      interactions. For PHYCO, both microheterogeneity and protein-capillary wall
      interactions contribute to peak spreading. GPD exhibits relatively little
      microheterogeneity or interaction with capillary walls. Thus, its peak width
      appears to be mostly affected by an extracolumn source of spreading such as the
      initial zone length.

PMID- 11197182
TI  - Determination of ebrotidine metabolites in overlapping peaks from capillary zone
      electrophoresis using chemometric methods.
AB  - This paper illustrates the possibilities of chemometric methods in the resolution
      and quantification of various compounds in overlapping peaks from capillary
      electrophoresis. Ebrotidine and most of its metabolites were efficiently
      separated by capillary zone electrophoresis (CZE) in a fused-silica capillary.
      However, the procedure was not suitable for the physical separation of the three
      less ionizable metabolites, which comigrated and overlapped with the
      electroosmotic flow signal. Multivariate curve resolution based on an alternating
      least squares procedure was used for their mathematical resolution. For such a
      purpose, data obtained in the CZE system with a diode array detector, which
      consisted of UV spectra registered over time, were analyzed. The ebrotidine
      metabolites were successfully resolved and quantified in synthetic mixtures and
      urine samples.

PMID- 11197183
TI  - Quantitative and qualitative precision improvements by effective mobility-scale
      data transformation in capillary electrophoresis analysis.
AB  - By transforming the time-based x-axis of electropherograms in capillary zone
      electrophoresis (CZE) into the corresponding effective mobility-scale, we propose
      a simple and robust data representation for a better qualitative and quantitative
      capillary electrophoresis (CE) analysis. The time scale of the raw
      electrophoretic data (detection signal versus time) is transformed into an
      effective electrophoretic mobility scale (mu eff-scale) with account of the
      electroosmotic flow (EOF) peak or of an internal standard of known effective
      mobility. With the new scaling (detection signals versus effective mobility), the
      obtained electropherograms are more representative of the velocity-based
      electrophoretic separation and the comparison of complete electropherograms is
      directly possible. This is of importance when tracking peaks in real samples
      where alteration in EOF stability can occur or when comparing electrophoretic
      runs from different experimental setups (independence in column length and
      voltage). Beside the qualitative possibilities, a quantitative improvement is
      achieved in the mu eff-scale with significant better peak area reproducibility
      and equal to more precision in quantitative analysis than with the primary time
      scale integration.

PMID- 11197184
TI  - Molecular recognition by chiral cationic micellar and micelle-like aggregates in
      electrokinetic capillary chromatography.
AB  - We examined the enantiomer separation with micelles and a micelle-like polymer
      made with trimethylammonium-terminated surfactants all of whose hydrocarbon
      chains contain hydrogen bonding valinediamide moieties in electrokinetic
      chromatography (EKC). The surfactants used were 3-(N-dodecanoyl-L-valylamino)
      propyltrimethylammonium bromide (surfactant 1) and 6-(N-nonanoyl-L
      valylamino)hexyl-trimethylammonium bromide (surfactant 2); the micelle-like
      polymer was derived from 3-(N-10-undecenoyl-L-valyl)aminopropyltrimethylammonium
      bromide (surfactant 3). N-Acylamino acids and their isopropyl esters were
      separated with enantiomers with the same configuration as the chiral surfactant
      and which were retained to a greater extent than the counterparts in micelles.
      The micellar hydrophobic environment, in which amides function as hydrogen
      bonding sites with solutes, and ceased micellar kinetic association-dissociation
      with polymerization are discussed.

PMID- 11197185
TI  - Separation and identification of platinum adducts with DNA nucleotides by
      capillary zone electrophoresis and capillary zone electrophoresis coupled to mass
      spectrometry.
AB  - Platinum adducts are supposed to be the cytotoxic lesions in DNA after platinum
      containing anticancer therapy. Various adducts are formed upon interaction of
      platinum complexes with nucleotides, but contribution of individual adducts to
      antitumor activity and toxicity of platinum complexes still remains to be
      examined. A capillary zone electrophoresis (CZE) method is described that is
      suitable to separate individual platinum adducts. We investigated the formation
      of adducts following the reaction of cis-diamminedichloroplatinum (II)
      (cisplatin) with various DNA nucleotides. Baseline separation of unmodified and
      modified nucleotides (adducts) was achieved using uncoated fused-silica
      capillaries and basic separation buffers. In order to elucidate the observed peak
      pattern, a coupled CZE-electrospray ionization-mass spectrometry (ESI)-MS
      approach was applied. After incubation of mononucleotides with cisplatin,
      monochloro, monoaqua and bifunctional adduct species were detected. Consequently,
      the migration order of nucleotides and individual platinum adducts could be
      determined. Moreover, the time-dependent conversion from monochloro to monoaqua
      and subsequently to bifunctional adducts was monitored. In conclusion, individual
      platinum adducts were separated by CZE and identified by CZE-ESI-MS. Formation
      and conversion of distinct species were confirmed. Potential applications
      comprise studies of novel platinum complexes, investigations of platinum-adduct
      formation with DNA, and determination of platinum-DNA adducts in cells.

PMID- 11197186
TI  - Temporality, sequential iconography and linearity in figures: the impact of the
      discovery of division in infusoria.
AB  - The paper analyses the impact of the discovery of the division of infusoria on
      eighteenth century microscopical iconography. In Autumn 1765, when reproducing
      the antispontaneist experiments of Lazzaro Spallanzani, Horace-Benedict de
      Saussure (1740-1799) discovered a new method of generation of the animalcules of
      the infusions, namely their division. Drawing a dividing animalcule raised
      particular problems, notably the question of how to depict the time sequence of a
      microscopical creature. Although Saussure's journal of microscopical experiments
      remained unpublished, the discovery was soon diffused and acknowledged by the
      European naturalists who began to repeat the observations and quickly faced
      iconographic problems similar to those experienced by Saussure. Indeed,
      linearity, used to picture time, is a construction, and, notably for public
      images, scholars had to contend with the conventions of drawers and engravers.
      The analysis of microscopical iconographic material of the period 1740-1786 shows
      that during this period, certain naturalists invented new solutions for depicting
      time, but diffusion of their innovations was not immediate. Nevertheless, in
      regards to the illustration of microscopical creatures, it is between 1765 and
      1776 that the use of linearity was established as a solution enabling an audience
      to read an iconographic time process as a text.

PMID- 11197187
TI  - A century of research into the cause of cancer: is the new oncogene paradigm
      revolutionary?
AB  - Contemporary oncological research is predominantly characterised by genetic
      explanations, a situation which may be briefly denoted as the oncogene paradigm.
      This essay discusses why the new paradigm was perceived so attractive that it
      could take over the whole field of oncology within a time-span of less than two
      decades. It is argued that the revolutionary character of the oncogene paradigm
      stems from the fact that it transcends a dichotomy which has kept experimental
      cancer research divided for more than three quarters of a century. This concerns
      the dichotomy between so-called exogenous and endogenous explanations of cancer
      causation. This essay mainly focuses on the role of the exogenous/endogenous
      dichotomy in the reception of research on oncogenic viruses, especially
      discussing the work of Nobel laureate Peyton Rous on cancer viruses at the
      Rockefeller Institute. Rous was severely criticised by James Ewing, director of
      the Memorial Hospital for Cancer and Allied Diseases in New York, who held the
      idea that the origin of cancer was based in the cell. The twentieth century
      controversy over oncogenic viruses is placed in the context of the intense
      discussion over causality in medicine during the first decades of the twentieth
      century in Germany. It is argued that the oncogene paradigm may be seen as
      revolutionary because it succeeded in uniting the exogenous and endogenous
      explanations of cancer in a single paradigm.

PMID- 11197188
TI  - The blood from Auschwitz and the silence of the scholars.
AB  - The Kaiser Wilhelm Institute for Anthropology, Human Genetics and Eugenics in
      Berlin-Dahlem was the centre of scientific racism in Nazi Germany. Its bad
      history culminated in a research project to analyse the molecular basis of racial
      differences in the susceptibility to various infectious diseases such as
      tuberculosis. Josef Mengele, a former postdoc of the director of the institute,
      Otmar von Verschuer, collected blood samples and other material in Auschwitz from
      families and twins of Jews and Gypsies. The blood samples were analysed by
      Gunther Hillmann in the Berlin laboratory of Nobel Prize winner Adolf Butenandt.
      Butenandt had just moved to Tubingen. The project was paid for by the Deutsche
      Forschungsgemeinschaft. Butenandt, Hillmann and von Verschuer made scientific
      careers in the Federal Republic. To the present day this past has not been
      acknowledged by the Max-Planck-Gesellschaft as part of its history.

PMID- 11197189
TI  - The legacy of a scientist and his historian.

PMID- 11197190
TI  - Adherence to health messages: a social psychological perspective.
AB  - Non-adherence to regimes recommended by health practitioners is prevalent in the
      health and safety area. Even the most effective of interventions does not tend to
      lead to substantial improvements in adherence. This paper reviews models from the
      health psychology sphere that predict which factors might lead people to practice
      health-enhancing behaviours. In terms of health messages, the paper evaluates the
      methods of persuasion found to be most successful. It provides an analysis of a
      successful intervention, in which a target audience was motivated to adopt a
      health-enhancing choice. The paper concludes by examining the principles that can
      be drawn from successful interventions, in terms of changing a target audience's
      health behaviours. The focus is on those that can be applied to situations in
      which a health practitioner hopes to convince the patient to adhere to a
      preventive regime.

PMID- 11197191
TI  - Patient compliance with oral hygiene regimens: a behavioural self-regulation
      analysis with implications for technology.
AB  - Achieving optimal oral health through preventive efforts is a hallmark of the
      dental profession. A primary goal of a preventively-oriented dental practice is
      to encourage patients to practice appropriate oral self-care behaviours. When
      patients are asked to follow an oral self-care regimen, they are being given a
      target or goal (for example, brush twice a day) and their task is to control or
      regulate their behaviour to achieve that objective. Unfortunately, patients often
      fail to meet the expectations set forth by the clinical recommendation. This
      review examines the problem of poor patient compliance with oral hygiene regimens
      by applying the general principles that govern the self-regulation of behaviour.
      The component parts of a behavioural self-regulation model are reviewed in the
      context of oral self-care. Research in the area of toothbrushing behaviour is
      reviewed and methods for providing patients with feedback about their degree of
      compliance are discussed.

PMID- 11197192
TI  - An intervention programme to establish regular toothbrushing: understanding
      parents' beliefs and motivating children.
AB  - AIMS/OBJECTIVES: To determine the benefit of twice daily toothbrushing on newly
      erupted first permanent molars. To investigate, through the Health Belief Model,
      how parents' beliefs influence the likelihood of their children brushing twice a
      day. To identify aspects of a toothbrushing intervention programme that can be
      used in general dental practice. DESIGN: Randomised controlled trial. SETTING:
      Schools in deprived communities in Scotland. PARTICIPANTS: 461, 5-year-old
      children. INTERVENTIONS/METHODS: Supervised toothbrushing on school-days with a
      1,000 ppm chalk-based fluoride toothpaste for two years. A school and home-based
      incentive scheme including toothbrushing charts, 6-monthly dental examinations
      and parental questionnaires. MAIN OUTCOME MEASURES: Caries increment and twice
      daily toothbrushing. RESULTS: In the control group, children who brushed once a
      day or less had 64% more caries than those who brushed at least twice a day (P =
      0.001). In the intervention group this difference in caries was reduced to 16% (P
      > 0.05). The most significant parental belief explaining variation in twice-daily
      brushing was whether parents feel strongly that there is time to check their
      child's toothbrushing (P = 0.0001). The odds of these parents reporting that
      their child brushes twice daily are nearly three times greater. 95% of parents
      felt that toothbrushing charts would be a good way for dentists in practice to
      encourage children to brush regularly. CONCLUSIONS: The benefit of twice daily
      toothbrushing on caries development in newly erupted first permanent molar teeth
      is around 50% compared to brushing once a day or less. Parents' beliefs do
      influence the likelihood of their children brushing twice a day. Key parts of the
      intervention programme can be used when children attend general dental practice
      and would be welcomed by parents.

PMID- 11197193
TI  - The relevance of behavioural sciences in dental practice.
AB  - The aim of this paper is to illustrate how knowledge from behavioural sciences is
      necessary and relevant in creating a successful dental practice, benefitting
      patients and dental professionals. There are many ways to create a successful
      dental practice, the products of which are the various treatments performed by
      dentists or dental hygienists for their patients. Advanced technologies and
      methods are constantly improving these treatments and thus the technical and
      managerial aspects of dentistry. However, the success of dental practice is not
      only dependent on the technique applied or the technical skills of dental
      professionals, but also on patients, their attitudes and behaviour and the
      interaction between dental professionals and patients. It is well known that the
      success of dental treatments (for example, periodontal, orthodontic or implants)
      depends on the patient's behaviour, which includes compliance with certain oral
      hygiene regimens or specific dental visiting patterns. The outcome of the
      treatment depends on both the dental professional's knowledge and skills and the
      patient's skills, objectives and expectations. Furthermore, dental professionals
      and patients should be satisfied with the treatment plan as well as the outcome.
      This paper argues that in order for this to happen dental professionals need
      additional knowledge and skills from fields outside traditional dental sciences.
      In order to treat patients successfully, dental professionals must understand and
      change or modify patient behaviour, and the knowledge necessary for this is
      provided by the behavioural sciences.

PMID- 11197194
TI  - Reasons for replacement of restorations in permanent teeth in general dental
      practice.
AB  - OBJECTIVE: The analysis of reasons for the replacement of 9,805 amalgam,
      composite, glass ionomer, resin modified glass ionomer and 'other' restorations
      in permanent teeth in general dental practice. DESIGN: The data were subdivided
      on the bases of age and gender of the patients, the types of restorations and the
      clinicians' gender, experience and practice setting. RESULTS: The clinical
      diagnosis of secondary caries was the main reason for replacement of all types of
      restorations studied, followed by fracture of restorations, especially bulk
      fracture, irrespective of patient's age. Bulk discoloration was the third most
      common reason for replacement of resin based materials in adults, but it rarely
      occurred in adolescents 18 years and younger. The reasons for replacement of
      restorations were not associated with the gender of the patients. Subgroupings
      based on the clinicians' gender showed that female clinicians diagnosed secondary
      caries more often than male clinicians. Otherwise, the reasons for replacements
      were similar for both genders of clinicians. Subdivision of restorations based on
      the years since graduation of the clinicians resulted in small groups. The
      youngest group of clinicians diagnosed relatively more secondary caries both for
      amalgam and composite restorations than the most experienced group. CONCLUSION:
      The clinical diagnosis secondary caries was the main reason for replacement of
      all types of restorations studied.

PMID- 11197195
TI  - Further evidence for the reliability and validity of the Modified Dental Anxiety
      Scale.
AB  - AIM: To gain further evidence of the psychometric properties of the Modified
      Dental Anxiety Scale. SETTING: Dental admission clinics. DESIGN: Consecutive
      sampling, cross-sectional survey. PARTICIPANTS: Patients (n = 800) in four cities
      (Belfast, Northern Ireland; Helsinki, Finland; Jyvaskyla, Finland and Dubai,
      UAE). METHODS: Questionnaire booklet handed to patients, attending clinics, for
      completion following an invitation by the researcher to be included in the study.
      MEASURES: Modified Dental Anxiety Scale (MDAS), together with further questions
      concerning dental attendance and nervousness about dental procedures. RESULTS:
      Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high
      levels of internal consistency, and good construct validity. The relationship of
      dental anxiety with age was similar to previous reports and showed lowered
      anxiety levels in older patients. CONCLUSION: Data from three countries has
      supported the psychometric properties of this modified and brief dental anxiety
      scale.

PMID- 11197196
TI  - Workforce requirements for a primary oral health care system.
AB  - AIM: To present the case for a primary health care (PHC) approach for dental care
      in Vietnam, and thereby contribute to a better understanding of the oral health
      problems that exist in many developing countries. METHODS: Information was
      obtained in Vietnam through discussions with dental and medical authorities of
      provincial health offices, educational institutions, hospitals, health centres
      and schools and by collecting data from record books and reports. FINDINGS:
      Dentistry lacks a PHC strategy and consequently urgent oral care and oral disease
      prevention and control are not available for the majority of the population in
      Vietnam. The curriculum of dental students and dental auxiliaries is not
      adequately directed to the oral health needs of the population. The present
      number of dental personnel is too low. CONCLUSION: A basic oral health care
      package (BOHCP) advocated by the WHO which could be incorporated into primary
      health services at sub-district level and in the school dental service would be
      most suitable to meet the oral health needs of the population in Vietnam. The
      oral health education component of the BOHCP may have more impact when it is
      conducted in close collaboration with non-dental health personnel and lay
      persons. The curriculum of dental personnel should be adjusted to meet the
      requirements of their future tasks. Dental auxiliaries, provided they are well
      trained can carry out the BOHCP. Consequently, there is a large need for this
      type of dental personnel in Vietnam.

PMID- 11197197
TI  - Introducing the Significant Caries Index together with a proposal for a new
      global oral health goal for 12-year-olds.
AB  - AIM: To describe a new index, the 'Significant Caries Index' (SiC Index) with the
      intention of focusing attention on those individuals with the highest caries
      scores in each population. METHOD: Attention is drawn to the skewed distribution
      of dental caries within a given population, indicating that there are still large
      groups of individuals who have considerably more caries than the WHO/FDI target
      level of DMFT 3 by the year 2000. The index is calculated as follows: individuals
      are sorted according to their DMFT values. The one third of the population with
      the highest caries score is selected and the mean DMFT for this subgroup is
      calculated. This value constitutes the SiC Index. RESULTS: The SiC Index can be
      easily calculated and used as a measure for future oral health goals. CONCLUSION:
      The SiC Index should be less than 3 DMFT in the 12-year-olds in a given
      population and it is hoped that this global oral health goal is reached at the
      latest by the year 2015.

PMID- 11197198
TI  - Caries patterns and their relationship to infant feeding and socio-economic
      status in 2-4-year-old Chinese children.
AB  - AIMS: To describe the prevalence, severity and patterns of caries in 2-4-year-old
      children and to evaluate the association between caries experience of the
      children and their feeding patterns and socio-economic background in terms of
      mothers' education and family income. DESIGN: Cross-sectional survey. SETTING:
      Suburban area of Hanchuan in Hubei province, China. PARTICIPANTS: A sample of 426
      children (250 boys and 176 girls). METHODS: Dental-examinations were undertaken
      in kindergartens using World Health Organization diagnostic criteria for dental
      caries. Mothers completed a short questionnaire. OUTCOME MEASURES: Prevalence of
      caries; rampant caries; caries in incisors; caries in incisors and/or canines and
      molars; mean number of decayed, missing and filled teeth/surfaces (dmft/s).
      RESULTS: 36% of the children had caries, 7% had rampant caries. The more
      extensive pattern of caries involving primary molars as well as incisors and/or
      canines was seen in 12% of children. Children who had been wholly bottle-fed had
      five times the risk of having rampant caries compared to children who were breast
      fed. CONCLUSIONS: The results indicated that infant feeding practice might be a
      key risk factor for the development of caries at an early age in this country as
      elsewhere.

PMID- 11197199
TI  - Professional education and practice arrangements: are there gender differences
      among paediatric dentists in Israel?
AB  - AIM: To assess gender differences in professional education, practice setting and
      working arrangements among dentists in Israel, who primarily treat children.
      SUBJECTS: All 112 participants in the meeting of the Israeli Society of Dentistry
      for Children that was held in February 1999. METHODS: A questionnaire completed
      during the meeting. RESULTS: Seventy participants (63 per cent) completed the
      questionnaire and returned it. There were 43 females and 27 males. Less than half
      of the population were specialists (40 per cent of the females, 48 per cent of
      the males). No significant differences were found in the educational background
      and working in academia between females and males. With regard to practice
      arrangement, males significantly reported more frequently working in two clinics
      or more, than females (P = 0.049), and working in clinics with general
      practitioners (GPs) and specialists in various fields in dentistry, while more
      women reported working with either GPs or specialists (P = 0.007). In all other
      variables, no significant gender differences were found. The results of our study
      show that paediatric dentistry in Israel appears as a branch of the profession
      which shows great sexual equality of opportunity.

PMID- 11197200
TI  - Oral health status and treatment needs of 35-44-year old adults in Lebanon.
AB  - OBJECTIVES: The purpose of this study was to assess the oral health status and
      treatment needs of a Lebanese adult population. DESIGN: An epidemiological survey
      of 401 Lebanese adults aged 35-44 years was carried out in 1996. It followed the
      WHO methodology in assessing the oral health status and treatment needs of adult
      populations. A structured questionnaire and a standardised oral health exam were
      used for the investigation. RESULTS: Showed that the Decayed, Missing and Filled
      Teeth (DMFT) index was 16.3 and that 1.5 per cent of the sample had a DMFT score
      of zero, whereas, 55 per cent had a score of less than 4. Of the 401 subjects, 24
      per cent had at least one bridge and 16 per cent had a removable prosthesis.
      Compared to other neighbouring countries, Lebanon ranked the highest in the DMFT
      index and its separate components. Close to 60 per cent of the sample was in need
      of operative treatment, 31 per cent needed tooth extraction and 60 per cent were
      in need of a crown or a bridge. Significant variations were observed in the oral
      health status as well as treatment needs of the sample when examining gender,
      socio-economic status, and place of residence differences. CONCLUSION: This study
      can be used as a stepping stone in the direction of building the base of
      knowledge on oral health in Lebanon. The planning and implementation of any
      strategy for oral health status improvement is crucial, alongside the country's
      infrastructure development.

PMID- 11197201
TI  - In vitro evaluation of two adhesive systems used with compomer filling materials.
AB  - AIM: To evaluate and compare the in-vitro shear bond strength, microleakage and
      dentine-restorative interface of a self-etching/self-priming dentine bonding
      agent with a three-component dentine-bonding agent. METHOD: For shear bond
      strength (SBS) testing 30 non-carious human molars were used of which 15 were
      tested with Non-Rinse Conditioner (NRC)/Prime&Bond NT (PBNT) and Dyract AP and 15
      were tested with Scotchbond Multi-Purpose Plus (SBMP) and F2000. For the
      microleakage evaluation cavity preparations were made on the facial surfaces of
      30 non-carious human premolars of which 15 were restored with NRC and PBNT with
      Dyract AP and 15 were restored with SBMP and F2000. The dentine-restorative
      interface was examined through a confocal scanning laser microscope (CSLM).
      RESULTS: The mean SBS of PBNT and SBMP were 12.8 and 18.1 MPa, respectively. The
      microleakage scores showed NRC/PBNT leaked on the dentine side in 13 of the 15
      specimens examined. On the enamel side two of the 15 specimens showed
      microleakage. With SBMP no microleakage was observed on either enamel or dentine
      sides. The CSLM images show clear resin tag and hybrid layer formation for both
      the materials examined although SBMP showed better and deeper penetration into
      the dentine with longer resin tags. SBMP showed resin tags measuring about 150 mm
      while the hybrid layer measured about 5 mm. The length of the resin tags as well
      as the thickness of the hybrid layer for PBNT were 20 mm Pounds and 2 mm Pounds,
      respectively. CONCLUSIONS: The acid-etch technique of SBMP produced higher bond
      strength and no microleakage when compared with the self-etching/self-priming
      'non-rinse technique' of NRC with PBNT. Thus it can only be speculated that SBMP
      should be the superior in the clinical situation.

PMID- 11197202
TI  - Teaching of posterior composite restorations in Japanese dental schools.
AB  - AIM: This study was conducted to assess the teaching programmes for Class I and
      II composite restorations in Japanese dental schools to obtain an overview of
      what is being taught, the relative teaching volume, the criteria for the
      provision of posterior composite restorations and the placement techniques
      taught. DESIGN: Questionnaire forms mailed to the operative dentistry teaching
      departments in all 29 Japanese dental schools. RESULTS: The response rate was 93
      per cent, with replies from 27 of the 29 dental schools. Twenty-five (93 per
      cent) responding schools taught the use of Class I and two schools stated that
      they did not teach the use of posterior composite restorations. One of the two
      schools had no plan to teach posterior composites within the next five years. The
      other school did not answer this question. Most schools anticipated that the
      proportion of teaching time devoted to posterior composite restorations would
      increase within the next five years. Diversities and similarities between
      teaching programmes were noted between Japanese, North American and European
      dental schools, the Japanese programmes being closer to those in Europe than
      those in North America. CONCLUSION: The diversities in the teaching of posterior
      composite restorations in Japanese dental schools are as great as in other parts
      of the world. Such diversities must affect the overall quality of restorations in
      general practice.

PMID- 11197203
TI  - Interleukin-8: an expanding universe beyond neutrophil chemotaxis and activation.
AB  - Since the discovery 13 years ago of interleukin (IL)-8 as a potent neutrophil
      chemotactic factor, accumulating evidence has established it as a crucial
      mediator in neutrophil-dependent acute inflammation. Numerous observations have
      demonstrated that various types of cells can produce a large amount of IL-8,
      either in response to various stimuli or constitutively, after malignant
      transformation. Recent studies of IL-8-mediated signaling have revealed that IL-8
      activates a wide range of signaling molecules in a coordinate manner. IL-8 has
      been proven to have diverse actions on various types of leukocytic and
      nonleukocytic cells besides neutrophils. The author reviews recent progress in IL
      8 signal transduction and biological actions on nonneutrophilic leukocytes,
      including T lymphocytes, monocytes, and hematopoietic progenitor cells. Potential
      involvement of IL-8 in viral infections and tumor progression is also discussed.

PMID- 11197204
TI  - Role of chemokines in trafficking of lymphocytes and dendritic cells.
AB  - Lymphocytes continuously recirculate between the vascular system and tissues.
      Furthermore, different lineages and subsets are capable of migrating to different
      tissues and tissue microenvironments. Upon proinflammatory stimulation or antigen
      loading, immature dendritic cells in the skin and mucosa migrate into the T-cell
      zones of regional lymph nodes, where they become fully differentiated dendritic
      cells capable of activating naive T cells. These migratory properties of
      lymphocytes and dendritic cells, which are essential for the homeostasis and
      function of the immune system, are regulated by various cell-adhesion molecules
      and by a group of chemokines collectively called "immune chemokines." These
      chemokines are expressed constitutively in specific tissue microenvironments
      within the primary and secondary lymphoid organs, act via highly specific G
      protein-coupled receptors, and regulate the migration of lymphocytes and
      dendritic cells to specific tissue microenvironments. Immune chemokines are thus
      key elements in the genesis, maintenance, and function of the immune system.

PMID- 11197205
TI  - A chemokine, SDF-1/PBSF, and its receptor, CXC chemokine receptor 4, as mediators
      of hematopoiesis.
AB  - A chemokine, stromal cell-derived factor/pre-B-cell growth-stimulating factor
      (SDF-1/PBSF), and its primary physiologic receptor, CXC chemokine receptor 4
      (CXCR4), are essential for B-lymphocyte production and colonization of bone
      marrow by myeloid lineage progenitors during embryogenesis. Moreover, CXCR4 is an
      autonomous cell essential for long-term lymphoid and myeloid reconstitution in
      adult bone marrow. Upregulation of CXCR4 expression may be useful for improving
      engraftment of repopulating stem cells in clinical transplantation.

PMID- 11197206
TI  - Roles of chemokines and chemokine receptors in HIV-1 infection.
AB  - Human immunodeficiency virus type 1 (HIV-1) uses a coreceptor together with CD4
      to enter CD4+ target cells. The chemokine receptors CXCR4 and CCR5 have been
      found to be the major coreceptors for T-cell line-tropic and macrophage-tropic
      HIV-1 strains, respectively, although many other chemokine and orphan receptors
      have also been identified as potential coreceptors for HIV-1. Genetic analyses
      has revealed the importance of chemokine and chemokine receptor genes in disease
      progression. The discovery of coreceptors provides a more defined scheme for
      virus entry in which the HIV-1 envelope glycoprotein sequentially binds CD4 and
      coreceptor, leading to a membrane fusion reaction between the viral envelope and
      the plasma membrane of the target cell. It also provides the basis for HIV-1 cell
      tropism. The identification of HIV coreceptors provides new opportunities for the
      development of anti-HIV therapy. Many coreceptor-based therapeutic approaches
      have been developed, some of which are currently in clinical trials.

PMID- 11197207
TI  - Multidrug resistance of acute leukemia and a strategy to overcome it.
AB  - A representative cause of multidrug resistance (MDR) is expression of the MDR
      gene (mdr1) and its product P-glycoprotein (P-gp). The function of P-gp is
      thought to be the extrusion of anticancer drugs from the cell against a
      concentration gradient. In acute myelogenous leukemia (AML), P-gp expression in
      leukemic blast cells at initial presentation has been reported to be 20% to 40%.
      The remission rate of acute leukemia patients is significantly lower in P-gp+
      patients than in P-gp- patients. A significantly shorter survival and relapse
      free survival in P-gp+ AML patients compared with P-gp- patients has been
      reported. Intracellular daunorubicin/Rhodamine123 content in P-gp+ leukemic blast
      cells is significantly lower than in P-gp- leukemic blast cells. By using a
      leukemic blast colony assay, lowered sensitivity to the anticancer drug was
      revealed not only in leukemic blast cells but also in leukemic progenitors. One
      method to overcome MDR with a possibility of clinical application is to use drugs
      that interfere with the function of P-gp. The addition of MS-209 in vitro as an
      MDR-reversing agent significantly enhanced the intracellular
      daunorubicin/Rhodamine 123 accumulation and the retention of P-gp+ leukemic blast
      cells to a level similar to that of P-gp- blast cells. Recent clinical trials
      using MDR-reversing agents have demonstrated some encouraging results in P-gp+
      patients but not in P-gp- patients.

PMID- 11197208
TI  - Chemoprotective and radioprotective effects of amifostine: an update of clinical
      trials.
AB  - Amifostine (Ethyol), the first broad-spectrum cytoprotectant approved in many
      countries for clinical use, is an analog of cysteamine and was originally
      developed by the U.S. Walter Reed Army Institute of Research in the 1950s as a
      radioprotective agent. Studies have shown that amifostine selectively protects
      normal tissues of various organs from the effects of radiation and multiple
      cytotoxic chemotherapeutic drugs. Amifostine has demonstrated broad-spectrum
      cytoprotection against myelotoxicity, nephrotoxicity, xerostomia, and mucositis
      associated with various chemotherapy and radiation modalities. Amifostine has
      been evaluated in large comparative clinical trials in patients with advanced
      ovarian cancer, rectal cancer, and head and neck cancer, and in many phase 2
      trials in patients with various neoplastic diseases. These trials have shown that
      amifostine delivers protection from the cytotoxic effects of cisplatin,
      cyclophosphamide, and radiation on various organs. Pretreatment with amifostine
      has also improved salivary gland tolerance of high-dose radioiodine treatment.
      Recent unique observations include improvement in cytopenia in patients with
      myelodysplastic syndrome. This review summarizes preclinical and clinical data on
      amifostine and includes trials that evaluated the drug's chemoprotective and
      radioprotective effects and other potential uses in clinical oncology.

PMID- 11197209
TI  - Structure and function of fibrinogen inferred from hereditary dysfibrinogens.
AB  - The structure-function relationships of human fibrinogen and their clinical
      implications are discussed on the basis of data provided by biochemical and
      electron microscopic analyses of normal and abnormal fibrinogen and by recent
      crystallographic studies on certain functional domains and segments of normal
      fibrinogen. Particularly, ultrastructure studies of individual fibrinogen
      molecules and fibrin networks of structurally elucidated dysfibrinogens enable us
      to understand the structure-function relationships of these dysfibrinogens more
      clearly than ever. Electron micrographs of some representative dysfibrinogen
      molecules are provided.

PMID- 11197210
TI  - Glanzmann thrombasthenia: integrin alpha IIb beta 3 deficiency.
AB  - Integrins, a family of noncovalently associated alpha beta heterodimeric adhesion
      receptors, are involved in a variety of pathological and physiological processes.
      The importance of integrins is evident in the severe pathogenic consequences of
      their congenital deficiencies: Glanzmann thrombasthenia (GT) and leukocyte
      adhesion deficiency. In this review, I have focused on GT, a rare autosomal
      recessive bleeding disorder characterized by the quantitative and/or qualitative
      abnormality of integrin alpha IIb beta 3 (glycoprotein IIb-IIIa). Molecular
      genetic analysis of GT, when caused by a quantitative abnormality of alpha IIb
      beta 3, provides important information regarding key structures for alpha IIb
      beta 3 biosynthesis. Of particular interest is GT when caused by a qualitative
      abnormality of alpha IIb beta 3 (GT variants). The analyses of GT variants
      provide new insight into the regulation of alpha IIb beta 3 function and the
      interaction between alpha IIb beta 3 and its ligands. This research could
      contribute to new and better alpha IIb beta 3 antagonists with minimal
      complications (such as bleeding and thrombocytopenia) for the prevention and
      treatment of pathological thrombosis.

PMID- 11197211
TI  - Glycoprotein 130 and c-kit signals synergistically induce thrombopoietin
      production by hematopoietic cells.
AB  - We have reported that simultaneous activation of glycoprotein (gp) 130 and c-kit
      signals by interleukin (IL)-6, soluble IL-6 receptor (sIL-6R), and stem cell
      factor (SCF) promotes proliferation of human hematopoietic progenitor cells and
      their differentiation into erythroid, myelocytic, and megakaryocytic cells. We
      recently found that erythropoietin produced by erythroid progenitors stimulates
      erythropoiesis via gp130 and c-kit signals. Here we examined thrombopoietin (TPO)
      production by hematopoietic cells cultured with IL-6, sIL-6R, and SCF. Reverse
      transcription-polymerase chain reaction analysis indicated that hematopoietic
      cells generated from cord blood CD34+ cells with the 3 factors expressed a minor
      splice variant of TPO messenger RNA, P1 delta E2, which can be translated to TPO
      protein more efficiently than regularly spliced isoforms. The reduction in c-mpl,
      receptors for TPO, by antisense oligodeoxynucleotides suppressed the generation
      of erythroid, myelocytic, and pluripotent progenitors in suspension culture, plus
      colony formation of megakaryocytic progenitors in addition to these progenitors
      in clonal culture of cord blood CD34+ cells with IL-6, sIL-6R, and SCF. The
      addition of anti-human TPO antibody to the clonal culture also suppressed colony
      formation. These findings indicate that TPO production by hematopoietic cells
      stimulated by IL-6, sIL-6R, and SCF is involved in promoting their own growth.

PMID- 11197212
TI  - Severe aplastic anemia associated with chronic natural killer cell lymphocytosis.
AB  - Chronic natural killer (NK) lymphocytosis involves a persistent increase in CD56+
      large granular lymphocytes (LGLs) that is sometimes associated with immune
      mediated complications, such as anemia and neutropenia. However, aplastic anemia
      (AA) is a rare complication. Here we describe 2 patients with severe AA who
      presented with persistent increases in NK cells. Their LGLs were positive for
      CD56, CD16, and intracellular interferon (IFN)-gamma but negative for CD3, Fas
      ligand, and T-cell receptor rearrangement, findings that are compatible with NK
      cells. Not only the number of NK cells, but NK activity as well, was increased in
      both patients. The number of NK cells changed according to hematologic recovery
      and relapse in 1 case. Thus, there seemed to be a close relationship between NK
      cells and the progression of AA, at least in this instance. Further investigation
      of the clinical course of similar cases and the characteristics of NK cells is
      necessary.

PMID- 11197213
TI  - Trisomy 11 acute myeloid leukemia: 5 additional cases from the Japan Adult
      Leukemia Study Group AML-92 and AML-95 databases.
AB  - We searched for trisomy 11 in acute myelogenous leukemia (AML) patients using the
      Japan Adult Leukemia Study Group (JALSG) AML-92 and -95 databases to clarify the
      clinical and hematologic features of a rare numerical chromosome abnormality.
      Among the sequentially registered patients of JALSG AML-92 (655 patients) and
      JALSG AML-95 (531 patients), chromosome findings were obtained for 1074 patients
      (90.6%); we found 5 patients with trisomy 11 as the sole abnormality. The
      patients were 4 women and 1 man with trisomy 11 AML, all aged more than 45 years
      (median, 52 years), with 4 M1 morphologies and 1 M2. No patients manifested
      hepatosplenomegaly or lymph node enlargement, and no central nervous system
      leukemia or extramedullary lesions were detectable. All showed positivity for
      CD13 (5/5), CD33 (5/5), CD34 (3/3), CD38 (2/2), and HLA-DR (5/5). Except for 1
      patient, all achieved complete remission after 1 course of induction
      chemotherapy, but 2 relapsed after discontinuation of chemotherapy. A third case
      of relapse occurred during intensification of chemotherapy, and the patient
      underwent allogenic bone marrow transplantation but died from interstitial
      pneumonia.

PMID- 11197214
TI  - Good prognosis of patients with acute promyelocytic leukemia who achieved second
      complete remission (CR) with a new retinoid, Am80, after relapse from CR induced
      by all-trans-retinoic acid.
AB  - A new synthetic retinoid, Am80, is effective in treating acute promyelocytic
      leukemia relapsed from all-trans-retinoic acid-induced complete remission (CR).
      We report here the long-term clinical outcomes of patients who achieved second CR
      with Am80. Of 24 evaluable patients, 14 achieved a second CR by Am80 therapy. Of
      those patients, 4 relapsed within 6 months, despite subsequent consolidation
      chemotherapy. Six patients underwent sibling or unrelated HLA-matched allogeneic
      bone marrow transplantation (BMT), and 4 are alive without relase for more than
      49 months after achieving second CR. Four of 8 patients who did not receive BMT
      are alive without relapse for more than 49 months. Promyelocytic leukemia
      retinoic acid receptor alpha (PML-RAR alpha) fusion transcript was undetectable
      by reverse transcriptase-polymerase chain reaction in all living patients.
      Therefore, if patients achieve second CR with Am80 and HLA-matched donors are
      available, BMT is the treatment of choice. However, it is noteworthy that CR was
      maintained for more than 49 months in half of the patients who did not receive
      BMT.

PMID- 11197215
TI  - Lymphoid blast crisis during interferon-alpha therapy in a patient with chronic
      myelogenous leukemia in myeloid blast crisis.
AB  - A 47-year-old woman was admitted to the hospital on March 13, 1998, because of
      general malaise and fever. It was determined that she had chronic myelogenous
      leukemia (CML) in myeloid blast crisis. Hydroxyurea was started initially, and
      the blasts completely disappeared from peripheral blood on day 9 of therapy.
      Interferon (IFN)-alpha was subsequently started, but lymphoblasts newly appeared
      on day 13 of administration. Treatment with adriamycin, vincristine, and
      prednisolone (AdVP) was immediately started, which rapidly reduced the
      lymphoblasts. However, the myeloblasts again began to gradually increase.
      Subsequent examinations showed the combined presence of myeloblasts and
      lymphoblasts in the marrow and peripheral blood. The ratio between myeloblasts
      and lymphoblasts depended on the treatment (IFN-alpha or AdVP). The patient died
      from respiratory failure on November 16, 1998. This patient may have had an
      underlying bipotential blastic clone that evolved differently in response to IFN
      alpha or AdVP. In some CML patients, IFN-alpha may induce lymphoid blast crisis.

PMID- 11197216
TI  - Clinicopathological analyses of 5 Japanese patients with CD56+ primary cutaneous
      lymphomas.
AB  - We analyzed the clinicopathological features of 5 Japanese patients with CD56+
      primary cutaneous lymphomas (3 men and 2 women aged 25 to 73 years). Except for 1
      patient in whom bone marrow involvement was simultaneously observed, all patients
      presented with cutaneous lesions. Based on their Epstein-Barr virus (EBV) status,
      we categorized these patients into 2 groups, namely EBV-encoded small RNA-1 (EBER
      1) (3 patients) and EBER-1- (2 patients). Generalized lymphadenopathy and bone
      marrow involvement were observed only in EBER-1 patients. Morphologically,
      angiocentric proliferation was more prominent in EBER-1+ patients and was
      accompanied by panniculitis-like changes. The lymphomas in EBER-1- patients
      featured monomorphic proliferation of lymphoblastic cells with no cytoplasmic
      granules. Phenotypically, CD3-, cytoplasmic CD3 epsilon+, and CD56+ were common
      findings in both types. The EBER-1- type showed an additional distinguishing
      feature, CD7+, CD4+, CD8-, HLA-DR+, and terminal deoxynucleotidyl transferase
      positive (TdT+) phenotype. The lymphoma was primarily resistant in the EBER-1+
      type, and the patients died within 6 months of admission. In contrast, the
      lymphoma in the EBER-1- patients was originally chemosensitive. Collectively, we
      consider there to be at least 2 types of CD56+ primary cutaneous lymphomas,
      corresponding to nasal-type natural killer (NK)/T-cell lymphomas (EBER-1+) and
      blastic NK-cell lymphomas (EBER-1-).

PMID- 11197217
TI  - Anti-apoptotic role of Bfl-1 in staurosporine-treated B-lymphoblastic cells.
AB  - To examine the relationship between the expression level of Bfl-1 and the
      susceptibility to staurosporine-induced apoptosis in B-lymphoblastic cells, we
      tested cell survival in 4 cell lines: 2 that are Bfl-1-nonexpressing (Reh and JM
      1) and 2 that are Bfl-1-expressing (IM-9 and Wil2-NS). Reh and JM-1 showed
      apoptosis levels of 62% (Reh) and 30% (JM-1) as early as 3 hours after treatment
      with staurosporine, whereas IM-9 and Wil2-NS showed apoptosis levels of only 40%
      and 26%, respectively, even after 1 day of treatment with staurosporine. Either
      induced expression of Bfl-1 with 12-o-tetradecanoyl phorbol-13-acetate or
      exogenous expression of Bfl-1 by transfection in Reh cells promoted cell
      survival. These results suggest that expression of Bfl-1 contributes to
      regulating apoptosis in the B-cell lines we examined.

PMID- 11197218
TI  - Successful treatment of multiple myeloma--associated amyloidosis by interferon
      alpha, dimethyl sulfoxide, and VAD (vincristine, adriamycin, and dexamethasone).
AB  - A 45-year-old Japanese man was admitted to our hospital because of a mass in the
      submandibular region, abnormal hematologic findings, and proteinuria. A diagnosis
      of multiple myeloma was made based on the results of bone marrow analysis and M
      protein in hematologic tests, and a diagnosis of amyloidosis was made on the
      basis of deposition of amyloid in the rectal submucosal and lip tissues and the
      mass in the submandibular region. Combination therapy of interferon (IFN)-alpha
      at 1-day intervals and daily oral dimethyl sulfoxide (DMSO) and vincristine,
      adriamycin, and dexamethasone (VAD) resulted in a marked decrease in the size of
      the mass and hypertrophy of the back, as well as a decrease in the levels of
      plasma cells in bone marrow and of M-protein and immunoglobulin G in serum. The
      results of this case indicate that long-term administration of IFN-alpha and DMSO
      with VAD is effective in treating amyloidosis with multiple myeloma.

PMID- 11197219
TI  - Successful treatment of disseminated Fusarium infection in an infant with
      leukemia.
AB  - Disseminated Fusarium infection in an immunocompromised host is intractable and
      results in high mortality. We provide the first full case report on successful
      treatment of a disseminated Fusarium infection in an infant. The 6-month-old
      infant, whose family raised livestock, had infantile leukemia. During the
      neutropenic period after intensive chemotherapy, vomiting, diarrhea, fever,
      subcutaneous nodes, and coughing appeared. Pneumonia was diagnosed, and Fusarium
      moniliforme was isolated from blood culture. A central venous catheter was
      removed. Granulocyte colony-stimulating factor (G-CSF) and amphotericin B (AMPH
      B) (total dose, 65 mg/kg) were administered continuously for 8 weeks. The
      infection was resolved according to improvement of clinical and laboratory
      findings, and intensive chemotherapy was restarted for the leukemia. Cord blood
      stem cell transplantation from an unrelated donor was performed. The Fusarium
      infection did not recur, but after transplantation, leukemia relapsed. Treatment
      of neutrophils using G-CSF, AMPH-B, and local treatment induced resolution of the
      disseminated Fusarium infection in this immunocompromised host with malignancy.
      We suggest caution for patients living in an environment conducive to the
      development of Fusarium infection because of the particular risk of infection.

PMID- 11197220
TI  - Successful engraftment of allogeneic peripheral blood stem cell transplant after
      nonmyeloablative preparative regimen with cytarabine and cyclophosphamide: report
      of 2 cases.
AB  - We report our experience with allogeneic peripheral blood stem cell
      transplantation (allo-PBSCT) following a nonmyeloablative conditioning regimen
      consisting of cytarabine (8 g/m2) and cyclophosphamide (120 mg/kg) in the
      treatment of 2 patients aged 50 and 55 years with refractory chronic
      myelomonocytic leukemia and chronic myeloid leukemia in accelerated phase,
      respectively. Our nonmyeloablative regimen was well tolerated by older patients
      at high risk of regimen-related toxicity by the conventional conditioning regimen
      but was immunosuppressive enough to achieve mixed chimerism. After allo-PBSCT, we
      monitored chimerism in these patients by fluorescence in situ hybridization using
      X- and Y-specific probes and polymerase chain reaction-based analysis of a
      variable number of tandem repeats. We found that full chimerism and graft-versus
      leukemia (GVL) effects could be induced in these patients by donor lymphocyte
      infusions and withdrawal of posttransplantation immunosuppressive therapy. Our
      observations suggest that a nonmyeloablative conditioning regimen can establish
      mixed chimerism and that donor lymphocyte infusion may induce GVL effects in
      older patients at high risk of regimen-related toxicity.

PMID- 11197221
TI  - Successful allogeneic bone marrow transplantation in a case of adult precursor B
      lymphoblastic lymphoma.
AB  - A 42-year-old woman was admitted to the National Cancer Center Hospital in Tokyo,
      Japan, because of lumbago and bilateral leg pain. Clinical examination revealed a
      retroperitoneal bulky tumor, a breast tumor, and lymphoblasts in bone marrow. She
      did not have surface lymph node swelling or systemic symptoms such as weight loss
      and night sweats. Lymphoblasts in bone marrow were positive for CD10 and CD19 but
      negative for CD20, surface immunoglobulin, and T-cell antigens. Needle biopsy of
      a retroperitoneal mass revealed diffuse infiltration of lymphoblastic tumor
      cells. Because the cells were immunoreactive for CD79a, CD10, and terminal
      deoxynucleotidyl transferase, the patient was diagnosed as having precursor B
      lymphoblastic lymphoma (which is rare in adults) with bone marrow involvement.
      The patient achieved complete remission by an induction therapy for acute
      lymphoblastic leukemia, underwent allogeneic bone marrow transplantation, and has
      remained in complete remission for more than 3 years.

PMID- 11197222
TI  - Circulating adhesion molecules in patients with stable coronary artery disease.
AB  - To evaluate platelet and endothelial function in patients with stable coronary
      artery disease (CAD), we investigated levels of the plasma-soluble (s) adhesion
      molecules E-selectin (sE-selectin), P-selectin (sP-selectin), and intercellular
      adhesion molecule-1 (sICAM-1) in 74 patients (mean age, 53 +/- 8 years) with
      angiographically documented coronary artery disease. Levels were compared to 27
      matched healthy control subjects. Patients were excluded if they had recent
      cardiovascular events or any illness that might influence platelet and
      endothelial cell function. Concentrations of sP-selectin were significantly
      higher in patients with stable CAD (276 +/- 61 ng/mL) compared with control
      subjects (188 +/- 32 ng/mL) (P = .0001), whereas sE-selectin and sICAM-1 levels
      were similar between the 2 groups. Pooling both groups showed that sICAM-1
      correlated weakly with triglycerides (r = 0.240, P = .01) and sP-selectin
      correlated weakly with low-density lipoprotein cholesterol (r = 0.204, P = .04).
      Although plasma sICAM-1 concentrations were significantly increased in
      hypercholesterolemic patients compared with those of normocholesterolemic
      patients (P = .04), sP-selectin and sE-selectin levels were similar between the 2
      groups. In conclusion, significantly increased sP-selectin levels, indicating
      platelet activation, were found in patients with stable CAD. No other sign of
      endothelial cell activation in these patients could be detected. Moreover, sP
      selectin levels seem to reflect the activation of platelets rather than of
      endothelial cells.

PMID- 11197223
TI  - A new mutation, Ala1500-->Glu, responsible for type 2A von Willebrand disease.
AB  - Two patients (from the same family) with a bleeding disorder were diagnosed with
      type 2A von Willebrand disease (vWD). The 28th exon of the von Willebrand factor
      (vWF) gene was obtained by polymerase chain reaction and then screened by
      denaturing gradient gel electrophoresis. The fragments displaying abnormal
      melting behavior were directly sequenced. A heterozygous C-->A substitution
      changing alanine 1500 to glutamic acid at position 4750 in the A2 domain of vWF
      was found. The structure of recombinant A1500E vWF within transfected COS-7 cells
      and the secretion of high-molecular-weight (HMW) multimers were similar to wild
      type vWF. HMW forms of vWF multimers were absent in plasma but present in
      platelets. The mutation described here corresponds to the group II type 2A vWD
      characterized by normal secretion of all vWF multimers.

PMID- 11197225
TI  - Transformation of polycythemia vera to acute promyelocytic leukemia.

PMID- 11197224
TI  - Transient factor VIII inhibitor in a hemophilia patient after staphylococcal
      septic shock syndrome.
AB  - We report a transient type I factor VIII inhibitor that arose in a 30-year-old
      hemophilia patient just after staphylococcal septicemia. This situation usually
      occurs early in the course of substitution therapy with factor VIII concentrate
      in hemophilia patients. Although disseminated intravascular coagulation and acute
      respiratory distress syndrome developed after septic shock, the patient recovered
      following intravenous administration of antibiotics (meropenem and gentamycin),
      an antithrombin preparation, high-dose methylprednisolone, and recombinant factor
      VIII concentrate (rFVIII). During this therapy, however, activated partial
      thromboplastin time gradually lengthened. On the seventh day of hospitalization,
      intracranial hemorrhage occurred with right hemiplegia, even though the
      substitution therapy had continued at the same dosage (30 U/kg per day) of
      rFVIII. At that point, 4 Bethesda units of the type I inhibitor against factor
      VIII were detected in the plasma. Increased amounts (46 U/kg per day) of rFVIII
      and prednisolone were administered, and hypothermic therapy was initiated.
      Following these treatments, the patient's general condition gradually improved,
      and within 25 days the inhibitor titer dropped to undetectable levels and did not
      recur during treatment. These clinical findings suggest that the staphylococcal
      septic shock may have acted as a trigger in the development of transient factor
      VIII inhibitor in this patient.

PMID- 11197226
TI  - Second International Symposium on Myelodysplastic Syndromes in Childhood.
AB  - This article summarizes presentations from the Second International Symposium on
      Myelodysplastic Syndromes in Childhood, May 11 to 14, 2000, in Funen, Denmark.
      Topics included epidemiology, pathology, pathophysiology, cytogenetics,
      congenital neutropenia, transplantation, and classification. Dr. Henrik Hasle was
      the Meeting Chair and Dr. Gitte Kerndrup was the Co-Chair.

PMID- 11197227
TI  - Ultrastructure of the pellicle of Euglena gracilis.
AB  - Deep-etching technique was used to investigate the organization of the pellicle
      complex of Euglena gracilis. The interpretation of the images was further
      supported by SEM and TEM investigations. Our results mainly validate data
      obtained by previous freeze-fracture studies on the E and P faces of the outer
      cortical membrane. At the level of the ridges, the outer E fracture face is
      highly organized in a regular striated pattern, whereas the P inner face shows a
      particulate structure. However, our images reveal that this particulate
      organization of the P face is not limited to the ridges, but it is displayed also
      by the grooves. Moreover, this face shows two distinct layers, a particulate
      layer facing the cytoplasm and a striated layer facing the E face; these layers
      represent different true fracture levels of the same P face.

PMID- 11197228
TI  - Apoptosis and mitosis of parenchymal cells in the duct-ligated rat submandibular
      gland.
AB  - Apoptosis and proliferation of parenchymal cells during atrophy of rat
      submandibular gland induced by double duct ligation were investigated using
      immunohistochemistry for proliferating cell nuclear antigen (PCNA), terminal
      deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labelling
      (TUNEL) and transmission electron microscopy (TEM). At 2 and 3 days after
      ligation, increased PCNA positive cells and mitoses were seen in ducts;
      thereafter PCNA positive cells decreased in number. At 3 and 4 days, the acinar
      cell population rapidly decreased, with many remaining TUNEL positive acinar
      cells. During this period, TEM showed typical apoptotic acinar cells that were
      phagocytosed by adjacent acinar cells or intraepithelial macrophages. After 7
      days, most acinar cells had disappeared, leaving prominent residual ducts; a few
      acinar cells remained, especially at the lobule periphery. Submandibular gland
      duct ligation thus induced marked depletion of acinar cell by apoptosis and a
      concurrent short-lived cycle of duct cell proliferation.

PMID- 11197229
TI  - 20-Hydroxyecdysone-induced differentiation and apoptosis in the Drosophila cell
      line, l(2)mbn.
AB  - 20-Hydroxyecdysone has an inhibitory effect on the proliferation of l(2)mbn
      cells, causes vacuolization and fragmentation of cells, and promotes a strong
      phagocytotic activity. From several lines of evidence, it can be concluded that
      20-hydroxyecdysone induces apoptosis. Long-term video observations following the
      fate of individual cells, scanning and transmission electron microscopy reveal
      the typical characteristics of apoptosis: sequestration of small cellular
      protuberances or larger parts of the cell with nuclear fragments (apoptotic
      bodies), chromatin condensation, condensation and vesiculation of cytoplasm,
      whereas the mitochondria retain their normal appearance. The induction of
      apoptosis by 20-hydroxyecdysone was confirmed by the TUNEL reaction and
      quantitatively determined by a method based on this reaction. Onset of apoptosis
      precedes phagocytotic activity. JH III alone has no clear-cut effect on l(2)mbn
      cells. In double treatments, the inhibitory effect of 20-hydroxyecdysone on cell
      proliferation is significantly reduced by the addition of JH III. Whether or not
      JH III also reduces apoptotic activity is not yet clear. It is shown that the
      l(2)mbn cell line is an advantageous model system for the exploration of steroid
      induced apoptosis.

PMID- 11197230
TI  - Swelling of the collagen-keratocyte matrix of the bovine corneal stroma ex vivo
      in various solutions and its relationship to tissue thickness.
AB  - AIM: The mammalian corneal stroma, like some other connective tissues, can absorb
      fluid, swell and become oedematous. Since studies on the corneal stroma have been
      carried out with different types of preparations and solutions, inter-study
      comparisons are very difficult. A study was thus undertaken on a standardised
      preparation to assess the relative magnitude of this swelling and its
      relationship to thickness of the preparations. METHODS: From selected recent post
      mortem eyes of adult cattle, stroma preparations were cut from the central part
      of the cornea. These preparations were immersed in various solutions of known pH
      and osmolality, and the time-dependent changes in wet mass were assessed over 9 h
      at 37 degrees C. The relative rates and magnitude of the swelling of the tissue
      were then compared. RESULTS: A reference value for stromal swelling was obtained
      by incubation in a 35 mM bicarbonate-buffered mixed salts solution equilibrated
      with 5% CO2-air (pH 7.60) where a 3.39-fold increase in wet mass and a 4.58-fold
      increase in thickness was realised in 9 h, at an initial rate of 76 +/- 3%/h. The
      swelling was essentially the same in an organic buffer-mixed salt solution (pH
      7.5) but progressively greater in phosphate-buffered saline (pH 7.5), a range of
      phosphate buffers (10-67 mM, pH 7.5), NaCl solutions (0.025-1%) and with gross
      swelling observed in water (where a 15.9-fold increase in wet mass occurred along
      with a 25-fold increase in thickness, at an initial rate of 643 +/- 62%/h).
      Overall, the wet mass changes were strongly related to thickness (P < 0.001).
      CONCLUSIONS: The results confirm that the selection of solution(s) for studies on
      corneal stromal swelling is critical. The swelling (oedema) is lower in a
      physiologically-relevant solution (similar to the aqueous humour of the eye).
      This indicates that the swelling tendency of the corneal stroma has been
      overestimated in the past, and that a similar discrepancy may also exist for
      studies on other connective tissues ex vivo when non-physiological experimental
      solutions are used.

PMID- 11197231
TI  - Study of the microbial aggregation in Mycobacterium using image analysis and
      electron microscopy.
AB  - Cellular aggregation, which occurs in both prokaryotes and eukaryotes, is
      controlled by the hydrophobicity as well as the electrokinetic potential of the
      cell surface and substratum. It is known that the Mycobacterium genus form
      aggregates, but the influence of sugar on the cellular aggregation has not been
      reported for this genus. The mutant strain Mycobacterium sp. MB-3683 that
      transforms sterol to androstenedione (AD), a steroidal precursor used by the
      pharmaceutical industries, was employed in this study. This strain was cultivated
      in a synthetic medium on three sugars (glycerol, glucose and fructose) at
      different concentrations, and at 144 h microbial growth, cellular aggregation,
      hydrophobicity, lipid content, fatty acid composition, and width of cellular
      walls were measured. It was observed that at different sugar concentrations,
      similar growth and pH were obtained. However, in fructose, the aggregation level
      was significantly high, followed by glycerol and glucose (fructose < glycerol <
      glucose). These results were confirmed using electron microscopy and the
      aggregate area quantified by image analysis. Hydrophobicity was the highest in
      fructose and the lowest in glucose. The total lipids, in contrast to cellular
      hydrophobicity, were higher in glucose than glycerol. Although, the hydrophilic
      lipophilic balance (HLB) of principal fatty acids isolated was similar regardless
      of sugar used. In glycerol and fructose, the paraffins were observed, which are
      responsible for the high cellular hydrophobicity detected above. The width of
      cell wall of the organisms grown on glucose and fructose was similar, but in
      glycerol the walls were very thin. There is a correspondence between cell wall
      width and lipid content.

PMID- 11197233
TI  - Ultrastructural study of acrosome formation in mongolian gerbil (Meriones
      unguiculatus).
AB  - Spermatogenesis is a complex and very well organized process lasting from 30 to
      75 days in mammals. The spermatogenic process has been described mainly in
      laboratory mammals, such as the rat, while correspondent studies in wild animals
      are scarce. The gerbil (Meriones unguiculatus) is a small rodent native of the
      arid regions of Mongolia and China. Few reports are available on reproduction in
      the male Mongolian gerbil. The present study provides the first description of
      the ultrastructural alterations in spermatid cytoplasm and nucleus, with
      particular reference to acrosome formation in gerbils. The testes were processed
      by conventional transmission electron microscopy technique. Based on the
      development of the acrosomal system and changes in nuclear morphology, the
      transformation of spermatids in spermatozoon was divided into 15 steps. There
      were four phases in the spermiogenesis process in the gerbil: Golgi, cap,
      acrosomal and maturation phases. This provides the foundation for a variety of
      future studies of the spermiogenesis of this animal.

PMID- 11197232
TI  - Regulation of acrosome formation in mice expressing green fluorescent protein as
      a marker.
AB  - Transgenic mice expressing enhanced green fluorescent protein under acrosin
      promoter were used to study the role of the Golgi complex and of the cytoskeleton
      during early development of the acrosomic system in exactly defined stages of the
      seminiferous epithelial cycle during in vitro differentiation. First acrosin
      expression was found uniformly in the cytoplasm of stage IV pachytene
      spermatocytes. The steady-state level increased up to stage X pachytene
      spermatocytes, and in diakinetic primary spermatocytes, acrosin started to
      accumulate into the Golgi complex. During step 2 of spermiogenesis, several small
      fluorescent proacrosomic granules were seen in various parts of the Golgi
      complex, and they fused to a solid acrosomic system at step 3. In cultured stage
      I-III seminiferous tubule segments, nocodazole slowed down acrosin incorporation
      and increased the distance of the acrosomic system from the nucleus. Follicle
      stimulating hormone had an opposite effect by increasing density of the acrosomic
      system together with activation of the surrounding microtubule network. The
      observations suggest that microtubules have an important function during the
      early differentiation of the acrosomic system.

PMID- 11197234
TI  - Ultrastructural characterization of the isolated hydrogenosome in Tritrichomonas
      foetus.
AB  - In the present study we show new aspects of the hydrogenosome ultrastructure as
      well alterations induced by the fractionation technique. The morphology of
      freshly isolated hydrogenosomes as well those found in whole cells of
      Tritrichomonas foetus were examined in thin-sections, in replicas of fast
      freezing, and conventional freeze-fracture, freeze-etching, and by high
      resolution scanning electron microscopy (field emission in-lens scanning electron
      microscopy). The true surface as well the concave and convex fracture faces of
      the inner and outer membranes are shown. We showed that after fractionation
      procedures the hydrogenosome ultrastructure can be changed, since isolated
      hydrogenosomes present patchwork-like structures, rosettes and the inner
      hydrogenosomal membrane is displaced. The peripheral vesicle is seen as a
      distinct compartment, since its content and morphological appearance is quite
      different from the rest of the organelle. The peripheral vesicle shows a smooth
      surface but presenting pores with 20 nm in diameter with a density of 7/micron 2
      when observed after freeze-etching. We report the existence of characteristic
      intramembrane particles distribution and density on hydrogenosome membranes of
      isolated and whole T. foetus, suggesting that this organelle can have its
      morphology changed as consequence of technical modifications or as expression of
      its metabolic state.

PMID- 11197235
TI  - The osteochondral ligament: a fibrous attachment between bone and articular
      cartilage in Rana catesbeiana.
AB  - The anuran epiphyseal cartilage shows a lateral expansion that covers the
      external surface of the bone, besides other features that distinguish it from the
      corresponding avian and mammalian structures. The fibrous structure that attaches
      the lateral cartilage to the bone was characterized in this work. It was
      designated osteochondral ligament (OCL) and presented two main areas. There was
      an inner area that was closer to the periosteal bone and contained a layer of
      osteoblasts and elongated cells aligned to and interspersed with thin collagen
      fibers. The thin processes of the cells in this area showed strong alkaline
      phosphatase activity. The outer area, which was closer to the cartilage, was rich
      in blood vessels and contained a few cells amongst thick collagen fibers. TRITC
      phaloidin staining showed the cells of the inner area to be rich in F-actin, and
      were observed to form a net around the cell nucleus and to fill the cell
      processes which extended between the collagen fibers. Cells of the outer area
      were poor in actin cytoskeleton, while those associated with the blood vessels
      showed intense staining. Tubulin-staining was weak, regardless of the OCL region.
      The main fibers of the extracellular matrix in the OCL extended obliquely upwards
      from the cartilage to the bone. The collagen fibers inserted into the bone matrix
      as Sharpey's fibers and became progressively thicker as they made their way
      through the outer area to the cartilage. Immunocytochemistry showed the presence
      of type I and type III collagen. Microfibrils were found around the cells and
      amongst the collagen fibrils. These microfibrils were composed of either type VI
      collagen or fibrilin, as shown by immunocytochemistry. The results presented in
      this paper show that the osteochondral ligament of Rana catesbeiana is a complex
      and specialized fibrous attachment which guarantees a strong and flexible
      anchorage of the lateral articular cartilage to the periosteal bone shaft,
      besides playing a role in bone growth.

PMID- 11197236
TI  - Peptic ulcer bleeding.

PMID- 11197237
TI  - Endoscopic surveillance and ablative therapy for periampullary adenomas.
AB  - OBJECTIVES: Periampullary adenomas are an increasingly recognized condition, both
      in those with familial adenomatous polyposis syndromes (FAP) as well as sporadic
      cases. Endoscopic management has been advocated for these lesions without
      differentiating between these two patient groups regarding aim of therapy. The
      aims of this study were to determine the safety and effectiveness of endoscopic
      surveillance and ablative therapy of periampullary adenomas in patients with both
      sporadic and FAP-associated lesions. METHODS: Retrospective analysis of 59
      patients with FAP and 32 with sporadic lesions who were all enrolled in a program
      of endoscopic surveillance and ablative therapy. Median follow-up was 24 months
      (range, 1-134 months). RESULTS: Ampullary ablative therapy has resulted in return
      to normal histology in 44 and 34% of sporadic and FAPassociated lesions,
      respectively. Complications of endoscopic therapy were mild in 12 patients and
      severe in 3 patients: the latter category involved one occurrence of asymptomatic
      duodenal stenosis and one occurrence of postcoagulation syndrome--both after Nd
      YAG laser therapy-and necrotizing pancreatitis after ampullary biopsy in one
      patient. Thirteen patients have been referred for surgical intervention. There
      has been no mortality and no cases of advanced malignancy missed by endoscopy.
      CONCLUSIONS: Endoscopic surveillance and ablative therapy of periampullary
      lesions is safe and can be effective, although eradication of ampullary tissue
      requires multiple ablative sessions.

PMID- 11197238
TI  - The effect of the modified puestow procedure on diabetes in patients with
      tropical chronic pancreatitis--a prospective study.
AB  - OBJECTIVES: Surgical decompression of the pancreatic duct in patients with
      chronic pancreatitis relieves pain in 80-90% of subjects, but its effect on
      exocrine and endocrine pancreatic function is not clear. We sought to further
      examine such effects. METHODS: We performed the modified Puestow procedure
      (lateral pancreaticojejunostomy) in 53 patients with chronic tropical
      pancreatitis. Pain evaluation was done subjectively and objectively, and the
      fasting and postprandial blood glucose, insulin requirements, and 72-h fecal fat
      levels were estimated before and at 3 months and 5 yr after operation. We
      compared 46 operated patients who completed 5 yr of follow-up with 40 patients
      who did not undergo operation. RESULTS: Forty-one patients (89%) had complete
      pain relief. The mean fasting (209 mg/dl) and postprandial (320 mg/dl) blood
      glucose and insulin requirements (40 U/day) decreased postoperatively (fasting,
      162 mg/dl; postprandial blood glucose, 254mg/dl; insulin requirement, 18.2 U/day;
      p < 0.01), and steatorrhea improved in one of six patients. In the nonoperated
      group, endocrine and exocrine pancreatic function remained unchanged.
      CONCLUSIONS: Patients with tropical chronic pancreatitis who undergo the Puestow
      procedure not only have relief from pain but also improvement of diabetes.

PMID- 11197239
TI  - Osteoporosis in a north american adult population with celiac disease.
AB  - OBJECTIVE: Osteoporosis, common in European and South American adults with celiac
      disease, has not been reported in those patients with celiac disease residing in
      North America. We therefore evaluated bone density in a group of patients from
      the United States. METHODS: Patients (105 women and 23 men) with celiac disease,
      who had completed a questionnaire and had bone mineral density (BMD) measured by
      dual energy x-ray absorptiometry, were evaluated. The patients were an average
      age of 56 yr old (range 21-83 yr) and had been on a gluten-free diet from 0
      months to 46 yr (mean 7.5 yr). RESULTS: Osteoporosis (T score < -2.5) was present
      in 34% of the patients at the lumbar spine, 27% at the femoral neck, and 36% at
      the radius. Low bone mass (T score between -1.0 and -2.5) was present in 38% at
      the lumbar spine, 44% at the femoral neck, and 32% at the radius. When compared
      to age-matched controls, men were more severely affected than women. BMD did not
      differ between those on a gluten-free diet and those who had not begun therapy.
      BMD was remeasured 16 +/- 2 months after beginning a gluten-free diet in 5
      patients; it increased by 7.5% at the femoral neck (p < 0.02). In 16 patients who
      had followed a gluten-free diet for an average of 12 yr, BMD remained stable over
      an additional 2 yr of observation. CONCLUSIONS: Osteoporosis and low bone mass
      often affect North American adults with celiac disease, whether or not they are
      on dietary therapy. Routine screening for osteoporosis is indicated in patients
      with celiac disease.

PMID- 11197240
TI  - Prevalence of IgA-antiendomysial antibody in asymptomatic low bone mineral
      density.
AB  - OBJECTIVE: Celiac disease (CD) is a relatively common gastrointestinal disorder
      that can be asymptomatic. However, even among asymptomatic patients a long-term
      reduction in bone mineral density (BMD) is found. Excellent noninvasive screening
      tests for CD are now available. Studies using older screening techniques have
      suggested a 10-fold increased prevalence of CD among patients with low BMD, but
      this has not been confirmed with current testing methodology. We set out to
      confirm these prevalence estimates using antiendomysial antibody testing.
      METHODS: A total of 100 consecutive patients referred to our outpatient
      endocrinology clinic for evaluation of idiopathic low BMD were studied. In
      addition to the routine evaluation, patients completed a symptom questionnaire
      and underwent serological testing for the presence of the IgA antiendomysial
      antibody (EMA). All patients with a positive EMA underwent small bowel biopsy and
      permeability studies. RESULTS: EMA results were available on 96 patients; 78/96
      patients were female and the mean age was 57 yr (range 18-86 yr). Seven of 96
      (7.3% [95% CI 2.1-12.5%]) were EMA-positive, but all tests were low titer (< or =
      1:20). However, none of the biopsies showed any histopathological features of CD,
      nor did EMA status correlate with any of the clinical or laboratory features
      assessed. CONCLUSIONS: Despite a high rate of weakly positive antibody tests, our
      data do not support an increased prevalence of CD among asymptomatic patients
      referred for evaluation of low BMD. Without an increase over the background
      prevalence, the high cost of EMA testing argues against routine use of this test
      for screening of this population.

PMID- 11197241
TI  - Characteristics of adult celiac disease in the USA: results of a national survey.
AB  - OBJECTIVE: The clinical spectrum of adults with celiac disease in the United
      States, where the disease is considered rare, is not known. We sought this
      information by distributing a survey. METHODS: A questionnaire was distributed by
      way of a celiac newsletter, directly to celiac support groups, and through the
      Internet. RESULTS: Respondents (1,612) were from all United States except one.
      Seventy-five percent (1,138) were biopsy proven. Women predominated (2.9:1). The
      majority of respondents were diagnosed in their fourth to sixth decades. Symptoms
      were present a mean of 11 yr before diagnosis. Diarrhea was present in 85%.
      Diagnosis was considered prompt by only 52% and 31% had consulted two or more
      gastroenterologists. Improved quality of life after diagnosis was reported by
      77%. Those diagnosed at age > or = 60 yr also reported improved quality of life.
      Five respondents had small intestinal malignancies (carcinoma 2, lymphoma 3)
      accounting for a relative risk of 300 (60-876) for the development of lymphoma
      and 67 (7-240) for adenocarcinoma. CONCLUSIONS: Patients with celiac disease in
      the United States have a long duration of symptoms and consider their diagnosis
      delayed. Improved quality of life after diagnosis is common. An increased risk of
      developing small intestine malignancies is present.

PMID- 11197242
TI  - Efficacy of gluten-free diet alone on recovery from iron deficiency anemia in
      adult celiac patients.
AB  - OBJECTIVE: Iron deficiency anemia has been reported as the most frequent
      extraintestinal symptom in adult celiac disease. Prospective studies on the
      effect of gluten-free diet on recovery from iron deficiency anemia are lacking.
      The aim of this study was to verify in adult patients with celiac disease the
      efficacy of and the time course of recovery from iron deficiency anemia by a
      gluten-free diet alone. METHODS: We studied 190 consecutive adult patients with
      iron deficiency anemia, screened for celiac disease by duodenal biopsies. New
      diagnosed celiac patients were invited to follow a gluten-free diet alone without
      iron supplementation. After 6 months of diet, duodenal biopsies were performed
      and hematological tests were repeated at 6, 12, and 24 months. RESULTS: Celiac
      disease was diagnosed in 26 (24 women, 2 men; 13.7%) adult patients. After 6
      months of gluten-free diet 14 of 18 (77.8%) female patients recovered from
      anemia, but only 5 of 18 (27.8%) reversed from iron deficiency. At 12-month
      control all but one patient (94.4%) recovered from anemia and 9 patients (50%)
      from iron deficiency. After 24 months of diet, only the patient who did not
      recover from anemia at 12-month control was still anemic, whereas 10 patients
      (55.5%) reversed from iron deficiency. A significant inverse correlation (r = 
      0.7141, p = 0.0003) between increase of Hb concentrations and decrease of
      individual histological scores of duodenitis was observed. CONCLUSIONS: A
      screening for celiac disease should be carried out in adult patients with iron
      deficiency anemia. Recovery from anemia occurs between 6 and 12 months on a
      gluten-free diet alone as a consequence of normalization of histological
      alterations of the intestinal mucosa.

PMID- 11197243
TI  - Celiac sprue: another autoimmune syndrome associated with hepatitis C.
AB  - OBJECTIVE: Celiac sprue is being diagnosed with increasing frequency by screening
      individuals with epidemiologically associated autoimmune syndromes. We sought to
      test our hypothesis that hepatitis C also may predispose to celiac sprue because
      it can trigger autoimmune reactions. METHODS: Two hundred fifty-nine
      consecutively evaluated patients with chronic hepatitis C infection, 59 with
      autoimmune liver disease, 137 with other hepatic diseases, 356 with various GI
      syndromes, and 221 normal volunteers underwent serologic screening for celiac
      sprue. Patients with antigliadin, antiendomysial, and antitissue transglutaminase
      antibodies in serum underwent duodenoscopy and biopsy. RESULTS: There was a
      statistically significantly higher prevalence of antigliadin antibody in all
      groups of patients with liver disease compared with GI controls and normal
      controls. However, only patients with hepatitis C (n = 3; 1.2%) or autoimmune
      liver disease (n = 2; 3.4%) had antiendomysial/antitissue transglutaminase
      antibody in serum. One of 221 normal volunteers (0.4%) was antigliadin,
      antiendomysial, and antitissue transglutaminase positive; this individual also
      was found to have hepatitis C (previously undiagnosed). Each of these six
      individuals had mild intestinal symptoms, duodenal histopathology consistent with
      celiac sprue, and the celiac-associated HLA-DQ2 allele. Five of the six followed
      a prescribed gluten-free diet and experienced symptomatic improvement.
      CONCLUSION: Celiac sprue is epidemiologically associated with chronic hepatitis C
      infection and with autoimmune liver disease. Because hepatitis C is much more
      frequently encountered than autoimmune liver disease, hepatitis C appears to be
      the most common hepatic disease associated with the development of celiac sprue.

PMID- 11197244
TI  - High prevalence of thrombophilic genotypes in patients with acute mesenteric vein
      thrombosis.
AB  - OBJECTIVES: Mesenteric vein thrombosis is a rare but severe abdominal emergency,
      often requiring intestinal resection. New genetic prothrombotic defects such as
      factor V Leiden, the prothrombin transition G20210A, and the
      methylenetetrahydrofolate reductase TT677 genotype have been described in
      association with venous thrombosis. Our goal was to assess prevalence and
      clinical significance of genetic thrombophilia in mesenteric vein thrombosis.
      METHODS: Twelve patients with acute mesenteric vein thrombosis were compared with
      431 healthy people from the same geographical area. The factor V Leiden, the
      prothrombin transition G20210A, and the methylenetetrahydrofolate reductase TT677
      genotype were identified by polymerase chain reaction and restriction analysis.
      RESULTS: A thrombophilic genotype was present in 9 patients (75%): the
      methylenetetrahydrofolate reductase TT677 genotype was present in 6 (50%), the
      factor V Leiden in 3 (25%), and the prothrombin transition G20210A in 3 (25%).
      Combined mutations were present in 4 (33%) patients. CONCLUSIONS: The factor V
      Leiden, the prothrombin transition G20210A, and the methylenetetrahydrofolate
      reductase TT677 genotype are important predisposing factors in the pathogenesis
      of mesenteric vein thrombosis. Their identification bears strong clinical
      implications for management of patients with mesenteric vein thrombosis.

PMID- 11197245
TI  - IL-15 drives the specific migration of CD94+ and TCR-gammadelta+ intraepithelial
      lymphocytes in organ cultures of treated celiac patients.
AB  - OBJECTIVES: Celiac disease (CD) is an under-diagnosed but extremely frequent
      disease, triggered by the ingestion of gliadin. The pathogenic mechanisms of CD
      are still poorly understood, but intraepithelial lymphocytes are considered to
      have a key role. We intended to define the subsets of T lymphocytes migrating
      upon gliadin challenge in organ cultures of treated celiac patients and establish
      the type of factor(s) driving such an infiltration. METHODS: Duodenum biopsies
      from 10 treated celiacs and 7 controls were cultured in vitro with/without
      gliadin digest (1 mg/ml) or interleukin (IL)-15 (10 ng/ml). In 7 treated celiacs
      IL-7, IL-4, and IL-2 were similarly tested. Intraepithelial CD3, CD8, TCR
      gammadelta, and CD94 were detected by immunohistochemistry and numbered per mm
      epithelium. RESULTS: IL-15 but not IL-7, IL-4, or IL-2 induced intraepithelial
      increase of CD3+ and CD8+ cells in celiac and control intestine (p < 0.001 vs
      cultures with medium). IL-15 induced increases in the number of intraepithelial
      TCR- gammadelta+ and CD94+ cells only in celiacs (p < 0.001). IL-7 was also
      effective in increasing intraepithelial TCR-gammadelta+ (but not CD94+) cells in
      celiac biopsies (p < 0.001). Gliadin induced intraepithelial migration of CD3+,
      CD8+ (p < 0.001), and CD94+ (p < 0.05) cells in celiacs, but not in controls.
      CONCLUSIONS: The results we describe in this report indicate that IL-15 might
      have a key role in modulating and driving intraepithelial infiltration and
      ultimately in the pathogenesis of CD.

PMID- 11197246
TI  - Influence of psychiatric diagnoses on interferon-alpha treatment for chronic
      hepatitis C in a veteran population.
AB  - OBJECTIVE: The prevalence of psychiatric problems and substance abuse is high in
      the veteran population with hepatitis C. The purpose of this study was to
      retrospectively analyze the effect of preexisting psychiatric conditions in
      veteran patients undergoing treatment with interferon a-2b (IFN-alpha) with
      respect to adverse events, compliance, and treatment response. METHODS: Thirty
      three veterans with chronic hepatitis C were treated with IFN-alpha (5 million
      units three times weekly) for 6 months, followed by a tapering dose for an
      additional 6 months. All patients fulfilled standard criteria for treatment
      eligibility. Psychiatric diagnoses, adverse events, and virological and
      biochemical responses to therapy were determined. RESULTS: Nineteen of 33 (58%)
      patients with hepatitis C had documented psychiatric conditions before starting
      IFN-alpha therapy. Of the patients with preexisting psychiatric diagnoses, 13/19
      (68%) developed major adverse events requiring intervention or discontinuation of
      therapy. In contrast, 4/14 (29%) patients without psychiatric diagnoses developed
      major adverse events (p = 0.024) In the psychiatric group, 6/19 (32%) developed
      major neuropsychiatric side effects compared with 2/14 patients (14%) in the
      nonpsychiatric group (p = 0.25). Patients with and without psychiatric diagnoses
      had equivalent biochemical and virological responses to therapy. Overall, only
      2/33 (6%) patients had a sustained virological response. CONCLUSIONS: Veterans
      with chronic hepatitis C and psychiatric diagnoses experienced a significantly
      greater number of major adverse events during treatment with IFN-alpha. Veteran
      patients with hepatitis C should be carefully screened for psychiatric conditions
      and may require more intensive monitoring during IFN-alpha therapy.

PMID- 11197247
TI  - Apoptosis in gastric epithelium induced by Helicobacter pylori infection:
      implications in gastric carcinogenesis.
AB  - OBJECTIVES: Helicobacter pylori is an identified carcinogen for gastric cancer,
      however, the underlying mechanisms remain to be defined. In this review, we
      sought to elucidate the role of apoptosis in gastric carcinogenesis, to determine
      the influence of H. pylori infection on apoptosis, and finally to provide
      insights into the mechanisms by which H. pylori may lead to gastric
      carcinogenesis. METHODS: A broad-based MEDLINE and Current Contents literature
      search was performed to identify relevant publications between 1966 and March
      2000 addressing H. pylori infection, apoptosis, cell proliferation, gastric
      carcinoma, oncogenes, and tumor suppressor genes, as well as the products of
      these genes. Abstracts from recent major conferences that provided adequate
      additional data were also included. RESULTS: Apoptotic cells are rare in the
      glandular neck region (the generative cell zone) of normal gastric mucosa. With
      progression of atrophic gastritis, the generative cell zone shifts downward and a
      relatively large number of apoptotic cells occur. In intestinalized glands, both
      apoptotic cells and proliferative cells are present in deeper portions of the
      glands, corresponding to the generative zone. A higher frequency of apoptosis has
      been observed in gastric dysplasia than in coexisting gastric carcinomas, whereas
      the number of proliferative cells is significantly higher in gastric carcinoma
      than in dysplasia. Upregulation of oncogene bcl-2 in premalignant lesions and
      "downregulation" of the gene after malignant change is probably a common event.
      Accumulation of p53 protein is first detected in dysplasia, although mutation of
      the pS3 gene may occur in intestinal metaplasia. H. pylori infection induces
      apoptosis in gastric epithelial cells, which returns to normal after eradication
      of the infection. Numerous molecules produced by H. pylori including cytotoxin
      (VacA), lipopolysaccharide, monochloramine, and nitric oxide may directly induce
      apoptosis. Moreover, H. pylori-stimulated host inflammatory/immune responses lead
      to release of a large amount of cytokines. Cytokines produced by type 1 T helper
      cells, such as TNF-alpha and IFN-gamma, markedly potentiate apoptosis. Gastric
      cell proliferation is significantly higher in patients with H. pylori infection
      than in normal controls, and eradication of the infection leads to a reduction in
      cell proliferation. Apoptosis and cell proliferation are also increased in
      precancerous lesions such as gastric atrophy, intestinal metaplasia, and
      dysplasia in the presence of H. pylori infection. However, H. pylori-induced
      apoptosis may no longer be cell cycle-dependent in these lesions because of the
      occurrence of alterations and mutations of apoptosis-regulating genes, resulting
      in a loss of balance between apoptosis and cell proliferation. CONCLUSIONS: It is
      hypothesized that H. pylori-induced apoptosis may play a key role in gastric
      carcinogenesis by increasing cell proliferation and/or resulting in gastric
      atrophy.

PMID- 11197248
TI  - The incidence and clinical characteristics of symptomatic propylthiouracil
      induced hepatic injury in patients with hyperthyroidism: a single-center
      retrospective study.
AB  - OBJECTIVES: Although symptomatic propylthiouracil (PTU)-induced hepatic injury is
      known to be rare, there have been few reports about its exact incidence in
      patients with hyperthyroidism. We tried to evaluate its incidence in a single
      center and its clinical course. METHODS: Medical records of 912 hyperthyroid
      patients who had been diagnosed between March 1990 and December 1998 were
      reviewed about clinical characteristics, management, and laboratory findings.
      Symptomatic PTU-induced hepatic injury was defined as the development of jaundice
      or hepatitis symptoms with at least a 3-times elevation of liver function tests
      (LFT) without other causes. RESULTS: Four hundred ninety-seven patients (age 42.6
      +/- 10.7 yr, male/female 140/357) were included. Clinically overt hepatitis
      developed in six patients (1.2%; age, 43.7 +/- 14.8 yr; male:female ratio, 3:3)
      between 12 and 49 days after PTU administration. Jaundice and itching developed
      in five patients, fever in two, rash in two, and arthralgia in one. Bilirubin,
      ALT, and ALP increased in five, four, and six patients, respectively (293 +/- 288
      micromol/L, 143 +/- 111 U/L, and 265 +/- 81 U/L; normal, < 117 U/L). The type of
      hepatic injury was cholestatic in three, hepatocellular in one, and mixed in two
      patients. None resulted from viral hepatitis. There were no statistical
      differences in age, sex, PTU dose, or T4 and T3 levels at initial diagnosis
      between patients with and without hepatic injury. LFT normalized in all patients
      between 16 and 145 (72.8 +/- 46.4) days after the PTU withdrawal. CONCLUSIONS:
      Symptomatic hepatic injury develops usually within the first few months of PTU
      administration with rare frequency, but its clinical course is relatively benign
      once the drug is withdrawn. However, it may be difficult to predict its
      development, so all patients should be monitored for rise in LFTs at regular
      intervals, especially during the early period.

PMID- 11197249
TI  - Comorbidities and quality of life in patients with interferon-refractory chronic
      hepatitis C.
AB  - OBJECTIVES: Patients with chronic hepatitis C (HCV) consistently report a
      reduction in multiple domains of health-related quality of life (HRQOL) that does
      not correlate with liver disease severity. This may in part be due to the use of
      insensitive HRQOL instruments or extrahepatic factors that independently
      influence HRQOL. We hypothesized that a past history of substance abuse or active
      medical and psychiatric comorbidities would correlate with HRQOL scores. METHODS:
      In 107 patients who had failed previous interferon therapy, HRQOL was measured by
      using the modified SF-36, a disease-specific instrument, and the Health Utilities
      Index (HUI) Mark III, a generic instrument. RESULTS: Multiple SF-36 subscale and
      summary scores as well as the HUI Mark III attributes of emotion and pain were
      significantly reduced in the study population compared with healthy controls (p <
      0.001). Serum alanine aminotransferase and HCV RNA levels, HCV genotype, liver
      histology, and HCV risk factors as well as demographic variables did not
      correlate with modified SF-36 and HUI scores. In addition, a history of alcohol
      abuse or dependency and intravenous drug use or dependency, identified in 52 and
      51% of participants, respectively, did not correlate with HRQOL scores. However,
      the presence of one or more active medical comorbidities, defined as a chronic
      medical condition requiring treatment and monitoring, was significantly
      associated with both the modified SF-36 scores and HUI attribute deficits (p <
      0.001). In particular, painful medical comorbidities or depressed mood requiring
      treatment were significantly associated with modified SF-36 scores and with HUI
      attribute deficits and utility scores (p < 0.001). CONCLUSIONS: Active medical
      and psychiatric comorbidities may account for some of the reduction and
      variability in HRQOL scores in patients with chronic HCV who have failed previous
      interferon therapy. Future studies that control for the presence of active
      comorbidities in large groups of treatment naive patients with varying severity
      of chronic HCV are needed to confirm these findings.

PMID- 11197250
TI  - Hepatocellular carcinoma in HIV-infected patients with chronic hepatitis C.
AB  - OBJECTIVES: Chronic hepatitis C is frequently seen in HIV-positive subjects
      infected through needle sharing or transfusion of contaminated blood products.
      Progression to end-stage liver disease seems to occur faster in these patients.
      As the life expectancy of HIV-infected persons has dramatically improved since
      the introduction of highly active antiretroviral therapies, cirrhosis and
      eventually hepatocellular carcinoma (HCC) may be recognized at an increasing rate
      in patients coinfected with HIV and hepatitis C virus (HCV). METHODS: We
      identified the main features of HIV-infected individuals with end-stage liver
      disease due to HCV infection and diagnosed with HCC in three HIV/AIDS referral
      centers, and compared these features to those of a control group of patients with
      HCV-related HCC but without HIV infection. RESULTS: Seven HIV-infected patients
      were identified. Of these, six were <45 yr of age and had been intravenous drug
      users. The mean time between exposure to HCV and the development of HCC was
      estimated to be 17.8 yr. Two subjects were coinfected with hepatitis B and delta
      viruses, respectively. Only one individual had been diagnosed of an AIDS-defining
      condition before the diagnosis of HCC was made. However, all subjects had < 500
      CD4+ T cells at the time of HCC diagnosis. Five died within the first 4 months of
      follow-up. Patients in the control group (n = 31) were significantly older (68.9
      +/- 8.9 vs 42.2 +/- 10.4; p < 0.001) and the duration of HCV infection was
      significantly longer (28.1 +/- 10.9 vs 17.8 +/- 2.7; p < 0.05) than in those with
      HIV-HCV coinfection. CONCLUSIONS: HCC seems to occur at a younger age and after a
      shorter period of HCV infection in subjects coinfected with HIV. Thus, treatment
      of CHC should be encouraged in HIV-positive patients, and in those with HCV
      related cirrhosis the periodic monitoring of alpha-fetoprotein and abdominal
      ultrasonography should be recommended.

PMID- 11197251
TI  - Effects of folate supplementation on two provisional molecular markers of colon
      cancer: a prospective, randomized trial.
AB  - OBJECTIVES: Dietary folate intake is inversely associated with the risk of
      colorectal cancer. This study investigated the effect of folate supplementation
      on genomic DNA methylation and DNA strand breaks in exons 5-8 of the p53 gene of
      the colonic mucosa, two provisional biomarkers of colon cancer. METHODS: Twenty
      subjects with adenomas were randomized to receive either folate (5 mg/day) or
      placebo for 1 yr after polypectomy. At baseline, 6 months and 1 yr, systemic and
      colonic measures of folate status were determined, as were the biomarkers
      mentioned earlier. RESULTS: Folate supplementation increased serum, red blood
      cell and colonic mucosal folate concentrations (p < 0.02). Folate supplementation
      also increased the extent of genomic DNA methylation at 6 months and 1 yr (p =
      0.001), whereas placebo administration was associated with an increase in the
      extent of genomic DNA methylation only at 1 yr. Similarly, folate supplementation
      decreased the extent of p53 strand breaks in exons 5-8 at 6 months and 1 yr (p <
      0.02), whereas placebo administration was associated with a decrease in the
      extent of p53 strand breaks only at 1 yr. CONCLUSIONS: Both of these provisional
      biomarkers of colon cancer underwent accelerated improvement at 6 months with
      folate supplementation. However, these markers also improved with placebo at 1
      yr. Therefore, potential confounding factors that seem to modulate these
      biomarkers need to be identified and corrected in order for these markers to
      serve as suitable surrogate endpoints in folate chemoprevention trials.

PMID- 11197252
TI  - Factors that influence the decision to do an adequate evaluation of a patient
      with a positive stool for occult blood.
AB  - OBJECTIVE: The factors that influence the decision to do an adequate evaluation
      for a positive test for fecal occult blood in a middle-aged or elderly patient
      are largely unknown. Our study was undertaken to determine whether factors such
      as the number of positive Hemoccult II card windows, age, gender, family history
      of colon cancer, the patient's concern that he or she might have colon cancer, or
      history of rectal bleeding influence the evaluation performed. METHOD: A mass
      screening program for colon cancer was performed using unrehydrated Hemoccult II
      cards in the Boston area. RESULTS: Among the 23,593 Hemoccult II cards returned
      to Beth Israel Deaconess Medical Center, cards from 1,112 patients (4.7%) were
      found to be positive for one or more of the six possible card windows. Ninety
      percent, or 940 patients, over 40 yr of age had follow-up information available.
      As the number of positive windows increased from one to four, there was a
      significant trend (p < 0.001) for the adequacy of the evaluation to increase.
      Family history (p = 0.044) and a patient's worry that he or she might have colon
      cancer (p = 0.003) significantly improved a patient's chance for an adequate
      evaluation. CONCLUSIONS: Hemoccult testing is not followed by an adequate
      evaluation in a significant proportion of patients. Our study points out for the
      first time that the number of positive Hemoccult windows significantly influences
      the decision-making.

PMID- 11197253
TI  - Ethnic differences in colorectal cancer among Arab and Jewish neighbors in
      Israel.
AB  - OBJECTIVES: Migrant studies indicate that the differences in the incidence of
      colorectal cancer (CRC) are probably environmental and not genetic. There is
      epidemiological documentation that Israeli-born Arabs have much less CRC than
      Israeli-born Jews. We investigated these differences among Jews and Arabs living
      within the same central coastal region in Israel. METHODS: The files of pathology
      diagnosed patients with CRC hospitalized from 1988 to 1996 were reviewed, and
      demographic data and incidence and location of malignancies were retrieved for
      this relative frequency study. RESULTS: Of the 527 patients (51.4% men) diagnosed
      as having CRC, 489 (92.8%) were Jews and 38 (7.2%) were Arabs (p < 0.001),
      representing 0.46% and 0.04% of the respective populations in the region. The
      average age at disease diagnosis of the Jews was 73.8 yr and that of the Arabs
      61.4 yr (p < 0.001). Both groups shared identical health facilities and habits of
      attending them. The Arab patients were or had been employed in occupations that
      involved more physical activity. The site of lesion was on the right colon in
      24.9% of all the cases-23.5% of the Jewish patients and 42.1% of the Arab
      patients (p < 0.001). Rectal cancer was found in 25.7% of the former and 15.8% of
      the latter (p < 0.001). CONCLUSIONS: The lower incidence of CRC among the Arabs
      persisted over time, and that group had greater right side and lesser rectal
      involvement than their Jewish neighbors, possible indications of genicity. The
      incidence of CRC among the Jews rose concomitantly with "Westernization" of their
      lifestyle, supporting a role for environmental influences.

PMID- 11197254
TI  - Managing patients with acute, nonvariceal gastrointestinal hemorrhage:
      development and effectiveness of a clinical care pathway.
AB  - OBJECTIVES: To develop a clinical care pathway for the management of patients
      with acute upper or lower nonvariceal GI hemorrhage (GIH) who do not require
      immediate surgical intervention. To test the effectiveness and safety of the
      pathway in improving the efficiency of care for patients with acute GIH. METHODS:
      A multidisciplinary team developed the evidence-based GIH clinical care pathway
      by consensus techniques. In a quasiexperimental design, pathway outcomes were
      measured prospectively during the first 8 months of pathway implementation, and
      compared to similar time periods in the 2 prior yr. Effectiveness measures were
      the number of patients <65 yr of age admitted for GIH and the hospital length of
      stay for all patients. Thirty-day safety outcomes were the rates of recurrent
      GIH, mortality, and readmission to hospital for any reason. RESULTS: Of 368
      patients studied after pathway implementation, 81 (22%) were managed as
      outpatients. The number of admissions for pathway patients <65 yr of age was
      significantly lower compared to 691 prepathway patients (p < 0.002). Mean length
      of stay (+/- 95% CI) for pathway inpatients was 3.5 (3.1, 3.9) days, compared to
      5.3 (4.9, 5.7) and 4.6 (4.2, 5) days in the 2 prepathway yr, respectively (p <
      0.001). Multivariable regression controlling for admission vital signs, comorbid
      conditions, age, and the etiology of GIH confirmed that admission after pathway
      implementation was an independent predictor of a reduced length of hospital stay.
      There were no significant between-year differences in the 30-day rates of
      recurrent GIH, mortality, or hospital readmission. CONCLUSION: A
      multidisciplinary clinical care pathway may improve the efficiency of caring for
      patients with acute upper or lower nonvariceal GIH. Decreasing the number of
      admissions for GIH and reducing the hospital length of stay can be achieved
      without increasing the number of adverse outcomes.

PMID- 11197255
TI  - Drug jars.

PMID- 11197256
TI  - Progressive gastrointestinal histoplasmosis leading to colonic obstruction two
      years after initial presentation.
AB  - A 37-yr-old man from Ecuador presented with abdominal pain, diarrhea, and weight
      loss. Endoscopy revealed duodenal histoplasmosis. The patient improved with
      antifungal therapy but was readmitted 2 yr later with diarrhea and fever.
      Colonoscopy revealed histoplasmosis lesions, including a constricting transverse
      colon lesion. The patient refused surgery and died of colonic perforation. We
      discuss the diagnosis and management of gastrointestinal histoplasmosis in this
      report.

PMID- 11197257
TI  - Marked gastric foveolar hyperplasia associated with active cytomegalovirus
      infection.
AB  - Transient protein-losing gastropathy with marked gastric rugal hypertrophy, a
      Menetrier's disease-like process, is an uncommon condition of unknown etiology.
      Most of these cases have been reported in pediatric patients; the clinical course
      is usually favorable. Cytomegalovirus infection has been implicated as a possible
      etiology in many of the reported cases. This type of Menetrier's-like disease has
      not been well documented in adult patients. We describe here an elderly man who
      presented with severe protein-losing gastropathy and large polypoid nodules in
      the stomach. Gastric mucosal biopsies revealed marked gastric foveolar
      hyperplasia with morphological evidence of cytomegalovirus (CMV) infection.
      Immunohistochemical analysis demonstrated an aberrant topographic distribution of
      staining for transforming growth factor-alpha and transforming growth factor-beta
      receptor II, as described in other cases of Menetrier's disease in the
      literature. This transient Menetrier's-like disease associated with CMV infection
      should be considered in the differential of both pediatric and adult patients
      with GI protein loss.

PMID- 11197258
TI  - Primary hepatic anaplastic large-cell lymphoma of T-cell phenotype in acquired
      immunodeficiency syndrome: a report of an autopsy case and review of the
      literature.
AB  - Anaplastic large-cell lymphomas (ALCL) were first described by Stein et al. in
      1985 as large-cell neoplasms with a pleomorphic appearance, subtotal effacement
      of the lymph node structure, and expression of the lymphoid activation antigen CD
      30 (Ki-l). Since their first description, these tumors have been documented in a
      variety of extranodal sites. We report a primary hepatic anaplastic large-cell
      lymphoma in a patient with advanced AIDS, who presented with hepatic failure and
      multiple nodules in the liver. A complete autopsy showed discrete tumor nodules
      throughout the entire liver without gross or microscopic involvement of lymph
      nodes or any other organs by the neoplastic process. The tumor cells showed
      typical histological and immunohistochemical features of ALCL and were strongly
      immunoreactive with the T-cell markers CD-3 and UCHL-1. Only one previous case of
      primary hepatic ALCL has been reported in the literature, and this tumor occurred
      in an immunocompetent patient and was not immunoreactive for B- or T-cell
      markers. To our knowledge, this study represents the first reported case of
      primary hepatic anaplastic large-cell lymphoma of T-cell phenotype. Additionally,
      this is the first case of primary hepatic ALCL reported in an AIDS patient.

PMID- 11197259
TI  - Delayed fatal hemorrhage from pseudoaneurysm of the hepatic artery after
      percutaneous liver biopsy.
AB  - Hemorrhage is the most common serious complication of percutaneous liver biopsy.
      Liver biopsy is usually done in an outpatient setting because most significant
      hemorrhage is evident within a few hours after biopsy. Delayed hemorrhage occurs
      much less frequently but carries a much higher mortality. We present a 41-yr-old
      man with chronic hepatitis C who underwent a percutaneous liver biopsy
      uneventfully but was found to have a pseudoaneurysm of the hepatic artery 5 days
      later. Shortly after admission, the patient experienced bleeding into the liver
      from the pseudoaneurysm, which was controlled initially by angiographic
      embolization. However, recurrent bleeding could not be controlled by repeat
      angiography and surgical intervention, and the patient expired. The diagnosis and
      management of pseudoaneurysm of the hepatic artery complicating liver biopsy is
      reviewed.

PMID- 11197260
TI  - Aggressive multiple myeloma presenting as mesenteric panniculitis.
AB  - Mesenteric panniculitis is a rare disease of the bowel mesentery, characterized
      by tumor-like infiltration by chronic inflammatory cells, fat necrosis, and
      fibrosis. Reported cases cited clinical presentation ranging from abdominal pain
      to fever of unknown origin, the majority of which were idiopathic and associated
      with a benign prognosis. We report the case of a 43-yr-old male who presented
      with malaise, weight loss, microcytic anemia, and a high erythrocyte
      sedimentation rate. Radiographic and histological investigations revealed typical
      features of mesenteric panniculitis. Initial treatment with high-dose oral
      prednisolone led to rapid and complete resolution of symptomatology,
      radiographic, and laboratory anomalies. Within 6 months, the patient presented
      again with anemia, renal failure, and hypercalcemia. A diagnosis of IgA kappa
      chain myeloma was made. Despite chemotherapy and restoration of normocalcemia, he
      died from refractory pulmonary edema. This is the first report of a hematological
      malignancy initially presenting with features of mesenteric panniculitis
      culminating in an aggressive course and a fatal outcome.

PMID- 11197261
TI  - Angiodysplasia of the appendix.
AB  - Angiodysplasia of the gastrointestinal tract is thought to be one of the most
      common causes of lower gastrointestinal bleeding in the elderly, and, in the
      majority of cases, lesions are located in the cecum or ascending colon. The
      authors report an extremely rare case of appendicular angiodysplasia. A 76-yr-old
      woman was hospitalized with massive recurrent red anal bleeding. Selective
      superior mesenteric arteriography revealed an extravasation of contrast material
      from the appendicular artery, and this finding proved to be bleeding from an
      angiodysplasia of the appendix. An appendectomy was performed, and anal bleeding
      did not recur postoperatively. A review of the literature revealed this to be an
      extremely rare case of angiodysplasia.

PMID- 11197262
TI  - Qua Vadis.

PMID- 11197263
TI  - Some of what glitters may be gold.

PMID- 11197264
TI  - Can postoperative relapse of Crohn's disease be prevented?

PMID- 11197265
TI  - Re: Saunders et al.--High mortality rate after percutaneous endoscopic
      gastrostomy in patients with dementia.

PMID- 11197266
TI  - WAGR syndrome in a baby--the result of 6-MP treatment in a father affected by
      Crohn's disease?

PMID- 11197267
TI  - Further evidence that 6-MP taken by the father with IBD provides risk of
      congenital anomaly to the pregnancy.

PMID- 11197268
TI  - Anti-Saccharomyces cerevisiae antibodies in autoimmune liver disease.

PMID- 11197269
TI  - Re. Zuckerman et al.--Sensitivity of CA-125 in patients with liver cirrhosis in
      the presence of ascites.

PMID- 11197270
TI  - Absence of toxicity of ornidazole after a 10-yr continous daily use for Crohn's
      disease.

PMID- 11197271
TI  - Partial obstruction of the colon caused by postoperative adhesions after
      cholecystectomy as a rare form of postcholecystectomy syndrome.

PMID- 11197272
TI  - Recurrent supraventricular extrasystolia due to retrocardiac stomach.

PMID- 11197273
TI  - A case of pancreatic cancer with production of granulocyte colony-stimulating
      factor.

PMID- 11197274
TI  - A nematode (ascaris) recognized by enteroclysis: a rare reason for chronic
      diarrhea.

PMID- 11197275
TI  - Enterolith-induced perforation in small bowel carcinoid tumor.

PMID- 11197276
TI  - Cytomegalovirus hepatitis in a nontransplant patient with autoimmune hepatitis
      taking immunosuppressants.

PMID- 11197277
TI  - Gallbladder carcinoma complicating Crohn's disease.

PMID- 11197278
TI  - Routine endoscopic "marking" of Dieulafoy-like lesions.

PMID- 11197279
TI  - Acute liver failure during lamivudine treatment in a hepatitis B cirrhotic
      patient.

PMID- 11197280
TI  - Mesenteric arteriovenous fistula causing jejunal varices and recurrent GI
      bleeding.

PMID- 11197281
TI  - Percutaneous endoscopic gastrostomy in patients with dementia.

PMID- 11197282
TI  - Esomeprazole once daily for 6 months is effective therapy for maintaining healed
      erosive esophagitis and for controlling gastroesophageal reflux disease symptoms:
      a randomized, double-blind, placebo-controlled study of efficacy and safety.
AB  - OBJECTIVE: Esomeprazole, the S-isomer of omeprazole, achieves a significantly
      greater healing rate and symptom resolution of erosive esophagitis than that
      achieved by omeprazole. The objective of this study is to assess the efficacy of
      the new proton pump inhibitor esomeprazole in preventing relapse over a prolonged
      period in patients with healed erosive esophagitis. METHODS: A total of 318
      gastroesophageal reflux patients whose erosive esophagitis was healed in a
      comparative study of esomeprazole 40 mg, 20 mg, or omeprazole 20 mg, were
      randomized to maintenance therapy with once daily esomeprazole 40 mg, 20 mg, or
      10 mg, or placebo in a U.S., double-blind multicenter trial. RESULTS: After 6
      months, healing was maintained (cumulative life table rates) in 93.6% (95% CI
      87.4-99.7) of patients treated with esomeprazole 40 mg, 93.2% (95% CI 87.4-99.0)
      treated with esomeprazole 20 mg, and 57.1% (95% CI 45.2-69) treated with
      esomeprazole 10 mg; p < 0.001 vs placebo (29.1%; 95% CI 17.7-40.3). Of patients
      relapsing, mean time to first recurrence of esophagitis increased with dose, from
      34 days (placebo) to 78 days (10 mg), 115 days (20 mg), and 163 days (40 mg).
      Patients treated with esomeprazole had less frequent and less severe heartburn
      than those treated with placebo. At month 6, more than 70% of patients being
      treated with esomeprazole remained symptom-free. CONCLUSIONS: Esomeprazole is
      effective and well tolerated in the maintenance of a healing erosive esophagitis.
      Esomeprazole 40 mg and 20 mg maintain healing in over 90% of patients while
      providing effective control of heartburn symptoms.

PMID- 11197283
TI  - Treating chronic Hepatitis C patients with psychiatric disorders: an uphill
      battle.

PMID- 11197284
TI  - Effect of age on differences in upper esophageal sphincter and pharynx pressures
      between patients with dysphagia and control subjects.
AB  - OBJECTIVES: The aim of this study was to explore the effect of age and food
      consistency on manometric data of the swallow sequence in patients with
      dysphagia. METHODS: Manometric data from 41 patients (age range, 32-88 yr) and 41
      age-matched control subjects was examined for differences between subgroups < 60
      yr and > or = 60 yr of age, as well as for changes with food consistency.
      RESULTS: Only pharynx peak pressure showed an age-dependent decrease (144.1 +/-
      21.4 mm Hg vs 95.8 +/- 15.1 mm Hg, p < 0.05) in patients. Significant higher
      upper esophageal sphincter residual pressure and delayed onset of upper
      esophageal sphincter relaxation were noted in patients aged <60 yr compared to
      age-matched controls, whereas only pharynx peak pressure was significantly lower
      in patients compared to controls aged > or = 60 yr. Food consistency did not have
      a consistent effect on manometric results in patients with dysphagia.
      CONCLUSIONS: This is the first study to systematically explore the influence of
      age and food consistency on manometric parameters in dysphagia patients. These
      results may provide useful insights when identifying actual manometric
      abnormalities in patients with dysphagia. They also suggest possible different
      underlying mechanisms of dysphagia in younger versus older patients.

PMID- 11197285
TI  - Risk factors for erosive reflux esophagitis: a case-control study.
AB  - OBJECTIVES: It is presently not fully understood which risk factors contribute to
      the occurrence of reflux esophagitis and how such factors might influence the
      severity of the disease. The aim of this study was to delineate the clinical
      epidemiology of erosive reflux esophagitis. METHODS: Outpatients from a medicine
      and gastroenterology clinic who underwent upper GI endoscopy were recruited into
      a case-control study. A total of 1,533 patients with and 3,428 patients without
      endoscopically diagnosed reflux esophagitis were categorized as case and control
      subjects, respectively. Using multivariate logistic regressions for statistical
      analysis, the presence of esophageal erosions, ulcers or strictures, served as
      three separate outcome variables. Demographic characteristics, intake of
      nonsteroidal anti-inflammatory drugs (NSAIDs), consumption of alcohol and
      cigarettes, and the presence of hiatus hernia or peptic ulcer served as predictor
      variables. RESULTS: Erosive reflux esophagitis tended to occur more frequently in
      Caucasian male patients. Hiatus hernia was associated with a strong risk for
      developing esophageal erosions, ulcers, and strictures. Although statistical
      significance was demonstrated only for esophageal erosions, in all grades of
      reflux esophagitis alike, gastric and duodenal ulcer exerted a protective
      influence. Consumption of NSAIDs increased the risk for esophageal ulcers only.
      Smoking and alcohol were not associated with an increased risk of developing any
      type of erosive reflux esophagitis. CONCLUSIONS: The results stress the critical
      role played by hiatus hernia in all grades of erosive reflux esophagitis. NSAIDs
      may act through a mechanism of topically induced esophageal injury. Our data also
      suggest that the presence of either gastric or duodenal ulcer exerts a protective
      influence against the development of reflux disease.

PMID- 11197286
TI  - Bleeding reflux esophagitis: a prospective 1-year study in a university hospital.
AB  - OBJECTIVES: The prevalence of bleeding from reflux esophagitis has not been
      studied. The aim of the study was to evaluate the 1-yr prevalence of bleeding
      from reflux esophagitis, as well as the independent factors associated with
      bleeding. METHODS: All patients with reflux esophagitis diagnosed with upper
      digestive tract endoscopy in Reims Hospital in 1996 were included. Studied
      parameters were prospectively recorded and compared between patients with
      bleeding and nonbleeding reflux esophagitis. RESULTS: Endoscopy was performed in
      1983 patients of whom 219 (11.0%) had overt upper digestive tract hemorrhage.
      Reflux esophagitis was the cause of bleeding in 32 patients (14.6%). Reflux
      esophagitis was diagnosed in 391 patients during the same period of time.
      Bleeding reflux esophagitis accounted for 8.2% of them. Independent factors
      associated with bleeding were grade 3 or 4 (Savary-Miller) esophagitis (odds
      ratio [OR]: 25.5, 95% confidence interval [CI]: 9.6-67.9), cirrhosis (OR: 5.7,
      95% CI: 1.7-18.9), Eastern Cooperative Oncology Group performance status > or = 3
      (OR: 4.6, 95% CI: 1.5-14.2), and anticoagulant therapy (OR: 3.9, 95% CI: 1.2
      12.5). A history of reflux esophagitis or heartburn was noted in only 28.1% or
      37.5% of the patients with bleeding reflux esophagitis, respectively.
      CONCLUSIONS: In this population of patients with reflux esophagitis, the
      prevalence of bleeding esophagitis was high (8.2%). Bleeding esophagitis occurred
      primarily in patients with severe esophagitis and was the revealing clinical form
      of gastroesophageal reflux disease in the majority of cases, suggesting that
      bleeding prevention would hardly be effective.

PMID- 11197287
TI  - Initial validation of a diagnostic questionnaire for gastroesophageal reflux
      disease.
AB  - OBJECTIVES: Brief, reliable, and valid self-administered questionnaires could
      facilitate the diagnosis of gastroesophageal reflux disease in primary care. We
      report the development and validation of such an instrument. METHODS: Content
      validity was informed by literature review, expert opinion, and cognitive
      interviewing of 50 patients resulting in a 22-item survey. For psychometric
      analyses, primary care patients completed the new questionnaire at enrollment and
      at intervals ranging from 3 days to 3 wk. Multitrait scaling, test-retest
      reliability, and responsiveness were assessed. Predictive validity analyses of
      all scales and items used specialty physician diagnosis as the "gold standard."
      RESULTS: Iterative factor analyses yielded three scales of four items each
      including heartburn, acid regurgitation, and dyspepsia. Multitrait scaling
      criteria including internal consistency, item interval consistency, and item
      discrimination were 100% satisfied. Test-retest reliability was high in those
      reporting stable symptoms. Scale scores significantly changed in those reporting
      a global change. Regressing specialty physician diagnosis on the three scales
      revealed significant effects for two scales (heartburn and regurgitation).
      Combining the two significant scales enhanced the strength of the model. Symptom
      response to self-directed treatment with nonprescription antisecretory
      medications was highly predictive of the diagnosis also, although the item
      demonstrated poor validity and reliability. CONCLUSIONS: A brief, simple 12-item
      questionnaire demonstrated validity and reliability and seemed to be responsive
      to change for reflux and dyspeptic symptoms.

PMID- 11197288
TI  - Randomized study of two "rescue" therapies for Helicobacter pylori-infected
      patients after failure of standard triple therapies.
AB  - OBJECTIVES: A novel rifabutin-based therapy is able to cure Helicobacter pylori
      infection in most patients who have failed eradication after standard proton pump
      inhibitor (PPI)-based triple therapy. We compared this regimen with the quadruple
      therapy. METHODS: A total of 135 patients were randomized into three groups who
      were treated for 10 days with pantoprazole 40 mg b.i.d., amoxycillin 1 g b.i.d.,
      and rifabutin 150 mg o.d. (RAP50150 group), or 300 mg o.d. (RAP300 group), and
      pantoprazole 40 mg b.i.d., metronidazole 250 mg t.i.d., bismuth citrate 240 mg
      b.i.d., and tetracycline 500 mg q.i.d. (QT group). Before therapy, patients
      underwent endoscopy with biopsies for histology, culture and antibiotic
      susceptibility tests. H. pylori eradication was assessed by the 13C-urea breath
      test. RESULTS: On intention-to-treat analysis, eradication rates (with 95%
      confidence intervals [CI]) were 66.6% (53-80%) in the RAP150 and QT groups,
      respectively, and 86.6% (76-96%) in RAP300 group (p < 0.025). Most patients
      harboring metronidazole- and clarithromycin-resistant strains were eradicated at
      an equal rate by each of the three regimens. Side effects were observed in 9% and
      11% of rifabutin-treated patients, and in 47% of those on quadruple therapy (p <
      0.0001). CONCLUSIONS: In patients who failed standard eradicating treatments, a
      10-day course of rifabutin with pantoprazole and amoxycillin is more effective
      and well tolerated than the quadruple therapy.

PMID- 11197289
TI  - Associations of food-cobalamin malabsorption with ethnic origin, age,
      Helicobacter pylori infection, and serum markers of gastritis.
AB  - OBJECTIVES: Food-cobalamin malabsorption is common in patients with low cobalamin
      levels. However, characterization of affected subjects has been limited. The aim
      of this study was to analyze demographic and gastric data in a large study
      population. METHODS: Data were collected prospectively in 202 subjects (43
      volunteers and 159 patients) who underwent the egg yolk-cobalamin absorption test
      (EYCAT). H. pylori status was determined in 167 of the subjects, serum gastrin
      and antiparietal cell antibody in 158 and pepsinogen (PG) I and PG II levels in
      133. RESULTS: Latin American and black patients had lower EYCAT results than did
      white or Asian-American ones (p = 0.0001) and had severe food-cobalamin
      malabsorption (EYCAT < 1%) more often (p = 0.0001). Age correlated inversely with
      EYCAT results (p = 0.02). H. pylori infection was associated with food-cobalamin
      malabsorption (p = 0.0001), especially with severe malabsorption where 29/37
      subjects (78.4%) were infected. Malabsorption was also associated with higher
      gastrin levels (p = 0.0001) and lower PG I levels (p = 0.01) and PG I:PG II
      ratios (p = 0.0001). Multivariate analysis showed that ethnic origin, gastrin
      levels, H. pylori infection and, to a lesser extent, age were independently
      associated with the EYCAT results. CONCLUSIONS: Latin American and black patients
      have food-cobalamin malabsorption more often than do white and Asian-American
      patients. This association is independent of the malabsorption's association with
      H. pylori infection, markers of gastritis, such as gastrin, and older age. The
      patterns of gastric tests suggest that malabsorption may be due to diverse
      mechanisms, not just atrophic gastritis. The possible role of H. pylori infection
      in many cases of severe food-cobalamin malabsorption also suggests avenues of
      treatment and prevention.

PMID- 11197290
TI  - Impact of chronic gastrointestinal symptoms in diabetes mellitus on health
      related quality of life.
AB  - OBJECTIVES: Morbidity from GI symptoms in diabetes is considered to be high, but
      no studies have quantified the impact of GI symptoms in diabetes on health
      related quality of life. We hypothesized that diabetics reporting increased GI
      symptoms would experience more impaired quality of life. METHODS: Subjects from
      the community with diabetes (n = 892) and outpatients with diabetes (n = 209)
      were recruited for this study. Subjects were divided into type 1 (diabetes
      diagnosed at age <30 yr and requiring insulin) and type 2. A validated
      questionnaire measuring GI symptoms and diabetes status and the Short Form-36
      were completed. The results were compared with Australian normal data. GI symptom
      groups measured were frequent abdominal pain, bowel-related abdominal pain,
      reflux, dyspepsia, constipation, diarrhea, and fecal incontinence. RESULTS: There
      was a clinically significant decrease in quality-of-life scores in diabetics
      compared with population norms across all subscales. The impact on quality of
      life in diabetes was predominantly observed in type 2 diabetics. The quality-of
      life scores in all subscales decreased markedly with increasing numbers of
      distinct GI symptom groups, and this was similar in community and outpatient
      diabetics. For all the Short Form-36 subscales, GI symptom groups were
      significantly (all p < 0.0001) associated with poorer quality of life in
      diabetes, independent of age, gender, smoking, alcohol use, and type of diabetes.
      CONCLUSIONS: GI symptoms impact negatively on health-related quality of life in
      diabetes mellitus.

PMID- 11197291
TI  - Gastric involvement in systemic sclerosis: a prospective study.
AB  - OBJECTIVES: This study aims to assess the prevalence of gastric electrical
      activity dysfunction with cutaneous electrogastrography (EGG), disturbances of
      gastric emptying function using radiopaque pellets, and gastric endoscopic
      abnormalities in patients with systemic sclerosis (SSc). We also investigate for
      an association between EGG and gastric-emptying data with clinical manifestations
      and esophageal motor disturbances. METHODS: Fasting and postprandial gastric
      electrical activity was studied in 22 consecutive patients with SSc (17 with and
      5 without clinical gastric manifestations) and 22 age- and sex-matched healthy
      subjects. Gastric emptying of radiopaque pellets and gastroscopy were also
      performed in SSc patients. RESULTS: The prevalence of EGG disturbances was as
      high as 81.82% in SSc patients. SSc patients exhibited, compared with controls,
      higher median percentage of dominant frequency in bradygastria during the fasting
      period and lower median values for postprandial electrical power and postprandial
      to fasting ratio for electrical power. Gastric emptying of radiopaque pellets was
      delayed in 11 SSc patients, and gastroscopy demonstrated "watermelon stomach" in
      3 SSc patients. No correlation was found between the severity of gastric
      impairment and clinical presentation, SSc duration and subsets, and esophageal
      manometric impairment. CONCLUSIONS: Our study underlines the high frequency of
      gastric dysfunction in SSc patients. It suggests the usefulness of EGG in SSc in
      noninvasively detecting disorders of gastric electrical activity at an early
      stage and symptomatic patients with gastroparesis (because there was a
      correlation between values of postprandial to fasting ratio for electrical power
      of < 1 on EGG and delayed gastric emptying). Gastric-emptying evaluation of
      radiopaque pellets may further be a helpful method to depict symptomatic SSc
      patients with gastroparesis. Finally, our series confirms that watermelon stomach
      diagnosis should be excluded in SSc patients presenting with gastrointestinal
      hemorrhage or with anemia related to iron deficiency.

PMID- 11197292
TI  - Genetic and familial considerations of primary biliary cirrhosis.
AB  - The genetic basis of human autoimmune diseases is receiving increasing attention.
      Primary biliary cirrhosis (PBC) is a model autoimmune disease reflective of other
      organ-specific autoimmune pathology. PBC is an enigmatic autoimmune disease that
      predominantly affects women and leads to destruction of intrahepatic bile ducts.
      The serological hallmark of this disease is characterized by antimitochondrial
      antibodies that specifically react with the E2 components of 2-oxodehydrogenase
      enzymes, including PDC-E2. There are no clear major histocompatibility complex
      associations with the development of PBC, despite the observation that first
      degree relations of index patients with PBC have a 4-6% prevalence of development
      of PBC. This risk factor is comparable or higher than any other human autoimmune
      disease and suggests that a genome-wide approach towards dissection of genetic
      associations would lead to valuable new insights. In this review, we place these
      concepts in perspective and highlight in particular the genetic associations in
      PBC and the importance of studying siblings with PBC who are concordant for
      disease.

PMID- 11197293
TI  - Seroprevalence of Helicobacter pylori in patients with colorectal polyps and
      colorectal carcinoma.
AB  - OBJECTIVES: The role of Helicobacter pylori in the pathogenesis of colorectal
      polyps and colorectal carcinoma is unknown. H. pylori infection causes fasting
      and meal stimulated hypergastrinemia. Gastrin increases colorectal mucosal
      proliferation and promotes tumor growth. We performed a prospective study to
      determine the seroprevalence of H. pylori in patients with colorectal polyps and
      colorectal carcinoma and in controls. METHODS: Blood samples were collected from
      189 patients with colorectal carcinoma, 57 patients with colorectal polyps, and
      179 controls. H. pylori serology was determined by an ELISA assay. RESULTS:
      Logistic regression showed no difference in seroprevalence of H. pylori between
      patients with colorectal cancer and controls (odds ratio, 1.1; 95% confidence
      interval, 0.7 to 1.8) or between patients with colorectal polyps and controls
      (odds ratio 1.3; 95% confidence interval, 0.7 to 2.5). Age and sex were not found
      to be associated with H. pylori infection. Patients in social classes IV and V
      were 2.3 times more likely to have H. pylori infection than those in social
      classes I, II, and III (95% confidence interval, 1.3 to 4.2). CONCLUSIONS: This
      study shows that there is no increase in the seroprevalence of H. pylori in
      patients with colorectal polyps or colorectal carcinoma compared with controls.
      These results do not support the hypothesis that there is a relationship between
      H. pylori infection and the development of colorectal neoplasia.

PMID- 11197294
TI  - Peptic ulcer bleeding: comparison of two hemostatic procedures.
AB  - OBJECTIVE: Bleeding is a serious complication of peptic ulcer. Endoscopic
      injection therapy is accepted as a homeostatic endoscopic treatment in acute
      nonvariceal of upper GI hemorrhages, particularly in bleeding peptic ulcers. The
      risk of rebleeding is predicted by the endoscopic appearance of ulcer features
      classified according to Forrest's criteria. METHODS: Two hundred twenty-three
      patients were selected from 1,003 emergency upper endoscopies for GI bleeding.
      According to Forrest's criteria, 99 well-matched patients with ulcers F1 and F2
      were considered at risk of rebleeding; 54 patients (group A) received local ulcer
      injection of epinephrine solution 1:10,000, whereas (group B) patients were
      treated with local epinephrine injection and then with endoscopic Hemoclips. (1)
      We considered the control of bleeding, the number of rebleeding episodes, the
      need for emergency surgery, and mortality. RESULTS: Bleeding ulcers stopped
      completely in 83.3% group A patients, and in 95.6% group B patients (p = not
      significant). In a subset of F1b patients the rebleeding rate was 31 % for group
      A and 0% for group B (p < 0.05). There was no mortality as a result of the
      procedure. There was a trend toward reducing surgery in favor of the combined
      therapy (0% vs 7.4%). No differences were found in transfusion requirements or
      mean hospitalization days. CONCLUSIONS: We conclude that endoscopic injection of
      l:10,000 epinephrine solution alone and epinephrine solution plus application of
      Hemoclips are equivalent therapies in treating bleeding and rebleeding from
      peptic ulcers. There was no difference between therapies in terms of need for
      surgery or mortality. Possibly combination therapy is more effective in treating
      ulcers that are actively oozing.

PMID- 11197295
TI  - A randomized controlled trial of total colonic decompression after colonoscopy to
      improve patient comfort.
AB  - OBJECTIVES: Bloating occurring after colonoscopy may cause significant discomfort
      in some patients. We sought to determine whether total colonic decompression
      decreased bloating and improved comfort after colonoscopy. METHODS: Consecutive
      outpatients undergoing elective colonoscopy were randomized to total colonic
      decompression or to the control group after completion of the routine
      colonoscopy. The colonoscope was advanced again to the cecum and the air
      aspirated during withdrawal in patients randomized to decompression and the
      procedure was terminated without decompression in control patients. Pain and
      bloating was assessed in the recovery room and in 24-48 h using a five-point
      scale. RESULTS: Sixty-five patients were randomized to decompression and 61 were
      randomized to the control group. The baseline demographic and procedural
      characteristics were similar between the two groups, but decompression took
      significantly longer (median, 17 min vs 14 min, p = 0.0002). Seventy-five percent
      of the decompression group and 80% of the control group denied any pain during
      colonoscopy. Significantly fewer patients from the decompression group complained
      of bloating after the procedure (25% vs 59%, p < 0.001) when questioned in the
      recovery room. However, comparable patients complained of postprocedure bloating
      when questioned in 24-48 h after the procedure (45% of decompression group vs 47%
      of control group, p = 0.86). The nurse and the endoscopist were poor at
      predicting the patient's bloating and significantly overestimated the level of
      pain. CONCLUSIONS: Total colonic decompression does not significantly reduce
      bloating after colonoscopy when assessed 24-48 h after the procedure.

PMID- 11197296
TI  - [What is your diagnosis? Erythema migrans].

PMID- 11197297
TI  - [Treatment of depression with St. Johns wort in general practice].
AB  - 70-90% of depressive patients are treated by their own family doctors.
      Recognising and treating depression is an important daily problem for family
      doctors. The severity of the disorder decides whether non-pharmacological therapy
      or pharmacotherapy is preferable. The choice and dosage of an antidepressant is
      dictated by the severity and the symptomatology of the disorder as well as the
      expected adverse effects. Not least on account of their low rate of adverse
      effects, phytotherapeutic agents are enjoying growing popularity among patients
      and thus assure high compliance. The use of herbal preparations is useful, in
      particular for mild to moderate depression in young patients or patients with a
      reserved attitude toward "chemical drugs". Of all phytopharmaceuticals St.-John's
      wort has been most widely scientifically documented for the treatment of
      depression.

PMID- 11197298
TI  - [St. Johns wort extract as plant antidepressant].
AB  - In 1998 a standardized hypericum extract has been approved in Austria and Germany
      for treatment of mild and moderate depression. The efficacy has been already
      recognized since 1984 from the German Health Authorities based on traditional
      knowledge. However, this has been substantiated in the subsequent years in
      controlled clinical trials. Twenty of these studies including a total of 1787
      patients have been filed, among them ten older studies in which hypericum was
      extracted with ethanol compared to newer studies in which the extract was
      methanol (LI 160). In the past ten years several controlled clinical trials have
      been conducted compared with placebo as well as synthetic antidepressants. These
      studies have shown that the effective dosage is within a range of 600-900 mg
      extract. The side effects are substantially fewer than with synthetic
      antidepressants and range within 3%. The most important risk is
      photosensitization, which is however without clinical relevance in the
      recommended dosages. Recent pharmacological studies revealed that hypericum
      extracts have a similar mechanism of action like the selective serotonin reuptake
      inhibitors (SSRI), however, very likely to a smaller extent.

PMID- 11197299
TI  - [Phytotherapeutic drugs and sleep].
AB  - Most of the studies about phythotherapeutics and sleep confirmed only hypnotic
      effects on subjective sleep variables. For LI 160, a hypericum extract, an
      induction of slow wave sleep was demonstrated in older volunteers. In patients
      with major depression (MD) an increase of slow wave sleep was observed by our
      group after a six week therapy with hypericum extract (LI 160) and after an
      adjunct therapy with Ginkgo biloba LI 1370 extract. In MD sleep disturbances and
      hypersecretion of glucocorticoids are common features. For LI 160 beneficial
      effects on depressed mood and for LI 1370 effects on cognitive functioning are
      well documented. The potential relationship between influence on sleep structure
      and the hypothalamic-pituitary-adrenal axis will be discussed within the
      neurophysiological-neuroendocrine "extended two process model" of sleep
      regulation.

PMID- 11197300
TI  - [Treatment of dysthymia].
AB  - Hippocrates described both melancholy and dysthymia. An episode of mild
      depression lasting up to 2 years, which does not make patients unfit to work,
      although the repressive irritative mood disorder does reduce their ability to
      work. Severe depressive moods can develop from dysthymia. While dysthymia
      responds to antidepressant treatment similarly to depressive episodes, treatment
      must be carried out for a considerably longer period. The dosage dose not differ
      from that for severe depressive episodes. A few examples of cases are presented
      from the speaker's own cases to illustrate how well they responded to treatment
      with St.-John's wort.

PMID- 11197301
TI  - Allelic variants of human beta-chemokine receptor 5 (CCR5) promoter: evolutionary
      relationships and predictable associations with HIV-1 disease progression.
AB  - Variability in the natural history of HIV-1 infection has been repeatedly
      associated with genetic variants in the beta-chemokine receptor 5 (CCR5) locus.
      While CCR5 coding sequences have demonstrated relatively limited variation,
      sequences of its promoter appear polymorphic in all major populations. Our
      studies revealed five major CCR5 promoter alleles with distributions that
      differed widely among the four distinct ethnic groups from Kigali, Rwanda and
      Bronx, New York. In particular, promoter allele P*0103 (G59029-T59353-T59356
      A59402-C59653) was largely restricted to black subjects. The promoter allele
      P*0202 (A59029-C59353-C59356-A59402-T59653) was tightly linked to the slightly
      less frequent CCR2b-641, a variant of the CCR2b gene, which is about 12.7 kbp
      upstream from the promoter region. Another closely related promoter allele P*0201
      (A59029-C59353-C59356-A59402-C59653) exclusively carried the far less common CCR5
      delta 32, a 32-bp deletion in the CCR5 coding sequence 2 kbp downstream from the
      promoter. The homozygous P*0201/*0201 genotype can be predicted as a risk factor
      for more rapid disease progression. Among human, chimpanzee, pig-tailed macaque,
      and sooty mangabey promoter allelic sequences, the apparent ancestral lineage of
      the promoter sequence (G59029-T59353-C59356-A59402-C59653 = human P*0102) was
      highly conserved across the primate species analyzed here while P*0201 and P*0202
      arose more recently than the other three major alleles. Further effort to
      establish the mechanism by which CCR chemokine receptor polymorphisms govern the
      initiation and pathogenesis of primate lentivirus infection apparently requires
      fully detailed genotypic characterization of the affected populations.

PMID- 11197303
TI  - Cytokine gene polymorphism in human disease: on-line databases.
AB  - The pathologies of many infectious, autoimmune and malignant diseases are
      influenced by the profiles of cytokine production in pro-inflammatory (TH1) and
      anti-inflammatory (TH2) T cells. Interindividual differences in cytokine profiles
      appear to be due, at least in part, to allelic polymorphism within regulatory
      regions of cytokine gene. Many studies have examined the relationship between
      cytokine gene polymorphism, cytokine gene expression in vitro, and the
      susceptibility to and clinical severity of diseases. A review of the findings of
      these studies is presented. An on-line version featuring appropriate updates is
      accessible from the World Wide Web site,
      http://www.pam.bris.ac.uk/services/GAI/cytokine4.htm.

PMID- 11197302
TI  - Genetic analysis of multiplex rheumatoid arthritis families.
AB  - To examine the genetic contribution of HLA and non-HLA genes in the
      etiopathogenesis of rheumatoid arthritis (RA), 60 Caucasian multiplex families
      were identified and DNA analyzed for over 52 markers including DRB1, DQA1 and
      DQB1 alleles. Many of the markers were chosen because of close proximity to
      candidate genes suggested by previous studies or models of pathogenesis. Sibling
      pair analysis (SIBPAL), relative pair analysis (RELPAL) and linkage studies using
      two different models of inheritance suggested linkage for the MHC and two
      additional chromosomal regions: chromosome 2 (D2S443 near CD8 and IGk; 2p13
      2p11.1), and chromosome 15 (CYP19-estrogen synthase; 15q15). No support was found
      for two chromosomal regions, 1p36 and 3q13, recently suggested by other studies.
      We used transmission disequilibrium testing (TDT), conditional logistic
      regression, and segregation analysis to study the contributions that the shared
      epitope and TNF-c have in contributing to risk for RA. These studies provide
      additional evidence that the association of HLA alleles in RA patients from
      multiplex families is similar to that observed in sporadic disease, suggest
      candidate regions for further analysis and find additional support for an
      association of TNF-c alleles with RA susceptibility.

PMID- 11197304
TI  - The interferon gene cluster: a candidate region for MS predisposition? Multiple
      Sclerosis Study Group.
AB  - The clinical benefits of interferon (IFN) beta therapy in some multiple sclerosis
      (MS) patients are still unexplained, raising the question whether polymorphism
      within the IFNB gene itself would provide an explanation. Screening the IFNB gene
      by single strand conformation polymorphism (SSCP) analysis and sequencing, a
      single nucleotide polymorphism was identified. Both alleles were distributed with
      similar frequencies in MS patients and controls. Significant linkage
      disequilibrium (LD) between the IFN allele [153C] and allele [02] of the
      previously analyzed IFNA microsatellite (Epplen et al. Ann Neurol 1997; 41: 341
      352) was observed in MS patients only, indicating a disease related haplotype. On
      the other hand an increased risk (RR = 12.41; Pc < 8 x 10(-5)) was observed for
      allele [07]. Hence the study was extended to neighbouring genes. Functionally
      relevant polymorphisms, i.e., premature stop codons in the IFNA10 [Cys20Stop] and
      IFNA17 [58Stop] genes and an aminoacid (aa) substitution [ile 184Arg] in the
      IFNA17 gene were analyzed. Patients carrying a non-functional IFNA17 allele bear
      an increased risk to develop MS (RR = 25.68; Pc < 0.06). In addition, LD analysis
      between IFNA10 [Cys20Stop], IFNA17 [58Stop] and the IFNA microsatellite alleles
      provides evidence for IFNA14, IFNA16 or IFNA5 as additional, most likely
      candidate genes. The present study excludes the IFNB gene as a candidate for MS
      predisposition but provides first evidence for predisposing IFNA genes.

PMID- 11197305
TI  - Association of IL-6 gene alleles with systemic lupus erythematosus (SLE) and with
      elevated IL-6 expression.
AB  - To evaluate the association of alleles of regions having regulatory potential in
      the IL-6 gene, with SLE, the AT-rich minisatellite in the 3' flanking region and
      the 5' promoter-enhancer of the IL-6 gene were genotyped by PCR- and RFLP-based
      methods. The AT-rich minisatellite allele distribution pattern was significantly
      different in SLE (n = 146) as compared to 139 controls (chi 2(7) = 48.97, P =
      0.001, Caucasians; and chi 2(7) = 19.93, P = 0.006, African-Americans). In either
      race, short allele sizes (< or = 792 bp) were seen exclusively in SLE patients (P
      = 0.001), whereas the 828-bp allele was over-represented in controls (P = 0.015
      and 0.002). In contrast, there was no preferential association of SLE with G/C
      alleles in the 5' region of the IL-6 gene. Furthermore, our results suggest that
      the 3' minisatellite alleles have biological significance: (1) B lymphoblastoid
      cells of patients having one or two SLE-associated alleles secreted IL-6 in 3- to
      4-fold higher levels than non-allelic cells (P < 0.05); (2) higher percentages
      (approximately 4-fold) of IL-6 positive monocytes were observed in individuals
      having SLE-associated IL-6 alleles; (3) in lupus patients having SLE-associated
      minisatellite alleles, IL-6 mRNA stability was significantly enhanced.

PMID- 11197306
TI  - Association of Fc gamma receptor IIIB, but not of Fc gamma receptor IIA and IIIA
      polymorphisms with systemic lupus erythematosus in Japanese.
AB  - Human Fc gamma receptor (Fc gamma R) genes form a clustered gene family on
      chromosome 1q21-24. Although the association of Fc gamma R polymorphisms with
      systemic lupus erythematosus (SLE) has been extensively studied, the results are
      often contradictory. In this study, Fc gamma RIIA-131H/R, Fc gamma RIIIA-176F/V
      and Fc gamma RIIIB-NA1/2 genotypes were determined in the Japanese patients with
      SLE (n = 81) or rheumatoid arthritis (RA, n = 115) as well as in healthy
      individuals (n = 217), and possible association with the disease was tested using
      case-control analysis. Unlike in other populations, significant difference was
      not observed in the frequencies of Fc gamma RIIA and Fc gamma RIIIA genotypes
      between patients with SLE and healthy individuals. However, significant
      difference was detected in the frequencies of Fc gamma RIIIB genotypes between
      SLE and healthy individuals (P = 0.008). The odds ratio [OR] of the Fc gamma
      RIIIB-NA2/NA2 homozygotes for the development of SLE was 2.52 (95% confidence
      interval [CI]: 1.33-4.79). Among the patients with SLE, individuals with NA2/2
      were significantly more likely to have lupus nephritis (P = 0.007). No
      association was observed between any of the Fc gamma R polymorphisms and RA.
      Significant linkage disequilibrium was detected between Fc gamma RIIIA and IIIB,
      but neither between IIA and IIIA, nor between IIA and IIIB. These observations
      may underscore the relevance of defective immune complex handling in the
      pathogenesis of SLE, or may suggest the presence of primarily associated gene(s)
      in linkage disequilibrium with Fc gamma R genes.

PMID- 11197307
TI  - An IL-13 promoter polymorphism associated with increased risk of allergic asthma.
AB  - IL-13 plays a crucial role in the development of allergic asthma by several
      mechanisms, including induction of IgE antibodies, airway eosinophilia and hyper
      reactivity. We previously established a deregulated production of IL-13 by T
      cells from allergic asthma patients. In this report we describe the
      identification of a novel IL-13 promoter polymorphism (C to T exchange) at
      position -1055. The IL-13 -1055 TT genotype is associated with allergic asthma (P
      = 0.002), altered regulation of IL-13 production (P < 0.002), and increased
      binding of nuclear proteins to this region. We postulate that the presence of
      this polymorphism predisposes to the development of allergic asthma.

PMID- 11197308
TI  - Heat-shock protein (HSP70-2) allelic frequencies in three distinct Mexican
      populations.
AB  - The major histocompatibility complex (MHC) genes are highly polymorphic and
      therefore have been useful in population genetics and disease association
      studies. We analyzed restriction fragment length polymorphism of HSP70-2 alleles
      in healthy unrelated Mestizo, Mazatecan and Nahua populations. Both Indian
      groups, Mazatecans and Nahuas, were in Hardy-Weinberg equilibrium, while Mestizos
      were in disequilibrium (chi 2 = 0.399; P < 0.05). The Mazatecan Indians presented
      a high frequency of BB homozygosity (17.35%) compared to Mestizos (5%) (P =
      0.01). Mexican ethnic groups present differences in distribution of BB genotype.
      The low frequency of BB genotype in Mestizos may be the result of a negative
      selection process.

PMID- 11197309
TI  - What's new in Nicotine & Tobacco Research?

PMID- 11197310
TI  - Newspaper advertising could distort research results.

PMID- 11197311
TI  - Correlates of youth smokeless tobacco use.
AB  - The objectives of this study are to identify knowledge and attitude variables
      that correlate with smokeless tobacco use and how youth users and non-users
      differ in their attitudes and knowledge about smokeless tobacco. A randomized
      cluster sample of 1834 total fifth, eighth, and 11th grade students in West
      Virginia public schools during the 1996-1997 school year were surveyed on
      smokeless tobacco knowledge, attitudes and practices. Data from 648 male non
      users and 160 male monthly and daily users of smokeless tobacco were compared
      using chi 2 and two-tailed t-tests. Logistic regression analysis of survey
      variables revealed the following correlates of smokeless tobacco use: having a
      family member not living in the home who uses, having a friend who uses, playing
      football, having tried cigarettes, and having parents who would permit use at
      home. Important differences exist in knowledge and attitudes regarding smokeless
      tobacco between users and non-users in fifth, eighth, and 11th grade West
      Virginia public schools. Correlates of smokeless tobacco use are identified which
      can be used to target prevention programs.

PMID- 11197312
TI  - Does smoking reduction result in reduction of biomarkers associated with harm? A
      pilot study using a nicotine inhaler.
AB  - The aim of the study was to determine if smoking reduction using a nicotine
      inhaler in heavy cigarette smokers who wanted to reduce but not stop smoking
      results in decreased levels of known biomarkers of harm. The study design was a
      one-sample within-subject comparative open-label study of 23 (10 male and 13
      female) subjects using a nicotine inhaler to reduce smoking, with follow-up at 24
      weeks. A structured protocol was used with a smoking-reduction schedule from 40
      or more cigarettes per day to 10 cigarettes per day by week 9. Behavioral
      counseling was provided by a research assistant and ad lib use of the nicotine
      inhaler for 12 weeks was permitted. Blood thiocyanate, cotinine, 4-aminobiphenyl
      hemoglobin adducts; urine NNAL and NNAL-glucuronide; and expired air carbon
      monoxide were measured. On average, the subjects were able to reduce their
      smoking by over 50% at week 12, but only two were able to reduce to 10 cigarettes
      per day. The reported reduction in smoking was not associated with a consistent
      reduction in the biomarkers. There was no reduction in the NNAL, 4-aminobiphenyl
      hemoglobin adducts nor carbon monoxide levels of expired air. There was a
      significant reduction of NNAL-glucuronide and the sum of NNAL and NNAL
      glucuronide but only at week 24. Thiocyanate levels increased. Before widely
      promoting harm reduction as a treatment strategy for heavy smokers, more research
      needs to be performed to prove conclusively that such smokers who want to reduce
      but not stop can actually reduce and maintain their smoking rate at a level which
      is likely to reduce harm. It also needs to be determined whether a reduction in
      the smoking rate translates into reduction of harm. At the present, for heavy
      smokers, an abstinence approach seems to be more scientifically sound.

PMID- 11197313
TI  - Ethnic differences in patterns and correlates of age of initiation in a
      population of Air Force recruits.
AB  - Early age of initiation is a significant risk factor for long-term dependent
      smoking and may also relate to other unhealthy behaviors. The current study
      assessed age of initiation in relationship to smoking dependence and motivation
      to quit, physical activity, dietary intake, body mass index (BMI), attitude
      toward illegal drug use, binge drinking, seat belt use, and smoking status at
      follow-up. Subjects were 7995 Air Force recruits who reported smoking regularly
      up to Basic Military Training. Euro-Americans initiated smoking more than a year
      earlier on average (15.5 years) than did African-Americans (16.8 years), with
      Hispanic-Americans (16.0 years) between these two groups. No gender differences
      were found for age of initiation for any ethnic group. Early age of initiation in
      Euro-Americans was associated with greater dependence on tobacco, reduced
      motivation to quit, less likelihood of quitting in the next 12 months, and a
      number of other health risk factors including lower self-reported physical
      activity, greater intake of high-fat foods, more favorable attitudes toward
      illegal drugs, increased likelihood of binge drinking, and less reported use of
      seat belts. Relationships between early age of initiation and other unhealthy
      behaviors were less consistent for African-Americans and for neither African
      Americans nor Hispanics did age of initiation predict smoking status at 1-year
      follow-up.

PMID- 11197314
TI  - Effects of nicotine replacement therapy on markers of oxidative stress in
      cigarette smokers enrolled in a smoking cessation program.
AB  - Twenty healthy, asymptomatic long-term cigarette smokers (8 males, 12 females;
      mean age: 43 +/- 9 years) were selected at random from a larger series receiving
      nicotine replacement therapy (NRT) for 12 weeks to study the effects of NRT on
      plasma markers of oxidative stress. Plasma aliquots, obtained at baseline (T0)
      and after 12 weeks (T12) of NRT, were used to measure malondialdeyde (MDA) and
      total Trolox-equivalent antioxidant capacity (TEAC). In subjects who completely
      quit smoking ('quitters', n = 10), MDA was higher at T0 (1.08 mumol/l,
      interquartile range 0.85-1.16) than at T12 (0.71 mumol/l, range 0.32-0.92; p <
      0.01), and TEAC was lower at T0 (1.20 mM, range 1.11-1.31) than at T12 (1.43 mM,
      range 1.31-1.49; p < 0.05). In subjects who had only reduced the number of
      cigarettes smoked per day ('reducers', n = 10), differences between the T0 and
      T12 levels of MDA (0.81 [0.75-0.96] vs. 0.76 [0.58-0.84] mumol/l) and TEAC (1.28
      [1.05-1.50] vs. 1.25 [1.09-1.42] mM) were not significant. At T0, MDA and
      cotinine levels correlated in reducers (r = 0.79, p < 0.05) and, though not
      significantly, in quitters (r = 0.50, p = 0.12). At T12 this relationship between
      MDA and cotinine was still present in the reducers (r = 0.70, p < 0.05), while
      the scatter of points in quitters was completely dispersed (r = (0.09). These
      results show that smoking cessation but not smoking reduction is associated with
      decreased markers of oxidative stress in the plasma of active cigarette smokers.

PMID- 11197315
TI  - Effect of cigarette smoking on coumarin metabolism in humans.
AB  - Extant data, mostly from studies in vitro, suggest that coumarin and nicotine are
      both metabolized by CYP2A6, a cytochrome P450 isozyme. In order to investigate
      this issue further, the activity of this enzyme in vivo was measured in 37 non
      smokers and 37 smokers using coumarin (2.0 mg, PO) as the metabolic probe. The
      percentage of coumarin metabolized to 7-hydroxycoumarin in 8 h was measured in
      urine by high-pressure liquid chromatography. There was more than 10-fold
      variability in coumarin metabolism in both groups. Coumarin metabolism was
      significantly reduced in smokers (46.6 +/- 4.4%) as compared to non-smokers (66.4
      +/- 3.5%; p < or = .001). The results support previous in vitro findings that
      both coumarin and nicotine are metabolized, at least in part, by a common
      pathway, which most likely is CYP2A6.

PMID- 11197316
TI  - Socioeconomic status, ethnicity, and environmental tobacco exposure among non
      smoking females.
AB  - This study examined the relationship between socioeconomic status (SES) and
      environmental tobacco smoke (ETS) exposure among non-smoking females, determined
      which SES variable(s) were most strongly associated with ETS exposure, and
      examined whether the relationship between SES and ETS exposure was the same for
      Blacks and Whites. Participants were 404 never-smoker females recruited in the
      community. Independent variables included income, education, occupation, median
      income within zip code of participants' residence, and ethnicity. Number of days
      per week exposed to ETS in the past year was the dependent variable. There was a
      significant correlation between CO levels (parts per million, ppm) and self
      reported ETS exposure (r = 0.22, p < 0.001). The mean CO level exposure was 1.81
      +/- 1.19 ppm, and the mean number of days per week of ETS exposure was 4.72 +/-
      4.71. The most frequent source of ETS exposure was at public places (64.4%).
      Although Blacks tended to report higher ETS exposure than Whites (p = 0.08), this
      tendency disappeared when SES indicators were entered in the model. Correlations
      among SES indicators were either non-significant or very modest suggesting that
      different SES indicators may not measure the same construct. Education was the
      only SES variable that was significantly associated with ETS exposure in this
      population. The relationship between SES and ETS exposure was similar for both
      Blacks and Whites. These findings suggest that education may be the most
      important factor to be considered when designing interventions to decrease ETS
      exposure among young non-smoking females (e.g., public education of the hazards
      of ETS exposure and awareness of existing tobacco-control laws and regulations).

PMID- 11197317
TI  - A self-help cessation program for smokeless tobacco users: comparison of two
      interventions.
AB  - While the use of smokeless tobacco products has increased, there has been a
      paucity of research evaluating interventions to help users quit. This study is
      the first large-scale randomized trial evaluating two levels of self-help
      cessation intervention with adult smokeless tobacco (SLT) users. Smokeless users
      in five Northwest states were recruited to call a toll-free number and 1069 users
      were randomized to receive one of two interventions, Manual Only (MAN) or
      Assisted Self-Help (ASH), who received a video and two support phone calls in
      addition to the manual. The study demonstrated that low-cost minimal
      interventions done by mail and phone can help a sizable proportion of SLT users
      quit both SLT and all tobacco use. Follow-up data at 6 months showed that
      subjects in the ASH condition had a significantly higher quit rate for both
      smokeless (23.4% vs. 18.4%, p < 0.05) and all tobacco use (21.1% vs. 16.5%, p <
      0.05), using an intent-to-treat model. Further analysis revealed that use of the
      recommended cessation procedures mediated the effect of intervention condition on
      outcomes. This may be the result of phone counselors getting subjects to carry
      out behavioral cessation procedures. Public health implications for this
      intervention are discussed.

PMID- 11197318
TI  - Efficacy of the nicotine patch for relief of craving and withdrawal 7-10 weeks
      after cessation.
AB  - The objective of this study was to test the efficacy of the nicotine patch for
      relief of craving and withdrawal beyond 6 weeks (during weeks 7-10), among heavy,
      dependent smokers, using a multicenter, randomized, double-blind, placebo
      controlled trial. The subjects were 421 nicotine-dependent smokers who had quit
      smoking with the NicoDerm CQ nicotine patch, recruited from among enrollees in
      the NicoDerm CQ Committed Quitters behavioral program. Following 6 weeks of 21-mg
      active patch use, participants who had not relapsed were randomized to receive
      either active or placebo patches for an additional 4 weeks with tapering (14-mg
      patch in weeks 7-8 and 7-mg patch in weeks 9-10). Craving and withdrawal symptoms
      were assessed daily by phone interview during weeks 7-10 following cessation. The
      active patch group reported significantly lower craving and withdrawal, and
      higher positive mood scores in weeks 7-8 (p < 0.001, 0.001, and 0.03,
      respectively) and weeks 9-10 (p < 0.02, 0.01, and 0.02, respectively) compared to
      the placebo group. It was concluded that some smokers may be best served by 10
      weeks of patch treatment. This study demonstrated the utility of continuing patch
      treatment for symptom relief in weeks 7-10 of abstinence. Future research should
      examine the optimal duration of treatment, which may vary across different
      classes of smokers.

PMID- 11197319
TI  - Reducing tobacco use: a report of the Surgeon General--executive summary.

PMID- 11197320
TI  - Phylogenetic origin of a secondary pathway: the case of pyrrolizidine alkaloids.
AB  - Recent studies have revealed high sequence similarity between homospermidine
      synthase (HSS), the first pathway-specific enzyme in the biosynthesis of
      pyrrolizidine alkaloids, a class of sporadically occurring plant defence
      compounds, and deoxyhypusine synthase (DHS), a ubiquitous enzyme involved in the
      post-translational activation of the eukaryotic initiation factor 5A (eIF5A). The
      recruitment of DHS during the evolution of the alkaloid pathway is discussed and
      interpreted as evolution by change of function.

PMID- 11197321
TI  - The role of hexokinase in plant sugar signal transduction and growth and
      development.
AB  - Previous studies have revealed a central role of Arabidopsis thaliana hexokinases
      (AtHXK1 and AtHXK2) in the glucose repression of photosynthetic genes and early
      seedling development. However, it remains unclear whether HXK can modulate the
      expression of diverse sugar-regulated genes. On the basis of the results of
      analyses of gene expression in HXK transgenic plants, we suggest that three
      distinct glucose signal transduction pathways exist in plants. The first is an
      AtHXK1-dependent pathway in which gene expression is correlated with the AtHXK1
      mediated signaling function. The second is a glycolysis-dependent pathway that is
      influenced by the catalytic activity of both AtHXK1 and the heterologous yeast
      Hxk2. The last is an AtHXK1-independent pathway in which gene expression is
      independent of AtHXK1. Further investigation of HXK transgenic Arabidopsis
      discloses a role of HXK in glucose-dependent growth and senescence. In the
      absence of exogenous glucose, plant growth is limited to the seedling stage with
      restricted true leaf development even after a 3-week culture on MS medium. In the
      presence of glucose, however, over-expressing Arabidopsis or yeast HXK in plants
      results in the repression of growth and true leaf development, and early
      senescence, while under-expressing AtHXK1 delays the senescence process. These
      studies reveal multiple glucose signal transduction pathways that control diverse
      genes and processes that are intimately linked to developmental stages and
      environmental conditions.

PMID- 11197322
TI  - Caleosins: Ca2+-binding proteins associated with lipid bodies.
AB  - We have previously identified a rice gene encoding a 27 kDa protein with a single
      Ca2+-binding EF-hand and a putative membrane anchor. We report here similar genes
      termed caleosins, CLO, in other plants and fungi; they comprise a multigene
      family of at least five members in Arabidopsis (AtClo1-5). Northern hybridization
      demonstrated that AtClo2-4 mRNAs levels were low in various tissues, while AtClo1
      mRNA levels were high in developing embryos and mature seeds. Analysis of
      transgenic Arabidopsis plants expressing the GUS reporter under control of the
      AtClo1 promoter showed strong levels of expression in developing embryos and also
      in root tip cells. Antibodies raised against AtCLO1 were used to detect caleosin
      in cellular fractions of Arabidopsis and rapeseed. This indicated that caleosins
      are a novel class of lipid body proteins, which may also be associated with an ER
      subdomain.

PMID- 11197323
TI  - Increased abundance of MTD1 and MTD2 mRNAs in nodules of decapitated Medicago
      truncatula.
AB  - To gain insight into the molecular processes occurring in root nodule metabolism
      after stress, we used a mRNA differential display (DDRT-PCR) approach to identify
      cDNAs corresponding to genes whose expression is enhanced in nodules of
      decapitated Medicago truncatula plants. Two full-length cDNAs of plant origin
      were isolated (MTD1 and MTD2). Sequence analysis revealed that MTD1 is identical
      to an EST clone (accession number AW559774) expressed in roots of M. truncatula
      upon infection with Phytophthora medicaginis, while MTD2 is highly homologous to
      an Arabidopsis thaliana gene (accession number AL133292) coding for a RNA binding
      like protein. The two mRNAs started to accumulate in root nodules at 4 h after
      plant decapitation and reached even higher transcript levels at 24 h from the
      imposition of the treatment. MTD1 and MTD2 mRNAs were mainly induced in nodules,
      with very little induction in roots. The abundance of the two transcripts did not
      change in response to other perturbations known to decrease nitrogenase activity,
      such as nitrate and Ar/O2 treatments. Our results suggest that MTD1 and MTD2
      represent transcripts that accumulate locally in nodules and may be involved in
      changes in nodule metabolism in response to decapitation.

PMID- 11197324
TI  - Identification and characterization of a heat-induced isoform of aldolase in oat
      chloroplast.
AB  - An analysis of protein synthesis at elevated temperatures in oat (Avena sativa)
      leaves revealed a heat-induced 44 kDa polypeptide. A cDNA library of heat-treated
      leaves was constructed and screened with specific antibodies raised against this
      44 kDa polypeptide. A clone encoding the 44 kDa protein was identified as a form
      of the chloroplast-localized fructose-bisphosphate aldolase (EC 4.1.2.13).
      Northern and western blot analyses indicated heat-induced accumulation of the
      chloroplast aldolase isoform at both the RNA and protein level. Heat inducibility
      was restricted to the chloroplastic form of the enzyme, and was not observed for
      the cytoplasmic aldolase. The heat-induced isoform co-purified with thykaloid
      fractions, as confirmed by immunoassay and activity analyses. However, when
      thylakoid membranes were treated with proteinase K, the aldolase isoform
      completely disappeared, suggesting that this enzyme is not embedded but rather
      tends to adhere to the chloroplast membranes. Immunoblot analysis of other plant
      species revealed similar heat induction of thykaloid-associated aldolase
      homologues, suggesting the possible existence of a universal control mechanism
      for this enzyme's heat tolerance

PMID- 11197325
TI  - The Arabidopsis thaliana PPX/PP4 phosphatases: molecular cloning and structural
      organization of the genes and immunolocalization of the proteins to plastids.
AB  - The PPX/PP4 Ser/Thr protein phosphatases belong to the type 2A phosphatase
      subfamily and are present in most eukaryotic organisms. We have previously
      isolated two closely related DNAs encoding PPX isoforms (PPX-1 and PPX-2) of
      Arabidopsis thaliana. Here we report the molecular cloning of the genes encoding
      these proteins. The genes PPX-1 and PPX-2 are composed of eight exons and seven
      introns located at equivalent positions related to the coding sequences. Whereas
      the intron-exon organization of the PPX genes is completely different from that
      of the PP2A-3/PP2A-4 A. thaliana family, specific intron-exon boundaries are
      conserved among PPX genes from distantly related organisms. Based on GUS
      expression, both PPX genes show the same spatial and temporal pattern of
      expression: they are expressed in all the organs and tissues analyzed, and from
      the earliest stage of development. When PPX proteins were localized to the root
      in semi-thin methacrylate sections by immunofluorescence, staining was
      predominantly confined to small organelles, shown to be plastids by co
      localization of PPX and ferredoxin. Interestingly, only some ferredoxin-positive
      plastids were also PPX-positive, and PPX staining was consistently brighter in
      the epidermis. The localization was confirmed with immunogold and electron
      microscopy. Our results suggest that, despite its strong sequence conservation,
      PPX in plants functions differently than in animals.

PMID- 11197326
TI  - Two rice MADS domain proteins interact with OsMADS1.
AB  - OsMADS1 is a MADS box gene controlling flower development in rice. In order to
      learn more about the function of OsMADS1, we searched for cellular proteins
      interacting with OsMADS1 employing the yeast two-hybrid system. Two novel
      proteins with MADS domains, which were named OsMADS14 and OsMADS15, were isolated
      from a rice cDNA library. OsMADS14 and -15 are highly homologous to the maize
      MADS box gene ZAP1 which is an orthologue of the floral homeotic gene APETALA1
      (AP1). Interactions among the three MADS domain proteins were confirmed by in
      vitro experiments using GST-fused OsMADS1 expressed in Escherichia coli and in
      vitro translated proteins of OsMADS14 and -15. We determined which domains in
      OsMADS1, -14, and -15 were required for protein-protein interaction employing the
      two-hybrid system and pull-down experiments. While the K domain was essential for
      protein-protein interaction, a region preceded by the K domain augmented this
      interaction. Interestingly, the C-terminal region of OsMADS1 functioned as a
      transcriptional activation domain in yeast and mammalian cells, while, on the
      other hand, the C domains of OsMADS14 and -15 exhibited only very weak
      transcriptional activator functionality, if any at all.

PMID- 11197327
TI  - The sequence and secondary structure of the 3'-UTR affect 3'-end maturation, RNA
      accumulation, and translation in tobacco chloroplasts.
AB  - RNA maturation and modulation of RNA stability play important roles in
      chloroplast gene expression. In vitro and in vivo studies have shown that both
      the 5'- and 3'-untranslated regions (UTRs) contain sequence and structural
      elements that guide these processes, and interact with specific proteins. We have
      previously characterized the spinach chloroplast petD 3'-UTR in detail by in
      vitro approaches. This stem-loop forming sequence is a weak terminator but is
      required for RNA maturation and also exhibits sequence-specific protein binding.
      To test petD 3'-UTR function in vivo, tobacco chloroplast transformants were
      generated containing uidA reporter genes flanked by variants of the petD 3'-UTR,
      including one which does not form an RNA-protein complex in vitro, and one which
      lacks a stem-loop structure. Analysis of uidA mRNA indicated that a stable
      secondary structure is required to accumulate a discrete mRNA, and that changes
      in the 3'-UTR sequence which affect protein binding in vitro can also affect RNA
      metabolism in vivo. The 3'-UTR also influenced beta-glucuronidase protein
      accumulation, but not in proportion to RNA levels. These results raise the
      possibility that in tobacco chloroplasts, the 3'-UTR may influence translational
      yield.

PMID- 11197328
TI  - Binding of cell type-specific nuclear proteins to the 5'-flanking region of maize
      C4 phosphoenolpyruvate carboxylase gene confers its differential transcription in
      mesophyll cells.
AB  - C4-type phosphenolpyruvate carboxylase (C4PEPC) acts as a primary carbon
      assimilatory enzyme in the C4 photosynthetic pathway. The maize C4PEPC gene
      (C4Ppc1) is specifically expressed in mesophyll cells (MC) of light-grown leaves,
      but the molecular mechanism responsible for its cell type-specific expression has
      not been characterized. In this study, we introduced a chimeric maize C4Ppc1 5'
      flanking region/beta-glucuronidase (GUS) gene into maize plants by Agrobacterium
      mediated transformation. Activity assay and histochemical staining showed that
      GUS is almost exclusively localized in leaf MC of transgenic maize plants. This
      observation suggests that the introduced 5' region of maize C4Ppc1 contains the
      necessary cis element(s) for its specific expression in MC. Next, we investigated
      whether the 5' region of the maize gene interacts with nuclear proteins in a cell
      type-specific manner. By gel shift assays with nuclear extracts prepared from MC
      or bundle sheath cells (BSC), cell type-specific DNA-protein interactions were
      detected: nuclear factors PEP(Ib) and PEP(Ic) are specific to MC whereas PEP(Ia)
      and PEP(IIa) are specific to BSC. Light alters the binding activity of these
      factors. These interactions were not detected in the assay with nuclear extract
      prepared from root, or competed out by oligonucleotides corresponding to the
      binding sites for the maize nuclear protein, PEP-I, which is known to bind
      specifically to the promoter region of C4Ppc1. The results suggest that novel
      cell type-specific positive and negative nuclear factors bind to the maize C4Ppc1
      5'-flanking region and regulate its differential transcription in MC in a light
      dependent manner.

PMID- 11197329
TI  - Genes normally expressed in the endosperm are expressed at early stages of
      microspore embryogenesis in maize.
AB  - Reproduction in flowering plants is characterized by double fertilization and the
      resulting formation of both the zygotic embryo and the associated endosperm. In
      many species it is possible to experimentally deviate pollen development towards
      an embryogenic pathway. This developmental switch, referred to as microspore
      embryogenesis or androgenesis, leads to the formation of embryos similar to
      zygotic embryos. In a screen for genes specifically expressed during early
      androgenesis, two maize genes were isolated by mRNA differential display. Both
      genes represent new molecular markers expressed at a very young stage of
      androgenic embryogenesis. When their expression pattern was studied during normal
      reproductive development, both showed early endosperm-specific expression.
      Investigation of the cytological features of young androgenic embryos revealed
      that they present a partially coenocytic organization similar to that of early
      endosperm. These findings suggest that maize androgenesis may possibly involve
      both embryogenesis and the establishment of endosperm-like components.

PMID- 11197330
TI  - 2,4-Disubstituted oxazoles and thiazoles as latent pharmacophores for
      diacylhydrazine of SC-51089, a potent PGE2 antagonist.
AB  - 8-Chlorodibenz[b,f][1,4]oxazepine-10(11H)-carboxylic acid, 2-[1-oxo-3-(4
      pyridinyl)propyl]hydrazide, monohydrochloride (1, SC-51089) is a functional PGE2
      antagonist selective for the EP1 receptor subtype with antinociceptive activity.
      Analogues of SC-51089, in which the diacylhydrazine moiety has been replaced with
      2,4-disubstituted-oxazoles and-thiazoles, are described.

PMID- 11197331
TI  - Synthesis and characterization of a tetranucleotide analogue containing
      alternating phosphonate-amide backbone linkages.
AB  - Described herein is the synthesis and characterization of a tetranucleotide, 5'
      dC-phosphonate-T-amide-T-ophosphonate-dC (III), in which the C-T and T-C steps
      contain a phosphonate backbone bond and T-T is a peptide nucleic acid dimer unit
      (neutral backbone). The 5'- and 3'-OH groups of the tetramer can be further
      derivatized and, thus, the compound is a potential building block for longer
      oligonucleotides which will contain alternating backbone modifications at
      designated positions. The synthesis involved first the preparation of two hybrid
      peptide-deoxyribose dinucleotides, CT-CO (I) and N-CT (II) (C and T are
      nucleobases; CO and N are carboxylic and amino terminal, respectively); each is
      linked through a phosphonate linkage. A condensation reaction between the two
      dimers, followed by deprotection, resulted in the formation of a peptide linkage
      to give the desired tetramer III. The reaction conditions used are mild to afford
      products in moderate to excellent yields. The DNA-PNA-DNA tetramer, d(CTTC), is a
      substrate for T4 kinase but fails to give a ligation product, even though NMR
      shows weak interactions between the tetramer III with its complementary sequence,
      d(GAAG).

PMID- 11197332
TI  - Specific inhibitor of puromycin-sensitive aminopeptidase with a homophthalimide
      skeleton: identification of the target molecule and a structure-activity
      relationship study.
AB  - 2-(2,6-Diethylphenyl)-1,2,3,4-tetrahydroisoquinoline-1,3-dione (2: PIQ-22) was
      found to be a potent and specific inhibitor of puromycin-sensitive aminopeptidase
      (PSA). Lineweaver-Burk plot analysis showed that PSA is inhibited by PIQ-22 in a
      non-competitive manner. Structure -activity relationship studies indicated that
      tautomerism of the imidobenzoylketone group in the cyclic imide moiety of the PIQ
      22 skeleton is important for the inhibitory activity.

PMID- 11197333
TI  - A phosphatidylinositol 3,4,5-trisphosphate analogue with low serum protein
      binding affinity.
AB  - Phosphatidylinositol 3,4,5-trisphosphate (PIP3) plays an important role in the
      regulation of diverse physiological functions. Recent evidence indicates that
      PIP3 is cell permeant, and can be added exogenously to modulate cellular
      responses. However, like many other phospholipids, PIP3 binds serum proteins with
      high affinity, resulting in rapid deactivation of this lipid second messenger.
      Our study indicates that bovine serum albumin (BSA) at concentrations as low as
      10 microg/mL abrogated the biological activity of dipalmitoyl-PIP3. This
      nonspecific interaction with serum proteins hampers the use of PIP3 in biological
      studies where serum is needed. We report here an ether-linked PIP3 analogue, 1-O
      (1-O-hexadecyl-2-O-methyl-sn-glycero-3-phosphoryl)-myo-inositol 3,4,5
      trisphosphate (C16Me-PIP3). which displays low serum protein-binding affinity
      while retaining the biological function of PIP3. The affinity of C16Me-PIP3 with
      BSA was two orders of magnitude lower than that of its dipalmitoyl-counterpart.
      Biochemical data indicate that C16Me-PIP3 was able to stimulate Ca2+ influx in T
      cells in the presence of moderate levels (up to 1 mg/mL) of BSA. Thus. C16Me-PIP3
      may provide a useful tool to study the physiological function of phosphoinositide
      (PI) 3-kinase in vivo.

PMID- 11197334
TI  - Estrogen pyrazoles: defining the pyrazole core structure and the orientation of
      substituents in the ligand binding pocket of the estrogen receptor.
AB  - Previously, we reported that certain tetrasubstituted 1,3,5-triaryl-4-alkyl
      pyrazoles bind to the estrogen receptor (ER) with high affinity (Fink, B. E.;
      Mortenson, D. S.; Stauffer, S. R.; Aron, Z. D.; Katzenellenbogen, J. A. Chem.
      Biol. 1999, 6, 205-219; Stauffer, S. R.; Katzenellenbogen, J. A. J. Comb/. Chem.
      2000, 2. 318 329; Stauffer, S. R.: Coletta, C. J.: Sun, J.; Tedesco, R.,
      Katzenellenbogen, B. S.; Katzenellenbogen, J. A. J. Med. Chem. 2000, submitted).
      To investigate how cyclic permutation of the two nitrogen atoms of a pyrazole
      might affect ER binding affinity, we prepared a new pyrazole core isomer, namely
      a 1,3,4-triaryl-5-alkyl-pyrazole (2), to compare it with our original pyrazole
      (1). We also prepared several peripherally matched core pyrazole isomer sets to
      investigate whether the two pyrazole series share a common binding orientation.
      Our efficient, regioselective synthetic route to these pyrazoles relies on the
      acylation of a hydrazone anion, followed by cyclization, halogenation, and Suzuki
      coupling. We found that the ER accommodates 1,3,4-triaryl-pyrazoles of the
      isomeric series only somewhat less well than the original 1,3,5-triaryl series,
      and it appears that both series share a common binding mode. This preferred
      orientation for the 1,3,5-triaryl-4-alkyl-pyrazoles is supported by binding
      affinity measurements of analogues in which the phenolic hydroxyl groups were
      systematically removed from each of the three aryl groups, and the orientation is
      consistent, as well, with molecular modeling studies. These studies provide
      additional insight into the design of heterocyclic core structures for the
      development of high affinity ER ligands by combinatorial methods.

PMID- 11197335
TI  - Triarylpyrazoles with basic side chains: development of pyrazole-based estrogen
      receptor antagonists.
AB  - Recently, we developed a novel triaryl-substituted pyrazole ligand system that
      has high affinity for the estrogen receptor (ER) (Fink, B. E.: Mortenson, D. S.:
      Stauffer, S. R.; Aron, Z. D.: Katzenellenbogen, J. A. Chem. Biol. 1999, 6, 205).
      Subsequent work has shown that some analogues in this series are very selective
      for the ERalpha subtype in terms of binding affinity and agonist potency
      (Stauffer, S. R.: Coletta, C. J.: Tedesco. R.: Sun, J.: Katzenellenbogen, J. A.
      J. Med. Chem. 2000, submitted). We now investigate how this pyrazole ER agonist
      system might be converted into an antagonist or a selective estrogen receptor
      modifier (SERM) by incorporating a basic or polar side chain like those typically
      found in antiestrogens and known to be essential determinants of their mixed
      agonist/antagonist character. We selected an N-piperidinyl-ethyl chain as a first
      attempt, and introduced it at the four possible sites of substitution on the
      pyrazole core structure to determine the orientation that the pyrazole might
      adopt in the ER ligand binding pocket. Of these four, the C(5) piperidinyl-ethoxy
      substituted pyrazole 5 had by far the highest affinity. Also, it bound to the ER
      subtype alpha (ERalpha) with 20-fold higher affinity than to ERbeta. In cell
      based transcription assays, pyrazole 5 was an antagonist on both ERalpha and
      ERbeta, and it was also more potent on ERalpha. Based on structure-binding
      affinity relationships and on molecular modeling studies of these pyrazoles in a
      crystal structure of the ERalpha-raloxifene complex, we propose that pyrazoles
      having a basic substituent on the C(5) phenyl group adopt a binding mode that is
      different from that of the pyrazole agonists that lack this group. The most
      favorable orientation appears to be one which places the N(1) phenol in the A
      ring binding pocket so that the basic side chain can adopt an orientation similar
      to that of the basic side chain of raloxifene.

PMID- 11197336
TI  - Synthesis and cytotoxicity of 4'-C- and 5'-C-substituted toyocamycins.
AB  - Toyocamycin and some analogues have shown potent antitumor activities; however,
      none of them could be used clinically primarily owing to their cytotoxicity to
      normal human cells. In order to overcome the weakness of these nucleoside
      analogues, substitution of a variety of modified sugars for the ribofuranose was
      explored in our laboratories with expectation that certain sugar-modified
      toyocamycin analogues may be selectively cytotoxic to cancer cells. In this
      article, we report synthesis and cytotoxicity of 4'-C- and 5'-C-substituted
      toyocamycins, which were prepared via the condensations of 4-C- and 5-C
      substituted ribofuranose derivatives 11, 12, 13, 20, 21, and 26 with the
      silylated form of 4-amino-6-bromo-5-cyanopyrrolo[2,3-]pyrimidine (27) and
      subsequent debromination and debenzoylation. When compared to the parent
      toyocamycin, all these analogues showed much lower cytotoxicity to human prostate
      cancer cells (HTB-81), mouse melanoma cancer cells (B16) as well as normal human
      fibroblasts. Compound 1e showed a significant cytotoxicity to the prostate cancer
      cells and a moderate selectivity. The results suggested that sugar modifications,
      especially those that may affect phosphorylation of nucleosides, could alter
      cytotoxicity profile significantly.

PMID- 11197337
TI  - Synthesis and bioactivity of 2,4-diacyl analogues of paclitaxel.
AB  - The 2,4-diacyl paclitaxel analogues 8a-8r were prepared from paclitaxel by
      acylation of 4-deacetyl-2-debenzoylpaclitaxel 1,2-carbonate (3) followed either
      by hydrolysis of the carbonate and acylation or by direct treatment of the
      carbonate with an aryllithium. Some of the resulting derivatives showed
      significantly improved tubulin assembly activity and cytotoxicity as compared
      with paclitaxel; in some cases this improvement was especially significant for
      paclitaxel-resistant cell lines.

PMID- 11197338
TI  - Iantherans A and B, unique dimeric polybrominated benzofurans as Na,K-ATPase
      inhibitors from a marine sponge, Ianthella sp.
AB  - Two novel tetrabrominated benzofuran derivatives, named iantherans A and B, were
      isolated from an Australian marine sponge of the genus lanthella. The unique
      structures comprised of 2,3-bis(sulfooxy)-1,3-butadiene and two brominated
      benzofuran moieties were determined by spectroscopic and chemical methods.
      Iantheran A has a (Z,Z)-1,3-butadiene moiety, whereas iantheran B is the
      geometric isomer possessing a (Z,E)-1,3-butadiene moiety. The inhibitory
      activities of the iantherans and their derivatives against Na,K-ATPase as well as
      the efficacy of iantheran A against other several enzymes were evaluated.

PMID- 11197339
TI  - N-(Hydroxyaminocarbonyl)phenylalanine: a novel class of inhibitor for
      carboxypeptidase A.
AB  - N-(Hydroxyaminocarbonyl)phenylalanine (1) was designed rationally as a new type
      of inhibitor for carboxypeptidase A (CPA). The designed inhibitor was readily
      prepared from phenylalnine benzyl ester in two steps and evaluated to find that
      rac-1 inhibits CPA in a competitive fashion with the Ki value of 2.09 microM.
      Surprisingly, inhibitor 1 having the D-configuration is more potent (Ki = 1.54
      microM) than its antipode by about 3-fold. A possible explanation for the
      stereochemistry observed in the inhibition of CPA with 1 is presented.

PMID- 11197341
TI  - Enzyme-catalyzed prodrug approaches for the histamine H3-receptor agonist (R)
      alpha-methylhistamine.
AB  - Five novel prodrug types of the potent and selective histamine H3-receptor
      agonist (R)-alpha-methylhistamine (1) were prepared and pharmacologically tested
      in vitro as well as in vivo. In particular, an amide of fatty acid, mono- and
      dicarbamates, an (acyloxy)alkylcarbamate, and a diphthalidyl derivative were
      synthesized, all of which require initial prodrug activation through an enzyme
      catalyzed reaction in contrast to formerly developed azomethine prodrugs which
      are cleaved by chemical hydrolysis only. Further drug liberation may ensue
      spontaneously in a cascade to give 1. Since they have diverse stabilities the
      prodrugs were investigated for drug liberation in vitro under neutral, acidic,
      and basic conditions at different temperatures as well as with liver homogenates.
      In vivo investigation of prodrugs after oral administration to mice proved that
      the fatty amide 2, the Nalpha-methylcarbamate 4a, and the Nalpha-(1
      (acetyloxy)ethylcarbamate) 5 showed moderate to high plasma levels of 1. Compound
      5 displayed even more than 2.5 times the AUC for 1 than that of the reference
      azomethine prodrug BP2.94 in the periphery and also displayed a detectable drug
      level in the central nervous system. It was shown that prodrug approaches based
      on an initial enzyme-catalyzed liberation step are successfully applicable to
      different pro-moieties for improved bioavailability and prolonged half-live.
      These approaches may also be used for other aminergic compounds of this class to
      optimize pharmacokinetic behavior.

PMID- 11197340
TI  - N-(3-Acyloxy-2-benzylpropyl)-N'-(4-hydroxy-3-methoxybenzyl) thiourea derivatives
      as potent vanilloid receptor agonists and analgesics.
AB  - A series of N-(3-acyloxy-2-benzylpropyl)-N'-(4-hydroxy-3-methoxybenzyl) thiourea
      derivatives were investigated as vanilloid receptor ligands in an effort to
      discover a novel class of analgesics. The proposed pharmacophore model of
      resiniferatoxin. which includes the C20 homovanillic moiety, the C3-carbonyl and
      the orthoester phenyl ring as key pharmacophoric groups, was utilized as a guide
      for drug design. The compounds were synthesized after several steps from
      diethylmalonate and evaluated in vitro in a receptor binding assay and in a
      capsaicin-activated channel assay. Additional evaluation of analgesic activity,
      anti-inflammatory activity and pungency was conducted in animal models by the
      writhing test, the ear edema assay, and the eye-wiping test, respectively. Among
      the new compounds, 23 and 28 were found to be the most potent receptor agonists
      of the series with Ki values of 19 nM and 11 nM, respectively. Their strong in
      vitro potencies were also reflected by an excellent analgesic profile in animal
      tests with ED50 values of 0.5 microg kg for 23 and 1.0 microg/kg for 28. Relative
      to capsaicin these compounds appear to be ca. 600 and 300 times more potent. Both
      23 and 28 were found to be less pungent than capsaicin based on the eye-wiping
      test. However, the compounds did not show significant anti-inflammatory activity.
      A molecular modeling study comparing the energy-minimized structures of
      resiniferatoxin and 35 demonstrated a good correlation in the spatial disposition
      of the corresponding key pharmacophores. The thioureas described in this
      investigation, which were designed as simplified resiniferatoxin surrogates,
      represent a novel class of potent vanilloid receptor agonists endowed with potent
      analgesic activity and reduced pungency.

PMID- 11197342
TI  - Mechanism of toxicity of esters of caffeic and dihydrocaffeic acids.
AB  - Ten esters each of caffeic acid and dihydrocaffeic acid have recently been
      synthesized. Cytotoxicity evaluations of these esters versus L1210 leukemia and
      MCF-7 breast cancer cells in culture have led to the delineation of substantially
      different QSAR for each series. The L1210 QSAR for dihydrocaffeic acid esters
      resembles the QSAR obtained for simple phenols and estrogenic phenols. However,
      the QSAR pertaining to the caffeic acid esters differs considerably from its
      sister QSAR. This difference may be attributed to the presence of the olefinic
      linkage in the side chain. The octyl ester of caffeic acid is nearly ten times as
      toxic to the leukemia cells than the widely studied phenethyl ester, CAPE.

PMID- 11197343
TI  - Synthesis and stereostructure-activity relationship of three asymmetric center
      pyrethroids: 2-methyl-3-phenylcyclopropylmethyl 3-phenoxybenzyl ether and
      cyanohydrin ester.
AB  - 2-Methyl-3-phenylcyclopropylmethyl 3-phenoxybenzyl ether 2 and cyanohydrin ester
      3, a couple of pyrethroids with three asymmetric centers, were synthesized. Of
      each of the four diastereomers of 2 and 3, only the (1R*,2R*,3R*)-2a and 3a
      showed significant insecticidal activities. Dual sets of enantiomers [(1R,2R,3R)
      (-)-2a and (1S,2S,3S)-(+)-2a] and [(1R,2R,3R)-(-)-3a and (1S,2S,3S)-(+)-3a] were
      synthesized through the asymmetric cyclopropanation using the Aratani catalyst.
      Significant separations of insecticidal activities were observed between both the
      enantiomers against the tobacco cutworm (Spodoptera litura) and the common
      mosquito (Culex pipiens pallens); (1S,2S,3S)-(+)-2a and (+)-3a showed higher
      activities than their antipodes (1R,2R,3R)(-)-2a and (-)-3a. This result is the
      second example of such synthetic pyrethroids with three asymmetric centers.

PMID- 11197344
TI  - Antioxidant constituents from rhubarb: structural requirements of stilbenes for
      the activity and structures of two new anthraquinone glucosides.
AB  - The methanolic extracts from five kinds of rhubarb were found to show scavenging
      activity for DPPH radical and .O2-. Two new anthraquinone glucosides were
      isolated from the rhizome of Rheum undulatum L. together with two anthraquinone
      glucosides, a naphthalene glucoside, and 10 stilbenes. In the screening test for
      radical scavenging activity of rhubarb constituents, stilbenes and a naphthalene
      glucoside showed activity, but anthraquinones and sennosides did not. In
      addition, most stilbenes inhibited lipid peroxidation of erythrocyte membrane by
      tert-butyl hydroperoxide. Detailed examination of the scavenging effect on
      various related compounds suggested the following structural requirements; 1)
      phenolic hydroxyl groups are essential to show the activity; 2) galloyl moiety
      enhances the activity; 3) glucoside moiety reduces the activity; 4)
      dihydrostilbene derivatives maintain the scavenging activity for the DPPH
      radical, but they show weak activity for .O2-. In addition, several stilbenes
      with both the 3-hydroxyl and 4'-methoxyl groups inhibited xanthine oxidase.

PMID- 11197345
TI  - Chemical synthesis and biological investigation of a 77-mer oligoribonucleotide
      with a sequence corresponding to E. coli tRNA(Asp).
AB  - A 77-mer RNA with the sequence of Eschlerichia coli tRNA(Asp) has been chemically
      synthesised using standard automated phosphoramidite chemistry with the coupling
      reagent 4,5-dicyanoimidazole (DCI). The synthesis was carried out on a 1000 A CPG
      column and. after deprotection and gel purification, a yield of about 7 mmol with
      a purity of > 95% was reproducibly obtained. By comparing automated synthesis of
      the 77-mer RNA using 1H-tetrazole and DCI as activator, DCI is advantageous in
      producing longer RNAs. However, for shorter RNAs ( <40 mer) no difference could
      be observed. In addition to the all-ribo tRNA(Asp) carrying the wild-type
      sequence, two variants were synthesised, one with a single C to G48 mutation and
      the second with a 2'-deoxy modification at C48. The three tRNAs were tested for
      their aminoacylation efficiency and high affinity binding to E. coli RNase P RNA.
      The results demonstrate that chemically synthesised 77-mer oligoribonucleotides
      can be successfully used for structure function studies.

PMID- 11197346
TI  - Participation of the beta-hydroxyketone part for potent cytotoxicity of
      callystatin A, a spongean polyketide.
AB  - The participation of the beta-hydroxyketone part of callystatin A in the potent
      cytotoxicity was analyzed through the analogue-syntheses and the assessment of
      their biological potencies. The ketonic carbonyl, the 19-hydroxyl, and the three
      asymmetric methyl groups located in the beta-hydroxyketone part of callystatin A
      were revealed to contribute to the cytotoxic potency, respectively. Moreover, the
      alpha,beta-unsaturated delta-lactone portion was shown to serve as a conclusive
      functional group for the cytotoxic activity.

PMID- 11197347
TI  - Molecular determinants of non-specific recognition of delta, mu, and kappa opioid
      receptors.
AB  - Identification of the molecular determinants of recognition common to all three
      opioid receptors embedded in a single three-dimensional (3D) non-specific
      recognition pharmacophore has been carried out. The working hypothesis that
      underlies the computational study reported here is that ligands that bind with
      significant affinity to all three cloned opioid receptors, delta, mu, and kappa,
      but with different combinations of activation and inhibition properties at these
      receptors, could be promising behaviorally selective analgesics with diminished
      side effects. The study presented here represents the first step towards the
      rational design of such therapeutic agents. The common 3D pharmacophore developed
      for recognition of delta, mu, and kappa opioid receptors was based on the
      receptor affinities determined for 23 different opioid ligands that display no
      specificity for any of the receptor subtypes. The pharmacophore centers
      identified are a protonated amine, two hydrophobic groups, and the centroid of an
      aromatic group in a geometric arrangement common to all 23, non-specific, opioid
      ligands studied. Using this three-dimensional pharmacophore as a query for
      searching 3D structural databases, novel compounds potentially involved in non
      specific recognition of delta, mu, and kappa opioid receptors were retrieved.
      These compounds can be valuable candidates for novel behaviorally selective
      analgesics with diminished or no side effects, and thus with potential
      therapeutic usefulness.

PMID- 11197348
TI  - Alternative heterocycles for DNA recognition: an N-methylpyrazole/N-methylpyrrole
      pair specifies for A.T/T.A base pairs.
AB  - Side-by-side pairs of three five-membered rings, N-methylpyrrole (Py), N
      methylimidazole (Im), and N-methylhydroxy-pyrrole (Hp), have been demonstrated to
      distinguish each of the four Watson Crick base pairs in the minor groove of DNA.
      However, not all DNA sequences targeted by these pairing rules achieve affinities
      and specificities comparable to DNA binding proteins. We have initiated a search
      for new heterocycles which can expand the sequence repetoire currently available.
      Two heterocyclic aromatic amino acids. N-methylpyrazole (Pz) and 4-methylthiazole
      (Th), were incorporated into a single position of an eight-ring polyamide of
      sequence ImImXPy-gamma-lmPyPyPy-beta-Dp to examine the modulation of affinity and
      specificity for DNA binding by a Pz/Py pair and or a Th/Py pair. The X/Py
      pairings Pz/Py and Th/Py were evaluated by quantitative DNase I footprint
      titrations on a DNA fragment with the four sites 5'-TGGNCA-3' (N=T, A, G, C). The
      Pz/Py pair binds T.A and A.T with similar affinity to a Py/Py pair but with
      improved specificity. disfavoring both G.C and C.G by about 100-fold. The Th/Py
      pair binds poorly to all four Watson Crick base pairs. These results demonstrate
      that in some instances new heterocyclic aromatic amino acid pairs can be
      incorporated into imidazole-pyrrole polyamides to mimic the DNA specificity of
      Py/Py pairs which may be relevant as biological criteria in animal studies become
      important.

PMID- 11197349
TI  - New constituents and antiplatelet aggregation and anti-HIV principles of
      Artemisia capillaris.
AB  - Five new constituents including a flavonoid, artemisidin A (1), and four
      coumarins, artemicapins A (2), B (3), C (4) and D (5), together with 70 known
      compounds (6-75), have been isolated and characterized from the aerial part of
      Artemisia capillaris. The structures of these compounds were determined from
      spectral analyses and/or chemical evidence. Among them, 15 compounds (3, 6, 10,
      18. 30-32, 38-41, 44, 45, 51, and 55) showed antiplatelet aggregation activity
      and three compounds (10, 17, and 51) demonstrated significant activity against
      HIV replication in H9 lymphocytic cells.

PMID- 11197350
TI  - Design and synthesis of a multivalent homing device for targeting to murine CD22.
AB  - CD22 is a cell-surface glycoprotein uniquely located on mature B-cells and B-cell
      derived tumour cells. Current evidence suggests that binding of endogenous
      ligands to CD22 leads to modulation of B-cell activation by antigen.
      Incidentally, however, B-cell activation may derail. and lead to an undesired
      immune response, for example in cases of allergy, rheumatoid arthritis and
      Crohn's disease. In this situation, synthetic high-affinity ligands for CD22 may
      be of therapeutic value as inhibitors of B-cell activation. Recent studies have
      revealed that natural ligands for CD22 contain the trisaccharide NeuAc alpha-2,6
      Lac as the basic binding motif. In addition, it has been demonstrated that
      binding to CD22 is strongly enhanced by multivalent presentation of the basic
      binding motif (cluster effect). In this paper. the stepwise development of a
      novel multivalent high-affinity ligand for CD22 is described. In the first stage,
      a series of monovalent NeuAc alpha-2,6-Glc(Y)X type binding motifs was prepared,
      and their affinity for murine CD22 was monitored, to obtain more insight into the
      effect of separate structure elements on ligand recognition. In the second stage,
      we prepared a trivalent cluster, based on the monovalent motif that displayed the
      highest affinity for CD22, NeuAc alpha-2,6-GlcNBzNO2OMe (7). This cluster,
      TRIS(NeuAc alpha-2,6-GlcNBzNO2)3 (52), displayed a more than 58-fold higher
      affinity for CD22 than the reference structure NeuAc alpha-2,6-LacOMe (10). To
      our knowledge, the cluster 52 is one of the most potent antagonists for CD22 yet
      synthesised.

PMID- 11197351
TI  - N-nitrosoanilines: a new class of caspase-3 inhibitors.
AB  - Caspases are a family of cysteine proteases activated during apoptosis. In
      cultured human endothelial cells, physiological levels of NO prevent apoptosis
      and interfere with the activation of the caspase cascade. Previous studies have
      demonstrated that NO inhibits the activity of caspase-3 by S-nitrosylation of the
      enzyme. In this study, the inhibitory effect of a new class of NO donors. N
      nitrosoaniline derivatives, were examined against caspase-3. Initially eight
      small molecule inhibitors bearing N-nitroso moieties were assayed. It was found
      that the presence of an electron-donating group on the phenyl ring led to better
      inhibitory potency, a trend consistent with the results from the previous papain
      studies. Based on the analysis of the enzyme and substrates' structures, two
      peptidyl N-nitrosoaniline inhibitors [Ac-DVAD-NNO (1) and Ac-DV-AMO (2)] were
      designed and synthesized. Both compounds exhibited enhanced inhibitory potency
      against caspase-3.

PMID- 11197352
TI  - Grants, not loans, for the developing world?

PMID- 11197353
TI  - Clinical picture: a newborn with gynaecomastia.

PMID- 11197354
TI  - Molecular quantification and mapping of lymph-node micrometastases in cervical
      cancer.
AB  - BACKGROUND: A proportion of patients with cancer and lymph nodes negative on
      histology will develop recurrence. Reverse-transcriptase PCR (RT-PCR) is a highly
      sensitive method for detection of lymph-node micrometastases, but accurate
      quantitative assessment has been difficult. METHODS: We studied primary tumours
      and 156 lymph nodes from 32 patients with cervical cancer (stage IA2, IB1, and
      IB2) and 32 lymph nodes from nine patients with benign disease. A fully
      quantitative, real-time RT-PCR assay was used to document absolute copy numbers
      of the epithelial marker cytokeratin 19. Primers and probe were designed not to
      amplify either of the two cytokeratin 19 pseudogenes. FINDINGS: All primary
      tumours and histologically involved lymph nodes (six) had more than 106 copies of
      cytokeratin 19 mRNA per microg total RNA. Expression of cytokeratin 19 (up to 1.1
      x 10(5) copies per microg RNA) was detected in 66 (44%) of 150 histologically
      uninvolved lymph nodes, and in nodes from 16 of 32 patients with cervical cancer.
      15 of these 16 patients with evidence of micrometastases had the highest
      cytokeratin 19 transcription level in a first lymph-node drainage station (three
      obturator, six internal, and six external iliac node). Transcription of
      cytokeratin 19 was found at a low level in just one of 32 lymph nodes obtained
      from nine patients with benign disease. Median copy number of cytokeratin 19
      transcription was significantly higher (>10(3) copies) in association with
      adverse prognostic features. INTERPRETATION: The results suggest that about 50%
      of early-stage cervical cancers shed tumour cells to the pelvic lymph nodes. The
      amount of cytokeratin 19 expression was related to clinicopathological features.
      Further studies are required to document the clinical implications of molecular
      micrometastases.

PMID- 11197355
TI  - Is host endothelium a silver lining for allografts?

PMID- 11197356
TI  - Visualisation of presence, location, and transmural extent of healed Q-wave and
      non-Q-wave myocardial infarction.
AB  - BACKGROUND: A technical advance in contrast-enhanced magnetic resonance imaging
      (MRI) has significantly improved image quality. We investigated whether healed
      myocardial infarction can be visualised as hyperenhanced regions with this new
      technique, and whether assessment of the transmural extent of infarction yields
      new physiological data. METHODS: 82 MRI examinations were carried out in three
      groups: patients with healed myocardial infarction; patients with non-ischaemic
      cardiomyopathy; and healthy volunteers. Patients with healed myocardial
      infarction were prospectively enrolled after enyzmatically proven necrosis and
      imaged 3 months (SD 1) or 14 months (7) later. The MRI procedure used a segmented
      inversion-recovery gradient-echo sequence after gadolinium administration.
      Findings were compared with those of coronary angiography, electrocardiography,
      cine MRI, and creatine kinase measurements. FINDINGS: 29 (91%) of 32 patients
      with infarcts imaged at 3 months (13 non-Q-wave) and all of 19 imaged at 14
      months (eight non-Q-wave) showed hyperenhancement. In patients in whom the
      infarct-related-artery was identified by angiography, 24 of 25 imaged at 3 months
      and all of 14 imaged at 14 months had hyperenhancement in the appropriate
      territory. None of the 20 patients with non-ischaemic cardiomyopathy or the 11
      healthy volunteers showed hyperenhancement. Irrespective of the presence or
      absence of Q waves, the majority of patients with hyperenhancement had only non
      transmural involvement. Normal left-ventricular contraction was shown in seven
      patients examined at 3 months and three examined at 14 months, but in these cases
      hyperenhancement was limited to the subendocardium. INTERPRETATION: The presence,
      location, and transmural extent of healed Q-wave and non-Q-wave myocardial
      infarction can be accurately determined by contrast-enhanced MRI.

PMID- 11197357
TI  - Brand appearances in contemporary cinema films and contribution to global
      marketing of cigarettes.
AB  - BACKGROUND: The appearance of a cigarette brand in a cinema film gives the brand
      a certain distinction through its association with the characters and general
      tone of the film. Through the worldwide distribution of films, brands are
      promoted globally. We assessed the tobacco-brand appearances in a 10-year sample
      of contemporary films. METHODS: We viewed the contents of the top 25 US box
      office films for each year of release, from 1988 to 1997 (250 films in total). We
      compared the prevalence of brand appearances for films produced before a
      voluntary ban on paid product placement by the tobacco industry (1988-90) with
      films produced after the ban (1991-97). Tobacco-brand appearance was defined as
      the screen appearance of a brand name, logo, or identifiable trademark on
      products or product packaging, billboards, store-front advertising, or tobacco
      promotional items. We defined actor endorsement of a brand as the display of a
      brand while being handled or used by an actor. FINDINGS: More than 85% of the
      films contained tobacco use. Tobacco brands appeared in 70 (28%) films. Brand
      appearances were as common in films suitable for adolescent audiences as they
      were in films for adult audiences (32 vs 35%), and were also present in 20% of
      those rated for children. Prevalence of brand appearance did not change overall
      in relation to the ban. However, there was a striking increase in the type of
      brand appearance depicted, with actor endorsement increasing from 1% of films
      before the ban to 11% after. Four US cigarette brands accounted for 80% of brand
      appearances. Revenues outside the USA accounted for 49% of total revenues for
      these films, indicating a large international audience. INTERPRETATION: Tobacco
      brand appearances are common in films and are becoming increasingly endorsed by
      actors. The most highly advertised US cigarette brands account for most brand
      appearances, which suggests an advertising motive to this practice.

PMID- 11197358
TI  - Unexamined assumptions in explorations of upper limit for cases of variant
      Creutzfeldt-Jakob disease.

PMID- 11197360
TI  - Septicaemia in a pig-farm worker.

PMID- 11197359
TI  - Endothelial cell chimerism after renal transplantation and vascular rejection.
AB  - BACKGROUND: The blood vessels of a transplanted organ are the interface between
      donor and recipient. The endothelium in the blood vessels is thought to be the
      major target for graft rejection. Endothelial cells of a transplanted organ are
      believed to remain of donor origin after transplantation. We aimed to verify this
      concept. METHODS: We studied biopsy samples from 12 renal transplants for the
      presence of endothelial cells of recipient origin. We used three different
      techniques: immunohistochemistry for MHC class-I antigens, immunohistochemistry
      for ABO-blood-group antigens, and in-situ hybridisation for X and Y chromosomes.
      After we had confirmed that these techniques did identify endothelial cells of
      recipient origin, tests were done in a second group of 26 patients to find out
      whether endothelial chimerism correlated with graft rejection. FINDINGS: We found
      a strong correlation between the percentage of recipient endothelial cells in the
      peritubular capillaries and the type of graft rejection (r = 0.71, p < 0.0001).
      These cells were found mainly in grafts of patients who had had rejection,
      especially among patients with vascular rejection. In grafts of patients without
      rejection only sporadically recipient endothelial cells were detectable.
      INTERPRETATION: Our data show that endothelial cells of the recipient can replace
      those of the donor. This replacement is associated with graft rejection. We
      postulate that endothelium that is damaged by vascular rejection is repaired by
      endothelial cells of the recipient.

PMID- 11197361
TI  - Resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue
      lymphoma to Helicobacter pylori eradication therapy.
AB  - 20-30% of gastric mucosa-associated lymphoid tissue (MALT) lymphoma associated
      with Helicobacter pylori do not regress after antibiotic therapy. Regression can
      be assessed only by extended follow-up. To assess whether t(11;18, q21;q21),
      which results in a chimeric transcript between the AP12 and MLT genes, predicts
      lymphoma resistance to antibiotic therapy, we screened for the fusion transcript
      with RT-PCR in ten responsive and 12 non-responsive gastric MALT lymphomas. The
      AP12-MLT transcript was detected in nine (75%) of 12 patients non-responsive to
      antibiotic therapy but not in responsive patients. Most H pylori-associated
      gastric MALT lymphomas that do not respond to antibiotic therapy are associated
      with t(11;18, q21;q21).

PMID- 11197362
TI  - Sunlight "D"ilemma: risk of skin cancer or bone disease and muscle weakness.

PMID- 11197363
TI  - Effect of vancomycin and rifampicin on meticillin-resistant Staphylococcus aureus
      biofilms.
AB  - Decolonisation of patients with urinary catheter colonisation by meticillin
      resistant Staphylococcus aureus (MRSA) is often difficult. Replacement of the
      catheter after prophylactic vancomycin administration has been one approach that
      is often unsuccessful in clinical practice. We suspected that formation of MRSA
      biofilms might account for the persistence of infection, and our study confirms
      this, also showing that MRSA is able to colonise a silastic rubber surface even
      in the presence of prophylactic vancomycin or rifampicin.

PMID- 11197364
TI  - Multidrug-resistance protein 1 in focal cortical dysplasia.
AB  - Drug resistance in epilepsy is poorly understood. We used routine
      immunohistochemistry to assess overexpression of a multidrug-resistance protein
      in dysplastic neurons, glia, and around vessels in surgically resected
      epileptogenic human brain tissue. We showed non-tumoral overexpression of this
      multidrug-resistance protein, which might contribute to drug resistance in
      epilepsy caused by focal cortical dysplasia.

PMID- 11197365
TI  - Treatment of aplastic anaemia with granulocyte-colony stimulating factor and risk
      of malignancy. Italian Aplastic Anaemia Study Group.
AB  - Granulocyte-colony stimulating factor (G-CSF) is being increasingly used in
      healthy volunteers to harvest haemopoietic stem cells. A possible role of G-CSF
      in the development of clonal disorders or leukaemia has been suggested. We
      analysed 144 patients with aplastic anaemia treated with immunosuppression
      protocols with or without G-CSF, with normal cytogenetics at diagnosis or
      immediately after immunosuppression. Our findings indicated that the risk of
      developing myelodysplasia or leukaemia was similar in patients with aplastic
      anaemia on immunosuppressive treatment with or without G-CSF. Therefore, it seems
      unlikely that G-CSF causes leukaemia in healthy volunteers.

PMID- 11197366
TI  - Aid organisations rebuke UN for Afghanistan sanctions.

PMID- 11197367
TI  - Music tunes up memory in dementia patients.

PMID- 11197368
TI  - Robert Butler: championing a healthy view of ageing.

PMID- 11197369
TI  - "Blood heads" and AIDS haunt China's countryside.

PMID- 11197370
TI  - New injuries for Kashmir as tentative steps towards peace are taken.

PMID- 11197371
TI  - "Plan Colombia"--parallels drawn with Vietnam war.

PMID- 11197372
TI  - Pathogenesis and genetics of pre-eclampsia.
AB  - After more than a century of intensive research, pre-eclampsia and eclampsia
      remain an enigmatic set of conditions. Aberration of the interaction between
      placental and maternal tissue is probably the primary cause, but the exact nature
      of the differences from normal pregnancy remain elusive. In this review attempts
      to understand the sequence of physiological changes have concentrated on vascular
      endothelium and oxidative stress issues. There are genetic components to
      susceptibility, but the relative contributions of maternal and fetal genotypes
      are still unclear. Whole-genome mapping could ultimately define the causative
      genes.

PMID- 11197373
TI  - Defining and refining international donor support for combating the AIDS
      pandemic.
AB  - The international aid effort against AIDS is greatly incommensurate with the
      severity of the epidemic. Drawing on the data that international aid donors self
      reported to the Organization for Economic Cooperation and Development (OECD), we
      find that, between 1996 and 1998, finance from all rich countries to sub-Saharan
      Africa for projects designated as AIDS control averaged US $69 million annually,
      and, assuming a safe margin for under-reporting and misreporting, we estimate
      that total donor spending on HIV/AIDS control was perhaps twice that at most.
      Since the late 1980s, aid levels have dropped relative to the prevalence of HIV
      infection, and stood recently at about $3 per HIV-infected person. Lack of
      finance is now the primary constraint on progress against AIDS, notwithstanding
      the widespread belief that a lack of interest from the goveements of poor
      countries is limiting. We argue that to produce a meaningful response to the
      pandemic, international assistance must be based on grants, not loans, for the
      poorest countries; be increased within the next 3 years to a minimum of $7.5
      billion or more; be directed toward funding projects which are proposed and
      desired by the affected countries themselves, and which are judged as having
      epidemiological merit against the pandemic by a panel of independent scientific
      experts; and fund concurrent needs, including prevention, drug treatment (such as
      highly active antiretroviral therapy), and blocking mother-to-child HIV
      transmission. An effort of this scope and scale will both radically alter the
      prospects for intervention against AIDS in poor countries, and together with
      comparable efforts to control other infectious diseases, is easily afforded by
      the OECD donor economies, whose aggregate national income recently surpassed $21
      trillion annually.

PMID- 11197374
TI  - Renal failure after bone-marrow transplantation.

PMID- 11197375
TI  - Concealing medication in patients' food.

PMID- 11197376
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197377
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197378
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197379
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197380
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197381
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197382
TI  - Tamoxifen and risk of endometrial cancer.

PMID- 11197383
TI  - Viraemia and faecal shedding of HEV in symptom-free carriers.

PMID- 11197384
TI  - Public health and air pollution.

PMID- 11197385
TI  - Importance of differentiating health status from quality of life.

PMID- 11197386
TI  - Public health and air pollution.

PMID- 11197387
TI  - Public health and air pollution.

PMID- 11197388
TI  - Survival after liver transplantation.

PMID- 11197389
TI  - Headache angina.

PMID- 11197390
TI  - Origin of AIDS.

PMID- 11197391
TI  - Origin of AIDS.

PMID- 11197392
TI  - Origin of AIDS.

PMID- 11197393
TI  - Non-communicable disease in sub-Saharan Africa.

PMID- 11197394
TI  - Floating kidney.

PMID- 11197395
TI  - Withholding and withdrawal of life support in intensive-care units in France: a
      prospective survey. French LATAREA Group.
AB  - BACKGROUND: In France, there are no guidelines available on withholding and
      withdrawal of life-sustaining treatments, and information on the frequency of
      such decisions is scarce. METHODS: We undertook a prospective 2-month survey in
      113, of a total of 220, intensive-care units (ICUs) in France to study the
      frequency of, and processes leading to, decisions to withhold and withdraw life
      sustaining treatments. FINDINGS: Life-supporting therapies were withheld or
      withdrawn in 807 (11.0%) of 7309 patients (withholding in 336 [4.6%] and
      withdrawal in 471 [6.4%], preceded in 358 by withholding). Of 1175 deaths in ICU,
      628 (53%) were preceded by a decision to limit life-supporting therapies.
      Futility and poor expected quality of life were the most frequently cited
      reasons. Decisions were strongly correlated with the simplified acute
      physiological score, but an independent centre effect persisted after adjustment
      for this score. Decisions were mostly taken by all the ICU medical staff, with
      (54%) or without (34%) the nursing staff; however, a single physician made
      decisions in 12% of cases. The patient's family was involved in the decision
      making process in 44% of cases. The patient's willingness to limit his or her own
      care was known in only 8% of the cases; only 0.5% of the patients were involved
      in decisions. INTERPRETATION: Withholding and withdrawal of life-support
      therapies are widely practised in French ICUs, despite their prohibition by the
      French legislation. The lack of an official statement from French scientific
      bodies may explain several limitations on the various steps of the decision
      making process.

PMID- 11197396
TI  - The genetics of haemostasis: a twin study.
AB  - BACKGROUND: The concentrations of fibrinogen, factor VII and VIII, von Willebrand
      factor, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen
      activator have been associated with coronary-heart disease. In addition,
      polymorphisms in the genes coding for fibrinogen, factor VII, PAI-1, and factor
      XIII have been reported to affect both protein concentrations and cardiovascular
      disease risk. METHODS: We did a classic twin study to assess heritabilities of
      these haemostatic factors. We enrolled 1002 female twins; 149 pairs of
      monozygotic and 352 pairs of dizygotic twins. 89 monozygotic and 196 dizygotic
      twin pairs were analysed for factor VII. FINDINGS: Quantitative genetic model
      fitting showed that genetic factors contributed to about 41-75% of the variation
      in concentrations of fibrinogen, factor VII, factor VIII, PAI-1, tissue
      plasminogen activator, factor XIII A-subunit and B-subunit, and von Willebrand
      factor. Factor XIII activity showed higher (82%) and factor XIIa lower (38%)
      heritability. INTERPRETATION: We have shown that genetic factors have a major
      effect on plasma concentrations of haemostatic proteins. Our results stress the
      importance of research into the genetic regulation of proteins involved in
      haemostasis and atherothrombotic disorders, including myocardial infarction and
      stroke.

PMID- 11197397
TI  - Quality of hospital care for seriously ill children in less-developed countries.
AB  - BACKGROUND: Improving the quality of care for sick children referred to hospitals
      in less-developed countries may lead to better outcomes, including reduced
      mortality. Data are lacking, however, on the quality of priority screening
      (triage), emergency care, diagnosis, and inpatient treatment in these hospitals,
      and on aspects of these potential targets that would benefit most from
      interventions leading to improved health outcomes. METHODS: We did a qualitative
      study in 13 district hospitals and eight teaching hospitals in seven less
      developed countries. Experienced paediatricians used a structured survey
      instrument to assess initial triage, emergency and inpatient care, staff
      knowledge and practices, and hospital support services. FINDINGS: Overall quality
      of care differed between countries and among hospitals and was generally better
      in teaching hospitals. 14 of 21 hospitals lacked an adequate system for triage.
      Initial patient assessment was often inadequate and treatment delayed. Most
      emergency treatment areas were poorly organised and lacked essential supplies;
      families were routinely required to buy emergency drugs before they could be
      given. Adverse factors in case management, including inadequate assessment,
      inappropriate treatment, and inadequate monitoring occurred in 76% of inpatient
      children. Most doctors in district hospitals, and nurses and medical assistants
      in teaching and district hospitals, had inadequate knowledge and reported
      practice for managing important childhood illnesses. INTERPRETATION:
      Strengthening care for sick children referred to hospital should focus on
      achievable objectives with the greatest potential benefit for health outcome.
      Possible targets for improvement include initial triage, emergency care,
      assessment, inpatient treatment, and monitoring. Priority targets for individual
      hospitals may be determined by assessing each hospital.

PMID- 11197398
TI  - Long-term prospective observational study of patients with peanut and nut allergy
      after participation in a management plan.
AB  - BACKGROUND: Peanut and nut allergy is common and the most frequent cause of
      severe or fatal reactions to foods. Current advice is poor--doctors give an
      epinephrine injector to patients, without training or advice on nut avoidance--so
      that further reactions are common and deaths occur. We devised and assessed a
      management programme providing advice on nut avoidance and emergency medication.
      METHODS: Unselected referrals with confirmed peanut or tree-nut allergy were
      recruited. Severity of nut allergy was graded 1-5 and emergency medication
      allocated accordingly: oral antihistamine with or without inhaled or injected
      epinephrine. Patients, parents, and school staff received verbal and written
      advice on nut avoidance as well as training in recognition and self-treatment of
      reactions, with a written treatment plan. At follow-up (more than 13610 patient
      months) retraining was given and details of further reactions obtained. FINDINGS:
      88 (15%) of 567 patients had a follow-up reaction of reduced severity. 62 of 88
      were mild (grades 1-3, mainly cutaneous) and 49 patients used oral antihistamine,
      six inhaled adrenaline, and ten took no treatment. 12 of 12 patients with a
      moderate follow-up reaction improved after inhaled epinephrine. Only three (0.5%)
      of 567 patients, aged 27-40 years, had a severe follow-up reaction (involving
      dyspnoea) compared with 12% initially. Only one of 567 changed from a mild index
      reaction to a severe follow-up reaction. Patients with a moderate/severe (grade 4
      5) reaction were older (median 18 years vs 9 years; p=0.03) and nine of 26
      received injected epinephrine which was always effective. 85% of patients had no
      further reactions. Severity was related to the amount of nut eaten.
      INTERPRETATION: Self-treatment was effective (inhaled epinephrine for early
      laryngeal oedema and an epinephrine injector for severe reactions) but provision
      of this treatment, including who should carry epinephrine, required assessment of
      allergy severity. Our management plan was effective, and our results indicate
      that patients should be referred to specialist allergy centres for advice on nut
      avoidance.

PMID- 11197399
TI  - The pituitary gland and hereditary haemochromatosis.

PMID- 11197400
TI  - A 25-year-old with severe coronary artery disease.

PMID- 11197401
TI  - Long-term propofol infusion and cardiac failure in adult head-injured patients.
AB  - Five adult patients with head injuries inexplicably had fatal cardiac arrests In
      our neurosurgical intensive-care unit after the introduction of a sedation
      formulation containing an increased concentration of propofol. To examine the
      possible relation further, we did a retrospective cohort analysis of head-injured
      adults admitted to our unit between 1996 and 1999 who were sedated and
      mechanically ventilated. 67 patients met the inclusion criteria, of whom seven
      were judged to have died from propofol-infusion syndrome. The odds ratio for the
      occurrence of the syndrome was 1.93 (95% CI 1.12-3.32, p=0.018) for every mg/kg
      per h increase in mean propofol dose above 5 mg/kg per h. We suggest that
      propofol infusion at rates higher than 5 mg/kg per h should be discouraged for
      long-term sedation in the intensive-care unit.

PMID- 11197402
TI  - Inhaled nitric oxide in neonates with persistent pulmonary hypertension.
AB  - To investigate the oxygenation and haemodynamic dose response to inhaled nitric
      oxide in neonates with persistent pulmonary hypertension (PPHN), we gave seven
      neonates nitric oxide and measured directly pulmonary arterial pressure. Inhaled
      nitric oxide produced peak improvement in oxygenation at 5 parts per million
      (ppm) whereas peak improvement in the pulmonary-to-systemic arterial pressure
      ratio did not occur until a nitric oxide dose of 20 ppm, which suggests that an
      Initial dose of 20 ppm is optimum for the treatment of PPHN.

PMID- 11197403
TI  - Mifepristone abortion outside the urban research hospital setting in India.
AB  - Medical abortion holds great promise in less-developed countries, where abortion
      morbidity and mortality remain high. We tested the French mifepristone
      misoprostol regimen in two urban outpatient family-planning clinics (n=600) and a
      rural hospital (n=300) in India. 4% of urban women and 1% of rural women were
      lost to follow-up. Perfect use and typical-use success rates were as high as
      European rates at all sites. Although rural women reported fewer side-effects,
      most women in urban and rural settings were satisfied with their medical
      abortions. Medical abortion can be offered safely, effectively, and acceptably in
      urban outpatient clinics and rural hospitals in India.

PMID- 11197404
TI  - Sentinel-node biopsy in axillary lymph-node staging for patients with
      multicentric breast cancer.
AB  - Multicentric breast cancer is thought to be a contraindication for sentinel-node
      biopsy by most clinicians. In a prospective study we took sentinel-node biopsy
      samples from 19 patients with multicentric invasive breast cancer with use of a
      blue dye and radiolabelled colloid mapping technique at the subareolar injection
      site. All patients underwent complete axillary dissection after sentinel-node
      biopsy. Nine patients had tumour-free and ten had metastatic sentinel nodes. The
      sentinel-node status was in concordance with the axillary sample in all patients.
      Sentinel-node biopsy might become an alternative to complete axillary dissection
      in patients with multicentric breast cancer with clinically negative lymph nodes.

PMID- 11197405
TI  - Audit further exposes UK's worst serial killer.

PMID- 11197406
TI  - Elusive platelet ADP receptor identified.

PMID- 11197407
TI  - Should stress carry a health warning?

PMID- 11197408
TI  - Bush picks Wisconsin governor for key health post.

PMID- 11197409
TI  - US mental health care services failing children, report says.

PMID- 11197410
TI  - Nigerian government investigates Pfizer drug trial allegations.

PMID- 11197411
TI  - Paris' Pompidou hospital plagued by setbacks.

PMID- 11197412
TI  - Alternative strategies suggested to eradicate "hidden hunger" in India.

PMID- 11197413
TI  - Blood-pressure measurement and classification in pregnancy.
AB  - Pre-eclampsia is usually defined on the basis of new onset hypertension and
      albuminuria developing after 20 weeks of pregnancy. There are difficulties with
      measurement of these variables. Conventional sphygmomanometry remains the gold
      standard for blood-pressure measurement. The value of ambulatory blood-pressure
      measurement has yet to be established. Oedema is now omitted from all definitions
      of preeclampsia, although the finding of widespread severe oedema of sudden onset
      should not be ignored for clinical purposes. Definitions of pre-eclampsia based
      solely on hypertension and proteinuria ignore the wide clinical variability in
      this syndrome. Women with no proteinuria but who do have hypertension and other
      features such as severe headache or other symptoms, thrombocytopenia,
      hyperuricaemia, disordered liver function, and fetal compromise are likely to
      have pre-eclampsia. This notion is accepted in the new Australasian definition of
      pre-eclampsia and more than hinted at in the new American College of
      Obstetricians and Gynecologists' definition. Definitions used for clinical
      purposes should be as safe as practical; they are likely to include a
      considerable number of false positives. Most research studies are weakened if
      patients without the disease are included. Therefore, a separate stringent
      research definition of pre-eclampsia we also suggest.

PMID- 11197414
TI  - Suicide of the nephron.
AB  - There are various causes of renal disease. However, progressive renal disease is
      closely linked to the degree and duration of proteinuria. At first sight, this
      seems a perverse response in which a compromised organ unleashes a coordinated
      series of reactions that exacerbate the damage already done. Although the nephron
      has mechanisms whereby it can compensate for damage both by hypertrophy and
      hyperfunction after renal injury or ablation, these changes seem to provide only
      a temporary compensation. I and my colleagues found altered renal telomere
      shortening in the male rat linked to increased or decreased proteinuria and
      longevity, which suggests a mechanism whereby this compensatory process may be
      limited. I hypothesise that when the damaging or hypertrophic processes shorten
      renal telomeres to a critical length, the cells senesce with loss of function. I
      also suggest that the complex series of responses triggered in a protein-leaking
      nephron is normally a beneficial and limited process. It leads to the replacement
      by fibrosis of a malfunctioning unit in an otherwise healthy organ that has
      substantial spare capacity. The response only becomes life threatening when there
      is widespread nephron damage, the acceleration of which results in the ablation
      of all nephron function.

PMID- 11197415
TI  - Anderson-Fabry's disease: alpha-galactosidase deficiency.

PMID- 11197416
TI  - Uses of error: clinical and epidemiological.

PMID- 11197417
TI  - Mother-to-child HCV transmission.

PMID- 11197418
TI  - Mother-to-child HCV transmission.

PMID- 11197419
TI  - Mother-to-child HCV transmission.

PMID- 11197420
TI  - Mother-to-child HCV transmission.

PMID- 11197421
TI  - Mother-to-child HCV transmission.

PMID- 11197422
TI  - Cystatin for estimation of glomerular filtration rate.

PMID- 11197423
TI  - Voluntary counselling and testing for HIV-1.

PMID- 11197424
TI  - Voluntary counselling and testing for HIV-1.

PMID- 11197425
TI  - Diagnosis of meningococcal septicaemia.

PMID- 11197426
TI  - Diagnosis of meningococcal septicaemia.

PMID- 11197427
TI  - Diuretic response to water loading.

PMID- 11197428
TI  - Care for stroke patients.

PMID- 11197429
TI  - Care for stroke patients.

PMID- 11197430
TI  - The idea and the experiment.

PMID- 11197431
TI  - The idea and the experiment.

PMID- 11197432
TI  - Conjoined twins.

PMID- 11197433
TI  - Research in complex emergencies. Medical Emergency Relief International.

PMID- 11197434
TI  - Informed consent is flawed.

PMID- 11197435
TI  - Research agenda in less-developed countries.

PMID- 11197436
TI  - Accuracy of references in theses.

PMID- 11197437
TI  - Will India's medical sites learn from the US experience?

PMID- 11197438
TI  - The real lessons from Harold Frederick Shipman.

PMID- 11197439
TI  - Genetics of haemostasis.

PMID- 11197440
TI  - Aspirin for primary prevention of cardiovascular events.

PMID- 11197441
TI  - Relation between dermatomyositis and polymyositis and cancer.

PMID- 11197442
TI  - Paediatric emergency care in developing countries.

PMID- 11197443
TI  - Management of peanut and nut allergies.

PMID- 11197444
TI  - We all make mistakes: tell us yours.

PMID- 11197445
TI  - Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised
      trial in general practice. Collaborative Group of the Primary Prevention Project.
AB  - BACKGROUND: In addition to the treatment of specific cardiovascular risk factors,
      intervention which interferes with the general mechanisms of atherosclerosis
      could further reduce the incidence of cardiovascular events. We aimed to
      investigate in general practice the efficacy of antiplatelets and antioxidants in
      primary prevention of cardiovascular events in people with one or more major
      cardiovascular risk factors. METHODS: We did a randomised controlled open 2x2
      factorial trial to investigate low-dose aspirin (100 mg/day) and vitamin E (300
      mg/day) in the prevention of cardiovascular events, in people with one or more of
      the following: hypertension, hypercholesterolaemia, diabetes, obesity, family
      history of premature myocardial infarction, or individuals who were elderly.
      FINDINGS: 4495 people (2583 female, mean age 64.4 years) were included in the
      trial. After a mean follow-up of 3.6 years the trial was prematurely stopped on
      ethical grounds when newly available evidence from other trials on the benefit of
      aspirin in primary prevention was strictly consistent with the results of the
      second planned interim analysis. Aspirin lowered the frequency of all the
      endpoints, being significant for cardiovascular death (from 1.4 to 0.8%; relative
      risk 0.56 [95% CI 0.31-0.99]) and total cardiovascular events (from 8.2 to 6.3%;
      0.77 [0.62-0.95]). Severe bleedings were more frequent in the aspirin group than
      the no-aspirin group (1.1% vs 0.3%; p<0.0008). Vitamin E showed no effect on any
      prespecified endpoint. Analyses were by intention-to-treat. INTERPRETATION: In
      women and men at risk of having a cardiovascular event because of the presence of
      at least one major risk factor, low-dose aspirin given in addition to treatment
      of specific risk factors contributes an additional preventive effect, with an
      acceptable safety profile. The results on vitamin E's cardiovascular primary
      preventive efficacy are not conclusive per se, although our results are
      consistent with the negative results of other large published trials on secondary
      prevention.

PMID- 11197446
TI  - Frequency of specific cancer types in dermatomyositis and polymyositis: a
      population-based study.
AB  - BACKGROUND: Dermatomyositis and polymyositis are associated with cancer, but
      previous nationwide studies have not had sufficient cases to test the association
      between myositis and specific cancer types. Our aim was to investigate the risk
      of specific cancer types in individuals with dermatomyositis and polymyositis.
      METHODS: We did a pooled analysis of published national data from Sweden,
      Denmark, and Finland. All patients with dermatomyositis and polymyositis (> or
      =15 years old) were identified by discharge diagnosis from the Swedish National
      Board of Health (1964-83), Danish Hospital Discharge Registry (1977-89), and
      Finnish National Board of Health (1969-85). Personal details were matched to
      national cancer registries, to identify all cases of cancer up to 1987 in Sweden,
      1995 in Denmark, and 1997 in Finland, and to national death registries for the
      same periods. We calculated standardised incidence ratios (SIR) for individual
      cancer sites for dermatomyositis and polymyositis separately, using national
      cancer rates by country, sex, age, and date. FINDINGS: We identified 618 cases of
      dermatomyositis, of whom 198 had cancer. 115 of the 198 developed cancer after
      diagnosis of dermatomyositis. This disease was strongly associated with malignant
      disease (SIR 3.0, 95% CI 2.5-3.6), particularly ovarian (10.5, 6.1-18.1), lung
      (5.9, 3.7-9.2), pancreatic (3.8, 1.6-9.0), stomach (3.5, 1.7-7.3), and colorectal
      (2.5, 1.4-4.4) cancers, and non-Hodgkin lymphoma (3.6, 1.2-11.1). 137 of the 914
      cases of polymyositis had cancer, which developed after diagnosis of polymyositis
      in 95. Polymyositis was associated with a raised risk of non-Hodgkin lymphoma
      (3.7, 1.7-8.2), and lung (2.8, 1.8-4.4) and bladder cancers (2.4, 1.3-4.7). In
      both dermatomyositis and polymyositis, risk of malignant disease was highest at
      time of myositis diagnosis. INTERPRETATION: Our results provide evidence that
      dermatomyositis is strongly associated with a wide range of cancers. The overall
      risk of malignant disease is also modestly increased among patients with
      polymyositis, with an excess for some cancers.

PMID- 11197447
TI  - Oedema in childhood.
AB  - Oedema is a common childhood problem with important public health implications.
      It is an abnormal accumulation of fluid in the interstitial space which might
      result from a decrease in intravascular oncotic pressure, an increase in
      intravascular hydrostatic pressure, an increase in capillary permeability or
      impaired lymphatic drainage. Renal sodium retention is an important factor in
      generalised oedema. This article reviews the pathophysiology and aetiology of
      oedema in children and suggests an approach to evaluation, diagnosis and
      management of the problem.

PMID- 11197448
TI  - Urinary tract infection in children: a review of its pathogenesis and risk
      factors.
AB  - Urinary tract infection (UTI) is one of the commonest bacterial infections seen
      in children, ranking second only to those of the respiratory tract. A steady flow
      of urine, complete emptying of the bladder and various host defences provide the
      principal means of protection. Urinary stasis, on the other hand, provides an
      opportunistic environment for bacterial multiplication; several other factors
      also contribute to UTI, such as urinary obstruction, vesico-ureteric reflux (VUR)
      and other urinary tract malformations. UTI, especially in the presence of VUR,
      may lead to scarring of the kidney and progressive renal disease. It is vital,
      therefore, to diagnose such anomalies at an early stage, the overall aim being to
      identify those at high risk so that measures may be taken to prevent serious
      complications and preserve renal function. Those at low risk of UTI, however,
      should not be over investigated; this is in order to keep invasive procedures
      down to a minimum. Whenever possible, the management of high risk cases is best
      discussed between paediatrician, microbiologist, radiologist, urologist and the
      general practitioner.

PMID- 11197449
TI  - Dietary advice on cancer prevention: time for a change?
AB  - Media coverage of recent dietary intervention studies has cast doubt on dietary
      advice for cancer prevention. The studies cited focussed on colorectal adenoma
      initiation as opposed to progression. There is ample evidence that in the
      colorectum the factors controlling initiation of adenomas differ from those
      causing progression to cancer, and that it is the latter that are the most
      important. In the light of this it is argued that studies of adenoma initiation
      are irrelevant to the advice given for overall cancer prevention.

PMID- 11197450
TI  - The use of anthropometric and clinical parameters for early identification and
      categorisation of nutritional risk in pre-school children in Benin City, Nigeria.
AB  - This study was conducted in Benin City, Nigeria between June and August 1996 to
      assess nutritional status and health risks of three to five-year-old children,
      with the view to suggesting practical approaches to their early detection and
      intervention. A total of 165 children comprising 90 males and 75 females was
      studied. Mid-upper arm circumference (MUAC), weight-for-age (WFA), weight-for
      height (WFH) and height-for-age (HFA) z-scores were determined and used to
      calculate percentage prevalence of malnutrition. Clinical features of macro- and
      micro-nutrient deficiency were used to develop a clinical scoring system which
      was subsequently matched with anthropometric z-scores. The results showed that
      MUAC z-scores (-1.91 SD +/- 0.74) gave the highest percentage prevalence of
      malnutrition of 45.2% in this population, followed by the WFA (-1.22 SD +/- 1.07)
      and HFA (-0.84 SD +/- 1.42) z-scores with a percentage prevalence of 23.3% and
      20.6% respectively. The WFH z-score (-0.89 SD +/- 1.06) was the least sensitive
      in detecting malnutrition (14.7% prevalence). The percentage prevalence
      calculated from MUAC z-scores matched FAO figures (43%) for the sub-Saharan
      African region in 1996. MUAC z-scores also correlated more closely with the
      clinical features of malnutrition (R2 = 0.7087). Progressively worsening clinical
      features were also seen with decreasing z-scores for all variables. Even though
      moderate differences in clinical and anthropometric variables were detected
      between the sexes with females fairing better than male subjects, these
      differences were not statistically significant. Comparisons between
      anthropometric variables showed only weak correlation, except for WFA vs. HFA z
      scores (R2 = 0.5233) and WFH vs. WFA z-scores (R2 = 0.4559) which showed
      moderately positive correlation. We conclude that whereas MUAC z-scores were most
      sensitive in detecting the extent of malnutrition in this population, merely
      using anthropometric variables alone may lead to significant under-reporting of
      the prevalence of malnutrition in a community. A combination of various
      anthropometric z-scores with clinical features will however help in the early
      identification and categorisation of subjects in terms of degree of nutritional
      risk. The training of field health and nutrition workers should therefore
      emphasise the routine use and combination of anthropometric and clinical
      variables in the determination of prevalence of malnutrition and in the
      formulation of intervention strategies for nutrition rehabilitation.

PMID- 11197451
TI  - Is childhood allergy more common amongst an island population?
AB  - A rise in the prevalence of childhood asthma has been reported in both the UK and
      in several overseas countries during recent years. Wide geographical variations
      have also been demonstrated in the distribution of hay fever, atopic eczema and
      other allergic symptoms. It is the impression of many parents and some clinicians
      that allergic symptoms may be even higher amongst children in an island
      environment compared with a similar population on the mainland. To test this
      hypothesis, Guernsey and Jersey in the Channel Islands, and the Isle of Man in
      the Irish Sea participated as an independent arm in the International Study of
      Asthma and Allergy in Childhood (ISAAC). This entailed self-completion of a 38
      part pretested and validated questionnaire in a classroom setting under
      standardised conditions. A total of 3,772 secondary students in school years
      eight and nine living in the three islands were compared with 27,507 students of
      similar age in 93 British secondary schools enrolled in the larger UK study.
      There are a number of demonstrable differences in climate, home environment and
      lifestyle factors between the islands and mainland UK. Although results were
      generally above the UK mean, they were comparable with the reference region of
      South West England and invariably below the UK maximum. For instance, the
      prevalence of 'ever wheezed?', 'wheezed in last twelve months?', 'wheezed with
      exercise?' and 'diagnosis of asthma' were a mean of 50.5%, 34.5%, 31% and 19.7%
      in the islands compared with a UK prevalence of 48.8%, 33.3%, 28.5% and 20.7%,
      whilst the prevalence of 'runny nose ever?' and 'runny nose in last twelve
      months?' was a mean of 46.6% and 36.7% in the islands, compared with 47.1% and
      37.9% in the UK mean. These differences were not statistically significant. This
      information will be reassuring to parents of island children, and also
      demonstrates that services for the management of asthma and other allergic
      conditions should not be a higher public health priority in these locations than
      on the mainland of Britain.

PMID- 11197452
TI  - Dietary fibre, physicochemical properties and their relationship to health.
AB  - Dietary carbohydrates that escape digestion and absorption in the small intestine
      include non-digestible oligosaccharides (carbohydrates with a degree of
      polymerisation between three and ten), resistant starch and non-starch
      polysaccharides. The physiological effects of this heterogeneous mixture of
      substrates are partly predictable on the basis of their physicochemical
      properties. Monosaccharide composition and chain conformation influence the rate
      and extent of fermentation. Water-holding capacity affects stool weight and
      intestinal transit time. Viscous polysaccharides can cause delayed gastric
      emptying and slower transit through the small bowel, resulting in the reduced
      rate of nutrient absorption. Polysaccharides with large hydrophobic surface areas
      have potentially important roles in the binding of bile acids, carcinogens and
      mutagens. Ispaghula is capable of binding bile acids through a large number of
      weak binding sites on the polysaccharide structure, and having greatest effect on
      the potentially more harmful secondary bile acids deoxycholic acid and
      lithocholic acid.

PMID- 11197453
TI  - Do Asians with diabetes in Sandwell receive inferior primary care? A
      retrospective cohort study.
AB  - Although diabetes is more prevalent among Asian people, Asians with diabetes are
      anecdotally believed to receive a lesser standard of care, compared with non
      Asians. The aim of this study was to evaluate whether Asian patients with
      diabetes in Sandwell receive an inferior standard of care in primary care
      compared with non-Asians. Standards were based on tests carried out, in
      compliance with Sandwell's Diabetes Local Clinical Guideline. Data were collected
      from records of 774 patients with diabetes in 14 Sandwell practices. Proportions
      were recorded of Asian patients receiving specified tests, compared with non
      Asians. No significant differences were observed between Asians and non-Asians
      for checks on feet, eyes, body mass index (BMI), smoking or blood pressure.
      Significantly fewer Asians received an HbA1c check. The mean HbA1c value was
      higher in Asians. More Asian patients received a urine test than non-Asians.
      Asian patients generally had lower BMI values. When stratified by practice
      however, no significant differences between Asians and non-Asians were observed
      for any single check. No significant differences were found between the overall
      proportions of checks carried out between Asians and non-Asians. A wide variation
      was observed in the proportion of patients who had individual checks done,
      between practices. There were no systematic differences in the standard of care
      given to Asian and non-Asian patients. Practices varied a great deal in the
      extent to which they carry out, and record, checks on patients with diabetes. A
      possible explanation for the reason that no summary result showed a significant
      difference was due to the confounding effect of the practice: that general
      practices tended to treat all their patients--Asian and non-Asian--similarly.
      Nevertheless, general practitioners should therefore take steps to ensure that
      all patients with diabetes have these checks at recommended intervals.

PMID- 11197454
TI  - Medicine 2000 years ago: the case of Qumran and other biblical sites.
AB  - Since the eighteenth century, the dominance of orthodox or allopathic medicine in
      the West led to the branding of other forms of medicine as alternative. However,
      research shows a narrowing in the gap in popularity of the two methods and it is
      possible to envision a time when alternative medicine and mainstream medicine
      will work in tandem. As the West completes a year of millennium celebrations and
      looks back to the events that shaped the founding of the first millennium two
      thousand years ago, it is appropriate to increase our understanding of the form
      medicine took at that time. Research on Qumran and other biblical sites shows
      that the therapies offered there were based on alternative therapies such as
      herbal medicine and hydrotherapy as well as conventional therapy such as surgery.
      The article shows that the twin reliance on alternative and orthodox methods
      emerging today, marks a return to a pattern of provision which prevailed at the
      time the first millennium was born.

PMID- 11197455
TI  - Extramedullary plasmacytoma presenting as upper back pain.
AB  - Extramedullary plasmacytoma (EMP) is a rare soft tissue plasma cell tumour,
      usually presenting as a mass within the upper respiratory tract. It is most
      unusual for it to present in the posterior mediastinum as a primary solitary
      lesion. Discussed here is the case report of a patient who initially presented
      with musculoskeletal pain. Subsequent investigations, however, revealed the cause
      to be an EMP; diagnosis was made on finding aggregates of plasma cells on
      histological examination of the tissue specimen. The latter had been obtained by
      way of a computerised tomography scan guided biopsy of the tumour. Bone marrow
      aspiration studies showed no evidence of multiple myelomatosis. There was
      significant clinical improvement in response to radiotherapy. It is possible that
      this might represent one of the first documented reports of a primary solitary
      EMP in the posterior mediastinum.

PMID- 11197457
TI  - Future of the Web.

PMID- 11197456
TI  - A secondary interpretation is needed on serum CA 125 levels in case of serosal
      involvement.

PMID- 11197458
TI  - An overview of EPA regulation of the safe disposal of transuranic waste at the
      Waste Isolation Pilot Plant.
AB  - In March of 1999, the Waste Isolation Pilot Plant (WIPP) in southeast New Mexico,
      the world's first deep geological repository for radioactive materials, began
      receiving defense-related transuranic waste. The WIPP was designed and
      constructed by the U.S. Department of Energy, but critical to its opening was
      certification by the U.S. Environmental Protection Agency that the repository
      complies with the radioactive waste disposal regulations set forth as
      environmental radiation protection standards (40 CFR Part 191) and compliance
      criteria (40 CFR Part 194). This paper provides a summary of the regulatory
      process, including the Environmental Protection Agency's waste containment,
      groundwater protection, and individual dose regulations for the WIPP; the
      Department of Energy's performance assessment and the other parts of its
      compliance certification application; and the Environmental Protection Agency's
      review and analysis of the compliance certification application and related
      documentation.

PMID- 11197459
TI  - Detection of anthropogenic radionuclides by the CA002 monitoring station for the
      comprehensive test ban treaty.
AB  - A worldwide monitoring system for radioactive aerosols is being implemented for
      verification of the Comprehensive Test Ban Treaty. These 80 stations will detect
      airborne radioactivity not only from nuclear explosions but also from other
      anthropogenic and natural sources. A prototype unit has been in operation since
      April 1996 in Vancouver, British Columbia, Canada. It is a very sensitive system
      and reports clear signals for natural radioactivity, including cosmogenic 7Be,
      and the decay products from soil exhalation of 220Rn (thoron). In addition, there
      have been frequent detections of anthropogenic nuclides, probably coming from
      three distinct facilities-a medical isotope production center, a major university
      hospital, and a particle accelerator laboratory--all between 1 and 2 km away from
      the monitoring station. This experience is discussed to sensitize health
      physicists to the potential uses of this publicly available information.

PMID- 11197460
TI  - Determination and use of the monetary values of the averted person-sievert for
      use in radiation protection decisions in Hungary.
AB  - The monetary value of the averted dose is a key element in the implementation of
      the optimization principle both in radiation praxis and intervention. The main
      concept of this principle is to select options so as to maintain exposures at a
      reasonable level. The feature of this concept is to look for the minimal total
      cost, i.e., the sum of the costs of protection and health detriment. In its
      publications, ICRP emphasized the need for developing models which also take into
      account the "subjective" aspects of health detriment in the optimization process,
      such as the perception of risk by individuals and the need to put more emphasis
      on equity in the distribution of individual doses. This paper proposes a modified
      alpha-value model based on CEPN's model (Centre d'Etude sur L'Evaluation de la
      Protection dans le Domaine Nucleaire) to put more emphasis on recently published
      considerations about the smaller effects of the portion of collective dose
      derived from small doses. The parameters of the monetary value of unit collective
      dose averted, which is a key element of this type of model, can be estimated by
      means of approaches like human capital (HC) and willingness to pay (WTP) from the
      point of view of economic theories. The present study summarizes the results
      achieved by WTP among the radiation specialists mainly from the Paks Nuclear
      Power Plant, Hungary. The aim of the effort was to determine the value of a
      statistical life and the monetary value of a unit person-sievert associated with
      averted occupational exposure due to ionizing radiation. To apply the WTP method,
      a questionnaire has been prepared on the basis of the one introduced by CEPN in
      the late 1990's. The investigations show that the value of US$6,200 person-Sv(-1)
      seems to be acceptable for the alphabase-value for the occupational situation in
      Hungary in 1999. WTP assessments should be applied with caution since the
      economic level of the country, the workplace surveyed, and the computational
      methods affect the results. In addition, achieving a high level safety culture
      must rely on international cooperation both from the theoretical and practical
      viewpoints, and international markets affect the associated costs. Therefore the
      monetary requirements cannot always be assessed solely on a national basis.

PMID- 11197461
TI  - Methodology of radon monitoring and dose estimates in Postojna Cave, Slovenia.
AB  - Due to the specific work regime in the Postojna Cave, which depends primarily on
      the daily number of visitors, and on seasonal variations in air radon
      concentrations, an optimal methodology for radon and progeny measurement and dose
      calculation was sought. The program of measurement throughout the years was
      optimized, and now comprises 3-mo exposures of etched-track detectors, and twice
      a year, 8-10-d measurements using continuous monitors. Radon concentrations range
      from about 500 Bq m(-3) in winter to about 6,000 Bq m(-3) in summer, and
      equilibrium factors range from 0.42 to 0.69 in winter and from 0.33 to 0.86 in
      summer. Radiation doses from radon decay products for employees in the cave were
      calculated according to the ICRP 65 methodology. The basic input data are radon
      concentrations and equilibrium factors at two selected locations in the cave and
      the records of the time spent by a worker in the cave. Effective doses received
      by employees annually ranged from 0.02 to 8.4 mSv.

PMID- 11197462
TI  - 222Rn emanation from uranium-glazed ceramics.
AB  - Orange-red uranium-glazed dinnerware was found to emanate 222Rn to produce an
      average of less than 0.1 Bq 222Rn decay per piece, which should have no
      associated health risks. Comparison of 222Rn emanation to 226Ra in glazes
      (measured by alpha spectrometry) indicated inefficient emanation (<5%) of 222Rn,
      consistent with the low radon levels observed and with the presence of 222Rn
      progeny in glazes. These studies also showed that reagent grade uranium compounds
      may emanate measurable 222Rn.

PMID- 11197463
TI  - Thermodiffusion in concrete slab as a driving force of indoor radon entry.
AB  - The core of the hypotheses considered is that there is an additional strong
      driving force-the thermodiffusion of radon and soil air in concrete and soils,
      which can cause an intensive indoor radon entry. A vertical thermogradient in the
      slab causes thermodiffusion air flux through concrete into the house. The proof
      of this concept is based on consideration of concrete slab as a micro-porous
      system having a pore-size distribution that mostly pertains to Knudsen's region
      and a transition zone of pore sizes. The Knudsen's theory for a transition zone
      is developed, which is consistent with the known experimental data of
      thermodiffusion. Calculated thermodiffusion air flux across a concrete slab under
      thermogradient 80 K m(-1) approximately ranges 1 x 10(-7)-1 x 10(-6) kg x m(-2) x
      s(-1). The calculated typical radon-bearing advective air velocity in soil due to
      thermogradient in the slab is about 1 x 10(-6) m x s(-1).

PMID- 11197464
TI  - Chromosome aberrations study of pupils in high radon level elementary school.
AB  - The ICRP Publication 65 recommends 200-600 Bq x m(-3) as the indoor radon action
      level for the general public. In Slovenia, a value of 400 Bq x m(-3) has been
      proposed but not yet approved. In a nation-wide radon project financed by the
      Health Inspectorate of Slovenia, it was discovered that the elementary school
      named "S3" belongs to a group of schools with elevated winter indoor radon
      concentrations up to 7,000 Bq x m(-3). Opening windows and doors during classes
      substantially decreased radon concentrations, but very seldom below 1,000 Bq x m(
      3). Yearly effective doses for pupils, estimated according to ICRP 65, ranged
      from 7 to 11 mSv. Because the pupils have been subjected to the elevated radon
      concentrations, special preventive health checks have been performed. The
      examination protocol included mutagenetic tests, one for structural chromosomal
      aberrations and the other a micronucleus test. Altogether 85 pupils (37 girls and
      48 boys) from the first four grades between the ages of 9 and 12 y were examined.
      An increase in cytogenetic damage was found for these pupils, compared to the
      control group, composed of pupils of the same age from another area with indoor
      radon concentrations in their school of below 400 Bq x m(-3). The incidence of
      structural chromosomal aberrations reached 2.0% (0.5-4) and micronucleus test was
      6.52 per 500 cells with a maximum of 15 in some cases. In the control group
      structural chromosomal aberrations varied from 0.5 to 2.5%, while the maximum
      incidence of micronucleus was 9 micronucleus per 500 CB cells. The results
      obtained are preliminary and suggest a need to expand the study. A long-term
      radon survey, at least over a year, of the homes and wider residential
      environment of the pupils would be necessary to assess the correlation between
      radon exposure and both structural chromosomal aberrations and micronucleus
      findings.

PMID- 11197465
TI  - Effects of gadolinium on the retention and translocation of 239Pu-hydroxide.
AB  - The effect of gadolinium on the lung retention, excretion, and translocation of
      plutonium was studied in rats instilled intratracheally with plutonium hydroxide
      with and without gadolinium. Three types of plutonium hydroxide were prepared:
      pure 239Pu-hydroxide colloid, that containing a high concentration of gadolinium,
      and that containing a low concentration of gadolinium. The lung retention of
      239Pu was higher and the fecal excretion was lower in the rats administered 239Pu
      hydroxide containing a high concentration of gadolinium than those administered
      pure 239Pu-hydroxide colloid. The translocation of 239Pu from lung to other
      organs including the liver, spleen, femur, and kidney was not affected by
      gadolinium. The cytological examination of bronchoalveolar lavage cells showed
      that the administration of 239Pu-hydroxide containing a high concentration of
      gadolinium induced the inflammatory reactions in the lung. The delayed alveolar
      clearance of plutonium in the rats administered 239Pu-hydroxide colloid
      containing a high concentration of gadolinium may be attributable to the change
      in physicochemical characteristics of colloid and the inflammation induced in the
      lung by gadolinium.

PMID- 11197466
TI  - Radon in public water supplies in Migdonia basin, Central Macedonia, Northern
      Greece.
AB  - The main objective of this work is the accurate measurement of radon
      concentration in the public water supplies of the Migdonia basin in Northern
      Greece. The main aim is to localize the sub-areas that present high radon
      concentrations in water and to inform the local authorities so that more detailed
      studies might be set up in these areas. About 80 samples from special bore holes
      and taps that supply the local population with fresh water were collected in
      order to obtain detailed radon measurements. For the analyses, a liquid
      scintillation counting system, using the Packard protocol for measuring radon in
      water, was employed. The results of the investigation show that radon
      concentrations in these public water supplies are significant. The concentrations
      ranged from background concentrations to 170 Bq x L(-1). The level of 50 Bq x L(
      1) is exceeded in 23% of water supplies. These preliminary results with initial
      data interpretation and inter-comparison assessment are presented. These results
      of the analyses showed that elevated radon concentrations were detected in water
      samples from an area at the western part of the Lake Volvi, due probably to the
      local intense tectonism, and from a village above the Lake Koronia.

PMID- 11197467
TI  - Temperature dependence of adsorption coefficients of 222Rn on activated charcoal
      determined by adsorption-desorption method.
AB  - Adsorption coefficients of 222Rn on five activated charcoal were determined (at 
      21, +7 and +26 degrees C) by an adsorption-desorption technique using a radon
      source and an Erlenmeyer flask. They varied from 1.1 to 41.2 L x g(-1). From this
      variation the mean heat of adsorption of radon on our charcoal was calculated as
      equal to 4,630(50) cal/mole.

PMID- 11197468
TI  - Did NATO attacks in Yugoslavia cause a detectable environmental effect in
      Hungary?
AB  - Because of the intensive NATO bombardment of the neighboring region to Hungary,
      i.e., Vojvodina, North Yugoslavia, air monitoring for detection of depleted
      uranium particles supposed to be used as a component of bullets was extended to
      the Southern region of the country. Alpha spectrometry was applied as a sensitive
      analytical technique able to detect uranium. Though no depleted uranium was
      detected in air by the sensitive technique of alpha-spectrometry, the increased
      uranium content in natural ratio as a component of normal soil, natural gas,
      etc., is suggested to originate from well dispersed dust (2.5 microm size)
      emitted to the atmosphere by explosions during bombing. This observation is
      supported by the geographical distribution and the relatively rapid decrease of
      pollution after the bomb attacks ceased.

PMID- 11197469
TI  - Radiographic operations and safety in the Nigerian petroleum industry.
AB  - This work reports on a radiation safety study of the use of radioactive sources
      and radiation-producing machines for radiographic purposes in the Nigerian
      Petroleum Industry. It is a part of a wider study on the level of safety in the
      use of radiation in the country-a study that covered the manufacturing and
      petroleum industries. The survey assessment is based on minimum requirements for
      radiological safety, on a scale of 0-100, to protect personnel, the public, and
      the environment from artificial radiation sources. The survey result shows that
      the level of safety in the use of radiation-emitting machines for radiographic
      purposes is scored at 52, while it is 66 in the use of radioisotopes.
      Consequently, the level of safety in radiographic practices in the Nigerian
      Petroleum Industry is about 60% of the ideal.

PMID- 11197470
TI  - Comment on article by Skedsmo and Vistnes.

PMID- 11197471
TI  - IAEA report to the UN. International Atomic Energy Agency.

PMID- 11197472
TI  - Spiers Memorial Lecture. On the hypothesis of cathodic protection of genes.

PMID- 11197473
TI  - Electron transfer mediated by glucose oxidase at the liquid/liquid interface.
AB  - In order to establish an experimental basis for exploring the reactivity of
      membrane-bound redox enzymes using electrochemistry at an organic/aqueous
      interface, the reactivity of glucose oxidase adsorbed at the dichloroethane/water
      interface has been studied. Turnover of glucose in the aqueous phase mediated by
      dimethyl ferricenium electrogenerated in the organic phase was measured by
      measuring the feedback current caused by recycling the mediator as the generator
      electrode approached close to the interface from the organic side. An unexpected
      self-exchange reaction of the ferrocene at the interface was suppressed by
      adsorption of a surfactant. The interfacial enzyme reaction could be
      distinguished from reaction within the bulk of the aqueous phase. Reaction within
      a protein-surfactant film formed at the interface is conjectured.

PMID- 11197474
TI  - Biomaterial engineered electrodes for bioelectronics.
AB  - A series of single-cysteine-containing cytochrome c, Cyt c, heme proteins
      including the wild-type Cyt c (from Saccharomyces cerevisiae) and the mutants
      (V33C, Q21C, R18C, G1C, K9C and K4C) exhibit direct electrical contact with Au
      electrodes upon covalent attachment to a maleimide monolayer associated with the
      electrode. With the G1C-Cyt c mutant, which includes the cysteine residue in the
      polypeptide chain at position 1, the potential-induced switchable control of the
      interfacial electron transfer was observed. This heme protein includes a
      positively charged protein periphery that surrounds the attachment site and faces
      the electrode surface. Biasing of the electrode at a negative potential (-0.3 V
      vs. SCE) attracts the reduced Fe(II)-Cyt c heme protein to the electrode surface.
      Upon the application of a double-potential-step chronoamperometric signal onto
      the electrode, where the electrode potential is switched to +0.3 V and back to 
      0.3 V, the kinetics of the transient cathodic current, corresponding to the re
      reduction of the Fe(III)-Cyt c, is controlled by the time interval between the
      oxidative and reductive potential steps. While a short time interval results in a
      rapid interfacial electron-transfer, ket1 = 20 s-1, long time intervals lead to a
      slow interfacial electron transfer to the Fe(III)-Cyt c, ket2 = 1.5 s-1. The fast
      interfacial electron-transfer rate-constant is attributed to the reduction of the
      surface-attracted Fe(III)-Cyt c. The slow interfacial electron-transfer rate
      constant is attributed to the electrostatic repulsion of the positively charged
      Cyt c from the electrode surface, resulting in long-range electron transfer
      exhibiting a lower rate constant. At intermediate time intervals between the
      oxidative and reductive steps, two populations of Cyt c, consisting of surface
      attracted and surface-repelled heme proteins, are observed. Crosslinking of a
      layered affinity complex between the Cyt c and cytochrome oxidase, COx, on an Au
      electrode yields an electrically-contacted, integrated, electrode for the four
      electron reduction of O2 to water. Kinetic analysis reveals that the rate
      limiting step in the bioelectrocatalytic reduction of O2 by the integrated Cyt
      c/COx electrode is the primary electron transfer from the electrode support to
      the Cyt c units.

PMID- 11197475
TI  - Engineering artificial redox chains by molecular 'Lego'.
AB  - This work reports on a novel approach for building artificial redox chains: the
      molecular 'Lego' approach. This exploits the scaffold of natural redox proteins
      by fusing together functional protein modules with the desired properties. The
      molecular 'Lego' mimics the natural molecular evolution that proceeded by modular
      assembly of genes/DNA segments. Non-physiological electron transfer partners,
      flavodoxin (fld) and cytochrome c553 (c553) from Desulfovibrio vulgaris and the
      haem domain of P450 BM3 (BMP) from Bacillus megaterium have been used as building
      blocks in different combinations to build artificial redox chains. The kinetic
      characterization of the electron transfer (ET) between the separate building
      blocks has been carried out. Under pseudo-first order conditions, a limiting ET
      rate, klim, of 0.48 +/- 0.05 s-1 and 43.77 +/- 2.18 s-1 and an apparent binding
      constant, Kapp, of 21 +/- 6 microM and 1.23 +/- 0.32 microM have been found for
      the fld/c553 and fld/BMP redox pairs, respectively. These results show that fld
      can be used as a module for transferring electrons to c553 and BMP. A 3D model of
      the fld/c553 and fld/BMP complexes was used to guide the construction of
      covalently linked assemblies via engineered disulfide bridges or by fusion of the
      relevant genes via an engineered loop. The first approach led to the
      construction, expression and characterization of the S35C and S64C mutants of fld
      and M23C and G51C mutants of c553. Although the redox potentials of the separate
      mutants were found to be the same as those of recombinant wild type proteins (
      408 mV for the semiquinone/hydroquinone couple of fld and +32 mV for the c553),
      the c553 homo-dimers M23C-M23C and G51C-G51C were found to have redox potentials
      of +88 and +105 mV, respectively. These differences have been analysed in terms
      of exposure of the haem cofactors to the solvent, and these lead to some
      interesting questions on the redox potentials of the transient redox complexes in
      physiological systems. The fld-c553 S64C-M23C and S35C-M23C chimeras were
      constructed, expressed and purified but the FMN was found to be destabilised
      resulting in the apo-form of these proteins. The gene fusion strategy was used to
      produce covalently linked assemblies of both fld-c553 and fld-BMP. The former was
      expressed using a seven amino acid (GPGPGPG) loop linking the C-terminus of fld
      to the N-terminus of c553. The fld-BMP fusion protein was successfully expressed
      by using the naturally occurring loop of the P450 BM3 (residues 471-479) to link
      the BMP domain at the N-terminus with fld domain at the C-terminus. This fusion
      was found to be correctly folded and functional. Efficient ET from the FMN to the
      haem domain (370 s-1) was also found to be in the same region of the
      physiological redox partners (250 s-1). This work demonstrates the feasibility of
      the molecular 'Lego' approach in generating functional multi-domain proteins with
      designed properties, beyond the restrictions imposed by the naturally occurring
      protein domains.

PMID- 11197476
TI  - A scanning tunnelling study of immobilised cytochrome P450cam.
AB  - A site-specifically engineered surface cysteine residue, located in a region
      where the haem moiety is closest to the surface, is used to anchor cytochrome
      P450cam enzyme molecules covalently to a gold electrode. More reproducibly
      ordered adsorption, at high coverage, occurs with this K344C mutant than with the
      wild-type enzyme. The subsequently formed close-packed monolayer arrays have been
      probed by scanning tunnelling microscopy under ambient conditions and under
      aqueous (buffered) solution at high resolution. Initial indications suggest that
      the immobilised enzyme is both electrochemically addressable and catalytically
      active.

PMID- 11197477
TI  - Using direct electrochemistry to probe rate limiting events during nitrate
      reductase turnover.
AB  - Protein film voltammetry of NarGH catalysing nitrate reduction under steady state
      conditions provides information on events occurring within the enzyme during the
      catalytic cycle. In this discussion we have focused on exploring the ability of
      two simple catalytic schemes to reproduce the voltammetric response of NarGH;
      electron transfer to the enzyme's active site being described either by
      interfacial electron exchange (Scheme 1) or intramolecular electron delivery via
      the operation of an electron relay centre (Scheme 2). When the two electron
      reduced, catalytically competent active site of the enzyme is generated from the
      oxidised form in 'rapid', non-rate limiting steps of the catalytic cycle, the
      voltammetric behaviour of NarGH cannot be reproduced. Rather under all the
      conditions investigated, one electron reduction of the active site from a semi
      reduced to a fully-reduced state is found to be crucial to progression through
      the enzyme's catalytic cycle. The catalytically relevant semi- and fully-reduced
      oxidation states of the NarGH active site are most likely to correspond to the
      Mo(V) and Mo(IV) states of the Mo(MGD)2 centre, respectively, although it is not
      possible to rule out the possibility that they correspond to molybdopterin based
      oxidation states as observed in other enzymes. We suggest that the rate of either
      conformational rearrangement within the semi-reduced active site or
      intramolecular electron delivery to the active site constitutes a defining
      feature in the catalytic cycle of NarGH and results in the napp approximately 1
      appearance of the catalytic waveform.

PMID- 11197478
TI  - Fast voltammetric studies of the kinetics and energetics of coupled electron
      transfer reactions in proteins.
AB  - A wealth of information on the reactions of redox-active sites in proteins can be
      obtained by voltammetric studies in which the protein sample is arranged as a
      layer on an electrode surface. By carrying out cyclic voltammetry over a wide
      range of scan rates and exploiting the ability to poise or pulse the electrode
      potential between cycles, data are obtained that are conveniently (albeit
      simplistically) analysed in terms of plots of peak potentials against scan rate.
      A simple reversible electron-transfer process gives rise to a 'trumpet'-shaped
      plot because the oxidation and reduction peaks separate increasingly at high scan
      rate; the electrochemical kinetics are then determined by fitting to Butler
      Volmer or Marcus models. Much more interesting though are the ways in which this
      'trumpet plot' is altered, often dramatically, when electron transfer is coupled
      to biologically important processes such as proton transfer, ligand exchange, or
      a change in conformation. It is then possible to derive particularly detailed
      information on the kinetics, energetics and mechanism of reactions that may not
      revealed clearly or even at all by other methods. In order to interpret the
      voltammetry of coupled systems, it is important to be able to define 'ideal
      behaviour' for systems that are expected to show simple and uncoupled electron
      transfer. Accordingly, this paper describes results we have obtained for several
      proteins that are expected to show such behaviour, and compares these results
      with theoretical predictions.

PMID- 11197479
TI  - The effect of pH and ligand exchange on the redox properties of blue copper
      proteins.
AB  - A study of the structure and redox properties of the copper site in azurins by
      means of EXAFS, NMR, redox titrations, potentiometry, equilibrium cyclic
      voltammetry and rapid scan voltammetry on protein films is reported. The results
      are discussed in light of existing theories on structure and function of type-1
      copper sites. The exit and entry of electrons take place through the C-terminal
      histidine ligand of the copper. The hydrophobic patch through which this residue
      penetrates the protein surface plays an important role in partner docking (cf.
      The rim of the porphyrin ring sticking through the surface of the cytochromes-c).
      We find no experimental evidence for strain around the metal site. The active
      centre is able to maintain ET activity even in the presence of fairly gross
      disturbances of the site structure. The analysis of the thermodynamics of the
      redox reaction shows that the protein matrix and the solvent play an important
      role in 'tuning' the redox potential around a "design" value of around 300 mV at
      room temperature. The metal site appears "designed" to stabilise the Cu(II)
      instead of the Cu(I) form. The remarkable evolutionary success of the blue copper
      proteins is ascribed to the sturdy overall beta-sandwich structure of the protein
      in combination with a metal site that is structurally adaptable because three of
      its four ligands are located on a loop. The electronic "gate" that occurs in the
      middle of a hydrophobic patch allows for fine tuning of the docking patch for
      recognition purposes.

PMID- 11197480
TI  - Modulation of redox potential in electron transfer proteins: effects of complex
      formation on the active site microenvironment of cytochrome b5.
AB  - The reduction potential of cytochrome b5 is modulated via the formation of a
      complex with polylysine at the electrode surface (Rivera et al., Biochemistry,
      1998, 37, 1485). This modulation is thought to originate from the neutralization
      of a solvent exposed heme propionate and from dehydration of the complex
      interface. Although direct evidence demonstrating that neutralization of the
      charge on the heme propionate contributes to the modulation of the redox
      potential of cytochrome b5 has been obtained, evidence demonstrating that water
      exclusion from the complex interface plays a similar role has not been
      conclusive. Herein we report the preparation of the V45I/V61I double mutant of
      rat liver outer mitochondrial membrane (OM) cytochrome b5. This mutant has been
      engineered with the aim of restricting water accessibility to the exposed heme
      edge of cytochrome b5. The X-ray crystal structure of the V45I/V61I mutant
      revealed that the side chain of Ile at positions 45 and 61 restricts water
      accessibility to the interior of the heme cavity and protects a large section of
      the heme edge from the aqueous environment. Electrochemical studies performed
      with the V45I/V61I mutant of cytochrome b5, and with a derivative in which the
      heme propionates have been converted into the corresponding dimethyl ester
      groups, clearly demonstrate that dehydration of the heme edge contributes to the
      modulation of the reduction potential of cytochrome b5. In fact, these studies
      showed that exclusion of water from the complex interface exerts an effect
      (approximately 40 mV shift) that is comparable, if not larger, than the one
      originating from neutralization of the charge on the solvent exposed heme
      propionate (approximately 30 mV shift).

PMID- 11197481
TI  - Surface immobilized biochemical macromolecules studied by scanning Kelvin
      microprobe.
AB  - The measurement of work function is a particularly effective method for the
      characterization of surfaces because of the sensitivity of the parameter to
      interfacial structure, modification and overall chemistry. Accordingly,
      techniques for the analysis of work function offer a powerful tool for monitoring
      surface chemical changes, especially for situations involving the immobilization
      of new moieties at the interface. In the present paper, we describe the
      performance of a new, modified scanning Kelvin microprobe which is capable of the
      tandem measurement of contact potential and surface topography with resolutions
      of 1 mV and 10 nm, respectively. The lateral resolution is 1 micron. The
      instrument has been applied to the study of substrates modified by the attachment
      of biochemical macromolecules such as oligonucleotides and DNA. This preliminary
      work confirms the great potential of the technique in the study of
      biocompatibility, macromolecular structure and microarray devices.

PMID- 11197482
TI  - Polyferredoxin-based electrode materials.
AB  - Electrochemical oxidation of the hydrosulfide cluster [Fe4S4(SH)4]2- on gold,
      platinum or vitreous carbon in a methyl cyanide electrolyte leads to the growth
      of a conducting film. Spectroscopic and other evidence suggests that the film has
      cubane centres, predominately in the [4Fe4S]3+ oxidation state, which are linked
      by disulfide ligands to give an anionic array of [Fe4S4(S approximately)4]n-
      units. X-ray data suggests some long-range order in the electrode material. The
      polyferredoxin binds redox active cations consistent with an anionic array.

PMID- 11197483
TI  - Electron-transfer pathways between redox enzymes and electrode surfaces:
      reagentless biosensors based on thiol-monolayer-bound and polypyrrole-entrapped
      enzymes.
AB  - Based on previous results which showed that quinohemo-protein alcohol
      dehydrogenase (QH-ADH) entrapped within polypyrrole is able to directly transfer
      electrons via the conducting polymer to the electrode surface, the electron
      transfer properties of this multi-cofactor enzyme adsorbed and covalently-bound
      to self-assembled thiol monolayers and bare electrode surfaces has been
      investigated more closely. While the dissolved enzyme is able to transfer
      electrons to the electrode via heme c as well as via the more deeply buried PQQ
      (fast adsorption-chemical reaction-desorption mechanism), an orientation of
      adsorbed QH-ADH on hydrophobic electrode surfaces, as well as of adsorbed and
      covalently bound QH-ADH on negatively-charged thiol monolayers could be observed.
      In these cases the heme c units are pointing towards the electrode surfaces
      resulting in an optimised direct ET rate.

PMID- 11197484
TI  - Electrochemical approach to the dynamics of molecular recognition of redox enzyme
      sites by artificial cosubstrates in solution and in integrated systems.
AB  - Application of antigen-antibody technology allows the attachment to an electrode
      surface of an enzyme monolayer structure to which both the enzyme and the
      mediator are bound. As illustrated with the example of glucose oxidase and a
      ferrocene mediator, the enzyme preserves its full activity in such structures,
      which may be easily reproduced. In spite of their fixation to the structure, the
      mobility of the ferrocene heads is sufficient to ensure that its transport to the
      enzyme prosthetic group is not rate determining. The reaction is rather
      controlled by the prior formation of a complex between the ferrocenium ion and
      the flavin required for electron transfer to occur. The efficiency of this step
      is affected by steric hindrance and the various observations made with free
      moving and attached ferrocene-ended poly(ethylene glycol) chains may be
      rationalized by the interplay of factors controlling their distribution and
      shape. Analyzing the dynamics of this system, in comparison with previous
      systems, was thus an occasion to shed further light on the recognition
      phenomenon. The enzyme monolayer integrated system is a good starting point for
      the step-by-step construction of spatially ordered multilayered assemblies with
      strong catalytic efficiencies. Fast responding systems are expected both in terms
      of electron transport and electron transfer between the mediator and the enzyme.
      The spatial order resulting from the step-by-step construction should allow a
      much more precise analysis of electron transport and electron transfer than in
      conventional assemblies of redox centers. Mastering both the construction and the
      functioning of such systems should help the design of more complex systems,
      integrating additional functionalities electrically controlled by means of their
      electron transport/electron transfer connection to the electrode surface.

PMID- 11197485
TI  - Direct heterogeneous electron transfer of recombinant horseradish peroxidases on
      gold.
AB  - Clean polycrystalline gold electrodes were modified with native glycosylated
      horseradish peroxidases (HRP) or two different recombinant (carbohydrate free)
      HRPs; recombinant wild-type HRP (rec-HRP) and recombinant HRP containing a six
      histidine-tag at the C-terminus of the polypeptide chain (rec-HRP-His),
      respectively. Only the electrodes modified with the recombinant HRPs exhibited
      high current responses to H2O2 due to relatively rapid direct electron transfer
      (ET) between recombinant HRP and gold. The absence of a carbohydrate shell on rec
      HRP and the additionally existing histidine-tag on rec-HRP-His improved the
      electrode sensitivity to H2O2 by more than 100 times if compared with the
      response observed at gold modified with native HRP. Rotating disk electrode
      experiments indicated that the heterogeneous electron transfer rates are equal to
      4.7 and 7.5 s-1 for direct electron transfer between the gold electrode and rec
      HRP or rec-HRP-His, respectively.

PMID- 11197486
TI  - Development and comparison of biosensors for in-vivo applications.
AB  - Electrochemical biosensors have been of increasing interest, especially those
      developed to be directly applied in diagnostic areas, such as neuroscience. We
      have been interested in developing a range of biosensors for monitoring glucose,
      lactate, pyruvate, and glutamate in order to study on-line both brain function in
      the laboratory and to monitor brain health in neurointensive care. For a
      biosensor to function effectively in these situations, it has to combine the
      following characteristics: quick response and high sensitivity, good
      reproducibility and adequate stability. In this study we compared the performance
      of a number of different amperometric biosensors strategies. These included
      ferrocene mediation of immobilised enzymes (system A), a redox hydrogel based
      system (system B), and a conducting polymer approach using polyaniline (system
      C). All assays were operated as flow-injection systems with upstream immobilised
      enzyme beds if necessary. When calibrated for H2O2 systems A and B reacted
      quickly enough to give quantitative conversion up to 0.2 mM. Above this
      concentration the response was limited by horseradish peroxidase enzyme kinetics
      and eventually enzyme loading. System C showed a restricted H2O2 response. When
      calibrated for glucose (by use of immobilised glucose oxidase) system B exhibited
      the highest sensitivity but its analytical range was restricted because the
      system became limited by H2O2 response. System A had low sensitivity for analyte
      compared to H2O2 and system B, but a greater useful range. Problems of mediator
      cycling between the immobilised enzymes are discussed. System C gave an excellent
      linear range but sensitivity was limited by background noise. Stability and
      reproducibility of the systems are also described. In conclusion, from this study
      the ferrocene system proved to be overall most useful and has now been used in
      the first dual on-line monitoring of glucose and lactate in patients in
      neurointensive care.

PMID- 11197487
TI  - An independently addressable microbiosensor array: what are the limits of sensing
      element density?
AB  - A microdisc sensor array, prepared by thin film technology, has been used as a
      model for miniaturized multi-functional biosensors. It consists of a series of
      wells, 20 microns in diameter, possessing a 1000 A Pt layer at the bottom that
      serves as the indicating electrode. The depth of the wells ranged from 2.3-24
      microns, depending on the photoresist employed and the spinning speed used to
      coat the electrode interconnect grid. Ten such wells were arranged in a circular
      array within an area of radius 130 microns. The center to center distance between
      any two of the discs ranged from 30 to 155 microns. Each disc is connected by a
      conductive film line to corresponding pads on the side of the sensor chip. A
      cylinder placed on top of the chip array formed the electrochemical cell into
      which a common reference and counter electrode were placed. The reference
      electrode was operated at ground potential. Prior to the evaluation of enzyme
      sensors, an assessment of "chemical cross-talk", the perturbation of sensor
      response resulting from the overlap of proximal diffusion layers, was made using
      Fe(CN)6(4-). The preliminary conclusion is that the sensing elements probably
      must be separated by about 100 microns in order to avoid interference from
      adjacent sensors. A technique was developed for the precision delivery of enzyme
      and cross-linking agent to the 2.3 microns cavity, having a capacity of 4 pL.
      This procedure makes possible the preparation of sensor arrays capable of
      detecting different analytes by employing different enzymes. The sensors gave
      reasonably rapid (2-4 s) response with linearity (up to about 10 mM. However, the
      sensors in the center of the array clearly showed the effects of depletion of
      substrates by the surrounding sensors.

PMID- 11197488
TI  - Analysis of individual biochemical events based on artificial synapses using
      ultramicroelectrodes: cellular oxidative burst.
AB  - Carbon fiber platinized ultramicroelectrodes placed within micrometres of a
      single living cell are used to monitor cellular events. This artificial synapse
      is used here to collect and examine the very nature of the massive oxidative
      bursts produced by human fibroblasts when their membrane is locally depolarized
      by a puncture made with a micrometre sized sealed pipette. The electrochemical
      analysis of the response indicates that oxidative bursts consist of a mixture of
      a few femtomoles of highly cytotoxic chemicals: hydrogen peroxide, nitrogen
      monoxide and peroxynitrite, together with nitrite ions, which may result from a
      partial spontaneous decomposition of peroxynitrite prior to its release by the
      cell.

PMID- 11197489
TI  - Protein adsorption on nanoporous TiO2 films: a novel approach to studying
      photoinduced protein/electrode transfer reactions.
AB  - We have investigated the use of nanoporous TiO2 films as substrates for protein
      immobilisation. Such films are of interest due to their high surface area,
      optical transparency, electrochemical activity and ease of fabrication. These
      films moreover allow detailed spectroscopic study of protein/electrode electron
      transfer processes. We find that protein immobilisation on such films may be
      readily achieved from aqueous solutions at 4 degrees C with a high binding
      stability and no detectable protein denaturation. The nanoporous structure of the
      film greatly enhances the active surface area available for protein binding (by a
      factor of up to 850 for an 8 microns thick film). We demonstrate that the redox
      state of proteins such as immobilised cytochrome-c (Cyt-c) and haemoglobin (Hb)
      may be modulated by the application of an electrical bias potential to the TiO2
      film, without the addition of electron transfer mediators. The binding of Cyt-c
      on the TiO2 films is investigated as a function of film thickness, protein
      concentration, protein surface charge and ionic strength. We demonstrate the
      potential use of immobilised Hb on such TiO2 films for the detection of dissolved
      CO in aqueous solutions. We further show that protein/electrode electron transfer
      may be initiated by UV bandgap excitation of the TiO2 electrode. Both
      photooxidation and photoreduction of the immobilised proteins can be achieved. By
      employing pulsed UV laser excitation, the interfacial electron transfer kinetics
      can be monitored by transient optical spectroscopy, providing a novel probe of
      protein/electrode electron transfer kinetics. We conclude that nanoporous TiO2
      films may be useful both for basic studies of protein/electrode interactions and
      for the development of novel bioanalytical devices such as biosensors.

PMID- 11197490
TI  - Layer-by-layer electrostatic deposition of biomolecules on surfaces for molecular
      recognition, redox mediation and signal generation.
AB  - Layer-by-layer supramolecular structures composed of alternate layers of
      negatively charged enzymes and cationic redox polyelectrolyte have been
      assembled. Glucose oxidase (GOx), lactate oxidase (LOx) and soybean peroxidase
      (SBP) have been electrically wired to the underlying electrode by means of
      poly(allylamine) with [Os(bpy)2ClPyCOH]+ covalently attached (PAA-Os) in
      organized structures with high spatial resolution. Biotinylated glucose oxidase
      has also been used to assemble step-by-step on antibiotin goat immunoglobulin
      (IgG) layers and the enzyme was electrically wired by PAA-Os. These spatially
      organized multilayers with mono- and bienzymatic schemes can work efficiently in
      molecular recognition, redox mediation and generation of an electrical signal.
      The concentration of redox mediator integrated into the multilayers, obtained
      from the voltammetric charge and an estimation of the layer thickness, exceeds by
      100-fold the amount of deposited enzyme assessed by quartz crystal microbalance.
      Differences in GOx electrical wiring efficiency have been detected with the
      different assembling strategies. The surface concentration of electrically wired
      enzyme represents a small proportion of all the enzyme molecules present in the
      multilayers which can be oxidized by the soluble mediator [Os(bpy)2Cl PyCOOH]Cl.
      This proportion, as well as the rate of FADH2 oxidation by PAA-Os, increases with
      the number of electrically wired enzyme layers and with the spatial accessibility
      of the Os moiety to the enzyme active center.

PMID- 11197491
TI  - Applications of polyion films containing biomolecules to sensing toxicity.
AB  - This paper describes several applications of polyion-biomolecule films on
      electrodes related to future development of in vitro chemical toxicity sensors.
      In the first example, composite films of DNA and ionomers cast onto pyrolytic
      graphite (PG) electrodes are shown to be useful for detecting DNA damage during
      incubation with the carcinogen styrene oxide at pH 5.5. Single electrodes can be
      used to estimate relative damage rates by derivative square wave voltammetry.
      Films containing the ionomer Nafion gave better reproducibility than another
      ionomer, Eastman AQ38. In the second example, films containing redox proteins
      myoglobin (Mb) and cytochrome (cyt) P450cam were constructed in alternate layers
      with polyions including DNA on rough PG electrodes. Films with reversible protein
      FeIII/FeII electrochemistry with up to 7 electroactive layers were made. Amounts
      of electroactive protein on rough PG that were 7 to 17-fold larger than in
      similar films on smooth gold were achieved because many more layers were
      electroactive. Films of Mb/DNA also showed oxidation peaks after short
      incubations with styrene oxide that may be attributable to DNA damage. Results
      are relevant to the future design of enzyme-DNA films which convert pollutants
      and drugs to reactive metabolites, followed by electrochemical detection of the
      resulting DNA damage.

PMID- 11197492
TI  - The electrochemistry of ubiquinone-10 in a phospholipid model membrane.
AB  - The electrochemistry of ubiquinone-10, UQ, incorporated over a phospholipid layer
      adsorbed on a mercury drop electrode has been investigated over a wide pH range.
      It is shown that the position of the quinone headgroup in relation to the lipid
      determines the reversibility of the redox chemistry. For pH <7, the reaction
      follows a disproportionation route involving the ubiquione radical. There is
      evidence for the presence of a parallel reaction sequence. The bifurcation point
      appears to occur for the UQ molecule, which disproportionates after protonation
      and reduction, in parallel with direct electron transfer to yield the UQ--radical
      anion. The incorporation of UQ in a lipid monolayer makes its reduction very
      irreversible for pH > 7.

PMID- 11197493
TI  - Transforming growth factor-beta1 adsorbed to tricalciumphosphate coated implants
      increases peri-implant bone remodeling.
AB  - Increasing experimental interest has emerged for the use of growth factors to
      stimulate bone healing and bone formation in various clinical situations. We and
      others have demonstrated that recombinant human transforming growth factor-beta1
      (rhTGF-beta1) adsorbed onto tricalcium phosphate (TCP)-coated implants can
      improve mechanical fixation and bone ongrowth. The present study evaluated bone
      remodeling in newly formed bone and adjacent trabecular bone around TCP-coated
      implants with and without rhTGF-beta1 adsorption. Unloaded cylindrical grit
      blasted titanium alloy implants coated with TCP were inserted bilaterally into
      the femoral condyles of 10 skeletally mature mongrel dogs. The implants were
      initially surrounded by a 2 mm gap. Implants with 0.3 microg rhTGF-beta1 were
      compared with implants without growth factor. The dogs were sacrificed after six
      weeks. Bone remodeling was evaluated by histomorphometry on Goldner-stained
      undecalcified sections. The bone volume in the gap was increased significantly
      from 17.6% in the control group to 25.6% in the rhTGF-beta1 group (p = 0.03).
      Also bone surface was increased in the rhTGF-beta1 group. The osteoclast covered
      surfaces were increased from 3.6% in the control group to 5.9% in the rhTGF-beta1
      group (p = 0.02). In the surrounding trabecular bone no significant changes in
      bone remodeling parameters was demonstrated. This study suggests that rhTGF-beta1
      adsorbed onto TCP-ceramic coated implants accelerates repair activity in the
      newly formed bone close to the implant, but it does not seem to influence bone
      remodeling in preexisting bone at a greater distance from the implant.

PMID- 11197494
TI  - Biocompatibility and biodegradation of intravitreal hyaluronan implants in
      rabbits.
AB  - To study the biocompatibility and the biodegradation rate in vivo of new
      intravitreal implants made with three different hyaluronic acid esters: Hyaff7,
      Hyaff11 and Hyaff11p75 (100% ethyl ester, 100 and 75% benzyl esters,
      respectively), the plugs were implanted through a sclerotomy at 3.5 mm from the
      limbus of rabbit eyes. In order to evaluate the in vivo biodegradation the shaft
      diameter of the plugs was measured by ultrasound biomicroscopy. Slit lamp
      microscopy, ophthalmoscopy and ERG were performed periodically. The effects of
      the implants on ocular tissues were also evaluated histologically. All the plugs
      showed a good biocompatibilitv. Plugs of both the total esters, Hyaff7 and
      Hyaff11, were found to undergo a slow dissolution process for 60 and 150 days,
      respectively. The partial benzyl ester, Hyaff11p75, was completely reabsorbed
      after 15 days. Analysis of variance showed a high correlation between
      biodegradation rate and the time of resorption (F = 90.5; p < 0.001). The
      biodegradation rate of each implant is related to the chemical structure of the
      three types of Hyaff (F = 4.51; p = 0.005). The present data suggest that
      intravitreal implants based on hyaluronic acid esters represent useful
      biocompatible and biodegradable devices for a potential drug delivery system in
      the treatment of posterior segment ocular diseases.

PMID- 11197495
TI  - Microphase separation in bioerodible copolymers for drug delivery.
AB  - This research examines the microstructure of bioerodible polyanhydrides with an
      eye towards precise design of drug delivery devices. Our main hypothesis is that
      the bioerodible copolymer poly(1,6-bis-p-carboxyphenoxyhexane-co-sebacic
      anhydride) (CPH : SA) undergoes micro-phase separation at certain copolymer
      compositions due to differences in relative hydrophobicity of the co-monomers,
      resulting in thermodynamic partitioning of drugs incorporated into these
      copolymers. We investigate the thermal properties, degree of crystallinity, and
      surface microstructure of several compositions of CPH : SA using differential
      scanning calorimetry (DSC), wide-angle X-ray diffraction (WAXD), and atomic force
      microscopy (AFM). We observe that the degree of crystallinity decreases, while
      the crystal lamellar thickness increases with CPH content. Phase-imaging using
      AFM indicates the presence of micro-domains in 20 : 80 and 80 : 20 CPH : SA,
      while poly(SA) and 50 : 50 CPH : SA show no micro-phase separation. Finally, drug
      polymer interactions are studied by loading the polymers with different amounts
      of brilliant blue (hydrophilic) and p-nitroaniline (hydrophobic). DSC and WAXD
      analysis shows that loading hydrophobic drugs into relatively hydrophobic
      polymers (poly(SA)) lowers melting point that becomes more pronounced with
      increased drug loading.

PMID- 11197496
TI  - Synthesis, characterization and in vitro degradation of a new family of alternate
      poly(ester-anhydrides) based on aliphatic and aromatic diacids.
AB  - A new family of alternate poly(ester-anhydrides) containing aliphatic and
      aromatic diacids were synthesized. The dicarboxylic acids were obtained by
      derivatization of p-hydroxy benzoic acid at the hydroxy terminus with cyclic
      anhydride (adipic anhydride and succinic anhydride) and subsequently polymerized
      via the corresponding mixed anhydrides by melt polycondensation. DSC traces
      revealed that the polymers had low Tg (< 40 degrees C) and no crystallinity. The
      static contact angle measurements indicated that the poly(ester-anhydrides) were
      more hydrophobic than poly(D,L-lactide) and poly(adipic anhydride). In vitro
      degradation of the polymers was also investigated in pH 7.4 PBS at 37 degrees C.
      It was found that degradation rate of the poly(ester-anhydrides) increased with p
      carboxy phenyl adipic monoester (CPA) content in the polymers and the degradation
      duration could be adjusted from ca. 20 days to ca. 2 months. Erosion curve of
      poly(p-carboxy phenyl adipic monoester anhydride) (PCPA) was characterized by a
      linear region of weight loss at nearly constant rate in the first 7 days (ca. 80%
      of weight loss) followed by a gradual decrease region. IR and SEM analysis showed
      that significant erosion of PCPA occurred in the outer layer and no apparent
      erosion could be seen in the inner layer of the degrading sample after 7-day
      degradation. The poly(ester-anhydrides) may be used as either anti-infective
      polymeric prodrugs or matrices for drug delivery.

PMID- 11197497
TI  - Behavior of osteoblasts on a type I atelocollagen grafted ozone oxidized poly L
      lactic acid membrane.
AB  - With oxidizing poly-L-lactic acid (PLLA) surface by ozone, peroxide groups are
      easily generated on the surface. Those peroxides are broken down by redox
      coupling reaction, and provide active species that initiate grafting by reaction
      with the collagen molecules. The surface density of generated peroxide on a PLLA
      surface was determined by an iodide method. The maximum concentration of peroxide
      was about 2.87 x 10(-8) mol/cm2 when ozone oxidation was performed at 60 V for 60
      min. After the surface oxidation, type I atelocollagen was grafted onto PLLA
      surface. All physical measurements on the collagen-grafted surface indicated that
      the PLLA surface was effectively grafted with type I atelocollagen. Behavior of
      rat calvaria osteoblasts on type I atelocollagen grafted PLLA (PLLA + COL)
      surface was observed. Initial attachment of osteoblasts on the surface was
      significantly enhanced, and it is assumed that the atelocollagen matrix supported
      the initial attachment and growth of cells. Collagenous protein synthesis of
      osteoblasts was maintained at relatively low level in the early stage of
      proliferation due to the primarily existing grafted type I atelocollagen, and
      then increased in 7 days as the osteoblast differentiated. After 7 days,
      collagenous protein synthesis in osteoblasts was activated. Alkaline phosphatase
      (ALPase) activity and mineralization by osteoblasts were promoted on PLLA + COL
      surface. In comparison with PLLA + COL, non-treated PLLA and tissue culture plate
      (TCPS) did not show any feature expressed in osteoblasts' maturation up to 9 days
      in this experiment. The grafted type I atelocollagen provided a favorable matrix
      for cell migration in relation with collagenase expression. Ozone oxidation might
      be a favorable method for surface modification of PLLA membranes by collagen
      grafting, and cell behavior could be modulated by the grafted collagen.

PMID- 11197498
TI  - Morphology, drug distribution, and in vitro release profiles of biodegradable
      polymeric microspheres containing protein fabricated by double-emulsion solvent
      extraction/evaporation method.
AB  - The surface and internal morphology, drug distribution and release kinetics at 22
      degrees C of polyesters such as PCL (polycaprolactone) and PLGA (poly(DL-lactic
      co-glycolic acid)) 65:35 microspheres containing BSA (bovine serum albumin) have
      been investigated in order to understand the relationship amongst morphology,
      drug distribution and in vitro release profiles and to develop controlled release
      devices for marine fishes in tropical area. CLSM (confocal laser scanning
      microscope) micrographs reveal that the polyvinylalcohol (PVA as an emulsifier)
      concentration in the external water phase strongly influences drug distribution
      within microspheres and release profiles. The presence of PVA in the internal
      water phase enhances the stabilization of inner water droplets against
      coalescence. This results in a more uniform drug distribution and a slower BSA
      release. Different oil-phase volumes and polymer concentrations yield different
      solvent exchange and precipitation mechanisms, which lead to different
      morphologies. A low oil-phase volume yields microspheres with a porous matrix and
      defective skin surface, which gives a high initial BSA burst as well as a fast
      release profile. Microspheres fabricated from a low polymer concentration have
      less defective skin surface, but with a less tortuous inner matrix which results
      in a more rapid BSA release. A higher BSA loading yields a larger concentration
      gradient between the emulsion droplet and the continuous water phase as well as
      between the microspheres and the in vitro medium. The former results in a lower
      encapsulation efficiency, whereas the latter yields a faster initial burst and a
      more rapid release profile. High stirring speed can reduce microsphere size, but
      decreases the yield of microspheres.

PMID- 11197499
TI  - Preparation and performance of protein-adsorption-resistant asymmetric porous
      membrane composed of polysulfone/phospholipid polymer blend.
AB  - To obtain protein-adsorption-resistant membrane for hemodialysis, we prepared a
      polymer blend composed of polysulfone and 2-methacryloyloxyethyl
      phosphorylcholine (MPC) polymer (PSf/MPC polymer). The content of the MPC polymer
      in the PSf was 7 and 15 wt%. The asymmetric porous membrane was obtained by the
      dry/wet membrane processing method. The surface characterization of the PSf/MPC
      polymer membrane by X-ray photoelectron spectroscopy revealed that the MPC
      polymer located at the surface. The mechanical strength of the PSf/MPC polymer
      membrane did not change compared with that of the PSf membrane. On the other
      hand, the permeability of solute below a molecular weight (Mw) of 2.0 x 10(4)
      through the PSf membrane increased with the addition of the MPC polymer, which is
      considered to be an effect of the hydrophilic character of the MPC polymer. The
      amount of protein adsorbed on the PSf membrane from plasma was reduced by the
      addition of the MPC polymer. The permeability of low-molecular-weight protein (Mw
      = 1.2 x 10(4)) did not change even after the PSf/MPC polymer membrane was
      contacted with plasma protein solution for 4 h, whereas it decreased dramatically
      in the case of the PSf membrane. Platelet adhesion was also effectively
      suppressed on the PSf/MPC polymer membrane. Based on these results, the MPC
      polymer could serve as a doubly functional polymeric additive, that is, to
      generate a protein-adsorption-resistant characteristic and to render the membrane
      hydrophilic.

PMID- 11197500
TI  - In vitro reaction to orthopaedic biomaterials by macrophages and lymphocytes
      isolated from patients undergoing revision surgery.
AB  - Periprosthetic tissues observed at sites of loose total joint implants exhibit
      abundant macrophages, lymphocytes, fibroblasts and particulate debris.
      Macrophages phagocytose orthopaedic debris and release proinflammatory cytokines,
      chemokines, matrix metalloproteinases and other substances. In addition, other
      cell types present in tissues harvested from the bone-implant interface are
      thought to influence periprosthetic bone resorption. The present study examined
      the effects of polymethylmethacrylate (PMMA), cobalt chrome molybdenum alloy
      (CoCr), and titanium-alloy particle challenge on macrophages co-cultured with
      lymphocytes in vitro. Potential synergistic effects of lymphocytes on macrophage
      activation were determined by measuring interleukin-6 and tumor necrosis factor
      alpha release following exposure to orthopaedic biomaterial particles. Exposure
      of macrophages or macrophages co-cultured with lymphocytes to all three types of
      particles resulted in increased release of interleukin-6 and tumor necrosis
      factor-alpha at 48 h, when compared to macrophages or macrophages co-cultured
      with lymphocytes, respectively, cultured in the absence of particles. Lymphocytes
      isolated from periprosthetic tissues secreted increased basal levels of cytokines
      relative to peripheral blood lymphocytes. Higher doses of PMMA and titanium-alloy
      particles stimulated increased levels of cytokine release in the macrophage and
      macrophage/lymphocyte groups. In contrast, a higher dose of CoCr particles
      (0.075% v/v) was not as effective as the 0.015% v/v dose, indicating probable
      CoCr toxicity. The macrophage/lymphocyte co-culture did not show synergism
      between the two types of cells with respect to cytokine release. T-cells at the
      bone-implant interface may alter the biological response to particulate debris.

PMID- 11197501
TI  - Influence of the degree of acetylation on some biological properties of chitosan
      films.
AB  - In this study, we investigated in vitro the role of the degree of acetylation
      (DA) on some biological properties of chitosan films. We noticed that, whatever
      the DA, all chitosan films were cytocompatible towards keratinocytes and
      fibroblasts. We also demonstrated that the higher the DA of chitosan, the lower
      was the cell adhesion on the films. Fibroblasts appear to adhere twice as much as
      keratinocytes on these materials. We observed that keratinocyte proliferation
      increases when the DA of chitosan films decreases. Thus, DA influences the cell
      growth in the same way as cell adhesion. On the other hand, although they remain
      alive, fibroblasts do not proliferate on chitosan films. This behaviour is
      related to an extremely high adhesion on this kind of material, which certainly
      inhibits cell growth. In conclusion, DA plays a key role in cell adhesion and
      proliferation, but does not change the cytocompatibility of chitosan. In
      parallel, it is also important to notice the role played by the surface
      morphology of the material, a second major parameter which influences the
      mechanism of adhesion.

PMID- 11197502
TI  - Corrosion behavior of a welded stainless-steel orthopedic implant.
AB  - The corrosion behavior of combinations of materials used in an orthopedic
      implant: the spherical part (forged or forged and annealed) constituting the
      head, the weld (tungsten inert gas (TIG) or electron beam (EB) techniques), and
      the cylindrical part (annealed) constituting the shaft of a femoral prosthesis -
      has been investigated. Open-circuit potentials, potentiodynamic curves, Tafel
      slope, mixed potential theory and susceptibility to intergranular attack are
      electrochemical and chemical procedures selected for this work. Electrochemical
      measurements using a microelectrode have been made in the following zones:
      spherical part, cylindrical part, weld, and weld/sphere, and weld/shaft
      interfaces. To detect intergranular attack, the Strauss test has been used. At
      the interfaces, corrosion currents, measured (Icorr) and predicted (Icouple) are
      low, in the order of the pico- to nanoampere. The electrochemical behavior of the
      electron beam (EB) weld is better than that of the tungsten inert gas (TIG).
      Welds at interfaces can behave either anodically or cathodically. It is better if
      welds, which are sensitive parts of the femoral prosthesis, behave cathodically.
      In this way, the risk of starting localized corrosion (pitting, crevice or
      intergranular corrosion) from a galvanic couple, remains low. From this point of
      view, the sample with the EB weld offers the best behavior. All the other samples
      containing a TIG type of weld exhibit a less favorable behavior. The mechanical
      treatments (forged, and forged and annealed) of the steel sphere did not show any
      difference in the corrosion behavior. No intergranular corrosion has been
      observed at the weld/steel interface for unsensitized samples. With sensitized
      samples, however, a TIG sample has exhibited some localized intergranular
      corrosion at a distance of 500 microm along the weld/stainless steel (sphere)
      interface.

PMID- 11197503
TI  - A novel formulation for controlled release of heparin-DOCA conjugate dispersed as
      nanoparticles in polyurethane film.
AB  - Heparin is a potent anticoagulant agent that interacts strongly with antithrombin
      III to prevent the formation of fibrin clot. In this study, we propose a new
      method for preparing a heparin-releasing system using a simple solvent casting.
      The heparin-DOCA conjugate, having an amphiphilic property, was homogeneously
      mixed with polyurethane in the co-solvent of dioxane, propanol and water. After
      casting the film, heparin-DOCA was homogeneously dispersed as nanoparticles in a
      polyurethane film. As the loading amount of heparin-DOCA in the film was
      increased, nanoparticle size, water uptake, and release rate were increased.
      Moreover, the percentage of released amount of heparin-DOCA was increased with
      the increase in the loading amount of heparin-DOCA. This was because the size of
      heparin-DOCA particles increases with the increase in the loading amount of
      heparin-DOCA, thereby decreasing the distance between particles and the total
      diffusion length to the surface. The release rate of heparin-DOCA can be
      controlled by the amount of the drug being loaded and the film thickness. When
      the heparin-DOCA loaded on the polyurethane films was above 7.5%, the released
      heparin-DOCA prevented the formation of fibrin clot and the platelet adhesion on
      the film surface.

PMID- 11197504
TI  - Retinal pigment epithelial cell adhesion on novel micropatterned surfaces
      fabricated from synthetic biodegradable polymers.
AB  - Novel synthetic biodegradable polymer substrates with specific chemical
      micropatterns were fabricated from poly(DL-lactic-coglycolic acid) (PLGA) and
      diblock copolymers of poly(ethylene glycol) and poly(DL-lactic acid) (PEG/PLA).
      Thin films of PLGA and PEG/PLA supported and inhibited, respectively, retinal
      pigment epithelial (RPE) cell proliferation, with a corresponding cell density of
      352,900 and 850 cells/cm2 after 7 days (from an initial seeding density of 15,000
      cells/cm2). A microcontact printing technique was used to define arrays of
      circular (diameter of 50 microm) PLGA domains surrounded and separated by regions
      (width of 50 microm) of PEG/PLA. Reversed patterns composed of PEG/PLA circular
      domains surrounded by PLGA regions were also fabricated. Both micropatterned
      surfaces were shown to affect initial RPE cell attachment, limit cell spreading,
      and promote the characteristic cuboidal cell morphology during the 8-h period of
      the experiments. In contrast, RPE cells on plain PLGA (control films) were
      elongated and appeared fibroblast-like. The reversed patterns had continuous PLGA
      regions that allowed cell-cell interactions and thus higher cell adhesion. These
      results demonstrate the feasibility of fabricating micropatterned synthetic
      biodegradable polymer surfaces to control RPE cell morphology.

PMID- 11197505
TI  - We reap only what we sow.

PMID- 11197506
TI  - A radiation safety infraction notification form.
AB  - The use of a well constructed form can serve as an official notification of the
      violation of good radiation safety practice while providing a paper trail for
      documentation of corrective action.

PMID- 11197507
TI  - Experience with a medical waste portal monitoring system.
AB  - A portal monitor was installed to detect radioactivity in trash and laundry
      leaving the hospital facility. Experiences with selection, installation,
      calibration and detection capabilities are reviewed. Also reviewed are the topics
      used in training hospital employees on proper use of the monitor and response
      detected activity in trash or laundry.

PMID- 11197508
TI  - Using fault tree analysis to identify causes of non-compliance: enhancing
      violation outcome data for the purposes of education and prevention.
AB  - An enhanced coding system for the characterization of notices of violation
      (NOV's) issued to radiation permit holders in the State of Texas was developed
      based on a series of fault tree analyses serving to identify a set of common
      causes. The coding system enhancement was retroactively applied to a
      representative sample (n = 185) of NOV's issued to specific licensees of
      radioactive materials in Texas during calendar year 1999. The results obtained
      were then compared to the currently available summary NOV information for the
      same year. In addition to identifying the most common NOV's, the enhanced coding
      system revealed that approximately 70% of the sampled NOV's were issued for non
      compliance with a specific regulation as opposed to a permit condition.
      Furthermore, an underlying cause of 94% of the NOV's was the failure on the part
      of the licensee to execute a specific task. The findings suggest that
      opportunities exist to improve permit holder compliance through various means,
      including the creation of summaries which detail specific tasks to be completed,
      and revising training programs with more focus on the identification and
      scheduling of permit-related requirements. Broad application of these results is
      cautioned due to the bias associated with the restricted scope of the project.

PMID- 11197509
TI  - Minimum detectable activity in gamma-ray spectrometry--statistical properties and
      limits of applicability.
AB  - Some statistical properties of the essential physical quantity "Minimum
      Detectable Activity" were analyzed, as well as the limits of its applicability in
      gamma-ray spectrometry. It was shown that the Minimum Detectable Activity is not
      linear with respect to the quantity of the measured sample and it is advisable
      not to calculate the Minimum Detectable Activity per unit mass or volume (in Bq
      kg-1 or Bq cm-3). The MDA has a clear decisive relevance to samples that have an
      identical geometry and chemical composition with that of the sample that was used
      to derive the MDA. The relative uncertainty of the Minimum Detectable Activity is
      approximately +/- 32%. It is recommended not to exclude from evaluations those
      results that are below minimum detectable activities.

PMID- 11197510
TI  - Measurements in radioactivity should not be recorded as less than MDA.
AB  - Sometimes the results of measurements in radioactivity are reported as less than
      MDA. Over the years there have been articles informing the reader that it is
      incorrect to express the results of measurements as less than MDA. A very brief
      review of past comments on expressing the results of measurements precedes a
      discussion of why measurements should not be reported as less than MDA.

PMID- 11197511
TI  - Some health physics aspects of working with 203Hg in university research.
AB  - The radioisotope 203Hg is used in university toxicology research experiments.
      When our commercial vendor ceased the production of the high specific activity
      203Hg we required, an alternative source was sought. Other commercial sources
      were investigated without success leaving the synthesis of this radioisotope to
      us. This paper outlines the method we used to synthesize 203Hg and provides a
      summary of our results to date and a discussion of our experiences.

PMID- 11197512
TI  - Results of a Division of Radiation Protection scrap yard exercise.
AB  - For years the Division of Radiation Protection (DRP) has participated in
      exercises, which are required by the Federal Emergency Management Agency (FEMA)
      to demonstrate our ability to deal with an accident at a nuclear power plant.
      These demonstrations are defined by objectives and are structured such that they
      offer little opportunity to practice for real-world radiological events in the
      exercise. Since real-world radiological incidents do occur throughout the year,
      this exercise was designed to be as realistic as possible. A scrap yard incident
      was chosen as the most probable type of event. The exercise was conducted on May
      5 and 6, 1999.

PMID- 11197514
TI  - Review of Electronic Library for Radiation Protection.

PMID- 11197513
TI  - Ask the expert.

PMID- 11197515
TI  - Dose rate outside primary barriers.
AB  - The author has investigated the use of the inverse square function to predict the
      photon dose rate outside primary barriers for medical accelerators. Measurements
      of the dose rate as a function of distance outside the barriers were made at five
      medical accelerator facilities. An analysis of the data showed that the radiation
      field appears to diverge from a point between the x-ray target and primary
      barrier. This behavior of the x-ray beam was attributed to scattering of photons
      in the shield barrier. It was concluded that the dose outside the barrier will be
      overestimated if the distance from the x-ray target to the point of calculation
      is utilized to carry out an inverse square correction.

PMID- 11197516
TI  - Contaminating incident investigation in medicine and biomedical research.
AB  - Regardless of how well trained, experienced and careful individuals are, if they
      handle radioactive materials often enough they will eventually have a
      contaminating incident. When the incident occurs it is imperative that the proper
      actions are taken to control the incident, minimize contamination and exposure,
      assure that proper remediation is implemented, assure that the incident remains
      confined, that no others become contaminated or exposed and that effective
      remediation is documented. This paper discusses our approach to such incidents
      and discusses the incident report form and our philosophy of information
      recording.

PMID- 11197517
TI  - Statistical methods in epidemiology. VI. Correlation and regression: the same or
      different?
AB  - PURPOSE: The statistical terms 'correlation' and 'regression' are frequently
      mistaken for each other in the scientific literature. Why this is so is unclear.
      This paper discusses their differences/ similarities arguing that in most
      circumstances regression is the most appropriate technique to use, since
      regression incorporates a notion of dependency of one variable on another.
      METHOD: Pearson's correlation coefficient (r) is introduced as a method for
      estimating the degree of linear association between two normally distributed
      variables. The problem of least squares' regression (when y depends on x) is
      introduced by considering the best-fitting straight line between points on a
      scatter plot. RESULTS: Correlation, regression analysis and residual estimation
      are discussed by taking examples from the author's own teaching experiences.
      CONCLUSIONS: Correlation and regression share some similarities. However,
      regression is the better technique to use because with it comes a notion of
      dependency of one variable upon another. Regression model checking includes
      residual examination. The importance of plotting and examination of residuals
      cannot be overemphasized. Residual examination should become as much a part of a
      regression analysis as the estimation of the regression coefficients themselves.

PMID- 11197518
TI  - The feasibility of a kinematic measure of lip closure during meaningful speech.
AB  - PURPOSE: Assessment of dysarthria has traditionally been based on perceptual
      methods. The purpose of this study was to examine the feasibility of using 2D
      kinematic analysis to measure lip closure during normal speech. METHOD:
      Retroflective markers (4 mm diameter) were placed on the midline of each lip of
      three healthy male, caucasian volunteers aged 69 years who repeated the sentence
      'My mother made me an apple and blackberry pie' six times. Videorecordings were
      analysed using the Ariel Performance Analysis System to calculate the distance
      between the lips before, during and after the sentence. RESULTS: The graphs
      produced from the data objectively measured the distance between the lips and
      identified the eight bilabial sounds. However, in spite of stringent study
      criteria to minimize differences linked to age, gender and race, differences were
      found between participants. CONCLUSION: Kinematic 2D analysis may have potential
      for the objective measurement of lip closure in dysarthria in the context of
      meaningful speech. These results justify further pilot work to explore: the
      possible variability within defined populations; and the usefulness of 2D
      kinematic analysis in the measurement of disordered lip closure in dysarthria.

PMID- 11197519
TI  - Strain and psychological distress among informal supporters of reflex sympathetic
      dystrophy patients.
AB  - PURPOSE: A study to investigate strain and psychiatric morbidity in informal
      caregivers of patients with reflex sympathetic dystrophy (RSD). METHOD: Fifty one
      caregivers of RSD patients in the community, identified from a support group in
      Leeds or a conference in Eastbourne completed standardized questionnaire measures
      of strain, mood, adjustment, positive and negative affectivity and social
      support. RESULTS: Fifty seven percent of caregivers experienced significant
      strain and 53% had poor mood. Adjusting for age and gender, partial correlations
      showed that the experience of strain in caregivers was associated with poor mood,
      poor psychological adjustment to the patient's illness, high levels of negative
      affectivity, increased handicap and disability of the patient. CONCLUSIONS: A
      high proportion of caregivers of RSD patients experience poor mood and
      significant levels of strain. Caregivers who are poorly adjusted to the illness
      experience the most strain. These findings suggest a need for intervention to
      alleviate the negative impacts of caregiving and facilitate adjustment.

PMID- 11197520
TI  - The modified rivermead mobility index: validity and reliability.
AB  - PURPOSE: This paper presents the evaluation of the following psychometric
      properties of the Modified Rivermead Mobility Index (MRMI): face/content
      validity, responsiveness, test-retest reliability, inter-rater reliability and
      internal consistency. This mobility scale represents a further development of the
      Rivermead Mobility Index (RMI). In its new form the scoring was adapted from a
      two-point to a six-point scale. The number of test items was reduced from fifteen
      to eight items in order to measure mobility-related items that physiotherapists
      consider being essential for demonstrating treatment effects in patients
      following a stroke. METHOD: A consensus exercise with forty-two physiotherapists
      attending a stroke care conference established face/content validity. Inter-rater
      and test-retest reliability were examined by assessing thirty patients by two
      independent raters selected from a pool of eight physiotherapists in two
      different settings, an elderly care unit and a stroke rehabilitation unit. All
      patients were hospitalised and had experienced a stroke within the past six
      weeks. Responsiveness was examined by calculating the effect size statistic on
      the admission and discharge score of sixteen acute patients following stroke.
      RESULTS: The results showed that the modified RMI was: responsive to change
      (effect size = 1.15), stable when tested on two occasions (paired t-test = 0.732;
      p = 0.47), highly reliable between raters (ICC = 0.98; p < 0.001) with high
      internal consistency (Cronbach's alpha = 0.93). CONCLUSIONS: These results
      suggest that when using the Modified RMI to assess patients in the early stages
      following stroke, similar results can be obtained by different raters, regardless
      of experience. However there needs to be a difference of more than 4.5 points
      (degree of measurement error at 95% confidence level) in the overall score to
      detect true changes in the patient's level of mobility.

PMID- 11197521
TI  - The actual state of the effects, treatment and incidence of disabling pain in a
      gender perspective-- a Swedish study.
AB  - PURPOSE: The purpose of the study was to elicit the actual state of self
      perceived experience of long-term and/or recurrent pain and its effects as
      reported by women and men with disabilities due to pain, in order to determine
      criteria for assessing the need for measures in rehabilitation/occupational
      therapy. METHODS: The study used a comparative design with a sample randomized
      from the Swedish population aged 18-58 years (n = 10,000). The inclusion
      criterion was that the respondents had or had had pain causing activity
      limitation or restricting participation in daily life. A special questionnaire
      including items concerning demography, pain, coping, occupations in daily life,
      work, treatments, care institutions and hospital/care staff visited, was posted
      to 1,849 persons and was answered by 1,448 respondents (study group n = 1,305,
      control group n= 117). RESULTS: Gender differences were found in the overall
      prevalence of pain, women reporting more frequent episodes of pain than men did.
      Differences were also found in pain variables, in daily occupations, days of sick
      leave and work variables. Women completed more varied treatment than men. The
      incidence rate of long-term/recurrent pain in the population studied was 0.07.
      CONCLUSIONS: As a conclusion from this study, three essential components are
      suggested for use when assessing the need for rehabilitation/occupational
      therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing
      character, particularly among women; (2) emotional/affective pain effects causing
      restlessness and depression, particularly among women; and (3) limitations in
      daily occupations assessed by FSQ and the demand/control/support model with
      results falling within the warning zones plus long sick-leave periods.

PMID- 11197522
TI  - To what extent are the needs of severely disabled people met by community
      rehabilitation services? A follow-up study.
AB  - PURPOSE: To evaluate which needs of disabled people would be met over a one year
      follow-up period and to examine which factors would be predictive of identifying
      those people who had more needs met from those who had fewer needs met. METHOD: A
      follow-up study of a cohort of community dwelling disabled people (aged 16-65)
      from two NHS Health Districts in Southern England with contrasting patterns of
      rehabilitation provision, who had participated in a cross-sectional interview
      study one year previously which had assessed their met and unmet needs. The
      Southampton Needs Assessment Questionnaire was used to examine needs. Disability
      was evaluated with the OPCS Disability and Severity Scales and perceived health
      status with the SF-36. RESULTS: Participation rate at follow-up was 92 %. Of the
      300 baseline unmet needs reported by 69 of the 77 participants 33% had been met
      at follow-up. People whose disability had increased more and/or whose mental
      health status had improved more had greater percentages of their baseline needs
      met. There was a non-significant trend for smaller percentages of baseline needs
      to be met in Basingstoke than in Southampton. CONCLUSIONS: At ground level,
      disabled people's views were taken into account, to some extent, in the provision
      of rehabilitation services. This input should be made at a higher level, in the
      overall shaping of services.

PMID- 11197523
TI  - Why knee disarticulation (through-knee-amputation) is appropriate for non
      ambulatory patients.
AB  - PURPOSE: To determine the reason why 79% of knee disarticulation amputees had not
      received a prosthesis. METHOD: A 10 year survey was carried out of all patients
      who had undergone a knee disarticulation at our medical centre. RESULTS:
      Seventeen of the 37 patients that had not received a prosthesis were recognized
      to be non-ambulators prior to the surgery. Four patients died after the surgery
      and in 16 of the patients their general condition limited functional ambulation.
      An effort had been made to ambulate the patients but had failed. CONCLUSIONS:
      From a biomechanical point of view many advantages are to be gained for sedentary
      and bedridden amputees when the level of amputation is through-the-knee.

PMID- 11197524
TI  - An integrated theory of ageing in the nematode Caenorhabditis elegans.
AB  - Numerous theories of ageing have been proposed, and many have been tested
      experimentally, particularly using nematode models such as Caenorhabditis
      elegans. By combining those theories of ageing that remain plausible with recent
      findings from studies of C. elegans life span mutants, an integrated theory of
      ageing has been devised. This is formed from 3 interconnected elements: the
      evolutionary theory of ageing, the oxidative damage theory of ageing, and a
      nonadaptive programmed ageing theory. This tripartite theory of ageing gives rise
      to a number of predictions that may be tested experimentally.

PMID- 11197525
TI  - Appearance of biomarkers of in vitro ageing after successive stimulation of WI-38
      fibroblasts with IL-1alpha and TNF-alpha: senescence associated beta
      galactosidase activity and morphotype transition.
AB  - Sublethal oxidative stresses increase the proportions of human fibroblasts
      positive for senescence associated beta-galactosidase activity and accelerate the
      transition in the fibroblast morphotypes characterising fibroblast ageing.
      Stimulation of fibroblasts with TNF-alpha or IL-1alpha transiently increases the
      production of reactive oxygen species (ROS) in human fibroblasts. Here we propose
      that repeated stimulation of WI-38 fibroblasts with TNF-alpha or IL-1alpha can
      generate enough ROS to accelerate the transition in the fibroblast morphotypes
      and increase the proportion of cells positive for senescence associated beta
      galactosidase activity. The involvement of ROS is suggested by experiments where
      the stimulation of fibroblasts with TNF-alpha or IL-1alpha are performed in the
      presence of N-acetylcysteine which increases the intracellular antioxidant
      potential. It is proposed that the decrease in the proportions of morphotypes I
      and II, and the increase in the proportions of morphotypes III to VI observed
      after successive stimulation with TNF-alpha or IL1-alpha is attributed to an
      increased ROS production occurring during the stimulation.

PMID- 11197526
TI  - Exercise, oxidative stress and ageing.
AB  - Skeletal muscle has the unique ability to increase the rate of oxygen usage
      during contraction. This has led several workers to suggest that by-products of
      this increased oxygen consumption, oxygen-derived free radicals, may be primarily
      responsible for exercise-induced damage to skeletal muscle. However, because of
      this rapidly changing redox state, skeletal muscle has developed a number of
      different endogenous mechanisms which adapt rapidly following a period of
      exercise. These include numerous structural and biochemical changes such as
      increased muscle activity of antioxidant enzymes and content of stress or heat
      shock proteins (HSPs). This adaptation is associated with protection against the
      potentially damaging effects of a second period of exercise. In addition, we have
      recently demonstrated a significant increase in free radical production during a
      period of nondamaging exercise, which is rapidly followed by a significant
      increase in the expression of antioxidant enzymes and HSPs, suggesting that a
      change in redox state of the muscle may act as signal for adaptation.

PMID- 11197527
TI  - Cytokine/neurotrophin interaction in the aged central nervous system.
AB  - Age-associated neurodegenerative diseases such as Alzheimer's disease are
      characterised by neuronal impairment that leads to cognitive deficits. As certain
      affected neurons depend on trophic factors such as neurotrophins (NTs),
      impairment in NT function has been suggested to be a component of neuronal damage
      associated with such disorders. Age-related neurodegenerative diseases are also
      characterised by high levels of proinflammatory cytokines such as tumour necrosis
      factor alpha (TNFalpha) in the CNS. Because TNFalpha receptors and certain NT
      receptors share a high degree of homology and are capable of activating similar
      signalling pathways, one possibility is that altered cytokine levels may affect
      NT function in the aged or diseased CNS. Here we wish briefly to review the
      evidence suggesting a role for cytokine and NT in the onset of age-associated
      neurodegenerative diseases. We propose that cytokine/NT interactions may alter
      neuronal homeostasis, thus possibly contributing to some of the neuronal
      degeneration occurring during such age-associated CNS diseases.

PMID- 11197528
TI  - Glucocorticoids and the ageing hippocampus.
AB  - Approximately 30 % of human and mammalian populations develop cognitive
      impairments with ageing. Many of these impairments have been linked to
      dysfunction of the hippocampus, a well studied area of the medial-temporal lobe,
      which is involved in episodic memory and control of the hypothalamo-pituitary
      adrenal stress axis and, thus, of glucocorticoid secretion. This paper reviews
      the growing body of studies which explore a possible relationship between
      lifetime exposure to glucocorticoids and hippocampal impairment. There is now
      strong evidence which associates hypercortisolemia in aged men with later
      cognitive dysfunction and this complements a wealth of rodent and other human
      data. We conclude with a discussion of possible pharmacological and behavioural
      interventions.

PMID- 11197529
TI  - Parameters of calcium homeostasis in normal neuronal ageing.
AB  - The last decade has witnessed a significant turn in our understanding of the
      mechanisms responsible for the decline of cognitive functions in aged brain. As
      has been demonstrated by detailed morphological reassessments, the senescence
      related changes in cognition cannot be attributed to a simple decrease in the
      number of neurons. It is becoming clearer that a major cause of age-induced
      deterioration of brain capability involves much subtler changes at the level of
      synapses. These changes are either morphological, i.e. reduction in the number of
      effective synapses and/or functional alterations, i.e. changes in the efficacy of
      remaining synapses. Important questions are now raised regarding the mechanisms
      which mediate these synaptic changes. Clearly, an important candidate is calcium,
      the cytotoxic role of which is already firmly established. The wealth of evidence
      collected so far regarding the changes of Ca2+ homeostasis in aged neurons shows
      that the overall duration of cytoplasmic Ca2+ signals becomes longer. This is the
      most consistent result, demonstrated on different preparations and using
      different techniques. What is not yet clear is the underlying mechanism, as this
      result could be explained either through an increased Ca2+ influx or because of a
      deficit in the Ca2+ buffering/clearance systems. It is conceivable that these
      prolonged Ca2+ signals may exert a local excitotoxic effect, removing
      preferentially the most active synapses. Uncovering of the role of Ca2+ in the
      synaptic function of the aged brain presents an exciting challenge for all those
      involved in the neurobiology of the senescent CNS.

PMID- 11197530
TI  - Forkhead transcription factors are targets of signalling by the proto-oncogene
      PKB (C-AKT).
AB  - Following the discovery that the proto-oncogene protein kinase B (PKB) functions
      as a downstream element in signalling from phosphoinositide 3'-kinase (PI3
      kinase) (Burgering & Coffer, 1995), PKB has been shown to mediate a diverse array
      of PI3-kinase dependent cellular responses. Most recently PKB-dependent
      phosphorylation of 3 members of the family of Forkhead transcription factors has
      been demonstrated to play a role in PI3-kinase dependent effects on
      transcription. This review focuses on this newly discovered function of PKB in
      conveying the diversity of PI3-kinase dependent cellular responses.

PMID- 11197532
TI  - Evolution, stress, and longevity.
AB  - The disposable soma theory suggests that longevity is determined through the
      setting of longevity assurance mechanisms so as to provide an optimal compromise
      between investments in somatic maintenance (including stress resistance) and in
      reproduction. A corollary is that species with low extrinsic mortality are
      predicted to invest relatively more effort in maintenance, resulting in slower
      intrinsic ageing, than species with high extrinsic mortality. We tested this
      prediction in a comparative study of stress resistance in primary skin
      fibroblasts and confirmed that cells from long-lived species are indeed more
      resistant to a variant of stressors. A widely studied example of within-species
      variation in lifespan is the rodent calorie restriction model. Food-restricted
      animals show elevations in a range of stress response mechanisms, and it has been
      suggested that this is an outcome of natural selection for life history
      plasticity. We have developed a theoretical model for dynamic optimisation of the
      allocation of effort to maintenance and reproduction in response to fluctuations
      in food availability. The model supports the suggestion that the response to
      calorie restriction may be an evolutionary adaptation, raising interesting
      questions about the hierarchy of genetic control of multiple stress response
      systems. The model identifies ecological factors likely to support such an
      adaptation that may be relevant in considering the likely relevance of a similar
      response to calorie restriction in other species. Comparative and theoretical
      studies support the role of somatic maintenance and stress response systems in
      controlling the rate of ageing.

PMID- 11197531
TI  - The effects of growth hormone and IGF-1 deficiency on cerebrovascular and brain
      ageing.
AB  - Research studies clearly indicate that age-related changes in cellular and tissue
      function are linked to decreases in the anabolic hormones, growth hormone and
      insulin-like growth factor (IGF)-1. Although there has been extensive research on
      the effects of these hormones on bone and muscle mass, their effect on
      cerebrovascular and brain ageing has received little attention. We have also
      observed that in response to moderate calorie restriction (a treatment that
      increases mean and maximal lifespan by 30-40%), age-related decreases in growth
      hormone secretion are ameliorated (despite a decline in plasma levels of IGF-1)
      suggesting that some of the effects of calorie restriction are mediated by
      modifying the regulation of the growth hormone/IGF-1 axis. Recently, we have
      observed that microvascular density on the surface of the brain decreases with
      age and that these vascular changes are ameliorated by moderate calorie
      restriction. Analysis of cerebral blood flow paralleled the changes in
      vasculature in both groups. Administration of growth hormone for 28 d was also
      found to increase microvascular density in aged animals and further analysis
      indicated that the cerebral vasculature is an important paracrine source of IGF-1
      for the brain. In subsequent studies, administration of GHRH (to increase
      endogenous release of growth hormone) or direct administration of IGF-I was shown
      to reverse the age-related decline in spatial working and reference memory.
      Similarly, antagonism of IGF-1 action in the brains of young animals impaired
      both learning and reference memory. Investigation of the mechanisms of action of
      IGF-1 suggested that this hormone regulates age-related alterations in NMDA
      receptor subtypes (e.g. NMDAR2A and R2B). The beneficial role of growth hormone
      and IGF-1 in ameliorating vascular and brain ageing are counterbalanced by their
      well-recognised roles in age-related pathogenesis. Although research in this area
      is still evolving, our results suggest that decreases in growth hormone and IGF-1
      with age have both beneficial and deleterious effects. Furthermore, part of the
      actions of moderate calorie restriction on tissue function and lifespan may be
      mediated through alterations in the growth hormone/IGF-1 axis.

PMID- 11197533
TI  - VEGF enhances intraneural angiogenesis and improves nerve regeneration after
      axotomy.
AB  - Whilst there is an increased understanding of the cell biology of nerve
      regeneration, it remains unclear whether there is a direct interrelationship
      between vascularisation and efficacy of nerve regeneration within a nerve
      conduit. To establish this is important as in clinical surgery peripheral nerve
      conduit grafting has been widely investigated as a possible alternative to the
      use of nerve autografts. The aim of this study was to assess whether vascular
      endothelial growth factor (VEGF), a highly specific endothelial cell mitogen, can
      enhance vascularisation and, indirectly, axonal regeneration within a silicone
      nerve regeneration chamber. Chambers containing VEGF (500-700 ng/ml) in a laminin
      based gel (Matrigel) were inserted into 1 cm rat sciatic nerve defects and nerve
      regeneration examined in relation to angiogenesis between 5 and 180 d.
      Longitudinal sections were stained with antibodies against endothelial cells
      (RECA-1), axons (neurofilament) and Schwann cells (S-100) to follow the
      progression of vascular and neural elements. Computerised image analysis
      demonstrated that the addition of VEGF significantly increased blood vessel
      penetration within the chamber from d 5, and by d 10 this correlated with an
      increase of axonal regeneration and Schwann cell migration. The pattern of
      increased nerve regeneration due to VEGF administration was maintained up to 180
      d, when myelinated axon counts were increased by 78 % compared with plain
      Matrigel control. Furthermore the dose-response of blood vessel regeneration to
      VEGF was clearly reflected in the increase of axonal regrowth and Schwann cell
      proliferation, indicating the close relationship between regenerating nerves and
      blood vessels within the chamber. Target organ reinnervation was enhanced by VEGF
      at 180 d as measured through the recovery of gastrocnemius muscle weights and
      footpad axonal terminal density, the latter showing a significant increase over
      controls (P < 0.05). The results demonstrate an overall relationship between
      increased vascularisation and enhanced nerve regeneration within an acellular
      conduit, and highlight the interdependence of the 2 processes.

PMID- 11197534
TI  - Ultrastructural characteristics and lectin-binding properties of M cells in the
      follicle-associated epithelium of chicken caecal tonsils.
AB  - To clarify the nature of M cells, the detailed ultrastructural characteristics
      and lectin-binding properties of M cells were investigated in follicle-associated
      epithelium (FAE) of chicken caecal tonsils. M cells presented various outlines
      from columnar to dome shaped. Their polymorphism was dependent on the number of
      harboured intraepithelial migrating cells. The lighter and larger nuclei of M
      cells were situated at more apical levels in the epithelial lining compared with
      those of neighbouring microvillous epithelial cells. The microvilli, which were
      significantly shorter and thicker than those of adjacent microvillous epithelial
      cells, were sparsely distributed or completely absent on the apical surfaces of M
      cells. In general, the apical cytoplasm of M cells without microvilli protruded
      slightly into the intestinal lumen. Numerous small vesicles were often contained
      in the apical cytoplasm. The numerous small invaginations of the apical and
      lateral cell surfaces suggested active transportation of luminal substances. No
      canaliculi existed in the apical cytoplasm of M cells whereas they were often
      detected in the neighbouring microvillous epithelial cells. A noteworthy finding
      was the frequent detection of multivesicular bodies in the apical cytoplasm of M
      cells. These multivesicular bodies suggest some degradation of ingested luminal
      substances during transcytoplasmic transportation. WGA and 4 other lectins
      strongly reacted with all epithelial cells except for M cells, this negativity
      suggesting a means of detecting M cells in chicken caecal tonsils. Three lectins,
      DSL, ConA and Jacalin, reacted weakly with the glycocalyx on M cells. The
      positive reactivity might allow chicken M cells to be utilised for specific
      antigen delivery into the mucosal immune system in some parenteral vaccinations.

PMID- 11197536
TI  - The mechanical behaviour of a novel mammalian intervertebral joint.
AB  - The mechanics of mammalian intervertebral joints are complicated by the
      viscoelastic nature of the connective tissues joining vertebrae, and by multiple
      vertebral articulations and complex morphologies. Further, interspecific
      variation in these structures can greatly compound their functional variation
      between species, making comparative mechanical analyses even more difficult.
      Despite these sources of variation however, mammalian intervertebral joints
      universally exhibit a creep relaxation behaviour based on the viscoelastic nature
      of the soft tissue joint. We have evaluated, in 6 degrees of freedom, the
      mechanical signature of a novel mammalian lumbar intervertebral joint found in
      the Scutisorex spine, and compared it with a more typical mammalian joint in the
      Rattus (rat) lumbar spine. Scutisorex, the hero shrew, is an East African species
      of shrew with what is likely the most highly modified vertebral morphology in the
      entire history of mammals. Thus we decided to evaluate the mechanical behaviour
      of the intervertebral joint of this species, comparing it with a more
      representative mammal species in Rattus. We built a custom, 6 degrees of freedom,
      intervertebral joint transducer and a combined axial moment and load application
      system in order to quantify and compare the complex mechanical behaviour of these
      joints. Our results suggest that the Scutisorex joint is 5 times more resilient
      to simple axial torsion per body mass unit than Rattus, and that the complex load
      (combined axial compression and torsion) mechanical signature of Scutisorex is
      probably novel among all mammalian intervertebral joints. Under significant but
      physiological axial compression the Scutisorex intervertebral joint demonstrates
      no creep relaxation behaviour, simulating the mechanical behaviour of a rigid
      construct rather than a viscoelastic joint. The purpose of this rigid
      intervertebral joint in the ecology of Scutisorex remains unknown.

PMID- 11197535
TI  - Structure of the human tibialis anterior tendon.
AB  - The structure and vascular pattern of the human tibialis anterior tendon was
      investigated using injection techniques, light and transmission electron
      microscopy and immunohistochemistry. From the well vascularised peritenon, blood
      vessels penetrate the tendon tissue and anastomose with a longitudinally oriented
      intratendinous network. The distribution of blood vessels within the tibialis
      anterior tendon was not homogenous. The posterior part of the tendon had a
      complete vascular network that extends from the musculotendinous junction to the
      insertion at the first metatarsal and medial cuneiform bones. In the anterior
      half, the tissue was avascular in a zone with a length of 45-67 mm. This zone was
      covered by a single layer (approximately 30 microm) of oval shaped cells.
      Transmission electron microscopy showed that these cells have the characteristics
      of chondroid cells. This region was stained by Alcian blue at pH 1 which
      indicates a high concentration of acid glycosaminoglycans and immunohistochemical
      staining for chondroitin-4-sulphate, chondroitin-6-sulphate and aggrecan was
      positive. However, immunostaining for the typical cartilage specific type II
      collagen within this zone was negative. The location of the avascular zone
      corresponds to the region where the tibialis anterior tendon wraps around the
      superior and inferior retinacula which serve as fibrous pulleys. This is the
      region where most spontaneous ruptures of the tibialis anterior tendon occur. The
      presence of fibrocartilage within gliding tendons is a functional adaptation to
      compressive and shearing forces. In contrast to reports from the literature about
      the structure of gliding tendons wrapping around a bony pulley, the gliding zone
      of the tibialis anterior tendon has only a narrow layer of chondroid cells and
      proof of type II collagen is lacking.

PMID- 11197537
TI  - Immunohistochemical analysis of development of desmin-positive hepatic stellate
      cells in mouse liver.
AB  - Development of desmin-positive hepatic stellate cells was studied in mice using
      double immunofluorescent techniques and in vitro cultures with special attention
      given to their cell lineages. Several studies recently reported on the presence
      of cells that are immunologically reactive with both antidesmin and
      anticytokeratin antibodies in young fetal rat livers, and suggested the
      possibility that these cells give rise to hepatocytes and hepatic stellate cells.
      At early stages of mouse liver development, stellate cells with desmin-positive
      filaments were scattered in the liver parenchyma. However, the stellate cells
      definitely differed from hepatoblasts and hepatocytes in terms of their
      morphology and expression of desmin and hepatoblast and hepatocyte-specific E
      cadherin in the liver. Fetal hepatoblasts and hepatocytes did not react with
      antidesmin antibodies, nor did desmin-positive stellate cells express E-cadherin
      in vivo and in vitro. Thus it is likely that desmin-positive stellate cells and
      hepatoblasts belong to different cell lineages. In the fetal liver, the desmin
      positive stellate cells surrounded blood vessels, and extended their processes to
      haematopoietic cells and megakaryocytes. Many, but not all, hepatoblasts and
      hepatocytes were observed to be associated with the stellate cells. At fetal
      stages, cellular processes positive for desmin in the stellate cells were also
      thick compared with those in the adult liver, in which desmin-positive stellate
      cells lay in Disse's space and were closely associated with all hepatocytes.
      These developmental changes in the geography of desmin-positive cells in the
      liver parenchyma and their morphology may be associated with their maturation and
      interactions with other cell types.

PMID- 11197538
TI  - Influence of age and gender on thoracic vertebral body shape and disc
      degeneration: an MR investigation of 169 cases.
AB  - There are limited data detailing the pattern of age and gender-related changes to
      the thoracic vertebral bodies and intervertebral discs. A retrospective MR
      investigation, involving T1-weighted midsagittal images from 169 cases, was
      undertaken to examine age influences on the anterior wedge (anteroposterior
      height ratio or Ha/Hp), biconcavity (midposterior height ratio or Hm/Hp), and
      compression indices (posterior height/anteroposterior diameter or Hp/D) of the
      thoracic vertebral bodies. Disc degenerative changes in the annulus, nucleus, end
      plate and disc margin were noted on T2-weighted sagittal images for the 169
      cases, based on a 3-level grading system. A linear age-related decline in the
      Ha/Hp and Hm/Hp indices was noted. The Hp/D index increased during the first few
      decades of life, then decreased gradually thereafter. The prevalence of abnormal
      findings in the annuli, nuclei and disc margins increased with increasing age,
      particularly in the mid and lower thoracic discs. Greater disc degenerative
      changes were observed in males. These findings provide further insight into the
      nature of thoracic vertebral shape changes across the lifespan, and the typical
      patterns of degeneration of the thoracic intervertebral discs.

PMID- 11197539
TI  - Morphological and biochemical re-evaluation of the process of cavitation in the
      rat knee joint: cellular and cell strata alterations in the interzone.
AB  - To assess the contribution of apoptosis to the mechanism of synovial joint
      cavitation, and to clarify morphological cellular changes during cavitation, we
      investigated the development of the rat knee joint by light and electron
      microscopy, TUNEL methods, and electrophoresis of DNA fragments. Although
      cavitation occurred within the interzone, which consists of 2 outer and a middle
      layer termed the intermediate zone, no morphological or biochemical signs of cell
      death, in particular apoptosis, were seen in the interzone at any embryonic
      stage. Microscopic and ultrastructural alterations affecting cell differentiation
      were clearly observed in the interzone, i.e. mesenchymal cells gradually showed
      elongation, cytoplasmic vacuolation and pyknosis in the intermediate zone where
      the elongated cells were arranged in parallel in some strata. Some of these cells
      were further flattened into spindle cells and the number of strata decreased to
      2. The rest of the cells were incorporated secondarily into the outer layers,
      becoming chondroblasts. Collagen fibrils were arranged in a network structure in
      the outer layers, which obviously differed from the directional pattern parallel
      to the long axis of elongated cells in the intermediate zone. In addition, the
      density of collagen fibrils was higher in the outer layers than in the
      intermediate zone. During cavitation, the initial separation was detected between
      the elongated cells in the intermediate zone in paraffin sections at E16.5 and
      the spindle cells in epoxy sections at E18.5. The spindle cells lining the
      cavity, namely, the surfaces of the epiphysis and meniscus, finally became
      chondrocytes. The diminution of proteoglycans and collagen fibrils and the
      synthesis of hyaluronan in the extracellular matrix are now generally believed to
      be parts of the mechanism for cavitation based on the concept of 'loss of
      cohesion'. The microscopic and ultrastructural alterations in the interzone
      seemed to reflect differences in the arrangement and density of collagen fibrils
      and the developmental condition of the extracellular matrix between layers. Also
      it did not seem likely that these alterations inhibit the synthesis of hyaluronan
      at the presumptive joint line because this synthesis takes place at the plasma
      membrane. Separation between spindle cells should therefore represent the
      mechanism for developmentally programmed cavitation. Reorganization of the
      extracellular matrix is probably necessary for the cellular metamorphoses in the
      interzone involved in the process of cavitation.

PMID- 11197540
TI  - Compartments of the adult parasellar region.
AB  - In the infant the region lateral to the sella turcica which is traditionally
      termed the 'cavernous sinus' is composed of 3 individual compartments. The aim of
      this study was to demonstrate a similar compartmentation of the adult cavernous
      sinus and to identify and quantify the adipose bodies which are located within
      the compartments. The region of the cavernous sinus in 136 adults was analysed by
      microdissection and histology. We demonstrate that in 66% of the cavernous sinus
      in adults is composed of at least 2 compartments and in 22% it is made up of 3.
      Assimilating the renaming in infants we termed the compartments
      'pterygopalatine', 'orbital' and 'lateral sellar'. The pterygopalatine and
      orbital compartments are connected with extracranial tissue spaces via the
      superior orbital fissure and contain characteristic adipose bodies. Exact
      topographic descriptions and measurements of the compartments and their adipose
      bodies are provided. Our study clearly defines compartmentation of the adult
      parasellar space in most individuals and thus changes the anatomical view of this
      space. The direct connection of 2 of these compartments with extracranial tissue
      spaces and the measurements of their adipose bodies are of interest for surgeons
      and neuroradiologists.

PMID- 11197541
TI  - Distribution of cartilage thickness on the head of the human first metatarsal
      bone.
AB  - Articular hyaline cartilage takes on the contours of the subchondral bone on
      which it lies, but its thickness varies between joints, within a single joint and
      within a single articular surface. Previous studies have correlated articular
      cartilage thickness distribution with the degree of stress and weight bearing on
      joint surfaces, but few studies have considered the thickness of the calcified
      cartilage in relation to these parameters. Here we report a correlation between
      the cartilage thickness distribution and weight bearing distribution on the head
      of the 1st metatarsal bone, a component of one of the major weight bearing joints
      in the lower extremity during the gait cycle. The greatest total and uncalcified
      articular cartilage thickness was found on the central and lateral distal aspects
      of the metatarsal head, a region that receives maximal ground reactive force
      during the propulsive phase of the normal gait cycle. Although the thickness of
      the calcified cartilage was correlated with the thickness of the uncalcified
      cartilage, it varied to a lesser extent across the articular surface than did
      that of the uncalcified cartilage.

PMID- 11197542
TI  - [Multiple bacterial resistance in daily practice].
AB  - Present and future solutions to the problem of bacterial multiple resistance
      involve physicians, patients and veterinarians. Their behaviour should evolve to
      take into account the medical and economical issues of antibiotic prescription.
      The clinical diagnosis requires a more rigorous assessment, based on
      bacteriological and rapid antigenic tests. Vaccination in both young people and
      the elderly, is an essential prophylactic tool, which is too often neglected.
      When a bacterial infection is suspected or proven, priority should be given to a
      targeted antimicrobial therapy with a bactericidal activity, in order to quickly
      eradicate pathogens. Therapies should be shorter and questionable
      antibioprophylaxis should also be avoided. A watch laboratory network should
      provide physicians with an adequate information on local bacterial resistance
      patterns on a regular basis, in order to allow them adjusting their prescription.

PMID- 11197543
TI  - [Prions].

PMID- 11197544
TI  - [Gamma irradiation of solid and liquid collagen]  .

PMID- 11197545
TI  - [Methods of obtaining and formation mechanisms of polymer nanoparticles].
AB  - Severals processes exist today for manufacturing colloidal systems of nanospheres
      or nanocapsules. These nanoparticles have applications in various industrial
      fields such as cosmetic, pharmacy, food industry, agrochemicals.... The formation
      of nanoparticles allows the protection of an active molecule by a polymeric
      coating and the release of this product following a perfectly defined profile,
      which depends on the nature of the polymer, the type of particle and the field of
      use. The purpose of this article is to expose the different methods of
      preparation of nanoparticular systems. These methods are classified in two mains
      categories. The first gathers most of the methods which are based on
      polymerization reactions, the second presents the use of preformed polymers (of
      natural or synthetic origin). A thorough study is devoted to the mechanisms of
      formation, in order to find the advantages and the disadvantages of each
      technique to support the development of manufactoring processes.

PMID- 11197546
TI  - Soluble scute proteins of healthy and ill desert tortoises (Gopherus agassizii).
AB  - OBJECTIVES: To characterize protein composition of shell scute of desert
      tortoises and to determine whether detectable differences could be used to
      identify healthy tortoises from tortoises with certain illnesses. ANIMALS: 20
      desert tortoises. PROCEDURES: Complete postmortem examinations were performed on
      all tortoises. Plastron scute proteins were solubilized, scute proteins were
      separated by use of sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      (SDS-PAGE), and proteins were analyzed, using densitometry. Two-dimensional
      immobilized pH gradient-PAGE (2D IPG-PAGE) and immunoblot analysis, using
      polyclonal antisera to chicken-feather beta keratin and to alligator-scale beta
      keratin, were conducted on representative samples. The 14-kd proteins were
      analyzed for amino acid composition. RESULTS: The SDS-PAGE and densitometry
      revealed 7 distinct bands, each with a mean relative protein concentration of > 1
      %, ranging from 8 to 47 kd, and a major protein component of approximately 14 kd
      that constituted up to 75% of the scute protein. The 2D IPG-PAGE revealed
      additional distinct 62- and 68-kd protein bands. On immunoblot analysis, the 14-,
      32-, and 45-kd proteins reacted with both antisera. The 14-kd proteins had an
      amino acid composition similar to that of chicken beta keratins. There was a
      substantial difference in the percentage of the major 14-kd proteins from scute
      of ill tortoises with normal appearing shells, compared with 14-kd proteins of
      healthy tortoises. CONCLUSIONS AND CLINICAL RELEVANCE: The major protein
      components of shell scute of desert tortoises have amino acid composition and
      antigenic features of beta keratins. Scute protein composition may be altered in
      tortoises with certain systemic illnesses.

PMID- 11197547
TI  - Use of an orally administered combined sugar solution to evaluate intestinal
      absorption and permeability in cats.
AB  - OBJECTIVE: To evaluate intestinal permeability and absorption in healthy cats in
      association with diet and normal intestinal microflora. ANIMALS: 6 healthy
      domestic shorthair cats. PROCEDURE: A sugar solution containing D-xylose, 30
      methyl-D-glucose, L-rhamnose, lactulose, and 51Cr-EDTA was administered
      intragastrically to healthy cats, and urinary excretion of ingested sugars was
      determined 5 hours after administration. After the same cats had received
      metronidazole for 1 month, the study was repeated. A final study was performed
      while cats were maintained on a new diet differing in composition and processing.
      RESULTS: Lactulose-to-rhamnose ratios, reflecting intestinal permeability, were
      higher in cats, compared with values for humans or dogs, and values obtained
      before and after metronidazole administration (mean +/- SEM; before, 0.40 +/-
      0.08; after, 0.45 +/- 0.09) were not significantly different. Intestinal
      absorption also was unaltered after antibiotic administration, and the xylose-to
      glucose ratio was 0.70 +/- 0.03 before and 0.71 +/- 0.06 after metronidazole
      administration. Sugar recovery did not differ significantly while cats were
      maintained on canned or dry food. CONCLUSIONS AND CLINICAL RELEVANCE: Reference
      ranges were established for the percentage urinary recovery of orally
      administered D-xylose, 3-0-methyl-D-glucose, L-rhamnose, lactulose, and 51Cr-EDTA
      obtained after 5 hours in healthy cats. The intestines of cats appear to be more
      permeable than those of other species, although the normal bacterial microflora
      does not appear to influence the integrity or function of the feline intestine,
      because values obtained for the measured variables before or after antibiotic
      administration were not significantly different. In addition, differences were
      not detected when the diet was completely altered.

PMID- 11197548
TI  - Determination of optimal immobilizing doses of a medetomidine hydrochloride and
      ketamine hydrochloride combination in captive reindeer.
AB  - OBJECTIVE: To establish optimal immobilizing doses of medetomidine hydrochloride
      (MED) with ketamine hydrochloride (KET) for hand- and dart-administered
      injections in captive reindeer. ANIMALS: 12 healthy 6- to 9-month-old reindeer
      (Rangifer tarandus tarandus). Procedure An optimal dose was defined as a dose
      resulting in an induction time of 150 to 210 seconds, measured from the time of
      IM injection until recumbency. Initially, each stalled reindeer was immobilized
      by hand-administered injection. If the induction time was > 210 seconds, the dose
      was doubled for the next immobilization procedure. If it was < 150 seconds, the
      dose was halved for the next immobilization procedure. This iteration procedure
      was continued for each reindeer until an optimal dose was found. Later the
      reindeer was placed in a paddock and darted with its optimal dose as determined
      by hand-administered injection. Adjusting to a linear relationship between dose
      and induction time, optimal darting doses for each reindeer were predicted and
      later verified. RESULTS: The established mean optimal hand- and dart-administered
      doses were 0.10 mg of MED/kg of body mass with 0.50 mg of KET/kg, and 0.15 mg of
      MED/kg with 0.75 mg of KET/kg, producing mean induction times of 171 seconds and
      215 seconds, respectively. The mean induction time after darting was 5 seconds
      greater than the upper limit of the predefined time interval. CONCLUSIONS AND
      CLINICAL RELEVANCE: The higher dose requirement of MED-KET administration
      outdoors, compared with indoors, was explained by factors inherent in the darting
      technique and the different confinements. The iteration and the prediction
      methods seem applicable for determination of optimal doses of MED-KET in
      reindeer. The iteration and the prediction procedures may be used to reduce the
      number of experimental animals in dose-response studies in other species.

PMID- 11197549
TI  - Arrhythmogenic effect of hypercapnia in ducks anesthetized with halothane.
AB  - OBJECTIVE: To determine effects of hypercapnia on arrhythmias in ducks
      anesthetized with halothane. ANIMALS: 12 ducks, 6 to 8 months old, weighing 1.1
      to 1.6 kg. PROCEDURES: Each duck was anesthetized with a 1.5% mixture of
      halothane in oxygen, and anesthetic depth was stabilized during a 20-minute
      period. We added CO2 to the inspired oxygen to produce CO2 partial pressures of
      40, 60, and 80 mm Hg in the inspired gas mixture.The CO2 partial pressure was
      increased in a stepwise manner. When arrhythmias were not evident during
      inhalation of the gas mixture at a specific CO2 partial pressure, the CO2 partial
      pressure was maintained for 10 minutes before a sample was collected for blood
      gas analysis. When arrhythmias were detected, a sample for blood gas analysis was
      collected after the CO2 partial pressure was maintained for at least 2 minutes,
      and CO2 inhalation then was terminated. RESULTS: During the stabilization period,
      PaCO2 (mean +/- SD) was 33 +/- 5 mm Hg,and arrhythmias were not detected. In 6
      ducks, arrhythmias such as unifocal and multifocal premature ventricular
      contractions developed during inhalation of CO2. Mean PaCO2 at which arrhythmias
      developed was 67 +/- 12 mm Hg. In 5 of 6 ducks with arrhythmias, the arrhythmias
      disappeared after CO2 inhalation was terminated. CONCLUSION AND CLINICAL
      RELEVANCE: Analysis of data from this study indicated that hypercapnia can lead
      to arrhythmias in ducks during halothane-induced anesthesia. Thus, ventilatory
      support to maintain normocapnia is important for managing ducks anesthetized with
      halothane.

PMID- 11197550
TI  - Effect of repetitive bronchoalveolar lavage on cytologic findings in healthy
      dogs.
AB  - OBJECTIVE: To determine reference values for cytologic examination results of
      bronchoalveolar lavage fluid (BALF) and to investigate effects of repeated
      lavages on pulmonary health and on results of cytologic examination of BALF in
      dogs. ANIMALS: 16 healthy adult Beagles. PROCEDURE: All dogs underwent pulmonary
      lavage to obtain BALF. Eleven dogs were repeatedly lavaged 6 times at 5- to 7
      week intervals. Analyses for total and differential cell counts and for viability
      of cells before and after cell processing were performed. Arterial blood gas
      analysis before and after bronchoalveolar lavage was used to study the safety of
      the lavage procedure. Histologic and radiologic examinations were used to study
      effects of repeated lavages on pulmonary health. RESULTS: Mean (+/- SD) cell
      count was 104 +/- 69 cells/microl, comprising 75 +/- 7% alveolar macrophages, 13
      +/- 6% lymphocytes, 5 +/- 4% neutrophils, 4 +/- 5% eosinophils, 2 +/- 2% mast
      cells, 0.6 +/- 0.7% epithelial cells, and 0.3 +/- 0.4% plasma cells.
      Centrifugation of samples and washing of cells caused significant cell loss (59
      +/- 13%). Repeated lavages did not cause significant variations in cell counts of
      BALF or results of arterial blood gas analysis, thoracic radiography, or
      histologic examination of pulmonary specimens. Only a moderate, although
      significant, decrease in arterial oxygen content was observed after
      bronchoalveolar lavage. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis indicated
      that several lavages performed at 5- to 7-week intervals can safely and reliably
      be used to study the kinetics of pathologic processes in pulmonary tissues or for
      evaluation of therapeutic efficacy.

PMID- 11197551
TI  - Polymerase chain reaction analysis for viruses in paraffin-embedded myocardium
      from dogs with dilated cardiomyopathy or myocarditis.
AB  - OBJECTIVE: To perform polymerase chain reaction (PCR) analysis on paraffin
      embedded myocardium from dogs with dilated cardiomyopathy (DCM) and dogs with
      myocarditis to screen for canine parvovirus, adenovirus types 1 and 2, and
      herpesvirus. SAMPLE POPULATION: Myocardial specimens from 18 dogs with an
      antemortem diagnosis of DCM and 9 dogs with a histopathologic diagnosis of
      myocarditis were evaluated. PROCEDURE: Paraffin-embedded myocardial specimens
      were screened for viral genome by PCR analysis. Positive-control specimens were
      developed from cell cultures as well as paraffin-embedded tissue specimens from
      dogs with clinical and histopathologic diagnoses of viral infection with canine
      parvovirus, adenovirus types 1 and 2, and herpesvirus. The histologic
      characteristics of all myocardial specimens were classified regarding extent,
      location, and type of inflammation and fibrosis. RESULTS: Canine adenovirus type
      1 was amplified from 1 specimen from a dog with DCM. Canine parvovirus,
      adenovirus type 2, and herpesvirus were not amplified from any myocardial
      specimens. Histologic analysis of specimens from dogs with DCM revealed variable
      amounts of fibrosis; myocardial inflammation was observed in 1 affected dog.
      Histopathologic analysis of specimens from dogs with myocarditis disclosed
      variable degrees of inflammation and fibrosis. CONCLUSIONS AND CLINICAL
      RELEVANCE: Viral agents canine parvovirus, adenovirus types 1 and 2, and
      herpesvirus are not commonly associated with DCM or active myocarditis in dogs.
      Additional studies evaluating for nucleic acid from viruses that less commonly
      affect dogs or different types of infectious agents may be warranted to gain
      insight into the cause of DCM and myocarditis in dogs.

PMID- 11197552
TI  - Effects of Mannheimia haemolytica leukotoxin on apoptosis and oncosis of bovine
      neutrophils.
AB  - OBJECTIVE: To investigate the concentration-dependent effects of Mannheimia
      haemolytica (formerly Pasteurella haemolytica) leukotoxin (LKT) on apoptosis and
      oncosis in bovine neutrophils and to examine the role of calcium ions (Ca2+) in
      LKT-induced apoptosis. SAMPLE POPULATION: Neutrophils isolated from blood samples
      obtained from healthy calves. PROCEDURE: Neutrophil suspensions were exposed to
      lytic or sublytic dilutions of LKT and then examined by use of transmission
      electron microscopy (TEM) or gel electrophoresis. Contribution of extracellular
      Ca2+ to LKT-induced apoptosis was investigated by incubating neutrophils with LKT
      or control solutions in buffer containing 1 mM CaCl2 or in Ca2+-free buffer
      containing 1 mM ethylene glycol-bis (b-aminoethyl ether)-N,N-tetraacetic acid
      (EGTA) prior to diphenyl amine analysis. RESULTS: Examination by TEM revealed
      that bovine neutrophils exposed to lytic dilutions of LKT had changes consistent
      with oncosis, whereas neutrophils exposed to sublytic dilutions of LKT and
      staurosporin, an inducer of apoptosis, had changes consistent with apoptosis.
      Effects of sublytic dilutions of LKT on apoptosis were confirmed by gel
      electrophoresis. Replacement of extracellular Ca2+ with EGTA, a Ca2+ chelator,
      reduced apoptosis attributable to the calcium ionophore A23187, but it did not
      have significant effects on apoptosis induced by LKT or staurosporin. CONCLUSIONS
      AND CLINICAL RELEVANCE: The ability of LKT to cause apoptosis instead of oncosis
      is concentration-dependent, suggesting that both processes of cell death
      contribute to an ineffective host-defense response, depending on the LKT
      concentration in pneumonic lesions. Furthermore, although Ca2+ promotes A23187
      induced apoptosis, it is apparently not an essential second messenger for LKT
      induced apoptosis.

PMID- 11197553
TI  - Effects of the synthetic selectin inhibitor TBC1269 on tissue damage during acute
      Mannheimia haemolytica-induced pneumonia in neonatal calves.
AB  - OBJECTIVE: To determine effects of the selectin inhibitor TBC1269 on neutrophil
      mediated pulmonary damage during acute Mannheimia haemolytica-induced pneumonia
      in newborn calves. ANIMALS: Eighteen 1- to 3-day-old colostrum-deprived calves.
      PROCEDURE: Mannheimia haemolytica or saline (0.9% NaCl) solution was inoculated
      in both cranial lung lobes of 12 and 6 calves, respectively. Calves were
      euthanatized 2 (saline, n = 3; M haemolytica, n = 4) or 6 hours (saline, n = 3; M
      haemolytica, n = 8) after inoculation. Four M haemolytica-inoculated calves
      euthanatized at 6 hours also received TBC1269 (25 mg/kg, IV) 30 minutes before
      and 2 hours after inoculation. Conjugated diene (CD) concentrations, inducible
      nitric oxide synthase (iNOS) expression, and apoptotic cell counts were
      determined in lung specimens collected during necropsy. RESULTS: Conjugated diene
      concentrations were significantly increased in all M haemolytica-inoculated
      groups, compared with saline-inoculated groups. Calves treated with TBC1269 had
      decreased concentrations of CD, compared with untreated calves, although the
      difference was not significant. Number of apoptotic neutrophils and macrophages
      increased significantly inTBC1269-treated calves, compared with untreated calves.
      Inducible nitric oxide synthase was expressed by epithelial cells and leukocytes.
      However, iNOS was less abundant in airway epithelial cells associated with
      inflammatory exudates. Degree of iNOS expression was similar between TBC1269
      treated and untreated calves. CONCLUSIONS: Mannheimia haemolytica infection in
      neonatal calves resulted in pulmonary tissue damage and decreased epithelial cell
      iNOS expression. The selectin inhibitor TCB1269 altered, but did not completely
      inhibit, neutrophil-mediated pulmonary damage.

PMID- 11197554
TI  - Evaluation of an in-shoe pressure measurement system in horses.
AB  - OBJECTIVE: To develop an objective, accurate method for quantifying forelimb
      ground reaction forces in horses by adapting a human in-shoe pressure measurement
      system and determine the reliability of the system for shod and unshod horses.
      ANIMALS: 6 adult Thoroughbreds. PROCEDURE: Horses were instrumented with a human
      in-shoe pressure measurement system and evaluated at a trot (3 m/s) on a
      motorized treadmill. Maximum force, stance time, and peak contact area were
      evaluated for shod and unshod horses. Three trials were performed for shod and
      unshod horses, and differences in the measured values were examined with a mixed
      model ANOVA for repeated measures. Sensor accuracy was evaluated by correlating
      measured variables to clinically observed lameness and by a variance component
      analysis. RESULTS: 4 of 6 horses were determined to be lame in a forelimb on the
      basis of clinical examination and measured values from the system. No significant
      differences were observed between shod and unshod horses for maximum force and
      stance time. A significant decrease in peak contact area was observed for shod
      and unshod horses at each successive trial. Maximum force measurements provided
      the highest correlation for detecting lameness (r = 0.91, shod horses; r = 1.0,
      unshod horses). A variance component analysis revealed that 3 trials provided a
      variance of 35.35 kg for maximum force (+/- 5.78% accuracy), 0.007 seconds for
      stance time (+/- 2.5% accuracy), and 8.58 cm2 for peak contact area (+/- 11.95%
      accuracy). CONCLUSIONS AND CLINICAL RELEVANCE: The in-shoe pressure measurement
      system provides an accurate, objective, and effective method to evaluate lameness
      in horses.

PMID- 11197555
TI  - Evaluation of a polyvalent enzyme-linked immunosorbent assay incorporating a
      recombinant p44 antigen for diagnosis of granulocytic ehrlichiosis in dogs and
      horses.
AB  - OBJECTIVE: To develop and evaluate a polyvalent ELISA incorporating a highly
      specific recombinant antigen (p44) for diagnosis of granulocytic ehrlichiosis in
      dogs and horses. ANIMALS: 32 dogs and 43 horses. PROCEDURE: Results of the ELISA
      were compared with results of indirect fluorescent antibody (IFA) staining and
      western immunoblotting incorporating whole-cell antigen. RESULTS: For the canine
      and equine samples, percentages of samples with positive IFA staining, western
      immunoblotting, and ELISA results were similar. For 29 (91 %) canine samples and
      30 (70%) equine samples, results of IFA staining, western immunoblotting, and the
      ELISA were in complete agreement. Results of the ELISA for 3 canine serum samples
      known to contain antibodies to Ehrlichia canis and 12 equine serum samples known
      to contain antibodies to E risticii were negative. CONCLUSIONS AND CLINICAL
      RELEVANCE: Results of the present study suggest that a polyvalent ELISA
      incorporating a recombinant p44 antigen is suitable for detecting antibodies to E
      equi in dogs and horses.

PMID- 11197556
TI  - Evaluation of the cardiac actin gene in Doberman Pinschers with dilated
      cardiomyopathy.
AB  - OBJECTIVE: To evaluate the coding region of the cardiac actin gene in Doberman
      Pinschers with dilated cardiomyopathy (DCM) for mutations that could be
      responsible for the development of the condition ANIMALS: 28 dogs (16 Doberman
      Pinschers with DCM and 12 mixed-breed control dogs). PROCEDURE: Ten milliliters
      of blood was collected from each dog for DNA extraction. Polymerase chain
      reaction (PCR) primers were designed to amplify canine exonic regions, using the
      sequences of exons 2 to 6 of the cardiac actin gene. Single-stranded
      conformational polymorphism analysis was performed for each exon with all
      samples. Autoradiographs were analyzed for banding patterns specific to affected
      dogs. The DNA sequencing was performed on a selected group of affected and
      control dogs. RESULTS: Molecular analysis of exons 2 to 6 of the cardiac actin
      gene did not reveal any differences in base pairs between affected dogs and
      control dogs selected for DNA evaluation. CONCLUSIONS: Mutations in exons 5 and 6
      of the cardiac actin gene that have been reported in humans with familial DCM do
      not appear to be the cause of familial DCM in Doberman Pinschers. Additionally,
      evaluation of exons 2 to 6 for causative mutations did not reveal a cause for
      inherited DCM in these Doberman Pinschers. Although there is evidence that DCM in
      Doberman Pinschers is an inherited problem, a molecular basis for this condition
      remains unresolved. Evaluation of other genes coding for cytoskeletal proteins is
      warranted.

PMID- 11197557
TI  - Spectral analysis of circadian rhythms in heart rate variability of dogs.
AB  - OBJECTIVE: To determine characteristics of power spectral analysis of heart rate
      variability (HRV) during a 24-hour period in dogs and to evaluate the effects of
      vagal and sympathetic tone on HRV ANIMALS: 16 healthy adult Beagles. PROCEDURE:
      Power spectral analysis of HRV was conducted, using 24-hour ambulatory ECG
      recordings. Circadian rhythms were evaluated in terms of absolute units of low
      frequency (LF) and high-frequency (HF) powers, their ratio (LF:HF), and their
      adjusted (normalized) units (LF[norm] and HF[norm]). Three or 4 dogs were used
      for simultaneous measurement of heart rate and respiratory waveform as well as to
      evaluate treatment (propranolol, atropine, or both) administered to cause
      blockade of the autonomic nervous system. RESULTS: Values for LF and HF powers,
      LF:HF, LF(norm), and HF(norm) had obvious rhythmicity in clinically normal dogs.
      The HF power of HRV in dogs was extremely high, compared with that of other
      species, and HF peaks corresponded to peaks obtained from respiratory waveforms.
      Blockade of the autonomic nervous system documented that HRV in dogs was mostly
      attributable to vagal activity. CONCLUSION AND CLINICAL RELEVANCE: We determined
      characteristics of power spectral analysis of HRV in dogs, including circadian
      rhythm of the autonomic nervous system. Power spectral analysis of HRV may
      provide a useful noninvasive technique for assessing the effect of drugs on
      activity of the autonomic nervous system in dogs.

PMID- 11197558
TI  - CRWAD dedicated to Coggins. Conference of Research Workers in Animal Diseases.

PMID- 11197559
TI  - Use of intraosseous blood for repeated hematologic and biochemical analyses in
      healthy pigs.
AB  - OBJECTIVE: To evaluate the clinical and histologic effects of repeated
      intraosseous (IO) needle placement in domestic pigs and determine whether blood
      and serum obtained intraosseously could be used for CBC and biochemical analyses.
      ANIMALS: 5 healthy 10-week-old pigs. PROCEDURE: An IO needle was placed in the
      proximomedial region of the tibia of anesthetized pigs every other week for 2
      months, and IO blood was obtained for CBC and serum biochemical analyses. Results
      were compared with those obtained for blood collected at the same time from the
      auricular vein. Two weeks after the final samples were obtained, pigs were
      euthanatized and tibias were processed for histologic examination. RESULTS:
      Clinical abnormalities, including lameness, were not detected following IO needle
      placement. Histologic examination revealed only mild multifocal periosteal
      fibrosis and slight thickening of the periosteum without evidence of
      osteomyelitis. Chloride, creatinine, glucose, total protein, sodium, and BUN
      concentrations, alanine transaminase and gamma glutamyl transpeptidase
      activities, RBC count, mean corpuscular volume, and Hct did not significantly
      differ between IO and venous samples. However, aspartate transaminase activity,
      potassium, hemoglobin, and mean corpuscular hemoglobin concentrations, mean
      corpuscular hemoglobin, and platelet and WBC counts were significantly different.
      CONCLUSION AND CLINICAL RELEVANCE: Repeated placement of 10 needles may be a safe
      and clinically useful method to obtain serial blood samples from domestic pigs,
      particularly when other vascular sites are not accessible. Intraosseous blood can
      be used for many of the tests comprising CBC and serum biochemical analyses.

PMID- 11197560
TI  - Biomechanical properties of braided polyester tapes intended for use as intra
      articular cranial cruciate ligament prostheses in dogs.
AB  - OBJECTIVE: To determine the in vitro structural and material properties of
      braided, multifilament, nonabsorbable polyester tapes, used for intra-articular
      stabilization of cranial cruciate ligament- (CCL-) deficient stifle joints in
      dogs, and compare those with properties of multifilament polyamide tapes. SAMPLE
      POPULATION: 30 polyester tapes (width, 4 mm), 10 polyester tapes (width, 7 mm),
      and 30 polyamide tapes (width, 4 mm) were tested to failure. Cyclic loading
      experiments were also performed, using 3 polyester tapes of each width.
      PROCEDURE: Tapes were mounted in a tensile tester as single loops, simulating
      intra-operative conditions, and elongated to failure at 1,000 mm/min.
      Additionally, the behavior of polyester tapes was tested at different elongation
      rates. In a second series of experiments, biomechanical variables of the
      polyester tapes were measured after 25 sets of 2,000 cycles between physiologic
      force limits. RESULTS: Mean (+/- SD) ultimate loads of the 4-mm wide polyamide
      tapes, 4-mm wide polyester tapes, and 7-mm wide polyester tapes were 266.48 +/-
      13.19 301.78 +/- 16.92, and 726.40 +/- 37.74 N, respectively. Corresponding
      stiffnesses were 15.57 +/- 0.49, 21.63 +/- 2.19, and 34.85 +/- 2.66 N/mm,
      respectively. Failure properties of polyester tapes were affected by previous
      cyclic loading. CONCLUSIONS AND CLINICAL RELEVANCE: Polyester tapes of 4- or 7-mm
      widths should be able to resist forces resulting from weight bearing in dogs,
      suggesting that these tapes will be effective for stabilization of the stifle
      joint in dogs with a ruptured CCL.

PMID- 11197561
TI  - Effects of anti-inflammatory drugs on lipopolysaccharide-challenged and 
      unchallenged equine synovial explants.
AB  - OBJECTIVE: To evaluate the effects of anti-inflammatory drugs on
      lipopolysaccharide (LPS)-challenged and -unchallenged equine synovial membrane in
      terms of production of prostaglandin E2 (PGE2) and hyaluronan, viability, and
      histomorphologic characteristics. SAMPLE POPULATION: Synovial membranes were
      collected from the carpal, tarsocrural, and femoropatellar joints of 6 adult
      horses. PROCEDURE: Synovial membranes from each horse were minced and pooled and
      explants were treated with one of the following: no drug (control), drug, LPS
      alone, or LPS and drug. Treatment drugs were phenylbutazone (PBZ), flunixin
      meglumine (FNX), ketoprofen (KET), carprofen (CRP), meloxicam (MEL), low
      concentration methylprednisolone (METH), high-concentration METH, dimethyl
      sulfoxide (DMSO), or an experimental COX-2 inhibitor (dissolved in DMSO).
      Following 48 hours of culture, medium was assayed for PGE2 and hyaluronan
      concentration. Synovial explants were assessed for viability and histomorphologic
      characteristics. RESULTS: For the LPS-challenged explants, PBZ, FNX, KTP CRF MEL,
      and low-concentration METH suppressed PGE2 production, compared with LPS
      challenge alone. Only MEL suppressed PGE2 production from LPS-challenged
      explants, compared with unchallenged explants. Synovial explants maintained > 90%
      viability and there was no significant difference in viability or hyaluronan
      production among explants. Histomorphologic scores were significantly decreased
      for explants treated with low-concentration METH or DMSO. CONCLUSIONS AND
      CLINICAL RELEVANCE: PBZ, FNX, KTP, CRFP MEL, and low-concentration METH
      suppressed PGE2 production in LPS-challenged explants. Meloxicam appeared to have
      more selective suppression of COX-2 activity. Histomorphologic scores suggest
      detrimental effects of METH, DMSO, and the experimental COX-2 inhibitor. Commonly
      used nonsteroidal anti-inflammatory drugs suppress induced synovial membrane PGE2
      production without detrimental effects on synovial membrane viability and
      function.

PMID- 11197562
TI  - Nucleotide and deduced amino acid sequence of equine retinal and pineal gland
      phosducin.
AB  - OBJECTIVES: To determine the full-length complementary DNA (cDNA) sequence of
      equine retinal and pineal gland phosducin (PHD) and to clone these sequences.
      SAMPLE POPULATION: Samples of equine retinal RNA. PROCEDURE: A primer set was
      designed for use in identifying a fragment of the equine PHD nucleotide sequence,
      derived from retinal RNA samples, and subsequently for use to deduce specific
      primers for additional examination. The full-length cDNA was determined by the
      method of rapid amplification of cDNA ends (RACE). For full-length cDNA, newly
      designed primers were used. Nucleotide sequences were analyzed by use of computer
      software. The deduced amino acid sequence was compared with sequences of PHD
      reported for other species. In addition, the sequence of equine pineal PHD was
      cloned. RESULTS: The cDNA nucleotide sequence for equine PHD was 1,209 base pairs
      (bp) in length with an open-reading frame encoding a protein of 245 amino acids
      and a calculated molecular mass of 28.214 kd. Similarity with amino acid
      sequences of PHD from other species was 89 to 93%. Sequences of equine PHD from
      retina and pineal gland were identical. Equine PHD contained a peptide sequence
      with 100% homology to an uveitopathogenic peptide reported for rat PHD.
      CONCLUSIONS: Equine PHD is a highly conserved protein that has homology of
      immunologic interest with rat PHD. These results establish a basis for studying
      the role of PHD in ocular inflammation of horses.

PMID- 11197563
TI  - Use of western immunoblot for evaluation of myocardial dystrophin, alpha
      sarcoglycan, and beta-dystroglycan in dogs with idiopathic dilated
      cardiomyopathy.
AB  - OBJECTIVE: To evaluate the potential importance of dystrophin, alpha-sarcoglycan
      (adhalin), and beta-dystroglycan, by use of western blot analysis, in several
      breeds of dogs with dilated cardiomyopathy. SAMPLE POPULATION: Myocardial samples
      obtained from 12 dogs were evaluated, including tissues from 7 dogs affected with
      dilated cardiomyopathy, 4 control dogs with no identifiable heart disease
      (positive control), and 1 dog affected with Duchenne muscular dystrophy (negative
      control for dystrophin). Of the affected dogs, 4 breeds were represented
      (Doberman Pinscher, Dalmatian, Bullmastiff, and Irish Wolfhound). PROCEDURE:
      Western blot analysis was used for evaluation of myocardial samples obtained from
      dogs with and without dilated cardiomyopathy for the presence of dystrophin and 2
      of its associated glycoproteins, alpha-sarcoglycan and beta-dystroglycan.
      RESULTS: Detectable differences were not identified between dogs with and without
      myocardial disease in any of the proteins evaluated. CONCLUSIONS AND CLINICAL
      RELEVANCE: Abnormalities in dystrophin, alpha-sarcoglycan, and beta-dystroglycan
      proteins were not associated with the development of dilated cardiomyopathy in
      the dogs evaluated in this study. In humans, the development of molecular
      biological techniques has allowed for the identification of specific causes of
      dilated cardiomyopathy that were once considered to be idiopathic. The use of
      similar techniques in veterinary medicine may aid in the identification of the
      cause of idiopathic dilated cardiomyopathy in dogs, and may offer new avenues for
      therapeutic intervention.

PMID- 11197564
TI  - Prevalence and prognostic importance of hypomagnesemia and hypocalcemia in horses
      that have colic surgery.
AB  - OBJECTIVE: To determine the prevalence of hypomagnesemia and hypocalcemia in
      horses with surgical colic. ANIMALS: 35 horses with surgically managed colic.
      PROCEDURE: Serum concentrations of total magnesium (tMg2+) and calcium (tCa2+),
      as well as ionized magnesium (iMg2+) and calcium (iCa2+) were analyzed before
      surgery and 1, 3, 5, and 7 days following surgery. A lead-II ECG and pertinent
      clinical data were also obtained at each time. RESULTS: Preoperative serum tMg2+
      and iMg2+ concentrations were below the reference range in 6 (17%) and 19 (54%)
      horses, respectively. Serum concentrations of tCa2+ and iCa2+ were less than the
      reference range in 20 (57%) and 30 (86%) horses before surgery. Horses with
      strangulating lesions of the gastrointestinal tract had significantly lower
      preoperative serum concentrations of iMg2+ and iCa2+, as well as a higher heart
      rate than horses with nonstrangulating lesions. Horses that developed
      postoperative ileus had significantly lower serum concentrations of iMg2+ after
      surgery. Serum concentrations of magnesium and calcium (total and ionized)
      correlated significantly with the PR, QRS, QT, and corrected QT (QTc) intervals.
      Horses that were euthanatized at the time of surgery (n = 7) had significantly
      lower preoperative serum concentrations of iMg2+, compared with horses that
      survived. Neither serum magnesium nor calcium concentrations were predictors of
      hospitalization time or survival. CONCLUSIONS AND CLINICAL RELEVANCE:
      Hypomagnesemia and hypocalcemia were common during the perioperative period,
      particularly in horses with strangulating intestinal lesions and ileus. Serum
      concentrations of tMg2+ and tCa2+ were less sensitive than iMg2+ and iCa2+ in
      detecting horses with hypomagnesemia and hypocalcemia.

PMID- 11197565
TI  - Evaluation of polymyxin B in an ex vivo model of endotoxemia in horses.
AB  - OBJECTIVE: To evaluate effects of polymyxin B sulfate (PMB) on response of horses
      to endotoxin, using an ex vivo model. ANIMALS: 8 healthy horses. PROCEDURE: In a
      crossover design, 3 doses of PMB (100, 1,000, and 10,000 U/kg of body weight) and
      physiologic saline solution (control) were evaluated. Prior to and for 24 hours
      after administration of PMB, blood samples were collected into heparinized tubes
      for use in 2 assays. For the endotoxin-induced tumor necrosis factor (TNF) assay,
      blood samples were incubated (37 C for 4 h) with 1 ng of Escherichia coli or
      Salmonella Typhimurium endotoxin/ml of blood. Plasma was harvested and assayed.
      For the residual endotoxin activity assay, plasma was collected into sterile
      endotoxin-free borosilicate tubes, diluted 1:10 with pyrogen-free water, and
      incubated for 10 minutes at 70 C. Escherichia coli endotoxin (0.1 or 1 ng/ml of
      plasma) was added to the thawed samples prior to performing the limulus
      ameobocyte lysate assay. Serum creatinine concentrations were monitored for 1
      week. RESULTS: Compared with baseline values, PMB caused a significant dose- and
      time-dependent decrease in endotoxin-induced TNF activity. Compared with baseline
      values, residual endotoxin activity was significantly reduced after
      administration of 10,000 U of PMB/kg. Compared with baseline values, 1,000 and
      5,000 U of PMB/kg should inhibit 75% of endotoxin-induced TNF activity for 3 and
      12 hours, respectively. Serum creatinine concentrations remained within the
      reference range. CONCLUSION AND CLINICAL RELEVANCE: Results of the study suggest
      that PMB is a safe, effective inhibitor of endotoxin-induced inflammation in
      healthy horses.

PMID- 11197566
TI  - Pharmacodynamics and pharmacokinetics of ketoprofen enantiomers in sheep.
AB  - OBJECTIVE: To establish pharmacokinetic and pharmacodynamic properties of a
      racemic mixture and individual R(-) and S(+) enantiomeric forms of ketoprofen
      (KTP) in sheep and determine pharmacodynamic variables of KTP by pharmacokinetic
      pharmacodynamic modeling. ANIMALS: 8 female Dorset crossbred sheep. PROCEDURE: A
      tissue cage model of inflammation was used. Carrageenan was administered into
      tissue cages. Time course of cyclooxygenase (COX)-2 inhibition was determined in
      vivo by measurement of exudate prostaglandin E2 (PGE2) concentrations. Time
      course of COX-1 inhibition was determined ex vivo by measurement of serum
      thromboxane B2 (TXB2) concentrations. In addition, plasma concentration-time
      course and penetration of KTP enantiomers into inflammatory exudate and
      transudate (noninflamed tissue cage fluid) were investigated. Four treatments
      were compared: placebo, racemic mixture (rac-KTP [3 mg/kg of body weight, IV]),
      S(+) KTP (1.5 mg/kg, IV),and R(-) KTP (1.5 mg/kg, IV). RESULTS: Both KTP
      enantiomers had elimination half-life and mean residence time measurements that
      were short and volume of the central compartment and steady state volume of
      distribution that were low. Clearance was rapid, particularly for R(-) KTP
      Elimination of both enantiomers from exudate was > 10 times slower than from
      plasma. Both rac-KTP and the individual enantiomers significantly inhibited serum
      TXB2 concentrations for 12 hours. Rac-KTP and S(+) KTP, but not R(-) KTP, also
      significantly inhibited PGE2 synthesis in exudate for 12 hours. CONCLUSIONS AND
      CLINICAL RELEVANCE: Inhibition of serum TXB2 concentration and exudate PGE2
      synthesis for similar time courses after S(+) KTP administration indicates that
      it is a nonselective inhibitor of COX in sheep.

PMID- 11197567
TI  - Effect of a leukocyte-depleting filter in an extracorporeal circuit used for low
      flow ischemia and reperfusion of equine jejunum.
AB  - OBJECTIVE: To determine effect of leukocyte depletion on hematologic,
      morphologic, and metabolic variables of equine jejunum after induction of
      arterial low-flow ischemia and reperfusion by use of an extracorporeal circuit.
      ANIMALS: 14 healthy adult horses. PROCEDURE: A segment of jejunum was surgically
      removed and maintained in an isolated circuit for 3 hours (control group),
      arterial flow was reduced to 20% of baseline for 40 minutes followed by 1 hour of
      reperfusion (low-flow group), or leukocyte depletion was filter-induced, and low
      flow ischemia and reperfusion were conducted as in the low-flow control group
      (filter-treated group). Various metabolic, hemodynamic, and histomorphologic
      variables were evaluated, including effects of electrical field stimulation and L
      N-nitro-arginine-methyl-ester (L-NAME) on contractile activity. RESULTS: The
      extracorporeal circuit appeared to maintain the jejunum within physiologic limits
      for an extended period. Low-flow ischemia with reperfusion induced significant
      differences in various measurements, compared with control specimens. Significant
      differences were not detected between the low-flow and filter-treated groups.
      Myeloperoxidase activity was greater in the low-flow group than the control
      group, whereas a difference was not detected between control and filter-treated
      groups. CONCLUSIONS AND CLINICAL RELEVANCE: The extracorporeal circuit maintained
      intestine for 3 hours in a physiologic state and may be used for simulation of
      tissue injury. Leukocyte depletion generally did not attenuate the effects of low
      flow ischemia and reperfusion on equine small intestine.

PMID- 11197568
TI  - Incidence of the endothelin receptor B mutation that causes lethal white foal
      syndrome in white-patterned horses.
AB  - OBJECTIVE: To determine incidence of the Ile118Lys endothelin receptor B (EDNRB)
      mutation responsible for overo lethal white syndrome (OLWS) and its association
      with specific types of white patterning. ANIMALS: 945 horses of white-patterned
      bloodlines and 55 solid-colored horses of other breeds. PROCEDURE: Horses were
      genotyped by use of allele-specific polymerase chain reaction to determine
      incidence of the Ile118Lys EDNRB mutation. RESULTS: Genotypes detected were
      homozygous Ile118, homozygous Lys118, and heterozygous. All foals with OLWS were
      homozygous for the Ile118Lys EDNRB mutation, and adults that were homozygous were
      not found. White patterning was strongly associated with EDNRB genotype. Color
      patterns with highest incidence (> 94%) of heterozygotes were frame overo, highly
      white calico overo, and frame blend overo. White-patterned bloodlines with lowest
      incidence of heterozygotes (< 21 %) were tobiano, sabino, minimally white calico
      overo, splashed white overo, nonframe blend overo, and breeding-stock solid. The
      mutation was not detected in solid-colored horses from breeds without white
      patterning. CONCLUSIONS AND CLINICAL RELEVANCE: In homozygotes, the Ile118Lys
      EDNRB mutation causes OLWS. In heterozygotes, the mutation is usually responsible
      for a frame overo phenotype. The frame pattern can be combined with other white
      patterns, making accurate estimation of EDNRB genotype by visual inspection
      difficult. Wide range of incidence of heterozygotes in various subtypes of white
      patterned horses indicates different genetic control of these color patterns.
      Determination of EDNRB genotype by use of a DNA-based test is the only way to
      determine with certainty whether white-patterned horses can produce a foal
      affected with OLWS.

PMID- 11197569
TI  - Head lice resistance: itching that just won't stop.
AB  - OBJECTIVE: To evaluate the reports of resistance and cross-resistance to
      pediculicides in the head louse (Pediculus capitis), as well as the mechanisms
      involved. DATA SOURCES: Literature identified through a MEDLINE search (1966
      April 2000) and through other secondary literature databases and/or
      bibliographies of pertinent articles. DATA SYNTHESIS: Head lice infestation is a
      common, worldwide problem. The widespread use of insecticide treatments together
      with inadequate treatment methods has led to a concern regarding the potential
      development of resistant head lice. This literature review examines the reports
      of resistance of the head louse as well as the purported mechanisms involved.
      CONCLUSIONS: Current research suggests that head lice resistance exists, but
      little is known regarding the actual incidence of this resistance or whether this
      incidence is increasing. More research is needed to assess the status of this
      problem. Proposed mechanisms for head lice resistance include knock-down
      resistance, glutathione S-transferase-based resistance, and monooxygenase-based
      resistance.

PMID- 11197570
TI  - NSAID impairment of orthodontic tooth movement.
AB  - OBJECTIVE: To evaluate the impairment of orthodontic tooth movement caused by
      nonsteroidal antiinflammatory drugs (NSAIDs). DATA SOURCES: Biomedical literature
      accessed through MEDLINE (1966-January 2000), EMBASE (1980-January 2000), and
      International Pharmaceutical Abstracts (1970-January 2000). Key search terms
      included NSAIDs, orthodontics, and tooth movement. DATA SYNTHESIS: Orthodontic
      dentistry applies mechanical force to generate tooth movement. Since
      prostaglandins are mediators of tooth movement, it is reasonable to expect that
      prostaglandin inhibitors, such as NSAIDs, inhibit or delay tooth movement. An
      evaluation of studies measuring the extent of NSAID impairment on tooth movement
      was undertaken. CONCLUSIONS: Results from animal studies have shown that NSAIDs
      can impair the tooth movement process. Until long-term human data are obtained,
      acetaminophen remains an appropriate alternative to NSAIDs for treating
      orthodontic-associated pain.

PMID- 11197571
TI  - Comparison of Internet and community pharmacies.

PMID- 11197572
TI  - Colony-stimulating factors in acute leukemia: will we ever have an answer?

PMID- 11197573
TI  - Pulmonary edema associated with rosiglitazone and troglitazone.

PMID- 11197574
TI  - Comment: drug-herb interaction.

PMID- 11197575
TI  - Ritonavir-induced carbamazepine toxicity.

PMID- 11197576
TI  - Publication rates in Australia, Canada, UK, and US pharmacy schools.

PMID- 11197577
TI  - Possible interaction between cisapride and digoxin.

PMID- 11197578
TI  - Aseptic meningitis related to valacyclovir.

PMID- 11197579
TI  - Evaluation of outcomes in converting from intravenous ondansetron to oral
      granisetron: an observational study.
AB  - OBJECTIVE: To describe a systematic evaluation of the outcomes associated with
      revising institutional guidelines for the prevention of acute chemotherapy
      induced nausea and vomiting (CINV) to promote cost-effective use of the serotonin
      (5-HT3) antagonists. METHODS: The 5-HT3 antagonist of choice in the antiemetic
      guidelines was revised from intravenous ondansetron to oral granisetron in August
      1995. Patient assessments were conducted immediately prior to (Period 1) and
      after (Period 2) guideline revision using validated questionnaires. The
      effectiveness of the two 5-HT3 antagonists were compared and reported to the
      prescribing oncologists. Outcomes were assessed one year after guideline revision
      (Period 3) using identical methods. RESULTS: No difference was found in the rate
      of total control (no emesis, no nausea) between patients receiving oral
      granisetron (60%) and intravenous ondansetron (56%) (p = 0.408, Period 1 vs. 2).
      Nausea severity, the number of emesis episodes, and use of rescue antiemetics
      were also equivalent. Prescriber compliance with using the 5-HT3 antagonist of
      choice and dose increased from 48% to 61% following adoption of oral granisetron.
      By Period 3, compliance increased to 78%, and satisfactory control of acute CINV
      was again documented. The costs for prevention of acute CINV decreased from $107
      in Period 1 (intravenous ondansetron only) to $65 in Period 3 (oral granisetron).
      CONCLUSIONS: Outcomes associated with use of oral granisetron and intravenous
      ondansetron were equivalent in this patient population. Guideline revision and
      outcome documentation by the oncology pharmacists resulted in increased
      compliance with institution guidelines and a 40% cost savings.

PMID- 11197580
TI  - Lack of methemoglobinemia with flutamide.
AB  - OBJECTIVE: To determine whether the nonsteroidal antiandrogenic drug flutamide is
      a clinically relevant inducer of methemoglobinemia in patients with prostatic
      cancer. METHODS: Fifty consecutive outpatients with prostatic cancer stage D2
      entered the study (age 71.1 +/- 7.3 y). Five patients were lost to follow-up; the
      remaining 45 patients received the recommended oral dose of flutamide 250 mg
      three times daily. Total hemoglobin (Hb) and methemoglobin (Met-Hb)
      concentrations were measured on varying days using an ultraviolet/visible
      spectrophotometric method with an intra- and interday variability < 8%. In 12
      patients, Met-Hb was analyzed before initiating flutamide therapy and after
      therapy was begun. RESULTS: On average, 2.6 venous blood samples per patient were
      analyzed with a mean Met-Hb concentration of 1.9% of total Hb. Mean
      concentrations of > or = 3% were detected in only six patients (13%). The data
      from 12 patients evaluated before and after initiating flutamide therapy were
      without significantly different changes. During the study period, no clinical
      signs of methemoglobinemia were reported or observed. CONCLUSIONS: This study
      found no clinically relevant increase of Met-Hb concentrations in elderly
      patients with prostatic cancer during chronic treatment with flutamide. However,
      clinicians should be aware of the very rare possibility of flutamide-induced
      methemoglobinemia.

PMID- 11197581
TI  - Rhabdomyolysis secondary to a drug interaction between simvastatin and
      clarithromycin.
AB  - OBJECTIVE: To report a case of rhabdomyolysis resulting from concomitant use of
      clarithromycin and simvastatin. CASE SUMMARY: A 64-year-old African-American man
      was admitted to the hospital for worsening renal failure, elevated creatine
      phosphokinase, diffuse muscle pain, and severe muscle weakness. About three weeks
      prior to admission, the patient was started on clarithromycin for sinusitis. The
      patient had been receiving simvastatin for approximately six months. He was
      treated aggressively with intravenous hydration, sodium bicarbonate, and
      hemodialysis. A muscle biopsy revealed necrotizing myopathy secondary to a toxin.
      The patient continued to receive intermittent hemodialysis until his death from
      infectious complications that occurred three months after admission. There were
      several factors that could have increased his risk for developing rhabdomyolysis,
      including chronic renal failure. DISCUSSION: Clarithromycin is a potent inhibitor
      of CYP3A4, the major enzyme responsible for simvastatin metabolism. The
      concomitant administration of macrolide antibiotics and other
      hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have resulted in
      previous reports of rhabdomyolysis. Other factors may increase the risk of this
      drug interaction, including the administration of other medications that are
      associated with myopathy, underlying renal insufficiency, and administration of
      high doses of HMG-CoA reductase inhibitors. CONCLUSIONS: Macrolide antibiotics
      inhibit the metabolism of HMG-CoA reductase inhibitors that are metabolized by
      CYP3A4 (i.e., atorvastatin, cerivastatin, lovastatin, simvastatin). This
      interaction may result in myopathy and rhabdomyolysis, particularly in patients
      with renal insufficiency or those who are concurrently taking medications
      associated with myopathy.

PMID- 11197582
TI  - Disulfiram-ethanol induced delirium.
AB  - OBJECTIVE: To report a case of delirium, without major autonomic symptoms, as the
      primary manifestation of concomitant use of alcohol while taking disulfiram. CASE
      SUMMARY: A 50-year-old white woman with a history of bipolar disorder, type I,
      and alcohol dependence being treated with disulfiram was admitted to an inpatient
      psychiatric unit with a three- to four-day history of a change in mental status,
      including deficits in orientation, concentration, and visual hallucinations.
      Significant finding on review of systems included the spurious report of a 9.1-kg
      weight loss. Tachycardia and nonfocal neurologic signs on physical examination
      were also noted. Extensive metabolic, infectious, and neurologic work-up revealed
      no abnormalities that alone could explain the patient's acute confusional state.
      It was subsequently discovered that the patient had imbibed alcohol on at least
      two separate occasions while taking disulfiram prior to her change in mental
      status and that a similar, although shorter, experience had occurred previously.
      DISCUSSION: This is the first case, to the authors' knowledge, that describes an
      acute confusional state as the primary manifestation of a patient taking alcohol
      while being prescribed disulfiram as aversive therapy for alcohol abuse. Possible
      pathophysiologic mechanisms for delirium as a complication of alcohol ingestion
      while taking disulfiram include disturbances in various neuroendocrine axes,
      neurotransmitter systems, and metabolic derangements. Other reports of possible
      neuropsychiatric complications of disulfiram therapy are also reviewed.
      CONCLUSIONS: The differential diagnosis for the presentation of delirium in a
      patient known to be undergoing aversive therapy for alcohol dependence with
      disulfiram should include nonadherence to alcohol abstinence.

PMID- 11197583
TI  - Intramuscular ceftriaxone in the treatment of childhood meningitis due to
      Haemophilus influenzae type F.
AB  - OBJECTIVE: To describe a case of meningitis caused by Haemophilus influenzae type
      f (Hif) in a child. CASE SUMMARY: A 2.5-year-old white girl (18 kg) was
      hospitalized because of acute ataxia. The cerebrospinal fluid culture grew H.
      influenzae, which was later identified as type f. Therapy was limited by the
      inability to gain intravenous access. Treatment was initiated with dexamethasone
      8 mg (0.44 mg/kg) intramuscularly, one dose on the day prior to initiation of
      ceftriaxone therapy, and intramuscular ceftriaxone 2 g (111 mg/kg/dose) once a
      day. After the first day, dexamethasone was administered at 3 mg (0.17 mg/kg/d)
      orally four times per day for four days. Within two days, the patient became
      afebrile and improved significantly. The remaining treatments were given during
      daily hospital visits on an outpatient basis. No complications occurred during
      the follow-up visits. DISCUSSION: The clinical presentation and therapeutic
      management of Hif meningitis is similar to that of H. influenzae type b (Hib)
      meningitis. Factors that may predispose a child to infections caused by Hif
      include upper respiratory tract infections, day care attendance, Down syndrome,
      and immunodeficiency. Hif meningitis usually is treated with a third-generation
      cephalosporin (frequently ceftriaxone). Although most often administered
      intravenously, intramuscular ceftriaxone can provide a satisfactory clinical
      outcome in a child with adequate peripheral perfusion but limited intravenous
      access. The majority of reported cases of Hif meningitis resolve with appropriate
      antibiotic therapy; however, long-term neurologic sequelae occasionally occur.
      CONCLUSIONS: Hif occasionally causes pediatric meningitis. In a patient with good
      perfusion and difficult intravenous access, daily intramuscular administration of
      ceftriaxone can be an effective treatment option. In this case, Hif meningitis
      occurred abruptly and resolved within 48 hours of initiation of ceftriaxone and
      dexamethasone without long-term sequelae. The risks of giving dexamethasone
      appear to be minimal, although efficacy for preventing Hif complications remains
      to be proven.

PMID- 11197584
TI  - Trovafloxacin-associated leukopenia.
AB  - OBJECTIVE: To report a case of trovafloxacin-associated leukopenia, which
      occurred in a trauma patient shortly after administration and resolved following
      discontinuation of the drug. CASE SUMMARY: A 79-year-old white man was admitted
      to Yale New Haven Hospital after sustaining partial amputation of his right lower
      leg by an industrial lawn mower. After successful resuscitation, he underwent
      complete right lower amputation and was treated with intravenous alatrofloxacin
      mesylate. He developed leukopenia that resolved after discontinuation of the
      drug. DISCUSSION: Trovafloxacin is a broad-spectrum synthetic fluoroquinolone
      used for a wide variety of bacterial infections. We report, for the first time in
      the English-language literature, a case of trovafloxacin-associated leukopenia.
      The leukopenia resolved promptly after discontinuation of the drug. This
      association is further supported by the exclusion of other potential causes for
      this adverse effect. CONCLUSIONS: Leukopenia is a well-recognized adverse effect
      of several drugs. We report a case of trovafloxacin-associated leukopenia during
      treatment of a trauma patient. Healthcare personnel should be aware of this
      possible adverse reaction in patients treated with trovafloxacin.

PMID- 11197585
TI  - Treatment of bipolar depression with twice-weekly fluoxetine: management of
      antidepressant-induced mania.
AB  - OBJECTIVE: To report a case of treatment of bipolar depression and management of
      antidepressant-induced mania with a low-dose fluoxetine regimen. CASE SUMMARY: A
      59-year-old white woman was admitted involuntarily to a New York State
      psychiatric center with a diagnosis of bipolar (type I) disorder, mixed, with
      psychotic features. Initial treatment with lithium, olanzapine, and clonazepam
      produced a remission of manic and psychotic symptoms. However, the patient
      remained clinically depressed. Addition of oral fluoxetine 10 mg every morning to
      her medication regimen was followed 22 days later by the development of a manic
      state. Reduction of the fluoxetine dosage to 10 mg twice weekly was associated
      with the attainment of euthymia in 18 days. Thirteen days after the fluoxetine
      dosage reduction, the patient's fluoxetine blood concentration was 20
      micrograms/L and the norfluoxetine concentration was reported as 53 micrograms/L.
      DISCUSSION: To our knowledge, this is the first published case that describes the
      association between a low-dose fluoxetine regimen and the evolution of a bipolar
      affective state from depression to euthymia via manic switching. The temporal
      synchrony of this switching with initial implementation of fluoxetine 10 mg every
      morning, followed by a dose reduction to 10 mg twice weekly, suggests that
      bipolar depressed patients are extremely sensitive to low doses of
      antidepressants and to incremental changes in these doses. However, it also
      suggests that they can respond clinically to such treatment. Furthermore, our
      laboratory data indicate that antidepressant blood concentrations may play a
      contributory role in maintaining the balance between euthymia and mania in these
      patients. CONCLUSIONS: Manic switching is always a concern when treating a
      bipolar depressed patient. Utilization of a low-dose antidepressant drug regimen
      may be a clinically prudent approach in such an individual.

PMID- 11197586
TI  - Cilostazol: treatment of intermittent claudication.
AB  - OBJECTIVE: To review the pharmacology and clinical utility of cilostazol, an
      antiplatelet and vasodilator agent approved for the management of intermittent
      claudication. DATA SOURCES: Primary literature on cilostazol was identified from
      a comprehensive MEDLINE literature search (1980-February 2000). Selected meeting
      abstracts and manufacturer literature were also used as source material. Indexing
      terms included cilostazol, intermittent claudication, platelet inhibitors, and
      restenosis. STUDY SELECTION: Human clinical, pharmacokinetic and randomized
      comparative trials performed in the US and Asia were reviewed. Selected in vitro,
      ex vivo, and animal studies were evaluated when human data were not available.
      DATA SYNTHESIS: Intermittent claudication, defined as reproducible discomfort of
      a muscle group induced by exercise and relieved by rest, is the most common
      clinical manifestation of peripheral arterial disease (PAD). Cilostazol, a
      specific inhibitor of cyclic adenosine monophosphate phosphodiesterase in
      platelets and vascular smooth-muscle cells, is a potent antiplatelet agent and
      vasodilator that reduces vascular proliferation and has lipid-lowering effects in
      vivo. Recent multicenter, randomized, placebo-controlled trials have led to
      approval of cilostazol by the Food and Drug Administration for relief of
      intermittent claudication in patients with stable PAD. Cilostazol doubled walking
      distances and improved quality of life compared with placebo in these studies.
      One trial found that cilostazol was more effective than pentoxifylline, the only
      alternative pharmacologic therapy for claudication. Although frequent
      (approximately 50%) minor adverse effects, including headache, diarrhea, and
      palpitations, may occur in clinical practice, cilostazol has not been associated
      with major adverse events or increased mortality. Small, nonblind studies suggest
      that cilostazol may prove useful in preventing thrombosis and restenosis
      following percutaneous coronary interventions, although these remain unlabeled
      uses. CONCLUSIONS: The unique combination of antiplatelet, vasodilatory, and
      antiproliferative effects of cilostazol appear to make it an attractive agent for
      use in patients with PAD. Clinical trials demonstrating a significant improvement
      in walking distances with cilostazol therapy suggest that it will be an important
      tool in improving symptoms and quality of life in patients with intermittent
      claudication.

PMID- 11197587
TI  - Neuraminidase inhibitors: zanamivir and oseltamivir.
AB  - OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and safety of
      zanamivir and oseltamivir for the prophylaxis and treatment of influenza. DATA
      SOURCES: A MEDLINE search restricted to English-language journals was conducted
      (1980-May 2000). STUDY SELECTION AND DATA EXTRACTION: All efficacy and safety
      trials were included if conducted in humans and published in a journal. Abstracts
      were included if no other data source was available. DATA SYNTHESIS: Zanamivir
      and oseltamivir block influenza neuraminidase and prevent the cleavage of sialic
      acid residues, thus interfering with progeny virus dispersement within the
      mucosal secretions and reducing viral infectivity. The neuraminidase trials for
      prophylaxis and treatment of influenza enrolled predominantly young (mean age 29
      37 y), healthy, mostly unvaccinated individuals who were at the lowest risk of
      influenza and its complications. When zanamivir 10 mg inhaled twice daily or
      oseltamivir 75 mg orally twice daily were used for treatment, systemic symptoms
      such as myalgias,  fever, and headache were reduced by approximately 0.7-1.5
      days. Greater efficacy (symptom reduction by 1.5-2.0 d) was noted in proven cases
      of influenza infection, in febrile patients, and in patients who received the
      treatment medication within 30 hours of symptom onset. Clinical efficacy did not
      increase when doses higher than the treatment dose approved by the Food and Drug
      Administration were used. When given for prophylaxis, zanamivir 10 mg inhaled
      once daily or oseltamivir 75 mg orally once daily was used for four to six weeks
      and achieved protective clinical efficacy for laboratory-confirmed influenza
      ranging from 67% to 74%, depending on whether culture or serologic tests were
      performed. The most common adverse effects (usually < 5%) included upper
      respiratory tract symptoms. Patients with asthma or chronic obstructive pulmonary
      disease who received zanamivir had an increased incidence of a > 20% decline in
      forced expiratory volume in one second or peak expiratory flow rates. Headaches,
      nausea, and vomiting were more frequent in the oseltamivir groups than in placebo
      groups. The most common gastrointestinal adverse effects, nausea and vomiting,
      were reduced to approximately 10% by administering the medication with food.
      CONCLUSIONS: Zanamivir and oseltamivir are more effective in preventing culture
      positive influenza or for treatment of culture-positive influenza in febrile (>
      or = 37.8 degrees C) individuals. Treatment is more effective if initiated within
      30 hours of symptom onset in febrile individuals; however, it is difficult to
      meet these criteria. More realistically, clinical efficacy is closer to 60-70%
      and, for treatment started within 48 hours for laboratory-confirmed influenza,
      symptom reduction is approximately 0.7-1.5 days. If used appropriately to
      minimize the development of resistance, the neuraminidase inhibitors represent a
      new and unique class of antiinfluenza agents that can potentially reduce the
      morbidity associated with influenza.

PMID- 11197588
TI  - New competition in the realm of renin-angiotensin axis inhibition; the
      angiotensin II receptor antagonists in congestive heart failure.
AB  - OBJECTIVE: To critically review the studies comparing angiotensin II (AgII)
      receptor antagonists with placebo or angiotensin-converting enzyme (ACE)
      inhibitors in patients with congestive heart failure (CHF). DATA SOURCES: A
      MEDLINE search (1988 to January 2000) was used to identify pertinent literature.
      Additional references were also retrieved from selected articles. STUDY
      SELECTION: As most published CHF studies were performed with candesartan and
      losartan, these agents are the main focus of this article. However, all
      identified comparative clinical studies were reviewed and included, regardless of
      the agent used. DATA SYNTHESIS: AgII receptor antagonists inhibit the effects of
      AgII at its sub-type 1 receptor, independently of AgII's synthesis pathway. They
      present a hemodynamic profile similar to that of ACE inhibitors, without reflex
      neurohormonal activation. They have been shown to be at least as effective as ACE
      inhibitors in improving symptoms, exercise capacity, and New York Heart
      Association functional class in CHF patients. Although the ELITE (Evaluation of
      Losartan in the Elderly) trial suggested that losartan improved survival compared
      with captopril, this study was not designed to look at mortality. ELITE-II, an
      adequately powered study, showed no difference in mortality rates between
      patients taking captopril and those taking losartan. The combination of AgII
      receptor antagonists and ACE inhibitors provides additional benefit on blood
      pressure lowering and prevention of ventricular remodeling. AgII receptor
      antagonists are well tolerated, with an incidence of adverse effects similar to
      or lower than that of ACE inhibitors. Their lack of effect on bradykinin
      degradation might explain their lower incidence of cough. CONCLUSIONS: The data
      cumulated thus far in patients with CHF highlight that ACE inhibitors must remain
      the treatment of choice and that AgII receptor antagonists may be considered as
      an acceptable alternative for patients who are intolerant to ACE inhibitors.

PMID- 11197589
TI  - Opioid antagonists in the treatment of opioid-induced constipation and pruritus.
AB  - OBJECTIVE: To describe the role of opioid antagonists in the treatment of opioid
      induced constipation and pruritus. DATA SOURCES: A MEDLINE search was performed
      (1966-February 2000) for narcotics and opioid antagonists. Results were limited
      to English-language and clinical trials. Background information was obtained from
      pharmacology and pharmacotherapy references and review articles. Hand searching
      of selected bibliographies yielded several references. STUDY SELECTION AND DATA
      EXTRACTION: Studies were reviewed that examined the use of naloxone, naltrexone,
      and methylnaltrexone for opioid-related constipation and pruritus. Selected
      citations included various clinical trials and case series. DATA SYNTHESIS:
      Opioid agents are used for cancer and nonmalignant pain. Peripheral opioid
      receptor stimulation due to endogenous (i.e., endorphins) or exogenous (i.e.,
      morphine) stimulants may result in negative adverse effects, including
      constipation and pruritus. Adjuvant agents, such as laxatives and antihistamines,
      are often used to treat these adverse effects, but are themselves associated with
      adverse effects and are sometimes ineffective. Opioid antagonists have
      demonstrated reversal of peripheral opioid receptor stimulation. Clinical trials
      show adequate maintenance of pain control, as well as decreases in opioid-induced
      constipation and pruritus. CONCLUSIONS: Opioid antagonists offer a therapeutic
      alternative to conventional adjuvant agents, with the risk of loss of analgesia
      at higher doses. Methylnaltrexone offers the advantage of peripheral action only,
      therefore not reversing analgesia. Results are promising; however, larger
      clinical trials are necessary before opioid antagonists become the standard of
      care for opioid-induced constipation and pruritus.

PMID- 11197590
TI  - Impact of an intravenous fluconazole restriction policy on patient outcomes.
AB  - OBJECTIVE: To evaluate both the economic and clinical impact of an intravenous
      fluconazole restriction policy in a university teaching hospital. METHODS:
      Intravenous fluconazole was restricted to patients unable to take oral
      medications due to significant nausea or to patients whose oral intake was
      restricted. A retrospective chart review and computerized record review was
      conducted in patients receiving intravenous or oral fluconazole from January 1 to
      June 30, 1997, and again from January 1 to June 30, 1998, after implementation of
      the policy. RESULTS: Six-month institutional expenditures for intravenous
      fluconazole decreased following policy implementation, from $81,900 to $45,400,
      an estimated annual institutional savings of $73,000. A 47% reduction in the
      number of patients treated with intravenous fluconazole was observed over the six
      month period after policy implementation. During this time, the rate of
      successful clinical outcomes for documented or suspected disseminated Candida
      albicans infection or febrile neutropenia remained the same (66.6% prepolicy and
      65.9% postpolicy; p = 0.95). Similarly, the number of deaths in patients
      receiving fluconazole remained unchanged (p = 0.31). CONCLUSIONS: A restriction
      policy for intravenous fluconazole results in significant cost savings, with no
      significant decrease in successful outcomes or change in mortality.

PMID- 11197591
TI  - Efficacy of colony-stimulating factors in acute leukemia.
AB  - OBJECTIVE: To evaluate the literature describing the safety and efficacy of the
      hematopoietic colony-stimulating factors (CSFs) for the management of treatment
      related adverse effects in patients with acute leukemia. DATA SOURCES: A
      systematic MEDLINE search of the English-language literature (1995-April 2000)
      was performed to identify all randomized trials evaluating CSF use in acute
      leukemia. The following search terms were used: granulocyte colony-stimulating
      factor, filgrastim, granulocyte-macrophage colony-stimulating factor,
      sargramostim, acute lymphoblastic leukemia (ALL), acute myelogenous leukemia
      (AML), acute nonlymphocytic leukemia, and acute myeloid leukemia. The references
      from relevant literature were also examined in order to identify reports not
      discovered in the MEDLINE search. DATA SYNTHESIS: Six randomized trials in
      pediatric ALL, nine in adult AML, and four in adult ALL have examined the safety
      and efficacy of the CSFs. Two of the pediatric trials supported a reduction in
      either the duration of hospitalization or in the incidence of febrile neutropenia
      when a CSF was employed during the consolidation or intensification phase of
      chemotherapy. The remaining pediatric trials failed to demonstrate a clinical
      benefit. In adult AML, eight of the nine trials showed a significant decrease in
      the time to neutrophil recovery when a CSF was used. Only one of these trials
      demonstrated a decrease in hospital stay and none showed a decreased incidence of
      infection for patients who received a CSF. Three of the four trials in adult ALL
      demonstrated the efficacy of a CSF in decreasing the number of days to neutrophil
      recovery. Only one trial demonstrated that a CSF led to a reduction in the number
      of hospital days. Trials in children or adults have not demonstrated that the
      CSFs influence the long-term outcome of patients with acute leukemia.
      CONCLUSIONS: The published studies document a decrease in the time to recovery
      from neutropenia when patients with acute leukemia are treated with a CSF.
      However, a consistent reduction in infectious complications or in the duration of
      hospitalization has not been demonstrated when a CSF is used for either pediatric
      or adult patients. Very limited data exist to support the premise that CSFs meet
      the criteria established by the American Society of Clinical Oncology for
      demonstrating the value of these agents. Further careful study focused on
      resource utilization and pharmacoeconomics may help to elucidate how healthcare
      institutions may most effectively employ CSFs to treat patients with acute
      leukemia.

PMID- 11197592
TI  - Pituitary adenylate cyclase-activating polypeptide (PACAP) and its receptors in
      the brain.
AB  - Recent progress in research on pituitary adenylate-activating polypeptide (PACAP)
      with a special emphasis on the brain is reviewed. PACAP is a pleiotropic
      neuropeptide that belongs to the secretin/glucagon/vasoactive intestinal peptide
      family. PACAP functions as a hypothalamic hormone, neurotransmitter,
      neuromodulator, and neurotrophic factor. Studies on the gene encoding the PACAP
      precursor and the specific PACAP receptor (PAC1-R) and its subtypes have provided
      information on the control of gene expression for PACAP, and the relationship
      between the receptor subtypes and the signal transduction pathways. The PAC1-R is
      a G protein-coupled receptor with seven transmembrane domains and belongs to the
      VIP receptor family. At least eight subtypes of PAC1-R result from alternate
      splicing. Each subtype is coupled to specific signaling pathways, and its
      expression is tissue or cell specific. PACAP stimulates the release of arginine
      vasopressin and increases cytosolic Ca2+ ([Ca2+]i). PACAP serves as a
      neurotransmitter and/or neuromodulator and the activation of the PAC1-R
      stimulates a cAMP-protein kinase A signal transduction pathway which in turn
      evokes the [Ca2+]i signaling system. More importantly, PACAP is a neurotrophic
      factor that may play an important role during the development of the brain. The
      PAC1-R is actively expressed in different neuroepithelia from early developmental
      stages and expressed in various brain regions during prenatal and postnatal
      development. In the adult brain, PACAP appears to function as a neuroprotective
      factor that attenuates the neuronal damage resulting from various insults.

PMID- 11197593
TI  - Morphology of the metopic suture during the fetal period.
AB  - Assessment of the position and size of the metopic suture and anterior fontanelle
      is important in the routine examination during fetal period and in newborn
      infants. The aim of this study is to clarify the average size and its
      developmental changes of the anterior fontanelle and metopic suture by
      morphometry. Fifty-one cases were examined over a developmental period ranging
      from fetus of 14 weeks gestation to full term neonate. The width, and length of
      heads as well as head circumference of all fetuses were measured. The metopic
      suture and anterior fontanelle sizes were determined. The nearest distances
      between the parietal bones to the opposite frontal bones, and the distances
      between the nasion and lower angle of the anterior fontanelle, bregma and upper
      angle of the anterior fontanelle were measured. The averages of longitudinal and
      transverse diameters and areas of anterior fontanelle were calculated.
      Significant correlation was found between all the parameters and gestational
      ages, and between the sizes of the metopic suture and of skulls. There was no
      difference between male and female in any of the parameters. In our study, closed
      metopic suture was not observed. The anterior fontanelle is easy to palpate, and
      its enlargement might occasionally be helpful in the clinical examination of the
      newborn infants. The presence of a wide metopic suture may indicate the
      possibility of additional defects and anomaly in the newborn.

PMID- 11197594
TI  - Hepatic grooves and portal segmentation.
AB  - The aim of the present study was to examine the topographical relationship
      between the locations of the grooves and the borders of Couinaud's portal
      segments. We found 79 grooves on the diaphragmatic surfaces of 50 livers from 420
      cadavers. Most grooves were located within segment VIII wholly (31/79) or
      partially (39/79). By contrast, only 11 grooves corresponded to the border
      between two segments (segments VIII/IV in 6 cases and segments VIII/VII in 5
      cases). Diaphragmatic indentations (fold-like protrusions) into the groove were
      observed in 1 case. Our results suggest that the grooves did not form during the
      early embryonic period when intrahepatic vessels and ducts ramify, but that they
      formed during a later stage of diaphragmatic growth after establishment of the
      basic segmental configuration of the liver. The grooves do not seem to be
      critical landmarks for segmental borders of the liver.

PMID- 11197595
TI  - [Three-dimensional architecture of the intrinsic tongue muscles using a modified
      alkaline maceration method].
AB  - The three-dimensional architecture of the intrinsic tongue muscle fibers using
      the anterior part of the rabbit tongue was studied by scanning electron
      microscopy with a modified chemical-maceration method. The tongue tissues fixed
      with 10% formalin solution were treated with 1% OsO4 solution at 5 minutes for
      hardening of the specimen surface. Subsequently, they were immersed in 6N-NaOH
      solution for 30 minutes at 60 degrees C for the removal of connective tissues
      followed by dissection of muscle fibers under a binocular microscope to clarify
      the structure of the intrinsic tongue muscles. The specimens were treated with
      tannic acid and OsO4 (conductive staining method; Murakami, 1974), and observed
      with a SEM. Muscular fiber bundles of the transverse and vertical muscles of the
      tongue changed their direction at the alignment on the sites where the bundles
      enter the longitudinal muscles from the innermost surface to form monolayers of
      muscular bundles extending anteroposteriorly. These muscular bundles formed
      tunnel-like structures each of which covered a longitudinal muscle bundle. It was
      considered that these tunnel-like structures support the contraction of the
      longitudinal muscles as the "muscular sheath".

PMID- 11197596
TI  - Immune balance in critically ill patients.
AB  - The systemic inflammatory response reflects the non-specific clinical expression
      of a profound activation of the body's immune responsive elements. Immune
      activation and immune suppression coexist in the blood of patients with severe
      sepsis. It is their interaction and the resultant host parenchymal responses that
      ultimately define the course of sepsis. Importantly, neither profound immune
      activation (pro-inflammatory) or immune suppression (anti-inflammatory)
      characterize the dominant process. Rather, there is a combined low grade pro
      inflammatory state associated with an immune hyporesponsiveness that defines the
      usual immunologic state of the patient with severe sepsis.

PMID- 11197597
TI  - T cell integrin activation by chemokines in inflammation.
AB  - The adhesive function of integrins is regulated through cytoplasmic signaling
      induced by several stimuli, whose process is designated as "inside-out
      signaling". A large number of lymphocytes are recruited to the sites of
      inflammation where they form an essential component of the response to infection,
      injury, autoimmune disorders, allergy, tumor invasion, atherosclerosis and so on.
      The recruitment of leukocytes into tissue is regulated by a sequences of
      interactions between the circulating leukocytes and the endothelial cells.
      Leukocyte integrins play a pivotal role in leukocyte adhesion to endothelial
      cells. During the process, the activation of integrins by chemokines is essential
      for integrin-mediated adhesion in which a signal transduced to the leukocyte
      converts the functionally inactive integrin to an active adhesive configuration.
      The present review documents the relevance of cytoplasmic signaling and
      cytoskeletal assembly to integrin-mediated adhesion induced by chemokines during
      inflammatory processes.

PMID- 11197598
TI  - T cell chemokine receptor expression in human Th1- and Th2-associated diseases.
AB  - The interaction between chemokines and their receptors is an important step in
      the control of leukocyte migration into sites of inflammation. Chemokines also
      mediate a variety of effects independent of chemotaxis, including induction and
      enhancement of Th1- and Th2-associated cytokine responses. Recent studies have
      shown that human Th1 and Th2 clones, activated under polarizing conditions with
      polyclonal stimuli in vitro, display distinct patterns of chemokine receptor
      expression: Th1 clones preferentially express CCR5 and CXCR3, while many Th2
      clones express CCR4, CCR8 and, to a lesser extent, CCR3. These differential
      patterns of chemokine receptor expression suggest a mechanism for selective
      induction of migration and activation of Th1- and Th2-type cells during
      inflammation and, perhaps, normal immune homoeostasis. Studies have begun to
      examine T cell chemokine receptor expression in vivo to determine the relevance
      of these in vitro observations to human Th1- and Th2-associated diseases. In this
      review, we critically examine recent reports of T cell chemokine receptor
      expression in human autoimmune disorders (multiple sclerosis and rheumatoid
      arthritis) and atopic disorders (allergic rhinitis and asthma) which are believed
      to arise from inappropriate Th1- and Th2-dominated responses, respectively.

PMID- 11197599
TI  - Interleukin 15: its role in inflammation and immunity.
AB  - Interleukin 15 (IL-15) is a 14-15 kDa polypeptide that belongs to the 4 alpha
      helix-bundle family of cytokines and was originally discovered due to its T cell
      proliferative activity. It utilizes the signal-transducing beta/gamma
      polypeptides of the IL-2 receptor complex, thus sharing many biological
      activities with IL-2, in addition to its high-affinity private receptor subunit
      IL-15R alpha. Accumulating evidence indicates that the biological relevance of IL
      15 may not solely be confined to T lymphocytes, but to a variety of cell
      populations within the immune system as well as outside the immune system of the
      host. The expression of both IL-15 and its high-affinity receptor component, IL
      15R alpha, are readily demonstrable in a wide variety of tissues and appear to be
      augmented in response to environmental/stress stimuli and infectious agents.
      There is increasing evidence to suggest that IL-15 may play an important role in
      protective immune responses, allograft rejection and the pathogenesis of
      autoimmune diseases, where mononuclear cell infiltration is a hallmark feature.
      Herein, the effects of IL-15 on cells associated with host defense, immunity and
      inflammation are reviewed and support a central role for this cytokine in
      orchestrating multiple aspects of effector functions in immunity and
      inflammation.

PMID- 11197600
TI  - Cytokines and costimulatory molecules: positive and negative regulation of the
      immune response to Cryptococcus neoformans.
AB  - Cytokines are small proteins or glycoproteins that transmit information from one
      cell to another. Most cells in the body secrete and respond to cytokines and
      their effects have been described on a myriad of cellular functions. Cytokine
      interactions may not be linear, thus making the system extremely intricate and
      with unpredictable features. Therefore, each model of disease may be unique, with
      its own mechanism of autoregulation dictated by positive and negative feedback
      involving cytokines and costimulatory molecules. The emergence of some cytokines
      over others in the course of Cryptococcus neoformans infection may characterize a
      positive or negative outcome of cryptococcosis. Much less is known about the
      influence of costimulatory molecules in regulating C. neoformans immune response.
      The available information indicates a critical role for proinflammatory cytokines
      such as tumor necrosis factor alpha and interleukin 12 (IL-12). The positive role
      of interferon gamma in infected tissue as an inducer of antimicrobial function of
      innate immune cells and as positive feedback for IL-12 induction appears to be
      indisputable. In vitro studies indicate that costimulatory molecule expression
      appears to be regulated on antigen-presenting cells by C. neoformans and
      increased expression of B7-1 and CD40 on these cells may promote a protective
      response. These studies await confirmation in an in vivo system. The interplay
      between cytokines and costimulatory molecules has been scarcely explored and
      additional details are needed to better understand how they convey positive and
      negative information to immune cells in response to C. neoformans.

PMID- 11197601
TI  - Prostaglandins and inflammation: the cyclooxygenase controversy.
AB  - Prostaglandins (PGs) are arachidonic acid metabolites produced by the action of
      the enzyme cyclooxygenase (COX). Although PGs are important mediators of
      inflammation in various diseases, they also are key factors in the physiological
      regulation of gastrointestinal and renal homeostasis. The finding that two
      distinct COX isoforms are responsible for PG synthesis has provided basis to the
      opposite actions of PGs in inflammation and homeostasis regulation. COX-1-derived
      PGs are thought to mediate cytoprotective actions on the gastrointestinal mucosa,
      whereas COX-2-derived PGs are assumed to display pro-inflammatory properties.
      This dichotomy has led to the development of selective inhibitors of COX-2
      activity which are safer for the gastrointestinal mucosa than the classic
      inhibitors of both COX isoforms. However, some COX-2 anti-inflammatory properties
      have been recently demonstrated in several experimental models of inflammation.
      These studies have raised some concern about the potential adverse effects of COX
      2 selective inhibitors. In addition, there is evidence that COX-1 displays pro
      inflammatory properties, depending on the organ and on the stage of the
      inflammatory response. This review will focus on the roles of COX-1 and COX-2 in
      inflammation, based on studies involving pharmacologic COX inhibitors as well as
      COX knock-out mice, with a particular emphasis on the gastrointestinal tract.

PMID- 11197602
TI  - Nuclear import of arachidonate 5-lipoxygenase.
AB  - Leukotrienes are lipid messenger molecules that are secreted by leukocytes to
      orchestrate a rapid and prolonged immune response. The enzyme 5-lipoxygenase
      catalyzes the rate-limiting first two steps in the synthesis of leukotrienes from
      arachidonic acid. Although it has long been known that 5-lipoxygenase moves from
      the cytoplasm to a membrane following activation, it has only recently been
      recognized that the enzyme may shuttle into and out of the nucleus before
      activation. The regulation of this movement of soluble 5-lipoxygenase between the
      cytoplasm and the nucleoplasm, as well as its impact on 5-lipoxygenase action,
      leukotriene synthesis and cell function, is only now being elucidated. This
      review details the state of our understanding of the nuclear import of 5
      lipoxygenase and its potential importance in immunity.

PMID- 11197603
TI  - Suppression of mast cell activation by glucocorticoid.
AB  - Mast cells play a critical role in allergic diseases. When mast cells are
      activated by cross-linking of their high affinity IgE receptors by the antigen
      and IgE antibodies, release of chemical mediators is followed by secretion of
      multiple cytokines. We report that IL-3-dependent mucosal-type mast cells undergo
      apoptosis when IL-3 is withdrawn. In addition, cross-linking of high affinity IgE
      receptors prevents apoptosis of mast cells by paracrine mechanisms, producing IL
      3, IL-4 and granulocyte/macrophage colony-stimulating factor (GM-CSF). However,
      the secretion of endogenous growth factors are not enough for cell survival,
      whereas IL-4 induces cell aggregation by expressing adhesion molecules such as
      leukocyte function-associated antigen 1 (LFA-1), and makes it reactive to
      endogenous growth factors by contact cell to cell interaction. On the other hand,
      dexamethazone down-regulates the expression of intracelluar adhesion molecule 1
      (ICAM-1) and IL-4 in activated mast cells, by which the self-aggregation of mast
      cells is inhibited and apoptosis is induced. Thus, glucocorticoids suppress mast
      cell survival by inhibiting IL-4 production and expression of adhesion molecules.

PMID- 11197604
TI  - Pathogenetic mechanisms of atopic dermatitis.
AB  - Atopic dermatitis (AD) is a chronic inflammatory disease which results from
      complex interactions between genetic and environmental mechanisms. An altered
      lipid composition of the stratum corneum is responsible for the xerotic aspect of
      the skin and determines a higher permeability to allergens and irritants.
      Keratinocytes of AD patients exhibit a propensity to an exaggerated production of
      cytokines and chemokines, a phenomenon that can have a major role in promoting
      and maintaining inflammation. Specific immune responses against a variety of
      environmental allergens are also implicated in AD pathogenesis, with a bias
      towards Th2 immune responses. In particular, dendritic cells expressing membrane
      IgE receptors play a critical role in the amplification of allergen-specific T
      cell responses. Cross-linkage of specific IgE receptors on dermal mast cells
      provokes the release and synthesis of a vast series of mediators. Following their
      recruitment and activation into the skin, eosinophils are also thought to
      contribute relevantly to tissue damage. Thus, a complex network of cytokines and
      chemokines contributes to establishing a local milieu that favors the permanence
      of inflammation in AD skin.

PMID- 11197605
TI  - Recent advances in understanding how interleukin 13 signals are involved in the
      pathogenesis of bronchial asthma.
AB  - The prevalence of allergic disease has dramatically increased in recent decades,
      especially in urban and industrialized areas. Allergic diseases are disorders of
      the immune system, the results of complex interactions among various genetic and
      environmental factors. Among them, the important role of interleukin 13 (IL-13),
      a Th2-type cytokine, has recently emerged in the pathogenesis of bronchial
      asthma. Based on studies using mice, great attention has been paid to the direct
      effects of IL-13 on bronchial tissues. In this review, we describe recent
      advances in understanding the signal transduction mechanism of IL-13, the
      involvement of IL-13 signal-related genes as genetic factors in the pathogenesis
      of bronchial asthma, and the expression of IL-13 receptor on bronchial tissues.
      We describe potential strategies for targeting IL-13 signals to improve allergic
      states.

PMID- 11197606
TI  - The inflammatory response in Mycobacterium tuberculosis infection.
AB  - Infection with Mycobacterium tuberculosis (MTB) is accompanied by an intense
      local inflammatory response which may be critical to the pathogenesis of
      tuberculosis. Activation of components of the innate immune response, such as
      recruitment of polymorphonuclear (PMN) and mononuclear phagocytes and induction
      of pro-inflammatory cytokines, such as tumor necrosis factor alpha (TNF-alpha),
      by MTB occurs early after MTB infection, however, may persist as the organism
      establishes itself within granulomas. MTB and its protein and non-protein
      components are potent in induction of cytokines and chemokines from PMN and
      monocytes. This review focuses on the interaction of MTB and the host with regard
      to activation of the innate immune response. It also attempts to identify the
      potential impact of this early response on the subsequent pathogenesis of MTB,
      and its role in development and extent of tuberculosis. Insights into the
      initiation and persistent of the inflammatory response may allow the application
      of anti-inflammatory agents as adjuncts in the treatment of tuberculosis.

PMID- 11197608
TI  - The therapeutic potential of interleukin 10 in infection and inflammation.
AB  - Interleukin 10 (IL-10), a cytokine with inhibitory activity on inflammation and
      cell-mediated immune responses, holds enormous potential for the treatment of
      inflammatory and autoimmune disorders. In addition, IL-10 has also been
      implicated in the immunopathogenesis of a number of infectious diseases through
      the use of IL-10 knock-out or IL-10 transgenic mouse models. In this review, we
      delineate infectious and inflammatory conditions in which IL-10 has shown
      potential for therapeutic manipulation. Specifically, we review the role of IL-10
      in human endotoxemia/sepsis and in HIV infection, conditions for which
      preliminary phase I trials have recently been undertaken. It is suggested that
      the therapeutic potential of IL-10 to selectively ameliorate human infectious and
      inflammatory processes can be realized through a careful selection of the
      clinical conditions in which patients are undergoing concomitant treatment with
      anti-microbial regimens.

PMID- 11197607
TI  - Mechanisms of Mycobacterium avium pathogenesis.
AB  - Infections caused by Mycobacterium avium are common in AIDS patients and patients
      with chronic lung diseases. The bacterium can be acquired both through the
      intestinal route and respiratory route. M. avium is capable of invading mucosal
      epithelial cells and translocating across the mucosa. The bacterium can infect
      macrophages, interfering with several functions of the host cell. The host
      defense against M. avium is primarily dependent on CD4+ T lymphocytes and natural
      killer cells. Activated macrophages can inhibit or kill intracellular bacteria by
      mechanisms that are currently unknown, but M. avium can invade resting
      macrophages and suppress key aspects of their function by triggering the release
      of transforming growth factor beta and interleukin 10. Co-infection with HIV-1
      appears to be mutually beneficial, with both organisms growing faster.

PMID- 11197609
TI  - Idiopathic pulmonary fibrosis: molecular mechanisms and possible therapeutic
      strategies.
AB  - Idiopathic pulmonary fibrosis (IPF) is a devastating disease with an almost
      universally terminal outcome. In recent years much insight has been gained into
      the pathogenesis of IPF from both a bleomycin mice-model as well as ex vivo human
      tissue studies. Alveolar damage and inflammation of unknown etiology, eventually
      leading to interstitial fibrosis, characterize IPF. Apoptosis has emerged as an
      important factor in the pathogenesis of IPF. This review will outline the current
      understanding of the immunological and molecular mechanisms underlying IPF and
      discuss new therapeutic strategies.

PMID- 11197610
TI  - Bacteriophage therapy of bacterial infections: an update of our institute's
      experience.
AB  - 1307 patients with suppurative bacterial infections caused by multidrug-resistant
      bacteria of different species were treated with specific bacteriophages (BP). BP
      therapy was highly effective; full recovery was noted in 1123 cases (85.9%). In
      134 cases (10.9%) transient improvement was observed and only in 50 cases (3.8%)
      was BP treatment found to be ineffective. The results confirm the high
      effectiveness of BP therapy in combating bacterial infections which do not
      respond to treatment with the available antibiotics.

PMID- 11197611
TI  - A new diquat derivative appropriate for colourimetric measurements of biological
      materials in the presence of paraquat.
AB  - A new colourimetric method is described for the quantification of diquat using a
      yellow-coloured derivative produced by heating diquat in alkaline solution at 80
      degrees C. The absorption maximum of the yellow derivative is 420 nm and the
      molar absorption coefficient is 2.76 x 10(4) (0.15 in 1 microgram diquat/ml with
      1 cm light path). The absorption at 420 nm shows a linear concentration
      dependence in the range 0.1-10 micrograms/ml and fading of the colour is about 5%
      after 1 h. Under the same conditions, paraquat does not produce any coloured
      products. The concentration of diquat in the solution containing both diquat and
      paraquat can be determined by the absorption of diquat derivative at 420 nm
      without interference from paraquat. By adding sodium dithionite to the solution
      the concentration of paraquat can be determined by the absorption of paraquat
      radicals at 600 nm without interference from diquat, because the yellow
      derivative does not react with dithionite. This yellow diquat derivative can be
      extracted completely with cyclohexanol by saturating the solution with Na2SO4.
      The absorption maximum in cyclohexanol shifts to 440 nm with the same molar
      absorbance and the same half-band width as in water. Fading of the colour is less
      than 5% after 24 h in cyclohexanol. Perchloric acid (3%) and trichloroacetic acid
      (4.5%) which are often used for deproteinization of tissue homogenates, do not
      inhibit production of the coloured derivative at pH 13.5 or extraction of the
      derivative with cyclohexanol. This method is suitable for a quick determination
      of small amounts of diquat in tissues, since the extraction with cyclohexanol not
      only concentrates the derivative rapidly but also quite efficiently eliminates
      the coloured substances in tissue homogenates. The detection limit of diquat is
      0.02 microgram/ml for blood and 0.05 microgram/g for liver when 1 ml or 1 g is
      used for analysis. In three human cases of fatal intoxication, both paraquat and
      diquat were quantified using 50 microliters of serum. In non-toxic dosing of
      diquat to rats for 14 days, the diquat level was highest in the spleen followed
      by the kidneys.

PMID- 11197612
TI  - Suicide in a lions' den.
AB  - The case of a young man who committed suicide in a lions' den of a zoo is
      presented. Special attention is paid to the injury pattern which was
      characterised by numerous penetrating, stab-like wounds and lesions. The
      remarkable circumstances and history of this incident are most likely connected
      to a psychological or psychiatric disorder of the victim.

PMID- 11197613
TI  - Death caused by a letter bomb.
AB  - A 48-year-old man was killed by the explosion of a letter bomb after receiving
      severe injuries to his face and left hand. The autopsy ascertained that the right
      eye and orbit had been completely destroyed by a large piece of metal from a tin
      can that had entered the cranial cavity through the right eye and caused fatal
      brain damage. The victim had also sustained a severe injury to his left hand.
      Reconstruction of the metal and plastic fragments showed that the victim had
      received a padded envelope with a video cassette in which a simple explosive
      device was hidden in a flat tin. The explosive charge consisted of a mixture (ca.
      60 g) of sodium chlorate, sodium chloride and sucrose. The charge was detonated
      by a nylon cord attached to the inside of the envelope which was stretched when
      the video cassette was pulled out of the envelope. This removed a piece of
      plastic from between two contacts, and the explosion was set off immediately by a
      battery which activated two flash bulbs placed within the charge.

PMID- 11197614
TI  - The UV hand lamp as a helpful instrument for macroscopic visualisation of
      myocardial fibrosis during autopsy.
AB  - The application of ultraviolet light in forensic practice is a well-tested method
      to visualise traces or skin alterations. When viewing myocardial sections under
      UV light at autopsy, bluish-white fluorescent areas became visible that could not
      be detected in the seemingly homogenous myocardium in daylight. A systematic
      comparison of the macroscopic cardiac findings and the pertinent histological
      sections showed that in all cases with a positive UV fluorescence myocardial
      fibrosis or lipomatosis could be confirmed by histological methods. The
      examination for UV fluorescence of the myocardium seems to be a simple and rapid
      method improving the macroscopic perceptibility of fibrotic changes and minor
      scars.

PMID- 11197616
TI  - Molecular analysis of the human orosomucoid gene ORM1*Q0koln responsible for
      incompatibility in a German paternity case.
AB  - In a German paternity test, an alleged father was excluded only by reverse
      homozygosity of ORM1 phenotypes (mother ORM1 S, child ORM1 S and alleged father
      ORM1 F1) out of the 28 classical and DNA markers investigated. Without the ORM1
      system the biostatistical probability of paternity was calculated to exceed
      99.999%. The intensity of the immunoprinted bands of the ORM1 protein for the
      child and alleged father after isoelectric focusing appeared to be reduced to
      about half. To identify a possible null allele, gene-specific amplification
      followed by single-strand conformation polymorphism and sequencing analyses were
      carried out. Deletion of one of the two copies of a 4 bp direct repeat sequence
      (GTCT) in exon 4 of the consensus sequence of ORM1*F1 was observed in the child
      and alleged father. Thus, the sharing of a rare mutant gene, ORM1*Q0koln,
      increased the probability of paternity.

PMID- 11197615
TI  - Genetic diversity of nine STRs in two northwest Iberian populations: Galicia and
      northern Portugal.
AB  - The genotyping of two population samples from Galicia and northern Portugal was
      performed for nine STR loci using a single multiplex reaction with the AmpF/STR
      Profiler Plus PCR amplification kit which co-amplifies the systems D3S1358, vWA,
      FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820 and the XY homologous gene
      amelogenin. Allele frequencies for these nine tetranucleotide repeat markers were
      calculated and no significant differences were observed when comparing these two
      populations. Conformity with Hardy-Weinberg equilibrium proportions was good for
      all systems in both samples. The combined power of exclusion was 99.981% and
      99.980% in Galicia and northern Portugal, respectively and the combined power of
      discrimination was greater than 99.999%. Segregation analysis of all loci
      detected two incompatibilities, one in D3S1358 (out of 112 meioses) and another
      in D7S820 (out of 104 meioses). Both could be explained by single-step mutations.
      In general co-amplification was good except for some relatively degraded samples
      in which poor amplification was observed for the largest STRs. Nevertheless the
      system is technically robust even when small amounts of template DNA are used and
      in the addition is highly informative and time-saving. However, caution should be
      taken in the interpretation of profiles in degraded samples and the apparently
      high mutation rate of D3S1358 and D7S820 should also be kept in mind.

PMID- 11197617
TI  - Population genetics of the hypervariable locus D12S391 in Koreans.
AB  - The hypervariable short tandem repeat (STR) locus D12S391 was investigated in a
      Korean population and 34 fragments were sequenced to confirm the structure of
      alleles. From these sequenced fragments an allelic ladder containing 13 sequenced
      alleles was constructed. From 595 unrelated Koreans, 14 alleles were detected and
      one variant allele 19.3 was observed. The observed heterozygosity was 0.795 and
      no deviation from Hardy-Weinberg equilibrium was observed in the Korean
      population (p = 0.606). The allele frequency distribution in the Korean
      population was not similar to other racial or ethnic groups except for Egyptians,
      Yemenis, Japanese and Caucasoids from the Rhine area. No mutations were observed
      in the 702 meioses from 144 Korean families. This study demonstrates that the STR
      locus D12S391 is a useful tool for forensic identification and parentage testing.

PMID- 11197618
TI  - A fatal case of infantile scurvy.
AB  - We report a case of infant death due to scurvy, which is very rare in Japan. We
      initially had little knowledge of the disease and suspected that the bleeding in
      the body was caused by domestic violence. The case did not fall under the
      category of the battered child syndrome but the death was caused by ignorance
      with respect to child care. In addition the parents usually locked the child
      alone in a room during the day and this is probably a case of neglect.

PMID- 11197619
TI  - Highly informative Y-chromosomal haplotypes by the addition of three new STRs
      DYS437, DYS438 and DYS439.
AB  - The Y chromosome STRs DYS437, DYS438 and DYS439 were selected from publicly
      available genome databases and used to analyse an Italian population sample. A
      tetraplex PCR reaction including the highly informative DYS385 locus, was set up
      and used for the analysis of 131 male samples to determine allele frequencies and
      STR diversity values. The number of different haplotypes and the haplotype
      diversity value found from the analysis of the STRs included in the tetraplex
      reaction were very similar to those found from the analysis of the basic set of 7
      Y-STRs (DYS19, DYS389I/II, DYS390, DYS391, DYS392 and DYS393) previously carried
      out on the same population sample. By combining the allelic states of the 11 Y
      chromosomal STRs we could construct highly informative haplotypes that allowed
      the discrimination of 93.8% (120 out of 128) of the samples tested. This approach
      represents a very powerful tool for individual identification and paternity
      testing in forensic medicine.

PMID- 11197620
TI  - Mitochondrial DNA sequences for 118 individuals from northeastern Spain.
AB  - A population database was generated from 118 unrelated Caucasoid individuals
      living in Spain. Sequence polymorphisms of the mitochondrial DNA (mtDNA) control
      region, hypervariable regions I and II (HVRI and HVRII) were determined using the
      polymerase chain reaction (PCR) and direct sequencing. A total of 102 different
      sequences were found as defined by 105 variable positions. The most common
      sequence occurred six times, and this sequence is also the most frequent in other
      European populations such as Austria, Germany and Britain. The mean pair-wise
      difference for the two HVR regions taken together was 7.74. The study revealed
      that transitions made up the majority of the variations (88%), whereas we
      observed a significantly lower frequency of transversions (8%). Also one
      individual in this study was observed with two positions of heteroplasmy at
      nucleotides 150 (C/T) and 153 (G/A). A statistical estimate of the results for
      this population showed a genetic diversity of 0.99. The probability of two random
      individuals showing identical mtDNA haplotypes is 1.3%. In order to use the mtDNA
      analysis in forensic casework, we consider that it is of crucial importance to
      know the frequency of the different sequences of mtDNA, and this data base study
      could be a useful tool to statistically evaluate the results.

PMID- 11197621
TI  - Detection of gunshot residues in routine CTs.
AB  - The forensic assessment of non-fatal gunshot wounds often proves to be difficult
      as wounds have usually been cleaned and protected with a sterile bandage by the
      time of the examination. The aim of our investigation was to test the possible
      application of computed tomography (CT) for the forensic assessment. Doing so
      raised the questions whether gunshot residues in the soft tissues, detected by
      means of 3-dimensional CT, can be used as evidence of a close-range shot and
      whether conclusions can be drawn pertaining to the range of the shot or the type
      of bullet used based on the distribution of the radiologically detectable
      material? In this experimental study 39 shots were fired at fresh pig skin and it
      was possible to distinguish shots fired from distances of more than 10 cm and
      contact shots independent of the type of bullet. For unjacketed lead bullets,
      radiopaque material could be seen in the depth of the entrance would for firing
      distances up to 10 cm. In individual cases, CT data and the 3-D reconstruction
      could provide valuable information in the forensic assessment of patients with
      gunshot wounds.

PMID- 11197622
TI  - Odontological identification of human remains from mass graves in Croatia.
AB  - This paper reports the results and methods of dental identification of 1000 human
      remains exhumed from mass graves in Croatia up to July 1998. Personal
      identification of the victims was performed at the Department of Forensic
      Medicine and Criminology at the School of Medicine in Zagreb. A forensic
      odontologist participated in the identification process by carrying out the
      dental identification. A total of 824 victims were positively identified, while
      176 victims remained unidentified. Dental identification based on available
      dental antemortem data was achieved in 25% of the cases. Dental identification
      based on dental charts was achieved in 35%, on x-rays in 15%, on photographs of
      teeth in 22%, on interviews in 18%, and on confirmation by odontologists in 10%
      of the cases. Teeth, in combination with anthropological parameters, age, sex and
      height, as well as other specific characteristics such as tattoos, personal
      identification cards, clothes, jewellery and DNA, were helpful for identification
      of 64% of the victims, but the significance for the identification was not
      dominant. Only in 11% of the cases was identification achieved by other relevant
      means and teeth not used at all. Identification procedures in Croatia will
      continue until another 1700 people who are still missing or kept as prisoners of
      war since the aggression on Croatia in 1991 are found and/or identified.

PMID- 11197623
TI  - Species identification by means of the cytochrome b gene.
AB  - Species identification was carried out by nucleotide sequence analysis of the
      cytochrome b (cytb) gene. The aim of the study was to identify biological
      specimens from diverse vertebrate animals by extracting and amplifying DNA from
      44 different animal species covering the 5 major vertebrate groups (i.e. mammals,
      birds, reptiles, amphibians and fishes). The sequences derived were used to
      identify the biological origin of the samples by aligning to cytb gene sequence
      entries in nucleotide databases using the program BLAST. All sequences were
      submitted to the GenBank including new species which were not observed in the
      databases. The applicability of this method to the forensic field is demonstrated
      by simulated casework conditions where different types of samples including
      problematic specimens such as hair, bone samples, bristles and feathers were
      investigated to identify the species.

PMID- 11197624
TI  - Is vitreous humour useful for the interpretation of 3,4
      methylenedioxymethamphetamine (MDMA) blood levels? Experimental approach with
      rabbits.
AB  - As drug instability and redistribution are factors known to affect the
      interpretation of post-mortem blood levels, we questioned whether post-mortem
      vitreous humour concentrations could be useful as predictors for the MDMA load at
      the time of death. In a first series of in vivo experiments using rabbits, 3,4
      methylenedioxymethamphetamine (MDMA) concentrations in plasma, blood and vitreous
      humour were studied as a function of time after intravenous (i.v.) administration
      of MDMA. Equilibration between the vascular compartment and vitreous humour was
      attained about 1 h after i.v. MDMA administration. In a second series of
      experiments, the post-mortem stability of MDMA in vitreous humour in relation to
      ambient temperature was investigated. Post-mortem MDMA concentrations in vitreous
      humour were closer to the ante-mortem blood levels when compared to cardiac blood
      samples. These preliminary investigations in the rabbit model indicate that
      measurements of vitreous humour concentrations could also be of interest for
      predicting the blood concentration at the time of death in humans.

PMID- 11197625
TI  - Y chromosome STR haplotypes in four populations from northwest Africa.
AB  - The eight short tandem repeat (STR) polymorphic systems mapping on the male
      specific region of the human Y chromosome, DYS19, DYS388, DYS389I, DYS389II,
      DYS390, DYS391, DYS392 and DYS393, were typed in four populations from northwest
      (NW) Africa (Moroccan Arabs, southern Moroccan Berbers, Saharawis and Mozabites).
      Allele frequency distributions showed statistically significant differences for
      all loci among all the populations except for DYS19. Complete typing was obtained
      for 185 chromosomes, which showed 74 different haplotypes. The two most frequent
      haplotypes were found in 16.2% and 15.1% of the individuals, although the latter
      was almost exclusively found in the Mozabites. Locus and haplotype
      informativeness were measured by means of the gene diversity (D). The haplotype
      diversity ranged from 0.856 (Mozabites) to 0.967 (southern Moroccan Berbers). For
      some loci, allele frequencies in NW Africans were clearly different from those in
      Europeans. The most common NW African haplotype was found only in one individual
      out of a total of 494 Europeans typed for the whole STR set. Thus, NW African and
      European Y chromosomes are clearly differentiated.

PMID- 11197627
TI  - Forensic validation of a multiplex containing nine STRs--population genetics in
      northern Poland.
AB  - This paper presents the allele frequency distributions for the nine loci
      (D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317 and D7S820) present
      in the commercially available Profiler Plus kit. DNA samples of 202 individuals
      from Northern Poland were amplified in a multiplex reaction with subsequent
      automatic detection using capillary electrophoresis. All loci met the Hardy
      Weinberg equilibrium conditions. The calculated probability of identity was 2.26
      x 10(-11) giving an average probability of identity of 1 in 44 billion.
      Considerable improvement of analysis precision was observed after substituting
      the GeneScan 500 for the fluorescent ladder 60-400 bp. The influence of DNA
      concentration on stutter and artefact formation and the ratio of heterozygote
      alleles was analysed.

PMID- 11197626
TI  - A Korean population study of the nine STR loci FGA, VWA, D3S1358, D18S51, D21S11,
      D8S1179, D7S820, D13S317 and D5S818.
AB  - DNA typing was performed on 379 randomly selected unrelated Koreans using the
      nine short tandem repeat loci FGA, VWA, D3S1358, D18S51, D21S11, D8S1179, D7S820,
      D13S317 and D5S818 present in the AmpF/STR Profiler Plus PCR amplification kit.
      Allele frequencies, heterozygosity, power of discrimination, mean exclusion
      chance, and polymorphism information content of each locus were calculated by
      statistical analysis. All nine loci were in Hardy-Weinberg equilibrium. The
      combined discrimination index and the combined mean exclusion chance in Koreans
      was 2.31 x 10(-12) and 0.99983, respectively. By evaluation of 297 children from
      128 families, 2 mutations were found at the FGA locus and 1 each at the D18S51
      and D13S317 loci. This study demonstrates that this multiplex system is a useful
      and convenient tool for forensic identification and parentage testing in Korea.

PMID- 11197628
TI  - Demonstration of myocardial necrosis in the presence of advanced putrefaction.
AB  - Samples of heart tissue were investigated in two series for the detectability of
      myocardial necrosis after artificial and natural putrefaction, respectively. In
      the first series heart tissue with and without infarction was artificially
      subjected to humid and dry autolysis and putrefaction. In the second
      investigation heart tissue was obtained from exhumed bodies after periods of
      burial ranging between 10 and 929 days. Besides histology a variety of
      immunohistochemical markers were applied and C5b-9 gave positive results even
      after long periods of artificial and natural putrefaction. From the methods
      tested, this was by far the most sensitive method with a high robustness against
      putrefaction. NP57, which indicates neutrophilic leucocytes could be demonstrated
      considerably longer after humid putrefaction than after dry putrefaction. The
      time limits of detection were considerably longer than for H&E. These two methods
      are the methods of choice for the detection of myocardial infarction and
      leucocyte infiltration in advanced stages of putrefaction.

PMID- 11197629
TI  - DNA contamination of mortuary instruments and work surfaces: a significant
      problem in forensic practice?
AB  - A study of 20 mortuaries was undertaken to assess whether contamination of
      instruments, tables and cutting areas due to residual material containing human
      DNA after routine cleaning is an actual or only a theoretical problem. Of the 20
      mortuaries studied, 50% were found to have material containing quantifiable human
      DNA on the instruments and surfaces sampled. This DNA was amplified and found, in
      some cases, to have been derived from at least three people. Of those that did
      not yield measurable amounts of DNA, a number of samples were selected at random,
      amplified and were found to produce partial profiles indicating the presence of
      low levels of human DNA. The possible sources of human DNA from mortuaries are
      discussed as well as means to reduce or irradicate the problem of instrument
      contamination. Finally the implications of these findings for forensic
      investigations are discussed.

PMID- 11197630
TI  - Diatom detection in the diagnosis of death by drowning.
AB  - A medicolegal/algological collaboration lasting several years aimed at developing
      methods for dealing with dead bodies found in water where the circumstances are
      not clear, has led to an interdisciplinary procedure. To enable algological
      analysis, sample preservation and preparation must be free from contamination or
      carry-over at the beginning of the autopsy, although it should be noted that the
      demands on the digestion method are very high. One or more water samples from the
      site of drowning (from surface and bed) should be taken. Microscopic-algological
      analysis should record quantitative (diatom density), qualitative (species) and
      morphological (description of diatom valves) details for every sample.
      Furthermore, the species index and dominance identity similarity indices are
      calculated during the analysis procedure. The algological conclusions are based
      primarily on the separation values of Kater as well as on pair-matching. The
      final report is the result of interdisciplinary collaboration.

PMID- 11197631
TI  - The probability distribution of the number of loci indicating exclusion in a core
      set of STR markers.
AB  - The distribution of the number of loci out of the 13 in the CODIS STR set that
      would show an exclusion (i.e., a genotype set incompatible either with the
      prosecution hypothesis or with Mendelian transmission) was estimated in different
      scenarios. The knowledge of this distribution would provide a framework against
      which casework evidence can be compared. I used allele frequencies in Iberian and
      in Italian populations to generate individual genotypes at random and to test in
      1 million simulation replicates, how many of the 13 loci would give an exclusion
      in an individual identification case, a paternity case, and a double parenthood
      case. All three scenarios were tested under an expected overall exclusion, both
      for unrelated individuals and for cases in which the suspect or the alleged
      father was the brother of the real culprit or real father. Paternity and double
      parenthood cases were also tested in the true scenario, with exclusionary loci
      due to mutation. In individual identification cases, the average number of
      exclusionary loci was 11.95 with a minimum of 7. This STR set also showed
      sufficient power to resolve identification cases in which the evidence sample
      came from a suspect's sib. False paternity cases yielded an average of 7.65
      exclusionary loci and exclusions with only one (0.0108%) or two (0.14%)
      exclusionary loci were obtained only rarely. The cases of exclusion with one
      locus could lead to likelihood ratios in favour of paternity, while both true and
      false paternity cases with two exclusionary loci would often lead to non
      conclusive likelihood ratios. The average number of exclusionary loci in a
      paternity case where the alleged father was the real father's brother was 3.82,
      with a significant number of cases where no exclusions were obtained.

PMID- 11197632
TI  - Development of haemoglobin subtypes and extramedullary haematopoiesis in young
      rats. Effects of hypercapnic and hypoxic environment.
AB  - The influence of repeated hypoxia on the development of haemoglobin (Hb) subtypes
      and on extramedullary haematopoiesis (EMH) was investigated in young Wistar rats
      of different ages. The rats were exposed to hypercapnic/hypoxic and to "simple"
      hypoxic conditions. The results obtained were compared to those of an untreated
      age-matched control group. Different globin chains were measured using HPLC and
      time-of-flight (TOF) mass analysis. The number of EMH cells was evaluated by cell
      counting. By determining the proportions of alpha- and beta-chains, fetal,
      neonatal and mature types of globin chain composition could be differentiated.
      The beta-2 chain levels were significantly higher in hypercapnic/hypoxic
      environments than in the controls and simple hypoxic environments. The numbers of
      EMH cells in the two groups subjected to hypercapnia/hypoxia decreased
      significantly more slowly compared to the controls and simple hypoxia groups.
      Therefore, the development of Hb subtypes and the EMH activity in rats were
      influenced by both repeated hypercapnia and hypoxia.

PMID- 11197633
TI  - The calculation of blood ethanol concentrations in males and females.
AB  - In German-speaking countries, blood ethanol concentrations (BECs) are usually
      calculated using Widmark's equation. The distribution factor r of this equation
      is a correction factor needed to obtain a reduced body mass and corresponds to
      the ratio of total body water and blood water content. To enhance the reliability
      of Widmark's model equation, the body weight, body height, blood water content
      and total body water of 256 women and 273 men were measured. The ratio of body
      water to blood water ranged from 0.44 to 0.80 in women and from 0.60 to 0.87 in
      men. For both sexes equations were developed by multiple regression analysis
      which allow the determination of the individual, more realistic distribution
      factors rFI (for females) and rMI (for males) even when only body height and body
      weight are known. Drinking experiments revealed a clearly higher congruence of
      calculated and measured blood ethanol concentrations when rFI or rMI were used
      instead of rigid distribution factors, i.e. 0.6 for women and 0.7 for men with or
      without the assumption of a 10% so-called resorption deficit. Additionally,
      Widmark's equation in combination with rFI or rMI allows a more accurate
      prediction of blood ethanol concentrations than the equations of Watson and
      Ulrich.

PMID- 11197634
TI  - Biostatistics for mixed stains: the case of tested relatives of a non-tested
      suspect.
AB  - Analysis of a mixed biological stain by means of highly polymorphic VNTR systems
      usually reveals a profile composed of multiple markers. If the victim and one or
      several suspects match the profile, the evidential strength of the matches has to
      be very carefully analysed. The appropriate methods for the statistical analysis
      of DNA profiles advanced recently were limited to cases with no relationship
      between the tested and non-tested persons. The present paper extends the theory
      beyond this limitation.

PMID- 11197635
TI  - Quality assurance in age estimation based on aspartic acid racemisation.
AB  - Estimates of the age of living and dead individuals, obtained in order to answer
      legal or social questions, require minimum quality standards in order to
      guarantee data quality. We present an outline strategy (with recommendations) for
      the attainment of quality assurance in age estimation based on aspartic acid
      racemisation. The strategy is based on a definition of minimum standards for
      laboratories, including documentation of procedures, methodology and levels of
      expertise, and the formulation of guidelines for intralaboratory and
      interlaboratory quality control.

PMID- 11197636
TI  - A new pentaplex PCR system for forensic casework analysis.
AB  - In 1998 the Federal Criminal Police Office of Germany (BKA) established a central
      genetic database of offenders and suspects to facilitate comparisons with
      biological samples from future criminal offences. The five obligatory short
      tandem repeat (STR) loci in this database (TH01, SE33, vWA, FGA and D21S11) were
      co-amplified in a new PCR pentaplex analysing system together with the sex
      specific locus amelogenin. Due to overlapping fragment sizes, amplification
      products were fluorescent dye-labelled with different colours, separated by
      electrophoresis and detected directly using the ABI PRISM 310 Genetic Analyzer.
      Reproducible and reliable results were obtained from as low as 125 pg template
      DNA, indicating high specificity and sensitivity of the assay. Environmental
      studies and enzymatic digest with DNase I revealed an excellent stability of the
      pentaplex system with typeable results even in cases of partially degraded DNA.
      Complete and reproducible DNA typing was possible in blood-stain mixtures with
      the minor component as low as 10%. Mean stutter peak intensities were analysed
      for all loci and ranged from 2.7 +/- 0.8% (TH01) to 10.6 +/- 1.6% (vWA) of the
      main signal intensity. Allele frequencies were determined in a North Bavarian
      population sample (n = 121). The combination of five systems resulted in a mean
      exclusion chance of 99.86% and a power of discrimination of 99.999996%. No
      deviation from Hardy-Weinberg equilibrium could be found.

PMID- 11197637
TI  - The distribution of laudanosine in tissues after death from atracurium injection.
AB  - A case is presented involving an acute fatality resulting from self
      administration of atracurium, a muscle relaxant by a 45-year-old nurse. In the
      body, atracurium undergoes a spontaneous non-enzymatic degradation to laudanosine
      and an acrylate moiety. Laudanosine was quantified using gas chromatography
      coupled to mass spectrometry after extraction with chloroform-isopropanol-n
      heptane (50:17:33 v/v) at pH 9.5 and separation on a HP5-MS capillary column.
      Laudanosine was subject to postmortem redistribution due to release from drug
      rich tissues such as the lung and heart. The heart blood (917 ng/ml) to
      peripheral blood (390 ng/ml) ratio was 2.4. No other drugs, including ethanol
      were detected.

PMID- 11197638
TI  - Postmortem absorption of dichloromethane: a case study and animal experiments.
AB  - A case of accidental death after occupational exposure to an atmosphere
      containing dichloromethane (DCM) is reported. The concentrations of DCM in the
      blood and tissues of a 40-year-old man who died while observing an industrial
      washing machine filled with DCM vapour were blood 1660 mg/l, urine 247 mg/l,
      brain 87 mg/kg, heart muscle 199 mg/kg and lungs 103 mg/kg which are 3-7 times
      higher than previously reported fatal levels. The body was left undiscovered in
      the machine filled with DCM vapour for about 20 h. The present study was designed
      to determine whether all the DCM detected in the tissues and body fluids had been
      inhaled while alive using rats as the experimental model. The concentrations of
      DCM in the tissues and body fluids of a rat that died from DCM poisoning and was
      left for 20 h in a box containing DCM vapour were the same as those in the
      tissues and body fluids of a rat that had died from an injected overdose of
      barbiturates and had then been placed in the DCM box in a similar manner.
      Moreover, the concentrations of DCM in the tissues and body fluids of the
      carcasses that were exposed to the DCM vapour increased gradually throughout the
      period of exposure. These findings imply that DCM is able to penetrate the
      tissues and body fluids of rat carcasses through a route other than inhalation
      such as through the skin.

PMID- 11197639
TI  - [In Process Citation]

PMID- 11197640
TI  - Laparoscopic tubal sterilization under spinal anesthesia in the Third World.
AB  - Adequate family planning options are extremely limited in the third world.
      Sterilization is desired by many and often unavailable. Quality of life for women
      and their families in the third world can be greatly improved by making
      additional family planning options available. This article describes a program to
      make sterilization available to women of southeastern Dominican Republic.

PMID- 11197641
TI  - The 2001 General Assembly: a look ahead.

PMID- 11197642
TI  - Of laws and sausages.

PMID- 11197643
TI  - May you live in interesting times.

PMID- 11197644
TI  - [Effect of mineral drinking water on hormonal reactions of rats under hypoxic
      conditions].
AB  - Acute action of hypoxia was modelled by raising 26 Wistar male rats (body mass
      230-250 g) in the low-pressure chamber at the height of 9000 m with the speed 15
      m/s. The exposure was 60 min. Before and after lifting the rat blood was examined
      for contents of hormones, glucose and body temperature. It was found that
      hormonal reactions in maximal hypoxia and in drinking mineral water were
      virtually the same. This explains potentiation of hypoxia by mineral water. It is
      suggested that hypoxia and drinking mineral waters should be included in the
      complex strengthening the reserves of human body.

PMID- 11197645
TI  - [Effectiveness of magnetotherapy in elderly hypertensive patients aging at
      different rates].
AB  - Effectiveness of general magnetotherapy was studied in 84 patients with essential
      hypertension and 36 patients with isolated systolic arterial hypertension of old
      age. It is thought necessary to determine biological age of the cardiovascular
      system in hypertensive patients over 60 years of age to specify indications and
      contraindications to physiotherapy.

PMID- 11197646
TI  - [Principles of rehabilitation of respiratory tract diseases].
AB  - The authors propose a conception of rehabilitation after respiratory diseases
      based on combined action of some nonpharmacological therapeutic factors operating
      etiologically, symptomatically, pathogenetically and sanogenetically. These
      rehabilitation methods can be used in persons with respiratory diseases risk
      factors and for prophylaxis.

PMID- 11197647
TI  - [Use of low-frequency ultrasound in rehabilitating chronic bronchitis patients].

PMID- 11197648
TI  - [Effectiveness of halotherapy of chronic bronchitis patients].
AB  - The chemoluminescence test in 49 patients with lingering inflammatory chronic
      bronchitis has revealed inhibition of generation of active oxygen forms in the
      whole blood, intensification of lipid peroxidation in the serum, depression of
      local immunity. Administration of halotherapy to the above patients results in
      correction of disturbances of free-radical oxidation, improves local immunity and
      clinical course of the disease.

PMID- 11197649
TI  - [Physiotherapeutic methods in combined rehabilitation of children with
      respiratory tract diseases, associated with congential maxillofacial pathology].

PMID- 11197650
TI  - [New aspects of rehabilitating patients with post-traumatic defects and
      deformation of the maxillofacial regions].
AB  - Efficacy was compared of local magnetotherapy and electrostimulation in
      rehabilitation of patients with posttraumatic maxillofacial defects and
      deformities. A multidirectional mechanism of the two complexes on peripheral and
      central structures of the maxillofacial region was discovered.

PMID- 11197651
TI  - [Physiopuncture therapy of trigeminal neuralgia].
AB  - 137 patients with typical trifacial neuralgia (TN) were divided into four groups.
      30 patients of group 1 received EHF therapy, 30 patients of group 2 were exposed
      to laser, 67 patients of group 3 were treated with combination of laser with EHF
      puncture, 10 patients of group 4 were controls on conventional physiotherapy.
      Patients of all the groups were given drug of choice--carbamazepin. The highest
      response was registered in group 3, 21(31.3%) patients of which could stop
      carbamazepin, while 40(59.7%) patients reduced carbamazepin dose by 50-70%.
      Positive results were due to restoration of self-regulation in pain and antipain
      systems which are disturbed in TN patients.

PMID- 11197652
TI  - [Low-frequency ultrasound: effect on the body, therapeutic use, and prospects for
      investigation].
AB  - The paper concerns characteristics and mechanisms of action of low-frequency
      ultrasound, indications for its use and prospects for the future.

PMID- 11197653
TI  - [Experience in using a subtonal frequency current for analgesia after gynecologic
      operations on adolescents].
AB  - High antipain effectiveness of early (within 36 postoperative hours) application
      of supratonal frequency after urgent operations on the ovaries was established
      after testing in 21 girls (mean age 13.0 +/- 0.5 years).

PMID- 11197654
TI  - [Use of super-high frequency electromagnetic fields on intrarenal circulation and
      morphological status of health kidneys (experimental study)].
AB  - The experimental study investigated action of electromagnetic waves (84 mW/cm2
      and 395 mW/cm2) on functional-morphological features of healthy kidney of female
      rats. A marked hemodynamic effect of decimetric waves is shown which operates via
      stimulation of intermediary zone with redistribution of intrarenal circulation.
      Disturbance of circulation occurs in dysregulation of the intrarenal blood flow
      under overstimulation of the organ circulation with 395 mW/cm2 decimetric waves.
      This entails disorders of hemodynamics, flebostasis, stromal edema, dystrophy of
      tubular epithelium, periglomerular sclerosis causing aseptic interstitial
      inflammation. This is also proved by levels of prostaglandin E2 in tissue of
      renal papillae. These findings should be considered in administration of
      decimetric waves in patients with renal inflammation.

PMID- 11197655
TI  - [Photophoresis of oxolin ointment in combined therapy of patients with chronic
      relapsing aphthous stomatitis].
AB  - Significant improvement of microcirculation and tissue immunity was found in 75
      patients with chronic recurrent aphtous stomatitis treated with photophoresis of
      0.25% oxolin ointment on the site of the disease focus.

PMID- 11197656
TI  - [Features of reaction of the cardiorespiratory system in patients with chronic
      obstructive bronchitis during speleotherapy].

PMID- 11197657
TI  - [Combined use of transcerebral electrostimulation and the "Defensor" traction
      system in treating patients with lumbar radiculitis].

PMID- 11197658
TI  - [Effect of low-intensity laser radiation on the ratio of various fractions of
      prostaglandins in patients' blood after hemorrhoidectomy].

PMID- 11197659
TI  - [Rehabilitation of children with insulin-dependent diabetes mellitus in a local
      sanitorium].

PMID- 11197660
TI  - [Requirement for studying therapeutic mud deposits. Scope and kinds of mud
      resource assessments].

PMID- 11197661
TI  - [Use of the recuperative "antistress" program in a general hospital].

PMID- 11197662
TI  - [History of the Central Institute of Sanitorium Treatment].

PMID- 11197663
TI  - [Experimental study of the effect of pulsed infrared laser radiation on skeletal
      muscle regeneration after mechanical trauma].
AB  - Impulse infrared laser radiation (0.89 microm) was examined for effect on
      regeneration of cross-cut musculus gastrocnemius in adult rats (ten 3-min
      exposures, 2-3 procedures weekly for one month after the operation, modulating
      frequency 10 Hz, total course dose 3.6 J/cm2). Histological, morphometric and
      biochemical parameters of muscular regenerates as well as biochemical serum
      indices show enhanced regeneration of the skeletal muscle. Formation of the
      muscular organ ends earlier vs untreated muscles. This was accompanied with more
      active sclerotization of the muscular regenerate.

PMID- 11197664
TI  - Motion adaptive x-ray therapy: a feasibility study.
AB  - Intrafraction motion caused by breathing requires increased treatment margins for
      chest and abdominal radiotherapy and may lead to 'motion artefacts' in dose
      distributions during intensity modulated radiotherapy (IMRT). Technologies such
      as gated radiotherapy may significantly increase the treatment time, while breath
      hold techniques may be poorly tolerated by pulmonarily compromised patients. A
      solution that allows reduced margins and dose distribution artefacts, without
      compromising delivery time, is to synchronously follow the target motion by
      adapting the x-ray beam using a dynamic multileaf collimator (MLC), i.e. motion
      adaptive x-ray therapy, or MAX-T for short. Though the target is moving with
      time, in the MAX-T beam view the target is static. The MAX-T method superimposes
      the target motion due to respiration onto the beam originally planned for
      delivery. Thus during beam delivery the beam is dynamically changing position
      with respect to the isocentre using a dynamic MLC, the leaf positions of which
      are dependent upon the target position. Synchronization of the MLC motion and
      target motion occurs using respiration gated radiotherapy equipment. The concept
      and feasibility of MAX-T and the capability of the treatment machine to deliver
      such a treatment were investigated by performing measurements for uniform and
      IMRT fields using a mechanical sinusoidal oscillator to simulate target motion.
      Target dose measurements obtained using MAX-T for a moving target were found to
      be equivalent to those delivered to a static target by a static beam.

PMID- 11197665
TI  - A global optimization method for three-dimensional conformal radiotherapy
      treatment planning.
AB  - Multiple local minima exist in almost every coplanar or non-coplanar radiotherapy
      treatment planning problem. We used a global optimization method based on
      topographical information about the distribution of local minima to find all
      local minima and select the best as the global minimum. We uniformly select N
      random points from search regions and construct a topographical graph, from which
      M (M << N) starting points are selected to launch a local search. Because every
      seed point was at or near the local minimum, the solutions found by the local
      search could be used as the final optimization results. We verified this
      algorithm by applying it to three different clinical cases and comparing the
      results with those obtained by a local optimization method (sequential quadratic
      programming). The results show that this algorithm is feasible and efficient.

PMID- 11197666
TI  - A method to incorporate leakage and head scatter corrections into a tomotherapy
      inverse treatment planning algorithm.
AB  - A detailed tomotherapy inverse treatment planning method is described which
      incorporates leakage and head scatter corrections during each iteration of the
      optimization process, allowing these effects to be directly accounted for in the
      optimized dose distribution. It is shown that the conventional inverse planning
      method for optimizing incident intensity can be extended to include a
      'concurrent' leaf sequencing operation from which the leakage and head scatter
      corrections are determined. The method is demonstrated using the steepest-descent
      optimization technique with constant step size and a least-squared error
      objective. The method was implemented using the MATLAB scientific programming
      environment and its feasibility demonstrated for 2D test cases simulating
      treatment delivery using a single coplanar rotation. The results indicate that
      this modification does not significantly affect convergence of the intensity
      optimization method when exposure times of individual leaves are stratified to a
      large number of levels (>100) during leaf sequencing. In general, the addition of
      aperture dependent corrections, especially 'head scatter', reduces incident
      fluence in local regions of the modulated fan beam, resulting in increased
      exposure times for individual collimator leaves. These local variations can
      result in 5% or greater local variation in the optimized dose distribution
      compared to the uncorrected case. The overall efficiency of the modified
      intensity optimization algorithm is comparable to that of the original unmodified
      case.

PMID- 11197667
TI  - Experimental verification of improved depth-dose distribution using hyper-thermal
      neutron incidence in neutron capture therapy.
AB  - We have proposed the utilization of 'hyper-thermal neutrons' for neutron capture
      therapy (NCT) from the viewpoint of the improvement in the dose distribution in a
      human body. In order to verify the improved depth-dose distribution due to hyper
      thermal neutron incidence, two experiments were carried out using a test-type
      hyper-thermal neutron generator at a thermal neutron irradiation field in Kyoto
      University Reactor (KUR), which is actually utilized for NCT clinical
      irradiation. From the free-in-air experiment for the spectrum-shift
      characteristics, it was confirmed that the hyper-thermal neutrons of
      approximately 860 K at maximum could be obtained by the generator. From the
      phantom experiment, the improvement effect and the controllability for the depth
      dose distribution were confirmed. For example, it was found that the relative
      neutron depth-dose distribution was about 1 cm improved with the 860 K hyper
      thermal neutron incidence, compared to the normal thermal neutron incidence.

PMID- 11197668
TI  - Anisotropy functions for low energy interstitial brachytherapy sources: an EGS4
      Monte Carlo study.
AB  - Anisotropy functions for low energy interstitial brachytherapy sources are
      examined. Absolute dose rates around 103Pd seed model 200 and 125I seed models
      6702 and 6711 have been estimated by means of the EGS4 Monte Carlo simulation
      system. The DLC-136/PHOTX cross section library, water molecular form factors,
      bound Compton scattering and Doppler broadening of the Compton-scattered photon
      energy were considered in the calculations. Following the formalism developed by
      the Interstitial Brachytherapy Collaborative Working Group, anisotropy functions,
      F(r, theta), have been calculated. Our Monte Carlo results were compared against
      a limited set of measured data selected from the literature and other Monte Carlo
      results. Binding corrections and phantom material selection have been found to
      have no influence on the anisotropy function. The accuracy of the geometrical
      source models used for the Monte Carlo calculations was validated against
      experimental measurements of in-air relative fluence at 100 cm from the source.
      More detailed knowledge about the geometrical design of 103Pd seed model 200 is
      needed in order to improve the agreement with experimentally measured in-air
      fluence. Values for in-air fluence of 125I model 6702 are sensitive to source
      position within the inner seed cylinder. Excellent agreement between calculated
      and measured in-air fluence is found for 125I model 6711. It was observed that
      using in-air relative fluence at 100 cm from the source to calculate the
      anisotropy function yields a less anisotropic dose distribution at distances
      close to the source than full Monte Carlo simulation, in contradiction with
      experimental data. Our results have estimated statistical uncertainties of 1%-3%
      at the 1sigma level within clinically relevant regions, but contain systematic
      uncertainties related to the assumed geometrical details.

PMID- 11197669
TI  - Characterization of monomer/crosslinker consumption and polymer formation
      observed in FT-Raman spectra of irradiated polyacrylamide gels.
AB  - Fourier transform Raman spectroscopy was undertaken in the study of irradiated
      polyacrylamide gels (PAGs) used in 3D radiation dosimetry. By employing
      correlation techniques, monomer and crosslinker consumption were characterized in
      the spectra as a function of absorbed dose. The consumption of both monomer and
      crosslinker is monoexponential up to 13 Gy, although the rates of consumption
      differ for the two molecules. A sensitivity parameter, D0, in the exponential
      function has been used to characterize this difference. Up to 13 Gy, D0(acr) = 12
      +/- 2 Gy while D0(bis) = 8.0 +/- 0.5 Gy, indicating that bis is consumed at a
      greater rate than acrylamide and that bis is the limiting factor in the onset of
      gel saturation, for a gel composition of 6% by weight total monomer (6%T) and
      where 3% of the total monomer is crosslinker (50%C). Direct evidence of polymer
      formation was observed in the Raman spectra of irradiated PAG. Polymer formation
      is monoexponential to a dose of 13 Gy, with a sensitivity parameter of D0(poly) =
      14 +/- 2 Gy. This is in good agreement with the consumption rate of acrylamide.
      The exponential nature of the polymer formation observed here is compared with
      existing MRI and x-ray CT dose response measurements previously reported to be
      linear. The results confirm previous studies indicating that Raman spectroscopy
      provides a direct and useful tool for characterization of irradiated PAG.

PMID- 11197670
TI  - Optical properties of porcine skin dermis between 900 nm and 1500 nm.
AB  - The weak absorption of shortwave infrared light by skin tissues between 700 and
      1500 nm offers an important window for diagnosis by optical means. The strong
      scattering of shortwave infrared light by the skin, however, presents a challenge
      to the modelling of light propagation through the skin and the understanding of
      skin optics. We have measured the collimated and diffuse transmittance and
      diffuse reflectance of porcine skin dermis samples within 30 h post-mortem. Monte
      Carlo simulations have been performed to inversely determine the absorption
      coefficient, scattering coefficient and anisotropy factor of the dermis samples
      in the spectral range from 900 to 1500 nm. We further analyse the sensitivity of
      the values of the parameters to the experimental errors and inverse calculation
      procedures. The state of the cellular integrity of the skin samples following
      optical measurements was verified using transmission electron microscopy. These
      results were correlated to study post-mortem effects on the in vitro optical
      properties of porcine dermis. We concluded that for samples stored within crushed
      ice for up to 30 h post-mortem the wavelength dependence of optical properties of
      the dermis remains unchanged while the values of the parameters vary moderately
      due to modification of the water content of the tissue.

PMID- 11197671
TI  - High-resolution SAR modelling for regional hyperthermia: testing quasistatic
      zooming at 10 MHz.
AB  - Present-day regional hyperthermia treatment planning systems are limited to
      centimetre resolution. To obtain CT-resolution SAR distributions, a method called
      quasistatic zooming has been developed: using the centimetre-resolution E-field
      distribution and the CT-resolution tomogram, the CT-resolution SAR distribution
      is obtained. For a low frequency of 10 MHz this method has been validated
      sucessfully using CT-resolution SAR computations. It appears that these CT
      resolution SAR distributions are completely different from centimetre-resolution
      SAR distributions, indicating the necessity for high-resolution SAR modelling.
      Using the presented zooming technique, reliable CT-resolution SAR modelling is
      now possible with relatively short computation times. So far, the zooming method
      has only been validated for low frequencies, but clinically relevant frequencies
      appear to be possible.

PMID- 11197672
TI  - Changes in dielectric properties of ex vivo bovine liver at 915 MHz during
      heating.
AB  - We have developed a coaxial measurement system for determining the time and
      temperature dependence of the dielectric properties of bovine liver at 915 MHz
      during heating. Our data suggest that changes in dielectric properties due to
      heating are dominated by the relaxation response of two tissue components: tissue
      water and proteins. At temperatures above 60 degrees C, the effects of these two
      components contribute to increases of up to 100% and 5% in the values of
      conductivity and permittivity respectively. Changes due to tissue water content
      were found to be reversible with temperature, while changes due to protein
      denaturation were found to be permanent. The temperature coefficients for
      reversible changes were found to be 1.82 +/- 0.28% degrees C(-1) and -0.130 +/-
      (5.9 x 10(-2))% degrees C(-1) for conductivity and permittivity respectively. The
      critical temperatures and activation energies leading to irreversible changes in
      conductivity and permittivity were determined using Arrhenius analysis. Frequency
      factors of (1.14 +/- 0.27) x 10(43) s(-1) and (1.95 +/- 0.49) x 10(36) s(-1) were
      determined for permittivity and conductivity respectively. The activation
      energies were calculated to be 70.7 +/- 15.8 kcal mol(-1) for permittivity and
      60.1 +/- 14.0 kcal mol(-1) for conductivity.

PMID- 11197673
TI  - Analysis of the influence of the cell geometry, orientation and cell proximity
      effects on the electric field distribution from direct RF exposure.
AB  - This paper shows the importance of using a cell model with the proper geometry,
      orientation and internal structure to study possible cellular effects from direct
      radiofrequency exposure. For this purpose, the electric field intensity is
      calculated, using the finite element numerical technique, in single- and
      multilayer spherical, cylindrical and ellipsoidal mammalian cell models exposed
      to linearly polarized electromagnetic plane waves of frequencies 900 and 2450
      MHz. An extensive analysis is performed on the influence that the cell geometry
      and orientation with respect to the external field have in the value of the
      electric field induced in the membrane and cytoplasm. We also show the
      significant role that the cytoplasmic and extracellular bound water layers play
      in determining the electric field intensity for the cylindrical and ellipsoidal
      cell models. Finally, a study of the mutual interactions between cells shows that
      polarizing effects between cells significantly modify the values of field
      intensity within the cell.

PMID- 11197674
TI  - X-ray image intensifier performance and patient doses for combinations of
      supplemental beam filters and vascular contrast agents.
AB  - We present an investigation of the fluoroscopic imaging and dosimetric
      performances of iodine- and gadolinium-based vascular contrast agents in
      combination with K-absorption edge filters of atomic numbers between 50 (tin) and
      82 (lead). These combinations were studied using a theoretical model for a range
      of diagnostic x-ray spectra (55 to 100 kVp) and for water phantoms representative
      of thin and thick anatomies. Performance was characterized by radiographic
      contrast, a derived image quality index, the patient integral and entrance skin
      doses, and the x-ray tube load. For a given thickness of anatomy, an optimum
      combination of spectrum kVp, contrast agent and supplemental filter was defined
      by maximum imaging performance for a minimum or tolerable x-ray tube load and
      patient dose. It was possible to both improve imaging performance and reduce dose
      by the use of an appropriate combination of spectrum kVp and filter. For
      gadolinium-based contrast, performance was optimized with tungsten filtration at
      90 kVp for both thin and thick anatomies. It was not possible, however, to
      optimize the iodinated contrast performance with a single combination of
      supplemental filter and spectrum kVp. The optimal performance for iodinated
      contrast was achieved with gadolinium filtration at 60 kVp for thin anatomy and
      with ytterbium filtration at 80 kVp for thick anatomy. The best performance for
      thin anatomy was that of the combination of iodinated contrast/gadolinium filter
      at 60 kVp and the best performance for thick anatomy was that of the combination
      of gadolinium-based contrast/tungsten filter at 90 kVp.

PMID- 11197675
TI  - Development of an MR-compatible, rotation-insensitive, annular pressure sensor.
AB  - There is a growing interest in performing intravascular interventions guided by
      MR imaging--a technique which offers the possibility of flow measurements during
      the intervention. For a reliable assessment of the haemodynamic significance of a
      stenosis, the flow and the pressure decay within the stenosis should both be
      measured. We have developed an optical, MR-compatible, pressure sensor (Annupres)
      that uses a novel annular element. Existing optical pressure sensors measure
      pressures unilaterally, thus giving rise to artefacts because of the dependence
      of the measurement on the angular orientation of the aperture. The annular
      element, however, measures blood pressure on all sides, and we show that by using
      circularly polarized light this pressure measurement is intrinsically insensitive
      to rotation of the sensor around its long axis. The Annupres sensor has been
      tested in an experimental set-up, and was able to measure pressures from 50 mmHg
      to 180 mmHg reliably with an accuracy of 1.5%.

PMID- 11197676
TI  - Application of anisotropic diffusion to digital enhancement of portal images.
AB  - We propose the use of anisotropic diffusion filtering to remedy difficulties in
      analysis of electronic portal images, stemming from their low contrast and high
      noise levels. Anisotropic diffusion is a nonlinear filter based on the numerical
      solution to the partial differential equation describing the process of
      diffusion. In this study we show that this filter is capable of greatly reducing
      noise in homogeneous areas of portal images while preserving the edges and
      contrast associated with anatomical features. We also demonstrate that the
      application of anisotropic diffusion leads to more consistent and reproducible
      visual extraction of features from portal images.

PMID- 11197677
TI  - The effect of measurement location on tibia lead XRF measurement results and
      uncertainty.
AB  - The aims of this study were to determine whether the location on the tibia
      measured by 109Cd-based K-shell x-ray fluorescence (XRF) affected the measurement
      result and its uncertainty, and whether higher tibia lead levels at the
      extremities of the tibia and/or inhomogeneity in the distribution of lead in the
      tibia could be inferred therefrom. Replicate XRF measurements were performed at
      multiple locations on ten adult cadaver intact legs and on nine bare tibiae
      dissected from them. Mean lead levels in the bare tibiae ranged from 16 to 48
      microg Pb per g of bone mineral. Bare tibia measurements showed that both the XRF
      result and its uncertainty increased towards the proximal and distal ends of the
      tibia. The XRF result decreased away from the medial-lateral mid-point of the
      tibia, but XRF uncertainty was not significantly affected. Intact leg
      measurements showed no effect of proximal distal location on XRF result but did
      show an effect on XRF uncertainty. We conclude that the XRF method used can
      determine the differences in bone lead level resulting from the more trabecular
      composition at the ends of the tibia, and we present limited evidence for
      localized regions of low tibia lead level.

PMID- 11197678
TI  - Non-invasive and quantitative near-infrared haemoglobin spectrometry in the
      piglet brain during hypoxic stress, using a frequency-domain multidistance
      instrument.
AB  - The frequency-domain multiple-distance (FDMD) method is capable of measuring the
      absolute absorption and reduced scattering coefficients of optically turbid
      media. Absolute measurement of absorption at two near-infrared (NIR) wavelengths
      makes possible the quantitation of tissue haemoglobin concentration and tissue
      haemoglobin oxygen-saturation (StO2). However, errors are introduced by the
      uncertainties of background absorption and the dissimilarities between real
      tissues and the simplified mathematical model on which these measurements are
      based. An FDMD-based tissue instrument has been used for the monitoring of tissue
      haemoglobin concentration and oxygenation in the brain of newborn piglets during
      periods of hypoxia and hyperoxia. These tissue haemoglobin saturation values were
      compared with arterial saturation (SaO2) and venous saturation (SvO2) measured by
      blood gas analyses. A linear correlation was observed between StO2 and the
      average of SaO2 and SvO2. However, StO2 is not equal to any fixed weighted
      average of SaO2 and SvO2 unless we introduce an effective background tissue
      absorption. The magnitude of the background absorption was about 0.08 cm(-1) at
      758 nm and 0.06 cm(-1) at 830 nm, and it was nearly consistent between piglets.
      The origin of this 'effective' background absorption may be real, an artefact
      caused by the application of a simplified model to a complex sample, or a
      combination of factors.

PMID- 11197679
TI  - Automated counting of mammalian cell colonies.
AB  - Investigating the effect of low-dose radiation exposure on cells using assays of
      colony-forming ability requires large cell samples to maintain statistical
      accuracy. Manually counting the resulting colonies is a laborious task in which
      consistent objectivity is hard to achieve. This is true especially with some
      mammalian cell lines which form poorly defined or 'fuzzy' colonies, typified by
      glioma or fibroblast cell lines. A computer-vision-based automated colony counter
      is presented in this paper. It utilizes novel imaging and image-processing
      methods involving a modified form of the Hough transform. The automated counter
      is able to identify less-discrete cell colonies typical of these cell lines. The
      results of automated colony counting are compared with those from four manual
      (human) colony counts for the cell lines HT29, A172, U118 and IN1265. The results
      from the automated counts fall well within the distribution of the manual counts
      for all four cell lines with respect to surviving fraction (SF) versus dose
      curves, SF values at 2 Gy (SF2) and total area under the SF curve (Dbar). From
      the variation in the counts, it is shown that the automated counts are generally
      more consistent than the manual counts.

PMID- 11197680
TI  - Evaluation of inverse methods and head models for EEG source localization using a
      human skull phantom.
AB  - We used a real-skull phantom head to investigate the performances of
      representative methods for EEG source localization when considering various head
      models. We describe several experiments using a montage with current sources
      located at multiple positions and orientations inside a human skull filled with a
      conductive medium. The robustness of selected methods based on distributed source
      models is evaluated as various solutions to the forward problem (from the sphere
      to the finite element method) are considered. Experimental results indicate that
      inverse methods using appropriate cortex-based source models are almost always
      able to locate the active source with excellent precision, with little or no
      spurious activity in close or distant regions, even when two sources are
      simultaneously active. Superior regularization schemes for solving the inverse
      problem can dramatically help the estimation of sparse and focal active zones,
      despite significant approximation of the head geometry and the conductivity
      properties of the head tissues. Realistic head models are necessary, though, to
      fit the data with a reasonable level of residual variance.

PMID- 11197681
TI  - Operational characteristics of a prototype x-ray needle device.
AB  - A prototype x-ray needle, which emits 62.5 kVp x-rays at the tip of a 20 cm long,
      4 mm diameter steel needle, has been developed by Titan Pulse Sciences
      Incorporated (PSI) (Albuquerque, NM) and was tested for its suitability in
      brachytherapy applications in comparison with a similar device by the
      Photoelectron Corporation. The depth dose profiles were also compared with those
      of two common brachytherapy sources (125I and 192Ir). The depth dose
      characteristics of the radiation were comparable with the two brachytherapy
      sources with a slightly reduced attenuation gradient. The dose rate from the x
      ray needle tip was relatively isotropic at the needle tip and was continuously
      adjustable over the range of 0 cGy min(-1) to upwards of 62 cGy min(-1) at a
      reference distance of 1 cm in air. We detected a significant proportion of x-rays
      generated along the needle shaft, and not at the needle tip, as intended. The
      energy spectrum emitted from this device had a peak intensity at 21 keV and an
      average energy of 28 keV. The beam was attenuated in both aluminium (the first
      half-value layer being less than 0.1 mm) and in water (50% dose at approximately
      2 mm). These studies confirm that although there is potential for a system
      similar to this one for clinical applications, the simplistic electron guidance
      used in this particular prototype device limits it to research applications.
      Further optimization is required in focusing and steering the electron beam to
      the target, improving x-ray production efficiency and using x-ray target cooling
      to achieve higher dose rates.

PMID- 11197682
TI  - An algorithm for stereotactic localization by computed tomography or magnetic
      resonance imaging.
AB  - Stereotactic localization of an intracranial lesion by computed tomography or
      magnetic resonance imaging requires the use of a head frame that is fixed to the
      skull of the patient. To such head frames are attached either N-shaped or V
      shaped localization rods. Because of patient positioning, the transverse imaging
      slices may not be parallel to the frame base; a coordinate transformation
      algorithm that takes this possibility into consideration is crucial. Here we
      propose such an algorithm for a head frame with V-shaped localization rods. Our
      algorithm determines the transformation matrix between the image coordinate
      system of a transverse image and the frame coordinate system. The determining
      procedure has three steps: (a) calculation of the oblique angles of a transverse
      image relative to the head frame and calculation of the image magnification
      factor; (b) determination of the coordinates of four central markers in both
      coordinate systems; and (c) determination of the 3 x 3 transformation matrix by
      using the coordinates of the four markers. This algorithm is robust in principle
      and is useful for improving the accuracy of localization.

PMID- 11197683
TI  - Determination of isocentric machine parameters for inclined treatment volumes: a
      single solution for angled transverse or coronal treatment planes.
AB  - The derivation of the trigonometric equations necessary to calculate gantry,
      floor and collimator settings for a treatment plane at an angle phi to the
      transverse plane of the patient has been described previously. The derivation of
      a second set of equations to facilitate treatment in a plane at an angle phi to
      the coronal plane has also been described previously. This work reinterprets the
      geometry of inclined volumes and shows that essentially only one set of equations
      is required to determine the settings for treatment planes at an angle phi to
      either the transverse or coronal planes of the patient.

PMID- 11197684
TI  - A method for determining the alignment accuracy of the treatment table axis at an
      isocentric irradiation facility.
AB  - At an isocentric irradiation facility, the rotation axis of the treatment table
      has to be accurately aligned in vertical orientation to the isocentre, which is
      usually marked by three perpendicular laser planes. In particular, high precision
      radiotherapy techniques, such as radiosurgery or intensity modulated
      radiotherapy, require a higher alignment accuracy of the table axis than
      routinely specified by the manufacturers. A simple and efficient method is
      presented to measure the direction and the size of the displacement of the table
      axis from the isocentre as marked by the lasers. In addition, the inclination of
      the table axis against the vertical direction can be determined. The measured
      displacement and inclination provide the required data to correct for possible
      misalignments of the treatment table axis and to maintain its alignment.
      Measurements were performed over a period of two years for a treatment table
      located at the German heavy ion therapy facility. The mean radial distance
      between the table axis and the isocentre was found to be 0.25 +/- 0.25 mm. The
      mean inclination of the table axis in the XZ- and YZ-planes was measured to be 
      0.03 +/- 0.02 degrees and -0.04 +/- 0.01 degrees, respectively. The measurements
      demonstrate the good alignment of the treatment table over the analysed time
      period. The described method can be applied to any isocentric irradiation
      facility, especially including isocentric linear accelerators used for
      radiosurgery or other high precision irradiation techniques.

PMID- 11197685
TI  - Radiochromic film dosimetry in water phantoms.
AB  - Radiochromic film is investigated for use in dosimetry in water phantoms as
      opposed to solid phantoms. Investigations are performed to measure the
      penetration rates of water into radiochromic film and to assess the effects on
      optical density that this penetration causes. The effects of film orientation
      during irradiation in water are also tested. Results show that only a small
      penetration rate is seen from water into the film which only affects the outer
      areas of the film, with penetration being less than 0.5 mm per hour. The optical
      density measurements of the film at 660 nm remain unchanged in the unaffected
      regions of the radiochromic film. Minimal effects are seen due to beam
      orientation in a water phantom as opposed to solid water phantoms in which an
      overestimation in dose is normally seen for parallel irradiation. Radiochromic
      film seems to be an adequate detector for dosimetry in a water phantom where high
      spatial resolution is needed and angle of beam incidence at the point of interest
      is important.

PMID- 11197686
TI  - Field equivalence for clinical electron beams.
AB  - The concept of field equivalence for electron beams is examined using a pencil
      beam theory applied to circular fields. It is shown that a circular field can be
      found for a field of any size, shape and energy for which the depth dose
      distribution is approximately equivalent. The usefulness of the concept in
      clinical dosimetry is discussed.

PMID- 11197687
TI  - Genetic control of susceptibility to infection with Mycobacterium tuberculosis in
      mice.
AB  - Genetic factors play a key role in host response, disease severity, and ultimate
      outcome of infection with Mycobacterium tuberculosis in humans. In the mouse, the
      DBA/2J strain is very susceptible to M. tuberculosis H37Rv infection, while the
      C57Bl/6J strain is resistant. In DBA/2J, a heavier bacterial burden causes a
      unique phenotype, that includes very severe and rapidly fatal pulmonary disease
      with extensive exudation of neutrophils and tissue necrosis, as opposed to slower
      progressive pulmonary disease characterized by the accumulation of epithelioid
      macrophages with protective immune and inflammatory responses in C57Bl/6J. To
      identify the genes responsible for differences in host response to M.
      tuberculosis in these two strains, 95 animals of an informative (C57Bl/6J x
      DBA/2J) F2 cross were infected intravenously with M. tuberculosis (1 x 10(5) CFU)
      and duration of survival was used as a quantitative phenotypic measure of
      susceptibility in a whole genome scan. Quantitative trait locus analysis (QTL)
      showed that the genetically controlled susceptibility was multigenic. QTL
      analysis identified two significant linkages on the distal portion of chromosome
      1 (Trl-1, LOD, 4.80) and on the proximal portion of chromosome 7 (Trl-3, LOD,
      4.66) that each account for approximately 21% of the phenotypic variance. A third
      suggestive linkage was identified on the proximal portion of chromosome 3 (Trl-2,
      LOD, 3.93; additional 18% of the variance). At each locus, homozygosity for the
      parental C57Bl/6J alleles was associated with increased resistance to infection.
      These novel mouse loci provide the basis for evaluating a possible association of
      the corresponding syntenic chromosomal regions in humans with susceptibility to
      tuberculosis.

PMID- 11197688
TI  - No evidence for transmission disequilibrium between a new marker at the myelin
      basic protein locus and multiple sclerosis in French patients.
AB  - The myelin basic protein (MBP) gene is a candidate locus for susceptibility to
      multiple sclerosis. Several groups have tested a complex (TGGA)n repeat in the 5'
      region of this gene for association/linkage with multiple sclerosis, with
      divergent results. This region of tandem repetitive sequence has been subjected
      to complex rearrangements, and there is a possibility that alleles of the same
      size have different internal structures, which reduces the interest of this
      marker for linkage disequilibrium studies and may at least partly explain the
      conflicting results obtained so far. To overcome this problem, we isolated a new
      polymorphic (CA)n repeat within the Golli-MBP locus. The limited number of
      alleles identified makes this other marker suitable for transmission
      disequilibrium studies. We tested this marker for linkage with multiple
      sclerosis, using the transmission-disequilibrium test (TDT) on a sample of 196
      nuclear families in which the genotypes of both parents could be unambiguously
      defined. We found no evidence of transmission disequilibrium between multiple
      sclerosis and any of the three alleles of this marker, even when the patients
      were subdivided according to their HLA-DRB1*1501 status. The present data thus
      provide no evidence for a contribution of the MBP gene to multiple sclerosis
      susceptibility in French patients.

PMID- 11197689
TI  - A new type of genetic regulation of allogeneic response. A novel locus on mouse
      chromosome 4, Alan2 controls MLC reactivity to three different alloantigens:
      C57BL/10, BALB/c and CBA.
AB  - The intensity of the mixed lymphocyte response (MLR) depends on the genetic
      disparity between the donors of responding and stimulating cells. Differences in
      the major histocompatibility complex (MHC) and Mls1 antigens induce the strongest
      responses. However, even with comparable incompatibilities in MHC and Mls
      antigens, some strains of genetically defined mice respond remarkably better than
      other strains. Apparently other, so far undefined, genetic factors contribute to
      the magnitude of the MLR. The strain OcB-9 (H2pz) has 87.5% genes from the strain
      O20/A (O20) and 12.5% genes from strain B10.O20 (both H2pz). In spite of the
      overal similarity of their genomes, OcB-9 mice differed from O20 mice in response
      to three different alloantigens C57BL/10 (H2b), BALB/c (H2d) and CBA (H2k). As
      both O20 and OcB-9 strains carry identical haplotype H2pz, their differences in
      alloantigen response depend only on non-MHC genes. We analyzed the genetic basis
      of these strain differences using (OcB-9 x O20)F2 hybrids, and we mapped a novel
      locus Alan2 (Alloantigen response 2) on chromosome 4 near D4Mit72 that influences
      the response to all alloantigens tested. This linkage was significant for
      C57BL/10 and for BALB/c alloantigens (corrected P values 0.0475 and 0.0158,
      respectively) and highly suggestive for CBA (corrected P = 0.0661). The response
      to DBA/1 (H2q) alloantigens exhibited a similar pattern but the linkage was not
      significant. As MLR reflects the recognition phase of transplantation reaction,
      identification of human counterparts of the Alan genes and a better understanding
      of the regulation of alloresponsiveness might lead to a better prediction of
      patients' reactions to allografts and to a more individualized measures to
      prevent rejection.

PMID- 11197690
TI  - IL-TIF/IL-22: genomic organization and mapping of the human and mouse genes.
AB  - IL-TIF is a new cytokine originally identified as a gene induced by IL-9 in
      murine T lymphocytes, and showing 22% amino acid identity with IL-10. Here, we
      report the sequence and organization of the mouse and human IL-TIF genes, which
      both consist of 6 exons spreading over approximately 6 Kb. The IL-TIF gene is a
      single copy gene in humans, and is located on chromosome 12q15, at 90 Kb from the
      IFN gamma gene, and at 27 Kb from the AK155 gene, which codes for another IL-10
      related cytokine. In the mouse, the IL-TIF gene is located on chromosome 10, also
      in the same region as the IFN gamma gene. Although it is a single copy gene in
      BALB/c and DBA/2 mice, the IL-TIF gene is duplicated in other strains such as
      C57Bl/6, FVB and 129. The two copies, which show 98% nucleotide identity in the
      coding region, were named IL-TIF alpha and IL-TIF beta. Beside single nucleotide
      variations, they differ by a 658 nucleotide deletion in IL-TIF beta, including
      the first non-coding exon and 603 nucleotides from the promoter. A DNA fragment
      corresponding to this deletion was sufficient to confer IL-9-regulated expression
      of a luciferase reporter plasmid, suggesting that the IL-TIF beta gene is either
      differentially regulated, or not expressed at all.

PMID- 11197691
TI  - Characterization of new polymorphisms in the 5' UTR of the human interleukin-1
      receptor type 1 (IL1R1) gene: linkage to type 1 diabetes and correlation to IL
      1RI plasma level.
AB  - The human interleukin-1 type I receptor (IL-1RI) is the signal transducing
      receptor for IL-1, a principal proinflammatory cytokine, which is cytotoxic to
      pancreatic islet beta cells. The IL-1RI gene, IL1R1, maps to chromosome 2q12. We
      have previously examined part of the IL1R1 promoter region and in the present
      study we further characterized the promoter region demarcating exon 1B and 1C by
      sequencing and mutation scanning. New sequence was obtained 1762 bp upstream and
      1609 bp downstream the known region. Within this sequence, we identified four
      frequent single nucleotide polymorphisms (SNPs). PCR-based RFLP assays were
      established and three of the polymorphisms were typed in a Danish Type 1 (insulin
      dependent) diabetes mellitus (T1DM) family collection comprising 103 simplex and
      150 sib-pair affected families. Linkage was evaluated by the sib-TDT
      (transmission disequilibrium test). One of the polymorphisms, defined by a Hinfl
      RFLP assay, demonstrated linkage to T1DM, P(sTDT) = 0.026. Random transmission
      was observed to unaffected offspring from heterozygous parents, P = 0.87. No
      evidence for positive linkage was seen for the other tested polymorphisms, P =
      0.14 and P = 0.21, respectively. To evaluate the possible functional significance
      of the Hinfl polymorphism, we measured circulating IL-1RI plasma level in 30 T1DM
      patients and in 30 control subjects--10 with each genotype in both groups.
      Significant differences in plasma levels in relation to genotype--independent of
      disease status--were found (P = 0.04). In both diabetic and non-diabetic
      subjects, the wt/wt genotype correlated with the highest IL-1RI plasma level,
      whereas the plasma levels were lowest for the mt/mt genotype.

PMID- 11197692
TI  - New single nucleotide polymorphisms in the coding region of human TNFR2:
      association with systemic lupus erythematosus.
AB  - We recently reported the association of the allele coding for Arg at the position
      196 (196R: nucleotide [nt] 587G) of tumor necrosis factor receptor 2 (TNFR2, TNF
      R75) with systemic lupus erythematosus (SLE) in Japanese. In the present study,
      we completed the variation screening of the entire coding region of TNFR2. Three
      new single nucleotide polymorphisms within the coding sequence (cSNPs), as well
      as several variations within the promoter, introns and 3'-untranslated region (3'
      UTR), were identified. Among the new SNPs, nt168G, a synonymous substitution
      (K56K), was in tight linkage disequilibrium with nt587G. Two other cSNPs, nt543
      (C-->T) (P181P) and nt694 (G-->A) (E232K), were not significantly associated with
      SLE. Thus, among the non-synonymous cSNPs, only nt587 (T-->G) (M196R) was found
      to be significantly associated with SLE in Japanese.

PMID- 11197693
TI  - The NKG2 natural killer cell receptor family: comparative analysis of promoter
      sequences.
AB  - The NKG2 receptor family is crucially involved in target cell recognition by
      natural killer cells and comprises several activating as well as inhibitory
      family members. We have established approximately 3 kilobases of upstream
      promoter sequences of the human NKG2-C, -E and -F genes and have carried out a
      comparative analysis with available NKG2-A sequences. We found extended regions
      of homology which contain numerous putative transcription factor binding sites
      conserved in the NKG2 genes. However, variation in Alu insertion among family
      members has led to promoter structures unique to the respective family members,
      which could contribute to differences in transcriptional initiation as well as
      gene-specific regulation.

PMID- 11197694
TI  - The -403 G-->A promoter polymorphism in the RANTES gene is associated with atopy
      and asthma.
AB  - Asthma is a complex inflammatory condition often associated with bronchial
      hyperreactivity and atopy. Genetic and environmental factors are implicated and
      several candidate genes have been implicated. Of these, the chemokine RANTES is
      responsible for the recruitment of inflammatory cells such as eosinophils and T
      lymphocytes. We have recently identified a polymorphism within the RANTES
      promoter (-403 G-->A) and have examined its role, using a PCR-RFLP assay, in the
      development of atopy and asthma in 201 Caucasian subjects. Atopic status was
      determined using skin prick testing and serum IgE levels. Severity of airway
      dysfunction was assessed using spirometric measurement (FEV1) and methacholine
      challenge (PC20). The -403 A allele was associated with an increased
      susceptibility to both atopy and asthma. Thus, the proportion of subjects
      carrying this allele was higher in each of atopic non-asthmatics, non-atopic
      asthmatics and atopic asthmatics compared with non-atopic, non-asthmatic
      controls. In particular, this allele was associated with skin test positivity but
      not IgE level. Homozygosity for the -403 A allele conferred a 6.5-fold increased
      risk of moderate/severe airway obstruction (FEV1 < or = 80% predicted), a marker
      for established asthma. Our data, whilst preliminary, indicate that the
      association of RANTES genotype with both atopy and asthma reflect independent
      effects, suggesting different mechanisms for the role of this chemokine in atopy
      and development of airway obstruction.

PMID- 11197695
TI  - Complete primary structure, chromosomal localisation, and definition of
      polymorphisms of the gene encoding the human interleukin-12 p40 subunit.
AB  - Owing to the importance of interleukin (IL)-12 in regulating immune responses, we
      have determined the complete genomic sequence and organization of the gene
      encoding its p40 subunit. The genomic sequence was determined and was compared to
      cDNA sequences to derive exon/intron boundaries. Unusually, both the first and
      last of the eight exons of this gene are not translated. An extensive search
      identified several polymorphisms in IL-12p40, including repeat elements in
      introns 2 and 4 and a polymorphic Taql site in the 3'UTR. However, no
      polymorphisms were found which could result in amino acid substitutions. This
      finding places constraints on any preferential involvement of alleles of IL-12p40
      in contributing to autoimmune, inflammatory or infectious diseases.

PMID- 11197696
TI  - New variations in human OX40 ligand (CD134L) gene.
AB  - We found three new variations in the OX40 ligand (OX40L, CD134L) gene and its 5'
      upstream region. -921 (G-->A) at 5' upstream region, -19 (C-->G) at 5'
      untranslated region, and 202 + 25 (G-->T) at intron 2 were identified. -921 (G-
      >A) and 202 + 25 (G-->T) were detected in a substantial proportion of healthy
      Japanese individuals and were considered to be single nucleotide polymorphisms
      (SNPs). -19 (C-->G) was detected in only one healthy individual. There was no
      association between these variations and the presence of rheumatoid arthritis
      (RA) or systemic lupus erythematosus (SLE).

PMID- 11197697
TI  - Presidential address--the end of the beginning (again!).

PMID- 11197698
TI  - The future of neuropathology.

PMID- 11197699
TI  - Honored guest presentation-developments in surgery of posterior circulation
      aneurysms.

PMID- 11197700
TI  - Aneurysms requiring extended cranial base approaches.

PMID- 11197701
TI  - Selecting aneurysms for adequate exposure without extended cranial base
      approaches: neurovascular decision-making counterpoint.

PMID- 11197702
TI  - Which aneurysms should be referred for endovascular therapy?

PMID- 11197703
TI  - Surgery for cerebral gliomas: past, present, and future.

PMID- 11197704
TI  - Present and future technical developments on aneurysm embolization. Impact on
      indications and anatomic results.

PMID- 11197705
TI  - Arteriovenous malformations: indications for stereotactic radiosurgery.

PMID- 11197706
TI  - Extracranial carotid lesions that should be managed with angioplasty and
      stenting.

PMID- 11197707
TI  - Pediatric brain tumors: a contemporary prospectus.

PMID- 11197708
TI  - Update on craniofacial surgery: the differential diagnosis of lambdoid
      synostosis/posterior plagiocephaly.
AB  - There has been an evolution of thought on the diagnosis and treatment of
      posterior plagiocephaly. Synostotic posterior plagiocephaly (lambdoid synostosis)
      can be diagnosed and differentiated from non-synostotic posterior plagiocephaly
      (positional molding) based on specific cosmetic and radiologic criteria. The
      advent of high-resolution three-dimensional CT analysis of cranial morphology
      combined with meticulous clinical studies of the two major causes of posterior
      plagiocephaly has added much to our understanding of this skull deformity.
      Children with lambdoid synostosis have a trapezoid-shaped skull with posterior
      displacement of their ipsilateral ear, ipsilateral mastoid bossing, contralateral
      occipital bossing, and a fused lambdoid suture that appears as a ridge. Children
      with posterior plagiocephaly without lambdoid synostosis have a characteristic
      parallelogram-shaped skull with anterior displacement of the ipsilateral ear and
      ipsilateral frontal bossing. This subject is surrounded in controversy because
      many of the children in the past thought to have lambdoid synostosis probably did
      not, based in part on the aforementioned specific criteria. This is an important
      point, as most patients with posterior plagiocephaly without synostosis will
      improve without surgery. One should thus be appropriately conservative in the
      selection of patients for surgery. The majority of infants evaluated at
      craniofacial clinics presumably have posterior plagiocephaly without synostosis
      and can be successfully treated with frequent head turning, helmet, or band
      therapy. Patients with clinically and radiologically proven synostotic posterior
      plagiocephaly and a severe deformity should undergo craniofacial surgery. The
      technique of biparieto-occipital craniotomy is safe, simple, and delivers a good
      cosmetic result. Our postoperative photographic evaluations have shown an
      immediate, aesthetically pleasing change in the contour of the occiput, which
      tends to improve with time.

PMID- 11197709
TI  - Pediatric trauma made simple.
AB  - At present, similar to the adult, conventional management in the child following
      TBI appropriately attempts to lessen the second insults that occur after the
      injury and the effects of the secondary physiologic events. Many of the treatment
      modalities used for the child after severe TBI have been extrapolated from the
      adult data, as there is little literature that primarily involves children.
      Though children as a group overall have a better outcome than adults, there are
      many factors that influence prognosis in the pediatric population. The age at
      injury, mechanism of injury, injury severity, multiple trauma, second insults,
      and/or the extent of secondary injury can all impact on the final outcome. It is
      clear that many of the poor outcomes observed are best prevented by preventing
      either the initial impact or the second insults that typically occur following
      TBI. Interestingly, very young and preschool children have worse outcomes both in
      mortality and long-term disability than older children and adolescents. The
      deficits observed are often persistent and severe in the long term even with
      aggressive management. Continued aggressive intervention to prevent secondary
      injury and, in the future, mechanistically targeted therapeutic modalities in the
      acute setting will hopefully improve the mortality rates and functional recovery
      in these children.

PMID- 11197710
TI  - Cerebrospinal fluid shunt technology.

PMID- 11197711
TI  - Congenital malformations of the central nervous system.

PMID- 11197712
TI  - Moyamoya syndrome: a surgically treatable cause of stroke in the pediatric
      patient.

PMID- 11197713
TI  - Indications and outcomes for lobectomy, corpus callosotomy, and hemispherectomy
      in pediatric neurosurgical patients.

PMID- 11197714
TI  - Epilepsy surgery in children.

PMID- 11197715
TI  - Selective dorsal rhizotomy: an excellent therapeutic option for spastic cerebral
      palsy.

PMID- 11197716
TI  - Baclofen infusion for spastic cerebral palsy.

PMID- 11197717
TI  - Developmental glial biology: the key to understanding glial tumors.

PMID- 11197718
TI  - The biomechanics of lumbar interbody fusion and sagittal plane balance.

PMID- 11197719
TI  - Posterior lumbar interbody fusion (PLIF): past, present, and future.

PMID- 11197720
TI  - Posterolateral fusion of the lumbar spine: rationale, indications, techniques,
      and results.

PMID- 11197721
TI  - The role of pedicle screw fixation for lumbar spinal stabilization and fusion.

PMID- 11197722
TI  - Posterior lumbar interbody fusion: indications, techniques, and results.

PMID- 11197724
TI  - Open anterior lumbar interbody fusion.

PMID- 11197723
TI  - The role of anterior lumbar interbody allograft bone dowel fusion as an adjunct
      to posterior segmental lumbar fixation.

PMID- 11197725
TI  - Laparoscopic anterior lumbar interbody fusion.

PMID- 11197726
TI  - The biomechanics of interbody fusion and the shortcomings of lumbar fusion with
      cages and interbody bone dowels.

PMID- 11197727
TI  - Resident curriculum guidelines for neurosurgery. Congress of Neurological
      Surgeons Education Committee.

PMID- 11197729
TI  - The future of pituitary surgery.

PMID- 11197728
TI  - BEHAB/brevican: an extracellular matrix component associated with invasive
      glioma.
AB  - The extracellular matrix (ECM) has a prominent role in many physiological
      processes, including organ development, wound healing, and neoplastic growth and
      invasion. In each of these processes, changes in the composition of the matrix
      can lead to increased cell movement. In this review, we discuss the role of ECM
      components in glioma invasion, with special emphasis on the brain-specific
      proteoglycan, Brain-Enriched Hyaluronan Binding (BEHAB)/brevican.

PMID- 11197730
TI  - Perspective in pituitary adenomas: an end of the century review of tumorigenesis,
      diagnosis, and treatment.
AB  - Significant advances have been made in the molecular biological understanding of
      pituitary tumorigenesis. These advances will have an impact on the gene therapy
      of pituitary tumors in the coming century. Transsphenoidal surgery remains the
      mainstay of treatment for the majority of pituitary adenomas, with endoscopic
      surgery being used at some centers in select patients. Pharmacotherapy of
      pituitary adenomas has made great strides in the management of prolactinomas and
      GH-secreting pituitary adenomas. Finally, radiosurgery has become a very
      important adjuvant therapy in the treatment of hypersecreting pituitary adenomas.

PMID- 11197731
TI  - Optimism, satisfaction and time perspective in the elderly.
AB  - In contrast to younger groups, research with the elderly suggest a predominantly
      present-focused temporal orientation. One aspect of satisfaction, optimism is
      conceptualized as a form of future perspective. Health psychology generally
      asserts that health-enhancing messages depend for effect on a person perceiving
      future benefits to actions taken in the present to enhance health or minimize ill
      health risk. The extent to which the elderly perceive or value the future should
      impact on health maintenance behaviors. In a study of eighty-six elderly people,
      the dominant ways of viewing time coalesced around a variety of present time
      perspectives. Within-group differences revealed that as people aged, they became
      less satisfied with life relative to their level of optimism. For the young-old,
      optimism was positively correlated with satisfaction, but for the oldest-old the
      variables were negatively associated. Optimism increased with age while
      satisfaction decreased with age. The decrease in satisfaction is most probably
      related more to a sense of realism about the tasks of aging than a sense of
      "death anxiety," or avoidance of the future. As people age, temporal variables
      become less important in predicting optimism or satisfaction and optimism becomes
      less important as a predictor of satisfaction. Implications for developing models
      of health management in the elderly are discussed.

PMID- 11197732
TI  - Meeting the challenge of raising grandchildren.
AB  - More grandparents are raising grandchildren than ever before. The predictable
      problems they experience include a revision of personal goals; learning how
      growing up has changed since they raised their own children; cooperating with the
      parent who shares responsibility for child care; monitoring social and academic
      progress of children; becoming aware of rights and available social services; and
      arranging periodic relief from the daily demands of their surrogate obligations.
      Full-time grandparents often rely on support groups for comfort and advice. The
      advantages and limitations of this approach are examined. Recommendations are
      made for ways to improve how support groups function so they can achieve their
      purposes.

PMID- 11197733
TI  - Sharing of culture: adult grandchildren's perceptions of intergenerational
      relations.
AB  - The current study addressed the sharing of traditions, beliefs, and customs
      (i.e., culture) between grandparents and grandchildren. Two hundred and forty-six
      adult grandchildren were surveyed on both existing and newly created measures of
      grandparenting. Results indicated that extent of shared activities, attitudes
      toward grandparents, and perceptions of cultural sharing were significantly
      related. Additionally, it was found that minority and female participants were
      more likely to engage in intergenerational culture sharing and reported more
      positive statements about this sharing in response to open-ended questions.
      Findings highlights the importance of cultural sharing to perceptions of
      grandchild-grandparent relationships.

PMID- 11197734
TI  - Toward a culturally inclusive understanding of wisdom: historical roots in the
      East and West.
AB  - To establish a clearer definition of wisdom as a psychological concept, Western
      and Eastern historical literatures were reviewed and assessed within a general
      analytical/synthetic framework. In the West, either in an ancient Egyptian,
      biblical, or philosophical sense, wisdom had been often identified as a form of
      analytical ability such as an increase in the knowledge database or an increase
      in information processing efficiency. By contrast, the Eastern understanding of
      wisdom, primarily derived from the ancient Vedic text, had been more inclusive,
      with both analytical and synthetic domains regarded as necessary moments to the
      whole of wisdom. The inclusive account was also discussed with respect to two
      important Eastern themes of wisdom: "void" and "codependence."

PMID- 11197735
TI  - The meaning of life: animism in the classificatory skills of older adults.
AB  - Seventy-five participants aged from their teens to their seventies were measured
      on a battery of measures of personality, lifestyle, intelligence, and educational
      background. These measures were gauged against performance on a measure of
      animism, in which participants judged twenty-three items (4 alive, 19 non-living)
      as living or non-living. Although animism errors increased with age, all groups
      displayed animism errors, thereby contradicting Piaget (1965). Performance is
      partially explained by fluid intelligence level, but is more plausibly ascribed
      to progressive loss of what is essentially peripheral information to non-academic
      people.

PMID- 11197736
TI  - From the rotating drum dialyzer to the personal hemodialysis system: a brief
      history of hemodialysis technology.

PMID- 11197737
TI  - The role of plasmapheresis in the treatment of focal segmental glomerulosclerosis
      (FSGS).

PMID- 11197738
TI  - Recombinant human growth hormone therapy in adult dialysis patients.

PMID- 11197739
TI  - Nosocomial transmission of hepatitis C virus infection in hemodialysis patients:
      clinical perspectives.

PMID- 11197740
TI  - Optimized growth conditions for tissue engineering of human cardiovascular
      structures.
AB  - Optimized in vitro formation of strong tissue is a prerequisite for tissue
      engineering of cardiovascular structures, such as heart valves and blood vessels.
      This study evaluates different growth media additives as to cell proliferation,
      extracellular matrix formation, and mechanical characteristics. Biodegradable
      polymers were seeded with human vascular myofibroblasts. Group A was cultured
      with standard medium, groups B, C, and D were in addition supplemented with
      ascorbate, fibroblast growth factor (bFGF), and both respectively. Analysis
      included histology, electron microsocopy, mechanical testing, and biochemical
      assays for cell proliferation (DNA) and extracellular matrix (collagen). DNA
      content increased in all groups, showing significantly more cells in group C and
      D after 14d. Collagen increased in all groups, except for C. Morphology showed
      viable, layered cellular tissue, with collagen fibrils after 2w, most pronounced
      in B and D. Mechanical properties decreased initially, stabilizing after 2w. In
      conclusion, standard nutrient media were efficient for seeded human vascular
      cells cultured on biodegradable meshes. Supplementation with bFGF+ascorbate
      resulted in enhanced early cell proliferation and structurally more mature tissue
      formation.

PMID- 11197741
TI  - Biomaterials in spinal fixation. An experimental animal study to improve the
      performance.
AB  - Different pedicle screws were biomechanically and morphologically studied and
      compared through the use of an animal model to determine their efficacy and
      resistance in spinal fixation. The principal objective was to compare
      biomechanical and histomorphological aspects of HA-coated screws to uncoated
      ones. Fourty-eight cylindrical transpedicular self-tapping screws divided into
      three groups of sixteen each were employed; Group A: stainless steel screws;
      Group B: titanium screws; Group C: HA-coated titanium screws. The screws were
      implanted bilaterally and randomly into the L3, L4, and L5 pedicles of eight
      adult mongrel sheep. The final insertion torque was measured in all the implants.
      After one and four months, upon euthanization, four samples per group were
      extracted from the surrounding bone and the screw extraction torque was measured.
      The remaining samples were examined and processed for histological and
      histomorphological evaluations. No differences were observed at one month among
      the extraction torque of the three groups. After four months the only
      significance between insertion and extraction values was for the HA group, i.e.
      p=0.001. Comparing the extraction torque values of the three groups after four
      months of healing, the HA-coated group showed a greater than twofold increase
      (p<0.0005). No differences were observed at one month among the percentages of
      bone-implant contact in the three groups. After four months the percentage was
      significant only for the C group (p<0.0005). At four months a correlation was
      found between the morphological and the biomechanical data of group C (p<0.0005).
      The use of hydroxyapatite-coated screws could act as an effective method to
      improve the bone-implant interface, thus obtaining a strong fixation of the
      implant independently of the arthrodesis achieved with bone graft.

PMID- 11197742
TI  - Apligraf--a living human skin equivalent for the treatment of chronic wounds.
AB  - Apligraf, a manufactured living human skin equivalent, was the first true
      composite tissue analog to become commercially available. It has been approved by
      the FDA for the treatment of venous leg ulcers and diabetic foot ulcers. The
      tissue engineered bi-layered skin equivalent has both an epidermis and a dermis,
      which consist of keratinocytes and fibroblasts derived from neonatal foreskin and
      bovine collagen. The skin equivalent produces a great number of cytokines and
      growth factors and is immunologically well tolerated. The product is easy to
      handle in clinical use and can be applied in an outpatient setting.

PMID- 11197743
TI  - Therapeutic apheresis in children: experience in a pediatric dialysis center.
AB  - The use of apheretic procedures in pediatric patients has always been restricted
      by technical difficulties and the low incidence of diseases requiring this kind
      of treatment. The aim of the present study was to describe the solutions adopted
      to solve technical difficulties related to priming, vascular access and
      monitoring and then to evaluate clinical results. Between 1982 and 2000, 51
      consecutive children (28 male, 23 female) with a mean age of 4.9 +/- 4.8 years (3
      months-14.8 years) and a mean weight of 19.7 +/- 12.8 kg (5-52 kg), with renal
      and/or extra-renal diseases requiring apheretic procedures were selected for the
      study. The overall number of procedures performed were: 226 plasma-exchange (PE),
      6 LDL-apheresis (LDL-A) and 8 protein A immunoadsorption (IAPA) sessions. Our
      therapeutic protocol involves hematic flux of 20-100 ml/min and ultrafiltration
      of 5-20 ml/min. In each 70-95 minute session we exchanged plasmatic volume with
      fresh frozen plasma or with a solution of 6% albumin in lactated Ringer's, using
      heparin (10-20 UI/kg/h). We used Paired Filtration Dialysis Monitor in PE and LDL
      A; Citem 10 in IAPA. As plasma separator, we used a filter made of polypropylene,
      0.2 m2 surface, 30 ml priming (Hemaplex BT 900). Hemolytic uremic syndrome was
      the most commonly treated disease (18/51 cases) with good results in 10/18 cases.
      We recorded, good results in vasculitis as well, in one girl with focal
      glomerulosclerosis in transplanted kidney and rapid improvement in all children
      with Guillaine-Barre Syndrome. PE treatment was effective in metabolic disorders
      such as tirosynemia and familiar hypercholesterolemia. Only 4/12 patients with
      acute liver failure due to viral hepatitis recovered. We had poor results in the
      remaining eight cases. Complications were rare and no viral infection was found
      in any patient. Our data show that it is possible to use these procedures in
      pediatric patients even though clinical indications and real effectiveness still
      need to be cleared up.

PMID- 11197744
TI  - Autotransfusion during extracorporeal membrane oxygenation.
AB  - To reduce allogeneic blood transfusion requirements during extracorporeal
      membrane oxygenation (ECMO) we evaluated an autotransfusion device which
      processes and retransfuses erythrocytes of changed ECMO-systems. We studied 10
      elective changes of ECMO-systems in 7 patients. Hemoglobin levels, the amount of
      retransfused autologous blood and of transfused allogeneic packed red blood cell
      units were documented within 48 h after the system change and compared to the
      measurements obtained from former ECMO-system changes without using any
      autotransfusion device. We determined the Horrowitz-index, Interleukin 6, 10, TNF
      alpha and endothelin-I concentrations and coagulation parameters during the 48
      hours after system change to study the compatibility of this procedure.
      Allogeneic blood transfusion was reduced from 7 to 2 units of packed red cells
      using the autotransfusion device. Additionally, no hints of any harmful side
      effects in these patients was observed.

PMID- 11197745
TI  - Regeneration of the junctional epithelium and connective tissue after
      transplantation of detergent-processed allo-teeth.
AB  - The authors have developed a new artificial dental implant and evaluated it in a
      dog model in terms of its potential to produce: I) regeneration of junctional
      epithelium; II) regeneration and attachment of connective tissue. The implants
      were constructed from allo-teeth. We removed the cell components from the
      periodontal ligaments of these teeth with a detergent (1% TritonX-100); the
      remaining acellular periodontal ligament acted as an extracellular matrix upon
      which regeneration and attachment could proceed. We placed 10 of these implants
      in the just-extracted sites of three beagle dogs. We observed regeneration of
      both junctional epithelium and connective tissue at all implant sites after 3
      months. The connective tissue was attached in all cases. Use of the acellular
      periodontal ligament as an extracellular matrix may facilitate regeneration of
      host periodontal ligament tissue, thus contributing to recovery of host
      immunological defense and long-term oral function.

PMID- 11197746
TI  - Evidence for a nucleus accumbens CCK2 receptor regulation of rat ventral pallidal
      GABA levels: a dual probe microdialysis study.
AB  - We employed dual probe microdialysis in the nucleus accumbens and ipsilateral
      ventral pallidum of the halothane anaesthetized rat to investigate the effect of
      intra-accumbens perfusion with the sulphated octapeptide cholecystokinin (CCK-8S,
      10-1000 nM, 60 min) alone and in the presence of the selective CCK1 and CCK2
      receptor antagonists L-364,718 (10 and 100 nM) and PD134308 (10 nM), tetrodotoxin
      (TTX, 1000 nM) and the GABA(A) receptor antagonist bicuculline (1000 nM), on
      dialysate GABA levels in the ventral pallidum. Intra-accumbens perfusion with the
      100 and 1000 nM concentration of CCK-8S was associated with a significant
      decrease (-16+/-3% and -23+/-3% vs basal, respectively) in ventral pallidum GABA
      levels. The CCK-8S (1000 nM) induced decrease in ventral pallidal dialysate GABA
      levels was abolished when PD134308, TTX and bicuculline, but not L-364,718, were
      included into the perfusion medium of the accumbens probe. The data indicate that
      nucleus accumbens CCK-8S exerts a CCK2 receptor mediated inhibition of ventral
      pallidal GABA levels. Furthermore, the TTX and bicuculline sensitivity of this
      effect suggests that this is possibly mediated via CCK2 receptors probably
      located on local GABA interneurons.

PMID- 11197747
TI  - The abundance of mRNAs for pyruvate dehydrogenase kinase isoenzymes in brain
      regions of young and aged rats.
AB  - The abundance of mRNAs for pyruvate dehydrogenase kinase (PDK) isoenzymes in four
      brain regions of young (10 wk) and aged (50 wk) rats was investigated by reverse
      transcription-polymerase chain reaction (RT-PCR). The mRNAs for PDK1, 2, and 4
      were detected in all the regions examined. The level of PDK2 mRNA was the most
      abundant among the isoenzymes in all the brain regions when judged from the PCR
      cycles. The level of PDK1 mRNA was relatively high in cerebellum and cerebral
      cortex compared to medulla oblongata and hippocampus. Aging decreased the levels
      of mRNAs for PDK1 and 2 in cerebellum and increased the PDK2 mRNA in hippocampus
      and cerebral cortex. The level of PDK4 mRNA was not affected by aging. These
      results provide the first evidence suggesting that there is the regional
      difference in the abundance of mRNAs for PDK isoenzymes in rat brain and that the
      levels of mRNAs for the isoenzymes were affected by aging.

PMID- 11197748
TI  - Enhanced macrophage functions and cytokine production of lymphocytes after
      ingestion of bon narine in female BALB/c mice.
AB  - The purpose of this investigation was to determine the effects of bon narine
      treatment on macrophage and lymphocyte functions in mice. Twelve week-old female
      inbred BALB/c mice were given bon narine p.o. at 30 mg/kg per day and sacrificed
      after three months. Glucose consumption of peritoneal macrophages in the bon
      narine treated group during incubation up to 72 h was significantly higher than
      that in the control group. Activities of acid phosphatase (APH), beta
      glucuronidase (GLU) and lactate dehydrogenase (LDH) in the peritoneal macrophages
      in the bon narine treated group significantly increased compared to that in the
      control group. Macrophage production of nitric oxide stimulated by
      lipopolysaccharide (LPS) in the bon narine treated group was significantly
      increased. Interleukin-1beta (IL-1beta) production of peritoneal macrophages
      stimulated by LPS was significantly higher in the bon narine treated group.
      Stimulation indices in splenic lymphocytes by concanavalin A (Con A) in the bon
      narine treated group were significantly higher than that in the control group.
      Interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) production stimulated by
      Con A were significantly increased in the bon narine treated mice. Interleukin-4
      (IL-4) production of splenic lymphocytes stimulated by Con A was not different in
      the control group and the bon narine treated group. These findings might suggest
      that oral administration of bon narine effectively enhanced the macrophage
      function and lymphocyte responsiveness in mice.

PMID- 11197749
TI  - N-ethylmaleimide inhibits xanthine oxidase activity with no detectable change in
      xanthine dehydrogenase activity in rabbit liver.
AB  - The effect of an alkylating agent, N-ethylmaleimide (NEM), on the activities of
      xanthine oxidase (XO) and xanthine dehydrogenase (XD) in the presence and absence
      of Cu2+ or trypsin in the cytosolic fraction from rabbit liver was examined. At
      concentrations ranging from 0.25 to 2.0 microM, allopurinol, which is generally
      considered to be a XO inhibitor, suppressed the XD activity (41.5-93.4%
      inhibition) in addition to the XO activity (28.6-88.4% inhibition) under basal
      conditions, without the addition of Cu2+ or trypsin. In contrast, NEM (100-400
      microM) inhibited the XO activity (35.7-85.7% inhibition) without affecting the
      XD activity. Also, NEM inhibited the Cu2+- and trypsin-induced XO activities, but
      did not affect the XD activity at the same concentration range. These results
      demonstrate that NEM can be a selective inhibitor of XO activity in rabbit liver.

PMID- 11197750
TI  - Bile duct ligation promotes covalent drug-protein adduct formation in plasma but
      not in liver of rats given zomepirac.
AB  - Acyl glucuronides are reactive electrophilic metabolites of carboxylate drugs,
      capable of undergoing hydrolysis, rearrangement and covalent binding reactions
      with proteins in vivo. Such covalent drug-protein adducts may be prerequisites
      for certain idiosyncratic immune and toxic responses in susceptible individuals.
      The present study examined the effect of experimental cholestasis on the extent
      and pattern of formation of protein adducts in plasma and liver of rats given the
      non-steroidal antiinflammatory drug (NSAID) zomepirac (ZP). Groups of intact,
      bile-exteriorized and bile duct-ligated rats given a 50 mg/kg i.v. dose of ZP
      were studied for 24 hr. In intact rats, only 1.4% of the dose was recovered as
      the sum of ZP, ZP acyl glucuronide (ZAG) and its rearrangement isomers (iso-ZAG)
      in urine in 24 hr. In bile-exteriorized animals, 0.5% of the dose was recovered
      in urine in 24 hr, with 31.6% of the dose being recovered in bile (2.7% as ZP,
      20.0% as ZAG and 8.9% as iso-ZAG). In the bile duct-ligated group, recovery of
      dose in 24 hr urine totalled 17.5% (1.7% as ZP, 6.7% as ZAG and 9.1% as iso-ZAG).
      ZAG and iso-ZAG were measurable in plasma only in the bile duct-ligated group,
      and covalent binding of ZP to plasma proteins was much higher (5-6 fold) than in
      intact or bile-exteriorized rats. Total adduct concentrations in liver were not
      significantly different among the three groups. Immunoblotting using a polyclonal
      ZP antiserum confirmed that serum albumin was a major target protein in plasma.
      The major ZP-modified bands in the livers of intact and bile-exteriorized rats
      were at about 110, 140 and 200 kDa. However, the bands at 110 and 140 kDa were
      much lower in the livers of bile duct-ligated rats. The results show that about
      30% of ZP doses are normally excreted as ZAG and its isomers in bile, with only
      minor excretion in urine. Bile duct ligation shunts the glucuronide into blood
      (and urine), strongly promoting adduct formation with plasma proteins, and alters
      the pattern but not the total quantity of drug-modified proteins formed in the
      liver.

PMID- 11197751
TI  - Hepatocyte growth factor protects gastric epithelial cells against ceramide
      induced apoptosis through induction of cyclooxygenase-2.
AB  - Forced overexpression of cyclooxygenase-2 (COX-2) in intestinal cells has been
      shown to be associated with resistance to apoptosis. However, the role of
      physiologically-induced COX-2 in the regulation of apoptosis remains unclear. In
      the present study, we examined whether hepatocyte growth factor (HGF)-induced COX
      2 affects ceramide-induced apoptosis in RGM-1 gastric epithelial cells. An
      externally applied cell permeable ceramide analogue, C2-ceramide, caused RGM-1
      cell death in a dose-dependent manner, whereas an inactive ceramide analogue, C2
      dihydroceramide, did not. TdT-mediated dUTP nick end labeling (TUNEL) assay
      showed that the C2-ceramide-induced cell death was apoptosis. Application of HGF
      rapidly induced the expression of COX-2, and HGF prevented the apoptotic cell
      death induced by C2-ceramide. However, the anti-apoptotic action of HGF was
      antagonized by coapplication of NS-398, a selective inhibitor of COX-2. Thus,
      these results indicate that COX-2 is involved in the survival signaling from HGF
      in gastric epithelial cells, and suggest a role for physiologically-induced COX-2
      in the protection of the cells from apoptosis.

PMID- 11197752
TI  - A single neuron response to photodynamic effect of various aluminum and zinc
      phthalocyanines.
AB  - The photodynamic effects of sulphonated zinc and aluminum phthalocyanine
      derivatives as well as phosphonated aluminum phthalOcyanine on the firing of
      isolated crayfish mechanoreceptor neurons were studied. After 30 min staining
      neurons were irradiated with He-Ne laser (632.8 nm, 0.3 W/cm2) and changes in
      neuron firing frequency were recorded. Neuron firing was found to be very
      sensitive to photodynamic effect and could serve as a sensitive indicator of cell
      photodamage. It changed the firing level and then died at nanomolar
      concentrations of phthalocyanines. The dynamics of the neuron responses to
      photodynamic effects included stages of firing activation and/or inhibition prior
      to irreversible firing abolition. The order of these stages depended on
      photosensitizer type and concentration. The comparison of the dependencies of
      neuron lifetime on photosensitizer concentrations showed ZnPcS2 to be the most
      effective photosensitizer.

PMID- 11197753
TI  - Troglitazone has no effect on K(ATP) channel opener induced-relaxations in rat
      aorta and in human saphenous veins from patients with type 2 diabetes.
AB  - Troglitazone, a thiazolidinedione derivative, is an oral antidiabetic agent that
      enhances insulin sensitivity in insulin-resistant states. K(ATP) channels, on the
      other hand, have important roles protecting cardiovascular system in ischemic
      and/or hypoxic states. They are also important in the control of vascular tone,
      and therefore of blood pressure. We tested whether troglitazone can directly
      affect vascular K(ATP) channel opener-induced relaxations in vitro. 1, 10 or 100
      microM troglitazone incubations for 30 min did not alter cromakalim (a K(ATP)
      channel opener)--induced relaxations in endothelium-denuded aortas from rat,
      saphenous veins from type 2 diabetic and nondiabetic patients. In addition, we
      compared the sensitivity to cromakalim in diabetic saphenous veins with that of
      nondiabetic veins. The concentration-response curve for cromakalim was shifted to
      the right in diabetic vein. pD2 values for cromakalim were 6.85+/-0.08 vs. 6.61+/
      0.04 (p<0.05) in nondiabetic (n:10) and diabetic (n:7) veins respectively. %
      maximum response of cromakalim was also significantly decreased by 24+/-3% in
      diabetic veins. However, responsiveness of veins to phenylephrine or sodium
      nitroprusside were similar in both groups. The results obtained may be clinically
      useful 1. suggesting that in ischaemic and/or hypoxic insults troglitazone may
      not worsen vascular dilatation, through K(ATP) channel, in diabetic patients who
      are more prone to these conditions than healthy people, 2. providing an evidence
      that diabetes causes an impaired dilatation of human saphenous vein through
      K(ATP) channels. This may partly be related with diabetes-induced vascular
      complications, such as vasospasm and even hypertension. Accordingly, since
      saphenous veins are used as conduit vessels in coronary by-pass graft surgery,
      the results also suggest that the defective dilatation through K(ATP) channels
      may play a role on the performance of saphenous vein grafts in type 2 diabetes.

PMID- 11197754
TI  - Gender differences of exploratory eye movements: a life span study.
AB  - Exploratory eye movements of normal subjects (39 male and 39 female) were
      recorded using an eye-mark recorder. Four parameters mean gazing time, total
      number of gazing points, mean scanning length, and total scanning length) were
      analyzed. Subjects were divided into three life spans as prepuberty (boys and
      girls), adult, and postpuberty. The mean gazing time of adult women was
      significantly longer than that of age-matched adult men, but not between men and
      women in prepuberty or postpuberty (postmenopausal older women and age-matched
      older men). The total number of gazing points of women was significantly smaller
      than that of men, but not significantly different between men and women in both
      prepuberty and postpuberty. Both the mean scanning length and total scanning
      length of adult women were shorter than those of age matched adult men, but no
      significant differences were found between men and women in both prepuberty and
      postpuberty. Furthermore, the mean gazing time of adult women was longer than
      that of men in prepuberty and postpuberty. The total scanning length of adult men
      was longer than that of women in both prepuberty and postpuberty. These findings
      suggest that gender differences of exploratory eye movements are observed only
      during the adult phase, which indicates that visual information processing may be
      regulated by gonadal hormones in humans.

PMID- 11197755
TI  - Contribution of diet to the dosing time-dependent change of vitamin D3-induced
      hypercalcemia in rats.
AB  - We have recently reported that the degree of hypercalcemia as an adverse effect
      induced by a single large-dose of active vitamin D3 varied with its dosing time
      without alteration in therapeutic effect for secondary hyperparathyroidism in
      patients with chronic renal failure. The present study was conducted to elucidate
      an effect of intestinal calcium (Ca) absorption on the chronopharmacological
      profiles of vitamin D3. 1, 25-dihydroxy-cholecalciferol (D3, 2 microg/kg) or
      vehicle alone was orally administered at two different times (2 and 14 hours
      after lights on; HALO) to male Wistar rats (n= 10) kept in rooms with a 12 h
      light-dark cycle. Blood samples for serum Ca concentration were taken before and
      3, 6, 9, and 12 hours after the administration. Urine was collected for 6 hours
      after dosing. An identical protocol was repeated using the same animals after 16
      hours fasting by a cross-over fashion. Under free-fed condition, basal
      concentration of serum Ca was higher at a resting period (lights on) than during
      an active period (lights off). Serum Ca reached its peak at 6 hours after dosing
      in both timings, while the value was significantly higher in the 2 HALO trial
      than in the 14 HALO trial. Area under the serum Ca concentration-time curve from
      0 to 12 hours (AUC0-12h) and urinary excretion of Ca for 6 hours were also
      significantly higher in the 2 HALO trial than in the 14 HALO trial. When fasted,
      basal Ca concentration was reduced compared with the free-fed condition, while
      the daily variation was maintained. Serum Ca concentration profiles from 3 to 12
      hours after dosing were not significantly different between the 2 HALO and 14
      HALO trials. The AUC0-12h of serum Ca or its urinary excretion was not different
      between both trials. Serum concentrations of parathyroid hormone and total
      protein, measured before and 6 hours after the dosing were not affected by the
      dosing schedule. We have concluded that intestinal Ca absorption is a major
      factor for the chronopharmacological phenomenon of D3-induced hypercalcemia in
      intact rats, while intestinal and renal involvement may be relatively small in
      the mechanism of the intrinsic diurnal variation of serum Ca.

PMID- 11197756
TI  - Immediate effects of the serotonin antagonist granisetron on temporomandibular
      joint pain in patients with systemic inflammatory disorders.
AB  - The aim of this study was to investigate if the 5-HT3 antagonist granisetron
      reduces temporomandibular joint (TMJ) pain in patients with systemic inflammatory
      joint disorders. Sixteen patients with systemic inflammatory joint disease with
      pain localized over the TMJ region and tenderness to digital palpation of the TMJ
      were included. The current resting pain (VASRest) and the pain during maximum
      mouth opening (VAS(MVM)) of the TMJs were assessed with a 100 mm visual analogue
      scale. An electronic pressure algometer was used to estimate the pressure pain
      threshold (PPT) over the lateral aspect of the TMJ. Venous blood was collected
      for measurement of the plasma and serum levels of 5-HT, erythrocyte sedimentation
      rate, rheumatoid factor and C-reactive protein. The selective 5-HT3 receptor
      antagonist granisetron or saline were injected into the posterior part of the
      upper TMJ compartment in a randomized double-blind manner. The patients in the
      granisetron group had lower VASRest than the patients in the saline group after
      10 min. In the granisetron group, VASRest was decreased after 10 min, while
      VAS(MVM) was decreased and PPT increased after 20 min. In the saline group,
      VAS(MVM) was decreased after 20 min. In conclusion, granisetron has an immediate,
      short-lasting and specific pain reducing effect in TMJ inflammatory arthritis.
      The 5-HT3 receptor may therefore be involved in the mediation of TMJ pain in
      systemic inflammatory joint disorders.

PMID- 11197757
TI  - Characterization of three genes encoding enzymes of the folate biosynthetic
      pathway in Plasmodium falciparum.
AB  - Although the folate metabolic pathway in malaria parasites is a major
      chemotherapeutic target, resistance to currently available antifolate drugs is an
      increasing problem. This pathway, however, includes a number of enzymes that, to
      date, have not been characterized despite their potential for clinical
      exploitation. As a step towards evaluation of additional targets in this pathway,
      we report the isolation and characterization of 3 new genes that encode
      homologues of GTP cyclohydrolase I (GTP-CH), dihydrofolate
      synthase/folylpolyglutamate synthase (DHFS/FPGS) and serine
      hydroxymethyltransferase (SHMT). The genes encoding GTP-CH and SHMT are
      unambiguously assigned to chromosome 12, while that for DHFS/FPGS is tentatively
      assigned to chromosome 13. All 3 genes are expressed in blood-stage parasites,
      yielding transcripts of which only ca 60-70% is accounted for by coding sequence.
      All 3 of the proteins predicted to be encoded by these genes display sequence
      differences compared to the human host homologues that may be of functional
      significance. These data bring the complement of cloned genes that encode
      activities in the pathway to seven, leaving only the gene encoding
      dihydroneopterin aldolase (DHNA) to be identified in the route from GTP to folate
      synthesis and folate turnover in the thymidylate cycle.

PMID- 11197758
TI  - The effect of anthelmintic treatment on helminth infection and anaemia.
AB  - A 24-week randomized double blind intervention trial was conducted on adult
      female tea pluckers from an estate in Bangladesh to investigate the impact of
      iron supplementation and anthelmintic treatment on changes in ferritin and
      haemoglobin levels as well as on prevalence and intensity of helminth infections.
      A total of 553 women were randomly assigned to 1 of 4 intervention groups: group
      1 received iron supplementation on a weekly basis, group 2 received anthelmintic
      treatment at the beginning and half way through the trial, group 3 received both
      iron supplementation as group 1 and anthelmintic treatment as group 2, and group
      4 was a control group and received placebos for both iron supplementation and
      anthelmintic treatment. Prevalence and intensity of helminth infections (egg
      counts/g stool) of Ascaris lumbricoides, Trichuris trichiura and hookworms
      significantly fell in the 2 groups receiving anthelmintic treatment and there
      were some reductions in the 2 groups not receiving anthelminthic treatment.
      Haemoglobin and haematocrit concentrations increased significantly in the iron
      supplemented groups with smaller increases in the anthelmintic only group. All
      women showed a decrease in serum ferritin levels post-trial with greater losses
      in the 2 dewormed groups. Significant negative associations were found between
      hookworm egg counts and ferritin levels and Trichuris trichiura egg counts and
      haemoglobin concentration.

PMID- 11197759
TI  - Cuticle heterogeneity as exhibited by Pasteuria spore attachment is not linked to
      the phylogeny of parthenogenetic root-knot nematodes (Meloidogyne spp.).
AB  - The cuticle is a major barrier prohibiting the infection of nematodes against
      micro-organisms. The attachment of bacterial spores of the nematode hyperparasite
      Pasteuria penetrans (PP1) to field populations of root-knot nematodes (RKN,
      Meloidogyne spp.) from Burkino Faso, Ecuador, Greece, Malawi, Senegal and
      Trinidad and Tobago were assayed in standard attachment tests. The attachment of
      spore population PP1 to different field populations of root-knot nematode showed
      that the rates of attachment differed between countries. Similar tests were also
      undertaken on P. penetrans spores from these countries against 2 species of RKN,
      M. incognita and M. arenaria. The results showed a high degree of variability in
      spore attachment with no clear distinction between the 2 species of nematode. It
      has been hypothesized that Pasteuria spore attachment is linked to nematode
      species designations and this study clearly shows that this is not the case.
      Further tests showed that variation in spore attachment was not linked to
      nematode phylogeny. The results therefore beg the question of how do
      parthenogenetic root-knot nematodes maintain cuticle variability in the face of
      such an aggressive hyperparasite.

PMID- 11197760
TI  - Membrane localization and demonstration of isoforms of nucleoside triphosphate
      hydrolase from Toxoplasma gondii.
AB  - Toxoplasma gondii has a unique enzyme, a NTPase, which has a wide specificity
      toward NTP. In the present study, we produced a monoclonal antibody (IgG1, 6C6)
      against the enzyme which could recognize NTPase isozymes among several strains of
      T. gondii. Three avirulent strains of T. gondii, ME49, Beverley and Nakayama,
      were found to have 1 NTPase (63 kDa, pI 6.0), while a virulent strain RH and an
      avirulent strain Fukaya had 2 isozymes (63 kDa) with different pIs (pIs 6.0 and
      6.5 for the former, and pIs 6.2 and 6.4 for the latter, respectively), suggesting
      that this monoclonal antibody recognizes a common epitope of NTPase among T.
      gondii strains. Furthermore, 6C6 could inhibit NTPase activity in the presence of
      dithiothreitol in a dose-dependent manner, and immuno-EM study of NTPase revealed
      that this molecule is located on the surface membrane of T. gondii tachyzoites.
      When Vero cells were co-cultured with tachyzoites pre-treated with 6C6, the
      number of infected cells significantly decreased, suggesting that 6C6 inhibits
      invasion of the parasites to host cells. These data suggest that the molecule
      recognized by 6C6 might be considered a potential candidate antigen for vaccines
      against T. gondii tachyzoites.

PMID- 11197761
TI  - Gp63 gene polymorphism and population structure of Leishmania donovani complex:
      influence of the host selection pressure?
AB  - The gp63 encoding genes were characterized by PCR-RFLP in 35 isolates
      representative of the Leishmania donovani complex (L. infantum, L. donovani, L.
      archibaldi and L. chagasi), with special attention to Mediterranean L. infantum
      from different geographical origins, and in separate groups from Old World
      Leishmania (L. major, L. tropica and L. aethiopica). The aim was to evaluate how
      the possible selective pressure by the host on these important surface proteins
      would influence structuring of our sample. Comparison was carried out with the
      structure obtained (i) from reported isoenzyme data, characters supposed to vary
      neutrally, and (ii) from PCR-RFLP analysis of gp63 inter-genic regions,
      containing nontranslated spacers and regulatory genes. Polymorphism within the
      gp63-encoding region, was much higher than in gp63 inter-genic regions. In the
      gp63 intra-genic dendrogram, the 4 species of L. donovani complex were
      discriminated and quite distinct from outgroups. Within L. infantum, geographical
      structuring was observed and did not overlap with the structure built-up from
      isoenzymes and inter-genic data. These results support the idea of a strong host
      selection on gp63, at vector level but most of all at vertebrate (human or dog)
      immunological level. Furthermore, they illustrate how the nature of genetic
      characters may influence the perception of population structuring.

PMID- 11197762
TI  - Species-specific antigens in salivary glands of phlebotomine sandflies.
AB  - Saliva inoculated by sandfly females during feeding stimulated production of high
      levels of anti-saliva antibodies. To determine whether 3 species of the genus
      Phlebotomus have species-specific salivary antigens we performed dot-blots and
      immunoblots using sera from mice, hamsters and rabbits repeatedly bitten by
      sandflies. Important differences were found in the antigen components of the
      salivary gland lysates (SGL) of Phlebotomus papatasi, P. perniciosus and P.
      halepensis. In total 4-9 species-specific antigens were detected in each species
      by immunoblotting. Cross-reactivity was not detected between P. papatasi and the
      other species tested; in the SGL of P. papatasi sera from animals bitten by this
      species recognized 5-7 major antigens while sera from animals bitten by other
      species did not react. A weak cross-reaction was observed between P. perniciosus
      and P. halepensis; in SGL from P. perliciosus, the sera from rabbits and hamsters
      bitten by this species recognized about 8 intense bands while sera from animals
      bitten by P. halepensis reacted weakly with up to 4 saliva polypeptides.

PMID- 11197763
TI  - Factors affecting the component community structure of haemoparasites in bank
      voles (Clethrionomys glareolus) from the Mazury Lake District region of Poland.
AB  - The prevalence and abundance of infections with haemoparasites were studied over
      a 3 year period in Clethrionomys glareolus (bank vole, n = 420) sampled from
      forests in the NE of Poland. Total species richness was 5 (Prevalence =
      Haemobartonella sp. 63.1%, Bartonella grahamii 27.4%, Hepatozoon erhardovae
      31.4%, Trypanosoma evotomys 15% and Babesia microti 1.0%) with 81.9% of the voles
      carrying at least 1 species and a mean infracommunity species richness of 1.4.
      Variation in species richness was determined primarily by season and year, and
      the interaction of these factors. The observed frequency distribution of
      infracommunity species richness did not differ from that predicted by a null
      model, suggesting that there were no marked associations between the species.
      Analyses of prevalence and abundance of infection with each species in turn,
      revealed that overall the principal causes of variation were temporal and
      seasonal and their interaction, intrinsic factors such as age and sex playing
      only a minor role. However, the relative importance of specific extrinsic, and
      rarely intrinsic, factors varied and was distinct for each of the species in the
      study. Prevalence data revealed 4 sets of 2-way associations between species,
      mostly varyingly dependent on combinations of intrinsic and extrinsic factors.
      Analysis of quantitative associations suggested 4 sets of positive 2-way
      interactions, 3 of which remained after controlling for the effect of extrinsic
      and intrinsic factors on the abundance of each species, but only one could be
      unequivocally accepted (Haemobartonella sp. +B. grahamii) after correction for
      multiple comparisons. These data are discussed in the context of the changing
      ecological profiles in this region of Eastern Europe and, in a wider context, in
      relation to current understanding of the factors which shape component community
      structures of haemoparasites in wild rodents.

PMID- 11197764
TI  - Myxosporidia and macrophage centres in chub (Leuciscus cephalus)--quantitative
      interactions focus on Myxobolus cyprini.
AB  - Six myxosporidian species were found in chub (Leuciscus cephalus) originating
      from Lower Austrian rivers. The frequency of the parasites and their localization
      was recorded. In all chub, independent of size and origin, Myxobolus cyprini
      occurred predominantly in the macrophage centres (MCs) of the haematopoietic
      organs, spleen and kidney. Exclusively in the head kidney of young fish not yet
      described vermicular plasmodia containing spores of M. cyprini were found. In
      muscle tissue the prevalence of M. cyprini was comparatively low. Other species
      of Myxobolus characterized by plasmodial cysts frequently occurred in gills and
      swimbladder but were rarely detected, and only in small numbers, in the
      haematopoietic organs. The number of M. cyprini spores and the relative volume of
      MCs in the haematopoietic organs were estimated in order to examine possible
      correlations. Significant interrelated changes were found only in juvenile fish
      up to a size of 15 cm. In bigger fish, the number and size of macrophage
      aggregates were highly variable and independent of infection intensity and fish
      size, but the number of spores never exceeded that of the aggregated macrophages.
      The data suggest that due to an early date of infection M. cyprini is the only
      species which is closely associated with macrophage aggregation.

PMID- 11197765
TI  - Praziquantel-induced tegumental damage in vitro is diminished in schistosomes
      derived from praziquantel-resistant infections.
AB  - The aggressive use of praziquantel to combat schistosomiasis in Egpyt raises
      concern about the possible emergence of resistance. Eggs from Egyptian patients
      with praziquantel-resistant infections (not cured by 3 doses of praziquantel)
      have been used to establish infection-specific schistosome isolates in mice. The
      response of these worms to the drug was observed in vitro, in order to determine
      if the isolates obtained from these resistant infections were, in fact, less
      responsive to praziquantel. One of the hallmark effects of praziquantel on
      schistosomes in vitro is a disruption of the worm's outer surface, the tegument.
      Here, praziquantel-induced tegumental damage is observed in 3 distinct isolates,
      2 derived from resistant infections and 1 from an infection cured by a single
      dose. The isolates from the resistant infections were less susceptible to
      praziquantel-induced tegumental damage in vitro, suggesting that the worms are in
      some way less responsive to the drug.

PMID- 11197766
TI  - The Schistosoma mansoni host-interactive tegument forms from vesicle eruptions of
      a cyton network.
AB  - During trans-dermal invasion of the vertebrate host, larval schistosomes
      (cercariae) transform into schistosomula and become enveloped by a double lipid
      bilayered, tegumental membrane. The glucose transporter protein SGTP4 is found
      exclusively in these host-interactive tegumental membranes and in membranous
      vesicles proposed to be their precursor. In this study, we monitored the
      appearance and migration of this tegumental marker protein during larval
      transformation to test the current model of tegumental membrane biosynthesis in
      parasitic blood flukes. Only minutes after transformation was initiated, SGTP4
      began accumulating in a previously unrecognized, bilaterally symmetrical, 'cyton
      network' beneath the peripheral muscle. Approximately 30 min after the initiation
      of transformation the marker protein was seen in tubules connecting the network
      to the surface and erupting onto the surface in discrete patches. After I h the
      patches were regularly arrayed over the schistosomula body and began to cover the
      anterior organ. By 3 h the staining has largely resolved into a contiguous layer
      of fluorescence covering most of the worm surface. These findings confirm earlier
      suggestions, based on electron microscopy, that the parasite's surface tegumental
      membranes are derived from the migration of membranous vesicles produced within
      cytons and reveal a new subtegumental architecture interconnecting the cytons.

PMID- 11197767
TI  - Toxicity of cadmium and zinc to encystment and in vitro excystment of Parorchis
      acanthus (Digenea: Philophthalmidae).
AB  - The toxicity of cadmium, zinc and cadmium/zinc mixtures at concentrations ranging
      from 1000 to 50000 microg/l were investigated against cercariae and metacercariae
      of Parorchis acanthus obtained from the dog whelk Nucella lapillus. Cercarial
      encystment at concentrations of 25000 microg/l or higher was significantly
      impaired by all test metals; however, at lower concentrations only zinc
      demonstrated toxicity. Mixtures of cadmium and zinc had a synergistic effect
      compared with single metal toxicity but only at 50000 microg/l. Excystment in
      vitro was only significantly affected by cercariae exposed to cadmium/zinc
      mixtures whilst encysting. Twenty-four h exposures of fully formed cysts had no
      effect on excystment in vitro. Effects on in vitro excystment rates over a 2 h
      period demonstrated widespread effects for cercariae-exposed P. acanthus. No
      effects were evident on excystment rates of cyst-exposed parasites.

PMID- 11197768
TI  - Toxicity of cadmium and zinc to miracidia of Schistosoma mansoni.
AB  - The specific objectives of this study were to elucidate metal toxicity to
      hatching, survival and avoidance behaviour of Schistosoma mansoni miracidia. The
      toxicity of cadmium, zinc, and cadmium/zinc mixtures at concentrations ranging
      from 10000 to 10 microg/l was investigated. Metal mixture toxicity investigation
      was undertaken with equal concentrations of the metals. The hatching of miracidia
      from eggs was inhibited by concentrations of 1000-10000 microg/l of single
      metals. Metal mixtures had no effect on egg hatching. Survival of miracidia was
      reduced by increasing metal concentration except at concentrations of 10 microg/l
      for single metal toxicity where survival was increased above the control.
      Miracidia demonstrated a rapid avoidance behaviour when briefly exposed to heavy
      metals. The mechanisms of metal toxicity to miracidia are briefly discussed.

PMID- 11197769
TI  - Distribution of nitric oxide synthase immunoreactivity in the nervous system and
      peripheral tissues of Schistosoma mansoni.
AB  - The distribution of nitric oxide synthase (NOS) immunoreactivity and putative NOS
      activity in adult Schistosoma mansoni was analysed using 3 different types of NOS
      antibodies and NADPH-diaphorase histochemistry. Although potential involvement of
      the gaseous radical nitric oxide (NO) in host response to infection by
      schistosomes has been suggested, there is little or no information available
      regarding the role, or even the presence, of the NO pathway in schistosomes
      themselves. Here, we demonstrate that antibodies against neuronal NOS (nNOS) and
      inducible NOS (iNOS) isoforms stain adult worms with distinctive patterns; anti
      endothelial NOS (eNOS) shows no selective labelling. nNOS-like immunoreactivity
      is found in the main nerve cords and the peripheral nervous system. Putative
      sensory neurons with apical neuronal processes leading to the tegument of male
      worms are also immunoreactive for nNOS. Anti-iNOS labels a variety of
      predominantly non-neuronal tissues, showing intense labelling at or near the
      surface of the worm and in components of the gastrointestinal tract. The
      distribution of NADPH-diaphorase reactivity (a histochemical marker of NOS), is
      generally similar to the pattern of NOS immunoreactivity, including labelling of
      neuronal-like cells as well as developing eggs. These results suggest that an NOS
      like enzyme is present in S. mansoni, and indicate potential roles for the
      different NOS isoforms in neuronal signalling, reproduction and development.

PMID- 11197770
TI  - A phylogenetic analysis of filarial nematodes: comparison with the phylogeny of
      Wolbachia endosymbionts.
AB  - Infection with the endosymbiotic bacteria Wolbachia is widespread in filarial
      nematodes. Previous studies have suggested concordance between the phylogeny of
      Wolbachia with that of their nematode hosts. However, there is only one published
      molecular phylogenetic study of filarial species, based on the 5S rRNA gene
      spacer. The phylogeny proposed by this study is partially incongruent with
      previous classifications of filarial nematodes, based on morphological
      characters. Furthermore, both traditional classifications and molecular
      phylogenies are, in part, inconsistent with the phylogeny of Wolbachia. Here we
      report mitochondrial cytochrome oxidase I (COI) gene sequences for 11 species of
      filaria and for another spirurid nematode which was included as an outgroup. In
      addition, 16S rRNA, wsp and ftsZ gene sequences were generated for the Wolbachia
      of several filarial species, in order to complete the available data sets and
      further resolve the phylogeny of Wolbachia in nematodes. We used these data to
      evaluate whether nematode and Wolbachia phylogenies are concordant. Some of the
      possible phylogenetic reconstructions based on COI gene were congruent with the
      phylogeny of Wolbachia and supported the grouping of the rodent filaria
      Litomosoides sigmodontis with the lymphatic filariae (i.e. Brugia spp. and
      Wuchereria spp.) and the sister group relationship of Dirofilaria spp. and
      Onchocerca spp. However, the placement of the Wolbachia-free filaria
      Acanthocheilonema viteae is ambiguous and dependent on the phylogenetic methods
      used.

PMID- 11197771
TI  - [An approach to early genetic alterations in precancerous cells].
AB  - To investigate the potential role of the PTEN tumor-suppressor gene in the
      carcinogenesis of ovarian endometrioid carcinoma and its related subtype, clear
      cell carcinoma, we examined 20 ovarian endometrioid carcinomas, 24 clear cell
      carcinomas and 34 solitary endometrial cysts of the ovary for LOH at 10q23.3 and
      point mutations of the PTEN gene, using a laser-assisted microdissection method.
      LOH was found in 8 of 19 ovarian endometrioid carcinomas (42.1%), 6 of 22 clear
      cell carcinomas (27.3%) and 13 of 23 solitary endometrial cysts (56.5%). Somatic
      mutations in the PTEN gene were identified in 4 of 20 ovarian endometrioid
      carcinomas (20.0%), 2 of 24 clear cell carcinomas (8.3%) and 7 of 34 solitary
      endometrial cysts (20.6%). In 5 endometrioid carcinomas with endometriosis, 3
      displayed LOH events common to both the carcinoma and the endometriosis. In 7
      clear cell carcinomas with endometriosis, 3 displayed LOH events common to both
      the carcinoma and the endometriosis. In no cases there were LOH events in the
      endometriosis only. These results indicate that inactivation of the PTEN gene is
      an early event in the development of both endometrioid and clear cell carcinoma
      of the ovary. A laser-assisted microdissection method enables us to collect
      target cells without contamination by non-tumor cells. We expect that this
      technique will be very useful for investigating genetic alterations in cancerous
      or precancerous lesions. Early genetic alterations in various precancerous cells
      detected by light microscopy can be readily identified by the tissue
      microdissection method.

PMID- 11197772
TI  - [Comparative genomic hybridization for analysis of chromosomal changes in
      cisplatin-resistant ovarian cancer].
AB  - In our attempt to find characteristic genetic changes in resistant tumors, we
      screened the whole genome for gene aberrations in 28 primary ovarian cancers,
      using the comparative genomic hybridization (CGH) method. These cancers included
      14 tumors from patients who did not respond to cisplatin-based combination
      chemotherapy in comparison with 14 tumors from patients who completely responded
      to the chemotherapy. We found gains in chromosomal region 1q21-q22 and 13q12-q14
      to be related to the drug-resistant phenotype in ovarian cancer patients. Several
      genes encoding transcription factors, oncogenes, cell cycle regulators and
      regulators of the apoptotic pathway are found to be located on these regions of
      the chromosomes, and these genes are potential modulators for toxic insults in
      cancer cells. This is the first report that shows the relationship between
      certain genomic aberrations and clinical resistance for cisplatin-based
      chemotherapy in ovarian cancer patients based on the CGH analysis. Present
      findings suggest that these chromosomal gains may be potential indicators for
      prediction of resistance in ovarian cancer patients prior to cisplatin-based
      chemotherapy.

PMID- 11197773
TI  - Immunohistochemical estimation of in-situ cell cycle time in neoplastic
      epithelial cells in human large intestine: a new cell proliferation index.
AB  - In-situ cell cycle time (in-situ Tc) of epithelial cells could be estimated by
      using a formula; in-situ Tc = cell proliferation rate divided by mitosis rate, on
      a scale of Tm (cell cycle time in M phase) arbitrary unit (AU), In order to see
      the nature of in-situ Tc in the adenoma-carcinoma sequence in the human large
      intestine, the in-situ Tc in 27 cases of adenoma and 71 cases of adenocarcinoma
      with adenoma components in the human large intestine was estimated by using this
      formula, counting proliferating cells and mitotic cells in the
      immunohistochemistry of Ki-67 antigen. C12 antigen was examined as an oncogenic
      progression indicator in the adenoma-carcinoma sequence. The in-situ Tc tended to
      shorten in adenoma in accordance with the histological grading of atypia but not
      in adenoma component. No significant differences in the in-situ Tc was recognized
      as a whole among adenomas, adenoma components and adenocarcinomas in the mucosa,
      whereas the in-situ Tc of adenoma components with moderate to severe atypia was
      significantly longer than that of adenocarcinomas in the mucosa (p = 0.05). The
      in-situ Tc lengthened in adenocarcinomas invading the submucosa and shortened in
      adenocarcinomas invading the proper muscular layer. The cases expressing the C12
      antigen increased in order of adenoma, adenoma component and adenocarcinoma. The
      cases expressing the C12 antigen indicated short in situ Tc in the adenomas and
      adenocarcinomas but not in the adenoma components. Thus, the estimated in-situ Tc
      is a useful index of the oncogenetic progression, which is different from that
      detected by the C12 antigen.

PMID- 11197774
TI  - Direct effect of danazol on endometrial hyperplasia in adenomyotic women:
      treatment with danazol containing intrauterine device.
AB  - It is well known that danazol has a direct effect on endometriosis tissue and
      cell. We have been treating adenomyotic women with danazol containing
      intrauterine device (D-IUD) from June 1993 to August 2000 and significant
      decrease of dysmenorrhea and serum CA-125 levels were observed. Of fifty-nine
      adenomyotic women, eight women were also diagnosed by endometrial biopsy as
      endometrial hyperplasia and one woman was diagnosed as atypical endometrial
      hyperplasia. In these endometrial hyperplastic patients, endometrial tissues were
      obtained before insertion and at the time of removal or exchange of D-IUD and
      examined pathologically. In all of the 9 women, histopathological findings of
      endometrial hyperplasia disappeared after D-IUD treatment. In particular, in one
      patient, findings of atypical endometrial hyperplasia also disappeared after D
      IUD treatment. She is now closely observed at our clinic using D-IUD. By these
      evidences, we postulate that D-IUD is one of the treatment choices of endometrial
      hyperplasia given exposure of the endometrium to such an extraordinary high
      concentration of danazol released by D-IUD and avoidance of adverse effects of
      oral danazol or general administration of GnRH and progesterone. In particular,
      in atypical endometrial hyperplasia case, its mechanisms might give great benefit
      to patient. However, mechanisms of direct effect of danazol on endometrial
      hyperplasia remain to be elucidated in the future study.

PMID- 11197775
TI  - Genome-wide profiling of gene amplification and deletion in cancer.
AB  - Accumulations of genetic changes in somatic cells induce phenotypic
      transformations leading to cancer. Among these genetic changes, gene
      amplification and deletion are most frequently observed in several kinds of
      cancers. Amplification of oncogene and/or deletion of tumor suppressor gene,
      together with dysfunction of the gene by point mutation, are the main causes of
      cancer. Genome-wide analysis of amplification and deletion of genes in cancers is
      basic to resolving the mechanisms of carcinogenesis. Comparative genomic
      hybridization (CGH) developed in 1992 has been utilized to identify DNA copy
      number abnormalities in various kind of cancers and several reports have shown
      its usefulness in screening of the genes involved in carcinogenesis, and also in
      the identification of prognostic factors in cancer. We have shown that 1q23 gain
      is associated with neuroblastomas that are resistant to aggressive treatment, and
      have poor prognosis, and 1q and 13q gains are possibly related to drug resistance
      in ovarian cancers. Recently, the "rough draft" of the human genome was reported
      and we are ready to utilize the vast information on genomic sequences in cancer
      research. Moreover, microarray technology enables us to analyze more than ten
      thousand genes at a time and revealed genetic abnormalities in cancers at a
      genome-wide level. By combination of microarray and CGH, a powerful screening
      method for oncogenes and tumor suppressor genes in cancers, called array-CGH, has
      been developed by several groups. In this article, we overview these genome-wide
      analytical methods, CGH and array-CGH, and discuss their potential in molecular
      characterization of cancers.

PMID- 11197776
TI  - Gastrointestinal tumorigenesis in Smad4 (Dpc4) mutant mice.
AB  - The SMAD4 (Dpc4) gene plays a key role in the TGF-beta signaling pathway. We
      recently inactivated the mouse homolog Smad4. The homozygous mutants were
      embryonic lethals, whereas the heterozygotes were viable and fertile. Although
      young heterozygotes were normal, old mice developed gastric and duodenal polyps
      similar to those found in human juvenile polyps characterized by abundant stroma
      and eosinophilic infiltrations. These data are consistent with the reports that a
      subset of human juvenile polyposis kindreds carry germline mutations in the SMAD4
      gene. We then introduced the Smad4 mutation into the Apc delta 716 knockout mice,
      a model for human familial adenomatous polyposis. Because both Apc and Smad4 are
      located on mouse chromosome 18, we constructed by meiotic recombination, compound
      heterozygotes carrying both mutations on the same chromosome. In such mice,
      intestinal polyps developed into more malignant tumors than those in the simple
      Apc delta 716 heterozygotes, showing an extensive stromal cell proliferation and
      strong submucosal invasion. These results indicate that mutations in SMAD4 play a
      significant role in the malignant progression of colorectal tumors.

PMID- 11197777
TI  - [Transforming growth factor-beta signaling and cancer].
AB  - Transforming growth factor-beta (TGF-beta) is a multifunctional cytokine that
      inhibits the growth of most types of cells and induces fibrosis of various
      tissues. TGF-beta binds to two different types of serine/threonine kinase
      receptors, and activate Smad proteins. Perturbation of the TGF-beta signaling
      pathway results in tumorigenesis of various tissues. TGF-beta/Smad signaling is
      regulated by several regulatory proteins, including inhibitory Smads and
      transcriptional corepressors. Abnormalities in these negative regulators of TGF
      beta signaling may also involved in tumorigenesis of certain tissues.

PMID- 11197778
TI  - Antibiotic therapy of enteric fever.

PMID- 11197779
TI  - Potential mechanisms of hypothyroidism-induced hyponatremia.

PMID- 11197780
TI  - KL-6 as a serum marker for amiodarone-induced pulmonary toxicity.

PMID- 11197781
TI  - Parkinsonism in a patient with AIDS.

PMID- 11197782
TI  - Re-analysis of clinical features of 89 patients with autoimmune hepatitis using
      the revised scoring system proposed by the International Autoimmune Hepatitis
      Group.
AB  - OBJECTIVE: The diagnostic criteria of autoimmune hepatitis (AIH) were recently
      modified by the International Autoimmune Hepatitis Group. This study was
      performed to assess the impact of the revised scoring system on the diagnosis of
      AIH. PATIENTS AND METHODS: We re-analyzed the clinical features of 89 patients
      diagnosed as AIH in Nagasaki Prefecture, Japan, using the revised scoring system,
      and compared the scores and final diagnosis with our previously published results
      using the original system. RESULTS: Of the 89 patients with AIH, 40 (45%) were
      classified using the new system as "definite" AIH, 41 (46%) as "probable" AIH,
      and 8 (9%) patients were categorized as "others". Of these, 37 (42%), 35 (39%),
      and 4 (4%) patients who were classified as "definite", "probable", and "others"
      by the original system remained in the same category by the revised system,
      respectively. However, 3, 4, and 6 patients were re-categorized as "definite"
      from "probable", "others" from "probable", and "probable" from "definite",
      respectively. The difference in aggregate scores between the above two systems
      ranged from -5 to +2. The main contributing factors to the changes in aggregate
      AIH score were "other autoimmune disease(s)" and "interface hepatitis without
      lobular involvement and bridging necrosis on liver histology". However, the main
      contributing factors to the demotions from "definite" to "probable" and form
      "probable" to "others" were those related to the characteristics of biliary
      diseases, i.e., antimitochondrial antibody positive, biliary changes in liver
      histology, and alkaline phosphatase: aspartate aminotransferase ratio between 1.5
      and 3.0. Moreover, two patients who had no histological evidence of AIH were both
      re-categorized as "others" from "probable" AIH. CONCLUSION: Our results indicated
      that the diagnosis, whether based on the revised or original system, was the same
      in the majority of AIH patients, but the revised scoring system excluded cases
      who had features suggestive of biliary diseases from "definite" AIH, and also
      confirmed that a diagnosis of "definite" AIH should not be made without liver
      histology.

PMID- 11197783
TI  - Depressor effect by exercise training is associated with amelioration of
      hyperinsulinemia and sympathetic overactivity.
AB  - OBJECTIVE: In hypertensive subjects, exercise training is a therapeutic modality
      that not only lowers blood pressure but also corrects metabolic abnormality, such
      as hyperinsulinemia. Insulin causes sympatho-excitation via the modification of
      baroreflex, norepinephrine release, or central sympathetic outflow. However, the
      link between neural and metabolic changes by exercise training in hypertensive
      patients remains unknown. The aim of this study was to examine whether or not the
      blood pressure lowering effect of exercise training is associated with the
      improvement of insulin sensitivity in conjunction with the inhibition of
      sympathetic tone in hypertensive patients. METHODS: We evaluated plasma insulin
      levels, arterial baroreflex function and humoral parameters before and after
      exercise training. Twenty-nine patients with essential hypertension under
      hospitalization participated in the study. Before and after three weeks of
      exercise training (75% max VO2, 6 min, q.i.d.), 24-hour blood pressure
      recordings, arterial baroreflex function testing and 75 g glucose tolerance tests
      were conducted. Area under the curve of insulin (sigma insulin) to glucose load
      was calculated as an index of hyperinsulinemia. RESULTS: Three weeks of exercise
      training decreased the 24-hour mean arterial pressure, heart rate and sigma
      insulin, and improved barorefiex function. There was a significant correlation
      between the reduction of arterial pressure and the change in sigma insulin.
      Furthermore, the reduction of sigma insulin was correlated with the improvement
      of baroreflex function and with the decrease in heart rate. CONCLUSIONS: Exercise
      training lowered the arterial pressure, with parallel changes in heart rate,
      baroreflex function and insulin resistance. The correction of sympathetic
      overactivity was closely associated with the amelioration of hyperinsulinemia.
      Our results suggest that the improvement of neuro-metabolic factors may be
      involved in the depressor effect caused by exercise training.

PMID- 11197784
TI  - Intermittent nitrate therapy for prior myocardial infaraction does not induce
      rebound angina nor reduce cardiac events.
AB  - OBJECTIVE: Long-term nitrate therapy for ischemic heart disease may cause drug
      tolerance which diminishes its beneficial effects; consequently, intermittent
      administration of nitrates is recommended. With this regimen, however, the
      potential occurrence of rebound angina during the nitrate-free intervals is a
      source of concern. SUBJECTS AND METHODS: We carried out a retrospective study of
      606 patients to determine whether rebound angina occurred when conventional
      continuous nitrate administration was replaced by intermittent administration as
      part of a long-term therapy protocol for prior myocardial infarction. The
      subjects were receiving treatment for myocardial infarction and included 293
      patients treated with nitrates (Nitrate group) and 313 patients who were not (No
      nitrate group). The former included 186 patients who received intermittent
      nitrate administration (Intermittent group) and 107 patients who received
      continuous administration (Continuous group). The mean period of observation was
      4.3 +/- 1.6 months. RESULTS: There were no cases of rebound angina in the
      Intermittent group. Cardiac events occurred in one case in the No-nitrate group
      (0.3%), in 4 cases in the Continuous group (3.7%) and in 2 cases in the
      Intermittent group (1.1%). The incidence of cardiac events was thus significantly
      increased in the Continuous group compared to the No-nitrate group (p < 0.05;
      odds ratio 9.06; 95% CI 1.41-58.28). The Intermittent group did not significantly
      differ from the No-nitrate group in the incidence of cardiac events. CONCLUSION:
      It is concluded that intermittent administration of nitrates does not cause
      rebound angina and is therefore safe. A randomized controlled trial is needed to
      find the long-term effect on cardiac events.

PMID- 11197785
TI  - Efficacy of anti-anginal drugs in the treatment of angina pectoris associated
      with silent myocardial ischemia: importance of quantitative Holter ECG data for
      patient activity.
AB  - METHODS: We evaluated the clinical efficacy of transdermal nitroglycerin (NTG
      TTS), a patch application of a nitrate, in the treatment of 27 patients with
      angina pectoris who had asymptomatic myocardial ischemic (SMI) attacks, using a
      double-blind cross-over method. Evaluation was made using Holter ECG and patient
      activity data. RESULTS: In frequency and duration of continuation of SMI
      episodes, no significant differences were noted between the observation and
      placebo treatment periods, while the values of both these parameters were
      decreased significantly in the active drug treatment period compared with those
      in the observation and placebo treatment periods. Critical heart rate, the heart
      rate at the initiation of ST-segment depression, was significantly higher during
      the period of active drug treatment than during the placebo treatment and
      observation periods. In SMI frequency index, which was determined by adjusting
      the SMI frequency for the number of steps taken, there were no significant
      differences between the 3 periods. The SMI time index was significantly lower in
      the active drug treatment period than in the observation period. CONCLUSIONS:
      These results indicated that the clinical evaluation of the efficacy of anti
      anginal drugs against SMI should take into consideration individual patient
      activity data.

PMID- 11197786
TI  - Clinical features and predictors of in-hospital mortality in patients with acute
      and chronic pulmonary thromboembolism.
AB  - OBJECTIVE: The differences in the clinical findings of patients with acute
      pulmonary thromboembolism (acute-PTE) and chronic pulmonary thromboembolism
      (chronic-PTE) were compared, and the association between the clinical findings
      and prognosis in the two groups was analyzed. PATIENTS: This study included 204
      patients with PTE, 139 patients with acute-PTE and 65 patients with chronic-PTE.
      RESULTS: There were significant differences between acute-PTE and chronic-PTE in
      the predisposing factors of post operation (19.4 versus 1.5%, p = 0.0003), and
      electrocardiographic signs such as sinus tachycardia (73.7 versus 50.9 %, p =
      0.007), ST-depression (25.3 versus 9.4%, p = 0.03), right ventricular hypertrophy
      (20.0 versus 47.2%, p = 0.0007), and right axis deviation (3.2 versus 22.6%, p =
      0.0003). Thirty-one of the 139 acute-PTE patients died from PTE, as did 17 of the
      65 chronic-PTE patients. The prognosis was poor in patients older than 70 years
      old (p = 0.01), with stroke (p = 0.008), syncope (p = 0.01), shock (p = 0.0006),
      hypocapnia (PaCO2 < or = 25 torr; p = 0.0006) and an elevation in total pulmonary
      resistance (TPR >1,000 dyne-sec cm(-5) (p = 0.02)) in acute-PTE, and in those
      with syncope (p = 0.03), shock (p = 0.008), and right ventricular hypertrophy on
      electrocardiogram (p = 0.03) in chronic-PTE. CONCLUSION: The results of this
      study indicate a relationship between the clinical features of patients with
      acute-PTE and chronic-PTE, and the predictors of in-hospital mortality.

PMID- 11197787
TI  - Oral administration of fluoroquinolones in the treatment of typhoid fever and
      paratyphoid fever in Japan.
AB  - OBJECTIVE: To study the adverse reactions and therapeutic effects of
      fluoroquinolones to investigate whether they can be used for the treatment of
      patients with typhoid fever and paratyphoid fever. METHODS: The adverse reactions
      and therapeutic effects of fluoroquinolones were studied retrospectively in
      patients with typhoid fever and paratyphoid fever. PATIENTS: 58 patients (54
      Japanese) with typhoid fever, 42 patients (41 Japanese) with paratyphoid fever,
      and 1 Japanese patient with both typhoid fever and paratyphoid fever, who were
      admitted in hospitals in Tokyo, Kawasaki, Yokohama, Kyoto, and Osaka from 1995 to
      1998 and treated with fluoroquinolones. RESULTS: Almost 80% of the patients were
      treated with tosufloxacin (TFLX) and the remaining 20 % were treated with
      norfloxacin, ciprofloxacin, levofloxacin, or sparofloxacin. Side effects (nausea,
      urticaria, aphthous stomatitis) and elevation of serum amylase were found in 3.6%
      and 8.3 % of patients treated with TFLX, respectively, but these adverse
      reactions disappeared in all of these cases either with or without a change in
      the drug used. No adverse reactions were found in patients treated with the other
      fluoroquinolones. The clinical and bacteriological effects of these drugs were
      adequate. CONCLUSION: Though further studies still need to be performed on the
      fluoroquinolones other than TFLX, we can preliminarily conclude that
      fluoroquinolones are safe drugs and they can be recommended for the initial
      therapy of patients with typhoid fever and paratyphoid fever.

PMID- 11197789
TI  - Multiseptate gallbladder with cholelithiasis diagnosed incidentially in an
      elderly patient.
AB  - A 70-year-old woman with rheumatoid arthritis was admitted to our hospital
      because of gastric ulcers. Abdominal echography incidentally revealed that the
      patient's gallbladder was multiseptate, an extremely rare anomaly. The diagnosis
      was confirmed by endoscopic retrograde cholangiography. This is the 26th case of
      multiseptate gallbladder in the world literature, but the patient is the oldest
      yet recorded with this condition. Furthermore, unlike most patients with
      multiseptate gallbladder, she had no biliary symptoms with concomitant
      cholelithiasis.

PMID- 11197788
TI  - Paradoxical progression of biliary strictures against recovery of biochemical
      parameters under ursodeoxycholic acid treatment in a case of primary sclerosing
      cholangitis with ulcerative colitis.
AB  - Ursodeoxycholic acid (UDCA) treatment for primary sclerosing cholangitis (PSC)
      has been considered a rational therapy, though its effectiveness in the clinical
      course is still open to discussion. In this report, we describe a 22-year-old man
      with PSC at an early stage, which was associated with ulcerative colitis (UC). He
      showed progressive strictures of bile ducts over a 1.5-year period in spite of an
      improvement in the biochemical parameters by UDCA treatment. Therefore, care
      should be taken in interpreting the effectiveness of UDCA, because the
      biochemical parameters may not change in parallel with the clinical course of
      PSC.

PMID- 11197790
TI  - Radiation enteritis: a rare complication of the transverse colon in uterine
      cancer.
AB  - Radiation therapy is a powerful method for the control of cancer. The utilization
      of abdominal or pelvic radiation has been extended, and the incidence of
      radiation enteritis appears to be increasing. The majority of the induced lesions
      is in the distal ileum, sigmoid colon, or rectum. Reported here is an unusual
      case of radiation enteritis which caused a severe sequelae of stricture in the
      transverse colon as a long-term effect of therapeutic irradiation for uterine
      cancer, and required a surgical resection.

PMID- 11197792
TI  - Hepatitis-associated aplastic anemia and transfusion-transmitted virus infection.
AB  - A 17-year-old man was admitted to our hospital because of severe acute hepatitis.
      Serologic studies were negative for A, B, C and G hepatitis viruses. Later, he
      was found to be positive for transfusion-transmitted virus (TTV) DNA. He was
      discharged after normalization of liver function tests. Four months after the
      onset of hepatitis, he was re-admitted because of pancytopenia. Bone marrow
      findings were consistent with aplastic anemia. The anemia responded to steroid
      therapy. In this case, TTV was probably involved in the development of aplastic
      anemia.

PMID- 11197791
TI  - Acute fatty liver of pregnancy showing microbial infection in the liver.
AB  - A 24-year-old, nulliparous woman in her 30th week of pregnancy was admitted due
      to threatened premature delivery. Ritodrin chloride relieved the premature
      contraction of the uterus but jaundice and drowsiness appeared 7 weeks later.
      Laboratory data revealed disseminated intravascular coagulation (DIC) with
      intrahepatic cholestasis, and ultrasound examination showed fatty liver. The
      patient was diagnosed with acute fatty liver of pregnancy (AFLP). Emergency
      delivery by Caesarean section was performed at 37 weeks of pregnancy and the
      liver function and DIC improved immediately. Liver biopsy 13 days after delivery
      showed nuclear swelling and cytoplasmic ballooning with mild fatty deposition.
      These findings were relatively compatible with acute AFLP. Higher magnification
      and electron microscopy revealed intracytoplasmic bacteria and fungus in the
      residual stage. The bacterial infection could be considered related to AFLP.

PMID- 11197793
TI  - Percutaneous balloon pericardiotomy by the use of Inoue balloon for the
      management of recurrent cardiac tamponade in a patient with lung cancer.
AB  - A 32-year-old man with lung cancer involving pericarditis carcinomatosa underwent
      pericardiotomy, using an Inoue balloon dilating catheter, to create a non
      surgical pericardial window. The procedure was performed from the thoracic wall
      to the left pleural effusion and parietal pericardium under local anesthesia. The
      effects of non-surgical pericardial window had been maintained until this patient
      died from his primary disease. It is concluded that percutaneous balloon
      pericardiotomy is helpful in the management of massive pericardial effusions
      particularly in patients with malignancies and poor clinical condition

PMID- 11197794
TI  - Hyponatremia with increased plasma antidiuretic hormone in a case of
      hypothyroidism.
AB  - We report a 70-year-old woman with hypothyroidism and severe hyponatremia. Her
      plasma antidiuretic hormone (ADH) level was inappropriately high for her low
      plasma osmolality. Her low serum sodium level was gradually corrected by water
      restriction and sodium supplementation prior to the initiation of thyroid hormone
      replacement. After a diagnosis of Hashimoto's thyroiditis had been made, the
      patient was treated with levothyroxine. Following this treatment, the patient's
      serum sodium level increased drastically. It is suggested that the elevated
      plasma ADH level played an important role in the development of hyponatremia in
      this case.

PMID- 11197795
TI  - Histological changes of the pancreas in an elderly diabetic patient positive for
      GAD antibody.
AB  - We examined the histological changes of the pancreas in a 75-year-old diabetic
      woman who was treated with sulphonylurea for 10 years and required insulin
      treatment for the subsequant 10 years. She was positive for antiglutamic acid
      decarboxylase antibody (GAD Ab) 20 years after the diagnosis of diabetes. Her
      autopsied pancreas revealed disfigured islets and no beta cells. These changes
      were indistinguishable from those of the long-sustained type 1 diabetes mellitus,
      and insulitis was not found. This case suggests that diabetic patients positive
      for the GAD Ab, even if oral hypoglycemic agents are effective, may develop
      complete beta cell destruction over a long period.

PMID- 11197796
TI  - A mediastinal hemangioma, associated with perirenal hemangioma and congenital
      anomaly of the inferior vena cava.
AB  - In a 40-year-old man, a mediastinal hemangioma was discovered intially as a
      compression of the esophagus by upper gastrointestinal endoscopy. Furthermore,
      perirenal hemangioma and inferior vena cava (IVC) malformation were
      stimultaneously found. Hemangiomas, which occur in the mediastinal and perirenal
      area, are extremely uncommon and congenital IVC malformation, like the present
      case, has not been reported. We review the literature of these vascular
      abnormalities.

PMID- 11197797
TI  - Clinical experiences of stenting in patients with esophago-bronchial fistula:
      report of four cases.
AB  - The esophagorespiratory fistula is difficult to treat, and the patients' quality
      of life is generally poor due to suffering from dysphagia and dyspnea. We
      performed stent therapy in four cases of the esophagorespiratory fistula
      associated with esophageal cancer. Three of four patients showed improved
      symptoms, enabling oral liquid or food intake, although one died of dyspnea
      despite the therapy. The findings suggest that stent therapy is an effective
      method to close the esophagorespiratory fistula and to improve the patients'
      quality of life, although it is temporary and not a radical treatment.

PMID- 11197798
TI  - Good's syndrome presenting with cytomegalovirus pneumonia.
AB  - A 61-year-old woman who had undergone an operation for thymoma 17 years
      previously suddenly became dyspneic and showed bilateral pulmonary infiltrates on
      a chest radiograph. In the bronchoalveolar lavage fluid cells contained
      characteristic cytomegalic inclusion bodies, as well as cytomegalovirus DNA
      demonstrated by a polymerase chain reaction. Immunological findings included
      hypogammaglobulinemia, deficient numbers of circulating B cells, and impaired
      blast transformation of peripheral blood T cells in response to mitogens in
      vitro. Considering all of the findings, the patient was diagnosed with Good's
      syndrome presenting with cytomegalovirus pneumonia.

PMID- 11197799
TI  - Serum KL-6 as a possible marker for amiodarone-induced pulmonary toxicity.
AB  - Amiodarone is a useful drug for the treatment of life-threatening cardiac
      arrhythmias. However, amiodarone can induced pulmonary toxicity (APT) and may
      cause life-threatening lung damage. APT can be difficult to diagnose, but early
      diagnosis is important. Here, in a 51-year-old man with APT, the high serum KL-6
      level was correlated with the severity of symptoms and chest X-ray findings, and
      it was inversely correlated with PaO2 and diffusion capacity for carbon monoxide
      levels. The findings suggest that the serum KL-6 level may be increased in APT
      and that therefore it's the determination of serum KL-6 may provide a useful
      indicator and/or monitoring marker of APT. KL-6 is believed to be produced and
      secreted by type II pneumocytes. Typical pathological findings of APT include
      proliferation of type II pneumocytes which may produce KL-6, and result in
      increased serum KL-6 levels.

PMID- 11197800
TI  - VEGF is causative for pulmonary hypertension in a patient with Crow-Fukase
      (POEMS) syndrome.
AB  - We report a case of Crow-Fukase (POEMS) syndrome associated with pulmonary
      hypertension (PH). In this case, the concentration of vascular endothelial growth
      factor (VEGF) was extremely high in the serum, and the levels of IL-1beta, IL-6,
      TNF-alpha, and thiamine, which were thought in past reports to be mediators of PH
      in Crow-Fukase syndrome, were normal. After prednisolone therapy, PH disappeared
      with a dramatic decrease in serum VEGF. Our results suggest that VEGF is closely
      correlated with PH in Crow-Fukase syndrome.

PMID- 11197801
TI  - Parietal cheiro-oral syndrome.
AB  - Cheiro-oral syndrome due to a parietal lesion has been reported in conjuction
      with a brain tumor, infarction and migraine. Only six reports of cheiro-oral
      syndrome due to a parietal infarction have been reported to date. We treated a 45
      year-old woman with cheiro-oral syndrome due to a parietal infarction. Her
      sensory disturbance was characterized by paresthesia in the lower face and hand
      on the left side, and severe involvement of stereognosis and graphesthesia in the
      left hand. The pathogenesis of parietal cheiro-oral syndrome is discussed.

PMID- 11197802
TI  - Rapidly progressive polymyositis with elevated antiacetylcholine receptor
      antibody activity.
AB  - We report a 51-year-old woman with polymyositis accompanied by a high titer of
      antiacetylcholine receptor antibody. The patient presented with weakness of grip
      strength followed by rapidly progressive dyspnea, which required mechanical
      ventilation. She was treated with a glucocorticoid and came off the respirator
      one week later. Antiacetylcholine receptor antibody activity was elevated in the
      acute phase and decreased during recovery, although other signs of myasthenia
      gravis were negative. This patient suggested that in cases of rapidly progressive
      bulbar palsy and limb muscle weakness, it is necessary to include polymyositis
      associated with elevated antiacetylcholine receptor antibody activity in the
      differential diagnosis.

PMID- 11197803
TI  - Parkinsonian symptoms as an initial manifestation in a Japanese patient with
      acquired immunodeficiency syndrome and Toxoplasma infection.
AB  - We studied a Japanese patient who developed parkinsonian symptoms over 3 months
      before the diagnosis of acquired immunodeficiency syndrome. Brain MRI showed
      multiple lesions with mass effect and ring enhancement in the basal ganglia and
      subcortical white matter suggesting Toxoplasma infection. Anti-Toxoplasma therapy
      and highly active antiretroviral therapy for 6 months allowed improvement of
      parkinsonism, brain MRI findings, and immune system.

PMID- 11197804
TI  - Simultaneous macroamylasemia and macrolipasemia in a patient with systemic lupus
      erythematosus in remission.
AB  - We report the fourth case of simultaneous macroamylasemia and macrolipasemia. A
      39-year-old woman had been treated for systemic lupus erythematosus from 1982 to
      1993. She was found to have an unexplained increase in serum amylase and lipase
      activities since 1996. Immunoprecipitation assay showed that amylase was bound to
      IgA2-kappa and IgA1-kappa (IgA2 > IgA1), whereas lipase was bound to IgA1-kappa.
      During a follow-up period up to December 1999, the patient did not develop any
      additional autoimmune or lymphoproliferative disorders. In the situation of
      atypical clinical features associated with hyperamylasemia and hyperlipasemia,
      the possibility of macroenzymes should be considered.

PMID- 11197805
TI  - Mixed connective tissue disease with multiple organ damage: successful treatment
      with plasmapheresis.
AB  - A 24-year-old-woman with mixed connective tissue disease (MCTD) developed
      multiple organ failure, disseminated intravascular coagulation (DIC), metabolic
      acidosis, and respiratory and renal failure resulting from visceral vasospasm, so
      called visceral Raynaud's phenomenon. After plasmapheresis, the condition of
      multiple organ failure was markedly improved. The successful treatment with
      plasmapheresis was dependent upon the removal of immune complexes in serum and
      improvement of visceral circulation. Thus plasma exchange is recommended as a
      possible a treatment for multiple organ damage in MCTD.

PMID- 11197806
TI  - Polymyalgia rheumatica and type 2 diabetes mellitus complicated with
      electromyographic abnormalities that responded well to corticosteroid therapy.
AB  - A 62-year-old man who had a 14-year history of diabetes complained of low-grade
      fever, general malaise, pain of bilateral femurs and hip girdle, and was
      adniitted to our hospital. The diagnosis of polymyalgia rheumatica (PMR) was made
      from the clinical symptoms, elevated C-reactive protein and erythrocyte
      sedimentation rate. Electromyography revealed abnormalities that suggested
      diabetic peripheral neuropathy. However, the abnormalities were improved after
      starting treatment with corticosteroids (PSL). After stopping PSL, electric nerve
      conduction disturbance developed; therefore, it was suggested that peripheral
      nerve involvement due to PMR was improved by administration of PSL regardless of
      the existence of diabetic peripheral neuropathy.

PMID- 11197807
TI  - Rapidly progressive pneumonia due to Aeromonas hydrophila shortly after near
      drowning.
AB  - An 87-year-old woman died of rapidly progressive pneumonia due to Aeromonas
      hydrophila shortly after a near-drowning event. Autopsy showed necrotizing
      pneumonia and postmortem cultures of both blood and lung revealed the organism.
      Fulminant pneumonia should be considered in patients of a near-drowning event.

PMID- 11197808
TI  - Acute eosinophilic pneumonia caused by cigarette smoking.

PMID- 11197809
TI  - Tandospirone, a promising alternative drug in the treatment of chorea.

PMID- 11197810
TI  - Revised criteria for diagnosis of autoimmune hepatitis.

PMID- 11197811
TI  - [Vestibular symptoms and ENG findings during periods of convalescence after
      endolymphatic sac drainage and steroid-instillation surgery (EDSS)].
AB  - Understanding the appearance of vestibular symptoms during periods of
      convalescence after surgery for the treatment of Meniere's disease is important
      for determining when a patient can return to work as well as the long-term
      results of the operation. We have treated 20 cases of intractable Meniere's
      disease with endolymphatic sac drainage & steroid-instillation surgery (EDSS)
      [Kitahara T, et al., Ann Otol Rhlnol Laryngol in press, 2000] and observed the
      subjective symptoms and objective vestibular findings using electronystagmogram
      (ENG) during the subsequent period of convalescence. The average postoperative
      durations of subjective static and evoked vestibular symptoms were 1.7 and 6.7
      days, respectively. Those of spontaneous, positional and positioning nystagmus
      observed using ENG were 1.2, 2.0 and 7.9 days, respectively. In cases with a long
      history of Meniere's disease, postoperative static vestibular sensation and
      positional nystagmus lasted significantly longer than in cases with short
      histories. In cases with poorly developed temporal bony pneumatization in the
      area behind the posterior semicircular canal, postoperative evoked vestibular
      sensations and positioning nystagmus lasted significantly longer than in cases
      with well developed temporal bony pneumatization. Vestibular symptoms resulting
      from direct invasion during EDSS were considered to be slighter than those
      resulting from vestibular neurectomy or gentamicin treatment and almost the same
      as those resulting from endolymphatic sac surgery.

PMID- 11197812
TI  - [Seven cases of tuberculous otitis media].
AB  - Tuberculous otitis media (TOM) is a variable and puzzling infectious disease that
      is sometimes confused with other chronic middle ear diseases. A series of 7 cases
      (9 ears) of TOM recently treated at Osaka Prefectural Habikino Hospital is
      reviewed to assess the recent features of the disease. In most cases, the
      pathogenetic mechanism was probably aspiration of tubercle bacilli through the
      eustachian tube. In most cases, abundant granulations were observed in the middle
      and external ears, but multiple perforations of the tympanic membrane were not
      seen. The manifestations were variable, such as otorrhea from the perforation and
      otitis media with effusion. In their early stage, most cases of TOMs due to
      transmission via the eustachian tube are tend to resemble otitis media with
      effusion. Smear tests, culture, PCR, and histopathological examinations, each of
      which has advantages and disadvantages, must be repeated to achieve a definitive
      diagnosis. Tuberculin tests can be unreliable, but a chest x-ray is indispensable
      whenever TOM is suspected. Antitubercular chemotherapy and 2% kanamycin earwash
      yielded good results. Since the classical criteria for the diagnosis of TOM are
      no longer valid, we propose a new criterion for diagnosis in the early stage of
      the disease.

PMID- 11197813
TI  - [Factors influencing satisfaction of cochlear implant users--a questionnaire
      based study].
AB  - We surveyed on cochlear implant (CI) users using a questionnaire to determine how
      they use their CIs in daily life and to what degree they are satisfied with them.
      We also studied the relationship between the degree of satisfaction and speech
      perception score, age at operation, and deafness duration. Subjects were 37,
      postlingually-deafened adult CI users were subjected to this study. Average CI
      use per day was 13.6 hours. Some 60% of subjects understood person-to-person
      conversation without lipreading, but most could not communicate on the telephone,
      in meetings, or in noisy places, for example. Most--about 80%--were satisfied
      with CI, but 20% were not. Those not satisfied tended to be unable to understand
      person-to-person conversation even with CI and lipreading, indicating that
      understanding person-to-person conversation is one of the most important reasons
      for satisfaction in CI users. Speech recognition scores improved in all cases
      after implantation. Most patients with high speech recognition score-->40% in
      consonant recognition--were satisfied with CI, but those with recognition scores
      < 40% in consonant recognition, the degree of satisfaction varied. These results
      indicate that the degree of satisfaction in CI users does not always correspond
      to the degree of improvement in speech recognition score. Two patients not
      satisfied with CI had undergone surgery after the age of 65 years and deafness
      duration exceeding 20 years. Advanced age and a long deafness duration may thus
      reduce satisfaction with CIs.

PMID- 11197814
TI  - [Bilateral facial palsy in a patient with human immunodeficiency virus infection-
      a case report].
AB  - We report a 37-year-old male with bilateral peripheral facial palsy associated
      with HIV infection. He was serologically tested for HIV and was found to be
      positive (by Western blot and ELISA). Serum chemistry studies showed elevated HIV
      RNA and were negative for p24 antigen. The CD4+ count was 533 cells x 10(6) per
      liter, with a CD4+:CD8+ ratio of 0.47. Since there was no evidence of any other
      underlying systemic illness, his facial palsy was considered to be secondary to
      HIV infection.

PMID- 11197815
TI  - [Comparison of combined operation and nasal CPAP treatments for sleep disorders].
AB  - Uvulopalatopharyngoplasty (UPPP) and nasal CPAP are used for the treatment of
      obstructive sleep apnea syndrome (OSAS) in different institutions. Although OSAS
      results from an abnormality in the soft-palate, almost no reports have been made
      on the selection of UPPP or nasal CPAP procedures according to the type of
      abnormality. The most probable reason for this is that a comparison of treatment
      methods in individuals cases is difficult. We performed CPAP titration before and
      after operations, and compared the treatment methods, and evaluated the medical
      therapy. METHOD: A sleep polygraph was performed on the first night, and cases
      diagnosed as OSAS received CPAP titration on the second night. The blocked region
      was identified by endoscopic examination. The results of the operation were
      evaluated after 1-2 months, and apnea hypopnea index (AHI) improvements of less
      than 50% received a second CPAP titration. RESULTS: The operation results were
      poor for cases where endoscopic examination showed full-circumference palatal
      type, and good for soft palate and tonsillar type abnormalities. When endoscopic
      examinations were performed in conjunction with nasal CPAP, the treatment was
      observed to act on the soft palate and expand the air way in all cases. Nasal
      CPAP was effective in cases with full-circumference palatal abnormalities because
      in these cases, the pressure was caused by inflamma. Combined medical treatments
      were effective in cases where CPAP alone was ineffective because the pressure was
      too high.

PMID- 11197816
TI  - [Intracellular calcium kinetics after odorant stimulus in olfactory receptor
      cells isolated from mice].
AB  - cAMP and IP3 act as secondary messengers in olfactory signal transduction and
      when activated, stimulate calcium levels in olfactory receptor cells. Little is
      known however, about the causal mechanism. We studied calcium kinetics in mouse
      olfactory receptor cells after odorant stimuli. Olfactory receptor cells were
      isolated from female BALB/c mice, treted with trypsin, and stained with Fura
      2/AM. Changes in intracellular Ca2+ concentrations in stained cells were measured
      with a fluorescent microscopic image-processing device (ARGUS-50; Hamamatsu
      Photonix, Japan). We found that intracellular Ca2+ concentrations rose after
      exposure to a set of odorants, including 3-ethoxy-4-hydroxy-benzaldehyde,
      caprylic acid, heptanoic acid, nonanoic acid, eugenol, phenethyl alcohol, and n
      amyl acetate. Adding 2', 5'-dideoxyadenosine, a cAMP inhibitor, beforehand
      suppressed olfactory receptor cell response to odorants. Intracellular Ca2+
      concentrations increased substantially in response to stimulation by odorants in
      calcium-free Ringer's solution, but only a slight increase was seen in
      intracellular calcium concentration in response stimulation by a high
      concentration of K+ (145.6 mM) in calcium-free Ringer's solution. The increase in
      intracellular Ca2+ concentration after odorant stimuli was suppressed when
      olfactory receptor cells were pretreated with ryanodine, which releases Ca2+ from
      intracellular stores. These findings suggest that elevated Ca2+ concentrations
      may be involved in releasing Ca2+ from intracellular calcium stores in mouse
      olfactory receptor cells, in which cAMP functions as a secondary messenger in
      olfactory signal transduction.

PMID- 11197817
TI  - Differences in left ventricular response between rheumatic and myxomatous mitral
      valve disease following mitral valve replacement.
AB  - OBJECTIVE: We studied whether differences exist between hearts having rheumatic
      mitral valves and those having myxomatous mitral valves, in functional,
      geometrical, and mass changes in the left ventricle after mitral valve
      replacement. METHODS: Patients who underwent mitral valve replacement without
      preservation of annular-papillary continuity for pure mitral incompetence were
      classified into rheumatic and myxomatous based on valvular histopathology.
      Echographic data measured before surgery was compared to that about 3 weeks after
      surgery. RESULTS: In the rheumatic group, ejection fraction decreased from 57.5
      +/- 10.8 to 47.7 +/- 12.0, indexed left ventricular internal dimension in systole
      (mm/m2) from 24.7 +/- 6.8 to 20.7 +/- 6.2 (P = 0.0001), and left ventricular mass
      index (g/m2) from 205 +/- 55 to 138 +/- 54 (P = 0.0002). In the myxomatous group,
      ejection fraction decreased from 60.4 +/- 11.6 to 39.7 +/- 14.5 (P = 0.0001),
      indexed left ventricular internal dimension in systole from 24.2 +/- 5.6 to 23.1
      +/- 5.5, and left ventricular mass index from 195 +/- 83 to 111 +/- 72 (P =
      0.0004). Mean wall thickness index and relative wall thickness showed significant
      differences between the two groups postoperatively but no significant difference
      preoperatively. CONCLUSION: Hearts dilated due to chronic mitral incompetence
      respond differently after valvular replacement with total chordal excision
      depending on whether a rheumatic or myxomatous mitral valve is involved.

PMID- 11197818
TI  - Ipsilateral recurrence frequency after video-assisted thoracoscopic surgery for
      primary spontaneous pneumothorax.
AB  - OBJECTIVE: We retrospectively evaluated the results of video-assisted
      thoracoscopic surgery for primary spontaneous pneumothorax and recurrence.
      METHODS: A series of 424 patients with primary spontaneous pneumothorax were
      treated by video-assisted thoracoscopic surgery-289 with an ipsilateral recurrent
      episode, 88 with persistent air leakage for 7 days or longer, 34 with a
      contralateral episode, 9 with hemopneumothorax, and 4 with tension pneumothorax.
      The commonest management was stapling of an identified bleb, undertaken in 375
      patients (88.4%). Pleural abrasion was conducted in 250 (59.0%), but the abraded
      area was one-third or less of the thoracic cavity in 187 (74.8%). RESULTS: No
      operative deaths occurred. Revisional thoracotomy was required in 1 patient with
      postoperative bleeding and another with incomplete postoperative lung
      reexpansion; 26 had prolonged air leakage, but none required revisional
      thoracotomy. During a mean follow-up of 31.4 months, ipsilateral pneumothorax
      recurred in 40 patients (9.4%), with 26 (65.0%) having recurrence within 1 year
      postoperatively. A video-assisted thoracoscopic surgery was conducted again in 8,
      and thoracotomy in 14. CONCLUSIONS: The ipsilateral recurrence of primary
      spontaneous pneumothorax after video-assisted thoracoscopic surgery was high at
      9.4%. If video-assisted thoracoscopic surgery is to be considered as a treatment
      for spontaneous pneumothorax, we must therefore reduce postoperative ipsilateral
      recurrence by training practitioners not to overlook blebs during the procedure
      and/or consider widening the area of pleurodesis.

PMID- 11197819
TI  - Prevention of paraplegia in transluminally placed endoluminal prosthetic grafts
      for descending thoracic aortic aneurysms.
AB  - OBJECTIVE: To evaluate the efficacy of a temporary balloon occlusion test for the
      prevention of paraplegia following transluminally placed endoluminal prosthetic
      grafts for descending thoracic aortic aneurysms. SUBJECTS AND METHODS: Two
      occlusion balloons were inserted via the brachial and femoral arteries and
      positioned in the proximal and distal neck of the descending thoracic aortic
      aneurysms using fluoroscopy. After temporary occlusion of the thoracic aorta by
      inflation of both the proximal and distal balloons, the evoked spinal potential
      was measured for 15 mins. A maximum amplitude during temporary balloon occlusion
      test decreasing by more than 20% of the pre-balloon occlusion level was
      considered to be significant, enough to not perform transluminally placed
      endoluminal prosthetic grafts, but instead an open repair. The test was applied
      in 12 cases (9 males and 3 females, 50-86 years old). All aneurysms were located
      between the Th6 and Th12 with a maximum diameter of 40-70 mm, and average of 56
      mm. RESULTS: The changes in maximum amplitude of evoked spinal potential remained
      within 20% of the value before balloon occlusion in 11 cases. Transluminally
      placed endoluminal prosthetic grafts were performed in these 11 cases and no
      instance of paraplegia or other complication relating to the test was observed.
      Deployment of stent-grafts was successful in 10 cases (91%). CONCLUSION: It is
      suggested that the preoperative measurement of evoked spinal potential during
      temporary balloon occlusion is clinically useful for the assessment of the risk
      to paraplegia occurring in transluminally placed endoluminal prosthetic grafts.

PMID- 11197820
TI  - Sarpogrelate reduces mechanical hemolysis in patients with heart valve
      prostheses.
AB  - OBJECTIVE: We evaluate the clinical efficacy of sarpogrelate, an antiplatelet
      drug that improves red blood cell deformability, to reduce the intravascular
      hemolysis problems suffered frequently by patients implanted with heart valve
      prostheses. SUBJECTS: Subjects were 34 patients undergoing mechanical heart valve
      replacement and having serum lactate dehydrogenase concentrations 20% above the
      maximum normal range. METHOD: Sarpogrelate was given daily, 100 mg orally for the
      first 6 months and 200 mg thereafter. RESULTS: Average serum lactate
      dehydrogenase decreased significantly from 423 +/- 108 IU/l, to 391 +/- 83 IU/l
      with the 100 mg dose, and to 361 +/- 86 IU/l with the 200 mg dose. The percentage
      of reticulocytes decreased from 15.5 +/- 5.3/1000 to 15.3 +/- 5.7/1000 at the 100
      mg dose and 13.1 +/- 4.0/1000 at the 200 mg dose. Serum iron concentrations
      increased significantly from 63.2 +/- 24.8 micrograms/dl to 76.2 +/- 16.2
      micrograms/dl at the 100 mg dose, and to 70.9 +/- 26.2 micrograms/dl with the 200
      mg dose. CONCLUSION: Sarpogrelate is a useful drug for patients with implanted
      heart valve prostheses and subsequent high serum lactate dehydrogenase because it
      works as an antiplatelet drug and reduces mechanical hemolysis.

PMID- 11197821
TI  - Freehand cryopreserved mitral valve allograft with flexible ring in the pig.
AB  - OBJECTIVE: Cryopreserved valve allografts have proven satisfactory in aortic and
      pulmonary positions but not mitrally because of the difficulty in properly
      aligning the mitral valve allograft due to the complex subvalvular apparatus. To
      make the surgical procedure easier, we developed a freehand cryopreserved mitral
      valve allograft with a flexible ring. METHODS: Whole cryopreserved mitral valve
      allografts with the papillary muscle, chordae, and leaflets from donor pigs were
      implanted mitrally in recipient pigs under cardiopulmonary bypass divided into 2
      experimental groups; control allografts without the ring (n = 6) (CA group) and
      allografts with a flexible ring (n = 7) (RA group). Postimplantation hemodynamics
      and valvular function were evaluated by measuring arterial pressure, left
      ventricular end diastolic pressure, and left atrial pressure and by evaluating 2
      dimensional echocardiography. Allografts were evaluated pathohistologically after
      cryopreservation and surgery by light microscopy. RESULTS: Hemodynamics did not
      differ significantly between groups. Aortic cross-clamping and Cardiopulmonary
      bypass times were significantly shorter in the RA group than the CA group (p <
      0.05). Pigs requiring optional procedures with sutured annuloplasty and
      valvuloplasty numbered more in the CA group than the RA group. Postoperative
      echocardiography showed satisfactory mitral valve opening in diastole and good
      leaflet coaptation in systole in both groups. Light microscopic examination of
      cryopreserved allografts after surgery showed almost normal structures.
      CONCLUSIONS: Acute hemodynamic function and morphology of freehand cryopreserved
      valve allografts implanted mitrally in pigs proved acceptable. Adaptation of the
      flexible ring to allografts might be useful for technical benefit to facilitate
      accurate positioning of mitral subvalvular apparatus at implantation.

PMID- 11197822
TI  - Cerebral protection selection in aortic arch surgery for patients with
      preoperative complications of cerebrovascular disease.
AB  - OBJECTIVE: Retrograde perfusion is gaining acceptance as a means of cerebral
      protection, but it remains unclear how long the brain is protected and whether it
      is effective in patients with preoperative cerebrovascular disease. METHODS: From
      January 1989 to August 1999, 205 patients--118 male and 87 female patients who
      ranged 12 to 86 years old, mean: 65.5 years old--underwent surgery at our
      hospital for aortic arch aneurysm using cerebral protection. We focused on
      mortality, stroke incidence and perioperative risk factor between 2 groups-
      selective cerebral and retrograde cerebral perfusion--also studying patients with
      preoperative cerebrovascular disease that influenced postoperative stroke.
      RESULTS: The hospital mortality was 11.7% (selective cerebral perfusion group:
      12%, retrograde group: 10.9%). Stroke occurred in 11 patients (5.3%), 4.7% in the
      selective cerebral perfusion group and 7.3% in the retrograde group. Preoperative
      cerebrovascular disease does not appear to be a risk factor for postoperative
      brain damage in aortic arch surgery. Regarding total replacement of the aortic
      arch, the incidence of postoperative brain damage in the retrograde group with
      preoperative cerebrovascular disease was higher than that in another group (p =
      0.072). Cardiopulmonary bypass time and selective cerebral perfusion time in the
      patients with postoperative stroke were significantly longer than that in non
      stroke group. CONCLUSIONS: Preoperative cerebrovascular disease did not appear to
      be a risk factor in postoperative neurological deficit in the selective cerebral
      perfusion group. Prolonged selective cerebral perfusion time and cardiopulmonary
      bypass time may, however, lead to brain edema and cause neurological deficit.

PMID- 11197823
TI  - Standard coronary artery bypass grafting and beating heart bypass. Indications
      and long-term results.
AB  - OBJECTIVES AND METHOD: We have performed 225 cases of coronary artery bypass
      grafting (CABG), between October 15 1995 and September 8 1999. We have evaluated
      the operative results of 121 cases (53.8%) of conventional CABG and 104 cases
      (46.2%) of minimally invasive coronary artery bypass grafting performed during
      this period. The average numbers of bypassed grafts was 3.45 for conventional
      CABG, and 1.41 for minimally invasive coronary artery bypass grafting. Sixty
      seven right internal thoracic arteries, 145 left internal thoracic arteries, 71
      gastroepiploic arteries, 38 radial arteries and 12 saphenous veins were used for
      conventional CABG, and 29 right internal thoracic arteries, 81 left internal
      thoracic arteries, 18 gastroepiploic arteries, 3 radial arteries, 10 saphenous
      veins and 2 inferior epigastric arteries were used for minimally invasive
      coronary artery bypass grafting. The total number of 303 grafts were anastomosed
      to 417 coronary arteries for conventional CABG, and 143 grafts were anastomosed
      to 147 coronary arteries for minimally invasive coronary artery bypass grafting.
      RESULTS: Although two saphenous veins were occluded, the early postoperative
      patency rate was 100% for conventional CABG using right internal thoracic
      arteries, left internal thoracic arteries, gastroepiploic arteries and radial
      arteries. Three site of stenosis in 18 left internal thoracic arteries and 2 in
      16 right internal thoracic arteries were recognized in minimally invasive
      coronary artery bypass grafting without the use of stabilizers. One site of
      stenosis in 63 left internal thoracic arteries was recognized in minimally
      invasive coronary artery bypass grafting with the use of stabilizers. CONCLUSION:
      The use of stabilizers enables adaptation of the minimally invasive coronary
      artery bypass grafting procedure to a wider range of coronary artery bypass
      procedures, and a higher graft patency can be expected.

PMID- 11197824
TI  - Minimally invasive coronary artery bypass grafting for the left anterior
      descending coronary artery.
AB  - OBJECTIVE: A single surgeon conducted One hundred and twelve patients underwent
      minimally invasive direct coronary artery bypass grafting for the left anterior
      descending coronary artery 112 patients at Yamato Seiwa Hospital from September
      1996 until August 1999. METHODS: All procedures were performed via left anterior
      short thoracotomy using a stabilizer during graft anastomosis. RESULTS: No
      operative deaths occurred but 3 patients died while hospitalized due to
      noncardiac events. Graft occlusion was seen in 3 patients early postoperatively.
      Other angiography graft failure such as stenosis was seen in 11 patients.
      Occlusive lesions of other coronary arteries occurred in 77 patients (69%) and 53
      patients underwent percutaneous transluminal coronary angioplasty the
      pre/postoperatively for those lesions. CONCLUSIONS: These results suggest that
      minimally invasive direct coronary artery bypass grafting is seen by
      cardiologists as a reasonable form of revascularization in conditioned patients
      having left anterior descending artery lesion, and that minimally invasive direct
      coronary artery bypass grafting has a spectrum of candidates different from that
      of conventional surgical revascularization for the coronary artery.

PMID- 11197826
TI  - Neuroblastoma resection in an adult with a 10-year history of chest-mass shadow.
AB  - Neuroblastoma is rare in adults. We encountered this tumor in an asymptomatic 21
      year-old man with a 10-year history of a mass-like shadow in chest radiography.
      Diagnosis was confirmed after resection, and 60 Gy radiation therapy was started.
      One year later, the patient has no clinical or radiological evidence of
      recurrence.

PMID- 11197825
TI  - Clinical assessment of unilateral pulmonary artery occlusion test with dobutamine
      infusion. Expansion of surgical indications in patients with primary lung cancer
      and impaired cardiopulmonary functions.
AB  - OBJECTIVES: We evaluated the possibility of expanding indications for pulmonary
      resection based on an assessment of the pressure-flow relationship in pulmonary
      circulation. METHODS: In 6 of 28 lung cancer patients whose total pulmonary
      vascular resistance index exceeded the threshold during unilateral pulmonary
      artery occlusion testing, we conducted unilateral pulmonary artery occlusion
      testing with dobutamine administration, followed by lung resection. We studied
      hemodynamics during testing and derived a new indication for pulmonary resection
      from the postoperative course. RESULTS: Cardiac output was 3.82 +/- 0.74 l/min
      before testing, 3.66 +/- 0.76 l/min during pulmonary artery occlusion testing,
      and 5.92 +/- 1.78 l/min during unilateral pulmonary artery occlusion testing with
      dobutamine infusion. The total pulmonary vascular resistance index was 890 +/-
      350 dyne.sec.cm-5.m2 before testing, 1170 +/- 320 dyne.sec.cm-5.m2 during
      testing, and 800 +/- 160 dyne.sec.cm-5.m2 during testing with dobutamine
      infusion. Cardiac output increased (p = 0.014) during unilateral pulmonary artery
      occlusion testing with dobutamine infusion, and the total pulmonary vascular
      resistance index significantly decreased (p = 0.034). Of the 4 patients eligible
      for lobectomy, 2 underwent the procedure--one undergoing segmentectomy in which
      pulmonary metastasis was found during surgery and the other undergoing
      radiotherapy for cN2 disease with chest wall invasion. Of the 2 initially
      ineligible for lobectomy, one underwent partial pulmonary resection and the other
      underwent lobectomy because the total pulmonary vascular resistance index was
      less than 800 dyne.sec.cm-5.m2 during selective pulmonary artery occlusion
      testing with dobutamine infusion, indicating eligibility for lobectomy. No severe
      complications of cardiopulmonary function failure after surgery occurred in any
      of the 5 cases. CONCLUSIONS: Unilateral pulmonary artery occlusion testing with
      dobutamine infusion is useful in determining patient eligibility for pulmonary
      resection.

PMID- 11197827
TI  - Coronary surgery through partial sternotomy in a patient with tracheostoma.
AB  - We report successful coronary artery bypass grafting through a lower partial
      sternotomy for a patient with a tracheostoma. He required a tracheotomy for
      serious laryngeal edema which developed during anesthetic induction prior to
      elective conventional coronary surgery. A safe alternative approach, comprising a
      lower midline skin incision with a lower partial sternotomy distant from the
      stoma, facilitated coronary artery bypass grafting to the left and right coronary
      arteries after four weeks.

PMID- 11197828
TI  - Benign mesenchymoma of the mediastinum.
AB  - We report our recent experience of a rare case of a benign mesenchymoma in the
      mediastinum. A 24-year-old man was admitted to our hospital with an abnormal
      shadow on chest X-ray. A chest computerized tomography scan and magnetic
      resonance imaging showed an anterior mediastinal mass along the right border of
      the pericardium. The tumor was surgically resected. It was yellow on the surface,
      12.5 x 10.0 x 3.8 cm in size, and 230 g in weight. The histopathological
      diagnosis was a benign mesenchymoma. The postoperative course was uneventful. A
      search of the literature revealed that a benign mesenchymoma in the mediastinum
      is extremely rare. It seems to be difficult to reach a definitive diagnosis
      preoperatively. Surgical resection can confirm the diagnosis, and is curative.

PMID- 11197829
TI  - Primary tracheal mucosa-associated lymphoid tissue lymphoma accompanying lung
      cancer. Common tumorigenesis or coincidental coexistence?
AB  - We report a 67-year-old patient with coexistent tracheal non-Hodgkin's lymphoma
      and lung cancer the first case, to our knowledge, of this concomitant incidence
      in the literature. Chest radiography showed a mass in the right lung and
      pulmonary fibrosis. Biopsy of the unanticipated tracheal irregularity revealed
      non-Hodgkin's lymphoma, compatible with mucosa-associated lymphoid tissue
      lymphoma. After right upper lobectomy, chemotherapy for non-Hodgkin's lymphoma
      was conducted, but the patient died 11 months postoperatively of pulmonary
      fibrosis. Pulmonary fibrosis was suspected of having progressed from drug-induced
      pneumonitis caused by anticancer drugs. A common tumorigenetic factor may thus
      exist between tracheobronchial mucosa-associated lymphoid tissue lymphoma and
      lung cancer.

PMID- 11197830
TI  - Hypertrophic obstructive cardiomyopathy associated with mitral regurgitation due
      to infective endocarditis.
AB  - A 25-year-old woman treated for hypertrophic obstructive cardiomyopathy and
      suffering from mitral regurgitation due to infective endocarditis was referred to
      our department for surgery. Preoperative examinations revealed asymmetric septal
      hypertrophy, a large left ventricular outflow gradient (100 mmHg), and
      perforation of the anterior mitral leaflet resulting in severe mitral
      regurgitation. The entire mitral complex was resected and septal myectomy
      conducted to dilate the left ventricle. A bioprosthetic valve was then implanted.
      Although postoperative heart failure was severe, cardiac function has gradually
      recovered. The left ventricular outflow gradient has decreased to 8 mmHg, the
      diastolic left ventricular diameter has increased from 26 to 30 mm, and her New
      York Heart Association classification has improved from IV to I.

PMID- 11197831
TI  - Early small cell lung cancer with extensive inflammation and scar formation.
AB  - A 56-year-old man, at one year before his first visit to our hospital, had
      presented cough, stridor and chest pain, and expectorated a mass, resulting in
      prompt disappearance of the symptoms. He was afflicted with recurrent symptoms,
      and the bronchoscopy showed a polypoid tumor occluding the right lower bronchus.
      The tumor was resected via bronchoscopy, which revealed histologically small cell
      carcinoma with significant inflammation and scar formation. The tumor was
      macroscopically the same as the one that had been expectorated by the patient at
      one year previously. A right lower lobectomy was conducted, but the specimen
      demonstrated no residual tumor. Tumor invasion into the bronchial wall was
      therefore limited within the submucosal layer for more than a year. Finally, the
      present tumor was diagnosed as an early small cell lung cancer with a
      characteristic of self involution. With no adjuvant treatment, the patient is
      well without tumor recurrence at 3 years to date after the surgery.

PMID- 11197832
TI  - [Liver intervention].
AB  - Interventional radiology is now widely performed for the treatment of liver
      tumors, because surgery is sometimes limited by poor liver function.
      Transcatheter arterial chemoembolization(TACE) is an effective therapy for
      hepatocellular carcinoma. Lipiodol TACE shows a strong antitumor effect because
      of the overflow of excess iodized oil into the portal veins, and segmental TACE
      is recommended to avoid deteriorating liver function. Selective CT arteriography
      is performed in order to decide on the treatment area, and TACE under CT guidance
      leads to effective results in terms of dense accumulation of the chemotherapeutic
      drug in the individual tumors that are affected by the ischemic state and
      anticancer drugs. Percutaneous microwave or radiofrequency coagulation therapy is
      adequate for a few of the hypovascular tumors. Excessive coagulation through the
      needle tract is indispensable in these therapies, and precisely designed puncture
      is necessary to minimize damage to the liver parenchyma. Selective chemotherapy
      to the tumor-bearing organ is the first step in a number of liver tumors.
      Continuous intra-arterial infusion chemotherapy is performed for multiple liver
      metastases. The reservoir implantation technique is percutaneously achieved via
      the left subclavian artery under ultrasound guidance, without the exposure of an
      artery in the incision method, which can induce thrombus formation.

PMID- 11197833
TI  - [Biopsy].
AB  - We reviewed the current devices, techniques, guiding images, indications and
      complications of needle biopsy with CT guidance. The development of new devices
      such as automated cutting needle has enabled radiologists to obtain tissue
      specimens of good quality at biopsy. Techniques such as the tandem or coaxial
      method ensure more a more accurate biopsy route. And helical CT and CT
      fluoroscopy have markedly shortened the time required for needle biopsy. However,
      we sometimes encounter minor complications, and rarely major ones, during and
      after needle biopsy. Some of these complications may be caused by malpractice.
      Therefore it is important always to pay attention to the possibility of
      complications of needle biopsy and to minimize radiation exposures from CT
      fluoroscopy.

PMID- 11197834
TI  - [Radiation exposure to patient and radiologist during transcatheter arterial
      embolization for hepatocellular carcinoma].
AB  - PURPOSE: To evaluate radiation exposure to patients and radiologists during
      transcatheter arterial embolization(TAE) for hepatocellular carcinoma. MATERIALS
      AND METHODS: In 39 TAE procedures performed at eight institutes, skin doses were
      evaluated with thermoluminescence dosimeters at the patient's back(entrance
      surface) and lower abdomen, and at the radiologist's forehead and abdomen. Real
      time dosimeters were also used to evaluate patient skin dose. RESULTS: The
      patients' mean entrance surface dose was 973 +/- 681 mGy(range, 185 to 3543 mGy)
      with the mean fluoroscopic time of 21 minutes and 6 digital subtraction
      angiography(DSA) acquisitions. The dose at the patients' lower abdomen was 0.98
      +/- 0.77 mGy. Doses for the radiologists were 0.04 +/- 0.04 mGy at the forehead
      and 0.15 +/- 0.19 mGy and 0.005 +/- 0.01 mGy at the abdomen over and under the
      apron, respectively. Fifty-six percent of the patients' skin dose was from DSA
      and 44% from fluoroscopy. CONCLUSIONS: Patient skin dose may occasionally exceed
      the dose for transient erythema. Because a patient may have repeated TAEs, skin
      doses or X-ray conditions should be recorded. The exposed doses of radiologists
      were considered to be acceptable with proper techniques. Further efforts to
      reduce radiation should be directed toward both DSA and fluoroscopy.

PMID- 11197835
TI  - [Study of the radioprotective effects of TMG on teratogenic malformations in
      irradiated mice].
AB  - ICR mice fetuses in the organogenesis stage were used to clarify experimentally
      the mechanism of the protective effect of vitamin E derivant (TMG: 2-(alpha-D
      Glucopyranosyl) methyl-2, -5, -7, -8-Teramethylchorman-6-working woman) on the
      effects of radiation. The authors paid careful attention to radiation, and the
      radioprotective effects of TMG on the induction of malformations was examined.
      Radiation is an important consideration because of its widespread use in the
      areas of medicine, nuclear energy, and industry. Malformations induced by
      radiation at the organogenesis stage, skeletal malformations, and the effects at
      the cellular level of embryos were examined in this research. Further, the
      mechanism of the protection effect of TMG against radiation-induced malformations
      was analyzed and observed experimentally. Thus, this study was done to provide
      fundamental data on the radioprotective agent TMG. It was clear that TMG exerted
      radioprotective effects against embryonic death and the rate of teratogenesis
      when administered before exposure. Such effects were also exerted against
      skeletal malformations and fetal body weight. In summary, radioprotective effects
      were observed at the whole-body level as well as at the cellular level.

PMID- 11197836
TI  - [Development of DICOM image viewing software for efficient image reading and
      evaluation of distributed server system for diagnostic environment].
AB  - To construct an efficient diagnostic environment using computer displays, the
      author investigated the time of network transmission using clinical images. In
      our hospital, we introduced optical-fiber 100Base-Fx Ethernet connections between
      22 HIS-segments and one RIS-segment. Although Ethernet architecture is
      inexpensive, the speed of image transmission becomes 2371 KB/sec. (4.6 CT
      slice/sec.) in the RIS-segment and 996 KB/sec. (1.9 CT-slice/sec.) from the RIS
      segment to HIS-segments. Because one examination is transmitted in one minute, it
      does not disturb image reading. Otherwise, a distributed server system using
      inexpensive personal computers helps in constructing an efficient system. This
      investigation showed that commercially based Digital Imaging and Communications
      in Medicine(DICOM) servers and RSNA Central Test Node servers are not so
      different in transmission speed. The author programmed and developed DICOM
      transmission and viewing software for Macintosh computers. This viewer includes
      two inventions, dynamic tiling window system (DTWS) and window binding mode(WBM).
      On DTWS, windows, tiles, and images are independent objects, which are movable
      and resizable. The tile-matrix is changeable by mouse dragging, which realizes
      suitable tile rectangles for wide-low or narrow-high images. The arranging window
      tool prevents windows from scattering. Using WBM, any operation affects each
      window similarly. This means that the relationship of compared images is always
      equivalent. DTWS and WBM contribute greatly to a filmless diagnostic environment.

PMID- 11197837
TI  - [A study of entrance surface dose with CR and film/screen systems, and analysis
      of the X-ray conditions for chest radiography].
AB  - Several previous studies have indicated that the medical exposure dose(entrance
      surface dose) is lower with Computed Radiography(CR) than with the
      Film/Screen(F/S) system. We conducted a questionnaire survey of 1,297 hospitals
      regarding the radiation exposure conditions of X-ray examinations. From the
      survey results, we calculated the entrance surface dose(first quartile, median,
      third quartile, and mean) using the NDD calculation method. In the case of chest
      radiography(adult patients) by CR, the entrance surface dose was 150% of the
      median value for the overall examination and 160% of the median value for
      orthochromatic screen systems. The CR exposure set-up using a lower voltage and
      higher mAs than the F/S method was found to result in a high entrance surface
      dose. We also found a difference in patient dose among hospitals using CR. Mean
      surface dose in CR system was 0.12 mGy in a quartile, 0.19 mGy in the middle and
      0.27 mGy in the third quartile. Among the hospitals which showed higher doses of
      third quatile them above mentioned, dose differences of a quartile were
      distributed 2 to 10 times higher them mean exposure doses.

PMID- 11197838
TI  - [Molecular genetic mechanism of the kidney cancer].
AB  - The oncogenic mechanisms of renal cell carcinoma(RCC) are becoming elucidated
      with recent advances in molecular biology. von Hipple-Lindau disease(VHL) tumor
      suppressor gene is mutated and inactivated frequently in clear cell type RCCs.
      The VHL protein forms a complex which shows a ubiquitin ligase activity. The lost
      of the ubiquitin ligase activity of VHL protein may be a key step for clear cell
      tumorigenesis. Papillary renal cell carcinomas are caused by activating mutation
      in the tyrosine kinase domain of the MET gene. This tumorigenic pathway is
      regulated by c-Src. Immunogene therapies have been started for the patients with
      advanced RCC. The information based on microarray and Serial Analysis of Gene
      Expression(SAGE) will provide novel diagnosis and therapy which focus on the
      tumorigenic mechanism of RCC in the near future.

PMID- 11197839
TI  - [Overview on the millennium genome project].
AB  - Millennium genome project had started 2000 April as a national research project.
      In this project, analysis of single nucleotide polymorphism of human genome and
      application of its information on prevention, diagnosis and treatment of major
      diseases, and on drug development, regenerative medicine, and analysis of rice
      genome are included. This project is scheduled to complete by 2004. Since large
      amount of research money and research power is going to be poured to this
      project, fruitful results are a national expectation.

PMID- 11197840
TI  - [Gene therapy for breast cancer].
AB  - Not only the local treatments like surgery and radiation but also the systemic
      treatments like chemotherapy and hormone therapy are rather effective on both
      primary and metastatic breast cancer patients. Nevertheless, the curativity and
      survival of this disease have been not satisfied yet. The difficulties of the
      treatment seems the emergence of drug-resistant cells and the low immunity of the
      host. Gene therapy offers a potentially useful approach for the treatment of
      breast cancer. The approaches of gene therapy for breast cancer that are now
      undergoing as clinical protocols in USA can be divided into three strategies: (1)
      approaches that alter the metabolic or signaling pathways within the breast
      cancer cell; (2) approaches designed to enhance the immune response to the tumor
      cells(immuno gene therapy); and (3) approaches that use the drug-resistant gene
      with chemotherapy. According to the new biology of breast cancer by Fisher, the
      systemic treatments are more important. Immuno-therapy seems especially promising
      in this field. Moreover, the immuno gene therapy is hopeful that could overcome
      the difficulties like heterogeneity and low immunogenicity of breast cancer cell.

PMID- 11197841
TI  - [Perspectives on postgenome medicine: Neurodegenerative disease].
AB  - The genes of the majority neurodegenerative disorders have been identified for
      the past decade. Diseases of early onset are usually transmitted as autosomal
      recessive trait and caused by the deficiency of the gene products, becoming good
      candidates for gene or protein transfers. Late onset diseases are usually
      transmitted dominantly where the gains of function by the mutant gene accumulate
      into specific lesion. The pathophysiology following gene mutation need to be
      clarified for the therapeutic approach. Recent progresses on neurodegenerative
      mechanism have specified crucial targets for the treatments. Stimulation to
      intrinsic mechanisms, i.e., chaperon, ubiquitin-proteasome system and stress
      response in endoplasmic reticulum and/or antagonize the toxic cascade by
      caspases, mitochondria insufficiency are argued as therapeutic targets, hoping
      that in this decade we can propose effective therapies for these devastating
      disorders.

PMID- 11197842
TI  - [Perspectives on postgenome medicine: Gene therapy for AIDS].
AB  - Following the introduction of HAART(highly active anti-retroviral therapy) marked
      decreases in AIDS-related morbidity and mortality have been observed. Despite of
      the clinical success, recent work suggests that there are persistent viral
      replication in whom plasma HIV-RNA is consistently below detectable level.
      Furthermore, some experts even suggest that it will be difficult for many of the
      patients to continue the HAART because of the long-term side effects and drug
      resistance. Recent studies that supported the correlation of HIV-specific CD4-T
      cell(helper) response with the control of viral replication in vivo have promoted
      the development gene-based immunotherapy. However, further elucidation of viral
      pathogenesis in the patient under HAART will be required to develop the
      immunotherapeutic interventions.

PMID- 11197843
TI  - [Gene therapy for acute myocardial infarction].
AB  - For patients with myocardial infarction, direct angioplasty(PTCA plus stent
      implantation) has become common practice in Japan. For a better prognosis,
      inhibition of thrombosis and restenosis in the afflicted coronary artery, salvage
      of ischemic myocardium, and suppression of myocardial remodeling are all highly
      desirable. Transfer of genes for molecules appropriate for each of the above
      pathological conditions is a potential effective therapy. The combined use of a
      recombinant protein and gene transfer of anti-thrombosis molecule into the
      injured artery may be an effective and practical local therapy without systemic
      side-effects. Angiogenesis gene therapy with an aid of endothelial progenitor
      cells will soon be used in the clinic, while sometime in the future replacement
      of the myocardial infarct with engineered fresh tissue could be the ultimate
      therapy.

PMID- 11197844
TI  - [Gene therapy for cardiomyopathy].
AB  - Cardiac transplantation has become accepted therapy for a number of patients with
      severe cardiomyopathy. The cellular cardiomyoplasty is expected as an alternative
      therapy for cardiomyopathy. The experimental foundation was laid for the approach
      to cellular cardiomyoplasty--the molecular and cellular treatment of
      cardiomyopathy by augmentation, regeneration or replacement of cardiomyocytes--by
      experiments in cardiac gene transfer and transgenic animals. Recently,
      cardiomyocyte has been reported to be generated from embryonic stem cell or
      marrow stromal cell in vitro. However, differentiation from non-cardiomyocyte to
      cardiomyocyte cannot be controlled completely yet. It is now under investigation
      mainly in an experimental setting. For successful gene therapy, not only
      characterization of proper targets but also elimination of undesirable side
      effects are indispensable.

PMID- 11197845
TI  - [Gene-therapy for peripheral vascular diseases].
AB  - The prognosis for patients with chronic critical leg ischemic is often poor. The
      treatment of peripheral vascular disease, although greatly improved over recent
      decades by drug medication, surgical and minimally-invasive techniques, remains
      limited by vascular proliferative lesions and by our inability to modulate the
      progression of native disease. The therapeutic angiogenesis is now the most
      expected therapy for peripheral vascular diseases. This review explores some of
      concepts and methods of therapeutic angiogenesis including gene therapy using
      angiogenic growth factor such as VEGF and basic FGF and an implantation of bone
      marrow derived endothelial progenitor cells.

PMID- 11197846
TI  - [Possible pathogenesis of rheumatoid arthritis].
AB  - Rheumatoid fibroblast-like synoviocytes characteristically proliferate in an
      anchorage-independent manner, and are deeply implicated in cartilage destruction.
      Our previous results showed that rheumatoid synoviocytes expressed Fas ligand and
      were induced apoptosis by anti-Fas antibody treatment. In addition, several
      transcriptional factors, such as NF kappa B and AP-1 significantly activated in
      rheumatoid synoviocytes. We are now clarifying the pathogenesis of RA with the
      method, yeast two-hybrid system as 'post genome' strategy. We recently found that
      several factors that related with cell differentiation highly expressed in
      rheumatoid synoviocytes. In this report we discuss possible pathogenesis of RA
      based on our recent data and application to the therapy tool against RA.

PMID- 11197847
TI  - [Persectives on postgenome medicine: Gene therapy for liver cirrhosis].
AB  - Liver cirrhosis is the irreversible end result of chronic liver disease,
      characterized by diffuse disorganization of the normal hepatic structure of
      regenerative nodules and fibrotic tissue. It is associated with prominent
      morbidity and mortality, and is induced by many factors. The ideal strategy for
      the treatment of liver cirrhosis should include prevention of fibrogenesis,
      stimulation of hepatocyte mitosis, and reorganization of the liver architecture.
      We have developed a novel gene therapy approach for rat liver cirrhosis by muscle
      directed gene transfer of hepatocyte growth factor(HGF). HGF gene transduction
      inhibited fibrogenesis and hepatocyte apoptosis, and also produced resolution of
      fibrosis in the cirrhotic liver. Thus, HGF gene therapy may be potentially useful
      for the treatment of patients with liver cirrhosis, which is otherwise fatal and
      untreatable by conventional therapy.

PMID- 11197848
TI  - [Perspectives on postgenome medicine: Gene therapy for diabetes mellitus].
AB  - Several topics in diabetes research and practice in the coming 'post-genomic era'
      are described. 1) Insulin-producing pancreatic beta cells are a plausible target
      of gene therapy for type 1 diabetes mellitus. Functional genomics will reveal the
      mechanism of beta cell growth and regeneration. Attempts are being made to
      differentiate non-beta cells(including ES cells) into insulin-producing cells in
      vitro or in vivo. 2) Very recently, an intron variation in calpain 10 gene was
      found to be associated with type 2 diabetes, which confirmed the importance of
      SNPs in common diseases. More and more SNPs related to type 2 diabetes will be
      discovered and, in combination with pharmacogenomics, 'personalized medicine'
      based on SNP information of the individuals will hopefully be achieved.

PMID- 11197849
TI  - [Gene therapy for the treatment of hypertension].
AB  - Gene therapy for hypertension is very important for the next generation of
      antihypertensive drugs. Important question regarding vector-related limitations
      and suboptimal in vivo delivery systems will require expeditious attention for
      gene therapy to become a more widely applicable option in cardiovascular diseases
      including hypertension. However, the elucidation of molecular mechanisms of
      transcriptional activation of several important genes in the cardiovascular
      physiology enables us to develop clinical application of gene therapy for
      hypertension at the level of transcription factors. Recent studies showed that in
      vivo or ex vivo transfection of double-stranded oligodeoxynucleotides to block
      the binding of nuclear factors to specific cis-elements in the promoter regions
      of several genes resulted in inhibition of gene trans-activation and suppressed
      pathological changes in the cardiovascular system.

PMID- 11197850
TI  - [Molecular mechanism of hyperlipidemia and future aspects on the therapy].
AB  - Elucidating the mechanism of the onset of atherosclerosis is indispensable to
      understanding the significance of treatment of hyperlipidemia. Atherosclerotic
      lesions can be characterized as accumulations of cholesterol esters and
      pathologic reactions by various cell groups. Plasma lipid abnormalities such as
      hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol are known as
      important risk factors for atherosclerotic diseases. The purpose of treating
      plasma lipid abnormalities is to prevent or treat atherosclerosis. Future studies
      are required for the development of a powerful therapy for hyperlipidemia by
      understanding the molecular basis of polygenic hyperlipidemia which is most
      commonly observed in advanced countries.

PMID- 11197851
TI  - [Perspectives of post-genomic medical care in osteoporosis].
AB  - Osteoporosis is a multifactorial disease for which genetic and environmental
      factors are determinants. Recently, polymorphisms of many bone metabolism-related
      genes have been examined in the association study with bone mineral density and
      fracture incidence. Some showed significant correlation and others not. In
      addition, genome-wide QTL analysis was done using genome-wide random markers and
      showed some hot loci. However, the statistical power of each gene and locus are
      low and the genes to determine human bone mineral density have not been obtained.
      The accumulating information of genome science will help understand the
      pathogenesis of osteoporosis and find the useful ways for the prevention and the
      treatment of this disease.

PMID- 11197852
TI  - [Post-genome challenges against inflammatory bowel diseases].
AB  - Advancement of genome analysis might give great impact to the treatment of
      inflammatory bowel diseases(IBD). IBD patients are treated by sulfadrugs,
      steroids and anti-immune drugs. For difficult cases, leukocytapheresis,
      beclomethasone dipropionate, anti-TNF therapy, anti-LTB4 therapy and other new
      methods are applied. Developing epoch-making drugs will be achieved by finding
      new molecular targets. Histologic identification of dysplasia is important in the
      surveillance of long-standing ulcerative colitis. The molecular diagnosis is
      required for the distinction of dysplasia from the regenerative inflammatory
      changes. P53 immunostaining have been proved useful. Various molecular targets
      will be taken into discussion as additional procedures. Recent genome analysis
      have revealed some genetic factors contribute to pathogenesis of IBD, which are
      HLA, IL4, MUC3, IBD1 locus, IBD2 locus and so on. More information about genes
      concerning IBD will be provided by analyzing dense SNP map using DNA tip. They
      will open the way to the tailored therapy.

PMID- 11197853
TI  - [Ethical issues in relation to genetic analysis research].
AB  - On April 2000, the so-called Millennium project which was launched by Japanese
      Government has started. Genetic research is one of the important subject in this
      project. Since there has been no official guideline for ethical issues in
      relation to genetic analysis research, Ministry of Health and Welfare arranged a
      special committee to prepare such a guideline. The process and key points of this
      guideline which has been published on April 2000 by Ministry of Health and
      Welfare was described.

PMID- 11197855
TI  - [Perspectives on postgenome medicine: Neurological disorders].
AB  - Aims of scientific research on post-human genome(post-genome sequence) era would
      be analysis of molecular structure and function of gene products, analysis of
      particular phenomenon of higher organisms, and development of the way of
      treatment and prevention of human diseases. Particularly, in the research field
      of neuroscience and neurological disorders, the progress of human molecular
      genetics would greatly facilitate the elucidation of molecular pathophysiology of
      the neurological disorders and finally develop molecular therapy for the
      diseases. In molecular therapy, fundamental technique of gene therapy should be
      combined with stem cell-based cell transplantation and new drug design based of
      scientific evidence.

PMID- 11197856
TI  - [Tailor-made drug therapy].
AB  - Progress in the field of pharmacogenetics has revealed that the phenotypically
      different responses of patients to drugs are genetically determined by the
      polymorphisms in the genes involved in their pharmacokinetics and
      pharmacodynamics. Information on genetic polymorphisms, including single
      nucleotide polymorphisms, found in the genes encoding drug-metabolizing enzymes,
      drug transporters, drug receptors, and so on, are now applicable to tailor
      made(individualized) drug therapy. This report presents the current status of
      pharmacogenetic approaches to the individualized therapy.

PMID- 11197854
TI  - [Life style-related disease].
AB  - Diabetes mellitus, hyperlipidemia, hypertension and atherosclerotic diseases have
      recently defined as typical life style-related diseases. A common background of
      these life style-related diseases is overnutrition and its consequence, obesity.
      Recent advances in the biology of adipose tissue have revealed that adipose is
      not simply an energy storage organ but it also secretes a variety of molecules
      which affect the metabolism of the whole body. Through a systematic search of
      active genes in adipose tissue, we found that adipose tissue, especially visceral
      fat expressed numerous genes for secretory proteins. Among them, plasminogen
      activator inhibitor-1(PAI-1) was over expressed in the visceral fat in an animal
      model of obesity. Plasma level of PAI-1 was closely correlated with visceral
      adiposity in human. Thus, PAI-1 secreted from visceral fat may play an important
      role in vascular disease in visceral obesity. Adiponectin, a novel adipose
      specific gene product, is abundantly presented in human plasma. This molecule has
      been shown to have protective roles against atherosclerotic vascular changes and
      its plasma level is negatively correlated with visceral adiposity. In conclusion,
      dysregulated secretion of these adipose-specific secretory
      proteins(adipocytokines) may have important roles in the development of life
      style-related diseases, especially atherosclerotic diseases.

PMID- 11197857
TI  - [Progress in targeted gene repair].

PMID- 11197858
TI  - [Perspectives on postgenome medicine: Cancer].
AB  - Carcinogenesis is a multistep process which is the outcome of the accumulation of
      genetic and epigenetic events. However, characteristics of cancers, such as drug
      sensitivity, abilities in invasion and metastasis, are different in each
      patients, and reliable prediction of those characteristics is not available. DNA
      microarray and SNP have become the most widely used functional genomics tools.
      Microarray technology has provided the ability to analyse the expression profiles
      for thousands of genes, and a wealth of new information that should aid in cancer
      diagnosis and ultimately in therapy. The SNP project also will generate very
      variable resources for cancer therapy. The medicine in the next century will be
      so called 'personalized medicine' based on the new information of patients and
      diseases.

PMID- 11197859
TI  - [Perspectives on postgenome medicine: Inborn error of metabolism].
AB  - The news that human DNA structure will be completely analyzed in very near future
      does not mean the whole human genomes being clarified including own function and
      interaction between each gene. Concerning the diseases of inborn error of
      metabolism, we should clarify the implication of mutant gene, especially on non
      cording regions, and genotype and phenotype relationship in each disease.
      Additional factors producing different phenotypes, even the same mutant gene
      being involved, such as environmental factors, modifier genes and SNPs in the
      affected gene are also the project of further discussion. Such information will
      be most useful for genetic counseling, and treatment and prevention of the
      diseases. New drugs designed by unique idea, gene therapy and therapy using hES
      cells should be developed for clinical practice, and for this purpose,
      fundamental research is indispensable.

PMID- 11197860
TI  - [Gene therapy for arteriosclerotic diseases].
AB  - Recent progress in molecular biology gives us gene therapy, as a new strategy for
      treatment of cardiovascular diseases. Targeted diseases have been wide-spread
      from single gene-deficient diseases to more complexed adult diseases such as
      restenosis after angioplasty and ischemic diseases. Clinical gene therapy for
      restenosis and angina using VEGF gene have already performed in USA and they can
      show beneficial effects of such strategies. On the other hand, we have just
      started a clinical trial using E2F decoy for restenosis after PTA or PTCA, since
      April 2000. E2F decoy is expected to become a new treatment for restenosis as a
      gene therapy. Also, the feasibility of a novel therapeutic strategy using
      angiogenic growth factors such as VEGF to augment collateral artery development
      has recently entered the realm of treatment of ischemic diseases. We focus on
      HGF, which is a novel endothelial growth factor. HGF-based therapeutic
      angiogenesis would possibly result a new treatment for severe ischemic diseases.

PMID- 11197861
TI  - [A model for clinical study based on genome science--trials in disorders of the
      immune system and allergies].
AB  - Disorders of the immune system, such as allergies, have multi-factorial
      etiologies that include both genetic and environmental components. The recent
      advances in genome science have facilitated two strategies for studying the
      genetic basis of disease: (1) systematic analysis of gene expression profiles and
      (2) comprehensive analysis of gene variations, such as polymorphisms. Here, we
      describe a unique research institute, Genox Research Inc., that can relate the
      clinical profile of a patient to genotyping and molecular profiling. Systematic
      gene expression analyses using differential display have been performed to
      explore genes related to allergy, and revealed 93 differentially expressed
      candidate genes in T-cells. Also, a single nucleotide polymorphism(SNP) analysis
      project has been designed to mine disease-related and/or drug-response-related
      genes involved in allergic disorders using biochip technologies. As exemplified
      above, clinical studies based on these applications of genome science would be of
      considerable value in clarifying our understanding of multi-gene disorders.

PMID- 11197862
TI  - [Perspectives on postgenome medicine: Hematological diseases].
AB  - With advances in DNA chip(DNA microarray) technology, it has become possible to
      obtain genome-wide gene-expression profiling. This novel technology is now
      applied to the study of molecular pathogenesis, differential diagnosis, and
      prediction of prognosis in the field of hematological malignancies. Importantly,
      the list of informative genes includes new markers of diseases, which will be
      utilized for further investigation. As for clinical gene therapy, it has been
      criticized for promising too much and providing too little during the last 10
      years. In 1999, however, the success of hematopoietic stem cell gene therapy was
      reported in the patients with X-SCID(X-linked severe combined immunodeficiency).
      The gene therapy of hemophilia B using AAV(adeno-associated virus) vector has
      also successfully started. Genetic manipulation will be applied to the treatment
      of various diseases with the development of novel technologies.

PMID- 11197863
TI  - [Gene therapy and tissue engineering in nephrology and renal transplantation].
AB  - Human genome project will be completed in 2003 and we will soon obtain the
      information of the whole DNA sequence of the human genome. This should affect the
      therapy of progressive renal diseases since we have no effective remedy to cure
      the renal diseases. Gene therapy, renal engineering and generation of new drug
      can be achieved by using the information of human genome. In this context, we
      described our recent endeavors concerning the gene therapy of transplant kidney,
      seeking the renal stem cells and reprogramming factors, and exploring genes
      related to renal fibrosis. Completion of bioinformatics, can facilitate the above
      post-genome project.

PMID- 11197864
TI  - [Perspectives on postgenome medicine in the 21st century].
AB  - Since the human genome project has been almost completed in 2000, the year of
      2001 is the first year of the postgenomic era. A variety of postgenome studies
      will be done in the next decade, including functional, comparative and structural
      genomics. These studies may open new area in medicine, because disease
      susceptibility and drug metabolism would be predicted from genetic
      characteristics of individuals. Genome studies may also shed a light on cell
      biology, brain research and regeneration medicine and promote these studies.
      Bioinformatics will become a basis of postgenome biology and medicine.

PMID- 11197865
TI  - [Gene therapy for adenosine deaminase (ADA) deficiency: review of the past, the
      present and the future].
AB  - ADA deficiency is the first disease being treated by gene therapy. Since the
      first trial of gene therapy performed ten years ago, more than 10 patients
      including our case with ADA deficiency have been treated by the gene therapy with
      different clinical protocols. In contrast to the recent successful report for X
      SCID patients, however, no curative effect of gene therapy for ADA deficiency has
      been achieved at the moment. In this chapter, I would like to review the past,
      the present and the future of gene therapy for ADA deficiency, and discuss an
      issue, especially PEG-ADA therapy, regarding the prospect for stem cell gene
      therapy for the disease.

PMID- 11197866
TI  - [Perspectives on postgenome medicine: Gene therapy for brain tumors].
AB  - Recent development of therapeutic modalities in neurosurgery has brought about
      dramatic improvement for prognosis of brain tumors. Nevertheless, malignant
      glioma is one of the most formidable neoplasms in humans. According to a report
      by the Committee of Brain Tumor Registry of Japan, five-year relative survival
      rate of malignant gliomas is less than 10%. Malignant gliomas grow aggressively
      infiltrating into the surrounding normal brain tissue. So that total surgical
      resection is impossible. The tumors respond to radiation and chemotherapy,
      however, the efficiency has sustained transiently. The advert of new strategies
      for the treatment of malignant gliomas has long been awaited. We have developed a
      cytokine gene therapy for malignant glioma since about 10 years ago. Here, we
      introduce both suicide gene therapies and immune gene therapies including our
      case(IFN-beta gene therapy).

PMID- 11197867
TI  - [Perspectives on postgenome medicine: Gene therapy for lung cancer].
AB  - The gene therapy or the immunotherapy targeting specific molecule(s) have just
      introduced into the clinical field in Japan. The first gene therapy for the human
      lung cancer is underway; an adenoviral vector harboring wild type p53 gene is
      intratumorally injected. A cancer immunotherapy using the Cyclophilin B derived
      peptide is in the phase I clinical trial. As the next generation cancer
      therapies, a variety of strategies are planned and investigated at the laboratory
      level. They range from the usage of a new viral vector to the introduction of
      genes with specific biological functions into the cells. In this article, by
      reviewing the possible approach, an ideal combination of the future remedies is
      discussed.

PMID- 11197868
TI  - [Perspectives on postgenome medicine: Gene therapy for esophageal cancer].
AB  - Despite improvements in perioperative treatment and surgical techniques, rapid
      recurrence led to death of many patients with advanced esophageal cancer. Since
      surgical resection alone rarely results in long term survival, efforts now are
      focused on combined multi modality treatment in an attempt to improve local
      control and eliminate micro metastasis present at time of surgery. We have
      reported that the importance of alteration of p53 gene in progression and
      prognosis of esophageal cancer. P53 molecule of solid tumors has been shown to
      play an important role in the response to DNA damage induced by chemotherapeutic
      agents and radiation therapy, including induction of apoptosis. Based on the
      research of p53 gene therapy for esophageal cancer, we applied clinical study in
      1997. After intensive reference, phase study was accepted in May, 2000. Phase
      I/II study will start on October 2000.

PMID- 11197869
TI  - [Gastric cancer--novel strategy of gene therapy for gastric cancer].
AB  - Recently stage-oriented treatment for gastric cancer has been done in Japan.
      Endoscopic mucosal resection for intramucosal cancer and wedge resection under
      laparoscopy for minimal invasive cancer in the stomach have been performed. For
      advanced gastric cancer, extended lymph node dissection(D2) has been applied as
      standard treatment in Japan. However, new strategy has been required for advanced
      gastric cancer with distant lymph node metastasis and/or peritoneal
      dissemination. It is well known that gene therapy for cancer has limitation of
      efficacy, but we believe the new strategy will be available in post-genome era
      for gastric cancer treatment using 1. developing novel adenovirus, 2. usage of
      drug delivery system and 3. effective treatment for adverse effect.

PMID- 11197870
TI  - [Gene therapy for colorectal cancer].
AB  - Gene therapy represents a novel approach to the treatment of colorectal cancer,
      and this brief review addresses the current strategies and ongoing clinical
      trials, including tumor suppressor gene replacement therapy with wild-type p53,
      virus-directed enzyme-prodrug therapy and immunomodulatory approaches. All of the
      clinical trials have been phase I, principally designed to evaluate safety, but
      some of them provided the evidence of gene delivery and expression. Although the
      results of pre-clinical studies have been encouraging, clinical trials have not
      yet demonstrated anti-tumor effect. Gene therapy for colorectal cancer is still
      in the early stages of development, and fundamental research in the molecular and
      cellular biology will improve the therapy.

PMID- 11197871
TI  - [Development of gene therapy for pancreatic cancer].
AB  - In order to develop the new therapeutic intervention for pancreatic cancer, we
      have examined the effect of gene therapy for this miserable pancreatic disease.
      The transfection of UPRT, a 5-FU converting enzyme, gene resulted in the
      significant change in sensitivity of pancreatic cancer cells against 5-FU. Anti
      angiogenesis gene therapy has been also demonstrated to be a promising strategy
      for pancreatic cancer. It has been revealed that replication-competent
      adenoviruses are not only the strong weapon themselves but also useful carriers
      of genes possessing anti-tumor activities as virus vectors specific to tumors
      without normal p53 function nor intact Rb pathway. Whether these experimental
      results are universally true require the clinical trials in future.

PMID- 11197872
TI  - Reminiscence therapy using odor in alcohol-dependent patients-
      psychophysiological evaluation and psychological evaluation; power spectral
      analysis of heart rate variability.
AB  - OBJECTIVE: This research was based on the hypothesis that when alcohol-dependent
      patients describe themselves, awakening of emotion by affirmative odor
      stimulation may facilitate memory reframing focusing on more affirmative emotion
      and memories. To prove the hypothesis, physiological changes accompanied by
      emotional awakening were evaluated by measuring the autonomic activity. In
      addition, subjective evaluation by a self-report manner was examined to
      investigate the effectiveness of Reminiscence Therapy (RT) using odor in alcohol
      dependent patients. SUBJECTS: Thirty-four patients who met the DSM-IV criteria of
      alcohol-related disorders and were hospitalized in a ward specialized to alcohol
      dependence therapy. METHODS: Each patient underwent a one-to-one interview twice.
      For counterbalance, one interview was performed with odor stimulation using an
      odor with a relaxing effect that recall pleasant emotion, and the other was
      without odor stimulation. As the evaluation indices of physiological changes
      accompanied by emotional awakening, index of autonomic function (HRV; Heart rate
      variability) for objective evaluation and psychological indices (STAI; State
      Trait Anxiety Inventory VAS; Visual Analog Scale) for subjective evaluation were
      measured. RESULTS: 1) Objective evaluation: Regarding the evaluation index of the
      autonomic function, the sympathetic nervous system activity (LF/HF; low frequency
      component/high frequency component ratio) was significantly inhibited by odor
      stimulation (p < 0.05). 2) Subjective evaluation: Compared to the state prior to
      interview, state anxiety judged by STAI was significantly decreased after
      interview (p < 0.01). The VAS score was significantly decreased after interview
      regardless of the presence or absence of odor stimulation (p < 0.0001).
      CONCLUSIONS: A reduction in state anxiety was observed. The effect of odor was
      not significant on the subjective evaluation, but the objective evaluation
      suggested that the odor inhibited the sympathetic nervous system. Thus, it was
      suggested that odor can be used in RT, that is, emotional changes due to
      stimulation of odor may be applicable in RT.

PMID- 11197873
TI  - The Japanese version of Substance Abuse Subtle Screening Inventory and its
      psychometric assessment.
AB  - OBJECTIVE: The purpose of our study was the development of the Japanese version
      of the Substance Abuse Subtle Screening Inventory (SASSI) and its psychometric
      assessment. METHOD: We translated SASSI-3 into Japanese and refined it through a
      back-translation technique and focus group approach. Study 1 was a preliminary
      study to examine the internal consistency and discriminant function of subscales,
      sensitivity and specificity of the Japanese version SASSI-3 (SASSI-3J). The
      participants were 20 drug-dependent individuals and 23 non-dependent comparison
      individuals. Study 2 comprised three parts. The participants were university
      students recruited from three classes. The first part examined the internal
      consistency of subscales and the relationship between the subscale Face Valid
      Alcohol (FVA) and the Kurihama Alcoholism Screening Test (KAST) with 269
      students. The second part examined the 2-week test-retest reliability with 51
      students. The third part examined the robustness of SASSI-3J against response
      distortion with 65 students: participants completed the SASSI-3J under standard
      instructions, under instructions to minimize any alcohol problems they might have
      (fake good), and under instructions to exaggerate any alcohol problems they might
      have (fake bad). They also completed the Social Desirability Scale. RESULTS: 1)
      SASSI-3J showed relatively high sensitivity and specificity when only the Risk
      Prediction Scales were used or when Rule 9 was excluded from the decision tree;
      2) The Risk Prediction Scales of SASSI-3J had high internal consistency, and
      among them, Face Valid Alcohol (FVA) showed moderately high concurrent validity
      with the KAST; 3) In both Study 1 and Study 2, the internal consistencies of OAT,
      SAT, DEF and SAM were moderate to low (0.05 to 0.57). This may not interfere with
      the subscales' discriminant power but does deny sufficient uni-dimensionality of
      these scales; 4) SASSI-3J clinical scale scores were shown to be robust against
      faking good/social desirability bias.

PMID- 11197874
TI  - Stress-related behavioral alterations accompanying cocaine toxicity: the effects
      of mixed opioid drugs.
AB  - The present study evaluated the effects of mixed opioid drugs on the severity of
      cocaine (COCA) toxicity by examining stress-related behavioral alterations in
      mice. In order to ascertain the strength of the stress, the continuous
      observation of the behavioral symptoms in the cage and the forced swimming test
      (Porsolt test) were performed in the COCA (75 mg/kg, i.p.)-treated groups, with
      or without the mixed mu-kappa receptor-related opioid drugs, buprenorphine (BUP)
      and pentazocine (PEN). Using the high-sensitivity activity measuring instrument
      Supermex, both the spontaneous behaviors in the cage and the forced swimming
      behaviors in the water were assessed as activity counts. The behavioral
      alterations in the COCA-treated groups were compared with a group of mice given a
      10 min immobilization stress (IM group). In the COCA-only group, a prolonged
      increase in the spontaneous behaviors accompanied by convulsive seizures was
      observed even in the surviving mice, unlike in the IM group. However, an
      acceleration of behavioral despair in the Porsolt test similar to that observed
      in the IM group was observed in the COCA group after the disappearance of the
      acute toxic symptoms (5 hours after the COCA treatment). Among the opioid-treated
      groups, the mortality rate was attenuated only in the COCA-BUP (0.25 mg/kg, i.p.)
      group. In the COCA-BUP group, a prolonged suppression of the morbid hyperactivity
      in the cage except for the convulsive seizures, and a normalization of the
      swimming behavior in the Porsolt test were observed in the survivors. On the
      other hand, in the COCA-PEN (5 mg/kg, i.p.) group, the swimming behavior in the
      Porsolt test was abnormally increased in addition to the prolonged morbid
      hyperactivity in the cage. Therefore, the COCA-induced stress-related behaviors
      were normalized in the group of mice treated with BUP, a group with a good
      prognosis.

PMID- 11197875
TI  - A study on the socio-psychiatric aspects of short-term ARP (Alcohol
      Rehabilitation Program).
AB  - The duration of the majority of Alcohol Rehabilitation Programs (ARP) at major
      hospitals specializing in this treatment is three months. Recently, however,
      because of diverse backgrounds and patients needs, long periods of
      hospitalization have become difficult. In response to this, Okamotodai Hospital
      initiated a one-month ARP program three years ago. One feature of this program is
      that it can be freely structured to meet the requirements of individual patients.
      This study compares the prognosis of patients treated under this one-month
      program with that of those who have undergone the three-month program. A group of
      56 patients who had completed a one-month ARP program during a period of two to
      three years was compared with a group of 46 patients who had completed a three
      month program over a similar period. The backgrounds of the subjects were
      researched by questionnaire. A comparison of the prognosis of patients in the
      respective programs showed there was no statistical difference, with a recovery
      rate of 45% for both programs. Results of this study statistical difference, with
      a recovery rate of 45% for both programs. Results of this study cannot be
      generalized, due to the lack of subjects and recovery of questionnaires. Since
      enforcement of the one-month ARP, increasing number of patients have been using
      the program. This fact doesn't necessarily show that the use of ARP improve,
      although the possibility remains that utilization of the one-month ARP is
      promoted. In recent years, utilization of brief intervention has been
      demonstrated and recovery from alcoholism in the outpatient clinics reported.
      Considering such things, results of the study show that the one-month ARP is a
      valid and effective program.

PMID- 11197876
TI  - [Theophylline].

PMID- 11197878
TI  - [Behavior of indoor air pollutants].

PMID- 11197877
TI  - [Pediatric allergy].

PMID- 11197879
TI  - [Japanese cedar pollinosis in infants in the allergy clinic].
AB  - Recently, the number of patients with Japanese cedar (Cryptomeria japonica)
      pollinosis has increased, especially in children. However, little is known about
      the incidence in infants. We studied on the rate of sensitization and the onset
      of pollinosis in children under 6 years old. The percentage of positive CAP-RAST
      to Japanese cedar pollen was 27.6%, in 76 infants (51 male and 25 female, 2
      months-5 years old) who visited National Mie Hospital pediatric allergy clinic
      due to bronchial asthma and/or atopic dermatitis. The youngest child who has been
      sensitized to pollen was 1 year 8 month old boy. The percentage of positive rate
      of CAP-RAST to house dust mite was 61.8%. Twenty-seven infants (20 male and 7
      female, 2-5 years of age) were diagnosed as Japanese cedar pollinosis in National
      Mie Hospital Otorhinolaryngology clinic in 1999 and 2000. The youngest child with
      pollinosis was 2 year 5 month old boy. Most of the 27 infants complained of
      rhinorrhea and/or eye symptoms and some of them complained cough, snoring, or
      epistaxis. About 40% were sensitized to Japanese cedar and/or cupressaceae pollen
      alone, 60% were also sensitized to house dust mite. In conclusion, it is possible
      that the sensitization to Japanese cedar pollen occurs after 2 season of pollen
      exposure and pollinosis occurs in 2 years old. Japanese cedar pollen has been an
      important allergen not only in school children, but also in infants.

PMID- 11197880
TI  - [Intestinal flora of infants with cow milk hypersensitivity fed on casein
      hydrolyzed formula supplemented raffinose].
AB  - We studied the intestinal flora of infants with cow milk hypersensitivity fed on
      casein-hydrolyzed formula (MA-1) and the influence of that supplemented with
      Raffinose (MA-1[R]). Infants with cow milk hypersensitivity were fed with MA-1
      for 2 weeks, after which the formula was changed to MA-1[R]. Fourteen subjects
      were enrolled in this study and divided into two groups; three who fed with
      breast or conventional milk in addition to MA-1 or MA-1[R](BM group) and 11
      mainly fed with MA-1 or MA-1[R] (TF group). Intestinal flora was investigated at
      two weeks after MA-1 feeding and at two weeks after MA-1[R] feeding,
      respectively. Bifidobacterium was detected as the most predominant bacteria in
      all examples in the BM group, and that count and the ratio in all bacteria
      remained high even after changing MA-1 to MA-1[R]. On the other hand, bacteria
      count and ratios of Bifidobacterium in all bacteria were conspicuously low in the
      TF group as compared with the BM group. And with the change from MA-1 to MA-1[R]
      in the TF group, the bacterial number and the occupation ratio of Bifidobacterium
      were increased, and Enterobacteriaceae bacterial count and the occupation ratio
      were decreased. The change of the intestinal flora with MA-1[R] feeding was
      mainly caused by the breeding action of Raffinose on bifidobacteria. Further
      studies are needed from a viewpoint of clinical effectiveness about the influence
      of normalization of the intestinal flora for the treatment of food
      hypersensitivity.

PMID- 11197881
TI  - [An electron microscopic study of the relation between epithelial cell damage and
      eosinophilia in the nasal mucosa of patients with nasal allergy].
AB  - To determine the relationship between epithelial damage and eosinophilia in the
      nasal mucosa of patients with nasal allergy, we examined the nasal mucosa
      (obtained by surgery) from 74 patients with allergic rhinitis, using light and
      electron microscopy. The extent of eosinophilia correlated significantly to
      grades of epithelial damage and torn tight junctions of the epithelial cells. No
      significant relationships were found between the severity of nasal symptoms and
      the extents of eosinophilia or grades of torn tight junctions of the epithelial
      cells. More than 50% specific granules in eosinophils in the allergic nasal
      mucosa showed normal findings. There were no significant relationships between
      the extent of eosinophil degranulation and grades of epithelial damage. Based on
      our results, the release of tubular vesicular structures from the eosinophil
      granule may be one form of eosinophil degranulation in the nasal mucosa of
      patients with nasal allergy.

PMID- 11197882
TI  - [The effect of suplatast tosilate on immunological parameters for the patients
      with atopic dermatitis].
AB  - A dose of 300 mg/day of suplatast tosilate was administered to one hundred one
      cases of atopic dermatitis for eight weeks, and the severity scores, peripheral
      blood eosinophil count, total serum IgE levels, plasma eosinophil cationic
      protein (ECP) levels, and other immunological parameters before and after the
      trial were observed and comparatively examined. The results are as follows: 1)
      Temporary improvements were found in the scores of severity and itchiness on all
      evaluated skin regions (face, limbs, and trunk). These scores decreased
      significantly for all observation periods at two, four, six and eight weeks after
      administration of suplatast tosilate compared with those before the
      administration (p < 0.01). 2) There was no sign of adverse effects on the drug.
      In the blood tests, one patient displayed elevated levels of GPT and another
      showed elevated total bilirubin. In the urine test (qualitative test), one case
      with positive urinary protein was observed. 3) Clinical examinations including
      assessment of the immunologic parameters were conducted at an average of 8.68 +/-
      0.36th week. The peripheral blood eosinophil count, the percentage of eosinophil,
      and plasma ECP levels significantly diminished compared with those before
      administration, but no significant difference was found in total serum IgE levels
      and LDH levels. 4) The subjects were divided into two groups, one in which the
      clinical scores were improved by more than five and another with scores of less
      than five (including worsening), and the fluctuation of the immunological
      parameters (values before and after administration of the drug) of the two groups
      were compared. As a result, a significant difference was observed in the plasma
      ECP levels (p = 0.02) and peripheral blood eosinophil count (p = 0.091), but no
      difference was observed in total serum IgE levels and LDH levels. From the above
      mentioned results, the high efficacy and safety of suplatast tosilate in the
      treatment of severe atopic dermatitis were confirmed. At the same time, a
      decrease in the peripheral blood eosinophil count and the serum ECP levels were
      observed, suggesting the possibility that these values could be used as indices
      of the severity of atopic dermatitis.

PMID- 11197883
TI  - [Genetic analysis of two patients with adenosine deaminase (ADA)-deficiency:
      detection of three novel mutations and characterization of two paradoxical
      carriers].
AB  - Genetic basis of two patients (AT, MT) with ADA deficiency was studied. We
      identified three novel mutations (119 Q-->Stop, 235 R-->Q, one base deletion in
      Exon 4) from the patients. 119 Q-->Stop was detected in AT and her father.
      Deletion of one base in Exon 4 which would change the reading frame after codon
      105 H, was detected in MT, her father and brother. There was no relation between
      the two families, however, 235 R-->Q was also detected in both the patients and
      their mothers. Extremely low ADA activity of PBMCs was revealed in healthy MT's
      mother and brother just as MT, although their dAXP levels of RBCs showed
      significantly lower than that of MT. We defined that they shared an additional
      mutation (310 M-->T) together with the mutation described above, respectively.
      EBV-transformed B-cell line (EBV-B) were established from the carriers. To our
      surprise, ADA activity of their lines was 1/10-1/5 of normal. The result of heat
      treatment studies using the EBV-B showed that the mutant ADA rapidly lose its
      enzyme activity without degradation of the protein. It suggests that 310 M-->T
      mutant ADA rapidly lost its enzyme activity due to conformational change of the
      catalytic site of ADA.

PMID- 11197885
TI  - Increased augmentation index and systolic stress in type 1 diabetes mellitus.

PMID- 11197884
TI  - [Allergic granulomatous angitis causing ureteral stenosis].

PMID- 11197886
TI  - Illustrating the machinery of life.

PMID- 11197887
TI  - The artistry of Clemente Susini and the La Specola waxes.

PMID- 11197888
TI  - [Epidemiological and clinical study of West syndrome in Nagasaki Prefecture,
      Japan].
AB  - To determine the occurrence, outcome, and prognostic factors of West syndrome
      (WS), we performed a retrospective epidemiological study of WS occurred in 47
      children (26 boys and 21 girls) in Nagasaki prefecture during a recent 10-year
      period from 1989 to 1998. The incidence of WS was 3.1/10,000 live births. The
      mean age at onset of spasm is 6.3 months (range: 2 to 12 months). Thirty-nine
      patients (83%) had symptomatic WS, in which the prenatal causes (patients) were
      most frequent, followed by low-birth weight infants (patients), perinatal
      (patients) and postnatal (patients). The brain CT was performed in 37 patients,
      and revealed congenital brain malformations (9 patients), destructive brain
      disorders (12 patients), and no structural abnormalities (16 patients). The
      seizure outcome was worse in the symptomatic WS than in the cryptogenic WS;
      seizure/disappeared in 39% of the former and in 75% of the latter/developmental
      delay before the onset of WS, relapse of WS and persistence of seizures were
      associated with poor seizure outcomes. Among the remaining seizures at the time
      of this surveillance, a tonic seizure was most frequently observed, followed by
      the partial seizures. Lennox-Gastaut syndrome was observed in 2 patients only.
      Epileptic discharge in the latest interictal EEG were diffuse in 4.3%, focal or
      multifocal in 60.7%, and absent in 35%, suggesting that many patients with WS had
      cortical epileptogenic foci. The developmental outcome was very poor in both the
      symptomatic and cryptogenic WS. The mean DQ in all the patients was 25, and only
      4 patients (11%) had a normal DQ (> 75). DQ was lower in patients with congenital
      brain malformations than in those with destructive brain disorders.

PMID- 11197889
TI  - [Aims and roles of child neurologists for the 21st century].

PMID- 11197890
TI  - [Survey of vaccination for physically-handicapped and epileptic children].
AB  - We studied immunization for 128 handicapped patients, from 3 to 15 years of age,
      in a Seishi Gakuen Hospital, with 8 vaccines: diphtheria-purified acellular
      pertussis-tetanus combined (DPT), BCG, polio, measles, rubella, mumps, varicella,
      and Japanese B encephalitis. The rate of vaccination in these patients was lower
      than in healthy children at 3 years of age in Kanazawa City. There was no
      significant difference between patients with and without epilepsy. The rate was
      higher in the hospitalized patients than in the outpatients. More than 90% of the
      hospitalized patients was immunized against influenza under informed consent in
      1997 and 1998. Despite pandemics of influenza in Kanazawa City, where the
      hospital was located, the period of fever by influenza was significantly shorter
      in our patients in both 1997 and 1998 than in 1996. Although a half of our
      patients had epilepsy, they were safely vaccinated with few side effects.

PMID- 11197891
TI  - [Seizures associated with fever in children of congenital adrenal hyperplasia].
AB  - We investigated seizures in 22 children with congenital adrenal hyperplasia
      (CAH), eight of whom had seizures associated with fever. The follow-up period was
      5-18 years. The onset of seizures ranged from 1 to 4 years of age, and the total
      number of seizures was one to three in all cases. Four cases had seizures twice
      within 24 hours. None had seizures after 5 years of age. In two of the eight
      cases, the seizures may have caused by hypoglycemia or hyponatremia, in the
      remaining six they were considered to be febrile seizures. Three of them had
      first-degree relatives with febrile seizures. Electroencephalogram was recorded
      in five cases, with normal results in all of them. One case with febrile status
      developed localization-related epilepsy later. None showed developmental delay
      during follow-up. Although seizures in CAH have been ascribed to hypoglycemia
      and/or metabolic disorders (hyponatremia), our findings implicate unknown factors
      in the pathogenesis such as excess secretion of corticotropin releasing factor
      (CRF) under stress, prolonged elevation of CRF during fetus life and linkage
      between CAH and febrile seizures on the chromosome 6.

PMID- 11197892
TI  - [Child neurology and neurobiology].

PMID- 11197893
TI  - [The developmental effects of an early intervention program for very low
      birthweight infants].
AB  - We assessed the efficacy of an early intervention program (EIP) designed to
      promote the neonatal behavioral organization and developmental progress in
      infants born prematurely. The study subjects consisted of 48 very low birthweight
      infants (< or = 1,500 gms) who received care in NICU of Nagasaki University
      Hospital, Nagasaki, Japan. During 1993-1996, the experimental group (n = 30)
      received the NBAS (Neonatal Behavioral Assessment Scale) based intervention
      combined with a therapeutic program (EIP), for 44 weeks starting from 38 weeks of
      postmenstrual age. The control group (historical control, n = 18) received the
      standard medical-nursing care without EIP during 1990-1992. Developmental outcome
      was assessed in both groups using the NBAS examination after EIP at 44 weeks of
      postmenstrual age, and the Bayley Scales at 12 months corrected age. Multivariate
      analyses were performed to adjust for baseline variables that might be associated
      with the developmental outcome: sex, appropriate or light for dates infant,
      birthweight, gestational age, Apgar score at 1 minute, duration of intubation,
      and NBAS cluster score before EIP. In the NBAS examination after EIP, the
      experimental group achieved significantly higher scores in orientation, motor
      performance, state range and state regulation tasks than the control group.
      Furthermore, the experimental group showed significantly higher Bayley Mental and
      Psychomotor Developmental Indices compared with the control group. These results
      suggested that EIP was effective in promoting the neonatal neurobehavioral
      development of very low birthweight infants.

PMID- 11197894
TI  - [Regional variation in bone mineral density and motor function in children with
      cerebral palsy].
AB  - Bone mineral density (BMD) and motor activity of the upper extremities, were
      studied in 18 children with spastic cerebral palsy (CP group) and 12 age-matched
      normal boys (control group). The motor activity was monitored by a piezoelectric
      transducer. Whole body BMD as well as BMD of the head, upper limbs, ribs, spine,
      pelvis, and lower limbs was evaluated by dual energy x-ray absorptiometry. In the
      CP group, BMDs were lower compared to control group in the whole body and in all
      the body regions (except for the head) especially in the pelvis and lower limbs.
      BMDs of these regions were higher in walking patients than in bed-ridden,
      rolling, and crawling patients. Motor activities in the upper extremities were
      lower in the CP than in the control group. BMD increased with developing motor
      activity in the upper extremities. These results implicate diminished BMDs of the
      lower limbs and pelvis, which are associated with standing and walking, to the
      high incidence of femur fractures in CP.

PMID- 11197895
TI  - [Teratoma in the cerebellar hemisphere of an infant].
AB  - We report here a 4-month-old male infant with a cerebellar teratoma. After
      vomiting for 5 days, he had a tonic-clonic seizure on the left showing secondary
      generalization. Neuroimaging studies showed severe hydrocephalus and a large
      tumor in the left cerebellar hemisphere, which showed calcification. Postictal
      scalp electroencephalogram showed right hemispheric spikes and spike-waves. He
      underwent an emergency operation and had the tumor totally removed. Histological
      diagnosis of the tumor was immature teratoma. Intracranial teratomas have a
      predilection for supratentorial and midline sites. They are the most common in
      the neonatal period. We presented a very rare case of teratoma in the cerebellar
      hemisphere of an infant.

PMID- 11197896
TI  - [A case of multiple sclerosis with recurrent episodes of psychiatric symptoms].
AB  - We reported a 19-year-old woman with multiple sclerosis (MS) with recurrent
      episodes of psychiatric symptoms at the age of 10 and 19, as the first and 11th
      relapse, respectively. Her first episode of MS resembled acute encephalitis at
      the age of 9 and she relapsed 12 times. The psychiatric symptoms were not mood
      disorders but altered states of consciousness, such as the delirous state. She
      was treated with high doses of intravenous methylpredonisolone and her symptoms
      were almost resolved, but her anxiety neurosis remained. Her MRI showed
      demyelination in the white matter of the frontal lobe and the hippocampus, which
      suggested that psychiatric symptoms of MS would be related to the frontal lobe
      lesion.

PMID- 11197897
TI  - [A case of bilateral coronal craniosynostosis with the P250R mutation in FGFR3
      gene].
AB  - Recently, the substitution of proline 250 by arginine in the fibroblast growth
      factor receptor 3 (FGFR3) gene, has been identified in patients with
      craniosynostosis and defines a new syndrome on a molecular basis. We report a 1
      year-1-month-old female with bilateral coronal craniosynostosis who had the P250R
      mutation in FGFR3 gene detected by DNA sequencing. She had brachycephaly,
      temporal bossing, high and flat forehead, hypertelorism, mild proptosis, low set
      ears and no digital abnormalities. She underwent surgical repair at 7 months and
      her cosmetic problems were improved. Her development was normal up to 13 months
      of age. DNA analysis from her parents showed that her father had the same
      mutation. The phenotypes of the P250R mutation in the FGFR3 syndrome are variable
      even within the same family, but main characteristic clinical features are
      follows, 1) lateral or bilateral coronal craniosynostosis, 2) mild hand and foot
      anomalies, and 3) sensory deafness. In FGFR3 syndrome the diagnosis of P250R
      mutation by polymerase chain reaction (PCR) is very easy and important for early
      diagnosis and genetic counseling.

PMID- 11197898
TI  - [Effect of diazepam on apnea attacks in a 6-year-old girl with Rett syndrome: a
      polysomnographic study].
AB  - We reported a 6-year-old girl with Rett syndrome with severe apnea attacks
      following hyperventilation during wakefulness for which oral diazepam, 1.5 mg per
      day, showed marked effect. We evaluated the efficacy of diazepam by
      polysomnography. Polygraphical examinations revealed decrease of apnea attacks
      from 15.7/hour to 0.6/hour and of the duration of the longest apnea attack from
      40 seconds to 18 seconds. These results support the previous reports which
      suggests involvement of the cerebral cortex and the reticular formation for
      respiratory disturbance in Rett syndrome.

PMID- 11197899
TI  - [EEG findings in a case of acute necrotizing encephalopathy of childhood
      associated with influenza A virus infection].
AB  - We reported here a case of symptomatic partial epilepsy following acute
      necrotizing encephalopathy of childhood associated with influenza A virus
      infection. This 2-year-old boy underwent repeated EEG recordings, which at the
      acute stage was dominated by diffuse 1-2 Hz slow waves. The background activity
      was 5 Hz theta waves on the 49th day. Paroxysmal activities appeared after the
      89th day of illness. On the 231st day, EEG showed spike-and-waves on the left and
      right frontal areas. Interestingly, paroxysmal activities preceded the onset of
      epileptic seizures by 7 months, and spike-and-waves by 2 months. After 10 months,
      he had generalized seizures with fever, and partial seizures on awakening without
      fever. Interictal EEG showed spike-and-waves on the bilateral frontal areas, and
      diffuse polyspikes and slow waves were occasionally seen. Though the background
      activity improved, his consciousness level did not recover probably because the
      thalamus, basal ganglia, brainstem were damaged more severely than the cerebral
      cortex.

PMID- 11197900
TI  - [Hopkins syndrome: oral prednisolone was effective for the paralysis].
AB  - We describe here a 5-year-old girl who presented flaccid paralysis of the left
      upper limb after recovery from bronchial asthma. T2-weighted magnetic resonance
      imaging of the cervical cord revealed a focal high intensity area in the left
      anterior horn at the C6-C7 level. She was treated with oral prednisolone, and
      paralysis resolved within two months. Thirty cases of Hopkins syndrome have been
      reported so far, but its cause remains unknown. Early administration of
      prednisolone might ameliorate paralysis in this syndrome.

PMID- 11197901
TI  - [A novel allelic variation of serotonin transporter gene polymorphism in anorexia
      nervosa].

PMID- 11197902
TI  - [Decreased serotonin level in patients with anorexia nervosa].

PMID- 11197903
TI  - [Carinal resection of bronchogenic carcinoma].
AB  - Carinal resection was performed in 10 cases of bronchogenic carcinoma during 12
      year-period. The mean age of patients was 58 years, with a range of 42 to 68
      years. There were 7 male and 3 female. The tumor was located on the right side in
      7 cases, on the left side in 1 case on the carina in 2 cases. The histological
      examination showed squamous cell carcinoma in 5 cases, adenocarcinoma in 4 cases
      and adenoid cystic carcinoma in 1 case. The staging revealed T3N2 M0 Stage IIIA
      in 2 cases, T4N0M0 Stage IIIB in 1 case, T4N1M0 Stage IIIB in 1 case, T4N2M0
      Stage IIIB in 5 cases and T4N3M0 Stage IIIB in 1 case. The surgical methods were
      as follows; sleeve pneumonectomy in 5 cases, wedge carinal resection with
      pulmonary resection in 3 cases (right sleeve upper lobectomy in 2 cases and right
      pneumonectomy in 1 case), carinal resection in 2 cases. The site of bronchial
      anastomosis was overlapped by thymus in 6 cases. The 30-day mortality rate in
      tracheo-carinal resection was 10% (one patient). Eight patients died and
      remaining 2 patients are still alive without any evidence of recurrence. 5-year
      survival rate was 36%. These outcomes were almost equal to those of surgical case
      in the same stage.

PMID- 11197904
TI  - [Successful resection of endotracheal metastatic lung cancer using percutaneous
      cardiopulmonary support system: a case report].
AB  - We experienced a rare case of endotracheal metastasis derived from squamous cell
      lung cancer. The patient was 56 year-old male whose primary lung cancer of the
      left upper lobe was completely resected. Pathological diagnosis indicated stage
      IIB and he underwent two cycles of chemotherapy with CDDP + VDS. He had been
      asymptomatic thereafter, however, two years postoperative chest CT revealed a
      nodular lesion of the anterior carinal wall. Bronchofiberoptic examination showed
      same as CT finding and its brushing cytology confirmed squamous cell carcinoma.
      WE successfully resected his endotracheal metastatic lesion and reconstructed by
      direct sutures assisted by PCPS (Percutaneous Cardiopulmonary Support System).
      His postoperative course was uneventful. Majority of the reported cases of
      endotracheal metastases were treated conservatively as radiation, laser and/or
      chemotherapy. We conclude that PCPS is useful device for surgical management for
      selected cases.

PMID- 11197905
TI  - [New approaches for excellent operative field during tracheobronchial anastomoses
      in sleeve pneumonectomy: cardiopulmonary bypass and diseased lung ventilation].
AB  - Cardiopulmonary bypass (CPB) and diseased lung ventilation were presented as new
      methods of oxygenation during carinal reconstruction. Two cases of left sleeve
      pneumonectomy (SP) were performed for bronchial gland carcinoma through clamshell
      incisions. Adequate oxygenation and excellent operative fields were provided by
      CPB in both patients. The postoperative courses of these patients were
      uneventful, although they developed temporary pulmonary edema that needed
      mechanical ventilation and appropriate diuretics for several days. One case of
      patient with squamous cell carcinoma after chemotherapy was successfully treated
      by right SP through midline sternotomy. Adequate oxygenation and excellent
      operative fields was obtained by diseased right lung ventilation in this patient.
      The postoperative course of the patient was uneventful without mechanical
      ventilation support. These procedures of oxygenation in this paper are considered
      to be safe and effective methods for carinal reconstruction.

PMID- 11197906
TI  - [A case of adenoid cystic carcinoma of the left main bronchus, which was
      performed carinal resection and reconstruction while the aortic arch is pulled
      down].
AB  - A 55-year-old woman, who had treated as bronchial asthma for eight months, was
      admitted to our hospital. Chest CT scan showed a mass in the left main bronchus.
      Bronchoscopic examination revealed a tumor obstructing the left main bronchus and
      invading the left lower portion of the trachea. The pathologic diagnosis was
      adenoid cystic carcinoma. Primary resection of the left main bronchus and the
      carina with the objective and one-stoma-type carinal reconstruction were
      performed by the left thoracotomy. We pulled down the aortic arch to obtain an
      operative field, and carried out the operative procedure at the upper side of the
      aortic arch. As the resection margin contained residual tumor, the postoperative
      irradiation (50 Gy) was added.

PMID- 11197907
TI  - [Carinal resection for lung cancer].
AB  - Between January 1993 and March 2000, 16 patients underwent carinal resection for
      lung cancer; primary carcinoma in 15 patients and recurrent disease in 1. Age
      ranged from 41 to 74 years old, and the mean age was 58 years. Sleeve
      pneumonectomy was performed in 8 patients, right upper sleeve lobectomy in 7, and
      only carinal resection for the recurrent lesion in 1 patient. Combined resection
      of the aorta was performed in 2 patients, superior vena cava, in 5, left atrium
      and esophageal wall, in 1, and panpleura, in 1. The 30-day mortality rate was
      25.0% (4/16) and the morbidity rate was 50% (8/16). The causes of death were
      pneumonia, airway bleeding without vascular fistula, brain edema and acute
      cardiac failure. Anastomotic complication including tracheo-pulmonary vascular
      fistula and stricture occurred in 2 patients. The 5-year survival rate was 23%.

PMID- 11197908
TI  - [Carinal reconstruction with wide airway resection by a new technique].
AB  - Carinal reconstruction with wide airway resection by a new technique was
      conducted in two cases. A 61-year man with tracheal stenosis by tracheal cancer,
      6 tracheal rings, 2 left bronchial rings, total right main bronchus, for which
      carina was resected and reconstructed by a new technique and for a 69 year man
      with lung cancer in right upper lobe, for which right upper-middle bilobectomy,
      S6 segmental resection and circumferential pulmonary artery resection were
      performed. The tracea, left main bronchus, and right basal segment bronchus were
      anastomosed by new technique and the right main pulmonary artery and basal
      segment artery was anastomosed subsequent to chemotherapy. Both patients
      discharged within seventeen postoperative days in consideration of the absence of
      postoperative complication. Bronchoscopic findings after reconstruction indicated
      neither stenosis nor dehiscence at the site of anastomosis. The new
      reconstructive method of carina permits simple anastomosis, the possibility of
      carina reconstruction even in the case of wide airway resection and loss tension
      at the site of anastomosis.

PMID- 11197909
TI  - [Carinal resection for bronchogenic carcinoma].
AB  - The purpose of this study was to evaluate the results of carinal resection for
      bronchogenic carcinoma in our institute. From 1981 to 1999, 24 carinal resection
      were performed for squamous cell carcinoma (n = 19), adenoid cystic carcinoma (n
      = 2), small cell carcinoma (n = 1), adenocarcinoma (n = 1), and mucoepidermoid
      carcinoma (n = 1). Nineteen underwent sleeve pneumonectomy, 2 had carinal
      resection without lung resection, 2 had carinal resection with right middle and
      lower lobectomy, and 1 had wedge pneumonectomy. In the patients with sleeve or
      wedge pneumonectomy, there were 5 operative death and 3 patients had survived for
      more than 3 years. Two patients with low-grade malignant tumors underwent carinal
      resection without lung resection and survived more than 10 years. We believe that
      limited carinal resection for low-grade malignant tumors are safe and valuable
      procedure. Careful selection of patients with sleeve or wedge pneumonectomy is
      mandatory.

PMID- 11197910
TI  - [Results of carinal resection for primary lung cancer].
AB  - Carinal resection for primary lung cancer was clinical evaluated. Carinal
      resection was performed in 18 patients. Thirteen patients underwent carinal
      resection and the other 5 sleeve or wedge pneumonectomy. The carinal
      reconstruction was of montage type in 10 patients and the double-barrel type in
      2. There were 2 operative deaths, postoperative mortality rate was 11.1%. The 5
      year survival for 16 patients excluding the 2 operative deaths was 38.8%. The 5
      year survivals were 41.7% and 21.4% for N0 and N2 disease, respectively. Selected
      patients with localized lesion without mediastinal lymph node metastasis are the
      candidate for carinal resection and reconstruction.

PMID- 11197911
TI  - [Aortic root replacement after operation for the ascending aorta and/or aortic
      valve].
AB  - We reviewed ten cases who underwent aortic root replacement after operation for
      the ascending aorta and/or aortic valve. As initial operation, aortic valve
      replacement (AVR) was performed in five patients, replacement of the ascending
      aorta in two, original Bentall operation in two, and entry closure and suspension
      of the aortic valve in one. At reoperation, three patients were diagnosed as
      aneurysm of the ascending aorta, two were annulo-aortic ectasia, and one was
      acute aortic dissection, chronic dissecting aneusym, pseudoaneurysm of the
      ascending aorta, prosthetic valve endocarditis, and massive aortic regurgitation.
      Aortic root replacement was performed using mechanical valved composite graft in
      all cases. One patient who underwent repeat aortic root replacement for
      prosthetic valve endocarditis was died of septemia and ventricular fibrillation.
      Five patients had nine complications (two low output syndrome, respiratory
      failure and cerebral infarction, one gastrointestinal bleeding, septemia and
      ventricular fibrillation). In conclusion, aortic root replacement after operation
      for the ascending aorta and/or aortic valve was performed with acceptable
      morbidity and mortality.

PMID- 11197912
TI  - [A case of surgical treatment for cardiac tamponade caused by a ruptured coronary
      aneurysm accompanied by a coronary artery-pulmonary artery fistula].
AB  - A 67-year-old woman experienced a sudden severe pain in the area of her left
      shoulder and back. Three days later the pain recurred, after which she fell into
      shock and was taken to another hospital by ambulance. A plain chest CT scan
      showed a cardiac tamponade, while an enhanced chest CT scan demonstrated a
      coronary aneurysm in the left anterior descending branch draining to the
      pulmonary artery. Coronary arteriography revealed a saccular type aneurysm, 5 cm
      in diameter, with a coronary artery-pulmonary artery fistula. After
      pericardiocentesis, she recovered from her state of shock. The patient was then
      transferred to our hospital, where she underwent emergency surgery. Under a
      cardiopulmonary bypass, the stem of the aneurysm and the fistula were ligated and
      resected. She recovered smoothly and was discharged on the 24th postoperative
      day.

PMID- 11197913
TI  - [A case of a left atrial primary malignant fibrous histiocytoma].
AB  - Primary malignant fibrous histiocytoma (MFH) of the heart is very rere. We report
      a case of a primary intracardiac MFH. A 50-year-old woman underwent an operation
      for congestive heart failure due to left atrial (LA) tumor. Cardiac
      echocardiogram showed the tumor attached to the septal wall and posterior wall of
      LA. We extendedly resected the tumor with septal and partially posterior wall and
      reconstructed there with pericardial substitute. Pathological diagnosis was MFH.
      Although she did well postoperatively, cardiac echocardiogram showed a recurrent
      tumor in the LA at 10 days after operation. She developed respiratory failure,
      and chest and abdominal CT demonstrated metabolism to the lung, liver and bladder
      at post operative 47 days. At 77 days after operation, she expired. The prognosis
      of MFH is poor despite surgery. We recommend extended surgery, if the LA tumor
      had wide base attached to the septal or posterior wall.

PMID- 11197914
TI  - [A case of lung cancer underwent carinal resection with right upper lobectomy and
      carinal reconstruction with double-barreled anastomosis].
AB  - A 70-year-old male complaining cough was admitted to our hospital. Bronchoscopic
      examination revealed a tumor mass which occluded the orifice of the right upper
      lobe. Chest computed tomographic (CT) scans gave the image of tumor invasion at
      the carina. The pathological diagnosis of the tumor was squamous cell carcinoma.
      Operation was accomplished by right posterolateral thoracotomy approach through
      the fifth rib bed. The carinal resection with right upper lobectomy was followed
      by a double-barreled anastomosis of the right intermediate trunk and left main
      stem bronchus into the carina. The operation was successfully performed and was
      considered curative. The length of resected airway measured 4.0 cm from tracheal
      line of resection to the divided the right intermediate trunk. Reinforcement of
      the anastomosis was not performed in this case. No postoperative complication
      occurred but mild ischemia of the anastomosis. The patient died of recurrent
      tumor in a year and 2 months after operation.

PMID- 11197915
TI  - [Surgical analysis for N 2 factor in non-small cell lung cancer].
AB  - In this study we analyzed 33 cases which underwent complete surgical resection to
      assess the role of surgery in the treatment of patients with N 2 NSCLC. The 3
      year survival rate was 33.3% and the median survival time was 26.1 months. The
      survival curve for patients with T 3 factor was statistically worse than those
      with T 1 or T 2 factor. Further, the survival curve for patients with p 2 or p 3
      factor was significantly lower than than that for those classified as p 0.
      Patients classified with p 2 or p 3 had a survival rate under 2 years. Only one
      patient diagnosed as T 3 achieved 3 year survival. This patient had a pm1 tumor
      with p 0 factor. We thereby recommend that surgery should only be performed for
      those N 2 NSCLC patients diagnosed as T 1 or T 2 with a classification of p1 or
      less.

PMID- 11197916
TI  - Idiopathic Budd-Chiari syndrome in a patient with homozygous Factor V Leiden and
      heterozygous Factor II G20210A mutations.

PMID- 11197917
TI  - Vagus-sparing gastric fundectomy in the rat: development of osteopenia,
      relationship to urinary phosphate and net acid excretion, serum gastrin and
      vitamin D.
AB  - In man and experimental animals, partial and total gastrectomy and gastric
      vagotomies disturb extracellular mineral homeostasis, osteopenia being among the
      late outcomes. The sequence of events is complex and insufficiently understood.
      We report on the long-term effects of gastric fundectomy (FX; FX-1, n=11; sham
      operated controls, n=14) sparing gastric vagal fibers at the lesser curvature in
      the rat, a procedure eliminating gastric acid production but preserving gastric
      reservoir function. After FX-1 there was a marked increase of gastrinemia [FX-1:
      590 (SE 95); controls: 82 (5) pg-equiv/ml; P<0.001], serum 1,25-dihydroxyvitamin
      D [FX-1: 188 (17); controls: 86 (6) pg/ml; P<0.001], phosphaturia [FX-1: 32 (2);
      controls 23 (2) micromol/h; P<0.001] due to increased fractional phosphate
      clearance, elevated urinary net acid [FX-1: 21 (2); controls: 16 (1) micromol/h;
      P=0.03], and low urinary pH. The urinary excretion of hydroxyproline was
      increased [FX-1: 137 (15); controls: 99 (8) micromol/h; P=0.01], and crosslinks
      were also high. These changes were associated with a significant decrease of bone
      ash calcium, magnesium, and phosphorus. Bone histomorphometry revealed signs of
      high bone turnover. No signs of hyperparathyroidism were detectable. Acute
      stimulation of serum gastrin by gastric acid abolishing omeprazole failed to
      provoke extra-osseous changes, as seen in the long-term after fundectomy. It was
      concluded that the described type of fundectomy disturbs gastrinemia, acid-base
      and phosphorus metabolism, thereby initiating osteopenia. This animal model may
      be suitable for research into post-gastrectomy bone disease.

PMID- 11197918
TI  - Measurement of respiratory impedance by impulse oscillometry--effects of
      endotracheal tubes.
AB  - Impulse Oscillometry is a new, noninvasive method to measure respiratory
      impedance, i.e. airway resistance and reactance at different oscillation
      frequencies. These parameters are potentially useful for the monitoring of
      respiratory mechanics in the critically ill patent with respiratory dysfunction.
      The endotracheal tube, used to mechanically ventilate these patients, however,
      represents an additional nonlinear impedance that introduces artifacts into the
      measurements. The objective of this work was therefore to investigate the effects
      of clinically available endotracheal tubes on resistance and reactance of an in
      vitro analogue of the respiratory system. Additionally, the effects of decreasing
      the compressible gas volume in this experimental model, as a simulation of
      decreased lung capacity and compliance, was investigated. Impulse oscillometric
      measurements of the test analogue gave highly reproducible results with and
      without an endotracheal tube. The tubes had significant influence on the
      measurement of the test object at all frequencies investigated. Changes of low
      frequent reactance were negligible - at least if repetitive measurements of the
      same system are performed - for realistic measurement of airway resistance, a
      correction of the tube impedance or measurement of the pressure distal of the
      tube is required. Resistance increased and low frequent reactance decreased
      significantly with decreasing gas volume. These changes were of magnitudes higher
      than the variations due to the introduction of the endotracheal tubes. Our
      results suggest that changes of respiratory reactance measured with impulse
      oscillometry may be used as a monitoring parameter in intubated patients.

PMID- 11197919
TI  - Wet-to-dry ratio of lung tissue and surfactant outwash after one-lung flooding.
AB  - Unilateral flooding of the lung after intubation with a double-lumen tube enables
      intraoperative sonography of the lung tissue. The flooding restricts the
      pulmonary blood stream of the flooded lung in a relevant degree and thus reduces
      the right-to-left shunt volume. The deficient perfusion of the lung tissue during
      the flooded phase might cause capillary permeability disorders and secondary
      oedema development. This can be determined by examination of extravascular lung
      water (EVLW) after draining and reventilation of the flooded lung. Although one
      time unilateral lung flooding must be distinguished from bronchopulmonary lavage,
      it is interesting to study the effects of flooding on the surfactant system. The
      wet-to-dry ratio of the lung tissues of 13 female pigs was ascertained at
      different times following one-lung flooding (1 to 11 weeks). A trend towards an
      increased wet-to-dry ratio in the previously flooded lung was found only in the
      tissue samples taken 1 h after reventilation. After only 24 h, the two lungs no
      longer differed in their wet-to-dry ratio. In six pigs, the phospholipid content
      of the drained flooding liquid was determined. It was shown that the surfactant
      loss caused by flooding was maximally 47% of the calculated surfactant pool of
      the respective lung.

PMID- 11197920
TI  - Relationship between mast cells/parietal cells and maximal/basal acid output
      ratio in chronic gastritis.
AB  - Mast and parietal cells were concomitantly demonstrated in biopsies from corpus
      mucosa of patients with various forms of chronic gastritis. The ratio of
      mast/parietal cells and the ratio of maximal and basal acid output were
      negatively correlated.

PMID- 11197921
TI  - Protective effects of trimetazidine in transient spinal cord ischemia.
AB  - The neuroprotective effect of trimetazidine (TMZ) was tested prospectively in a
      rabbit spinal cord ischemia model. Ischemia was induced by clamping the aorta
      just distal to the left renal artery and proximal aortic bifurcation for 20 min.
      Twenty-five male New Zealand white rabbits were randomized as follows: TMZ group
      (n=100) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the
      aorta; control group undergoing occlusion but receiving no pharmacologic
      intervention (n=10); sham-operation group (n=5) subjected to operative
      dissections without aortic occlusion. Physiological parameters and somatosensory
      evoked potentials (SEP) were monitored in animals before the ischemia, during the
      ischemia and in the 1st, 15th and 60th min of reperfusion. Neurologic status was
      assessed 24 and 48 h after the operation. The spinal cord, abdominal aorta, and
      its branches were processed for histopathologic examinations 48 h after the
      operation. At the end of the ischemic period, the average N1-P1 amplitude was
      reduced to 22% of the baseline in all ischemic animals. This was followed by a
      gradual return to 90+/-2% of the initial amplitude in the TMZ group and 81+/-2%
      in the control group (P<0.05) after 60 min of reperfusion. The average motor
      function score was significantly higher in the TMZ group than the control group
      (3.7+/-0.5 vs 3.1+/-0.6 at 24 and 3.5+/-0.7 vs 2.9+/-0.6 at 48 h; P<0.05).
      Histologic observations were clearly correlated with the neurologic findings. The
      results suggest that trimetazidine reduces spinal cord injury during
      thoracoabdominal aortic operations and may have therapeutic utility during high
      risk operations.

PMID- 11197922
TI  - Leucine and protein metabolism after bilateral nephrectomy in rats: the role of
      hepatic tissue.
AB  - The aim of this study was to evaluate the effect of acute uremia on changes in
      leucine and protein metabolism in the whole body and in hepatic tissue. Acute
      renal insufficiency was induced by bilateral nephrectomy (BNX). Twenty-four hours
      later, parameters of protein and amino acid metabolism were evaluated in the
      whole body using primed constant intravenous infusion of L-[1-14C]leucine, and in
      isolated perfused liver (IPL) using cx-keto[1-14C]isocaproate. The control group
      consisted of sham-operated rats. BNX induced a marked decrease in proteolysis,
      protein synthesis, leucine oxidized fraction and leucine clearance. The decrease
      in protein synthesis was higher than in proteolysis. A significant drop in
      protein synthesis was observed in muscle, gut, heart and spleen. The study with
      IPL in BNX animals showed decreased oxidation of ketoisocaproic acid and higher
      concentrations of the branched-chain amino acids (BCAA) leucine, isoleucine and
      valine in perfusion solution. We conclude that the cause of rapid depletion of
      body proteins after BNX is a greater decrease in protein synthesis than in
      proteolysis associated with an increase in leucine oxidized fraction. The data
      obtained in the IPL model indicate that BNX causes metabolic changes that enable
      resynthesis of BCAA from corresponding branched-chain keto acids in liver.

PMID- 11197923
TI  - The effect of family intervention on chronic schizophrenics under individual
      psychosocial treatment: a 3-year study.
AB  - BACKGROUND: The effectiveness of family intervention in schizophrenia has mainly
      been tested by controlled trials which recruited patients after hospital
      discharge. Less is known about its effectiveness when chronic schizophrenics
      displaying negative rather than positive symptoms are engaged in treatment. This
      study was conducted in two community-based rehabilitation units for chronic
      psychiatric patients and was planned to test: (1) whether family intervention
      combined with individual psychosocial treatment is more effective than individual
      psychosocial treatment in improving the clinical and social prognosis of
      schizophrenic patients belonging to high expressed emotion (high-EE) families,
      and (2) whether family intervention exerts its effect on the patients through the
      reduction of EE in their families. METHODS: Forty patients from high-EE families,
      all under neuroleptic medication and in remission at intake, were evenly assigned
      to individual psychosocial treatment or to psychoeducational family intervention
      plus individual psychosocial treatment. Individual treatment consisted of
      vocational and social skills training; family intervention mainly comprised 13
      group sessions with relatives. Patients were treated for 12 months and were
      followed-up for the next 2 years. Measures of clinical outcome comprised relapse,
      hospitalization and clinical exacerbation. Measures of social outcome included
      social functioning and role performance. Re-employment served as an additional
      measure at the follow-up assessments. RESULTS: The experimentals were free of
      relapses and hospitalizations during the 1st year of follow-up. The difference in
      relapse rates between experimentals and controls over the same period was
      statistically significant (P = 0.05), especially if drop-outs were included in
      the statistical analysis. The difference in hospitalization rates did not yield
      any statistical significance. All differences declined in the 2nd year of follow
      up. Family intervention was found to be positively, but not significantly,
      associated with higher reversal rates from high to low EE, especially among full
      attenders of relatives' group sessions. High EE was identified as a predictor of
      relapse, but not of hospitalization, over the 2-year follow-up period.
      CONCLUSION: Results support the importance of encompassing family members in the
      community care and tertiary prevention of schizophrenia.

PMID- 11197924
TI  - Suicidal acts and ideation in homosexual and bisexual young people: a study of
      prevalence and risk factors.
AB  - BACKGROUND: Suicide attempts are the most robust clinical predictor of suicide,
      which is now the second cause of death among young people in many countries.
      Previous research has shown an increased risk of attempted suicide associated
      with a homosexual orientation. However, the mechanisms underlying this increased
      risk are not yet clear. This study therefore aimed to determine the risk of
      attempted suicide and the effect of potential risk factors on the occurrence of
      suicidal ideation and behaviour among homosexual youngsters. METHODS: The
      association between suicidal ideation and behaviour and potential risk factors
      was assessed by means of a questionnaire in a general population sample of
      homosexual or bisexual young people and a control sample consisting of school
      pupils. RESULTS: A twofold increased risk of suicidal ideation was found
      associated with a homosexual or bisexual orientation. A significantly increased
      risk of attempted suicide associated with homosexuality or bisexuality was found
      in females. Independent of sexual orientation, depression was identified as a
      significant risk factor for suicidal ideation, while suicidal behaviour was
      associated with low self-esteem, higher levels of hopelessness and suicidal
      behaviour in someone close. Among homosexual or bisexual young people, less
      satisfying homosexual friendships were an additional risk factor for suicidal
      behaviour. CONCLUSIONS: The identified increased risk of suicidal ideation among
      homosexual or bisexual young people is associated with depression and may lead to
      suicidal behaviour, independent of sexual orientation, especially in the presence
      of a role model of suicidal behaviour, and among those with unsatisfying
      friendships.

PMID- 11197925
TI  - The social context of insight in schizophrenia.
AB  - BACKGROUND: Psychiatrists place great weight on impaired insight in
      schizophrenia, generally attributing it to pathological mental processes.
      However, denial of illness may be based on attitudes common in patients' social
      and cultural groups. Moreover, even where denial of illness has a pathological
      element, it may be affected by the social context. In this paper, we predicted
      that denial of illness would be associated with social distance between clinician
      and patient, and reduced by access to 'normalizing' social interaction. METHOD:
      One hundred and fifty patients with schizophrenia in the London arm of the
      European Schizophrenia cohort were assessed using the 'Awareness of Illness' (AI)
      subscale of David's Assessment of Insight. Clinical and social attributes were
      related to AI. RESULTS: There was little evidence for our social distance
      hypotheses: there was little variation in AI by social class, ethnicity,
      membership of a drug taking culture or the presence of strongly held religious
      beliefs. However, there were strong relations between AI and the size of primary
      group, consistent with our normalizing hypothesis. CONCLUSIONS: The normalizing
      function of social support is in line with modern psychological models of
      delusion formation. Longitudinal data will eventually be available from the
      current study that will assist in establishing the causal direction of this
      association.

PMID- 11197926
TI  - Multiple applications of the GHQ-12 in a general population sample: an
      investigation of long-term retest effects.
AB  - BACKGROUND: Previous studies have indicated that the 60-, 30-, 28- and 12-item
      versions of the General Health Questionnaire (GHQ) are liable to retest effects,
      especially when administered multiple times with short intervals. The aim of this
      study was to examine data from a large general population sample for evidence of
      any retest effects over 7 yearly applications. METHODS: A core panel was drawn
      from the British Household Panel Survey of those respondents who had completed
      the GHQ-12 seven times from 1991 to 1997 (n = 4749). The panel results were
      compared with cross-sectional data from the Health Surveys for England for the
      same years. The analyses were conducted separately for males and females broken
      down by age groupings. RESULTS: No evidence of retest effects was found. For
      males, the panel results did not diverge significantly from the cross-sectional
      results. For females, the panel results did indicate a divergence from the cross
      sectional results, but this was due to the age composition of the panel and
      differing age trajectories. CONCLUSION: The GHQ-12 is a consistent and reliable
      instrument when used in general population samples with relatively long intervals
      between applications.

PMID- 11197927
TI  - Factors associated with immediate dropout of outpatient treatment for drug abuse
      in Rio de Janeiro.
AB  - BACKGROUND: The advantage of treatment of drug addiction over no intervention has
      long been recognized. The high dropout rates that are often reported in
      outpatient clinics may limit treatment effectiveness. This study aimed to analyze
      adherence to an outpatient program for drug addicts, mainly cocaine addicts, in
      Rio de Janeiro, Brazil, and its correlates. METHODS: Of particular interest was
      immediate dropping out, defined as coming just once to the facility. The data
      were collected from medical charts and registers of a randomly selected sample of
      480 patients. RESULTS: A total of 468 medical records were available for review,
      and 57% of the patients came just once to the facility. A negative association
      was found between immediately dropping out and female gender, being white,
      prescription of medication and use of multiple management resources by the
      therapist (referral to mutual support groups, social workers, family therapy and
      medical assessment, even with no prescription). A positive association was found
      with parental death in childhood, history of mental illness in the family and
      addiction to alcohol combined with abuse of other illicit substance(s).
      CONCLUSIONS: The high dropout rates associated with certain treatment approaches
      strongly indicate opportunities for improving care of drug addicts at that
      outpatient center.

PMID- 11197928
TI  - Computerised information systems in English mental health care providers in 1998.
AB  - BACKGROUND: This study formed part of the background work for the development
      work of a new Mental Health Minimum Data Set in England. It surveyed the range
      and nature of information systems currently used by English mental health care
      provider Trusts. It also surveyed relevant aspects of their organisational
      arrangements. METHOD: Information was collected by a telephone survey of Trust
      information and clinical service managers. RESULTS: Most Trusts have a complex
      array of different information systems--the median number is four. Even where
      fully integrated systems are in place, these do not necessarily cover all data
      areas over the whole of the Trust's operations. Sixty-three percent of Trusts use
      more than one patient numbering system. Sixty-percent have implemented or
      formally piloted routine collection of outcome scoring, 51% using the Health of
      the Nation Outcome Scale (HoNOS). A simple model suggested that the proposed data
      set could realistically be implemented nationally over a 4-year timescale.
      CONCLUSIONS: Given the current information system context and planned
      developments it would be realistic to implement the proposed Mental Health
      Minimum Data Set over a 4-year timescale.

PMID- 11197929
TI  - A comprehensive clinical database for mental health care in England.
AB  - BACKGROUND: Monitoring and researching clinical care calls for comprehensive
      clinical databases. In mental health care these need to cover all aspects of the
      care of each patient and to accommodate the complexity of care which may last
      from weeks to years. This paper describes the pilot work for a mental health
      clinical database intended to be implemented throughout the English National
      Health Service. METHODS: In collaboration with three pilot sites, a set of data
      extracts was defined which could reasonably easily be produced, mostly using
      existing statistical data collection systems. Software was designed to integrate
      these extracts into patient-based records describing overall spells of mental
      health care. These data were extracted from their systems for a 6-month pilot
      period. RESULTS: Two of the three sites produced data sets, which appeared to
      give a reasonably complete account of the work undertaken in the pilot period.
      Known differences in service design and clinical perspective between the two
      sites were clearly reflected. CONCLUSIONS: The approach to extracting and
      collating the data is workable within existing resources and produces
      illuminating data for clinical audit, management and planning. Completeness and
      accuracy of data is likely to be a continuing problem, as for any routine data
      capture exercise. However, the process of integrating data from several channels
      assists this, as inconsistencies become apparent and can be tackled. The approach
      is now being implemented throughout England.

PMID- 11197930
TI  - [Arthrosis--histology and pathogenetic approaches].
AB  - Osteoarthitis is the most common joint disease affecting over 60% of the elderly
      population. It is characterized by the progressive erosion of articular cartilage
      leading to incapacity of movement. In the great majority of instances,
      osteoarthritis appears insidiously, without apparent initiating cause. This
      primary form is usually oligoarticular involving hip, knee, cervical vertebrae,
      interphalangeal joints of the fingers or tarsometatarsal joints of the feet. In
      case of an underlying systemic disease or local injury the cartilage destruction
      is considered as secondary osteoarthritis. The pathogenesis of primary
      osteoarthritis suggests an intrinsic disease of cartilage in which biochemical
      and metabolic alterations result in its breakdown. Within the last decades
      different models were established which also concentrated on other joint
      structures such as bone or ligaments. Changes of the subchondral bone were found
      to precede cartilage damage suggesting a primary alteration of the subchondral
      region. Other studies concentrated on the metabolic activity of chondrocytes in
      healthy cartilage of osteoarthritis patients. The precise event that leads to
      these changes is still not clear. This review concentrates on the histological
      features in the course of the disease and tries to provide a summary on different
      pathogenetic concepts.

PMID- 11197931
TI  - [Arthrosis--a single or many diseases?].
AB  - The classical features of osteoarthritis (OA) include osteophytosis, joint space
      narrowing, subchondral cyst formation, sclerosis, deformity and low-grade
      synovitis. OA has been tacitly assumed to be a homogeneous disorder and dismissed
      as "degenerative". This short article will seek to challenge this traditional
      view and suggest that at least two major processes emerge from detailed
      radiological studies in patients with OA. One comprises osteophytosis associated
      with hyaline cartilage thinning and perhaps joint instability. This may represent
      a normal response to joint instability, and be seen as a healing mechanism. The
      other, when subchondral sclerosis and bone attrition predominate, may reflect
      joint failure.

PMID- 11197932
TI  - [Magnetic resonance tomography (MRI) of joint cartilage. Current status of
      knowledge and new developments].
AB  - MRI is the most accurate noninvasive technique available for assessment of normal
      articular cartilage and cartilage lesions. MRI cannot only provide morphologic
      information about the area of damage, but can also provide unique insight into
      the biochemical composition of the articular cartilage. New image processing
      techniques such as three-dimensional mapping of cartilage thickness will help to
      establish automated analysis of cartilage loss. Theses techniques are ideally
      suited for monitoring patients who undergo treatment with new chondroregenerative
      drugs.

PMID- 11197933
TI  - [Pediatric arthroses as a sequelae of enchondral damage. Examples of frostbite,
      Kashin-Beck disease, rat bites and other etiologies].
AB  - PURPOSE: To review the similarities of the radiographic changes in frostbite, the
      Asian disease of Kashin-Beck, and long term growth damage from injury such as
      rate bite. MATERIALS AND METHODS: Radiographs and literature from subjects with
      these diagnoses were analyzed for the common features and differences. Included
      was an infant with hand changes 8 months after unwitnessed rat bites. RESULTS:
      Each condition revealed findings consistent with the hypothesis of localized
      damage to sites of enchondral ossification, including at acrophyses--the growth
      plates that are not between epiphysis and metaphysis, but instead lie at the
      margins of growth centers, including carpal and tarsal bones, and the non
      epiphyseal ends of small tubular bones. DISCUSSION: The patterns observed support
      a final common pathway of damage in frostbite due to cold injury, Kashin-Beck
      disease (endemic in China) of unknown etiology, and damage from toxins
      associated, for example, with rat bite. In frostbite, the distribution is acral
      because of the site of exposure, while the distribution in Kashin-Beck is more
      diffuse and often less contiguous. In each condition, arthrotic sequelae may be
      expected in the natural course of follow-up. MRI may play a role in acute
      diagnosis that might modify the course of each disease.

PMID- 11197934
TI  - [Radiologic quantification of joint changes. A methodological overview].
AB  - Osteoarthritis as well as rheumatoid arthritis lead to chronical progressive
      destruction of diseased joints. As aggressive new treatments need to be
      evaluated, plenty of (semi-) quantitative methods for the radiological joint
      evaluation had been developed. They lack sufficient reproducibility due to their
      low objectivity. Modern approaches of computer-assisted radiological
      quantification should increase the reproducibility and efficiency of radiological
      scoring. Automatically calculated, computer-assisted measurements of joint space,
      cartilage- and synovial volume, periarticular assessment of bone mineral density
      and quantitative analysis of the subchondral plate will have major impact on the
      radiological routine of the future.

PMID- 11197935
TI  - [HIRE (high intensity reduction). New cerebrospinal fluid suppressed T2-weighted
      imaging sequence].
AB  - PURPOSE: The HIRE sequence utilizes the very long T2 value of CSF to suppress its
      high signal contribution in T2-weighted imaging by an image subtraction
      technique. METHODS: To assess the diagnostic potential of a new dark fluid
      sequence HIRE (High Intensity REduction) in the diagnostic work-up, 20 patients
      with histologically confirmed cerebral gliomas were examined with T2-weighted
      FSE, T1-weighted SE, fast FLAIR and HIRE using identical scan parameters. In
      patients with enhancing lesions fast FLAIR and HIRE were added to the contrast
      enhanced T1-weighted SE images. Images were analyzed in a qualitative and
      quantitative evaluation. In the qualitative lesion analysis, lesion delineation
      and differentiation between enhancing and non enhancing tumor tissue were by two
      readers. For the quantitative analysis lesion-to-background and lesion-to-CSF
      contrast and contrast to noise ratios were determined in an region of interest
      analysis. RESULTS: HIRE achieved a significant reduction of the CSF signal
      without loosing the high gray-to-white matter contrast of T2 weighted sequences.
      In the quantitative analysis, the contrast ratios of the HIRE were lower compared
      to the FLAIR images due to a relative high background and CSF signal. After the
      application of contrast media HIRE images revealed a significant signal increase
      in enhancing lesions, which subsequently increased the contrast and contrast-to
      noise ratios. In the qualitative analysis, both readers found all tumors clearly
      delineated on HIRE imaging. Compared to T2-weighted FSE the tumor delineation
      with HIRE was better in nine patients, equal in four patients and less in one
      patient. Compared to the FLAIR images HIRE was rated superior in three patients,
      equal in nine patients and inferior in another three patients. Delineation of the
      enhancing tumor parts was possible with HIRE in all patients. HIRE images present
      significant less image artifacts than FLAIR images due to reduced inflow effects.
      CONCLUSIONS: The presented T2 based HIRE sequence is an alternative to the T1
      based FLAIR sequence with the advantage of a better gray to white matter contrast
      and shorter measurement time. Due to the subtraction technique signal intensities
      from tissues with T2 relaxation times in the range between white matter and CSF
      are also partially affected depending on their T2 values. With respect to this
      undesired effect, an improvement in HIRE imaging will be expected by a self
      weighted subtraction algorithm.

PMID- 11197936
TI  - [Peri-interventional drug therapy in PTA of supra-aortic blood vessels].
AB  - Percutaneous transluminal angioplasty in conjunction with stent implantation
      (PTAS) is the treatment of choice in several indications. Despite its frequent
      use in supraaortic arterial disease and the scientific effort to establish PTAS
      of the internal carotid artery there is relatively little data in the literature
      to provide an evidence-based ground for periinterventional medical therapy. This
      article reviews the current periprocedural protocols and gives an overview of the
      hemodynamic management as necessary in carotid PTAS. Furthermore, problems of
      antithrombotic therapy with heparin and platelet inhibitors are discussed and a
      short introduction into medical cerebroprotection and thrombolytic therapy in
      ischemic cerebrovascular events is given.

PMID- 11197937
TI  - [Chronic pain in the mid-foot area. Osteoarticular tuberculosis of the tarsal
      bones].

PMID- 11197938
TI  - [Nobel Prize for Medicine 2000. Communicating nerve cells].

PMID- 11197939
TI  - [Basic principles and general practice of digital photo- and video-documentation.
      1].

PMID- 11197940
TI  - C.T. Scanner dies.

PMID- 11197941
TI  - New approaches to cystic fibrosis.

PMID- 11197943
TI  - Dementia: causes, evaluation, and management.

PMID- 11197942
TI  - Hypertension in patients with type 2 diabetes.

PMID- 11197944
TI  - Issues of academic integrity in U.S. dental schools.
AB  - Evidence of violations of academic integrity can be identified at all levels of
      education. A survey on academic integrity was mailed in 1998 to the academic
      deans of all fifty-five U.S. dental schools, with a response rate of 84 percent.
      This survey showed that reported incidents of academic dishonesty occur in most
      dental schools, with the average school dealing with one or two cases a year. The
      most common incidents of dishonest behavior involved copying or aiding another
      student during a written examinations; the second most common involved writing an
      untrue patient record entry or signing a faculty member's name in a patient
      chart. Respondents indicated the major reason for failure to report academic
      dishonesty was fear of involvement because of time and procedural hassles and
      fear of repercussions from students and peers.

PMID- 11197945
TI  - Pilot study of dental hygienists' comfort and confidence levels and care planning
      for patients with disabilities.
AB  - A questionnaire assessing comfort levels and behaviors of dental hygienists
      concerning treatment of patients with special needs or disabilities was mailed to
      a random sample of 175 practicing dental hygienists in Idaho. All respondents had
      seen patients with disabilities, although 53 percent had never completed a formal
      course or received training directed specifically toward this population. Survey
      respondents were moderately to always comfortable treating special needs and
      disabled patients. Use of a wheelchair was the only disability in which
      clinicians were significantly more comfortable with treatment following
      completion of a course or receipt of training. Severity of a patient's disability
      and limited time were considered moderate to very high barriers to the provision
      of dental hygiene care. Recommended treatment planning techniques are being used
      to a limited extent, and respondents were slightly to moderately confident using
      alternative communication and treatment techniques. The findings suggest that
      although education or training was not strongly associated with comfort and
      confidence levels of these dental hygienists, they were interested in
      opportunities for further training in caring for patients with special needs.

PMID- 11197946
TI  - An initial evaluation of the Iowa Dental Surgical Simulator.
AB  - The University of Iowa colleges of dentistry and engineering are collaborating to
      build an effective but low-cost surgical simulator that uses force feedback to
      teach and assess the tactile skills of dentistry. A prototype simulator was
      built, and a formative evaluation examined the realism of the haptics and
      identified directions for future work. Using a cross-over design, twelve
      experienced practitioners probed two virtual teeth using two instruments attached
      to the force feedback device. The session was videotaped, the forces recorded,
      and a standardized questionnaire completed. Two analyses were conducted: an ANOVA
      examined practitioners' questionnaire responses, and a t-test analyzed the
      probing forces. Significant tooth order by instrument order interaction and
      instrument effects were found. Practitioners were generally satisfied. They
      preferred a standard joystick to an explorer, felt that two-dimensional graphics
      were sufficient, and emphasized that the existing vibration be eliminated. Random
      placement of caries should help teach generalized skills.

PMID- 11197947
TI  - Information for patients on dental school websites.

PMID- 11197948
TI  - Rethinking knowledge and pedagogy in dental education.
AB  - Dentistry as a profession has often been considered both art and science.
      Traditional dental education has attempted to address both; however, in many
      places only the science of dentistry is emphasized. The move toward competency
      based curricula in dental education requires an expansion of what constitutes
      meaningful knowledge in the curriculum and what pedagogies best support that
      curriculum. The scientific and technical knowledge considered foundational to
      clinical practice is not sufficient to teach competencies associated with the art
      of dentistry. Habermas, a social scientist, offers a way of looking beyond
      technical knowledge to consider two other forms of knowledge: practical and
      emancipatory. Pedagogy that supports development of practical and emancipatory
      knowledge includes problem-based learning and case methods, heuristics,
      reflective practica, journals, storytelling, and performance-based assessment
      methods. These important teaching strategies are being integrated into various
      dental curricula including a new competency-based dental curriculum at Marquette
      University's School of Dentistry. It will be critical for dental educators to
      continue developing these methods to provide efficient and effective education
      for future practitioners in both the art and science of dentistry.

PMID- 11197949
TI  - U.S. dental school applicants and enrollees: a ten year perspective.
AB  - Applications to dental schools increased throughout the 1990s until 1997. In 1998
      this pattern reversed, and the number of dental school applicants has dropped
      each year since that time and continues to decline through the application cycle
      for the 2001-2002 first-year class. Possible reasons for the decline in
      applications include an abundance of financially rewarding career opportunities
      fueled by the robust U.S. economy, a reluctance by college students to assume
      more educational debt, an unfavorable view of healthcare careers in the light of
      managed care and declining federal reimbursement, and assumptions about the
      difficulty of gaining admittance to dental school given the high academic
      achievement of those who have been admitted in recent years. A national decline
      in the applicant pool does not necessarily translate into a decline for any given
      dental school. The quality of applicants, judged by grade point averages and
      Dental Admissions Test scores, is high. Nevertheless, the recent drop in dental
      school applicants is a cause for concern. Because recruitment must be approached
      as a process that takes years to yield results, stakeholders in dental education
      need to sustain vigorous recruiting efforts even in the best of times.

PMID- 11197950
TI  - The Oklahoma repair technique: a biomechanical study of a new suture repair
      technique.
AB  - We designed and evaluated the biomechanical advantages of a new (Oklahoma) suture
      technique for repairing flexor tendons in fresh, frozen cadaver specimens. Forty
      flexor digitorum profundi tendons from the middle three fingers were sharply cut
      and repaired with a number 3-0 braided polyester using the new technique and the
      Modified Kessler technique with and without an epitenon repair. The repaired
      tendons were then stressed to failure. The Modified Kessler with epitendon repair
      initiated gap formation on an average of 15.3 +/- 2.7 newtons and failed at 40.9
      +/- 4.3 newtons. The Oklahoma suture technique with a running epitenon repair
      initiated gap formation on average of 48.6 (SD +/- 4.0) newtons and required an
      average load of 57.9 (SD +/- 3.0) newtons to fail. Thus, it was significantly
      stronger than the modified Kessler technique with epitendon repair (P < 0.01).
      The tendons repaired with the Oklahoma and epitenon repair suture technique did
      not form a 2 mm gap prior to failure. The epitendon repair increased the
      resistance to gap formation by 80% to 100% and the repair failure by 17.5% to 25%
      for both types of repairs. We concluded that the addition of the epitendon repair
      increases the tensile strength of the repair regardless of the core suture
      technique, and it should be used. In comparison with the Modified Kessler repair
      technique, the Oklahoma repair technique has superior tolerance to gap
      initiation, 2 mm gap formation, and physical failure of the repaired tendon.

PMID- 11197951
TI  - Improving the health of Oklahomans through clinical prevention, Part III:
      Immunizations and chemoprophylaxis.
AB  - Vaccines are one of the greatest achievements of biomedical science and public
      health and are clearly one of the most effective tools of clinical prevention.
      Diseases that once caused significant morbidity and mortality in Americans-
      particularly children--have been virtually eliminated from the population through
      effective immunization programs. But until these diseases have been eradicated
      globally we must continue to maintain high immunization levels to prevent their
      return; a 90% coverage rate has been set as the national goal for recommended
      vaccines in preschool age children. In Oklahoma we have only achieved that goal
      for two vaccines (measles and polio) and for the last several years we have
      ranked near the bottom in vaccine coverage rates compared to other states.
      Although achieving high vaccination rates in children involves numerous partners,
      private physicians must play a major role in that effort since they are the
      primary vaccine providers in the state. Physicians should also be alert to the
      vaccine needs of their adolescent and adult patients, particularly for
      pneumococcal disease, influenza, hepatitis A and B, and tetanus. This article
      describes current vaccination levels in Oklahoma children and adults for several
      routine and newly recommended vaccines and discusses the role of private
      physicians in maintaining and improving immunization coverage.

PMID- 11197952
TI  - Vaccine-preventable diseases.

PMID- 11197953
TI  - Leaders in medicine. Floyd Miller, MD.

PMID- 11197954
TI  - Monkey business. A tiny primate with a gene from a jellyfish raises scientists'
      hopes--and some serious ethical questions.

PMID- 11197955
TI  - Executive physical. There's a whole battery of new high-tech scans for those who
      can afford them. Are they worth it?

PMID- 11197956
TI  - Bearing no ill will. Employers are finding ways to support and retain the growing
      number of chronically ailing employees in America's work force.

PMID- 11197957
TI  - Reporter genes and imagene.

PMID- 11197958
TI  - Portal-Systemic shunts reduce asialoglycoprotein receptor density in rats.
AB  - The clinical usefulness of quantitative functional imaging techniques that use
      asialoglycoprotein receptor (ASGP-R) binding is based on the correlation between
      ASGP-R density and hepatic functional reserve. Portal-systemic shunting (PSS) is
      common in patients with cirrhosis and portal hypertension-the same group that is
      most frequently considered for such imaging. PSS occurs spontaneously through
      collateral vessels and from the creation of surgical shunts or placement of
      transjugular intrahepatic portal-systemic shunts (TIPS). Understanding the
      physiologic relationship between PSS and ASGP-R activity may aid in the
      interpretation of quantitative clinical imaging. This study was conducted to
      determine the relationship between PSS and ASGP-R density in the absence of
      parenchymal disease. METHODS: Sprague-Dawley rats with end-to-side portal
      systemic shunts and sham-operated control rats were imaged with 99mTC
      diethylenetriaminepentaacetic acid galactosyl-neoglycoalbumin. Pharmacokinetic
      modeling of the liver and heart time-activity data was used to measure ASGP-R
      concentration, as well as hepatic plasma volume and flow. RESULTS: The mean ASGP
      R density (nmol/g of liver) was significantly decreased in the shunted rats.
      Blood ammonia was significantly elevated, whereas hepatic plasma flow, alkaline
      phosphatase, alanine aminotransferase, and aspartate aminotransferase levels were
      unaltered. Liver histology was normal in both groups. CONCLUSION: A significant
      change in the ASGP-R density occurs with PSS in the absence of parenchymal
      disease. PSS appears to be an independent variable affecting ASGP-R activity.
      This could prove clinically important during interpretation of quantitative
      imaging from patients with varying degrees of PSS based on underlying disease or
      the presence of a surgical shunt or TIPS device.

PMID- 11197959
TI  - Specific and rapid scintigraphic detection of infection with 99mTc-labeled
      interleukin-8.
AB  - Interleukin-8 (IL-8) is a chemotactic cytokine involved in activation and
      recruitment of neutrophils to areas of infection. In our previous studies in
      rabbits we tested 123I-labeled IL-8 for its potential to image infections and
      showed that IL-8 rapidly and efficiently accumulated in infectious foci. However,
      labeling of IL-8 with 123I is costly and laborious and the specific activity of
      the preparation was low. In this study IL-8 was labeled with 99mTc through the
      hydrazinonicotinamide (HYNIC) chelator. METHODS: The leukocyte receptor-binding
      capacity of the preparation was determined in vitro. Rabbits with Escherichia
      coli abscesses were injected intravenously with 7 MBq 99mTc-HYNIC-IL-8.
      Biodistribution of the radiolabel was determined by gamma camera imaging and
      tissue counting at 8 h after injection. 99mTc-HYNIC-lysozyme was used as a size
      matched control. RESULTS: The leukocyte receptor-binding capacity of the 99mTc
      HYNIC-IL-8 preparation was preserved as determined in vitro, but labeling
      efficiency was modest with a specific activity of 3 MBq/microg. 99mTc-HYNIC-IL-8
      accumulated rapidly in the abscess up to 0.33 +/- 0.06 percentage injected dose
      per gram (%ID/g) at 8 h after injection (vs. 0.025 +/- 0.003 %lD/g for 99mTc
      HYNIC-lysozyme). Total uptake in the abscess was 4.9 +/- 0.7 %ID (vs. 0.44 +/-
      0.05 %ID for 99mTc-HYNIC-lysozyme). Abscess-to-contralateral muscle ratios
      increased up to 127 +/- 23 (compared with 6.7 +/- 1.1 for 99mTc-HYNIC-lysozyme)
      and abscess-to-blood ratios increased to 11.9 +/- 2.2 (0.24 +/- 0.03 for 99mTc
      HYNIC-lysozyme). The radiolabel was excreted renally, with a retention in the
      kidneys of 28 %ID. Gamma camera imaging rapidly visualized the abscess from 1 h
      after injection onward, with abscess-to-background ratios improving with time up
      to 22 at 8 h after injection (vs. 2.7 for 99mTc-HYNIC-lysozyme), as determined by
      quantitative analysis of the images. Most important, only a transient (30 min)
      moderate drop of leukocyte counts and no leukocytosis were observed after
      injection of an imaging dose of 99mTc-HYNIC-IL-8. CONCLUSION: IL-8 can be labeled
      with 99mTc using HYNIC as a chelator. By this method the leukocyte receptor
      binding capacity is preserved. The preparation allows rapid visualization of
      infection in a rabbit model with high target-to-background ratios. The mild
      transient drop of leukocyte counts and the absence of leukocytosis suggest that
      99mTc-HYNIC-IL-8 may be used as an imaging agent with only mild and transient
      side effects.

PMID- 11197960
TI  - Myocardial lipid metabolism in compensated and advanced stages of heart failure:
      evaluation by canine pacing model with BMIPP.
AB  - The normal myocardium uses primarily fatty acid as its energy source, but, as
      heart failure develops, the myocardial fatty acid metabolism is limited. In this
      study, impairment of the lipid metabolism in heart failure was serially evaluated
      with 123I-(rho-iodophenyl)3-(R,S)-methylpentadecanoic acid (BMIPP), a
      radioiodinated fatty acid analog. METHODS: Rapid ventricular pacing was
      introduced in 10 beagle dogs. Dogs were subjected to hemodynamic assessment and
      measurement of catecholamine before and after pacing. After 1 wk (group A; n = 4)
      and 4 wk (group B; n = 6) of pacing, BMIPP was injected directly into the left
      anterior descending artery; its extraction, retention, and washout rate in the
      early phase were calculated, and the metabolites in the myocardium were evaluated
      using high-performance liquid chromatography. These factors were compared with
      those of healthy control animals (group C; n = 6). RESULTS: The left ventricular
      ejection fraction and cardiac output decreased significantly in groups A and B
      after pacing. The pulmonary capillary wedge pressure did not change in group A
      but increased significantly in group B. Plasma norepinephrine increased
      progressively as heart failure developed but did not reach statistical
      significance. The washout rate in the early phase increased, significantly in
      groups A and B compared with that of group C. Extraction and retention of BMIPP
      did not change in group A. In group B, extraction tended to decrease and
      retention decreased significantly compared with that of group C. The levels of
      full metabolite formed by complete oxidation of BMIPP decreased, and
      backdiffusion of BMIPP increased significantly in groups A and B compared with
      that of group C. Myocardial blood flow did not change among the three groups.
      CONCLUSION: Our study indicates that myocardial fatty acid oxidation begins to be
      inhibited and that washout of BMIPP increases in the compensated stage of left
      ventricular dysfunction but that myocardial extraction and retention of fatty
      acid are definitely impaired in the advanced stage of heart failure. Therefore,
      as assessed by BMIPP, the myocardial lipid metabolism is related to the
      pathophysiology of the development and worsening of heart failure.

PMID- 11197961
TI  - Challenges in development and use of radiopharmaceuticals.

PMID- 11197962
TI  - Immunoscintigraphy of aortic dissection with 99mTc-labeled murine anti-smooth
      muscle myosin monoclonal antibody in rats.
AB  - Aortic dissection is among the most common of fatal conditions of the aorta.
      Prompt and accurate diagnosis of the site and extent of the lesion is necessary
      for adequate therapy. However, this catastrophic disease, characterized by
      extensive damage to smooth muscle cells, lacks specific signs and symptoms. As a
      result, the diagnosis is still frequently missed today and a new diagnostic
      method to specifically identify aortic dissection would be attractive. The
      purpose of this study was to examine the feasibility of radioimmunoscintigraphy
      using 99mTc-anti-smooth muscle myosin monoclonal antibody (SM-MAb) for the
      noninvasive diagnosis of aortic dissection in the rat experimental model.
      METHODS: The accumulation of 99mTc-anti-SM-MAb was studied, and scintigraphic
      imaging with 99mTc-anti-SMMAb was performed in rats immediately after
      experimental aortic dissection and 1 and 2 wk later. RESULTS: The radioactivity
      of 99mTc-anti-SM-MAb in the dissected aorta showed a significant increase
      compared both with the normal portion of the aorta and with blood 6 h after
      injection of the radiotracer; the ratio of the percentage injected dose per gram
      (%lD/g) in the lesion to that retained in the normal portion was 4.17 +/- 1.47.
      Scintigraphic imaging with 99mTc-anti-SM-MAb allowed distinct visualization of
      the dissected aorta with specific accumulation of antibody 6 h after tracer
      injection. Selective accumulation of the tracer in the dissected portion of the
      aorta persisted even 1 wk after aortic injury, allowing clear visualization of
      the dissected lesion by scintigraphy. CONCLUSION: Radioimmunoscintigraphy using
      anti-SM-MAb is a potentially useful noninvasive diagnostic method for imaging
      aortic dissection.

PMID- 11197963
TI  - In vivo detection of deposition of radiolabeled lupus antikidney antibody and its
      inhibition by soluble antigen.
AB  - This investigation in an animal model was designed to test the feasibility of
      using radiolabeled lupus antikidney antibody to show renal deposition in vivo and
      the ability to block this deposition with a binding peptide. METHODS: BALB/c mice
      received injections of radiolabeled murine anti-DNA antibody, antibody with no
      DNA binding capability, and DNA antibody simultaneously with blocking peptide.
      RESULTS: Significantly higher renal deposition of anti-DNA antibody than of
      antibody without DNA binding capability occurred in the animals at 48 h after
      injection (5.21% of the injected dose per gram of tissue versus 2.5%, P < 0.0004)
      and at 7-8 d after injection (1.44% versus 0.20%, P < 0.00004). The simultaneous
      injection of blocking peptide with anti-DNA binding antibody significantly
      reduced the renal deposition of the anti-DNA antibody at 48 h (1.53%, P <
      0.00001) and at 7-8 d (0.64%, P < 0.0017). CONCLUSION: This study showed the
      feasibility of using a radiolabeled antibody to evaluate deposition of anti-DNA
      antibody in the kidney and the successful use of a peptide to block antibody
      deposition-a strategy that may be useful for renal preservation in lupus. These
      data support the possibility of using antikidney-labeled antibodies to evaluate
      immunologic renal disease in vivo in humans.

PMID- 11197964
TI  - Joint scintigraphy in rabbits with 99mtc-N-[3-(triethylammonio)propyl]-15ane-N5,
      a new radiodiagnostic agent for articular cartilage imaging.
AB  - The aim of this study was to investigate joint scintigraphy in rabbits with 99mTc
      N-[3-(triethylammonio)propyl]-15ane-N5 (NTP 15-5), a new radiopharmaceutical that
      specifically localizes in cartilaginous tissues. METHODS: Scans obtained after
      intravenous injection of the 99mTc-labeled compound in normal and arthropathy
      induced rabbits were compared with those of the bone-imaging agent 99mTc
      methylene diphosphonate (99mTc-MDP). RESULTS: The radioactive uptake of 99mTc-NTP
      15-5 was detected in cartilaginous tissues 5 min after injection and was stable
      for 2 h. The uptake intensity was related to age and joint disease severity, and
      cartilage alterations not revealed by radiography induced a significant decrease
      of radiotracer uptake. On the other hand, imaging performed with 99mTc-MDP did
      not reveal the early changes in arthrosis but was more specific for bone
      remodeling in advanced stages of diseases or in inflammatory processes.
      CONCLUSION: Our results indicate that 99mTc-NTP 15-5 could be a good tracer for
      human arthrosic and arthritic cartilage detection, especially for the early
      diagnosis of joint diseases.

PMID- 11197965
TI  - Two-step targeting of xenografted colon carcinoma using a bispecific antibody and
      188Re-labeled bivalent hapten: biodistribution and dosimetry studies.
AB  - Radioimmunotherapy (RIT) is currently being considered for the treatment of solid
      tumors. Although results have been encouraging for pretargeted 131I RIT with the
      affinity enhancement system (AES), the radionuclide used is not optimal because
      of its long half-life, strong gamma emission, poor specific activity, and low
      beta particle energy. 188Re, though unsuitable for direct antibody labeling,
      could be used with the AES two-step targeting technique. The purpose of this
      study was to compare the distribution and dosimetry of a bivalent hapten labeled
      with 188Re or 125I. For dosimetry calculations and biodistribution data, 125I was
      substituted for 131I. METHODS: After preliminary injection of a bispecific
      anticarcinoembryonic antigen (CEA) or antihapten antibody (Bs-mAb F6-679), AG 8.1
      or AG 8.0 hapten radiolabeled with 188Re or 125I was injected into a nude mouse
      model grafted subcutaneously with a human colon carcinoma cell line (LS-174-T)
      expressing CEA. A dosimetry study was performed for each animal from the
      concentration of radioactivity in tumor and different tissues. RESULTS:
      Radiolabeling of AG 8.1 with 125I afforded a 40% yield with a specific activity
      of 11.1 MBq/nmol after purification. Radiolabeling of AG 8.0 with 188Re afforded
      a 72% yield with a specific activity of 31.82 MBq/nmol. In all experiments, the
      percentage of tumor uptake of 125I-AG 8.1 was always significantly greater than
      that of 188Re-AG 8.0. The corresponding tumor-to-tissue ratios reflected uptake
      values. The least favorable tumor-to-normal tissue ratios in the dosimetry study
      were 8.1 and 8.5 for 131I (tumor-to-blood ratio and tumor-to-kidney ratio,
      respectively) and 2.3 for 188Re (tumor-to-intestine ratio). CONCLUSION: This
      study indicates that 188Re can be used for radiolabeling of hapten in two-step
      radioimmunotherapy protocols with the AES technique. 188Re has a greater range
      than 131I, which should allow the treatment of solid tumors around 1 cm in
      diameter. Although the method used for hapten radiolabeling did not provide
      optimal tumor uptake, the use of a bifunctional chelating agent associated with
      AG 8.1 should solve this problem.

PMID- 11197966
TI  - Nuclear medicine chemistry.

PMID- 11197967
TI  - Evaluation of 99mTc-RP128 as a potential inflammation imaging agent: human
      dosimetry and first clinical results.
AB  - 99mTc-RP128 is a bifunctional peptide chelate designed to target the tuftsin
      receptor, expressed by neutrophils, monocytes, and macrophages. Studies in animal
      models of both infectious and noninfectious inflammation have shown a positive
      correlation between accumulation of 99mTc-RP128 and quantitative measures of
      inflammation. A phase 1 trial was conducted with the objective of determining the
      safety, biodistribution, and human dosimetry of 99mTc-RP128 in eight healthy
      volunteers. For evaluation of the potential of 99mTc-RP128 for imaging sites of
      inflammation, 10 patients with active rheumatoid arthritis were studied. METHODS:
      Normal biodistribution was determined using the conjugate view method up to 24 h
      after intravenous injection of 280 MBq 99mTc-RP128. Dosimetry calculations were
      based on standard MIRD methodology, using the International Commission on
      Radiological Protection model 30 of the gastrointestinal tract and a voiding
      bladder model with an interval of 4.8 h. For rheumatoid arthritis patients, whole
      body scans and spot views of the hands, knees, and feet were obtained at 1 and 3
      h after injection of 475 MBq 99mTc-RP128. RESULTS: 99mTc-RP128 was cleared
      rapidly from the blood by renal excretion, and no major organs showed significant
      accumulation. The synovia of the major joints were visualized for all subjects.
      The effective dose equivalent and the effective dose were calculated to be 0.011
      and 0.0094 mSv/MBq, respectively. The highest dose was to the bladder wall, which
      received 0.076 mGy/MBq. In all rheumatoid arthritis patients, we observed a
      markedly increased uptake in several affected joints. Painful and swollen joints
      were detected with a sensitivity of 76% and 69%, respectively. Seventy-three
      percent of the joints with radiographic signs of erosion were scintigraphically
      positive. In some patients, lines of increased activity were observed and were
      considered to correspond to uptake in the synovium lining tendon sheaths in the
      wrists and hands. CONCLUSION: This study shows that 99mTc-RP128 is safe and can
      successfully be used to visualize clinically affected joints in patients with
      long-standing rheumatoid arthritis. A proposed radioactive dose of 450-500 MBq
      will produce an effective dose well within the range of effective doses for
      commonly used radiopharmaceuticals.

PMID- 11197969
TI  - Nuclear medicine in the military.

PMID- 11197968
TI  - Biologic dosimetry of bone marrow: induction of micronuclei in reticulocytes
      after exposure to 32P and 90Y.
AB  - Bone marrow is the dose-limiting organ in targeted radionuclide therapy. Hence,
      determination of the absorbed dose to bone marrow from incorporated radionuclides
      is a critical element in treatment planning. This study investigated the
      potential of the micronucleus assay in peripheral blood reticulocytes (MnRETs) as
      an in vivo biologic dosimeter for bone marrow. METHODS: After intravenous
      administration of 32P-orthophosphate or 90Y-citrate in Swiss Webster mice, DNA
      damage induced in bone marrow erythroblastoid cells was measured by subsequent
      scoring of MnRETs in peripheral blood. The response to exponentially decreasing
      dose rates was calibrated by irradiating animals with external 137Cs-gamma-rays.
      The gamma-ray dose rate was decreased exponentially, with the dose-rate decrease
      half-time corresponding to the effective clearance half-time (Te) of the
      radioactivity from the femoral bone (Te = 64 h for 90Y-citrate and Te = 255 h for
      32P-orthophosphate). RESULTS: The maximum MnRETs frequency occurred on the second
      and third day after injection of 90Y-citrate and 32P-orthophosphate,
      respectively. The same pattern was observed for exponentially decreasing dose
      rates of 137Cs-gamma-rays. For each type of exposure, the maximum MnRETs
      frequency increased in a dose-dependent manner. Using the calibrated dosimeter,
      the initial dose rates to the marrow per unit of injected activity were 0.0020
      cGy/h/kBq and 0.0026 cGy/h/kBq for 32P-orthophosphate and 90Y-citrate,
      respectively. CONCLUSION: Micronuclei in peripheral blood reticulocytes can be
      used as a noninvasive biologic dosimeter for measuring absorbed dose rate and
      absorbed dose to bone marrow from incorporated radionuclides.

PMID- 11197970
TI  - Paclitaxel-Based chemotherapy for non-small cell lung cancer: predicting the
      response with 99mTc-tetrofosmin chest imaging.
AB  - The purpose of this study was to retrospectively predict the chemotherapeutic
      response to paclitaxel for non-small cell lung cancer (NSCLC) using 99mTc
      tetrofosmin (TF) uptake and to detect the expression of 170-kDa multidrug
      resistance-mediated P-glycoprotein (MDR-Pgp). METHODS: Before chemotherapy with
      paclitaxel, 20 patients with stage IIIb or IV NSCLC were enrolled in this study
      to undergo early and delayed 99mTc-TF chest imaging for calculating tumor-to
      normal lung ratios (T/NL) and retention indices (RI) for assessment of the MDR
      Pgp in NSCLC. RESULTS: The early and delayed mean T/NLs were 1.59 +/- 0.25 and
      1.50 +/- 0.25, respectively, for 10 patients with a good response and 1.09 +/-
      0.09 and 1.03 +/- 0.05, respectively, for 10 patients with a poor response. The
      differences were shown to be significant (P < 0.001) by independent Student t
      tests. However, no significant differences (P = 0.801) between good-response
      patients (-5.70% +/- 3.67%) and poor-response patients (-5.23% +/- 4.51%) were
      found in RI. In addition, other prognostic factors (age, sex, tumor size, stage,
      and cell type) were not significantly different between good-response patients
      and poor-response patients. CONCLUSION: 99mTc-TF chest images are potential tools
      for understanding MDR-Pgp expression in NSCLC and for predicting the
      chemotherapeutic response to paclitaxel.

PMID- 11197971
TI  - Hypoxia-Induced increase in FDG uptake in MCF7 cells.
AB  - Recent clinical data indicate that tumor hypoxia negatively affects the treatment
      outcome of both radiotherapy and surgery in various cancers, emphasizing the need
      for noninvasive detection of tumor hypoxia. Several studies have shown an
      increased uptake of FDG in hypoxic regions of xenografts, suggesting the use of
      PET with FDG as a potential technique. In this study, we examine the mechanism
      underlying the hypoxia-induced increase of FDG uptake in the human breast
      carcinoma cell line MCF7. METHODS: The uptake of 3H-FDG into MCF7 cells was
      determined after incubation under hypoxic (0% oxygen) or normoxic conditions,
      with or without redox agents, for varying time periods. In addition, the effects
      of the redox agents on the glucose transporter activity and the hexokinase
      activity were determined independently, and the effects of hypoxia on glucose
      transporter protein and hexokinase levels were assessed. RESULTS: A more than
      twofold increase (2.53 +/- 0.79; P < 0.005) in 3H-FDG uptake was observed under
      hypoxic conditions, but no changes in the cellular levels of glucose transporter
      proteins or hexokinase were observed. A reducing agent, dithiothreitol (DTT),
      also caused an increase in 3H-FDG uptake but failed to affect uptake under
      hypoxic conditions. This indicates that the mechanisms by which hypoxia and DTT
      affect 3H-FDG uptake might be the same. The oxidizing agent p
      chloromercuribenzenesulfonic acid (pCMBS) had no effect on 3H-FDG uptake under
      normoxic conditions but counteracted the effect of hypoxia. DTT caused an
      increase in glucose transporter activity, whereas it had no effect on hexokinase
      activity. pCMBS had no effect on either glucose transporter activity or
      hexokinase activity. CONCLUSION: The hypoxia-induced increase in 3H-FDG uptake in
      MCF7 cells is the result, in part, of an increase in glucose transporter activity
      resulting from the modification (reduction) of thiol group(s) in the glucose
      transport protein(s). Modulation of hexokinase activity is probably not involved
      in the hypoxia-induced increase in 3H-FDG uptake in these cells.

PMID- 11197972
TI  - The severity of pulmonary emphysema investigated with fractal analysis: regional
      dependence.

PMID- 11197973
TI  - Somatostatin receptor scintigraphy and gallium scintigraphy in patients with
      sarcoidosis.
AB  - Somatostatin receptor scintigraphy (SRS) has been shown to reveal sarcoidosis
      sites. The aim of this study was to prospectively compare SRS and gallium
      scintigraphy in the evaluation of pulmonary and extrapulmonary involvement in
      patients with proven sarcoidosis. METHODS: Eighteen patients with biopsy-proven
      sarcoidosis were included. Nine were or recently had been receiving steroid
      therapy at the time of the examination. Planar gallium scintigraphy (head, chest,
      abdomen, and pelvis) and thoracic SPECT were performed at 48-72 h after injection
      of a mean dose of 138 +/- 21 MBq 67Ga. Planar SRS and thoracic SPECT were
      performed at 4 and 24 h after injection of a mean dose of 148 +/- 17 MBq 111n
      pentetreotide. RESULTS: Gallium scintigraphy found abnormalities in 16 of 18
      patients (89%) and detected 64 of 99 clinically involved sites (65%). SRS found
      abnormalities in 18 of 18 patients and detected 82 of 99 clinically involved
      sites (83%). Of the 9 treated patients, gallium scintigraphy found abnormalities
      in 7 (78%), detecting 23 of 39 clinically involved sites (59%), whereas SRS found
      abnormalities in 9, detecting 32 of 39 clinically involved sites (82%).
      CONCLUSION: This study suggests that, compared with gallium scintigraphy, SRS
      appears to be accurate and contributes to a better evaluation of organ
      involvement in sarcoidosis patients, especially those treated with
      corticosteroids.

PMID- 11197974
TI  - Looking ahead to government regulation and response in nuclear medicine.

PMID- 11197975
TI  - Parametric images of antibody pharmacokinetics in Bi213-HuM195 therapy of
      leukemia.
AB  - Kinetic analysis of gamma camera patient images can provide time-dependent
      information about antibody behavior. Current region-of-interest-based techniques
      for the kinetic analysis of these images rely on user selection and drawing of
      regions to be analyzed. Such analyses do not reveal unexpected kinetic activity
      outside of the selected regions of interest and do not provide a whole-image
      assessment regarding the pharmacokinetics of an agent. At Memorial Sloan
      Kettering Cancer Center, a method for generating images in which the pixel value
      represents a kinetic parameter has been developed. This work extends the method
      into a new application in which whole-body parametric images are used to examine
      the kinetics of Bi213-HuM195 in patients with leukemia. METHODS: Bi213-HuM195 is
      typically administered in multiple injections over 2-4 d, yielding a progressive
      increase in the amount of antibody administered. Patients are injected with
      individual doses while positioned in a gamma camera, and imaging is initiated at
      the start of the injection. The acquisition is performed in dynamic mode with
      images collected at several time intervals over 1 h. Using software developed in
      house, images are corrected for patient movement through iterative alignments,
      decay corrected, and summed to yield a series of images over regular time
      intervals. Parametric rate images are obtained by fitting a linear expression to
      the counts in each pixel. In this study, rate images from a patient's first
      injection were compared with rate images from the last injection. RESULTS: The
      conventional planar images of antibody distribution showed significant uptake in
      liver, spleen, and marrow, whereas the generated rate images displayed different
      patterns, sometimes with negative values in liver and spleen and positive values
      in marrow, reflecting clearance and uptake rates rather than total accumulation.
      The impact of the progressive increase in antibody administration was observed by
      comparing the first with the last rate images. Interpatient comparisons were also
      made and showed that rate image patterns varied depending on patient-specific
      conditions such as the amount of disease and previous therapies undergone by the
      patient. CONCLUSION: Rate images make it possible to succinctly display kinetic
      information about an agent's behavior over the entire acquired image.

PMID- 11197976
TI  - Prediction of the usefulness of combined mammography and scintimammography in
      suspected primary breast cancer using ROC curves.
AB  - The aim of this study was to compare the accuracy of 99mTc
      methoxyisobutylisonitrile scintimammography (SMM) and conventional mammography in
      patients presenting with suspected primary breast cancer. Receiver-operating
      characteristic (ROC) curve analysis was applied to determine if a combination of
      x-ray mammography (XMM) and SMM was more accurate than a single test alone.
      METHODS: The results of SMM, XMM, and a combination of both studies performed
      over a 3-y period on 374 suspicious lesions in 353 patients with no previous
      history of breast cancer were reviewed. Each scan report was reviewed and graded
      as follows: grade 1, definitely normal or benign; grade 2, probably normal or
      benign; grade 3, equivocal; grade 4, probably cancer; and grade 5, definitely
      cancer. The results were verified by pathologic examination of biopsy material
      obtained from each suspicious mass. ROC curves were generated from these results.
      RESULTS: There were 204 malignant breast tumors and 170 nonmalignant breast
      lesions. SMM diagnosed correctly 181 breast cancers and was true-negative in 122
      benign breast lesions: sensitivity, 89%; specificity, 71%; positive predictive
      value (PPV), 79%; and negative predictive value (NPV), 84%. XMM diagnosed
      correctly 143 malignant tumors and was true-negative in 117 nonmalignant lesions.
      The sensitivity, specificity, PPV, and NPV for XMM were 70%, 69%, 73%, and 66%,
      respectively. Using a combination of the two tests, the combined sensitivity was
      93%, specificity was 72%, PPV was 80%, and NPV was 90%. Using the index of the
      area under the ROC curve obtained by the rating method showed that the
      combination of XMM and SMM was significantly more accurate than either of the
      individual tests if performed alone (P < 0.05). CONCLUSION: This study shows that
      the combination of XMM and SMM produces more accurate results than either
      modality alone. Therefore, if there is doubt about the accuracy of XMM, SMM
      should be used as the second-line test in breast imaging.

PMID- 11197977
TI  - 99mTc-MIBI scintigraphy in musculoskeletal tumors.
AB  - The aim of this study was to assess the value of 99mTc-hexakis2
      methoxyisobutylisonitrile (MIBI) scintigraphy in patients with clinical and
      radiologic features of primary or metastatic musculoskeletal tumors. METHODS: The
      scintigraphic findings for 84 patients were compared with the surgical and
      histologic findings. Each patient underwent three-phase bone scanning with 99mTc
      methylene diphosphonate (MDP) and dynamic and static MIBI scintigraphy. The MIBI
      scans were evaluated by visual and quantitative analysis. The count ratio of the
      lesion to the adjacent or contralateral normal area (L/N) was calculated from the
      region of interest drawn on the MIBI scan. The Mann-Whitney test was used to
      determine the differences between the uptake ratios of malignant and benign
      lesions. RESULTS: Although increased MDP uptake was not specific for bone
      malignancy, a significant difference was found between benign tumors (L/N = 1.22
      +/- 0.43) and malignant tumors (L/N = 2.25 +/- 1.03) on MIBI scans. Sensitivity
      and specificity were 81% and 87%, respectively. Forty-six of 53 proven benign
      lesions did not show significant MIBI uptake. The negative predictive value was
      88%. In all seven sites of pathologic fracture, significant uptake was seen.
      However, three malignant lesions were not detected by MIBI scintigraphy, whereas
      seven benign lesions showed false-positive results. CONCLUSION: The major
      diagnostic worth of MIBI scintigraphy is its high negative predictive value.
      Although not capable of replacing tissue biopsy as a definitive diagnostic
      modality for musculoskeletal neoplasms, MIBI scintigraphy does appear to have a
      role in better preoperative assessment and in distinguishing between pathologic
      and simple fractures.

PMID- 11197978
TI  - Study of quantitative oral radioactivity in salivary gland scintigraphy and
      determination of the clinical stage of Sjogren's syndrome.
AB  - In this study, the oral radioactivity seen in salivary gland scintigraphy, which
      was established entirely on the basis of radioactive saliva secreted by the
      parotid and submandibular glands, was evaluated quantitatively in healthy
      volunteers and in patients with Sjogren's syndrome. METHODS: Salivary gland
      scintigraphy and labial biopsy were performed on 70 patients with Sjogren's
      syndrome. After intravenous administration of 99mTc-sodium pertechnetate, dynamic
      scintigraphy was performed and time-activity curves for the oral cavity and four
      major salivary glands were generated. Lemon juice stimulation was delivered at 40
      min. The prestimulatory oral activity index, poststimulatory oral activity index,
      and time interval between the vascular perfusion peak and the prestimulated
      maximum oral activity point were calculated to quantify the oral activity. Other
      glandular functional parameters-namely, maximum accumulation (MA), maximum
      secretion, secretion velocity, time at maximum count, time interval from
      stimulation to minimum count, and uptake ratio (UR) of the parotid and
      submandibular glands-were also calculated. Salivary gland scintigraphy was also
      performed on 21 healthy subjects with no evidence of salivary gland malfunction.
      RESULTS: Histopathologic grade 1 or 2 was found in 29 patients and grade 3 or 4
      was found in 41 patients, and they were regarded as being in the early and
      advanced stages of Sjogren's syndrome, respectively. After overall analysis, all
      of the oral activity indices and the MA and UR of the submandibular gland clearly
      decreased as clinical severity progressed, and statistically significant
      differences were observed. CONCLUSION: New oral activity indices correlated with
      the stage of Sjogren's syndrome, and these quantitative oral indices together
      with certain glandular parameters (mainly MA and UR of the submandibular gland)
      were found to be sensitive enough to distinguish the disease severity of
      Sjogren's syndrome.

PMID- 11197979
TI  - The promising role of 18F-FDG PET in detecting infected lower limb prosthesis
      implants.
AB  - The purpose of this study was to evaluate the feasibility of using 18F-FDG and
      PET for the detection of infection associated with lower limb arthroplasty.
      METHODS: Seventy-four prostheses in 62 patients in whom infection was suspected
      after artificial hip or knee placement were studied with this technique. Images
      were obtained 60 min after an intravenous injection of FDG. The images were
      interpreted as positive for infection if tracer uptake was increased at the bone
      prosthesis interface. A final diagnosis was made by surgical exploration or
      clinical follow-up for 1 y. PET results were compared with the follow-up outcome
      in all patients. RESULTS: The sensitivity, specificity, and accuracy of PET for
      detecting infection associated with knee prostheses were 90.9%, 72.0%, and 77.8%,
      respectively. The sensitivity, specificity, and accuracy of PET for detecting
      infection associated with hip prostheses were 90%, 89.3%, and 89.5%,
      respectively. Overall, the sensitivity was 90.5% and the specificity was 81.1%
      for detection of lower limb infections. CONCLUSION: FDG PET is a useful imaging
      modality for detecting infections associated with lower limb arthroplasty and is
      more accurate for detecting infections associated with hip prostheses than for
      detecting infections associated with knee prostheses.

PMID- 11197980
TI  - Recovery of the cardiac adrenergic nervous system after long-term beta-blocker
      therapy in idiopathic dilated cardiomyopathy: assessment by increase in
      myocardial 123I-metaiodobenzylguanidine uptake.
AB  - In chronic heart failure, elevated plasma norepinephrine (NE) levels and a
      disparity between the neuronal release and the effective reuptake of NE lead to
      an increased concentration of NE in the presynaptic cleft, causing a
      downregulation of the myocardial beta-adrenoceptors. The clinical and prognostic
      effectiveness of beta-blocker therapy has been shown in patients with chronic
      heart failure in several large trials. The purpose of this study was to
      investigate the effect of long-term beta-blocker therapy on the cardiac
      adrenergic nervous system as assessed by the myocardial uptake of 123I
      metaiodobenzylguanidine (MIBG), an analog of NE, in idiopathic dilated
      cardiomyopathy (IDC). METHODS: In 10 patients with IDC and stable chronic heart
      failure the myocardial MIBG uptake was measured at baseline and at 1 y (median,
      11.5 mo) after treatment with beta-blockers (metoprolol, n = 5; bisoprolol, n =
      1; and carvedilol, n = 4) in addition to standard medication. In parallel with
      the changes in MIBG uptake, the New York Heart Association functional class, the
      left ventricular ejection fraction (LVEF), and the left ventricular end-diastolic
      diameter (LVEDD) were documented before and after 1 y of therapy with beta
      blockers. RESULTS: During the 1-y follow-up, a significant increase in myocardial
      123I-MIBG uptake (P = 0.005) in parallel with an improved LVEF (P = 0.005) and a
      reduced LVEDD (P = 0.019) was found. A trend toward an improvement of the New
      York Heart Association functional class under the beta-blocker therapy (P =
      0.139) was also found. CONCLUSION: Assessment of the myocardial 123I-MIBG uptake
      is a useful noninvasive tool for evaluating changes in cardiac sympathetic nerve
      activity under medical therapy. Long-term treatment with beta-blockers in IDC
      causes a recovery of the cardiac adrenergic nervous system concomitantly with a
      clinical and hemodynamic improvement.

PMID- 11197981
TI  - An evaluation of myocardial fatty acid and glucose uptake using PET with
      [18F]fluoro-6-thia-heptadecanoic acid and [18F]FDG in Patients with Congestive
      Heart Failure.
AB  - Understanding the metabolic consequences of heart failure is important in
      evaluating potential mechanisms for disease progression and assessing targets for
      therapies designed to improve myocardial metabolism in patients with heart
      failure. PET is uniquely suited to noninvasively evaluate myocardial metabolism.
      In this study, we investigated the kinetics of 14(R,S)-[18F]fluoro-6-thia
      heptadecanoic acid (FTHA) and [18F]FDG in patients with stable New York Heart
      Association functional class III congestive heart failure and a left ventricular
      ejection fraction of no more than 35%. METHODS: Twelve fasting patients underwent
      dynamic PET studies using [18F]FTHA and FDG. From the dynamic image data, the
      fractional uptake rates (Ki) were determined for [18F]FTHA and FDG. Subsequently,
      serum free fatty acid and glucose concentrations were used to calculate the
      myocardial free fatty acid and glucose uptake rates, respectively. Uptake rates
      were compared with reported values for [18F]FTHA and FDG in subjects with normal
      left ventricular function. RESULTS: The average Ki for [18F]FTHA was 19.7 +/- 9.3
      mL/100 g/min (range, 7.2-36.0 ml/100 g/min). The average myocardial fatty acid
      use was 19.3 +/- 2.3 mmol/100 g/min. The average Ki for FDG was 1.5 +/- 0.37
      mL/100 g/min (range, 0.1-3.3 mL/100 g/min), and the average myocardial glucose
      use was 12.3 +/- 2.3 mmol/100 g/min. CONCLUSION: Myocardial free fatty acid and
      glucose use in heart failure can be quantitatively assessed using PET with
      [18F]FTHA and FDG. Myocardial fatty acid uptake rates in heart failure are higher
      than expected for the normal heart, whereas myocardial glucose uptake rates are
      lower. This shift in myocardial substrate use may be an indication of impaired
      energy efficiency in the failing heart, providing a target for therapies directed
      at improving myocardial energy efficiency.

PMID- 11197982
TI  - Measurement of myocardial blood flow with PET using 1-11C-acetate.
AB  - 11C-acetate has been used extensively for the noninvasive assessment of
      myocardial oxygen consumption and viability with PET. The use of early uptake of
      acetate by the heart to measure myocardial perfusion has been proposed. This
      study evaluated the application of 11C-acetate for absolute measurement of
      myocardial blood flow using a simple compartmental model that does not require
      blood sampling. METHODS: Eight healthy volunteers and 13 subjects with concentric
      left ventricular hypertrophy were studied under resting conditions with both
      11Cacetate and 15O-water. Myocardial blood flow with 11C-acetate was obtained by
      fitting the first 3 min of the blood and tissue tracer activity curves to a two
      compartment model. Flows obtained were compared with a validated approach using
      15O-water. RESULTS: In healthy volunteers, regional myocardial perfusion at rest
      estimated with 11C-acetate was comparable with values obtained with 15O-water
      (1.06 +/- 0.25 and 0.96 +/- 0.12 mL/g/min, respectively). Perfusion in subjects
      with left ventricular hypertrophy was also comparable if the recovery coefficient
      (FMM) used was corrected for ventricular mass. If a fixed FMM was used, flow was
      greatly overestimated. FMM could be estimated from left ventricular mass (FMM =
      0.46 + 0.002 x mass, r = 0.86, P < 0.0001). CONCLUSION: The results of this study
      suggest that 11C-acetate can be applied to quantitatively estimate myocardial
      perfusion under resting conditions using a two-compartment model without the need
      for blood sampling, provided that an appropriate FMM is chosen. This approach
      should increase the usefulness of this tracer and obviate administration of a
      separate tracer to independently measure perfusion.

PMID- 11197983
TI  - Impact of FDG PET on patients with differentiated thyroid cancer who present with
      elevated thyroglobulin and negative 131I scan.
AB  - FDG PET is increasingly performed in patients with differentiated thyroid cancer
      who present with elevated human thyroglobulin (hTG) levels and negative 131I
      scan. The aim of this study was to evaluate the impact of FDG PET on treatment in
      these patients. METHODS: A total of 118 FDG PET studies were performed on 64
      patients, and follow-up data were available for all patients. Whole-body images
      were acquired 1 h after intravenous injection of 370 MBq (10 mCi) FDG using a PET
      scanner with an axial field of view of 16.2 cm. Tumor-suspicious FDG PET studies
      were evaluated by histology, cytology, 131I uptake, CT or MRI, and follow-up of
      hTg levels. The therapeutic consequence was noted for each patient. Moreover,
      results of FDG PET were correlated with hTg levels. RESULTS: Forty-four patients
      had positive scans, which were proven to be true-positive in 34 patients, whereas
      7 patients had false-positive findings. Two patients exhibited a secondary
      malignancy. One patient did not fit in any category, having true-positive, false
      positive, and false-negative findings. On the other hand, 20 patients had
      negative scans. These were true-negative findings in 5 patients, whereas the
      remaining 15 patients had false-negative results. Accordingly, the positive
      predictive value of FDG PET was 83% (34/41), whereas the negative predictive
      value was 25% (5/20). Treatment was directly changed in 19 of 34 patients with
      true-positive PET studies: 18 patients had further surgery, and 4 patients were
      referred for external irradiation, 3 of them after incomplete removal of local
      recurrences. FDG PET showed widespread disease in 7 patients; thus, palliative
      treatment, rather than curative therapy, was initiated. True-positive FDG PET
      findings were correlated positively with increasing hTg levels (i.e., FDG PET was
      true-positive in 11%, 50%, and 93% of patients with hTg levels of <10, 10-20, and
      >100 microg/L, respectively). CONCLUSION: FDG PET is a valuable diagnostic tool
      in patients with differentiated thyroid cancer who present with increased hTg
      levels and negative 131I scans because it permits selection of patients for
      surgery, which may be curative. FDG PET is most promising at hTg levels of >10
      microg/L.

PMID- 11197984
TI  - Clinical usefulness of FDG PET in differentiated thyroid cancer.

PMID- 11197985
TI  - Relationship between preoperative viability and postoperative improvement in LVEF
      and heart failure symptoms.
AB  - The presence of myocardial viability is predictive of improvement in regional
      left ventricular (LV) function after revascularization. Studies on predicting
      improvement in global LV function are scarce, and the amount of viable myocardium
      needed for improvement in LV ejection fraction (LVEF) after revascularization is
      unknown. Moreover, whether the presence of viability is associated with relief of
      heart failure symptoms after revascularization is uncertain. Hence, the aims were
      to define the extent of viable myocardium needed for improvement in LVEF and to
      determine whether preoperative viability testing can predict improvement in heart
      failure symptoms. METHODS: Patients (n = 47) with ischemic cardiomyopathy (mean
      LVEF +/- SD, 30% +/- 6%) undergoing surgical revascularization were studied with
      18F-FDG SPECT to assess viability. Regional and global function were measured
      before and 3-6 mo after revascularization. Heart failure symptoms were graded
      according to the New York Heart Association (NYHA) criteria, before and 3-6 mo
      after revascularization. RESULTS: The number of viable segments per patient was
      directly related to the improvement in LVEF after revascularization (r = 0.79, P
      < 0.01). Receiver operating characteristic curve analysis revealed that the
      cutoff level of four viable segments (representing 31% of the left ventricle)
      yielded the highest sensitivity and specificity (86% and 92%, respectively) for
      predicting improvement in LVEF. Furthermore, the presence of four or more viable
      segments predicted improvement in heart failure symptoms after revascularization,
      with positive and negative predictive values of 76% and 71%, respectively.
      CONCLUSION: The presence of substantial viability (four or more viable segments,
      31% of the left ventricle) on FDG SPECT is predictive of improvement in LVEF and
      heart failure symptoms postoperatively.

PMID- 11197986
TI  - Does CABG improve left ventricular ejection fraction in patients with ischemic
      cardiomyopathy, and does it matter?

PMID- 11197987
TI  - Glucose metabolism of breast cancer assessed by 18F-FDG PET: histologic and
      immunohistochemical tissue analysis.
AB  - Breast cancer is characterized by elevated glucose consumption resulting in
      increased uptake of 18F-FDG. However, tracer uptake varies considerably among
      tumors imaged with PET. This study compared histologic and immunohistochemical
      tissue analysis of breast carcinomas with preoperative FDG uptake assessed by PET
      to identify tumor characteristics that define the degree of tracer accumulation.
      METHODS: FDG uptake in breast tumors was quantified by calculating standardized
      uptake values (SUVs) corrected for partial-volume effect and normalized to blood
      glucose level at the time of tracer injection. The histologic sections of 50
      invasive and 6 noninvasive breast carcinomas were analyzed for histologic type,
      microscopic tumor growth pattern, percentage of tumor cells, presence of
      inflammatory cells, density of blood vessels, histopathologic grading, tumor cell
      proliferation (mitotic rate and antibody binding of MIB-1), expression of
      estrogen and progesterone receptors, and expression of the glucose transporter
      protein Glut-1. RESULTS: A positive correlation was found between FDG uptake and
      histologic tumor type (ductal vs. lobular; P = 0.003), microscopic tumor growth
      pattern (nodular vs. diffuse; P = 0.007), and tumor cell proliferation (MIB-1; P
      = 0.009). Tumors with diffuse growth patterns had significantly lower SUVs
      compared with clearly defined tumors. A weak relationship was found between FDG
      uptake and the percentage of tumor cells (P = 0.06). Lower densities of blood
      vessels corresponded to higher FDG uptakes (P = 0.08). However, even significant
      correlations showed poor correlation coefficients. No relationship was found
      between FDG uptake and the following: tumor size; axillary lymph node status;
      percentage of necrotic, fibrotic, and cystic compounds; presence of inflammatory
      cells; steroid receptor status; and expression of Glut-1. CONCLUSION: Histologic
      and immunohistochemical tissue analysis was unable to sufficiently explain the
      variation of FDG uptake in breast cancer. The degree of metabolic changes after
      malignant transformation is most likely explained by a complex interaction
      between cellular energy demand and tumoral microenvironment. Therefore, FDG PET
      imaging may not be used to estimate tumor biologic behavior of breast cancer such
      as differentiation, histopathologic grading, cell proliferation, or axillary
      lymph node status.

PMID- 11197988
TI  - Renal cortical scintigraphy and diuresis renography in infants and children.
AB  - Renal scintigraphy is performed frequently in infants and children. Renal
      cortical scintigraphy using 99mTc dimercaptosuccinic acid is predominantly
      performed to assess the renal sequelae of urinary tract infection. It is most
      commonly performed for the evaluation of chronic renal scars, although it is also
      undertaken in the assessment of acute pyelonephritis. Diuresis renography using
      99mTc mercaptoacetyltriglycine is of great use in the evaluation of renal tract
      obstruction, which may occur at a variety of levels, but most commonly occurs at
      the ureteropelvic junction. Consensus statements have been formulated in an
      attempt to standardize methods of performing these investigations. However,
      several areas of controversy exist in the performance of these studies, and these
      are outlined. Radionuclide cystography and renal function estimation using
      clearance calculations are not covered in this article.

PMID- 11197989
TI  - 8-[18F]Fluoropenciclovir: an improved reporter probe for imaging HSV1-tk reporter
      gene expression in vivo using PET.
AB  - We have synthesized and evaluated 8-[18F]fluoropenciclovir (FPCV) and compared it
      with 8-[18F]fluoroganciclovir (FGCV) for monitoring the expression of herpes
      simplex virus type 1 thymidine kinase (HSV1 -tk) reporter gene in cell culture
      and in vivo. METHODS: C6 rat glioma cells stably transfected with HSV1-tk (C6-stb
      tk+) and control C6 cells were evaluated for their ability to accumulate FGCV
      versus FPCV. For in vivo studies, 15 mice were injected by tail vein with
      increasing levels of an adenoviral vector carrying HSV1-tk. Forty-eight hours
      later the mice were injected with FPCV and killed 3 h later. The percentage
      injected dose per gram (%ID/g) liver was then determined. Two additional mice
      were studied by microPET and autoradiography using FPCV to image adenoviral
      mediated hepatic HSV1-tk reporter gene expression. A tumor-bearing mouse (C6
      control and C6-stb-tk+) was imaged with FDG, FGCV, and FPCV. Two mice carrying
      tumors expressing two different reporter genes, HSV1-tk and dopamine type 2
      receptor (D2R), were also imaged by microPET using FPCV (day 1) and 3-(2'
      [18F]fluoroethyl)spiperone (FESP) (day 2). RESULTS: FPCV shows a significantly
      greater accumulation in C6-stb-tk+ cells than does FGCV (P < 0.05). Over
      identical ranges of adenoviral administration, mouse liver shows a higher %ID/g
      liver for FPCV (0%-9%) compared with our previously reported results with FGCV
      (0%-3%). In C6 control and C6-stb-tk+ tumor-bearing mice, FPCV has a greater
      accumulation than does FGCV for equal levels of HSV1-tk gene expression. In mice
      carrying tumors expressing either HSV1-tk or D2R reporter genes, there is a
      corresponding retention of FPCV and FESP, respectively. CONCLUSION: These results
      indicate that FPCV is a better reporter probe than is FGCV for imaging lower
      levels of HSV1 -tk gene expression in vivo. The results also reveal the ability
      to monitor the expression of two distinct reporter genes in the same animal using
      reporter probes specific for each gene.

PMID- 11197990
TI  - Update on investigation of Ritalin conspiracy.

PMID- 11197991
TI  - Fluvoxamine approved for treating OCD in children.

PMID- 11197992
TI  - PMS and PMDD in the domain of mental health nursing.
AB  - Premenstrual syndrome (PMS) is a complex cluster of symptoms that occurs 7 to 14
      days prior to menses and ends 1 to 2 days after menses. Premenstrual syndrome
      symptoms can create severe, debilitating psychological and physical problems. The
      Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)
      provides criteria for premenstrual dysphoric disorder (PMDD), which can be
      considered the most severe presentation on the PMS continuum. A critical part of
      determining the diagnosis is evaluating the timing of symptoms. True PMS only
      occurs during the luteal phase of the menstrual cycle, with a symptom-free period
      during the follicular phase. After identifying a diagnosis of PMS or PMDD, the
      first-line treatment of these symptom clusters continues to be lifestyle changes,
      including stress management, healthy diet, regular aerobic exercise, cognitive
      behavioral therapy, and fortified coping strategies. Women whose symptoms are not
      controlled adequately with lifestyle modifications may benefit from medications.
      Possible medication recommendations include selective serotonin re-uptake
      inhibitors (SSRIs), diuretics, gonadotropin-releasing hormone (GnRH) agonists,
      and vitamin and mineral supplements.

PMID- 11197993
TI  - Role conflicts & coping strategies in caregiving. A symbolic interactionist view.
AB  - Institutional health care delivery is characterized by interdependency among
      caregivers and between caregivers and care receivers, which leads to role
      conflicts. This article examines role conflicts and coping strategies of health
      care aides who are faced with differing expectations of RNs and residents. Guided
      by a symbolic interactionist perspective, ethnographic data from 12 RNs, 15
      health care aides, and 32 nursing home residents of Italian-Catholic and Anglo
      Saxon descent in Toronto, Ontario, Canada, was gathered. Results showed that
      health care aides differed in how they handled role conflict and their elderly
      clients' concerns. Health care aides were more likely to reject conflicting role
      expectations from residents than from RNs.

PMID- 11197994
TI  - Scope of practice issues in forensic nursing.
AB  - 1. There is significant role variation, across the Western world, in relation to
      how forensic nurses practice. 2. The authors conducted a pilot survey of forensic
      nurses in Australia, New Zealand, the United States, and the United Kingdom to
      examine forensic nursing practice, role definition, and role boundaries. 3.
      Issues arising from the data include the visibility of forensic nurses, the
      client group, forensic-specific education, and role development.

PMID- 11197995
TI  - How people with schizophrenia build their hope.
AB  - 1. Both clinicians and consumers identified the importance of maintaining
      relationships and experiencing success as helpful in building and nurturing hope
      for consumers. 2. To provide holistic care, clinicians need to discuss
      spirituality and meaning with clients. 3. Because being hopeful is an active
      process, clinicians need to talk to clients about hope, openly, realistically,
      and strategically.

PMID- 11197996
TI  - The way it is, was, and will be.

PMID- 11197997
TI  - [Nanobacteria as a cause of renal diseases and vascular calcifying pathology in
      renal patients ("endovascular lithiasis"].

PMID- 11197998
TI  - [Varicella pneumonia in the adult: study of 22 cases].
AB  - BACKGROUND: Retrospective study of the varicella pneumonia in adults with
      clinical, therapeutic and evolutive features in 22 patients in the last 5 years.
      MATERIAL AND METHODS: The diagnosis was established by clinical and radiologic
      criteria in the course of varicella infection. The antecedents of pregnancy,
      smoking habit, previous contact with patients with varicella and underlying
      disease were evaluated. RESULTS: Twenty-two patients (14 males and 8 women: mean
      age 31 years. range: 22-40) were included in the study. None of them were
      immunocompromised, 16 (72.7%) have had previous contact with varicella patients.
      19 (86.3%) were heavy smokers and none of the female patients was pregnant. All
      patients had fever and exanthem, cough had 20 (90.9%) dyspnea 16 (72.7%), chest
      pain 9 (40.9%) and hemoptysis 5 (22.7%). Only two patients showed pO2 < 60 mmHg.
      Chest X-ray revealed an interstitial pattern in 14 cases (63.3%), and
      micronodular in 8 (36.3%). All patients received treatment with intravenous
      acyclovir. Three patients (13.6%) were admitted to the Intensive Care Unit due to
      respiratory insufficiency, needing mechanical ventilation one of them (4.5%).
      Another three developed failure renal reversible associated with acyclovir. All
      patients had a favourable clinical course. CONCLUSIONS: We believe, that early,
      aggressive use of intravenous acyclovir in adult varicella pneumonia may be
      lifesaving, preventing progressive respiratory failure and reducing the high
      mortality rate of the disease. Therapy with corticosteroids should be considered
      in addition to antiviral therapy in patients with severe varicella pneumonia.
      While oral acyclovir chemoprophylaxis is probably beneficial in populations with
      chicken pox.

PMID- 11197999
TI  - [Epidemiologic study of infection by hepatitis C virus in a hemodialysis unit].
AB  - OBJECTIVE: To analyze the prevalence of infection, the frequency of HCV genotypes
      and the epidemiology characteristics among the patients in hemodialysis treatment
      in one 25 years old hospital hemodialysis center and one 15 years old secondary
      unit by a transversal cross-section study in 1998. PATIENTS AND METHODS: 171
      hemodialyzed-patients were studied. Patients sera were analyzed by the presence
      of HCV antibodies anti-VHC by a enzymoimmunoassay (Abbott Cientifica) and the
      presence of antibodies was confirmed by a line immunoassay (Inno-LIA HCV AbIII)
      and by the presence of VHC-RNA by reverse transcriptase PCR (Cobas Amplicor HCV).
      Genotypes were determinate by reverse hybridization (Inno-LIA HCV III). RESULTS:
      Fifty (29.2%) of the patients were HCV antibody positive. Forty-five (26.3%) were
      HCV-RNA positive, all of them with antibodies positive. The distribution of
      genotypes was: 1b, 34 (75.5%); 4f, 4 (8.9%); 1a, 3 (6.7%); 1, 3 (6.7%) and 1 case
      could not be typed (2.2%). In 14 patients (28.0%), seroconversions were
      documented Twenty-one patients (42.0%) were diagnosed when the routine tests were
      available and 15 patients (30.0%) were diagnosed pre-dialysis. The multivariate
      analysis showed that the risk of HCV infection was greater for patients who had
      been more 8 years on dialysis (OR: 6.22; 95% CI: 1.24-31.07). CONCLUSIONS: Data
      presented indicate that the prevalence of HCV infections in our hemodialysis
      units and the number of seroconversions were high and the HCV subtype 1b was more
      frequent; because of this, the screening by both serological and molecular
      methods is necessary, at least twice a year, to identify all the infected
      patients. Besides, we think that is necessary to increase the control of the
      completion of the Universal Precautions.

PMID- 11198000
TI  - [False resistance to imipenem in gram negative bacilli with and automatized
      system].
AB  - BACKGROUND: The aim of this study was to evaluate the reliability of MIC values
      of imipenem against gramnegative rods obtained with the automated system WalkAway
      98 (MicroScan, Dade, USA). MATERIAL AND METHODS: One-hundred and seventy three
      consecutive clinical isolates of Gram-negative rods for which the MIC of imipenem
      were > or = 4 mg/l (Urine-Combo 6I panels, U6I) or > or = 8 mg/l (Neg-Combo 6I
      panels, N6I) were evaluated, including 104 non-fermenting gram-negative rods
      (NFGNR) and 69 enterobacteria. Panels were inoculated and read according to
      manufacturer's instructions. Microdilution, according to NCCLS guidelines, was
      used as the method of reference. MIC of imipenem determined by WalllAway-96 and
      microdilution differing > or = 2 dilution steps from those obtained with
      mirodilution were considered as discrepant results. Discrepancies in clinical
      categories were also evaluated by calculating three types of errors: very major
      (false susceptibility), major (false resistance) and minor (either susceptible or
      resistant by one method and intermediate by the other one). RESULTS: The
      percentages of discrepancies in the MIC of imipenem determined with U6I panels
      were 74% and 84% for NFGNR and enterobacteria, respectively. No very major errors
      were detected. Major errors were observed for 6% and 12% of the strains with U6I
      panels in NFGNR and enterobacteria, respectively, and in 12% (NFGNR) and 50%
      (enterobacteria) with N61 panels. With U61 panels minor errors were observed in
      11% and 25% of NFGNR and enterobacteria, respectively, while with N61 panels
      minor error were observed in 39% and 45% of both groups, respectively.
      CONCLUSIONS: MIC of imipenem > or = 4 mg/l obtained with the WalkAway-96 system
      against gramnegative rods, particularly in the case of enterobacteria, should be
      confirmed with a reference susceptibility method.

PMID- 11198001
TI  - [Presence of conjugative transposon Tn1545 in strains of Streptococcus pneumoniae
      with mef(A), erm(B), tet(M), catpC194 and aph3'-III genes].
AB  - We studied the association of MLS resistance genes (erm(B) and mef(A) with others
      non-MLS resistance genes: tet(M) (tetracycline and minocycline), catpC194
      (chloramphenicol) and aph3'-III (kanamycin) in order to know how is selected the
      multiresistant in Streptococcus pneumoniae. The tet(M) and catpC194 genes were
      present very often in the pneumococci with the erm(B) gene but the aph3'-III was
      found only in four strains. Tn1545 was nearly always the responsible for the
      dissemination of these genes. In contrast, mef(A) was not associated with tet(M)
      and and catpC194 and is disseminated in a different conjugative transposon. The
      linkage of multiple antibiotic resistance genes on the same mobile element is of
      importance for public health, because the use of one antibiotic selects for the
      transposon which carries multidrug resistance genes.

PMID- 11198002
TI  - [Serologic response against hepatitis C virus as a predictive factor to the
      treatment with interferon].
AB  - AIM: Serologic response of patients with chronic hepatitis C (CHC) was studied as
      a predictor of response to IFN therapy and we evaluated the correlation between
      such response with gender, risk factor, serum ferritin, GGT, Knodell's index and
      fibrosis. MATERIALS AND METHODS: A study was carried out in 40 patients with CHC
      who were treated with interferon-alpha 3 MU 3 times weekly 48 weeks. The
      diagnosis of hepatitis C was made based upon Inmuno-Blot (core, NS3, NS4 y NS5)
      and confirmed by detection of HCV-RNA in serum. Responses were evaluated (normal
      ALT and undetectable HCV-RNA in serum) at three months, at the end of treatment
      and six months after treatment. RESULTS: No significant differences were observed
      in responses at three months with regard to gender (47% males responded versus
      55% females, n.s.), source of infection (50% intravenous drug users versus 50%
      non intravenous drug users; n.s.) and GGT level (50% with high levels versus 50%
      with normal levels, n.s.); however 25% of patients with high level of serum iron
      responded versus 59% with normal values (p = 0.04) and 28% of patients with
      fibrosis at liver histopathology responded versus 82% without fibrosis (p =
      0.0006). No differences were observed at the response rates with regard to levels
      of core (20.1 SD:4 versus 19.5 SD:2.2, n.s.), NS3 (18.6 SD:7 versus 17.1 SD:7.3,
      n.s.) and NS4 (14.3 SD:7.7 versus 10.5 SD:9.2, n.s.). However NS5 levels in
      responders were 2.5 (0-16) versus 5.2 (0-16.5) in nonresponders (p < 0.05) and
      score in Knodell's index was 6.1 SD:2.6 in responders versus 9.2 SD:2.4 in
      nonresponders (p = 0.006). 47% of responders relapsed 6 months after the end of
      treatment with IFN. CONCLUSIONS: Titers of anti-NS5 showed predictive value of
      response as opposed to anti-core, anti-NS3 and anti-NS4 and it may justify its
      determination in the assessment of a patient with CHC at centers without capacity
      for measuring genotype and viral load. Low level of serum iron and Knodell's
      index like absence of fibrosis at liver histopathology were also variables with
      predictive value of response, as opposed to gender, GGT level and source of
      infection.

PMID- 11198003
TI  - [Varicella vaccine. An immunization of the child and the adult].

PMID- 11198004
TI  - [Hepatic lesions after cholecystectomy for cholelithiasis].

PMID- 11198005
TI  - [Inflammatory cutaneous nodules in an immunodepressed patient].

PMID- 11198006
TI  - [Cavitary pulmonary cryptococcosis in a patient with AIDS].

PMID- 11198007
TI  - [Pseudomonas aeruginosa in a patient splenectomized for non-Hodgkin's lymphoma].

PMID- 11198008
TI  - [Aggressive acute endocarditis caused by Staphylococcus lugdunensis complicated
      with multiple cerebral septic emboli].

PMID- 11198009
TI  - [Diagnosis of tuberculous arthritis from the isolation of Mycobacterium
      tuberculosis in blood agar and chocolate agar].

PMID- 11198010
TI  - [Corporal distribution of infections caused by herpes simplex virus types 1 and
      2].

PMID- 11198011
TI  - [Parenteral antibiotic treatment and hospital based home care units. The current
      situation].

PMID- 11198012
TI  - [levofloxacin and behavior disorder in a patient admitted to intensive care].

PMID- 11198013
TI  - [Milk auto-inoculation as an exceptional cause of fever of unknown origin].

PMID- 11198014
TI  - Routine DNA analysis based on 12S rRNA gene sequencing as a tool in the
      management of captive primates.
AB  - Automated DNA sequencing of a fragment of the relatively slowly evolving
      mitochondrial 12S rRNA gene was used to distinguish primate species, and the
      method was compared with species determination based upon classical taxonomy. DNA
      from blood from 53 monkeys housed at the Stichting AAP Shelter for Exotic
      Animals, all Old World monkeys, was amplified by polymerase chain reaction (PCR)
      with a primer set spanning approximately 390 nucleotides of the mitochondrial 12S
      rRNA gene. The products were directly sequenced and compared with our database of
      primate 12S sequences. Many individuals were found to harbor a 12S sequence
      identical to one of the reference sequences. For others, phylogenetic methods
      were used for species estimation, which was especially informative in
      Cercopithecus species.

PMID- 11198015
TI  - Nosocomial transmission of Mycobacterium tuberculosis from an extrapulmonary
      site.
AB  - OBJECTIVE: To assess the extent of nosocomial transmission and risk factors
      associated with tuberculin skin test (TST) conversions among healthcare workers
      (HCWs) exposed to a patient with genitourinary Mycobacterium tuberculosis.
      DESIGN: Retrospective cohort study of exposed HCWs. SETTING: A 275-bed community
      hospital in Middle Tennessee. PARTICIPANTS: A total of 128 exposed HCWs and the
      index patient, who required drainage of a prostatic abscess and bilateral
      orchiectomy and expired after a 27-day hospitalization. Disseminated tuberculosis
      was diagnosed at autopsy. METHODS: Contact tracing was performed on exposed HCWs.
      Logistic regression was used to identify independent risk factors associated with
      TST conversion. RESULTS: A total of 128 HCWs were exposed to the index patient.
      There was no evidence of active pulmonary tuberculosis throughout the patient's
      hospitalization; TST conversions occurred only among HCWs who were exposed to the
      patient during or after his surgical procedures. A total of 12 (13%) of 95
      exposed HCWs who were previously nonreactive had newly positive TST: 6 of 28
      nurses, 3 of 3 autopsy personnel, 2 of 17 respiratory therapists, and 1 of 12
      surgical staff. By logistic regression, irrigation or packing of the surgical
      site was the only independent risk factor associated with TST conversion among
      nurses (odds ratio, 9; 95% confidence interval, 1.2-67; P=.03). CONCLUSION:
      Manipulation of infected tissues of the genitourinary tract can result in
      nosocomial transmission of tuberculosis.

PMID- 11198016
TI  - An outbreak of scabies in a teaching hospital: lessons learned.
AB  - OBJECTIVE: To investigate an outbreak of scabies in an inner-city teaching
      hospital, identify pathways of transmission, institute effective control measures
      to end the outbreak, and prevent future occurrences. DESIGN: Outbreak
      investigation, case-control study, and chart review. SETTING: Large tertiary
      acute-care hospital. RESULTS: A patient with unrecognized Norwegian (crusted)
      scabies was admitted to the acquired immunodeficiency syndrome (AIDS) service of
      a 940-bed acute-care hospital. Over 4 months, 773 healthcare workers (HCWs) and
      204 patients were exposed to scabies. Of the exposed HCWs, 147 (19%) worked on
      the AIDS service. Risk factors for being infested with scabies among HCWs
      included working on the AIDS service (odds ratio [OR], 5.3; 95% confidence
      interval [CI95], 2.17-13.15) and being a nurse, physical therapist, or HCW with
      extensive physical contact with infected patients (OR, 4.5; CI95, 1.26-17.45).
      Aggressive infection control precautions beyond Centers for Disease Control and
      Prevention barrier and isolation recommendations were instituted, including the
      following: (1) early identification of infected patients; (2) prophylactic
      treatment with topical applications for all exposed HCWs; (3) use of two
      treatments 1 week apart for all cases of Norwegian scabies; (4) maintaining
      isolation for 8 days and barrier precautions for 24 hours after completing second
      treatment for a diagnosis of Norwegian scabies; and (5) oral ivermectin for
      treatment of patients who failed conventional therapy. CONCLUSIONS: HCWs with the
      most patient contact are at highest risk of acquiring scabies. Because HCWs who
      used traditionally accepted barriers while caring for patients with Norwegian
      scabies continued to develop scabies, we found additional measures were required
      in the acute-care hospital. HCWs with skin exposure to patients with scabies
      should receive prophylactic treatment. We recommend (1) using heightened barrier
      precautions for care of patients with scabies and (2) extending the isolation
      period for 8 days or 24 hours after the second treatment with a scabicide for
      those patients with Norwegian scabies. Oral ivermectin was well tolerated for
      treating patients and HCWs who failed conventional treatment. Finally, we
      developed a surveillance system that provides a "barometric measure" of the
      infection rate in the community. If scabies increases in the community, a tiered
      triage system is activated to protect against transmission among HCWs or hospital
      patients.

PMID- 11198017
TI  - An evaluation of hospital special-ventilation-room pressures.
AB  - OBJECTIVE: To quantitate the magnitude and consistency of positive (airflow out)
      and negative (airflow in) hospital special-ventilation-room (SVR) airflow.
      DESIGN: A room-pressure evaluation was conducted during two seasons on a total of
      18 rooms: standard rooms, airborne infection isolation rooms, and protective
      environment rooms. The pressures were measured using a digital pressure gauge
      piezoresistive pressure sensor that measured pressure differentials. With doors
      closed, the rooms were measured a minimum of 30 times each for a cooling season
      and a heating season. RESULTS: The standard rooms showed the least amount of
      variability in pressure differential, with an average of -0.2 Pa (median, -0.2
      Pa), and an interquartile range (IQR) of 0.4 Pa. Airborne infection isolation
      rooms showed more variability in pressure, with an average of -0.3 Pa (median, 
      0.2 Pa) and an IQR of 0.5 Pa. Protective environment rooms had the greatest
      fluctuation in pressure, with an average of 8.3 Pa (median, 7.7 Pa) and an IQR of
      8.8 Pa. Dramatic pressure changes were observed during this evaluation, which may
      have been influenced by room architectural differences (sealed vs unsealed);
      heating, ventilation, and air-conditioning zone interactions; and stack effect.
      CONCLUSION: The pressure variations noted in this study, which potentially affect
      containment or exclusion of contaminants, support the need for standardization of
      pressure requirements for SVRs. To maintain consistent pressure levels, creating
      an airtight seal and continuous pressure monitoring may be necessary.

PMID- 11198018
TI  - Epidemiology of surgical-site infections diagnosed after hospital discharge: a
      prospective cohort study.
AB  - OBJECTIVE: To study postoperative infections in hospital and after discharge, and
      to identify the risk factors for such infections. DESIGN: Prospective cohort
      study, with telephone follow-up for 1 month after hospital discharge. SETTING:
      The general surgery service of a tertiary hospital in Spain. MAIN OUTCOME
      MEASURE: In-hospital and postdischarge surgical-site infection (SSI), always
      confirmed by a physician. RESULTS: Of the 1,506 patients initially enrolled, 29
      died during hospital stay, and 33 were lost to postdischarge follow-up. An SSI
      was identified prior to discharge in 123 patients and after discharge in 103. For
      several variables (age, serum albumin, glycemia, lengths of preoperative and
      postoperative hospital stay, etc), there were no differences between patients
      with postdischarge SSI and noninfected patients; however, there were differences
      detected between patients with postdischarge SSI and in-hospital SSI, as well as
      between patients with in-hospital SSI and noninfected patients. The analysis of
      risk factors showed that most predictors for in-hospital SSI did not behave in
      the same manner for postdischarge SSI. Stepwise logistic regression only
      identified chemoprophylaxis, age (advanced age was a preventive factor), and body
      mass index as independent risk factors for postdischarge SSI. Differences in risk
      factors between in-hospital and post-discharge SSIs remained even after
      controlling for time from operation to diagnosis. CONCLUSIONS: Most predictors of
      in-hospital SSI were not predictors of postdischarge SSI.

PMID- 11198019
TI  - Converting incidence and prevalence data of nosocomial infections: results from
      eight hospitals.
AB  - OBJECTIVE: To investigate the use of the formula of Rhame and Sudderth for the
      interconversion of prevalence and incidence data on the frequency of nosocomial
      infections. DESIGN: Comparison of observed and calculated incidence data and
      prevalence data. SETTING: One 8-week incidence investigation in the surgical and
      intensive care units of eight medium-sized hospitals; three separate point
      prevalence studies in the same units. RESULTS: The overall prevalence observed
      after the three prevalence studies in 2,169 patients was 6.8% (95% confidence
      interval [CI95], 5.7-8.0). In 2,882 discharged patients observed during the
      incidence study, the mean hospitalization was 9.8 days; patients with one or more
      nosocomial infection had a mean hospitalization time of 22.3 days and a mean
      interval of 8.2 days from admission to the first day of infection. Based on these
      data, the overall calculated incidence was 4.7%, whereas the observed incidence
      was 4.3% (CI95, 3.6-5.2). Vice versa, an overall prevalence of 6.2% was found
      when calculated from the observed incidence data. The incidence data calculated
      from prevalence data also were within the confidence interval of the incidences
      observed for urinary tract infections and surgical-site infections. (However, it
      was not possible to convert the data for two of the eight hospitals.) CONCLUSION:
      The approximate mathematical relationship between the prevalence and incidence
      data of nosocomial infection is confirmed by this study. However, although it is
      theoretically possible, we would not recommend the conversion of prevalence into
      incidence data or vice versa.

PMID- 11198020
TI  - An outbreak of imipenem-resistant Acinetobacter baumannii in critically ill
      surgical patients.
AB  - OBJECTIVE: To describe an outbreak of imipenem-resistant Acinetobacter baumannii
      (IR-Ab) and the measures for its control, and to investigate risk factors for IR
      Ab acquisition. DESIGN: An observational and a case-control study. SETTING: A
      surgical intensive care unit (ICU) in a university tertiary care hospital.
      METHODS: After admission to the ICU of an IR-Ab-positive patient, patients were
      prospectively screened for IR-Ab carriage upon admission and then once a week.
      Environmental cleaning and barrier safety measures were used for IR-Ab carriers.
      A case-control study was performed to identify factors associated with IR-Ab
      acquisition. Cases were patients who acquired IR-Ab. Controls were patients who
      were hospitalized in the ICU at the same time as cases and were exposed to IR-Ab
      for a similar duration as cases. The following variables were investigated as
      potential risk factors: baseline characteristics, scores for severity of illness
      and therapeutic intervention, presence and duration of invasive procedures, and
      antimicrobial administration. RESULTS: Beginning in May 1996, the outbreak
      involved 17 patients over 9 months, of whom 12 acquired IR-Ab (cases), 4 had IR
      Ab isolates on admission to the ICU, and 1 could not be classified. Genotypic
      analysis identified two different IR-Ab isolates, responsible for three clusters.
      Ten of the 12 nosocomial cases developed infection. Control measures included
      reinforcement of barrier safety measures, limitation of the number of admissions,
      and thorough environmental cleaning. No new case was identified after January
      1997. Eleven of the 12 cases could be compared to 19 controls. After adjustment
      for severity of illness, a high individual therapeutic intervention score
      appeared to be a risk factor for IR-Ab acquisition. CONCLUSION: The outbreak
      ended after strict application of control measures. Our results suggest that high
      work load contributes to IR-Ab acquisition.

PMID- 11198021
TI  - Increase in hand-alcohol consumption among medical staff in a general hospital as
      a result of introducing a training program and a visualization test.
AB  - To assess the impact of training programs, including a visualization test for
      hand disinfection, we monitored the hand-alcohol consumption of medical staff.
      The consumption increased steadily from 5.7 L of hand alcohol per capita per year
      in 1990 to 9.1 L in 1998. There was no significant increase in skin problems.

PMID- 11198022
TI  - Clostridium difficile-associated diarrhea in a VA medical center: clustering of
      cases, association with antibiotic usage, and impact on HIV-infected patients.
AB  - A case-control study of patients with stools assayed for Clostridium difficile
      toxin over a 24-month period at a Veterans Affairs hospital found that the
      majority of cases (70.6%) occurred in temporal clusters. Clustering was
      particularly evident on a designated human immunodeficiency virus (HIV) unit.
      Thirty-four (75.5%) of 45 HIV-infected patients with C difficile-associated
      diarrhea (CDAD) died during their hospitalization. Third-generation
      cephalosporins were the antibiotics most strongly associated with CDAD.

PMID- 11198023
TI  - Invasive aspergillosis outbreak on a hematology-oncology ward.
AB  - An outbreak of invasive aspergillosis occurred in a community hospital in
      temporal association with construction activity. Epidemiological investigation
      showed that patients who are at highest risk comprise a small group and are
      readily identifiable. Clinicians should strive to protect these patients,
      following guidelines published by the Centers for Disease Control and Prevention.

PMID- 11198024
TI  - A nosocomial outbreak of multiresistant Acinetobacter baumannii originating from
      an intensive care unit.
AB  - An outbreak of a multiresistant Acinetobacter baumannii in February through
      September 1996 affected 103 patients in a regional hospital in Singapore. We
      describe the effectiveness of closure of the outbreak area and the importance of
      good teamwork in the management of the outbreak.

PMID- 11198025
TI  - Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care
      unit (ICU) and relation to Pseudomonas infections of ICU patients.
AB  - Water faucets on a surgical intensive care ward were examined prospectively as a
      source of Pseudomonas aeruginosa infections. All water outlets harbored distinct
      genotypes of P aeruginosa over prolonged time periods. Over a period of 7 months,
      5 (29%) of 17 patients were infected with P aeruginosa genotypes also detectable
      in tap water.

PMID- 11198026
TI  - Management of occupational exposures to hepatitis C virus: current practice and
      controversies.
AB  - Unlike hepatitis B virus and human immunodeficiency virus, there currently are no
      immunization or chemoprophylactic interventions available to prevent infection
      after an occupational exposure to hepatitis C virus (HCV). A "Reality Check"
      session was held at the 4th Decennial International Conference on Nosocomial and
      Healthcare-Associated Infections to gather information on current practices
      related to management of occupational exposures to HCV, generate discussion on
      controversial issues, and identify areas for future research. Infection control
      professionals in attendance were knowledgeable in most issues addressed regarding
      the management of occupational exposures to HCV. Areas of controversy included
      the use of antiviral therapy early in the course of HCV infection and the
      appropriate administrative management of an HCV-infected healthcare worker.

PMID- 11198027
TI  - The rocky road: qualitative research as evidence.

PMID- 11198028
TI  - Cervical screening: quality assurance developments in Europe.

PMID- 11198029
TI  - Organ sparing management for carcinoma of the vulva & vagina.

PMID- 11198030
TI  - Minimizing morbidity from radical abdominal hysterectomy.

PMID- 11198031
TI  - Controversies in surgical management of advanced ovarian cancer (stage III-IV).

PMID- 11198032
TI  - Endometrial carcinoma. Is routine intensive periodic follow-up of value?

PMID- 11198034
TI  - Solitary metastasis to the uterine cervix from the early gastric cancer: a case
      report.
AB  - Metastasis of gastric cancer to the uterine cervix is rare, and a case of
      metastasis to the uterine cervix from early gastric cancer has never before been
      reported. We here present a patient who underwent a gastrectomy due to
      asymptomatic early gastric cancer found by chance and who subsequently suffered
      from a solitary metastasis to the uterine cervix from the primary early gastric
      cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is
      regarded as the route of metastasis from the stomach to the uterine cervix. We
      surmise that the present metastasis occurred through the lymphatic channel
      because lymph vessel permeations were found in both the primary lesion of the
      stomach and the metastatic lesion of the uterine cervix.

PMID- 11198033
TI  - Radical abdominal versus laparoscopic hysterectomy for stage IB cervical cancer:
      what's the point?
AB  - OBJECTIVE: To evaluate surgical morbidity and length of stay for type III radical
      abdominal hysterectomy performed in the private practice setting, and to compare
      these results with currently available data on laparoscopic radical hysterectomy.
      METHODS AND MATERIALS: One hundred seventy-five consecutive type III radical
      abdominal hysterectomies performed by the author in a uniform fashion over a ten
      year period for patients with stage IB cervical cancer were evaluated. All
      surgeries were performed in private community hospitals in New Jersey. RESULTS:
      Type III radical abdominal hysterectomy performed in the private setting using
      the author's protocol resulted in lower surgical morbidity, equivalent hospital
      stay and resumption of normal activities, and much shorter operating times than
      laparoscopic radical hysterectomy. CONCLUSION: Laparoscopic radical hysterectomy
      provides no surgical or financial advantage over radical abdominal hysterectomy
      when the latter is performed in the private practice setting; results from
      laparoscopic surgery are inferior with respect to morbidity.

PMID- 11198035
TI  - Intraoperative gold grain implants for pelvic wall recurrences of various
      malignancies: toxicity, results, and failure analysis in 37 patients.
AB  - PURPOSE: We conducted this study to determine the complications and long-term
      results of intraoperative gold-grain implants as therapy for pelvic wall
      recurrences of various malignancies. MATERIALS AND METHODS: We retrospectively
      analyzed complications and long-term results of intraoperative radioactive 198Au
      gold grain implants of 4-mc radon equivalent in 37 patients with pelvic wall
      recurrences of various malignancies treated at the University of Texas M. D.
      Anderson Cancer Center. The estimated dose was 30-100 Gy, which was increased to
      100-120 Gy plus external-beam irradiation if the dose to the tumor volume was too
      low. All patients had follow-up of 4 months to 12 years. Of the 37 patients, 34
      had lower leg edema, 22 had lower limb pain, and 22 had ureteral obstruction.
      RESULTS: Six of 34 patients with lower limb pain had partial relief and nine had
      complete relief. Of 22 patients with ureteral obstruction, ten had complete
      resolution and four had partial relief. Lower limb edema was improved in 16 of 22
      patients. Of the 37 patients studied, 14 are alive and 23 have died. CONCLUSION:
      In selected patients, gold grain implantation to a dose of 70-100 Gy relieved
      some symptoms of unresectable pelvic wall recurrences of various malignancies. We
      believe that intraoperative gold grain implants appear to be the only useful
      treatment for patients with recurrent malignancies fixed to the pelvic wall and
      provide these patients with better and longer palliation and a good quality of
      life.

PMID- 11198036
TI  - Nuclear grading of endometrial cancer harbors heterogenous prognostic groups as
      detected by proliferation activity.
AB  - OBJECTIVE: Nuclear grading, in addition to the histopathological result of every
      tumor, is responsible for consecutive treatment designs. Ki-S5 is the monoclonal
      antibody against a formalin-resistant epitope of the Ki-67 antigen and can be
      determined in paraffin-embedded samples. The aim of the study was a comparative
      analysis of the nuclear grading of endometrial cancer and the proliferation
      marker Ki-S5. METHODS: In 126 specimens of endometrial cancer the proliferation
      activity of the monoclonal antibody Ki-S5 was determined (streptavidin-biotin
      complex method) in correlation to nuclear grading. In the group of grade 2,
      stages Ib and Ic andenocarcinomas, proliferation rates were compared to
      recurrence rates. RESULTS: Divergent proliferation rates resulted.
      Adenoacanthomas showed a relatively low proliferation rate (<28%). For the
      andenosquamous carcinomas the proliferation rate ranged between 28-43%. The
      largest group of adenocarcinomas showed proliferation rates from 5-74%. A clear
      dependency between increasing proliferation rates and decreasing differentiation
      (nuclear grading 2-3) was observed. In the small group of patients with
      andenocarcinomas, nuclear grading G2 stages Ib and Ic, 38 suffered no recurrence
      after 6-10 years. However, the six patients with proliferation rates of over 35%
      all suffered a recurrence. CONCLUSIONS: The results emphasize the need to
      differentiate G2 tumors, depending on their proliferation rate, into low risk
      (KiS5<35%) and high risk cases (Ki-S5>35%).

PMID- 11198037
TI  - Prognostic value of protein p53 and ki-67 in invasive vulvar squamous cell
      carcinoma.
AB  - The aim of this research was to detect new valid prognostic indicators that allow
      us to choose the best therapy and follow-up for patients with a poor prognosis.
      One hundred and twenty-nine patients with invasive squamous carcinoma of the
      vulva treated at the Gynecology Clinic of the University of Padua between January
      1, 1975 and December 31, 1999 have been evaluated: Protein p53 and ki-67 were
      studied by immunohistochemical investigations and their prognostic significance
      was evaluated. The relation with the classic clinico-pathological prognostic
      factors was also studied. The results showed a close association between tissue
      overexpression of the two proteins and clinico-pathological characteristics of
      the aggressivity of the neoplasm. Moreover, the group of positive p53 patients
      with a diffuse distribution pattern of ki-67 resulted in having a somewhat
      shorter survival with respect to the groups with negative p53 and/or a focal
      pattern. Such negative prognostic significance was confirmed by the results of
      the multivariate analysis performed with the Cox model which shows that patients
      with p53 positive values and a diffuse pattern have a higher relative risk of
      death compared to patients with p53 negative values and focal pattern (p=0.0001).
      The statistical significance of the prognostic value of the association of p53
      and ki-67 thus seems to give these two factors greater weight with respect to the
      others we investigated.

PMID- 11198038
TI  - Diagnostic reliability of prebioptic methods in the prediction of a histological
      basis of cervical lesions and its correlation with accuracy of colposcopically
      directed biopsy in patients with cervical neoplasia.
AB  - OBJECTIVE: High incidence of cervical cancer in the Czech Republic leads us to
      look for an optimal model of screening. The evaluation of the realiability of
      prebiopsy (cytology and colposcopy) and of punch biopsy is an important
      diagnostic step. MATERIAL AND METHODS: In a prospective study we examined 308
      women detected by cytological screening who afterwards underwent surgery for a
      cervical lesion. Punch biopsy before the operation, most frequently by
      conization, was performed in every patient after assessing the prebioptic
      prediction (colposcopy and cytology). RESULTS: Reliable cytological screening
      associated with good colposcopy permits a correct diagnosis with high
      reliability. The rate of errors which increase the risk (threatening of health or
      the life of women) was 2.9% by prebioptic methods (high reliability) and 4.4% by
      punch biopsy. CONCLUSION: These good results are achieved in centers led by
      trained physicians and experts in cytology and skilled in colposcopy.

PMID- 11198039
TI  - Management of lymphocysts after cervical carcinoma surgery.
AB  - In the Gynecological Clinic of the Oncological National Center of Georgia from
      1964 to 1999 1,805 extended hysterectomies due to carcinoma of the cervix uteri
      were performed. Retroperitoneal lymphocysts were revealed in 4.3% of the cases.
      Of all stage I disease lymphocysts had developed in 2.8% of cases and in stage II
      7.2%. Correlations between lymph node metastatic damage and development of
      lymphocysts were not found. The peak incidence (6.2-6.4%) of lymphocysts appeared
      to be in women younger than 30 and in elderly women (over 60 years). Unilateral
      lymphocysts developed more frequently (left-side in 38.9% in right-side in 33.3%)
      than bilateral ones (28.3%). In 32.5% of cases the size was less than 5 cm, in
      42.3% of cases 6-10 cm and in 25.6% of cases more than 10 cm; 18% of the
      lymphocysts were asymtomatic and did not need any treatment. High temperature,
      pain, changes in blood occurring 4-5 days after surgery are indications of
      parametritis. Lymphocysts usually arise 11-12 days after surgery. Ultrasonography
      is a highly informative diagnosic method to detect this disease. In 23% of cases,
      the method of treatment was conservative therapy, 35.8% of patients had
      punctures, thus micro-drainage was performed and a cocktail injection into the
      cyst cavity was carried out. In 7.7% of cases lymphocyst resection and drainage
      was carried out.

PMID- 11198040
TI  - Clinical significance of numerical aberrations on chromosome 17 in uterine
      cervical and endometrial neoplasias.
AB  - In order to determine the clinical significance of numerical aberrations on
      chromosome 17 in uterine cervical and endometrial neoplasias, we investigated 140
      cell specimens obtained from the uterine cervix and endometrium using the
      fluorescence in situ hybridization (FISH) method. These specimens consisted of
      ten normal cervical epithelium (NCE), 16 cervical intraepithelial neoplasias (CIN
      1), 15 CIN 2, 35 CIN 3, 11 early invasive squamous cell carcinoma of the uterine
      cervix (early invasive SCC), 11 invasive SCC, 13 normal endometrium (NE), 17
      endometrial hyperplasias (EH), and 12 endometrial ademocarcinomas (EA). After
      Papanicolaou staining on these specimens was decolorized, FISH was performed
      using chromosome 17 specific repetitive DNA probes. Signals of centromere of
      chromosome 17 in marked atypical cells were counted using a fluorescence
      microscope. There was a significant difference in the rate of cells with one
      signal on chromosome 17 between CIN 1 (7.1+/-0.7%) or 2 (7.0+/-0.5%) and CIN 3
      (12.6+/-0.9%) (p<0.01), and also between CIN 3 and early invasive SCC (19.6+/
      1.0%) (p<0.01). The rate of cells with three signals was significantly increased
      when the uterine cervical lesions were progressive to CIN 3 (p<0.01). Cells with
      five or more signals occurred only in early invasive SCC and invasive SCC. There
      was a significant difference in the rate of cells with three signals between EH
      (4.8+/-0.6%) and EA (11.4+/-2.1%) (p<0.05). Cells with five or more signals
      occurred only in EA. Examination of the numerical aberrations on chromosome 17 in
      uterine cervical and endometrial neoplasias has been suggested to be useful as an
      additional method for the differential diagnosis of these lesions.

PMID- 11198041
TI  - Expression of bcl-2 and bax in cervical intraepithelial neoplasia and invasive
      squamous cell carcinoma of the uterine cervix.
AB  - Bcl-2 protein together with the pro-apoptotic protein bax, are thought to
      function by forming homo- and heterotypic dimers which control the progression to
      apoptosis. In this immunohistochemical study we investigated the expression of
      bcl-2 and bax apoptosis related proteins in cervical intraepithelial neoplasia
      and invasive squamous cell carcinoma of the uterine cervix. Twenty-four cervical
      intraepithelial neoplasias grade 1-2 (CIN I/II), 38 grade 3 (CIN III), and 53
      invasive squamous cell carcinomas (ISCC) were investigated by immunohistochemical
      staining for bcl-2 and bax protein. Bcl-2 immunoreactivity was found in five of
      the 24 CIN I/II cases (20.8%), 18 of 38 CIN II cases (47.4%) and nine of 53 ISCC
      cases (17%). The positivity for CIN III was significantly higher than for CIN
      I/II or ISCC (p=0.0351 and p=0.0018, respectively). The percentage of bax
      immunopositivity was somewhat higher in CIN III than in CIN I/II but this slight
      difference was not statistically significant. Correlation of the immunostaining
      results with tumor grade revealed a significant difference for bcl-2 which was
      more frequently immunopositive in well-differentiated tumors than in poorly
      differentiated tumors. There was no significant relation between bax expression
      and tumor differentiation. Our results suggest that alterations of bcl-2 and bax
      expression may occur as a relatively early event in cervical tumorigenesis.

PMID- 11198042
TI  - Cervical sarcoma botryoides treated with conservative surgery and adjuvant
      chemotherapy: a case report.
AB  - A case of cervical sarcoma botryoides treated with conservative surgery and
      adjuvant monochemotherapy is presented.

PMID- 11198043
TI  - Complications following combined surgery (radical vulvectomy versus wide local
      excision) and radiotherapy for the treatment of carcinoma of the vulva: report of
      73 patients.
AB  - Cancer of the vulva is uncommon, accounting for only 5% of all gynecologic
      malignancies, and usually occurs in women over 60 years of age. The historic
      treatment of choice for invasive squamous cell carcinoma of the vulva is radical
      vulvectomy with bilateral inguinal lymphadenectomy, which has produced excellent
      long-term survival. We retrospectively analyzed the complications of wide local
      excision plus postoperative radiotherapy compared with those of radical
      vulvectomy and bilateral lymphadenectomy plus pre-or postoperative radiotherapy
      in 73 patients with vulvar cancer. There were no significant differences among
      these treatments in terms of primary tumor control, 5-year disease-free survival,
      and overall survival. Based on these results, the best treatment alternative for
      advanced vulvar cancer is wide local excision plus radiotherapy, as this method
      retains the high survival of traditional therapy but has less morbidity.

PMID- 11198044
TI  - Sarcoma botryoides of the uterine cervix in a young woman: a case report.
AB  - Among the rhabdomyosarcomas, which represent an uncommon neoplasm of mesoderm
      origin comprising about 1% of all female genital malignancies, sarcoma botryoides
      (SB) is an embrional variant usually found in the vagina of infants and young
      children under 16 years of age. The onset of SB from the uterine cervix is very
      rare with a peak incidence in the second decade; only a few cases have been
      published in the international literature so far. The authors report a case of
      embryonal rhabdomyosarcoma of the uterine cervix which occurred in a young woman
      treated by radical surgery, followed by adjuvant chemotherapy and radiotherapy.

PMID- 11198045
TI  - Retroperitoneal epithelioid angiosarcoma presenting with lymph node metastases.
      Clinicopathological study of an extremely rare tumor.
AB  - A case of retroperitoneal angiosarcoma in a woman 39 years of age is reported.
      The tumor presented with inguinal (right) and iliac (left) lymph node metastases
      and a mass protruding under the left vaginal wall. The unusual morphology of the
      tumor demanded special immunohistochemical investigation (factor 8, CD 31, CD 34,
      pancytokeratin 20, LCA, S100, cytokeratin 7, CEA, MU1, HMB 45 and melan A) which
      confirmed the diagnosis of epithelioid angiosarcoma. The problems in the
      differential diagnosis and therapeutic approach are discussed.

PMID- 11198046
TI  - Immunohistochemical analysis of nm23-H1 expression in human cervical lesions.
AB  - Reduced expression of the metastasis suppressor gene nm23-H1 has been previously
      correlated with high tumor metastatic potential and fatal clinical outcome in
      several types of human carcinomas. The aim of the study was to identify the
      expression of nm23-H1 in a variety of premalignant and malignant cervical
      lesions. The study comprised 106 cervical biopsies obtained from 106 women
      ranging in age from 23 to 68 (median 42) years. Histologic slides stained with
      H&E were evaluated blindly by two pathologists and a consensus diagnosis was
      established for each case. In addition, immunohistochemical stain was employed
      and a monoclonal antibody against nm23-H1 (YLEM Rome, Italy) was used. Twenty
      five of the cervical biopsies showed changes of mild dysplasia (CIN I), whereas
      28 demonstrated features of moderate dysplasia (CIN II) and 28 severe dysplasia
      (CIN III). In 25 cases infiltrating squamous cell carcinoma was identified.
      Expression of nm23-H1 was evident in 9/25 (36%) CIN I, 13/28 (46%) CIN II, 22/28
      (78.5%) CIN III and 17/25 (68%) infiltrating carcinoma biopsies. Statistically
      significant differences were observed between CIN II and CIN III (p=0.003), and
      CIN II and infiltrating carcinoma (p=0.002) groups. Expression of the nm23-H1
      gene in premalignant and malignant cervical lesions indicates that this gene may
      play a substantial role in carcinogenesis and tumor progression.

PMID- 11198047
TI  - Conseusus statements on prognostic factors in epithelial ovarian carcinoma.
      Report of the Consensus Meeting organized by the European Society of
      Gynaecological Oncology, ESGO.

PMID- 11198048
TI  - Evidence that long-lasting potentiation in limbic circuits mediating defensive
      behaviour in the right hemisphere underlies pharmacological stressor (FG-7142)
      induced lasting increases in anxiety-like behaviour: role of benzodiazepine
      receptors.
AB  - The hypothesis that benzodiazepine receptors mediate initiation of lasting
      behavioural changes induced by FG-7142 was supported in this study. Behavioural
      changes normally induced by FG-7142 were blocked by prior administration of the
      competitive benzodiazepine receptor blocker, Flumazenil. When cats were
      subsequently given FG-7142 alone, the drug produced lasting behavioural changes
      in species characteristic defensive responses to rodent and cat vocal threat. FG
      7142 also induced long-lasting potentiation (LLP) of evoked potentials in a
      number of efferent pathways from the amygdala in both hemispheres. Flumazenil
      given prior to FG-7142 blocked LLP in all but one of the amygdala efferent
      pathways, suggesting benzodiazepine receptor dependence of initiation of LLP.
      Three physiological changes were most closely correlated with behavioural
      changes. LLP in the right amygdalo-ventromedial hypothalamic (VMH) and amygdalo
      periacqueductal gray (PAG) pathways coincided closely with behavioural changes,
      as did a reduced threshold for the right amygdalo-VMH evoked potential.
      Administration of Flumazenil after FG-7142 returned defensive behaviour to pre FG
      7142 baseline levels in a drug-dependent manner. At the same time LLP only in the
      right amygdalo-PAG pathway was reduced by Flumazenil. LLP in other pathways and
      amygdalo-VMH threshold were unaltered by Flumazenil. Moreover, covariance
      analyses indicated that increased defensiveness depended solely on LLP in the
      right amygdalo-PAG. These findings support the view that maintenance of lasting
      increases in defensive behaviour depend upon LLP of excitatory neural
      transmission between amygdala and lateral column of the PAG in the right
      hemisphere. Moreover, FG-7142 may be a useful model of the effects of traumatic
      stressors on limbic system function in anxiety, especially in view of the recent
      data in humans implicating right hemispheric function in persisting negative
      affective states in post-traumatic stress disorder.

PMID- 11198049
TI  - Evidence that long-lasting potentiation of amygdala efferents in the right
      hemisphere underlies pharmacological stressor (FG-7142) induced lasting increases
      in anxiety-like behaviour: role of GABA tone in initiation of brain and
      behavioural changes.
AB  - The hypothesis that long-lasting potentiation (LLP) in amygdala efferents to the
      periacqueductal gray (PAG) of the right hemisphere mediates initiation of lasting
      increases in defensive response to rats induced by FG-7142 was supported in this
      study. GABA transmission was potentiated with Vigabatrin (gamma vinyl GABA, GVG),
      a suicide inhibitor of GABA transaminase. It was predicted that increasing GABA
      transmission would interfere with LLP and behavioural changes. The hypothesis was
      confirmed, for the most part. GVG given 1 day prior to FG-7142 prevented
      increased defensive response to rats as well as LLP in right amygdala efferent
      transmission to the PAG. It did not prevent LLP in the left amygdalo-PAG pathway,
      although LLP duration was shortened. Nor did it prevent LLP in the right amygdalo
      ventromedial hypothalamic (VMH) pathway, and LLP in this pathway was associated
      with a slightly increased response to vocal threat, but not to rats. GVG given
      without FG-7142 had no behavioural effects, although it did potentiate
      transmission in the left amygdalo-PAG pathway. The effects of increasing GABA
      transmission are consistent with the hypothesis that FG-7142 changes behaviour by
      inducing a failure of GABA transmission, which in turn facilitates NMDA
      transmission and NMDA dependent limbic LLP. Finally, the hypothesis that altering
      GABA tone would change the efficacy of Flumazenil from a neutral antagonist to an
      inverse agonist was tested on limbic transmission. The hypothesis was confirmed
      in the left amygdalo-VMH pathway, but no other. It was concluded that mechanisms
      other than a change in GABA tone account for the drug-dependent reversal of LLP
      in the right amygdalo-PAG by Flumazenil. The findings of the present study
      suggest that response to FG-7142 may be a useful model of the effects of
      traumatic stressors on limbic system function in anxiety.

PMID- 11198050
TI  - Manipulation of operant responding for an ethanol-paired conditioned stimulus in
      the rat by pharmacological alteration of the serotonergic system.
AB  - It is becoming increasingly clear that environmental stimuli play a critical role
      in the maintenance of drug taking behaviour. This has led to investigations into
      the neural mechanisms by which environmental stimuli can come to control
      behaviour using paradigms such as conditioned reinforcement. The majority of this
      work has involved the use of food-paired conditioned stimulus rodent paradigms.
      Relatively few studies have attempted to investigate the neuropharmacology of
      behaviour maintained by presentation of a stimulus paired with ethanol drinking.
      Several lines of research support an important role for brain serotonin (5-HT)
      neurotransmitter systems in the control of alcohol drinking behaviour. The aim of
      the present study was, initially, to establish a procedure in which rats respond
      for an ethanol-paired conditioned stimulus, and second, to study the effects of a
      range of serotonergic compounds previously shown to be effective in reducing oral
      ethanol self-administration, on responding for this conditioned stimulus. Results
      showed that the 5-HT releaser d-fenfluramine, the selective serotonin reuptake
      inhibitor fluoxetine, the 5-HT1A receptor agonist 8-hydroxy-2[di-n
      propylamino]tetralin, the partial 5-HT1A receptor agonist buspirone, and the 5
      HT1B/5-HT2C receptor agonist 1-(3-trifluoromethylphenyl)piperazine, but not the 5
      HT2A/5-HT2C receptor agonist 1-(2,5-dimethoxy-4-iodophenylaminopropane)-2,
      selectively reduced responding on a lever leading to presentation of an ethanol
      paired conditioned stimulus. In addition the non-specific D1/D2 dopamine receptor
      antagonist haloperidol was active in this paradigm. Results are consistent with
      involvement of the dopaminergic and 5-HT systems, in particular activation of 5
      HT1A and 5-HT1B receptor subtypes, in mediation of the conditioned or secondary
      reinforcing properties of ethanol.

PMID- 11198051
TI  - Different effect of desipramine on locomotor activity in quinpirole-treated rats
      after repeated restraint and chronic mild stress.
AB  - We have studied the effect of chronic treatment with the tricyclic antidepressant
      drug desipramine on locomotor activity in rats challenged with the administration
      of the D2-like dopamine agonist quinpirole, after prolonged exposure to two
      different stress regimens, repeated restraint stress and chronic mild stress
      (different stressors randomly presented). These stress schedules have been
      previously reported to influence in opposite ways the sensitivity to the
      locomotor response mediated by the stimulation of mesolimbic dopamine receptors.
      In particular, repeated restraint has been reported to induce an increased
      response to the locomotor effect of amphetamine, while chronic mild stress has
      been reported to induce a decreased locomotor response to quinpirole. In the
      present study, repeated restraint stress failed to influence the locomotor
      activity after challenge with quinpirole, while chronic mild stress reduced this
      response. Chronic treatment with desipramine failed to influence this response in
      the control group, but exerted opposite effects in the two stressed groups. In
      particular, chronic desipramine reduced locomotor activity in quinpirole-treated
      rats in the restraint stress group, and increased it in the chronic mild stress
      group, thus preventing the subsensitivity induced by this stress regimen. The
      present results, taken together with results from earlier studies, are consistent
      with the hypothesis that the effect of antidepressants on the sensitivity of the
      mesolimbic dopamine receptors mediating the locomotor behavioural response tends
      to be opposite with respect to that exerted by stress, regardless of its
      direction. However, since we failed to show an increased locomotor activity after
      quinpirole challenge in the repeated restraint group, this hypothesis remains to
      be demonstrated. The two stress schedules reduced body weight gain in a similar
      way, therefore their different effects do not seem to be due to a difference in
      stress severity. Thus, the observation that both stress schedules reduced body
      weight gain in a similar way, but only chronic mild stress reduced the
      sensitivity to the locomotor response to quinpirole, shows that this effect is
      not an artefact of body weight decrease.

PMID- 11198052
TI  - Clozapine pharmacokinetics and pharmacodynamics studied with Cyp1A2-null mice.
AB  - The aim of this study was to use the CYP1A2-null mouse to investigate the in-vivo
      contribution of CYP1A2 to clozapine pharmacokinetics and pharmacodynamics. An
      intraperitoneal injection of 10 mg/kg clozapine was administered to four male
      CYP1A2 -/- mice and four male wild-type mice. Clozapine, desmethylclozapine, and
      clozapine N-oxide concentrations in sequential tail blood samples were measured
      by HPLC with UV detection. Behavioural parameters were recorded at each time
      point. The area under the curve (AUC) of clozapine was 2.6 times greater, the
      clearance of clozapine was 2.6 times slower, and the half-life was 1.2 times
      longer in the CYP1A2 -/- mice (p = 0.0143) as compared to the wild-type mice.
      Sixty-one percent of the clozapine clearance in wild-type mice was calculated to
      be mediated by CYP1A2. The AUC of desmethylclozapine was 1.6 times lower in the
      CYP1A2 -/- mice compared to the wild-type mice (p = 0.0286), while there was a
      trend for the AUC of clozapine N-oxide to be greater in the CYP1A2 -/- mice (p =
      0.0571). The CYP1A2 -/- mice were significantly more drowsy and showed more motor
      impairment (p = 0.0145) and myoclonus than the wild-type mice. Our results
      indicate that, in vivo, CYP1A2 is the major determinant of clozapine clearance,
      contributes significantly to the demethylation of clozapine, and has a negligible
      contribution to the N-oxidation. Our data also indicate that CYP1A2 poor
      metabolizers might be more susceptible than extensive metabolizers to dose
      related adverse effects of clozapine, such as sedation, myoclonus and seizures.

PMID- 11198053
TI  - Acute effects of LI 160 (extract of Hypericum perforatum, St John's wort) and two
      of its constituents on neuroendocrine responses in the rat.
AB  - Extracts of Hypericum perforatum (St John's wort), such as LI 160, which are
      effective antidepressants have several active constituents. Their mode of action
      in depression, however, is unclear. In the present investigation, we assessed the
      effect of equivalent doses of LI 160 and two of its components, hypericin and
      hyperforin on serotonin (5-HT) and dopamine (DA)-mediated neuroendocrine
      responses in the rat. LI 160, hypericin and hyperforin significantly and
      equivalently increased plasma corticosterone. This effect was blocked by
      ketanserin but not WAY-100635, suggesting mediation via 5-HT2 receptors. LI 160
      also lowered plasma prolactin and prevented the increase in plasma prolactin
      following haloperidol administration. Hyperforin had a similar but somewhat less
      pronounced effect. We conclude that LI 160, hypericin and hyperforin all increase
      5-HT-mediated corticosterone release while LI 160 enhances DA-mediated inhibition
      of prolactin release. Hyperforin may contribute to the facilitatory effect of LI
      160 on DA function, but hypericin does not.

PMID- 11198054
TI  - D2 receptor occupancy under recommended and high doses of olanzapine: an iodine
      123-iodobenzamide SPECT study.
AB  - The aim of this study was to compare the degree of striatal dopamine D2 receptor
      availability in patients treated with recommended (5-20 mg, mean dose 11.9 +/-
      6.3 mg daily) and higher doses (25-40 mg, mean 32.1 +/- 5.6 mg daily) of the
      novel antipsychotic drug olanzapine by means of [123I] IBZM Single photon
      emission computed tomography (SPECT). The results were compared to those of a
      group of 10 untreated, healthy, age- and sex-matched controls. The degree of
      dopamine D2 receptor occupancy in the patient group was correlated with the
      presence of extrapyramidal symptoms (EPS). A total of 20 patients who met the DSM
      III R criteria for schizophrenia or schizoaffective disorder received a
      clinically effective antipsychotic monotherapy with olanzapine. The mean daily
      dose of olanzapine ranged from 0.05-0.6 mg/kg body weight. The dopamine D2
      receptor binding was reduced in all patients treated with olanzapine. Specific
      IBZM binding expressed as the [STR-BKG]/BKG ratio ranged from 0.13-0.61 (healthy
      controls 0.95). The D2 receptor availability revealed an exponential dose
      response relationship (r = - 0.85, p < 0.001). The frequency of EPS induced by
      olanzapine was considerably lower. Only one patient, treated with 40 mg
      olanzapine, suffered from severe EPS symptoms and had to be given biperiden.
      There were no significant differences in the presence of EPS symptoms between
      patients with recommended doses and those with higher doses of olanzapine.

PMID- 11198055
TI  - Individual differences in mood reactions to d-amphetamine: a test of three
      personality factors.
AB  - Individual differences in self-reported mood following either 5 mg or 10 mg d
      amphetamine challenge were examined in order to test the modifying role of three
      factors of personality, viz., the Eysencks' psychoticism, Cloninger's novelty
      seeking, and Depue and Collins' extraversion. In a double-blind study, mood
      measures (energetic arousal, tense arousal, and hedonic tone) were taken
      immediately following a single-dose of d-amphetamine and then again after 90 min.
      The results showed significant psychoticism x d-amphetamine interactions for both
      drug doses: d-amphetamine increased energetic arousal and hedonic tone, and
      reduced tense arousal, only in low psychoticism individuals; in high psychoticism
      individuals, it led to lowered energetic arousal and hedonic tone, and increased
      tense arousal. Neither novelty seeking nor extraversion modified the effects of d
      amphetamine. These data suggest a link between psychoticism and dopaminergic
      functioning, although they do not rule out the involvement of other transmitter
      systems (e.g. noradrenergic). In common with other studies, such findings point
      to the important role that well-established factors of personality play in
      accounting for individual differences in reactions to psychoactive drugs. It is
      concluded that the routine inclusion of personality measures in future
      psychopharmacological studies may help to refine the characterization of drug
      effects.

PMID- 11198056
TI  - Sleep and daytime sleepiness the next day following single night-time dose of
      fluvoxamine, dothiepin and placebo in normal volunteers.
AB  - To explore the effects of sedating and non-sedating antidepressants, we conducted
      a placebo-controlled, double-blind cross-over study in 12 normal subjects of the
      effects of a single night-time dose of fluvoxamine 100 mg, dothiepin 100 mg or
      placebo on night-time sleep recorded at home, and sleepiness and performance the
      following day. Night-time sleep was altered significantly by both drugs, with
      main effects on rapid eye movement (REM) sleep and sleep continuity. Dothiepin
      increased total sleep time, REM latency and stage 2 sleep and decreased arousals,
      wake after sleep onset and stage 1, whereas fluvoxamine decreased total sleep
      time and REM time and increased wake after sleep onset. Sleep latencies in
      daytime naps were significantly shorter for dothiepin and longer for fluvoxamine,
      showing that subjects were more sleepy when taking dothiepin.
      Electroencephalograms (EEG) performed during performance tasks failed to
      distinguish significantly between drugs. There were no significant differences
      between groups on our measures of tracking performance or reaction time; however,
      these tasks were designed primarily to provide a standard setting in which to
      monitor continuous EEG, and were unsuitable to detect sleepiness effects
      themselves. Saccadic eye movement velocity, acceleration and deceleration showed
      small non-significant changes after both drugs. Mood self ratings showed no
      significant differences among the groups. Subjective measures of night-time sleep
      reflected the objective measures of sleep continuity, and the items for
      difficulty and speed of wakening in the morning were significantly higher (i.e.
      more difficulty and slower) in the dothiepin group. The home-recorded sleep
      findings after fluvoxamine in this study were very similar to sleep laboratory
      studies with other antidepressant drugs, thus providing more validation of the
      home recording method.

PMID- 11198057
TI  - Effects of pentagastrin and the cold pressor test on the acoustic startle
      response and pupillary function in man.
AB  - Pentagastrin, a cholecystokinin2 (CCK2) receptor agonist, evokes autonomic and
      subjective features of anxiety in healthy volunteers. The present experiments
      examined the effects of pentagastrin on two responses with known sensitivity to
      another anxiogenic procedure (threat of electric shock): the acoustic startle
      response and the pupillary light reflex. The effects of pentagastrin were
      compared with those of the cold pressor test, a procedure known to elicit
      sympathetic activation. Twelve healthy males (18-35 years) participated in two
      experiments each consisting of two sessions in which they received (1)
      pentagastrin (0.3 microg/kg, i.v.) and a control infusion (saline), and (2) cold
      pressor test (90 s hand immersion at 4 degrees C) and a control immersion (37
      degrees C), using a balanced single-blind protocol. Electromyographic responses
      of the orbicularis oculi to 40 ms, 1 kHz, 115 dB tones ('startle responses')
      [Experiment 1], and miotic responses to 200 ms, 0.43 mW/cm2 light pulses
      [Experiment 2] were recorded before, during and after the infusions and hand
      immersions. Heart rate, blood pressure and subjective feelings were also
      recorded. The amplitude of the startle response was not significantly affected by
      pentagastrin, but was reduced during the cold pressor test. Resting pupil
      diameter increased during both pentagastrin infusion and the cold pressor test,
      but neither procedure altered the amplitude of the light reflex. Tachycardia,
      increased blood pressure and subjective anxiety were induced by both pentagastrin
      and the cold pressor test. The cardiovascular and mydriatic effects of
      pentagastrin and the cold pressor test are consistent with the known ability of
      these treatments to induce sympathetic activation. The anxiety induced by these
      treatments, unlike anxiety induced by threat of electric shock, was not
      accompanied by potentiation of the startle response or reduction of the miotic
      response. The results indicate that different anxiogenic procedures do not have
      equivalent effects on these reflexes.

PMID- 11198058
TI  - Selective cognitive processing of drug cues in heroin dependence.
AB  - Previous studies provide evidence for the selective processing of disorder
      related stimuli on anxiety, depression, and eating disorders. There exist some
      preliminary indications that selective processing of drug cues may be involved in
      drug craving and relapse that deserve further investigation. In order to
      investigate the role of processing bias in an abnormal motivational system, the
      attentional bias for drug related stimuli was studied in a heroin dependent
      population. Heroin dependent participants (n = 21) and control participants (n =
      30) performed a supra- and subliminal heroin Stroop task and heroin craving was
      assessed. Heroin dependent participants showed a considerable attentional bias
      for supraliminally presented heroin cues. However, there was no evidence for a
      preattentive bias on the subliminal presented cues. Reaction time on heroin cues
      was significantly predicted by heroin craving-levels. Results indicate that
      selective processing may be related to motivational induced states in general.
      The finding are discussed in the context of selective information processing in
      general psychopathology and in motivational processes as addiction specifically.

PMID- 11198059
TI  - Residual effects of hypnotics on disengagement of spatial attention.
AB  - In an earlier study, we postulated that the residual effects of hypnotics could
      induce a spatial attention disengagement deficit independent of any decrease in
      alertness. To test this hypothesis, we compared the residual effects of zolpidem,
      zopiclone and flunitrazepam in two ocular saccade tests, gap and overlap. In the
      gap paradigm, the lateral target is illuminated 200 ms after the extinguishing of
      the central target. In the overlap paradigm, the central target stayed on when
      the lateral target was illuminated. Zopiclone increases latency in the overlap,
      but not in the gap test, which appears to be specific to a deficit of
      disengagement of spatial attention. Zopiclone impairs the saccadic precision in
      gap, but not in overlap, which may be interpreted as an impairment of
      visuospatial memory. The effects of zolpidem are limited to visuospatial
      impairment. The effects of flunitrazepam are massive and probably the results of
      a decrease in alertness.

PMID- 11198060
TI  - Adverse effects associated with the use of donepezil in general practice in
      England.
AB  - Donepezil is an acetylcholinesterase inhibitor indicated for the symptomatic
      treatment of mild to moderate Alzheimer's disease. It is reported to have a
      relatively favourable side-effect profile. We report here on a pharmacovigilance
      study carried out post-marketing in England. An observational cohort study using
      the technique of Prescription-Event Monitoring was carried out. Some 1762
      patients (mean age 72.9 years; 42% male) were followed up for 6 months minimum.
      The commonest adverse events were nausea, diarrhoea, malaise, dizziness and
      insomnia. Aggression, agitation and abnormal dreams were uncommonly associated
      with the drug. There were no cardiac rhythm disturbances or liver disorders
      causally associated. The commonest adverse drug reactions are already reported in
      the product information. Given the relatively small size of this cohort, the
      signals of abnormal dreams and psychiatric disturbance as possible adverse drug
      reactions need further investigation in carefully planned studies.

PMID- 11198061
TI  - Refractory schizophrenia and atypical antipsychotics.
AB  - Treatment resistant or refractory schizophrenia is a difficult to define
      condition of largely unknown prevalence. For 10 years, clozapine has been the
      standard treatment in this condition and is recognized unequivocally as being
      effective. However, clozapine is sometimes poorly tolerated and has the potential
      for severe toxicity. Partly as a result of this, other atypicals have recently
      been evaluated as treatments for refractory schizophrenia. In order to evaluate
      the evidence base relating to the drug treatment of refractory schizophrenia, we
      developed a refractoriness rating based on previous work. Using this rating, we
      assessed all trials of atypicals in schizophrenia unresponsive to at least one
      drug. Overall, clozapine was consistently shown to be effective in refractory
      schizophrenia, even when stringently defined. Data relating to olanzapine and
      risperidone are equivocal at best, and there is some evidence to suggest that
      they are less effective than clozapine. There is essentially no cogent evidence
      to support the use of any other atypical in refractory schizophrenia. Clozapine
      remains the drug of choice in this condition.

PMID- 11198062
TI  - Dopaminergic sensitivity and prediction of antidepressant response.

PMID- 11198063
TI  - Serotonin, stress and corticoids.

PMID- 11198064
TI  - Methodological issues in community-based studies of gynecological morbidity.
AB  - This report describes the lessons learned from a series of community-based
      studies of gynecological morbidity among young married women in Karnataka State,
      India. Women's self-reports of symptoms of illness were found to be responsive to
      the context of the interview and the nature of questioning. In particular, women
      appeared much readier to report symptoms to lay interviewers after being invited
      to undergo a clinical examination in the near future than they were if no
      examination were offered. Little consistency was found in the results obtained
      from interviews, clinical examinations, and laboratory tests. Apparently, no
      alternative exists to the collection of biological specimens for laboratory
      analysis when estimates of disease prevalence are needed. Use of generic health
      related quality-of-life assessments is recommended for future surveys.
      Prospective studies will yield more valuable data on these topics than will cross
      sectional surveys.

PMID- 11198065
TI  - Can poor countries surmount high maternal mortality?
AB  - Does poverty bind developing countries to high levels of maternal death in
      childbirth? Or, as safe-motherhood advocates claim, do public health and social
      policy interventions have the potential to accelerate maternal mortality
      transitions? Globally, almost one in 200 live births leads to the death of the
      mother, making maternal mortality an issue of critical international import. This
      article presents an analysis of the determinants of national maternal mortality
      levels with a view to shedding light on these questions. A cross-national
      regression of 64 countries shows that wealth indicators explain only a portion of
      the variance in national maternal mortality levels. Other determinants, including
      women's educational levels and the proportion of deliveries attended by trained
      health personnel, are more clearly associated with national maternal mortality
      levels than are measures of wealth. The results offer grounds for optimism
      concerning the potential for global safe-motherhood efforts to induce maternal
      mortality transitions.

PMID- 11198066
TI  - The effect of gender preference on contraceptive use and fertility in rural
      Egypt.
AB  - Data are used from two surveys of currently married women aged 15-44 conducted in
      1979-80 and 1990-91 to explore the changing impact of gender preference on modern
      contraceptive use and on fertility in rural Menoufia, Egypt. The significantly
      positive effects on contraceptive use of having one or more sons in 1979 remained
      constant in 1990. Families without living sons had higher odds of having a birth
      than did families with two or more sons during 1979-80, and these relative odds
      were even higher in 1990-91 among families with three or more living children.
      The implications of these findings for subsequent declines in aggregate fertility
      are discussed.

PMID- 11198067
TI  - Abortion trends in Japan, 1975-95.
AB  - In this study, recent trends in the incidence of induced abortion are analyzed in
      order to identify the target population and its requirements for family planning
      policy in Japan. Abortion statistics from 1975 to 1995 from the Ministry of
      Health and Welfare are reviewed. The abortion rate (the number of cases of
      induced abortion per 1,000 women per year) for women younger than 20 increased
      during the study period. The abortion ratio (number of cases per 1,000 live
      births) remained the highest among women aged 40-44. An increase in the abortion
      ratio was seen in the two youngest groups (younger than 20 and 20-24), especially
      among those who were born after 1955. The proportion of abortions experienced by
      women younger than 25 increased from 18 percent between 1976 and 1980 to 30
      percent between 1991 and 1995, and a slight increase was also observed among
      women aged 40-44. The proportion of abortions performed after eight weeks of a
      pregnancy for the two youngest groups remained higher than that for older age
      groups during 1975-95. The analysis demonstrates that women younger than 25
      should be the principal concern of family planning policy in Japan. Further
      investigations on unintended pregnancy are recommended.

PMID- 11198068
TI  - Women's reports of severe (near-miss) obstetric complications in Benin.
AB  - This study examines the validity of a survey instrument on near-miss obstetric
      complications. Three groups of women--with severe complications, with mild
      complications, and with a normal delivery--were identified retrospectively in
      three hospitals in South Benin and interviewed at home. The concept of "near
      miss" was used to identify women with severe episodes of morbidity. The
      questionnaire was able to detect, with some accuracy, eclamptic fits, abnormal
      bleeding in the third trimester for a recall period of at least three to four
      years, and all episodes of bleeding independent of timing within a period of two
      years. Questions concerning dystocia and infections of the genital tract
      generated disappointing results except when information on treatment was
      included. Overall, better results were achieved for antepartum and acute events.
      Severity made a positive difference only in the case of eclampsia, with an
      increase in sensitivity. The implications of the results for using women's recall
      of obstetric complications in surveys are discussed.

PMID- 11198069
TI  - Mobilizing demand for contraception in rural Gambia.
AB  - A community trial was conducted in rural Gambia in order to determine whether a
      community-based intervention designed to mobilize latent demand for contraception
      would increase use of modern contraceptives, even in the absence of improved
      availability of family planning services. Analysis of trial data indicates that
      the demand-mobilization intervention had a statistically significant positive
      effect on nonusers' adoption of modern contraception and that coterminous
      implementation of an intervention designed to improve access to services offered
      no additional benefit. The program component found to have the greatest impact
      was the "kabilo approach," in which village women provide basic health and family
      planning counseling to other women in their extended families. These results
      suggest that the principal barriers to increased contraceptive use in rural
      Gambia are psychosocial and that these barriers can be overcome through village
      based interventions designed to provide socially appropriate counseling to
      potential contraceptive users.

PMID- 11198070
TI  - Directional microphones--they work.

PMID- 11198071
TI  - Clinical application of the satisfaction with amplification in daily life scale
      in private practice I: statistical, content, and factorial validity.
AB  - Statistical, content, and factorial validity of the Satisfaction with
      Amplification in Daily Life (SADL) scale was assessed. SADL subscales closely
      correspond to four satisfaction domains. Subjective benefit is a key component of
      satisfaction, but other nonauditory factors contribute to wearer satisfaction,
      notably telephone use and appearance. Results confirm the SADLs psychometric
      properties and verify its use to validate hearing aid fitting satisfaction in
      private practice settings for a general patient population at 1-year postfitting.
      Interim SADL norms may be refined as more SADL data are obtained for different
      patient populations, hearing aid types, and fitting environments.

PMID- 11198072
TI  - Comparison of benefits provided by different hearing aid technologies.
AB  - The performance of 40 hearing-impaired adults with the GN ReSound digital BZ5
      hearing instrument was compared with performance with linear hearing aids with
      input compression limiting (AGC-I) or two-channel analog wide dynamic range
      compression (WDRC) instruments. The BZ5 was evaluated with an omnidirectional
      microphone, dual-microphone directionality, and a noise reduction circuit in
      combination with dual-microphone directionality. Participants were experienced
      hearing aid users who were wearing linear AGC-I or analog WDRC instruments at the
      time of enrolment. Performance was assessed using the Connected Speech Test (CST)
      presented at several presentation levels and under various conditions of signal
      degradation and by the Profile of Hearing Aid Benefit (PHAB). Subjective ratings
      of speech understanding, listening comfort, and sound quality/naturalness were
      also obtained using 11-point interval scales. Small performance advantages were
      observed for WDRC over linear AGC-I, although WDRC did not have to be implemented
      digitally for these performance advantages to be realized. Substantial
      performance advantages for the dual microphones over the omnidirectional
      microphone were observed in the CST results in noise, but participants generally
      did not perceive these large advantages in everyday listening. The noise
      reduction circuit provided improved listening comfort but little change in speech
      understanding.

PMID- 11198074
TI  - Effect of interstimulus interval on subjective categorical loudness judgements.
AB  - The Independent Hearing Aid Fitting Forum uses the visual input/output locator
      algorithm and the Contour Test of Loudness Perception to achieve the goal of
      restoring normal loudness perception with amplification. This method presupposes
      that subjective categorical loudness judgments are valid and reliable when using
      the procedure outlined by the test developers. There is no indication in the
      instructions of the Contour Test of a specific duration for interstimulus
      interval (ISI). The effect of ISI on loudness perception is important to
      establish because of potential time-error effects. Time-error refers to the
      extent to which the judged magnitude of a second stimulus varies with the time
      interval by which it follows the first stimulus. Past research has indicated that
      judgments of a second stimulus are shifted in the direction of the intensity of
      the preceding stimulus and that this effect intensifies with shorter ISIs. The
      current experiment was designed to examine whether a change in ISI produced a
      change in the loudness rating of the subsequent stimulus for subjective
      categorical loudness judgment testing. A trend toward lower, median dB values for
      ratings 2 to 5 at 500 Hz in a group of subjects with normal hearing was noted
      when 1-sec intervals were used in comparison with longer ISIs. No trends for the
      effect of ISI were noted at 3000 Hz. The findings provide ISI recommendations for
      loudness judgment test administration.

PMID- 11198073
TI  - Predicting directional hearing aid benefit for individual listeners.
AB  - The fitting of directional microphone hearing aids is becoming increasingly more
      routine, and this fitting option has proven to be a successful method to improve
      speech intelligibility in many noisy listening environments. Data suggest,
      however, that some hearing-impaired listeners receive significantly more
      directional benefit than others. It is of interest, therefore, to determine if
      directional benefit is predictable from identifiable audiologic factors. In this
      report, we examined whether the slope of audiometric configuration, amount of
      high-frequency hearing loss, and/or the aided omnidirectional performance for a
      speech-in-noise intelligibility task could be used to predict the magnitude of
      directional hearing aid benefit. Overall results obtained from three separate
      investigations revealed no significant correlation between the slope of
      audiometric configuration or amount of high-frequency hearing loss and the
      benefit obtained from directional microphone hearing instruments. Although there
      was a significant, negative relationship between aided omnidirectional
      performance and the directional benefit obtained in one study, there was
      considerable variability among individual participants, and nearly all of the
      listeners with the best omnidirectional hearing aid performance still received
      significant additional benefit from directional amplification. These results
      suggest that audiologists should consider the use of directional amplification
      for patients regardless of audiogram slope, high-frequency hearing loss, or
      omnidirectional speech intelligibility score.

PMID- 11198075
TI  - Recipient of the 2001 Pioneer Award. Philip J. Dziuk, Ph.D.

PMID- 11198076
TI  - Use of embryo transfer and IVF to bypass effects of heat stress.
AB  - Although heat stress has multiple effects to lower pregnancy rate in lactating
      dairy cows, a major pathway is in its effects on the early cleavage stage embryo.
      Conceptually, and in practice, higher pregnancy rates can be obtained with
      transfer of late cleavage stage embryos. The literature is reviewed, and
      conclusion is made that application of these technologies may be in part, a
      solution to this long-standing problem.

PMID- 11198077
TI  - Feed and forage toxicants affecting embryo survival and fetal development.
AB  - Early embryonic and fetal development in mammals is sensitive to deficiencies and
      excesses of specific nutrients and toxicants. Operating directly and/or
      indirectly, these deficiencies and excesses can result in embryonic death or, in
      less severe circumstances, disruption of normal embryo and fetal growth. This
      paper explores the threats posed by feed and forage toxicants to the developing
      embryo and their impact on early programming of fetal development. Using
      significant examples, we consider the relevance of temporal sensitivities during
      early development in utero, and their implications for the morphology and
      functional competence of specific organs and tissues.

PMID- 11198078
TI  - Endocrine disrupting compounds: effect of octylphenol on reproduction over three
      generations.
AB  - With the growing concern that environmental chemicals might impair human and
      animal fertility, it is important to investigate the possible influence of these
      substances on sexual differentiation and genital development of mammals. Many of
      these substances are suspected to interfere with endocrine processes, and
      exposure during critical periods of prenatal development might affect
      reproductive performance over several generations. Alkylphenols and their
      metabolites are lipophilic substances exerting apparent estrogenic action in in
      vitro and in vivo testing systems. With the widespread industrial use of
      alkylphenols, these are disseminated in the environment with sewage sludge, and
      domestic animals and humans are likely to be exposed via the food chain. Using
      the pig as an in vivo model, we studied the effect of intrauterine exposure to
      tertiary octylphenol (OP) on essential reproductive parameters over 3
      generations. Sows were treated daily from D 23 to 85 of pregnancy with either 0,
      10 or 1000 micrograms OP/kg body weight. Treatment with OP extended pregnancy
      length and induced basal cell proliferation in the cervical epithelium of the
      parental generation. In F1 offspring of sows treated with the low dosage of OP,
      onset of puberty was accelerated. Furthermore, when F1 gilts and F1 boars
      originating from sows treated with high dosages of OP were bred, the litter size
      was reduced. The results of the present study are compared with previous reports
      on estrogenicity of OP, and the usefulness of in vivo animal or embryo models for
      the evaluation of possible consequences of human exposure to endocrine disrupting
      compounds is discussed. Furthermore, possible consequences of exposure to
      endocrine disrupting compounds for the embryo transfer industry are addressed.

PMID- 11198079
TI  - Recent progress in livestock genomics and potential impact on breeding programs.
AB  - Most of the major livestock breeding organizations in the world are actively
      involved in using the emerging tools for genome analysis to obtain a better
      understanding of the molecular architecture of their favourite production traits.
      This is bound to generate a considerable amount of novel biological information
      that will provide a competitive advantage to those that have access to it. At
      present, the preferred avenue to exploit this information is via marker-assisted
      selection (MAS), and several breeding organisations are starting to implement MAS
      in breeding programs. However, it seems unlikely that the exploitation of
      genomics information will be limited to MAS in the future. Even though it is
      difficult to anticipate the ultimate impact of genomics on animal production, it
      would be very surprising if it were not to revolutionize this industry as it is
      already revolutionizing the biomedical and plant breeding industries.

PMID- 11198080
TI  - Influence of in vitro systems on embryo survival and fetal development in cattle.
AB  - In vitro systems are commonly used for the production of bovine embryos.
      Comparisons between in vivo and in vitro produced embryos illustrate that the
      morphology of preimplantation-stage embryos differ significantly, the survival of
      embryos and fetuses is decreased, the size distributions of the populations of
      conceptuses and fetuses are altered throughout gestation, and placental
      development is significantly changed. Taken together these findings indicate that
      exposure to some in vitro environments during the first 7 days of life can
      profoundly influence fetal and placental development in cattle. An understanding
      of how in vitro oocyte maturation, in vitro fertilization, and embryo culture
      systems influence both fetal and placental development should result in systems
      that consistently produce normal embryos, fetuses, and calves.

PMID- 11198081
TI  - Genetic regulation of embryo death and senescence.
AB  - The survival of the preimplantation mammalian embryo depends not only on
      providing the proper conditions for normal development but also on acquiring the
      mechanisms by which embryos cope with adversity. The ability of the early
      conceptus to resist stress as development proceeds may be regulated by diverse
      factors such as the attainment of a cell death program and protective mechanisms
      involving stress-induced genes and/or cell cycle modulators. This paper reviews
      the recent research on the genetic regulation of early embryo cell death and
      senescence focussing on the bovine species where possible. The different modes of
      cell death will be explained, clarifying the confusing cell death terminology, by
      advocating the recommendations set forth by the Cell Death Nomenclature Committee
      to extend to the embryology research field. Specific pro-death and anti-death
      genes will be discussed with reference to their expression patterns during early
      mammalian embryogenesis.

PMID- 11198082
TI  - Genes regulating embryonic and fetal survival.
AB  - Embryonic mortality in both farm animals and humans occurs most frequently during
      the first few weeks after conception. It can be attributed to abnormalities in
      the earliest developmental processes during embryogenesis that include
      implantation, maternal recognition of pregnancy, and formation of the placenta
      and cardiovascular system. The molecular mechanisms that are essential for all of
      these early processes are being elucidated at a rapid pace using transgenic and
      gene knockout approaches in mice. Two important general conclusions have emerged
      from this work. First, placental defects can occur by a number of different
      molecular mechanisms and can result from defects in the development or function
      of its trophoblast, mesenchymal or vascular components. Second, placental and
      cardiovascular functions are intimately linked. Cells of the placenta, for
      example, produce hormones that have profound effects on maternal and fetal
      cardiac and vascular function. In addition, development of the two is linked
      mechanistically through the use of some genes that are essential for development
      of both. Understanding the molecular basis of these processes should help to
      address the major limits to the success of embryo transfer, IVF and embryo
      cloning practices in livestock species.

PMID- 11198083
TI  - Responsiveness of early embryos to environmental insults: potential protective
      roles of HSP70 and glutathione.
AB  - Early embryos are not as passive as previously thought. In the bovine, embryos as
      early as the 2-cell stage can respond to environmental insults at both the
      cellular and molecular level by altering expression of specific genes and
      synthesis of proteins. Moreover, sex related differences exist in how early
      embryos respond to otherwise hostile environments. As aggressive as early embryos
      may be to tolerate environment insults, the majority will fail to continue in
      development. Reduced developmental potential of embryos exposed to elevated
      temperatures is likely due to direct effects on the early embryo. However, as
      embryos proceed in development they acquire the ability to better withstand
      environmental insults. Developmental acquisition of tolerance to environmental
      stress may be contingent upon acquisition of protective biochemical mechanisms or
      simply due to increased cell numbers. Correlative evidence has suggested a
      potential role of heat shock protein 70 and glutathione for protection of embryos
      in face of elevated temperature. Of these two possibilities, HSP70 appears least
      likely to play a significant role in developmental acquisition of
      thermotolerance. Bovine embryos as early as the 2-cell stage, are able to mount a
      heat shock response; a developmental stage that is most sensitive to elevated
      temperatures. A more likely candidate for conferring increased resistance of
      early embryos to elevated temperature is glutathione.

PMID- 11198084
TI  - Mechanisms for managing cellular and homeostatic stress in vitro.
AB  - The ability to maintain embryo development in culture depends upon the ability of
      the embryo to maintain cellular homeostasis. Disruptions in the ability to
      regulate cellular homeostasis such as pH, calcium levels and osmotic pressure
      result in perturbed development and a reduced ability to establish and maintain a
      pregnancy following transfer. Therefore, it is important that in vitro conditions
      are designed to minimize stress on the embryo and maximize the ability of the
      embryo to maintain cellular homeostasis. While embryos do exhibit a degree of
      plasticity and can adapt to their environment, this requires expenditures of
      extra energy which negatively impacts viability. Therefore, reducing stress by
      taking into account the physiology of the embryo is essential for the maintenance
      of developmental competence in vitro.

PMID- 11198085
TI  - Progress on methods of gene detection in preimplantation embryos.
AB  - The advent of the polymerase chain reaction (PCR) and the development of
      fluorescence in situ hybridization (FISH) have had a tremendous impact on
      preimplantation genetic diagnosis (PGD). While PCR is a powerful tool in
      detecting genetic diseases or molecular markers affecting quantitative trait
      loci, the main use of FISH is screening for chromosomal aberrations. This
      presentation reviews the recent progress in preimplantation genetic diagnosis
      with an emphasis on bovine embryos. In particular the importance of biopsy size
      and strategies to avoid PCR contamination are discussed. Alternative DNA
      amplification and detection methods as well as methods to meet the challenge of
      multiple locus detection for marker assisted selection are presented.

PMID- 11198086
TI  - Sex related embryo development.
AB  - Although sexual dimorphic development in the mammalian embryo prior to
      differentiation of the gonad has been documented, there are many seemingly
      conflicting observations and gaps in our understanding of this process.
      Conditions that influence the process include gamete interaction, that might give
      one sex and advantage in the fertilization process and in rates of blastomere
      cleavage that would allow one sex to accumulate cells at a faster rate. In this
      scenario, males could accumulate more cells within a defined window of
      development. Another key difference between males and females is the number of
      copies of genes located on the sex chromosomes. Transcripts from the Y-chromosome
      are thought to function as transcription factors, which could accelerate
      development. Conversely, the X-chromosome contains genes that code for rate
      limiting steps in pathways key to embryo metabolism and stress reduction. It can
      be envisioned that prior to X-chromosome inactivation in females, elevated levels
      of transcripts for such genes may enable greater protection from environmental
      stress and regulate growth. As we gain a better understanding of how males and
      female develop we will be able to exert greater control over the manipulation of
      the sex ratio for the offspring of domestic animals.

PMID- 11198087
TI  - Cloning to reproduce desired genotypes.
AB  - Cloned sheep, cattle, goats, pigs and mice have now been produced using somatic
      cells for nuclear transplantation. Animal cloning is still very inefficient with
      on average less than 10% of the cloned embryos transferred resulting in a live
      offspring. However successful cloning of a variety of different species and by a
      number of different laboratory groups has generated tremendous interest in
      reproducing desired genotypes. Some of these specific genotypes represent animal
      cell lines that have been genetically modified. In other cases there is a
      significant demand for cloning animals characterized by their inherent genetic
      value, for example prize livestock, household pets and rare or endangered
      species. A number of different variables may influence the ability to reproduce a
      specific genotype by cloning. These include species, source of recipient ova,
      cell type of nuclei donor, treatment of donor cells prior to nuclear transfer,
      and the techniques employed for nuclear transfer. At present, there is no solid
      evidence that suggests cloning will be limited to only a few specific animals,
      and in fact, most data collected to date suggests cloning will be applicable to a
      wide variety of different animals. The ability to reproduce any desired genotype
      by cloning will ultimately depend on the amount of time and resources invested in
      research.

PMID- 11198088
TI  - Genetic manipulation of sex differentiation and phenotype in domestic animals.
AB  - In mammals, a gene based sex determination system ensures that approximately 50%
      of offspring will be of the male sex and 50% will be of the female sex. In
      domestic animal production systems, this ratio is not always ideal. Recent
      advances in our understanding of the molecular biology of sex determination and
      differentiation, as well as in the control of gene expression and the direct
      modification of animal genomes, allows us to consider methods for the direct
      genetic manipulation of sexual phenotype.

PMID- 11198089
TI  - Is stress really all that important?
AB  - There is growing concern in many parts of the world that fertility of dairy
      cattle is reducing as milk yields increase. Stress could be one important cause.
      As an example, fertility is lower after caesarian operations. Delayed uterine
      involution after dystocia is associated with abnormal ovarian cyclicity and
      prolonged intervals to the next pregnancy. There is a greater reduction in
      fertility as the clinical conditions of lameness, milk fever or mastitis worsen.
      Changes in social groupings greatly increase the number of inseminations required
      per pregnancy. Transport reduces the number of CL after superovulation, and can
      interfere with pregnancy rates after estrous synchronization. Embryos collected
      from heat-stressed donors are less viable and have delayed trophoblast function.
      Human-animal interactions influence stress-responses in cattle--the behavior of
      stockman and embryo transfer personnel could affect success. Putting aside
      financial aspects, exposure of an animal to avoidable stress compromises welfare,
      whether application of biotechnology is involved or not. The fact that stressors
      can be deleterious to such an important function as reproduction, emphasizes that
      stress is very important and should be minimized whenever possible.

PMID- 11198090
TI  - Effects of hormonal treatments on reproductive performance and embryo production.
AB  - Developments in the use of drugs to improve reproduction and embryo production
      have focused on estrus and ovulation synchronization protocols and embryonic
      survival. Protocols for synchronization of ovulation eliminate the need for
      detection of estrus and allow timed insemination of all cows enrolled. Various
      estrogenic, progestational, GnRH and PGF2 alpha-like drugs are used to
      synchronize follicle development, CL regression and induction of ovulation.
      Strategies are discussed to optimize such programs to maximize herd pregnancy
      rates. Use of bovine Somatotrophin (bST) in combination with the Ovsynch protocol
      resulted in increased pregnancy rates, indicating possible effects on oocyte and
      embryonic development. Treatment of embryo donor cows with bST reduced the
      proportion of unfertilized oocytes and increased the number of transferable
      embryos. Furthermore, bST increased pregnancy rate when given to the recipient.
      Sub-luteal plasma progesterone concentrations after insemination have been
      associated with lower pregnancy rates. Injection of hCG on day 5 post
      insemination resulted in induction of an accessory CL, increased plasma
      progesterone concentrations and increased conception rates. Strategies involving
      the use of sustained GnRH agonists to enhance CL development and alter follicular
      development are considered for future programs to enhance pregnancy rates.

PMID- 11198091
TI  - Adverse impact of heat stress on embryo production: causes and strategies for
      mitigation.
AB  - The production of embryos by superovulation is often reduced in periods of heat
      stress. The associated reduction in the number of transferable embryos is due to
      reduced superovulatory response, lower fertilization rate, and reduced embryo
      quality. There are also reports that success of in vitro fertilization procedures
      is reduced during warm periods of the year. Heat stress can compromise the
      reproductive events required for embryo production by decreasing expression of
      estrus behavior, altering follicular development, compromising oocyte competence,
      and inhibiting embryonic development. While preventing effects of heat stress can
      be difficult, several strategies exist to improve embryo production during heat
      stress. Among these strategies are changing animal housing to reduce the
      magnitude of heat stress, utilization of cows with increased resistance to heat
      stress (i.e., cows with lower milk yield or from thermally-adapted breeds), and
      manipulation of physiological and cellular function to overcome deleterious
      consequences of heat stress. Effects of heat stress on estrus behavior can be
      mitigated by use of estrus detection aids or utilization of ovulation
      synchronization treatments to allow timed embryo transfer. There is some evidence
      that embryonic survival can be improved by antioxidant administration and that
      pharmacological treatments can be developed that reduce the degree of
      hyperthermia experienced by cows exposed to heat stress.

PMID- 11198092
TI  - Exercise program effects on one woman with multiple sclerosis, Crohn's disease,
      fibromyalgia syndrome, and clinical depression.

PMID- 11198093
TI  - The challenge of eliminating health disparities in North Carolina.

PMID- 11198094
TI  - 2000 annual report of the state health director.

PMID- 11198095
TI  - Addressing health professions shortage areas in eastern North Carolina.

PMID- 11198096
TI  - Learning the thunder.

PMID- 11198097
TI  - Climbing up the pyramid. My experience as a surgical resident at Duke, 1936-1942.

PMID- 11198098
TI  - Punctuality--the politeness of kings.

PMID- 11198099
TI  - An ultimate board exam.

PMID- 11198100
TI  - Improving office-based preventive care for diabetes. The beneficial results of a
      patient questionnaire and a flow chart.

PMID- 11198101
TI  - Functional anatomy of execution, mental simulation, observation, and verb
      generation of actions: a meta-analysis.
AB  - There is a large body of psychological and neuroimaging experiments that have
      interpreted their findings in favor of a functional equivalence between action
      generation, action simulation, action verbalization, and perception of action. On
      the basis of these data, the concept of shared motor representations has been
      proposed. Indeed several authors have argued that our capacity to understand
      other people's behavior and to attribute intention or beliefs to others is rooted
      in a neural, most likely distributed, execution/observation mechanism. Recent
      neuroimaging studies have explored the neural network engaged during motor
      execution, simulation, verbalization, and observation. The focus of this
      metaanalysis is to evaluate in specific detail to what extent the activated foci
      elicited by these studies overlap.

PMID- 11198102
TI  - A data compression method for image time series.
AB  - Image time series for functional studies frequently vary relatively little from
      one time point to the next. We describe here a method of lossless file
      compression that calculates the change in signal intensity as a char (one byte),
      as opposed to a short or long integer (usually two or four bytes), thus resulting
      in a compressed file size just over half the size of the original (a 2:1
      compression ratio). The calculations and format are exceedingly simple; the
      compression time is comparable to the time required for a file copy, and is thus
      transparent to most users. The approach works equally well on any integer-based
      scanning modality, such as PET, CT, or DSA. Our purpose in this communication is
      to advocate it as a potential standard, to promote free interchange of scan data.

PMID- 11198103
TI  - A new approach to measure single-event related brain activity using real-time
      fMRI: feasibility of sensory, motor, and higher cognitive tasks.
AB  - Real-time fMRI is a rapidly emerging methodology that enables monitoring changes
      in brain activity during an ongoing experiment. In this article we demonstrate
      the feasibility of performing single-event sensory, motor, and higher cognitive
      tasks in real-time on a clinical whole-body scanner. This approach requires
      sensitivity optimized fMRI methods: Using statistical parametric mapping we
      quantified the spatial extent of BOLD contrast signal changes as a function of
      voxel size and demonstrate that sacrificing spatial resolution and readout
      bandwidth improves the detection of signal changes in real time. Further
      increases in BOLD contrast sensitivity were obtained by using real-time multi
      echo EPI. Real-time image analysis was performed using our previously described
      Functional Imaging in REal time (FIRE) software package, which features real-time
      motion compensation, sliding window correlation analysis, and automatic reference
      vector optimization. This new fMRI methodology was validated using single-block
      design paradigms of standard visual, motor, and auditory tasks. Further, we
      demonstrate the sensitivity of this method for online detection of higher
      cognitive functions during a language task using single-block design paradigms.
      Finally, we used single-event fMRI to characterize the variability of the
      hemodynamic impulse response in primary and supplementary motor cortex in
      consecutive trials using single movements. Real-time fMRI can improve reliability
      of clinical and research studies and offers new opportunities for studying higher
      cognitive functions.

PMID- 11198105
TI  - Winning the fight against perinatal AIDS transmission.

PMID- 11198104
TI  - Functional networks in motor sequence learning: abnormal topographies in
      Parkinson's disease.
AB  - We examined the neural circuitry underlying the explicit learning of motor
      sequences in normal subjects and patients with early stage Parkinson's disease
      (PD) using 15O-water (H2 15O) positron emission tomography (PET) and network
      analysis. All subjects were scanned while learning motor sequences in a task
      emphasizing explicit learning, and during a kinematically controlled motor
      execution reference task. Because different brain networks are thought to
      subserve target acquisition and retrieval during motor sequence learning, we used
      separate behavioral indices to quantify these aspects of learning during the PET
      experiments. In the normal cohort, network analysis of the PET data revealed a
      significant covariance pattern associated with acquisition performance. This
      topography was characterized by activations in the left dorsolateral prefrontal
      cortex (PFdl), rostral supplementary motor area (preSMA), anterior cingulate
      cortex, and in the left caudate/putamen. A second independent covariance pattern
      was associated with retrieval performance. This topography was characterized by
      bilateral activations in the premotor cortex (PMC), and in the right precuneus
      and posterior parietal cortex. The normal learning-related topographies failed to
      predict acquisition performance in PD patients and predicted retrieval
      performance less accurately in the controls. A separate network analysis was
      performed to identify discrete learning-related topographies in the PD cohort. In
      PD patients, acquisition performance was associated with a covariance pattern
      characterized by activations in the left PFdl, ventral prefrontal, and rostral
      premotor regions, but not in the striatum. Retrieval performance in PD patients
      was associated with a covariance pattern characterized by activations in the
      right PFdl, and bilaterally in the PMC, posterior parietal cortex, and precuneus.
      These results suggest that in early stage PD sequence learning networks are
      associated with additional cortical activation compensating for abnormalities in
      basal ganglia function.

PMID- 11198106
TI  - Parental notification legislation would be harmful.

PMID- 11198107
TI  - Arlene D. Bardeguez, MD award-winning physician.

PMID- 11198108
TI  - Senate passes health care reform package.

PMID- 11198109
TI  - Medical errors? A review of selected law cases.

PMID- 11198110
TI  - Cancer in people with AIDS in New Jersey.
AB  - A total of 2,460 persons with AIDS (PWA) and cancer were identified--2,159 men
      and 301 women--among 22,382 men and 7,931 women reported with AIDS from 1979-1995
      in New Jersey. Of these, 50% were diagnosed with Kaposi's sarcoma (KS), 33% with
      non-Hodgkin's lymphoma (NHL), and the remainder with other cancers, including
      lung and bronchus, oral, cervical, Hodgkin's disease, and digestive other than
      anal. The proportions of PWA who also had cancer, specifically KS and NHL, varied
      significantly by gender, race, and mode of HIV transmission. These findings are
      discussed in terms of risk factors in addition to immunosuppression that may
      account for the higher rates of cancer among PWA than the general population.
      Cancer prevention and detection measures likely will become more important as PWA
      survive longer.

PMID- 11198112
TI  - Acquiring new equipment. The leasing decision.

PMID- 11198111
TI  - Medical examinations and appeals for NJ public service workers.
AB  - The state of New Jersey has more than 200,000 employees in merit system jobs, who
      are covered by the Department of Personnel's formal hiring mechanism, including a
      medical examination and appeals process in which physicians play an important
      role. The State Medical Examiners Panel provides an innovative and practical
      approach to supply the Merit System Board with independent and objective findings
      and medical recommendations regarding the appeals. This article summarizes this
      process and discusses the structure, functions, and outcomes of the medical
      examiners Panel.

PMID- 11198113
TI  - Aetna US healthcare FAQs. Continued.

PMID- 11198114
TI  - [Mechanisms of cellular defense in cadidiasis].
AB  - The data obtained in this research on experimental lung candidiasis in mice
      suggest that a specific part of cellular resistance (thymus) evidently fails to
      play the leading role in initiating the infectious process. The major function of
      hindering candidiasis development belongs to neutrophilic leucocytes whose
      phagocytosis is eliminating the causal agents from the organism.

PMID- 11198115
TI  - [Differential diagnosis of oxyphilic (Hurthle cell) adenomas and carcinomas of
      the thyroid].
AB  - Successful application of a double immunostaining of oxyphilic tumors with a
      specific antimitochondrial antibody and proliferative marker Ki-67 was made for
      the first time. Comparative study of proliferative activity did not show a
      statistically significant difference between Hurthle-cell adenomas and
      carcinomas. However, oxyphilic carcinomas had a statistically significant
      positive correlation between proliferative index and aggressive course of tumor,
      tendency to recurrence, high metastatic activity, tumor size, presence of
      necrosis and capsule penetration.

PMID- 11198116
TI  - [Histological and immunohistochemical characteristics of diffuse large cell B
      cell lymphomas].
AB  - In the REAL classification, diffuse large B-cell non-Hodgkin's lymphomas are
      grouped together. We investigated histological variants and immunohistochemical
      profile of diffuse large B-cell lymphomas in 53 patients. Accuracy of the
      diagnosis was 73.6% without immunohistochemistry. The usefulness of
      immunophenotyping in making the correct diagnosis depended on a specific
      histological variant of diffuse large B-cell lymphoma. Variants with polymorphic
      and anaplastic morphology or massive reactive component have been diagnosed by
      routine histological methods with poor validity.

PMID- 11198117
TI  - [Structural changes in the brain in HIV infection complicated by drug addiction].
AB  - Comparative analysis of brain alterations in drug addicts who were HIV
      seropositive and died of sepsis and HIV-seronegative addicts showed similarity of
      these changes which manifested with ganglion cell rarefaction and losses, changed
      neuron content of main structural-functional types; massive satellitosis and
      neuronophagia, massive glycosis and leucodystrophy. These changes were diffuse in
      seropositive patients and rather focal in seronegative patients. The authors, on
      the basis of these findings, suggest a wider spread of HIV infection in drug
      addicts; they express doubts in the secondary nature of HIV-encephalopathy and
      believe that drug addiction should be considered as factor promoting HIV
      infection development.

PMID- 11198118
TI  - [Liver fatty degeneration and chronic hepatitis HCV].
AB  - Fatty degeneration in HCV-hepatitis is, according to the authors' data, an active
      process determining progression of liver fibrosis. This allow to formulate new
      approaches to treatment of chronic HCV-hepatitis.

PMID- 11198119
TI  - [Candidiasis of mucous membranes].
AB  - The author presents a new concept of complex relationship between the organism
      and Candida. According to this concept there is transformation of Candida
      carriage into invasive candidiasis of the mucous membranes. The idea is
      formulated on mixed-mycocenosis as association of fungal, bacterial, protozoic
      and viral biota. For the first time the notion of intermediate preinvasive form
      of candidiasis is given and clinical, morphological criteria of differential
      diagnosis between candida carriage, preinvasive and invasive candidiasis of
      mucous membranes are presented.

PMID- 11198120
TI  - [Clinico-morphological and molecular-biological characteristics of idiopathic
      fibrous alveolitis and lung sarcoidosis].
AB  - Lung biopsies of 16 patients with classic idiopathic fibrosing alveolitis (IFA)
      and 6 patients with sarcoidosis were studied immunohistochemically. It was found
      that adenomatous hyperplasia (AH) and fibrosing in IFA are potentiated by high
      expression of thrombocytic growth factor (TGF) and insulin-like growth factor
      type 1 (IGF-1). Tumor necrosis factor alpha (TNFa) in IFA is actively produced at
      early stages of the disease. TNFa is drastically reduced in IFA with atypical AH.
      High level of TNFa produced by alveolar macrophage, pneumocytes type 2 and by
      other cells is observed in the lungs in sarcoidosis. The level of transforming
      growth factor (B1-TGF) is rather low in sarcoidosis this being combined with weak
      interstitial fibrosis (3.75 against 5.06 in IFA). Sarcoidosis granuloma contains
      proliferating epithelioid cells (as judged by Ki-67), produces a high amount of
      FTN (4.66), moderate amount of cell fibronectin (2.7), fibroblast growth factor,
      beta-TGF and IGF-system (1.7; 1.1; 0.8, respectively). Thus, IFA and sarcoidosis
      are distinguished not only morphologically but by the cytokine profile as well.
      This implies different approaches to their diagnosis and treatment.

PMID- 11198121
TI  - [Morphology of lymphoid tissue from airways in bronchiectasis].
AB  - Morphological and morphometrical study is performed on serial and stepped
      sections of the lungs surgically removed from patients with bronchoectatic
      disease. As compared to healthy persons, hyperplasia of all structural components
      with formation of lymphoid and lymphoepithelial follicles was detected. The
      degree of lymphoid tissue hyperplasia in bronchoectatic disease is determined by
      inflammation activity and does not depend on the age. The number of
      interepithelial lymphocytes is significantly increased as well as that of
      peribronchial and peribronchiolar lymphoid accumulations, and the degree of
      diffuse infiltration. However, the number of periglandular and periductal
      lymphoid accumulations and lymphoid follicles is significantly reduced.
      Bronchoectatic disease with high active inflammation as compared to low activity
      is characterized by more pronounced hyperplasia with formation of lymphoid and
      lymphoepithelial follicles with clear centers.

PMID- 11198122
TI  - [Dynamic morphologic follow-up of diabetic microangiopathy].
AB  - Skin thigh biopsies were regularly taken in 186 patients with insulin-dependent
      and non-insulin-dependent diabetes. Progression of diabetic microangiopathy was
      found in spite of hypoglycemic treatment. Development of lesions of microvessels
      was somewhat inhibited only by angioprotectors (ticlid, dyamicron, dipiridamol).

PMID- 11198123
TI  - [Pathogenetic and morphological characteristics of acute inflammation of the
      central nervous system].
AB  - Virus, bacteria, mycoplasma, protozoa can be the causes of acute neuroinfections.
      The agents can penetrate into the brain by blood, nerve, lymphatic vessels, from
      the sinuses directly. Peculiarities of manifestations of acute neuroinfections
      depend on the agent tropism to receptors of nervous cell and specificity of brain
      immunoreactivity. The brain injuries can be induced by microorganism action or
      through immunopathologic processes. Dynamics of morphological changes in acute
      neuroinfections of different etiology are summarized. Histological, cytological,
      bacteriological, serological, immunofluorescent, histochemical methods are
      evaluated. Acute neuroinfection pathogenesis has many unresolved problems.

PMID- 11198124
TI  - [The role of infection in the development of immune inflammation and pathogenesis
      of atherosclerosis].
AB  - Pathogenesis of atherosclerosis from the point of view of immune inflammation in
      the vascular wall is discussed in this review. Potential role of adenoviruses and
      chlamydia in the development of immune inflammation and mechanisms and transport
      of infectious agents into the vascular wall and their influence on the cell
      kinetics are reviewed.

PMID- 11198125
TI  - Behavioural pharmacology and its contribution to the molecular basis of memory
      consolidation.
AB  - Recent findings have significantly advanced our understanding the mechanisms of
      memory formation. Most of these advances stemmed from behavioural pharmacology
      research involving, particularly, the localized infusion of drugs with specific
      molecular actions into specific brain regions. This approach has revealed brain
      structures involved in different memory types and the main neurotransmitter
      systems and sequence of metabolic cascades that participate in memory
      consolidation. Biochemical studies and, in several cases, studies of genetically
      manipulated animals, in which receptors or enzymes affected by the various drugs
      were absent or overexpressed, have complemented the pharmacological research.
      Although most studies have concentrated on the involvement of the hippocampus,
      many have also investigated the entorhinal cortex, other regions of the cortex,
      and the amygdala. Behavioural pharmacology has been of crucial importance in
      establishing the major neurohumoral and hormonal systems involved in the
      modulation of memory formation. These systems act on specific steps of memory
      formation in the hippocampus and in the entorhinal, parietal, and cingulate
      cortex. A specialized system mediated by the basolateral amygdaloid nucleus, and
      involving several neuromodulatory systems, is activated by emotional arousal and
      serves to regulate memory formation in other brain regions. The core mechanisms
      involved in the formation of explicit (declarative) memory are in many respects
      similar to those of long-term potentiation (LTP), particularly in the
      hippocampus. However, there are also important differences between memory
      formation and LTP. Memory formation involves numerous modulatory influences, the
      co-participation of various brain regions other than the hippocampus, and some
      properties that are specific to memory and absent in LTP (i.e. flexibility of
      response). We discuss the implications of these similarities and differences for
      understanding the neural bases of memory.

PMID- 11198126
TI  - Differential effects of 5-HT agonists and antagonists on the repeated acquisition
      and performance of response sequences in monkeys.
AB  - As a means of characterizing the role of 5-HT1A and 5-HT2A receptors in learning,
      5-hydroxytryptamine (5-HT) agonists and antagonists with selective affinities for
      each receptor subtype (i.e. 8-hydroxy-dipropylaminotetralin (8-OH-DPAT), (-)-4
      (dipropylamino)-1,3,4,5-tetrahydrobenz-(c,d,)indole-6-carboxamide (LY228729), (+/
      )-1-(4-iodo-2,5-dimeth-oxyphenyl)-2-aminopropane hydrochloride (DOI), 4-iodo-N-[2
      [4-(methoxyphenyl)-1-piperazinyl] ethyl]-N-2-pyridinyl-benzamide hydrochloride
      (p-MPPI), N-[2- [4- (2-methoxyphenyl)-1-piperazinyl] ethyl] -N-2-pyridinyl
      cyclohexanecarboxamide maleate (WAY-100635), 1-(2-methoxyphenyl)-4-[4-(2
      phthalimido)butyllpiperazine hydrobromide (NAN-190) and ritanserin) were
      administered to monkeys responding under a multiple schedule of repeated
      acquisition and performance. In addition, a selective 5-HT1A receptor agonist (8
      OH-DPAT) was administered in combination with a 5-HT2A receptor antagonist
      (ritanserin) to examine any potential interactions between the two 5-HT receptor
      subtypes. When administered alone, 8-OH-DPAT (0.1-3.2mg/kg), LY228729 (0.32-3.2
      mg/kg) and DOI (0.018-3.2 mg/kg) dose-dependently decreased overall response rate
      in both schedule components, and generally increased the percentage of errors in
      the acquisition components at doses lower than those that increased the
      percentage of errors in the performance components. At the doses of each drug
      tested (i.e. 0.1 or 0.32 mg/kg), both p-MPPI and WAY-100635 antagonized the
      disruptive effects of 8-OH-DPAT, by shifting the dose-effect curves for overall
      response rate and the percentage of errors to the right. In contrast, ritanserin
      (0.32 or 1mg/kg) had little or no effect on the disruptions produced by 8-OH
      DPAT, but it effectively antagonized the rate-decreasing and error-increasing
      effects produced by the 5-HT2A agonist DOI. Administration of the 5-HT1A
      antagonists WAY-100635 and NAN-190 alone produced dose-dependent rate-decreasing
      effects, but the effects on accuracy of responding in the acquisition components
      differed from those of the 5-HT1A agonists (8-OH-DPAT and LY228729), in that they
      did not produce an increase in the percentage of errors. Together, these results
      suggest that 5-HT is capable of disrupting learning in monkeys through actions at
      both the 5-HT1A and 5-HT2A receptors, and that 5-HT2A receptor antagonism does
      not unilaterally modify the effects produced by 5-HTA1A receptor activation.

PMID- 11198127
TI  - A comparison of fixed and variable doses of cocaine in producing and augmenting
      tolerance to its effects on schedule-controlled behavior.
AB  - Twelve pigeons were trained to peck a key under a fixed-ratio 20-response
      schedule of food presentation. Acute effects of cocaine (03-10.0 mg/kg),
      determined by administering the drug once per week, revealed dose-dependent
      decreases in frequency of key pecking. The pigeons were then divided into six
      pairs, matched with respect to acute dose-response curves. One of each pair
      received one of five different doses before each daily session (variable-dosing
      condition) and the other received a fixed dose equal to the arithmetic average of
      the doses experienced by its pair mate (fixed-dosing condition). Following 50
      days of exposure, subjects in the variable-dosing condition were then switched to
      the fixed-dosing condition. Dose-response functions were then determined in both
      groups by substituting doses for the fixed daily dose, once per week. Rate
      decreasing effects were attenuated similarly in both groups of subjects, both at
      the end of the variable-dosing regimen and during subsequent fixed dosing. Next,
      an attempt was made to increase the degree of tolerance. Specifically, pigeons in
      the variable-dosing condition were exposed repeatedly to a range of doses in
      which the largest dose was 1/8 to 1/4 log unit larger than in the original
      variable-dosing phase. Pigeons in the fixed-dosing group were exposed daily to
      the largest dose that did not eliminate key pecking by the end of the initial
      repeated-dosing regimen. Dose effects were determined after at least 35 days of
      exposure. If the dose-response function had shifted to the right, the largest
      dose for the variable-dosing subjects was increased by 1/8 to 1/4 log unit and
      the smallest dose in the sequence was eliminated, and another period of variable
      dosing commenced. For the fixed-dosing subjects, if the curve had shifted to the
      right, the fixed dose was increased by 1/8 to 1/4 log unit and the process
      repeated. Only very modest shifts of the dose-response function to the right were
      observed, and in several cases curves shifted left after exposure to larger
      doses. Overall the results suggest that a variable-dosing regimen holds promise
      as a technique for investigating the development of tolerance to the effects of
      cocaine, and that the magnitude of tolerance cannot be increased to any great
      degree by increasing the dose or doses repeatedly experienced. Additionally, it
      appears that experience with relatively large doses of cocaine may limit the
      degree to which tolerance can be developed, or decrease the magnitude of
      tolerance previously observed.

PMID- 11198128
TI  - Effects of MAO inhibitors upon MPTP mice chronically treated with suprathreshold
      doses of L-dopa.
AB  - Groups of mice were administered either saline or 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP) (2 X 40 mg / kg, s.c., separated by a 24-hour interval)
      4-6 weeks prior to behavioural testing. At testing, all the MPTP-injected mice
      were repeatedly administered L-dopa (20 mg / kg, s.c., five times each week,
      Monday-Friday), by applying a procedure that induced a severe reduction of motor
      activity parameters from Day 1 to Day 25. Control (uninjected mice) received only
      saline and were retained only for neurochemical analysis. In each of three
      experiments, following the reduction of the activity-stimulating effects of L
      dopa by repeated administration, a restorative effect of different monoamine
      oxidase (MAO) inhibitors was tested by co-administration of the test compounds
      (irreversible MAO-B inhibitor, reversible MAO-A inhibitors, or irreversible MAO-A
      / mixed MAO inhibitors) with L-dopa (20 mg / kg). In each case the MAO inhibitor
      was injected 60 min prior to L-dopa. L-Deprenyl (3 or 10 mg / kg, s.c.), in
      combination with L-dopa, reinstated locomotion and total activity, but not
      rearing, dose-dependently, in L-dopa-tolerant mice. The reversible MAO-A
      inhibitors, amiflamine and alpha-ethyltryptamine, in combination with L-dopa,
      reinstated locomotion and total activity, leaving rearing unaffected; Ro 41-1049
      (3 mg / kg, s.c.) restored all three parameters of activity; locomotor activity
      was restored by all three doses (1, 3, and 10 mg / kg, s.c.). On the other hand,
      neither the irreversible MAO-A inhibitor, clorgyline, nor the mixed MAO
      inhibitor, phenelzine, produced any directly effective restorative increments.
      Neurochemical analysis confirmed the severe striatal dopamine depletion of MPTP
      treated mice. These results demonstrate a synergistic and restorative action of
      combining certain MAO inhibitors, namely the reversible MAO-A inhibitors, with
      the suprathreshold dose of L-dopa in MPTP-treated, L-dopa-tolerant mice.

PMID- 11198129
TI  - Place aversion induced by blockade of mu or activation of kappa opioid receptors
      in the dorsal periaqueductal gray matter.
AB  - Neural circuits in the dorsal periaqueductal grey matter (DPAG) play an important
      role in the integration of defensive behaviour. As considerable numbers of mu and
      kappa opioid receptors have been found in this region, we studied the effects of
      morphine, [3H]-[H-D-Phe-Cys-Tyr- D-Trp-Orn-Thr-Pen-Thr-NH2] (CTOP), a selective
      peptide antagonist for mu opioid receptors, U-50488H, a specific agonist for
      kappa opioid receptors, and nor-binaltorphimine (nor-BNI), a long-lasting
      selective antagonist for kappa opioid receptors, injected into the DPAG of rats
      submitted to the corral method, a conditioned place preference test. The
      behavioural testing apparatus was a circular open field consisting of four
      uniform quadrants that were equally preferred by the rats prior to drug
      treatments. For conditioning, rats received drug injections on three consecutive
      days and were placed into their assigned quadrant. Injection of 40 nmol of
      morphine into the DPAG produced place aversion effects, with reduced time spent
      in the drug-paired quadrant on the testing day. These place aversion effects were
      not inhibited by previous DPAG microinjection of CTOP (1 nmol) but were
      significantly reduced by prior systemic injections of nor-BNI (2 mg / kg).
      Microinjection of CTOP alone produced a clear decrease in the time spent in the
      treatment quadrant, whereas nor-BNI alone did not. Similarly, microinjection into
      the DPAG of the kappa agonist U-50488H (10 nmol) mimicked the effects of
      morphine, also producing place aversion for the drug-paired quadrant. These
      findings suggest that blockade of mu opioid receptors or activation of kappa
      opioid receptors in the DPAG may produce conditioned place aversion.

PMID- 11198130
TI  - Ethanol-induced conditioned place aversion in mice.
AB  - Previous studies have shown that ethanol produces conditioned place preference
      (CPP) in mice when injections are given immediately before exposure to the
      conditioned stimulus (CS). Paradoxically, however, injection of ethanol
      immediately after the CS produces conditioned place aversion (CPA). Four
      experiments were conducted to characterize the parametric boundaries of CPA
      produced by post-CS ethanol exposure. Experiment 1 showed that CPA is positively
      related to ethanol dose, with significant CPA at 2 and 4 g / kg, but not at 1 g /
      kg. Experiment 2 revealed an inverse relationship between CPA and trial duration,
      i.e. significant CPA occurred when the trial duration was 5, 15 or 30 min, but
      not when it was 60 or 90 min. Experiment 3 indicated that ethanol pre-exposure
      (eight daily injections) significantly reduced subsequent development of CPA.
      Finally, experiment 4 showed that repeated exposure to the CS alone (six 30 min
      exposures to each CS) after CS-ethanol pairings produced complete extinction of
      CPA. The same extinction procedure also completely eliminated CPP induced by pre
      CS injections of ethanol. Overall, these studies demonstrate that CPA induced by
      post-CS ethanol injection is influenced by many of the same variables that affect
      CPP produced by pre-CS ethanol injection in mice. However, these findings do not
      resolve the issue of whether the 'before-versus-after' effect in ethanol place
      conditioning is better explained by assuming ethanol produces only rewarding
      effects or by assuming that ethanol produces both rewarding and aversive effects.

PMID- 11198131
TI  - Influence of training history on ethanol discrimination in rats.
AB  - The compound stimulus hypothesis of ethanol discrimination predicts that a
      history of training to discriminate drugs that mimic individual elements of the
      ethanol stimulus should attenuate stimulus control by other stimulus elements
      (associative blocking). Rats were trained initially to discriminate either
      chlordiazepoxide (5 mg / kg s.c., n = 10) or dizocilpine (0.08 mg / kg i.p., n =
      10) from vehicle in two-lever procedures with food reinforcers presented on a
      tandem variable-interval fixed ratio schedule. Control rats received 'sham
      training' (vehicle injections only, n = 9). All subjects were then trained to
      discriminate ethanol (1.5 g / kg intragastrically (i.g.)) until discrimination
      accuracy reached 95%. Chlordiazepoxide (1.25-10.0 mg / kg s.c.) produced more
      drug-appropriate responding in rats with a previous history of training to
      discriminate chlordiazepoxide than in either of the other two groups, but
      stimulus control by dizocilpine was not attenuated. Equivalent results were
      obtained in rats with a previous history of training to discriminate dizocilpine.
      Ethanol (0.375-3.0 g / kg i.g.) produced similar dose-related increases in drug
      appropriate responding in all three groups. Thus, previous discrimination
      training modified the characteristics of ethanol discrimination in a way that may
      be explained by persistence of the original discriminations. The lack of evidence
      for associative blocking contrasts with results of previous experiments on the
      discrimination of compound stimuli produced by administering drug mixtures. The
      findings provide limited support for the hypothesis that ethanol produces a
      compound stimulus that includes elements of positive modulation of gamma
      aminobutyric acid (GABA(A)) receptors and of N-methyl-D-aspartate (NMDA)
      antagonism.

PMID- 11198132
TI  - Nicotine enhances acquisition of a T-maze visual discrimination: assessment of
      individual differences.
AB  - In the present report, rats' performance was assessed in five tasks designed to
      measure behavioral response to different novel stimuli under different
      experimental situations. Daily nicotine treatment (0, 0.3 or 1.0 mg / kg) began
      after the conclusion of the behavioral tasks and continued throughout the
      experiment. Training of a T-maze visual discrimination task commenced after 11
      days of nicotine pretreatment. As a group, rats treated with the higher dose of
      nicotine (1.0 mg / kg) made fewer errors to acquire the initial T-maze
      discrimination than saline-treated controls. Activity induced by an inescapable
      novel environment (i.e. first behavioral screen) was positively correlated with
      the number of errors to acquire the initial discrimination in the T-maze for the
      two nicotine-treated groups (0.3 and 1.0 mg / kg). To examine this positive
      correlation further, a median split analysis was conducted on the novelty-induced
      activity for each group. Nicotine, especially the high dose (1.0 mg / kg),
      enhanced performance in rats that were less active in the inescapable novel
      environment. Nicotine treatment did not affect the performance of rats that were
      more active in that environment. After the initial visual discrimination was
      acquired, the reverse discrimination was trained. Nicotine treatment did not
      affect performance; the number of errors to acquire the reversal for nicotine-
      and saline-treated rats did not differ. Overall a nicotine-induced improvement in
      performance is demonstrated which can be predicted by a rat's reactivity to
      environmental novelty.

PMID- 11198133
TI  - Moving out of the laboratory: does nicotine improve everyday attention?
AB  - The most robust demonstrations of the nicotine-related performance effects on
      human cognitive processes are seen in tasks that measure attention. If nicotine
      does have some potential for enhancing attention, the obvious question to ask is
      whether the effects demonstrated in the laboratory hold any significance for real
      life performance. This paper describes three studies that compare the effects in
      smokers of a single own brand cigarette on laboratory tests of attention and on
      everyday analogues of these laboratory tasks. In the laboratory measures of
      sustained attention and in the everyday analogue, performance advantages were
      registered in the smoking condition. These benefits were observed in smokers who
      abstained for a self-determined period of not less than 2 h. The studies were
      unable to replicate previous research reporting positive effects of smoking on a
      laboratory task of selective attention, the Stroop task. Small but significant
      improvements in performance were registered in the everyday analogues, which
      involved sustaining attention in a dual task situation, a telephone directory
      search task and a map search task. In addition, smokers showed a significant
      colour-naming decrement for smoking-related stimuli in the Stroop task. This
      attentional bias towards smoking-related words occurred independent of whether
      they had abstained or recently smoked an own brand cigarette. The effect is
      discussed in terms of the two-component model of processing bias for emotionally
      valenced stimuli.

PMID- 11198134
TI  - D-Cycloserine, a positive modulator of NMDA receptors, inhibits serotonergic
      function.
AB  - The administration of the N-methyl-D-aspartate (NMDA)-associated glycine
      recognition site agonist D-cycloserine (DCS) to rats inhibited the head shakes
      and the forepaw treading induced by the serotonin (5HT) precursor, L-5-hydroxy
      tryptophan [(-)5HTP], as well as the forepaw treading and motility elicited by
      the selective 5HT1A receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8
      OH-DPAT). The head shakes typically induced by the 5HT2 receptor agonist, 1-(2,5
      dimethoxy-4-iodophenyl)-2-aminopropane HCl (DOI), were unaffected by DCS
      pretreatment. The results are consistent with reduced serotonergic transmission
      produced by NMDA activation, as suggested by other authors. Due to the important
      role played in the pathogenesis of schizophrenia by glutamate
      deficiency/serotonin activation, the results support the view that positive
      modulators of NMDA receptors, activating glutamate receptors and reducing
      serotonergic tone, might be useful in the alleviation of psychotic symptoms.
      However, because of its partial agonist properties at the glycine recognition
      site, D-cycloserine shows some effects that might make it unsuitable for clinical
      use.

PMID- 11198135
TI  - Serotonin, noradrenaline and cognitive function: a preliminary investigation of
      the acute pharmacodynamic effects of a serotonin versus a serotonin and
      noradrenaline reuptake inhibitor.
AB  - Comparisons of the behavioural side-effect profiles of antidepressants that
      inhibit either serotonin or both serotonin and noradrenaline reuptake, may reveal
      differences in cognitive and psychomotor functions, which may be attributed to
      their relative pharmacological selectivity for potentiating monoamine
      neurotransmission in the central nervous system. The aim of the present study was
      to determine the acute pharmacodynamic effects of citalopram and venlafaxine, on
      cognitive and psychomotor performance. Nine healthy male volunteers received a
      single clinical dose of citalopram, venlafaxine or amitriptyline (positive
      control) in a double-blind placebo-controlled design. Cognitive and psychomotor
      tests and a subjective measure of sedation were examined before and 1, 2 and 4
      hours after drug administration. Citalopram improved psychomotor responses to
      sensory stimuli and sustained attention, with significant decreases in movement
      times of the choice reaction time test and an increase in critical flicker fusion
      threshold. Venlafaxine did not affect performances on any of the cognitive or
      psychomotor tests examined. Differences may be related to relative potencies of
      the compounds for monoamine reuptake inhibition.

PMID- 11198136
TI  - Neurotrophic keratitis.

PMID- 11198137
TI  - Treatable forms of retinitis pigmentosa associated with systemic neurological
      disorders.
AB  - In this chapter; we have described the role of nutritional supplements or
      selective dietary restriction (or both) on the maintenance and function of the
      retina and nervous system in some diseases. Oral vitamin A therapy has proven to
      be effective in the treatment of the common forms of retinitis pigmentosa. Bassen
      Kornzweig disease can be treated with vitamin A and vitamin E and, in some cases,
      with vitamin K. Vitamin E therapy for Friedreich-like ataxia associated with
      retinitis pigmentosa has been shown to be effective in the short term. Classic
      Refsum's disease responds to a low phytol-low phytanic acid diet. Undoubtedly,
      future research will bring more insight into the biochemical pathways responsible
      for other diseases and, it is hoped, aid in developing treatments for additional
      retinal degenerations associated with systemic neurological disease.

PMID- 11198138
TI  - Apoptosis, neuroprotection, and retinal ganglion cell death: an overview.

PMID- 11198139
TI  - Causes of enlarged corneal nerves.

PMID- 11198140
TI  - Retinal manifestations of morning glory disc syndrome.

PMID- 11198141
TI  - Nonglaucomatous cupping of the optic disc.
AB  - Optic disc cupping is a consequence of myriad disorders. The anatomy and
      vasculature of the disc provide great insight into why, how, and when ODC occurs
      in various conditions. Approaches to distinguish glaucomatous from
      nonglaucomatous causes of ODC should rely on patient history, visual fields
      assessment, and funduscopic findings, as described. Cupping can be seen with
      neurological processes, including benign tumors, that are treatable. The
      clinician must remain vigilant to detect uncommon but potentially threatening
      forms of nonglaucomatous optic disc cupping.

PMID- 11198142
TI  - Temporal arteritis.

PMID- 11198143
TI  - Cortical visual impairment in infants and children.

PMID- 11198144
TI  - Magnetic resonance imaging of primary anterior visual pathway tumors.

PMID- 11198145
TI  - Ocular findings in neurofibromatosis type 1.

PMID- 11198146
TI  - Uveitis with neurological manifestations.
AB  - Neurological symptoms are not rare in patients with various uveitic syndromes,
      and they can be used as a guide to diagnosis. Some of the findings are
      nonspecific, but others can be typical of certain pathological conditions
      (table). After combining the information obtained in the medical history with the
      physical examination, target-oriented laboratory and diagnostic tests may then be
      obtained to confirm a diagnosis. Neurological manifestations can be of great
      value throughout this process and clearly should be carefully evaluated in every
      patient with uveitis.

PMID- 11198147
TI  - Maculopathies that resemble optic neuropathies.
AB  - This chapter outlines some diseases in which diagnosis of retinal pathology can
      prove difficult and often mislead one to think of optic nerve disease. Clinicians
      should consider these entities when atypical features or unexplained visual loss
      occurs. A careful medical history, review of systems, and the appropriate use of
      ancillary studies (as outlined) can provide insights helpful in making the
      correct diagnosis.

PMID- 11198148
TI  - Leber's congenital amaurosis and RPE65.

PMID- 11198149
TI  - Neuroretinitis.
AB  - Despite the growing list of agents that can present as neuroretinitis, nearly one
      half remain idiopathic. However, many of the candidate etiologies are treatable
      conditions, and accurate diagnosis can result in visual rehabilitation. A
      complete workup in patients presenting with acute neuroretinitis should include a
      thorough history and general medical evaluation. Exposure history should be
      thoroughly explored, including recent travel, unpasteurized and uncooked foods,
      sexual experience, and animal contacts. A detailed physical examination should be
      performed to note hidden rashes and inoculation sites and should include routine
      measurements of blood pressure and heart rate. Laboratory tests should be
      tailored to the history and may include complete blood count; erythrocyte
      sedimentation rate; bacterial, fungal, and viral blood cultures; antinuclear
      antibody test; angiotensin-converting enzyme; anti-double-stranded DNA; and C3.
      Serological evaluation should look for syphilis, Lyme disease, histoplasmosis,
      brucellosis, chlamydia, HIV, toxoplasmosis, Epstein-Barr virus, viral hepatitis B
      and C, and tuberculin skin test. Neuroretinitis is a clinical entity in which
      there is inflammation of the retinal architecture and optic nerve. There are
      numerous entities that can cause a picture of neuroretinitis ranging from
      vascular to infectious to autoimmune. With regards to the infectious etiologies,
      it is interesting to note that many of these organisms are obligate intracellular
      pathogens. The microorganisms B. henselae, T. gondii, R. typhi, T. pallidum,
      Mycobacterium tuberculosis, Histoplasma capsulatum, and various viruses, such as
      HIV, mumps, and HSV, are known intracellular agents. Other major infectious
      agents, such as B. burgdorferi and Leptospirosis spp. are known to remain
      sequestered within the circulatory system. It is possible that in this way these
      agents are able to breach the delicate blood-brain barrier. The implication of
      such findings on the treatment and management of neuroretinitis remains to be
      explored. Interestingly, the vast majority of infected patients do not develop
      neuroretinitis or demonstrate CNS involvement. Detailed examination of this
      variability may provide further insight into the pathogenic properties of these
      infectious agents, host tissue susceptibility, and mechanisms of blood-retina
      barrier integrity. A detailed retinal examination can provide an unobstructed
      view of the CNS. Careful inspection of this delicate interface may reveal subtle
      findings critical for accurate and rapid diagnosis of underlying systemic
      pathology. The varied visual and neurological symptoms of neuroretinitis attest
      to the fact that this is a disease of both the retina and contiguous neuronal
      elements. Such involvement significantly elevates the risk to the patient and
      emphasizes the need for early detection and prompt treatment.

PMID- 11198150
TI  - Influence of chronic ethanol consumption on the muscarinic cholinergic control of
      rat pancreatic acinar cells.
AB  - There are a number of hypothetical explanations for the actions of ethanol on the
      exocrine pancreas; among them, the cholinergic hypothesis has received special
      attention. According to this hypothesis, chronic alcohol consumption induces
      alterations in the control of exocrine pancreatic function resulting in
      cholinergic hyperstimulation of pancreatic acinar cells and their muscarinic
      receptors. Our aim was to investigate the cholinergic control of pancreatic
      enzyme secretion and the number and affinity of muscarinic receptors in the
      pancreatic acinar cells of rats subjected to chronic ethanol ingestion. We also
      investigated whether a high-fibre diet modifies the actions of ethanol on these
      aspects of the exocrine pancreatic function. Four groups of rats received either
      a standard or a high fibre diet, and either water or 20% (v/v) ethanol. After 6
      months of treatment, isolated pancreatic acini were used for the determination of
      carbachol-stimulated amylase secretion and for the analysis of muscarinic
      receptors, using 1-[N-methyl-3H]scopolamine as a radioligand. Neither chronic
      ethanol intake nor a high fibre diet caused any apparent alteration in pancreatic
      histology, neither did them modify plasmatic amylase levels. Chronic
      alcoholization resulted in a significant increase in the amylase released from
      pancreatic acini in response to carbachol stimulation, but it did not affect
      either the number or the affinity of pancreatic acinar muscarinic receptors. The
      actions of ethanol are not significantly modified by the simultaneous consumption
      of a high fibre diet.

PMID- 11198151
TI  - Self-design of fish diets by means of self-feeders: validation of procedures.
AB  - In this paper, we show the results from four different experiments in which sea
      bass, maintained under laboratory conditions, could choose between two or three
      different diets through self-feeders, which gradually increased the complexity
      and potential range of selection, to design their own diet in accordance with
      their requirements. At first, sea bass were allowed to select between two
      complete diets differing in the proportion of protein (52-58%): this showed their
      capacity to distinguish between two diets made of the same ingredients. Next, two
      incomplete diets, containing a fixed amount of protein (56%) and lacking either
      fat or carbohydrate, were made available. Three mixed diets made up of pairs of
      macronutrients (protein-carbohydrate, protein-fat or fat-carbohydrate) were
      tested in the next experiment and, finally, three diets containing only one
      macronutrient (protein fat or carbohydrate) were made available to fish. Taking
      into account selection made by the fish in the first three experiments, in which
      macronutrient selection was statistically different, protein was the main
      macronutrient chosen by fish (278.15 kJ/kgBW/day, on average), followed by fat
      and carbohydrate (162.85 and 64.56 kJ/kgBW/day, respectively). In conclusion, the
      results reveal the ability of sea bass to select an appropriate diet from
      experimental diets containing two or three macronutrients and suggest that the
      proposed methodology is a powerful tool for studying the differing nutritional
      needs of different species of fish.

PMID- 11198152
TI  - Effects of chronic insulin treatment on blood pressure in rats.
AB  - There is an evident epidemiological association between plasma insulin levels and
      blood pressure. The mechanism that relates insulin to blood pressure and the role
      of insulin in the pathogenesis of arterial hypertension have not been clearly
      defined. The present study was designed to examine the effects of chronic
      hyperinsulinism on blood pressure and to determine different related
      morphological variables. WistarKyoto rats were subcutaneously injected with
      insulin (25 UI/Kg of weight) daily during the eight weeks of the experiment. Data
      were collected on systolic and diastolic arterial pressures and heart rate by
      plethysmography and direct recording (in the last week), and on morphological
      variables. A statistically significant elevation of systolic arterial pressure
      was produced after the sixth week of hyperinsulinaemia. At the end of the
      treatment, the systolic arterial pressure was 173.7 +/- 26.1 in the
      hyperinsulinaemic rats versus 153.09 +/- 21.7 in the control group. The values
      obtained by direct recording and by plethysmography did not differ. These results
      indicate that chronic hyperinsulinism produces a significant elevation in
      systolic blood pressure levels in the rats studied.

PMID- 11198153
TI  - Effects of antioxidants on calcium signal induced by cholecystokinin in mouse
      pancreatic acinar cells.
AB  - Digital imaging fluorescence microscopy was used to study the effect of two
      antioxidants, N-acetyl-cysteine (NAC) and glutathione, on the cytosolic free
      calcium concentration ([Ca2+]i) induced by cholecystokinin-octapeptide (CCK-8) of
      mouse pancreatic acinar cells. When acinar cells were preincubated with either
      NAC or glutathione, subsequent stimulation with CCK-8 in the presence of each
      antioxidant had no significant effect on the typical pattern of [Ca2+]i transient
      evoked by the gastrointestinal hormone. However, application of NAC to acinar
      cells pretreated for 60 min with the same antioxidant, strongly blocked the
      oscillatory pattern initiated by CCK-8, inhibiting both amplitude and frequency
      of calcium oscillations. By contrast, glutathione had no effect on the
      oscillatory pattern evoked by CCK-8. The present results allow us to speculate
      that during [Ca2+]i oscillation there is a production of oxidants that facilitate
      oscillations by enhancing release of calcium from internal stores.

PMID- 11198154
TI  - Role of prostanoids and nitric oxide inhibition in rats with experimental hepatic
      fibrosis.
AB  - Nitric oxide (NO) and prostaglandins have been proposed as vasodilator substances
      involved in peripheral vasodilatation characteristic of the liver cirrhosis. A
      link between NO and prostanoids has been suggested. The present study
      investigated the effect of simultaneous blockade of both, NO synthase (NOS) and
      cyclooxigenase (COX) in sham-operated (SO), or rats with bile-duct ligation (BDL)
      in the development of liver fibrosis. Animals were distributed in two groups SO
      (n=15) or BDL (n=15). Treatments (5 days) started three weeks after surgical
      procedure. Both, SO and BDL animals were treated with indomethacin (INDO) (5
      mg/kg/day) alone, with NG-nitro-L-arginine-methyl-ester (NAME) (4 mg/kg/day)
      alone or with INDO and NAME combination at the same doses. At the end of follow
      up body weight, packed cell volume, mean arterial blood pressure (MAP) and heart
      rate were measured. Liver tissue was processed for histological studies. In this
      study, BDL animals showed a decreased MAP. Treatment with L-NAME in BDL rats
      increased MAP. The chronic COX inhibition alone did not play an important role in
      the haemodynamic changes. The BDL produced a loss of hepatic structure, with
      ductular metaplasia that occupied the greater part of the hepatic parenchyma.
      Also, an important degree of fibrosis was observed. Both NO and PG synthesis
      inhibitors, alone or in combination, induced enhancing collagen fiber deposition
      in the hepatic parenchyma. These findings support the notion that the interaction
      between the NOS and COX pathways should be relevant in hepatic cirrhosis in which
      both NOS and COX are induced.

PMID- 11198155
TI  - Role of S-adenosylmethionine on the hepatobiliary homeostasis of glutathione
      during cyclosporine A treatment.
AB  - The effects of cyclosporine A (CyA) treatment on the hepatic content and biliary
      output of reduced (GSH) and oxidized (GSSG) glutathione and lipid peroxidation in
      the liver, and the ability of S-adenosylmethionine (SAMe) to antagonize the CyA
      induced alterations were studied in male Wistar rats. To evaluate the efficacy of
      SAMe, three CyA and SAMe protocols were used: cotreatment with SAMe plus CyA,
      pretreatment with SAMe before starting cotreatment, and post-treatment with SAMe
      after beginning treatment with CyA alone. CyA treatment for one and four weeks
      depleted liver GSH, decreased the GSH/GSSG ratio and significantly reduced GSH
      and GSSG biliary concentrations and secretion rates. Additionally, long-term
      treatment enhanced lipid peroxidation. By contrast, when the rats were treated
      with CyA plus SAMe using any of the administration protocols, SAMe was seen to be
      efficient in antagonizing the GSH hepatic depletion, the changes in hepatic
      GSH/GSSG ratio and the increase induced by CyA in lipid peroxidation.
      Furthermore, SAMe also abolished the effects of CyA on the biliary secretion
      rates of GSH and GSSG. The efficacy of SAMe was similar, regardless of the
      administration protocols used. In conclusion, our results clearly demonstrate
      that SAMe is good for preventing, antagonizing and reversing the CyA-induced
      alterations in the hepatobiliary homeostasis of glutathione.

PMID- 11198156
TI  - Influence of goat and cow milk on the digestive and metabolic utilization of
      calcium and iron.
AB  - The effects of goat and cow milk on the digestive and metabolic utilization of
      calcium and iron were studied in rats using a standard (non-milk) control diet.
      The digestive utilization of calcium is greater when the animals consume the goat
      milk-based diet rather than that based on cow milk or the standard diet. The
      digestive utilization of iron, however, is similar for the goat-milk diet and the
      standard diet, and in both cases superior to that based on cow milk. The calcium
      content in the femur, sternum and Longissimus dorsi muscle (L.D. muscle) provides
      an indication of what happens during the utilization of the mineral; more is
      deposited when the rats consume a milk-based diet, particularly one based on goat
      milk. The iron content in the reserve organs, namely the liver and the spleen, is
      greater with the standard diet and the goat milk diet than with that containing
      cow milk. There is an obviously beneficial effect of goat milk on the metabolism
      of calcium and iron, which minimizes any interaction between the two minerals.

PMID- 11198157
TI  - Patient-controlled analgesia with ketorolac in pediatric surgery.
AB  - Our aim was to quantify the analgesic efficiency of the patient-controlled
      analgesia technique (PCA), using ketorolac, in children aged 6-14 undergoing a
      surgical intervention. We carried out a double-blind test with two randomly
      selected groups: the PCA group comprising patients submitted to intravenous PCA,
      with "bolus on demand" and the Standard group, with conventional analgesia
      dispensed with ketorolac I.V. (0.5 mg/kg/6 hours). Evaluation of pain experienced
      was performed using the Hannallah behavioural scale and quantification of the
      summing of pain intensity. Analgesic efficiency was determined by the pain
      intensity difference (PID) score. Evaluation of pain experienced during hour 1
      reveals a marked reduction with time for each group; no inter-group differences
      were found. At hour 6 there were neither intra-group nor inter-group differences.
      The accumulated pain score revealed a significant reduction in hour 6, with no
      differences between the two groups. Evaluation of the analgesic effect revealed
      no differences, either intra-group or intergroup, during the experimental period.
      The sum of the PIDs revealed significant differences in the standard group
      between the values for hours 1 and 6. Under the experimental conditions
      described, both techniques were equally effective for pain treatment, but the
      efficiency was higher for the PCA group.

PMID- 11198158
TI  - Effect of magnesium deficiency on enterocyte Ca, Fe, Cu, Zn, Mn and Se content.
AB  - In previous studies based on indirect procedures, we reported that Mg deficit
      increased the bioavailability of a number of elements such as calcium, zinc,
      iron, copper, manganese and decreased selenium absorption. The present study was
      designed to verify these findings by direct methods. We investigated the effect
      of dietary magnesium deficiency on enterocyte Ca, Fe, Zn, Cu, Mn and Se
      concentrations. Male Wistar rats were fed a Mg-deficient diet (129 mg Mg/kg food)
      for 70 days. Whole enterocytes from the upper jejunum were isolated and Ca, Fe,
      Zn, Cu, Mn and Se were determined. The results were compared with findings in a
      control group that was pair-fed with an identical diet except that it covered
      this species's nutritional requirements for Mg (480 mg Mg/kg food). The Mg
      deficient diet significantly increased enterocyte content of Ca, Fe, Zn, Cu and
      Mn; however, we found no significant changes in the Se content of these cells.
      These data support the results obtained by indirect methods.

PMID- 11198159
TI  - Physiological responses of pre-ruminant kid goats and lambs to different
      environmental temperatures.
AB  - The purpose of this study was to establish the metabolic behaviour of both
      preruminant kid goats and lambs, when they are kept at different environmental
      temperatures (12, 24 and 30 degrees C). The animals were fed ad libitum with a
      milk replacer for the first two months of life. Blood samples were taken from all
      the animals on days 30, 40, 50 and 60 post partum, to determine serum levels of
      glucose, insulin, free fatty acids, triiodothyronine (T3) and thyroxine (T4),
      both when fasting and 4 hours after starting feeding. The high sensitivity of
      both kinds of animal to the lowest of the environmental temperatures used,
      particularly for the first periods of life here considered, was established from
      the glucose/insulin and T3/T4 molar ratios and from the concentrations of free
      fatty acids. The results obtained by species were also evidence of metabolic
      behaviour typical of leanner animals in kids.

PMID- 11198160
TI  - Production of healthier goat milk. Use of a concentrate supplemented with a
      "protected" fat rich in PUFA.
AB  - In order to obtain healthier goat milk as far as its fat composition is
      concerned, milk production and composition trials were carried out with Granadina
      goats kept in semi-extensive breeding conditions. The animals were feeding
      indoors with a concentrate supplemented or not with 7% of fat conveniently
      protected against the action of rumen, which had 35% of polyunsaturated fatty
      acids (PUFA). The amount of milk produced was higher (p < 0.05) with consumption
      of the fat supplemented concentrate. At the same time, and although there was no
      difference in the milk concentration of fat and protein nitrogen (p > 0.05), the
      corresponding yields were higher for consumption of the fat supplemented
      concentrate. As for the composition of milk fat, the use of the supplemented
      concentrate resulted in fat with a higher (p < 0.05) concentration of PUFA and a
      lower (p < 0.05) concentration of stearic acid. At the same time, the
      concentration of medium chain triglycerides, which is the specific nutritional
      value particular to goats' milk, was the same whichever concentrate was consumed.

PMID- 11198161
TI  - Influence of heat treatment of casein in presence of reducing sugars on Zn
      solubility and Zn uptake by Caco-2 cells after in vitro digestion.
AB  - The effect of the heat treatment of casein in presence of reducing sugars on some
      aspects of Zn availability was investigated. Samples were prepared by mixing
      casein with glucose-fructose, and were used unprocessed (C) or heated (HC).
      Changes in Zn speciation after the in vitro digestion of the samples, both as
      part of a diet and in isolation, were studied. The uptake of soluble Zn from the
      digested samples was investigated in Caco-2 cells. After in vitro digestion, the
      percentage of precipitated Zn was significantly higher with the HC sample, both
      when digested alone and as a part of the diet. In assays with Caco-2 cells, a
      significant decrease in Zn uptake was observed when the uptake buffer contained
      the sample C digest, by comparison with the control buffer, without casein
      digest. When the digested heated mixture was added, Zn uptake by the cells was
      significantly lower than in either of the two other cases. It may be concluded
      that the heat treatment of casein in the presence of glucose-fructose has a
      negative effect on Zn availability because, after in vitro digestion, Zn
      insolubilization was enhanced and Zn uptake by the enterocyte was impaired,
      compared with the unheated mixture. In addition, the usefulness of Caco-2 cells
      in this kind of research has been shown.

PMID- 11198162
TI  - Effects of folic acid and amino acids supplementation on zinc intestinal
      absorption in the progeny of ethanol-treated rats.
AB  - This study was designed to examine the effects of supplementation with folic acid
      and amino acids in dams that consumed ethanol during gestation and lactation to
      see whether there is an improvement in the intestinal absorption of zinc in pup
      rats on the 21st day after birth. The rats were randomized into two groups:
      Ethanol-rats (EG) were administered ethanol during the pregnancy and lactation
      periods; the ethanol-folic acid group (EFG) received a folic acid and amino acid
      supplement concomitantly with ethanol administration during pregnancy and
      lactation. The dams were mated to obtain the first offspring. Two sets of
      experiments were performed on the offspring at 21 days after birth. In general,
      in the first set, jejunal zinc absorption in the offspring of EG and EFG groups
      showed a gradual increase along with increased perfusion time at all assayed
      concentrations. Jejunal zinc absorption expressed as nmol/intestinal surface was
      higher in the ethanol-folic acid group than in ethanol animals at all assayed
      concentrations except at 25 microM concentration. In the second set of
      experiments, distal ileum zinc absorption in the offspring of ethanolfolic acid
      dams showed a significant increase at all concentrations tested. These results
      indicate that supplementation of folic acid and amino acids to dams that consume
      ethanol during gestation and lactation increase serum and milk zinc levels,
      although the zinc ingestion is lower. In pups of the supplemented dams, the
      jejunal and ileal absorption of zinc increased; as a consequence, the serum zinc
      levels increased. The activity of alcohol dehydrogenase, a metaloenzyme dependent
      on zinc levels, also increased.

PMID- 11198164
TI  - Protein nutrition in fish: protein/energy ratio and alternative protein sources
      to fish meal.
AB  - Those interested in the design and manufacture of feeds for intensive fish
      farming face the basic concern of formulating mixtures for the best yield at the
      lowest costs. Of the macronutrients in the feed, protein has and continues to
      receive special consideration because fish present high and specific needs for
      this constituent. Traditionally, protein has been supplied primarily by fish
      meals. This paper presents a synthesis of the efforts made and the lines explored
      to achieve an effective reduction of the amount of fish meal in the feeds for
      fish, following two strategies: reduction of the protein in the feeds and the use
      of new raw materials to replace fish meal.

PMID- 11198165
TI  - The role of phytic acid in legumes: antinutrient or beneficial function?
AB  - This review describes the present state of knowledge about phytic acid (phytate),
      which is often present in legume seeds. The antinutritional effects of phytic
      acid primarily relate to the strong chelating associated with its six reactive
      phosphate groups. Its ability to complex with proteins and particularly with
      minerals has been a subject of investigation from chemical and nutritional
      viewpoints. The hydrolysis of phytate into inositol and phosphates or phosphoric
      acid occurs as a result of phytase or nonenzymatic cleavage. Enzymes capable of
      hydrolysing phytates are widely distributed in micro-organisms, plants and
      animals. Phytases act in a stepwise manner to catalyse the hydrolysis of phytic
      acid. To reduce or eliminate the chelating ability of phytate, dephosphorylation
      of hexa- and penta-phosphate forms is essential since a high degree of
      phosphorylation is necessary to bind minerals. There are several methods of
      decreasing the inhibitory effect of phytic acid on mineral absorption (cooking,
      germination, fermentation, soaking, autolysis). Nevertheless, inositol
      hexaphosphate is receiving increased attention owing to its role in cancer
      prevention and/or therapy and its hypocholesterolaemic effect.

PMID- 11198163
TI  - Effect of psychogenic stress on gastrointestinal function.
AB  - This review summarizes the studies published over the last twenty years on the
      effects of psychogenic stress on gastrointestinal function, using animal models.
      The effects of stress on gastric ulceration have received wide attention and the
      central and local mechanisms of mucosal damage have been, for the most part,
      clearly delineated. In comparison, relatively few studies have focused on the
      impact of stress on intestinal and colonic physiology, even though its influence
      on intestinal motility, mucosal permeability and inflammation has been
      established. More work is necessary in this field, especially considering the
      importance of irritable bowel syndrome in modern society.

PMID- 11198166
TI  - Adaptation of the exocrine pancreas to dietary fats.
AB  - This article reviews studies on the adaptation of the exocrine pancreas to
      dietary fat. We include all the latest information about the mechanisms that
      underlie the adaptation of the secretory mechanism of the exocrine pancreas to
      the amount and the type of dietary fat. We review the kinetics of pancreatic
      adaptation and the mediators of the adaptive response of the pancreas including
      cellular and molecular mechanisms (modulation of intracellular messengers and
      gene expression of the different enzymes and secretagogues involved in the
      adaptation process). At the same time we include our results in this field in
      dogs and humans.

PMID- 11198167
TI  - Potential of two epigeic and two anecic earthworm species in vermicomposting of
      water hyacinth.
AB  - The potential of two epigeic species (Eudrilus eugeniae Kinberg, and Perionyx
      excavatus Perrier) and two anecic species (Lampito mauritii Kinberg and Drawida
      willsi Michaelson) of earthworms was assessed in terms of efficiency and
      sustainability of vermicomposting water hyacinth (Eichhornia crassipes, Mart.
      Solm.). In different vermireactors, each run in duplicate with one of the four
      species of earthworms, and 75 g of 6:1 water hyacinth:cowdung as feed, vermicasts
      were produced with steadily increasing output in all the reactors. E. eugeniae
      was by far the most efficient producer of vermicasts, followed by the other
      epigeic P. excavatus. The two anecics came next, with D. willsi being the least
      effective which could generate only about half the quantity of vermicasts
      achieved in a corresponding time by E. eugeniae. In all the reactors, the
      earthworms grew well, increasing their weights by more than 250%. The maximum net
      gain of weight (average 30.7 g) was by E. eugeniae, followed by P. excavatus, L.
      mauritii and D. willsi. This trend, which followed the efficiency of vermicast
      production, was also shown in terms of reproductive ability as measured by the
      number of offspring produced by the four species.

PMID- 11198168
TI  - A re-appraisal of wood-fired combustion.
AB  - Targets for a considerable increase in electricity generation from renewables
      have been set in order to reduce greenhouse gas emissions and fossil fuel
      dependence. Extensive planting of willow, poplar and alder as energy crops has
      been planned for power generation plants which use wood as the fuel. The current
      trend is to use gasification or pyrolysis technology, but alternatively a case
      may be made for wood combustion, if wood becomes readily available. A range of
      wood-fired circulating fluidised bed combustion (CFBC) plants, using from 10 to
      10,000 dry tonne equivalent (DTE)/day, was examined using the ECLIPSE process
      simulation package. Various factors, such as wood moisture content, harvest
      yield, afforestation level (AL) and discounted cash flow rate (DCF) were
      investigated to test their influence on the efficiency and the economics of the
      systems. Steam cycle conditions and wood moisture content were found to have the
      biggest effects on the system efficiencies; DCF and AL had the largest influences
      on the economics. Plants which could handle more than 500 dry tonnes/day could be
      economically viable; those using more than 1000 dry tonnes wood/day could be
      competitive with large-scale, conventional coal-fired plants, if sufficient wood
      were available.

PMID- 11198169
TI  - The role of HRT and low temperature on the acid-phase anaerobic digestion of
      municipal and industrial wastewaters.
AB  - Two identical 31 completely mixed reactors with solids recycling capabilities
      were used to investigate the effects of hydraulic retention time (HRT) and low
      temperatures on volatile fatty acid (VFA) production. One reactor was fed with a
      1:1 ratio of diluted primary sludge and a starch-rich industrial wastewater,
      while the other was fed with diluted primary sludge alone. The VFA and soluble
      COD concentrations and specific production rates reached their highest values at
      30 h HRT and at 25 degrees C. Further increase in HRT (at 25 degrees C) or
      decrease in temperature (at an HRT of 30 h) resulted in lower amounts of VFA and
      COD produced. All parameters related to VFA and COD production were significantly
      higher in the industrial-municipal reactor than in the municipal-only reactor.
      The VFA:COD ratios were very high, with values ranging from about 0.8 to 1.0
      indicating that hydrolysis was the rate-limiting step. Degradation of proteins
      (measured by ammonia production) was inhibited by the starch-rich wastewater in
      the industrial-municipal reactor, while no evidence of inhibition was found in
      the municipal-only reactor. This study revealed that VFA production was feasible
      at low temperatures (down to 8 degrees C), particularly in the presence of the
      industrial waste. Ultimately, the amount VFA produced was adequate, in most
      cases, to support subsequent biological nutrient removal (BNR) processes.

PMID- 11198170
TI  - Soil biochemical activity and growth response of rice Oryza sativa in flyash
      amended soil.
AB  - Soil amended with different proportions of flyash, a solid waste generated from
      coal-fired thermal power plants, was evaluated as a soil conditioner and nutrient
      supplement during a field study on the growth of rice, Oryza sativa. Generally,
      pH and organic carbon (OC) content did not increase significantly (P > 0.05) in
      flyash amended soil, but significant increases (P < 0.05) in soil conductivity
      (32%), available phosphorus (48%) and organic matter (OM, 29%) were observed
      during harvest at the 20 t ha-1 flyash application rate. Amylase, invertase,
      dehydrogenase and protease activities, and CO2 evolution increased in flyash
      amended soil over the control. The pigment (chl-a, chl-b, and carotenoid) content
      in rice plants did not vary significantly (P > 0.05) between different flyash
      amendments. Total plants biomass and aboveground biomass increased (P < 0.05)
      significantly (17% and 25%, respectively) at the 20 t ha-1 flyash application.
      However, there was a retarded growth of underground biomass. Grain and straw
      yield increased by 21% and 18%, respectively, at 17.5 t ha-1 flyash amendment
      when compared to the control. Although, a significant increase (P < 0.05) in
      plant biomass and grain yield in flyash amended soil is encouraging from the
      point of waste disposal and management, elucidation of reasons for retarded
      growth in underground biomass will require additional research based on long-term
      studies.

PMID- 11198171
TI  - Enzyme assisted ensiling of alfalfa with enzymes by solid substrate fermentation.
AB  - A crude enzyme preparation, obtained by solid substrate fermentation (SSF) with a
      Gliocladium spp. and added at the 5% level to wilted or non-wilted alfalfa,
      improved the fermentation characteristics and stability of alfalfa silages as
      effectively as commercial preparations, Novo-Nordisk Celluclast 1.5 L and
      Viscozyme 120 L, applied at the 0.025% level. The effective dose of the crude
      enzyme costs about one-fourth of the cost of the commercial enzymes.

PMID- 11198172
TI  - The influence of aeration and hemicellulosic sugars on xylitol production by
      Candida tropicalis.
AB  - The influence of other hemicellulosic sugars (arabinose, galactose, mannose and
      glucose), oxygen limitation, and initial xylose concentration on the fermentation
      of xylose to xylitol was investigated using experimental design methodology.
      Oxygen limitation and initial xylose concentration had considerable influences on
      xylitol production by Canadida tropicalis ATCC 96745. Under semiaerobic
      conditions, the maximum xylitol yield was 0.62 g/g substrate, while under aerobic
      conditions, the maximum volumetric productivity was 0.90 g/l h. In the presence
      of glucose, xylose utilization was strongly repressed and sequential sugar
      utilization was observed. Ethanol produced from the glucose caused 50% reduction
      in xylitol yield when its concentration exceeded 30 g/l. When complex synthetic
      hemicellulosic sugars were fermented, glucose was initially consumed followed by
      a simultaneous uptake of the other sugars. The maximum xylitol yield (0.84 g/g)
      and volumetric productivity (0.49 g/l h) were obtained for substrates containing
      high arabinose and low glucose and mannose contents.

PMID- 11198174
TI  - Influence of substrate wood-chip particle size on shiitake (Lentinula edodes)
      yield.
AB  - Wood chips from four commercial hardwood sawmills were screened with 10 US
      standard sieves (4-0.21 mm) to assess particle size distributions. 96-98% of wood
      chips were < 4 mm while 95-99% of particles were > 0.21 mm. The majority (mean =
      64.5%) of wood chips passed through US standard sieve size 14 (< 1.4 mm).
      Shiitake (Lentinula edodes) was grown in three crops to determine the effect of
      four particle size classes (1 = 2.8-4 mm; 2 = 1.7-2.8 mm; 3 = 0.85-1.7 mm; 4 = <
      0.85 mm) on mushroom yield. Yields from substrates prepared with wood chips from
      class 4 (< 0.85 mm) were lower by 27.7%, 12.4% and 2% (mean = 14.9%) for Crops I,
      II, and III, respectively, when compared to controls. Profiling of wood chips may
      help growers optimize their production media and reduce production costs.

PMID- 11198173
TI  - Reclamation of a burned forest soil with municipal waste compost: macronutrient
      dynamic and improved vegetation cover recovery.
AB  - The reclamation of burned soils in Mediterranean environments is of paramount
      importance in order to increase the levels of soil protection and minimise
      erosion and soil loss. The changes produced in the content of total organic
      carbon (TOC), N (Kjeldahl) and available P, K, Ca and Mg by the addition of
      different doses of a municipal solid waste compost to a burned soil were
      evaluated during one year. The effect of organic amendment on the improvement in
      the vegetation cover after one year was also evaluated. The organic amendment,
      particularly at a high dose, increased the TOC and N-Kjeldahl content of the soil
      in a closely related way. The levels of available K in soil were also enhanced by
      the organic amendment. Although the effects on all three parameters tended to
      decrease with time, their values in the amended soils were higher than in the
      control soil, which clearly indicates the improvement in the chemical quality of
      the soil brought about by the organic amendment. The available P content did not
      seem to be influenced by organic treatment, while available Mg levels were higher
      than in the control during the first 4 months following organic amendment. The
      application of compost to the burned soil improved its fertility and favoured
      rapid vegetal recovery, thus minimising the risk of soil erosion.

PMID- 11198175
TI  - Effects of pig manure and wheat straw on growth of mung bean seedlings grown in
      aluminium toxicity soil.
AB  - Crop production in red soil areas may be limited by Al toxicity. A possible
      alternative to ameliorate Al toxicity is the application of such organic manure
      as crop straw and animal manure. A pot experiment was conducted to investigate
      the effects of organic materials on the alleviation of Al toxicity in acid red
      soil. Ground wheat straw, pig manure or CaCO3 were mixed with the soil and
      incubated, at 85% of water holding capacity and 25 degrees C, for 8 weeks. After
      the incubation, 14 seedlings of mung bean (Phaseolus aures Roxb) were allowed to
      grow for 12 days. Results showed that application of organic material or CaCO3
      increased soil pH and decreased soil monomeric inorganic Al concentrations.
      Growth of mung bean seedling was improved sustantially by the application of
      organic material or CaCO3. Pig manure or wheat straw was more effective in
      ameliorating Al toxicity than was CaCO3. Mung bean plants receiving pig manure or
      wheat straw contained relatively high concentrations of P, Ca and K in their
      leaves. It is suggested that the beneficial effect of organic manure on mung bean
      is likely due to decreasing concentrations of monomeric inorganic Al
      concentrations in soil solution and improvement of mineral nutrition.

PMID- 11198176
TI  - Enhanced biodegradation of cyclotetramethylenetetranitramine (HMX) under mixed
      electron-acceptor condition.
AB  - The biodegradation of cyclotetramethylenetetranitramine, commonly known as 'high
      melting explosive' (HMX), under various electron-acceptor conditions was
      investigated using enrichment cultures developed from the anaerobic digester
      sludge of Thibodaux sewage treatment plant. The results indicated that the HMX
      was biodegraded under sulfate reducing, nitrate reducing, fermenting,
      methanogenic, and mixed electron accepting conditions. However, the rates of
      degradation varied among the various conditions studied. The fastest removal of
      HMX (from 22 ppm on day 0 to < 0.05 ppm on day 11) was observed under mixed
      electron-acceptor conditions, followed in order by sulfate reducing, fermenting,
      methanogenic, and nitrate reducing conditions. Under aerobic conditions, HMX was
      not biodegraded, which indicated that HMX degradation takes place under anaerobic
      conditions via reduction. HMX was converted to methanol and chloroform under
      mixed electron-acceptor conditions. This study showed evidence for HMX
      degradation under anaerobic conditions in a mixed microbial population system
      similar to any contaminated field sites, where a heterogeneous population exists.

PMID- 11198177
TI  - Biodegradation of phenol in a continuous process: comparative study of stirred
      tank and fluidized-bed bioreactors.
AB  - The paper presents the main results obtained from the study of the biodegradation
      process of phenol by a pure culture of Pseudomonas putida ATCC 17484. The
      experimental work was carried out in two different systems: a stirred tank where
      cells grew as a suspended culture and a fluidized bed where cells were
      immobilized within calcium alginate gel beads. The influence of the hydraulic
      residence time (HRT) and organic loading rate on the removal efficiency of phenol
      was determined for both bioreactors. Also, the stability of the fluidized-bed
      bioreactor (FBB) in terms of its ability to withstand sudden phenol overdoses is
      also reported. Experimental values indicated that both bioreactors showed high
      phenol degradation efficiencies, higher than 90%, even for a phenol loading rate
      in the influent as high as 4 g phenol/l day. The FBB showed better performance
      than the suspended-culture bioreactor due to its better control and because it
      could operate with lower HRT.

PMID- 11198178
TI  - Utilization of brewer's yeast cells for the production of food-grade yeast
      extract. Part 1: Effects of different enzymatic treatments on solid and protein
      recovery and flavor characteristics.
AB  - Yeast extract was produced from brewer's yeast of a beer factory by combined
      enzymatic treatments using endoprotease, exoprotease, 5'-phosphodiesterase, and
      adenosine monophosphate (AMP)-deaminase. Effects of enzyme combination, enzyme
      dosages and treatment sequence on the recovery of solid and protein, flavor and
      compositional characteristics were investigated. Exoprotease dosage strongly
      affected the recovery of protein and degree of hydrolysis (DH) and sensory
      characteristics. When the yeast cells were treated using optimal combination of
      endoprotease and exoprotease (0.6% Protamex and 0.6% Flavourzyme), high solid
      recovery (48.3-53.1%) and the best flavor profile were obtained. Among various
      treatment sequences using multiple enzymes, treatment with protease followed by
      nuclease resulted in the highest 5'-guanosine monophosphate (5'-GMP) content. The
      optimal concentrations of both 5'-phosphodiesterase and AMP-deaminase were found
      to be 0.03%. After treatments using optimal combination of enzyme, enzyme dosages
      and treatment sequence for four enzymes, a high solid yield of 55.1% and 5'
      nucleotides content of 3.67% were obtained.

PMID- 11198179
TI  - Influence of thermal treatment on sequential extraction and leaching behaviour of
      trace metals in a contaminated sewage sludge.
AB  - The losses of weight and organic matter of a sludge caused by thermal treatments
      at 180 degrees C, 300 degrees C and 400 degrees C were determined in order to
      assess how the possibilities of sludge use were influenced. The sludge heated at
      180 degrees C lost small amounts of weight and organic matter (9.8%) but the
      losses from the two other treatments were large enough (92.2% and 99.9% in
      organic matter) to preclude the use of the sludges as organic amendments. The
      concentration and potential lability and leachability of Cr, Cu, Fe, Mn, Ni, Pb
      and Zn in the native sludge and in the thermal-treated sludge samples were
      studied by means of a five-step chemical fractionation method and a column
      experiment. As a consequence of heating, the trace metals were more strongly
      fixed in the treated sludges, as could be seen by the decrease with temperature
      of the ratio between the sum of the first two sequential-extracted fractions and
      the residual fraction. The leaching results showed that, for the native sludge,
      the quantities of studied metals leached were larger than for the sludge heated
      to 180 degrees C. The order of leachability of metals was the same in both cases,
      and the same equation could be used to calculate the quantities of metals
      leached. The amounts of metals leached correlated significantly with the first
      extracted fraction (exchangeable metals) and an equation could be used to
      calculate the quantities leached, as a function of that fraction.

PMID- 11198180
TI  - Physico-chemical properties and productivity of a Nigerian Typic-Haplustult
      amended with fresh and burnt rice-mill wastes.
AB  - In order to arrest the declining productivity of the soils in the Abakaliki agro
      ecological zone of S.E. Nigeria, four levels (12.5, 25.0, 37.5 and 50.0 Mg ha-1)
      of fresh (FW) and burnt (BW) rice-mill wastes abundant in the area, and a mixture
      of the waste + NPK and NPK alone were added to the soil (Typic-Haplustult) to
      evaluate their immediate and residual effects on the productivity of the soil
      using maize (Zea mays L.) as a test crop. Results showed a significant reduction
      in bulk density as well as improvements in total porosity and water stable
      aggregates (WSA > 0.5 mm) at levels > 12.5 Mg ha-1 of the FW amendments. Although
      both amendments failed to improve the soil pH, significant improvements in soil
      C, N and BS were obtained at 37.5 Mg ha-1 and above in both amendments. The
      highest relative increase (TF) of 135.1% and 102.8% in C and N in the first
      season and 94.4% and 99.3% in the second season were obtained in the FW at 50.0
      Mg ha-1. The highest maize grain yields of 2.74 and 2.66 Mg ha-1 were obtained in
      the waste + NPK mixtures (FW/BW + NPK) in the first season. The residual yield
      was highest (1.45 Mg ha-1) in the FW amendment at 50.0 Mg ha-1. The results
      showed that regular and properly planned applications of these wastes can sustain
      the productivity of soils in this region.

PMID- 11198181
TI  - Insecticidal properties of volatile extracts of orange peels.
AB  - Statistical studies using the randomised complete block design with four
      replicates showed that volatile extracts of two species of orange peel--Citrus
      sinensis (sweet orange) and Citrus aurantifolia (lime) had insecticidal activity
      against mosquito, cockroach and housefly. Insecticidal activity was better after
      60 min than at 30 min spraying of rooms. Volatile extracts of C. sinensis showed
      greater insecticidal potency, while the cockroach was the most susceptible to the
      orange peels among the three insects studied.

PMID- 11198182
TI  - Co-composting of sugarbeet vinasse: influence of the organic matter nature of the
      bulking agents used.
AB  - Two composts were obtained by co-composting of a concentrated depotassified beet
      vinasse and two agricultural solid residues with different organic matter nature:
      grape marc (GM; lignin waste) and cotton gin trash (C; cellulosic waste).
      Composting was carried out in aerated piles with mechanical turning, in
      controlled conditions during 4 months. After 71 days of composting, a new
      addition of vinasse similar to the initial addition was made. Changes in
      temperature, pH and inorganic nitrogen followed a similar path for both mixtures.
      However, organic matter fractions showed different behaviour depending on the
      material co-composted with vinasse. Lower organic matter degradation was observed
      when GM was used as bulking agent due to its high lignin content. No
      phytotoxicity was detected in the end products. The chemical and physical
      properties of both vinasse composts suggest their possible use as fertiliser.

PMID- 11198183
TI  - Bioaugmentation and treatment of cephalexin drug-based pharmaceutical effluent in
      an upflow anaerobic fluidized bed system.
AB  - Cephalexin is a constituent of the cephalosporin group used for the treatment of
      bronchitis and other heart diseases due to its enhanced oral activity. The
      effluent from these industries contains a disintegrated form of the drug
      contributing high chemical oxygen demand (COD), volatile solids and organic
      solvent. A laboratory-scale study was conducted to evaluate the efficiency of a
      fluidized bed reactor operated under anaerobic condition with bioaugmentation to
      treat the cephalexin containing pharmaceutical factory effluent. The main
      objective of the study was to show that bioaugmentation could be used to promote
      biological treatment to applications where conventional operation might be
      difficult or unfavourable. The effluent, with COD of 12,000-15,000 mg/l, was
      diluted and studied in single and multiple inoculation experiments with hydraulic
      retention times of 3-12 h. The removal efficiency after inoculation from an
      anaerobic sequencing batch reactor was related to influent concentration, mass of
      inoculum and hydraulic retention time characterized by calculating the initial
      food to microorganism ratio. Continuous COD removal efficiency attained a maximum
      value of 88.5% using bioaugmentation through periodic addition of acclimated
      cells every 2 days with 30-73.2 g of cells from an off-line enricher-reactor.

PMID- 11198184
TI  - gamma-Linolenic acid production by solid-state fermentation of Mucorales strains
      on cereals.
AB  - Oleaginous fungi of the genus Mucorales were screened for gamma-linolenic acid
      (GLA) production on solid substrates containing moistened cereals. Cunninghamella
      elegans CCF 1318 produced the highest yields of GLA when cultivated on barley.
      Substrate moisture and cultivation temperature proved critical for effective GLA
      production. Vegetable oil supplied to the cultures improved GLA production.
      Rotating bottles and plastic bags were used as cultivation vessels to reproduce
      the conditions found in rotating drums and tray bioreactors, respectively. After
      11 days of cultivation at 21 degrees C, C. elegans produced 14.2 mg of GLA per
      gram of dry substrate, composed of a mixture of barley, spent malt grains (SMG)
      and peanut oil. GLA represented 15.6% of the total fatty acids in the lipid
      extract.

PMID- 11198185
TI  - Repellent activity of Ferronia elephantum Corr. (Rutaceae) leaf extract against
      Aedes aegypti (L.).
AB  - The repellent activity of a methanol extract of Ferronia elephantum leaves
      against Aedes aegypti was studied in the laboratory. The percentage protection in
      relation to the dose method was used. The repellent activity at 1.0 and 2.5
      mg/cm2 concentrations gave 100% protection up to 2.14 +/- 0.16 h and 4.00 +/-
      0.24 h, respectively. The total percentage protection of Ferronia elephantum was
      45.8% at 1.0 mg/cm2 and 59.0% at 2.5 mg/cm2 for 10 h.

PMID- 11198186
TI  - Application of the RealAudio package to computerized medical lectures.
AB  - We created a multimedia system to computerize past lectures using RealAudio
      software. Physicians, medical researchers and students can browse the contents of
      lecture slides and handouts with synchronous audio using the Internet. The
      audience can easily review the most interesting parts of lectures and medical
      students can listen to complete medical lectures from remote sites with narration
      and slide depiction, whenever convenient. We have created three multimedia
      programs; the memorial lecture of a professor's retirement, a new method of hand
      washing for surgical procedures and a lecture on medical informatics. The cost of
      this system and the results of the evaluation by medical students are described.
      The ease of using this application makes it a potentially valuable tool for
      clinicians and researchers.

PMID- 11198187
TI  - GASTON: an architecture for the acquisition and execution of clinical guideline
      application tasks.
AB  - Recently, studies have shown the benefits of using clinical guidelines in the
      practice of medicine. There have been numerous efforts to develop clinical
      decision support systems that support guideline-based care in an automated
      fashion, covering a wide range of clinical settings and tasks. Despite these
      efforts, only a few systems progressed beyond the prototype stage and the
      research laboratory. For guideline-based clinical decision support systems to be
      successful, a balance must be made between intuitive but imprecise
      representations usually encountered by most of today's systems and
      representations that support a strong underlying clinical performance model. The
      project described in this paper tries to achieve such a balance. It presents the
      GASTON architecture that contains a set of reusable software components for the
      application of guidelines, including design-time components to facilitate the
      guideline authoring process based on guideline representation models along with
      execution-time components for building decision support systems that incorporate
      these guidelines. This architecture was used to develop several guideline
      representation models such as a rule-based representation to model rule-based
      guidelines and guideline representation models that address more complex tasks.
      Also, decision support systems that incorporate these models were developed with
      the architecture. For the representation and application of various classes of
      guidelines, rules were also viewed as instances of more complex tasks. By
      identifying similar characteristics of sets of rules, we developed several tasks
      such as a drug intera ction and drug contraindication task. Based on these
      models, we have developed and validated guidelines and decision support systems
      for use in several application domains such as intensive care, family physicians
      and psychiatry. In order to be able to represent more complex time-oriented
      plans, new guideline representation models are being developed.

PMID- 11198188
TI  - Development of an Internet Security Policy for health care establishments.
AB  - The Internet provides unprecedented opportunities for interaction and data
      sharing among health care providers, patients and researchers. However, the
      advantages provided by the Internet come with a significantly greater element of
      risk to the confidentiality and integrity of information. This paper defines the
      basic security requirements that must be addressed in order to use the Internet
      to safely transmit patient and/or other sensitive Health Care information. It
      describes a suitable Internet Security Policy for Health Care Establishments and
      provides the set of technical measures that are needed for its implementation.
      The proposed security policy and technical approaches have been based on an
      extensive study of the related recommendations from the security and standard
      groups both in EU amid USA and our related work and experience. The results have
      been utilized in the framework of the Intranet Health Clinic project, where the
      use of the Internet for the transmission of sensitive Health Care information is
      of vital importance.

PMID- 11198189
TI  - MASTOS: Mammography Simulation Tool for design Optimization Studies.
AB  - Mammography is a high quality imaging technique for the detection of breast
      lesions, which requires dedicated equipment and optimum operation. The design
      parameters of a mammography unit have to be decided and evaluated before the
      construction of such a high cost of apparatus. The optimum operational parameters
      also must be defined well before the real breast examination. MASTOS is a
      software package, based on Monte Carlo methods, that is designed to be used as a
      simulation tool in mammography. The input consists of the parameters that have to
      be specified when using a mammography unit, and also the parameters specifying
      the shape and composition of the breast phantom. In addition, the input may
      specify parameters needed in the design of a new mammographic apparatus. The main
      output of the simulation is a mammographic image and calculations of various
      factors that describe the image quality. The Monte Carlo simulation code is PC
      based and is driven by an outer shell of a graphical user interface. The entire
      software package is a simulation tool for mammography and can be applied in basic
      research and/or in training in the fields of medical physics and biomedical
      engineering as well as in the performance evaluation of new designs of
      mammography units and in the determination of optimum standards for the
      operational parameters of a mammography unit.

PMID- 11198190
TI  - Molecular organization of excitatory chemical synapses in the mammalian brain.
AB  - Chemical synapses are highly specialized cell-cell junctions designed for
      efficient signaling between nerve cells. Distinct cytoskeletal matrices are
      assembled at either side of the synaptic junction. The presynaptic cytomatrix at
      the active zone (CAZ) defines and organizes the site of neurotransmitter release
      from presynaptic nerve terminals. The postsynaptic density (PSD) tethers
      neurotransmitter receptors and the postsynaptic signal transduction machinery.
      Recent progress in the identification and characterization of novel CAZ and PSD
      components has revealed new insights into the molecular organization and assembly
      mechanisms of the synaptic neurotransmission apparatus. On the presynaptic side,
      Bassoon and Piccolo, two related giant proteins, are crucially involved in
      scaffolding the CAZ. On the postsynaptic side, two families of multidomain
      adaptor proteins, the MAGuKs (membrane-associated guanylate kinase homologs) and
      the ProSAP (proline-rich synapse-associated protein, also termed Shank) family
      members are thought to be major organizing molecules of the PSD.

PMID- 11198191
TI  - The Sun's normal modes of oscillation.

PMID- 11198192
TI  - Three dimensional path integration in the house mouse (Mus domestica).
AB  - Previous studies have explored two-dimensional path integration in rodents by
      recording responses to passive rotation on a horizontal plane. This study adds
      the element of passive rotation in a vertical plane, necessitating the mouse to
      integrate positional information from three dimensions. Mice were trained to
      climb a wire mesh joining two horizontal planes. The whole arena was rotated 90
      degrees while the mouse was vertically oriented as it moved between planes.
      Rotation was conducted both clockwise and counter-clockwise, controls being
      provided by rotation of the arena while the mouse was in its nest-box. All 16
      mice tested altered their direction of travel subsequent to rotation in the
      vertical plane, compensating with a change in their path on the following
      horizontal plane.

PMID- 11198193
TI  - Involvement of opioid peptides in the regulation of reproduction in the prawn
      Penaeus indicus.
AB  - The possible involvement of an endogenous opioid system in the regulation of
      ovarian development in the prawn Penaeus indicus was investigated. Injection of
      leucine-enkephalin significantly increased the ovarian index and oocyte diameter
      in a dose-dependent manner. In contrast, injection of methionine-enkephalin
      significantly decreased the ovarian index and oocyte diameters. These results
      provide evidence to support the hypothesis that an opioid system is involved in
      the regulation of reproduction in crustaceans.

PMID- 11198194
TI  - Enzymatic activation of lignin leads to an unexpected copolymerization with
      carbohydrates.

PMID- 11198195
TI  - A new type of infrared organ in the Australian "fire-beetle" Merimna atrata
      (Coleoptera: Buprestidae).
AB  - The Australian buprestid beetle Merimna atrata (Coleoptera: Buprestidae)
      approaches forest fires because its larvae develop in freshly burnt wood. So far
      nothing is known about possible sensory systems enabling the beetles to detect
      fires and to cope with the thermal environment close to the flames. We found that
      M. atrata has two pairs of infrared (IR) organs on the ventrolateral sides of the
      abdomen. Each IR organ consists of a specialized IR-absorbing area which is
      innervated by one thermosensitive multipolar neuron. The primary dendritic
      branches ramify into more than 800 closely packed terminal endings which contain
      a large number of mitochondria. We called the special morphology of the dendritic
      region a terminal dendritic mass. The type of IR receptor found in M. atrata is
      unique in insects and can best be compared with the IR organs of boid snakes.

PMID- 11198196
TI  - Non-discriminatory incorporation of L-phenylalanine and L-tyrosine into cinnamoyl
      part of mulberroside A, a stilbene di-glucoside, in Morus alba cell cultures.

PMID- 11198197
TI  - Agro-predation: usurpation of attine fungus gardens by Megalomyrmex ants.
AB  - A new ant species of Megalomyrmex conducts mass raids to usurp gardens of the
      fungus-growing ant Cyphomyrmex longiscapus, then lives in the gardens and
      consumes the cultivated fungus. Unlike attine ants, however, Megalomyrmex sp.
      does not forage for substrate to manure the gardens; therefore, when gardens
      become depleted, Megalomyrmex sp. must locate and usurp new gardens. Megalomyrmex
      sp. workers feed their larvae with attine brood, but only after removing the
      fungal mycelium that covers the attine larval integument, suggesting that this
      fungal coat may provide partial protection against other predators. Unlike other
      known Megalomyrmex species, which coexist as social parasites in attine colonies,
      Megalomyrmex sp. expels its attine hosts during the garden raids. Megalomyrmex
      sp. thus maintains a unique agro-predatory lifestyle that is described here for
      the first time.

PMID- 11198198
TI  - Low chitinase activity in Acacia myrmecophytes: a potential trade-off between
      biotic and chemical defences?
AB  - We determined chitinase activity in leaves of four myrmecophytic and four non
      myrmecophytic leguminous species at the plants' natural growing sites in Mexico.
      Myrmecophytic plants (or 'ant plants') have obligate mutualisms with ants
      protecting them against herbivores and pathogenic fungi. Plant chitinases can be
      considered a reliable measure of plant resistance to pathogenic fungi. The
      myrmecophytic Acacia species, which were colonised by mutualistic ants, exhibited
      at least six-fold lower levels of chitinase activity compared with the non
      myrmecophytic Acacia farnesiana and three other non-myrmecophytes. Though
      belonging to different phylogenetic groups, the myrmecophytic Acacia species
      formed one distinct group in the data set, which was clearly separated from the
      non-myrmecophytic species. These findings allowed for comparison between two
      recent hypotheses that attempt to explain low chitinase activity in ant plants.
      Most probably, chitinases are reduced in myrmecophytic plant species because
      these are effectively defended indirectly due to their symbiosis with mutualistic
      ants.

PMID- 11198199
TI  - A molecular phylogenetic analysis of the neotropical dart-poison frog genus
      Phyllobates (Amphibia: Dendrobatidae).
AB  - A phylogenetic analysis of the Neotropical dart-poison frogs, genus Phyllobates,
      was performed based on mitochondrial cytochrome b sequences. Members of
      Phyllobates from South and Central America were found to form each an
      evolutionary lineage. Among the South American lineage, species with uniform
      dorsal coloration as adults form a derived monophyletic clade.

PMID- 11198200
TI  - Communal peeing: a new mode of flood control in ants.
AB  - The behavioral response of the obligate bamboo-nesting ant Cataulacus muticus to
      nest flooding was studied in a perhumid tropical rainforest in Malaysia and in
      the laboratory. The hollow internodes of giant bamboo, in which C. muticus
      exclusively nests, are prone to flooding by heavy rains. The ants showed a two
      graded response to flooding. During heavy rain workers block the nest entrances
      with their heads to reduce water influx. However, rainwater may still intrude
      into the nest chamber. The ants respond by drinking the water, leaving the nest
      and excreting water droplets on the outer stem surface. This cooperative 'peeing'
      behavior is a new survival mechanism adaptive to the ants' nesting ecology.
      Laboratory experiments conducted with two other Cataulacus species, C. catuvolcus
      colonizing small dead twigs and C. horridus inhabiting rotten wood, did not
      reveal any form of water-bailing behavior.

PMID- 11198201
TI  - Variation in the heritability and evolvability of human lifespan.
AB  - The heritability and evolvability of lifespan in two socioeconomically different
      groups of humans, including birth cohorts for 1600-1800s, were investigated.
      Among the aristocratic Europeans, the heritability estimates based on offspring
      mother regressions ranged from 0.46 to 0.89, while the estimates based on
      offspring-father regressions varied from 0.23 to 0.59. However, the rural Finns
      possessed either no inheritable component or a clearly lower level of
      heritability than did the aristocrats, the estimates ranging from 0 to 0.40,
      depending on the method used. The additive genetic coefficients of variation and
      standardized evolvabilities were high in the aristocrats, especially in the data
      set including all data instead of limiting the data to the older age group. Among
      rural Finns, the values were considerably lower.

PMID- 11198202
TI  - Correlation between MRI findings and long-term outcome in patients with severe
      brain trauma.
AB  - Our aim was to relate MRI findings in patients with severe traumatic brain injury
      (TBI) to clinical severity and long-term outcome. We studied 37 patients with
      severe TBI, who were submitted to clinical assessment for disability and
      cognition and to MRI 60-90 days after trauma. Clinical assessment was also
      performed 3, 6 and 12 months later. The number and volume of lesions in various
      cerebral structures were calculated semiautomatically from FLAIR and fast field
      echo images. Possible correlations between total and regional lesion volume and
      clinical deficits were then investigated. The frontal and temporal lobes were
      most frequently involved. Total lesion volume on FLAIR images correlated
      significantly with clinical outcome, whereas that on FFE images did not. Regional
      analysis showed that FLAIR lesion volume in the corpus callosum correlated
      significantly with scores on disability and cognition scales at the first
      clinical assessment. FLAIR lesion volume in the frontal lobes correlated
      significantly with clinical scores 1 year later.

PMID- 11198203
TI  - Poststenotic signal attenuation on 3D phase-contrast MR angiography: a useful
      finding in haemodynamically significant carotid artery stenosis.
AB  - We performed blinded visual evaluation of MR angiography (MRA) films in 44
      patients with unilateral carotid artery stenosis to determine whether a flow gap
      and poststenotic signal attenuation on 3D-PC MRA were useful signs of severe
      carotid artery stenosis. Although nine patients with a flow gap alone had various
      degrees of stenosis ranging from 22.2 to 77.3% without any decrease in regional
      cerebral blood flow (rCBF), 13 patients with both a flow gap and poststenotic
      signal attenuation had severe stenoses of 80% or more, with a definite decrease
      in baseline rCBF. The presence of both a flow gap and poststenotic signal
      attenuation on 3D-PC MRA appeared to be a reliable marker of severe carotid
      artery stenosis with a decrease in rCBF.

PMID- 11198204
TI  - Gadolinium-myelocisternography for cerebrospinal fluid rhinorrhoea.
AB  - Knowledge of the exact site of leakage of cerebrospinal fluid CSF leakage is
      important for planning surgery. We report our experience with myelocisternography
      with Gd-DTPA. We decided that intrathecal use of this contrast medium was
      justified in selected cases when other techniques have failed. After we had given
      detailed information to four patients with CSF leakage, they underwent five
      examinations. The images were interpreted by comparing those before and after
      injection. In all cases the contrast medium arrived at the basal cisterns, giving
      high contrast against adjacent structures. All patients tolerated the examination
      without complications or any indication of side effects.

PMID- 11198205
TI  - Cavernous dilatation of mesencephalic Virchow-Robin spaces with obstructive
      hydrocephalus.
AB  - We describe two patients with mild ventricular dilatation, shown to have cystic
      spaces in the midbrain, which we interpreted as greatly enlarged Virchow-Robin
      spaces. We discuss the pathophysiology and the possible relations to the mild
      hydrocephalus.

PMID- 11198206
TI  - Qualitative and quantitative volumetric evaluation of the efficacy of intravenous
      immunoglobulin in multiple sclerosis: preliminary report.
AB  - We conducted a double-blind, placebo-controlled study in 13 patients (aged 22 to
      54 years) with relapsing-remitting multiple sclerosis (MS). They were randomly
      assigned to receive a loading dose of immunoglobulin IgG, 0.4 g/kg body
      weight/day for 5 consecutive days, followed by single booster doses of 0.4
      g/kg/day, or placebo, once a month for 9 months. MRI was obtained before and
      during the 3rd and 6th months of treatment; examinations in the 9th and 12th
      months were planned. Qualitative and quantitative blinded assessments were
      performed. There were seven patients who received active treatment and six who
      received placebo. Statistical analysis was performed by the Wilcoxon test. A
      decrease in the size and number of lesions was observed on MRI in five patients
      (71%) in the treatment group, and in two (33%) of the placebo group at 3-month
      follow-up. At 6 months follow-up MRI, a decrease in the amount of lesions was
      observed in all patients treated with i.v. IgG, and in two (33%) of the placebo
      group; four patients (66%) receiving placebo showed an increase. Quantitative
      analysis showed a statistically significant decrease in the volume of lesions in
      treatment group at both 3 and 6 month follow-up. There was no statistically
      significant change in the placebo group.

PMID- 11198207
TI  - Idiopathic granulomatous hypophysitis: are there reliable, constant radiological
      and clinical diagnostic criterias?
AB  - Idiopathic granulomatous hypophysitis is a rare inflammatory disease of unknown
      aetiology; few cases are reported. We review the clinical presentation and
      radiological characteristics of these cases and our own experience with three new
      surgical cases, to determine diagnostic criteria. MRI of three cases revealed
      sellar lesions extending into the chiasmatic cistern. Their shape varied, from
      dumbbell to spherical and elliptical. All were isointense with the brain on T1
      weighted images and gave heterogeneously high signal on T2-weighted images.
      Contrast enhancement was homogeneous in one case and heterogeneous in another.
      The pituitary stalk could not be identified. There was no dural enhancement. The
      sphenoid sinus mucosa was thickened in two cases and normal in one.

PMID- 11198208
TI  - Reversible posterior leukoencephalopathy after combination chemotherapy.
AB  - We describe a young woman with Burkitt's lymphoma, treated with intravenous
      adriamycine and cyclophosphamide and intrathecal cytarabine. She developed a
      reversible posterior leukoencephalopathy syndrome (RPLS) with typical MRI
      findings. Diffusion-weighted images during the first days after the onset of
      symptoms predicted a small irreversible lesion in the frontal lobe, verified on
      T2-weighted images 1 month later. The patient showed full recovery after high
      dose steroid treatment.

PMID- 11198209
TI  - Transcranial colour Doppler sonography in emergency management of intracerebral
      haemorrhage caused by an arteriovenous malformation: case report.
AB  - We present a case which demonstrates the use of transcranial colour Doppler
      (TCCD) sonography in screening for an underlying arteriovenous malformation (AVM)
      in a middle-aged hypertensive patient with a spontaneous thalamic haematoma. The
      AVM was not detected on emergency CT but its presence, site and shape were
      demonstrated by TCCD, in the presence of a massive cerebral haemorrhage and acute
      intracranial hypertension.

PMID- 11198210
TI  - A case of ochronosis: MRI of the lumbar spine.
AB  - We present the MRI features of the lumbar spine in a patient with ochronosis.

PMID- 11198211
TI  - Perirolandic hypoperfusion on single-photon emission computed tomography in term
      infants with perinatal asphyxia: comparison with MRI and clinical findings.
AB  - We describe the findings on single-photon emission computed tomography (SPECT) in
      patients with perinatal asphyxia at term, with perirolandic cortico-subcortical
      changes on MRI, and to correlate them with clinical features. SPECT of 7 patients
      was obtained after injection of 185-370 MBq of Tc-99m-ECD (ethyl cysteinate
      dimer). The patients had spastic quadriplegia (7/7) with perinatal asphyxia (6/7)
      at term (7/7). The results were correlated with the MRI findings. Hypoperfusion
      of the perirolandic cortex was clearly seen on SPECT in all patients, even in two
      with subtle changes on MRI. SPECT demonstrated a more extensive area of
      involvement than MRI, notably in the cerebellum (in 4), the thalamus (in 7) and
      basal ganglia (in 5), where MRI failed to show any abnormalities.

PMID- 11198212
TI  - Subacute sclerosing panencephalitis: brain stem involvement in a peculiar
      pattern.
AB  - The most common pattern in subacute sclerosing panencephalitis, is in the
      cerebral hemisphere white matter on T2-weighted images with or without atrophy.
      Brain-stem lesions are rare. We report brain-stem involvement in two children
      with subacute sclerosing panencephalitis. A peculiar pattern, with involvement of
      the pons with extension to both middle cerebellar peduncles and substantia nigra
      but sparing the pontine tegmentum, is suggested.

PMID- 11198213
TI  - MRI of ranulas.
AB  - We reviewed the MRI of 20 patients with a ranula (8 simple and 12 plunging) and
      ten with other cystic masses in the floor of the mouth and/or suprahyoid portion
      of the neck (three haemangiomas, two neuromas, one monomorphic adenoma, one
      lipoma, two lateral cervical cysts and one dermoid cyst). Histological diagnoses
      were obtained in all cases with the exception of one presumed haemangioma.
      Ranulas were all well-defined, homogeneous masses giving low signal on T1- and
      markedly high signal on T2-weighted images. While simple ranulas were all
      confined to the sublingual space, plunging ranulas were centered on the
      submandibular space and tended to spill into one or more adjacent spaces. They
      extended into the sublingual space anteriorly (producing a so-called tail sign)
      in eight of 12 cases and into the parapharyngeal space superiorly in five.
      Although they sometimes filled a considerable part of the parapharyngeal space,
      displacement of surrounding muscles or vessels was usually slight, which was
      thought to reflect the nature of extravasation pseudocysts. All other cystic
      masses in our study had one or more MRI finding different from those of ranulas
      and could be easily differentiated from them.

PMID- 11198214
TI  - A thyroglossal duct cyst with calcification.
AB  - We report a thyroglossal duct cyst with calcification, the second case in the
      world literature. The ultrasound and CT findings are described and we highlight
      the differential diagnosis.

PMID- 11198215
TI  - Combined endovascular therapy of ruptured aneurysms and cerebral vasospasm.
AB  - We describe two patients with subarachnoid haemorrhage due to a ruptured
      intracranial aneurysm and severe symptomatic vasospasm. The aneurysm was occluded
      with detachable coils followed by intra-arterial infusion of papaverine to treat
      vasospasm as an one-stage procedure. There was significant resolution of the
      vasospasm. The long-term clinical outcome in one patient was excellent, the other
      still has minor deficits. Combined endovascular aneurysm therapy followed by
      intra-arterial spasmolysis with papaverine is a technically feasible therapeutic
      alternative in patients with symptomatic vasospasm.

PMID- 11198216
TI  - An unusual association of intracranial aneurysms and oesophageal duplication in a
      case of Klippel-Trenaunay syndrome.
AB  - The Klippel-Trenaunay syndrome (KTS) is a congenital disorder resulting from a
      mesodermal abnormality, characterised by cutaneous capillary haemangiomas,
      hypertrophy of bone and soft tissues and varicose veins. The presence of
      intracranial aneurysms has rarely been described, while oesophageal duplication
      has not been reported previously. We describe a patient with the KTS with both
      there additional abnormalities, which could be explained by a postulated mosaic
      gene abnormality.

PMID- 11198217
TI  - Chrysotile-induced cell transformation and transcriptional changes of c-myc
      oncogene in human embryo lung cells.
AB  - It has been verified that asbestos induce neoplastic transformation of several
      rodent cell lines in vitro. Very little information is available, however, on
      asbestos-induced human cell line transformation and oncogene activation in the
      development of asbestos-induced cell transformation. This study was designed to
      investigate the induction of cell transformation and transcriptional changes of
      the c-myc oncogene by chrysotile asbestos fibers (CAF) in human embryo lung (HEL)
      cells. Surface-modified CAF soaked in aluminium citrate (AC), rare earth
      compounds (REC) or sodium selenite (SS) solutions were used to observe the
      effects of surface modification on chrysotile-induced cell transformation and
      transcriptional changes in the c-myc oncogene. The results showed that the
      natural CAF caused dose-dependent increases in transformed foci, along with
      increased transcription of the c-myc oncogene in HEL cells, while the pretreated
      CAF induced fewer transformed foci and less c-myc oncogene transcription than the
      natural CAF. The percent inhibition of equivalent AC, REC and SS were 38.9%,
      50.0%, 33.3% (for transformation focus), 81.6%, 69.5%, 89.9% (for c-myc oncogene
      transcription), respectively. These results indicated that CAF may induce cell
      transformation and transcriptional changes and that the carcinogenicity of CAF
      might be reduced by pretreatment of CAF with the above-mentioned compounds.

PMID- 11198218
TI  - The effects on cell growth of tea polyphenols acting as a strong anti
      peroxidatant and an inhibitor of apoptosis in primary cultured rat skin cells.
AB  - Studies during the past few years have indicated an inhibitory effect of green
      tea or tea polyphenols on tumorigenesis in animal and even in human. The purpose
      of this study was to observe the possible effects of tea polyphenols on skin cell
      growth and on apoptosis in rat primary cultured keratinocytes and fibroblasts.
      The release of a cell plasma enzyme (LDH), lipid peroxidation products (MDA
      production), and GSH-Px (glutathione peroxidase) into the medium in cultured
      cells was determined after treatment with tea polyphenols in a primary culture of
      skin cells. The percentage of cells in each cell cycle phase and in apoptosis
      were assayed by flow cytometry (FCM). Tea polyphenols may have a beneficial
      effect on skin cells at concentrations from 0.05% to 0.1%, showing a dose
      dependent decrease in LDH, MDA (malondialdehyde) production, and a significant
      dose-dependent increase in GSH-Px and cell number. These effects were more
      obvious after exposure for 24 h than after 12 h. The results indicate that tea
      polyphenols may stabilize and protect the cell membrane against the release of
      cell plasma enzyme LDH, and its anti-peroxidation effect is also important for
      cell growth. FCM analysis revealed that treatment with 0.01% to 0.1% tea
      polyphenols decreased the percentage of cells in the G1/G0 (quiescent) phase from
      81.32% to 74.38%, and increased the percentage of cells in S and G2/M phase from
      9.87% to 15.26%, and from 6.51% to 10.36%, respectively. Tea polyphenols also
      increased the value of PI (proliferation index) from 18.17 to 25.62. At the same
      time it decreased the percentage of apoptosis from 27.10% to 17.97%, which
      indicates that green tea stimulates cell growth and inhibits the occurrence of
      apoptosis. Our results indicate that tea polyphenols are effective anti-oxidants
      and also inhibit apoptosis, which may improve the proliferative capacity of
      primary skin cells in vitro.

PMID- 11198219
TI  - Adaptive response of thymocyte apoptosis and cell cycle progression induced by
      low dose X-ray irradiation in mice.
AB  - The dose-effect of adaptive response of thymocyte apoptosis and cell cycle
      progression induced by whole-body X-ray irradiation (WBI) was studied in male
      Kunming mice. The inductive doses (D1) were 25, 50, 75, 100 or 200 mGy 6 h before
      the challenging doses (D2) of 1.0, 1.5 or 2.0 Gy. The changes in the percentages
      of the thymocyte apoptotic bodies (TAB) and the cells in different phases of cell
      cycle were measured with flow cytometry. The percentages of TAB decreased, the
      arrests of G1 and G2 + M phases diminished, and the cells of DNA synthesis of S
      phase increased when the D1 + D2 groups was compared with the D2 groups. When D1
      was 200 mGy, the adaptive response of thymocyte apoptosis and cell cycle
      progression were no longer induced by low dose radiation (LDR). In addition, the
      extracellular fluid from the splenocytes were cultured with Con A for 48 h in
      vitro 24 h after 75 mGy WBI was placed in the murine thymocyte suspension from
      mice irradiated with 2.0 Gy WBI and co-incubated. The thymocyte apoptosis
      decreased. Especially, noteworthy was that the percentages of TAB after the
      incubation for 72 h were significantly lower than those in 2.0 Gy irradiated
      thymocytes (P < 0.05). These results indicate that when the mice were irradiated
      with 25-100 mGy (D1, 12.5 mGy/min) 6 h before 1.0-2.0 Gy (D2, 0.287 Gy/min)
      exposure, an adaptive response of thymocyte apoptosis and cell cycle progression
      may be induced under the condition of WBI, and LDR (75 mGy) may change the
      microenvironment of immune cells and decrease the thymocyte apoptosis.

PMID- 11198220
TI  - The association of BMI and WHR on blood pressure levels and prevalence of
      hypertension in middle-aged and elderly people in rural China.
AB  - The purpose of this study was to examine the effects of BMI (Body Mass Index) and
      WHR (Waist Hip Ratio) on average blood pressure and the prevalence of
      hypertension in middle-aged and elderly population in rural China. A total of
      12955 subjects including 6276 males and 6688 females over 40 years of age were
      surveyed. Height, weight, waist circumference, hip circumference and blood
      pressure were measured. The association of BMI and WHR on average blood pressure
      levels and prevalence of hypertension were analyzed by dividing BMI and WHR into
      tertiles. The average blood pressure levels and the prevalence of hypertension in
      males and females increased significantly with the increase of BMI or WHR (P <
      0.01), as well as with the increase of both of them (P < 0.01). The average blood
      pressure and the prevalence of hypertension stopped increasing when WHR was > or
      = 0.76, suggesting that WHR > or = 0.80 could be used as a cut-off value for the
      prediction of hypertension risk for both males and females. Therefore
      hypertension could be effectively prevented and controlled by controlling BMI and
      WHR.

PMID- 11198221
TI  - Comparative assay of Hepatitis B and C virus infection markers by different assay
      kits.
AB  - In order to compare sensitivity of EIA and RIA assay kits for hepatitis B and C
      virus (HBV and HCV, respectively) infection markers, 100 serum samples in total
      were collected form 50 adult women each in urban and rural areas in northeast
      China. The number of positive cases to the three infection markers on HBV (i.e.,
      HBsAg+, anti-HBs+, and anti-HBc+) and the one on HCV (anti-HCV+) were examined in
      two laboratories, i.e., in Laboratory A with EIA kits produced in China and in
      Laboratory B with RIA kits. HCV infection positivity (anti-HCV+) was examined by
      EIA kits in both laboratories, but from different sources in and outside of
      China, respectively. The assay in Laboratory A gave 2 HBsAg+ cases out of the 100
      cases examined, whereas there were 9 positive cases in Laboratory B. In contrast,
      19 cases were positive to anti-HCV when examined in Laboratory A, and there were
      3 cases in Laboratory B. Thus, the kits used in Laboratory A gave fewer HBsAg+
      and more anti-HCV+ cases than the kits used in Laboratory B. The prevalence of
      anti-HBs+ or anti-HBc+ and cases did not differ when assayed in the two
      laboratories with EIA and RIA kits, respectively. The agreement of positive and
      negative findings between the two sets of testing were 93%, 93%, 93%, 86% and 82%
      for HBsAg, anti-HBs, anti-HBc, HBV (i.e., either positive to anyone of the three
      markers or negative to all three markers), and anti-HCV, respectively. The
      implication of the observation on epidemiology on HBV and HCV infection
      prevalence was discussed.

PMID- 11198222
TI  - Chelation in metal intoxication. XLIV: Efficacy of alpha-mercapto-beta-(5
      substituted, 2-furyl) acrylic acids in mobilizing intracellularly bound cadmium
      in rat.
AB  - The efficacy of alpha-mercapto-beta-(2-furyl) acrylic acid (MFA), alpha-mercapto
      beta-(5-sodiumsulfonate, 2-furyl) acrylic acid (MSFA) and alpha-mercapto-beta-(5
      acetoxymethyl, 2-furyl) acrylic acid (MAFA) to mobilize intracellularly bound
      cadmium in liver and kidney was investigated in rats pre-exposed to cadmium. MFA
      was effective in reducing cadmium levels of hepatic and renal supernatant
      cytosolic fraction (SCF) while MSFA and MAFA were effective in lowering cadmium
      levels of renal SCF and hepatic SCF respectively. All the chelating agents also
      enhanced the excretion of cadmium more in feces than in urine. However,
      substitution on the furan ring lowered cadmium mobilizing efficacy of the parent
      compound, MFA. The treatment with MFA did not affect the status of endogenous
      zinc and copper while the treatment with MSFA and MAFA enhanced their excretion.
      MSFA increased hepatic and renal zinc and renal copper while MAFA increased their
      copper levels.

PMID- 11198223
TI  - Effects of black tea extract on transplantable and solid tumors in Swiss albino
      mice.
AB  - The chemopreventive effects of green tea and its polyphenols are well documented
      in the literature. Epidemiological studies have suggested that green tea
      consumption might be effective in the prevention of certain human cancers. About
      80% of the tea is consumed as black tea. Limited studies have been carried out to
      assess the usefulness of black tea as anti-carcinogen. The present set of
      investigations were initiated to study the anti-tumorigenic potential of aqueous
      black tea extract (ATE) in Swiss albino mice in in vivo animal bioassay, using 7,
      12 dimethyl-benzanthracene (DMBA) as carcinogen. In the experimental group, 2%
      ATE was given orally as sole source of drinking water, while the control were
      allowed to drink normal water, ad lib. The results revealed that drinking of 2%
      ATE could effectively inhibit the onset of tumorigenesis, cumulative number of
      tumors and average number of tumors per mouse. In ATE drinking group 44% animals
      remained tumor free till the termination of experiment, i.e. 26 weeks. In the
      second set of experiment the preventive efficacy of 2% ATE of different cultivars
      of black tea, viz orthodox, CTC and dust were tested in Ehrlich Ascites (EA)
      tumor bearing mice. The preventive effects of ATE were observed in terms of
      increased life span (ILS). All the cultivars of tea showed more than 25% increase
      in life span of the animals. Cytotoxic effect of various doses of all three
      cultivars of black tea was also observed in vitro on EA cells.

PMID- 11198224
TI  - Upgrading of industrial wastewater treatment units at automobile industry.

PMID- 11198225
TI  - Sulphur mustard induced oxidative stress and its prevention by sodium 2,3
      dimercapto propane sulphonic acid (DMPS) in mice.
AB  - Sulphur mustard [bis(2-chloro ethyl) sulfide] (SM), a bifunctional alkylating
      agent has been frequently used as a chemical warfare agent. In the present study,
      the effects of sodium 2-3-dimercaptopropane sulphonic acid (DMPS) on some
      biochemical and histological parameters in mice, exposed to 1/4LC50 concentration
      of SM vapor (10.5 mg/m3) were examined over a period of seven days. Exposure of
      SM resulted in a significant loss of blood, hepatic and pulmonary glutathione
      (GSH) and an elevation of hepatic and pulmonary oxidized glutathione (GSSG).
      These biochemical changes were accompanied by a number of histopathological
      alterations. The most prominent was congestion and degeneration in viscera and
      obliteration of chromatin material. These biochemical and histopathological
      changes were less marked in animals pre-administered with DMPS followed by DMPS
      exposure indicating some protective value of the thiol (DMPS) against SM induced
      oxidative injury in mice.

PMID- 11198226
TI  - Object recognition and image understanding: theories of everything?

PMID- 11198227
TI  - The architecture of visual cortex and inferential processes in vision.
AB  - This paper is organised approximately into two halves. In the first half, I
      review evidence about the structure of the visual system, and I use that evidence
      to frame what I think are widely held but often implicit ideas about how it
      works, namely that vision is principally analysis of retinal input. These ideas
      have been strongly influenced by engineering approaches; form a default view of
      the visual system that suffuses all the language used to describe it (at least in
      visual neuroscience); and are to some extent supported by the structural
      evidence. In the second half, I explore some inconvenient facts from neuroanatomy
      and neurophysiology which are quite uncomfortable for the traditional view. I
      then set out a contrary view of how structure and function are linked in the
      visual system, which is a neurobiological variety of the quite developed view in
      psychophysics that vision is better understood as knowledge-rich inference.
      Finally, I explore some of the ramifications of this view for neurophysiological
      understanding of how the visual system might operate during normal vision.

PMID- 11198228
TI  - Mechanisms of visual object recognition studied in monkeys.
AB  - Cells in area TE of the inferotemporal cortex of the monkey brain selectively
      respond to various moderately complex object-features, and those responding to
      similar features cluster in a columnar region elongated vertical to the cortical
      surface. Although cells within a column respond to similar features, their
      selectivity is not identical. The data of optical imaging in TE have suggested
      that the borders between neighboring columns are not discrete but columns
      representing related features overlap one another. We have also found, by
      training adult monkeys for discrimination of a specific set of shapes, that such
      a long-term training increases the proportion of TE cells responding to the
      shapes used in the training even in the adult. The data suggested that TE plays
      important roles in discrimination of complex shapes and in visual expert learning
      of discriminating a certain class of objects in the adult.

PMID- 11198229
TI  - Object recognition: holistic representations in the monkey brain.
AB  - Cognitive-psychological and neuropsychological studies suggest that the human
      brain processes facial information in a distinct manner, relying on mechanisms
      that are anatomically and functionally different from those underlying the
      recognition of other objects. Face recognition, for instance, can be disrupted
      selectively as a result of localized brain damage, and relies strongly on
      holistic information rather than on the mere processing of local features.
      Similarly, in the non-human primate, distinct neocortical and limbic structures
      have cell populations responding specifically to face stimuli and only weakly to
      other visual patterns. Moreover, such cells tend to respond to the entire
      configuration of a face rather than to individual facial features. But are faces
      the only objects represented in this way? Here I present some evidence suggesting
      that at least one aspect of facial processing, the processing of holistic
      information, may be employed by the primate brain when recognizing any arbitrary
      homogeneous class of even artificial objects, which the monkey has to
      individually learn, remember, and recognize again and again from among a large
      number of distractors sharing a number of common features with the target.
      Acquiring such an expertise can induce configurational selectivity in the
      response of neurons in the visual system. Our findings suggests that regarding
      their neural encoding faces are unlikely to be 'special', but they rather are the
      default 'special class' of the primate visual system.

PMID- 11198230
TI  - Disruption of space perception due to cortical lesions.
AB  - Space control has for a long time been considered a unitary function. The
      structure associated with this function was the right parietal lobe. Hemispheric
      specialization for space appeared to make it automatically a human-specific
      function. However, recent primate research shows different regions of the
      parietal lobes to be differently involved with space control. A review of the
      literature, together with own cases shows that there is ample evidence of a
      modular organization of space control in humans on the basis of specific deficits
      subsequent to circumscribed cerebral lesions. Lesions influence differentially
      retinotopic, spatiotopic, egocentric, and allocentric frames of references. They
      also influence differentially the attention to far or near space, or to global or
      local features of space. Moreover, preattentive processes can be studied in the
      neglected hemispace of humans and prove to be sensible to the meaning of visual
      stimuli. Space representation and attentional mechanisms that seem to operate on
      these representations are organized in our brain in a very modular fashion,
      similar to the modularity of visual submodalities. There is probably not a
      unified space representation in the parietal lobes, but distributed functional
      modules. Thus, the study of visual optic recognition, either by the brain or by
      machines, is inconceivable without considering space, attention and awareness.

PMID- 11198231
TI  - A geometric view on early and middle level visual coding.
AB  - As opposed to dealing with the geometry of objects in the 3D world, this paper
      considers the geometry of the visual input itself, i.e. the geometry of the
      spatio-temporal hypersurface defined by image intensity as a function of two
      spatial coordinates and time. The results show how the Riemann curvature tensor
      of this hypersurface represents speed and direction of motion, and thereby allows
      to predict global motion percepts and properties of MT neurons. It is argued that
      important aspects of early and middle level visual coding may be understood as
      resulting from basic geometric processing of the spatio-temporal visual input.
      Finally, applications show that the approach can improve the computation of
      motion.

PMID- 11198232
TI  - Object and scene analysis by saccadic eye-movements: an investigation with higher
      order statistics.
AB  - Based on an information theoretical approach, we investigate feature selection
      processes in saccadic object and scene analysis. Saccadic eye movements of human
      observers are recorded for a variety of natural and artificial test images. These
      experimental data are used for a statistical evaluation of the fixated image
      regions. Analysis of second-order statistics indicates that regions with higher
      spatial variance have a higher probability to be fixated, but no significant
      differences beyond these variance effects could be found at the level of power
      spectra. By contrast, an investigation with higher-order statistics, as reflected
      in the bispectral density, yielded clear structural differences between the image
      regions selected by saccadic eye movements as opposed to regions selected by a
      random process. These results indicate that nonredundant, intrinsically two
      dimensional image features like curved lines and edges, occlusions, isolated
      spots, etc. play an important role in the saccadic selection process which must
      be integrated with top-down knowledge to fully predict object and scene analysis
      by human observers.

PMID- 11198233
TI  - Vision as temporal trace.
AB  - Most current models of human and animal vision assume that the processes of
      vision involve 2D (or even 3D) internal representations of the external world--an
      iconic representation. Within these models, recognition involves some form of
      lineal, areal or volumetric comparison of these internal representations (either
      learned or innate) with current sensory inputs. However, this view has recently
      come under criticism. In this paper, a neural model of vision is explored in
      which this iconic world view is replaced by a temporally ordered trace of
      (essentially) local features. The model employs hierarchical, recurrently linked,
      self-organizing topological maps.

PMID- 11198234
TI  - Dynamics and context dependence of visual category learning.
AB  - Visual category learning by humans is observed within a paradigm of supervised
      learning. Mental representations for recognition are reconstructed from the
      observed data structures by fitting to them predicted classification data
      obtained from similarity-based models of recognition on the one hand and machine
      vision systems for image understanding on the other hand. These principles are
      illustrated with examples concerning the dynamics and the dependence on context
      of processes of category learning.

PMID- 11198235
TI  - Recognizing depth-rotated objects: a review of recent research and theory.
AB  - Many of the phenomena of object classification can be derived from a
      representation specifying a nonaccidental characterization of an object's parts
      (geons) and relations, termed a geon structural description (GSD). Such a
      representation: (a) enables the facile recognition of depth-rotated objects, even
      when they are novel, (b) provides the information that is employed not only to
      distinguish basic-level but also highly similar members of subordinate-level
      classes, and (c) enables mapping onto verbal and object-reasoning structures.
      Recent psychophysical and neural investigations of object recognition have
      provided additional support to this theory of object representation.

PMID- 11198236
TI  - (Coarse coding of shape fragments) + (retinotopy) approximately = representation
      of structure.
AB  - The ability to deal with object structure--to determine what is where in a given
      object, rather than merely to categorize or identify it--has been hitherto
      considered the prerogative of 'structural description' approaches, which
      represent shapes as categorical compositions of generic parts taken from a small
      alphabet. In this note, we propose a simple extension to a theoretically
      motivated and extensively tested appearance-based model of recognition and
      categorization, which should make it capable of representing object structure. We
      describe a pilot implementation of the extended model, survey independent
      evidence supporting its modus operandi, and outline a research program focused on
      achieving a range of object processing capabilities, including reasoning about
      structure, within a unified appearance-based framework.

PMID- 11198237
TI  - Perception, representation and recognition: a holistic view of recognition.
AB  - It is clear that humans have mental representations of their spatial environments
      and that these representations are useful, if not essential, in a wide variety of
      cognitive tasks such as identification of landmarks and objects, guiding actions
      and navigation and in directing spatial awareness and attention. Determining the
      properties of mental representation has long been a contentious issue (see
      Pinker, 1984). One method of probing the nature of human representation is by
      studying the extent to which representation can surpass or go beyond the visual
      (or sensory) experience from which it derives. From a strictly empiricist
      standpoint what is not sensed cannot be represented; except as a combination of
      things that have been experienced. But perceptual experience is always limited by
      our view of the world and the properties of our visual system. It is therefore
      not surprising when human representation is found to be highly dependent on the
      initial viewpoint of the observer and on any shortcomings thereof. However,
      representation is not a static entity; it evolves with experience. The debate as
      to whether human representation of objects is view-dependent or view-invariant
      that has dominated research journals recently may simply be a discussion
      concerning how much information is available in the retinal image during
      experimental tests and whether this information is sufficient for the task at
      hand. Here we review an approach to the study of the development of human spatial
      representation under realistic problem solving scenarios. This is facilitated by
      the use of realistic virtual environments, exploratory learning and redundancy in
      visual detail.

PMID- 11198238
TI  - Reconstructing mental object representations: a machine vision approach to human
      visual recognition.
AB  - This paper introduces a new approach to assess visual representations underlying
      the recognition of objects. Human performance is modeled by CLARET, a machine
      learning and matching system, based on inductive logic programming and graph
      matching principles. The model is applied to data of a learning experiment
      addressing the role of prior experience in the ontogenesis of mental object
      representations. Prior experience was varied in terms of sensory modality, i.e.
      visual versus haptic versus visuohaptic. The analysis revealed distinct
      differences between the representational formats used by subjects with haptic
      versus those with no prior object experience. These differences suggest that
      prior haptic exploration stimulates the evolution of object representations which
      are characterized by an increased differentiation between attribute values and a
      pronounced structural encoding.

PMID- 11198239
TI  - Learning in brains and machines.
AB  - The problem of learning is arguably at the very core of the problem of
      intelligence, both biological and artificial. In this paper we sketch some of our
      work over the last ten years in the area of supervised learning, focusing on
      three interlinked directions of research: theory, engineering applications (that
      is, making intelligent software) and neuroscience (that is, understanding the
      brain's mechanisms of learning).

PMID- 11198240
TI  - Learning to recognize objects.
AB  - Several aspects of systems for learning pattern or object recognition rules are
      discussed. First, how are recognition rules developed and to what extent is
      structural pattern information embedded into these recognition rules. Second, how
      are these rules applied to the recognition of complex patterns such as objects
      embedded in scenes and how is evidence from different rules combined into a
      single evidence vector. Third, how can learned rules be improved through
      performance evaluation and feedback to rule generation stages.

PMID- 11198241
TI  - Learning paradigms for image interpretation.
AB  - In this paper we discuss image understanding and object recognition as a class of
      processes which involve binding what is seen with what is known. It follows from
      this perspective that it is important to explicate how systems may learn about
      spatial information from images, how it is encoded, and, how, in turn, such
      knowledge is matched with new image data. As well as discussing very specific
      solutions to these problems, this paper questions the view that our scientific
      understanding of image understanding is sufficiently circumscribed by the study
      of how image features are extracted and matched, per se.

PMID- 11198242
TI  - Learning about dynamic scenes.

PMID- 11198243
TI  - Spatio-temporal organization of behavior.
AB  - One of the most widely used terms in the study of human performance is attention.
      Yet it can also be argued that it is one of the most confusing and misunderstood.
      Huge variations in performance, from not noticing large changes in images or
      natural situations, to differences of tens of milliseconds have all been
      described as attentional effects. We argue that the large disparity in results
      can be more easily understood in the context of a fairly complete model of human
      performance that describes the execution of a set of complex natural tasks via a
      collection of visual routines that extract crucial information from the optical
      array. The description of visual routines is hierarchical. At the most abstract
      level, a scheduler must pick a small set of programs for the current tasks. Each
      program contains steps which are keyed to information in the scene. This is
      extracted by visual routines which run during a single fixation and extract
      pertinent information. The library of routines themselves are designed to execute
      quickly, but their actual performance depends on signal-to-noise characteristics
      of the imaged scene. The hierarchical description of behavior shows that
      questions about attention make sense in the context of the descriptive level in
      which they are embedded. We illustrate these principles with examples of driving
      behaviors.

PMID- 11198244
TI  - Graph matching for visual object recognition.

PMID- 11198245
TI  - Antioxidant supplements to prevent heart disease. Real hope or empty hype?
AB  - Antioxidants in foods and supplements are being widely promoted for their health
      benefits. Protection from heart disease is one claim that seems compelling in
      light of scientific evidence and large-scale observational studies. But will
      antioxidant supplements help your patients? To examine this question, Dr Tran
      reviews numerous clinical studies and evaluates the discrepancies between
      observational and clinical results.

PMID- 11198246
TI  - Superficial fungal infection of the skin. Where and how it appears help determine
      therapy.
AB  - Superficial fungal infections of the skin are a common presentation in clinical
      practice. Any skin surface, the mucous membranes, nail plates, and nail beds can
      be affected. Tinea pedis is the most common fungal infection and may affect up to
      70% of the adult population worldwide. Ubiquitous candidal organisms are found in
      the oral flora of many healthy persons and result in infection in the presence of
      certain host factors or immunodeficiency disorders. Onychomycosis has had an
      increasing incidence worldwide, and it now accounts for almost half of all nail
      disorders. These and many other infections can have varying presentations as well
      as features that resemble nonfungal disorders. Therefore, it is important that
      primary care physicians are familiar with the many cutaneous fungal infections
      and their differential diagnosis to ensure that appropriate therapy is selected.

PMID- 11198247
TI  - Human error in perspective. The patient safety movement.

PMID- 11198248
TI  - An unusual vertebral radiographic finding. "H-type" vertebral deformity due to
      sickle cell disease.

PMID- 11198249
TI  - Abnormal uterine bleeding. Diagnostic considerations, management options.
AB  - The approach to diagnosis of abnormal uterine bleeding is guided by a sound
      knowledge of menstrual physiology and differential diagnosis. Often, simple
      anovulation is the underlying problem, although the possibility of pregnancy,
      endometrial hyperplasia with atypia, or benign reproductive tract disease must be
      considered. In the majority of cases, abnormal uterine bleeding can be fully
      evaluated and effectively treated medically without the need for gynecologic
      referral.

PMID- 11198250
TI  - Basics of joint injection. General techniques and tips for safe, effective use.
AB  - Successful joint and soft-tissue aspiration and injection rely on the physician's
      understanding of the indications, contraindications, and general techniques
      involved in these procedures. The procedures are generally well tolerated and can
      be used to treat many painful musculoskeletal and soft-tissue conditions.

PMID- 11198251
TI  - OTC agents for ringworm?

PMID- 11198252
TI  - Recognizing UTIs in infants and children. Early treatment prevents permanent
      damage.
AB  - The risk of irreversible renal scarring leading to hypertension and renal failure
      underscores the importance of expedient and accurate diagnoses of UTIs in infants
      and children. The selective use of invasive techniques to obtain urine for
      culture may reduce false-positive results that lead to unnecessary treatment.
      Subsequent management of UTIs depends on the age of the patient and the severity
      of the illness. Heightened awareness and prompt management of UTIs in infants and
      children can result in reduced morbidity and improved outcomes.

PMID- 11198253
TI  - Are water supplies safe from bioterrorism?

PMID- 11198254
TI  - Breast self-examination.

PMID- 11198255
TI  - Put a scanner in your pocket. Handheld OCR technology saves time and typing.

PMID- 11198256
TI  - The persistent nonhealing ulcer. Could it be basal cell carcinoma?

PMID- 11198257
TI  - Migraine's impact today. Burden of illness, patterns of care.
AB  - Migraine is a common disorder that causes severe headaches and associated nausea,
      photophobia, phonophobia, and temporary disability. Though the pain and other
      symptoms of migraine can be effectively managed, the condition remains
      underdiagnosed and undertreated. In this article, Drs Lipton, Stewart, Reed, and
      Diamond consider the scope and distribution of the migraine problem and the
      current patterns of care in the United States.

PMID- 11198258
TI  - A fresh look at migraine therapy. New treatments promise improved management.
AB  - Successful management of migraine headaches involves identifying and avoiding
      headache triggers and using appropriate abortive therapy once a headache is
      recognized. Pain relief measures include over-the-counter analgesics, parenteral
      NSAID therapy when needed, and use of antiemetics and cold packs. Narcotic
      analgesics are best used only as a "last resort" measure. Prophylactic therapy
      should be considered for patients who have more than two acute migraine attacks
      each month or whose daily activities are seriously compromised by headaches. For
      the patient in whom status migrainosus threatens well-being, hospitalization and
      more intensive therapy may be needed.

PMID- 11198259
TI  - Relief of cluster headache and cranial neuralgias. Promising prophylactic and
      symptomatic treatments.
AB  - When a patient presents with persistently unilateral head or face pain, cluster
      headache and trigeminal neuralgia should be considered. Diagnosis is based on the
      patient's history; anatomical studies are performed only to rule out problems
      other than tumor or stroke. A patient who presents with pain in the pharynx,
      tonsils, and ear--particularly if it is initiated by swallowing, yawning, or
      eating--may have glossopharyngeal neuralgia. Treatment with carbamazepine is
      indicated; if the patient does not respond to this drug, the diagnosis is
      doubtful. Several effective treatments are available for these conditions.
      Oxygen, drug therapy, or surgery may be indicated depending on the course of the
      disease.

PMID- 11198260
TI  - Sexual aspects of headache. How sexual function relates to headaches and their
      causes and treatment.
AB  - Since the sexual revolution of the 1960s, medical complications of sexual
      activity and sexual side effects related to use of medications have become a
      significant part of healthcare practice. Specifically, there has been an
      expanding interest in the treatment of headaches and their relationship to sexual
      function. Most sexual side effects associated with headache treatment are benign
      and can be managed with reassurance or changes in medication regimens. However,
      sudden headache should always be investigated carefully to rule out a dangerous
      intracranial event.

PMID- 11198261
TI  - Resources on headache.

PMID- 11198262
TI  - Prophylactic and symptomatic treatment of influenza. Current and developing
      options.
AB  - The influenza vaccine is the primary method for the prevention and control of
      influenza. Anti-influenza drugs also have been shown to be useful
      prophylactically and to shorten the duration of illness by 1 or 2 days when
      started within 48 hours of symptom onset. In this article, Dr Mossad discusses
      indications for the vaccine and compares the relative advantages and
      disadvantages of each of the anti-influenza drugs.

PMID- 11198263
TI  - Collecting cancer risk factor data from hospital outpatients: use of touch-screen
      computers.
AB  - The aim of this study was to assess the prevalence of selected cancer risk factor
      data from hospital outpatients and the proportion of "at risk" patients who would
      like help from hospital staff to reduce risk factors. A touch-screen computer
      collected data from outpatients in Newcastle, NSW, Australia. Eight hundred and
      nineteen outpatients completed the computerized interview. Of these, 35% were
      smokers, of whom 25% said that they would like help to stop smoking; 47% were
      overweight, with 48% indicating that they wanted assistance; 17% consumed harmful
      levels of alcohol, with 2% wanting help; 30% of eligible women were overdue for a
      Pap test, of whom 75% said that they wanted a referral to be screened, and 25%
      were overdue for a mammogram, of whom 83% said that they would like a referral
      for an examination. Touch-screen computerized health risk assessments are
      practical for collecting and monitoring valid cancer risk factor data for
      hospital outpatients.

PMID- 11198264
TI  - New evidence for antioxidant properties of vitamin C.
AB  - This study was designed to examine the effect of 500 to 5,000 mg of ascorbic acid
      on DNA adducts, natural killer (NK) cell activity, programmed cell death, and
      cell cycle analysis of human peripheral blood leukocytes. According to our
      hypothesis, if ascorbic acid is a pro-oxidant, doses between 500 and 5,000 mg
      should enhance DNA adduct formation, decrease immune function, change the cell
      cycle progression, and increase the rate of apoptosis. Twenty healthy volunteers
      were divided into four groups and given either placebo or daily doses of 500,
      1,000 or 5,000 mg of ascorbic acid for a period of 2 weeks. On days 0, 1, 7, 15,
      and 21, blood was drawn from them, and the leukocytes were separated and examined
      for intracellular levels of ascorbic acid, the level of 8-hydroxyguanosine, NK
      cell activity, cell cycle progression, and apoptosis. Depending on the subjects,
      between a 0% and a 40% increase in cellular absorption of ascorbic acid was
      observed when daily doses of 500 mg were used. At doses greater than 500 mg, this
      cellular absorption was not increased further, and all doses produced equivalent
      increases in ascorbic acid on days 1 to 15. This increase in cellular
      concentration of ascorbic acid resulted in no statistically meaningful changes in
      the level of 8-hydroxyguanosine, increased NK cytotoxic activity, a reduced
      percentage of cells undergoing apoptosis, and switched cell cycle phases from S
      and G2/M to G0/G1. After a period of 1 week, with no placebo or vitamin washout,
      ascorbic acid levels along with functional assays returned to the baseline and
      became equivalent to placebos. In comparison with baseline values, no change (not
      more than daily assays variation) was seen in ascorbate concentrations or other
      assays during oral placebo treatment. We concluded that ascorbic acid is an
      antioxidant and that doses up to 5,000 mg neither induce mutagenic lesions nor
      have negative effects on NK cell activity, apoptosis, or cell cycle.

PMID- 11198265
TI  - Thyroperoxidase: a tumor marker for post-therapeutic follow-up of differentiated
      thyroid carcinomas? Results of a time course study.
AB  - Serum thyroperoxidase (TPO) and serum human thyroglobulin (hTg) were studied in
      80 patients with differentiated thyroid carcinoma after thyroidectomy before and
      after the first therapeutic radioiodine application ("radioiodine thyroid
      ablation") and, in some cases, after the second radioiodine application. Eighteen
      patients with an autonomous adenoma were studied in the same manner. The values
      of TPO and hTg in 25 persons without thyroid impairment were used as controls. In
      34 of 50 evaluable cases, TPO levels behaved as hTg during follow-up studies: The
      majority (n= 30) of these patients showed an increase in TPO and hTg serum levels
      immediately after radioiodine therapy, followed by a decrease approximately 3
      days later. However, in 16 of 50 patients, the TPO and hTg serum levels showed
      different patterns of change both before and after radioiodine therapy. In six of
      seven patients with extensive postoperative residues and high anti-hTg levels,
      distinctly elevated TPO values were associated only by slightly elevated
      thyroglobulin values. There was no rise of TPO in autonomous adenoma except in
      patients treated with thyroid depressants. We assumed that TPO levels could serve
      as an "indicator" for destruction of thyroid cells or thyroid carcinoma cells and
      an aid in screening cases of false-negative hTg values.

PMID- 11198266
TI  - Quantitative detection of tumor M2-pyruvate kinase in plasma of patients with
      lung cancer in comparison to other lung diseases.
AB  - Lung cancer is one of the predominant causes of cancer death. The aim of this
      project is the development of a screening method in persons with high risk for
      developing lung cancer, based on the measurement of Tumor M2-pyruvate kinase
      (Tumor M2-PK). Tumor M2-PK is quantitatively detectable in
      ethylenediaminetetraacetic acid-plasma with a sensitive enzyme-linked
      immunosorbent assay. So far, 60 patients with newly diagnosed lung cancer were
      included. These were compared to 24 patients with acute inflammatory lung
      diseases, 56 patients with pneumoconiosis, 22 patients with obstructive airway
      diseases, and 28 healthy persons. Tumor patients and some individuals suffering
      from severe inflammatory lung diseases had significantly higher Tumor M2-PK
      concentrations in ethylenediaminetetraacetic acid-plasma than all the other
      groups. The histologic tumor type had no influence on the plasma levels of Tumor
      M2-PK. Tumor M2-PK concentrations correlate strongly with the tumor stage,
      showing significantly increasing concentrations with progressive tumor stages.
      The present data indicate that Tumor M2-PK could be a valuable tumor marker for
      the detection of lung cancer.

PMID- 11198267
TI  - Expression of bcl-2, bax-xL, and bcl-xS in endometrial and cervical tissues.
AB  - We assessed the protein expression levels of bcl-2, bax, bcl-xL, and bcl-xS in a
      group of 51 endometrial cancers and 8 normal samples as well as in 59 cervical
      neoplasms and in 15 normal cervical tissues. Neoplastic endometria (median, 1.30
      absorbance units [AU]; range, 0.13-7.26 AU) had slightly higher bcl-2 levels than
      did normal tissue (median, 0.83 AU; range, 0.29-1.90 AU; P < .068), whereas bcl-2
      was lower in neoplastic (median, 3.59 AU; range, 0.13-19.86 AU) than in normal
      cervical samples (median, 8.45 AU; range, 2.09-15.04 AU; P < .010). Bcl-xL levels
      were higher in endometrial carcinoma (median, 1.23 AU; range, 0.03(4.29 AU) than
      in normal tissues (median, 0.56 AU; range, 0.46-1.48 AU; P < .048), whereas no
      significant difference was observed in cervical tissues. Bax levels did not show
      any variation in either system. The protein bcl-xS was marginally detectable in
      only a few samples. In endometrial carcinoma, bcl-2 and bcl-xL levels were
      correlated inversely (r = -0.27; P < .054), whereas in cervical cancer, they were
      correlated directly (r = +0.40; P < .002). The different expression patterns of
      bcl-2 family members in endometrial and cervical tissues confirm the hypothesis
      of a strictly tissue-specific regulation of these proteins.

PMID- 11198268
TI  - Blood polyamine levels after oral ornithine load, a diagnostic marker of
      hyperproliferative premalignant and malignant stages in a model of colon
      carcinogenesis.
AB  - This study was performed to determine whether a single oral dose of ornithine
      (Orn), the substrate of ornithine decarboxylase (ODC), increases blood
      concentrations of polyamines premalignant stage, and whether blood polyamine
      levels could be used as predictive markers of cancer development. Male Wistar
      rats were divided into two groups, control and 1,2-dimethylhydrazine (DMH)
      treated rats. DMH (20 mg/kg body weight) was injected intraperitoneally once
      weekly for 10 weeks. Five, 7, and 10 weeks after the last injection when
      premalignant aberrant crypt foci have developed in the colon, blood levels of
      putrescine (PUT), spermidine (SPD), and spermine (SPM) were estimated before and
      after an oral load of ORN. The results showed that after a single oral load of
      Orn, blood PUT, but not SPD and SPM, concentrations were significantly higher in
      DMH-treated rats compared with control rats, indicating enhancement of ODC
      activity. These results support the view that the increased blood concentration
      of PUT after administration of Orn may be a useful marker to detect
      hyperproliferative premalignant and malignant stages of cancer development.

PMID- 11198269
TI  - Breast cancer screening among Cambodian American women.
AB  - Our aim was to describe and identify factors associated with breast cancer
      screening among Cambodian American women. We conducted a cross-sectional survey
      of 1,365 households using bilingual and bicultural interviewers. We found that
      low proportions of Cambodian American women were up to date on their clinical
      breast examinations (CBE; 42%) and mammograms (40%). More than 80% of women with
      female physicians have had at least one prior screening, and 52% have had the
      tests recently. Women with male Asian American physicians were less likely to
      have had screening as compared to women with female non-Asian physicians: ever
      had CBE (odds ratio [OR], 0.26); recent CBE (OR, 0.39); ever had mammogram (OR,
      0.36); and recent mammogram (OR, 0.22). Breast cancer screening among Cambodian
      American women lags behind the general U.S. population. Tailored promotion
      efforts should address barriers and promote cancer screening by physicians,
      staff, and organizations serving this population.

PMID- 11198270
TI  - Ethnic differences in serum pepsinogen levels among Japanese and non-Japanese
      Brazilian gastric cancer patients and controls.
AB  - A low level of serum pepsinogen I (Pg I) is a risk factor for gastric cancer
      (GC); low levels of Pg I and the pepsinogen ratio (Pg I:Pg II) are correlated
      with chronic atrophic gastritis. We report serum Pg levels and compare the degree
      of association with GC among Japanese and non-Japanese Brazilians. Sera were
      cross-sectionally ascertained from 93 Japanese Brazilian patients category
      matched by age and sex with 110 controls, and 228 non-Japanese Brazilian patients
      individually matched by age and sex with one control. Among non-Japanese
      Brazilians, GC was associated with a Pg I level <30 ng/ml (odds ratio [OR], 2.5;
      95% confidence interval [CI], 1.7-3.8) and a Pg I:Pg II ratio < 3.0 (OR, 3.4; 95%
      CI, 2.2-5.3). However, among Japanese Brazilians, the association was present
      with a level of Pg I < 30 ng/ml (OR, 3.5; 95% CI, 1.9-6.3), and was weak with a
      Pg I:Pg II ratio < 3.0 (OR, 1.3; 95% CI, 0.73-2.4). Serum Pg I may be preferred
      to the Pg I:Pg II ratio to study the association between Pg and GC among Japanese
      Brazilians.

PMID- 11198271
TI  - Immunohistochemical localization of pancreatic secretory trypsin inhibitor in
      malignant pancreatic endocrine tumors.
AB  - Differentiation of benign from malignant pancreatic endocrine tumors by existing
      clinical, biochemical, histologic, and cytologic criteria is difficult. We
      immunohistochemically localized pancreatic secretory trypsin inhibitor (PSTI) in
      28 pancreatic endocrine tumors (13 benign, 15 malignant). PSTI-immunoreactive
      cells were detected in nine endocrine tumors. Immunoreactivity in these tumors
      was detected in nearly all tumor cells in five cases, scattered cells in two
      cases, and a few cells in two cases. All positive cases were malignant, and eight
      were equal to or larger than 10 cm. Serum concentrations of PSTI were markedly
      elevated in the two patients so tested. PSTI may be a specific
      immunohistochemical marker for malignant pancreatic endocrine tumors.

PMID- 11198273
TI  - Cancer screening behaviors among Korean-American women.
AB  - The goals of this study were to evaluate breast and cervical cancer screening
      tests and to examine the correlates of cancer screening behaviors. A cross
      sectional face-to-face survey of 438 Korean-American women residing in Maryland
      was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6%
      of these women age 40 and older had had a mammogram in the past 2 years. In
      multiple logistic regression analyses, the strongest correlate of screening
      behaviors was having a regular medical checkup. Age and acculturation were found
      to be important correlates of cancer screening tests: Women less than 50 years of
      age were more likely to have cancer screening tests than those 50 years and
      older. English language proficiency was associated with having a mammogram and
      the proportion of life spent in the United States was associated with having a
      Pap smear. Employment interacted with marital status for a Pap smear, with those
      married and unemployed being less likely to have a Pap smear than women who were
      both married and employed. For strategies to increase cancer-screening tests
      among Korean-American women, we need to aim at developing culturally appropriate
      educational programs about cancer for less acculturated and recent immigrants.

PMID- 11198272
TI  - Detection of prostate-specific membrane antigen expressing cells in blood
      obtained from renal cancer patients: a potential biomarker of vascular invasion.
AB  - Originally, prostate-specific membrane antigen (PSMA) was described in benign and
      malignant prostate cells. On the basis of recent reports that this antigen also
      is expressed in normal renal proximal tubular cells and in the neovascular
      endothelium associated with renal carcinoma, we used a nested reverse
      transcriptase-polymerase chain reaction assay to evaluate whether PSMA-expressing
      cells might be present in specimens of peripheral blood obtained from renal
      cancer patients, benign renal tumor patients, and healthy volunteers. Our reverse
      transcriptase-polymerase chain reaction PSMA assay had a sensitivity of detecting
      1 lymph node prostate cancer (LNCaP) per 10(7) lymphocytes. None of the 20 non
      renal cancer controls were positive for PSMA mRNA, whereas 11 of 50 patients
      (22%) with diagnosed renal cancer were positive. Despite a comparative increase
      of PSMA positivity with stage, no statistical correlation was found. However, 44%
      of PSMA-positive patients had tumor size greater than 12 cm, versus only 9% in
      patients negative for PSMA (P = .03), and 67% of positive PSMA patients were
      found to have vascular invasion versus only 16% of patients negative for PSMA (P
      = .006; odds ratio, 10.8). This preliminary study suggests the possibility that
      PSMA expression in peripheral blood might be a useful biomarker for detecting or
      monitoring the progression of renal cancer in patients.

PMID- 11198274
TI  - Fine needle aspiration of bone tumors.
AB  - Fine needle aspiration cytology (FNAC) was performed in 226 cases of bone tumors
      and the cytohistologic correlation was calculated to assess the technique's
      diagnostic efficacy aided by immunocytochemistry, considering histopathology as
      the gold standard. Of the 226 cases, 136 were malignant and 72 cases were benign
      tumors. In the remaining 18 cases, cytohistopathologic examination revealed no
      bony lesion. There were 178 evaluable cases, but the specific morphologic
      diagnosis on FNAC was possible only in 159 cases with one false positive and 29
      false negatives. Giant cell tumor (32%) and Ewing's sarcoma (22%) were the most
      common bony tumors encountered in this series. The diagnostic indices were
      calculated by a decision matrix comparison. The overall sensitivity and
      specificity were 86.0 (confidence interval [CI], 80.3-90.3) and 94.7 (CI, 71.9
      99.7), respectively. The positive predictive value (PPV) was as high as 99.4 (CI,
      96.5-100), while the negative predictive value (NPV) was 38.3 (CI, 24.9-53.6)
      with positive and negative likelihood ratios of 16.338 and 0.147, respectively.
      Diagnosis of malignant tumors was more accurate with a PPV of 99.2 (CI, 94.8
      100.0) and specificity of 94.7 (CI, 71.9-99.7), while the sensitivity was 89.0
      (CI, 82.2-93.5) and NPV was 54.5 (CI, 36.6-71.5). This study highlights the
      usefulness of FNAC along with the use of immunocytochemistry in the rapid
      diagnosis of bone tumors.

PMID- 11198275
TI  - Iontophoresis treatment of basal cell carcinoma with cisplatin: a case report.
AB  - Iontophoresis is a process that uses electrical current to increase the flux of
      ionized substances through tissue. Iontophoresis has been used in rehabilitation
      to decrease inflammation and pain using dexamethasone and lidocaine. In 1993,
      Chang et al. reported visual improvements in the lesions of nine patients
      diagnosed with basal cell carcinoma (BCC) following iontophoresis of cisplatin.
      The present case report describes the successful treatment of a 67-year-old male
      with a histologically confirmed BCC on his upper anterolateral left leg. The
      treatment consisted of four cycles of five successive days of cisplatin
      iontophoresis, with a 2-week rest period between cycles. The cisplatin solution
      (5 mL at 1 mg/mL) was used in combination with epinephrine hydrochloride. The
      effectiveness of the treatment was confirmed by post-treatment biopsies, which
      revealed granulation tissue scarring without evidence of BCC. Measurements of
      cellular proliferation were monitored immunohistochemically with Ki-67 and cell
      cycle distribution analyzed by flow cytometry.

PMID- 11198276
TI  - Deletion mapping on the short arm of chromosome 1 in Merkel cell carcinoma.
AB  - Twenty-two Merkel cell carcinoma (MCC) biopsies and six cell lines from 24
      patients were examined for loss of heterozygosity (LOH) at 11 loci on 1p and one
      on 1q, to determine LOH regions on chromosome 1p. Sixteen (73%) tumors had LOH
      for at least one locus; 14 demonstrated LOH at more than one locus, and 7 (29%)
      samples had more than one region of loss, with 4 of these having loss at all
      informative loci on 1p. Three common regions of loss (SRO) were defined by LOH in
      multiple tumors. Eight samples demonstrated LOH between D1S214 and D1S160 (1p36),
      seven between D1S234 and D1S186 (1p35), and 11 for the region centromeric of
      D1S211 and D1S220 (1p32-1p33). Seven samples (29%) demonstrated more than one
      region of loss. LOH on 1p occurs frequently in MCC and more than one tumor
      suppressor gene on 1p is likely to play a role in the development of this tumor
      type.

PMID- 11198277
TI  - Herpes simplex virus type 1 (HSV-1)--induced retinitis following herpes simplex
      encephalitis: indications for brain-to-eye transmission of HSV-1.
AB  - Herpes simplex encephalitis is a severe neurological disease with high mortality
      and morbidity rates. Reactivated herpes simplex virus type 1 (HSV-1) can cause
      relapses and might even spread to the retina, where it can induce a potentially
      blinding eye disease, known as acute retinal necrosis. In the present study, the
      HSV-1 strains in the brain and eye of 2 patients with acute retinal necrosis
      following an episode of herpes simplex encephalitis were genotyped. The HSV-1
      strains in both the brain and eye were identical in each patient, but they
      differed interindividually. The data suggest brain-to-eye transmission of HSV-1
      in these patients.

PMID- 11198278
TI  - A novel mtDNA mutation in the ND5 subunit of complex I in two MELAS patients.
AB  - We identified a novel heteroplasmic mutation in the mitochodrial DNA gene
      encoding the ND5 subunit of complex I. This mutation (13514A-->G) hits the same
      codon affected by a previously reported mitochondrial encephalomyopathy, lactic
      acidosis, and strokelike episodes (MELAS)-associated mutation (13513G-->A), but
      the amino acid replacement is different (D393G vs D393N). The 13514A-->G mutation
      was found in two unrelated MELAS-like patients. However, in contrast to typical
      MELAS, lactic acidosis was absent or mild and the muscle biopsy was
      morphologically normal. Strongly positive correlation between the percentage of
      heteroplasmy and defective activity of complex I was found in cybrids. We found
      an additional 13513G-->A-positive case, affected by a progressive mitochondrial
      encephalomyopathy. Our results clearly demonstrate that the amino acid position
      D393 is crucial for the function of complex I. Search for D393 mutations should
      be part of the routine screening for mitochondrial disorders.

PMID- 11198279
TI  - Decreased binding of [11C]flumazenil in Angelman syndrome patients with GABA(A)
      receptor beta3 subunit deletions.
AB  - We used positron emission tomography (PET) to study brain [11C]flumazenil (FMZ)
      binding in four Angelman syndrome (AS) patients. Patients 1 to 3 had a maternal
      deletion of 15q11-q13 leading to the loss of beta3 subunit of gamma-aminobutyric
      acidA/benzodiazepine (GABA(A)/BZ) receptor, whereas Patient 4 had a mutation in
      the ubiquitin protein ligase (UBE3A) saving the beta3 subunit gene. [11C]FMZ
      binding potential in the frontal, parietal, hippocampal, and cerebellar regions
      was significantly lower in Patients 1 to 3 than in Patient 4. We propose that the
      15q11-q13 deletion leads to a reduced number of GABA(A)/BZ receptors, which could
      partly explain the neurological deficits of the AS patients.

PMID- 11198280
TI  - No evidence for genetic association or linkage of the cathepsin D (CTSD) exon 2
      polymorphism and Alzheimer disease.
AB  - Two recent case-control studies have suggested a strong association of a missense
      polymorphism in exon 2 of the cathepsin D gene (CTSD) and Alzheimer disease (AD).
      However, these findings were not confirmed in another independent study. We
      analyzed this polymorphism in two large and independent AD study populations and
      did not detect an association between CTSD and AD. The first sample was family
      based and included 436 subjects from 134 sibships discordant for AD that were
      analyzed using the sibship disequilibrium test (SDT, p = 0.68) and the sib
      transmission/disequilibrium test (Sib-TDT, p = 0.81). The second sample of 200 AD
      cases and 182 cognitively normal controls also failed to show significant
      differences in the allele or genotype distribution in cases versus controls
      (chi2, p = 0.91 and p = 0.88, respectively). In addition, two-point linkage
      analyses in an enlarged family sample (n = 670) did not show evidence for linkage
      of the chromosomal region around CTSD. Thus, our analyses on more than 800
      subjects suggest that if an association between the CTSD exon 2 polymorphism and
      AD exists, it is likely to be smaller than previously reported.

PMID- 11198281
TI  - SCA12 is a rare locus for autosomal dominant cerebellar ataxia: a study of an
      Indian family.
AB  - Spinocerebellar ataxia 12 (SCA12) is an autosomal dominant cerebellar ataxia
      (ADCA) described in a single family with a CAG repeat expansion in the PPP2R2B
      gene. We screened 247 index cases, including 145 families with ADCA, for this
      expansion. An expanded repeat ranging from 55 to 61 triplets was detected in 6
      affected and 3 unaffected individuals at risk in a single family from India. The
      association of the PPP2R2B CAG repeat expansion with disease in this new family
      provides additional evidence that the mutation is causative.

PMID- 11198282
TI  - Inherited Myoclonus-dystonia syndrome: narrowing the 7q21-q31 locus in German
      families.
AB  - Genetic studies were performed in four German families with autosomal dominant
      myodonus-dystonia syndrome. Mutations in the D2 dopamine receptor gene, which
      have been implicated in this disorder, were excluded in all four families by
      linkage analysis and direct sequencing. All four families supported linkage to
      the second reported locus on chromosome 7q21 with a combined maximum multipoint
      lod score of 5.99. The observation of key recombinations in one family refined
      the disease locus to a 7.2 cM region flanked by the markers D7S652 and D7S2480.

PMID- 11198283
TI  - Variable phenotype of Alzheimer's disease with spastic paraparesis.
AB  - A variant form of Alzheimer's disease (AD), in which spastic paraparesis (SP)
      precedes dementia, is characterised by large, noncored, weakly neuritic Abeta
      amyloid plaques resembling cotton wool balls and is caused by genomic deletion of
      presenilin 1 exon 9. A pedigree with a 5.9 kb exon 9 deletion shows a phenotypic
      spectrum including subjects with typical AD or with SP and numerous cotton wool
      plaques. In SP subjects, dementia onset is delayed and modified. This phenotypic
      variation suggests that modifying factors are associated with exon 9 deletions.

PMID- 11198284
TI  - Distal anterior compartment myopathy: a dysferlin mutation causing a new muscular
      dystrophy phenotype.
AB  - We report a family with a new phenotype of autosomal recessive muscle dystrophy
      caused by a dysferlin mutation. The onset of the illness is distal, in the
      muscles of the anterior compartment group. The disease is rapidly progressive,
      leading to severe proximal weakness. Muscle biopsy showed moderate dystrophic
      changes with no vacuoles. Dysferlin immunostaining was negative. Gene analysis
      revealed a frameshift mutation in the exon 50 (delG5966) of the DYSF gene. This
      phenotype further demonstrates the clinical heterogeneity of the
      dysferlinopathies.

PMID- 11198285
TI  - Chlamydia pneumoniae-specific humoral immune responses and clinical disease
      parameters in multiple sclerosis.

PMID- 11198286
TI  - Tracking post-stroke recovery with magnetoencephalography.

PMID- 11198287
TI  - Hypocretin deficiency in familial symptomatic narcolepsy.

PMID- 11198288
TI  - Down's syndrome fibroblasts anticipate the accumulation of specific ageing
      related mtDNA mutations.

PMID- 11198289
TI  - Decreased serum ceruloplasmin and copper levels in cervical dystonia.

PMID- 11198290
TI  - Prospects for the treatment of multiple sclerosis by raising serum levels of uric
      acid, a scavenger of peroxynitrite.

PMID- 11198291
TI  - Widespread occurrence of intranuclear atrophin-1 accumulation in the central
      nervous system neurons of patients with dentatorubral-pallidoluysian atrophy.
AB  - Dentatorubral-pallidoluysian atrophy (DRPLA) is an autosomal dominant
      neurodegenerative disorder caused by a CAG repeat expansion. In the present study
      of DRPLA, we have demonstrated immunohistochemically that diffuse accumulation of
      mutant atrophin-1 in the neuronal nuclei, rather than the formation of neuronal
      intranuclear inclusions (NIIs), was the predominant pathologic condition and
      involved a wide range of central nervous system regions far beyond the systems
      previously reported to be affected. In the neuronal nuclei harboring NIIs,
      promyelocytic leukemia protein (PML) nuclear bodies were redistributed into a
      single NII, and the CREB (cAMP-responsive element-binding protein)-binding
      protein was also recruited into NIIs. The results suggest that the novel lesion
      distribution revealed by the diffuse nuclear labeling may be responsible for a
      variety of clinical features, such as dementia and epilepsy in DRPLA, and that
      certain transcriptional abnormalities may be induced secondarily in neuronal
      nuclei with the formation of NIIs.

PMID- 11198292
TI  - Ocular oscillations induced by shifts of the direction and depth of visual
      fixation.
AB  - Shifts of the point of fixation between two targets aligned on one eye that are
      located near and far (Muller paradigm) stimulates a combined saccadic-vergence
      movement. In normal subjects, this test paradigm often induces saccadic
      oscillations of about 0.3 degrees at 20 to 30 Hz. We measured eye movements using
      the magnetic search coil technique in 2 patients recovering from viral opsoclonus
      myoclonus syndrome, comparing saccadic-vergence responses to the Muller paradigm
      with conjugate saccades between distant targets. Both patients exhibited
      intermittent conjugate ocular oscillations of about 4 to 5 degrees amplitude at
      about 10 Hz. Combined saccadic-vergence movements induced these oscillations
      twice as often as did conjugate saccades. One patient also exhibited disjunctive
      ocular oscillations at 10 Hz while sustaining fixation on the near target. The
      Muller paradigm provides a useful clinical and experimental technique for
      inducing saccadic oscillations. The probable mechanism is that pontine omnipause
      neurons, which normally gate saccades, are inhibited during the sustained
      vergence movement that follows the saccadic component of the response to the
      Muller paradigm.

PMID- 11198293
TI  - Quantitative neuropathological changes in presymptomatic Huntington's disease.
AB  - Morphometric studies of the tail of the caudate nucleus, the site where the
      pathology is first seen, were performed on 16 brain specimens collected from
      individuals at risk for inheriting Huntington's disease (HD). Medical records and
      information obtained from immediate family members indicated that all had died
      without symptoms of HD. Six individuals had 37 or more CAG repeats and were
      designated HD gene carriers, whereas 10 were determined to be non-carriers. Cell
      counts of the tail of the caudate nucleus revealed an increased density of
      oligodendrocytes among the presymptomatic HD gene carriers (mean cells/field:
      carriers = 40.0, noncarrier = 21.3; age, sex, repeated measure adjusted F[126] =
      11.7, p = 0.0008). No statistically significant differences were found between HD
      carriers and noncarriers in the density of neurons (carriers = 16.9, noncarriers
      = 15.5), astrocytes (carriers = 27.8, noncarriers = 21.3) or microglial cells
      (carriers = 7.9, noncarriers = 5.6). Ubiquitin immunostaining performed in 3 gene
      carriers revealed intranuclear inclusions in all 3 cases, including 1, with 37
      repeats, who died 3 decades before the expected age for onset of the clinical
      syndrome. Normal densities of other cell types and careful macroscopic
      examination suggest that the increase in oligodendroglial density is not a
      consequence of atrophy and may instead reflect a developmental effect of the HD
      gene.

PMID- 11198294
TI  - Sexual arousal and orgasm in women: effects of spinal cord injury.
AB  - Sexual disorders are common in women; however, the neurological basis of female
      sexual response has not been adequately investigated. This information is
      necessary to characterize the impact of various neurological disorders on sexual
      arousal in women and to develop appropriate management strategies for sexual
      dysfunction. To assess the spinal mediation of sexually stimulated genital
      vasocongestion in women, we conducted two laboratory-based, controlled analyses:
      (1) of women's genital, subjective, and autonomic responses to audiovisual erotic
      and audiovisual erotic combined with manual genital stimulation; and (2) of
      women's ability to achieve orgasm. Subjects included 68 premenopausal women with
      spinal cord injuries (SCIs) and 21 able-bodied, age-matched controls. Results
      indicated that preservation of sensory function in the T11-L2 dermatomes is
      associated with psychogenically mediated genital vasocongestion. Less than 50% of
      women with SCIs were able to achieve orgasm, compared with 100% of able-bodied
      women (p = 0.001). Only 17% of women with complete lower motor neuron dysfunction
      affecting the S2-S5 spinal segments were able to achieve orgasm, compared with
      59% of women with other levels and degrees of SCIs (p = 0.048). Time to orgasm
      was significantly increased in women with SCIs compared with able-bodied controls
      (p = 0.049). Independent raters were unable to differentiate between subjective
      descriptions of orgasm from SCI women compared with controls. This information
      should be used when counseling women with spinal dysfunction about their sexual
      potential.

PMID- 11198295
TI  - Migraine, aura, and cortical spreading depression: why are we still talking about
      it?

PMID- 11198296
TI  - Causes of epilepsies: insights from discordant monozygous twins.
AB  - Whereas some patients with epilepsy have known acquired or genetic causes, in
      many the cause is unknown. By analyzing monozygotic twins, discordant for
      epilepsy, subtle etiological factors may be detected. We analyzed 12 monozygotic,
      discordant twins for factors explaining discordancy. These factors were presence
      of major clinical risk factors, presence of possibly epileptogenic lesions on
      brain magnetic resonance imaging (MRI), and quantitative brain volume
      abnormalities. Major risk factors, with associated acquired lesions were found in
      4 of 12 twins. An MRI lesion without a major risk factor was found in a further 4
      of 12 twins. Two of these had unilateral malformations of cortical development, 1
      had bilateral periventricular heterotopia, and 1 had focal atrophy. Significant
      twin-twin differences in MRI volumes without obvious MRI lesions or major risk
      factors were found in 2 of 12 twins. Both had larger volumes than their co-twins,
      and idiopathic generalized epilepsy. No clinical or MRI findings accounting for
      discordance for epilepsy were found in 2 of 12 twins. In 10 of 12 pairs a
      clinical or MR correlate of epilepsy was found; some of those were subtle and
      only apparent by twin-twin comparison. They may be due to occult acquired
      factors, such as prenatal insults, or to genetic abnormalities resulting from
      postfertilization genetic processes.

PMID- 11198297
TI  - The selective vulnerability of brainstem nuclei to Alzheimer's disease.
AB  - In a study of thioflavin S-stained serial sections from the entire brainstem, we
      found that the inferior and superior colliculi and the autonomic, monoaminergic,
      cholinergic, and classical reticular nuclei were affected with varying degrees of
      severity and frequencies in 32 patients with Alzheimer's disease, whereas no
      changes were seen in the brainstems of 26 control subjects. The majority of the
      affected nuclei in patients with Alzheimer's disease exhibit either
      neurofibrillary tangles or senile plaques, and only a few display both. However,
      when sections were immunostained with the antibodies 10D5 and AT8 or ALZ50, both
      beta-amyloid and hyperphosphorylated epitopes of tau protein were found to be
      present in various concentrations in all the affected nuclei. Our findings
      suggest that each brainstem nucleus has a distinct vulnerability to Alzheimer's
      disease-related pathological changes. Given that each nucleus has idiosyncratic
      neuroanatomical connections and prevailing neurochemical characteristics, the
      heterogeneous collection of brainstem nuclei can be considered a suitable
      anatomical ground for further investigation of selective vulnerability in
      Alzheimer's disease. The finding of severe pathological changes in some brainstem
      nuclei also raises the possibility that the dysfunction of these nuclei may
      contribute to the cognitive defects and increased rates of morbidity and
      mortality in patients with Alzheimer's disease.

PMID- 11198298
TI  - Selective alterations in glutamate and GABA receptor subunit mRNA expression in
      dysplastic neurons and giant cells of cortical tubers.
AB  - The molecular pharmacologic basis of epileptogenesis in cortical tubers in the
      tuberous sclerosis complex is unknown. Altered transcription of genes encoding
      glutamatergic and gamma-aminobutyric acid (GABA)-ergic receptors and uptake sites
      may contribute to seizure initiation and may occur selectively in dysplastic
      neurons and giant cells. Arrays containing GABA A (GABAAR), GluR, NMDA receptor
      (NR) subunits, GAD65, the vesicular GABA transporter (VGAT), and the neuronal
      glutamate transporter (EAAC1) cDNAs were probed with amplified poly (A) mRNA from
      tubers or normal neocortex to identify changes in gene expression. Increased
      levels of EAAC1, and NR2B and 2D subunit mRNAs and diminished levels of GAD65,
      VGAT, GluR1, and GABAAR alpha1 and alpha2 were observed in tubers. Ligand-binding
      experiments in frozen tuber homogenates demonstrated an increase in functional
      NR2B-containing receptors. Arrays were then probed with poly (A) mRNA from
      single, microdissected dysplastic neurons, giant cells, or normal neurons (n = 30
      each). Enhanced expression of GluR 3, 4, and 6 and NR2B and 2C subunit mRNAs was
      noted in the dysplastic neurons, whereas only the NR2D mRNA was upregulated in
      giant cells. GABAAR alpha1 and alpha2 mRNA levels were reduced in both dysplastic
      neurons and giant cells compared to control neurons. Differential expression of
      GluR, NR, and GABAAR mRNAs in tubers reflects cell-specific changes in gene
      transcription that argue for a distinct molecular phenotype of dysplastic neurons
      and giant cells and suggests that dysplastic neurons and giant cells make
      differential contributions to epileptogenesis in the tuberous sclerosis complex.

PMID- 11198299
TI  - Is there a correlation between spreading depression, neurogenic inflammation, and
      nociception that might cause migraine headache?
AB  - The time course of propagation of scotoma and blood flow changes during migraine
      aura parallels the phenomenon of cortical spreading depression (CSD). It was
      proposed that CSD generates a sterile neurogenic inflammation in the meninges,
      which may then lead to the activation or sensitization of nociceptors, thus
      generating headache. We performed rat experiments in which the effect of CSD on
      plasma extravasation in the dura mater and on neuronal activity in deep laminae
      of the trigeminal nucleus was assessed in vivo. CSD did not alter dural plasma
      extravasation measured by means of bovine serum albumin-coupled flourescein (n =
      17 rats) compared to the CSD-free contralateral side. In an in vitro model, the
      application of KCl to the dura at concentrations extracellularly found during CSD
      did not alter the release of calcitonin gene-related peptide and prostaglandin E2
      from the dura. In 33 rats, neither single CSDs nor a series of CSDs altered
      ongoing neuronal activity or mechanical and/or thermal sensitivity of the deeply
      located neurons to stimulation of their receptive fields in the dura mater. These
      results are at variance with data that showed increased c-Fos labeling in
      superficial laminae of the trigeminal nucleus following CSD. They do not suggest
      that CSD initiates migraine headache via neurogenic inflammation.

PMID- 11198300
TI  - Role of mitochondrial dysfunction and dopamine-dependent oxidative stress in
      amphetamine-induced toxicity.
AB  - To define the molecular mechanisms underlying amphetamine (AMPH) neurotoxicity,
      primary cultures of dopaminergic neurons were examined for drug-induced changes
      in dopamine (DA) distribution, oxidative stress, protein damage, and cell death.
      As in earlier studies, AMPH rapidly redistributed vesicular DA to the cytoplasm,
      where it underwent outward transport through the DA transporter. DA was
      concurrently oxidized to produce a threefold increase in free radicals, as
      measured by the redox-sensitive dye dihydroethidium. Intracellular DA depletion
      using the DA synthesis inhibitor alpha-methyl-p-tyrosine or the vesicular
      monoamine transport blocker reserpine prevented drug-induced free radical
      formation. Despite these AMPH-induced changes, neither protein oxidation nor cell
      death was observed until 1 and 4 days, respectively. AMPH also induced an early
      burst of free radicals in a CNS-derived dopaminergic cell line. However, AMPH
      mediated attenuation of ATP production and mitochondrial function was not
      observed in these cells until 48 to 72 hours. Thus, neither metabolic dysfunction
      nor loss of viability was a direct consequence of AMPH neurotoxicity. In
      contrast, when primary cultures of dopaminergic neurons were exposed to AMPH in
      the presence of subtoxic doses of the mitochondrial complex I inhibitor rotenone,
      cell death was dramatically increased, mimicking the effects of a known
      parkinsonism-inducing toxin. Thus, metabolic stress may predispose dopaminergic
      neurons to injury by free radical-promoting insults such as AMPH.

PMID- 11198301
TI  - Lack of activation of human secondary somatosensory cortex in Unverricht-Lundborg
      type of progressive myoclonus epilepsy.
AB  - Previous electroencephalographic and magnetoencephalographic studies have
      demonstrated giant early somatosensory cortical responses in patients with
      cortical myoclonus. We applied whole-scalp magnetoencephalography to study
      activation sequences of the somatosensory cortical network in 7 patients with
      Unverricht-Lundborg-type progressive myoclonus epilepsy diagnostically verified
      by DNA analysis. Responses to electric median nerve stimuli displayed 30-msec
      peaks at the contralateral primary somatosensory cortex that were four times
      stronger in patients than in control subjects. The amplitudes of 20-msec
      responses did not significantly differ between the groups. In contrast to control
      subjects, 5 patients displayed ipsilateral primary somatosensory cortex activity
      at 48 to 61 msec in response to both left- and right-sided median nerve stimuli.
      Furthermore, their secondary somatosensory cortex was not significantly
      activated. These abnormalities indicate altered responsiveness of the entire
      somatosensory cortical network outside the contralateral primary somatosensory
      cortex in patients with Unverricht-Lundborg-type progressive myoclonus epilepsy.
      The deficient activation of the secondary somatosensory cortex in Unverricht
      Lundborg patients may reflect disturbed sensorimotor integration, probably
      related to impaired movement coordination.

PMID- 11198302
TI  - Bruising and the ketogenic diet: evidence for diet-induced changes in platelet
      function.
AB  - Excessive bruising is a symptom noted by parents of some children treated with
      the ketogenic diet for epilepsy control, although this side effect is not
      reported in the literature. We evaluated our cohort of current and past diet
      treated patients for symptoms of bruising or bleeding through chart review and
      prospective screening at clinic follow-up visits. A significant increase in
      bruising or other minor bleeding was reported and/or observed in 16 of 51
      patients (31.4%). There were no differences in sex distribution or number of
      anticonvulsants used between patients with bruising/bleeding and those without
      this symptom, although the group with bruising/bleeding was significantly
      younger. No specific anticonvulsant was associated with bruising/bleeding. Six
      patients with diet-induced bruising/bleeding underwent an investigation for
      bleeding diathesis. Five of these patients had prolonged bleeding times and all
      had diminished responsiveness to various platelet aggregating agents, with no
      evidence of a release defect. The abnormalities all normalized in the 1 patient
      tested after ceasing the diet. No patients had serious hemorrhage. One patient
      had mild von Willebrand disease, which had been asymptomatic before diet
      initiation. Some patients were Stimate responsive, suggesting a treatment for
      more severe bouts of symptoms. These data suggest that a ketogenic diet-related
      bleeding tendency occurs in about one third of treated patients owing to
      preexisting factors defining susceptibility in combination with diet-induced
      depression of platelet responsiveness, possibly related to changes in platelet
      membrane lipid composition and/or concentration and resultant effects on function
      of membrane-embedded proteins. Patients on the diet undergoing anticoagulation or
      surgery should be evaluated carefully for symptoms of bleeding tendency.

PMID- 11198303
TI  - Coronary-to-pulmonary fistulae: what are they? What are their causes? What are
      their functional consequences?

PMID- 11198304
TI  - Reflections from the past and thoughts for the future.

PMID- 11198305
TI  - Impact of the "stent-when-feasible" policy on in-hospital and 6-month success and
      complication rates after coronary angioplasty: single-center experience with
      17,956 revascularization procedures (1993-1997).
AB  - This retrospective, observational, single-center study analyzed the results of a
      "stent-when-feasible" policy in a real-world setting. The study began in the "pre
      stent" period (1993) and ended after the beginning of the "routine stent" period
      (1997). When the 1993 and 1997 global data were compared, the early and 6-month
      results included significant improvements in the rates of angiographic success
      (89.3% vs 97.1%), emergency surgical revascularization (1.0% vs 0.3%), freedom
      from in-hospital major events (91.2% vs 95.9%), and freedom from 6-month major
      events (77.2% vs 85.1%). The 6-month redo revascularization rate was reduced by
      almost half for "any catheter intervention" (19.6% vs 10.7%) and was lowest after
      stent use (7.7% in 1997).

PMID- 11198306
TI  - The string phenomenon: an important cause of internal mammary artery graft
      failure.
AB  - Internal mammary arteries are the grafts of choice for coronary artery bypass
      because they are generally free of atherosclerosis and they have high patency
      rates as grafts. There are, however, increasing reports of graft failure due to
      diffuse or distal narrowing, known as the string phenomenon. From June 1999 to
      October 1999, we prospectively reviewed all cases of internal mammary artery
      angiography at our institution. Twenty-eight cases of internal mammary artery
      graft failure were identified (M:F, 15:13; mean age, 62 years) out of 261
      patients who had undergone internal mammary artery grafting at any institution,
      including ours. The mean interval between coronary artery bypass and re
      angiography was 35 months. There was evidence of competitive flow in 81% (22 of
      27) of patients whose internal mammary grafts had developed the string sign. This
      observational study supports the hypothesis that competitive flow predisposes
      internal mammary grafts to the string phenomenon. Given the high frequency of
      competitive flow situations amongst patients with internal mammary artery graft
      failure, caution should be exercised in the anastomosis of the internal mammary
      artery to recipient vessels that are less than severely stenosed.

PMID- 11198307
TI  - Should a regurgitant mitral valve be replaced simulataneously with a stenotic
      aortic valve?
AB  - Mitral valve regurgitation frequently accompanies aortic valve stenosis. It has
      been suggested that mitral regurgitation improves after aortic valve replacement
      alone and that the mitral valve need not be replaced simultaneously Furthermore,
      mitral regurgitation associated with coronary artery disease, particularly in
      patients with poor left ventricular function, shows immediate improvement after
      coronary artery bypass grafting. We studied 60 consecutive patients with aortic
      stenosis and mitral regurgitation to determine the degree of improvement in
      mitral regurgitation after aortic valve replacement alone versus aortic valve
      replacement combined with coronary artery bypass grafting. Thirty-six of the
      patients had normal coronary arteries (Group 1); the other 24 had symptomatic
      coronary artery disease requiring bypass surgery (Group 2). Echocardiography was
      performed preoperatively, 1 week postoperatively, and at follow-up. In Group 1,
      left ventricular ejection fraction did not improve early or at 2.5 months
      postoperatively, but mitral regurgitation improved gradually during follow-up. In
      Group 2, mitral regurgitation showed improvement 1 week postoperatively (p <
      0.001), and left ventricular ejection fraction was improved at 2.5 months. We
      conclude that patients with aortic valve stenosis and mild-to-severe mitral
      regurgitation, without echocardiographic signs of chordal or papillary muscle
      rupture and without coronary artery disease, should undergo aortic valve
      replacement alone. The mitral regurgitation will remain the same or improve. For
      patients with coexisting coronary artery disease, simultaneous aortic valve
      replacement and coronary artery bypass grafting are imperative; however, the
      mitral valve again requires no intervention, since mitral regurgitation improves
      significantly after the other 2 procedures.

PMID- 11198308
TI  - Cardiac surgery in patients infected with human immunodeficiency virus.
AB  - From January 1991 through December 1999, 5 consecutive patients who were infected
      with human immunodeficiency virus presented in need of cardiac surgery. All were
      men; the median age was 44 years. Two of them presented with mitral and aortic
      infectious valve endocarditis, 1 with tricuspid endocarditis, 1 with prosthetic
      valve endocarditis, and 1 with pericarditis and pericardial tamponade. Under
      cardiopulmonary bypass, the 4 patients with endocarditis underwent these
      procedures: mitral and aortic valve replacement (2), tricuspid valve replacement
      (1), and aortic valve replacement (reoperation) and concomitant repair of a
      mycotic ascending aortic aneurysm (1). In the patient who had pericardial
      effusion, subxifoid pericardiostomy and drainage were performed, and a
      pericardial window was created. There was no intraoperative mortality. The
      patient with pericardial effusion died 8 days after surgery; he was in septic
      shock and had multiple organ failure. Two deaths occurred at 2 and 63 months, due
      to hemoptysis and sudden death, respectively. The 2 patients who underwent double
      valve replacement are alive and in good condition after a median follow-up of 71
      months. Cardiac surgery is indicated in selected patients infected by the human
      immunodeficiency virus. These patients are frequently drug abusers or homosexual.
      Valvular endocarditis is the most common finding. Hospital morbidity and
      mortality rates are higher than usual in this group of patients.

PMID- 11198309
TI  - Assessment of perfusion toward the aortic valve using the new dispersion aortic
      cannula during coronary artery bypass surgery.
AB  - When there is an echocardiographic diagnosis of severe mobile atherosclerotic
      plaque in the aortic arch or descending aorta, perfusion toward the aortic arch
      during cardiopulmonary bypass may create a high risk of embolic neurologic
      injury. Other perfusion methods, such as cannulation of the femoral or axillary
      arteries, are not always possible, due to atherosclerosis. The ascending aorta
      may be an alternative site for perfusion, since it is less frequently diseased.
      We assessed a new technique of perfusion toward the aortic valve using a new
      cannula designed for this purpose (Dispersion aortic cannula). Our study included
      100 consecutive patients, 72 men and 28 women, with an average age of 68 +/- 1.0
      years (range, 39-89 years). There were no complications related to insertion of
      the cannula or perfusion. The ascending aorta could be cross-clamped and side
      clamped without perfusion problems. Three deaths occurred; none was related to
      the cannulation technique. No intra-operative stroke occurred. Two patients
      suffered neurologic events, one on day 1 and the other on day 6; both had been
      fully alert after surgery. Perfusion toward the aortic valve appears to be safe
      and hemodynamically effective. This cannulation technique appears to be an
      acceptable alternative to present methods. Comparative studies will be needed to
      determine whether this alternative technique is effective in patients with severe
      aortic arch disease.

PMID- 11198310
TI  - Bentall operation with valved homograft conduit.
AB  - Lesions of the ascending aorta associated with aortic valve disease are usually
      treated by implanting a prosthetic valved conduit (Bentall procedure). In this
      report, we present our experience in which a valved homograft conduit was used
      for the procedure. Six patients underwent a Bentall procedure with the use of a
      cryopreserved valved homograft conduit. Two of the patients had annuloaortic
      ectasia, 2 had Marfan syndrome, and 1 had an atherosclerotic aneurysm of the
      aorta. One patient had severe aortic stenosis due to a bicuspid aortic valve,
      along with an aneurysm and localized dissection of the ascending aorta. In all of
      the patients, the aortic annulus was substantially dilated, with accompanying
      moderate-to-severe aortic regurgitation. A standard procedure was performed with
      moderate hypothermia, cardiopulmonary bypass, and aortic and bicaval cannulation.
      The ascending aorta and the aortic valve were replaced with a cryopreserved
      valved homograft conduit (aortic in 5 patients and pulmonary in 1). The native
      coronary ostia were anastomosed directly to the homograft. Echocardiography,
      which was performed intraoperatively, before discharge from the hospital, and at
      follow-up visits (1 to 36 months), revealed good valve function without
      dilatation of the homograft conduits. There was 1 late death due to Aspergillus
      fumigatus endocarditis, 6 months postoperatively. In 1 patient, magnetic
      resonance imaging performed at 24 months revealed normal caliber of the homograft
      conduit. We conclude that the Bentall procedure can be performed, safely and with
      excellent results, using cryopreserved homograft conduits.

PMID- 11198312
TI  - Austin Flint: clinician, teacher, and visionary.

PMID- 11198311
TI  - Update on endovascular treatment of peripheral vascular disease: new tools,
      techniques, and indications.
AB  - The treatment of peripheral vascular disease is one of the most rapidly expanding
      fields of medicine today At one time, patients who had peripheral vascular
      disease had few medical or surgical options. Now, however, options abound. The
      number of peripheral interventions increased from 90,000 in 1994 to more than
      200,000 in 1997 and endovascular techniques may soon replace up to 50% of
      traditional vascular operations. Cardiologists, interventional radiologists, and
      vascular surgeons bring various types of expertise to endovascular intervention;
      nonetheless, they seem to share similar levels of enthusiasm about this treatment
      option. The many advantages to the patient that such intervention offers over
      traditional surgery, such as the avoidance of anesthesia and other surgical
      risks, the rapid recovery time, and the relatively low treatment costs, provide
      encouragement to these specialists. Endovascular intervention requires dedication
      on the part of practitioners, because it demands such complete knowledge of
      vascular disease and of the anatomic changes experienced by the patient. The
      challenge is intensified by the continual introduction of new products and
      methods. We hope, herein, to offer pertinent information about recent advances in
      interventional techniques and devices, and to provide a framework for future
      education.

PMID- 11198313
TI  - Local pulmonary malformation caused by bilateral coronary artery and bronchial
      artery fistulae to the left pulmonary artery in a patient with coronary artery
      disease.
AB  - At 10 years of age and again at 25, our patient had been treated for pulmonary
      tuberculosis due to the presence of a localized pulmonary shadow. Coronary
      angiography at age 59 revealed 3 fistulous communications: from the right and
      circumflex coronary arteries and from the left bronchial artery. All 3 emptied
      into the same recipient artery, the distal part of a left pulmonary artery
      branch, which produced substantial left-to-right shunt. On computed tomography,
      cystic formations could be seen in the pulmonic area. The pulmonary tuberculosis
      for which this patient had been treated in his youth was in the same part of the
      lung where the shunt was discovered. Our conclusion is that the initial diagnosis
      was in error.

PMID- 11198314
TI  - Plexus between internal mammary graft and pulmonary vasculature after minimally
      invasive coronary surgery.
AB  - We report a complication associated with minimally invasive direct coronary
      artery bypass grafting surgery The patient suffered a nonfatal anterior
      myocardial infarction 1 day after he underwent minimally invasive bypass grafting
      using the internal mammary artery. Two months later, coronary arteriography
      revealed a fistulous connection between the left internal mammary graft and the
      left pulmonary vasculature. To our knowledge, this particular complication has
      not been reported following minimally invasive coronary surgery.

PMID- 11198315
TI  - Double aortic arch in D-transposition of the great arteries: confirmation of
      dominant arch by magnetic resonance imaging.
AB  - We report the case of a female infant who had the rare combination of double
      aortic arch and D-transposition of the great arteries. The double aortic arch was
      diagnosed at the time of her arterial switch procedure. Magnetic resonance
      imaging identified the left arch as dominant, and the right arch was successfully
      ligated.

PMID- 11198316
TI  - Right ventricular and septal anomalies complicated by subacute bacterial
      endocarditis.
AB  - We report the case of a 31-year-old woman with no history of heart disease. She
      came to the hospital with fever, dyspnea, palpitation, and edema of the lower
      extremities. She was found to have aortic, mitral, and pulmonary valve
      insufficiency, and the initial diagnosis was subacute bacterial endocarditis. At
      surgery, we replaced the aortic and mitral valves with mechanical prostheses and
      the pulmonary valve with a bioprosthesis. The prostheses were soaked
      intraoperatively with fluconazole and the heart chambers were irrigated with
      povidone-iodine to prevent infection by bacteria and fungi. We also found 2
      previously unsuspected anomalies: 1 was a muscular bundle that divided the right
      ventricle into 2 chambers, and the other was a ventricular septal defect, 1.0 cm
      in diameter. We resected the muscular bundle and patched the septal defect. The
      patient had an uneventful postoperative course and was in New York Heart
      Association functional class I at the 15-month follow-up visit. We speculate that
      this patient's congenital anomalies made the heart more susceptible to damage
      from the endocarditis. Therefore, any patient who has infective endocarditis
      should also be examined closely for congenital defects.

PMID- 11198317
TI  - Tricuspid and pulmonary valve involvement in carcinoid disease.
AB  - We report the case of a 62-year-old woman in whom carcinoid disease had been
      diagnosed 6 years earlier. She subsequently developed tricuspid and pulmonary
      valve disease. Both valves were incompetent and mildly stenotic. The tricuspid
      valve required surgery; the pulmonary vaive was explored but not treated. Valve
      surgery in patients with carcinoid disease is discussed in light of the prognosis
      of these patients, the timing of valvular lesion presentation, and the choice of
      prosthesis. The justification for multiple-valve procedures in such cases is also
      considered.

PMID- 11198318
TI  - Endovascular treatment of a noninfected anastomotic juxtarenal aortic aneurysm.
AB  - An 82-year-old man underwent an endovascular procedure with a commercially
      available endovascular graft for an anastomotic juxtarenal abdominal aortic
      aneurysm. The anastomotic aneurysm, which showed no sign of infection, developed
      4 years after implantation of an aortic end-to-end graft for an infrarenal aortic
      aneurysm. The aneurysm was diagnosed during routine ultrasonographic follow-up;
      there was no apparent infection of the graft. Aortography confirmed the diagnosis
      and also revealed a small pseudoaneurysm at the level of the distal aortic
      anastomosis. Endovascular surgery was performed in the operating room with the
      guidance of C-arm fluoroscopy and intravascular ultrasound. Two Vanguard Straight
      Endovascular Aortic Graft Cuffs (26 x 50 mm and 24 x 50 mm) were implanted,
      successfully excluding both the anastomotic juxtarenal aortic aneurysm and the
      distal pseudoaneurysm. The renal arteries were preserved and no early or late
      endoleaks were observed. The patient was discharged 2 days after the procedure.
      Sixteen months later, he was alive and well, with no endovascular leakage, no
      enlargement of the aortic aneurysms, and no sign of infection. In our opinion,
      this experience shows that commercially available endovascular grafts may be used
      successfully to treat anastomotic aortic aneurysms and pseudoaneurysms.

PMID- 11198319
TI  - Two-stage elephant trunk reconstruction for aneurysm of an aberrant right
      subclavian artery in association with aneurysmal distal aortic arch and
      descending thoracic aorta.
AB  - Surgical treatment of the combination of aneurysms of an aberrant right
      subclavian artery, distal aortic arch, and descending thoracic aorta requires
      control of structures in both the right and the left hemithorax. We report a 2
      stage surgical approach. The 1st stage, performed through a median sternotomy,
      consists of an elephant trunk reconstruction and an interposition graft to the
      ligated aberrant right subclavian artery. The 2nd stage, performed through a left
      thoracotomy is an interposition graft from the elephant trunk to the distal
      descending thoracic aorta.

PMID- 11198320
TI  - Hydatid cyst in the interventricular septum: a rare cause of dizziness?

PMID- 11198321
TI  - Intermittent constriction of the ductus arteriosus in the fetus: a cause for
      concern?

PMID- 11198322
TI  - Curved sternotomy incision.

PMID- 11198323
TI  - Report on accreditation learning sets in the West Midlands region of the NHS.
AB  - This article reports on the evaluation of the first year of a project, which
      utilized learning sets to support librarians undergoing the accreditation
      process, in the health libraries in the West Midlands region of the NHS. The West
      Midlands Health region is divided up into education consortia patches. Each group
      of patch librarians was allocated a local accreditation facilitator. The groups
      met regularly to discuss problems and progress relating to their library's
      accreditation. The results of the evaluation suggest that this is a valuable
      approach to use. The recommendations state that regular, frequent meetings are
      needed. Extra training and guidance would help the facilitators to be more
      effective in their role.

PMID- 11198324
TI  - Canada's national initiative to advance access to electronic journals.
AB  - This paper describes a national experiment in the licensing of full text
      information in journals, primarily in the fields of science, technology and
      medicine. It discusses the initiative of the federal government of Canada through
      the creation of the Canada Foundation for Innovation as a new funding agency,
      with an objective of improving research and creativity in Canadian science. The
      successful efforts initiated by the Canadian Association of Research
      Libraries/Association des bibliotheques de recherche du Canada to create a
      funding opportunity to develop the 'information infrastructure' for Canadian
      researchers and the resulting Canadian National Site Licensing Project (CNSLP)
      progress is discussed. The evolution of a project governance structure to
      maintain the support of the 64 participating institutions is reviewed and the
      need to develop an appropriate exit strategy at the conclusion of the federal
      funding is also considered.

PMID- 11198325
TI  - Information and its value to health workers in rural Uganda: a qualitative
      perspective.
AB  - A study was conducted in 1998/99 to investigate the accessibility and use of
      information by health workers in rural Uganda. Data were collected qualitatively
      using semi-structured interviews. As a qualitative study, it focused in-depth on
      a relatively small sample of health workers selected purposefully. Different
      categories of health workers were interviewed. Data were analysed using a
      grounded theory approach. In this paper, two main categories that emerged from
      the data will be discussed, namely: value of information and constraints.
      Information was valuable in clinical work, information dissemination, decision
      making, administration and detection. Constraints to effective information use
      included the quality and relevance of the information as well as the difficulties
      of sometimes putting theory into practice. Finally, the concepts that emerged
      from the analysis of the use of information pointed directly to the information
      needs of the health workers studied, which shows that information was valuable in
      meeting those needs. Some implications of the study and areas for further
      research are highlighted.

PMID- 11198326
TI  - Improving the provision of traditional health knowledge for rural communities in
      Ghana.
AB  - In Ghana many rural illiterate people practise traditional medicine and spread
      their knowledge through oral communication among themselves. This paper observes
      that traditional health information which freely circulates, and is actively
      disseminated by healers in rural communities greatly contributes to the knowledge
      for preparing home remedies and other traditional interventions. Oral
      communication can give rise to inaccurate and even dangerous information where
      charlatans can penetrate and operate within the health system. The Danfa project,
      which involved verbal teaching of modern health techniques to illiterate
      herbalists, and educating villagers about improved traditional medical practices,
      is described as a success story of information provision for illiterates. The
      experience is applied to propose the modification of some training programmes
      under the Ministry of Health to produce traditional health care information
      providers. Repackaged information and the public media are recommended as the
      most effective method of transferring knowledge to those unable to read.

PMID- 11198327
TI  - Creating books for the National electronic Library for Health: expected barriers
      and useful lessons.
AB  - The National electronic Library for Health (NeLH) is now taking shape, as the
      virtual branch libraries begin to accumulate 'books', among their resources. In
      the Primary Care branch (http://www.nelh-pc.nhs.uk), one of the first available
      books was the Statement of Fees and Allowances (otherwise known as the Red Book).
      While being held up as an example of what the NeLH can offer, this book and the
      story of its transformation from paper to Internet format is a powerful example
      of how much further the National Health Service (NHS) must go before it can claim
      to be fully exploiting the benefits of information technology (IT). This article
      refers to the author's experience in producing electronic books for primary care
      using WaX software, and an example of a process change from paper to screen that
      was managed within a university administrative office. The author suggests that
      to reap optimal benefits from IT, the NeLH and its collaborators must address the
      fundamental issues of people and the paper-based processes used by information
      providers. The NeLH must work with both NHS IT trainers and information providers
      in a three-way collaboration involving key people and processes, to achieve the
      efficient production of an updateable and user-friendly library of electronic
      books.

PMID- 11198328
TI  - Qualitative research in health information user studies--a methodological
      comment.

PMID- 11198329
TI  - The Forest Healthcare Clinical Support Librarian: 6 months on.

PMID- 11198330
TI  - Access to reliable information for health workers in developing countries:
      information for all, starting at grass roots level in Africa.

PMID- 11198331
TI  - Primary care information management: 5 years of progress 1995-2000. A personal
      view.

PMID- 11198332
TI  - 'Clearly evident' a CD-ROM to teach junior doctors information skills.

PMID- 11198333
TI  - Research. Increasing the uptake of research findings by health librarians depends
      on two core skills.

PMID- 11198334
TI  - [Physical exercise: a little developed intervention in primary care].

PMID- 11198335
TI  - [Quality analysis of clinical practice guidelines on cardiovascular risks in the
      Basque country and a proposal for their evaluacion].
AB  - OBJECTIVES: To find the implantation and quality of clinical practice guidelines
      (CPG) to manage the major cardiovascular risks: tobacco dependency, hypertension,
      hyperlipaemia and diabetes mellitus. To work out a model to evaluate the quality
      of the CPG in primary care. DESIGN: Cross-sectional descriptive study. SETTING:
      The primary care centres of the Basque Country. PARTICIPANTS: 170 CPG used at
      present to manage the four mentioned cardiovascular risks. MEASUREMENTS AND MAIN
      RESULTS: Information was requested on the use of CPG and copies of their
      guidelines were requested from those in charge of 103 ranked centres. 77 centres
      replied (76%), of which 66 said they used one of them. A total of 170 CPG were
      received. On the basis of non-specific prior proposals for primary care, 21
      quality criteria for the CPG, grouped in 6 blocks, were drawn up. Top quality was
      found in the block for clarity of clinical procedure with 63% compliance with the
      CPG, followed by general description (54%), and evaluation and measurement of
      impact (30%). The blocks with worst compliance were identification of people
      involved in their design (23%), evidence of their recommendations (19%) and
      conditions of application (4%). CONCLUSIONS: A model was proposed to evaluate the
      quality of the CPG. Major deficiencies in quality were found. These were most
      marked in key aspects such as bibliographic support for their recommendations,
      envisaging of conditions for application and identification of authors and
      reviewers.

PMID- 11198336
TI  - [Design of a method for the evaluation of clinical competence in primary care].
AB  - OBJECTIVE: To measure clinical competence in primary care (PC). DESIGN:
      Descriptive cross-sectional study. SETTING: Six PC teams in Barcelona.
      PARTICIPANTS: 25 family doctors volunteering out of a total of 60. MEASUREMENTS
      AND MAIN RESULTS: Three simulated visits took place on three different days,
      allocated at random as a prior appointment for hypertension. Clinical competence
      was measured through the Miller criteria, a method with open short-reply
      questions combining the clinical interview with standardised patients (SP),
      review of clinical histories (CH) and doctor's self-evaluation (DS). The
      following components of competence (CC) were evaluated: anamnesis, physical
      examination, further tests, differential diagnosis, management, clinical history
      and communication. 22 doctors completed the study. Each CC was weighted by a
      group of experts, who also agreed two minimum levels of competence, 50% and 60%.
      Each doctor's final score was the result of the addition of each of the three
      cases divided by the maximum score possible. The CC values were always higher
      with SP than otherwise. 63.3% of doctors surpassed the 60% mark, and 90.9% the
      50% mark. Internal consistency, measured with Cronbach's alpha, was 0.94, 0.73
      and 0.67 for each clinical case. The kappa reproduction test was 0.25.
      CONCLUSIONS: The use of SP is a good method of evaluation, as it enables
      anamnesis, management of the patient, physical examination and communication to
      be assessed. The study is very reliable, with low reproduction, which is probably
      due to the few cases used.

PMID- 11198337
TI  - [Postcoital hormonal contraception: study on the attitudes and prescription of
      primary care physicians].
AB  - OBJECTIVE: To study the understanding, attitudes and practice of primary care
      doctors in the prescription of hormonal post-coitus interception, along with the
      social and demographic, educational, legal and ethical variables associated with
      this prescription. DESIGN: Cross-sectional descriptive study. SETTING: Area IV de
      INSALUD in Asturias. PARTICIPANTS: Family doctors, excluding locums (n = 178).
      MEASUREMENTS AND RESULTS: An anonymous self-administered questionnaire with 33
      questions, re-sent once, between November 1999 and February 2000. The association
      independence of variables was contrasted through the chi 2 test (a statistically
      significant association if p < 0.05). 77% responded, 51% of whom were men.
      Average age was 43 (SD = 6.69), with professional experience of 17 years worked
      (SD = 6.87). 47% were family doctors and 39% general practitioners. 85% worked in
      health centres; 46% in urban settings. 71% were catholics, 73% (95% CI: 66%-80%)
      had been asked on at least one occasion in the previous six months for the post
      coitus pill (PCP), with demand greater in the urban environment (83%). 18%
      considered the PCP an abortion method. 88% said they would prescribe it (95% CI:
      82.5%-93.5%), of which 30% (95% CI: 16%-44%) did so according to WHO
      recommendations. 100% of the "non-prescribers" were catholics. CONCLUSIONS: Most
      doctors receive requests for the PCP and prescribe it on demand, though
      prescription varies with age, categories and, in particular, religious belief.
      Only a third prescribes according to WHO recommendations.

PMID- 11198338
TI  - [Comparison of primary care teams in Barcelona according to management formulas].
AB  - OBJECTIVE: The aim of the study is to compare, among socio-economically similar
      areas, the use of medical services, clinical practice and pharmacy costs
      depending on the how the primary healthcare teams, that provide these services,
      are organized according to different managemental formulas. DESIGN: Descriptive
      study of the evaluation of health care services. PATIENTS AND METHODS: The
      population units (basic health areas) attended by the reformed primary health
      care services in Barcelona were classified into three levels according to the
      population's socioeconomic status (high, medium or low). For each level, two
      primary health care teams were selected representing different primary health
      care providers: "Institut Catala de la Salut"; and others. The influence of both
      the provision option and the population characteristics on service use, clinical
      practice and costs of prescription were compared. MAIN RESULTS: The services
      offered by the two provision options differ. However, the use of medical services
      is related to the socioeconomic characteristics and not to the option for service
      provision. Whilst there are no relevant differences in clinical practice between
      the different options, we observed variations among different primary care teams,
      notably in referrals to specialists and influenza vaccine coverage. The greater
      source of variation in prescription costs seems to be related to an external
      confounding factor. CONCLUSIONS: Empirical data have not identified relevant
      differences in the pattern of use, clinical practice, or costs between the
      different options for service provision within the model of reformed primary care
      services. Observed variations seem to be associated mainly with the population's
      characteristics, its pattern of health service use or other external confounding
      factors.

PMID- 11198339
TI  - [Nocturnal drop of arterial blood pressure: determinant factors and relationship
      with organic damage secondary to hypertension].
AB  - OBJECTIVES: To evaluate the night-time drop in blood pressure in patients with
      light hypertension and to determine its possible relationship with damage in key
      organs. DESIGN: Cross-sectional study. SETTING: Eight urban health centres.
      PATIENTS: Four hundred and eighteen adults with light-moderate hypertension.
      INTERVENTIONS: a) Blood pressure reading on three visits; b) ambulatory
      monitoring of pressure for 24 hours; c) echocardiograph (in 219 patients); d)
      albuminuria determination (in 134 patients). A night-time drop in blood pressure
      was defined as the difference between day and night ambulatory pressures; and
      relative drop, as the night-time pressure drop as a percentage of the day-time
      pressure. RESULTS: Night-time drop in systolic and diastolic pressures was 13.6
      (10.7) and 12.1 (8.6) mmHg, respectively. The predictive factors of night-time
      drop in blood pressure were, directly, daily ambulatory blood pressure (p < 0.05)
      and female gender (p < 0.05) and, inversely, age (p < 0.05). No association was
      observed between night-time drop in blood pressure and left ventricular mass.
      Only in women was an independent relationship found, inversely, between night
      time drop in blood pressure and urinary excretion of albumin (p < 0.05).
      CONCLUSIONS: Relative night-time drop in blood pressure is greater in women than
      in men, diminishes with age and depends on the day-time ambulatory pressure. In
      women a minor night-time drop in blood pressure is associated with greater
      organic damage.

PMID- 11198340
TI  - [Are occupation and education interchangeable as social indicators in community
      health? A study in an employed population].
AB  - OBJECTIVE: Epidemiological studies and interventions to reduce inequalities in
      community health require the assignation of exhaustive and easy-to-obtain social
      indicators. Occupation and education are two of the most often used. In this
      study we attempt to evaluate the association between education and occupation
      among adult working population because if, in the absence of one of these two
      variables, it will be feasible to use the remaining with the lesser lost of socio
      economic information. DESIGN: From a representative sample (n = 3091) of general
      population (18-65 years old) drawn out from a prevalence survey on chronic
      disease risk factors performed in the Region of Murcia, a log-lineal analysis has
      been made between education and occupation among working people (65.8% of males
      and 34.2% of females from the original sample). RESULTS: Men present significant
      association between managerial positions and university education. The
      association drops between clerks and high school graduates to increase among all
      manual workers with or without primary schooling education. Among women--with a
      lesser number of participants--the education/occupation association describes the
      same pattern but with higher magnitudes in the positive associations between
      managerial positions and university education. For both genders, the greatest
      associations are found in both diagonals of the education by occupation tables
      indicating: better occupation, more education, and the opposite. CONCLUSIONS: The
      classification of working people according to education and occupation presents
      association, internal consistency and gradient. In absence of comprehensive
      information regarding occupation, education could be an alternative as socio
      economic indicator.

PMID- 11198341
TI  - [Home chronic illness and consumption of psychopharmaceuticals].
AB  - OBJECTIVE: To assess the consumption of psychiatric drugs by chronic homebound
      patients. DESIGN: Descriptive, longitudinal study. SETTING: Raval Nord Health
      District, Barcelona. PATIENTS AND OTHER PARTICIPANTS: All 243 chronically ill
      homebound patients registered on the home care programme in May 1996. After three
      years 16% had gone into a home, 9% had moved residence, 38% had died, and 37%
      remained active. MEASUREMENTS AND MAIN RESULTS: Of the 90 patients still active,
      40% took some psychiatric drug in May 1999. 8% of the patients who said they had
      taken psychiatric drugs did so by self-medication. The most commonly consumed
      pharmacological group of the psychiatric drugs were benzodiazepines at 64%. Women
      took more psychiatric drugs (45%), as did persons living alone or who had been
      bereaved (50%). The proportion of patients taking psychiatric drugs was greater
      when there was worse autonomy according to the Katz index (67%), a cognitive
      deficit on the Short Portable Mental Status Questionnaire (SPMSQ) of Pfeiffer
      (62%), and in the presence of comorbidity (56%) (p < 0.01). CONCLUSIONS: There is
      high consumption of psychiatric drugs by chronic homebound patients, especially
      when there is physical-cognitive deterioration and presence of comorbidity.

PMID- 11198342
TI  - [Effectiveness, strategies and successes in weight loss in function of
      anthropometric parameters].
AB  - OBJECTIVES: To find the variability in women's appearance at three moments of
      their life cycle and its relationship with practices aiming at weight loss,
      analysing the efficacy of this behaviour. DESIGN: Cross-sectional. SETTING: Women
      from the Community of Madrid who formed part of an investigation by the Unit of
      Anthropology of the Department of Biology of the Autonomous University of Madrid
      (UAM) into perception of image and associated behaviour as a function of age,
      body mass index, and social and economic conditions. PARTICIPANTS: 535 women in
      three age groups: 200 adolescents belonging to two secondary schools in Madrid;
      202 university students from the Biology Faculty of the UAM, and 135 women aged
      between 45 and 65 and living in the Madrid area of Alcobendas, who were taking
      part in a women's health programme run by the Alcobendas town council. MATERIAL
      AND METHODS: Information was collected on body measurements, self-perception and
      image assessment, with perception indicators and body form indicators contrasted.
      RESULTS: There were a great many attempts to lose weight by adolescents and women
      over 45, with the starting age for such practices much earlier in the
      adolescents' and students' groups. It was particularly striking that 44% of the
      adolescents within the thin category had tried to lose weight. Among the students
      and women over 45 this percentage rose in consonance with their overweight. The
      older women were more effective at losing weight, but it was very difficult for
      them to maintain this loss. The speed of weight loss was higher in women with
      higher body mass index. CONCLUSIONS: Physical appearance varies between young
      women and women over 45, in that the former are taller, thinner and with a
      straighter figure. Despite this, young women develop behaviour designed to lose
      weight much more often than older women, with an earlier starting age and more
      rapidly, which can have serious health consequences.

PMID- 11198343
TI  - [Validity of the declared tobacco consumption in pregnancy].
AB  - OBJECTIVES: To analyse the relationship between the stated consumption of tobacco
      by pregnant women who say they smoked before pregnancy and the levels of cotinine
      in their urine at the start and end of pregnancy. DESIGN: Observational,
      longitudinal study. PARTICIPANTS: During 1997. STUDY GROUP: 147 pregnant women at
      their first pre-natal visit to outclinics of the Hospital del Mar. CONTROL GROUP:
      50 non-smoker pregnant women monitored during their pregnancy. MEASUREMENTS AND
      MAIN RESULTS: The numbers of cigarettes per day that they said they smoked on
      their first monitoring visit to our centre and at the last attendance before
      giving birth were recorded. Cotinine levels in the urine samples taken on these
      visits were measured. Mean cotinine in pregnant women who said they had given up
      smoking was higher than in non-smokers. There was a statistically significant
      linear relationship between the number of cigarettes stated and cotinine levels
      at the first and last pregnancy monitoring visits, as well as between the
      variation in the number of cigarettes and cotinine levels at these two visits.
      The negative predictive value of what they said about their tobacco habit was
      82.9%. CONCLUSIONS: There was a certain under-declaration by pregnant smokers,
      although their statements of consumption and cotinine levels correlated closely.
      The under-declaration did not increase despite reiterated advice to stop smoking,
      which means that, despite its limitations, it could be a useful indicator for
      evaluating the effect of interventions aimed at stopping women smoking during
      pregnancy.

PMID- 11198344
TI  - [Rational use of rofecoxib].

PMID- 11198345
TI  - [New drugs or therapeutic novelties? El Comite de Evaluacion de Nuevos
      Medicamentos del Instituto Catalan de Salud].

PMID- 11198346
TI  - [The family physician and elderly abuse syndrome].

PMID- 11198347
TI  - [All that glitters is not hysteria].

PMID- 11198348
TI  - [Antibiotic resistance: a public health problem].

PMID- 11198349
TI  - [AMPA (AutoMonitoring of Arterial Pressure) and MAPA (Ambulatory Monitoring of
      Arterial Pressure].

PMID- 11198350
TI  - Post-injury multiple organ failure: the role of the gut.
AB  - Despite intensive investigation, the pathogenesis of post-injury multiple organ
      failure (MOF) remains elusive. Laboratory and clinical research strongly suggests
      that the gastrointestinal tract (i.e., the gut) plays a pivotal pathogenic role.
      Since its inception in 1988, the Trauma Research Center (TRC) at the University
      of Texas-Houston Medical School (UTHMS) has focused its efforts on elucidating
      the role of the gut in post-injury MOF. On the basis of our observations and
      those of others, we believe that 1) shock with resulting gut hypoperfusion is an
      important inciting event, 2) the reperfused gut is a source of proinflammatory
      mediators that can amplify the early systemic inflammatory response syndrome
      (SIRS) and thus contribute to early MOF, 3) early gut hypoperfusion causes an
      ileus in both the stomach and small bowel that sets the stage for progressive gut
      dysfunction so that the proximal gut becomes a reservoir for pathogens and toxins
      that contribute to late sepsis-associated MOF, and 4) late infections cause
      further worsening of this gut dysfunction. Thus, the gut can be both an
      instigator and a victim of MOF. The purpose of this article is to provide the
      rationale behind these beliefs and to provide a brief overview of the ongoing
      research projects in the TRC at UTHMS.

PMID- 11198351
TI  - Decreased oxidant buffering impairs NF-kappaB activation and ICAM-1 transcription
      in endothelial cells.
AB  - The DNA binding activity of the transcription factor, NF-kappaB, is regulated by
      the phosphorylation and degradation of its inhibitory protein, IkappaB, and post
      translational modification involving redox reaction of a cysteine residue (Cys62)
      of NF-kappaB. We addressed the role of the redox state of endothelial cells in
      modulating TNFalpha-induced NF-kappaB activity. The effects of TNFalpha on DNA
      binding activity of NF-kappaB and expression of mRNA encoding ICAM-1 (an NF
      kappaB-activated gene) were studied in human pulmonary artery endothelial (HPAE)
      cells under basal conditions and after decreasing the intracellular glutathione
      (GSH) concentration. HPAE cells were treated with buthionine sulfoximine (BSO)
      (16 h), an inhibitor of GSH synthesis, which caused concentration-dependent
      decreases in GSH concentration. Stimulation of control cells with TNFalpha
      resulted in reactive oxygen species (ROS) generation and activation of NF-kappaB
      binding to the ICAM-1 promoter and ICAM-1 transcription. However, stimulation of
      GSH-depleted cells with TNFalpha resulted in ROS accumulation secondary to the
      decreased ROS buffering capacity, and marked impairment of NF-kappaB-binding
      activity and ICAM-1 mRNA expression. Exposure of BSO-treated cells to the
      reducing agent dithiothreitol (DTT) before TNFalpha treatment or supplementation
      of nuclear extract (isolated after TNFalpha challenge of BSO-treated cells) with
      DTT significantly augmented the effect of TNFalpha on NF-kappaB-binding activity
      and ICAM-1 mRNA expression. Thus the oxidative modification of NF-kappaB
      secondary to the loss of ROS buffering capacity may regulate NF-kappaB binding to
      ICAM-1 promoter, and thereby ICAM-1 transcription in endothelial cells.

PMID- 11198352
TI  - Under-resuscitation of near-lethal uncontrolled hemorrhage: effects on mortality
      and end-organ function at 72 hours.
AB  - Laboratory studies of uncontrolled hemorrhage demonstrate that under
      resuscitation (UR) improves short-term survival, but at the expense of tissue
      perfusion. The long-term effects of UR have not been studied. The purpose of this
      study was to evaluate survival and the incidence of end-organ injury (EOI), 3
      days following moderate and severe UR of uncontrolled hemorrhage. Thirty-four
      swine (14-24 kg) were assigned to 4 groups: Groups I, II, and III were
      hemorrhaged to a pulse pressure = 5 mmHg in the presence of a 4-mm aortic tear:
      Group I (control; n = 6) was not resuscitated; Group II (n = 11) was severely
      under resuscitated (MAP [mean arterial pressure] = 40 mmHg) for 75 min; Group III
      (n = 9) was moderately under resuscitated (MAP = 60 mmHg) for 75 min. After 75
      min, the aortotomy was repaired, and animals were resuscitated to baseline
      physiologic parameters. Group IV (sham; n = 8) was instrumented, but not
      hemorrhaged. Seventy-two-hour mortality was 100%, 36%, 22%, and 0% for Groups I
      through IV (P = .001 Fisher's exact). Cardiac indices, serum bicarbonate, and
      systemic oxygen delivery were significantly lower in Group II as compared to
      Group III during the 75 min of UR (P < 0.05; repeated measures ANOVA). By 72 h,
      physiologic parameters in surviving animals had returned to baseline levels.
      Measures of kidney, liver, neurologic, and pulmonary function did not change from
      baseline. There was no histologic evidence of EOI. In this model, 75 min of UR
      did not result in EOI. There was a trend toward greater survival, and tissue
      perfusion was better preserved with moderate as compared to severe UR.

PMID- 11198353
TI  - Modulation of organ ICAM-1 expression during IV-TPN with glutamine and bombesin.
AB  - The gut primes neutrophils (PMNs) during injury, which can then induce distant
      organ damage after a second insult. ICAM-1 is an important adhesion molecule in
      PMN attachment to the vascular endothelium. Parenteral nutrition (TPN) decreases
      gut levels of interleukin (IL)-4 and IL-10, two cytokines that are normal
      inhibitors of ICAM-1 expression. TPN also increases gut ICAM-1 expression and PMN
      accumulation. Since glutamine (GLN) and bombesin (BBS) prevent TPN-associated
      impairment of mucosal immunity, we hypothesized that GLN and BBS would modulate
      organ ICAM-1 expression in association with normalization of IL-4 and IL-10
      levels. Forty-four mice were fed chow, TPN, or GLN-TPN (isonitrogenous 2% GLN
      enriched TPN). After 5 days of diets, ICAM-1 expression was quantified in organs
      using the dual radiolabeled monoclonal antibody technique. In the next
      experiment, 29 mice were fed chow, TPN, or BBS-TPN (BBS 15 microg/kg TID) for 5
      days to measure organ ICAM-1 expression. Total IL-4 and IL-10 levels were
      measured with ELISA from intestinal homogenates of another set of 52 mice fed
      chow, TPN, GLN-TPN, or BBS-TPN. TPN significantly increased ICAM-1 expression in
      the lung, kidney, and intestine compared with chow mice. GLN-TPN decreased
      intestinal, but not lung, ICAM-1 expression, while BBS-TPN reduced pulmonary, but
      not gut, ICAM-1 levels. GLN- and BBS-TPN returned gut IL-4 levels to normal, but
      failed to increase IL-10 levels. GLN and BBS had different effects on organ ICAM
      1 expression induced by lack of enteral nutrition. Mechanisms other than recovery
      of IL-4 alone may be responsible for gut ICAM-1 expression.

PMID- 11198354
TI  - TNF mediates a murine model of Addison's crisis.
AB  - Addison's crisis is the most serious complication of adrenal insufficiency. To
      elucidate the mechanism of this disorder following infection, the role of TNF in
      adrenalectomized murine models of Addison's crisis and Addison's disease (chronic
      hypoglucocorticoidism) were examined. Adrenalectomy conferred a 40-fold increased
      sensitivity to the lethal effects of lipopolysacharride (LPS) (P < .001).
      Enhanced sensitivity to LPS was found to increase with duration of adrenal
      insufficiency (P < .02). Enhanced lethality to heat-killed Streptococcus
      pneumonia was also demonstrated (P < 0.02). Necropsy of endotoxin-killed
      adrenalectomized mice demonstrated similar pathologic findings to those found by
      others when the control mice were administered a lethal dose of either LPS or
      TNF. Adrenalectomized TNF receptor Ia and Ib double null mice were demonstrated
      to be resistant to the lethal effects of LPS (P < 0.02). Pretreatment with anti
      TNF, but not control antisera, was found to prevent death in LPS-treated wild
      type adrenalectomized mice as well (P < 0.02). Studies into the mechanism by
      which TNF was precipitating Addison's crisis demonstrated enhanced sensitivity to
      TNF (3-fold; P < 0.02), and a marked increase in serum TNF concentration
      (approximately 5-fold; P < 0.001) following LPS challenge. The effect of TNF upon
      long-term survival in adrenalectomized mice was examined in TNF-receptor Ia- and
      Ib-deficient mice. Deficiencies in either the TNF-receptor Ia or Ib was noted to
      confer a survival advantage relative to colony controls following adrenalectomy
      (P < 0.02). In summary, both LPS-induced Addison's crisis and chronic adrenal
      insufficiency are disorders of TNF disregulation. Based upon these data,
      therapeutic strategies targeted at controlling TNF in adrenal insufficiency are
      suggested.

PMID- 11198355
TI  - Spectral changes in systemic arterial pressure signals during acute mevinphos
      intoxication in the rat.
AB  - We investigated the cardiovascular consequences of acute intoxication by the
      organophosphate poison, mevinphos (Mev), and delineated the underlying mechanism.
      Based on on-line power spectral analysis of systemic arterial pressure (SAP)
      signals in rats anesthetized and maintained by propofol, we identified two
      distinct phases after intravenous administration of Mev (160 or 320 microg/kg).
      Phase I was characterized by transient hypertension and mild tachycardia,
      concurrent with an increase in the very high-frequency (BVHF; 5-9 Hz), high
      frequency (BHF; 0.8-2.4 Hz), low-frequency (BLF; 0.25-0.8 Hz),and very low
      frequency (BVLF; 0-0.25 Hz) components of SAP signals. Phase II exhibited
      significant hypotension, a reversal of the BVHF and BVLF power to control levels,
      and further reduction in the power density of both BHF and BLF components to
      below baseline. Microinjection of Mev (2 microg) into the bilateral nucleus
      reticularis ventrolateralis (NRVL), the medullary origin of sympathetic
      neurogenic vasomotor tone, essentially duplicated those phasic cardiovascular
      changes. Similarly, sympathoexcitatory NRVL neurons exhibited respectively an
      elevation and a decline in their spontaneous activities during Phase I and Phase
      II Mev intoxication. We conclude that the progressive accumulation of
      acetylcholine over time induced by a direct inhibition of Mev on cholinesterase
      in the NRVL may be responsible for the phasic changes in cardiovascular events
      over the course of acute Mev intoxication. Whereas the initial amount of
      acetylcholine is excitatory to NRVL neurons, overstimulation by the amassed
      acetylcholine results instead of an inhibitory action.

PMID- 11198356
TI  - Evolution of an immune suppressive macrophage phenotype as a product of P38 MAPK
      activation in polymicrobial sepsis.
AB  - Studies indicate that polymicrobial sepsis in humans and animals is characterized
      by a biphasic response, which is dominated early by proinflammation, but over
      time develops into a state of generalized anti-inflammation (depressed Th1 cell
      response and decreased macrophage (M0) capacity to release proinflammatory
      cytokines). However, with respect to the macrophage, it remains unknown what
      mechanism(s) controls this change. In this regard it is well documented that the
      p38 mitogen activated protein kinase pathway (MAPK) plays a central role in the
      regulation of Mphi functions. However, the contribution of p38 MAPK activation to
      the loss of these Mphi functions in polymicrobial septic animals remains unknown.
      To determine this we induced polymicrobial sepsis in C3H/HeN male mice using
      cecal ligation and puncture (CLP). Twenty-four hours post-CLP, during the late,
      immune-suppressed stage of sepsis, splenic and peritoneal Mphi were harvested,
      stimulated with lipopolysaccharide (LPS), and the activation of p38 MAPK
      assessed. In Mphi from CLP mice, p38 MAPK activity was markedly increased. To
      determine the extent that these changes in p38 MAPK had an impact on Mphi immune
      function, cells were pretreated with 10 microM of the p38 MAPK inhibitor,
      SB203580, or with DMSO vehicle, and subsequently stimulated with LPS. IL-10, IL
      6, IL-12, and nitric oxide release was determined. Our results indicate that with
      LPS stimulation alone, there was a marked increase in the release of the anti
      inflammatory mediator, IL-10 after CLP. Alternatively, proinflammatory IL-12 and
      IL-6 release was suppressed. Treatment with SB203580 suppressed the increase in
      IL-10 release seen after CLP, while partially restoring IL-12 secretion. IL-6
      release was partially restored only in splenic macrophages treated with SB203580.
      To the extent that these in vitro findings could be translated to an in vivo
      setting, we assessed the in vivo effects of p38 MAPK inhibition on survival. Mice
      were given 100 mg of SB203580/kg body weight or saline vehicle (intraperitoneal)
      either immediately post-CLP or 12 h post-CLP. Delayed administration of SB203580
      significantly improved survival, while also preventing the increased NO and IL-10
      release and improving IL-12 release by macrophages. These results suggest that
      p38 MAPK pathway plays a critical role in the induction of an immune-suppressive
      macrophage phenotype, and that inhibition of p38 MAPK markedly improves survival
      following polymicrobial sepsis.

PMID- 11198357
TI  - Calcium uptake by sarcoplasmic reticulum is impaired during the hypodynamic phase
      of sepsis in the rat heart.
AB  - Alterations of the ATP-dependent Ca2+ uptake in the cardiac sarcoplasmic
      reticulum (SR) during the 2 hemodynamically distinct phases of sepsis were
      investigated. Sepsis was induced by cecal ligation and puncture (CLP). Control
      rats were sham-operated. The SR vesicles were isolated by sucrose gradient
      centrifugation. The results show that the rates of ATP-dependent Ca2+ uptake in
      the cardiac SR were unaffected during the early hyperdynamic phase, whereas they
      were decreased by 41-46% (P < 0.01) during the late hypodynamic phase of sepsis.
      Analysis of the kinetics of Ca2+ transport indicates that during the late phase
      of sepsis, the Vmax values of Ca2+ pump for ATP and Ca2+ were decreased, whereas
      the affinities of Ca2+ pump for ATP and Ca2+ were unaffected. Magnesium
      stimulated, whereas vanadate inhibited the ATP-dependent Ca2+ uptake, but the
      Mg2+-stimulated and the vanadate-inhibited Ca2+ uptake activities were
      significantly lower during the late sepsis. Phosphorylation of SR by the cAMP
      dependent and the calmodulin-dependent protein kinases stimulated the ATP
      dependent Ca2+ uptake in the control and the early septic experiments, whereas it
      failed to stimulate Ca2+ uptake in the late sepsis. The extent of the
      phosphorylation-stimulated Ca2+ uptake activities was reduced by 65-69% (P <
      0.01) during the early sepsis, and they were completely abolished during the late
      sepsis. These data indicate that the ATP-dependent Ca2+ uptake in cardiac SR was
      impaired during the late hypodynamic phase of sepsis. The impaired Ca2+ uptake
      during late sepsis was associated with a defective phosphorylation of SR
      proteins. Because the ATP-dependent Ca2+ uptake by cardiac SR plays an important
      role in the regulation of contraction-relaxation coupling, our findings may
      contribute to the understanding of the pathogenesis of altered cardiac function
      during the progression of sepsis.

PMID- 11198358
TI  - Pmax, end systolic elastance, and Starling's law of the heart.
AB  - Starling's law is a description relating the energy released by the contracting
      ventricle to the end diastolic fiber length. The peak systolic pressure during
      isovolumic contraction is an example of this relationship; Sunagawa and coworkers
      (12) termed that pressure Pmax. It may also be estimated during ejecting beats.
      Here we compare the variable Pmax at a given end diastolic volume with that of
      end systolic elastance as an indicator of ventricular function, changes in either
      being indicative of changes in the inotropic state of the heart. We specifically
      investigate 2 points on the end systolic pressure-volume relationship (ESPVR)
      plot: 1) the Pmax, EDV point, obtained from the concept of the maximum pressure,
      Pmax, the pressure an isovolumically contracting ventricle would produce at a
      given end diastolic volume (EDV); and 2) the end systolic pressure, end systolic
      volume point. Both points would be expected to shift proportionally with changes
      in the slope of ESPVR. Data were obtained from 2 published reports in humans in
      the literature and from a group of 5 dogs subjected to a wide range of preloads
      and afterloads. High correlations (>0.9) were obtained for changes in the slope
      of ESPVR and the Pmax, EDV points. The latter, a more readily obtainable variable
      from single ejecting beats, is proposed as a version of Starling's law, the
      changes in which are directly comparable with the changes in end systolic
      elastance. The changes in the end systolic pressure, end systolic volume points,
      were not as reliable (<0.7).

PMID- 11198359
TI  - Acute hemodynamic effects of induced hypothermia in hemorrhagic shock: an
      experimental study in the pig.
AB  - Hypothermia (HT) is used in certain surgical procedures to reduce metabolism and
      protect the brain, but in trauma victims accidental HT is considered harmful.
      Recent animal studies indicate that HT has protective effects in hemorrhagic
      shock. The aim of the present study was to examine how induced HT modifies the
      hemodynamic pattern in hemorrhagic shock. Twenty pigs with a body weight of
      between 17 and 24 kg (mean 20.8) were anesthetized, 50% of their blood volume was
      withdrawn, and hypothermia (30 degrees C) was induced in half of them (HT group)
      while the others served as controls. Central hemodynamics was monitored during 4
      h via an arterial line and a pulmonary artery catheter. Blood samples were
      obtained for measurement of leukocyte and platelet counts. Three of the control
      pigs died while all the animals in the HT group survived the experiment. The
      hemorrhage resulted in a marked increase in heart rate and a drop in cardiac
      output and mean arterial pressure. HT slowed the heart rate and induced a further
      reduction of cardiac output, which parallelled the depression of the core
      temperature, while the stroke volume did not change in any of the groups. A
      significant decrease in mean arterial pressure and the leukocyte count became
      apparent 2 h after the induction of HT. HT aggravated the hypokinetic situation
      resulting from hemorrhagic shock but without increasing the mortality.

PMID- 11198360
TI  - Differential roles of iNOS and nNOS at rostral ventrolateral medulla during
      experimental endotoxemia in the rat.
AB  - We investigated the differential contribution of inducible and neuronal nitric
      oxide synthase (iNOS and nNOS) at the rostral ventrolateral medulla (RVLM) to
      endotoxemia induced by E. coli lipopolysaccharide (LPS). In Sprague-Dawley rats
      maintained under propofol anesthesia, i.v. administration of LPS (15, 30, or 45
      mg/kg) induced a reduction (phase I), followed by an augmentation (phase II) and
      a secondary decrease (phase III) in the power density of the vasomotor components
      (0-0.8 Hz) in systemic arterial pressure (SAP) signals. LPS also induced an
      immediate hypotension, followed by a rebound increase and a secondary decrease in
      SAP. In addition, the level of iNOS mRNA exhibited a significant surge that began
      with phase I endotoxemia, reaching progressively its peak at phase III.
      Discernible down-regulation of nNOS mRNA was not detected until the last phase of
      endotoxemia. Pretreatment with microinjection of the selective iNOS inhibitor,
      aminoguanidine (250 pmol), into the bilateral RVLM significantly prolonged phases
      II and III endotoxemia, blunted the initial and secondary hypotension, and
      antagonized the upregulation of iNOS mRNA. Similar pretreatment with the
      selective nNOS inhibitor, 7-nitroindazole (1 pmol), on the other hand,
      discernibly shortened phase II and prolonged phase III endotoxemia, and induced
      progressive hypotension by antagonizing the rebound increase in SAP. We conclude
      that the relative prevalence of functional expression and molecular synthesis of
      iNOS over nNOS in the RVLM may be a crucial determinant for the reduction or loss
      in power density of the vasomotor components of SAP signals during experimental
      endotoxemia.

PMID- 11198361
TI  - Effect of sodium arsenite on iNOS expression and vascular hyporeactivity
      associated with cecal ligation and puncture in the rat.
AB  - Induction of the heat shock response protects animals from either endotoxemia or
      peritonitis. In endotoxemia, heat shock protein (HSP) induction is associated
      with reversal of vascular hyporeactivity and inhibition of iNOS expression.
      Recent studies suggest differences in the inflammatory mechanisms during
      endotoxemia and peritonitis animal models and their response to therapeutic
      interventions. We therefore studied the effect of the HSP inducer sodium arsenite
      (SA) on vascular reactivity and iNOS expression in rats undergoing cecal ligation
      and puncture (CLP). CLP resulted in suppression of the pressor effect of
      norepinephrine (NE) in vivo (measured by changes in blood pressure in response to
      NE boluses) and ex vivo (changes in contraction force in isolated mesenteric
      arteries in response to NE concentrations), and in the expression of iNOS
      protein. Pretreatment of the rats with SA resulted in reversal of CLP-induced
      vascular hyporeactivity in vivo and ex vivo, and inhibition of iNOS expression
      after 22 h. SA pretreatment improved 7-day survival after CLP from 18.2% to 70%
      (P < 0.005). Glucocorticoid receptor inhibition did not affect the effect of HSP
      induction on iNOS expression. The similarity of the effect of HSP on vascular
      reactivity and iNOS expression in two distinct sepsis models suggests that this
      effect may be clinically important and that a causative relationship between HSP
      induction, iNOS inhibition, and reversal of vascular reactivity is likely.

PMID- 11198362
TI  - Production of interleukin-12 is under the control of endogenous interleukin-10 in
      myocardial ischemia-reperfusion.
AB  - Interleukin (IL)-12 is a heterodimeric cytokine that is secreted mainly by
      antigen-presenting cells and plays a key role in determining the nature of immune
      response to exogenous or endogenous antigens. Negative regulators of IL-12
      production include IL-10. With use of wild-type and IL-10-deficient mice, the aim
      of the current investigation was to determine whether IL-12 is produced in
      myocardial reperfusion injury and whether endogenous IL-10 modulates its
      production. IL-10 levels were significantly higher than baseline at both 2 h and
      6 h after the start of the reperfusion. In the IL-10-deficient animals, no IL-12
      could be detected in the plasma. In the wild-type animals, at baseline, and at 1
      6 h after myocardial ischemia-reperfusion, no detectable increases in IL-12 were
      measured. However, in the IL-10-deficient mice, a significant and pronounced
      increase in IL-12 was detected. IL-10-deficient mice also exhibited significantly
      higher mortality during reperfusion than wild-type animals. We conclude that the
      production of IL-12 in myocardial reperfusion injury is dramatically affected by
      the levels of endogenous IL-10.

PMID- 11198363
TI  - The circumoval precipitin reaction in Fasciola. Detection of shell pores by
      scanning electron microscopy.
AB  - Precipitation reaction was detected around Fasciola eggs containing mature
      miracidia when they were incubated for 20 minutes with the sera of acute and
      chronic fasciolosis patients. The reaction was of the bleb type. The amount of
      blebs formed around the eggs was greater in case of acute than chronic
      fasciolosis. Scanning electron microscopy illustrated pores in the shell of
      Fasciola eggs. It is probable that the metabolic antigen passes through these
      pores leading to the positive circumoval precipitin reaction in cases of Fasciola
      infection. Antibodies specific to Fasciola excretory/secretory (E/S) egg antigens
      were not detected in the sera of Schistosoma cases.

PMID- 11198364
TI  - Immunohistochemical nuclear staining for P53 in nodular scabies.
AB  - Fifty patients with scabies were included in this study. Clinical,
      parasitological and histopathological study of all patients was done. P-53
      expression was examined, using immunohistochemical techniques. Biopsies of
      nodular scabies showed atypical changes in the epidermis, the dermis showed dense
      inflammatory infiltrate. Focal positivity for P-53 have been demonstrated which
      could favour premalignant changes, and recommend further investigations.

PMID- 11198365
TI  - Toxocara canis: determination of the origin of antigenic materials released from
      infective larvae.
AB  - Indirect fluorescent antibody test (IFAT) revealed antigenic focal areas in the
      brain tissues of mice infected by Toxocara canis as determined by the light,
      electron and fluorescent microscopic examination of the infective larvae. The
      oesophageal gland was well defined and its secretory activity was evident. The
      oral orifice and the lumen of oesophagus were strongly fluorescing by using anti
      ES serum. These indicate the antigenic property of oesophageal gland secretion.
      Intestine appeared to be non-functional. There was a well-developed "H" shaped
      excretory cell with two lateral excretory columns. The sharing of the excretory
      system in released antigenic materials was evident by the fluorescence of its
      pore onto the parasite surface. An electron dense coat that covered the surface
      of the larva may be formed by products released from the oesophageal gland and
      the excretory system. Shedding of the outer larval surface was detected by IFAT
      at 37 degrees C.

PMID- 11198366
TI  - IgM and IgG cystatin capture enzyme linked immunosorbent assays: a tool for
      serodiagnosis and assessment of cure of acute fascioliasis after triclabendazole
      (TCZ; Fasinex) therapy.
AB  - This study included 71 individuals: 25 patients with confirmed acute
      fascioliasis, 9 patients with suspected fascioliasis, 27 patients with parasitic
      infections other than fascioliasis and 10 normal controls. Patients with
      fascioliasis were treated with TCZ as a single dose and followed up 1 and 4
      months after therapy. The results showed that both IgM and IgG cystatin capture
      ELISAs had very high sensitivity and specificity of 100%. They were also able to
      diagnose early fascioliasis even before indirect haemagglutination test (IHAT)
      became positive. Within 4 months after treatment, only 20 patients (80%) with
      fascioliasis were cured as evidenced clinically, by normal eosinophil count and
      negative IHAT. After the first month of treatment, IgM and IgG cystatin capture
      ELISAs became negative in 16.6% and 83.3% of the cured cases respectively,
      reaching 95% for both assays after 4 months. They remained positive in 5 cases
      (20%) not responding to treatment.

PMID- 11198367
TI  - Evaluation of the in-vitro pediculicidal action of four known insecticides and
      three medicinal plant extracts.
AB  - Human lice is an increasing community health problem worldwide. This is
      particularly true among school children who spend most of their daytime in
      crowded areas. Four commercially known insecticides and three medicinal plant
      extracts were studied to evaluate their pediculicidal activities in-vitro. The
      best result with insecticides was achieved with malathion (Lt5o 10.396 and slope
      function 1.183). The best result with medicinal plant extracts was achieved with
      neem oil (A. indica) (Lt5o 85.27 and slope function 1.480). Although, neem oil
      extract was less active than malathion, yet it is more safe for human usage.

PMID- 11198368
TI  - A comparison between human, crustacean and bivalve isolates of Microsporidia.
AB  - Identification of Microsporidia detected in diarrhoeic stool of human and from
      press preparation of crabs, and bivalves muscles was done by staining with
      Giemsa, modified trichrome and H & E stains respectively. Positive samples were
      isolated & used for infection of 3 groups of mice viz group A human isolate,
      group B crab & group C bivalve isolates. Parasitological and histopathological
      studies using light and transmission electron microscopy (TEM) were done for
      samples from each group. The results clarified that human, crab & bivalve
      Microsporidia isolates showed common features. They were found in the
      supranuclear region of enterocytes. The stages observed were meronts, sporonts
      and free spores. Each spore was 1-2 um in length containing a single nucleus, a
      vacuole and a polar filament. Further genetical and biochemical studies will be
      undertaken to confirm the similarity or differences between these isolates.

PMID- 11198369
TI  - Cryptosporidiosis in Benha, study of some recent modalities in diagnosis and
      treatment.
AB  - A total prevalence of cryptosporidiosis was carried out on 1087 diarrheal
      patients of all age groups attending the outpatient clinics using modified Ziehl
      Neelsen stain (MZN) and Meriflour direct immunofluorescent technique (IFA). IFA
      was more sensitive, specific and gave positive results 19.5% than MZN stain which
      gave a positivity 13.5% Cases were divided into 3 groups, each group was treated
      by one of nitazoxanid (NTZ), or co-trimoxazole or placebo. The most effective
      drug was NTZ which cured 39 patients (79.6%) out of 49 patients followed by co
      trimoxazole that gave cure of 20 (41.6%) out of 48 patients. Placebo cured 20
      (40%) out of 50 patients.

PMID- 11198370
TI  - Two contagious ectoparasites in an orphanage children in Nasr City, Cairo.
AB  - Lice and scabies are the main ectoparasites transmitted by contagious,
      particularly among children living in crowded areas. Examination of an orphanage
      children (both sex, 2-6 years old), showed infestation with head louse (64.1%),
      body louse (53.8%) and scabies (26.9%). The results were discussed on the light
      of the work done before.

PMID- 11198371
TI  - A novel chemotherapeutic combination for Trichomonas vaginalis targeting purine
      salvage pathways of the parasite.
AB  - A novel combination of chemotherapy (Dipyridamole/Allopurinol) targeting the
      possible purine salvage mechanisms of Trichomonas vaginalis was used in this
      study. The possible effect of these drugs either individually or in combination,
      on the multiplication of T. vaginalis in modified TYM axenic culture, was
      assessed on 24 hours intervals. The combination of both drugs at concentrations
      of 5 microM and 10 microM each showed a potent lethal effect on the parasite and
      an almost complete inhibition of parasite multiplication in culture. Each drug,
      individually, has a significant but partial inhibitory effect on parasite
      multiplication. Surprisingly, allopurinol, a competitive inhibitor of
      hypoxanthine, a nucleobase that is not salvaged by the parasite, showed a more
      potent inhibitory effect on parasite multiplication than dipyridamole, a specific
      inhibitor of the transport of adenosine, a favored nucleoside to T. vaginalis.
      However, the inhibitory effect of either drugs declines with time in contrast
      with that of the combination of both drugs which continues throughout all time
      points of the experiment. These results prove that a combination of dipyridamole
      and allopurinol could be useful, not only in the treatment of trichomoniasis, but
      also in other parasites that are unable of de novo purine synthesis.

PMID- 11198372
TI  - The effect of ivermectin on Cryptosporidium parvum in experimentally infected
      rat.
AB  - Ivermectin, (=ivomec) a broad spectrum antiparasitic agent has become a promising
      drug for treating wide range of parasitic infection and infestation. This study
      was carried out to investigate its activity against cryptosporidiosis in a rat
      model. The results showed that ivermectin is effective at a dose of 200 mg/kg.

PMID- 11198373
TI  - Trichinella encysted larvae in slaughtered pigs in Cairo (1995-1999).
AB  - Trichinosis is one of the most serious meat borne parasites. Examination of pigs
      in the slaughtered houses over the last five years showed an overall rate of
      1.691%. The trichinoscope and sometimes the muscle digestion technique were
      adopted to diagnose infection. Trichinosis as a zoonotic parasitic disease was
      discussed.

PMID- 11198374
TI  - Preliminary observations on cross-mating of the malaria vector, Anopheles
      sergentii from two Egyptian oases.
AB  - Intra- and inter-strain crosses were made between randomly collected adults
      Anopheles sergentii originated from Tersa village (El-Faiyum Governorate) and
      Siwa oasis (Matruh Governorate). The success of such crosses and their effects on
      fecundity and fertility of the parental females and on survival and development
      velocities of the F1 immatures were examined. No overall heterosis effects on
      such attributes were detected suggesting absence of genetic differences between
      the vector populations in these two malarious areas.

PMID- 11198375
TI  - First record of natural infection with Borrelia in ornithodoros (Ornithodoros)
      savignyi. Reservoir potential and specificity of the tick to Borrelia.
AB  - Field and laboratory data provided convincing evidence implicating O. savignyi at
      Shelateen, Halayeb province as a reservoir and a vector of a specific Borrelia.
      Using direct immunofluorescence Borrelia infection was detected for the first
      time in a natural population of O. savignyi in Egypt. The overall infection rate
      (IR) was relatively high (50.63%) and the infected ticks were capable of
      transmitting the infection to hamsters during feeding. Infected nymphs maintained
      borrelial infection transstadially to adults and the transstadially infected
      stages transmitted the spirochetes to hamsters. However, directly infected
      females were more efficient than males in transmitting the spirochetes to hamster
      and the IR of hamsters increased gradually by increasing the number of feeding
      infected ticks upon each hamster. Transovarial transmission of Borrelia intrinsic
      to O. savignyi occurred during the first and second gonadotrophic cycle of the
      infected females. The Borrelia sp. detected in the field collected O. savignyi
      showed specificity for its own natural tick host species when compared with B.
      crocidurae isolated from O. erraticus. Although the two tick species acquired,
      transstadially transferred and transmitted the two spirochetal infections, each
      tick species failed to transovarially transmit Borrelia isolated from the natural
      population of the other tick species.

PMID- 11198376
TI  - IL-1, IL-4 production and IgE levels in acute and chronic fasciolosis before and
      after triclabendazole treatment.
AB  - IL-1 generation by mononuclear phagocytes, IL-4 production by Th2 lymphocytes and
      IgE levels in serum were measured in eight patients with acute fasciolosis and
      seven patients in the chronic stage of the disease before and after
      triclabendazole treatment. Results were compared with those of a control group of
      ten individuals. The monocytes and lymphocytes from patients with acute and
      chronic fasciolosis produced significantly lower levels of IL-1 and IL-4
      respectively, particularly in the chronic phase of the disease, as compared to
      the control. A significant increase in IgE level in both acute and chronic
      fasciolosis was observed. The level was significantly higher in acute as compared
      to chronic cases. After treatment with triclabendazole IL-1, IL-4 and IgE levels
      moved towards the control indicating obvious improvement in the immunological
      responses of the patients.

PMID- 11198377
TI  - Effect of niclosamide on the marketable fish Liza ramada (Risso, 1826) concerning
      accumulation in muscles and activities of three metabolic liver enzymes.
AB  - The accumulation in muscles and the effect of different concentrations of
      niclosamide (Bayluscide) on the metabolic enzymes; succinate dehydrogenase (SDH),
      pyruvate dehydrogenase (PDH) and lactate dehydrogenase (LDH) in the liver of the
      Thin-lip grey mullet after 1, 2 & 3 weeks were studied. The molluscicide residues
      were detected in the muscles. The residues increased with the increase of
      concentrations of niclosamide as well as the time of exposure. On the other hand,
      LDH showed significant increase. But, SDH and PDH showed significant decrease. No
      doubt, this disturbance in the three liver enzymes cause disturbance in the
      process of metabolism. The important point is what about man who consumes a fish
      with niclosamide accumulated in its muscles.

PMID- 11198378
TI  - On the schistosomicidal effect of triclabendazole an experimental study.
AB  - Mice were infected with S. mansoni cercariae and divided to three groups: one as
      control, the others were treated with a single oral dose of PZQ or TCBZ. The
      efficacy of the drugs was evaluated on the basis of egg excretion, number, sex
      and distribution of worms, oogram changes and tissue egg load. Results
      demonstrated that eggs disappeared from the stools in both treated groups, all
      worms died in the PZQ treated group while in the TCBZ group, worm production
      amounted to 84%. Male worms were more susceptible to the two drugs, they died
      earlier. On the fourth week after TCBZ, the few surviving worms returned back
      from their hepatic shift to the mesenteric veins. By studying the oogram pattern,
      it was found that PZQ had a direct lethal effect on the mature eggs; TCBZ had a
      lower effect on egg viability but the oogram findings indicated cessation of egg
      laying.

PMID- 11198379
TI  - Sublethal concentration of Ambrosia maritima(Damsissa) affecting compatibility of
      Biomphalaria alexandrina snails to infection with Schistosoma mansoni through
      disturbing the glycolytic pathway.
AB  - High glycolytic flux as an emergency pathway for generating ATP was recorded as
      the most important metabolic pathway required for the success of Biomphalaria
      Schistosome sporocyst interaction. Effect of LC25 of dry powdered Ambrosia
      maritima (Damsissa) as plant molluscicide on hexokinase (HK), pyruvate
      kinase(PK), glucose phosphate isomerase(GPI) was tested. It resulted in a
      significant inhibition of the three investigated enzymes. Treatment of snails
      with LC10 concentrations of A. maritima reduced considerably the infection rate
      of Biomphalaria alexandrina with Schistosoma mansoni to be 34% compared to an
      infection rate of 80% in control non-treated snails. Longer prepatent period and
      remarkable decrease in cercarial production was also recorded in snails treated
      with the sublethal concentrations of this molluscicide.

PMID- 11198380
TI  - DNA sequence polymorphisms in two strains of Fasciola hepatica from Egypt and
      Europe.
AB  - A new PCR based system was used that had broad detection capability among
      parasites based on a conserved region of the 18 S ribosomal DNA gene. Five
      samples each of European and Egyptian Fasciola hepatica of bovine origin were
      obtained and DNA was isolated. The target of the PCR primers was a fragment of
      approximately 600 nucleotides in length corresponding to a region of the 18 S
      rRNA gene. Sequences were compared over a 107 base pair region that identified
      polymorphism between the strains. All five Egyptian isolates were identical.
      Likewise all of the European isolates had identical sequence. There were
      polymorphisms between the two strains and also with F. hepatica isolates from
      North America. Both the European and Egyptian isolates have a single base
      addition in the polymorphic region. In addition there is a single base
      substitution in the Egyptian isolates when compared to the others. This region is
      a small target that can be used to identify the origins of different F. hepatica
      isolates.

PMID- 11198381
TI  - Effect of vaccination on expression of intracellular adhesion molecules 1 and
      vascular cell adhesion molecules 1 in murine schistosomiasis.
AB  - This work studied the approach of vaccination by utilizing ultraviolet attenuated
      S. mansoni cercariae on two surface adhesion molecules expression, intercellular
      adhesion molecules 1 (ICAM-1) and vascular cell adhesion molecules 1(VCAM-1).
      ICAM-1 and VCAM-1 expression were studied in livers of 37 CD-1 female mice (2
      months aged and about 30 gm waited) which were divided into 3 groups. Analysis of
      adhesion molecules expression was done by direct immunofluorescence staining and
      quantitative measurement of positive signals by image analyzer. The main findings
      were: (1) ICAM-1 and VCAM-1 expression was mainly localized on granuloma cells.
      (2) The video count areas that expressed ICAM-1 and VCAM-1 were markedly
      increased in vaccinated than naive animals. The ICAM-1 intensity was (58.7%) in
      VC while (31.1%) in NC mice group. (3) Similarly the intensity of VCAM-1
      expression was (73%) In VC while (54.2%) in NC. (4) The % change in ICAM-I
      expression relative to naive mice group was (326.9%) and (704.7) in NC and VC
      mice group respectively. (5) The % change in VCAM-1 expression in vaccinated
      animals relative to naive animals was (67,700) and (91,175) in NC and VC mice
      groups respectively.

PMID- 11198382
TI  - Potential for Culex pipiens to develop resistance against Bacillus sphaericus
      toxins.
AB  - Susceptibility of field Culex pipiens populations to Bacillus sphaericus and the
      possibility of resistance development in the selected laboratory colony were
      investigated. 180 populations collected from Giza and Qualyobia over one year
      show no marked variation at LC50 and LC90 values. Larvae of laboratory colony of
      Cx pipiens were subjected to selection pressure with a preparation of Bacillus
      sphaericus strain 2362 at LC80 values for 20 successive generations. The selected
      laboratory colony began developing resistance at F10 (RR = 1.69) when compared
      with its unselected counterpart. The magnitude of resistance increased gradually
      and reached 33 fold by F20. The unselected colony reared without any exposure to
      the B. sphaericus toxin, did not show any marked change in their susceptibility
      to this microbial agent.

PMID- 11198383
TI  - Demodex folliculorum causing pathological lesions in immunocompetent children.
AB  - Scabies and pediculosis are the vast major ectoparasites infesting man. Demodex
      folliculorum is unreported ectoparasite, since it is considered harmless. Marked
      pathologic infestations caused by D. folliculorum were diagnosed in five
      immunocompetent children, The infestations are successful treated with 2%
      permethrin cream.

PMID- 11198384
TI  - Identification of mouth part antigens of Fasciola gigantica and Toxocara
      vitulorum and its molecular targets recognized by homologous and heterologous
      adult anti-sera against adult.
AB  - Sodium dodecyl sulphate poly-acrylamide gel electrophoresis (SDS-PAGE)
      fractionation of whole-worm and mouth part antigens of F. gigantica and T.
      vitulorum showed obvious qualitative and quantitative differences. Three
      different anti-sera, raised in rabbits against adult extracts of F. gigantica, T.
      vitulorum and Monieza expansa, were utilized in immunoblotting for identification
      of mouth part antigens that cross-react with adult worm of the same species or of
      different species. 7 and 8 poly peptides were recognized in F. gigantica and T.
      vitulorum mouth parts respectively by their homologous rabbits anti-adult anti
      sera. The cross reactive antigens in F. gigantica which recognized by T.
      vitulorum anti-sera was 234 KD, while two components of M.wt. 113 and 93 KD were
      detected by M. expansa serum in the same extract. Furthermore, T. vitulorum
      antigens which cross-reacted with F. gigantica anti-serum 150 and 65 KD and with
      M. expansa were 65 and 49 KD.

PMID- 11198385
TI  - The effects of Nosema algerae Vavra and undeen (Microsporida: Nosematidae)
      pathogen of Culex pipiens L.(Diptera: Culicidae) from Egypt on fecundity and
      longevity of the host.
AB  - A microsporidian, Nosema algerae Vavra and undeen, was found parasitizing larvae
      and adults of a laboratory colony of Culex pipiens L. originated from Gharbia
      Governorate. A detailed examination of the developmental stages of the pathogen
      under light and electron microscopes showed that they are typical of the original
      characteristics of N. algerae. Other observations on the infected individuals
      revealed that spores of the pathogen were found in all organs of the infected
      mosquitoes except the nervous system. The most heavily infected organ was the
      alimentary canal, particularly the mid gut. The susceptibility of the different
      larval instars of a laboratory maintained Cx. pipiens colony to infection by N.
      algerae was determined. Using 24 hours exposure to a range of doses between 40
      and 5 x 10(5) spores per cm, larvae of the 1st and 2nd instars were more
      susceptible to infection than 3rd and 4th instar larvae as indicated by the
      differences in the estimated IC50 dosages. The dosages of N. algerae which
      produced 50% mortality (LC50) in each group of treated larvae was approximately
      25-30 times higher than the doses that caused 50% infection. When a sublethal
      dose of 1.2 x 10(3) spores per cm2 of N. algerae was used to induce infection in
      each of the different larval instars infection rates of 100% were obtained in all
      exposed larval instars and in adults developed from them. Females from larvae
      infected with N. algerae had significantly reduced fecundity, fertility, and
      longevity regardless the larval instar in which infection was initiated. However,
      the reduction was obviously high when 1st and 2nd instars were exposed. The
      accumulative effects of reduced survival and fecundity on the reproductive
      potential of the infected females derived from larvae that were infected as 1st
      and 2nd instars probably serve to limit the natural increase of mosquito
      populations. Further studies are necessary, however, to determine the efficacy of
      this pathogen on target species in the natural environment where the combined
      effect of the pathogen and environmental stresses may enhance its pathogenicity.

PMID- 11198386
TI  - Study of protein profile in the visceral leishmaniasis.
AB  - A study of the ten proteins of the protein profile in 7 children infected with
      visceral leishmaniasis leads to obtain an evocating diagram of the protein
      profile in this disease. In these patients, the authors have found the
      association of a polyconal hypergammaglobulinaemia, an inflammatory syndrom
      (increase of orosomucoid, CRP, alpha-1-antitrypsin, decrease of albumin,
      prealbumin and transferrin), and an haemolytic syndrom (decrease of haptoglobin).
      Such a diagram may be an supplementary help to establish the diagnosis of
      visceral leishmaniasis, in some cases when it is difficult to find the parasites.

PMID- 11198387
TI  - Seasonal infestation of Oestrus ovis larvae in sheep heads in central region of
      Saudi Arabia.
AB  - During a period of 12 months, 544 sheep heads were examined for infestation with
      Oestrus ovis larvae in Riyadh abattoir, Central Region of Saudi Arabia. The
      tested animals were males, less than one year old. The prevalence of infestation
      was 5.9%. The peak of infestation reached 23.3% in March 2000. The highest mean
      number of larva per infested sheep head in first, second and third instars larvae
      were 5, 7, and 5.3 respectively in spring months. A total for all instars being
      4.3 larva per sheep head. All three stages disappeared in summer and winter
      months probably due to the very hot and dry weather.

PMID- 11198388
TI  - Schistosoma mansoni egg specific antibodies and circulating antigens: assessment
      of their validity in immunodiagnosis of schistosomiasis.
AB  - A total of 127 individuals of different age and sex; 92 from Kafr-Sendewa,
      Qualyobia Governorate, Egypt, in comparison to 23 cases with hydatidosis and
      fascioliasis as a parasitic control group, and 12 healthy control group from non
      endemic area. All cases were screened by clinical examination, urine, stool,
      rectal snip, abdominal ultrasonographic examination and indirect
      haemagglutination test (IHAT). Accordingly, they were grouped into active
      intestinal schistosomiasis group, seropositive group by (IHAT), normal control
      group from the same endemic area, parasitic control group and normal control
      group. All cases were subjected to detection of IgG, IgM, IgG4, anti-soluble egg
      antigen (SEA) and anti-excretory-secretory egg antigen (ESEA) by ELISA tests; and
      circulating egg antigens by double-sandwich ELISA techniques. The results showed
      that IgG4 anti-SEA is the best diagnostic test, as it gave the best diagnostic
      efficacy (90%). Also, it is a good screening test which can be used in endemic
      area as it gave significant difference between the active intestinal
      schistosomiasis cases with each of the endemic control group (P < 0.001) and the
      seropositive cases (P < 0.05). Other valid diagnostic egg specific antibodies
      tests were IgM anti-SEA and IgG anti-SEA as their diagnostic efficacy were 80%
      and 76.6% respectively (P < 0.05). The diagnostic efficacy of circulating antigen
      detection (C.Ag) test was 70% (P < 0.05). In addition, it was the most specific
      test with 100% specificity. IG4-anti-ESEA gave the least cross-reaction with
      other parasites (17.3%). The mean optical density (OD) level of circulating
      antigen detection test was significantly higher in the organomegalic
      (hepatosplenomegaly) cases than the non-organomegalic cases (P < 0.05).

PMID- 11198389
TI  - The immunological responses in relation to egg extrusion rate and pathological
      changes in Schistosoma haematobium patients.
AB  - A total of 30 males with proven S. haematobium infection were subjected to egg
      count, serological estimation of serum levels of soluble egg antigens and its
      specific antibody "SEA IgG" and cystoscopic examination of lower urinary tract.
      Correlation between the pathological changes and number of living extruded eggs
      showed negative insignificant correlation. However, the relation between the
      pathological changes and anti-SEA IgG showed positive insignificant correlation.

PMID- 11198390
TI  - Bioactivity of Anagallis arvensis and Calendula micrantha plants, treated with
      ammonium nitrate, superphosphate and potassium sulphate fertilizers, on
      Biomphalaria alexandrina.
AB  - The survival rate of B. alexandrina snails maintained in aqueous solutions of the
      two tested plants (Calendula micrantha and Anagallis arvensis) decreased
      gradually with time until the 9th week and 10th week where the survival rate was
      zero in the high concentration of A. arvensis and C. micrantha, respectively,
      meanwhile, the survival rate of the control was 20%. Also, the two plants caused
      reduction in hatchability of snails egg masses. Thus, the percent of hatching in
      A. arvensis (82 ppm) was 46% and in C. micrantha was 72% compared with control
      (97.29%). Both plants reduced the infection rate of Biomphalaria alexandrina
      snails with Schistosoma mansoni miracidia to 41.17% and 61.9%, respectively,
      compared with control (90%). C. micrantha caused much higher reduction in snail
      infection rate than A. arvensis. The prepatent period was significantly prolonged
      in snails maintained at higher concentration of both plants. The cercarial output
      (expressed as mean number/snail) revealed that, A. arevensis caused a significant
      reduction in cercarial production than control. While, high concentration (120
      ppm) of C. micrantha caused a significant elevation in the mean number of
      cercariae/snail. However, the total number of cercariae produced by all snails in
      each group showed a reverse relation with the tested concentrations in both
      plants.

PMID- 11198391
TI  - The pathogenesis of arthropathy in experimental Schistosomiasis mansoni.
AB  - The pathogenesis of arthropathy in experimental schistosomiasis mansoni was
      studied. 70 Swiss albino mice were used, 14 served as control while 56 were
      subcutaneously infected with 80-100 Schistosoma mansoni cercariae/mouse. Mice
      were sacrificed at 8, 10, 12, 14, 16, 18 and 20 weeks postinfection (p.i.).
      Shoulder and knee joints were taken and processed for H & E stain and
      immunoperoxidase stain. As regards histopathological examination, 75% of infected
      mice showed marked pathological joint changes, with no Schistosoma ova could be
      detected in all examined sections. These changes appeared at the 12th week (p.i)
      and became more severe with the chronicity of infection. Immunohistochemical
      examination of the infected joints, revealed 75% positivity of schistosomal
      antigen deposition with mild to moderate expression (in early and late stages of
      infection respectively). The detection of schistosomal antigen in joints of
      infected mice which coincided with the histopathological affection, can be
      considered as the aetiological agent in induction of schistosomal arthropathy.
      Hence, the term reactive schistosomal arthropathy can be changed into
      schistosomal arthritis.

PMID- 11198392
TI  - Stapling procedure for hemorrhoids versus conventional haemorrhoidectomy.
AB  - Forty patients admitted at the Saudi German Hospital were randomly assigned to
      Milligan-Morgan haemorrhoidectomy (n = 20) or the circular stapled procedure.
      Under general anesthesia patients underwent standardized haemorrhoidectomy or had
      a circumferential doughnut of rectal mucosa and submucosa above the dentate line
      excised and closed with a standard circular end to end stapling device. All
      patients received the same preoperative and postoperative analgesic and laxative
      regimens. Patients completed linear analogue pain charts each day and were
      interviewed at 1, 3, and 12 weeks postoperatively. Summary measures of average
      pain experience were calculated from 10 cm linear analogue pain scores and were
      used as the primary outcome measure. The stapled group was found to have shorter
      anesthesia time (9-25 minutes, median 18) versus (15-35 minutes, median 22).
      Average pain in the stapled group was significantly lower than it was in the
      Milligan-Morgan group (0.2-7.6, median 2.1) versus (3.1-8.5, median 6.5).
      Hospital stay and time to first bowel motion were not significantly different
      between both groups. Return to normal activity was significantly shorter in the
      stapled group (3-60 days, median 17) versus (14-90 days, median 34). Early and
      late complications, patient assessed symptom control, and functional outcome
      appear to be similar after short term follow up.

PMID- 11198393
TI  - A case report of human coenurus cerebralis in Tanta, Egypt.

PMID- 11198394
TI  - Detection of cytomegalovirus in urine of hearing-impaired and mentally retarded
      children by PCR and cell culture.
AB  - This study was carried out to determine the prevalence of cytomegalovirus (CMV)
      excretion in urine among 30 deaf children and 91 mentally retarded children by
      cell culture and PCR. As a control, urine samples from 121 children without
      hearing disability or mental retardation were also tested. The study revealed
      that 15 of 30 (50%) deaf children and 16 of 91 (17.6%) mentally retarded children
      were excreting CMV in their urine. Among the control group we observed that only
      2 of the 121 (1.8%) children were CMV excretors. As CMV excretion in urine is
      generally considered to indicate a congenital infection, it is very likely that
      congenital CMV is highly incriminated in mental retardation and deafness among
      children in Mauritius.

PMID- 11198395
TI  - Glucose transport in cerebral microvessels during Plasmodium yoelii nigeriensis
      infection in mice.
AB  - Plasmodium yoelii infected cerebral micro vessels of mice registered a
      significant increase in D-[U-14C] Glucose transport as compared to normal
      microvessels which was found to be time, temperature and concentration dependent.
      Metabolic inhibitors galactose, manose, 2-deoxy glucose and D-glucose showed
      noticeable inhibition of the same.

PMID- 11198396
TI  - Relevance of direct agglutination test in seroepidemiological survey of Kala-azar
      in epidemic foci of Bihar.
AB  - The performance of direct agglutination test (DAT) was evaluated under field
      conditions in three endemic districts of Bihar. In three villages of these
      districts, 197 households were surveyed with a population of 1167 individuals.
      Out of 1167 individuals, 603 were clinically examined for VL and blood samples of
      each examined individual were collected for DAT. The proportion of DAT positivity
      in both males (32.33%) and females (32.94%) was statistically not significant (p
      > 0.05). The proportion of DAT positivity in all age groups was observed to be
      similar (p > 0.05). The GMRT was observed highest in active VL cases. Out of 20
      DAT positive individuals having fever, 5 were examined parasitologically (bone
      marrow aspiration) and in three cases positivity was observed. This showed the
      relevance of DAT in early diagnosis of visceral leishmaniasis and usefulness of
      DAT in field conditions.

PMID- 11198397
TI  - Serological investigation of malaria outbreak in Thar desert of Rajasthan.
AB  - A serological investigation by a repeat cross-sectional survey was conducted in
      Thar desert (Rajasthan) during and after one year of malaria outbreak to
      determine malaria endemicity using ELISA as a tool. The assay was based on
      indirect ELISA to measure antibody levels against a nonapeptide R1 (EENVEHDA-cys)
      derived from Pf 155/Resa and Plasmodium falciparum crude antigen. Finger prick
      blood samples were collected from individuals belonging to all age groups. Sera
      were tested at already standardized optimum dilution to detect antigen specific
      immunoglobulin isotype. The mean ELISA O.D. values 0.153 for anti R1 peptide and
      0.162 for anti Pf antigen reflected the seronegative profile, when the focal
      malaria outbreak occurred in 1994. A substantial increase in antibody levels was
      detected in individuals after one year showing mean ELISA values for anti-R1 and
      anti-Pf antigens as 0.52 and 0.58 and seropositivity as 75.2% and 52%
      respectively. Data obtained from the present study indicate that serological
      survey could be done to assess the situation in case of reappearing or
      disappearing status of malaria in a defined population.

PMID- 11198398
TI  - Role of macrophages in experimental malaria: VII--studies on adoptive transfer of
      macrophages.
AB  - Adoptive transfer of purified macrophages harvested from normal, Plasmodium
      berghei infected and latent/cured mice and also macrophages exposed to parasites
      in vitro were carried out to see the role of macrophages in transferring immunity
      against P. berghei infection. Macrophages obtained from mice having high
      parasitaemia at a dose of one million cells/animal showed significant increase in
      survival period (SP) and K values, compared to controls. Macrophages exposed to
      low parasite density conferred significant K values only. There was a decrease in
      prepatent period (PP) in the animal which received macrophages from animals cured
      7-11 months compared to controls. The adoptive transfer studies with macrophages
      conditioned in vitro to parasite contributed towards increased protection of host
      against P. berghei as expressed by K values only. These studies showed that the
      macrophages harvested from infected mice were capable of acting as immunogen
      against P. berghei infection.

PMID- 11198399
TI  - Efficacy of chloroquine in febrile Plasmodium falciparum infected children in
      Mewat region of Haryana.
AB  - During 1996, Mewat region of Gurgaon district in Haryana experienced high
      incidence of Plasmodium falciparum malaria, assuming epidemic proportion in large
      number of villages affected by floods. Mortality due to fever was also high. In
      vivo 7 days study amongst 32 febrile P. falciparum infected children of 1 to 14
      years age group in flood affected villages of Ferozpur Jhirka Community Health
      Centre of Mewat region was carried out. All the 32 cases showed good response to
      chloroquine suggesting that drug was effective and useful as first line of
      treatment, reducing severity of P. falciparum infection and resolving fever due
      to infection of the species. The study also indicated that chloroquine was an
      effective drug in controlling epidemic situation and mortality in areas of high
      incidence of P. falciparum. Pyrogenic stimulus was variable among different
      developmental stages of P. falciparum and suggestive of the need of earliest
      possible initiation of anti-malaria treatment, community based fever survey and
      blood smear examination. Increase in incidence of fever in an endemic community,
      particularly in children, should be considered as an indicator of impending
      outbreak of P. falciparum malaria. Effectiveness of diagnostic and control
      measures taken can be evaluated on the basis of incidence of malaria particularly
      due to P. falciparum infection and also incidence of fever in an endemic
      community.

PMID- 11198400
TI  - A preliminary field study on repellency of neem oil against Anopheles dirus
      (Diptera:Culicidae) in Assam.

PMID- 11198401
TI  - Plasmodium malariae--a case of quartan malaria in Assam.

PMID- 11198402
TI  - Implementation of revised strategy of filaria control-baseline clinico
      parasitological survey.
AB  - A clinico-epidemiological study of filariasis was carried out in Varanasi
      District in October and November, 1997 to generate baseline data for assessing
      the impact of Mass Drug Administration (MDA) in the district. Disease rate was
      found to be 6.6% (9.9% in males and 3.0% in females) and microfilaria rate was
      5.3% (5.2% in males and 5.5% in females). Mean microfilaria density was found to
      be 9.86 per 20 Cu.mm blood. Genital manifestations (77.5%) outnumbered all other
      forms of clinical manifestations. Vector infectivity rate was found to be 0.93%.

PMID- 11198403
TI  - Occurrence of asymptomatic microscopic haematuria in a filarial endemic area of
      Orissa, India.
AB  - To determine the frequency of occurrence of asymptomatic microscopic haematuria
      in filarial endemic area of Orissa, where the mf rate and disease rate were
      observed to be 14.8% and 37.2% respectively, clinical examination, night blood
      smear examination, morning midstream urine examination were conducted on 697
      persons-randomly selected from all age groups in 8 villages of Puri tehsil. Out
      of them, 15.6% were found to have asymptomatic haematuria (Grade I-14.7%, Grade
      II-0.6%, Grade-III 0.3%). The prevalence of asymptomatic microscopic haematuria
      was observed to have positive statistical correlation with mf status (P < 0.001),
      filarial antigenaemia (Ag) (P < 0.001), antibody (Ab) (P < 0.001) and circulating
      immunocomplex antigen (CIC-Ag) (P < 0.001). The prevalence was also found to be
      increased with the progression of the disease process i.e. from endemic normal to
      chronic manifestations. None of the cases having Grade-II and III haematuria
      cases revealed any gross renal pathological lesions, when subjected to special
      investigations like X-ray, IVP, cystoscopy and urethroscopy.

PMID- 11198404
TI  - Anthropophily of Anophelines in Duars of West Bengal and other regions of India.
AB  - Attempts have been made to identify the source of blood meals of twenty three
      anopheline species from various areas of high malaria endemicity in India.
      Anopheles minimus, Anopheles fluviatilis and Anopheles dirus showed a high
      propensity for human blood in North-Eastern parts of the country while Anopheles
      sundicus was found to be anthropophilic in Andaman & Nicobar Islands. Anopheles
      culicifacies, Anopheles maculatus and Anopheles philippinensis were found
      primarily zoophilic in north-eastern areas. High anthropophily has been closely
      related to sporozoite infection in anophelines specially in Anopheles minimus and
      is of great epidemiological significance.

PMID- 11198405
TI  - Honing type 2 diabetes treatment.

PMID- 11198406
TI  - Will I get sick if I accidentally eat moldy bread or cheese?

PMID- 11198407
TI  - What's the truth about the health risks of sugar substitutes such as saccharin
      and aspartame?

PMID- 11198408
TI  - Can you contract the AIDS-causing HIV virus if an infected person sneezes on you?

PMID- 11198410
TI  - The pros and cons of home testing.

PMID- 11198409
TI  - Hope for leukemia.

PMID- 11198411
TI  - Wound, heal thyself.

PMID- 11198412
TI  - Aspirin for healthy hearts.

PMID- 11198413
TI  - A more accurate prostate test?

PMID- 11198414
TI  - New treatment for postherpetic neuralgia.

PMID- 11198415
TI  - Re-evaluating Down syndrome tests.

PMID- 11198416
TI  - Migraine: tailored treatment works best.

PMID- 11198417
TI  - Hip protectors are hip.

PMID- 11198418
TI  - Don't lose sight of your diet.

PMID- 11198419
TI  - Proteomics: a link between genomics, genetics and physiology.
AB  - Thanks to spectacular advances in the techniques for identifying proteins
      separated by two-dimensional electrophoresis and in methods for large-scale
      analysis of proteome variations, proteomics is becoming an essential methodology
      in various fields of plant biology. In the study of pleiotropic effects of
      mutants and in the analysis of responses to hormones and to environmental
      changes, the identification of involved metabolic pathways can be deduced from
      the function of affected proteins. In molecular quantitative genetics, proteomics
      can be used to map translated genes and loci controlling their expression, which
      can be used to identify proteins accounting for the variation of complex
      phenotypic traits. Linking gene expression to cell metabolism on the one hand and
      to genetic maps on the other, proteomics is a central tool for functional
      genomics.

PMID- 11198420
TI  - An osmotin-like cryoprotective protein from the bittersweet nightshade Solanum
      dulcamara.
AB  - Cold acclimation in plants is a polygenic phenomenon involving increased
      expression of several genes. The gene products participate either directly or
      indirectly towards increasing cold tolerance. Evidence of proteins having a
      direct effect on cold tolerance is emerging but limited. With isolated
      protoplasts from warm-grown kale (Brassica oleracea) as a model system, we tested
      protein fractions from winter bittersweet nightshade, Solanum dulcamara, stems
      for the presence of proteins that have a cryoprotective effect. Purification of
      one such fraction resulted in isolation of a 25 kDa protein. N-terminal Edman
      degradation amino acid sequence analysis showed that it has high homology to
      osmotin and osmotin-like proteins. When added to warm-grown protoplasts, it
      increased the cryosurvival of frozen-thawed protoplasts by 24% over untreated or
      BSA-treated controls at -8 degrees C. A cDNA library which was made in November
      from stems and leaves of S. dulcamara was successfully screened for the
      corresponding cDNA clone. The deduced amino acid sequence indicated that the
      protein consists of 206 amino acid residues including a N-terminal signal
      sequence and a putative C-terminal propeptide. The mature protein, without the N
      terminal signal sequence, was expressed in Escherichia coli. The partially
      purified protein in the supernatant fraction of the culture medium had
      cryoprotective activity.

PMID- 11198421
TI  - Amino acid deletions in loop C of the chlorophyll a-binding protein CP47 alter
      the chloride requirement and/or prevent the assembly of photosystem II.
AB  - The chlorophyll a-binding protein CP47 directs excitation energy to the reaction
      center of photosystem II (PSII) during oxygenic photosynthesis and has additional
      structural and functional roles associated with the PSII water-oxidizing complex.
      Oligonucleotide-directed mutagenesis was employed to study loop C of CP47
      (approximately Trp-162 to Gly-197) which faces the thylakoid lumen. Five short
      amino acid deletion strains, delta(S169-P171), delta(Y172-G176), delta(G176
      P180), delta(E184-A188) and delta(F190-N194), were created that span this domain.
      The deletion between Gly-176 and Pro-180, located around the middle of loop C,
      produced an obligate photoheterotroph that could not assemble functional PSII
      centers. The deletions in mutants delta(S169-P171) and delta(Y172-G176) reduced
      PSII levels to < or = 20% of the control and thus impaired photoautotrophic
      growth. In contrast, mutants delta(E184-A188) and delta(F190-N194) were
      photoautotrophic even though the number of photosystems was decreased by 50%. All
      PSII complexes assembled in the deletion strains had an increased susceptibility
      to photoinactivation and deletion of Glu-184 to Ala-188 prevented
      photoautotrophic growth under chloride-limiting conditions. Furthermore, the
      removal of the extrinsic PSII-O, PSII-U and PSII-V proteins from mutants
      delta(E184-A188) and delta(F190-N194) reduced the rates of oxygen evolution and,
      in the strains lacking either the PSII-O or PSII-V proteins, also increased the
      photoautotrophic doubling times. These effects were greater in mutant delta(E 184
      A188) than in mutant delta(F190-N194) and the order of importance for the removal
      of the extrinsic proteins was found to be deltaPSII-V > or = deltaPSII-O >
      deltaPSII-U.

PMID- 11198422
TI  - Molecular characterization of quinolinate phosphoribosyltransferase (QPRtase) in
      Nicotiana.
AB  - Quinolate acid phosphoribosyltransferase (QPRTase), a key enzyme in nicotinamide
      adenine dinucleotide (NAD) biosynthesis, also plays an important role in ensuring
      nicotinic acid is available for the synthesis of defensive pyridine alkaloids in
      Nicotiana species. In this study, cDNAs for QPRTase were characterized from N.
      rustica and N. tabacum. Deduced proteins from both cDNAs are almost identical and
      contain a 24 amino acid N-terminal extension, not reported in other QPRTases,
      that has characteristics of a mitochondrial targeting sequence. In N. tabacum and
      N. sylvestris, both of which contain nicotine as the major pyridine alkaloid,
      QPRTase transcript was detected in roots, the site of nicotine synthesis, but not
      in leaves. QPRTase transcript levels increased markedly in roots of both species
      12-24 h after damage to aerial tissues, with a concomitant rise in transcript
      levels of putrescine N-methyltransferase (PMT), another key enzyme in nicotine
      biosynthesis. In N. glauca, however, in which anabasine represents the major
      pyridine alkaloid, QPRTase transcript was detected in both leaf and root tissues.
      Moreover, wound induction of QPRTase but not PMT was observed in leaf tissues,
      and not in roots, 12-24 h after wounding. Southern analysis of genomic DNA from
      the Nicotiana species noted above, and also several others from within the genus,
      suggested that QPRTase is encoded by a small gene family in all the species
      investigated.

PMID- 11198423
TI  - Structure and expression of duplicate AGAMOUS orthologues in poplar.
AB  - To investigate the homeotic systems underlying floral development in a dioecious
      tree, and to provide tools for the manipulation of floral development, we have
      isolated two Populus trichocarpa genes, PTAG1 and PTAG2, homologous to the
      Arabidopsis floral homeotic gene AGAMOUS (AG). PTAG1 and PTAG2 are located on
      separate linkage groups, but their non-coding regions are highly similar,
      consistent with a phylogenetically recent duplication. Intron/exon structure is
      conserved in relation to AG and the Antirrhinum AG orthologue, PLENA (PLE), and
      low-stringency Southern analysis demonstrated the absence of additional genes in
      the poplar genome with significant PTAG1/2 homology. PTAG1 and PTAG2 exhibit an
      AG-like floral expression pattern, and phylogenetic analysis of the AG subfamily
      strongly supports evolutionary orthology to C-class organ identity genes. The
      high degree of similarity shared by PTAG1 and PTAG2 in both sequence (89% amino
      acid identity) and expression indicates that they are unlikely to be functionally
      associated with specification of tree gender. Unexpectedly, PTAG transcripts were
      consistently detected in vegetative tissues.

PMID- 11198424
TI  - Molecular cloning and characterization of OsPSK, a gene encoding a precursor for
      phytosulfokine-alpha, required for rice cell proliferation.
AB  - We previously characterized an OsPSK cDNA encoding a precursor of phytosulfokine
      alpha (PSK-alpha), a peptide plant growth factor. Southern blot analysis
      suggested that OsPSK is a single-copy gene in rice, which we have isolated and
      characterized. The OsPSK gene consists of one large intron and two exons. The 5
      amino acid PSK-alpha sequence located close to the COOH-terminus of the precursor
      is encoded in the second exon. A putative TATA box was found at position -68 with
      respect to the transcription initiation site. Upstream of this sequence, several
      potential regulatory elements, including one CAAT-box, three CCAAT-boxes, one
      enhancer core-like sequence, and three E-boxes could be identified. By
      constructing plasmids with various lengths of the 5'-upstream regions of the
      OsPSK gene fused to the coding sequence for bacterial beta-glucuronidase (GUS),
      we demonstrated a region 1.9 kb upstream of the transcription initiation point,
      which contains most of the putative 5'-regulatory elements, to be sufficient for
      maximal-level GUS expression in transformed rice Oc cells. The promoter of the
      OsPSK gene gave significantly higher levels of GUS expression than the CaMV 35S
      promoter. These results suggest that the OsPSK promoter could be useful for the
      constitutive expression of a foreign gene at high levels in transformed rice
      culture cells. Northern blot analyses suggest that the expression of OsPSK is
      reinforced by auxin and cytokinin.

PMID- 11198425
TI  - Circadian and senescence-enhanced expression of a tobacco cysteine protease gene.
AB  - A cDNA clone encoding a cysteine protease was isolated from a tobacco cDNA
      library, utilizing as a probe a PCR fragment obtained from degenerated primers
      based on the conserved sequences of plant cysteine protease genes. A putative
      protein encoded by the clone NTCP-23 had an amino acid sequence with significant
      similarities to those of plant senescence-associated cysteine proteases and
      mammalian cathepsin H. Northern blot analysis showed that NTCP-23 mRNA is
      expressed in all organs and the mRNA and protein expression is enhanced during
      natural senescence. We propose that NTCP-23 is responsible for amino acid
      remobilization especially in senescencing leaves. Furthermore, it was found that
      the mRNA expression follows a circadian rhythm and is reduced by continuous
      darkness, wounding and hypersensitive reaction (HR). NTCP-23 is the first
      cysteine protease whose mRNA expression has been shown to be temporarily reduced
      by wounding.

PMID- 11198426
TI  - Characterization of carrot nuclear proteins that exhibit specific binding
      affinity towards conventional and non-conventional DNA methylation.
AB  - DNA methylation is associated with transcriptional silencing in vertebrates and
      plants. In mammals, the effects of methylation are mediated by a family of methyl
      CpG-binding proteins. In plants the mechanisms by which methylation represses
      transcription are still not clear. In this paper we describe protein factors in
      carrot nuclear extracts exhibiting specific affinities for conventional or non
      conventional methylation acceptor sites. We characterized two classes of
      proteins: the first, dcMBPI (Daucus carota methylated DNA-binding protein 1),
      shows high affinity for sequences containing 5-methylcytosine; the second, dcMBP2
      (Daucus carota methylated DNA-binding protein 2), efficiently complexes sequences
      containing 5-methylcytosine in both CpXpX and CpXpG trinucleotides and shows much
      lower affinity for 5-methyl CpG dinucleotides. Both dcMBP1 and dcMBP2 are
      abundant proteins differing in molecular weight and binding features. Their
      activities are modulated during carrot vegetative cell growth and somatic embryo
      development. This is the first time that, in either plants or mammals, proteins
      exhibiting specific binding affinities for conventional or non-conventional DNA
      methylation have been shown. Based on these results, the possibility that both
      the extent and the context of the methylation might contribute to modulate gene
      expression is discussed.

PMID- 11198427
TI  - A Catharanthus roseus BPF-1 homologue interacts with an elicitor-responsive
      region of the secondary metabolite biosynthetic gene Str and is induced by
      elicitor via a JA-independent signal transduction pathway.
AB  - Plants respond to pathogen attack by induction of various defence responses,
      including the biosynthesis of protective secondary metabolites. In Catharanthus
      roseus, the elicitor-induced expression of the terpenoid indole alkaloid
      biosynthetic gene Strictosidine synthase (Str) is mediated via the plant stress
      hormonejasmonate. In the promoters of several defence-related genes, cis-acting
      elements have been identified that are important for transcriptional regulation
      upon stress signals. Here we show that an upstream region in the Str promoter
      confers responsiveness to partially purified yeast elicitor and jasmonate. Yeast
      one-hybrid screening with this element as a bait identified a MYB-like protein,
      which shows high homology to parsley box P-binding factor-1 (PcBPF-1). In vitro
      analyses showed that the Str promoter fragment contained a novel binding site for
      BPF-1-like proteins with higher binding affinity than the previously described
      box P. CrBPF-1 mRNA accumulated rapidly in elicitor-treated C. roseus suspension
      cells, whereas no induction was observed with jasmonate. Inhibitor studies
      indicated that CrBPF-1 plays a role in an elicitor-responsive but jasmonate
      independent signal transduction pathway, acting downstream of protein
      phosphorylation and calcium influx.

PMID- 11198428
TI  - Hexose transporters of tomato: molecular cloning, expression analysis and
      functional characterization.
AB  - A full-length (LeHT2) and two partial (LeHT1 and LeHT3) cDNA clones, encoding
      hexose transporters, were isolated from tomato (Lycopersicon esculentum) fruit
      and flower cDNA libraries. Southern blot analysis confirmed the presence of a
      gene family of hexose transporters in tomato consisting of at least three
      members. The full-length cDNA (LeHT2) encodes a protein of 523 amino acids, with
      a calculated molecular mass of 57.6 kDa. The predicted protein has 12 putative
      membrane-spanning domains and belongs to the Major Facilitator Superfamily of
      membrane carriers. The three clones encode polypeptides that are homologous to
      other plant monosaccharide transporters and contain conserved amino acid motifs
      characteristic of this superfamily. Expression of the three genes in different
      organs of tomato was investigated by quantitative PCR. LeHT1 and LeHT3 are
      expressed predominantly in sink tissues, with both genes showing highest
      expression in young fruit and root tips. LeHT2 is expressed at relatively high
      levels in source leaves and certain sink tissues such as flowers. LeHT2 was
      functionally expressed in a hexose transport-deficient mutant (RE700A) of
      Saccharomyces cerevisiae. LeHT2-dependent transport of glucose in RE700A
      exhibited properties consistent with the operation of an energy-coupled
      transporter and probably a H+/hexose symporter. The Km of the symporter for
      glucose is 45 microM.

PMID- 11198429
TI  - Limitations in the use of ozone to disinfect maple sap.
AB  - The sap of the maple sugar tree (Acer saccharum) contains 2 to 3% sucrose and is
      traditionally collected early in the year and concentrated by boiling to produce
      maple syrup. High levels of microorganisms in the sap occur during holding,
      leading to a darker syrup with lower economic value. We investigated the use of
      dissolved ozone as a method to reduce the microbial population in sap. After 40
      min of ozone treatment, concentrations of up to 0.30 mg/liter were achieved but
      were ineffective in reducing the aerobic plate count. Three predominant colonies
      on nutrient agar were selected for isolation and identification from sap. These
      included one mucoid and one nonmucoid yeast, both identified as Candida, and
      Pseudomonas fluorescens. When suspended in buffer, each was readily inactivated
      by ozone. Addition of 3% sucrose to the buffer markedly reduced the effectiveness
      of ozone. With the use of an ozone generator with a larger ozone output,
      saturating ozone concentrations (1 mg/liter) were achieved within 5 min but were
      accompanied by only a 1-log reduction in aerobic plate count of maple sap. After
      40 min of ozone treatment, a less than 3-log reduction occurred. The results
      indicate that, because of the presence of sucrose, ozone may be of limited use in
      reducing the microbial population in sap.

PMID- 11198430
TI  - Facilitation of cleaning of alumina surfaces fouled with heat-treated bovine
      serum albumin by ozone treatment.
AB  - Facilitation of cleaning of alumina (A12O3) particles fouled with heat-treated
      bovine serum albumin (BSA), which contains sulfhydryl groups on the molecule, by
      gaseous ozone was studied. With increasing temperature of heat treatment, the
      amount of adsorbed BSA onto A12O3 surfaces increased, whereas the rate of BSA
      desorption during alkali cleaning decreased markedly, resulting in the larger
      amounts of BSA remaining on 12O3 surfaces. No significant amounts of BSA were
      removed from A12O3 surfaces by alkali cleaning alone when treated at temperatures
      above 120 degrees C. Before alkali cleaning, the heat-treated, BSA-fouled AI2O3
      at 150 degrees C were treated with 0.05 to 0.30% (vol/vol) gaseous ozone at room
      temperature. Ozone pretreatment markedly accelerated the rate of BSA desorption
      during subsequent alkali cleaning. The effect of ozone pretreatment on BSA
      removal depended on the concentration of ozone and treatment time and hence on
      the total amount of ozone supplied. The molecular weight (MW) of desorbed BSA
      during alkali cleaning without ozone pretreatment coincided with the MW of the
      native BSA, whereas the MW of desorbed BSA during the combined ozone-alkali
      cleaning was lower than the MW of the native BSA. This indicated that the heat
      treated BSA molecules adsorbed on A12O3 were partially decomposed into some
      fragments by ozone pretreatment, resulting in the facilitation of the removal of
      BSA during alkali cleaning.

PMID- 11198431
TI  - Bactericidal effects of negative air ions on airborne and surface Salmonella
      enteritidis from an artificially generated aerosol.
AB  - The bactericidal effect of high levels of negative ions was studied using a
      custom-built electrostatic space charge device. To investigate whether the ion
      enriched air exerted a bactericidal effect, an aerosol containing Salmonella
      Enteritidis (SE) was pumped into a sealed plastic chamber. Plates of XLT4 agar
      were attached to the walls, top, and bottom of the chamber and exposed to the
      aerosol for 3 h with and without the ionizer treatment. The plates were then
      removed from the chamber, incubated at 37 degrees C for 24 h, and colonies were
      counted. An average of greater than 10(3) CFU/plate were observed on plates
      exposed to the aerosol without the ionizer treatment (control) compared with an
      average of less than 53 CFU/plate on the ionizer-treated plates. In another
      series of experiments, the SE aerosol was pumped for 3 h into an empty chamber
      containing only the ionizer and allowed to collect on the internal surfaces. The
      inside surfaces of the chamber were then rinsed with 100 ml phosphate-buffered
      saline that was then plated onto XLT4 plates. While the rinse from the control
      chamber contained colony counts greater than 400 CFU/ml of wash, no colonies were
      found in the rinse from the ionizer-treatment chamber. These results indicate
      that high levels of negative air ions can have a significant impact on the
      airborne microbial load, and that most of this effect is through direct killing
      of the organisms. This technology, which also causes significant reduction in
      airborne dust, has already been successfully applied for poultry hatching
      cabinets and caged layer rooms. Other potential applications include any enclosed
      space such as food processing areas, medical institutions, the workplace, and the
      home, where reduction of airborne and surface pathogens is desired.

PMID- 11198432
TI  - Identification of bovine-specific DNA in feedstuffs.
AB  - Considering the menace of transmission of bovine spongiform encephalopathy, feed
      components intended for cattle nutrition must be checked for the presence of
      bovine-derived materials. We have been using a method based on polymerase chain
      reaction for the identification of bovine-specific mitochondrial DNA sequences
      for this purpose. The specificity of the primers for polymerase chain reaction
      has been tested using samples of DNA of other vertebrate species, which may also
      be present in rendering plant products. The method allows the detection in
      concentrate mixtures of 0.125% of bovine-derived material. Bovine DNA at
      concentrations corresponding to less than 0.5% of bovine-derived material was
      detected in 3 of the 30 samples of concentrate mixtures collected from
      distributors' stores all over the Czech Republic. All 44 samples of fish meal
      collected from the same sources were free of bovine-derived material.

PMID- 11198433
TI  - Salmonella in the lairage of pig slaughterhouses.
AB  - The purpose of this study was to determine if lairages of pig slaughterhouses can
      act as a source of contamination of slaughtered pigs with Salmonella. The
      prevalence and variety of serotypes of Salmonella in the lairages of two pig
      slaughterhouses were determined, and the efficacy of the usual cleaning and
      disinfection on the presence of Salmonella was estimated. Lairages of two pig
      slaughterhouses were sampled three times when pigs were present. Furthermore,
      these lairages were sampled after the usual cleaning and disinfection, whereas
      the lairage of one slaughterhouse was sampled an additional time after improved
      cleaning and disinfection. Samples were collected by swabbing floor and wall
      surfaces and collecting the residing fluids on the floor throughout the lairage.
      Salmonella was isolated in 70 to 90% of the samples when pigs were present. The
      usual cleaning and disinfection reduced the level of contamination with
      Salmonella to 25% positive samples, whereas improved cleaning and disinfection
      reduced this level to 10% positive samples. It is concluded that the waiting
      period in the lairage of at least 2 h contains a substantial risk for slaughter
      pigs to become infected with Salmonella, especially for pigs originating from
      Salmonella-free herds. The usual cleaning and disinfection of the lairage were
      not sufficient to eliminate this risk, whereas an improved procedure for cleaning
      and disinfection still was unsatisfactory.

PMID- 11198434
TI  - Dietary strategies to counteract the effects of mycotoxins: a review.
AB  - We reviewed various dietary strategies to contain the toxic effects of mycotoxins
      using antioxidant compounds (selenium, vitamins, provitamins), food components
      (phenolic compounds, coumarin, chlorophyll and its derivatives, fructose,
      aspartame), medicinal herbs and plant extracts, and mineral and biological
      binding agents (hydrated sodium calcium aluminosilicate, bentonites, zeolites,
      activated carbons, bacteria, and yeast). Available data are primarily from in
      vitro studies and mainly focus on aflatoxin B1, whereas much less information is
      available about other mycotoxins. Compounds with antioxidant properties are
      potentially very efficacious because of their ability to act as superoxide anion
      scavengers. Interesting results have been obtained by food components contained
      in coffee, strawberries, tea, pepper, grapes, turmeric, Fava tonka, garlic,
      cabbage, and onions. Additionally, some medicinal herbs and plant extracts could
      potentially provide protection against aflatoxin B1 and fumonisin B1. Activated
      carbons, hydrated sodium calcium aluminosilicate, and bacteria seem to
      effectively act as binders. We conclude that dietary strategies are the most
      promising approach to the problem, considering their limited or nil interference
      in the food production process. Nevertheless, a great research effort is
      necessary to verify the in vivo detoxification ability of the purposed agents,
      their mode of action, possible long-term drawbacks of these detoxification
      decontamination procedures, and their economical and technical feasibility.

PMID- 11198435
TI  - Inhibition of in vitro Salmonella Typhimurium colonization in porcine cecal
      bacteria continuous-flow competitive exclusion culturest.
AB  - Continuous-flow (CF) chemostate cultures were used as models to determine the
      potential usefulness of undefined porcine cecal bacteria as competitive exclusion
      (CE) cultures against colonization by Salmonella Typhimurium. One culture, pCF1,
      was derived from cecal bacteria of an animal maintained on antibiotic-free feed,
      while the other culture, pCF4, was derived from cecal bacteria of an animal
      maintained on feed containing chlortetracycline. The effectiveness against a
      chlortetracycline-resistant Salmonella Typhimurium was examined in CF cultures
      maintained in the absence (pCF1 and pCF4) and presence (cpCFl and cpCF4) of
      chlortetracycline. CF cultures were inoculated with each of 10(2), 10(4), and
      10(6) Salmonella Typhimurium CFU/ml. Chemostat inocula of 10(2) Salmonella CFU/ml
      resulted in no Salmonella Typhimurium being detected at 2 and 3 days
      postinoculation in pCF1 and pCF4, respectively, and after 2 days in both cpCF1
      and cpCF4. Inoculations of 10(4) Salmonella Typhimurium CFU/ml resulted in
      clearance from pCF1 and pCF4 within 4 days and within 3 days from cpCF1 and
      cpCF4. Following inoculation with 10(6) CFU/ml, no Salmonella Typhimurium were
      detected in all CF cultures by 6 days postinoculation. The results indicated that
      in vitro CF cultures of porcine cecal bacteria were able to inhibit the growth of
      Salmonella Typhimurium. The ability to limit Salmonella Typhimurium growth was
      not restricted by prior exposure of the cecal bacteria to the feed additive
      chlortetracycline. The present study demonstrates the potential application of CF
      cultures as models to aid in the identification of CE cultures against
      salmonellosis in pigs.

PMID- 11198436
TI  - Survival and growth of Salmonella and Listeria in the chicken breast patties
      subjected to time and temperature abuse under varying conditions.
AB  - Chicken breast patties were inoculated with a mixture of Salmonella Senftenberg,
      Salmonella Typhimurium, Salmonella Heidelberg, Salmonella Mission, Salmonella
      Montevideo, Salmonella California, and Listeria innocua. The initial inoculation
      of bacteria was approximately 10(7) log10 CFU/g. The inoculated patties were
      processed in a pilot-scale air convection oven at an air temperature of 177
      degrees C, an air velocity of 9.9 m3/min, and a low (a wet bulb temperature of 48
      degrees C) or high (a wet bulb temperature of 93 degrees C) humidity condition.
      The patties were processed to a final center temperature of 65 to 75 degrees C.
      The survivors of Salmonella and Listeria in the processed patties were evaluated.
      Processing humidity affected the survivors of bacteria. More survivors of
      Salmonella and Listeria (>2 logs) were obtained for the patties cooked at low
      humidity than at high humidity. After thermal processing, the patties were stored
      under air, vacuum, or CO2 at refrigerated (4 degrees C) or thermally abused (8 to
      15 degrees C) temperatures. Storage temperature, time, and gas environment
      affected the bacteria growth. Higher storage temperature and longer storage time
      correlated to an increased growth of bacteria in the cooked chicken patties. Less
      Salmonella (2 logs) and Listeria (0.5 to 1 log) cells were obtained in the
      patties stored under vacuum than in air. Storing the patties in 30% CO2 reduced
      the growth of Salmonella more than 2 log10 CFU/g. At a CO2 level of 15%, 1 log10
      CFU/g of reduction was obtained for Listeria in cooked chicken patties.

PMID- 11198437
TI  - Fecal shedding of Salmonella spp. by dairy cows on farm and at cull cow markets.
AB  - As part of a national study of the U.S. dairy cow population, fecal samples were
      collected from representative cows on 91 dairies and 97 cull dairy cow markets in
      19 states. Salmonella spp. were recovered from 5.4% of milk cows, 18.1% of milk
      cows expected to be culled within 7 days, and 14.9% of culled dairy cows at
      markets. On a premise basis, Salmonella shedding in milk cows was detected on
      21.1% of dairies and 66% of cull dairy cow markets. The percentage of herds with
      at least one cow with detectable Salmonella fecal shedding was higher during the
      sampling period from May through July, in herds with at least 100 milk cows, and
      in herds in the South region. The most common Salmonella serogroups isolated were
      E (30.8% of isolates) and C1 (28.6%); the most common serotypes isolated were
      Salmonella Montevideo (21.5% of isolates), Salmonella Cerro (13.3%), and
      Salmonella Kentucky (8.5%). Fecal shedding of Salmonella Typhimurium or
      Salmonella Typhimurium var. copenhagen was infrequent (2.8% of isolates). Most
      isolates (88.9%) were susceptible to all 17 antimicrobials evaluated; multiple
      resistance was an infrequent occurrence. This study provides information
      describing the distribution of Salmonella fecal shedding from dairy cows on farm
      and at markets and will serve as a baseline for future studies.

PMID- 11198438
TI  - Comparison of different enrichment broths and background flora for detection of
      heat-injured Listeria monocytogenes in whole milk.
AB  - Various primary enrichment broths, including University of Vermont medium (UVM),
      Listeria enrichment broth (LEB), modified LEB, and aerobic and anaerobic L
      PALCAMY, were compared with aerobic and anaerobic Pennsylvania State University
      (PSU) broths for the detection of severely heat-injured (62.8 degrees C for 5,
      10, or 15 min; no colony appearance after heat injury on aerobic Trypticase soy
      agar containing 0.6% yeast extract and modified Oxford medium) Listeria
      monocytogenes Scott A. Anaerobic conditions were produced by adding L-cysteine
      and then purging the headspace with N2. The effect of uninjured background flora
      (10(3) CFU/ml of Enterococcus faecium) on frequency of detection was examined.
      Anaerobic PSU broth resulted in the lowest false-positive rate and the highest
      frequency of detection of severely heat-injured L. monocytogenes compared with
      UVM, LEB, and modified LEB (P < 0.05). The presence of E. faecium significantly
      enhanced the detection of heat-injured (10 min at 62.8 degrees C) L.
      monocytogenes in aerobic and anaerobic PSU and aerobic and anaerobic L-PALCAMY
      broths (P < 0.05). The highest concentration of uninjured E. faecium (>10(6)
      CFU/ml) inhibited the detection of heat-injured L. monocytogenes (P < 0.05). A
      heat-resistant, LiCl-tolerant Lactobacillus isolate from raw milk increased the
      rate of both false-positive and false-negative reactions.

PMID- 11198439
TI  - Surface plasmon resonance analysis of staphylococcal enterotoxin B in food.
AB  - Surface plasmon resonance (SPR) biosensors are electro-optical instruments used
      for analyzing real-time protein-protein interactions. This work evaluates an SPR
      biosensor (Biacore 3000) in the detection of staphylococcal enterotoxin B (SEB)
      in foods. A sandwich SPR immunosensor involving two antibodies was used. The
      capturing antibody, bound covalently to the surface of the biosensor chip,
      performs the initial binding of the antigen and a second antibody binds to the
      captured antigen. The second antibody makes antigen verification possible and
      amplifies the signal. Pure SEB as well as SEB in spiked foods (milk and meat)
      were detected with little interference from the food matrix. In the control
      experiments with uncontaminated food samples no significant signal was detected.
      The SPR biosensor assay detects SEB at approximately10 ng/ml rapidly, with
      initial binding within 2 min. The entire measurement cycle (including washing and
      chip regeneration) may take 5 min using one antibody or 8 min using two
      antibodies. These results suggest that the SPR biosensor may be a useful tool for
      real-time analysis of toxin in foods.

PMID- 11198440
TI  - Evaluation of a selective broth for detection of Staphylococcus aureus using
      impedance microbiology.
AB  - Experiments were conducted to evaluate a selective nutrient broth containing
      acriflavine and nalidixic acid for detection of Staphylococcus aureus using an
      impedance microbiological method. Nine species of bacteria, other than S. aureus,
      were evaluated using the selective broth to determine if these species could be
      inhibited. A total of 10 ppm of nalidixic acid inhibited the gram-negative
      species tested, with the exception of Pseudomonas aeruginosa. Similarly, 10 ppm
      of acriflavine suppressed the Staphylococcus spp. examined; however, S. aureus
      retained the ability to proliferate. Nutrient broth solution containing 10 ppm of
      nalidixic acid and 10 ppm of acriflavine (S. aureus impedance broth [SIB])
      inhibited multiplication of most of the bacterial species tested and allowed S.
      aureus to be detected in an average of 16.4 h. Fresh chicken carcass rinses and
      cooked chicken rinses were inoculated with Escherichia coli and S. aureus and
      assayed using SIB in conjunction with impedance. Results demonstrated that S.
      aureus could be detected in less than 11.5 h, although the presence of E. coli
      decreased detection times. Additionally, impedance assays were conducted using
      five different poultry products to evaluate the sensitivity of the broth for
      detecting S. aureus. S. aureus could be detected on poultry products when present
      at low levels (10(1) CFU/ml) in less than 24 h. These studies demonstrated that
      SIB may be used in conjunction with impedance for rapid detection of S. aureus.
      However, without further modification, this method should not be used for
      enumeration of S. aureus from samples containing mixed microflora.

PMID- 11198441
TI  - Modeling the growth boundary of Staphylococcus aureus for risk assessment
      purposes.
AB  - Knowing the precise boundary for growth of Staphylococcus aureus is critical for
      food safety risk assessment, especially in the formulation of safe, shelf-stable
      foods with intermediate relative humidity (RH) values. To date, most studies and
      resulting models have led to the presumption that S. aureus is osmotolerant.
      However, most studies and resulting models have focused on growth kinetics using
      NaCl as the humectant. In this study, glycerol was used to investigate the
      effects of a glass-forming nonionic humectant to avoid specific metabolic aspects
      of membrane ion transport. The experiments were designed to produce a growth
      boundary model as a tool for risk assessment. The statistical effects and
      interactions of RH (84 to 95% adjusted by glycerol), initial pH (4.5 to 7.0
      adjusted by HC1), and potassium sorbate (0, 500, or 1,000 ppm) or calcium
      propionate (0, 500, or 1,000 ppm) on the aerobic growth of a five-strain S.
      aureus cocktail in brain heart infusion broth were explored. Inoculated broths
      were distributed into microtiter plates and incubated at 37 degrees C over
      appropriate saturated salt slurries to maintain RH. Growth was monitored by
      turbidity during a 24-week period. Toxin production was explored by enterotoxin
      assay. The 1,280 generated data points were analyzed by SAS LIFEREG procedures,
      which showed all studied parameters significantly affected the growth responses
      of S. aureus with interactions between RH and pH. The resulting growth/no growth
      boundary is presented.

PMID- 11198442
TI  - Lactic acid sprays reduce bacterial pathogens on cold beef carcass surfaces and
      in subsequently produced ground beef.
AB  - Organic acids have been shown to be effective in reducing the presence of
      pathogenic bacteria on hot beef carcass surfaces; however, application for
      decontaminating chilled carcasses has not been fully evaluated. In this study, a
      postchill, 30-s lactic acid spray (500 ml of 4% L-lactic acid, 55 degrees C) was
      applied onto outside rounds that had been contaminated with Escherichia coli
      O157:H7 and Salmonella Typhimurium, subsequent to prechill hot carcass treatments
      consisting of water wash alone or water wash followed by a 15-s lactic acid spray
      (250 ml of 2% L-lactic acid, 55 degrees C). The prechill treatments reduced both
      pathogens by 3.3 to 3.4 log cycles (water wash alone) to 5.2 log cycles (water
      wash and lactic acid). In all cases, the postchill acid treatment produced an
      additional reduction in E. coli O157:H7 of 2.0 to 2.4 log cycles and of 1.6 to
      1.9 log cycles for Salmonella Typhimurium. The counts of both pathogens remained
      significantly lower in ground beef produced from the outside rounds that received
      prechill and postchill acid spray than from those that received a postchill spray
      only. These data indicate that organic acid sprays may be successfully applied
      for pathogen reduction in beef carcass processing after the cooler, especially
      when combined with prechill treatments.

PMID- 11198443
TI  - Development of a multiple-step process for the microbial decontamination of beef
      trim.
AB  - A multiple-hurdle antimicrobial process for beef trim was developed. The
      microbial profiles of inoculated lean beef trim tissue (BTL) and fat-covered lean
      beef trim (BTF) were monitored during prolonged refrigerated storage following
      the application of successive multiple antimicrobial treatments applied to
      inoculated beef trim on a processing conveyor belt set at a belt speed of 1 cm/s.
      Beef trim (meat size approximately 15 by 15 cm) was preinoculated with bovine
      feces before all treatments that included the following: control, no treatment;
      water wash at 65 psi for five passes; water plus lactic acid (2% [vol/vol] room
      temperature lactic acid wash at 30 psi for three passes); combination treatment 1
      (water plus 65 degrees C hot water at 30 psi for one pass plus hot air at 510
      degrees C for four passes plus lactic acid), combination treatment 2 (water plus
      hot water at 82 degrees C for one pass plus hot air at 510 degrees C for five
      passes plus lactic acid), and combination treatment 3 (water plus hot water at 82
      degrees C for three passes plus hot air at 510 degrees C for six passes plus
      lactic acid). The effects of treatments on bacterial populations were monitored
      by enumerating mesophilic aerobic bacteria (APC), presumptive lactic acid
      bacteria (PLAB), psychrotrophic bacteria (PCT), coliforms, and Escherichia coli
      biotype 1 on product stored for up to 7 days at 4 degrees C. In the case of BTL,
      the numbers of APC, PCT, and PLAB increased during storage at 5 degrees C,
      whereas the numbers of coliform and E. coli decreased on average by 1.8 log
      CFU/cm2, then remained constant following the initial reduction. Negligible
      effects on color quality were observed from multihurdle treatment combination 1.
      In the case of the BTF, the microbial reductions by treatments were much greater
      than the reduction on BTL. The pH of treated BTF increased more slowly than the
      pH of treated BTL, resulting in further reduction of the microflora on BTF.
      Except for control and water treatments, all sample treatments involving lactic
      acid resulted in continuously decreasing microbial populations. Based on
      microbial reduction and quality aspects, it was concluded that successively
      applied combination antimicrobial treatments for meat trim could offer potential
      food safety benefits.

PMID- 11198444
TI  - Quantification and variability analysis of bacterial cross-contamination rates in
      common food service tasks.
AB  - This study investigated bacterial transfer rates between hands and other common
      surfaces involved in food preparation in the kitchen. Nalidixic acid-resistant
      Enterobacter aerogenes B199A was used as a surrogate microorganism to follow the
      cross-contamination events. Samples from at least 30 different participants were
      collected to determine the statistical distribution of each cross-contamination
      rate and to quantify the natural variability associated with that rate. The
      transfer rates among hands, foods, and kitchen surfaces were highly variable,
      being as low as 0.0005% and as high as 100%. A normal distribution was used to
      describe the variability in the logarithm of the transfer rates. The mean +/- SD
      of the normal distributions were, in log percent transfer rate, chicken to hand
      (0.94 +/- 0.68), cutting board to lettuce (0.90 +/- 0.59), spigot to hand (0.36
      +/- 0.90), hand to lettuce (-0.12 +/- 1.07), prewashed hand to postwashed hand
      (i.e., hand washing efficiency) (-0.20 +/- 1.42), and hand to spigot (-0.80 +/-
      1.09). Quantifying the cross-contamination risk associated with various steps in
      the food preparation process can provide a scientific basis for risk management
      efforts in both home and food service kitchens.

PMID- 11198445
TI  - The effects of cultivating lactic starter cultures with bacteriocin-producing
      lactic acid bacteria.
AB  - The effects of bacteriocins produced by six strains of lactic acid bacteria on 9
      mesophilic and 11 thermophilic commercial starter cultures were investigated in
      mixed cultures of commercial starters with bacteriocin-producing strains in milk.
      The bacteriocins produced by the test organisms were nisin A, nisin Z, lacticin
      481, enterocin AS-48, a novel enterocin, and a novel plantaricin. Mesophilic
      commercial starters were in most cases tolerant of bacteriocins, with only two of
      the starters being partially inhibited, one by four and the other by two
      bacteriocins. The aminopeptidase activities of mesophilic starters were generally
      low, and only one of the combinations of mesophilic starter-bacteriocin producer
      gave double the aminopeptidase activity of the starter culture without the
      bacteriocin producer. Thermophilic commercial starters were more sensitive to
      bacteriocins than mesophilic starters, with six thermophilic starters being
      partially inhibited by at least one of the bacteriocins. Their aminopeptidase
      activities were generally higher than those of the mesophilic starters. The
      aminopeptidase activities of seven thermophilic starters were increased in the
      presence of bacteriocins, by factors of up to 9.0 as compared with the
      corresponding starter cultures alone. Bacteriocin-producing strains may be used
      as adjunct cultures to mesophilic starters for the inhibition of pathogens in
      soft and semihard cheeses, because mesophilic starters are rather tolerant of
      bacteriocins. Bacteriocin producers may also be used as adjunct cultures to
      thermophilic starters of high aminopeptidase activity, more sensitive to lysis by
      bacteriocins than mesophilic starters, for the acceleration of ripening in
      semihard and hard cheeses.

PMID- 11198446
TI  - Cleanability of soiled stainless steel as studied by atomic force microscopy and
      time of flight secondary ion mass spectrometry.
AB  - The hygienic status of food contact surfaces can deteriorate with wear. Effective
      cleaning regimes must remove any adsorbed organic material as well as
      microorganisms. Previous work has determined the extent of surface wear occurring
      on a stainless steel surface within the food industry, and we have reproduced
      representative samples in vitro. Two surface analytical techniques, atomic force
      microscopy and time of flight secondary ion mass spectrometry were combined with
      fluorescence microscopy to give detailed analysis of stainless steel surfaces
      fouled with starch and milk powder, then cleaned with water either by a spray or
      brushing method. It was found that the surface cleanability is affected by the
      cleaning regime and the surface roughness, not only the average vertical
      roughness but also by the shape of the surface defects, with sharp scratches more
      difficult to clean than wider surface defects. Spray cleaning with distilled
      water was found to be a selective method by preferentially removing proteinaceous
      material more easily than fatty acid ester material. The analytical techniques
      employed provided information on selective cleanability and surface topography at
      a hitherto unexplored level, and the information gained may be of value in the
      design and investigation of novel cleaning regimes and hygienic surfaces.

PMID- 11198447
TI  - Changes in K value and microorganisms of tilapia fillet during storage at high
      pressure, normal temperature.
AB  - This study determined the effect of high-pressure, normal temperature (25 degrees
      C) storage on tilapia fillets. After pressurization, the fillets were stored at
      normal condition (1 atm [1 atm = 101.29 kPa] and 25 degrees C) for 12 h to
      evaluate the changes of microbes and K value. The fillets stored at 2,000 atm for
      12 h still kept the K value, a freshness index that represents putrefaction with
      the value beyond 60%, still below 40%, and the K value of the meat without
      pressurization was up to 92%. Total plate counts of the fillets stored at below
      1,000 atm for 12 h were maintained at the value of 4.7 log CFU/g of meat, which
      was similar to the initial level. However, the counts were obviously decreased to
      about 2.0 log CFU/g of meat for the fillets stored at above 2,000 atm. The same
      effect was obtained for psychrophilic bacteria. Enzymes and microbes reactivated
      apparently after 12 h of normal condition storage of mild pressurized fillets.
      The study demonstrates that high-pressure storage can inhibit the putrefaction of
      tilapia meat but no longer after that.

PMID- 11198448
TI  - Microbiological survey of retail herbs and spices from Mexican markets.
AB  - In the present study, 304 samples of herbs and spices (garlic powder, cumin
      seeds, black pepper, oregano, and bay leaves) widely used in Mexico were analyzed
      for the presence of Bacillus cereus, Salmonella Typhi, Shigella dysenteriae,
      Escherichia coli, total and fecal coliforms, total mesophilic aerobic organisms,
      and fungi. Samples were nonpackaged or packaged in polyethylene bags or glass
      containers. High levels (10(5) to 10(7) CFU/g) of mesophilic aerobic
      microorganisms were found in most of the samples of garlic powder, cumin seed,
      and black pepper. Lower levels (<102 CFU/g) were found in oregano and bay leaves.
      Total and fecal coliforms counts were dependent on the type of packaging. More
      than 70% of the polyethylene-packaged samples had less than 10(3) CFU/g of
      microorganisms. Glass and nonpackaged spices showed lower levels of these
      microorganisms. B. cereus was present in 32 samples of which most were
      polyethylene packaged. The other pathogenic bacteria were not detected.
      Aspergillus niger was detected in 29% of the samples, Rhizopus sp. in 19%, and
      Penicillum sp. and Cunninghamella in 8%.

PMID- 11198449
TI  - Psychological risk factors in pregnant inmates. A challenge for nursing.
AB  - PURPOSE: To explore pregnant prisoners' experiences with childhood violence and
      substance abuse, their parenting attitudes, and their psychological health.
      DESIGN: This study used a prospective design to describe incarcerated pregnant
      women's experiences with childhood violence, substance abuse, parenting
      attitudes, and psychological health and the relationships among these factors.
      METHODS: Sixty-three pregnant prisoners in their third trimester were
      interviewed. Owing to the low literacy of this population, all questions were
      read to participants to maximize comprehension and reliability. RESULTS: Over 60%
      of respondents reported experiencing family violence during childhood or
      adolescence. Almost one-half of the women reported using drugs and alcohol during
      the past year and in their current pregnancy. Substance-abusing respondents were
      twice as likely to have been victims of physical abuse. All of the women who had
      been sexually abused during childhood were substance abusers; women who did not
      use drugs had no such history. Many women in the study had parenting and child
      rearing attitudes indicative of risk for poor parenting and abuse. More than 70%
      of the women reported depressive symptoms above the level considered indicative
      of clinical depression. Women reported low levels of social support; further, 50%
      of the women had lost an important relationship within the last year and 80% were
      not in a relationship with a partner at the time of their interview. CLINICAL
      IMPLICATIONS: The essential components of caring for pregnant prisoners should
      include extensive screening for substance abuse as well as history of past and
      current violence. Pregnant prisoners, with their many risk factors, are a group
      that could benefit from programs that address substance abuse and violence to
      decrease mental distress.

PMID- 11198450
TI  - Minimizing risks associated with peripherally inserted central catheters in the
      NICU.
AB  - Peripherally inserted central catheters (PICC lines) provide prolonged venous
      access, a means of administration of needed medications that would otherwise be
      irritating to peripheral vessels, and a means of assuring better parenteral
      nutrition to infants who are unable to tolerate enteral feedings. Not only do
      these central lines provide life-saving therapy, they are easily inserted, cost
      effective, and convenient. Although there are many benefits to the use of these
      catheters, physicians and nurses within the NICU must remain acutely aware of the
      risks involved with placement of PICC lines so that complications can be
      minimized. Prevention of sepsis in neonates is always a priority, and several
      measures can be implemented to reduce this risk, including scrupulous aseptic
      technique, knowledgeable selection of the insertion site, and consistent daily
      care. Other complications such as thrombosis, extravascular collection of fluid
      due to catheter migration or blockage, vessel perforation, and line leakage are
      all concerns when using this valuable tool in the care of infants. Careful
      catheter tip placement and conscientious ongoing monitoring can assist in
      reducing morbidity as well as mortality related to PICC lines.

PMID- 11198451
TI  - Somebody's grandma and grandpa. Children's responses to contacts with elders.
AB  - PURPOSE: This article describes the planning, implementation, and evaluation of a
      program that introduced children into a nursing home. METHOD: A qualitative
      descriptive design was employed to measure the responses of children to the
      program. The sample consisted of 61 children, including preschoolers and
      adolescents. Data were collected from children who participated in the activities
      (n = 33), and from children who had not participated (n = 28). Content analysis
      was used to analyze the data. RESULTS: There were no differences in perceptions
      of preschoolers who participated or did not participate in the nursing home
      visitation program. In contrast, adolescents who had not participated in the
      activities with elders described physical infirmities and negative experiences
      with elders, and talked about smells and boredom. However, adolescent
      participants in the program demonstrated positive perceptions and descriptions of
      elders. A favorite activity for all ages was hearing the residents' stories and
      memories. Adolescent participants reported that their experiences and activities
      in the program had altered their opinions and beliefs, and they expressed the
      intent to include elders in their lives in the future. CLINICAL IMPLICATIONS:
      Because adolescent children exposed to these visits expressed positive
      perceptions of elders it is prudent to plan larger scale studies with these
      populations, and also to evaluate the effects of the visits on nursing home
      residents.

PMID- 11198452
TI  - Giving birth. Perceptions of Finnish childbearing women.
AB  - PURPOSE: To describe the lived experience of childbirth with women giving birth
      in Finland. DESIGN: Phenomenology. METHODS: Twenty Finnish women who had recently
      given birth were interviewed within 2 weeks following childbirth, sharing their
      perceptions of meaning of their childbirth experiences. Culturally appropriate
      strategies for qualitative data collection were employed. Trustworthiness of the
      data was ensured. RESULTS: The richness and diversity of the childbirth
      experience emerged from the data. One theme identified was a sense of awe at the
      creation of a new life within the context of birth as a bittersweet paradox. A
      strong sense of maternal confidence or self-efficacy was identified, which
      influenced the women's perception of and management of childbirth pain. Feelings
      of self-actualization were articulated as Finnish women successfully negotiated a
      challenging life event. CLINICAL IMPLICATIONS: Perinatal nurses should increase
      their sensitivity to the socio-cultural context of giving birth by acknowledging
      women's experiences as legitimate sources of knowledge.

PMID- 11198453
TI  - Pregnant adolescents and their mothers. A shared experience of teen mothering.
AB  - PURPOSE: To explore and describe the relationships between African American
      adolescent mothers and their mothers. DESIGN: A qualitative, descriptive approach
      was used. METHODS: In-depth, audio-taped interviews, using a semi-structured
      interview guide with open-ended questions, were conducted with a convenience
      sample of 12 mother/daughter pairs and three teen mother/mother-figure pairs in a
      university research area designed for the comfort of the participants. Mothers
      and daughters were interviewed separately to enhance free expression of their
      feelings. Participants were recruited through an ongoing study on adolescent
      motherhood. RESULTS: Four major themes emerged from the analysis. The two
      symbolic themes were communication between mother and daughter and role change.
      The two dominant interactive themes were conflict and social isolation. CLINICAL
      IMPLICATIONS: Nursing assessment of pregnant and parenting teen mothers that
      includes an assessment of the character of the mother/daughter relationship can
      be valuable in assisting the pregnant teen toward better health.

PMID- 11198454
TI  - Sexuality & cystic fibrosis.
AB  - The life expectancy for a child with Cystic Fibrosis has steadily increased over
      the past few decades from an average of 8 years in 1970 to 29.5 years in 1998.
      Nurses who care for this special population need to be open to discussions about
      the quality of life of these individuals, including sexuality, body image, and
      self-esteem. Specific information concerning expected body image, fertility, and
      safe-sex practices is essential. Males will want to know about their reproductive
      choices, and females will need to have counseling about the decision to become
      pregnant, including the genetic implications for both themselves and the unborn
      child.

PMID- 11198455
TI  - Does breastfeeding reduce risk for breast cancer? A short lesson in evidence
      based practice.
AB  - Breastfeeding has been promoted by some healthcare providers and childbirth
      educators as having a protective effect against breast cancer. In an effort to
      use the best evidence available for teaching patients, this article was written
      to summarize the literature about the protective effects of breastfeeding. The
      studies examined consistently demonstrated a mild to moderate protective effect
      from breast cancer; however, many variables including age, medication use,
      smoking, and family history affected the risk. While nurses and childbirth
      educators are in key positions to disseminate information to women concerning
      their choice in feeding their newborns and how that choice affects their health
      in general, it is essential that the information they impart is based on
      evidence.

PMID- 11198456
TI  - Print and Internet copyrights: cite them!

PMID- 11198457
TI  - Legal issues surrounding the use of unlicensed assistive personnel.

PMID- 11198458
TI  - Journey to family-centered care.

PMID- 11198459
TI  - Journey to family-centered care.

PMID- 11198460
TI  - Journey to family-centered care.

PMID- 11198461
TI  - Journey to family-centered care.

PMID- 11198462
TI  - . . . and then there were two.

PMID- 11198463
TI  - Should there be laws mandating seatbelts in all school buses? Writing for the pro
      position.

PMID- 11198464
TI  - Should there be laws mandating seatbelts in all school buses? Writing for the con
      position.

PMID- 11198465
TI  - [Primary effusion lymphoma and other lymphoproliferative diseases associated with
      HHV-8].

PMID- 11198466
TI  - Pancreatobiliary adenosquamous carcinoma (report of two cases).
AB  - Adenosquamous carcinomas are rare malignant tumors of the pancreas and
      periampullary region. We present two cases of pancreatic and periampullary
      adenosquamous carcinoma with clinicopathologic, histo- and immunohistochemical
      findings. A 51-year-old and a 48-year-old man presented with right upper quadrant
      pain of three months duration and jaundice for two weeks. Both cases had an
      elevation of liver enzymes and CA 19-9. In the first case, computerized
      tomography showed a 3 cm-mass at the pancreatic head. In the second one,
      endoscopic retrograde choledocopancreatography (ERCP) revealed a mass at the
      ampulla Vateri localization. A pancreatoduodenectomy was performed for both
      cases. Gross pathologic examination displayed a solid, gray-white colored 4 cm
      tumor at the pancreatic head and a solid, pink-white colored, 2 cm-tumor at the
      periampullary region bulging into the duodenal lumen. Microscopically, both
      tumors were composed of solid nests of squamous cells with pearl formation and
      mucin-containing glandular cells and diagnoses were adenosquamous carcinoma.
      Furthermore, histo- and immunohistochemical findings were consistent with
      microscopic diagnoses.

PMID- 11198467
TI  - [Histopathologic examination of the intervertebral lumbar disk. Evaluation of its
      usefulness and limitations].
AB  - A retrospective clinical-pathological review of 192 lumbar intervertebral discs
      removed via an interlaminar approach or percutaneous nucleotomy from patients
      suffering from sciatic pain was carried out in order to assess if routine
      examination is useful. Only for a case of our series, which showed ill defined
      features at preoperative neuroradiologic imaging, an intraoperative pathologic
      examination was necessary. Immunohistochemical study was never required. A
      routine examination with a hematoxilin-eosin stain was sufficient also to
      recognize postoperative scar in patients reoperated. In conclusion we think that
      routine examination of the intervertebral disc is a procedure which is not
      expensive and useful to assess the nature of the lesion in reoperated patients
      and in rare cases showing unclear radiologic pattern.

PMID- 11198468
TI  - [Heterotopic mesenteric ossification. Description of a case].
AB  - We describe a case of heterotopic mesenteric ossification presented in a 25 year
      old male who underwent laparotomy for a fire-gun injury. Two weeks later he
      experienced small bowel obstruction and for this reason he has been operated five
      times with removal of segments of small bowel. Now, nine months later, he needs
      ileostomy to avoid another obstruction.

PMID- 11198469
TI  - [Guidelines for reporting cutaneous melanocytic lesions].

PMID- 11198470
TI  - [Guidelines for reporting cutaneous melanocytic lesions].

PMID- 11198471
TI  - Tumour cell hybridization and metastasis revisited.
AB  - This article reviews a long-standing hypothesis that metastases might be
      initiated through the generation of hybrids between primary tumour cells and
      tumour-infiltrating leucocytes such as macrophages. In this concept the hybrids
      become metastatic through expression of the leucocyte motility phenotype. A
      history of the hybrid hypothesis is presented along with recent evidence on how
      macrophage x tumour cell hybridization could account for some of the most
      defining characteristics of metastatic cells: aneuploidy, enhanced motility,
      aberrant glycosylation and, particularly seen in melanoma, phenotypic diversity.

PMID- 11198472
TI  - Partial characterization of an abundant human skin melanosomal 66 kDa protein (MP
      66) and investigation to purify a similar protein from B16 murine melanoma
      tumours.
AB  - A single polypeptide protein of molecular weight 66kDa (MP 66), purified to
      homogeneity from melanosomes of normal human cadaver skin epidermal melanocytes,
      was further characterized. Based on the yield in the present investigation, the
      intracellular concentration of this protein was calculated to be 4.2 microM. It
      was shown to be a glycoprotein on gel electrophoresis. Based on its partial N
      terminal amino acid sequence, it was shown to be distinct from known melanosomal
      proteins such as gp 75, tyrosinase-related protein-2 (TRP-2) and Pmel 17.
      Investigation to purify a similar type of protein from B16 murine melanoma
      tumours by following the same purification procedure resulted in a partially
      purified protein with a molecular weight of 66 kDa. However, unlike MP 66, this
      protein did not show inhibition of the monophenolase activity of tyrosinase at pH
      6.8. Finally, the effects of 0.5 mM each of CaCl2, ZnSO4 and FeSO4 together, and
      of human skin epidermal melanosomal proteins, were studied on melanin
      polymerization at pH 4.7. The metal cations failed to initiate melanin
      polymerization, while melanosomal proteins did in a dose-dependent manner.

PMID- 11198473
TI  - Overexpression of nPKCdelta in BL6 murine melanoma cells enhances TGFbeta1
      release into the plasma of metastasized animals.
AB  - Transforming growth factor-beta (TGFbeta) contributes to the promotion of
      invasion, metastasis, angiogenesis and even immunosuppression. Since
      overexpression of the delta isoform of protein kinase C (nPKCdelta) in BL6 murine
      melanoma cells (BL6T cells) increases their metastatic capacity, we investigated
      the possible involvement of TGFbeta1 in this process. Immunohistochemical
      analysis demonstrated lower levels of TGFbeta1 in BL6T lung metastases compared
      with BL6 lung metastases. On the other hand, higher levels of this cytokine, in
      particular in its active form, occur in the plasma of BL6T metastasized animals,
      suggesting a nPKCdelta-dependent TGFbeta1 release. Therefore, nPKCdelta-dependent
      TGFbeta1 release and activation may be involved in the greater angiogenic and
      metastatic capacity of murine melanoma BL6T cells.

PMID- 11198474
TI  - Lack of vasopressin expression in malignant melanomas.

PMID- 11198475
TI  - Comparative study of the expression of DNA mismatch repair genes, the adenomatous
      polyposis coli gene and growth arrest DNA damage genes in melanoma recurrences
      and metastases.
AB  - The main goal of this study was to examine the expression of DNA mismatch repair
      genes (MLH1, MSH2, PMS1 and PMS2), the adenomatous polyposis coli (APC) gene and
      growth arrest DNA damage inducible (GADD) genes (GADD34, GADD45 and GADD153) in
      the different stages of melanoma recurrences and metastases, and to identify any
      mutual consistencies in their expression pattern. All the cases of primary
      melanoma examined showed a reduced expression of DNA repair genes. These results
      demonstrate that disturbances of DNA repair begin in the early stages of
      melanoma. No significant differences were found in the expression of these
      markers between cutaneous melanomas and their recurrences and metastases (P>
      0.05). Eighteen significant correlations between markers were found in the
      primary melanomas, and 10 significant correlations were observed in the first
      recurrences of melanoma. In contrast, 27 statistically significant relationships
      were demonstrated in metastatic lymph nodes. The different correlations found in
      primary and metastatic tumours confirmed the hypothetical difference in marker
      interaction in the diagnostic groups investigated. Our results suggest that DNA
      repair genes may play an important role in the recurrence and metastasis of
      melanomas.

PMID- 11198476
TI  - Role of RT-PCR tyrosinase detection in the monitoring of patients with advanced
      metastatic melanoma.
AB  - In recent studies a new method has been proposed to detect circulating melanoma
      cells in the peripheral blood of patients, based on the amplification of the mRNA
      for tyrosinase, an enzyme involved in melanin biosynthesis that is expressed only
      by melanocytic cells. The sensitivity and clinical relevance of this method are
      still controversial. In the present study, 596 blood samples from 186 melanoma
      patients at various clinical tumour stages, together with samples from 25 healthy
      volunteers, were analysed with the aim of investigating the value of tyrosinase
      detection in predicting melanoma recurrence. We suggest a possible role for this
      marker in the monitoring of melanoma patients after the excision of regional
      lymph node metastases, and provide evidence that tyrosinase is related to the
      status of disease in advanced metastatic patients. Moreover, chemotherapy
      administration appeared to influence tyrosinase determination and may explain the
      discrepancies in the reported percentages of positive samples.

PMID- 11198477
TI  - Computer-aided epiluminescence microscopy of pigmented skin lesions: the value of
      clinical data for the classification process.
AB  - Early melanoma is often difficult to differentiate from benign pigmented skin
      lesions (PSLs). Digital epiluminescence microscopy (DELM) and automated image
      analysis could represent possible aids for inexperienced clinicians. We designed
      an automated computerized image analysis system that has the potential for use as
      an additional tool for the differentiation of melanoma from dysplastic naevi and
      common naevi. The PC-based pilot system was attached to a common DELM system as
      the image source. Digital images of PSLs were automatically segmented and a panel
      of 107 morphological parameters were measured. Additionally, seven clinical
      parameters were evaluated and used as an additional source of information. Neural
      networks were then trained to distinguish melanoma from benign PSLs. One class of
      networks was trained solely based on the morphometric features, whereas the
      second class of networks was trained on the combination of morphometric and
      clinical features. The automatic segmentation algorithm was correct in 96% of
      cases. Using three-way receiver operating characteristic (ROC) analysis, for
      networks trained solely on morphometric features the volume under surface (VUS)
      was 0.617 (SD 0.036). The performance was significantly better for networks
      trained on the combination of both morphometric and clinical features (VUS =
      0.682, SD 0.035). In a dichotomous model, distinguishing benign lesion (common
      naevi + dysplastic naevi) from melanoma, the area under the curve (AUC) from two
      way ROC analysis was 0.942 (SD 0.018) for networks trained solely on morphometric
      features and 0.968 (SD 0.012) for those trained on the combination of clinical
      and morphometric data (P= NS). Automated feature extraction from PSLs and the
      training of neural networks as classifiers has thus shown satisfactory
      performance in a large scale experiment. The addition of clinical data
      significantly increases the diagnostic performance for distinguishing three
      classes of lesions (i.e. common naevi, dysplastic naevi and melanoma). Such
      integrated systems hold promise as a decision aid for the diagnosis of PSLs.

PMID- 11198478
TI  - Precision of automatic measurements of pigmented skin lesion parameters with a
      MelaFind(TM) multispectral digital dermoscope.
AB  - The purpose of this study was to assess the precision of automatic computerized
      measurement of parameters that may be useful in the differentiation of malignant
      melanoma from benign pigmented skin lesions, and also to determine the
      feasibility of quantitative monitoring of skin lesions over time. Ten independent
      sequences of images were acquired with a MelaFind multispectral digital
      dermoscope for each of 12 benign or malignant pigmented skin lesions. The
      sequences of images were processed automatically to provide 10 independent
      measurements of the various parameters for each lesion. Parameters included
      lesion area, greatest 'diameter', perimeter, reflectance and asymmetry. The
      precision of each parameter determination was computed from the mean and standard
      deviation of the 10 measurements of that parameter. The relative errors in
      determining the lesion area, 'diameter' and perimeter were found to be 6%, 3% and
      4%, respectively. Other lesion parameters that are used in differentiating
      melanomas from benign skin lesions were also analysed as a function of
      wavelength. In the blue band (about 430 nm) the relative error was about 7% for
      the mean lesion reflectance and about 7% for the asymmetry parameter. These
      results demonstrate the feasibility of using MelaFind for objective quantitative
      monitoring of changes in pigmented skin lesions over time. As suggested by some
      studies, such information is useful in the early detection of malignant melanoma.
      The results show that parameters obtained automatically from MelaFind images are
      sufficiently precise to allow pertinent parameters to be used to classify
      pigmented skin lesions.

PMID- 11198479
TI  - Plantar malignant melanoma -- a challenge for early recognition.
AB  - The incidence of malignant melanoma has been continuously increasing over the
      last few decades. Non-plantar melanomas are nowadays usually diagnosed and
      treated surgically at an early stage. In contrast, melanoma in a plantar location
      is usually diagnosed at an advanced tumour stage, conferring a poor prognosis. To
      discover the reasons for this remarkable difference in recognition and prognosis,
      we analysed our cases of plantar malignant melanoma in a retrospective study.
      From 1990 to 1997, we treated 925 melanoma patients. Of these, 68 cases (7%) were
      classified as plantar melanoma. For non-plantar melanoma patients the mean age
      was 52.6 years, the mean Clark level was 2.8 and the mean tumour depth was 1.22
      mm. In contrast, the mean age of patients with plantar melanoma was 63.3 years,
      the mean Clark level was 3.61 and the mean tumour depth was 2.55 mm. The mean
      time between the first observation of the plantar skin lesion and the first
      consultation with a physician (patients' delay) was 4.8 years and, on average, it
      took an additional 7 months before adequate surgical treatment was performed
      (physicians' delay). The prognosis of our patients was poor. In 98.5% (n = 67)
      further metastases were observed on follow-up. Since there is still no cure for
      advanced plantar malignant melanoma, the early detection and subsequent surgical
      treatment of plantar melanoma is decisive for the prognosis. Based on our
      results, the poor survival can be improved by a significant reduction in the time
      period between the first observation of a plantar skin lesion and surgical
      treatment. Therefore there is an urgent need for special preventive health care
      campaigns to reduce significantly both the patients' and the physicians' delay.

PMID- 11198480
TI  - In vivo electroporation of plasmids encoding GM-CSF or interleukin-2 into
      existing B16 melanomas combined with electrochemotherapy induces long-term
      antitumour immunity.
AB  - When cancer cells, including melanoma cells, are genetically altered to secrete
      cytokines, irradiated and injected into subjects, long-term antitumour immunity
      is induced. Optimally, existing melanomas induced to produce cytokines in vivo
      could stimulate this same immune response. Although in vivo electroporation
      enhances plasmid expression, electroporation of plasmids encoding granulocyte
      monocyte colony stimulating factor (GM-CSF) and interleukin-2 (IL2) into B16
      mouse melanomas did not significantly alter tumour growth at the concentration
      tested. Electrochemotherapy, which causes short-term, complete regressions of
      treated tumour but no resistance to challenge, was combined with plasmid
      delivery. The combination treatment resulted in the induction of long-term
      immunity to recurrence and resistance to challenge in up to 25% of mice.

PMID- 11198481
TI  - Efficient palliation of haemorrhaging malignant melanoma skin metastases by
      electrochemotherapy.
AB  - Electric pulses can cause transient permeabilization of cell membranes
      (electroporation) and this can be utilized to increase the uptake of chemotherapy
      (electrochemotherapy). Preclinical studies have shown that in vivo
      electroporation causes transient shut down of blood flow both in normal and, in
      particular, malignant tissues. We report the successful palliation of a malignant
      melanoma patient with bleeding skin metastases using electrochemotherapy. In an
      on-going study of combined electrochemotherapy and low dose interleukin-2, one
      patient with bleeding skin metastases was included. Nine skin metastases, of
      which seven were ulcerated, were treated. After intratumoral bleomycin injection,
      needle electrodes with two arrays 4 mm apart were inserted into the tumours.
      Eight square wave electric pulses each 99 micros in duration and with an applied
      voltage to electrode distance ratio of 1.2 kV/cm were administered. In all the
      treated lesions, bleeding immediately stopped on administration of the electric
      pulses and did not recur. The treated metastases developed crusts and the lesions
      healed in a matter of weeks. Treatments were given under local anaesthesia,
      lasted a few minutes, and patient discomfort was brief and modest. In conclusion,
      we propose that electrochemotherapy should be considered for the palliation of
      haemorrhaging metastases as it is an efficient, tolerable, brief, outpatient,
      once-only treatment.

PMID- 11198482
TI  - Baroreflex dysfunction induced by microgravity: potential relevance to postflight
      orthostatic intolerance.
AB  - Microgravity imposes adaptive changes in the human body. This review focuses on
      the changes in baroreflex function produced by actual spaceflight, or by
      experimental models that simulate microgravity, e.g., bed rest. We will analyze
      separately studies involving baroreflexes arising from carotid sinus and aortic
      arch afferents ("high-pressure baroreceptors"), and cardiopulmonary afferents
      ("low-pressure receptors"). Studies from unrelated laboratories using different
      techniques have concluded that actual or simulated exposure to microgravity
      reduces baroreflex function arising from carotid sinus afferents ("carotic
      cardiac baroreflex"). The techniques used to study the carotid-cardiac
      baroreflex, using neck suction and compression to simulate changes in blood
      pressure, have been extensively validated. In contrast, it is more difficult to
      selectively study aortic arch or cardiopulmonary baroreceptors. Nonetheless,
      studies that have examined these baroreceptors suggest that microgravity produces
      the opposite effect, ie, an increase in the gain of aortic arch and
      cardiopulmonary baroreflexes. Furthermore, most studies have focus on
      instantaneous changes in heart rate, which almost exclusively examines the vagal
      limb of the baroreflex. In comparison, there is limited information about the
      effect of microgravity on sympathetic function. A substantial proportion of
      subjects exposed to microgravity develop transient orthostatic intolerance. It
      has been proposed that alterations in baroreflex function play a role in the
      orthostatic intolerance induced by microgravity. The evidence in favor and
      against this hypothesis is reviewed.

PMID- 11198483
TI  - Vascular responses to orthostatic stress in patients with postural tachycardia
      syndrome (POTS), in patients with low orthostatic tolerance, and in asymptomatic
      controls.
AB  - Patients with postural tachycardia syndrome (POTS) are characterized by
      development of symptoms of orthostatic intolerance during standing that are not
      because of hypotension but are associated with tachycardia. The goal of this
      study was to compare the cardiac and vascular responses to orthostatic stress for
      patients with POTS (n = 8) with those for patients with low orthostatic tolerance
      (n = 29) and for healthy control subjects (n = 12). Responses of heart rate
      (ECG), arterial blood pressure, and brachial artery blood velocity (Doppler) were
      determined during a progressive orthostatic stress test of head-up tilt and lower
      body suction. Changes in forearm vascular resistance (mean arterial
      pressure/brachial velocity) were less for patients with POTS than for healthy
      persons, and also less than for most of the patients with low orthostatic
      tolerance. However, patients with POTS did not have a low tolerance to
      orthostatic stress (measured as time to discontinuation of the test). For the
      patients with POTS, the test was discontinued often because of symptoms
      associated with tachycardia but not hypotension, whereas for the other two
      groups, the test was discontinued because of hypotension. This study shows that
      for patients with POTS, abnormal sympathetic responses exist, with an increased
      sympathetic drive to the heart but deficient peripheral vascular responses, as
      measured in the forearm. This supports the hypothesis that patients with POTS may
      have a selective peripheral neuropathy, with small responses in some regions
      being compensated by overactivity in other regions.

PMID- 11198484
TI  - Noninvasive detection of sympathetic neurocirculatory failure.
AB  - In sympathetic neurocirculatory failure (SNF), reflexive sympathetically mediated
      cardiovascular stimulation does not compensate for decreased cardiac filling.
      This explains orthostatic hypotension in chronic primary autonomic failure
      (CPAF). During phase 2 of the Valsalva maneuver (phase 2_L), blood pressure
      increases from its peak. During phase 4, blood pressure normally "overshoots" the
      baseline. Because these changes depend on sympathetically mediated cardiovascular
      stimulation, a progressive decrease in pressure during phase 2 and absence of the
      overshoot in phase 4 may indicate SNF. Moreover, because beat-to-beat blood
      pressure can be measured noninvasively using a photoplethysmographic or
      tonometric device, evaluating reflexive pressure responses might enable
      noninvasive diagnosis of SNF. This study assessed the relative frequencies of
      abnormal phase 2_L and phase 4 blood pressure in patients with CPAF and
      orthostatic hypotension and whether noninvasive measurement of beat-to-beat blood
      pressure can be used to diagnose SNF in patients. Twenty patients with chronic
      primary autonomic failure and orthostatic hypotension and 50 comparison patients,
      including several with CPAF but lacking orthostatic hypotension, underwent
      arterial pressure monitoring during performance of the Valsalva maneuver. Of the
      20 patients with CPAF and orthostatic hypotension, all had an abnormal phase 2_L
      or phase 4 pressure response (sensitivity 100%), whereas only 3 of the 50
      comparison patients had an abnormal response in either phase (specificity 94%).
      Seventeen patients with CPAF and orthostatic hypotension had abnormal responses
      in both phases (sensitivity 85%), but none of the comparison patients had such
      findings in both phases (specificity 100%). Of 13 patients in whom beat-to-beat
      blood pressure was recorded simultaneously invasively and noninvasively, all had
      abnormal blood pressure responses during phase 2_L and phase 4, whereas none of
      29 comparison patients had such symptoms. Detection of abnormal blood pressure
      responses during phase 2_L or phase 4 of the Valsalva maneuver is a highly
      sensitive test for SNF. Abnormal pressure during these phases appears to identify
      SNF specifically. Noninvasive measurements can detect both of these
      abnormalities.

PMID- 11198485
TI  - Clinical improvement in patients with orthostatic intolerance after treatment
      with bisoprolol and fludrocortisone.
AB  - Orthostatic intolerance is the development of disabling symptoms upon assuming an
      upright posture that are relieved partially by resuming the supine position.
      Postural tachycardia syndrome (POTS) is an orthostatic intolerance syndrome
      characterized by palpitations because of excessive orthostatic sinus tachycardia,
      lightheadedness, tremor, and near-syncope. Patients usually undergo extensive
      medical, cardiac, endocrine, neurologic, and psychiatric evaluation, which
      usually fails to identify a specific abnormality. The authors investigated the
      autonomic and hemodynamic profile of patients with POTS and the effectiveness of
      bisoprolol and fludrocortisone. The authors evaluated 11 female patients with
      POTS before and after medical treatment with a cardioselective bisoprolol beta
      blocker or fludrocortisone, or both, and 11 age-matched control patients.
      Variability of heart rate and systolic blood pressure was assessed by fast
      Fourier transform, and spontaneous baroreceptor gain was assessed by use of the
      temporal sequences slope and alpha index. Modelflow was used to quantify
      hemodynamics. Symptoms in all patients improved greatly after medication. The
      autonomic and hemodynamic impairment observed in patients with POTS, particularly
      after orthostatic stress, is treated effectively with bisoprolol or
      fludrocortisone or both. These results need further confirmation in a controlled
      double-blind study. Proper medical treatment improves dramatically the clinical
      and autonomic-hemodynamic disturbances observed in patients with POTS. The data
      support the hypothesis that POTS is the result of a hyperadrenergic activation or
      hypovolemia during orthostasis.

PMID- 11198487
TI  - Lack of autonomic nervous dysfunction in progressive supranuclear palsy, a study
      of blood pressure variability.
AB  - Blood pressure and heart rate variability were analyzed in eight patients with
      progressive supranuclear palsy in comparison with two control groups (10 healthy
      patients and 10 patients with multiple system atrophy). Blood pressure and heart
      rate were recorded using digital photoplethysmography with the patient in supine
      position and during a head-up-tilt test (70 degrees for 10 minutes). Spectral
      analysis was performed using fast Fourier transformation for 512 consecutive
      systolic blood pressure and heart rate values. The head-up-tilt test induced a
      significant increase in systolic blood pressure in patients with progressive
      supranuclear palsy and in healthy patients and a significant systolic blood
      pressure decrease in patients with multiple system atrophy. During the head-up
      tilt test, low-frequency energy of systolic blood pressure (70-130 mHz) that
      reflected baroreflex-dependent sympathetic tone also increased in patients with
      progressive supranuclear palsy and in healthy patients. By contrast, in patients
      with multiple system atrophy, the low-frequency energy of systolic blood pressure
      decreased significantly. The changes observed in the low-frequency band and the
      high-frequency band of heart rate (reflecting parasympathetic drive to the heart)
      were not different among the three groups. These data show the lack of impairment
      in autonomic nervous system activity in patients with progressive supranuclear
      palsy.

PMID- 11198486
TI  - Sympathoadrenal activation and the dumping syndrome after gastric surgery.
AB  - Dumping symptoms suggest concomitant sympathoadrenal activation. To evaluate the
      relation between dumping symptoms and postprandial plasma catecholamine changes,
      standardized dumping-provocation tests with use of oral glucose were performed
      for 16 gastric surgery patients with dumping, for 14 gastric surgery patients
      without dumping, and for 14 healthy control patients. Early dumping symptoms were
      present for all patients with dumping, and late symptoms developed in three
      patients with dumping after glucose ingestion. Patients without dumping and
      healthy control patients had slight complaints or no complaints. Systolic and
      diastolic blood pressure remained unaffected for the three groups. Positive
      breath-hydrogen tests, heart rate increments, and reactive plasma glucose
      decrements were present for patients with dumping and for patients without
      dumping, but not for control patients. Plasma noradrenaline and adrenaline
      increased for patients with dumping and for patients without dumping, but not for
      control patients. The noradrenaline increment was higher for patients with
      dumping (98%) than for patients without dumping (78%; p <0.05). The noradrenaline
      increment was related to the dumping score and to the heart rate increment for
      the first hour after glucose ingestion, whereas the adrenaline increment was
      related to the plasma glucose decrement for the third hour. Therefore, dumping
      symptoms clearly are accompanied by postprandial sympathoadrenal activation, but
      sympathoadrenal activation cannot account completely for development of dumping
      symptoms.

PMID- 11198488
TI  - Autonomic studies in hypertensive patient with unusual sexual dysfunction:
      response to reserpine.
AB  - The authors examined a 48-year-old man with a history of hypertension (6 years)
      and a history of erection and ejaculation during cold exposure and confrontation
      with fear (20 years). Exposing the foot to cold water induced ejaculation in 10
      seconds. A variety of antihypertensive medications resulted in control of
      hypertension, without improvement in ejaculatory dysfunction. Similarly, prazosin
      controlled the blood pressure, but not the episodes of ejaculation. Treatment
      with reserpine resulted in gradual reduction in blood pressure and an improvement
      in ejaculatory dysfunction.

PMID- 11198489
TI  - Oral mucosal blood flow following dry ice stimulation in humans.
AB  - The aim of the current pilot study was to establish a procedure that would allow
      the investigation of microcirculatory changes in the oral cavity. The authors
      studied the effects of painful stimulation using dry ice (CO2). To investigate
      potential regional differences in the change of blood flow, recordings were made
      for the tongue and at the mucosa of the hard palate, lip, and oral vestibule. The
      authors investigated 26 patients divided into groups of younger subjects (10 men,
      3 women; age range 21-31 y) and older patients (2 men, 11 women; age range 54-74
      y). Mucosal blood flow (mBF) was obtained at the hard palate, at the tip of the
      tongue, on the midline of the oral vestibule, and at the lip. Measurements were
      made during rest and for 2 minutes after application of dry ice for a 10-second
      duration, using a pencil-shaped apparatus. Blood pressure, heart rate, cutaneous
      blood flow, transcutaneous partial pressure of carbon dioxiode (PCO2) and partial
      pressure of oxygen (PO2) were recorded. Mucosal blood flow increased at all sites
      in response to application of dry ice (p <0.001), with peak flow at 0.5 minute to
      1.5 minutes after onset of stimulation. During the 1.5 minutes to 2 minutes,
      blood flow decreased at all measurement sites with a tendency to return to
      baseline. Heart rate, blood pressure, pCO2, PO2, and cutaneous blood flow did not
      show significant changes. Overall, responses in older patients showed more
      variance when compared with younger patients. Stimulation by dry ice appears to
      be an effective, noninvasive, and tolerable means to investigate mucosal blood
      flow at different mucosal sites. Preliminary data indicate different levels of
      responsiveness to painful cold stimulation at different sites on the oral and
      perioral mucosa; particularly, mucosal blood flow response at the tongue was
      least pronounced. Therefore, assessment of stimulated mucosal blood flow appears
      to be a promising tool to investigate the pathophysiology of a number of
      neurologic symptoms, eg, the burning mouth syndrome.

PMID- 11198490
TI  - Outcome measures in pediatric neurology: why do we need them?
AB  - Outcome measures should include the patient's values and preferences (from the
      patient's perspective) in addition to performance ratings and physiologic states.
      Outcome measures can assess relationships between services and interventions and
      their end results, can clarify which therapies are worth providing and which
      therapies need more evidence about their effectiveness, and can measure the
      burdens of different disorders and interventions. Researchers recently have shown
      the feasibility of creating and using outcome measures for children with
      neurodevelopmental disorders. Clinicians may wish to familiarize themselves with
      the concepts of outcome measures and health-related quality of life in order to
      understand the rationale, utility, properties, and various types of outcome
      measures in order to select the most appropriate instruments that will best serve
      their patient populations. Ongoing research efforts are currently using such
      measures in children with central nervous system tumors, with neural tube
      defects, and of extremely low birthweight; in childhood and adolescent epilepsy;
      and in adolescents with headaches.

PMID- 11198491
TI  - Six-year follow-up of children with intrauterine growth retardation: long-term,
      prospective study.
AB  - This prospective study was designed to characterize the neurodevelopmental and
      cognitive difficulties specific to children with intrauterine growth retardation
      and to detect early clinical predictors of these difficulties. Eighty-one
      children with intrauterine growth retardation were monitored up to 6 to 7 years
      of age using biometric parameters, perinatal risk questionnaires, and detailed
      neurodevelopmental and cognitive assessments. Forty-one children served as age
      matched, appropriate for gestational age controls. A significant difference in
      growth parameters (P < .001), neurodevelopmental score (P < .05), and IQ (P <
      .05) was found between the children with intrauterine growth retardation and
      controls. A specific profile of difficulties in coordination, lateralization,
      spatial and graphomotor skills, and abundance of associated movements is typical
      of the children with intrauterine growth retardation and hints at possible later
      learning disabilities. The clinical parameters best predicting neurodevelopmental
      outcome were the neonatal risk score (P < .05) and the weight and height at 6
      years of age (P < .05). The children with intrauterine growth retardation with
      neonatal complications had lower neurodevelopmental scores than the controls but
      no difference in IQ. Intrauterine growth retardation children diagnosed
      prenatally had the same neurodevelopmental and IQ scores as those diagnosed at
      birth, probably due to the careful perinatal and obstetric care provided.
      Children with intrauterine growth retardation demonstrate a specific profile of
      neurodevelopmental disabilities at preschool age. Early diagnosis and
      intervention could probably reduce these difficulties to a minimum.

PMID- 11198492
TI  - The ketogenic diet: seizure control correlates better with serum beta
      hydroxybutyrate than with urine ketones.
AB  - The objective of this study was to determine the relationship between beta
      hydroxybutyrate levels and seizure control in children on the ketogenic diet.
      Seventy-four children on the ketogenic diet presenting for routine follow-up
      visits had blood levels of beta-hydroxybutyrate correlated with their seizure
      control. Forty-two children admitted for initiation of the ketogenic diet had
      urine ketones measured by dipstick and correlated with simultaneous blood levels
      of beta-hydroxybutyrate. Blood beta-hydroxybutyrate levels statistically
      correlated with seizure control (P = .003). Children with blood beta
      hydroxybutyrate levels greater than 4 mmol/L were significantly more likely to
      have a decrease in seizure frequency than those with levels less than 4 mmol/L.
      Urine ketones of 4+ (160 mmol/L) were found on dipstick when blood beta
      hydroxybutyrate levels exceeded 2 mmol/L. Seizure control correlates with blood
      beta-hydroxybutyrate levels and is more likely when blood beta-hydroxybutyrate
      levels are greater than 4 mmo/L. The traditional measurement of urine ketones by
      dipsticks in children on the ketogenic diet provides a less than optimal
      assessment of the degree of blood ketosis. Three to four plus (80-160 mmol/L)
      urine ketones are necessary, but not necessarily sufficient, to achieve optimal
      seizure control in children on the ketogenic diet. At present, however, urine
      ketones are the only readily available inexpensive approach to ketone assessment.

PMID- 11198493
TI  - Persistent preceding focal neurologic deficits in children with chronic Epstein
      Barr virus encephalitis.
AB  - Epstein-Barr virus encephalitis is a self-limiting disease with few sequelae.
      Persistence of neurologic deficits prior to and after the acute illness has yet
      to be described in children. We describe five children with persistent cognitive
      and focal neurologic deficits due to chronic Epstein-Barr virus encephalitis with
      various T2-weighted magnetic resonance imaging abnormalities. Clinical features
      were a 9-year-old boy with aphasia and apraxia, an 11-year-old girl with
      impulsivity and inappropriate behavior, a 17-year-old boy with deterioration of
      cognitive skills and judgment, a 5-year-old boy with complex-partial seizures,
      and a 6-year-old girl with obsessive-compulsive behavior. All patients had
      elevated serum Epstein-Barr virus titers for acute infection, with cerebrospinal
      fluid polymerase chain reaction positive for Epstein-Barr virus in four patients.
      Three children were treated with methylprednisolone with minimal improvement
      without changes on magnetic resonance imaging. Epstein-Barr virus encephalitis
      can present with chronic and insidious neurologic symptoms and should be
      considered in the differential diagnosis of children with acute or chronic
      neurologic illness of unknown etiology.

PMID- 11198494
TI  - Insulin-like growth factor-I in cerebrospinal fluid and serum in Rett syndrome.
AB  - Rett syndrome is a neurodevelopmental disease characterized by failure of somatic
      and brain growth. The insulin-like growth factor system mediates most actions of
      growth hormone. Evidence that it plays an important role in early development of
      the brain is increasing. The aim of the study reported was to assess the role of
      the insulin-like growth factor system in the pathogenesis of Rett syndrome. We
      measured insulin-like growth factor-I levels in serum (8 patients, mean age 9.1
      years) and cerebrospinal fluid (13 patients, mean age 7 years) using a sensitive
      radioimmunoassay method and compared them with those in age-matched controls (13
      and 26 patients, respectively). Neither serum nor cerebrospinal fluid insulin
      like growth factor-I levels differed from those in controls. We also measured
      insulin-like growth factor binding protein-3 levels in serum (in 9 patients and 8
      controls) and in cerebrospinal fluid (in 12 patients and 11 controls) and serum
      growth hormone levels (in 8 patients and 11 controls); the levels in patients did
      not differ from those in controls. We found no significant correlation between
      serum and cerebrospinal fluid insulin-like growth factor-I in Rett syndrome. This
      may indicate an independent role of insulin-like growth factor system in the
      central nervous system, making serum insulin-like growth factor-I measurement
      unreliable as an indicator of disturbed function in the central nervous system.
      Our results did not support the notion that a defective insulin-like growth
      factor-I system explains the lack of somatic and brain growth in Rett syndrome.

PMID- 11198495
TI  - Neurologic symptoms in children with systemic lupus erythematosus.
AB  - Neurologic complications of systemic lupus cerebritis are not as well known in
      children as in adults. Twenty-five children with neurologic complications were
      identified after reviewing the hospital medical records of 86 children with
      systemic lupus erythematosus. Seven children (28%) had neurologic symptoms at the
      time of initial diagnosis of systemic lupus erythematosus; median time between
      diagnosis of systemic lupus erythematosus and onset of neurologic complications
      was 1 month (range 0-5 years). Seizures were the most common neurologic symptoms
      overall, but headaches were the most frequent neurologic manifestation in
      children without a previous diagnosis of systemic lupus erythematosus. Sixteen
      children had seizures, and 12 children had seizures as the initial central
      nervous system involvement. Almost all children who developed seizures had an
      established diagnosis of systemic lupus erythematosus; only one child had
      seizures that led to the diagnosis of systemic lupus erythematosus. No patient
      had status epilepticus, and, in general, seizures were not difficult to control.
      In six children, headache was the initial symptom of central nervous system
      involvement. Five children had lupus cerebritis, three children had stroke, and
      two had isolated cranial neuropathies. Chorea was seen in only two cases, and
      three children had pseudotumor cerebri. Treatment with high-dose intravenous
      methylprednisolone led to a good response in 18 children; cyclophosphamide was
      required in 6 patients and plasmapheresis in 1 child. Outcome was generally good,
      although one child developed fulminant cerebritis with intracranial hypertension
      and died.

PMID- 11198496
TI  - Asymmetric crying facies and associated congenital anomalies: prospective study
      and review of the literature.
AB  - Congenital asymmetric crying facies, a minor congenital anomaly due to absence or
      hypoplasia of the depressor anguli oris muscle on one side of the mouth, is
      associated at times with major congenital anomalies, most commonly in the
      cardiovascular system. In a prospective study of 5532 infants born at the Assaf
      Harofeh Medical Center, Israel, during 12 months (January to December 1998), 17
      infants (an incidence of 0.31%) had asymmetric crying facies. One of the affected
      infants had ventricular septal defect and another infant had VATER (vertebral
      defects, imperforate anus, tracheoesophageal fistula, and radial and renal
      dysplasia) syndrome. No noxious obstetric perinatal factors could be identified.
      Family history was unremarkable in all cases. Diagnostic work-up performed in all
      of the affected infants failed to reveal an additional congenital malformation.
      Asymmetric crying facies is a minor isolated finding in most of the cases;
      however, a thorough search for other congenital malformations, especially of the
      cardiovascular system, should be performed.

PMID- 11198497
TI  - Febrile convulsions after 5 years of age: long-term follow-up.
AB  - In order to examine the natural history of febrile convulsions occurring after 5
      years of age, we studied 44 children in whom febrile convulsions persisted after
      5 years of age (group 1) and compared their development of unprovoked seizures
      with a group of 195 children in whom febrile convulsions occurred before 5 years
      of age (group 2). All subjects of group 1 were re-evaluated at the mean age of
      13.4+/-1.7 years. The children in group 2 were followed up until they reached the
      same mean age as children in group 1 (13.1+/-2.3 years). In group 1, we found a
      higher percentage of unprovoked seizures than in children with febrile
      convulsions with onset before 5 years of age (18.1% vs 7.4%, P < .05). Our data
      suggest that children with febrile convulsions after 5 years of age probably must
      be considered as a group of patients at risk of developing unprovoked seizures.

PMID- 11198498
TI  - Reflections.

PMID- 11198499
TI  - Hypotension following the initiation of tizanidine in a patient treated with an
      angiotensin converting enzyme inhibitor for chronic hypertension.
AB  - Centrally acting alpha-2 adrenergic agonists are one of several pharmacologic
      agents used in the treatment of spasticity related to disorders of the central
      nervous system. In addition to their effects on spasticity, certain adverse
      cardiorespiratory effects have been reported. Adults chronically treated with
      angiotensin converting enzyme inhibitors may have a limited ability to respond to
      hypotension when the sympathetic response is simultaneously blocked. The authors
      present a 10-year-old boy chronically treated with lisinopril, an angiotensin
      converting enzyme inhibitor, to control hypertension who developed hypotension
      following the addition of tizanidine, an alpha-2 agonist, for the treatment of
      spasticity. The possible interaction of tizanidine and other antihypertensive
      agents should be kept in mind when prescribing therapy to treat either
      hypertension or spasticity in such patients.

PMID- 11198500
TI  - Evidence for altered basal ganglia and cortical functions in transient idiopathic
      dystonia.
AB  - Idiopathic dystonia with onset in the first year of life has been described as a
      transient movement disorder, in contrast to other forms of idiopathic dystonia We
      report on a girl who showed, from her 5th month, episodes of dystonic postures of
      her neck and arm, which lasted for seconds and occurred several times a day.
      Neurologic findings and the psychomotor development were and remained normal.
      Neurometabolic screening tests and cerebral magnetic resonance imaging showed
      normal results. Functional cerebral imaging showed decreased perfusion of the
      basal ganglia and the left temperomesial cortex using single photon emission
      computed tomography (SPECT with technetium 99m hexamethylpropyleneamine oxime
      [99mTc-HMPAO]) and decreased glucose metabolism in the basal ganglia and the
      cerebellum using positron emission tomography (PET with [18F]fluorodeoxyglucose
      [18FDG]). Follow-up revealed that the episodes disappeared at the age of 16
      months. The findings of PET and SPECT give evidence of an alteration in basal
      ganglia function but also in functions of other central nervous system regions,
      which may, however, be temporary.

PMID- 11198501
TI  - Mitochondrial DNA depletion in children.
AB  - The first girl of an unrelated couple was noted to have failure to thrive since
      age 3 months, generalized hypotonia and weakness, hepatomegaly, hypoglycemia, and
      lactic acidosis at 4 months. She was found to have severe mitochondrial DNA
      (mtDNA) depletion and respiratory chain complex IV deficiency in both skeletal
      muscle and liver but without other common mtDNA mutations. Her younger brother
      developed vomiting at age 3 weeks and was diagnosed as having pyloric stenosis.
      His skeletal muscle and liver also showed severe mtDNA depletion. He developed
      generalized weakness and hypotonia, hepatomegaly, and lactic acidosis at age 3
      months. Both siblings died of hepatic failure and hemorrhagic complication before
      6 months of age. The brother also had chemical pancreatitis, which had not been
      reported before in mtDNA depletion in children. Severe mtDNA depletion may
      present with nonspecific symptoms such as vomiting, failure to thrive, and
      developmental delay; multiorgan involvement such as hepatomegaly, pancreatitis,
      and myopathy occurs later. Mitochondrial DNA depletion should be considered in
      the differential diagnosis in children with developmental delay or failure to
      thrive of unknown etiology.

PMID- 11198502
TI  - Cerebellar involvement in Langerhans' cell histiocytosis: a progressive
      neuropsychiatric disease.
AB  - We describe a 21-year-old patient who was being followed since the age of 3(1/2)
      years for Langerhans' cell histiocytosis. Although previously a bright and gifted
      student, the patient presented at age 16(1/2) with new-onset cerebellar
      neurologic signs, obsessive-compulsive disorder, and dementia. Findings on
      magnetic resonance imaging study of the brain were normal, but brain single
      photon emission computed tomography with technetium 99m ethylene cysteinate dimer
      showed markedly decreased cerebellar perfusion. This case is unique for the wide
      extent of the central nervous system involvement in Langerhans' cell
      histiocytosis, which has not been reported previously. Although obsessive
      compulsive disorder has also been associated with several other cerebellar
      disorders, it is still unknown whether the cerebellum plays a role in its
      development. We suggest that in some cases, brain single photon emission computed
      tomography may be superior to magnetic resonance imaging for demonstrating
      cerebellar disorder in Langerhans' cell histiocytosis.

PMID- 11198503
TI  - Severe migraine associated with coarctation of aorta: complete recovery following
      balloon dilation.
AB  - We report on a rare association of severe migraine headaches associated with
      coarctation of aorta that completely resolved following dilation of the
      constricted aorta. A 6-year-old girl presented with severe pounding headaches
      accompanied with recurrent vomiting, associated with photophobia and phonophobia.
      She experienced frequent awakenings with severe headaches and vomiting. The
      described excruciating, prolonged, and practically persistent headaches were not
      relieved by analgesics and ergotamines. Neurologic assessment and brain computed
      tomography were both normal. A systolic murmur at the third right intercostal
      space prompted a cardiac echocardiogram, which demonstrated coarctation of the
      ascending aorta beyond the orifice of the left common carotid artery.
      Catheterization revealed a systolic gradient of 54 mm Hg, and the constricted
      lumen of the aorta was then dilated by a balloon. The excruciating vascular
      headaches and associated symptoms had abated instantaneously following this
      procedure. To the best of our knowledge, this is the first report associating
      severe migraine headaches in a child with coarctation of the aorta. Given
      complete recovery following balloon dilation of the aorta, cardiac echocardiogram
      should be added to the diagnostic battery of children with severe unresponsive
      migraine.

PMID- 11198504
TI  - Intravenous valproate dosing in neonates.
AB  - The loading dosage of intravenous valproate required to achieve a desired serum
      concentration in neonates is not known. Two neonates with seizures received
      loading doses of intravenous valproate over 30 minutes. Serum valproate
      concentrations were measured 45 minutes and 3 hours after initiation of the
      infusion. Both neonates had received phenobarbital and phenytoin before the
      loading infusions. In the first patient, a loading dose of intravenous valproate
      of 10 mg/kg increased the 45-minute postinfusion serum valproate concentration to
      41 microg/mL with a 3-hour postinfusion serum valproate concentration of 33
      microg/mL. In the second patient, a loading dose of 25 mg/kg increased the 45
      minute postinfusion serum valproic acid concentration to 100 microg/mL with a 3
      hour postinfusion serum valproic acid concentration of 78 microg/mL. We found
      that each 1 mg/kg of intravenous valproate increased the 45-minute and 3-hour
      postinfusion serum valproic acid concentrations by approximately 4 microg/mL and
      3 microg/mL, respectively. We suggest that these figures be used to calculate the
      desirable loading dose of intravenous valproate in neonates until larger studies
      are conducted. The volume of distribution and the serum clearance of valproate
      were approximately 0.245 L/kg and 25 mL/h/kg, respectively.

PMID- 11198505
TI  - Fatal infantile X-linked neuropathy.
AB  - We report a pedigree with severe X-linked neuropathy that occurs in male infants
      and results in death, typically by 2 years of age. The proband of our report was
      weak with preserved mentation. He underwent extensive evaluation, which revealed
      abnormal nerve conduction studies, neurogenic changes on muscle biopsy, a
      decreased number of large myelinated fibers and rare onion bulb formations on
      nerve biopsy, negative gene testing for spinal muscular atrophy, CMT1a, and CMTX1
      and a normal brain magnetic resonance image. The proband's mother, an obligate
      carrier, had normal nerve conduction studies. Male infants with a spinal muscular
      atrophy phenotype but normal genetic studies should be evaluated for this fatal X
      linked neuropathy.

PMID- 11198506
TI  - Mitochondrial DNA point mutation T9176C in Leigh syndrome.
AB  - Leigh syndrome is a progressive neurodegenerative disease frequently associated
      with mitochondrial abnormalities. The mitochondrial DNA T9176C mutation in the
      adenosine triphosphatase 6 gene has recently been described as a cause of Leigh
      syndrome. Leukocyte DNA from 59 children with Leigh syndrome was screened for the
      T9176C mutation by conventional polymerase chain reaction methods. Two unrelated
      patients were found to be homoplasmic for this mutation in blood. Both patients
      had similar clinical and biochemical features. They had first presented acutely
      at 3 and 5 years, respectively, with ataxia and slurred speech. Magnetic
      resonance imaging changes were consistent with Leigh syndrome, and the
      cerebrospinal fluid lactate was elevated. They have both had relatively stable
      disease since the time of diagnosis. The mother of one of the children had
      presented at age 29 years with sudden onset of ataxia, headache, and blurred
      vision. She was heteroplasmic for the T9176C mutation. The T1976C is an important
      cause of Leigh syndrome especially in the subgroup of patients with more stable
      disease and normal respiratory chain enzyme analysis.

PMID- 11198507
TI  - Nasal midazolam effects on childhood acute seizures.
AB  - Sixteen children, aged from 2 months to 14 years, with a diagnosis of acute
      seizures and seen at Dr. Sami Ulus Child Health and Disease Center, were included
      in this study. Midazolam (5 mg/mL) 0.2 mg/kg was administered intranasally in 30
      seconds by an injector. The heart rate, respiratory rate, blood pressure, and
      oxygen saturation were recorded at 0, 5, and 10 minutes after administration. The
      seizures of three (18.7%) patients terminated within 1 minute, of seven (43.7%)
      patients in 1 to 2 minutes, and of three (18.7%) patients in 2 to 5 minutes.
      However, three (18.7%) patients did not respond to treatment. As a result, it was
      concluded that intranasal midazolam administration is easy and effective. The
      half-life of midazolam is shorter than diazepam, and midazolam has fewer
      complications when compared with diazepam. It is easier to use in nasal drop and
      spray forms.

PMID- 11198508
TI  - Gelastic seizures of neocortical origin confirmed by resective surgery.
AB  - Ictal laughter is a relatively unusual phenomenon that appears to arise from
      within hypothalamic hamartomas. Gelastic seizures of neocortical origin are rare
      and when reported typically originate from temporofrontal regions in proximity to
      the hypothalamus, raising the possibility of a subtle lesion in the hypothalamus.
      A girl with gelastic seizures originating in a dysembryoblastic neuroepithelial
      tumor at the cranial vertex had resolution of her seizures following surgical
      resection. Electrical propagation of seizures via the cingulate gyrus appears to
      be an alternative mechanism underlying gelastic seizures.

PMID- 11198509
TI  - Thalidomide therapy in childhood tuberculous menigitis.

PMID- 11198510
TI  - Is there a treatment for testosterone?

PMID- 11198511
TI  - Injury to Maori. I: Fatalities.
AB  - AIMS: Our aim was to determine the significance in Maori of injury in relation to
      other health problems, to describe the leading causes of injury, and to determine
      age specific rates for major classes of injury. METHODS: We used New Zealand
      Health Information Services mortality data files. The New Zealand Census
      classification of 'Sole-Maori' was used to determine injury mortality rates.
      RESULTS: For more than three contiguous decades of life (1-34 yrs) injuries were
      the leading cause of death. For all age groups combined, unintentional injury
      accounted for 75% of injury deaths, suicide 17%, and assault 7%. The leading
      mechanism of death was motor vehicle traffic crashes (49%). Occupants of motor
      vehicles accounted for the majority of the victims. The occupant fatality rate
      remained relatively constant for all age groups from 15-24 years. The second most
      common mechanism of death was suffocation (13%), 76% of which were self
      inflicted, all of these being hangings. CONCLUSIONS: There is a need for
      government agencies with a mandate for injury prevention to develop specific
      injury prevention goals for Maori.

PMID- 11198512
TI  - Injury to Maori. II: Serious injury.
AB  - AIMS: To determine the significance of serious injury in Maori relative to other
      health problems, to describe the leading causes, and to determine age specific
      rates for major classes of injury. METHOD: We used New Zealand Health Information
      Services' public hospital inpatient data files. The New Zealand Census
      classification of 'Sole-Maori' was used to determine injury mortality rates.
      RESULTS: On average, one in every eight admissions in Maori, was for injury.
      Injury was the leading reason for admission for those 5-44 years old.
      Unintentional injury accounted for 85% of injuries, with those ages 1-14 and 15
      24 years having the highest numbers and rates. Falls, followed closely by motor
      vehicle traffic crashes, were the leading causes, accounting for 23% and 20%
      respectively. CONCLUSIONS: In order to address the priorities identified here,
      appropriate partnerships between crown agencies and social agencies, both Iwi
      and/or community based, must be established.

PMID- 11198513
TI  - Integrating primary and secondary care: the case of Christchurch South Health
      Centre.
AB  - AIMS: To study health services utilisation linkages and methodological issues in
      integrating primary and secondary care services for a defined general practice
      population (Christchurch South Health Centre, CSHC). METHODS: The Centre supplied
      national health index (NHI) linked data on date of birth, gender and community
      services card (CSC) status for 10,174 patients, and data on primary care.
      Secondary care providers supplied NHI linked data on specialist outpatients,
      emergency department usage for 1996 to 1998, and waiting lists. The Health
      Funding Authority (HFA) supplied NHI linked data on inpatient/daypatients for
      1996 and 1997. Data were also obtained relating to community support services and
      long-term care. Rates of hospital utilisation for the Centre's population were
      standardised for comparison with national and Christchurch figures using age,
      gender and CSCs. Overall per capita expenditure was calculated for this
      population. RESULTS: Patients with CSCs constituted 31.2% of the practice
      population, but generated 60.8% of bed-days. Patients with high use health cards
      (HUHCs) constituted 8.6% of the population, but generated 42.4% of bed-days. This
      group was at high risk of hospitalisation over a wide range of disease
      categories. Standardised rates of hospital utilisation were significantly lower
      for the Centre's older patients, especially for bed-days, than both national and
      Christchurch figures. Only a small proportion of referrals to specialist
      outpatients, 28.2% in 1998, was from the Centre's general practitioners (GPs),
      the remainder being generated internally within the specialist services. The
      overall expenditure per capita on the Centre's population was $1012, which was
      substantially less than expected in comparison with national figures. CONCLUSION:
      The study demonstrates the importance of primary care factors in the utilisation
      of secondary care, especially acute hospitalisation in older patients. This needs
      further study as it could provide important insights into ways of reducing acute
      admissions. If there is to be more effective management of the primary/secondary
      care interface, more research and development effort is needed into the
      characteristics of patients at high risk of referral and admission, and how
      inappropriate secondary care can be averted.

PMID- 11198514
TI  - Variations in self-reported health status: results from a New Zealand survey.
AB  - AIMS: To report measures of the self-reported health of a sample of the New
      Zealand adult population elicited using the EuroQol Group's EQ-5D questionnaire,
      and to investigate variations in these measures, according to respondents' socio
      demographic characteristics. METHODS: Personal health status questions were
      included in a self-completed postal questionnaire mailed to a non-stratified
      sample of 3000 New Zealanders, selected at random from the electoral roll. 1350
      questionnaires were completed and returned. Each respondent rated their health on
      the five EQ-5D dimensions- mobility, self care, usual activities, pain/discomfort
      and anxiety/depression- and assigned a global score to their profile. RESULTS:
      Pain/discomfort was the most commonly experienced health problem, with 41% of all
      respondents and 63% of over-70 year olds reporting moderate or extreme problems.
      Just 4.5% of respondents reported problems with self-care. Respondents were more
      likely to report problems on each of the five dimensions and to have a lower
      global score if they smoked, if they were unemployed, a houseworker or retiree,
      and if their education did not continue past the minimum school leaving-age, or
      they did not have a degree or equivalent qualification. Problems on all
      dimensions were more common the older the respondent, and the global score was
      lower for over-70 year olds than for younger people. Neither the global score nor
      the incidence of problems on any of the dimensions was related to sex or
      ethnicity. CONCLUSIONS: The EQ-5D is a potentially useful instrument for
      monitoring health in the New Zealand context. Further research to explore its
      validity and reliability, particularly for Maori, would be valuable.

PMID- 11198515
TI  - Bilateral femoral artery thrombosis in nephrotic syndrome.

PMID- 11198516
TI  - Waikato mental health service reorganisation: a model to reduce bed needs?

PMID- 11198517
TI  - Radiation protection for health care workers.

PMID- 11198518
TI  - Doctor global is unethical and dangerous.

PMID- 11198519
TI  - Green Prescriptions doing well.

PMID- 11198520
TI  - Stable angina and coronary angioplasty.

PMID- 11198521
TI  - Quantitative volumetry in patients with carotid disease--effects of
      acetazolamide.
AB  - The intracranial effects of acetazolamide on flow velocities can be monitored
      noninvasively by transcranial Doppler (TCD) sonography. Extracranial volume flow
      changes can now reliably be measured with color duplex M-mode systems. The
      authors tested the volumetric effects of acetazolamide in patients with high
      grade unilateral carotid disease to quantify the amount of flow changes. Patients
      in group 1 had a high-grade > 70% internal carotid artery (ICA) stenosis, without
      collateral flow through the ophthalmic artery (OA). Patients with occluded ICA
      were included in group 2 (patent OA collateralization) or group 3 (no OA
      collateralization) (n = 6 per group). In group 1, common carotid artery (CCA)
      volume flow in the stenotic (normal contralateral) side increased from 271 (388)
      ml/min by 52 (54%) with 1 g aceta-zolamide intravenously. Simultaneously, middle
      cerebral artery (MCA) flow velocities increased from 54 (56) cm/s by 47 (53%). In
      group 2, extracranial volume flow increased from 166 (444) ml/min by 19 (52)%.
      MCA flow velocities increased from 43 (65) cm/s by 13 (30)%. In group 3, volume
      flow increased from 159 (467) ml/min by 2 (46)%. Intracranial flow velocities
      rose from 49 (54) cm/s by 27 (41)%. Volume flow data showed the expected decline
      in patients with high-grade ICA stenosis and even more pronounced in patients
      with occlusion of the vessel. Cerebral reserve capacity was less sufficient in
      patients with a patent OA, despite an additional supply of 30 ml/min, indicating
      a hemodynamically critical situation.

PMID- 11198522
TI  - Ultrasonic assessment of physiological echo-contrast agent distribution in brain
      parenchyma with transient response second harmonic imaging.
AB  - OBJECTIVES: The present study was designed to provide normal data of transient
      response second harmonic imaging (TRSHI) examinations of cerebral echo contrast
      enhancement using different modes of electrocardiogram (ECG) gating and echo
      contrast agent doses. MATERIALS AND METHODS: Fifty-five patients were examined in
      an axial diencephalic plane of section using the transtemporal acoustic bone
      window. TRSHI examinations (ECG gating: systolic, frame-rate once every 2 cardiac
      cycles = "basical instrument setting") could be performed in 50 individuals with
      adequate insonation conditions after application of 4 g of a galactose-based
      microbubbles suspension in a concentration of 400 mg/ml. For comparison,
      diastolic ECG gating (20 patients), cardiac-cycle triggering frequency of once
      every 2 seconds (15 patients), or an echo contrast agent dose of 2 g Levovist (15
      patients) were used. Analysis of peak intensities (PIs) and areas under the curve
      (AUCs) was done in posterior (region of interest [ROI]a) and anterior (ROIb)
      parts of the thalamus, in the lentiform nucleus (ROIc), and the white matter
      (ROId). RESULTS: In 41 patients with basical instrument setting, characteristic
      time intensity curve (TIC) could be detected in all ROIs. In ROIa (90%) and ROIb
      (82%), focal contrast enhancement was most difficult to visualize, and in ROIc
      and ROId, characteristic TICs were observable in more than 90% of the
      examinations. Background subtracted PIs and AUCs were significantly higher in
      ROIc (mean PI: 12.2 +/- 8 acoustic units [AUs]; mean AUC: 598.8 +/- 451.1 AU x
      Cardiac cycles), and ROId (11.8 +/- 6.9; 559.2 +/- 404) as compared to ROIa (8.3
      +/- 5.2; 368.9 +/- 242.7) and ROIb (7.1 +/- 4.7; 298.2 +/- 199.1) (P < .0001).
      Values for corresponding examinations with a diastolic ECG gating and a cardiac
      cycle triggering frequency of once every 2 seconds were not different as compared
      to the basical instrument setting. A 4 g Levovist dose increased the portion of
      typical TIC in all ROIs. PI of 4 g examinations were significantly higher in ROId
      and ROIb as compared to the 2 g examination. CONCLUSION: Our findings indicate
      that TRSHI allows noninvasive assessment of focal cerebral contrast enhancement
      in the majority of patients with adequate insonation conditions. This study
      provides data about normal quantitative and qualitative TRSHI values in patients
      without cerebrovascular diseases. A dose of 4 g Levovist is recommended in those
      individuals with inaccurate echo contrast enhancement using the 2 g dose.

PMID- 11198523
TI  - The use of clinical scales in depicting cerebrovascular complications in
      bacterial meningitis.
AB  - To evaluate the utility of different scales for clinical assessment, over time,
      in acute bacterial meningitis, the authors investigated 53 consecutive patients
      (mean age 53 +/- 17 years). Clinical status on days 1, 3, 5, 8, and 14 after
      admission was determined by the Scandinavian Stroke Scale (SSS), Glasgow Coma
      Scale (GCS), and Hunt and Hess Scale (HH), and, on day 21, by the Glasgow Outcome
      Scale (GOS). Transcranial Doppler examinations were performed serially to assess
      for disease-related arterial narrowing. This was observed in 27 patients (51%)
      within 2 weeks of admission. All scales were observed to correlate with the 21
      day GOS. Patients with cerebral arterial narrowing had significantly decreased
      SSS scores between days 1 and 8 and worse GCS and HH scores between days 3 and 5.
      Mean blood flow velocity in the middle cerebral artery on days 5 and 8
      significantly correlated with GOS (r = 0.268, P < .008; r = -0.324, P < .003,
      respectively). The use of such clinical scales allows standardized assessment of
      patients with bacterial meningitis and provides prognostic information. Cerebral
      arterial narrowing was observed to correlate with neurologic impairment.

PMID- 11198524
TI  - Modeling of receptor ligand data in PET and SPECT imaging: a review of major
      approaches.
AB  - Over the past decade, a number of new kinetic modeling techniques have been
      developed for PET and SPECT ligands. This article will review commonly used
      modeling solutions for reversible positron-emission tomography (PET) and single
      photon emission computed tomography (SPECT) radioligands, with an emphasis on
      noninvasive methods. All of the modeling approaches in PET and SPECT assume a
      compartmental system and derive parameters that describe the compartmental
      system. These parameters will be defined, and their relationship to analogous
      parameters in pharmacology will be discussed. Then the major approaches are
      presented under the categories of graphical or mathematical as well as invasive
      or noninvasive.

PMID- 11198525
TI  - Poor prognosis of acute stroke patients denied thrombolysis due to early CT
      findings.
AB  - OBJECTIVES: Whether acute stroke patients with major early infarct signs on
      computed tomography (CT) should be treated with intravenous (i.v.) thrombolysis
      remains controversial. The authors sought to define the outcomes in 5 consecutive
      patients who were not treated with i.v. thrombolysis, according to established
      guidelines. METHODS: The authors retrospectively analyzed the outcomes of a
      consecutive series of 5 patients evaluated by an acute stroke team at a
      university medical center and who were denied i.v. tissue plasminogen activator
      due to early CT changes. RESULTS: Five patients with a median National Institutes
      of Health Stroke Scale score of 22 (range 20-28) were evaluated. Despite
      aggressive care (e.g., hemicraniectomy), 2 patients died owing to herniation, 1
      patient died of cardiac causes, and neither of the 2 surviving patients achieved
      a 3-month Rankin score below 4 (moderately severe disability). CONCLUSIONS: Given
      the poor prognosis of patients with hemispheric stroke and early CT changes,
      alternative treatment modalities such as intra-arterial thrombolysis, early
      hemicraniectomy, and neuroprotective therapy should be vigorously pursued.

PMID- 11198526
TI  - Localization of clinical syndromes using DWI: two examples of the "capsular"
      warning syndrome.
AB  - The capsular warning syndrome (CWS) is a subtype of transient ischemic attack
      characterized by its recurrent nature, absence of cortical signs, and high
      probability of early capsular stroke. Currently, standard imaging techniques have
      identified only internal capsule lesions in this entity. The authors present 2
      cases with an otherwise typical CWS in whom a brainstem stroke was detected by
      diffusion-weighted imaging (DWI). DWI's ability to differentiate between acute
      and chronic infarcts may assist in more accurate localization of clinical
      syndromes.

PMID- 11198527
TI  - Ganglioneurocytoma mimicking a malignant tumor: case report with a literature
      review of the MRI appearance of neurocytomas and gangliogliomas.
AB  - A 14-year-old girl presented with symptoms of increased intracranial pressure
      after her head was squeezed at a party. MRI demonstrated a mass that was
      hypointense to brain on T1WI and heterogeneous in signal on PD and T2WI;
      compression of the ventricle, midline shift, and mild ventriculomegaly also were
      present. Contrast enhancement was extensive and heterogeneous, mimicking a
      malignant tumor. Neuropathology revealed a ganglioneurocytoma.

PMID- 11198528
TI  - Vertebral artery dissection in Turner's syndrome: diagnosis by magnetic resonance
      imaging.
AB  - Aortic artery dissection is a rare but well-recognized complication of Turner's
      syndrome. Isolated carotid or vertebral artery dissection has not previously been
      reported. The authors report the clinical and magnetic resonance imaging findings
      in a 30-year-old woman with Turner's syndrome who developed a high cervical
      spinal cord infarction with a Brown-Sequard syndrome owing to bilateral vertebral
      artery dissection. The diagnosis and management of the case is reviewed.

PMID- 11198529
TI  - Limbic encephalitis investigated by 18FDG-PET and 3D MRI.
AB  - Two patients with clinically probable or possible limbic encephalitis (LE) are
      reported, both cases with typical findings in clinical symptoms (severe
      neuropsychological deficits and complex partial seizures) and in routine magnetic
      resonance imaging (MRI) (hyperintense mesiotemporal lesions). Underlying
      malignancy was identified (rectal carcinoma) in one case but could not be
      detected in the other patient. The 2 patients were investigated by cerebral 18F
      fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) and 3-dimensional
      (3D) MRI, and abnormalities in metabolic activity were mapped using
      coregistration of spatially normalized PET and MRI. Highly significant focal
      hypermetabolism in bilateral hippocampal areas was found in both cases. The
      authors' findings support FDG-PET coregistered to 3D MRI as a potentially
      valuable additional tool in the imaging diagnostics of LE. Results are discussed
      with respect to the clinical symptoms and previously reported imaging findings in
      the disease.

PMID- 11198530
TI  - Cerebral and oculorhinal manifestations of a limited form of Wegener's
      granulomatosis with c-ANCA-associated vasculitis.
AB  - The authors report on cerebral and oculorhinal manifestations in a patient with a
      cytoplasmic pattern of antineutrophil cytoplasmic autoantibody (c-ANCA)
      associated vasculitis. Recurrent Tolosa-Hunt syndrome, cavernous sinus syndrome,
      Raeder's paratrigeminal neuralgia, and seizures were the major clinical
      manifestations. Brain MRI showed localized enhancing lesions initially in the
      cavernous sinus and later in the convexity pachymeninges. The lesions disappeared
      following 9 months of oral prednisolone (15 mg/day) and cyclophosphamide (100
      mg/day) therapy. The presence of c-ANCA, demonstration of vasculitis, and
      depositions of immunoglobulin G (IgG) and fibrinogen in the vessel walls of
      pachymeninges of the patient confirmed an immune-mediated cause of the
      vasculitis. Cranial pathology without renal and pulmonary involvement suggests a
      variant of Wegener's granulomatosis, which is called the "limited" form of
      Wegener's granulomatosis. MRI, Raeder's paratrigeminal neuralgia, localized
      pachymeningitis.

PMID- 11198531
TI  - Temporal changes in brain volume and cognition in a randomized treatment trial of
      vascular dementia.
AB  - OBJECTIVE: To measure changes in brain and ischemic volume over time by magnetic
      resonance imaging (MRI) as part of a randomized treatment trial of vascular
      dementia. METHODS: Participants who met criteria for vascular dementia underwent
      comprehensive neurological and neuropsychological testing on entrance, during,
      and at completion of the 1-year study. For those centers who had easily available
      MRI, MRI of the brain was to be performed on entry and completion of the study.
      Image analysis was performed on all balanced and T2-weighted MR films to
      determine ventricular, sulcal, ischemic, and hemispheric brain volumes. RESULTS:
      Of the 105 patients who met the criteria for vascular dementia, 40 had a baseline
      MRI study that met protocol requirements and was of excellent image quality. The
      baseline ventricular volume in these 40 patients with high-quality MR correlated
      with most measures of cognitive and behavioral function, including the total
      Alzheimer's Disease Assessment Score (ADAS) (r = 0.51, P = .0024), as well as
      activities of daily living (r = 0.61, P = .0002). The baseline ischemic brain
      volume correlated well only with the gait and postural stability scale (r = 0.74,
      P = .009). Of the 40 participants, 25 had MRI studies at baseline and at
      completion of the study that were comparable and of excellent image quality. For
      these 25 patients, the mean ventricular volumes increased by 9% over the study
      year (P = .001) and the mean ischemic brain volume increased by 18% (P = .01).
      Temporal changes in the sulcal and nonischemic brain volume did not reach
      significance. None of the 14 clinical score measures changed significantly
      between baseline and completion of the study in these 25 patients. CONCLUSION: In
      summary, ventricular volume correlated well with cognitive measures in patients
      with vascular dementia and was a more sensitive marker for change during the
      study year than the clinical scales used in this study. This study also points
      out the practical limitations of brain imaging as a surrogate measure of clinical
      outcome in multicenter randomized treatment trials of brain disease.

PMID- 11198532
TI  - Anticoagulation and microembolus detection in a case of internal carotid artery
      dissection.
AB  - BACKGROUND: Microembolic signals (MES) have been demonstrated by transcranial
      Doppler (TCD) in cases of internal carotid artery dissection. The influence of
      treatment on MES in arterial dissection is uncertain. The authors here present a
      case of internal carotid artery dissection in which we detected a reduction of
      MES after the initiation of intravenous heparin. METHODS: A 37-year-old woman
      developed a right temporal headache 10 days prior to admission. This was followed
      by episodes of left arm numbness and weakness. Magnetic resonance imaging (MRI)
      showed a right frontal and deep subcortical ischemic infarct. Catheter
      angiography confirmed a right internal carotid artery dissection with
      intracranial extension. She was then monitored with TCD for MES before and after
      intravenous heparin was started. RESULTS: The first TCD, performed 12 days after
      symptom onset, showed 39 MES during 60 minutes of insonation of the right middle
      cerebral artery. Treatment with intravenous heparin resulted in a decline in MES
      by 50% after 96 hours. This decline continued and no further MES were detected
      after 11 days of anticoagulation. CONCLUSION: The authors were able to
      demonstrate a decline of MES with heparin anticoagulation in a case of internal
      carotid artery dissection.

PMID- 11198533
TI  - Solitary intramedullary neurosarcoidosis: role of MRI in early detection.
AB  - BACKGROUND: Intramedullary neurosarcoidosis may be the first manifestation of the
      disease and may mimic a tumor clinically and radiographically. Two patients who
      presented with cervical intramedullary lesions on magnetic resonance imaging
      (MRI) scans were found to have neurosarcoidosis. CLINICAL PRESENTATION: Two
      patients with negative past medical history presented with progressive
      myelopathic features, and intramedullary cervical lesions were detected on MRI
      scan; the diagnosis was made on biopsy of the lesions. Early therapeutic
      intervention led to a favorable outcome. CONCLUSION: Intra-medullary
      neurosarcoidosis, especially in the cervical cord, can be the initial
      presentation of the disease, mimicking a tumor. MRI scan, biopsy, and, in fewer
      cases, angiotensin-converting enzyme levels can help with the diagnosis and may
      lead to a favorable outcome.

PMID- 11198534
TI  - Endovascular treatment of a ruptured dual aperture cavernous aneurysm.
AB  - The authors describe the diagnosis and endovascular management of a
      multiaperture, ruptured cavernous internal carotid artery aneurysm causing a
      carotid cavernous fistula (CCF) using both transarterial and transvenous
      techniques. Although uncommon, recognition of the imaging characteristics of such
      a lesion will aide in successful management and improve treatment outcome. To the
      authors' knowledge, CCF due to a ruptured cavernous aneurysm with multiple shunts
      has not been previously reported.

PMID- 11198535
TI  - Extensive subdural mass.
AB  - An unusual case of a 62-year-old man with focal seizures, tinnitus, and
      progressive left hemiparesis due to an extensive subdural plasma cell granuloma
      is presented. Five-year clinical and radiologic follow-up demonstrating the
      chronic yet progressive nature of this granuloma is presented. This is the first
      report of focal calcification seen in an intracranial plasma cell granuloma. The
      imaging, neuropathologic, and clinical characteristics of this rare lesion are
      reviewed.

PMID- 11198536
TI  - Continuity of patient care and safety standards.

PMID- 11198537
TI  - Environmental tobacco smoke: views from the Dunedin hospitality industry on
      prohibition of smoking in licensed premises.
AB  - AIMS: To describe Dunedin hospitality industry perceptions of difficulties in
      enforcement of a prohibition on smoking in licensed premises, and possible
      effects on staff, customers and business. To identify any need for education to
      assist transition and reduce compliance difficulties with smoke-free legislation.
      METHODS: A reply paid questionnaire was mailed to all 311 licensed premises
      registered with the Dunedin District Licensing Agency, operational in May 1999.
      RESULTS: overall response rate (67%) differed significantly by type of premises
      (bar, club, restaurant and off-licence). Overall, a smoking ban was considered
      likely to be difficult to enforce (82%), upset customers (74%), reduce business
      (59%) and negatively effect employees (51%). On each issue, there was a
      consistent pattern of increasing concern from off-licenses (least concern)
      through restaurants, to clubs and bars (most concern). CONCLUSIONS: Considerable
      concern exists in the hospitality industry about the effects of extending smoke
      free status to licensed premises. To assist transition and future compliance,
      there is a need to address these concerns and provide reliable information to
      calm unnecessary fears and develop appreciation of the need for change.

PMID- 11198538
TI  - Promotion of smoking cessation by New Zealand general practitioners: a
      description of current practice.
AB  - AIMS: To describe the advice and support New Zealand general practitioners (GPs)
      reported providing to patients about smoking cessation, to explore barriers
      encountered in providing this advice, and to compare reported practice with
      recommended best practice. METHODS: 450 GPs were surveyed from four different
      localities using a structured postal questionnaire. RESULTS: Questionnaires were
      returned by 283 GPs, giving a response rate of 63%. Approximately one-third of
      GPs asked every adult patient about their smoking status. Fewer recorded this
      information in the patient's notes. GPs, based on their own experience,
      considered nicotine replacement therapy (NRT) and their own advice to quit to be
      the two most useful smoking cessation strategies. They perceived patient
      resistance and time pressures as the main barriers limiting their ability to give
      advice to patients about smoking cessation. CONCLUSIONS: GPs provide smoking
      cessation advice to many patients, but this needs to be viewed in the context of
      the New Zealand fee-for-service primary care system and competing demands placed
      on the limited time available within a consultation. There is potential to
      increase the practice nurse's involvement in providing smoking cessation advice.

PMID- 11198539
TI  - Tuberculosis: reasons for diagnostic delay in Auckland.
AB  - AIMS: First, to quantify the interval between the onset of symptoms and the start
      of anti-tuberculous treatment in a series of Auckland tuberculosis patients.
      Second, to examine the help-seeking behaviour of the patients and the responses
      of the health-care providers whom they consulted about their symptoms. Third, to
      identify potentially modifiable reasons for delayed presentation or diagnosis.
      METHODS: 100 patients with tuberculosis (TB) were interviewed using a
      questionnaire which sought symptom duration and help-seeking behaviour. The
      doctors whom they consulted were surveyed about their diagnostic, therapeutic and
      referral responses. RESULTS: Delayed presentation by patients ('patient delay')
      was found in smokers, patients who reported cough, patients who hoped their
      symptoms would go away on their own, and patients reporting fear of what would be
      found on diagnosis. 'Doctor delay' (the interval from first consultation with a
      doctor to start of treatment) was longer than that found in most published series
      and was a more important component of total delay than delayed presentation by
      patients. Longer doctor delay was found if patients had pre-existing lung disease
      or consulted multiple doctors, and if doctors did not inquire into past exposure
      to TB or request a chest X-ray. CONCLUSIONS: Awareness programmes for high-risk
      communities are needed to encourage early reporting of symptoms. Continuing
      medical education for general practitioners is needed to encourage vigilance for
      TB and earlier use of diagnostic tests in patients who have symptoms of TB and
      are in high-risk groups.

PMID- 11198540
TI  - Increased mesothelioma incidence in New Zealand: the asbestos-cancer epidemic has
      started.
AB  - AIMS: To examine the incidence and mortality patterns for malignant mesothelioma
      and pleural cancer in New Zealand between 1962-1996, and relate these to past use
      of asbestos. METHODS: Data concerning cases of mesothelioma 1962-1996, deaths
      from pleural and lung cancers 1974-1996, and data on imports of raw asbestos and
      asbestos products were obtained from government registers and publications. Time
      trends were analysed using different models. RESULTS: Mesothelioma incidence
      rates have increased progressively in New Zealand since the 1960s, and reached 25
      per million for men in 1995. The increase follows an exponential model departing
      from a crude 'background rate' of 1-2 per million in 1984, and is particularly
      steep in males 50 to 60 years of age. The incidence is expected to double by
      2010. CONCLUSION: New Zealand has entered an unrivalled period of occupational
      cancer deaths resulting from past workplace exposure to airborne asbestos fibres.
      The steep rise in mesothelioma incidence is likely to be accompanied by increases
      in other asbestos related diseases such as lung cancer. The unique causal
      association between mesothelioma and asbestos may be used to monitor changes in
      the public health impact of these exposures. The notification by medical
      practitioners of all potential asbestos related conditions/exposures to the
      Occupational Safety and Health (OSH) service is of great importance.

PMID- 11198541
TI  - Occupational asthma cases notified to OSH from 1996 to 1999.
AB  - AIMS: To update notifications to the Occupational Safety and Health Service of
      the Department of Labour (OSH) Notifiable Occupational Disease System (NODS) from
      June 1996 to the beginning of 1999. METHODS: All notifications received for non
      asbestos related occupational respiratory disease were reviewed to confirm the
      clinical diagnosis, occupational causation, and to identify the causative agent
      where possible. RESULTS: 54 cases of asthma were notified, of which 21 (39%) were
      accepted as being occupationally caused. These cases arose from 'predictable'
      industries. CONCLUSIONS: NODS offers sentinel data from interested practitioners
      and workplaces. Occupational asthma and other occupational respiratory diseases
      remain poorly notified to this system. NODS confirms the presence of occupational
      asthma in New Zealand from predictable and preventable causes not dissimilar to
      other countries. This data collection system needs supplementation by other
      mechanisms.

PMID- 11198542
TI  - General practitioner management of upper respiratory tract infections: when are
      antibiotics prescribed?
AB  - AIM: To assess General Practice (GP) description and management of upper
      respiratory tract infections (URTI), including conditions under which they
      prescribe antibiotics. METHOD: A telephone survey of a randomised sample of
      Auckland GPs. RESULTS: There was a 61% response rate. 82 of the 100 GPs
      interviewed agreed that most patients presenting with URTI expected antibiotics.
      Persistent symptoms and indication of specific infection (tonsillitis, otitis
      media, sinusitis, pharyngitis, purulent sputum) were common reasons for
      prescribing. Patients travelling overseas, expecting or requesting antibiotics
      and prior use of over-the-counter (OTC) medications increased antibiotic
      prescribing-rates. Most GPs (95%) issued as-needed prescriptions on occasion; 13%
      did this often. Amoxicillin and amoxicillin/clavulanic acid were most commonly
      used. Despite wide-ranging antibiotic use for URTI (0 to 90%), only 6% of GPs
      felt they prescribed more antibiotics than others. CONCLUSIONS: The results
      suggest over-prescription is common-place, but use of as-needed prescriptions to
      reduce antibiotic use is encouraging. Exploration of patient expectations in the
      consultation may assist in decreasing prescribing rates.

PMID- 11198543
TI  - High pharyngeal carriage rates of Streptococcus pyogenes in Dunedin school
      children with a low incidence of rheumatic fever.
AB  - AIM: To document the incidence and type distribution of Streptococcus pyogenes in
      a group of Dunedin children throughout the 1997 school year. METHODS: The 780
      children recruited from ten primary schools had their throats swabbed on each
      reporting of pharyngitis. Additional pharyngeal swabbings were obtained monthly
      from a representative subset of these children, referred to as group 1. All swab
      samples were plated on CNA-P, a blood agar medium that facilitates detection of
      haemolytic streptococci. S. pyogenes isolates were classified according to the
      RFLP patterns of PCR products of their emm genes (ERP typing). Representative
      isolates of each ERP pattern were also emm-typed, a sequence typing method that
      correlates with serological M-typing. RESULTS: 28% of the group 1 children were
      found to carry S. pyogenes for more than two months. This carriage rate is
      similar to that previously detected in Dunedin and Waikato schoolchildren, but is
      higher than that generally reported in other countries. Although the predominant
      S. pyogenes types detected in Dunedin are similar to those in North Island
      populations, some of the types frequently associated with North Island cases of
      rheumatic fever and glomerulonephritis were absent or isolated infrequently from
      the Dunedin children. CONCLUSION: The high pharyngeal carriage rates of S.
      pyogenes in Dunedin schoolchildren, without the concomitant increased occurrence
      of post-streptococcal sequelae observed in North Island populations may, in part,
      be due to a relatively lower occurrence of the M-types most commonly implicated
      in these diseases.

PMID- 11198544
TI  - Home ventilation: the Green Lane Hospital experience.
AB  - AIMS: To describe the characteristics and outcomes of patients treated with
      domiciliary nocturnal support ventilation (NSV). METHODS: Case-note review of all
      patients treated with home NSV by Green Lane Hospital. RESULTS: 111 patients
      received home NSV between 1990 and 1999. 59 had respiratory failure due to
      obesity-hypoventilation syndrome (OHS), most of whom were Maori or Pacific Island
      people. Their mean BMI was 53 kg/m2. They frequently presented acutely, and often
      in extremis. After a median duration of 22 months treatment, 37 patients
      continued treatment. Four have died, but none from respiratory failure. Other
      causes of respiratory failure included: neuromuscular disease (26),
      kyphoscoliosis (19) and obstructive sleep apnoea (8). Patients who did not have
      OHS were mostly of New Zealand European ethnicity, required lower ventilation
      pressures than patients with OHS, and had better arterial blood gases on
      treatment. After a median follow-up of 35 months, however, fourteen have died. 33
      continued on treatment. Both OHS and non-OHS patients had high deprivation scores
      according to NZdep96. This was most apparent for patients with OHS. CONCLUSIONS:
      OHS is an important cause of respiratory failure in New Zealand, particularly
      affecting Maori and Pacific people. The prognosis of OHS treated with NSV appears
      to be good despite significant co-morbidity.

PMID- 11198546
TI  - On the temperature dependence of ultrasonic attenuation in human calcaneus.

PMID- 11198545
TI  - Influenza vaccination coverage in Canterbury rest homes.
AB  - AIMS: First, to investigate the effect on Canterbury rest home residents of
      national policy making influenza vaccination free for those aged 65 years and
      over. Second, to assess rest home staff influenza vaccination coverage. METHODS:
      A comparison of influenza vaccination coverage in Canterbury rest home residents
      during 1996 and 1997 was conducted. Subgroups of rest homes were formed in 1997
      to minimise the bias introduced through conducting a coverage survey in 1996.
      Staff vaccination coverage was also assessed in 1997. RESULTS: Influenza
      vaccination coverage of Canterbury rest home residents was 74% in 1996 and 76% in
      1997. Staff vaccination coverage was 21% in 1997. Significantly more staff were
      vaccinated in rest homes that offered free influenza vaccination to their staff.
      CONCLUSIONS: The free influenza vaccination policy had no measurable impact on
      Canterbury rest home residents' vaccination coverage. This may be due to a
      ceiling effect of previously high coverage. Coverage was low amongst rest home
      staff. Providing the vaccination free of charge might improve staff coverage.

PMID- 11198548
TI  - Presidential address. The Ministry of Health.

PMID- 11198547
TI  - Which should be the role of bone ultrasonography in the therapeutic follow-up of
      postmenopausal osteoporosis?

PMID- 11198549
TI  - Address to open the Biennial Conference of the New Zealand Dental Association,
      Dunedin, 4 October 2000.

PMID- 11198550
TI  - Clinical anxieties among dental students.
AB  - We analysed the perceived stresses associated with the transition from
      preclinical to clinical teaching among dental students at the Faculty of
      Dentistry, University of Otago. An anxiety questionnaire was completed by 120
      students in their Second and Third Years of study. Because of the institution of
      a new curriculum, these students were uniquely in the same class. The highest
      levels of anxiety associated with general clinical situations were felt for
      getting diagnoses wrong, hurting patients, dealing with medical emergencies, and
      getting infected. In general, there were no significant gender or academic year
      differences. When faced with specific situations, students were most stressed by
      the prospect of surgical procedures, temporomandibular joint problems, and failed
      local analgesia. Significant differences between the two years centred on giving
      an inferior alveolar nerve block and in dealing with poor oral hygiene, the
      Second-year students showing the greater anxiety.

PMID- 11198551
TI  - Leukaemia in children. Part II--Dental care of the leukaemic child, including
      management of oral side effects of cancer treatment.
AB  - The treatment of a leukaemic child requires a multidisciplinary approach. The
      dental team should provide interceptive and preventive measures prior to the
      commencement of therapy whenever possible. During therapy, preventive and
      palliative measures are essential. Once remission is achieved, the child
      continues to have increased dental needs due to the effects of treatment. These
      needs may include an increased caries rate, dental maldevelopment, and secondary
      malignancy.

PMID- 11198552
TI  - Oranga niho.

PMID- 11198553
TI  - [Cost effectiveness of bisoprolol in treatment of heart failure in Germany. An
      analysis based on the CIBIS-II study].
AB  - OBJECTIVES: Economic analysis of bisoprolol plus standard therapy versus placebo
      plus standard therapy in the treatment of chronic heart failure in Germany.
      MATERIALS AND METHODS: Prospective analysis of resource use and costs by way of
      integration into the international, randomized, double-blind CIBIS (Cardiac
      Insufficiency Bisoprolol Study)-II clinical trial, which treated 1,327 patients
      with bisoprolol and 1,320 with placebo. Two hundred and fifteen German patients
      were included in CIBIS-II (bisoprolol: 112, placebo: 103). The German health
      economic subpopulation comprised 97 patients (bisoprolol: 52, placebo: 45). The
      economic base analysis valued the resource use of every single patient of this
      subpopulation in monetary terms, from the perspective of Germany's third party
      payer (statutory sick funds). RESULTS: Mean observation time was 1.3 years.
      During this time hospitalization costs of DM 783.--were saved in the bisoprolol
      group. Total direct medical costs amounted to DM 7,651.--in the bisoprolol group
      and DM 8,905.--in the placebo group. This means savings of DM 1,254.--per
      patient, or a 14.1% cost reduction. If mean data of all German CIBIS-II patients
      are used as a broader basis, bisoprolol therapy saves DM 1,203.--per patient.
      Bisoprolol therapy induced a mortality rate reduction from 17% to 12% in the
      overall clinical CIBIS-II population (n = 2,647). This difference is
      statistically highly significant (p < 0.0001). Altogether 74 lives could be saved
      by bisoprolol therapy. Saved life years amounted to 0.03 per patient after 65
      weeks of therapy (460 days), and to 0.12 per patient after 130 weeks (30 months).
      As bisoprolol therapy leads to net savings, a formal cost-effectiveness analysis,
      which would relate incremental clinical efficiency to additional costs, is not
      needed. CONCLUSION: The use of bisoprolol in the therapy of chronic heart failure
      is not only clinically effective, it also saves net costs.

PMID- 11198554
TI  - [Risk factors and surgery rates in gallstones. Results of a population-based
      study].
AB  - STUDY OBJECTIVE: The prevalence of gallstone disease, time trends in the
      frequency of cholecystectomies and risk factors for the occurrence of
      cholelithiasis were examined in a cross-sectional population study. METHODS: The
      survey was based on a random sample from the populations of 4 regions in Germany,
      stratified by region, age and sex. Information on the frequency of gallstone
      disease and on potential risk factors were collected by standardized interviews.
      For the statistical analysis, multiple logistic regression was used. RESULTS:
      Overall, 1,085 persons were interviewed. The age-standardized prevalence of known
      gallstones was 4.2% for men and 14.5% for women. The frequency of cholecystectomy
      almost tripled in women from 1985 to 1994 as compared to 1975 to 1984 despite a
      decreasing trend in gallstone diagnoses in the same time period. No such trend
      was apparent in men. In men, age, body weight, changes in body weight, diabetes
      and use of corticosteroids were identified as risk factors for gallstone disease.
      In women, gallstone disease was also associated with body weight, changes in body
      weight and age, and, in addition, the number of births. An inverse association
      with gallstone disease was found for use of oral contraceptives and level of
      education in women.

PMID- 11198555
TI  - [Prevention of infection with Streptococcus pneumoniae].
AB  - Streptococcus pneumoniae is the most common etiologic agent in outpatients
      pneumonia. Pneumococcal infections are often associated with high mortality risk
      in immunocompromised patients. An increasing resistance of Streptococcus
      pneumoniae to antibiotics is observed worldwide. This led to the official
      recommendation by the STIKO to use the vaccination in special risk groups. The
      commercially available 23-valent polysaccharide vaccine produces a reliable
      immune response against pneumococcal infection in children aged over 2 years and
      adults. The recommendation should be more realized in practice.

PMID- 11198556
TI  - [Renin-angiotensin-aldosterone system and fibrinolysis].
AB  - Experimental, genetic and clinical evidence suggests that the renin-angiotensin
      aldosterone system (RAAS) may participate in the pathogenesis of thromboembolic
      cardiovascular disorders such as coronary heart disease. This interrelationship
      may involve mechanisms other than changes in arterial blood pressure. In addition
      to various possible interactions, accumulating evidence suggests that the RAAS is
      involved in the regulation of the fibrinolytic system. Several recent studies
      have shown that stimulation of the RAAS may be associated with an activation of
      plasminogen activator inhibitor 1 (PAI-1). Since profibrinolytic factors
      (especially tissue plasminogen activator [t-PA]) remain unchanged, increased
      activity of the RAAS may thus alter the fibrinolytic balance towards a decreased
      fibrinolytic activity. These findings may be of special importance for a variety
      of clinical problems such as the long-term effect of a low NaCl-intake on
      cardiovascular morbidity and mortality and the possible value of drugs indirectly
      or directly interfering with the RAAS such as diuretics, ACE-inhibitors and
      angiotensin II Type 1 (AT1) receptor antagonists.

PMID- 11198557
TI  - [Mitochondrial medicine for internists].
AB  - Human mitochondrial DNA (mtDNA) is a small, circular molecule, encoding for the
      translational machinery of the mitochondrion, as well as for 13 structural
      proteins that are all subunits of the respiratory chain. Point mutations,
      deletions, and copy-number variations are now functionally and genetically linked
      to human disease. Despite the fact that mtDNA is solely transmitted from the
      mother to the offspring, e.g. is maternally inherited, some mutations may occur
      spontaneously or may be acquired due to defects in nuclear DNA, e.g. are
      inherited in a mendelian fashion. The internist encounters predominantly
      myopathies, cardiomyopathies, lactic acidosis or diabetes mellitus but mtDNA
      changes are also present with neurologic, hematologic and renal symptoms.
      Acquired mtDNA alterations are responsible for important drug side effects, such
      as ifosfamide, carboplatin, doxorubicin or nucleoside-analog reverse
      transcriptase inhibitors. A specific mtDNA point-mutation predisposes to
      aminoglycoside-induced sensorineural deafness.

PMID- 11198558
TI  - [Cystic fibrosis--initial diagnosis in a 39-year-old patient].
AB  - BACKGROUND: Cystic fibrosis is the most common hereditary disorder among
      Caucasians. Most of the patients are diagnosed as children. However, some cases
      are going undiagnosed into adulthood and are then often misdiagnosed because the
      non-pediatricians do not know cystic fibrosis very well and do not consider this
      diagnosis in adult patients. CASE REPORT: We present the medical history of a
      woman, who was diagnosed with cystic fibrosis at the age of 39 years, although
      she had suffered from bronchiectasis, pancreatic insufficiency and liver
      cirrhosis since many years. Her medical history was long with some diagnosis, but
      because of her age nobody considered the final diagnosis. CONCLUSION: In adult
      patients with bronchiectasis, liver cirrhosis and pancreatic insufficiency in
      combination or with only one of these symptoms, cystic fibrosis should be
      included into the differential diagnosis.

PMID- 11198559
TI  - [Isolated ACTH deficiency as a rare cause of recurrent syncope and hypoglycemia].
AB  - HISTORY AND CLINICAL FINDINGS: A 63-year-old man was assigned into emergency room
      presenting with an acute syncope associated with hypoglycemia and hypotension.
      Clinical findings showed a pale, waxing-colored skin and a disorder of impulse.
      During the clinical stay the patient's behavior was slowed down and adynamic.
      INVESTIGATIONS: After exclusion of cardiovascular and neurologic disorders as
      reason for the repeated syncopes a detailed endocrine diagnostic screening was
      performed, which revealed a deficiency of cortisol with missing increase of
      cortisol in the ACTH stimulation test. The ACTH-GnRH-TRH test showed an isolated
      deficiency of corticotropic hormones. Stimulation with CRH revealed no increase
      of ACTH or cortisol. Insulin tolerance test revealed an isolated ACTH
      insufficiency with consecutive deficit of cortisol. A tumor of the adrenal gland
      was excluded by abdominal scan. Cerebral CT was inconspicuous. Cerebral NMR was
      suspicious of volume deficiency of the hypophysis. TREATMENT AND COURSE: Under
      therapy with hydrocortisone 20 mg and fludrocortisone 0.05 mg orally the clinical
      symptoms of the patient improved impressively. The patient became efficient and
      dynamic. Systolic blood pressure increased in mean over 120 mm Hg. There were no
      more hypoglycemic episodes. CONCLUSION: Secondary insufficiency of the adrenal
      gland should be considered as a rare cause of hypoglycemia if combined with
      hypotensive circulatory disturbance and missing pigmentation of the skin.

PMID- 11198560
TI  - [Remission of nocturnal pathological respiratory patterns after orthotopic heart
      transplantation. A case report and overview of current status of therapy].
AB  - BACKGROUND: Cheyne-Stokes respiration is characterized by recurrent phases of
      central apneas during sleep alternating with a crescendo-decrescendo
      hyperventilation. This abnormal respiratory pattern is often observed in patients
      with severe congestive heart failure and associated with fragmentation of sleep,
      excessive daytime sleepiness, and a relatively high mortality. Increased
      peripheral and central chemosensitivity, prolonged circulation time, and reduced
      blood gas buffering capacity are the major factors contributing to the pathology.
      However, the exact pathophysiologic mechanisms are not clear yet. Respiratory
      stimulants, oxygen and continuous or bilevel positive airway pressure (CPAP or
      BiPAP) might reduce the severity of Cheyne-Stokes respiration but have little
      effect on daytime sleepiness and cardiac function. There is only limited data
      supporting the assumption that intensive heart failure therapy has an effect on
      Cheyne-Stokes respiration. CASE REPORT: A 55-year-old male patient with dilative
      cardiomyopathy (NYHA IV) suffered excessive daytime sleepiness (Epworth
      Sleepiness Scale: 24 points). The patient was a heavy snorer with a normal body
      mass index. Treatment was initiated including ACE-inhibitors, beta-receptor
      blockers, diuretics and digoxin. The patient underwent sleep analysis with a
      Somno-Check system which demonstrated Cheyne-Stokes breathing (Respiratory
      Disturbance Index RDI: 40/h, lowest desaturation 76%) and body position dependent
      snoring. Oxygen therapy (21/min) had no effect on daytime sleepiness. Due to the
      cardiac condition, the patient was accepted for heart transplantation. Three
      weeks after transplantation sleep analysis was repeated and demonstrated a lack
      of evidence for periodic breathing (RDI 1/h, no desaturations below 90%), while
      snoring remained unchanged. Daytime sleepiness improved significantly (Epworth
      Sleepiness Scale: 6 points). Three weeks after normalizing left ventricular
      function a complete recovery from severe Cheyne-Stokes respiration was observed.
      CONCLUSION: Adequate therapy of the underlying cause of Cheyne-Stokes breathing
      such as end-stage congestive heart failure might sufficiently abolish any
      breathing abnormalities.

PMID- 11198561
TI  - [Egg shell hili in silicosis].

PMID- 11198562
TI  - [Euthanasia: spiritual roots in the 19th, crime in the 20th, legalization in the
      21st century?].

PMID- 11198563
TI  - You don't bring me anything but down: adolescent romance and depression.
AB  - What accounts for the sex difference in depression that emerges during the period
      of adolescence? We propose that females become more depressed than males in
      adolescence partly as a consequence of their involvement in romantic
      relationships. Using two waves of data from the National Longitudinal Study of
      Adolescent Health (N = 8,181), a study which began interviewing respondents in
      1994, we compare change in levels of depression for adolescents with and without
      romantic involvement between interviews. Our results suggest that males and
      females who become romantically involved between interviews experience a larger
      increase in depression than their counterparts who do not; however, females
      experience a larger increase in depression than males in response to romantic
      involvement. Our results suggest that females' greater vulnerability to romantic
      involvement explains a large part of the emerging sex difference in depression
      during adolescence.

PMID- 11198564
TI  - Adolescent cigarette smoking in U.S. racial/ethnic subgroups: findings from the
      National Education Longitudinal Study.
AB  - Using nationally representative data for 16,454 8th graders and 13,840 10th
      graders, we explore racial/ethnic differences in "daily cigarette initiation,"
      beginning to smoke on a daily basis between baseline interviews and reinterviews
      conducted two years later. In both samples, the initiation rate among whites is
      more than double the rate among blacks and higher than rates among Asian/Pacific
      Islanders and Hispanics. Risk factors at the individual, family, and peer-group
      levels of analysis do not explain most racial/ethnic differences. We develop
      alternative hypotheses by extending theories of cigarette use to the school
      level, and we test them using multilevel models: Consistent with social learning
      theory, cigarette risk among blacks and Hispanics decreases as the percentage of
      racial/ethnic minority students in the school increases. Consistent with strain
      theory, cigarette risk increases with the academic competitiveness of the school-
      especially among females--after controlling for the adolescent's academic
      performance.

PMID- 11198565
TI  - Abuse, support, and depression among homeless and runaway adolescents.
AB  - This study examines the effectiveness of social support networks on psychological
      well-being among 602 homeless and runaway adolescents. The respondents were
      interviewed in shelters, drop-in centers, and on the streets in cities of four
      Midwestern states (Missouri, Iowa, Nebraska, and Kansas). The path model was used
      to test the direct effect of family abuse and precocious independence on
      adolescent depressive symptoms and indirect effects through social support
      networks. Results indicate that although abusive family origins contribute
      directly to depressive symptoms there are indirect effects of family abuse and
      early independence through social support networks. Family abuse and early
      independence drive homeless adolescents to rely on peers for social support.
      While support from friends on the street reduces depression, association with
      deviant peers increases depression.

PMID- 11198566
TI  - Underemployment and depression: longitudinal relationships.
AB  - We conceptualize employment status not as a dichotomy of working versus not
      working but as a continuum ranging from adequate employment to inadequate
      employment (involuntary part-time or low wage) to unemployment. Will shifts from
      adequate to inadequate employment increase depression as do shifts from
      employment to unemployment, and to what extent does prior depression select
      workers into such adverse employment change? We analyze panel data from the
      National Longitudinal Survey of Youth for the years 1992-1994 for the 5,113
      respondents who were adequately employed in 1992. Controlling for prior
      depression, both types of adverse employment change resulted in similar,
      significant increases in depression. These direct effects persisted despite
      inclusion of such potential mediators as changes in income, job satisfaction, and
      marital status. Marital status buffered the depressive effect of both types of
      adverse change, but education and job dissatisfaction amplified the effect of
      unemployment on depression. Prior depression did not predict higher risk of
      becoming inadequately employed but did predict increased risk of unemployment,
      particularly for those with less education. These results confirm that both
      unemployment and inadequate employment affect mental health, and they invite
      greater efforts to monitor the extent and impact of underemployment.

PMID- 11198567
TI  - Age, debt and anxiety.
AB  - What is the association between debt and anxiety? Is the relationship between age
      and anxiety in part due to financial debt? Recently there has been a renewed
      interest for the reconceptualization and measurement of socioeconomic status that
      moves beyond the standard education, occupation, and income. This paper uses
      credit card debt and stress regarding debt to examine the relationship among age,
      debt, and anxiety. Using data from a 1997 representative sample of more than
      1,000 adults in Ohio, results show that anxiety does increase with the ratio of
      credit card debt to income, and with being in default; but credit card debt
      accounts for little of the age-anxiety association. Stress regarding overall debt
      does explain some of the age effect. In addition, stress also explains some of
      the effect of the credit card debt to income ratio, and all of the effect of
      default on anxiety.

PMID- 11198568
TI  - Marital trajectories and mental health.
AB  - This study expands the marital status and mental health literature by examining
      several dimensions of marital trajectories, including the number and type of
      prior marital losses and duration in current status. Data are drawn from the
      Piedmont Health Survey of the National Institute of Mental Health Epidemiologic
      Catchment Area Study, collected in 1982-83 (n = 2,158). Results indicate that
      number of prior losses moderates the health-enhancing effect of being currently
      married; higher order marriages are associated with worse mental health. Although
      results vary across the mental illnesses examined (depression, anxiety, and
      substance use), the negative effect of multiple loss also is observed for the
      currently divorced and widowed. There is less evidence that the type of prior
      loss (i.e., divorce or widowhood) moderates the effect of current marital status
      on mental health; however, some support is found among the presently widowed. The
      analyses of duration in current status suggest that the rate of decline in
      symptoms of anxiety following one's most recent loss varies by marital history
      among the currently widowed.

PMID- 11198569
TI  - A cross-national examination of the determinants of self-assessed health.
AB  - Self-assessed health measures are often utilized in surveys of older adults, and
      these have been found to be powerful predictors of other health indicators and
      future health. However, there is still much that is puzzling about the measure.
      Few studies use comparative techniques to ascertain the determinants of self
      assessed health across diverse settings. Using recent data from the Philippines,
      Taiwan, and Thailand, the current study tests whether determinants of self
      assessed health are similar across samples and whether there are distinct country
      effects acting upon the association. Ordered probit models reveal that, on the
      one hand, the determinants of self-assessed health are relatively similar across
      the three countries, while, on the other, the overall probabilities of reporting
      favorable self-assessed health remain differentiated even when controlling for a
      broad series of determinants. The results suggest that cultural variation in the
      interpretation of health may be a factor and that more subtle measures should be
      included in future studies of this nature.

PMID- 11198570
TI  - Emerging therapies for hepatitis C virus (HCV) infection: the importance of HCV
      genotype.

PMID- 11198571
TI  - Phaeochromocytomas discovered during coronial autopsies in Sydney, Melbourne and
      Auckland.
AB  - BACKGROUND: The diagnosis of phaeochromocytoma can be difficult and previous
      autopsy studies have found that many of these tumours are not recognised during
      life. AIM: To determine the incidence of phaeochromocytoma during coronial
      autopsies and the characteristics of the individuals concerned. METHOD: Review of
      coronial autopsy records from Auckland (1981-97), Melbourne (1991-97) and Sydney
      (1991-97). RESULTS: Twenty-two patients were found giving an incidence of 0.05%
      (one tumour per 2031 autopsies) with similar figures in each centre. Thirteen of
      the patients were men, 12 were overweight (body mass index >25 kg/m2) and three
      of the seven Auckland patients were Maori. Fourteen of the tumours were left
      sided, one was extra-adrenal and none had metastasised. The one patient with
      bilateral tumours had multiple endocrine neoplasia syndrome type 2 (MEN-2) which
      had not been recognised during life. The heart weight was increased in 95% of the
      patients. The tumour may have contributed to the patient's death in up to 50% of
      the cases, although the true significance of these lesions as a cause of death
      remains unclear. Three patients died soon after general anaesthetics had been
      given for unrelated reasons. CONCLUSIONS: Even though phaeochromocytomas are
      uncommon, we fail to diagnose a significant number of these tumours during life.
      Methods are needed to increase the detection of phaeochromocytoma and to
      distinguish functional and non-functional tumours.

PMID- 11198572
TI  - A multivariate analysis of the association between social class of origin and
      current social class with self-rated general health and psychological health
      among 16-year-old Australians.
AB  - BACKGROUND: A recent review of international literature concludes that there is a
      relative absence of social class differentials in health in early youth. There is
      an absence of Australian studies on the effect of social class on the health of
      this age group. AIMS: To examine the association between social class and health
      among 16-year-old Australians. METHODS: The data on 1048 16-year-olds came from
      the fifth wave (1993) of the Australian Youth Survey conducted by the former
      Department of Employment, Education and Training. Outcome measures were self
      rated general health and psychological health (GHQ-12). Binary logistic
      regression was used to analyse data. RESULTS: Neither social class of origin nor
      current social class was associated with self-rated general health or
      psychological health. CONCLUSION: The argument that social class inequalities in
      health exist in childhood, disappear during early youth, and reappear later
      appears to hold ground within the Australian context.

PMID- 11198573
TI  - Cost-effectiveness and accuracy of exercise stress echocardiography in the non
      invasive diagnosis of coronary heart disease.
AB  - BACKGROUND: Exercise stress echocardiography (ESE) is a more recent form of
      totally non-invasive stress testing which like exercise thallium SPECT
      scintigraphy (ETS) was developed to overcome the known limitations of ECG stress
      testing, namely the limited diagnostic accuracy and the inability of ECG stress
      testing to site the region of coronary artery disease (CAD) induced ischaemia.
      AIMS: To determine the sensitivity and specificity (and overall accuracy) of ESE
      in a group of patients referred for ETS imaging and compare the relative costs of
      each technique. METHODS: One hundred and fifteen patients referred for ETS
      consented to a simultaneous ESE. Of this group, 59 patients underwent coronary
      angiography which was utilised as the gold standard. RESULTS: The feasibility of
      ESE was 97% (112 of 115 patients of the total study population and 57 of the 59
      patients who underwent coronary angiography). Of the 59 patients undergoing
      coronary angiography, the sensitivity of ESE and ETS were not significantly
      different (84.1% versus 91.3% respectively). However, despite the apparent marked
      difference in specificity (92.3% versus 61.5% respectively), p = NS (Fisher's
      exact test) as there were only 13 normals in the group who underwent coronary
      angiography. Overall accuracy was also closely similar (86.0% versus 84.7%
      respectively) and therefore also not significantly different. By contrast,
      agreement with coronary angiography as measured by the kappa statistic (kappa +/-
      SEk) was good for ESE (0.66 +/- 0.11) but only moderate for ETS (0.54 +/- 0.13).
      Moreover, there was a cost saving of at least $594.00 per patient in favour of
      ESE. CONCLUSION: ESE is a totally non-invasive, sensitive, specific and cost
      effective imaging modality for the detection and localisation of CAD.

PMID- 11198575
TI  - Multiple endocrine neoplasia.

PMID- 11198574
TI  - A serological re-evaluation of acute non-A non-B hepatitis from the early 1970s.
AB  - BACKGROUND: The epidemiology and natural history of recently discovered viruses,
      which may be responsible for cases of seronegative infectious hepatitis, are
      currently being investigated. Retrospective studies of stored sera can provide a
      historical perspective of these infections. AIMS: To re-evaluate the serological,
      demographic and clinical characteristics of patients hospitalised in the early
      1970s with acute hepatitis. METHODS: The stored sera of 57 patients hospitalised
      between 1971 and 1974 with acute hepatitis, designated at that time as non-A non
      B (NANB) hepatitis, were re-tested using commercially available enzyme-linked
      immunosorbent assays (ELISAs) for the presence of anti-hepatitis A virus (HAV)
      IgM, hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV) IgG, and
      anti-hepatitis E virus (HEV) IgG. Stored sera from a group of 57 patients
      concurrently hospitalised for other conditions were also tested. Detailed records
      of the original epidemiological interviews were examined to compare patient
      demographics, risk factors for infectious hepatitis and clinical data for the
      NANB hepatitis group and an original control group of 604 hospitalised patients.
      RESULTS: Serum from 15 of the 57 (26%) previously designated NANB hepatitis cases
      had elevated anti-HAV IgM and are likely to represent missed cases of hepatitis
      A. Thirteen (23%) of cases previously designated as NANB hepatitis had positive
      hepatitis C antibody tests. These patients were younger and significantly more
      likely to have used intravenous drugs than control patients. Three NANB hepatitis
      and two hospital control patients were anti-HEV IgG antibody positive. All of
      these individuals were born in, or had travelled to, developing countries. Serum
      from 27 (47%) of the NANB hepatitis patients were negative on all tests. These
      hepatitis non-A-E cases included children and elderly adults, but as a group were
      significantly more likely to have used intravenous drugs than hospitalised
      control patients. CONCLUSION: Both HCV and probable  non-A-E virus(es) were
      important causes of acute NANB hepatitis during the early 1970s.

PMID- 11198576
TI  - The value of evidence-based medicine to consultant physicians.

PMID- 11198577
TI  - The clinical significance of antiphospholipid antibodies in patients without
      autoimmune disease.

PMID- 11198578
TI  - Atherosclerosis and the vulnerable plaque--imaging: Part II.

PMID- 11198579
TI  - Mycophenolate mofetil for treatment of refractory lupus nephritis: four pilot
      cases.

PMID- 11198580
TI  - Do we need a new word for patients?

PMID- 11198581
TI  - Requirements for a biotechnology future: the current position of Australia and
      the United Kingdom.

PMID- 11198582
TI  - Leptomeningeal metastases from anaplastic thyroid carcinoma.

PMID- 11198583
TI  - Left main coronary artery dissection during coronary angioplasty or angiography
      treated by stent insertion without requirement for emergency bypass graft
      surgery.

PMID- 11198584
TI  - Alternating two finger tapping as part of the neurological motor examination.

PMID- 11198585
TI  - Factitious haemoptysis.

PMID- 11198586
TI  - Multiple organ failure and pantoprazole.

PMID- 11198587
TI  - Hypothyroidism--an unusual cause of cardiac tamponade.

PMID- 11198588
TI  - Lymphoproliferative disease causing angioedema--an uncommon association.

PMID- 11198589
TI  - Visual loss as the presenting feature of giant cell arteritis.

PMID- 11198590
TI  - Extensive jugular and upper limb thrombosis in a patient with factor V Leiden
      mutation and non-Hodgkin's lymphoma.

PMID- 11198591
TI  - Silent myocardial ischaemia following methysergide overdose.

PMID- 11198592
TI  - 'A touch of sugar'--a dangerous euphemism still alive and well.

PMID- 11198593
TI  - Successful renal transplantation in children under 6 years of age.
AB  - To evaluate the efficacy of renal transplantation in small pediatric patients, we
      have reviewed 41 allografts performed in 39 children (28 M/11 F) less than 6
      years of age between 1987 and 1998 in the North Italy Transplant Program. Of
      these patients, 39 had a cadaver donor and 2 a living-related donor, with ages
      ranging from 20 days to 35 years. The mean follow-up was 56 months. Graft
      survival was 74.5% and 70.5% at 1 and 5 years, respectively. The causes of graft
      lost were acute rejection (4), graft vascular thrombosis (4), and hemolytic
      uremic syndrome recurrence (1). Only 1 patient has died due to chickenpox. Double
      and triple immunosuppressive therapies were used in 63% and 37% of patients,
      respectively, on the basis of different center protocols, without differences in
      graft survival. Steroids were successfully administered on alternate days in 37%
      of patients, 6-12 months after transplantation. Thrombosis was reported in 2 of 6
      kidneys from donors less than 1 year of age and in 2 of 35 donors older than 1
      year (P < 0.05). Thirty rejections occurred in 23 patients: 7 episodes were
      steroid resistant and were treated with ATG/OKT3. Thirty-four infections were
      reported in 16 of 41 patients; of these 17 were viral, 14 bacterial, and 3 due to
      Mycoplasma. Four surgical complications were reported: 1 graft artery stenosis, 1
      ureteral stenosis, 1 urinary leak, and 1 lymphocele. Mean height standard
      deviation score improved from -2.0 +/- 1.3 pre transplantation to -1.8 +/- 1.4, 
      1.5 +/- 1.3, and -1.5 +/- 1.5 at 1, 2, and 5 years post transplantation. Linear
      growth was significantly better in infants treated with alternate-day steroids.
      Hypertension was a frequent complication, since 19 of the 30 patients with a 5
      year follow-up were still being treated with antihypertensive drugs. In
      conclusion, graft survival in patients less than 6 years old is satisfactory and
      similar to that obtained in children aged from 6 to 18 years (70.5% vs. 78.9% at
      5 years, P = NS). Consequently, since there are many difficulties in managing
      infants on maintenance dialysis, an early transplant should be considered. Donors
      older than 24 months carry a low risk of vascular thrombosis and may be
      successfully grafted in infants.

PMID- 11198594
TI  - Chronic renal insufficiency from infancy to adulthood.

PMID- 11198595
TI  - Low serial serum neopterin does not predict low risk for chronic renal graft
      rejection.
AB  - Research has provided new and potent immunosuppressants which can potentially
      stop ongoing rejection. Subclinical rejection is a particular problem in the
      pediatric age group and early identification of children at risk is of the utmost
      importance. Neopterin has been previously shown to be a non-specific but
      sensitive marker for immunologic activity. In this study we hypothesized that low
      serum neopterin in the 1st year after transplantation predicts a low risk of
      chronic rejection. We retrospectively analyzed serial neopterin data obtained
      beyond the early postoperative period in 21 children and correlated the peak and
      average with glomerular filtration rate (GFR) loss during the subsequent years (P
      = 0.63, NS, r = 0.10). Our results show that serum neopterin did not differ
      between the majority of children who developed chronic transplant dysfunction and
      children with stable transplant function beyond the early post-transplant period.
      Thus serum neopterin failed to delineate a low-risk population who might be
      spared more invasive diagnostic procedures such as protocol biopsy.

PMID- 11198596
TI  - Non-invasive intravascular monitoring in the pediatric hemodialysis population.
AB  - Assessment of dry weight in pediatric hemodialysis (HD) patients is difficult,
      since small fluid shifts may result in dialysis-associated morbidity (DAM) and
      children may not verbalize complaints. Achieving dry weight is critical since
      chronic fluid overload can result in hypertension and left ventricular
      hypertrophy. To determine if non-invasive monitoring of hematocrit (NIVM) is
      useful in preventing DAM in pediatric HD patients, we reviewed 200 HD treatments
      performed with or without NIVM (no NIVM). DAM was defined as an "event" (e.g.,
      hypotension, headache, cramping) that required nursing intervention. Patient age,
      weight, and gender were similar in both groups. Desired ultrafiltration was
      obtained in both groups. The event rate was lower in NIVM than no NIVM for all
      treatments (0.22 vs. 0.3, P = 0.07) and significantly lower in patients < 35 kg
      (0.25 vs. 0.47, P = 0.01). The second event rate (fraction of treatments with one
      event that had a subsequent event occurring at least 15 min later) was lower with
      NIVM (P < 0.01). For the NIVM group, events in the first 90 min occurred when
      blood volume changed > 8% per hour; 71% of events (43/60) at 90-240 min occurred
      when blood volume changed > 4% per hour. NIVM decreases DAM in pediatric HD
      patients, especially those < 35 kg. Ultrafiltration with blood volume change < 8%
      per hour is safe in the 1st h and < 4% after 1 h reduces DAM in children.

PMID- 11198597
TI  - Monitoring cardiovascular changes during hemodialysis in children.
AB  - Hemodialysis (HD) causes rapid volume shifts and circulatory changes. In chronic
      renal failure (CRF) Na+/K+ATP-ase is depressed, whereas endogenous digoxin-like
      factor (EDLF) is elevated. Our aim was to characterize HD-induced cardiovascular
      adaptation and its possible links to Na+/K+ATP-ase and EDLF. Eleven children with
      CRF on HD (aged 14.7 +/- 3.7 years) and 11 healthy children were investigated for
      basic circulatory parameters. Thoracic impedance (Zo) and circulatory parameters
      were monitored by impedance cardiography (ICG) during HD. Erythrocyte Na+/K+ATP
      ase and EDLF were measured before and after HD. Up to the loss of 6% of total
      body weight, Zo rose linearly with fluid removal, above this no further increase
      occurred. Heart rate and mean arterial pressure (MAP) were inversely related (r =
      -0.97); MAP rose in the first and decreased in the second part of HD. Systemic
      vascular resistance paralleled MAP, whereas stroke volume rapidly decreased, but
      stabilized in the second part of HD. The ratio of preejection period/ventricular
      ejection time (PEP/VET) correlated positively with HD duration (r = 0.92),
      suggesting diminished cardiac filling. Cardiac index (CI) remained stable. EDLF
      was high in uremia accompanied by depressed Na+/K+ATP-ase (P < 0.05 and P < 0.01,
      respectively). Following HD Na+/K+ATP-ase normalized. Correlation between
      Na+/K+ATP-ase activity and MAP was linear (r = 0.85). In conclusion, ICG during
      HD provides detailed information concerning circulatory adaptation resulting in
      stable CI, suggesting that the dialysis-induced hypovolemia is compensated by the
      centralization of the blood volume. Changes of Na+/K+ATP-ase indicate that
      dialyzable blood pressure-regulating substance(s) inhibit(s) the pump. However,
      lack of further correlation between Na+/K+ATP-ase, EDLF, and cardiovascular
      parameters indicates the complexity of the regulatory processes.

PMID- 11198598
TI  - Signs of autonomic neuropathy in childhood uremia.
AB  - To evaluate the presence of autonomic neuropathy in childhood uremia,
      cardiovascular autonomic reflexes were examined in children with chronic renal
      failure. Cardiovascular autonomic reflexes of 10 uremic patients on chronic
      dialysis and 10 transplanted patients were compared to assess the effect of
      transplantation on autonomic neuropathy. Resting heart rate, heart rate changes
      induced by deep breathing, by Valsalva maneuver, and following standing up, and
      blood pressure change induced by handgrip test were examined. Of the 10 uremic
      children, 4 showed early involvement and 2 had definite involvement of autonomic
      neuropathy. Only 1 of the 10 transplanted patients showed early signs of
      autonomic neuropathy. Autonomic tests demonstrated predominantly parasympathetic
      dysfunction. In conclusion, cardiovascular autonomic neuropathy is not rare in
      children and adolescents and young adults with chronic renal failure. In
      contrast, the prevalence is very low in transplanted patients with similar uremic
      precedents. Efforts should be made to prevent or delay this uremia-related
      complication.

PMID- 11198599
TI  - Intraperitoneal administration of recombinant human growth hormone in children
      with end-stage renal disease.
AB  - Recombinant human growth hormone (GH) therapy has been shown to be effective in
      the treatment of growth failure related to growth hormone resistance among
      children with chronic renal failure. The traditional route of administration is
      subcutaneous injection. This study was designed to evaluate the effectiveness and
      tolerability of intraperitoneal (i.p.) administration of GH in prepubertal
      peritoneal dialysis patients. Nine subjects were enrolled. Eight completed 24
      months of therapy with GH. Baseline height standard deviation scores (SDS) and
      growth velocity for the prior year were used for comparison. Peak serum GH was
      achieved 4 h after administration and serum half-life was 4.6 h. Mean height SDS
      was -3.1 at baseline, -2.5 at 1 year, and -2.3 at 2 years (NS) of GH therapy.
      Mean height velocity increased from a baseline of 4.6 cm/yr to 8.5 cm/yr in year
      1 (P < 0.05) and 6.1 cm/yr in year 2 (NS) of i.p. GH therapy. Peritonitis
      infection rates were not increased from overall center rates. This research
      suggests that the intraperitoneal route of administration of GH can be utilized
      in the treatment of short stature among children requiring maintenance peritoneal
      dialysis therapy.

PMID- 11198600
TI  - Fungal peritonitis caused by Curvularia species in a child undergoing peritoneal
      dialysis.
AB  - We report the first case of peritonitis caused by Curvularia species in a child
      undergoing peritoneal dialysis. He presented with gray-black proteinaceous
      material obstructing the lumen of his Tenckhoff catheter. Although the peritoneal
      fluid was cloudy, the patient suffered neither significant abdominal tenderness
      nor systemic symptoms. Catheter removal and treatment with amphotericin B allowed
      complete recovery and return to peritoneal dialysis within 7 days. Outdoor play
      in a wooded environment may have allowed contact of this saprophytic fungus with
      the child's indwelling catheter transfer set.

PMID- 11198601
TI  - Nephron induction--the epithelial mesenchymal interface revisited.
AB  - While more and more humoral factors are being implicated in nephrogenesis, there
      is no detailed knowledge of the morphological structures at the interface of the
      nephron inducer and the surrounding mesenchyme. Hence we examined this area in
      the cortex of neonatal rabbit kidneys by scanning and transmission electron
      microscopy. Our interest was focused on the basal aspect of the collecting duct
      ampulla and the surrounding competent mesenchyme where morphogenic signals are
      exchanged during nephron induction. Close contact between these two tissues is
      assumed during nephrogenesis to allow direct cellular contact or diffusion of
      soluble factors across a short distance. However, our data show the presence a
      wide cleft around the collecting duct ampulla spatially separating the inducer
      and the competent mesenchyme during nephron induction. This cleft is filled with
      a characteristic fibrillar mesh-work.

PMID- 11198602
TI  - Two novel alternatively spliced 9-bp exons in the COL4A5 gene.
AB  - The existence of an alternatively used 18-bp sequence has been described in type
      IV collagen alpha 5 chain mRNA from human kidney (Guo et al., Kidney Int 44,
      1993). In this study we have shown that this sequence is encoded by two exons,
      termed 41A and 41B, that are located in a 9-kb intron 41 that was sequenced in
      its entirety. The sequences of exon 41A and 41B were shown to be present in mRNAs
      from a variety of tissues.

PMID- 11198603
TI  - Renal dysfunction but not cystic change is ameliorated by neonatal epidermal
      growth factor in bpk mice.
AB  - BALB/c mice homozygous for the bpk gene exhibit a form of autosomal recessive
      (AR) polycystic kidney disease (PKD) with massive collecting duct cysts, common
      bile duct dilation and chaotic intrahepatic bile ducts/portal triads. The
      combined renal and biliary pathology mimics much of the pathology seen in human
      ARPKD. Murine models of ARPKD generally have a reduced renal expression of
      epidermal growth factor (EGF) and an increased expression of EGF receptors (EGF
      R). However, the role that EGF and EGF-R play in the progression of PKD has been
      unclear. Evidence from various model systems/ages of treatment produces
      conflicting results. Treating neonatal C57BL/6J-cpk mice with EGF ameliorates the
      renal pathology and dysfunction while treating 2- and 3-week-old bpk mice with an
      EGF-receptor tyrosine kinase inhibitor also ameliorates ARPKD. Therefore, to
      determine whether neonatal EGF treatment would accelerate or inhibit the
      progression of the PKD in bpk mice, we administered exogenous EGF (1 microgram/g
      body weight subcutaneously) daily from postnatal days 3-9 (a critical period for
      tubule maturation). Neonatal EGF treatment but not sham treatment retarded the
      development of azotemia and common bile duct dilation and the chaotic hepatic
      triad changes in cystic mice. However, EGF treatment neither reduced the severity
      of the renal cystic pathology nor reduced the degree of cystic enlargement of the
      kidneys. Cystic mice treated past 9 days of age died prior to their scheduled
      termination at 21 days of age. The role of EGF in the progression of polycystic
      kidney disease in bpk mice is relatively complicated, with neonatal treatment
      being associated with some amelioration of the renal dysfunction and extrarenal
      pathology without an effect on the renal pathology. Continuation of treatment
      beyond 9 days increased morbidity. Therefore, in discussing the role of EGF or
      EGF receptor in mediating the pathophysiology of PKD, the stage of development
      may be an important consideration.

PMID- 11198604
TI  - Human T-cell lymphotropic virus-1-associated renal disease in Jamaican children.
AB  - This report documents the clinicopathological features in two Jamaican children
      who presented with infective dermatitis, glomerulonephritis, renal failure and
      human T-cell lymphotropic virus (HTLV-1) seropositivity. Severe hypertension with
      hypertensive encephalopathy was the most impressive clinical feature.
      Histological findings from renal biopsy specimens in both cases revealed
      significant glomerulosclerosis with fibrosis, chronic inflammatory cell
      infiltrates in the interstitium, and arteriolar hypertensive changes.
      Membranoproliferative glomerulonephritis (MPGN) was demonstrable in case 1 and
      marked focal glomerulosclerosis in case 2. Case 1 developed end stage renal
      failure and died within 3 years of diagnosis. Case 2 remains hypertensive and in
      chronic renal failure. Although a causal relationship between HTLV-1 infection
      and renal disease cannot be proven by these two cases, it appears that renal
      involvement in children with HTLV-1 infection is severe, with the potential for
      chronic renal failure and malignant hypertension. HTLV-1 nephropathy should be
      suspected in children with infective dermatitis and renal disease.

PMID- 11198605
TI  - A survey of pediatric nephrologists on adolescent sexual health.
AB  - Chronic renal disease often has an adverse effect on adolescent physiologic and
      psychosocial development. The severity of the disease may necessitate that the
      pediatric nephrologist be the adolescent's main medical provider and the most
      available physician to screen for adolescent health risk behaviors. The purpose
      of this study was to determine pediatric nephrologists' practices of sexual
      history taking and diagnosis and treatment of sexually transmitted infections in
      their adolescent patients. A survey was performed on a convenience sample of 66
      pediatric nephrologists attending an educational seminar on adolescent care at
      the 1997 national meeting of the American Society of Pediatric Nephrology. The
      outcome measures included physicians' reports of interviewing adolescents alone
      and screening for sexually transmitted infections. Fifty-six percent reported
      interviewing adolescents alone, 55% routinely ask female adolescents about sexual
      intercourse (53% ask males) and 10% routinely perform pelvic exams. Current
      practice in this selected sample of pediatric nephrologists, who by their
      attendance at the seminar may represent those most motivated to do screening,
      still leaves adolescents with chronic renal disease potentially at risk for
      sexually transmitted infections and pregnancy. Educational efforts should be
      directed at increasing routine confidential sexual history taking for adolescents
      with chronic renal disease.

PMID- 11198606
TI  - Sex differences in the renal transforming growth factor-beta 1 system after
      puberty.
AB  - Transforming growth factor-beta 1 (TGF-beta 1) has been implicated in many
      progressive kidney diseases. The present study examines this growth factor during
      the pubertal and early adult periods. Mixed-sex Munich-Wistar rat kidneys were
      obtained on selected days of life from birth through 6 months of age. A survey of
      the TGF-beta 1 system was performed, and then a second experiment focused on
      cortex and medulla from both sexes at 6 weeks and 16 weeks of age. Reverse
      transcription polymerase chain reaction for TGF-beta 1 and TGF-beta inducible
      gene H3 (beta IG-H3) was performed. Active and total levels of protein for TGF
      beta 1 were isolated from tissue. Active levels of TGF-beta 1 were somewhat lower
      in older than in younger animals, without sex differences. beta IG-H3 levels were
      similar. At 16 weeks females had levels of total growth factor approximately
      threefold greater than males, while adult males appeared to activate the growth
      factor much more efficiently. These findings suggest that activation of TGF-beta
      1 becomes more efficient following puberty in the male rat, while females appear
      to have reduced activation efficiency compensated by increased total growth
      factor. These differences may help explain the deterioration at puberty and
      sexual dimorphism noted with some progressive nephropathies.

PMID- 11198607
TI  - Recurrence and follow-up after urinary tract infection under the age of 1 year.
AB  - In order to analyze the risk factors for recurrence and the value of routine
      follow-up by monthly urine cultures in a group of children who had their first
      episode of urinary tract infection (UTI) under 1 year of age, we performed a
      retrospective survey of 262 children (134 girls, 128 boys) who were treated for
      their first UTI while aged under 1 year in the Department of Pediatrics,
      University of Oulu, during the years 1978-1984. Detailed data on these children
      concerning their first and recurrent UTIs were collected from hospital records
      using a formulated data sheet. Causative bacteria and vesicoureteral reflux (VUR)
      were analyzed as possible risk factors for recurrent UTI. The time of recurrence
      and the possible symptoms during the recurrent UTI were also investigated. The
      follow-up period after the first UTI was 3 years; 35% of the boys and 32% of the
      girls contracted a recurrent UTI during the 3-year follow-up. In 86% of cases,
      the first UTI recurrence occurred within 6 months of the primary UTI. Recurrent
      UTIs were detected significantly earlier with routine monthly follow-up compared
      with those seeking treatment because of symptoms (log rank test P < 0.01). There
      was a significant difference in the number of recurrences of UTI according to the
      grade of VUR (P = 0.006). Recurrence-free survival was shorter and recurrent UTIs
      occurred more often in the children with grade 3-5 VUR than in those with grade 0
      2 VUR (log rank test P = 0.0005). Children without VUR and children with grade 1
      2 VUR did not differ in the recurrence rate, and thus grade 1-2 VUR did not
      increase the risk for recurrent UTI. Monthly routine urine cultures are efficient
      in detecting recurrent UTI infections in children. Since grade 3-5 VUR is a risk
      factor both for increased recurrence rate of UTI and for possible subsequent
      renal damage, these children should be followed with monthly urine cultures for
      UTI recurrences if not on preventive medication. Since the vast majority of UTI
      recurrences occur within 6 months of the first UTI, routine follow-up for 6
      months seems to be sufficient after symptomatic UTI in children with grade 3-5
      VUR.

PMID- 11198608
TI  - Quantification of proteinuria in children using the urinary protein-osmolality
      ratio.
AB  - A prospective study was conducted to determine the correlation of early morning
      urinary protein/osmolality ratio (mg/l/mosmol/kg) with 24-h urinary protein
      excretion (mg/m2/day). Study patients consisted of 53 children (aged 1 month to
      15 years). Early morning urine samples and 24-h urine samples were collected and
      analyzed. In group 1 (children without proteinuria), early morning urinary
      protein/creatinine ratio (Uprot/Ucr, mg/mg) was 0.061 +/- 0.011 and the
      protein/osmolality ratio (Uprot/Uosm, mg/l/mosmol/kg) was 0.073 +/- 0.014. Twenty
      four hour urinary protein excretion in group 1 had no significant correlation
      with Uprot/Ucr or Uprot/Uosm. In group II (children with proteinuria), Uprot/Ucr
      was 5.78 +/- 1.10 and Uprot/Uosm was 4.42 +/- 1.34. Twenty-four hour urinary
      protein excretion in group 2 was 1483.6 +/- 303.7 mg/m2/day and its correlation
      with both Uprot/Uosm and Uprot/Ucr was highly significant (r = 0.87, P < 0.001
      and r = 0.88, P < 0.001, respectively). The accepted nephrotic level of
      proteinuria of 40 mg/m2/h coincides with a Uprot/Uosm ratio of 1.9. In
      conclusion, early morning urinary Uprot/Uosm is a simple and potentially useful
      test for 24-h urinary protein excretion, and possibly could be used safely for
      the assessment of the degree of proteinuria in children.

PMID- 11198609
TI  - Coccidioidomycosis in adolescents with lupus nephritis.
AB  - Coccidioidomycosis, a fungal infection endemic in the southwestern United States,
      can cause life-threatening infections in immunosuppressed patients. We report the
      contrasting cases of two adolescents with lupus nephritis, treated with
      intravenous pulse cyclophosphamide and daily oral corticosteroids, who developed
      pulmonary coccidioidomycosis. One patient developed a fatal form of fulminant
      disseminated coccidioidomycosis, while the other patient developed a solitary
      pulmonary Coccidioides immitis abscess which was responsive to intravenous
      liposomal amphotericin and fluconazole therapy. Because serologies and initial X
      ray studies can be negative, definitive diagnostic studies including
      bronchoaveolar lavage and needle aspiration should be performed when there is
      clinical suspicion of coccidioidomycosis in an immunocompromised patient.
      Immunosuppressed patients with coccidioidomycosis should receive early
      intravenous amphotericin therapy and may benefit from long-term suppressive
      antifungal therapy to prevent relapse.

PMID- 11198610
TI  - Fatal cytomegalovirus disease in a high-risk renal transplant recipient.
AB  - The incidence of CMV infection in pediatric renal transplant recipients has
      increased as immunosuppression levels deepen following the use of newer
      immunosuppressive agents. It has been thought that 3-5 months of anti-CMV
      prophylaxis offers sufficient protection for these patients. We present a case of
      late-onset fatal CMV disease in a pediatric renal transplant recipient who
      received prolonged anti-CMV prophylaxis while on "quadruple" immunosuppression
      with daclizumab, mycophenolate, tacrolimus, and prednisone. Our case has prompted
      us to reassess CMV surveillance, prophylaxis, and immunosuppression levels in our
      pediatric renal transplant patients.

PMID- 11198611
TI  - Immunotactoid glomerulopathy in sickle cell anemia.
AB  - A 12-year-old African American male with homozygous sickle cell disease (SCD) was
      admitted with insidious onset of periorbital and scrotal edema. The initial
      evaluation failed to reveal any underlying monoclonal gammopathy, or
      cryoglobulinemia, or other systemic causes for the renal disease. A percutaneous
      renal biopsy was consistent with immunotactoid glomerulopathy (ITG), which is
      rare in children and is characterized histologically by fibrillar deposits in the
      glomeruli. Children can present with symptoms of nephrotic syndrome and progress
      to end stage renal disease. Our patient was treated with an ACE inhibitor and is
      currently free of edema and with normal renal function on follow-up at 1 year.
      Immunotactoid glomerulopathy should be considered in the differential diagnosis
      of nephrotic syndrome in children with sickle cell disease. Renal biopsy is
      indicated in children with sickle cell disease and nephrotic syndrome and ITG
      should be considered as potential cause. Although there is no effective treatment
      for this condition, ACE inhibitors can decrease the protein-uria and possibly
      delay the progression to end stage renal disease. The side effects related to the
      use of ACE inhibitors should be monitored. These include renal impairment,
      hyperkalemia, anemia, neutropenia, and angioedema. Since we have a short follow
      up in our patient, the role and safety of ACE inhibitors in the management of ITG
      need further evaluation.

PMID- 11198612
TI  - Treatment of chronic hypertension with intravenous enalaprilat and transdermal
      clonidine.
AB  - We report an 11-year-old boy with hypertension and chronic intestinal pseudo
      obstruction, which renders him totally dependent on parenteral nutrition and
      prevents the use of oral medications. Here we report the feasibility of utilizing
      chronic i.v. enalaprilat and transdermal clonidine on a chronic basis to control
      hypertension. Over the last 10 months, the patient's hypertension has been well
      controlled by 1.25 mg i.v. enalaprilat every 8 h and a 0.2-mg clonidine patch
      every 6 days, with no apparent side-effects. There are no reports of i.v.
      enalaprilat usage exceeding 3 weeks' duration. Therefore we believe that it is
      possible to effect reasonable management of chronic hypertension with the use of
      chronic i.v. enalaprilat and transdermal clonidine therapy.

PMID- 11198613
TI  - Plasmapheresis in a very young infant with atypical hemolytic uremic syndrome.
AB  - Atypical hemolytic uremic syndrome (HUS) is a heterogeneous group of disorders,
      the pathogenesis of which is unclear. Plasma transfusions and plasmapheresis are
      widely used modes of therapy for adults with this life-threatening syndrome.
      There is very limited experience in using plasmapheresis therapy in children and
      infants with atypical HUS. Plasmapheresis, which is considered a relatively safe
      procedure in adults and older children, may be hazardous in neonates and very
      young infants and can result in severe complications. We report a 2-month-old
      infant with idiopathic atypical HUS, who was successfully treated with a 1-month
      course of plasmapheresis during the acute phase of the disease. Appropriate
      preparations as well as several adjustments were made in order to meet the
      special needs of this very young infant who, to the best of our knowledge, is the
      youngest reported patient with atypical HUS to undergo plasmapheresis.
      Plasmapheresis therapy of the infant was not associated with any complications of
      the procedure and resulted in marked clinical improvement. We conclude that
      plasmapheresis in neonates and in very small infants is technically feasible, can
      be performed without major complications, and may be of benefit in individual
      cases.

PMID- 11198614
TI  - Macrohematuria with electron-dense deposits in a 14-year-old boy with minimal
      change nephrotic syndrome.

PMID- 11198615
TI  - Gastroesophageal reflux in hemolytic uremic syndrome.

PMID- 11198616
TI  - Antithrombin III, protein S, and coagulation in the nephrotic syndrome.

PMID- 11198617
TI  - Trisomy 21 with hypercalcemia, hypercalciuria, medullary calcinosis and renal
      failure--a syndrome?

PMID- 11198618
TI  - The renin angiotensin system in bypass graft surgery.
AB  - The renin angiotensin system is implicated in the development of vein graft
      disease after coronary artery bypass surgery. Components of this system have been
      shown to play important roles in determining the short-term and long-term
      performance of coronary artery bypass grafts. Significant differences exist in
      the commonly used arterial and venous grafts in angiotensin converting enzyme
      activity and angiotensin responses. The existence of a dual enzyme pathway in
      angiotensin II formation has also been demonstrated. Such findings have
      implications for the use of AT1-receptor antagonists over enzyme inhibitors to
      improve graft performance and prevent the development of coronary artery bypass
      graft disease.

PMID- 11198619
TI  - Developments in robotic cardiac surgery.
AB  - A new generation of surgical telemanipulation systems has helped to overcome the
      limitations of conventional endoscopic tools. These computer-enhanced
      instrumentation systems provide tremor filtering and motion scaling and allow
      dexterous manipulations in confined spaces through ports or trocars. Using these
      systems, total endoscopic coronary artery bypass grafting both on the arrested
      and on the beating heart has been performed successfully. Repair of mitral valves
      as well as atrial septal defects has also been performed remotely through 1
      centimeter incisions. Despite some early procedural success, operating times are
      prolonged and a number of conversions have been reported. Currently, the use of
      telemanipulation systems is restricted to selected patients and limited to very
      few indications. Further refinements in telemanipulator technology as well as
      integration of image-based navigation systems may expand the use of computer
      enhanced instrumentation systems in the near future.

PMID- 11198620
TI  - Trials comparing coronary artery bypass grafting with percutaneous transluminal
      coronary angioplasty and primary stent implantation in patients with multivessel
      coronary artery disease.
AB  - With marked improvements in stent technology as adjunct to balloon angioplasty
      for multivessel coronary disease, several newer trials are currently in progress
      reviewing the optimal revascularization strategy. This review provides background
      from older studies and addresses the current progress and design of these newer
      trials.

PMID- 11198621
TI  - Lipid lowering and coronary bypass graft surgery.
AB  - This article reviews the rationale for lipid lowering in patients who have
      coronary heart disease, and specifically for post-bypass patients. It has been
      well demonstrated that after coronary artery bypass graft surgery,
      atherosclerosis continues to progress in the native circulation and develops at
      an accelerated rate in saphenous vein bypass grafts. During the last decade,
      numerous clinical trials based on angiographic or clinical outcomes have clearly
      shown the beneficial effect of lipid lowering in coronary heart disease. Three
      trials (CLAS, post-CABG, and CARE) have demonstrated delayed progression of
      atherosclerosis in SVGs and/or a reduction of cardiac deaths, nonfatal MI, and
      the need for revascularization after lowering LDL-cholesterol. The recommended
      target of LDL cholesterol level of more than 100 mg/dl can be safely reached with
      diet and monotherapy using one of the statin drugs (HMG-CoA reductase
      inhibitors). Despite this widely-circulated information, there appears to be
      inadequate public and professional awareness of the importance of properly
      managing hyperlipidemia after coronary artery bypass graft surgery.

PMID- 11198622
TI  - Severe morbidity after coronary artery surgery.
AB  - When operations become safer, attention inevitably shifts from mortality to
      morbidity. Unfortunately, morbidity is more difficult to measure than death, but
      it is arguably of greater interest to the patient and to those from public or
      private institutions that have the responsibility for balancing a health care
      budget. Studies that focus on morbidity are currently few, and specific risk
      models are being developed. It is already evident that risk factors associated
      with hospital death are qualitatively different from risk factors associated with
      prolonged hospital stay. The study of morbidity after coronary artery surgery is
      important to surgeons and physicians, to assess quality of care and the impact of
      new treatments and procedures.

PMID- 11198623
TI  - Roles of endothelial dysfunction in coronary artery disease.
AB  - Endothelial dysfunction is an early and persistent vascular abnormality in the
      evolution of atherothrombotic disease. Risk factors for atherosclerosis promote
      an inflammatory oxidative environment in the vasculature that induces pathologic
      changes in endothelial function, including the support of enhanced smooth muscle
      tone, thrombosis, and smooth muscle proliferation. This article provides an
      overview of the molecular basis of endothelial dysfunction and of its diagnosis
      and treatment.

PMID- 11198624
TI  - Emerging concepts in metabolic abnormalities associated with coronary artery
      disease.
AB  - To an increasing degree, cardiology and endocrinology are finding a broadening
      interface. There is little doubt that atherosclerosis is in many ways a metabolic
      disorder, just as it is becoming increasingly clear that diabetes is a vascular
      disease. Framing such notions is evidence of diabetes as a risk equivalent for
      coronary disease, and clinical cardiovascular trials demonstrate the impact of
      altering lipid metabolism. Although the focus has been on statins and LDL, data
      continues to emerge for other therapies for triglycerides and HDL. These issues
      are discussed, as are future directions for metabolic therapeutic interventions
      for vascular disease.

PMID- 11198625
TI  - Cardiac allograft vasculopathy.
AB  - Cardiac transplantation has emerged as a valuable therapy for various end-stage
      cardiac disorders. Cardiac allograft vasculopathy (CAV), an unusually accelerated
      and diffuse form of obliterative coronary arteriosclerosis, determines long-term
      function of the transplanted heart. Cardiac allograft vasculopathy is a
      complicated interplay between immunologic and nonimmunologic factors resulting in
      repetitive vascular injury and a localized sustained inflammatory response.
      Dyslipidemia, oxidant stress, immunosuppressive drugs, and viral infection appear
      to be important contributors to disease development. Endothelial dysfunction is
      an early feature of CAV and progresses over time after transplantation. Early
      identification of CAV is essential if long-term prognosis is to be improved.
      Annual coronary angiography is performed for diagnostic and surveillance
      purposes. Intravascular ultrasound is a more sensitive diagnostic tool for early
      disease stages and has revealed that progressive luminal narrowing in CAV is in
      part due to negative vascular remodeling. Because of the diffuse nature of CAV,
      percutaneous and surgical revascularization procedures have a limited role.
      Prevention of CAV progression is a primary therapeutic goal.

PMID- 11198626
TI  - Intravascular hemodynamic factors responsible for progression of coronary
      atherosclerosis and development of vulnerable plaque.
AB  - The initiation, localization, growth, composition, and rupture of intracoronary
      atheromatous plaque-factors that define the natural history of coronary artery
      disease-are all dependent on inhomogenieties and irregularities of intracoronary
      local blood flow and endothelial shear stress. Restenosis of mechanically
      recanalized coronary arteries may be related in part to similar abnormalities of
      disturbed local flood flow and shear stress. Low or reversed shear stress leads
      to plaque development and progression. High shear stress contributes
      significantly to plaque rupture. Regions of hemodynamic stasis caused by major
      luminal irregularities may lead to thrombosis and myocardial infarction without
      plaque rupture. This review outlines the mechanisms that link hemodynamic factors
      to plaque development and rupture and describes in some detail recently developed
      techniques that, for the first time, make it possible to determine these factors
      in vivo in patients during routine cardiac catheterization procedures.

PMID- 11198627
TI  - Medical treatment for acute coronary syndromes.
AB  - The medical treatment of acute coronary syndromes with thrombolytic,
      antithrombin, and antiplatelet agents is a major area of research and a vast
      topic for clinical review. This review summarizes important recent findings on
      the background of existing pathological and clinical knowledge to provide an
      understanding of the basis of current therapy and the new therapies that are
      likely to be introduced in the near future. Current controversies regarding the
      management of these conditions and the choice between medical, interventional,
      and combined strategies in different situations are also discussed.

PMID- 11198629
TI  - Bibliography. Current world literature. Coronary artery surgery.

PMID- 11198628
TI  - Revascularization interventions for ischemic heart disease.
AB  - Coronary artery bypass grafting and percutaneous transluminal coronary
      angioplasty are now well established methods of myocardial revascularization. The
      choice of a method of revascularization depends on several clinical and
      angiographic parameters. Patients who derive the greatest benefit from coronary
      artery bypass grafting are those with left main coronary artery disease or those
      with three-vessel disease with left ventricular impairment. Patients with single
      vessel disease achieve more symptomatic relief with coronary angioplasty than
      with medical therapy alone, but with no improvement in long-term mortality. In
      nondiabetic patients with multiple-vessel disease, angioplasty and bypass
      grafting likely yield similar results, and the choice of revascularization
      technique rests on weighing the more invasive nature of bypass grafting against
      the need for additional future revascularizations with angioplasty. Diabetic
      patients with multiple-vessel disease seem to achieve better outcomes with bypass
      grafting. Minimally invasive bypass surgery is an evolving technique. It is less
      invasive in nature but its applications are limited, and its advantages over
      traditional bypass grafting have not yet been shown. Stenting now plays a major
      role in percutaneous revascularization and is performed in more than two thirds
      of all interventional procedures. It improves both the short-term and the long
      term outcomes of coronary angioplasty. Other novel percutaneous techniques such
      as directional or rotational atherectomy, laser angioplasty, or thrombectomy
      devices have not shown convincing superiority over coronary angioplasty alone.
      Transmyocardial laser revascularization can be performed surgically or
      percutaneously and may be beneficial in patients with angina refractory to
      traditional revascularization procedures.

PMID- 11198630
TI  - Bibliography. Current world literature. Ischemic heart disease.

PMID- 11198631
TI  - 8th Conference on Radioimmunodetection and Radioimmunotherapy of Cancer. October
      12-14, 2000. Princeton, New Jersey, USA. Abstracts.

PMID- 11198632
TI  - The development of atopic disease and asthma. Proceedings of a workshop. 10-13
      February 1999, Fulda, Germany.

PMID- 11198633
TI  - Ourania Horaitis: linking Human Mutation and the HUGO-Mutation Database
      Initiative.

PMID- 11198634
TI  - Life-threatening severe malarial anaemia.
AB  - Despite our improved understanding of the pathophysiology of severe malaria,
      major changes in clinical management have not been forthcoming. However, in the
      case of life-threatening severe malarial anaemia, preliminary evidence suggests
      that changes in current clinical practice rather than the introduction of novel
      interventions may improve child survival. This review argues that further
      research into the clinical physiology of this syndrome is required and could
      provide compelling evidence for changes in practice particularly with regard to
      blood transfusion. We focus on the syndrome of severe, symptomatic malarial
      anaemia associated with a metabolic acidosis which has a high fatality rate.
      However, it should be remembered that a far greater number of children without
      signs of life-threatening disease nonetheless experience significant morbidity
      from severe anaemia. Many of these less-severely ill children may also require
      blood transfusion. However, the mode and rationale for transfusion in this less
      severely ill group is specifically not addressed. Indeed, the arguments presented
      should not be extrapolated to suggest a uniform approach to transfusion is
      warranted, the role of blood in the less-critically ill child with severe malaria
      anaemia being a further area that requires urgent research.

PMID- 11198635
TI  - Lymphatic filariasis: setting the scene for elimination.

PMID- 11198636
TI  - Lymphatic filariasis: economic aspects of the disease and programmes for its
      elimination.

PMID- 11198637
TI  - New insights into the natural history and pathology of bancroftian filariasis:
      implications for clinical management and filariasis control programmes.

PMID- 11198638
TI  - Wolbachia bacteria of filarial nematodes in the pathogenesis of disease and as a
      target for control.

PMID- 11198639
TI  - Lymphatic filariasis in Ghana: from research to control.

PMID- 11198640
TI  - The role of NGDOs in disease elimination programmes: the lessons from
      onchocerciasis control.

PMID- 11198641
TI  - Tuberculosis treatment failure and drug resistance--same strain or reinfection?
AB  - Tuberculosis patients may have Mycobacterium tuberculosis in their sputum at the
      end of treatment, and may show new drug resistance, due to either inadequate
      treatment of the original episode or reinfection with a new strain during
      therapy. In a cohort study of mineworkers with tuberculosis in South Africa, 57
      of 438 patients had positive sputum cultures 6 months after recruitment in 1995.
      Of the 31 patients who initially had fully sensitive strains, 3 developed
      multidrug resistance (MDR) and 3 single-drug resistance (SDR). Of the 6 who
      started with SDR, 3 became MDR. HIV infection was not associated with drug
      resistance at enrollment or 6 months later. We compared pairs of DNA fingerprints
      from isolates of M. tuberculosis at recruitment and 6 months later in the 48
      patients for whom we had both available. In 45, the pairs were identical. In 1
      patient, although both isolates were fully sensitive, the later fingerprint had 1
      less band (transposition). In 2 pairs, the fingerprint patterns were completely
      different: one seemed to be the result of laboratory error and the other was a
      true reinfection with an MDR strain. Despite a high risk of infection, with a
      moderate proportion of background drug-resistant strains (11% SDR, 6% MDR),
      reinfection is not a common cause of treatment failure or drug resistance at 6
      months.

PMID- 11198642
TI  - London School of Hygiene and Tropical Medicine Meeting at Keppel Street, London,
      12 April 2000. The Professor Gerald Webbe Memorial Lecture: global control of
      schistosomiasis.

PMID- 11198643
TI  - Investigation of risk factors for porcine Taenia solium cysticercosis: a multiple
      regression analysis of a cross-sectional study in the Yucatan Peninsula, Mexico.
AB  - A cross-sectional survey for seropositivity to cysticercosis of pigs in the
      Yucatan Peninsula, Mexico, was carried out in 1996 together with a standardized
      questionnaire on predetermined individual pig and household risk factors for
      porcine infection. Serum samples from 697 pigs were analysed by immunoblot for
      antibodies to Taenia solium cysticercosis and questionnaires from 227 households
      in 18 villages were collected. All the data were analysed using multivariate
      analytical techniques taking household clustering into account. The overall
      porcine seroprevalence in the area was found to be 29%. The most important risk
      factors for seropositivity in pigs were presence versus absence of a toilet
      (adjusted odds ratio [adj. OR] 2.37, P = 0.005), crowded households (adj. OR
      1.75, P = 0.034) and both corralling (adj. OR 2.14, P = 0.017) and letting pigs
      loose (adj. OR 2.32, P = 0.035) versus tying them up. There was evidence of
      clustering at household level and that possible risk factors at municipal or
      village level may also interact with higher risk management practices such as
      allowing pigs to run loose.

PMID- 11198644
TI  - The potential of ivermectin to control the malaria vector Anopheles farauti.
AB  - We investigated mortality in Anopheles farauti mosquitoes, a major coastal
      malaria vector in the south-west Pacific, fed on a volunteer who had taken a 250
      micrograms/kg dose of ivermectin. High mortality was recorded in mosquitoes
      feeding during the first week after treatment of the volunteer, for instance 100
      80% failed to survive 3 days. A long-term residual effect of ivermectin in the
      blood was indicated by a small but significantly higher mortality in mosquitoes
      fed 6 weeks after ivermectin was taken. These effects were included in malaria
      transmission models that incorporated host choice and host-induced mortality
      parameters. For the zoophilic An. farauti, ivermectin treatment of animals
      resulted in a greater reduction in malaria than ivermectin treatment of humans
      alone, whereas for an anthropophilic vector, treatment of humans was more
      important. This suggests that ivermectin treatment of animals could have an
      important role in malaria control where An. farauti is the vector. Improvement in
      the health of humans and domestic animals through control of parasitic worms and
      mites might encourage community participation in strategies involving ivermectin.

PMID- 11198645
TI  - The use of live-bait traps for the study of sylvatic Rhodnius populations
      (Hemiptera: Reduviidae) in palm trees.

PMID- 11198646
TI  - Spraying houses in the Peruvian Andes with lambda-cyhalothrin protects residents
      against cutaneous leishmaniasis.
AB  - A household vector control trial was carried out in the Peruvian Andes to measure
      the effect of spraying inside walls and ceilings with lambda-cyhalothrin on the
      risk for residents of cutaneous leishmaniasis caused by Leishmania peruviana. The
      mortality rates of Lutzomyia verrucarum measured with WHO contact bioassay cones
      set on adobe walls characteristic of the endemic region indicated an LD95 for
      lambda-cyhalothrin of about 20 mg/m2, and no reduction in effectiveness for at
      least 6 months on indoor adobe walls sprayed with 25 mg/m2. A random selection of
      112 houses were sprayed (starting in 1992/93) at 6-monthly intervals with a mean
      dose of 34 mg/m2, leaving 154 control houses (with closely matched pre
      intervention measurements of incidence and sandfly abundance). Comparisons of pre
      and post-intervention sandfly indoor abundance, measured at regular intervals
      for up to 2 years using CDC light traps, in 22 sprayed and 21 control houses
      demonstrated that spraying significantly reduced the indoor abundance of Lu.
      verrucarum by an average of 78% and of Lu. (Helcocyrtomyia) peruensis by 83%.
      Spraying was also associated with a significant reduction of 77% in the
      proportion of bloodfed sandflies collected in light traps. The proportion of
      susceptible householders acquiring leishmaniasis during the trial was
      significantly reduced by 54% as a result of spraying. The observed impact of
      spraying was greatest, 81% (95% confidence intervals 20-95%), when the cases
      detected during the first 6 months after the intervention were excluded from the
      analysis, suggesting a significant pre-patent period.

PMID- 11198647
TI  - Rural and urban differences in diabetes prevalence in Tanzania: the role of
      obesity, physical inactivity and urban living.
AB  - A population-based survey in 1996 and 1997 of 770 adults (aged > or = 15 years)
      from an urban district of Dares Salaam and 928 from a village in rural
      Kilimanjaro district (Tanzania) revealed that the prevalence of diabetes,
      impaired fasting glucose (IFG), overweight, obesity, and physical inactivity was
      higher in the urban area for men and women. The difference between urban and
      rural prevalence of diabetes was 3.8 [1x1-6.5]% for men and 2x9 [0x8-4.9]% for
      women. For IFG, the difference was 2x8 [0x3-5x3]% for men and 3x9 [1x4-6x4]% for
      women; for overweight and obesity, the difference was 21.5 [15.8-27.1]% and 6.2
      [3x5-8.9]% for men and 17x4 [11.5-23.3]% and 12.7 [8x5-16x8]% for women,
      respectively. The difference in prevalence of physical inactivity was 12x5 [7.0
      18.3]% for men and 37.6 [31x9-43.3]% for women. For men with diabetes, the odds
      for being overweight, obese and having a large waist:hip ratio were 14.1, 5.3 and
      12.5, respectively; for women the corresponding values were 9x0, 10x5 and 2x4
      (the last not significant) with an attributable fraction for overweight between
      64% and 69%. We conclude that diabetes prevalence is higher in the urban
      Tanzanian community and that this can be explained by differences in the
      prevalence of overweight. The avoidance of obesity in the adult population is
      likely to prevent increases in diabetes incidence in this population.

PMID- 11198648
TI  - The epidemiology of febrile malaria episodes in an area of unstable and seasonal
      transmission.
AB  - This study investigated the epidemiology of uncomplicated falciparum malaria in
      an area of unstable and seasonal transmission in eastern Sudan. About 90% of
      malaria morbidity in this region occurs in the months of September to November,
      and very few malaria cases occur during the intensely arid Sudanese dry season
      and during years of drought. The malaria situation in the study site, the village
      of Daraweesh, was analysed during 3 consecutive malaria seasons in 1993-95 during
      which the 457 inhabitants suffered at total of 436 episodes of falciparum
      malaria. Using an Andersen-Gill proportional hazard model for recurrent events
      stratified by family, we have calculated the relative hazard for clinical malaria
      episodes by age, sex, haemoglobin genotype, blood type and infection in the
      previous season. The malaria risk was significantly lower in individuals aged 20
      88 years than in the 5-19 years age-group. The relative protection due to
      adulthood varied between seasons (relative risk, RR, 0x34 to 0x67). Serological
      data were not consistent with the hypothesis that the age difference in incidence
      was due to differences in exposure. During the 1993 season the malaria incidence
      in males was lower than in females (RR = 0x75), during the 1994 season the
      incidences were comparable, whereas males had an increased risk of malaria in
      1995 (RR = 1x87). The relative risk in individuals carrying the haemoglobin AS
      genotype compared to homozygous AA individuals was 0x57.

PMID- 11198649
TI  - Mosquito distribution and entomological inoculation rates in three malaria
      endemic areas in Gabon.
AB  - Mosquitoes were collected during 3 separate periods in 3 areas of different
      malaria transmission rates in the province of Moyen Ogooue, Gabon, within 1 year
      (July 1996-May 1997). The campus of the Albert Schweitzer Hospital (HAS) and 2
      villages, Bellevue and Tchad, were investigated. A total of 19,836 specimens were
      collected: 13,122 Mansonia, 3944 Anopheles, 2755 Culex and 15 Aedes were
      captured. The number of mosquitoes was 7896 and 7995 in July to August and from
      April to May respectively, and dropped to approximately half in November to
      December. The individual species showed a different distribution pattern in the 3
      study areas. In Tchad we found the lowest number of mosquitoes and also the
      fewest Anopheles, but when we investigated the number of Plasmodium falciparum
      infected Anopheles sp. we observed the highest entomological inoculation rate
      (EIR) there. The EIRs were 23 in HAS, 53 in Bellevue and 61 in Tchad. The method
      used to determine the number of infected mosquitoes was an enzyme-linked
      immunosorbent assay (ELISA), confirmed by a polymerase chain reaction-based
      approach. The ELISA alone revealed too many false-positive mosquitoes.

PMID- 11198650
TI  - Epidemic Schistosoma mansoni in a known S. haematobium area.
AB  - An epidemic of bloody diarrhoea was observed in 1997 and 1998 in Bessoum, north
      Cameroon. Of 1176 inhabitants, 16.7% went for medical consultation to a public
      health centre located 10 km away. This epidemic was probably due to the recent
      introduction of Schistosoma mansoni in an ancient focus of S. haematobium,
      following the development of irrigated farming. The prevalences amongst primary
      school children were 76.6% for S. haematobium in urine, and 60.9% for S. mansoni
      in stool. S. mansoni was found in urine in 28.1%. This epidemic emergence may be
      secondary to interspecific competition between the 2 schistosomes.

PMID- 11198651
TI  - Epidemiology of paragonimiasis in Colombia.
AB  - Five newly discovered endemic foci for paragonimiasis in Colombia are described
      for the first time. The disease was diagnosed in 24 people from the Embera Indian
      communities located at the Colombian Pacific Coast and investigated in 1993-98.
      We also describe the clinical, epidemiological and treatment response aspects. In
      these foci an Aroapyrgus sp. snail different from A. colombiensis was found to be
      the first intermediate host, and the crab Hypolobocera emberarum nsp. the second
      intermediate host.

PMID- 11198652
TI  - Meningitis seasonal pattern in Africa and detection of epidemics: a retrospective
      study in Niger, 1990-98.
AB  - Control of epidemic meningitis is still an unresolved problem in Africa. WHO has
      promoted the use of surveillance and response following alerts based on weekly
      threshold levels. In order to avoid any waste of resources related to false
      positive alerts, it was decided not to choose too sensitive thresholds. This
      policy, however, leads to delayed response. The seasonal pattern of epidemics
      provides a solution to this dilemma. We carried out a retrospective survey of
      district-level surveillance data in Niger from June 1990 to June 1998. We
      identified an early and late meningitis season. Following this pattern, we
      studied the performance of the WHO-recommended threshold as compared to
      alternative thresholds for identifying early, late and non-epidemic district
      years (DYs). (ADY was defined as a 52-week period starting in the last week of
      June, at the district level). We studied 296 DYs, comprising 50 early epidemic,
      38 late epidemic, and 208 non-epidemic DYs. Early epidemics were more often large
      and accounted for almost 75% of total cases. When applied no later than the first
      week of March, a highly sensitive alternative threshold resulted in initiation of
      an alert, with a median of 3 weeks earlier than the standard threshold, with no
      false-positive alerts, i.e., a specificity of 1.

PMID- 11198653
TI  - Seroprevalence of human herpesvirus 6 in Andino Punenos (Argentina).
AB  - We carried out a seroepidemiological survey to define the prevalence of human
      herpesvirus 6 (HHV6) infection in an aboriginal population (Andino Punenos) from
      a remote region in north-west Argentina. Antibodies against HHV6 (total IgG and
      the 4 subclasses of IgG) were studied in 84 serum samples (collected in 1995 and
      stored at -70 degrees C), using core blood mononuclear cells infected with HHV6
      in an immunofluorescence assay. Of the 84 samples, 70 (83%; 95% confidence
      interval, 75-91%) exhibited IgG antibodies against HHV6. No significant
      differences in the frequency of humoral immunity were found among the 4 age
      groups studied (mean ages 13, 31, 47 and 70 years) namely, 75%, 89.7%, 79.2% and
      100%, respectively. HHV6-specific IgG1 was found in all the positive serum
      samples tested but none of them contained specific IgG2, IgG3 and IgG4. These
      results confirmed a high rate of infection with HHV6 within this aboriginal group
      in Argentina and an IgG1 anti-HHV6 activity compatible with a maintenance of
      immunity.

PMID- 11198654
TI  - Serum antigen detection in the diagnosis, treatment, and follow-up of
      neurocysticercosis patients.
AB  - The efficacy of albendazole (ABZ) treatment for human neurocysticercosis (NCC)
      was assessed by using a monoclonal antibody-based parasite antigen detection
      ELISA which specifically detects the products of living cysticerci in human
      serum. The assay displayed 85% diagnostic sensitivity, detecting 39 of 46 NCC
      cases. Only patients with a single viable cyst or only enhancing lesions
      (degenerating parasites) were seronegative. Specificity of the assay was 92%
      (23/25) when tested in healthy Peruvian volunteers. In 'cured' patients, in whom
      all parasites died after ABZ therapy, parasite antigen levels fell sharply by 3
      months post treatment. This pattern was not observed in patients refractory to
      treatment. The sensitivity of the assay with serum samples, and its ability to
      identify successfully treated patients, make this monoclonal antibody-based ELISA
      the test of choice for the follow-up of NCC cases.

PMID- 11198655
TI  - Sputum concentration improves diagnosis of tuberculosis in a setting with a high
      prevalence of HIV.
AB  - Sputum microscopy for acid-fast bacilli (AFB), although relatively insensitive,
      is still the cornerstone of tuberculosis (TB) diagnosis in the developing world.
      Its diagnostic value has been eroded owing to the increasing number of HIV
      related smear-negative pulmonary TB cases. Concentration of sputum by
      centrifugation after liquefaction with sodium hypochlorite is a possible means of
      increasing the sensitivity of direct microscopy. This procedure has been studied
      recently in developing countries although with conflicting results. The aim of
      our study, performed in 1996 in Addis Ababa, Ethiopia, was to evaluate the
      sensitivity of the concentration method in a large cohort of consecutive patients
      with suspected pulmonary TB. We show that the overall sensitivity increased from
      54.2% using conventional direct microscopy to 63.1% after concentration (P <
      0x0015). In HIV-positive patients, sensitivity increased from 38.5% before to
      50.0% after concentration (P < 0x0034). The significant increase in yield of AFB
      in HIV-positive patients suggests that this method has a place in routine
      diagnosis of pulmonary TB in countries with a high prevalence of HIV.

PMID- 11198656
TI  - Detection of 'Norwalk-like viruses' in Vellore, southern India.

PMID- 11198657
TI  - Presence of pro-oxidants in plasma of patients suffering from falciparum malaria.
AB  - Haemolysis is the major cause of anaemia in acute Plasmodium falciparum malaria,
      destroying both parasitized and non-parasitized erythrocytes. Oxidative stress on
      erythrocytes is considered an important mechanism of haemolysis. Since non
      parasitized erythrocytes are also destroyed, the extracellular environment of the
      erythrocyte may be a contributor to the oxidative stress. To examine the
      influence of extracellular factors on oxidative stress and haemolysis, baseline
      values of erythrocyte thio-barbituric acid-reactive substance (ETBAR) and
      haemolytic indices such as plasma haemoglobin and lactate dehydrogenase (LDH)
      were estimated in 19 children in Orissa (India) with acute P. falciparum malaria
      (haemoglobin level < or = 70 g/L). The indices were measured after incubating
      cross-matched isogroup adult control erythrocytes with patient's plasma, and
      patient's erythrocytes with adult control plasma both in presence of and in
      absence of t-butyl hydroperoxide (t-BHP). The procedure was repeated in the blood
      of 19 age- and sex-matched non-malarial children. Baseline plasma LDH,
      haemoglobin and ETBAR concentrations were significantly greater in malaria
      patients than non-malarial children (P < 0.001 for all). Post-incubation values
      of ETBAR and plasma haemoglobin were significantly higher (P < 0.05) when adult
      control erythrocytes were incubated with patient plasma, and plasma haemoglobin
      was significantly higher (P < 0.05) in incubates of patient erythrocytes with
      adult control plasma, than their respective pre-incubation values when incubated
      in absence of t-BHP. These differences were not noticed in the incubates of non
      malarial children with healthy adult control samples. When incubated in presence
      of t-BHP all the post-incubation values in the patients were significantly higher
      than their respective pre-incubation values and post-incubation values without t
      BHP (P < 0.001). In non-malarial control samples, only ETBAR concentration was
      higher than their respective pre-incubation and post-incubation values without t
      BHP (P < 0.01). All the values for post-incubation samples with t-BHP were
      significantly higher in patients than controls (P < 0.001). In post-incubation
      samples of control erythrocytes and patient plasma in presence of t-BHP, ETBAR
      correlated inversely with pre-incubation haptoglobin values (P < 0.001). Thus,
      plasma of acute malaria patients appears to contain pro-oxidants, which may
      contribute to extracellular oxidative stress on both parasitized and non
      parasitized erythrocytes.

PMID- 11198658
TI  - Randomized comparison of mefloquine-artesunate versus quinine in the treatment of
      multidrug-resistant falciparum malaria in pregnancy.
AB  - Since no effective malaria prevention measures have been identified for pregnant
      women living on the western border of Thailand, prompt diagnosis and efficient
      treatment are paramount, although drug resistance in Plasmodium falciparum has
      narrowed the treatment options. An open randomized comparison of supervised
      quinine (10 mg salt/kg every 8 h) for 7 days (Q7) versus mefloquine 25 mg base/kg
      (total dose) plus artesunate 4 mg/kg per day for 3 days (MAS3) was conducted in
      1995-97 in 108 Karen women with acute uncomplicated falciparum malaria in the
      second or third trimesters of pregnancy. The MAS3 regimen was more effective than
      the Q7 regimen: day 63 cure rates were 98.2% (95% CI 94.7-100) (n = 65) for MAS3
      and 67.0% (95% CI 43x3-90x8) (n = 41) for Q7, P = 0x001. The MAS3 regimen was
      also associated with less gametocyte carriage; the average person-gametocyte
      weeks for MAS3 was 2.3 (95% CI 0-11) and for Q7 was 46x9 (95% CI 26-78) per 1000
      person-weeks, respectively (P < 0.001). MAS3 was significantly better tolerated.
      These evident advantages must be balanced against a possible increased risk of
      stillbirth with the use of mefloquine in pregnancy. Further randomized studies
      assessing the safety and efficacy of other artemisinin-containing combination
      regimens in pregnancy are needed urgently.

PMID- 11198659
TI  - The antimalarial activity of Vernonia amygdalina Del (Compositae).

PMID- 11198660
TI  - Miltefosine in a case of visceral leishmaniasis with HIV co-infection; and rising
      incidence of this disease in India.

PMID- 11198661
TI  - Safety and immunogenicity of a killed Leishmania (L.) amazonensis vaccine against
      cutaneous leishmaniasis in Colombia: a randomized controlled trial.
AB  - The safety and immunogenicity of an intramuscular (i.m.) and intradermal (ID)
      formulation of autoclaved Leishmania (Leishmania) amazonensis vaccine was
      evaluated in 296 volunteers in a randomized, placebo-controlled, double-blind
      trial in Colombia. There were 4 vaccination groups: i.m. vaccine, i.m. placebo,
      ID vaccine, and ID placebo. The ID formulations were mixed with BCG as adjuvant
      at the time of injection. For each group, 3 vaccinations were given with a 20-day
      interval between injections, and adverse events were monitored at 20 min, and at
      2, 7 and 21 days after each injection. BCG-induced adverse reactions resulted in
      cancellation of the third vaccine administration in the ID groups. Antibody
      titres did not differ significantly between the groups. Montenegro skin-test
      conversion was achieved by 86.4% and 90% of the i.m. vaccine group and by 25% and
      5% of the i.m. placebo group 80 days and 1 year after vaccination, respectively.
      A significant increase in mean Leishmania-antigen lymphocyte proliferation
      indexes was observed after i.m. vaccine immunization, but not after i.m. placebo
      immunization, 80 days and 1 year after vaccination. Significant levels of IFN
      gamma but not IL-10 were observed 1 year after vaccination in the i.m. vaccine
      group compared to the i.m. placebo group. The good safety profile and evidence of
      Th1 immune reactions due to i.m. vaccination in this phase-I/II study suggest
      that a population-based phase-III efficacy trial of the i.m. vaccine should be
      initiated.

PMID- 11198662
TI  - Chikungunya fever as a risk factor for endemic Burkitt's lymphoma in Malawi.
AB  - The geographical and age distributions of endemic Burkitt's lymphoma (eBL), in
      Africa, parallel those of certain arboviruses, which include chikungunya fever.
      Increased incidences of antibodies to assorted arboviruses, including
      chikungunya, have been found in eBL sera compared to controls. An increased
      incidence and space-time case-clusters of eBL occurred during a chikungunya fever
      epidemic which were confirmed by serology and clinical observation. The present
      study, conducted in 1987-89, involved 108 eBL patients, and 97 local and 111
      hospital controls. We examined, as hospital controls, patients with afebrile, non
      malignant conditions admitted to Kamuzu Central Hospital, Malawi, during the eBL
      patients' first admission there. Analyses were for hospital controls and eBL
      patients at the end of their first admission and for local controls and eBL
      patients at the beginning of their third admission, about 8 weeks after the day
      of first admission, because of the local controls' temporal bias. Patients in
      case-clusters were among those seropositive for chikungunya virus, with a history
      compatible with arbovirus infection preceding the lymphoma, suggesting
      involvement of chikungunya virus in the case-clusters and a possible association
      between recent infection with this virus and development of the lymphoma. eBL
      patients were significantly more likely to be seropositive for chikungunya virus
      antibody (68x5%) than either hospital controls (46.8%) or local controls (50x5%)
      (P = 0x002 and 0x009, respectively), raising the possibility of an association
      between infection with an arbovirus and developing eBL in children already primed
      by holoendemic malaria and Epstein-Barr virus infection.

PMID- 11198663
TI  - Development of anti-filarial antibodies in a group of expatriate mine-site
      workers with varying exposure to the disease.

PMID- 11198664
TI  - Detection of ehrlichiae in African ticks by polymerase chain reaction.

PMID- 11198665
TI  - The parting glass.

PMID- 11198666
TI  - Congratulations from the editor of Journal of Occupational and Environmental
      Medicine.

PMID- 11198667
TI  - The recollections and musings of a former editor.

PMID- 11198668
TI  - The three faces of Occupational Medicine: printed paper, problems in practice,
      and professional purpose.
AB  - The 50-year run of the journal Occupational Medicine and its forbears
      demonstrates the ways in which UK occupational medical practice has developed and
      changed since 1950. This has been in response to changes in society, technology
      and medicine. The journal has played an important part in education and
      professional development. It has also been the voice for the aspirations and
      concerns of its readers. Two aspects stand out: the development of occupational
      medicine as a specialty, and the way in which a medical model for occupational
      health service provision has been championed. A distinguished line of journal
      editors has been central to the crystallization of ideas within occupational
      medicine and their editorials map out professional successes and challenges over
      the years.

PMID- 11198669
TI  - Age and ageing: an overview.
AB  - Europe is ageing, as exemplified by the UK population where, in the foreseeable
      future, more people will be over than under age 50: industry appears slow to
      recognise and appreciate all that older workers still have to offer: bundling
      them off into early retirement wastes precious talents. Memory difficulty is not
      an inevitable part of ageing.

PMID- 11198670
TI  - Designing and managing healthy work for older workers.
AB  - Throughout many countries in the developed world, largely because of increasing
      life expectancy, the population is ageing. One of the economic implications of
      this demographic change is that workers may need to work longer and retire later
      than they have done in recent years. Much needs to be done to ensure that work
      remains a positive experience for workers throughout their career trajectories,
      and that it does not damage their health. The major contemporary challenges to
      health at work are those associated with the way work and work organizations are
      designed and managed. This is especially true for older workers. This paper
      focuses on the relationships between age and work performance, between age and
      work-related health, and between age and work-related stress. It concludes that
      there remains considerable scope for designing optimal work systems to harness
      the potential and protect the health of older workers. This important initiative
      will require a co-ordinated and multidisciplinary occupational health strategy.

PMID- 11198671
TI  - Acquisition and application of new technology skills: the influence of age.
AB  - This paper reviews the literature relating to the effects of ageing on the
      acquisition and application of new technology skills. Experiential,
      physiological, and cognitive factors are identified that place older adults at a
      disadvantage, relative to younger adults, when using new technologies. Consistent
      with this position, experimental evidence indicates an advantage for younger
      adults in speed of task performance, coupled with a tendency toward greater
      accuracy. The possibility that these differences can be overcome by means of
      training intervention is considered. However, it seems that age differences in
      performance persist, regardless of a training regime. Although some older adults
      are capable of high levels of performance, these tend to be individuals of high
      cognitive ability, relative to their peers. When age group means are considered,
      the only way that older adults are able to equal the performance of younger
      adults on new technology tasks is through additional practice.

PMID- 11198672
TI  - Ageing and fitness to work.
AB  - Ageing workers can be found in almost all occupations. Assessment of fitness to
      work in these workers is important, as it aims to match their functional capacity
      (which is reduced compared to younger workers), to the demands of their work
      (which may remain the same as that for younger workers). This outcome of
      assessment is influenced by the interaction between functional capacity, state of
      health, the nature of work, and possibilities for work accommodation. The
      assessment of functional capacity should include physical, mental and social
      capacity, as well as assessment of any disability. In addition to clinical or
      laboratory measurements, several authors have suggested the use of a 'work
      ability index' for specific occupations as a practical means of selecting the
      appropriate worker for the job. This index can also be used for monitoring
      functional capacity. In addition, as for any fitness to work assessment, a good
      understanding of the nature of the work and the work environment is required, and
      possibilities for work accommodations considered. While changes in the work
      environment and working conditions can be made to suit the functional capacity of
      the ageing worker, the maintenance of functional capacity is another important
      issue. There is a place for a greater role for disease screening and health
      promotion for such workers.

PMID- 11198673
TI  - What are the causes, prevention and treatment of hearing loss in the ageing
      worker?
AB  - Hearing loss is more common in the ageing population as compared to young adults.
      Individuals are not protected from other causes of hearing loss just because they
      are in work. Their hearing may therefore be at risk from causes not related to
      their occupation. Some factors may be synergistically linked to noise exposure,
      thus increasing the effect of noise on hearing. Although some traumatic and
      infective causes of hearing loss are amenable to treatment, most occupational
      hearing loss is not curable once present and rehabilitative measures are the only
      option. General health and safety measures must be maintained throughout a
      worker's employment whatever their age.

PMID- 11198674
TI  - Surveillance of work-related diseases by occupational physicians in the UK: OPRA
      1996-1999.
AB  - The Occupational Physicians' Reporting Activity (OPRA) surveillance scheme for
      occupational physicians has now been in place for 4 years. During this period, an
      estimated 43,764 new cases of work-related disease have been reported.
      Musculoskeletal conditions make up nearly half (49%) of all cases; mental ill
      health and skin disease account for 20% each, with respiratory conditions (8%)
      and hearing loss (5%) seen in lower proportions. Overall, eight of 42 diagnoses
      made up four-fifths of the new cases reported by occupational physicians. These
      were hand and arm disorders (8052 estimated cases), contact dermatitis (7104),
      disorders of the lumbar spine (6000), anxiety and depression (4788), work-related
      stress (3336), hearing loss (2100), elbow disorders (2040), and asthma (1680).
      Dermatitis and hearing loss were most frequent in manufacturing industries, lower
      back complaints in health care, and upper limb disorders in automotive
      manufacture. Psychiatric illnesses presented a different pattern, mainly
      affecting those in health, education and social service.

PMID- 11198675
TI  - Non-attendance for Social Security medical examination: patients who cannot
      afford to get better?
AB  - This paper reports results from a cross-sectional study of 290 consecutive
      Invalidity Benefit cases in the north-west of England referred to the Benefits
      Agency Medical Service in 1994. The hypothesis is that socio-economic factors,
      such as high locality unemployment rates, may be implicated, not only in the
      initial causation of ill health, but also in its continuance, by giving incentive
      to the ongoing adoption of the sick role. Results showed that residence in
      Liverpool, a diagnosis of anxiety/depression or simple back pain, and age under
      40 years were all significantly related to non-attendance (P < 0.01). Claimants
      from Liverpool were also younger, overall, more likely to be called for
      examination, but less likely to be found fit for work if they attended. This
      suggests that some claimants may not attend examination because they fear being
      found fit for work and losing the benefit on which they and their families
      depend.

PMID- 11198676
TI  - Cytochrome P450-2E1 and glutathione S-transferase mu polymorphisms among
      Caucasians and mulattoes from Brazil.
AB  - The variable interindividual ability to metabolize environmental toxicants, also
      known as metabolic polymorphism, may be of substantial importance in the
      modulation of cancer risk. The ethnic distribution of these polymorphisms could
      be interesting in order to establish an association with cancer risk or even to
      establish selective advantage of some genotypes. Cytochrome P450 2E1 (CYP2E1) is
      a secondary enzyme that can metabolize ethanol, and glutathione S-transferase
      (GSTM1) is thought to be involved in the detoxification of epoxides and
      polycyclic aromatic hydrocarbons. Mutation in these genes was investigated in a
      random sample of healthy subjects from Sao Paulo, Brazil, which included 206
      Caucasians and 86 mulattoes. Pst I restriction fragment length polymorphism
      (RFLP) in the 5'-flanking region of the CYP2E1 gene has been identified in 10.2%
      of Caucasian individuals and in 11.6% of mulattoes. For GSTM1 the frequency of
      the null genotype was significantly higher in Caucasian individuals (60.2%) than
      in mulattoes (41.9%). Allele frequencies were (1) CYP2E1 locus: P = 0.949, q =
      0.051, se(p) = se(q) = 0.011 among Caucasians; and p = 0.942; q = 0.058; se(P) =
      se'(q) = 0.018 among mulattoes; and (2) GSTM1 locus: p = 0.224, q = 0.776, se(p)
      = se(q) = 0.022 among Caucasians; and p = 0.353; q = 0.647; se(p) = se(q) = 0.041
      among mulattoes.

PMID- 11198677
TI  - Burnout syndrome: a disease of modern societies?
AB  - In the light of social change and a transformation in the work situation,
      interest in the problem of burnout has grown over the past decade. There is a
      conspicuous discrepancy, however, between what is regarded as certain knowledge
      and what is published opinion. To date, there is no generally accepted definition
      of burnout, or binding diagnostic criteria. According to the most common
      description at present, burnout syndrome is characterized by exhaustion,
      depersonalization and reduced satisfaction in performance. Because of its
      aetiopathogenesis, burnout is today mainly regarded as the result of chronic
      stress which has not been successfully dealt with. This paper gives an overview
      of the current definition for burnout syndrome and states possible contemporary
      hypotheses for its aetiology. By examining diagnostic criteria and possible
      therapies, methods of prevention are discussed. There is an urgent need for
      further investigations to determine whether burnout syndrome is a work-related
      disease.

PMID- 11198678
TI  - An investigation of the relationship between psychological health and workload
      among managers.
AB  - BACKGROUND: Anecdotally, many workers complain of stress at work. However, the
      relationship between work and stress needs clarification to allow risk assessment
      and risk management of this hazard in the workplace. OBJECTIVES: To examine
      relationships between working hours, perceived work stressors, and psychological
      health in a group of managers. METHODS: Managers at two factories were invited to
      participate in an anonymous cross-sectional survey. All were asked to complete a
      work diary for a period of 1 week and a questionnaire comprising the 30-item
      General Health Questionnaire, an anxiety and depression scale, and questions
      identifying perceived workplace stressors. RESULTS: Over 60% of managers were
      above the threshold of caseness on at least one measure of psychological health.
      No statistically significant relationship was demonstrated between actual hours
      of work and psychological health. A relationship was demonstrated between some
      perceived workplace stressors and actual hours worked, and between some perceived
      workplace stressors and psychological health. CONCLUSIONS: A large proportion of
      managers in a typical production environment appeared at risk of developing
      psychological illness. Hours of work were not directly related to psychological
      health, but were significantly associated with individual perception of some work
      stressors which, in turn, were associated with measures of psychological health.
      Perceived workload appeared more important in determining psychological health
      than actual workload.

PMID- 11198679
TI  - Occupational health in the USA in the 21st century.
AB  - Comparable to the confusion encountered in the birth of the machine age is the
      perplexing reconfiguration of the United States' health care system. Paralleling
      the advances in medicine have been the divesting mergers and downsizing of
      industry, coupled with globalization, which have released millions of long-time
      workers. The labour contingent is changing, with the addition of great numbers of
      women and immigrant workers, and the manufacturing economy has become one of
      service and information. Serving the occupational health (OH) needs of such a
      force have been the professional societies of physicians, nurses, and industrial
      hygienists, with their members providing care in a broad variety of facilities.
      It is possible that a national organization, including all these disciplines,
      would have a greater voice in the protection of workers' health. Immediate
      leadership of an occupational health service (OHS) can be rotated among the
      disciplines, so that competition for primacy among the professionals would end.
      The new workforce demands culture sensitivity among OH personnel and polylingual
      capabilities may be demanded in the future. Management skills will be required of
      all in OH, and greater participation of employees in OH policy will characterize
      the decades ahead. Nearly neglected up to now, occupational mental health
      programming will be required to meet the real needs of workers, and to counter
      the move to outsource OH services, where little patient contact results.
      Behavioural safety, total quality management, and application of the rapidly
      developing technologies in health care will define the 21st century efforts in
      OH. Remaining issues, such as violence, telecommuting injuries, the inclusion of
      alternative medicine, and women's health, among others, will see carry-over for
      resolution into the year 2000.

PMID- 11198680
TI  - Do symptomatic radiographers provide evidence for 'darkroom disease'? Nallon et
      al. Occup Med 2000; 50: 1:39-42.

PMID- 11198681
TI  - Do symptomatic radiographers provide evidence for 'darkroom disease'? Nallon et
      al. Occup Med 2000; 50: 39-42.

PMID- 11198682
TI  - Does vacation enable recuperation? Changes in well-being associated with time
      away from work. Strauss-Blasche et al. Occup Med 2000; 50: 167-172.

PMID- 11198683
TI  - It's official: evaluative research must become part of routine care in the NHS.

PMID- 11198684
TI  - Expedition health and safety: a risk assessment.
AB  - Little has been published on the risks of participating in an expedition. A
      questionnaire survey was conducted to quantify those risks and to determine how
      expedition organizers plan for medical mishaps. 246 expeditions, taking 2381
      participants to more than one hundred countries, were studied retrospectively. 65
      expeditions (26%) reported no medical incidents; the remaining 181 reported 835
      in 130,000 man-days (6.4 per 1000 man-days). 59% of the medical incidents seen on
      expeditions were preventable, one-third of these being due to gastrointestinal
      upsets. 78% of medical incidents were classified as minor and only 5% (40) as
      serious. There was no excess of serious incidents in any particular
      organizational group or environment. The findings of this survey suggest that the
      health risks of participating in a well-planned expedition are similar to those
      encountered during normal active life.

PMID- 11198685
TI  - General practitioners' attitudes to sexual activity in under-sixteens.
AB  - In the UK, under-sixteen-year-olds with some exceptions can be provided with
      contraceptive care even if unwilling to inform their parents. Nonetheless, many
      teenagers express doubts about confidentiality in these circumstances, as well as
      fear of being judged. The attitudes of general practitioners in North and East
      Devon towards the Gillick ruling regarding the treatment of under sixteens for
      sexual health matters were assessed. They were asked to indicate their level of
      agreement or disagreement with a series of statements. 235 (73%) responded, and
      only 15 (6.5%) rejected the notion that the same duty of confidentiality applies
      to under-sixteens as to older patients. 76% did, however, prefer parents to know
      they had been consulted about contraception. Only 7 GPs believed that provision
      of contraception encourages under-age sex. Despite GPs' general acknowledgment of
      the importance of confidentiality in relation to sexual activity, teenagers may
      well be discouraged from seeking advice if they expect strong pressure to tell
      their parents.

PMID- 11198686
TI  - Knowledge and the Internet.

PMID- 11198687
TI  - Medical constraints on the quantum mind.

PMID- 11198688
TI  - Colorectal liver metastases: alternatives to resection.

PMID- 11198689
TI  - Public health outputs from the British Paediatric Surveillance Unit and similar
      clinician-based systems.

PMID- 11198690
TI  - Primary angiitis of the central nervous system.

PMID- 11198691
TI  - Evolving electrocardiographic changes in a patient with hyperthyroidism.

PMID- 11198692
TI  - Hermansky-Pudlak syndrome presenting with subdural haematoma and retinal
      haemorrhages in infancy.

PMID- 11198693
TI  - Sucking noise and collapse after central venous catheter removal.

PMID- 11198694
TI  - Femoral vein obstruction with an arthritic hip.

PMID- 11198695
TI  - Reversible dementia in Paget's disease.

PMID- 11198696
TI  - Two historical cases of giant epidermoid cyst of the skull, treated surgically.

PMID- 11198697
TI  - Clinical judgment.

PMID- 11198698
TI  - Surgical treatment for hidradenitis suppurativa.

PMID- 11198699
TI  - Innovation in the pharmaceutical industry.

PMID- 11198700
TI  - Educating health professionals about disability.

PMID- 11198701
TI  - A puzzle: where was the airgun pellet?

PMID- 11198702
TI  - Use of autologous limbal epithelial cells cultured on amniotic membranes for
      unilateral stem cell deficiency.

PMID- 11198703
TI  - A comparison of correlates of DSM-IV alcohol abuse or dependence among more than
      400 sons of alcoholics and controls.
AB  - BACKGROUND: Alcohol dependence and abuse are defined as separate disorders.
      However, relatively few data are available about whether the same characteristics
      predict both syndromes. METHODS: Complete data were available from the 15 year
      follow-up of 411 men who originally had been evaluated from a university
      population at about age 20. Both baseline data gathered prospectively and the
      retrospective ratings in six domains of life functioning were analyzed for their
      relationship to the development of alcohol abuse or dependence during the follow
      up. RESULTS: Baseline characteristics of a family history of substance use
      disorders, the quantity and frequency of drinking, the history of alcohol-related
      problems, and the level of response to alcohol all predicted future alcohol abuse
      or dependence, but only an alcoholic second-degree relative or a first-degree
      drug-dependent family member differentially predicted dependence. Logistic
      regression analyses revealed that similar baseline characteristics combined to
      predict dependence and, separately, abuse. When the domains of functioning during
      the 15 years were included, positive alcohol expectancies, poor coping
      mechanisms, low level of social support, and drinking in the environment
      contributed to both dependence and abuse, although the relationship was stronger
      for dependence. CONCLUSIONS: The predictors and correlates of alcohol abuse and
      dependence in this group of men were similar. Further research in additional
      populations and on other drugs is needed to determine if the two syndromes
      overlap sufficiently to be combined.

PMID- 11198704
TI  - Effect of repeated exposure to alcohol on the response of the hypothalamic
      pituitary-adrenal axis of the rat: II. Role of the length and regimen of alcohol
      treatment.
AB  - BACKGROUND: Prior exposure to alcohol alters the adrenocorticotropin hormone
      (ACTH) response to a second drug challenge administered several days later. We
      used three models of alcohol treatment to investigate the mechanisms that may be
      involved in this phenomenon. METHODS: Adult male rats were exposed to alcohol
      vapors daily for 3 days (4-4.5 hr/day) and then were exposed to shocks or an
      intragastric injection of alcohol 7 days later (group A); were injected daily
      with alcohol (4.5 g/kg intragastrically) for 3 days and then exposed to shocks or
      an intragastric injection of alcohol 7 days later (group B); or were exposed to
      alcohol vapors for 6 days and exposed to shocks or an intragastric injection 24
      hr later (group C). Control animals were not exposed to the vapors or received
      the appropriate vehicle. RESULTS: Compared with animals administered the vehicle,
      rats of groups A and B that had been exposed to alcohol all exhibited a
      significantly decreased ACTH response to a second drug challenge. In contrast,
      their ACTH response to footshocks was statistically comparable to that of vehicle
      pretreated animals. Rats of group C that had been exposed to alcohol for 6 days
      also showed decreased ACTH release when injected with alcohol 7 days later while
      responding normally to shocks. Measurement of anterior pituitary pro
      opiomelanocortin indicated that alcohol pretreatment had produced a 54% increase
      of these transcripts in group C and a 27% decrease in group A. There were no
      changes in pituitary receptors type 1 for corticotropin-releasing factor (CRFR1)
      in any of the groups. CONCLUSION: Regardless of whether they are delivered
      shortly before an acute alcohol injection or several days earlier, alcohol vapors
      or injections interfere with the ACTH response to the drug but not to shocks. Our
      results also suggest that changes in ACTH responses may not be correlated
      directly with small changes in pituitary pro-opiomelanocortin or CRFR1 mRNA
      levels.

PMID- 11198705
TI  - Thiamin treatment and working memory function of alcohol-dependent people:
      preliminary findings.
AB  - BACKGROUND: Wernicke-Korsakoff syndrome (WKS) is most often seen in people who
      are alcohol dependent. Treatment with thiamin may rapidly resolve acute symptoms.
      However, much evidence suggests that identification of WKS on clinical
      examination is relatively insensitive when compared with diagnosis at postmortem.
      No study has investigated the therapeutic effect of thiamin in a sample of
      alcohol-dependent people without the clinical triad of acute WKS. METHODS: We
      conducted a randomized, double-blind, multidose study of thiamin treatment in 107
      subjects who were detoxifying from alcohol. Five groups of subjects were assessed
      with the Mini-Mental State Examination and were examined for the presence of
      neurological signs. Subjects were given different doses of intramuscular thiamin
      for two consecutive days. The posttreatment performance of these groups then was
      examined on a test of working memory derived from comparative neuropsychology,
      namely, the delayed alternation task. This test has been established as sensitive
      to the neuropathology of WKS. RESULTS: Pretreatment measures of mental status and
      neurological signs were equivalent across groups. Groups were equated with
      respect to the background variables of age, education, typical daily alcohol
      consumption, and years of drinking. On the posttreatment measure, a superior
      performance was found in the group that received the highest dose of thiamin,
      compared with the other four treatment groups. CONCLUSIONS: A therapeutic
      relationship between dose and working memory performance was indicated. These
      results have important implications for the management and prevention of WKS, but
      further investigations are needed to substantiate the nature of the therapeutic
      relationship.

PMID- 11198706
TI  - Alcohol and behavioral control: cognitive and neural mechanisms.
AB  - This article represents the proceedings of a symposium at the 2000 RSA Meeting in
      Denver, Colorado. The organizer/chair was Muriel Vogel-Sprott. The presentations
      were (1) Alcohol-induced impairment of inhibitory control: Some commonalities
      with attention deficit hyperactivity disorder, by Mark Fillmore; (2) Neural
      interactions that underlie response inhibition under alcohol: A functional
      magnetic resonance imaging investigation, by Craig Easdon; (3) Intentional
      control of behavior under alcohol, by Muriel Vogel-Sprott; and (4) Working memory
      and the disinhibiting effects of alcohol on passive avoidance learning, by Alicia
      Justius and Peter Finn.

PMID- 11198707
TI  - Differences in services utilization between white and Mexican American DUI
      arrestees.
AB  - BACKGROUND: Hispanics traditionally have been considered an underserved
      population in relation to medical care and related services utilization. METHODS:
      Selected health and social services utilization (both alcohol-specific and non
      alcohol-specific) during the last year was compared between a sample of 249
      Mexican American (half of whom were born in Mexico) and 250 white participants
      interviewed in all five DUI (driving under the influence) treatment programs in
      one northern California county. RESULTS: Among those who met DSM-IV criteria for
      alcohol dependence and/or alcohol abuse, 49% of the white subjects compared with
      59% of the Mexican American subjects reported no utilization, 77% of whites and
      82% of Mexican Americans reported no utilization in which drinking was a factor,
      and 70% of whites and 80% of Mexican Americans reported no contact with an
      alcohol program. Mexican Americans were also significantly less likely to report
      contact with more than one program, and among Mexican Americans, those born in
      Mexico were significantly less likely to report utilization than those born in
      the U.S. CONCLUSIONS: The data suggest that despite the higher rates of heavy
      drinking found among Mexican American DUI arrestees (especially those born in
      Mexico) in this sample, Mexican Americans with an alcohol use disorder are less
      likely to use health and social services than whites, and this may be related to
      country of birth and related variables that include health insurance.
      SIGNIFICANCE: The data suggest that DUI programs may offer one of the few
      opportunities Mexican American problem drinkers have of establishing contact with
      the health and social service system and, as such, would be well positioned to
      also offer other types of alcohol-related health and social services and
      referrals to this underserved population. These findings have implications for
      intervention efforts for problem drinking and prevention of DUI among Mexican
      Americans, which are a rapidly growing ethnic minority in California.

PMID- 11198708
TI  - Improving alcoholism treatment across the spectrum of services.
AB  - This article represents the proceedings of a symposium at the 2000 RSA Meeting in
      Denver, Colorado. The chair was Michael E. Hilton. The presentations were (1) The
      effects of brief advice and motivational enhancement on alcohol use and related
      variables in primary care, by Stephen A. Maisto, Joseph Conigliaro, Melissa
      McNiel, Kevin Kraemer, Mary E. Kelley, and Rosemarie Conigliaro; (2) Enhanced
      linkage of alcohol dependent persons to primary medical care: A randomized
      controlled trial of a multidisciplinary health evaluation in a detoxification
      unit, by Jeffrey H. Samet, Mary Jo Larson, Jacqueline Savetsky, Michael Winter,
      Lisa M. Sullivan, and Richard Saitz; (3) Cost-effectiveness of day hospital
      versus traditional alcohol and drug outpatient treatment in a health maintenance
      organization: Randomized and self-selected samples, by Constance Weisner,
      Jennifer Mertens, Sujaya Parthasarathy, Charles Moore, Enid Hunkeler, Teh-Wei Hu,
      and Joe Selby; and (4) Case monitoring for alcoholics: One year clinical and
      health cost effects, by Robert L. Stout, William Zywiak, Amy Rubin, William
      Zwick, Mary Jo Larson, and Don Shepard.

PMID- 11198709
TI  - Genetic and environmental influences on alcohol metabolism in humans.
AB  - This manuscript represents the proceedings of a symposium at the 2000 RSA Meeting
      in Denver, Colorado. The organizer/chair was Ting-Kai Li. The presentations were:
      (1) Introduction to the Symposium, by Ting-Kai Li; (2) ALDH2 polymorphism and
      alcohol metabolism, by Shih-Jiun Yin; (3) ALDH2 promoter polymorphism and alcohol
      metabolism, by David W. Crabb; (4) Use of BrAC clamping to estimate alcohol
      elimination rates: Application to studies of the influence of genetic and
      environmental determinants, by Sean O'Connor; and (5) Effect of food and food
      composition on alcohol elimination rates as determined by clamping, by Vijay A.
      Ramchandani.

PMID- 11198710
TI  - Nursing experiences with an alcohol-intoxicated rat dam counteract appetitive
      conditioned responses toward alcohol.
AB  - BACKGROUND: Infant rats detect small amounts of alcohol (175 mg%) that are
      present in maternal milk whenever the dam is moderately intoxicated with alcohol.
      Interaction with an alcohol-intoxicated mother during the first 2 weeks of life
      facilitates the preweanling's subsequent discrimination of alcohol's orosensory
      attributes and produces conditioned aversion to alcohol. The present study
      further analyzed the hedonic content of infantile alcohol memories established in
      the nursing context by testing the interaction between experiences with an
      alcohol-intoxicated dam and learning procedures aimed at establishing an
      appetitive conditioned response toward alcohol. METHODS: Experiment 1 was to
      determine appropriate parameters to establish a reliable conditioned preference
      for alcohol in 16-day-old infants. For conditioning, intraorally infused sucrose
      solution (appetitive reinforcer) was paired with alcohol's orosensory cues
      derived from an acute state of alcohol intoxication (3 g/kg). Two control groups
      included an unpaired condition and a group given sucrose after water intubation.
      Infants then were evaluated in an alcohol intake test. Relative to control
      animals, a reliable conditioned preference for alcohol was registered in paired
      pups. In experiment 2, these conditioning procedures were applied to infant rats
      which, before conditioning, suckled from dams subjected to a 2.5 g/kg alcohol
      dose (intragastric) or from water-treated females during postpartum days 3, 5, 7,
      9, 11, and 13. RESULTS: Experiment 2 showed that maternal treatment significantly
      affected the establishment of conditioned preferences for alcohol. Whereas pups
      reared by control dams exhibited reliable appetitive conditioning to alcohol,
      infants raised by alcohol dams completely failed to develop appetitive
      conditioning. CONCLUSIONS: The present results suggest that alcohol-related
      memories generated via infantile interactions with an intoxicated dam counteract
      subsequent conditioning of alcohol ingestion. In conjunction with prior studies,
      it is concluded that alcohol-related nursing experiences are capable of promoting
      alcohol memories with a negative hedonic content.

PMID- 11198711
TI  - Suppression of ethanol responding by centrally administered CTOP and naltrindole
      in AA and Wistar rats.
AB  - BACKGROUND: Both mu- and delta-opioid receptors have been implicated in the
      reinforcing actions of ethanol. However, selective opioid receptor antagonists
      have not altered ethanol intake in all rodent strains consistently, which
      suggests that genotype may modulate their suppressive effects. Therefore, we
      tested the effects of the selective mu-antagonist D-Pen-Cys-Tyr-D-Trp-Orn-Thr-Pen
      Thr-NH2 (CTOP) and the selective delta-antagonist naltrindole in both high
      drinking AA (Alko, Alcohol) and heterogeneous Wistar rats. METHODS: AA and Wistar
      rats were trained to respond for ethanol (10% w/v) in a two-lever operant
      condition by using a saccharin fading procedure. After stable baseline responding
      was established, rats were implanted stereotaxically either with a guide cannula
      above the lateral ventricle or with bilateral cannulas above the nucleus
      accumbens, basolateral amygdala, or ventral tegmental area. After postoperative
      recovery, AA and Wistar animals were tested after intracerebroventricular
      microinjections of either CTOP (0-3 microg) or naltrindole (0-30 microg) or
      subcutaneous injections of naloxone (0-1 g/kg), which was used as a reference
      antagonist. Effects of intracerebral microinjections of CTOP and naltrindole
      (both 0-500 ng) were tested only in Wistar rats. RESULTS: Subcutaneous naloxone
      and intracerebroventricular CTOP and naltrindole suppressed ethanol self
      administration in a similar manner in AA and Wistar rats. Cumulative response
      patterns indicated that naloxone and naltrindole had no effect on the initiation
      of responding but suppressed it later during the session, whereas CTOP also
      affected initiation. In Wistar rats, naltrindole microinjections into both the
      nucleus accumbens and basolateral amygdala decreased ethanol responding, whereas
      CTOP was effective only in the amygdala. Injections of these antagonists into the
      ventral tegmental area had little effect on ethanol intake. CONCLUSIONS: The
      results confirm previous results which showed that both mu- and delta-opioid
      receptors are involved in the regulation of ethanol self-administration and
      indicate that genetic differences between AA and Wistar rats produced by
      selection do not modify the effects of opioid antagonists. The nucleus accumbens
      and the basolateral amygdala may be important central sites for the mediation of
      their suppressive effects.

PMID- 11198712
TI  - Possible reasons why heavy drinking increases carbohydrate-deficient transferrin.
AB  - BACKGROUND: Transferrin is a globular protein synthesized in the liver that is
      responsible for iron transport in plasma. The structure of the molecule consists
      of two carbohydrate residues to which six sialic acid moieties can be attached.
      After periods of chronic, heavy alcohol consumption, carbohydrate-deficient
      transferrin (CDT) isoforms often increase, which makes CDT a useful marker in
      screening for alcohol abuse and monitoring progress of alcoholics in treatment.
      However, the precise mechanism behind CDT increase remains unknown. METHODS: A
      review of the most relevant literature on CDT was conducted with a computer
      assisted literature search. RESULTS: During the past several years, a number of
      studies have explored possible mechanisms that may account for the alcohol
      induced increase of CDT. An inhibition of protein synthesis and a general effect
      of alcohol on protein glycosylation have been reported. Although the exact
      mechanisms that underlie production of CDT are not yet fully understood, possible
      bases for the phenomenon are presented in this article. CONCLUSIONS: Experimental
      findings indicate that the ethanol-induced effect on glycoprotein metabolism is a
      multistep process in which protein transport and changes of enzyme activity may
      play an important role.

PMID- 11198713
TI  - Adverse drinking consequences among alcohol abusing intravenous drug users.
AB  - BACKGROUND: Heavy alcohol use is common among out-of-treatment injection drug
      users (IDUs); however, the relationship between alcohol and drug use behaviors in
      codependent populations is not well understood. Our specific objectives were (1)
      to describe the psychometric properties of the Drinker Inventory of Consequences
      (DrInC) in a sample of active IDUs, and (2) to compare DrInC scores of active
      IDUs with those reported for the alcohol treatment seeking sample on which the
      instrument was developed. METHODS: Interview data were collected from 187 active
      IDUs who scored positively (> or = 8) on the Alcohol Use Disorders Identification
      Test, who were recruited from a Providence, RI, needle exchange program (1998
      1999). DrInC total and subscale scores for the 159 (85%) participants who met DSM
      IV criteria for alcohol abuse/dependence were analyzed. Six-month follow-up data
      were used to estimate test-retest reliability. RESULTS: The DrInC total scale
      exhibited high internal consistency and test-retest reliability. With the
      exception of adverse physical consequences, reliability estimates for DrInC
      subscales were good to very good. These data indicate higher subscale redundancy
      than reported for the development sample. Active IDUs had significantly higher
      adverse impulse control consequences than the alcohol treatment seeking
      population on which the instrument was developed. CONCLUSIONS: The DrInC exhibits
      desirable psychometric properties for assessing adverse drinking consequences in
      active IDU populations. IDUs who met DSM-IV criteria for alcohol abuse/dependence
      reported overall levels of adverse drinking consequences comparable with non-IDU
      alcohol treatment populations but were more likely to exhibit adverse impulse
      control consequences.

PMID- 11198714
TI  - Detection of alcohol abuse in neurological patients: variables of clinical
      relevance to the accuracy of the %CDT-TIA and CDTect methods.
AB  - OBJECTIVES: Alcohol-related neurological diseases are encountered frequently.
      Early diagnosis is essential, because minimal intervention effectively reduces
      hazardous alcohol consumption and may prevent permanent neurological damage.
      Carbohydrate-deficient transferrin (CDT) is a valuable tool for the
      identification of alcohol abuse, but for unselected patient populations, reduced
      test accuracy has been reported. Recently, factors other than alcohol use have
      been shown to influence CDT levels. Our aim was to identify clinically relevant
      factors that might reduce test accuracy. MATERIAL AND METHODS: We included 397
      neurological patients consecutively hospitalized for seizures, ischemic stroke,
      or sciatica and 87 patients who attended routine outpatient controls for
      epilepsy. Blood samples were analyzed for CDT by using two commercially available
      tests, %CDT-TIA and CDTect. All patients underwent a semistructured clinical
      interview that included a record of the reported ethanol consumption during the
      last 8 days, and all completed the Alcohol Use Disorders Identification Test
      (AUDIT). Current medication, medical history, and demographic information also
      were obtained. RESULTS: Both tests were elevated in female antiepileptic drug
      users, compared with others who reported no recent ethanol intake. A higher
      number of false-positive cases was seen for CDTect than for %CDT. Various
      combinations of CDT and gamma-glutamyltransferase improved sensitivity, but at
      the cost of reduced specificity. Variables that predicted the variation of CDT
      included antiepileptic drug use, sex, body mass index, and smoking. Total
      transferrin levels were reduced significantly in postmenopausal women, whereas a
      falling trend was seen for CDTect. Transferrin alterations caused a higher number
      of false-positive results for CDTect than for %CDT. The area under the receiver
      operating characteristics curve for women was higher for CDTect than for %CDT,
      and for %CDT, the area under the receiver operating characteristics curve was
      higher for men than for women. CONCLUSION: The accuracy of CDT for detection of
      alcohol abuse in neurological patients was generally low, particularly for women.
      Combination variables of CDT and gamma-glutamyltransferase did not increase test
      accuracy. Variables that were associated with higher CDT levels included female
      sex, antiepileptic drug use, transferrin alterations, and possibly low body mass
      index. When factors known to cause poor accuracy in particular patient groups are
      appreciated, CDT may be a good adjunct to the clinical examination.

PMID- 11198715
TI  - Injury risk among medically identified alcohol and drug abusers.
AB  - BACKGROUND: Although nonfatal injury prevalence is higher among substance abusers
      than in the general population, few studies have estimated the injury risk for
      clinically recognized substance abusers. The extant studies, moreover, analyze
      rates of visits for injury treatment rather than rates of injury events. This
      study estimates the excess risk of medically treated and hospitalized
      nonoccupational injury for people under age 65 with medically identified
      substance abuse problems and private health care coverage. METHOD: We conducted a
      retrospective cohort study by using medical claims data from Medstat Systems,
      Inc., with a longitudinal database of health care claims for 1.5 million people
      with health care coverage from 70 large corporations. Claims histories for anyone
      who had an alcohol-related or drug-related primary or secondary diagnosis during
      1987 to 1989 were analyzed. A random sample was selected from the remaining
      people without a substance abuse diagnosis in their medical records. Injury rates
      were compared among groups. We used logistic regression to estimate odds of
      medically treated and hospitalized injury, controlling for demographics. RESULTS:
      Medically identified substance abusers had an elevated risk of injury in a 3-year
      period; alcohol and drug abusers had the highest risk (58%), followed by drug
      only abusers (49%), alcohol-only abusers (46%), and controls (38%). Alcohol and
      drug abusers were almost four times as likely to be hospitalized for an injury in
      a 3-year period when compared with controls. Injury risks were elevated
      substantially more for female then male substance abusers. CONCLUSIONS: This
      study greatly improves on available information about the risk of injury for drug
      and multiple-substance abusers. Medically identified substance abusers,
      especially adult women, have a higher probability of injury, more hospitalized
      injuries, and more injury episodes per person injured than nonabusers. More
      aggressive identification and subsequent treatment of female substance abusers
      appear warranted.

PMID- 11198716
TI  - Genetic influences on craniofacial outcome in an avian model of prenatal alcohol
      exposure.
AB  - BACKGROUND: Understanding the basis for ethanol's teratogenic effects may inform
      the etiology of fetal alcohol syndrome. Here we investigate how genetic
      background and susceptibility to ethanol-induced neural crest apoptosis
      contribute to the distinctive craniofacial phenotype observed after prenatal
      alcohol exposure. METHODS: Nine different chick strains were exposed to ethanol
      at gastrulation. The sensitivity of these embryos to ethanol-induced neural crest
      apoptosis was reported elsewhere (Debelak and Smith, 2000). Here, these embryos
      were permitted to develop until embryonic day 10, when facial morphogenesis was
      largely complete, and cephalometric measurements were made on cleared skulls.
      Shifts in facial growth were correlated against the severity of ethanol-induced
      apoptosis in facial precursors. RESULTS: The facial shape produced by ethanol
      exposure was a function of the embryos' genetic strain. Three general responses
      were observed: apparent midfacial flattening (Babcock B300 x Hampshire Red, ISA
      Babcock, HyLine W98, and HyLine W36 strains), overall facial expansion (Spafas
      and Babcock B300 strains), or overall facial hypoplasia (DeKalb strains). When
      dose and timing of exposure were held constant, the embryo's genetic background
      predicted the facial outcome. For ethanol-sensitive strains, apoptosis of facial
      precursor populations was required to produce the facial defects. That some
      strains had essentially normal faces despite extensive cell death indicated a
      capacity to recover from the earlier neural crest losses. CONCLUSIONS: We propose
      that ethanol's effects on craniofacial development are multifactoral, and these
      influences may include susceptibility to apoptosis, regenerative capacity, and
      compensatory outgrowth of the facial primordia. The embryo's genetic background
      may modulate these events. The high and low responder chick strains are useful
      tools to dissect these contributions.

PMID- 11198717
TI  - Reduced seizure threshold and hippocampal cell loss in rats exposed to alcohol
      during the brain growth spurt.
AB  - BACKGROUND: Epilepsy is a prominent sign of neurologic dysfunction in some
      children with fetal alcohol syndrome (FAS). However, it is unknown whether the
      epileptic disorders in these children are directly due to the neuroteratogenic
      effects of alcohol or to some other factor accompanying maternal alcoholism. The
      hippocampus is vulnerable to alcohol-induced pathologic changes, and dysfunction
      of the hippocampus often manifests as epilepsy. We examined the effect of alcohol
      exposure during development on the seizure threshold and examined the
      relationship between alteration of seizure threshold and alcohol-induced neuronal
      loss from the hippocampus. METHODS: Rat pups received 0.85, 2.5, or 3.75 g/kg of
      alcohol via intragastric intubation daily over postnatal days (PD) 4-9. An
      intubated control and a suckle control group were also included. To assess the
      effect of a single day of alcohol exposure, an additional group received 3.75
      g/kg of alcohol on PD 4 alone. Behavioral seizure thresholds were determined by
      intravenous infusion of the proconvulsant, pentylenetetrazol (PTZ), on PD 31 or
      on PD 90. In addition, electrographic seizure thresholds were determined by
      recording extracellular field potentials from the dentate gyrus. The number of
      hippocampal CA1 pyramidal cells, CA3 pyramidal cells, and granule cells of the
      dentate gyrus were determined by stereology. RESULTS: Daily exposure to alcohol
      resulted in a dose-dependent decrease in the seizure threshold and in the
      selective loss of CA1 pyramidal cells. Reduction in the seizure threshold was
      significantly correlated with loss of CA1 pyramidal cells. Recordings of
      extracellular field potentials confirmed the alcohol-induced reduction in seizure
      threshold, demonstrated that PTZ-induced seizures involve hippocampal
      parahippocampal circuitry, and provided evidence that the hippocampal formation
      is the generator of the PTZ-induced seizures in alcohol-exposed animals.
      CONCLUSIONS: These findings demonstrate that exposure of the developing brain to
      alcohol can permanently reduce the threshold for both behavioral and
      electrographic seizures and can selectively kill hippocampal CA1 pyramidal cells.
      Both the pathologic findings and the physiologic recordings support the concept
      that the reduced seizure threshold in alcohol-exposed animals is due to
      hippocampal pathology.

PMID- 11198718
TI  - Increased circulating leptin levels in chronic alcoholism.
AB  - BACKGROUND: Malnutrition seen in chronic alcoholics is partly due to reduced
      energy intake. Leptin is a peptide hormone implicated in the regulation of
      appetite and expenditure of energy. The prevalence and significance of abnormal
      circulating leptin levels in alcoholics, as well as the relationship of these
      levels with nutritional status, liver disease, and ethanol consumption, remain
      uncertain. METHODS: Serum leptin levels were measured in 60 active asymptomatic
      alcoholics, 20 active alcoholics with cirrhosis of the liver, 20 abstinent
      alcoholics, and 60 controls. Nutritional status and ethanol consumption also were
      assessed. RESULTS: In the control group, circulating leptin levels (mean 4.7+/
      0.3 microg/liter) correlated with body fat stores. Despite showing a lower fat
      area of the arm, active alcoholics had significantly higher leptin levels than
      the controls (p < 0.001), regardless of the presence of cirrhosis. By contrast,
      none of the abstinent alcoholics showed hyperleptinemia. In the multivariate
      regression analysis, the fat area of the arm (p < 0.001), the lifetime ethanol
      consumption (p = 0.007), and the number of cigarettes smoked per day (p = 0.02)
      were found to be independent factors that influenced leptin levels in active
      alcoholics. After we adjusted for age, fat area of the arm, and tobacco
      consumption, a significant correlation was observed between lifetime consumption
      of ethanol and serum leptin concentrations (r = 0.36, p < 0.001). CONCLUSIONS:
      Circulating leptin levels are increased in a dose-dependent manner in chronic
      alcoholism, regardless of nutritional status or the presence of compensated liver
      disease.

PMID- 11198719
TI  - Effects of chronic alcohol consumption on the broad phospholipid signal in human
      brain: an in vivo 31P MRS study.
AB  - BACKGROUND: Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the
      measurement of phospholipids and their breakdown products in the human brain.
      Fairly mobile membrane phospholipids give rise to a broad signal that co
      resonates with metabolic phosphodiesters. Chronic alcohol exposure increases the
      rigidity of isolated brain membranes and, thus, may affect the amount and
      transverse relaxation times (T2) of MRS-detectable phospholipids. We tested the
      hypothesis that subjects who were heavy drinkers have stiffer membranes than
      controls who were light drinkers, as reflected in a smaller broad signal
      component and a shorter T2 of the broad signal in 31P MR spectra of the brain.
      METHODS: Thirteen alcohol-dependent heavy drinkers (mean age 44 years) were
      studied by localized 31P MRS in the centrum semiovale and compared with 17
      nondependent light drinkers of similar age. The broad component signal was
      separated from the metabolite signal by convolution difference, which is based on
      the large difference in line widths of these two signals. Longitudinal and T2
      relaxation times were measured using standard methods. RESULTS: The broad
      component integral was 13% lower in the brain of heavy drinkers compared with
      light drinkers (p < 0.001) and remained significantly smaller after corrections
      for both longitudinal and transverse relaxations (p < 0.01). The T2 distribution
      of the broad component consistently showed two resolvable components in both
      groups. The fast relaxing component had the same T2 in both groups (T2 = 1.9
      msec). The slower relaxing component T2 was 0.6 msec shorter in heavy drinkers
      compared with light drinkers (p = 0.08). CONCLUSIONS: These results, observed in
      the absence of white matter volume loss, are consistent with biochemical
      alterations and higher rigidity of white matter phospholipids associated with
      long-term chronic alcohol abuse. The observed smaller broad signal component in
      these relatively young heavy drinkers is a sensitive measure of white matter
      phospholipid damage.

PMID- 11198720
TI  - Pretreatment with hydromorphone, a mu-opioid agonist, does not alter the acute
      behavioral and physiological effects of ethanol in humans.
AB  - BACKGROUND: Endogenous opioid systems are thought to mediate at least some of the
      behavioral effects of ethanol. Opioid antagonists, like naloxone and naltrexone,
      decrease ethanol self-administration under a variety of conditions in different
      species of laboratory animals (e.g., rodents and nonhuman primates). Opioid
      agonists, like morphine, also alter ethanol consumption. However, the dose
      response functions for opioid agonists are complex in that low doses increase
      ethanol self-administration, whereas moderate to high doses decrease ethanol self
      administration. The results of prospective human laboratory studies that assessed
      the behavioral effects of ethanol after pretreatment with an opioid antagonist
      are mixed. The aim of the present study was to assess the acute subject-rated
      effects of ethanol (0, 0.5, and 1 g/kg) after pretreatment with hydromorphone, a
      mu-opioid agonist. METHODS: In the present experiment, the acute subject-rated,
      performance-impairing, and physiological effects of ethanol (0, 0.5, and 1 g/kg)
      were examined after pretreatment with hydromorphone (0, 1, and 2 mg), a mu-opioid
      agonist, in nine healthy volunteers. Volunteers received one of the nine possible
      ethanolhydromorphone combinations during each of nine experimental sessions.
      RESULTS: Ethanol produced prototypical subject-rated drug effects (e.g., dose
      dependently increased ratings of "high"), impaired performance, and increased
      heart rate. Hydromorphone pretreatment generally did not significantly alter the
      subject-rated, performance-impairing, or physiological effects of ethanol.
      CONCLUSIONS: The results of the present experiment suggest that hydromorphone
      pretreatment does not significantly affect the subject-rated effects of ethanol.
      Future human laboratory studies should test higher doses of hydromorphone. Future
      studies also might use more sophisticated behavioral procedures like self
      administration, or perhaps drug discrimination, to determine if opioid agonists
      can modulate the behavioral effects of ethanol in humans.

PMID- 11198721
TI  - Effect of repeated exposure to alcohol on the response of the hypothalamic
      pituitary-adrenal axis of the rat: I. Role of changes in hypothalamic neuronal
      activity.
AB  - BACKGROUND: Prior (3-12 days) injection of alcohol significantly blunts the
      response of the hypothalamic-pituitary-adrenal (HPA) axis to a second drug
      challenge without measurably altering responses to other stressors. We therefore
      determined whether adaptation in hypothalamic neurons underlies this decreased
      activity. METHODS: Adult male rats were administered alcohol (4.5 g/kg
      intragastrically) or vehicle daily for three consecutive days and then were
      challenged with the vehicle or alcohol 7 days later. Levels of
      adrenocorticotropin hormone (ACTH) in the circulation, corticotropin-releasing
      factor (CRF), CRF receptors type 1 (CRFR1) and vasopressin (VP) transcripts in
      the paraventricular nucleus (PVN) of the hypothalamus, and CRF/VP peptide in the
      median eminence were measured. RESULTS: Resting PVN levels of CRF, CRFR1, and VP
      were comparable in all animals on day 7 of recovery, whereas CRF and VP stores in
      the external zone of the median eminence were decreased in animals previously
      exposed to alcohol. After the acute alcohol challenge on day 7, rats previously
      exposed to the drug exhibited a significant (p < 0.01) dampening of their PVN CRF
      and CRFR1, but not VP neuronal response, compared with vehicle-pretreated rats.
      CONCLUSION: Blunted neuronal activity of PVN CRF neurons may be responsible for
      the decreased ACTH response that we previously reported in rats that had been
      injected with alcohol several days earlier. In addition, and despite comparable
      PVN VP transcript levels, the lower levels of this peptide in the median eminence
      also may participate in the blunted ACTH response that we observed.

PMID- 11198722
TI  - Sexual dysfunction and cardiovascular disease: a transatlantic consensus.

PMID- 11198723
TI  - Difficulties in interpreting the results of carotid endarterectomy: the
      importance of prospective independent audit.

PMID- 11198724
TI  - The dogma of identifying occult bacterial infections in young febrile children: a
      survey of primary-care physicians.
AB  - Management of undifferentiated febrile illness in young children continues to be
      a controversial issue among primary-care physicians. A self-administered
      questionnaire was mailed to 600 randomly selected physicians regarding their
      management of children with high fever and no focus of infection at various ages:
      3 weeks, 7 weeks, 4 months and 20 months. Completed questionnaires were returned
      by 419 (70%) physicians. Nearly 77% of physicians would hospitalize a 3-week old
      infant with fever and 70% would treat these infants empirically with antibiotics.
      Sixty-one per cent of physicians would hospitalize a 7-week-old infant with fever
      and 46% would treat empirically with antibiotics. Approximately 80% and 93% of
      physicians, respectively, would not hospitalize 4- and 20-month-old infants with
      high fever and no focus of infection, but 72% and 59%, respectively, would treat
      such infants with antibiotics. There was considerable variation in the way
      physicians managed young febrile children with no focus of infection and the
      clinical approach of some physicians was remarkably different from current
      knowledge and recommendations.

PMID- 11198725
TI  - Relief of sore throat with the anti-inflammatory throat lozenge flurbiprofen 8.75
      mg: a randomised, double-blind, placebo-controlled study of efficacy and safety.
AB  - In this double-blind study, 301 patients with subjective and objective signs of
      sore throat were randomly assigned to flurbiprofen 8.75 mg (n = 129),
      flurbiprofen 12.5 mg (n = 43) or placebo (demulcent lozenge without active drug
      [n = 129]). Efficacy was assessed by changes in subjective rating scales
      primarily after a single dose and also over a 4-day period. Flurbiprofen 8.75 mg
      was superior to placebo in a number of efficacy parameters, notably throat
      soreness. Throat soreness was significantly reduced after 15 minutes (p < 0.05),
      with effects sustained for at least 2 hours (p < 0.05). Multiple dosing with
      flurbiprofen 8.75 mg lozenges continued to provide effective symptomatic relief
      over the 4-day treatment period. The small sample size was considered
      contributory to the variable results obtained with flurbiprofen 12.5 mg lozenges,
      but overall these were not inconsistent with previous trials. Both treatments
      were tolerated well. Flurbiprofen 8.75 mg lozenges provide an effective and well
      tolerated treatment for sore throat.

PMID- 11198726
TI  - Moxifloxacin versus cephalexin in the treatment of uncomplicated skin infections.
AB  - The efficacy and safety of oral moxifloxacin (400 mg once daily, 7 days) versus
      cephalexin (500 mg three times daily, 7 days) were compared in a prospective,
      multicentre, randomised, double-blind trial in 401 adults with uncomplicated skin
      infections. Clinical outcome was evaluated in 351 patients. Moxifloxacin proved
      to be as effective as cephalexin both clinically (90% versus 91%, respectively)
      and bacteriologically in eradicating the most frequently isolated pathogen
      Staphylococcus aureus (92% and 93%, respectively). Moxifloxacin was more
      effective than cephalexin in eliminating Streptococcus spp. (90% and 82%,
      respectively). Drug-related adverse events were comparable in both treatment
      groups with the most frequently reported being nausea in the moxifloxacin-treated
      patients and headache in the cephalexin-treated patients. Medication was
      discontinued due to unwanted reactions in 3% of the moxifloxacin- and 4% of the
      cephalexin-treated patients. Moxifloxacin, 400 mg once daily for 7 days, is as
      safe and effective as cephalexin 500 mg three times daily for 7 days in the
      treatment of uncomplicated skin infections.

PMID- 11198727
TI  - Can prophylactic oral erythromycin reduce time to full enteral feeds in preterm
      neonates?
AB  - Efficacy of oral, prophylactic erythromycin in reducing the time to establish
      full enteral feeds (150 ml/kg/day) was assessed in neonates < 32 weeks, ready for
      enteral feeds. Seventy-three consecutive neonates were randomised to receive oral
      erythromycin ethyl succinate (n = 36) or placebo (n = 37) in a double-blind trial
      until full enteral feeds or 14 days of therapy were reached. A prospectively
      designed feeding regimen, including plan of action for signs of feed intolerance,
      was common for all enrolled neonates. The median gestational age, birth weight
      and postnatal age at start of feeds were 29 versus 30 weeks (p = 0.40), 1232
      versus 1280 g (p = 0.96) and 5 versus 5 days (p = 0.84) for erythromycin and
      placebo group, respectively. Time to achieve full feeds was not significantly
      different in the two groups. (median times: erythromycin 93.5 versus placebo 104
      hours, p = 0.60). Erythromycin-related side-effects did not occur.

PMID- 11198728
TI  - A comparison of nisoldipine ER and amlodipine for the treatment of mild to
      moderate hypertension.
AB  - This multicentre, double-blind, double-dummy, randomised trial compared the
      efficacy and tolerability of nisoldipine extended release (10-40 mg) and
      amlodipine (2.5-10 mg) in 161 patients. The primary end point was a between
      treatment comparison of change from baseline to week 8 in mean office diastolic
      blood pressure (DBP). The least squares mean reductions in systolic (S)BP/DBP (+/
      standard error) for nisoldipine and amlodipine were -11.7/-9.3 +/- 1.4/0.8 and 
      14.3/-12.0 +/- 1.4/0.8 mmHg, respectively. The DBP treatment difference was 2.7
      mmHg (90% confidence interval: 1.1 to 4.3 mmHg; p = 0.005). Tolerability profiles
      were similar between treatments. The drug acquisition cost per mmHg DBP reduction
      was 40% lower with nisoldipine; an acquisition cost analysis revealed that
      amlodipine was 80% more expensive than nisoldipine for treating hypertension. In
      summary, nisoldipine and amlodipine provide clinically equivalent
      antihypertensive efficacy; however, nisoldipine is more economical than
      amlodipine.

PMID- 11198729
TI  - Prognostic value of CT scan features in acute ischaemic stroke and relationship
      with clinical stroke syndromes.
AB  - The aim of this prospective study was to investigate the value of CT scan in
      prognosis of acute ischaemic stroke patients as a variable additional to clinical
      stroke syndromes to develop a simple classification of CT scan features to
      provide a practical approach to prognosticate and manage such patients. One
      hundred and eight nine patients admitted with ischaemic stroke were investigated
      with a CT scan. CT scan features were classified into two groups: large infarct,
      LI (across more than one lobe) and non-large infarcts (N-LI) for all other
      features. Patients were also studied for clinical syndromes, analysing results
      for total anterior circulation syndrome (TACS). Outcome was measured as early
      post stroke Barthel index, acute phase and 3-month mortality. Patients with LI
      had features of severe strokes and had a lower Barthel index (p < 0.001), lower
      Glasgow coma score (p < 0.001), more association with incontinence (p < 0.001),
      pyrexia (p = 0.007) and dysphagia (p < 0.001). LI patients required higher level
      of care in acute wards and had a higher length of stay (p = 0.01). Both the LI
      and TACS individually had a significantly higher mortality (p < 0.001) and
      similar positive predictive value, sensitivity and specificity for 3-month
      mortality. While the combined factor of 'large infarct and TACS' provided the
      highest likelihood ratio (3.1) for mortality, the factor of 'large infarct or
      TACS' was the most sensitive (85%) to identify majority of patients at a risk of
      mortality. N-LI patients had a better prognosis. Classification of cerebral
      infarcts into large and non-large categories identifies patients who require
      higher level of care in acute wards and have a higher mortality. Combined factor
      of 'large infarct and/or TACS' identifies the majority of patients at risk of 3
      month mortality as compared to either variable taken individually. CT scan
      features are complimentary to clinical syndromes for managing acute stroke
      patients.

PMID- 11198731
TI  - Axillary arch and its implications in axillary dissection--review.
AB  - Axillary arch is an anomalous muscular slip of latissimus dorsi muscle
      occasionally encountered in axillary dissection. A systematic review of medical
      literature published between 1966 to 1999 was performed regarding its incidence,
      clinical features and management. Its presence in axillary dissection should be
      recognised to avoid confusion in staging of lymph nodes and to prevent injury to
      axillary vessels and brachial plexus.

PMID- 11198730
TI  - Catecholamine secretion and ploidy in phaeochromocytoma.
AB  - The aim was to evaluate 24 hr urine catecholamine, HMMA and HVA excretion in
      relation to ploidy in phaeochromocytoma. Data from five diploid and nine
      tetraploid tumours showed a significant reduction in urine noradrenaline (p =
      0.02) and HMMA (p = 0.03) in diploid tumours but no difference in adrenaline,
      dopamine and HVA excretion using the Mann-Whitney U test. None of the patients
      showed recurrence after a mean of 5.7 years of follow up. A review of published
      ploidy studies in phaeochromocytoma shows that malignancy is more than six times
      more common in non-diploid tumours but diploidy does not equate with benignity.
      No biochemical marker is a reliable index of malignancy. All patients should
      undergo lifetime review for recurrence.

PMID- 11198732
TI  - Skeletal muscle relaxants: pharmacodynamics and pharmacokinetics in different
      patient groups.
AB  - Muscle relaxants can be safely administered during anaesthesia, providing the
      basic pharmacodynamic and pharmacokinetic characteristics of the compounds
      together with the physiological status of the patient are known. In this review
      the pharmacodynamics and pharmacokinetics of the neuromuscular blocking agents
      are discussed and related to the physical health or disease state of groups of
      patients.

PMID- 11198733
TI  - Diabetes knowledge--are patients getting the message?
AB  - Diabetes knowledge in a multi-ethnic population was assessed in 161 insulin
      treated diabetic patients using a 21-point multiple choice questionnaire
      translated into the appropriate languages. Our data showed a significant
      difference in diabetes knowledge related to ethnicity, being less in Asians and
      Afro-Caribbeans groups compared to Caucasians. In all groups there was a negative
      correlation with age, with older adults achieving lower scores. Gender and
      duration of disease did not appear to influence knowledge scores. This
      information has implications for the way in which we deliver our diabetes
      educational programme to ethnic minority groups and the elderly.

PMID- 11198734
TI  - Esomeprazole, a new proton pump inhibitor: pharmacological characteristics and
      clinical efficacy.
AB  - Esomeprazole, the S-isomer of omeprazole, is the first proton pump inhibitor
      synthesised as an optical isomer to become available for clinical use.
      Esomeprazole is optically stable in humans with negligible inversion to the R
      isomer. Esomeprazole has significantly higher oral bioavailability than
      omeprazole, resulting in greater acid suppression. In clinical studies, 4 weeks'
      treatment with 40 mg esomeprazole demonstrated greater healing of all grades of
      erosive oesophagitis, compared with 20 mg omeprazole (76-82% versus 69-71%) and
      higher rates of symptom resolution (65-68% versus 58-61%) Furthermore,
      esomeprazole maintained healing rates of up to 90% over 6 months in erosive
      oesophagitis. Comparisons with other proton pump inhibitors in oesophagitis are,
      as yet, unavailable. In patients with endoscopy-negative gastro-oesophageal
      reflux disease (GERD), on-demand therapy with esomeprazole 20 mg has been shown
      to be very efficacious compared with placebo, and is well tolerated; however,
      comparisons with other proton pump inhibitors have not been performed. Long-term
      use of esomeprazole for up to 12 months in patients with GERD have not raised any
      significant safety concerns with respect to the development of atrophic gastritis
      or clinically relevant changes in enterochromaffin-like cells.

PMID- 11198735
TI  - Myocardial bridging.
AB  - We present a case of myocardial bridging, which was seen following urgent cardiac
      catherisation for post-infarction unstable angina in a 55-year-old man who was
      initially admitted with an acute inferior myocardial infarction.

PMID- 11198736
TI  - Progressive heart block in active rheumatoid arthritis.
AB  - A 68-year-old woman presented with active rheumatoid arthritis (RA) and severe
      extra-articular manifestations. During the course of her treatment, her
      electrocardiogram (ECG) transformed from normal sinus rhythm to left bundle
      branch block and finally to complete heart block (CHB). Investigations ruled out
      an ischaemic event. A permanent pacemaker was inserted due to the symptoms of
      heart failure and she made an uneventful recovery. CHB in RA is probably a marker
      of severity of the disease.

PMID- 11198737
TI  - A case of haemophagocytic syndrome and Kikuchi-Fujimoto disease occurring
      concurrently in a 17-year-old female.
AB  - An unusual case in which a young Asian female presenting with fever,
      lymphadenopathy and cytopaenia was found to have distinct histological features
      of both haemophagocytic syndrome (HS) and histiocytic necrotising lymphadenitis
      (Kikuchi-Fujimoto disease, KFD) is presented. We review the clinical features of
      each of these rare, but important, diagnoses and propose the hypothesis that they
      may form part of a disease continuum, rather than representing separate entities.

PMID- 11198738
TI  - Catastrophic antiphospholipid syndrome presenting as dilated cardiomyopathy with
      bilateral branch retinal artery thrombosis.
AB  - Cardiac manifestation of antiphospholipid syndrome (APS) is mainly in the form of
      left-sided valvular insufficiency, intra-cardiac thrombi or coronary artery
      occlusion. Dilated cardiomyopathy is a rare but important cardiac manifestation
      of APS, and responds well to adequate anticoagulation and steroids. We describe a
      case in which APS presented with dilated cardiomyopathy and bilateral retinal
      artery thrombosis.

PMID- 11198739
TI  - Mesenchymal hamartoma of the liver in an adult: a review of the literature.
AB  - Mesenchymal hamartoma of the liver is an unusual oncologic entity which occurs
      almost exclusively in infancy and childhood; fewer than 200 cases have been
      reported. We present the case of a 21-year-old female, who was admitted to our
      institution with a painful right subcostal mass lasting for 6 months, who had no
      evidence of generalised disease. Imaging procedures revealed a central solid
      lesion, 15 cm in diameter, in the right lobe of the liver, with cystic
      degeneration. The patient underwent a formal right hepatectomy. The pathology
      report ascertained the presence of a benign mesenchymal hamartoma of the liver.

PMID- 11198740
TI  - Mitral valve prolapse, panic attack and chest pain.

PMID- 11198741
TI  - Who should do thyroid surgery?

PMID- 11198742
TI  - Postnatal care: no time for complacency.

PMID- 11198743
TI  - Neuropathic pain.
AB  - Neuropathic pain is a distressing, poorly understood and under-treated condition.
      In this review we seek to examine the definition and classification of
      neuropathic pain, summarize clinically important underlying mechanisms, outline
      current management strategies and look at future directions for research and
      therapy.

PMID- 11198744
TI  - Pitfalls in the diagnosis of motor neurone disease.
AB  - Motor neurone disease is characterized by progressive degeneration of upper and
      lower motor neurones with preservation of cognition. Recognition of classical
      motor neurone disease is not difficult, but during the early stages both false
      positive and false negative diagnoses are common. Careful examination, frequent
      follow-up and ancillary tests are necessary to avoid erroneous diagnoses.

PMID- 11198745
TI  - The treatment of malignant cerebral tumours.
AB  - Malignant cerebral tumours are uncommon. While a large proportion are resistant
      to conventional therapies there are a significant number of curable malignant
      brain tumours that require recognition and appropriate therapy.

PMID- 11198746
TI  - Management of toxic epidermal necrolysis.
AB  - Toxic epidermal necrolysis and Stevens-Johnson syndrome are rare, life
      threatening drug reactions. Widespread epidermal necrosis and mucosal erosions
      lead to complications similar to those developing after extensive burns.
      Treatment is supportive. The role of steroids and other potential disease
      modifying agents remains to be established by controlled studies.

PMID- 11198747
TI  - The use of Scopoderm in palliative care.
AB  - The drug hyoscine has several indications for symptom control for patients with
      end-stage disease. The transdermal preparation, Scopoderm, is most widely used to
      control excess salivary secretions but it can also have a role in the management
      of terminal secretions and in the control of nausea.

PMID- 11198748
TI  - Zyban: an effective treatment for nicotine addiction.
AB  - Recent research has identified nicotine as a powerfully addictive substance. This
      article outlines how the new non-nicotine smoking cessation drug, Zyban, can help
      people to break the cycle of addiction and stop smoking.

PMID- 11198749
TI  - Statins: where are we now?
AB  - Statin therapy reduces the risk of cardiac events by 30% in both primary and
      secondary prevention. Although fine-tuning of the evidence will occur as more
      clinical trials report, the challenge is now to implement the evidence to the
      benefit of patients.

PMID- 11198750
TI  - The management of alcohol-related seizures: an overview.
AB  - Alcohol-withdrawal seizures are one of the common medical emergencies. The
      seizures are generalized and usually occur abruptly between 6-8 hours after
      cessation of alcohol use (peak 12-24 hours). These patients are often
      uncooperative and therefore need careful assessment. Lorazepam is the first-line
      drug for termination and prophylaxis of alcohol-withdrawal seizures.

PMID- 11198751
TI  - Sample size determination in clinical research: 2.
AB  - In the second of this two-part series, comparative study design is considered
      and, using examples, power calculation is explained. The information required for
      calculating sample size for comparative studies is highlighted.

PMID- 11198752
TI  - Finding health information on the Internet: health consumers.
AB  - The quality of health information on the Internet is extremely variable. This
      article highlights some of the problems consumers encounter when searching for
      health information and suggests ways in which these can be overcome.

PMID- 11198753
TI  - Resolution of nephrotic syndrome caused by amyloidosis following surgery for
      Crohn's disease.

PMID- 11198754
TI  - Renal cell carcinoma presenting with cardiac failure.

PMID- 11198755
TI  - An unusual case of recurrent septicaemia.

PMID- 11198756
TI  - Who should do thyroid surgery?

PMID- 11198757
TI  - Management of the acute abdomen.

PMID- 11198758
TI  - Management of flail chest.

PMID- 11198759
TI  - Ethics and regulation in neurosurgical practice.

PMID- 11198760
TI  - Good practice: a guide for neurosurgeons.

PMID- 11198761
TI  - Principles of gene therapy: potential applications in the treatment of cerebral
      ischaemia.
AB  - In this review we explore gene therapy as a possible treatment for conditions
      causing cerebral ischaemia and briefly consider other neurological pathologies
      such as brain tumours. DNA transfer may be achieved using retrovirus, herpes
      simplex virus, adenovirus, and adeno-associated virus vectors or liposomes. After
      cerebral ischaemia, these vectors are used to upregulate genes that increase
      survival and inhibit those that promote death in the injured cells. In contrast,
      in brain tumours gene therapy aims to kill the target cells. Examples from
      studies using cell culture, animal models and patients are presented. We conclude
      that manipulation of gene expression has potential for the treatment of cerebral
      ischaemia and brain tumours, although, at present, there are formidable technical
      obstacles to be overcome before clinical applications become a reality.

PMID- 11198762
TI  - Depression: a role for neurosurgery?
AB  - After providing an overview of depression this article briefly reviews the
      development of psychosurgery and outlines the current procedures in use world
      wide. Stereotactic subcaudate tractotomy (SST) is described in particular detail,
      and the rationale for its use in the treatment of resistant depression is then
      discussed by considering the findings of neuropsychological, neurophysiological
      and neuroimaging studies. The emerging evidence suggests that the prefrontal
      cortex subserves an essential function in emotion and that disruption of its
      connections modifies mood.

PMID- 11198763
TI  - The cause and incidence of secondary insults in severely head-injured adults and
      children.
AB  - The cause and incidence of reductions in cerebral perfusion pressure, and rises
      in intracranial pressure have been examined in a series of patients with severe
      head injury defined as an initial Glasgow Coma Sum of less than or equal to 8.
      Two-hundred-and-seven adults (aged over 16 years) and 84 children admitted to
      Newcastle General Hospital, who had intracranial pressure monitoring as part of
      their routine management, were studied. Intracranial pressure (ICP), arterial
      pressure and cerebral perfusion pressure (CPP) were sampled and recorded every 2
      min. Patients' CT findings were classified into distinct groups using the method
      described by Marshall. Secondary insults were defined using the Edinburgh
      University Secondary Insult Grades (EUSIG) and the incidence and cause (raised
      ICP, reduced CPP or a combination of the two) was established. Outcome was
      assessed at 6 months using the Glasgow Outcome Scale. In the majority of adults
      with head injury it is the combination of reduced arterial pressure and raised
      ICP that contributes to the reduction in cerebral perfusion pressure. This was
      not the case for Diffuse Injury Type I. In children similar characteristics were
      found across each of the CT classifications. The vast majority of falls in CPP
      down to 60 mmHg were caused by reduced arterial pressure. Reductions below 50
      mmHg were almost always due to a combination of both reduced arterial pressure
      and raised ICP. The results in adults were similar, but not identical, to those
      of the paediatric cases. Diffuse Injury Type I stood out from all the other
      categories as the only one where reductions in perfusion pressure were almost
      exclusively due to reductions in arterial pressure and not to increases in ICP.
      The management of these patients should ensure the adequacy of perfusion pressure
      by maintaining arterial pressure at a satisfactory level. These results suggest
      that vigilant monitoring of both intracranial pressure and arterial pressure is
      required to lower the incidence of secondary insults.

PMID- 11198764
TI  - Endoscopic transsphenoidal pituitary surgery: various surgical techniques and
      recommended steps for procedural transition.
AB  - Various techniques in pituitary endoscopy are reviewed in the attempt to assemble
      the transitional steps necessary to take a neurosurgeon from traditional
      microscopic transsphenoidal surgery to endoscopic endonasal pituitary surgery.
      The senior author's (HDJ) experiences of endonasal endoscopy in more than 200
      operations as well as the reports in the literature on pituitary endoscopy are
      reviewed. Two distinct advantages that an endoscope has over an operating
      microscope are its ability to visualize through a narrow surgical corridor and
      its ability to provide angled, close-up views. An endoscope can be used to assist
      the operating microscope (endoscope-assisted microsurgery). Endoscopy can also be
      used for endonasal retractor placement when microscopic surgery is preferred
      (endoscopic sphenoidotomy). When endonasal endoscopy is chosen, the surgical
      approach can be made with a deep-transseptal, a paraseptal, a middle turbinectomy
      or a middle meatal approach (endonasal transsphenoidal endoscopy). Endonasal
      endoscopy can be performed via either one or two nostrils. Working-channel
      endoscopy can be performed for restricted purposes. When a neurosurgeon desires
      to adopt endoscopy into pituitary surgery, the author recommends endoscope
      assisted microsurgery as the first step followed by endoscopic sphenoidotomy as a
      combined effort between an endoscopic rhinologist and the neurosurgeon as the
      next step leading finally to endonasal pituitary endoscopy. Various methods of
      transsphenoidal endoscopy and the authors' recommendations for transitional steps
      are reported based on the authors' personal experience and literature review.

PMID- 11198765
TI  - Prediction of cerebral ischaemia during carotid endarterectomy with preoperative
      CO2-reactivity studies and angiography.
AB  - The objective of this study was to assess the value of combining the preoperative
      CO2 cerebrovascular reactivity index (CO2RI) with carotid and cerebral
      angiography in predicting the risk of severe cerebral ischaemia (SCI) during
      carotid endarterectomy (CEA). Seventy-four consecutive patients scheduled for CEA
      underwent preoperative digital subtraction angiography and CO2-reactivity tests.
      During CEA, cerebral function monitor (CFM) was used to document cortical
      electrical activity, whilst transcranial Doppler measured the middle cerebral
      artery flow velocity (FV). A persistent fall in CFM voltage and/or a fall in FV >
      or = 60% on internal carotid artery (ICA) clamping were used as criteria for
      defining SCI. Complete data from 59 patients were obtained for final analysis.
      Twelve cases showed a fall in FV > or = 60%; 11 of these also showed a sustained
      fall in CFM voltage. Using logistic regression, the risk of SCI was found to be
      negatively associated with (1) contralateral CO2RI, (2) the percentage stenosis
      of the contralateral ICA, and (3) the difference between ipsilateral and
      contralateral CO2RI. Using these factors, a logistic regression model for
      predicting the risk of SCI was established which provided a sensitivity of 75%
      and specificity of 100%. The risk of SCI during CEA was related to the
      contralateral ICA stenosis and the CO2RI of both cerebral hemispheres. This
      information may assist in presurgical planning and help to select asymptomatic
      carotid lesions for surgery.

PMID- 11198766
TI  - Intracerebral haemorrhage and drug abuse in young adults.
AB  - The epidemic of abuse of the so-called 'designer drugs' amphetamine, cocaine and
      ecstasy--is fast replacing traditional aetiological factors as the largest cause
      of intracerebral haemorrhage among young adults. Traditional teaching is that
      these represent hypertensive haemorrhages. Recent reports, however, have
      indicated that these patients may harbour underlying vascular malformations. We
      review 13 patients with a positive history of drug abuse preceding the onset of
      intracerebral haemorrhage. These patients presented to the National Hospital for
      Neurology and Neurosurgery in central London over a 7-month period. Of the 13
      patients (eight male, five female), average age 31 years (19-43) years), 10 were
      well enough to undergo cerebral angiography. Intracranial aneurysms were
      demonstrated in six patients and arteriovenous malformations in three patients.
      In only one of the patients was the angiogram normal. A further patient was
      subsequently shown to have a middle cerebral artery aneurysm at autopsy. The
      epidemiology, pharmacology and systemic effects of these drugs are considered.
      The mechanisms by which these compounds cause intracerebral complications and
      their influence on prognosis are discussed. The incidence of intracerebral
      haemorrhage (ICH), ischaemic cerebral infarctions and subarachnoid haemorrhage
      (SAH) following drug abuse is increasing. Contrary to historical opinion, drug
      related ICH is frequently related to an underlying vascular malformation.
      Arteriography should be part of the evaluation of most young patients with
      nontraumatic ICH. A thorough history focusing on the use of illicit substances
      and toxicological screening of urine and serum should be part of the evaluation
      of any young patient with a stroke.

PMID- 11198767
TI  - Third ventricular cysts and membranes unsuspected on conventional CT and MRI.
AB  - Three cases are presented of symptomatic cysts or membranes within the third
      ventricle interfering with CSF flow and presenting as non-communicating
      triventricular hydrocephalus. None was visible on conventional CT or MRI, two
      being discovered at neuroendoscopy and one only with a specific MRI sequence
      designed to show CSF partitioning.

PMID- 11198768
TI  - Prothrombin complex concentrate for oral anticoagulant reversal in neurosurgical
      emergencies.
AB  - The incidence of spontaneous intracranial haemorrhage has increased markedly in
      line with the increased use of oral anticoagulant agents. Recent guidelines for
      reversal of this acquired coagulation defect in an emergency have been
      established, but they are not adhered to in all centres. Our unit is referred
      between 20 and 60 patients per year (1994-1999) who are anticoagulated and
      require urgent neurosurgical intervention. In order to investigate this, we
      performed a prospective study using prothrombin complex concentrate (PCC). PCC
      was given to the first six patients with intracranial haemorrhage admitted to the
      neurosurgical unit requiring urgent correction of anticoagulation (Group 1) and
      compared with patients receiving standard treatment with fresh frozen plasma and
      vitamin K (Group 2). Mean International Normalised Ratios of Group 1 were 4.86
      pretreatment and 1.32 posttreatment, and of Group 2 were 5.32 and 2.30,
      respectively. Results for complete reversal and reversal time were significant
      for PCC with p < 0.001. We recommend PCC for rapid and effective reversal of
      warfarin in life-threatening neurosurgical emergencies.

PMID- 11198769
TI  - Ventriculo-atrial shunt insertion: pressure monitoring as an aid to accurate
      placement.
AB  - The objective of this paper is to describe a new method to ensure accurate
      placement of a ventriculo-atrial shunt distal catheter. A technique is described
      using pressure waveform changes within the right side of the heart. Pressure
      monitoring is a new method of placing atrial catheters and is easy to perform.

PMID- 11198770
TI  - Microvascular Doppler ultrasound-assisted neuroendoscopic surgery.
AB  - To achieve endoscopic procedures more safely and less invasively, an operative
      strategy with ultrasound-assisted neuroendoscopic surgery is described. The
      improvement in the endoscope unit is that endoscopic viewing can be stopped on
      the display, anytime we choose and simultaneously visualize the ongoing view on
      the same display. The ultrasound unit, using a miniature Doppler probe, is to
      able to detect even invisible vessels in real-time, easily and non-invasively.
      The information from both units can be switched intraoperatively, whenever
      required.

PMID- 11198771
TI  - Use of a non-penetrating staple device for spinal dural closure.
AB  - Closure of the spinal dura by suture can be technically demanding and a
      watertight closure is rarely achieved. A method of dural closure using non
      penetrating staples is described which permits rapid watertight closure of the
      dura even in confined spaces.

PMID- 11198772
TI  - Multimodality monitoring and the diagnosis of traumatic caroticocavernous fistula
      following head injury.
AB  - Increases in jugular bulb saturations (SjO2) following head injury are usually
      due to hyperaemia. Less commonly this may be due to the development of an
      arteriovenous fistula. We describe how SjO2 monitoring can be used in conjunction
      with transcranial Doppler ultrasound to make the distinction between these two
      conditions, which require distinct therapies. Multimodality monitoring in acute
      injury provides information regarding underlying pathophysiology and permits
      individualization of therapy.

PMID- 11198773
TI  - Spinal extradural angiolipoma.
AB  - We report a case of spinal angiolipoma, causing paraplegia in a 38-year-old
      pregnant female. The tumour was excised and the patient made remarkable recovery.
      The role of pregnancy and its associated hormonal profiles on tumour growth is
      discussed.

PMID- 11198774
TI  - Metastatic prostate adenocarcinoma of the dura mater.
AB  - A 70-year-old man with known metastatic prostate carcinoma to the long bones of
      the lower extremities, presented with a several day history of lethargy and
      confusion. CT was interpreted as showing bilateral acute and chronic subdural
      hematomas (SDH). Upon opening the dura, a yellowish, firm tumor was layered over
      the frontal convexity. No hematoma was found. Histological examination revealed
      prostate carcinoma.

PMID- 11198775
TI  - Intramedullary spinal cord metastases from a hypernephroma 11 years following the
      diagnosis and treatment of the primary lesion.
AB  - Intramedullary spinal cord metastases are rare. An intramedullary spinal cord
      metastasis of renal origin, presenting 11 years after the diagnosis of the
      primary lesion, is reported.

PMID- 11198776
TI  - Heterotopic bone formation causing recurrent donor site pain following iliac
      crest bone harvesting.
AB  - An unusual case of recurrent iliac crest donor site pain secondary to heterotopic
      bone formation is described. The literature is reviewed with a special emphasis
      on the aetiology and treatment of this entity.

PMID- 11198777
TI  - Rupture of an internal carotid artery aneurysm in the petrous temporal bone.
AB  - A case of otorrhagia following the rupture of an aneurysm of the intrapetrous
      portion of the internal carotid artery is presented. The aneurysm was
      successfully treated by balloon occlusion of the parent artery. The problems
      associated with diagnosis and clinical management of these lesions is discussed
      and possible solutions suggested.

PMID- 11198778
TI  - Spinal teratoma: is there a place for adjuvant treatment? Two cases and a review
      of the literature.
AB  - Spinal teratomas are rare intradural spinal tumours, commonly of benign
      histological profile. The main treatment remains surgical excision which often is
      incomplete as the tumour is frequently intimately related to surrounding nerve
      roots and adjacent spinal cord. The value of adjuvant treatment in the form of
      radiotherapy has not been clearly identified. We report two patients with spinal
      teratomas in the lower thoracic and conus region, who were treated with surgical
      excision and did not receive radiotherapy. One of the tumours recurred at 38
      months following surgical excision and required a second operation. We review in
      addition another 20 patients reported in the literature with such tumours. With a
      mean follow-up of 25 months a local recurrence rate of 10% was observed, the same
      in both total and subtotal excision groups. No deaths were reported. Analysis of
      cumulative survival from surgery to treatment failure demonstrated that
      recurrence occurs late, verifying a slow biological progression of this tumour
      type. Although no reliable information of the effect of radiotherapy can be
      obtained, it is difficult to see how radiotherapy could have an impact on such a
      slow growing tumour. Initial treatment of choice remains surgical excision. If
      the teratoma shows any malignant histological features or germ cell elements
      radiotherapy should be employed after surgical excision, even if apparently
      totally excised. In the presence of benign histology it would seem appropriate to
      avoid radiotherapy after initial surgery. In case of tumour recurrence or
      progression to explore the possibility of further surgery first, before
      considering radiotherapy which even then may have doubtful efficacy.

PMID- 11198779
TI  - Split cord malformation and neurenteric cyst--case report and a theory of
      embryogenesis.
AB  - A rare case of split cord malformation with neurenteric cyst is presented. The
      clinical, radiological and surgical findings are presented, and the possible
      embryological basis is discussed. To our knowledge, only seven such cases have
      been reported in the literature.

PMID- 11198780
TI  - Intracranial plasma cell granuloma--a case report and review of the literature.
AB  - We report a case of plasma cell granuloma which is a rare intracranial tumour
      showing plasma cell infiltration. It mimics meningioma and solitary plasmacytoma
      clinically and radiologically. Clinical presentation, diagnostic investigations
      and management are discussed with a review of the literature.

PMID- 11198781
TI  - Intrathecal migration of a lumboperitoneal shunt.

PMID- 11198782
TI  - Detection of Kernohan's notch on magnetic resonance imaging in a patient with
      acute subdural haematoma.

PMID- 11198783
TI  - Dietary fibre and ischaemic heart disease.

PMID- 11198784
TI  - Is dietary fiber beneficial in chronic ischemic heart disease?
AB  - OBJECTIVES: To evaluate the benefit of a dietary fiber preparation (Fibernat) in
      patients with chronic ischemic heart disease (IHD). METHODS: From January 1997 to
      March 1998, 114 consecutive patients with chronic IHD were enrolled in this
      prospective double blind randomized placebo controlled trial. The fiber (F) and
      placebo (P) groups were comparable at baseline. All patients were given advice
      regarding dietary and lifestyle modifications. Concomitant drug therapy was not
      altered. The drug (consisting of soluble and insoluble fibers obtained from
      fenugreek, guar gum and wheat bran) and placebo were administered for six months
      (10 grams twice daily). RESULTS: The following parameters improved in both
      groups: HDL cholesterol (32 to 39 mg/dl, p < 0.0009 in F and 33 to 38, p < 0.007
      in P), total: HDL cholesterol ratio (6.7 to 5.6, p < 0.0007 in F and from 7.0 to
      6.0, p < 0.01 in P) and weight (64.0 to 63.0 kg, p < 0.002 in F and 60.3 to 59.5,
      p < 0.002 in P). The Apolipoprotein B increased (101 to 129 mg/dl, p < 0.00001 in
      F and 98 to 127, p < 0.0008 in P). The following parameters improved only in
      group F: LDL cholesterol (146 to 134, p < 0.027), Apolipoprotein A-1 (105 to 139,
      p < 0.001), body mass index (24.9 to 24.5, p < 0.03) and waist circumference
      (37.2 to 36.7, p < 0.03). Total cholesterol, VLDL cholesterol, triglycerides, hip
      circumference, W:H ratio, exercise time and blood sugar were unchanged in both
      groups. CONCLUSIONS: Fibernat is well tolerated, safe and had favorable effects
      on LDL cholesterol, Apolipoprotein A-1, body mass index and waist circumference.

PMID- 11198785
TI  - Epidemic dropsy--a clinical study of the Delhi outbreak.
AB  - BACKGROUND: A major outbreak of epidemic dropsy occurred in Delhi, India, in
      August-September 1998, due to the consumption of contaminated mustard oil.
      METHODS: The clinical data of 212 adult patients of epidemic dropsy who presented
      to our hospital is analysed. RESULTS: Pitting pedal oedema (100%), skin erythema
      (75%), limb tenderness (63%), diarrhea (51%) and hepatomegaly (34%) were the
      prominent clinical manifestations observed in the patients. Superficial retinal
      haemorrhages and retinal venous dilatation was observed on fundus examination and
      9% of patients developed an open angle glaucoma over a three month follow up
      period. Cardiac failure was present in 14% of patients. Most patients had mild
      disease which responded to cessation of mustard oil consumption, bed rest,
      diuretics and antioxidants. There were six deaths, all of whom had intractable
      cardiac failure. A unique feature of this outbreak was the documentation of acute
      renal failure in three patients, a phenomenon never described previously.
      CONCLUSIONS: Strict law enforcement to prevent the contamination of edible oils
      is essential to avoid the occurrence of future similar outbreaks.

PMID- 11198786
TI  - Incidence of tuberculosis among patients receiving treatment with oral
      corticosteroids.
AB  - OBJECTIVES: To study the incidence and pattern of tuberculosis in patients taking
      systemic corticosteroids (CS). METHODS: Seventy seven patients taking oral CS for
      various respiratory diseases and eighty patients suffering from similar diseases
      but not receiving steroids were followed up for one year to study the incidence
      of tuberculosis. RESULTS: Five patients (6.5%) receiving CS developed
      tuberculosis as against none amongst the controls (p < 0.05). Of these, three
      patients had sputum positive pulmonary tuberculosis and one each had sputum
      negative pulmonary tuberculosis and tubercular meningitis. All patients were
      treated with standard anti-tubercular therapy; four patients improved whereas one
      died due to complications of disease. CONCLUSION: Systemic CS therapy causes a
      significant increase in incidence of tuberculosis.

PMID- 11198787
TI  - Composition of gallstones and sequential events in biliary lithogenesis--is it
      different in south India compared to north?
AB  - AIMS: This study was carried out to determine the gross type and composition of
      gallstones from South India in order to compare it with published results from
      the North to see whether the sequential events in biliary lithogenesis are
      different in these two geographical areas. MATHODOLOGY: A total of 76 stones
      collected from various hospitals in South India including JIPMER were analysed
      using X-ray crystallography. Patient characteristics were recorded. Gross typing
      was done according to Bockus' morphological criteria. RESULTS: Patients with
      gallstones in South India were found to be older in age with near equal gender
      distribution. Pigment calcium stones accounted for 56.5%, pigment stones for
      17.2% and mixed stones for 14.2% of gallstones. Bilirubin and its salts were the
      most frequently identified class of compounds by crystallography. Analysis of
      gallstones layer by layer revealed equal distribution of bilirubin compounds
      between the centre and outer layers except crystalline bilirubin which was found
      only in outer layers. Vaterite, a polymorph of calcium carbonate was found in the
      nucleus, whereas vaterite and aragonite were found in the outer layers.
      Combination of anhydrous cholesterol and cholesterol II were found in the
      nucleus. Epitaxial relationship were found to hold good except for vaterite and
      aragonite. CONCLUSION: Gallstones from South India are probably due to infection
      rather than supersaturation as evidenced by predominance of pigment calcium
      stones and various types of bilirubin and calcium carbonate compounds. Vaterite
      is important for nucleation. Further growth of stones is influenced by epitaxial
      relationship. These findings are dissimilar to that reported from North India
      indicating a different stimulus for stone precipitation in these two areas.

PMID- 11198788
TI  - Intracystic tetracycline therapy for hypofunctioning cystic thyroid nodules.
AB  - OBJECTIVES: Hypofunctioning benign cystic thyroid nodules are a common occurrence
      in iodine deficient region. There are reports of resolution of recurrent thyroid
      cysts with tetracycline instillation. Hence we conducted a study in 20 patients
      with hypofunctioning benign cystic thyroid nodules to document response to
      intracystic instillation of tetracycline as a primary modality of treatment.
      METHODS: Twenty patients were thoroughly investigated for the presence of
      malignancy clinically, radiologically and cytologically. One milliliter of
      tetracycline was instilled under ultrasonographic guidance. Response to therapy
      was assessed clinically and ultrasonographically at one, three, six and 12
      months. RESULTS: Study group comprised of five male and 15 female patients with
      mean age 30 +/- 8 years. Initial mean volume of nodules was 15 +/- 7 ml (6 to 27
      ml), which was decreased to 3 +/- 3 ml at one month, 2 +/- 3 ml at three months,
      and 1 +/- 2 ml at six months. Maximum number of patients (75%) responded within
      three months, however two patients required reaspiration and reinstallation of
      tetracycline. Ultrasonography revealed fibrotic scar as thick wall with internal
      echodensities in six patients (30%) six month after sclerotherapy. There was high
      rate of patient satisfaction, as cosmetically tetracycline did not leave any
      scar, which was unavoidable with surgery. Six patients (30%) reported mild pain
      after injection, and one patient developed redness at the site of injection.
      CONCLUSIONS: Intracystic tetracycline sclerotherapy is highly effective as
      primary mode of treatment in hypofunctioning benign cystic thyroid nodule in
      selected group of patients not at high risk of malignancy.

PMID- 11198789
TI  - Lipid profile in smokers and tobacco chewers--a comparative study.
AB  - OBJECTIVE: The present study was undertaken to evaluate lipid profile in
      cigarette smokers and tobacco chewers and to see whether tobacco chewing causes
      same degree of alteration in lipid profile as done by smoking. METHODS: Serum
      lipid profile was studied in 30 smokers (Group A), 30 tobacco chewers (Group B)
      and 30 controls i.e., non-smokers and non-tobacco chewers (Group C). RESULTS:
      High density lipoprotein-cholesterol was lower both in smoker (P < 0.01) as well
      as in tobacco chewers (P < 0.001) than the controls. Both smokers and tobacco
      chewers had higher values of total cholesterol, low density lipoprotein
      cholesterol, very low density lipoprotein-cholesterol and, triglycerides as
      compared to non-smoker, non-tobacco chewer group whereas the differences in
      levels of lipids in smokers and tobacco chewers were not statistically
      significant. CONCLUSION: Though different mode of addictions, smoking and tobacco
      chewing have an equal and comparable adverse effects on lipid profile and
      therefore raising cardiovascular risk in same proportion.

PMID- 11198790
TI  - Variation of axillary temperature and its correlation with oral temperature.
AB  - Unilateral axillary temperature is recorded in unconscious patients and children
      due to its easy approach. OBJECTIVE: To evaluate variation of axillary
      temperature on the two sides and its correlation with oral temperature. SUBJECTS:
      One hundred and 46 healthy men and women, aged 12 through 52 years. METHODS:
      Axillary temperature from both sides and oral temperature were recorded using
      digital electronic thermometer in supine position with due precautions. RESULTS:
      Difference in temperature on the two sides of axilla was found to vary by as much
      as 0 degree F to 3.4 degrees F. Therefore, the data was grouped into higher and
      lower temperature ranges. The difference between mean oral and mean higher
      axillary temperature was found to be 0.5 degree F +/- 0.6 degree F (r = 0.564)
      while that in comparison to mean lower axillary temperature was 1.0 degree F +/-
      0.89 degree F (r = 0.64). The difference between mean oral and mean axillary
      temperature was 1.0 degree F +/- 0.80 degree F (r = 0.84). CONCLUSIONS: Based on
      our observations, it is found that an average of temperature of both sides of
      axilla represents the axillary temperature more accurately and to get the correct
      oral equivalent of axillary temperature one should add 1 degree F to the mean
      axillary temperature.

PMID- 11198792
TI  - Evolving trends in the etiopathogenesis of acute renal failure.
AB  - Research during the last few years has uncovered the mechanisms responsible for
      acute renal failure. During the initiation phase of acute tubular necrosis
      sublethal injury, apoptosis or necrosis of the tubular epithelium, hemodynamic
      alterations, tubule obstruction and back leakage occur. Hypofiltration persists
      due to imbalance between endothelins and endothelium derived nitric oxide,
      medullary congestion and tubuloglomerular feedback. Recovery is characterised by
      tubular epithelium regeneration. A greater understanding of the pathogenesis of
      acute renal failure will allow better management of such cases.

PMID- 11198791
TI  - The foam mattress-back syndrome.
AB  - BACKGROUND: Many medical residents used to sleeping on cotton mattresses at home
      complain of mild to moderate back pain after sleeping on foam mattresses provided
      in the hospital and hostel rooms. OBJECTIVE: To determine the relationship of
      sleeping on foam mattress with the appearance of back pain in a 500 bedded
      multispecialty tertiary care hospital. METHODS: One hundred medical residents
      were interviewed for the appearance of backache after sleeping on 10 cm thick
      foam mattress provided to them in the hostels. Pain was scored over a visual
      analog scale of 10 cm. Effect of sleeping on a regular cotton mattress was
      assessed. RESULTS: Sixty-three (5 female residents) developed back pain on the
      morning of a night of sleep over the foam mattress. The pain was mostly of lower
      back and was not associated with any objective neurodeficit. Four residents on
      account of the backache reported thirteen episodes of absenteeism. Sixty-one
      residents had a relief of the pain on going home where they would sleep on
      regular cotton mattresses, only to recur after sleeping again on the foam
      mattress in the hospital/hostel. CONCLUSION: Sleeping on foam mattress is
      associated with the appearance of backache in medical residents which is
      reproducible and gets relieved after using regular cotton mattresses.

PMID- 11198793
TI  - Therapeutic angiogenesis.

PMID- 11198794
TI  - Face of God.

PMID- 11198795
TI  - Disseminated tuberculosis causing bilateral adrenal enlargement and Addison's
      disease.
AB  - The clinical features and computed tomography imaging of a patient with acute
      adrenal failure following disseminated tuberculosis is described.

PMID- 11198796
TI  - Heterophil negative infectious mononucleosis like syndrome due to hepatitis B
      virus.
AB  - A case of acute viral hepatitis B with features suggestive of infectious
      mononucleosis in a 20 year girl is described. A differential diagnosis of
      heterophil negative infectious mononucleosis like syndrome due to varied
      aetiology based on serology is emphasised.

PMID- 11198797
TI  - Histoplasmosis: an unusual presentation.
AB  - Histoplasma capsulatum (HC) infection is rare in India. We document a case of
      unilateral adrenal histoplasmosis in a 56 year male. The patient presented with
      hepatosplenomegaly, unilateral adrenal mass and significant weight loss. Since
      FNAC of adrenal mass was inconclusive, he underwent splenectomy, adrenalectomy
      and liver biopsy, histology of these specimens revealed HC only in adrenal mass.
      Subsequently, histoplasmin test was also performed which was also found to be
      positive. He responded well to parenteral amphotericin B and is under regular
      follow-up with no complaints now.

PMID- 11198798
TI  - Hydroxyurea induced leg ulcers.
AB  - A 34 years non diabetic lady with chronic myeloid leukaemia (CML) was treated
      with hydroxyurea and interferon. She developed leg ulcers. First time on left toe
      and three months later on right foot, a rare complication of hydroxyurea. Both
      were treated with local wound care and antibiotics. First time dose of
      hydroxyurea was reduced and second time drug was discontinued.

PMID- 11198799
TI  - Situs inversus and compressive myelopathy in Klippel Feil syndrome.

PMID- 11198800
TI  - Primary hypothyroidism presenting as vaginal bleeding in a five year old girl.

PMID- 11198801
TI  - Multiple myeloma presenting as malabsorption syndrome due to amyloidosis.

PMID- 11198802
TI  - Familial Pelger--Huet anomaly in a female with adenocarcinoma of colon in a
      cancer prone family.

PMID- 11198803
TI  - Effect of protein and phosphate restricted and calcium and alphacalcidol
      supplemented diet on renal and parathyroid functions and protein status in
      chronic renal failure patients.

PMID- 11198804
TI  - Bradyarrhythmia due to Rauwolfia in homeopathic doses.

PMID- 11198805
TI  - Paracetamol (acetaminophen) poisoning: report of two cases.

PMID- 11198806
TI  - Idiopathic hypoparathyroidism with extensive intracranial calcification
      associated with kinesogenic choreoathetosis.

PMID- 11198807
TI  - Relevance of timely multidrug antimalarial regime in falciparum malaria.

PMID- 11198808
TI  - Acute intermittent porphyria: a new cause of posterior leukoencephalopathy
      syndrome.

PMID- 11198809
TI  - Neurocysticercosis presenting as chronic meningitis.

PMID- 11198810
TI  - Angina--an Indian disease.

PMID- 11198811
TI  - Prognostic factors in severe and complicated malaria.

PMID- 11198812
TI  - Availability of thiazide diuretics in Chandigarh.

PMID- 11198813
TI  - Norfloxacin-induced hallucination--an unusual CNS toxicity of 4-fluoroquinolones.

PMID- 11198814
TI  - Medicine in the next millennium.

PMID- 11198815
TI  - Combinatorial biochemistry in plants: the case of O-methyltransferases.
AB  - Combinatorial chemistry is common place today in chemical synthesis. Virtually
      thousands of derivatives of a molecule can be achieved by automated systems. The
      use of biological systems to exploit combinatorial chemistry (combinatorial
      biochemistry) now has multiple examples in the polyketide field. The modular
      functional domain structure of polyketide synthases have been recombined through
      genetic engineering into unnatural constellations in heterologous hosts in order
      to produce polyketide structures not yet discovered in nature. We present herein
      an example for a potential type of combinatorial biochemistry in alkaloidal
      systems using various combinations of Thalictrum tuberosum (meadow rue) O
      methyltransferase subunits that result in heterodimeric enzymes with substrate
      specificities that differ from those of the homodimeric native enzymes.

PMID- 11198816
TI  - Cytotoxic labdane diterpenoids from Croton oblongifolius.
AB  - Three labdane diterpenoids, 2-acetoxy-3-hydroxy-labda-8(17),12(E)-14-triene, 3
      acetoxy-2-hydroxy-labda-8(17),12(E)-14-triene, and 2,3-dihydroxy-labda
      8(17),12(E),14-triene were isolated from stem bark of Croton oblongifolius. Their
      structures were established by spectroscopic data, and each was also tested for
      cytotoxicity against various human tumor cell lines. The latter compound showed
      non-specific, moderate, cytotoxicities against all the cell lines; whereas the
      first two compounds were less active.

PMID- 11198817
TI  - Phenylbutanoid dimers from the leaves of Alpinia flabellata.
AB  - Three phenylbutanoid dimers, cis- and trans-1-(2,4,5-trimethoxy-E-styryl)-2
      (2,4,5-trimethoxy-Z-styryl)cyclobutane and 1,2-bis(2,4,5-trimethoxy-Z-styryl)-
      cyclobutane, were isolated from the leaves of Alpinia flabellata Ridley, together
      with three known compounds (2,4,5-trimethoxybenzaldehyde, 2,4,5
      trimethoxycinnamaldehyde and 3,5-dihydroxy-7,4'-dimethoxyflavone). The structures
      of these compounds were determined by spectroscopic analysis.

PMID- 11198818
TI  - The chemical diversity and distribution of glucosinolates and isothiocyanates
      among plants.
AB  - Glucosinolates (beta-thioglucoside-N-hydroxysulfates), the precursors of
      isothiocyanates, are present in sixteen families of dicotyledonous angiosperms
      including a large number of edible species. At least 120 different glucosinolates
      have been identified in these plants, although closely related taxonomic groups
      typically contain only a small number of such compounds. Glucosinolates and/or
      their breakdown products have long been known for their fungicidal,
      bacteriocidal, nematocidal and allelopathic properties and have recently
      attracted intense research interest because of their cancer chemoprotective
      attributes. Numerous reviews have addressed the occurrence of glucosinolates in
      vegetables, primarily the family Brassicaceae (syn. Cruciferae; including
      Brassica spp and Raphanus spp). The major focus of much previous research has
      been on the negative aspects of these compounds because of the prevalence of
      certain "antinutritional" or goitrogenic glucosinolates in the protein-rich
      defatted meal from widely grown oilseed crops and in some domesticated vegetable
      crops. There is, however, an opposite and positive side of this picture
      represented by the therapeutic and prophylactic properties of other "nutritional"
      or "functional" glucosinolates. This review addresses the complex array of these
      biologically active and chemically diverse compounds many of which have been
      identified during the past three decades in other families. In addition to the
      Brassica vegetables, these glucosinolates have been found in hundreds of species,
      many of which are edible or could provide substantial quantities of
      glucosinolates for isolation, for biological evaluation, and potential
      application as chemoprotective or other dietary or pharmacological agents.

PMID- 11198819
TI  - Purification and characterization of a lectin from the mushroom Mycoleptodonoides
      aitchisonii.
AB  - A lectin was isolated from the mushroom Mycoleptodonoides aitchisonii by means of
      affinity chromatography on bovine submaxillary mucin (BSM)-Toyopearl and gel
      filtration on Superose 12 HR10/30 using a FPLC system. This lectin is composed of
      four identical 16 kDa subunits and the molecular mass of the intact lectin was
      estimated to be 64 kDa by gel filtration. In a hemagglutination inhibition assay,
      it exhibited strong sugar-binding specificity towards asialo-BSM among the mono-
      or oligo-saccharides and glycoproteins tested. The binding specificity of the
      lectin was also examined by surface plasmon resonance analysis.

PMID- 11198820
TI  - Tropane alkaloid production by shoot culture of Duboisia myoporoides R. Br.
AB  - This work demonstrates the presence of hyoscyamine and scopolamine at different
      stages of shoot regeneration from non-organogenic and organogenic calli. The 11
      week-old non-organogenic calli contained 0.41+/-0.03 and 0.23+/-0.02 microg g(-1)
      dry wt hyoscyamine and scopolamine respectively. However, no root meristem was
      found in the calli. The alkaloids were absent in 2-week-old organogenic calli.
      The shoot-buds induced on the non-organogenic and organogenic calli did not
      contain these alkaloids. Hyoscyamine and scopolamine contents of the 6-week-old
      non-rooted shoots regenerated from non-organogenic calli were 7.8+/-0.1 and 6.5+/
      0.4 microg g(-1) dry wt respectively and those in the 9-week-old non-rooted shoot
      regenerated from organogenic calli were 38.5+/-0.4 and 3.6+/-0.1 microg g(-1) dry
      wt respectively. Hyoscyamine and scopolamine contents of the 4-week-old roots
      regenerated from non-organogenic and organogenic calli were higher than those in
      the non-rooted shoots. Since the presence of hyoscyamine and scopolamine in the
      non-rooted shoot depends on the stage of differentiation, manipulation of culture
      environment may improve hyoscyamine and scopolamine contents of the non-rooted
      shoots.

PMID- 11198821
TI  - Metabolism of gibberellins A1 and A3 in fruits and shoots of Prunus avium.
AB  - Isotope-labelled GA metabolites were identified by GC--MS, following HPLC
      fractionation of extracts derived from fruits or shoots, that had been incubated
      with [2H]- and [3H]- GA1 or [2H]- and [3H]- GA3. GA1 (1) was converted into GA8
      (10) by developing fruits and vegetative shoots of sweet cherry (Prunus avium cv.
      'Stella'), while GA3 (4) was converted into GA3-isolactone (17). Other
      metabolites of each GA were detected but were not identified unequivocally. These
      included a metabolite of GA1 (1) in fruitlets that was more polar (by reverse
      phase HPLC) than GA8 (10) and a metabolite of similar polarity to GA87 (6), was
      obtained after incubating fruitlets with GA3 (4). However, no evidence was
      obtained to suggest that GA87 (6) was a metabolite of GA3 (4) or that GA85 (2)
      was a metabolite of GA1 (1) in these tissues, under the conditions used. The
      pattern of metabolites obtained from vegetative tissues was similar to that from
      fruitlets. However, the results suggested that GA1 (1) and GA3 (4) were
      metabolised at a greater rate in shoots from mature trees than in shoots from
      seedlings, and that GA1 (1) was metabolised more rapidly than GA3 (4) in juvenile
      and mature shoots. We conclude from these observations that GA3 (4) is not a
      precursor of GA87 (6) and GA32 (5), also, that GA1 (1) is not a precursor of GA85
      (2) and GA86 (3) in developing fruits or in vegetative shoots of sweet cherry.

PMID- 11198822
TI  - Profiling changes in metabolism of isoflavonoids and their conjugates in Lupinus
      albus treated with biotic elicitor.
AB  - Liquid chromatography with ultraviolet and mass spectrometric detection was
      applied to monitor changes in profiles of isoflavonoid glycosides and free
      isoflavonoid aglycones in Lupinus albus L. Four isoflavonoid aglycones, fourteen
      isoflavonoid glycosides, four flavonol glycosides and flavone glycoside were
      identified in lupin tissue after LC/ESI/MS analyses. An elicitor preparation from
      purified yeast cell wall was used to inject the shoots of 3-week old seedlings or
      to infiltrate the cut lupin leaves. Qualitative and quantitative changes of
      isoflavonoids were measured at different time points after elicitation. In
      elicited lupin seedlings increased amounts of prenylated isoflavone aglycones
      were identified. The concentrations of glycosidic conjugates of isoflavones
      present in plant tissue were less affected.

PMID- 11198823
TI  - A distinctive flavonoid chemistry for the anomalous genus Biebersteinia.
AB  - Leaf surface extracts of Biebersteinia orphanidis have yielded a complex mixture
      of five flavones with the unusual 5,7-dihydroxy-6,8-dimethoxy A ring substitution
      pattern. They are acerosin, hymenoxin, nevadensin, sudachitin and 5,7,4'
      trihydroxy-6,8-dimethoxyflavone. Also present at the leaf surface are gardenin B,
      luteolin, apigenin, acacetin and the coumarin umbelliferone. The internal leaf
      flavonoids include the 7-glucosides of apigenin, luteolin and tricetin, together
      with the 7-rutinosides of apigenin and luteolin. This profile differs from those
      of B. heterostemon and B. odora. It appears that B. orphanidis is as highly
      distinctive in its flavonoid pattern as it is phytogeographically. The data also
      confirm the conclusion of other studies, including rbcL and atpB gene sequence
      analysis, that Biebersteinia is completely unrelated to the Geraniaceae, where it
      was once placed.

PMID- 11198824
TI  - Bioactive oleanolic acid saponins and other constituents from the roots of
      Viguiera decurrens.
AB  - The bisdesmoside oleanolic acid saponin, 3-0-(methyl-beta-D
      glucuronopyranosiduronoate)-28-0-beta-D-glucopyranosyl-oleanolate along with nine
      known compounds (two diterpenic acids, one chromene, three triterpenes, one
      steroidal glycoside, and two monodesmoside oleanolic acid saponins), were
      obtained from Viguiera decurrens roots. The chemical structure of the
      bisdesmoside oleanolic saponin was determined by chemical and NMR spectral
      evidence. A mixture of monodesmoside saponins displayed cytotoxic activity
      against P388 and COLON cell lines (ED50= 2.3 and 3.6 microg/ml, respectively).
      Two of the known compounds showed insecticidal activity against the Mexican bean
      beetle larvae (Epilachna varivestis).

PMID- 11198825
TI  - Trianthenol: an antifungal tetraterpenoid from Trianthema portulacastrum
      (Aizoaceae).
AB  - An antifungal tetraterpenoid named trianthenol 1 has been isolated from the
      chloroform extract of Trianthema portulacastrum. Its structure was established as
      15-hydroxymethyl-2,6,10,18,22,26,30-heptamethyl-14-methylene- 17-hentriacontene
      on the basis of spectroscopic data including high resolution mass and two
      dimensional NMR techniques. A benzaldehyde derivative 2, a pentacyclic
      triterpenoid 3 and benzoic acid derivatives 4-5 are also reported for the first
      time from Trianthema portulacastrum.

PMID- 11198826
TI  - Victory!

PMID- 11198827
TI  - Ultrasonographic screening for developmental dysplasia of the hip: an
      epidemiologic analysis (Part II).

PMID- 11198828
TI  - SLAP lesions: current concepts.
AB  - The presence and significance of superior glenoid labral tears have received
      increasing attention in the 1990s. The symptoms associated with labral tears can
      be quite disabling to competitive and recreational athletes alike. Recent basic
      science and clinical studies have contributed much to the understanding of these
      injuries, including their association with suprascapular nerve entrapment. This
      article reviews the current basic science and clinical understanding of SLAP
      (superior labrum anterior and posterior) lesions in order to guide clinicians and
      promote further investigation.

PMID- 11198829
TI  - Efficacy of single-dose and multidose rofecoxib in the treatment of post
      orthopedic surgery pain.
AB  - To determine the efficacy of rofecoxib in post-orthopedic surgery pain, we
      conducted a double-blind, randomized, placebo- and active-comparator-controlled,
      parallel-group trial. Two hundred eighteen patients enrolled. Day 1 patients
      received placebo, rofecoxib 50 mg, or naproxen sodium 550 mg. Days 2 through 5,
      the placebo and naproxen sodium groups received placebo, and the rofecoxib group
      received rofecoxib 25 or 50 mg. Rofecoxib 50 mg was superior to placebo (P < .05)
      and similar to naproxen sodium for all single-dose measures of pain relief. Days
      2 through 5, the rofecoxib 50 mg group used less supplemental narcotic analgesia
      (P = .005) and reported less pain on global evaluations (P = .041) when compared
      with the placebo group; the efficacy of rofecoxib 25 mg fell between that of
      placebo and rofecoxib 50 mg for these endpoints (P < or = .267). Rofecoxib 50 mg
      once daily effectively treated post-orthopedic surgery pain.

PMID- 11198830
TI  - Back pain caused by benign tumors and tumor-like lesions of the thoracolumbar
      spine.
AB  - Twenty-two patients with benign tumors or tumor-like lesions of the spine
      (vertebral echinococcal cysts, eosinophilic granuloma) presented with back pain
      and deformity. The duration of pain ranged from 1 to 6 years. Five patients had
      incomplete paraplegia at admission. Spine deformity was observed in patients with
      osteoid osteoma, osteoblastoma, hemangioma, and vertebral echinococcal
      involvement. All patients underwent clinical evaluation, laboratory studies, and
      histologic studies. Electromyogram studies were performed in patients who had a
      neurologic deficit or nerve root irritation. Imaging evaluation consisted of
      plain films, bone scans, computed tomography scans, and magnetic resonance
      imaging scans. Fifteen patients had lumbar involvement; 7 had thoracic
      involvement. For 18 patients, management included tumor excision and thorough
      debridement of the lesion. Spinal instrumentation and fusion were used to correct
      the deformity and treat the instability in 5 patients. Patients were followed for
      1 to 8 years. Of the 5 patients with incomplete paraplegia, 4 recovered
      completely, and the fifth (who had spinal cord hemangioma) improved 2 grades on
      Frankel's scale. The remaining patients were disease free and returned to routine
      daily activities. Benign tumors or tumor-like lesions of the thoracolumbar or
      lumbar spine are very rare and easily misdiagnosed in patients with persistent
      back pain. Patients whose symptoms progress or fail to respond over an
      appropriate period of time should be evaluated further. Complete excision of the
      tumor followed by spinal instrumentation in the presence of deformity or
      instability is the treatment of choice.

PMID- 11198831
TI  - Axial computed tomography of the pedicle in the lower cervical spine.
AB  - Using axial computed tomography (CT), we measured pedicle width, pedicle axis
      length, pedicle transverse angle, and distance between screw entry point and
      vertebrae midline in the cervical spines (C3-C7) of 40 patients. All measurements
      were greater in men than in women, and we noted significant sex differences at
      most levels of pedicle inner and outer widths (P < or = .05 or P < or = .01).
      Mean pedicle inner and outer widths for all levels and all patients ranged from
      2.3 to 3.0 mm and from 5.0 to 6.0 mm, respectively. Mean distances between screw
      entry point and vertebrae midline ranged from 22.2 to 23.7 mm. Results of this
      study-along with axial CT measurements of individual pedicle diameter, pedicle
      transverse angle, and screw entry point-would be useful when considering and
      performing transpedicular screw fixation in the cervical spine.

PMID- 11198832
TI  - Two cases of osteochondroma recurrence after surgical resection.
AB  - Osteochondromas are the most common bone tumor found in children. A review of 114
      resected osteochondromas over a 10-year period revealed recurrence in 2 cases.
      The overall recurrence rate of these lesions is less than 2% and was found to be
      1.8% in this review.

PMID- 11198833
TI  - Intramedullary fixation of pediatric forearm diaphyseal fractures.
AB  - Surgical treatment of pediatric forearm fractures is controversial. In this
      retrospective study, we reviewed 24 skeletally immature radial and ulnar
      fractures in 24 patients treated with intramedullary Rush pins and/or Kirschner
      wires between 1994 and 1999. The indication for surgical intervention was
      unacceptable closed reduction, unstable fracture pattern, open fracture, or
      recurrence after nonsurgical treatment. For each patient, a sugar tong splint was
      used for 4 weeks, and pins were removed 8 weeks after surgery. Average length of
      follow-up was 32 months (range, 6-58 months). All fractures in this series
      healed. Average time to union was 8 weeks. There were no complications of delayed
      union, nonunion, infection, or neurovascular injury. All patients regained full
      range of motion of the injured extremity.

PMID- 11198834
TI  - Use of a reciprocating rasp as an adjunct to open acromioplasty.

PMID- 11198835
TI  - A 22-year-old woman with chronic, mild, intermittent knee pain.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to orthopedic surgeons. The initial history,
      physical findings, and roentgenographic examination are found on the first page.
      The final clinical and roentgenographic diagnosis is presented on the following
      page.

PMID- 11198836
TI  - Esophageal cancer: a systematic review.
AB  - Carcinoma of the esophagus has one of the lowest possibilities of cure, with 5
      year survival rates estimated to be approximately 10% overall; these rates are
      second only to hepatobiliary and pancreatic cancers. This fact and the rapid
      increase in the incidence of adenocarcinomas of the esophagus in recent years
      challenges us to identify areas of improvement for all aspects of this disease.
      We discuss potential reasons for the increase in the incidence of
      adenocarcinomas, evidence that defines the similarity between tumors of the
      gastroesophageal junction and the tubular esophagus, and other prognostic factors
      that may influence future modifications of our staging classification of this
      disease. Surgical advances have translated into improvements in surgical
      morbidity and mortality rates. Current therapeutic options and the relative
      merits of the options are discussed. Improvements in patient outcome most likely
      hinge on earlier diagnosis, more accurate staging, and the optimal use of
      combined modalities, coupled with technical advances in the modalities. A
      systematic review approach was undertaken to evaluate the performance
      characteristics of newer staging tools and the value of different combined
      modality approaches with particular focus on the use of those approaches for
      patients with potentially curable disease. A similar methodologic approach was
      used to address the utility of the many strategies currently used in practice for
      the palliation of esophageal tumors, with particular focus on the relief of
      malignant dysphagia. Finally, a summary of published guidelines and population
      based patterns of care are presented. This serves as an overview of how all of
      this evidence actually translates into the care we are providing. A coordinated
      international effort in population-based research and randomized controlled
      trials would be the cornerstone to future advances in this relatively uncommon
      but devastating disease.

PMID- 11198837
TI  - Benefits and outcomes of staff nurses' participation in decision making.
AB  - OBJECTIVES: To investigate the relations among staff nurses' participation in
      phases of the decision-making process related to decisions in nursing practice,
      competencies of nurse manager leadership, and nurse-physician collaboration.
      METHODS: This study is a secondary analysis of the Variations in Nursing Practice
      Model study. The data were derived from the responses of staff nurses to a
      questionnaire asking about their participation in decision making, their
      perception of the competency of nurse manager leadership, and their collaboration
      with physicians. RESULTS: Nurse-physician collaboration contributed to greater
      participation in all phases of both caregiving and condition-of-work decisions.
      The competency of nurse manager leadership had a small but significant positive
      correlation with participation in decision making, but it did not have a
      significant effect on phases of participation in both types of decisions.
      CONCLUSIONS: The study findings provide evidence to support the relations among
      an organizational structure, an organizational process, and a provider process of
      healthcare. Further research is needed to clarify the relation among structure,
      process, and specific outcomes.

PMID- 11198838
TI  - Building a strong nursing organization in a merged, service line structure.
AB  - In an increasingly complex healthcare environment, the discipline of nursing is
      difficult to define. Although a designated "department of nursing" may be absent
      on the organizational chart, the functional elements of the discipline remain.
      Nursing leaders will benefit from a framework to define and operationalize the
      core elements of nursing. The authors offer a five-phase methodology to enable
      the creation of a strong nursing organization in the face of mergers, service
      lines, and complex reporting structures.

PMID- 11198839
TI  - Nurse experience and education: effect on quality of care.
AB  - OBJECTIVE: To describe the relationships between the quality of patient care and
      the education and experience of the nurses providing that care. BACKGROUND: There
      is a call for more nurses with baccalaureate degrees and more experienced nurses
      to work in hospitals. Previous research studies have examined the
      characteristics, abilities, and work assignments of nurses with and without
      baccalaureate degrees but have not examined the quality of the patient care
      delivered. It is generally believed that more experienced nurses provide higher
      quality care, but again few studies have actually examined this issue. METHODS: A
      secondary analysis of data, collected in two previous studies of the relationship
      between nurse staffing (hours of care, staff mix) and the quality of patient
      care, was used to determine the relationship between nurses' education and
      experience and the quality of care provided. The data were collected at the
      patient care unit level (42 units in study 1 and 39 units in study 2). Quality of
      care was indicated by lower unit rates of medication errors and patient falls.
      RESULTS: Controlling for patient acuity, hours of nursing care, and staff mix,
      units with more experienced nurses had lower medication errors and lower patient
      fall rates. These adverse occurrence rates on units with more baccalaureate
      prepared nurses were not significantly better.

PMID- 11198840
TI  - Program logic. A planning and evaluation method.

PMID- 11198841
TI  - Nursing student residency program: a model for a seamless transition from nursing
      student to RN.
AB  - It takes a relatively long time for new nursing graduates to become oriented and
      comfortable with work routines on the nursing unit. To address the problem, the
      authors formed a partnership among three educational programs and three
      hospitals. This article describes a 900-hour residency program for senior
      baccalaureate nursing students to ease their transition into the role of
      beginning-level staff nurse in an acute-care setting. The benefits to the
      hospitals were decreased orientation time, less turnover in staff (50% at 2
      years), and lower recruitment costs.

PMID- 11198842
TI  - E-learning: directions for nurses in executive practice.

PMID- 11198843
TI  - An expanded professional nursing role: increasing hospital reimbursement.

PMID- 11198844
TI  - Publicly available healthcare databases for administrative strategic planning.
AB  - Existing public databases may help nurse administrators better understand the
      rapidly changing and increasingly complex healthcare environment. The authors
      discuss the availability of public healthcare databases and demonstrate through a
      hypothetical query how nurse administrators can use these databases during their
      decision-making efforts.

PMID- 11198845
TI  - The structure-directing properties of [VOF5]2-.

PMID- 11198846
TI  - Syntheses of ketonated disulfide-bridged diruthenium complexes via C-H bond
      activation and C-S bond formation.
AB  - The alpha-C-H bonds of 3-methyl-2-butanone, 3-pentanone, and 2-methyl-3-pentanone
      were activated on the sulfur center of the disulfide-bridged ruthenium dinuclear
      complex [(RuCl(P(OCH3)3)2)2(mu-S2)(mu-Cl)2] (1) in the presence of AgX (X = PF6,
      SbF6) with concomitant formation of C-S bonds to give the corresponding ketonated
      complexes [(Ru(CH3CN)2(P(OCH3)3)2)(mu-SSCHR1COR2)(Ru(CH3CN)3(P(OCH3)3)2)]X3
      ([5](PF6)3, R1 = H, R2 = CH(CH3)2, X = PF6; [6](PF6)3, R1 = CH3, R2 = CH2CH3, X =
      PF6; [7](SbF6)3, R1 = CH3, R2 = CH(CH3)2, X = SbF6). For unsymmetric ketones, the
      primary or the secondary carbon of the alpha-C-H bond, rather than the tertiary
      carbon, is preferentially bound to one of the two bridging sulfur atoms. The
      alpha-C-H bond of the cyclic ketone cyclohexanone was cleaved to give the complex
      [(Ru(CH3CN)2(P(OCH3)3)2)(mu-SS-1- cyclohexanon-2
      yl)(Ru(CH3CN)3(P(OCH3)3)2)](SbF6)3 ([8](SbF6)3). And the reactions of
      acetophenone and p-methoxyacetophenone, respectively, with the chloride-free
      complex [(Ru(CH3CN)3(P(OCH3)3)2)2(mu-S2)]4+ (3) gave [(Ru(CH3CN)2(P(OCH3)3)2)(mu
      SSCH2COAr)(Ru(CH3CN)3(P(OCH3)3)2)](CF3SO3)3 ([9](CF3SO3)3, Ar = Ph;
      [10](CF3SO3)3, Ar = p-CH3OC6H4). The relative reactivities of a primary and a
      secondary C-H bond were clearly observed in the reaction of butanone with complex
      3, which gave a mixture of two complexes, i.e., [(Ru(CH3CN)2(P(OCH3)3)20(mu
      SSCH2COCH2CH3)(Ru(CH3CN)3(P(OCH3)3)2)](CF3SO3)3 ([11](CF3SO3)3) and
      [(Ru(CH3CN)2(P(OCH3)3)2)(mu-SSCHCH3COCH3)(Ru(CH3CN)3(P(OCH3)2)](CF3SO3)3
      ([12](CF3SO3)3), in a molar ratio of 1:1.8. Complex 12 was converted to 11 at
      room temperature if the reaction time was prolonged. The relative reactivities of
      the alpha-C-H bonds of the ketones were deduced to be in the order 2 degrees > 1
      degree > 3 degrees, on the basis of the consideration of contributions from both
      electronic and steric effects. Additionally, the C-S bonds in the ketonated
      complexes were found to be cleaved easily by protonation at room temperature. The
      mechanism for the formation of the ketonated disulfide-bridged ruthenium
      dinuclear complexes is as follows: initial coordination of the oxygen atom of the
      carbonyl group to the ruthenium center, followed by addition of an alpha-C-H bond
      to the disulfide bridging ligand, having S=S double-bond character, to form a C-S
      S-H moiety, and finally completion of the reaction by deprotonation of the S-H
      bond.

PMID- 11198847
TI  - Unsaturated Ru(0) species with a constrained bis-phosphine ligand:
      [Ru(CO)2(tBu2PCH2CH2PtBu2)]2. Comparison to [Ru(CO)2(PtBu2Me)2].
AB  - The synthesis of Ru(C2H4)(CO)2(dtbpe) (dtbpe = tBu2PC2H4PtBu2), then green
      [Ru(CO)2(dtbpe)]n is described. In solution, n = 1, while in the solid state, n =
      2; the dimer has two carbonyl bridges. DFTPW91, MP2, and CCSD(T) calculations
      show that the potential energy surface for bending one carbonyl out of the
      RuP2C(O) plane is essentially flat. Ru(CO)2(dtbpe) reacts rapidly in benzene
      solution to oxidatively add the H-E bond of H2, HCl, HCCR (R = H, Ph),
      [HOEt2]BF4, and HSiEt3. The H-C bond of C6HF5 oxidatively adds at 80 degrees C.
      CO adds, as does the C=C bond of H2C=CHX (X = H, F, Me). The following do not
      add: N2, THF, acetone, H3COH, and H2O.

PMID- 11198848
TI  - Preparation of polyetherol-appended sulfur porphyrazines and investigations of
      peripheral metal ion binding in polar solvents.
AB  - We describe the complete synthesis and characterization of a new family of
      peripherally functionalized porphyrazines (pz's) with four, three, or two (in a
      trans conformation) bis[thioethoxy(ethoxy)ethanol] moieties appended at the
      pyrroles. These "polyetherol" groups serve as weak exocyclic binding sites for a
      number of metal ions and also provide solubility of the pz's in low molecular
      weight alcohols and water. Electronic spectra of the modified porphyrazines
      exhibit distinct changes in the visible region (both absorbance and fluorescence)
      in response to treatment with Ag+, Pb2+, Cd2+, Cs+, and Ni2+ in solution. Such
      properties make these compounds intriguing candidates for incorporation into the
      transducer layers in optically based chemical sensors.

PMID- 11198849
TI  - Vanadium(IV) and -(V) complexes with O,N-chelating aminophenolate and
      pyridylalkoxide ligands.
AB  - Two different monoanionic O,N-chelating ligand systems, i.e., [OC6H2(CH2NMe2)-2
      Me2-4,6]- (1) and [OCMe2([2]-Py)]- (2), have been applied in the synthesis of
      vanadium(V) complexes. The tertiary amine functionality in 1 caused reduction of
      the vanadium nucleus to the 4+ oxidation state with either [VOCl3], [V(=NR)Cl3],
      or [V(=NR)(NEt2)3] (R = Ph, (3a, 5a), R = p-Tol (3b, 5b)), and applying 1 as a
      reducing agent resulted in the synthesis of the vanadium(IV) complexes
      [VO(OC6H2(CH2NMe2)-2-Me2-4,6)2] (4) and [V(=NPh)(OC6H2(CH2NMe2)-2-Me2-4,6)2] (6).
      In the case of [V(=N-p-Tol)(NEt2)(OC6H2(CH2NMe2)-2-Me2-4,6)2] (7b), the reduction
      was sufficiently slow to allow its characterization by 1H NMR and variable
      temperature studies showed it to be a five-coordinate species in solution.
      Although the reaction of 1 with [V(=N-p-Tol)(O-i-Pr)3] (9b) did not result in
      reduction of the vanadium nucleus, vanadium(V) compounds could not be isolated.
      Mixtures of the vanadium(V) (mono)phenolate, [V(=N-p-Tol)(O-i-Pr)2(OC6H2(CH2NMe2)
      2-Me2-4,6)] (10), and the vanadium(V) (bis)phenolate, [V(=N-p-Tol)(O-i
      Pr)(OC6H2(CH2NMe2)-2-Me2-4,6)2] (11), were obtained. With the pyridylalkoxide 2,
      no reduction was observed and the vanadium(V) compounds [VOCl2(OCMe2([2]-Py))]
      (12) and [V(=N-p-Tol)Cl2(OCMe2([2]-Py)] (13) were obtained. 51V NMR showed 7b and
      12 to be five-coordinate in solution, whereas for 10, 11, and 13 a coordination
      number of 6 was found. Compounds 12 and 13 showed decreased activity compared to
      their nonchelated vanadium(V) analogues when applied as catalysts in ethene
      polymerization. Two polymorphic forms with a difference in the V-N-C angle of
      12.5 degrees have been found for 6. Crystal data: 6.Et2O, triclinic, P1, a =
      11.1557(6) A, b = 12.5744(12) A, c = 13.1051(14) A, alpha = 64.244(8) degrees,
      beta = 70.472(7) degrees, gamma = 87.950(6) degrees, V = 1547(3) A3, Z = 2;
      6.C6H6, triclinic, P1, a = 8.6034(3) A, b = 13.3614(4) A, c = 15.1044(5) A, alpha
      = 98.182(3) degrees, beta = 105.618(2) degrees, gamma = 107.130(2) degrees, V =
      1551.00(10) A3, Z = 2; 12, orthorhombic, Pbca, a = 11.8576(12) A, b = 12.6710(13)
      A, c = 14.722(2) A, V = 2211.9(4) A3, Z = 8.

PMID- 11198850
TI  - An integrated approach to the mid-spin state (S = 3/2) in six-coordinate
      iron(III) chiroporphyrins.
AB  - An intermediate-spin state very close to the mid-spin state (S = 3/2) can be
      stabilized in a ferric porphyrin by an integrated approach which combines the
      favorable effects of a weak axial field strength and of a small macrocycle hole.
      Axial ligand exchange by reaction of chloroiron(III)tetramethylchiroporphyrin
      [(TMCP)FeCl] with silver perchlorate in ethanol-chloroform leads to ethanol
      ligated ferric chiroporphyrins. Two distinct crystalline products containing a
      bisethanol complex [[(TMCP)FeIII(EtOH)2]ClO4] and three variants of a mixed
      ethanol-water complex [[(TMCP)FeIII(EtOH)(H2O)]ClO4] have been structurally
      characterized in the solid state. The small hole of the ruffled chiroporphyrin
      and the weak axial oxygen ligation result in strongly tetragonally distorted
      complexes. The six-coordinate species exhibit long axial Fe-O bond distances
      (2.173(5)-2.272(4) A) and the shortest equatorial Fe-N(av) distances (1.950(5)
      1.978(7) A) found as yet in a ferric porphyrin, reflecting a singly occupied dz2
      orbital and a largely depopulated dx2-y2 orbital. An intriguing case of bond
      stretch isomerism is seen for the axial Fe-O bonds in two crystallographically
      independent mixed ethanol-water species, and it is accounted for by their
      distinct intra- and intermolecular hydrogen-bond arrays. The Mossbauer spectrum
      (delta = 0.35(1) mm s-1 and delta EQ = 3.79(1) mm s-1 at 77 K) indicates a strong
      tetragonal distortion around the ferric ion, in agreement with the structural
      data. The value of the magnetic moment (mu eff = 3.8 mu B in the range 50-300 K)
      strongly supports a mid-spin state (S = 3/2). The EPR spectrum at 80 K (g
      perpendicular approximately 4.0, g parallel approximately 2.00) is consistent
      with a nearly pure mid-spin state (4A2) with little rhombic distortion. The 1H
      NMR spectra in CDCl3-EtOH exhibit upfield-shifted resonances for the pyrrole
      protons (delta approximately -30 ppm) which are consistent with the depopulated
      iron dx2-y2 orbital. Solution equilibria with water and various alcohols, and the
      spin state of the corresponding species, are discussed on the basis of the NMR
      data. The bisethanol and ethanol-water species are potential models of unknown
      hemoprotein ligation states such as Tyr(OH)/Tyr(OH) or Tyr(OH)/H2O that could be
      obtained by site-directed mutagenesis.

PMID- 11198851
TI  - Syntheses of novel exo and endo isomers of ansa-substituted fluorophosphazenes
      and their facile transformations into spiro isomers in the presence of fluoride
      ions.
AB  - Reactions of the dilithiated diols RCH2P(S)(CH2OLi)2 [R = Fc (1), Ph (2) (Fc =
      ferrocenyl)] with N3P3F6 in equimolar ratios at -80 degrees C result exclusively
      in the formation of two structural isomers of ansa-substituted compounds, endo
      RCH2P(S)(CH2O)2[P(F)N]2(F2PN) [R = Fc (3a), Ph (4a)] and exo
      RCH2P(S)(CH2O)2[P(F)N]2(F2PN) [R = Fc (3b), Ph (4b)], which are separated by
      column chromatography. Increasing the reaction temperature to -40 degrees C
      results in more of the exo isomers 3b and 4b at the expense of the endo isomers.
      The formation of the ansa-substituted compounds is found to depend on the
      dilithiation of the diols, as a reaction of the silylated phosphine sulfide
      FcCH2P(S)(CH2OSiMe3)2 (5) with N3P3F6 in the presence of CsF does not yield
      either 3a or 3b but instead gives the spiro isomer [FcCH2P(S)(CH2O)2 PN](F2PN)2
      (6) as the disubstitution product of N3P3F6. The ansa isomers 3a and 3b are
      transformed into the spiro compound 6 in the presence of catalytic amounts of CsF
      at room temperature in THF, while 4a and 4b are transformed into the spiro
      compound [PhCH2P(S)(CH2O)2PN](F2PN)2 (7) under similar conditions. The novel
      conversions of ansa-substituted phosphazenes into spirocyclic phosphazenes were
      monitored by time-dependent 31P NMR spectroscopy. The effect of temperature on a
      transformation was studied by carrying out reactions at various temperatures in
      the range from -60 to +33 degrees C for 3b. In addition, compounds 3a, 3b, 4a,
      and 6 were structurally characterized. In the case of the ansa compounds, the
      nitrogen atom flanked by the bridging phosphorus sites was found to deviate
      significantly from the plane defined by the five remaining atoms of the
      phosphazene ring.

PMID- 11198852
TI  - Application of n-Bu4NHF2 as a fluorinating agent for the preparation of
      fluoroanions: synthesis and crystal structure of the anions [t-BuPO3AlF2]2(2-),
      [PhPO3AlF2]2(2-), and [(O-i-Pr)3Ti(mu-F)2(mu-O-i-Pr)Ti(O-i-Pr)3]-.
AB  - The first phosphonate anions of aluminum-containing fluorine and an anionic
      bridged fluoroalkoxy derivative of titanium have been realized using n-Bu4NHF2 as
      a fluorinating agent in organometallic synthesis. Reactions of [RPO3AlMe]4 [R =
      Ph (1), t-Bu] with n-Bu4NHF2 yield organic-soluble compounds of the type [n
      Bu4N]2[RPO3AlF2]2 [R = Ph (2), t-Bu (3)], whereas the reaction of Ti(O-i-Pr)4
      with n-Bu4NHF2 results in the formation of [n-Bu4N][O-i-Pr)3Ti(mu-F)2(mu-O-i
      Pr)Ti(O-i-Pr)3] (4). These compounds have been obtained in high yields and have
      been adequately characterized through spectroscopic techniques and X-ray
      diffraction studies.

PMID- 11198853
TI  - TAS+(Z)-Me3CNSN- and TAS+(E)-Me3SiNSN-: does the anion-cation interaction
      influence the configuration?
AB  - TAS+ salts (TAS = (Me2N)3S) of the sulfur diimide anions Me3XNSN- (X = C (1a), Si
      (1b)) were prepared by Si-N bond cleavage from the corresponding sulfur diimides
      Me3XNSNSiMe3 and TAS-fluoride ((Me2N)3S+Me3SiF2-) and characterized by X-ray
      crystallography and multinuclear NMR spectroscopy. According to the
      experimentally determined bond lengths and theoretical calculations, the Me3XNSN-
      anions are best described as thiazylamides Me3X-N-S identical to N rather than
      sulfur diimides Me3X-N=S=N. In agreement with the calculated and experimentally
      determined structures of the isoelectronic thionylimides RNSO, 1a adopts the Z
      configuration, which is electronically favored due to anomeric effects. The
      electronically disfavored E-configuration of 1b in the solid state can be
      explained by weak anion-cation interaction.

PMID- 11198854
TI  - Steric effects control the structure of the solvated lanthanum(III) ion in
      aqueous, dimethyl sulfoxide, and N,N'-dimethylpropyleneurea solution. An EXAFS
      and large-angle X-ray scattering study.
AB  - The structure of the solvated lanthanum(III) ion has been determined in aqueous,
      dimethyl sulfoxide, and N,N'-dimethylpropyleneurea solution by means of the EXAFS
      and large-angle X-ray scattering (LAXS) techniques. The close agreement between
      the EXAFS spectra of solid nonaaqualanthanum(III) trifluoromethanesulfonate and
      of an aqueous lanthanum(III) perchlorate solution shows that the hydrated
      lanthanum(III) ion in aqueous solution most probably has the same structure as in
      the solid, i.e., nine water molecules coordinated in a tricapped trigonal
      prismatic configuration. The data analysis from EXAFS and LAXS measurements of
      the aqueous solution resulted in the La-O bond distances 2.52(2) and 2.65(3) A to
      the water molecules in the prism and the capping positions, respectively. The
      LAXS study shows a second hydration sphere consistent with approximately 18 water
      molecules at 4.63(2) A. The EXAFS spectra of solid octakis(dimethyl
      sulfoxide)lanthanum(III) trifluoromethanesulfonate and a dimethyl sulfoxide
      solution of this salt are also similar. The data analysis of EXAFS and LAXS
      measurements assuming eight-coordination around lanthanum yielded an La-O bond
      distance of 2.50(2) A, and an La...S distance of 3.70(3) A, giving an La-O-S
      angle of 133(2) degrees. The EXAFS data of an N,N'-dimethylpropyleneurea solution
      of lanthanum(III) trifluoromethanesulfonate gave the La-O bond distance 2.438(4)
      A and the La...C distance 3.41(2) A, which correspond to an La-O-C angle of
      131(2) degrees. The La-O bond distance is consistent with seven-coordination
      around lanthanum, on the basis of the variation of the ionic radii of the
      lanthanum(III) ion with different coordination numbers.

PMID- 11198855
TI  - Solvation of the bismuth(III) ion by water, dimethyl sulfoxide, N,N'
      dimethylpropyleneurea, and N,N-dimethylthioformamide. An EXAFS, large-angle X-ray
      scattering, and crystallographic structural study.
AB  - The structure of the solvated bismuth(III) ion in aqueous, dimethyl sulfoxide,
      N,N'-dimethylpropyleneurea, and N,N-dimethylthioformamide solution has been
      studied by means of EXAFS and large-angle X-ray scattering (LAXS). The crystal
      structures of the solid compounds octakis(dimethyl sulfoxide)bismuth(III)
      perchlorate, [Bi(OS(CH3)2)8](ClO4)3, hexakis(N,N'
      dimethylpropyleneurea)bismuth(III) perchlorate, [Bi(OCN2(CH2)3(CH3)2)6](ClO4)3,
      and nonaaquabismuth(III) trifluoromethanesulfonate, [Bi(H2O)9](CF3SO3)3
      (redetermination), have been determined. The aqueous solutions must be strongly
      acidic, since the hydrated bismuth(III) ion starts to hydrolyze into
      Bi6O4(OH)4(6+) complexes already at an excess of strong acid at 1.0 mol.dm-3. For
      very acidic aqueous perchlorate solutions, the LAXS and EXAFS data gave a
      satisfactory fit for eight-coordination of the bismuth(III) ion, with a mean Bi-O
      bond distance of 2.41(1) A. The crystal structure of octakis(dimethyl
      sulfoxide)bismuth(III) perchlorate shows that the bismuth(III) ion coordinates
      eight dimethyl sulfoxide molecules via the oxygen atoms in a distorted square
      antiprismatic configuration. The mean Bi-O bond distance is 2.43 A and the mean
      Bi...S distance 3.56 A. For the dimethyl sulfoxide solution, the corresponding
      mean distances were found to be 2.411(6) and 3.535(12) A. The N,N'
      dimethylpropyleneurea-solvated bismuth(III) ion is octahedrally coordinated in
      both solid state and solution with the Bi-O bond distances of 2.324(5) and
      2.322(3) A, respectively. The bismuth(III) ion is six-coordinated in the sulfur
      donor solvent N,N-dimethylthioformamide with a mean Bi-S bond distance of
      2.794(8) A. A comparison with the structure of the solvated lanthanum(III) ion
      shows that the bismuth(III) ion is smaller for all coordination numbers. New
      effective ionic radii for the bismuth(III) ion in different coordination numbers
      are proposed, based on results in this study and in the literature.

PMID- 11198856
TI  - Luminescent Langmuir-Blodgett films of platinum(II) complex [Pt(L18)Cl](PF6) (L18
      = 2,6-bis(1-octadecylbenzimidazol-2-yl)pyridine).
AB  - A novel amphiphilic Pt complex containing 2,6-bis(1-octadecylbenzimidazol-2
      yl)pyridine (L18), [Pt(L18)Cl](PF6), has been synthesized. The complex exhibits
      concentration-dependent absorption and emission spectra in solution. With
      increasing the concentration of the Pt complex, we observed a new absorption band
      centered at 550 nm derived from a metal-metal d sigma* to ligand pi* charge
      transfer (MMLCT) transition and the corresponding broad emission centered at 650
      nm. The Pt complex is surface-active, and the surface pressure-area isotherm
      reveals three phase transitions. The three phases correspond to one liquid
      expanding phase and two solid-condensed phases, respectively, with different
      intermolecular overlap in the "flat-on" orientation at the air-water interface.
      Without additives such as fatty acids, the complex forms a stable and
      reproducible Langmuir-Blodgett (LB) multilayer film above a surface pressure of
      15 mN m-1. Strong emission from the LB films, even monolayer, was observed.
      Comparing the relative emission intensity of the MMLCT band for transferred LB
      monolayer film with that for cast films, we concluded that Pt-Pt interactions are
      suppressed in the LB film. Instead, the emission at 600 nm arising from the
      ligand-ligand pi-pi interacted excited state became dominant. The results would
      provide the insight into the control of molecular ordering for planar Pt
      complexes from the viewpoint of characteristic excited states.

PMID- 11198857
TI  - M(mu-CN)Fe(mu-CN)M' chains with phthalocyanine iron centers: preparation,
      structures, and isomerization.
AB  - The molecular building blocks Fe(II)Pc (Pc = phthalocyaninato2-), Fe(III)Pc,
      ZnPc, Cp(dppe)Fe, and Cp(PPh3)2Ru were combined in the cyanide-bridged dinuclear
      reference compounds with M-CN-ZnPc and M-CN-FePc-CN arrays containing Fe(II)Pc
      and Fe(III)Pc. The linear trinuclear species with the M(mu-CN)Fe(mu-CN)M'
      backbone were prepared for both Fe(II)Pc and Fe(III)Pc centers, for terminal
      Fe/Fe, Fe/Ru, and Ru/Ru combinations and for all three possible cyanide
      orientations (M-CN-Fe-NC-M', M-CN-Fe-CN-M', and M-NC-Fe-CN-M'). The 15 complexes
      obtained were identified from their IR spectra and six structure determinations.
      The preferred orientation of the cyanide bridges could be established starting
      from the [Fe-NC-Fe(III)Pc-CN-Fe]+ complex, which is labile in solution and
      isomerizes to the corresponding [Fe-CN-Fe(III)Pc-NC-Fe]+ complex. A kinetic
      analysis of this isomerization has yielded an activation barrier of roughly 110
      kJ/mol.

PMID- 11198858
TI  - M(mu-CN)Fe(mu-CN)M' chains with phthalocyanine iron centers: redox, spin-state,
      and mixed-valence properties.
AB  - Dinuclear complexes with M-CN-ZnPc and M-CN-FePc-CN arrays and trinuclear
      complexes with M(mu-CN)Fe(mu-CN)M' arrays containing central metal
      phthalocyaninato (Pc) and external Cp(dppe)Fe or Cp(PPh3)2Ru building blocks (M)
      and having all possible orientations of the bridging cyanide ligands were
      subjected to electrochemical and preparative redox reactions. The species with
      unpaired electrons show characteristic MMCT bands in the near-IR spectra, the
      energies of which depend in a typical fashion on the nature of the building
      blocks and the orientation of the cyanide bridges and can be correlated with the
      redox potentials. Cyclic voltammetry has revealed electronic communication
      between the external organometallic units. An analysis of the MMCT spectra allows
      the assignment of the odd-electron complexes as class II mixed-valence species.
      The magnetic moments of the complexes with central Fe(III)Pc units are
      characteristically higher than the spin-only value for one unpaired electron. A
      Mossbauer investigation has shown that the M-CN-Fe(III)Pc-NC-M complexes undergo
      a low-spin-to-high-spin crossover of the Fe(III) component above room
      temperature.

PMID- 11198859
TI  - Manganese citrate chemistry: syntheses, spectroscopic studies, and structural
      characterizations of novel mononuclear, water-soluble manganese citrate
      complexes.
AB  - The first two mononuclear manganese citrate complexes, (NH4)4[MnII(C6H5O7)2] (1)
      and (NH4)5[MnIII(C6H4O7)2].2H2O (2) were synthesized in aqueous solutions near
      physiological pH values. They were isolated in their pure crystalline forms and
      characterized by elemental analyses and spectroscopic techniques, including
      UV/visible, electron paramagnetic resonance, Fourier transformed infrared, and
      magnetic susceptibility measurements. Compound 1 crystallizes in the monoclinic
      space group P2(1)/c, with a = 8.777(1) A, b = 13.656(3) A, c = 9.162(2) A, beta =
      113.62(2) degrees, V = 1006.2(6) A3, and Z = 2. Compound 2 crystallizes in the
      triclinic space group P1, with a = 9.606(3) A, b = 9.914(3) A, c = 7.247(3) A,
      alpha = 91.05(1) degrees, beta = 105.60(1) degrees, gamma = 119.16(1) degrees, V
      = 571.3(3) A3, and Z = 1. The X-ray crystal structures of 1 and 2 revealed that,
      in both cases, the manganese ion is six-coordinate and is bound by two citrate
      ligands in a distorted octahedral fashion. In the case of complex 1, the citrate
      ion binds to Mn2+ as a triply deprotonated ligand, retaining the central carbon
      hydroxyl hydrogen, whereas, in the case of compound 2, the citrate ligand
      coordinates to Mn3+ as a fully deprotonated entity. Compound 2 contains water
      molecules of crystallization in the unit cell which, through extensive hydrogen
      bonding interactions, bestow considerable stability upon the Mn(3+)-citrate
      assembly. There are significant contributions to the stabilities of the assembled
      lattices in 1 and 2 arising from the ammonium counterions neutralizing the high
      anionic charges of the complexes. The EPR spectra attest to the presence of
      paramagnetic Mn2+ and Mn3+ species in the solid state. Corroborative evidence is
      obtained from the magnetic susceptibility measurements in the range 5-300 K.
      Complexes 1 and 2 present clear cases of mononuclear manganese citrate species
      relevant to manganese speciation in biological media and potentially related to
      the beneficial as well as toxic effects of manganese on humans.

PMID- 11198860
TI  - Metal vs ligand reduction in complexes of 1,3-dimethylalloxazine (DMA) with
      copper(I), ruthenium(II), and tungsten(VI). Crystal structures of (DMA)WO2Cl2 and
      (bis(1-methylimidazol-2-yl)ketone)WO2Cl2.
AB  - The complexes [(DMA)Cu(PPh3)2](BF4) (1) (DMA = 1,3-dimethylalloxazine),
      [(DMA)Ru(bpy)2](PF6)2 (2), and (DMA)WO2Cl2 (3) were obtained as O4-N5-chelated
      species, as evident from an X-ray crystal structure analysis for 3 and from
      spectroscopy (NMR, IR, and UV-vis spectroelectrochemistry) for 1 and 2. The
      tungsten(VI) center in 3 has its oxide ligands in a cis/equatorial position and
      the chloride ligands in a trans/axial position; it also exhibits a relatively
      short bond to O4 (2.232(3) A) and a very long bond to N5 (2.462(3) A). Comparison
      with the new structurally characterized compound (BIK)WO2Cl2 (4) (BIK = bis(1
      methylimidazol-2-yl)ketone), which has W-N bonds of about 2.30 A, confirms the
      unusual length of the W-N bond in 3, probably caused by repulsion between one of
      the oxo ligands and the peri-hydrogen atom (H6) of DMA. One-electron reduction of
      the complexes occurs reversibly at room temperature in THF (1, 2) or at 198 K in
      CH2Cl2 (3). EPR spectroscopy reveals that this process is ligand-centered for 1
      and 2 but metal-centered for 3. Density functional methods and ab initio
      methodology are used to illustrate the correspondence in spin distribution
      between the radical anion pi systems of alloxazine and isoalloxazine
      ("flavosemiquinone").

PMID- 11198861
TI  - Ligand macrocycle structural effects on copper-dioxygen reactivity.
AB  - With the goal of understanding how the nature of the tridentate macrocyclic
      supporting ligand influences the relative stability of isomeric mu-eta 2:eta 2
      peroxo- and bis(mu-oxo)dicopper complexes, a comparative study was undertaken of
      the O2 reactivity of Cu(I) compounds supported by the 10- and 12-membered
      macrocycles, 1,4,7-R3-1,4,7-triazacyclodecane (R3TACD; R = Me, Bn, iPr) and 1,5,9
      triisopropyl-1,5,9-triazacyclododecane (iPr3TACDD). While the 3-coordinate
      complex [(iPr3TACDD)Cu]SbF6 was unreactive with O2, oxygenation of
      [(R3TACD)Cu(CH3CN)]X (R = Me or Bn; X = ClO4- or SbF6-) at -80 degrees C yielded
      bis(mu-oxo) species [(R3TACD)2Cu2(mu O)2]X2 as revealed by UV-vis and resonance
      Raman spectroscopy. Interestingly, unlike the previously reported system
      supported by 1,4,7-triisopropyl-1,4,7-triazacyclononane (iPr3TACN), which yielded
      interconverting mixtures of peroxo and bis(mu-oxo) compounds (Cahoy, J.; Holland,
      P. L.; Tolman, W. B. Inorg. Chem. 1999, 38, 2161), low-temperature oxygenation of
      [(iPr3TACD)Cu(CH3CN)]SbF6 in a variety of solvents cleanly yielded a mu-eta 2:eta
      2-peroxo product, with no trace of the bis(mu-oxo) isomer. The peroxo complex was
      characterized by UV-vis and resonance Raman spectroscopy, as well as an X-ray
      crystal structure (albeit of marginal quality due to disorder problems).
      Intramolecular attack at the alpha C-H bonds of the substituents was indicated as
      the primary decomposition pathway of the oxygenated compounds through examination
      of the decay kinetics and the reaction products, which included bis(mu-hydroxo)-
      and mu-carbonato-dicopper complexes that were characterized by X-ray diffraction.
      A rationale for the varying results of the oxygenation reactions was provided by
      analysis of (a) the X-ray crystal structures and electrochemical behavior of the
      Cu(I) precursors and (b) the results of theoretical calculations of the complete
      oxygenated complexes, including all ligand atoms, using combined quantum
      chemical/molecular mechanics (integrated molecular orbital molecular mechanics,
      IMOMM) methods. The size of the ligand substituents was shown to be a key factor
      in controlling the relative stabilities of the peroxo and bis(mu-oxo) forms, and
      the nature of this influence was shown by both theory and experiment to depend on
      the ligand macrocycle ring size.

PMID- 11198862
TI  - Tuning the rotational behavior of lopsided heterocyclic nitrogen ligands (L) in
      octahedral cis-[Ru(bpy)2(L)2](PF6)2 complexes. A variable-temperature 1H NMR
      study.
AB  - In this paper are presented the syntheses, characterizations, and dynamic
      solution behaviors of three cis-[Ru(bpy)2(L)2] (bpy = 2,2'-bipyridine) complexes,
      1-3, in which L represents the monodentate ligands 1-methylimidazole (MeIm), 1,2
      dimethylimidazole (Me2Im), and 1-methylbenzimidazole (MeBim), respectively.
      Because of their different steric properties, these three monodentate ligands
      yield complexes that show quite different fluxional behaviors in solution. These
      behaviors are studied with several 1H NMR techniques at various temperatures
      between -95 and  degrees C. The 1H NMR spectra of 1, which has the smallest
      monodentate ligand of the three used, indicate the complex to be in fast exchange
      (i.e., the imidazoles rotate around their Ru-N axes) at all recording
      temperatures. The sterically more demanding ligands, Me2Im and MeBim, in 2 and 3,
      respectively, are in fast exchange at 55 degrees C and in slow exchange at low
      temperatures, showing three different atropisomers: two head-to-tail (HT) isomers
      and one head-to-head (HH) isomer. The newly synthesized bidentate ligand 1,2-bis
      (1-methyl-2-benzimidazolyl)ethane (mdbz) forms the complex cis
      [Ru(bpy)2(mdbz)](PF6)2 (4), in which the two benzimidazole moieties are
      constrained and relatively fixed. The two tethered benzimidazoles in 4 cannot
      rotate around their Ru-N axes, and therefore 4 is a good model for the main HT
      isomer of 3.

PMID- 11198863
TI  - Aminotroponiminates as ligands for potential metal-based nitric oxide sensors.
AB  - A family of new fluorescently labeled ligands, HRDATI, was prepared to develop
      transition-metal-based NO sensing strategies. The ligands are composed of
      aminotroponiminates (ATIs) with a dansyl fluorophore on one of the imine nitrogen
      atoms and an alkyl substituent, either i-Pr (8), t-Bu (9), or Bz (10), on the
      other. Bis(chelate) Co2+ ([Co(i-PrDATI)2] (12), [Co(t-BuDATI)2] (14),
      [Co(BzDATI)2] (15)) and Zn2+ ([Zn(i-PrDATI)2] (13)) complexes were prepared and
      characterized by X-ray crystallography. The bis(ATI) complex [Co(i-Pr2ATI)2] (11)
      was also prepared and its X-ray crystal structure determined. Cyclic voltammetry
      reveals reversible redox waves at -2.57 and -0.045 V (vs Cp2Fe/Cp2Fe+) in THF for
      the Co2+/Co+ and Co3+/Co2+ couples, respectively, of 11. Only a Co2+/Co+ wave at 
      2.09 V is observed for 12. When excited at 350 nm, the HRDATI ligands and the
      diamagnetic Zn2+ complex 13 fluoresce around 500 nm, whereas the paramagnetic
      Co2+ complexes quench the fluorescence. These air-stable cobalt compounds react
      with nitric oxide to dissociate a DATI ligand and form neutral dinitrosyl
      complexes, [Co(NO)2(RDATI)]. The release of the fluorophore-containing ligand is
      accompanied by an increase in fluorescence intensity, thus providing a strategy
      for fluorescent NO sensing. Linking two DATI moieties via a tetramethylene chain
      affords the ligand H2DATI-4 (18). The Co2+ complex [Co(DATI-4)] (19) reacts more
      readily with NO than the bis(DATI) compounds and also displays an increase in
      fluorescence intensity upon NO binding.

PMID- 11198864
TI  - Trithiacyclononane as a ligand for potential technetium and rhenium
      radiopharmaceuticals: synthesis of [M(9S3)(SC2H4SC2H4S)][BF4] (M = 99Tc, Re,
      188Re) via C-S bond cleavage.
AB  - Chemical or electrochemical reduction of the 1,4,7-trithiacyclononane (9S3)
      complexes [MII(9S3)2][BF4]2 (M = Re (3a) or Tc (3b)) results in instantaneous C-S
      bond cleavage to yield ethene and the stable MIII thiolate complexes
      [MIII(9S3)L][BF4] (M = Re (4a) or Tc (4b), L = SCH2CH2SCH2CH2S). Compounds 4 have
      been characterized by 1H NMR spectroscopy, and the pseudo-octahedral geometry of
      4b has been confirmed by X-ray crystallography. Upon electrochemical reduction 4a
      loses ethene, while 4b can be reversibly reduced to [TcII(9S3)L], which is then
      further reduced to Tc(I) with loss of ethene. Successive ethene loss is observed
      in the mass spectra of compounds 3 and 4. The radiosynthesis of 4a with 188Re can
      be comfortably completed within 10 min starting with 188ReO4- from a 188W/188Re
      generator, with a radiochemical yield in excess of 90%, and thus represents a
      practical approach to the preparation of stable 188Re (and 99mTc) thioether
      complex derivatives/conjugates for clinical use. Crystal data: 4b, C10H20S6Tc,
      orthorhombic Pbca, a = 12.233(2) A, b = 14.341(2) A, c = 20.726(3) A, Z = 8.

PMID- 11198865
TI  - Calix[4]arene rhenium(V) complexes as potential radiopharmaceuticals.
AB  - The calix[4]arene platform was used for the syntheses of novel rhenium(V)
      complexes, that may have potential applications as radiopharmaceuticals. The
      reaction of ReO(PPh3)2Cl3 with tetradentate N2O2-calix[4]arene ligand 8 in
      ethanol gave the novel mixed-ligand rhenium complex 9 with the structure ReO(N2O2
      calix)OEt. The configuration was elucidated by using a number of 1H NMR
      techniques. In 9, the ethoxy ligand could be easily and quantitatively exchanged
      for another monodentate ligand to give complex 12. Tetradentate N2S2
      calix[4]arene ligand 15 formed the rhenium complex 16 either via reaction with
      ReO(PPh3)2Cl3 in an organic solvent or by reaction with rhenium gluconate in an
      aqueous solution. Complex 16 showed good stability in phosphate-buffered saline
      solution (37 degrees C, 5 d). The crystal structures of a mono- and a bimetallic
      complex were determined. The bimetallic N2O2-calixarene complex dimer 11
      crystallized in the monoclinic space group C2/c, with a = 38.963(5) A, b =
      23.140(6) A, c = 27.382(6) A, beta = 128.456(10) degrees, V = 19,333(7) A3, Z =
      8, and final R = 0.0519. The monometallic N2S2 model complex 17 crystallized in
      the monoclinic space group Cc, with a = 15.715(2) A, b = 12.045(2) A, c =
      20.022(3) A, beta = 94.863(12) degrees, V = 3776.3(10) A3, Z = 4, and final R =
      0.0342.

PMID- 11198866
TI  - Hydrolysis, hydrosulfidolysis, and aminolysis of imido(methyl)rhenium complexes.
AB  - The tris(imido)methylrhenium complex CH3Re(NAd)3 (1a, Ad = 1-adamantyl) reacts
      with H2O to give CH3Re(NAd)2O (2a) and AdNH2. The resulting di(imido)oxo species
      can further react with another molecule of H2O to generate CH3Re(NAd)O2 (3a). The
      kinetics of these reactions have been studied by means of 1H NMR and UV-vis
      spectroscopies. The second-order rate constant for the reaction of 1a with H2O at
      298 K in C6H6 is 3.3 L mol-1 s-1, which is much larger than the value 1 x 10(-4)
      L mol-1 s-1 obtained for the reaction between CH3Re(NAr)3 (1b, Ar = 2,6
      diisopropylphenyl) and H2O in CH3CN at 313 K. Both 1a and 1b react with H2S to
      produce the rhenium(VII) sulfide, (CH3Re(NR)2)2(mu-S)2 (4a, R = Ad; 4b, R = Ar),
      with second-order rate constants of 17 and 1.6 x 10(-4) L mol-1 s-1 in C6H6 and
      CH3CN, respectively. Complex 4b has been structurally characterized. The crystal
      data are as follows: space group C2/c, a = 30.4831 (19) A, b = 10.9766 (7) A, c =
      18.1645 (11) A, beta = 108.268(1) degrees, V = 5771.5 (6) A3, Z = 4. The reaction
      between CH3Re(NAr)2O (2b) and H2S also yields the dinuclear compound 4b. Unlike
      1b, 1a reacts with aniline derivatives to give mixed imido rhenium complexes.

PMID- 11198867
TI  - Kinetics and mechanisms of reactions of methyldioxorhenium(V) in aqueous
      solutions: dimer formation and oxygen-atom abstraction reactions.
AB  - The stable compound CH3ReO3 (MTO), upon treatment with aqueous hypophosphorous
      acid, forms a colorless metastable species designated MDO, CH3ReO2(H2O)n (n = 2).
      After standing, MDO is first converted to a yellow dimer (lambda max = 348 nm;
      epsilon = 1.3 x 10(4) L mol-1 cm-1). That reaction follows second-order kinetics
      with k = 1.4 L mol-1 s-1 in 0.1 M aq trifluoromethane sulfonic acid at 298 K.
      Kinetics studies as functions of temperature gave delta S++ = -4 +/- 15 J K-1 mol
      1 and delta H++ = 71.0 +/- 4.6 kJ mol-1. A much more negative value of delta S++
      would be expected for simple dimerization, suggesting the release of one or more
      molecules of water in forming the transition state. If solutions of the dimer are
      left for a longer period, an intense blue color results, followed by
      precipitation of a compound that does, even after a long time, retain the Re-CH3
      bond in that aq. hydrogen peroxide generates the independently known
      CH3Re(O)(O2)2(H2O). The blue compound may be analogous to the intensely colored
      purple cation [(Cp*Re)3(mu 2-O)3(mu 3-O)3ReO3]+. If a pyridine N-oxide is added
      to the solution of the dimer, it is rapidly but not instantaneously lost at the
      same time that a catalytic cycle, separately monitored by NMR, converts the bulk
      of the PyO to Py according to this stoichiometric equation in which MDO is the
      active intermediate: C5H5NO + H3PO2-->C5H5N + H3PO3. A thorough kinetic study and
      the analysis by mathematical and numerical simulations show that the key step is
      the conversion of the dimer D into a related species D* (presumably one of the
      two mu-oxo bonds has been broken); the rate constant is 5.6 x 10(-3) s-1. D* then
      reacts with PyO just as rapidly as MDO does. This scheme is able to account for
      the kinetics and other results.

PMID- 11198868
TI  - Electron transfer. 144. Reductions with germanium(II).
AB  - Solutions 0.2-0.4 M in Ge(II) and 6 M in HCl, generated by reaction of Ge(IV)
      with H3PO2, are stable for more than 3 weeks and can be diluted 200-fold with
      dilute HCl to give GeCl3- preparations to be used in redox studies. Kinetic
      profiles for the reduction of Fe(III) by Ge(II), as catalyzed by Cu(II),
      implicate the odd-electron intermediate, Ge(III), which is formed from Cu(II) and
      Ge(II) (k = 30 M-1 s-1 in 0.5 M HCl at 24 degrees C) and which is consumed by
      reaction with Fe(III) (k = 6 x 10(2) M-1 s-1). A slower direct reaction between
      Ge(II) and Fe(III) (k = 0.66 M-1 s-1) can be detected in 1.0 M HCl. The reaction
      of Ge(II) with I3- in 0.01-0.50 M iodide is zero order in oxidant and appears to
      proceed via a rate-determining heterolysis of a Ge(II)-OH2 species (k = 0.045 s
      1) which is subject to H(+)-catalysis. Reductions of IrCl6(2-) and PtCl6(2-) by
      Ge(II) are strongly Cl(-)-catalyzed. The Ir(IV) reaction proceeds through a pair
      of 1e- changes, of which the initial conversion to Ge(III) is rate-determining,
      whereas the Pt(IV) oxidant probably utilizes (at least in part) an inner-sphere
      PtIV-Cl-GeII bridge in which chlorine is transferred (as Cl+) from oxidant to
      reductant. The 2e- reagent, Ge(II), like its 5s2 counterpart, In(I), can partake
      in 1e- transactions, but requires more severe constraints: the coreagent must be
      more powerfully oxidizing and the reaction medium more halide-rich.

PMID- 11198869
TI  - C-substituted macrocycles as candidates for radioimmunotherapy.
AB  - The reaction between aryl aldehydes, the macrocyclic ligand 6-methyl-1,4,8,11
      tetraazacyclotetradecane-6-amine (L1), and NaBH3CN produces the corresponding
      benzyl-substituted ligands in good yield. Copper(II) complexes of the ligands
      derived from salicylaldehyde (L2), p-hydroxybenzaldehyde (L4), and p
      carboxybenzaldehyde (L5) were structurally characterized: [CuL2](ClO4)2.3H2O
      (monoclinic, P2(1)/c, a = 11.915(6) A, b = 13.861(2) A, c = 17.065(8) A, beta =
      102.14(2) degrees, Z = 4); [CuL4](ClO4)2 (monoclinic, P2(1)/n, a = 9.550(3) A, b
      = 17.977(2) A, c = 14.612(4) A, beta 96.76(1) degrees, Z = 4), and [CuL4](ClO4)2
      (monoclinic, P2(1)/n, a = 9.286(2) A, b = 11.294(1) A, c = 23.609(8) A, beta
      93.68(1) degrees, Z = 4). Conjugation of several CuII complexes to a protein
      (bovine serum albumin) has been pursued with a view to the application of these
      macrocycles as bifunctional chelating agents in radioimmunotherapy.

PMID- 11198870
TI  - Characterization of a new hexasodium diphosphopentamolybdate hydrate,
      Na6[P2Mo5O23]x7H2O, by 23Na MQMAS NMR spectroscopy and X-ray powder diffraction.
AB  - A novel hexasodium disphosphopentamolybdate hydrate, Na6[P2Mo5O23]x7H2O, has been
      identified using X-ray powder diffraction, 1H, 23Na, and 31P magic-angle spinning
      (MAS) NMR, and 23Na multiple-quantum (MQ) MAS NMR. Powder XRD reveals that the
      hydrate belongs to the triclinic spacegroup P1 with cell dimensions a = 10.090(3)
      A, b = 15.448(5) A, c = 8.460(4) A, alpha = 101.45(6) degrees, beta = 104.09(2)
      degrees, gamma = 90.71(5) degrees, and Z = 2. The number of water molecules of
      crystallization has been determined on the basis of a quantitative evaluation of
      the 1H MAS NMR spectrum, the crystallographic unit cell volume, and a hydrogen
      content analysis. The 23Na MQMAS NMR spectra of Na6[P2Mo5O23]x7H2O, obtained at
      three different magnetic fields, clearly resolve resonances from six different
      sodium sites and allow a determination of the second-order quadrupolar effect
      parameters and isotropic chemical shifts for the individual resonances. These
      data are used to determine the quadrupole coupling parameters (CQ and eta Q) from
      simulations of the complex line shapes of the central transitions, observed in
      23Na MAS NMR spectra at the three magnetic fields. This analysis illustrates the
      advantages of combining MQMAS and MAS NMR at moderate and high magnetic fields
      for a precise determination of quadrupole coupling parameters and isotropic
      chemical shifts for multiple sodium sites in inorganic systems. 31P MAS NMR
      demonstrates the presence of two distinct P sites in the asymmetric unit of
      Na6[P2Mo5O23].7H2O while the 31P chemical shielding anisotropy parameters,
      determined for this hydrate and for Na6[P2Mo5O23]x13H2O, show that these two
      hydrates can easily be distinguished using 31P MAS NMR.

PMID- 11198871
TI  - Speciation and kinetics related to catalytic carbonylation in the presence of cis
      [Ir(CO)2I2]P(C6H5)4 under CO and H2 pressures.
AB  - The differences in the reactivities of the square-planar complexes cis
      [Rh(CO)2I2]- (1) and cis-[Ir(CO)2I2]- (2), involved in the catalytic
      carbonylation of olefins, are investigated, with P(C6H5)4+ as the counterion, by
      ambient- and high-pressure NMR and IR spectroscopy. Under an elevated pressure of
      CO, 1 and 2 form the [M(CO)3I] complexes with the equilibrium constants KIr
      approximately 1.8 x 10(-3) and KRh approximately 4 x 10(-5). The ratio KIr/KRh
      close to 50 shows that, under catalytic conditions (a few megapascals), only
      complex 1 remains in the anionic form, while a major amount of the iridium
      analogue 2 is converted to a neutral species. The oxidative addition reactions of
      HI with 1 and 2 give two monohydrides of different geometries, mer,trans
      [HRh(CO)2I3]- (3) and fac,cis-[HIr(CO)2I3]- (4), respectively. Both hydrides are
      unstable at ambient temperature and form, within minutes for Rh and within hours
      for Ir, the corresponding cis-[M(CO)2I2]- (1 or 2) and [M(CO)2I4]- (5 or 6)
      species and H2. When an H2 pressure of 5.5 MPa is applied to a nitromethane
      solution of complex 2, ca. 50% of 2 is transformed to cis-dihydride complexes.
      The formation of cis,cis,cis-[IrH2(CO)2I2]- (8a) is followed by intermolecular
      rearrangements to form cis,trans,cis-[IrH2(CO)2I2]- (8b) and cis,cis,trans
      [IrH2(CO)2I2]- (8c). A small amount of a dinuclear species, [Ir2H(CO)4I4]x- (9),
      is also observed. The formation rate constants for 8a and 8b at 262 K are k1(262)
      = (4.42 +/- 0.18) x 10(-4) M-1 s-1, k-1(262) = (1.49 +/- 0.07) x 10(-4) s-1,
      k2(262) = (2.81 +/- 0.04) x 10(-5) s-1, and k-2(262) = (5.47 +/- 0.16) x 10(-6) s
      1. The two equilibrium constants K1(262) = [8a]/([2][H2]) = 2.97 +/- 0.03 M-1 and
      K2(262) = [8b]/[8a] = 5.13 +/- 0.10 show that complex 8b is the thermodynamically
      stable addition product. However, no similar H2 addition products of the rhodium
      analogue 1 are observed. The pressurization with H2 of a solution containing 2
      and 6 give the monohydride 4, the dihydrides 8a and 8b, the dinuclear complex 9,
      and the two new complexes [Ir(CO)2I3] (10) and [HIr(CO)2I2] (11). The reactions
      of the iridium complexes with H2 and HI are summarized in a single scheme.

PMID- 11198872
TI  - Sc6MTe2 (M = Mn, Fe, Co, Ni): members of the flexible Zr6CoAl2-type family of
      compounds.
AB  - The compounds Sc6MTe2 (M = Mn, Fe, Co, Ni) have been prepared by high-temperature
      solid-state techniques and their structures determined to be hexagonal P62m (No.
      189), Z = 1, a = 7.662(1) A, 7.6795(2) A, 7.6977(4) A, 7.7235(4) A and c =
      3.9041(9) A, 3.8368(2) A, 3.7855(3) A, 3.7656(3) A for M = Mn, Fe, Co, and Ni,
      respectively. Crystal structures were refined for M = Fe and Ni, while M = Mn and
      Co were assigned as isostructural on the basis of powder diffraction data. The
      Sc6MTe2 compounds belong to a large family with the Zr6CoAl2-type structure, an
      ordered variant of the Fe2P structure. The structure contains confacial tricapped
      trigonal prisms of scandium centered alternately by the late transition metal or
      tellurium atoms. The Sc6MTe2 compounds are the electron-poorest examples of this
      structure type. Extended Huckel band calculations for M = Fe and Ni show that
      both compounds exhibit largely 1D metal-metal bonding and are predicted to be
      metallic.

PMID- 11198873
TI  - Azido derivatives of low-valent group 14 elements: synthesis, characterization,
      and electronic structure of [(n-Pr)2ATI]GeN3 and [(n-Pr)2ATI]SnN3 featuring
      heterobicyclic 10-pi-electron ring systems.
AB  - Treatment of THF solutions of [(n-Pr)2ATI]MCl (where [(n-Pr)2ATI]- = N-(n-propyl)
      2-(n-propylamino)troponiminate; M = Ge and Sn) with sodium azide affords the
      compounds [(n-Pr)2ATI]MN3 in excellent yield. X-ray analyses revealed that these
      Ge(II) and Sn(II) compounds feature linear azide moieties and planar
      heterobicyclic C7N2M ring systems. Germanium and tin atoms adopt a pyramidal
      geometry. IR spectra of [(n-Pr)2ATI]GeN3 and [(n-Pr)2ATI]SnN3 display a nu
      asym(N3) band at 2048 and 2039 cm-1, respectively. DFT calculations on the
      corresponding methyl-substituted species demonstrate that the geometrical and
      electronic structure of these two species are very similar, and the dominant
      canonical form of the metal-azide moiety is M-N-N identical to N. The tin system
      is, as expected, slightly more ionic. A comparative CASSCF/DFT study on the model
      system H-Sn-N3 illustrates that the DFT approach is viable for the calculation of
      the structures of these species.

PMID- 11198874
TI  - Synthesis and molecular structure of a plutonium(IV) coordination complex:
      [Pu(NO3)2(2,6-[(C6H5)2P(O)CH2]2C5H3NO)2](NO3)2x1.5H2Ox0.5MeOH.
AB  - The trifunctional ligand 2,6-[(C6H5)2P(O)CH2]2 C5H3NO (1), in a mixed EtOH/MeOH
      solvent system, when combined with an aqueous nitric acid solution of Pu(IV),
      produces a 2:1 coordination complex, [Pu(1)2(NO3)2](NO3)2. A single crystal of
      [Pu(NO3)2(2,6-[(C6H5)2P(O)CH2]2C5H3NO)2](NO3)2x1.5H2Ox0.5MeOH was characterized
      by X-ray diffraction analysis. The crystal is monoclinic, space group P2(1)/n,
      with a = 19.1011(9) A, b = 18.2873(9) A, c = 21.507(1) A, alpha = gamma = 90
      degrees, beta = 108.64(1) degrees, and Z = 4. Two neutral ligands (1) are bonded
      to the Pu(IV) ion in a tridentate fashion. Two nitrate ions also occupy inner
      sphere coordination positions, while two additional NO3- ions reside in the outer
      sphere. Comparison of the solution optical absorbance and solid diffuse
      reflectance spectra shows the same Pu(IV) chromophore exists in both solid and
      solution states.

PMID- 11198875
TI  - Plutonium(IV) sequestration: structural and thermodynamic evaluation of the
      extraordinarily stable cerium(IV) hydroxypyridinonate complexes.
AB  - Ligands containing the 1-methyl-3-hydroxy-2(1H)-pyridinone group (Me-3,2-HOPO)
      are powerful plutonium(IV) sequestering agents. The Ce(IV) complexes of bidentate
      and tetradentate HOPO ligands have been quantitatively studied as models for this
      sequestration. The complexes Ce(L1)4, Ce(L2)4, Ce(L3)2, and Ce(L4)2 (L1 = Me-3,2
      HOPO; L2 = PR-Me-3,2-HOPO; L3 = 5LI-Me-3,2-HOPO; L4 = 5LIO-Me-3,2-HOPO) were
      prepared in THF solution from Ce(acac)4 and the corresponding ligand. The complex
      Ce(L4)2 was also prepared in aqueous solution by air oxidation of the Ce(III)
      complex [Ce(L4)2]-. Single-crystal X-ray diffraction analyses are reported for
      Ce(L1)(4)x2CHCl3 [P1 (no. 2), Z = 2, a = 9.2604(2) A, b = 12.1992(2) A, c =
      15.9400(2) A, alpha = 73.732(1) degrees, beta = 85.041(1) degrees, gamma =
      74.454(1) degrees], Ce(L3)2x2CH3OH [P2(1)/c (no. 14), Z = 4, a = 11.7002(2) A, b
      = 23.0033(4) A, c = 15.7155(2) A, beta = 96.149(1) degrees], Ce(L4)(2).2CH3OH [P1
      (no. 2), Z = 2, a = 11.4347(2) A, b = 13.8008(2) A, c = 15.2844(3) A, alpha =
      101.554(1) degrees, beta = 105.691(1) degrees, gamma = 106.746(1) degrees], and
      Ce(L4)2x4H2O [P2(1)/c (no. 14), Z = 4, a = 11.8782(1) A, b = 22.6860(3) A, c =
      15.2638(1) A, beta = 96.956(1) degrees]. A new criterion, the shape measure S,
      has been introduced to describe and compare the geometry of such complexes. It is
      defined as [formula: see text], where m is the number of edges, delta i is the
      observed dihedral angle along the ith edge of delta (angle between normals of
      adjacent faces), theta i is the same angle of the corresponding ideal polytopal
      shape theta, and min is the minimum of all possible values. For these complexes
      the shape measure shows that the coordination geometry is strongly influenced by
      small changes in the ligand backbone or solvent. Solution thermodynamic studies
      determined overall formation constants (log beta) for Ce(L2)4, Ce(L3)2, and
      Ce(L4)2 of 40.9, 41.9, and 41.6, respectively. A thermodynamic cycle has been
      used to calculate these values from the corresponding formation constants of
      Ce(III) complexes and standard electrode potentials. From the formation constants
      and from the protonation constants of the ligands, extraordinarily high pM values
      for Ce(IV) are generated by these tetradentate ligands (37.5 for Ce(L3)2 and 37.0
      for Ce(L4)2). The corresponding constants for Pu(IV) are expected to be
      substantially the same.

PMID- 11198877
TI  - Three-dimensional manganese(II) coordination polymers based on m
      pyridinecarboxylates: synthesis, X-ray structures, and magnetic properties.

PMID- 11198876
TI  - Syntheses, structures and magnetic behaviors of di- and trinuclear pivalate
      complexes containing both cobalt(II) and lanthanide(III) ions.

PMID- 11198878
TI  - A new porous three-dimensional lanthanide coordination polymer.

PMID- 11198879
TI  - The vanadium(V) borophosphate (NH4)5[V3BP3O19]xH2O.

PMID- 11198880
TI  - Weak ferromagnetism in a three-dimensional manganese(II) azido complex, [Mn(4,4'
      bipy)(N3)2]n (bipy = bipyridine).

PMID- 11198881
TI  - Colorectal cancer: evolving concepts in diagnosis, treatment, and prevention.

PMID- 11198882
TI  - Adjuvant therapy of colon cancer.
AB  - Adjuvant therapy, believed by some to be of no benefit for colorectal cancer as
      recently as 10 years ago, now offers thousands of patients considerable hope
      after surgical resection. The first effective adjuvant regimen--combined
      fluorouracil (5-FU) and levamisole--described in 1989, was soon supplanted by a
      variety of 5-FU-based regimens, usually combined with leucovorin. Although most
      recent research in the adjuvant setting has focused on refining chemotherapy
      doses, schedules, and combinations, with the aim of improving efficacy and
      decreasing toxicity, investigators have also explored other approaches, such as
      portal vein infusion, monoclonal antibodies, interferon-alpha, and vaccines.
      Future directions being evaluated for adjuvant therapy of colon cancer include
      the use of oral fluorinated pyrimidines, which may replace current intravenous
      treatments, as well as the incorporation of new agents, such as oxaliplatin and
      CPT-11, into adjuvant chemotherapy programs.

PMID- 11198883
TI  - Laparoscopic management of colorectal cancer.
AB  - Laparoscopic treatment of colorectal cancer has emerged as a result of the
      technical advances that have been made since the introduction of laparoscopic
      cholecystectomy. The minimal-access approach to treatment of benign disease
      results in smaller incisions, reduced length of hospital stay, and a faster
      return to productive life. Laparoscopic approaches to colon cancer must take into
      consideration the potential effects of the technique on tumor dissemination at
      the time of the surgical procedure, as well as rates of recurrence and overall
      survival. Several technical approaches to laparascopic colon resection have now
      become possible, utilizing either total intra-abdominal maneuvers or laparoscopic
      assisted techniques. Margins of resection and lymph node removal with the minimal
      access techniques compare favorably with those of open colectomy. Several series
      now show that early results utilizing laparoscopic resection for colorectal
      cancer are favorable but that routine implementation of this procedure should
      await confirmatory outcomes generated by well-done prospective clinical trials.

PMID- 11198884
TI  - Surgical therapy of hepatic colorectal metastasis.
AB  - This review summarizes data demonstrating the safety and efficacy of liver
      resection for colorectal metastases. Hepatic resection in appropriately selected
      patients remains the only potentially curative treatment for patients with such
      metastases. Recommendations for preoperative patient evaluation, patient
      selection, adjuvant therapy, and postoperative follow-up are presented. Other
      surgical modalities utilized in the treatment of unresectable or recurrent
      hepatic colorectal metastases, including ablative modalities and surgical
      delivery of regional chemotherapy, are described.

PMID- 11198885
TI  - Cytoreductive surgery and adjuvant immunotherapy: a new management paradigm for
      metastatic melanoma.
AB  - Although patients with metastatic disease are usually not offered surgery as part
      of their comprehensive treatment plan, the authors suggest that surgical
      reduction of the tumor burden may enhance the host immune response and create a
      favorable setting for the use of active specific immunotherapy.

PMID- 11198886
TI  - Dendritic cell-based immunotherapy for prostate cancer.
AB  - Dendritic cells are unique in their ability to stimulate naive T cells. These
      investigators have developed a prostate cancer vaccine using autologous dendritic
      cells as a vehicle to present prostate antigens to T cells in vivo.

PMID- 11198887
TI  - New "patient-friendly" version of clinical breast cancer guidelines.

PMID- 11198888
TI  - A new era of cancer immunotherapy: converting theory to performance.
AB  - The major impact of recent scientific advances, such as the discovery of genes
      and gene products, has been to facilitate development of immunotherapies based on
      the specific stimulation of immune reactions against characterized tumor
      antigens.

PMID- 11198890
TI  - Is there a safe place between terra firma and the slippery slope?

PMID- 11198889
TI  - T cell-based immunotherapy for cancer: a virtual reality?
AB  - The goal of harnessing the immune system to recognize tumor as "nonself" is not
      new. Now, thanks to new knowledge and new techniques, however, modalities that
      seek to activate the host immune system are becoming increasingly feasible as
      treatments for advanced malignancies.

PMID- 11198891
TI  - Oncology services in the ambulatory setting. Oncology Nursing Society.

PMID- 11198892
TI  - Prevention and reporting of medication errors. Oncology Nursing Society.

PMID- 11198893
TI  - The role of unlicensed assistive personnel in cancer care. Oncology Nursing
      Society.

PMID- 11198894
TI  - Taking time for support.

PMID- 11198895
TI  - Ameliorating the tension: use of forgiveness for healing.
AB  - PURPOSE/OBJECTIVES: To generate a grounded substantive theory of the process of
      forgiveness in patients with cancer. DESIGN: Qualitative approach, grounded
      theory. SETTINGS: Inpatient hospice, cancer support groups, homecare patients.
      SAMPLE: 25 adult patients with cancer between the ages of 35 and 88 (X = 62.4
      years): 13 men and 12 women receiving active, palliative, or terminal treatment.
      METHODS: Using grounded theory methodology, open-ended interviews were
      transcribed verbatim and analyzed using constant comparative analysis and expert
      and participant validation. MAIN RESEARCH VARIABLE: Forgiveness as reflected in
      participants' past and current experiences. FINDINGS: Participants described
      hurtful events that initially caused severe negative emotional responses.
      Participants also described attempts to focus on living out priority values
      prompted by their cancer diagnosis. An escalating tension ensued between
      maintaining negative emotions and acting on personal values. Forgiveness was used
      to relieve this tension. Using several methods to gain perspective allowed
      resolving these negative emotions and living out priority values to various
      degrees. CONCLUSIONS: A cancer diagnosis promotes the rethinking of life
      priorities regardless of the stage of disease. For these participants,
      forgiveness was used to help clarify personal values and to help eliminate
      negative emotions from an inflicted hurt. IMPLICATIONS FOR NURSING PRACTICE:
      Nurses can facilitate the healing process by helping patients to identify and
      clarify priority values, recognizing appropriate definitions of forgiveness,
      using active listening or referral to help patients analyze their situations,
      encouraging active approaches to forgiving, and encouraging perseverance in the
      process.

PMID- 11198896
TI  - Oncology nurses' experiences with requests for assisted dying from terminally ill
      patients with cancer.
AB  - PURPOSE/OBJECTIVES: To explore oncology nurses' experiences with receiving
      requests for assisted dying from terminally ill patients with cancer. DESIGN:
      Descriptive, naturalistic. SETTING: RNs who identified themselves as direct care
      providers or clinical nurse specialist members of the Oncology Nursing Society.
      SAMPLE: 40 oncology nurses who responded to a randomized, sequential direct
      mailing submitted 48 stories for analysis. METHODS: Anonymously submitted written
      stories analyzed using Denzin's process of interpretive interactionism. MAIN
      RESEARCH VARIABLE: The experience of receiving a request for assisted dying.
      FINDINGS: Four main themes emerged from the thematic analysis: Control, Conflict,
      Covert Communication, and the Enduring Influence. Eleven subthemes included the
      Cry for Help, Hastening the Process, What if, Managing the Morphine, Countering
      With Palliative Care, Collision of Values, Sense of Distress, Dialogue Around the
      Request, Silent Knowing, the Unforgettable, and Reflections on Lessons Learned.
      CONCLUSIONS: Experiences included a mixture of direct-patient and family requests
      for pain relief, anticipatory fear of future pain, desire to end life before
      unacceptable deterioration, family requests to hasten the dying trajectory, and
      others. Stories reflected the larger societal struggle with desires to control
      life, health, and the dying process. IMPLICATIONS FOR NURSING PRACTICE: Nurses
      should be prepared to respond to such requests in a compassionate and helpful way
      that is respectful of both the patient's and the nurse's personal values.
      Diversity of individual values and priorities may trigger some patients to seek
      assistance in controlling the timing and circumstances of death. Thus, continued
      study of nurse, patient, and family member experiences with this ethical dilemma
      is warranted.

PMID- 11198897
TI  - Israeli oncology and nononcology nurses' attitudes toward physician-assisted
      dying: a comparison study.
AB  - PURPOSE/OBJECTIVES: To compare the attitudes of Israeli oncology and nononcology
      nurses toward physician-assisted dying (PAD) and its legalization and to
      determine the factors that may be related to their attitudes. DESIGN:
      Nonrandomized, correlational study. SETTING: A teaching hospital in Jerusalem,
      Israel. SAMPLE: 71 oncology nurses and 52 nurses working in the maternity and
      nursery departments. RESULTS: The majority of nurses supported PAD and its
      legalization, with the greatest support being given when a suffering patient was
      involved. In the vignettes dealing with the nurse-patient relationship, oncology
      nurses were significantly less likely than nononcology nurses to agree with PAD
      but more likely to stay with their patients while the lethal drug was being
      given. Nononcology nurses were more supportive of legalization than oncology
      nurses. Religious nurses and nurses who observed religious traditions were
      significantly less likely to support PAD or vote for its legalization.
      CONCLUSION: Israeli nurses generally are supportive of PAD. However, oncology
      nurses were less likely to support its practice. In addition, the more religious
      nurses considered themselves, the less likely they were to support the practice.
      IMPLICATIONS FOR NURSING PRACTICE: Israeli nurses need to be made aware of the
      ethical, social, and legal implications of PAD and its legalization for the
      Israeli nursing profession. In addition, more cross-cultural research on
      attitudes toward PAD needs to be conducted.

PMID- 11198898
TI  - A death with dignity in Oregon.
AB  - PURPOSE/OBJECTIVES: To inform readers about the Oregon Death With Dignity Act and
      present a compilation and summary of major arguments in debates regarding
      physician assistance in dying for the terminally ill. DATA SOURCES: Experience,
      medical records, the patient's physician and family, books, periodicals,
      legislative documents, and publications. DATA SYNTHESIS: The Oregon Death With
      Dignity Act became a legal option for terminally ill Oregon residents in October
      1997. Persuasive psychological, theological, philosophical, and pragmatic
      arguments protest the Act as being irrational, immoral, contrary to medical
      ethics, and dangerous. Equally persuasive arguments advocate the Act as rational,
      moral, consistent with the practice of healing, and safe. CONCLUSIONS: Physician
      assistance in dying is a legal option for terminally ill patients in the State of
      Oregon. For such a practice to be "out of the closet," as well as legal, is
      novel. The debate about the appropriateness of this Act revolves around values
      and beliefs that are seasoned and cherished. IMPLICATIONS FOR NURSING PRACTICE:
      As the practice of the terminally ill requesting physician assistance to die
      moves into the realm of a rational patient choice and legal physician action,
      nurses increasingly will be faced with having to deal with their own beliefs,
      attitudes, and emotions regarding this issue. Nurses cannot hide behind glib
      responses, quick referals, institutional policies, or organizational standards to
      cover their own discomfort or confusion. They must discuss and formulate an
      understanding of healing and caring in situations that may challenge their core
      values.

PMID- 11198899
TI  - Spiritual needs of dying patients: a qualitative study.
AB  - PURPOSE/OBJECTIVES: To identify dying patients' definitions of spirituality and
      their spiritual needs. DESIGN: Descriptive, qualitative. SETTING: Participants'
      places of residence. SAMPLE: 19 hospice patients (10 females and 9 males), mean
      age 72, with a range of length of time as a hospice patient of 2 weeks to 12
      months. METHODS: Semistructured interviews were conducted. Interview transcripts
      and field notes were analyzed to reduce data into codes and themes. Data were
      coded by extracting verbatim phrases used to describe spirituality and spiritual
      needs. Themes emerged from the data as commonalities among the codes developed.
      MAIN RESEARCH VARIABLES: Meaning of "spiritual" and perceived spiritual needs.
      FINDINGS: Participants initially defined spiritual as relating to God or
      religion; however, as interviews progressed, it was apparent that their
      spirituality was a part of their total existence. Twenty-nine unique spiritual
      needs were identified and grouped into six themes: need for religion, need for
      companionship, need for involvement and control, need to finish business, need to
      experience nature, and need for positive outlook. CONCLUSIONS: Participants
      perceived spirituality as a broad concept that may or may not involve religion.
      Spiritual needs were likewise broad in scope and were linked closely to purpose
      and meaning in life. IMPLICATIONS FOR NURSING PRACTICE: Spiritual care of dying
      patients is within the scope of nursing practice. Spiritual needs are quite
      varied and encompass more than religion. If nurses are to enhance the quality of
      life of dying patients, spiritual needs must be addressed.

PMID- 11198900
TI  - The relationships between family primary caregiver characteristics and
      satisfaction with hospice care, quality of life, and burden.
AB  - PURPOSE/OBJECTIVES: To examine relationships between family primary caregiver
      characteristics and satisfaction with hospice care, quality of life (QOL), and
      burden. DESIGN: Exploratory, quantitative. SETTING: Five hospice organizations in
      Eastern Washington and Northern Idaho. SAMPLE: 44 primary caregivers of patients
      enrolled in hospice for more than two weeks. METHODS: Telephone surveys measured
      primary caregivers' satisfaction with hospice care, QOL, and burden. Demographic,
      personal, and situational characteristics were compiled. Multivariate regression
      techniques were used to identify caregiver characteristics that explained the
      most variation in satisfaction with hospice care, QOL, and burden. MAIN RESEARCH
      VARIABLES: Satisfaction with hospice care, QOL, and burden. FINDINGS: Being
      retired, being a wife or daughter, patient diagnosis, per diem rate paid to the
      hospice organization, county population and density, length of time in hospice,
      and length of time as a caregiver were significantly related to satisfaction with
      hospice care, QOL, and burden. Age, sex, education level, occupation, income,
      patient functional status, and social support were not related to these
      variables. CONCLUSION: Although caregivers reported satisfaction with hospice
      care, the caregiver role negatively affects their QOL and they are burdened. "At
      risk" caregivers are still working, have been providing care for a long time, and
      live in a rural locale. IMPLICATIONS FOR NURSING PRACTICE: These findings create
      a profile of "typical" and "at-risk" primary caregivers and support the role of
      hospice to care for family caregivers.

PMID- 11198901
TI  - Changes in well-being of women cancer survivors following a survivor weekend
      experience.
AB  - PURPOSE/OBJECTIVES: To determine the long-term effects on quality of life (QOL)
      of women cancer survivors following a retreat experience. DESIGN: One-group
      repeated measures. SETTING: Southern California. SAMPLE: Participants in two 1998
      Healing Odyssey Retreats (N = 41; response rate 67%). Most women were married
      (50%), had breast cancer (93%), and had been diagnosed within two years of the
      retreat (69%). Participants' mean age was 48 years. METHODS: The rehabilitative
      retreats took place in a mountain retreat center and consisted of multiple
      experiences guided by experiential learning theory. Exercises aimed to help women
      learn new tools for dealing with the challenges of cancer, treatment, and
      recovery. The QOL-Breast Cancer survey was used to collect data preretreat,
      immediately postretreat, at six weeks postretreat, and at six to seven months
      postretreat. MAIN RESEARCH VARIABLES: QOL subscale scores (physical,
      psychological, social, and spiritual well-being) and overall QOL scores.
      FINDINGS: At preretreat, women scored lower on psychological and social well
      being than on physical and spiritual well-being. Total QOL, physical,
      psychological, and spiritual well-being scores differed significantly over time,
      with a significant increase immediately following the retreat that was maintained
      at six weeks and six months. Social well-being at six months was significantly
      greater than at the other three points. CONCLUSIONS: The Healing Odyssey Retreats
      enhanced women cancer survivors' total QOL-specifically their well-being in four
      dimensions. IMPLICATIONS FOR NURSING PRACTICE: Women who seek programs dealing
      with living life more fully after cancer and connections with other survivors may
      benefit from rehabilitative efforts such as this retreat.

PMID- 11198902
TI  - Developing and using preparatory information for women undergoing radiation
      therapy for cervical or uterine cancer.
AB  - PURPOSE/OBJECTIVES: To describe symptoms associated with radiation therapy
      necessary to develop preparatory concrete, objective information for women with
      cervical or uterine cancer. DESIGN: Prospective, descriptive. SETTING: University
      affiliated radiation oncology department in the mid-south. SAMPLE: 49 of 52 women
      undergoing external beam radiation and low-dose rate brachytherapy for cervical
      or uterine cancer. Stage of disease ranged from I-IIIA. Mean age of subjects was
      54 years; mean years of education was 11. METHODS: Investigator-developed symptom
      checklist based on prior research. MAIN RESEARCH VARIABLES: Symptom reports.
      FINDINGS: At least 40% of the women reported difficulty sleeping, fatigue,
      diarrhea, anorexia, nausea, urinary frequency, dysuria, vaginal discharge, and
      perineal irritation. Incidence and timing of symptoms varied by operative status
      and brachytherapy timing. CONCLUSIONS: Findings confirm and clarify the symptoms
      women associate with radiation treatment for cervical or uterine cancer.
      IMPLICATIONS FOR NURSING PRACTICE: Assessing research findings for relevance to
      the care of patients in specific settings is necessary. These findings are
      appropriate for developing preparatory information for women undergoing external
      beam radiation and low-dose rate brachytherapy.

PMID- 11198903
TI  - Relationships between certification and job perceptions of oncology nurses.
AB  - PURPOSE/OBJECTIVES: To explore relationships between oncology nursing
      certification and oncology nurses' job perceptions. DESIGN: Descriptive,
      correlational. SETTING: Questionnaire mailed to homes of Oncology Nursing Society
      (ONS) members. SAMPLE: 703 certified and 514 noncertified ONS members (N = 1,217;
      50% response rate). METHODS: Data were collected using survey methods and grouped
      by respondents' certification status for statistical analysis. MAIN RESEARCH
      VARIABLES: Certification, group cohesion, organizational commitment, and job
      satisfaction. FINDINGS: Certification was weakly correlated with cohesion,
      commitment, and satisfaction. Work setting, rather than certification, accounted
      for differences in job perceptions. Job perceptions were most positive in
      settings characterized by a high percentage of patients with cancer (> 75%), a
      high percentage of RNs (> or = 80%), and monetary support for continuing
      education. CONCLUSIONS: The hypothesis that oncology nurses' certification status
      is associated with job perceptions that are valued by employers was not
      supported. IMPLICATIONS FOR NURSING PRACTICE: Nurses' job perceptions have been
      linked to control over nursing practice and participation in organizational and
      clinical decision making. Managerial strategies that empower certified nurses to
      practice with more autonomy and participate in decisions that affect patient care
      should be emphasized.

PMID- 11198904
TI  - Using feedback to reduce students' judgment bias on test questions.
AB  - Judgment bias represents a common tendency of people to inaccurately gauge the
      extent of their own knowledge. While research has shown that people tend to
      overestimate their knowledge on hard questions and underestimate their knowledge
      on easy questions, overconfidence poses a more pernicious problem from an
      educational perspective since it can undermine students' ability to monitor their
      own learning effectively and interfere with their test performance. The findings
      of the present study show that students who perform poorly on a test are more
      overconfident about their answers to hard test questions, especially those they
      answer wrongly, than are students who perform better. The results also show that
      judgment bias can be reduced by providing feedback to students about their prior
      performance and confidence on specific test questions. This intervention was
      found to be effective in decreasing both underconfidence on easy questions and
      overconfidence on hard questions regardless of students' performance level.

PMID- 11198905
TI  - Writing multiple-choice test items that promote and measure critical thinking.
AB  - Faculties are concerned about measurement of critical thinking especially since
      the National League for Nursing Accrediting Commission cited such measurement as
      a requirement for accreditation (NLNAC, 1997). Some writers and researchers
      (Alfaro-LeFevre, 1995; Blat, 1989; McPeck, 1981, 1990) describe the need to
      measure critical thinking within the context of a specific discipline. Based on
      McPeck's position that critical thinking is discipline-specific, guidelines for
      developing multiple-choice test items as a means of measuring critical thinking
      within the discipline of nursing are discussed. Specifically, criteria described
      by Morrison, Smith, and Britt (1996) for writing critical-thinking multiple
      choice test items are reviewed and explained for promoting and measuring critical
      thinking.

PMID- 11198906
TI  - Assessment of multiple-choice questions in selected test banks accompanying text
      books used in nursing education.
AB  - The purpose of this study was to assess multiple-choice questions used in test
      banks accompanying selected nursing textbooks. A random sample of 2,913 questions
      was selected from a convenience sample of 17 test banks. Questions were evaluated
      on (a) adherence to generally accepted guidelines for writing multiple-choice
      questions; (b) cognitive level as defined by Bloom's (1961) taxonomy; and (c)
      distribution of correct answers as A, B, C, or D. The results were 2,233
      violations of item-writing guidelines, most of which were minor but some were
      serious. A large number of questions (47.3%) were written at the knowledge level
      and only 6.5% were written at the analysis level. The correct answers were evenly
      distributed: c2s ranged from 0.00 to 4.84; chi square value needed to reach .05
      probability was 26.30. Faculty are encouraged to evaluate multiple-choice
      questions from test banks carefully before using them for exams.

PMID- 11198907
TI  - Measurement and evaluation in nursing education.

PMID- 11198908
TI  - Validating nursing credit: an alternative to challenges.

PMID- 11198909
TI  - Clinical performance appraisal: renewing graded clinical experiences.

PMID- 11198910
TI  - Case study class tests: assessment directing learning.

PMID- 11198911
TI  - The use of the cognitive behavior survey to assess nursing student learning.

PMID- 11198912
TI  - External examiners: quality assurance in nursing education.
AB  - External examining is a system of quality assurance in nursing education that is
      quite foreign to most American nurses. The concept of an external examiner-a
      visiting assessor of high academic standing and possessed of integrity and
      objectivity-supports a notion of the universality of educational standards and
      justice for the individual student. Potential external examiners are appointed
      primarily through informal social and professional networks within educational
      institutions of the host country. Criteria for appointment, roles and functions
      of an examiner, and the four stages of the external examination process are
      discussed. Suggestions to facilitate each stage as well as implications for
      potential American external examiners are included. The manuscript concludes with
      insights from two American nurse educators about their experience as external
      examiners.

PMID- 11198913
TI  - The abundance and seasonal distribution of Culex mosquitoes in Iowa during 1995
      97.
AB  - The abundance and seasonal distribution of Culex mosquitoes were monitored by
      measuring oviposition activity during the summers of 1995, 1996, and 1997. Five
      species of culicine mosquitoes laid egg rafts in ovitraps. Egg rafts of 4 Culex
      species-Cx. restuans (54.98%), Cx. pipiens (25.41%), Cx. salinarius (12.18%), and
      Cx. tarsalis (0.14%)-constituted more than 92% of the total egg rafts collected.
      Culiseta inornata (0.1%) was the only other species to lay viable egg rafts in
      the ovitraps. A small percentage (7.19%) of egg rafts did not hatch; thus
      identification was not possible. Compared with New Jersey light trap data in a
      nearby area, the abundance of Cx. tarsalis and Cs. inornata was markedly
      underestimated with ovitraps. These data may also reflect differences in the
      specific location of the 2 trap sites rather than attractiveness of ovitraps for
      Cx. tarsalis and Cs. inornata. In general, Cx. restuans oviposition activity
      began in late May, and it was the dominant Culex species through June. After July
      1, the number of egg rafts laid by Cx. restuans decreased continually until the
      end of the summer. Culex pipiens and Cx. salinarius oviposition began in early
      June and increased gradually during the summer. Over the course of a summer,
      there were about twice as many Cx. pipiens as there were Cx. salinarius. A
      crossover in the number of Cx. pipiens and Cx. restuans egg rafts occurred in
      late July or early August, depending on the year. By late August each year, Cx.
      pipiens was the most abundant species. At this time, Cx. restuans and Cx.
      salinarius populations were similar, but each was about half of the Cx. pipiens
      population. Differences in the abundance of all 3 species could not be explained
      by changes in ambient temperature (both minimum and maximum) or relative
      humidity, either within or among years.

PMID- 11198914
TI  - Anopheline ecology and malaria transmission at a new irrigation project area
      (Bargi Dam) in Jabalpur (Central India).
AB  - Anopheline ecology and malaria transmission were studied in a newly irrigated
      area of the Bargi Project, District Jabalpur, Madhya Pradesh, Central India.
      Observations were made for 2 years (1993-95) in 10 villages along the Bargi
      irrigation canal, which are situated between 44 km (head end of canal) and 78 km
      (tail end of canal) from the dam site. Anopheles annularis was the predominant
      species in the head-end villages and its abundance was directly related to the
      opening of the canal, whereas Anopheles culicifacies was the most abundant
      species in tail-end villages, where irrigation is limited. Anopheles culicifacies
      showed 2 typical peaks not related to canal irrigation. Site-related differences
      in species prevalence were significant in both immatures and adults. Malaria
      infection was due to Plasmodium vivax and Plasmodium falciparum. The annual
      parasite incidence in children and adults was significantly higher in head-end
      villages (>4-fold) as compared to that in tail-end villages. However, seasonal
      trends in the prevalence of P. falciparum and P. vivax were the same in each
      group, with some fluctuations. In this study, preliminary results of the
      investigation are presented, demonstrating the trends in anopheline ecology and
      parasite prevalence in relation to the dynamics of irrigation development.

PMID- 11198915
TI  - Comparative development of Brugia pahangi and variation in acid hydrolase enzyme
      titers in.
AB  - The development of the filarial nematode Brugia pahangi was monitored and
      compared in susceptible (BLACK EYE) and refractory (ROCK) strains of Aedes
      aegypti. Simultaneously, the activities of acid phosphatase, beta-glucuronidase,
      alpha-glucosidase, and N-acetyl-beta-glucosaminidase were measured. Three- to
      five-day-old females of both strains were fed on infected and uninfected clawed
      jirds (Meriones unguiculatus) then dissected or homogenized at 2 h, at 24-h
      intervals for 5 days, and at 8 and 10 days after treatment. Enzyme activities
      were assayed by a fluorometric procedure. The susceptible strain maintained an
      80% infection and 18.6 larvae/mosquito over the 10-day period. In contrast, the
      refractory strain was initially 33% infected and had a mean of 4.9
      larvae/mosquito and this decreased to 20% by 3 days, and to 3% with a mean of
      0.33 larvae/mosquito at 10 days. Significantly higher acid phosphatase and beta
      glucuronidase activities were observed in the refractory strain at specific time
      intervals after infection. Alpha-glucosidase and N-acetyl-beta-glucosaminidase
      were highly variable among strains and according to infection status. Analysis of
      the results of this study suggests that certain acid hydrolase enzymes could be
      involved in the elimination of B. pahangi in refractory strains of Ae. aegypti
      and could be used to monitor biochemical changes in response to filarial nematode
      infections in certain mosquito populations.

PMID- 11198916
TI  - Mosquito vector control and biology in Latin America--a tenth symposium.
      Abstracts.
AB  - The 10th annual Latin American symposium presented by the American Mosquito
      Control Association (AMCA) was held as part of the 66th Annual Meeting in
      Atlantic City, NJ, in March 2000. The principal objective, as for the previous 9
      symposia, was to promote participation in the AMCA by vector control specialists,
      public health workers, and academicians from Latin America. This publication
      includes summaries of 57 presentations that were given orally in Spanish or
      presented as posters by participants from 9 countries in Latin America. Topics
      addressed in the symposium included results from chemical and biological control
      programs and studies; studies of insecticide resistance; and molecular,
      ecological, and behavioral studies of vectors of dengue (Aedes aegypti). malaria
      (Anopheles albimanus and Anopheles aquasalis). leishmaniasis (Lutzomyia), and
      Chagas' disease (Triatoma). Related topics included biology and control of
      scorpions and Chironomus plumosus.

PMID- 11198917
TI  - Evaluation of Agnique MMF in man-made ponds for the control of pestiferous
      chironomid midges (Diptera: Chironomidae).
AB  - The efficacy of a monomolecular surface film, Agnique MMF (a liquid isostearyl
      alcohol ethoxylate containing 2 oxyethylene groups [ISA-2OE]) in suppressing
      emergence of adult Chironomidae from man-made earthen ponds was studied. Three
      replicated rates, 0.23, 0.47, and 0.94 ml/m2 (or 0.25, 0.5, and 1.0 gal/acre) of
      Agnique MMF were applied. Pretreatment and periodic posttreatment samples of
      adult chironomids were collected by employing submerged metal-cone traps as well
      as floating traps. Concurrently, water pH, dissolved oxygen, specific
      conductance, and water temperature were measured. Tanytarsini (>82%), Chironomini
      (16%), and Tanypodinae (1%) midges were collected during the study period. Midge
      adult collections in floating traps were not significantly reduced by the 0.23
      ml/m2 treatment rate, but were significantly reduced (73-93%) for 1-2 wk
      posttreatment at 0.47 and 0.94 ml/m2 of Agnique MME The lowest rate significantly
      reduced midge adult emergence for 1 day posttreatment as measured by metal-cone
      traps, whereas the 2 higher rates reduced emergence by 78.6-97% for 1 wk
      posttreatment. Using either trap, the highest rate of Agnique MMF did not produce
      suppression of adult midges of any greater magnitude or duration than the middle
      rate. Agnique MMF was not detected by the indicator oil in any treated pond after
      7 days posttreatment. Water pH, dissolved oxygen, specific conductance, and water
      temperature in the ponds were not significantly influenced by Agnique MMF
      treatments. Analysis of these data supports the possible use of Agnique MMF for
      chironomid control in areas where the surface film of this material can be
      maintained for sufficient time to interfere with adult emergence.

PMID- 11198918
TI  - Control of aedes aegypti breeding in desert coolers and tires by use of Bacillus
      thuringiensis var. Israelensis formulation.
AB  - Three different formulations of Bacillus thuringiensis var. israelensis (Bti)
      were evaluated for their efficacy against immature Aedes aegypti in desert
      coolers and tires. Three formulations, viz., VectoBac tablets, VectoBac granules,
      and Bacticide powder, at the application rate of 0.75, 2, and 1 g per cooler,
      respectively, and VectoBac tablets at 0.75 and 0.375 g per tire, were evaluated.
      In coolers and tires, 100% reduction in the abundance of late larval instars of
      Ae. aegypti was observed for a period of 2 and 3 wk, respectively. The
      possibility of using tablets and capsules filled with Bti granules and powder
      formulation by individuals or communities for control of Ae. aegypti breeding has
      been discussed in view of the increasing outbreaks of dengue and dengue
      hemorrhagic fever in India. Use of these formulations over conventional methods
      is better and more user-friendly.

PMID- 11198919
TI  - Malathion resistance in Aedes aegypti and Culex quinquefasciatus after its use in
      Aedes aegypti control programs.
AB  - The continued widespread use of malathion in Aedes aegypti control programs in
      Latin America has generated insecticide resistance to this chemical in Culex
      quinquefasciatus but not in Ae. aegypti. To determine the extent of this
      resistance, the susceptibility of Cx. quinquefasciatus and Ae. aegypti from
      several countries to malathion was evaluated. Bioassay results indicated that all
      Ae. aegypti strains evaluated from Cuba, Venezuela, Costa Rica, and Jamaica were
      susceptible to malathion in spite of the historical use of this insecticide in
      Ae. aegypti control programs in these countries. In contrast, a high level of
      resistance to this insecticide was found in Cx. quinquefasciatus from Venezuela,
      Colombia, Brazil, and Cuba. Synergist assays indicated that neither esterases nor
      mixed-function oxidases (MFOs) were involved as the resistance mechanism to
      malathion in any of the Ae. aegypti strains tested. In Cx. quinquefasciatus,
      synergist assays confirmed that esterases played an important role in malathion
      resistance but MFOs were not involved in causing malathion resistance in this
      species. Biochemical assays showed that both resistance mechanisms were present
      in the Ae. aegypti and Cx. quinquefasciatus populations. Acrylamide
      electrophoresis gels revealed that all Ae. aegypti strains had a strongly
      staining, clear band, named A4, and had a relative mobility (Rm) value of 0.7.
      Analysis if the results of this study suggested that malathion could continue to
      be used for the emergency control of Ae. aegypti, the mosquito vector for dengue
      and dengue hemorrhagic fever in the Americas, but that malathion is probably not
      effective for the control of adult Cx. quinquefasciatus in urban areas.
      Therefore, control operations should integrate nonorganophosphate insecticides
      such as pyrethroids for control of these 2 species found in the urban
      environment.

PMID- 11198920
TI  - Insecticide susceptibility in Anopheles pseudopunctipennis from Colombia:
      comparison between bioassays and biochemical assays.
AB  - Anopheles pseudopunctipennis, one of the primary vectors of malaria in the
      southwest of Colombia, was evaluated for susceptibility to the 3 major
      insecticide groups (organophosphates, pyrethroids, and carbamates) by bioassay
      and biochemical assay. Larval populations, which were collected principally from
      irrigation channels in agricultural areas, where the intensity of insecticide use
      varied, were utilized to establish susceptibility for the 1st time in this
      species. The baselines for each population showed a range of biological
      susceptibility to the insecticides evaluated, but overall no resistance was
      detected according to standards established by the World Health Organization. The
      high sensitivity of biochemical microassays enabled the detection of a small
      proportion of mosquitoes with higher levels of nonspecific esterases and mixed
      function oxidases from 2 areas where agricultural application of organophosphate
      and pyrethroid insecticides had been heavy. These differences were not sufficient
      to affect susceptibility as measured by bioassay. No evidence of insensitive
      acetylcholinesterase was observed. Absence of resistance in areas that have
      experienced heavy insecticide application could be explained by genetic drift, by
      gene flow from areas without insecticide pressure, by manner of exposure to the
      insecticides, or by recent changes in agricultural activities that decreased
      insecticide use. Baseline values were established that serve as provisional
      susceptibility thresholds for applying simple Centers for Disease Control and
      Prevention biochemical assay and bioassay methods to larvae of this anopheline
      species.

PMID- 11198921
TI  - Aircraft-mediated mosquito transport: new direct evidence.
AB  - A case is reported of a capture of an Aedes taeniorhynchus female mosquito in an
      aircraft cabin as it attempted to bloodfeed on one of the authors during a
      transoceanic flight from the USA to the Iberian Peninsula.

PMID- 11198922
TI  - Seasonal incidence of Aedes (Rhinoskusea) portonovoensis in a mangrove forest of
      South India.
AB  - The seasonal incidence of Aedes (Rhinoskusea) portonovoensis in its type locality
      is reported. This is the Ist information on the bionomics of this species
      described from a mangrove forest in South India. Peak density of adults occurred
      in August. The larval habitat of the species is also defined.

PMID- 11198923
TI  - Evaluation of methylated soy oil and water-based formulations of Bacillus
      thuringiensis var. Israelensis and Golden Bear Oil (GB-1111) against anopheles
      quadrimaculatus larvae in small rice plots.
AB  - The efficacy of formulations containing methylated soybean oil (MSO) alone and
      with technical-grade Bacillus thuringiensis var. israelensis (Bti) were compared
      to Golden Bear Oil (GB-1111) and a water-based Bti formulation against 3rd- to
      4th-stage Anopheles quadrimaculatus larvae confined to sentinel cages in small
      rice plots. Three replicates each of MSO with 2% Pyroter added as a surfactant
      (MSO + PYR), MSO with 2% Pyroter and 4 g of Bti technical powder (MSO + PYR +
      Bti), GB-1111, a water-based formulation with 4 g of Bti technical powder (Bti +
      water), and untreated controls were performed. Mosquito larvae were introduced on
      the 1st day of treatment and at 4 days posttreatment. Mortality was recorded at
      24 and 48 h posttreatment for the 1st installation and at 5 days posttreatment
      for the 2nd installation. The Bti + water formulation provided 71% control and
      the MSO + PYR + Bti formulation achieved 64% control, whereas MSO + PYR and GB
      1111 produced 16 and 18% control, respectively, at 24 h posttreatment. With the
      exception of MSO + PYR + Bti, which decreased by 2%, the mean percent control
      increased slightly at 48h posttreatment across remaining treatments, with Bti +
      water obtaining 72% control. This was significantly higher than GB-1111, which
      achieved 23% control at 48 h posttreatment. The MSO + PYR and MSO + PYR + Bti
      formulations yielded 56 and 62% control, respectively, during the same interval
      and were not significantly different from one another. Formulations containing
      MSO + PYR exhibited delayed activity similar to GB-1111, with all formulations
      except MSO + PYR + Bti providing greatest control at 48 h posttreatment. Both MSO
      formulations (MSO + PYR + Bti and MSO + PYR) were statistically comparable to Bti
      + water and GB-1111, respectively, at 24 and 48 h posttreatment. None of the
      formulations exhibited a residual activity adequate enough to control An.
      quadrimaculatus larvae for up to 5 days.

PMID- 11198924
TI  - Inhibition of interleukin-1beta (IL-1beta) production in human cells by ribozymes
      against IL-1beta and IL-1beta converting enzyme (ICE).
AB  - We and others have shown previously that hairpin ribozyme genes, when stably
      expressed in cells, can reduce the steady-state levels of target mRNA and their
      cognate proteins. Despite this capability, ribozymes have not been as widely used
      in knockdown experiments as one might expect, probably because specific rules
      governing the selection of ribozymes that will have high activity have not been
      described. In this report, we show that parallel screening of less than 10
      ribozyme expression constructs, with no advanced knowledge of cleavage activity
      or preselection, can efficiently identify knockdown ribozymes. This empirical
      selection study, which used interleukin-1beta (IL-1beta) and IL-1beta converting
      enzyme (ICE) as example targets, resulted in (1) the rapid identification of
      ribozymes that can reduce the production of IL-1beta in THP-1 cultures by 10-fold
      and (2) the consequent direct generation of stable knockdown cell lines. We
      conclude, based on these and similar studies, that parallel screening of ribozyme
      constructs could be used in high throughput gene functional analysis programs as
      a means of rapidly generating specific knockdown cell lines.

PMID- 11198925
TI  - In vivo expression of single-stranded DNA in mammalian cells with DNA enzyme
      sequences targeted to C-raf.
AB  - The use of antisense oligodeoxynucleotides (AS-ODN) remains a viable method to
      downregulate selected gene function. However, limitations to the antisense
      approach remain, such as (1) difficulties in delivery of the AS-ODN into target
      tissues, (2) instability of AS-ODN in vivo, (3) uncertanties about the precise
      mode of action, and (4) toxic effects in animal and human studies. To circumvent
      some of these difficulties, we designed a vector set that directs the in vivo
      production of single-stranded DNA (ssDNA) of a desired target sequence with
      limited extraneous vector nucleotide sequences. One plasmid was designed to
      express Moloney murine leukemia virus (MoMuLV) reverse transcriptase (RT).
      Another expression plasmid contains the MoMuLV primer binding site at the 3'-end
      of its RNA transcript so that an ssDNA would be synthesized by RT when both
      plasmids are cotransfected into cells. To test this expression system, we
      constructed a plasmid set, pssXA/pssXB that produces ssRNA-cleaving DNA 10-23
      enzyme (Santoro, S.W., and Joyce, G.F. [1997]. Proc. Natl. Acad. Sci. USA 37,
      13330-13342). The DNA enzyme sequence was placed between two oligonucleotide arms
      that are complementary and able to specifically target C-raf kinase mRNA. These
      plasmids were transfected into the A549 lung carcinoma cell line. Reduced C-raf
      mRNA levels by up to 34%-36%, as determined by Northern blot analysis, were
      observed in the transfected cells. Our results demonstrate the feasibility of
      using this novel ssDNA expression system to generate any sequence of interest in
      vivo for antisense, RNA-cleavage DNA enzyme, or triplex-forming strategies.

PMID- 11198926
TI  - Oligonucleotide sequence-specific inhibition of gene expression, tumor growth
      inhibition, and modulation of cAMP signaling by an RNA-DNA hybrid antisense
      targeted to protein kinase A RIalpha subunit.
AB  - The primary mediator of cAMP action in mammalian cells is cAMP-dependent protein
      kinase (PKA). There are two types of PKA, type I (PKA-I) and type II (PKA-II),
      which share a common catalytic subunit but contain distinct regulatory subunits,
      RI and RII, respectively. Evidence suggests that increased expression of
      RIalpha/PKA-I correlates with neoplastic cell growth. Here, we show that sequence
      specific oligonucleotide inhibition of RIalpha expression results in inhibition
      of growth and modulation of cAMP signaling in cancer cells. The antisense
      promoted growth inhibition in a time-dependent, concentration-dependent, and
      sequence-dependent manner in human cancer cells in monolayer culture, and it
      inhibited colony formation in soft agar and tumor growth in nude mice. Among the
      cancer cells are LS-174T, HCT-15, and Colo-205 colon carcinoma cells; A-549 lung
      carcinoma cells; LNCaP prostate adenocarcinoma cells; Molt-4 leukemia cells; and
      Jurkat T lymphoma cells. Northern blot and immunoprecipitation analyses revealed
      that the growth inhibitory effect of the antisense correlated with a decrease in
      RIalpha expression at both the mRNA and protein levels. Pulse-chase experiments
      revealed that the antisense-directed inhibition of RIalpha expression resulted in
      compensatory changes in expression of the isoforms of R and C subunits and cAMP
      signaling in a cell type-specific manner. These results demonstrate that cAMP is
      ubiquitous in the regulation of cell growth and that the antisense
      oligonucleotide, which inhibits the synthesis of the RIalpha subunit of PKA, can
      be targeted to a single gene for treatment of cancer in a variety of cell types.

PMID- 11198927
TI  - Comparison of the pharmacokinetics of subcutaneous and intravenous administration
      of a phosphorothioate oligodeoxynucleotide in cynomolgus monkeys.
AB  - The pharmacokinetics of subcutaneous (s.c.) administration of a phosphorothioate
      oligodeoxynucleotide (PS-ODN) was evaluated in cynomolgus monkeys. In a single
      dose study, monkeys were injected s.c. or intravenously (i.v.) with doses of
      either 1 or 5 mg/kg ISIS 2302. The bioavailability of s.c. injection ranged from
      26% to 55% and appeared to be dependent on the concentration of the dosing
      solution rather than the dose. The bioavailability of a subcutaneously
      administered 5 mg/kg dose of ISIS 2302 was 55% using a 50 mg/ml dosing solution
      and only 26% using a 10 mg/ml dosing solution. Slow absorption from the s.c.
      injection site significantly blunted the maximal concentration (Cmax) compared
      with i.v. administration. The time to peak plasma concentration (Tmax) increased
      slightly with increasing dose, from 0.5 to 1 hour for the 1 mg/kg dose to 1 to
      2.5 hours for the 5 mg/kg dose. Plasma half-lives were prolonged after s.c.
      administration, indicating more dependence on absorption than elimination. The
      half-lives after s.c. administration averaged 3 hours, whereas after i.v.
      administration, the half-lives were <1 hour. Metabolism of the ISIS 2302 after
      s.c. injection was consistent with exonucleolytic cleavage, as previously
      observed after i.v. administration. In summary, s.c. administration of PS-ODN
      resulted in prolonged and extensive absorption of the ODN.

PMID- 11198928
TI  - Targeting the human mdr1 gene by 125I-labeled triplex-forming oligonucleotides.
AB  - Antigene radiotherapy is our approach to targeting specific sites in the genome
      by combining the highly localized DNA damage produced by the decay of Auger
      electron emitters, such as 125I, with the sequence-specific action of triplex
      forming oligonucleotides (TFO). As a model, we used the multidrug resistance gene
      (mdr1) overexpressed and amplified nearly 100 times in the human KB-V1 carcinoma
      cell line. Phosphodiester pyrrazolopyrimidine dG (PPG)-modified TFO complementary
      to the polypurine-polypyrimidine region of the mdr1 gene were synthesized and
      labeled with 125I-dCTP at the C5 position of two cytosines by the primer
      extension method. 125I-TFO were delivered into KB-V1 cells with several delivery
      systems. DNA from the 125I-TFO-treated cells was recovered and analyzed for
      sequence-specific cleavage in the mdr1 target by Southern hybridization.
      Experiments with plasmid DNA containing the mdr1 polypurine-polypyrimidine region
      and with purified genomic DNA confirmed the ability of the designed 125I-TFO to
      bind to and introduce double-strand breaks into the target sequence. We showed
      that 125I-TFO in nanomolar concentrations can recognize and cleave a target
      sequence in the mdr1 gene in situ, that is, within isolated nuclei and intact
      digitonin-permeabilized cells. Our results demonstrate the ability of 125I-TFO to
      target specific sequences in their natural environment, that is, within the
      eukaryotic nucleus. The nearly 100-fold amplification of the mdr1 gene in KB-V1
      cells affords a very useful cell culture model for evaluation of methods to
      produce sequence-specific DNA double-strand breaks for gene-specific
      radiotherapy.

PMID- 11198929
TI  - Variations in mRNA content have no effect on the potency of antisense
      oligonucleotides.
AB  - A fundamental question with regard to antisense pharmacology is the extent to
      which RNA content or transcription rate or both affect the potency of antisense
      drugs. We have addressed this by controlling RNA content and transcription rate
      using either an exogenous gene expressed after transfection or an endogenous gene
      induced with a cytokine. We have demonstrated that in both A549 and HeLa cells,
      varying RNA copy numbers from <1 to >100 copies per cell has no effect on the
      potency of RNase H-active antisense drugs transfected into cells, nor did
      variation in transcription rate have an effect on potency. We demonstrate that
      this is because the number of oligonucleotide molecules per cell is vastly in
      excess of the RNA copy number. These data further suggest that a significant
      fraction of cell-associated antisense drug molecules may be unavailable to
      interact with the target RNA, an observation that is not surprising, as
      phosphorothioate oligonucleotides interact with many cellular proteins. We
      suggest that these data may extrapolate to in vivo results.

PMID- 11198930
TI  - A short phosphodiester window is sufficient to direct RNase H-dependent RNA
      cleavage by antisense peptide nucleic acid.
AB  - The potential pharmacologic benefits of using peptide nucleic acid (PNA) as an
      antisense agent are tempered by its incapacity to activate RNase H. The mixed
      backbone oligonucleotide (ON) (or gapmer) approach, in which a short internal
      window of RNAse H-competent residues is embedded within an RNase H-incompetent ON
      has not been applied previously to PNA because PNA and DNA hybridize to RNA with
      very different helical structures, creating structural perturbations at the two
      PNA-DNA junctions. It is demonstrated here for the first time that a short
      internal phosphodiester window within a PNA is sufficient to evoke the RNase H
      dependent cleavage of a targeted RNA and to abrogate translation elongation in a
      well-characterized in vitro assay.

PMID- 11198931
TI  - Downregulation of the p75 neurotrophin receptor in tissue culture and in vivo,
      using beta-cyclodextrin-adamantane-oligonucleotide conjugates.
AB  - Formation of complexes with beta-cyclodextrin derivatives via adamantyl groups
      was found to enhance the uptake and antisense efficacy of phosphorothioate oligos
      targeted to the p75 neurotrophin receptor in neuronally differentiated PC12
      cells. After a 2-week course of systemic administration to mice (by
      intraperitoneal injection), there was evidence of a pronounced uptake of these
      oligos by the dorsal root ganglia (DRG), as well as by liver and kidney. There
      was no uptake by the brain. Consistent with uptake of antisense oligos by the
      DRG, systemic administration resulted in marked and consistent downregulation of
      p75 in DRG neurons. These results indicate that cyclodextrin-adamantane-oligo
      conjugates have great potential as agents to downregulate target genes in
      neurons, particularly in vivo in the peripheral nervous system.

PMID- 11198932
TI  - A 5-year-old boy with failure to thrive and progressive neurological
      disabilities.

PMID- 11198933
TI  - Growth hormone therapy in Turner syndrome.

PMID- 11198934
TI  - Rational approach to the clinical protocol design for drug combinations: a
      review.
AB  - Based on the median-effect equation of Chou and the combination index (CI)
      equation of Chou-Talalay, a computer software for automated dose-effect analysis
      has been developed. This method provides quantitation of synergism (CI < 1) and
      antagonism (CI > 1) at different dose and effect levels. Therefore, it allows the
      selection of the best pair (or triplet) of combination, optimal combination
      ratio, and the best schedule of treatment. These analyses has been shown to be
      useful for the clinical protocol design. (Chang et al. Cancer Res. 45: 2434-2439,
      1985). The user-friendly computer program also gives dose-reduction index (DRI)
      which determines how many fold of dose-reduction is allowed for each drug in
      synergistic combinations. Dose reduction leads to reduced toxicity while
      maintaining the desired efficacy (Chou et al. Encyclopedia of Human Biology 2:675
      683, 1997; Encyclopedia of Cancer 1:368-379, 1997). The Chou-Talalay method
      distincts from all other methods by the fact that it not only takes into account
      the "potency" but also the "shape" of dose-effect curves of each drug and their
      combinations (Chou & Hayball, CalcuSyn for Windows, Biosoft, Cambridge UK, 1996).
      This method has been applied in combination of anticancer agents, anti-HIV
      agents, purging leukemic cells for autologous bone marrow transplantation (Chang
      et al. Cancer Res. 47:119-122, 1987) and combination of immunosuppressants for
      organs transplants. Specific examples of the theoretical equations, the median
      effect plot, the CI plot, the isobologram, and the polygonogram are illustrated.

PMID- 11198935
TI  - Genetic studies in acute lymphoblastic leukemia.
AB  - As the long-term event-free survival rate in children with acute lymphoblastic
      leukemia approaches 80%, emphasis is being placed on risk-directed therapy to
      prevent over- or undertreatment. It has become apparent that risk assignment
      based on primary genetic abnormalities is inadequate by itself, and that
      measurement of early responses to therapy and the extent of minimal residual
      disease is needed to improve the accuracy of risk classification. Studies to
      identify genetic polymorphisms with pharmacokinetic and pharmacodynamic
      significance promise to enhance the discovery of new drugs and to optimize
      chemotherapy. Recent successes in directing therapy to specific genetic
      abnormalities demonstrate the feasibility of molecular medicine for the childhood
      leukemias, and predict the development of highly effective drug regimens with
      minimal toxicity against normal hematopoietic cells.

PMID- 11198936
TI  - Mortality, morbidity, length and cost of hospitalization in very-low-birth-weight
      infants in the era of National Health Insurance in Taiwan: a medical center's
      experience.
AB  - The impact of implementation of the National Health Insurance on the outcome,
      cost, and length of hospitalization of very-low-birth-weight (VLBW) infants is
      not clear in Taiwan. These data are important for the planning of medical care
      and regionalization in this area. This study was an attempt to examine these
      questions. We retrospectively collected mortality, morbidity, and length and cost
      of hospitalization data of VLBW (BW < 1500 g) infants between March 1995 and
      February 1998. There were totally 162 patients enrolled. The overall mortality
      rate was 21.6%; the birth weight (BW)-specific mortality rate was 72%, 31%, 19%,
      and 3% for infants with BWs of < 750 g, 750-999 g, 1000-1249 g, and 1250-1499 g,
      respectively. The incidence of morbidities were: respiratory distress syndrome
      (74%), patent ductus arteriosus (36%), necrotizing enterocolitis (9%), sepsis
      (42%), intraventricular hemorrhage (15%), retinopathy of prematurity (31%),
      failure to pass auditory brainstem response (ABR) (34%), and chronic lung disease
      (17%). The average length of hospitalization was 67.2 days, and the cost per
      infant was 62 x 10(4) NT dollars; 108 +/- 38 days, 73 +/- 32 x 10(4) NT dollars
      if BW < 750 g; 94 +/- 15 days, 99 +/- 35 x 10(4) NT dollars if BW 750-999 g; 66
      +/- 23 days, 64 +/- 36 x 10(4) NT dollars if BW 1000-1249 g; and 43 +/- 14 days,
      39 +/- 37 x 10(4) NT dollars if BW 1250-1499 g. In conclusion, VLBW infants are
      associated with high mortality and morbidity rates. They have long lengths and
      high costs of hospitalization, and therefore deserve attention in the
      implementation of the National Health Insurance and regionalization.

PMID- 11198937
TI  - Partial liquid ventilation in normal rabbits: comparison of three kinds of
      perfluorocarbon.
AB  - Perfluorocarbon liquids have been used in liquid ventilation studies and
      considered an effective technique of gas exchange with less barotrauma when
      compared with gas ventilation. We compared the effects of partial liquid
      ventilation (PLV) using 3 kinds of perfluorocarbon liquids (Fluorinert FC 43, FC
      77 and FC 84) available in Taiwan in normal rabbits. We were able to achieve
      adequate oxygenation and ventilation during a 2-hour-duration of PLV using FC 43,
      FC 77 or FC 84. There was no significant difference in hemodynamic status or
      laboratory findings between control group and PLV groups. There were also no
      significant differences before LV and after 2 hours of PLV among PLV groups.
      Histological study of lung tissue revealed intact and well expanded alveoli, and
      no significant pathological change after 2 hours of PLV. These results show that
      PLV using FC 43, FC 77 or FC 84 is an effective technique for maintaining
      adequate pulmonary gas exchange in normal rabbits.

PMID- 11198938
TI  - Bacterial infection in patients with transfusion-dependent beta-thalassemia in
      central Taiwan.
AB  - The microorganisms, outcome of infections and the risk factors were evaluated in
      39 patients with beta-thalassemia who received frequent blood transfusions. Among
      these patients, thirteen developed 22 episodes of infections, and bacteremia
      accounted for 72.7% (16/22) of all infections. Three patients developed
      meningitis, two patients had liver abscesses, three patients had soft tissue
      infections, one patient had a urinary tract infection and one patient had lobar
      pneumonia. Interestingly, a large proportion of the patients were infected by
      Gram-negative bacteria. Patients who were implanted with intravascular catheters
      were most susceptible to bacterial infection (1.70 episodes/patient) (P =
      0.0069). So were patients with ferritin levels over 2,000 ng/mL (1.18
      episodes/patient) (P = 0.028). The frequency of bacterial infections in patients
      with splenectomies (1.08 episode/patient) was also significantly higher than that
      of the average patient (P = 0.025). In conclusion, three major risk factors for
      bacterial infection were identified in this group of patients: intravascular
      catheterization, high serum ferritin levels (> or = 2,000 ng/mL) and splenectomy.
      The infection rate of these patients (0.45 episode/100 patient-year) is about 20
      fold higher than that of general pediatric patients (0.023 episode/100 patient
      year).

PMID- 11198939
TI  - Growth response and final height in Turner syndrome after combination therapy of
      growth hormone and anabolic steroid.
AB  - To improve the growth of Turner syndrome patients we administered human growth
      hormone (GH) combined with anabolic steroid. Thirty three patients completed at
      least one year of GH therapy. Daily GH injection was started at a dose of 1.0
      IU/kg/wk at age 12.6 +/- 2.1 years when their heights were below -3.2 +/- 2.1
      standard deviation, growth velocity was less than 4 cm/year and bone age (BA) was
      9.9 +/- 1.7 years. Anabolic steroid was added at 14.3 +/- 1.3 years of age when
      their growth velocity slowed. Their consecutive annual growth velocities were:
      7.40 cm/year; 6.15 cm/year; 5.47 cm/year; 4.74 cm/year and 4.05 cm/year
      respectively. Growth hormone therapy was discontinued when patients grew less
      than 4 cm/year, their BA reached 14 years or they were satisfied with their
      height. After combination therapy of GH for 3.0 +/- 1.1 years and anabolic
      steroids for 1.9 +/- 1.0 years, the final height of 17 patients was 150.3 +/- 4.1
      cm. We compared our results with worldwide reports and analyzed demographic
      factors related to growth response and final height. We conclude that combination
      therapy of GH and anabolic steroid is effective in improving growth and final
      height of Chinese Turner patients.

PMID- 11198940
TI  - Ultrasound screening of neonatal adrenal hemorrhage.
AB  - Neonatal adrenal hemorrhage (NAH) is frequently overlooked because the majority
      of cases are asymptomatic. In this study, we investigated the clinical symptoms,
      echographic characteristics and incidence of NAH from January 1998 to December
      1999 at Cathay General Hospital, Taipei, Taiwan. Among 3273 newborns who had
      ultrasound screening, 18 cases were diagnosed as having NAH. The incidence was
      0.55% which was compatible with other reports. But there was a female
      predominance (10:8) which was different from previous reports. Only one premature
      baby was diagnosed with NAH. No patients had perinatal asphyxia, and this was
      different from other reports. The mean birth body weight was 3530 grams which was
      more than the 75th percentile of normal term baby birth weight. Sixteen cases had
      right-sided NAH and two cases had left-sided NAH. Eleven cases (61%) within this
      study were asymptomatic. The incidence of pathologic jaundice was 11%. Four
      babies (22%) had poor oral feeding combined with vomiting. Only one had severe
      anemia for which blood transfusion was required. There were no cases of
      adrenocortical insufficiency in our study. Only one patient received
      adrenalectomy. In conclusion, NAH can be detected early by sonography and most
      cases require only supportive treatment. Thus, unnecessary surgery and severe
      complications due to delayed diagnosis can be avoided.

PMID- 11198941
TI  - Common variable immunodeficiency with mosaic trisomy 8: report of one case.
AB  - This case study reported a 17-year-old female of common variable immunodeficiency
      (CVID) associated with bronchiectasis, pernicious anemia and mosaic trisomy 8.
      Clinically this patient presented with recurrent sinopulmonary infections,
      intractable diarrhea, macrocytic anemia, and primary amenorrhea. Immunological
      tests showed pan-hypogammaglobulinemia and a decrease of peripheral blood B cells
      (4%) and CD4+ cells (25%). Lymphoproliferative responses to mitogen (PHA) and
      specific antigen (BCG) were profoundly impaired in the patient in comparison to
      those in control. Production of interleukin 4 (IL-4) and gamma interferon (IFN
      gamma) in the in vitro lymphoproliferation was also profoundly depressed.
      Pernicious anemia demonstrated by larger MCV (112.9 fl) and hyper-segmental
      granulocytes on peripheral blood smear responded to parental administration of
      vitamin B12. Interestingly, she had a mosaic trisomy 8 in peripheral blood
      mononuclear cells but normal 46XX karyotype in the bone marrow cells. To our
      knowledge, this is the first case of CVID associated with mosaic trisomy 8
      reported in the literature. As the case exemplifies, CVID should be considered
      when the physicians evaluate the patient presenting with recurrent sinopulmonary
      infections, diarrhea, malnutrition, and pernicious anemia. It requires further
      study to explore whether the genes in the chromosome 8 are linked to CVID.

PMID- 11198942
TI  - Hirschsprung's disease presenting with diffuse intestinal pneumatosis in a
      neonate.
AB  - In the neonate, pneumatosis intestinalis is almost always associated with
      necrotizing enterocolitis. The manifestation of diffuse intestinal pneumatosis in
      Hirschsprung's disease has been reported rarely. It may occur as a result of
      Hirschsprung's disease complicated with enterocolitis. We report a two-day-old
      female baby born at term with the problems of failure to pass meconium,
      progressive abdominal distension and bile stained vomiting. There was an early
      roentgenographic presentation of pneumatosis intestinalis which might have led to
      a diagnosis of necrotizing enterocolitis. However, the intestinal pneumatosis
      resolved within 48 hours. After anorectal manometry and contrast enema
      examination, an ileostomy was performed at the age of 23 days, and multiple
      biopsies of intestine showed aganglionosis up to the ileum at the level of 85 cm
      above the ileocecal valve. Unfortunately, the patient developed short bowel
      syndrome after operation and died suddenly after an accidental choking at the age
      of three months. This case suggests that Hirschsprung's disease may have an
      unusual early roentgenographic presentation with diffuse intestinal pneumatosis
      in the first few days of life. Anorectal manometries and suction biopsies are
      crucial for further diagnosis.

PMID- 11198943
TI  - Menetrier's disease associated with cytomegalovirus infection in a child.
AB  - Menetrier's disease is a rare disease with unknown etiology characterized by
      protein-losing hypertrophic gastropathy and hypoproteinemia. We report on a 4
      year-old boy who presented with a 2-week history of vomiting and periorbital
      edema. Upper gastrointestinal endoscopy revealed prominent gastric rugae, while
      pathological examination showed hyperplastic mucosa with proliferation,
      elongation, and basal cystic dilatation of the gastric glands replaced by mucous
      secreting epithelium, confirming the diagnosis of Menetrier's disease. Virus
      isolation from urine revealed cytomegalovirus (CMV); and CMV immunoglobulin G and
      immunoglobulin M antibodies were detected in the serum. His condition gradually
      improved under omeprazole, with complete histological recovery after 3 months.

PMID- 11198944
TI  - Marketplace. California ruling means medical groups must be careful about
      disciplining docs.

PMID- 11198945
TI  - Perspectives. Taking back the BBA, 2001 edition: hello, telehealth; goodbye, UPL
      loophole.

PMID- 11198946
TI  - Serious adverse events attributed to nevirapine regimens for postexposure
      prophylaxis after HIV exposures--worldwide, 1997-2000.
AB  - In September 2000, two instances of life-threatening hepatotoxicity were reported
      in health-care workers taking nevirapine (NVP) for postexposure prophylaxis (PEP)
      after occupational human immunodeficiency virus (HIV) exposure. In one case, a 43
      year-old female health-care worker required liver transplantation after
      developing fulminant hepatitis and end-stage hepatic failure while taking NVP,
      zidovudine, and lamivudine as PEP following a needlestick injury (1). In the
      second case, a 38-year-old male physician was hospitalized with life-threatening
      fulminant hepatitis while taking NVP, zidovudine, and lamivudine as PEP following
      a mucous membrane exposure. To characterize NVP-associated PEP toxicity, CDC and
      the Food and Drug Administration (FDA) reviewed MedWatch reports of serious
      adverse events in persons taking NVP for PEP received by FDA (Figure 1). This
      report summarizes the results of that analysis and indicates that healthy persons
      taking abbreviated 4-week NVP regimens for PEP are at risk for serious adverse
      events. Clinicians should use recommended PEP guidelines and dosing instructions
      to reduce the risk for serious adverse events.

PMID- 11198947
TI  - Nosocomial poisoning associated with emergency department treatment of
      organophosphate toxicity--Georgia, 2000.
AB  - Emergency department (ED) staff caring for patients contaminated with toxic
      chemicals are at risk for developing toxicity from secondary contamination. This
      report describes three cases of occupational illnesses associated with
      organophosphate toxicity caused by exposure to a contaminated patient and
      underscores the importance of using personal protection equipment (PPE) and
      establishing and following decontamination procedures in EDs and other areas of
      acute care hospitals.

PMID- 11198948
TI  - Special breast cancer stamp generates funds for novel studies.

PMID- 11198949
TI  - Dietary change and cancer prevention: what don't we know and when didn't we know
      it?

PMID- 11198950
TI  - Goals for nutrition in the year 2000.
AB  - Ongoing research continues to support the hypothesis that dietary factors
      significantly influence the incidence of many human malignancies. Despite some
      conflicting and confusing studies reported over the past two decades, it is
      becoming increasingly clear that maintenance of a healthy adult weight, through
      proper balance of caloric intake and physical activity, is key to cancer
      prevention. Moreover, current nutritional recommendations for the prevention of
      cancer include increased consumption of fruits and vegetables; reduced
      consumption of red meat and animal fat; and avoidance of excessive alcohol use.
      For many individuals, a daily multivitamin that contains folic acid may also be
      part of a reasonable overall cancer prevention strategy.

PMID- 11198951
TI  - What can randomized controlled trials tell us about nutrition and cancer
      prevention?
AB  - Randomized controlled trials are regarded as the most definitive of study
      designs. The randomized controlled trials that have tested nutritional factors
      for cancer prevention are reviewed. Trials that have tested the effects of
      nutrients given as high-dose supplements have been largely disappointing,
      typically showing either no or harmful effects. Possible benefits of vitamin E
      for prostate cancer prevention and selenium for prostate, colorectal, and lung
      cancer prevention have emerged only as secondary endpoints in trials conducted
      for other purposes; confirmatory new trials for these nutrients are now underway
      or are planned. The limitations of both past and current randomized controlled
      trials for studying diet-cancer relationships are discussed. The disappointing
      findings that have emerged from short-term studies of high-dose supplements
      cannot be interpreted as direct tests of the diet-cancer relationship because
      high-dose supplements cannot fully simulate the effects of whole foods on cancer
      risk. As we await findings from current and future trials, we should not forget
      that the ample evidence from observational epidemiologic research--suggesting
      that diets rich in fruits and vegetables can reduce the risk of many of the most
      common cancers--can provide a sound basis for nutritional recommendations aimed
      at reducing cancer risk.

PMID- 11198952
TI  - Evaluating complementary and alternative therapies for cancer patients.
AB  - "Complementary and alternative" therapies are actually a vast collection of
      disparate, unrelated regimens and products, ranging from adjunctive modalities
      that effectively enhance quality of life and promising antitumor herbal remedies
      now under investigation, to bogus therapies that claim to cure cancer and that
      harm not only directly, but also indirectly by encouraging patients to avoid or
      postpone effective cancer care. Complementary therapies such as music and
      massage, herbal teas to aid digestion and relieve nausea, yoga, tai chi,
      meditation, and the many other well-documented techniques that relieve stress and
      enhance well-being should be made available to patients to augment and ease the
      experience of cancer treatment and recovery. Many time-tested herbal and diet
      based remedies are now being studied for their abilities to induce or extend
      remission without toxicity. At the same time, lack of government regulatory
      authority leaves consumers at the mercy of those who promote unproved remedies,
      scores of which the grocery store and pharmacy shelves. Many of these over-the
      counter products contain harmful ingredients. Herb-drug interactions, only some
      of which are documented, occur with frequency and are sufficiently problematic to
      require that patients stop taking herbal remedies prior to surgery (to prevent
      interactions with anesthetics and anticoagulant effects); before radiation (due
      to potential for increased photosensitivity); and during courses of chemotherapy
      (to prevent product-drug interactions). Moreover, both good information and
      misinformation that appear in printed materials and on the Internet appeal to
      better educated consumers, who are, in fact, the most likely to try complementary
      and alternative methods.

PMID- 11198953
TI  - The challenge of prostate cancer.

PMID- 11198954
TI  - Prostate-specific antigen: current status.
AB  - Prostate-specific antigen (PSA) is the most important of all tumor markers in
      that it has significant applications in all aspects of the management of men with
      prostatic disease. Certainly, the most important utilization of PSA is for the
      early detection of this most ubiquitous of all human neoplasms. This article
      reviews the salient features of PSA, with particular emphasis on strategies to
      improve its utility in the diagnosis of prostate cancer. So-called PSA
      derivatives--including age-specific PSA, PSA velocity, and PSA density--are
      discussed. With the recognition of molecular forms of PSA, however, the ratio of
      free-to-total PSA, and now the complex form of PSA, have been shown to be more
      specific indicators of the presence of malignancy. Significant public interest
      and research efforts in prostate cancer have resulted in numerous advances over
      the past decade. The discovery of PSA and the development of assays to measure it
      will undoubtedly be recorded as one of the most important advances in the
      management of men with prostate cancer.

PMID- 11198955
TI  - Contemporary results of anatomic radical prostatectomy.
AB  - With current clinical practice, most newly diagnosed cases of prostate cancer are
      potentially life-threatening yet still curable. The anatomical (nerve-sparing)
      radical prostatectomy has dramatically improved the results of surgical
      treatment. Other new management options, including conformal (three-dimensional)
      external beam radiation therapy, radioactive seed implantation (brachytherapy),
      cryoablation, and hormonal therapy, may be useful in some patients, but they are
      all probably less effective than radical prostatectomy. Suitability for radical
      prostatectomy generally requires a clinically localized, potentially life
      threatening tumor [as defined by Gleason grade, tumor stage, and serum prostate
      specific antigen (PSA) level], a life expectancy of 10 years, and no serious co
      morbid medical conditions. With contemporary radical prostatectomy, about 70% of
      men with clinically localized disease will be cured, depending on tumor grade,
      tumor stage, and the serum PSA level. Urinary continence and sexual potency can
      be preserved in most patients, but substantially better results have been
      reported from centers of excellence than from community-based series. Other
      complications occur in about 10% of patients and with greater frequency in older
      patients. The operative mortality rate is less than 0.5%. Neoadjuvant hormonal
      therapy does not appear to affect treatment failure rates in patients undergoing
      radical prostatectomy. Prostatectomy may be beneficial in patients with
      microscopic lymph node metastases. Postoperative adjuvant radiotherapy may also
      be beneficial for patients with adverse pathologic findings. Salvage radical
      prostatectomy after radiation failure is associated with a 10-fold higher risk of
      complications and limited prospects for cure. Prospective, randomized clinical
      trials are underway to compare the results of radical prostatectomy with other
      treatments. Currently, radical prostatectomy is considered the preferred
      treatment for men with localized disease and a 10-year life expectancy.

PMID- 11198957
TI  - [An article for the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of
      Medicine)?].
AB  - Original articles are the backbone of this journal, as with any scientific
      journal. The Nederlands Tijdschrift voor Geneeskunde stimulates submissions in
      this category of articles by offering an annual prize for young authors. On the
      other hand 30-40% of original articles has to be turned away by the editors,
      because of vital short-comings. The subject matter can be unsuitable, such as
      details about organisation of health care or a highly specialised topic. More
      often the methods are at fault. Common problems are: lack of a proper research
      question, result of medical or surgical treatment without a control group, use of
      a questionnaire, poor validity because of bias in selection of patients, circular
      reasoning in the assessment of a diagnostic test, or an inappropriate measure of
      outcome. We urge prospective authors to seek advice from a clinical
      epidemiologist or at least from a colleague with experience in clinical research
      before embarking on a clinical study. If such help is difficult to obtain the
      editors are prepared to act as intermediary between authors and methodological
      experts.

PMID- 11198956
TI  - Epithelial ovarian cancer: prevention, diagnosis, and treatment.
AB  - The leading cause of death from gynecologic malignancies in the United States is
      epithelial ovarian cancer. The significant risk factor for development of ovarian
      cancer is advancing age, although there is clearly a genetic predisposition-
      often associated with the BRCA1 and BRCA2 genes--in at least 5% to 10% of all
      epithelial ovarian cancers. Oral contraceptives are known to reduce the risk for
      development of ovarian cancer and should be considered as a method of birth
      control in women at increased risk. Currently, there is no acceptable method of
      screening for this disease, although measurement of CA-125 level and transvaginal
      ultrasound have been utilized. Ovarian cancer is a surgically staged disease. In
      apparent early-stage disease, complete surgical staging is critical for the
      selection of adjunctive therapy. In advanced-stage disease, the goal is primary
      cytoreduction. Standard postoperative therapy for advanced-stage ovarian cancer
      includes platinum-based chemotherapy with the substitution of paclitaxel for
      cyclophosphamide occurring in the last decade. Despite these advances in
      chemotherapy, ovarian cancer continues to be fatal in far too many cases.

PMID- 11198958
TI  - [Iron deficiency in premenopausal women and criteria for iron supplementation].
AB  - Currently iron deficiency is treated only when anaemia has developed. In
      premenopausal women a haemoglobin level lower than 7.5 mmol/l justifies the
      diagnosis of anaemia. Reference values for haemoglobin in women have, however,
      been established while excluding only the extreme iron-deficient group, in which
      no iron could be found in the bone marrow. Studies on iron substitution in
      sufficient dosage in premenopausal women recorded haemoglobin values rising up to
      > or = 8.0 mmol/l. Premenopausal women will benefit from iron supplementation to
      optimize haemoglobin values and iron stores. Their physical condition is directly
      proportional to haemoglobin values. When pregnancy occurs sufficient iron stores
      corresponding to a ferritin value of > or = 80 micrograms/l are beneficial to
      mother and child. There are no rational arguments to refrain from iron
      supplementation in premenopausal women with suboptimal iron stores.

PMID- 11198959
TI  - [Importance of pharmacogenetics].
AB  - Pharmacogenetics deals with the differences in effect of drugs caused by genetic
      variation. Differences can occur in therapeutic effect and in adverse events.
      Genetic variation in metabolism may result in high concentrations of drugs and an
      increased risk of adverse effects in slow metabolizers, which is important when
      using for example antidepressants or chemotherapy. Genetic variation also occurs
      in proteins interacting with drugs, which may change the effect of e.g. asthma
      drugs and antipsychotics. The selection of drugs and their dosages may be
      improved, and the number of adverse effects reduced by pharmacogenetic
      investigations. However, it may be important also in case of medical examinations
      for insurances and job appointments, since some patients may turn out to need
      expensive drugs or to be susceptible to a certain disease. Therefore, the use of
      genetic data in these instances has to be regulated.

PMID- 11198960
TI  - [Physical examination--measurement of muscle strength].
AB  - Measuring muscle strength and establishing paretic symptoms are done first of all
      by having the patient perform actions or movements that require normal muscle
      strength. Measuring or grading the strength of separate muscle groups is usually
      done by means of the so-called Medical Research Council (MRC) scale that runs
      from 0 to 5, with the movement against gravity as an important criterion. This
      scale is not very valid in tract 4 (more strength than needed to overcome
      gravity, but still subnormal). Using a manual dynamometer or a fixed dynamometer
      it is possible to measure the strength of most clinically important muscle groups
      of the extremities and to compare them with values found in a normal population.
      For following the individual patient with a neuromuscular disorder, strength
      measurement with the dynamometer is more reliable than grading using the MRC
      scale.

PMID- 11198961
TI  - [Diagnostic image (19). Ecthyma gangraenosum].
AB  - During chemotherapy for acute myeloid leukaemia a 30-year-old man developed skin
      lesions. Cultures from these lesions and of blood showed growth of Pseudomonas
      aeruginosa. The diagnosis was: ecthyma gangraenosum. Treatment with antibiotics
      and normalization of the granulocytes resulted in a complete recovery of the
      patient.

PMID- 11198963
TI  - [Original articles in the Netherlands Tijdschrift voor Geneeskunde in the second
      part of the 20th century: type of research described and the number and
      background of authors].
AB  - OBJECTIVE: To determine the quantitative changes in methods and number of authors
      of original articles (OA) describing a (medical) scientific study in the
      Nederlands Tijdschrift voor Geneeskunde (NTvG) during 6 volumes in the second
      part of the 20th century. DESIGN: Retrospective bibliometric. METHOD: All OA
      published in 1949, 1959, 1969, 1979, 1989 and 1999 were screened on describing a
      (medical) scientific study, the method used, the number of authors, (medical)
      students or interns being part of the author list, the number of disciplines of
      the authors and the institutes where the authors did the study. RESULTS: The
      volumes mentioned contained 888 OA. The percentage of OA describing the used
      method increased from 47 in 1949 to 98 in 1999. In these OS 52% of the designs
      were retrospective. The proportion of prospective studies increased, but never
      met 25% of all OA. The median number of authors increased from 1 (range: 1-5) in
      1949 to 5 (1-16) in 1999. The median number of disciplines of the authors
      increased from 1 (1-2) in 1949 to 3 (1-6) in 1999. The percentage of OA with
      students or interns being part of the author list varied from 1 in 1949 to 13 in
      1999. In 1969-1999 most OA were received from authors from universities or
      academic hospitals. The percentage of OA received from authors from academic
      hospitals in collaboration with general hospitals increased from 0 in 1949 to 15
      in 1999. Randomized clinical trials and prospective studies were mainly received
      from authors from universities or academic hospitals. The part of retrospective
      studies was largest among OA received from authors from general hospitals (58%).
      CONCLUSION: In the second part of the 20th century the OA published in the NTvG
      changed. The number of authors increased. In recent years most authors were from
      universities or academic hospitals, although the proportion written by authors
      from these institutes in collaboration with those from general hospitals
      increased. Most OA described retrospective studies, the proportion received from
      authors from general hospitals being the largest. The percentage of OA describing
      prospective studies increased over the years.

PMID- 11198962
TI  - [Limited effect of Health Council guideline on outpatient preoperative evaluation
      clinics in the Netherlands: an inventory].
AB  - OBJECTIVE: To investigate the current status of preoperative evaluation in the
      Netherlands and the implementation of the Health Council recommendations. DESIGN:
      Cross-sectional study. METHOD: All Dutch anaesthesiologic partnerships and their
      hospital managers in February 2000 received a structured questionnaire about the
      existence of an outpatient evaluation clinic, possible problems in creating such
      a clinic and the contents of preoperative evaluation. RESULTS: We received
      responses of 101 (80%) and 111 (87%) from anaesthesiologists and managers,
      respectively. From 119 hospitals (94%) we received at least one useful
      questionnaire. On January 1, 2000, 24 (20%) hospitals had a complete and 36 (30%)
      a partial outpatient clinic. Within one year, 44% of the hospitals without a
      preoperative outpatient clinic expected to create one. The most common problem
      concerned financing this clinic. In hospitals with a complete clinic,
      anaesthesiologists were more often in employment (odds ratio (OR): 2.5; 95%
      confidence interval (95% CI): 1.0-10.0) and a routinely performed physical
      examination by the anaesthesiologist (or under his or her responsibility) was
      also conducted more often (OR: 5.0; 95% CI: 1.6-15.0). Not every patient saw an
      anaesthesiologist before entering the operating room in 70% of all hospitals. In
      hospitals without outpatient clinic, 57% of the day-surgery patients contacted
      the anaesthesiologist in the operating room. CONCLUSION: The recommendations of
      the Health Council of the Netherlands with respect to contents and organisation
      of the preoperative evaluation had, 3 years after being published, limited
      effect.

PMID- 11198964
TI  - [Loss of an eye due to hyper-IgE syndrome after corneal transplantation].
AB  - A 37-year-old patient with bilateral keratoconus underwent a perforating cornea
      transplantation after acute onset of pain and hydrops of the right cornea. One
      day after operation endophthalmitis developed, caused by a viridans
      streptococcus. Hyper-IgE syndrome was suspected because of the patient's crude
      facial features. His medical history brought up additional symptoms of this
      disease. IgE levels were extremely elevated (7320 kU/l), the eosinophil count was
      slightly raised (0.25 x 10(9)/l). The patient was treated with several local
      antibiotics but his vision was only light perception at the time of discharge
      from the hospital. This case illustrates how an usually successful operation may
      have a disastrous outcome in case of late diagnosis of the hyper-IgE syndrome.
      The hyper-IgE syndrome can be recognized by the characteristic facial features in
      combination with the often extensive (juvenile) medical history with infections,
      and by elevated serum IgE levels. As patients with the hyper-IgE syndrome are
      extremely susceptible to develop infections, prophylactic antibiotic therapy is
      indicated in surgical procedures.

PMID- 11198965
TI  - [Research proposals submitted to the Dutch Investigative Medicine Fund;
      evaluation of the scientific quality by the Council for Scientific Research
      (NWO)].
AB  - The Council for Medical and Health Research (MW-NWO) assessed the scientific
      quality of research proposals submitted to the Dutch Investigative Medicine Fund,
      and analysed if there had been changes over time in the proportion of proposals
      which the MW-NWO advised to reject, the role of reports of external reviewers and
      the most important methodological flaws. In the period 1995-1999 'reject' had
      been advised for an average of 50% of the proposals, with a tendency to a smaller
      proportion in recent years. In nearly half of the proposals the judgements of
      external reviewers were not in agreement with each other. There was only a weak
      correlation between the judgements of the reviewers and the final advice of NWO.
      Among the most important flaws mentioned in the NWO advice were: efficacy not
      proven (a prerequisite for the Fund), proposed study not needed to solve the
      policy problem and methodological flaws, e.g. design and power calculation not
      adequate, deficiencies of inclusion and exclusion criteria.

PMID- 11198966
TI  - [Mix-up of patient specimen: DNA-microsatellite analysis as a fast identification
      method].
AB  - In a man aged 56 years with dysphagia, an oesophageal biopsy was found to contain
      an adenocarcinoma. In view of the discrepancy between the clinical and the
      histological pictures, the biopsy was repeated; in a second biopsy no carcinoma
      was demonstrable. DNA microsatellite analysis proved that the first biopsy
      originated from another person. The scheduled oesophageal resection was cancelled
      and the patient was reassured. A woman aged 77 years underwent gastrectomy
      because of biopsy samples with adenocarcinoma. However, no tumour was found in
      the resected stomach. DNA microsatellite analysis showed that the biopsy samples
      indeed originated from the patient. Unfortunately, mix-up of patient specimens
      occasionally occurs. Especially a discrepancy between the clinical picture and
      the histological diagnosis must raise the suspicion of a specimen mix-up. In such
      cases, DNA microsatellite analysis can give a rapid and reliable answer whether a
      mix-up has indeed taken place.

PMID- 11198967
TI  - [Summary of the guideline 'Sentinel Node Biopsy for Breast Cancer'].

PMID- 11198968
TI  - [Summary of the guideline 'Sentinel Lymph Node Biopsy for Breast Cancer'].

PMID- 11198969
TI  - [Summary of the guideline 'Sentinel Lymph Node Biopsy for Breast Cancer'].

PMID- 11198970
TI  - [Mix-up of patient specimens: error prevention through a systems approach].
AB  - A correct diagnosis may reach the wrong patient because of a mix-up of either
      diagnostic specimens or identification data. It is astonishing how little
      attention is paid to this problem in medicine while the scale, the reach and the
      complexity of diagnosis are growing fast. More research is urgently needed to
      detect and investigate these types of errors. There is no quick remedy for this
      problem: a systems approach with comprehensive assessment of potential risks and
      subsequent management is the only sensible way out. Regrettably it is impossible
      to completely eliminate swapping errors, at best they can be reduced to an
      absolute minimum.

PMID- 11199061
TI  - Can the theory of planned behavior explain patterns of health behavior change?
AB  - This article tested the ability of the theory of planned behavior (TPB) to
      predict patterns of behavior change associated with health screening. Attitudes,
      subjective norms, perceived behavioral control, and intentions were used to
      predict objective measures of attendance 1 month and 13 months later among
      participants who had never previously been screened (N = 389). Findings showed
      that the TPB predicted attendance on each occasion and also predicted frequency
      of attendance. However, the model was unable to reliably distinguish among
      consistent attendees, participants who delayed attending, and participants who
      initially attended but relapsed. Thus, the TPB needs to be extended to understand
      behaviors that must be performed promptly and repeatedly for health benefits to
      accrue.

PMID- 11199062
TI  - Cognitive-behavioral stress management intervention decreases the prevalence of
      depression and enhances benefit finding among women under treatment for early
      stage breast cancer.
AB  - The authors tested effects of a 10-week group cognitive-behavioral stress
      management intervention among 100 women newly treated for Stage 0-II breast
      cancer. The intervention reduced prevalence of moderate depression (which
      remained relatively stable in the control condition) but did not affect other
      measures of emotional distress. The intervention also increased participants'
      reports that having breast cancer had made positive contributions to their lives,
      and it increased generalized optimism. Both remained significantly elevated at a
      3-month follow-up of the intervention. Further analysis revealed that the
      intervention had its greatest impact on these 2 variables among women who were
      lowest in optimism at baseline. Discussion centers on the importance of examining
      positive responses to traumatic events--growth, appreciation of life, shift in
      priorities, and positive affect-as well as negative responses.

PMID- 11199063
TI  - Health locus of control in late life: a study of genetic and environmental
      influences in twins aged 80 years and older.
AB  - The factor structure of health locus of control (Form A; K. A. Wallston, B. S.
      Wallston, & R. DeVellis, 1978) was examined in 420 octogenarians (M age = 83.2
      years), and the contributions of genetic and environmental factors to health
      control beliefs in 141 octogenarian twin pairs (71 identical, 70 same-sex
      fraternal) were estimated. Factor analyses reproduced previously proposed factors
      (Internal, Chance, and Powerful Others). Associations between health-control
      beliefs and life satisfaction, depression, and other health-related measures
      (e.g., self-rated health, outpatient contacts, and hospitalization), were modest.
      Quantitative genetic analyses revealed significant shared environmental influence
      on the Chance subscale, and significant familiality (attributable to a
      combination of genetic and shared environmental influences) on the Powerful
      Others subscale; there was no evidence of familiality on the Internal subscale.

PMID- 11199064
TI  - Associations between stress, trait negative affect, acute immune reactivity, and
      antibody response to hepatitis B injection in healthy young adults.
AB  - Eighty-four healthy graduate participants were administered the standard course
      of 3 hepatitis B vaccinations. Five months after the first dose (shortly after
      the second injection), each participant completed psychosocial measures, and a
      blood sample was drawn for determination of hepatitis B surface antibody titer.
      After completion of the vaccination series, participants performed an acute
      stress protocol, consisting of a 30-min adaptation period and a 5-min evaluative
      speech task. Blood was drawn at the end of the resting and task periods for
      assessment of cellular immune measures. Lower antibody response, as assessed
      after the second hepatitis B injection, was predicted independently by (a) high
      trait negative affect and (b) diminished T-cell proliferation in response to PHA.
      These data provide evidence that trait negative affect and the magnitude of
      stress-induced suppression of immune function may have clinical significance.

PMID- 11199065
TI  - An exploratory study of social support, distress, and life disruption among low
      income Hispanic women under treatment for early stage breast cancer.
AB  - Relationships between distress and perceived availability of social support were
      examined in 51 Hispanic women being treated for early stage breast cancer.
      Distress and different types (emotional, instrumental) and sources (spouse, women
      family members, other family members, friends) of support were measured at
      presurgery, postsurgery, and at 3-, 6-, and 12-month follow-ups. Emotional
      support from friends and instrumental support from spouse at presurgery predicted
      lower distress postsurgery. No other prospective benefits of perceived support
      emerged. Distress at several time points predicted erosion of subsequent support,
      particularly instrumental support from women in the family. In contrast to the
      adverse effects of distress (and independent of them), illness-related disruption
      of recreational and social activities at 6 months elicited greater support at 12
      months.

PMID- 11199066
TI  - Psychological interventions and the immune system: a meta-analytic review and
      critique.
AB  - This article reviews evidence for the hypothesis that psychological interventions
      can modulate the immune response in humans and presents a series of models
      depicting the psychobiological pathways through which this might occur. Although
      more than 85 trials have been conducted, meta-analyses reveal only modest
      evidence that interventions can reliably alter immune parameters. The most
      consistent evidence emerges from hypnosis and conditioning trials. Disclosure and
      stress management show scattered evidence of success. Relaxation demonstrates
      little capacity to elicit immune change. Although these data provide only modest
      evidence of successful immune modulation, it would be premature to conclude that
      the immune system is unresponsive to psychological interventions. This literature
      has important conceptual and methodological issues that need to be resolved
      before any definitive conclusions can be reached.

PMID- 11199067
TI  - The effects of racial stressors and hostility on cardiovascular reactivity in
      African American and Caucasian men.
AB  - This study examined the effects of race-related stressors and hostility on
      cardiovascular reactivity in 31 African American and 31 Caucasian men.
      Participants viewed 3 film excerpts that depicted neutral, anger-provoking (but
      race-neutral), and racist situations. Participants exhibited significantly
      greater diastolic blood pressure reactivity to anger-provoking and racist stimuli
      compared with neutral stimuli. In addition, high hostility was associated with
      higher recovery systolic and diastolic blood pressure levels after exposure to
      the films. Although the results failed to confirm previous reports of greater
      reactivity to racism in African Americans, the findings suggest that diastolic
      blood pressure levels may remain elevated after exposure to racist stimuli. These
      results indicate that even indirect exposure to interpersonal conflict elicits
      significant reactivity, which can persist after exposure to the stressor,
      especially among high-hostile men.

PMID- 11199068
TI  - Persistent symptoms among survivors of Hodgkin's disease: an explanatory model
      based on classical conditioning.
AB  - Persistent symptoms of nausea, distress, and vomiting triggered by reminders of
      cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20
      years posttreatment. Prevalence rates were high for distress and nausea but low
      for vomiting. Retrospective report of anticipatory symptoms during treatment was
      the strongest predictor of persistent symptoms, suggesting that treatment-induced
      symptoms are less likely to persist if conditioning does not occur initially.
      Time since treatment was also a significant predictor, with patients more
      recently treated more likely to experience persistent symptoms. Thus, an
      explanatory model based on classical conditioning theory successfully predicted
      presence of persistent symptoms. Symptoms also were associated with ongoing
      psychological distress, suggesting that quality of life is diminished among
      survivors with persistent symptoms. Recommendations for prevention and treatment
      of symptoms are discussed.

PMID- 11199069
TI  - Statistical power of articles published in three health psychology-related
      journals.
AB  - Power was calculated for 8,266 statistical tests in 187 journal articles
      published in the 1997 volumes of Health Psychology (HP), Addictive Behaviors
      (AB), and the Journal of Studies on Alcohol (JSA). Power to detect small, medium,
      and large effects was .34. .74. and .92 for HP; .34, .75, and .90 for AB; and
      .41, .81. and .92 for JSA. Mean power estimates are .36, .77, and .91, giving a
      good estimation for the field of health psychology. J. Cohen (1988) recommended
      that power to detect effects should be approximately .80. Using this criterion,
      the articles in these journals have adequate power to detect medium and large
      effects. Intervention studies have much less power to detect effects than
      nonintervention studies do. Results are encouraging for this field, although
      studies examining small effects are still very much underpowered. This issue is
      important, because most intervention effects in health psychology are small.

PMID- 11199070
TI  - [Diagnosis of lethal poisoning with some substances used by toxicomaniacs].
AB  - The authors analyze 62 expert conclusions on deaths from acute and chronic
      poisoning with various toxic substances used by toxicomaniacs. Forensic medical
      examination of corpses and forensic chemical analysis identified drugs, toluene,
      freon, organophosphorus compounds, and other toxins.

PMID- 11199071
TI  - [Regional forensic medical characteristics of sexual maturity].
AB  - Published data on sexual maturity of women in the North are reviewed. The authors
      analyze the findings of their studies and the anthropometric parameters of sexual
      maturity recorded in Regulations of Forensic Medical Obstetrical and
      Gynecological Expert Evaluations (1966) and find essential differences in the
      values of some parameters as regards the population of the Russian European
      North. The authors propose revision of the current Regulations in order to define
      regional standards.

PMID- 11199072
TI  - [Morphology of hairs on the head and other parts of the body in the residents of
      Africa].
AB  - The morphology of hairs from the head, beard, chest, armpits, and pubis was
      studied in indigenous population of Sudan, Sierra-Leone, Cote d'Ivoir, Ruanda,
      Nigeria, Gambia, Kenya, Uganda, Burundi, Zaire, Southern African Republic,
      Angola, Benin, and Guinea Bissau. A total of 327 hair specimens were examined. A
      number of new parameters of hairs were determined: thickness, number of cuticle
      pattern lines per mm, optic edge pattern, cuticle patterns, methods for detecting
      the cortical and medullar layers, width of hair layers and their transverse
      sections. The resultant morphological signs are new specific signs for African
      residents (Negroid) which can be used in forensic medical studies for identifying
      the race appurtenance of hairs.

PMID- 11199073
TI  - [Verification of amplified DNA profiles by electrophoresis in various gels].
AB  - Differentiation of genotypical mixtures resultant from amplification analysis of
      mixed DNA preparations and false multi-strip profiles, which can result from
      amplification typing of individual DNA under certain conditions and simulate
      mixtures, impedes the molecular genetic identification expert evaluations. This
      paper offers an effective method for verification of amplification profiles of
      DNA, which is based on the use of alternative gel electrophoretic systems. This
      methodological approach helps detect the polymerase chain reaction artefacts
      without using additional expert material and promotes correct interpretation of
      expert findings even in difficult cases.

PMID- 11199074
TI  - [Immunochemical methods in detection of opiates in tissues and organs].
AB  - Conditions of isolation of opiates from tissues and analysis of the resultant
      extracts by immunochemical methods are discussed. The main characteristics of
      OPIATES U kits (Pharmatech) for polarization fluorescent immunoanalysis of
      cadaveric material (liver) are determined. Immunochemical methods for forensic
      chemical analysis for opiates are experimentally compared.

PMID- 11199075
TI  - [Mechanism of sudden death in female pseudohermaphroditism].
AB  - Sudden death in female pseudohermaphroditism is described. Hemorrhage into
      hyperplastic adrenals leads to acute adrenal failure and is the immediate cause
      of death.

PMID- 11199076
TI  - [Expert significance of evaluating volatile non-metal combustion products in
      analysis of blood from subjects dead in fire].
AB  - Qualitative and quantitative composition and time course of formation of toxic
      substances during burning of polymers have been studied for two polymers, P-53-P
      and STBO. The most toxic gaseous products of nitrogen combustion are listed:
      hydrogen cyanide, nitrites, acid nitriles, aldehydes, aromatic carbohydrates,
      alkanes, and carbon oxide. Two expert conclusions are presented, including
      analysis of blood and viscera from subjects who died during fire. The following
      toxic substances were detected: carbon oxide, hydrogen cyanide, nitrites,
      acrylonitrile, acetonitrile, benzene, and methane in one case and the same
      products except carbon oxide in the other. The author considers that the list of
      tested toxic substances should be extended, particularly in cases with negative
      results of blood testing for carbon oxide and carboxyhemoglobin.

PMID- 11199077
TI  - [Antibodies in threshold dilutions of group-specific immune sera and their
      forensic medical significance].
AB  - Antibodies of nonadsorbed antisera are specific and under certain conditions can
      react with nonhomologous antigens. This assumption is scientifically based and
      experimentally confirmed. This property of antibodies opens new vistas for
      solving theoretical and practical tasks in medicine and biology with regard to
      the antigen-antibody tests. A technology of making highly effective group
      specific immunoreagents for forensic medical institutions and blood transfusion
      service has been created. The technology of immunoreagent making is patented.

PMID- 11199078
TI  - [Forensic medical evaluation of injury outcome in a hemophilic patients].

PMID- 11199079
TI  - [Detection of vaginal epithelial cells in a washing from a carrot].

PMID- 11199080
TI  - [Validation of main notions of flaws in medical care].
AB  - The authors define the notions of defects in medical care (DMC) in accordance
      with the new Criminal Code and Regulations for Estimating Harm to Health (Order
      No. 407 of Ministry of Health of the Russian Federation of December 10, 1996).
      Definitions of DMC, flaws in organization, diagnosis, and treatment, etc., at the
      prehospital and hospital stage of medical care are defined. List of the main
      components of DMC and their causes is presented.

PMID- 11199082
TI  - [Quality in forensic medical expert activities].

PMID- 11199081
TI  - [Forensic medical diagnosis of chronic narcotic intoxication by morphological
      data].

PMID- 11199083
TI  - [Forensic medical expert evaluation in connection with civil actions of patients
      complaining of improper dental care].
AB  - The authors discuss questions facing forensic medical experts in connection with
      civil "medical" actions. The questions are classified as common and private.
      Expert evaluations of correspondence of the scope and quality of dental care are
      offered as the base for analysis of these problems within the framework of civil
      legislation. The data evidence efficiency of forensic medical expert evaluations
      in civil legal procedure and the significance of forensic medical service in the
      solution of problems of quality and efficiency of medical (including dental) care
      of the population.

PMID- 11199084
TI  - Perceived body image and eating behavior in young adults with cystic fibrosis and
      their healthy peers.
AB  - Treatment aimed at achieving an ideal nutritional status is an integral part of
      the management of patients with cystic fibrosis (CF). Emphasis is continually
      placed upon dietary intake and weight. The effects of this on eating behavior and
      self-perceptions are unclear. This work compared male and female CF adults with a
      healthy male and female control population with regard to (a) clinical variables,
      (b) actual, perceived, and desired body shape/body mass index (BMI), and (c) body
      satisfaction, eating behaviors and attitudes, and self-esteem. Clinical data were
      recorded for 221 adults with CF and 148 healthy controls. All subjects completed
      BMI Charts (perception of body weight/BMI), the Eating Attitudes Test, and scales
      of body satisfaction and self-esteem. CF patients had poorer lung function and
      nutritional status than controls. Control males accurately perceived their body
      shape/BMI and were content with it, whereas CF males viewed their BMI as greater
      than it actually was and desired to be much heavier. Control females viewed their
      body shape/BMI as less than it actually was and desired to be even slimmer, in
      comparison with CF females, who perceived their BMI as less than it actually was
      but were happy with their perceived shape/weight. Control subjects, especially
      females, dieted to a greater extent and were more preoccupied with food (with
      binge eating and intended vomiting) than CF patients. Conversely, those with CF
      reported greater pressure from others to eat than did controls. More problems
      with food/eating behavior were associated with less body satisfaction and reduced
      self-esteem. In comparison with a healthy control population, the perceptions and
      behaviors of CF adults relating to eating, weight, and body image are not
      abnormal. Indeed, females with CF have fewer problems than their healthy peers.

PMID- 11199085
TI  - Serum cholesterol concentrations and mood states in violent psychiatric patients:
      an experience sampling study.
AB  - The well-documented negative association between serum cholesterol and aggressive
      behavior has led Kaplan to propose a cholesterol-serotonin hypothesis of
      aggression. According to this hypothesis, low dietary cholesterol intake leads to
      depressed central serotonergic activity, which itself has been reported in
      numerous studies of violent individuals. In the present study, 25 violent
      psychiatric patients participated in a microbehavioral experience sampling
      procedure to examine differences in self-reports of affective and cognitive
      experiences as a function of serum cholesterol concentrations. For 7 days, they
      wore signaling devices that emitted an average of seven signals a day. Following
      each signal, patients filled out a mood questionnaire. Total serum cholesterol
      (TSC) concentration was positively associated with measures of affect, cognitive
      efficiency, activation, and sociability, suggesting a link between low TSC and
      dysphoria. These findings are consistent with the cholesterol-serotonin
      hypothesis and with the substantive literature linking both aggression and
      depression to depressed central serotonergic activity.

PMID- 11199086
TI  - DNA repair capacity in healthy medical students during and after exam stress.
AB  - There has been extensive research into the effects of stress on immune function
      but little on the effects of stress on DNA repair capacity (DRC), a process
      central to maintaining a normal cell cycle. Defective DRC is one of the factors
      responsible for carcinogenesis. In the present study we assessed DRC in healthy
      medical students during times of high and low stress. Sixteen medical students
      were evaluated during the third day of a 5-day exam period and then again 3 weeks
      later, after vacation. At both time points, participants underwent a brief
      physical examination, had venous blood drawn, and completed questionnaires to
      identify subjective stress levels. The DRC was assessed by the host-cell reaction
      assay, which measures nucleotide excision repair capacity. Participants reported
      significantly higher levels of subjective stress during the exam period than
      after vacation. DRC was also significantly higher during the exam period than
      after vacation, suggesting a positive association between subject stress levels
      and DRC. The results are discussed in relation to previous findings and
      implications for cancer research.

PMID- 11199087
TI  - Sex, drugs, and HIV: does methadone maintenance reduce drug use and risky sexual
      behavior?
AB  - This study examined differences in drug use, sexual behavior, attitudes, and
      perceptions of vulnerability for AIDS between injection drug users who received
      methadone treatment in the previous 6 months and those who did not. Of the 123
      participants assessed, 62 (50%) received methadone treatment. Methadone patients
      reported fewer sexual partners and greater use of condoms compared to
      nonmethadone patients. Methadone patients also reported fewer high-risk sexual
      partners than those not in treatment. Women reported more high-risk partners than
      men. Methadone patients reported drinking alcohol less, but smoking marijuana
      more than nonmethadone users. Methadone users had more positive beliefs about the
      efficacy of condoms for preventing AIDS and expressed less anger than
      nonmethadone users in situations related to condom usage. These findings have
      important implications for using methadone maintenance to reduce the dual risk
      for HIV in injection drug users.

PMID- 11199088
TI  - A social-ecologic approach to assessing support for disease self-management: the
      Chronic Illness Resources Survey.
AB  - We report on the development and validation of an instrument to assess support
      and resources for chronic illness management (the Chronic Illness Resources
      Survey; CIRS). The 64-item full instrument and the 29-item Brief CIRS are based
      on a social-ecologic model, designed to apply across chronic diseases, and assess
      support and resources at each of seven levels (e.g., family and friends,
      physician and health care team, neighborhood/community). A prospective evaluation
      with 123 patients having heart disease, arthritis, diabetes, and/or COPD revealed
      that the overall instrument, as well as subscales and the brief instrument, had
      acceptable internal consistency, moderate to high test-retest reliability, good
      construct validity, and moderate concurrent and prospective criterion validity.
      We discuss potential uses of the CIRS for assessment, feedback, tailoring
      intervention, and evaluation and make recommendations for future research.

PMID- 11199089
TI  - Verifying drug abuse prevention program effects using reciprocal best friend
      reports.
AB  - Considerable research suggests that social influences-based drug abuse prevention
      programming has produced the most consistently successful preventive effects.
      However, a common criticism of this literature is that most prevention
      intervention studies rely solely on self-reported substance use. The purpose of
      this study was to assess the effects of normative education, arguably the most
      successful component of social influence based prevention programs, on alcohol
      and cigarette consumption using both self- and reciprocal best friend reports of
      substance use. Analyses of subsamples of data from 11,995 students participating
      in the Adolescent Alcohol Prevention Trial revealed that normative education
      significantly delayed the onset of alcohol use across the eighth, ninth, and
      tenth grades among public school students. A similar but somewhat less robust
      pattern was found for cigarette use. These results suggest that self-report bias
      does not account for previous findings and demonstrate rather convincingly that
      normative education is an effective drug prevention strategy for public school
      settings.

PMID- 11199091
TI  - Epithelial cells and fibroblasts.
AB  - Chronic obstructive pulmonary disease (COPD) is characterized by acute and
      chronic alterations in the cellular composition structure of the airways and
      alveoli. Much attention has been focused on the increase in inflammatory cells
      present both within the airway lumen and within the airway wall. The parenchymal
      cells of the airway are intimately involved in the recruitment and activation of
      these inflammatory cells. Conversely, the behaviour of parenchymal cells can be
      modulated by inflammatory cells. The parenchymal cells can also alter the
      structural elements present within the airway leading to architecture changes
      which can impair lung function. Finally, epithelial cells and fibroblasts can
      directly modify each other's behaviour. The activity of these cells, therefore,
      undoubtedly can play a variety of roles in the pathophysiologic processes which
      underlie COPD.

PMID- 11199092
TI  - Macrophage control of inflammation: negative pathways of regulation of
      inflammatory cytokines.
AB  - The recruitment of leukocytes from the blood compartment constitutes a multistep
      process which involves primary and secondary inflammatory cytokines, as well as
      adhesion molecules expressed on leukocytes and endothelial cells. The properties
      of the interleukin (IL)-1 system and of chemokines, as well as their interplay,
      are analysed. These mediators offer new paradigms to understand diverse
      pathologies, and provide tools and targets for the development of novel
      therapeutic strategies.

PMID- 11199093
TI  - Neutrophils in chronic obstructive pulmonary disease.
AB  - Neutrophil accumulation in the lung is a prominent feature of chronic obstructive
      pulmonary disease (COPD) and the activation of these cells, producing proteases
      and oxygen-derived free radicals, is thought to be important in the pathogenesis
      of the disease. An important step in recruitment is the local generation of a
      neutrophil chemoattractant signal which mediates the trapping and firm adhesion
      of rolling neutrophils on the microvascular endothelium, followed by migration
      via intercellular junctions. Two neutrophil chemoattractants are particularly
      important in this respect, C5a generated by cleavage of complement C5 in
      interstitial fluid, and interleukin (IL)-8 synthesized by cells in the lung, e.g.
      macrophages, epithelial cells, endothelial cells, smooth muscle cells and
      neutrophils themselves. Lipid mediators, such as leukotriene B4 (LTB4), are also
      potentially important. Several studies have been carried out to investigate the
      role of IL-8 in COPD. IL-8 has been detected in bronchoalveolar lavage fluid and
      sputum from such subjects and in the systemic circulation. The levels of IL-8
      have been found to correlate with neutrophil numbers and markers of neutrophil
      activation, such as myeloperoxidase activity. Some studies have also found a
      correlation between IL-8 levels, neutrophil numbers and the degree of lung
      dysfunction. These parameters are insensitive to steroids. Thus, the mechanisms
      involved in neutrophil recruitment, i.e. chemoattractant secretion or action,
      adhesion and endothelial transmigration, are important potential targets for the
      development of novel therapy. The IL-8 receptors on neutrophils, CXCR1 and CXCR2,
      are of particular interest.

PMID- 11199094
TI  - Lymphocytes, chronic bronchitis and chronic obstructive pulmonary disease.
AB  - Chronic obstructive pulmonary disease (COPD) is a cytotoxic T lymphocyte (CD8)-
      and macrophage (CD68)-predominant chronic inflammatory disorder of the conducting
      airways and alveoli. This is often associated with a neutrophilia, inflammation
      of small airways and destruction of tissue beyond the terminal bronchiolus, i.e.
      emphysema. In contrast, asthma is a helper T cell (CD4; type 2)-predominant
      chronic inflammatory disorder of the conducting airways in which there is T
      lymphocyte-derived gene expression for interleukin (IL)-4 and IL-5 but not
      interferon gamma. There is fragility of airway surface epithelium, thickening of
      the reticular basement membrane, bronchial vessel congestion and (when severe) an
      increase in the mass of bronchial smooth muscle. This is usually (but not always)
      associated with tissue and peripheral blood eosinophilia rather than a
      neutrophilia and there is exudative plugging of the airways. These differences of
      inflammatory profile, remodelling and lung function are seen when smokers with
      COPD are compared with non-smoking mild asthmatics. However there may be
      important similarities and overlap, particularly in more severe asthma when
      neutrophils predominate and in the older and or smoking asthmatic when
      reversibility of airflow is less obvious. We have recently demonstrated gene
      expression for IL-4 and IL-5 in and around the mucus-secreting glands of airways
      resected from smokers without a history of asthma. Also exacerbations of
      bronchitis may be associated with a tissue eosinophilia. On examination of
      bronchial biopsies from these patients we show surprisingly strong gene
      expression for IL-4, IL-5 and even human eotaxin and RANTES (regulated on
      activation normal T cell expressed and secreted). Whilst CD4 T lymphocytes of the
      Th2 phenotype might be expressing these cytokines in bronchitis, CD8 T
      lymphocytes are also capable of secreting IL-4 and IL-5. Viruses may modulate
      these changes in distinct lymphocyte functional phenotypes. The relevance and
      importance of CD4/CD8 T lymphocyte ratio to the development of COPD is discussed.

PMID- 11199095
TI  - Oxidants/antioxidants and chronic obstructive pulmonary disease: pathogenesis to
      therapy.
AB  - There is now considerable evidence for an increased oxidant burden in smokers,
      particularly in those smokers who develop chronic obstructive pulmonary disease
      (COPD), as shown by increased markers of oxidative stress in the airspaces,
      breath, blood and urine. The presence of increased oxidative stress is a critical
      feature in the pathogenesis of COPD, since it results in inactivation of
      antiproteinases, airspace epithelial injury, mucus hypersecretion, increased
      sequestration of neutrophils in the pulmonary microvasculature, and gene
      expression of pro-inflammatory mediators. The sources of the increased oxidative
      stress in patients with COPD derive from the increased burden of oxidants present
      in cigarette smoke, or from the increased amounts of reactive oxygen species
      released from leukocytes, both in the airspaces and in the blood. Antioxidant
      depletion or deficiency in antioxidants also contributes to oxidative stress. The
      development of airflow limitation is related to dietary deficiency of
      antioxidants and hence dietary supplementation may be a beneficial therapeutic
      intervention in this condition. Oxidative stress also has a role in enhancing the
      airspace inflammation, which occurs in smokers and patients with COPD through the
      activation of redox-sensitive transcriptions factors such as NF-kappa B and AP-1,
      which regulate the genes for pro-inflammatory mediators and protective
      antioxidant gene expression. Antioxidants that have good bioavailability or
      molecules that have antioxidant enzyme activity are therefore therapies that not
      only protect against the direct injurious effects of oxidants, but also may
      fundamentally alter the inflammatory events which have a central role in the
      pathogenesis of COPD.

PMID- 11199096
TI  - Proteases and antiproteases.
AB  - Serine proteases have been implicated in the pathogenesis of chronic obstructive
      pulmonary disease (COPD) since the identification of alpha 1-antitrypsin
      deficiency in 1963. This inhibitor efficiently inactivates several enzymes
      released by activated neutrophils including neutrophil elastase, cathepsin G and
      proteinase 3, all of which have been shown to generate features of COPD in animal
      models. Recent studies have identified the mechanisms of enzyme release from
      activated neutrophils and indicate that the concentrations are usually two orders
      of magnitude above that of normal alpha 1-antitrypsin. This results in an area of
      obligate proteolysis in the immediate vicinity of a migrating neutrophil. The
      area is greatly enlarged in alpha 1-antitrypsin deficiency explaining the
      increased susceptibility of such patients to develop lung damage. The migration
      into and activation of neutrophils in the lung is likely to be a major
      determinant of the development of COPD. Understanding the processes has important
      implications for the design of new therapeutic strategies.

PMID- 11199097
TI  - Matrix metalloproteinases and TIMPs: properties and implications for the
      treatment of chronic obstructive pulmonary disease.
AB  - The matrix metalloproteinases (MMPs) are a unique family of metalloenzymes that,
      once activated, can destroy connective tissue. The active enzymes are all
      inhibited by tissue inhibitors of metalloproteinases (TIMPs). The relative
      amounts of active MMPs and TIMPs are important in determining whether tissues are
      broken down in disease. Although elastase is often regarded as the target enzyme
      in chronic obstructive pulmonary disease (COPD), both the neutrophils and
      macrophages in the lung contain metalloproteinases and both collagen and elastin
      are degraded in disease. Transgenic studies have shown that when MMP1 is over
      expressed, pulmonary emphysema develops in mice, while MMP12 knockout mice do not
      develop pulmonary emphysema when exposed to cigarette smoke. New drugs that can
      specifically block active MMPs are now available. These potent inhibitors are
      effective in vitro and prevent the destruction of tissue in animal models. Future
      patient trials will test the effectiveness of these compounds in preventing
      tissue destruction.

PMID- 11199098
TI  - Pulmonary alveolus formation: critical period, retinoid regulation and
      plasticity.
AB  - Pulmonary alveoli, the lung's gas-exchange structures, are formed in part by
      subdivision (septation) of the saccules that constitute the gas-exchange region
      of the immature lung. Although little is known about the regulation of septation,
      relatively recent studies show: (1) all-trans retinoic acid (RA) treatment of
      newborn rats increases septation and prevents the inhibition of septation
      produced by treatment of newborn rats with dexamethasone, a glucocorticosteroid
      hormone; (2) treatment with RA of adult rats that have elastase-induced emphysema
      increases lung elastic recoil, induces the formation of alveoli, and increases
      volume-corrected alveolar surface area; and (3) in tight-skin mice, which have a
      genetic failure of septation, and in rats in which septation had previously been
      prevented by treatment with dexamethasone, treatment with RA partially rescues
      the failed septation. These findings raise the possibility that treatment with RA
      will induce the formation of alveoli in humans with pulmonary emphysema.

PMID- 11199099
TI  - Systemic effects of chronic obstructive pulmonary disease.
AB  - Traditionally, chronic obstructive pulmonary disease (COPD) has been understood
      as a disease of the lungs, characterized by irreversible airflow limitation due
      to chronic bronchitis and/or emphysema. The latter are thought mainly to be the
      consequence of an excessive inflammatory response to tobacco smoking. Recently,
      several studies have shown that this pulmonary inflammation may also be detected
      in the systemic circulation, and that this systemic inflammation may have
      important clinical consequences. Most prominent among them is the loss of
      skeletal muscle mass that a significant percentage of patients with COPD will
      show during the course of their disease. This limits considerably their exercise
      capacity, jeopardizes their health status, and has a negative impact on their
      prognosis. Importantly, such prognostic value is independent of the degree of
      airflow obstruction and potentially reversible with appropriate therapy. This
      chapter summarizes available evidence supporting the concept that COPD is more
      than a lung disease (the systemic effects of COPD), and speculates on potential
      cellular mechanisms as future therapeutic targets.

PMID- 11199100
TI  - Potential novel therapies for chronic obstructive pulmonary disease.
AB  - While considerable progress has been made in development of drugs for asthma,
      there have been few advances in the treatment of chronic obstructive pulmonary
      disease (COPD). New therapeutic approaches to prevent disease progression are
      urgently needed and these will arise out of better understanding of the disease
      process at a cell and molecular level. The inflammatory response in COPD differs
      markedly from that of asthma, with differences in inflammatory cells, mediators
      and response to therapy. The neutrophilic inflammation is orchestrated by
      chemotactic factors, such as interleukin (IL)-8, other CXC chemokines and
      leukotriene B4; receptor blockers (CXCR1, CXCR2, BLT antagonists) or synthesis
      inhibitors (5'-lipoxygenase inhibitors) might be effective. Tumour necrosis
      factor (TNF) alpha may be an important amplifying cytokine and there are several
      strategies for blocking it (antibodies, soluble receptors, TACE inhibitors). IL
      10 is effective in blocking the synthesis of IL-8 and TNF alpha as well as
      proteases. Oxidative stress and peroxynitrite may be important in COPD; more
      effective antioxidants are now in development. The inflammatory response in COPD
      is essentially steroid-resistant so that alternative anti-inflammatory treatments
      are needed. Phosphodiesterase 4 inhibitors look promising in early clinical
      studies. Nuclear factor-kappa B inhibitors and p38 MAP kinase inhibitors may also
      be effective. Several protease inhibitors are in development including those for
      neutrophil elastase, selective matrix metalloproteinase and cathepsin.

PMID- 11199101
TI  - Overview of current therapies.
AB  - The therapy of chronic obstructive pulmonary disease has been comprehensively
      reviewed in a number of international treatment guidelines. There is consensus
      about what elements should be included, but the purposes of therapy and the
      timing of its introduction remain poorly defined. Major factors limiting
      effective treatment beyond those associated with the biology of the condition
      itself are poor diagnostic methodology, failure to identify relevant co
      morbidities and reluctance to devote appropriate resources to maximizing patient
      gain. Too many patients are identified at the end-stages of their illness when
      treatment is relatively limited. Most therapy is directed at reducing the impact
      of the disease in terms of symptoms, exercise performance and exacerbations on
      the individual and only smoking cessation modifies the evolution of the disease.
      Treatment of hypoxaemic patients with domiciliary oxygen improves mortality and
      slows the development of pulmonary hypertension. Effective smoking cessation is
      relevant at all stages of the disease. It depends on the willingness of the
      individual to participate, and quit rates can be improved by the use of nicotine
      replacement therapy and possibly bupropion. Inhaled bronchodilator drugs palliate
      symptoms and improve exercise performance in pharmacologically predictable ways.
      In patients with severe disease, reduction in operating lung volumes is more
      important than 'bronchodilitation' and is better sustained by long acting beta
      agonists and anticholinergics. Inhaled corticosteroids reduce exacerbation rates
      and improve health status in established disease but do not modify disease
      evolution. Pulmonary rehabilitation improves exercise performance and health
      status without changing underlying pulmonary mechanics. Whether hospitalizations
      and exacerbations can be modified is still to be established. Nutritional therapy
      is in its infancy but calorie supplementation alone is insufficient to improve
      patient well being. Selected individuals can undergo lung volume reduction
      surgery with benefits extending up to two years but the risks are dependent on
      the skill of the operators and the appropriateness of patient selection. Lung
      transplantation is symptomatically helpful but does not modify the natural
      history of the disease. Hospitalization due to exacerbations of disease is
      frequent and their treatment with bronchodilators, antibiotics and
      corticosteroids now have a basis in randomized trial data. Mortality reflects the
      incidence of respiratory acidosis and noninvasive ventilation has a role in
      safely managing patients outside of the intensive care unit. Effective prevention
      of exacerbation should be possible with newer antiviral agents but data are
      presently lacking.

PMID- 11199102
TI  - Chronic obstructive pulmonary disease: an overview of pathology and pathogenesis.
AB  - A cigarette smoke-induced inflammatory process underlies the pathogenesis of the
      majority of pathologic lesions associated with chronic obstructive pulmonary
      disease (COPD). In chronic bronchitis, this process is located in the mucosa,
      gland ducts and glands of intermediate sized bronchi with an internal diameter of
      2-4 mm. The mucus-containing exudate produced by the inflammatory response
      overpowers the normal clearance mechanisms, resulting in the cough and
      expectoration that characterize chronic bronchitis. In some cases of chronic
      bronchitis, the inflammatory process extends to smaller bronchi and bronchioles
      less than 2 mm in internal diameter. In this location, the inflammatory process
      thickens the wall, narrows the lumen and destroys the parenchymal support of the
      airways. These changes progressively increase peripheral airways resistance and
      eventually reduce the patient's ability to empty their lungs to a degree that can
      be measured by a reduction in FEV1 (forced expiratory volume in one second). The
      reduction in lung surface area produced by parenchymal inflammation contributes
      to the decline in FEV1 by reducing lung elastic recoil, which is the major force
      driving air out of the lung. It also contributes to the reduction in diffusing
      capacity by reducing the lung capillary bed. The purpose of this presentation is
      to review the quantitative aspects of these pathological changes and attempt to
      provide insight into factors which result in progression of these lesions.

PMID- 11199103
TI  - Genetics of chronic obstructive pulmonary disease.
AB  - The marked variability in the development of chronic obstructive pulmonary
      disease (COPD) in response to cigarette smoking has been known for decades, but
      severe alpha 1-antitrypsin deficiency (PI Z) remains the only proven genetic risk
      factor for COPD. With cigarette smoking, PI Z subjects tend to develop more
      severe pulmonary impairment at an earlier age than non-smoking PI Z individuals.
      However, PI Z individuals exhibit wide variability in pulmonary function
      impairment, even among individuals with similar smoking histories. Therefore,
      other genes and environmental exposures are also likely involved. The role of
      heterozygosity for the Z allele as a risk factor for COPD remains controversial,
      but accumulating evidence suggests that at least some PI MZ individuals are at
      increased risk of developing airflow obstruction. In individuals without alpha 1
      antitrypsin deficiency, familial aggregation of COPD has been reported in several
      studies. To study novel genetic determinants of COPD, our research group enrolled
      44 severe, early-onset COPD probands (FEV1 < 40%, age < 53 yrs, non-PI Z) and 266
      of their relatives. A marked female predominance was noted among the early-onset
      COPD probands. In addition, increased risk to current or ex-smoking first-degree
      relatives of early-onset COPD probands for reduced FEV1, chronic bronchitis and
      spirometric bronchodilator responsiveness has been demonstrated. These data
      strongly support the genetic basis for the development of COPD and the potential
      for gene-by-environment interaction. A variety of studies have examined candidate
      gene loci with association studies, comparing the distribution of variants in
      genes hypothesized to be involved in the development of COPD in COPD patients and
      control subjects. For most genetic loci which have been tested, there have been
      inconsistent results. Genetic heterogeneity could contribute to difficulty in
      replicating associations between studies. In addition, case-control association
      studies are susceptible to supporting associations based purely on population
      stratification, which can result from incomplete matching between cases and
      controls--including differences in ethnicity. No association studies in COPD have
      been reported which used family-based controls, a study design which is immune to
      such population stratification effects. More importantly, no linkage studies have
      been published in COPD to identify regions of the genome which are likely to
      contain COPD susceptibility genes--regions in which association studies are
      likely to be more productive.

PMID- 11199104
TI  - Mucus hypersecretion in chronic obstructive pulmonary disease.
AB  - Most patients with chronic obstructive pulmonary disease (COPD) exhibit
      characteristics of airway mucus hypersecretion, namely sputum production,
      increased luminal mucus, submucosal gland hypertrophy and goblet cell
      hyperplasia. The clinical consequences of hypersecretion are impaired gas
      exchange and compromised mucociliary clearance, which encourages bacterial
      colonization and associated exacerbations. However, the extent of the
      contribution of mucus to pathophysiology of COPD is controversial. Early
      epidemiological studies found little evidence for the involvement of mucus in the
      age-related decline in lung function and mortality associated with COPD and
      concluded that chronic airflow obstruction and mucus hypersecretion were
      independent processes. Later studies found positive associations between phlegm
      production and decline in lung function, hospitalization and death. Thus,
      although not diagnostic for the condition, mucus hypersecretion contributes to
      morbidity and mortality in certain groups of patients with COPD. This suggests
      that it is important to develop drugs that inhibit mucus hypersecretion in these
      patients. Unfortunately, ambiguity in clinical studies of mucoactive drugs means
      that mucolytics are not recommended in clinical management. Future research
      should determine whether there is an intrinsic abnormality in mucus in COPD,
      which will determine development of appropriate inhibitors, which in turn can be
      used in 'proof of concept' and in treatment.

PMID- 11199105
TI  - Mechanisms of exacerbations.
AB  - Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause
      of morbidity and mortality and hospital admission. Some patients are particularly
      susceptible to develop frequent exacerbations; exacerbation frequency being an
      important determinant of health related quality of life. Patients with frequent
      exacerbations (three or more exacerbations per year) have increased induced
      sputum cytokine interleukin (IL)-6 and IL-8 levels when stable, suggesting that
      frequent exacerbation is associated with increased airway inflammatory changes.
      Respiratory viral infections are a major cause of COPD exacerbations, with upper
      respiratory tract infections (colds) being associated with two-thirds of COPD
      exacerbations. Rhinovirus has been detected in induced sputum by PCR in 25% of
      exacerbations, suggesting that rhinovirus may directly infect the lower airway
      triggering exacerbation. The presence of an upper respiratory tract infection
      leads to a longer symptom recovery time at exacerbation. At exacerbation induced
      sputum IL-6 levels were increased compared to stable, though there were no
      significant increases in IL-8 or sputum cell counts. Sputum IL-6 levels were
      found to be higher in those patients with symptoms of a common cold. Increased
      airway eosinophilia has been also found at exacerbation. Other factors including
      bacterial colonization of the airways, temperature and interactions with
      environmental pollutants may also play a role in COPD exacerbation.

PMID- 11199106
TI  - [Writing process, PPmP and I in the middle of the word].

PMID- 11199107
TI  - [Differences in 2 diagnostic groups of psychosomatic patients on the Symptom
      Checklist 90-R (SCL-90-R). Consequences for using SCL-90-R in follow-up
      research].
AB  - 680 unselected outpatients of our Psychosomatic Clinic were divided into six
      diagnostic groups and examined by the SCL-90-R. By ANOVA we found differences of
      means between the diagnostic groups for the global severity score (GSI) and for
      the subscale scores. We describe the model of Jacobson et al. [1,2] for the
      determination of cut-off-points and reliable change indices for the assessment of
      changes over time, e.g. after psychotherapy. Our results lead to the conclusion
      that, although an overall reliable change index for the GSI can be applied to all
      psychosomatic patients, cut-off-points should be different following the
      diagnostic groups. Furthermore, information from the SCL-90-R-subscales as well
      as other specific symptom scales should be used for the interpretation of
      significant changes of the GSI.

PMID- 11199108
TI  - [Axis I "illness experience and treatment preconditions" of operational
      psychodynamic diagnosis (OPD). Experiences in clinical practice].
AB  - In a selective survey, results on psychometric properties and aspects of
      application of the axis I, "illness experience and treatment preconditions" of
      the Operational Psychodynamic Diagnoses (OPD) are described. Following remarks on
      the role of defense and coping theories in the conceptualisation of the axis, its
      structure and contents are outlined. After a brief summary of findings on its
      interrater reliability, several aspects of validity are discussed. Results on
      discriminative validity show that axis I items are useful in the statistical
      discrimination of subsamples differing in age, clinical diagnoses, and diagnostic
      setting (psychotherapy outpatient vs. psychosomatic consultation-liasion
      services). The contribution of axis I items to prediction of treatment outcomes,
      moreover, reveals high degree of predictive or treatment validity. After an
      integrative discussion of these findings, implications of patient personality and
      coping behaviour for axis I ratings are highlighted as important objectives for
      future OPD research.

PMID- 11199109
TI  - [Retinopathia centralis serosa--stomach ulcer of ophthalmology?].
AB  - Centralis serosa retinopathy is regarded in ophthalmology as a psychosomatic
      disease, although this assumption has not been satisfactorily proven so far. With
      the use of the Freiburg Personality Inventory (FIP, [4]), the questionnaire for
      the evaluation of psychosomatic pathological processes [10], and by recording the
      affliction undergone by stressful events in the patients' lives, the question as
      to whether a psychogenic contributory cause existed was examined with a control
      group study (n = 11), parallelised according to age and sex. The results proved
      significantly that there was a psychosomatic connection, specifically a tendency
      to somatisation in patients with centralis serosa retinopathy. However, it was
      not possible to compile a typical personality profile, although it was possible
      to describe some conspicuous personality features. As a conclusion, the
      consequences for a subsequent study are being discussed.

PMID- 11199110
TI  - [Method of plan formulation: first German language rehabilitation study of the
      Joseph Weiss "control mastery theory"].
AB  - The paper gives a survey of the "Control Mastery Theory" (CMT) of Joseph Weiss.
      CMT is a cognitive-affective, psychoanalytic theory of the psychotherapeutic
      process. The San Francisco Psychotherapy Research Group empirically investigated
      und confirmed several concepts of the CMT. Some research results are summarized
      and the "Plan Formulation Method" is described in detail. The results of the
      first German reliability study applying the plan formulation method on the case
      "Amalie" show that the method can be used reliably for research purposes outside
      the USA.

PMID- 11199111
TI  - [The Antonovsky Sense of Coherence Scale. Test statistical evaluation of a
      representative population sample and construction of a brief scale].
AB  - In this article we will describe the evaluation of Antonovsky's 29-items Sense of
      Coherence Scale (SOC-29) in a large community sample (n = 2.005) of the German
      population and the development of the Leipzig Short Scale (SOC-L9), which
      consists of only 9 items. The SOC-29 has a high internal consistency (alpha =
      0.92), however, the SOC-subscales (comprehensibility, manageability,
      meaningfulness) were correlated with each other. A principal component factor
      analysis did not identify the 3-factor structure of the SOC-Scale. It appears
      that the best solution consists of one global factor. The newly developed SOC-L9,
      conceptualized as an unidimensional scale, is a reliable and valid instrument,
      which allows to assess the SOC economically. In our study the Sense of Coherence
      depended on age and gender. Women and older people reported a lower SOC.
      Furthermore we found significant associations between SOC and different
      subjective health measures. A high SOC was associated with both a lower extent of
      subjective body complaints and somatoform symptoms and with minor health-related
      problems in daily living.

PMID- 11199112
TI  - [Promotional Prize of the German Lung Foundation, "Production of nitric oxide in
      human respiratory tract"].

PMID- 11199113
TI  - [Recruitment of immunocompetent cells in a transplanted lung is not impaired
      despite incompletel reinnervation].
AB  - BACKGROUND: It is not clear whether surgical intervention during lung
      transplantation which includes cutting vegetative nerves, lymphatic vessels and
      bronchial arteries, leads to alterations in immune responses. Thus, it was
      studied in an animal model whether an induced pulmonary immune reaction after
      syngenic lung transplantation was impaired without the influence of
      immunosuppression and rejection. The recruitment of leukocytes and the status of
      reinnervation was examined. METHODS: Syngenic transplantation of the left lung
      was performed in Lewis rats without rejection and therefore without
      immunosuppressive therapy. In a subgroup of animals host and donor leukocytes
      were distinguished. An ovalbumin (OVA)-specific pulmonary immune response was
      induced four months after transplantation. Bronchoalveolar lavage (BAL) and
      interstitial leukocytes were examined using flow cytometry and immunocytology,
      comparing the right lung and the grafted left lung. Immunohistology was performed
      to detect nerve fibers on cryostat sections. RESULTS: An induced cellular
      inflammation was observed in the right host lung as well as in the grafted left
      lung. However, the CD4 T cell numbers in the BAL were increased in the left lung.
      Single donor-type leukocytes could still be observed four months after
      transplantation. A partial reinnervation was found. CONCLUSIONS: The recruitment
      of immune cells into the lung interstitium and bronchoalveolar space of grafted
      lungs is not impaired. The incomplete reinnervation has no influence on leukocyte
      recruitment.

PMID- 11199114
TI  - [Correlation of plasma glutathione and total IgE level: evidence for a regulatory
      role of antipxodants in vivo].
AB  - BACKGROUND: Atopy is characterized by increased levels of circulating
      immunoglobulin E (IgE). Moreover, elevated IgE levels are frequently observed in
      HIV-infected individuals and are of prognostic significance in these patients.
      Several In vitro studies have established an association of intracellular
      antioxidants like glutathione with IgE production by B-lymphocytes, suggesting a
      regulatory role of these substances in IgE synthesis. However, in vivo data
      consistent with these findings have not been reported. METHODS: Total IgE levels,
      CD4(+)-lymphocyte count and plasma glutathione were determined in non-atopic, HIV
      positive individuals. RESULTS: 27 HIV-positive subjects (mean age Alter +/- SD:
      43 +/- 11 years, 85% males) were studied. Mean CD4(+)-lymphocyte count was 250 +/
      136/microliter. The median serum IgE level was 85.3 U/ml (Range: 3-1298 U/ml),
      and the mean plasma glutathione concentration was 2.08 +/- 0.7 muMol. Plasma
      glutathione was significantly correlated with CD4(+)-lymphocyte count (r = 0.37;
      p = 0.05), and was inversely related to total IgE (r = -0.46; p = 0.01).
      CONCLUSIONS: Plasma glutathione and total IgE levels are negatively correlated in
      HIV-positive individuals. This observation supports the concept of a regulatory
      role of antioxidants and IgE synthesis in vivo. Further studies aiming at the
      possible significance of these mechanisms in atopic patients are clearly
      warranted.

PMID- 11199115
TI  - [Value of retrospective assessment of the Epworth Sleepiness Scale after long
      term CPAP therapy in obstructive sleep apnea disorder]].
AB  - BACKGROUND: Daytime-sleepiness is the main symptom of the obstructive sleep
      apnoea syndrome. Standarized questionnaires (e.g. the Epworth sleepiness scale =
      ESS) have become useful diagnostic tools. In this study we investigated wether
      there is a difference between the estimation of initial "pre-treatment" daytime
      sleepiness (by ESS) compared to the retrospective ESS score after implementation
      of CPAP therapy. PATIENTS AND METHODS: We included 46 patients (RDI 39/h +/-
      20.2, CPAP pressure 8 cm/H2O +/- 1.7, daily use of 5.8 h +/- 1.8, RDI with CPAP
      7.6/h +/- 5.3). We examined the ESS score before CPAP-therapy (ESS-base) in
      comparison to the retrospective estimation of the initial conditions after one
      year of CPAP-therapy (ESS-retro). RESULTS: There was no statistical significant
      difference between ESS base (11.7 +/- 4.6) and ESS-retro (12.7 +/- 5.2). ESS
      decreased to 5.4 +/- 3.7 by CPAP-therapy (p < 0.01). CONCLUSION: From a
      chronological point of view ESS is a consistent parameter of daytime sleepiness.
      Hence, the retrospective estimation of pre-CPAP ESS can be considered as a useful
      diagnostic tool.

PMID- 11199116
TI  - [Prevalence of stroke and transitory ischemic attacks in obstructive sleep apnea:
      a retrospective analyis so f 187 consecutive patients].
AB  - BACKGROUND: Obstructive sleep apnea (OSA) is presumed to be significantly
      associated with cerebrovascular disease; however, there are no consistent
      epidemiological data providing proof of such a link. Hence, the aim of the
      present study was to determine the prevalence of stroke and transient ischemic
      attack (TIA) in patients with OSA. PATIENTS AND METHODS: 187 consecutive patients
      with a polysomnographically verified diagnosis of OSA who had been admitted to
      our sleep laboratory during 1/98-3/00 were retrospectively analysed. RESULTS: The
      prevalence of stroke and TIA was 7%. This rate was lower if compared with those
      for coronary artery disease and arterial hypertension in the same study cohort
      (14% and 53% respectively). The 13 OSA patients with stroke were elderly
      overweight men (age: 64 +/- 1.7 years, BMI: 31.4 +/- 1.1 kg/m2). They had quite
      severe OSA (AHI: 43 +/- 5/h) and almost all of them suffered from arterial
      hypertension. In all cases, the insult was caused by cerebral or brain stem
      ischemia. None of the patients presented with persistent neurological deficits.
      The mean latency period between the occurrence of stroke or TIA and the diagnosis
      of OSA was 41.9 +/- 11.3 months. CONCLUSION: In summary, the prevalence of stroke
      or TIA in our series of 187 consecutive OSA patients was 7%. Further prospective
      studies controlling for confounding factors such as age, body weight and arterial
      hypertension are needed to clarify the risk potential of OSA for the development
      of cerebrovascular disorders.

PMID- 11199117
TI  - [Studies with the fully automated EEG sleep analysis system QUISI].
AB  - To judge sleep reliably would be interesting not only for outpatient sleep
      diagnostics, but also in the inpatient sphere. A step in this direction is the
      easy-to-apply fully automated sleep-EEG-analysis system QUISI. Nine males
      patients with obstructive sleep apnoea syndrome were examined simultaneously by
      polysomnography and the QUISI system. A comparison of the sleep profiles
      evaluated by polysomnographic recordings using Rechtschaffen and Kales' rules
      with the automated classification using QUISI recording shows that the difference
      of the sleep parameters sleep period time (SPT), total sleep time (TST), REM,
      stage 1, stage 2, slow-wave sleep and the awake stage of maximum five patients
      ranged between +/- 10 minutes, respectively +/- 5 per cent. Only two of nine
      sleep profiles could be compared as far as the sequence of the sleep stages was
      concerned. According to our results it is important to edit the original data and
      to treat the fully automated sleep profile. We cannot recommend QUISI to
      establish sleep profiles for the obstructive sleep apnoea syndrome.

PMID- 11199118
TI  - [Efficient ventilator weaning].

PMID- 11199119
TI  - [Diagnosis of acute pulmonary embolism. Recommendations of the German Society of
      Pneumology].

PMID- 11199120
TI  - [Fractional CO uptake in breathing at risk for detection of diffusion disorder.
      Comparative cross-sectional and longitudinal validation with the single breath
      method].
AB  - Methodically it is very simple to determine fractional CO-uptake (FCO) from
      inspiratory and mean expiratory CO-concentrations. In two longitudinal studies
      the single-breath-TCO (49 patients) and FCO (813 patients) have been compared.
      The oscillations of DCO are smaller than those of TCO, but it remains unclear
      which method for determination of CO-transfer has a higher validity.

PMID- 11199121
TI  - [Recommendations for updated lung function reference values from the SAPALDIA
      study].

PMID- 11199122
TI  - Antioxidant and antimicrobial activity of Foeniculum vulgare and Crithmum
      maritimum essential oils.
AB  - The essential oils obtained from Crithmum maritimum L. (marine fennel) and two
      samples of Foeniculum vulgare Miller (common fennel) were analysed by GC and GC
      MS and assayed for their antioxidant and antibacterial activities. The
      antioxidant activity of the oils was evaluated by two lipid model systems: a
      modified thiobarbituric acid reactive species (TBARS) assay and a
      spectrophotometric detection of hydroperoxydienes from linoleic acid in a
      micellar system. The oils demonstrated antioxidant capacities, comparable in some
      cases to that of alpha-tocopherol and butylated hydroxytoluene (BHT), used as
      reference antioxidants. Concerning the antimicrobial tests the essential oils
      were assayed against twenty-five genera of bacteria, including animal and plant
      pathogens, food poisoning and spoilage bacteria. Oils from the two samples of F.
      vulgare showed a higher and broader degree of inhibition than that of C.
      maritimum.

PMID- 11199123
TI  - Anti-hepatitis B virus effects of wogonin isolated from Scutellaria baicalensis.
AB  - By using an HBV-producing cell line (MS-G2) in vitro culture system, we found
      that wogonin isolated from Scutellaria baicalensis can suppress HBV surface
      antigen production (P < 0.001) without evidence of cytotoxicity. By assaying the
      endogenous HBV DNA polymerase activity, we found that both the relaxed circular
      and the linear forms of HBV DNA are significantly reduced in the wogonin-treated
      group. Wogonin deserves to be further evaluated for the treatment of human HBV
      infection.

PMID- 11199124
TI  - Mitogenic effect of Parkia speciosa seed lectin on human lymphocytes.
AB  - Mitogenic activity of a lectin, purified from Parkia speciosa seeds, on the
      isolated peripheral blood lymphocytes taken from normal blood donors and patients
      with esophageal carcinoma was examined using [3H]thymidine incorporation. The
      lectin increases the incorporation of [3H]thymidine into DNA of human
      lymphocytes. The activity of the lectin increased as its concentration was
      increased and then declined once the concentration passed an optimum point. The
      stimulant effect was also expressed using a proliferation index (PI): the ratio
      of [3H]thymidine incorporated into lymphocytes in the presence and absence of the
      lectin. The mitogenic activity of the lectin is comparable to those of the known
      T-cell mitogens, such as concanavalin A, phytohaemagglutinin, and pokeweed
      mitogen. Only slightly less responsiveness was observed in the case of
      lymphocytes from esophageal cancer compared to lymphocytes from normal donors.

PMID- 11199125
TI  - Effect of ginseng total saponin on extracellular dopamine release elicited by
      local infusion of nicotine into the striatum of freely moving rats.
AB  - We investigated the effect of ginseng total saponin (GTS) on nicotine-induced
      dopamine (DA) release in the striatum of freely moving rats using an in vivo
      microdialysis technique. In order to further characterize the mechanism by which
      GTS affects DA release, the effect of GTS on K(+)-induced DA release was also
      examined. Local infusion of nicotine (1, 5, and 10 mM) into the striatum produced
      a dose-dependent increase in extracellular DA in dialysate samples (maximal
      response = 154.0 +/- 10.8%, 308.1 +/- 55.7%, and 499.9 +/- 77.9% over basal
      levels, respectively). GTS (100 mg/kg i.p.) had no effect on basal levels of
      extracellular DA. However, GTS inhibited maximal DA release induced by
      intrastriatal infusion of nicotine (1, 5, and 10 mM) by 35.3%, 36.6%, and 58.5%,
      respectively. Intra-striatal infusion of high K+ solution (100 mM) produced an
      increase in extracellular DA in the striatum (maximal response = 796.6 +/- 98.8%
      over basal levels). However, GTS had no effect on the K(+)-induced increase in
      extracellular DA. The present study demonstrated that GTS inhibited striatal DA
      release stimulated by local infusion of nicotine. This may reflect the blocking
      effect of GTS on the striatum-related behavior induced by nicotine as well as
      other psychostimulants. The results also suggest that GTS may act on presynaptic
      nicotinic acetylcholine receptors or receptor-operated Na+ channels in
      dopaminergic nerve terminals, but not on voltage-sensitive ion channels.

PMID- 11199126
TI  - Hepatocurative effect of picroliv and silymarin against aflatoxin B1 induced
      hepatotoxicity in rats.
AB  - Single doses of aflatoxin B1 (2 mg/kg, i.p.) caused significant increases in the
      activities of tau-glutamyl transpeptidase, 5'-nucleotidase, acid phosphatase and
      acid ribonuclease, and decreases in the activities of succinate dehydrogenase and
      glucose-6-phosphatase in liver, after 8 weeks. The level of lipid peroxides, DNA,
      RNA, and cholesterol increased while glycogen decreased. It also increased the
      serum level of transaminases, sorbitol dehydrogenase, glutamate dehydrogenase,
      lactate dehydrogenase, acid phosphatase, alkaline phosphatase, and bilirubin.
      Oral administration of picroliv (25 mg/kg/day for 15 days), a standardised
      iridoid glycoside fraction of Picrorhiza kurroa, 6 weeks after aflatoxin B1
      toxication, significantly prevented the biochemical changes induced in liver and
      serum of aflatoxin B1 treated rats. The hepatocurative effect of picroliv and
      silymarin, a plant based standard hepatoprotective are comparable.

PMID- 11199127
TI  - Panax vietnamensis protects mice against carbon tetrachloride-induced
      hepatotoxicity without any modification of CYP2E1 gene expression.
AB  - In order to explore the effect of Panax vietnamensis on carbon tetrachloride
      induced hepatotoxicity, mice were pretreated for 7 days with either crude extract
      or total saponins. Crude extract and total saponins dramatically decreased carbon
      tetrachloride-induced increase of serum GST alpha level (-50.0%, -49.5%
      respectively). Serum AST level was significantly decreased only with total
      saponins (-52.2%) and ALT level was slightly modified. In vitro experiments shown
      that both preparations at high concentrations (> 2000 micrograms/ml) are able to
      inhibit CYP2E1 enzymatic activity in mouse and human microsomes. However, we did
      not observe any modification of Cyp2e1 gene expression (enzymatic activity,
      protein and mRNA levels) in mice treated with either crude extract or total
      saponins. Taken together, these data demonstrated that Panax vietnamensis could
      be used as an hepatoprotectant. However, the mechanism of action is not
      associated with CYP2E1 expression, as previously suggested in vitro in rat for
      total saponins from Panax ginseng.

PMID- 11199128
TI  - Bioactive constituents of Conyza albida.
AB  - The bioactivity-guided fractionation of an active chloroform extract of Conyza
      albida led to the isolation of three alkenynes, deca-4,6-diyn-2-(Z)-enoic methyl
      ester (1), deca-4,6-diyn-2-(Z)-enoic ethyl ester (2) and deca-2,4-diene-4-hydroxy
      6-yn-1,4-olide (3), and the terpenoid spathulenol (4), as the active toxic
      metabolites in the Artemia sp. lethality test. When tested in the KB cell
      cytotoxicity assay, compounds 1-4 demonstrated IC50 values of 52.2, 38.4, 117.9,
      and 83.8 microM, respectively. All compounds studied were inactive in the DNA
      methyl green and DNA strand scission assays, while compounds 3 and 4 showed
      moderate activity as inhibitors of human topoisomerase I. Compound 2 is reported
      here for the first time.

PMID- 11199129
TI  - Peroxidase activity in Aloe barbadensis commercial gel: probable role in skin
      protection.
AB  - A basic peroxidase (EC 1.11.1.7) (pl around 9.0) has been identified in
      commercial gel of Aloe barbadensis. In vivo, the activity is localised in the
      vascular system of inner aqueous leaf parenchyma. Some relevant properties of
      this basic peroxidase of Aloe have been investigated in leaf extract and in
      commercial gel where it is notably stable. The acid optimum pH (5.0) for activity
      and the low KM for H2O2 (0.14 mM) suggest that, when topically applied, Aloe
      peroxidase may scavenge H2O2 in skin surface.

PMID- 11199130
TI  - Bioactive coumarin derivatives from the fern Cyclosorus interruptus.
AB  - Three new coumarin derivatives, compounds 1-3, three new furanocoumarins,
      compounds 4-6, and a novel dioxocane derivative, compound 7, were isolated from
      the fern Cyclosorus interruptus (Willd.) H. Ito. Based on spectrometric and
      spectroscopic analysis (FAB or El mass spectrometry as well as 1D and 2D NMR
      experiments) their structures were characterised as 5,7-dihydroxy-6-methyl-4
      phenyl-8-(3-phenylpropionyl)-1-benzopyran-2-one (1), 5,7-dihydroxy-6-methyl-4
      phenyl-8-(3-phenyl-trans-acryloyl)-1- benzopyran-2-one (2), 5,7-dihydroxy-8-(2
      hydroxy-3-phenylpropionyl)-6-methyl-4-phenyl-1- benzopyran-2-one (3), 8-benzyl
      5,8-dihydroxy-6-methyl-4-phenylfuro[2,3-h]-1-benzopyran-2,9- dione (4), 8-benzyl
      5,8 beta,9 beta-trihydroxy-6-methyl-4-phenyl-8,9-dihydro- furo[2,3-h]-1
      benzopyran-2-one (5), 8-benzyl-5,8 beta,9 alpha-trihydroxy-6-methyl-4-phenyl-8,9
      dihydro- furo[2,3-h]-1-benzopyran-2-one (6) and 5,11-dihydroxy-6-methyl-4-phenyl
      11-(1-phenylmethyl)-7,10-dioxocane [5,6-h]-1-benzopyran-2,12-dione (7). For these
      compounds we propose the trivial names interruptins A-F. Compounds 1, 5/6 and 7
      showed antibacterial activity while compounds 1 and 2 were cytotoxic to a KB cell
      line.

PMID- 11199131
TI  - Phytotoxic compounds from Xanthocephalum gymnospermoides var. eradiatum.
AB  - Investigation of the aerial parts of Xanthocephalum gymnospermoides var eradiatum
      led to the isolation of two new labdane-type of diterpenes, namely, 8 alpha,13S
      epoxylabdane-14S,15-diol (1) and methyl grindelate (2). In addition, grindelic
      acid (3), 7 alpha, 8 alpha-epoxygrindelic acid (4), 7 alpha-hydroxy
      8(17)dehydrogrindelic acid (5), 17-hydroxygrindelic acid (6) and 4,5-epoxy-beta
      caryophyllene (7) were obtained. The isolated compounds were characterized by
      spectral means. The absolute configuration of compound 1 was established by
      chemical correlation with 8 alpha,13S-epoxy-15-nor-labdan-14-oic acid methyl
      ester of known absolute stereochemistry and by using the advanced Mosher's ester
      methodology. The results of the present investigation indicated that the known
      compound barbatol (8) could be an enantiomer of compound 1. Compounds 1-3 and 7
      caused significant inhibition of the radicle growth of seedlings of Amaranthus
      hypochondriacus.

PMID- 11199132
TI  - Phytochemical investigation of Aglaia andamanica.
AB  - Four new compounds, the limonoid 24-epi-melianodiol (8), the tirucallane
      aglaiodiol (9), and the two cyclopentatetrahydrobenzopyran derivatives
      pyramidaglain A (11) and B (12) were isolated from the leaves of Aglaia
      andamanica Hiern (Meliaceae), together with the eleven known constituents beta
      sitosterol, beta-sitosterol glucoside, cycloart-23E-ene-3 beta,25-diol (1), three
      flavonoids 5-hydroxy-3,4',7-trimethoxyflavone (2), retusin (3) and pachypodol
      (4), the tirucallane 24-epi-piscidinol A (5), the lignan yangambin (6), the
      limonoid melianodiol (7), the bisamide pyramidatine (10) and the amino acid N
      methyl-trans-4-hydroxy-L-proline (13). All structures were established by means
      of detailed spectroscopic analysis.

PMID- 11199133
TI  - Radical scavenger activity of phenylethanoid glycosides in FMLP stimulated human
      polymorphonuclear leukocytes: structure-activity relationships.
AB  - Radical scavenger activities of 21 phenylethanoid glycosides, including 15 ester
      derivatives of caffeic, ferulic, vanillic and syringic acid as well as 6 deacyl
      derivatives were determined by quantifying their effects on the production of
      reactive oxygen species (ROS) in a luminol-enhanced chemiluminescence assay with
      formyl-methionyl-leucyl-phenylalanine (FMLP) stimulated human polymorphonuclear
      neutrophils (PMNs). All phenylethanoids acylated with phenolic acids showed
      strong antioxidant activity whereas the deacyl derivatives were more than 30-fold
      less active. Therefore, the antioxidant activity is mainly related to the number
      of aromatic methoxy and hydroxy groups and the structure of the acyl moiety (C6
      C1 or C6-C3). In contrast, modification of the sugar chain or replacement of
      hydroxy groups by methoxy groups in the acyl or the phenylethanoid moiety is of
      minor importance. The position of the acyl moiety is without significance. Free
      caffeic, ferulic, vanillic and syringic acid are less active compared to the
      phenylethanoid derivatives. This points to the importance of dissociation and
      lipophilicity of these acids in a cellular test system.

PMID- 11199134
TI  - Tetrahydrofuran lignans from Illicium floridanum and their activity in a luminol
      enhanced chemiluminescence assay.
AB  - Two lignans of the tetrahydrofuran type, di-O-methyltetrahydrofuroguaiacin B (1)
      and (+)-veraguensin (2) were isolated from fruits and leaves of Illicium
      floridanum Ellis (Illiciaceae). These compounds are the first genuine lignans
      isolated from the genus Illicium. We investigated their radical scavenging
      potency towards 1,1-diphenyl-2-picrylhydrazyl radical reagent and their influence
      on luminol enhanced chemiluminescence (CHL) induced by different stimuli in human
      polymorphonuclear neutrophils (PMN). Both compounds were inactive in the TLC
      assay for chemical radical scavenge. In the PMN assay, the symmetric lignan 1 at
      concentrations below 1.0 microM displayed a strong inhibition of CHL induced by N
      formyl-methionyl-leucyl-phenylalanine (fMLP). At concentrations above 5 microM, 1
      led to a pronounced increase of fMLP induced CHL. When CHL was stimulated with
      opsonized zymosan, both compounds were completely inactive. Thus, 1 must
      interfere selectively with a step in the signal cascade evoked by fMLP. In
      addition to their known PAF-receptor antagonism tetrahydrofuran lignans may thus
      also interfere with inflammatory responses by inhibition of free radical
      formation.

PMID- 11199135
TI  - Inhibition of neutrophil elastase activity by cinnamic acid derivatives from
      Cimicifuga racemosa.
AB  - Caffeic acid, fukinolic acid as well as cimicifugic acids A, B, E and F isolated
      from the rhizomes of Cimicifuga racemosa (Ranunculaceae) inhibited the activity
      of neutrophil elastase (EC 3.4.21.37) in a dose-dependent manner. An IC50 of 93
      mumol/L was determined for caffeic acid and 0.23 mumol/L for fukinolic acid.
      Cimicifugic acid A inhibited the enzyme with an IC50 of 2.2 mumol/L, cimicifugic
      acid B with 11.4 mumol/L, and cimicifugic acid F with 18 mumol/L. Cimicifugic
      acid E was only a very weak inhibitor.

PMID- 11199136
TI  - Galloyl esters from rhubarb are potent inhibitors of squalene epoxidase, a key
      enzyme in cholesterol biosynthesis.
AB  - Galloyl glucoses and galloyl proanthocyanidins obtained from rhubarb (Rhei
      Rhizoma, Rheum palmatum L., Polygonaceae); e.g. 1,2,6-tri-O-galloyl-beta-D
      glucose (IC50 = 0.63 microM), 1,6-di-O-galloyl-2-O-cinnamoyl-beta-D-glucose (IC50
      = 0.58 microM), procyanidin B-2 3,3'-di-O-gallate (IC50 = 0.54 microM), and
      procyanidin B-5 3,3'-di-O-gallate (IC50 = 0.55 microM), were found to be potent
      inhibitors of rat squalene epoxidase (SE). The inhibition at submicromolar level
      was far more potent than that of chemically synthesized substrate analogs. It was
      demonstrated for the first time that the cholesterol-lowering effect of rhubarb
      may be attributed to the potent inhibition activities of SE, a rate-limiting
      enzyme of cholesterol biogenesis.

PMID- 11199137
TI  - Antimycobacterial and antiplasmodial cyclodepsipeptides from the insect
      pathogenic fungus Paecilomyces tenuipes BCC 1614.
AB  - Bioassay-guided fractionation of the crude extract from the insect pathogenic
      fungus Paecilomyces tenuipes BCC 1614 led to the isolation and identification of
      two antimycobacterial and antiplasmodial cyclodepsipeptides, beauvericin and
      beauvericin A.

PMID- 11199138
TI  - In vitro cytotoxicity of norviburtinal and isopinnatal from Kigelia pinnata
      against cancer cell lines.
AB  - Crude dichloromethane extracts of Kigelia pinnata stem bark and fruit showed
      cytotoxic activity in vitro against cultured melanoma and other cancer cell lines
      using the Sulphorhodamine B assay, which was used for bioassay-guided
      fractionation. Thin layer chromatography (TLC) examination of the most active
      fractions of both stem bark and fruits showed the presence of the same major
      components which were found to be norviburtinal and beta-sitosterol.
      Norviburtinal was found to be the most active compound but had little selectivity
      for melanoma cell lines whilst isopinnatal also showed some cytotoxic activity.
      beta-Sitosterol was found to be comparatively inactive. HPLC analysis of the
      crude extract showed that the amount of norviburtinal present in the plant
      material did not account for all of the activity of the total extracts.

PMID- 11199139
TI  - Protective effects of green tea catechins against asbestos-induced cell injury.
AB  - Green tea extract was found to provide a strong protective effect against
      asbestos-induced injury of peritoneal macrophages and red blood cells in vitro.
      The main polyphenolic constituents of green tea extract, (-)-epicatechin gallate
      (ECG) and (-)-epigallocatechin gallate (EGCG), were also efficient in preventing
      injury of cells following exposure to asbestos fibers. The protective efficacies
      of EGCG and ECG expressed as IC50 values were, respectively, 10 microM and 12
      microM if peritoneal macrophages were injured by chrysotile and 4 microM and 5
      microM in the case of crocidolite-induced cell injury. Antiradical and chelating
      properties of ECG and EGCG were evaluated and it was concluded that the
      protective effect of catechins against asbestos-induced injury may be related to
      both scavenger properties towards to superoxide anion and the ability to chelate
      iron ions.

PMID- 11199140
TI  - Smooth muscle relaxing activity of gentiopicroside isolated from Gentiana
      spathacea.
AB  - Bioassay directed fractionation of the (1:1) chloroform-methanol extract of
      Gentiana spathacea H.B.K (Gentianaceae) led to the isolation of gentiopicroside
      (gentiopricrin) (1), the major spasmolytic component of the plant.
      Gentiopicroside inhibited, in a concentration-dependent manner, the spontaneous
      contractions of isolated guinea pig ileum. Contractions induced by histamine,
      acetylcholine, BaCl2 and KCl on the ileum were also significantly blocked by this
      monoterpene glucoside, which suggests that this compound might be interfering
      with calcium influx into the smooth muscle cells.

PMID- 11199141
TI  - Antimicrobial triterpenoids from Licania heteromorpha.
AB  - Six triterpenoids having a lupane and oleane skeleton were isolated from the
      leaves and young branches of Licania heteromorpha Bentham var. heteromorpha and
      were identified as: betulinic acid 1, alphitolic acid 2, 3 beta-O-trans-p
      coumaroyl alphitolic acid 3, 3 beta-O-cis-p-coumaroyl alphitolic acid 4, 3 beta-O
      trans-p-coumaroyl maslinic acid 5, 3 beta-O-cis-p-coumaroyl maslinic acid 6. The
      antimicrobial activity of these compounds was evaluated in vitro on clinically
      isolated microorganisms employing a microdilution method. Compounds 2, 3, 5, and
      6 showed antimicrobial activity on Gram-positive bacteria and yeasts, whereas
      none of the six triterpenoids were active against Gram-negative organisms.

PMID- 11199142
TI  - Antinociceptive profile of hodgkinsine.
AB  - To further understand the mechanism of analgesic activity and structural
      requirements of pyrrolidinoindoline alkaloids identified in Psychotria colorata,
      we here report the analgesic activity of the trimer hodgkinsine on thermal and
      chemical models of analgesia. Results show that hodgkinsine produces a dose
      dependent naloxone reversible analgesic effect in thermal models of nociception,
      suggesting that activation of opioid receptors participates in hodgkinsine's mode
      of action. Hodgkinsine shows a potent dose-dependent analgesic activity against
      capsaicin-induced pain, indicating the participation of NMDA receptors in
      hodgkinsine-induced analgesia. Such a dual mechanism of action may be of interest
      for developing innovative analgesics.

PMID- 11199143
TI  - Isolation of taxoids from cell suspension cultures of Taxus wallichiana.
AB  - Cell suspension cultures of stem-derived callus of Taxus wallichiana in MS-F
      culture media were found to produce three C-14 oxygenated taxoids and one regular
      taxoid. The taxoids were identified as yunnanxane (1), 2 alpha, 5 alpha, 10 beta,
      14 beta-tetraacetoxy-4(20),11-taxadiene (2), 2 alpha, 5 alpha, 10 beta-triacetoxy
      14 beta-(2-methyl)-butyryloxy-4(20),11-taxadiene (3) and 1 beta-hydroxybaccatin I
      (4).

PMID- 11199144
TI  - Chemical variations in the essential oil of Sideritis tragoriganum.
AB  - The essential oil composition from Sideritis tragoriganum has been investigated
      by capillary gas chromatography and gas chromatography-mass spectrometry. Among
      the 47 identified mono- and sesquiterpenes, alpha-bisabolol is the most prominent
      component. Correlation analysis of essential oil components from this population
      of S. tragoriganum with two other geographically distinct populations revealed
      the existence of unrelated chemical types.

PMID- 11199145
TI  - Quantitative changes of dianthrones, hyperforin and flavonoids content in the
      flower ontogenesis of Hypericum perforatum.
AB  - Samples of Hyperici herba were obtained by harvesting Hypericum perforatum L. in
      different plant development stages. The relation of flower development phases in
      the drug's flower fraction was examined. The HPLC method was then employed for
      the analysis of the content of secondary metabolites in different flower
      ontogenesis phases. The content of dianthrones, derivatives of quercetin and
      hyperforin increased from the first bud phases (0.29%, 0.80%, and 2.47%,
      respectively) to flowers just opened (1.04%, 4.23% and 6.60%, respectively). The
      content of dianthrones and quercetin glycosides then decreased (in unripe fruits
      0.11% and 0.08%, respectively), whereas the amounts of hyperforin increased to
      8.07% in fruits. The content of I3,II8-biapigenin increased from 0.21% in small
      buds to 1.04% in buds just before opening and has then decreased gradually to a
      value of 0.02% in fruits. Rutin was not detected in the samples.

PMID- 11199146
TI  - 3-Acetoxy group of genuine AKBA (acetyl-11-keto-beta-boswellic acid) is alpha
      configurated.
AB  - The pentacyclic triterpenoid 3-acetyl-11-keto-beta-boswellic acid (AKBA) from the
      resin of Boswellia spec. is a potent inhibitor of 5-lipoxygenase (5-LO). We
      noticed discrepancies in the nomenclature and stereochemistry of the 3-acetoxy
      group of boswellic acids. Isolation of AKBA under mild conditions and the data
      from the first X-ray crystallography study evidence the 3 alpha-orientation of
      AKBA's acetoxy function.

PMID- 11199147
TI  - Sesquiterpenes from the leaves of Ligularia fischeri var. spiciformis.
AB  - From the leaves of Ligularia fischeri var. spiciformis, a new eremophilanolide, 8
      alpha-methoxy-6-oxoeremophil-7(11)-en-12,8-olide (6-oxoeremophilenolide) and a
      eudesmane-type sesquiterpene, (+)-intermedeol were isolated. The structures were
      determined on the basis of 2D-NMR spectral data. Data on cytotoxicity showed that
      the latter was clearly more potent than the former compound.

PMID- 11199148
TI  - [Lung maturation therapy with glucocorticoids in threatened premature labor.
      Considerations of risk-benefit in evidence-based medicine].
AB  - Prematurity is a major cause of perinatal morbidity and mortality. Antenatal
      administration of glucocorticoids improves the neonatal outcome of preterm born
      infants. 1994 the NIH published recommendations for the use of glucocorticoids
      for women at risk of preterm delivery. A recent evaluation by the Cochrane
      Collaboration in 1999 showed that antenatal administration of glucocorticoids
      significantly reduced the rate of RDS and IVH in the gestational age between 24
      and 34 weeks. Consequences of repeated courses of antenatal glucocorticoids are
      not sufficiently studied. The effectivity and safety regarding birth weights,
      infectious diseases, and the best timing remains unknown. Administration of
      glucocorticoids lowers fetal activity and heart rate variability. Effects on
      fetal growth, maternal and fetal immunosystem, and the development of atopic
      diseases are controversely discussed. Thus preterm labour not leading to a
      cervical ripening is not necessarily a reason for antenatal glucocorticoids.
      Antenatal glucocorticoids with PROM do not lower the rate of RDS but of IVH. No
      prospective randomized trial evaluated the effectivity of antenatal
      glucocorticoids in diabetes mellitus and IUGR. In preeclampsia beta-methason
      could improve the rate of RDS and the neonatal outcome. Still our knowledge of
      antenatal glucocorticoid administration is not sufficient. But despite possible
      (longtime-) risks for mother and child the administration of glucocorticoids
      according to the guidelines of the NIH is a major part in the treatment of
      prematurity and improves the outcome of premature infants. The indication for
      multiple courses of glucocorticoids should be considered carefully.

PMID- 11199149
TI  - [HIV/AIDS in gynecology. On the treatment readiness of established gynecologists
      for HIV positive women].
AB  - BACKGROUND: Decreasing vertical transmission rates of HIV due to highly active
      antiretroviral therapy regimens faciliate the choice for childbearing in HIV
      positive women. Recent trends in epidemiology of HIV show increasing incidence of
      HIV-related gynecologic diseases. These facts implicate the question about the
      role of gynecologists in primary care of HIV-infected women and furthermore about
      the use of health services by HIV-infected women. MATERIALS AND METHODS: 143 of
      the total of 298 office-based gynecologists practicing in Vienna (41%) completed
      a questionnaire to assess their knowledge, attitudes, and practice with respect
      to HIV-infection and AIDS. In addition, personal interviews with 30 HIV-positive
      women were conducted. RESULTS: Although about 75% of the gynecologists are
      willing to care for HIV-positive women in their private practice, only about a
      third of them already care and 17.9% refuse to care for these patients. More than
      two thirds of the gynecologists refuse to care for intravenous drug users and
      patients with manifestations of AIDS. Barriers to care are the fear to be
      confronted with the psychosocial problems of patients, the fear to need more time
      to care for these patients and the fear of a lack in knowledge about HIV/AIDS.
      HIV-positive women are highly satisfied with care, although the majority of the
      women reported about a lack of confidentiality and therefore did not inform their
      gynecologist about their HIV-infection. CONCLUSIONS: The physician-patient
      relationship of gynecologists and HIV-positive women is characterized by
      gynecologist's barriers to care on the one hand, on the other hand HIV-positive
      women report about a lack of confidentiality, which often is associated with a
      delay in seeking medical care. DISCUSSION: A strategy to overcome gynecologist's
      barriers in care for HIV-positive women is medical education. The improvement of
      the physician-patient relationship will enhance the effects of HIV/STD risk
      assessment as well as the quality of care.

PMID- 11199150
TI  - [Intrauterine growth retardation--perinatal mortality and postnatal morbidity in
      a perinatal center].
AB  - OBJECTIVES: The intrauterine growth retardation (IUGR) contributes specially to
      perinatal mortality and morbidity. An effective treatment is not yet available.
      The purpose of this study is to analyse the perinatal data of a cohort with IUGR
      infants including mortality and morbidity and to describe prematurity and IUGR as
      a combination of high risk. STUDY DESIGN: We have analysed the perinatal data of
      a cohort of 220 patients with IUGR-infants including mortality and morbidity.
      Regularly we examined fetal ultrasonographic growth, doppler measurements of
      fetal and maternal vessels and CTG, as well as indicated amniocentesis,
      placentesis and cordocentesis. Entry criteria were: normal menstrual period
      before pregnancy, clear gestational age, complete history of pregnancy. RESULTS:
      At the Department of Gynaecology & Obstetrics, University Hospital, Homburg/Saar,
      the incidence of IUGR (< 10th Percentile) in premature babies and newborns was
      13.1% over five years (1993-1997). The percentage of premature babies with IUGR
      was 18.6%. The overall mortality was 4.1%, the perinatal mortality was 3.6% and
      the neonatal mortality was 2.7%. In 1.4% intrauterine foetal death was observed,
      all associated with a birthweight below the 3th percentile. The average duration
      of pregnancy was 34 + 4 weeks. A high perinatal mortality of 13.1% and an overall
      mortality of 14.7% was observed. 11.4% of the premature babies with IUGR showed
      deformities and about 2% presented chromosome aberrations. 46.4% of children have
      been transferred to the Neonatal Intensive Care Unit. 57.1% of the postnatal
      complications have been related to the lungs, 26.5% to the cardiovascular system
      and 14.3% to the cerebrum. Maternal complications were referred to: SIH/EPH
      gestosis (65.4%), HELLP-syndrome (5.8%), nicotine abuse (31.4%), pregnancy
      anaemia (17.3%) and gestational diabetes with insuline therapy (7.7%). On the
      placental site the most noticeable conditions have been placental insufficiency
      (40.6%) and placental infarction (28.7%). CONCLUSION: Children with IUGR are
      exposed to high perinatal mortality and postnatal morbidity. Premature babies in
      association with an IUGR are at high risk. The surveillance of the pregnant women
      and the new-born children should be performed in a perinatal centre.

PMID- 11199151
TI  - [Damage to the brachial plexus in vaginal delivery from breech presentation-
      correlation with reducing the extended arm].
AB  - BACKGROUND: Brachial plexus injuries in foetuses delivered spontaneously by
      breech presentation is very rare. The aim of this study was to evaluate the
      frequency of brachial plexus injuries in connection with the rate of the
      reduction of the extended arm. MATERIALS AND METHODS: In our retrospective study
      we examined 1194 vaginally intended breech deliveries (> 32 completed weeks) for
      the frequency of extended arms and subsequent plexus brachialis palsies. RESULTS:
      One brachial plexus injury occurred in 796 vaginally delivered newborns
      (1.2@1000). The outcome corresponds with the frequency of brachial plexus palsy
      in spontaneous deliveries with cephalic presentation (1@1000). The mean frequency
      of reduction of the extended arm in vaginal deliveries in breech is 10-20%.
      CONCLUSION: We found that the rate of reduction of the extended arm was not
      associated with an increase in morbidity of newborns. DISCUSSION: Many reports in
      the literature demonstrate that a higher rate of caesarean section does not
      prevent these severe foetal injuries. Noxious factors already occurring during
      the prenatal phase of development can be suspected as possible causes.

PMID- 11199152
TI  - The concentration of alpha 1-antitrypsin in the maternal serum after delivery of
      normal and small for gestational age infants.
AB  - BACKGROUND: alpha 1-antitrypsin (A-1-AT) is an acute-phase protein. It is present
      in plasma and other extracellular fluids and in human trophoblastic tissue. It
      accounts for 80 to 90 per cent of antiprotease reactions occurring in plasma. It
      has the ability to greatly affect enzyme activity and plays an important role in
      immunomodulatory processes. MATERIALS AND METHODS: The purpose of the study was
      to determine the plasma concentration of A-1-AT in mothers giving birth to
      hypotrophic (small for gestational age, SGA), and eutrophic (appropriate for
      gestational age, AGA) infants. 33 women who gave birth to SGA infants and 36
      women who gave birth to AGA infants participated in the study. The control group
      consisted of 30 non-pregnant women who were of reproductive age. All women gave
      birth at term. To measure A-1-AT concentration, we used the diffusion method
      described by Mancini et al. RESULTS: The highest concentration of A-1-AT (379
      mg/dl) was found in women giving birth to SGA infants, compared with 345 mg/dl
      for women giving birth to AGA infants. In the control group, the concentration
      was found to be 270 mg/dl. CONCLUSIONS: Statistical analysis of the results
      showed a significant difference between the two groups of women gave birth and
      between each parturient compared with control subjects. Increasing concentration
      of A-1-AT in the plasma of women in labor may be the result of an acute phase
      reaction triggered by the stress during parturition. Additionally, increased
      concentrations of A-1-AT in women who gave birth to SGA rather than AGA infants
      suggest that it may play a role in the processes of intrauterine growth
      retardation (IUGR).

PMID- 11199153
TI  - [Primary hyperparathyroidism in pregnancy--a case report].
AB  - BACKGROUND: Primary hyperparathyroidism during pregnancy is rare. The incidence
      of primary hyperparathyroidism in women of child-bearing age is estimated to be
      approximately 8 cases per 100,000 population per year. CASE REPORT: We provide a
      case report of a 33-year old pregnant woman, in whom primary hyperparathyroidism
      was diagnosed because of neonatal hypocalcemia two days after delivery. There was
      a history of recurrent urinary tract infections with hydronephrosis on the left
      side. The woman had been treated on an outpatient basis by an urologist,
      nephrostomy had been performed. After delivery, nephrolithiasis was diagnosed by
      x-ray and treated endoscopically. Parathyroid adenoma was found and removed
      successfully. DISCUSSION: Due to physiological changes of calcium metabolism
      primary hyperparathyroidism is often without symptoms during pregnancy. Operative
      elimination of adenoma as a frequent cause of primary hyperparathyroidism reduces
      maternal and fetal morbidity and mortality. CONCLUSIONS: In pregnant women with
      hydronephrosis on the left side primary hyperparathyroidism should be considered.
      If undetected, hyperparathyroidism causes considerable morbidity, not only for
      the mother but also for the child.

PMID- 11199154
TI  - [Ultrasound and endoscopic image of exencephaly (acrania) in the 12th week of
      pregnancy].
AB  - BACKGROUND: Acrania is a rare congenital anomaly of unknown pathogenesis, in
      which the flat bones of the cranial vault are absent and the facial bones are
      normally present. MATERIALS AND METHODS: We present a case of a 4th gravida, who
      had already born 2 children with acrania and came for an ultrasound examination
      in the 12th week of gestation. RESULTS: By transvaginal ultrasonography it was
      possible to diagnose fetal acrania already in the 12th week. By hysteroscopy at
      the same time we could see, that the brain was covered by a thin membrane, the
      facial bone and the shape of the cranium were normal. CONCLUSIONS: By
      hysteroscopy it was possible to confirm the diagnosis and to detect additional
      malformations. This fetus showed a small omphalocele, hexadactylism on both sides
      and clubfeet on both sides. DISCUSSION: By hysteroscopy in this early week of
      pregnancy we could demonstrate, that acrania is an independent anomaly and not
      the first stage of an anencephaly as reported by other authors. Hysteroscopy also
      offers the advantage of viewing the intact fetus before pregnancy termination.

PMID- 11199155
TI  - Evaluating mutant mice: anatomic pathology.
AB  - As the human and mouse genome projects approach their goals, initiatives in
      functional genomics are advancing. When the nucleotide sequences are available,
      identification of gene functions will assume even greater importance.
      Determination of gene products and their proximal biochemical functions provide a
      part of the picture, but determination of their functions in the context of the
      whole organism is the ultimate goal. The manipulated mouse genome has become
      accepted as a model for understanding the genetic basis of human conditions and
      diseases. Consequently, biomedical research institutions have seen significant
      increases in the use of mice since the early 1980s, and these increases are
      largely attributable to the use of genetically modified mice. The role of
      comparative pathology in research on mutant mouse models of disease is increasing
      in response to these trends. Evaluation and phenotypic characterization of mutant
      mice, via clinical and anatomic pathology techniques, will be an important
      component of functional genomics initiatives.

PMID- 11199156
TI  - Hypotensive infarction of the spinal cord in a rhesus macaque (Macaca mulatta).
AB  - A 6.5-year-old male rhesus macaque (Macaca mulatta) was presented with acute
      paraplegia following a surgical procedure. During surgery, he experienced an
      acute hypotensive episode that required 3 hours of supportive therapy before
      hemodynamic stability was restored. Paraplegia remained unchanged until
      euthanasia 72 hours later. At necropsy, spinal cord segments T10-S3 had acute,
      massive panmedullary necrosis, which involved most of the central and middle
      spinal cord, sparing the peripheral white matter. Additional lesions included
      arterial border zone necrosis of the brain, centrilobular hepatic necrosis, and
      proximal renal tubular necrosis. The histologic findings of central spinal cord
      necrosis with a preserved rim of white matter is consistent with severely
      decreased flow in the anterior spinal artery. Such lesions can result from
      episodes of generalized hypoperfusion. Possible factors contributing to the
      hypotensive episode in this case included the addition of xylazine to ketamine
      and atropine in the preanesthetic medication, positioning during anesthesia, and
      decreased blood pressure during surgery.

PMID- 11199157
TI  - Cerebral vascular hamartomas in five dogs.
AB  - Vascular hamartomas are considered developmental lesions rather than true
      neoplasms. Reports of such anomalies in the canine brain are scarce, and their
      classification is confusing. This case series of vascular hamartomas from the
      brains of five dogs was characterized using histochemistry and
      immunohistochemistry, in addition to gross and microscopic findings. All five
      hamartomas were located in the telencephalon, three in the pyriform lobe, without
      any predilection for the left or right side. Each hamartoma consisted of a
      proliferation of thin-walled vessels which varied in caliber. These vessels were
      elastin-negative, with varying amounts of collagen and no muscular component. In
      four of the five hamartomas, lining cells were actin- and factor VIII-positive.
      All five hamartomas contained glial fibrillary acid protein (GFAP)-positive
      parenchyma at moderate to high frequency, and four contained neurofilament
      positive axons between component vessels. This report shows that vascular
      hamartomas in the canine brain are structural malformations for which
      immunohistochemistry is useful for accurate classification.

PMID- 11199158
TI  - The pagetoid variant of urothelial carcinoma in situ of urinary bladder in a cow.
AB  - A case of urothelial carcinoma in situ of urinary bladder is reported in a 10
      year-old cow naturally grazing on bracken-infested land. The cow suffered from
      enzootic hematuria for more than 5 years. The presence of bovine papillomavirus
      type 2 (BPV-2) DNA sequences was detected by polymerase chain reaction. The
      carcinoma in situ was characterized by the presence of anaplastic cells with
      amphophilic cytoplasm and pleomorphic nuclei containing granular, irregularly
      dispersed chromatin. Focal areas within the tumor contained large isolated and/or
      clustered cells. These cells had pale acidophilic cytoplasm, large nuclei with
      single or multiple nucleoli, and well-defined borders resembling Paget's cells.
      Immunohistochemically, all malignant cells were negative for vimentin and S-100
      and positive for cytokeratins. In addition, normal and neoplastic cells expressed
      fragile histidine triad (FHIT) protein; surprisingly, some pagetoid cells did
      not. FHIT, the tumor suppressor gene at 3p14.2, encodes a protein of 147 amino
      acids (16.8 kd) with diadenosine triphosphate hydrolase activity and is a common
      target of deletions in human cancers of epithelial origin. Antibody to laminin
      detected a continuous epithelial basement membrane, thus clearly showing that
      neoplastic changes were limited to urothelial cells without invading stromal
      tissue. To our knowledge, this is the first report of an unusual pattern of
      spread of urothelial carcinoma in situ in a cow.

PMID- 11199159
TI  - Expression of cyclooxygenase-2 in canine renal cell carcinoma.
AB  - Cyclooxygenase-2 (COX-2) has been shown to be the primary enzyme responsible for
      prostaglandin production during inflammation but is absent in most tissues under
      normal physiological states. High levels of COX-2 expression have been observed
      in the macula densa and thick ascending limbs of fetal kidneys; this expression
      declines to minimal levels during renal maturation. We hypothesized that the
      neoplastic cells of renal cell carcinoma (RCC) may revert to high expression of
      COX-2, and we evaluated its expression in three spontaneous cases of canine RCC
      by using immunohistochemical methods. The neoplastic cells of two of the three
      cases exhibited moderate to marked COX-2 immunoreactivity. These results suggest
      that some canine renal cell carcinomas express high levels of COX-2, which may
      play a role in the modulation of neoplastic cell growth.

PMID- 11199160
TI  - Necrotizing meningoencephalitis associated with cortical hippocampal hamartia in
      a Pekingese dog.
AB  - A 4-year-old male Pekingese dog was referred to the clinic with a history of
      recurrent seizures and progressive abnormal gait and behavior, which did not
      respond to treatment. At necropsy, a large cortical defect in the right temporo
      parietal cortex, malacia of subcortical white matter, right basal nuclei, and
      capsula interna, as well as abnormalities of the right hippocampus were observed.
      Histological examination of the brain revealed moderate to severe nonsuppurative
      meningoencephalitis in the left cerebral hemisphere and extensive infarction-like
      lesions with milder inflammation in the right hemisphere. In the right
      hippocampus, the pyramidal cells were arranged in a gyrus-like pattern and
      intermingled with gemistocytic and fibrillary astrocytes. The histopathological
      features of the inflammatory lesions were consistent with necrotizing
      meningoencephalitis and resembled those described in so-called Pug dog
      encephalitis. The hippocampal changes were interpreted as dysplasia (monolateral
      hippocampal cortical hamartia), unrelated to clinical signs and necrotizing
      inflammatory lesions.

PMID- 11199161
TI  - Special considerations in the evaluation of the hematology and hemostasis of
      mutant mice.
AB  - The study of mutant mice with altered or deficient hematopoietic or hemostatic
      gene products provides a challenge to the researcher, particularly when genetic
      alterations lead to lethal phenotypes. The following review provides a framework
      for understanding murine hematopoiesis, based on work with mutant mice, and
      details experimental approaches used to evaluate these animals. Mice with
      deficiencies in hemostatic and fibrinolytic system proteins are discussed, and
      the investigation of their phenotypes is reviewed.

PMID- 11199162
TI  - Activation of the immune system is the pivotal event in the production of wasting
      disease in pigs infected with porcine circovirus-2 (PCV-2).
AB  - Porcine circovirus (PCV)-2, a newly described single-stranded circular DNA virus
      pathogen of swine is the cause of postweaning multisystemic wasting syndrome
      (PMWS). In gnotobiotic piglets, PCV-2 infection alone produces asymptomatic
      infection without evidence of overt PMWS. Gnotobiotic piglets infected with PCV-2
      were injected with keyhole limpet hemocyanin in incomplete Freund's adjuvant
      (KLH/ICFA), and the effects on virus production and development of PMWS were
      determined. In the first experiment, piglets were injected subcutaneously on the
      left hip and shoulder, and viral burden was assessed in regional lymph nodes
      draining the injection sites and in contralateral lymph nodes 13-14 days after
      infection. Immune activation increased the number of virus antigen-positive cells
      in draining lymph nodes and increased the amount of infectious virus recovered by
      1-4 log10. In a second experiment, the effects of injections of KLH/ICFA with or
      without concurrent stimulation of peritoneal macrophages by intraperitoneal
      injections of thioglycollate broth on induction of PMWS was assessed. All
      immunized piglets developed moderate to severe PMWS, whereas none of the piglets
      infected with PCV-2 alone developed PMWS. In PMWS-affected piglets, extensive
      replication of PCV-2 was documented by both immunocytochemistry and quantitative
      viral titrations. Thus, immune activation is a key component of the pathogenesis
      of PCV-2-associated PMWS in swine.

PMID- 11199163
TI  - Ocular histopathology of Ehrlichial infections in the dog.
AB  - Histologic examination of eyes and brains of 27 dogs experimentally infected with
      either Ehrlichia canis, E. ewingii, E. chaffeensis, or human granulocytic
      ehrlichia (HGE) was conducted in the course of several experiments, the primary
      objectives of which were to investigate the susceptibility of the domestic dog to
      infection with various ehrlichial species and to assess the ability of ixodid
      tick species to acquire and transmit those infections. Uveitis and meningitis
      occurred in each of the dogs infected with E. canis but was not observed in dogs
      infected with the other Ehrlichia species. The inflammatory infiltrate was
      predominantly lymphocytic, monocytic, and plasmacytic; granulocytes were notably
      few. Ocular inflammation was most common and most intense in the ciliary body,
      becoming less intense in the choroid, iris, and retina, respectively. Meningitis
      was often accompanied by mild neuroparenchymal vascular cuffing and gliosis. The
      meningeal inflammatory cell infiltrate included a prominent monocyte population.
      Ocular and meningeal lesions were present in all E. canis-infected dogs from 22
      through 200 days postexposure. Neither ocular nor brain lesions were observed
      with any of the other ehrlichial infections.

PMID- 11199164
TI  - Primary canine and feline nervous system tumors: intraoperative diagnosis using
      the smear technique.
AB  - The recent application of neuroimaging techniques in veterinary neurology has led
      to the accurate localization of many types of intracranial lesions but has also
      created a clinical need, particularly with brain tumors, for a specific
      intraoperative diagnosis. For human brain tumors, a smear technique has been used
      successfully for many years to provide an extremely rapid, highly accurate
      intraoperative diagnosis. In similar smear preparations of intracranial lesions,
      obtained either by computed tomography (CT)-guided stereobiopsy or from a
      craniotomy, we have described distinguishing cytologic features of some primary
      spontaneous nervous system tumors in 80 dogs and 13 cats. A final diagnosis was
      confirmed by evaluation of paraffin-embedded sections from the same sample and,
      when appropriate, by immunocytochemical staining. Preliminary findings indicate
      that, in dogs and cats, this procedure is useful for rapid, accurate
      intraoperative diagnosis of many primary nervous system tumors. The
      distinguishing features of the canine and feline tumors bear a remarkably close
      resemblance to their human counterparts.

PMID- 11199165
TI  - Evidence for the localization of porcine reproductive and respiratory syndrome
      virus (PRRSV) antigen and RNA in ovarian follicles in gilts.
AB  - The pathogenesis of porcine reproductive and respiratory syndrome virus (PRRSV)
      infection in ovary was studied in sexually mature, cycling, nonsynchronized gilts
      infected with the PRRSV 16244B, a virulent field strain. Previous studies have
      shown that PRRSV can be isolated from ovaries and is transplacentally passed from
      gilts to the fetuses. The cause of infertility following PRRSV infection is not
      known. In this study, we identified the tropism of PRRSV in ovarian tissue from
      experimentally infected gilts in samples collected between 7 and 21 days
      postinfection (DPI). Tissues were collected and examined by virus isolation, in
      situ hybridization (ISH), immunohistochemistry (IHC), and double labeling to
      identify PRRSV-infected cell types. PRRSV was isolated in ovarian follicles at 7
      days DPI. The IHC and ISH indicated that PRRSV-positive cells in ovaries were
      predominantly macrophages, which were numerous in atretic follicles. No evidence
      of infection and/or perpetuation of PRRSV in ova was observed, indicating that
      the female gonad is an unlikely site of persistence. No alteration of the normal
      ovarian architecture that would support a possible role of PRRSV infection in
      porcine female infertility was observed.

PMID- 11199166
TI  - Periventricular changes associated with spontaneous canine hydrocephalus.
AB  - Causes of canine juvenile hydrocephalus have been well documented. However, the
      effects of hydrocephalus on periventricular white matter have been only partially
      described. The present report shows that hydrocephalus-associated lesions of the
      periventricular white matter, i.e., formation of diverticula, clefts, and tears,
      are prevalent. Marked hydrocephalus was identified at necropsy in 20 juvenile
      dogs between 1990 and 1999. The severity grade was based upon a ratio of lateral
      ventricular dimensions to cortical thickness. All animals exhibited ependymal
      lesions consisting of attenuation, with or without abortive attempts of ependymal
      regeneration, and ulceration. In 10 dogs (50%), unilateral or bilateral
      periventricular diverticula and cleft formation in the region of the caudate
      nucleus were observed. The diverticula were formed at the caudal pole of the
      caudate nucleus, communicated with the ventricular lumen, and were associated
      with ependymal denudation. Loss of the ependymal lining probably contributes to a
      bulk shift of cerebrospinal fluid from the ventricular lumen to the
      periventricular white matter, leading to diverticulum formation. Clefts were
      observed within the parenchyma at the border of the internal capsule and putamen,
      consistent with an ischemic insult. Occasionally tearing with separation of the
      caudate nucleus from the subcortical white matter was found, representing
      unification of expanding clefts and diverticula. In one of the few clinically
      well-documented cases, tearing was correlated with a sudden decline in neurologic
      function, culminating in euthanasia. However, tears and clefts may exhibit a
      chronicity of several days, as indicated by the presence of astroglial scars
      along the lesion margins.

PMID- 11199167
TI  - Viral replication and lesions in BALB/c mice experimentally inoculated with
      porcine circovirus isolated from a pig with postweaning multisystemic wasting
      disease.
AB  - Eight-week-old BALB/c mice were either sham inoculated (control mice) or were
      inoculated intraperitoneally (IP) and intranasally (IN) with a single (sPCV mice)
      or multiple (mPCV mice) doses of porcine circovirus 2 (PCV2). Four control mice
      and 4 sPCV mice were sacrificed 7, 14, 28, and 42 days postinoculation (PI). All
      4 mPCV mice were sacrificed 42 days PI. In addition, 7-day and 14-day pregnant
      BALB/c mice were either sham inoculated (control mice) or were inoculated IP and
      IN with a single dose of PCV2. Newborn mice were euthanatized 1, 8, and 15 days
      after birth. Necropsies were performed on all euthanatized mice and tissues were
      collected for histopathology, electron microscopy, in situ hybridization, and
      polymerase chain reaction (PCR). PCV2 replicated in 8-week-old BALB/c mice that
      were inoculated with PCV2 and caused fetal infection when inoculated into
      pregnant BALB/c mice at 7 days and 14 days of gestation. PCV was detected by in
      situ hybridization and PCR in sPCV mice on days 7, 14, 28, and 42 PI; in mPCV
      mice on day 42 PI; and in newborn mice from mothers inoculated with PCV at 7 days
      and 14 days of gestation at 1, 8, and 15 days after birth, but not in control
      mice. No clinical signs or gross lesions were found in sPCV or mPCV mice during
      the study. Microscopic lesions in sPCV mice and mPCV mice were characterized by
      expansion of germinal centers in lymphoid organs with large numbers of
      histiocytic cells and lymphoblasts, apoptosis of histiocytic cells in germinal
      centers, and mild lymphoid depletion of the paracortex. PCV nucleic acid was
      detected in the nuclei and cytoplasm of histiocytes and apoptotic cells in
      germinal centers in lymphoid tissues as well as in the nuclei of hepatocytes in
      the liver, in the nuclei of renal tubular epithelial cells, and in the cytoplasm
      of single lymphocytes in the thymus. Congenitally infected mice only had PCV
      nucleic acid detected in putative Kupffer cells in livers.

PMID- 11199168
TI  - Canine model and genomic structural organization of glycogen storage disease type
      Ia (GSD Ia).
AB  - A canine model of glycogen storage disease Ia (GSD Ia), similar clinically,
      biochemically, and pathologically to the human disease, was established by
      crossbreeding Maltese and Beagle dogs carrying a mutated, defective glucose-6
      phosphatase (G-6-Pase) gene. Ten puppies were born in three litters from these
      crossbreedings. Six were homozygous for the previously described M121I GSD Ia
      mutation. Of these six affecteds, two were stillborn, and one died at 2, 32, and
      60 days of life, respectively (puppies A, B, C, D, E), while one is alive at age
      15 months (puppy F). Affected puppies exhibited tremors, weakness, and neurologic
      signs when hypoglycemic. They had postnatal growth retardation and progressive
      hepatomegaly. Biochemical abnormalities included fasting hypoglycemia,
      hyperlactacidemia, hypercholesterolemia, hypertriglyceridemia, and hyperuricemia.
      Microscopic examination of tissues from affected puppies showed diffuse, marked
      hepatocellular vacuolation, with distended clear hepatocytes and central to
      marginally located rounded nuclei. In the kidneys of puppies D and E, there was
      segmental glomerular sclerosis and vacuolation of proximal convoluted tubular
      epithelium. Biochemical analysis revealed increased liver glycogen content and
      isolated markedly reduced G-6-Pase enzyme activity in liver and kidney. The
      canine G-6-Pase gene was characterized by screening a canine genomic library. It
      spans approximately 11.8 kb and consists of five exons with >90% amino acid
      sequence homology to the derived human sequence. The first 1.5 kb of the 5'
      region was sequenced and contains several putative response element motifs
      homologous to the human 5' region. Establishment of this canine colony of GSD Ia
      that closely resembles human disease and isolation of the canine genomic gene
      provides an excellent model for studying pathophysiology and long-term
      complications and an opportunity to develop novel therapeutic approaches such as
      drug and gene therapy.

PMID- 11199169
TI  - Physeal dysplasia with slipped capital femoral epiphysis in 13 cats.
AB  - Separation of the femoral capital epiphysis is associated with severe trauma in
      most species. This report describes 13 cats with slipped capital femoral
      epiphysis characterized by a distinctive lesion in the physeal cartilage. The
      lesion consists of irregular clusters of chondrocytes separated by abundant
      matrix on both the epiphyseal and metaphyseal side of the cleavage site. The
      affected population in this study is 85% male, 90% overweight, 23% Siamese, and
      4.5-24 months old. The histopathology and demographics are similar to slipped
      capital femoral epiphysis in humans, which most often affects overweight
      adolescent boys.

PMID- 11199170
TI  - Origin of enzootic intranasal tumor in the goat (Capra hircus): a
      glycohistochemical approach.
AB  - Enzootic intranasal tumor (EIT) appears glandular in type and has recently been
      classified as an adenocarcinoma of low malignancy. The aim of this study was to
      characterize the secretion of surface glycoconjugates (GCs) in EIT and in normal
      respiratory and olfactory mucosae of the goat by means of conventional and lectin
      histochemistry, in order to shed light on the histogenesis of EIT. Morphologic
      and ultrastructural investigations showed two growth types of EIT: i.e., tubular
      and papillary patterns. Conventional histochemistry revealed the presence of
      neutral and carboxylated GCs in the olfactory glands and in the tubular part of
      EIT, as well neutral and sulphated GCs in the respiratory glands and in the
      papillary part of EIT, suggesting that the papillary pattern tumor arises from
      the respiratory glands, whereas the tubular portion of EIT arises from the
      olfactory glands. Lectin histochemistry gave further information on the expressed
      GCs.

PMID- 11199171
TI  - [Temporary work disability among firemen employed in rescue and fire brigades].
AB  - Workers of rescue and fire brigades participating in actions are exposed to
      harmful effect of toxic substances, chemicals or physical factors. They also
      experience enormous emotional shock evoked by direct threat or contact with
      victims of disasters and fires. The aim of the study was to define the pathology
      which increases the risk of temporary work disability among firemen. The study
      covered 150 firemen employed during the years 1994-97 in rescue and fire brigades
      selected at random. The data on the number of days and cases of work disability
      during the period of four years for each firemen covered by the study were
      analysed. In the group under study a mean annual number of work disability due to
      sickness accounted for 1443 days per 100 employed. The major causes of work
      disability were as follows: diseases of the respiratory system (22% of total
      sickness absenteeism); diseases of the nervous system and sense organs (19%);
      diseases of the musculoskeletal system (18%), diseases of the circulatory system
      (13%); mental disorders (8%); and diseases of digestive system (7%). Sickness
      absenteeism among workers of rescue and fire brigades was lower by 30% on average
      than that among men employed in the national economy. But in the 50-59 age group,
      it was higher by 68%. In this age group, the highest level of sickness
      absenteeism was associated with mental disorders (15 times higher than in other
      male occupational groups); diseases of the musculoskeletal system (higher by
      53%); diseases of the respiratory system (2 times higher); neoplasms (7 times
      higher); diseases of the nervous system (higher by 46%). It should be stressed
      that the study revealed increased work disability due to lung (by 33%), bladder
      (6 times higher) and brain (over 3 times higher) cancers. The results of this
      study find their confirmation in many other epidemiological studies of this
      occupational group.

PMID- 11199172
TI  - [Mortality in the tire plant workers].
AB  - This paper describes a cohort study of the mortality among workers employed in
      one of Polish tyre plants. The scope of the study was limited to the analysis of
      mortality from main disease categories. Mortality from particular cancer sites
      will be discussed in a separate publication. The cohort comprised 17,747 workers
      (11,660 men and 6,087 women) employed during the years 1950-95 for at least three
      months in the tyre plant. As of 31 December 1995, the follow-up of the cohort was
      completed. A detailed analysis of mortality by causes was carried out using
      standardised mortality ratio (SMR) calculated by the person-years method. The
      general population of Poland was used as the reference. The results indicated
      general mortality significantly lower in the cohort (men: SMR = 72; women: SMR =
      62), than in the reference population. The number of observed deaths from main
      disease categories was also lower than those expected. The analysis by specific
      causes revealed significant excess of deaths, due to hypertensive disease among
      men (36 deaths, SMR = 142; 95% CI: 99-197). SMRs were also calculated in sub
      cohorts identified by activities performed (preparatory works: production of
      tyres and inner tubes; maintenance; storage; others). General mortality in sub
      cohorts was similar to that in the total cohort. After analysis by causes of
      death, some non-significant excess mortality could be observed. It was very small
      or it applied only to single cases of death. Excess mortality from hypertensive
      disease in male maintenance workers (21 deaths, SMR = 262; 95% CI: 162-400) was
      the only exception. The absence of adverse health effects pronounced by
      significant excess mortality should be attributed to a relatively short period of
      exposure among the majority of the followed-up workers (over 58% of workers in
      the cohort employed in the plant for a period shorter than five years) and to
      their young age. Almost 56% of workers in the cohort were born in the 1950s or
      later which means that at the end of the follow-up they were not older than 45
      years. In order to complete the final mortality assessment the follow-up should
      continue.

PMID- 11199173
TI  - [Function of dopamine in mesenteric blood vessels of rats poisoned with lead and
      cadmium].
AB  - The aim of this study was to evaluate the impact of combined exposure to lead and
      cadmium, used in hypertensive doses, on the reactivity of isolated mesenteric rat
      vessels to dopamine. Experiments were performed on 64 male Buffalo rats (195-245
      g body weight) administered intragastrically with lead acetate (35 mg Pb/kg b.w.)
      and/or cadmium chloride (5 mg Cd/kg b.w.) once a week for seven weeks. The
      isolated mesenteric bed was prepared according to McGregor's method. Dopamine
      (800 micrograms) was injected before and during the infusion, one after the
      other, of angiotensin converting enzyme (0.0004 j/ml/min), ketoprofen (0.2
      mg/ml/min), and losartan (0.05 mg/ml/min) or infusion of nitric oxide synthase
      blocker, N-omega-nitro-L-argine (22 micrograms/ml/min), verapamil (0.001
      mg/ml/min), and then propranolol (0.3 mg/ml/min). The results show an unchanged,
      in comparison to controls, vascular effect of dopamine in lead and cadmium
      poisoned rats. However, these metals modified the reactivity of mesenteric
      vessels to endogenous angiotensin and prostaglandins mediated pressor action of
      dopamine.

PMID- 11199174
TI  - [Use of the ACSL simulation language for physiologic toxicokinetic models].
AB  - For the description of the processes of absorption, excretion or elimination of
      chemicals, the open one- or two-compartment models have been used thus far. The
      latter consist mainly of the fast (central) and slow (peripheral) compartments.
      The toxicological studies were based on an assumption that the organic processes
      develop according to is the first order kinetic reaction. However, the
      absorption, elimination or excretion of toxic chemicals are in fact much more
      complicated processes that should be explained using, e.g. the physiologically
      based toxicokinetic (PBTK) models, covering physiological, biochemical and
      metabolic parameters, as well as the allometric calibration of selected
      parameters for interspecies extrapolations, and in vitro/in vivo extrapolations
      of metabolic parameters. Simulation languages, e.g. ACSL (Advanced Continuous
      Simulation Language) are indispensable application tools to be operated with PBTK
      models. They have been developed for modelling systems described by time
      dependent non-linear differential equations and/or transfer functions. ACSL with
      its interfaces (ACSL Builder, ACSL Graphic Modeller, ACSL Math) ensures data
      input and communication inside the model by the control, transfer and computed
      parameters. The physiologically-based toxicokinetic models employ a large number
      of different parameters, which enables, e.g. forecasting the dose/effect or
      dose/response relationship absorption rate, metabolic pathways, excretion or
      elimination according to the absorbed dose of xenobiotic; evaluation of risk
      assessment; extrapolation from high to low doses characteristic of environmental
      exposure or setting biological exposure limits.

PMID- 11199175
TI  - [Irritating effect and dermal toxicity of virkon, a disinfectant widely used in
      Poland].
AB  - The aim of the study was to define the threshold irritating effect of Virkon, a
      disinfectant widely used in Poland, on the rabbit's skin and eye, and its dermal
      toxicity in single exposure. The studies were carried out according to the OECD
      guidelines, modified by Krysiak. A 10% aqueous solution of Virkon in the
      conditions of multiple open exposure was defined as the threshold concentration
      evoking small inflammatory reaction. After a single administration of Virkon in
      aqueous solutions into the rabbit's eye, the value of sensitising effect index
      was 1.5 for 1% solution of the disinfectant in question which indicates weak
      inflammatory reaction. The study of dermal toxicity in a single exposure revealed
      neither animal death nor morphological changes in internal organs which suggests
      non-cutaneous absorption of Virkon. The present study may provide the basis for
      assessing dermatological changes in people exposed to disinfectants.

PMID- 11199176
TI  - [The fibrogenic effect of artificial ceramic fibres in experimental rats].
AB  - The fibrogenic effect of aluminosilicate ceramic fibres in rats administered
      intratracheally with a single dose of 25 mg was assessed on the basis of the lung
      hydroxyproline concentration and morphological changes in the lung parenchyma and
      mediastinum lymphatic nodes. Control groups were composed of rats administered
      with NaCl saline and crocidolite UICC. The rats were exposed for 6 and 9 months.
      It was found that after 6 and 9 months, aluminosilicate ceramic fibres (L-1,
      Langfaser, Thermowool and Kaowool) showed weak fibrogenic properties. The range
      of changes in reactivity, and the presence of fibres of fibrous connective tissue
      in granulomas, induced by ceramic fibres were lower than the range of changes and
      the contribution of connective tissue produced by asbestos and crocidolite UICC.

PMID- 11199177
TI  - [Efficacy of vaccination against influenza among working people--results of
      epidemiological studies].
AB  - Influenza among working people is responsible for the enhanced sickness
      absenteeism, limited work capacity and efficiency, as well as for the increased
      health service demand. The efficacy of vaccination against influenza has been
      assessed most frequently on the basis of clinical symptoms without taking
      virological tests to confirm the presence of virus in the patients' serum.
      According to current epidemiological studies on the occurrence of the influenza
      like symptoms, the efficacy of vaccination usually range between 18.3-23%.
      However, values reaching 54% or even 88% have also been noted. Only a few single
      studies did not show significant effects of vaccination against influenza.
      Savings due to vaccination have ranged from several to 20, and in one study even
      to 46 dollars per one vaccinated worker. These economic differences should be
      mainly attributed to the differences in the structure of direct and indirect
      costs taken into account. The direct costs depend, to a great extent, on whether
      savings due to the number of visits not attended by patients who had been
      vaccinated and thus, not suffered from flue, as well as the costs incurred in
      vaccination-promoting programmes and their implementation by nurses have been
      taken into account. In the structure of indirect costs, the largest difference
      was noted in regard to savings due to not wasted working time. These savings
      ranged from 9.9 dollars per one worker in Poland to 52.87 dollars in Canada. The
      range of savings obtained depends on the index of workers' participation in the
      vaccination programme, and this index is usually a derivative of the input of
      resources into the promotion of such kind of health conducive behaviour. It seems
      that in view of preliminary positive results of the economic assessment, the
      employers will encourage their workers to undergo preventive vaccination against
      influenza. It may be expected that appropriate promotion actions of much wider
      scope will be undertaken that will contribute to the increased number of
      vaccinated workers. However, the final decision in this respect will always
      depend on the worker's good will.

PMID- 11199178
TI  - [Effect of arsenic and its compounds on the circulatory system].
AB  - Arsenic is a metal which occurs widely in both occupational and physical
      environments. Therefore, its easy accessibility and high toxicity raise the
      question on whether arsenic, particularly in relatively small doses, can cause
      damage of relevant molecular, biochemical and clinical significance to the
      cardiovascular system. The present review is focused on the confirmed and
      potential mechanisms of arsenic effect on the function and structure of vascular
      endothelium (nitric oxide, peroxynitrite), its role in stimulating the oxidative
      species formation (hydroxyperoxide, superoxide and lipid peroxide formation), as
      well as in decreasing the antioxidative response (enzymes: superoxide dysmutase,
      catalase, glutation peroxidase), its cytotoxic effects, including immunotoxic
      properties, arsenic action in the signal transduction pathways network (kinases
      and DNA transcription factors), impact on cell proliferation, differentiation and
      apoptosis, not to mention its interference with DNA synthesis and repair
      processes. Apart from mechanisms of arsenic action, the article provides the up
      to-date information on various cardiovascular diseases of the established or
      presumed arsenic origin.

PMID- 11199179
TI  - [Problems faced in hygiene evaluation of Welders' working conditions--analysis of
      chemical hazards].
AB  - Dissemination of individual welding methods, as well as assessment of welding
      fume and gas emissions and their physical properties, chemical composition and
      related difficulties in hygiene evaluation of working conditions are discussed.

PMID- 11199180
TI  - [Electromagnetic diagnostic and therapeutic equipment--patient and medical
      personnel exposure to electromagnetic fields].
AB  - The mechanisms responsible for the interaction between electromagnetic fields and
      the biological matter were reviewed. For each of the mechanisms one or more
      relevant diagnostic and/or therapeutic methods were applied. The characteristics
      of exposure to electromagnetic fields generated by individual types of medical
      equipment among the diagnosed or treated subjects, as well as the magnitude of
      exposure observed in the medical personnel are present.

PMID- 11199182
TI  - 8th Meeting of the European Society of Gene Therapy (ESGT). Stockholm, Sweden, 7
      10 October 2000. Abstracts.

PMID- 11199181
TI  - [Assurance and assessment of quality education in occupational medicine in
      selected countries of western Europe and in the United States. 1. Western
      Europe].
AB  - The author discusses the studies undertaken with the general aim to provide
      education in occupational medicine and assure and assess its quality in some
      countries of Western Europe advanced more than Poland in this area. It becomes
      quite evident that despite a widespread interest in quality of education, there
      is a lack of basic systemic solutions. A gap between basic theoretical and
      methodological guidelines and a large number of dispersed reports on concrete
      analytical and evaluation studies can be still observed. In addition to the
      presentation of an inside view of research activities carried out in some
      countries of Western Europe and the United States, based on selected professional
      publications, the author formulates general conclusions on how the assurance and
      quality assessment of education in occupational medicine function in those
      countries.

PMID- 11199183
TI  - Internet-based strategies in teaching and research.

PMID- 11199184
TI  - Determinants of bone mineral density in older men.
AB  - Although osteoporosis in men is increasingly recognized as an important health
      issue and bone mass appears to be a major determinant of fracture, there remain
      few data concerning the determinants of bone mass in men. To determine the
      correlates of bone density in men, we studied a large group of older subjects
      recruited from three rural communities in the northwestern United States. Three
      hundred and fifty-five men over the age of 60 years (mean 71.5 +/- 7.4 years)
      without known disorders of mineral metabolism were recruited by community
      advertising. Bone mineral density was measured at the lumbar spine, proximal
      femur and radius by dual-energy X-ray absorptiometry, and factors potentially
      related to skeletal status were assessed by direct measurements or questionnaire.
      In univariate analyses weight (positively) and age (negatively) were associated
      with bone density. After adjustment for these two factors, alcohol intake,
      osteoarthritis and thiazide use were associated with higher bone density, while
      previous fractures, gastrectomy, peptic ulcer disease, rheumatoid arthritis,
      glucocorticoid use, hypertension, previous hyperthyroidism, height loss since age
      20 years, chronic lung disease and smoking were related to lower density. In
      multivariate models, only weight and a history of cancer were related to higher
      bone mass, and age, previous fracture, rheumatoid arthritis, gastrectomy and
      hypertension were associated with lower density. These data contribute to the
      emerging field of osteoporosis in men, and may help in the clinical
      identification of men at higher risk of osteopenia.

PMID- 11199185
TI  - The injury mechanisms of osteoporotic upper extremity fractures among older
      adults: a controlled study of 287 consecutive patients and their 108 controls.
AB  - The risk factors for falls in older adults are well known but knowledge on the
      direct injury mechanisms that result in various osteoporotic fractures has been
      very sparse. The purpose of this study was therefore to clarify the injury
      mechanisms of osteoporotic upper extremity fractures of older adults and to
      compare these mechanisms with those of the control fallers, and in this way to
      obtain reliable insight into the etiology and pathogenesis of upper extremity
      fractures and thus to enable fracture prevention. One hundred and twelve patients
      with a fresh fracture of the proximal humerus, 65 patients with an elbow
      fracture, 110 patients with a wrist fracture and 108 controls (no fracture, or a
      fracture other than the case fracture) were interviewed and examined between
      September 1995 and December 1997. The inclusion criteria of the subjects were
      that the patient was 50 years of age or older at the time of the accident, and
      that the fracture/injury had occurred as a result of low-energy trauma (typically
      a fall from standing height or less) within a week before the interview and
      examination. In 97% of patients with a proximal humerus or elbow fracture, and in
      all patients (100%) with a wrist fracture, the fracture was a result of a fall.
      In the control group this figure was 93%. In a polychotomous logistic regression
      analysis the intergroup differences in the fall directions (adjusted by gender,
      age and functional capacity) were statistically highly significant (chi 2 = 43.6,
      d.f. = 15, p < 0.001). Most of the patients with a proximal humerus fracture or
      elbow fracture reported that they had fallen 'obliquely forward' (43% and 38%) or
      'to the side' (29% and 26%), whereas in the wrist fracture group the main fall
      direction was also 'obliquely forward' (34%) but the other fall directions (i.e.,
      'forward', 'to the side', 'obliquely backward' and 'backward') were quite equally
      represented (13-19%). The odds ratio (OR) for an obliquely forward fall resulting
      in a proximal humerus fracture was 3.5 [95% confidence interval (CI) 1.4-9.2), as
      compared with the fall directions of the controls and the 'obliquely backward'
      fall direction. In a logistic regression analysis the patients with a wrist
      fracture managed to break their fall (e.g., with an outstretched arm) more
      frequently than the patients in the other groups (OR 3.9; 95% CI 2.0-7.3). The
      patients with a proximal humerus fracture, in turn, managed to break their fall
      less frequently than the controls (OR 0.33; 95% CI 0.14-0.80). The same was true
      of the patients with an elbow fracture, although the difference was not
      significant (OR 0.49%; 95% CI 0.19-1.3). As objective evidence for a direct fall
      induced impact on the fracture site, 68% of patients with a proximal humerus
      fracture revealed a fresh subcutaneous hematoma on the shoulder/upper arm, while
      such a hematoma was rare in the controls (2%) (p < 0.001). Correspondingly, 62%
      of patients with an elbow fracture showed a similar hematoma on the elbow area,
      while this was seen in none of the controls (p < 0.001). In patients with a wrist
      fracture a hand/wrist hematoma was seen in 58% of the victims, as compared with
      18% of the controls (p < 0.001). The study shows that the most typical
      osteoporotic upper extremity fractures of older adults have their specific injury
      mechanisms. A great majority of these fractures occur as a result of a fall and a
      subsequent direct impact of the fractured site. Effective fracture prevention
      could be achieved by minimizing the obvious risk factors of falling and reducing
      the fall-induced impact force with injury site protection.

PMID- 11199186
TI  - The effect of weight change on total body dual-energy X-ray absorptiometry:
      results from a clinical trial.
AB  - In the past decade dual-energy X-ray absorptiometry (DXA) scanning has assumed an
      important role in the evaluation of new treatments for osteoporosis. Although the
      spine and hip are the sites usually chosen for monitoring bone mineral density
      (BMD) changes, total body DXA is also of interest because of the comprehensive
      view it gives of the whole skeleton. However, recent studies have reported
      anomalies in total body DXA in subjects undergoing weight change, suggesting that
      the technique may not be valid in this circumstance. The present study evaluated
      total body DXA in a trial of cyclical etidronate therapy in which many subjects
      underwent significant weight change. The study population was 152 postmenopausal
      women who had spine, hip and total body DXA scans performed at baseline, 1 and 2
      years. The total body scans were analyzed using two software options referred to
      as 'standard' and 'enhanced'. The following variables were studied: total body
      BMD, total body bone mineral content (BMC), and subregional BMD values for the
      following seven sites: lumbar spine, thoracic spine, pelvis, head, ribs, arms and
      legs. The percentage change from baseline was analyzed in a multivariate
      regression analysis to derive the treatment effect (defined as the difference in
      changes between the etidronate and placebo groups) and a coefficient that
      described the effect of weight change on the total body DXA variable. Mean weight
      change after 2 years was +1.1 kg (range -9.3 to +16.8 kg). Results for the weight
      change coefficient were significantly different from zero for five of nine total
      body variables using the standard analysis and seven of nine for the enhanced
      analysis with values (and standard errors) that varied from +0.67 (0.04)%/kg for
      standard total body BMC to -0.32 (0.11)%/kg for enhanced arm BMD. Results for the
      treatment effect at 2 years were significantly different from zero for total body
      BMD, total body BMC and for the lumbar spine, thoracic spine and pelvis BMD
      subregions, but were not significant for head, rib, arm or leg BMD. Findings for
      the standard and enhanced analyses agreed closely and the size of the treatment
      effect was related to the proportion of trabecular bone at the measurement site.
      We conclude that in a randomized study the effects of weight change can be
      corrected and total body DXA can give useful information about the response to
      treatment across the whole skeleton.

PMID- 11199187
TI  - Prediction of bone strength from cancellous structure of the distal radius: can
      we improve on DXA?
AB  - Recent studies show that structural parameters of bone, obtained from
      computerized image analysis of radiographs, can improve the noninvasive
      determination of bone strength when used in conjunction with bone density
      measurements. The present study was designed to assess the ability of image
      features alone to predict the mechanical characteristics of bones. A
      multifactorial model was used to incorporate simultaneously a number of
      characteristics of the image, including periodicity and spatial orientation of
      the trabeculae. Fifteen pairs (29 specimens) of unembalmed human distal radii
      were used. The cancellous bone structure was determined using computerized
      spectral analysis of their radiographic images and the bones were tested to
      failure under compression. Multilayered perceptron neural networks were used to
      integrate the various image parameters reflecting the periodicity and the spatial
      distribution of the trabeculae and to predict the mechanical strength of the
      specimens. The correlation between each of the isolated image parameters and bone
      strength was generally significant, but weak. The values of mechanical parameters
      predicted by the neural networks, however, had a very high correlation with those
      observed, namely 0.91 for the load at fracture and 0.93 for the ultimate stress.
      Both these correlations were superior to those obtained with dual-energy X-ray
      absorptiometry and with the cross-sectional area from CT scans: 0.87 and 0.49
      respectively. Our observation suggests that image parameters can provide a
      powerful noninvasive predictor of bone strength. The simultaneous use of various
      parameters substantially improved the performance of the system. The
      multifactorial architecture applied is nonlinear and possibly more effective than
      traditional multicorrelation methods. Further, this system has the potential to
      incorporate other non-image parameters, such as age and bone density itself, with
      a view to improving the assessment of the risk of fracture for individual
      patients.

PMID- 11199188
TI  - Osteocalcin gene polymorphism is related to bone density in healthy adolescent
      females.
AB  - Recently a polymorphism was found in the human osteocalcin gene, and its
      association with bone mass was investigated in healthy postmenopausal Japanese
      women. The osteocalcin gene allelic variant HH was found to be overrepresented in
      women with osteopenia. The purpose of this study was to investigate whether the
      previously demonstrated polymorphism of the osteocalcin gene was related to bone
      mineral density (BMD; g/cm2) or osteopenia in a group of 97 healthy Caucasian
      adolescent females (aged 16.9 +/- 1.2 years, mean +/- SD). BMD of the left
      humerus, right femoral neck, lumbar spine and total body was measured using dual
      energy X-ray absorptiometry. The relation between the allelic variants and bone
      density was analyzed as presence or absence of the H allele. Presence of the H
      allele was found to be related to a lower BMD of the humerus (0.97 vs 1.02, p =
      0.03). There was also a strong tendency towards significance at the femoral neck
      (p = 0.06) and total body (p = 0.11). Using a multiple linear regression and
      including physical activity, weight, height and years since menarche, presence of
      the H allele was found to be an independent predictor of humerus BMD (beta = 
      0.21, p < 0.05) and femoral neck BMD (beta = -0.23, p < 0.01). Using logistic
      regression, presence of the H allele was also independently associated with a 4.5
      times increased risk of osteopenia (p = 0.03) in the whole group. Osteopenia was
      defined as at least 1 SD lower bone density than the mean for the whole group of
      at least one of the BMD sites measured. We have demonstrated that the osteocalcin
      HindIII genotype is independently related to bone density in healthy adolescent
      females. The present study also suggests that presence of the H allele is
      predictive of osteopenia at an early age.

PMID- 11199189
TI  - Site-specific variation in the classification of osteoporosis, and the diagnostic
      reclassification using the lowest individual lumbar vertebra T-score compared
      with the L1-L4 mean, in early postmenopausal women.
AB  - In this study we report first the concordance and variation in diagnostic
      osteoporosis classification using multiple skeletal site measurements compared
      with the lumbar spine only; and secondly, at the lumbar spine, the variation and
      diagnostic osteoporosis reclassification using the lowest individual vertebra T
      score compared with the L1-L4 mean T-score. One hundred and fifty early
      postmenopausal women were evaluated as part of the recruitment for a multicenter
      osteoporosis prevention study. Bone mineral density (BMD) was restricted such
      that no more than 10% of the subjects had a lumbar spine BMD below 0.8 g/cm2.
      Forty-seven per cent of the subjects were classified as having low bone mass (T
      score < or = -1.0) at the lumbar spine, 63% at the mid-forearm, 39% at the distal
      forearm and 50% at the hip (p < 0.05). The greatest proportion of subjects were
      categorized as osteoporotic at the lumbar spine, followed by the forearm and then
      the hip. Correlation between sites ranged from 0.57 to 0.60 (p < 0.01). Eighty
      one percent of the subjects had a significant difference between their highest
      and lowest individual lumbar vertebra T-score (defined as a difference outside
      the 90% confidence interval coefficient of variation T-score value). Using the
      lowest individual lumbar T-score, recategorized 33% of the subjects classified as
      osteopenic (based on the mean L1-L4 T-score) as osteoporotic, and 23% of those
      classified as normal as osteopenic (p < 0.05). Of all four vertebrae, L2 had the
      highest T-score in 37.7% of the subjects (mean -0.3) and L4 the lowest in 61%
      (mean -1.5) (mean difference 1.2 units, 95% CI 0.7 to 1.7). The classification of
      osteoporosis varies according to skeletal site, with pronounced differences in
      the early menopausal population. T-scores are useful for characterizing subjects
      with the highest risk of osteoporosis but BMD and fracture risk must be
      recognized in a continuum. Individual T-scores of the lumbar vertebrae show wide
      variation in the absence of degenerative spinal disease or vertebral collapse and
      the use of the lowest, significantly different, individual lumbar vertebra T
      score reclassified over half of the subjects in this study. This poses a great
      therapeutic dilemma in clinical practice, particularly if these fractures are at
      higher risk of future collapse.

PMID- 11199190
TI  - Reference data of forearm bone mineral density in healthy Japanese male and
      female subjects in the second decade based on calendar age and puberty onset:
      Japanese Population Based Osteoporosis (JPOS) study.
AB  - Osteoporosis is a major public health problem in Japan. The second decade is an
      important period in which to attain a high peak bone mass. However, normal values
      of forearm bone mineral density (BMD) are not well known in children and
      adolescents. BMD at one-third of forearm length proximal to the ulnar end plate
      (BMD1/3) and the ultradistal forearm (BMDud) was measured using dual-energy X-ray
      absorptiometry (DXA) in 1207 (631 males, 576 females) Japanese subjects aged 9-18
      years. Puberty onset was assessed by questionnaire, by obtaining the time that
      pubic hair appeared in males and the time that menstruation started in females.
      BMD1/3 and BMDud increased steadily with age in males. In relation to puberty
      development, these parameters also increased after puberty onset although the
      increase in BMD1/3 was not statistically significant after the fifth year from
      puberty onset and that of BMDud was not significant after the sixth year from
      puberty onset. BMD1/3 and BMDud increased with age and then plateaued in females.
      The increase in BMD1/3 was not statistically significant after 15-16 years of age
      and that of BMDud was not significant after 13-14 years of age. In relation to
      puberty development, the increase in BMD1/3 leveled out after the fourth year
      from puberty onset and that of BMDud also plateaued after the third year from
      puberty onset. We provide reference values of forearm BMD in Japanese children
      and adolescents by DXA according to calendar age and puberty development. Peak
      bone mass of the forearm may be in the late second decade in Japanese females.

PMID- 11199191
TI  - Bone mineral density, hip axis length and risk of hip fracture in men: results
      from the Cornwall Hip Fracture Study.
AB  - Bone mineral density (BMD) and hip axis length (HAL) are important determinants
      of fracture risk in women. There are, however, few data concerning their
      predictive risk in men. The aim of this study was to determine the relationship
      between BMD, HAL and the risk of hip fracture in men. A case-control design was
      used. Cases were men aged 50 years and over with a minimal-trauma hip fracture
      admitted to the Royal Cornwall Hospital, Truro, during 1995-1997. Controls were
      recruited from a large general practice within the catchment area of the
      hospital. Subjects were invited for assessment of BMD at the lumbar spine and
      proximal femur, using dual-energy X-ray absorptiometry. HAL was assessed using
      machine software. Data concerning BMD were available in 62 fracture cases and 100
      controls. After adjusting for age, height and weight, a reduction in BMD was
      associated with a significant increase in the risk of hip fracture [odds ratio
      (OR) 1.8-4.0 per standard deviation (SD) reduction, depending on site]. HAL was
      similar in both fracture and control groups (12.0 cm vs 12.0 cm). After adjusting
      for height, there was no association between HAL and the risk of hip fracture (OR
      per 1 SD increase in HAL = 0.9; 95% confidence interval 0.6, 1.3). Compared with
      those with a cervical fracture (n = 31), those with an intertrochanteric fracture
      (n = 31) had lower BMD at all skeletal sites, though this was significant for the
      trochanteric site only. It is concluded that BMD though not hip axis length is a
      risk factor for low-trauma hip fracture in Caucasian men.

PMID- 11199192
TI  - Three-dimensional modeling of the effects of parathyroid hormone on bone
      distribution in lumbar vertebrae of ovariectomized cynomolgus macaques.
AB  - Biomechanical and quantitative computed tomography (QCT) analyses showed
      beneficial effects of parathyroid hormone (PTH (1-34)) on lumbar vertebrae from
      ovariectomized monkeys, even after withdrawal of treatment for 6 months. Adult
      cynomolgus monkeys were randomized, ovariectomized (except for sham ovariectomy
      controls), and treated subcutaneously with vehicle (OVX) or 5 micrograms/kg per
      day PTH (1-34) (PTH5) for 18 months. An additional group was treated
      subcutaneously with 5 micrograms/kg per day PTH (1-34) (PTH5W) for 12 months and
      then switched to vehicle for the remaining 6 months. Lumbar vertebrae were
      excised at necropsy, and L5 were serially scanned by QCT, using 70 x 70 x 500
      microns voxels. PTH increased volumetric bone mineral density (BMD, mg/cm3) and
      bone mineral content (BMC, mg) for both PTH5 and PTH5W compared with OVX and Sham
      without inducing hypermineralization, without stimulating periosteal expansion,
      and without significant constriction of the neural canal. BMD values for the
      voxels were then averaged to create nearly isotropic voxels of 490 x 490 x 500
      microns. Serial scans were stacked and a triangular surface mesh generated for
      each bone, using a 'marching cubes' algorithm. A smoothed version of each surface
      mesh was used to generate a tetrahedral element for three-dimensional finite
      element modeling. An isotropic Young's modulus for each tetrahedral element was
      calculated as a function of the original voxel BMDs. Linear elastic stress
      analysis was then performed for each finite element model in which a distributed
      load of 100 newtons (N) was applied to the top surface of the centrum,
      perpendicular to the bottom surface with the bottom surface constrained in the
      direction of loading. Analysis of the effective strain showed considerable
      reduction in vertebral strain for both PTH5 and PTH5W, compared with OVX.
      Compression testing of the adjacent L3 and L4 confirmed that vertebral strength
      and stiffness for PTH5 and PTH5W were significantly greater than for OVX.
      Histogram and QCT analyses showed PTH conversion of low-density bone (trabecular
      bone) into medium-density bone (more and thicker trabeculae) by stimulating bone
      apposition. PTH withdrawal induced conversion of medium-density into low-density
      and high-density bone with the latter higher than in OVX. These data show that
      even transient PTH treatment improves vertebral architecture and bone quality to
      reduce the likelihood of fracture, and that transient treatment is better than no
      PTH treatment at all.

PMID- 11199193
TI  - In elderly women weight is the best predictor of a very low bone mineral density:
      evidence from the EPIDOS study.
AB  - Currently, few elderly women have a measurement of bone mineral density (BMD).
      The aim of this study was to assess the potential value of a two-step screening
      process to identify the elderly women who are at greatest risk of fracture
      because of very low BMD: (1) use simple clinical criteria to select women who are
      highly likely to have a very low BMD and (2) measure the BMD of the women so
      selected. We used baseline data from 6958 women aged 75 years or older who were
      participants in the EPIDOS prospective study of risk factors for hip fracture.
      The outcome variable was very low BMD measured at the femoral neck by dual-energy
      X-ray absorptiometry and defined as a T-score < or = -3.5. The factors most
      predictive of very low BMD were low weight, history of fracture after the age of
      50 years, slow gait, balance impairment, low grip strength, and dependence for
      instrumental activities of daily living. A score based on the risk function
      including these factors has a sensitivity of 80% at the median cut-off. Hence, by
      measuring the BMD of only half the population, 80% of the women with very low BMD
      can be identified. Weight is the strongest determinant of very low BMD and has
      approximately the same sensitivity as the complete score. In conclusion, a risk
      score for very low BMD based on simple criteria such as weight could be a useful
      clinical tool to select elderly women for bone densitometry.

PMID- 11199195
TI  - Estimation of the prevalence of low bone density in Canadian women and men using
      a population-specific DXA reference standard: the Canadian Multicentre
      Osteoporosis Study (CaMos).
AB  - The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study
      which will measure the incidence and prevalence of osteoporosis and fractures,
      and the effect of putative risk factors, in a random sample of 10,061 women and
      men aged > or = 25 years recruited in approximately equal numbers in nine centers
      across Canada. In this paper we report the results of studies to establish peak
      bone mass (PBM) which would be appropriate reference data for use in Canada.
      These reference data are used to estimate the prevalence of osteoporosis and
      osteopenia in Canadian women and men aged > or = 50 years. Participants were
      recruited via randomly selected household telephone listings. Bone mineral
      density (BMD) of the lumbar spine and femoral neck were measured by dual-energy X
      ray absorptiometry using Hologic QDR 1000 or 2000 or Lunar DPX densitometers. BMD
      results for lumbar spine and femoral neck were converted to a Hologic base. BMD
      of the lumbar spine in 578 women and 467 men was constant to age 39 years giving
      a PBM of 1.042 +/- 0.121 g/cm2 for women and 1.058 +/- 0.127 g/cm2 for men. BMD
      at the femoral neck declined from age 29 years. The mean femoral neck BMD between
      25 and 29 years was taken as PBM and was found to be 0.857 +/- 0.125 g/cm2 for
      women and 0.910 +/- 0.125 g/cm2 for men. Prevalence of osteoporosis, as defined
      by WHO criteria, in Canadian women aged > or = 50 years was 12.1% at the lumbar
      spine and 7.9% at the femoral neck with a combined prevalence of 15.8%. In men it
      was 2.9% at the lumbar spine and 4.8% at the femoral neck with a combined
      prevalence of 6.6%.

PMID- 11199194
TI  - Quantitative computed tomography in the evaluation of spinal osteoporosis
      following spinal cord injury.
AB  - Disuse osteoporosis occurs in the lower extremities of patients with spinal cord
      injury (SCI). However, spinal osteoporosis is not usually observed in these
      patients. We investigated lumbar spine bone mineral density (BMD) in SCI patients
      using single energy quantitative computed tomography (QCT) and dual-energy X-ray
      absorptiometry (DXA). Our study population consisted of 64 patients with long
      standing SCI. Spine BMD (g/cm3) was assessed by QCT at four vertebrae ranging
      from T11 to L4 with single mid-vertebral CT slices 1 cm thick parallel to the
      vertebral end-plates. Confounding variables affecting normal trabecular bone
      pattern, such as compression fractures, surgical hardware or fat replacement,
      were excluded. For a subset of 29 patients, DXA values of the spine and femoral
      neck were also measured, and QCT and DXA Z-scores were compared On the average,
      the 64 SCI patients had Z-scores 2.0 +/- 1.2 below those of age-matched controls.
      In the subset of 29 patients with both QCT and DXA measurements, the QCT and DXA
      Z-scores were 2.4 +/- 1.1 below and 1.3 +/- 2.3 above the mean, respectively (p <
      0.0001). Our results indicate that QCT reveals osteoporosis of the spine after
      SCI, in contrast to DXA. We postulate that QCT is more valuable for evaluating
      spinal osteoporosis following SCI than DXA and thus recommend QCT for spinal BMD
      studies in SCI.

PMID- 11199196
TI  - 2nd International Meeting on Social and Economic Aspects of Osteoporosis and Bone
      Diseases. 7-9 December 2000, Liege, Belgium. Abstracts.

PMID- 11199197
TI  - [Health, public health, society--results from the past, responsibilities for the
      future].
AB  - Communication is the basic precondition of a global society. At the same time,
      however, communication is a basic cause for today's health hazards and diseases.
      This is an experience of our time, it is a historical experience of social change
      as well. If a global society wants to survive, the existing hazards to life and
      health have to be understood and treated on a global scale. Apart from a "new
      morbidity" and chronic diseases also infectious diseases again require more and
      more attention even in industrialised countries. The history of public health
      offers an overwhelming expertise of well-established concepts for every
      imaginable risk, to handle infectious diseases which are either not yet or no
      longer controllable on an individual therapeutical level. History of medicine
      also shows, that the effectiveness of hygienic concepts is based on their
      scientific validity and the resulting predictability of their interventions. This
      implies, that modern hygiene has to incorporate actively the concept of molecular
      medicine. Every single discipline involved, i.e. hygiene/sanitation, toxicology,
      microbiology, bacteriology, immunology, and infectiology, has to join in
      interdisciplinary scientific and interventional efforts.

PMID- 11199198
TI  - [Inpatient management of children and adolescents with psychiatric diseases in
      Germany].
AB  - Employing official statistics from the year 1997 the present article analyses in
      patient treatment of children and adolescents with psychological disorders in all
      16 German Bundeslaender. Sixty per cent of the children and adolescents who are
      referred to and treated in a German clinic for psychological disorders on the
      basis of a psychiatric diagnosis are not given professionally adequate treatment.
      Furthermore, evidence is presented documenting inpatient treatment of children
      only 0 to 12 months of age in clinics throughout Germany on the basis of
      psychiatric diagnoses. A new measure is introduced for future planning of
      inpatient health care for children and adolescents with psychological disorders
      in Germany.

PMID- 11199199
TI  - [DRGs in psychiatric hospital financing exemplified by Hungary. A model for
      Germany?].
AB  - One of the most important provisions incorporated in the reform of the German
      health sector has been the introduction of a per case prospective payment system
      for hospitals with the exception of admissions to psychiatric care. The reasons
      for the exclusion of psychiatric care are unclear, but it is as a result all the
      more interesting to look at the experience of Hungary, where in-patient
      psychiatric care has been financed on the basis of diagnosis-related groups
      (DRGs) for the past seven years. The article describes how in the early 1990's
      the funding of the Hungarian health service was reorganized from being a state
      financed system with a set budget to a system financed by contributions. Parallel
      to this development, service-related financing was introduced. In the hospital
      sector this involved DRGs. At the beginning of 1993 the Hungarian DRGs comprised
      only 437 categories, but this has since increased to 758. Furthermore, other
      characteristics are listed which, apart from the number of groups, differentiate
      the Hungarian DRGs from the AP-DRGs. Among other things, service-related
      financing includes non-typical areas such as psychiatry. In this case, it covers
      in-patient psychiatric care in an unusual combination of DRGs in the acute case
      category (50% of all beds in psychiatric units in Hungary are for acute cases)
      with daily nursing charges in the chronic case category. An analysis is given in
      the article of 16 homogeneous diagnostic categories in psychiatric care, followed
      by experiences gathered in conjunction with the application of this approach in
      this particular sphere, with special reference to three problem areas. These are
      as follows: the trend towards diagnoses with a relatively high weighting; the
      practice of charging for psychiatric DRGs in somatic wards; and, finally, the
      perpetuation of poor service structures and practices through DRGs. In general,
      evidently the introduction of psychiatric DRGs may also be recommended in Germany
      because of the danger that otherwise psychiatry might be marginalized and
      isolated in a corner for chronic medical cases. As the only discipline or
      specialist sphere with a non-service based budget there is a real threat that
      funding would be kept low. Thus, under the superior financial conditions in
      Germany, the disadvantages registered in Hungary would not occur or would become
      manifest only in a milder form. However, it is important that prior to
      implementation costing is done with extreme care to determine the relative
      weighting and duration of treatment for each of the categories and that following
      introduction of DRGs there is a regular control of coding practices, structure of
      diagnoses and case-mix changes.

PMID- 11199200
TI  - [1998 social epidemiological analysis of caries incidence and degree of dental
      restoration in young men].
AB  - Basing on the hypothesis that adult dental health is co-determined by the
      conditions and influences prevailing in the family of origin during childhood and
      adolescence, we analysed the associations of socio-economic status of the family,
      personal dental care behaviour and other educational and structural factors, with
      caries prevalence (DMF-T) and the level of restoration in 642 young men between
      18 and 24 years eligible for conscription. Additionally, we presented the changes
      in caries prevalence in conscripted persons during the 1990s comparing our
      results with those of a study conducted in 1989-90. RESULTS: The average number
      of DMF-T teeth was 5.7. 15% of subjects were caries-free. The mean level of
      restoration in those with a history of caries was 79.2%. The prevalence of caries
      and the level of restoration were strongly associated with the level of
      education, and the socio-economic status of the family of origin. Parental
      working time, number of siblings, structural deficiencies in the family, parental
      preventive education and training with regard to dental care, frequency of
      brushing the teeth, belief in the success of preventive health measures and
      prevalence of fissure sealings were significantly associated with DMF-T.
      Frequency of dental visits showed an association with the level of restoration.
      From 1989/90 to 1998 prevalence of caries in conscripts decreased by 42% (after
      adjusting for the different levels of education of both studies the decrease was
      36%). Whereas in 1989/90 the average number of DMF-T in the 9-year elementary
      school graduates exceeded those of the high school graduates ("seniors") by 22%,
      this difference increased to 88% by 1998. More than 40% of the differences in the
      prevalence of caries among subjects of different educational levels were due to
      risk factors of social origin, preventive dental behaviour and utilisation of
      dental services, all of these being less favourable in elementary school or
      secondary school graduates compared to high-school graduates.

PMID- 11199201
TI  - [Vaccination status of medical and dental students].
AB  - Infectious diseases are still a worldwide health problem, and hence physicians
      are responsible for providing the population with sufficient vaccinations. Until
      now, however, comprehensive studies on vaccination behaviour in German
      medical/dental students, the future physicians/dentists, are lacking. The study
      analysed vaccinations of medical/dental students against tetanus, diphtheria,
      poliomyelitis, hepatitis A + B and tried to find possible influences on the
      vaccination behaviour. 126 medical and 99 dental students participated by working
      on an anonymous questionnaire related to sociodemographic data, smoking/drinking
      habits, drug abuse and vaccinations. The response rate was between 76 and 85%.
      Altogether, the investigated students were not sufficiently vaccinated.
      Nevertheless, they were better vaccinated than a normal reference sample. Except
      for a significantly better immunisation against hepatitis B in dental students,
      no differences between medical and dental students were found. In comparison to
      male students, female students presented better immunisation. On the other hand,
      students from the former West Germany, smoking students and students who are
      taking illegal drugs, were more insufficiently immunised than the other students.
      To optimise vaccinations in future physicians and dentists, medical/dental
      education should focus more on infectious diseases and knowledge about
      vaccinations. This would help to protect future physicians and dentists against
      preventable infectious diseases. Additionally, they are better skilled to prevent
      infectious diseases by providing the population with information and
      vaccinations.

PMID- 11199202
TI  - [Insufficient ventilation as the etiology of illness perception in an elementary
      school].
AB  - PURPOSE: Two years after renovation of the classrooms in a primary school
      (installation of insulated windows and closing of the ventilation shaft) pupils
      and teachers complained about offensive odours, irritation of the eyes and of the
      nose, complaints of the respiratory tract, headaches and disturbed mental
      concentration. The presented study determines the causes, suggests measures for
      help and checks their effectiveness by means of measurements. METHODS: Before
      starting our measurements, the air quality had already been assessed by an
      expert. There was no evidence of elevated concentrations of air contaminants.
      Because of the content of phthalate plasticizers and flame retardants in the
      linoleum sealants there was an offensive odour. To determine the cause, the air
      in the subjective mostly affected classroom was analysed for phthalate
      plasticizers, their metabolites and alkyl phosphates. We also made aerosol
      measurements with a cascade impactor, determined bacterial counts in the air, and
      measured the indoor climate and the internal air flow. RESULTS: The
      concentrations of phthalate plasticizers and their metabolites in the air were
      not elevated significantly. The screening for alkyl phosphates was negative. The
      amount of inhalable particles was 0.046 mg/m3. The bacterial count in the air was
      negligible. On the other hand the indoor climate during the heating period in
      winter was remarkably changed. The average room temperature was 26 degrees C
      (reaching a maximum of 36 degrees C with direct sunlight in the classroom), the
      average humidity was 21% (minimum 7%) and the change of air was approximately 0.5
      per hour. Reopening the ventilation shaft and tilting of only one window resulted
      in a much greater rate of air change. After installation of temperature
      regulators and regular use of the venetian blinds in the classroom, the room
      temperature and the relative humidity during the morning lessons were, as a rule,
      normalised. Among both pupils and teachers the reports of offensive odours and
      health disorders were subsequently clearly reduced. CONCLUSIONS: To determine the
      cause of health disorders indoors, it is apparently to be of great importance to
      carry out measurements of the climate as well as to assess the level of air
      contaminants. By use of modern energy-saving construction possible effects on the
      indoor climate should be be taken into account during the planning stage of
      changes to avoid health disorders resulting from changed interior climate
      conditions.

PMID- 11199203
TI  - [Does public access to defibrillators have a chance in Germany?--On the US model,
      legal considerations and justification].
AB  - PURPOSE: The introduction of public access to defibrillation via automated
      external defibrillators makes it possible to reduce the incidence of sudden
      cardiac arrest cases. Since they may expect civil and criminal liability after
      negligence causing damage, many German potential First Responders might hesitate
      to use an AED. METHODS: After we demonstrate the medical reasons and compare the
      legal situation of Public Access Defibrillation between the USA and Germany we
      analyse a possible hesitation of German First Responders. RESULTS: More than 30
      states of the USA provide immunity from civil liability after a public access
      defibrillation followed by damage due to negligence. However, only an AED-trained
      US-First Responder is granted immunity from civil liability. In Germany there is
      no immunity from civil and criminal liability in case of public access
      defibrillation with damage caused by negligence. CONCLUSION: German law will not
      decrease any possible hesitation by First Responders. For a successful system of
      public access defibrillation, revision of the legal situation is mandatory.

PMID- 11199204
TI  - [Public health in homes for the aged and nursing homes--experiences from
      monitoring by the public health office in Frankfurt am Main from 1989 to 1998].
AB  - Hygiene conditions in residential homes for the aged must be surveyed by the
      Public Health services according to German legislation (Bundesseuchengesetz, Law
      for Protection against Infectious Diseases). We report here on the data of the
      routine controls of the public health department in Frankfurt am Main in all of
      the 31 residential homes for the aged of the city. RESULTS: In 1989, a special
      plan for cleaning and disinfection was available in one home only, whereas a
      hygiene plan was not available in any of the homes. Up to 1998, plans for
      cleaning and disinfection were established in 29 of the homes, and more than 50%
      of them had fulfilled their hygiene plan. The supply and maintenance of
      dispersers for disinfectants, the usage of disinfectants and the knowledge
      regarding proper disinfection and sterilisation procedures could be improved. The
      same was true of the kitchens: there, up to 1998 testing of samples set aside for
      later reassessment was properly done in most of the homes. CONCLUSION: Hygiene in
      the homes and the knowledge of the staff members were markedly improved during
      the last years. Some of the most relevant hygienic problems are today: wearing
      private clothing instead of special working clothes, or deficits in the knowledge
      of the management of MRSA-colonised residents.

PMID- 11199205
TI  - Synchronization of lactating dairy cows with prostaglandin F2 alpha: insemination
      on observed oestrus versus timed artificial insemination.
AB  - The effect of two insemination policies after synchronization of oestrus on
      reproductive performance in two groups of cows was investigated. Oestrus was
      synchronized by two treatments with prostaglandin F2 alpha (PGF2 alpha) at a 14
      day interval. Cows in Group 1 (n = 234) were inseminated twice on appointment 66
      and 90 h after the second treatment. Cows in Group 2 (n = 222) were intensively
      watched for signs of oestrus after the synchronization protocol and inseminated
      on observed oestrus. Cows with abnormal discharge after synchronization were
      excluded from breeding and inseminated later during the study period. Service
      rate within 1 week after synchronization was higher in Group 1 than in Group 2
      (89.3 versus 67.1%). Conception rates on first service did not differ between
      groups (33.2 versus 30.0%). Days to first service and days open were shorter in
      Group 1 (P < 0.05). The number of cows culled for infertility did not differ
      between the groups. Endometritis 14-20 days post-partum decreased the percentage
      of cows pregnant at the end of the study period in both groups but did not have a
      significant effect on conception rates and days open. It is concluded that
      additional inseminations required in the timed artificial insemination protocol
      were economically justified by the reduction in days open in comparison with
      insemination on observed oestrus after synchronization.

PMID- 11199206
TI  - Binding profile of spiramycin to oviducal proteins of laying hens.
AB  - In vitro protein binding of spiramycin (SP) in the plasma and oviducts of laying
      hens was studied. The data for SP were compared with those for oxytetracycline
      (OTC), sulphadimidine (SDD), sulphamonomethoxine (SMM) and sulphaquinoxaline
      (SQ). The two oviduct segments, magnum (M) and isthmus plus shell gland (IS),
      were collected. The soluble (cell sap) fractions from the magnum (M-S9) and the
      isthmus plus shell gland (IS-S9) were used as samples. Plasma protein binding was
      highest for SQ (81.4%) (P < 0.01), and lowest for SDD (30.9%) (P < 0.01). No M-S9
      protein binding of OTC was found. The IS-S9 protein binding of SP (60.4%) was
      very much higher than those of OTC (0.8%), SDD (4.1%), SMM (4.0%) and SQ (12.3%)
      (P < 0.01). Biological half-lives of these drugs in egg albumen were directly
      correlated to the extent of their binding to IS proteins. Of plasma, M-S9 and IS
      S9, variation in SP concentration in the ranges from 1 to 20 micrograms/ml did
      not alter the binding properties of the drug.

PMID- 11199207
TI  - Comparative studies in the promoter and exon 1 regions of tumour suppressor p53
      in several mammalian species: absence of mutations in a panel of spontaneous
      domestic animal tumours.
AB  - Tumour suppressor p53 is critical in a broad panel of tumour types in human,
      mouse and other mammals. Regions of the promoter and exon 1 play an important
      role in expression of p53. In the present study, the DNA sequences of promoter
      and exon 1 regions of four domestic animal species (dog, cat, horse and cattle)
      are determined and compared with experimental rodents (mouse, rat and hamster)
      and man. A broad panel of tumour types have been investigated for mutations in
      this regulatory area in 90 canine, 136 feline, 25 equine and 10 bovine patients.
      No mutation was detected in any of the tumours analysed.

PMID- 11199208
TI  - Effects of vitamin E and different energy sources on vitamin E status, milk
      quality and reproduction in transition cows.
AB  - We investigated whether vitamin E supplementation and supplemental energy sources
      (fat or starch) influenced plasma and milk levels of vitamin E, and reproductive
      and other parameters in 28 Italian Friesian multiparous dry cows. From 14 days
      before expected calving to 7 days after, the animals were assigned to either
      basal diet (containing 1000 IU/day of vitamin E) or an extra 1000 IU/day of
      vitamin E (total 2000 IU). In addition they received either 0.5 kg/day of corn or
      0.2 kg/day of calcium soaps. Plasma samples were collected 4 days before expected
      calving and 4 days after calving and analysed for alpha-tocopherol and
      cholesterol. Milk yield as well as the composition, somatic cell count (SCC) and
      alpha-tocopherol of milk were determined 7 and 14 days after calving. Milk yield
      and composition were unaffected by treatments. SCC was significantly lower in
      (SCC Log 4.62 versus Log 5.1, P < 0.01) 2000 IU/day animals than in the 1000
      IU/day group. Milk alpha-tocopherol was higher (P < 0.001) in animals receiving
      2000 IU/day (1.11 vs. 0.65 microgram/ml, P < 0.01). Plasma alpha-tocopherol in
      animals receiving 2000 IU/day was also higher (P < 0.001) than in cows receiving
      1000 IU/day (4.85 vs. 3.25 micrograms/ml), but was not affected by dietary energy
      source. Number of services and days to conception were lower (P < 0.01) in the
      2000 IU vitamin E supplemented cows. To conclude, dietary vitamin E
      supplementation to periparturient dairy cows increased plasma and milk vitamin E,
      decreased SCC in milk, and improved fertility but different energy sources had no
      effect on any measured variable.

PMID- 11199209
TI  - Reproductive efficiency of cows with endometritis after treatment with
      intrauterine infusions or prostaglandin injections, or no treatment.
AB  - Data from 3276 cows with 6598 lactations in 85 herds participating in a herd
      health monitoring programme were selected for an observational study. Cases of
      endometritis were diagnosed based on a clinical examination after 21 days
      postpartum. The cases were grouped by the severity of endometritis (mild, severe)
      and by the treatment performed (intrauterine infusion, prostaglandin injection,
      no treatment). The conception rates and the calving-to-conception intervals of
      these groups were compared statistically. Conception rate was lower in cows with
      severe endometritis compared to cows with mild endometritis while it did not
      differ between treatment groups. In cows with mild endometritis a significantly
      longer calving-to-conception interval was observed if intrauterine infusions were
      performed compared to the other two treatment options. The occurrence of other
      fertility problems during the same service period had a significant effect on
      conception rate and calving-to-conception intervals. In cows with severe
      endometritis intrauterine or prostaglandin treatments appeared to be beneficial,
      whereas intrauterine infusions in cows with slight endometritis had a negative
      effect on reproductive efficiency.

PMID- 11199210
TI  - Na(+)-dependent transport of D-xylose by bovine intestinal brush border membrane
      vesicles (BBMV) is inhibited by various pentoses and hexoses.
AB  - To detect whether pentoses and hexoses occurring in rumen bacteria or in
      hemicellulose ingested with feed and partly released in the small intestine have
      an affinity for the Na(+)-dependent glucose transporter of the bovine intestinal
      brush border membrane (BBM), we investigated whether these monosaccharides
      inhibit Na(+)-dependent transport of 14C-labelled D-xylose across the BBM using
      brush border membrane vesicles (BBMV) isolated from the mid-jejunum of cows. We
      used D-xylose as the transport substrate, because it has a low affinity for the
      Na(+)-dependent glucose transporter and thus its uptake into BBMV is more
      efficiently competitively inhibited by other sugars than that of D-glucose. D
      Ribose, D-mannose and L-rhamnose occurring in rumen bacteria significantly
      inhibited Na(+)-dependent uptake of D-xylose into BBMV, but their inhibitory
      effect was less than that of D-glucose, D-xylose and phlorizin. This also applied
      to L-arabinose (and D-arabinose), which is, like D-xylose and D-galactose, a
      constituent of hemicellulose, and to 2-deoxy-D-glucose. Of all monosaccharides
      tested, only D-fructose did not affect Na(+)-dependent D-xylose transport. It is
      concluded that some pentoses and hexoses occurring in rumen bacteria (D-ribose, D
      mannose and L-rhamnose) or hemicellulose (L-arabinose and D-xylose) have a low
      affinity for the Na(+)-dependent glucose transporter of the bovine BBM and may
      therefore be absorbed from the jejunum when released in the small intestine.

PMID- 11199211
TI  - The effect of repeated follicular puncture on ovarian function in dairy heifers.
AB  - Three dairy heifers were examined during three consecutive oestrous cycles
      (control period, CP). Subsequently, the animals were subjected to 4 and then 5
      weeks of twice-weekly ovum pick-up (OPU) (FPP1 and FPP2, respectively) with a
      recovery period (RP) of two consecutive oestrous cycles between FPP1 and FPP2.
      After FPP2, the animals were slaughtered and the ovaries were macroscopically
      examined. Throughout, ovarian activity was monitored by transrectal
      ultrasonography and concentrations of plasma progesterone. During CP, all the
      heifers showed normal cyclicity. During FPPs, the heifers occasionally presented
      oestrous activity. Corpus luteum (CL)-like structures developed from punctured
      follicles with diameters and life-spans varying from smaller and shorter than
      those in the CP (P > 0.05) to equal to those in the CP. There was a tendency for
      a lower number of emerging and punctured follicles in the presence of a CL-like
      structure. Subsequently to FPP1, all heifers regained normal cyclicity. A
      thickening of the ovarian tunica albuginea and a slight hardening of the ovaries
      were found postmortem. In conclusion, dairy heifers can occasionally show cyclic
      activity and form CL-like structures during twice-weekly OPU. Further, OPU did
      not seem to cause any major negative effects on ovarian structure and subsequent
      ovarian function.

PMID- 11199212
TI  - A stability-indicating LC method for the simultaneous determination of ramipril
      and hydrochlorothiazide in dosage forms.
AB  - A simple, rapid and sensitive HPLC method has been developed for the simultaneous
      determination of ramipril and hydrochlorothiazide in their dosage forms.
      Acetonitrile: sodium perchlorate solution (0.1 M) adjusted to pH 2.5+/-0.2 with
      phosphoric acid (46:54 v/v), was used as the mobile phase, at a flow rate of 1.5
      ml/min. A supelcosil LC-8 column (5 microm), 15 cm x 4.6 mm i.d. was utilized as
      stationary phase. Detection was affected spectrophotometrically at 210 nm.
      Clobazam was used as an internal standard. The method was also applied for the
      determination of ramipril in the presence of its degradation products. Linearity
      ranges for ramipril and hydrochlorothiazide were 4.5-45 and 0.6-14 microg/ml,
      respectively. Minimum detection limits (S/N = 2) obtained were 180 and 23 ng/ml
      for ramipril and hydrochlorothiazide, respectively. The proposed method was
      further applied to the analysis of tablets containing the two drugs, the
      percentage recoveries +/- S.D. (n = 5) were 100.45%+/-0.63 and 99.55%+/-0.78 for
      ramipril and hydrochlorothiazide, respectively.

PMID- 11199213
TI  - Visualization of fluid-bed granulation with self-organizing maps.
AB  - The degree of the instrumentation of pharmaceutical unit operations has
      increased. This instrumentation provides information of the state of the process
      and can be used for both process control and research. However, on-line process
      data is usually multidimensional, and is difficult to study with traditional
      trends and scatter plots. The Self-Organizing Map (SOM) is a recognized tool for
      dimension reduction and process state monitoring. The basics of the SOM and the
      application to on-line data collected from a fluid-bed granulation process are
      presented. As a batch process, granulation traversed through a number of process
      states, which was visualized with SOM as a two-dimensional map. In addition, it
      is demonstrated how the differences between granulation batches can be studied.
      The results suggest that SOM together with new in-line process analytical
      solutions support the in-process control of the pharmaceutical unit operations.
      Further, a novel research tool for understanding the phenomena during processing
      is achieved.

PMID- 11199214
TI  - Optimization of TLC analysis of flavonoids and phenolic acids of Helleborus
      atrorubens Waldst. et Kit.
AB  - Numerical methods for the evaluation of the separation power of thirteen thin
      layer chromatographic systems for splitting a methanolic extract of leaves of
      Helleborus atrorubens Waldst. et Kit. into 15 compounds (flavonoids and phenolic
      acids) have been investigated. For this purpose, the following mathematical
      approaches have been applied: calculation of the information content (I),
      determination of discriminating power (DP) and formation of clusters and
      dendrogram. The most suitable chromatographic system for the separation of
      investigated compounds is ethyl acetate-formic acid-water (65:15:20, v/v/v).

PMID- 11199215
TI  - Ion-selective piezoelectric sensor for niacinamide assay in serum and urine.
AB  - An ion-selective piezoelectric (ISP) sensor was successfully applied for the
      determination of niacinamide in serum and urine. By coating a polyvinylchloride
      membrane containing niacinamide-silicotungstate on one electrode of a thickness
      shear mode piezoelectric quartz crystal, the ISP device can adsorb niacinamide
      selectively. The amount of coating applied to the crystal was calculated from the
      Sauerbrey equation by monitoring the frequency change. The logarithm of the
      frequency shift was linear with the logarithm of niacinamide concentration over
      the range from 1.0 x 10(-9) to 1.0 x 10(-3) M with a detection limit of 1.0 x 10(
      9) M at pH 7.0. Influencing factors were investigated and optimized. The results
      for real samples obtained by the proposed method were in good agreement with
      those obtained by the conventional methods.

PMID- 11199216
TI  - A stability-indicating HPLC assay method for budesonide.
AB  - The official (European) pharmacopeial assay for budesonide was found to be non
      specific and non-stability-indicating when used to qualify several batches of
      pharmaceutical grade drug substance from different sources. In contrast, the most
      widely cited HPLC method in the literature was found to be specific and stability
      indicating with respect to drug substance stored in the dry state. However, that
      method failed the pharmacopeia's assay system suitability requirements because of
      peak tailing. Moreover, it was unable to detect or resolve two major degradation
      products which resulted from drug storage in non-aqueous solution. A new
      stability-indicating HPLC method described here overcomes these problems. This
      method used a Hypersil C18 column with a mobile phase consisting of ethanol
      acetonitrile phosphate buffer (pH 3.4; 25.6 mM) (2:30:68, v/v/v), a flow rate of
      1.5 ml/min and UV detection at 240 nm. The purity of budesonide EP and its
      impurity profile (related substances) were tested using the new assay method, and
      the results compared to those from the two other methods described above. Solid
      state and solution stressed stability samples were used to evaluate all methods.
      Using the novel method, the epimers of budesonide. their related impurities and
      degradation products were separated successfully. Validation studies demonstrated
      that the novel method possessed a linear UV response, good system precision and
      accuracy, high sensitivity and specificity for budesonide. The novel method will
      be used for future studies of budesonide's degradation kinetics.

PMID- 11199217
TI  - Determination of cilostazol and its metabolites in human urine by high
      performance liquid chromatography.
AB  - A high performance liquid chromatography (HPLC) method with ultraviolet detection
      for the simultaneous quantification of cilostazol, and its known metabolites in
      human urine was developed and validated. Cilostazol, its metabolites and the
      internal standard OPC-3930 (structural analogue of cilostazol) were extracted
      from human urine using liquid-liquid extraction with chloroform. The organic
      extract was then evaporated and the residue was reconstituted in 8% acetonitrile
      in ammonium acetate buffer (pH 6.5). The reconstituted solution was injected onto
      an HPLC system and was subjected to reverse-phase HPLC on a 5-microm ODS column.
      A gradient mobile phase with different percentages of acetonitrile in acetate
      buffer (pH 6.5) was used for the resolution of analytes. Cilostazol, its
      metabolites and the internal standard were well resolved at baseline with
      adequate resolution from constituents of human urine. The lower limit of
      quantification was 100 ng/ml for cilostazol and all metabolites. The method was
      validated for a linear range of 100-3000 ng/ml for all the metabolites and
      cilostazol. The overall accuracy (% relative recovery) of this method ranged from
      86.1 to 116.8% for all the analytes with overall precision (%CV) being 0.8-19.7%.
      The long-term stability of clinical urine samples was established for at least 3
      months at -20 degrees C in a storage freezer. During validation, calibration
      curves had correlation coefficients greater than or equal to 0.995 for cilostazol
      and the seven tested metabolites. The method was successfully used for the
      analysis of cilostazol and its metabolites in urine samples from clinical
      studies, demonstrating the reliability and robustness of the method.

PMID- 11199219
TI  - Determination of isepamicin sulfate and related compounds by high performance
      liquid chromatography using evaporative light scattering detection.
AB  - A simple reversed phase high performance liquid chromatographic method was
      developed for the analysis of isepamicin sulfate. The use of evaporative light
      scattering detection eliminates the need for sample derivatization. Separation of
      the isepamicin aminoglycoside from structurally similar related compounds was
      achieved using two Waters X-Terra RP18 columns connected in tandem at 10 degrees
      C. The assay of isepamicin sulfate and the estimation of its impurities was
      accomplished using external standard calibration curves at two sample
      concentrations: 1.6 mg ml(-1) for the analysis of isepamicin sulfate and 8.0 mg
      ml(-1) for the estimation of lower level impurities. The limit of detection was
      0.1%. The specificity, assay linearity, low level assay linearity and assay
      repeatability were also investigated.

PMID- 11199218
TI  - Validation of an HPLC method for the determination of urinary and plasma levels
      of N1-methylnicotinamide, an endogenous marker of renal cationic transport and
      plasma flow.
AB  - N1-Methylnicotinamide (NMN) is an endogenous cationic metabolite of nicotinamide
      (niacine, vitamine PP) whose renal clearance reflects both the capacity of the
      renal tubular transport system to secrete organic cations and renal plasma flow.
      NMN is present in human plasma and urine at the 1-117-ng ml(-1) and 0.5-25-microg
      ml(-1) concentration range, respectively, and its level depends notably on
      pathophysiological (age, renal or hepatic diseases) conditions. We report the
      optimization and validation of an HPLC method for the measurement of endogenous
      NMN in biological fluids after derivatization into a fluorescent compound. Plasma
      is first deproteinized with TCA 20% and the urine diluted 1:10 with HCI 10(-4) M
      prior to the derivatization procedure, which includes a condensation reaction of
      NMN with acetophenone in NaOH at 0 degrees C, followed by dehydration in formic
      acid and subsequent formation of the fluorescent 1,6-naphthyridine derivatives
      after heating samples in a boiling water bath. The synthetic homologous
      derivative N1-ethylnicotinamide (NEN) reacts similarly and is added as internal
      standard into the biological fluid. The reaction mixture is subjected to reverse
      phase high performance liquid chromatography on a Nucleosil 100-C18 column using
      a mobile phase (acetonitrile 22%, triethylamine 0.5%, 0.01 M sodium
      heptanesulfonate adjusted to pH 3.2), delivered isocratically at a flow rate of 1
      ml min(-1), NMN and NEN are detected at 7.8 and 10 min by spectrofluorimetry with
      excitation and emission wavelengths set at 366 and 418 nm, respectively. The
      addition-calibration method is used with plasma and urine pools. Calibration
      curves (using the internal standard method) are linear (r2 > 0.997) at
      concentrations up to 109 ng ml(-1) and 15.7 microg ml(-1) in plasma and urine,
      respectively. Both intra- and inter-assay precision of plasma control samples at
      10, 50 and 90 ng ml(-1) were lower than 3.3% and concentrations not deviating
      more than 2.7% from their nominal values. In urine intra- and inter-assay CVs of
      control samples at 1, 5 and 9 microg ml(-1) are lower than 8.3%, with
      concentrations not deviating more than -9.0 to +11.8% from their nominal values.
      This analytical method has therefore the required sensitivity and selectivity to
      measure NMN in plasma and urine, enabling the non-invasive determination of the
      tubular secretory capacity of the kidney and the renal plasma flow.

PMID- 11199220
TI  - Stripping voltammetric determination of indapamide in serum at castor oil-based
      carbon paste electrodes.
AB  - The diuretic drug indapamide has been characterized voltammetrically at carbon
      paste electrodes by means of cyclic and differential pulse voltammetry. An
      adsorptive stripping method at carbon paste electrode modified with castor oil
      for trace determination of indapamide was described. A study of the variation of
      the peak current with solution variables such as pH, ionic strength,
      concentration of indapamide, possible interference, and instrumental variables
      such as scan rate, pulse amplitude, preconcentration time, accumulation
      potential, paste composition has resulted in the optimization of the oxidation
      signal for analytical purposes. By anodic stripping differential pulse
      voltammetry, the calibration plot was linear in the range 5 x 10(-8) x 10(-7) M
      with a detection limit of 5 x 10(-9) M at carbon paste electrode modified with
      castor oil in pH 4.0. The preconcentration medium-exchange approach was utilized
      for selective determination of indapamide in spiked serum. A detection limit of
      15 ng ml(-1) was obtained for dilute serum sample after 3 min accumulation and
      medium-exchange procedure.

PMID- 11199221
TI  - Determination of ambroxol or bromhexine in pharmaceuticals by capillary
      isotachophoresis.
AB  - Expectorant drugs ambroxol (AX) and bromhexine (BX) were determined by capillary
      isotachophoresis (ITP) with conductimetric detection. The leading electrolyte
      (LE) was a buffer solution that contained 5 mM picolinic acid and 5 mM potassium
      picolinate (pH 5.2). The terminating electrolyte (TE) was 10 mM formic acid. The
      driving current was 80 microA (for approximately 200 s) or 50 microA (for
      approximately 350 s) and the detection current was 20 microA (a single analysis
      took about 8 min). The effective mobilities of AX and BX (evaluated with
      tetraethylammonium as the mobility standard) were 18.8 x 10(-9) m2 V(-1) s(-1)
      and 14.3 x 10(-9) m2 V(-1) s(-1) respectively. The calibration graphs relating
      the ITP zone length to the concentration of the analytes were rectilinear (r =
      0.9993-0.9999) in the range 10 mg L(-1) (20 mg L(-1) for BX) to 200 mg l(-1) of
      the drug standard. The relative standard deviations (RSD) were 1.2 1.6% (n = 6)
      when determining 100 mg l(-1) of the analytes in pure test solutions. The method
      has been applied to the assay of AX or BX in seven commercial mass-produced
      pharmaceutical preparations. According to the validation procedure based on the
      standard addition technique the recoveries were 97.5-102.7% of the drug and the
      RSD values were 0.11-2.20% (n = 6).

PMID- 11199222
TI  - Immunoreactivity of 80-kDa peptidoglycan and teichoic acid-like substance of
      slime producing S. epidermidis and specificity of their antibodies studied by an
      enzyme immunoassay.
AB  - S. epidermidis is considered an important cause of nosocomial bacteraernia in
      immunocompromized hosts as well as the commonest agent of sepsis in patients with
      prosthetic devices. Pathogenesis is attributed to adherence and growth on
      bioniaterials facilitated by production of extracellular slime. The major
      macromolecules of slime are: a 20-kDa acidic polysaccharide (20-kDa PS)
      comprising the 60% of carbohydrate-containing slime macromolecules, a
      peptidoglycan with average molecular size of 80-kDa (30% of slime dry weight) and
      cell wall teichoic acid-like substance. In this study, antibodies to these
      macromolecules as well as crude slime were raised in rabbits and their
      immunological reactivity and specificity were studied by an enzyme immunoassay.
      All isolated macromolecules induced the production of specific antibodies. 20-kDa
      PS was less immunogenic than 80-kDa peptidoglycan and teichoic acid-like
      substance. However, 20-kDa PS was the most potent inhibitor of the reaction of
      slime with its homologous antibodies revealing that this polysaccharide is the
      major antigenic determinant of slime. All three antibodies specifically recognize
      (p < 0.05) and react with slime-producing S. epidermidis in comparison to other
      staphylococci species. Obtained results indicate that the 20-kDa PS may be
      distributed in the surface of the slime exposing most of its antigenic
      determinants to the immune system, whereas those of 80-kDa peptidoglycan and
      teichoic acid-like substance seem to be less accessible.

PMID- 11199223
TI  - A method for measuring potency of narasin extracts using near-IR spectroscopy.
AB  - We present a method for extracting the active component from granulated narasin
      samples using chloroform with subsequent quantitation by near-infrared absorption
      spectroscopy (NIRS). A multiple linear regression (MLR) calibration equation was
      developed using a set of 41 calibration samples. The potencies obtained using NIR
      analysis exhibit no larger than an 8% (3.03 mg/g) error when compared to results
      based on the primary HPLC reference method. We estimate the detection limit using
      this method to be 400 ppm narasin (20 mg/g potency), and the standard deviation
      for five independent extractions of the same sample is approximately 24 ppm
      (approximately 1.2 mg/g potency or approximately 1%). We also present the results
      from a robustness study based upon a full factorial experimental design in which
      we varied extraction and measurement parameters. This study indicates that sample
      mass causes the most variation in the results. Bottle-to-bottle variations in the
      chloroform used for the extraction also proved significant. Variations in sample
      batch, number of spectral scans, and the interactions between sample
      hatch*soneration time, no. Scans*time in NIR, and sample batch*sample mass were
      borderline significant.

PMID- 11199224
TI  - A single-channel method for evaluation of very magnitudes of Ca2+ ion fluxes
      through epsilon4/zeta1 N-methyl-D-aspartate receptor channels in bilayer lipid
      membranes.
AB  - A single-channel method for evaluating agonist selectivity in terms of the very
      number of Ca2+ ions passed through the epsilon4/zeta1 N-methyl-D-aspartate (NMDA)
      receptor ion channel in bilayer lipid membranes (BLMs) is described. The number
      of Ca2+ passed through the single-channel was obtained from single-channel
      recordings in a medium where the primary permeant ion is Ca2+. The recombinant
      epsilon4/zeta1 NMDA channel was partially purified from Chinese hamster ovary
      cells expressing the channel and incorporated in BLMs formed by the tip-dip
      method. It was found that the epsilon4/zeta1 channel in BLMs is permeable to Ca2+
      and Na+, but the number of Ca2+ passed through the channel is much fewer than
      that of Na+. The integrated Ca2+ currents induced by three typical agonists NMDA,
      L-glutamate and L-CCG-IV were obtained at concentration of 50 microM, where the
      integrated currents for all the agonists reached their saturated values. The
      integrated Ca2+ currents obtained are (3.1+/-0.21) x 10(-13) C/s for NMDA, (4.6+/
      0.31) x 10(-13) C/s for L-glutamate and (5.7+/-0.25) x 10(-13) C/s for L-CCG-IV,
      respectively, suggesting that the three kinds of agonists have different
      efficacies to induce permeation of Ca2+. The range of the agonist selectivity
      thus obtained is much narrower than that of binding affinities for the NMDA
      receptors from rat brain. The present method is able to detect Ca2+ permeation
      with a detection limit of approximately 10(5) Ca2+ ions/s.

PMID- 11199225
TI  - High-performance liquid chromatographic analysis and stability of anti-tumor
      agent temozolomide in human plasma.
AB  - Temozolomide (SCH 52365; TEMODAL) is an antineoplastic agent with activity
      against a broad spectrum of murine tumors. This compound is currently marketed in
      the European Union for the treatment of patients with glioblastoma multiforme and
      anaplastic astrocytoma, which are serious and aggressive types of brain cancers.
      It has been postulated that temozolomide exerts its in vivo activity via the
      decomposition product MTIC, which is believed to alkylate nucleophiles, and in
      the process is converted to AIC. A high-performance liquid chromatographic (HPLC)
      method was developed and validated for the analysis of temozolomide in human
      plasma. The determination of temozolomide involved extraction with ethyl acetate
      followed by separation on a reversed phase C-18 column and quantification by UV
      absorbance at 316 nm. The calibration curve was linear over a concentration range
      of 0.1-20 microg/ml. The limit of quantitation was 0.1 microg/ml, where the
      coefficient of variation (CV) was 0% and the bias was 10.0%. The method was
      precise with a coefficient of variation ranging from 2.5 to 6.9% and accurate
      with a bias ranging from 5.0 to 10.0%. Temozolomide was unstable at 37 degrees C
      in human plasma with a degradation t1/2 of 15 min; however, it was stable at 4
      degrees C for at least 30 min. Temozolomide was stable in acidified human plasma
      (pH < 4) for at least 24 h at 25 degrees C, and for at least 30 days at -20
      degrees C. Moreover, temozolomide was stable in acidified human plasma after
      being subjected to three freeze thaw cycles. The assay was shown to be specific,
      accurate, precise, and reliable for use in pharmacokinetic studies.

PMID- 11199226
TI  - Simultaneous determination of paracetamol and methocarbamol in tablets by ratio
      spectra derivative spectrophotometry and LC.
AB  - The application of the ratio spectra derivative spectrophotometry and high
      performance liquid chromatography (HPLC) to the simultaneous determination of
      paracetamol (PAR) and methocarbamol (MET) in combined pharmaceutical tablets is
      presented. The spectrophotometric procedure is based on the use of the first
      derivative of the ratio spectra obtained by dividing the absorbtion spectrum of
      the binary mixtures by a standard spectrum of one of the compounds. The first
      derivative amplitudes were measured at 243.0 and 230.3 nm for the assay of PAR
      and MET, respectively. Calibration graphs were established for 2-30 microg ml for
      PAR and 2-36 microg/ml for MET in binary mixture. The detection limits for PAR
      and MET were found 0.097 and 0.079 microg/ml, respectively; while the
      quantification limits were 0.573 microg/ml for PAR and 1.717 microg/ml for MET.
      For the HPLC procedure, a reversed-phase column with a mobile phase of methanol
      water (60:40, v/v), was used to separate both compounds with a detection of 274.0
      nm. Linearity was obtained in the concentration range of 2 300 and 1.5-375
      microg/ml for PAR and MET, respectively. The detection and quantification limits
      were found to be 0.42 and 1.4 microg/ml for PAR and 0.36 and 1.2 microg/ml for
      MET, respectively. The relative standard deviations were found to be less than
      0.52%, indicating reasonable repeatibility of both methods. The proposed methods
      were successfully applied to the determination of these drugs in commercial
      tablets.

PMID- 11199227
TI  - LC-1H NMR used for determination of the elution order of S-naproxen glucuronide
      isomers in two isocratic reversed-phase LC-systems.
AB  - The reactive metabolite S-naproxen-beta-1-O-acyl glucuronide was purified from
      human urine using solid phase extraction (SPE) and preparative HPLC. The
      structure was confirmed by 600 MHz 1H NMR. Directly coupled 600 MHz HPLC-1H NMR
      was used to assign the peaks in chromatograms obtained when analysing a sample
      containing S-naproxen aglycone and the 1-, 2-, 3-, and 4-isomers of S-naproxen
      beta-1-O-acyl glucuronide in two simple isocratic reversed phase HPLC-systems.
      Using mobile phase 1 (50 mM formate buffer pH 5.75/acetonitrile 75:25 v/v) the
      elution order was: 4-O-acyl isomers, beta-1-O-acyl glucuronide, 3-O-acyl isomers,
      2-O-acyl isomers, and S-naproxen aglycone. Using mobile phase II (25 mM potassium
      phosphate pH 7.40/acetonitrile 80:20 v/v) the elution order was: alpha/beta-4-O
      acyl isomers, S-naproxen aglycone, beta-1-O-acyl glucuronide, 3-O-acyl isomers,
      and alpha/beta-2-O-acyl isomers. In both systems the elution order for the 2-, 3-
      and 4-O-acyl isomers corresponded with previously published results for 2-, 3-,
      and 4-fluorobenzoic acid glucuronide isomers determined by reversed phase HPLC-1H
      NMR (U.G. Sidelmann, S.H. Hansen, C. Gavaghan, A.W. Nicholls, H.A.J. Carless,
      J.C. Lindon, I.D. Wilson, J.K. Nicholson, J. Chromatogr. B Biomed. Appl. 685
      (1996) 113-122]. The alpha-1-O-acyl isomer was found to be present at
      approximately 3% of the initial S-naproxen-beta-1-O-acyl glucuronide
      concentration in the glucuronide isomer mixture after 6 h of incubation at pH
      7.40 and 37 degrees C. In both HPLC systems it eluted just before the beta-1-O
      acyl glucuronide well separated from other isomers. Investigators should consider
      the possible formation of a alpha-1-O-acyl isomer when studying glucuronide
      reactivity and degradation.

PMID- 11199228
TI  - Determination of perfluorobutane in rat blood by automatic headspace capillary
      gas chromatography and selected ion monitoring mass spectrometry.
AB  - A new contrast agent (Sonazoid; NC100100) for ultrasound imaging has been
      developed. It is an aqueous suspension of lipid stabilised perfluorobutane (PFB)
      gas microbubbles. An automatic headspace capillary gas-chromatographic mass
      spectrometric method using electron impact ionisation was developed for analysis
      of Sonazoid PFB in rat blood. The calibration standards were gaseous PFB
      dissolved in ethanol in the range of 0.5-5000 ng PFB. Fluorotrichloromethane (CFC
      11) was used as an internal standard of the method and the MS detector was set to
      single ion monitoring of the base fragment ions of PFB (m/z 69 and 119) and CFC
      11 (m/z 101). The calibration graph, made by plotting the peak area ratios of PFB
      (m/z 69) to CFC 11(m/z 101) against the amount of PFB, was fitted to a second
      order polynomial equation with weighting 1/y2 and found to be reproducible. The
      limit of quantification of the method was set to 0.4 ng PFB. The between-day
      variation of the method was below 9.2% relative standard deviation (RSD) and the
      within-day variation of the method was below 7.6% RSD. The accuracy of the
      method, as compared to Coulter counter, was estimated by determination of PFB in
      samples where Sonazoid was added to saline and found to range from 91.5% to
      105.2%. PFB, added as Sonazoid, was found to be stable for at least 7 months in
      rat blood samples when stored at -20 degrees C.

PMID- 11199229
TI  - Determination of Cremophor EL in plasma after sample preparation with solid phase
      extraction and plasma protein precipitation.
AB  - The non-ionic emulsifier Cremophor EL can be quantified using a special
      potentiometric titration technique with barium chloride activation and
      precipitation with sodium tetraphenylborate. The end point of the titration is
      indicated by an ionsensitive coated wire electrode which responds to an excess of
      tetraphenylborate ions. Sample preparation is necessary to quantify the excipient
      in plasma of patients receiving ciclosporin formulations with Cremophor EL
      (Sandimmun), since plasma proteins cause disturbances of the titration. Solid
      phase extraction was tested with various sorbent materials. Although some of the
      sorbents yielded good extraction rates of Cremophor EL from aqueous solutions,
      the extraction rates from plasma were significantly lower. Therefore, plasma
      protein precipitation with acetonitrile has been examined as an alternative to
      SPE and has been proved the superior method. Using the precipitation technique, a
      recovery rate of above 90% was achieved. Furthermore, the limit of detection from
      plasma was found to be 30 microg, in analogy to the determination from aqueous
      solutions. The combination of the plasma protein precipitation with the
      potentiometric titration allows quantitation and thus pharmakokinetic
      investigations of Cremophor EL in patients treated with Sandimmun after kidney
      transplantation.

PMID- 11199230
TI  - Analysis of glimepiride by using derivative UV spectrophotometric method.
AB  - Glimepiride (Amaryl), which is a new oral antidiabetic drug in the sulfonylurea
      class, was analysed by using second order derivative UV spectrophotometry. The
      quantification of glimepiride in dimethylformamide was performed in the
      wavelength range of 245-290 nm at N = 6, ?lambda = 21. The second order
      derivative spectra was calculated using peak to peak (lambdaDMF = 263.3-268.2
      nm), peak to zero (lambdaDMF = 268.2 nm) and tangent (lambdaDMF = 263.3-271.8 nm)
      method for calibration curves, the linearity range of 1.00-500.00 microg ml(-1)
      by using the second order derivative UV spectrophotometric method. The developed
      method was applied to directly and easily to the analysis of the pharmaceutical
      tablet preparations. R.S.D. were found to be 4.18% (Amaryl tablet; 1 mg) and
      2.21% (Amaryl tablet; 2 mg). The method was completely validated and proven to be
      rugged. The limit of quantitation and the limit of detection were found as 1.00
      and 0.4 microg ml(-1), respectively. This validated derivative UV
      spectrophotometric method is potentially useful for a routine laboratory because
      of its simplicity, rapidity, sensitivity, precision and accuracy.

PMID- 11199231
TI  - LC coupled to ion-trap MS for the rapid screening and detection of polyphenol
      antioxidants from Helichrysum stoechas.
AB  - Liquid Chromatography-Ion Trap Mass Spectrometry with an atmospheric pressure
      chemical ionization (APCI) interface in the negative and positive-ion modes in
      parallel to UV-diode-array detection (DAD), was applied for the rapid
      detection/characterization in crude extracts of the water-soluble antioxidant
      phenolics from Helichrysum stoechas. APCI-MS provides unequivocal molecular
      weight data of these compounds and useful information about their structures
      (diagnostic fragments ions), which were confirmed by the UV-DAD fingerprints.
      This combined approach allows the identification of ten constituents, including
      the three naturally occurring isomers of caffeoylquinic acid (CGAs), namely neo
      chlorogenic acid, chlorogenic acid and crypto-chlorogenic acid, 2 isomeric
      dicaffeoyl quinic acids, 2 isomeric naringenin glucosides, quercetin, kaempferol
      and apigenin glucosides and a tetrahydroxychalcone-glucoside. The water-soluble
      extract from H. stoechas, standardized in both total polyphenol and kaempferol-3
      glucoside content, exhibits strong antioxidant activity in vitro when tested in
      both artificial membrane systems (phosphatidylcholine liposomes) and in a cell
      model (rat erythrocytes).

PMID- 11199232
TI  - Milly Haagedoorn awarded the 2000 Margaret Hay Edwards Achievement Medal.

PMID- 11199233
TI  - The Cancer Education Grant Program of the National Cancer Institute.

PMID- 11199234
TI  - Cancer skills laboratories for medical students: a promising approach for cancer
      education.
AB  - BACKGROUND: Most medical students graduate without the skills necessary to assist
      patients in cancer control. To address this problem, the authors developed a
      cancer skills laboratory for second-year medical students. METHODS: The skills
      laboratory consists of two hours of training, with 15 minutes allotted per
      station (six to eight students assigned per station). Faculty and fellows lead
      the stations on prostate cancer, breast cancer, colorectal cancer, skin cancer,
      counseling for smoking cessation, and a discussion of anti-tobacco
      advertisements. Students completed pre- and post-laboratory surveys consisting of
      ten brief questions. RESULTS: Overall, 94% of eligible students in 1997 and 1998
      completed the surveys. Using a five-point scale, self-rated skill level increased
      from 2.12 to 3.83 when all modalities were averaged (p < .001). CONCLUSIONS:
      Cancer skills laboratories are a promising new means for cancer education.

PMID- 11199235
TI  - Effective use of the web to expand a summer predoctoral program: the St. Jude
      experience.
AB  - BACKGROUND: Since 1978, the St. Jude Children's Research Hospital has oncology
      education (POE) program for medical and other health professional students to do
      two-to-four-month clinical and/or basic research rotations in pediatric oncology.
      Limitations in funding, recruitment capability, and faculty interest held student
      numbers to 0-18 per year. METHODS: In early 1997, the program announcement and an
      on-line application were put on the Web site, <http://www.stjude.org/poe>. An
      applicant's online submission is delivered immediately to the program director's
      e-mail inbox, promptly acknowledged via e-mail, transferred to a digital
      database, and forwarded electronically to prospective institutional preceptors.
      RESULTS: The program accepted 36 of 61 applicants (56% minority) in 1997. A
      supplemental funding award enabled expansion of the program to include students
      preparing for health professions or biomedical sciences careers. In 1999, 75 of
      139 applicants were accepted (47% minority) from 39 schools in 18 states, the
      District of Columbia, Puerto Rico, Mexico, and Ireland. CONCLUSIONS: Effective
      use of the Web and e-mail made it possible to inform students effectively about
      the institution and program, match students with preceptors, increase the number
      of minority participants, and expand the regional program into a national one.

PMID- 11199236
TI  - The UICC/WHO-CCCE Cancer Education project: a different approach.
AB  - The Union Internationale Contre le Cancer (UICC) and the WHO-Collaborating Centre
      for Cancer Education (WHO-CCCE) have started an international pilot project
      offering assistance to medical schools that want to implement in their curricula
      a two-week multidisciplinary cancer course aimed at cancer care in general
      practice. The approach will be bottom-up (based on the possibilities in
      individual medical schools) instead of top-down (based on general recommendations
      and rules established in published studies). In April 2000 one or more medical
      schools from each of four continents had registered. Registration is open to any
      medical school and to other schools that have satisfactory ongoing cancer
      courses. The aim is to develop a network among medical schools in order for them
      to learn from each other's cancer education strategies and experiences.

PMID- 11199237
TI  - Assessing the need for Clinical Breast Examination (CBE) training: the Oregon
      experience.
AB  - BACKGROUND: Despite the widely held perception that CBE training has high
      priority among the continuing medical education (CME) needs of breast health care
      providers, there is actually little published information to support this notion.
      METHODS: The authors conducted a statewide needs assessment mail survey of
      providers regarding a number of potential CME needs, including CBE training.
      RESULTS: Of the 4,179 surveys from the single mailing, 1,427 were returned (34%
      response rate). Six categories of provider types responded; 51% were physicians
      and 23% were nurse practitioners. Fifty-nine percent of the respondents were
      female; 96% felt that routine CBE was an important or very important part of
      providing breast care. Although 79% of all respondents performed CBE at least
      weekly and 41% performed more than ten CBEs/week, 80% were interested in
      receiving some form of CME regarding CBE, and 79% of those who performed CBE at
      least weekly were interested in receiving skill-based CBE training. CONCLUSIONS:
      Despite the respondent bias inherent in survey studies, it can be concluded that
      there is indeed a CME need for CBE training, even among providers who perform CBE
      frequently. Based on these findings the authors are implementing a statewide CME
      program of CBE training.

PMID- 11199238
TI  - The effects of a postgraduate course on opioid-prescribing patterns of general
      practitioners.
AB  - BACKGROUND: The objective of this study is to evaluate whether a single
      palliative cancer care workshop, which included information about drug
      prescribing, had an effect on the opioid-prescription patterns of general
      practitioners in daily practice. METHOD: The opioid-prescription figures of 68
      general practitioners who had participated in the workshop were aggregated from
      the computer system of the Regional Sick Fund. The prescription figures of a year
      before and a year after the workshop were compared and a control group of non
      participants was included. RESULTS: This study showed a limited efficacy of a
      palliative cancer care workshop on the morphine-prescription figures of the
      general practitioners in daily practice. This limited effect did not accord with
      the results of a pre- and post-workshop questionnaire evaluating the attitudes of
      the same practitioners. CONCLUSION: A single workshop can not effectuate
      substantial changes in prescription behaviors. Possibilities for more
      reinforcements are discussed.

PMID- 11199239
TI  - Is hands-on experience more effective than didactic workshops in postgraduate
      cancer pain education?
AB  - BACKGROUND: This study examined the nurse outcomes of a cancer pain education
      program for nurses of patients from 11 different ethnic groups. METHODS: Four
      hundred ninety six home, hospital, and hospice nurses participated in a one-day
      workshop or two half-day workshops on cancer pain assessment and management. Of
      these, 116 were randomized to participate in a bedside-precepted visit with an
      oncology nurse specialist with pain specialization and a focus group to discuss
      attitudinal issues. Eighty-six nurses served as controls. Pre-, post- and one
      year follow-up tests were administered. RESULTS: Attitudes, knowledge, and
      application skills significantly improved for workshop-only and enriched-model
      nurses relative to controls. CONCLUSION: For postgraduate nurses, daylong cancer
      pain education workshops were, in the group studied, as effective as hands-on
      experience in improving cancer pain knowledge and changing attitudes. Both the
      workshop-only and the enriched-model nurses relative to controls had
      significantly improved knowledge and changed attitudes towards optimal pain
      management.

PMID- 11199240
TI  - The effect of timing of the provision of information on anxiety and satisfaction
      of cancer patients receiving radiotherapy.
AB  - BACKGROUND: To improve the provision of information to their radiotherapy
      patients, the authors examined whether the timing of given written information
      has an effect on anxiety and satisfaction. METHODS: Two sources of information
      were used: 1) a booklet with a description of radiotherapy procedures and the
      sensations patients can experience; 2) teaching sheets with treatment-site
      related information. 68 patients were randomized to a simultaneous-information
      group (n = 31) and a stepwise-information group (n = 37). The patients were being
      treated for cancers of the breast, lung, head, and neck or the pelvic region. The
      authors analyzed the impacts of several variables on patient learning, including
      anxiety, age, gender, support, referral, stage of illness, and diagnosis.
      Assessments were recorded before the simulation procedure and during the second
      and last weeks of treatment. RESULTS: The stepwise-information group was
      significantly less anxious before simulation (p = 0.02) and more satisfied (p =
      0.001). Of the variables studied, only the support variable was associated with
      high state anxiety (p < 0.0001). CONCLUSIONS: Provision of patient information in
      a stepwise format leads to less treatment-related anxiety and greater patient
      satisfaction among radiation therapy patient undergoing simulation.

PMID- 11199241
TI  - Adolescent girls' knowledge of and attitudes toward breast self-examination:
      evaluating an outreach education program.
AB  - BACKGROUND: The purpose of the study was to analyze the effectiveness of a one
      hour educational intervention to increase knowledge about and improve attitudes
      towards breast self-examination (BSE) and early cancer detection among adolescent
      girls. METHODS: The sample used in this quasi-experimental study was selected
      from schools participating in an education program provided by a regional health
      education center. The instrument and scales used in the study were developed and
      pilot-tested for reliability and validity in the area schools prior to the start
      of the study. The sample consisted of 137 adolescent girls who provided consent
      forms and participated in the intervention. The comparison group, which consisted
      of students attending the same schools, was scheduled to receive the intervention
      at a later date. RESULTS AND CONCLUSIONS: Findings suggest that a one-hour lesson
      can improve knowledge and attitudes of adolescent girls with respect to BSE and
      early cancer detection. Suggestions for further research are discussed.

PMID- 11199242
TI  - Impact of a cancer education multimedia device on public knowledge, attitudes,
      and behaviors: a controlled intervention study in Southern Sweden.
AB  - BACKGROUND: The objective was to determine the impact of a multimedia device
      offering information about malignant melanoma on public knowledge, attitudes, and
      behaviors. METHODS: Two municipalities in Sweden, Dalby and S Sandby, were
      chosen. The population of Dalby was exposed to the multimedia program during 1994
      97, whereas the S Sandby population was not. A questionnaire was sent to random
      samples of the populations (10% of those aged 20-59 years) before (1994, n = 373
      and n = 409, respectively) and after the intervention (1996, n = 375 and n = 418,
      respectively). Response rates were 74-89%. RESULTS: The groups were well balanced
      at baseline. In both areas women scored higher both at baseline and in 1996.
      Dalby women showed less fear of skin cancer in 1996 than in 1994 (2.13 vs 2.27, p
      < 0.01). This was not so in the controls. There was no major change in "sun
      behavior" in Dalby, whereas there was a negative change in S Sandby. After the
      intervention Dalby men had more "knowledge" (from 2.64 to 2.70, p < 0.05) and a
      tendency to better "sun behavior" (from 1.77 to 1.85, p = 0.076). There was no
      significant change over time in the S Sandby men. CONCLUSIONS: The multimedia
      program had a modest effect. The population in Dalby had more knowledge and
      changed its attitudes in a sun-protective direction. In the control area, the two
      year follow-up sun behavior score was lower than at baseline. There was also
      significantly less fear of skin cancer after the intervention.

PMID- 11199243
TI  - Tailored, interactive soap operas for breast cancer education of high-risk
      Hispanic women.
AB  - BACKGROUND: While Hispanic women have lower rates of breast cancer than do women
      of other ethnic groups, they are the least likely to undergo screening
      examinations. This study evaluated a culturally sensitive and linguistically
      appropriate, tailored, computer-based, educational program for early detection of
      breast cancer aimed at high-risk Hispanic women. METHODS: Spanish-speaking
      Hispanic women from an inner-city community health clinic were recruited and
      randomly assigned either to a computer intervention with an interactive soap
      opera format (n = 118) or to a comparison group (n = 60). Pre- and posttests were
      used to identify any change in breast-cancer-related knowledge and beliefs.
      RESULTS: Both younger (18-40 years old) and older (41-65 years old) women in the
      intervention group demonstrated significant increases in their breast cancer
      screening knowledge and beliefs as compared with the younger and older women in
      the comparison group (n < 0.05). CONCLUSIONS: Computer-based tailored and
      interactive soap operas that are linguistically and culturally appropriate are
      effective in increasing breast cancer screening knowledge and beliefs among
      underserved Spanish-speaking Hispanic women.

PMID- 11199244
TI  - Thoughts from a medical oncologist/teacher.

PMID- 11199245
TI  - Inspiration from a forum arranged by students.

PMID- 11199246
TI  - Shiftwork and cardiovascular disease: review of disease mechanisms.
AB  - This paper reviews the main findings concerning mechanisms explaining the
      increased risk of coronary heart disease (CHD) in shiftworkers. We discuss a
      conceptual model, in which three main shiftwork pathways to CHD are postulated-
      social problems, behavioral change, and disturbed circadian rhythm. Social
      problems that are associated with shiftwork might lead to stress. Significant
      shiftwork-related behavioral problems are smoking and unhealthy food habits.
      Disturbed circadian rhythm might result in sleep deprivation. Unphysiologic
      timing of physical activity and food intake in relation to circadian rhythms is
      another possible explanation for the negative impact on the cardiovascular
      system.

PMID- 11199247
TI  - The effect of high ambient temperature on the adjustment of operators to fast
      rotating 12-hour shiftwork.
AB  - The aim of the investigation was to study the effect of high ambient temperature
      (HAT) on the adjustment to fast rotating 12-h shifts by following the time-of-day
      variations of certain circadian and stress indicators. We investigated 12 male
      HAT operators and 21 individuals working in normal ambient temperature (NAT) in a
      thermoelectric power plant. The shift system of both groups comprised an 8-day
      cycle of 2 shifts per day (day shift: 0700 to 1900; night shift: 1900 to 0700),
      with 2 successive days of the same shift followed by 2 days off. We followed
      variations in oral temperature, 11-oxycorticoids, as well as catecholamines
      adrenaline and noradrenaline excretion at 4-h intervals during 2 day and 2 night
      shifts. Our data show daily oriented circadian rhythms of operators working on
      fast rotating 12-h shifts in conditions of HAT and NAT. Reduced general
      activation was observed in the second half of the prolonged 12-h night shifts,
      more pronounced in HAT operators. The stress indicators investigated here showed
      a stress reaction in HAT operators at the beginning of the first day shift. Both
      prolonged 12-h shifts and high ambient temperature impose extra demands and may
      have an impact on the performance and work safety of the operators.

PMID- 11199248
TI  - The use of epidemiological data to direct resources in food safety control.
AB  - In the United States, food-borne disease results in financial losses estimated at
      $2.9 to $6.7 billion annually as a result of illness that is due to six specific
      food-borne pathogens. A model is proposed that analyzes epidemiological data and
      highlights areas in food safety control that have the greatest impact on food
      borne disease. The model identifies Critical Control Points for use by the food
      industry, prioritizes criteria for inspection of food processes by regulatory
      authorities, and provides a focus for food hygiene training programs and
      campaigns. The model also provides a cost-benefit analysis that can be used to
      direct resources that are used in food safety control in a cost-effective manner.

PMID- 11199249
TI  - Somatotype, nutrition, and obesity.
AB  - The purpose of this investigation is to evaluate the somatotype characteristics
      of the studied group and search for a relation between somatotype, obesity, and
      particular features of nutrition. METHODS: Somatotype after Health & Carter
      (1990), nutritional status according to Body mass index (BMI), and nutrition
      determined by food-frequency questionnaires. RESULTS: Over 94% of the subjects in
      this study were distributed into five somatotype categories: 51.6% endomorphic
      mesomorphs, 17.1% mesomorph-endomorphs, 16.7% mesomorphic endomorphs, 6.1%
      balanced mesomorphs, and 3.0% ectomorphic mesomorphs, with a pronounced sexual
      dimorphism. Males were distributed into five categories: over 65% were
      endomorphic mesomorphs, and above 40 years of age the mesomorphy increased.
      Females were distributed into three somatotype categories: up to and above 40
      years of age over 44% were mesomorphic endomorphs. In the most common somatotype
      categories, 1 of 5 subjects (from 21.4% to 19.9%) had normal body mass (< 25
      kg/m2), 4 of 5 subjects (from 34.2% to 52.6%) were overweight (> 25 kg/m2) or
      obese (> 30 kg/m2) kg/m2 (from 44.4% to 27.5%). In the remaining eight
      categories, all subjects had normal body mass. Hyperenergetic, sodium- and fat
      excess nutrition had an especially unfavorable influence.

PMID- 11199250
TI  - Impact of pesticides use on human health in Mexico: a review.
AB  - Pesticides having a high adverse effect on the health and environment of
      inhabitants of the Mexican Republic were studied to establish the main parameters
      to bear in mind for their use and application. The investigation showed that
      Mexico is the agricultural zone with the highest health damage to its population
      from pesticides. The valid regulation norms for the use and application of these
      agrochemicals were analyzed. Case histories recorded by the public health sector
      in Mexico were reviewed. In this way, a strong relation was found between the
      health problems and the pesticides applied. Finally, the study concludes that the
      various Mexican States appear as a risk zone because of contamination by
      pesticides that are permitted by the regulation norms and by others whose use is
      prohibited in other countries and in Mexico. This situation causes a serious
      effect on the health deterioration of people who are exposed to these agro
      chemicals and, in some cases, leads to death.

PMID- 11199251
TI  - Environmental exposure to manganese and combined exposure to gaseous upper
      respiratory irritants: mechanism of action and adverse health effects.
AB  - This review relates to possible explanations of the often-observed findings that
      exposure to certain air pollutants or their mixture results in an increased rate
      of acute respiratory diseases. Epidemiological investigations have shown that
      exposure to manganese (MnO2) concentrations only 10 to 50 times higher than the
      normal urban concentrations of 0.01 to 0.03 microgram/m3 air might have an
      adverse health effect on respiratory organs. The assumption that one possible
      mechanism of action could be that manganese at such exposure levels disturbs
      certain protective functions in the lung--thus making the organism more
      susceptible to infections--is supported by toxicological studies. In vitro
      studies have demonstrated the cytotoxic action of manganese, including the
      inhibition of activities of alveolar macrophages. Animal experiments showed a
      decrease in resistance toward respiratory infections that were caused by
      simultaneous exposure to MnO2 and pathogenic bacteria. In cases of combined
      exposure to gaseous upper respiratory tract irritants and suspended particles,
      the involvement of adsorption of gaseous compounds on solid particles as carriers
      has been suggested. The assumption is that through such a mechanism, water
      soluble gaseous irritants can be transported deep into air passages, which such
      irritants normally do not reach. As the adsorption is reversible, the gaseous
      compounds can later be released from the particles, inducing a local irritating
      effect in the small airways and alveoli.

PMID- 11199252
TI  - Chlorpyrifos: an unwelcome pesticide in our homes.
AB  - Chlorpyrifos is an extensively used organophosphate insecticide having many urban
      and agricultural crop pest control uses. Studies conducted in indoor environments
      after termiticide, crack-and-crevice, broadcast, or fogger applications have
      shown that chlorpyrifos exposure can occur via inhalation of residual air
      concentrations, dermal or oral exposure from residues on floors and carpets,
      children toys, food, and dust. Not long ago the weight of scientific evidence
      supported safe indoor use, but recent studies support the possibility that when
      pregnant female rats are given the pesticide, chlorpyrifos causes brain damage in
      fetal rats. Moreover, the exposure of young rats to chlorpyrifos impairs early
      nervous system development. After finding that chlorpyrifos is an exposure risk
      especially to children, in June 2000 the United States Environmental Protection
      Agency and manufacturers agreed to voluntary measures that will reduce the
      exposure of children to chlorpyrifos-containing products. This action implies a
      search for less harmful new products to replace it and/or safer ways to control
      pests through basic hygiene. Whichever pest control method is selected, one
      should keep in mind that preventing environmental pesticide exposure in children
      is always better than treating the resulting disease.

PMID- 11199253
TI  - Differences in psychological and physical health among layoff survivors: the
      effect of layoff contact.
AB  - This study examined health and well-being among workers who have experienced
      varying types of contact with layoffs in an organization undergoing downsizing.
      Using survey data from a large organization employing both white- and blue-collar
      workers (N = 2,279), the authors argued that there are important differences
      among surviving workers as a function of their layoff experiences. Having any
      kind of personal contact with layoffs is found to be associated with less job
      security, more symptoms of poor health, depression, and eating changes as
      compared with having no layoff contact. Being laid off and rehired is associated
      with more work-related injuries and illnesses and missed work days due to such
      events than is receiving a "warn" notice, indirect contact (i.e., friends or
      coworkers laid off), or no contact with layoffs. Job security partially mediates
      the relationship between type of layoff contact experiences and health.

PMID- 11199254
TI  - Job insecurity in white-collar workers: toward an explanation of associations
      with health.
AB  - This article describes 2 studies that examined changes in psychosocial work
      characteristics (job strain model) and health-related behaviors as potential
      explanations of the job insecurity-health relationship in a longitudinal cohort
      of white-collar British civil servants. Job insecurity arising from anticipation
      of change was associated with a modest increase in self-reported morbidity,
      whereas chronic job insecurity was associated with some adverse physiological
      changes. Anticipation of change and chronic job insecurity were associated with
      adverse changes in other psychosocial work characteristics, but few changes were
      significant and consistent across both exposure groups. Changes in health-related
      behaviors associated with either exposure were slight. Apart from a minor role
      for social support at work in both sexes and a modest role for job demands in
      women, adverse changes in these factors explain little of the job insecurity
      health relationship.

PMID- 11199255
TI  - Changes in general health and musculoskeletal outcomes in the workforce of a
      hospital undergoing rapid change: a longitudinal study.
AB  - This article aimed to examine changes in general health and time with back pain
      and neck pain and to identify predictors of any such changes. Hospital workers
      were studied longitudinally with surveys in 1995, 1996, and 1997 (N = 712). Back
      and neck pain were reported only at the 2nd and 3rd surveys. There was a
      significant decline in general health and significant increases in time with neck
      pain and back pain. Predictors of changes in these outcomes were mainly work
      related variables (initial or change values), such as job interference with
      family, job influence, work psychological demands, and hours worked.

PMID- 11199256
TI  - Burnout and inequity among human service professionals: a longitudinal study.
AB  - In a composite sample of human service professionals (N = 245), longitudinal
      relations across 1 year were tested between equity in the professional-recipient
      relationship and burnout (i.e., emotional exhaustion, depersonalization, and
      reduced personal accomplishment). The 1st research question was whether inequity
      influenced burnout across time. The 2nd research question was whether
      longitudinal relations between equity and burnout were curvilinear, as predicted
      by equity theory. The results confirmed that inequity affects the central
      component of burnout (i.e., emotional exhaustion) and that this relation is
      curvilinear. Feeling more deprived and feeling more advantaged resulted in higher
      future emotional exhaustion levels. No indication was found for a longitudinal
      relation between inequity and depersonalization. A synchronous relation was found
      suggesting that personal accomplishment influences equity.

PMID- 11199257
TI  - Deriving benefits from stressful events: the role of engagement in meaningful
      work and hardiness.
AB  - This research explored the relationship between the meaningfulness of work,
      personality hardiness, and deriving long-term benefits from a stressful event.
      U.S. soldiers participating in a peacekeeping mission to Bosnia completed
      measures assessing the meaning of their work and personality hardiness midway
      through a 1-year deployment (mid-deployment) and completed a measure of deriving
      benefits from the deployment 4-5 months after it was over (postdeployment).
      Structural equation modeling revealed that personality hardiness was associated
      with being engaged in meaningful work during the deployment, which was strongly
      associated with deriving benefits from the deployment months after it was over.
      Enriching experiences were also associated with deriving benefits from the
      deployment. Discussion focuses on the linkages between personality processes,
      meaningful work, and deriving benefits from a stressful experience.

PMID- 11199258
TI  - Incivility in the workplace: incidence and impact.
AB  - This study extends the literature on interpersonal mistreatment in the workplace
      by examining the incidence, targets, instigators, and impact of incivility (e.g.,
      disrespect, condescension, degradation). Data were collected from 1,180 public
      sector employees, 71% of whom reported some experience of workplace incivility in
      the previous 5 years. As many as one third of the most powerful individuals
      within the organization instigated these uncivil acts. Although women endured
      greater frequencies of incivility than did men, both genders experienced
      similarly negative effects on job satisfaction, job withdrawal, and career
      salience. Uncivil workplace experiences were also associated with greater
      psychological distress; however, indices of psychological and physical health
      were relatively unaffected. The authors discuss these findings in the context of
      organizational and cognitive stress theories.

PMID- 11199259
TI  - Critters in the cube farm: perceived psychological and organizational effects of
      pets in the workplace.
AB  - This article reports the findings of an exploratory study examining the perceived
      functions and psychological and organizational effects of pets in the workplace.
      Participants were 193 employees from 31 companies allowing pets in the workplace
      who completed anonymous questionnaires. Results indicated that participants
      perceived pets in the workplace to reduce stress and to positively affect
      employee health and the organization. Participants who brought their pets to work
      perceived greater benefits than participants who did not bring their pets to work
      and participants who did not own pets.

PMID- 11199260
TI  - Hybrid vector designs to control the delivery, fate and expression of transgenes.
AB  - One of the greatest challenges to gene therapy is the targetting of gene delivery
      selectively to the sites of disease and regulation of transgene expression
      without adverse effects. Ultimately, the successful realization of these goals is
      dependent upon improvements in vector design. Over the years, viral vector design
      has progressed from various types of replication-defective viral mutants to
      replication-conditioned viruses and, more recently, to 'gutted' and hybrid
      vectors, which have, respectively, eliminated expression of non-relevant or toxic
      viral genes and incorporated desired elements of different viruses so as to
      increase the efficacy of gene delivery in vivo. This review will focus on the
      different viral and cellular elements which have been incorporated into virus
      vectors to: improve transduction efficiencies; alter the entry specificity of
      virions; control the fate of transgenes in the host cells; and regulate transgene
      expression.

PMID- 11199261
TI  - MLV-10A1 retrovirus pseudotype efficiently transduces primary human CD4+ T
      lymphocytes.
AB  - BACKGROUND: Previously, we showed that retroviral vectors pseudotyped with the
      envelope of the amphotropic murine leukemia virus 10A1 (MLV-10A1) more
      efficiently transduce primary human CD8+ T lymphocytes when compared with other A
      MLV, gibbon ape leukemia virus (GaLV) and feline endogenous retrovirus (RD114)
      vector pseudotypes. For the success of several gene therapeutic approaches (ADA,
      HIV) it is important to effectively transduce primary human CD4+ T lymphocytes.
      METHODS: We have used retroviral vectors encoding the enhanced green fluorescent
      protein (EGFP) as a marker gene and carrying envelopes of MLV-10A1, A-MLV and
      GaLV and have analyzed the transduction efficiency of both human CD4+ T cell
      lines (CEM, H9, HUT78, J16) and primary human CD4+ T lymphocytes using a
      RetroNectin-assisted transduction protocol and virus-containing supernatant.
      RESULTS: In CD4+ T cell lines the MLV-10A1 vector pseudotype was most effective
      and infected up to 85% of cells which then stably expressed GFP over time. MLV
      10A1 was also superior and infected approximately 32% of primary human CD4+ T
      lymphocytes in comparison to GaLV (18%) and A-MLV (12%). The superior efficiency
      of MLV-10A1 for the transduction of CD4+ T cells correlates with the longer half
      life of this pseudotype in comparison to A-MLV and, as previously shown by
      interference analysis, with the usage of both the A-MLV (Pit2) and the GaLV
      receptor (Pitl) for cell entry. CONCLUSIONS: MLV-10A1 is a suitable vector for
      transferring genes with high efficacy into primary human CD4+ T lymphocytes. The
      use of MLV-10A1 pseudotyped vectors should make it easier to obtain a sufficient
      number of gene-modified T lymphocytes for an adoptive transfer.

PMID- 11199262
TI  - T cell-specific expression from Mo-MLV retroviral vectors containing a CD4 mini
      promoter/enhancer.
AB  - BACKGROUND: Gene therapy of various immunological disorders will greatly benefit
      from improved retroviral vectors (RVs) with T cell specificity. Such vectors can
      be designed by placing a gene of therapeutic interest under the control of tissue
      specific transcriptional elements. However, low titers and loss of specificity
      are frequently encountered with tissue-specific vectors. The aim of the present
      study was to develop a T cell-specific RV. METHODS: We constructed a series of
      Moloney murine leukemia virus (Mo-MLV)-based RVs expressing enhanced green
      fluorescent protein (EGFP) under the control of a mini-promoter/enhancer cassette
      derived from the CD4 gene (CD4pmE) and tested them in cell lines and peripheral
      blood lymphocytes. Expression of EGFP was monitored by fluorescence microscopy
      and analyzed by flow cytometry. RESULTS: The CD4pmE cassette was inserted between
      the viral long terminal repeats (LTRs) in self-inactivating vectors (SIN vectors)
      or was substituted to the 3' U3 viral promoter/enhancer (hybrid vectors). High
      vector titers but poor specific expression of EGFP were achieved when CD4pmE was
      inserted in sense orientation in SIN vectors. Low titers but high specificity
      were observed when the CD4pmE cassette was in anti-sense orientation. In
      contrast, high titers and good T cell specificity were obtained with hybrid
      vectors. CONCLUSION: An efficient T cell-specific retroviral vector was obtained.

PMID- 11199263
TI  - p53 adenoviral vector (Ad-CMV-p53) induced prostatic growth inhibition of primary
      cultures of human prostate and an experimental rat model.
AB  - BACKGROUND: Benign prostatic hyperplasia (BPH) is the most common proliferative
      disease affecting men. Numerous minimally invasive technologies are being
      developed or are currently in use to obviate the need for transurethral surgery.
      The goal of the present study was to develop a novel molecular based approach for
      the treatment of BPH using recombinant p53 adenoviral vector. The over-expression
      of wt-p53 can cause cell apoptosis or cell growth arrest, thus preventing the
      uncontrolled cell proliferation underlying BPH pathophysiology. METHODS: Ad-CMV
      p53, a replication-deficient recombinant adenovirus containing cytomegalovirus
      promoter driving p53 gene, was used. Human prostate stromal (PS) cells were
      evaluated for apoptosis (TUNEL assay), mRNA levels of key cell cycle regulators
      influencing apoptosis (p-53, Bax and Bcl-2) using quantitative RT-PCR and
      cytotoxicity after Ad-CMV-p53. Ad-CMV-p53 was unilaterally injected into rat
      ventral prostates and growth inhibition was measured by prostate weight 3 weeks
      after injection. RESULTS: In vitro exposure to Ad-CMV-p53 significantly inhibited
      the proliferation of PS cells, induced mRNA over-expression of both wt-p53 and
      Bax, and increased the proportion of apoptotic cells. A 30% decrease in average
      prostate weight was demonstrated in rodents after Ad-CMV-p53 injection.
      CONCLUSIONS: The results suggest that further investigation of molecular gene
      therapy with recombinant wt-p53 adenovirus for the treatment of BPH is warranted.

PMID- 11199264
TI  - Differential influence of the E4 adenoviral genes on viral and cellular
      promoters.
AB  - BACKGROUND: Strong and stable transgene expression is fundamental to the success
      of recombinant adenovirus vectors in human gene therapy. However, control of
      transgene expression is a complex process, involving both viral and cellular
      factors. In this study, the influence of the E4 adenoviral region on the activity
      of various promoters was investigated in vitro and in vivo. METHODS: Pairs of
      isogenic E1o and E1oE4o vectors were generated and compared. Levels of transgene
      expression were determined by Northern blot, ELISA and FACS analysis. Initiation
      of transcription was studied by nuclear run-on assays. RESULTS: Similar to the
      viral CMV and RSV promoters, the activity of the ubiquitous cellular PGK promoter
      required the presence of the E4 genes in vitro and in vivo. In contrast,
      transgene expression from selected liver- and tumor-specific promoters did not
      require E4 functions. CONCLUSION: Together with the reported low liver toxicity
      of E1oE4o vectors, the independence of E4 of liver-specific promoters renders
      such vectors interesting alternatives to the use of gutless vectors.

PMID- 11199265
TI  - Scaleable chromatographic purification process for recombinant adeno-associated
      virus (rAAV).
AB  - BACKGROUND: Adeno-associated virus (AAV) is a human parvovirus currently being
      developed as a vector for gene therapy applications. Traditionally AAV has been
      purified from cell lysates using CsCl gradients; this approach however is not
      likely to be useful in large-scale manufacturing. Moreover gradient-purified AAV
      vectors tend to be contaminated with significant levels of cellular and
      adenoviral proteins and nucleic acid. To address the issue of purification we
      have developed a process scale method for the rapid and efficient purification of
      recombinant AAV (rAAV) from crude cellular lysates. METHODS: The preferred method
      for the purification of rAAVbetagal includes treatment of virally infected cell
      lysates with both trypsin and nuclease followed by ion exchange chromatography
      using ceramic hydroxyapatite and DEAE-Sepharose in combination with cellufine
      sulphate affinity chromatography. RESULTS: Purification of rAAV particles from
      crude cellular lysates co-infected with adenovirus was achieved using column
      chromatography exclusively. Column-purified rAAV was shown to be greater than 90%
      pure, free of any detectable contaminating adenovirus, biologically active, and
      capable of directing efficient gene transfer to the lungs of both cotton rats and
      mice. CONCLUSIONS: This study demonstrates the feasibility of using column
      chromatography alone for the isolation of highly purified rAAV vector. The
      methods described here are advancements in procedures to purify rAAV and are
      adaptable for commercial production of clinical-grade rAAV vector.

PMID- 11199266
TI  - An optimized amphiphilic cationic peptide as an efficient non-viral gene delivery
      vector.
AB  - BACKGROUND: Due to their chemical definition and reduced size, the use of
      peptides as gene delivery systems is gaining interest as compared to the more
      common polymeric non-viral vectors. To achieve gene transfer efficiencies that
      would make peptides a realistic alternative to existing methods, we have
      evaluated and attempted to concert those properties with a direct impact on the
      activity of the system. These considerations have led to the design, synthesis
      and characterization of a 23-residue cationic peptide which we term RAWA.
      METHODS: We have characterized RAWA biophysically and functionally. Biophysical
      studies include evaluation of DNA condensation and membrane perturbing
      activities. DNA transfer activity has been evaluated in cell culture at
      controlled DNA-to-peptide stoichiometries, using a luciferase gene as reporter.
      Requirements for additional effectors such as chloroquine and peptide cofactors
      have also been considered. RESULTS: RAWA displays in vitro DNA condensing
      activity similar to that of protamines, reaching maximum effect at a peptide-to
      DNA molar charge ratio (CR) of 4 (+/-). The reduced membrane perturbing activity
      diminishes its cytotoxic potential. In COS-7 cells, transfection efficiency with
      RAWA peptiplexes, compares favorably with well-recognized systems, including
      Lipofectamine Plus, Superfect, GenePorter and FuGene. The peptide-associated
      activity between free and DNA-bound species has been mapped by analyzing
      dependency on chloroquine treatment. The lack of significant serum inhibition and
      low toxicity make this system advantageous for potential in vivo application. A
      ternary complex including the acid-triggered fusogenic JTS-1 peptide is presented
      as a potential strategy for further in vivo studies. CONCLUSIONS: We have
      developed a gene delivery system based on an amphipathic cationic peptide with
      improved DNA condensation ability and reduced cytotoxicity, which maintains
      membrane binding and perturbing activities. Observed efficiency with this
      molecule is very high and compares favorably with currently available
      transfection systems.

PMID- 11199267
TI  - Serum as a modulator of lipoplex-mediated gene transfection: dependence of
      amphiphile, cell type and complex stability.
AB  - BACKGROUND: Cationic liposomes belong to the family of non-viral vectors for gene
      delivery. Despite several drawbacks, such as low efficiency compared to viruses
      and inactivation by serum, cationic liposomes remain a promising tool for gene
      therapy. Therefore further investigation of the mechanism of transfection and
      improvement of formulations are warranted. METHOD: In a comparative study, we
      investigated the effect of serum on the ability of SAINT, a novel synthetic
      amphiphile, and Lipofectin to mediate transfection in vitro, employing a variety
      of cell lines. RESULTS: In all cell types, SAINT-mediated transfection was not
      significantly affected by the presence of serum, in contrast to Lipofectin
      mediated transfection. Intriguingly, the extent of complex association was
      enhanced in the presence of serum, while cell association of the Lipofectin
      complex was approximately two-fold higher than that of SAINT. These data imply
      that transfection efficiency and the amount of cell-associated complex are not
      related. However, when the helper lipid dioleoylphosphatidylethanolamine (DOPE)
      was substituted for cholesterol, SAINT-mediated transfection was reduced in the
      presence of serum. This indicates that lipoplex composition rather than the
      cationic lipid per se codetermines the effect of serum. Also, the presence of
      serum decreased cytotoxicity, while no correlation could be demonstrated between
      toxicity and transfection efficiency. The binding of serum proteins to either
      complex was identical, both in terms of protein identity and relative amounts.
      CONCLUSION: We propose that serum, in conjunction with cell-specific factors and
      lipoplex composition, determines complex (in)stability, which is crucial for
      effective gene delivery and expression.

PMID- 11199268
TI  - Role of endosomes in gene transfection mediated by photochemical internalisation
      (PCI).
AB  - BACKGROUND: Most non-viral gene therapy vectors deliver transgenes into cells
      through the endocytic pathway. Lack of escape from endocytic vesicles in many
      cases constitutes a major barrier for delivery of the functional gene. We have
      developed a new technology named photochemical internalisation (PCI) to achieve
      light-inducible cytosolic delivery of the transgene. The technology is based on a
      photochemical treatment employing photosensitisers localised in endocytic
      vesicles. In this work mechanisms involved in PCI-mediated transfection
      (photochemical transfection) were studied. METHODS: Human melanoma or colon
      carcinoma cells were pre-incubated with the photosensitiser aluminium
      phthalocyanine disulfonate (AlPcS2a) followed by treatment with plasmid encoding
      enhanced green fluorescent protein (EGFP) complexed with poly-L-lysine, N-(1-(2,3
      dioleoxyloxy)propyl)-N,N,N,-trimethylammonium-methyl-sulfate (DOTAP) or
      polyethylenimine (PEI) and light exposure. The expression of the EGFP-gene was
      scored by fluorescence microscopy and flow cytometry. RESULTS: The photochemical
      treatment using light doses corresponding to D50 substantially improves the
      efficiency of transfection mediated by poly-L-lysine and PEI, but not by DOTAP.
      The treatment does not enhance the delivery of the plasmid complex across the
      plasma membrane, since the amount of internalised plasmid is similar for
      irradiated and non-irradiated cells. Light-inducible transfection occurs only
      under temperature conditions allowing endocytic uptake and is not improved by
      chloroquine or ammonium chloride, but is inhibited by bafilomycin A1 (agents that
      increase vesicular pH and interfere with the endocytic transport). CONCLUSIONS:
      Photochemical transfection occurs through endocytosis, followed by cytosolic
      release of the transfecting DNA from photochemically permeabilised endocytic
      vesicles. Release of plasmid from early endosomes seems to be of importance in
      photochemical transfection, although a role of later endocytic vesicles can,
      however, not be ruled out.

PMID- 11199269
TI  - Alcohol, the brain, and behavior. Mechanisms of addiction.
AB  - The actions of alcohol that cause intoxication, initiate and maintain excessive
      drinking behavior, and promote relapse during abstinence occur primarily in the
      brain. A thorough understanding of alcohol's effects on the mechanisms underlying
      brain function is essential to develop and improve alcoholism prevention and
      treatment strategies. This article is not an exhaustive overview of alcoholism
      neurobiology, but a sampling of the more significant recent advances in the
      field.

PMID- 11199270
TI  - Why do some people drink too much? The role of genetic and psychosocial
      influences.
AB  - A sizable minority of the population abuses alcohol. Research has found that some
      vulnerability to developing alcohol-related problems is conveyed genetically, and
      animal research has indicated that inheritance can take many forms. Studies in
      mice have demonstrated that various individual genes or groups of genes can shape
      very distinct responses to alcohol. By identifying the proteins these genes
      encode and the mechanisms by which the genes influence an animal's biochemical
      response to alcohol, scientists can gain insight into the features of human
      alcoholism and provide a basis for developing pharmaceuticals that short-circuit
      these genetically defined processes.

PMID- 11199271
TI  - Medical consequences of alcohol abuse.
AB  - Studies have shown that long-term alcohol abuse produces serious, harmful effects
      on a variety of the body's organ systems. Parts of the human body most affected
      include the liver and the immune, cardiovascular, and skeletal systems. Current
      research has examined some of these effects in an effort to better understand the
      medical consequences of alcohol use and abuse and to ultimately develop more
      effective treatments for responding to alcohol-induced bodily damage. This
      article discusses some of those findings.

PMID- 11199272
TI  - Prenatal exposure to alcohol.
AB  - Maternal alcohol consumption during pregnancy can cause serious birth defects, of
      which fetal alcohol syndrome (FAS) is the most devastating. Recognizable by
      characteristic craniofacial abnormalities and growth deficiency, this condition
      includes severe alcohol-induced damage to the developing brain. FAS children
      experience deficits in intellectual functioning; difficulties in learning,
      memory, problem-solving, and attention; and difficulties with mental health and
      social interactions. An FAS diagnosis, however, fails to identify prenatal
      alcohol-exposed children who lack the characteristic facial defects and growth
      deficiency of FAS. Nonetheless, these often undiagnosed children may still
      experience serious fetal alcohol effects (FAE), including alcohol-induced mental
      impairments (i.e., alcohol-related neurodevelopment disorder) or alcohol-related
      abnormalities of the skeleton and certain organ systems (i.e., alcohol-related
      birth defects). Neuroimaging techniques can assist researchers in identifying FAE
      through precise pictures of brain abnormalities in persons prenatally exposed to
      alcohol. By understanding the mechanisms underlying FAE and the behavioral
      manifestations of the resulting structural brain damage, researchers can
      ultimately develop effective FAS prevention strategies that identify and assist
      high-risk women at varying levels of pregnancy.

PMID- 11199273
TI  - Latest approaches to preventing alcohol abuse and alcoholism.
AB  - Scientists and policymakers have explored numerous strategies to prevent alcohol
      abuse and dependence as well as the adverse social, legal, and medical
      consequences of alcohol use. Many of these efforts have focused on reducing
      alcohol-impaired driving and the associated injuries and fatalities. As reported
      in this article, such efforts have included general deterrence laws (e.g.,
      reduced minimum legal drinking age, administrative license revocation, and lower
      legal limits for blood alcohol concentrations), measures targeted at repeat
      offenders, and measures to control alcohol availability (e.g., increased taxes
      and decreased numbers of establishments selling alcohol).

PMID- 11199274
TI  - Health risks and benefits of alcohol consumption.
AB  - Alcohol consumption has consequences for the health and well-being of those who
      drink and, by extension, the lives of those around them. The research reviewed
      here represents a wide spectrum of approaches to understanding the risks and
      benefits of alcohol consumption. These research findings can help shape the
      efforts of communities to reduce the negative consequences of alcohol
      consumption, assist health practitioners in advising consumers, and help
      individuals make informed decisions about drinking.

PMID- 11199275
TI  - Research refines alcoholism treatment options.
AB  - Every day, more than 700,000 people in the United States receive treatment for
      alcoholism. In recent years, much progress has been made in understanding how
      both psychological approaches and medications can help these patients achieve
      sobriety, including evaluation of existing treatment approaches and development
      of new ones. Continued research to refine therapies for alcoholism will have
      widespread benefits for alcohol-dependent people, for their families, and for
      society as a whole, which bears the weight of the enormous economic and social
      costs of problem drinking. This article reviews the current state of alcoholism
      treatment research.

PMID- 11199276
TI  - Economic analysis aids alcohol research.
AB  - Economic research contributes to our understanding of alcohol use and the
      prevention and treatment of alcohol-related problems in several ways. This
      article reviews three areas in which the tools of economic analysis have produced
      significant insights in recent years. First, economic researchers have analyzed
      the effects of beverage prices and taxation on alcohol consumption and on adverse
      consequences associated with alcohol use. Second, analyses of the costs and cost
      effectiveness of treatment for alcohol use disorders have provided insight into
      the long-term costs and benefits of alternative approaches to alcoholism
      treatment. Finally, studies have incorporated economic techniques in estimating
      the overall magnitude of the burden placed on society by the misuse of alcoholic
      beverages.

PMID- 11199277
TI  - Animal models of alcohol withdrawal.
AB  - One diagnostic criterion of alcohol dependence is the appearance of a withdrawal
      syndrome when alcohol consumption ceases. Researchers have used various animal
      models, including isolated brain cells, slices of brain tissue, and intact
      animals, to study the mechanisms and manifestations of withdrawal. Results from
      these experimental studies have demonstrated that many consequences of withdrawal
      found in animals resemble those observed in humans. Such signs and symptoms of
      alcohol withdrawal include enhanced activity of the autonomic nervous system;
      body posture and motor abnormalities; hyperexcitability of the central nervous
      system, including sensory hyperreactivity; convulsions; anxiety; and
      psychological discomfort. Researchers also have used animal models to study the
      electrophysiological correlates of withdrawal, as well as neurobiological
      mechanisms underlying alcohol dependence and withdrawal.

PMID- 11199278
TI  - Modeling adolescent development and alcohol use in animals.
AB  - Though certain characteristics found in human adolescents are clearly unique,
      there are other key characteristics of this developmental stage that are common
      across a number of species. Animal models offer researchers unique insight into
      the effects of alcohol on the adolescent. This age period is particularly
      important for study, because this is the time during which many people first
      experiment with alcohol. It is possible that features of the adolescent brain may
      in fact predispose a youngster to behave in ways that place him or her at
      particular risk for experimenting with alcohol or other drugs. In addition to
      behavioral changes, a number of important physiological alterations occur during
      adolescence, including changes in brain regions implicated in modulating the
      reinforcing effects of alcohol and other drugs of abuse.

PMID- 11199279
TI  - Recent animal models of alcoholism.
AB  - Animal models on alcohol preference have a long-standing tradition in biomedical
      research on alcoholism. However, these models allow only limited conclusions
      regarding alcohol addiction. Therefore, during the past 15 years, researchers
      have developed new animal models that mimic different aspects of human alcohol
      addiction, such as craving, relapse, and loss of control over drinking. These
      models include the reinstatement model, the alcohol deprivation model, and the
      point-of-no-return model. Some of these models have been pharmacologically
      validated with anti-craving compounds that are used clinically for treating
      alcoholics. The detailed behavioral characterization of these new models and
      their pharmacological validation also allow researchers to study the
      neurochemical and molecular bases of addictive behavior.

PMID- 11199280
TI  - An economic approach to animal models of alcoholism.
AB  - Researchers have long sought an animal model for human alcohol consumption. This
      article describes an economic-based approach to a model of alcohol preference in
      rats. The procedures are based on an analogy between clinical accounts of human
      drinking and the economic analysis of consumption. Both clinical and economic
      investigators typically define consumption patterns in terms of the influence of
      negative consequences. For example, the clinical account emphasizes the
      persistence of heavy drinking despite mounting alcohol-related aversive
      consequences, and in economic analyses, the term "inelastic demand" is used to
      refer to the persistence of consumption despite large increases in prices. In the
      experimental procedure described here, rats worked for alcohol and food. Presses
      on one lever earned a drink of 10 percent alcohol plus saccharin, and presses on
      a second lever earned isocaloric drinks of a starch solution. After behavior
      stabilized, the response requirements (which are analogous to prices) for one or
      both drinks were increased. The rats maintained baseline alcohol consumption
      levels despite large increases in the "price" of alcohol. In contrast, the same
      price increases markedly reduced starch intake. That is, food consumption was
      sensitive to price hikes, but alcohol consumption was not. The results
      demonstrate that a common economic framework can be used to describe human and
      animal behavior and, hence, the possibility of an animal model of human alcohol
      consumption. The article also points out that economic concepts provide a
      framework for understanding a wide range of human drinking patterns, including
      controlled social drinking and excessive alcoholic drinking.

PMID- 11199281
TI  - Animal models in alcohol research.
AB  - Animal models are important tools in the study of alcohol use, abuse, and
      dependence because they allow researchers to use methods that cannot be used with
      human subjects. Animal models have been developed to study various aspects of
      alcohol use and dependence, including alcohol-seeking behavior, alcohol-related
      organ damage, tolerance to alcohol, and physical dependence on alcohol. Because
      animal models can be genetically manipulated, they are also valuable for research
      into the genetic determinants of alcoholism. Issues surrounding the use of animal
      models in alcohol research include the species of animal used, the method of
      alcohol administration, and the model's face and predictive validity.

PMID- 11199282
TI  - Animal models of alcohol's motivational effects.
AB  - Alcohol's positive and negative motivational effects are believed to be important
      influences on alcohol-seeking behavior and, therefore, key factors among the many
      and varied causes of alcohol abuse and dependence. Alcohol's positive effects,
      such as enhanced mood, and negative effects, such as hangover, are considered
      important factors in motivating drinkers to increase or decrease their drinking.
      Scientists have developed a variety of animal behavioral models to study
      alcohol's motivational effects. These models include "self-administration
      models," in which the animal controls the exposure to alcohol, and "conditioning
      models," in which the researcher controls the animal's exposure to alcohol. Such
      models have been used to study the influence of genetic differences on
      sensitivity to alcohol's positive and negative motivational effects, the brain
      mechanisms underlying alcohol's motivational effects, as well as relapse and
      craving.

PMID- 11199283
TI  - Modeling alcohol's effects on organs in animal models.
AB  - Researchers have developed numerous animal models to investigate the development
      of various alcohol-related diseases. Such models have provided insights into the
      mechanism through which alcohol can induce liver damage. Animal models also have
      helped researchers explore the mechanisms by which both short-term (e.g., binge)
      and long-term drinking can interfere with the function of the heart, a condition
      referred to as alcoholic cardiomyopathy. Furthermore, animal models have provided
      substantial information on the causes of fetal alcohol syndrome. Such models have
      demonstrated that exposure to alcohol during gestation can lead to prenatal and
      postnatal growth retardation, characteristic facial malformations, immune system
      deficiencies, and alterations in the central nervous system.

PMID- 11199284
TI  - Animal models of psychiatric disorders and their relevance to alcoholism.
AB  - Animal models are important tools in the study of psychiatric disorders,
      including alcoholism, because they allow the use of research methods that cannot
      be used for ethical reasons in humans. Consequently, scientists have developed
      numerous approaches to evaluate the validity and reliability of animal models for
      studying human behavior and human disorders. Researchers have developed animal
      models of schizophrenia, fear and anxiety, depression, and alcoholism, all of
      which are being used to study the relationship between alcoholism and co
      occurring psychiatric disorders. These models may help researchers and clinicians
      determine how best to treat patients with alcoholism and co-occurring psychiatric
      disorders.

PMID- 11199285
TI  - Selected lines and inbred strains. Tools in the hunt for the genes involved in
      alcoholism.
AB  - In their quest to elucidate the genetic influences contributing to alcoholism,
      researchers have long used selected lines and inbred strains of rodents. Selected
      lines are obtained by repeatedly mating those animals within a population that
      show extremely high or low values of the desired trait. Inbred strains are
      generated by mating male and female siblings, irrespective of any particular
      trait, over several generations. Both of these approaches have provided
      researchers with extensive knowledge about the genetic and neurobiological
      mechanisms contributing to alcohol-related traits. However, the use of these
      models is associated with some limitations, mostly resulting from the inbreeding
      involved in generating such lines and strains. Nevertheless, these models can
      offer some advantages over other genetic approaches, such as the analysis of
      quantitative trait loci or the generation of transgenic and knockout mice.

PMID- 11199286
TI  - The candidate gene approach.
AB  - Alcoholism has a significant genetic basis, and identifying genes that confer a
      susceptibility to alcoholism will aid clinicians in preventing and effectively
      treating the disease. One commonly used technique to identify genetic risk
      factors for complex disorders such as alcoholism is the candidate gene approach,
      which directly tests the effects of genetic variants of a potentially
      contributing gene in an association study. These studies, which may include
      members of an affected family or unrelated cases and controls, can be performed
      relatively quickly and inexpensively and may allow identification of genes with
      small effects. However, the candidate gene approach is limited by how much is
      known of the biology of the disease being investigated. As researchers identify
      potential candidate genes using animal studies or linking them to DNA regions
      implicated through other analyses, the candidate gene approach will continue to
      be commonly used.

PMID- 11199287
TI  - Quantitative trait locus analysis.
AB  - Alcoholism is a quantitative disorder that is caused by the combined influences
      of numerous genes (i.e., quantitative trait loci [QTLs]) and environmental
      factors. To identify QTLs for alcoholism, researchers compare subject groups
      (e.g., inbred mouse strains) that differ in both their genetic makeup (i.e.,
      genotype) and alcohol-related trait (e.g., sensitivity to certain alcohol
      effects). Using statistical tests one can then determine whether a specific gene
      or DNA region contributes to the trait of interest. This strategy requires that
      the relevant gene exists in several variants (i.e., is polymorphic). To conduct
      such QTL analyses, researchers study either a large population of mice that all
      differ in their genotypes or compare several strains, each of which has a fixed
      genotype. However, QTL analyses still have several limitations. Nevertheless,
      such studies already have identified several DNA regions and genes that may
      affect the response to alcohol and thus may contribute to the risk for
      alcoholism.

PMID- 11199288
TI  - Applications of transgenic and knockout mice in alcohol research.
AB  - Multiple genetic and environmental factors contribute to the development of
      alcoholism. Researchers attempting to elucidate the roles of specific genes in
      alcoholism risk have benefited from advances in genetic engineering. Two
      important tools used by researchers include transgenic mice, in which a foreign
      gene is integrated into an animal's genetic material, and knockout/knock-in mice,
      in which targeted genes either are rendered nonfunctional or are altered. Both of
      these animal models are currently used in alcohol research to determine how genes
      may influence the development of alcoholism in humans.

PMID- 11199289
TI  - Genetics of alcohol-induced behaviors in Drosophila.
AB  - Researchers frequently study the fruit fly Drosophila melanogaster as a model
      system for mammalian development and behavior. Drosophila appear resistant to
      alcohol's toxic effects and display many behaviors resembling intoxication (e.g.,
      impaired motor control) when exposed to alcohol vapors. Accordingly,
      investigators have begun to measure alcohol sensitivity in Drosophila and to
      identify genetic mutations associated with increased or decreased sensitivity.
      One mutant called cheapdate affects a signaling system that plays a role in many
      regulatory processes in a cell and which involves the compound cyclic adenosine
      monophosphate (cAMP). Additional Drosophila mutants with altered alcohol
      sensitivity carry mutations in other components of the cAMP signaling system.
      Because the cAMP system also is affected in human alcoholics, these results
      indicate that studies using Drosophila as a model system may identify genetic
      changes relevant to human alcoholism.

PMID- 11199290
TI  - Future directions in alcoholism research. Genomics and gene transfer.
AB  - Alcohol affects the process by which genes direct the synthesis of proteins
      (i.e., expression). Therefore, patterns of gene expression in the presence of
      alcohol can help scientists identify the specific molecular sites of alcohol's
      actions within the brain. New technologies can detect and quantify changes in the
      expression of thousands of genes simultaneously by scanning microscopic gene
      arrays applied to glass or silicon chips an inch or so square. However, genes
      whose activity is altered in the presence of alcohol may either be contributing
      to alcoholism development or may be reacting to alcohol's presence. This question
      can be researched by observing the effects of manipulating the level of specific
      gene products. One way to accomplish this end is by means of viruses that have
      been engineered to express a specific gene in infected cells. This technique has
      been applied successfully in studying addictive behaviors. It is suggested that
      patterns of gene expression may become a diagnostic tool, with different disease
      states being characterized by distinct expression profiles.

PMID- 11199291
TI  - Hyperbaric oxygen therapy in acute necrotizing infections with a special
      reference to the effects on tissue gas tensions.
AB  - Clostridial gas gangrene and perineal necrotizing fasciitis or Fournier's
      gangrene are rare but serious infections with an acute onset, rapid progression,
      systemic toxemia and a high mortality rate. The aim of this study was to
      investigate the efficacy of surgery, antibiotic treatment, surgical intensive
      care and in particular the role of hyperbaric oxygen (HBO) in the management of
      these infections. An experimental rat model was used to investigate the
      possibilities for measuring tissue oxygen and carbon dioxide tensions during
      hyperbaric oxygen treatment. In addition to this preliminary experimental study,
      Silastic tube tonometer and capillary sampling techniques were tested to measure
      the effect of hyperbaric oxygen treatment on subcutaneous oxygen and carbon
      dioxide tensions in patients with necrotizing fasciitis and healthy controls.
      Between January 1971 and April 1997, 53 patients with Clostridial gas gangrene
      were treated in the Department of Surgery, University of Turku. The patients
      underwent surgical debridement, broad spectrum antibiotic therapy and a series of
      hyperbaric oxygen treatments at 2.5 atmospheres absolute pressure (ATA). Twelve
      patients died (22.6%). Hyperbaric oxygen therapy in gas gangrene seems to be life
      , limb- and tissue saving. Early diagnosis remains essential. Patient survival
      can be improved if the disease is recognized early and appropriate therapy
      instituted promptly. Between February 1971 and September 1996, 33 patients with
      perineal necrotizing fasciitis were treated in the Department of Surgery,
      University of Turku. The management included surgical debridement of the necrotic
      tissue with incisions and drainage of the involved areas, antibiotic therapy,
      hyperbaric oxygen treatment at 2.5 ATA pressure and surgical intensive care.
      Three patients died giving a mortality rate of 9.1%. The survivors received
      hyperbaric oxygen therapy for 2-12 times. Our results indicate that hyperbaric
      oxygenation is an important therapeutic adjunct in the treatment of Fournier's
      gangrene. Electrical equipment should not be used unsheltered in a hyperbaric
      chamber due to the increased risk of fire. The subcutaneous tissue gas tensions
      of rats were therefore measured using a subcutaneously implanted Silastic tube
      tonometer and a capillary sampling technique. The method was successfully adapted
      to hyperbaric conditions. The subcutaneous oxygen tension levels increased five
      fold and the carbon dioxide tension levels two fold compared to initial levels.
      The PO2 and PCO2 of subcutaneous tissue and arterial blood were measured directly
      in six patients with necrotizing fasciitis and three healthy volunteers in
      normobaric conditions and during hyperbaric oxygen exposure at 2.5 ATA pressure.
      The measurements were carried out in healthy tissue and at the same time in the
      vicinity of the infected area of the patients. During HBO at 2.5 ATA subcutaneous
      oxygen tensions increased several fold from baseline values and carbon dioxide
      tensions also increased, but to a lesser degree in both healthy and infected
      tissues. When examining the subcutaneous PO2 levels measured from patients with
      necrotizing fasciitis, the PO2 was regularly higher in the vicinity of the
      infected area than in healthy tissue. In general, HBO treatment resulted in a
      marked increase in tissue oxygenation in both healthy tissue and in the vicinity
      of infected tissue. The hyper-oxygenated tissue zone surrounding the infected
      area may be of significance in preventing the extension of invading
      microorganisms.

PMID- 11199292
TI  - [Bullet injury of the bladder. In the novel "La Regenta" by Leopoldo Alas
      "Clarin"].
AB  - Some great literature works show medical pictures of high historical value. In
      "La Regenta", by Leopoldo Alas Clarin (1852-1901), considered the best XIX
      century Spanish novel and one of the most important of the whole Spanish
      literature, there is a faithful account of a bullet wound of the bladder: the
      possibility of making the diagnosis, the complications and inevitable poor
      prognosis are depicted, since in the story the wound is followed by peritonitis
      and death of the wounded character, with the attending doctors rejecting a
      transfer to the hospital or a surgical intervention. This episode reminds us of
      an important chapter in the History of Surgery and Urology: the diagnosis of
      trauma wounds of the urinary tract, based over a long time on the data provided
      by urethral catheterisation; and the treatment of penetrating abdominal wounds in
      general, a matter of discussion between partisans and detractors of surgical
      exploration, that had a high mortality until well into the XX-century, when
      modern means of vital support, anaesthesia and antiseptics were on hand.

PMID- 11199293
TI  - [Effect of the neuropeptides bombesin and calcitonin on the growth of prostate
      cell lines, PC-3, DU 145, and LNCaP].
AB  - Neuroendocrine cells are present in normal and tumoral prostate tissue, the
      neuropeptides secreted by this cells have a biological functions that have not
      been fully elucidated. The presence of neuroendocrine cells in prostatic
      carcinoma have been shown to increase tumor progression. We characterized the in
      vitro proliferative influence of bombesin and calcitonin in androgen-insensitive,
      PC-3 and DU-145, and androgen-sensitive, LNCaP, cell lines of human prostate
      cancers. The influence of these neuropeptides on proliferation were assessed
      using the colorimetric XTT assay and by cells counts with a hemocytometer. The
      growth of PC-3 and DU-145 cell lines is stimulated by bombesin and calcitonin but
      exerted any stimulatory effect on the proliferation of the LNCaP cell line. This
      indicate that bombesin and calcitonin can modulate proliferation of androgen
      insensitive human prostate cell lines "in vitro" and may be potential paracrine
      growth promoters in stablished androgen irresponsive human prostatic carcinoma
      cells.

PMID- 11199294
TI  - [DNA ploidy determination with flow cytometry, Ki-67 index, and overexpression of
      p53 protein in 121 T1 superficial bladder carcinoma. Retrospective study.
      Correlation with classic variables].
AB  - OBJECTIVE: Observe the correlation between Ki-67 label index, p53 expression and
      flow cytometry-DNA ploidy with the classic variables (grade, lymphatic
      permeation, multiplicity, volume, primary). MATERIAL AND METHOD: 121 superficial
      bladder tumors T1. 10% Cut-off level for Ki-67 and p53. Aneuploidy is defined as
      a tumor with DNA index different of 1 or more than 20% in G2-M phase. RESULTS:
      Statistical correlation with grade and lymphatic permeation. Ki-67 label index
      and p53 expression can distinguish between G1, G2 vs G3 and Lx, L0 vs. L1. The
      volume correlates with positivity to p53. CONCLUSIONS: Aneuploidy and positivity
      to Ki-67 and p53 increase with grade and lymphatic permeation.

PMID- 11199295
TI  - [Test with intracavernous injection of PGE1 in erectile dysfunction: our
      experience].
AB  - OBJECTIVES: To evaluate the answer and side-effects after the test of
      intracavernous injection of prostaglandin E1 in patients with erectile
      dysfunction. MATERIAL AND METHOD: In the last three years we have carried on 500
      tests of intracavernous injection of prostaglandin E1 with the support of
      infirmary. The purpose was to train the patient and his partner on this
      technique. RESULTS: The more frequent cause of erectile dysfunction turned to
      have a vascular origin. In most of the cases, once that the technique has been
      learnt, the intracavernous injection has been carried on by the patient. The
      level of acceptance has reached a 85%, with a very low rate of complications.
      According with our protocol, the learning process has required of a media of 2 or
      3 visits where the couple has been trained on this technique and the optim
      individual dose has been set. CONCLUSION: The intracavernous injection test
      carried on by an erectile dysfunction unit with the support of an infirmary team
      reach a high level of acceptance and efficiency. Although new medicine has
      appeared, we considered the objectification test of the erection with PGE1 very
      useful, easy-to-use and with low complication rate. It can also be used as a
      therapeutical option.

PMID- 11199296
TI  - [Determining factors in the presence of carcinoma in prostate biopsies].
AB  - PURPOSE: Prostate biopsy is the diagnostic method to detect prostate carcinoma.
      We try to identify the optimal PSA cut-off, biopsy indication and the clinico
      pathological characteristics in order to differentiate those patients with
      negative biopsy in which we should repeat the proceeding. METHOD: We study 344
      biopsies in 292 patients for 16 months. An univariate and multivariate study to
      identify the influent factors in the existence of prostate cancer in the first
      biopsy and in the patients with a second one was taken place. RESULTS: Patients
      in the first biopsy Univariate study: Out of these variables (PSA, PSA ratio,
      digital rectal examination and prostate volume) just the PSA has statistical
      significance. Multivariate study: Only the the PSA is an indepent influence
      factor. Receiving Operated Curve: The optimal cut-off is 10.5 ng/ml. Patients
      with a second biopsy Univariate study: None of the variables is related with the
      existence of prostate cancer. Groups comparison: A comparison between the
      patients in the first biopsy and the patients with a second biopsy is performance
      with no statistical differences in the variables already mentioned. CONCLUSION:
      The patient with a PSA greater than 4 ng/ml should be perform a prostate biopsy,
      mostly if his PSA is over 10 ng/ml. In our experience we do not related the need
      of a second biopsy with any factor in particular, therefore in our opinion and
      because of the high rate of negative false, all of the patients should be
      controlled and undergo a second biopsy if any change in PSA or clinics
      modification takes place.

PMID- 11199297
TI  - [Subepithelial hemorrhage of renal pelvis (Antopol-Goldman lesion). Report of 4
      cases and review of the literature].
AB  - OBJECTIVES: The subepithelial hematoma of renal pelvis (Lesion of Antopol
      Goldman) is a rare entity that preferably is diagnosed clinically as a neoplasic
      lesion. METHODS: We present four new cases of subepithelial hematoma of renal
      pelvis diagnosed in our hospital from 1989. RESULTS: Our cases presented
      clinically with hematuria and flanc pain, preferably in the left side (3 out of
      4). After nephrectomy, all the cases showed a subepithelial hematoma of variable
      extension that can occupy the renal pelvis and calices, associated to
      hidronefrosis, cortical infartion, renomegaly or renal angioma. Additionally, two
      of our patients presented with dilation of the pielocalicial system, and a third
      one presented with urotelial carcinoma of the ureter, being therefore the lesion
      of Antopol-Goldman an incidental discovery. In the remaining case, the presence
      of multiple renal hemangiomas was identified as cause of the renal pelvic
      hematoma. CONCLUSIONS: The preoperatore diagnosis of the lesion of Antopol
      Goldman is difficult although it should be included as differential diagnosis in
      those cases with hematuria and alterations of renal pelvis in the image
      techniques, because an early diagnosis could imply a conservative treatment with
      pieloplastia or partial nephrectomy.

PMID- 11199299
TI  - [Spontaneous extraperitoneal bladder perforation caused by bladder carcinoma].
AB  - We show a case of spontaneous extraperitoneal vesical perforation due to presence
      of a bladder cancer with urotelial origin.

PMID- 11199298
TI  - [Conservative treatment of germ cell tumor of the testis].
AB  - Testis germ cell tumor is the most frequent cancer in men between 15 and 35 years
      old. The therapeutic results of radical orchiectomy and chemotherapy reaches 90%
      free disease survival al the present time. This great chemosensibility is opening
      new doors to alternative therapeutic options, directed to preserve the sufficient
      amount of tissue to avoid the problems derived from testicular insufficiency.
      Such alternatives are clearly beneficial in bilateral germinal tumors or in
      solitary testis. In this article we describe a case of seminoma developed in a
      solitary functional testis managed in a conservative approach: organ preserving
      surgery and surveillance. We analyzed the indications and international results
      of such approach based on the best evidences now available.

PMID- 11199300
TI  - [Spontaneous autoembolization in a child with high-flow post-traumatic priapism].
AB  - There are two sort of priapism: the venous or low flow priapism, that is usually
      painful, and the arterial or high flow one, painless and rare, especially in
      childhood. We present a case of a boy 5 years old, who 6 days after to suffer a
      perineal closed traumatism, had a painless and arterial priapism, with aneurism
      and fistula of the dorsal penile arteria, that was resolute spontaneously through
      self-embolization, 11 days after. We review the bibliography of 14 cases of
      arterial posttraumatic priapism in childhood, without find any case resolute by
      spontaneous self-embolization.

PMID- 11199301
TI  - [Ultrasonographic diagnosis of massive bladder hernia at the inguinoscrotal
      level: report of a case].
AB  - We present a case of massive inguinoscrotal bladder hernia in a 58 years-old man
      with a left inguinal hernia. It was diagnosed by ultrasound during evaluation of
      a mass in the left inguinal region extending to the scrotum. Cystography later
      confirmed the ultrasound findings but provided no new information. Although
      filling cystography is considered to be the gold-standard radiological diagnostic
      procedure for this entity I the use of ultrasound should not be discarded.
      Firstly I because direct and indirect ultrasonographics signs characterising
      inguinal bladder hernias have been reported, and secondly I to help in the
      differential diagnosis of a scrotal mass.

PMID- 11199302
TI  - [Cobb's collar. Unusual cause of hematuria].
AB  - The Cobb's collar is a congenital narrowing of the bulbar urethra with variable
      clinical presentation and obstruction grade. Herein we report a clinical case of
      a 13-year-old boy presenting terminal macroscopic haematuria and post-mictional
      urethral bleeding. At cystoscopy a membrane on the bulbar urethra distal to the
      external sphincter and prominent vessels in the prostatic urethra were found.
      Transurethral endoscopic incision was carried out with no complications or
      recurrence at 9-month follow-up. The authors briefly review the
      embryopathogenesis, clinical features and treatment of this uncommon anomaly.

PMID- 11199303
TI  - [Testicular microlithiasis. Clinical significance and therapeutic implications].
AB  - Testicular microlithiasis is a rare condition usually diagnosed by scrotal
      ultrasound and associated with pathology of the testis. We report two pediatric
      cases presented with acute scrotum. Testicular sonography revealed significant
      bilateral testicular microlithiasis. One case was diagnosed as having torsion of
      the right testis and the other case as orchiepididymitis. A careful review of the
      literature is made and a periodic follow-up of this disease is advocated.

PMID- 11199304
TI  - [Massive lymphatic involvement secondary to prostatic adenocarcinoma].
AB  - Prostatic carcinoma may be diagnosed by the clinic manifestations or by the
      symptoms for locoregional disemination and distance metastasis. The lymphatic
      system is the first metastatic station, which is affected in a high percentage of
      cases. Event it may simulate lymphoproliferatives process and it si uncommon the
      lymphatic macroaffectation at first. In theses cases, the histologic and
      immunohistochemical study by the determination of prostatic specific antigen in
      lymph nodes can provice the diagnosis. Treatment of these tumors is palliative
      with hormonotherapy. Prognosis is bad with a low survival at five years.

PMID- 11199305
TI  - [Trazodone-induced priapism].
AB  - We present a 41 years old male, treated with trazodone because of depression. He
      was seen at our Andrology unit for a 72 hours evolutioned priapism. We review the
      literature and submit this paper for publication because it is an uncommon
      pathology.

PMID- 11199306
TI  - [Fibroepithelial polyp in distal ureter].

PMID- 11199307
TI  - Carbon coated polyethylene: effect of surface energetics and topography on human
      platelet adhesion.
AB  - The influence of surface energy and structural properties of carbon coated
      polyethylene (PE) on the human platelet adhesion was studied. Three types of
      amorphous carbon coating were obtained by plasma pulse discharge, with the number
      of pulses grading as 10, 50, 100. Human serum albumin adsorption experiments have
      been carried out with all samples in vitro. Platelet adhesion analysis by SEM
      included determination of total quantity of adherent platelets, and respective
      quantities of platelets at different stages of activation (single, spread,
      aggregates). Surface topographies ranged from bare PE and such (10 pulses), to
      globular 0.5 microm in size (50 pulses), and complex fibrillar 3-4 microm
      structures (100 pulses). Surface free energy varies from 31.7 +/- 0.6 to 40.4 +/-
      0.6 mN/m for uncoated PE and 10 pulse coatings, respectively, as determined by
      contact angle techniques. All studied coatings demonstrate weaker platelet
      activation properties in comparison with untreated PE. Among all studied
      coatings, the 50 pulse coated surface seems to be the least suitable for contact
      with platelets, mainly due to its structural rather than to its energy
      properties. These data are related to a sharp decrease in the adsorbed protein
      level for the samples with 50 pulse coatings. The applied analysis of platelet
      activation enables more accurate characterization of platelet-biomaterial
      interaction.

PMID- 11199308
TI  - Investigation on the ability of an ultrasound bubble detector to deliver size
      measurements of gaseous bubbles in fluid lines by using a glass bead model.
AB  - Detectors based on ultrasonic principles are today's state of the art devices to
      detect gaseous bubbles that may be present in extracorporeal circuits (ECC) for
      various reasons. Referring to theoretical considerations and other studies, it
      also seems possible to use this technology to measure the size of detected
      bubbles, thus offering the chance to evaluate their potential hazardous effect if
      introduced into a patient's circulation. Based on these considerations, a
      commercially available ultrasound bubble detector has been developed by Hatteland
      Instrumentering, Norway, to deliver bubble size measurements by means of
      supplementary software. This device consists of an ultrasound sensor that can be
      clamped onto the ECC tubing, and the necessary electronic equipment to amplify
      and rectify the received signals. It is supplemented by software that processes
      these signals and presents them as specific data. On the basis of our knowledge
      and experience with bubble detection by ultrasound technology, we believe it is
      particularly difficult to meet all the requirements for size measurements,
      especially if these are to be achieved by using a mathematical procedure rather
      than exact devices. Therefore, we tried to evaluate the quality of the offered
      bubble detector in measuring bubble sizes. After establishing a standardized test
      stand, including a roller pump and a temperature sensor, we performed several
      sets of experiments using the manufacturers software and a program specifically
      designed at our department for this purpose. The first set revealed that the
      manufacturer's recommended calibration material did not meet essential
      requirements as established by other authors. Having solved that problem, we
      could actually demonstrate that the ultrasonic field, as generated by the bubble
      detector, has been correctly calculated by the manufacturer. Simply, it is a
      field having the strongest reflecting region in the center, subsequently losing
      strength toward the ECC tubing's edge. The following set of experiments revealed
      that the supplementary software not only does not compensate for the ultrasonic
      field's inhomogeneity, but, furthermore, delivers results that are inappropriate
      to the applied calibration material. In the last set of experiments, we were able
      to demonstrate that the signals as recorded by the bubble detector heavily depend
      upon the circulating fluid's temperature, a fact that the manufacturer does not
      address. Therefore, it seems impossible to resolve all these sensor related
      problems by ever-increasing mathematical intervention. We believe it is more
      appropriate to develop a new kind of ultrasound device, free of these
      shortcomings. This seems to be particularly useful, because the problem of
      determining the size of gaseous bubbles in ECC is not yet solved.

PMID- 11199309
TI  - The LPD-II: a modified locked percutaneous device that permits safe subcutaneous
      access.
AB  - A locked percutaneous device, the LPD-I (previously described as LPD), is
      effective in overcoming the problems of skin downgrowth and local tissue
      infection; however, it can only be implanted at a site providing adequate
      subcutaneous adipose tissue to attach to the subcutaneous connector of the LPD-I.
      A modified device, the LPD-II, has been developed that has a thin dome and skin
      connector but does not have a subcutaneous tissue connector. In addition, a newly
      designed structure called the skin stop collar (SSC) has been developed. It is
      positioned just beneath the mesh collar described in the LPD-I to further improve
      the function of the LPD-II. Six rabbits were implanted with one LPD-II without
      the SSC (group 1) and five rabbits were implanted with one LPD-II with the SSC
      (group 2). For more than 6 months, two of the implants in group 1 rabbits were
      successful. Four of the implants in group 2 rabbits were successful for more than
      1 year. One of the animals in group 2 died of causes unrelated to the device. We
      conclude the following: the mesh collar skin connector can function well as a
      locked percutaneous device without the subcutaneous tissue connector; the LPD-II
      can be implanted in any site and does not require the presence of subcutaneous
      adipose tissue; and the SSC may increase the success rate of LPD-II implantation
      provided the mesh collar is made of soft material.

PMID- 11199310
TI  - Altruism and the volunteer: psychological benefits from participating as a
      research subject.
AB  - Psychiatric assessment of potential volunteers for hazardous biomedical
      experimentation should include an assessment of the motivations underlying the
      altruistic action of volunteering. Screening goals include evaluation of informed
      consent as well as screening out experimental subjects who would be likely to be
      psychologically harmed by participation. This discussion of psychological issues
      to be considered, beyond those of informed consent and screening for severe
      psychopathology, originated in the psychiatric screening of the small group of
      original volunteers for the "Dobelle eye" Artificial Vision Project. These
      individuals entered the project over 20 years ago at a time when they could
      expect no tangible benefit from participation. Superficially altruistic behavior,
      such as volunteering for this project, serves multiple psychological functions
      and in a given clinical case, the determinants are often complex. A spectrum of
      altruistic behavior is suggested, based on interviews with these original
      subjects as well as from extensive evaluation of patients studied in the setting
      of psychoanalytic treatment with one of the authors (B.J.S.). We suggest that
      adaptive altruism can explain the finding that some volunteers gained actual
      psychological benefit from their participation. This unanticipated finding, that
      participating in research as an experimental subject can result in lasting
      improvement in self-esteem, is discussed. Suggestions are made for increasing the
      likelihood of such benefit. Ethical ramifications are addressed.

PMID- 11199311
TI  - Survival of prosthetic grafts of different materials after impairment of a native
      arteriovenous fistula in hemodialysis patients.
AB  - In our department, hemodialysis vascular accesses with graft, are used in
      patients with impairment of native distal and proximal arteriovenous fistulas
      (AVF-E). The aim of this study was to compare the survival of grafts of different
      materials (PTFE vs. bovine vein) in these patients. From 1991 to 1999, we
      prospectively evaluated 53 patients (35 women, 18 men, age 68 +/- 11 years, on
      dialysis for 70 +/- 65 months). Fifty-three PTFE, 10 reinforced PTFE, and 22
      bovine vein grafts were placed. We evaluated the primary patency (PP) (days
      between fistula placement and the last dialysis before thrombosis occurred) and
      the secondary patency (SP) (days between fistula placement and the last dialysis
      treatment before it was considered lost) by separating PTFE survival from that of
      bovine veins. In the same patients, we also evaluated the survival of the native
      arteriovenous fistulas (AVF-E) during the pregraft period. Furthermore, we
      evaluated 404 patients (172 women, 232 men, age 65 +/- 14 years, on dialysis for
      50 +/- 53 months) in whom only AVF-E were placed during the same follow-up
      period. Graft and AVF-E survival were calculated according to the Kaplan-Meier
      method. In patients with grafts, the PP at 1 year was 17.4% for PTFE and 23.9%
      for bovine veins. At 12 months, the SP of bovine veins was significantly higher
      than that of PTFE (81,9% vs. 50%, p < 0.04). In the patients who only had AVF-E,
      the PP and SP was, respectively, 43% at 12 months and 52.4% at 50 months. A
      preliminary experience in 22 patients with a 20 month follow-up confirms better
      survival of bovine veins than PTFE (p < 0.04).

PMID- 11199312
TI  - Anatomic study of the pulmonary artery as a conduit for an artificial lung.
AB  - Our group is developing an artificial lung as a bridge to transplant. We
      evaluated the sheep pulmonary artery (PA) for the presence or absence of a
      septum, which may increase PA resistance and affect artificial lung flow. We also
      measured the PA size to determine whether it is a suitable conduit for artificial
      lung implantation using a PA-PA shunt. Adult Suffolk ewes in two groups were
      studied. Group 1 consisted of animals (n = 12, 30-43 kg) prepared for
      thoracotomy. Group 2 (n = 21, 30-43 kg) consisted of postmortem dissections. In
      both groups, the length and girth of the PA was measured. The heart and lungs
      were removed on all postmortem animals (group 2), the ductus arteriosum was
      crosscut, and the common PA was incised. The average length of the PA in live
      animals was 5.5 cm and the average diameter was 2.2 cm. The average length of the
      PA in postmortem animals was 4.8 cm and the average diameter was 2.0 cm. All
      pulmonary arteries were aseptate, and the ligamentum arteriosum in each PA was
      not patent. We conclude that the PA is not a source of increased resistance and
      is a suitable conduit for artificial lung implantation in the PA-PA
      configuration.

PMID- 11199314
TI  - Perfusion with lipopolysaccharide negative blood eliminates lipopolysaccharide
      induced lung injury.
AB  - We investigated whether perfusion with control blood improves pulmonary functions
      compromised by lipopolysaccharide (LPS) infusion. This was an animal study in a
      research laboratory at a university hospital by using Sprague-Dawley rats (n =
      19), each weighing 325 to 350 g. All animals were pretreated with a 24 hour
      infusion of either LPS (5 mg/kg) or vehicle, after which, excised lungs were
      reperfused for 2 hours with either LPS+ or control blood. Three groups were
      studied: (1) group S (n = 6); LPS pretreated lungs reperfused with LPS containing
      blood to mimic persistent sepsis, (2) group N (n = 6); LPS pretreated lungs
      reperfused with control blood to mimic the removal of the septic blood
      components, and (3) group C (n = 7); vehicle pretreated lungs reperfused with
      normal blood as a control. Blood gas exchange, shunt fraction (Qs/Qt), alveolar
      arterial oxygen gradient (A-aDO2), and variables for lung mechanics were
      measured. Leukosequestration was quantified with a myeloperoxidase (MPO) assay.
      The PO2 (mm Hg) values at 90 min after reperfusion in groups S, N, and C were
      67.8 +/- 7.0*, 85.2 +/- 9.2, and 90.1 +/- 7.5, respectively (*p < 0.05; vs. group
      N and C). In addition to PO2, A-aDO2 and Qs/Qt significantly deteriorated in
      group S. MPO activity in the lungs after LPS infusion was significantly higher
      than that after vehicle infusion (1.7 +/- 0.3 vs. 0.12 +/- 0.04 units/g tissue; p
      < 0.001). Subsequent reperfusion with LPS+ blood (group S) increased MPO activity
      to 3.1 +/- 0.6 (p < 0.05), but reperfusion with normal blood (group N) caused a
      significant decrease to 1.1 +/- 0.2 (p < 0.05). MPO activity in group C did not
      significantly change compared with those after vehicle infusion. Reperfusion with
      control blood normalized lung function compromised by pretreatment with LPS and
      significantly reduced leukosequestration. These results favor the possibility
      that the removal of LPS+ blood components may eliminate septic lung injury.

PMID- 11199313
TI  - Comparison of three commercially available hollow fiber oxygenators: gas transfer
      performance and biocompatibility.
AB  - The new generation of oxygenators have improved blood flow pathways that enable
      reduction in priming volume and, thus, hemodilution during cardiopulmonary bypass
      (CPB). We evaluated three oxygenators and two sizes of venous reservoirs in
      relation to priming volume, gas transfer, and blood activation. To compare
      priming volume, gas transfer, and biocompatibility of three hollow fiber
      oxygenators and two different size venous reservoirs, 60 patients were randomly
      allocated in groups to undergo cardiopulmonary bypass. In each group, an
      oxygenator with a different surface area and priming volume was used: 1.8 m2 and
      220 ml (group 1, n = 23), 2.2 m2 and 290 ml (group 2, n = 20), and 2.5 m2 and 270
      ml (group 3, n = 17). In groups 1 and 3, a large soft shell (1900 ml) venous
      reservoir was used, whereas in group 2, a smaller soft shell (600 ml) venous
      reservoir was used. Gas transfer was assessed by calculating the oxygen transfer
      rate for each group and per square meter for each oxygenator group. Partial
      arterial oxygen pressure (paO2) and partial arterial carbon dioxide pressure
      (paCO2) between the groups were assessed with forward stepwise regression
      analysis. Biocompatibility was evaluated through measurement of platelet numbers,
      complement activation products (C3b/c), coagulation (thrombin anti-thrombin III
      complex), and fibrinolysis (plasmin anti-plasmin complex). No differences were
      found in oxygen transfer rate per group. However, when correcting the oxygen
      transfer rate for surface area, group 1 demonstrated a higher oxygen transfer
      rate compared with group 2 (p < 0.05) at an FiO2 of 40 and 60% and compared with
      group 3 at an FiO2 of 60 and 70%. The regression analysis showed that the average
      arterial PO2 was the highest in group 3, i.e., 79.2 mm Hg higher than in group 1
      (p < 0.001) and 73.5 mm Hg higher than in group 2 (p < 0.001). Group 3 also had
      the lowest average arterial pCO2, 0.57 mm Hg lower than in group 1 (p = 0.004)
      and 0.81 mm Hg lower than in group 2 (p < 0.001). During CPB, platelet numbers
      decreased significantly in all groups (p < 0.001), without differences between
      the groups. C3b/c levels increased in all groups during CPB. At cessation of CPB
      the C3b/c level in group 2 (398 nmol/L(-1)) was significantly higher compared to
      group 1(251 nmol/L(-1); p < 0.05) and group 3 (303 nmol/L(-1); p < 0.05).
      Thrombin anti-thrombin III complexes and plasmin anti-plasmin complex complexes
      increased during CPB to significantly high levels at cessation of CPB, but there
      were no differences between the groups. The oxygenator with the smallest surface
      area and lowest priming volume (group 1) had the highest oxygen transfer rate per
      square meter and showed the least blood damage, as depicted by complement
      activation. The oxygenator with the largest blood contact surface area and
      improved geometric configuration (group 3) showed the lowest oxygen transfer rate
      per square meter. However, this oxygenator elevated oxygen partial pressure the
      most and reduced carbon dioxide partial pressure the most. In group 2, where a
      smaller venous reservoir was used, the highest blood activation was observed.

PMID- 11199315
TI  - LD-PACE II: a new cardiomyostimulator for cardiac bioassist.
AB  - The LD-PACE II was designed for use in cardiomyoplasty, aortomyoplasty, and
      skeletal muscle ventricles. All parameters specified as programmable can be
      changed in a noninvasive manner (using a programming interface wand connected to
      a computer using the Windows 95/98 environment). Two new functions may be very
      useful clinically, based on experimental research. 1. Work-rest regimen. The LD
      PACE II is able to deliver alternating periods of muscle contractions and rest.
      Work and rest periods may be programmed independently between 1 and 120 minutes
      in increments of 1 minute. The work-rest regimen may be useful clinically if
      muscle contractions are needed for cardiac assist postoperatively. 2. Night/day
      regimen. This feature allows for a change in the ratio of muscle contractions
      according to a patient's activity level. During the day the cardiosynchronization
      ratio may be set from 1:1 to 1:4, and during the night it may be set for 1:8 to
      1:16. This allows the muscle to have a long rest period, prevents overuse, and
      prolongs battery life. These two new features make this cardiomyostimulator very
      attractive for cardiomyoplasty in particular. The addition of the work-rest and
      night-day regimens allow the muscle to rest for periods during the day to prevent
      overuse, subsequent damage, and potential atrophy.

PMID- 11199316
TI  - Optimized veno-venous bypass with the affinity pump.
AB  - Veno-venous bypass (VVBP) is increasingly used to avoid acute venous hypertension
      and low cardiac output after clamping the vena cava. Air embolism upon accidental
      decannulation of the inflow line and endothelial damage due to suction of the
      blood collecting cannula to the vessel wall are known complications specific to
      the currently used roller and centrifugal pumps, because they generate negative
      pressure at the inflow site of the pump. The Affinity pump has a unique chamber
      design with an occlusive segment, that collapses in low filling states preventing
      negative pressure at the inflow site of the pump chamber. This device was tested
      for VVBP in three pigs (each weighing 52.3 +/- 5.1 kg) with hepatic vascular
      exclusion. Blood was pumped from the femoral and portal veins to the external
      jugular vein and perfusion was maintained for 6 hours. The hemodynamic state of
      the animals was assessed by recording heart rate; systolic, mean arterial, and
      diastolic pressure; as well as central venous pressure. Mean pump flow during the
      experiment was 1,629.3 +/- 372.2 ml/min. After clamping, the inflow line of the
      pump mean arterial pressure significantly decreased (from 69.5 +/- 4.4 to 43.1 +/
      3.5 mm Hg), and mean pressure in the femoral vein increased significantly (from
      16.1 +/- 2.6 to 26.8 +/- 5.9 mm Hg), whereas the mean pressure in the internal
      jugular vein did not significantly change (from 6.0 +/- 1.7 to 5.0 +/- 2.1 mm
      Hg). There was no suction by the blood collecting cannula on the vessel wall, and
      neither bubbles nor air emboli were detected and no operator intervention was
      needed. In conclusion, the Affinity pump eliminates device related complications
      due to negative pressure generated at the inlet, and guarantees stable
      hemodynamics. Its application is simple and safe and minimal operator
      intervention is needed, making the Affinity pump particularly suited for veno
      venous bypass.

PMID- 11199317
TI  - Impact of United States artificial organ development in Latin America.
AB  - The University of Minnesota may be considered the cradle of heart surgery
      worldwide. That is where Dr. F. John Lewis carried out the first open heart
      surgery in September, 1952 and repaired an atrial septal defect in a 5 year old
      girl. Thenceforth, new solutions to allow systematic heart surgeries have been
      extensively investigated. This requires boldness and imagination. In 1954, Dr.
      Walton Lillehei, who had been working in Minnesota since after the war, carried
      out the first surgery with cross circulation using a second person who worked as
      a circulatory support, while the patient's heart was operated on. In 1955, he
      started using extracorporeal circulation using an oxygenator developed in
      association with Dr. Richard de Wall and the roller pump introduced by Michael
      DeBakey. By 1956 they had already performed 80 surgeries using the bubble
      oxygenator.

PMID- 11199318
TI  - Effects of prosthetic valve placement on mitral annular dynamics and the left
      ventricular base.
AB  - Insertion of a rigid mitral prosthesis impairs the function of the mitral annulus
      and induces systolic narrowing of the left ventricular outflow tract (LVOT). To
      study this mechanism, we investigated dynamic changes in the left ventricular
      (LV) base, which consists of the mitral annulus and LVOT orifice. In seven
      patients with mechanical mitral valve prostheses and eight normal subjects, the
      image of the LV base was reconstructed three-dimensionally and its dynamic change
      during systole was studied. In the patients, the rigid prosthetic valve (=mitral
      annulus) tilted toward the left ventricle with a hinge point at the posterior
      mitral annulus during systole. The left ventricular base exhibited contraction,
      but the size of the prosthetic valve was constant. As a consequence, the
      prosthetic valve occupied more of the left ventricular base, which resulted in
      narrowing of the LVOT. In the normal subjects, the mitral annulus did not
      interfere with the region of the LVOT orifice during systole as the mitral
      annulus underwent both dorsiflexion and contraction. Thus, fixation of the mitral
      annulus induces an anti-physiologic motion of the annulus. Conscious preservation
      of annular flexibility in mitral valve surgery is important in avoiding potential
      dynamic LVOT obstruction.

PMID- 11199319
TI  - Evaluation of a novel vitamin E coated cellulosic membrane hollow fiber dialyzer.
AB  - Adverse physiologic effects accompany hemodialysis. Biocompatible dialyzer
      membranes may both limit oxidative stress and decrease beta2-microglobulin
      production, thereby reducing patient morbidity. We compared standard solute
      clearance, lipid, and antioxidant effects of a novel cellulosic membrane dialyzer
      modified with covalently bonded vitamin E (Excebrane Clirans E15, Terumo
      Australia) with standard cellulosic and polysulphone membrane dialyzers. Stable
      adult hemodialysis patients taking no lipid lowering or antioxidant therapy (n =
      17; 9 male, 8 female) were recruited into a 10 week, prospective, unblinded
      study. Measurements were made at baseline on their usual dialyzer and after 2, 4,
      and 10 weeks of Excebrane use. Excebrane demonstrated good in vivo clearance of
      standard solutes relative to surface area. Predialysis beta2-microglobulin levels
      were unchanged with time and were significantly lower postdialysis than with
      cellulose acetate (p < 0.05). Oxidized low density lipoprotein levels as measured
      by nitrotyrosine residues were high predialysis, but tended to decrease with both
      membranes (p > 0.05). Total antioxidant status fell during dialysis (p < 0.0005),
      but plasma vitamin A and E concentrations increased (p = 0.007 and p = 0.02,
      respectively). Baseline vitamin A levels were high in all patients and, along
      with vitamin E, total antioxidant status and lipid profiles did not change over
      time with Excebrane use. Excebrane is an efficient, biocompatible membrane with
      no deleterious effects on beta2-microglobulin or lipids. More long-term study is
      merited.

PMID- 11199320
TI  - Risk factor paradox in hemodialysis: better nutrition as a partial explanation.
AB  - The higher mortality rate in patients on hemodialysis is primarily due to the
      higher rate of cardiovascular disease. Yet, paradoxically, overweight,
      hypertension, and hyperlipidemia, which are cardiovascular risk factors in the
      general population, have been reported to correlate with better patient survival
      in hemodialysis. To examine whether this "risk factor paradox" in hemodialysis is
      due to the positive influence of accompanying better nutrition, we prospectively
      obtained data on fasting lipids, biochemical markers of nutrition, body mass
      index (BMI), and blood pressure (BP) in 453 hemodialysis patients and related
      them to 1 year mortality. As previously noted, body weight, blood pressure, and
      certain serum lipids positively correlated with survival. Serum prealbumin, one
      of the most sensitive and specific biochemical markers for nutrition, correlated
      positively with hypercholesterolemia (r = 0.30, p < 0.001) and BMI (r = 0.12, p <
      0.02), but not with mean arterial pressure (MAP) (r = 0.01, p = NS). By analysis
      of variance, patients in the upper tertile (i.e., higher levels) of BMI and
      cholesterol but not MAP had significantly higher serum prealbumin and creatinine
      compared with those in the lower tertile. Our data lend support to the hypothesis
      that, in patients on hemodialysis, the positive effect of higher BMI and
      hyperlipidemia but not of high BP could be partially explained on the basis of
      the accompanying better nutrition. Although not proven, correcting risk factors
      while improving nutrition may offer better outcomes for patients on dialysis.

PMID- 11199321
TI  - Predictors of erythropoietin responsiveness in chronic hemodialysis patients.
AB  - The impact of dialysis intensity on erythropoietin (EPO) requirements is unclear.
      Previous work suggests that increased dialysis is associated with increased
      erythropoietin responsiveness (ERSP), but average dialysis intensity has
      increased since those publications. We hypothesized that ERSP would be
      independent of delivered Kt/V(urea) at current intensities of hemodialysis. We
      prospectively studied 135 stable chronic hemodialysis patients who receive iron
      and subcutaneous EPO dosed according to current guidelines. We collected
      biochemical, hematologic, and single pool urea kinetics data. ERSP was expressed
      as units per kilogram per week of EPO administered. Simple and multiple linear
      regression were used to identify characteristics predictive of ERSP. The mean age
      of the patients was 62 +/- 17 years (range, 17-90 years); 68 of 135 (50.3%) were
      women, and 120 of 135 (88.9%) were Caucasian. Mean delivered Kt/V(urea) was 1.60
      +/- 0.49, with 102 of 135 (75.6%) of patients with a delivered Kt/V(urea) > 1.3.
      Univariate linear regression showed seven significant independent predictors of
      erythropoietin requirements. Low serum albumin (p < 0.001), low serum calcium (p
      = 0.002), high serum phosphate (p = 0.004), and high serum iPTH (p = 0.007) were
      all associated with lower levels of ERSP. Lower ERSP was also correlated with
      lower hemoglobin and lower serum iron and transferrin saturation. Delivered
      dialysis (Kt/ V(urea)) was not a significant predictor of ERSP (p = 0.61).
      Multivariate regression confirmed low serum albumin (p < 0.01), high serum
      phosphate (p = 0.001), high immunoreactive parathyroid hormone (p = 0.025), and
      low transferrin saturation (p < 0.0005) as predictors of low ERSP, and also found
      high serum ferritin to be correlated with low ERSP (p = 0.016). We found no
      relationship between erythropoietin responsiveness and intensity of hemodialysis
      in this population of patients with a mean delivered Kt/V(urea) of 1.6. This may
      indicate a threshold effect beyond which more dialysis will not improve ERSP.
      However, markers of an underlying inflammatory state and of secondary
      hyperparathyroidism were associated with decreased response to erythropoietin.

PMID- 11199322
TI  - Predictors of mortality in patients treated with continuous hemodiafiltration for
      acute renal failure in an intensive care setting.
AB  - We performed this study to identify predictors of mortality in critically ill
      patients treated with continuous venovenous hemodiafiltration (CVVHDF) for acute
      renal failure in an intensive care setting. It was an uncontrolled, observational
      study that took place in a general intensive care unit in a university hospital.
      Forty-one patients undergoing CVVHDF for acute renal failure in a consecutive
      sample of 1,018 ICU treatments were studied. The underlying disease included 25
      postsurgical cases and 16 medical cases. Between survivors (n = 23) and
      nonsurvivors (n = 18), the following factors were assessed: demographic data; the
      number and type of failed organs; Acute Physiology and Chronic Health Evaluation
      (APACHE) II scores; urine production; pH; base excess; serum creatinine levels;
      bilirubin levels; lactate levels; platelet counts; and hemodynamic variables,
      including cardiac index and central venous pressure. On univariate analyses, the
      number of failed organs (p < 0.01), presence of hepatic failure (p < 0.01),
      APACHE II scores (p < 0.01), pH (p < 0.01), base excess (p < 0.001), average
      urinary production before the initiation of CVVHDF (p < 0.05), and serum
      bilirubin (p < 0.01) and lactate levels (p < 0.001) were significantly different.
      Multiple regression analysis identified serum bilirubin (p < 0.01) and lactate
      levels (p < 0.01) as the predictors of hospital mortality. Presence of hepatic
      failure was also predictive of hospital mortality (p < 0.01) in the analysis of
      the type of organ failure. The cut-off value set at bilirubin levels > 10 mg/dl
      or arterial lactate levels > 3.5 mmol/L provided 83.3% sensitivity and 90.9%
      specificity in the prediction of hospital death. The crucial factors in
      predicting outcome of critically ill patients undergoing CVVHDF for renal failure
      are elevated serum bilirubin and lactate levels at the onset of CVVHDF. Presence
      of hepatic failure, defined as both jaundice and coagulopathy, may also worsen
      outcome of critically ill patients undergoing CVVHDF for renal failure. The cut
      off value set at bilirubin levels > 10 mg/dl or arterial lactate levels > 3.5
      mmol/L may serve as beneficial predictors of hospital mortality.

PMID- 11199323
TI  - Moment in History. In the beginning.
AB  - The purpose of this editorial is to give the reader a picture of the earliest
      days in the delivery of chronic dialysis. It is viewed by a psychiatrist who was
      asked to help evaluate patients in one of the first hemodialysis centers, not
      only in the United States, but in the world.

PMID- 11199324
TI  - Influence of design of the hemodialyzer inlet chamber on red blood cell damage
      during hemodialysis.
AB  - Red blood cell damage occurring in the inlet chamber of a hollow fiber dialyzer
      was investigated by using a simplified model assembly. To vary the geometry of
      the inlet chamber, four parameters were used in this study, including the
      entrance angle, the chamber length, the convergence ratio, and the number of
      holes. The degree of red blood cell damage was represented by the hemolysis
      ratio. The results show that the hemolysis ratio was affected mostly by the
      chamber length and the convergence ratio, and less affected by the entrance angle
      and number of holes. The hemolysis ratio was the lowest when the chamber length
      was 2 mm and the entrance angle was 15 degrees. In addition, the hemolysis ratio
      decreased with the convergence ratio. Because the hemolysis ratio was only
      slightly affected by the number of holes and the flow channel length, the
      experimental results of this simplified assembly can be used to improve the
      design of an actual inlet chamber.

PMID- 11199325
TI  - Resource utilization for peritoneal catheter placement.
AB  - We reviewed hospitalization data for our large regional peritoneal dialysis (PD)
      program between January 1, 1997, and November 30, 1998, to determine the impact
      of inpatient PD catheter placement, by using Toronto Western II catheters placed
      under general anesthesia. Of 106 catheter placements, 80 were elective in
      previously identified renal failure patients. In elective cases, mean length of
      hospital stay was 6.75 days (SD, 7.01), median 4.5 days. These Canadian data are
      similar to those from the American Health Cost and Utilization Project. Evidently
      surgical PD catheter placement even in elective, planned circumstances involves a
      significant use of hospital resources. Current published reports do not outline
      hospital resource requirements or complication rates for this method.

PMID- 11199326
TI  - Genetic inferences to elucidate inflammation in atherosclerosis.

PMID- 11199327
TI  - Physiological consequences of tropomyosin mutations associated with cardiac and
      skeletal myopathies.
AB  - Mutations have been identified in alpha-tropomyosin (Tm), a key regulatory
      protein in striated muscle cells, that are associated with a human cardiac
      myopathy, hypertrophic cardiomyopathy (FHC) and a human skeletal myopathy,
      nemaline myopathy (NM). In this review, we highlight experiments aimed at
      identifying the underlying mechanisms by which mutations in alpha-Tm cause
      inherited diseases of cardiac and skeletal muscle. Gene transfer of normal and
      mutant alpha-Tm to isolated adult cardiac myocytes was used to study the primary
      effects of mutant alpha-Tm proteins on the structure and contractile function of
      fully differentiated striated muscle cells. Both FHC and NM mutant alpha-Tm
      proteins incorporated normally into the adult muscle sarcomere, similar to normal
      Tm but exerted differential "dominant-negative" effects on the contractile
      function of the muscle cell. FHC mutant alpha-Tm proteins produced
      hypersensitivity of Ca2+-activated force production with a hierarchy that was
      related to the clinical severity of each mutation. Conversely, the NM mutant
      alpha-Tm produced a hyposensitivity of Ca2+-activated force production that may
      underlie, at least in part, the muscle weakness observed in NM. Taken together,
      the results suggest that the differential changes in the ability of the mutant Tm
      proteins to regulate muscle contraction in response to changing Ca2+
      concentrations underlie the differential clinical presentation of the cardiac and
      skeletal muscle myopathies associated with mutations in alpha-Tm.

PMID- 11199328
TI  - Serum levels of leptin and proinflammatory cytokines in patients with advanced
      stage cancer at different sites.
AB  - Leptin is a recently identified hormone produced by the adipocyte ob gene which
      acts as a negative feedback signal critical to the normal control of food intake
      and body weight. A number of proinflammatory cytokines, such as interleukin (IL)
      1alpha, IL-6, tumor necrosis factor (TNF) alpha and interferon (IFN) gamma, have
      been proposed as mediators of cancer cachexia. These data suggest that
      abnormalities in leptin production/release or in its feedback mechanism play a
      role in cancer patients. To elucidate this we studied the relationship between
      total serum leptin and serum cytokines IL-1alpha, IL-6, TNFalpha as well as the
      production of leptin and cytokines by peripheral blood mononuclear cells (PBMC)
      isolated from cancer patients. Sixteen advanced cancer patients (mainly stage IV)
      with tumors at different sites were included in the study. The serum levels of
      leptin in cancer patients were significantly lower than those of healthy
      individuals at all times (7 a.m., noon, 3 p.m.). No significant differences were
      found in circadian rhythm between patients and controls. Serum levels of IL
      1alpha, IL-6, and TNFalpha were significantly higher in cancer patients than in
      healthy individuals. An inverse correlation between serum levels of leptin and IL
      6 was found in cancer patients. The production in culture of leptin by
      unstimulated PBMCs and those stimulated by phytohemagglutinin M or by phorbol
      myristate acetate isolated from cancer patients was very low; no differences were
      observed in comparison with leptin production by PBMCs from healthy individuals.

PMID- 11199329
TI  - A prospective study of genetic markers of susceptibility to infection and
      inflammation, and the severity, progression, and regression of coronary
      atherosclerosis and its response to therapy.
AB  - Inflammation plays a key role in susceptibility to coronary atherosclerosis and
      response to therapy. A diverse array of factors modulates inflammation, including
      interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and CD14 receptors
      on the surface of macrophages. Genes encoding for inflammatory markers have
      variants that regulate their expression and are potential risk factors for
      atherosclerosis. We prospectively analyzed the possible association of CD14 
      260C/T, TNF-alpha -308G/A, and IL-6 -174G/C variants, located in the promoter
      regions, with the severity, progression, and response to therapy of coronary
      atherosclerosis in a well-characterized cohort. We studied 375 subjects enrolled
      in the Lipoprotein and Coronary Atherosclerosis Study (LCAS). Genotypes were
      determined by polymerase chain reaction (PCR) and restriction mapping. Fasting
      plasma lipids and quantitative coronary angiograms were obtained at baseline and
      2.5 years following randomization to fluvastatin or placebo. Distributions of
      genotypes were--for CD14: 100 CC, 184 CT, and 86 TT; IL-6: 152 GG, 153 GC, and 62
      CC; and TNF-alpha: 244 GG, 110 GA, and 17 AA. The CD14 CC genotype was associated
      with incidence of new coronary occlusion (P=0.026); TNF-alpha AA genotype with
      history of myocardial infarction (MI, P=0.04), and A allele with total occlusions
      at baseline (P=0.027), and systolic blood pressure (P=0.046); and IL-6-174 CC
      genotype with baseline minimum lumen diameter (P=0.043) and reduction in
      lipoprotein(a) with fluvastatin (P=0.03). Otherwise, no association between the
      genotypes and the biochemical, angiographic, and clinical phenotypes was
      detected, and neither were genotype-treatment interactions. Functional variants
      of CD14 -260C/T, TNF-alpha -308G/A, and IL-6 -174G/C, implicated in the
      susceptibility to infection, are unlikely to confer major risk for susceptibility
      to coronary atherosclerosis and its progression or response to therapy in the
      LCAS population.

PMID- 11199330
TI  - Elevated p21 mRNA level in skeletal muscle of DMD patients and mdx mice indicates
      either an exhausted satellite cell pool or a higher p21 expression in dystrophin
      deficient cells per se.
AB  - Abnormalities in proliferation and differentiation of the dystrophin-deficient
      muscle are a controversial aspect of the pathogenesis of Duchenne muscular
      dystrophy (DMD). Analyses of molecules involved in cell cycle modulation do not
      exist in this context. Cells withdrawn from the cell cycle permanently express
      p21. The fact that p2 1, in contrast to other cell cycle proteins, is not
      diminished when myotubes are reexposed to growth media, allocates this cyclin
      dependent kinase inhibitor a special function. Here we report for the first time
      statistically increased p21 mRNA levels in dystrophin-deficient muscle tissue.
      Only 42% of conventional RT-PCRs from six muscle samples of human controls
      yielded positive results but almost all skeletal muscle biopsy samples (87%) from
      DMD patients (n=5). For p21 mRNA quantification in murine muscle samples we were
      able to use the exact real-time TaqMan PCR method due to generally higher p21
      mRNA levels than in human muscles. In addition, contamination with fibroblasts
      can be excluded for the murine samples because they do not demonstrate fibrosis
      at the age of 350 days but start to lose their regenerative capacity. In accord
      with the results in humans, we observed p21 mRNA levels in mdx mice that were
      approx. four times as high as those in control mice. Elevated p21 mRNA level may
      indicate a shift in cell composition towards differentiated p21 expressing cells
      as a result of an exhausted pool of undifferentiated, non-p21-expressing
      satellite cells due to previous cycles of de- and regeneration. Alternatively,
      dystrophin-deficient cells per se may express higher p21 levels for unknown
      reasons. Although we cannot distinguish between these possibilities, the eventual
      transfec tion of a patient's own satellite cells with p21 antisense
      oligonucleotides may enable the dystrophic process to be influenced.

PMID- 11199331
TI  - Vitamin D receptor gene polymorphism is associated with serum total and ionized
      calcium concentration.
AB  - Restriction fragment length polymorphisms of the vitamin D receptor gene have
      recently been reported to be associated with changes in bone mineral density.
      Alterations in systemic calcium balance and Ca-regulating hormones such as
      1,25(OH)2 vitamin D3 and parathyroid hormone have been demonstrated in essential
      hypertension. We investigated the relationship between polymorphisms of the
      vitamin D receptor gene and systemic Ca metabolism in patients with essential
      hypertension and in normotensives. We compared 147 subjects with essential
      hypertension and 100 normotensive control subjects. The genotype distribution and
      derived allele frequencies for the vitamin D receptor gene were similar in the
      two groups (genotype bb/Bb/BB and allele B/b: 60.1/32.6/7.2 and 0.24/0.76 in
      hypertensives vs. 56.0/36.0/8.0 and 0.26/0.74 in normotensive subjects). Serum
      concentrations of total Ca in the bb, Bb, and BB groups were, respectively, 4.5+/
      0.3 vs. 4.5+/-0.4 vs. 4.4+/-0.5 mmol/l in normotensives and 4.6+/-0.3 vs. 4.6+/
      0.4 vs. 4.4+/-0.5 mmol/l in hypertensives. Ionized Ca levels were 1.17+/-0.04 vs.
      1.16+/-0.04 vs. 1.15+/-0.04 mmol/l in normotensives and 1.16+/-0.04 vs. 1.16+/
      0.04 vs. 1.14+/-0.05 mmol/l in hypertensives, respectively. These results
      indicate that the BB genotype of the vitamin D receptor gene is associated with
      lower serum Ca levels but is not a useful predictive marker for the development
      of essential hypertension in Japanese subjects.

PMID- 11199332
TI  - Enhanced detection of mutations in BRCA1 exon 11 using restriction endonuclease
      fingerprinting-single-strand conformation polymorphism.
AB  - A novel approach to mutation screening in the large exon 11 (comprising 3427 bp)
      of the human BRCA1 gene is presented. Restriction endonuclease fingerprinting
      single-strand conformation polymorphism (REF-SSCP) is based on repeated detection
      of DNA sequence variants in different restriction endonuclease fragments, and we
      evaluated the method using blood samples from 25 Norwegian patients with
      hereditary breast/ovarian cancer. We compared REF-SSCP to constant denaturant gel
      electrophoresis (CDGE) and to the protein truncation test (PTT). REF-SSCP
      detected 12 different DNA variants. Four of these were not detected by CDGE, and
      only one variant detected by CDGE was missed by REF-SSCP. PTT detected 4 of these
      13 variants. REF-SSCP was subsequently applied to a second patient series
      (Swedish, n=20). A total of 14 different DNA variants were detected by REF-SSCP,
      6 of which were truncating mutations (PTT detected only 4). Nonsense and
      frameshift mutations that are putative breast/ovarian cancer mutations, were
      detected in 7 of the 25 Norwegian and 9 of the 20 Swedish patients.

PMID- 11199333
TI  - A naturalistic observation of children drawing: peer collaboration processes and
      influences in children's art.

PMID- 11199334
TI  - The development of individual styles in children's drawing.

PMID- 11199335
TI  - The artistic evolution of mommy: a longitudinal case study of symbolic and social
      processes.

PMID- 11199336
TI  - Continuity of styles in the drawings of adolescent girls.

PMID- 11199337
TI  - Looking for the development of artistic style in children's artworlds.

PMID- 11199338
TI  - Uptake of prolactin and tyroliberin by the heart.
AB  - The aim of this study was to observe the specificity of prolactin and tyroliberin
      uptake and thus to determine their affinity for the heart ventricles and atria.
      Comparison of the uptake of the examined substances revealed that more of these
      hormones reached the atria than the ventricles. The contents of prolactin and
      tyroliberin in the atria were statistically significant compared with 125J. The
      results observed provide evidence for nonuniform prolactin uptake by the heart.

PMID- 11199339
TI  - Production of interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha
      by a rat corneal epithelial cell line.
AB  - Production of interleukin (IL)-1 beta, IL-6 and tumor necrosis factor (TNF)-alpha
      by rat corneal epithelial cells in response to lipopolysaccharide and phorbol-12
      myristate-13-acetate (PMA) was tested. Supernatants from rat corneal epithelial
      cells treated with lipopolysaccharide and PMA were collected after 6, 24 and 48 h
      and tested with enzyme-linked immunosorbent assay for IL-1 beta, IL-6 and TNF
      alpha. The activity of TNF-alpha was additionally confirmed with bioassay on L929
      cells. It was found that control groups did not produce significant levels of
      either cytokine. However, after stimulation with lipopolysaccharide, cells
      produced mainly IL-6, whereas after PMA they produced mainly TNF-alpha. IL-6
      levels 24 and 48 h after PMA stimulation were also elevated, which could have
      been caused by the presence of TNF-alpha. Production of IL-1 beta in all groups
      was very low and remained within the test sensitivity range. These results show
      that the rat corneal epithelial cell line produces inflammatory cytokines in
      response to proinflammatory mediators. For this reason, it could be used for
      measuring the effects of irritants on the cornea.

PMID- 11199340
TI  - Disodium clodronate in painful nonresponsive periarthropathy of the hip.
AB  - This article identifies and describes a small group of patients with trochanteric
      tendinitis and bursitis in whom all modes of traditional therapy failed. We
      hypothesized that obstinate pain could be due to an increase in bone turnover
      associated with the formation of marginal bony outgrowths or enthesophytes.
      Injectable disodium clodronate is known to be highly efficacious in inhibiting
      bone reabsorption and is able to reduce several types of bone pain. The aim of
      the study was to evaluate the effectiveness of disodium clodronate in
      periarticular pathology of the hip in a group of patients resistant to
      traditional treatments and who were hypothesized to have a component of bone pain
      in their pain syndrome. Periarticular ultrasound examination is a useful method
      for detecting soft tissue alterations and is of interest in the study of these
      patients. In this study ultrasound examination showed periarticular alterations
      even when results of radiography were negative. Reduction in the hyperechoic
      ultrasound image, which confirms periarticular calcification, was observed in 75%
      of the patients treated with disodium clodronate vs. 33% of those treated with
      paracetamol. At the end of the study, all patients treated with disodium
      clodronate had a reduction in spontaneous and provoked pain > or = 1/3 vs. the
      basal visual analogue scale, unlike those treated with paracetamol.

PMID- 11199342
TI  - Consequences of price controls.

PMID- 11199341
TI  - Inhibition of NF kappa B activation by pyrrolidine dithiocarbamate prevents in
      vivo hypoxia/reoxygenation-mediated myocardial angiogenesis.
AB  - This study sought to examine the effect of nonlethal moderate whole body hypoxic
      challenge (10% 02/90% N2) on rat myocardial angiogenesis. Sprague Dawley rats
      were subjected to 4 h of systemic normobaric hypoxemic hypoxia (10 +/- 0.4% O2)
      in an anesthesia chamber or to 4 h of normoxia (ambient 20.9 +/- 0.4% O2) to time
      match the duration of hypoxia. All rats were then kept under normoxic conditions.
      Rats were sacrificed and hearts harvested either after 2 h for subsequent
      electrophoretic mobility gel shift assay for NF kappa B, or after 24 h for
      subsequent Western blot analysis for vascular endothelial growth factor (VEGF)
      and after 7 days for immunohistochemistry for capillary density measurement. We
      also used pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF kappa B, before
      1 h of hypoxia to establish the possible role of NF kappa B in modulating
      myocardial angiogenesis. The results showed significant induction of VEGF protein
      expression after 4 h of hypoxia followed by 24 h of reoxygenation in the rat
      myocardium. The DNA binding activity of NF kappa B was increased compared with
      the hypoxic group. However inhibition of NF kappa B by PDTC decreased capillary
      density significantly when compared with the hypoxic group. These findings
      demonstrate the role of NF kappa B and VEGF in myocardial angiogenesis for the
      first time.

PMID- 11199343
TI  - Myositis of the quadriceps muscle group including vastus lateralis, vastus
      medialis, and rectus femoris.

PMID- 11199344
TI  - Resurfacing the patella offers lower complication and revision rates.

PMID- 11199345
TI  - Patella resurfacing during knee replacement remains controversial in Y2K.

PMID- 11199346
TI  - Removal of incarcerated braided titanium cables.

PMID- 11199347
TI  - Exercise treatment for sacroiliac pain.
AB  - The reciprocal relationship of the latissimus dorsi on one side and the gluteus
      maximus on the other side has been demonstrated anatomically. To demonstrate this
      relationship by muscle action, electromyographic studies were performed in 15
      healthy individuals. This formed the baseline for evaluation of 5 symptomatic
      patients with sacroiliac dysfunction. Abnormal hyperactivity of the gluteus
      muscle on the involved side and increased activity of the latissimus on the
      contralateral side was contrasted with the normal function of the healthy
      individuals. All patients in the rotary strengthening exercise program improved
      in strength and return of myoelectric activity to more normal patterns.

PMID- 11199348
TI  - Arthrodesis with the Ilizarov device after failed knee arthroplasty.
AB  - Thirteen patients with failed total knee arthroplasty (TKA) due to infection (12
      patients) or aseptic loosening (1 patient) underwent arthrodesis using the
      Ilizarov external fixator. Solid fusion was achieved in all patients with an
      average healing time of 27.6 weeks. Patients spent an average 18.8 weeks in the
      fixator followed by an average 8.8 weeks in a plaster cylinder cast. Five
      patients had a pin tract infection and one a superficial wound infection. One
      patient had 15 degrees recurvatum after surgery that was gradually corrected by
      adding a hinge system to the fixator. Average shortening of the affected limb was
      3.7 cm (range: 1-6 cm). The Ilizarov fixator for knee arthrodesis after failed
      TKA produced favorable results and should be considered for use by surgeons
      familiar with the technique.

PMID- 11199349
TI  - Tension-band technique for ankle fusion.
AB  - A prospective study was conducted to develop a better technique for ankle fusion.
      Eleven consecutive patients were treated using the tension-band technique for
      ankle fusion and underwent follow-up for a minimum of 2 years (range: 2-5 years).
      All 11 patients achieved solid fusion for a fusion rate of 100%. Average time to
      fusion was 3 months (range: 2-6 months). The indication for ankle fusion was
      intractable aching pain that could not be controlled by conservative methods. Two
      of 11 patients underwent surgery due to infected arthritis. After ankle fusion,
      there was no recurrence of infection during a 3-year follow-up period. The
      technique included osteotomy of the bimalleoli from the inside out, removal of
      articular cartilage and preserving wedge space for cancellous bone grafting, with
      or without staple stabilization, and external immobilization supplementation. The
      functional outcome in all 11 patients improved from unsatisfactory preoperatively
      to satisfactory at latest follow-up (P<.001). No significant complications were
      noted. This simple technique proved excellent for ankle fusion with a
      satisfactory outcome and is recommended for treating severe ankle arthropathies.

PMID- 11199350
TI  - Recombinant human erythropoietin therapy for autologous blood donation in
      rheumatoid arthritis patients undergoing total hip or knee arthroplasty.
AB  - The effect of recombinant human erythropoietin on autologous blood donation was
      investigated in 73 rheumatoid arthritis patients who underwent hip or knee
      arthroplasty. Autologous blood donation of 400 mL was successful with recombinant
      human erythropoietin (12,000 U per week), and no homologous blood was required.
      The mean period of blood collection was 33.8 days. Mean hemoglobin levels were
      9.7 g/dL before treatment, 10.7 g/dL before surgery, and 10.2 g/dL after surgery.
      This study confirmed recombinant human erythropoietin is effective for enabling
      preoperative blood donation in rheumatoid arthritis patients.

PMID- 11199351
TI  - Percutaneous sclerotherapy for congenital venous malformations in the
      extremities.
AB  - Between January 1991 and January 1998, a total of 15 patients underwent direct
      injection sclerotherapy for painful peripheral venous malformations. Duplex
      ultrasonography or venography was used in all cases for the detection and
      localization of tortuous venous structures. Direct injection with absolute ethyl
      alcohol was performed in 12 patients, and Sotradecol or sodium morrhuate was used
      in 5 patients. Provocative lidocaine testing was used in 2 patients in whom major
      nerves were in proximity to the malformations. All patients underwent follow-up
      in the clinic with duplex examination after each sclerotherapy. Clinical symptoms
      of all patients improved during average follow-up of 2.5 years (range: 3 months
      to 6 years.) Duplex examination was useful in detecting the venous component
      including the size and course of veins, which were often less well seen on
      magnetic resonance imaging. Duplex study was helpful in follow-up after
      sclerotherapy in all patients. Direct injection sclerotherapy is an acceptable
      treatment modality for venous malformations. Complications are manageable, and
      regular follow-up with Duplex is helpful.

PMID- 11199352
TI  - Human immunodeficiency virus testing for elective orthopedic procedures: results
      in a community-based hospital.
AB  - Between January 1, 1989 and July 31, 1995, voluntary preoperative screening tests
      for human immunodeficiency virus (HIV) infection, using an enzyme-linked
      immunosorbant assay, were completed on 2,727 patients who underwent elective
      orthopedic surgical procedures. There were 2,719 (99.7%) negative, 4 (0.15%)
      positive, and 3 (0.11%) false-positive results; 1 test was indeterminate (0.04%).
      All 4 positive patients were men with a mean age of 32 years (range: 26-43
      years). Although the prevalence of positive tests is low in this setting,
      voluntary testing alerts the surgeon to higher risk patients, does not sacrifice
      patient care, and enables the incorporation of more extensive precautionary
      measures in the operating room to minimize occupational risks to the surgical
      team.

PMID- 11199353
TI  - Anatomic considerations of the posterolateral lumbar disk region.
AB  - Sixteen embalmed cadavers were dissected to determine the location of the lumbar
      nerve root and sympathetic trunk with reference to the superior border of
      transverse process. In the posterolateral lumbar disk region, a safe zone was
      found between the anterior limit of the lumbar nerve and the posterior limit of
      the sympathetic trunk. It has a transverse dimension of 22 mm at the T12-L1 disk
      region and 25 mm at the L4-L5 disk region. The only exception to this was the
      genitofemoral nerve running close to the lateral margin of the L2-L3 disk. The
      study provides an understanding of the posterolateral orientation of the lumbar
      nerves and sympathetic trunk.

PMID- 11199354
TI  - Cryptococcal osteomyelitis with septic arthritis.

PMID- 11199355
TI  - Distal radioulnar synostosis following K-wire fixation.

PMID- 11199356
TI  - Thrombosis of the brachial vein and pulmonary embolism after subacromial
      decompression of the shoulder.

PMID- 11199357
TI  - Upper extremity fractures and Parkinson's disease.

PMID- 11199358
TI  - Bone marrow edema syndrome.

PMID- 11199359
TI  - Trends, controversies and contradictions in the management of gastroesophageal
      reflux disease patients.

PMID- 11199360
TI  - Effect of elimination of acid reflux on epithelial cell proliferative activity of
      Barrett esophagus.
AB  - BACKGROUND: Barrett esophagus (BE) is a premalignant condition resulting from
      chronic acid gastroesophageal reflux and is associated with increased epithelial
      cell proliferation. Elimination of acid reflux might decrease cancer risk by
      affecting cell proliferation in BE. The effect of elimination of acid reflux on
      epithelial cell proliferation in BE was studied. METHODS: Forty-five patients
      with long segment Barrett esophagus were treated in a randomized 2-year follow-up
      study with either omeprazole 40 mg b.i.d. (OME) or ranitidine 150 mg b.i.d. (RAN)
      and were compared for the effect on epithelial cell proliferation. Biopsies were
      taken 3 cm above the GE junction and just below the Z-line, at 0, 3, 9, and 24
      months. Epithelial cell proliferation was determined by in vitro labeling with 5
      bromo-2-deoxyuridine and immunohistochemistry. Labeling indices (LI) were
      established for luminal and crypt epithelium separately. Ambulatory 24-h
      esophageal pH-metry was performed at 0 and 3 months. Comparisons were made for
      the timeframes 0-3 months, 3-24 months, and 0-24 months. RESULTS: OME reduced
      mean acid reflux to 0.1 %/24 h, RAN to 9.4%. In the distal and the proximal
      biopsies, change in LI after 3 months was n.s. at either level for both
      treatments. In the distal biopsies (OME 22, RAN 23 patients) luminal LI increased
      significantly for RAN from 3 to 24 months (+12.64% month, mean area under the
      curve (AUC)), while that for OME remained stable, RAN versus OME P < 0.05. Crypt
      LI increased in both groups, only in RAN significantly so (+30.75% month), RAN
      versus OME n.s. In the proximal biopsies luminal LI at 24 months (OME 20, RAN 21
      patients) had increased slightly but not significantly in RAN (+8.86% month), RAN
      versus OME n.s., whereas in the crypts LI in OME it had increased significantly
      (+28.80% month), OME versus RAN n.s. CONCLUSION: Elimination of acid reflux
      resulted in a stabilization of luminal cell proliferative activity of Barrett
      epithelium in the distal esophagus, whereas this activity increased during
      continued acid reflux. Whether this finding has any implication for the cancer
      risk in Barrett esophagus remains to be seen.

PMID- 11199361
TI  - Rabeprazole, 20 mg once daily or 10 mg twice daily, is equivalent to omeprazole,
      20 mg once daily, in the healing of erosive gastrooesophageal reflux disease.
AB  - BACKGROUND: Proton pump inhibitors are the most potent pharmacologic inhibitors
      of gastric acid secretion currently available, and have proven effective in the
      treatment of gastro-oesophageal reflux disease (GERD). The object of this study
      was to compare the efficacy and tolerability of a new proton pump inhibitor,
      rabeprazole at two different dosages, with that of omeprazole in the healing of
      erosive GERD. METHODS: Rabeprazole 20 mg once daily (QD) and 10 mg twice daily
      (BID) were compared with omeprazole 20 mg QD in a double-blind, multicentre,
      parallel group study involving 310 patients with erosive GERD. The primary
      efficacy endpoint was oesophageal mucosal healing determined by endoscopy.
      Secondary endpoints included reduction in symptoms and improvements in quality-of
      life scores. RESULTS: The healing rates between both rabeprazole groups and the
      omeprazole group were equivalent in both the per-protocol and intent-to-treat
      populations. In the per-protocol population, rabeprazole 20 mg was noted to have
      a numerical trend toward more rapid daytime heartburn relief. However, by 4 and 8
      weeks of treatment, no significant differences were found between groups for
      secondary endpoints, adverse events, or laboratory abnormalities including
      elevation of serum gastrin levels. CONCLUSIONS: Rabeprazole 20 mg in two
      different dosing schedules is as effective as omeprazole 20 mg QD with regard to
      efficacy and tolerability in patients with erosive GERD.

PMID- 11199362
TI  - No evidence of an association between Helicobacter pylori infection and Raynaud
      phenomenon.
AB  - BACKGROUND: Raynaud phenomenon (RP) is a vasospastic condition that manifests
      itself as cold-induced ischemic attacks of the fingers with skin color changes.
      It may be classified as primary (PRP) or secondary (SRP), if associated to other
      diseases, mainly connective-tissue diseases. Recently, the association between
      PRP and Helicobacter pylori infection has been reported. The aims of this study
      were to evaluate the prevalence of gastric H. pylori infection in a large group
      of patients affected by PRP and SRP and to assess whether it was more evident in
      patients with more recent onset of RP. METHODS: Ninety-eight consecutive patients
      (93 F and 5 M), referring to our videocapillaroscopic service for the diagnosis
      of vascular and connective-tissue diseases, were evaluated. Forty-nine of them
      were affected by PRP and 49 by SRP. Patients were classified as having PRP on the
      basis of normal serological and immunological findings, normal
      videocapillaroscopic examination and exclusion of other conditions inducing RP.
      H. pylori infection was diagnosed by 13C-urea breath test (UBT). Two groups of 49
      age-and sex-matched controls, respectively, were also evaluated. RESULTS:
      Patients with SRP resulted significantly older than those with PRP (P < 0.006).
      UBT was found positive in 22/49 patients with PRP (45%) and in 29/49 patients
      with SRP (59%). The positivity of the respective control groups was 36% and 53%
      (P = NS). There was no higher prevalence of H. pylori infection in patients with
      RP lasting for less than 4 years. CONCLUSIONS: The results do not confirm the
      previously reported high prevalence of H. pylori infection in patients with PRP.
      A high association was not even found between the presence of the microorganism
      and SRP. There was no difference in the prevalence of H. pylori infection among
      the subgroups with more recent onset of both PRP and SRP.

PMID- 11199363
TI  - Effect of white wine on esophageal peristalsis and acid clearance.
AB  - BACKGROUND: In a previous study it was demonstrated that white wine reduces the
      lower esophageal sphincter pressure and induces gastroesophageal reflux
      characterized by reflux episodes of long duration. In the present study, it was
      evaluated whether wine disturbs esophageal peristalsis and acid clearance.
      METHODS: Twelve healthy volunteers (7F, 23-37 years) received 300 ml white wine
      (8% vol/vol; WW), an ethanol solution (8% vol/vol; ET) or tap water (WA) together
      with a standardized meal in a random order. Acid clearance was tested by
      instillation of 15 ml 0.1 N HCI into the distal esophagus. The number of swallows
      (dry swallow every 30 sec) were counted until pH rose again above 5. Five wet
      swallows (5 ml) were applied to test primary peristalsis and five insufflations
      of 20 ml of air were performed to test secondary peristalsis. Each test was done
      immediately after and 60 min after ingestion of the beverages. RESULTS: A
      significantly higher number of swallows were needed to clear the esophagus
      immediately after ingestion of wine (P < 0.01; median number: WW 12; ET 8; WA 7)
      due to an increase in the frequency of failed, simultaneous, and low-amplitude
      contractions. The frequency of triggered secondary contractions was decreased (P
      < 0.02; WW 70%; ET 100%; WA 100%) and the latency between air injection and onset
      of secondary peristalsis was prolonged (P < 0.05; WW 9 sec; ET 7 sec; WA 6 sec)
      immediately after ingestion of white wine. Wet swallow induced primary
      peristalsis was not influenced by wine. No significant differences in the
      measured parameters were seen 60 min after ingestion of the three beverages.
      CONCLUSION: White wine disturbs temporarily esophageal clearance due to a
      disturbance of triggering secondary peristalsis and due to an increase in
      ineffective contractions. The ethanol content alone is not responsible for the
      effects of white wine on esophageal peristalsis and acid clearance.

PMID- 11199364
TI  - Intragastric CO2 and nitric oxide participate in the regulation of peptone
      induced gastrin release in humans.
AB  - BACKGROUND: Moderate acidification of the gastric lumen inhibits peptone-induced
      gastrin release. The aim of the present study was to investigate if the gastric
      acid neutralization products CO2 (from secreted HCO3) and NO (from reduced
      salivary nitrite) could act as intermediate messengers between luminal acidity
      and the inhibition of peptone-induced gastrin release. METHODS: Fourteen healthy
      volunteers (mean age, 27 years; range, 20-39 years; 3 women) participated in the
      study. Intragastric perfusion with saline or peptone was performed on the healthy
      volunteers. Venous blood samples were analyzed for serum gastrin concentrations.
      Intragastric NO was measured by chemiluminescence. RESULTS: Basal serum gastrin
      ranged between 11 and 23 pmol/l. Peptone in Sorensen's phosphated buffer (pH 6.9,
      PCO2 0 mmHg) increased serum gastrin by 83% +/- 23%, whereas acidified peptone
      (pH 2.0) did not stimulate gastrin release. Acidified peptone buffered with
      NaHCO3 to neutrality (pH 6.9, PCO2 approximately 600 mmHg) increased serum
      gastrin by 166% +/- 29%. Low intragastric NO levels were obtained by deviation of
      saliva. During such salivary depletion, acidified peptone (pH 2.0) stimulated
      gastrin release to a level of about 40% of the control response (pH 6.9). This
      peptone-induced gastrin response during salivary deviation was inhibited by
      addition of nitrite to the perfusate. CONCLUSIONS: Acid-induced inhibition of
      peptone-stimulated gastrin release is partly dependent on intraluminal NO formed
      in the reaction between salivary nitrite and gastric acid. In addition, the
      gastric acid neutralization product CO2 seems to potentiate the effect of peptone
      on gastrin release.

PMID- 11199365
TI  - Probiotic therapy fails to improve gut permeability in a hapten model of colitis.
AB  - BACKGROUND: Studies in clinical and experimental inflammatory bowel disease (IBD)
      have shown disturbances in intestinal bacterial flora with an increase in
      potentially pathogenic and a decrease in protective organisms. It was
      hypothesized that Lactobacillus plantarum species 299 (LP299), a probiotic, would
      ameliorate colitis and improve intestinal permeability in experimental colitis.
      This study investigated the effect of LP299 in the trinitrobenzenesulfonic
      acid/ethanol (TNBS/E) rat model of colitis. METHODS: Twelve week old male Wistar
      rats were randomized to receive rectal instillates of either TNBS/E (n = 48) or
      saline (n = 16). For the next 7 days the animals were gavaged with 2.5 ml of oat
      fibre suspension containing 10(9) colony forming units (CFU) of LP299 (LP299/OF),
      oat fibre suspension alone (OF) or no treatment. At the end of the experiment
      rats received radiolabelled polyethylene glycol and urine was collected for 24 h
      to assess permeability. Animals were then anaesthetized and colons were harvested
      for colon macroscopic scoring (CMS). RESULTS: TNBS/E per rectum resulted in a
      greater CMS (P < 0.001) and gut permeability (P = 0.006) than saline.
      Administration of LP299/OF or oat fibre alone did not result in a reduction in
      CMS or gut permeability when compared to colitic controls. CONCLUSIONS: LP299/OF,
      when administered after TNBS instillation, does not reduce the severity of
      colitis or improve gut permeability in this hapten model of colitis.

PMID- 11199366
TI  - Disease outcome in inflammatory bowel disease: mortality, morbidity and
      therapeutic management of a 796-person inception cohort in the European
      Collaborative Study on Inflammatory Bowel Disease (EC-IBD).
AB  - BACKGROUND: The course of inflammatory bowel diseases (IBD) has mainly been
      studied using different methods in single patient cohorts. The aim of the present
      study was to assess clinical aspects of disease outcome in a population-based
      cohort of IBD patients over a 4-year period in multiple centres across Europe.
      METHODS: A total of 796 patients with IBD diagnosed in 10 centres between October
      1991 and October 1993, registered at the EC IBD study centre (98% of the original
      cohort), participated in the study. Investigators filled out a standard follow-up
      form containing questions on the method of follow-up, vital status of the
      patient, change in diagnosis, extraintestinal manifestations, medical and
      surgical treatment, and physician's global assessment of disease activity.
      RESULTS: Complete relief of the complaints was reported in 255 (48%) patients
      with ulcerative colitis (UC), 9 (50%) with indeterminate colitis (IC), but only
      in 87 (35%) of patients with Crohn disease (CD). Improvement was reported in 195
      (37%) patients with UC, 113 (45%) with CD and 6 (33%) with IC. During the 4-year
      follow-up period, 23 patients died (14 UC, 8 CD. and 1 IC). The mean age at death
      was 69.3 years (s, 14.9 years). The deaths of three patients were recorded as
      directly due to IBD. CONCLUSIONS: With the present approach to therapeutic
      management the short-term outcome of patients with IBD seems to be favourable in
      10 medical centres in the north and south of Europe. However, more detailed
      studies including both objective and subjective measures are necessary.

PMID- 11199367
TI  - Fas/Fas ligand expression and characteristics of primed CD45RO+ T cells in the
      inflamed mucosa of ulcerative colitis.
AB  - BACKGROUND: Chronic immune activation in the colon is characteristic of
      ulcerative colitis (UC). Fas/Fas ligand (FasL) system is a mechanism responsible
      for activation-induced cell death (AICD), which maintains homeostasis within the
      immune system. Thus, Fas/FasL expression on activated colonic T cells of UC
      patients, as well as the susceptibility of such T cells to AICD was investigated
      in order to determine the role of activated colonic T cells in the long lasting
      inflammation in UC. METHODS: Fas, FasL, and CD45RO expression on peripheral blood
      and colonic T cells of UC patients were assayed by flow cytometry. Apoptosis of
      colonic T cells induced by anti Fas antibody was assessed using the terminal
      deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL)
      assay. RESULTS: The majority of colonic T cells expressed both CD45RO and Fas in
      the colonic mucosa, a situation that was quite different from that in the
      peripheral blood. The number of CD45RO+CD8+ and Fas+CD8+ T cells was
      significantly lower in UC patients than the controls, unlike the number of
      Fas+CD4+ T cells. In contrast, the number of both CD45RO+CD4+ and CD45RO+CD8+ T
      cells in UC mucosa expressing FasL was significantly higher than in the controls.
      While Fas mediated apoptosis of CD45RO+CD8+ T cells was higher in UC patients
      than the controls, the number of apoptotic CD45RO+CD4+ T cells from UC mucosa was
      not. CONCLUSIONS: In UC patients, CD45RO+CD4+ T cells are less sensitive to
      apoptotic signals mediated by Fas. These phenomena may contribute to the
      pathogenesis of UC.

PMID- 11199368
TI  - Impact of screening examinations on survival in familial adenomatous polyposis.
AB  - BACKGROUND: Prophylactic family screening and surgery has improved the outcome of
      patients with familial adenomatous polyposis (FAP) largely preventing deaths due
      to colorectal cancer. The present study compared the mortality rates and causes
      of death of FAP patients diagnosed by symptoms (probands) or by family screening
      (call-up). METHODS: The study comprised all 236 FAP patients registered in the
      Finnish Polyposis Registry until the end of June 1998. There were 116 probands
      and 120 call-up patients with a median age of 36.8 and 22.8 at diagnosis and
      median follow-up times of 6.3 and 9.9 years, respectively. Cumulative crude and
      relative survival estimates were calculated for each group and the causes of
      death were determined. RESULTS: The life expectancy was significantly better in
      the call-up group than in the probands after colectomy (P < 0.001). The survival
      rates of the call-up group equaled those expected for a comparable group in the
      general population up to 18 years after colectomy. The main cause of death was
      colorectal cancer accounting for 54 out of 68 deaths: four in the call-up group
      (all rectal stump cancer) and 50 in probands. Upper GI-tract cancer caused four
      deaths (periampullary cancer two, stomach cancer two) and two deaths were due to
      postoperative pulmonary embolism. CONCLUSION: The survival of FAP patients is
      significantly improved by prophylactic screening and surgery. Further improvement
      may be possible by using restorative proctocolectomy instead of colectomy and
      ileorectal anastomosis and by regular upper GI-tract endoscopic surveillance.

PMID- 11199369
TI  - Incidence and associated factors of neutralizing anti-interferon antibodies among
      chronic hepatitis C patients treated with interferon in Taiwan.
AB  - BACKGROUND: The administration of interferon (IFN) could be complicated by the
      development of neutralizing anti-interferon antibodies (NA). This study evaluates
      the frequency and associated factors of NA among chronic hepatitis C patients
      treated with different IFNs. METHODS: Ninety-five chronic hepatitis C patients
      were randomized to be treated with recombinant IFN-alpha2a (n = 28), IFN-alpha2b
      (n = 39) or lymphoblastoid IFN-alpha1 (n = 28) given intramuscularly, 3-6 million
      units, thrice weekly for 24 weeks. Serum samples collected before, during and
      after the cessation of treatment were checked for NA. RESULTS: Three patients
      were withdrawn from treatment. All patients were negative for NA before treatment
      and 13 (14%) patients developed neutralizing antibodies. Of the 26 patients
      treated with IFN-alpha2a, 6 (23.1%) developed NA. whereas NA were detected in
      only 6 (15.4%) of 39 and 1 (3.7%) of 27 patients treated with IFN-alpha2b and IFN
      alphanl, respectively. Age, gender, HCV genotype, ALT level, IFN total dose and
      liver histology were not associated with the development of NA. By using
      multivariate logistic regression it was shown that pretreatment HCV RNA level and
      IFN preparation were the two major factors related to the production of NA. The
      response of treatment was related to pretreatment viremia but not to the presence
      of NA. CONCLUSIONS: The frequency of development of NA among Taiwanese patients
      with chronic hepatitis C might be related to different IFN preparations and
      pretreatment HCV RNA level. The response of treatment was related to pretreatment
      HCV RNA level but not to the presence of NA.

PMID- 11199370
TI  - In situ expression of transforming growth factor-beta1-3, latent transforming
      growth factor-beta binding protein and tumor necrosis factor-alpha in liver
      tissue from patients with chronic hepatitis C.
AB  - BACKGROUND: The mechanisms determining liver damage in chronic hepatitis C remain
      unclear. The aim was to evaluate the in situ expression of transforming growth
      factor beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha), two key
      cytokines implicated as important pathogenic mediators in the development of
      liver fibrosis. METHODS: In situ expression of TNF-alpha and of TGF-beta isoforms
      1-3, and its transport protein latent TGF-beta binding protein (LTBP), was
      determined by immunohistochemistry in 9 untreated patients with chronic hepatitis
      C infection and in 6 controls without liver disease. In addition, TGF-beta1
      expression was analyzed in 10 HCV patients before and after treatment with
      interferon-alpha alone, or in combination with ribavirin. RESULTS: Liver biopsies
      from HCV patients showed positive staining for TGF-beta1-3 isoforms and LTBP, and
      to a lesser degree for TNF-alpha, in areas with inflammation and fibrosis. Normal
      control liver showed no positive staining. TGF-beta1 expression before treatment,
      quantified by morphometric analysis, did not differ between non-responders and
      sustained responders. In patients responding to therapy, TGF-beta1 expression
      decreased in parallel with histological improvement, while no difference in TGF
      beta1 expression was seen before and after treatment in non-responders.
      CONCLUSION: These results suggest that TNF-alpha and all three isoforms of TGF
      beta are involved in the pathogenesis of HCV related liver disease, and that
      treatment leading to eradication of the virus affects the expression of TGF
      beta1.

PMID- 11199371
TI  - The clinical expression of hemochromatosis in Oslo, Norway. Excessive oral iron
      intake may lead to secondary hemochromatosis even in HFE C282Y mutation negative
      subjects.
AB  - BACKGROUND: The prevalence of hereditary hemochromatosis in Norway is one of the
      highest reported in the world. However, the clinical presentation in patients
      with hemochromatosis in Norway seems to be different compared with recent studies
      elsewhere. The aim of this study was to investigate patients with hemochromatosis
      in one community hospital in Norway and to study the prevalence of the C282Y
      mutation. METHODS: One hundred and twenty patients were consecutively admitted to
      one medical department in Oslo. Serum transferrin and ferritin concentrations
      were measured in all patients, and a percutaneous liver biopsy was obtained in
      108 of 120 (90%) patients. Stainable iron (Perls stain) in hepatocytes was graded
      from 0 to 4+ and fibrosis from 1 to 4. Genotyping for the C282Y and H63D mutation
      in the HFE gene was performed by PCR-RFLP. RESULTS: Forty-eight (40%) of the
      patients suffered from tiredness and astenia and 29 (24%) had typical
      arthropathy. Only 5 of 105 (4.5%) had biopsy confirmed cirrhosis and 5 had
      diabetes mellitus. Patients referred from a blood bank had significantly less
      symptoms and signs compared with other patients. Twenty-one of 120 (17.5%)
      patients were C282Y mutation negative. Seventeen (81%) of these patients (16
      women and 1 man) had a history of extensive oral iron intake lasting from 5 to 50
      years. When excluding those with extensive oral iron intake (n = 17), 92 of 103
      (89%) were homozygous for the C282Y mutation, 7 (7%) were heterozygous including
      3 compound heterozygous and 4 (4%) were mutation negative. CONCLUSIONS: Only a
      minority of our patients with hemochromatosis had a far advanced disease at the
      time of diagnosis (less than 5% had cirrhosis) and hemochromatosis in a majority
      of the C282Y mutation negative patients was associated with excessive oral iron
      intake for several years.

PMID- 11199373
TI  - Gut permeability in patients with acute pancreatitis.
AB  - BACKGROUND: The bacterial contamination of pancreatic necrosis in acute
      pancreatitis is supposed to occur through translocation of intestinal bacteria.
      Increased gut permeability may be the initial phenomenon in this process. To test
      the hypothesis that gut permeability is increased in acute pancreatitis a
      clinical study was made where gut absorption and permeability were assessed with
      multi-sugar probes in patients with acute pancreatitis within 2 days after
      admission to hospital and again after recovery of disease. METHODS AND RESULTS:
      Twenty-three patients with acute pancreatitis and 20 healthy controls were
      studied. According to Atlanta classification, 15 patients had mild and 8 patients
      severe pancreatitis. Gut absorption, assessed as the 5-h urine excretion of L
      rhamnose, D-xylose and 3-O-methylglucose, was decreased in patients with acute
      pancreatitis and more pronounced in patients with severe pancreatitis (L-rhamnose
      and D-xylose: P < 0.001; 3-O-methylglucose: P < 0.05). Gut permeability, assessed
      as the ratio of lactulose/L-rhamnose, was increased in severe pancreatitis (0.16
      +/- 0.13, 0.07 +/- 0.03, 0.04 +/- 0.04; severe pancreatitis, mild pancreatitis,
      controls, respectively; P < 0.001 between three groups, P < 0.05 between
      pancreatitis groups). CONCLUSIONS: Gut absorption capacity is decreased and gut
      permeability is increased in patients with acute pancreatitis. Patients with
      severe pancreatitis may be more exposed to impaired gut barrier function.

PMID- 11199372
TI  - Chronic inhibition of nitric oxide ameliorates splanchnic hyposensitivity to
      glypressin in a hemorrhage-transfused rat model of portal hypertension.
AB  - BACKGROUND: Vasopressin given during hemorrhage is less effective than when given
      during a stable state in experimental portal hypertension or patients with
      cirrhosis (the so-called hyposensitivity phenomenon). This study investigated
      whether chronic inhibition of nitric oxide (NO) synthesis by NG-nitro-L-arginine
      methyl ester (L-NAME), a non-selective NO synthase inhibitor, could potentiate
      the portal-hypotensive effect of glypressin (a long-acting vasopressin analogue)
      in portal-hypertensive rats during acute bleeding status. METHODS: Portal
      hypertension was induced by partial portal vein ligation (PVL). Rats were divided
      to receive either L-NAME (approximately 25 mg/kg/day in tap water) or placebo
      (tap water) treatment orally from 2 days prior to until 14 days after the
      operation. At the end of treatment, L-NAME-and placebo-treated PVL rats were
      subdivided into without-bleeding and with-bleeding groups to assess the effects
      of glypressin (0.07 mg/kg) on systemic and portal hemodynamics. In rats with a
      hypotensive hemorrhage, 4.5 ml of blood was withdrawn and 50% of the withdrawn
      blood was reinfused before the administration of glypressin. RESULTS: As compared
      with placebo-treated rats, chronic treatment with L-NAME in PVL rats
      significantly increased mean arterial pressure (P < 0.001) without modulating
      portal pressure (P > 0.05). In placebo-treated PVL rats, glypressin resulted in a
      less decrease in portal pressure in rats with bleeding than in those without
      bleeding (P < 0.05). For PVL rats with bleeding, the portal-hypotensive effect of
      glypressin was significantly potentiated after chronic L-NAME treatment (P <
      0.05). CONCLUSIONS: Chronic inhibition of NO alleviates the splanchnic
      hyposensitivity to glypressin observed in bleeding PVL rats, suggesting the
      pathophysiological role of nitric oxide in mediating this splanchnic
      hyposensitivity.

PMID- 11199374
TI  - Buprenorphine or procaine for pain relief in acute pancreatitis. A prospective
      randomized study.
AB  - BACKGROUND: To assess the analgesic efficacy and side effects of buprenorphine
      and procaine in patients with acute pancreatitis. METHODS: Forty patients
      (average age, 50 years; 23 male) with acute pancreatitis or an acute bout of a
      chronic pancreatitis were prospectively randomized to receive buprenorphine or
      procaine for pain relief. Both analgesics were administered as constant
      intravenous (i.v.) infusions and additional analgesics were given on demand. Pain
      scores were assessed on a visual analogue scale. Close clinical control and
      laboratory checks were performed during the three-day study period. RESULTS:
      Patients receiving buprenorphine were significantly less likely to demand
      additional analgesics (1 versus 14 patients; P < 0.0001). The pain scores for
      patients in the buprenorphine group were significantly lower over the treatment
      period in comparison to procaine (P < 0.05). The reduction of pain score was
      significantly greater during the initial two treatment days using buprenorphine
      (day 1: 55 versus 25, P < 0.0001; day 2: 62 versus 40, P = 0.005). Side effects
      were comparable for both groups with the exception of a slightly higher sedation
      rate under buprenorphine. CONCLUSIONS: Constant i.v. application of buprenorphine
      is more effective than the recommended procaine for pain relief in acute
      pancreatitis.

PMID- 11199375
TI  - Pancreatic ductal morphological pattern and dilatation in postoperative abdominal
      pain in patients with congenital choledochal cyst: an analysis of postoperative
      pancreatograms.
AB  - BACKGROUND: Postoperative abdominal pain associated with pancreatitis has been
      reported as a pancreas-associated complication after total biliary excision. The
      aim of the present study was to determine pancreatic ductal patterns in the head
      of the pancreas and evaluate pancreatic ductal dilatation in patients presenting
      with postoperative abdominal pain after radical biliary excision for congenital
      choledochal cyst. METHODS: Postoperative endoscopic retrograde pancreatography
      (ERP) was performed in a total of 38 patients (27 female and 11 male) with a
      history of postoperative abdominal pain or an increase in serum and urinary
      amylase on laboratory analysis. Pancreatic ductal configuration and ductal
      dilatation were determined. RESULTS: Pancreatic configurations included the usual
      type (n = 20), ansa pancreatica type (n = 11), loop type (n = 5), and divisum
      type (n = 2). Dilatation of the pancreatic duct was observed in 34 patients. The
      common channel was dilated in 29 patients. Mild postoperative pancreatitis
      occurred in 4 patients in the long term. Protein plugs were observed in the
      dilated pancreatic duct. CONCLUSIONS: Pancreatic ductal morphological pattern and
      ductal dilatation, possibly caused by long-standing stagnation of the pancreatic
      juice, may be associated with postoperative abdominal pain and pancreatitis in
      congenital choledochal cyst.

PMID- 11199376
TI  - Mucin ball-producing extrahepatic bile duct carcinoma.
AB  - The characteristic features of surgically curable mucin-producing extrahepatic
      bile duct carcinoma (MPEBC) have not previously been elucidated. Three (6.5%) of
      46 patients who underwent surgery in our department for bile duct carcinoma
      between 1986 and 1997 had MPEBC. Clinicopathological features, diagnostic
      procedures and operative methods for patients with MPEBC were investigated.
      Tumors in the bile duct were identified by cholangioscopy combined with
      cholangiography after removal of mucin balls. Tumors were located close to the
      hepatic confluence in these patients. Two patients underwent hepatic lobectomy
      together with caudate lobectomy while the other underwent resection of the
      hepatic confluence. Absence of residual tumors was confirmed histologically in
      these patients. All three patients remain alive without evidence of recurrence,
      22-54 months after surgery. MPEBC is a curable disease. Accurate localization in
      the biliary tree is essential and can only be obtained after, i) removal of mucin
      balls, and ii) extensive diagnostic work-up including cholangiography,
      cholangioscopy and intraoperative pathological examination.

PMID- 11199377
TI  - Mass spectrometric studies of elusive molecules that contain an N(+)-X- bond.
AB  - This review will be concerned with the gas phase chemistry of 1,2- and 1,3
      dipolar systems that contain a carbon-nitrogen bond. Although most of these
      compounds are stable molecules under normal conditions, certain congeners are
      reactive species that cannot be prepared using conventional procedures. The
      isolation and observation of these elusive compounds therefore require
      appropriate experimental conditions such as those provided by the gas phase of a
      mass spectrometer. In these experiments, the radical cations, corresponding to
      the molecule under study, must be prepared via indirect procedures, including
      dissociative electron ionization, on-line flash-vacuum pyrolysis-mass
      spectrometry, or ion-molecule reactions. Their characterization is mainly based
      on collisional activation and ion-molecule reactions. The formation of the
      corresponding highly reactive neutrals is attempted by neutralization
      reionization mass spectrometry. This review presents more than one hundred
      different molecules together with their methods of preparation and the experiment
      used to identify them.

PMID- 11199378
TI  - New separation tools for comprehensive studies of protein expression by mass
      spectrometry.
AB  - Mass spectrometry has emerged as a core technique for protein identification and
      characterization because of its high sensitivity, accuracy, and speed of
      analysis. The most widespread strategy for studying global protein expression in
      biological systems employs analytical two-dimensional polyacrylamide gel
      electrophoresis (2D PAGE) followed by enzymatic degradation of isolated protein
      spots, peptide mapping, and bioinformatics searches. Using this method, thousands
      of proteins can be resolved in a gel and their expression quantified. However,
      certain types of proteins possessing important cellular functions are not easily
      analyzed using this strategy. These proteins include membrane, low copy number,
      highly basic, and very large (> 150 kDa) and small (< 10 kDa) proteins. To meet
      the growing need to simultaneously monitor all types of proteins in a biological
      system, new separation strategies have emerged that are amenable to hyphenation
      to mass spectrometric techniques. This article will review these new techniques
      and examine their usefulness in studies of protein expression.

PMID- 11199379
TI  - Applications and mechanisms of charge-remote fragmentation.
AB  - Studies on the applications, energetics, and mechanisms of charge-remote
      fragmentations are reviewed, with emphasis given to those articles published
      after 1992. Independent of the charge status, charge-remote fragmentations are
      analogous to gas-phase thermolysis. Under collisional activation and with a fixed
      charge, ions containing long-chain or poly-ring structures undergo charge-remote
      fragmentations, generating productions that are structurally informative.
      Interpretation of the production spectra enables one to elucidate molecular
      structures. Although charge-remote fragmentations have been successfully used in
      the structural determination of fatty acids, phospholipids, glycolipids,
      triacylglycerols, steroids, peptides, ceramides, and other systems, the
      energetics and mechanisms of these reactions are still debated because none of
      the existing mechanisms can explain all the experimental data.

PMID- 11199380
TI  - Malignant pleural mesotheliomas: an environmental health risk in southeast
      Turkey.

PMID- 11199381
TI  - Preparing for a JCAHO survey: Part 5.

PMID- 11199382
TI  - Raising the bar: improving standards for social work practice in long-term care.

PMID- 11199383
TI  - Survey finds health care workers short on commitment to employers.

PMID- 11199384
TI  - Corporate compliance: the social work role.

PMID- 11199385
TI  - After discharge planning: taking a leadership role in community outreach.

PMID- 11199386
TI  - Programmed cell death of tracheary elements as a paradigm in plants.
AB  - Plant development involves various programmed cell death (PCD) processes. Among
      them, cell death occurring during differentiation of procambium into tracheary
      elements (TEs), which are a major component of vessels or tracheids, has been
      studied extensively. Recent studies of PCD during TE differentiation mainly using
      an in vitro differentiation system of Zinnia have revealed that PCD of TEs is a
      plant-specific one in which the vacuole plays a central role. Furthermore, there
      are recent findings of several factors that may initiate PCD of TEs and that act
      at autonomous degradation of cell contents. Herein I summarize the present
      knowledge about cell death program during TE differentiation as an excellent
      example of PCD in plants.

PMID- 11199387
TI  - Programmed cell death in cereal aleurone.
AB  - Progress in understanding programmed cell death (PCD) in the cereal aleurone is
      described. Cereal aleurone cells are specialized endosperm cells that function to
      synthesize and secrete hydrolytic enzymes that break down reserves in the starchy
      endosperm. Unlike the cells of the starchy endosperm, aleurone cells are viable
      in mature grain but undergo PCD when germination is triggered or when isolated
      aleurone layers or protoplasts are incubated in gibberellic acid (GA). Abscisic
      acid (ABA) slows down the process of aleurone cell death and isolated aleurone
      protoplasts can be kept alive in media containing ABA for up to 6 months. Cell
      death in barley aleurone occurs only after cells become highly vacuolated and is
      manifested in an abrupt loss of plasma membrane integrity. Aleurone cell death
      does not follow the apoptotic pathway found in many animal cells. The hallmarks
      of apoptosis, including internucleosomal DNA cleavage, plasma membrane and
      nuclear blebbing and formation of apoptotic bodies, are not observed in dying
      aleurone cells. PCD in barley aleurone cells is accompanied by the accumulation
      of a spectrum of nuclease and protease activities and the loss of organelles as a
      result of cellular autolysis.

PMID- 11199388
TI  - Programmed cell death in plant reproduction.
AB  - Reproductive development is a rich arena to showcase programmed cell death in
      plants. After floral induction, the first act of reproductive development in some
      plants is the selective killing of cells destined to differentiate into an
      unwanted sexual organ. Production of functional pollen grains relies
      significantly on deterioration and death of the anther tapetum, a tissue whose
      main function appears to nurture and decorate the pollen grains with critical
      surface molecules. Degeneration and death in a number of anther tissues result
      ultimately in anther rupture and dispersal of pollen grains. Female sporogenesis
      frequently begins with the death of all but one of the meiotic derivatives, with
      surrounding nucellar cells degenerating in concert with embryo sac expansion.
      Female tissues that interact with pollen undergo dramatic degeneration, including
      death, to ensure the encounter of compatible male and female gametes. Pollen and
      pistil interact to kill invading pollen from an incompatible source. Most
      observations on cell death in reproductive tissues have been on the histological
      and cytological levels. We discuss various cell death phenomena in reproductive
      development with a view towards understanding the biochemical and molecular
      mechanisms that underlie these processes.

PMID- 11199389
TI  - Programmed cell death during endosperm development.
AB  - The endosperm of cereals functions as a storage tissue in which the majority of
      starch and seed storage proteins are synthesized. During its development, cereal
      endosperm initiates a cell death program that eventually affects the entire
      tissue with the exception of the outermost cells, which differentiate into the
      aleurone layer and remain living in the mature seed. To date, the cell death
      program has been described for maize and wheat endosperm, which exhibits common
      and unique elements for each species. The progression of endosperm programmed
      cell death (PCD) in both species is accompanied by an increase in nuclease
      activity and the internucleosomal degradation of nuclear DNA, hallmarks of
      apoptosis in animals. Moreover, ethylene and abscisic acid are key to mediating
      PCD in cereal endosperm. The progression of the cell death program in developing
      maize endosperm follows a highly organized pattern whereas in wheat endosperm,
      PCD initiates stochastically. Although the essential characteristics of cereal
      endosperm PCD are now known, the molecular mechanisms responsible for its
      execution remain to be identified.

PMID- 11199390
TI  - Regulation of cell death in flower petals.
AB  - The often rapid and synchronous programmed death of petal cells provides a model
      system to study molecular aspects of organ senescence. The death of petal cells
      is preceded by a loss of membrane permeability, due in part to increases in
      reactive oxygen species that are in turn related to up-regulation of oxidative
      enzymes and to a decrease in activity of certain protective enzymes. The
      senescence process also consists of a loss of proteins caused by activation of
      various proteinases, a loss of nucleic acids as nucleases are activated, and
      enzyme-mediated alterations of carbohydrate polymers. Many of the genes for these
      senescence-associated enzymes have been cloned. In some flowers, the degradative
      changes of petal cells are initiated by ethylene; in others, abscisic acid may
      play a role. External factors such as pollination, drought and temperature stress
      also affect senescence, perhaps by interacting with hormones normally produced by
      the flowers. Signal transduction may involve G-proteins, calcium activity changes
      and the regulation of protein phosphorylation and dephosphorylation. The efficacy
      of the floral system as well as the research tools now available make it likely
      that important information will soon be added to our knowledge of the molecular
      mechanisms involved in petal cell death.

PMID- 11199391
TI  - Hypersensitive response-related death.
AB  - The hypersensitive response (HR) of plants resistant to microbial pathogens
      involves a complex form of programmed cell death (PCD) that differs from
      developmental PCD in its consistent association with the induction of local and
      systemic defence responses. Hypersensitive cell death is commonly controlled by
      direct or indirect interactions between pathogen avirulence gene products and
      those of plant resistance genes and it can be the result of multiple signalling
      pathways. Ion fluxes and the generation of reactive oxygen species commonly
      precede cell death, but a direct involvement of the latter seems to vary with the
      plant-pathogen combination. Protein synthesis, an intact actin cytoskeleton and
      salicylic acid also seem necessary for cell death induction. Cytological studies
      suggest that the actual mode and sequence of dismantling the cell contents varies
      among plant-parasite systems although there may be a universal involvement of
      cysteine proteases. It seems likely that cell death within the HR acts more as a
      signal to the rest of the plant rather than as a direct defence mechanism.

PMID- 11199392
TI  - Transgene-induced lesion mimic.
AB  - Lesion mimic, i.e., the spontaneous formation of lesions resembling
      hypersensitive response (HR) lesions in the absence of a pathogen, is a dramatic
      phenotype occasionally found to accompany the expression of different, mostly
      unrelated, transgenes in plants. Recent studies indicated that transgene-induced
      lesion formation is not a simple case of necrosis, i.e., direct killing of cells
      by the transgene product, but results from the activation of a programmed cell
      death (PCD) pathway. Moreover, activation of HR-like cell death by transgene
      expression is viewed as an important evidence for the existence of a PCD pathway
      in plants. The study of lesion mimic transgenes is important to our understanding
      of PCD and the signals that control it in plants. PCD-inducing transgenes may
      provide clues regarding the different entry points into the cell death pathway,
      the relationships between the different branches of the pathway (e.g.,
      developmental or environmental), or the different mechanisms involved in its
      induction or execution. Cell death-inducing transgenes may also be useful in
      biotechnology. Some lesion mimic transgenes were found to be induced in plants a
      state of systemic acquired resistance (SAR). These genes can be used in the
      development of pathogen-resistant crops. Other cell death-inducing transgenes may
      be used as specific cell ablation tools. Although mainly revealed
      unintentionally, and at times considered 'an adverse phenotype', lesion mimic
      transgenes should not be ignored because they may prove valuable for studying PCD
      as well as developing useful traits in different plants and crops.

PMID- 11199393
TI  - Ozone: a tool for probing programmed cell death in plants.

PMID- 11199394
TI  - Programmed cell death in cell cultures.
AB  - In plants most instances of programmed cell death (PCD) occur in a number of
      related, or neighbouring, cells in specific tissues. However, recent research
      with plant cell cultures has demonstrated that PCD can be induced in single
      cells. The uniformity, accessibility and reduced complexity of cell cultures make
      them ideal research tools to investigate the regulation of PCD in plants. PCD has
      now been induced in cell cultures from a wide range of species including many of
      the so-called model species. We will discuss the establishment of cell cultures,
      the fractionation of single cells and isolation of protoplasts, and consider the
      characteristic features of PCD in cultured cells. We will review the wide range
      of methods to induce cell death in cell cultures ranging from abiotic stress,
      absence of survival signals, manipulation of signal pathway intermediates,
      through the induction of defence-related PCD and developmentally induced cell
      death.

PMID- 11199395
TI  - Regulators of cell death in disease resistance.
AB  - Cell death and disease resistance are intimately connected in plants. Plant
      disease resistance genes (R genes) are key components in pathogen perception and
      have a potential to activate cell death pathways. Analysis of R proteins suggests
      common molecular mechanisms for pathogen recognition and signal emission whereas
      the subsequent signalling unexpectedly involves a network of pathways of
      parallel, branching and converging action. Disease resistance signalling mutants
      have revealed novel types of regulatory proteins whose biochemical functions are
      still unknown. Accumulation of small molecules such as salicylic acid, reactive
      oxygen intermediates, and nitric oxide amplifies resistance responses and directs
      cells to initiate cell death programs. Genetic analyses of lesion mimic mutants
      provide a glimpse of how cell death thresholds are set via an interplay of
      positive and negative regulatory components.

PMID- 11199396
TI  - Endonucleases.
AB  - Programmed cell death (PCD) involves hydrolysis of genomic DNA, which must be
      catalyzed by endonuclease(s) capable of digesting dsDNA. Plants have two major
      classes of endonucleases active towards dsDNA, Zn2+-dependent endonuclease and
      Ca2+-dependent endonuclease. Both classes are found among endonucleases nominated
      for machineries of PCD in plants. Survey of plant endonucleases in relation to
      PCD leads to a possibility that a different class of endonuclease reflects a
      different phase of PCD-associated DNA hydrolysis.

PMID- 11199398
TI  - Caspase-like protease involvement in the control of plant cell death.
AB  - Cell death as a highly regulated process has now been recognized to be an
      important, if not essential, pathway that is ubiquitous in all multicellular
      eukaryotes. In addition to playing key roles in the morphogenesis and sculpting
      of the organs to give rise to highly specialized forms and shapes, cell death
      also participates in the programmed creation of specialized cell types for
      essential functions such as the selection of B cells in the immune system of
      mammals and the formation of tracheids in the xylem of vascular plants. Studies
      of apoptosis, the most well-characterized form of animal programmed cell death,
      have culminated in the identification of a central tripartite death switch the
      enzymatic component of which is a conserved family of cysteine proteases called
      caspases. Studies in invertebrates and other animal models suggest that caspases
      are conserved regulators of apoptotic cell death in all metazoans. In plant
      systems, the identities of the main executioners that orchestrate cell death
      remain elusive. Recent evidence from inhibitor studies and biochemical approaches
      suggests that caspase-like proteases may also be involved in cell death control
      in higher plants. Furthermore, the mitochondrion and reactive oxygen species may
      well constitute a common pathway for cell death activation in both animal and
      plant cells. Cloning of plant caspase-like proteases and elucidation of the
      mechanisms through which mitochondria may regulate cell death in both systems
      should shed light on the evolution of cell death control in eukaryotes and may
      help to identify essential components that are highly conserved in eukaryotes.

PMID- 11199400
TI  - Cell death: the 'Yin' path in the balancing act of the life cycle.

PMID- 11199397
TI  - Plant proteolytic enzymes: possible roles during programmed cell death.
AB  - Proteolytic enzymes are known to be associated with developmentally programmed
      cell death during organ senescence and tracheary element differentiation. Recent
      evidence also links proteinases with some types of pathogen- and stress-induced
      cell suicide. The precise roles of proteinases in these and other plant
      programmed cell death processes are not understood, however. To provide a
      framework for consideration of the importance of proteinases during plant cell
      suicide, characteristics of the best-known proteinases from plants including
      subtilisin-type and papain-type enzymes, phytepsins, metalloproteinases and the
      26S proteasome are summarized. Examples of serine, cysteine, aspartic, metallo-
      and threonine proteinases linked to animal programmed cell death are cited and
      the potential for plant proteinases to act as mediators of signal transduction
      and as effectors of programmed cell death is discussed.

PMID- 11199399
TI  - Salicylic acid in the machinery of hypersensitive cell death and disease
      resistance.
AB  - Although extensive data has described the key role of salicylic acid (SA) in
      signaling pathogen-induced disease resistance, its function in physiological
      processes related to cell death is still poorly understood. Recent studies have
      explored the requirement of SA for mounting the hypersensitive response (HR)
      against an invading pathogen, where a particular cell death process is activated
      at the site of attempted infection causing a confined lesion. Biochemical data
      suggest that SA potentiates the signal pathway for HR by affecting an early
      phosphorylation-sensitive step preceding the generation of pro-death signals,
      including those derived from the oxidative burst. Accordingly, the epistatic
      relationship between cell death and SA accumulation, analyzed in crosses between
      lesion-mimic mutants (spontaneous lesion formation) and the transgenic nahG line
      (depleted in SA) places the SA activity in a feedback loop downstream and
      upstream of cell death. Exciting advances have been made in the identification of
      cellular protective functions and cell death suppressors that might operate in
      HR. Moreover, the spatio-temporal patterns of the SA accumulation (non
      homogeneous distribution, biphasic kinetics) described in some HR lesions, may
      also reveal important clues for unraveling the complex cellular network that
      tightly balances pro- and anti-death functions in the hypersensitive cell death.

PMID- 11199401
TI  - [Snowboarding accidents].
AB  - The present review summarises the related literature of the last ten years with
      request to snowboarding accidents. Sport accident statistics of snowboarding show
      high and increasing numbers of injuries. Already snowboarding ranks third of all
      sport accidents in Switzerland. According to the literature the injury risk in
      snowboarding is twice that of skiing, although the injuries are less serious.
      About 50% of the injured snowboarders are beginners. Beginners have a higher risk
      of injury than more advanced snowboarders. Additionally, and a relative large
      part of them are injured the first day of their snowboard career. The pattern of
      injury has changed over the last years. Today, injuries to the lower extremities
      account no longer for more than 50% but are now decreased to about 25%. Nowadays,
      wrist, knee, ankle, and shoulder are the most frequently injured body parts. It
      is the authors opinion that with up-to-date protectors, release bindings, and
      training of falling techniques the numbers and seriousness of injuries could be
      reduced, in particular injuries to the wrist and ankle.

PMID- 11199402
TI  - [Injuries and overuse syndromes due to rock climbing on artificial walls].
AB  - The purpose of this study was to obtain an overview of acute injuries and chronic
      overuse syndromes due to rock climbing on artificial climbing walls. Strategies
      for prevention should then be developed based on these experiences. From October
      1995 to December 1996 314 climbers of both sexes and all degrees of climbing
      abilities were individually interviewed at five different indoor climbing arenas
      with the help of a special questionnaire. Type, quantity and cause of typical
      injuries and overuse syndromes on artificial climbing walls were determined.
      Injuries (n = 204) as well as overuse syndromes (n = 266) increased with the
      performance level. Experienced climbers often suffered from injuries to the
      finger flexor tendons (n = 42) and the finger flexor pulleys (n = 37) while
      holding small grips. Beginners sustained skin injuries (n = 26) and joint
      distortions (n = 22) of the lower limb while falling. Reasons are a lack of
      experience in the techniques of belaying and falling as well as incomplete
      covering of the ground with crash mats. Chronic overuse syndromes mainly
      presented as swelling and pain in the finger joints (n = 140) and as
      epicondylitis in the elbow (n = 30). Especially knee problems (n = 12) were
      caused by new climbing techniques used on artificial climbing walls. Referring to
      injuries as well as to overuse syndromes climbing on artificial climbing walls is
      a very safe sport, compared to climbing on natural rock. Further prevention could
      be provided by a well-based instruction of beginners, especially in techniques of
      belaying and falling. The ground of climbing walls should always be completely
      covered by sufficient crash mats. More experienced climbers should minimize
      harmful climbing techniques, like using very small holds with a cling grip, long
      distance reaches and inside rotation of the leg under pressure.

PMID- 11199403
TI  - [Plantar pressure distribution in inline skating on straights].
AB  - Plantar pressure distribution in inline skating on straight was measured with a
      flexible insole in 13 experienced subjects at a speed of 18 and 24 km/h. The
      results showed three areas that were exposed to high pressures, i.e. the heel
      with 258 and 265 kPa, the first metatarsal head with 265 and 281 kPa, the hallux
      with 319 and 324 kPa at 18 and 24 km/h, respectively. All other areas showed peak
      pressures that were less than half of these values. Lowest values were found in
      the midfoot area. Changing speed from 18 to 24 km/h led to a small increase of
      peak pressures in all areas. Peak pressures were comparable to walking but showed
      the trend to be lower than in running.

PMID- 11199404
TI  - [Incidence of dental, mouth, and jaw injuries and the efficacy of mouthguards in
      top ranking athletes].
AB  - The aim of the study was to determine the prevalence of orofacial injuries among
      German top athletes and their attitudes to mouthguards. A questionnaire was
      mailed to athletes of 10 German contact sports associations. 64.3 percent (303)
      of the athletes returned questionnaires. 62 percent (188) of the respondents
      reported that at some time they wore a mouthguard for sports participation. 47.3%
      (male: 57.8%, female: 38.3%) of these were currently using one. 50% of the
      mouthguards were custom made by dentists, and 50% were shop bought (boil-and
      bite). 32 percent of the participants had, at some time during their sports
      career, suffered an orofacial injury. The incidence of fractured anterior upper
      teeth and completely knocked out teeth for athletes without mouthguards was 7 and
      14, respectively. Whereas for athletes wearing mouthguards one fractured tooth
      was reported. Athletes with mouthguards complained of problems with speaking
      (19.9%) rather than of breathing (3.4%) and fitting difficulties (4.8%). Boil-and
      bite mouthguards caused more fitting problems than custom-made ones. As
      prevalence of oral injuries in body-contact sports is high, athletes should be
      advised that custom-made mouthguards offer the greatest comfort, fit, durability,
      and protection against dental injuries.

PMID- 11199405
TI  - [Diagnosis and therapeutic management following traumatic anterior shoulder
      dislocation according to extrinsic prognostic factors].
AB  - We examined the importance of preoperative CT- and NMR-imaging concerning the
      detection of a bankart-lesion by a retrospective evaluation of 36 patients with
      primary traumatic or posttraumatic recurrent shoulder dislocations. Because of
      unfavourable extrinsic prognostic factors, we advised shoulder arthroscopy and
      surgical stabilization in all cases. Intraoperatively 35 of 36 patients (97%)
      presented a bankart-lesion. Preoperatively a bankart-lesion was detected in 32
      cases (91%) by CT (n = 29) or NMR (n = 7). We could predict the probability of a
      bankart-lesion with a high reliability by clinical evaluation alone due to
      several risk-factors. All patients had at least 2 unfavourable prognostic
      factors. Under these circumstances we could assume a bankart-lesion with a
      probability of 97%. Therefore in our opinion preoperative CT or NMR is not
      advised as standard diagnostic procedure in patients with high-risk of recurrence
      according to extrinsic prognostic factors. We recommend preoperative CT or NMR
      when the estimation of prognostic factors concerning the risk of redislocation is
      doubtful and in case of difficult clinical and ultrasound examination regarding
      shoulder laxity or rotator cuff lesions.

PMID- 11199406
TI  - [N. thoracicus longus lesion--a rare injury in weight lifting].
AB  - The case of long thoracic mononeuropathy associated with sport participation a
      presented. The diagnosis was confirmed with electromyography. It is suggested
      that the athletic activity caused a stretch injury to the long thoracic nerve.
      Degenerative changes and infections were excluded. Conservative management,
      consisting of range of motion exercises for the shoulder and strengthening of the
      serratus anterior muscle, resulted in a forable outcome. The 12 month follow-up
      showed only slight changes in EMG and clinical examination.

PMID- 11199407
TI  - [Documentation in sport physiotherapy].

PMID- 11199408
TI  - [Orthopedics 2000. Address by the President of the German Society of Orthopedics
      and Traumatology].

PMID- 11199409
TI  - [Diagnosis of rotator cuff rupture: correlation of clinical findings and magnetic
      resonance tomography with intraoperative findings].
AB  - The diagnosis of rotator cuff tears may be based on clinical examination and MRI.
      The aim of this study was to define the relative value of these methods. Clinical
      and MRI diagnoses of 88 shoulders were compared with the intraoperative findings.
      The correct diagnosis of a posterosuperior rotator cuff rupture was made in 79%
      of the cases by clinical examination and in 91% of the cases by MRI. For the
      subscapularis tendon clinical examination corresponded to the intraoperative
      findings in 73% of the cases versus 59% for MRI. MRI was superior to clinical
      examination in diagnosing a posterosuperior rotator cuff rupture. For the
      evaluation of ruptures of the subscapularis tendon, clinical examination was more
      reliable than MRI. Diagnosis of rotator cuff rupture can most often be obtained
      by a simple physical examination.

PMID- 11199410
TI  - [MRI-based 3-D analysis of the glenohumeral translation in patients with shoulder
      instability].
AB  - AIM: Until now, pathological translation of the glenohumeral joint could not be
      assessed three-dimensionally and in functionally important arm positions in the
      living. The objektive of this study was therefore to develop an MR-based
      technique for determining the three-dimensional glenohumeral translation in
      functionally relevant positions in vivo. METHOD: In an open MR scanner both
      shoulder joints of 5 volunteers with an unilateral traumatic instability were
      examined in different positions of abduction and rotation. After semiautomatic
      segmentation, 3D reconstruction of the bony structures of the shoulder girdle was
      performed and the center of mass of the glenoid cavity was determined and used as
      reference point. In a virtual reality, the midpoint of the humeral head was
      assessed and its position relative to the center of mass of the glenoid cavity
      was calculated. RESULTS: At 30 degrees of abduction, in both shoulders, the
      humeral head was positioned inferior and posterior relative to the glenoid cavity
      (healthy: 0.42 +/- 1.1 inf., 0.75 +/- 1.0 mm post.; unstable: 1.31 +/- 0.87 mm
      inf., 0.51 +/- 1.28 mm post.) The maximal translation (to anterior and inferior)
      was observed both on the healthy side (mean 1.0 mm, max. 1.8 mm) and in the
      unstable shoulders (mean 2.5 mm, max. 4.6 mm) with the arm in 90 degrees of
      abduction and external rotation, thus being 1.7 to 2.5 times higher in the
      pathological shoulders. CONCLUSIONS: With this technique the glenohumeral
      translation can be quantified three-dimensionally in functionally important
      positions and without projectional artefacts. In the future, this method can be
      applied to patients with different entities of shoulder instability.

PMID- 11199411
TI  - [Damage to the glenoid labrum and expert assessment].
AB  - AIM: Development of criteria for the medical-legal interpretation of different
      patterns of labral lesions according to the labrum pathology and mechanism of
      injury. METHODS: A metaanalysis of the literature concerning injuries and
      diseases of the shoulder involving the glenoid labrum was performed. RESULTS:
      Lesions of the superior, anterior and posterior labrum are rare and of different
      severity. Arthroscopically they are divided into distinct types. They develop
      either spontaneously together with intraarticular diseases, due to chronic
      fatigue or by injury. In this field the stability of the shoulder joint and the
      tension of the long head of the biceps tendon play an important role. There is no
      correlation between the type of lesion and mechanism of injury. With respect to
      medical-legal interpretation, the currently used classification of labral lesions
      is not very helpful or is even confusing. We therefore propose a new
      classification according to the meniscus pathology which shows a striking
      similarity to labral pathology. There are two types of labral lesions: Type one
      shows degenerative defects, which may be influenced by mechanical loading; type
      two follows from shoulder instability. CONCLUSIONS: Medical-legal interpretation
      of labral lesions should follow the same principles that were shown to be useful
      in knee joint instability and meniscal tears. Only traumatic luxations of the
      shoulder joint may lead to labral tears without any other alterations.

PMID- 11199412
TI  - [Effectiveness of epicondylitis bandages from the biomechanical viewpoint--an
      experimental study].
AB  - QUESTIONS: During extension of the elbow joint (test measurement) and extension
      of the wrist (control measurement), maximal bandage pressure is desired on the
      extensor group of the forearm, especially of the M. extensor carpl radialis
      brevis (ECRB). Do the various commercial epicondylitis bandages produce a
      mechanical effect on the extensor group of the forearm and how do the maximal
      pressures of these bandages behave in direct comparison? Are the pressures
      produced clinically relevant? METHODS: Eleven different epicondylitis bandage
      constructions were examined for their biomechanical effects. The exerted pressure
      was measured continously during the above-mentioned movements. A fist-closing
      strength of ca. 30 N was maintained for the necessary pre-stressing of the
      forearm muscles. RESULTS: Strap-type bandages were the only bandages to produce
      adequately high pressures. Bands applied at pressures which approach those of the
      straps led to obstruction in bloodflow. Stocking designs showed no effect in
      respect to our study. CONCLUSION: Bandages which apply pressure to relieve the
      tendon insertion of the extensor muscles must, from a technical standpoint, be of
      a strap construction in order to build up adequate pressures to be effective.

PMID- 11199413
TI  - [Is open synovectomy of the metacarpophalangeal joint in chronic polyarthritis
      worthwhile?].
AB  - PURPOSE/METHODS/PATIENTS: This work retrospectively analysed 252 synovectomies
      performed on 153 patients from 1958 to 1995 at the Balgrist University
      Orthopaedics Clinic, and evaluated the short-term and long-term benefits of open
      synovectomy of the metacarpo-phalangeal joint in rheumatoid arthritis. RESULTS:
      Rheumatoid arthritis (n = 182) was by far the most common of the 21 different
      diagnoses involved, and the metacarpo-phalangeal joint (n = 101) was by far the
      most frequently operated of the 7 different joint types in question. In the short
      tenn (n = 97), after a mean of 5.5 months, open synovectomy of a metacarpo
      phalangeal joint in rheumatoid arthritis patients provided a benefit in terms of
      mobility in 85% of cases and in terms of joint swelling and pain in 93% of cases.
      Among one-third of the originally operated cases (n = 38), long-term benefit,
      i.e. after a mean of 6.9 years, was obtained in 89% of cases with regard to joint
      mobility, 87% with regard to swelling and 97% with regard to pain relief. Two
      thirds of the joints presented normal mobility and swelling, and three-quarters
      were pain-free. CONCLUSIONS: The metacarpo-phalangeal joint is very important for
      maintaining the independence of a patient (gripping). Open synovectomy of the
      metacarpo-phalangeal joint in rheumatoid arthritis patients is an effective
      therapeutic procedure with little morbidity and very good long-term benefit in
      the management of metacarpo-phalangeal pain, swelling and stiffness refractory to
      conservative therapy.

PMID- 11199414
TI  - [Surgical shortening of the Achilles tendon for correction of elongation
      following healed conservatively treated Achilles tendon rupture].
AB  - INTRODUCTION: Is operative shortening of the achilles tendon an adequate therapy
      in cases of elongation following conservative treatment of achilles tendon
      rupture? METHODS: From 11/89 to 12/97, 12 patients underwent achilles tendon
      shortening (9 male, 3 female, average age 43 years). All patients had an
      elongated tendon following conservative treatment of achilles tendon rupture. We
      were able to examine 8 patients (67%) after the operation. The average follow-up
      period was 35 (7-103) months with an average span between the primary trauma and
      surgery of 22 (8-45) months. RESULTS: Prior to surgery, all patients complained
      of weakness, gait disturbance and limitation of activity. At follow-up a
      subjective weakness of the plantar flexion remained in five and an objective
      weakness in all patients. We found a decrease of the isometric plantar flexion
      strength to 52% of the non-operated lower extremity while the maximum calf
      circumference was only 5% decreased. Only two patients reported of a gait
      disturbance and activity limitation whereas three patients were free of
      complaints. Using a modified Trillat score (1,967), 7 patients rated good or very
      good (1 poor). CONCLUSIONS: Achilles tendon shortening in case of elongation
      following conservative treatment of achilles tendon rupture helps to decrease
      gait disturbance and limitation of activity whereas a lack of the isometric
      plantar flexion strength persists. In our opinion an early decision for achilles
      tendon shortening might prevent this deficit.

PMID- 11199415
TI  - [Bursitis tendinis calcanei in extensive calcaneus erosion].
AB  - INTRODUCTION: Mechanical and static stress as well as rheumatic diseases may
      cause retrocalcanear bursitis. Anatomic variants of the calcaneus predispose to
      this bursitis. CASE: A 51-year-old woman being afraid of operation waited 2 years
      before undergoing bursectomy al her right heel. For this reason the increase of
      calcanear bone loss and its stabilisation by sclerosis is well documented in X
      rays and MR images. A secondary synovialitis of the peroneal tendons decided
      completely after bursectomy. No signs of rheumatic disease were found.
      CONCLUSION: The radiological, clinical and hisiological findings in long
      persisting bursitis are often simular to those found in patients with rheumatic
      disease. Normal laboratory findings do not preclude an early stadium of rheumatic
      disease. For this reason, these patients had to be instructed to return if they
      develop further synovialitis to verify the diagnosis and to avoid delayed
      therapy.

PMID- 11199416
TI  - [Early results of a prospective study in patients with computer-assisted femur
      shaft preparation in total hip endoprosthesis implantation (Robodoc system)-
      indications, outcome, complications].
AB  - AIM: Indications, results, advantages and disadvantages of the computer-guided
      femoral preparation in total hip arthroplasty (Robodoc) in our patients are
      recorded and represented. METHOD: 41 patients who underwent a computer-guided
      femoral preparation in total hip arthroplasty (Robodoc) were examined after 1
      year on average in a prospective study. The evaluation was made using the Harris
      Hip Score. The advantages and disadvantages of the Robodoc-assisted surgery are
      described. RESULTS: More than 80% of the patients had a good or very good result
      (> 80 points of Harris Hip Score) 3 month after surgery; after 6 months in 20 of
      21 patients a score of more than 85 pts. was calculated. The following
      complications were noticed: thrombotic embolism (2) with one lethal embolism
      included, fracture of the greater trochanter using the straight stem (3), aseptic
      drainage due to hematoma (2). 12 patients noticed a postoperative pain at the
      distal marking pin location (condylus femoris medialis) for an average of 3
      months. CONCLUSION: Generally, Robodoc-assisted surgery may be performed in all
      uncemented total hip arthroplasties. The individual indication should be checked
      because of the increased effort of surgery, the advantages and disadvantages, and
      the non-proven better long-term results in comparison to the regular technique.
      It seems that the Robodoc system provides advantages in post-traumatic arthritis
      and deformities of the proximal femur (varus and valgus neck) on account of the
      computer-aided preoperative planning and correct operative realization.

PMID- 11199417
TI  - [Computer-assisted navigated acetabulum placement in hip prosthesis implantation-
      application study in routine clinical care].
AB  - AIM: This study serves to examine the feasibility of a CAS system in clinical
      routine use in the field of total hip replacement. METHOD: Within a prospective
      study 70 total hip replacements were performed by one surgeon (KB) between March
      and November, 1999 using a CAS system for preoperative planning and
      intraoperative cup placement. RESULTS: The average operating time was 70 min.
      This means an average increase in total time of operation about 15-20 min. The
      average blood loss was 630 ml. No additional specific complications due to the
      use of the system were seen. There was no additional trauma created by
      percutaneous pointing at the spina or flxing a dynamic reference base (DRB) at
      the pelvis. CONCLUSION: The active application of this CAS system in clinical
      routine use showed very good results in feasibility and can be considered as
      reliable. The navigated cup placement shows the potential of improving the
      results in cup placement, thus improving the outcome of hip arthroplasty.

PMID- 11199418
TI  - [Polyethylene content and cell size of foreign body giant cells in aseptic hip
      prosthesis loosening--a histomorphometric study].
AB  - INTRODUCTION: In aseptic loosening of cementless hip arthroplasty polyethylene
      particles are phagocytized by macrophages and foreign-body giant cells. This
      initiates an osteolytic cascade. In this study, the authors investigated if there
      are correlations between the size of foreign-body giant cells and the
      polyethylene loading and number of intracellular particles as determined by light
      microscopy. MATERIAL AND METHOD: Histological specimens were processed from
      tissues retrieved during revision surgery of 7 cases of cementless hip
      arthroplasty which had become aseptically loose. The specimens were analyzed by
      histolomorphology and histomorphometry. The cell size, polyethylene loading and
      intracellular particle number of 111 foreign-body giant cells were determined. A
      regression analysis was performed to investigate if there was a correlation
      between these variables. RESULTS: The mean cell size was 1417 +/- 487 micron 2,
      the mean polyethylene loading was 49 +/- 42 micron 2 and the mean intracellular
      particle number was 10.4 +/- 5.4. The cell size correlated with both the
      intracellular particle number (r = 0.25) and the polyethylene loading (r = 0.39).
      CONCLUSIONS: In the cellular reaction to polyethylene particles in aseptic
      loosening of cementless total hip arthroplasty, the size of foreign-body giant
      cells correlates with intracellular polyethylene loading and intracellular
      polyethylene particle number as determined by light microscopy. The presence of
      large foreign body giant cells might be associated with a high particle load of
      the tissue and a high osteolytic activity.

PMID- 11199419
TI  - [Evaluating rehabilitation progress by measuring thigh circumference].
AB  - QUESTION: Thigh girth measurements have been widely used to quantify
      rehabilitation progress following knee surgery, but the correlation between thigh
      girth and other functional measures has not been investigated. This study
      intended to investigate whether such a correlation exists. METHODS: 15 women with
      bilateral osteoarthrosis of the knee participated in this study. Isokinetic knee
      extensor strength, thigh girth and body mass were measured immediately before,
      then at six weeks and six months following cementless total knee arthroplasty.
      RESULTS: The involved side showed clear pre-operative isokinetic knee extensor
      strength deficits, and slight reductions in thigh girth. Post-operatively, mean
      strength deficits were reduced, whereas differences in mean thigh girth became
      lager. Although thigh girth changes correlated well with body mass, they did not
      correlate with knee extensor strength. CONCLUSION: Changes in thigh girth are
      mainly due to changes in body mass. Thigh girth measurement is of no use for the
      quantification of the rehabilitation progress in total knee arthroplasty.

PMID- 11199420
TI  - [Chronic recurrent multifocal osteomyelitis].
AB  - The aim of this paper is to give a detailed description of the so-called "chronic
      recurrent multifocal osteomyelitis" (CRMO). The clinical, radiological and
      histopathological results of an analysis of 29 cases (15 children/adolescents and
      14 adults) are presented and correlated to current data from the literature. We
      could delinate the following points: 1. CRMO is a systemic aseptic inflammation
      of the bone marrow (Osteitis), it can occur polytopically and association with
      pustulous dermatologic symptoms is possible. 2. It is not a rare disease 3.
      Osteomyelitis is probably "reactive" and a plasma-cell sclerotic process with ist
      own characteristic histologic three-phase course. 4. We could observe 5 specific
      types of localization which can be documented by X-ray or bone scan. 5.
      Accompanying arthritis os often present, especially "sympathetic coxitis". 6. The
      use of drugs in treatment of CRMO (i.e. azithromycin, calcitonin, and
      bisphosphonates) is discussed. In conclusion we want to point out, that 1. 99mTC
      bone scan should always be performed when there is suspicion for CRMO to reveal
      the pattern of affection, 2. the rheumatologist and dermatologist should be
      contacted, 3. operation is normally not necessary for treatment of the mostly
      self-limitin disease, and 4. the term "SAPHO syndrome" should be avoided, further
      differentiation of the diagnosis is necessary.

PMID- 11199421
TI  - [Osseontegration of trial implants of carbon fiber reinforced plastics].
AB  - PROBLEM: To what extent are carbon fibre-reinforced plastics (CFRP) suitable as
      an osseous integration surface for implants? METHOD: CFRP test implants having a
      plexus-structured, rhombus-structured, and plexus-structured, hydroxyapatite
      surface were implanted in the femura of mini-plgs. Exposure time lasted 12 weeks.
      The implants were subjected to a macroradiological, a histological
      histomorphometrical, and a fluorescence-microscopical evaluation. RESULTS: One
      half of the uncoated, plexus-structured implants were not osteointegrated, the
      other half displayed an osteointegration rate of 11.8% in the spongy area and
      29.8% in the cortex layer. The HA-coated test implants showed an osteointegration
      of 29.5% in the spongiosa and 56.8% in the cortex layer. The rhombus-structured
      test implants had an osteointegration of 29.2% (spongiosa) and 46.2% (cortex
      layer). CONCLUSION: Compared to the osteointegration of metallic, especially
      titanium surfaces the CFRP surfaces tested by us fared worse, especially the
      uncoated, plexus-structured surfaces. For this reason we view very critically the
      use of carbon-fibre reinforced plastics together with the surfaces tested by us
      as osteointegrating surfaces.

PMID- 11199422
TI  - [Arterial complications caused by using an axillary crutch].
AB  - BACKGROUND: Of all upper extremity emboli, up to twenty percent arise from an
      arterial, not a cardiac source. METHOD: We report about a patient with recurrent
      embolism, caused by an axillary crutch-induced aneurysm of the axillary artery.
      RESULT: After revascularisation by embolectomy and axillo-brachial vein graft
      bypass, the patient was free of symptoms. CONCLUSION: Angiography and duplex
      scanning were necessary for the correct diagnosis.

PMID- 11199423
TI  - [Transplantation of osteochondral cylinders in various joints--technique and
      initial results].

PMID- 11199424
TI  - [Role of HLA-B27 in Bechterew disease].

PMID- 11199425
TI  - [Changes in muscle strength after implantation of knee joint endoprostheses].

PMID- 11199426
TI  - [Small intestinal transit with radio-opaque markers to localize   intermittent
      small bowel obstruction]  .
AB  - AIM: In difficult diagnostic cases of partial small bowel obstruction,
      radiopaque, non-digestible markers were used to challenge and localize the site
      of obstruction. MATERIAL AND METHOD: 32 patients (19 female, 13 male, 3-80 years)
      were examined. Each patient received 20 4-mm radiopaque markers orally. Abdominal
      radiographs were obtained at 4-8 h intervals. Mechanical obstruction was defined
      as the clustering of at least 3 markers for 4 hours or longer. The transit of
      radiopaque markers was compared to plain radiography, ultrasound, barium meal,
      computed tomography, enteroclysis and operative findings. RESULTS: 18 of 32
      patients showed small bowel clustering suggestive of obstruction. Diagnostic
      agreement was found in 12 of 14 cases with ultrasound, in 7 of 13 cases with
      plain radiography and in 3 of 6 cases with enteroclysis. 13 of the 18 patients
      with clustering had surgery. All of them (13/13) had adhesions with the need of
      resection. CONCLUSION: This investigation is an alternative diagnostic method for
      the decision between conservative and surgical treatment in cases of intermittent
      partial small bowel obstruction.

PMID- 11199427
TI  - [Tissue harmonic imaging sonography. Is the image quality in routine  abdominal
      ulstrasound improved?].
AB  - PURPOSE: Evaluation and statistical analysis of the influence of THI with pulse
      inversion technology on image quality in abdominal ultrasound in comparison to
      conventional sonography. MATERIAL AND METHODS: In 25 patients 398 ultrasound
      images of the abdomen were evaluated in a prospective, double blind study. 49% of
      the images were obtained with THI sonography, 51% with conventional sonography,
      respectively. Image parameter, anatomical region and image plane were kept
      constant by using a switchable ultrasound probe. Image contrast, delineation of
      organs, detection of vessels and artifacts in cystic structures were evaluated by
      four radiologists using a 3-grade scale. The interobserver variability was
      determined. RESULTS: The results of all groups showed statistically significant
      improvement compared to conventional sonography. High agreement of the evaluaters
      was achieved for image contrast and delineation of organs, less agreement in
      detection of vessels and artifacts in cystic structures, respectively.
      CONCLUSION: Image contrast and delineation of organs to neighboring structures as
      well as reduction of artifacts in cystic structures and vessels are statistically
      significantly improved with THI sonography using pulse-inversion technology in
      comparison to conventional sonography.

PMID- 11199428
TI  - [Papillary renal cell carcinoma: comparison of CT and gross morphology].
AB  - OBJECTIVE: To analyze the CT appearance of papillary renal cell tumor (pRCT)
      under consideration of gross pathology. MATERIAL AND METHODS: Preoperative CT
      scans of 10 patients suffering from pRCT were re-evaluated by two experienced
      radiologists. CT appearance was correlated to gross morphology. RESULTS: On CT,
      9/10 tumors were depicted as rounded, well circumscribed and sharply delineated
      masses. These tumors presented a hypodense central area correlating to necrosis
      in gross pathology. The central area of necrosis was surrounded by vital tumor
      tissue, presenting as a serpiginous, contrast-enhancing margin on CT. One tumor
      was polycyclic due to multiple tumor nodules, but sharply demarcated towards the
      surrounding renal tissue. CONCLUSIONS: pRCT presents a quite unique CT appearance
      similar to its gross pathology.

PMID- 11199429
TI  - [MRI of osteomyelitis: sensitivity and specificity of STIR sequences in
      comparison with contrast-enhaned T1 spin echo sequences].
AB  - PURPOSE: To evaluate the need for additional MR sequences including
      administration of Gd-DTPA after inconspicuous Short-Tau Inversion-Recovery (STIR)
      sequence to exclude the diagnosis of osteomyelitis. MATERIAL AND METHODS: 112 MR
      examinations of 79 patients acquired for the detection of possible osteomyelitis
      were analyzed retrospectively. All examinations were performed at 0.5 T including
      STIR, T1-weighted spin echo sequences (T1 SE) before and after application of Gd
      DTPA. Additionally, 93 T2-weighted spin echo sequences were available. The
      examinations were analyzed by two experienced radiologists. First, the STIR
      sequences were studied, followed by the T1 SE images before and after
      administration of contrast material. Finally, the T2-weighted images were
      evaluated. Diagnoses were confirmed by operation (22), biopsy (10), and follow-up
      (80). RESULTS: In 53 cases osteomyelitis was diagnosed, while the remaining 59
      cases suffered from another disease. The sensitivity of the STIR sequence was
      100% while the specificity for osteomyelitis was 49.2%. The specificity increased
      to 79.7% by including T1 SE images into the analysis and reached 83.1% after
      considering the contrast enhanced images. T2-weighted images yielded no
      additional information. CONCLUSION: The combination of STIR and T1SE images shows
      a high sensitivity and specificity for osteomyelitis, thus obviating the need for
      any additional examinations.

PMID- 11199430
TI  - [CT-guided percutaneous intratumoral chemotherapy with a novel 
      cisplatin/epinephrine injectable gel for the treatment of inoperable malignant
      liver tumors].
AB  - PURPOSE: To evaluate prospectively the volumetric changes of tumor and necrosis
      in unresectable malignant liver tumors and the clinical aspects after CT-guided
      direct intratumoral administration of a novel cisplatin/epinephrine injectable
      gel in a clinical phase II study. PATIENTS AND METHODS: 8 patients with 17
      colorectal liver metastases with a mean volume of 42 ml were treated with a mean
      of 5.1 injections and 8 patients with 11 HCC nodules (mean volume of 22.1 ml)
      with a mean of 3.25 treatments with CT-guided local administration of a novel
      cisplatin/epinephrine gel. This method of administration provides a higher local
      and lower systemic drug concentration. Volumes of tumor and necrosis prior to and
      after treatment were measured by computer-generated volumetric analysis. RESULTS:
      Contrast-enhanced studies verified pretherapeutic tumor necrosis with a value of
      12.6% in the metastases and 0.6% in the HCC nodules. Intratumoral drug
      administration resulted in a necrotic volume of 110% in metastases and 128% in
      HCC versus the mean initial tumor volume, at least 4 treatments resulted in 122%
      necrosis in metastases and 130% in HCC. Local therapy control rate for the follow
      up to 6 months was 38% and 83.3% for the group of metastases and HCC,
      respectively. CONCLUSIONS: Direct intratumoral injection of a novel
      cisplatin/epinephrine injectable gel results in an induction of a relevant
      necrosis in malignant liver tumors, with a substantially higher local therapy
      control rate for HCC compared to colorectal metastases.

PMID- 11199431
TI  - [Low-dose thrombolysis using rt-Pa in extensive peripheral vascular occlusion].
AB  - PURPOSE: To evaluate the efficacy of intra-arterial thrombolysis by rt-PA in
      acute and subacute extensive peripheral vascular occlusion. MATERIAL AND METHODS:
      100 patients with acute and subacute occlusion of peripheral arteries were
      treated by catheter thrombolysis using 20 mg of rt-PA over a period of 20-24
      hours. In all cases the occlusion extended to more than 20 cm and two stages of
      the extremity were involved. In 80 patients the original vessels (69/80 by
      thrombosis, 11/80 by embolization) and in 20 cases the femoro-popliteal bypass
      vessel was occluded. A catheter was inserted into the thrombus into which rt-PA
      and heparin were separately infused by two injectors. Heparin was given in a dose
      of 800-1000 U/h depending on the continuously monitored PTT levels. A control
      angiography was performed after 10 mg of rt-PA. After successful thrombolysis
      either PTA or aspiration thrombectomy was performed, if necessary, to reestablish
      a nearly normal vascular lumen. Open arteries of the thigh and at least one main
      vessel of lower leg was considered as success. RESULTS: Recanalization of the
      original vessels was successfully by thrombolysis, PTA or aspiration thrombectomy
      in 68/80 [85%] cases. Thrombolysis and PTA reestablished a normal lumen of the
      bypass vessel in 11/20 [65%] and in 6 more cases a recanalization with minor
      stenosis. In 13/15 patients with critical ischemia, thrombolysis probably helped
      to avoid amputation by reopening smaller collateral arteries. Bleeding at the
      puncture site, as a complication of thrombolysis, was the reason for stopping
      therapy in three cases. There was no retroperitoneal or cerebral bleeding. After
      successful thrombolysis, reocclusion occurred in 15 patients within one year,
      only in five cases amputation was necessary. CONCLUSION: Extensive occlusion of
      peripheral arteries or of a femoro-cural bypass can be successfully treated by
      low dose rt-PA thrombolysis with a low complication rate. Even partial reopening
      may prevent amputation.

PMID- 11199432
TI  - [The sacral perineural system--are there radiological criteria for an indication
      for surgery? First results and literature survey].
AB  - PURPOSE: To establish recommendations for diagnostic imaging of cystic lesions of
      the sacral region and to evaluate for potential predictors of therapeutic
      outcome. METHODS: Conventional imaging of the lumbar spine, conventional CT,
      myelography, post myelo-CT and MRI were performed in 7 symptomatic [corrected]
      patients. All patients underwent operative decompression and histological
      examination. The radiographic examinations were reevaluated retrospectively and
      correlated with the postoperative outcome. RESULTS: In one patient the
      differential diagnosis of a neurinoma could not be excluded with CT and CT
      myelography alone. In all 7 patients MRI provided a definite diagnosis and a
      precise presentation of the cyst extension. A complete postoperative remission of
      symptoms was noticed in 4, a partial remission in three cases. The correlation of
      cyst extension, cyst shape, and the communication with the subarachnoid space did
      not provide predictive information concerning operative outcome. CONCLUSION: MR
      can be used as the sole imaging tool for demonstration of cystic lesions.
      Relevant disadvantages in comparison to myelography and myelo-CT were not
      evident. No imaging modality could predict the value of surgical intervention.

PMID- 11199433
TI  - [Quantification of fluid flow in magnetic resonance tomography: an experimental
      study of a flow model and liquid flow measurements in the cerebral aqueduct in
      volunteers].
AB  - PURPOSE: To study the feasibility o MRI for quantification of fluid flow in a
      tube model and the cerebral aqueduct (CA) in volunteers. VOLUNTEERS AND METHODS:
      All studies were performed on a 1.5 T MR scanner using a head coil and a FLASH 2D
      phase contrast sequence with a velocity encoding at 20 cm/s. Flow (real value,
      ml/sec) of a saline fluid was measured in a flexible tube model with different
      inside diameters: 0.75-3 mm. Three flow velocities were given (normal value). To
      test the reproducibility, three studies were done using a flow of 0.12 or 0.14
      ml/sec and a tube diameter of 0.75 and 2.0 mm. The ratio of normal to real flow
      value was calculated (ideal ratio = 1). MRI of CA and flow quantification was
      done in 24 volunteers (28 +/- 4 years). RESULTS: Using tubes with a diameter of
      0.75 and 1.5 mm the real flow was sometimes higher than the velocity encoding of
      the phase contrast sequences. Because of this measurements of the fluid flow and
      the flow velocities were impossible. There was agreement for fluid flow
      quantification in the tube of 3.0 mm and high agreement in the tube of 2.0 mm in
      diameter with reproducible results. The mean diameter of the CA in normal
      subjects was 2.0 +/- 0.3 mm, the mean cerebral flow was 0.04 +/- 0.02 ml/sec and
      the peak velocity 3.06 +/- 1.59 cm/sec. CONCLUSIONS: Reliable flow quantification
      with MRI is feasible if the diameter of the lumen is greater than 1.5 mm, and if
      the flow velocity is lower than the velocity encoding. In cases of smaller
      diameters and higher flow velocities the velocity encoding has to be changed.
      Because of this the quantification seems to be inaccurate in cases of aqueductal
      stenosis with the method we used.

PMID- 11199434
TI  - [Full-field digital mammography: dose-dependent detectability of breast lesions
      and microcalcinosis].
AB  - OBJECTIVES: The study compares contrast-detail and microcalcification
      detectability of a full-field digital mammography (FFDM) to a state-of-the-art
      conventional screen-film mammography (SFM) by using different doses in the
      digital system. MATERIALS AND METHODS: The investigations were performed with an
      FFDM (Senographe 2000 D, GEMS) and an SFM system (Senographe DMR, GEMS) using a
      contrast-detail mammography phantom (CDMAM) and an anthropomorphic breast phantom
      with superimposed microcalcifications. The digital detector was exposed with
      standard dose of SFM and with a dose reduction of up to 75%. Contrast-detail
      curves and correct observation ratio (COR) were performed for the CDMAM phantom.
      ROC analysis with a confidence level ranging from 1 to 5 was done with the
      results of the anthropomorphic phantom. RESULTS: Digital mammography with the
      same dose revealed at least an equivalent or even higher detectability rate than
      conventional mammography, COR could be increased at about 10-25%. The ROC
      analysis yielded better results for the FFDM system. The same lesion
      detectability in digital mammography as in the conventional method was reached at
      a dose reduction of about 25%, concerning spot views even at higher reduction.
      Dose reduction in the anthropomorphic phantom resulted in a linear loss of
      detectability. The same detectability as in conventional mammography was reached,
      however, by a dose reduction of about 50%. CONCLUSION: The results suggest that
      FFDM is at least equivalent to or--as far as spot views are concerned--superior
      to conventional SFM concerning the detectability of simulated lesions. Thus, a
      potential of dose reduction is suggested.

PMID- 11199435
TI  - [Reduction of the radiation exposure of patients caused by selected
      interventional and angiographic procedures].
AB  - PURPOSE: To reduce patient doses caused by selected interventional and
      angiographic procedures using the digital C-arm unit "Multiskop". MATERIALS AND
      METHODS: After a patient study done previously, physical measurements with test
      phantoms were carried out, and physical-technical parameters such as distance
      between focus and image intensifier, additional filtration, and radiation dose
      per image were optimised. Then, the dose-area product (DAP) and the fluoroscopic
      time were measured for 130 percutaneous transluminal angioplasties (PTA), 40 PTA
      with stent implantation, 61 embolisations, and 302 digital subtraction
      angiographies (DSA). In the case of 16 PTA, 9 embolisations, and 38 DSA the
      number of radiographs was determined, and the DAP was divided into two parts,
      fluoroscopy and radiography. The measuring values were compared with data of the
      patient study done previously. RESULTS: The median values of the DAP and the
      fluoroscopic time amounted to 25 Gy cm2 and 9.7 min for PTA, 97 Gy cm2 and 8.5
      min for PTA with stent implantation, 88 Gy cm2 and 17.2 min for embolisation as
      well as 54 Gy cm2 and 2.8 min for DSA. For the relation between DAP caused by
      fluoroscopy and radiography, and the number of radiographs, median values of 0.76
      and 63 for PTA, 0.81 and 123 for embolisation as well as 1.85 and 134 for DSA
      were determined. In comparison to the patient study done previously the median
      values of the DAP were reduced by 31% for PTA, 26% for PTA with stent
      implantation, 55% for embolisation, and 38% for DSA. CONCLUSIONS: The comparison
      between the patient studies done previously and recently indicates the great
      potential of dose reduction for interventional and angiographic procedures.
      Although the X-ray equipment is ten years old the patient dose can be reduced by
      organizational and physical-technical modifications to such an extent that
      preliminary national reference dose values will not be exceeded. For further
      significant dose reductions while maintaining adequate image quality it will be
      necessary to purchase a modern X-ray equipment with pulsed fluoroscopy and
      automatic filter selection.

PMID- 11199436
TI  - [A review of molecular radiology. I: Gene therapy].
AB  - The term molecular radiology intermediate region between radiological imaging and
      interventional radiology on the one side and molecular biology on the other. In
      the field of imaging methods are currently being developed by which molecular
      processes, i.e., gene expression and protein function, can be visualized in vivo.
      These techniques open new perspectives for research and clinical diagnosis and
      will be presented in the second part of this review. The present part provides a
      survey of current developments in gene therapy from a radiological point of view
      and highlights the part that our specialty may play in this field.

PMID- 11199437
TI  - [Full-field digital mammography].
AB  - Due to the extremely high image quality requirements in mammography, there has
      for a long time been no adequate digital alternative to conventional film-screen
      mammography. The longest experience so far exists with digital mammography on the
      basis of storage phosphor (CR) systems. However, at normal dose this technique
      has a relatively poor signal-to-noise ratio and has not found general acceptance.
      Recently three novel systems for digital mammography by the companies Fischer
      (slot-scan detector), Trex (CCD-array), and GE (amorphous silicon detector) have
      been introduced and are currently under clinical investigation. The main
      advantage of digital mammography is the linear relationship between dose and
      detector signal with the possibility of a tailored optimization of image
      contrast. Other advantages include digital image storage, telemammography, and
      computer-assisted diagnosis.

PMID- 11199438
TI  - [Experimental studies on image quality in conventional film screen system,
      digital phosphor storage plate mammography in mangnification technique and
      digital mammography in CCD-technique].
AB  - Comparison of image quality between conventional film screen system, digital
      phosphor storage plate mammography in magnification technique and digital
      mammography in CCD-technique. MATERIALS AND METHODS: Radiograms of a RMI
      mammography phantom were acquired using a conventional film screen system, two
      digital storage plate systems and two digital systems in CCD-technique.
      Additionally, the radiograms of one digital phosphor storage plate system were
      postprocessed emphasizing contrast and included in the comparison. RESULTS: The
      detectability of details was the best with the digital mammography in CCD
      technique in comparison with the conventional film screen technique resp. digital
      phosphor storage plate in magnification technique. CONCLUSIONS: Based on these
      results there is the possibility to replace the conventional film screen system
      by further studies--this has to be confirmed.

PMID- 11199439
TI  - [Intraoperative digital radiography for diagnosis of nonpalpable breast lesions].
AB  - PURPOSE: A procedure for performing intraoperative digital radiography of
      diagnostic breast specimens directly in the operating suite with teleradiologic
      assessment by a radiologist is presented. The efficiency of this procedure is
      compared with that of conventional magnification mammography performed in the
      radiology department. MATERIAL AND METHODS: Thirty-six specimen radiographs
      obtained by conventional magnification mammography were compared with 38
      intraoperative digital magnification radiographs (DIMA Soft P42 prototype,
      Feinfocus Inc., Garbsen). The radiographs were assessed for lesion conspicuity
      and time savings for the surgeon, anesthesiologist, and radiologist. RESULTS: The
      new procedure identified all 38 labeled pathological lesions, and the
      conventional technique likewise had a detection rate of 100% (36/36). The new
      technique resulted in considerable time savings for the surgeon and the
      radiologist. The duration of surgery was shorter and the time interval from
      removal of the specimen to reporting of the results was reduced from about 23 min
      to about 13 min. A single radiograph was sufficient for complete visualization of
      the specimen in all cases. CONCLUSION: Digital intraoperative specimen
      radiography considerably reduces the time of surgery depending on the local
      conditions and is highly accurate in locating a suspicious area within the
      tissue.

PMID- 11199440
TI  - [High resolution multislice CT of the lung: comparison with sequential HRCT
      slices].
AB  - PURPOSE: To compare the image quality of high-resolution (HR) spiral CT scans
      from a multislice CT scanner with sequential HRCT scans from a singleslice CT
      scanner. MATERIALS AND METHODS: 20 patients with diffuse lung disease received a
      high-resolution spiral CT on a multislice scanner (4 slices) and 5 HRCT single
      slices (1 mm) on a singleslice scanner. Scan parameters of the multislice scanner
      were: Collimation 4 x 1 mm, pitch 6, slice thickness 1 mm. 5 HRCT slices were
      compared to the corresponding HR spiral CT slices using a 5-point scale by 5
      radiologists with regard to the image quality and the number of artifacts. The
      evaluation was performed with a multivariate analysis (MANOVA test). RESULTS:
      Overall impression of image quality, noise, central vessels and bronchi, and all
      pathological changes were not significantly different between the two CT methods.
      Sequential HRCT scans were considered to be significantly better than HR spiral
      CT scans for spatial resolution (p = 0.02), depiction of peripheral vessels (p =
      0.02), and of small bronchi (p = 0.05), and significantly worse for depiction of
      interlobar septa (p < 0.001). Diagnostically relevant differences were found in
      only 2.2%. Breathing and heartbeat artifacts each were 3 times higher in the
      sequential HRCT technique than in the multislice-spiral technique (p < 0.0001).
      CONCLUSION: HR spiral CT scans performed on a multislice CT scanner provide
      significantly less artifacts and an equal diagnostic image quality compared to
      sequential HRCT scans performed on a singleslice CT scanner. Multislice spiral CT
      in HR technique may replace the common scanning technique with conventional
      spiral CT and additional HRCT scans for diffuse lung diseases.

PMID- 11199441
TI  - [Contrast media-enhanced 3D MR angiography of peripheral arteries using an
      automatic tracking technique at 1.0 Tesla].
AB  - PURPOSE: Assessment of the value of contrast-enhanced MR angiography (ceMRA)
      using an automatic tracking technique at 1.0 Tesla in comparison with digital
      subtraction angiography (DSA) of the pelvic and lower limb arteries. MATERIALS
      AND METHODS: In 15 patients with peripheral arterial occlusive disease a ceMRA
      (3D FLASH, TR/TE = 6.2/2.3 ms, Flip angle alpha = 30 degrees, Matrix 170 x 256)
      using a new automatic tracking technique was accomplished. The reference method
      was DSA. Twenty-one vessel segments of each patient were graded as normal,
      stenosed (> 50%) or occluded. Image material was evaluated independently by two
      radiologists. RESULTS: In comparison, the interobserver agreement showed a good
      (Cohen's kappa > 71%) concordance for 38% of the 21 vessel segments, a moderate
      (Cohen's kappa between 31%-70%) for 21% and a poor (Cohen's kappa < 30%)
      concordance for 38% of the 21 vessel segments. Regarding the MRA and DSA results,
      a good concordance was achieved for 62% of the 21 vessel segments, 14% showed a
      moderate concordance and 24% only a poor concordance. CONCLUSION: In patients
      with peripheral arterial occlusive disease ceMRA using an automatic tracking
      technique enables a reliable evaluation of pelvis and upper limb arteries at 1.0
      Tesla. However, a reliable evaluation of lower limb arteries is not yet possible.

PMID- 11199442
TI  - [Contrast media-enhanced 3D MR angiography before endovascular treatment of
      aneurysm in the abdominal aorta, iliac artery and peripheral vessels].
AB  - PURPOSE: The value of DSA for the measurement of aortic and peripheral arterial
      aneurysm dimensions before endovascular treatment is limited by projection
      effects. It was evaluated if additional gadolinium-enhanced three-dimensional MR
      angiography (3D-CEMRA) could compensate for the disadvantages of DSA. MATERIALS
      AND METHODS: 21 patients with 35 aneurysms in the abdominal aorta (14), iliac (9)
      and femoropopliteal vessels (12) were assessed with DSA (7 with calibrated
      catheter, 14 with yardstick) and 3D-CEMRA (TR/TE 7.8/2.1 ms, flip-angle 40
      degrees, Matrix 512 x 224, FOV 500 mm, eff. slice 1.8 mm). We measured and
      compared aneurysm dimensions on both modalities. 3D-CEMRA was regarded as the
      reference method to evaluate the dimension of DSA-projection effects. RESULTS:
      Diameter and length of aneurysms were underestimated on DSA with the yardstick as
      reference. The deviation ranged from 15% (+/- 5%) in the aorta to 21% (+/- 10%)
      in the iliac vessels. Only with calibrated catheters as reference (7/21 DSA),
      were the distances on DSA correlated well with MRA. In 2/35 aneurysms 3D-CEMRA
      detected thrombosis with difference between length of inner lumen dilatation on
      DSA and whole aneurysm length. 2/5 accessory renal arteries found on DSA were not
      detected on 3D-CEMRA. CONCLUSIONS: 3D-CEMRA is a valuable adjunct to DSA for pre
      interventional diagnostics of aortic and peripheral arterial aneurysms. It
      provides exact evaluation of aneurysm dimensions and information about partial
      thrombosis.

PMID- 11199443
TI  - [Contrast media-enhanced MR angiography of the lower extremity arteries using a
      dedicated peripheral vascular coil system. First clinical results].
AB  - PURPOSE: To evaluate contrast enhanced magnetic resonance angiography (ceMRA) of
      the pelvic and peripheral arteries with a dedicated peripheral vascular coil
      system and automated table-feed technique in patients with arterial occlusive
      disease. METHODS: Three-dimensional gadolinium-enhanced MR angiography in a two
      step automatic table feed technique was performed in 45 patients using a 1.5
      Tesla imager (Magnetom Symphony, Siemens). The pelvic arteries were imaged with a
      single injection of contrast material. The upper and the lower leg were imaged
      with a second injection of contrast material in an automated table feed technique
      using a dedicated vascular coil system. In 20 patients ceMRA was compared with
      digital subtraction angiography (DSA) as the standard of reference and in 25
      patients ceMRA was performed solely. RESULTS: Sensitivity and specificity for
      grading significant stenoses > or = 50% and occlusions (in parenthesis) were in
      the pelvic arteries 94.7%, 96.8%, (100%, 100%), in the arteries of the upper leg
      92.3%, 93.3% (87.5%, 100%) and in the arteries of the lower leg 96.5%, 95.8%,
      (95.2%, 96.8%), respectively. Depiction of the runoff vessels of the lower leg
      was excellent in ceMRA. CeMRA was of diagnostic quality in all the patients.
      CONCLUSION: Contrast-enhanced MRA using a dedicated peripheral vascular coil
      system increases the diagnostic quality of the lower leg. The runoff vessels can
      be evaluated. Thus, ceMRA in the presented technique is a diagnostic alternative
      to arterial angiography.

PMID- 11199444
TI  - [Diagnostic radiological guidelines in the area of the head and neck].

PMID- 11199445
TI  - [The Diagnosis Related Groups for Germany: "Clinician, take the lead!"].

PMID- 11199446
TI  - [Australian Refined Diagnosis Related Groups. Formal and inherent problems of
      grouping with the example of stroke care].
AB  - BACKGROUND AND OBJECTIVES: With the Health Reform 2000, the Australian Refined
      Diagnosis Related Groups (AR-DRG), Version 4.1 have been chosen as the basis for
      the future German costing system for hospitals. With regard to Stroke Severity
      (Barthel Index [BI]) we investigated to what extent the grouping according to AR
      DRGs can reproduce healthcare expenditures for such patients. Options to adapt
      and optimize the system are discussed. PATIENTS AND METHODS: 632 patients who had
      suffered a cerebrovascular accident and were discharged from conservative acute
      care in 1999, were classified according to the AR-DRGs. For the grouping we
      alternatively used data from the current hospital information system and a stroke
      database for quality assurance. The results were also compared with the clinical
      profiles for the public hospital sector of the corresponding DRGs in Australia
      (1997-98). RESULTS: On average 0.99 additional diagnoses per case were documented
      in the hospital information system, compared to 3.65 in the stroke database. In
      the stroke database 177 cases (36.8%) were assigned to the DRG with the highest
      cost weight. 53.7% of these patients suffered a serious stroke (BI < 30).
      Grouping on the basis of hospital information system data led only to 14 cases
      (2.8%) assigned to the DRG with the highest cost weight. CONCLUSIONS: Type and
      extent of additional diagnoses are crucial for the grouping process. From a
      clinical and economic point of view, measures of disability and impairment should
      be assigned to the grouping process to improve homogeneity under both aspects.
      Scores can also serve for determining reliable outcome parameters. For the
      development of an outcome related reimbursement system, procedures must be
      included in the definition of medical DRGs. In future, DRGs, which cover
      overlapping healthcare sectors, should be developed for patients with poststroke
      rehabilitation.

PMID- 11199447
TI  - [Assessment of teaching at the faculties of medicine in Germany].
AB  - BACKGROUND AND OBJECTIVES: The aim of this study was to gather, against the
      background of a long-discussed deficit in academic teaching, data on the current
      activities of medical faculties with regard to teaching, and to analyse these
      findings. Another aim was to obtain suggestions for establishing a consensus on
      indicators that could be used to assess the quality of teaching. MATERIAL AND
      METHODS: In March 2000, a written inquiry was addressed to the deans of all 37
      medical faculties in Germany. The questionnaire, arranged so that responses could
      be entered into a data-base, consisted of ten items in three parts. Part 1
      concerned the evaluation of teaching, parts 2 and 3 dealt with the place of
      specific assessment of teaching in the process of choosing lecturers
      ("habilitation") and appointing senior professors. In addition to providing
      alternative answers (in some instances, allowing a choice of several
      alternatives) there was also space for written comments. The answers were
      analysed by descriptive statistics. RESULTS: All questionnaires were returned in
      a usable form (response rate 100%). 36 faculties had, at the time of receiving
      the questionnaire, already instituted teaching assessments, of clinical teaching
      sessions more often than preclinical ones (97% vs 89%). The most widespread
      method of assessment consisted of obtaining students' opinion and of using the
      centralized written examinations of the institute for Medical and Pharmaceutical
      Examination Questions. In more than half of the faculties (57%) an above-average
      teaching performance by teachers was acknowledged in special ways
      (honours/prizes). In 31 faculties (84%) teaching experience counted as an
      absolute prerequisite for obtaining a lectureship, but as a rule without
      employing any defined standards. With regard to the selection of senior
      professors, 27 faculties (73%) explicitly took teaching competence into account.
      Defined criteria for assessing teaching ability were largely absent. CONCLUSIONS:
      The assessment of teaching quality can be considered as well established at
      medical faculties in Germany. However, the methods and models used are highly
      heterogeneous. Furthermore, numerous activities exist in the various faculties to
      increase the importance attached to academic teaching. However, despite using
      diverse indicators of quality, the central problems for assessing teaching
      ability remain unsolved.

PMID- 11199448
TI  - [Food-dependent Cushing syndrome of long standing with mild clinical features].
AB  - HISTORY AND CLINICAL FINDINGS: A 40-year-old woman complained of weight gain for
      10 years. Because of this, she yearly went on a excessive weight reduction diet
      with weight loss of up to 12 kg. Nevertheless, a total weight gain of 15 kg as
      well as changing degrees of hypertension, muscular weakness and severe depression
      were registered during this long period. For 5 years ecchymosis and for 2 years
      oligomenorrhoea as well as oedema had become evident. Recently large macronodular
      adrenal glands were found on routine abdominal ultrasound. At the time of
      clinical investigation early this year she presented with relatively mild Cushing
      features, such as moon face, central obesity, hirsutism, ecchymosis and
      hypertension. INVESTIGATIONS: Endocrine testing demonstrated suppressed plasma
      ACTH, low to normal plasma cortisol after overnight fasting and an inverse
      diurnal rhythm. During 24 hours of fasting plasma cortisol levels and free
      urinary cortisol excretion were within normal range, but highly elevated under
      normal food intake. Plasma cortisol levels increased dramatically in response to
      a lipid-rich meal (5.6-fold), to a protein-rich meal (6.6-fold) and to oral
      glucose (3.7-fold). Increases in plasma cortisol were closely correlated to
      increases of gastric inhibitory polypeptide (GIP) concentrations. Subcutaneous
      injection of octreotide completely inhibited the plasma cortisol and GIP response
      to oral glucose. Plasma ACTH and cortisol levels did not increase after CRH
      administration, but fasting plasma cortisol promptly increased after ACTH
      stimulation. Non-fasting plasma cortisol levels and free urinary cortisol
      excretion were not suppressed by high doses of dexamethasone. Abdominal computed
      tomography showed macronodular enlargement of both adrenal glands. TREATMENT AND
      COURSE: The patient underwent bilateral adrenalectomy. Postoperatively, she was
      treated with replacement doses of hydrocortisone and fludrocortisone. All Cushing
      features have regressed, a normal menstrual cycle and normal plasma ACTH
      concentrations have become evident. CONCLUSION: This case report not only
      presents a very rare cause of Cushing's syndrome--food-dependent or gastric
      inhibitory peptide (GIP)-dependent hypercortisolism--but it also demonstrates a
      special course of this disease of relatively long duration. Severe adrenal
      hyperplasia contrasted with mild clinical symptoms obviously caused by frequent
      periods of weight reduction diet. Considering this moderate clinical course it
      might well be that food-dependent hypercortisolism is more frequent than
      supposed, but not diagnosed owing to relatively mild clinical symptoms.

PMID- 11199449
TI  - [Proton pump inhibitors in acute ulcer bleeding--what is evident?].

PMID- 11199450
TI  - [Alternatives to standard therapy for bronchial asthma].

PMID- 11199451
TI  - [Quo vadis, medicina?].

PMID- 11199453
TI  - [Multiple primary carcinomas in patients with head and neck malignancies].
AB  - BACKGROUND: Multiple primary tumors can lead to diagnostic and therapeutical
      problems. In this study we surveyed frequency, localisation, diagnostic,
      chronologic and therapeutic aspects of multiple primary carcinomas in patients
      with head and neck tumors. PATIENTS AND METHODS: The data of 843 patients from
      the tumor registry of the ENT-clinic Aachen were retrospectively studied.
      RESULTS: Larynx (41.87%) and oropharynx (12.57%) were the main localisation of
      the first primary neoplasma. In 65 patients (7.71%) multiple primary tumors were
      observed. 24.6% of these tumors occurred synchronously. Preferential localisation
      of a second tumor were lung (20%), oral cavity (15.3%) and larynx (13.8%). 28.57%
      of the metachronous tumors were observed after more than five years. In 46.15%
      clinical complaints led to the suspicion of a second tumor. Panendoscopy was the
      most reliable diagnostic procedure. The survival rate and time was significantly
      reduced in patients with synchronous tumors. 3-year survival rate was 15%
      compared to 81% in patients with metachronous tumor appearance (p < 0.0001).
      CONCLUSION: Patients with head and neck tumors have a high incidence of multiple
      primary malignomas varying from the region of the first presentation of a
      malignant tumor. Concepts comprising surgery provide the highest survival rates.
      Because of the high incidence of metachronous carcinomas after five years found
      in this study, the authors regard a prolonged follow-up period as necessary.

PMID- 11199452
TI  - [Prophylaxis of infection in neutropenic patients. Guidelines of the Working
      Party on Infections in Hematology and Oncology].

PMID- 11199454
TI  - [Molecular biology and immunohistochemical prognostic markers in head and neck
      squamous epithelial carcinomas].
AB  - BACKGROUND: Scientific research work of the last decade has been performed in
      order to investigate biological parameters of prognostic significance for head
      and neck squamous cell carcinoma. In contrast to other cancer types, like colon
      carcinoma, where tumour progression is accompanied by an almost defined sequel of
      gene activations and inactivations, cells of squamous cell carcinoma behave more
      heterogenously. METHODS: Publications concerning the most important
      immunohistochemical, molecular biological and cytogenetic prognostic markers in
      head and neck cancer have been analyzed. RESULTS: The prognostic markers
      discussed in this publication have been classified into the following areas:
      Apoptosis, cell cycle regulation, viral infections, cytokines and growth
      factors/growth factor receptors, angiogenesis and hypoxia, proteinases, cell-cell
      contacts and cell-matrix contacts, cytokeratin fragments, chromosomal
      rearrangements and genetically inherited susceptibility to toxic reagents.
      CONCLUSIONS: Significant prognostic markers are important for the clinical follow
      up of patients and the choice of therapeutical approach. However, none of the
      factors analyzed can be used as an individual and universal prognostic marker at
      present.

PMID- 11199455
TI  - [Coexpression of VEGF and bFGF is associated with increased vascular density in
      head and neck carcinomas].
AB  - BACKGROUND: Angiogenesis is crucial for tumor growth and metastasis. In several
      tumors, microvascular density has been shown to correlate with metastasis and
      aggressiveness. Vascular endothelial growth factor (VEGF) and basic Fibroblast
      Growth Factor (bFGF) are known to have potent angiogenic activity. Their
      expression has been identified in a wide variety of malignancies including head
      and neck squamous cell carcinoma (HNSCC). Aim of our study was to investigate the
      role of co-expression of VEGF and bFGF for angiogenesis in HNSCC. MATERIAL AND
      METHODS: Cryostat sections of 51 primary HNSCC were immunostained for VEGF and
      bFGF using a standard streptavidin-biotin complex procedure. To evaluate
      angiogenesis, endothelial cells were stained immunohistochemically using anti-vWF
      polyclonal antibody. Microvessels were quantified by counting vessels in a x200
      field in the most vascular area of the tumor. RESULTS: 25/51 (49%) of the
      investigated carcinomas showed co-expression of both factors (VEGF+/bFGF+), while
      6/51 (11.7%) carcinomas only expressed VEGF and 13/51 (25.5%) carcinomas
      expressed bFGF. 7/51 (13.7%) tumors showed no expression of these factors (VEGF
      /bFGF-). Carcinomas with a co-expression of VEGF and bFGF showed a significantly
      increased mean microvessel density (88.3 +/- 24.4) compared to tumors expressing
      only VEGF (77 +/- 16.8) or bFGF (71.1 +/- 15.8) (p = 0.022) or tumors with no
      expression of both factors (51.1 +/- 13.4) (p < 0.001). The association of VEGF
      and bFGF expression level was not significant (p = 0.178). CONCLUSIONS: The
      positive correlation of the co-expression of angiogenic VEGF and bFGF with
      increased microvessel density underlines the importance of both factors for tumor
      angiogenesis in HNSCC. VEGF and bFGF might act cooperatively in the process of
      neovascularization in human head and neck cancer.

PMID- 11199456
TI  - [Classification and prognosis of esthesioneuroblastoma based on 7 treated cases].
AB  - BACKGROUND: The esthesioneuroblastoma is a rare tumour of neuroectodermal origin,
      which arises usually in the area of the olfactory epithelium and invades the
      paranasal sinuses, the orbit and the brain. The low incidence of this disease
      makes a development of standardised clinical and histological classification
      difficult. Up to now this tumour is considered to be slow progressive but
      strained by a high rate of local recurrences. Metastasis are usually seen late at
      an advanced stage. PATIENTS: In the last 18 years 7 patients with an
      esthesioneuroblastoma were treated in our department. This relatively large
      number of patients allows a retrospective evaluation of the different already
      existing classifications concerning treatment and prognosis. RESULTS AND
      CONCLUSIONS: In all cases of a disease limited on the paranasal sinuses the
      patients were successfully treated either by a combination of resection and
      radiation (4 cases) or resection alone (1 case). No patient underwent a
      chemotherapy. Two cases with lethal outcome showed an extremely aggressive tumour
      progression. In such cases of extensive disease an additional chemotherapy has
      always to be taken into account. Our experiences and the analysis of the
      literature gives some indications that middle-aged patients have a worse
      prognosis than young or old patients.

PMID- 11199458
TI  - [Temperature and humidity profile of the paranasal sinuses before and after
      mucosal decongestion by xylometazolin].
AB  - BACKGROUND: One of the most important functions of the nose is to warm and to
      humidify air before it reaches the lower respiratory tract. Nasal decongestants
      as one of the most common drugs used in otorhinolaryngology are often associated
      with the feeling of a "dry nose". The purpose of this study was to determine the
      short-term influence of xylometazoline on temperature and humidity in the nasal
      airways. METHODS: 15 healthy volunteers were enclosed into the study. A
      miniaturised humidity sensor and thermocouple was used for detection of humidity
      and airway temperature in the nasal vestibule, at the nasal valve area and in the
      nasopharynx at the end of inspiration. Measurements were done before and after
      topical application of xylometazoline. RESULTS: Temperature and relative humidity
      increase from the anterior parts of the nose to the nasopharynx at the end of
      inspiration. The temperature and humidity values after nasal decongestion are not
      significantly different from the values before application of xylometazoline. As
      a tendency temperature and humidity values after nasal decongestion are even
      somewhat higher at the nasal valve area compared to the values before application
      of xylometazoline. CONCLUSIONS: Widening of the nasal airways by mucosal
      decongestion did not lead to a significant change of the nasal temperature and
      humidity profile 20-30 min after application of xylometazoline. The use of
      xylometazoline seems not to influence humidifying and heating of inspired air
      within a short period after onset of the maximal decongestive effect of
      xylometazoline.

PMID- 11199457
TI  - [A new therapy concept in esthesioneuroblastoma].
AB  - BACKGROUND: We introduce a new concept in treatment of esthesioneuroblastomas,
      developed in the University Medical School of Graz, Austria. PATIENTS AND
      METHODS: Six patients suffering from esthesioneuroblastoma have been treated in
      the years 1993-1999; five of them with a curative aspect, one with a palliative
      one. Three tumours were classified according to Kadish as stage B, three as stage
      C. The selection criteria included tumours without deep infiltration into the
      orbit nor into the pterygopalatine fossa and without any involvement of the
      posterior wall of the frontal sinus. The treatment consists of endoscopic nasal
      and paranasal sinus surgery and consecutive stereotactic radiosurgery by means of
      the Gamma-Knife unit. RESULTS: Over an average follow-up period of 38 months all
      patients remained free of disease. Because of the minimally invasive character of
      our concept the complications and side effects are minimised and the patients are
      less traumatised in comparison to conventional treatment such as craniofacial
      resection or irradiation. CONCLUSION: Due to the excellent outcome of our six
      patients we recommend this new treatment concept, in selected cases, as an
      alternative to the usual therapeutic modalities for esthesioneuroblastoma.

PMID- 11199460
TI  - [Local antibiotic administration decreases risk of inner ear damage in
      effodation].
AB  - BACKGROUND: Mobilising the stapes via the removal of the tympanosclerotic plaques
      from the oval window niche (effodation) and stapedectomy or malleovestibulopexy
      are the different procedures generally available for the surgical therapy of
      stapes fixation due to tympanosclerosis. These techniques bear a significant risk
      of sensory hearing loss. Here we analyse our results using the mobilisation
      technique together with locally applied antibiotics. PATIENTS: Nineteen ears in
      seventeen patients with tympanosclerosis involving the stapes and its footplate
      which underwent stapes mobilisation between 1991 and 1999 have been investigated
      retrospectively. According to the literature this operation has a high risk of
      cochlear hearing loss. To reduce this risk, azlocillin was instilled locally
      during removal of tympanosclerotic plaques. RESULTS: Different operation
      techniques have been used: classic type III with placement of a cartilage disc on
      the head of the stapes (4), interposition of the incus (3), interposition of the
      head of malleus (1), interposition of a ceramic-PORP (6) and cartilage columella
      in cases of significant stapes footplate erosion (3). In two operations the chain
      was intact and no reconstruction was necessary. Pure-tone-audiometry showed no
      significant decrease of bone-conduction thresholds. Preoperatively 4 (21.1%) ears
      had an average air-bone-gap < or = 30 dB, while postoperatively 15 (78.9%) ears
      had this level of hearing. CONCLUSIONS: Until the exact causes of the loss of
      hearing after mobilisation or stapedectomy in cases of tympanosclerosis are
      known, the local administration of antibiotics is certainly recommended, bearing
      in mind the initial hypothesis that infection may be jointly responsible for
      cochlear hearing loss on mobilisation or stapedectomy in cases of
      tympanosclerosis.

PMID- 11199459
TI  - [Detection of central auditory compensation in unilateral deafness with
      functional magnetic resonance tomography].
AB  - BACKGROUND: Functional magnetic resonance imaging (fMRI) is a noninvasive method
      to detect focal brain activity at high spatial resolution. Acoustic stimulation
      induces an increase of regional cerebral blood flow in the primary auditory
      cortex. This entails an increased concentration of diamagnetic oxyhemoglobin in
      the capillaries and the venous system. The resulting decrease of the local
      magnetic susceptibility was detected as a signal increase in T2*-weighted images.
      The central auditory pathways predominantly cross to the contralateral hemisphere
      in normally hearing subjects. The aim of the present study was to investigate the
      primary auditory cortex after acoustic stimulation in unilateral deaf patients
      using fMRI. METHODS: Magnetic resonance images were acquired on a 1.5 T Siemens
      Vision scanner. For fMRI, a single shot gradient recalled, echo planar imaging
      (EPI) sequence with decreasing excitation order was used, allowing the aquisition
      of 9 slices within 1.8 s. The 9 slices covered a slab of 3.6 cm in cranio-caudal
      extension in the region of the temporal lobes. For statistical processing of the
      raw image data the SPM96 software package was used. A p-value of p < 0.01 was
      applied to differentiate between activated and non-activated. The resulting
      functional activation maps were superimposed onto the EPI scan. The number of
      activated pixels was used to quantitate the cortical response upon acoustic
      stimulation. Stimulation consisted of a 1000-Hz sine tone (100 dB SPL at the
      distal end of the head phone, pulsed at 6 Hz) to which the patients were asked to
      listen passively. A piezoelectric loudspeaker was mounted on the subject table
      and connected to a plastic tube system leading to a combination of bilateral ear-
      and headphones. Auditory paradigms require disentangling experimental excitation
      from the scanner noise that approximates 90 dB. Headphones suppress noise by
      approximately 30 dB. To decrease the acoustic background-to-stimulation ratio and
      to keep background noise constant during stimulation and resting, we employed
      short scanning (1.8 s) and long resting periods (10.2 s; TR = 12 s). This
      acquisition mode allows sufficient recovery during off-periods and sufficient
      excitation during on-periods. 14 unilateral deaf patients were examined. The mean
      duration of deafness was 22.5 years. RESULTS: Acoustic stimulation of the deaf
      ear revealed only weak cortical activation which could be explained by sound
      transmission via bone conduction to the other ear. A significant increase of BOLD
      (blood oxygen level dependent)-activation in the primary auditory cortex could be
      demonstrated in all patients after stimulation of the hearing ear. However,
      remarkable individual differences were noticed concerning the absolute number of
      activated pixels. The lateralization ratio was calculated by the number of
      activated pixels on the hearing side divided by the number of activated pixels on
      the deaf side. A mean lateralization ratio of 0.9 (Stdv +/- 0.6) was found. The
      mean lateralization ratio for patients with a right deaf ear (n = 8) and those
      with a left deaf ear (n = 5) was 1.1 (Stdv +/- 0.7) and 0.6 (Stdv +/- 0.3)
      respectively. However, the difference was not significant (Wilcoxon test: p =
      0.08). CONCLUSIONS: Central-auditory compensation by bilateral cortical
      activation was demonstrated in unilateral deaf patients. Moreover, a tendency
      towards a dominance of the left primary auditory cortex was found, although the
      difference between both hemispheres was not significant. The lateralization ratio
      in unilateral deaf patients is similar to findings after binaural stimulation in
      normally hearing subjects.

PMID- 11199461
TI  - [Scanning electron microscopy findings in titanium middle ear prostheses].
AB  - BACKGROUND: Titanium as a biomaterial in ossicular replacement has widely spread
      within the last couple of years. METHODS: 23 prostheses (12 PORPs, partial
      ossicular replacement prostheses and 11 TORPs total ossicular replacement
      prostheses) removed during revision surgery were studied using scanning electron
      microscopy. The average implantation time was 8 (range 3-15) months. The
      specimens were investigated regarding tissue growth, epithelialization,
      inflammation and cellular signs of rejection. RESULTS: Only few prostheses were
      totally covered by connective tissue or epithelium due to technical problems in
      removing the implant and the covering tissue as one specimen. But this offered
      the possibility to study the interface at the edges where the tissue was torn
      off. The connective tissue looked unremarkable. Polygonal squamous epithelium was
      detected on several implants. Respiratory epithelium with ciliated cells and
      mucus producing goblet cells was seen in two specimens. In cases of cholesteatoma
      or protrusion the explanted prostheses showed typical rosette-like formation of
      hornifying squamous epithelium. According to underlying disease a lymphocytic
      infiltration could be seen. There were no cellular signs of incompatibility
      noticed neither macrophages nor foreign body giant cells. CONCLUSIONS: From these
      investigations titanium seems to be a favorable biomaterial for ossicular
      replacement with good acceptance also in an implantation site showing chronic
      inflammation.

PMID- 11199462
TI  - [Abducens paralysis from the viewpoint of the ENT physician and skull base
      surgeon].
AB  - BACKGROUND: Among the nerves supplying the extraocular muscles, abducent nerve
      paralysis is the most common one resulting in double vision. Surveys confirm that
      the palsy is most often benign and transient. In most cases Ophthalmologist,
      Neurologist, Pediatrician and Physician are involved in diagnosis and treatment
      of this symptom. The Otorhinolaryngologist is needed in the least common cases of
      abducent nerve palsy due to intra- or extracranial diseases, for example trauma,
      inflammatory complications or tumors of the skull base. PATIENTS AND RESULTS: 12
      patients (6 male, 6 female) with abducent nerve paralysis were seen and treated
      in the Department of Ear-Nose- and Throat Diseases, Head, Neck and Facial Plastic
      Surgery, Klinikum Fulda between 1984 and October 1999 and included in our series.
      Their records were evaluated and the main aetiology listed, was checked. An
      inflammatory process was the most common cause in 6 patients, one of them
      presented with otogenic meningitis and bilateral abducent nerve paralysis. In 4
      patients neoplasm was the underlying pathology, in 1 patient head injury
      associated with temporal bone fracture and in 1 patient an orbital pseudotumor.
      Complete recovery of abducent nerve was achieved in 7 patients (58%). CONCLUSION:
      Using modern imaging techniques enables us to diagnose the aetiopathology of
      abducent nerve paralysis. Using modern imaging techniques, planning of
      therapeutic strategy and clarifying the prognosis of this symptom has improved
      considerably.

PMID- 11199463
TI  - [Diagnosis and treatment of necrotizing fasciitis of the head and neck region].
AB  - BACKGROUND: Necrotizing fasciitis of the head and neck is a rare occurrence. It
      spreads rapidly along fascial planes causing extensive necrosis; it often results
      in gangrene of the overlying skin. Mostly involved are immunodeficient patients
      with banal infections of the upper aerodigestive tract, small traumas, but also
      after surgical procedures. The "Federal Health Agency" of the Federal Republic of
      Germany estimates a number of 40 cases a year in Germany for all regions of the
      body. The mortality is about 20%-50% dependent on the localisation of this soft
      tissue infection. PATIENTS: Four cases of necrotizing fasciitis of the head and
      neck region, which were treated at the ENT-Department of the Martin Luther
      University Halle-Wittenberg since 1995, were described. RESULTS: Despite
      aggressive surgical debridement and intensive care medicine two patients died
      because of streptococcus-associated-toxic-shock-syndrome. In all patients we
      found a diabetes mellitus as a known risk factor for this necrotizing soft tissue
      disease. In two of four patients with cervical involvement mediastinitis was
      diagnosed as a complication. The CT-scan showed this mediastinal spread only in
      one case. CONCLUSIONS: Only rapid diagnosis and surgical treatment with radical
      debridement can influence the disease positively. Thoracal CT-scan is necessary
      in all cases of cervical necrotizing fasciitis because of the high risk of
      mediastinal involvement. A strong complication is a streptococcus-associated
      toxic-shock-syndrome, which should be prevented because it is often associated
      with a lethal outcome. Penicillin G and clindamycin are advocated for antibiotic
      treatment.

PMID- 11199464
TI  - [Water-jet dissection in parotid surgery--initial clinical results].
AB  - INTRODUCTION: The most frequent complication following parotidectomies is
      postoperative facial nerve dysfunction. In animal experiment we successfully
      studied the technique of water-jet-dissection for safe and functional
      preservation in facial nerve dissection in parotid gland surgery. The aim of the
      present study was to evaluate our animal experiments clinically. METHODS: Until
      November '99 ten patients with benign parotid gland tumors (4 female, 6 male, age
      32-77 years) underwent lateral or latero-segmental parotidectomies using water
      jet-dissection ("Hydro-Jet", Andreas Pein Medizintechnik GmbH, Schwerin,
      Germany). All operations were performed under permanent intraoperative facial
      nerve monitoring ("Neurosign 100", Fa. Inomed, Tenningen, Germany). The
      postoperative facial nerve function was measured daily by the House-Brackmann and
      Stennert-Paresis-Index for at least one week. RESULTS: A quick parotid gland and
      safe facial nerve dissection could be performed in all operations using the 120
      microns-nozzle with effective working pressures from 30-50 bar. In addition
      strong connective tissue fibers were transected with scissors. Intraoperative
      facial nerve lesions did not occur and cardiopulmonary complications due to
      eventual cutting-fluid-resorption were not seen. After surgery all patients had a
      normal facial nerve function. DISCUSSION: The results of our studies showed that
      the technique of water-jet-dissection provides safe facial nerve dissection and
      preservation during parotid gland surgery. CONCLUSIONS: The tissue selective
      cutting qualities of the new surgical method are an excellent alternative
      compared to standard dissection methods in parotid surgery.

PMID- 11199465
TI  - [Medical aspects of diving in otorhinolaryngology. I. Barotrauma and
      decompression sickness].
AB  - Recreational scuba diving has become immensely popular in recent years and is no
      longer restricted to individualists or adventurers. During a dive, the human body
      with its gas-filled cavities is exposed to an increased ambient pressure. In the
      present review article, aspects of diving and hyperbaric medicine related to the
      otolaryngology field are presented. The basics of physics, physiology and
      pathophysiology that are essential to understand the effects of an increased and
      varying ambient pressure are reviewed. Barotrauma of the outer, middle and inner
      ear, the paranasal sinuses, face, teeth and larynx are explained and classified
      in those during the compression and decompression phase. This is followed by a
      discussion of inner ear decompression sickness. The present article will provide
      a background and foundation for both, an adequate treatment of these diseases and
      a critical and responsible health education of the diver.

PMID- 11199466
TI  - [Electrophysiological diagnosis of the caudal cranial nerves].
AB  - The lower cranial nerves (CN. IX-XII) are responsible for the nerve supply of the
      pharyngolaryngeal region. Loss of innervation is manifested by dysphagia,
      aspiration, altered speech production, dyspnea and/or stridor, and visible loss
      of movement. In general electrophysiological testing should be applied in every
      kind of paresis. Beside standard equipment for electromyography limited special
      equipment is necessary. Examination under local anaesthesia is possible and can
      serve as a basis for therapeutic consequences. In this article general aspects as
      seen from an oto-rhino-laryngological standpoint are presented.

PMID- 11199467
TI  - [Interesting case no. 40. Complete esophageal stent obstruction by dental
      prosthesis impression material].

PMID- 11199468
TI  - [Functional impairment of outer hair cells by noise and assessment by measuring
      distortion product emissions (DPOAE)].

PMID- 11199469
TI  - Does [meso-1,2-bis(2,6-dichloro-4-hydroxyphenyl)ethylenediamine]-
      dichloroplatinum(II) act on the hormone-sensitive, murine breast cancer as a
      biological response modifier? Part II. Studies on the influence of [meso-1,2
      bis(2,6-dichloro-4-hydroxyphenyl)ethylenediamine] dichloroplatinum(II) on the
      specific immune defense in MXT-M-3,2 breast cancer bearing mice.
AB  - The anti-tumor activity of [meso-1,2-bis(2,6-dichloro-4-
      hydroxyphenyl)ethylenediamine]dichloroplatinum(II) on the MXT-M-3,2 breast cancer
      implanted into B6D2F1 mice was not significantly reduced by splenectomy or co
      administration of cyclosporine A. Neither did the use of T-lymphocyte-deficient
      NMRI (nu/nu) mice as hosts substantially influence its anti-tumor effect.
      Obviously, [meso-1,2-bis(2,6-dichloro-4-
      hydroxyphenyl)ethylenediamine]dichloroplatinum(II) does not act by an enhancement
      of the specific immune defense.

PMID- 11199470
TI  - Does [meso-1,2-bis(2,6-dichloro-4-hydroxyphenyl)ethylenediamine]- dichloro
      platinum(II) act as an immune response modifier? Part III: Progressively growing
      MXT-M-3,2 breast cancer stimulates the proliferation of phagocytes in B6D2F1
      mice.
AB  - MXT-M-3,2 breast cancer implanted into female B6D2F1 mice accelerates the growth
      of an identical second tumor. This process is accompanied by a significant
      increase of the granulocyte and monocyte numbers in the blood and of the
      granulocyte and macrophage numbers in the spleen. A significant positive
      correlation of strong intensity was found between the tumor weight on the one
      hand and the number of the granulocytes and macrophages on the other hand. The
      tumor-dependent promotion of the myelopoiesis is explained with a secretion of
      hematopoietic growth factors, e.g. of the granulocyte-macrophage-stimulating
      growth factor (GM-CSF), by the breast cancer cells.

PMID- 11199471
TI  - Studies on synthesis, chromatographic resolution, and antiinflammatory activities
      of some 2-thioxo-1,2,3,4-tetrahydropyrimidines and their condensed derivatives.
AB  - In this study, the synthesis of some new 2-thioxo-1,2,3,4-tetrahydropyrimidines
      and their condensed derivatives, thiazolo[3,2-a]pyrimidines, are described. The
      structures of the compounds were confirmed by 1R, 1H-NMR, 13C-NMR, and mass
      spectroscopy. The direct high-performance liquid chromatographic separation of
      the compounds on derivatized cellulose chiral stationary phases such as cellulose
      tris(3,5-dimethylphenylcarbamate) (OD), cellulose tris(4-methylphenylcarbamate)
      (OG), and cellulose tris(4-methylbenzoate) (OJ) was studied. All of the compounds
      were screened for their antiinflammatory activity and also investigated
      histopathologically. Compounds 3 and 1a were found to be the most promising
      antiinflammatory agents in this group.

PMID- 11199472
TI  - Crosslinked polyvinylalcohol hydrogels as vehicles for hydrophilic drugs.
AB  - Polyvinylalcohol crosslinked with succinyl, adipoyl, or sebacoyl chloride at two
      different degrees of crosslinking was prepared and employed as a supporting
      material for aqueous topical gels containing propranolol hydrochloride, which was
      chosen as a hydrophilic model drug suitable for transdermal delivery. We analysed
      the effect of the nature of the crosslinker and the degree of crosslinking on
      drug permeation through porcine skin by means of the permeation parameters
      obtained from the gels and the corresponding aqueous solution. The gels showed
      greater drug permeation than the liquid solution due to an increase in drug
      solubility in the skin. Increasing degree of crosslinking and decreasing
      crosslinker acyl chain length in the gel enhance the drug permeability through
      the skin.

PMID- 11199473
TI  - Synthesis, structure, and binding of some 2-imidazolines to rat brain alfa-1 and
      alfa-2-adrenergic receptors.
AB  - A series of novel 2-[(2-aminophenyl)imino]imidazolinium salts 3a-d and N-benzyl-N
      (4,5-dihydro-imidazol-2-yl)-O-methylhydroxylamine hydrochloride 7a-c were
      prepared and their structure was determined by IR and NMR spectroscopic data as
      well as X-ray analysis of the imidazolinium azide salt 3e. Binding evaluation for
      both alpha 1- and alpha 2-adrenergic receptors in rat brain preparations of these
      compounds and the previously described alpha-hydroxy-2-aryliminoimidazolines 11a
      d, N-(4,5-dihydroimidazol-2-yl)-1,3-2-oxodihydrobenzimidazoles 12a-b, 2-amino-N
      (4,5-dihydroimidazol-2-yl)-benzimidazoles 13a-b, and N-(4,5-dihydroimidazol-2-yl)
      indoles 14a-b was performed. Among the compounds tested, 2-[(2-amino-4,5
      dichlorophenyl)imino]imidazolinium chloride 3c showed highest binding affinity to
      alpha 2-adrenoreceptors (Ki = 30 nM).

PMID- 11199474
TI  - Novel piperidinedione analogs as inhibitors of breast cancer cell growth.
AB  - We previously reported the utility of antineoplaston-A10 (3-phenylacetylamino-2,6
      piperidinedione) as an endogenous cancer protector and immune modulator in breast
      cancer patients (Cancer Lett., 2000, 157, 57). In this study, four new
      piperidinedione A10 analogs were synthesized and tested for their antimitotic
      activity on a human breast cancer cell line against the prototype A10 and the
      antibreast cancer drug tamoxifen. Moreover, the DNA binding capacity of such
      compounds was evaluated against A10, (E)-3-(4-Nitrocinnamoylamino)-2,6
      piperidinedione "3B" and (E)-3-(4-hydroxycinnamoylamino)-2,6-piperidinedione "3D"
      were several-fold more potent antiproliferative agents than A10 and tamoxifen.
      They also had significantly higher capacity to bind DNA than A10. Conversely, (E)
      3-(cinnamoylamino)-2,6-piperidinedione "3A" and (E)-3-(4-methoxycinnamoylamino)
      2,6-piperidinedione) "3C" had weaker biological profiles than the lead compound
      A10. Detailed synthetic, spectroscopic, and biological data are reported.

PMID- 11199475
TI  - Mini review of canine stifle joint anatomy.
AB  - The stifle is a complex, condylar, synovial joint that allows motion in three
      planes. The complexity of the normal motion is directly related to the structure
      and functions of the anatomical components that form the joint. Alteration in any
      one of these components often leads to dysfunction as well as an increased risk
      of damage to other structures in the joint. Thus understanding of the normal
      anatomy and function of each stifle joint component is essential for proper
      diagnosis and treatment of any stifle joint injury. This review highlights the
      basic anatomy and function of the stifle joint components.

PMID- 11199476
TI  - Light and electron microscopic study of the thyroid gland of the camel (Camelus
      dromedarius).
AB  - The thyroid gland of sexually immature dromedary camels was studied using both
      light and electron microscopy. The thyroid gland contained follicles of different
      sizes in both summer and winter. However, most of the follicles were large in
      summer and small in winter. The large follicles were lined by very low cuboidal
      or semi-squamous follicular cells whereas the small ones were lined by high
      cuboidal or low columnar follicular cells. Electron microscopy showed that the
      very low cuboidal follicular cells were poor in organelles and were considered
      hypoactive. High cuboidal follicular cells on the other hand, were rich in
      organelles that included mitochondria, cisternae of rough endoplasmic reticulum,
      secretory vesicles, colloid droplets, heterosomes and autophagic vacuoles; they
      were considered to be very active. The possible role played by these organelles
      is synthesis of thyroglobulin and liberation of tri- and tetraiodothyronine is
      discussed. A few degenerate follicular cells were infrequently encountered in the
      camel thyroid. Parafollicular (C) cells were not seen in this study either with
      light or electron microscopy.

PMID- 11199477
TI  - Anatomical and descriptive study of the radial extensor muscle (M. extensor carpi
      radialis).
AB  - The M. extensores carpi radiales have been studied in detail in humans. The aim
      of this study was to carry out a comparative anatomical study of these muscles
      using four species--rabbit, cat, dog and sheep--and to propose a
      'systematization' in a few standard models according to the morphological
      variations seen. In these species, there is marked morphological evolution, with
      two muscles in humans, one in sheep and a more or less distinct division of the
      muscle in the rabbit, cat and dog. Examination of the vascularization and nerve
      supply enables us to determine degrees of division in species with similar muscle
      morphology. Thus we were able to distinguish three morphological types which
      allow us to infer the morphological evolution of the M. extensores carpi radiales
      and to estimate the point at which one muscle became two. However, there is a
      strong chance that some process of convergence may have occurred, and in
      pentadactyl species many elements represent the plesiomorphis and are therefore
      of little use in constructing a classification on the basis of evolution.

PMID- 11199478
TI  - Immunohistochemical demonstration of cytochrome oxidase in different parts of the
      central nervous system: a comparative experimental study.
AB  - Cytochrome oxidase, the terminal enzyme of the electron transport chain, is a
      marker of the functional activity of the cell. In this study; localization of
      cytochrome oxidase in cerebrum, cerebellum, hippocampus, substantia nigra and
      choroid plexus of adult rats was investigated using immunohistochemical methods.
      Neural bodies were immunoreactive while neuroglial cells and axonal areas did not
      show significant immunostaining. The cerebral cortical substantia grisea region
      was stained almost homogeneously with cytochrome oxidase. In the cerebellar
      cortex, immunolabelling was more intense in the granular layer than the molecular
      layer. There was significant immunostaining in Purkinje cells. White matter, both
      in cerebrum and cerebellum, did not show immunoreactivity for cytochrome oxidase.
      Neurones in the hippocampus showed variable immunostaining; some of them were
      negative while others revealed high immunoreactivity. The neurones in substantia
      nigra were heavily labelled. Immunostaining for cytochrome oxidase in plexus
      choroideus epithelial cells was also remarkable. The morphological findings
      demonstrate the regions which most require and produce energy and reflect the
      differences in cellular activity in these parts of the central nervous system.

PMID- 11199479
TI  - The effects of two different decalcification procedures on size and structure of
      embryonic epithelial tissue in objects prepared for light microscopy.
AB  - Electrolytic decalcification is a very fast and effective method for removing
      calcium compounds from bones with minimum damage to tissues. Changes of dimension
      of tissues in histological sections prepared from specimens decalcified by
      immersion in a formic acid solution and sections prepared from specimens treated
      in an electrolytic decalcifier were studied. Heads of mouse foetuses were cut in
      half, decalcified by one of the above-mentioned methods and embedded in histowax.
      Dimensional changes of skin, tongue and nasal epithelia in histological sections
      were evaluated by t-test. Significant shrinking and other unwanted effects of
      decalcification, such as acidophilia of nuclei, were found in objects decalcified
      by both methods. No significant differences in the effects of the two methods on
      tissue dimensions were demonstrated. It is concluded that both decalcification
      methods are equivalent from the qualitative point of view.

PMID- 11199480
TI  - Cell-specific localization of the cholecystokininA receptor in the porcine
      pancreas.
AB  - Cholecystokinin (CCK) produced in the mucosa of the upper small intestine exerts
      several biological functions. Its secretion in physiological amounts is modulated
      by the interaction of extracellular regulators and by binding to intracellular
      receptors of the target cells. The relative affinity of CCK to its receptor has
      been characterized in various biological and pharmacological studies and it is
      now well established that CCK has a higher affinity to the CCKA than to the CCKB
      receptor. Furthermore CCK influences the secretion of pancreatic enzymes in
      several species but very little is known about the relationship between CCK and
      the islet hormone-producing cells in the pig pancreas. The localization of this
      receptor at the cellular level showed conflicting results in animal studies and
      has not been described in pigs. The aim of the present study was to characterize
      the precise cellular location of the CCKA receptor in the porcine pancreas.
      Polyclonal antiserum was raised against the N-terminal epitope of the CCKA
      receptor molecule and used for localization studies. Using immunohistochemistry
      on methanol/acetic acid-fixed, paraffin-embedded pancreas, the CCKA receptor
      could successfully be localized in islet cells. Parallel staining of serial
      sections with antibodies directed against insulin and glucagon revealed
      colocalization with glucagon in alpha cells. No immunoreaction was found in the
      exocrine pancreas. Our results support the concept that in the porcine species
      the stimulation of the exocrine pancreas is mediated by the CCKB rather than the
      CCKA receptor, as it is known for the rat species.

PMID- 11199481
TI  - Teratogenicity of edoferon kappa A, a molecule derived from salicylate, in
      cultured rat embryos: differences from salicylate and interaction with free
      oxygen radical scavenging enzymes.
AB  - The effect of edoferon kappa A (E-KA), a non-specific immunomodulatory and anti
      neoplastic chemical substance derived from the methyl form of salicylate (acetyl
      salicylic acid; ASA), on mammalian embryos was studied and compared to the
      effects of ASA. Rat embryos were cultured in vitro from 9.5 days of gestation for
      48 h. E-KA (0.1-12.8 mg/ml) and ASA (0.1-0.6 mg/ml) were added to the whole rat
      serum. To investigate the interaction of these molecules with antioxidant agents,
      the lowest effective concentrations of E-KA (0.6 mg/ml) and ASA (0.3 mg/ml) for
      all parameters were added to the culture media in the presence of superoxide
      dismutase (SOD) (30 U/ml) or glutathione (0.5 mumol/ml). The growth and
      development of embryos was compared and each embryo was evaluated for the
      presence of any malformations. E-KA and ASA decreased growth and development in a
      concentration-responsive manner. There was also a concentration-related increase
      in overall dysmorphology (haematoma in the yolk sac and neural system, open
      neural tube, abnormal tail torsion and the absence of fore limb bud). There were
      no statistically significant differences between the control and embryos grown in
      the presence of 0.1-0.4 mg/ml E-KA, although the effects of ASA started at a
      concentration of 0.2 mg/ml. Embryos showed significant growth retardation in all
      scoring criteria and severe malformations when 0.5-3.2 mg/ml E-KA and 0.3-0.6
      mg/ml ASA were added. When SOD was added, there was a significant decrease in the
      incidence of malformations and growth and developmental parameters were increased
      but this decrease never reached the control level. We concluded that E-KA has
      direct toxic effects on the developing embryo but at much higher concentrations
      than ASA, and the teratogenic effects of these molecules might be related to free
      oxygen radicals.

PMID- 11199482
TI  - Morphology of the dorsal lingual papillae in the black rhinoceros (Diceros
      bicornis).
AB  - The dorsal lingual surface of a black rhinoceros (Diceros bicornis) was examined
      by scanning electron microscopy. The tongue was about 30 cm in length. There were
      about 60 vallate papillae on both sides. Filiform, fungiform and vallate papillae
      were found. The filiform papillae were distributed over the entire dorsal surface
      of the tongue. The papillae had a hair-like shape. The fungiform papillae were
      round in shape, and more densely distributed on the lingual apex. No foliate
      papillae were seen on the dorsal surface. The vallate papillae were located on
      both sides of the posterior end of the lingual body. Each papilla was surrounded
      by a groove.

PMID- 11199483
TI  - Distribution of tyrosine hydroxylase-immunoreactive neurones in the diencephalon
      and mesencephalon of the coypu (Myocastor coypus).
AB  - The aim of the present study was to examine the catecholaminergic neurones
      located within the midbrain of the coypu, a South American hystricomorph rodent.
      The neuronal distribution of the catecholaminergic systems and morphological
      parameters of the immunostained cell bodies and fibres were investigated, using
      an immunohistochemical method. The brains of five coypu were fixed, immersed in
      gelatine-glycerol and cut in 40-micron slices using a freezing microtome. Samples
      were processed with ultrasound-based antigen retrieval and stained with labelled
      antityrosine hydroxylase monoclonal antibody. An image analyser was used to
      measure the neuronal bodies. The catecholaminergic neurones of the
      tuberoinfundibular system were mainly observed in the arcuate and periventricular
      nuclei with their axons projecting towards to the median eminence; they
      represented 28% of the global population of tyrosine hydroxylase-immunoreactive
      cells observed. Significant morphological differences were observed in comparison
      with the other two studied systems. Fifty per cent of total catecholaminergic
      neurones were detected in the nigrostriatal system distributed in the reticular
      and compact substance nigra. Most neuronal bodies had a fusiform aspect. The
      immunoreactive neurones of the mesolimbic system represented 22% of the total
      population. They were distributed around the interpeduncular nucleus. Two types
      of morphologically different catecholaminergic systems of the brain were
      established: hypothalamic neurones located in the periventricular and arcuate
      nuclei and mesencephalic neurones located in the substance nigra and
      interpeduncular nuclei. These systems showed morphological and probably
      physiological-pharmacological differences.

PMID- 11199484
TI  - Comparative studies on the distribution of glutamate transporters in the retinae
      of the Mongolian gerbil and the rat.
AB  - Glutamate is the major excitatory amino acid transmitter in vertebrate retinae.
      Glutamate transporters therefore play an important role in the precise control of
      glutamate concentration in the synaptic cleft by regulating extracellular
      glutamate concentration. In the present study, we performed an analysis of the
      expressions of three glutamate transporters in gerbil retina using
      immunohistochemistry. In the gerbil retina, excitatory amino acid carrier 1 and
      glutamate transporter 1 immunoreactivity was predominant in the ganglion cells
      but not amacrine or bipolar cells. Glutamate/aspartate transporter (GLAST)
      immunoreactivity was observed in the radial gliocytes of which the dense network
      of fine processes was localized in the inner and outer plexiform layers. GLAST
      immunoreactivity was also detected in astrocytes in the nerve fibre layer. These
      results demonstrate that three glutamate transporters show specific distributions
      in the gerbil retina and suggest that the glutamate re-uptake system in the
      gerbil retina may be different from that of the rat.

PMID- 11199485
TI  - [Weismann's potentially immortal single cells are mortally self-cloning cells].
AB  - The theory of Weismann (A. F. L. Weismann, 1834-1914) is reviewed in the light of
      recent genetic experiments and considerations.

PMID- 11199486
TI  - Distribution of peptidergic nerve fibres in the guinea pig trabecular meshwork.
AB  - A quantitative analysis of peptidergic nerve fibres located in the trabecular
      meshwork of the guinea pig has been performed. Our results confirm that this
      structure contains VIP-, NPY- and substance P-like immunoreactivity as major
      neurotransmitters. These findings were obtained using immunohistochemical
      techniques. For this purpose serial sections of the eye were stained by
      immunohistochemistry for each of three neurotransmitters and stained sections
      were analysed by quantitative image analysis. Our findings demonstrate that SP
      positive, NPY-positive and VIP-positive nerve fibres occupy 11.2, 4.9 and 2.4%,
      respectively, of the observed area (expressed as conventional units, C.U.) in the
      trabecular meshwork of the guinea pig eye. It is relevant to emphasize that the
      area containing these three types of peptidergic nerve fibres appears to be large
      (18.5 +/- 6.6 C.U.) in proportion to the total observed area. The innervation of
      the drainage angle of the guinea pig eye has been well described by many authors.
      This is the first study to report quantitative measurements of three types of
      peptidergic nerve fibres identified and measured in this area. The presence of
      these three neurotransmitters in the trabecular meshwork of guinea pig eye
      suggests their possible participation in aqueous humor regulation.

PMID- 11199487
TI  - Ultrastructural features of myenteric ganglia of adult Wistar rats (Rattus
      norvegicus).
AB  - The ultrastructural features of the ganglia of the myenteric plexus exhibit
      changes according to the animal species. These myenteric ganglia in the duodenum
      of adult rats of the Wistar strain were characterized ultrastructurally in this
      work. Those ganglia were depicted as compact structures, composed of neurones and
      glial cells, forming a dense neuropil surrounded by a continuous basal lamina and
      collagen fibrils. Glial cell bodies were smaller and apparently more frequent
      than neuronal cell bodies, being morphologically distinguished by nuclear
      features. In the neuronal extensions granular and agranular synaptic vesicles of
      different sizes predominate, in addition to mitochondria and myelinized profiles.
      Gliofilaments were not observed on the glial extensions of the rats.

PMID- 11199488
TI  - Evidence for high affinity nickel transporter genes in heavy metal resistant
      Streptomyces spec.
AB  - We have isolated 25 new strains of streptomycetes from soil samples of a polluted
      site at the former uranium mine, Wismut, in eastern Thuringia, Germany. The
      strains grew on medium containing 1 mM NiCl2 and thus were resistant to the heavy
      metal ion. Seven of the strains were further characterized. All of these strains
      were resistant to heavy metals in various degrees with up to 10 mM resistance
      against NiCl2 supplied with the liquid minimal growth medium. The high level of
      resistance prompted us to look for high affinity nickel transporter genes thought
      to provide a means to eliminate the excess nickel ions form the cells. Degenerate
      oligonucleotide primers derived from sequences of P-type ATPase transporter genes
      of Gram negative bacteria identified a fragment which shows deduced amino acid
      sequence similarities to known high affinity nickel transporters. Investigation
      of two genes obtained from the isolates Streptomyces spec. E8 and F4 showed high
      sequence divergence. This was unexpected since a transmissible plasmid had been
      thought to convey heavy metal resistance.

PMID- 11199489
TI  - Isolation of an 1,3-1,4-beta-glucan degrading Enterococcus faecium strain from
      the intestinal tract of chicken and partial characterization of its novel 1,3-1,4
      beta-glucanase.
AB  - An Enterococcus faecium strain with a novel endo 1,3-1,4-endo-beta-glucanase
      (lichenase, E.C. 3.2.1.73) was isolated from the intestinal tract of broiler
      chicken. The enzyme was secreted into the culture medium and acted exclusively on
      mixed linked 1,3-1,4-beta-glucans as determined with a reducing sugar assay. The
      purified enzyme has its isoelectric point at pI 4.8, maximum activity was
      determined at pH 6.5 and 40 degrees C. Thermal stability of the enzyme was low,
      but high pH stability and high residual activity was observed after incubation in
      digesta samples from the chicken intestine. Multiple lichenase activities were
      obtained from culture supernatants on SDS/PAGE and native zymograms, but it is
      concluded that the lichenase consists of one active protein at 30.5 kD and
      additional polypeptides of unknown function.

PMID- 11199490
TI  - Bacterial amylolytic activity enhances beta-glucuronidase expression of amylase
      negative Escherichia coli strain in starch-medium.
AB  - The possibility of associating starch degradation with bacterial beta
      glucuronidase expression was examined. We proved that starving, in starch medium,
      amylase-negative Escherichia coli (M94) which has constitutive beta-glucuronidase
      greatly reduces (p < 0.01) its background activity, but the addition of both cell
      free supernatants or cells of Bacillus subtilis (B10) producing amylase greatly
      increases (p < 0.01) the E. coli beta-glucuronidase activity. Increases in
      activity were maximal when amylase in the medium ranged from 0.3 to 0.8 U ml-1
      and pH from 6.8 to 6.3, whereas higher amylase activity interacted with E. coli
      viability and the effect on beta-glucuronidase was less evident. The impact of B.
      subtilis amylase on E. coli beta-glucuronidase induction, observed when the
      organisms were co-cultured, indirectly supports the hypothesis that amylolytic
      activity of hindgut bacteria may be effective on beta-glucuronidase induction of
      the climax microflora. This last finding is important in the health field,
      considering the implication between the deconjugating role of this enzyme and
      consequent activation of toxic and carcinogenic compounds.

PMID- 11199491
TI  - Sequential synthesis and secretion of pectinases by Penicillium frequentans.
AB  - Penicillium frequentans synthesized eleven polygalacturonases and three
      pectinesterases when grown in the presence of pectin, sodium polypectate or
      monogalacturonic acid. When glucose was the sole carbohydrate source in the
      medium two of these polygalacturonases and one pectinesterase were produced. The
      enzymes produced under any of these conditions degraded pectic substrates to
      monogalacturonic acid, suggesting that this monosaccharide or its metabolites
      should induce the pectinolytic complex. All pectinesterases and most of the
      extracellular polygalacturonases were synthesized after the 2nd hour of
      incubation. The pectinases produced by Penicillium frequentans were not secreted
      at the same time but after 5 hours of incubation all of them could be detected
      outside the cell those detected only inside the cell were probably membrane
      associated or unglycosylated forms of the extracellular pectinases.

PMID- 11199492
TI  - Rosaria succina spec. nov.--a fossil cyanobacterium from tertiary amber.
AB  - A fossil cyanobacterium found in a piece of Tertiary amber is assigned to the
      recent genus Rosaria N. Carter (Stigonemataceae) and described as R. succina. The
      fossil allows a new systematic evaluation of the genus Rosaria.

PMID- 11199493
TI  - Influence of inoculum type and cultivation conditions on natamycin production by
      Streptomyces natalensis.
AB  - This study demonstrates the effect of cultivation conditions on the production of
      natamycin. Of these conditions, the effect of oxygen limitation and type of
      inoculum were extensively investigated. Increasing the shaking speed and
      decreasing the medium volume improved both the volumetric and specific natamycin
      production. Also, decreasing the dissolved oxygen level in the cultivation medium
      through the addition of soluble biopolymer (alginate) resulted in a significant
      decrease in the natamycin yield without effect on the cell growth. On the other
      hand, spore inoculum yielded higher concentration of natamycin compared to the
      vegetative cells by about 40%. The maximal cell productivity based on biomass
      [Yp/x] of about 0.4 [g/g] was obtained by using shake flask of 50 ml working
      volume agitated at 200 rpm and the inoculum was in the form of spore 2 x 10(8)
      spores/ml. These results showed that the production process of natamycin is
      highly dependent on oxygen level in the cultivation medium and type of inoculum
      as well.

PMID- 11199494
TI  - Bacterial counts associated with poultry processing at different sampling times.
AB  - Aerobic plate counts, Enterobacteriaceae counts and Pseudomonas counts were
      performed on neck skin samples from six processing steps in a poultry abattoir at
      three different sampling times. Sampling time 1 was shortly after start-up of
      processing operations, time 2 after a tea break which was preceded by a cold
      water rinse-down of equipment surfaces, and time 3 before shut-down. No
      significant differences (P > 0.05) in microbial numbers of neck skin samples were
      observed between the three sampling times at the six sampling sites. At this
      particular processing plant, therefore, sampling at any time of the processing
      shift would thus not lead to significantly different bacterial counts of neck
      skins. The lowest aerobic plate counts, over all three sampling times, were
      obtained for neck skins sampled after spray washing, and the highest for neck
      skins sampled after packaging. This indicated the efficacy of the washing step in
      reducing microbial contamination but subsequent re-contamination of carcasses.
      Despite the Pseudomonas counts of neck skins being lower than the
      Enterobacteriaceae counts at the beginning of processing, packaging of carcasses
      resulted in Pseudomonas counts that were higher than the Enterobacteriaceae
      counts.

PMID- 11199495
TI  - Biological and molecular characterization of cellular differentiation in
      Tetrahymena vorax: a potential biocontrol protozoan.
AB  - Tetrahymena vorax (T. vorax) is an indigenous fresh water protozoan with the
      natural biological potential to maintain a specific aquatic microbial flora by
      ingesting and eliminating specific microorganism. To investigate the molecular
      mechanisms controlling Tetrahymena vorax (T. vorax) cellular differentiation from
      a small-mouth vegetative cell to a voracious large-mouth carnivore capable of
      ingesting prey ciliates and bacteria from aquatic environments, we use DNA
      subtraction and gene discovery techniques to identify and isolate T. vorax
      differentiation-specific genes. The physiological necessity for one newly
      discovered gene, SUBII-TG, was determined in vivo using an antisense
      oligonucleotide directed against the 5' SUBII-TG DNA sequence. The barriers to
      delivering antisense oligonucleotides to the cytoplasm of T. vorax were
      circumvented by employing a new but simple procedure of processing the
      oligonucleotide with the differentiation stimulus, stomatin. In these studies,
      the antisense oligonucleotide down-regulated SUBII-TG mRNA expression, and
      blocked differentiation and ingestion of prey ciliates. The ability to down
      regulate SUBII-TG expression with the antisense oligonucleotide suggests that the
      molecular mechanisms controlling the natural biological activities of T. vorax
      can be manipulated to further study its cellular differentiation and potential as
      a biocontrol microorganism.

PMID- 11199496
TI  - New enzymatic method for determining D-arabinitol in serum.
AB  - A new reagent has been developed to determine D-arabinitol. This utilizes D
      arabinitol 2-oxidoreductase derived from Bacillus sp. with high stability, and
      water-soluble tetrazolium salt, that can detect NADH with high sensitivity. Since
      this enzyme does not react to D-mannitol, elimination of D-mannitol is
      unnecessary. Thus, this is a much simpler process than currently available with
      commercial kits use D-arabinitol 4-oxidoreductase. The within-run and between-run
      precisions (CV) were 2.4-6.9% and 3.1-8.7%, respectively, whilst the correlation
      (r) between the results obtained with our proposed method (y) and those obtained
      with the commercial "Arabinitec-auto" kit (x) was 0.964 (y = 1.02x + 0.933
      mumol/l; n = 69). However, some samples deviated remarkably from correlation in
      both methods. Our analyzing accuracy is satisfactory in clinical application, as
      it does not miss positive sample over cut-off value. We are refining this method
      by investigating why some specimens are apart from correlation significantly.

PMID- 11199497
TI  - Factors affecting the production of (-)-mitorubrinic acid by Penicillium
      funiculosum.
AB  - The optimum conditions for the production of (-)-mitorubrinic acid by mutant
      strain of Penicillium funiculosum CCM F-8080 were examined in shaken flask
      cultures. The highest production of this metabolite was achieved in a medium with
      glucose as the sole carbon source and (NH4)2HPO4 as the nitrogen source. The most
      suitable concentrations of the given sources for production of (-)-mitorubrinic
      acid are 80 g/l glucose and 2 g/l (NH4)2HPO4 (maximal production, 814.9 mg/l). We
      also observed the influence of concentration of L-phenylalanine and inorganic
      phosphate in culture medium on the production of (-)-mitorubrinic acid. The
      biological activity of mitorubrinic acid as trypsin inhibitor was determined
      (IC50 41.05 mumol/l).

PMID- 11199498
TI  - A highly homologous 68 kbp plasmid found in Vibrio vulnificus strains virulent
      for eels.
AB  - Vibrio vulnificus serovar E (biotype 2) strains are virulent for eels and have
      also been reported to cause illness in humans. Studies on the plasmid content of
      serovar E strains revealed the existence of a plasmid of approximately 70 kbp
      present in most of these strains. In this study we characterized the 70 kbp
      plasmids of seven biotype 2 strains isolated from seawater, diseased eels and
      wound infections in humans. We determined the exact size of the high molecular
      weight plasmids to be 68 kbp. A comparison of the plasmids of the seven strains
      by restriction length polymorphism and hybridization analysis showed them to be
      almost identical.

PMID- 11199499
TI  - Diversity of Bacillus thuringiensis in different habitats of northern Jordan.
AB  - A survey of Bacillus thuringiensis was conducted for 17 locations in Northern
      Jordan representing 12 different habitats. Eighty isolates were identified as B.
      thuringiensis in the majority of the tested samples. Results showed that soils
      contaminated with the slaughterhouses waste materials had the highest content of
      spore-forming bacteria [(4.05-2.2) 10(7) CFU/g)] and B. thuringiensis [(4.05-7.9)
      10(7) CFU/g)] with a (5.5%-14.9%) and (5.2%-7.7%) of the total viable bacterial
      count, respectively. These bacteria were more abundant in soils contaminated with
      such animal by-products.

PMID- 11199500
TI  - Metabolism of benzonitrile by Cryptococcus sp. UFMG-Y28.
AB  - The yeast Cryptococcus sp. UFMG-Y28 can utilize benzonitrile as a nitrogen and
      possible additional carbon source. The kinetics of growth on Yeast Carbon Base
      (YCB) added of benzonitrile as sole nitrogen source showed that benzonitrile was
      metabolized to benzoic acid and ammonia. Liquid chromatography analysis indicated
      that Cryptococcus sp. UFMG-Y28 metabolized 12 mM benzonitrile to 10 mM benzoic
      acid. Resting cells cultivated on YCB-propionitrile medium showed nitrilase
      activity against benzonitrile. This strain appears to be promising for
      bioconversion of nitriles to high value acids and for bioremediation of sites
      contaminated with aliphatic and aromatic nitriles.

PMID- 11199501
TI  - Comparative growth of ectomycorrhizal basidiomycetes (Hebeloma spp.) on organic
      and inorganic nitrogen.
AB  - In the largely organic soils in which ectomycorrhizas are commonly found, a
      preference for absorbing organic nitrogen over mineral forms is likely to be an
      advantage, especially where mineralisation rates are low. To determine rates of
      both independent and preferential growth of ectomycorrhizal basidiomycetes on
      organic and inorganic nitrogen, strains of Hebeloma were grown on nutrient agar
      media containing either NH4+ or glutamic acid as the sole source of nitrogen, on
      both single medium and split plate Petri dishes. Growth rates on the split plate
      Petri dishes, where the fungi had access to both nitrogen sources, were generally
      greater than on the single medium dishes. Growth on glutamic acid was at least
      equal to, and usually greater than, that on NH4+. In some cases growth on NH4+
      alone appeared severely inhibited, a condition that was partially alleviated by
      access to glutamic acid on the split plates Petri dishes. This highlights a
      potential pitfall of single nitrogen source growth studies. The greater growth of
      most strains on glutamic acid suggests an adaptation to organic nitrogen
      utilisation in these strains. If this is so in soils with low mineralisation
      rates, direct uptake of amino acids by ectomycorrhizal plants could by-pass the
      bottle neck that requires mineral nitrogen to be made available for plant uptake.

PMID- 11199502
TI  - Exopolysaccharide production by entrapped cells of the fungus Aureobasidium
      pullulans ATCC 201253.
AB  - The production of the exopolysaccharide pullulan using entrapped cells of the
      fungus Aureobasidium pullulans ATCC 201253 was investigated. Fungal cells
      entrapped in agarose or carrageenan were capable of elaborating pullulan for 2
      production cycles. Those fungal cells entrapped in carrangeenan were more
      productive than the agarose-immobilized cells during the initial cycle while the
      reverse was true during the second production cycle. The agarose-entrapped cells
      synthesized polysaccharide with a higher pullulan content than did the
      carrageenan-immobilized cells. Fungal cells entrapped in carrageenan demonstrated
      a lower degree of leakage than did those entrapped in agarose.

PMID- 11199503
TI  - Primary leiomyosarcoma of the heart subsequent to double carcinomas of the
      thyroid and lung.
AB  - A 63-year-old woman underwent surgical operations for left lower lung cancer and
      for thyroid cancer. Nine months later, a third cancer developed in her heart and
      this tumor was removed by open heart surgery. A pathologic study revealed that
      the tumor was primary leiomyosarcoma of the heart and thus independent from the
      previous lung and thyroid carcinomas. This case was regarded as a triple
      carcinoma including a primary leiomyosarcoma arising from the left atrium.
      Reports in the literature on primary malignant tumors of the heart are reviewed
      briefly.

PMID- 11199504
TI  - Prognostic value of Doppler transmittal flow patterns and cardiac natriuretic
      peptides in patients with chronic congestive heart failure admitted for episodes
      of acute decompensation.
AB  - This study was designed to determine whether the restrictive filling transmitral
      flow velocity pattern is associated with increased plasma levels of atrial
      natriuretic peptide (ANP) and brain natriuretic peptide (BNP). It was also
      designed to evaluate the prognostic value of these parameters from patients with
      chronic congestive heart failure (CHF) admitted for episodes of acute
      decompensation. We performed Doppler echocardiography, measured plasma levels of
      ANP and BNP in 33 patients at the time of admission, and assessed the subsequent
      cardiac mortality for 3 months. Eleven patients (33%) had a restrictive filling
      pattern of deceleration time (DcT) < 120ms. Plasma ANP and BNP levels were
      markedly increased in all patients to 189 +/- 145 pg/ml and 865 +/- 559 pg/ml,
      respectively. Seventeen patients (52%) showed more than 700 pg/ml of plasma
      levels of BNP. There was a significant correlation of DcT with the plasma ANP
      level (r = -0.41, P = 0.017), and a better correlation of DcT with the plasma BNP
      level (r =-0.50, P = 0.003). The combined index of both shorter DcT (< 120 ms)
      and higher plasma BNP levels (>700 pg/ml) was the best predictor of cardiac
      mortality by Cox univariate analysis (chi2 = 5.87, P = 0.015). Furthermore, the
      sensitivity and specificity of this index for the detection of cardiac mortality
      were 80% and 86%, respectively. In conclusion, the combined analysis of the
      Doppler transmitral flow velocity pattern and measurement of the plasma BNP level
      is noteworthy since it is noninvasive and convenient. Moreover, it is extremely
      useful in predicting the prognosis for patients with chronic CHF admitted for
      episodes of acute decompensation.

PMID- 11199505
TI  - Pulmonary arterial compliance in children with atrial and ventricular septal
      defect.
AB  - Previous studies have documented the normal values of pulmonary arterial
      compliance (Cp) in animals and adult humans. In the past, variations in Cp and
      its measurement in children with septal defects has been unknown. In the present
      study, we found the Windkessel model, which uses compliance and resistance as
      parameters, to be a useful tool in understanding Cp in pediatric patients.
      Calculations of Cp were based on the pulmonary arterial diastolic pressure
      waveform as an exponential function of time. First, Cp was estimated by studying
      pressure tracings of the main pulmonary artery (MPA) obtained from both routine
      cardiac catheterization and pressure measured by a catheter-tip manometer, which
      was performed during a catheterization study of seven children with various
      congenital heart diseases. Second, 124 children with atrial and ventricular
      septal defects aged between 45 days and 12 years were studied using the data
      obtained from routine catheterization. Hemodynamic data were used to calculate
      pulmonary vascular resistance (Rp), pulmonary arterial time constant (Tp) and Cp.
      A strong correlation (r = 0.954) was found in the Cp value estimated by data
      obtained from routine catheterization and from the catheter-tip manometer study.
      The present study shows an estimated mean (SEM) Cp in normal children of 1.53
      (0.17) ml/mmHg per m2. The estimated mean (SEM) Cp was 1.91 (0.10) and 1.70
      (0.11) ml/mmHg per m2 in children with atrial septal defect (ASD) and ventricular
      septal defect (VSD), respectively. It was found that Cp was significantly (P =
      0.04) higher in female patients with a VSD. Also, a significantly low Cp (0.95 +/
      0.06 ml/mmHg per m2) was observed in patients with a VSD and pulmonary
      hypertension (VSDPH). In conclusion, Cp was calculated by the exponential decay
      portion of the MPA diastolic pressure waveform. A normal Cp value was observed in
      ASD and VSD patients and a significantly low Cp was observed in children with a
      VSDPH. Cp was higher in female VSD patients than in male VSD patients.

PMID- 11199506
TI  - Effects of a phosphodiesterase III inhibitor on circulating blood volume after
      cardiopulmonary bypass.
AB  - Using a new method based on pulse dye densitometry, circulating blood volume (BV)
      was measured without direct sampling in patients undergoing open-heart surgery,
      and the effects of phosphodiesterase (PDE) III inhibitor administration during
      cardiopulmonary bypass (CPB) were evaluated. Sixteen patients scheduled for
      elective coronary artery bypass grafting were randomly assigned to the PDE III
      inhibitor group or control group. BV was determined before CPB, and immediately,
      and 4 and 12h after operation. After declamping of the aorta, the PDE III
      inhibitor amrinone (1 mg/kg) was infused as a single bolus into the venous
      reservoir in the PDE III inhibitor group. BV decreased significantly soon after
      the operation in the control group. It did not decrease in the PDE III inhibitor
      group (48.6 +/- 44 and 60.6 +/- 8.0 ml/kg for the control and PDE III inhibitor
      groups. respectively). Four hours after surgery and beyond no significant changes
      in BV were observed in either group. The body fluid balance was negative in both
      groups. In conclusion, a single administration of PDE III inhibitor during CPB
      was found to sustain BV soon after operation and, therefore, is useful for
      postoperative management of open-heart surgery.

PMID- 11199507
TI  - Effect of overexpression of very low density lipoprotein receptor on cell growth.
AB  - The very low density lipoprotein (VLDL) receptor is a member of the LDL receptor
      gene family and binds only apoE-containing lipoproteins. Although the VLDL
      receptor has been shown to play an important role in the proliferation of
      vascular smooth muscle cells and the formation of foam cells as primary responses
      of atherogenesis, its actual functions are still unclear. To understand the
      biological roles of the VLDL receptor in foam cell formation and cell growth, we
      tried to overexpress VLDL receptors in various cells. When COS-7 cells were
      transfected with an expression plasmid containing VLDL receptor cDNA, cell growth
      was inhibited by overexpression of the receptor and this growth inhibition was
      ligand-independent. The O-linked glycosylation region, but not the cytoplasmic
      domain, of the receptor appeared to be responsible for this growth inhibition. On
      the other hand, VLDL receptor expression induced enhanced incorporation of lipids
      and cytoplasmic enlargement. These changes were dependent on the exogenous ligand
      and the cytoplasmic domain of the receptor. These results suggest that the VLDL
      receptor functions as a regulator of cell growth and differentiation, which may
      be distinct from its lipid-incorporating function.

PMID- 11199509
TI  - Right heart bypass for left circumflex coronary artery bypass grafting.
AB  - Displacement of the heart to expose the left circumflex artery (LCX) causes
      hemodynamic disturbance during off-pump coronary artery bypass grafting (CABG).
      We applied right heart bypass (RHB) using a heparin-coated centrifugal pump
      without an oxygenator in an attempt to stabilize the hemodynamics. Five mongrel
      dogs (15.5-20 kg) were used. Hemodynamic parameters were continuously monitored
      at a fixed rate of 80 beats/min. The LCX was exposed with the use of an Octopus
      Tissue Stabilizer. After baseline data were obtained, each dog was placed in the
      Trendelenburg position. Finally, RHB was established with different pump flows.
      LCX exposure caused a significant decrease in aortic flow (to 33.1% +/- 13.1% of
      the baseline value) and arterial mean pressure (to 68.3% +/- 8.5%) (P < 0.001).
      Trendelenburg positioning caused these values to recover to 57.1% +/- 6.7% and
      72.5% +/- 7.7%, respectively. RHB with 50% flow significantly improved the
      hemodynamic values, although 100% flow significantly increased LAP by 134.8% +/-
      19.7% (P < 0.01). Tilting of the canine heart to expose the LCX caused
      significant deterioration of the hemodynamic values. Trendelenburg positioning
      was moderately effective, and RHB very effective, in improving the hemodynamics.
      In a limited number of cases, an appropriate flow of RHB may provide safe
      hemodynamic assistance during off-pump CABG of the LCX.

PMID- 11199508
TI  - Nicorandil increases adenosine 5'-monophosphate-primed interstitial adenosine via
      activation of ecto-5'-nucleotidase in rat hearts.
AB  - With the use of microdialysis techniques, we examined the effects of nicorandil,
      a hybrid of an ATP-sensitive K+ (K ATP) channel opener and a nitrate compound, on
      the production of interstitial adenosine in rat hearts in situ. The level of
      dialysate adenosine measured under a constant supply of adenosine 5'
      monophosphate (AMP) reflected the activity of endogenous ecto-5'-nucleotidase.
      Nicorandil (0.3-3mM) increased the level of AMP (100 microM)-primed dialysate
      adenosine in a concentration-dependent manner, and this effect was completely
      abolished by the guanylate cyclase inhibitor, methylene blue (100 microM), but
      not by the K ATP channel blocker, glibenclamide (10 microM). Another K ATP
      channel opener, cromakalim (0.1-1mM), did not increase the production of AMP
      primed dialysate adenosine. These results suggest that nicorandil increases the
      level of interstitial adenosine via cyclic guanosine monophosphate-mediated
      activation of ecto-5'-nucleotidase.

PMID- 11199510
TI  - Gallic acid induces vascular smooth muscle cell death via hydroxyl radical
      production.
AB  - In the present study, we investigated whether gallic acid (GA) can induce death
      in cultured vascular smooth muscle cells (VSMCs), and whether production of the
      hydroxyl radical (.OH) is involved in the process of GA action. GA killed
      cultured VSMCs from rat aorta, in a dosc- and time-dependent manner. Cytoplasmic
      shrinkage and nuclear condensation were observed light microscopically in GA
      treated VSMCs, which appeared apoptotic. However, the ultrastructure of the VSMC
      was not typical of apoptosis: nuclear condensation was not glossy, and the plasma
      membrane and subccellular organelles were disrupted. Although the VSMC were
      positive for in situ nick end-labeling (TUNEL). they did not show a DNA ladder
      pattern on gel electrophoresis and were negative for T aq polymerase-based in
      situ ligation, which is more specific for apoptosis than TUNEL. Moreover. GA
      induced cell death was not prevented by Boc-Asp-fmk (a pan-caspase inhibitor).
      Production of OH was detected in GA-treated VSMCs using high-performance liquid
      chromatography with salicylic acid as a trapping agent. Lipid peroxidation was
      also observed. The production of .OH was inhibited by catalase (CAT) and
      deferoxamine (DFX), and these treatments completely rescued VSMCs from cell
      death. In a cell-free system, GA produced .OH in the presence of Fe2+-EDTA, which
      was quenched by CAT and DFX, suggesting involvement of the Haber-Weiss reaction.
      Oxidative stress by reactive oxygen species, .OH in particular, is one of the
      mechanisms of GA-induced death of VSMCs, the mode of which was different from
      typical apoptosis.

PMID- 11199511
TI  - Scrub jays (Aphelocoma coerulescens) form integrated memories of the multiple
      features of caching episodes.
AB  - Four experiments examined whether food-storing scrub jays remember when and where
      they cached different foods. The scrub jays cached and recovered perishable and
      nonperishable foods in visuospatially distinct and trial-unique cache sites. They
      rapidly learned to avoid searching for foods that had perished by the time of
      recovery, while continuing to search for the same foods after shorter retention
      intervals when the foods were still fresh. The temporal control of searching at
      recovery was also observed when the familiarity of cache sites did not provide
      any information about the time of caching and when the same food was cached in
      distinct sites at different times. The authors argue that the jays formed an
      integrated memory for the location and time of caching of particular foods.

PMID- 11199512
TI  - Cognitive precedence for local information in hierarchical stimulus processing by
      pigeons.
AB  - Four experiments investigated the processing of hierarchical stimuli by pigeons.
      Using a 4 alternative divided-attention task, 4 pigeons were food-reinforced for
      accurately identifying letters arranged as either hierarchical global- or local
      relevant stimuli or as size-matched filled stimuli. Experiment 1 found that task
      acquisition was faster with local-relevant than global-relevant stimuli. This
      difference was not due to letter size. Experiment 2 demonstrated successful
      transfer to a novel irrelevant letter configuration. Experiments 3 and 4 tested
      pigeons' responses to conflict probe stimuli composed of equally discriminable
      relevant letters at each level. These tests revealed that all of the pigeons
      showed a cognitive precedence for local information early in processing, with the
      pigeons using different cues to initiate the processing of global information.
      This local advantage contrasts with previously reported results for humans and
      pigeons but is similar to that reported for nonhuman primates. Alternatives
      attempting to reconcile these contrasting comparative results are considered.

PMID- 11199513
TI  - Taste preconditioning augments odor-aversion learning.
AB  - On the basis of previous work that has shown a taste can potentiate odor-aversion
      conditioning in AX+ conditioning, 6 experiments used rats to examine the effects
      of pairing a preconditioned taste (A) with a novel odor cue (X) in an A+/AX+
      aversion conditioning design. Experiments 1A and 1B demonstrated that a
      preconditioned taste produced a robust odor aversion that was significantly
      stronger than a potentiated odor aversion. The results of Experiment 2 showed
      that the robust odor aversion produced by A+/AX+ conditioning was not the result
      of the potentiated odor aversion summating with generalization from the taste
      aversion. The augmented odor aversion was produced only when the taste and odor
      stimuli were presented simultaneously (Experiment 3) and the preconditioned taste
      aversion was intact at compound conditioning (Experiment 4). Pairing a novel odor
      with a preconditioned taste was not sufficient to condition an aversion to odor
      (Experiment 5), although other results implicated a role for an association
      between odor and taste in the odor augmentation effect (Experiment 6). The
      present results have implications for current models of taste + odor interactions
      in flavor-aversion conditioning.

PMID- 11199514
TI  - Conditioned inhibition produced by extinction-mediated recovery from the relative
      stimulus validity effect: a test of acquisition and performance models of
      empirical retrospective revaluation.
AB  - Empirical retrospective revaluation is a phenomenon of Pavlovian conditioning and
      human causal judgment in which posttraining changes in the conditioned response
      (Pavlovian task) or causal rating (causal judgment task) of a cue occurs in the
      absence of further training with that cue. Two experiments tested the contrasting
      predictions made by 2 families of models concerning retrospective revaluation
      effects. In a conditioned lick-suppression task, rats were given relative
      stimulus validity training, consisting of reinforcing a compound of conditioned
      stimuli (CSs) A and X and nonreinforcement of a compound of CSs B and X, which
      resulted in low conditioned responding to CS X. Massive posttraining extinction
      of CS A not only enhanced excitatory responding to CS X, but caused CS B to pass
      both summation (Experiment 1) and retardation (Experiment 2) tests for
      conditioned inhibition. The inhibitory status of CS B is predicted by the
      performance-focused extended comparator hypothesis (J. C. Denniston, H. I.
      Savastano, & R. R. Miller, 2001), but not by acquisition-focused models of
      empirical retrospective revaluation (e.g., A. Dickinson & J. Burke, 1996; L. J.
      Van Hamme & E. A. Wasserman, 1994).

PMID- 11199515
TI  - Relative validity effects with either one or two more valid cues in Pavlovian and
      instrumental conditioning.
AB  - Two experiments investigated the relative validity effect with either 1 or 2
      continuously reinforced cues in Wistar rats using appetitive Pavlovian and
      instrumental preparations. Discrimination training involved 3 compound cues
      containing a common element (1AX: 1BX: 2CX). In the first true-discrimination
      group (TD-1), CX was followed by food, but AX and BX were not. In the second true
      discrimination group (TD-2), AX and BX but not CX were followed by food. In the
      third, pseudodiscrimination group (PD), food followed 50% of each compound.
      Compared with the PD group, there were lower levels of responding to X in Groups
      TD-1 and TD-2, which did not differ. That is, both TD treatments showed
      equivalent relative validity effects. There was evidence for a relative validity
      effect on the context. The Rescorla-Wagner model incorrectly predicts a smaller
      relative validity effect after the TD-2 than the TD-1 treatment. Comparator
      theory predicts these results.

PMID- 11199516
TI  - Circadian time perception.
AB  - The variability of anticipating a meal was investigated. Sprague-Dawley rats
      earned food by inspecting a food source during a 3-hr interval. Food was not
      available at other times. In Experiment 1, the meal started 3 or 7 hr after light
      offset in a 12-hr light-dark cycle. Experiment 2 was conducted in constant
      darkness with 14-, 22-, 22.5-, 24-, 25.5-, 26-, or 34-hr intermeal intervals.
      Inspections increased before the meal. Rats timed intervals in the circadian
      range (22-26 hr) with lower variability than that for intervals outside this
      range (3-14 and 34 hr). Higher precision in timing selected intervals violates
      the scalar property. Proximity to a circadian oscillator improves timing
      precision. Variability may be used to identify oscillators with noncircadian
      periods.

PMID- 11199517
TI  - Stability and variability in extinction.
AB  - Some studies have found that extinction leaves response structures unaltered;
      others have found that response variability is increased. Responding by Long
      Evans rats was extinguished after 3 schedules. In one, reinforcement depended on
      repetitions of a particular response sequence across 3 operanda. In another,
      sequences were reinforced only if they varied. In the third, reinforcement was
      yoked: not contingent upon repetitions or variations. In all cases, rare
      sequences increased during extinction--variability increased--but the ordering of
      sequence probabilities was generally unchanged, the most common sequences during
      reinforcement continuing to be most frequent in extinction. The rats' combination
      of generally doing what worked before but occasionally doing something very
      different may maximize the possibility of reinforcement from a previously
      bountiful source while providing necessary variations for new learning.

PMID- 11199519
TI  - On opening of the National Practitioner Data Bank.

PMID- 11199518
TI  - New York needs to take lead in ethics training.

PMID- 11199520
TI  - Palm trees.

PMID- 11199521
TI  - NYSDA Membership Survey. How the components stack up.
AB  - There are many similarities and differences between the demographic
      characteristics of dentists, their practice arrangements, business activities,
      income and other factors, which do not follow the purported "downstate-upstate"
      dichotomy. In each district society, most respondents are sole proprietors, and
      26+ years is the most frequently reported period of time in practice. A great
      majority of dentists in most component societies work 32+ hours per week, and
      average 50 to 56 scheduled and six to nine emergency visits per week. $175,000+
      was reported most frequently as the net income of dentists in eight component
      societies. A small percent of practitioners belong to IPAs and capitation plans.
      A small percent accepts Medicaid patients. A somewhat larger percent belongs to
      DR plans. A much greater percent belongs to PPO arrangements. Approximately 25%
      of respondents expect that their primary occupation will change in the next 10
      years, with the vast majority anticipating no longer being in dental practice.

PMID- 11199522
TI  - The man-eaters with bad teeth.
AB  - Two cases of man-eating lions feeding on large numbers of humans (1898, 1991) are
      discussed. The forensic dental evidence from the lions' remains and eyewitness
      reports indicate all three lions had serious dental/oral pathology, which may
      have contributed to their selection of human food over more challenging natural
      animal prey.

PMID- 11199523
TI  - Macrognathia of renal osteodystrophy in a dialysis patient. Report of a case.
AB  - A case of macrognathia secondary to renal osteodystrophy in a dialysis patient is
      presented. The case reviewed demonstrates a variety of radiographic and
      histopathologic features, some of which resemble fibrous dysplasia and others
      suggestive of Paget's disease of bone. This article contains diagnostic criteria
      for differentiating renal osteodystrophy from similar fibro-osseous diseases.
      There is a discussion of the underlying cause and appropriate therapeutic
      interventions of renal osteodystrophy.

PMID- 11199524
TI  - Restoration of endodontically treated tooth containing wide or flared canal.
AB  - There has been much anecdotal information and misinformation disseminated
      regarding the restoration of endodontically treated teeth, which has comprised
      the foundation for our restorative protocol. In the past, it was considered
      appropriate to place a cast post and core in every pulpless tooth without regard
      to the amount of remaining supportive tooth structure present. Recent
      developments in available ceramics, greater cosmetic demands by patients, and the
      advent of adhesive bonding techniques have caused clinicians to reevaluate their
      restorative protocol. This article reviews the current literature with regard to
      restoration of the endodontically treated tooth and presents a method for
      restoration and reinforcement using a combination of polyethylene ribbon and a
      prefabricated fiber post to create a post and core that is retentive, supportive,
      cosmetic and able to impart reinforcement to a structurally compromised root.

PMID- 11199525
TI  - Is there a doctor on the plane?

PMID- 11199526
TI  - If you've got it, advertise it.

PMID- 11199527
TI  - Irukandji and Chironex fleckeri jellyfish envenomation in tropical Australia.
AB  - OBJECTIVE: To compare the temporal distribution of Irukandji and Chironex
      fleckeri stings, the demographics of victims, the prevailing physical conditions
      at the time of a sting, and the prevalence of unsuitable first aid strategies.
      METHODS: Retrospective assessment of 478 Chironex and 544 Irukandji stings in
      Queensland and the Northern Territory of Australia. RESULTS: Adolescent and young
      adult males were the most common victims of Irukandji (median age 21 years) and
      Chironex stings (median age 16 years). Most Chironex stings occurred on the legs,
      while Irukandji stings were more common on the arms. Vinegar was correctly used
      to remove tentacles in 90.5% of Chironex stings, whereas inappropriate treatments
      were used in the remaining cases. Chironex stings were reported in every month in
      the Northern Territory, and in all months but June and July in Queensland. The
      peak prevalence for Chironex stings occurred in January in both areas, while the
      number of Irukandji stings peaked in December in Queensland and in May in the
      Northern Territory. Chironex stings were more common on still, cloudy days,
      whereas Irukandji stings were more common on still, clear days. Irukandji stings
      were more frequent than Chironex stings on rough days (P = .0005). Chironex and
      Irukandji stings were similar with respect to tides, moon phases, and rainfall.
      CONCLUSIONS: This study failed to predict exact weather patterns or other
      contributing factors to reduce the risk of stings to an acceptable level, but did
      identify several factors that increase the incidence of stings. The "stinger
      free" season reported on Chironex warning signs is inaccurate and should be
      changed to warn bathers that Chironex may be present year round, particularly in
      the Northern Territory.

PMID- 11199528
TI  - Optimization and preliminary characterization of venom isolated from 3 medically
      important jellyfish: the box (Chironex fleckeri), Irukandji (Carukia barnesi),
      and blubber (Catostylus mosaicus) jellyfish.
AB  - OBJECTIVE: To optimize venom extraction and to undertake preliminary biochemical
      studies of venom from the box jellyfish (Chironex fleckeri), the Irukandji
      jellyfish (Carukia barnesi), and the blubber jellyfish (Catostylus mosaicus).
      METHODS: Lyophilized crude venoms from box jellyfish tentacles and whole
      Irukandji jellyfish were prepared in water by homogenization, sonication, and
      rapid freeze thawing. A second technique, consisting of grinding samples with a
      glass mortar and pestle and using phosphate-buffered saline, was used to prepare
      crude venom from isolated nematocysts of the box jellyfish, the bells of
      Irukandji jellyfish, and the oral lobes of blubber jellyfish. Venoms were
      compared by use of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS
      PAGE) and Western blot test. Toxicity of some venoms was determined by
      intravenous median lethal dose assay in mice. RESULTS: Different venom extraction
      techniques produced significantly different crude venoms for both box and
      Irukandji jellyfish. Irukandji and blubber venom SDS-PAGE protein profiles were
      established for the first time. Analysis of Western blot tests revealed that box
      jellyfish antivenin reacted specifically with the venom of each jellyfish.
      Toxicity was found in Irukandji jellyfish venom derived by use of the mortar-and
      pestle method, but not in the lyophilized venom. CONCLUSIONS: Glass mortar-and
      pestle grinding and use of an appropriate buffer was found to be a simple and
      suitable method for the preparation of venom from each jellyfish species studied.
      This study contributes to biochemical investigations of jellyfish venoms,
      particularly the venom of the Irukandji jellyfish, for which there are, to our
      knowledge, no published studies. It also highlights the importance of optimizing
      venom extraction as the first step toward understanding the complex biological
      effects of jellyfish venoms.

PMID- 11199529
TI  - Inhaled nitric oxide improves survival in the rat model of high-altitude
      pulmonary edema.
AB  - OBJECTIVES: High-altitude pulmonary edema (HAPE) afflicts certain individuals
      after a rapid gain in elevation. Those susceptible demonstrate an exaggerated
      hypoxic pulmonary vasoconstrictive response. This causes pulmonary hypertension,
      which may disrupt vascular integrity. This experiment was designed to test
      whether inhaled nitric oxide would affect development of HAPE in a rat model.
      METHODS: Subjects were exposed in a hypobaric chamber to a simulated altitude of
      6200 m (barometric pressure = 380 mm Hg, fraction of inspired oxygen = 0.19) for
      24 hours. Control animals (n = 48) spontaneously breathed a mixture of 90% room
      air and 10% nitrogen, whereas the nitric oxide group (n = 48) received a similar
      mixture containing 83 ppm nitric oxide. Postmortem examination of lungs was
      performed for light microscopy, total hemoglobin, and gravimetric estimates of
      water content. RESULTS: Mortality was 39.5% (n = 19) in control animals and 6.2%
      (n = 3) in the nitric oxide group (P < .001). Both groups significantly increased
      their lung weight-body weight ratio. Percentage of lung water was similar in both
      groups despite increases in lung weight, which is consistent with the protein
      rich edema characteristic of HAPE. Light microscopic examination of survivors'
      lungs in both groups revealed scattered alveolar hemorrhage. No significant
      cellular inflammatory response was present. CONCLUSIONS: We conclude that inhaled
      nitric oxide improves survival in the rat model of HAPE.

PMID- 11199530
TI  - Planning for an annual episodic mass gathering: emergency department and clinic
      utilization in Yellowstone.
AB  - OBJECTIVE: Planning and providing emergency and primary care for a large
      transient population of visitors and employees in a national park can be
      problematic. Furthermore, planning for emergency and primary health care needs of
      visitors and itinerant workers in a wilderness area national park has not been
      well documented. A study was performed to analyze emergency and primary health
      care utilization in a national park. METHODS: Data was gathered from all patients
      presenting to Lake Hospital Emergency Department in Yellowstone in 1995, and a
      retrospective chart review was performed. RESULTS: Two distinct populations with
      different health care needs were identified. CONCLUSION: Utilization analysis
      revealed differences between conventional mass gatherings and the mass gatherings
      in Yellowstone. Because of the unique conditions and populations found in a
      wilderness area, conventional mass gathering emergency medical service models may
      not be an appropriate model for planning health care in a national park. Analysis
      of utilization data can help plan resources for emergency and primary health care
      for a park population.

PMID- 11199531
TI  - Practical aspects in mountain medicine education.
AB  - Mountain medicine education is provided through many different courses. The
      newest developments include an international Union Internationale des
      Associations Alpinistes--Internationale Kommission fur Alpines Rettungswesen-
      International Society of Mountain Medicine (UIAA-IKAR-ISMM) label for mountain
      medicine courses that comply with certain minimal requirements in theoretical and
      practical educational aspects. Participants in the courses that fulfill these
      specific conditions are eligible to obtain the International Diploma of Mountain
      Medicine, which is recognized by the above-mentioned international bodies
      governing mountain sports and mountain medicine. The Swiss course cycle, and
      especially the structure and content of the Swiss summer course 1999, which was
      organized by the Swiss Alpine Club and the Swiss Society for Mountain Medicine,
      are described in this article and some annotations are given. Theoretical and
      practical requirements for obtaining the International Diploma of Mountain
      Medicine in Switzerland are also presented.

PMID- 11199532
TI  - Clinical images. Immersion injury.

PMID- 11199533
TI  - Joseph Lister, antiseptic surgery, and wilderness medicine--a commentary.

PMID- 11199534
TI  - Illustrations of the antiseptic system of treatment in surgery. 1867.

PMID- 11199535
TI  - Creative anatomy teaching.

PMID- 11199536
TI  - Brains and video games at high altitude.

PMID- 11199537
TI  - Acclimatization of genetically related adults and children.

PMID- 11199538
TI  - The millennium and beyond.

PMID- 11199539
TI  - The limitations of learning from a clinical diagnosis of "probable high-altitude
      pulmonary edema".

PMID- 11199540
TI  - Medical emergencies at high altitude.

PMID- 11199541
TI  - Death from high-altitude pulmonary edema preventable by appropriate treatment.

PMID- 11199542
TI  - Lifting spirits and restoring dignity.

PMID- 11199543
TI  - An unusual alteration in the shape of a tooth.
AB  - Dental anomalies are an important issue and dentists should be able to manage
      these conditions. Often, treatment is not necessary; however, some abnormalities
      may affect the esthetics or function of teeth and can lead to other problems.
      This case report presents an unusual case of alteration in shape affecting the
      left lower canine in a 34-year-old woman.

PMID- 11199544
TI  - Potassium nitrate.

PMID- 11199545
TI  - Gift ethics.

PMID- 11199546
TI  - AGD and the ADA.

PMID- 11199547
TI  - The new COX-2 inhibitors: rofecoxib (Vioxx) and celecoxib (Celebrex).

PMID- 11199548
TI  - Experimental therapy research in general dental practice.

PMID- 11199549
TI  - Evidence-based dentistry and esthetics.
AB  - Separating hype from the truth in dental marketing can be frustrating and it is
      difficult at best for the average dentist to evaluate the safety and efficacy of
      new products and techniques. Keynote clinicians are presenting information and
      influencing other dentists without the scientific evidence to support their
      claims. For the benefit of our patients, the system needs to change. It will not
      come soon, but until more evidence-based testing is commonplace and made readily
      available to the practicing dentist, most dentists will continue tradition-based
      practices.

PMID- 11199550
TI  - Anterior mandibular radiolucency. Glandular odontogenic cyst.

PMID- 11199551
TI  - Radiolucency of maxillary alveolus. Fibrous scar.

PMID- 11199552
TI  - Comprehensive treatment planning involving implant reconstruction.

PMID- 11199553
TI  - A comparison of all-ceramic restorative systems: Part 2.
AB  - Overall, any of these systems can provide well-fitting, natural looking
      restorations as long as care is taken during the preparation and fabrication
      procedures. A key to successful use of all-ceramic materials is proper selection
      based on the clinical conditions involved in specific restorative procedures (see
      table). All systems have limitations on their use and when we try to stretch
      those limits, success rates may fall drastically. High stress areas should shift
      selection to high strength, clinically documented materials. Low stress areas
      requiring high translucency may be restored successfully using the lower strength
      castable glasses. Intermediate areas may shift selection to higher strength yet
      still translucent materials such as In-Ceram Spinell or Empress 2. Posterior
      regions might best be addressed with the use of In-Ceram Alumina or Procera. The
      case of posterior bridges would lock the selection into In-Ceram Zirconia.
      Finally, it is important for each of us to continually educate ourselves and to
      examine the evidence in order to make an informed decision and maximize clinical
      success.

PMID- 11199554
TI  - Recognition of bulimia nervosa in dental patients: implications for dental care
      providers.
AB  - Patients with bulimia nervosa commonly exhibit distinctive oral characteristics.
      Dental health providers should be able to recognize these signs and identify
      patients with this condition. Members of the dental health team then must
      intervene and assist in facilitating treatment of the eating disorder. Current
      knowledge about bulimia nervosa and its oral signs and preventive, interventive,
      and restorative strategies for dental health practitioners are presented.

PMID- 11199555
TI  - Drug use for the pregnant or lactating patient.
AB  - The dental patient who is pregnant or lactating may require management involving
      the administration or prescription of drugs. The approach of completely avoiding
      all drugs may not permit appropriate treatment of the patient and most often is
      not warranted. This article reviews the current considerations in the use of
      drugs in the dental patient who is either pregnant or lactating. The safety of
      the local anesthetics, vasoconstrictors, analgesics, antimicrobials, and
      sedatives used in dentistry is discussed.

PMID- 11199556
TI  - Oral condyloma acuminatum.
AB  - Oral condyloma acuminatum is a papillomatous lesion that is transmitted sexually
      and associated with the human papilloma virus. Condyloma acuminatum generally
      appears one to three months after exposure to an infected partner and presents in
      multiple form in the oral cavity.

PMID- 11199557
TI  - Desensitization of exposed root surfaces using a semilunar coronally positioned
      flap.
AB  - A definitive treatment is described for cervical dentinal sensitivity, featuring
      a semilunar coronally positioned flap to cover the denuded root surface. Many
      patients who complain of having sensitive teeth from exposed dentin secondary to
      gingival recession can be easily and conservatively treated with a semilunar flap
      procedure.

PMID- 11199558
TI  - Incorporating Piaget's theories into behavior management techniques for the child
      dental patient.
AB  - This presentation reviews psychologist Jean Piaget's contributions to knowledge
      of cognitive development in children, relating it to behavior management
      techniques. Piaget theorized that children's knowledge about reality is realized
      by touching and observing; he termed this constructivism. He recognized that
      there are stages of development in knowledge acquisition. Practitioners should
      try to stimulate these needs to develop a positive dental experience. Another
      Piaget model is egocentrism, wherein a child views the world subjectively. The
      dentist should let the child patient know what's going on and have an active part
      in treatment.

PMID- 11199560
TI  - Patient satisfaction.

PMID- 11199559
TI  - Class V lesions restored with flowable composite and added surface sealing resin.
AB  - This in vitro study evaluates the marginal sealing ability of three different
      flowable composite systems at enamel and dentin margins, using sealants. Class V
      preparations were made on the facial surfaces in enamel and dentin/cement of 60
      freshly extracted teeth, which were allotted randomly into six groups of ten. The
      control groups (I, II, and III) showed leakage in the majority of cases. However,
      Groups IV and V had very limited microleakage scores (2 of 30) in comparison to
      Group VI (p < 0.001, Mann-Whitney Test).

PMID- 11199561
TI  - Unhealed extraction sites mimicking TMJ pain.
AB  - A case of unhealed extraction sites in the mandible is described, including
      clinical, radiographic, and biopsy findings. The subject was treated for TMJ
      disease in the past but still had related signs and symptoms and facial pain.

PMID- 11199562
TI  - The double arch impression technique: a solution to prevent supraocclusion in the
      indirect restoration.
AB  - The literature relating to inaccuracies in the mounting of casts of semi
      adjustable articulators and other factors that influence the fabrication of
      indirect restorations is reviewed. The effects of such discrepancies often result
      in "high" cast restorations which require considerable adjustment clinically
      before definitive placement. Some solutions to "high" cast restorations are
      offered with indications and contraindications for their use.

PMID- 11199563
TI  - A review of the amalgapin technique for complex amalgam restorations.
AB  - For many years, large amalgam restorations have been retained with stainless
      steel pins or dentinal slots. In 1980, Shavell introduced the amalgapin technique
      for what he termed "complex" amalgam restorations. This technique consisted of
      preparing dentin chambers 1.0-2.0 mm deep just inside the dentinoenamel junction.
      As the technique became more popular, comparisons of its fracture strength to
      that of stainless steel pins were evaluated. This article reviews the literature
      concerning the amalgapin technique, examines its resistance compared to other
      retentive means, and discusses the method of preparation.

PMID- 11199565
TI  - Addressing the real future of dentistry.

PMID- 11199564
TI  - The oral brush biopsy: a new reason to screen every patient for oral cancer.
AB  - Awareness about the prevention of oral cancer by both the public and the dental
      professional is expected to increase significantly. This article provides timely
      information about the computer-assisted analysis of an oral brush biopsy, a
      practical and accurate aid to oral cancer screening.

PMID- 11199566
TI  - Tobacco is a drag on your practice.

PMID- 11199567
TI  - Sexual ethics in dentistry.

PMID- 11199568
TI  - Bonding techniques.

PMID- 11199569
TI  - Hypertension medications and dental considerations.

PMID- 11199570
TI  - Truth and lies: when patients request falsifications.

PMID- 11199571
TI  - Diffuse white lesions.

PMID- 11199572
TI  - Palatal mass.

PMID- 11199573
TI  - Treatment of early childhood caries: a review and case report.
AB  - Caries in infants and young children long has been recognized as a clinical
      entity and described variously as nursing caries, nursing bottle syndrome and so
      on. Although prolonged use of the baby bottle is believed to be associated with
      increased risk of caries, use of the bottle may not be the most important factor
      in caries development. The term early childhood caries (ECC) has been suggested
      because it more closely reflects the multifactorial etiologic process involved in
      the disease. A case of ECC treated in a general dental practice and managed under
      local anesthesia is reported.

PMID- 11199574
TI  - A comparison of parenteral and electronic dental anesthesia during operative
      procedures in children.
AB  - The effectiveness of electronic dental anesthesia (EDA) for pain control during
      restorative procedures was compared with local anesthesia (LA) in 108 pediatric
      patients aged 6-12. One tooth was treated with LA and another with EDA at the
      same appointment. The pain levels during restorative treatment were assessed
      using a color scale. Behavior also was assessed using sound, eye, and motor (SEM)
      scale. Although the success rate of EDA was less than that of LA, there was no
      significant difference between the two methods. On the other hand, 63% of the
      patients preferred EDA while 27.8% preferred LA. These results suggest that EDA
      is an effective nondrug pain control technique for amalgam restorations in
      primary and permanent molars for some patients.

PMID- 11199575
TI  - Sports dentistry in general practice.
AB  - The sports dentistry movement in the United States and worldwide is experiencing
      new momentum. Much of this is generated by general dentists working in
      conjunction with like-minded specialists as well as with dental hygienists,
      dental laboratory technicians, and dental assistants. This article explores
      several issues of relevance to stimulate the interest of general dentists to
      become involved in private practice and community service activities in sports
      dentistry.

PMID- 11199576
TI  - Early intervention to remove mesiodens and avoid orthodontic therapy.
AB  - Recognition of dental anomalies is essential in determining appropriate treatment
      for each patient. Diagnosis and assessment of mesiodens are critical in avoiding
      complications such as blocking the eruption of the maxillary central incisors,
      cyst formation, and dilaceration of the permanent incisors. Collecting data for
      diagnostic criteria, utilizing diagnostic radiographs, and determining when to
      refer to a specialist are important steps in the treatment of mesiodens. Early
      diagnosis and timely intervention could reduce or eliminate the need for
      orthodontic treatment and prevent serious complications.

PMID- 11199577
TI  - Current dental concepts in antibiotic prophylaxis for total joint replacement
      patients.
AB  - The subject of antibiotic prophylaxis has evoked controversy and much debate over
      the validity of such practice. In July 1997, the American Dental Association and
      American Academy of Orthopedic Surgeons issued an advisory statement concerning
      the use of antibiotic prophylaxis for patients with total joint replacements. A
      historical perspective of the subject is presented, with a review of the
      recommendation for total joint replacement antibiotic prophylaxis, a discussion
      of the new decision-making responsibility for the dentist, and medicolegal
      ramifications of this change.

PMID- 11199578
TI  - Postreplantation management of avulsed teeth: an endodontic literature review.
AB  - Today's dental treatment goals are directed at reducing the incidence of root
      resorption resulting from periodontal ligament devitalization or pulp necrosis.
      Although the American Association of Endodontists recommends the use of long-term
      therapy, short-term therapy may be utilized with confidence in well-defined
      clinical applications. Early final obturation with gutta-percha will increase the
      long-term prognosis in those cases where patient motivation is questionable or
      long-term follow-up prior to obturation is not possible. However, where
      inflammatory resorption is already present, long-term calcium hydroxide therapy
      is indicated. Long-term post treatment follow-up is imperative in both calcium
      hydroxide therapies.

PMID- 11199579
TI  - Smile enhancement via internal gingivectomies.
AB  - Periodontal plastic surgical procedures provide a wide range of techniques to
      improve the esthetics of the mucogingival complex. Often these procedures are
      prerequisites for successful restorative therapy. This article presents a simple
      means of enhancing a patient's smile that can be provided by simple internal
      gingivectomies. The technique can be provided as a stand-alone procedure or in
      conjunction with restorative care. The surgery is simple and predictable with
      virtually no postsurgical sequellae.

PMID- 11199580
TI  - Evaluations of the interface between amalgam and dentin with a single component
      dentin bonding system.
AB  - The purpose of this scanning electron microscope study was to observe the dentin
      amalgam interface after utilizing a standard restorative liner and a single
      component dentin adhesive. Continuous interface gaps of over 15 mu were observed
      in specimens containing no lining and Copal varnish. Discontinuous 5 microns gaps
      were observed in specimens treated with PQ1. Additionally, specimens treated with
      PQ1 exhibited resin interpenetration into the dentin surfaces.

PMID- 11199582
TI  - The complexities of cosmetics.

PMID- 11199581
TI  - Bonded arch bars to manage traumatic injuries to the teeth and alveolar bone.
AB  - A simple, rapid, painless, and bloodless method of successfully treating avulsed
      and partially avulsed teeth with or without associated dentoalveolar fractures is
      presented for management by the general practitioner in the office. It is a
      bonding technique with the key elements being a prefabricated malleable mesh
      backed arch bar in combination with any light curing composite procedure that is
      standard in the individual's office.

PMID- 11199584
TI  - Is there a doctor in the house?
AB  - The two cases presented deal with urgent situations experienced by persons
      unknown to the dentist in the area. It is likely that dentists, physicians,
      nurses, and other medical professionals will encounter persons in urgent need of
      medical attention in other venues. Certainly, it is possible for someone to
      experience an emergency in a ballpark, grocery store, church, or other public
      gathering. While these settings may not offer the advantage of a medical
      emergency kit, they do pose the same ethical requirement for those trained in
      medical management of urgent problems to step forward, identify themselves, and
      attempt to help the ill person. Fortunately, most non-air settings usually allow
      for contacting emergency medical help and prompt transport to hospitals. The
      public may never reach a general understanding of the extent to which doctors
      other than physicians are trained to handle medical emergencies. Similarly, when
      someone in a crowded theater yells, "Is there a doctor in the house?" he or she
      most likely is thinking about a physician. This does not mean that a dentist is
      excused from acting as a medically trained Good Samaritan. The ethical obligation
      of specific beneficence requires dentists to minister to the ill in medical
      emergencies unless a more qualified health care provider is present and
      identifies himself or herself. The ethical obligation of general beneficence
      requires dentists and other citizens to assist those in urgent circumstances
      whose needs do not call upon specialized knowledge or training. Fortunately, the
      law in this country is designed to protect those who do attempt to help those in
      need.

PMID- 11199583
TI  - Osteoporosis, alveolar bone loss, and drug development.

PMID- 11199585
TI  - The importance of contacts and embrasures and their effect on the periodontium.
AB  - Operative and restorative dentistry are challenging disciplines of dentistry.
      When esthetics and periodontics are added to the equation, it becomes that much
      more difficult for any operator to restore teeth in an ideal manner. In order to
      be successful and have reasonable occlusal harmony, periodontal health, and
      beautiful esthetics, knowledge of all of these disciplines is necessary no matter
      what kind of material is being placed. Continuing education, care, skill,
      practice, a desire for excellence, and, most of all, patience will allow any
      dentist to accomplish these goals.

PMID- 11199586
TI  - Fiber reinforced composite resin systems.
AB  - The Targis/Vectris and Sculpture/FibreKor systems were devised to create a
      translucent maximally reinforced resin framework for fabrication of crowns,
      bridges, inlays, and onlays. These materials are esthetic, have translucency
      similar to castable glass-ceramics such as OPC and Empress, and have fits that
      are reported to be acceptable in clinical and laboratory trials. These
      restorations rely on proper bonding to the remaining tooth structure; therefore,
      careful attention to detail must be paid to this part of the procedure.
      Cementation procedures should involve silane treatment of the cleaned abraded
      internal restoration surface, application of bonding agent to the restoration as
      well as the etched/primed tooth, and finally use of a composite resin. Each
      manufacturer has a recommended system which has been tested for success with its
      resin system. These fiber reinforced resins are somewhat different than classical
      composites, so not all cementation systems will necessarily work with them.
      Polishing of the restoration can be accomplished using diamond or alumina
      impregnated rubber wheels followed by diamond paste. The glass fibers can pose a
      health risk. They are small enough to be inhaled and deposited in the lungs,
      resulting in a silicosis-type problem. Therefore, if fibers are exposed and
      ground on, it is extremely important to wear a mask. Also, the fibers can be a
      skin irritant, so gloves also should be worn. If the fibers become exposed
      intraorally, they can cause gingival inflammation and may attract plaque. The
      fibers should be covered with additional composite resin. If this cannot be
      accomplished, the restoration should be replaced. The bulk of these restorations
      are formed using a particulate filled resin, similar in structure to conventional
      composite resins. Therefore, concerns as to wear resistance, color stability,
      excessive expansion/contraction, and sensitivity remain until these materials are
      proven in long-term clinical trials. They do hold the promise of minimizing tooth
      reduction and may be particularly useful in preserving sound tooth structure.
      Although not the primary intended use, an excellent application is long-term
      temporization, such as for patients requiring full mouth rehabilitation. The
      belleGlass/Connect, Ribbond, and GlasSpan materials rely on nonimpregnated
      polyethylene fibers which have mechanical properties inferior to Vectris and
      FibreKor. These fibers may be used to greater success as splinting materials, in
      provisional restorations, and in repair of complete and partial removable
      dentures.

PMID- 11199587
TI  - Radiolucency of the anterior mandible. Dentigerous cyst.

PMID- 11199588
TI  - Ulcerated palatal lesion. Ulcerating sialometaplasia.

PMID- 11199589
TI  - Whitening of endodontically untreated calcified anterior teeth.
AB  - Definitive treatment for whitening endodontically untreated anterior teeth with
      dystrophic calcification is provided by removing the coronal sclerotic dentin and
      utilizing internal and external bleaching as necessary.

PMID- 11199590
TI  - Combined professional and home care nightguard bleaching of tetracycline-stained
      teeth.
AB  - The effectiveness of combining in-office and at-home nightguard vital bleaching
      on tetracycline-stained teeth was evaluated. Grade 1 and grade 2 tetracycline
      stains were eliminated completely in two months by this combination approach.
      Grade 3 stains, the most severe, were lightened significantly with a reduction in
      the banding effect. The most common side effect was an increase in tooth
      sensitivity, especially to cold, while actively in treatment. All patients
      reported disappearance of the sensitivity after termination of the treatment
      phase.

PMID- 11199591
TI  - Comparison of 10% carbamide peroxide and sodium perborate for intracoronal
      bleaching.
AB  - The purpose of this study was to compare 10% carbamide peroxide to the
      combination of sodium perborate and water as intracoronal bleaching agents. Forty
      four extracted teeth were discolored in vitro. Bleaching agents were placed
      intracoronally to the level of the cemento-enamel junction for 12 days; solutions
      were replaced after four and eight days. Standardized slides were used to rank
      color changes; a colorimeter was used to quantify color change. After 12 days,
      65% of the discolored teeth in the 10% carbamide peroxide group and 67% of the
      discolored teeth in the sodium perborate group had lightened to their original
      shade or lighter. While there was no statistical difference between the two
      treatments, sodium perborate was easier to use.

PMID- 11199592
TI  - A simple screening test for color matching in dentistry.
AB  - This study compared a simple and readily available shade guide color-matching
      test with the general industry standard test for color discrimination. This study
      indicates that a simple screening test for color defective vision and color
      discrimination skills in dentistry can be performed by matching two Vita-Lumin
      shade guides. Those dental office personnel who score a low number of matches in
      the Vita test (that is, seven or fewer correct matches) should have additional
      color discrimination testing and refer shade matching to other personnel with
      higher scores.

PMID- 11199593
TI  - Accessing restoration margins--a multidisciplinary approach.
AB  - Dentists frequently balance periodontal, restorative, and esthetic concerns that
      will provide adequate tooth length, ensure periodontal health, and provide
      biological predictability. This report discusses the current and classical
      literature and provides a multidisciplinary approach of predictably "accessing"
      the restoration margins to facilitate long-term gingival health and tooth
      survival.

PMID- 11199594
TI  - Effects of evaporation on the properties of water-based dental luting agents.
AB  - The most commonly used luting agents for fixed prosthodontics are water-based
      cements: zinc phosphate, zinc polycarboxylate, glass ionomer, and resin-modified
      glass ionomer. Properties were tested at baseline and after the cement liquids
      were allowed to evaporate for 10, 20, and 30 minutes. Viscosity, pH, contact
      angle, and surface tension were determined using the cement liquids only; tensile
      strength, hardness, film thickness, and working/setting times were determined
      after the cements had been mixed with the various liquids. pH decreased over 30
      minutes, while viscosity, contact angle, and film thickness all increased,
      especially for the zinc polycarboxylate and glass ionomer cements. Changes in
      mechanical properties depended upon time and material.

PMID- 11199595
TI  - Stainless steel crown and pulpotomy: procedure and technique for primary molars.
AB  - The purpose of this article is to facilitate performance of the stainless steel
      crown and pulpotomy procedures in order to save chair time and provide a more
      durable and reliable final restoration for primary molars. The rationale and
      methods for preparing the tooth, crown selection, and placement of a stainless
      steel crown are included, along with alternatives for selection and technique for
      fabrication of more esthetic options. Medicament and tips for the pulpotomy
      procedure also are discussed. Information for patient education and consent
      regarding the procedures and their limitations is provided to complete this step
      by-step guide for the clinician.

PMID- 11199596
TI  - Systemic effects of an intraosseous injection of 2% lidocaine with 1:100,000
      epinephrine.
AB  - The effect of a mandibular intraosseous injection of 2% lidocaine with 1:100,000
      epinephrine on the heart rate and blood pressure of 20 volunteer patients was
      examined. Changes in blood pressure from preoperative levels were minimal and did
      not vary significantly at any time of measurement. The only statistically
      significant change in heart rate occurred immediately after the intraosseous
      injection (an increase of 12 beats per minute). In young healthy adults, the
      intraosseous injection of 1.5 mL of 2% lidocaine with 1:100,000 epinephrine
      resulted in a slight transient elevation in heart rate but had no significant
      effect on systolic or diastolic blood pressure.

PMID- 11199597
TI  - Ridge preservation: important buzzwords in dentistry.
AB  - Ridge preservations is the prevention of the 40-60% jawbone atrophy that normally
      takes place two to three years postextraction. It is the new paradigm in patient
      care that is effective, simple, and beneficial for a multitude of reasons. It is
      achieved by the immediate grafting of the extraction socket with or without the
      use of an immediate implant. The ability to not only preserve the alveolar ridge
      for future restorative dentistry but also to preserve and restore esthetics and
      prevent postoperative pain and bleeding makes this modality important for all
      practicing dentists.

PMID- 11199598
TI  - Replacement of a tooth with a fiber-reinforced direct bonded restoration.
AB  - Today's methods and materials for tooth replacement are multiple and varied.
      Modern materials now allow for highly conservative abutment preparations that can
      retain bonded single tooth replacement fixed prostheses. A case report is
      presented in which fiber reinforced with composite resin was used for placement
      of a three-unit fixed long-term provisional restoration, providing fracture
      resistance while achieving an esthetically pleasing, durable restoration.

PMID- 11199600
TI  - Early treatment of malocclusion: a guidance system for the general dentist.
AB  - Opportunities for preventive orthodontic treatment of children arise during all
      stages of oral growth and development. It is in the best interest of the child to
      achieve a state of normalcy in the neuromuscular, skeletal, and dental
      structures. This article provides a guide for treating malocclusion with utility
      archwire appliances in the mixed dentition and finishing the permanent dentition
      with a fully adjusted appliance.

PMID- 11199599
TI  - Retention of four endodontic posts cemented with composite resin.
AB  - Retention was compared of an active post system (Flexi-Flange), a metal passive
      prefabicated post system (ParaPost), a passive prefabricated burnout post system
      (ExactaCast) with and without grooved dentin walls, and a zirconium oxide ceramic
      post design (Cerapost). The Flexi-Flange with Flexi-Flow Natural cement obtained
      the highest retentive value of 270.4 lb. The Cerapost cemented with Universal
      Cement had the lowest retention value of 23.4 lb. The ExactaCast with grooved
      dentin walls was significantly stronger than the ExactaCast without grooving, the
      ParaPost, and the Cerapost. The two ExactaCast groups and the ParaPost group had
      higher retention than the Cerapost group.

PMID- 11199601
TI  - Caries detection accuracy by multiple clinicians and techniques.
AB  - This study compared caries detection by multiple clinicians with the accuracy of
      detection with Caries Detector dye. Four clinicians rated the extent of caries on
      100 extracted teeth. After dye application, visual assessment of residual dye was
      recorded for each specimen. This was repeated after the teeth were embedded in
      epoxy resin and sectioned. The results indicate that although reasonably accurate
      overall, clinicians often disagree whether caries is present. The use of a caries
      detector solution may be a valuable adjunct tool to correct caries diagnosis.

PMID- 11199602
TI  - The dentist's role in reporting suspected child abuse and neglect.
AB  - While dentists are in a position to report suspected child abuse and neglect
      (SCAN), few reports are made by dentists. Evidence exists that dentists are not
      well-informed about SCAN, but even with education about SCAN, dentists continue
      to make few reports. Reasons for low reporting are noted. This article lists
      criteria which will be helpful in determining whether a traumatic injury to a
      child is accidental or intentional.

PMID- 11199603
TI  - Orthodontic relapse and the mandibular third molar: a literature review.
AB  - This review of the literature considers the role of the mandibular third molars
      in orthodontic relapse. Theories attempting to resolve the mystery of relapse
      following orthodontic treatment are presented. While the literature supports the
      conclusion that there are valid reasons to remove third molars, it does not
      greatly support prophylactic removal and removal to avoid orthodontic relapse.

PMID- 11199604
TI  - Crisis management.

PMID- 11199606
TI  - Third-party treatment.

PMID- 11199605
TI  - Amalgam restorations.

PMID- 11199607
TI  - Early removal of mesiodens.

PMID- 11199608
TI  - New drug approvals in 1999.

PMID- 11199609
TI  - Ethical duties when patients make suspicious narcotic requests.
AB  - Practicing dentists are likely to be familiar with the prospect of patients who
      request controlled substances for doubtful indications. Torn between ethical
      obligations of beneficence and nonmaleficence, the dentist may be uncertain
      whether to prescribe a medication with the intention of alleviating pain or to
      refuse the prescription due to concerns related to chemical dependency,
      underlying emotional illness, or ulterior motives on the part of the patient.
      Pharmaceutical choices often do not provide a mechanism for sidestepping this
      dilemma as chemically dependent patients may be quite sophisticated in their
      knowledge of drugs and the ways in which to couch their requests. Dentists have
      an ethical obligation to move beyond simply refusing prescriptions for patients
      suspected to be chemically dependent; they should sensitively discuss the issue
      with these patients and be prepared to offer referral for intervention. However,
      dentists must always be open to the possibility that a particular patient's
      assertion of chronic physical pain may be of complex origin. When this is the
      case, appropriate treatment is essential and may involve referring the patient to
      others with specialized skills. Dentists should not withhold pain medication from
      patients with uncontrolled pain in the final stages of life.

PMID- 11199610
TI  - Rough buccal mucosa.

PMID- 11199611
TI  - Bilateral white buccal mucosa.

PMID- 11199612
TI  - Location of incisal edge position for esthetic restorative dentistry.
AB  - Restorative dentistry means just that--changing the position and morphology of
      teeth (when indicated) to restore the patient to a functional and esthetic
      occlusion. The first step considers the mandibular incisal edge position.
      Following that choice, the maxillary anterior teeth are evaluated for position
      against the lips and with the rest of the dentition, particularly the mandibular
      incisors and canines. When the three major determinants of incisal edge position
      (occlusion, phonetics, and esthetics) are used to place the anterior teeth where
      they will function best, all cases have the potential for a more enduring
      esthetic success.

PMID- 11199613
TI  - The longevity of resin-based composite restorations in posterior teeth.
AB  - A survey of published prospective and retrospective studies examining the
      longevity of posterior resin-based composite and amalgam restorations confirms
      the need for clinical judgment in materials selection.

PMID- 11199614
TI  - Retention strength of tin plated gold inlays bonded with two resin cements.
AB  - Research has shown bonding of restorations to tooth structure to enhance
      retention of the restoration to increase the fracture resistance of the tooth,
      and to reduce microleakage. Resin cements have superior physical properties to
      traditional cements such as zinc phosphate. The purpose of this study was to
      compare the retention of gold inlays luted with two resin cements to that of
      those luted with zinc phosphate cement.

PMID- 11199615
TI  - Effect of prebonding procedures on shear bond strength of resin composite to
      pressable ceramic.
AB  - Low bond strength between tooth structure and restorative ceramic material is a
      major cause of ceramic fractures or failures. Prebonding measures performed on
      pressable ceramic material were evaluated and the different shear bond strengths
      obtained by each method were tabulated. The three individual groups were
      subjected to 9% hydrofluoric (HF) acid gel for 0, 1, and 5 minutes. The different
      acid-etched time groups were chemically treated with silane coupler alone, silane
      coupling agent with bonding agent, and bonding agent alone. The silane coupling
      agent produced the highest bond strength between the composite structure and the
      pressable ceramic restorative material. High bond values were achieved by etching
      the porcelain for one minute. The use of the silane coupling agent with a one
      minute 9% HF acid etch yielded the greatest bond strength.

PMID- 11199616
TI  - Comparison of composite resin-to-porcelain bond strength with three adhesives.
AB  - Three resin-based adhesives were evaluated for suitability for porcelain repair
      with composite resin, as measured by shear bond strength of attachment. Photo
      Bond and SE Bond were associated with significantly greater shear bond strengths
      than their respective controls at both time periods investigated. Single Bond did
      not have shear bond strengths greater than its control and its values were
      significantly lower than those obtained with the other resins.

PMID- 11199617
TI  - Treatment of endodontic perforations by guided tissue regeneration.
AB  - Case reports of mandibular molars with iatrogenic perforations are presented.
      Such perforations have been treated with internal amalgam repair or by surgical
      intervention. However, the potential exists for tissue migration and pocket
      formation. The use of guided tissue regeneration as a barrier for apical
      migration is beneficial in surgical treatment of perforations. Follow-up
      examination of perforated teeth treated with resorbable barriers showed
      successful repair. Results obtained with this technique offer the possibility of
      a successful repair for an otherwise hopeless complication of endodontic therapy.

PMID- 11199618
TI  - Periodontitis--the risks for its development.
AB  - The relationships between periodontitis and systemic disease and conditions,
      environmental factors, and behavioral influences are evolving rapidly. Success in
      preventing and treating periodontal diseases may well rest to a large extent on
      our understanding of the relevant influences which may exacerbate and perpetuate
      the disease process. As researchers work to clarify these relationships, we as
      practitioners must continue to alter our treatment in the best interests of the
      patient's overall health. The impact of recent findings on the development and
      progression of periodontitis relevant to diabetes mellitus, HIV, genetic
      susceptibility, smoking, stress, and osteoporosis is reviewed.

PMID- 11199619
TI  - Evaluation of ergonomic dental stools through clinical simulation.
AB  - Work-related musculoskeletal pain occurs commonly within the dental community.
      Three stool designs were utilized in this study: a standard dental stool, a stool
      with dual arm supports, and a stool with dual arm supports and chest support.
      Electromyographic data from four muscle groups were collected on 13 clinicians
      during a simulated crown preparation procedure. Clinical simulation suggests that
      a potential musculoskeletal benefit to the clinician exists through utilization
      of dental stool designs which incorporate static arm supports.

PMID- 11199620
TI  - Acupuncture/acupressure to treat gagging dental patients: a clinical study of
      anti-gagging effects.
AB  - Noninvasive methods advocated by some clinicians are not very successful in
      dealing with patient gagging, while sedation approaches run the risk of the
      patient aspirating foreign bodies. The P-6 Neikuan acupuncture point, located on
      the wrist, has been used in the Far East for thousands of years for its anti
      nausea and anti-anxiety properties. In the West, it is the acupuncture point most
      studied. Only recently has interest been shown in the P-6 point for its possible
      anti-gagging effect. The anti-gagging effect of P-6 stimulation is documented in
      this article. The P-6 point has remarkable anti-gagging effects if stimulation is
      applied correctly. Clinicians may apply thumb pressure at the P-6 point to
      achieve some effect, although this is not as effective as acupuncture.
      Nevertheless, a substantial percentage of gagging patients would be able to go
      through dental procedures without gagging when the P-6 point is stimulated.

PMID- 11199621
TI  - Attachment loss associated with the presence of a tongue bar: a case report.
AB  - Recent reports demonstrate that tongue bars can cause damage to the dentition.
      The first known report of attachment loss associated with the presence of a
      tongue bar is described.

PMID- 11199622
TI  - Tuberculous ulcer of the tongue as presenting feature of pulmonary tuberculosis
      and HIV infection.
AB  - Tuberculosis (TB), once a lethal disease, has shown a decrease in incidence with
      improved public health measures and availability of antituberculous drugs. But
      with the advent of human immunodeficiency virus (HIV) infection and acquired
      immunodeficiency syndrome (AIDS), it has re-emerged alarmingly as an
      opportunistic infection in immunocompromised patients. Lungs are the most
      commonly affected organs and involvement of the oropharyngeal region in TB is
      very rare. Two cases of TB manifesting as ulcer of the tongue are reported here.
      Interestingly, both of these cases were reported within a span of six months and
      both of the patients were in their early thirties. A primary diagnosis of both
      pulmonary TB and HIV sero-positivity was made after the diagnosis of the oral TB
      ulcer.

PMID- 11199623
TI  - Cancer awareness and dentistry.
AB  - Dentists have the prime responsibility to screen for cancer of the oral cavity. A
      history, head and neck examination, and intraoral examination including the
      pharynx should be performed on all new dental patients and at all recall
      appointments. Patients with lesions that appear clinically to be cancer are best
      managed by immediate referral to a head and neck surgeon or cancer treatment
      center for biopsy and treatment. Lesions that may be cancerous can be biopsied by
      the general dentist or oral surgeon. Dentists also should be prepared to talk
      with patients at risk for cancer of the breast, colon, cervix, prostate, and skin
      about the advantages and disadvantages of being screened. These patients should
      be encouraged to talk with their primary care physicians about being screened for
      cancer.

PMID- 11199625
TI  - Seniors discounted.

PMID- 11199624
TI  - Potential fear-provoking patient experiences during treatment.
AB  - During a four-month period in 1998, 250 new patients arriving at the General
      Dentistry Clinic of Tufts University School of Dental Medicine were asked to
      complete a questionnaire regarding behavior by dental professionals and its
      effect on dental care. Surveys were returned by 121 women and 82 men, who
      evaluated seven behaviors from five previously determined categories of anxiety.
      Age and gender were the only factors considered in analyzing the results. The
      data suggest that dentists often may exhibit a variety of negative behaviors and
      attitudes. These can cause increased levels of concern in patients and may act as
      fear-provoking stimuli, leading to increased fear and avoidance of dental
      treatment.

PMID- 11199626
TI  - Elder abuse: society's forgotten issue.

PMID- 11199627
TI  - The top 50 prescription medications dispensed in pharmacies in 1999.

PMID- 11199628
TI  - The dentist's role in bereavement support.
AB  - An aging population that is retaining more dentition and an increasing number of
      persons affected by terminal illnesses have resulted in dentists encountering
      dying patients and patient deaths with increasing frequency. These events call
      upon dentists and their staffs to provide support for the terminally ill and for
      survivors of the deceased. Dentists are effective in providing bereavement
      support and survivors benefit greatly from it. However, this type of support is
      stressful for dentists and many report the need for more formal education in this
      area. The ethical basis for dealing effectively with a dying patient's need for
      open and honest discussion derives from the obligations of the doctor-patient
      relationship. These ethical requirements carry over to providing some level of
      bereavement support for the surviving loved ones of the deceased and address the
      professional duties of compassion and care. Sending a sympathy card with a
      personal note, attending the patient's funeral, or making a follow-up telephone
      call to the patient's survivors are all appropriate, beneficial, and appreciated.

PMID- 11199629
TI  - Esthetic and functional reconstruction of the geriatric patient.
AB  - Esthetics is not only for the young. People at every age want to look their best
      and have a confident and beautiful smile. Generally speaking, restored senior
      citizens become very appreciative of the care they receive, refer others like
      themselves, and, most importantly, have a renewed self-worth and can continue to
      interact socially for many years.

PMID- 11199630
TI  - Impression materials: basic properties.

PMID- 11199631
TI  - Mulifocal intraosseous pathoses.

PMID- 11199632
TI  - Multiple radiolucencies and loose teeth.

PMID- 11199633
TI  - Spectrum of care treatment planning: application of the model in older adults.
AB  - A model for treatment planning is presented to help emphasize the most important
      elements of the clinical decision-making process for older adult patients. The
      patient's concerns and needs in the domains of function, symptoms, pathology, and
      esthetics are the central elements of the process. With sophisticated assessment
      methods and creative interventions, the dentist can work with each patient to
      identify and successfully address his or her needs and concerns. This model is
      applied to two clinical cases which illustrate the importance of considering
      innovative treatment plans, even when the patient is advanced in years.

PMID- 11199634
TI  - Aging and oral health for the 21st century.
AB  - Americans' oral health, along with their life expectancy, has improved
      dramatically during the 20th century. The 21st century offers dental
      professionals the opportunity to help patients maintain their oral health for a
      lifetime. This article describes trends in health and wellness among older adults
      that will affect use of dental services; reviews risk factors such as chronic
      diseases, medications, and nursing home placement that will increase oral
      diseases in older adults; and concludes with opportunities for dental leadership
      to improve the oral health of aging Americans.

PMID- 11199635
TI  - Restorative considerations in the dental treatment of the older patient.
AB  - The older person and his or her dentition will have a clinical presentation and a
      reaction to treatment that is influenced by his or her unique blend of aging and
      disease processes. Changes seen in enamel, dentin, pulp, and cementum of the
      older patient are described in terms of their causes and the impacts of the
      changes on clinical presentation and treatment choices.

PMID- 11199636
TI  - Management of systemic diseases and chronic impairments in older adults: oral
      health considerations.
AB  - This paper reviews the most common systemic diseases and chronic conditions among
      the elderly. It provides an overview of the adverse effects these conditions and
      their treatments have on oral health and function and summarizes some treatment
      methodologies to be employed in the dental office.

PMID- 11199637
TI  - Providing general dentistry for people with disabilities: a demographic review.
AB  - In the mid-1990s, approximately 54 million American people had some level of
      disability, including 26 million who had a severe disability. In addition, more
      than three-quarters of individuals with mental retardation/developmental
      disabilities were deinstitutionalized during the past 30 years and now reside in
      our communities, relying upon community practitioners for needed services. This
      review is provided to make dental practitioners aware of the magnitude and
      dimensions of the situations in which persons with special needs require their
      services.

PMID- 11199638
TI  - Parkinson's disease: an update for dentists.
AB  - One of the diseases that will afflict the growing number of elderly American
      dental patients is Parkinson's disease, yet few dental articles and textbooks
      address the condition. This article reviews the clinical and diagnostic features,
      pathophysiology, management, and dental concerns in patients with Parkinson's
      disease who undergo dental care.

PMID- 11199639
TI  - Analgesic prescribing patterns in a group of dentists.
AB  - Dentists have an increasing number of analgesic agents available to enable them
      to deal with pain relief. Each of these agents has advantages tempered by
      undesirable side effects. Five years ago the authors conducted a survey of
      dentists to compare analgesic prescribing habits. A follow-up study was conducted
      to ascertain any changes in analgesic therapy prescribing habits. It was
      determined that most dentists prefer to prescribe on an as-needed basis rather
      than by the clock. New drugs in the marketplace have not changed the approach of
      dental practitioners in handling pain management; similarly, prescription writing
      patterns have not changed appreciably in the last five years. More restraint
      probably could be used in prescribing narcotic agents.

PMID- 11199640
TI  - Early creeping attachment after frenectomy: a case report.
AB  - An abnormal labial frenutomy is capable of causing retraction of gingival
      margins, formation of diastema and inhibition of lip and tongue movements. When
      aberrant frenula are present traditional frenectomy procedures are very
      successful. Often mucogingival procedures are needed to correct the defects that
      result from harmful frenum pulls. In this case presentation, an aberrant frenum
      was diagnosed to be associated with an area of recession on a mandibular left
      central incisor. Surgery was planned as a staged approach. The first phase of
      care was a simple frenectomy. A follow-on procedure consisting of a connective
      tissue graft for root coverage was planned. After only four weeks of healing from
      the frenectomy, creeping attachment of 1.0 mm was appreciated and the patient was
      able to avoid the secondary corrective surgery.

PMID- 11199641
TI  - Endodontic radiographs: realities and illusions.
AB  - Several case reports show how, on occasion, radiographs fail to disclose
      important realities. The illusions that are presented radiographically have the
      potential to misdirect diagnosis and treatment as well.

PMID- 11199642
TI  - Biomechanically-induced dental disease.
AB  - Malocclusion, as an etiological agent in dental disease, is among the most
      controversial subjects in dentistry. Bruxism has been blamed on stress and many
      other nondental factors. A biomechanical mechanism that serves as a contributing
      factor to stimulate tooth clenching and grinding is defined and used to identify
      the 12 common dental symptoms caused by tooth clenching and grinding. A method is
      proposed through which the practitioner can link the observable dental signs with
      the biomechanical factors for accurate diagnosis and appropriate treatment,
      preferably at an early stage before the damage becomes severe.

PMID- 11199643
TI  - Submandibular gland sialolithiasis: a case report.
AB  - Most cases of sialolithiasis of the submandibular duct are resolved by an
      intraoral surgical approach. This case is unique in that by virtue of the
      sialolith's proximity to the hilum of the gland, it was more prudent to perform
      an excision of the entire gland through an extraoral approach.

PMID- 11199644
TI  - Microleakage study of flowable composite resin systems.
AB  - The purpose of this in vitro microleakage study was to evaluate four low
      viscosity composite resin systems. Each resin system included the corresponding
      bonding agent for each respective flowable composite. A hybrid material was used
      as a control. A total of 75 noncarious, freshly extracted human teeth were
      prepared with a Class 5 occlusal preparation and a gingival preparation at the
      cementoenamel junction. The materials were inserted according to the
      manufacturers' recommendations using the single-component bonding agent for each
      system. Teeth were thermocycled 800 times between 5 degrees C and 55 degrees C
      with 30-second dwell times. The teeth were then coated with nail polish 1 mm
      short of the restoration, placed in a basic fuchsin dye for 24 hours, and
      sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed
      for microleakage on a scale of 0 (no leakage) to 3 (axial wall). Results were
      evaluated with the Fisher's exact test. The results of the study indicate that
      there was no leakage at the enamel margin of any restorations. No statistically
      significant differences in microleakage were found in dentin/cementum margins
      among the samples in the experimental group or between the experimental group and
      control group. The results indicate flowable composites demonstrate resistance to
      microleakage in both enamel and cementum/dentin margins similar to TPH hybrid
      composite.

PMID- 11199645
TI  - A final OSHA tuberculosis standard: are mandatory government regulations
      necessary?

PMID- 11199646
TI  - Creeping attachment: autogenous graft vs dermal matrix allograft.
AB  - For many years, free autogenous grafts have been used as a method of gaining
      keratinized tissue around teeth with mucogingival problems. Creeping attachment
      using autogenous graft material has been actively studied. In addition,
      biocompatible, acellular connective-tissue material has recently been used as an
      alternative to free gingival grafts to increase the zone of keratinization. This
      report presents a patient with bilateral mucogingival defects in the canine and
      premolar areas. The patient received an autogenous graft on one side and a dermal
      matrix allograft on the contralateral side. Creeping attachments were measured
      and compared at 3 months and 12 months after surgery. After 12 months of healing,
      an average of 1.23 mm of creeping attachment was measured on the free gingival
      graft side and 0.96 mm of creeping attachment was measured with the dermal matrix
      allograft.

PMID- 11199647
TI  - Subgingival restorations with resin ionomer: a periodontal alternative.
AB  - The successful use and placement of subgingival resin-ionomer restorations in
      both anterior root and molar furcation defects are demonstrated in this article.
      Sustained tissue health and minimal probing depths at the surgical site
      demonstrate clinical success. These case reports illustrate the continued success
      of alternative treatment procedures for restoring subgingival mechanical root or
      periodontal lesions.

PMID- 11199648
TI  - Resin-based luting cements.

PMID- 11199649
TI  - Patient and dentist satisfaction with a computerized local anesthetic injection
      system.
AB  - The fear of dental injections is common among dental patients. Many approaches to
      reducing this fear of injections and improving local dental anesthesia delivery
      have been tried in the last few decades. One approach is the use of a
      computerized or electronic local anesthetic system. This study surveyed dentist
      and patient satisfaction when local dental anesthesia was delivered with a
      computerized delivery system. The patients and dentists were both satisfied with
      the effectiveness of the anesthesia. The patients were satisfied with the level
      of comfort with the injections. This was particularly true when compared to their
      previous anesthetic injections. Although the dentists were very satisfied with
      the performance of the anesthetic delivery system and the anesthesia itself, they
      did not, in general, choose to use the system in everyday practice. Possible
      reasons for this within the context of this study are discussed.

PMID- 11199650
TI  - Replacement of the incisal angle in aged dentition.

PMID- 11199651
TI  - Opportunities in dental, oral, and craniofacial research.

PMID- 11199652
TI  - Orthodontic tooth extrusion as an adjunct to periodontal therapy.

PMID- 11199653
TI  - Strengthening mechanisms of current dental porcelains.
AB  - Dental porcelains have a high glass content, which provides the translucency
      necessary for esthetic restorations. Because glasses are brittle, they fail under
      tension or bending by the propagation of preexisting flaws (e.g., scratches,
      porosities). Several approaches that are based on impeding the propagation of
      flaws have been used to strengthen dental porcelains, including bonding to
      metals, adding microcrystalline phases, and surface treatments (i.e., polishing,
      ion exchange, hydration). Through these methods, porcelain systems are used
      routinely for all-ceramic anterior restorations; however, porcelain-fused-to
      metal restorations remain the most reliable for posterior applications.

PMID- 11199655
TI  - Ceramic design concepts based on stress distribution analysis.
AB  - This article discusses general design concepts involved in fabricating ceramic
      and metal-ceramic restorations based on scientific stress distribution data.
      These include the effects of ceramic layer thickness, modulus of elasticity of
      supporting substrates, direction of applied loads, intraoral stress, and crown
      geometry on the susceptibility of certain restoration designs to fracture.

PMID- 11199654
TI  - Approaches for intraoral repair of ceramic restorations.
AB  - Ceramic-based restorations are an important part of a dentist's armamentarium for
      durability and esthetics. Because of the brittle nature of ceramic materials,
      these restorations have the potential to fracture. Repairing ceramic-based
      restorations can increase the clinical longevity of failed restorations and offer
      the dentist and patient a cost-effective alternative to replacement. Newer
      porcelain repair systems show excellent adhesion durability of resin-based
      composites to the fractured ceramic and exposed metal surfaces. This article
      reviews the basic principles of ceramic repair and details the use of five
      intraoral porcelain repair systems.

PMID- 11199656
TI  - To silanate or not to silanate: making a clinical decision.
AB  - Etched porcelain-bonded restorations have become the treatment of choice for the
      esthetic restoration of anterior teeth. The bond strength of composite resin to
      properly etched and silanated porcelain exceeds the cohesive strength of
      porcelain. Although bonding to enamel is accomplished by only etching the surface
      to create micromechanical retention, bonding to porcelain is achieved both
      mechanically through etching porcelain and chemically through the use of a silane
      coupling agent. Literature supports silanization of porcelain, which provides a
      more reliable bond than etching with hydrofluoric acid only, although the
      combination of both are recommended. This article discusses the importance of
      proper silanization of porcelain in obtaining a durable and reliable resin
      composite bond with porcelain.

PMID- 11199657
TI  - Early detection of caries.

PMID- 11199658
TI  - Restorative options for malformed permanent molars in children.

PMID- 11199659
TI  - Relationship of the periodontium to impression procedures.

PMID- 11199660
TI  - A simplified approach to optimizing denture stability with lingualized occlusion.
AB  - Occlusal prematurities are destructive and destabilizing influences in complete
      dentures. Unless denture bases are adequately and evenly stabilized, it is
      virtually impossible to properly equilibrate the occlusion. One reason is that
      all artificial teeth in a denture unit are physically bound into a single denture
      base and literally act as a single tooth. Therefore, a single point of occlusal
      prematurity disrupts the entire denture occlusion and negatively affects the
      denture base stability and retention, preventing proper equilibration. This
      article describes a step-by-step approach using an intraoral central bearing
      point tracing device and lingualized occlusion to achieve an effective and
      simplified equilibration.

PMID- 11199661
TI  - Additive analgesia without opioid side effects.
AB  - Postoperative pain control is often inadequate because of insufficient pain
      relief or unacceptable side effects. Nonsteroidal antiinflammatory drugs (NSAIDs)
      are very efficacious for pain of dental origin, but their ceiling of efficacy
      does not result in greater peak analgesia if the dose is raised beyond
      recommended limits. Switching to an opioid combined with acetaminophen or aspirin
      does not result in greater analgesia, but increases the incidence of side effects
      such as drowsiness and nausea. Combining NSAIDs with opioids has been largely
      unsuccessful and still results in opioid side effects. The combination of NSAIDs
      with acetaminophen holds promise for greater analgesia than either drug alone,
      but without the increased side effects associated with opioids in ambulatory
      dental patients.

PMID- 11199662
TI  - Ridge preservation of dentition with severe periodontitis.
AB  - Severe loss of alveolar bone height and width can occur following the removal of
      teeth with advanced periodontitis. This compromise of the alveolar bone can limit
      the options available for achieving an acceptable dental restoration. Two case
      reports are presented of alveolar ridge augmentation after tooth removal and
      before implant placement using bone grafting and a biodegradable membrane. The
      resultant alveolar ridges in both patients were adequate for the placement of
      dental implants.

PMID- 11199664
TI  - Report on a unique polymer barrier system.

PMID- 11199663
TI  - Autogenous bone harvest and bone compacting for dental implants.
AB  - The long-term success of a dental implant depends on having or creating an
      adequate amount of autogenous bone. An instrument is described that conserves the
      drilled bone during implant preparation, as well as during bone-block graft
      preparation. Compression of the autogenous bone is performed within the
      instrument. Also, a simple particulate bone harvest technique from the anterior
      mandible is offered. The value of a compacted cake of corticocancellous
      autogenous bone is discussed for dehiscence/fenestration defects as well as for
      sinus lift bone grafting.

PMID- 11199665
TI  - Packable composites for posterior clinical applications.

PMID- 11199666
TI  - Periodontal disease: link to cardiovascular disease.
AB  - Poor oral hygiene that leads to dental infections could contribute to adverse
      medical outcomes such as cardiovascular disease. Twelve studies of varying
      degrees of design rigor have associated dental conditions, such as periodontal
      disease, missing teeth, and edentulousness, with either coronary heart disease or
      a cerebral vascular accident. Six of the studies were longitudinal so that the
      demonstration of the oral health parameters as significant predictors of the
      cardiovascular event would elevate the dental parameter to the status of a risk
      factor. Because dental diseases (especially periodontal disease) are treatable,
      the dental component is a modifiable risk factor; therefore, maintaining good
      oral health should receive the highest priority for a healthy life.

PMID- 11199667
TI  - Using a system of diagnosis and treatment planning to reduce stress.
AB  - Because a thorough system of treatment planning was used, the dentist was able to
      change the patient's smile and discuss potential problems with the patient before
      treatment. This discussion allowed the patient and dentist to proceed with
      treatment knowing that any problems would be dealt with if they arose. The work
      up of the case also made it easier for the laboratory to know exactly what
      outcome the dentist and patient were expecting. This enhanced communication
      allowed the case to proceed with a minimum of stress for everyone.

PMID- 11199668
TI  - Simultaneous and staged approaches for guided bone regeneration.
AB  - Two approaches for obtaining bone augmentation around implants by guided tissue
      regeneration are described. In the first, bone is regenerated simultaneously with
      implant placement, which is a time saving tactic. However, when initial stability
      of the implant cannot be obtained because of insufficient bone volume, a staged
      approach must be considered. In the staged approach, the bone is augmented and
      the implant is inserted later. The staged approach offers improved primary
      stability, allows the implant to be inserted in mature bone, and enables
      examination of the newly augmented bone before a decision is made whether or not
      to use it as an implant site. Two case reports are presented which illustrate the
      approaches.

PMID- 11199669
TI  - An overview of delayed passive eruption.
AB  - The condition of delayed or altered passive eruption exists in adults when the
      gingival unit remains positioned on the convex prominence of the enamel rather
      than at or in proximity to the cementoenamel junction. Treatment protocol is
      based on periodontal, esthetic, and prosthetic considerations. In addition, the
      gingival/osseous relationship becomes important for proper diagnosis and
      treatment. The purpose of this article is to increase awareness of the
      pathognomonic signs and symptoms of delayed passive eruption so that appropriate
      treatment can be rendered.

PMID- 11199670
TI  - Nontray whitening.

PMID- 11199671
TI  - Comparison of sensitometric and diagnostic performance of two films.
AB  - The sensitometric properties of Kodak Ektaspeed Plus and Flow E-speed film as
      well as their diagnostic efficacy for detecting proximal surface caries were
      compared. Flow and Kodak E-speed films were exposed and processed according to
      American National Standards Institute and American Dental Association (ADA)
      specifications, and film speed, contrast, and density of base plus fog were
      measured. Additionally, 80 premolar and molar teeth were imaged and their
      proximal surfaces scored by 12 dentists for the presence of caries. The actual
      depth of the caries was determined by microscopic examination of the teeth after
      sectioning. Kodak Ektaspeed Plus and Flow E-speed films, although labeled E-speed
      by the manufacturers, are both slow F-speed films. They have comparable base plus
      fog densities and comparable contrast curves. Dentists detected carious lesions
      equally well using both film types. The sensitivity, specificity, accuracy, and
      receiver operating characteristic area for detecting enamel and dentinal caries
      were not significantly different between the two films. Kodak Ektaspeed Plus and
      Flow E-speed films both meet or exceed the ADA performance specifications in
      terms of sensitometric properties. Both offer equal diagnostic utility for
      detecting caries.

PMID- 11199672
TI  - Using calcium sulfate in guided tissue regeneration: a recipe for success.
AB  - The concept of guided tissue regeneration was first introduced in the literature
      more than 20 years ago. Since then, the concept has evolved to include different
      materials and different techniques. This article describes the technique of using
      calcium sulfate as a component of a composite graft and as a resorbable barrier.
      Its unique biological and clinical advantages are described.

PMID- 11199673
TI  - Defect morphology: effects on regenerative predictability and membrane selection.
AB  - In clinical experience, guided tissue regeneration has been associated with
      complications, which include membrane exposure. The maintenance of a stable blood
      clot under the membrane is key to a successful regenerative outcome. This
      requires adequate membrane stabilization, tension-free suturing, and maintenance
      of a good vascular supply to the defect. Careful selection of defects after a
      thorough periodontal evaluation and modification of surgical techniques from
      those used for conventional resective procedures can lead to predictable outcomes
      for guided tissue regeneration.

PMID- 11199674
TI  - Using absorbable collagen membranes for guided tissue regeneration, guided bone
      regeneration, and to treat gingival recession.
AB  - This article reviews the role of barrier membranes in guided tissue regeneration
      (GTR) and guided bone regeneration (GBR), including the advantages of using
      absorbable barrier membranes in GTR and GBR and the unique properties of collagen
      membranes. The indications and contraindications for using collagen membranes for
      these procedures are examined, and successful cases are presented. Finally, the
      role of collagen membranes in the future of regenerative therapy is considered.

PMID- 11199675
TI  - Clinical software & electronic charting--essential tools.

PMID- 11199676
TI  - Is there a light at the end of the tunnel?

PMID- 11199677
TI  - Implant site development using guided bone regeneration techniques.

PMID- 11199678
TI  - New advances in local anesthesia.
AB  - In dentistry, local pain management is a critical component of patient care. When
      efforts to achieve local anesthesia are unsuccessful, the resulting stress for
      both the patient and practitioner can be significant. This Forum has reviewed new
      technologies that are reported to increase the probability of a favorable outcome
      with local anesthesia. Like all new techniques, devices, and drugs, there is a
      learning curve that must be mastered. However, the potential benefits of the new
      devices and techniques available in local anesthesia broaden the practitioners'
      choices. There may not yet be a "magic bullet" in local anesthesia, but the
      advances reviewed here hold great promise. Our participants seem to agree that
      predictable local anesthesia will always require a thorough understanding of the
      broad range of devices, techniques, and drugs available and a commitment by the
      dentists to use them wisely.

PMID- 11199679
TI  - Soft-tissue maintenance techniques: optimal esthetics without periodontal plastic
      surgery.

PMID- 11199680
TI  - Practice management software: reading the fine print.

PMID- 11199681
TI  - Trigeminal neuralgia--an update.
AB  - The purpose of this article is to give a concise review of the diagnosis and
      management of trigeminal neuralgia (TN), with particular emphasis on idiopathic
      TN and symptomatic TN. The clinical characteristics of both conditions are
      presented, and the suspected underlying etiologies are discussed. Because it is
      crucial for clinicians to be able to rule out pain unrelated to TN, a list of
      differential diagnoses is presented. The authors stress that the diagnosis of TN
      is made clinically; however, diagnostic imaging may be indicated in selected
      cases. Current pharmacological and neurosurgical options for the management of TN
      are discussed in detail. In light of the popularity of unconventional treatments
      in the United States, the value of acupuncture and homeopathy, both of which have
      been suggested by some authors for the treatment of TN, is critically assessed.

PMID- 11199682
TI  - Emdogain: evidence of efficacy.
AB  - This article addresses the use of enamel matrix proteins (Emdogain) to enhance
      regeneration of the periodontium. Information regarding the role of Emdogain to
      induce cementogenesis and histologic evidence in animals and humans that it can
      initiate regeneration of diseased sites are discussed. Several clinical trials
      have indicated that Emdogain plus modified Widman flap surgery provide a better
      result than the surgery alone. Several other investigations have indicated that
      flap surgery plus Emdogain or a bioabsorbable membrane achieve similar results.
      However, this latter finding needs further validation. Clinical examples of
      successful therapy with Emdogain are presented.

PMID- 11199683
TI  - Restorative dentistry using a multidisciplinary approach.
AB  - Multidisciplinary treatment was essential for this patient to optimally manage
      the occlusion and missing teeth. When the space distribution was completed, ridge
      management procedures for pontic site development were accomplished. The final
      restorative treatment required was actually minimized to a 7-unit fixed partial
      denture. It was apparent the multidisciplinary treatment was essential to
      predictably manage this patient by decreasing risk and ensuring a long-term
      strategy for enhanced patient satisfaction.

PMID- 11199684
TI  - Using the PerioChip in treating adult periodontitis: an interim report.
AB  - Multicenter clinical trials have established that the adjunctive use of the
      subgingival controlled release of chlorhexidine, in the form of the PerioChip,
      significantly reduces pocket probing depth, improves probing attachment levels,
      and reduces bleeding on probing compared to scaling and root planing alone, for
      periods up to 9 months. The purpose of the present study was to report on the
      adjunctive use of the PerioChip for the long-term management of adult
      periodontitis for 2 years. A total of 836 patients with adult periodontitis from
      private dental offices were recruited into the trial. This interim report is on
      the first 72 patients to have completed the 2-year study. Treatments included
      initial definitive therapy followed by PerioChip placement in pocket sites with a
      pocket probing depth of > or = 5 mm after 1 month. Subsequently, the patients
      received routine periodontal maintenance therapy together with the placement of a
      PerioChip in pockets with pocket probing depths > or = 5 mm every 3 months.
      Results indicated that there was a continuous decrease in pocket probing depth
      over the 2 years (1.26 +/- 0.77 mm). This decrease in pocket probing depth was
      marked over the first 9 to 12 months, and then appeared to be less marked over
      the next 12 months. At 2 years, 60% of the patients had at least 2 pockets
      showing a reduction of 2 mm or more, and only 10% of the patients showed no
      change or increased pocket probing depth. The results indicate that adjunctive
      PerioChip use is a clinically effective treatment option for dental professionals
      and their patients for the long-term management of adult periodontitis.

PMID- 11199685
TI  - Ultralight composite resin for whitened teeth: case reports.

PMID- 11199686
TI  - The periodontal-medical risk relationship.

PMID- 11199687
TI  - Secondary caries and restoration replacement: an unresolved problem.
AB  - This article reviews the prevalence and main causes of restoration failure and
      replacement. It then focuses on secondary caries, its histopathology, etiology,
      difficulties in diagnosis, and prevention and remineralization possibilities.
      This article concludes that although secondary caries is still the main reason
      for restoration replacement, the development of new technologies for detecting
      and monitoring these lesions at an early stage should allow for testing new
      interventions to arrest or remineralize these lesions, which would delay the need
      for re-restoration.

PMID- 11199688
TI  - Using the Master Diagnostic Model to enhance restorative success in implant
      treatment.
AB  - Pretreatment planning is the most important step for definitive diagnosis and
      treatment. Often, the pretreatment phase consists of a radiograph and study
      models without confirmation of the patient's jaw relationships and how they
      affect dentition. The Master Diagnostic Model waxing technique confirms jaw
      relationships and determines which hard and soft tissues should be replaced on
      the articulated models. In addition, this technique allows the patient to observe
      and comprehend what the final result will resemble. Documentation of patients
      with various clinical situations using the Master Diagnostic Model technique is
      presented.

PMID- 11199689
TI  - Preemptive vs preventive analgesia: which approach improves clinical outcomes?
AB  - Administering a drug that blocks painful (nociceptive) input from entering the
      central nervous system before a surgical procedure attenuates the development of
      changes that manifest as increased pain at later time points. Clinically, this
      strategy predicts not only less pain during the initial postoperative period, but
      also lowers the intensity of pain during the days after the procedure. By
      lessening pain during recovery, fewer analgesics are consumed, which results in
      fewer adverse drug reactions (i.e. side effects) complicating the postoperative
      course and delaying the patient's return to normal activities. The patient can be
      assured that the postoperative pain associated with the procedure will be
      minimized, thereby decreasing postoperative apprehension, increasing patient
      motivation for enduring the procedure, and enhancing the probability of a smooth
      postoperative course. The adaptation of this method as a standard clinical
      practice has been delayed by controversy over whether the pharmacological
      intervention should be administered before the surgical event (preemptive
      analgesia), before pain onset (preventive analgesia), or by repeat administration
      over the expected postoperative course. Evidence reviewed in this article
      supports all of these approaches for decreasing the development of central
      sensitization, attenuating postoperative pain, decreasing analgesic consumption,
      and enhancing recovery.

PMID- 11199690
TI  - Antiseptics and antibiotics as chemotherapeutic agents for periodontitis
      management.
AB  - Antiseptics and antibiotics have both been used to treat periodontal infections.
      Although antiseptics and antibiotics have antibacterial properties, they
      represent two distinct and separate categories for agents. Sustained-release
      delivery systems have made it possible to use these agents to augment the
      beneficial effects of mechanical periodontal therapy. This article provides an
      overview of antiseptics and antibiotics, and compares and makes recommendations
      for the use of these agents in periodontics. The objective of this article is to
      provide an understanding of the distinct properties of each of these categories
      of antimicrobial agents.

PMID- 11199691
TI  - Esthetic posterior tooth replacement using a fiber reinforced bridge.

PMID- 11199692
TI  - Practical antimicrobial periodontal therapy.
AB  - Specific pathogenic bacteria play a central role in the etiology and pathogenesis
      of destructive periodontal disease. Under suitable conditions, periodontal
      pathogens colonize the subgingival environment and are incorporated into a
      tenacious biofilm. Successful prevention and treatment of periodontitis is
      contingent on effective control of the periodontopathic bacteria, which is
      accomplished with professional treatment of diseased periodontal sites and
      patient performed plaque control. Subgingival mechanical debridement, with or
      without surgery, constitutes the basic means of disrupting the subgingival
      biofilm and controlling pathogens. Appropriate antimicrobial agents that can be
      administered systemically or via local delivery may enhance eradication or
      suppression of subgingival pathogens. Microbiological testing may aid the
      clinician in the selection of the most effective antimicrobial agent or
      combination of agents. Understanding the benefits and limitations of antibiotics
      and antiseptics will optimize their usefulness in combating periodontal
      infections.

PMID- 11199693
TI  - Direct-indirect heat-cured occlusal splint fabrication for a patient with limited
      mouth opening.
AB  - There are several conditions that can cause limited mouth opening. Recent
      literature on some of the most common conditions is discussed in this article.
      The difficulty in making alginate impressions may prevent indirect laboratory
      fabrication of heat-cured occlusal splints for patients with limited mouth
      opening. This article presents a combined direct-indirect technique for
      fabricating a heat-cured laboratory-processed maxillary occlusal splint in a case
      where making a mandibular alginate impression would have been extremely
      difficult. An extra-hard baseplate wax interocclusal record was used as a
      template for occlusal splint fabrication. The wax record was fitted to the
      maxillary side, then the mandible was gently manipulated to provide light
      imprints of the opposing teeth. The wax record provided the therapeutic vertical
      dimension as well as the therapeutic interocclusal relationship for the occlusal
      splint. The wax record was seated and sealed to the maxillary cast and modified
      on the palatal and facial aspects for the appropriate splint shape. The splint
      was processed using clear heat-cured acrylic resin. It required minimum
      adjustment on delivery. This procedure spared the patient from having a lower
      impression, which would have been required for the traditional laboratory-made
      occlusal splint. Increased adjustment time and excessive exposure to unoccurred
      acrylic resin, which would have occurred with direct intraoral fabrication, were
      minimized or eliminated using this technique.

PMID- 11199694
TI  - A guide to polishing direct composite resin restorations.

PMID- 11199695
TI  - Controlling contacts and contours using preformed ceramic inserts.
AB  - Current adhesive techniques and materials that seal both enamel and dentin have
      revolutionized modern restorative dentistry. Unfortunately, the durability
      problems associated with direct polymeric materials of the past have not been
      adequately solved. Nevertheless, when cost and esthetics form part of the
      treatment decision process, patients presenting with Class 2 defects are most
      often provided with a direct restorative option. Direct composite resin
      restorations are fraught with problems largely related to the mechanical stresses
      that accompany polymerization shrinkage. A partial solution is to incorporate
      prefabricated ceramic inserts into the substance of the composite resin, thereby
      decreasing the volume of directly cured restorative material and effectively
      reducing the magnitude of the polymerization stresses. SONICSYS approx is a
      unique addition to the restorative continuum that takes the insert strategy one
      step further by using specifically shaped sonically driven diamond-coated
      preparation tips to adjust the cavity form to fit presized ceramic proximal
      inlays. The SONICSYS approx system represents a technique intermediate between a
      direct resin composite and a laboratory fabricated inlay. This article describes
      the background of this development, and the components and application of the
      system. In addition, within the presentation of a case study, operative
      innovations are introduced that improve interfacial integrity and allow for the
      conveyance of predictable contacts and proper physiological contour.

PMID- 11199696
TI  - Use low-tech ideas to streamline your dental office.

PMID- 11199697
TI  - Regarding rationale for using single-use disposable air/water syringe tips,
      Raghunath Puttaiah, BDS, MPH; James A. Cottone, DMD; John Guildersleeve, DDS; et
      al (November 1999, p. 1056).

PMID- 11199698
TI  - Gloves--continuing effectiveness, new technologies, and recommendations.

PMID- 11199699
TI  - Dynamics of dental implants and orthodontics in today's periodontal prosthesis.
AB  - Periodontal prosthesis refers to multidisciplinary efforts to stop disease
      progression, correct deformities created by dental diseases, and establish a
      therapeutic occlusion to restore the form and function of the masticatory system.
      These efforts are critical for the long-term prognosis and maintenance of the
      guarded teeth and the overall prosthesis. This article presents a functionally
      and esthetically challenging case, which illustrates a multidisciplinary approach
      -specifically implantology and orthodontics--and how they impact on each other
      during treatment. The role and importance of dental implants and orthodontics in
      setting up a case is illustrated in this article.

PMID- 11199700
TI  - The role of enamel matrix proteins in periodontal regeneration.

PMID- 11199701
TI  - Prognosis vs outcome: predicting tooth survival.
AB  - The assignment of prognosis is one of the most important functions undertaken in
      clinical practice, yet there is little evidence to support the current decision
      making process. This article will review four articles that evaluate the
      traditional method of assigning a prognosis and predicting tooth survival.
      Limitations of the current method of assigning a prognosis are discussed, and
      models are presented that should allow clinicians to be more confident in their
      projections.

PMID- 11199702
TI  - All-ceramic restorations--predicting esthetic restorative success.

PMID- 11199703
TI  - Efficacy of a chlorine dioxide-containing mouthrinse in oral malodor.
AB  - Studies have suggested that when chlorine dioxide is contained in a mouthrinse,
      it neutralizes volatile sulfur compounds in mouth air. The efficacy of a chlorine
      dioxide-containing mouthrinse in the reduction of oral malodor was evaluated in a
      randomized, controlled, double-blind, parallel group study of 31 men and women.
      Subjects with a maximum odor pleasantness score of < or = -1 (slightly
      unpleasant/stale) on a 7-point ordinal scale at both screening and baseline were
      randomized to treatment with the chlorine dioxide-containing rinse (n = 16) or
      distilled water (negative control) (n = 15). Oral malodor was evaluated at
      baseline (prerinse) and at 2, 4, 8, 24, 48, 72, and 96 hours postrinse by both a
      trained, previously calibrated panel of organoleptic judges and a factory
      calibrated portable sulfide monitor. The sulfide monitor measured concentrations
      of volatile sulfur compounds in the subjects' mouth air 3 minutes after
      completion of the organoleptic assessment at each time point. The correlation
      between the organoleptic assessments and log-transformed sulfide monitor values
      was evaluated. With the chlorine dioxide mouthrinse, a statistically significant
      improvement in odor pleasantness, reduction in odor intensity, and reduction in
      oral volatile sulfur compound concentrations compared to the water control were
      evident at 2 hours postrinse and persisted through 8 hours postrinse. The mean
      (+/- SD) odor pleasantness improved from -1.25 +/- 0.31 at baseline to -0.73 +/-
      0.33 at 2 hours postrinse in the chlorine dioxide group compared to -1.40 +/-
      0.38 at baseline to -1.31 +/- 0.67 at 2 hours in the control group (P < 0.01).
      Odor pleasantness reached its maximum change from baseline to 0.63 +/- 0.45 at 8
      hours postrinse. The mean (+/- SD) log-transformed sulfide monitor measurement
      decreased from 5.40 +/- 0.29 at baseline to 5.17 +/- 0.13 at 2 hours postrinse in
      the chlorine dioxide group, but increased from 5.47 +/- 0.40 at baseline to 5.56
      +/- 0.54 at 2 hours in the control group (P < 0.01). As measured by the sulfide
      monitor, the mean volatile sulfur compound concentration in the chlorine dioxide
      group reached its minimum level at 8 hours postrinse (change from baseline in the
      log-transformed Halimeter measurement of -0.35 +/- 0.31). Thus, this study
      demonstrates that a one-time use of a chlorine dioxide-containing mouthrinse
      significantly improves mouth odor pleasantness, reduces mouth odor intensity, and
      reduces volatile sulfur compound concentrations in mouth air for at least 8 hours
      after use.

PMID- 11199704
TI  - Effect of alendronate on immature human dental root explants.
AB  - This study investigated the use of alendronate in the formation of new dentin in
      vitro. Extracted human premolar and molar teeth with immature apices were grown
      in tissue culture medium for 60 days. Six control specimens were grown without
      alendronate in the medium, and 22 experimental specimens were grown with
      alendronate at [10(-9) M] in the medium. Newly formed dentin was stained with
      tetracycline and procion brilliant red at days 1 to 3, 30 to 33, and 60.
      Specimens were decalcified and 5-micron sections were prepared for examination
      using fluorescent microscopy. New dentin formation was measured in microns at the
      most apical region, at 125-micron from the apical measurement and at 250-micron
      from the apical measurement. The alendronate group had 57.15% more growth than
      the control group at the most apical region, and this difference was significant
      (p = 0.0001). The results indicate that alendronate at [10(-9) M] is effective in
      accelerating dentin formation in vitro.

PMID- 11199705
TI  - Temperature rise during Er:YAG and Nd:YAP laser ablation of dentin.
AB  - This in vitro study compared temperature rises during cavity preparation with an
      Er:YAG laser, Nd:YAP laser, and a high-speed handpiece. Eighteen teeth were
      sectioned longitudinally and divided into six groups: group 1 was treated with a
      carbide bur on a high-speed dental handpiece; group 2 was treated with an Er:YAG
      laser with an energy of 140 mJ, a pulse repetition rate of 4 Hz; and group 3 was
      treated with an Nd:YAP laser with an energy of 240 mJ, a pulse repetition rate of
      10 Hz. In these groups no water cooling was used. Groups 4 to 6 were treated in
      the same way, but with water spray. Temperature increases were measured at
      different dentin thicknesses by a microthermocouple attached to the inner side of
      the pulp chamber. Water cooling was essential to reduce temperature effects in
      all groups. Nd:YAP laser induced significantly higher temperature rises than
      Er:YAG or handpiece. Temperature response to the Er:YAG laser and the handpiece
      seemed to be similar.

PMID- 11199706
TI  - Effect of gutta-percha solvents on surface microhardness of IRM fillings.
AB  - Eighty identical samples of IRM were prepared and embedded in acrylic resin. The
      samples were polished, rinsed, and divided into experimental groups and controls,
      10 specimens each. Each experimental group was treated for 1 or 5 min with one of
      the following gutta-percha solvents: chloroform, xylene, or halothane. Sterile
      saline was used as a control. Treatment consisted of pipetting each solvent onto
      the external IRM surface. The specimens were then sealed in plastic assay tubes
      for the corresponding exposure periods. At each time period, surface
      microhardness of the samples was measured using a mini-load hardness tester with
      a 500 g load for 20 s. It was found that xylene and halothane caused significant
      reduction in surface microhardness of IRM after 5 min (p < 0.01). Chloroform
      caused significant reduction in surface microhardness of IRM after 1 min of
      treatment (p < 0.01). Chloroform caused total dissolution after 5 min of
      treatment. Saline caused only minor and nonsignificant changes in surface
      microhardness of IRM.

PMID- 11199707
TI  - Radiation dose reduction during endodontic therapy: a new technique combining an
      apex locator (Root ZX) and a digital imaging system (RadioVisioGraphy).
AB  - This study was undertaken on 14 teeth in order to evaluate a new technique for
      radiation dose reduction during endodontic therapy. After examination of the
      preoperative film, usually available in the patient file, an apex locator (Root
      ZX) was used to measure the working length. Complete chemomechanical debridement
      was then performed, and the master cone was evaluated by a digital imaging system
      (RadioVisioGraphy (RVG)). Obturation was performed when measurements of the
      electronic device and RVG were comparable. A postoperative image was made by the
      RVG system to evaluate the final obturation. A clinical and radiographic follow
      up examination (follow-up period: 6 to 8 months) revealed satisfactory apical
      healing. These results indicated that a successful obturation technique can be
      performed by a single radiation exposure, using the RVG unit for master cone
      evaluation. This technique may be useful in medically compromised patients who
      need not to be exposed to excessive or repeated radiation during endodontic
      therapy.

PMID- 11199708
TI  - Apical microleakage of radiolabeled lysozyme over time in three techniques of
      root canal obturation.
AB  - The three methods of obturation assessed in this study were lateral condensation
      (80 teeth), Thermafil (40 teeth), and McSpadden (40 teeth). All teeth were
      prepared to the master apical file 30 and widened coronally by Gates Glidden burs
      before being randomly assigned to experimental groups to be filled by each
      technique; they were then sealed with nail polish, except for the apical 1 mm.
      Quantitative evaluation of apical microleakage for each technique was obtained
      after periods of 1 day, 7 days, 14 days, and 28 days of immersion in a lysozyme
      solution labeled with radioactive iodine by preparing horizontal sections of the
      teeth and measuring the level of radioactivity in each section using a gamma
      counter. Initial (1-day) leakage was least in the Thermafil group and was
      significantly different from the other techniques. Leakage was greatest in the
      laterally condensed samples. By the end of the study (28th day) values for
      lateral condensation were lowest, but were significantly different only for the
      McSpadden group. For all techniques leakage was most significant in the first 3
      mm from the apex and was very low below this level so that all methods can be
      considered as giving a hermetic seal below 3 mm.

PMID- 11199709
TI  - Effects of a bacterial cell wall fragment on monocyte inflammatory function.
AB  - Gram-negative bacteria recovered from necrotic pulps of teeth with periapical
      lesions have been shown to promote bone resorption through the effects of their
      lipopolysaccharide (LPS). Recently, it was shown that microflora of root-filled
      teeth with persisting periapical lesions consisted mainly of single species of
      Gram-positive bacteria. But Gram-positive bacteria do not contain LPS and their
      role in the development of periapical lesions is not clearly understood. The
      purpose of this study was to evaluate the effects of muramyl dipeptide (MDP), a
      cell wall component of both Gram-negative and Gram-positive bacteria, on cytokine
      release from monocytes. Human monocyte cultures were treated with MDP or LPS and
      interleukin-1 beta, and tumor necrosis factor-alpha levels in the supernatants
      were estimated. MDP and LPS stimulated cytokine release, but the effect of MDP
      was significantly less than that of LPS.

PMID- 11199710
TI  - Torque during canal instrumentation using rotary nickel-titanium files.
AB  - Nickel-titanium engine-driven rotary instruments are used increasingly in
      endodontic practice. One frequently mentioned problem is fracture of an
      instrument in the root canal. Very few studies have been conducted on torsional
      characteristics of these instruments, and none has been done under dynamic
      conditions. The purposes of this study were to measure the torque generated and
      the apical force applied during instrumentation with a commercial engine-driven
      nickel-titanium file system, and to relate torque generated during simulated
      clinical use to torsional failure of the instruments. Ten extracted human teeth
      (five with small-sized and five with medium-sized straight root canals) were
      instrumented with Quantec Series 2000 files, and the torque and apical force
      generated were measured. The applied apical force was generally low, not
      exceeding 150 g in either small or medium canals. The torque depended on the tip
      size and taper of each instrument, and on canal size. Instruments with 0.05 and
      0.06 taper generated the highest torque, which was greater in small than in
      medium canals. The torque at failure was significantly (p < 0.001) higher than
      torque during instrumentation, but with considerable variation in the extent of
      the difference.

PMID- 11199711
TI  - Defects in rotary nickel-titanium files after clinical use.
AB  - The purpose of this study was to analyze the type and frequency of defects in
      nickel-titanium rotary endodontic files after routine clinical use, and to draw
      conclusions regarding the reasons for failure. All of the files (total: 378,
      Quantec Series 2000) discarded after normal use from a specialist endodontic
      practice over 6 months were analyzed. Almost 50% of the files showed some visible
      defect; 21% were fractured and 28% showed other defects without fracture.
      Fractured files could be divided into two groups according to the characteristics
      of the defects observed. Torsional fracture occurred in 55.7% of all fractured
      files, whereas flexural fatigue occurred in 44.3%. The results indicated that
      torsional failure, which may be caused by using too much apical force during
      instrumentation, occurred more frequently than flexural fatigue, which may result
      from use in curved canals.

PMID- 11199712
TI  - CD45/isotypes expression in the immune cells of human periapical lesions.
AB  - Expression of some leukocyte antigens (including CD45) and its isoforms (CD2,
      CD4, CD5, CD6, CD7, and CD8) was examined in the human periapical granulation
      tissue samples in the present study. The majority of the infiltrating cells
      expressed heavy molecular-weight isoforms of the CD45 antigen. Expression of CD2,
      CD5, CD6, and CD7 antigens was also detected, implying significant roles for
      these antigens in the immune reaction taking place in periapical lesions. This
      suggests that the immune response taking place at the periapical region is
      predominantly cellular and the humoral responses to antigenic challenge are
      conducted mainly by regional lymph nodes.

PMID- 11199713
TI  - Sulfated glycosaminoglycan synthesis and its regulation by transforming growth
      factor-beta in rat clonal dental pulp cells.
AB  - Dental pulps contain sulfated glycosaminoglycans (GAGs), such as chondroitin 4
      sulfate (CSA/4CS), dermatan sulfate (CSB/DS), and chondroitin 6-sulfate
      (CSC/6CS). Sulfated GAGs play important roles in mineralization and collagen
      fibrillogenesis during primary, secondary, and reparative dentin formations.
      Transforming growth factor-beta (TGF-beta) is a potent regulator for several
      extracellular matrix (ECM) components and modulates the proliferation and
      differentiation. Using rat clonal dental pulp cells (RPC-C2A), we investigated
      the constituents of GAGs synthesized by the cells and the effect of TGF-beta on
      their synthesis by measuring the radioactivity of [35S]sulfate incorporated into
      GAG fractions. Cellulose acetate electrophoresis analysis revealed that RPC-C2A
      cells synthesized CSA and CSB but not CSC and that 10 ng/ml of TGF-beta increased
      the production of CSA and CSB in the cell/ECM fraction. Measurement of
      [35S]sulfate incorporation showed a significant increase in the amount of GAGs by
      TGF-beta, 1.3-fold CSA, and 1.2-fold CSB in the cell/ECM fraction. In the medium
      fraction the most secreted GAG was CSA, whereas CSB was stored in the cell/ECM
      fraction. Secreted CSA in the medium was markedly increased by 10 ng/ml of TGF
      beta (1.7-fold). These findings indicate that CSA and CSB are major sulfated GAGs
      synthesized by RPC-C2A cells and that TGF-beta acts as a stimulator of sulfated
      GAG synthesis in dental pulp cells.

PMID- 11199714
TI  - A simple method for the analysis of root canal preparation.
AB  - The purpose of this article is to present a simple and easy method for in vitro
      analysis of root canal instrumentation that permits one to observe and measure
      the diameter of a root before and after instrumentation, using the teeth
      themselves as control.

PMID- 11199715
TI  - Pulpal pain diagnosis--a review.
AB  - Evidence gathered from our studies and the work of others appears to support the
      presence of two distinct nerve pain pathways in the dental pulp, represented by
      fast conducting A-delta and slow conducting C-fibers. Each of these types of
      fibers has different pain characteristics: A-delta fibers evoke a rapid, sharp,
      lancinating pain reaction, and C-fibers cause a slow, dull, crawling pain. Pain
      response thresholds vary in different regions of the tooth, and thermal, osmotic,
      ionic, and electric stimuli involve different mechanisms to provoke nerve
      excitation of the dental pulp. Evidence also points to the fact that the
      incidence of pain increases as the histopathosis worsens. On interrogation,
      patients who manifest severe or referred pain almost always give a previous
      history of pain in the tooth with the ache. Eighty percent of patients who give a
      previous history of pain manifest histopathologic evidence of chronic partial
      pulpitis with partial necrosis, the untreatable category, for which endodontics
      or extraction is indicated. The other 20% exhibit histopathosis of the pulp with
      slight inflammation to chronic partial pulpitis without necrosis, a treatable
      category. Clinically, one can determine the degree of pulp histopathosis by
      asking the patient about a previous history of pain in the involved tooth. This
      history of previous pain adds another dimension in diagnosis for the clinician as
      to whether the painful pulpitis is reversible. This information also aids in
      referred pain localization.

PMID- 11199716
TI  - A suspected periradicular scar: treat or not?
AB  - This paper presents an unusual case of a tooth with multiple adjacent endodontic
      problems. The diagnosis was complicated by a bony scar that untypically was
      located around the apex of one of the teeth.

PMID- 11199717
TI  - Allergic reaction after rubber dam placement.
AB  - In the last few years allergic reactions to natural rubber latex (NRL) have
      increased in dental practice affecting both the dental team and patients. Some
      case reports discuss the potential risks of hypersensitivity to NRL products. An
      adverse patient reaction after dental rubber dam placement is reported. About 1
      min after the isolation of the tooth with a rubber dam the patient presented
      signs and symptoms of hypersensitivity. Oxygen and intravenous hydrocortisone
      were administered and the patient kept under observation. After 2 h she had
      stable vital signs and no more allergics symptoms. It is unclear whether
      components of the NRL dam or the cornstarch powder incorporated with the rubber
      dam was responsible for the allergic reaction. Dentists must be aware of the
      health problem and be prepared for an adequate management in dental practice.

PMID- 11199718
TI  - Effect of 10% carbamide peroxide bleaching gel on enamel microhardness,
      microstructure, and mineral content.
AB  - The effect of 10% carbamide peroxide on human enamel subsurface layers was
      examined. Microhardness, microstructure, and mineral content were studied in such
      a manner that control and test side were located on the same tooth.
      Longitudinally sectioned samples were obtained from six teeth and Vickers
      microhardness of the enamel was measured. Enamel microstructure was analyzed
      using a scanning electron microscope and subjected to electron probe
      microanalysis for chemical analysis of calcium (Ca) and phosphorus (P). The
      concentration of Ca in the bleaching gel was measured spectrophotometrically and
      the concentration of P was measured photometrically. Results showed that a
      bleaching gel of 10% carbamide peroxide did not significantly affect the
      microhardness of the enamel. Scanning electron microscopic analysis showed local
      changes in enamel microstructure similar to those of initial caries. Electron
      probe microanalysis showed lowered concentrations of Ca and P; in addition the
      Ca:P ratio was lowered. There was some Ca and P in the bleaching gel after use.
      It is concluded that 10% carbamide peroxide causes local microstructural and
      chemical changes in enamel that are likely not clinically significant.

PMID- 11199719
TI  - In vitro yeast infection of human dentin.
AB  - An in vitro model was developed for investigation of Candida albicans penetration
      into human dentinal tubules. The model consisted of a dentin disc mounted between
      two cuvettes that each had a circular opening facing the disc. The cuvettes were
      filled with Tryptic-Soy-Broth, and the pulpal side cuvette was inoculated with C.
      albicans and incubated at 37 degrees C in air until growth occurred in the
      uninoculated cuvette or up to 30 days. The system was also used with Enterococcus
      faecalis. Completely glue-covered dentin specimens served as negative controls.
      Brown & Brenn-stained histological preparations of the specimens were examined
      with light microscopy. The time needed before growth occurred in the uninoculated
      cuvette showed great variation with C. albicans, whereas E. faecalis penetrated
      within 1 to 5 days of incubation. Slight penetration both by hyphae and yeast
      cells was observed in specimens inoculated with C. albicans, whereas specimens
      inoculated with E. faecalis showed deep and effective penetration. This study
      demonstrates the penetration of dentin as a possible pathway of infection by C.
      albicans. However, dentin penetration by C. albicans was slow and limited in
      comparison with E. faecalis.

PMID- 11199720
TI  - Leakage along apical root fillings in curved root canals. Part I: effects of
      apical transportation on seal of root fillings.
AB  - Occurrence of apical transportation (AT) may complicate the root filling
      procedure and result in a compromised seal. In part I of this study, human
      mandibular premolars with single, curved (21 to 39 degrees), or straight canals
      were prepared by Lightspeed or a step-back hand filing technique. An AT index was
      determined using a double exposure radiographic technique. The prepared canals
      were obturated using lateral condensation of gutta-percha. Leakage along the
      apical 3 mm of root filling was measured with a fluid transport model. After hand
      filing, AT and perforation occurred in 87% of the curved canals. The AT indices
      were > or = 0.4 mm. After Lightspeed preparation, AT occurred in only 19% of the
      curved canals. The hand filing/curved group leaked statistically significantly
      more than the hand filing/straight and Lightspeed/curved groups (p = 0.002). We
      conclude that occurrence of AT is a factor that negatively influences the apical
      seal when curved canals are obturated by lateral condensation of gutta-percha.

PMID- 11199721
TI  - Whole genomic DNA probe for detection of Porphyromonas endodontalis.
AB  - The purpose of the present study was to develop a DNA probe for Porphyromonas
      endodontalis. Pure cultures of P. endodontalis were grown in TYP medium, in an
      anaerobic chamber. DNA was extracted from the P. endodontalis and labeled using
      the Genius System by Boehringer Mannheim. The labeled P. endodontalis DNA was
      used in dot-blot hybridization reactions with homologous (P. endodontalis) and
      unrelated bacterial samples. To determine specificity, strains of 40 other oral
      bacterial species (e.g. Porphyromonas gingivalis, Porphyromonas asaccharolytica,
      and Prevotella intermedia) were spotted and reacted with the P. endodontalis DNA
      probe. None of the panel of 40 oral bacteria hybridized with the P. endodontalis
      probe, whereas the blot of the homologous organism showed a strong positive
      reaction. To determine the sensitivity of the probe, dilutions of a P.
      endodontalis suspension of known concentration were blotted onto a nylon membrane
      and reacted with the probe. The results of our investigation indicate that the
      DNA probe that we have prepared specifically detects only P. endodontalis and can
      detect at least 3 x 10(4) cells.

PMID- 11199722
TI  - Antibiotic susceptibility of bacteria detected from the root canal exudate of
      persistent apical periodontitis.
AB  - Intracanal exudates in persistent endodontic cases were sampled for detecting
      bacteria using a preculture method, and the antibiotic susceptibility of the
      bacteria identified was examined. Twelve species were recovered from 15 cases.
      The species most commonly detected were alpha-Streptococcus and Enterococcus. The
      results of the antibiotic susceptibility tests revealed that Enterococcus was
      highly resistant to antibiotics tested, especially to cephalosporin products.
      Enterococcus is known as one of the bacteria that show multidrug resistance. In
      cases of prolonged endodontic treatment, a specific antibiotic prescription would
      play an important role for efficient treatment. Collecting data about antibiotic
      susceptibility could be helpful. Identification, however, take approximately 2 wk
      and a further study to develop the method that rapidly informs us about the
      antibiotic susceptibility that might be needed.

PMID- 11199723
TI  - bcl-2, p53, and MIB-1 in human adult dental pulp.
AB  - Little is known about the renewal of some groups of cells in dental pulp, and the
      occurrence and significance of physiological cell death in dental pulp is not yet
      understood. The possibility of odontoblast disappearance by apoptosis has been
      proposed, and the presence of apoptotic cells in the rat and human odontoblastic
      and subodontoblastic layers has been recently described. bcl-2 and p53 are
      proteins involved in the apoptotic pathway, whereas MIB-1 is a proliferating cell
      marker. The aim of our study was an immunohistochemical evaluation of bcl-2, p53,
      and MIB-1 in healthy normal pulps of young human subjects. With bcl-2
      immunostaining, some positive cells were found in the odontoblastic and
      subodontoblastic layers, whereas with MIB-1, only a few stromal cells were
      positive, and all odontoblasts were consistently negative. No cells were positive
      to p53. The bcl-2 immunoreactivity of the cells of the odontoblastic and
      subodontoblastic layers could help to explain the presence of apoptotic cells
      found in these regions.

PMID- 11199724
TI  - An in vitro study of the cytotoxicity of two root canal sealers.
AB  - The purpose of this in vitro study was to determine the cytotoxicity of two root
      canal sealing materials (AH26 and AH-Plus). This cytotoxicity test (agar
      diffusion test) was conducted based on the procedures described in the
      International Organization for Standardization. The biological reactivity of a
      mammalian monolayer, L929 mouse fibroblast cells, in response to the tested
      agents was determined. After the 48-h observation period, the cell cultures
      exposed to the test articles discs for AH26 and AH-Plus exhibited severe
      reactivity (grade 4). The positive control article exhibited moderate reactivity
      (grade 3). No signs of reactivity (grade 0) were noted for the negative control
      article or the negative control discs. The tested samples of AH26 and AH-Plus are
      considered cytotoxic and do not meet the requirement of the agar diffusion test.
      Similar cytotoxicity results have been found in the literature for AH26 and other
      root canal sealing cements.

PMID- 11199725
TI  - Dentin bonding and sealing ability of a new root canal resin sealer.
AB  - The aims of this study were to find a dentin bonding system suitable for root
      canal treatment using a newly developed root canal resin sealer, and to examine
      its sealing ability. The sealer was composed of vinylidene
      fluoride/hexafluoropropylene copolymer, methyl methacrylate, zirconia, and
      tributylborane catalyst. The effects of dentin conditioners and primers on dentin
      bonding were studied by tensile bond strength testing and scanning electron
      microscopy. Apical and coronal leakage were evaluated at 1-, 4-, and 12-wk
      intervals by a dye penetration test using a methylene blue solution. Pulp Canal
      Sealer EWT and Sealapex were used as controls. Significantly high bond strength
      was obtained by treating dentin with EDTA, followed by application of a
      glutaraldehyde/2-hydroxyethyl methacrylate primer. The experimental resin sealer
      produced a significantly superior coronal seal at 12 wk when compared with the
      two control sealers (p < 0.05). Scanning electron microscopic examination
      revealed few gaps at the resin sealer-dentin interface.

PMID- 11199726
TI  - In vitro study of the penetration of Streptococcus sanguis and Prevotella
      intermedia strains into human dentinal tubules.
AB  - The persistent presence of bacteria in the root canal system often leads to the
      failure of treatment. The purpose of this study was to determine in vitro
      penetration of Streptococcus sanguis and Prevotella intermedia into dentinal
      tubules. Samples obtained from human teeth were inoculated with a strain of S.
      sanguis (NCTC 7853) and P. intermedia (NCTC 93336) for 20 days. Bacterial
      penetration into tubules was investigated at scanning electron microscopy and
      light microscopic level. The results showed that S. sanguis could penetrate into
      dentinal tubules 382.3 microns, whereas P. intermedia could penetrate 25.9
      microns. It was observed that P. intermedia had not penetrated into all dentinal
      tubules. If penetration occurred the depth was quite limited.

PMID- 11199727
TI  - Retreatment decisions--a comparison between general practitioners and endodontic
      postgraduates.
AB  - One of the most subjective areas with regard to interexaminer variations is the
      dental radiograph. The variations in radiographic interpretation lead to
      differences in treatment planning decisions. This study compared the endodontic
      retreatment planning decisions for endodontically treated teeth between 12
      general practitioners and 12 endodontic postgraduate students. Utilizing dental
      radiographs of completed cases, both groups were asked to make treatment choices
      based on two hypothetical ages of a case: 1 or 3 yr postoperatively. General
      practitioners chose to initiate treatment at an earlier date and also chose more
      extensive treatment modalities. The age of the root filling was looked on as more
      important in treatment planning by the endodontics postgraduates.

PMID- 11199728
TI  - Persistent pain related to root canal filling and apical fenestration: a case
      report.
AB  - Endodontic treatments may give rise to persistent pain whose origin is sometimes
      difficult to determine. Although it is unusual, pain may occur due to apical
      fenestrations following endodontic treatment. If this occurs, the solution is
      surgical intervention. This surgical procedure consists of raising a flap to
      expose the fenestration, followed by curettage of any overextended canal filling
      materials that may be potentially irritating to the underlying mucosa, remodeling
      of the apex, and its repositioning below the level of the cortical bone. A case
      is described that illustrates this clinical situation. The case also demonstrates
      information that can be obtained from tomodensitometric films.

PMID- 11199729
TI  - Apexification of an infected untreated immature tooth.
AB  - A case of a traumatized permanent young tooth in which apexification occurred
      without the benefit of endodontic treatment is reported. It illustrates how a
      immature incisor that underwent pulp necrosis and periapical inflammation could
      progress to complete apical formation.

PMID- 11199730
TI  - An unusual indication for root resection.
AB  - This report presents an unusual indication for root resection of a lower molar
      tooth and also reviews the history of root resection.

PMID- 11199731
TI  - Pulpal responses to cooling tooth temperatures.
AB  - This investigation measured pulpal blood flow and sensitivity to electrical
      stimulation as tooth temperatures were lowered. Dark rubber dams were placed on
      test teeth before placement of the cooling device in an attempt to shield
      gingival microcirculation. Laser Doppler flowmetry was used to measure pulp blood
      flow, whereas sensory thresholds were recorded simultaneously using an electric
      pulp tester. As tooth temperatures were lowered, the teeth became less
      responsive. Pulp blood flow also slowed, but did not completely stop. Results
      indicated that sensory thresholds were altered, and in some subjects, abolished,
      without total cessation of pulpal blood flow.

PMID- 11199732
TI  - Comparative evaluation of antibacterial effects of Nd:YAG laser irradiation in
      root canals and dentinal tubules.
AB  - The antibacterial effects of the Nd:YAG laser on contaminated root canals and
      dentinal tubules were observed as the aim of this study. The samples were
      inoculated with Streptococcus sanguis (NCTC 7853) and Prevotella intermedia (NCTC
      93336), and the effects of Nd:YAG laser were tested on these teeth. The specimens
      were lased with 1.8 W and 2.4 W Nd:YAG laser for 30 s, and the presence of
      bacteria in tubules was observed under light microscopy. The 1.8 W laser
      sterilized the tubules in 86.3% of sections inoculated with S. sanguis, whereas
      2.4 W laser sterilized in 98.5% of the sections. Both laser powers sterilized all
      samples inoculated with P. intermedia. The scanning electron microscopic
      observations supported the light microscopic findings.

PMID- 11199733
TI  - Histopathological evaluation of the dental pulps in crown-fractured teeth.
AB  - Trauma is a common cause of pulpal damage. In traumatic injuries, the first
      priority is to protect the vitality of pulps. But the time between the trauma and
      treatment must be short to preserve vital, noninflamed pulps. The aim of this
      study was to investigate the histopathological changes in pulpal tissues at
      different time periods after crown fractures. Twenty-three teeth with enamel and
      dentin fractures, with and without pulp exposure were evaluated. The reasons for
      seeking dental treatment were aesthetic consideration, pain, or discomfort. The
      extirpated pulps were histologically prepared for microscopical evaluation. There
      was myelin degeneration surrounding the axons and edema in the early
      posttraumatic stages (17 h). In the later stages (4 to 20 days), the tissues
      showed varying degrees of inflammation, and neuronal degeneration such as
      intramyelin edema, aberrant myelin synthesis, and axonal swelling.

PMID- 11199734
TI  - Antimicrobial activity and flow rate of newer and established root canal sealers.
AB  - Endodontic sealers that possess both optimum flow ability and antimicrobial
      properties may theoretically assist in the elimination of microorganisms located
      in confined areas of the root canal system. The antimicrobial effects and the
      flow rate of the following sealers were investigated and compared: Kerr Pulp
      Canal Sealer EWT, Grossman's Sealer, ThermaSeal, Sealer 26, AH Plus, and Sealer
      Plus. The agar diffusion test was used to assess the antimicrobial activity of
      the sealers. In the flow assay, the sealers were placed between two glass slabs
      and a weight of 500 g was placed on the top of the glass. The diameters of the
      formed discs were recorded. All root canal sealers tested showed some
      antimicrobial activity against most of the microorganisms. There were no
      significant differences between the materials tested (p > 0.05). All root canal
      sealers also flowed under the conditions of this study. Statistical analysis of
      the results revealed that AH Plus and Kerr Pulp Canal Sealer EWT had flow values
      significantly superior to the other sealers tested (p > 0.05). Taken together,
      these findings suggest that these sealers have the potential to help in the
      microbial control in the root canal system.

PMID- 11199735
TI  - Comparative analysis of curved root canal preparation using nickel-titanium
      instruments with or without EDTA.
AB  - The purpose of this study was to examine the effect of the use of EDTA as a root
      canal irrigant in curved root canals instrumented with nickel-titanium (Ni-Ti)
      instruments. Twenty extracted maxillary molars were selected. Mesiobuccal roots
      were used. Teeth were mounted in self-curing acrylic resin bases to allow
      standardized angulation of the initial and final radiographs. The
      preinstrumentation radiographs were made with a #15 file in the canal. The canals
      were instrumented with Ni-Ti instruments by the step-back technique, using or not
      using EDTA. The post-instrumentation radiographs were made with a #30 file in the
      canal. The films were projected (x10 magnification), drawn, and superimposed. Ni
      Ti instruments used with EDTA were less effective in maintaining the original
      path of curved canals.

PMID- 11199736
TI  - Quality of root-end preparations using ultrasonic and rotary instrumentation in
      cadavers.
AB  - Prior investigations have demonstrated dentinal cracking and chipping during
      ultrasonic preparation of the root-end. This study compared the frequency of
      cracking and chipping in two groups, cadaver and extracted teeth, using an
      indirect resin technique. Preparations were performed using either a 33 1/2
      inverted cone bur in a high-speed handpiece, or with ultrasonics using a CT-2 tip
      at either high or low intensity. After replication of the root-end in epoxy
      resin, all teeth were evaluated for cracking and chipping under scanning electron
      microscopy. Statistical analysis using a general contingency table or ANOVA with
      Scheffe post-hoc analysis (p = 0.05) revealed no significant difference between
      all groups in terms of root-end cracking. In extracted teeth (n = 15), rotary
      instrumentation produced less chipping than either ultrasonic technique. Varying
      the intensity was not significant. There was no significant difference between
      any instrumentation group in cadaver teeth (n = 10) related to the amount of
      chipping.

PMID- 11199737
TI  - Influence of albumin and collagen on the cell mortality evoked by zinc oxide
      eugenol in vitro.
AB  - Zinc oxide-eugenol (ZOE) is cytotoxic in vitro but does not cause pulp damage.
      Various dentin proteins may play a protective role in vivo. We investigated the
      influence of bovine serum albumin (BSA) and collagen on ZOE cytotoxicity in the
      Millipore filter test and a dentin barrier test. Agar or agarose with 1% or 5%
      BSA or calf collagen (1% and 2%) were introduced between L-929 fibroblasts and
      test specimens. ZOE was severely toxic in the absence of BSA. However BSA (1% and
      3%) reduced cell damage to 50% and 35%. In contrast, collagen did not provide
      protection from ZOE cytotoxicity. When dentin was loaded with 3% BSA and the
      "pulpal" side of a dentin barrier test chamber was perfused with cell culture
      medium containing 3% BSA, cytotoxicity of ZOE was completely inhibited. Therefore
      we conclude that albumin may be one factor responsible for the absence of ZOE
      toxicity in pulp studies.

PMID- 11199738
TI  - Cytotoxicity of mineral trioxide aggregate using human periodontal ligament
      fibroblasts.
AB  - The purpose of the present study was to compare the cytotoxicity of mineral
      trioxide aggregate (MTA) to other commonly used retrofilling materials, Super-EBA
      and amalgam. This was accomplished using a cell viability assay for mitochondrial
      dehydrogenase activity in human periodontal ligament fibroblasts after 24-hr
      exposure to extracts of varying concentrations of the test materials, in both
      freshly mixed and 24-hr set states. Methyl methacrylate 2% (vol/vol) served as
      the positive control, and complete culture medium served as the negative control.
      Differences in mean cell viability values were assessed by ANOVA (p < 0.05). In
      the freshly mixed state, the sequence of toxicity was amalgam > Super-EBA > MTA.
      In the 24-hr set state the sequence of toxicity at a low extract concentration
      was Super-EBA > MTA, amalgam, and Super-EBA > amalgam > MTA at a higher extract
      concentration. This study supports the use of MTA in the root-end environment.

PMID- 11199739
TI  - Effect of canal drying methods on the apical seal.
AB  - The purpose of this study was to observe the seal obtained in human root canals
      under different in vitro treatment conditions. Root canals of freshly extracted
      human maxillary incisors received traditional biomechanical preparation and
      irrigation with 10% NaClO, followed by a final rinse of distilled water. Teeth
      were divided into four groups. In group 1, each root canal was dried with one
      paper point. In group 2, each root canal was dried with four paper points. Group
      3 was dried with four paper points, followed by a gentle burst of warm air. Group
      4 was dried using four paper points, followed by an internal 200 degrees C heat
      probe. Twenty canals in each group were filled with a gutta-percha cone and a
      zinc oxide-eugenol sealer, whereas 20 were filled with a glass ionomer sealer.
      All teeth were immediately immersed in India ink for 1 or 4 wk. The teeth were
      cleared, and the dye penetration-leakage measured with an accuracy of +/- 0.01
      mm. Optimum sealing conditions were observed when the canal was dried with paper
      points and a 200 degrees C probe. There were no significant differences between 1
      and 4 wk immersion. Glass ionomer sealer appeared more susceptible to the wet
      condition of the root canal walls than zinc oxide-eugenol sealer. An additional
      40 teeth were prepared in the same manner as the dye penetration tests to observe
      the drying conditions of the root canal walls, and the moisture inside the canals
      was measured to an accuracy of 0.0001 g. The highest degree of internal canal
      wall dryness was found in group 4.

PMID- 11199740
TI  - The radicular groove: its potential clinical significance.
AB  - This report examines three clinical cases of root-filled teeth with primary
      endodontic lesions. During endodontic surgery, an area of incomplete root
      bifurcation beginning in the coronal or middle third of the root surface and
      terminating at or near the apical foramen were observed. The radicular grooves of
      two teeth were eliminated using a round bur ("saucerization"), and the resulting
      defect was filled with a bone substitute or calcium sulfate and covered by an
      absorbable collagen membrane. The other tooth was extracted, the groove was
      eliminated with a similar technique, and the tooth was replanted. Bacteria have
      been reported in chronic apical lesions. Our observations suggest that after
      conventional endodontic therapy, the etiology of a nonresolving primary
      endodontic lesion may be bacteria of endodontic origin sequestered within the
      protective confines of an apical-radicular groove.

PMID- 11199741
TI  - Idiopathic root resorption: report of a case.
AB  - A case of multiple idiopathic apical root resorption in a 26-yr-old female
      patient is presented. A review of the literature revealed that extensive
      idiopathic root resorption is unusual. Neither local nor systemic etiological
      factors were found in our case. Examination of parents and siblings did not
      reveal a familiar tendency. Radiographs and clinical evaluation showed a very
      poor prognosis for most of the teeth present in the mouth of our patient.

PMID- 11199742
TI  - Custom-fabricated endodontic implants: report of two cases.
AB  - Teeth that have lost a good portion of alveolar support can be stabilized and
      maintained by the use of endodontic endosseous implants. Two hopeless cases were
      restored to function with ceramic-coated, custom-fabricated chrome-cobalt
      implants. The technique for fabrication is described.

PMID- 11199743
TI  - Five canals in a mandibular second premolar.
AB  - A case of conservative endodontic therapy for a mandibular second premolar with
      five root canals is described. A thorough knowledge of the root canal anatomy,
      careful interpretation of the radiographs, and access cavity modifications are
      essentials for enhancing intracanal procedures.

PMID- 11199744
TI  - Antimicrobial substantivity of chlorhexidine-treated bovine root dentin.
AB  - Previous studies have demonstrated antimicrobial substantivity in root canal
      dentin up to 7 days after treatment with chlorhexidine. This in vitro study
      assessed the antimicrobial substantivity of chlorhexidine-treated bovine root
      dentin over a period of 21 days. Sixty standardized bovine root sections were
      randomly divided into three equal groups, and their canals immersed in one of the
      following solutions: (i) sterile saline; (ii) 2.5% NaOCl; or (iii) 0.2%
      chlorhexidine (CHX). Half the specimens in each group were treated with the
      solution for 5 min and the other half for 7 days. After solutions were removed,
      the specimens were incubated at 37 degrees C in Brain Heart Infusion broth
      containing Enterococcus faecalis (ATCC 29212). A fresh inoculum was added to the
      broth every other day over a 21-day period. The canals were then enlarged with
      sterile burs, and the dentin shavings collected and cultured for the presence of
      cultivable bacteria in the dentinal tubules. Specimens treated with CHX for 7
      days demonstrated significantly less dentin colonization by E. faecalis than the
      other specimens. CHX has potential as an intracanal medicament, if it can be
      applied for a period of at least 7 days.

PMID- 11199745
TI  - Effect of smear layer and direction of dentinal tubules on osteoblast adhesion to
      human dentin tissue.
AB  - The purpose of this study was to investigate the effect of smear layer and
      direction of dentinal tubules on osteoblast adhesion to human dentin tissue in
      vitro. Dentin disks were made from human premolars extracted for orthodontic
      reasons. Dentin disks were cut either perpendicularly to the long axis of the
      tooth or at 45 degrees to the long axis of tooth. The smear layer was removed by
      34% phosphoric acid gel from half of the dentin disk surface. Human osteoblast
      like Saos-2 cells were grown in RPMI medium with 10% fetal bovine serum and 1%
      antibiotic/antimycotic cocktail under standard cell culture conditions. Cells
      were seeded into Nunc four-well culture plates at 1.5 x 10(5) cells per well with
      dentin disks in the bottom of each well. After 1 day in culture the dentin disks
      along with cells grown on their surface were examined with a scanning electron
      microscopy. Osteoblasts attached and spread on the dentin surface and formed a
      monolayer in the presence and absence of a smear layer. Cells spread over the
      dentinal tubules despite their direction. These results suggest that cell
      adhesion and spreading of osteoblasts is not influenced either by the existence
      of a smear layer or the direction of the dentinal tubules on the dentin surface.

PMID- 11199746
TI  - The mutagenic potential of AH+ and AH26 by Salmonella/microsome assay.
AB  - The aim of this study was to examine the mutagenic potential of canal sealers AH+
      and AH26 by Salmonella/microsome assay. The materials were tested immediately
      after mixing, 1 hr and 1 month later, respectively. The dimethyl sulfoxide
      extracts of sealers in amounts of 3.0, 1.5, and 0.75 microliters/plate were used.
      The plated bacterial strains of Salmonella were TA 98 and TA 100. The results
      showed that AH+ is mutagenic toward strain TA 100 1 hr after mixing. One month
      after mixing, mutagenic activity was expressed only in TA 98. Paste A showed
      strong mutagenicity toward TA 100. AH26 was more mutagenic to the TA 100
      immediately after mixing, 1 hr later, and 1 month after it was polymerized. Also
      it was mutagenic toward TA 98 in the polymerized condition. Further examinations
      should be conducted to establish a definitive conclusion about mutagenic
      potential for these two endodontic materials.

PMID- 11199747
TI  - Effect of systemic doxycycline on alveolar bone loss after periradicular surgery.
AB  - Studies in the periodontic literature have shown an average of 0.5 mm to > 1.0 mm
      of bone loss after full thickness flap reflection. Similar literature has
      revealed that the tetracycline family of antibiotics can prevent bone loss. The
      purpose of this study was to observe the effect of systemic Doxycycline on
      crestal alveolar bone loss after periradicular surgery in beagle dogs. Five
      beagle dogs were used in two phases of this study. In the first phase (control
      sides), after reflecting full thickness flaps in one mandibular quadrant, notches
      were placed in the enamel of the third and fourth premolar teeth using a one
      quarter round bur. Using magnification, measurements were taken from the
      reference notches to the height of the alveolar crest. After 8 wk, flaps were
      reflected in the same quadrant and measurements retaken, and the amount of bone
      loss was then measured. In the second phase (experimental sides), the same
      procedure was performed on the contralateral mandibular quadrant, but the dogs
      were placed on 4.4 mg/kg/day of Doxycycline for 10 days after reflections of full
      thickness flaps. After another 8 wk, the area was reflapped and measured. There
      was significantly (p < 0.01) less bone loss on the Doxycycline-treated side.

PMID- 11199748
TI  - Evaluation of cell culture cytotoxicity of five root canal sealers.
AB  - The cytotoxicity of four calcium hydroxide-based root canal sealers (Sealapex,
      CRCS, Apexit, and Sealer 26) and one zinc oxide-eugenol-based sealer (Fill Canal)
      was evaluated microscopically for morphological changes in rat peritoneal
      macrophages. The least cytotoxic sealer was Fill Canal, followed in increasing
      order of cytotoxicity by CRCS, Sealer 26, Apexit, and Sealapex.

PMID- 11199749
TI  - Chemomechanical reduction of the bacterial population in the root canal after
      instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite.
AB  - Given the importance of bacteria in the development of periradicular lesions, the
      eradication of the root canal infection is paramount in endodontic treatment.
      This study evaluated the in vitro intracanal bacterial reduction produced by
      instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite
      (NaOCl) or saline solution. Root canals inoculated with Enterococcus faecalis
      were instrumented and irrigated with the solutions tested. Canals were sampled
      before and after preparation. After serial dilution, samples were plated onto
      Mitis salivarius agar, and the colony-forming units grown were counted.
      Inhibitory effects of the three NaOCl solutions on E. faecalis were also
      evaluated by means of the agar diffusion test. All test solutions significantly
      reduced the number of bacterial cells in the root canal (p < 0.05). There was no
      significant difference between the three NaOCl solutions tested (p > 0.05).
      Nonetheless, all NaOCl solutions were significantly more effective than saline
      solution in reducing the number of bacterial cells within the root canal (p <
      0.05). The three NaOCl concentrations showed large zones of inhibition against E.
      faecalis. The results of this study suggest that regular exchange and the use of
      large amounts of irrigant should maintain the antibacterial effectiveness of the
      NaOCl solution, compensating for the effects of concentration.

PMID- 11199750
TI  - Immunolocalization of macrophages and transforming growth factor-beta 1 in
      induced rat periapical lesions.
AB  - Apical periodontitis was induced in Wistar rats by exposing the pulp chamber of
      right mandibular first molars to the oral environment. Animals were killed 0, 5,
      10, 15, 20, 30, 60, and 80 days after lesion induction. Microradiographic and
      automated image analysis showed that the lesions expanded significantly in a time
      dependent manner from day 0 to day 20 (0.039 mm2/day, p < 0.05, active phase) and
      stabilized thereafter (chronic phase). A linear regression test revealed a
      positive correlation between the numbers of ED-1 positive macrophage per
      microscopic high power field and the periapical lesion size during the active
      phase (r = 0.98, p < 0.01). Immunohistochemical studies showed that transforming
      growth factor-beta 1 positive macrophages distributed around the root apex and
      areas showing bone resorption during active lesion phase, whereas TGF-beta 1
      positive osteoblasts were detected during the chronic stage (days 30, 60, and 80
      after pulp exposure). Histologically TGF-beta 1 positive osteoblasts possessed a
      large, round nucleus as well as an abundant cytoplasm and located in close
      vicinity to areas exhibiting reparative bone formation. These results suggest
      that macrophages may play important role(s) in the initiation and development of
      periapical lesions and TGF-beta 1 may play dual roles in both bone resorption and
      deposition in induced rat periapical lesions.

PMID- 11199751
TI  - Effect of root canal sealers and irrigation agents on retention of preformed
      posts luted with a resin cement.
AB  - This study examined the effect of three sealers and four irrigants on retention
      of Dentatus preformed posts luted with Panavia 21 resin cement. Gutta-percha with
      one of the following sealers--EWT, AH26, Nogenol, or no sealer (control)--was
      used to fill the root canals of 160 autoclaved incisor and premolar tooth roots.
      After 72 hr 8 mm post spaces were created with Dentatus Probos Pathfinders and
      Dentatus reamers. After irrigating the post spaces with saline, 5.25% NaOCl, 50%
      citric acid followed by NaOCl, or 40% H3PO4, followed by NaOCl, Panavia 21 TC
      cement was introduced into the canal on the Dentatus #4 stainless steel post's
      threads. An up-and-down and counterclockwise motion and then a forward twist
      seated the posts without engaging dentin. Mesiodistal and faciolingual
      radiographs visualized the chambers. After 72 hr posts were removed axially with
      an Instron at 5 mm/min. Surprisingly, using Nogenol sealer reduced post retention
      whereas EWT and AH26 increased retention compared with no sealer. Post retention
      improved after acid etchants, especially for AH26.

PMID- 11199752
TI  - Macroscopic and microscopic analysis of the palato-gingival groove.
AB  - With the objective of correlating the anatomical aspects of the palato-gingival
      groove with its etiology, diagnosis, and alternative treatments, 13 permanent
      maxillary incisors with palato-gingival grooves were selected from a large sample
      and subjected to macroscopic and microscopic analysis of groove morphology. The
      palato-gingival groove occurred most frequently on the lingual aspect of the
      lateral incisor (11 of 13), and its coronal and radicular extensions were on the
      disto-lingual surface of the incisors (7 of 13 and 6 of 13, respectively).
      Deformation of the contour of the pulp cavity was noted subjacent to the groove
      (9 of 13), along with diminished enamel and dentin thickness (11 of 13 and 13 of
      13, respectively) and an increase in cement (12 of 13). The groove was observed
      extending to the apical third in nine specimens, and a direct communication
      between the pulp and periodontium was observed in only one case. From these
      examinations it is concluded that the palato-gingival groove can be clinically
      diagnosed, preventing subsequent problems; however microscopic analysis of the
      affected tooth is necessary to allow precise evaluation of the groove's extension
      and damage to the dental structure.

PMID- 11199753
TI  - Smear layer influence on the apical seal of four different obturation techniques.
AB  - The purpose of this study was the in vitro evaluation of four techniques for the
      obturation of the root canal system in the presence or absence of a smear layer.
      Ninety-six human upper central incisors were instrumented using the pressureless
      crown-down technique and irrigated with 5.25% NaOCl. The teeth that had the smear
      layer removed were irrigated with this solution in combination with 17% EDTA. The
      teeth were obturated with lateral condensation with an accessory or standardized
      cone as the main cone, with vertical condensation of warm gutta-percha or with
      thermoplasticized injectable gutta-percha. Apical leakage was assessed by
      measuring the linear penetration of methylene blue dye with a stereomicroscope.
      The results showed no significant differences in the degree of leakage with and
      without the smear layer when the samples were considered as a whole. However,
      when the groups were assessed separately, teeth in the lateral condensation with
      an accessory main cone group and teeth in the thermoplasticized group leaked less
      with a smear layer present. In contrast teeth with lateral condensation and a
      standardized main cone leaked more with a smear layer present. In the vertical
      condensation groups there was no difference attributable to the smear layer.

PMID- 11199754
TI  - Efficacy of final irrigation--a scanning electron microscopic evaluation.
AB  - The purpose of this in vitro study was to determine the degree of removal of
      pulpal remnants and smear layer from root canals after final irrigation with
      three different solutions. During instrumentation the step-back preparation and
      1% NaOCl were used. The final 4-min, 30-ml irrigation varied as follows: group I,
      10 ml of 1% NaOCl + 10 ml of 10% citric acid + 10 ml of distilled water; group
      II, 15 ml of 0.5% NaOCl + 15 ml of EDTA-T; and group III, 10 ml of 5% NaOCl + 10
      ml of 3% H2O2 + 10 ml of 5% NaOCl. Scanning electron microscopic photomicrographs
      were evaluated for the mean number of visible open dentinal tubules by three
      observers. The largest number of visible tubules in the three groups was in the
      cervical third, followed by the middle and apical thirds. There was no
      statistically significant difference between groups I and II when third was
      compared with third; however, groups I and II had significantly more visible
      dentinal tubules than group III.

PMID- 11199755
TI  - Furcation groove of buccal root of maxillary first premolars--a morphometric
      study.
AB  - Furcation grooves on the palatal aspect of the buccal roots of 35 maxillary first
      premolars, randomly selected, were assessed and found to exist in 97% of the
      sample. The buccal roots were sectioned into slices, 1 mm thick, and morphometric
      horizontal and vertical measurements were taken by a Toolmaker Microscope. The
      slice with the deepest invaginations served as the reference plane. The deepest
      invaginations were found to be at a mean distance of 1.18 mm from the
      bifurcation, with a mean depth of 0.4 mm. The canal had a kidney-shaped
      appearance in cross-section, and the mean distance from the invagination to the
      canal wall was 0.81 mm. It is thus hazardous to use rotary instruments for
      flaring these roots and any circular-shaped post space preparation at this level
      is contraindicated. The outcome of such procedures might be root thinning,
      perforation, or vertical root fracture, thus causing a poor prognosis.

PMID- 11199756
TI  - Effect of using electronic apex locators on selected endodontic treatment
      parameters.
AB  - The purpose of this study was to determine the effect of using electronic apex
      locators on the number of radiographs taken and the adequacy in length of the
      final obturation. Patients in an undergraduate student endodontics clinic
      participated in the study. The working length (WL) was estimated by the authors
      for all cases (36 teeth; 58 canals), using both a preoperative standardized
      radiograph and an electronic measurement. The students were then asked to place
      WL files to one of the estimates (electronic or radiographic; chosen by random
      assignment) and take a WL radiograph. Neither the students nor their instructors
      knew which method was chosen for the estimates. Once treatment was completed, the
      total number of working radiographs was counted. The number of cases with
      acceptable (0 to 2 mm short of the apex) or unacceptable obturation was also
      blindly registered. An electronic estimate of the WL improved length quality of
      the final obturation, compared with a radiographic estimate. The number of
      working radiographs taken was less in the electronic apex locator group in
      anterior and premolar teeth, but not in molars.

PMID- 11199757
TI  - Broken instrument removal--two cases.
AB  - This paper reports two clinical aids for the removal of broken instruments in
      root canals using a combination of hand instrumentation and ultrasonic devices.
      This technique is based on two phases: hand instrumentation with stainless-steel
      K-file instruments for bypassing the fragments, and K-files mounted on an
      ultrasonic handpiece for loosening and retrieval of the broken instruments. This
      method offers the following advantages: conservation of the remaining dentin wall
      of the root canal and elimination of the necessity for surgical treatment.

PMID- 11199758
TI  - Central giant cell granuloma: a troublesome lesion.
AB  - This case reports a central giant cell granuloma, an uncommon but potentially
      troublesome idiopathic benign lesion. Its radiographic similarity to a routine
      inflammatory periradicular lesion led to not only delay in diagnosis, but also
      further delay in successful treatment.

PMID- 11199759
TI  - Nasal fistula associated with dental infection: a report of a case.
AB  - Most clinicians have come across a patient with difficult symptoms to diagnose.
      Often confusion occurs between odontogenic and nonodontogenic causes of sinus
      discomfort. On many occasions, sinus pain is due to purely dental causes, whereas
      in other situations dental pain is reported when the sinuses are infected. Due to
      the intimate association between the roots of the maxillary teeth and the floor
      of the nasal cavity and maxillary sinuses, diagnosis may be difficult. The
      following is a case report of a nasal fistula that developed from an abscessed
      maxillary central incisor.

PMID- 11199760
TI  - Gutta-percha softening: "Hemo-De" as a xylene substitute.
AB  - The putative hazardous nature of chloroform and xylene implies that safer
      substitutes should be considered. Standard cylindrical gutta-percha samples were
      immersed in Hemo-De, a xylene substitute, for 60 s at 37 degrees C. Weight loss
      of a sample, after drying, was used as a measure of its solubility. Master and
      accessory cone gutta-percha of three brands were compared. The highest solubility
      of all kinds of gutta-percha was in chloroform, which served as a positive
      control. The average solubility of all samples in xylene and Hemo-De was 61% and
      52% of that in chloroform, respectively. DMS gutta-percha was more soluble than
      of Hygienic and DeTrey. Master cone gutta-percha of all brands was more soluble
      than that of their accessory cones. These results indicate that (a) large
      differences exist in the solubility of gutta-percha and (b) Hemo-De dissolved
      gutta-percha in a range similar to that of xylene and may be considered as a
      potential substitute for this organic solvent.

PMID- 11199761
TI  - Evaluation of pH and calcium ion release of three root canal sealers.
AB  - The pH and calcium ion release of three root canal sealers--Sealapex, Sealer 26,
      and Apexit--were assessed at 24 and 48 hr, and at 7 and 30 days after
      spatulation. After manipulation, the sealers were placed in 1-cm-long tubes
      measuring 4 mm in diameter and immersed in a glass flask containing 10 ml of
      deionized water, which was hermetically sealed and stored at 37 degrees C. The
      tubes were removed at the scheduled times and the water in which they were
      immersed was tested for pH with a pHmeter and for released calcium by atomic
      absorption spectrophotometry. Starting 48 hr after immersion, Selapex produced an
      alklaine pH and released significantly higher calcium amounts compared with the
      other two sealers, with even more pronounced results after 30 days. On the basis
      of the results obtained, we conclude that Sealapex presented the highest calcium
      and hydroxyl release, especially after longer time intervals, whereas Sealer 26
      showed highest release during the initial periods (i.e. during its setting time).
      Apexit presented the least satisfactory results.

PMID- 11199762
TI  - In vitro evaluation of antimicrobial activity of sealers and pastes used in
      endodontics.
AB  - The antimicrobial activity of four root canal sealers (AH Plus, Sealapex, Ketac
      Endo, and Fill Canal), two calcium hydroxide pastes (Calen and Calasept), and a
      zinc oxide paste was evaluated. Seven bacterial strains were used, six of them
      standard; Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 25923,
      Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 12228,
      Escherichia coli ATCC 25922, and Enterococcus faecalis ATCC 10541. There was a
      wild strain of Streptococcus mutans isolated from saliva obtained in an adult
      dental clinic. Activity was evaluated using the agar diffusion method with Brain
      Heart Infusion agar and Muller Hinton medium seeded by pour plate. Calcium
      hydroxide-based sealers and pastes were either placed directly into 4.0 x 4.0 mm
      wells or by using absorbent paper points. The plates were kept at room
      temperature for 2 hr for diffusion. After incubation at 37 degrees C for 24 hr,
      the medium was optimized with 0.05 g% TTC gel and inhibition haloes were
      measured. All bacterial strains were inhibited by all materials using the well
      method. However, when the materials were applied with absorbent paper points,
      Enterococcus faecalis was not inhibited by zinc oxide, and Pseudomonas aeruginosa
      was not inhibited by AH Plus, Fill Canal, and the zinc oxide-based paste. We
      conclude that sealers and pastes presented antimicrobial activity in vitro and
      culture medium optimization with 0.05 g% TTC gel facilitated observation of the
      inhibition haloes.

PMID- 11199763
TI  - Cytotoxicity evaluation of perforation repair materials on human periodontal
      ligament cells in vitro.
AB  - Perforation of a tooth structure resulting in communication of the pulp space
      with periodontium occasionally occurs during endodontic therapy. For the best
      prognosis, the perforation area must be sealed as soon as possible. Because these
      materials will be in direct contact with periodontal tissues, their cytotoxic
      potential must be evaluated before clinical use. The purpose of this study was to
      determine the cytocompatibility of three perforation repair materials (amalgam,
      resin, and glass ionomer). Cultured human periodontal ligament (PDL) cells were
      used to evaluate the cellular response resulting from these materials by cell
      viability and proliferation assays. Twenty-seven 5 x 4 mm cylinders of each
      material were fabricated for this study. All tested materials were cytotoxic to
      human PDL cells. Both types of material and time affected cell viability and
      proliferation. Resin exhibited the most cytotoxic effects followed by glass
      ionomer and amalgam during a 14-day incubation period. Amalgam and glass ionomer
      slightly inhibited cell viability and growth in the first 24 hr, compared with
      the control. Amalgam or glass ionomer may initially react more favorably to PDL
      cells than resin. The present model of cultured human PDL cells is simple,
      relatively cheap, and easily established and propagated under standardized
      conditions in any laboratory. Furthermore, this method allows long-term
      observation of human cellular reactions and thus might be a preliminary screening
      test for initial biocompatibility of dental materials.

PMID- 11199764
TI  - Growth inhibitory activity of gutta-percha points containing root canal
      medications on common endodontic bacterial pathogens as determined by an
      optimized quantitative in vitro assay.
AB  - Gutta-percha points containing calcium hydroxide, zinc oxide (ZnO), a mixture of
      ZnO and chlorhexidine (ZnO/CHX), iodine-polyvinylpyrrolidone (ZnO/J-PVP), or a
      mixture of CHX and J-PVP and ZnO (ZnO/CHX/J-PVP) were tested for their ability to
      inhibit growth of pure cultures of bacterial species commonly involved in
      endodontic infections (Peptostreptococcus micros, Streptococcus intermedius,
      Enterococcus faecalis, and Porphyromonas gingivalis). To quantitate growth
      inhibition, an in vitro assay was established that controlled for important
      parameters of root canal infection. Approximately 10(7) bacteria per assay were
      suspended in diluted human serum and co-incubated with the gutta-percha points in
      an anaerobic atmosphere for up to 2 wk. Aliquots used for determination of colony
      counts were taken on days 0, 1, 2, 4, 7, and 14 of incubation. As judged by
      colony-forming unit reduction kinetics and final counts, calcium hydroxide had
      better growth inhibitory activity than ZnO/CHX, ZnO/J-PVP, and ZnO alone for all
      bacteria tested except Peptostreptococcus micros. The combination of CHX and J
      PVP with ZnO did not render results different from those of ZnO/CHX or ZnO/J-PVP.
      The results of this study support the introduction of standardized assays for
      testing antibacterial properties of root canal medications under conditions that
      more closely resemble those encountered in endodontal infections.

PMID- 11199765
TI  - Adhesion of human osteoblasts on root-end filling materials.
AB  - Adhesion of human osteoblasts to root-end filling materials (mineral trioxide
      aggregate (MTA), IRM, composite, and amalgam) was observed by scanning electron
      microscopy. Root-end filling materials were inserted into 96-well flat-bottomed
      plates and condensed to disks of approximately 1 mm thick and the same diameter
      as the wells. After the disks were set, they were placed in the bottom of Nunc
      four-well culture plates at one disk per well. Then human osteoblasts were seeded
      into the wells at 1.5 x 10(5) cells per well. After 1 day in culture the disks of
      root-end filling materials along with cells grown on their surface were examined
      with a scanning electron microscopy. Results showed that osteoblasts attached and
      spread on MTA and composite by forming a monolayer. Osteoblasts also attached on
      amalgam, but with few cells spreading. In the presence of IRM, osteoblasts
      appeared rounded with no spreading. These results indicate that osteoblasts have
      a favorable response to MTA and composite resin compared with IRM and amalgam.

PMID- 11199766
TI  - Effect of a fifth-generation bonding agent on vascular responses in rats.
AB  - In the last years, several single-bottle dental adhesives have been developed.
      They are supposed to chemically adhere to dentin, and a liner to protect pulp is
      not thought to be necessary. In the case of direct pulp capping, hemorrhage
      control is an important step in success, but little is known about the effect of
      these new bonding agents on pulpal bleeding. The aim of this study was to
      evaluate the effect of a new one-step single-bottle adhesive on the smooth muscle
      contraction of rat uterine muscle and carotid arteries. Efficacy of the bonding
      agent was compared with that of epinephrine (control), and the contraction forces
      induced were recorded using a force displacement transducer. Statistical analysis
      of data revealed that the bonding material produced epinephrine-like
      concentration-dependent contractions of the smooth muscle, suggesting that one
      step bonding agents may act as candidates for hemorrhage control without the use
      of an additional agent in direct pulp capping procedures.

PMID- 11199767
TI  - Anaerobic bacterial extracts influence production of matrix metalloproteinases
      and their inhibitors by human dental pulp cells.
AB  - The role of human dental pulp (HDP) cells in extracellular matrix degradation in
      pulpitis is still unclear. In this study, the effects of sonicated bacterial
      extracts (SBEs) from Prevotella intermedia, Fusobacterium nucleatum,
      Porphyromonas endodontalis, and Porphyromonas gingivalis on the balance between
      the production of matrix metalloproteinases (MMPs) and that of their inhibitors
      [tissue inhibitors of metalloproteinases (TIMPs)] by HDP cells were examined. HDP
      cells were treated with SBEs, and their culture media were later harvested. MMP
      activities and TIMP concentrations were determined by use of independent
      measurement strategies and sensitive ELISAs. The production of MMP-1 and MMP-2
      was accelerated by all SBE. On the other hand, TIMP-1 production was slightly
      elevated; and TIMP-2 production was markedly inhibited by all of the extracts.
      SBEs derived from these anaerobic bacteria seemed to affect the acceleration of
      extracellular matrix degradation activity by HDP cells. These findings suggest
      that HDP cells stimulated by bacterial byproducts may be involved in the
      pathogenesis of pulpitis.

PMID- 11199768
TI  - Impact of two theoretical cross-sections on torsional and bending stresses of
      nickel-titanium root canal instrument models.
AB  - The use of nickel-titanium in the manufacture of endodontic instruments has given
      rise to continuous-rotation canal preparation techniques. These techniques
      involve unidirectional torque, meaning that files are under constant stress and
      strain when operating. The study presented herein compares torsional and bending
      stresses in triple U and triple helix models. This was done by applying the
      boundary integral method to theoretical cylindrical models. The two theoretical
      models underwent very different torsional stresses, both in terms of intensity
      and distribution. Bending stresses were much more similar, but to obtain the same
      curvature, bending moments had to be different. The results of the mathematical
      calculations indicated that triple U and triple helix instruments should be used
      for different operating procedures.

PMID- 11199769
TI  - Scanning electron microscopic investigation of the surface of gutta-percha cones
      after cutting.
AB  - The surface of auxiliary gutta-percha cones after cutting with different methods
      was evaluated. The tips of gutta-percha cones size fine were cut off using
      scissors, a razor blade against a glass slab, a razor blade combined with a
      calibrator, or a razor blade/calibrator followed by a further cutting with a
      razor blade against a glass slab. Samples were examined under scanning electron
      microscopy. Cutting with scissors and razor blade/calibrator produced significant
      irregularities in the cone surface. Cutting with razor blades against a glass
      slab, with or without previous use of a calibrator, allowed the development of a
      smooth gutta-percha cone surface.

PMID- 11199771
TI  - The use of two pluggers for the obturation of an uncommon C-shaped canal.
AB  - The complex configuration of C-shaped canals in mandibular second molars make
      root canal treatment unusually difficult. The present case highlights their
      unpredictable canal anatomy and describes the use of two pluggers simultaneously
      to downpack the main canals. The effect of such a modification on the high-flow
      characteristics of thermosoftened gutta-percha in vertical condensation is
      discussed.

PMID- 11199772
TI  - A successful nonsurgical treatment of an endodontic failure.
AB  - This study presents a relatively uncomplicated endodontic failure that responded
      to nonsurgical treatment. Speculation as to other interpretations of the failure
      with related treatment plans is offered to highlight how significant diagnosis
      can be in determining outcomes.

PMID- 11199773
TI  - The effect of immediate vs. delayed post space preparation on the apical seal of
      a root canal filling: a study in an increased-sensitivity pressure-driven system.
AB  - A 5 mm remaining length of root canal filling, after post space preparation, is
      commonly assumed to maintain sealing ability similar to that of the intact
      filling. Post spaces were prepared either immediately using hot pluggers, or
      later, using drills. The sealing ability of the fillings, 5 mm remaining length,
      were compared with each other and with an intact root canal filling control,
      using radioactive tracer in a pressure-driven system. When no pressure was
      applied, no differences could be detected between either of the groups and the
      control. When a pressure of 120 mm Hg was applied to the same teeth, the control
      group clearly maintained a better seal than each of the experimental groups,
      which did not significantly differ from each other. These results suggest that
      (a) the pressure-driven system was more sensitive than the passive leakage assay
      that failed to detect differences even at 14 days; (b) a remaining root canal
      filling of 5 mm was inferior to the intact root canal filling; and (c) the
      immediate post space preparation with hot pluggers did not differ from a delayed
      preparation with drills.

PMID- 11199774
TI  - Cytotoxic and nongenotoxic effects of phenolic compounds in human pulp cell
      cultures.
AB  - Phenolic compounds are widely used in clinical dentistry as sedatives for the
      dental pulp, as disinfectants for caries, and as root canal medications. The
      pathobiological effects of various phenolic compounds on human dental pulp
      fibroblasts were investigated with Hoechst 33258 fluorescence assay and DNA
      precipitation assay. All phenolic compounds showed cytotoxicity in Hoechst 33258
      fluorescence assay by inhibiting cellular DNA in a concentration-dependent
      manner. The 50% inhibition concentrations required to decrease the cellular DNA
      contents by guaiacol, phenol, eugenol, and thymol were 9.8, 4.5, 0.9, and 0.5 mM,
      respectively. However these phenolic compounds did not cause DNA single-strand
      breaks in cultured human pulp fibroblasts. These results indicate that phenolic
      compounds are cytotoxic agents but are without genotoxic effects on human pulp
      fibroblasts in vitro. However care should be taken to reduce the possibility of
      pulpal as well as periapical irritations from inadvertent extrusion of these
      substances in clinical usage.

PMID- 11199775
TI  - Retrograde seal in ultrasonically prepared canals.
AB  - The sealing ability of various retrofilling materials was compared. The root
      canals of 85 single-rooted teeth were cleansed and obturated with gutta-percha
      without sealer using lateral condensation. The apical 3 mm of the roots were
      resected and divided into positive control, negative control, and five
      experimental groups. The experimental teeth received root-end cavity preparation
      to 3 mm depth using an ultrasonic retroprep tip. The retrocavities were dried and
      divided into five groups to receive the following materials: amalgam with
      varnish, amalgam with Clearfil Liner Bond II, thermoplasticized gutta-percha
      (TGP) with sealer, Ketac-fil, and Super-EBA. After immersion in India ink for 7
      days, the roots were demineralized, cleared, and evaluated for dye leakage under
      a stereomicroscope. Statistical analysis showed that Super-EBA, Ketac-fil, and
      TGP with sealer demonstrated less leakage than amalgam with varnish and amalgam
      with Clearfil Liner Bond II (p < 0.05). Super-EBA also leaked significantly less
      than Ketac-fil or TGP sealer (p < 0.05). No significant difference was found
      between Ketac-fil and TGP or between the two groups filled with amalgam (p >
      0.05).

PMID- 11199776
TI  - The essential endodontic literature: a survey of postgraduate program directors.
AB  - Hundreds of new articles are added to the body of knowledge in endodontics each
      year. However, a comparatively small number of articles have had a
      disproportionately large influence on the progress and development of the
      specialty of endodontics. A survey of postgraduate program directors was
      conducted to attempt to identify a highly selective short list of articles that
      program directors felt should be included on every postgraduate reading list. The
      survey results were then compared with the more objective benchmark of citation
      indexing. The results of this survey suggest that the collective opinion of the
      postgraduate program directors correlates well with the results obtained from
      citation analysis.

PMID- 11199777
TI  - A comparison of the morphological changes after Nd-YAG and CO2 laser irradiation
      of dentin surfaces.
AB  - The purpose of this study was to compare the morphological changes after Nd-YAG
      and CO2 laser irradiation on dentin surfaces with or without the smear layer.
      Eighty-one 3-mm-thick dentin specimens collected from the middle third of molar
      crowns were used. The dentin surfaces were ground to #320, #400, and #600 grit in
      series to create a smear layer. Half of the specimens were treated with 14% EDTA
      for 2 min to remove the smear layers. The lasers were applied on each specimen
      perpendicularly with 1-mm focus distance to the dentin surface for 4 s. The
      parameters for the Nd-YAG laser were 50 mJ, 100 mJ, and 150 mJ at 10 pps, 20 pps,
      and 30 pps, and for the CO2 laser were 2 W, 3 W, and 4 W at 5 ms x 20 pps, 10 ms
      x 10 pps, 20 ms x 20 pps, 50 ms x 2 pps, 100 ms x 2 pps, and 200 ms x 2 pps. The
      results showed that the Nd-YAG laser caused crater and melting of the dentin
      surface, especially in dentin specimens with smear layers. The CO2 laser produced
      extensive cracking lines on dentin surfaces with a smear layer, whereas surface
      erosion and crater formation were found on specimens without a smear layer. In
      conclusion, both the laser types and smear layer have a significant influence on
      the morphological changes of dentin surfaces irradiated by lasers.

PMID- 11199778
TI  - Canal enlargement by Er:YAG laser using a cone-shaped irradiation tip.
AB  - To solve the problem of mechanical instrumentation, we developed a cone-shaped
      laser irradiation tip. This tip delivers 80% of the energy of the laser laterally
      and 20% of the energy forward. The tip was equipped with a water nozzle. The aim
      of this study was to examine the effect of Er:YAG laser irradiation using this
      tip on root canal enlargement and debridement. As a root canal model, a hole (0.5
      x 5 mm) was drilled into a bovine dentin block. The tip was inserted into this
      hole and moved from the apex to the orifice (45 mm/min). The power of 10 mJ x 10
      pps caused enlargement of the canal dimension by 106.5%. 20 and 40 mJ x 10 pps
      caused enlargements of 116.3 and 118.6%. 30 mJ x 10 pps caused the biggest change
      (129.8%). Scanning electron microscopic observations indicated that the dentin
      surface after laser preparation appeared cleaner than that obtained after
      preparation by drilling. This technique may have the advantage of decreasing the
      preparation time.

PMID- 11199779
TI  - Smear layer removal by EGTA.
AB  - The purpose of this study was to compare the effects of ethylene glycol-bis (beta
      aminoethyl ether)-N,N,N', N'-tetraacetic acid (EGTA) and EDTA on removal of the
      smear layer by using scanning electron microscopy. Fifteen single-rooted teeth
      were instrumented to size 60. Three teeth served as the control group, and the
      remaining teeth were assigned into two groups. After instrumentation, root canals
      of the first group were irrigated with 10 ml of 17% EDTA, and the second group
      was irrigated with 10 ml of 17% EGTA for 2 min. Both were then irrigated with 10
      ml of 5% NaOCl. The teeth in the control group were irrigated with only 10 ml of
      5% NaOCl. Then the specimens were sectioned longitudinally and processed for
      scanning electron microscopy. The results showed that the smear layer was
      completely removed by EDTA, but it caused erosion of the tubuli. EGTA was
      somewhat effective in removing the smear layer without inducing erosion. Our
      results suggest that EGTA is an alternative chelator for removing the smear
      layer.

PMID- 11199780
TI  - In vitro cytotoxicity of a new epoxy resin root canal sealer.
AB  - The cytotoxic effects of a new epoxy resin-based root canal sealer (AH-plus),
      together with those of two other commonly used endodontic sealers (AH26 and zinc
      oxide-eugenol), have been studied in vitro on a culture of human gingival
      fibroblasts. Cytotoxicity was assessed by direct incubation of sealers' extracts
      with the cultured fibroblasts at different time intervals. Morphological and
      cytotoxic effects of the sealers were evaluated microscopically and
      spectrophotometrically using the neutral red cytotoxicity assay. Our results
      demonstrated that the cytotoxic effects induced by zinc oxide-eugenol were
      detectable as early as 1 hr after mixing and remained at a high level until
      completion of the experiment (5 wk). AH26, however, induced early cytotoxic
      effects that lasted for 1 wk, followed by a substantial reduction in
      cytotoxicity. Cytotoxicity of the AH-plus was confined to the early period of
      experiment and was no longer detectable after 4 hr of mixing. Comparison between
      the results obtained for each sealer revealed significant differences at
      particular time intervals. Our findings suggest the potential advantage of this
      sealer over the other two sealers.

PMID- 11199781
TI  - Sealing furcation perforations with silver glass ionomer cement: an in vitro
      evaluation.
AB  - Furcation perforations sealed with silver glass ionomer cement (Chelon Silver)
      were evaluated in vitro compared with amalgam. Access cavities were prepared in
      25 extracted human molar teeth. The coronal orifices of the root canals were
      sealed with amalgam and varnish. Naturally occurring coronal leakage through the
      intact pulp chamber floor was determined quantitatively for each tooth, using a
      modified fluid transport model, under pressure of 1.2 Atm. Each tooth was then
      disconnected from the system, perforated at the furcation, and the perforation
      sealed with either Chelon Silver (10 teeth) or amalgam (10 teeth); five remaining
      teeth served as a negative control. After incubation for 24 h at 37 degrees C in
      100% humidity, teeth were reconnected to the modified fluid transport system, and
      coronal leakage under pressure was evaluated at 1, 2, 6, 15, and 24 h. Leakage
      through each tooth was compared with that of its own intact pulp chamber floor
      before perforation and the groups compared with each other. No significant
      difference was found between the mean leakage of the intact pulp chamber floors
      of the two groups. Chelon Silver had a significantly better sealing ability than
      amalgam (p < 0.01): leakage rate of 0.007 and 0.017 microliter/min, respectively.
      It is concluded that Chelon Silver could be an adequate sealer for furcation
      perforations.

PMID- 11199782
TI  - Zebra. XIX. Part 2. Oral herpes zoster.

PMID- 11199783
TI  - Delayed replantation of avulsed mature teeth with calcium hydroxide treatment.
AB  - Three avulsed teeth that were replanted and splinted after approximately a 200
      min dry extraoral period in two patients are presented. In case 1 calcium
      hydroxide treatment was performed 1 month after replantation, because the patient
      did not come for endodontic treatment on the day after replantation as requested.
      In case 2, calcium hydroxide treatment was initiated on the day after
      replantation. Calcium hydroxide treatment was used to prevent or treat
      inflammatory root resorption. During the follow-up periods the teeth reported in
      these cases have remained in a stable, functional position and did not reveal
      clinical ankylosis or replacement resorption.

PMID- 11199784
TI  - A case report of a compound odontoma causing delayed eruption of a central
      maxillary incisor: clinical and microscopic evaluation.
AB  - A case of a compound odontoma caused delayed eruption of a central incisor in the
      maxilla is presented with clinical, radiographic, and microscopic findings. The
      odontoma was surgically removed and microscopic examination showed a lot of crown
      like structures in a very irregular form, some of which were fused to each other
      at their apical parts. Enamel and pre-enamel were totally abnormal, whereas the
      inside of the pulp chamber tissue did not present any histological sign of
      functional tissue. The most homogeneous tissue was dentin. The removal of the
      odontoma was followed by a rapid eruption of the impacted central incisor.

PMID- 11199785
TI  - Long-term obturation quality using noninstrumentation technology.
AB  - The aim of the study was to evaluate and compare the sealing quality of hand- or
      vacuum-obturated root canals after hand instrumentation or noninstrumentation
      cleansing. A total of 60 single-rooted teeth were divided into six comparable
      groups. The root canals of three groups were instrumented with the balanced-force
      technique and obturated with gutta-percha condensation. The remaining teeth were
      cleansed and filled using noninstrumentation technology and the same sealers as
      with hand instrumentation (AH Plus, Apexit, Pulp canal sealer EWT). After aging
      the quality of coronal seal was assessed with a dye penetration method after
      perfusion with the dye under vacuum. The results of this study indicated superior
      sealing of the machine-filled roots (noninstrumentation technology), compared
      with laterally condensed conventionally filled root canals.

PMID- 11199786
TI  - Effects of calcium hydroxide and transforming [correction of tumor] growth factor
      beta on collagen synthesis in subcultures I and V of osteoblasts.
AB  - Collagen protein synthesis by osteoblasts is influenced by transforming growth
      factor-beta (TGF-beta 1) and is essential to bone formation. The effectiveness of
      TGF-beta 1 depends on efficient delivery of the growth factor to target cells,
      adequate binding to cell surface receptors, and an optimum environment for
      promotion of collagen synthesis. The effects of calcium hydroxide (Ca(OH)2), TGF
      beta 1, and Ca(OH)2/TGF-beta 1 co-administration on total protein, collagen
      protein, and noncollagen protein synthesis by early (subculture I) and late
      (subculture V) osteoblast cultures were tested. TGF-beta 1 significantly
      increased all protein synthesis in subculture I osteoblasts (p = 0.001; p <
      0.001; p = 0.019). Ca(OH)2/TGF-beta 1 co-administration significantly increased
      total protein and collagen protein levels in subculture I osteoblasts as well (p
      = 0.048; p = 0.012). TGF-beta 1 increased total protein and collagen protein
      synthesis significantly in subculture V cells (p = 0.025; p = 0.01). These data
      indicate that co-administration of Ca(OH)2 and TGF-beta 1 enhances collagen
      synthesis by osteoblasts and may have implications for the clinical setting.

PMID- 11199788
TI  - Cementoenamel junction: microscopic analysis and external cervical resorption.
AB  - There is a lack of data regarding the shapes and distribution of the mineralized
      tissue that composes the cementoenamel junction. A sample of 198 permanent human
      teeth was analyzed by optical microscopy and scanning electron microscopy.
      Scanning electron microscopy showed three types of tissue interrelations: enamel
      overlapped by cementum; enamel and cementum edge-to-edge; and a gap, revealing a
      strip of exposed dentin. Using optical microscopy, a fourth type of cementoenamel
      junction was observed: cementum overlapped by enamel. The distribution of the
      hard tissues found at the cementoenamel junction is unpredictable and irregular
      both for any tooth type (e.g. on cuspids) and on any one individual tooth. Based
      on these results and on analysis of the mechanisms involved in cervical root
      resorption, it is possible to consider the cervical region as prone to external
      resorption.

PMID- 11199787
TI  - A comparison of the surface tension of calcium hydroxide mixed with different
      vehicles.
AB  - The aim of this study was to evaluate and compare the surface tension of
      different liquids that are used as potential agents to mix with calcium hydroxide
      in root canal treatment. We also tried to evaluate final surface tension values
      of the calcium hydroxide mixed with glycerin, Ringer's solution, anesthetic
      solution, and saline. Surface tension values were measured using a "Du Nouy"
      tensiometer. The results showed statistically significant differences between
      vehicles alone and the calcium hydroxide combinations and also indicated that
      anesthetic solution (p = 0.018, p < or = 0.02) is the most favorable vehicle with
      the lowest surface tension values.

PMID- 11199789
TI  - Lactate dehydrogenase leakage of hepatocytes with AH26 and AH Plus sealer
      treatments.
AB  - Numerous root canals filling materials are available in the field of dentistry,
      based on various formulas that contain a variety of different and partly
      mutagenic components, such as epoxy resin sealers, Ca(OH)2-based materials, and
      zinc oxide-eugenol cements. AH Plus root canal sealer will not release
      formaldehyde according to the manufacturer, although AH26 does. The purpose of
      this study was to analyze the leakage of lactate dehydrogenase (LDH) from rat
      hepatocytes after treatment with AH26 and AH Plus root canal sealers in vitro.
      Hepatocytes from male Sprague-Dawley rats were used to test the cytotoxicity of
      AH26 and AH Plus. The root canal sealers were mixed and then dissolved in the
      dimethyl sulfoxide to final concentrations of 0.01%, 0.04%, and 0.1% (wt/vol),
      with a dimethyl sulfoxide concentration of < 0.05%. Dosage-dependent and time
      dependent lactate dehydrogenase leakage values were measured and tested by one
      way ANOVA. The results showed that both AH26 and AH Plus are toxic to rat
      hepatocytes. At a low concentration, AH26 had a higher toxicity than AH Plus to
      rat hepatocytes.

PMID- 11199790
TI  - Biocompatibility of two current adhesive resins.
AB  - The purpose of the study was to evaluate the biocompatibility of two current
      adhesive resins and a calcium hydroxide cement. Fifty-four polyethylene tubes
      were filled with these dental materials, which were hand-mixed or light-cured
      according to the manufacturer's directions: group 1--Clearfill Liner Bond 2
      (Kuraray); group 2--Single Bond (3 M); and group 3--calcium hydroxide cement
      (Dycal-Dentsply). The materials were implanted into dorsal connective tissue of
      rats, which were killed 7, 30, and 60 days after the implantation procedure. The
      implant sites were excised, immersed in buffered Karnovsky's fixative, and
      processed using routine histological techniques. Sections of 6 microns thickness
      were stained with hematoxylin and eosin and assessed under light microscopy. Both
      adhesive resins at 7 days elicited a moderate/intense inflammatory reaction that
      decreased over time. Fibrous capsules surrounding the tubes were observed at 30
      days. Half of the samples in groups 1 and 2 showed thin fibrous capsule formation
      containing macrophages, capillaries, lymphocytes, fibroblasts, and collagen
      fibers. Connective tissue healing was observed even though many specimens
      exhibited a persistent inflammatory reaction mediated by macrophages and giant
      cells at the 60-day evaluation. Dycal allowed complete healing at 30 days with
      only a thin fibrous capsule. In conclusion, all experimental materials were
      successfully walled off by the connective tissue of the rat. However the adhesive
      resins may release particulates that may, in turn, induce a persistent local
      inflammatory reaction. Consequently, in this specific condition, these materials
      cannot be regarded as biocompatible. Dycal was less irritating than the adhesive
      resins and was better tolerated by the connective tissue.

PMID- 11199791
TI  - A method to assess rotary nickel-titanium files.
AB  - A number of studies have assessed the physical properties and durability of
      rotary nickel-titanium files. This study proposes a method that will permit this
      to be done in a controlled manner. Files of 0.04 taper; 25 mm in length; and in
      ISO sizes 25, 30, and 35 were each used four times in plastic blocks. The canal
      in the block had a working length of 17 mm; 30 degrees curvature; 15 mm radius of
      curvature; size 20 at the apex; and the curve began at 8 mm from the orifice of
      the canal. The irrigant used was Glyde. An electric handpiece was configured to
      rotate at 200 rpm and secured to the testing device, which also held the plastic
      block. The testing device controlled the depth of penetration at 17 mm; the load
      was at 8 N and the rate of penetration was at 120 mm/min. Controls were not
      subjected to use. Torsional moment (N-cm) and angular deflection (degrees) at
      failure were determined on a Torsiometer/Memocouple. Data (n = 5) were analyzed
      by analysis of variance. Tukey-Kramer intervals at the 0.05 significance level
      were determined. Torsional moment significantly increased with an increase in
      size. Torsional moment also significantly increased for used instruments,
      compared with controls. Angular deflection had a range of 480 degrees to 810
      degrees for the instruments tested.

PMID- 11199793
TI  - Stress analysis of human tooth root using various root canal instruments.
AB  - This study compared external root stresses from instrumentation by several motor
      driven nickel-titanium instruments to stresses developed by hand files. Twelve
      curved first molar mesial roots were invested in PLM-9 photoelastic material to
      disclose net stress transmitted from the canal through the dentin. Minimal fringe
      patterns were observed during instrumentation with all techniques. Light-speed
      yielded the least change. In no case was a complete 60 psi fringe change noted.

PMID- 11199792
TI  - Effect of various mixing ratios on antibacterial properties and hardness of
      endodontic sealers.
AB  - Most chemically cured two-component dental materials, including endodontic
      sealers, are marketed with mixing instructions but with no strict mixing ratios.
      The present study evaluated the antibacterial properties and hardness of three
      endodontic sealers: Roth's cement (RC), CRCS, and AH26, mixed to four controlled
      consistencies within the range of the manufacturer recommendations. Using
      Enterococcus faecalis as the test microorganism, antibacterial activity was
      evaluated by agar diffusion and direct contact test. Surface hardness of sealers
      with the same consistency was evaluated on week-old specimens by the Knoop
      Hardness Number tester. In the agar diffusion test, light consistency of RC
      showed larger zones of inhibition than heavier consistency, whereas no
      significant differences were found with AH26 or CRCS. In the direct contact test,
      RC and CRCS exhibited complete inhibition of bacterial growth at all
      consistencies, whereas AH26 with the heavier consistencies did not inhibit
      bacterial growth at 24 h samples. The hardness of AH26 and CRCS was significantly
      lower with lighter consistencies. It is concluded that endodontic sealers possess
      different antibacterial and physical properties according to their mixing
      consistencies.

PMID- 11199794
TI  - Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a
      retrospective study.
AB  - One hundred twenty-three pulp cappings had been performed by students in 1984 to
      1987 (= 10-yr group) or in 1990 to 1992 (= 5-yr group) and were followed up in
      1997. Teeth were checked for sensitivity (CO2/electrical pulp testing),
      percussion, and palpation; radiographs were taken to assess periapical status. In
      addition several other factors were determined that might have an influence on
      the success or failure rates, such as base material, type of restoration, site of
      exposure, etc. Results showed 44.5% failures (18.5% questionable and 37%
      successful cases) in the 5-yr group and 79.7% failing, 7.3% questionable, and 13%
      successful cases in the 10-yr group. As a factor of influence, the placement of a
      definitive restoration within the first 2 days after pulp exposure was found to
      contribute significantly to the survival rate of these teeth.

PMID- 11199795
TI  - Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in
      a root canal sealant.
AB  - A 41-yr-old patient experienced an anaphylactic shock reaction caused by
      formaldehyde in a root canal sealant during endodontic treatment. The clinical
      events, positive skin tests, and a high level of immunoglobin E to formalin RAST
      (class 4) suggest the involvement of immunoglobin E-dependent mechanisms toward
      formaldehyde. This very infrequent observation in endodontic therapy focuses
      attention on the different pathological manifestations related to formalin, their
      mechanisms, and the prevention possibilities in dentistry.

PMID- 11199796
TI  - Orifice locating with a microscope.
AB  - The purpose of this study was to determine whether the use of the dental
      operating microscope (DOM) could increase the number of root canal orifices
      located in mandibular molars. Ninety-three first and 111 second extracted
      mandibular molars were used. With the naked eye, all access cavities were
      prepared and the number of canals in each root was recorded. Using a DOM with x8
      x13 magnification, all teeth had the access cavity preparations again examined.
      With the naked eye, a total of 641 canals were seen in all teeth. After the DOM
      examination, 50 more canals could be visualized, representing a 7.8% increase in
      the total number of located canals. From these canals, 35 were located in the
      first molars and 15 in the second molars. The use of the DOM increases the number
      of root canal orifices located.

PMID- 11199797
TI  - Quality of apical seal in curved canals using three types of spreaders.
AB  - The aim of the present study was to evaluate the influence of spreader shape on
      the quality of obturation. Forty-five single canal teeth with varying degrees of
      apical curvature were used throughout. The canals were prepared using the step
      back technique and obturated with lateral condensation. The teeth were classified
      into three groups (A, B, and C) and treated as follows. Group A was treated with
      markedly conical, flat-ended spreaders (A to D; Dentsply-Maillefer, Ballaigues,
      Switzerland). Group B was treated with slightly conical (15 to 40) sharp-pointed
      CC-cord spreaders. Group C was treated with CC-cord, slightly conical but flat
      ended spreaders. The obturated teeth were decalcified in 7.5% nitric acid to
      obtain four cross-sections: the first at 2 mm from the apex and then the
      following three sections at 1-mm intervals. Section thickness was approximately 1
      mm. Each section was photographed under a stereoscopic microscope. The following
      areas were measured on each of the microphotographs using a planimeter: (a) gutta
      percha mass, (b) mass of sealer, (c) foreign bodies, and (d) empty spaces. These
      four areas were added to determine total cross-sectional canal area and then the
      percent of that area attributable to a and to b + c + d was calculated. The
      statistical analysis of the data (parametric Student's t test for independent
      groups) revealed that only in group B was the area occupied by a, the gutta
      percha mass, significantly greater at all levels than the area occupied by b + c
      + d. Next in obturation effectiveness was group C, followed by group A.

PMID- 11199798
TI  - Surface tension of root canal irrigants.
AB  - The aim of this study was to evaluate the surface tension values of established
      and potential endodontic irrigants to which a surface active agent had not been
      added. Additionally, Cetredixine, a surfactant-containing 0.2% chlorhexidine
      gluconate solution, was included in the measurements. Surface tension
      measurements were performed using the ring method on a DuNouy tensiometer at a
      standard room temperature. Ringer's solution, saline solution, and distilled
      water had the highest surface tension values, whereas those of NaOCl (2.5% and
      5%) and 17% EDTA were relatively low. Two anesthetic solutions, Ultracaine and
      Citanest, demonstrated values similar to NaOCl and EDTA, although a statistically
      significant difference was found between all solutions tested. Cetredixin
      displayed the lowest surface tension. A low surface tension agent should
      penetrate tubules better.

PMID- 11199799
TI  - Effects of the Nd:YAP laser on coronal restorative materials: implications for
      endodontic retreatment.
AB  - With new wavelengths that allow light transmission by optical fibers, the laser
      is now often used in endodontics either during treatment or retreatment. The aims
      of this study were to (i) specify the effects of laser irradiation on restorative
      materials in terms of topographic effects and (ii) describe different protocols
      for the first steps of retreatment. The laser used in this study was an optical
      fiber Nd:YAP (Lokki dt, Vienne, France) with a wavelength of 1.34 microns.
      Samples of the following restorative materials were prepared: amalgam, composite,
      permanent and temporary cements, and prosthodontic alloy. The handpiece of the
      Nd:YAP laser was fixed perpendicular to the surface of the different
      preparations. All trials were performed with the fiber tip either in contact with
      or at a distance of 2 mm from the material. The surface effects in all cases were
      (i) the creation of craters in the center of the lased areas, (ii) a border of
      fusion material at the edge of the craters, and (iii) cracks or fractures at a
      distance from the target areas. For the cements, amalgam and composite, the
      effects included a projection of material from the center to the edge of the
      lased area and/or the apparent photovolatization of light particles. For all
      materials the laser induced deeper absorption in the areas of direct contact than
      when it was held at a distance. This suggests that the fiber should be in contact
      with the restorative material for lasing in the straight part of the canal when
      the objective is either to pass through the material or alongside it between
      material and tooth. If the practitioner cannot determine the direction of the
      curve of the canal, lasing should be performed at a distance to weaken the
      material and thus permit more efficient use of an ultrasonic device. Lasing
      should in all cases be performed under close X-ray monitoring. Provided that
      sufficient caution is used, the laser may be helpful in removing restorative
      materials during retreatment.

PMID- 11199800
TI  - Isolation of Enterococcus faecalis in previously root-filled canals in a
      Lithuanian population.
AB  - The occurrence of Enterococcus faecalis in root canals of previously root filled
      teeth with apical periodontitis requiring retreatment was studied in Lithuanian
      patients. Twenty-five asymptomatic teeth were included in the study. Avoiding
      contamination microbiological samples were taken from the canals before and after
      preparation and irrigation with sodium hypochlorite and EDTA. Microbes were
      isolated from 20 of 25 teeth. E. faecalis was isolated from 14 of those 20
      culture positive teeth, usually in pure culture or as a major component of the
      flora. Second samples taken after preparation revealed growth in 7 of the 20
      teeth. Five of the seven cases were E. faecalis in pure culture. Isolation of E.
      faecalis was not related to the use of any particular root filling material in
      the original root filling. The results indicate that, rather than previous
      chemical treatment, it is the ecological conditions present in the incompletely
      filled root canal that are important for the presence of E. faecalis in these
      teeth.

PMID- 11199801
TI  - Quantitative analysis of catecholamines in human dental pulp.
AB  - Catecholamines are important elements of neuroendocrine regulation, and their
      concentrations in dental pulp are of interest. Two groups of teeth were used in
      this study: (i) healthy teeth and (ii) periodontally diseased teeth. After the
      processing of dental pulp obtained from the extracted teeth, the samples were
      analyzed in a computer-controlled Merck-Hitachi HPLC system at 280 nm wavelength.
      The external and internal standard methods of the HPLC Manager Program were used
      for validation. In healthy teeth the norepinephrine level of dental pulp was 4.86
      +/- 0.96 micrograms/g, whereas the epinephrine level was 8.1 +/- 1.18
      micrograms/g. In periodontally diseased teeth norepinephrine and epinephrine
      levels were significantly higher (p < 0.01) at 13.98 +/- 21.13 micrograms/g and
      1.42 +/- 0.32 micrograms/g, respectively. Dopamine could not be demonstrated in
      87% of the pulps. Summing up we succeeded in demonstrating norepinephrine and
      epinephrine in human pulp, but in most cases we could not demonstrate dopamine.
      Further investigations are needed on pulp tissue infected because of caries.

PMID- 11199802
TI  - Molecular epidemiology and association of putative pathogens in root canal
      infection.
AB  - The purpose of this study was to investigate the epidemiology of putative
      pathogens in root canals with apical periodontitis and to determine the
      associations among the putative pathogens. Eighteen symptomatic and 20
      asymptomatic teeth from 36 subjects were studied. This research was performed
      with polymerase chain reaction and hybridization using rRNA-based oligonucleotide
      probes. The most frequently found species was Fusobacterium sp. (68.4%), followed
      by Peptostreptococcus micros (44.7%) and Porphyromonas gingivalis (26.3%).
      Sixteen teeth (42.1%) contained one or more species of the selected black
      pigmented bacteria. Bacteroides forsythus and Treponema sp. were detected in 8
      teeth and 6 teeth, respectively. Among the analyzed bacteria, significant
      relationships were shown in the combination of B. forsythus/P. gingivalis and
      Treponema sp./P. gingivalis. There was no significant association between any
      bacteria and any symptoms.

PMID- 11199803
TI  - Structure and chemical composition of an experimentally formed apical barrier
      after the application of calcium-glycerophosphate.
AB  - Transformation in the structure and composition of calcium-glycerophosphate (Ca
      GP) was investigated using a scanning electron microscope fitted with an energy
      dispersive X-ray microanalysis (EDX) system. Ca-GP was packed inside roots that
      were subsequently implanted into the mandibles of rats to stimulate the formation
      of an apical barrier. Scanning electron microscopic observations of packed Ca-GP
      revealed three types of structures: globular aggregates, plate or flake-like
      aggregates, and granular aggregates. The average Ca/P molar ratios of EDX by area
      mode--postoperatively obtained at days 1, 3, 5, and 7--were 1.300, 1.533, 1.472,
      and 1.495 (analytic area: 0.01 to 0.03 mm2) and those of EDX by point mode were
      1.220, 1.451, 1.487, and 1.467 (analytic point: 0.05 micron 2). The magnesium
      (Mg) weight percentage was found to be approximately 1.9 at days 3, 5, and 7,
      similar to Mg-substituted whitlockite. These findings suggest that Ca-GP are
      transformed, over a period of 3 days into Mg-substituted whitlockite as a result
      of being hydrolyzed by tissue fluid.

PMID- 11199804
TI  - A survey of participation in managed care programs by endodontic specialists.
AB  - A survey was published in the Quarterly Survey of Dental Practice (QSDP) Special
      Topics that dealt with contractual agreements in dentistry. This survey evaluated
      general dental practitioner participation apart from that of dental specialists
      in general. The Quarterly Survey of Dental Practice survey was modified and used
      in the present study to specifically determine the participation by endodontists
      in various contractual insurance agreements, including Preferred Provider
      Organization and Health Maintenance Organization programs. A 10% sample of
      practicing endodontists was randomly selected to participate in this survey.
      Questionnaires (331) were sent out, and 229 or 69% were returned. Total
      participation by endodontists responding to this survey in any Health Maintenance
      Organization and/or Preferred Provider Organization insurance plans was 31.3%;
      however the total percentage of patients treated under these insurance plans was
      only 6.6%. These results were similar to those in the 1994 survey in which it was
      shown that 27% of the general dental practitioners and 41% of the dental
      specialists participated in one or more of these insurance programs and treated
      respectively, 5% and 9%, of their patients under these plans. Although
      participation in various managed care programs by endodontists in this survey was
      close to one-third, the total number of patients treated under these plans was
      low. Overall patients treated under fee-for-service arrangements by endodontists
      responding to this survey formed 85.3% of their patient pool. It does not appear
      from the results of this survey that managed care insurance has a significant
      impact on the practice of endodontics. It can be postulated that endodontists are
      unwilling to accept more than a small reduction in fees to join managed care
      plans, and they also desire to retain full control of their dental practice.

PMID- 11199805
TI  - Measurement of endodontic file lengths: a density profile plot analysis.
AB  - The purpose of this study was to evaluate measurements of endodontic files of
      known length and diameter using a density profile plot analysis of digital
      images. Ten single-rooted teeth with relatively straight roots in cadaver
      specimens were used. The crowns of the teeth were removed and a rectangular
      orthodontic wire, 5.13 mm in length, was placed horizontally on the occlusal
      surface to serve as a calibration reference point. The #8, #10, #15, and #20
      FlexOFiles were measured to the nearest 0.5 mm and then placed to four working
      lengths that terminated within the apical third of each root. A GE X-ray unit and
      a Schick CDR #2 sensor were used to digitally acquire 160 images. The digital
      images were placed in random order and an independent, blinded investigator
      determined the file length using a density profile plot analysis. The
      measurements generated by the histogram analysis (experimental) were compared
      with the original clinical measurements. The paired t test, intraclass
      correlation coefficient, and the Bradley-Blackwood test were used to assess
      reliability. The results revealed that the means of the experimental measurements
      of all file sizes were within 0.5 mm of the known lengths and were always shorter
      than the known lengths. Also, the larger the file size the less deviation from
      the known lengths: #20, -0.16 mm (p = 0.0001); #15, -0.21 mm (p = 0.0001); #10, 
      0.34 mm (p = 0.0001); and #8, -0.45 mm (p = 0.0001). This study demonstrated that
      the density profile plot analysis might be a useful adjunct for the measurement
      of endodontic file lengths on a digital image.

PMID- 11199806
TI  - Accessory branch of the mental nerve.
AB  - This case report presents a surgical case in which an accessory branch of the
      mental nerve exited the mandible distal and slightly superior to the mental
      foramen. Careful manipulation of the surgical site allowed proper identification
      of the mental nerve, and the accessory branch and permanent nerve damage was
      avoided.

PMID- 11199808
TI  - Diagnostic thermal pulp testing: a technique.
AB  - This paper presents a technique for thermal testing that has proved useful where
      the usual diagnostic routine was unable to clarify the problem.

PMID- 11199807
TI  - Hemangioma of the mandible presenting as a periapical radiolucency.
AB  - A case of an hemangioma of the mandible in a 53-yr-old female patient is
      presented. The lesion was removed, and no atypia or mitotic cells were found. The
      excision was curative, and the overall prognosis was excellent. A differential
      diagnosis of radiolucent periapical lesions of the mandibular symphysis is
      presented.

PMID- 11199809
TI  - Dyskinesia in Parkinson's disease. Pathophysiology and clinical risk factors.
AB  - Development of dyskinesia is a common phenomenon during the long-term course of
      Parkinson's disease. During the last few years some but not all pathogenetic
      mechanisms causing dyskinesias in PD have been better understood. Severity of
      Parkinson's disease and levodopa dosing are the main clinical risk factors. Most
      concepts underline the significance of pulsatile D1-receptor stimulation for the
      development of dyskinesias. The interactions between D1- and D2-mediated STR-Gpi
      pathways and co-localized neuropeptides are important but not fully understood.
      Glutamatergic overactivity might also be a significant pathogenetic factor.
      According to these pathophysiological concepts, therapeutic strategies focus
      mainly on continuous postsynaptic DA-receptor stimulation by long acting DA
      agonists or highly selective D2 agonists. Another strategy is the use of NMDA
      antagonists.

PMID- 11199810
TI  - Long-term treatment with dopamine agonists in idiopathic Parkinson's disease.
AB  - Long-term treatment studies with any antiparkinsonian drug are rather limited.
      Especially, double-blind, randomized and multicenter studies do not exist except
      for some rare exceptions. Nonetheless, such studies are mandatory to prove
      certain therapy regimens. This overview reports on the comparison between
      dopamine agonists and levodopa. There are open studies comparing bromocriptine,
      lisuride, pergolide with levodopa which demonstrate that the use of dopamine
      agonists in monotherapy or combination with levodopa decreases the percentage of
      patients who develop dyskinesias compared to levodopa only. A long-term study was
      performed with cabergoline (3 years) which was extended in an open trial for
      another 2 years and which underlined the above mentioned observation. In a very
      recent study, ropinirole was compared with levodopa. This double-blind study
      spans 5 years and shows that about 30% of patients were able to stay for 5 years
      on ropinirole monotherapy, that withdrawal rate was not higher in the dopamine
      agonist group and that the side effects were similar in the levodopa and the
      ropinirole group. The major finding of this study was a very low dyskinesia rate
      when treating patients with ropinirol alone. Thus, this study underlines our
      therapy concept which advocates the early use of dopamine agonists in IPS.

PMID- 11199811
TI  - SPECT and PET imaging of the dopaminergic system in Parkinson's disease.
AB  - This paper gives an overview of the clinical importance of SPECT and PET imaging
      of the dopaminergic system in the differential diagnosis and for the
      determination of the progression rate of Parkinson's disease (PD). D2 receptor
      imaging can help to differentiate multiple system atrophy (MSA) and progressive
      supranuclear palsy (PSP) from PD. In patients treated with neuroleptics it is
      possible to determine the rate of striatal D2 receptor blockade using this
      technique. This occupancy rate parallels the occurrence of parkinsonian side
      effects. Its measurement helps in the selection of newer atypical neuroleptics,
      which can be used to treat drug-induced psychosis in PD because they do not
      aggravate parkinsonian symptoms. Imaging of dopaminergic neurons with [123I]beta
      CIT SPECT or [18F]DOPA PET is a way to visualize and quantify the nigrostriatal
      dopaminergic lesion in PD. Findings correlate with clinical rating scales and
      demonstrate the feasibility of detecting the preclinical lesion in patients with
      hemiparkinson or familial PD. [123I]beta-CIT SPECT can easily distinguish
      patients with essential tremor and patients with "lower body parkinsonism" due to
      a subcortical vascular encephalopathy. MSA and PSP cannot be separated from PD
      with this method alone. Longitudinal studies with [123I]beta-CIT SPECT and
      [18F]DOPA PET can quantify the progression rate in PD. SPECT results from our own
      group show a low rate of progression in patients with a long duration of disease
      and a more marked progression rate in patients with shorter disease duration. In
      the former group regions in the striatum with higher beta-CIT binding at the time
      of the first SPECT scan decline faster than regions with lower binding. These
      findings suggest a curvilinear course of progression which starts at different
      time points in different striatal regions and which levels off after several
      years of disease duration. These findings are in line with data from PET studies
      and underline the importance of an early start of neuroprotective strategies.
      Preliminary data from PET and SPECT studies in early PD suggest that dopamine
      agonists might have a slight neuroprotective effect and might slow down the rate
      of progression of the disease.

PMID- 11199812
TI  - Parkinson's disease and sleep.
AB  - There are many reasons for patients with idiopathic Parkinson's disease to
      develop sleep disorders and subsequent daytime sleepiness. Important causes are
      reduction of total sleep duration and sleep efficiency, and an increase in
      respiratory and motor arousals. This daytime sleepiness at first glance seems
      different from the "sleep attacks" which caused motot vehicle mishaps reported
      recently in persons taking pramipexole and ropinirole. There is, however, only
      little evidence that we deal with a new phenomenon in a new clinical situation,
      i. e. cataplexy-like attacks after high doses of new non-ergot dopamine-agonists.
      Until now there is no single case of a proven cataplexy on one hand, and older
      dopamine agonists like pergolide as well as L-Dopa + carbidopa have been reported
      to induce sudden onsets of sleep, too.

PMID- 11199813
TI  - Effects of parkinsonian medication on sleep.
AB  - Patients suffering from Parkinson's disease (PD) often report about sleep
      disorders and excessive daytime sleepiness. To some extent, motor disabilities or
      neural degeneration of sleep modulating structures may be responsible for these
      effects. Depressive disorders also contribute to the occurrence of insomnia and
      daytime sleepiness. Nevertheless, dopaminergic, anticholinergic, and other drugs
      used in PD have a great impact on sleep/wakefulness mechanisms. They may
      indirectly improve or worsen sleep by changing motor symptoms such as akinesia,
      hyperkinesia, or tremor. Although their is only little information on the complex
      regulation of vigilance, it is well known that monoaminergic and cholinergic
      drugs could influence it directly. Data from animal experiments and clinical
      experiences led to the hypothesis of a biphasic influence on sleep by
      dopaminergic substances: small doses of L-Dopa e. g. appear to improve sleep
      whilst higher doses led to insomnia. Different dopaminergic receptor types or
      changes in receptor sensitivity may explain these phenomena. Dopaminergic and
      anticholinergic drugs suppress REM sleep. Recently, initial data on 'sleep
      attacks' after pramipexole or ropinirole treatment were published. Our
      preliminary results using 24 h polygraphic recordings showed excessive daytime
      sleepiness in patients taking ropinirole and L-Dopa which disappeared when
      changed to ropinirole monotherapy. Sleepiness did never appear as an irresistible
      attack. Current hypotheses on this topic are reviewed.

PMID- 11199814
TI  - Parkinson's disease and the ability to drive.
AB  - Criteria for assessment of the ability to drive in Germany are based on
      guidelines published by the Gemeinsamer Beirat fur Verkehrsmedizin and
      incorporated into the legislation. Decisions relating to the ability to drive
      must always be taken on an individual basis. In parkinsonian patients the ability
      to drive is very often impaired by motor symptoms, psychiatric complications,
      multimorbidity, increased daytime sleepiness and especially by cognitive
      disturbances. Increased daytime tiredness is common in Parkinson's disease with
      additional sedative effects of all dopaminergic agents (e. g., pramipexole,
      ropinirole). Unwanted falling asleep (e. g., at the wheel) can be avoided if
      notice is taken of the early signs of tiredness. A recommendation is included how
      to advise patients with Parkinson's disease treated with a dopamine agonist
      regarding the ability to drive.

PMID- 11199815
TI  - Costs in the treatment of parkinsonism.
AB  - Parkinson's disease imposes a considerable economic burden on our society. Apart
      from the direct costs for therapy, the indirect costs of the disease are
      estimated to be substantially higher. Unfortunately, only the high costs of
      current medication are usually considered, when financial aspects are discussed.
      An ideal therapy should ameliorate the symptoms of the disease and achieve a high
      quality of life. but the prognosis should also be improved. Cost estimates have
      to be extended throughout the course of the disease. We recommend a treatment
      schedule which is expected to result in a favorable cost profile when the entire
      course of the disease, is considered. L-Dopa monotherapy in working patients is
      obsolete. During the course of the disease dopamine agonists, amantadine,
      budipine, COMT inhibitors and selegiline will be used.

PMID- 11199816
TI  - Workshop I: Parkinson's disease and sleep--results of the group discussion.
AB  - The group agreed on the facts that unwanted sleep onset has been observed after
      non-ergot as well as ergot dopamine agonists, that patients on these drugs need
      to be warned, that patients who have experienced sleepiness already must not
      drive a car unless the dosage is lowered and sleepiness has vanished, that a
      genetic predisposition for narcoleptic cataplexy has to be ruled out, that
      predictors of so-called sleep attacks need to be explored individually with the
      help of sleepiness scales and collectively in a careful study, respectively.

PMID- 11199817
TI  - Workshop II: "neuroprotection"--the Lugano consensus.
AB  - Consensus could be reached that there is overwhelming evidence of preclinical
      neuroprotection. However, the evidence of neuroprotection/neurorescue under
      clinical conditions is limited. Lessons from clinical trials designed to show
      neuroprotection (selegiline, amantadine, dopamine agonists) demonstrate that with
      the drugs available neuroprotection/neurorescue has to start as early as
      possible. A PET-controlled clinical trial with ropinirole shows that there seems
      to be a good chance for neuroprotection in the early phase of Parkinson's disease
      in patients treated from the very beginning of the disease while there is no such
      benefit in patients with a late start of a neuroprotective therapeutic strategy.
      Also long-term neuroprotection cannot be reached. Complicating factors to
      demonstrate clinical neuroprotection are discussed.

PMID- 11199818
TI  - Workshop III: late motor complications of Parkinson's disease.
AB  - The aim in the current treatment of Parkinson's disease is to delay L-Dopa
      administration and to keep the L-Dopa dosage as low as possible. Such a treatment
      strategy can delay the onset of late motor complications and reduce their
      severity. L-Dopa remains the most potent anti-parkinsonian medication, but its
      use for the initial therapy of Parkinson's disease is limited to elderly
      patients. In all other cases, dopamine agonists, budipine, amantadine and
      selegiline are primarily used. With the occurrence of late motor complications
      continuous dopamine receptor stimulation becomes essential. In this situation,
      combination therapy has to be individualized, with dopamine agonists playing a
      key role. In addition, COMT inhibitors, budipine, amantadine and selegiline may
      be used. Anticholinergic drugs are of very limited importance in the current
      treatment of Parkinson's disease.

PMID- 11199819
TI  - Workshop IV: drug treatment guidelines for the long-term management of
      Parkinson's disease.
AB  - An attempt was made to establish a decision algorithm for the treatment of
      idiopathic Parkinson's disease at various stages and in different subgroups such
      as akinetic-rigid or tremor dominance type. We suggest treating young patients
      with selegiline and a dopamine agonist. In the tremor dominance type we use
      either budipine or a dopamine agonist. Due to levodopa-induced dyskinesia, we try
      to avoid levodopa in the early stages of the disease and use it only later in
      more advanced situations in a combination therapy with dopamine agonists. Since
      IPS is not only based upon dopamine deficiency but also on resulting
      glutamatergic overstimulation, we advocate the use of a glutamate antagonist such
      as amantadine or budipine. Catechol-O-methyl inhibitors are very helpful when
      wearing-off occurs. Anticholinergics are only used in the early stages of tremor
      dominant IPS because we fear enhancing the risk of dementia.

PMID- 11199820
TI  - Is there neuroprotection in Parkinson syndrome?
AB  - Parkinson's disease (PD) is a neurodegenerative disorder of the aging population
      with unknown etiopathogenesis. It is assumed that the underlying pathobiochemical
      processes comprise multifactorial and multigenetic disturbances leading to a
      progressive and devastating disorder without remission. Subtypes exist suggesting
      that "PD" is a spectrum disorder with variations in the cascade of
      pathobiochemical and genetic events. Neuroprotective endogenous processes are
      lost at the very beginning of PD. Supplementation of substances with
      neuroprotective and/or neurorescue capacity is eminent for future therapeutic
      strategies. MAO-B inhibitors, NMDA-receptor antagonists and dopamine receptor
      agonists fulfill such a criterion in preclinical studies while there is no clear
      evidence for clinical neuroprotection. However, PET-controlled studies comparing
      L-DOPA-treated and ropinirol-treated PD patients give evidence for the "concept
      of neuroprotective treatment strategies".

PMID- 11199821
TI  - Lessons, labels, license, uses, and the FDA.

PMID- 11199822
TI  - Diode laser (980 nm) in oral and maxillofacial surgical procedures: clinical
      observations based on clinical applications.
AB  - OBJECTIVE: The aim of this study was to examine the wound healing of soft tissue
      after the application of a diode laser (980 nm) in oral surgical procedures.
      SUMMARY BACKGROUND DATA: Like the CO2 laser, the diode laser can be used for soft
      tissue surgery without extensive experience in the field of oral surgical.
      METHODS: A diode laser was used to treat a variety of oral soft tissue lesions in
      22 patients. The oral surgical procedures included removal of soft tissue tumors,
      frenectomies, excision of gingival hyperplasias, vestibuloplasties, hemangioma
      removal, and periimplant soft tissue surgery. The laser was used in both pulsed
      and continuous modes, with and without contact to the tissue. Intraoperative and
      postoperative clinical observations are reported. RESULTS: Our preliminary
      clinical findings include sufficient hemostasis and precise incision margin with
      all of the surgical procedures. The coagulation properties, associated with the
      use of a diode laser, were particularly beneficial during removal of vascular
      lesions. The postoperative advantages, i.e., lack of swelling, bleeding, pain or,
      scar tissue formation, and the good wound healing were observed in all of the
      clinical applications and were dependent only on the laser physical parameters
      used. CONCLUSIONS: The clinical application of the diode (980 nm) laser in oral
      and maxillofacial surgical procedures seems to be of beneficial effect for daily
      practice.

PMID- 11199823
TI  - The fluidodynamics of potentially neoplastic plumes produced by medical lasers:
      first quantitative non-tissue-specific measurements using PMMA samples (phase I).
AB  - OBJECTIVE: This study has two goals: (1) to identify and discuss key factors that
      contribute to the spread of potentially dangerous plumes chaotically in the
      vicinity of patients following surgery with medical lasers and (2) to recommend
      safety procedures for surgical staff members based on the measurements, analysis
      of results, and conclusions. SUMMARY BACKGROUND DATA: In the past years, only a
      few studies have attempted to quantify the risks associated with routine exposure
      to plumes generated by medical lasers used to treat malignant tissue. The
      invasive thermodynamic sublimation processes following beam-tissue interaction
      generate plumes, which also contain particles of tumoral tissue not completely
      burned by the laser beam itself. These fumes can also be chemical by-products
      produced by normal tissue combustion. In both cases they retain a certain degree
      of malignancy (mainly depending on the type of tumor and by-product), which could
      result in spreading metastasis in the respiratory system of the surgical staff
      members and of the patient following inhalation. Only a few studies in the
      literature discuss this phenomenon, but all of them demonstrate clearly that
      current fume evacuator systems based on fixed air suctioning probes near the tip
      of the laser's focal head do not guarantee sufficient aspiration of the total
      dangerous gas volume (mixture of air and fumes) generated during complete
      surgical intervention. METHODS: The author has made several measurements of the
      size, shape, dimension, and speed of the plumes associated with crater
      development in polymethylmethacrylate (PMMA) blocks exposed to a pulsed CO2 laser
      beam. The laser device has been optimized for visualization via the thermocamera
      and each smoke burst was measured as follows: 2.5 and 5 inch focal lengths, peak
      energy of 33 mJ, TEM00 mode, 4 Hz, pulse width tp = 10 msec, and total exposure
      time te = 10 sec have been used to irradiate 3 x 2 x 3 cm3 PMMA blocks. From a
      pure thermochemical point of view, PMMA has been used as the gross first
      approximation medium for a large variety of biological tissues because the aim is
      to provide a global non-tissue-specific modeling rather than a very detailed
      investigation of the large variety of possible combinations of tissues exposed to
      the laser beam. This part of the study is necessary and it will be addressed in
      Phase II of this project. RESULTS: A quantitative description of the dynamic
      process present in the production of plumes with PMMA samples has been obtained
      along with the quantification of seven key parameters, such as ejection
      velocities and plume size, which accurately describe the process itself.
      CONCLUSIONS: Although this can be only a first approximation study, its results
      provide a very good idea about the orders of magnitude of the key parameters
      involved in the processes and dynamics of global plume production. The author
      suggests how these conclusions can be extrapolated for in vivo applications and
      can be used as recommendations to design new suctioning devices aimed at
      increasing safety in the operating room.

PMID- 11199824
TI  - Treatment of cervical dentin hypersensitivity by various methods using pulsed
      Nd:YAG laser.
AB  - OBJECTIVE: The purpose of this study was to evaluate the results of two
      irradiated regions, the cervical and apical, for cervical dentin hypersensitivity
      treatment using pulsed a Nd:YAG laser with or without black ink. SUMMARY
      BACKGROUND DATA: There has been no reports on the irradiated area(s) except the
      cervical region for dentin hypersensitivity treatment using pulsed Nd:YAG laser.
      METHODS: A total of 180 teeth diagnosed with cervical dentin hypersensitivity in
      54 (39 females, 15 males, aged 21 to 73) healthy adult patients were included in
      this study, and teeth were randomly divided into four groups of 45 each.
      Sensitivity was rated using a blast from a fully depressed air syringe on a four
      grade scale both before and up to 2 months after laser treatment. The
      effectiveness was evaluated on the change in the degree of hypersensitivity after
      laser treatment. The tooth surfaces in groups 1 and 2 were observed by the
      replica model method using scanning electron microscopy (SEM). RESULTS: The
      methods of irradiation at the cervical regions were better than those at the
      apical regions except for the period 2 months later. The laser effect was
      enhanced by black ink at both areas. The effective (excellent and good) rate was
      decreased depending on the time in every group. SEM observation at the tooth
      surfaces from group 2 showed that dentinal tubules were occluded or narrowed
      after laser irradiation. CONCLUSIONS: These results show that the method of
      irradiation by a pulsed Nd:YAG laser at cervical regions with black ink is the
      most effective for cervical dentin treatment of hypersensitivity and recurrence
      by this method is less than in other methods.

PMID- 11199825
TI  - A study on the morphological changes of the rat mandibular bone with TEA CO2
      laser.
AB  - OBJECTIVE: The purpose of this study was to investigate the morphological changes
      of the bone structure induced by transversely excited, atmospheric TEA pressure
      CO2 laser irradiation. Moreover, the healing process at 3 weeks was also
      observed. SUMMARY BACKGROUND DATA: It has been demonstrated that dental hard
      tissue can be removed by a long pulse of TEA CO2 laser irradiation with minimal
      thermal damage. However, there are few studies on the morphological changes of
      the TEA CO2 laser on bone tissue. METHODS: The TEA CO2 laser was irradiated on
      the surface of the rat mandibular bone under the following irradiation
      conditions: wavelength, 10.6 microns; output, 95 mJ/pulse; pulse repetition rate,
      1 Hz; irradiation time, 7.5 microseconds/shot; spot size, 0.8 x 1.5 mm; energy
      density, 7.9 J/cm2. Histological and scanning electron microscopic examinations
      were performed. RESULTS: In the stereoscopic examination, a defect with clean-cut
      margins was produced. In the light microscopic examination, a basophilic line at
      the bottom of the defect was noted. Examining the defect with SEM, a smear-like
      appearance and cone structures were found. In the histological examination, a
      healing process by formation of new bones at the junction site was recognized.
      CONCLUSIONS: These findings suggest that it is possible to remove bone tissues by
      TEA CO2 laser irradiation. However, a particle-like structure associated with a
      basophilic line and melted surface indicated that some thermal damage was
      produced during the laser irradiation.

PMID- 11199826
TI  - Increasing the width of periodontal attached gingiva using an Nd:YAG laser and
      GTM: results of a clinical study.
AB  - OBJECTIVE: Demonstrate a new technique to increase the width of keratinized
      gingiva using a biological membrane material in place of donor tissue. SUMMARY
      BACKGROUND DATA: Most current surgical techniques require donor tissue as a graft
      to increase keratinized gingiva, which results in a second trauma site for the
      patient. METHODS: Using an Nd:YAG laser with contact tip. Laser energy at
      settings of 3.0-6.0 W continuous mode. Local anesthetic, lidocaine 2% and
      epinephrine 1:100,000, was administered. A mucogingival flap was made to the
      periosteum and reflected, followed by placement of a biological membrane, and
      sutured into place, over the surgical site. RESULTS: A total of 20 sites were
      treated on 20 different patients of 15 mandible and 5 maxillary sites. The
      average increase for all sites was 3.8 mm of keratinized gingiva per site. No
      adverse events (e.g., bleeding, allergic reactions, abscesses, or pain) after any
      of the treatments were noted during the entire observation. The treatment
      procedure led to significant improvements in width of gingiva. The 20 patients
      were pleased with this new technique using the Nd:YAG laser with contact tip.
      CONCLUSION: It may be concluded that the new procedure provides significant
      increase of keratinized gingiva with the advantage of minimal morbidity and
      pleasing cosmetic results. Further clinical studies are needed to compare
      traditional procedures with the laser augmentation technique.

PMID- 11199827
TI  - Acquired acid resistance of dental hard tissues by CO2 laser irradiation.
AB  - OBJECTIVE: This investigation was performed to evaluate the effect of CO2 laser
      irradiation on the acquired acid resistance of dental hard tissues to artificial
      caries-like formation and the ultrastructure of lased areas was morphologically
      investigated in vitro. SUMMARY BACKGROUND DATA: In recent years, many studies
      have been carried out to evaluate the effect of the CO2 laser on the enhanced
      resistance to artificial caries formation of enamel. However, a limited number of
      papers concerning its effect on dentin have been published. METHODS: A CO2 laser
      of 10.6 microns wavelength was used to irradiate human enamel and dentin samples
      from 20 extracted human molar teeth, and samples were subjected to 2 microliters
      of 0.1 M lactic acid solution (pH 4.8) for 24 h at 36 degrees C. The parts per
      million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by
      atomic absorption spectrophotometry and the morphological changes were
      investigated by scanning electron microscopy (SEM). RESULTS: The lowest mean Ca2+
      ppm was recorded in the samples irradiated at 3 W, followed by 2 W, 1 W, and
      unlased samples. SEM observation showed that the lased areas were melting with
      solidification of the smear layer. Even after acid demineralization, the lased
      surfaces were almost unchanged. CONCLUSIONS: The results of this study suggested
      that CO2 laser irradiation could sufficiently melt and solidify the enamel and
      dentin surfaces and thus enhance resistance to artificial caries-like formation.

PMID- 11199828
TI  - Ablation depths and morphological changes in human enamel and dentin after Er:YAG
      laser irradiation with or without water mist.
AB  - OBJECTIVE: This investigation was performed quantitatively to determine the
      ranges of ablation and to evaluate the morphological changes in human enamel and
      dentin irradiated by Er:YAG laser with or without water mist. SUMMARY BACKGROUND
      DATA: Recently, several infrared lasers have been introduced in the dental clinic
      to remove carious dental hard tissues in anticipation of replacing the high-speed
      dental drill. Among them, the Er:YAG laser has shown the most promise for hard
      tissue ablation. METHODS: An Er:YAG laser was used to ablate human dental hard
      tissues using a pulse energy that ranged from 100 to 400 mJ at a frequency of 2
      Hz for 5 seconds. Ablation rates with or without water mist at different pulse
      energies were measured, and the morphological changes on enamel and dentin were
      also investigated by stereomicroscopy and scanning electron microscopy (SEM).
      RESULTS: The relationship between ablation depths and energies was almost linear
      at both enamel and dentin samples. The irradiation with water mist reduced the
      ablation depths, but only minimally, when compared to those irradiated without
      water mist. Morphological findings by SEM indicated that Er:YAG laser irradiation
      with water mist could produce the cavities without signs of thermal damage to the
      surrounding enamel and dentin. CONCLUSIONS: The results of this study suggest
      that addition of a fine water mist directed at the ablation sites does not
      greatly decrease the ablation, and does not cause any carbonization and melting
      in the surrounding dental hard tissues.

PMID- 11199829
TI  - Three years of clinical evaluation of endodontically treated teeth by 15 F CO2
      laser microprobe: in vivo study.
AB  - OBJECTIVE: Evaluation of the efficiency of 15 F CO2 laser microprobe, in cases of
      periapical lesions. The elimination of the pathological reaction caused by
      certain species of bacteria by reduction of reinfection and stimulation of
      osteogenesis. SUMMARY BACKGROUND DATA: Until now, no suitable delivery fiber
      existed for CO2 laser endodontic radiation in the apical region where it is most
      difficult to eliminate the pulp tissue using conventional methods. To overcome
      this problem, Sharplan Lasers designed a microprobe that reaches closer to the
      apex, distributing the energy density to a smaller area of the root canal, thus
      favorably increasing the thermal effects. METHODS: The study was conducted on 900
      teeth, corresponding to 1512 root canals, divided in two groups. Four hundred
      sixty-eight were new cases, carefully selected according to strict parameters
      such as wide periapical translucency over 1 mm, supported by digital x-ray, with
      a lesion of 3 mm and more. All root canals were mechanically prepared in the
      conventional method up to size 35, Physiological saline solution served as
      rinsing solution and the root canals were treated by 15 F CO2 laser microprobe
      for 60 pulses repeatedly. The temperature at the surrounding tissue of the root
      did not exceed 38 degrees C. RESULTS: Filling of the canal was possible at the
      same appointment, without antibiotic treatment. Four hundred thirty-two of the
      cases, which were referred to us by other dentists after an unsuccessful
      treatment according to the classic therapy, were treated by the same laser
      therapy. Follow-up was performed by clinical examination, and a digital x-ray was
      taken, during and after treatment as well as after 3, 6, 9, and 12 months.
      CONCLUSIONS: There is a 98% success rate in both study groups, according to
      objective criteria for successful treatment including reduction of apical
      translucency after 2-6 months, freedom from clinical complaints, and no need for
      periapical surgery.

PMID- 11199830
TI  - A comparison of three methods for the diagnosis of sound, stained, and carious
      dentine: conventional, mechanico-acoustic, and laser-acoustic methods.
AB  - OBJECTIVE: The authors examined two novel and objective methods for diagnosing
      stained, carious, and sound dentine, a mechanico-acoustic method and a laser
      acoustic method, and compared these with the conventional but subjective method
      of visual and tactile assessment using a dental probe. SUMMARY BACKGROUND DATA:
      It is accepted clinical practice to leave stained but relatively firm dentine on
      the pulpal surface of dental cavities prepared for restoration. The problem for
      the clinician is in deciding which dentine is carious and which is stained but
      acceptable to be left in situ. There is no objective method for making this
      decision, it is usually made on the basis of visual examination and tactile
      assessment using a dental probe. METHODS: The authors used Fourier analysis of
      acoustic waves arising from mechanical (dental probe) or laser (Er:YAG laser)
      interaction with the tooth surface and compared the results with the subjective
      assessment of the same tissue surfaces as judged by a clinician using visual and
      tactile assessment with the same dental probe. RESULTS: The results showed that
      both the mechanico-acoustic and laser-acoustic methods were more accurate and
      more objective than the conventional visual/tactile method and that an analysis
      of both the integral and spectral signals produced by the Er:Yag Laser (lambda =
      2.94 microns) allowed for a more accurate diagnosis than the other two methods
      examined. CONCLUSIONS: Both mechanico-acoustic and laser-acoustic methods of
      diagnosing sound, stained, and carious dentine were more accurate than the
      subjective visual/tactile method using a dental probe. The laser-acoustic method
      was the most accurate of all of the methods compared. An advantage of the laser
      acoustic method is that it could be included into the actual process of cavity
      preparation when using an Er:YAG laser, providing an objective and more accurate
      assessment of the nature of the remaining dentin and may therefore be more
      economic of time, eliminating the necessity for constant cessation of drilling to
      assess the nature of the target tissue.

PMID- 11199831
TI  - Study on apical leakage of the teeth after argon laser treatment and obturation.
AB  - OBJECTIVE: This study was performed to compare the apical leakage degree after
      laser treatment and obturation with that without laser treatment, and to evaluate
      the efficiency of argon laser irradiation in removing debris and smear layer from
      the prepared root canal walls in vitro. SUMMARY BACKGROUND DATA: There has been
      no report of laser effect on apical leakage after laser treatment and obturation.
      METHODS: Fifty-six human extracted single root teeth were used in this study.
      Teeth were divided into four groups of 14 teeth each and prepared up to a #60 K
      file size at 1 mm short of the apical foramen using a step-back technique. Argon
      laser at the wavelength of 470 nm and at the output of 0.3 W was irradiated at
      apical stop for 1, 2, or 3 seconds at the continuous mode. In each group, ten
      teeth for the microleakage study were obturated and immersed in rhodamine B
      solution for 48 hours at 37 degrees C, and the others were used for the
      observation by scanning electron microscopy (SEM). All teeth were bisected
      longitudinally and observed by stereoscopy or SEM. RESULTS: The apical leakage
      degree after laser treatment and obturation was reduced compared to that in the
      control, but not significantly (p > 0.05). However, debris and smear layer in the
      laser-treated groups were removed from apical stop even at low energy density.
      CONCLUSIONS: These results suggest that apical leakage after argon laser
      treatment is not reduced significantly, but that argon laser is useful for
      removing debris and smear layer from root canals.

PMID- 11199832
TI  - Characterization of enamel and dentin response to Nd:YAG picosecond laser
      ablation.
AB  - OBJECTIVE: We investigated the main characteristics of human dental tissue under
      Nd:YAG picosecond laser ablation. SUMMARY BACKGROUND DATA: The use of ultrashort
      laser pulses for teeth ablation prevents overheating and is an alternative for
      mechanical material removal; it also minimizes the volume of damaged material.
      METHODS: Laser pulses of picosecond at 15 Hz repetition rates from a Q-switched
      and mode-locked Nd:YAG laser were focused on sound human molars for 30 seconds.
      Variation of light intensity in the pulse train allowed us to obtain drilled
      holes with different characteristics. Enamel and dentin surfaces were examined by
      optical and scanning electron microscope (SEM). The samples consisted of three
      sound human molars. The ablation rate was determined after taking an average of
      all samples. RESULTS: Images from the SEM showed an interesting contrast between
      the morphology of the ablated enamel and dentin regions. In enamel, the ablated
      region appears to be more superficial than in dentin. The dentin fragility
      normally causes cracks that originate in the ablated region. The ablation rates
      in both enamel and dentin demonstrate a saturation behavior as the laser
      intensity increases. Furthermore, the ablation rate in dentin is about eight
      times greater than in enamel for the same laser fluence. CONCLUSION: Our results
      show an important correlation between the surface morphology and the pulsed laser
      fluence, which is compatible to the ablation mechanisms presented when ultrashort
      laser pulses are used.

PMID- 11199833
TI  - "New lamps for old": technology dreams and risks.

PMID- 11199834
TI  - Skin resurfacing improved with a new dual wavelength Er:YAG/CO2 laser system: a
      comparative study.
AB  - OBJECTIVE: The efficacy of a new dual wavelength Er:YAG and CO2 laser system was
      tested for skin resurfacing results on rabbits' ears and human facial skin. The
      dual wavelength laser delivers simultaneous pulses of low-energy CO2 and high
      energy Er:YAG energies. Theoretically, combining the strengths of both laser
      types in one console should lead to improved clinical outcome. SUMMARY BACKGROUND
      DATA: The use of the laser for skin resurfacing and remodeling has dramatically
      increased over the past few years. The CO2 laser was the first laser to be used
      in this field, followed more recently by the E:YAG laser. Both lasers offer
      unique advantages and disadvantages. METHODS: The present study consists of an
      ear chamber experiment, conducted on eight rabbits, to examine vascular network
      formation, after laser resurfacing with a standard CO2 laser and the Er:YAG/CO2
      laser. Resurfacing was also performed on human patients with the Er:YAG/CO2 laser
      and the results were compared with previously published results of CO2 laser
      resurfacing. RESULTS: Significant advantages, including an attenuation in the
      degree of edema and erythema and a shorter reepithelialization time compared to
      results with conventional CO2 systems, were observed with the Er:YAG/CO2 system.
      Improved tissue reorganization and good clinical results in nine of the ten
      patients (six ratings of "very good" and three "good") were observed. The
      clinical outcome of the remaining patient was rated as "fair." Minimal side
      effects were reported and observed in only three patients. The learning curve
      required to maximize the efficiency of the system is steep, however, requiring a
      thorough understanding of the different laser/tissue interactions associated with
      the two wavelengths. CONCLUSION: It is the authors' opinion that the dual
      wavelength Er:YAG/CO2 laser system offers a particularly efficient and flexible
      system to perform standard CO2 procedures for skin resurfacing with an improved
      clinical outcome, as well as other applications with the CO2 or Er:YAG energy
      delivered separately.

PMID- 11199835
TI  - "When the bough breaks".

PMID- 11199836
TI  - Morphological changes of rat mandibular bone with ArF excimer laser in vivo.
AB  - OBJECTIVE: The purpose of this study was to investigate the morphological changes
      of bone tissue by ArF excimer laser irradiation in vivo. SUMMARY BACKGROUND DATA:
      Recently, it has been demonstrated that soft and hard tissues can be removed by
      excimer laser irradiation with little thermal damage. METHODS: ArF excimer laser
      was irradiated on the surface of the rat mandibular bone using the following
      parameters: wavelength; 193 nm; output: 0.12 W; pulse repetition rate: 10 Hz;
      spot size: 1.0 x 4.0 mm; irradiation time: 90 and 120 seconds. The ablation depth
      was measured at 90 and 120 seconds. Furthermore, the irradiated surface was
      examined histologically using scanning electron microscopy (SEM). RESULTS: The
      relationship between ablation depth and irradiation time was almost linear.
      Macroscopically, the ArF excimer laser beam produced a defect with clean-cut
      margins without carbonization in the mandibular bone. Histologically, there was
      minimal evidence of thermal damage to the surrounding tissue. The bottom of the
      defect revealed a sawtooth appearance. In SEM observation, mosaic structures
      corresponded to the sawtooth structures observed with light microscopy.
      CONCLUSIONS: These findings suggest that it is possible to remove bone tissue
      using ArF excimer laser irradiation without thermal damage. The effectiveness of
      this laser can be attributed to the photoablation of the bone tissue.

PMID- 11199837
TI  - Diamond-shaped optical fiber delivery system.
AB  - OBJECTIVE: Physicians who use laser systems are looking for new fiberoptic
      delivery systems with better performance. We searched for a delivery system with
      high power and with a tip of high durability that may be reused many times.
      SUMMARY BACKGROUND DATA: The delivery systems currently found on the market can
      burn and break easily. The surgeon may either finish the surgery with a damaged
      delivery system, or have to switch to a new one during surgery, thus increasing
      the inconvenience and cost of the surgery. METHODS: Distal tips of fibers used
      with Nd:YAG and diode lasers have been shaped and polished according to their
      specific function, including excision, vaporization, and coagulation of tissue.
      RESULTS: We have developed several prototypes of optical fiber delivery systems,
      and in particular, we have developed a prototype of a delivery system, called the
      Diamond-Shaped Optical Fiber Delivery System, or Diamond. By making the tip of an
      optical fiber diamond shaped, we are able to obtain greater mechanical resistance
      than that of other delivery systems that were tested in our laboratory. In the
      Colorectal Unit, we applied it in surgical procedures such as perianal
      fistulectomy, hemorrhoidectomy, and excision of condilomata acuminata and
      pilonidal cyst and sinuses. During cutting and coagulating, the system performed
      well with no technical problems. CONCLUSIONS: A new delivery system (Diamond)
      gave satisfactory performance during surgical operations. Its main component, the
      diamond-shaped distal end, provided high durability and was reused many times,
      thus improving the quality of operations and reducing expenses greatly.

PMID- 11199838
TI  - Effects of Er,Cr:YSGG laser irradiation in human enamel and dentin: ablation and
      morphological studies.
AB  - OBJECTIVE: This investigation was performed to determine quantitatively the
      ranges of ablation and to evaluate the morphological changes in human enamel and
      dentin irradiated by Er,Cr:YSGG laser with or without water spray. SUMMARY
      BACKGROUND DATA: Recently, Er,Cr:YSGG laser has been introduced in dental clinics
      to remove carious dental hard tissues in anticipation of replacing the high-speed
      dental drill. METHODS: A total of 40 extracted human teeth were used in this
      study. An Er,Cr:YSGG laser was used to ablate human dental hard tissues with the
      output powers of 3 to 6 W. Ablation extent with or without water spray at
      different output powers was measured, and the morphological changes on enamel and
      dentin were also investigated by stereoscopy and scanning electron microscopy
      (SEM). RESULTS: The irradiation with water spray significantly (p < 0.001)
      increased the ablation depths compared to those irradiated without water mist.
      Morphological findings by SEM indicated that when irradiated without water spray,
      carbonization with brown or dark color was recognized in enamel or dentin,
      respectively. In addition, cavities with a molten lava-like appearance were
      produced and an irregular structure with many microholes was observed in dentin.
      CONCLUSIONS: These results suggest that during the Er,Cr:YSGG laser irradiation,
      water spray directed at the ablation sites increases the ablation depths and
      water plays an important role as an initiator of the ablation of dental hard
      tissues.

PMID- 11199839
TI  - The bactericidal effect of Nd:YAG, Ho:YAG, and Er:YAG laser irradiation in the
      root canal: an in vitro comparison.
AB  - OBJECTIVE: The aim of this study was to compare the antibacterial effectiveness
      of the Nd:YAG, the Ho:YAG, and the Er:YAG laser in infected root canals. SUMMARY
      BACKGROUND DATA: Lasers are gaining increasing importance in the field of
      endodontics. Numerous studies have shown the beneficial effects of laser
      treatment in disinfecting root canals. METHODS: In our in vitro experimental
      setup, 40 extracted and endodontically treated teeth were inoculated with a
      suspension of Escherichia coli and Enterococcus faecalis and then irradiated at
      standardized power settings. The disinfecting efficacy of each laser was proved
      by classical microbiological examination. RESULTS: This article highlights that
      all three lasers substantially decreased the bacterial population with only
      minimal differences in their microbicidal efficacy. At 1.5 W, the best results
      were obtained by the Er:YAG laser achieving a mean bacterial elimination of
      99.64%, followed by the Nd:YAG laser (99.16%), and the Ho:YAG laser (99.05%).
      CONCLUSION: Our findings indicate that all three lasers act as strongly effective
      microbicides without causing unfavorable temperature rises at the settings used.
      They can thus be considered a valuable tool for root canal treatment.

PMID- 11199840
TI  - Nd:YAG laser influence on sound dentin bond strength.
AB  - OBJECTIVE: In the present study, the authors evaluated tensile bond strength of
      composite resin to dentin treated with Nd:YAG laser before and after bonding
      procedures. SUMMARY BACKGROUND DATA: Lasers have been widely used in dentistry
      and have contributed to the development of new technologies. Adhesive systems
      have been indicated for most dental procedures and have produced good results.
      Studies concerned with the combined use of this adhesive system was the subject
      of this study. METHODS: Thirty noncarious human anterior teeth, freshly
      extracted, for periodontal reasons, were used. After grinding the buccal dentinal
      surface until its exposition, specimens were separated into three groups and
      received the following treatments: (group 1) control--acid etching plus primer
      plus bond; (group 2) laser plus acid etching plus primer plus bond; (group 3)
      acid etching plus primer plus bond plus laser. Specimens of composite resin
      (Z100, 3M, Saint Paul, MN) were constructed on an inverted truncated 3-mm
      diameter cone mold. Tensile bond strength was performed using Instron Universal
      machine, at 0.5 mm/min speed. RESULTS: Analysis of variance (ANOVA) (p < 0.05)
      determined that the type of dentinal treatments used had an influence on tensile
      bond strength. Tukey's test, however, showed that group 1 (15.46) and 3 (15.67)
      had similar results both of which were higher than group 2 (4.57). CONCLUSIONS:
      Based on the results obtained, one can conclude that group 1 (without laser) and
      group 3 (laser after bonding) had similar results, both higher than those
      observed for group 2 (laser before bonding). These results indicate that more
      research is needed about how a hybrid layer is formed when laser radiation is
      used.

PMID- 11199841
TI  - In vitro study of the Nd:YAG laser effect on human dental enamel: optical and
      scanning electron microscope analysis.
AB  - OBJECTIVE: The Nd:YAG laser irradiation of dental enamel was evaluated in enamel
      demineralization experiments in a Streptococcus mutans culture media. SUMMARY
      BACKGROUND DATA: Previous studies had shown that a continuous wave Nd:YAG laser
      at an energy of approximately 67 mJ may induce an increased acid resistance in
      human dental enamel when exposed to severe demineralization conditions. METHODS:
      Enamel windows of 3 x 4 cm in the buccal surface were irradiated with a
      continuous wave Nd:YAG laser at a wavelength of 1,064 microns using energy
      densities of from 83.75 to 187.50 J/cm2. Enamel windows of 3 x 4 cm on the
      lingual surface served as control (without the laser irradiation). The enamel
      windows were then exposed to a Streptococcus mutans culture media at a
      temperature of 37 degrees C for 15 and 21 days. The laser effects and
      demineralization were examined both by optical microscopy and scanning electron
      microscopy (SEM). RESULTS: A comparison between the lased and the unlased windows
      of enamel showed fusion and recrystalization of the enamel and increased acid
      resistance in all groups irradiated with the Nd:YAG laser. On the other hand, the
      3 x 4 delimited enamel surfaces from the control group (not irradiated with the
      Nd:YAG laser) showed 100% demineralization. CONCLUSIONS: These findings are
      consistent with the finding that laser irradiation of dental results in
      significant reduction of the effective solubility of enamel mineral.

PMID- 11199842
TI  - Acute and long-term humoral immunity following active immunization of rabbits
      with inactivated spores of various Encephalitozoon species.
AB  - Microsporidia of the genus Encephalitozoon are increasingly being reported as a
      cause of severe, often disseminated infections, mainly in patients with acquired
      immunodeficiency syndrome (AIDS). Immunological identification of each of the
      three recognized species (E. cuniculi, E. hellem, and E. intestinalis) requires
      the availability of specific immune sera. All sera available thus far have been
      generated by direct inoculation of rabbits with virulent microsporidian spores.
      This study demonstrates for the first time that subcutaneous immunization with
      inactivated spores of E. cuniculi, E. helleri, or E. intestinalis is capable of
      generating highly active rabbit hyperimmune sera to the homologous antigens, with
      maximal titers being 1:5,120, 1:1,280, and 1:2,560, respectively, as determined
      by the indirect immunofluorescence technique (IIF). Broad cross-reactivity of the
      rabbit antisera with all heterologous Encephalitozoon antigens was determined by
      IIF and immunogold electron microscopy; however, only the E. hellem immune serum
      strongly cross-reacted with spores of Enterocytozoon bieneusi. During the 35
      month follow-up period the antibody titers to the homologous antigens declined to
      1:640, 1:160, and 1:320, respectively. The observed decay curves for antibody
      titers against E. cuniculi, E. hellem, and E. intestinalis were fitted using
      mathematical modeling, resulting in a predicted duration for specific immune
      responses of about 7 years on average. Knowledge of the magnitude and duration of
      specific immune responses is a prerequisite for further evaluation of the concept
      of using inactivated microsporidian spores in the quest for vaccines against
      microsporidian infections.

PMID- 11199843
TI  - High prevalence of infection with Entamoeba dispar, but not E. histolytica, in
      captive macaques.
AB  - A total of 268 nonhuman primates (20 species) kept in the Primate Research
      Institute, Kyoto University, Japan, were surveyed for intestinal amebas. Total
      positive rates as based on the presence of cysts in the stool following formalin
      ether sedimentation were as follows: Entamoeba histolytica/E. dispar, 53%; E.
      coli, 34%; E. hartmanni, 34%; Iodamoeba buetschlii, 25%; Endolimax nana, 8%; and
      E. chattoni, 3%. Positive rates were higher in Old World monkeys and lower in New
      World monkeys. All the 141 E. histolytica/E. dispar-positive animals were Macaca
      monkeys. The E. histolytica/E. dispar-positive samples were analyzed by
      polymerase chain reaction (PCR) for identification of E. histolytica and E.
      dispar. E. dispar DNA was detected in 137 samples, whereas no E. histolytica DNA
      was seen. Zymodeme analysis and reactivity to monoclonal antibodies of cultured
      trophozoites also supported the presence of E. dispar and the absence of E.
      histolytica. When the sera of 93 macaques were examined by an indirect
      fluorescent antibody test, only 3 animals proved to be positive for E.
      histolytica, showing the lowest titer. These results demonstrate that infection
      with E. dispar, but not E. histolytica, is predominant in macaques.

PMID- 11199844
TI  - Therapeutic and prophylactic effects of isometamidium chloride (Samorin) against
      the hemoflagellate Cryptobia salmositica in chinook salmon (Oncorhynchus
      tshawytscha) and the effects of the drug on uninfected rainbow trout (O. mykiss).
AB  - A series of compounds (triphenylmethanes, thiazines, xanthenes, benzidines,
      phenanthridiniums, napthalamines, and diamidines) were screened for in vitro
      toxicity against Cryptobia salmositica. Isometamidium chloride (Samorin) was
      cryptobiacidal at low concentrations and was examined for therapeutic and
      prophylactic activities against C. salmositica in chinook salmon (Oncorhynchus
      tshawytscha). An intramuscular dose (1.0 mg/kg) of Samorin 3 weeks post-infection
      significantly reduced the parasitemia in adult chinook. A higher dose (2.5 mg/kg)
      eliminated the infection in 30% of adult fish and parasitemias were significantly
      reduced in the remaining infected fish. Juvenile chinook treated with 1.0 mg
      Samorin/kg at 2-3 weeks post-infection survived, while 100% of untreated control
      fish died from cryptobiosis. The high dose (2.5 mg/kg) was lethal to small fish
      (98.93 +/- 12.09 g) and 50% died within 24 h of treatment, while all large fish
      (168.38 +/- 13.87 g) survived. Samorin (1.0 mg/kg) did not affect growth, food
      consumption, complement, or hematocrit values in uninfected rainbow trout (O.
      mykiss).

PMID- 11199845
TI  - Experimental leishmaniasis: synergistic effect of ion channel blockers and
      interferon-gamma on the clearance of Leishmania major by macrophages.
AB  - We have previously shown that cultured Leishmania promastigotes are sensitive to
      drugs blocking K+ and Na+ channels and Na+/H+ transport systems and that the
      percentage of parasite-infected macrophages decreases significantly in the
      presence of the drugs. In the present work, we analyzed whether this drug
      susceptibility of intracellular amastigotes was associated with the activation of
      macrophage microbicidal mechanisms. Pretreatment of the cells with glibenclamide
      (GLIB) increased their resistance to infection with Leishmania, an effect that
      may be mediated by calcium fluxes since it was reversed by ethylene glycol bis
      (beta-aminoethyl ether)-N,N,N',N-tetraacetic acid (EGTA). It was noteworthy that
      in infected macrophages post-treated with the drugs the clearance of parasites
      was strongly enhanced when the cells were treated simultaneously with GLIB and
      interferon-gamma; this effect correlated with an increased production of reactive
      nitrogen intermediates. In conclusion, the data suggest that GLIB treatment
      increases the resistance of macrophages to infection with Leishmania and
      potentiates the interferon-gamma-stimulated clearance of parasites via the
      induction of nitric oxide.

PMID- 11199846
TI  - Experimental infections of copepods and sticklebacks Gasterosteus aculeatus with
      small ensheathed and large third-stage larvae of Anisakis simplex (Nematoda,
      Ascaridoidea, Anisakidae).
AB  - Free-swimming ensheathed larvae of Anisakis simplex were shown experimentally to
      be ingested by the copepods Oitona similis and Acartia tonsa and by the nauplii
      of barnacles Balanus sp. The larvae did not grow in the copepod hemocoel.
      Experimental infections of various malacostracans were unsuccessful. Sticklebacks
      Gasterosteus aculeatus are naturally infected with larvae of A. simplex in
      coastal brackish water. Such sticklebacks may have acquired the infection by
      eating either a crustacean host or third-stage larvae (L3) from fish.
      Experimental infections of cod Gadus morhua with L3 from viscera of herring
      Clupea harengus showed that about one-third of the ingested larvae passed through
      the cod alimentary tract and were extruded whole but dead. Experiments showed
      that larvae from herring viscera survived and remained infective after at least 6
      weeks in brackish water and seawater and that L3 from herring viscera were
      ingested by sticklebacks (and flounder Platichthys flesus), where they
      reencapsulated on the viscera; the L3 were alive 2 years later.

PMID- 11199847
TI  - Comparative studies on the development of Oesophagostomum dentatum in vitro and
      in vivo.
AB  - Although in vitro cultivation of Oesophagostomum dentatum provides defined
      material of third- (L3) and fourth- (L4) stage larvae, these are morphologically
      and biochemically different from larvae recovered ex vivo. The development of pre
      cultivated larvae was investigated by rectal transplantation into worm-free pigs
      with subsequent recovery of worms from intestinal contents after different time
      periods and determination of worm burdens and sizes. Additionally, the in vitro
      maintenance of L4 and adults recovered from intestinal contents of orally
      infected pigs in different media was investigated. Although growth and
      development rates of cultivated L4 are lower than those of larvae recovered from
      intestinal contents after oral infection, pre-cultured L4 are able to develop
      into egg-laying adults in the large intestines (without nodule formation) within
      9-14 days in rates comparable with those after oral infection. In contrast,
      rectally transplanted L3 only establish in low numbers without egg excretion. L4
      and adult worms recovered from intestinal contents cannot be maintained in
      cultivation medium for more than 1 week, although most L4 grow and moult during
      the first 3 days. Although the standard cultivation conditions for mass
      production of L4 are not suitable for development or maintenance of preadult and
      adult stages, L4 recovered from cultures have the ability to establish in vivo as
      fertile adults, indicating that the basic biological functions are retained in
      vitro.

PMID- 11199848
TI  - Efficacy of toltrazuril and ponazuril against experimental Neospora caninum
      infection in mice.
AB  - Neosporosis is a disease affecting predominantly fetal development in cattle and
      dog hosts; and it may cause neuromuscular disfunction in infected newborn calves
      and pups. Predispositions--including, e.g. transient immunosuppression during
      pregnancy--may result in an increased dissemination of the parasite within the
      host or its offspring. Chemotherapeutic treatment of neosporosis may be an issue,
      provided that an appropriate drug is made available. In this respect, we describe
      the use of a mouse model for the evaluation of toltrazuril and ponazuril
      medication as a means of preventing parasite dissemination and subsequent
      formation of cerebral lesions. Toltrazuril- and ponazuril-treated mice were
      experimentally infected intraperitoneally (i.p.) with 2 x 10(6) Neospora caninum
      tachyzoites. The infection was monitored at three levels: clinically, by
      assessing symptoms, histologically, by assessing the occurrence of cerebral
      lesions and parasites by immunohistochemistry, and on the molecular level, by
      detection of parasite DNA using PCR. Chemotherapy using either toltrazuril or
      ponazuril, both applied in a drinking-water formulation (20 mg toltrazuril or
      ponazuril kg(-1) body weight day(-1)) completely prevented the formation of
      cerebral lesions in all treated animals, as assessed by immunohistochemistry. PCR
      analyses of these treated animals showed that DNA-detectability was reduced by
      91% and 90% upon toltrazuril and ponazuril medication, respectively.

PMID- 11199849
TI  - Entamoeba histolytica: production of nitric oxide and in situ activity of NADPH
      diaphorase in amebic liver abscess of hamsters.
AB  - Entamoeba histolytica trophozoites were inoculated into the liver of hamsters and
      serum nitrate/nitrite levels [expressed as nitric oxide (NO) production] were
      determined at different times during amebic liver abscess (ALA) development. We
      also tested the effects of NO synthase (NOS) inhibitors such as N(G)-nitro-L
      arginine methyl ester (L-NAME), aminoguanidine, and dexamethasone during ALA
      production. Since NOS activity has been correlated with expression of reduced
      nicotinamide adenine dinucleotide phosphate diaphorase (NADPHd) in tissues, we
      performed histochemistry studies to determine the activity of the latter in
      livers infected with E. histolytica trophozoites. Production of NO in serum was
      directly proportional to the size of ALAs, and NOS inhibitors caused low levels
      of NO and smaller ALAs. Our data suggest that NO does not have any lytic effect
      on E. histolytica trophozoites and is therefore incapable of providing protection
      against the amebic liver infection. In addition, NADPHd activity was detected
      histochemically in hepatocytes and inflammatory cells associated with focal
      necrosis containing trophozoites. The positive reactivity observed in these
      parasites may be attributable to a close biochemical similarity of NADPHd to the
      NADPH:flavin oxidoreductase described in E. histolytica by other investigators.

PMID- 11199850
TI  - Molecular arguments for splitting of Schistosoma intercalatum, into two distinct
      species.
AB  - The taxonomic status of the two known strains of Schistosoma intercalatum, the
      Lower Guinea strain (originating from Edea, Cameroon) and the Zaire strain
      (originating from Kinshasa, Democratic Republic of Congo, formerly Zaire) was
      examined using random amplified polymorphic DNA (RAPD) markers. Two additional
      species within the S. haematobium group, S. haematobium and S. mattheei, were
      included in the study. DNA was extracted from four male and four female worms of
      each species and strain under investigation. In all, 13 primers gave reproducible
      and informative marker patterns; the monomorphic bands in all the males and
      females of each sample were scored, and 138 bands were included in the final
      analysis. Overall, 14 RAPD fragments were shared by all the schistosomes studied,
      and 19 RAPD fragments were considered to be sex markers. Only 22% (20/91) of the
      RAPD fragments were shared between S. intercalatum Zaire and S. intercalatum
      Cameroon. The mean values recorded for the Nei and Li's genetic distances between
      S. haematobium and S. mattheei and between S. intercalatum Zaire and S.
      intercalatum Cameroon were 0.546 and 0.596, respectively. A principal component
      analysis and one-way analysis of variance (ANOVA/MANOVA) showed a significant
      separation between S. intercalatum Zaire and S. intercalatum Cameroon. The data
      support the hypothesis that S. intercalatum Zaire and S. intercalatum Cameroon
      are distinct species. Additional molecular-biology studies are in progress that
      involve the use of nuclear and mitochondrial markers to confirm the extent of the
      genetic divergence prior to the establishment of final decision on the taxonomic
      status of the two strains of S. intercalatum.

PMID- 11199851
TI  - Electron microscopic study on sporocysts and sporozoites of parental strains and
      precocious lines of rabbit coccidia Eimeria intestinalis, E. media and E. magna.
AB  - The fine structure of sporocysts and sporozoites of parent strains and precocious
      lines of rabbit coccidia Eimeria intestinalis, E. magna and E. media was studied.
      The parent strains and precocious lines differ only in the shape and size of
      refractile bodies (RB). In the sporocysts of precocious lines of E. magna and E.
      media, one extremely large RB was seen, either inside one of the sporozoites, or
      free in the sporocyst. In the oocysts of the precocious strain of E.
      intestinalis, two sporocysts resembled those of the precocious lines of E. magna
      and E. media, whereas the other two sporocysts did not harbour any RB.
      Sporozoites of all the precocious lines contained no, or very small, RB after in
      vitro excystation.

PMID- 11199852
TI  - Serum levels of vascular cell adhesion molecule 1 in the early post-treatment
      defervescent phase of falciparum malaria.
AB  - Elevated plasma or serum levels of vascular cell adhesion molecule 1 (VCAM-1)
      have been reported in the febrile phase of falciparum malaria. However, little is
      known about serum VCAM-1 levels in the early post-treatment defervescent phase.
      Serum VCAM-1, tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL
      1beta), and creatinine levels were determined in six Japanese patients with
      uncomplicated falciparum malaria during the acute febrile phase and the early
      post-treatment defervescent phase. The serum VCAM-1 values recorded for patients
      during the early post-treatment defervescent phase were significantly lower than
      those noted during the febrile phase (P < 0.05), but no significant difference in
      serum creatinine values was identified. TNF-alpha and IL-1beta levels were below
      the limit of detection in the serum of all patients during both the febrile phase
      and the early post-treatment defervescent phase. The serum levels of VCAM-1 were
      not related to parasitemia.

PMID- 11199853
TI  - Internet user profile in the field of parasitology.
AB  - This study determined a profile of current Internet users in parasitology, their
      use patterns on the Internet for parasitologic purposes, and the Web sites they
      would recommend. In a European survey, 689 parasitologically engaged scientists
      were asked to fill out a questionnaire about Internet access, current problems,
      current and future use, and which Web sites they would recommend as well as about
      the use of e-mail. In all, 153 (22.2%) of the interviewees returned the
      questionnaire. Only one participant had no access to the Internet. Time
      expenditure was considered the main problem involved in use of the Internet. The
      Internet was mainly used for e-mail (96.1%); for literature research (93.5%); for
      reading of electronic journals (51.6%); and for gathering of information, e.g.,
      about institutes and colleagues (58.2%) and about congresses (49.7%). In the
      future, 71.9% of the respondents would like to read electronic journals more
      often and 49.7% would like to use the web more intensively for acquisition of
      information about congresses, universities, and institutions. Requests for the
      future included an easier application of the browser software (33%) and a shorter
      response time (47.7%). The survey demonstrates that the Internet has assumed a
      definite place in the lives of researchers in the field of parasitology. Survey
      responses indicate a need for electronic journals. In our opinion, universities
      and parasitology societies should be urged to publish journals electronically on
      the Web. To diminish current problems involved in the finding of relevant
      information on the Internet, we strongly recommend careful reading of the
      instructions regarding the search engines used. Web pages with clear structures,
      small file sizes, precise HTML (hypertext markup language) key-word editing, and
      page titles would facilitate more accurate discovery of specific sites. In
      addition, there seems to be a need for regular publication of reviewed
      parasitology-link collections.

PMID- 11199854
TI  - Genetic immunization with plasmid DNA coding for the ROP2 protein of Toxoplasma
      gondii.
AB  - The ROP2 protein of Toxoplasma gondii has previously been proposed as a vaccine
      candidate against toxoplasmosis. In this work we characterize the immune response
      induced by injection of plasmid DNA coding for this protein in three strains of
      mice (BALB/c, C57BL/6, and CBA/J) displaying different levels of susceptibility
      to toxoplasmosis and compare it with that obtained by vaccination with the live
      attenuated ts-4 strain of T. gondii. The ROP2 gene was cloned in the eukaryotic
      expression vector pcDNA3 and the resulting plasmid, named pcDNA3/ROP2, was used
      to immunize mice. After three immunizations with the plasmid, mice developed
      antibodies that could be detected by ELISA using a recombinant truncated form of
      ROP2; and these antibodies also recognized the natural protein by Western blot.
      Plasmid immunization generated antibodies against the ROP2 of both of the IgG1
      and IgG2a isotypes in CBA/J and BALB/c mice and both of the IgG1 and IgG2c
      isotypes in C57BL/6 mice. However, animals vaccinated with the ts-4 strain
      generated only IgG2a (in CBA/J and BALB/c mice) or IgG2c (in C57BL/6 mice)
      against ROP2. Kinetic studies of the generation of isotypes indicated that both
      isotypes were generated at the same time. Mice immunized with the plasmid DNA did
      not resist a challenge with the virulent RH strain of T. gondii, while mice
      vaccinated with the ts-4 strain resisted the same challenge. However, in
      pcDNA3/ROP2-immunized BALB/c mice, death was significantly delayed with respect
      to the pcDNA3-immunized control group. These results suggest that plasmid
      immunization using the ROP2 gene generates a mixed T(H1)/T(H2) response against
      ROP2, which is different from that obtained by vaccination with live tachyzoites
      of the ts-4 strain (T(H1) response) and is not protective against the highly
      virulent RH strain of the parasite.

PMID- 11199855
TI  - Fasciolopsiasis: is it a controllable food-borne disease?
AB  - Fasciolopsiasis, endemic to the Orient and Southeast Asia, is a snail
      transmitted, intestinal, food-borne parasitic zoonosis caused by a trematode,
      Fasciolopsis buski, which also infects farm pigs. Fasciolopsiasis remains a
      public health problem despite changes in eating habits, alterations in social and
      agricultural practices, health education, industrialization, and environmental
      alterations. The disease occurs focally and is most prevalent in school-age
      children. In foci of parasite transmission, the prevalence of infection in
      children ranges from 57% in mainland China to 25% in Taiwan and from 50% in
      Bangladesh and 60% in India to 10% in Thailand. Control programs implemented for
      food-borne zoonoses are not fully successful for fasciolopsiasis because of
      century-old traditions of eating raw aquatic plants and using untreated water.
      Fasciolopsiasis is aggravated by social and economic factors such as poverty,
      malnutrition, an explosively growing free-food market, a lack of sufficient food
      inspection and sanitation, other helminthiases, and declining economic
      conditions.

PMID- 11199856
TI  - Helminth fauna of toads in Belorussian Polesie.

PMID- 11199857
TI  - Helminth fauna of the hare (Lepus europaeus Pallas, 1778) in the  southern part
      of Belarus.
AB  - Facts about helminth fauna of hares have not been published in Belarus since
      1972. Results of helminthological studies of 22 hare carcasses carried out
      between 1985 and 1999 in the southern part of Belarus are presented.

PMID- 11199858
TI  - Withdrawal reactions of a premature neonate after maternal use of paroxetine.

PMID- 11199859
TI  - Guidelines for Group B streptococcus.

PMID- 11199860
TI  - Neonatal intensive care and parental participation in decision making.

PMID- 11199861
TI  - [Sensitization to common airborne allergens in school children with bronchial
      asthma].
AB  - The main purpose of the paper was to assess the prevalence of atopy in the
      population of preadolescent children in Krakow on the basis of allergic skin
      testing to airborne allergens and to look into the relationship between atopy and
      chronic asthma-like respiratory symptoms. The field study was carried out in 1998
      among 311 children being the subgroup of the cohort of 1044 children included in
      the 3-year follow-up in Krakow. The health assessment accounted for the
      standardised interviews and skin prick testing to 11 common airborne allergens.
      In the total, the positive allergic reaction at least to only one allergen was
      found in 32.5% children, and it was more prevalent in boys than in girls (40.4%
      vs 28.1%). Allergy only to indoor allergens was present in 9.7% children, allergy
      only to outdoor allergens in 9.7%, and allergy both to outdoor and indoor
      allergens was confirmed in 13% persons. Most frequently, allergy was established
      to house mites: Dermatophagoides pter. (16.2%), Dermatophagoides farinae (12.0%)
      and to cat dander (11.4%). Asthma-like symptoms occurred in 11.0% of children and
      asthma diagnosed by physician in 7.8% of the sample under the study. The results
      of this study proved that the prevalence of asthma was about twice so high in
      boys than in girls. The risk of asthma-like symptoms and/or asthma diagnosed by
      physician increased significantly with the number of positive allergic tests to
      airborne allergens (OR = 1.30; 95% CI: 1.11-1.52) and atopy in mother (OR = 1.84;
      95% CI: 1.03-3.37).

PMID- 11199862
TI  - [Occupational allergic diseases in the steel industry. Population studies].
AB  - The aim of this study was to evaluate the occurrence of occupational allergic
      diseases of the respiratory system and skin. The study was carried out in a
      population of 17,600 employees of Huta im. T. Sendzimira (T. Sendzimir
      Steelworks) in 1992-96. During this period 543 employees were referred to the
      Occupational Diseases Department with a suspection of occupational allergy.
      Connection between the kind of occupation and disease was confirmed in 215 cases.
      104 (48%) suffered from upper respiratory tract diseases or bronchial asthma and
      111 patients (52%) suffered from allergic skin disease as contact dermatitis of
      the hand or generalized dermatitis. The analysis showed that allergic skin
      diseases occurred more frequently in 1992-94 and allergenic respiratory diseases
      were more frequent in 1995-96. Industrial dust containing metals (nickel, chrome,
      iron, cooper) turned out to be the main allergic factor. The highest prevalence
      was observed in the Rolling-Mill Department, Chemistry of Coke Department and
      Incombustible Materials Department. 33% of patients suffering from allergic
      respiratory diseases and 10% suffering from allergic skin diseases had a family
      predisposition to allergy (features of atopy).

PMID- 11199863
TI  - [Concentration of prothrombin fragments 1+2 (F1+2) and thrombin-antithrombin III
      complexes (TAT)in patients with primary non-small cell lung cancer, before and
      after resection].
AB  - The aim of our study was to detect the hypercoagulability in patients with lung
      cancer as well as to search for the marker indicating the effectiveness of tumour
      resection. Twenty four patients aged: 47-66 years were included into the study.
      The control group comprised 24 healthy human beings. The plasma concentrations of
      prothrombin 1 + 2 fragments (F1 + 2) and thrombinantithrombin III complexes (TAT)
      were measured before and 10 days after the tumour resection. It was shown, that
      F1 + 2 was a more sensitive hypercoagulability marker in patients with NSCLC,
      than TAT concentrations. Ten days after tumour resections, 78% of the patients
      have a normal level of TAT, while only 42% showed normalization of F1 + 2
      concentrations. Our data indicate on coagulation activation in patients with
      different histological types of lung cancer. The risk of thromboembolic disorders
      still remains 10 days after tumour resection.

PMID- 11199864
TI  - [Evaluation of antianginal efficacy of long-term therapy with low dose isosorbide
      dinitrate in patients with stable angina pectoris].
AB  - The aim of this study was to evaluate two ways of long-term therapy with lower
      doses of oral isosorbide dinitrate (ISDN) in normal tablets and in sustained
      release form (SR), in patients with stable angina. METHODS: In double-blind,
      placebo (PL) controlled with cross-over design study 38 male patients with stable
      angina and angiographically proven coronary artery disease, received ISDN in
      normal tablets in two doses: 10 mg and 20 mg, and also two doses SR: 20 mg-SR and
      40 mg-SR or PL in the first ingestion and in long-term therapy in two 7 day
      phases: 4-times-daily (4x) every 6 h and 3-times-daily (3x) with 12 h interval.
      In 3x patients received ISDN only in doses: 20 mg, 20 mg-SR and 40 mg-SR. After
      the first ingestion and on the last day of long-term phases, exercise stress
      tests on the treadmill were performed: preceding ingestion, 2 h and 6 h after.
      Evaluation of antianginal efficacy of ISDN was performed by analysis of walking
      times: total, to angina and to ischemia (WTI). RESULTS: 6 h after first ingestion
      all doses of ISDN improved significantly WTI in comparison to PL: 10 mg by 34.6%
      (p < 0.01), 20 mg by 49.6% (p < 0.0001), 20 mg-SR by 42.9% (p < 0.001) and 40 mg
      SR by 52.5% (p < 0.0001). None of the doses improved significantly WTI in the
      long-term 4x phase, in 3x--only 40 mg-SR by 12.1% (p < 0.05). CONCLUSIONS:
      Tolerance to anti-anginal efficacy of ISDN in lower doses in long-term therapy 4
      times-daily, every 6 h, was found. A 12-h interval is sufficient to prevent
      tolerance in long-term treatment of sustained-release ISDN in 40 mg dose.
      Intermitted dosing of nitrates, as a prevention of tolerance, and the practical
      results of works using other pharmacologic interventions in a clinical setting
      are discussed in the final section of this paper.

PMID- 11199865
TI  - [Interaction of platelets with monocytes with regard to arachidonic acid
      metabolites].
AB  - The aim of our study was the assessment whether internal peroxidase of
      arachidonic acid and/or prostaglandin can be transferred from platelets to
      monocytes. Monocytes were isolated from whole blood according to the method of
      Boyum. The monocytes cultures were led in the fluid environment, on the base of
      RPMI 1640 supplemented with autologous serum. Platelets were isolated from whole
      blood according to the method of Pinckard. During interaction of monocytes and
      platelets in the presence of indometacin we ascertained the increased of TXB2
      concentrations in supper-natant. Incubation of monocytes in cultures stimulated
      by LPS in presence of indomethacin with platelets did not cause increased
      secretion of TXB2. Incubation of platelets with indomethacin in 36 h culture of
      monocytes stimulated by LPS caused increase concentration of 6-keto-PGF1alfa. The
      results of our study may suggest the presence of the one way transformation of
      the arachidonic acid from platelets to monocytes.

PMID- 11199866
TI  - [Rupture of the cardiac wall during the course of acute myocardial infarction.
      Personal observations].
AB  - Out of 3673 patients with myocardial infarction treated between 1989 and 1998,
      128 (54 males and 74 females) deceased due to left ventricle wall rupture (death
      rate: 18.5%). Thrombolytic therapy started to be used in 1992. It was
      administered in 36.0% patients with myocardial infarction in the years 1992-1998.
      Out of the patients deceased due to left ventricle wall rupture thrombolytic was
      carried out in 24.2%, predominantly in males (31.5%) as compared to females
      (18.8%). Left ventricle wall rupture during acute myocardial infarction occurred
      mainly in females (57.7%), in patients with first infarction (89.8%), in the case
      of anterior wall infarction (66.4%), hypertension (80.5%), in patients aged 61-80
      and more (86.7%). Majority of the patients (83.6%) deceased because of this
      condition between 1 and 7 hospitalisation day, mainly during the first 48 hours
      (48.4%).

PMID- 11199867
TI  - [Change of lifestyle as a relevant therapy after myocardial infarction].
AB  - The risk of ischemic heart disease is connected with the definite mode of life.
      Improper nourishment, smoking, alcohol abuse, sedentary lifestyle and excessive
      mental stress cause disturbances leading to development of atherosclerosis. The
      change of the lifestyle may prevent from coronary heart disease and may play a
      main role in secondary prevention, making the prognosis after myocardial
      infarction much better. The epidemiological and clinical studies have shown the
      significance of particular risk factors reduction on survival after myocardial
      infarction and allowed to create the optimal preventive mode of life. Therefore
      the change of lifestyle should become the priority in the postinfarction therapy.

PMID- 11199868
TI  - [Physio-pathologic aspects of aging--possible influence of physical training on
      physical fitness].
AB  - Two physiological parameters seem to be of major importance in maintaining
      physical functioning in the elderly: a capacity to perform aerobic exercises
      (endurance fitness) and an ability to do anaerobic work, especially maximal
      muscle force and power. Regular physical activity helps in maintaining these
      parameters at levels enabling normal functioning at everyday's living,
      contributing therefore to preservation of functional autonomy and independence in
      the elderly.

PMID- 11199869
TI  - [Use of tissue Doppler echocardiography].
AB  - Tissue Doppler Echocardiography (TDE) is a new noninvasive technique which shows
      myocardial tissue by color-mapping. It's based on the color Doppler and used to
      assess in a direct way left ventricular systolic and diastolic function. It helps
      to measure velocities, acceleration and energy signal within the myocardial wall.
      The transmural gradient of velocities can be calculated too. TDE can be used to
      detect regional systolic dysfunction due to myocardial ischemia and viable
      myocardium. It gives specific view of intracardiac structures and is useful for
      identification tumors, thrombus and vegetations.

PMID- 11199870
TI  - [Asthma caused by allergy to cat fur].
AB  - Sensitivity to cats fur alergen, Fel. d. 1 is presented as the second most
      important cause, after allergy to mites, of perennial atopic asthma. The authors
      collected the data from literature concerning the concentrations of Fel. d. 1 in
      homes and public places. Further the structure and production of Fel d. 1 also
      its cross reactivity and the methods of it's elimination from the environment are
      described and discussed. Authors own observations of 20 cases of cats fur asthma
      and atopic dermatitis support the opinion that only half of the patients suspect
      cats as the cause of their illness and cats fur sensitivity is always accompanied
      by inhalant or food allergy.

PMID- 11199871
TI  - [Angioedema is caused by a defect in C1-inhibitor synthesis].
AB  - Deficit of the first component of complement inhibitor (C1-inhibitor, C1-inh) may
      clinically be manifested as angioedema. The disease is characterized by episodic
      swellings of mucosa and subcutaneous tissue at different locations of the body.
      Laryngeal swelling can be life-threatening. The major mediators of edema are
      discussed to be bradykinin and C2b derived peptides. These mediators increase
      capillary permeability. Antifibrinolytic agents (aminocaproic acid, tranexamic
      acid) and attenuated androgens (danazol or stanazolol) are used for prophylaxis.
      Prolonged use both of them might result in more or less severe side effects. In
      experiments in vitro it has been shown that IFN-gamma, IL-1, IL-6 have a
      stimulatory effect on C1-inh synthesis. We want to verify the practical use of
      probiotics as natural inductors of IFN-gamma synthesis for elevating C1-inh
      level.

PMID- 11199872
TI  - [Principles of optimal preparation of material from bronchoalveolar lavage
      (BAL)for cytoimmunologic examinations in interstitial lung diseases ].
AB  - In this paper we considered the value of correctly performed bronchoalveolar
      lavage (BAL) in diagnosis of interstitial lung diseases and in assessment of the
      activity of pathological process. We indicated the conditions of exact
      interpretation of the results of BAL cytoimmunological examination, i.e. fine
      standard handling of BAL material, including its collection, elaboration and
      choice of lavage site, as well as regarding external (e.g. cigarette smoking) and
      internal additional factors. We described the influence of BAL fluid recovery and
      of the method of staining on obtained results. We emphasized routinely performed
      BAL to be the valuable diagnostic and research tool in pulmonology however, the
      method may have limited usefulness and unnecessarily burden the patient, if
      technical guidelines are not observed.

PMID- 11199873
TI  - [Phenotype of alveolar lymphocytes--theoretical and practical implications].
AB  - Actual characteristics of alveolar lymphocytes was presented, including author's
      own experience, i.e. bronchoalveolar lavage (BAL) lymphocyte typing in over 450
      patients with interstitial lung diseases (ILD) and bronchial asthma. In healthy
      individuals as well as in the patients, alveolar lymphocyte population is
      dominated by T cell subset. Alveolar T lymphocytes present primed memory cell
      phenotype and usually do not proliferate; in normal conditions apoptosis occurs
      very seldom. T cytotoxic cell phenotype is characteristic for CD8 subset. Percent
      of B and NK cells found in BAL is very low--B cells are localized in interstitial
      space around the pulmonary alveoli, while NK cells do not seem to play the
      important role in the local pulmonary defense. CD4/CD8 ratio evaluation in BAL
      material is an auxiliary tool in ILD diagnostics; it reflects local imbalance
      between T helper primed memory cells and primed T cytotoxic cells.

PMID- 11199874
TI  - [Canavan disease in a young infant].
AB  - This paper shows the clinical status and neuroimaging data in the youngest
      described Polish child with Canavan disease.

PMID- 11199875
TI  - [Allergy to latex].

PMID- 11199876
TI  - [Allergy to drugs].

PMID- 11199877
TI  - [Contemporary methods in pharmacotherapy in the opiate dependent treatment].
AB  - In this review, we present methods of pharmacotherapy in opiate dependence
      currently used in Poland and worldwide. As problems associated with drug abuse
      increase in severity, it is particularly important to bring these methods to the
      attention of medical professionals, governmental agencies and the general public.
      Here we describe pharmacotherapeutic approaches used in detoxification as well as
      relapse prevention. The presented methods of detoxification include classical
      treatments with clonidine and methadone as well as newer methods of rapid and
      ultrarapid detoxification. Agonists, partial agonists, and antagonists can be
      used in preventing relapse in detoxified patients. Experimental therapeutic
      approaches in the treatment of drug dependence are also presented. Psychotherapy
      and psychiatric care, central to the successful treatment of opiate dependence,
      are reviewed as well.

PMID- 11199878
TI  - [Psychoactive agents: an analysis based on cases from the Department of Clinical
      Toxicology College of Medicine of the Jagiellonian University in Krakow in the
      years 1997-1999].
AB  - The aim of the study was to evaluate the frequency of acute poisoning with
      psychoactive substances in adult abusers of Krakow population in 1997, 1998 and
      1999 and to compare the number of poisoned patients suffering withdrawal syndrome
      as predominant. 27.2% (n = 945) of all 3472 acute poisonings treated in the
      Department of Clinical Toxicology in 1997, 36.9% (n = 1193) of all 3236 treated
      in 1998 and 47.9% (n = 1546) of all 3233 treated cases that were acute poisoning
      with psychoactive substances among the abusers of Krakow adult population.
      Ethanol followed by narcotics in 1998, and by drugs coingested with ethanol and
      by narcotics in 1997 and 1999 was predominant psychoactive agent in all the
      analysed years. Organic solvents and glue sniffing and drug dependency increased
      again in 1999. Opiate derivatives produced at home from poppy straw or juice of
      poppy head were still the most common narcotic detected in body fluids, but
      decrease in number of acute opiates poisoning was noted in 1999 as compared to
      previous analysed years. The most of ethanol abusers aged from 30-49 years. The
      highest incidence of narcotic and drug dependency was noted in age between 20-29
      years.

PMID- 11199879
TI  - [Preliminary evaluation of methadone program in Krakow].
AB  - Methadone maintenance programs have effectively reduced opiate dependency and are
      available in many countries, also in Poland. In Krakow 50 persons were qualified
      to methadone maintenance treatment. Their age varied from 21 to 46 years, mean
      27.8 years. Participants of the programme were mainly educated on basic technical
      level, unemployed, after 3 to 30 attempts of detoxification treatment. After
      initial observation at the Detoxification Unit of the Department of Clinical
      Toxicology and establishing effective daily oral dose of methadone, all patients
      in Outpatient Clinic of Abuse receive daily adequate dose of methadone, where in
      parallel, individual and group psychotherapy is used. Methadone programme which
      was applied seems to prove the fact, that it can significantly improve life
      quality of addicted patients as well as increase the level of public safety.

PMID- 11199881
TI  - Nervous regulation of breathing in opiate dependent patient. Part II. Respiratory
      system efficiency and breathing regulation of persons classified to the methadone
      maintenance treatment.
AB  - The measurements of respiratory pattern parameters, occlusion pressure and
      respiratory tract resistance had never been performed in opiate dependent persons
      administered by the methadone maintenance treatment. The aim of this study was
      assessment of ventilatory efficiency and nervous regulation of 35 depended on
      opiates before starting the treatment. The presently examined opiate addicts
      classified to the methadone programme had intensified changes in nervous
      breathing regulation compared to the group of opiate dependent patients treated
      at the Department of Clinical Toxicology CMUJ in the first stage of controlled
      abstinence and to the control group. They had the higher values of minute
      ventilation, occlusion pressure and higher value of tidal volume to the
      inspiratory flow (VT/TIN) index which is the driving component of the breathing
      cycle and reflects the activity of the respiratory centres in the spinal cord and
      pons. A monitoring of respiratory patterns parameters, occlusion pressure and
      respiratory resistance, which are not disturbed or biased by lack of patient's
      cooperation, will allow to determinate the direction of changes in ventilatory
      efficiency in the course of methadone maintenance treatment programme.

PMID- 11199880
TI  - Nervous regulation of breathing in opiate dependent patient. Part I. Respiratory
      system efficiency and breathing regulation in the first stage of controlled
      abstinence.
AB  - Neurotoxic properties of opioid drugs which are the central nervous system
      depressant may have also depressive action on the brain stem complex responsible
      for the breathing control. Disorders of breathing regulation are reflected in
      respiratory efficiency. The aim of this study was to evaluate the regulation of
      breathing by measuring of respiratory pattern parameters, occlusion pressure and
      also to estimate the respiratory efficiency in opiate abusers. There were 76
      persons under examination: group I--36 opiates abusers (29 men and 7 women; mean
      age 22.6 years) treated in the Detoxification Unit of the Department of Clinical
      Toxicology; group II (control group)--40 healthy persons (25 men and 15 women;
      mean age 28 years) not dependent of opiates and never treated at the Department.
      During hospitalisation the functional state of respiratory system was monitored.
      Ventilation efficiency was determined on the basic of the results from a "flow
      volume" curve, spirometry and the measurements of the respiratory tract
      resistance in a computerised system Lungtest-MES company (Poland). Respiratory
      regulation was evaluated by means of synchronic measurements of the respiratory
      pattern (according to the assumption of Milic-Emili) and occlusion pressure P 0.1
      (according to Whitlaw assumptions). In the examination performed directly after
      admission to the Unit the normal respiratory efficiency was noted in 24 persons.
      12 persons (33.3%) suffered from the bronchi obturation. In the examination
      performed after hospitalisation and 9 days of total abstinence the normal
      ventilatory efficiency was found in 23 persons. In 13 of the patients (38.5%)
      respiratory obturation was still observed. After treatment in group of opiate
      abusers compared to control group values of respiratory resistance, occlusion
      pressure, minute ventilation and VT/T(in) index describing the activity of the
      central breathing regulation were increased, while the time of expiration and
      time of total breathing cycle were shorter.

PMID- 11199882
TI  - [Nutritional problems of persons qualified for the methadone treatment. Part I.
      Nutritional status of opiate addicts].
AB  - The aim of the study was assessment of the nutritional status of opiate addicted
      persons. The study was carried out on 44 opiate abusers (14 women aged from 21-33
      years and 30 men aged from 21-46 years), who were classified to methadone
      maintenance treatment. Nutritional status was assessed by anthropometry methods
      and body composition was examined using bioelectric impedance. BMI (body mass
      index) of examined women ranged from 16.4 to 30.8, and BMI of examined men ranged
      from 17.1 to 44.9. 21% of women and 44% of men had BMI < 15th centile (this
      indicates undernutrition), 7% of women and 3% of men had BMI > 85th centile (this
      indicates overnutrition). The medium body fat content for women was 8.7 +/- 6.3
      kg (14.7% of body weight), for men 9.5 +/- 8.5 kg (11.9% of body weight). 50% of
      women and 53% of men had body fat deficiency upper 5% of range adjusted for age
      and sex, body fat excess upper 5% of range revealed 14% of women and 17% of men.
      The water content for examined women was 35.5 +/- 6.9 L (62.8 of body weight),
      for men 47.4 +/- 8.4 L (58.8% of body weight). Water deficiency upper 5% of range
      revealed 7% of men, 86% of women and 53% of men had water excess upper 5% of
      range. The lean body mass for women was 48.2% +/- 7.2 kg (85.4% of body weight),
      for men 62.7 +/- 10 kg (88.4% of body weight). Anthropometry as well as
      examination of body composition indicate prevalence of energy protein
      malnutrition among opiate addicted.

PMID- 11199883
TI  - [Nutrition disorders in persons qualified for the methadone treatment. Part II.
      Food choice and intake in diets of opiate addicts].
AB  - The aim of the study is to establish the composition and nutritional value of
      daily food in the group of opiate addicted patients qualified to methadone
      therapy. The presented data show the results of the survey carried out at the
      start of the treatment in the group of 42 patients (13 women aged from 21-33
      years and 29 men aged from 21-46 years). For the dietary survey the method of 24
      hour recall was used: nutrients of daily individual diets and mean values with
      standard deviations for examined groups were calculated with use of own computer
      programme and polish food composition data. The proportion of energy covered by
      groups of food products was also calculated. The results show wide distribution
      of food consumption: the mean level of the daily energy intake was 2438 kcal (SD
      +/- 976, range 492 kcal to 4193 kcal.) in the group of men, and 2039 kcal (SD +/-
      925, range 561-3860 kcal) in the group of women. The mean protein intake was 82 g
      (13.4 E%) for men and 63 g (12.4 E%) for women. In the diet of 5 men and 6 women
      carbohydrate energy exceeded 70% of the total energy intake, indicating high
      consumption of food items containing considerable amounts of sugar (bonbons,
      confectionery, cakes, sweets, chocolate, sweet drinks and similar).

PMID- 11199884
TI  - [The evaluation of methods of usage of addictive substances among high school
      students and Gdansk University students].
AB  - Anonymous questionnaire examination was performed among 222 high school pupils
      and 301 students of Gdansk Medical University, including 210 men and 313 women
      from 18 to 35 (mean 20.8 +/- 2.56) years old. Marijuana was used by 31.2% of them
      (once a week or more often 3.82%), amphetamine and Ecstasy by 9.4% (once a week
      or more often 1.52%), LSD by 3.8%, hallucinogenic mushrooms by 3.1%. Opium
      alkaloids, peyotl, jimsonweed were taken by a few pupils. The frequency of the
      drugs usage was significantly higher among school pupils (42.8%) than among
      Medical University students (30.2%) (chi 2 = 8.80; p < 0.003). Men applied drugs
      about twice as often as women and the difference was as well statistically
      significant (chi 2 = 12.95; p < 0.0003). 29.5% men and 25.2% women were cigarette
      smokers, but only in more advanced smokers (5 cigarettes and more per day) there
      was a significant difference between male and female (chi 2 = 8.69; p < 0.004).

PMID- 11199885
TI  - [Poisonings by selected drugs: analysis of 1995-1999 data files of the Clinic of
      Acute Poisonings Institute of Occupational Medicine in Lodz].
AB  - Over the period of 1995-1999 a total number of 439 cases were admitted to the
      Clinic of Acute Poisonings, Lodz, Poland, due to poisoning with opiates, opioids,
      amphetamine, cannabis products, LSD and cocaine. Most of the patients were males,
      the male to female ratio was 1:1.5 (266 to 173). The distribution by age
      indicated the persons aged 21-30 yr as the highest risk group, then those aged 14
      21 yr. Over the period under study the structure of poisonings changed
      significantly. Since 1997 the number of poisonings with amphetamine and cannabis
      products increased dramatically, while that of opiate poisonings declined.
      Approximately 84% of cases were found to be addicted to a combination of drugs
      and psychotropic agents, mostly benzodiazepine and ethyl alcohol. Drug addiction
      was reported by over 80% patients with opiate poisoning, 44.8% with
      tetrahydrocannabinole poisoning and only 9.5% with amphetamine poisoning. The
      efficacy of treatment in cases of drug addiction is very low. Repeated treatment
      was reported by almost 100% of patients who had attempted to quit drug abuse.
      Among opiate poisoning cases, only 8 out of 45 patients did not question the
      effectiveness of the withdrawal treatment.

PMID- 11199886
TI  - [Acute ethanol and drug poisoning in alcohol abusers].
AB  - In the period from 1997 to 1999 one hundred twenty one alcohol abusers were
      admitted to the clinic with acute ethanol and drug poisoning, including 95 men
      and 26 women from 18 to 69 (mean 36) years old. Fifty eight persons were poisoned
      by ethanol, in remaining 63 cases intoxications were mixed e.g. including
      benzodiazepines, tricyclic antidepressants, carbamazepine, amphetamine,
      phenothiazines, barbiturates, theophylline, salicylates. In the mixed poisonings
      group two men (3.2%) died at the age above 50 years old suffering from congestive
      heart failure, bronchopneumonia and ventricular fibrillation. In the ethanol
      intoxication group there was no fatal case.

PMID- 11199887
TI  - [Fatal ethanol poisoning of the alcohol abusers].
AB  - The examined cohort consisted of 137 alcohol abusers, who died suddenly because
      of the acute ethanol poisoning. Among them there were 109 men and 28 women from
      25 to 73 (mean 46.3 +/- 9.22) years old. Autopsy examinations performed in
      Department of the Forensic Medicine revealed no traumas or diseases explaining
      the sudden death, but showed the increased blood ethanol concentration from 3.6
      to 8.8 (mean 4.67 +/- 0.74) g/l and urine ethanol concentration from 2.0 to 7.3
      (mean 4.88 +/- 0.87) g/l. In the period 1996-1999 in Gdansk Province there was
      twofold decrease in the number of sudden death caused by the acute ethanol
      poisoning in the alcohol abusers.

PMID- 11199888
TI  - [Concentration of zinc, copper and magnesium in the serum of drug addicts].
AB  - The aim of this study was to determine the concentration of zinc, copper and
      magnesium in the blood serum of drug addicts in order to ascertain whether drug
      abuse has an effect on the concentration of these metals. The study was carried
      out on a group of 33 addicts undergoing treatment at the Department of Clinical
      Toxicology, Collegium Medicum, Jagiellonian University in Krakow. The control
      group consisted of 22 young, healthy, drug free, male volunteers. Analyses were
      performed using flame atomic absorption spectrometry. The results demonstrate
      that zinc serum concentrations in the examined group of addicts before therapy
      (mean 0.82 mg/l) were reduced in relation to the control group (mean 1.12 mg/l),
      and was slightly enhanced after the detoxification process (mean 0.86 mg/l). The
      opposite effect was observed in the case copper serum concentration. The copper
      level in the group of addicts on admission to hospital (mean 1.35 mg/l) increased
      in relation to the control group (mean 1.11 mg/l) and was lower during
      hospitalisation (mean 1.18 mg/l). The concentration of magnesium in the serum of
      drug addicts did not change during therapy and was in the same range as in the
      control group (mean concentrations were 20.3 mg/l, 20.2 mg/l and 20.6 mg/l
      respectively).

PMID- 11199889
TI  - [Profile of chemical analyses of psychoactive substances in the Laboratory of the
      Department of Clinical Toxicology in the years 1990-1999].
AB  - The chemical-toxicological Laboratory of the Department of Clinical Toxicology
      carry on the analyses of xenobiotics in biological fluid collected from poisoned
      patient leaving in Krakow and south-eastern Poland. The evaluation of frequency
      of performed analyses in the years 1990-1999 shown that among psychoactive
      substances, ethanol is the most common reason of acute poisoning, followed by
      psychotropic drugs and drugs of abuse. The level of ethyl alcohol above 2 g/L was
      observed in more than 40% of patients. In evaluated period the number of
      barbiturates analyses dropped, benzodiazepines stayed on the same level. During
      this time evident increase of illicit drugs (amphetamines, opiates and THC)
      analyses was observed.

PMID- 11199890
TI  - [Comparison of identification methods of compounds from the opium alkaloids
      groups on Remedi HS instrument with immunoassay methods].
AB  - The biological material of 28 abusers of compounds from the group of opium
      alkaloids were toxicologically analysed. To preliminary estimation of
      psychoactive substances ingestion the immunoassay methods (EMIT or FPIA) were
      used. The received results of total estimation compounds from opium alkaloids and
      their metabolites were compared to the ones obtained from high-performance liquid
      chromatography identification method with using Remedi HS. In the evaluated
      materials of all patients morphine, codeine, N-desmethylcodeine were identified.
      The presence of 6-mono-acethylmorphine was found in the urine of only 4 patients,
      which indicates the instability and a little amount of heroine in "kompot" of
      domestic production. The identification method can be used for simultaneous
      estimation of other substances of abuse from the groups of amphetamines and
      phenothiazines.

PMID- 11199891
TI  - [Medico-legal certification of fatal cases after drug: abuse in the light of
      modern toxicological analysis].
AB  - Introduction of modern instrumental methods for toxicological analysis make
      possible a detection and identification of xenobiotics in different kind of
      multicomponents biological samples (plant sources of narcotics, body fluids and
      tissues of abusers) on a low concentration level. In this way a range of
      possibilities for the interpretation of toxicological results was enlarged.
      General medicolegal trends are strictly connected with modern analytics and they
      can be discussed on the basis of drug--users and fatal cases of intoxications
      with narcotics. Toxicological findings of these cases were worked out by means of
      modern analytical method--liquid chromatography with mass detection (LC/MS).

PMID- 11199892
TI  - [Self-poisoning with Datura stramonium].
AB  - During last 5 years only single cases of poisoning with plants containing
      psychoactive substances, especially Datura stramonium, were treated in the
      Department of Clinical Toxicology in Krakow. In autumn 1999, during 1 month, 7
      patients, aged from 14 to 27 years (mean 18 years) poisoned with Datura
      stramonium were treated. On admission in all patients central and peripheral
      anticholinergic symptoms were stated. Four of them ingested seeds, three of them
      chewed seeds and leaves. Only one ingested Datura seeds in suicidal attempts. In
      the group, only one--20-years-old--previously abused amphetamine and smoked
      marihuana. For the remaining 5 boys (14-18 years-old), it was the first
      experience with psychoactive substances. All were successfully treated, in 5
      patients physostigmine was used, in dose ranged from 2 to 6 mg, with no adverse
      effects. Seasonal accessibility of natural psychoactive products may be the
      first, easy, free step of addiction.

PMID- 11199893
TI  - [Self-poisonings of the addicted persons with corrosive substances].
AB  - In this paper we present two cases of suicidal behaviour; case (1)--patient
      dependent to medicines and case (2)--patient co-dependent, related with alcohol
      addicted person. Both of them combine suicidal corrosive substances consumption,
      but differ clinical course, finished by recover of addicted person and death of
      co-dependent person. In this paper we also present chemical burns of
      gastrointestinal tract algorithm procedure.

PMID- 11199894
TI  - [Intravenous self-administration of metallic mercury by two alcohol abusers].
AB  - This paper presents two alcohol abusers, who intravenously self-injected metallic
      mercury. In one of them during the injection a portion of mercury penetrated into
      extravenous compartment of his right arm. The second patient with depression,
      sociopathy and three suicide attempts in the past repeated intravenous injections
      with small amounts of mercury several times. The results of physical examination
      and all laboratory tests for both the men were normal. Blood mercury
      concentrations were 300 micrograms/l and 710 micrograms/l, respectively. X-ray
      film revealed the presence of metallic mercury deposits in lungs, right ventricle
      and inside the interstitial tissue of the right arm. The largest deposits of
      mercury inside and necrotic tissue were surgically removed from the right arm.

PMID- 11199895
TI  - [How to differentiate acute isopropanol poisoning from ethanol intoxication? -- a
      case report].
AB  - 18-year-old man was found at the street in an unconsious state and brought to
      Department of Acute Poisonings with suspicion of unknown xenobiotic ingestion.
      There was no reliable informations concerning poisoning circumstances. On
      admission patient was confused and unable to answer questions; physical
      examination revealed symptoms resembling ethanol intoxication. Results of
      laboratory tests (e.g., ketonemia and lack of abnormalities of gasometric
      parameters; ethanol, methanol and ethylene glycol in blood and urine were absent)
      enabled to presume acute poisoning with isopropyl alcohol. According to
      informations obtained from patient's parents he had drunk unknown amount of
      liquid using as printing machine cleaner. During next hours rising acetone
      concentration in blood (1.7 g/l--4 hours after admission, 2.4 g/l--12 hours after
      admission) and ketonuria were observed. There was no possibility to evaluate
      level of isopropanol in blood and urine up to 12 hours after admission--gas
      chromatography performed at that time revealed lack of isopropanol both in blood
      and urine. Liquid brought by patient's parents was identified (on gas
      chromatography) as isopropyl alcohol. Patient was directed to be treated on
      hemodialysis, because of high concentration acetone in blood. After 16 hours-
      long hemodialysis patient came back to Department of Acute Poisonings. 3 days
      later patient left hospital in good condition.

PMID- 11199896
TI  - [Homocysteine as a risk factor for atherosclerosis].
AB  - This article presents current views on the significance of homocysteine as a
      potential risk factor for atherosclerosis. The majority of numerous and extensive
      comparative examinations indicate that considerable hyperhomocysteinemia is an
      independent risk factor for the development of the premature atherosclerotic
      lesions. Because of that experts of the Nutrition Committee of American Heart
      Association published in 1999 the recommendations for the application of the
      preventive diet rich in vitamins B6, B12 and folic acid.

PMID- 11199897
TI  - [Viper bites].
AB  - The common European adder (Vipera berus) is the only naturally occurring venomous
      snake in Poland. Adder bites occur mainly in the summer usually to individuals
      who accidentally or purposely bother snakes. Children often become victims of
      adders. The most common symptoms are: local swelling, rash and discoloration
      around the bite. General symptoms such as extensive edema spreading to the trunk,
      vomiting and diarrhoea, acute renal failure, CNS disturbances and cardiovascular
      problems are not frequent. Haemorrhages are extremely rare. Shock, although also
      rare, is the most serious symptom. Fatalities are quite exceptional. The
      treatment should start first of all with immobilization of the bitten limb and in
      most cases it will suffice. Any patient suspected of being bitten, should be kept
      under observation in hospital, where the supportive care is possible, if needed.
      Antivenoms, thought quite safe nowadays, can be used in case of adults only when
      all of the other means including intensive shock care have been ineffective. In
      children early treatment with new more purified antivenoms may be considered
      however existing literature does not offer evidence based efficiency of such
      treatment in larger groups of children. Tetanus protection is a routine.

PMID- 11199898
TI  - [ECG disorders in the course of acute suicidal poisonings by verapamil].
AB  - Data based on experience of Regional Toxicological Centre in Poznan shown that
      most of patients self-poisoned with calcium channel blockers were cases of
      verapamil overdose (41 among 50 patients treated during years 1994-1999).
      Verapamil's greatest toxic effect is on the conduction system, with depression of
      the sinus node and of conduction through the atrioventricular node, but it also
      causes severe myocardial depression. Sings of verapamil toxicity are: sinus
      bradycardia, sinus arrest, narrow complex junctional bradycadia, varying degrees
      of AV block, acute congestive failure and cardiogenic shock, hypotonia. In this
      paper 4 cases with ECG disturbances in the course of verapamil intoxication are
      presented.

PMID- 11199899
TI  - Current world literature. Bibliography.

PMID- 11199900
TI  - Comparison of mitral valve prolapse in dogs and humans.

PMID- 11199901
TI  - The good doctor: the literature and medicine of Anton Chekhov (and others).

PMID- 11199902
TI  - Family medicine scholars: a longitudinal enrichment program for medical students.

PMID- 11199903
TI  - Media advocacy for the office-based teacher of family medicine.

PMID- 11199904
TI  - Reflections on precepting.

PMID- 11199905
TI  - Continuity of care and trust in one's physician: evidence from primary care in
      the United States and the United Kingdom.
AB  - BACKGROUND AND OBJECTIVES: Patients' trust in their physician to act in their
      best interest contributes to the effectiveness of medical care and may be related
      to the structure of the health care system. This study explored the relationship
      between continuity of care and trust in one's physician, particularly in terms of
      differences between the United States and the United Kingdom (UK). METHODS: We
      conducted a cross-sectional survey of adult patients (n = 418 in the United
      States and n = 650 in the UK) who presented in outpatient primary care settings
      in the United States (Charleston, SC, and Lexington, Ky) and in the UK (Leicester
      and Exeter). RESULTS: A high percentage of both groups of patients reported
      having a usual place of care and doctor. A total of 69.8% of UK patients and 8.0%
      of US patients have had their regular physician for > or = 6 years. US patients
      (92.4%) are more likely than UK patients (70.8%) to value continuity with a
      doctor. Both groups had high levels of trust in their regular doctor. Trust was
      related to one continuity measure (length of time for the relationship) but not
      to another (usual provider continuity index more than 1 year). In a multivariate
      model, country of residence had no independent relationship with trust, but
      continuity of care was significantly related. CONCLUSIONS: Higher continuity is
      associated with a higher level of trust between a patient and a physician.
      Efforts to improve the relationship between patients and physicians may improve
      the quality and outcomes of care.

PMID- 11199906
TI  - A national survey of procedural skill requirements in family practice residency
      programs.
AB  - BACKGROUND AND OBJECTIVES: Procedural skill training is a controversial but
      important component of family practice residency programs. This study examines
      the use and composition of required procedure lists in US family practice
      residency programs. METHODS: The study used a cross-sectional nine-item
      questionnaire. This survey was sent to 467 residency program directors listed in
      the 1999 American Academy of Family Physicians Directory of Family Practice
      Residency Programs. RESULTS: A total of 326 programs (70%) responded to the
      survey. Of these, 242 programs (74% of respondents) reported use of a required
      procedure list. Sixty-six programs provided a list. Of these, 63 lists were
      interpretable. The number of required procedures on the lists ranged from a
      minimum of 3 procedures to a maximum of 117, with an average of 42. A total of
      265 distinct procedures were identified, with 25 procedures named on more than
      half of the lists. Thirteen programs (21%) mandated competency in required
      procedures, but only five programs (8%) gave clear definitions of what
      constituted competency. There were no significant differences in lists among
      training program type, university affiliation, number of hospitals used for
      rotation, size of affiliated hospital, or number of residents. CONCLUSIONS: The
      expectations of individual programs vary greatly in terms of required procedures.
      Few programs define how to evaluate the technical competency of their residents.

PMID- 11199907
TI  - Teaching cardiac auscultation using simulated heart sounds and small-group
      discussion.
AB  - BACKGROUND AND OBJECTIVES: Several educators have reported poor identification of
      abnormal cardiac sounds by primary care residents. Practice and review with
      cardiology patient simulators and prerecorded heart sounds has been shown to
      increase the accuracy of diagnosis by medical students and residents. METHODS:
      The participants were 15 members of an urban family practice residency. The
      residents were presented with simulated heart sounds and were asked to identify
      them in a pretest and posttest. Between the tests, participants were invited to
      three separate teaching sessions that involved a discussion of cardiac
      auscultatory findings and a review of audiotaped similar heart sounds. Residents
      who were unable to attend the teaching sessions formed a control group. RESULTS:
      The pretest identification rate was 36% for the heart sounds. This improved to
      62% for all residents after the intervention. Higher rates of improvement were
      demonstrated by the residents who attended one or more teaching sessions,
      compared with the residents who attended no teaching sessions. CONCLUSIONS: Small
      group discussion and repetitive auscultation of simulated heart sounds can
      improve the cardiac auscultatory proficiency of family practice residents.

PMID- 11199908
TI  - Successful Duluth program narrows the gender gap.

PMID- 11199909
TI  - Medical student body weight and preclinical medical education.

PMID- 11199910
TI  - [HIV protease inhibitors. Development and overview]  .

PMID- 11199911
TI  - ["It is necessary, so we go here." Drug development in the in DDR  particularly
      antihistamines]  .

PMID- 11199912
TI  - [Fomocaine from the chemical, pharmacokinetic and pharmacologic  viewpoint:
      current status and overview].

PMID- 11199913
TI  - [In vitro methods for the study of phase I metabolism]  .

PMID- 11199914
TI  - [Neuroactive steroids: actions and risks]  .

PMID- 11199915
TI  - [Plant excipients--valuable pharmaceutical aids or superfluous ballast?]  .

PMID- 11199916
TI  - [Inhibitors of histone deacetylase as new agents for prevention  and treatment of
      cancer]  .

PMID- 11199917
TI  - Mycophenolate mofetil in lupus nephritis.

PMID- 11199918
TI  - From BILAG to BLIPS--disease activity assessment in lupus past, present and
      future.
AB  - During the past 16 years, members of the British Isles Lupus Assessment Group
      (BILAG) have met on a regular basis and have been instrumental in devising a
      comprehensive disease activity index and, in association with others in the
      international rheumatological community, devising and/or testing damage and
      patients self-assessment indices. The history of what the BILAG group has
      achieved is set out here and the latest attempts at computerisation and
      improvements in the Disease Activity Index itself are described.

PMID- 11199919
TI  - Immunization with a bacterial ATP-binding cassette transporter fragment
      suppresses autoimmunity and prolongs survival in MRL/lpr lupus-prone mice.
AB  - The present study was undertaken to better define the role of the U1 70 kDa
      antigen in a spontaneous murine model of systemic lupus erythematosus (SLE) by
      testing whether immunization with the U1 70 kDa polypeptide could alter the
      production of antibodies against U1 70 kDa or against other small nuclear
      ribonucleoproteins (snRNP), modify disease expression or alter survival. We found
      that, while immunization with a U1 70 kDa derived fusion protein (70 KFP) tended
      to delay the development of anti-snRNP antibodies in the sera of MRL/lpr mice, it
      had no effect on autoimmune-mediated renal disease or survival. Unexpectedly, it
      was found that MRL/lpr mice immunized with a 367 amino acid fragment of a
      bacterial ATP-binding cassette transporter, MFP, had prolonged survival compared
      to saline injection or U1 70 kDa immunization and that this was associated with a
      delay in the onset of SLE-like proliferative glomerulonephritis. This is the
      first study, to our knowledge, in which a bacterial ATP-binding cassette
      transporter was shown to be beneficial in treating a murine model of SLE. We
      report that MFP significantly prolonged longevity in the MRL/lpr murine model of
      SLE compared to saline injection or 70 KFP immunization and that improved
      survival was associated with a delay in the onset of SLE-like glomerulonephritis.

PMID- 11199920
TI  - Activation of type I interferon system in systemic lupus erythematosus correlates
      with disease activity but not with antiretroviral antibodies.
AB  - The objective was to investigate the relation between serum levels of interferon
      alpha (IFN-alpha), the activity of an endogenous IFN-alpha inducing factor (SLE
      IIF), clinical and immunological disease activity as well as serum levels of
      antiretroviral antibodies in SLE. Serum levels of IFN-alpha were measured in
      serial sera from 30 patients sampled at different stages of disease activity
      (SLEDAI score). The SLE-IIF activity was measured by its ability to induce IFN
      alpha production in cultures of normal peripheral blood mononuclear cells. Both
      serum IFN-alpha and SLE-IIF increased markedly at flare in serially followed
      patients. The SLEDAI score, levels of anti-dsDNA antibodies and IL-10 correlated
      positively, and complement components Clq, C3 and leukocytes correlated inversely
      with serum concentrations of IFN-alpha. The extent of multiple organ involvement
      correlated with serum IFN-alpha. No relation between concentrations of retroviral
      peptide binding antibodies and IFN-alpha or SLE-IIF activity was found. The close
      relationship between disease activity in SLE patients and IFN-alpha serum levels
      suggests that activation of the type 1 IFN system might be of importance in the
      disease process.

PMID- 11199921
TI  - Vascular events in hypertensive patients with systemic lupus erythematosus.
AB  - Our purpose was to examine prospectively the relationship between systemic
      hypertension and vascular events in patients with SLE. SLE patients followed in
      the University of Toronto Lupus Clinic presenting between 1980 and 1988 and
      within one year of their diagnosis of SLE were identified. Standard definitions
      were used for hypertension and for all vascular events (MI, angina, CVA, PVD).
      The presence of traditional CAD risk factors, along with disease- and therapy
      related risk factors for the development of vascular disease, were compared in
      the hypertensive and normotensive group. A multivariate logistic regression was
      performed to determine the best predictor of a vascular event. One hundred and
      fifty patients were identified in our inception cohort [75 hypertensive (50%) and
      75 (50%) normotensive]. Seventeen hypertensive patients (22.7%) had at least one
      vascular event as compared to six (8.0%) normotensive patients (p = 0.022). The
      vascular events included 7 with CAD, 5 with CVA, and 5 with PVD in the
      hypertensive group while in the normotensive group 3 patients developed CAD, 2
      CVA and 1 PVD. Fifteen deaths were recorded in the hypertensive group as compared
      to eight deaths in the non-hypertensive groups (P = 0.09). The groups were
      comparable with respect to associated risk factors, except for higher frequency
      of hypercholesterolemia (P = 0.003), azotemia (P = 0.001) and corticosteroid use
      (P = 0.038) in the hypertension group. In a multivariate analysis the best
      predictor of a vascular event was hypercholesterolemia (OR 6.9, 95% CI 2.4-24.8,
      P < 0.001). We conclude that systemic hypertension is associated with an
      increased frequency of vascular events in SLE. This is best explained by its
      association with hypercholesterolemia.

PMID- 11199922
TI  - Safety profile and causes of withdrawal due to adverse events in systemic lupus
      erythematosus patients treated long-term with cyclosporine A.
AB  - Several case reports and uncontrolled trials have established the use of
      cyclosporine A (CsA) in systemic lupus erythematosus (SLE) but some concerns have
      been raised because of its kidney damaging effects. We here report the results of
      a retrospective follow-up study designed to assess the safety profile and causes
      of discontinuation due to adverse events in SLE patients treated with CsA. We
      treated 56 SLE patients with oral CsA at doses of 3-5 mg/kg for an average of 26
      months. Adverse events not leading to the discontinuation of therapy were
      observed in 62.5% of the patients, the most frequent being hypertrichosis. CsA
      was stopped because of the occurrence of side effects in 9/56 (16%) of the
      patients. The most common were nephrotoxicity (3/9) and the occurrence of tremors
      (3/9). These effects were always reversible within three months of CsA
      withdrawal. The patients who were older than 40 y had a significant slightly
      increased risk of stopping CsA therapy for any adverse events (RR 1.08; CI 95%
      1.03-1.14). In comparison with previous studies, this study involved a larger
      cohort of SLE patients who were evaluated for a longer period of follow-up, and
      confirmed the good tolerability of CsA in these subjects.

PMID- 11199923
TI  - ASE-1: an autoantigen in systemic lupus erythematosus.
AB  - ASE-1 is a 55 kDa nucleolar autoantigen. We show that autoantibodies to this
      antigen occur at a higher frequency in the sera of patients with SLE than in
      other systemic rheumatic diseases and that the specificity of ASE-1 as a serum
      marker of SLE increases as the number of epitopes recognized by the sera
      increases. Autoantibodies to ASE-1 were temporally associated with autoantibodies
      to HsEg5 but were not found in conjunction with other known serum markers of SLE.
      The frequency of antibodies to ASE-1 epitopes in a SLE cohort was approximately
      the same as anti-dsDNA. However, anti-dsDNA is associated with renal involvement,
      whereas ASE-1 reactivity shows an association with a history of serositis. We
      conclude that ASE-1 is correlated with serositis and that ASE-1 should be added
      to a list of autoantigens that are considered important serological features of
      SLE.

PMID- 11199925
TI  - The rating scale preference measure as an evaluative measure in systemic lupus
      erythematosus.
AB  - Preference measures may be useful tools to assess patients' overall health
      related quality of life. We studied the validity and sensitivity to change of the
      rating scale preference measure in patients with systemic lupus erythematosus
      (SLE), and compared its properties with those of the patient global assessment of
      SLE activity, in a prospective longitudinal observational study of changes in the
      symptoms and clinical disease activity of 23 patients. Patients were assessed
      every two weeks for up to 40 weeks. Construct validity was assessed by the
      strength of correlations between changes over time in the rating scale preference
      measure and patient global assessment and changes in the physician global
      assessment, Systemic Lupus Activity Measure (SLAM), European Consensus Lupus
      Activity Measure (ECLAM), the British Isles Lupus Assessment Group index (BILAG),
      and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Changes in the
      rating scale were more highly correlated with changes in each of these standards
      than were changes in the patient global assessment, demonstrating the construct
      validity of this measure. Sensitivity to change was measured using the two-week
      interval of greatest change in either the physician global assessment or the SLE
      activity measures as standards. The rating scale preference measure was less
      sensitive to change than the patient global assessment when tested against four
      different standards. The sensitivity to change of the rating scale was less than
      one-half that of the patient global assessment when either the SLAM or ECLAM was
      used as the standard. Although these results support the validity of the rating
      scale as a measure of health-related quality of life in patients with SLE, its
      limited sensitivity to change may make it less attractive as an endpoint measure
      in clinical trials.

PMID- 11199924
TI  - Antioxidant susceptibility of pathogenic pathways in subjects with
      antiphospholipid antibodies: a pilot study.
AB  - The pathogenesis of antiphospholipid antibody (aPL) related thrombosis is
      multifactorial and includes, amongst others, enhanced coagulation activation
      measured as prothrombin fragment 1 + 2 (F1 + 2), elevated plasma levels of von
      Willebrand factor (vWF), plasminogen activator inhibitor (PAI) and endothelin-1
      (ET-1) as well as heightened thromboxane generation and lipid peroxidation. To
      evaluate the antioxidant susceptibility of some of the above pathways, probucol
      (500 mg/d orally, a cholesterol lowering agent bearing antioxidant properties)
      was administered for a three week period to 14 subjects with aPL and to seven
      healthy controls. At baseline aPL participants showed higher plasma levels of vWF
      (P = 0.006), ET-1 (P = 0.0002) and enhanced urinary excretion of 11-dehydro
      thromboxane-B2 (TXB2) (P = 0.0004), F2-isoprostanes (marker of lipid
      peroxidation) (P = 0.02) and albumin (P = 0.04) than controls. In the aPL group
      baseline IgG anticardiolipin (aCL) titre positively related with urinary TXB2 (r2
      = 0.43, P = 0.01) and inversely with urinary NOx (r2 = -0.6, P = 0.005) whereas
      urinary NOx and TXB2 were negatively correlated (r2 = -0.42, P = 0.01). After the
      treatment period significant decreases from baseline values were noted for PAI (P
      = 0.01), ET-1 (P = 0.006), TXB2 (P = 0.02), F2-isoprostanes (P = 0.01) and
      albuminuria (P = 0.01) in aPL participants but not in controls. These pilot data
      support oxidative sensitive mechanisms and a potential role for antioxidant
      treatment in the pathogenesis of aPL induced vasculopathy.

PMID- 11199926
TI  - Validation of a Chinese version of the Medical Outcomes Study Family and Marital
      Functioning Measures in patients with SLE.
AB  - The objective was to validate a Chinese translation of the Medical Outcomes Study
      Family and Marital Functioning Measures (FFM and MFM) in patients with systemic
      lupus erythematosus (SLE). Chinese-speaking SLE patients (n = 69) completed a
      self-administered questionnaire containing the FFM and MFM and assessing
      demographic and socio-economic status twice within a 2 week period. SLE activity,
      disease-related damage and quality of life were assessed using the BILAG,
      SLICC/ACR Damage Index and SF-36 Health Survey, respectively. Scale psychometric
      properties were assessed through factor analysis, Cronbach's alpha, quantifying
      test-retest differences and known-groups construct validity. Factor analysis
      identified 1 factor corresponding to the FFM and 2 factors corresponding to the
      MFM. Internal consistency for the FFM was excellent (alpha = 0.92) while that for
      the MFM was acceptable (alpha = 0.62). Mean (s.d.) test-retest differences were
      0.06 (1.54) points for the FFM and 0.03 (2.08) points for the MFM. 11 and 10 of
      13 a priori hypotheses relating the FFM and MFM, respectively, to demographic,
      disease and quality of life variables were confirmed, supporting the construct
      validity of these scales. The Chinese FFM and MFM are valid and reliable measures
      of family and marital functioning in Chinese-speaking SLE patients, with
      psychometric properties very similar to the source English version.

PMID- 11199927
TI  - Validation of the Chinese SF-36 for quality of life assessment in patients with
      systemic lupus erythematosus.
AB  - We studied the reliability and validity of the Chinese Short-Form 36 Health
      Survey (SF-36) in a cross sectional study of patients with systemic lupus
      erythematosus (SLE). Sixty-nine consecutive subjects completed a questionnaire
      containing the Chinese SF-36 twice within 14 d. Disease activity and damage were
      assessed using the British Isles Lupus Activity Group (BILAG) and SLICC/ACR
      Damage Index (DI) scales, respectively. Internal consistency was assessed using
      Cronbach's alpha, reliability using Spearman's correlation and repeatability
      coefficients, and relationships between SF-36, BILAG and DI scores using
      Spearman's correlation. The Chinese SF-36 showed high internal consistency (alpha
      = 0.72-0.91) and good reliability, with correlations exceeding 0.70 for 7 scales
      and mean scale score differences of < 2 points for 6 scales. SF-36 scores
      correlated weakly with BILAG scores (-0.27 to -0.41) and DI scores (-0.24 to 
      0.35), and subjects' mean SF-36 scores were 6-24 points lower than the general
      population, supporting construct validity of the SP-36. These data suggest that
      the Chinese SF-36 is a reliable and valid measure of quality of life in patients
      with SLE.

PMID- 11199928
TI  - Maculopapular lupus rash in a young woman with systemic involvement.
AB  - We describe a 23-y-old woman with known systemic lupus erythematosus (SLE) who
      presented to us with the characteristic maculopapular lupus rash. Although well
      known among the LE-specific skin lesions, this acute cutaneous manifestation is
      rarely reported.

PMID- 11199929
TI  - Wegener's granulomatosis associated with antiphospholipid syndrome.
AB  - We report a case of Wegener's granulomatosis (WG) with pulmonary hemorrhage also
      satisfying the criteria for antiphospholipid antibody syndrome (APS). This
      association has, to the best of our knowledge, never been described before.
      Pulmonary hemorrhage may be an early manifestation of several immune and
      idiopathic disorders such as ANCA-associated vasculitis. Several case-reports of
      APS patients with capillaritis have been described. A possible explanation is
      that microvascular thrombosis with subsequent increase in vascular permeability
      facilitates perivascular IgG and complement deposition leading to development of
      capillaritis. Whether the vascular disease is secondary to thrombosis or
      vasculitis or both is important in choosing the proper management strategy. We
      suggest that anticardiolipin antibodies (aCL) should be detected in ANCA
      associated vascularitis because they may contribute to life-threatening events
      superimposed on vascular damage.

PMID- 11199930
TI  - SLE, diabetes mellitus and emphysematous infections of the urinary tract.

PMID- 11199931
TI  - Drug transporters revisited.

PMID- 11199932
TI  - Panic disorder and response to sertraline: the effect of previous treatment with
      benzodiazepines.
AB  - More than 50% of patients who seek psychiatric care for panic disorder have
      previously received prescriptions for a benzodiazepine (BZ). Research on the
      treatment of generalized anxiety suggests that a history of BZ exposure might
      decrease the efficacy and tolerability of treatment with a serotonergic
      anxiolytic. This study examines the effect of prior BZ treatment on the efficacy
      and tolerability of sertraline treatment for panic disorder. Data were pooled (N
      = 705) from four double-blind, placebo-controlled studies of the efficacy of
      sertraline for the treatment of panic. Two of the studies were 12-week fixed-dose
      studies with starting doses of 50 mg, whereas 2 were flexible-dose studies of 10
      week duration with starting doses of 25 mg. The effect of study treatment on the
      frequency of panic attacks, Clinical Global Impressions (CGI) Improvement Scale,
      and tolerability was examined for patients with or without prior BZ treatment.
      The efficacy of sertraline was not affected by prior treatment with BZs. The mean
      endpoint reduction in panic attack frequency was identical in patients with or
      without prior BZ use: 79% vs. 80% (not significant). A history of good versus
      poor response to prior BZ treatment did not significantly influence CGI responder
      rates for sertraline-treated patients (67% vs. 61%, respectively). Sertraline CGI
      responder rates were significantly greater than placebo response, which was 47%
      for the good-response prior-BZ subgroup (p = 0.007), and 36% for the poor
      response BZ subgroup (p = 0.013). Placebo response was lower in patients with any
      prior BZ use by 10% on an intent-to-treat last-observation-carried-forward
      analysis (p = 0.106) and by 15% on a completer analysis (p = 0.045). Prior BZ use
      did not influence either rates of adverse events or discontinuation rates within
      the first 3 weeks in patients treated with either sertraline or placebo.
      Sertraline is both well-tolerated and has significant efficacy in patients with
      panic disorder, including the subset of patients with panic disorder who have
      previously been treated with BZs.

PMID- 11199933
TI  - Adverse drug interaction between risperidone and carbamazepine in a patient with
      chronic schizophrenia and deficient CYP2D6 activity.

PMID- 11199934
TI  - Atypical antipsychotics and cardiovascular risk in schizophrenic patients.

PMID- 11199935
TI  - Heroin and schizophrenia: subjective responses to abused drugs in dually
      diagnosed patients.

PMID- 11199936
TI  - Repeated episodes of hypothermia in a subject treated with haloperidol,
      levomepromazine, olanzapine, and thioridazine.

PMID- 11199937
TI  - A case of risperidone-induced stuttering.

PMID- 11199938
TI  - Venlafaxine treatment of patients with comorbid alcohol/cocaine abuse and
      attention-deficit/hyperactivity disorder: a pilot study.

PMID- 11199939
TI  - Successful treatment of nonanticholinergic delirium with a cholinesterase
      inhibitor.

PMID- 11199940
TI  - The economic consequences of a drug-drug interaction.

PMID- 11199941
TI  - Treating neuroleptic malignant syndrome as catatonia.

PMID- 11199942
TI  - Olanzapine plasma concentrations and clinical response: acute phase results of
      the North American Olanzapine Trial.
AB  - Olanzapine is an atypical antipsychotic that is effective in the treatment of
      schizophrenia. Olanzapine plasma concentrations > or = 9.3 ng/mL (24 hours
      postdose) have been identified as a predictor of clinical response in acutely ill
      patients with schizophrenia. The authors report a receiver operating
      characteristic (ROC) curve analysis of 12-hour olanzapine concentrations and
      treatment response from the North American Double-Blind Olanzapine Trial. After a
      4- to 7-day placebo lead-in, patients meeting DSM-III-R criteria for
      schizophrenia were randomly assigned to receive olanzapine, haloperidol, or
      placebo. Patients who were randomly assigned to receive olanzapine were given
      daily doses ranging from 2.5 to 17.5 mg/day for up to 6 weeks. Blood samples for
      the determination of olanzapine plasma concentrations were obtained between 10
      and 16 hours (11.7 +/- 1.7 hours) after the last dose was administered.
      Therapeutic response data and olanzapine concentrations used for analysis were
      obtained from the endpoint visit for each patient if the patient had been
      receiving a fixed olanzapine dose for at least the last 2 weeks of the study.
      Plasma concentrations from previous visits were used if endpoint concentrations
      were invalid. Response was defined as a > or = 20% reduction in Brief Psychiatric
      Rating Scale (BPRS) scores and a Clinical Global Impression (CGI) Severity scale
      score of < or = 3 or a final BPRS score of < or = 35. The final ROC analysis
      included data from 84 patients and suggested an olanzapine concentration > or =
      23.2 ng/mL to be a predictor of therapeutic response. Fifty-two percent of
      patients with 12-hour olanzapine concentrations > or = 23.2 ng/mL responded,
      whereas only 25% of patients with concentrations < 23.2 ng/mL responded.
      Furthermore, an olanzapine concentration > or = 23.2 ng/mL was a predictor of
      response in the Scale for the Assessment of Negative Symptoms (> or = 20%
      decrease and endpoint CGI < or = 3). Olanzapine concentrations were found to be a
      function of olanzapine dose (in milligrams per day) and gender such that
      prospective olanzapine dosing is feasible. A 12-hour olanzapine plasma
      concentration of > 23.2 ng/mL was a predictor of therapeutic response in acutely
      ill patients with schizophrenia. Males required a higher olanzapine dose to reach
      this threshold concentration than their female counterparts.

PMID- 11199943
TI  - Divalproex sodium augmentation of haloperidol in hospitalized patients with
      schizophrenia: clinical and economic implications.
AB  - Divalproex sodium has been approved for use in treating bipolar disorder. Its
      usefulness in schizophrenia has yet to be adequately assessed. Three days after
      initiating haloperidol treatment, patients who were hospitalized for an acute
      exacerbation of schizophrenia received either valproate augmentation (early
      augmentation group) or continued to receive haloperidol alone (no-augmentation
      group). Patients in the no-augmentation group who failed to respond 14 days after
      the dose of haloperidol reached 20 mg/day received valproate augmentation
      (delayed-augmentation group). By day 14, the early-augmentation group improved
      32.4% more than the no-augmentation group. Fifty percent of the patients in the
      no-augmentation group failed to respond to haloperidol alone for 2 weeks. They
      improved by 29% upon the addition of valproate. Compared with those who received
      no or delayed augmentation, the early-augmentation group required 44.8% fewer
      inpatient days from the initiation of haloperidol treatment. Patient response to
      treatment was particularly noted in suspiciousness, hallucinations, unusual
      thought content, and emotional withdrawal. Early augmentation with valproate may
      reduce the length of inpatient stays and provide substantially better therapeutic
      outcomes. It is, however, premature to recommend changes in the standard clinical
      management of schizophrenia on the basis of the data provided herein, in view of
      the small sample and open-label nature of the report.

PMID- 11199944
TI  - Ziprasidone in the short-term treatment of patients with schizoaffective
      disorder: results from two double- blind, placebo-controlled, multicenter
      studies.
AB  - This study assessed the efficacy of ziprasidone for the treatment of
      schizoaffective disorder. Data were taken from subsets of patients with
      schizoaffective disorder, derived from two separate double-blind, placebo
      controlled, parallel-group, multicenter studies. A total of 115 hospitalized
      patients with an acute episode of schizoaffective disorder were randomly assigned
      to receive either fixed oral doses of ziprasidone 40 mg/day (N = 16), 80 mg/day
      (N = 18), 120 mg/day (N = 22), 160 mg/day (N = 25), or placebo (N = 34) for 4 to
      6 weeks. Mean baseline-to-endpoint changes in Brief Psychiatric Rating Scale
      (BPRS) total, BPRS Core, Clinical Global Impressions Severity scale (CGI-S), BPRS
      Depressive, BPRS Manic, and Montgomery-Asberg Depression Rating Scale total
      scores were compared between the placebo and ziprasidone groups. Neurological
      (Simpson-Angus, Barnes Akathisia, Abnormal Involuntary Movement Scale [AIMS]) and
      other side effects were also assessed. Significant dose-related improvements on
      all primary efficacy variables (BPRS total, BPRS Core, CGI-S) and for BPRS Manic
      items were observed with ziprasidone treatment in a combined analysis of data
      from both studies (p < or = 0.01). Ziprasidone 160 mg/day was significantly more
      effective than placebo in improving mean BPRS total, BPRS Core, BPRS Manic, and
      CGI-S scores (p < 0.05). At 120 mg/day, ziprasidone was significantly more
      effective than placebo in improving mean CGI-S scores (p < 0.05). The incidence
      of individual adverse events was generally low in all treatment groups and was
      not dose-related. In addition, no significant differences were observed between
      baseline-to-endpoint mean changes in Simpson-Angus and AIMS scores with placebo
      or ziprasidone 40 to 160 mg/day. These results suggest that ziprasidone may have
      efficacy in the treatment of affective as well as psychotic symptoms of
      schizoaffective disorder, with a low side-effect burden.

PMID- 11199945
TI  - Augmentation of fluoxetine's antidepressant action by pindolol: analysis of
      clinical, pharmacokinetic, and methodologic factors.
AB  - In a controlled trial, the beta-adrenoceptor/5-hydroxytryptamine-1A (5-HT1A)
      receptor antagonist pindolol accelerated and enhanced the antidepressant effect
      of fluoxetine. The median times to sustained response (> or = 50% reduction of
      baseline severity maintained until endpoint) were 19 days for fluoxetine plus
      pindolol (N = 55) and 29 days for fluoxetine plus placebo (N = 56) (p = 0.01).
      The response rate at endpoint was 16% greater in patients treated with the
      combination. The plasma concentration of pindolol remained stable between 3 days
      (first blood sampling) and 6 weeks. Mean values were approximately 26 nM, a
      concentration higher than the Ki of (-)pindolol for human 5-HT1A autoreceptors
      (11 nM). Plasma fluoxetine and norfluoxetine concentrations increased steadily
      until the fourth week of treatment. Fluoxetine concentrations were lower in
      patients receiving the combination (p = 0.043), but there was no significant
      relationship to the clinical response in either group. A reanalysis of the data
      using a survival analysis revealed that significant differences in the time to
      sustained response between both groups would have also been detected (1) in a 2
      week trial, (2) without a placebo lead-in phase, and (3) with less frequent
      visits. However, the use of "response" instead of "sustained response" as measure
      of clinically relevant change would have greatly diminished the difference
      between treatment arms (p = 0.08 instead of p = 0.01). This emphasizes the need
      of using stringent outcome criteria in antidepressant drug trials. A comparison
      of the data of all sustained responders (N = 27) in the fluoxetine-plus-placebo
      group with the first 27 responders in the fluoxetine-plus-pindolol group (of a
      total of 38) revealed a highly significant difference in the time to sustained
      response (18 and 10 days, respectively; p = 0.0002). This indicates that the
      faster response in the fluoxetine-plus-pindolol group is not a result of the
      greater proportion of responders.

PMID- 11199946
TI  - Mitchell B. Balter Award. Human leukocyte antigen-A1 predicts a good therapeutic
      response to clozapine with a low risk of agranulocytosis in patients with
      schizophrenia.
AB  - Several studies indicate an association between human leukocyte antigens (HLA)
      and clozapine-induced agranulocytosis. The authors have previously reported a
      significantly increased frequency of HLA-A1 among patients with schizophrenia who
      do not respond to conventional drugs, but do respond to clozapine treatment. In
      this study, the authors addressed the question of whether the same association is
      found in patients developing granulocytopenia or agranulocytosis. The frequency
      of the HLA-A1 allele in patients with clozapine-induced agranulocytosis or
      granulocytopenia was low (11.5%), whereas HLA-A1 was associated with a good
      therapeutic response to clozapine at an allele frequency of 58%. The frequency of
      HLA-A1 is 20% in the Finnish population. These results suggest that HLA-A1 may
      predict a good therapeutic outcome and a low risk of agranulocytosis and, thus,
      enable defining a subgroup of patients with schizophrenia in whom clozapine
      treatment could be started early to stop the disease from progressing.

PMID- 11199947
TI  - Long-term treatment of obsessive-compulsive disorder after an acute response: a
      comparison of fluoxetine versus placebo.
AB  - Few controlled studies have evaluated the long-term continuation of
      pharmacotherapy for relapse prevention in patients with obsessive-compulsive
      disorder (OCD). This study assessed efficacy and safety of fluoxetine versus
      placebo in preventing relapse of OCD during a 52-week period in responders to
      short-term administration of fluoxetine. Patients who met DSM-IV criteria for OCD
      and had a Yale-Brown Obsessive Compulsive Scale score > or = 19 were treated with
      single-blind fluoxetine 20, 40, or 60 mg/day (based on physician assessment of
      response and tolerability). After 20 weeks, responders were randomly assigned to
      receive continued treatment with fluoxetine or placebo and were monitored for
      relapse for up to 52 weeks. Of 130 patients who entered the study, 71 (55%) were
      randomly assigned to receive fluoxetine (N = 36) or placebo (N = 35). Patients
      who received fluoxetine had numerically lower relapse rates compared with those
      who received placebo, although the difference was not significant (Kaplan-Meier 1
      year relapse rates: fluoxetine, 20.6%; placebo, 31.9%; one-tailed p value =
      0.137). In additional analyses evaluating patients on the basis of fluoxetine
      dose at randomization, patients who continued treatment with fluoxetine 60 mg/day
      (N = 52) had significantly lower rates of relapse than those who were switched to
      placebo (Kaplan-Meier 1-year relapse rates: fluoxetine, 17.5%; placebo, 38.0%;
      one-tailed p value = 0.041). Those who responded to the acute treatment phase
      with 40 (N = 18) or 20 (N = 1) mg/day had low overall rates of relapse, and the
      difference between continued fluoxetine and placebo treatment for these patients
      was not significant. For responders to the 60 mg/day dosage, those patients who
      continued treatment with fluoxetine were provided greater protection against
      relapse than those patients switched to placebo.

PMID- 11199948
TI  - Increased 5-hydroxytryptamine-2 receptor binding in the frontal cortex of
      depressed patients responding to paroxetine treatment: a positron emission
      tomography scan study.
AB  - The changes in aminergic receptors elicited by antidepressant treatments have
      been extensively examined in the brain of experimental animals using radioligand
      and molecular techniques. However, there is a very limited direct information
      regarding the changes effected by such treatments in the human brain, as well as
      its relationship to clinical improvement. Using positron emission tomography
      (PET) scanning, the authors examined the cortical 5-Hydroxytryptamine-2A (5-HT2A)
      receptor binding of [18F]fluoro-ethyl-spiperone after a 4-week treatment with the
      selective serotonin reuptake inhibitor paroxetine. [18F]fluoro-ethyl-spiperone
      labels 5-HT2A receptors in the cortex and dopamine D2 receptors in the basal
      ganglia. A binding index (BI) was calculated in the frontal cortex and the basal
      ganglia (mostly caudate-putamen) by reference to cerebellum. Thirty-seven
      inpatients with major depression with a mean +/- SD score on the 21-item Hamilton
      Rating Scale for Depression (HAM-D-21) of 26.3 +/- 4.3 at admission were treated
      with paroxetine 40 mg/day. After 4 weeks of treatment, the BI in the frontal
      cortex of remitted patients (HAM-D-21 score = 4.7 +/- 4.0; N = 20) was
      significantly greater than the score in nonresponder patients (HAM-D-21 score =
      21.2 +/- 4.0; N = 17) (BI = 0.54 +/- 0.15 and 0.41 +/- 0.17, respectively; p <
      0.02). No such difference was observed in the basal ganglia (5.45 +/- 1.11 and
      5.39 +/- 0.82, respectively; p = 0.85). The significant difference in cortical BI
      persisted when age was used as covariate (p < 0.016). These data suggest that
      clinical improvement in patients treated with paroxetine is associated with an
      increase in the density of 5-HT2A receptors in the frontal cortex.

PMID- 11199949
TI  - Opipramol for the treatment of generalized anxiety disorder: a placebo-controlled
      trial including an alprazolam-treated group.
AB  - Opipramol, a drug widely prescribed in Germany, is a tricyclic compound with no
      reuptake-inhibiting properties. However, it has pronounced D2-, 5-HT2-, and H1
      blocking potential and high affinity to sigma receptors (sigma-1 and sigma-2). In
      early controlled trials, anxiolytic effects were revealed. However, those studies
      were performed before the concept of generalized anxiety disorder (GAD) was
      established. Because of the interesting receptor-binding profile and promising
      results of the early clinical trials, the authors performed a state-of-the-art
      placebo-controlled trial using alprazolam as an active control. Three hundred
      seven outpatients with GAD were included. After a 7-day single-blind placebo
      washout, patients were randomly assigned to receive either opipramol (final dose,
      200 mg/day), alprazolam (2 mg/day), or placebo and were treated for 28 days. The
      efficacy of both active compounds was higher than the effects with placebo
      treatment. There were statistically significant differences (p < 0.05, according
      to the analysis of covariance) in the main outcome criterion (baseline-adjusted
      final means of an intent-to-treat analysis of the total scores on the Hamilton
      Rating Scale for Anxiety) and in secondary efficacy parameters, with global
      improvement of 47% for placebo and significantly more for opipramol (63%) and
      alprazolam (64%). Regarding safety and tolerability, no substantial differences
      in the number of adverse events observed between treatment groups were obvious.
      Sedation seemed more pronounced with alprazolam treatment than with opipramol or
      placebo. In this trial, it was demonstrated for the first time that opipramol, a
      strong but nonselective sigma site ligand, possesses anxiolytic efficacy superior
      to placebo in the treatment of GAD.

PMID- 11199950
TI  - No difference in brain activation during cognitive performance between ecstasy
      (3,4-methylenedioxymethamphetamine) users and control subjects: a [H2(15)O]
      positron emission tomography study.
AB  - The long-term use of the serotonin-releaser and uptake-inhibitor 3,4
      methylenedioxymethamphetamine (MDMA, "Ecstasy") has been associated with memory
      impairments and increased liability to depressive mood and anxiety attacks. It is
      unclear, however, whether these psychologic deviations are reflected in
      alterations of the underlying neurophysiologic substrate. The authors compared
      mood and regional cerebral blood flow (rCBF) profiles between regular polytoxic
      Ecstasy users and Ecstasy-naive controls. Brain activity as indexed by rCBF was
      measured during cognitive activation by an attentional task using positron
      emission tomography and [H2(15)O]. Mood was assessed by means of the Hamilton
      Rating Scale for Depression (HAM-D) and the EWL Mood Rating Scale. Statistical
      parametric mapping revealed that brain activity did not differ between the two
      groups. Both groups also performed equally on the cognitive task requiring
      sustained attention. However, significantly higher levels of depressiveness as
      determined by the HAM-D and EWL scales were found in Ecstasy-using subjects.
      These data indicate that, despite differences in mood, polytoxic Ecstasy users do
      not differ from Ecstasy-naive controls in terms of local brain activity.
      Heightened depressiveness in the Ecstasy group was consistent with results from
      previous studies and could be related to serotonergic hypofunction resulting from
      repeated MDMA consumption. However, this study cannot exclude the possibility
      that the observed differences are preexisting rather than a result of Ecstasy
      use.

PMID- 11199951
TI  - Posttreatment results of combining naltrexone with cognitive-behavior therapy for
      the treatment of alcoholism.
AB  - Naltrexone, an opiate antagonist medication, has been reported to be efficacious
      in the treatment of alcohol dependence when added to psychosocial treatments.
      Although the within-treatment efficacy of naltrexone has received primary
      attention, there has been little published on the outcome of individuals once the
      medication is discontinued. Animal studies have led to concern regarding a quick
      rebound to heavy drinking. This report extends the data previously reported by
      evaluating the outcome in alcoholic subjects during the 14 weeks after a 12-week
      treatment with naltrexone or placebo in conjunction with cognitive behavioral
      therapy. Of the 131 subjects evaluated during the treatment phase, 124 (95%) had
      up to 14 weeks of posttreatment drinking data available for analysis. Measures of
      craving and blood markers of heavy drinking were also evaluated. By the end of
      treatment, naltrexone demonstrated significantly greater efficacy than placebo.
      However, once the medication was discontinued, there was a gradual increase in
      relapse rates, heavy drinking days, and drinks per drinking day, and fewer days
      of abstinence were reported. By the end of the 14-week follow-up period, although
      naltrexone-treated subjects were, on average, still doing better than control
      subjects, the effectiveness of naltrexone was no longer statistically
      significant. There was no evidence that naltrexone subjects had an immediate
      return to heavy alcohol use as suggested in animals. These data suggest that, for
      a number of alcoholic subjects, continued treatment with naltrexone, or perhaps
      psychosocial intervention, for longer than 3 months is indicated. Future research
      should identify which alcohol-dependent individuals may need prolonged treatment
      to improve treatment success in the long term.

PMID- 11199952
TI  - The relationship between mood state and plasma methadone concentration in
      maintenance patients.
AB  - Although methadone maintenance is designed to stabilize opioid-dependent
      patients, some experience significant withdrawal in the latter part of the 24
      hour interdosing interval. This study was designed to determine the mood changes
      that maybe associated with such withdrawal. Eighteen methadone patients, nine of
      whom experienced significant withdrawal, were tested over a single interdosing
      interval. During this time, 13 blood samples were collected to measure plasma
      racemic methadone concentrations, and the Profile of Mood States (POMS) was
      administered on 11 of these occasions. The POMS was also administered on 11
      occasions over 24 hours to 10 drug-free healthy controls. In comparison with
      controls, methadone patients showed increased anger, depression, tension,
      confusion, and fatigue, as well as decreased vigor. For all scales, maximal
      differences from controls occurred at times of trough methadone concentration and
      minimal differences around the time of peak concentration. Changes in mood over
      the interdosing interval were more exaggerated in the nine patients who
      experienced significant withdrawal compared with those who did not. The composite
      Total Mood Disturbance (TMD) scores were calculated for each subject at each time
      point. The sigmoid Emax model was used to relate plasma concentrations to these
      data and to calculate the slope factor (N). This model could be fitted for 14 of
      the 18 patients with a mean +/- SEM slope factor of 2.2 +/- 0.5. TMD score was
      also shown to be inversely related to the rate of decline in methadone
      concentration from peak to trough. These results show that significant mood
      changes occur in response to changes in methadone concentration, and these are
      more pronounced in those who experience withdrawal. The concentration-effect
      relationships suggest that relatively small changes in plasma concentration will
      result in significant mood change. Differences in the degree of mood change
      between those who do and do not experience significant withdrawal may be
      explained by variation in the rate of decline in plasma concentration from peak
      to trough.

PMID- 11199953
TI  - Effects of newer atypical antipsychotics on autonomic neurocardiac function: a
      comparison between amisulpride, olanzapine, sertindole, and clozapine.
AB  - As part of a prospective clinical study investigating the effects of atypical
      neuroleptics on autonomic neurocardiac function (ANF), serial standardized
      recordings of conventional electrocardiograms and computer-calculated
      measurements of 5-minute resting heart rate variability (HRV) were obtained from
      51 medication-free inpatients with schizophrenia (DSM-III-R-diagnosed) before and
      after an average of 14.1 days of treatment with amisulpride 400 mg/day (N = 12),
      olanzapine 20 mg/day (N = 13), sertindole 12 mg/day (N = 13), or clozapine 100
      mg/day (N = 13). Reference values for the HRV data were obtained from a large
      group of well-matched healthy controls (N = 70). The most important findings were
      the following: (1) clozapine, olanzapine, and sertindole all prolonged mean
      frequency-corrected QTc times, which, in the case of sertindole, proved to be
      significant (Wilcoxon test p <0.05); (2) sertindole and clozapine significantly
      increased the mean resting heart rate; and (3) only clozapine significantly
      reduced the parasympathetic resting tone. The results of the HRV studies are
      discussed considering the in vitro receptor profiles of the atypical neuroleptics
      under study. Potential implications for the cardiac safety and tolerance of these
      drugs are also discussed.

PMID- 11199954
TI  - The effect of extract of ginkgo biloba added to haloperidol on superoxide
      dismutase in inpatients with chronic schizophrenia.
AB  - The purpose of the study was to evaluate the effect of the classic antipsychotic
      haloperidol plus extract of ginkgo biloba (EGb) on treatment-resistant chronic
      schizophrenia and on blood superoxide dismutase (SOD) levels. Eighty-two patients
      with chronic refractory schizophrenia were studied. Forty-three patients were
      treated with haloperidol plus extract of ginkgo biloba (group 1), and 39 received
      haloperidol plus placebo (group 2). SOD levels of these patients were measured
      before and after treatment and were compared with SOD levels of 30 healthy
      volunteers. Therapeutic efficiency was equated with a change in clinical rating
      scores assessed by standardized measurement tools that included the Scale for the
      Assessment of Positive Symptoms and the Scale for the Assessment of Negative
      Symptoms (SANS) over this period. Patients in group 1 improved significantly as
      demonstrated by scores from these two assessment instruments; those in group 2
      improved significantly only as shown by scores on SANS. SOD levels before
      treatment in all patients were significantly higher than those in healthy
      controls; after treatment, the SOD level decreased significantly in group 1 but
      not in group 2. These results suggest that EGb may enhance the efficiency of the
      classic antipsychotic haloperidol in patients with schizophrenia, especially on
      their positive symptoms, and that EGb may work through an antioxidant effect that
      is involved in the therapeutic mechanism in patients with chronic refractory
      schizophrenia.

PMID- 11199955
TI  - The effects of concomitant phenytoin administration on the steady-state
      pharmacokinetics of quetiapine.
AB  - Quetiapine fumarate ('Seroquel') is a newly introduced atypical antipsychotic
      with demonstrated efficacy in the treatment of positive and negative symptoms of
      schizophrenia. It is extensively metabolized, predominantly by cytochrome P450
      3A4. Therefore, concurrent administration of drugs that induce or inhibit this
      enzyme may affect quetiapine pharmacokinetics. This study demonstrated that the
      potent cytochrome P450 enzyme-inducer phenytoin did indeed have a marked effect
      on the metabolism of quetiapine, resulting in a 5-fold increase in clearance when
      administered concomitantly to patients with DSM-IV-diagnosed schizophrenia,
      schizoaffective disorder, or bipolar disorder. These results indicate that dosage
      adjustment of quetiapine may be necessary when the two drugs are given
      concurrently and that caution may be required when administering other drugs that
      inhibit or induce cytochromes, particularly P450 3A4.

PMID- 11199956
TI  - A preliminary study of bupropion sustained-release for smoking cessation in
      patients with chronic posttraumatic stress disorder.
AB  - This study was conducted to evaluate the effect of bupropion sustained-release
      (SR) on smoking cessation in patients with chronic posttraumatic stress disorder
      (PTSD). Fifteen veterans with chronic PTSD who desired to stop smoking enrolled
      in a 12-week double-blind evaluation of bupropion SR and placebo. Patients were
      randomly assigned in a 2:1 ratio to receive either bupropion SR or placebo.
      Bupropion SR was initiated at 150 mg daily for 3 or 4 days and increased to a
      final dose of 150 mg twice daily (300 mg daily total). Ten patients received
      bupropion SR and five received placebo. Nine of the patients who received
      bupropion SR were already being treated with at least one other psychotropic
      medication. One of the ten patients did not complete the study because of
      medication side effects. Eighty percent of patients receiving bupropion SR
      successfully stopped smoking by the end of week 2, and 6 (60%) of these 10
      maintained smoking cessation at the study endpoint (week 12). At the 6-month
      follow-up, 40% of the patients (4 of 10) who received bupropion SR maintained
      smoking cessation. One (20%) of the five patients who received placebo stopped
      smoking and maintained smoking cessation at the 6-month follow-up. Bupropion SR
      was generally well-tolerated in combination with other psychotropic medications.
      Bupropion SR may be effective in helping patients who desire to quit smoking and
      who also have a concomitant anxiety disorder, such as PTSD.

PMID- 11199958
TI  - Enhanced TOF-SIMS imaging of a micropatterned protein by stable isotope protein
      labeling.
AB  - Patterning of biomolecules on surfaces is an increasingly important technological
      goal. Because the fabrication of biomolecule arrays often involves stepwise,
      spatially resolved derivatization of surfaces, spectroscopic imaging of these
      arrays is important in their fabrication and optimization. Although imaging time
      of-flight secondary ion mass spectrometry (TOF-SIMS) is a powerful method for
      spatially resolved surface analysis, TOF-SIMS images of micropatterned proteins
      on organic substrates can be difficult to acquire, because of the lack of high
      intensity, protein-specific molecular ions that are essential for imaging under
      static conditions. In contrast, low-mass ions are of suitable intensity for
      imaging, but can originate from different chemical species on the surface. A
      potential solution to this problem is to utilize stable isotope labeled proteins,
      an approach that has heretofore not been explored in TOF-SIMS imaging of
      micropatterned proteins and peptides. To investigate the feasibility of stable
      isotope enhanced TOF-SIMS imaging of proteins, we synthesized 15N-labeled
      streptavidin by labeling of the protein during expression from a recombinant
      gene. The spatial distribution of streptavidin bound to biotin micropatterns,
      fabricated on a polymer and on a self-assembled monolayer on gold, was imaged by
      TOF-SIMS. Imaging of high-intensity, low-m/z secondary ions (e.g., C15N-) unique
      to streptavidin enabled unambiguous spatial mapping of the micropatterned protein
      with a lateral resolution of a few micrometers. TOF-SIMS imaging of
      micropatterned 15N-labeled streptavidin also illustrated the exquisite
      sensitivity of TOF-SIMS to low fractional coverage of protein (5 A effective
      thickness) in the background regions of the protein micropattern.

PMID- 11199957
TI  - Effects of bupropion sustained-release on sexual functioning and nocturnal
      erections in healthy men.
AB  - Many antidepressants are known to cause adverse sexual effects. Bupropion is an
      antidepressant with fewer reported adverse sexual effects. Studies of sexual side
      effects are often confounded by psychiatric and medical conditions affecting
      sexual function. In this study, the effects of bupropion on subjective and
      objective sexual functioning were measured in healthy men. Thirteen men without
      psychiatric or medical illness completed a 2-week, placebo-controlled, double
      blind, crossover trial of bupropion sustained-release 300 mg/day. Subjects had a
      1-week washout period between trials. Sexual function was measured using a
      validated, self-administered questionnaire and the RigiScan, an instrument
      measuring nocturnal penile tumescence and rigidity. No differences were found in
      self-reported sexual function, number of erections, total erection time, or
      penile rigidity in subjects taking bupropion compared with those taking placebo
      or baseline. These findings support that bupropion does not have subjective
      adverse sexual side effects and does not affect nocturnal erections in healthy
      men.

PMID- 11199959
TI  - Full phase analysis of portland clinker by penetrating synchrotron powder
      diffraction.
AB  - Fabrication of portland cements commonly depends on X-ray fluorescence (XRF),
      which measures the elemental compositions. XRF is used to adjust the raw material
      proportions and to control the process conditions. However, to predict the
      mechanical strength of the resulting concrete, it is essential to know the phase
      composition which is, so far, indirectly inferred by the Bogue method. Here, we
      report a phase analysis of an industrial portland clinker containing six
      crystalline phases, Ca3SiO5, Ca2SiO4, Ca4Al2Fe2O10, Ca3Al2O6, NaK3(SO4)2, and
      CaO, by Rietveld refinement of synchrotron X-ray powder diffraction data (lambda
      = 0.442377 A). Even the minor component, CaO 0.45(2)%, was readily analyzed. We
      have also carried out a phase study of the same clinker with laboratory X-rays to
      characterize the changes in the detection limit and errors. Furthermore, by
      adding a suitable crystalline standard to the same clinker, we have determined
      the overall amorphous phase content. The procedure established for this state-of
      the-art phase analysis shows the high precision that can be achieved by using
      penetrating X-rays, which is of interest not only in cement chemistry but in
      other industrially important multiphase systems such as slags, superalloys, or
      catalysts.

PMID- 11199960
TI  - Microchannel DNA sequencing matrices with a thermally controlled "viscosity
      switch".
AB  - Polymers and hydrogels that swell or shrink in response to environmental stimuli
      such as changes in temperature, pH, or ionic strength are of interest as
      switchable materials for applications in biotechnology. In this paper, we show
      that thermoresponsive polymers offer some particular advantages as entangled
      matrices for DNA sequencing by capillary and microchip electrophoresis. Matrices
      based on conventional water-soluble polymers demand a compromise in their design
      for microchannel electrophoresis: whereas highly entangled solutions of high
      molar mass polymers provide optimal sequencing performance, their highly viscous
      solutions require application of high pressures to be loaded into electrophoresis
      microchannels. Here, we demonstrate the reproducible synthesis, precise
      characterization, and excellent DNA sequencing performance of high molar mass,
      thermoresponsive polymer matrices that exhibit a reversible, temperature
      controlled "viscosity switch" from high-viscosity solutions at 25 degrees C to
      low-viscosity, microphase-separated colloidal dispersions at a chosen, elevated
      temperature. The viscosity switch decouples matrix loading and sieving
      properties, enabling acceleration of microchannel flow by 3 orders of magnitude.
      DNA sequencing separations yielding read lengths of 463 bases of contiguous
      sequence in 78 min with 97% base-calling accuracy can be achieved in these
      matrices. Switchable matrices will be particularly applicable to microfluidic
      devices with dynamic temperature control, which are likely to provide the next
      major leap in the efficiency of high-throughput DNA analysis.

PMID- 11199961
TI  - Fabrication of phospholipid bilayer-coated microchannels for on-chip
      immunoassays.
AB  - Herein we describe a new class of microfluidic immunoassays based upon solid
      supported lipid bilayers. Two-dimensionally fluid bilayer material, which can
      accommodate multivalent binding between surface-bound ligands and aqueous
      receptors, was coated on the surface of poly(dimethylsiloxane) microchannels. The
      bilayers contained dinitrophenyl (DNP)-conjugated lipids for binding with
      bivalent anti-DNP antibodies. Twelve independent data points of surface coverage
      versus bulk protein concentration could be made simultaneously by forming a
      linear array of channels and flowing fluorescently labeled antibodies into them.
      This enabled an entire binding curve to be obtained in a single experiment. The
      measured apparent binding constant for the DNP/anti-DNP system was 1.8 microM.
      The methodology for performing heterogeneous assays developed here not only
      produces rapid results but also requires much less protein than traditional
      procedures and eliminates some standard sources of experimental error.

PMID- 11199962
TI  - Analysis of protein phosphorylation by a combination of elastase digestion and
      neutral loss tandem mass spectrometry.
AB  - Loss of phosphoric acid is the most effective fragmentation reaction of pSer- and
      pThr-containing phosphopeptides of small size (up to 10-15 residues) in low
      energy collision-induced dissociation. Therefore, tandem mass spectrometry with
      neutral loss scanning was evaluated for its utility to analyze protein
      phosphorylation using protein kinase A (PKA) catalytic subunit, which is
      phosphorylated at Thr197 and Ser338, as an example. Analysis of tryptic digests
      of phosphoproteins by tandem mass spectrometry with scanning for neutral loss of
      phosphoric acid resulted in spectra with poor signal-to-noise ratio, mainly
      because of the large size of the phosphopeptides formed (>2 kDa). This
      unfavorable size was caused by the distribution of tryptic cleavage sites in PKA
      and by interference of phosphorylation with tryptic cleavage. To generate a set
      of smaller peptide fragments, digestion was performed using the low-specificity
      protease elastase. Analysis of the total elastase digest with neutral loss
      scanning resulted in observation of a set of partially overlapping
      phosphopeptides with high abundance, providing a complete coverage of PKA
      phosphorylation sites. The peptide size generated by elastase (0.5-1.5 kDa) is
      ideally suited for this scan mode, which was found to provide the highest
      specificity for detection of singly charged phosphopeptides (neutral loss of 98).
      Identification of the PKA phosphorylation sites was performed by mass
      spectrometric sequencing of the elastase-derived phosphopeptides, which provided
      highly informative product ion spectra.

PMID- 11199963
TI  - Ion trap/ion mobility/quadrupole/time-of-flight mass spectrometry for peptide
      mixture analysis.
AB  - An ion trap/ion mobility/quadrupole/time-of-flight mass spectrometer has been
      developed for the analysis of peptide mixtures. In this approach, a mixture of
      peptides is electrosprayed into the gas phase. The mixture of ions that is
      created is accumulated in an ion trap and periodically injected into a drift tube
      where ions separate according to differences in gas-phase ion mobilities. Upon
      exiting the drift tube, ions enter a quadrupole mass filter where a specific mass
      to-charge (m/z) ratio can be selected prior to collisional activation in an
      octopole collision cell. Parent and fragment ions that exit the collision cell
      are analyzed using a reflectron geometry time-of-flight mass spectrometer. The
      overall configuration allows different species to be selected according to their
      mobilities and m/z ratios prior to collision-induced dissociation and final MS
      analysis. A key parameter in these studies is the pressure of the target gas in
      the collision cell. Above a critical pressure, the well-defined mobility
      separation degrades. The approach is demonstrated by examining a mixture of
      tryptic digest peptides of ubiquitin.

PMID- 11199965
TI  - Correction of H3+ contributions in hydrogen isotope ratio monitoring mass
      spectrometry.
AB  - Two fundamentally different approaches, termed "pointwise" and "peakwise," are
      currently used to correct hydrogen isotope ratio monitoring data for the presence
      of H3+ ion contributions. Consideration of the underlying assumptions shows that
      the peakwise approach is valid only for peaks with the same functional shape and
      only when background signals do not vary. The pointwise correction is much more
      versatile and can be used even when peak shapes and sizes, as well as background
      signals, vary significantly. It is not exact and is limited in accuracy by (1)
      the signal-broadening effects of electronic time constants, (2) the analog-to
      digital conversion frequency, and (3) the highest frequency of the sample signal.
      To minimize errors for typical gas chromatographic signals, time constants of
      <500 ms and analog-to-digital sampling intervals of < or =250 ms are needed.
      Errors are further minimized by matching sample and standard peaks in both
      amplitude and D/H ratio. Using the pointwise algorithm, we demonstrate that a
      series of 14 homologous n-alkanes varying in concentration over a 5-fold range
      can be analyzed with a mean precision of 2.3 per thousand and no systematic
      errors.

PMID- 11199964
TI  - A method for quantification from composite spectra: application to the
      determination of isomeric DNA photoproducts by tandem mass spectrometry.
AB  - Quantification of mixture components from their composite optical or mass spectra
      is a common need in analytical chemistry. We encountered the need when applying a
      combination of enzymatic digestion with nuclease P1 and tandem mass spectrometry
      to a mixture of isomeric photomodified oligodeoxynucleotides. In the procedure,
      we collisionally activated the [M - H]- or [M + Na - 2H]- ion of trinucleotide
      triphosphates, which were extricated enzymatically from the larger, damaged
      oligodeoxynucleotides, and we measured the relative abundances of characteristic
      fragment ions. The results sometimes yield curved calibrations for plots of the
      relative fragment ion abundances in the product ion spectra of isomers versus
      their relative amounts. We developed a normalized linear model, which brings
      understanding to the nonlinear plots and allows quantification of the mixture
      components from their composite spectra. The outcome demonstrates a general
      quantification procedure and shows that different yields for generating fragment
      ions from different constituents of the mixture cause the curved calibration
      lines.

PMID- 11199966
TI  - Determination of the the H3 factor in hydrogen isotope ratio monitoring mass
      spectrometry.
AB  - The H3 factor, K, is a parameter required in high-precision, mass spectrometric
      analyses of hydrogen isotopic abundances. When H2 is used as the sample gas, R* =
      R - Ki2, where R* is the true HD/H2 ratio, R is the observed (mass 3)/(mass 2)
      ion-current ratio, and i2 is the ion current at mass 2. Four different methods
      for the determination of K were defined and tested under conditions
      characteristic of isotope ratio monitoring systems. Three of these were peak
      based. The fourth employed steady flows of H2 from a conventional inlet system.
      Results obtained using the latter method were more precise (standard deviation of
      K = 0.1 versus approximately 0.6 ppm mV(-1) for the peak-based methods). However,
      use of the resulting values of K for correction of isotope ratio monitoring GC/MS
      results led to systematic errors as large as 9 per thousand, whereas use of the
      peak-based values led to no systematic errors. Values of K were only weakly
      dependent on the pressure of He, declining approximately 5% for each 10-fold
      increase in P(He). Small variations in partial pressures of H2O and CH4,
      potential contaminants under isotope ratio monitoring conditions, had no
      significant effect on values of K.

PMID- 11199967
TI  - Predicting electrospray response from chromatographic retention time.
AB  - The relationship between electrospray ionization response and HPLC retention time
      was explored. For the series of small peptides studied, higher ESI response was
      observed for analytes with longer reversed-phase HPLC retention times. This
      correlation existed for both experimentally measured retention times and those
      calculated from amino acid retention coefficients. This study is useful t

PMID- 11199968
TI  - Signal amplification using "spot-on-a-chip" technology for the identification of
      proteins via MALDI-TOF MS.
AB  - The presented "spot-on-a-chip" technology enables easy enrichment of samples in
      the low nanomolar (1-5 nM) range and provides a fast and reliable automated
      sample preparation method for performing matrix-assisted laser
      desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis
      with high sensitivity and throughput. Through microdispensing, which allows
      accurate deposition of 60-pL droplets, dilute samples were enriched by making
      multiple droplet depositions in nanovials. The sample was confined to a defined
      spot area (300 x 300 microm), and multiple depositions increase the surface
      density of analyte in the nanovial, thereby providing detection of low attomole
      levels. The impact of the nanovial geometry with respect to the MALDI-TOF MS
      resolution for peptides deposited in the microfabricated silicon vials was
      investigated and the optimal geometry and size were determined. The spot-on-a
      chip technology, that is, the combination of microdispensing, micromachined
      silicon nanovials and on-spot enrichment provides a signal amplification of at
      least 10-50 times as compared to an ordinary sample preparation. The linearity of
      the enrichment effect is shown by the analysis of a peptide mixture at the 5 nM
      level. The signal amplification provided by the spot-on-a-chip enrichment is
      demonstrated by the analysis of relevant biological samples, interleukin-8 from a
      spiked cell supernatant, and by successful protein identification of an excised
      spot from a high-sensitivity silver-stained two-dimensional electrophoresis gel
      separation.

PMID- 11199969
TI  - Sulfur isotope analysis of sulfide and sulfate minerals by continuous flow
      isotope ratio mass spectrometry.
AB  - A continuous flow method (CF-IRMS) for the rapid determination of the sulfur
      isotope composition of sulfide and sulfate minerals has significant advantages
      over the classic extraction method in terms of the reduced sample quantity and a
      rapid analytical cycle of less than 8 min/ analysis. For optimum performance, the
      technique is sensitive to a number of operating parameters, including sample
      weight and the O2 saturation of the Cu-reduction reactor. Raw data are corrected
      using a calibration based on five international and internal standards ranging
      from -17.3 to +20.3 per thousand, which requires monitoring in order to correct
      the effect of changing delta18O of the sample gas on the measured mass 66 values.
      Measured sulfur contents are within 1-1.5% of expected values and the
      reproducibility of delta34S values is +/-0.1 per thousand (1sigma). The technique
      has been used successfully for more than 1000 analyses of geological samples with
      a wide range of delta34S from -20 to +20 per thousand.

PMID- 11199970
TI  - Secondary ion mass spectrometry of zeolite materials: observation of abundant
      aluminosilicate oligomers using an ion trap.
AB  - Oligomeric oxyanions were observed in the secondary ion mass spectra (SIMS) of
      zeolite materials. The oxyanions have the general composition AlmSinO2(m+n)H(m
      1)(-)(m+n = 2 to 8) and are termed dehydrates. For a given mass, multiple
      elemental compositions are possible because (Al + H) is an isovalent and isobaric
      substitute for Si. Using 18 keV Ga+ as a projectile, oligomer abundances are low
      relative to the monomers. Oligomer abundance can be increased by using the
      polyatomic projectile ReO4- (approximately 5 keV). Oligomer abundance can be
      further increased using an ion trap (IT-) SIMS; in this instrument, long ion
      lifetimes (tens of ms) and relatively high He pressure result in significant
      collisional stabilization and increased high-mass abundance. The dehydrates
      rapidly react with adventitious H2O present in the IT-SIMS to form mono-, di-,
      and trihydrates. The rapidity of the reaction and comparison to aluminum oxyanion
      hydration suggest that H2O adds to the aluminosilicate oxyanions in a
      dissociative fashion, forming covalently bound product ions. In addition to these
      findings, it was noted that production of abundant oligomeric aluminosilicates
      could be significantly increased by substituting the countercation (NH4+) with
      the larger alkali ions Rb+ and Cs+. This constitutes a useful tactic for
      generating large aluminosilicate oligomers for surface characterization and ion
      molecule reactivity studies.

PMID- 11199971
TI  - Compositional analysis of glycosaminoglycans by electrospray mass spectrometry.
AB  - The purpose of this work is to analyze glycosaminoglycans (GAGs) directly from
      complex mixtures without the need to purify individual components. Novel
      conditions for negative ion electrospray MS of chondroitin sulfate (CS)
      oligosaccharides are described in which sodium adduction and fragmentation are
      avoided. Differentiation between positional sulfation isomers is demonstrated for
      CS disaccharides, and a selected reaction monitoring scheme is used to quantify
      sulfation isomers in disaccharides liberated from decorin and biglycan. A size
      exclusion chromatography LC/MS method is shown to be effective for compositional
      analysis of longer CS oligosaccharides. The SEC step serves to simplify the
      composition of GAGs entering the mass spectrometer at any time, thus allowing the
      masses of the constituent molecules to be extracted. Mass spectrometric detection
      produces far more information than conventional UV or fluorescent detectors and
      allows the monosaccharide composition of individual components to be determined.

PMID- 11199972
TI  - Control of electrochemical reactions at the capillary electrophoresis
      outlet/electrospray emitter electrode under CE/ESI-MS through the application of
      redox buffers.
AB  - It was found that combining capillary electrophoresis (CE) and electrospray
      ionization mass spectrometry (ESI-MS) overlays two controlled current techniques
      to form a three-electrode system (CE inlet, CE outlet/ES emitter, and MS inlet
      electrodes) in which the CE outlet electrode and the ES emitter electrode were
      shared between the CE and the ESI-MS circuits. Depending on the polarities and
      magnitudes of the voltages at the CE inlet, CE outlet/ES emitter, and MS inlet
      electrodes, the nature of the two redox reactions at the shared electrode was the
      same or different (both reduction, both oxidation, or one oxidation and the other
      reduction). Several redox buffers were introduced for controlling electrochemical
      reactions at the shared electrode. By reacting at this electrode, redox buffers
      were able to maintain electrode potentials below the onset of water electrolysis,
      thereby eliminating gas bubble formation and/or pH drift. The volume of the gas
      generated due to water electrolysis was used to quantitate water oxidation or
      reduction at this electrode. Two types of redox buffers were used. A reactive
      electrode with an oxidation potential below that of water was used as the
      electrode under anodic conditions. Also, a reactive compound with a redox
      potential below that of water was added to the CE and/or ESI running buffer. When
      the shared electrode was the anode of both CE and ESI-MS circuits, the use of
      iron or etched and sanded stainless steel (ss) wire, instead of platinum wire,
      suppressed bubble formation at the shared electrode. Under these conditions,
      corrosion of the Fe wire and formation of Fe2+ replaced oxidation of water,
      eliminating O2 gas bubble and H+ formation. When mixtures of peptides were
      analyzed, iron adducts of peptides were observed. For a fresh wire, however, the
      intensities of adduct ions were less than 3% of the protonated molecules. After a
      few days of operation, the intensities of the adduct ions increased to
      approximately 50%, due to rust formation on the Fe wire. On-column rinsing with a
      40% solution of citric acid rejuvenated the Fe wire and reduced the adduct peak
      intensities to less than 3%. Unmodified ss wire did not quench bubble formation,
      which was attributed to its passivated surface. When Fe, ss, and Pt wires were
      used as the shared electrode under forward polarity CE and positive ESI mode,
      where the shared electrode acted as a cathode with respect to CE inlet and as an
      anode with respect to MS inlet, reduction of water at the cathodic end of the
      electrode and, in the case of ss and Pt wires, oxidation of water at the anodic
      end of the shared electrode produced a significant amount of bubbles. Under these
      conditions, however, a buffer containing 50 mM p-benzoquinone completely
      suppressed both cathodic reduction and anodic oxidation of water for CE currents
      up to 4 microA. Reduction of p-benzoquinone at the cathodic end of the shared
      electrode to hydroquinone, and oxidation of this hydroquinone at the anodic end
      of the electrode, replaced reduction and oxidation of water, eliminating bubble
      formation. A 0.1% acetic acid solution saturated with I2 was also found to
      suppress bubble formation at the cathode for CE currents up to 3 microA; however,
      strong iodine adduct ions were observed under CE/ESI-MS when a mixture of
      peptides was analyzed. The application of iron as an in-capillary electrode for
      the analysis of a peptide mixture and a protein digest demonstrated a high
      separation efficiency similar to when hydroquinone was used as a redox buffer.

PMID- 11199973
TI  - Techniques for increasing the throughput of flow injection mass spectrometry.
AB  - Improvements to the design and operation of a Gilson 215 multiprobe liquid
      handling system have resulted in a significant increase in the throughput for
      flow injection molecular weight characterization of combinatorial chemistry
      libraries. The rapid injection sequence, and subsequent increased sample
      throughput, is effected by directing the entire mobile-phase flow through each of
      the injection loops sequentially while isolating or "dead-ending" the remaining
      nonactive loops. This mode of operation was accomplished by incorporating column
      switching valves prior to and following the set of eight parallel injectors.
      Analysis rates are achieved without sacrificing the integrity of the flow
      injection peak profile as baseline resolution is maintained for all samples.
      Using this system, the total analysis time for a 96-well microtiter plate has
      been reduced to approximately 5 min.

PMID- 11199974
TI  - Design and performance of an ESI interface for selective external ion
      accumulation coupled to a Fourier transform ion cyclotron mass spectrometer.
AB  - The coupling of Fourier transform ion cyclotron resonance mass spectrometry
      (FTICR MS) with electrospray ionization has advanced the analysis of large
      biopolymers and provided the basis for high-throughput protein characterization
      (e.g., for rapid "proteome" analyses). In this work, the combination of high
      performance capillary liquid chromatography with FTICR mass spectrometry and
      external ion accumulation has been shown to increase both sensitivity and
      analysis duty cycle. Instrument versatility is further improved by ion
      preselection followed by ion accumulation in an external linear quadrupole ion
      trap. The interface was tested with a 3.5-T FTICR mass spectrometer and evaluated
      with a number of peptides and proteins whose molecular weights ranged from 500 to
      66000. A significant increase in the sensitivity, duty cycle, and dynamic range
      over that of the previously used accumulated trapping was achieved, exhibiting a
      detection limit of approximately 10 zmol (approximately 6000 molecules) for
      smaller proteins such as cytochrome c. Capillary LC external accumulation
      interface with FTICR was successfully applied for the study of whole-proteome
      mouse tryptic digests.

PMID- 11199975
TI  - A thermodynamic study of the temperature-dependent elution order of cyclic alpha
      amino acid enantiomers on a copper(II)-D-penicillamine chiral stationary phase.
AB  - The reversal of the elution order of cyclic alpha-amino acid enantiomers as a
      function of the temperature on a copper(II)-N,S-dioctyl-D-penicillamine ligand
      exchange column is described. The thermodynamic parameters accounting for the
      retention and the separation of analytes were determined by means of van't Hoff
      plots. The influence of different chromatographic conditions on these parameters
      was investigated, showing little effect of the Cu(II) concentration in the eluent
      but strong influence of the organic modifier content on the separation. Further,
      the pH of the mobile phase was found to be a determining factor for the retention
      of the analytes. Based on these findings, a separation mechanism is postulated
      comprising the importance of complex formation for primary docking at the
      stationary phase, while hydrophobic interactions are crucial for chiral
      discrimination.

PMID- 11199976
TI  - Single-run capillary electrophoretic determination of inorganic nitrogen species
      in rainwater.
AB  - A capillary electrophoretic (CE) method for the simultaneous determination of
      nitrate, nitrite, and ammonium ions has been developed. Direct (NO3-, NO2-) and
      indirect (NH4+) UV detection at 214 nm in conjunction with electromigration
      sampling from both ends of the capillary was used. The optimized separations were
      carried out in 10 mmol/L imidazole sulfate, 2 mmol/L 18-crown-6, and 0.02 mmol/L
      tetradecyltrimethylammonium hydroxide electrolyte (pH 4.0). The method permits
      excellent separation of three nitrogen species in only 4 min. A 1 x 10(-4) mol/L
      KBr solution was used as an internal standard to limit possible electrokinetic
      injection biases. Experimental results showed that the use of an anionic internal
      standard for cationic analytes and vice versa gives only slightly better
      precision than analysis with no internal standard. Using Br- internal standard
      for NO3- and NO2- ions and K+ for NH4+, peak area RSD values decrease
      significantly. The proposed system was applied to the speciation of inorganic
      nitrogen ions in rainwater samples. The recovery tests established for external
      calibration and standard addition techniques using one or two internal standards
      were within the range 100 +/- 10%. The CE results agree with those obtained by
      spectrophotometric methods.

PMID- 11199977
TI  - Low-dispersion turns and junctions for microchannel systems.
AB  - Numerical methods are employed to optimize the geometry of two-dimensional
      microchannel turns such that the turn-induced spreading of a solute band is
      minimized. An inverted numerical method is first developed to compute the
      electric potential and local species motion in turns of arbitrary geometry. The
      turn geometry is then optimized by means of a nonlinear least-squares
      minimization algorithm using the spatial variance of the species distribution
      leaving the turn as the object function. This approach yields the turn geometry
      producing the minimum possible dispersion, subject only to prescribed
      constraints. The resulting low-dispersion turns provide an induced variance 2-3
      orders of magnitude below that of a comparable conventional turns. Sample results
      are presented for 180 and 90 degrees turns, and the use of these turns to form
      wyes and tees is discussed. A sample 45 degrees wye is presented. The use of low
      dispersion turns in folding separation columns is also discussed, and sample
      calculations are presented for folding a column 100 microm in width and up to 900
      mm in length onto a region of only 10 by 10 mm. These low-dispersion geometries
      are applicable to electroosmosis, electrophoresis, and some pressure-driven
      flows.

PMID- 11199978
TI  - Pulsed flow modulation for high-speed GC using a pressure-tunable column
      ensemble.
AB  - A computer-driven pressure controller is used to deliver pressure pulses to the
      junction point of two series-coupled columns using different stationary-phase
      chemistries. The column ensemble consists of a trifluoropropylmethyl polysiloxane
      column followed by a dimethyl polysiloxane column. Each pressure pulse causes a
      differential change in the carrier gas velocities in the two columns, which lasts
      for the duration of the pulse. A pressure pulse is used to selectively increase
      the separation of a component pair that is separated by the first column but
      coelutes from the series-coupled ensemble. If both components are on the same
      column when the pulse is applied, a small change in the ensemble separation
      occurs. If one component of the pair is on the first column and the other
      component is on the second column, a pressure pulse can result in a much larger
      change in the ensemble separation for the component pair. A model with a
      spreadsheet algorithm is used to predict the effects of a pressure pulse on the
      trajectories of component bands on the column ensemble. The effect of the
      initiation time of a pressure pulse is investigated for a two-component mixture
      that coelutes from the column ensemble. For the case where the entire pressure
      pulse occurs when one of the components is on the first column and the other
      component is on the second column, the peak separation from the ensemble
      increases nearly linearly with the product of the pressure pulse amplitude and
      the pulse duration. Peak shape artifacts are observed if the pressure pulse
      occurs when a solute band is migrating across the column junction point.

PMID- 11199979
TI  - A battery-powered notebook thermal cycler for rapid multiplex real-time PCR
      analysis.
AB  - A compact, real-time PCR instrument was developed for rapid, multiplex analysis
      of nucleic acids in an inexpensive, portable format. The instrument consists of a
      notebook computer, two reaction modules with integrated optics for four-color
      fluorescence detection, batteries, and a battery-charging system. The instrument
      weighs 3.3 kg, measures 26 x 22 x 7.5 cm, and can run continuously on the
      internal batteries for 4 h. Independent control of the modules allows differing
      temperature profiles and detection schemes to be run simultaneously. Results are
      presented that demonstrate rapid (1) detection and identification of Bacillus
      subtilis and Bacillus thuringensis spores and (2) characterization of a single
      nucleotide polymorphism for the hereditary hemochromatosis gene.

PMID- 11199980
TI  - Characterization of the polarity of reversed-phase liquid chromatographic
      stationary phases in the presence of 1-propanol using solvatochromism and
      multivariate curve resolution.
AB  - This work characterizes solvation effects in reversed-phase liquid chromatography
      in the presence of 1-propanol. The solvatochromic method combined with a
      multivariate curve resolution-alternating least-squares analysis method has been
      used to characterize two modified silica surfaces--phenyl bonded and C18 bonded
      silica in mobile-phase mixtures of methanol--water and acetonitrile--water in the
      presence of 1-propanol. The presence of a small amount of 1-propanol has been
      shown to affect mainly the polarity properties of the stationary phases while the
      mobile-phase properties are largely unaffected. The chain collapse mechanism for
      the C18 stationary phase at higher concentrations of water seems to be inhibited
      in the presence of 1-propanol, and partitioning is the predominant solute
      retention mechanism. The phenyl-based phase shows considerably different behavior
      from that of the C18 phase, and propanol appears to disrupt the pi-stacking
      interactions between the solute and the phenyl rings anchored to the silica
      support.

PMID- 11199981
TI  - Micro-SPE method for sample introduction in capillary HPLC/MS.
AB  - A new solid-phase extraction on-line device for micro-HPLC is presented. This
      device optimizes the injection of very dilute samples into a packed capillary
      column. It consists of two capillary, reversed-phase, HPLC columns of different
      length that can be linked together as a single chromatographic column. The first
      segment, only 2 cm long is connected to the HPLC injector. When disconnected from
      the longer column, several milliliters of an aqueous sample can be passed through
      at a high flow rate for fast trapping. On the basis of the retention mechanism,
      all suitable compounds are focused on the short column head in a sharp band. As
      soon as the chromatographic column is recomposed, the trapped analytes are eluted
      and separated at the optimal flow rate and gradient conditions. Due to the high
      preconcentration factor, trace-level analysis can be performed successfully.
      Different classes of analytes of various polarities and molecular weights can be
      determined, depending on the stationary phase and on the detector used. Some
      pesticides belonging to different classes were chosen to evaluate the performance
      of the device using an electron ionization mass spectrometer as HPLC detector. A
      fungicide in an irrigation canal water was determined at a concentration level of
      4.5 microg x L(-1).

PMID- 11199982
TI  - Quantitative analysis of etheno-2'-deoxycytidine DNA adducts using on-line
      immunoaffinity chromatography coupled with LC/ES-MS/MS detection.
AB  - Etheno DNA adducts, including 3,N4-etheno-2'-deoxycytidine (etheno-dC), are
      promutagenic lesions present in normal animal and human tissues. These DNA
      adducts are believed to be important in the etiology of cancer. Existing methods
      for quantifying etheno-dC use 32p. postlabeling. Although highly sensitive,
      postlabeling requires the use of an energetic radioisotope and considerable time
      and effort. The new methodology reported here permits automated quantification of
      trace levels of etheno-dC in crude DNA hydrolysates on the order of 5 adducts in
      10(8) normal nucleotides from 100-microg samples of DNA. This was accomplished by
      using on-line immunoaffinity chromatography, a reverse-phase LC separation on
      graphitized carbon, tandem mass spectrometric detection, and an isotopically
      labeled internal standard. The automated procedures permitted analysis of 4 DNA
      hydrolysates/hr. The sensitivity using immunoaffinity cleanup was approximately
      100-fold greater than that observed when using a silica-based trapping system.
      The validated method was applied to the analysis of etheno-dC in commercial calf
      thymus DNA, untreated mouse liver, and untreated rat liver DNA. The demonstrated
      level of performance suggests future applicability of this method in studies of
      cancer in humans and experimental animals.

PMID- 11199983
TI  - Uniformity test of bias when the reference value contains experimental error.
AB  - The uniformity test of biases for analytical methods must address uncertainties
      in the reference method. If the uncertainty associated with the estimates of true
      values is significant but ignored in the test of bias equality, the type I error
      can exceed the prespecified error rate. In general, when biases at each
      concentration level are confounded with a random component (confounding bias),
      the usual test of bias equality tests the uniformity of the combined bias, rather
      than the uniformity of fixed bias-the bias without the random component. Based on
      a confounding model that takes both the fixed and the confounding biases into
      account, the actual type I error rate of the uniformity test can be calculated.
      To eliminate the impact of confounding bias on the uniformity test of fixed
      biases, a new F'-test is proposed. The new F'-test is simply adding a correction
      factor to the conventional F-test. The correction factor is directly related to
      the uncertainty associated with the estimates of true values. A simulation study
      is conducted to show that the proposed test can bring the type I error rate down
      to the prespecified level. Data from two aldehyde methods are used to demonstrate
      how the proposed F'-test works. Recommendations on optimal sample allocation are
      also provided.

PMID- 11199984
TI  - Spatial and spectral imaging of single micrometer-sized solvent cast fluorescent
      plasticized poly(vinyl chloride) sensing particles.
AB  - Microscale plasticized PVC particles doped with hydrophobic ionophores are
      prepared by solvent evaporation of aqueous suspensions of sensing cocktails
      (poly(vinyl chloride), plasticizer, active sensing components, and
      tetrahydrofuran) and tested as particulate microoptical sensors. The particles
      contain either only the chromoionophore ETH 2458 as active reagent or the
      potassium ionophore BME-44, chromoionophore ETH 5294, and lipophilic anionic
      sites NaTFPB. The former system functions according to an anion-hydrogen ion
      coextraction mechanism and shows a Hofmeister anion selectivity pattern, while
      the latter sensor containing additional ionophores represents the more complex,
      truly selective optical sensors based on ion-exchange equilibria. Single
      microspheres are simultaneously characterized spatially and spectrally by
      fluorescence microscopy, coupled to a spectrometer equipped with a CCD detector.
      The results indicate that these microspheres respond in complete analogy to
      traditional thin-film-based optodes previously reported in the literature. The
      introduction of small, spherical ionophore-based sensing particles that operate
      on the basis of bulk extraction principles holds the promise of significantly
      expanding the available chemical palette of microsphere-based analytical assays.

PMID- 11199985
TI  - Comparison of the performance of different discriminant algorithms in analyte
      discrimination tasks using an array of carbon black--polymer composite vapor
      detectors.
AB  - An array of 20 compositionally different carbon black--polymer composite
      chemiresistor vapor detectors was challenged under laboratory conditions to
      discriminate between a pair of extremely similar pure analytes (H2O and D2O),
      compositionally similar mixtures of pairs of compounds, and low concentrations of
      vapors of similar chemicals. Several discriminant algorithms were utilized,
      including k nearest neighbors (kNN, with k = 1), linear discriminant analysis
      (LDA, or Fisher's linear discriminant), quadratic discriminant analysis (QDA),
      regularized discriminant analysis (RDA, a hybrid of LDA and QDA), partial least
      squares, and soft independent modeling of class analogy (SIMCA). H2O and D2O were
      perfectly classified by most of the discriminants when a separate training and
      test set was used. As expected, discrimination performance decreased as the
      analyte concentration decreased, and performance decreased as the composition of
      the analyte mixtures became more similar. RDA was the overall best-performing
      discriminant, and LDA was the best-performing discriminant that did not require
      several cross-validations for optimization.

PMID- 11199986
TI  - Rotating electrode potentiometry: lowering the detection limits of nonequilibrium
      polyion-sensitive membrane electrodes.
AB  - A rotating electrode configuration is evaluated as a means to lower the detection
      limits of newly devised polyion-sensitive membrane electrodes (PSEs). Planar
      potentiometric polycation and polyanion PSEs are prepared by incorporating
      tridodecylmethylammonium chloride and calcium dinonylnaphthalenesulfonate,
      respectively, into plasticized PVC or polyurethane membranes and mounting disks
      of such films on an electrode body housed in a conventional rotating disk
      electrode apparatus. Rotation of the PSEs at 5000 rpm results in an enhancement
      in the detection limits toward heparin (polyanion) and protamine (polycation) of
      at least 1 order of magnitude (to 0.01 unit/mL for heparin; 0.02 microg/mL for
      protamine) over that observed when the EMF responses of the same electrodes are
      assessed using a stir-bar to achieve convective mass transport. A linear
      relationship between omega(-1/2), where omega is the rotating angular frequency,
      and C1/2, the polyion concentration corresponding to half the total maximum
      deltaEMF response toward the polyion species, is observed. It is further shown
      that the rotating polycation sensor can be used as an end-point detector to
      greatly enhance (relative to nonrotated indicator electrode) the analytical
      resolution and precision for measurement of low concentrations of heparin when
      such samples are titrated with protamine. The theoretical basis for lowering the
      detection limits by rotating PSEs is discussed based on the unique nonequilibrium
      response mechanism of such sensors.

PMID- 11199987
TI  - Electrochemical monitoring of proton transfer across liquid/liquid interfaces on
      the surface of graphite electrodes.
AB  - Equilibrium partitioning of HClO4 between aqueous solutions and benzonitrile (BN)
      or nitrobenzene (NB) was measured and used to evaluate the pKa of the acid in the
      two organic solvents. The potential drop across the BN/ H2O interface was
      evaluated from the known potential drop across the NB/H2O interface and the
      voltammetrically measured formal potential of a ferrocenium/ferrocene redox
      couple confined within thin layers of the two organic solvents. The voltammetric
      reduction of tetrachloro-1, 4-benzoquinone in thin layers of BN was used to
      monitor changes in the concentration of protons in the layer during proton
      consuming faradaic reactions. The rate of proton transfer from the aqueous to the
      nonaqueous phase across the BN/H2O interface was shown to be adequate to sustain
      proton-consuming reactions at the electrode/BN interface.

PMID- 11199989
TI  - An experimental evaluation of cyclic voltammetry of multicharged species at
      macrodisk electrodes in the absence of added supporting electrolyte.
AB  - The reversible reduction of [S2Mo18O62]4- to [S2Mo18O62]5- and [S2Mo18O62]6- at a
      glassy carbon macrodisk electrode has been studied by cyclic voltammetry in
      acetonitrile as a function of the concentration of [(C6H13)4N]4[S2Mo18O62] in the
      absence and presence of [(C6H13)4N]ClO4 as the added supporting electrolyte.
      Consideration is given to the influence of scan rate, reference-working electrode
      distance, [(C6H13)4N]4[S2Mo18O62], and electrolyte concentrations. Experimental
      data confirm theoretical predictions that cyclic voltammetry at a macrodisk
      electrode is a viable technique for studies of multiply charged electroactive
      species without added electrolyte, provided the influence of enhanced
      complexities associated with effects of increased solution resistance, the mass
      transport contribution from migration, and convection arising from enhanced
      density gradients are considered. Enhanced density gradients present in the
      absence of added supporting electrolyte give rise to a more marked dependence of
      voltammograms on the angle of the electrode and hence lead to significant
      distortion of wave shapes at low scan rates. The summation of all these obstacles
      implies that quantitative evaluation of cyclic voltammograms of multiply charged
      species requires significantly greater care in the absence than in the presence
      of added supporting electrolyte.

PMID- 11199988
TI  - Potentiometric polymeric membrane electrodes for measurement of environmental
      samples at trace levels: new requirements for selectivities and measuring
      protocols, and comparison with ICPMS.
AB  - It is here established that potentiometric polymeric membrane electrodes based on
      electrically neutral ionophores are useful analytical tools for heavy metal ion
      determinations in drinking water at nanomolar total concentrations. This means
      that they can compete with the most sophisticated techniques of instrumental
      analysis. With optimized ion-selective membranes based on the lead-selective
      ionophore 4-tert-butylcalix[4]arenetetrakis(thioacetic acid dimethylamide) as
      model example, a number of native and spiked drinking water samples are
      potentiometrically assessed for lead, and the results compared with ICPMS
      measurements. The goal of this work is to demonstrate that detection limits in
      real world samples are routinely achieved that are, with 1.5 ppb, at least 10
      fold lower than the lead action limit imposed by the U.S. Environmental
      Protection Agency (15 ppb). In contrast to earlier reports, different
      conditioning and measuring protocols are followed, and membranes and inner
      filling solution of optimized composition are used. The sensors are shown to be
      useful for the speciation analysis of lead in water as well. Typical water
      samples are acidified to pH 4 to assess total lead rather than free, uncomplexed
      lead. For lead concentrations above 2 ppb, the values compare very well with
      ICPMS. Main interferences are found to be H+ and Cu2+, although Cu2+ only shows
      significant interference at levels around or above its own action limit (1.3
      ppm), in which case the water sample would anyway show quality problems. An
      explicit, simplified flux model targeted to the practical use of these sensors
      explains the extent of expected interference. Sensors are shown to require a
      higher selectivity than predicted by models not considering ion fluxes, since in
      dilute samples, the counterdiffusion flux of lead from the membrane into the
      sample becomes potential determining. The model and experiments shown here are a
      foundation for future trace level applications of potentiometric polymeric
      membrane electrodes.

PMID- 11199990
TI  - A low-power, atmospheric pressure, pulsed plasma source for molecular emission
      spectrometry.
AB  - A low-power, plasma source-based, portable molecular emission detector is
      described in this paper. The detector employs a pulsed-plasma source operated at
      atmospheric pressure for molecular fragmentation and excitation. The plasma was
      generated with a home-built high-voltage pulsed power supply. The average
      operational power of the detector was less than 0.2 W. The effects of operational
      parameters such as plasma gas, voltage, and plasma gas flow rate were
      investigated. Molecular emission spectra of a variety of organic compounds were
      studied. The features of the emission spectra obtained with the pulsed plasma
      source were significantly different from those obtained with direct current (dc)
      discharge at a power higher than 10 W. The spectra obtained in this work showed
      strong CH emission at 431.2 nm; however, the typical CN emission observed with a
      conventional dc plasma source at 383-388 nm was very weak in most cases. The
      strong CN emission was only obtained for compounds containing nitrogen, such as
      aniline. Dimethyl sulfoxide can be detected at a limit of 200 ppb using helium
      plasma by observing the emission band of the CH radical. The detector was very
      stable and did not experience electrode fouling even with the introduction of
      organic vapors. Such a detector is very promising for organic vapor detection.

PMID- 11199991
TI  - Water structures in ion-exchange resin particles: solvation dynamics of Nile Blue
      A.
AB  - The structures of water, partitioned in cation-exchange resin particles, were
      studied on the basis of fluorescence dynamics of Nile Blue A (NB). The
      fluorescence lifetime of NB in the resin was longer than that in water and
      increased with increasing cross-linking density of the resin (rho). The results
      demonstrated that the water structures in the resin were significantly different
      from those in water and dependent on rho. A study on solvation dynamics of NB in
      the resin, reflecting structured water around the ion-exchange group, revealed
      the roles of "bound water" molecules in the water structures, since the solvent
      relaxation time (tauS) in the resin was much longer than that in water and
      depended on p; tauS increased from 34 to 55 ps with increasing rho from 2 to 8%.
      The origin of the rho dependence of tauS was discussed in terms of the separation
      distance between the ion-exchange groups, and the effects of the counterion of
      the ion-exchange group on the solvation processes were also discussed.

PMID- 11199992
TI  - A compactly integrated flow cell with a chemiluminescent FIA system for
      determining lactate concentration in serum.
AB  - We have fabricated an integrated flow cell as a total microanalysis system
      (microTAS). This flow cell (size, 15 x 20 mm; total inner volume, 12.2 microL)
      was designed for a rational analyzing system of lactate determination for serum.
      This cell was made by micromachining techniques and consisted of two hollows of a
      lactate oxidase (LOD) reactor and a mixing cell, a spiral groove, and three
      penetrated holes. To form the reactor and capillary, these patterns, etched on a
      silicon wafer, were attached to a glass plate by the anodic bonding method. A
      photodiode was put under part of the spiral capillary. The compactly accumulated
      devices were integrated into a flow injection analysis (FIA) system. In the flow
      cell, lactate was catalyzed to pyruvate and hydrogen peroxide at the LOD reactor;
      subsequently, hydrogen peroxide reacted with the luminol-ferricyanic reagent at
      the mixing cell. The resulting chemiluminescent light was detected by the
      photodiode. Using the miniaturized flow cell, the sample volume for one
      measurement was greatly reduced to 0.2 microL. The response to lactate was
      obtained within 30 s and was linear between 0.5 and 5.0 mM (4.5 and 45 mg/dL)
      lactate with excellent correlative variances of 3.2% (average of three
      measurements at 5.0 mM). For practical application, the lactate concentration in
      control human serum was determined using this system. The results showed a good
      correlation coefficient (r = 0.979) with the results obtained by the
      spectrophotometric reference method. No difference in sera (normal or
      pathological) was found. Consequently, this integrated flow cell shows potential
      as a clinical device for lactate determination in serum. In this article, the
      effect of the design on the chemiluminescent FIA system is also described.

PMID- 11199993
TI  - A comparison of liquid hydrocarbon calibration standards in piston cylinders and
      standard cylinders with eductor tubes.
AB  - Natural gas liquid standards consist of various components primarily in the C1-C6
      range; they are available in three types of cylinder packages: piston cylinders
      and two other types of standard cylinders with eductor tubes. The three cylinder
      packages have different operation conditions and thus a sample may behave
      differently in each of the packages. The piston cylinder maintains the components
      in a single liquid phase at a constant pressure, while the standard cylinders
      maintain the components as a two-phase mixture. Typically, the components may
      distribute between the two phases in different concentrations depending on the
      various thermodynamic variables, such as temperature, pressure, and volume. This
      study will examine the integrity of the sample in the three cylinder packages
      during a controlled cylinder depletion. The results for the various cylinders
      will be compared with a theoretical model of the experiments.

PMID- 11199994
TI  - Screening metal binding selectivities of macrocycle mixtures by HPLC--ESI-MS and
      postcolumn reactions.
AB  - A rapid method for the screening of metal binding selectivities of host compounds
      in mixtures is presented. This method involves the separation of mixtures of
      hosts by HPLC, followed by postcolumn complexation with one or more metals, then
      analysis by mass spectrometry. The intensities of the host-guest complexes in the
      mass spectra correlate with the binding selectivities of the hosts. The method
      was applied to a series of lariat ethers that were synthesized as ion-selective
      reagents for ion-selective electrodes. The compounds most selective for Na+ vs
      Li+ and K+ were identified. Additionally, a mixture of substituted calixarenes
      was screened for alkali-metal-binding selectivity. These compounds were
      determined to be selective for Cs+ over Rb+, K+, and Na+.

PMID- 11199995
TI  - [Stomach cancer: old and new problems].

PMID- 11199996
TI  - [Descending perineum syndrome: iatrogenic or spontaneous pathology?].
AB  - Among the causes of constipation, there is an infrequently recognised condition
      called descending perineum syndrome. This pelvic floor dysfunction causes a
      rectal tone disorder, and the clinical features include excessive and frequent
      straining and incomplete evacuation. Electrophysiological studies have shown a
      pelvic neuropathy in incontinent patients with descending perineum. The
      aetiological agents have been identified as follows: greater parity, dystocias
      and obstinate constipation, particularly if caused by expulsion difficulty. It
      has been observed that pelvic floor surgery may have physiopathological
      consequences that bring on the onset of dynamic disorders. The diagnosis may
      present difficulties and failure to identify the syndrome leads to inadequate and
      repetitive treatment of no real benefit to the patient. Since it is impossible to
      correct the excessive descent of the pelvic floor, the treatment will be aimed at
      resolving the predominant symptom in relation to the physiopathological factors
      causing it.

PMID- 11199997
TI  - [Therapeutic strategy in symptomatic diverticular disease of the colon].
AB  - Diverticular disease of the colon has been recorded with increasing frequency and
      approximately 25-30% of symptomatic patients require surgery for complications.
      Controversy still surrounds the best operative approach for the management of
      diverticular disease, particularly when it presents with complications. The three
      stage operation has, for the most part, been abandoned because of its
      unacceptably high morbidity and mortality rates. Today it is generally believed
      that performing two-stage surgery is a wise decision, namely segmentary resection
      either without (Hartmann's procedure) or with anastomosis, protected by a
      covering colostomy. However, the ideal intervention is a one-stage surgical
      procedure (segmentary resection and primary anastomosis without a covering
      colostomy), but this can only be performed in selected patients. The aim of this
      study was to analyse the clinical course and the medical and surgical therapy
      retrospectively in 79 patients with symptomatic diverticular disease in order to
      identify the best therapeutic procedure; specifically, the severity of septic
      complications was evaluated using Hinchey's classification. The authors conclude
      that most patients with symptomatic diverticular disease require specific medical
      therapy. If surgical treatment is necessary (complicated diverticular disease),
      Hartmann's procedure is still a valid surgical option, particularly in the
      presence of diffuse faecal peritonitis. Colonic resection and primary anastomosis
      are certainly a satisfactory treatment, because of their low morbidity and
      mortality rates, but this surgical approach is only feasible in selected
      patients. Finally, it is a matter for the individual surgeon's experience to
      select the best surgical procedure in any particular situation, depending on age
      and general state, local findings and the extent of peritonitis.

PMID- 11199998
TI  - Primary breast carcinoma: immunocytochemical and immunohistochemical evaluation
      of biological parameters.
AB  - Fine needle aspiration biopsy is an effective procedure for the diagnosis and
      biological characterization of carcinoma of the breast. The authors compared the
      immunocytochemical expression of oestrogen receptor and progesterone receptor,
      Ki67 antigen and p53 protein, evaluated in pre-surgical fine needle aspirates,
      with the immunohistochemical results observed in the corresponding histological
      sections. Fine needle aspirates and paraffin embedded sections obtained from 37
      patients with primary carcinoma of the breast were studied by immunocytochemistry
      and immunohistochemistry, respectively. Percentage agreement between values
      obtained with cytology and histology was 89.6% for oestrogen receptor, 76.9% for
      progesterone receptor, 91.3% for Ki67 and 77.7% for p53. The data reported here
      suggest that the evaluation of biological parameters by fine needle aspiration
      biopsy may be useful to decide the best medical and surgical treatment for
      primary breast carcinoma.

PMID- 11199999
TI  - [Clinical evolution of chronic pancreatitis and quality of life].
AB  - Nowadays the availability of reliable, efficacious methods of assessing the
      outcome of chronic pancreatitis is mandatory, especially in view of the several
      new procedures developed to relieve the symptoms of the disease. Together with
      the traditional evaluation of postoperative morbidity and mortality and the
      assessment of exo/endocrine function in patient follow-up, we currently consider
      the patient's perception of his or her health status as a priority. This
      information is obtained by administering quality of life questionnaires along
      with reliable physical and psychometric evaluation.

PMID- 11200000
TI  - [Videolaparoscopy and carcinoma of the gallbladder].
AB  - There have been several reports claiming that there is a risk that laparoscopic
      cholecystectomy might worsen the prognosis of unexpected gallbladder cancer. The
      objective of this study was to evaluate which factors influence the prognosis of
      such cancers. A clinicopathological study was conducted in 25 patients with
      unexpected gallbladder cancer. The results of 10 patients undergoing laparoscopic
      cholecystectomy were compared with those of 15 patients undergoing open
      cholecystectomy. Correlations were evaluated between cumulative survival rates
      and seven prognostic factors, namely, age, sex, histopathological grade,
      pathological stage, occurrence of bile spillage, type of cholecystectomy
      (laparoscopic or open) and additional surgical treatments. Seven patients after
      laparoscopic cholecystectomy (70%) and 9 patients after open cholecystectomy
      (64%) had cancer recurrence: the difference was not statistically significant.
      There was a statistically significant correlation between survival rate and
      tumour stage (P < 0.01) and occurrence of bile spillage (P < 0.05). There was no
      difference in survival depending on whether cholecystectomy was carried out using
      laparoscopic or traditional techniques. Laparoscopic cholecystectomy does not
      adversely affect the prognosis of unexpected gallbladder cancer. Once the
      histological findings have been examined, the surgeon will decide whether it is
      necessary to extend surgery, regardless of whether laparoscopic or open
      cholecystectomy is carried out.

PMID- 11200002
TI  - [Laparoscopic approach to inguinal hernia pathology].
AB  - Laparoscopic hernia repair has already become as accepted a technique as the
      conventional ones and is routinely used in those centres where this kind of
      surgery is normally performed. The two most commonly used laparoscopic techniques
      (transabdominal and total extraperitoneal) have been shown to produce good
      results in terms of post-operative course and recurrence rates, but still present
      the disadvantages of high cost and the need for general anaesthesia. We report
      here a retrospective analysis of our early experience with laparoscopic treatment
      of inguino-crural hernias. The positive results achieved (no cases of conversion
      to an open technique; no recurrences to date; 4.7% major morbidity) allow us to
      consider this approach a valid alternative to the traditional ones in selected,
      well-informed patients.

PMID- 11200001
TI  - [Laparoscopic surgical treatment of cholecysto-choledochal calculi. A single step
      solution].
AB  - The laparoscopic era has created a new basis for the management of
      choledocholithiasis. Many surgeons now regard laparoscopic cholecystectomy and
      exploration of the common bile duct as the "gold standard". The main advantages
      of single-stage treatment consist in a significantly shorter hospital stay, very
      low complication rates and a reduction of average hospital costs. Among 601 cases
      of cholelithiasis treated over the period from 1994 to 1999, we report 73 cases
      of common-bile-duct stones. Surgical sphincterotomy was performed in 20 cases and
      endoscopic sphincterotomy in 24; only in 7 cases was choledochotomy and/or
      hepaticojejunostomy (3 cases) performed for critical situations. Twenty-two cases
      of cholelithiasis were treated by laparoscopic cholecystectomy and exploration of
      the common bile duct. Stone extraction was obtained with a balloon catheter or
      Dormia basket via a choledochotomy. Surgery was completed by suturing,
      cholangiography and the placement of sub-hepatic drainages. No mortality or long
      term complications were recorded with the laparoscopic procedure; only two
      immediate complications were reported, both of which were biliary leakages (9%)
      that resolved spontaneously. With the other procedures, high rates of mortality,
      morbidity, hospital admissions and technical failure were registered. We regard
      laparoscopic exploration of the common bile duct as the treatment of choice for
      bile-duct stones when combined with cholecystectomy. We reserve ERCP plus
      endoscopic sphincterotomy only for common-bile-duct stones alone, without a
      gallbladder or gallstones. Open surgery is performed in particular situations
      such as Mirizzi's syndrome or when other procedures have failed to yield
      satisfactory results.

PMID- 11200003
TI  - [Surgery of the carotid artery: locoregional anesthesia versus general
      anesthesia: Review of the literature].
AB  - The aim of the study was to compare locoregional and general anesthesia in
      carotid artery surgery in order to establish whether differences exist in terms
      of perioperative results, use of intraoperative shunts and costs. Seventeen
      studies, comprising 14,776 carotid endarterectomies performed with either
      locoregional or general anesthetic and published over the period from 1990 to
      March 2000, were reviewed. There were no statistically significant differences in
      the cardiovascular risk factors of the patients. Neurological morbidity and
      mortality were similar in the two groups, even if the use of shunts in the
      locoregional anesthesia group was lower than in the general anesthesia group and
      in four studies was associated with a significant difference (P < 0.01). No
      statistical differences in cardiac morbidity or mortality were found between the
      groups, except in two studies. Additional randomised prospective trials are
      needed in large numbers of patients. Locoregional anesthesia appears to allow a
      limited use of intraoperative shunts, but with neurological mortality and stroke
      rates very similar to those in the general anesthesia group. Routine use of
      locoregional anesthesia makes it possible to lower the cost of carotid surgery
      without sacrificing quality.

PMID- 11200004
TI  - [Anesthesia for inguinal hernioplasty: a comparison of techniques].
AB  - New surgical and modern anaesthesia techniques for inguinal hernioplasty have
      significantly reduced the duration of the procedure and the postoperative length
      of hospital stay. From 1994 to 1998, 405 patients with a mean age of 54.7 years
      (range: from 18 to 90) undergoing inguinal hernioplasty were studied. Four
      different anaesthetic techniques were used: (i) surgical field infiltration (SFI)
      with 0.5% carbonated lidocaine + 0.125% bupivacaine (193 pts.) in which monitored
      anaesthesia care was administered with propofol (3 to 4 mg/kg/h) when necessary;
      (ii) epidural anaesthesia with 2% lidocaine + fentanyl 100 mg (137 pts.); (iii)
      general anesthesia with isoflurane and fentanyl in N2O:O2 (48 pts.); and (iv)
      intrathecal anaesthesia with 1% hyperbaric bupivacaine 1-2 ml (25 pts.). Intra-
      and postoperative complications, intraoperative sedation, postoperative
      supplemental drugs for analgesia and postoperative length of hospital stay were
      recorded. The data obtained were analyzed statistically using Student's t-test
      Anova, Bonferroni post hoc analysis, chi square, and P values less than 0.05 were
      considered significant. Intraoperative hypotension/brachycardia were observed in
      4 patients (2%) in the SFI group and in 6 patients (4%) in the epidural group.
      Sedation was required in 29.5% of patients in the SFI group and in 15.3% in the
      epidural group (P < 0.05). Postoperative supplemental analgesic drugs
      administered and length of hospital stay were similar in the 4 groups. No
      difference in intra- and postoperative complications was observed among the 4
      groups. Patients who required sedation in the SFI group were significantly more
      numerous than those with epidural anaesthesia. In conclusion, both SFI and
      epidural anaesthesia are safe and suitable for the inguinal hernioplasty
      procedure, without intra- or postoperative complications.

PMID- 11200005
TI  - Stress of routine follow-up in colorectal cancer operated patients.
AB  - Postoperative follow-up is the logical consequence of cancer treatment, but
      colorectal cancer follow-up does not achieve all its goals. These unfavourable
      findings induced us to assess whether follow-up also causes negative
      psychological stress in our colorectal cancer patients. In this trial 100
      colorectal cancer follow-up patients were asked to compile three questionnaires:
      1) the McGil Pain Questionnaires; 2) Profile of Mood Status; and 3) Locus of
      Control. The questionnaires were handed to the patients at follow-up and were
      compiled immediately. In addition, the patients were asked to answer the firsts
      two tests spontaneously 30 days after follow-up and mail the questionnaires. Our
      results showed that only 41% of the patients complied the tests 30 days after
      follow-up. The scores for pain and mood disorders were greater in women,
      especially during the "before follow-up" period. The third test revealed a
      prevalence of subjects with internal-type reinforcement. Our data revealed that:
      1) patients tend to repress the problem; 2) women are affected by greater stress
      and anxiety; 3) subjects with internal-type reinforcement have a positive
      attitude during follow-up and this enables the ego to bear the anguish, process
      it and dilute it to anxiety, thus favouring future life experiences.

PMID- 11200006
TI  - Haemostatic treatment of a bleeding hepatocarcinoma by polypropylene mesh
      wrapping in a cirrhotic patient.
AB  - Spontaneous rupture of hepatocarcinoma (HCC) in a cirrhotic patient is a serious
      complication with a high incidence of mortality. The pathogenesis of this
      complication is unknown. Several hypotheses have been proposed in the literature
      worldwide. The diagnosis, in the absence of specific symptoms, is made by
      ultrasound, sometimes followed by a CT scan, and finally by exploratory
      paracentesis. An angiogram is performed to locate the site of the bleeding and
      possibly allow transcatheter arterial chemo-embolisation. Therapeutic options
      include one-stage or delayed resection, packing for sub-diaphragmatic bleeding
      HCC's, and hepatic artery ligation. Suture ligation of the bleeding source is
      usually impossible due to the friability of the tumor. No sizeable experience
      with the use of alcoholisation for haemostasis has been reported to date. We
      report a case of HCC bleeding from segment VI successfully treated by manual
      compression and placement of a polypropylene mesh (Biomesh P1, Cousin Biotech).

PMID- 11200007
TI  - Brunner's adenoma, esophageal reflux and gastric ulcer. A case report.
AB  - In this work the authors report a clinical case of Brunner's adenoma, which was
      responsible for the onset of other pathologies in the upper gastrointestinal
      tract, such as gastroesophageal reflux (GER), esophagitis and ulcerations of the
      antral mucosa. The preoperative diagnostic procedure (endoscopy, esophageal
      manometry, gastric emptying) and the follow-up at 3, 6 and 12 months from the
      surgery confirmed the relationship between the Brunner's adenoma and the
      alterations of the lower esophageal sphyncter (LES) tone and the gastric
      emptying. After a review of the international literature and a short analysis of
      the physiopathologic alterations, the authors point out the different
      therapeutical approach, in according to the size and implantation (sessile or
      peduncolated) of the lesion and to the related pathologies.

PMID- 11200008
TI  - [Inverted papilloma of the bladder: observation of 3 clinical cases and
      discussion on their clinico-pathologic characteristics].
AB  - Three cases of urothelial inverted papilloma, detected in two female patients
      aged 32 and 31 years, respectively and in one 67-year-old male patient, are
      described. Inverted papilloma is a benign lesion which occurs in the urinary
      epithelium with a 20% incidence in comparison with other urothelial tumours. The
      male:female ratio is 3:1. The histological structure of urothelial inverted
      papilloma is similar to that of inverted papilloma of the nasal and paranasal
      sinuses. It presents interanastomosed epithelial cords, with transitional cells,
      which develop in the tunica propria connective tissue. Some cells are distributed
      in such a way as to constitute vacuolated glandular-like structures. The
      histogenetic origin of the lesion from Home subtrigonal or Albarran subcervical
      glands is debatable. Recent aetiological hypotheses have claimed that the origin
      of the lesion may be related to Brunn's nest hyperplasia and/or to chronic
      urothelial inflammation. The latter hypothesis would currently appear to be the
      most accredited: immunostaining for cytokeratins would tend to support a
      urothelial inflammatory aetiology. In our cases, we achieved a definitive
      diagnosis of inverted papilloma only at histology, because of the  specificity of
      the echotomography and cystoscopy findings. Urinary cytology revealed only a
      large number of inflammatory cells with anaplastic elements, but without any more
      detailed morphological description. We performed a transurethral resection of the
      bladder (TURB) in all three patients: routine follow-up showed the absence of
      inverted papilloma relapses. On the basis of the above-mentioned data and a
      thorough review of the literature, we attempt to assess and classify the clinico
      pathological findings and the aetiological hypotheses of urothelial inverted
      papilloma. In addition, the benign nature of the lesion and any malignant
      transformation factors are discussed.

PMID- 11200009
TI  - [Sarcoidosis with a prevalent splenic localization: surgical option (presentation
      of a case].
AB  - Sarcoidosis is a granulomatosis disease of unknown origin with a variable
      clinical presentation. The reported frequency of splenomegaly in sarcoidosis
      ranges from 1% to 40%. Splenomegaly has been associated with clinical evidence of
      more extensive thoracic and extrathoracic sarcoidosis. We describe an interesting
      case of sarcoidosis with giant splenomegaly and abdominal pain but no evidence of
      systemic involvement. Sarcoidosis must be considered in the differential
      diagnosis of splenomegaly. The main indication for splenectomy is splenomegaly
      with resulting discomfort and/or haematological abnormalities. Though the natural
      history of sarcoidosis is generally unchanged after splenectomy, in our patient
      the operation resolved the abdominal pain completely with no need for further
      therapy.

PMID- 11200010
TI  - [Thyroid metastasis of a renal carcinoma. 3 clinical cases].
AB  - The clinical finding of metastasis to the thyroid is a very rare event. When a
      metastasis from a renal carcinoma is diagnosed, it is usually the distant
      evidence of a tumour discovered and removed surgically months or years before, or
      it may be the first clinical sign of an as yet undiagnosed asymptomatic renal
      tumour. A case of massive retrosternal goiter in a 65-year-old patient, operated
      on for a right renal carcinoma (nephrectomy 6 years before), is reported. The
      goiter, causing compression symptoms and dyspnoea, was treated by total
      thyroidectomy. The pathological diagnosis was metastasis from renal carcinoma.
      The authors present a second case of nodular goiter, in a 79-year-old woman, 9
      years after a right nephrectomy for a renal carcinoma. The expanding nodule,
      diagnosed intraoperatively as carcinoma, was treated by total thyroidectomy. The
      postoperative pathological diagnosis was metastasis from renal carcinoma. The
      authors report a third case of an expanding nodule of the thyroid, in a 65-year
      old patient, diagnosed intraoperatively as a metastasis from renal carcinoma,
      treated by right lobectomy and isthmusectomy. An abdominal CT scan revealed a
      renal asymptomatic tumor, treated by right nephrectomy. The diagnosis can be
      established by means of fine needle aspiration biopsy preoperatively or intra- or
      postoperative histology. Surgical therapy may resolve the compression symptoms
      and improve the prognosis.

PMID- 11200011
TI  - [Malignant stromal tumors of the duodenum. Report of a case].
AB  - The Authors report a rare case of undifferentiated duodenal malignant stromal
      tumour in a 69-years-old man radically managed by pancreaticoduodenectomy and
      resection of a liver metastasis. Several preoperative tests were performed
      (barium meal, endoscopy, ultrasonography and CT scan) but failed to yield a
      differential diagnosis between a tumour of the pancreatic head and a
      retroperitoneal neoplasm. The diagnosis was only histological. The tumour was
      considered to be high-grade due to its large size, high mitotic index, and the
      presence of necrosis and liver metastasis. Thorough surveillance revealed several
      hepatic metastases 29 months after resection, and chemotherapy performed at this
      stage proved completely ineffective. The patient died 38 months after surgery.

PMID- 11200012
TI  - [Postectomy for phimosis: 5-year-experience].
AB  - Phimosis, i.e. congenital or acquired preputial stenosis, is one of the most
      frequent problems encountered in surgery departments. Circumcision remains the
      most frequently adopted surgical treatment, but, since this operation entails the
      sacrifice of the prepuce and frenulum, the penis loses its natural protection.
      The Authors describe five years of experience with postectomy, a technique which
      spares both the prepuce and frenulum while repairing the preputial phimosis,
      defining its benefits compared with circumcision.

PMID- 11200013
TI  - A comparison of performance of three gamma camera systems for positron emission
      tomography.
AB  - The development of coincidence positron imaging using a gamma camera should
      significantly increase PET utilization. This study has compared the performance
      of three such systems with each other and with an equivalent single photon
      emission computed tomography (SPECT) measurement. A Carlson phantom, which
      consisted of a 20 cm diameter cylinder containing areas of uniform activity, hot
      lesions, cold lesions and orthogonal alternate hot and cold lines, was filled
      with an activity of 18F chosen to try and best exploit each camera and imaged for
      a fixed time (27 min). The image quality of 9 mm thick slices in each section of
      the phantom was compared visually. Several image quality parameters were also
      compared including line source resolution and noise equivalent count rate. There
      were considerable differences in PET image quality between the three cameras but
      all were at least as good as the SPECT image. The full width at half maximum
      (FWHM) resolution of all systems was similar (approximately 4.5 mm) but the
      maximum noise equivalent count rates in a 20 cm cylinder were significantly
      different (6.3, 2.6 and 1.6 kcps) (where cps is counts per second) and correlated
      with the phantom image quality.

PMID- 11200014
TI  - 99Tc(m)-ECD SPET perfusion changes by internal pallidum stimulation in
      Parkinson's disease.
AB  - High-frequency stimulation of the internal pallidum is an effective surgical
      approach for patients with advanced Parkinson's disease suffering from motor
      fluctuations and L-dopa induced dyskinesia. To study the acute effects of
      internal pallidum stimulation, changes in cerebral blood flow were measured by
      means of a single-day split-dose protocol using 99Tc(m)-ECD SPET. Nine patients
      with advanced Parkinson's disease and with a clinical picture predominated by
      tremor and drug-induced dyskinesia, were imaged before and immediately after
      electrostimulation. Brain perfusion data were mirrored to the same electrode side
      (five left and four right implants), co-registered and analysed statistically on
      a voxel-by-voxel basis (Statistical Parametric Mapping) and by an automated
      volume-of-interest approach. Acute stimulation of the internal pallidum induced a
      significantly decreased perfusion in the ipsilateral thalamus and striatum, as
      well as in the right parietal cortex. For the subgroup of seven patients with
      effective motor score improvements, a significant correlation between thalamic
      and striatal perfusion changes and UPDRS III motor score was present (P = 0.04).
      These results suggest that effective stimulation of the internal globus pallidus
      may produce symptom relief through decreased activity in pallido-thalamo-cortical
      circuits.

PMID- 11200015
TI  - Regional cerebral blood flow in schizophrenia before and after neuroleptic
      medication.
AB  - In order to investigate cerebral perfusion changes induced by neuroleptic drugs,
      we performed 99Tc(m) hexamethyl propyleneamine oxime (HMPAO) single-photon
      emission computed tomography (SPET). Fifteen patients (nine drug naive, six non
      naive) diagnosed by using the DSM-III-R criteria, and 10 right-handed age and sex
      matched normal volunteers were included in this study. The SPET study was
      performed with 740 MBq 99Tc(m)-HMPAO by using a 128 x 128 matrix, 30 s/frame for
      a total 64 view over 360 degrees before and after 1 month of neuroleptic
      treatment. A semiquantitative method was used for the analysis. Patients were
      clinically assessed using the Brief Psychiatric Rating Scale (BPRS). There was no
      significant regional cerebral blood flow (rCBF) difference between the patient
      group and control group in whole-brain regions except in the left temporal lobe.
      Although clinical scores of the patients improved after neuroleptic treatment no
      statistically significant difference was found in the rCBF between pre- and post
      treatment. Moreover, there was no statistically significant correlation between
      the rCBF and BPRS in any region. These results suggest that there was a
      discrepancy between the clinical situation and rCBF in schizophrenia and the
      lateralized temporal lobe blood flow, which may have important implications for
      the evaluation of patients with schizophrenia.

PMID- 11200016
TI  - Diffuse cortical reduction of neuronal activity in unipolar major depression: a
      retrospective analysis of 337 patients and 321 controls.
AB  - Reduction of neuronal activity in frontocortical and limbic circuits is
      considered a characteristic of depression. We aimed to test this hypothesis by
      pooling all available data from experimental literature. All investigations were
      included comparing regional cerebral blood flow (rCBF) or glucose metabolism
      (rCMRGlc) between acutely depressed unipolar major depressive patients and
      healthy controls. For cortical and subcortical regions we computed the percentage
      difference between depressives (n = 337) and controls (n = 321). In patients with
      unipolar major depression rCBF and rCMRGlc were lowered in left (-4.4%, P =
      0.022) and right frontal (-3.2%, P = 0.053), left (-1.7%, P = 0.061) and right
      temporal (-3.0%, P=0.003), left (-6.5%, P = 0.002), and right parietal (-8.8%,
      P=0.001), and left (-6.6%, P = 0.083) and right occipital cortex (-4.2%, P =
      0.02). Moreover, there were reductions in left (-6.3%, P = 0.029) and right basal
      ganglia (-4.8%, P = 0.002), left (-3.4%, P = 0.114) and right thalamus (-3.1%, P
      = 0.036), and left limbic system (-2.2%, P = 0.127). Parameters were increased by
      1.0% (P = 0.714) only in the right limbic system. There were no hemispheric
      asymmetries (P > 0.05). Moreover, there was no indication for an anterior
      posterior gradient (P > 0.05), and thus no 'hypofrontality'. In contrast to the
      current view, the data indicate a diffuse cortical rather than regionalized
      reduction of neuronal activity in unipolar major depression.

PMID- 11200017
TI  - Reproducibility of assessment of myocardial function using gated 99Tc(m)-MIBI
      SPECT and quantitative software.
AB  - PURPOSE: We investigated the reproducibility of the quantification of left
      ventricular volumes and ejection fraction, and grading of myocardial wall motion
      and systolic thickening with gated myocardial single-photon emission computed
      tomography (SPECT) and Cedars quantification software. PATIENTS, MATERIALS AND
      METHODS: We performed post-stress gated myocardial SPECT in 33 consecutive
      patients twice sequentially in situ. Sixteen frames per cycle were used for
      gating. Using Cedars quantitative gated SPECT software ventricular volumes and
      ejection fraction (EF) were calculated. Wall motion and thickening was graded
      using 5- and 4-point scores, respectively. Coefficients of variation for re
      examination of volumes and EF were calculated. Kappa values for assessing
      reproducibility of wall motion or wall thickening were calculated. RESULTS: Root
      mean square of errors was 5.0 ml for end-diastolic volume, 3.9 ml for end
      systolic volume and 1.9% for EF. No bias or difference was found between the
      first and second acquisition by Bland-Altman analysis. Kappa values for wall
      motion and thickening of repeated acquisition was 0.76 and 0.87, respectively.
      The value of 2 SD from Bland-Altman analysis was 14.4 ml for EDV, 11.2 ml for ESV
      and 5.3% for EF. CONCLUSION: We conclude that quantification of functional
      indices and assessment of wall motion or thickening using gated 99Tc(m)-sestamibi
      (MIBI) SPECT was reproducible and we found that their ranges of physiological
      fluctuation were narrow enough.

PMID- 11200019
TI  - Quantitative gated SPECT myocardial perfusion imaging with 201Tl: an assessment
      of the limitations.
AB  - Gated SPECT (GSPECT) perfusion imaging has been increasing in popularity both
      with 99Tc(m) agents and 201Tl. However, both higher activities than administered
      in the UK and multi-headed cameras are often used. The aim of this study was to
      assess GSPECT imaging using lower activities of 201Tl with a single-headed
      camera. Seventy patients underwent stress and redistribution GSPECT imaging after
      a mean injected activity of 62 +/- 7 MBq 201Tl. These patients also underwent
      radionuclide ventriculography (RNVG) imaging. The Cedars Sinai Quantitative Gated
      SPECT (QGS) package was used to calculate left ventricular ejection fraction
      (LVEF) from the GSPECT studies. Comparison of ejection fractions calculated using
      GSPECT with those calculated using RNVG yielded a correlation coefficient of 0.70
      for the stress studies and 0.71 for the redistribution studies. The width of the
      mean 95% prediction interval ranged from 22 to 74 percentage points for the
      stress studies and 22 to 86 percentage points for the redistribution studies.
      Ejection fractions calculated from stress and redistribution GSPECT studies
      showed a correlation of 0.80 with a mean 95% prediction interval of 42.6 +/- 0.4
      percentage points. In conclusion, left ventricular ejection fractions calculated
      using the QGS algorithm from 201Tl GSPECT studies are inadequate for use in
      clinical practice.

PMID- 11200018
TI  - Three-dimensional automatic image warping in cardiac SPECT.
AB  - This study presents a new tool for the visualization and analysis of three
      dimensional (3-D) cardiac single-photon emission computed tomography (SPECT). The
      first step consisted of computing the 3-D pseudo-skeleton of a binarized
      myocardium and, using the skeleton points, to design a bullet model (half
      ellipsoid prolonged by a cylinder). Afterwards, this model was used to drive the
      warping of the 3-D myocardium, initially egg-shaped, into a thick, flat disc
      using the thin-plate splines as deformation method. Hence, instead of achieving
      several rotations of the initial egg-shaped volume to have an idea on the
      myocardial outer face (epicardial) only, the whole myocardium is seen by looking
      either on top of the disc-shaped transformed myocardium (epicardial surface) or
      underneath for the inner face (endocardial). This new shape permitted us to
      localize any type of defect and to evaluate its extent and depth just by a single
      glance. A detailed analysis, achieved after stripping away this shape in about 10
      layers, allowed us to evaluate the defect extent layer by layer and to determine
      whether the defect involves the totality of the myocardium layers. Finally, its
      flattening following the ventricular long-axis led to a summed bull's eye.

PMID- 11200020
TI  - Estimation of ascitic fluid volume using 99Tcm labelled macroaggregated albumin.
AB  - We have assessed the usefulness of a radionuclide dilution method for estimation
      of ascitic fluid volume. 99Tc(m) macroaggregated albumin (10 MBq) was injected
      into the peritoneal fluid. Multiple samples were taken using a trocath peritoneal
      dialysis catheter over a 4-h period. Blood samples were taken at the same time
      and a 4-h urine collection was made during the study. At 4 h a controlled
      drainage of ascitic fluid, followed by suction drainage, was used and a total
      drained volume measured. For comparison, peritoneal volumes were measured from
      the radioactivity of peritoneal fluid activity samples using dilution techniques.
      The estimated peritoneal fluid volume using the radionuclide method was
      consistently higher than the drained volume. This was attributed to either a lack
      of uniform distribution of the activity in the peritoneal cavity by 4 h or early
      breakdown and absorption of activity from the peritoneal cavity. In two patients
      it was not possible to measure a volume due to poor distribution of the
      radionuclide in the peritoneal fluid. We found that in our group of patients the
      radionuclide dilution is of little value in estimating the peritoneal fluid
      volume.

PMID- 11200021
TI  - Plasma clearance of 99Tc(m)-MAG3: accuracy of five single-sample methods.

PMID- 11200022
TI  - How good is the slope on the second exponential for estimating 51Cr-EDTA renal
      clearance? A Monte Carlo simulation.

PMID- 11200023
TI  - Rethinking risk.

PMID- 11200024
TI  - "On a supposed right to lie [to the public] from benevolent motives":
      communicating health risks to the public.
AB  - There are three main categories of rationale for withholding information or
      telling lies: if overwhelming harm can only be averted through deceit; complete
      triviality such that it is irrelevant whether the truth is told; a duty to
      protect the interests of others. Public health authorities are frequently having
      to form judgements about the public interest, whether to release information or
      issue warnings. In June 1992, routine surveillance detected patulin levels (a
      known carcinogen) in samples of apple juice exceeding safety threshold. Remedial
      actions were promptly taken and it was planned to subsequently publish the
      information in the routine way. However, the media portrayed the handling of the
      problem as a conspiracy and there was a short term reduction in juice sales. In
      October 1995, the UK Committee on Safety of Medicines issued a warning about
      certain brands of the contraceptive pill, based on the interim results of three
      unpublished studies. The increased risk of thromboembolism was small, but the
      resulting scare led to an increase in unwanted pregnancies. The handling of the
      B.S.E. crisis in the U.K. also led to accusations of incompetence or conspiracy.
      Public health authorities have to handle uncertainty and frequently have to form
      judgements for public safety on the basis of evidence of poor quantity and
      quality. Their task is not helped by the sometimes conflicting agenda of
      scientists and media. The public also have differing perceptions and
      interpretations of risk. The series of scares and crises are having a detrimental
      effect on public confidence in public health authorities.

PMID- 11200025
TI  - Health risks and the health care professional.
AB  - Health care professionals are one of a large group of individuals who are exposed
      to significant risks by virtue of their occupation, such as the police, mountain
      rescuers, fire-service. The types of risk to which health care professionals are
      exposed are numerous, many of which remain largely unrecognised by the public and
      may even be underestimated by the professionals themselves. Examples of these
      health risks include fatigue, emotional/psychological trauma, physical injury
      caused by the use of machinery, back injuries, possible even violent physical
      assault from a patient or hospital visitor. There is also a very significant risk
      of acquiring an illness in the course of employment, for example, physical damage
      caused by the prolonged use of toxic substances, and also infectious diseases
      which are acquired by various routes, such as air-borne infections, needle-stick
      injuries. Subjective risk evaluation and the notion of risk in health care from
      the patients' perspective has been widely considered over many years, and in a
      number of different areas, including medical research, screening procedures,
      consent to surgery or other medical intervention. In this paper, however, the
      moral dilemmas which may arise for health care professionals in relation to
      health risks are highlighted and specific questions are raised.

PMID- 11200026
TI  - From risk factors to health resources in medical practice.
AB  - The healing and preventive powers of people's health resources and self-assessed
      knowledge have so far been grossly underestimated in medicine. In this article,
      we call attention to ethical and epistemological dilemmas related to knowledge,
      values, communication, and autonomy embedded in the prevailing risk-oriented
      epidemiology, and suggest a patient-centred salutogenetic approach to promote a
      better balance between resources and risks in medicine. Identification and
      intervention upon risk factors can provide hypotheses about origins of disease
      and predict and sometimes prevent disease at a group level. However, there are
      several pitfalls related to this perspective concerning causal factors, group
      level based possibilities, adequate end points for intervention, informed
      consent, and medicalization, especially in the individualized context of the
      clinical encounter. By introducing a salutogenic perspective, we urge to shift
      the attention toward resources, agency and strength, which may counteract risk of
      disease and empower the patient. Talk can mediate oppression as well as
      empowerment. A communicative key question approach, and self-assessed health
      resources identified through this strategy, are briefly presented as examples of
      empowerment through dialogue.

PMID- 11200027
TI  - Power and hope in the clinical encounter: a meditation on vulnerability.
AB  - A specific clinical encounter in which the author was an ethics consultant, after
      a brief summary, provides the basis for a phenomenological delineation and
      explication of the key ingredients of such encounters. A brief historical
      reflection on the myths of Gyges and Aesculapius suggests that several of these
      ingredients are essential to clinical encounters and help constitute their
      specific moral aspects and challenges. Understood as an interpersonal
      relationship framed by critical issues of illness experiences, the clinical
      encounter makes prominent such constitutive features as dialogue, trust,
      violence, and especially vulnerability and power. The role of the clinical
      ethicist is found to be often critical in these encounters, in particular because
      of the need to help patients and doctors identify, understand, and cope
      productively with fundamental moral phenomena.

PMID- 11200028
TI  - Oliver Sacks--a neurologist explores the lifeworld.
AB  - The neurologist Oliver Sacks has become very famous for his writings. His
      popularity has scattered all mass medias. In his books, he eloquently tells
      stories about patients suffering from extraordinary neurological diseases. Since
      the conceptual framework of Sacks' narratives has been widely unconsidered, this
      article pursues a more general and systematic approach to his work. Sacks terms
      his idiographic and phenomenological access to the world of science Romantical
      Science. With its features, he develops a concept of a Neurology of Identity,
      that is basically concerned with the patient's personality and subjectivity.
      Sacks' personal approach to medicine implies another understanding of diseases:
      For him, diseases cannot be reduced to pathological facts, they constitute other
      worlds. He characteristically uses philosophical, psychological and mythical
      terms for interpretation and narration. But conversely to its sympathetic
      appearance, Sacks' approach entails some deficits: His presentation is not always
      realistic, his interpretations are often one-sided. The theoretical reflections
      on his method and attitude remain poor. Nevertheless, he puts medicine back into
      lifeworld, to open it for many discourse universes beyond science in practice and
      theoretical reflection.

PMID- 11200029
TI  - Teaching for patient-centred ethics.
AB  - In this paper three models of teaching and learning medical ethics are discussed
      critically, the traditional and revised vocational models, and the patient
      centred model. The autonomy-oriented patient-centred ethics of Beauchamp and
      Childress is rejected in favour of a hermeneutic practical ethics. A performative
      conception of ethics teaching is recommended as the most appropriate model for
      use in the theory and practice of ethics pedagogy.

PMID- 11200030
TI  - Expert and non-expert knowledge in medical practice.
AB  - One problematic aspect of the rationality of medical practice concerns the
      relation between expert knowledge and non-expert knowledge. In medical practice
      it is important to match medical knowledge with the self-knowledge of the
      individual patient. This paper tries to study the problem of such matching by
      describing a model for technological paradigms and comparing it with an ideal of
      technological rationality. The professionalised experts tend to base their
      decisions and actions mostly on medical knowledge while the rationality of
      medicine also involves just as important elements of the personal evaluation and
      knowledge of the patients. Since both types of knowledge are necessary for
      rational decisions, the gap between the expert and the non-expert has to be
      bridged in some way. A solution to the problem is suggested in terms of
      pluralism, with the patient as ultimate decision-maker.

PMID- 11200031
TI  - On how to define the concept of health: a loose comparative approach.

PMID- 11200032
TI  - On the comparative approach to defining health: a reply to Brulde.

PMID- 11200033
TI  - More on the looser comparative approach to defining "health": a reply to
      Nordenfelt's reply.

PMID- 11200034
TI  - Supracondylar fractures of the humerus in children.

PMID- 11200035
TI  - X-linked hypophosphatemic rickets--a report of 2 cases and review of literature.
AB  - We report two cases of x-linked dominant hypophosphatemic rickets involving a man
      and his daughter. The family tree consists of 44 members with 13 of them having
      short stature and bowing of the lower limbs. The study of this family tree
      strongly suggests an x-linked dominant inheritance.

PMID- 11200036
TI  - Tuberculosis of the distal end of the radius mimicking a giant-cell tumour.
AB  - We report a case of a lady presenting with a lesion in the distal radius with
      classical radiological features of a giant-cell tumour. These tumours are often
      resected without preliminary histological confirmation. A biopsy done in this
      patient showed it to be tuberculosis.

PMID- 11200037
TI  - Osteopoikilosis--a case report.
AB  - Osteopoikilosis is a rare, inheritable, sclerosing bone dysplasia; sometimes
      mistaken for osteoblastic bone metastases. We report a case in a 25 year-old
      lady.

PMID- 11200038
TI  - Thoracolumbar fracture--dislocation results of surgical treatment.
AB  - Fifteen cases of unstable fracture-dislocation of the thoracolumbar spine have
      been treated by open reduction, short segment transpedicular fixation and fusion
      in Universiti Unit, Kuala Lumpur Hospital from January 1994 until December 1997.
      Twelve male and three female patients were injured; their age ranged from 18 to
      45 years. Five fracture-dislocations occurred in the lower thoracic spine (T8 to
      T11), eight at the thoracolumbar junction (T12 to L2) and two in the lumbar spine
      (L3 to L5). All the patients had neurological deficit. Seven patients with
      incomplete or cauda equina lesions regained some neural function, while all eight
      with complete lesions remained unchanged. Ten of the fifteen cases were grossly
      unstable and translated beyond 50% of the width of the spinal column. At the time
      of follow up (more than one year in all patients), no loss of reduction or of
      fixation was noted in any patient. Solid fusion was achieved in all patients. The
      advantages of this method of treatment include stable fixation, with maintenance
      of sagittal and coronal spinal alignments, to allow early rehabilitation.

PMID- 11200039
TI  - Spinal infection--an overview and the results of treatment.
AB  - A retrospective review of thirty-eight patients (16 males and 22 females) with
      spinal infection between 1993 and 1998 revealed that the mean age was 39.9 years
      and the peak incidence was in the 5th decade of life. Infections in thirty-two
      patients (84.2%) were tuberculous in origin, 13.2% were pyogenic and 2.6% were
      fungal. Back pain was a symptom in 94.7% while 55.8% had neurological deficits,
      of which two-thirds were tuberculous in origin. Twenty-two patients (57.9%) had
      an impaired immune status secondary to pulmonary either tuberculosis, diabetes
      mellitus, intravenous drug abuse, prolonged steroid treatment, malnutrition, or
      advanced age. History of contact with tuberculous patients was elicited in 31.3%,
      extraskeletal tuberculosis was found in 28.1%, while Mantoux test was only
      positive in 53.1% of tuberculous patients. Majority of the cases (57.9%) involved
      lumbar vertebra. The histopathological examination was only positive in 22.2%
      from material taken via CT guided biopsy but 93.3% were found to be conclusive
      from open biopsy. 4 out of 5 patients who had a pyogenic infection were treated
      conservatively and produced a good result. There was no difference in outcome for
      tuberculosis patients treated with either the 3 drug or 4 drug regimen. Anterior
      decompression and bone grafting in tuberculous patients was superior in terms of
      a faster fusion rate, early pain relief and prevention of kvphotic deformity. The
      initial neurological deficit did not reflect the future prognosis of patients
      with spinal infection.

PMID- 11200040
TI  - HUKM instrumentation system in surgical treatment of adolescent idiopathic
      scoliosis--an early experience.
AB  - Between May 1992 through October 1998, twenty-two patients who had adolescent
      idiopathic scoliosis were treated using Universiti Kebangsaan Malaysia (UKM)
      spinal instrumentation and fusion. The minimum length of follow-up was 2 years
      with an average of 2.9 years. Nineteen patients were female and three patients
      were male. The mean age at the time of the operation was 16.2 years (range, 13 to
      24 years). The average blood loss was 1,878 ml and the average operating time was
      291 minutes. The mean pre-operative curve was 61.2 degrees, with a range of 40
      degrees to 90 degrees. The average post-operative correction of the Cobb's angle
      was 53.5 per cent, with a range of 33 per cent to 81 per cent. Post-operative
      immobilization consisted of a maximum of six months in a body cast. There were no
      neurological injuries, no deep wound infections, and no evidence of
      pseudoarthroses. Only three complications occurred and these did not disturb the
      progress of the fusion. This technique safely achieves the objectives of
      scoliosis correction, and is cost-effective in the treatment of adolescent
      idiopathic scoliosis.

PMID- 11200041
TI  - Selective thoracic fusion of King II scoliosis with segmental spinal
      instrumentation.
AB  - Segmental spinal instrumentation with Harrington rod secured to the spine by
      sublaminar wires was a popular method of scoliosis correction in 1980's. It was
      gradually replaced by newer rod-hook systems due to concern about neurological
      complications. However, correction of type II and III curves by selectively
      fusing the thoracic curves with these new instruments has resulted in poor
      results in some cases. The aim of this study is to review the result of selective
      thoracic fusion treated by segmental spinal instrumentation. Between January 1989
      to October 1994, 31 patients with King II scoliosis were treated operatively in
      our unit. These consisted of 29 girls and 2 boys. The mean age of these patients
      were 11.3 years. The study population consisted of 21 Chinese, 5 Malays and 5
      Indians. In one patient, the thoracic curve was convex to the left whilst the
      thoracic curves in the majority were to the right. The surgery was performed by
      three surgeons using harrington rods and posterior fusion with autograft.
      Anterior releases were also required in eight patients to increase flexibility.
      The curve correction obtained was an improvement from a average preoperative
      cobb's angle of 71.5 degrees to 39.5 degrees postoperatively. After an average
      follow-up period of 77.9 months, the correction deteriorated by 22% in the
      thoracic curve and 59% in the lumbar spine without disturbance to truncal
      balance. Only one sublaminar wire broke. However, no implant failure or removal
      has to be performed as yet. This technique appears useful in our institution with
      minimal morbidity.

PMID- 11200042
TI  - Experience in snuffbox arteriovenous fistulae for hemodialysis.
AB  - Sixty-five patients with "Snuffbox" arteriovenous fistulae for hemodialysis were
      reviewed. The procedure was performed under local anaesthesia as an outpatient
      procedure. It was done as a "standby" procedure for 41.5% of patients with
      Chronic Ambulatory Peritoneal Dialysis. 58.5% of patients had the procedure done
      for primary hemodialysis. Patency was assessed as presence of an engorged vein
      and presence of thrill. This was assessed routinely at 4 to 6 weeks after the
      procedure. Patency rate was noted to be 83%. The commonest complication was
      thrombosis of the arteriovenous anastomosis. Some patients required repeated
      procedure at a more proximal site. Further study to determine the blood flow rate
      provided by the anastomosis, and comparison with other anatomical sites is
      necessary.

PMID- 11200043
TI  - Supracondylar fractures of the humerus in children--an epidemiological study of
      132 consecutive cases.
AB  - 132 consecutive cases of supracondylar fractures of the humerus admitted between
      July, 1997 and February, 1999 were included in a prospective study. There were 93
      boys and 39 girls. The age ranges from one to 14 years old. The non-dominant arm
      was more often injured. Ethnic Malay constituted the majority. Accidents mainly
      occurred at home with a peak between 4 pm and 8 pm. Majority was presented within
      24 hours of injury. Type III fracture with distal fragment in extension
      predominated. Nerve injuries occurred in 9 cases in which median nerve was the
      most commonly affected. There was only one open fracture and it was complicated
      by absent radial pulse and median nerve injury.

PMID- 11200044
TI  - The results of open reduction and pin fixation in displaced supracondylar
      fractures of the humerus in children.
AB  - The treatment of displaced supracondylar fracture humerus (Gartland Type III) in
      children continues to be a challenging problem. We did a retrospective study of
      such fractures treated in Hospital Muar, over a 2 years period (from January 1998
      to December 1999). A total of 42 cases with displaced supracondylar fractures,
      treated with open reduction and internal fixation were studied. All cases were
      operated using a posterior triceps splitting approach and crossed kirschner wires
      were used to stabilize the fracture site. An excellent outcome was seen in 34
      patients (81%) and a good outcome in 7 patients (17%). The incidence of
      complications such as pin tract infection (14%), nerve injury (2%) was very low.
      None of the patients had vascular complications or myositis ossificans.

PMID- 11200045
TI  - Functional outcome of open reduction and internal fixation of pelvic ring
      injuries.
AB  - Between January 1996 and August 1998, 15 patients with pelvic ring injuries were
      treated by open reduction and internal fixation. Fractures types included Tile A1
      (7%), B1 (33%), C1 (53%) and C3 (7%). The patients were observed for an average
      of 1 year (range: 5 to 21 months). Thirteen patients (87%) who were operated
      within 3 weeks after injury had their pelvic disruption healed. One patient with
      Tile C1 and non-union of the fracture dislocation of sacroiliac joint was
      operated 11 months after injury and developed implant failure and non-union of
      the fracture dislocation of sacroiliac joint. Another patient with Tile C1 injury
      with transforamina sacral fracture was fixed anteriorly only and developed non
      union of the sacral fracture and redisplacement of pelvic disruption. Both of
      them had a poor functional outcome. A 40 points pelvic outcome grading scale
      (Cole et al 1996) based on physical examination, pain, radiographic analysis and
      activity/work status was used. Six patients (40%) (1 Tile A1, 5 Tile B1) had an
      excellent functional outcome. Seven patients (47%) (6 Tile C1, 1 Tile C3) had a
      good functional outcome.

PMID- 11200046
TI  - Clinical experience with reamed locked nails for close and open comminuted tibial
      diaphyseal fractures: a review of 50 consecutive cases.
AB  - We present the results of our experience in treating comminuted tibial shaft
      fractures with reamed interlocking intramedullary nail from September 1993 to
      December 1995. In this retrospective study, there were fifty patients with an
      average follow-up of 14.3 months (range six to twenty-eight months). Ninety-eight
      percent of the fractures were due to motor-vehicle accident with majority of the
      patients being motorcyclist (96%). Thirty-eight fractures were closed and twelve
      were open (Gustilo grade I--8; grade II--4); 44% of them had additional fractures
      or other injuries. According to Winquist-Hansen classification of diaphyseal
      fracture comminution, there were 24% type I; 18% type II; 26% type III and 32%
      type IV. The union rate was 98%. There were 6 infections, 2 superficial and 4
      deep. All these infections arose from closed fractures, which was possibly due to
      the long operative time. No patients with open fractures, which underwent delayed
      nailing, had infection. One of the patient had severe deep infection which
      required early nail removal before union. Anterior knee pain following nailing
      occurred in 6% of the patients. The average hospital stay after operation was 3.4
      days. Ninety-four percent of the patients had excellent to good functional
      outcome after nailing. The mean time to regain full range of movement of knee and
      ankle was 8.4 weeks. Patients were allowed full weight bearing in the average
      time of 10.7 weeks and the mean time to return to work was 24.7 weeks.

PMID- 11200047
TI  - Proximal third femoral shaft fractures in children: prevention of angular
      deformities using bilateral Thomas splints.
AB  - This is a prospective study to look at the outcome of unilateral proximal third
      femoral shaft fractures in children treated with a bilateral Thomas splint in the
      Department of Orthopaedic Surgery Universiti Kebangsaan Malaysia between the
      period of January 1996 and June 1998. Eighteen children aged between 2 years and
      12 years old with unilateral proximal third fractures of the femoral shaft were
      treated using a bilateral Thomas splint. Angular deformities were measured using
      a goniometer metric scale before and after Thomas splints. The percentage of
      varus tilt corrected ranged from 17% to 72% with an average correction of 29%
      from the initial deformity and the difference was statistically significant (p <
      0.05). The percentage of posterior tilt corrected ranged from 19% to 60% with the
      average correction of 20% from the initial deformity. The difference was
      statistically significant (p < 0.05). From this study, we conclude that bilateral
      Thomas splints can give a better correction of angular deformity for proximal
      third femoral shaft fractures in children below twelve years of age.

PMID- 11200048
TI  - Total hip arthroplasty in Malaysia--the Universiti Kebangsaan Malaysia and
      Hospital Kuala Lumpur experience.
AB  - The results of 109 primary total hip arthroplasties in 92 patients performed in
      Hospital Kuala Lumpur from January 1987 to December 1996 were reviewed after a
      mean follow-up of 30.8 months. There were 22 males and 70 females with the
      average age of 49.9 years (range 19 to 94 years). Chinese females comprised the
      largest group of patients (52.2%). Avascular necrosis was the most common
      diagnosis (33.1%) followed by hip dysplasia and primary osteoarthritis (17.4%).
      The procedure was performed more on the right hip (64.2%) compared to the left
      (35.8%). All patients received prophylactic antibiotics but none were given deep
      vein thrombosis prophylaxis. The Charnley prosthesis was most commonly used and
      the majority of the arthroplasties were cemented (60.5%). About 80% of the THA
      were performed via the lateral approach. The functional hip score improved from
      an average of 8.9 to 15.0 with 66.3% of the patients categorized as good and
      excellent results. There were 16 patients (17.4%) with poor outcome. The most
      common complications encountered were dislocation (10.1%), aseptic loosening
      (9.2%) and periprosthetic fracture (5.5%). Other complications were deep
      infection (1.8%), deep vein thrombosis (0.9%), trochanteric osteotomy
      complications (1.8%), superficial infection (7.3%), urinary tract infection
      (5.5%), pressure sore (3.7%) and respiratory complication (1.8%). Fifteen hips
      (13.8%) required revision. The causes for revision were aseptic loosening,
      dislocation and infection. Technical anomalies were recognized as one of the
      factors contributing to poor results. Five-year survival rate was 87.3%. Better
      results can be expected with increasing experience and technical skulls.

PMID- 11200049
TI  - Limb reconstruction surgery with external fixators--university hospital
      experience.
AB  - We are describing 21 limb reconstruction procedures performed in 18 patients with
      the use of external fixators from 1996 to 1998. The average age of patients was
      21, ranging from 1 to 50 years old. Indications for surgery included short limb,
      non-union, pseudoarthrosis and bone or soft tissue deformities. Average length
      obtained for cases of limb lengthening was 6 cm. All the seven clubfoot
      deformities in five children were fully corrected. Equinus deformity recurred in
      one foot and was treated with supramalleolar osteotomy. Out of the seven cases
      with infected nonunion and bone loss, three failed to achieve union and required
      additional bone grafting procedures. One patient with unilateral external fixator
      for the correction of tibia shortening developed valgus deformity.

PMID- 11200050
TI  - Short segment posterior instrumentation, reduction and fusion of unstable
      thoracolumbar burst fractures--a review of 26 cases.
AB  - From January 1994 to January 1998, 26 patients of unstable thoracolumbar burst
      fracture were treated by a short segment posterior instrumentation (pedicular
      screw plate/rod system), reduction and fusion in Kuala Lumpur and Universiti
      Kebangsaan Malaysia Hospital. Majority of them were young and in a productive age
      group (mean age were 30 year-old). The mean duration of follow-up was 24.4
      months. The injuries were caused by fall from height (69%) and motor vehicle
      accident (31%). Most of the fracture occurred at 1st and 2nd lumbar vertebrae
      (24/26). Twelve of the patients did not have neurological deficits. Out of 14
      patients with neurological deficits, 64.4% of them showed an improvement of at
      least one Frankel's grade. There was no defect correlation between canal
      compromise and neurological deficit. Kyphotic angle improved from 20 degrees to 7
      degrees immediately after surgery. In the last follow-up average kyphotic angle
      was 9 degrees with average lost of 2 degrees. The average length of
      hospitalization following surgery was 24 days. A posterolateral bony fusion was
      achieved in all cases at an average of 3 months. Complication included 2
      loosening and 3 misplacement of pedicle screw fixation. We concluded that short
      segment fixation with posterolateral decompression and fusion is effective in the
      treatment of unstable thoracolumbar burst fracture.

PMID- 11200051
TI  - Candida albicans infection of a prosthetic knee replacement: a case report.
AB  - We report a 64 year old man who developed Candida albicans infection following
      total knee arthroplasty. A two-stage exchange arthroplasty was performed after an
      initial swab culture grew Acinobacter sp. A scanty growth of yeast was also found
      from the tissue culture. Intravenous cefuroxime was instituted for six weeks
      followed by reimplantation four months after the removal. Three weeks after that
      revision, the prosthesis became infected and a culture of knee aspirate
      established the diagnosis of Candida albicans infection. Treatment consisted of
      thorough debridement of the involved joint and oral fluconazole for a year.
      Infection was never totally resolved and a secondary infection with methicillin
      resistant staphylococcus aureus then developed. Excision arthroplasty was done at
      two and a half years after the initial infection. At five years follow-up the
      infection was quiescent and he had a range of movement of 30 degrees to 70
      degrees. Knee brace was used to control the valgus-varus stability.

PMID- 11200052
TI  - Neurological recovery in a patient with recurrent aggressive giant cell tumour of
      the axis--a case report.
AB  - A rare case of an aggressive recurrent giant cell tumour of axis is presented.
      The problems encountered in diagnosis and management are discussed. High dose
      dexamethasone was found to be useful managing this inoperable aggressive tumour
      which was compressing the cord. Early diagnosis would facilitate wide excision of
      the tumour with good prognosis.

PMID- 11200054
TI  - Heterogeneity of human peripheral blood monocyte subsets.
AB  - In recent years the number of reports describing phenotypically and functionally
      distinct subsets of human blood leukocytes, and in particular of subtypes of
      antigen-presenting cells has continuously increased. A great diversity was
      described not only for dendritic cells (DC), but also for human blood monocytes
      (Mo) and macrophages (Mac). Similar to DC, the different types of Mo subsets
      could be defined by distinct phenotypes and immunoregulatory functions. The
      characterization of blood Mo subpopulations revealed that some of them exhibit
      common features with myeloid or lymphoid DC and tissue Mac, but also demonstrate
      the existence of novel unique cell populations. The generation of lymphoid and
      myeloid DC and their heterogeneity has been the subject of recent reviews. Here
      we focus on Mo from human peripheral blood and summarize the data (including our
      own) dealing with their phenotypic and functional, in particular immunoregulatory
      properties.

PMID- 11200053
TI  - Pivotal role of 5-lipoxygenase in the activation of human eosinophils: platelet
      activating factor and interleukin-5 induce CD69 on eosinophils through the 5
      lipoxygenase pathway.
AB  - CD69 is an activation-related cell surface molecule on human eosinophils. It has
      been reported that interleukin (IL)-5, but not platelet-activating factor (PAF),
      can induce CD69 on human eosinophils in vitro. In this study, PAF induced CD69
      intensely on eosinophils from patients with hypereosinophilic syndrome (HES),
      while only weakly on those from normal donors. Because HES eosinophils contain
      abundant cytosolic phospholipase A2 (cPLA2) and 5-lipoxygenase (5-LO), we
      examined the roles of several enzymes involved in the metabolism of arachidonic
      acid in the PAF- or IL-5-induced CD69 expression on eosinophils. The CD69
      expression induced by PAF and IL-5 on HES eosinophils and that by IL-5 on normal
      eosinophils were both inhibited by AA861 and MK-886, inhibitors of 5-LO activity.
      In addition, AACOCF3, a selective cPLA2 inhibitor, inhibited IL-5-induced CD69
      expression on normal eosinophils, although it hardly affected either IL-5- or PAF
      induced CD69 expression on HES eosinophils. Moreover, PAF alone induced CD69 only
      weakly on normal eosinophils, but exogenous arachidonic acid remarkably enhanced
      PAF-induced CD69 expression on them. These findings suggest that IL-5 activates
      both cPLA2 and 5-LO but PAF activates only 5-LO. It is suggested that 5-LO plays
      a critical role in the induction of CD69 on eosinophils.

PMID- 11200055
TI  - Interleukin-12 can replace CD28-dependent T-cell costimulation during nonspecific
      cytotoxic T lymphocyte induction by anti-CD3 antibody.
AB  - Cytotoxic T lymphocyte (CTL) development is regulated closely by an intricate
      series of signals provided by the T-cell receptor/CD3 complex, cytokines, and
      costimulatory ligand/receptor systems. In this study, we have explored the role
      of interleukin (IL)-12 and CD28 in mouse CTL development. Activation of T cells
      with anti-CD3 monoclonal antibody (mAb) in the presence of anti-CD86 mAb, which
      prevents CD28-CD86 interaction, led to decreased production of type 1 (IL-2,
      interferon-gamma) and type 2 (IL-4, IL-6, IL-10) cytokines, as well as diminished
      expression of granzyme B (Gzm B) and reduced cytotoxic effector function.
      Cytolytic activity in T-cell cultures that were activated in the presence of anti
      CD86-blocking mAb alone or in combination with anti-CD80 mAb could be restored by
      the addition of exogenous IL-12 at initiation of culture. The ability of IL-12 to
      substitute for CD28-costimulatory signaling during CTL development was found to
      be dependent on the presence of IL-2 rather than interferon-gamma. IL-2 is
      required for IL-12Rbeta2 expression by T cells activated in the presence of anti
      CD86 mAb. Moreover, IL-12Rbeta2 expression by T cells activated in the presence
      of anti-CD86 mAb is enhanced by IL-12. We, therefore, conclude that the ability
      of IL-12 to substitute for CD28-costimulatory signaling during CTL development is
      a result of the interaction of IL-12 with IL-12Rbeta2 induced by low levels of IL
      2 synthesized by T cells activated in a CD28-independent manner.

PMID- 11200056
TI  - Activated human platelets express Fas-L and induce apoptosis in Fas-positive
      tumor cells.
AB  - In addition to their role in hemostasis and thrombosis, platelets are important
      modulators of immune and inflammatory responses. We provide evidence here that
      human platelets contain abundant quantities of Fas-L, and upon activation, they
      express it on their surface as well as release it into medium. This surface
      expressed Fas-L is biologically active and can induce apoptosis in Fas-positive
      human tumor cells. Therefore, activated platelets may represent an important
      player in Fas/Fas-L-mediated apoptosis.

PMID- 11200057
TI  - Tumor cell-derived TGF-beta and IL-10 dysregulate paclitaxel-induced macrophage
      activation.
AB  - Paclitaxel (TAXOL) activates in vitro macrophage (Mo) expression of
      proinflammatory and cytotoxic mediators, including IL-12, tumor necrosis factor
      alpha (TNF-alpha), and nitric oxide (NO). However, tumors dysregulate Mo through
      soluble suppressor molecules, and it is possible that tumors evade paclitaxel
      mediated immune effector function through the production of immunomodulatory
      molecules and inhibition of Mo function in situ. Because Mo activation in the
      tumor microenviroment is a desirable goal of anti-tumor immunotherapy, we
      evaluated whether tumor-derived immunomodulatory factors dysregulate paclitaxel
      mediated Mo activation. Tumor cell-derived supernatant suppressed paclitaxel's
      capacity to induce IL-12, TNF-alpha, and NO production by RAW264.7 Mo. Tumor
      factors also dysregulated paclitaxel-induced expression of a HIV-LTR, promoter
      driven luciferase construct in RAW264.7 Mo, suggesting that tumors may inhibit a
      broad range of Mo functionality. Depletion studies revealed that IL-10 and
      transforming growth factor-beta1 (TGF-beta1), but not prostaglandin E2 (PGE2),
      impaired paclitaxel-mediated activation, suggesting that abrogation of these
      factors in situ might restore paclitaxel's activating capacity and enhance anti
      tumor efficacy.

PMID- 11200058
TI  - Impaired IL-15 production associated with susceptibility of murine AIDS to
      mycobacterial infection.
AB  - LP-BM5 murine leukemia virus (MuLV) injection causes murine AIDS (MAIDS), a
      disease characterized by many functional abnormalities of immunocompetent cells.
      We show that MAIDS mice are susceptible to Mycobacterium bovis Bacille Calmette
      Guerin (BCG) infection as assessed by survival rate and bacterial counts. The
      peritoneal exudate macrophages from MAIDS mice produced a significant level of
      interleukin (IL)-12 soon after inoculation with BCG, whereas IL-15 and tumor
      necrosis factor (TNF) production were severely impaired in BCG-infected MAIDS
      mice. The appearance of natural killer (NK) and CD4+ T helper type 1 (Th1) cells
      specific for mycobacterial antigen were depressed in MAIDS mice after BCG
      infection. Thus, it appeared that impaired production of IL-15, besides other
      inflammatory cytokines, in MAIDS mice may be involved in the poor responses of
      the NK and Th1 cells, resulting in an increased susceptibility to BCG.

PMID- 11200059
TI  - Autocrine action of IL-10 suppresses proinflammatory mediators and inflammation
      in the HSV-1-infected cornea.
AB  - We investigated whether IL-10 produced endogenously would influence the
      development of HSV-1-induced acute corneal disease. Murine corneal epithelial
      cells and fibroblasts cultured in vitro expressed IL-10 mRNA and protein
      constitutively and also IL-10 receptors. Inclusion of IL-10 neutralizing antibody
      in the culture medium significantly (p<0.05) enhanced TNF-alpha-induced IL-6 and
      MIP-2 production by both corneal cell types. Endogenous IL-10 synthesis, which
      also occurred in vivo, was not modulated by Herpes virus infection or by
      depletion of neutrophils or natural killer cells. Antibody to IL-10 given locally
      at the time of HSV-1 intracorneal infection was associated with significantly
      (p<0.05) enhanced production of IL-6, MIP-2, and MIP-1alpha, increased neutrophil
      infiltration, and more extensive corneal disease. Similarly, mice with a
      disrupted IL-10 gene developed more severe corneal disease than wild-type
      controls. Collectively, these observations suggest that locally produced IL-10
      can act in an autocrine/paracrine fashion to down-regulate the production of
      proinflammatory mediators and thus limit corneal inflammation.

PMID- 11200060
TI  - Protein kinase C agonists enhance phagocytosis of P. aeruginosa by murine
      alveolar macrophages.
AB  - Pulmonary alveolar macrophages (AMphis) are incompetent to phagocytose
      unopsonized Pseudomonas aeruginosa, but ingestion by other macrophage phenotypes
      (i.e., peritoneal macrophages) occurs efficiently. The purpose of this study was
      to explore factors that might control such phenotypic differences. Our laboratory
      has demonstrated that AMphis exposed to sodium azide display enhanced
      phagocytosis of P. aeruginosa. Here we report that the phagocytic-enhancing
      effect of sodium azide was abrogated by inhibitors of protein kinase C (PKC).
      Furthermore, the addition of PKC agonists, such as phorbol myristate acetate
      (PMA), and tumor necrosis factor alpha (TNF-alpha), mimicked the phagocytic
      enhancing effect of sodium azide. We conclude that AM4phis are normally
      incompetent to phagocytose P. aeruginosa. Factors that up-regulate AMphi function
      (azide, PMA, TNF-alpha) can reverse the phagocytic incompetence in vitro.
      Although these compounds are not appropriate candidate therapeutic agents, their
      effects provide insights for understanding of the pathways responsible for
      regulation of P. aeruginosa phagocytosis.

PMID- 11200061
TI  - Transcriptional activation of the gp91phox NADPH oxidase subunit by TPA in HL-60
      cells.
AB  - The exposure to epigenetic effectors capable of inducing copious production of
      reactive oxygen species (ROS) has been associated with chronic inflammation,
      tumor initiation, and promotion. The objective of this study was to examine the
      regulation of gp91phox, the catalytic subunit of the NADPH oxidase, and the
      kinetics of ROS production in promyelocytic leukemia HL-60 cells induced with 12
      O-tetradeconylphorbol-13-acetate (TPA). The treatment of HL-60 cells with TPA
      (0.1 microM) induced cellular differentiation, which was followed after 48 h by a
      tenfold increase in chemiluminescence from lucigenin and a 2.5-fold increase in
      the intracellular oxidation of 2',7'-dicholorofluorescin (DCFH). Whereas higher
      concentrations (1.0 microM) of TPA did not stimulate further ROS production,
      repeated stimulation with 0.1 microM TPA of differentiated cells induced a modest
      (1.2-fold) but rapid (15 min) increase in chemiluminescence. In cells treated
      with TPA, the burst in ROS at 48 h was preceded by accumulation at 12 h of
      gp91phox (8.8-fold) and p47phox mRNA (threefold), whereas untreated cells
      contained steady-state levels of both transcripts. Time-course experiments with
      actinomycin D to inhibit transcription revealed that TPA did not improve the
      stability of gp91phox. In transient transfections, luciferase reporter activity
      directed from a 1.5-kb gp91phox promoter fragment was enhanced threefold upon
      treatment with TPA for 24 h. We conclude that TPA can commit HL-60 cells to
      differentiation and elicit transcription from the proximal gp91phox promoter.

PMID- 11200062
TI  - Modulation of H2 histamine receptor-mediated cAMP generation and granulocytic
      differentiation by extracellular nucleotides via activation of protein kinase C.
AB  - Extracellular ATP exerts a variety of biological actions through several kinds of
      P2 receptor in HL-60 promyelocytes. We show that stimulation of P2Y2 receptors
      with ATP and analogs resulted in the inhibition of a subsequently histamine
      induced cAMP production and functional differentiation. Treatment of the cells
      with phorbol 12-myristate 13-acetate also blocked the histamine-mediated cAMP
      generation just as ATP did. Incubation of the cells with the protein kinase C
      inhibitor bisindolylmaleimide (GF109203X) abolished the inhibitory effects of
      extracellular nucleotides, suggesting that protein kinase C may act as an inter
      regulator between two receptors. However, ATP did not affect the binding affinity
      or total binding of [3H]histamine to membrane receptors; it also did not
      heterologously desensitize H2 receptors. The ATP treatment synergistically
      elevated the cAMP levels induced directly by forskolin or indirectly by G protein
      activation after cholera toxin treatment. This indicates that the site of the
      protein kinase C action is not the G protein or effector enzyme. Co-stimulation
      of the cells with nucleotides and histamine inhibited histamine-mediated
      granulocytic differentiation, which was evaluated by looking at the extent of N
      formyl-methionyl-leucyl-phenylalanine responses. Taken together, the results
      demonstrate that extracellular nucleotides are negatively involved in the
      modulation of histamine signaling via activation of protein kinase C, probably by
      inhibiting coupling between receptor and G protein.

PMID- 11200063
TI  - The role of architectural transcription factors in cytokine gene transcription.
AB  - The strict control of cytokine gene transcription is required for the correct
      regulation of an immune response. Cytokine gene transcription is generally
      inducible and can also be cell-type specific. Promoter and enhancer regions that
      control the expression of these genes assemble complex arrays of transcription
      factors known as enhanceosomes. One important aspect of the organization of these
      multi-protein complexes is the presence of proteins known as architectural
      transcription factors. Architectural proteins influence structural aspects of
      enhanceosomes through protein:DNA as well as protein:protein interactions. The
      high mobility group I(Y) and the cold shock domain families of architectural
      proteins have been shown to play roles in cytokine gene transcription and will be
      discussed here. These families of proteins interact with specific structural
      features of DNA, modulate transcription factor binding to DNA, and interact
      directly with other transcription factors. The mechanisms by which they affect
      inducible cytokine gene transcription will be discussed.

PMID- 11200064
TI  - MAP kinase activation in macrophages.
AB  - Stimulation of macrophages by a variety of agents causes activation of mitogen
      activated protein kinases (MAPKs). Activation of MAPKs by lipopolysaccharide
      involves CD14 and Toll receptors. Subsequent steps still remain to be explored.
      Tumor necrosis factor-alpha (TNF-alpha)-induced activation of MAPKs has been
      shown to involve the death domain proteins (TRADD, FADD, MADD) and TRAFs. Other
      molecules involved in this pathway include the protein kinases, ASK1, germinal
      center kinase (GCK), hematopoietic progenitor kinase 1 (HPK1), and GCK-related
      kinase (GCKR). Although, these pathways have been described in various cell
      types, their role in macrophages remains to be established. The availability of
      knockout mice and constitutively active and dominant-negative mutants of MAPKs
      should greatly enhance our understanding of this field. The activation of MAPKs
      seems to be different in cell lines compared with primary cells. Among the
      macrophages, cells from different compartments show different expression of
      receptors and signal transduction molecules. These differences may account for
      differences in MAPK activation and other phenotypic differences in macrophages
      from different compartments. Therefore, it is important to use primary cells for
      studying MAPK signal-transduction pathways, and the data from cell lines should
      not be extrapolated to primary cells.

PMID- 11200065
TI  - Role of mast cells in zymosan-induced peritoneal inflammation in Balb/c and mast
      cell-deficient WBB6F1 mice.
AB  - Zymosan-induced peritonitis was investigated in mast cell-deficient WBB6F1 mice
      and in Balb/c mice pretreated with mast cell stabilizer (cromolyn) or antagonists
      of histamine receptors (mepyramine, triprolidine, cimetidine, or ranitidine). The
      inherited mast cell deficiency in W/Wv knockouts of WBB6F1 mice impaired
      significantly the level of histamine and plasma exudation (measured 30 min after
      stimulation) as well as the influx of exudatory leukocytes, accumulation of
      plasma and exudate chemoattractants, and the release of proinflammatory cytokines
      (TNF-alpha, IL-1beta, and IL-6) measured at 6 h of inflammation. All of those
      factors were fully restored after selective intraperitoneal reconstitution of
      W/Wv mice with bone marrow-derived mast cells from their control +/+
      counterparts. Cromolyn pretreatment of Balb/c mice reduced exclusively the early
      plasma exudation and histamine influx. Blocking of histamine receptors inhibited
      not only the early plasma exudation but also temporarily diminished primary
      leukocyte influx and levels of MCP-1 and IL-1beta. In conclusion, mast cells play
      an important role in the initiation of zymosan-induced peritonitis and modulate
      its further course.

PMID- 11200066
TI  - Iron transport into mycobacterium avium-containing phagosomes from an
      Nramp1(Gly169)-transfected RAW264.7 macrophage cell line.
AB  - Nramp1 is an important determinant of innate resistance of macrophages to the
      growth of intracellular microorganisms. We previously showed that Nramp1
      functions to transport iron from the cytoplasm into phagosomes of Mycobacterium
      avium-infected macrophages. The purpose of this investigation was to further
      characterize the factors that regulate Nramp1-mediated iron transport into
      phagosomes. Treatment of Nramp1(Gly169) macrophages with the lysomotrophic agents
      chloroquine or ammonium chloride reduced the import of iron significantly. We
      found that macrophage-activating cytokines, including TNF-alpha, IFN-gamma, IL
      1alpha, and GM-CSF, when added prior to M. avium, increased the transport of iron
      into the phagosome. This increase in iron transport was not a result of an
      increased amount of Nramp1 protein in the phagosome nor to new protein synthesis.
      Treatment of Nramp1(Gly169)-transfected macrophages with inhibitors of protein
      kinase C (PKC) diminished the import of iron into the phagosomes. Iron import was
      inhibited by an anti-Nramp1 antibody against the putative fourth outer-loop
      region of Nramp1 but not by an anti-Nramp1 antibody against the carboxy terminus.
      The significance of these results on the orientation of Nramp1 in the phagosome
      membrane and on the transport of iron is discussed.

PMID- 11200067
TI  - Neutrophil survival is markedly reduced by incubation with influenza virus and
      Streptococcus pneumoniae: role of respiratory burst.
AB  - Bacterial superinfections are an important cause of morbidity and mortality
      during influenza A virus (IAV) epidemics. We demonstrate that incubation with the
      combination of IAV and Streptococcus pneumoniae caused marked reductions in
      survival of neutrophils in vitro compared with treatment with control buffer or
      IAV or S. pneumoniae alone. This cooperative effect was in part mediated by
      acceleration of neutrophil apoptosis as evidenced by increases in annexin-V
      binding and caspase-3 activation. However, GM-CSF did not increase survival of
      neutrophils exposed to IAV and S. pneumoniae. IAV enhanced neutrophil uptake of
      S. pneumoniae significantly. Furthermore, the combination of IAV and S.
      pneumoniae caused significantly more hydrogen peroxide production than IAV or S.
      pneumoniae alone. This increased respiratory burst activity contributed to the
      diminished neutrophil survival caused by IAV and S. pneumoniae. The NADPH oxidase
      inhibitor, diphenyleneiodonium, significantly improved survival of neutrophils
      treated with IAV and S. pneumoniae. These findings may help to explain the
      increased susceptibility of IAV-infected patients to infections with S.
      pneumoniae.

PMID- 11200068
TI  - Neutrophil secretory vesicles are the intracellular reservoir for GPI-80, a
      protein with adhesion-regulating potential.
AB  - The subcellular localization of GPI-80, a novel, adhesion-regulating protein, was
      investigated in human neutrophils. Surface expression of GPI-80 was determined by
      FACS analysis as well as by the ability for phospholipase C to cleave the protein
      from the cell surface. Increasing amounts of GPI-80 were exposed on the cell
      surface after weak stimulation with the chemoattractant fMLF, suggesting that the
      protein can be translocated to the plasma membrane from intracellular stores. By
      subcellular fractionation of the neutrophils, GPI-80 was defined as a component
      of a light membrane fraction, containing secretory vesicles and plasma membranes,
      and it was absent from the neutrophil granule fractions. Separation of the plasma
      membranes from the secretory vesicles by flotation gradient fractionation
      confirmed that the GPI-80 was localized in the mobilizable secretory vesicles by
      approximately 50%, and the rest was plasma membrane-bound. Thus, we identify
      secretory vesicles as the reservoir of GPI-80 from which it may translocate to
      the plasma membrane after weak stimulation of the cells.

PMID- 11200069
TI  - PAF-mediated Ca2+ influx in human neutrophils occurs via store-operated
      mechanisms.
AB  - Many inflammatory mediators activate neutrophils (PMN) partly by increasing
      cytosolic calcium concentration ([Ca2+]i). Modulation of PMN [Ca2+]i might
      therefore be useful in regulating inflammation after shock or sepsis. The
      hemodynamic effects of traditional Ca2+ channel blockade, however, could endanger
      unstable patients. Store-operated calcium influx (SOCI) is known now to
      contribute to Ca2+ flux in "nonexcitable" cells. Therefore, we studied the role
      of SOCI in human PMN responses to the proinflammatory ligand PAF. PMN [Ca2+]i was
      studied by spectrofluorometry with and without external calcium. We studied the
      effects o

PMID- 11200070
TI  - Adjuvant effect of gamma-inulin is mediated by C3 fragments deposited on antigen
      presenting cells.
AB  - The adjuvant effect of gamma-inulin, a strong activator of the alternative
      complement pathway, is well-known, but its exact mechanism is not revealed yet.
      Here, we show that macrophages, isolated from the peritoneal cavity of gamma
      inulin-injected mice and used as antigen-presenting cells, enhance the
      proliferation of antigen-specific T-cells up to 2.5-fold when compared with
      macrophages of non-treated animals. This effect is abrogated by the presence of
      anti-C3 F(ab')2 fragments and by prior decomplementation of the donor animals
      with CVF. It is demonstrated that treatment of mice with the adjuvant results in
      deposition of C3-fragments onto the surface of peritoneal macrophages, as does in
      vitro incubation of the cells with gamma-inulin in the presence of fresh
      autologous serum. Prior incubation of macrophages with gamma-inulin plus serum in
      vitro enhances subsequent C3 production. Because it has been shown earlier that
      CR1/2 expressed on activated T-cells and interacting with covalently bound C3
      fragments plays an important role in the augmentation of the adaptive response,
      our present results reveal a mechanism that contributes to the adjuvant effect of
      gamma-inulin and point to a further link between innate and adaptive immunity.

PMID- 11200071
TI  - Severe exercise enhances phagocytosis by murine bronchoalveolar macrophages.
AB  - Because physical activity affects the immune competency of individuals by an
      unknown mechanism, we investigated the effect of acute exercise on phagocytosis
      of bronchoalveolar macrophages (BAMs). Male BALB/c mice, 7-9 weeks old, ran on a
      treadmill to exhaustion (severe exercise, SE) or at a final speed of 17 m/min for
      30 min (moderate exercise, ME). Although both exercise protocols induced
      differential leukocytosis, 95% leukocytes from lung lavages of both groups were
      BAMs. The BAM phagocytic capacity of nonopsonized beads increased immediately
      after SE but not after ME, gradually returning to the basal level after 4 h. SE
      upregulates the macrophage scavenger receptors (SR-A type I/II and MARCO), CR3,
      and ICAM-1, but not Fc gammaR. Although the blocking effect of MARCO antibody was
      most pronounced, that of ICAM-1 antibody was totally reversed by cross-linking
      CR3. Our results showed that SE, but not ME, activated BAMs and that the enhanced
      nonopsonized phagocytosis was mainly mediated by scavenger receptors and ICAM
      1/CR3.

PMID- 11200072
TI  - CpG DNA increases primary malignant B cell expression of costimulatory molecules
      and target antigens.
AB  - Multiple factors, including expression of costimulatory molecules, antigen
      presenting molecules, and target antigens, likely impact the efficacy of antibody
      therapy and other approaches to the immunotherapy of B cell malignancy.
      Unmethylated CpG-dinucleotides in select base contexts ("CpG motifs") that
      resemble sequences found in bacterial DNA are potent immunostimulatory agents
      capable of inducing a complex immune response, including a strong B cell
      stimulus. We examined the effect of a potent human CpG oligonucleotide (CpG ODN
      2006) on different types of primary human malignant B cells and reactive
      follicular hyperplasia. CpG oligodeoxynucleotide (CpG ODN), but not control (non
      CpG ODN), increased the expression of costimulatory molecules (CD40, CD80, CD86,
      CD54) on malignant B cells without altering the phenotype of B cells obtained
      from reactive follicular hyperplasia. CpG ODN also enhanced expression of class I
      and class II MHC in most samples. CD20 expression was increased in response to
      CpG ODN, most notably in B-CLL and marginal zone lymphoma. An inverse correlation
      was found between baseline expression of CD20 and CD40 and their expression after
      exposure to CpG ODN, thus the most significant increase in expression of these
      molecules was found in those samples that had the lowest baseline levels. In
      conclusion, CpG ODN can lead to increasing expression of molecules involved in
      costimulation, antigen presentation, and as targets for antibody-based therapy
      and deserve further evaluation as potential immunotherapeutic agents for B cell
      malignancy.

PMID- 11200074
TI  - Natural and synthetic agonists of the melanocortin receptor type 3 possess anti
      inflammatory properties.
AB  - The effects of the natural and synthetic ligands for the melanocortin receptor
      type 3 (MC3-R) have been evaluated in a murine model of experimental gout.
      Systemic treatment of mice with gamma2-melanocyte-stimulating hormone (gamma2
      MSH) and the synthetic agonist MTII inhibited accumulation of KC, interleukin-1
      beta (IL-1beta), and PMN elicited by urate crystals in the peritoneal cavity. In
      vitro, macrophage (Mo) activation, determined as release of KC and IL-1beta, was
      inhibited by gamma2-MSH and MTII. The mixed MC3/4-R antagonist SHU9119 prevented
      the inhibitory actions of gamma2-MSH and MTII in vitro and in vivo, whereas the
      selective MC4-R antagonist HS024 was without effect. Western blotting also showed
      the presence of MC3-R protein on murine peritoneal Mo. Furthermore, agonism at
      the MC3-R evoked accumulation of cAMP within the Mo, which was inhibited by
      SHU9119. Thus, naturally occurring melanocortins, as well as the synthetic long
      acting compound MTII, activate MC3-R on peritoneal Mo to inhibit the experimental
      inflammatory response.

PMID- 11200073
TI  - Subthreshold concentrations of anti-proteinase 3 antibodies (c-ANCA) specifically
      prime human neutrophils for fMLP-induced leukotriene synthesis and chemotaxis.
AB  - Anti-neutrophil cytoplasmic antibodies (ANCA) targeting proteinase 3 (PR3)
      possess a high sensitivity and specificity for Wegener's granulomatosis. Due to
      their capacity of directly activating neutrophils, a pathogenetic role for these
      autoantibodies has been proposed. We investigated the impact of subthreshold
      concentrations of monoclonal anti-PR3 antibodies (anti-PR3; 0.1 microg/mL) on
      neutrophil activation elicited by a secondary agent. Preincubation with anti-PR3
      resulted in a massive amplification of N-formyl-methionyl-leucyl-phenylalanine
      (fMLP)-induced leukotriene (LT) generation, with a marked increase in the
      liberation of LTB4, LTA4, and 5-hydroxyeicosatetraenoic acid (5-HETE). This
      priming commenced within 2.5 min, with a maximum after 5-7.5 min. Moreover, anti
      PR3 pretreatment markedly enhanced PMN movement toward fMLP. The priming effect
      of anti-PR3 toward fMLP challenge was reproduced by c-ANCA, but not by F(ab)2
      fragments of the antibodies and isotype-matched control IgG. Generation of
      superoxide anion and release of elastase were suppressed in anti-PR3-pretreated
      neutrophils undergoing fMLP challenge. In contrast, neutrophil activation by
      platelet-activating factor (PAF) or the calcium ionophore A23187 remained
      unaffected. We conclude that subthreshold concentrations of anti-PR3 antibodies
      selectively modify neutrophil responses to fMLP, with enhancement of leukotriene
      generation and chemotaxis, but suppression of respiratory burst and
      degranulation. Such priming might contribute to localized neutrophil accumulation
      together with blunted host defense in Wegener's granulomatosis.

PMID- 11200075
TI  - Modelling in surgical oncology--part III: massive data sets and complex systems.
AB  - Human tumours are complex and unstable biological systems. New intellectual and
      mathematical approaches together with massive computing power are transforming
      our capacity to model and investigate such complexity. Computers also allow
      massive data sets to be collated and analysed. Such sets include the medical and
      epidemiological records of entire populations; the entire genetic code of the
      human being and of other species, including parasites and disease vectors; and
      the genotype of each and every individual. Massive data sets take us into new
      dimensions of complexity for which simple linear mathematics are insufficient.
      The analysis of the grades of complexity which determine protein and cell
      construction, cell to cell interactions within tissues and organs, the
      morphogenesis of entire organisms and population interactions with disease
      vectors require the sophisticated mathematical tools of non-linear analysis,
      neural networks, chaos and complexity theory. The capacity for closer
      representations of reality through powerful computational models also allows us
      to look afresh at the generalizations of conventional statistics. Within this
      computational cauldron, we may also find help in the better understanding of
      oncogenesis and cancer therapy. This paper, the third in our series on modelling
      in tumour biology, considers the breadth of opportunity and challenge at the
      interface between cell biology and biomathematics.

PMID- 11200076
TI  - Immunohistochemical analysis of measles related antigen in IBD.

PMID- 11200077
TI  - Survivin gene expression and prognosis in recurrent colorectal cancer.

PMID- 11200078
TI  - The role of nitric oxide in the regulation of ion channels in airway epithelium:
      implications for diseases of the lung.
AB  - The human respiratory tract is covered with airway surface liquid (ASL) that is
      essential for lung defense and normal airway function. The quantity and
      composition of ASL is regulated by active ion transport across the airway
      epithelium. Abnormal electrolyte transport produces changes in ASL volume and
      composition, inhibits mucociliary clearance and leads to chronic infection of
      airway surfaces, as is evident in cystic fibrosis. Agonists that induce
      intracellular increases in cAMP or Ca2+ are generally associated with electrolyte
      secretion. While these mechanisms have been studied in detail for many years,
      modulation of ion channels by nitric oxide (NO) has emerged only recently as a
      significant determinant of ion channel function. NO is a physiological regulator
      of transepithelial ion movement and alterations of its generation and action may
      play an important role in the pathogenesis of lung disorders characterized by
      hypersecretion of ASL. This review presents the current understanding of
      regulation of airway epithelial ion channels by NO and attempts to highlight the
      importance of this regulation for lung defense.

PMID- 11200079
TI  - Mechanisms of biological S-nitrosation and its measurement.
AB  - Nitric oxide (NO) exhibits multiple biological actions through formation of
      various oxidized intermediates derived from NO. Among them, nitrosothiol adducts
      (RS-NOs) with the sulfhydryl moiety of proteins and amino acids appears to be an
      important species in view of its unique chemical reactivity. Understanding of the
      biologically relevant S-nitrosation mechanism is essential because RS-NOs seem to
      be critically involved in modulation of intracellular and intercellular signal
      transduction, including gene transcription, cell apoptosis, and oxidative stress.
      RS-NOs have been recently found to be formed efficiently via one-electron
      oxidation of NO catalyzed by ceruloplasmin, a major copper-containing protein in
      mammalian plasma. Ceruloplasmin is synthesized mainly by hepatocytes, but it is
      also expressed by other cells such as macrophages and astrocytes. Once RS-NOs are
      formed, they function as NO transporters in biological systems, the NO being
      transferred to different sulfhydryls of various biomolecules. This transfer may
      be mediated by transnitrosation reactions occurring chemically or enzymatically
      by a means of specific enzymes such as protein disulfide isomerase. The molecular
      mechanism of biological S-nitrosation is discussed as related to the important
      physiological and pathophysiological functions of RS-NOs. Also, RS-NO assays that
      are being successfully used for detection of biological S-nitrosation are briefly
      reviewed.

PMID- 11200080
TI  - Plasma protein carbonyls in nonpregnant, healthy pregnant and preeclamptic women.
AB  - Increased reactive oxygen species (ROS) and lipid peroxidation may be implicated
      in the pathogenesis of preeclampsia by causing cell (membrane) damage and
      impaired endothelial function. Carbonyl derivatives of proteins, or protein
      carbonyls, may be sensitive biomarkers of ROS-mediated damage. The aim of the
      study was to compare levels of protein carbonyls in plasma of preeclamptic,
      healthy pregnant and healthy nonpregnant women. Plasma protein carbonyls were
      measured in 47 preeclamptic, 45 healthy pregnant and 22 healthy nonpregnant women
      by using a sensitive ELISA-method. ANOVA, the unpaired t-test and Pearson's
      correlation were used for statistical analysis. Preeclamptic women had
      significantly higher plasma protein carbonyl levels than healthy pregnant women
      (P < 0.0001). Healthy pregnant women showed significantly higher protein carbonyl
      levels (P < 0.001) as compared to nonpregnant controls. The higher levels of
      protein carbonyls as compared to nonpregnant controls suggest that increased
      oxygen free radical damage occurs in normal pregnancy and to a much higher extent
      in preeclampsia.

PMID- 11200081
TI  - Calcium-dependent mitochondrial formation of species promoting strand scission of
      genomic DNA in U937 cells exposed to tert-butylhydroperoxide: the role of
      arachidonic acid.
AB  - Treatment of U937 cells with a sublethal concentration of tert-butylhydroperoxide
      generates DNA single strand breakage in U937 cells and this response is increased
      by caffeine, ATP, pyruvate or antimycin A. As we previously reported (Guidarelli,
      Clementi, Brambilla and Cantoni, (1997) Biochem. J. 328, 801-806), the enhancing
      effects of antimycin A are mediated by inhibition of complex III and the ensuing
      formation of superoxides and hydrogen peroxide in a reaction in which
      ubisemiquinone serves as an electron donor. Active electron transport was
      required in pyruvate-supplemented cells since the increased genotoxic response
      occurred as a consequence of enforced mitochondrial Ca2+ accumulation, a process
      driven by the increased electrochemical gradient. The enhancing effects of
      caffeine or ATP were also the consequence of mitochondrial Ca2+ accumulation but
      these responses were independent on electron transport. The increased formation
      of DNA lesions resulting from exposure to tert-butylhydroperoxide associated with
      the Ca2+-mobilizing agents or the respiratory substrate was mediated by
      arachidonic acid generated by Ca2+-dependent activation of phospholipase A2.
      Melittin, a potent phospholipase A2 activator, and reagent arachidonic acid
      mimicked the effects of caffeine, ATP or pyruvate on the tert-butylhydroperoxide
      induced DNA single strand breakage.

PMID- 11200082
TI  - Photosensitized formation of singlet oxygen by phycobiliproteins in neutral
      aqueous solutions.
AB  - Phycobiliproteins (PBPs) are a type of promising sensitizers for photodynamic
      therapy (PDT). Upon irradiation (lambda>500nm) of an oxygen-saturated aqueous
      solution of phycobiliproteins, particularly, C-phycocyanin (C-PC),
      allophycocyanin (APC) or R-phycoerythrin (R-PE), the formation of singlet oxygen
      (1O2) was detected by using imidazole in the presence of p-nitrosodimethylaniline
      (RNO). The bleaching of RNO caused by the presence of imidazole in our system
      showed typical concentration dependence with a maximum at about 8mM imidazole,
      which is in agreement with the formation of 1O2. In addition, the generation of
      1O2 was verified further in the presence of D2O and specific singlet oxygen
      quencher 1,4-diazabicyclo [2,2,2] octane (DABCO) and sodium azide (NaN3). Our
      experimental results indicated that APC possesses high ability to generate
      reactive oxygen species and the relative quantum yields of photogeneration of 1O2
      by PBPs are as follows: APC > C-PC > R-PE.

PMID- 11200083
TI  - Vinpocetine attenuates the metabolic dysfunction induced by amyloid beta-peptides
      in PC12 cells.
AB  - The cytoprotective effect of vinpocetine [14-ethoxycarbonyl-(3alpha, 16alpha
      ethyl)-14,15-eburnamine] was investigated on PC12 cells treated with the amyloid
      beta-peptides (Abeta) for 24 hours. Vinpocetine was shown to protect cells from
      the inhibition in redox status induced by exposure to Abeta25-35 and Abeta1-40,
      the maximal protection being achieved at a vinpocetine concentration of 40
      microM. At this concentration, vinpocetine blocked the inhibition of the
      mitochondrial respiratory chain complexes II-III and IV and completely abolished
      the depletion of pyruvate levels induced by toxic concentrations of Abeta
      peptides. Furthermore, the accumulation of ROS in cells exposed to Abeta25-35 and
      Abeta1-40 evaluated using the fluorescent probe 2',7'-dichlorofluorescin (DCF),
      was reduced in the presence of 40 microM vinpocetine. Taken together, the data
      presented herein demonstrate that vinpocetine protects cells from Abeta toxicity,
      preventing the generation of oxidative stress due to the excessive accumulation
      of ROS. This study suggests that vinpocetine can exert neuroprotective properties
      which might be of importance and contribute to its clinical efficacy in the
      treatment of Alzheimer's disease or other neurodegenerative disorders in which
      oxidative stress is involved.

PMID- 11200084
TI  - Oxidative stress increases potassium efflux from pancreatic islets by depletion
      of intracellular calcium stores.
AB  - Oxidative stress to B-cells is thought to be of relevance in declining B-cell
      function and in the process of B-cell destruction. In other tissues including
      heart, brain and liver, oxidative stress has been shown to elevate the
      intracellular free calcium concentration and to provoke potassium efflux. We
      studied the effect of oxidative stress on Ca2+ and K+ (Rb+) outflow from
      pancreatic islets using the thiol oxidants DIP and BuOOH. Both compounds
      reversibly increased 86Rb+ efflux in the presence of 3 and 16.7 mmol/l glucose.
      Stimulation of 86Rb+ efflux was also evident in the absence of calcium. DIP
      evoked release of 45Ca2+ from the pancreatic islets both in the presence or
      absence of extracellular calcium. Employing inhibitors of the calcium-activated
      potassium channel (KCa) and the high conductance K+-channel (BKCa), the effect of
      DIP on 86Rb+ efflux was slightly diminished. Tolbutamide had no effect on 86Rb+
      efflux in the presence of DIP. On the other hand thapsigargin, a blocker of the
      Ca+-ATPase of the endoplasmic reticulum, completely suppressed the DIP-mediated
      86Rb+ outflow. The data suggest that thiol oxidant-induced potassium efflux from
      pancreatic islets is mainly mediated through liberation of intracellular calcium
      and subsequent stimulation of calcium-activated potassium efflux.

PMID- 11200085
TI  - Glutathione loading prevents free radical injury in red blood cells after
      storage.
AB  - We have previously demonstrated that the loss of glutathione (GSH) and GSH
      peroxidase (GSH-PX) in banked red blood cells (RBCs) is accompanied by oxidative
      modifications of lipids, proteins and loss of membrane integrity. The objective
      of this study was to determine whether artificial increases in antioxidant (GSH)
      or antioxidant enzyme (catalase) content could protect membrane damage in the
      banked RBCs following an oxidant challenge. RBCs stored at 1-6 degrees C for 0,
      42 and 84 days in a conventional additive solution (Adsol) were subjected to
      oxidative stress using ferric/ascorbic acid (Fe/ASC) before and after enriching
      them with GSH or catalase using a hypotonic lysis-isoosmotic resealing procedure.
      This lysis-resealing procedure in the presence of GSH/catalase raised
      intracellular GSH and catalase concentrations 4-6 fold, yet produced only a small
      reduction in mean cell volume (MCV), mean cell hemoglobin (MCH) and mean cell
      hemoglobin concentrations (MCHC). Indicators of oxidative stress and membrane
      integrity were measured, including acetylcholinesterase (AChE) activity, GSH
      concentration, phosphatidylserine (PS) externalization (prothrombin-converting
      activity) and transmembrane lipid movements (14C-lyso phosphatidylcholine flip
      flop and PS transport). GSH-enrichment protected AChE activity in fresh (0 day)
      and stored (42 and 84 days) RBCs from Fe/ASC oxidation by 10, 23 and 26%,
      respectively, compared with not-enriched controls. Following oxidative stress,
      the rate of transbilayer lipid flip-flop did not increase in fresh cells, but
      increased 9.3% in 42-day stored cells. Phosphatidylserine exposure, as measured
      by prothrombinase activity, increased 2.4-fold in fresh and 5.2-fold in 42-day
      stored cells exposed to Fe/ASC. Previous studies have shown that 42-day storage
      causes a moderate decrease in PS transport (approximately 50%), whereas transport
      rates declined by up to 75% in stored RBCs when challenged with Fe/ASC. GSH
      enrichment prevented the increase in passive lipid flip-flop and the increase in
      prothrombinase activity, but offered no protection against oxidative damage of PS
      transport. In contrast to these effects, catalase-enrichment failed to protect
      GSH levels and AChE activity upon oxidative stress. Membrane protein thiol
      oxidation was assessed by labeling reactive protein thiols with 5
      acetalamidofluorescein followed by immunoblotting with antifluorescein
      antibodies. Significant oxidation of membrane proteins was confirmed by a greater
      loss of thiols in stored RBCs than in fresh RBCs. These results demonstrate that
      it may be possible to prevent storage-mediated loss of AChE, increased lipid flip
      flop, and increased PS exposure, by maintaining or increasing GSH levels of
      banked RBCs.

PMID- 11200086
TI  - Involvement of abscisic acid-dependent and -independent pathways in the
      upregulation of antioxidant enzyme activity during NaCl stress in cotton callus
      tissue.
AB  - The role of abscisic acid (ABA) in the signal transduction pathway associated
      with NaCl-induced up-regulation of antioxidant enzyme activity was examined in a
      NaCl-tolerant cotton callus cell line treated with NaCl, ABA, paraquat, or H2O2
      in the presence and absence or fluridone, an inhibitor of terpene, and therefore,
      ABA synthesis. Treatment with NaCl resulted in a rapid increase (within 30
      minutes) in the ABA levels of the callus tissue, and the NaCl, ABA, and paraquat
      treatments induced rapid increases in the activities of superoxide dismutase,
      catalase, peroxidase, and glutathione reductase. Pre-treatment with fluridone
      significantly suppressed the NaCl-induced increases, but only slightly delayed
      the increases in tissue subjected to exogenous ABA treatment. This implies that
      ABA is involved in the signal transduction pathway associated with the NaCl
      induced up-regulation of these antioxidant enzymes. Pre-treatment with fluridone
      had no effect on the paraquat-induced increases, suggesting that these enzymes
      can also be up-regulated by a pathway other than the one mediated by ABA. Both
      the NaCl and paraquat treatments produced significant increases in the superoxide
      levels within the callus, but the increase resulting from the paraquat treatment
      was significantly higher than the increase resulting from the NaCl treatment.
      These data suggest that NaCl stress results in the production of reactive oxygen
      intermediates (ROI) which signals the induction of an ABA-dependent signaling
      pathway. The production of very high levels of ROI, such as those that occur with
      paraquat treatment or perhaps during periods of prolonged or extreme stress, may
      induce an ABA-independent signaling pathway.

PMID- 11200087
TI  - Superoxide, amine buffers and tetranitromethane: a novel free radical chain
      reaction.
AB  - The amine buffer Tris slowly reduces tetranitromethane (TNM) to the nitroform
      anion in a non-accelerating reaction. The amine buffers HEPES and MOPS also
      (slowly) react with TNM but the dialkylaminoalkyl radicals formed from these two
      buffers undergo further reactions resulting in a rapid, accelerating, free
      radical chain process whereby the amine is oxidized and TNM reduced. The chemical
      functionality in any reaction component, not necessarily the buffer, required for
      this radical chain mechanism is >N-CH<. In the presence of such groups, the
      quantification of superoxide by TNM is impossible.

PMID- 11200088
TI  - DNA-breaking versus DNA-protecting activity of four phenolic compounds in vitro.
AB  - Given the paradoxical effects of phenolics in oxidative stress, we evaluated the
      relative pro-oxidant and antioxidant properties of four natural phenolic
      compounds in DNA nicking. The phenolic compounds differed dramatically in their
      ability to nick purified supercoiled DNA, with the relative DNA nicking activity
      in the order: 1,2,4-benzenetriol (100% nicking) > gallic acid > caffeic acid >
      gossypol (20% nicking). Desferrioxamine (0.02 mM) decreased DNA strand breakage
      by each phenolic, most markedly with gallate (85% protection) and least with
      caffeic acid (26% protection). Addition of metals accelerated DNA nicking, with
      copper more effective (approximately 5-fold increase in damage) than iron with
      all four phenolics. Scavengers revealed the participation of specific oxygen
      derived active species in DNA breakage. Hydrogen peroxide participated in all
      cases (23-90%). Hydroxyl radicals were involved (32-85%), except with 1,2,4
      benzenetriol. Superoxide participated (81-86%) with gallic acid and gossypol, but
      not with caffeic acid or 1,2,4-benzenetriol. With 1,2,4-benzenetriol, scavengers
      failed to protect significantly except in combination. Thus, in the presence of
      desferrioxamine, catalase or superoxide dismutase inhibited almost completely.
      When DNA breakage was induced by Fenton's reagent (ascorbate plus iron) the two
      catechols (caffeic acid and gossypol) were protective, whereas the two triols
      (1,2,4-benzenetriol and gallic acid) exacerbated damage.

PMID- 11200089
TI  - Arguments against the significance of the Fenton reaction contributing to signal
      pathways under in vivo conditions.
AB  - One of the common explanations for oxidative stress in the physiological milieu
      is based on the Fenton reaction, i.e. the assumption that radical chain reactions
      are initiated by metal-catalyzed electron transfer to hydrogen peroxide yielding
      hydroxyl radicals. On the other hand - especially in the context of so-called
      "iron switches" - it is postulated that cellular signaling pathways originate
      from the interaction of reduced iron with hydrogen peroxide. Using fluorescence
      detection and EPR for identification of radical intermediates, we determined the
      rate of iron complexation by physiological buffer together with the reaction rate
      of concomitant hydroxylations of aromatic compounds under aerobic and anaerobic
      conditions. With the obtained overall reaction rate of 1,700 M(-1)s(-1) for the
      buffer-dependent reactions and the known rates for Fenton reactions, we derive
      estimates for the relative reaction probabilities of both processes. As a
      consequence we suggest that under in vivo conditions initiation of chain
      reactions by hydroxyl radicals generated by the Fenton reaction is of minor
      importance and hence metal-dependent oxidative stress must be rather independent
      of the so-called "peroxide tone". Furthermore, it is proposed that - in the low
      (subtoxic) concentration range - hydroxylated compounds derived from reactions of
      "non-free" (crypto) OH radicals are better candidates for iron-dependent sensing
      of redox-states and for explaining the origin of cellular signals than the
      generation of "free" hydroxyl radicals.

PMID- 11200090
TI  - Comparison of LDL trap assay to other tests of antioxidant capacity; effect of
      vitamin E and lovastatin treatment.
AB  - Oxidized low density lipoprotein (LDL) has a major impact in the development of
      atherosclerosis. Risk for oxidative modification of LDL is usually determined
      indirectly by measuring the capability of LDL to resist radical insult. We
      compared three different methods quantifying the antioxidative capacity of LDL ex
      vivo in dyslipidemic patients with coronary heart disease. Plasma samples were
      obtained from two double-blinded cross-over trials. The duration of all
      interventions (placebo, lovastatin 60 mg/day, RRR-alpha-tocopherol 300 mg/day and
      lovastatin + RRR-alpha-tocopherol combined) was 6 weeks. The total radical
      capturing capacity of LDL (TRAP) in plasma was determined using 2,2-azo-bis(2,4
      dimethyl-valeronitrile) (AMVN) -induced oxidation, and measuring the extinction
      time of chemiluminescence. TRAP was compared to the variables characterizing
      formation of conjugated dienes in copper-induced oxidation. Also the initial
      concentrations and consumption times of reduced alpha-tocopherol (alpha-TOH) and
      ubiquinol in AMVN-induced oxidation were determined. Repeatability of TRAP was
      comparable to that of the lag time in conjugated diene formation. Coefficient of
      variation within TRAP assay was 4.4% and between TRAP assays 5.9%. Tocopherol
      supplementation produced statistically significant changes in all antioxidant
      variables except those related to LDL ubiquinol. TRAP increased by 57%, the lag
      time in conjugated diene formation by 34% and consumption time of alpha-TOH by
      88%. When data of all interventions were included in the analyses, TRAP
      correlated with the lag time (r = 0.75, p < 10(-6)), with LDL alpha-TOH (r =
      0.50, p < 0.001) and with the consumption time of alpha-TOH (r = 0.58, p <
      0.0001). In the baseline data, the associations between different antioxidant
      variables were weaker. TRAP correlated with the lag time (r = 0.55, p < 0.001)
      and alpha-TOH consumption time (r = 0.48, p < 0.05), and inversely with
      apolipoprotein Al (r = -0.51, p < 0.05). Lag time at the baseline did not
      correlate with ubiquinol or tocopherol parameters, or with any plasma lipid or
      lipoprotein levels analyzed. Lovastatin treatment did not significantly affect
      the antioxidant capacity of LDL. In conclusion, TRAP reflects slightly different
      properties of LDL compared to the lag time. Thus, LDL TRAP assay may complement
      the other methods used to quantify the antioxidant capacity of LDL. However, TRAP
      and the lag time react similarly to vitamin E supplementation.

PMID- 11200091
TI  - Effect of ozone treatment on reactive oxygen species and adenosine production
      during hepatic ischemia-reperfusion.
AB  - This study investigates whether ozone could confer protection from hepatic
      ischemia reperfusion by modifying the accumulation of adenosine and xanthine
      during ischemia. A significant increase in both adenosine and xanthine
      accumulation was observed as a consequence of ATP degradation during hepatic
      ischemia. Adenosine exerts a protective effect on hepatic ischemia reperfusion
      injury since the elimination of endogenous adenosine accumulation with adenosine
      deaminase increased the hepatic injury associated with this process. On the other
      hand, the high xanthine levels observed after ischemia could exert deleterious
      effects during reperfusion due to reactive oxygen species generation from
      xanthine oxidase. The administration of allopurinol, an inhibitor of xanthine
      oxidase, attenuated the increase in reactive oxygen species and transaminase
      levels observed after hepatic reperfusion. Ozone treatment in liver maintained
      adenosine levels similar to those found after ischemia but led to a marked
      reduction in xanthine accumulation. In order to evaluate the role of both
      adenosine and xanthine, we tried to modify the protection confered by ozone, by
      modifying the concentrations of adenosine and xanthine. The metabolization of
      endogenous adenosine after ischemia abolished the protective effect conferred by
      ozone. When xanthine was administered previous to ozone treatment, the protection
      conferred by adenosine disappeared, showing both postischemic reactive oxygen
      species and transaminase levels similar to those found after hepatic ischemia
      reperfusion. Ozone would confer protection against the hepatic ischemia
      reperfusion injury by the accumulation of adenosine that in turns benefits the
      liver and by blocking the xanthine/xanthine oxidase pathway for reactive oxygen
      species generation.

PMID- 11200092
TI  - In vitro study of the antioxidant properties of non steroidal anti-inflammatory
      drugs by chemiluminescence and electron spin resonance (ESR).
AB  - OBJECTIVES: To determine the antioxidant activities of nonsteroidal anti
      inflammatory drugs (NSAIDS), we examined by chemiluminescence (CL) and electron
      spin resonance (ESR) their scavenging properties towards lipid peroxides,
      hypochlorous acid and peroxynitrite. METHODS: The antioxidant properties of
      nimesulide (NIM), 4-hydroxynimesulide (4-HONIM), aceclofenac (ACLO), 4
      hydroxyaceclofenac (4-HOA-CLO), diclofenac (DICLO) and indomethacin (INDO) were
      tested on four different reactive oxygen species (ROS) generating systems: (I)
      phorbol-myristate acetate (PMA)-activated neutrophils, (II) Fe2+/ascorbate
      induced lipid peroxidation, (III) HOCl-induced light emission, (IV) the kinetics
      of ONOO- decomposition followed by spectrophotometry. ROS production was
      monitored by luminol-enhanced CL or by ESR using two different spin traps.
      RESULTS: At 10 microM, ACLO, NIM, 4-HONIM, 4-HOA-CLO, and DICLO decreased luminol
      enhanced CL generated by PMA-activated neutrophils. Inversely, INDO increased the
      luminol enhanced CL. Interestingly, hydroxylated metabolites were more potent
      antioxidants than the parent drugs. Furthermore, all drugs tested, excepted ACLO,
      lowered lipid peroxidation induced by Fe2+/ascorbate system. ACLO and DICLO, even
      at the highest concentration tested (100 microM), did not significantly lower
      HOCl induced CL, whereas the other drugs were potent scavengers. Finally, all the
      NSAIDS accelerated decomposition of ONOO-, suggesting a potential capacity of the
      molecules to scavenge peroxynitrite. CONCLUSION: The NSAIDs possess variable
      degrees of antioxidant activities, linked to their ability to react with HOCl,
      lipid peroxides or ONOO-. These antioxidant activities could offer interesting
      targeted side-effects in the treatment of joint inflammatory diseases.

PMID- 11200093
TI  - Distinct mechanisms of DNA damage in apoptosis induced by quercetin and luteolin.
AB  - Quercetin has been reported to have carcinogenic effects. However, both quercetin
      and luteolin have anti-cancer activity. To clarify the mechanism underlying the
      carcinogenic effects of quercetin, we compared DNA damage occurring during
      apoptosis induced by quercetin with that occuring during apoptosis induced by
      luteolin. Both quercetin and luteolin similarly induced DNA cleavage with
      subsequent DNA ladder formation, characteristics of apoptosis, in HL-60 cells. In
      HP 100 cells, an H2O2-resistant clone of HL-60 cells, the extent of DNA cleavage
      and DNA ladder formation induced by quercetin was less than that in HL-60 cells,
      whereas differences between the two cell types were minimal after treatment with
      luteolin. In addition, quercetin increased the formation of 8-oxo-7,8-dihydro-2'
      deoxyguanosine (8-oxodG), an indicator of oxidative DNA damage, in HL-60 cells
      but not in HP 100 cells. Luteolin did not increase 8-oxodG formation, but
      inhibited topoisomerase II (topo II) activity of nuclear extract more strongly
      than quercetin and cleaved DNA by forming a luteolin-topo II-DNA ternary complex.
      These results suggest that quercetin induces H2O2-mediated DNA damage, resulting
      in apoptosis or mutations, whereas luteolin induces apoptosis via topo II
      mediated DNA cleavage. The H2O2-mediated DNA damage may be related to the
      carcinogenic effects of quercetin.

PMID- 11200094
TI  - Bioavailability of (-)-epicatechin upon intake of chocolate and cocoa in human
      volunteers.
AB  - We evaluated the levels of (-)-epicatechin (EC) and its metabolites in plasma and
      urine after intake of chocolate or cocoa by male volunteers. EC metabolites were
      analyzed by HPLC and LC/MS after glucuronidase and/or sulfatase treatment. The
      maximum levels of total EC metabolites in plasma were reached 2 hours after
      either chocolate or cocoa intake. Sulfate, glucuronide, and sulfoglucuronide
      (mixture of sulfate and glucuronide) conjugates of nonmethylated EC were the main
      metabolites present in plasma rather than methylated forms. Urinary excretion of
      total EC metabolites within 24 hours after chocolate or cocoa intake was 29.8+/
      5.3%'; and 25.3+/-8.1% of total EC intake. EC in chocolate and cocoa was partly
      absorbed and was found to be present as a component of various conjugates in
      plasma, and these were rapidly excreted in urine.

PMID- 11200095
TI  - Inhibition of lipoprotein oxidation by prenylated xanthones derived from
      mangostin.
AB  - Oxidative damage is thought to play a critical role in cardiovascular and other
      chronic diseases. This has led to considerable interest in the antioxidant
      activity of dietary compounds. Flavonoids have received the most attention and
      much is known about the structural requirements for antioxidant activity.
      However, little is known about the antioxidant activity of other plant derived
      phenolic compounds such as the xanthones. We have previously shown that the
      prenylated xanthone, mangostin, can inhibit the oxidation of low density
      lipoprotein. In order to examine the effects of structure modification on
      antioxidant activity of this class of compound we have prepared a number of
      derivatives of mangostin and tested antioxidant activity in an isolated LDL and
      plasma assay. The results of this study show that structural modification of
      mangostin can have a profound effect on antioxidant activity. Derivatisation of
      the C-3 and C-6 hydroxyl groups with either methyl, acetate, propane diol or
      nitrile substantially reduces antioxidant activity. In contrast, derivatisation
      of C-3 and C-6 with aminoethyl derivatives enhanced antioxidant activity, which
      may be related to changes in solubility. Cyclisation of the prenyl chains had
      little influence on antioxidant activity.

PMID- 11200097
TI  - Quercetin 3-O-beta-glucoside is better absorbed than other quercetin forms and is
      not present in rat plasma.
AB  - The effect of the nature of the sugar moiety on quercetin absorption has been
      investigated in rats. Four groups of rats received an experimental meal
      containing 20 mg of quercetin equivalents, supplied as quercetin, quercetin 3-O
      beta-glucoside, quercetin 3-O-beta-rhamnoside or rutin. Four hours after the
      meal, the metabolites identified in hydrolysed plasma were identical in all
      groups (3'- and 4'-methylquercetin). However, the total concentration of
      metabolites was markedly different: 11.2+/-1.8, 2.5+/-2.0 and 33.2+/-3.5 microM
      for the quercetin, rutin, and quercetin 3-glucoside meals respectively. After
      quercetin 3-rhamnoside consumption, we failed to detect any metabolites in the
      plasma. These data suggest that the 3-O-glucosylation improves the absorption of
      quercetin in the small intestine, whereas the binding of a rhamnose to the
      aglycone markedly depresses it. Additional experiments have shown that the higher
      plasma levels measured after quercetin 3-glucoside meal compared to the quercetin
      meal were maintained throughout the 24-hour period following the meal. Using a
      multi-electrode coulometric detection, together with suitable chromatographic
      conditions, we were able to distinguish between the conjugated and the
      glycosylated forms. Thus, we clearly showed the absence of quercetin 3-O-beta
      glucoside in the plasma from rats fed a diet containing this glucoside. This
      result suggests that quercetin 3-O-beta-glucoside is hydrolysed before or during
      its intestinal absorption.

PMID- 11200096
TI  - Activity of artichoke leaf extract on reactive oxygen species in human
      leukocytes.
AB  - Artichoke leaf extract was studied in human leukocytes for activity against
      oxidative stress using flow cytometry and dichlorofluorescin diacetate as a
      fluorescence probe. It produces a concentration-dependent inhibition of oxidative
      stress when cells are stimulated with agents that generate reactive oxygen
      species (ROS): hydrogen peroxide, phorbol-12-myristate-13-acetate (PMA), and N
      formyl-methionyl-leucyl-phenylalanine (FMLP). Cynarin, caffeic acid, chlorogenic
      acid, and luteolin, constituents of artichoke leaf extract, also show a
      concentration-dependent inhibitory activity in the above models, contributing to
      the antioxidant activity of the extract in human neutrophils.

PMID- 11200099
TI  - Exploring the connection between pornography and sexual violence.
AB  - This article examines the relationship between sexual violence and pornography.
      Data about women's experiences of sexual violence and their abusers' use of
      pornography were collected at a rape crisis center from 100 survivors. Findings
      include that 28% of respondents reported that their abuser used pornography and
      that for 12% of the women, pornography was imitated during the abusive incident.
      The effects of pornography on women's experiences of sexual violence are
      discussed.

PMID- 11200098
TI  - Retinol supplementation induces DNA damage and modulates iron turnover in rat
      Sertoli cells.
AB  - Recent intervention studies revealed that supplementation with retinoids resulted
      in a higher incidence of lung cancer. Recently the causal mechanism has begun to
      be clarified. We report here that retinol caused cellular DNA damage probably
      involving cellular iron accumulation. Retinol (7 microM) significantly induced
      DNA single strands breaks, DNA fragmentation and production of 8-oxo-7, 8-dihydro
      2'-deoxyguanosine in cultured Sertoli cells. In contrast, lower doses seemed not
      to induce single-strands break in this experimental model. The breaks in DNA were
      inhibited by an iron scavenger; and 7 microM retinol treatment modulated iron
      turnover leading to iron accumulation, suggesting that iron ions were required
      for the retinol cellular effects. These findings suggest that retinol-induced DNA
      damage was associated with the modulation of iron turnover, and these
      characteristics could be responsible for the increased incidence of lung cancer
      associated with retinoids supplementation.

PMID- 11200100
TI  - Aggressive behavior among women sexually abused as children.
AB  - Although research shows that sexually abused children appear to be at risk of
      subsequent aggressive behavior, few investigations address whether such behavior
      persists beyond childhood. This research describes the self-reported adolescent
      and adult fighting behavior of 136 women sexually abused as children and examines
      the role of intervening variables in the risk of such behavior. The women are
      part of a longitudinal study of 206 primarily low-income, urban women whose abuse
      was documented at the time it occurred. Fighting was common, particularly during
      adolescence. Adult aggression was strongly associated with being a victim of
      violence by an intimate partner. A history of exposure to other forms of violence
      significantly increased the risk of fighting while strong maternal attachments
      mitigated the risk, primarily by reducing the likelihood of involvement in an
      abusive intimate relationship.

PMID- 11200102
TI  - Wife killing: risk to women as a function of age.
AB  - Younger women, relative to older women, incur elevated risk of uxoricide-being
      murdered by their husbands. Some evolutionary theorists attribute this pattern to
      men's evolved sexual proprietariness, which inclines them to use violence to
      control women, especially those high in reproductive value. Other evolutionary
      theorists propose an evolved homicide module for wife killing. An alternative to
      both explanations is that young women experience elevated uxoricide risk as an
      incidental byproduct of marriage to younger men who commit the majority of acts
      of violence. We used a sample of 13,670 uxoricides to test these alternative
      explanations. Findings show that (a) reproductive-age women incur an elevated
      risk of uxoricide relative to older women; (b) younger men are overrepresented
      among uxoricide perpetrators; and (c) younger women, even when married to older
      men, still incur excess risk of uxoricide. Discussion examines competing
      explanations for uxoricide in light of these findings.

PMID- 11200101
TI  - The relative frequency of offensive and defensive gun uses: results from a
      national survey.
AB  - Some controversy exists about the relative frequency of criminal and self-defense
      gun use in the United States. Using data from a national random-digit-dial
      telephone survey of over 1,900 adults conducted in 1996, we find that criminal
      gun use is far more common than self-defense gun use. This result is consistent
      with findings from other private surveys and the National Crime Victimization
      Surveys. In this survey, all reported cases of criminal gun use and many cases of
      self-defense gun use appear to be socially undesirable. There are many instances
      of gun use, often for intimidation, that are not reported to the police and may
      not appear in official crime statistics.

PMID- 11200103
TI  - Coping with chronic community violence: the variety and implications of women's
      efforts.
AB  - To date, most researchers concerned with chronic community violence have studied
      children, and focused on the types, extent, and effects of their violence
      experiences. In contrast, using a series of in-depth repeated interviews, the
      current study explored African American women's methods for coping with chronic
      community violence. This article describes the variety of ways these women
      developed to avoid, minimize, or manage their own and their children's encounters
      with community violence. It argues for the importance of using these data to
      inform professional intervention and suggests specific implications for practice,
      program development, and policy.

PMID- 11200104
TI  - Abuse during and before pregnancy: prevalence and cultural correlates.
AB  - This study examined the prevalence of abuse during pregnancy and the influence of
      cultural norms and acculturation on abuse in 1,004 Mexican American, Puerto
      Rican, Cuban American, Central American, African American and Anglo American
      women. Women were recruited from consecutive delivery logs in general community
      hospitals in Florida and Massachusetts. The Index of Spouse Abuse and the Abuse
      Assessment Screen ascertained history of adult physical, sexual, and emotional
      abuse, abuse during pregnancy, and childhood sexual abuse. An Interview Protocol
      assessed cultural attitudes, acculturation, and demographic information. Hispanic
      American women, as a whole, did not differ significantly from Anglo American
      women in their prevalence of abuse during pregnancy, after controlling for
      sociodemographic variables. However, Cuban American and Central American partners
      were significantly less likely to abuse their pregnant partners than were other
      groups even after adjustment. Women who spoke only Spanish (less acculturated)
      were less likely to report physical abuse from their partners both before and
      during pregnancy. Cultural norms, such as a partner's belief in wife/mother role
      supremacy and cultural group acceptability of men hitting women, were
      significantly positively related to both physical and emotional abuse. Other risk
      factors for abuse were the abuser not being the biological father of the baby,
      low income and little education, and being unmarried.

PMID- 11200105
TI  - Women's fear of crime: the role of fear for the well-being of significant others.
AB  - A number of explanations have been suggested in the literature for the finding
      that women consistently report higher levels of fear of crime than males. The
      "shadow" hypothesis argues that fear of crime among females reflects fear of
      sexual assault. The "intimate" hypothesis argues that women's fear of crime is
      the result of exposure to intimate violence. Females' fear of crime is expected
      to be explained by their fear of partners' violence. The main argument of this
      article is that women's fear of crime might be the result of traditional family
      gender roles. When asked, women might express fear not only for their own well
      being but for that of their children. A survey of a representative sample of
      women in the third largest city of Israel was used to test this assumption.
      Women's fear of crime was found to be affected by fear of sexual assault and fear
      of violent partners. In addition, consistent with the argument of this study,
      women's fear of violent and sexual victimization of their children had a
      significant effect on their perception of fear. Future directions for research
      are suggested.

PMID- 11200106
TI  - Anger, irrational beliefs, and dysfunctional attitudes in violent dating
      relationships.
AB  - The purpose of the present investigation was to evaluate whether perpetrators of
      dating violence could be differentiated from their nonviolent counterparts on
      measures of anger and cognitive distortion, specifically Ellis's (1994)
      irrational beliefs and Beck's (1976) dysfunctional attitudes. Of the 95 male and
      152 female undergraduates surveyed, 27% (24 males and 43 females) reported using
      some form of physical aggression against their current dating partner in the past
      year. On a self-report measure of anger (State-Trait Anger Expression Inventory),
      violent individuals reported higher levels of Anger Out and lower levels of Anger
      Control compared to nonviolent participants. While there were no differences
      between violent and nonviolent participants' levels of Trait Anger, the results
      suggest that violent individuals have difficulty controlling angry feelings when
      they arise, which may increase the likelihood of externally directed forms of
      anger expression. No significant group differences emerged on questionnaire
      measures of irrational beliefs and dysfunctional attitudes. Within the violent
      sample, there was no differential pattern of correlations between measures of
      anger and cognition relative to the nonviolent sample. The present data suggest
      that while trait-based measures of cognitive distortion explain little variance
      in self-reported acts of dating violence, future research should investigate
      whether (a) cognitive distortions are present during affect-inducing partner
      conflict situations, or (b) vary with violence severity.

PMID- 11200107
TI  - [Radiation therapy after mastectomy--interdisciplinary consensus puts and end to
      a controversy. German Society of Senology].
AB  - BACKGROUND: Recent publications of the Danish Breast Cancer Cooperative Group
      together with data from the British Columbia Trial have stirred major discussions
      concerning the role of radiation therapy after mastectomy. Different treatment
      approaches are to be found even within the same cancer center. The German Society
      of Senology, a cooperative group of all medical disciplines involved in the
      treatment of breast cancer, has therefore worked out a consensus statement.
      MATERIAL AND METHOD: The recently published literature and experts opinions, in
      particular randomized studies since 1997, meta-analyses from the Early Breast
      Cancer Trialists' Collaborative Group, epidemiological investigations with regard
      to the time course of distant metastases in breast cancer as well as the current
      consensus of the American Society for Therapeutic Radiology and Oncology served
      as the basis for discussion and consulting. RESULTS OF THE CONSENSUS: (1) An
      optimally performed mastectomy is a major prerequisite for tumor cure. Radical
      (R0) resection of the tumor as well as dissection of at least 10 lymph nodes from
      the axillary level I and II should be accomplished. If axillary lymph nodes are
      involved, the surgical removal of these lymph nodes is not only of diagnostic,
      but also of therapeutic value, as it reduces the risk for locoregional relapses.
      (2) Most probably, locoregional relapses do not only indicate, but are also a
      source for distant metastases. (3) Radiation therapy of the chest wall and the
      regional lymph nodes increases the overall survival in risk patients and reduces
      the risk of locoregional relapses. Moreover, radiation therapy improves the
      prognosis in case of residual tumor or an incomplete axillary dissection.
      Unequivocal and reasonable indications for radiation therapy after mastectomy
      include T3/T4-carcinoma, T2-carcinoma > 3 cm, multicentric tumor growth,
      lymphangiosis carcinomatosa or vessel involvement, involvement of the pectoralis
      fascia or a safety margin < 5 mm, R1- or R2 resection and more than 3 axillary
      lymph node metastases. Further reasonable indications, albeit not yet evaluated
      in clinical trials, include multifocality, extensive intraductal component,
      negative hormone receptor status, G3-differentiation grade, diffuse micro
      calcifications, 1 to 3 axillary lymph node metastases, multiple, non-complete
      biopsies and age < 35 years. (4) An endocrine therapy with tamoxifen concurrent
      to radiation therapy is also reasonable--despite some contradictory in-vitro data
      -as it enhances the apoptotic cell death. The CMF-regimen is usually performed as
      sandwich procedure, but can also be applied concurrently to radiation therapy, if
      indicated. Conversely, an anthracycline-containing chemotherapy should be
      finished prior to postoperative radiation therapy. CONCLUSIONS: Adjuvant
      radiation therapy after mastectomy improves the 10-year-survival probability up
      to 10%, at least for risk patients. The hypotheses of Halsted and Fisher do not
      exclude each other. There are patients, in which the one, and there are patients,
      in which the other hypothesis applies.

PMID- 11200108
TI  - [A model for primary and secondary metastasis in breast cancer and the clinical
      consequences].
AB  - BACKGROUND: An adjuvant locoregional radiotherapy after radical surgery results
      in a survival advantage for breast cancer patients. The advantage starts with a
      delay and reaches about 10% 15 years after diagnosis. What could explain such a
      delayed efficacy? METHODS: A population-based cohort from 1996 to 1998 and the
      Munich Cancer Registry with courses of breast cancer disease since 1977 are the
      empirical basis. The analysis concerns survival rates and survival times in
      respect to metastases, local and lymph node recurrencies. A metastatic model is
      derived from the data. RESULTS: A cohort of 9,347 patients with a mean follow-up
      of 6.5 years and 2,587 courses with metastases and/or local recurrencies were
      registered. The overall survival after 15 years was for pT1 57.6%, pT2 37.9%, pT3
      24.4% and for pT4 10.5%. Five years after metastasization 20.1 to 12.4% survived,
      10 years 6% independent on pT. Ten years after local recurrencies the survival
      was dependent on pT of the primary tumor: pT1 36.3%, pT2 21.0%, pT3 13.1% und pT4
      4.6%. A local recurrency is a prognostic factor for metastasization of the
      primary tumor, but local recurrencies can also cause metastases. The mean
      survival time after metastasization of the primary pT1 tumor is estimated about
      61 months, after metastasization by local recurrencies about 99 months with a
      mean time to local recurrencies of 38 months. Further results of the metastatic
      model are: the development of metastasization is homogeneous and independent on
      pT-category, the metastatic initiation starts up to 5 years before diagnosis,
      metastatic-free survival time and progression survival time are independent and
      an impact of lymph node recurrencies on survival could not be detected.
      CONCLUSIONS: The reduction of local recurrencies by high-quality primary therapy
      with radiotherapy and also the early detection of local recurrencies may reduce
      secondary metastasization and therefore improve survival. The metastasization
      model also explains the limitation of the therapeutical strategies and the almost
      mandatory chance of early detection programs of breast cancer.

PMID- 11200109
TI  - [Local tumor control and cosmetic outcome following breast-conserving surgery and
      radiation up to a total dose of 56 Gy without boost in breast cancer].
AB  - PURPOSE: To evaluate overall survival, local tumor control and cosmetic outcome
      after breast-conserving surgery followed by radiotherapy without boost
      irradiation. PATIENTS AND METHODS: In a retrospective study 270 breast cancer
      patients were treated with breast conserving surgery combined with a homogenous
      radiation of the tumor bearing breast up to a total dose of 56 Gy without local
      boost irradiation. Mean follow-up was 48 months. Local tumor control, side
      effects, cosmetic results and contentment with treatment were assessed using
      physical examinations and interviews based on a standardized questionnaire.
      RESULTS: Cause-specific survival at 5 years after treatment was 88.3%, actuarial
      disease-free survival at 5 years was 76.1%. Within 23 to 78 months after
      treatment 12 patients suffered from ipsilateral breast recurrence. The actuarial
      freedom from local recurrence (single tumor manifestation) was 96.8% at 5 years
      after treatment, 89% at 10 years. The occurrence of local failures was not
      significantly correlated to tumor size, margins, grading, nodal status, age or
      lymphangiosis. 15.6% of the patients developed distant metastases. In all
      patients treatment was performed without interruption. Side effects were
      predominantly of mild degree, no severe side effects were detected. 73% of
      physicians and 81% of patients scored their cosmetic outcome as excellent or
      good. 93% of patients would again decide in favor of this procedure. Whereas use
      of adjuvant chemotherapy as well as subcutaneous reconstruction of breast tissue
      did not significantly affect breast cosmesis, analysis demonstrated impaired
      cosmetic results related to a larger breast size. CONCLUSION: The data of this
      study show that tumor control achieved by breast conserving surgery in
      combination with a radiation technique up to a total dose of 56 Gy which omits
      boost irradiation is within the range of literature data. Side effects of the
      therapy were tolerable. The treatment displayed a good compatibility with
      tolerable side effects and good cosmetic results.

PMID- 11200110
TI  - Which patients don't need a tumor-bed boost after whole-breast radiotherapy?
AB  - BACKGROUND: Retrospective dose-response data suggest that a boost of about 15 Gy
      to the tumor bed following whole-breast radiotherapy reduces the risk of local
      recurrence (IBTR) by as much as 2-fold. Even if this benefit is confirmed by
      prospective trials, boost irradiation may not be considered cost-effective in
      patients having an IBTR risk of less than 1% per annum. METHODS: Published
      prospective trials of invasive breast cancers (National Surgical Adjuvant Breast
      and Bowel Project; Stockholm Adjuvant Tamoxifen Trial) in which patients received
      50 Gy whole-breast irradiation, without a boost, were analyzed to identify
      subgroups with IBTR risk less than 1% per year. All studies were based on
      lumpectomy (rather than segmental or quadrant excision) and eligibility required
      the absence of cancer cells at the margins. It was assumed that clinical and
      pathological factors, other than those defining trial eligibility, were of
      negligible importance regarding IBTR risk, with the exception of young age.
      RESULTS: All patients not receiving adjuvant systemic therapy, including tumors <
      1 cm, have IBTR risk justifying boost irradiation. Of patients receiving systemic
      therapy, only patients with node-negative, estrogen receptor-positive tumors have
      low IBTR risk (3% at 10 years), provided that tamoxifen is administered. Of
      patients receiving only adjuvant chemotherapy, low IBTR risk seems to be
      associated with administration concomitantly with radiotherapy. IBTR risk in
      patients receiving chemotherapy sequentially with respect to radiotherapy
      probably is high enough to justify a boost. A boost is probably indicated in all
      patients younger than 40 years, regardless of other factors.

PMID- 11200111
TI  - Determination of tolerance dose uncertainties and optimal design of dose response
      experiments with small animal numbers.
AB  - BACKGROUND: Dose response experiments aim to determine the complication
      probability as a function of dose. Adjusting the parameters of the frequently
      used dose response model P(D) = 1/[1 + (D50/D)k] to the experimental data, 2
      intuitive quantities are obtained: the tolerance dose D50 and the slope parameter
      k. For mathematical reasons, however, standard statistic software uses a
      different set of parameters. Therefore, the resulting fit parameters of the
      statistic software as well as their standard errors have to be transformed to
      obtain D50 and k as well as their standard errors. MATERIAL AND METHODS: The
      influence of the number of dose levels on the uncertainty of the fit parameters
      is studied by a simulation for a fixed number of animals. For experiments with
      small animal numbers, statistical artifacts may prevent the determination of the
      standard errors of the fit parameters. Consequences on the design of dose
      response experiments are investigated. RESULTS: Explicit formulas are presented,
      which allow to calculate the parameters D50 and k as well as their standard
      errors from the output of standard statistic software. The simulation shows, that
      the standard errors of the resulting parameters are independent of the number of
      dose levels, as long as the total number of animals involved in the experiment,
      remains constant. CONCLUSION: Statistical artifacts in experiments containing
      small animal numbers may be prevented by an adequate design of the experiment.
      For this, it is suggested to select a higher number of dose levels, rather than
      using a higher number of animals per dose level.

PMID- 11200113
TI  - Irradiation of histiocytosis X confined to the oral mucosa.
AB  - BACKGROUND: Histiocytosis X is a rare granulomatous disease and it is still under
      debate as to whether this disease has to be counted among malignant tumors or
      benign immunologic lesions. The typical localization is confined to the bone. In
      rare cases histiocytosis X may be localized in the oropharyngeal mucosa. PATIENTS
      AND METHODS: We report about a case of a 75-year-old woman presenting with
      histiocytosis X lesions solely located in the oral cavity. A total dose of 19.5
      Gy was administered without any side effects. RESULTS: Two weeks after completion
      of irradiation a rapid regression of mucosal ulcerations and improvement of
      symptoms occurred. In a follow-up of 24 months the patient is still in complete
      remission observed. CONCLUSION: Review of the literature revealed only casuistic
      reports about solitary lesions of histiocytosis X without bone involvement in the
      adulthood. External beam radiotherapy with total doses between 10 and 20 Gy seems
      to be effective for local control of this disease.

PMID- 11200112
TI  - A simple and non-invasive vacuum mouthpiece-based head fixation system for high
      precision radiotherapy.
AB  - PURPOSE: To demonstrate why conventional non-invasive mouthpiece-based fixation
      has not achieved the expected accuracy and to suggest a solution of the problem.
      PATIENTS AND METHODS: The Vogele Bale Hohner (VBH) head holder is a non-invasive
      vacuum mouthpiece-based head fixation system. Feasibility and repositioning
      accuracy were evaluated by portal image analysis in 12 patients with cranial
      tumors intended for stereotactic procedures, fixated with the newest version (VBH
      HeadFix-ARC). RESULTS: Portal image analysis (8 patients evaluated in 2-D, 4
      patients in 3-D) showed that even in routine external beam radiation therapy,
      treatment can be applied to within a mean 2-D and 3-D accuracy of under 2 mm (SD
      0.92 mm and 1.2 mm, respectively) with cost and repositioning time per patient
      and patient comfort comparable to that of common thermoplastic masks. CONCLUSION:
      These preliminary results show that high repositioning accuracy does not rule out
      simple and quick application and patient comfort. Paramount, however, is
      tensionless repositioning via the vacuum mouthpiece.

PMID- 11200114
TI  - [Lobular carcinoma in situ as a component of breast cancer points to no
      contraindication for breast-conserving therapy].

PMID- 11200115
TI  - [Local recurrence in premenopausal women with breast cancer: risk factors and
      effect of therapy].

PMID- 11200117
TI  - Often neglected yet important: the pericardium and its diseases.

PMID- 11200116
TI  - [No improvement in therapeutic results with neoadjuvant chemotherapy in cervical
      cancer compaared with radiotherapy alone].

PMID- 11200118
TI  - Microphysiology of the pericardium: substrate for intrapericardial therapeutics.
AB  - Recent capability to enter the normal effusion-free pericardium has expanded
      intrapericardial therapy which was formerly restricted to patients with effusive
      pericardial disease, to intrapericardial treatment of cardiac diseases of all
      kinds. It is now possible to deposit in the intact pericardium a variety of
      therapeutic agents targeting the myocardium, valves, conduction system and even
      the endocardium. In addition to such specific agents, the unique microphysiology
      of the pericardial mesothelium provides investigators with 2 entirely new
      applications of intrapericardial therapy: 1. supplementing substances like
      prostanoids and a variety of immune factors, and 2. stimulating pericardial
      production of such products of metabolism, e.g., superfusion of the normal
      pericardium by non-steroidal antiinflammatory agents to stimulate prostanoid
      production with a variety of effects including possible inhibition of coronary
      thrombosis. Continuing research and development should determine the precise
      roles of these new applications in human medicine.

PMID- 11200119
TI  - Morphological considerations of peri- and myocarditis.
AB  - In medicine, and thus in pathology, there are areas/topics of fashion and they
      shift from time to time. Pericardial diseases are not fashionable. Myocarditis
      is, and has been for a long time. Due to new ways of retrieving tissue samples
      from the pericardium the modern diagnostic tools such as immunohistochemistry and
      molecular pathology can be applied in this context as they have been in
      myocarditis for a long period. The diagnosis of inflammation rests on many other
      findings than morphological alterations and it is indeed questionable if
      inflammation is solely a morphological diagnosis. The methodologies of pathology
      can be improved and used in a better and more purposeful way even under routine
      conditions. It is concluded that morphology is still mandatory to make a final
      diagnosis of peri- and myocarditis.

PMID- 11200120
TI  - Arrhythmias in acute pericarditis. An endomyocardial biopsy study.
AB  - It is still controversial whether the arrhythmias in acute pericarditis are of
      myocardial or pericardial origin. The aim of the present study was to investigate
      the occurrence of arrhythmias and conduction disorders in patients with acute
      pericarditis with no endomyocardial biopsy evidence of myocarditis (group 1: 40
      patients, 65% males, mean age 45.6 +/- 15.7 years, mean heart rate [HR] 98.7 +/-
      22.2 beats per minute) in comparison to endomyocardial biopsy proven acute
      myocarditis/perimyocarditis (group 2: 10 patients, 3/10 with perimyocarditis, 70%
      males, mean age 46.1 +/- 15.8 years, mean heart rate 76.7 +/- 33.1 beats per
      minute). At the initial assessment all patients underwent comprehensive clinical
      work-up including echocardiography, cardiac catheterization, and endomyocardial
      biopsy. In all patients biventricular endomyocardial biopsy was performed using
      standard femoral approach and Schikumed 7 F or 8 F bioptomes. Tissue samples were
      stained by H & E, v. Gieson and independently reviewed by two cardiac
      pathologists. In addition immunohistochemistry and immunocytochemistry were
      performed, and only patients fulfilling Dallas and World Heart Federation
      criteria were selected for group 2. Comparative analysis of electrocardiograms
      and 24-hour Holter recordings at initial presentation revealed in group 1 vs
      group 2 significantly less frequent paroxysmal supraventricular tachyarrhythmias
      (5% vs 40%), and ventricular fibrillation (0 vs 20%), in contrast to atrial
      fibrillation that occurred more often (20% vs 0) (all p < 0.05). Furthermore, in
      the group 2 one patient died due to VF and two patients underwent ICD
      implantation. Low voltage (40% vs 30%) and ST/T wave changes (47.5% vs 30%), as
      well as the incidence of the II degree AV block (5% vs 0) and complete AV block
      (2.5% vs 10%) were not significantly different between the groups. In conclusion,
      patients with pericarditis and no endomyocardial biopsy indications of
      myocarditis had significantly less often life threatening rhythm disorders in
      contrast to patients with endomyocardial biopsy proven acute
      myocarditis/perimyocarditis. On the contrary, incidence of transitory atrial
      fibrillation was higher in acute pericarditis, than in myocarditis.

PMID- 11200121
TI  - Diagnostic value of echocardiography in cardiac tamponade.
AB  - Cardiac tamponade is a life-threatening condition. Accurate diagnosis and prompt
      intervention are necessary to prevent adverse outcomes. Clinical features of
      tamponade such as pulsus paradoxus, tachycardia, elevated jugular venous
      pressure, and hypotension are important clues to the diagnosis, but are non
      specific. Echocardiography allows rapid confirmation of the presence or absence
      of an effusion, and enables assessment of its hemodynamic impact. Decisions
      regarding treatment must take into account the clinical presentation and
      echocardiographic findings. Echocardiographically-guided pericardiocentesis with
      catheter drainage is the primary treatment strategy of choice for most large or
      hemodynamically significant effusions. In contemporary clinical practice,
      echocardiography is the gold standard for diagnosis of tamponade and is essential
      for directing treatment.

PMID- 11200122
TI  - Flexible percutaneous pericardioscopy: inherent drawbacks and recent advances.
AB  - Pericardioscopy enables endoscopic inspection and aimed biopsy of the parietal
      and visceral pericardium. To elucidate possible technical modifications
      contributing to the feasibility, diagnostic value and safety of the procedure,
      pericardioscopy with an Olympus HYF-1T flexible endoscope was performed in 32
      patients (53.1% males, mean age 46.2 +/- 13.1 years) with pericardial effusions.
      In all patients, the initial step of the procedure was subxiphoid
      fluoroscopically controlled pericardiocentesis and drainage of the pericardial
      effusion. An Olympus FB-41ST biopsy forceps was applied for endoscopically guided
      pericardial biopsies. Standard sampling was used in 22/32 patients (3 to 6
      samples/patient) and extensive sampling in 10/32 patients (18 to 20
      samples/patient). In additional 12 patients pericardial biopsy was performed
      without pericardioscopy, under fluoroscopic control. Endoscopic visualization was
      clearly superior when pericardial effusion was partially replaced with 100 to 300
      ml of air (29/32 procedures) in comparison to 3/32 procedures in which the
      pericardial effusion was replaced with warm normal saline (37 degrees C). In
      patients with hemorrhagic effusion (12/32), we either repeatedly injected and
      removed 100 to 150 ml volumes of normal saline (37 degrees C), or postponed
      pericardioscopy for 2 to 3 days of active drainage. The specificity of endoscopic
      findings is low and not decisive for the diagnosis. However, pericardioscopy is
      significantly contributing to the diagnostic value of pericardial biopsy,
      especially regarding establishing the new diagnosis and etiology of the
      pericardial disease. Sampling efficiency was also significantly higher for
      procedures using aimed pericardial biopsy with standard and extensive sampling
      compared to procedures performed under fluoroscopy: 86.2%, 87.3%, and 43.7%,
      respectively. No major complications directly related to the procedure were
      encountered. Minor complications included: short-run ventricular tachycardia
      (6.3%), pain at the sheath entry site (75%) and transient fever (37.5%). In
      conclusion, pericardioscopy with Olympus HYF-1T, after air instillation, is a
      technically complex, but safe procedure that enables excellent visualization and
      extensive pericardial sampling with improved diagnostic value of pericardial
      biopsies.

PMID- 11200123
TI  - Cytokine activation in pericardial fluids in different forms of pericarditis.
AB  - There are many causes of pericardial effusion and it is useful to classify them
      etiologically, since this disorder is the most common pathologic process
      involving the pericardium. This report details our experience with
      pericardioscopy and epicardial biopsy in 101 patients with pericardial effusions
      in whom pericardioscopy was performed. By means of clinical data and polymerase
      chain reaction we tried to elucidate the etiology of the pericardial effusion
      which were classified as follows: we found 41 effusions to be induced by primary
      malignant tumors or tumors metastatic to the pericardium. Specific diagnosis of
      viral and bacterial pericarditis was established in 17 patients by examination of
      the pericardial effusion with PCR, where we found 3 patients positive for
      adenovirus, 5 patients positive for cytomegalovirus, 2 patients positive for
      enterovirus-RNA and 5 patients positive for borrelia Burgdorferi-DNA.
      Additionally, idiopathic effusions (lymphocytic and autoreactive) were seen in 35
      patients. In summary immunological and molecular biology investigations seem to
      provide an additional tool in the diagnostic of pericardial effusion with unknown
      etiology. If we focus on the ELISA results, there is some evidence, that the
      demonstration [table: see text] of activation markers and soluble mediators of
      inflammation such as Il-6, Il-8 and IFN-gamma in pericardial effusion and the
      simultaneously lack of these mediators in sera of the patients first may be
      helpful in the discrimination of autoreactive and lymphocytic effusion. Second,
      this cytokine pattern or distribution indicates a possible local inflammatory
      process, where these cytokines were all released from activated T lymphocytes
      present in lymphocytic effusion. In the future, this may have therapeutic
      implications.

PMID- 11200124
TI  - [Contrast medium echocardiography-assisted pericardial drainage].
AB  - The most effective treatment for pericardial effusion and cardiac tamponade is
      removal of the pericardial fluid. Surgical pericardiotomy is associated with high
      mortality and morbidity. Similarly, subcostal percutaneous blind
      pericardiocentesis was reported to have unacceptably high mortality and
      complication rates. Major complications associated with blind needle punctures
      are right heart penetration, hemopericardium, puncture of the coronary arteries,
      liver and lung bleeding. Even under fluoroscopic guidance and
      electrocardiographic needle monitoring high complication rates persist.
      Pericardial drainage has been often inadequate, with frequent recurrences of
      significant pericardial effusions. Two-dimensional echocardiographically guided
      pericardiocentesis is reported to improve efficacy and safety of percutaneous
      puncture. Moreover, it allows immediate verification of the procedural success.
      We evaluated the efficacy and safety of an echocardiographically guided contrast
      agent controlled pericardiocentesis. This is a retrospective, descriptive study
      on 126 consecutive patients who underwent percutaneous pericardiocentesis at the
      University Hospital Essen, Germany, from 1995 to June 2000. There were 51 women
      (41%) and 75 men (55%) with a mean age of 52 +/- 14 years. Standard techniques
      for quantification of pericardial effusion were used. Depending on the
      localization of the pericardial effusion an apical or subxiphoidal approach was
      chosen. The puncture was performed under echocardiographic guidance and the
      position of the needle was controlled by injection of contrast agent. Over a long
      guidewire a pigtail catheter was inserted through a sheath for further drainage
      of pericardial fluid. The catheter was removed after a maximum of 48 hours to
      avoid infection of the pericardial cavity. An apical approach was chosen in 98
      patients (78%), a subcostal in 28 patients (22%). The procedure was successful in
      99% of the attempts. No death or clinical complication occurred. The maximal
      pericardial diameter measured by two-dimensional echocardiography was 32 +/- 16
      mm before and 5.3 +/- 2 mm after drainage. The calculated pericardial effusion
      was 657 +/- 342 ml. A fluid volume of 605 +/- 342 ml could be drained. In all
      patients a pericardial catheter was placed for 1.4 +/- 0.8 days. Recurrence of
      pericardial effusion occurred in 18 patients (14%). Of these, 15 patients
      underwent repeated successful pericardiocentesis (2.5 +/- 0.8), and 3 patients
      were referred to surgical pericardiotomy. Pericardiocentesis under
      echocardiographic contrast agent guidance is a safe, successful and cost
      effective procedure for diagnostic and therapeutic drainage of pericardial
      effusion. Two-dimensional echocardiography allows localization of the optimal
      puncture site as well as the quantification of the effusion depth. The injection
      of contrast agents into the pericardial cavity improves the safety and accuracy
      of the procedure. Even recurrent pericardial effusions can be treated
      successfully.

PMID- 11200125
TI  - Computer-guided pericardiocentesis: experimental results and clinical
      perspectives.
AB  - Percutaneous pericardial puncture is a relatively safe and effective technique in
      case of large pericardial effusions when practiced under echographic or
      radiological control. The goal of our project is to improve the performance of
      this technique, mainly in case of smaller and loculated effusions using an
      accurate guidance towards a preplanned target, based on a model of the
      pericardial effusion. This paper presents preclinical results of this new
      computer-assisted technique used to reach the pericardial cavity. The procedure
      is divided into 3 steps: 1. acquisition of ultrasound data, using an
      echocardiographic device connected to a 3-D localizer and to a computer, 2.
      modeling procedure to define the optimal strategy taking into account the
      mobility of organs on a digital model, 3. guided puncture with a localized needle
      to reach the predefined target using a passive guidance system. After validation
      on a dynamic phantom and a feasibility study on dogs, an accuracy and reliability
      analysis protocol was realized on pigs with experimental pericardial effusion.
      Feasibility of the technique is demonstrated on animal study with an accuracy of
      at least 2.5 mm. Further clinical investigation is in progress using a more
      ergonomic and less cumbersome system. This study demonstrates the feasibility of
      computer-assisted pericardiocentesis. Beyond the simple improvement of the
      current technique, this could be a new way to reach the heart or a new tool for
      percutaneous access and image-guided puncture of soft tissues.

PMID- 11200126
TI  - New directions in diagnosis and treatment of pericardial disease. A project of
      the Taskforce on Pericardial Disease of the World Heart Federation.
AB  - New directions in the diagnosis and treatment of pericardial diseases synthesize
      the achievements of modern imaging with molecular biology and immunology
      techniques. Comprehensive and systematic implementation of new techniques of
      pericardiocentesis, pericardial fluid analysis, pericardioscopy, epicardial and
      pericardial biopsy, as well the application of comprehensive molecular biology
      and immunology techniques for pericardial fluid and biopsy analyses have opened
      new windows to the pericardial diseases, permitting early specific diagnosis and
      creating foundations for etiologic treatment in many cases. In patients with
      recurrent pericarditis, resistant to conventional treatments, as well as in
      patients with neoplastic pericarditis an alternative intrapericardial treatment
      regimen was suggested by the Taskforce on Pericardial Diseases of the World Heart
      Federation. Intrapericardial application of medication avoids systemic side
      effects with increased local efficacy. The following protocols are proposed: CIRP
      (colchicine in recurrent pericarditis)--colchicine vs placebo in
      chronic/recurring pericarditis without pericardiocentesis; TRIPE (triamcinolone
      in pericardial effusion)--intrapericardial instillation of triamcinolone + 6
      months colchicine vs pericardial puncture without instillation + 6 months
      colchicine; NEPIN (neoplastic effusion and pericardial instillation)-
      pericardiocentesis and drainage + intrapericardial instillation of cisplatin or
      thiotepa.

PMID- 11200127
TI  - Intrapericardial treatment of autoreactive myocarditis with triamcinolon.
      Successful administration in patients with minimal pericardial effusion.
AB  - A major clinical drawback in the treatment of autoreactive pericarditis is its
      inherent feature to relapse. Intrapericardial treatment with triamcinolone was
      reported to be efficient in patients with large, symptomatic autoreactive
      pericardial effusions, avoiding side effects of systemic treatment as well as
      compliance problems. Intrapericardial treatment with 300 mg/m2 triamcinolone was
      for the first time performed in patients with autoreactive myopericarditis and
      minimal pericardial effusions (75 to 110 ml). After 12 months of follow-up both
      patients are asymptomatic and there were no further recurrences of pericardial
      effusion. Pericardiocentesis in these patients was performed with the application
      of the PerDUCER device, guided by pericardioscopy. This device has a
      hemispherical cavity at the top of the instrument connected with a vacuum
      producing syringe. In this cavity the pericardium is captured by vacuum and
      tangentially punctured by the introducer needle. Pericardium that can be
      captured, must be up to 2 mm thin to fit into the hemispherical cavity.
      Pericardioscopy performed from the anterior mediastinum significantly contributed
      to the success of the procedures enabling visualization of the portions of the
      pericardium free of adipose tissue or adhesions, suitable for puncture with the
      PerDUCER. In conclusion, intrapericardial treatment of symptomatic autoreactive
      myopericarditis with minimal pericardial effusion was safely and efficiently
      performed in 2 patients. Pericardiocentesis was enabled by means of the PerDUCER
      device, facilitated by pericardioscopy.

PMID- 11200128
TI  - Intrapericardial treatment of neoplastic pericardial effusions.
AB  - Pericardial effusion and cardiac tamponade are known complications of many
      advanced malignancies as lung cancer, breast cancer, lymphomas and leukemias.
      Initial relief can be easily obtained with percutaneous echo-guided
      pericardiocentesis, without significant mortality and morbidity and well
      tolerated even in critically ill patients. Effusion recurrences can be observed,
      however, in up to 40% of cases if only simple pericardial drainage is performed.
      Effective management can be obtained by instillation in the pericardial sac of
      different agents, with sclerosing or cytostatic activity, like tetracyclines,
      bleomycin, thiotepa or radionuclides. Intrapericardial sclerotherapy is
      associated to good results in terms of recurrence prevention and survival
      improvement. Absence of pericardial effusion at 30 days after drainage can be
      observed in 70 to 90% of all treated patients, without significant variations
      among different treatments. No significant side effects are observed, with the
      exclusion of chest pain during tetracyclines instillation. In our opinion
      pericardiocentesis associated to intrapericardial sclerotherapy with thiotepa is
      the best compromise in terms of recurrence prevention, tolerability and costs.
      Real randomized, case-control studies are moreover required to assess the gold
      standard of malignant pericardial effusions treatment.

PMID- 11200129
TI  - Indications, results, and pitfalls in the surgery of constrictive pericarditis.
AB  - Constrictive pericarditis is a rare disease with an often unclear etiology. There
      may be a long delay between the onset of the underlying disease and the onset of
      clinical symptoms, which are fatigue, abdominal swelling, peripheral edema and
      breathlessness. However, if clinically apparent, these symptoms may progress
      rapidly and severely disable the affected patient. Diagnosis is achieved by the
      clinical presentation, echocardiography and/or MRI and right heart
      catheterization. The standard therapy is an extended pericardiectomy to restore
      an unlimited inflow and outflow as well as an unrestricted diastolic function of
      both ventricles. The risks of this procedure are related to dense adhesions
      between the 2 pericardial layers and severe calcifications especially of the
      epicardium. Incomplete removal results in persistent diastolic restriction while
      lacerations of the underlying myocardium may lead to diffuse and extensive
      bleeding and finally to myocardial dysfunction. Also, the postoperative course
      may be complicated by persistent low output syndrome or acute ventricular
      dilatation. However, early surgical intervention in the hands of experienced
      surgeons offers the best prognosis.

PMID- 11200130
TI  - Assessment of the national communicable disease surveillance and response system,
      Ethiopia.

PMID- 11200131
TI  - [Effect of ectopic superexperssion of the anti-apoptotic gene bcl-2 on the level
      and character of karyotypic instability in the CHLL V-79 RJK Chinese hamster cell
      line].
AB  - Karyotypic destabilization in cells of Chinese hamster fibroblasts CHL V-79 RJK
      with ectopically overexpressed antiapoptotical human bcl-2 gene from pSFFV-bcl-2
      vector has been analysed. Analysis of G-banded metaphase chromosomes from 4
      clones with different levels of bcl-2 expression revealed an increased level of
      chromosomal instability in bcl-2-transfected cells. Besides, an increased
      percentage of aneu- and polyploid cells and high level of cells with different
      chromosomal aberrations was observed. The degree of karyotypic instability
      positively correlated with the level of bcl-2 expression in bcl-2-transfected
      cells. Cells of a clone with the highest bcl-2 expression at the 13th passage of
      cultivation displayed an almost 100% polyploidization and the presence of
      specific aberrations and a tricentric marker chromosome. Selection of cells with
      non-random specific chromosome changes was observed in pSFFV-bcl-2-transfected
      CHL V-79 RJK cells in the process of their long-term cultivation. By contrast,
      cells of the parental cell line, as well as the control pSFFV-neo transfectants,
      displayed a stable karyotype throughout the long period of cultivation. It is
      important that the presence of morphological markers of gene amplifications--DOO,
      DM, MH--was observed in bcl-2-transfected cells. These findings suggest that the
      overexpression of antiapoptotic human bcl-2 gene may result in destabilization of
      the karyotype structure in cells of Chinese hamster fibroblasts CHL V-79 RJK. The
      character and level of destabilization correlate with the level of ectopic
      overexpression of this gene.

PMID- 11200132
TI  - [Interaction of tumor cell differentiation induced in vitro and sensitivity of
      them to nonspecific lysis by natural killer cells. Possible mechanisms].
AB  - The literature data on the influence of a large group of cancer cell
      differentiation inducers on the modulation of their susceptibility to non-MHC
      restricted lysis (non-specific cytotoxicity, NCT) by natural killer (NK) cells
      have been analysed. A possible association between the apoptogenic action of
      differentiation inducers and their ability to modulate the NCT of cell targets by
      NK cells is discussed.

PMID- 11200133
TI  - [Morphogenesis and formation of a pattern in hydra. I. Distribution of
      morphogenetic potential].
AB  - True multicellularity is characterized by complex interactions between individual
      cells of the organism as well as by organization of cell masses into spatially
      and functionally determined structures promoting the exchange of information.
      Morphogenetic processes--genetically programmed generation of structures--always
      correlate with determination and maintenance of a pattern, i.e. a system of
      spatial relationships between them. Hydroid polyps provide a wide variety of
      approaches to study morphogenesis and patterning. Being comparatively simply
      organized, these animals have nevertheless certain developed mechanisms
      underlaying such processes as regeneration of missing structures, recovery of
      normal pattern after dissociation of polyps into single cells, tissue
      transdifferentiation in non-complementary chimaeras. An important feature of
      regeneration of hydroid polyps is its independence of the nerve net elements; the
      basis for regeneration is rather stored in epithelial cells and in their
      interactions. Phenomenological data, provided in the XVIII-XX centuries, allowed
      to propose several theoretical models of pattern regulation in hydra. The main
      goal of this paper is to review contemporary models of morphogenesis and
      patterning in the hydroid polyps.

PMID- 11200134
TI  - [Analysis of the proliferative activity of a cell using new monoclonal antibodies
      to nucleolar protein B23/nucleophosmin].
AB  - Nowadays, antinucleolar antibodies are widely used for exploration of the
      nucleolar organization and molecular mechanisms of ribosome production. Here we
      have described a new monoclonal antibody against the major nucleolar
      phosphoprotein B23/nucleophosmin (3C9) that is involved in the terminal stages of
      ribosome production. It is used to examine immunocytochemical peculiarities of
      the nucleolus in terms of the cell proliferative status and also during mitosis.
      In human peripheral blood lymphocytes, activated for proliferation with
      phytohaemagglutinin (PHA), PHA stimulation of lymphocytes was shown to result in
      accumulation of protein B23 in augmentative nucleoli. A comparative study of 3C9
      and two other anti-B23 antibodies 20B2 and anti-B23 by Western blots and indirect
      immunofluorescence favored the idea that 3C9 cross-reacted with the major isoform
      of B23, B23.1, that have an apparent molecular weight of 40 kDa.

PMID- 11200135
TI  - [Differentiated murine F9 teratocarcinoma cells are susceptible to apoptosis upon
      contact with substrate].
AB  - Epithelial and endothelial cells are susceptible to a subset of apoptosis known
      as anoikis. This type of programmed cell death is activated upon disruption of
      cell-substrate contacts. Here we demonstrate that mouse F9 embryonal carcinoma
      cell line acquires susceptibility to anoikis upon retinoic acid-induced
      differentiation towards non-malignant pariental endoderm-like cells. F9 cells
      survival becomes dependent on the substrate by the 4th day of retinoic acid
      treatment, when cells assume epithelial phenotype as revealed by actin, alpha
      actinin and vinculin expression and distribution, and when focal adhesion
      contacts are formed. Differentiated F9 cells die in suspension by apoptosis as
      revealed by oligonucleosomal DNA laddering, DAPI staining and DNA flow cytometry
      analysis. On the contrary, undifferentiated F9 cells form large multicellular
      aggregates in suspension and survive. Thus, F9 cell line provides a new model to
      study pathways involved in both anoikis induction and inhibition.

PMID- 11200136
TI  - [Cleavage of DNA-binding loops of actin by subtilisin prevent formation of a
      strong type of myosin binding with actin].
AB  - In order to elucidate the role of DNA-binding loop of actin (amino acid residues
      38-52) in mechanisms of muscle contraction, polarizational fluorimetry and ghost
      muscle fibers, containing thin filaments reconstructed by intact and subtilisin
      cleaved G-actin were used. The thin filaments were modified by fluorescent probes
      rhodamin-phalloidin and 1,5-IAEDANS. Changes in orientation and mobility of the
      probes were considered as an indication of changes in actin conformation. The
      stage AM of ATP hydrolysis cycle was simulated. For this purpose, thin filaments
      were decorated by myosin subfragment-1 (S1) in the absence of nucleotide. It has
      been shown that S1 binding to actin is accompanied by changes in orientation and
      mobility of the fluorescent probes. For intact filaments, the changes of these
      parameters indicate the formation of a strong binding between S1 and actin.
      Cleavage of DNA-binding loop by subtilisin markedly inhibits this effect. The
      cleavage of actin by subtilisin has also been shown to diminish the changes in
      fiber birefringence, which takes place at the formation of F-actin-S1 complex in
      the muscle fiber. The spatial organization of the actin DNA-binding loop is
      suggested to play an important role in determining the character of myosin
      interaction with actin in the ATP hydrolysis cycle.

PMID- 11200137
TI  - [Long-term action of vitamin D suppresses the estradiol-induced activity of erk-1
      MAPK and proliferation of MCF-7 and LNCaP cancer cells].
AB  - A study was made of the influence of a long-term exposure of 1,25
      dihydroxyvitamin D3 and 17 beta-estradiol on deactivation of MAP kinases in
      correlation with proliferation of cancer cells. The obtained results illustrate
      inhibition of cell growth after vitamin D treatment. Mechanisms of such an
      inhibition are discussed.

PMID- 11200139
TI  - Proceedings of the British Pharmacological Society Meeting. 6-8 September 2000,
      University of Bradford. Abstracts.

PMID- 11200138
TI  - [Ultrastructural characteristics of rat neuromuscular junctions after physical
      load].
AB  - It is interesting to ascertain the adaptive reaction of rat neuromuscular
      junctions (NMJ) of muscle fibers of different types to a chronic physical load.
      We examined ultrastructural changes in NMJ following both static load (pre- and
      postnatal ontogenesis of Wistar rats till a 2 month age took place under a
      constant rotation on the centrifuge at hypergravity conditions 2G), and after
      three kinds of dynamic loads (1/run on treadmill with a speed 35 m/min for 6 wks,
      10-60 min/day; 2/swimmings, each 10 hrs/day for 10 days; 3/strength exercises on
      a vertical treadmill with load for 6 wks). Differences in NMJ reaction of muscle
      fibers of the same type to various loads were established. A low secretory
      activity of axonal terminals of type I muscle fibers of m. soleus was shown after
      the static load. The dynamic load (run) is accompanied with a high secretory
      activity of axonal terminals in m. soleus type I muscle fibers and of some axonal
      terminals of m. quadriceps femoris IIB type muscle fibers after strength
      exercises; the secretory activity of axonal terminals of m. quadriceps femoris
      IIA and IIB types muscle fibers is expressed in a lesser degree after swimming.
      The NMJ ultrastructure remodelling (terminal renewal) of type I muscle fibers of
      the 2 month old control rats increases after static and dynamic (run) loads. Some
      correlations between different kinds of physical load, muscle fiber type and the
      degree of NMJ ultrastructure transformation have been shown.

PMID- 11200140
TI  - Statistics and analysis of the Camino ICP monitor.

PMID- 11200141
TI  - 21st Annual Meeting of the Society for Maternal-Fetal Medicine. February 5-10,
      2001. Reno, Nevada, USA. Abstracts.

PMID- 11200142
TI  - The evolving role of irinotecan: a broad-spectrum chemotherapeutic agent.
      Introduction.

PMID- 11200143
TI  - Irinotecan and cisplatin in advanced gastric or gastroesophageal junction
      carcinoma.
AB  - Chemotherapy for advanced gastric and gastroesophageal junction carcinomas
      remains suboptimal. Both irinotecan (Camptosar) and cisplatin (Platinol) are
      active against this group of malignancies. This article focuses on the results of
      an ongoing phase II trial with this combination in patients with advanced gastric
      or gastroesophageal junction carcinoma. Data from this trial suggest that the
      combination of irinotecan and cisplatin is active in untreated as well as
      previously treated patients with gastric or gastroesophageal junction carcinoma.

PMID- 11200144
TI  - Developments in the treatment of gastric cancer in Europe.
AB  - Metastatic gastric cancer is a relatively chemosensitive disease. With current
      regimens, 25% to 40% of patients can be expected to respond, and median survival
      of 6 to 8 months is achievable. These outcomes may be improved by the use of
      infusional fluorouracil (5-FU) in combination with cisplatin (Platinol) or the
      newer agents docetaxel (Taxotere) and irinotecan (Camptosar). Phase II studies
      using these approaches have reported response rates of 50% to 60% and median
      survival of 11 months. Chemotherapy may also have a role in earlier stages of
      gastric cancer. However, the value of adjuvant therapy in improving survival
      following successful resection has still to be demonstrated, as has the survival
      benefit of preoperative treatment. Nevertheless, primary chemotherapy has
      demonstrated a capacity to downstage disease in certain otherwise inoperable
      cases.

PMID- 11200145
TI  - Irinotecan in esophageal cancer.
AB  - Irinotecan (Camptosar) has shown activity in several solid tumor malignancies,
      including gastric and pancreatic cancer. In vitro studies suggest antitumor
      activity in esophageal cancer cell lines. Sequence-dependent synergy has been
      demonstrated in vitro between irinotecan and cisplatin. A phase I trial conducted
      at Memorial Sloan-Kettering Cancer Center (MSKCC) has demonstrated the safety and
      tolerability of cisplatin plus irinotecan. A phase II study of this combination
      in patients with previously untreated, advanced esophageal cancer, also at MSKCC,
      has demonstrated promising results. Current trials at MSKCC are attempting to
      combine this regimen with either paclitaxel (Taxol), fluorouracil (5-FU), or
      radiation therapy.

PMID- 11200146
TI  - Irinotecan in the management of patients with pancreatic cancer.
AB  - Synergy with no overlapping toxicities has been demonstrated for the combination
      of irinotecan (Camptosar, CPT-11) and gemcitabine (Gemzar) in vitro. Results of a
      single-institution phase I study in which patients with previously untreated
      pancreatic cancer were given irinotecan and gemcitabine were promising, with two
      of three patients achieving a partial response. Because of the favorable outcome
      of the phase I study, a multicenter phase II trial was undertaken in previously
      untreated patients with pancreatic carcinoma. Data from other sites entering
      patients in this phase II study have been analyzed, and a multicenter phase III
      trial of single-agent gemcitabine vs the irinotecan combination in first-line
      treatment of patients with locally advanced or metastatic pancreatic cancer is
      underway.

PMID- 11200147
TI  - Phase I study of irinotecan and concurrent radiation therapy for upper GI tumors.
AB  - Irinotecan (Camptosar) is an active chemotherapeutic agent for lung, gastric,
      esophageal, and colorectal cancers and a potent radiosensitizer. This phase I
      study was designed to assess the maximum tolerated dose of weekly irinotecan
      combined with concurrent radiotherapy for patients with locally advanced,
      unresectable gastric, gastroesophageal junction, or esophageal cancer. Patients
      who received previous chemotherapy (excluding irinotecan) or who experienced
      recurrent cancer after surgery were eligible for this protocol. The total dose of
      radiation did not exceed 50.4 Gy (28 fractions of 1.8 Gy each). The starting dose
      level of irinotecan was 30 mg/m2 infused over 90 minutes given weekly for 5
      weeks. Subsequent dose levels were increased in 10 mg/m2 increments to 40, 50,
      60, and 70 mg/m2. Of 15 patients who have been enrolled to date, all are
      evaluable for toxicities and 12 for response. Major hematologic toxicities (grade
      3/4) were neutropenia, chills, hemorrhage, and anemia. Grade 3/4 gastrointestinal
      toxicities included nausea, vomiting, dehydration, anorexia, and constipation.
      Other severe nonhematologic toxicities included fatigue, hypotension, and
      hypothermia, as well as cardiovascular toxicities. There was no severe diarrhea
      and no treatment-related deaths. Of the 12 evaluable patients, 7 (58%) responded,
      including 2 complete responses; 4 (30%) had no change and 1 had progressive
      disease. Survival ranged from 1 month to 15 months, with a median survival of 8
      months. When the total dose of irinotecan given concurrently with radiotherapy
      was higher than 250 mg/m2, patients experienced significantly more severe grade
      3/4 toxicities than with lower doses (P = .04), with no improvement in response
      rate. It was concluded that weekly doses of irinotecan of up to 60 mg/m2 with
      concurrent radiotherapy given over 5 weeks was feasible and demonstrated good
      response. This regimen did not cause severe diarrhea or pneumonitis, but
      neutropenia and fatigue were major toxicities. The study continues to accrue.

PMID- 11200148
TI  - Colorectal cancer: chemotherapy treatment overview.
AB  - Fluorouracil (5-FU) has remained the standard therapy for the treatment of
      advanced colorectal cancer for over 40 years. Unfortunately, only a minority of
      patients experience objective clinical response. Discussed herein are attempts to
      improve on the activity of 5-FU by biochemically modulating its action. In
      addition, novel agents for the treatment of advanced colorectal cancer (oral
      fluoropyrimidines, oxaliplatin, and irinotecan) are discussed. Oral
      fluoropyrimidines (UFT plus leucovorin, capecitabine, eniluracil plus oral 5-FU)
      provide the convenience of oral delivery with a marked reduction in febrile
      neutropenia and mucositis. Recent randomized trials with these agents have
      demonstrated therapeutic activity that is comparable with intravenous schedules
      of 5-FU plus leucovorin. Compared to 5-FU, both oxaliplatin and irinotecan have
      uniquely different mechanisms of action and have demonstrated clinical activity
      in patients whose disease has progressed with 5-FU treatment. Combinations of
      either irinotecan or oxaliplatin plus 5-FU/leucovorin have demonstrated that the
      addition of these agents to 5-FU/leucovorin improves response rates and time to
      progression compared to 5-FU/leucovorin alone. Combination chemotherapy regimens
      with these novel agents are rapidly being introduced into the adjuvant setting.

PMID- 11200149
TI  - Irinotecan-based combinations for the adjuvant treatment of stage III colon
      cancer.
AB  - Irinotecan (Camptosar) is a topoisomerase I inhibitor with demonstrated antitumor
      activity against a wide variety of malignancies. Phase II studies have shown that
      this agent has significant single-agent activity against both chemotherapy-naive
      and fluorouracil (5-FU)-refractory colorectal cancer. Phase III studies now
      indicate that irinotecan/5-FU/leucovorin combinations have antitumor activity
      superior to standard 5-FU/leucovorin regimens alone. These irinotecan-based
      combinations are now entering clinical trials for the adjuvant treatment of
      resected stage III colon cancer. It is hypothesized that the superior antitumor
      activity of these irinotecan-based combinations seen in the metastatic setting
      will translate into improved survival and increased cure rates in these earlier
      stage patients.

PMID- 11200150
TI  - Irinotecan and high-dose fluorouracil/leucovorin for metastatic colorectal
      cancer.
AB  - Two randomized phase III trials with irinotecan as second-line treatment of
      metastatic colorectal cancer have shown that irinotecan (CPT-11, Camptosar)
      significantly improves survival when compared with best supportive care or
      continuous infusion of fluorouracil (5-FU) after failure of 5-FU. The combination
      of irinotecan and 5-FU/leucovorin produced a significantly higher response rate
      (40.8% vs 23.1%, P < .001), longer time to progression of disease (6.7 vs 4.4
      months, P < .001), longer median survival (17.4 vs 14.1 months, P = .03), and a
      greater chance of survival at 1 year (69% vs 59%, P = .03) than 5-FU/leucovorin
      treatment alone. Such benefits have not previously been demonstrated in this
      setting. Although the use of irinotecan in combination with 5-FU/leucovorin
      increased the likelihood of neutropenia, the incidence of febrile neutropenia and
      infection remained low. Other toxic effects were manageable, noncumulative, and
      reversible.

PMID- 11200151
TI  - Irinotecan in preoperative combined-modality therapy for locally advanced rectal
      cancer.
AB  - Irinotecan (CPT-11, Camptosar) is a semisynthetic water-soluble derivative of the
      plant alkaloid camptothecin. This review will focus on the potential use of
      irinotecan in combination with fluorouracil (5-FU) in the preoperative combined
      modality treatment of advanced rectal cancer. The laboratory studies that define
      the mechanism of fluoropyrimidine- and camptothecin-mediated radiosensitization
      are discussed, and the rationale for combined-modality therapy using radiation
      with 5-FU and irinotecan is presented.

PMID- 11200152
TI  - Is there a need for plasticizer-free biomaterials in dialysis therapy?
AB  - The impact of plasticizers on general health is an extremely controversial
      subject. Most of the results in this area, especially those related to di
      ethylhexyl-phthalate, are collected from animal studies and the extrapolation to
      humans is still controversial and difficult. This review of research findings
      explores the science of using soft polyvinyl(chloride). With particular reference
      to dialysis, it explains why some companies now offer products made of
      plasticizer-free biomaterials.

PMID- 11200153
TI  - Microsystems: how to access the technology.
AB  - Microsystems are devices that incorporate a combination of microfluidic,
      micromechanical, micro-optical and microelectronic components. This users' guide
      provides information on how to access the technology and find the resources
      needed for design, prototyping and manufacture in Europe.

PMID- 11200154
TI  - Another design input: reimbursement issues.
AB  - In spite of diverse challenges, medical device companies are continuing to design
      and develop high quality products that significantly benefit patients. They are
      also succeeding in meeting increasingly stringent regulatory requirements.
      However, these accomplishments do not guarantee commercial success. The
      importance of designers considering the needs of purchasers during the design
      phase is examined.

PMID- 11200155
TI  - The medical device industry prepares to blow its own trumpet.

PMID- 11200156
TI  - Reuse of single-use devices.
AB  - The lack of regulation and procedures to monitor the reuse of single-use devices
      (SUDs) is allowing the use of medical devices that can pose a risk to patient
      health. Studies on reused SUDs show a range of defects. Despite this,
      uncontrolled reuse of SUDs continues. This article explores the extent of the
      problem, reports the findings of some of the studies and suggests what should be
      done.

PMID- 11200157
TI  - What the Internet means for the medical device industry.
AB  - The Internet is dramatically changing the structure of the industry. For the
      first time, direct communication between all suppliers and all hospitals is
      available. The Internet-based electronic market place not only provides the
      ability to choose products from a standardized catalogue, but also to send orders
      direct to suppliers' enterprise resource planning systems. One-to-one marketing
      is also becoming a reality. Medical device manufacturers are advised to test the
      different electronic sales and marketing initiatives that are now available.

PMID- 11200158
TI  - Japan. The high-tech giant.

PMID- 11200159
TI  - China. Huge long-term potential.

PMID- 11200160
TI  - Singapore. A favoured distribution centre.

PMID- 11200161
TI  - Thailand in recovery.

PMID- 11200162
TI  - South Korea. Fastest growing future.

PMID- 11200163
TI  - Taiwan. A great exporter.

PMID- 11200164
TI  - India. A flourishing private sector.

PMID- 11200165
TI  - Pakistan. In early development.

PMID- 11200166
TI  - Vietnam. Determined to renovate.

PMID- 11200167
TI  - The 2000 Medical Device Technology employment survey.

PMID- 11200168
TI  - Home-care products.

PMID- 11200169
TI  - PVC and medical devices: making an informed choice.

PMID- 11200170
TI  - NMDA receptors and nitric oxide regulate prostaglandin D2 synthesis in the rabbit
      hippocampus in vivo.
AB  - The aim of this in vivo microdialysis study was to characterise the regulation of
      prostaglandin D2 (PgD2) synthesis by NMDA receptors in the rabbit hippocampus in
      relation to changes in extracellular Ca2+ concentration ([Ca2+]e) and nitric
      oxide (NO) levels. Samples of dialysate were analysed for changes in PgD2
      concentration, in [Ca2+]e and in the level of NO. The results demonstrated that a
      20-min pulse application of 0.1-2.5 mM NMDA via a microdialysis probe induced a
      prolonged stimulation of PgD2 release that was sensitive to competitive NMDA
      receptor antagonists. An inhibitor of voltage-sensitive Na+ channels,
      tetrodotoxin, did not influence this effect but significantly suppressed basal
      PgD2 production, whereas a NOS inhibitor, N(G)-nitro-L-arginine methyl ester (L
      NAME), prevented NMDA-evoked NO release and inhibited NMDA-induced PgD2 release
      in an L-arginine-sensitive manner. NO donors, S-nitroso-N-acetylpenicillamine and
      sodium nitroprusside, stimulated PgD2 release. NMDA-evoked decrease in [Ca2+]e
      was insensitive to TTX and L-NAME. These results demonstrate an in vivo NMDA
      receptor-mediated modulation of PgD2 synthesis in the brain, in which NO
      participates.

PMID- 11200171
TI  - Postmicrosomal protein fractions from short-time-predegenerated rat sciatic
      nerve.
AB  - The postmicrosomal protein fraction obtained from distal stumps of rat sciatic
      nerves at 0-6 days following transection were investigated by means of one- and
      two-dimensional electrophoresis. In all experimental groups, total amount of
      protein was significantly higher than in the control group. Proteins were
      resolved into 27 bands after SDS-PAGE. Their molecular weights ranged between
      16.2 and 335.4 kDa. Eleven fractions displayed significant quantitative
      differences. After 2-D-electrophoresis, the pI of the proteins ranged from 4.2 to
      7.4. They were resolved to 28 molecular masses from 13.5 kDa to 335.4 kDa. The
      greatest numbers of fractions (90-109) were observed on the 3rd, 4th, 5th and 6th
      day after nerve transection. Thus, during first 6 days after transection
      intensive changes in protein fraction content and composition take place in the
      distal stump of peripheral nerve. These processes seem to be most prominent on
      the 4th day after lesion. Results confirm our earlier in vivo findings.

PMID- 11200172
TI  - Effects of acute and chronic triazolam treatments on brain GABA levels in albino
      rats.
AB  - The present study investigated the effects of acute and chronic intraperitoneal
      administration of Triazolam on g-aminobutyric acid (GABA) levels in different
      brain areas of albino rats. Three experiments were conducted. In the first, five
      groups of rats were acutely treated with different doses of Triazolam (0.25 mg/kg
      4.0 mg/kg). In the second experiment, rats were treated chronically with a single
      daily dose of Triazolam (started with 0.25 mg/kg and increased by time to 1.0
      mg/kg) for 5 weeks, simulating clinical use. In the third, rats were treated
      chronically with three daily doses of Triazolam (started with 0.25 mg/kg and
      increased by time to 0.5 mg/kg) for 20 days, representing a form of drug abuse.
      Brain levels of GABA and plasma levels of Triazolam were measured using high
      performance liquid chromatography (HPLC). The acute Triazolam administration
      produced an increase in GABA levels in all brain areas studied. The chronic
      administration of single daily dose of Triazolam produced normal GABA levels in
      all brain areas except brain stem where the levels were significantly decreased;
      this indicates the development of tolerance to Triazolam action on increasing
      GABA content. The chronic administration of three daily doses of Triazolam
      produced a decrease in GABA levels in all brain regions studied. In conclusion,
      chronic single daily dose treatment (representing normal use) produces tolerance
      to Triazolam effects on brain GABA levels, while chronic three daily doses
      administration (akin to drug abuse) causes a fall in GABA levels.

PMID- 11200174
TI  - Expectation of an important event affects responses to irrelevant stimuli of
      different modalities.
AB  - Periodic alterations of event-related potentials (ERPs) were studied during
      "oddball" tasks. Sequences of randomly intermixed frequent (non-target) and rare
      (target) stimuli were presented. In visual experiments, these were flashes of
      light of two different colors. In auditory tests there were two tones of
      different frequencies. The instruction was to keep a mental count of each target
      stimulus. To study the alterations of the "state of the brain" produced by target
      detection, responses to non-targets immediately following targets were compared
      with responses to an eighth subsequent non-target stimulus. To evaluate the
      effect of such "brain states" on responses to stimuli of a different modality,
      additional visual stimuli (probes) were delivered after both auditory and visual
      "oddball" stimuli. It was found that responses to the eighth presentation of non
      target stimulus were preceded by significant negative shift of recorded
      potential. This shift was smaller before the responses to non-targets immediately
      following the presentation of target stimuli. The difference was significant both
      in auditory and visual tests. Responses to "oddball" stimuli were little
      affected: only the reduction of P200 peaks in "after target" responses was
      significant in visual tests. Responses to probes showed stronger effects: when
      visual probes followed visual "oddball" stimuli, all three components measured
      (N100, P130 and P200) were shifted positively in responses to eighth
      presentations of non-targets. When visual probes were presented in auditory
      tests, only the amplitude of the N100 component was significantly affected.

PMID- 11200173
TI  - Escape from shock versus escape from shock accompanied by a visual stimulus in
      rats.
AB  - Two groups of 15 rats each were trained in a shuttle box to escape foot-shock
      either unsignalled or presented in compound with a visual cue: darkness. The
      visual cue presented in shock compartment amplifies the behavioral tendency
      actually prevailing in the response repertory of the rat. During the 1st session
      the compound enhanced the species-specific flight resulting in shortening of the
      rat's escape latency. Thereafter, during subsequent sessions, darkness
      exaggerated resistance to enter the other compartment; thus escape latencies were
      longer under compounded than under unsignalled procedure. The darkness cue
      reduces the intertrial response rate relative to the unsignalled group. This
      latter finding supports the discrimination model of the effect, since the
      compound helps the animals to discriminate the illuminated "safe" period between
      trials from the aversive shock period. Our data seem to suggest that the darkness
      presented synchronously with escapable grid-shock acquires aversive properties.

PMID- 11200175
TI  - Spontaneous behavior of the gray short-tailed opossum (Monodelphis domestica) in
      the elevated plus-maze: comparison with Long-Evans rats.
AB  - We observed the spontaneous behavior of a laboratory marsupial--the gray short
      tailed opossum (Monodelphis domestica)--in the elevated plus-maze (EPM) during
      six consecutive sessions and compared it with the behavior of Long-Evans rats.
      During the first exposure to the maze both species spent most of the time in the
      enclosed arms but opossums showed much higher frequency of entries into the open
      arms and stayed there longer. On the third and subsequent days opossums reduced
      their entries into the open arms and spent more time on the central square, where
      unlike rats they frequently groomed their lower belly and hind legs. During the
      last sessions they started spending more time in the enclosed arms. It is
      concluded that probably opossums, like rats show a stable anxiety evoked by open
      space. However, in the rat anxiety prevails over motivation to explore a new
      environment, while in the opossum it is initially at equilibrium with curiosity
      which habituates slower than in the rat. Results are discussed in the context of
      different ecology of the gray opossum that actively searches and hunts quickly
      moving insects. Thigmotaxic behavior, while strong in both species, dominates
      spontaneous behavior of the rat, but not opossum.

PMID- 11200176
TI  - Effect of unilateral injection of MK-801 into the area of A10 cells on feeding
      evoked by stimulation of homologous area in the contralateral hemisphere.
AB  - It was found previously that unilateral electrolytic and 6-OHDA lesions of the
      ventral tegmental area (VTA) and unilateral intra-VTA injection of bicuculline
      resulted in facilitation of behavioral responses evoked by electrical stimulation
      of the symmetrical VTA area in the contralateral hemisphere. We postulated that
      "the contralateral facilitation effect", which may reflect the yet unexplored
      mechanism of immediate compensation after acute unilateral brain injury, is
      attributable to the A10 DA neurons and their regulatory inputs. The present study
      was aimed at examining the possible involvement of NMDA-mediated glutamatergic
      transmission in VTA in the "contralateral facilitation effect". The behavioral
      model of the VTA stimulation-induced feeding in rats was used. Latency to eat was
      measured as a function of stimulation frequency before and after unilateral intra
      VTA injection of non-competitive NMDA receptors antagonist, MK-801, (doses 0.0,
      1.25 and 2.5 micrograms). MK-801 caused a dose-dependent augmentation of feeding
      evoked by stimulation of the contralateral VTA, which manifested as a decrease in
      the reaction frequency threshold and a leftward shift of the latency/frequency
      curve. Dose 2.5 micrograms replicated the facilitatory effect of electrolytic and
      6-OHDA lesions. The results are interpreted in terms of MK-801-evoked depression
      of excitatory glutamatergic tone over A10 DA cells and compensatory increase in
      DA release in the contralateral hemisphere.

PMID- 11200177
TI  - Complexity analysis of spontaneous EEG.
AB  - The aim of the present paper is the assessment of the overall complexity of
      spontaneous and non-paroxysmal EEG signals obtained from three groups of human
      subjects, e.g., healthy, seizure and mania. Linear complexity measure suitable
      for multi-variate signals, along with nonlinear measures such as approximate
      entropy (ApEn) and Taken's estimator are considered. The degree of linear
      complexity is significantly reduced for the pathological groups compared with
      healthy group. The nonlinear measures of complexity are significantly decreased
      in the seizure group for most of the electrodes, whereas a distinct
      discrimination between the maniac and healthy groups based on these nonlinear
      measures is not evident.

PMID- 11200178
TI  - Phonological and semantic fluencies are mediated by different regions of the
      prefrontal cortex.
AB  - Verbal phonological and semantic fluencies were investigated in 24 patients with
      unilateral prefrontal lesions and 10 normal control subjects. Lesions were
      limited to small areas within either the dorsolateral (Brodmann's area 46/9) or
      ventromedial (posterior part of the gyrus rectus) cortices. In a phonological
      fluency task, patients with lesions to the left dorsolateral region were
      impaired. In semantic fluency, not only the left dorsolateral group but also the
      two right frontal damaged groups performed worse than the control group. In
      agreement with previous studies, our results show that the phonological fluency
      is mediated by the left dorsolateral prefrontal cortex. In contrast to this,
      performance on the semantic fluency task depends on a wider portion of the
      prefrontal cortex involving the left and right dorsolateral and the right
      ventromedial areas.

PMID- 11200179
TI  - Protein kinase C in the barrel cortex.

PMID- 11200180
TI  - Acute Ginkgo biloba facilitates decision-making in a working memory task in rats.

PMID- 11200181
TI  - Brain injury: prolonged induction of transcription factors.
AB  - A specific temporal order of events at the cellular and molecular level occurs in
      response to injury to the brain. Injury-compromised neurons degenerate while
      surviving neurons undergo neuritogenesis and synaptogenesis to establish neuronal
      connectivity destroyed in the injury. Several genes, such as those coding
      cytoskeletal proteins and growth factors, have been shown to be regulated by AP-1
      and NF-kappa B transcription factors, two of the most studied DNA binding
      regulatory proteins. Our laboratory has discovered that Fos-related antigen-2
      from AP-1 transcription factor family and NF-kappa B p65 and p50 subunits are
      induced long-term (days to months) in the brain after neurotoxic, excitotoxic or
      ischemic insult. Fos-related antigen-2 is induced in neurons in several models of
      injury and its elevated expression lasts days to months, corresponding to the
      severity. The time-course of FRA-2 induction is abbreviated with less severe
      insult (terminal damage) relative to the cell death, but the induction occurs
      during the period of regeneration and repair in both models. NF-kappa B p65 is
      basally expressed in hippocampal and cortical neurons, but is elevated in
      reactive astrocytes in hippocampus and entorhinal cortex starting at two days and
      lasting at least two weeks after kainate treatment. Neurons of the hippocampus
      surviving ischemic or neurotoxic injury increase expression of NF-kappa B p50 for
      at least a week after injury, suggesting a function for p50 in neuronal survival
      and/or repair. The extended expression of these transcription factors implies a
      role in the activation of genes related to repair and regeneration, such as
      growth factors and synaptic proteins, after injury to the CNS.

PMID- 11200182
TI  - Signaling pathways mediating anti-apoptotic action of neurotrophins.
AB  - Neurotrophins promote survival and suppress apoptosis in many populations of
      neurons. Currently, phosphatidylinositol-3 kinase (PI-3K) is recognized as the
      main mediator of this protective effect. However, most of the data collected so
      far on the anti-apoptotic signaling of neurotrophins were obtained using trophic
      withdrawal paradigms. Recent data from our and other groups indicate that
      extracellular-signal-regulated kinase 1/2 (Erk 1/2) may play a critical role in
      suppressing neuronal apoptosis triggered by cellular damage. Thus, it appears
      that either Erk1/2 or PI-3K, depending on the nature of the death-inducing
      stimulus, can mediate anti-apoptotic signaling of neurotrophins. In this review,
      we discuss the contribution of Erk1/2 and PI-3K to neuroprotection by
      neurotrophins. We also present data suggesting possible mechanisms by which these
      pathways might suppress neuronal death.

PMID- 11200183
TI  - ITF mapping after drugs of abuse: pharmacological versus perceptional effects.
AB  - Analysis of inducible transcription factors (ITFs) expression is often applied to
      map drug-induced changes of neuronal activity in brain. Administration of cocaine
      and alcohol induces ITFs in a large number of brain structures. However,
      induction of ITFs in a brain region does not necessarily indicate a
      pharmacological effect of the drug in this brain region. Many of the brain
      regions could be activated by secondary effects. Perception of stimulus
      properties of the drug or locomotor effects of the drug are possible secondary
      effects. Anesthesia can block induction of ITFs by cocaine and alcohol suggesting
      that ITF expression in a majority of brain regions is more sensitive to secondary
      effects than to pharmacological effects of these drugs. In agreement with this
      hypothesis is our finding that the majority of brain regions responding with ITF
      expression to alcohol administration do not respond to voluntary alcohol self
      administration in animals. Only a few brain regions show similar ITF induction
      after both administration and self-administration of this drug. Presumably these
      brain regions could be responding to pharmacological effects of alcohol. Given
      the low resolution of invasive techniques, ITF mapping experiments will
      continually contribute to our understanding of mechanisms of drug addiction and
      alcoholism.

PMID- 11200184
TI  - Effect of opioids on Ca2+/cAMP responsive element binding protein.
AB  - Ca2+/cAMP response element binding protein (CREB) is an important factor linking
      the opioid-regulated secondary messenger systems to alterations in gene
      expression. Opioids regulate CREB level, its phosphorylation and binding to its
      corresponding response element in the promoters of several genes implicated in
      drug addiction. CREB mediates the action of opioids on the expression of several
      genes in brain regions responsible for drug-seeking behavior and manifestation of
      signs of dependence. Moreover, alterations in CREB level can effect the rewarding
      properties of morphine and regulate the self-administration of cocaine. At the
      cellular level CREB acts as convergence point for different cellular pathways.
      Opioids affect two different intracellular mediator systems: inhibitory-
      connected with cAMP, and stimulatory--involving calcium and the PKC pathway. Both
      can affect CREB but in different phases of opiate action. The presence of this
      biphasic mechanism can explain the phenomenon of the induction of some CRE
      controlled genes after both acute and chronic morphine administration. Cellular
      studies also highlight the relevance of other ATF/CREB family members which can
      affect Ca2+/cAMP response element (CRE) controlled transcription as well as other
      transcription factors which make the opioid induction longer lasting.

PMID- 11200185
TI  - Regulation of cell specific expression of calcyclin (S100A6) in nerve cells and
      other tissues.
AB  - Many of the small, acidic, calcium binding S100 proteins present in the brain
      specifically map different anatomical regions and cell types and their
      overexpression is implicated in pathological changes. Similarly to other members
      of the S100 protein family, calcyclin (S100A6) is expressed in a cell specific
      manner and is found in subpopulations of neurons and astrocytes in the brain and
      in epithelial cells and fibroblasts. In this article we review data concerning
      the cell specific expression of S100 protein genes and present experimental
      results on the regulation of the calcyclin gene. We have performed promoter
      deletion studies to locate regions within the calcyclin gene promoter responsible
      for transcriptional regulation. The results demonstrate that the 3 kb long
      calcyclin gene promoter lacks a cell specific cis-acting element and drives the
      expression of the reporter gene also in cells that do not express endogenous
      calcyclin. The expression is modulated by positive and negative elements acting
      uniformly in the four different cell lines studied. The first intron of the
      calcyclin gene was found to have an inhibitory influence on expression regardless
      of cell type. It was also shown that calcyclin expression can be induced in
      calcyclin-negative cells by treatment with 5-azacytidine suggesting the
      involvement of gene methylation in its cell specific expression. The results are
      discussed in light of the data available on the regulation of other S100 genes.

PMID- 11200186
TI  - A new CAPD battery--multiple auditory processing assessment: factor analysis and
      comparisons with SCAN.
AB  - Based on recommendations by Musiek & Chermak (1994, American Journal of
      Audiology, 3, 23-27) and ASHA (1996, American Journal of Audiology, 5(2), 41-54),
      a battery of four commonly used tests was selected and recorded for use in
      assessing school children. These tests were labeled the Multiple Auditory
      Processing Assessment (MAPA) and then administered to an initial sample of 81
      third grade children, along with the SCAN screening test for auditory processing
      disorders. Afterward, several exploratory factor analyses were performed on the
      findings, and comparisons were made between the results for the MAPA and SCAN.
      Four separate factors emerged from the four MAPA tests, which were linked closely
      to the components of central auditory processing disorders (CAPDs) defined by
      ASHA (1996, American Journal of Audiology, 5(2), 41-54). These factors were
      labeled monaural separation/closure (MSC), auditory pattern/temporal ordering,
      binaural integration, and binaural separation (BS). SCAN appears to measure two
      of these factors, MSC and BS. Use of MAPA is encouraging. Our findings suggest it
      may provide an appropriate multiple-test, CAPD battery for third grade children,
      and it meets at least some of the objectives described in the consensus document
      proposed by ASHA (1996, American Journal of Audiology, 5(2), 41-54).

PMID- 11200187
TI  - A holistic model for matching high-tech hearing aid features to elderly patients.
AB  - Successful hearing aid fittings using high-technology features for elderly
      patients require consideration of factors beyond results obtained from routine
      audiologic evaluations. A holistic hearing aid selection, fitting, and evaluation
      approach that considers patient characteristics from communication, physical,
      psychological, and social assessment domains is presented here along with a
      checklist and flowcharts for matching high-tech hearing aid features to older
      persons who are hearing aid candidates.

PMID- 11200188
TI  - Behavioral auditory assessment of young infants: methodological limitations or
      natural lack of auditory responsiveness?
AB  - The determination of auditory thresholds by means of behavioral techniques in
      young infants can be difficult. This could be the result of limitations in
      methodology, a lack of observable auditory responsiveness, or both. In the
      current study, 2- and 4-month old infants were tested under enhanced conditions
      for obtaining behavioral responses (i.e., salient auditory stimuli, reduced
      visual distractions, reinforced correct responses). A two-interval, forced-choice
      task with four intensity levels was used. Although a behavioral threshold was
      obtained for the 4-month-olds, threshold determination for the 2-month-olds
      remained elusive. In light of the current findings and previous studies of visual
      acuity of infants, these results suggest a lack of behavioral responsiveness to
      auditory stimuli for the younger infants rather than methodological limitations.
      With infants in the 2-month-old age range, clinical audiologists should expect
      few behavioral responses to auditory stimuli at intensity levels below those that
      elicit startle responses.

PMID- 11200189
TI  - Insert earphone depth and the occlusion effect.
AB  - Twenty individuals were tested to determine the occlusion effect caused by
      supraaural earphones and by insert earphones with shallow and deep insertion of
      its foam eartip. The bone-conduction oscillator was placed both on the forehead
      and the mastoid. It was concluded that using deeply inserted earphones is the
      most practical way in which to carry out clinical bone-conduction measurements.

PMID- 11200190
TI  - An investigation of maternal stress after neonatal hearing screening.
AB  - An investigation was undertaken to determine whether mothers whose infants failed
      a newborn hearing screening (MWIF) had significantly more stress and were
      consequently at risk for dysfunctional attachment than those mothers whose
      infants passed a newborn hearing screening (MWIP). The Parenting Stress Index
      (PSI; Abidin, 1995), a screening and diagnostic assessment questionnaire designed
      to measure the relative magnitude of stress in a parent-child dyad, was used.
      Twenty MWIP and 20 MWIF participated. The PSI was administered through a
      telephone interview approximately 1 month after participants' discharge while
      their infants were between their fourth and fifth week of life. In the case of
      MWIF, the interview occurred before their infant's hearing retest. No significant
      differences in Total Stress, Life Stress, Child Domain, and Parent Domain
      subscale raw scores of the PSI were found between MWIP and MWIF (p > .05). An
      examination of the individual PSI profiles of all participants for "high" and
      "low" normative percentile scores (i.e., percentile scores > or = 90th percentile
      and percentile scores < or = 0 percentile for the former and latter,
      respectively) revealed that the incidence of high scale/subscale percentile
      scores was essentially equivalent between groups. MWIP, however, displayed lower
      scale/subscale percentile scores. The results of the study suggest that those
      mothers whose infants receive a refer outcome after a newborn hearing screening
      demonstrate equivalent stress levels as those mothers whose infants received a
      pass.

PMID- 11200191
TI  - Outcome of newborn hearing screening by ABR compared with four different DPOAE
      pass criteria.
AB  - The purpose of this study is to compare the effectiveness and utility of
      distortion product otoacoustic emission (DPOAE) and auditory brain stem response
      (ABR) testing as screening methodologies suitable for universal application at a
      large birthing hospital. Five hundred sixty-nine neonates (1184 ears) without
      risk indicators for hearing loss underwent DPOAE and ABR screening before
      hospital discharge at birth. All ears (100%) passed the ABR screening. DPOAE
      results were categorized on the basis of the number of frequencies at which
      emissions were obtained as well as presence versus absence of a replicated
      response at each test frequency. Pass and refer rates varied widely, on the basis
      of whether the presence of DPOAE response at 2000 Hz or replication were
      required. With the most stringent criteria, only 64.44% of ears passed, whereas
      with the least stringent criteria 88.94% passed. Given that 100% of ears passed
      according to the gold standard of the ABR screening, these results indicate false
      positive rates ranging from 11% to 35% by DPOAE screening. This discrepancy in
      pass and refer rates when various criteria are applied indicates the need for
      standardization and further comparison of appropriate pass criteria for newborn
      hearing screening programs.

PMID- 11200192
TI  - Speech and language screening for audiologists.
AB  - Speech and language screening by audiologists is not new, although few
      audiologists screen speech and language, which should be an integral component of
      the audiological evaluation. This article considers ASHA's views about speech and
      language screening by audiologists, screening tests available to audiologists,
      and the training of audiologists to screen speech and language.

PMID- 11200193
TI  - Central auditory processes and test measures: ASHA 1996 revisited.
AB  - The theoretical issues surrounding central auditory processing disorders (CAPD)
      are reviewed here, especially with reference to the central auditory behavioral
      processes and the auditory test measures as prescribed in the ASHA (1996,
      American Journal of Audiology, 5(2), 41-54) statement on CAPD. A simplified
      nomenclature is recommended that directly relates process and test measure to
      facilitate the diagnostic process in CAPD. This new terminology closely follows
      the ASHA (1996, American Journal of Audiology, 5(2), 41-54) document, but
      provides some refinement based on recent research in CAPD. To support this
      recommendation, a confirmatory factor analysis (CFA) was applied to the findings
      of Domitz and Schow (2000, American Journal of Audiology), who proposed use of a
      battery of CAPD tests, the Multiple Auditory Processing Assessment (MAPA) for
      testing school children. The CFA was found to reinforce the four-factor model,
      which clearly emerged in the exploratory factor analysis of Domitz and Schow. The
      model was found to be reasonably consistent even when subtests from the SCAN were
      included in the analysis. Refinement and revision of ASHA (1996, American Journal
      of Audiology, 5(2), 41-54) is recommended to facilitate diagnosis,
      subclassification, and intervention for CAPD.

PMID- 11200194
TI  - Celebrating a decade of evaluation and treatment: the University of Maryland
      Tinnitus & Hyperacusis Center.
AB  - The University of Maryland Tinnitus & Hyperacusis Center in Baltimore was the
      first center in the United States dedicated to the evaluation and treatment of
      tinnitus and hyperacusis patients implementing an habituation-based protocol that
      has become known internationally as Tinnitus Retraining Therapy (TRT). A crucial
      feature of the model is the postulate that a number of systems in the brain are
      involved in the emergence of tinnitus. The cochlea and auditory periphery play
      only a secondary role. To facilitate the goal of habituation of the tinnitus
      signal, TRT implements both directive counseling to neutralize the negative
      emotional associations toward the tinnitus, and sound therapy to interfere with
      the signal. As an outgrowth of the work with tinnitus, the evaluation and
      treatment of hyperacusis has emerged as an increasingly important part of our
      program. This report describes the unique facility, staff, and services of the
      Center as we celebrate a decade of research and clinical management dedicated to
      the scientific understanding of tinnitus and hyperacusis.

PMID- 11200196
TI  - List equivalency and test-retest reliability of the Speech in Noise test.
AB  - The Speech in Noise (SIN) test consists of a series of Institute of Electrical
      and Electronic Engineers sentences presented in a background of four-talker
      babble at two presentation levels (83 and 53 dB SPL) and four signal-to-noise
      ratios (SNR) (15, 10, 5, and 0 dB). In this study, the nine lists were tested for
      equivalency and the test-retest reliability was determined. Twenty listeners with
      normal hearing and 20 listeners with sloping sensorineural hearing losses served
      as subjects. Five sentences were presented at each SNR at each level, and five
      key words in each sentence were scored (100 key words per presentation level).
      Each key word was scored as correct or incorrect, with errors of plurality scored
      as half-correct words. For percent-correct scores, Lists 1, 2, and 9 and Lists 3,
      4, and 5 were found to be equivalent for listeners with normal hearing. For both
      groups of listeners, the test-retest correlations were high, and the critical
      differences appropriate for sentence material were 10 to 16% at a .95 level of
      confidence. Because of floor and ceiling effects across the different lists, many
      subjects with normal hearing did not score as low as the 50% level, and many
      subjects with hearing loss did not score as high as 50%. Suggestions are offered
      for alternate scoring in order to obtain a SNR for 50% performance. Future
      versions of this test should be designed with improved list equivalency and 50%
      performance capability.

PMID- 11200195
TI  - Outcomes analysis for hearing conservation programs.
AB  - In health care, an increasing interest in accountability for outcomes, proof of
      quality care, and cost effectiveness is forcing many practitioners, including
      audiologists, in the direction of using outcomes analysis to provide proof of
      performance in their practices. Critical to the conduct of outcomes analysis are
      the selection of valid outcomes metrics and application of appropriate
      statistical processes. Modeling of clinical protocols is a useful exercise for
      developing outcomes data and data management standards. The authors describe the
      implications for wider use of outcomes modeling once the Health Insurance
      Portability and Accountability Act (HIPAA) administrative simplification law is
      implemented. This legislation will set up a wholly new administrative data set
      that has strong potential to provide outcomes metrics to a variety of Audiology
      practices. The modeling exercise described here was originally intended to derive
      assessment outcomes for evaluating hearing conservation program effectiveness in
      military populations from an administrative database implemented within the
      Military Health System starting in 1997. The outcomes modelers, however, soon
      realized the broader applicability of modeling techniques for other special
      populations and Audiology practices, particularly with the oncoming startup of
      HIPAA legislative mandates. The modeling exercise demonstrates a process of
      structuring standard health-care codes to produce outcomes data for epidemiologic
      and cost analyses, thereby providing better information to guide health-care
      practices toward improving quality and cost effectiveness. This information in
      time series should also provide a record of continuous quality improvement. The
      authors present a general hearing surveillance protocol for evaluating
      occupational hearing loss. The protocol is used as a specific instance to
      demonstrate the shaping of an outcomes metrics model. This same process can be
      applied more generally when used to model outcomes data from other audiology
      practices. Implementation of the administrative data model described here began
      at more than 400 Department of Defense (DOD) medical treatment facilities
      worldwide as of October 1, 1999. The exercise of developing similar outcomes
      metrics for newborn hearing screening programs, school hearing conservation
      programs, and other clinical and rehabilitative audiology practices in the
      civilian sector remains to be done.

PMID- 11200197
TI  - Social work practice and the Internet: Part 2--Online discharge planning and
      telemedicine.

PMID- 11200198
TI  - Preparing for a JCAHO survey: Part 6.

PMID- 11200199
TI  - Raising the bar: improving standards for social work practice in long-term care-
      Part 2.

PMID- 11200200
TI  - Social work home visits: impact on recidivism and health care costs.

PMID- 11200201
TI  - Climate change and stratospheric ozone depletion. Early effects on our health in
      Europe.

PMID- 11200202
TI  - Importance of positioning and technical factors in anatomic localization of
      sporting injuries in scintigraphic imaging.
AB  - Sports medicine is becoming increasingly important as more people take up
      exercise for health and well-being. It is adding to the spectrum of acute and
      chronic injuries that have traditionally been seen in elite or professional
      athletes. Because of its high sensitivity and lesion contrast, bone scintigraphy
      has traditionally played a key role in the detection of such injuries. This role
      has been reduced in recent times by the increased use of magnetic resonance
      imaging (MRI), which has functional capability, high-contrast resolution, and
      high-spatial resolution. Bone scintigraphy has the capability of detecting early
      cortical ligament avulsion and enthesopathic disease before the onset of edema or
      changes in bone marrow that are detected by MRI. If this capability is added to
      more precise anatomic localization of lesions, we may see a resurgence in its use
      in sports medicine. A number of techniques are presented in this article,
      encompassing positioning, special views, and tomographic reconstructions, that
      can significantly improve the accuracy of localization of scintigraphic
      abnormalities with reference to anatomic models or sources of cross-sectional
      anatomy.

PMID- 11200203
TI  - Quantitative studies of bone with the use of 18F-fluoride and 99mTc-methylene
      diphosphonate.
AB  - This article discusses methods for quantifying bone turnover based on tracer
      kinetic studies of the short-lived radiopharmaceuticals 99mTc-MDP and 18F
      fluoride. Measurements of skeletal clearance obtained by using these tracers
      reflect the combined effects of skeletal blood flow and osteoblastic activity.
      The pharmacokinetics of each tracer is described, together with some of the
      quantitative tests of skeletal function that have been described in the
      literature. The physiologic interpretation of quantitative measurements of bone
      obtained with the use of short half-life radionuclides is discussed, and the
      advantages and limitations of 99mTc-MDP and 18F-fluoride are compared and
      contrasted. Currently, 18F-fluoride dynamic positron emission tomography (PET) is
      the technique of choice for physiologically precise quantitative studies of bone.
      However, comparable data could probably be obtained by using 99mTc-MDP if methods
      for single photon emission computed tomography (SPECT) quantitation were
      improved.

PMID- 11200204
TI  - The role of single photon emission computed tomography in bone imaging.
AB  - Single photon emission computed tomography (SPECT) of the bone is the second most
      frequently performed SPECT examination in routine nuclear medicine practice, with
      cardiac SPECT being the most frequent. Compared with planar scintigraphy, SPECT
      increases image contrast and improves lesion detection and localization. Studies
      have documented the unique diagnostic information provided by SPECT, particularly
      for avascular necrosis of the femoral head, in patients with back pain, for the
      differential diagnosis between malignant and benign spinal lesions, in the
      detection of metastatic cancer in the spine, for the diagnosis of
      temporomandibular joint internal derangement, and for the evaluation of acute and
      chronic knee pain. Although less rigorously documented, SPECT is being
      increasingly used in all types of situations that demand more precise anatomic
      localization of abnormal tracer uptake. The effectiveness of bone SPECT increases
      with the selection of the proper collimator, which allows one to acquire adequate
      counts and minimize the patient-to-detector distance. Low-energy, ultrahigh
      resolution or high-resolution collimation is preferred over all-purpose
      collimators. Multihead gamma cameras can increase the counts obtained or shorten
      acquisition time, making SPECT acquisitions more practical in busy departments
      and also increasing image quality compared with single-head cameras. Iterative
      reconstruction, with the use of ordered subsets estimation maximization, provides
      better quality images than classical filtered back projection algorithms. Three
      dimensional image analysis often aids lesion localization.

PMID- 11200205
TI  - The role of positron emission tomography in skeletal disease.
AB  - The role of positron emission tomography (PET) in the evaluation and management
      of skeletal disorders is increasing. A number of reports are available in both
      benign and malignant disease with a variety of tracers. The bone agent 18F
      fluoride can be used to evaluate bone metastases both qualitatively and, for a
      number of focal and systemic skeletal disorders, quantitatively. 18
      Fluorodeoxyglucose is used as a tumor agent in both primary and metastatic bone
      and bone marrow malignancies; its use has also been described in the evaluation
      of infection within the skeleton. A possible role for the use of the hypoxia
      selective tracer 18F-fluoromisonidazole in skeletal infection also exists. This
      article summarizes the current role of PET in the skeleton with regard to these
      tracers and diseases.

PMID- 11200206
TI  - The palliative management of skeletal metastases in prostate cancer: use of bone
      seeking radionuclides and bisphosphonates.
AB  - In prostate cancer, the development of skeletal metastases is associated with a
      significant increase in morbidity, mainly because of severe bone pain, which
      eventually becomes refractory to conventional analgesia. Androgen ablation is the
      treatment of choice, but the majority of patients relapse within 2 to 3 years
      from initiation of treatment. After failure of hormone therapy, external-beam
      irradiation therapy is effective in the palliation of pain, but radionuclides
      represent an attractive and cost-effective alternative. Strontium 89 is currently
      the most commonly used radionuclide in the palliative management of prostate
      cancer metastatic to the skeleton. The rationale for the use of bisphosphonates
      in metastatic prostate cancer is not immediately obvious, given the predominantly
      osteoblastic nature of the metastatic process. The clinical use of these agents
      rests on a number of basic and clinical observations that provide ample evidence
      that, in prostate cancer, the metastatic process is associated with increased
      bone resorption. Evidence regarding the beneficial effects of bisphosphonates in
      reducing morbidity from metastatic prostate cancer is reasonably solid, although
      the choice of optimal bisphosphonate, mode of administration, dose, and duration
      of treatment must be determined in large, controlled studies before their
      widespread clinical use can be advocated. Available therapeutic modalities that
      use either radionuclides or bisphosphonates can effectively and safely be used in
      the palliative management of metastatic prostate cancer. Neither radionuclides
      nor bisphosphonates have been shown to prolong survival, but the potential of
      both agents to beneficially alter the metastatic process in prostate cancer is
      intriguing.

PMID- 11200207
TI  - Bone densitometry and the diagnosis of osteoporosis.
AB  - Over the past decade, bone density scanning has come to be seen as an essential
      part of the evaluation of patients at risk of osteoporosis. Although dual x-ray
      absorptiometry (DXA) is the technique most associated with the recent growth in
      bone densitometry, several innovative devices for performing measurements at
      sites in the peripheral skeleton are also available. This article examines the
      question of whether there is any one method or measurement site that performs
      better than all the others at identifying patients at risk of fracture. Given
      that it is essential to make greater use of the small, low-cost peripheral
      devices if the many millions of women most at risk are to be identified and
      treated, what approaches to the interpretation of bone density scans can be
      adopted to ensure the greatest degree of consistency among different methods?
      Finally, does it matter if the imperfect correlation among different types of
      measurement results in different patients being selected for treatment on the
      basis of different techniques?

PMID- 11200208
TI  - Cold vertebrae on bone scintigraphy.

PMID- 11200209
TI  - False-positive uptake of 18F-fluorodeoxyglucose in the hilar region and
      mediastinum.

PMID- 11200210
TI  - Community-based health practices and their challenges in the future.

PMID- 11200211
TI  - Knowledge and perception of oral health promotion in schools among dental nurses
      in Sarawak, Malaysia.
AB  - In recent years, the concept of a Health-Promoting School has received much
      interest. In Malaysia, dental nurses are ideally placed to play a lead role in
      promoting Oral Health within the school setting. This study aims to provide
      information on the knowledge, perception and perceived role of Oral Health
      Promotion in schools, among dental nurses. A postal questionnaire was used to
      measure dental nurses' knowledge, perception and perceived role of Oral Health
      Promotion. The majority (60%) of dental nurses had good knowledge of Oral Health
      Promotion. Generally, they perceived that they play an important role in
      promoting Oral Health in schools. However, a sizeable proportion (25%) did not
      think they had a role to play in working together with school authorities to
      provide children with healthy food choices in school canteens. The majority (60%)
      of dental nurses did not perceive Oral Health Promotion to be important as a
      whole. They had a good perception of the concepts: it supports behaviour change,
      it has appropriate goals, it integrates oral health and general health and
      relieves anxiety. However, they had a poorer perception of the concepts; diverse
      educational approaches, participation, focus on prevention, early intervention,
      "spread of effect" of dental health education and "make healthier choices the
      easier choices". Years of service was not significantly associated with knowledge
      and perception of Oral Health Promotion. Dental nurses should be reoriented
      towards a more holistic practice of Oral Health Promotion. Workshops that invite
      active participation from dental nurses should be conducted to equip them with
      the necessary knowledge and skills.

PMID- 11200212
TI  - Knowledge, attitude and practice of smoking among university students of allied
      health sciences in Japan.
AB  - A study was conducted to determine the knowledge, attitude and practice (KAP) of
      cigarette smoking among freshman students of Tokyo Metropolitan University of
      Health Sciences. Students were categorized as 'ever-smoker' or 'nonsmoker'. 18.3%
      of the 356 subjects were categorized as 'ever-smoker'. The two categories were
      then compared to determine significant differences in health knowledge, attitudes
      towards health and smoking, smoking perceptions and preferences, knowledge on the
      economic impact of tobacco and attitudes towards tobacco control measures. In
      most cases, significant differences were found between the two groups. However,
      concerning knowledge on the economic impact of tobacco, the majority of both ever
      smokers and nonsmokers had poor knowledge. Increased tobacco control education
      and related efforts are needed as is further research in determining the factors
      or influences that shape the significant differences found. Such information will
      be invaluable in formulating appropriate tobacco control measures for the future.

PMID- 11200213
TI  - A comparative study of rural clinics in remote islands and inland areas.
AB  - The social and professional isolation of physicians remains an important issue in
      rural areas. However, few studies have investigated the involvement of geographic
      factors in the isolation. This study investigates rural public clinics in inland
      and remote island locations and attempts to objectively compare the isolation of
      these physicians. A mailed questionnaire was sent to rural clinics where graduate
      physicians from Jichi Medical School were working in 1994 and 1995. Among the 198
      clinics with one or more full-time physicians, 185 (93 percent) responded to the
      inquiry. Geographic and demographic factors of the communities were compared
      between 43 clinics located in remote islands and the other 142 rural inland
      clinics. Rural clinics in remote islands have smaller subject populations, fewer
      part-time physicians, a longer journey to the nearest city, and a longer distance
      and travel time to the base hospital than rural inland clinics. Physicians in
      remote island clinics had less medical training and are more isolated than other
      physicians. More than half of the clinic physicians in remote islands have no
      regular training schedule, in contrast to less than a quarter of the inland
      clinic physicians. Almost all clinics (97.7%) in remote islands do not have a
      part-time physician, whereas about 20 percent of the rural inland clinics do.
      Physicians in remote island clinics are more socially and professionally isolated
      than those in inland clinics. Strategies to reduce these problems should be given
      priority in rural health policy and measures tailored to rural clinics in remote
      islands.

PMID- 11200214
TI  - Estimation of salt intake and recommendation for iodine content in iodized salt
      in Mongolia.
AB  - In 1996, the Mongolian Government pledged to eliminate iodine deficiency
      disorders by 2001 using salt iodization as its primary strategy. Iodine content
      in salt was set at 50 +/- 10 PPM based on an assumption of 5 g of daily salt
      intake. In 1998, the authors suspected that salt intake was more than 5 g and
      that pregnant women consumed more salt than non-pregnant women. Over 1,600 adults
      of both sexes were studied in five provinces. In this study we estimated salt
      intake based on urinary excretion of sodium and creatinine. A formula was used to
      calculate salt intake from excreted volumes of sodium and creatinine. Average
      values for pregnant women, non-pregnant women, and men, were found to be 15.6 g
      (n = 499), 12.6 g (n = 598), and 14.6 g (n = 571), respectively. We concluded
      that appropriate iodine content in salt should range from 20 to 40 PPM. It is
      recommended that health education regarding proper levels of salt intake be
      carried out with the general public, with emphasis on pregnant women.

PMID- 11200215
TI  - The content and efficacy of environmental public health journal homepages.
AB  - The information on several environmental public health journal homepages has been
      assessed for its quality and quantity, using selected key criteria. These
      criteria included the extent of text available, the ability to search the
      website, the table of contents free via email, and the presence of hyper-links. A
      high degree of variability is seen, with services and facilities offered ranging
      from none to the entire journal available for no fee. The journal homepages that
      are the most comprehensive are those that are associated with major institutions
      and hence financed by contributions from their members or public money, i.e. the
      British Medical Association, the World Health Organisation and the US National
      Institute of Environmental Health Sciences. The journal homepages associated with
      these institutions offered full text of both current and archived issues as well
      as additions such as the ability to search other sites, web links, and in some
      cases hyper-linked references and information on related articles. The provision
      of text on the Internet should be an essential aim for all journal Homepages, to
      ensure fast and effective conveyance of information to health professionals.

PMID- 11200216
TI  - A study on the effects of discotheque noise on the hearing of young patrons.
AB  - This study aims to find out whether discotheque music affects hearing by exposing
      48 young volunteers to discotheque music in discotheque sessions at two
      discotheques and evaluating their degree of auditory fatigue after exposure.
      Questionnaire interviews revealed that the majority of them visit discotheques
      regularly. A higher proportion of those attending the louder discotheque found
      the music too loud. The prevalence of tinnitus is also higher in those attending
      the noisier discotheque. The degree of threshold shifts, however, does not appear
      to be related to the volume of music or auditory fatigue. The noise level
      exposure was estimated to be 91 dBA to 98 dBA for weekly exposure and 85 dBA to
      92 dBA for monthly exposure. To avoid hearing loss, patrons should avoid loud
      discotheques, or cut down their frequency of visits if they choose to continue
      patronising them.

PMID- 11200217
TI  - Temporary overseas migration of rural Thai men: perception of changes in health
      and social interactions after returning to their communities.
AB  - A cross-sectional study was conducted to assess the perceived health effects of
      temporary overseas migration on rural Thai men and to evaluate the effects of
      financial gain on their social interactions with others. Houses in five villages
      in Khonkaen, northeastern Thailand were systematically visited and one returned
      overseas migrant per household was interviewed. One hundred and sixty one men
      participated in the study. Half of the respondents (50%) were manual workers.
      While overseas, 32% reported adverse effects of migration on their psychological
      health. Only 19% reported one or more physically ill while overseas. Their
      contribution to their communities increased. Inability to improve their financial
      status from overseas work is likely to have negative effects on the migrants'
      interaction with friends rather than their wives, families or relatives. The
      effects of migration on health are unlikely to persist after migrants return to
      their home communities. Overseas migration provides indirect health benefits
      through improvement of community facilities.

PMID- 11200218
TI  - Human immunodeficiency virus and hepatitis C virus infections among patients
      attending sexually transmitted disease clinics, Regional 2, Thailand.
AB  - A cross-sectional study of 400 patients attending sexually transmitted disease
      (STD) clinics at The Venereal Diseases and AIDS Centers, Regional 2, Thailand,
      was conducted from January to December 1996 in order to investigate the antibody
      prevalence to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and
      to describe some epidemiological characteristics among HIV and HCV co-infected
      individuals. The studied patients were interviewed and their blood specimens were
      collected for determining anti-HIV and anti-HCV antibodies. The results revealed
      that the prevalence of anti-HIV among studied patients was 25%, while 7.5% were
      positive for anti-HCV. The positivity of both antibodies present in the same
      individuals was 3.3% (13/400 cases). The highest prevalences of anti-HIV, anti
      HCV and both antibodies were found in studied patients aged 20 years or less.
      Patients with primary education, or lower, had relatively higher prevalence of
      anti-HIV and/or anti-HCV than those with higher level education. A relatively
      higher prevalence was found among commercial sex workers and labourers. Among 13
      HIV and HCV co-infected individuals, there were four cases who had histories of
      sexual contact without condom use, but no history of parenteral contact. The rest
      (9/13) had histories of both parenteral contact and sexual contact without condom
      use.

PMID- 11200219
TI  - Suicide in Fiji: a review of the literature.
AB  - Clinical experience, public perceptions and research have indicated that the
      Indian community have been overrepresented in suicide statistics in Fiji. A
      computerised Medline search of the literature back to 1966 on suicide and
      ethnicity in Fiji using the search words SUICIDE and FIJI was performed
      supplemented by other relevant research and published material. A consistent
      pattern of higher suicide rates for the Indian population in Fiji compared to the
      indigenous Fijian population was found. Factors including religious and cultural
      beliefs, higher suicide risk in rural areas, use of toxic biocides as a method of
      suicide and relatively high suicide rates in young Indian women are discussed.
      Evidence for Indian vulnerability to suicide in Fiji has to date been based upon
      uncontrolled, descriptive observations. Helpful directions for future research
      include studying postulated vulnerability variables for suicide in the Indian
      community.

PMID- 11200220
TI  - A new light on the community health fund--effective political support for a
      community essential drug project in Vietnam.
AB  - This report sheds new light on the development of a community health fund through
      the implementation of a community essential drug project, and its impact on the
      improvement of primary health care at the community level. The experience of
      community drug funds in Vietnam, supported by a strong government commitment, in
      which full delegation of authority on the management of drugs and finances is
      given to the community along with a measure for tax exemptions for drug fund
      revenues, provides a significant example of an autonomous community with active
      participation of people and effective resource mobilization, that is leading to
      the improvement of community health.

PMID- 11200221
TI  - Phylogenetic analyses and comparative genomics of vitamin B6 (pyridoxine) and
      pyridoxal phosphate biosynthesis pathways.
AB  - Vitamin B6 in its active form pyridoxal phosphate is an essential coenzyme of
      many diverse enzymes. Biochemistry, enzymology and genetics of de novo vitamin B6
      biosynthesis have been primarily investigated in Escherichia coli. Database
      searches revealed that the key enzymes involved in ring closure of the aromatic
      pyridoxin ring (PdxA; PdxJ) are present mainly in genomes of bacteria
      constituting the gamma subdivision of proteobacteria. The distribution of DXS, a
      transketolase-like enzyme involved in vitamin B6 biosynthesis as well as in
      thiamine and isoprenoid biosynthesis and the distribution of vitamin B6 modifying
      enzymes (PdxH: oxidase; PdxK: kinase) was also analyzed. These enzymes are also
      present in the genomes of animals. Two recent papers (Ehrenshaft et al., 1999,
      Proc. Natl. Acad. Sci. USA. 96: 9374-9378; Osmani et al., 1999, J. Biol. Chem.
      274: 23565-23569) show the involvement of an extremely conserved protein (a
      member of the UPF0019 or SNZ family) found in all three domains of life
      (bacteria, archaea, eukarya) in an alternative vitamin B6 biosynthesis pathway.
      Members of this family were previously identified as a stationary phase inducible
      protein in yeast, as an ethylene responsible protein in plants and in a marine
      sponge, as a singlet oxygen resistance protein in Cercospora nicotianae and as a
      cumene hydroperoxide and H2O2 inducible protein in Bacillus subtilis. In yeast,
      the SNZ protein interacts with another protein called SNO which also represents a
      member of a highly conserved protein family (called UPF0030 or SNO family).
      Phylogenetic trees for the DXS, PdxA, PdxJ, PdxH, PdxK, SNZ and SNO protein
      families are presented and possible implications of the two different vitamin B6
      biosynthesis pathways in cellular metabolism are discussed. A radically different
      view of bacterial evolution (Gupta, 2000, Crit. Rev. Microbiol. 26: 111-131)
      which proposes a linear rather than a treelike evolutionary relationship between
      procaryotic species indicates that the gamma subdivision of proteobacteria
      represents the most recently evolved bacterial lineage. This proposal might help
      to explain why the PdxA/PdxJ pathway is largely restricted to this subdivision.

PMID- 11200222
TI  - Phyloproteomics: species identification of Enterobacteriaceae using matrix
      assisted laser desorption/ionization time-of-flight mass spectrometry.
AB  - To evaluate matrix-assisted laser desorption/ionization time-of-flight mass
      spectrometry (MALDI-ToF MS) as a tool for rapid identification of common clinical
      bacterial isolates, we analyzed 25 carefully selected isolates of pathogenic
      Escherichia coli (E. coli) and additional Enterobacteriaceae members. Organisms
      were prepared according to clinical microbiological protocols and analyzed with
      minimal additional processing. Spectra were reproducible from preparation to
      preparation and comprised 40-100 peaks primarily representing intracellular
      proteins with masses up to 25 kDa. Spectra of 14 genetically diverse bacteremic
      isolates of E. coli were compared with isolates representing other genera within
      the Enterobacteriaceae family. Using a new spectrum comparison algorithm, E. coli
      isolates were closely related to each other and were readily distinguishable from
      other Enterobacteriaceae, including Salmonella and Shigella. Presently, the
      methodology permits the analysis of 40 unknown isolates per hour per instrument.
      These results suggest that MALDI-ToF MS offers a rapid and reliable approach for
      performing phyloproteomics i.e., identification of unknown bacterial isolates
      based on similarities within protein biomarker databases.

PMID- 11200223
TI  - Organisation and evolution of the tol-pal gene cluster.
AB  - The genomic context and phylogenetic distribution of the tol-pal gene cluster and
      homologues to its various components have been investigated. The structure of
      this operon is well conserved across the gram negative bacteria, and the machine
      encoded by these genes probably evolved with the appearance of gram negative
      bacteria. Since the evolutionary appearance of the operon some species appear to
      have lost the genes. These bacteria seem to fall into two classes, namely
      obligate intracellular parasites and bacteria that produce large numbers of outer
      membrane vesicles. The evolution of the alphabeta and gamma proteobacteria was
      accompanied by the association of an additional gene (ybgC) with the operon.
      Several coincidences of genomic context argue for an important role of the tol
      pal operon in cell envelope maintenance. Genes homologous to tolQ and tolR proved
      to be very widespread being found throughout the eubacteria, and one example in
      the archea, this distribution argues for an ancient origin of these genes. The
      genomic context of these genes often suggests a role in micronutrient uptake.
      Interestingly in all the cases examined the tolQ and tolR genes or their
      homologues appear to be present as a pair, with a potential for a tight
      translational regulation.

PMID- 11200224
TI  - Reduction of wobble-position GC bases in Corynebacteria genes and enhancement of
      PCR and heterologous expression.
AB  - Corynebacteria codon usage exhibits an overall GC content of 67%, and a wobble
      position GC content of 88%. Escherichia coli, on the other hand has an overall GC
      content of 51%, and a wobble-position GC content of 55%. The high GC content of
      Corynebacteria genes results in an unfavorable codon preference for heterologous
      expression, and can present difficulties for polymerase-based manipulations due
      to secondary-structure effects. Since these characteristics are due primarily to
      base composition at the wobble-position, synthetic genes can, in principle, be
      designed to eliminate these problems and retain the wild-type amino acid
      sequence. Such genes would obviate the need for special additives or bases during
      in vitro polymerase-based manipulation and mutant host strains containing
      uncommon tRNA's for heterologous expression. We have evaluated synthetic genes
      with reduced wobble-position G/C content using two variants of the enzyme 2,5
      diketo-D-gluconic acid reductase (2,5-DKGR A and B) from Corynebacterium. The
      wild-type genes are refractory to polymerase-based manipulations and exhibit poor
      heterologous expression in enteric bacteria. The results indicate that a subset
      of codons for five amino acids (alanine, arginine, glutamate, glycine and valine)
      contribute the greatest contribution to reduction in G/C content at the wobble
      position. Furthermore, changes in codons for two amino acids (leucine and
      proline) enhance bias for expression in enteric bacteria without affecting the
      overall G/C content. The synthetic genes are readily amplified using polymerase
      based methodologies, and exhibit high levels of heterologous expression in E.
      coli.

PMID- 11200225
TI  - Regulation of the early steps of 3-phenylpropionate catabolism in Escherichia
      coli.
AB  - Microbial catabolism of phenylpropanoid compounds plays a key role in the
      degradation of aromatic molecules originating from the degradation of proteins
      and plant constituents. In this study, the regulation of the early steps in the
      utilisation of 3-phenylpropionate, a phenylpropanoid compound, was investigated.
      Expression of the hcaA gene product, which is involved in 3-phenylpropionate
      catabolism in Escherichia coli, was positively regulated by HcaR, a regulatory
      protein similar to members of the LysR regulators family. Remarkably, the
      expression of hcaA in the presence of 3-phenylpropionate was sharply and
      transiently induced at the end of the exponential growth phase. This occurred in
      a rpoS-independent manner. This transient induction was also mediated by HcaR.
      The expression of this positive regulator is negatively autoregulated, as for
      other members of the LysR family. The expression of hcaR is strongly repressed in
      the presence of glucose. Glucose-dependent repression of hcaR expression could
      only be partially overcome by adding exogenous cAMP.

PMID- 11200226
TI  - Biosynthesis of K88 fimbriae in Escherichia coli: interaction of tip-subunit FaeC
      with the periplasmic chaperone FaeE and the outer membrane usher FaeD.
AB  - K88 fimbriae are ordered polymeric protein structures at the surface of
      enterotoxigenic Escherichia coli cells. Their production and assembly requires a
      molecular chaperone located in the periplasm (FaeE) and a molecular usher located
      in the outer membrane (FaeD). FaeC is the tip component of the K88 fimbriae. We
      studied the expression of the subcloned faeC gene, the subcellular localization
      of FaeC and its interaction with the chaperone and the outer membrane usher. In
      the absence of the chaperone or the usher, FaeC could not be detected in E. coli
      cells harbouring the faeC gene and its ribosome binding site under contol of the
      IPTG inducible lpp/lac promoter/operator. The expression of FaeC was detectable
      in the presence of chaperone FaeE, but a direct interaction between the chaperone
      and FaeC was not found. The expression of FaeC was also detectable in cells co
      expressing the outer membrane usher FaeD. Overexpression of FaeC after changing
      the faeC ribosome binding site appeared to induce lethality. Expression of
      subcloned FaeC in the absence of FaeE or FaeD could be detected when faeC was
      cloned under the tight control of the ara promoter/operator and when lethality
      induction was avoided. The direct interaction of FaeC with outer membranes
      containing the usher FaeD was studied by cell fractionation, isopycnic sucrose
      density gradient centrifugation, SDS-PAGE and immunoblotting. FaeC was found to
      bind to outer membranes containing FaeD or a FaeD-PhoA hybrid construct
      containing 215 amino-terminal residues of FaeD. This binding was not observed
      when control outer membranes without FaeD were used. No other K88 specific
      proteins were required for this interaction. The direct interaction between FaeC
      and FaeD in the outer membranes was shown by affinity blotting experiments. FaeE
      was not required for this interaction. Together these data indicate that the
      minor fimbrial subunit FaeC, unlike FaeG, H and F, does not have a strong
      interaction with the chaperone FaeE in the E. coli periplasm, but directly binds
      to the outer membrane molecular usher FaeD.

PMID- 11200227
TI  - Comparative genomics of prokaryotic GTP-binding proteins (the Era, Obg, EngA,
      ThdF (TrmE), YchF and YihA families) and their relationship to eukaryotic GTP
      binding proteins (the DRG, ARF, RAB, RAN, RAS and RHO families).
AB  - Several GTP-binding proteins with poorly defined functions were previously
      identified in Escherichia coli (i.e. Era, ThdF (TrmE)), Bacillus subtilis (i.e.
      Obg) and Neisseria gonorrhoeae (i.e. EngA). In these species, every individual
      protein is encoded by an essential gene. BLAST searches were used to detect
      orthologs in genomes of various organisms. Alignments of orthologous sequences
      allowed the construction of phylogenetic trees and the definition of protein
      families. The BLAST searches also resulted in the identification of two
      additional families, the YchF and YihA families, named after the ychF and yihA
      genes of E. coli. Most families are not present in archaeal genomes, but
      representatives of each family were also detected in eukaryotic genomes. Only
      representatives of the YchF family are present in every genome sequenced to date,
      suggesting that YchF-like proteins might be involved in a fundamental life
      process. The GTP1/DRG family consisting of eukaryotic and archaeal proteins is
      related to the YchF family of GTP-binding proteins. The relationship of the six
      prokaryotic families of GTP-binding proteins and the GTP1/DRG family to
      eukaryotic GTPase families was also investigated: With the exception of the ARF
      family, a clear separation of the six prokaryotic families and the GTP1/DRG
      family with respect to eukaryotic (RAB, RAN, RAS and RHO) GTPases was observed.

PMID- 11200228
TI  - Biology of Treponema pallidum: correlation of functional activities with genome
      sequence data.
AB  - Aspects of the biology of T. pallidum subsp. pallidum, the agent of syphilis, are
      examined in the context of a century of experimental studies and the recently
      determined genome sequence. T. pallidum and a group of closely related pathogenic
      spirochetes have evolved to become highly invasive, persistent pathogens with
      little toxigenic activity and an inability to survive outside the mammalian host.
      Analysis of the genome sequence confirms morphologic studies indicating the lack
      of lipopolysaccharide and lipid biosynthesis mechanisms, as well as a paucity of
      outer membrane protein candidates. The metabolic capabilities and adaptability of
      T. pallidum are minimal, and this relative deficiency is reflected by the absence
      of many pathways, including the tricarboxylic acid cycle, components of oxidative
      phosphorylation, and most biosynthetic pathways. Although multiplication of T.
      pallidum has been obtained in a tissue culture system, continuous in vitro
      culture has not been achieved. The balance of oxygen utilization and toxicity is
      key to the survival and growth of T. pallidum, and the genome sequence reveals a
      similarity to lactic acid bacteria that may be useful in understanding this
      relationship. The identification of relatively few genes potentially involved in
      pathogenesis reflects our lack of understanding of invasive pathogens relative to
      toxigenic organisms. The genome sequence will provide useful raw data for
      additional functional studies on the structure, metabolism, and pathogenesis of
      this enigmatic organism.

PMID- 11200229
TI  - Autoregulation of the biosynthesis of the CcpA-like protein, PepR1, in
      Lactobacillus delbrueckii subsp bulgaricus.
AB  - PepR1 from Lactobacillus delbrueckii subsp bulgaricus (Lb. bulgaricus) is
      involved in biosynthesis regulation of the prolidase PepQ. In this paper, we
      demonstrated that Lb. bulgaricus PepR1 biosynthesis is not constitutive like
      those of several bacteria but is auto-regulated and depends on the glucose
      concentration of the culture medium. We propose a model for PepQ regulation by
      PepR1.

PMID- 11200230
TI  - L-glutamate efflux with Corynebacterium glutamicum: why is penicillin treatment
      or Tween addition doing the same?

PMID- 11200231
TI  - Grouping together highly diverged PD-(D/E)XK nucleases and identification of
      novel superfamily members using structure-guided alignment of sequence profiles.
AB  - The PD-(D/E)XK nuclease domains, initially identified in type II restriction
      enzymes, serve as models for studying aspects of protein-DNA interactions,
      mechanisms of phosphodiester hydrolysis, and provide indispensable tools for
      techniques in genetic engineering and molecular medicine. However, the low degree
      of amino acid conservation hampers the possibility of identification of PD
      (D/E)XK superfamily members based solely on sequence comparisons. In several
      proteins implicated in DNA recombination and repair the restriction enzyme-like
      nuclease domain has been found only after the corresponding structures were
      determined experimentally. Here, we identified highly diverged variants of the PD
      (D/E)XK domain in many proteins and open reading frames using iterative database
      searches and progressive, structure-guided alignment of sequence profiles. We
      predicted the possible cellular function for many hypothetical proteins based on
      their relative similarity to characterized nucleases or observed presence of
      additional domains. We also identified the nuclease domain in genuine
      recombinases and restriction enzymes, whose homology to other PD-(D/E)XK enzymes
      has not been demonstrated previously. The first superfamily-wide comparative
      analysis, not limited to nucleases of known structure, will guide cloning and
      characterization of novel enzymes and planning new experiments to better
      understand those already studied.

PMID- 11200232
TI  - Protein-protein interaction between Bacillus stearothermophilus tyrosyl-tRNA
      synthetase subdomains revealed by a bacterial two-hybrid system.
AB  - We have recently developed a bacterial two-hybrid system (BACTH), based on
      functional complementation between two fragments of the catalytic domain of
      Bordetella pertussis adenylate cyclase (AC), that allows an easy in vivo
      screening and selection of functional interactions between two proteins in
      Escherichia coli. In this work, we have further explored the potentialities of
      the BACTH system to study protein-protein interactions, using as a model, the
      interactions between various subdomains of the dimeric tyrosyl-tRNA synthetase
      (TyrRS) of Bacillus stearothermophilus. Using the BACTH system we confirmed the
      known interactions of the alpha/beta domains and those between the alpha/beta
      domain and the alpha domain that could be anticipated from the three-dimensional
      structure of TyrRS. Interestingly, the BACTH system revealed the unexpected
      interaction between the TyrRS alpha domains which is presumably mediated by a
      pseudo-leucine zipper motif. This study illustrates the interest of the bacterial
      two-hybrid system to delineate interacting domains of proteins and shows that it
      can reveal interactions that occur in vivo and that were not anticipated from the
      three-dimensional structure of the protein of interest.

PMID- 11200233
TI  - OspA, a lipoprotein antigen of the obligate intracellular bacterial pathogen
      Piscirickettsia salmonis.
AB  - No effective recombinant vaccines are currently available for any rickettsial
      diseases. In this regard the first non-ribosomal DNA sequences from the obligate
      intracellular pathogen Piscirickettsia salmonis are presented. Genomic DNA
      isolated from Percoll density gradient purified P. salmonis, was used to
      construct an expression library in lambda ZAP II. In the absence of preexisting
      DNA sequence, rabbit polyclonal antiserum raised against P. salmonis, with a bias
      toward P. salmonis surface antigens, was used to identify immunoreactive clones.
      Catabolite repression of the lac promoter was required to obtain a stable clone
      of a 4,983 bp insert in Escherichia coli due to insert toxicity exerted by the
      accompanying radA open reading frame (ORF). DNA sequence analysis of the insert
      revealed 1 partial and 4 intact predicted ORF's. A 486 bp ORF, ospA, encoded a 17
      kDa antigenic outer surface protein (OspA) with 62% amino acid sequence homology
      to the genus common 17 kDa outer membrane lipoprotein of Rickettsia prowazekii,
      previously thought confined to members of the genus Rickettsia. Palmitate
      incorporation demonstrated that OspA is posttranslationally lipidated in E. coli,
      albeit poorly expressed as a lipoprotein even after replacement of the signal
      sequence with the signal sequence from lpp (Braun lipoprotein) or the rickettsial
      17 kDa homologue. To enhance expression, ospA was optimized for codon usage in E.
      coli by PCR synthesis. Expression of ospA was ultimately improved (approximately
      13% of total protein) with a truncated variant lacking a signal sequence. High
      level expression (approximately 42% tot. prot.) was attained as an N-terminal
      fusion protein with the fusion product recovered as inclusion bodies in E. coli
      BL21. Expression of OspA in P. salmonis was confirmed by immunoblot analysis
      using polyclonal antibodies generated against a synthetic peptide of OspA (110
      129) and a strong antibody response against OspA was detected in convalescent
      sera from coho salmon (Oncorhynchus kisutch).

PMID- 11200235
TI  - Nutritional support in the intensive care unit: are patients receiving what is
      prescribed?

PMID- 11200234
TI  - A sigmaB-like factor responsible for carotenoid biosynthesis in Streptomyces
      griseus.
AB  - Self-cloning experiments with a high-copy-number plasmid and Streptomyces griseus
      IFO13350 led to the cloning of a 11-kb DNA fragment that conferred yellow pigment
      production on the host. The cloned fragment contained a gene cluster for
      carotenoid biosynthesis, in which two polycistrons, crtE (encoding geranylgeranyl
      pyrophosphate synthase)-crtI (phytoene dehydrogenase)-crtB (phytoene synthase)
      crtV (functionally unknown methyltransferase-like protein) and crtY (lycopene
      cyclase)-crtT (functionally unknown methyltransferase-like protein)-crtU (beta
      carotene dehydrogenase), were present in a convergent way. Since strain IFO13350
      produced no detectable amount of carotenoids, an increase in the copy number of
      the crt gene cluster led to production of carotenoids at a detectable level.
      Overexpression of the stress-responsive sigmaB-like protein CrtS from
      Streptomyces setonii also activated the cryptic crt genes in S. griseus and
      conferred pigmentation. A CrtS homologue (sigmaCrtS) in S. griseus, which was
      predicted by a computer-aided homology search, caused carotenogenesis to the same
      extent as CrtS of S. setonii, indicating that the two sigmaB-like proteins were
      functionally the same. Yellow pigment production by S. griseus containing crtS
      under the control of a strong promoter on a high-copy-number plasmid resulted
      from activation of transcription of the crt genes, because overexpression of
      sigmaCrtS in S. griseus led to transcriptional activation of the promoters in
      front of crtE and crtY. S1 nuclease mapping showed that crtS itself was
      transcribed at a low level under the laboratory conditions, which may account for
      undetectable production of carotenoids. The crt genes were suggested to locate
      very near one end of the linear chromosome, since they were completely deleted in
      mutant HH1 having large deletions at both ends. The gene organization of crt in
      S. griseus is similar to that in S. coelicolor A3(2) where the whole crt gene set
      is near one end of the chromosome.

PMID- 11200236
TI  - Combined procoagulant and innate immune responses to infection: toward more
      potent drugs in septic patients.

PMID- 11200237
TI  - Intensive care unit frequent fliers: morbidity and cost.

PMID- 11200238
TI  - Daily versus admission mortality estimates: is admission severity yesterday's
      news?

PMID- 11200239
TI  - Acute respiratory distress syndrome: different syndromes, different therapies?

PMID- 11200240
TI  - Tempering the temptation to treat with tempol.

PMID- 11200241
TI  - Modulating nitric oxide synthesis: another contender enters the ring.

PMID- 11200242
TI  - Unilateral withdrawal of life-sustaining therapy: is it time? Are we ready?

PMID- 11200243
TI  - Conflict over communication and unprofessional staff behavior: a common source of
      dissatisfaction during the withdrawal of care?

PMID- 11200244
TI  - Axonal injury is accentuated in the caudal corpus callosum of head-injured
      patients.
AB  - Amyloid precursor protein (APP) accumulation is a sensitive marker for the axonal
      damage that is commonly seen in the brain as the result of head injury. This form
      of damage is particularly associated with midline structures such as the corpus
      callosum, although it is not clear whether some areas are more susceptible than
      others. The aim of this study was to determine if there was a differential
      distribution of axonal injury throughout the corpus callosum after head injury in
      an unselected group of cases. Coronal tissue sections from eight cases were taken
      at different levels through the corpus callosum, including the genu, body, and
      splenium. The sections were immunostained with an antibody to APP, and the amount
      of axonal damage at the different levels was quantified using computer image
      analysis to build up a rostro-caudal profile for each case. The profiles revealed
      a significantly higher APP load in caudal parts of the corpus callosum. This
      supports previous nonquantitative reports in the literature and has important
      implications in terms of choosing where tissue should be sampled to maximize the
      chance of detecting axonal injury post mortem.

PMID- 11200245
TI  - Improved recovery after spinal cord injury in neuronal nitric oxide synthase
      deficient mice but not in TNF-alpha-deficient mice.
AB  - Wild-type mice and mice lacking nitric oxide synthase (NOS) of neuronal type or
      TNF-alpha were subjected to an extradural compression of the thoracic spinal
      cord. The functional outcome of the hind limbs was assessed by using a motor
      function score (MFS). The injury resulted in paraplegia of the hind limbs in wild
      type mice at day 1 after injury. Gradual recovery was observed during the
      following 14 days. Injured NOS -/- animals had an improved hind limb motor
      function during the entire observation period compared to wild-type controls. The
      difference was statistically significant on day 10 (p < 0.022) and day 14 (p <
      0.048) after injury. At the site of injury, there was a trend of gray matter
      preservation in NOS -/- mice, as measured by MAP2 staining (p < 0.077). Injured
      mice lacking TNF-alpha had the lowest motor score among all the groups on day 1.
      During the following period, they had motor scores similar to those of wild-type
      controls and there was no significant difference at any time point. TNF-alpha -/-
      animals showed a trend of decreased white matter preservation compared to wild
      type animals (p < 0.097). Our study shows that after spinal cord injury, mice
      lacking NOS have a better functional ability of their hind limbs than controls
      with the same degree of injury. This would indicate that the functional outcome
      is influenced in a negative way in wild mice by the presence of NO. The degree of
      secondary damage to the spinal cord might be attenuated in NOS-deficient mice.

PMID- 11200246
TI  - The neuropsychology of blunt head injury in the early postacute stage: effects of
      focal lesions and diffuse axonal injury.
AB  - This investigation evaluated the neuropsychological symptoms in the early
      posttraumatic period following blunt head injury and their correlation to routine
      imaging data in a consecutive series of TBI patients (Magdeburg Neurotrauma
      Databank). Of 135 consecutive patients, 68 could be assessed neuropsychologically
      8-21 days after trauma. In 61 patients, routine clinical CT data were sufficient
      for neuroradiological analysis focusing on the presence or absence of CT signs of
      diffuse axonal injury (DAI) or focal traumatic injury. In these patients, the
      initial GCS score was significantly correlated with the presence of DAI but not
      with focal pathology. The presence of DAI was correlated with behavioral and
      cognitive symptoms of frontal lobe dysfunction, especially in interference tasks
      (Go/NoGO and Stroop reaction times) and semantic fluency. The presence of local
      frontal or temporal traumatic lesions was associated with deficits in concept
      formation, fluency tasks and behavioral symptoms, but not with increased
      interference. Patients with frontal contusions were impaired in a task of
      visuomotor planning and performance (Block design). Our data indicate that both
      traumatic DAI and focal lesions result in frontal lobe symptoms. We conclude
      that, even in clinically "mild" TBI, brain imaging should be used to identify
      patients with substantial brain damage. These should be assessed
      neuropsychologically for possible posttraumatic cognitive or behavioral
      impairment. In consideration of its easy accessibility, the refined use of the CT
      is considered a promising and valid tool for patient stratification. The
      application of MRI and biochemical markers may further improve prognostic
      predictions.

PMID- 11200247
TI  - Comparison of brain responses between frontal and lateral impacts by finite
      element modeling.
AB  - This study was conducted to investigate differences in brain response due to
      frontal and lateral impacts based on a partially validated three-dimensional
      finite element model with all essential anatomical features of a human head.
      Identical impact and boundary conditions were used for both the frontal and
      lateral impact simulations. Intracranial pressure and localized shear stress
      distributions predicted from these impacts were analyzed. The model predicted
      higher positive pressures accompanied by a relatively large localized skull
      deformation at the impact site from a lateral impact when compared to a frontal
      impact. Lateral impact also induced higher localized shear stress in the core
      regions of the brain. Preliminary results of the simulation suggest that skull
      deformation and internal partitions may be responsible for the directional
      sensitivity of the head in terms of intracranial pressure and shear stress
      response. In previous experimental studies using subhuman primates, it was found
      that a lateral impact was more injurious than a frontal impact. In this study,
      shear stress in the brain predicted by the model was much higher in a lateral
      impact in comparison with a frontal impact of the same severity. If shear
      deformation is considered as an injury indicator for diffuse brain injuries, a
      higher shear stress due to a lateral impact indicate that the head would tend to
      have a decreased tolerance to shear deformation in lateral impact. More research
      is needed to further quantify the effect of the skull deformation and dural
      partitions on brain injury due to impacts from a variety of directions and at
      different locations.

PMID- 11200249
TI  - Subtle alterations in NMDA-stimulated cyclic GMP levels following lateral fluid
      percussion brain injury.
AB  - This study examined whether NMDA-stimulated cyclic GMP levels were altered at two
      different time points following lateral fluid percussion injury. At 60 min and 15
      days postinjury, the left and right hippocampi were dissected and chopped into
      mini-prisms. Each hippocampus was divided into five equal parts and incubated
      with either the phosphodiesterase inhibitor IBMX (3-isobutyl-1-methylxanthine,
      500 microM) alone, IBMX and N-methyl-D-aspartic acid (NMDA) OR IBMX, NMDA, and
      glycine (10 MM). Two concentrations of NMDA were used: 500 or 1,000 microM.
      Tissues were then assayed for levels of cyclic GMP. Results indicated that there
      were no changes in basal levels of cyclic GMP at either postinjury time point. At
      60 min postinjury, there were no significant main effects for injury or drug
      concentration. There was a significant injury x side interaction effect with
      increased levels of NMDA-stimulated cyclic GMP in the hippocampus ipsilateral to
      the injury impact and decreased cyclic GMP levels in the contralateral
      hippocampus. There were no significant alterations in NMDA-stimulated cyclic GMP
      levels at 15 days postinjury. The data from this study indicated that NMDA
      stimulated cyclic GMP accumulation is differentially altered in the hippocampus
      ipsilateral and contralateral to the site of the injury at 1 h after injury, but
      is normalized by 15 days postinjury. These findings implicate NMDA-mediated
      intracellular signaling processes in the acute excitotoxic response to injury.

PMID- 11200248
TI  - Mapping cerebral glucose metabolism during spatial learning: interactions of
      development and traumatic brain injury.
AB  - Previous studies have demonstrated that, compared to adults, postnatal day 17
      (P17) and P28 rats show remarkable cognitive recovery in the Morris water maze
      (MWM) following fluid percussion injury (FPI). This observed age-at-trauma effect
      could result from either younger animals solving the MWM task using noninjured
      neural circuitry or an inability of adult and P28 brains to activate appropriate
      neural networks due to trauma-induced neurological dysfunction. To address these
      possibilities, we compared "activated" brain regions during normal MWM
      acquisition and following FP injury. To generate "activated" images of the brain
      while animals were performing the MWM task, qualitative [14C]2-deoxy-D-glucose
      was conducted on days 2, 5, and 14 during training in sham and injured adult,
      P28, and P17 rats. When maturational changes in cerebral glucose metabolism are
      taken into account, the results suggests similar activity changes in the cerebral
      cortex and lacunosum moleculare of CA1 during acquisition in all age groups,
      suggesting that the developmental rates of MWM learning do not correspond to
      different patterns of activated cerebral metabolism. Injured P17s, showing no
      latency deficits, revealed activated cerebral metabolic patterns similar to
      noninjured P17 animals. In P28 and adult cases, animals exhibited cognitive
      deficits and their metabolic studies indicated that the cortical-hippocampal
      pattern of activation was disrupted by marked injury-induced metabolic
      depression, which primarily affected the ipsilateral hemisphere and lasted for as
      long as 14 days in adult animals.

PMID- 11200250
TI  - The impact of hypercarbia on the evolution of brain injury in a porcine model of
      traumatic brain injury and systemic hemorrhage.
AB  - Carbon dioxide is perhaps the most potent available modulator of cerebrovascular
      tone and thus cerebral blood flow (CBF). These experiments evaluate the impact of
      induced hypercarbia on the matching of blood flow and metabolism in the injured
      brain. We explore the hypothesis that hypercarbia will restore the relationship
      of CBF to metabolic demand, resulting in improved outcome following traumatic
      brain injury (TBI) and hemorrhage. A behavioral outcome score, hemodynamic,
      metabolic, and pathologic parameters were assessed in anesthetized and ventilated
      juvenile pigs. Animals were assigned to either normocarbia or hypercarbia and
      subdivided into TBI (via fluid percussion) with or without hemorrhage. The
      experimental groups were TBI; TBI + 40% hemorrhage (40%H); TBI + hypercarbia
      (CO2); and TBI + 40%H + CO2. Hemorrhaged animals were resuscitated with blood and
      crystalloid. Hypercarbia was induced immediately following TBI using 10% FiCO2.
      The normocarbic group demonstrated disturbance of the matching of CBF to
      metabolism evidenced by statistically significant increases in cerebral oxygen
      and glucose extraction. Hypercarbic animals showed falls in the same parameters,
      demonstrating improvement in the matching of CBF to metabolic demand. Parenchymal
      injury was significantly decreased in hypercarbic animals: 3/10 hypercarbic
      versus 6/8 normocarbic animals showed cerebral contusions at the gray/white
      interface (p = 0.05). The hypercarbic group had significantly better behavioral
      outcome scores, 10.5, versus 7.3 for the normocarbic groups (p = 0.005). The
      decreased incidence of cerebral contusion and improved behavioral outcome scores
      in our experiments appear to be mediated by better matching of cerebral
      metabolism and blood flow, suggesting that manipulations modulating the balance
      of blood flow and metabolism in injured brain may improve outcomes from TBI.

PMID- 11200251
TI  - Adenovirus-mediated transfer and expression of beta-gal in injured hippocampus
      after traumatic brain injury in mice.
AB  - In models of focal cerebral ischemia, adenoviral gene transfer is often
      attenuated or delayed versus naive. After controlled cortical impact (CCI)
      induced traumatic brain injury in mice, CA1 and CA3 hippocampus exhibit delayed
      neuronal death by 3 days, with subsequent near complete loss of hippocampus by 21
      days. We hypothesized that adenoviral-mediated expression of the reporter gene
      beta-Galactosidase (beta-Gal) in hippocampus would be attenuated after CCI in
      mice. C57BL6 mice (n = 16) were subjected to either CCI to left parietal cortex
      or sham (burr hole). Adenovirus carrying the beta-Gal gene (AdlacZ; 1 x 10(9)
      plaque-forming units [pfu]/mL) was then injected into left dorsal hippocampus. At
      24 or 72 h, beta-Gal expression was quantified (mU/mg protein). Separate mice (n
      = 10) were used to study beta-Gal spatial distribution in brain sections. Beta
      Gal expression in left hippocampus was similar in shams at 24 h (48.4 +/- 4.1)
      versus 72 h (68.8 +/- 8.8, not significant). CCI did not reduce beta-Gal
      expression in left hippocampus (68.8 +/- 8.8 versus 88.1 +/- 7.0 at 72 h, sham
      versus CCI, not significant). In contrast, CCI reduced beta-Gal expression in
      right (contralateral) hippocampus versus sham (p < 0.05 at both 24 and 72 h).
      Beta-Gal was seen in many cell types in ipsilateral hippocampus, including CA3
      neurons. Despite eventual loss of ipsilateral hippocampus, adenovirus-mediated
      gene transfer was surprisingly robust early after CCI providing an opportunity to
      test novel genes targeting delayed hippocampal neuronal death.

PMID- 11200252
TI  - Characteristics of sustained blood-brain barrier opening and tissue injury in a
      model for focal trauma in the rat.
AB  - Minor stab wounding of rodent brain by needle or razor blade is a standard model
      for immunohistochemical investigations of secondary neuronal degeneration and
      scarring. Opening of the blood-brain barrier (BBB) to plasma molecules and
      inflammatory cells is integral to the secondary injury process. To facilitate
      quantitative study of these BBB phenomena, we tested the utility of a stereotaxic
      wire knife as a minimally invasive way for modeling of focal trauma and bleeding
      in brain parenchyma and substantial, reproducible BBB damage. Adult rats were
      anesthetized, and through a skull burr hole, the 0.3-mm dia guide cannula housing
      a laterally extendable tungsten wire (0.13 mm dia) was inserted into the right
      striatum. A layering of horizontal disk-like cuts (3 mm dia) was made, producing
      a cylindrical lesion of approximately 18 mm3 volume, approximately 2.7% of the
      cerebral hemisphere. Transfer constants (Ki) for blood to brain permeation of
      [3H]sucrose measured from 30 min to 2 weeks postlesion showed sustained BBB
      leakiness; for example, mean Ki +/- SEM (nL.g(-1) x s(-1)) for a standard, matrix
      dissected forebrain sample enclosing the lesion were 7.2 +/- 1.2 (day 1
      postlesion), 8.1 +/-1.4 (day 3), 5.4 +/- 0.8 (day 14) compared with values for
      contralateral nonlesioned forebrain ranging from 1.3 +/- 0.05 to 1.6 +/- 0.3 (n =
      3-4 samples per time point). Analysis of the simultaneous transport of
      [14C]sucrose (MW = 342 Da) and [3H]inulin (MW approximately 5,000) showed
      significantly larger upward increments in Ki for sucrose than inulin, indicating
      a pore-like opening mechanism. Significant edema was measured 3 days postlesion.
      A reactive glial response was indicated by an increase in S100beta by 6 h and a
      glial scar forming around the lesion by 7 days. Secondary brain injury was
      indicated by a 10% loss of hemisphere mass, measured at 2 months. The wire knife
      enabled tailoring of interstitial trauma with a minimum of extraneous injury and
      supported reproducible measurements of sustained BBB injury using relatively few
      animals.

PMID- 11200253
TI  - Preventive effects of lecithinized superoxide dismutase and methylprednisolone on
      spinal cord injury in rats: transcriptional regulation of inflammatory and
      neurotrophic genes.
AB  - The effects of lecithinized superoxide dismutase (PC-SOD) and/or
      methylpredisolone (MP) in preventing secondary pathological changes after spinal
      cord injury (SCI) were investigated in rats with reference to recovery of
      hindlimb motor function and expression of mRNA of pro-inflammatory and
      neurotrophic genes. Hindlimb motor function was assessed as the BBB open field
      locomotor scores. The BBB scores of three groups treated with either PC-SOD
      (40,000 units/kg), MP (30 mg/kg), or a combination of PC-SOD and MP (PC-SOD+MP)
      increased with time until 3 days after SCI, and were significantly higher than
      that of the control group (p < 0.05). Thereafter, the score of the PC-SOD group
      increased, whereas that of the MP group showed a temporary decrease from day 3 to
      5 and then it gradually recovered. The scores in all groups reached a plateau
      about 18 days after SCI. The PC-SOD+MP group did not show a synergism but a
      tendency similar to that of the MP group. PC-SOD and MP had down-regulatory
      effects on mRNA expression of pro-inflammatory substances such as interleukin
      1beta (IL-1beta), intercellular adhesion molecule-1 (ICAM-1), and inducible
      nitric oxide synthetase (i-NOS) after spinal cord compression at 3, 6, and 24 h,
      respectively, as judged by a semiquantitative reverse transcription-polymerase
      chain reaction and on the lipid peroxide (LPO) level 1 h after injury as
      determined by thiobarbituric acid-reactive substances. The suppression of pro
      inflammatory genes expression, especially IL-1beta were greater in the MP group
      than in the PC-SOD group, while suppression of LPO level was similar in these two
      groups. PC-SOD+MP treatment augmented the suppression of all three pro
      inflammatory genes expression and the decrease of the LPO level. The level of
      neurotrophin-3 (NT-3) mRNA increased from 6 h after SCI and reached a maximum
      after 48 h. NT-3 mRNA level was enhanced by PC-SOD treatment, but not by MP
      treatment. Thus, the effect of MP in suppressing these pro-inflammatory genes
      expression was more than that of PC-SOD. The difference in motor function in the
      early and later stage may be partially due to differences in expression of IL
      1beta and NT-3 after either treatment, through an IL-1beta-dependent or NT-3
      mediated repair response.

PMID- 11200254
TI  - Studies on reactions of nucleoside H-phosphonates with bifunctional reagents.
      Part VI. Reaction with diols.
AB  - Reactions of nucleoside H-phosphonates with various diols using different types
      of condensing agents have been studied. Depending on the coupling procedure and
      the length of a polymethylene chain of the diol, acyclic H-phosphonate diesters
      or cyclic phosphite triesters were formed. The course of oxidation with iodine to
      produce cyclic nucleoside alkyl phosphotriesters or hydroxyalkyl nucleoside
      phosphodiesters can be controlled by the amount of water present in the reaction
      medium.

PMID- 11200256
TI  - Synthesis and antiviral evaluation of the beta-L-enantiomers of some thymine 3'
      deoxypentofuranonucleoside derivatives.
AB  - 3'-Deoxy-beta-L-erythro- (3), 3'-deoxy-beta-L-threo- (6), 2'-fluoro- (7) and 2'
      azido-2',3'-dideoxy-beta-L-erythro- (10) pentofuranonucleoside derivatives of
      thymine have been synthesized and their antiviral properties examined. All these
      derivatives were stereospecifically prepared by glycosylation of thymine with a
      suitable peracylated 3-deoxy-L-erythro-pentofuranose sugar (1), followed by
      appropriate chemical modifications. The prepared compounds were tested for their
      activity against HIV, but they did not show an antiviral effect.

PMID- 11200255
TI  - The mechanism of DNA repair by uracil-DNA glycosylase: studies using nucleotide
      analogues.
AB  - 2',4'-Dideoxy-4'-methyleneuridine incorporated into oligodeoxynucleotides forms
      regular B-DNA duplexes as shown by Tm and CD measurements. Such oligomers are not
      cleaved by the DNA repair enzyme, UDG, which cleaves the glycosylic bond in dU
      but not in dT nor in dC nucleosides in single stranded and double stranded DNA.
      Differential binding of oligomers containing carbadU, 4'-thiodU, and dU residues
      to wild type and mutant UDG proteins identify an essential role for the furanose
      4'-oxygen in recognition and cleavage of dU residues in DNA.

PMID- 11200257
TI  - Guanosine analogues as anti-herpesvirus agents.
AB  - Several guanosine analogues, i.e. acyclovir (and its oral prodrug valaciclovir),
      penciclovir (in its oral prodrug form, famciclovir) and ganciclovir, are widely
      used for the treatment of herpesvirus (i.e. HSV-1, HSV-2, VZV and HCMV)
      infections. In recent years, several new guanosine analogues have been developed,
      including the 3-membered (cyclopropyl) sugar derivative A-5021 and the 6-membered
      D- and L-cyclohexenyl derivatives. Prominent features shared by all guanosine
      analogues are the following. They depend for their phosphorylation on the virus
      encoded thymidine kinase (TK), which makes them particularly effective against
      those viruses (HSV-1, HSV-2 and VZV) that encoded for such TK. They are also
      active against HCMV, whether or not they are subject of phosphorylation by the
      HCMV-induced UL97 protein kinase. Their antiviral activity can be markedly
      potentiated by mycophenolic acid, an IMP dehydrogenase inhibitor, and they hold
      great promise, not only as antiviral agents for the treatment of herpesvirus
      infections, but also as antitumor agents for the combined gene
      therapy/chemotherapy of cancer, provided that (part of) the tumor cells have been
      transfected by the viral TK gene.

PMID- 11200258
TI  - Synthesis and properties of 2'-deoxycytidine triphosphate carrying c-myc tag
      sequence.
AB  - The synthesis of 2'-deoxycytidine triphosphate carrying mercaptoethyl groups at
      position 4 of cytosine is described. This nucleoside triphosphate was reacted
      with a maleimido-peptide carrying the c-myc tag-sequence to yield a peptide
      nucleoside triphosphate chimera. Primer extension studies showed that the
      nucleoside triphosphate modified with the peptide sequence is incorporated by DNA
      polymerases opposite guanine.

PMID- 11200259
TI  - A remarkable stabilization of complexes formed by 2,6-diaminopurine
      oligonucleotide N3'-->P5' phophoramidates.
AB  - 2'-Deoxyribo- and ribo-oligonucleotide N3'-->P5'phosphoramidates containing 2,6
      diaminopurine nucleosides were synthesized. Thermal denaturation experiments
      demonstrated a significant stabilization of the complexes formed by these
      compounds with DNA and RNA complementary strands, relative to adenosine
      containing phosphoramidate counterparts. The increase in melting temperature of
      the complexes reached up to 6.9 degrees C per substitution. The observed
      stabilization was attributed to the apparent synergistic effects of N-type sugar
      puckering of the oligonucleotide N3'-->P5' phosphoramidate backbone, and the
      ability of 2,6-diaminopurine bases to form three hydrogen bonds.

PMID- 11200260
TI  - Transglycosylation reactions of 6-thioguanine acyclonucleosides.
AB  - 9-(2-Acetoxyethoxy)methyl-N2-acetyl-6-thoguanine (2) undergoes two different
      transglycosylation reactions: i) the 7<=>9 isomerization, which gives the
      respective 7-regioisomer (3) as the major product, ii) the 9<=>S6 glycosyl
      migration, which leads to a 9,S6-disubstituted product (4). S6-Methylation
      completely stopped the reversibility of transglycosylation.

PMID- 11200261
TI  - Fluorescence properties and base pair stability of oligonucleotides containing 8
      aza-7-deaza-2'-deoxyisoinosine or 2'-deoxyisoinosine.
AB  - The fluorescence and the base pairing properties of 8-aza-7-deaza-2'
      deoxyisoinosine (1) are described and compared with those of 2'-deoxyisoinosine
      (2). The corresponding phosphoramidites (11, 12) are synthesized using the
      diphenylcarbamoyl (DPC) residue for the 2-oxo group protection. The nucleosides 1
      and 2 base pair with 2'-deoxy-5-methylisocytidine in DNA duplexes with
      antiparallel chain orientation and with 2'-deoxycytidine in a parallel DNA. These
      base pairs are less stable than the canonical dA-dT pair and that of 2'
      deoxyinosine (4) with 2'-deoxycytidine. The fluorescence of the nucleosides 1 and
      2 is quenched (approximately 95%) in duplex DNA. The residual fluorescence is
      used to determine the Tm-values, which are found to be the same as determined UV
      spectrophotometrically.

PMID- 11200262
TI  - Synthesis and incorporation of pyrrole carboxamide nucleoside triphosphates by
      DNA polymerases.
AB  - We have synthesised and examined the enzymatic incorporation properties of the 5'
      triphosphates of 2'-deoxyribosyl pyrrole 3-monocarboxamide (dMTP) and 2'
      deoxyribosyl pyrrole 3,4-dicarboxamide (dDTP). These analogues we had hoped would
      behave as ambivalent base analogues in that they can present two alternative
      hydrogen-bonding faces either by rotation about the carboxamide group or about
      the glycosidic bond. The two pyrrole derivatives, dMTP and dDTP, exhibit a
      preference for incorporation with Klenow polymerase. They are preferentially
      incorporated as either A or C.

PMID- 11200263
TI  - The synthesis of deuterionucleosides.
AB  - The synthesis of deuterionucleosides for site-specific incorporation into oligo
      DNA or -RAA is herein reviewed for NMR or biological studies. The review covers
      the following aspects: (i) deuteration of the aglycone; (ii) single-site chemical
      deuteration of the sugar residues; (iii) multiple-site chemical deuteration of
      the sugar residues; (iv) enzymatic synthesis of deuterated nucleosides or
      nucleotides; and (v) synthesis of labelled nucleosides with multiple isotopes

PMID- 11200264
TI  - Nucleophilic N1-->N3 rearrangement of 5'-O-trityl-O2,3'-cycloanhydrothymidine.
AB  - 5'-O-Trityl-O2,3'-cycloanhydrothymidine (1) heated at 150 degrees C in the
      presence of O,O-diethyl phosphate or O,O-diethyl phosphorothioate anions
      undergoes rearrangement into N3-isomer (2); its structure was established by both
      advanced NMR methods and X-ray crystallographic studies. The most probable
      mechanism of 1-->2 rearrangement relies upon reversibility of glycosidic bond
      cleavage process.

PMID- 11200265
TI  - Cleavage of the phosphodiester bond of uridylyl-(3',5')-8
      carboxymethylaminoadenosine by hydronium, hydroxide and zinc(II) ions: a model
      study aimed at elucidating the potential of a carboxylate function as an
      intramolecular catalyst.
AB  - Uridylyl-(3',5')-8-carboxymethylaminoadenosine has been synthesised, and its
      transesterification to uridine 2',3'-cyclic phosphate in the presence and absence
      of Zn2+ ion has been studied. The results show that a carboxylate function in the
      vicinity of the phosphodiester bond accelerates the metal ion promoted cleavage
      but not the metal ion independent reaction. Under acidic conditions, the
      predominant reaction is the cleavage of the side chain, giving the 8-amino
      derivative.

PMID- 11200266
TI  - Synthesis of modified nucleotide building blocks containing electrophilic groups
      in the 2'-position.
AB  - Chemical syntheses of 2'-O-(allyloxycarbonyl)methyladenosine, 2'-O
      (methoxycarbonyl)methyladenosine and 2'-O-(2,3-dibenzoyloxy)propyluridine 3'-2
      cyanoethyl-N,N-diisopropyl phosphoramidite building blocks are described. These
      monomers were used successfully to incorporate carboxylic acid, 1,2-diol and
      aldehyde functionalities into synthetic oligonucleotides.

PMID- 11200267
TI  - Antisense phosphorothioate oligonucleotides targeted to the human chemokine
      receptor CXCR4.
AB  - The CXC chemokine receptor CXCR4 is used as a major co-receptor for fusion and
      entry by syncytia-inducing T-tropic (X4) isolates of HIV-1. In the present study,
      we report the effects of an antisense oligodeoxyribonucleotide on the inhibition
      of CXCR4 gene expression in X4 HIV-1 infected HeLa-CD4 cells, to find more
      efficacious therapeutic possibilities for Human Immunodeficiency Virus type 1
      (HIV-1) infection. Antisense phosphorothioate oligodeoxyribonucleotides (anti-S
      ODNs) corresponding to the sequence of bases 69 to 88 of the human CXCR4 mRNA
      gene were synthesized. When the naked anti-S-ODN was incubated with HeLa-CD4
      cells, the surface levels of this chemokine receptor were reduced up to 50%,
      indicating sequence-specific inhibition. We also examined the concomitant use of
      a basic peptide transfection reagent, nucleosomal histone proteins (RNP), for
      delivery of anti-S-ODNs. The anti-S-ODN encapsulated with RNP had higher
      inhibitory effects on p24 products than the naked anti-S-ODN.

PMID- 11200268
TI  - Anti-HIV-1 activity by a triple-helix forming oligonucleotides targeted to
      polypurine tract on viral RNA.
AB  - Reverse transcription of HIV-1 into double-stranded DNA involves initiation of
      plus-strand DNA synthesis at the polypurine tract, PPT, by reverse transcriptase
      (RT). The PPT is a possible target for triple-helix formation. We show the
      effects of triple-helix formation by assays of RNase H cleavage inhibition in
      vitro using two systems (two-strand-system (FTFOs) or three-strand-system (TFOs))
      targeted to the polypurine tract (PPT) of HIV-1. The two-stranded composition of
      a triple-helix is thermodynamically and kinetically superior to the three-strand
      system. The FTFOs inhibited the RNase H activity in a sequence-specific manner,
      i.e., the triplex actually formed at the PPT and blocked the RNase H. The FTFOs
      containing the phosphorothioate groups at the antisense strand showed greater 3'
      exonuclease resistance. In HIV-1 infected MT-4 cells, the FTFOs containing the
      phosphorothioate groups at the antisense strand and guanosine rich parts within
      the third Hoogsteen base pairing sequence inhibit the replication of HIV-1 more
      effectively than the antisense phosphorothioate oligonucleotides, indicating
      sequence-specific inhibition of HIV-1 replication.

PMID- 11200269
TI  - Fluorescent alpha-anomeric 1,N(6)etheno-deoxyadenosine in DNA duplexes. The alpha
      epsilondA / dG pair.
AB  - Structural properties of the fluorescent alpha-anomeric
      1,N(6)ethenodeoxyadenosine residue placed in opposition to all four canonical
      deoxynucleotide units within 11-mer DNA duplexes have been studied. The duplex
      with alpha-epsilondA / dG pairing is most thermodynamically stable while the
      alpha-epsilondA / dC one is the least stable. Fluorescence measurements confirm
      the thermodynamic data and indicate base-pair dependent stacking properties of
      alpha-epsilondA within duplex structures. Results of molecular dynamics (MD)
      simulations in aqueous solution for the most stable duplex point to the presence
      of different conformational states of the alpha-1,N(6)etheno-deoxyadenosine
      residue, including formation of a hydrogen bonded pair with the dG and possible
      occurrence of severe kinking in the duplex.

PMID- 11200270
TI  - New phosphoramidite reagents for the synthesis of oligonucleotides containing a
      cysteine residue useful in peptide conjugation.
AB  - The preparation is described of four 2-cyanoethyl-N,N-diisopropyl
      phosphoramidites of N-alpha-Fmoc-S-protected cysteine hydroxyalkyl amides. The
      phosphoramidites were used in solid-phase synthesis of 5'-cysteinyl
      oligonucleotides, useful intermediates in the preparation of peptide
      oligonucleotide conjugates through reaction with a maleimide peptide or with a
      peptide thioester via "native ligation".

PMID- 11200271
TI  - Nucleotides LXIV[1]: synthesis hydridization and enzymatic degradation studies of
      2'-O-methyloligoribonucleotides and 2'-O-methyl/deoxy gapmers.
AB  - 2'-O-Methyloligoribonucleotides, deoxyoligonucleotides and 2'-O-methyl/deoxy
      gapmers were synthesized using solid phase phosphoramidite chemistry employing
      the 2-(4-nitrophenyl)ethyl (npe) protection strategy. Melting temperatures of the
      synthesized oligonucleotides as well as their stability against degradation by
      several different nucleases were determined. 2'-O-Methyloligoribonucleotides
      showed the highest melting temperatures (Tm's) whereas 2'-O-methyl/deoxy gapmers
      revealed either slightly higher or surprizingly no thermal stabilities compared
      with their deoxy analogs when using self-complementary sequences. Gapmers with
      four 2'-O-methyl nucleotides on both ends showed about the same stability as all
      2'-O-methyloligoribonucleotides against micrococal nuclease, nuclease S1, and
      snake venom phosphodiesterase.

PMID- 11200272
TI  - New efficient synthesis of thymidine cyclic 3',5'-phosphorofluoridate and its
      sulfur analogue via the phosphoroamidite route.
AB  - We describe the convenient synthesis of thymidine cyclic 3', 5'
      phosphorofluoridate 6, which is superior to that previously reported. Our
      procedure is based on a sequence of reactions utilizing 3 as the key substrate.
      Similar sequence of reaction leads to the sulfur analogues of 6 the thymidine
      cyclic 3',5'-phosphorofluoridothioate 7.

PMID- 11200273
TI  - Synthesis of non-nucleoside triphosphate analogues, a new type of substrates for
      terminal deoxynucleotidyl transferase.
AB  - A series of non-nucleoside triphosphate analogues were synthesized. In place of
      the nucleoside fragment, substituents bearing aromatic groups were introduced;
      the triphosphate component was replaced at alpha, beta, or gamma-positions by
      phosphonates. Alpha-[2-N-(9-Fluorenylmethoxycarbonyl)aminoethylphosphonyl]
      beta,gamma-difluoromethylenediphosphonate (IIc) revealed the best substrate
      properties toward terminal deoxynucleotidyl transferase.

PMID- 11200274
TI  - P-(alkyl)-nucleoside 5'-hydrogenphosphonates as depot forms of antiviral
      nucleotide analogues.
AB  - P-(Alkyl)esters of AZT 5'-hydrogenphosphonate were synthesized and their
      stabilities in the phosphate buffer and human serum were evaluated. The esters
      bearing residues of primary and secondary alcohols were degraded to give AZT,
      whereas those containing tertiary alkyl groups yielded AZT 5'
      hydrogenphosphonate. The corresponding derivatives of d2A and d4T showed the same
      properties.

PMID- 11200275
TI  - Probing the MVAI methyltransferase region that interacts with DNA: affinity
      labeling with the dialdehyde-containing DNA duplexes.
AB  - Affinity labeling of methyltransferase MvaI by DNA duplexes containing oxidized
      2'-O-beta-D-ribofuranosylcytidine or 1-beta-D-galactopyranosyl)thymine residues
      was performed. Partial chemical hydrolysis of the covalently bound methylase in
      the conjugates with the dialdehyde-containing DNA allowed us to determine the
      amino acid region in the C terminus of methylase MvaI that interacts with DNA.

PMID- 11200276
TI  - Synthesis and RNAse L binding and activation of a 2-5A-(5')-DNA-(3')-PNA chimera,
      a novel potential antisense molecule.
AB  - Fully automated solid-phase synthesis gave access to a hybrid in which 5'
      phosphorylated-2'-5'-linked oligoadenylate (2-5A) is connected to the 5'-terminus
      of DNA which, in turn, is linked at the 3'-end to PNA [2-5A-(5')-DNA-(3')-PNA
      chimera]. This novel antisense molecule retains full RNase L activation potency
      while suffering only a slight reduction in binding affinity.

PMID- 11200277
TI  - New pyrimidine cyclonucleosides with hydrogenated aglycones: synthesis and X-ray
      structures.
AB  - Acid catalysed transformations of (6S)-6,5'-anhydro-6-hydroxy-1-(2',3'-O
      isopropylidene-beta-D-ribofuranosyl)hexahydropyrimidine-2-thione are studied.
      (6R)-6,2'-anhydro-6-hydroxy-1-(alpha-D-ribofuranosyl)hexahydropyrimidine-2-thione
      was formed as a thermodynamically stable product. Two intermediates, (6S)-6,5'
      anhydro-6-hydroxy-1-(beta-D-ribofuranosyl)hexahydropyrimidine-2-thione and 6
      hydroxy-1-(D-ribosyl)hexahydropyrimidine-2-thione and products of cleavage of
      glycosidic bond were identified in the reaction mixtures. Results of X-ray
      structural determination of the synthesised nucleosides are presented.

PMID- 11200278
TI  - Synthesis and properties of O-beta-D-ribofuranosyl-(1"-2')-adenosine-5"-O
      phosphate and its derivatives.
AB  - The synthesis of O-beta-D-ribofuranosyl-(1"-2')-adenosine-5"-O-phosphate and its
      suitably protected derivative for oligonucleotide synthesis have been developed.

PMID- 11200280
TI  - Pyrophosphoryl derivatives of 1-(2-deoxy-3-O-phosphono-methyl-beta- and -alpha-D
      erythro-pentofuranosyl)thymine: synthesis and substrate properties towards some
      DNA polymerases.
AB  - The synthesis of 1-(2-deoxy-3-O-phosphonomethyl-beta-D
      erythropentofuranosyl)thymine (17) and its alpha-anomer 18 is described. Attempts
      to prepare 1-[2-deoxy-3-O-(pyrophosphoryl)phosphonomethyl-beta-D-erythro
      pentofuranosyl]thymine (19) by an activation of the respective phosphonate 17
      with 1,1'-carbonyldiimidazole (Im2CO) resulted in the quantitative formation of
      the corresponding pyrophosphonate derivative 21 (Scheme 2). Activation of
      inorganic pyrophosphate with Im2CO followed by the condensation with the
      phosphonates 17 and 18 afforded the desired analogues of nucleoside triphosphate
      19 (35%) and its alpha-anomer 20 (27%) along with the respective pyrophosphonate
      derivatives 21 (37%) and 24 (38%) (Scheme 3). It was found that compounds 19 and
      20 display (i) no substrate properties toward calf thymus terminal
      deoxynucleotidyl transferase (TDT) and AMV reverse transcriptase, and (ii)
      moderate substrate activity with E. coli DNA polymerase I (Klenow fragment).

PMID- 11200279
TI  - Oligonucleotides containing 9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-adenine
      and -guanine: synthesis, hybridization and antisense properties.
AB  - Synthesis of 9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-adenine (7, ara-A2'F)
      and -guanine (12, ara-G2'F) was accomplished via the condensation of 2,6
      dichloropurine (1) with 2-deoxy-2-fluoro-1,3,5-tri-O-benzoyl-alpha-D
      arabinofuranose (2) as a key chemical step. Condensation of silylated N6
      benzoyladenine (6) with 2 gave, after deblocking and chromatographic separation,
      ara-A2'F (7) (14%), it's alpha-anomer 8 (14%) and N7-alpha-isomer 9 (25%). The
      PSEUROT analysis of N9-betaD-arabinosides 7 and 12 manifested slight preference
      for the S rotamer (64%) for the former, and an equal population of the N and S
      rotamers for the latter. The arabinosides 7 and 12 were used for the preparation
      of the respective phosphoamidite building blocks 13 and 14 for automated
      oligonucleotide synthesis. Four 15-mer oligonucleotides (ONs) complementary to
      the initiation codon region of firefly luciferase mRNA were prepared: unmodified
      2'-deoxy-ON (AS 1) and containing (i) ara-A2'F instead of the only A (AS2), (ii)
      ara-G2'F vs. 3-G from the 5'-terminus (AS3), and (iii) both arabinosides at the
      same positions (AS4). All these ONs display practically the same (i) affinity to
      both complementary DNA and RNA, and (ii) ability to inhibit a luciferase gene
      expression in a cell-free transcription-translation system.

PMID- 11200281
TI  - Substituent--directed aralkylation and alkylation reactions of the tricyclic
      analogues of acyclovir and guanosine.
AB  - Aryl or tert-butyl substituent in the 6 position of 3,9-dihydro-3-[(2
      hydroxyethoxy)methyl]-9-oxo-6-R-5H-imidazo[1,2-a]purine (6-R-TACV) 1 partly
      directs aralkylation reactions into unusual positions: N-4 to give 3 and C-7 to
      give N-5,7-disubstituted or N-4,7-disubstituted derivatives. In the case of
      alkylation the effect is limited to aryl substituent and position N-4.
      Replacement of acyclic moiety of 1 with a ribosyl one like in 7 prevents N-4
      substitution. Cleavage of the third ring of 3b to give 3-benzylacyclovir 10 is an
      example of a new short route to 3-aralkyl-9-substituted guanines.

PMID- 11200282
TI  - A new strategy of discrimination of a point mutation by tandem of short
      oligonucleotides.
AB  - A new strategy based on the use of cooperative tandems of short oligonucleotide
      derivatives (TSOD) has been proposed to discriminate a "right" DNA target from a
      target containing a single nucleotide discrepancy. Modification of a DNA target
      by oligodeoxyribonucleotide reagents was used to characterize their interaction
      in the perfect and mismatched complexes. It is possible to detect any nucleotide
      changes in the binding sites of the target with the short oligonucleotide
      reagent. In the presence of flanking di-3',5'-N-(2-hydroxyethyl)phenazinium
      derivatives of short oligonucleotides (effectors) the tetranucleotide alkylating
      reagent modifies DNA target efficiently and site-specifically only in the perfect
      complex and practically does not modify it in the mismatched complex. It has been
      shown that TSOD is much more sensitive tool for the detection of a point mutation
      in DNA as compared to a longer oligonucleotides.

PMID- 11200284
TI  - Large-scale solid-phase preparation of 3'-unprotected trinucleotide
      phosphotriesters--precursors for synthesis of trinucleotide phosphoramidites.
AB  - The approach to large-scale solid-phase synthesis of 3'-unprotected trinucleotide
      phosphotriesters has been developed. The trinucleotides have been synthesized in
      5 g scale by phosphotriester approach using CPG with pore size 70A. Total yield
      of target products was 75-90%. The molar extinctions of trinucleotides at various
      wave-lengths were calculated; the experimental UV-spectra of trinucleotides show
      a good agreement with theoretical ones. The trinucleotides synthesized were used
      for synthesis of trinucleotide phosphoramidites - synthons for generation of
      DNA/peptide libraries.

PMID- 11200283
TI  - Rapid routes of synthesis of oligonucleotide conjugates from non-protected
      oligonucleotides and ligands possessing different nucleophilic or electrophilic
      functional groups.
AB  - Optimized methods are described for post-synthetic conjugation of non-protected
      oligodeoxyribonucleotides to different ligands. Methods for the terminal
      functionalization of oligonucleotides by amino, sulfhydryl, thiophosphate or
      carboxyl groups using different chemical reactions and linkers in both organic
      and aqueous media are described and compared. Experimental conditions for
      subsequent coupling of ligands containing aliphatic and aromatic amines, aromatic
      alcohols, carboxylic, sulfhydryl, alkylating, aldehydic and other reactive
      nucleophilic and electrophilic groups to oligonucleotides were established,
      including covalent linkage to other oligonucleotides.

PMID- 11200285
TI  - S,X-acetals in nucleoside chemistry. III. Synthesis of 2'- and 3'-O-azidomethyl
      derivatives of ribonucleosides.
AB  - 2'- and 3'-O-azidomethyl derivatives of ribonucleosides were obtained by
      splitting the corresponding methylthiomethyl derivatives of ribonucleosides with
      bromine or SO2Cl2 followed by lithium azide treatment.

PMID- 11200286
TI  - Synthesis of N-labeled peptidyl AMP.
AB  - This paper deals with the synthesis of a new type of N-labeled peptidyl AMP,
      which would be used as a good substrate for analysis of the peptidyl transfer
      reaction on ribosome and for co-crystallization with ribosome. 4
      (Dimethylamino)azobenzene-4'-sulfonyl (Dabsyl) was selected as the labeling
      group. (N-Dabsylglycyl)-L-leucyl AMP was synthesized from glycyl-L-leucine via a
      three-step procedure.

PMID- 11200287
TI  - Synthesis and structure activity relationships of 5-substituted-4'-thio-beta-D
      arabinofuranosylcytosines.
AB  - Four 5-substituted (chloro, fluoro, bromo, methyl) 1-(4-thio-beta-D
      arabinofuranosyl)cytosines and their alpha anomers were synthesized by a facile
      route in high yields. All of these nucleosides were evaluated for cytotoxicity
      against a panel of human tumor cell lines in vitro. Only 5-fluoro-1-(4-thio-beta
      D-arabinofuranosyl)cytosine was found to be highly cytotoxic in all the cell
      lines and was further evaluated in vivo.

PMID- 11200288
TI  - Inhibition of human immunodeficiency virus type-1 (HIV-1) replication by immunor
      (IM28), a new analog of dehydroepiandrosterone.
AB  - The inhibition of HIV-1 replication in vitro by Immunor 28 (IM28), an analog of
      dehydroepiandrosterone (DHEA), was monitored using the HIV-1 laboratory wild-type
      strain IIIB. Evaluation of the 50% inhibitory dose (IC50) revealed a decrease in
      HIV-1 replication giving an IC50 value around 22 microM. The toxicity of the drug
      has been determined also, in MT2 cells and PBMCs. 60 microM of IM28 provoked a
      50% decrease in cell viability while DHEA caused the same decrease at 75 microM
      in MT2 cells. These values are 125 microM for IM28 in PBMCs and 135 microM for
      DHEA. Thus, DHEA is less toxic than IM28, but IM28 has a higher antiviral
      activity.

PMID- 11200289
TI  - Biographical sketch. Professor Alexander Krayevsky PhD, (1932-1999).

PMID- 11200290
TI  - Selected publications (1961-2000). Alexander Krayevsky.

PMID- 11200291
TI  - Atrial fibrillation occurring in a patient taking etanercept plus methotrexate
      for rheumatoid arthritis.
AB  - A 57-year-old man with nodular rheumatoid arthritis was started on a combination
      of etanercept and methotrexate. After treatment for five months on this therapy,
      he presented with new-onset atrial fibrillation. While this report is anecdotal,
      any new drug warrants intense monitoring for unexpected toxicities in the post
      marketing period. Etanercept is being tried in patients with congestive heart
      failure, where TNF-a seems to be increased. Further surveillance and caution are
      suggested in patients with known coronary artery disease or atrial dysrhythmia.

PMID- 11200292
TI  - Creating a physician Web site: Part 2.
AB  - An individual physician web site is a valuable augmentation to a professional
      practice. Enhancing patient care and increasing customer satisfaction are the
      most important goals of a physician web venue. Broadening your patient base,
      improving practice efficiencies, helping ensure corporate compliance, and
      decreasing liability exposure can also be accomplished by a well thought out and
      constructed site. Pages presenting information about the practice, the
      delineation of patient responsibilities, and evidence-based clinical content
      information will constitute the majority of the site. A user agreement and
      disclaimer page, feedback page, and corporate compliance page constitute the
      supplementary pages on the site.

PMID- 11200293
TI  - Domestic violence: a Resource Manual for Healthcare Providers for the State of
      Delaware. Part 3: Health Care Provider's Response.
AB  - The Medical Subcommittee of the Delaware Domestic Violence Coordinating Council
      (DVCC) has worked on and completed Domestic Violence: A Resource Manual for
      Healthcare Providers for the State of Delaware. It is both an educational tool
      and a handy resource for documentation and reference, with many examples of
      clinical guidelines, screening questions and checklists for safety screening. It
      is intended for all healthcare providers, not just physicians. The Delaware
      Medical Journal will be reprinting three very important chapters from this
      manual: Understanding Domestic Violence (October 2000), Legal issues (November
      2000), and Health Care Provider's Response.

PMID- 11200294
TI  - What is health management research?

PMID- 11200295
TI  - A realistic theory of health sector management. The case for critical realism.
AB  - To date the practice of health sector management has not been sufficiently
      theorised. An adequate theory should be able to answer the pre-eminent critique
      of managerial rationality and ethics mounted by Alasdair MacIntyre in After
      Virtue and should also offer robust analytical and ethical resources to identify
      and engage with the social, political, economic and moral issues underlying
      health sector management. Critical realism with its ontology of generative
      mechanisms, agency-structure relationships, valorisation of activity and ideology
      critique offers such resources in an empirically orientated but adequately
      theorised realist framework. Rather than negate MacIntyre, critical realism
      incorporates and transcends his key arguments regarding the rationality and
      ethics of management. This article introduces the main elements of critical
      realism and clears a conceptual space for the cumulation of critical realist case
      studies and managerial craft knowledge.

PMID- 11200296
TI  - Who really wants health-care choice?
AB  - An experiment was conducted to examine the impact of patients' freedom to choose
      a physician and health locus of control on patient satisfaction. The experiment
      was set within the scenario of a patient suffering from a lengthy viral infection
      after visiting a health clinic for the first time. All constructs with
      corresponding measurements are discussed and their relationships with
      satisfaction are examined. Hypotheses are developed and tested for each
      relationship using pencil and paper scenarios of a patient's service encounter at
      a health clinic. A 2 x 2 full factorial between subjects experimental design was
      used with 99 subjects. Results of the experiment indicated different patterns of
      satisfaction among subjects based on measures of health locus of control (HLC).
      Individuals with an internal HLC were more satisfied with having a choice of a
      physician than not having a choice and were also more satisfied than external HLC
      individuals who had a choice. In contrast, individuals with an external HLC did
      not discriminate between having or not having the opportunity to choose a
      physician.

PMID- 11200297
TI  - Effective leadership within hospice and specialist palliative care units.
AB  - In this study the Repertory Grid interview technique was used to investigate
      constructs of leadership held by a group of male and female senior managers from
      within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The themes
      that emerged were compared with those from existing research models of
      leadership. RESULTS: Men and women in these roles describe different constructs
      of effective leadership. The women's constructs that emerged were predominantly
      transformational, whilst the men's were predominantly transactional. Themes were
      also identified in this study, which differed from previous studied, i.e. those
      of political and environment awareness and the valuing of others' views
      regardless of their status. These themes do not feature highly in other research,
      and may be in response to the environment within which hospice and specialist
      palliative care functions.

PMID- 11200298
TI  - Renewing the model employer. Changing employment relations and "partnership" in
      the health and private sectors.
AB  - Drawing from original empirical data this paper compares the changing nature of
      employment relations in the health and private sectors. A key concern is to
      assess the extent to which the emergence of partnership-type arrangements between
      employers and trade unions lays the basis for the "renewal" of the traditional
      public sector concept of the model employer. Empirically, the paper draws on a
      survey of trade union representatives from 238 workplaces and a case study of a
      hospital trust. The data reveal that employment relations in the NHS are more
      collectivist when compared with the private sector. However, the development of
      partnership in the NHS is hamstrung by ongoing training and involvement gaps and
      widespread work intensification.

PMID- 11200299
TI  - The value of the facilities management function in the UK NHS community health
      care sector.
AB  - This paper stresses the importance of the strategic integration of the
      organisational facilities management function as being an essential prerequisite
      towards facilities and organisational effectiveness. The impact of both the
      strategic and operational facilities management function on community health-care
      facility users is also documented. The value of the facilities management
      function in terms of other health-care related organisational core deliverables
      is also observed. Mechanisms for general organisational facilities management
      improvement are identified and a number of facilities management performance
      measuring tools outlined.

PMID- 11200300
TI  - Patient perceptions of service quality. Combining the dimensions.
AB  - Empirically investigates, using a conjoint methodology, the importance weights
      given to the attributes of quality for acute care hospital services. The study
      shows that consumers evaluated the technical dimensions of nursing care,
      physician care, and outcome as more important than the accommodation functions of
      hospital care, and there are significant interactions among the technical
      dimensions. Both sets of dimensions were important and significant, but technical
      quality evaluations were not influenced by the perceived quality level of the
      affective attributes. The relative importance of these attributes were quite
      stable among various subgroups of past patients.

PMID- 11200301
TI  - Quality in health care. Medical or managerial?
AB  - Explores the notion that the introduction of total quality management (TQM) in
      the public health-care sector indicates a conceptual break with a tradition in
      which the authority to define and interpret the meaning of medical practice has
      been located solely within the medical profession. It also serves to shift the
      focus of medical practice away from its contextual and interactional character
      towards numerical representations and codification in monetary terms. Further, it
      is argued that the realization of management ideals in everyday practice is
      dependent more on the availability of pre-existing technologies and standard
      procedures than on the ingenuity of particular organizational and institutional
      actors. These arguments are illustrated with the reutilization for TQM purposes
      of "local incident reports" in a Swedish hospital organization.

PMID- 11200302
TI  - Basic estimate of needs for training in evidence-based medicine in Slovakia.
AB  - This study reports the findings of the first survey of the knowledge and needs
      for training in evidence based medicine (EBM) of health-care workers in Slovakia.
      This study was primarily qualitative and based on a triangular approach, which
      included: analysis of the situation in pre- and postgraduate education in
      Slovakia aimed at estimating needs in EBM and critical appraisal skills (CAS)
      training; analysis of questionnaires distributed in a sample of medical doctors
      and university educated public health workers undergoing postgraduate training;
      and focus group discussions. The findings revealed a real gap in knowledge in EBM
      and CAS in Slovakia and identified several areas as the focus for intervention.
      The results showed also some important behavioural and cultural aspects,
      including low individual responsibility for education; tendency to delegate
      responsibility to authorities (experts, top management, Ministry of Health); and
      persistence of the state paternalistic type of education. Concludes that managers
      planning to implement EBM in Slovakia should therefore consider a broader
      behavioural and cultural context for change, not just introduction of a training
      EBM module.

PMID- 11200303
TI  - Hospital human resource planning in Slovakia.
AB  - The study is an attempt to provide empirical evidence, in the context of acute
      hospital care, of the current human resource practices in the health sector of
      the Slovak Republic. Using a sample of 72 acute care hospitals the research
      explored the perceived functions, typical customers and priorities of hospital
      human resource departments, ownership of a workforce plan, and the relationships
      between ownership of a workforce plan and type of hospital, as well as the degree
      to which different human resource activities are given priority. Cross-tabulation
      procedure revealed statistically significant relationships between ownership of a
      workforce plan and the degree of priority given to having a quick, efficient and
      cost-effective recruitment and selection system and, not surprisingly, the degree
      of priority given to ensuring that the human resource department has a workforce
      plan. The study evidence also indicates that, although the human resource staff
      in hospitals seem to be aware of their role in assisting hospital management in
      decision making, the human resource function in the Slovak hospitals still rather
      resembles that of a personnel administration than that of an important strategic
      human resource activity.

PMID- 11200304
TI  - Testosterone: its role in development of prostate cancer and potential risk from
      use as hormone replacement therapy.
AB  - Evidence from studies in patients with prostate cancer of intermittent hormone
      therapy combined with results from rechallenge of hormone resistant patients with
      testosterone demonstrate that the majority of prostate cancers retain a similar
      degree of dependence on male sex hormone milieu as normal prostate cells. Yet
      there has so far been no conclusive evidence, despite 34 studies, that levels of
      circulating testosterone in individuals developing prostate cancer are higher
      than in controls. The aim of this article was to critically evaluate this
      evidence and seek clues to other mechanisms whereby sex hormones could influence
      the development of prostate cancer. Additionally, epidemiological data were
      examined to investigate the interplay between sex hormone levels and
      environmental factors to help understand the development of prostate cancer and
      identify a safe way to provide hormone replacement therapy (HRT). Three overviews
      provide similar evidence that there is no significant difference in mean
      testosterone levels between patients and controls. However in the most recent
      review of studies, though there was no difference in means between cases and
      controls, there was a significant risk (adjusted odds ratio 2.34) for individuals
      identified by comparing incidence of prostate cancer in men in the upper and
      lower quartile of testosterone level. This report, taken with epidemiological
      data demonstrating that prostate cancer risk is increased by early age of onset
      of sexual activity and multiple nonspecific sexually transmitted diseases (STDs),
      has led to the hypothesis that the link between sex hormones and prostate cancer
      is indirect. Those individuals with high testosterone levels were more at risk of
      acquisition of multiple nonspecific STDs. This promotes transformation of
      prostate cells and damage to Leydig cells in the testis leading to there being no
      difference in testosterone compared with controls by the time the tumour is
      diagnosed. Because of the observed relationship between testosterone and prostate
      cancer development there has been anxiety about marketing HRT for men. Two
      observations support the view that the prostate cancer risks from use of
      testosterone hormone replacement may not be as great as first feared. Firstly,
      prostate cancers arising in men with low serum testosterone levels are more
      malignant and frequently nonresponsive to hormones. Secondly, breast cancers
      diagnosed in women on HRT though increased in number are less malignant possibly
      because of enhanced sensitivity to hormone therapy, and the situation may prove
      to be analogous with prostate cancer and testosterone replacement.

PMID- 11200305
TI  - Choice and use of newer anticonvulsant drugs in older patients.
AB  - Epilepsy is common in the elderly. The incidence of epilepsy is age-dependent,
      with a peak during the first year of life and higher incidence in those older
      than 75 years. Cerebrovascular disease is a common cause of epilepsy in the
      elderly. Drug treatment of the elderly is a challenge because of pharmacokinetic
      changes with aging, including impaired drug protein binding or displacement of
      drug from protein binding sites, potentially causing drug toxicity as a result of
      increased free drug concentrations. With aging, hepatic mass and blood flow
      decline along with renal function. Established anticonvulsant drugs have adverse
      effects and drug interactions that can make treating the elderly difficult. Newly
      available anticonvulsants cause fewer drug-drug interactions and less toxicity.
      Gabapentin is not metabolised, is not bound to protein, and has a favourable
      adverse effect profile and thus may be useful in the treatment of elderly
      patients. Lamotrigine reduced seizures between 20 and 30% in trials. Dose
      response was between 300mg per day and 500mg per day. This drug was well
      tolerated in open-label trials. Rash occurred in younger patients. Oxcarbazepine
      is rapidly absorbed and is converted to a monohydroxy derivative. Use with
      hepatic enzyme-inducing drugs necessitates an increase in dose. This drug may be
      substituted for carbamazepine. Hyponatraemia has been reported and monitoring is
      suggested. Topiramate blocks voltage-dependent sustained repetitive firing and
      has an effect on the gamma-aminobutyric acid (GABA) receptors. It affects
      glutamate responses and inhibits carbonic anhydrase. Topiramate has a dose
      response pattern up to 400mg per day. Cognitive effects limits its use in some
      patients. Nephrolithiasis has occurred with this drug. Tiagabine blocks GABA
      transporter proteins. Clearance is rapid and metabolism complete. Hepatic
      dysfunction prolongs clearance. The use of tiagabine has not been reported in the
      elderly. Zonisamide is rapidly absorbed and protein binding is 50%. Plasma half
      life is 55 hours but is reduced to about 30 hours by hepatic enzyme-inducing
      drugs. Responder rate is 45%. Adverse effects include drowsiness, altered
      thinking and nephrolithiasis. Treatment of the elderly requires obligatory
      polypharmacy with potential drug interactions. Changes in body physiology alter
      absorption, binding, metabolism and elimination of drugs. Concomitant illness and
      sensitivity to drug effects narrow the therapeutic range and complicate
      pharmacokinetics in elderly patients. Newer anticonvulsant drugs have advantages
      that may outweigh risks and have therapeutic profiles that may aid in the
      treatment of this special population of patients.

PMID- 11200306
TI  - Glycaemic control and hormone replacement therapy: implications of the
      Postmenopausal Estrogen/Progestogen Intervention (PEPI) study.
AB  - Despite evidence that supports the beneficial effects of postmenopausal hormone
      replacement therapy (HRT), concerns remain about its possible adverse effects.
      However, entry into the postmenopausal state is associated with many
      characteristics of the insulin resistance syndrome, including increased
      cardiovascular morbidity and mortality, accretion of generalised and visceral
      adiposity and insulin resistance. Studies carried out in postmenopausal women
      have revealed that an increase in visceral obesity is associated with an increase
      in androgenicity that, in turn, is associated with type 2 (non-insulin-dependent)
      diabetes mellitus. Short term studies of HRT containing conjugated estrogens
      (CEE) and medroxyprogesterone (MPA) have shown prevention of the accretion of
      visceral fat. However, longer term studies using other techniques suggest that
      these effects may be evanescent. A few trials suggest that oral estrogen therapy
      reduces postmenopausal insulin resistance, as suggested by reductions in fasting
      insulin and glucose levels and an increase in glucose metabolism rates, whereas
      most studies do not show an adverse effect upon carbohydrate metabolism. MPA may
      decrease these beneficial effects. Transdermal estrogen is essentially neutral
      with regard to insulin sensitivity and oral estradiol (17beta-estradiol) may also
      be neutral or enhance sensitivity. Different progestogens vary in their effects
      upon carbohydrate metabolism. The Postmenopausal Estrogen/Progestogen
      Intervention (PEPI) Study was a prospective, 3-year, randomised trial in 875
      women that compared placebo, unopposed CEE, CEE plus continuous MPA, CEE plus
      cyclical MPA, and CEE plus cyclical micronised progesterone. Fasting insulin and
      glucose levels decreased significantly by 16.1% and 0.122 mmol/L, respectively,
      in all drug treatment groups. However, after a 75g glucose load, glucose levels
      at 2 hours increased by 0.33 mmol/L in the active treatment groups without a
      corresponding increase in insulin levels. No beneficial effects on waist/hip
      ratio could be demonstrated. Data from the PEPI trial also suggested that the
      maximum benefit regarding carbohydrate metabolism was achieved in patients who
      were the most hyperglycaemic and hyperinsulinaemic at the start of therapy. It
      can be concluded, therefore, that HRT has few, if any, harmful effects on
      carbohydrate metabolism and that it may be of benefit in women in modifying the
      long term complications of the postmenopausal state.

PMID- 11200309
TI  - [Evolution and weight and body composition determination after therapy for
      pathological obesity for measuring compliance in (re)-education].
AB  - Obesity, and its associated complications, is one of the most costly diseases in
      modern civilisations. Dieting alone rarely gives good long-term results. The
      effect of the combination of nutritional education and moderately intensive
      physical exercise on the evolution of weight and Body composition has been
      analysed by bio-impedancemetry over a one-year period. Patients could be divided
      into four groups: patients lost after the 3-week nutritional course, patients
      neither dieting nor exercising, patients dieting and patients both dieting and
      exercising. The results for the four groups were the following: undeterminably,
      5% loss compared to initial weight (and nearly 10% compared to reported maximum
      weight). 10% loss and 15% loss over one year. In the last group, Body composition
      showed a relative increase in muscle mass, which explains the lack of a drop in
      basal metabolic rates seen in the diet-alone group. This maintained metabolic
      rate probably prevented patients from weight cycling (yo-yo phenomenon). This
      result can be compared to other life-style changing studies or pharmacological
      treatments (Orlistat, sibutramine) of obesity, which resulted in an approx. 10%
      weight reduction.

PMID- 11200310
TI  - [Sleep apnea syndromes and traffic accidents].
AB  - The sleep apnea syndrome (SAS) is an independent and important risk factor of
      traffic accidents. The risk is further increased by cofactors such as alcohol
      intake or poor visibility driving conditions. It is still difficult to
      prospectively identify apneic patients at forseeable driving risk; previous
      accidents, reaction tests, steering simulation tests as different
      polysomnographic parametres appear to be the most promising markers. The
      initiation of nocturnal nasal continuous positive airway pressure treatment
      (nCPAP) normalizes patient's accident risk. Unfortunately there does not exist
      any accurate European nor national regulation dealing with issuing a driving
      licence for persons with sleep apnea disorder.

PMID- 11200307
TI  - Beneficial and detrimental effects of intensive glycaemic control, with emphasis
      on type 2 diabetes mellitus.
AB  - Diabetes mellitus is a major health problem in the world. Several clinical trials
      have shown that some of the major complications of diabetes mellitus can be
      partially prevented or delayed by intensive glycaemic control. However, there are
      benefits and risks in aiming for near normal blood glucose levels. Intensive
      glycaemic control delays the onset and progression of retinopathy, nephropathy
      and neuropathy. Epidemiological and observational studies have shown that
      cardiovascular events may be correlated with the severity and duration of
      diabetes mellitus, but major randomised trials have only shown weak and
      nonsignificant benefits of intensive glycaemic management in decreasing event
      rates. A modest improvement in lipid profile results from blood glucose control
      although, in the majority of cases, not enough to reach current targets.
      Detrimental effects of intensive glycaemic control include bodyweight gain and
      hypoglycaemia. Controversial issues in the management of patients with diabetes
      mellitus include the unproven increase in cardiovascular morbidity from
      sulphonylureas and hyperinsulinaemia, and the still unknown long term effects of
      newer oral antihyperglycaemic agents alone or in combination with traditional
      therapies (such as sulphonylureas and metformin). It is important to
      individualise management in setting glycaemic goals. Control of cardiovascular
      risk factors through blood pressure and lipid control and treatment with aspirin
      (acetylsalicylic acid) and ACE inhibitors have consistently shown benefits in the
      prevention of both macro- and microvascular complications in patients with
      diabetes mellitus; these measures deserve priority.

PMID- 11200311
TI  - [Ruptures of the anterior cruciate ligament (ACL) during growth].
AB  - Tears of the anterior cruciate ligament (ACL) in skeletally immature patients
      with open physes are becoming more frequent. The two main variants of this lesion
      include tibial eminence fractures with an avulsion of the bony avulsions of the
      ACL on the tibia and midsubstance ligament injuries. The treatment of bony
      avulsions is generally accepted. In complete midsubstance tears conservative
      treatment is insufficient, resulting in multiple giving way episodes and meniscal
      lesions. Controversy exists regarding the surgical treatment of complete
      midsubstance ruptures. Especially in younger patients with wide open physes, the
      risk of a growth disturbance due to transphyseal drilling has not been completely
      evaluated. In patients approaching physeal closure intraarticular ACL replacement
      using an autogenous bone-patellar tendon-bone graft has been shown to yield good
      short-term to mid-term results. There is a growing concern regarding the long
      term outcome of ACL grafts with higher rerupture rates being suspected in
      children compared to adults. For these reasons more clinical and experimental
      data are needed in forthcoming studies.

PMID- 11200308
TI  - Topical dorzolamide 2%/timolol 0.5%: a review of its use in the treatment of open
      angle glaucoma.
AB  - The nonselective beta-blocker timolol and the carbonic anhydrase inhibitor
      dorzolamide both lower intraocular pressure (IOP). Timolol and dorzolamide have
      different mechanisms of action and their effects are additive when administered
      together. Therefore, the 2 drugs are frequently used concomitantly to treat
      patients with open-angle glaucoma who have not adequately responded to first-line
      therapy. A barrier to good compliance with concomitant therapy is the need to
      administer 5 or 6 drops of medication on 2 or 4 occasions during the day. Timolol
      0.5% and dorzolamide 2.0% have therefore been combined in a single formulation,
      reducing the number of administrations required to 2 per day. Clinical trials in
      patients with glaucoma have demonstrated that dorzolamide 2%/timolol 0.5%
      (dorzolamide/timolol) is superior to monotherapy with the individual components.
      When dorzolamide/timolol administered twice daily was compared with concomitant
      treatment with dorzolamide 2% and timolol 0.5%, each administered twice daily for
      90 days, both regimens resulted in marked lowering of trough IOP (measured just
      before the morning dose) compared with baseline (reduction in IOP = 4.2mm Hg).
      The effect of the 2 regimens on IOP at all time points, both before treatment and
      at peak effect (2 hours after treatment), were virtually indistinguishable. When
      the combined formulation was compared with a concomitant regimen that included
      dorzolamide 2% 3 times daily and timolol 0.5% twice daily the concomitant regimen
      was slightly more efficacious than the combined regimen at trough after 90 days:
      IOP was lowered by 3.6mm Hg in the combined group versus 4.1 mm Hg in the
      concomitant group. Dorzolamide/timolol has been compared with concomitant
      administration of timolol 0.5% and the IOP lowering miotic drug, pilocarpine
      2.0%. This non-blind patient-preference study found that both regimens reduced
      IOP. However, the dorzolamide/timolol combination was preferred by the patients
      because of reduced frequency and severity of adverse effects and less frequent
      administration. Dorzolamide/timolol was well tolerated in clinical trials, the
      adverse effects reflected those of the individual components, and no additional
      tolerability issues were identified. However, the potential for timolol to cause
      cardiorespiratory effects must be considered when prescribing this combination.
      Furthermore, dorzolamide is a sulfonamide and can cause allergic reactions in
      those who are hypersensitive to this class of drug. CONCLUSIONS:
      Dorzolamide/timolol is a well tolerated and effective fixed combination for
      lowering IOP in the treatment of open-angle glaucoma and is likely to be useful
      in those patients who do not respond adequately to first-line monotherapy.
      Compared with concomitant therapy with the same 2 drugs the primary advantage is
      convenience, which may lead to improved compliance. Studies of compliance and
      comparisons with other currently available combination therapies would be useful
      to fully define the value of the formulation. Nonetheless, dorzolamide combined
      with timolol in a single applicator system will be a useful addition to the
      treatment options for glaucoma, a leading cause of preventable blindness.

PMID- 11200312
TI  - [History of aspirin in the Grand Duchy of Luxembourg].

PMID- 11200313
TI  - [15 years of exercise for cardiac patient in the Grand Duchy of Luxembourg:
      balance sheet and perspectives].

PMID- 11200314
TI  - From the private to the public sphere. The first generation of lady nurses in
      England.

PMID- 11200315
TI  - From the lower east side to the upper Galilee. The pioneering experiences of Sara
      Bodek Paltiel, 1909-1993.

PMID- 11200317
TI  - Nurses' residences: using the built environment as evidence.

PMID- 11200316
TI  - Florence Henderson. The art of open-drop ether.

PMID- 11200318
TI  - Passing on more than a blank disc. A task for nursing historians.

PMID- 11200319
TI  - "The steel cocoon". Tales of the nurses and patients of the iron lung, 1929-1955.

PMID- 11200320
TI  - "Barren of results?" The tuberculosis nurses' debate, 1908-1914.

PMID- 11200321
TI  - Blood work. Canadian nursing and blood transfusion, 1942-1990.
AB  - The extension of blood transfusion to civilian populations was contingent on the
      availability of a nursing workforce capable of taking on increasingly responsible
      roles. Nurses assumed a variety of roles as they incorporated blood work into
      patient care and, in the process, enabled, embodied, and engendered it as nurses'
      and women's work. Initially, the student workforce facilitated transfusion
      through roles that were congruent with nursing's domestic roots. Later, it
      constrained the expansion of blood work because of its perpetually novice nature.
      Delegation constituted one strategy by which a limited number of persons could
      become experienced and autonomous in a particular role. As long as the skill
      remained limited, nurses shared its associated power and status, which
      differentiated them within the work culture. A few women were able to shape blood
      work to their advantage, using their expertise either as job security or as a
      bargaining point to negotiate better working conditions. However, when the skill
      was routinized and dispersed among many nurses, it became dirty work. The
      examination of one specific technology that shifted from medicine into nursing
      contributes insights to current issues of expanded roles and delegated skills.
      Nurses need to question seriously what is gained and lost as they take on and let
      go of technologies. They need to consider what kinds of knowledge will be needed
      and how best to develop it. Finally, they need to reflect how changes might
      complicate care giving and nurses' work.

PMID- 11200322
TI  - Care of the maternal breast. Techniques and nurses' roles, 1900-1948.

PMID- 11200323
TI  - Ideology and self-interest. Nursing, medicine, and the elimination of the
      midwife.

PMID- 11200324
TI  - [Pharmacokinetic analysis of alpha- and beta-adrenoreceptors in the chick embryo
      amnion].
AB  - Following a stimulation with acetylcholine, the beta-adrenergic agonists
      adrenaline (A), noradrenaline (NA), isoproterenol (Iso) and salbutamol (Sal)
      induced a concentration-dependent decrease in the tone and (or) rate of amnion
      contraction with EC50 ISO < NA << A < Sal. Metaprolol, a specific beta 1
      antagonist, induced a rightward shift in the dose-response curves of Iso, NA and
      A, whereas beta-antagonist butoxamine was ineffective. pA2 values for beta
      antagonists were propranolol 8.3, metoprolol 7.0, butoxamine 5.6. EC50 values of
      alpha-adrenergic agonists form a sequence: clonidine < NA << methoxamine <
      phenylephrine. Specific alpha-antagonists yohimbine and idazoxan were found to
      antagonise competitively the effects of NA. The data obtained characterize the
      adrenergic receptors mediating stimulation of amniotic contractile activity as
      alpha 2-adrenergic receptors. Inhibition of contractile receptors in amnion is
      mainly mediated by beta 1-adrenergic receptor activation.

PMID- 11200325
TI  - [Effect of inhibitors of synthesis of dopamine and its antagonists on Hydra
      attenuata regeneration].
AB  - Obvious inhibition of the hydra regeneration with no subsequent morphological
      abnormalities, was shown to occur when using alpha-methylthyrosine and 3
      Jthyrosine. alpha-Methyldopa induced a slight inhibition but a considerable
      morphological change: ectopic tentacles, projections, bipolar forms in the
      gastric fragment. The apical and basal fragments did not suffer. The role of
      neurotransmitters in the hydra morphogenesis is discussed.

PMID- 11200326
TI  - [Non-dopaminergic neurons expressing dopamine synthesis enzymes: differentiation
      and functional importance].
AB  - The study has evaluated in vivo, ex vivo and in vitro ontogenesis and functional
      significance of the arcuate nucleus neurons expressing either individual enzymes
      of dopamine synthesis, tyrosine hydroxylase or aromatic L-amino acid
      decarboxylase as well as both of them (dopaminergic neurons) in rats from the
      17th embryonic day to adulthood. Monoenzymatic tyrosine hydroxylase-containing
      neurons were initially observed on the 18th embryonic day. On the 20-21 day, the
      monoenzymatic tyrosine hydroxylase- or aromatic L-amino acid decarboxylase
      expressing neurons comprised more than 99% of the whole neuron population
      expressing the dopamine-synthesizing enzymes. The dopamine production in the
      fetus arcuate nucleus was sufficient to provide an inhibitory control of
      prolactin secretion like in adults. The data suggest a possibility of the
      dopamine synthesis in the fetus arcuate nucleus by the monoenzymatic neurons
      containing either tyrosine hydroxylase or aromatic L-amino acid decarboxylase
      expressing neurons in co-operation.

PMID- 11200327
TI  - [Localization, kinetic parameters, and functions of cholinesterase of the
      starfish ampulla].
AB  - The starfish amplullae cholinesterase was shown to represent acetylcholinesterase
      and enhance its activity along with increasing motility of the starfish. Bundles
      of muscle fibres containing cholinesterase were found in the ampullae.
      Cholinesterase was shown to be localized in the muscle cells and in collagen
      layer in vicinity of the muscle cells. The data obtained suggest participation of
      the starfish ampullae cholinesterase in non-synaptic cholinergic transmission
      between the radial nerve axons and the muscle fibre extension. Besides, the
      enzyme could take part in functional relationship between the muscle cells and
      the outer epithelial cells of the starfish ampullae.

PMID- 11200328
TI  - [Analysis of the functional role in behavior of the neuromediator receptor by
      antisense knockdown of its gene expression].
AB  - Now available nucleotide sequences of neurotransmitter receptor genes enable to
      apply oligonucleotides targeted to mRNAs of these genes for highly selective
      inactivation of their expression (antisense-knockdown) and for function
      determination of single receptor subtype by this experimental approach. The
      antisense-knockdown may be of special importance in case of receptor families
      members of which are pharmacologically similar. Advantages of the antisense
      technology for investigation into the brain neurotransmitter receptor function in
      regulation of behaviour, are discussed.

PMID- 11200329
TI  - [Stress-limiting nitric oxide system].
AB  - The work substantiates a concept of the nitric oxide (NO) system as a universal
      transmitter and controller of physiological functions and as a new stress
      limiting system. The NO system can be activated by a stress, restrict release
      and/or production of stress hormones, restrict the stress damage to the organism,
      enhance the organism's resistance against stress, can be activated in adaptation
      to repeated exposure to environmental factors. Some specifics of the NO system
      differing it from other stress-limiting systems, are discussed.

PMID- 11200330
TI  - [Effect of hydrocortisone on purine actions in the nerve-muscle preparation].
AB  - Daily administration of hydrocortisone first increased and then decreased
      amplitude of multiquantal end-plate currents induced by motor nerve stimulation.
      The initial facilitating phase of the hormone action was accompanied by
      elimination of the ATP pre-synaptic effect. Later the inhibitory effect of the
      ATP becomes restored. The counteraction of the ATP effect was reproduced in the
      isolated muscle bathed in the saline with hydrocortisone which suggests a non
      genomic action of the hormone on pre-synaptic P2 receptor. The data obtained
      suggest that prevention of the ATP inhibitory action might be a component of a
      facilitating acute stress reaction.

PMID- 11200331
TI  - [Functions of neuromediators in plants].
AB  - In plants, neurotransmitters play a major biological role in chemo-signaling, as
      regulating agents of growth and development, membrane permeability, etc. In the
      plant cells, there are also main elements of cholinergic and aminergic systems
      including the enzymes as well as functional analogues of cholino- and
      aminoreceptors. It is important that the systems should be taken into
      consideration in fertilizing and chemical interaction of the plant cells.
      Acetylcholine and cholinesterase were shown to be secreted in male sexual cells
      (the pollen). Depression of cholinesterase on the gene level correlates with male
      sterility. Preliminary treatment of a female gametophyte with antagonists of
      acetylcholine and histamine, prior to pollination, blocked the normal process of
      fertilizing. Cholinesterase was also found in secrets released from the pollen
      surface and pistil.

PMID- 11200332
TI  - [Urokinase does not effect the tissue factor mediated monocyte pro-coagulant
      activity].
AB  - Both spontaneous and endotoxin-induced tissue factor expressions were not altered
      by exogenous urokinase. Inhibition of endogenous urokinase and plasmin did not
      affect the endotoxin-induced monocyte tissue factor's activity.

PMID- 11200333
TI  - [Pre- and postsynaptic effects of the calcium channel blocker verapamil in the
      nerve-muscle preparation].
AB  - Verapamil did not change the amplitude of the miniature and multiquantal end
      plate currents, synchronicity of the transmitter release and repetitive firing at
      the motor nerve endings. Verapamil shortened the decay of multiquantal currents,
      the effect being enhanced after acetylcholinesterase inhibition. In muscles with
      inhibited acetylcholinesterase, verapamil promoted the depression of successive
      end-late currents in rhythmic nerve stimulation. The data suggest that in
      skeletal muscles verapamil-sensitive calcium channels do not take part in
      physiological transmitter release or in chemical potentiation of the secretion
      after treatment with potassium channels blocking agents.

PMID- 11200334
TI  - [NMDA-Receptors in the central nervous system of the honey bee with kynurenine
      deficiency].
AB  - Effects of some drugs on the short-term memory were tested. In kynurenine
      deficit, mutant snow laranja manifested the same pharmacological profile and 10
      to 100-fold enhancement of sensitivity of the NMDA receptors' different sites.
      The data obtained suggest that the gene controlling the key enzyme activity of
      the kynurenine pathway of tryptophan metabolism is involved in regulation of the
      CNS NMDA receptors' functional condition. The kynurenines may be classified as
      endogenous modulators of the NMDA receptor sensitivity.

PMID- 11200335
TI  - [Triglyceride lipase activity and fatty acid transport in physical endurance in
      rats adapted to the muscular activity].
AB  - Aerobic training led to enhancement of lipase activity in type IIA type muscles.
      Still more obvious changes were found in rats trained to aerobic swimming with
      maximal intensity. In latter activity, a rise of the fatty acid-binding protein
      (FABP) was revealed in types I and IIA skeletal muscles. These adaptive changes
      led to enhancement of lipid metabolism. It was also shown that the FABP content
      decreased after physical exercise more obviously in the trained animals due,
      probably, to their substance turnover enhancement.

PMID- 11200336
TI  - [Decrease of the Ca(2+)-dependent K(+)-current by cyclic guanosine monophosphate
      does not depend on phosphorylation].

PMID- 11200337
TI  - [I. P. Pavlov Physiological Society at the Russian Academy of Sciences].

PMID- 11200338
TI  - [Neurochemical Research Society at the Russian Academy of Sciences].

PMID- 11200339
TI  - [Gerontological Society at the Russian Academy of Sciences].

PMID- 11200340
TI  - [International conference on 'Problems of physiology under extreme conditions'].

PMID- 11200342
TI  - Percutaneous management of chronic pancreatic duct strictures and external
      fistulas with long-term results.

PMID- 11200343
TI  - Noninvasive vascular laboratory for evaluation of peripheral arterial occlusive
      disease. Part III--Clinical applications: nonatherosclerotic lower extremity
      arterial conditions and upper extremity arterial disease.

PMID- 11200344
TI  - Translumbar embolization of type 2 endoleaks after endovascular repair of
      abdominal aortic aneurysms.

PMID- 11200345
TI  - Balloon tamponade: a novel technique for visualizing and catheterizing the common
      bile duct after partial transection.

PMID- 11200346
TI  - Re: temporary balloon occlusion in the internal iliac arteries for control of
      hemorrhage during cesarean hysterectomy in a patient with placenta previa and
      placenta increta.

PMID- 11200347
TI  - Early cerebral infarction after embolotherapy of a pulmonary arteriovenous
      malformation.

PMID- 11200348
TI  - Training standards for physicians performing uterine artery embolization for
      leiomyomata: consensus statement developed by the Task Force on Uterine Artery
      Embolization and the standards division of the Society of Cardiovascular &
      Interventional Radiology--August 2000.

PMID- 11200349
TI  - PTA versus Palmaz stent placement in femoropopliteal artery obstructions: a
      multicenter prospective randomized study.
AB  - PURPOSE: To evaluate if stent placement is superior to percutaneous transluminal
      angioplasty (PTA) in the treatment of chronic symptoms in short femoropopliteal
      arterial lesions. MATERIALS AND METHODS: One hundred fifty-four limbs in 141
      patients who ranged in age from 39 to 87 years (mean age, 67 years) were
      randomized to PTA (n = 77) versus PTA followed by implantation of Palmaz stents
      (n = 77). Inclusion criteria were patients with intermittent claudication (n =
      108, Society of Vascular Surgery/International Society of Cardiovascular Surgery
      [SVS-ISCVS] categories 1-3) or chronic critical limb ischemia (n = 46 with either
      ischemic rest pain [category 4] or minor tissue loss [category 5]), short
      stenosis or occlusion (lesion length < or = 5 cm), and at least one patent run
      off vessel at angiography. Follow-up included clinical assessment, measurement of
      ankle/ brachial index (ABI), color duplex ultrasound, and/or angiography at 6 or
      12 months. Angiographic follow-up between 12 and 36 months was available in 46
      limbs (29.9%). RESULTS: In the PTA group, initial technical success was achieved
      in 65 of 77 limbs (84%) versus 76 of 77 (99%) limbs in the stent group (chi2
      value = 0.009). Overall, major complications occurred in 3.9% (n = 6); n = 4 in
      the PTA group compared to n = 2 in the stent group. There was no difference
      between groups of treatment: hemodynamic/clinical success at 1 and 2 years in the
      PTA group was 72% and 65% versus 77% and 65% in the stent group (Gehan P value =
      .26). The cumulative 1- and 2-year angiographic primary patency rates were 63%
      and 53%, respectively, for both groups. The secondary 1- and 2-year angiographic
      patency rates were 86% and 74% in the PTA group versus 79% and 73% in the stent
      group (P = .5). CONCLUSION: After stent placement, the primary success rate was
      significantly higher than after PTA. However, 1-year angiographic and
      clinical/hemodynamic success was not improved.

PMID- 11200350
TI  - Contrast media-induced nephrotoxicity: identification of patients at risk and
      algorithms for prevention.

PMID- 11200351
TI  - The Legs for Life screening for peripheral vascular disease: compliance with
      physician recommendations in moderate- and high-risk assessed patients.
AB  - PURPOSE: To determine compliance within a community with recommendations made by
      physicians during the 1999 Legs for Life National Screening for Peripheral
      Vascular Disease (PVD) and Leg Pain. MATERIALS AND METHODS: Patients were
      initially screened for PVD by completion of the Legs for Life risk factor
      questionnaire and determination of bilateral ankle/brachial indexes (ABIs). Each
      patient subsequently met with an interventional radiologist or vascular surgeon.
      Patients with normal ABIs (>1.0 bilaterally) or mildly abnormal ABI(s) (<1.0 but
      >0.90) were classified at no and low risk for PVD, respectively; patients with
      ABI(s) of 0.70-0.89 were classified at moderate risk for PVD; and patients with
      ABI(s) <0.69 were classified at high risk for PVD. Risk factors for PVD were
      assessed by the consulting physician and discussed with all patients.
      Recommendations were made for additional evaluation and/or follow-up care, if
      necessary. Seven months after screening, patients who were assessed at moderate
      and high risk for PVD were contacted by telephone to determine if they had
      pursued additional care or testing. RESULTS: A total of 205 patients were
      screened for PVD, 48 (23%) of whom were determined to be at moderate to high
      risk. Forty-four (92%) patients were available for follow-up. At 7 months after
      screening, 31 (70%) patients had received no further medical advice or treatment.
      Thirteen (30%) of these patients had completed a follow-up appointment, but only
      three with a physician specializing in peripheral vascular disease. None of the
      patients had clinical follow-up with an interventional radiologist. Five (11%)
      patients had undergone noninvasive Doppler evaluation and one (2%) had undergone
      diagnostic arteriography. No patient had undergone any form of percutaneous or
      surgical intervention. CONCLUSION: Patient compliance with physician
      recommendations after outpatient screening for PVD is low. The Legs for Life
      screening program could be considered successful in that it provides for patient
      education and the identification of moderate to high-risk patients. Physicians
      participating in this program may have to modify their approach to patient
      screening and follow-up if a concomitant goal is to deliver specialty care.

PMID- 11200352
TI  - Uterine artery embolization: reduced radiation with refined technique.
AB  - PURPOSE: To determine the estimated absorbed ovarian dose (EAOD) and absorbed
      skin dose (ASD) that occurs during uterine artery embolization (UAE) using pulsed
      fluoroscopy and a refined procedure protocol. MATERIALS AND METHODS: The absorbed
      dose was measured in 20 patients who underwent UAE procedures. Radiation was
      limited by using low frequency pulsed fluoroscopy, bilateral catheter technique
      with simultaneous injections for embolization as well as pre-and postembolization
      exposures and focus on limitation of magnified and oblique fluoroscopy. Lithium
      fluoride dosimeters were placed both in the posterior vaginal fornix and on the
      skin at the beam entrance site. The vaginal dose was used to approximate the
      EAOD. Fluoroscopy time and exposures were recorded. The mean values for all
      patients were calculated and compared to our previous results obtained with
      conventional fluoroscopy and to threshold doses for the induction of
      deterministic skin injury. RESULTS: Mean fluoroscopy time was 10.95 min. (range 6
      21.3 min.) and the mean number of angiographic exposures was 20.9 (range 14-53).
      The mean EAOD was 9.5 cGy (range 2.21-23.21 cGy) and the mean ASD was 47.69 cGy
      (range 10.83-110.14 cGy). This compares to previous results with non-pulsed
      fluoroscopy of an EAOD of 22.34 cGy (range 4.25-65.08 cGy) and an ASD of 162.32
      cGy (range 66.01-303.89 cGy) as well as threshold doses for induction of
      deterministic radiation injury to the skin (400-500 cGy). CONCLUSION: When pulsed
      fluoroscopy is used with emphasis on dose reduction techniques, the EAOD and ASD
      can be substantially reduced to less than 1/2 (P = .017) and 1/3 (P < .0001) when
      compared to UAE performed with nonpulsed fluoroscopy. These radiation reduction
      tools should therefore be applied whenever possible.

PMID- 11200353
TI  - Contrast-enhanced moving-table MR angiography: prospective comparison to catheter
      arteriography for treatment planning in peripheral arterial occlusive disease.
AB  - PURPOSE: Prospective comparison of contrast-enhanced moving-table magnetic
      resonance (MR) angiography to catheter arteriography in endovascular and surgical
      treatment planning in patients with peripheral arterial occlusive disease.
      MATERIALS AND METHODS: Thirteen patients scheduled for catheter arteriography for
      lower extremity arterial occlusive disease underwent contrast-enhanced moving
      table MR angiography immediately prior to arteriography. A treatment plan was
      determined by the vascular surgeon, based on MR angiography, who was blinded to
      the catheter arteriogram. The treatment plan determined by the MR angiogram was
      compared to the final treatment plan, which was based on the catheter arteriogram
      and intraluminal pressure measurements. RESULTS: Treatment plans based on MR
      angiography and catheter arteriography were identical in 10 of 13 patients (71%).
      For identifying lesions resulting in intervention, MR angiography had sensitivity
      of 100% and a positive predictive value of 92%. MR angiography had a treatment
      specific predictive value of 88% for each lesion identified, and 95% for lesions
      identified in patients evaluated for claudication. If treatment plans were based
      on MR angiography only, 46% of patients would have avoided catheter
      arteriography. CONCLUSION: Contrast-enhanced moving-table MR angiography may be
      an effective alternative to catheter arteriography in endovascular and surgical
      treatment planning in selected patients with peripheral arterial occlusive
      disease, but larger studies are necessary to confirm this.

PMID- 11200354
TI  - Classifying complications of interventional procedures: a survey of practicing
      radiologists.
AB  - PURPOSE: To determine the variability of radiologists' classification of
      complications from interventional procedures. MATERIALS AND METHODS: Fifteen test
      cases were selected from a database of morbidity and mortality cases that
      occurred in our department during the past 2 years. Ten cases were selected
      randomly, and five were chosen because of classification difficulties within our
      department. A survey with the case descriptions was presented to 145 SCVIR
      members via the World Wide Web and 48 were distributed to participants at a
      statewide angiography club meeting. Participants were asked to complete a short
      assessment of the their clinical background and to classify each case as "no
      complication," "minor complication," or "major complication." RESULTS: Thirty
      eight percent (74 of 193) of the surveys were completed. Seventy percent (52 of
      74) of the respondents were affiliated with an academic program, 12% (nine of 74)
      were affiliated with private practice groups, and 18% (13 of 74) claimed both
      academic and private affiliation. The consensus rate in classifying the
      complications for the randomly selected cases varied from 50% to 95%, with a
      median of 69%, and the consensus rate in classifying the selected cases varied
      from 46% to 95%, with a median of 85%. The lowest consensus rates occurred when
      (i) a significant procedural event was followed by a normal outcome, (ii) when a
      procedure was aborted, and (iii) when a significant event occurred but did not
      prolong hospital stay. CONCLUSION: Current criteria for reporting complications
      are associated with moderate rates of disagreement among interventional
      radiologists.

PMID- 11200355
TI  - Transjugular liver biopsy with use of the shark jaw needle: diagnostic yield,
      complications, and cost-effectiveness.
AB  - PURPOSE: Obtaining transjugular liver biopsy specimens with use of single-use
      needle systems is expensive, whereas biopsy specimens obtained with use of
      reusable needle systems are frequently associated with inadequate core specimens.
      The authors report their experience with the reusable Cook Shark Jaw biopsy
      needle, including diagnostic yield, complications, and cost-effectiveness.
      MATERIALS AND METHODS: A retrospective audit was performed of a cohort of 134
      patients who underwent 136 transjugular liver biopsies with use of a reusable 16
      gauge Shark Jaw needle during a 30-month period. Specimen adequacy and
      complication rates were assessed and direct costs of expendable components
      calculated. Cost-effectiveness was expressed as cost-per-successful biopsy.
      RESULTS: Biopsies were technically successful in 126 of 136 (93%) patients, with
      diagnostic histologic core specimens obtained in 124 of 126 (98%) patients, for
      an overall success rate of 91%. Complications included capsular penetration in
      six (4.4%) patients, cardiac arrhythmia in two (1.5%) patients, and puncture site
      hematoma or bleeding in 10 (7.4%) patients. Three tract embolizations were
      performed for capsular penetration. No instances of subcapsular hematoma,
      hemoperitoneum, or sepsis occurred, and no deaths were attributed to the
      procedure. The cost of expendable components totaled $103 per biopsy,
      corresponding to a cost-effectiveness of $113/successful biopsy. CONCLUSION:
      Transjugular liver biopsy specimens obtained with use of the Shark Jaw needle
      have a diagnostic yield comparable to those obtained with use of single-use
      biopsy systems, at a substantially lower cost with no increase in serious
      complications.

PMID- 11200356
TI  - Nasolacrimal polyurethane stent placement for epiphora: technical long-term
      results.
AB  - PURPOSE: To assess technical problems related to implantation of a polyurethane
      stent to treat obstructive epiphora, and to assess the long-term patency of the
      nasolacrimal system. MATERIALS AND METHODS: Fluoroscopically guided placement of
      a polyurethane nasolacrimal stent was performed in 70 obstructed lacrimal systems
      of 62 patients with grade 3-4 obstructive epiphora. Follow-up was conducted for 1
      20 months (average, 11.3 months). The obstruction was at the lacrimal sac in six
      systems, at the junction between the lacrimal sac and the nasolacrimal duct in 60
      systems, and at the nasolacrimal duct in four systems. The cause of the
      obstruction was idiopathic in all cases but was probably residual to
      dacryocystitis. RESULTS: Of these 70 procedures, stent placement was technically
      successful in 61 systems (87%). On long-term follow-up, 41 (67.2%) stents
      remained in place, with resolution or clinical improvement, and 18 (29.5%) stents
      were removed (because of occlusion in 17 systems), with stent malpositioning in
      the duct in six cases. There were seven cases of malpositioning in all.
      Statistical analysis was performed to evaluate patency, compare patency in
      properly positioned stents and malpositioned stents, and establish the
      relationship between malpositioning and the need for irrigation to maintain stent
      patency. Of the total 70 stents originally placed, 41 (58.6%) were still in place
      and functional at long-term follow-up. At 1 year, 73% of properly positioned
      stents remained patent versus 0% of improperly positioned stents. Median stent
      patency in the former group was 20 months and was 1 month in the latter group (P
      = .00002). Eleven percent of properly positioned stents required irrigation
      versus 57% of incorrectly positioned stents (P = .01). CONCLUSION: After follow
      up for 1 year, recurrence of epiphora brought on by stent obstruction was 28%.
      Early stent blockage and the need for periodic irrigation may be indicative of
      malpositioning of the stent.

PMID- 11200357
TI  - Sclerotherapy with use of doxycycline after percutaneous drainage of
      postoperative lymphoceles.
AB  - PURPOSE: To assess the use of doxycycline as a sclerosing agent after
      percutaneous drainage of postoperative lymphoceles. MATERIALS AND METHODS:
      Symptomatic postoperative lymphoceles (n = 21) in 18 patients were treated by
      percutaneous tube drainage for an average of 10.8 days. Sclerosis was performed
      when the patient became asymptomatic, drainage had slowed to less than 30 mL/d
      and follow-up imaging (CT or US) showed either near complete or total resolution
      of the lymphocele. Doxycycline (500 mg) combined with 1% lidocaine (5 mL) was
      instilled into the cavity with use of a syringe after any remaining lymphocele
      fluid was removed through the tube. When possible, patients were instructed to
      perform a series of maneuvers for the next hour to distribute the sclerosing
      agent evenly throughout the cavity. After 1 hour, the sclerosing agent was
      aspirated from the cavity and the drainage tube was removed. Three patients with
      four lymphoceles underwent sclerotherapy immediately after percutaneous insertion
      of a drainage tube and aspiration of the lymphocele. No patients underwent
      previous sclerosis with any agent. RESULTS: Successful treatment of postoperative
      lymphoceles was achieved in 17 of 18 patients. Primary success was achieved in 17
      of 21 lymphoceles treated. There were four lymphocele recurrences in three
      patients. Three of the four recurrences were successfully treated by means of
      repeated drainage and sclerotherapy. One recurrent lymphocele persisted after re
      treatment with 1 g of doxycycline. This patient underwent successful surgical
      repair. There were no complications related to doxycycline sclerosis. The mean
      duration of drainage for initial and recurrent lymphoceles was 10.8 days (range,
      0-30 days). CONCLUSION: Sclerotherapy with use of doxycycline after percutaneous
      drainage is an easy, safe, inexpensive, and effective means of treating
      postoperative lymphoceles.

PMID- 11200358
TI  - Complete inhibition of intimal hyperplasia by perivascular delivery of paclitaxel
      in balloon-injured rat carotid arteries.
AB  - PURPOSE: To determine whether perivascular delivery of paclitaxel prevents
      luminal narrowing after balloon injury by inhibiting intimal hyperplasia.
      MATERIALS AND METHODS: Immediately after balloon injury of the entire left common
      carotid artery, three slow-release formulations of paclitaxel or control
      formulations without drug were applied around a distal segment of the artery. The
      noninjured right carotid arteries were evaluated as a control. The animals were
      maintained for 14 and 28 days (n = 5 in each group at each time interval).
      Histology, immunohistochemistry, and morphometric analysis were performed.
      RESULTS: Injured nontreated arteries exhibited a pronounced intimal hyperplasia
      (0.185 +/- 0.01 mm2 at 14 days and 0.189 +/- 0.01 mm2 at 28 days) and a marked
      reduction in luminal area (44% at 14 days and 43% at 28 days). Medial area and
      the number of medial cells increased by 44% and 45%, respectively, at 14 days,
      and by 22% and 37%, respectively, at 28 days. Injured arteries treated with
      perivascular paclitaxel did not show any intimal hyperplasia, and luminal area
      was increased in five of six groups and was unchanged in one group. These
      arteries had an increased medial area but they had fewer medial cells than
      noninjured arteries. Injured arteries treated with control implants without
      paclitaxel exhibited intimal hyperplasia and luminal narrowing. CONCLUSION:
      Perivascular slow release of paclitaxel totally inhibits intimal hyperplasia and
      prevents luminal narrowing after balloon injury. Because of its efficacy,
      perivascular paclitaxel represents a possible approach for prevention of
      restenosis in humans.

PMID- 11200359
TI  - The effects of a mechanical thrombolytic device on normal canine vein valves.
AB  - PURPOSE: To determine if the Arrow-Trerotola Percutaneous Thrombolytic Device
      (PTD) causes damage to normal vein valves. MATERIALS AND METHODS: Ten lateral
      saphenous veins in five dogs were studied with descending venography with use of
      a wedge balloon catheter positioned above 48 valves (demonstrating 51 valves)
      before and after five antegrade passes each with an over-the-wire (0.025-inch),
      6.5-F, 9-mm-diameter PTD. Vein diameters were 3.2-11.4 mm (mean, 5.9 mm).
      Contrast matter was injected at incremental rates from 3 to 15 mL/min during
      continuous pressure monitoring. Imaging was performed with digital subtraction
      angiography at a rate of 1 frame/sec. The time to valve reflux was determined by
      noting the frame at which reflux was first seen through the valve. The time to
      reflux and pressure required to reflux were compared before and after the PTD
      passes. All vessels were explanted and evaluated histologically for presence or
      absence of endothelial loss, thrombus formation, inflammation, or valve
      degeneration. Four veins in two animals were studied with venography to determine
      the variability of the venographic method. These veins thrombosed during
      venography and therefore served as positive pathologic controls. In two animals,
      one vein was studied with venography and one was not studied to provide
      pathologic controls. RESULTS: With use of two physiologic tests of valve
      function, 77% of valves had minimal or no damage as assessed by valve competency
      and 80% had minimal or no damage as demonstrated by the change in the pressures
      the valve can withstand before reflux. Twenty-six of 51 valves (51%) had no
      difference or later reflux after PTD use. Thirteen (26%) refluxed 1 second
      earlier after PTD use and 12 (23%) refluxed > or =2 seconds earlier (six at 2,
      four at 3, and two at 4). Four of the six valves with more than a 2-second
      difference in reflux times were in valves with diameters less than 4.2 mm. All
      these vessels were smaller than 7 mm in diameter. Twenty-one of 48 valve levels
      (44%) had no difference or sustained higher pressures before reflux after PTD
      use. Seventeen (36%) had a pressure drop of <10 mm Hg; five (10%) had drops of 12
      24 mm Hg; and five (10%) had drops of more than 40 mm Hg. There was a significant
      difference in endothelial loss, thrombus formation, and inflammation between
      experimental veins, the veins with thrombus, the venography controls, and the
      normal vein controls. There was significant difference only in terms of
      inflammation when the experimental group was compared to the thrombosis group.
      CONCLUSION: The antegrade use of the PTD across normal canine vein valves does
      not cause physiologically significant damage in valves 7 mm or larger in diameter
      in this animal model.

PMID- 11200360
TI  - Preclinical in vivo testing of the Arrow-Trerotola percutaneous thrombolytic
      device for venous thrombosis.
AB  - PURPOSE: To test the safety and efficacy of using the Arrow-Trerotola
      percutaneous thrombolytic device (PTD) for treating deep vein thrombosis (DVT) in
      an animal model. MATERIALS AND METHODS: An established canine model of iliocaval
      subacute thrombosis was used. Thrombosis was caused by balloon occlusion of the
      infrarenal inferior vena cava (IVC) for 7 (n = 12), 10 (n = 1), or 17 (n = 1)
      days. Treatment was performed with use of an 8-F, over-the-wire (0.035-inch) PTD
      with a 15-mm-diameter basket. The procedure was performed without IVC filtration.
      Two acute procedures were performed and 12 procedures were intended as survival
      procedures with 30-day follow-up. Pulmonary arteriography, blood gases, and
      pulmonary artery pressure measurement were performed before and after the
      procedure, and at follow-up. The animals were killed after the follow-up
      procedure and their IVC, iliac veins, and lungs were removed and examined
      histologically. Heparin was used intraprocedurally but thrombolytic agents were
      not used. Low-molecular-weight heparin was given daily after the procedure.
      RESULTS: Thrombolysis was completely (12 of 13) or partially (one of 13)
      successful in all animals in the 7- and 10-day groups, but was unsuccessful in
      the animal in the 17-day group (n = 1). Variable amounts of segmental and
      subsegmental pulmonary emboli were found in all animals with small increases in
      pulmonary artery pressure. Two animals died within 6 days of the procedure,
      possibly due to pulmonary emboli. At 30-day follow-up, IVC patency was preserved
      in 80% (eight of 10) of animals, but significant caval narrowing due to intimal
      hyperplasia was noted at follow-up. All pulmonary emboli had resolved
      angiographically at follow-up, but evidence of recanalized or resolving pulmonary
      thromboemboli was found in seven of the 12 surviving animals. No acute vascular
      injury (eg, perforation) occurred. CONCLUSION: The modified PTD used in this
      study is effective in treating subacute (<7 days old) venous thrombosis, but
      temporary filtration will probably be necessary to keep pulmonary emboli to a
      minimum during the procedure. The 30-day patency is encouraging. The results in
      this animal model indicate that the Arrow-Trerotola PTD may be useful in the
      percutaneous treatment of DVT in humans.

PMID- 11200361
TI  - Bothrops asper snake venom and its metalloproteinase BaP-1 activate the
      complement system. Role in leucocyte recruitment.
AB  - The venom of the snake Bothrops asper, the most important poisonous snake in
      Central America, evokes an inflammatory response, the mechanisms of which are not
      well characterized. The objectives of this study were to investigate whether B.
      asper venom and its purified toxins--phospholipases and metalloproteinase-
      activate the complement system and the contribution of the effect on leucocyte
      recruitment. In vitro chemotaxis assays were performed using Boyden's chamber
      model to investigate the ability of serum incubated with venom and its purified
      toxins to induce neutrophil migration. The complement consumption by the venom
      was evaluated using an in vitro haemolytic assay. The importance of complement
      activation by the venom on neutrophil migration was investigated in vivo by
      injecting the venom into the peritoneal cavity of C5-deficient mice. Data
      obtained demonstrated that serum incubated with crude venom and its purified
      metalloproteinase BaP-1 are able to induce rat neutrophil chemotaxis, probably
      mediated by agent(s) derived from the complement system. This hypothesis was
      corroborated by the capacity of the venom to activate this system in vitro. The
      involvement of C5a in neutrophil chemotaxis induced by venom-activated serum was
      demonstrated by abolishing migration when neutrophils were pre-incubated with
      antirat C5a receptor antibody. The relevance of the complement system in in vivo
      leucocyte mobilization was further demonstrated by the drastic decrease of this
      response in C5-deficient mice. Pre-incubation of serum with the soluble human
      recombinant complement receptor type 1 (sCR 1) did not prevent the response
      induced by the venom, but abolished the migration evoked by metalloproteinase
      activated serum. These data show the role of the complement system in bothropic
      envenomation and the participation of metalloproteinase in the effect. Also, they
      suggest that the venom may contain other component(s) which can cause direct
      activation of C5a.

PMID- 11200362
TI  - Effect of ricinoleic acid in acute and subchronic experimental models of
      inflammation.
AB  - Observational studies indicate that topical application of ricinoleic acid (RA),
      the main component of castor oil, exerts remarkable analgesic and anti
      inflammatory effects. Pharmacological characterization has shown similarities
      between the effects of RA and those of capsaicin, suggesting a potential
      interaction of this drug on sensory neuropeptide-mediated neurogenic
      inflammation. The aim of this study was to assess RA anti-inflammatory activities
      in comparison with capsaicin in several models of acute and subchronic
      inflammation. The acute inflammation was induced by intradermal injection of
      carrageenan in the mouse or by histamine in the guinea-pig eyelid. In either
      experiment, the extent of the oedema thickness was measured. Subchronic oedema
      was induced by complete Freund's adjuvant injection in the ventral right paw of
      mice. Tissue substance P (SP) was measured in the carrageenan experiments by
      radioimmunoassay (RIA). It was found that the acute topical application of RA
      (0.9 mg/mouse) or capsaicin (0.09 mg/mouse) significantly increased the mouse paw
      oedema induced by carrageenan, while an 8-day repeated topical treatment with the
      same doses of both compounds resulted in a marked inhibition of carrageenan
      induced paw oedema matched by a reduction in SP tissue levels. Similar effects
      were found against histamine-induced eyelid oedema in guinea-pigs after acute or
      repeated application of RA or capsaicin. RA and capsaicin given for 1-3 weeks
      reduced the established oedema induced by Freund's adjuvant, a subchronic model
      of inflammation, particularly if given by the intradermal route. Either in mouse
      paw or in guinea-pig eyelid, capsaicin but not RA by itself produced a slight
      hyperemia and activation of a behavioural response (e.g. scratching of the
      eyelids). On the basis of the present results, RA may be seen as a new capsaicin
      like, non-pungent anti-inflammatory agent suitable for peripheral application.

PMID- 11200364
TI  - Permeability characteristics of human endothelial monolayers seeded on different
      extracellular matrix proteins.
AB  - OBJECTIVE: To investigate whether endothelial monolayer permeability changes
      induced by inflammatory mediators are affected by the extracellular matrix
      protein used for cell seeding. METHODS: Human umbilical venular endothelial cells
      (HUVEC) were grown to confluent monolayers on membranes coated with either
      collagen, fibronectin or gelatin. The permeability to albumin and dextran was
      then assessed, both under normal conditions and after treatment with tumor
      necrosis factor-alpha (TNF-alpha) and bacterial lipopolysaccharide (LPS).
      RESULTS: With any of the three protein coatings, tight junctions were formed all
      over the monolayers. The permeability of the coated membranes to albumin and
      dextran was reduced strongly by confluent monolayers; the relative reduction was
      similar for the three matrix proteins used. Pre-incubation of the monolayers with
      either TNF-alpha or LPS increased permeability dose dependently. However, the
      relative increase due to either treatment was independent of the protein used for
      membrane coating. CONCLUSION: The extracellular matrix protein used for initial
      seeding of endothelial cultures plays a minor role in determining the
      permeability changes induced in HUVEC monolayers by inflammatory mediators.

PMID- 11200365
TI  - Effect of cyclosporin-A on the blood--retinal barrier permeability in
      streptozotocin-induced diabetes.
AB  - BACKGROUND: Our previous results showed that in retinas from streptozotocin (STZ)
      induced diabetic rats there is an increased level of interleukin-1beta (IL
      1beta). This cytokine may be involved in the expression of the inducible isoform
      of the nitric oxide synthase (iNOS), with consequent synthesis of large amounts
      of NO and blood-retinal barrier (BRB) breakdown. AIMS: The aim of this work was
      to examine whether the administration of cyclosporin-A (Cs-A) to STZ-induced
      diabetic rats inhibits the synthesis of IL-1beta and the expression of the
      inducible proteins, iNOS and cyclo-oxygenase-2 (COX-2) in retinal cells, and
      whether the activity of these proteins contribute to BRB breakdown. METHODS: The
      level of IL-1beta was evaluated by ELISA and the NO production by L-[3H]
      citrulline formation. Expression of iNOS and COX-2 proteins was determined by two
      methods, western blot and immunohistochemistry. The permeability of the BRB was
      assessed by quantification of the vitreous protein. RESULTS AND DISCUSSION: Our
      results indicated that the levels of IL-1beta and NO in retinas from Cs-A-treated
      diabetic rats are significantly reduced, as compared to that in non-treated
      diabetic rats. The treatment of diabetic rats with Cs-A also significantly
      inhibited the expression of the inducible proteins, iNOS and COX-2. The
      evaluation of the vitreous protein content revealed that Cs-A also reduces the
      BRB permeability. Taken together, these results suggest that the increased
      production of the inflammatory mediators, IL-1beta and NO, in diabetes may affect
      the BRB permeability and therefore contribute to the development of diabetic
      retinopathy.

PMID- 11200366
TI  - Spread of Staphylococcus aureus in hospitals: causes and prevention.
AB  - Methicillin-resistant Staphylococcus aureus (MRSA) has become a major nosocomial
      pathogen in many hospitals worldwide. Even more alarming, MRSA strains that are
      vancomycin intermediate-susceptible are isolated with increasing frequency,
      making therapy for staphylococcal infections even more difficult and prevention
      more important than ever. Spread of S. aureus in hospitals and infection control
      measures are reviewed. The major sources of S. aureus in hospitals are septic
      lesions and carriage sites of patients and personnel. Carriage often precedes
      infection. The anterior nares are the most consistent carriage site, followed by
      the perineal area. Skin contamination and aerial dissemination vary markedly
      between carriers and are most pronounced for combined nasal and perineal
      carriers. The principal mode of transmission is via transiently contaminated
      hands of hospital personnel. Airborne transmission seems important in the
      acquisition of nasal carriage. Infection control strategies include screening and
      isolation of newly admitted patients suspected of carrying MRSA or S. aureus with
      intermediate resistance to vancomycin, implementation of an infection control
      program to prevent transmission of resistant strains between patients and
      hospital personnel, and institution of a proper antibiotic policy to minimize
      antibiotic resistance development. MRSA carriers should be treated with
      intranasal antibiotics, e.g. mupirocin, and skin disinfectants to eliminate
      carriage. Education of hospital personnel is essential. Improved knowledge about
      the best ways to ensure favourable infection control practices is needed. Active
      intervention against the spread of MRSA is important.

PMID- 11200363
TI  - Plasma cytokine response in mice with bacterial infection.
AB  - BACKGROUND: Exposure to microorganisms elicts the production of cytokines. These
      soluble factors enhance several innate immune functions and regulate the ensuing
      specific immune response aimed at limiting the spread of infection. AIM: This
      study was undertaken to quantify the plasma levels of pro-inflammatory cytokines
      during the course of primary Listeria monocytogenes and Campylobacter jejuni
      infection. Using an in vivo infection the relationship between endogenous
      cytokines and the bacterial number in the liver of infected animals was examined.
      METHODS: C57BL/6 mice were infected by the intraperitoneal route. At different
      time points we determined the number of colony-forming units of bacteria in the
      liver of infected animals and paralled these with the plasma levels of interferon
      gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL
      6) measured by enzyme immunoassays. RESULTS: L. monocytogenes infection lasted 10
      11 days. IFN-gamma production occurred in the early phase but was more pronounced
      after day 4, following the appearance of specific immunity. The duration of
      experimental campylobacteriosis was 15 days. Early IFN-gamma production was not
      significant but a progressive rise of this cytokine in plasma was seen during the
      second week post infection. Mice produced measurable amounts of plasma TNF-alpha
      immediately after being given viable L. monocytogenes, peaking on day 2-3 when
      the greatest number of bacteria was present in the examined organs. During C.
      jejuni infection plasma TNF-alpha was produced in a similar manner, but the
      highest concentrations were found a few days later than in listeriosis, in
      correlation with the different course of campylobacteriosis. The quantity of IL-6
      increased and decreased in concordance with clearance of L monocytogenes and the
      clinical status of the animals. C. jejuni did not promote the induction of this
      cytokine. This is to some extent an unusual finding. With respect to the role of
      IL-6 in Th2 responses and antibody production, the appearance of this cytokine in
      campylobacteriosis was more expected. DISCUSSION: During systemic bacterial
      infection, a network of pro-inflammatory cytokines is activated and blood levels
      of these cytokines are elevated, albeit inconsistently, with large individual
      variations and depending on microbial characteristics and structure.

PMID- 11200367
TI  - Decrease in immune activation in HIV-infected patients treated with highly active
      antiretroviral therapy correlates with the function of hematopoietic progenitor
      cells and the number of naive CD4+ cells.
AB  - This study was conducted to determine the impact of immune activation, cytokine
      production and apoptosis on the naive CD4+ cell count and the function of
      hematopoietic progenitor cells during the initial phase of highly active
      antiretroviral therapy (HAART). Blood samples from 11 HIV-infected patients were
      collected prior to HAART and after 4 and 12 weeks of therapy. Flow cytometry was
      used to determine the naive CD4+ count and activated T cells. The cloning
      efficiency of progenitor cells was determined using a colony-forming cells assay.
      Finally, apoptosis and cytokine production were determined. During the study
      period, the naive CD4+ count and the cloning efficiency increased significantly.
      Immune activation was found in HIV-infected patients and decreased during HAART.
      The level of immune activation correlated negatively with both the naive CD4+
      count and the function of progenitor cells. A negative correlation was found
      between apoptosis and the naive CD4+ count. Alterations in cytokine production
      during HAART or correlation between cytokine production and the naive CD4+ count
      or the cloning efficiency of progenitor cells were not detected. In conclusion,
      immune activation in HIV-infected patients treated with HAART is inversely
      correlated with the function of progenitor cells and the naive CD4+ count.

PMID- 11200368
TI  - A case of Q fever acquired in Sweden and isolation of the probable ethiological
      agent, Coxiella burnetii from an indigenous source.
AB  - Serologically verified indigenous Q fever is described in a 52-y-old male, who
      presented with persistent fever, muscle and joint pain, headache and non-purulent
      cough. Institution of doxycycline resulted in prompt recovery. Coxiella burnetii
      was isolated from mouldy hay in a barn. The strain differs from previously
      isolated ones in Sweden.

PMID- 11200369
TI  - Invasive group A streptococcal infections in Sweden in 1994 and 1995:
      epidemiology and clinical spectrum.
AB  - A nationwide study of invasive group A streptococcal (GAS) infections in Sweden
      during 1994-1995 was carried out. All Swedish microbiological laboratories were
      asked to report isolates of GAS from normally sterile sites. During the study
      period they were also asked to send their isolates for T typing. Questionnaires
      were sent to the physicians in charge of each patient. The incidence, serotype,
      clinical presentation, symptoms and outcome were recorded. Clinical data were
      obtained for 468 of 556 patients with GAS bacteraemia. The lethality rate was
      16%, but was much higher (37%) in the 113 patients who developed streptococcal
      toxic shock syndrome (STSS). Streptococci of serotype T1 dominated during the
      study period and were linked to the increase in invasive GAS infections. They
      also carried an increased risk of causing STSS. Invasive streptococcal disease
      with STSS most often has an unknown primary focus or is associated with soft
      tissue infections. Invasive streptococcal disease not associated with STSS most
      often has a skin infection as portal of entry or else an unknown focus.

PMID- 11200370
TI  - Increased incidence of bacteraemia due to viridans streptococci in an unselected
      population of patients with acute myeloid leukaemia.
AB  - The aetiology, clinical characteristics and outcome of bacteraemia in patients
      with acute myeloid leukaemia were studied. All positive blood cultures collected
      at a haematological ward during 2 7-y periods were evaluated. Altogether, 274
      episodes of bacteraemia in 152 patients were recorded, 80 episodes during 1980-86
      and 194 during 1990-96. During the 2 periods, trimethoprim-sulfamethoxazol in
      combination with amikacin was the first-line empirical therapy in patients with
      neutropaenia and fever. In 1990, antimicrobial prophylaxis with ciprofloxacin and
      fluconazole was introduced. The incidence of bacteraemia due to viridans
      streptococci or coagulase-negative staphylococci increased from the first period
      to the second, whereas the incidence of Enterobacteriaceae decreased. In
      granulocytopaenic patients during 1990-96, viridans streptococci accounted for
      21% of the isolates and in patients treated prophylactically with
      fluoroquinolone, viridans streptococci accounted for 31%. All viridans
      streptococci were sensitive to penicillin. At the time of the positive blood
      cultures, the patients of the second period were granulocytopaenic in 83% of the
      episodes. The mortality related to septicaemia during the later period was 13%
      and only 1 of 33 (3%) of the patients with viridans streptococci died. Eight
      patients (9%) died in relation to septicaemia following curative antileukaemic
      therapy.

PMID- 11200371
TI  - Antimicrobial susceptibility patterns of Streptococcus agalactiae in a German
      university hospital.
AB  - Group B streptococci (GBS) are the major cause of neonatal sepsis and meningitis.
      GBS infection in neonates is usually treated with a combination of penicillin and
      gentamicin. According to consensus guidelines, pregnant women at risk receive
      intrapartum prophylaxis with either ampicillin or penicillin or, in case of
      allergy, with erythromycin or clindamycin. We investigated the susceptibility
      patterns of 190 GBS strains from neonates isolated from 1993-1999 and 150 GBS
      strains collected from adult women in 1997 and 1999. All isolates were
      susceptible to penicillin, ampicillin and cefotaxime. Erythromycin resistance
      among all isolates from neonates and from adult women in 1997 was 4.7% and 6%,
      respectively. In contrast, 12% of the isolates from adult women in 1999 were
      resistant to erythromycin and 7% were resistant to clindamycin. These findings
      show an increasing macrolide resistance in recent GBS strains and indicate the
      need for further surveillance.

PMID- 11200373
TI  - Fusidic acid disk diffusion testing of clostridium difficile can be calibrated
      using single-strain regression analysis.
AB  - Single-strain regression analysis (SRA) was employed to calibrate the disk
      diffusion antibiotic susceptibility test for fusidic acid and Clostridium
      difficile. MIC determinations of 40 clinical isolates of C. difficile were
      performed with the E-test. The disk diffusion test was standardized according to
      the Swedish Reference Group for Antibiotics (SRGA). Disks used for SRA contained
      1.5, 5, 15, 50 and 150 microg fusidic acid and the routine disk contained 50
      microg fusidic acid. A control strain, ATCC 9689, was also tested. SRA constants
      A and B of the regression lines were calculated. This permitted the determination
      of zone breakpoints for C. difficile. When applying the pharmacological MIC S and
      R limits set by SRGA to the E-test results I strain of C. difficile was
      interpreted as resistant. Zone breakpoints corresponding to the pharmacological
      MIC limits and calculated using the mean SRA constants for the 40 clinical
      isolates lead to all strains being interpreted as susceptible. SRA calculations
      enable laboratories to set up calibrated disk tests with species-related and
      laboratory-specific interpretations.

PMID- 11200372
TI  - Impact on human intestinal microflora of an Enterococcus faecium probiotic and
      vancomycin.
AB  - The aims of this study were to evaluate the impact of a fermented milk product
      containing viable Enterococcus faecium on human intestinal microflora and to
      evaluate any risk of development of vancomycin-resistant enterococci (VRE).
      Twenty Danish and 20 Swedish healthy volunteers were given 150 ml of the
      fermented milk product once daily, equivalent to a daily dose of 4.5 x 10(9) to
      7.5 x 10(9) CFU E. faecium, for 10 d. Half of the volunteers also received 125 mg
      vancomycin orally q.i.d. for 10 d. Faecal samples were collected on day 0 before
      intake, on day 10 directly after end of intake and on day 31, 3 weeks after the
      end of the experiment. There was a significant increase in the total number of
      enterococci on day 10 (p < 0.01) in the group receiving only the E. faecium
      supplement, but 3 weeks later the level was as before intake. In the vancomycin
      group, the total number of enterococci was reduced on day 10 (p < 0.01) but had
      increased on day 31 (p < 0.01) in relation to day 0. In none of the Swedish and 4
      of the Danish volunteers, VRE were sporadically detected, but without relation to
      intake of the probiotic or vancomycin. In healthy young Danish individuals the
      VRE carrier rate tended to be higher than previously found.

PMID- 11200374
TI  - Molecular epidemiology survey of toxinogenic Clostridium perfringens strain types
      by multiplex PCR.
AB  - Toxin genotypes of 95 C. perfringens strains collected within a 45-year period
      were analysed by a multiplex PCR. A set of primers designed for 4 different genes
      encoding the alpha, beta, epsilon, and iota toxins was used in a single reaction
      with a sensitivity of gene detection of 200 fg for DNA extracted from pure
      culture. Most of the strains (97%) conformed to the A biotype, and the remaining
      to the C or E biotypes. For biotype determination, seroneutralization of
      lethality in mice was performed by intravenous injection. Toxin phenotype and
      genotype profile were concordant in 94% of strains. Our results documented the
      presence of rare toxin genotypes of C. perfringens in a Polish geographical
      region and indicated the suitability of multiplex PCR as a method supplementing
      classical techniques and providing better insight into the prevalence of
      toxinogenic C. perfringens strains.

PMID- 11200375
TI  - Synergy of Bacteroides fragilis and Escherichia coli in the induction of KC gene
      expression in mouse peritoneal tissues.
AB  - B. fragilis induces cytokine expression, which can serve as a host signal leading
      to inflammatory reaction and abscess formation in the peritoneal cavity. We
      assessed the hypothesis that enteric bacteria may alter the B. fragilis-induced
      expression of KC genes in mouse peritoneal tissues (MPT). After C57BL/6 mice were
      inoculated with abscess-forming mixture containing B. fragilis in the presence or
      absence of E. coli, RNA was extracted from MPT. Expression of KC mRNA was
      quantified using reverse-transcription polymerase chain reaction and standard
      RNA. KC and TNFalpha proteins were measured by enzyme-linked immunosorbent assay.
      KC mRNA in MPT was upregulated following inoculation of B. fragilis and this was
      paralleled by increased KC protein secretion. When the mice were co-infected with
      E. coli and B. fragilis intraperitoneally, there was a synergistic increase in
      the expression of KC of MPT. Co-infection with L. acidophilus and B. fragilis
      downregulated KC mRNA expression, but co-infection with E. faecalis and B.
      fragilis synergistically increased KC expression in the infected MPT. Inhibition
      of TNFalpha production could downregulate KC expression in mixed infected MPT.
      These results suggest that enteric bacteria may significantly affect the KC
      signal produced by the host peritoneal cavity in response to B. fragilis
      infection.

PMID- 11200376
TI  - Clinical implications of stenotrophomonas maltophilia resistant to trimethoprim
      sulfamethoxazole: a study of 69 patients at 2 university hospitals.
AB  - We conducted a retrospective case study at 2 tertiary care centers to determine
      the clinical implications of trimethoprim-sulfamethoxazole resistant
      Stenotrophomonas maltophilia (TSRSM). Of 69 reviewed cases (mean age, 57 y; male
      gender, 70%), 40 (58%) were classified as infections associated with TSRSM
      (respiratory tract, 14; soft tissue, 11; bloodstream, 8; other sites, 7). Severe
      underlying comorbidities (86%) and previous antibiotic exposure (99%) were
      common. Cefotetan (susceptibility, 55%), chloramphenicol (49%) and ticarcillin
      clavulanate (45%) showed the highest in vitro activity against TSRSM, but were
      seldom used for therapy (7%). Among the 40 infected cases, 8 developed sepsis
      disorders and 8 died. Only 1 death could be directly attributed to autopsy-proven
      TSRSM infection (pneumonia). McCabe score (p = 0.03) and organ dysfunction (p =
      0.006) were associated with an increased risk of death in infected patients;
      exposure to appropriate therapy tended to be protective against death (p = 0.08).
      22 infected patients were treated medically; an additional procedure was
      necessary to clear the infection in 18 cases (surgery, 13; catheter removal, 5).
      Isolation precautions were rarely exercised, even in the presence of panresistant
      isolates. In summary, TSRSM-related infections occurred in severely ill patients
      with extensive exposure to the health-care system, and often required invasive
      procedures for cure. Infections were directly associated with severe morbidity,
      and tended to have an indirect rather than a direct impact on mortality.

PMID- 11200377
TI  - Evaluation of 120 mycobacterial strains isolated from clinical specimens to the
      species level by polymerase chain reaction-restriction enzyme analysis.
AB  - In this study, a total of 120 mycobacterial strains isolated from clinical
      specimens in Hacettepe University Hospital Clinical Pathology Laboratories were
      evaluated by polymerase chain reaction-restriction enzyme analysis (PRA), which
      analyses the common mycobacterial heat shock protein gene (hsp65). 95 of 120
      strains (79.1%) were identified as Mycobacterium tuberculosis and 25 (20.8%) were
      identified as non-tuberculous mycobacteria (NTM). M. gordonae I and IV were the
      most common NTM species (3.3% each) followed by M. chelonae (2.5%). Other NTM
      species isolated were M. gordonae III, M. avium, M. peregrinum (1.6%), M.
      fortuitum, M. flavescens, M. malmoense and M. mucogenicum (0.8%). Four isolates
      had PRA patterns that did not match any patterns previously described. The
      patients who had NTM had underlying diseases; the most frequent clinical
      diagnosis among these was chronic obstructive pulmonary disease (COPD) and
      chronic renal failure. AIDS and pulmonary carcinoma were the other underlying
      diseases detected.

PMID- 11200378
TI  - IS6110-RFLP and spoligotyping of Mycobacterium tuberculosis isolates in Iran.
AB  - To evaluate and compare the usefulness of IS6110-restriction fragment length
      polymorphism (RFLP) and spoligotyping in the epidemiology of tuberculosis in
      Iran, Mycobacterium tuberculosis complex strains, isolated in 2 different areas
      of Iran, were subjected to RFLP and spoligotyping. The average number of IS6110
      copies per strain was 11 and ranged from 5 to 18 among the M. tuberculosis
      strains. In total, among the 62 isolates, 56 different patterns were observed. 50
      strains had unique RFLP patterns (89%) and 12 (11%) revealed patterns that were
      found among at least 1 other isolate. Spoligotyping of 97 isolates resulted in 42
      different patterns, of which 72% were found in 15 clusters. 14 (29%) out of 48
      investigated isolates were resistant to 1 or more antituberculosis drugs and 57%
      of the resistant isolates were isolated from Afghan immigrants. Ten percent of
      the isolates represented the Beijing genotype, including 4 of the 14 (36%)
      resistant strains. Three of these resistant Beijing strains were isolated from
      Afghan patients. IS6110-RFLP typing could be useful for studying the epidemiology
      of tuberculosis in Iran. IS6110 patterns were polymorphic and the average IS6110
      copy number was high.

PMID- 11200379
TI  - Influence of pH and concentration on the postantifungal effect and on the effects
      of sub-MIC concentrations of 4 antifungal agents on previously treated Candida
      spp.
AB  - This study investigates the impact of different pH values (5.5 and 7.4) on the
      postantifungal effect (PAFE) and the effect of sub-MIC concentrations (1/4 x MIC)
      on C. albicans and C. glabrata in the PAFE stage (PAFSE). The PAFE stage was
      induced by a 1.5 h pretreatment with different doses (1, 4 and 8 x MIC) of 4
      antifungal agents. An increase in the pH and/or an increase in the dose of the
      antimycotic prolonged the duration of the PAFE induced by amphotericin B or 5
      fluorocytosine and the PAFSE induced by all 4 antifungal agents in both species.
      5-Fluorocytosine and amphotericin B (except for treatment with 1 x MIC at pH 5.5)
      induced significant PAFEs (0.5-3.0 h and 1.4-4.8 h, respectively), which were
      increased (to 0.9-3.2 h and 0.8-3.4 h, respectively) by posterior (PLEASE EXPLAIN
      WHAT YOU MEAN BY THE WORD "POSTERIOR" HERE) exposure to 1/4 X MIC of the
      respective antifungal agent. Although ketoconazole and fluconazole were not able
      to induce significant PAFEs, posterior exposure to 1/4 x MIC of each of these 2
      azoles led to significant PAFSEs of up to 2.6 h in both yeast species when the
      concentrations and pH were high enough.

PMID- 11200380
TI  - Efficacy of amphotericin B colloidal dispersion in the treatment of Mediterranean
      visceral leishmaniasis in immunocompetent adult patients.
AB  - Twelve immunocompetent adults with Mediterranean visceral leishmaniasis (VL) were
      treated with amphotericin B colloidal dispersion (ABCD; 2 mg/kg/d for 7 d). All
      patients showed rapid clinical response without significant adverse events. Two
      weeks after therapy they were parasitologically cured and no relapses occurred
      during 6 months. ABCD is a valid alternative in the management of Mediterranean
      VL in adult patients.

PMID- 11200381
TI  - Short therapy with amoxicillin-clavulanate and corticosteroids in acute
      sinusitis: results of a multicentre study in adults.
AB  - Evolution of bacterial resistance shortens antibiotic treatment in ENT
      infections. The efficacy and tolerance of amoxicillin-clavulanate (ACA), with and
      without associated short steroid therapy, was evaluated in acute sinusitis of
      adults at a dosage of 1.5 g/d for 5 d vs. 10 d. This multicentre, randomized,
      double-blind, placebo-controlled study included 433 patients, 417 of whom were
      suitable for intent-to-treat (ITT) analysis. The therapeutic success rate in the
      ITT population, assessed according to strict clinical and radiological criteria,
      was respectively, 80% and 85% in the 5-d and 10-d treatment groups. Due to the
      statistical risks that were evidenced, the 2 durations of treatment could not be
      considered equivalent. The analysis of medical history shows that some risk
      factors (recurrence of sinusitis, previous surgical sinus drainage) seem to
      promote therapeutic failure and that 5-d treatment is inappropriate in these
      patients. The persistence of therapeutic success on day 30 was not influenced by
      the initial duration of treatment. The efficacy and good tolerance of ACA in
      acute sinusitis in adults were confirmed. Further studies will be needed to
      define the indications of short treatments better, which seem to be indicated in
      the absence of specific risk factors.

PMID- 11200382
TI  - Duration of postoperative antibiotic therapy following revision for infected knee
      and hip arthroplasties.
AB  - In the period from 1990 to 1998 28 patients (14 males and 14 females) were
      treated for infected hip (19 cases) and knee (9 cases) arthroplasties. The median
      age at index operation was 72 y (range 34-82 y) and at revision surgery 74 y
      (range 36-83 y). The primary diagnosis was osteoarthritis (16 cases), rheumatoid
      arthritis (5 cases), failed femoral neck fracture (6 cases) and arthritis
      secondary to congenital hip dislocation (1 case). Nine cases were infected early,
      i.e. within 3 months postoperatively, and 19 had late infections. The median
      interval from index operation to diagnosis of the infected arthroplasty was 18
      months (range 1-156 months). Postoperatively, all patients received antibiotics
      based on susceptibility studies of the causative organism according to culture
      specimens. The erythrocyte sedimentation rate and CRP level were controlled twice
      a week during hospitalization and antibiotics were continued until normalization
      of CRP. The indication for the shift from intravenous to oral antibiotics was a
      rapid fall in CRP. Antibiotic therapy was terminated when CRP was close to or
      below 10 mg/l and there was evidence of clinical recovery. Based on the screening
      of ESR and CRP in this study we believe that CRP is a valuable parameter in
      deciding when to stop antibiotic therapy. However, it is not clear whether a
      shorter treatment period is effective or not.

PMID- 11200383
TI  - PCR in meningoencephalitis diagnosis.
AB  - Polymerase chain reaction (PCR) detection of a stretch of nucleic acid sequence
      of microbial origin from a clinical sample is not always diagnostic of disease
      unless the identified agent is a strict pathogen or its growth is documented. We
      describe here a case of acute meningoencephalitis in a 21-y-old man, in whom no
      pathogen was isolated by traditional bacterial or viral culture. Standard DNA PCR
      performed on the cerebrospinal fluid (CSF) identified the presence of 3
      infectious agents: HHV-6, HHV-7 and Mycoplasma pneumoniae. Additional PCRs
      performed on CSF fractions along with gene transcript analysis proved the
      bystander role of the 2 herpesviruses and indicated M. pneumoniae as the relevant
      replicating agent, most likely playing to be a pathogenic role. Until this useful
      analysis becomes routine, clinicians should deal carefully with DNA PCR results,
      especially when assessing the aetiological role of agents, such as herpesviruses,
      which are known to undergo latency.

PMID- 11200384
TI  - Iatrogenic meningitis: an increasing role for resistant viridans streptococci?
      Case report and review of the last 20 years.
AB  - Iatrogenic meningitis following lumbar puncture is a rare event. We present a 52
      y-old man who developed symptoms of meningitis within 12 h after spinal
      anaesthesia. Cerebrospinal fluid cultures grew Streptococcus salivarius partially
      resistant to penicillin and ceftriaxone. The patient was successfully treated
      with ceftriaxone and vancomycin and left the hospital with minor sequelae. A
      literature review of 60 cases revealed the median age of the patients to be 44 y.
      The median incubation period was 24 h. Most cases occurred after spinal
      anaesthesia (n = 27), myelography (n = 20) and diagnostic lumbar puncture (n =
      5). Organisms were isolated in 52 cases, and streptococcal species were
      responsible for 33 (63%) of them. An upward trend in resistance of S. viridans
      isolates is cause for concern and may change empirical treatment strategies.
      Death was reported in 3 cases (5%) and was associated with Pseudomonas and
      staphylococcal isolates. The recognition of this entity and the importance of
      proper infection control measures are underlined.

PMID- 11200385
TI  - Peritonitis due to Staphylococcus sciuri in a patient on continuous ambulatory
      peritoneal dialysis.
AB  - Among the coagulase-negative staphylococci, Staphylococcus sciuri has rarely been
      described as the aetiology of continuous ambulatory peritoneal dialysis (CAPD)
      peritonitis. It has been reported in 1 case of endocarditis and has been isolated
      from peritoneal dialysis fluid in 2 patients. The case reported here describes
      CAPD peritonitis due to S. sciuri shortly after a previous episode due to S.
      aureus, showing the necessity to identify coagulase-negative staphylococci to
      find new species that cause CAPD peritonitis.

PMID- 11200386
TI  - Spontaneous Escherichia coli meningitis in an adult.
AB  - Spontaneous meningitis due to gram-negative bacilli (excluding Hemophilus
      influenzae) is an infrequent infection in adult patients. It usually occurs in
      patients with underlying immunosuppressive conditions. Most of the cases are due
      to Escherichia coli and represent a complication of bacteraemia. The infection
      has a high mortality rate which may be as high as 90%, especially if associated
      with septicaemia. We report the case of a 53-y-old man with spontaneous,
      community-acquired Escherichia coli meningitis who was admitted with an unusual
      presentation. Blood and urine cultures were negative.

PMID- 11200387
TI  - Isolated splenic tuberculosis presenting with pyrexia of unknown origin.
AB  - We report a case of a 62-y-old man who presented with fever, malaise and weight
      loss. He was diagnosed with pyrexia of unknown origin due to tuberculosis of the
      spleen. Combination anti-tuberculous therapy was administered and fever gradually
      subsided after 6 weeks. A 12-month course of anti-tuberculous treatment would
      appear to be appropriate for the treatment of most patients with splenic
      tuberculosis.

PMID- 11200388
TI  - Fatal Mycobacterium tuberculosis brain abscess in an immunocompetent patient.
AB  - A non-HIV-infected 63-y-old woman presented seizures and coma during the course
      of Mycobacterium tuberculosis infection. Computerized tomography scan led to the
      diagnosis of a large compressive brain abscess. The patient died with multiorgan
      failure. Systematic central nervous system investigations should be done in cases
      of disseminated tuberculosis.

PMID- 11200389
TI  - Subdural empyema after tooth extraction in which Capnocytophaga species was
      isolated.
AB  - We describe a patient with meningitis and a subdural empyema arising from an
      infection after teeth extraction in which Capnocytophaga species was detected.
      The patient was a 54-y-old man without any underlying diseases. A computerized
      tomography scan showed a subdural empyema 21 d after the extraction.

PMID- 11200390
TI  - Early antibiotic treatment may prevent complete development of Lemierre's
      syndrome: experience from 2 cases.
AB  - Lemierre's syndrome is a rare fulminant condition caused by an acute
      oropharyngeal infection, with secondary septic thrombophlebitis of the internal
      jugular vein complicated by multiple metastatic infections. Herein we report 2
      patients with internal jugular vein thrombosis secondary to oropharyngeal
      infection, whose clinical course was indolent, and who were asymptomatic shortly
      after antibiotic therapy was begun. Careful examination of the neck in patients
      presenting with sore throat could help identify the typical 'cord sign'. In such
      cases, intravenous antibiotic treatment should be started as soon as possible to
      prevent development of metastatic infections and septicaemia characterizing
      Lemierre's syndrome.

PMID- 11200391
TI  - Brain abscess due to Xylohypha bantiana.
AB  - A case of brain abscess due to Xylohypha bantiana without any obvious
      predisposing factors and with the uncommon clinical feature of seizures is
      presented.

PMID- 11200392
TI  - E-health, your workforce and you: tales of the early adopters.

PMID- 11200393
TI  - Substance abuse: myths and realities in the corporate sector.

PMID- 11200394
TI  - Annual managed care survey. Employers are tied to the inflation track.

PMID- 11200395
TI  - Do single workers get their fair share?

PMID- 11200396
TI  - Sherman shares the wealth.

PMID- 11200397
TI  - Healthy pregnancies start with planning.

PMID- 11200398
TI  - Datawatch. You may find this hard to believe.

PMID- 11200399
TI  - Abnormal microheterogeneity of haptoglobin in serum from dogs with various
      diseases.
AB  - Changes in the patterns of glycosylation of canine haptoglobin have recently been
      demonstrated by isoelectric focusing and immunoblotting. Fucosylated fractions of
      haptoglobin were identified by selective binding of a fucose-specific lectin. In
      this study, similar changes were found in the serum of 86 of 137 dogs with
      various inflammatory, autoimmune and neoplastic diseases. Major changes,
      including fucosylation, were observed in 40 of the dogs and were most frequent in
      association with autoimmune haemolytic anaemia. All 40 cases had markedly
      increased concentrations of haptoglobin and decreased concentrations of
      haemoglobin. Minor changes were found in the other 46 dogs, whereas no changes in
      glycosylation were detected in the serum of 40 healthy dogs.

PMID- 11200400
TI  - Prevalence of antibodies to tickborne encephalitis and West Nile flaviviruses and
      the clinical signs of tickborne encephalitis in dogs in the Czech Republic.
AB  - Blood sera from 151 dogs from areas of the Czech Republic endemic for human
      tickborne encephalitis (TBE) were examined for the presence of antibodies to TBE
      and West Nile (WN) flaviviruses by the haemagglutination-inhibition test
      Antibodies to TBE virus at titres equal to or exceeding 40 were found in five
      dogs. Antibodies to WN virus were detected in only one dog that also had a high
      antibody titre to TBE, suggesting this was a cross-reaction between the two
      closely related viruses. Three of the dogs (all rottweilers) with a TBE titre of
      320 had clinical signs of meningoencephalitis or encephalitis. They all survived
      after treatment for the clinical signs. It was proved by seroconversion that the
      disease was caused by the TBE virus in one of these three dogs, and it seems very
      likely that the virus was responsible for the disease in the other two.

PMID- 11200401
TI  - Pregnancy following in vitro fertilisation of canine oocytes.

PMID- 11200402
TI  - Contagious caprine pleuropneumonia in Tanzania.

PMID- 11200403
TI  - 63,XO/65,XYY mosaicism in a case of equine male pseudohermaphroditism.

PMID- 11200404
TI  - Progress with PETS.

PMID- 11200405
TI  - The farming crisis and animal welfare.

PMID- 11200406
TI  - Neutering of dogs.

PMID- 11200407
TI  - Lunar influence?

PMID- 11200408
TI  - FAWC's concerns about leg problems in broilers. Farm Animal Welfare Council.

PMID- 11200409
TI  - Twenty years on: the small animal practice of the future.

PMID- 11200410
TI  - Immunohistochemical detection of PrP in the medulla oblongata of sheep: the
      spectrum of staining in normal and scrapie-affected sheep.
AB  - Sections of the medulla oblongata from the brains of sheep were examined for
      prion protein (PrP) by immunohistochemistry. On the basis of the morphology and
      neuroanatomical distribution of the deposits, distinct disease-associated
      patterns of PrP deposition were identified in scrapie-affected sheep, suggesting
      at least four distinct phenotypes of scrapie. In addition, clearly defined
      patterns of PrP deposition, readily distinguished from the disease-associated PrP
      deposits, were identified in some normal sheep from scrapie-free flocks. In five
      sheep, believed to be preclinically affected by scrapie, PrP deposition of a
      disease-specific type but of restricted distribution was identified,
      demonstrating the sensitivity of the technique for the diagnosis of scrapie. The
      neuroanatomical distribution of these early PrP deposits suggest that the route
      of entry of the scrapie agent into the brain is via parasympathetic motor neurons
      in the vagus nerve which innervate the gastrointestinal tract.

PMID- 11200411
TI  - Together we stand: liver units in the new millennium.

PMID- 11200412
TI  - Adult-to-adult living-donor liver transplantation: a critical analysis.
AB  - Adult-to-adult living-donor liver transplantation is the most recent achievement
      in the evolution of strategies to increase donor organ supply. Justification of
      the procedure has evolved from increased organ-waiting times, wait-list morbidity
      and mortality of adult transplant candidates. Successful application of adult-to
      adult living-donor liver transplantation mandates unique surgical, medical, and
      donor considerations as these procedures predispose to unique complications
      resulting from anatomic variations, technical considerations, and the
      transplantation of "partial" grafts. Additionally, because the magnitude of the
      donor operation is greater and potentially fraught with serious short and long
      term morbidity and possibly mortality, the utilization of living-donors for adult
      liver transplantation raises bio-ethical concerns heretofore not encountered.
      This review explores the current state of adult-to-adult living-donor liver
      transplantation.

PMID- 11200413
TI  - Liver transplantation for hepatic and biliary malignancy.
AB  - The treatment of liver cancer by transplantation has evolved into a process of
      selecting early stage tumors that have a high likelihood of cure. Carefully
      selected cirrhotic patients with early hepatocellular cancer (< or = 5 cm.
      diameter and single; < or = 3 cm. diameter if multiple and 3 or fewer lesions; no
      vascular invasion) have 5-year actuarial survival rates of approximately 75%
      after transplantation. Preoperative imaging should be as extensive as necessary
      to accurately define the characteristics of tumor size, location, and number and
      exclude signs of extrahepatic involvement. Adjuvant and neoadjuvant chemotherapy
      became part of treatment protocols in many centers at the same time that more
      stringent criteria for transplant candidacy were applied to patients with cancer,
      making it difficult to attribute improved results to the chemotherapy.
      Nevertheless, neoadjuvant chemoembolization for hepatocellular cancer is logical
      for patients who may wait long periods before receiving transplants. The
      fibrolamellar variant of hepatoma is a less aggressive tumor and patients can do
      well after transplantation, but late recurrences are common. Hepatoblastoma in
      children can respond very favorably to chemotherapy combined with
      transplantation. Cholangiocarcinoma remains a dreadful malignancy. The rare cases
      of insitu cholangiocarcioma in patients who receive transplants for sclerosing
      cholangitis can be cured, but known cholangiocarcinoma has an exceedingly high
      rate of recurrence after transplantation alone. Recent work combining
      chemotherapy and radiation with transplantation has not had dramatic success at
      improving cure rates. Patients with metastatic neuroendocrine tumors of the liver
      can receive good palliation by transplantation, but the majority of patients
      eventually develop recurrent cancer.

PMID- 11200414
TI  - Liver and small bowel transplantation: therapeutic alternatives for the treatment
      of liver disease and intestinal failure.
AB  - Intestinal transplantation is an established life-saving therapy for parenteral
      nutrition dependent patients suffering from severe complications of parenteral
      nutrition. Improvements in outcomes over the last decade have occurred with
      refinements in surgical technique, better immunosuppressive regimens, and
      clinical experience. The long-term results of intestinal transplantation are not
      well known and morbidity remains an important obstacle to wider application of
      this procedure to patients with short bowel syndrome (SBS). This article reviews
      the indications for intestinal transplantation, the evaluation of potential
      candidates, therapeutic considerations, postoperative management and common
      complications experienced by the recipients.

PMID- 11200415
TI  - Timing of liver transplantation.
AB  - Under the current environment of liver transplantation, there are several factors
      to be considered in the timing of liver transplantation. These include expected
      patient survival with and without liver transplantation, patient's morbidity and
      quality of life before and after liver transplantation and overall resource
      utilization. Statistical models have been developed for patients with chronic
      liver disease, particularly of cholestatic variety. By applying these models in
      patients being considered for liver transplantation, a window of optimal timing
      of liver transplantation may be defined in such way that the survival gain is
      maximized and perioperative mortality minimized. Likewise, a number of
      pretransplant morbidity indicators such as Child-Pugh score, UNOS status, and
      renal insufficiency have been found to have a profound influence on post
      transplant morbidity, thus resource utilization. An increasing number of
      investigators have measured and documented a dramatic improvement in the quality
      of life of patients before and after liver transplantation. As the waiting time
      and uncertainty of the outcome of liver transplantation increase, consideration
      of these factors may be useful for physicians evaluating transplant candidates to
      make best-informed decisions in the selection of candidates and timing for liver
      transplantation.

PMID- 11200416
TI  - Hepatitis B and C in the liver transplant recipient.
AB  - Liver disease related to chronic viral hepatitis is the leading indication for
      orthotopic liver transplantation (OLT) worldwide. The evolution of our
      understanding of hepatitis B and C infection in the OLT recipient has been rapid
      in the last decade. The spontaneous risk for viral recurrence after
      transplantation is high but has been effectively decreased in hepatitis B
      infected recipients with the use of HBIG and lamivudine with dramatic
      improvements in patient and graft survivals. HCV recurrence as defined by
      histologic injury is almost universal although graft or patient outcomes for the
      first decade after OLT do not appear to be limited by HCV infection for most
      patients. However, individual patients do suffer severe graft injury and even
      graft loss due to recurrent HCV. With longer follow up into the second decade,
      the prevalence of HCV-related graft failure is likely to increase. In addition,
      the role of different immunosuppressive protocols on disease recurrence requires
      further study. Thus, although hepatitis B recurrence has been effectively
      contained by use of HBIG with or without lamivudine, the more intractable problem
      of managing recurrent HCV has as yet no obvious solutions. Optimal antiviral
      strategies for hepatitis C post-OLT have yet to be identified.

PMID- 11200417
TI  - Recurrent primary biliary cirrhosis, primary sclerosing cholangitis, and
      autoimmune hepatitis after transplantation.
AB  - Viral hepatitis and malignancy frequently recur after transplantation, but
      recurrence of primary biliary cirrhosis (PBC), primary sclerosing cholangitis
      (PSC), and autoimmune hepatitis is controversial. Differences in study design,
      number of patients, immunosuppressive treatment, length of follow-up, and
      criteria for recurrence account for discrepant results. Most patients with
      suspected recurrent disease are asymptomatic after transplantation. In patients
      transplanted for PBC, antimitochondrial antibodies frequently persist and do not
      correlate with disease recurrence; liver biopsy remains the gold standard for
      diagnosis. Exclusion of other disorders that can mimic PBC is paramount prior to
      making a diagnosis of recurrent disease. The effects of immunosuppression may
      modify or delay disease expression within the graft. If PBC recurs, intermediate
      term patient and graft survival is excellent, but long-term studies will be
      necessary to address the impact of disease recurrence on the allograft. Due to
      lack of a diagnostic gold standard, a diagnosis of recurrent PSC after
      transplantation is difficult to make. An accurate diagnosis of PSC recurrence
      requires well-defined cholangiographic and histologic criteria. Other disorders
      that can produce biliary strictures after transplantation should be excluded. As
      with PBC, the effects of immunosuppression may modify or delay disease expression
      within the graft; medium-term patient and graft survival is excellent. Recurrence
      of autoimmune hepatitis is based on clinical, biochemical, serologic, and
      histologic criteria. As in patients transplanted for PBC and PSC, other
      conditions that can mimic autoimmune hepatitis require exclusion prior to making
      a diagnosis of recurrence. Most adult recipients respond to an increase in
      immunosuppression, whereas pediatric recipients do not respond as well. A
      cautious approach to withdrawal of immunosuppression is warranted in all patients
      transplanted for autoimmune hepatitis and the consequences of recurrent disease
      within the graft will require prolonged follow-up. Future studies should focus on
      preventive and therapeutic strategies for recurrent autoimmune diseases after
      transplantation.

PMID- 11200418
TI  - The mystique of hepatic tolerogenicity.
AB  - The evolution of clinical transplantation has hinged on 2 seminal turning points.
      The first was the demonstration in 1953 by Billingham, Brent, and Medawar that
      chimerism-associated tolerance could be induced deliberately in neonatal mice by
      infusing adult donor hematolymphopoietic cells. This discovery escalated in a
      straight line over the next 15 years to successful bone marrow transplantation in
      humans. The second turning point was the demonstration that organ allografts
      could self-induce tolerance under an umbrella of immunosuppression, or in some
      species without immunosuppression. Unfortunately, it was incorrectly concluded by
      most immunologists and surgeons that bone marrow and organ engraftment involved
      different immune mechanisms. In a derivative error, it became widely believed
      that the tolerogenicity of the liver differed fundamentally not only from that of
      bone marrow but also from that of other whole organs. These errors became dogma
      and were not corrected until low level donor leukocyte chimerism was found in
      humans and animals bearing long surviving liver, kidney, heart, and other kinds
      of allografts. With successful bone marrow transplantation, the trace population
      consisted of recipient rather than donor leukocytes. Thus, the consequences of
      organ and bone marrow engraftment were mirror images. From these observations, it
      was proposed that the engraftment of all kinds of organs as well as bone marrow
      cells (BMC) involved host versus graft (HVG) and graft versus host (GVH)
      reactions with reciprocal induction of variable degrees of specific non
      reactivity (tolerance). The maintenance of the tolerance was an active and
      ongoing process requiring the persistence of the transplanted fragment of the
      donor immune system. The immune responsiveness and unresponsiveness to both organ
      and bone marrow allografts are thought to be governed by the migration and
      localization of leukocytes. The clarifying principles of tranplantation
      immunology that have emerged from the chimerism studies are relevant to the
      adaptive immune response to microbial, tumor, allogeneic, and self antigens.
      These principles should be used to guide efforts to systematically induce
      tolerance to human tissues and organs, and perhaps ultimately to xenografts.

PMID- 11200419
TI  - Prospects for xenotransplantation of the liver.
AB  - A severe shortage of human livers for allotransplantation has sparked interest in
      the potential use of animals in lieu of humans as a source of livers, that is
      xenotransplantation. Xenotransplantation might also provide a means by which
      recurrence of hepatitis might be averted. Among the types of xenografts that
      might be undertaken are extracorporeal "xenoperfusion" or perfusion of devices
      containing xenogeneic hepatocytes, auxiliary liver transplants, bridge liver
      transplants, and hepatocyte transplants. The hurdles to xenotransplantation of
      the liver include the immune response of the recipient against the graft,
      incompatibility of the graft with complex physiologic and biochemical systems of
      the recipient, and the possibility of transferring infectious agent from the
      graft to the recipient. Recent progress in characterizing and overcoming these
      hurdles has encouraged some optimism regarding the ultimate application of
      xenotransplantation for the treatment of human disease.

PMID- 11200420
TI  - Immunosuppression in liver transplantation.
AB  - Prevention of graft rejection while minimizing morbidity remains the single most
      important objective in liver transplantation. Advances in immunosuppression have
      provided excellent patient and graft survival with relatively low incidences of
      acute rejection. However, it is apparent that the toxicity of the present
      immunosuppressive drugs accounts for much of the morbidity after transplantation.
      Attention is now being focused on combination drug therapies to reduce morbidity
      while maintaining the excellent results achieved with present immunosuppressive
      agents.

PMID- 11200421
TI  - Recurrence and accelerated progression of hepatitis C following liver
      transplantation.
AB  - The patient described had recurrent hepatitis C following OLT. This hepatitis
      appeared early postOLT and progressed to fibrosing cholestatic hepatitis, a
      severe form of HCV recurrence. Factors such as genotype 1, high viral load and
      severe damage on the first postOLT biopsy may indicate a more severe outcome. We
      have hypothesized that, in parallel to what is known for hepatitis B, this rare
      form of recurrence was linked to a high expression of virus C proteins in the
      liver graft. Severe form of hepatitis C recurrence should be treated early with
      the best currently available treatment which is a combination of IFN and
      ribavirin. Large series of patients with comparable virological, histological and
      immunological inclusions criteria are necessary to evaluate the efficacy of this
      treatment.

PMID- 11200422
TI  - Retrotransposons: central players in the structure, evolution and function of
      plant genomes.

PMID- 11200423
TI  - Scaling the soil-plant-atmosphere continuum: from physics to ecosystems.

PMID- 11200424
TI  - Seeds of change.

PMID- 11200425
TI  - Origins of halophilic microorganisms in ancient salt deposits.

PMID- 11200426
TI  - From protozoa to mammalian cells: a new paradigm in the life cycle of
      intracellular bacterial pathogens.
AB  - It is becoming apparent that several intracellular bacterial pathogens of humans
      can also survive within protozoa. This interaction with protozoa may protect
      these pathogens from harsh conditions in the extracellular environment and
      enhance their infectivity in mammals. This relationship has been clearly
      established in the case of the interaction between Legionella pneumophila and its
      protozoan hosts. In addition, the adaptation of bacterial pathogens to the
      intracellular life within the primitive eukaryotic protozoa may have provided
      them with the means to infect the more evolved mammalian cells. This is evident
      from the existence of several similarities, at both the phenotypic and the
      molecular levels, between the infection of mammalian and protozoan cells by L.
      pneumophila. Thus, protozoa appear to play a central role in the transition of
      bacteria from the environment to mammals. In essence, protozoa may be viewed as a
      'biological gym', within which intracellular bacterial pathogens train for their
      encounters with the more evolved mammalian cells. Thus, intracellular bacterial
      pathogens have benefited from the structural and biochemical conservation of
      cellular processes in eukaryotes. The interaction of intracellular bacterial
      pathogens and protozoa highlights this conservation and may constitute a
      simplified model for the study of these pathogens and the evolution of cellular
      processes in eukaryotes. Furthermore, in addition to being environmental
      reservoirs for known intracellular pathogens of humans and animals, protozoa may
      be sources of emerging pathogenic bacteria. It is thus critical to re-examine the
      relationship between bacteria and protozoa to further our understanding of
      current human bacterial pathogenesis and, possibly, to predict the appearance of
      emerging pathogens.

PMID- 11200427
TI  - N2-dependent growth and nitrogenase activity in the metal-metabolizing bacteria,
      Geobacter and Magnetospirillum species.
AB  - Cells of Geobacter metallireducens, Magnetospirillum strain AMB-1,
      Magnetospirillum magnetotacticum and Magnetospirillum gryphiswaldense showed N2
      dependent growth, the first anaerobically with Fe(III) as the electron acceptor,
      and the latter three species microaerobically in semi-solid oxygen gradient
      cultures. Cells of the Magnetospirillum species grown with N2 under microaerobic
      conditions were magnetotactic and therefore produced magnetosomes. Cells of
      Geobacter metallireducens reduced acetylene to ethylene (11.5+/-5.9 nmol C2H4
      produced min(-1) mg(-1) cell protein) while growing with Fe(III) as the electron
      acceptor in anaerobic growth medium lacking a fixed nitrogen source. Cells of the
      Magnetospirillum species, grown in a semi-solid oxygen gradient medium, also
      reduced acetylene at comparable rates. Uncut chromosomal and fragments from
      endonuclease-digested chromosomal DNA from these species, as well as Geobacter
      sulphurreducens organisms, hybridized with a nifHDK probe from Rhodospirillum
      rubrum, indicating the presence of these nitrogenase structural genes in these
      organisms. The evidence presented here shows that members of the metal
      metabolizing genera, Geobacter and Magnetospirillum, fix atmospheric dinitrogen.

PMID- 11200428
TI  - Identification of conserved traits in fluorescent pseudomonads with antifungal
      activity.
AB  - A collection of 29 fluorescent pseudomonads, some with known biological control
      activity against a range of phytopathogenic fungi, were characterized
      phenotypically and genotypically by comparing carbon source utilization patterns,
      suppression of Pythium ultimum both in planta and in vitro and the potential to
      produce known secondary metabolites. Fatty acid profiling and restriction
      fragment length polymorphism (RFLP) analysis of the ribosomal DNA operon
      (ribotyping) were used to determine the diversity of isolates. A small group of
      genetically related Pseudomonas spp. with similar properties was identified; each
      isolate produced a diffusible bioactive product in vitro and was active against
      Pythium ultimum in planta. However, other isolates that were able to suppress
      damping off disease but did not inhibit hyphal extension in vitro clustered
      outside this group. Phenotypic analyses revealed that the accumulation of C17:0
      cyclopropane fatty acid (17CFA) and the production of hydrogen cyanide correlated
      significantly with biological control activity and with the antagonism of fungal
      development. The potential of 17CFA as a marker for the selection of fluorescent
      pseudomonads with biocontrol agent (BCA) potential was demonstrated by the
      isolation of a novel active strain. This was selected after the screening of 13
      clonal groups of fluorescent pseudomonads identified from 500 isolates from the
      phytosphere of sugar beet. Levels of 17CFA synthesis possibly reflect the
      efficacy of the rpoS allele in particular strains.

PMID- 11200429
TI  - Online and in situ monitoring of environmental pollutants: electrochemical
      biosensing of cadmium.
AB  - Online sensitive monitoring of gene expression is essential for understanding
      microbial life and microbial communities, especially under stress-inducing
      conditions, such as the presence of environmental pollutants. We describe here a
      novel use of promoter-based electrochemical biosensing for online and in situ
      monitoring of gene expression in response to pollutants. As a model system, we
      used a cadmium-responsive promoter from Escherichia coil fused to a promoterless
      lacZ gene, which was monitored using an electrochemical assay of beta
      galactosidase activity. This whole-cell biosensor could detect, within minutes,
      nanomolar concentrations of cadmium in water, sea water and soil samples, and it
      can be used for continuous online and in situ monitoring.

PMID- 11200430
TI  - Green algal extracellular products regulate antialgal toxin production in a
      cyanobacterium.
AB  - Many bacterial genes and virulence factors are regulated by interbacterial and/or
      host-parasite chemical signals. We demonstrate that toxin production by a free
      living freshwater cyanobacterium is regulated in part by the presence of
      extracellular products of a eukaryotic green alga. In growth experiments,
      extracellular products made by the cyanobacterium Anabaena flos-aquae contained
      both anatoxin and microcystin, and significantly reduced the yield of
      Chlamydomonas reinhardtii, a green alga. Based on experiments in which we added
      purified toxins to C. reinhardtii cultures, we believe that microcystin was
      responsible for the growth reduction. A. flos-aquae produced anatoxin
      constitutively when grown alone, but anatoxin concentration increased in the
      presence of C. reinhardtii elicitors. Microcystin accumulation depended on the
      growth phase; however, high concentrations of C. reinhardtii extracellular
      products completely inhibited microcystin accumulation. Our results demonstrate
      that cyanobacterial toxin production may be regulated by complex growth phase
      dependent and environmental chemical cues, and suggest that secreted chemicals
      can mediate the outcome of competition between the cyanobacterium A. flos-aquae
      and the green alga C. reinhardtii.

PMID- 11200431
TI  - The biogeochemical controls of N2O production and emission in landfill cover
      soils: the role of methanotrophs in the nitrogen cycle.
AB  - Emissions of N2O from cover soils of both abandoned (> 30 years) and active
      landfills greatly exceed the maximum fluxes previously reported for tropical
      soils, suggesting high microbial activities for N2O production. Low soil matrix
      potentials (<-0.7 MPa) indicate that nitrification was the most likely mechanism
      of N2O formation during most of the time of sampling. Soil moisture had a strong
      influence on N2O emissions. The production of N2O was stimulated by as much as 20
      times during laboratory incubations, when moisture was increased from -2.0 MPa to
      -0.6 MPa. Additional evidence from incubation experiments and delta13C analyses
      of fatty acids (18:1) diagnostic of methanotrophs suggests that N2O is formed in
      these soils by nitrification via methanotrophic bacteria. In a NH3(g)-amended
      landfill soil, the rate of N2O production was significantly increased when
      incubated with 100 ppmv methane compared with 1.8 ppmv (atmospheric) methane.
      Preincubation of a landfill soil with 1% CH4 for 2 weeks resulted in higher rates
      of N2O production when subsequently amended with NH3(g) relative to a control
      soil preincubated without CH4. At one location, at the soil depth (9-16 cm) of
      maximum methane consumption and N2O production, we observe elevated
      concentrations of organic carbon and nitrogen and distinct minima in delta15N
      (+1.0%) and delta13C (-33.8%) values for organic nitrogen and organic carbon
      respectively. A delta13C value of -39.3% was measured for 18:1 carbon fatty acids
      in this soil, diagnostic of type II methanotrophs. The low delta15N value for
      organic nitrogen is consistent with N2 fixation by type II methanotrophs. These
      observations all point to a methanotrophic origin for the organic matter at this
      depth. The results of this study corroborate previous reports of methanotrophic
      nitrification and N2O formation in aqueous and soil environments and suggest a
      predominance of type II rather than type I or type X methanotrophs in this
      landfill soil.

PMID- 11200432
TI  - Cultivatable microbial biodiversity: gnawing at the Gordian knot.
AB  - Rapid and inexpensive sorting of bacterial isolates may be achieved using Fourier
      transform infrared spectroscopy (FT-IR), a method that has hitherto been applied
      to identification and classification. The comprehensive characterization of
      environmental samples requires the isolation of large numbers of isolates using
      different growth media and growth conditions. In such cases, sorting the isolates
      is critical before isolates are subjected to more detailed studies. Using FT-IR,
      isolates are grown under standardized conditions, and 100 strains can be tested
      within less than 8 h. Chemotaxonomic and molecular characterization of members of
      clusters emerging from FT-IR analysis either at a level of spectral distance
      values below 20-30 (analysis of region 600-800 cm(-1), average linkage algorithm)
      or at spectral heterogeneity values below 75 (regions 1,200-900, 3,000-2,798 and
      901-698, scaling to first region, Ward's algorithm) reveals great similarities in
      fatty acids and 16S rDNA sequences. As judged from riboprinting analyses and
      fatty acid analyses, FT-IR analysis is able to unravel intraspecific
      subclustering. The example used in this study of 100 isolates from a mat system,
      Lake Fryxell, Dry Valleys, Antarctica, selected from a larger number of isolates,
      picked mainly on the basis of colony pigmentation and form, reveals the utility
      of the method for identifying the number of putative species quickly. The method
      described is able to select strains rapidly that represent clusters at the
      specific and intraspecific level for subsequent characterization.

PMID- 11200433
TI  - Retrotransfer of DNA in the rhizosphere.
AB  - Retrotransfer of DNA refers to the phenomenon by which a plasmid travels from a
      host strain to a recipient one and returns to the original host, bringing with it
      DNA from the recipient. The resultant host strain with DNA from the recipient is
      called a retrotransconjugant. The retrotransfer phenomenon mediated by the TOL
      plasmid pWW0 and other plasmids has been documented on plates under optimal
      laboratory culture conditions, but never under natural conditions. In this work,
      we show that retrotransfer mediated by the IncP9 TOL pWW0 plasmid occurs in the
      rhizosphere, a niche in which the continuous supply of nutrients via root
      exudates allows cells to reach a high density. This suggests that this unusual
      sexual fertilization may be of great importance in lateral gene transfer. We also
      show that retrotransfer of DNA seems to require co-integration of the plasmid and
      the host chromosome and subsequent resolution, because a TOL plasmid with a
      mutation in the tnpR gene, encoding the resolvase of the Tn4653 of the TOL
      plasmid, was self-transferred between Pseudomonas strains, but unable to mobilize
      chromosome.

PMID- 11200434
TI  - Characteristics of attachment and growth of Thiobacillus caldus on sulphide
      minerals: a chemotactic response to sulphur minerals?
AB  - To further our understanding of the ecological role of sulphur-oxidizing
      microorganisms in the generation of acid mine drainage (AMD), growth and
      attachment of the chemoautotrophic sulphur-oxidizing bacterium, Thiobacillus
      caldus, on the sulphide minerals pyrite, marcasite and arsenopyrite was studied.
      Growth curves were estimated based on total cells detected in the system (in
      suspension and attached to mineral surfaces). In general, higher cell numbers
      were detected on surfaces than in suspension. Fluorescent in situ hybridizations
      to cells on surfaces at mid-log growth confirmed that cells on surfaces were
      metabolically active. Total cell (both surface and solution phase) generation
      times on pyrite and marcasite (both FeS2) were calculated to be approximately
      equals 7 and 6 h respectively. When grown on pyrite (not marcasite), the number
      of T. caldus cells in the solution phase decreased, while the total number of
      cells (both surface and solution) increased. Additionally, marcasite supported
      about three times more total cells (approximately equals 3 x 10(9)) than pyrite
      (approximately equals 8 x 10(8)). This may be attributed to the dissolution rate
      of marcasite, which is twice that of pyrite. Epifluorescent and scanning electron
      microscopy (SEM) were used to analyse the cell orientation on surfaces. Results
      of Fourier transform analysis of fluorescent images confirmed that attachment to
      all three sulphides occurred in an oriented manner. Results from high-resolution
      SEM imaging showed that cell orientation coincides with dissolution pit edges and
      secondary sulphur minerals that develop during dissolution. Preferential
      colonization of surfaces relative to solution and oriented cell attachment on
      these sulphide surfaces suggest that T. caldus may chemotactically select the
      optimal site for chemoautotrophic growth on sulphur (i.e. the mineral surface).

PMID- 11200436
TI  - Phylogenetic relationship and antifouling activity of bacterial epiphytes from
      the marine alga Ulva lactuca.
AB  - It is widely accepted that bacterial epiphytes can inhibit the colonization of
      surfaces by common fouling organisms. However, little information is available
      regarding the diversity and properties of these antifouling bacteria. This study
      assessed the antifouling traits of five epiphytes of the common green alga, Ulva
      lactuca. All isolates were capable of preventing the settlement of invertebrate
      larvae and germination of algal spores. Three of the isolates also inhibited the
      growth of a variety of bacteria and fungi. Their phylogenetic positions were
      determined by 16S ribosomal subunit DNA sequencing. All isolates showed a close
      affiliation with the genus Pseudoalteromonas and, in particular, with the species
      P. tunicata. Strains of this bacterial species also display a variety of
      antifouling activities, suggesting that antifouling ability may be an important
      trait for members of this genus to be highly successful colonizers of animate
      surfaces and for such species to protect their host against fouling.

PMID- 11200435
TI  - Disruption of the Paenibacillus polymyxa levansucrase gene impairs its ability to
      aggregate soil in the wheat rhizosphere.
AB  - Inoculation of wheat roots with Paenibacillus (formerly Bacillus) polymyxa CF43
      increases the mass of root-adhering soil. We tested the role of levan, a
      fructosyl polymer produced by strain CF43, in the aggregation of soil adhering to
      wheat roots. The P. polymyxa gene homologous to the Bacillus subtilis sacB gene
      encoding levansucrase was cloned and sequenced. The corresponding gene product
      synthesises high molecular weight levan. A P. polymyxa mutant strain, SB03, whose
      sacB gene is disrupted, was constructed using heterogramic conjugation. Effects
      of wheat inoculation with the wild type and the mutant strain were compared using
      two different cultivated silt loam soils in four independent pot experiments.
      Roots of wheat plantlets inoculated with CF43 or SB03 were colonized after 7-14
      days at the same level, and root and shoot masses were not significantly
      different from those of the non-inoculated control plants. The ratio of root
      adhering soil dry mass to root tissue dry mass was significantly higher for
      plants inoculated with strain CF43 than for those inoculated with mutant strain
      SB03: +30% in Orgeval soil and +100% in Dieulouard soil. Thus the levan produced
      by P. polymyxa is implicated in the aggregation of root-adhering soil on wheat.

PMID- 11200437
TI  - Microbes in biocontrol. An annotated selection of World Wide Web sites relevant
      to the topics in Environmental Microbiology.

PMID- 11200438
TI  - Pseudomonas entering the post-genomic era.

PMID- 11200439
TI  - [Blood protein technological industrial developments as a mirror of fundamental
      studies bgy the Institute of Biochemistry of the Ukrainian National Academy of
      Sciences].
AB  - We have examined the technology for an industrial chromatographic production
      highly purified factor VIII concentrate intended for therapy of the hemophilia A
      and characterized this factor VIII. The final product has been prepared from
      cryoprecipitate of pooled human plasma using a large-scale procedure combining
      three conventional chromatographic steps based on AEM and CEM ion exchange and
      SPG or SHR gel filtration chromatography. The specific activity of the product
      was 459 +/- 19 IU factor VIII/mg protein (n = 10), corresponding to a
      purification factor of about 15,000. The concentrate was free of the fibrinogen,
      alpha-2-macroglobulin, alpha-1-acidglycoprotein, haptoglobin. Only three
      contaminants could be detected: fibronectin, immunoglobulins A and G (about
      0.020, 0.004 and 0.034 microgram/IU factor VIII, respectively). The purity of the
      final product was confirmed by SDS polyacrylamide gel electrophoresis, cellulose
      acetate electrophoresis, Grabar-Williams immunoelectrophoresis, and bidimensional
      immunoelectrophoresis. Another examination was concern to the technology for an
      industrial chromatographic production highly purified factor IX concentrate
      intended for therapy of the hemophilia B and characterized this factor IX. The
      final product has been prepared from pooled human plasma using a large-scale
      procedure combining four conventional chromatographic steps based on AEM ion
      exchange, AFM affinity and SGS gel filtration chromatography. The specific
      activity of the product was 149 +/- 10 IU factor IX/mg protein (n = 10),
      corresponding to a purification factor of about 9000. The concentrate was free of
      the vitamin K-dependent clotting factors II, VII and X and of proteins C and S.
      Most of possible contaminants were absent in this new product. High-molecular
      weight kininogen, factor VIII, XI, XII or prekallikrein were not detected. There
      were no activated factors, such as factors IXa and Xa, no thrombin and no
      phospholipids. Only two contaminants could be detected: C4 and inter-alpha
      trypsin inhibitor (about 0.8 and 1.2 mg/IU factor IX, respectively). The purity
      of the final product was confirmed by SDS polyacrylamide gel electrophoresis,
      cellulose acetate electrophoresis, Grabar-Williams immunoelectrophoresis, and
      bidimensional immunoelectrophoresis. Thrombogenicity tests in rabbits revealed
      that the high purified factor IX by Institute of Biochemistry technology tested
      had a lower thrombogenic power than the commercial factors IX tested. The
      concentrate has been subjected to a special solvent--detergent treatment for
      definite time and temperature during its production to virus inactivation (it
      will be describe in following special examination). These data demonstrate that a
      highly purified therapeutic clotting factor VIII and IX concentrates can be
      prepared from human plasma by conventional chromatographic methods developed by
      Institute of Biochemistry of NAS of Ukraine and Combio Ltd.

PMID- 11200440
TI  - [Biological properties of the mechanism of "marine" phospholipids containing
      omega-3 fatty acids].
AB  - The Laboratory mainly deals with the development of biologic technologies for
      producing physiologically active lipid-protein-nature compounds from marine
      organisms containing omega-3 fatty acids (that are membrane components) with
      further evaluation of their action both in the normal state and in some simulated
      pathologic states as well as with creation of new preparations for application in
      medicine and agriculture on their basis. As a result of the experiments
      performed, a technology for producing two biologic preparations, namely, surface
      active compounds (phospholipids) and a nucleopeptid-lipid complex, exhibiting a
      specific action, was developed. The phospholipid complex, being surface-active in
      composition, was characterized as a complex possessing some surfactant-type
      properties and displaying an antioxidant and a membrane-stabilizing effect. On
      the basis of the complex including marine phospholipids with omega-3 fatty acids,
      the preparation "Phylomek", which is the concentrate of essential marine
      phospholipids, and the preparation "Morephyl", which is a marine agent with
      surfactant-type effect, intended for animals and poultry, were created. The
      ingredients of the nucleopeptid-lipid complex were identified, and its effect on
      the increase of testosterone levels in the blood of old and sick animals was
      determined. A stimulating agent of genital hormones secretion was recommended for
      application in the geriatrics in the case of genital function disturbance and
      presenilation. A fraction similar in chemical content and specific activity,
      found in the velvet antlers, was used as the base of the biologic preparation
      "Pantheron". The natural complexes of marine phospholipids were shown to be able
      to change the composition of lipids of membranes, but the intensity of these
      changes differed in cells differing in function. In the study of the biochemical
      mechanism of correction of disturbances in the cell membranes under an oxidative
      stress, the interrelation between the composition of lipids of membranes, their
      oxidation, and the content of natural antioxidants was determined. The reparative
      effect of marine phospholipids on the cell membranes under progressing pathology,
      caused by the restoration of the composition of phospholipids, by increases in
      the activities of antioxidant enzymes (SOD, catalase), and by a decrease of the
      accumulation of LPO products, was established. Under interaction of marine
      phospholipids and alpha-tocopherol, synergism was noticed, the antioxidant
      potential of the investigated substances and their membrane-stabilizing effect
      increased. The phospholipids with various residues of PUFA in the molecule were
      found to affect the inhibition and oxidation processes, as well as the modelling
      of lipid membranes. This is especially true for arachidonic and docosahexaenoic
      acids, the ratio of which changes under the oxidative stress. At administration
      of phospholipids omega-3, their ratio decreases due a decrease in the level of
      unetherificated PUFA. The main changes of the PUFA were found to occur in
      phosphatidylethanolamine isolated from microsomes. The particular role of
      phosphatidylethanolamine and arachidonic acid in the reparation of membranes
      under the action of phospholipids PUFA omega-3 and alpha-tocopherol was noted.

PMID- 11200442
TI  - [Physiologic functions of vitamin D3 and its metabolism in the body in normal
      states and in some pathologies].
AB  - In the review there are some results of investigations of the laboratory
      summarized on the mechanisms of vitamin D3 metabolism and its functioning in
      organism; investigation of infringement of mineral, lipid and protein metabolic
      processes with vitamin D3 deficiency and with different pathologies and the ways
      of their regulation as well as the data about some new high-effective forms of
      vitamin D3 for their implementation in medicine and agriculture.

PMID- 11200441
TI  - [Basis for the historical stages for studying the biochemistry of vitamins.
      Noncoenzymatic mechanisms of vitamin B1].
AB  - Biochemistry of vitamins is one of the leading trends in the fundamental
      researches of A. V. Palladin Institute of Biochemistry from the moment of its
      foundation in 1925. The Laboratory of Vitamins Biochemistry was organised in
      1994, it was reorganized into the Department of Vitamins Biochemistry in 1966,
      and later it was renamed as the Department of Coenzymes Biochemistry. Now the
      investigations at the Coenzymes Biochemistry Department headed (from 1986) by G.
      V. Donchenko, Corr.-Member of the National Academy of Sciences of Ukraine, are
      directed to estimation of vitamins A, E, B1 and PP action molecular mechanisms.
      Investigation of specific protein-acceptors of vitamins and their biologically
      active derivatives is a contemporary and effective methodological approach to the
      estimation of some molecular mechanisms of vitamins action on cellular
      metabolism. Considering the challenging theoretical and practical aspects of the
      further fundamental investigation development in the molecular vitaminology the
      following items are currently being worked in the Department last time: 1. Study
      of some molecular mechanisms of thiamine and vitamin PP neurotropic action. These
      investigations are oriented to clearing some new aspects of noncoenzymic
      mechanism of its influence on the nervous cell functioning both in the norm and
      at some nervous diseases. 2. Study of some molecular mechanisms of regulation by
      means of fat-soluble vitamins A, E and their specific proteins-acceptors of DNA,
      RNA and protein biosynthesis in the nuclei and mitochondria of actively
      proliferous cells. These investigations are aimed to the estimation of molecular
      mechanisms of fat-soluble vitamins participation in the regulation of DNA
      dependent synthesis of RNA, RNA-polymerase activity, mechanism of their
      anticancerogenous effect, vitamin E participation in the realisation of nuclear
      genetic information. 3. Study of intracellular protein-receptors, which take part
      in realisation of vitamins and their biologically active derivatives functions in
      the human and animals' organism. The investigations, directed to study of a role
      of retinol-binding proteins in exchange of the vitamin A and in biosynthesis of
      DNA, RNA and proteins, the role of tocopherol-binding proteins in realisation of
      biological action of vitamin E in cells and thiamine-binding proteins in
      realisation of neurotropic action of vitamin B1 are actively developed. 4.
      Investigation of mechanisms of antioxidizing and antiradical biological action of
      vitamin D3, ecdisterone and related biologically active compounds. Basing on the
      fundamental researches some vitamins preparations have been created, such as
      "Carotin-M", "Cardiovit", "Evit-1", "Soevit", "Metovit", "Caratel'ka" and others.
      The results of fundamental investigation of noncoenzymic thiamine function led us
      to elaboration of a new hypothesis about molecular mechanism of vitamin B1
      neurotropic action. According to the hypothesis the thiamine high neuroactivity
      is a result of existence in the nervous ending a specific mobile thiamine pool
      and connection thiamine metabolism with nervous cell membrane potential and
      acetylcholine metabolism.

PMID- 11200443
TI  - [Immunosensors: sources of origin, achievements and perspectives].
AB  - The analysis of the recent data in the literature and results of investigations
      in the field of the development and study of function efficiency of different
      types of immune sensors, that are performed at the Department of Biochemistry
      Sensory and Regulatory Systems of the A. V. Palladin Institute of Biochemistry of
      Ukrainian National Academy of Sciences are presented. Sources of origination and
      perspectives of the devlopment of biosensors are discussed as well. The paper
      also gives an overview of main research projects at the Department, mainly in the
      filed of biosensors. They include development of the scientific bases for the
      creation of a new generation of chemo- and biosensors for their application in
      medicine and ecology. Multi-immune, multi-enzyme and combined multi-parametrical
      sensors can provide express analyses in laboratory and field conditions with the
      purpose to perform immune chemical diagnostics of diabet, kidney diseases, immune
      defficiencies, autoimmune, allergic, pre-infarction and pre-tumor states as well
      as to control total toxicity of the environment and identification of main types
      of toxic elements in it. The investigations are based on the latest achivements
      in the field of physics, chemistry, information technology and electronics with
      the use of different types of planar electrodes, ion sensitive field effect
      transistors (ISFETs), semiconductor capacitive structures, termistors, optrodes,
      piezocrystalls and application of such methods and effects as laser correlation
      spectroscopy, chemiluminescence, fluorescence, surface plasmon resonance,
      photoluminescence of porous silicon, interferometry, evanescent wave technique,
      nonemmiting energy transfer and holography.

PMID- 11200444
TI  - [Institute of Biochemistry and the development of molecular biophyics in the
      Ukraine].
AB  - The development of molecular biophysics research in Ukraine is reviewed with
      historical perspective. Vladimir Belitser and his school were among the pioneers
      in the studies of protein denaturation and assembly of intermolecular structures.
      New methods of research of protein conformational transitions and dynamics at
      equilibrium have been developed at the Palladin Institute of Biochemistry.
      Presently, the biophysics aspects in different areas of protein research are
      actively explored. The studies of protein folding in both experimental and
      theoretical aspects promise especially good prospects.

PMID- 11200445
TI  - [Division of Regulatory Systems of Cells of the Institute of Biochemistry of the
      Ukrainian National Academy of Sciences (L'viv). History, achievements and
      perspectives].
AB  - A short review presented deals with the history of biochemistry development in
      the western regions of Ukraine. Two principal biochemical schools were founded
      here by J. Parnas (1884-1949) and S. Gzhytskiy (1900-1976). While most of the
      students and collaborators of Prof. J. Parnas left for Poland and other western
      states, those ones of Prof. S. Gzhytskiy stayed in Lviv and other scientific
      centers of Ukraine. In 1979 Prof. S. Kusen (one of Gzhytskiy's former students
      and collaborators) and Prof. G. Shavlovsky headed two scientific departments
      founded in Lviv at O. V. Palladin Institute of Biochemistry. This event could be
      considered as the beginning of modern biochemistry development in the western
      regions of Ukraine. Since 1992 in Lviv there exists the Division of Regulatory
      Cell Systems of O. V. Palladin Institute of Biochemistry of the National Academy
      of Sciences of Ukraine headed since 1995 by Prof. R. Stoika. Four Departments
      work in the structure of this Division: 1) the Department of Biochemistry of Cell
      Differentiation headed in 1979-1997 by S. Kusen and since 1997 by L. Drobot; 2)
      the Department of Regulation of Cell Proliferation created in 1993 and headed by
      R. Stoika; 3) the Department of Biochemical Genetics created in 1988 and headed
      by A. Sibirny; 4) the Department of Regulation of Synthesis of Low Molecular
      Compounds headed in 1979-1996 by G. Shavlovsky and since 1996 by D. Fedorovych.
      Division of Regulatory Cell Systems is presently the leading scientific center in
      Ukraine in the study of the biochemical mechanisms of proliferation,
      differentiation and apoptosis of normal and tumour cells and in the development
      of effective biotechnological processes for obtaining the biologically active
      substances using yeast. Numerous publications of its collaborators in the high
      impact factor scientific magazines as well as the realisation of the
      international grants confirm this statement. Taking into account the high level
      of scientific research and availability of highly skilled scientists at the
      Division in 1999 the Presidium of the National Academy of Sciences of Ukraine
      took a resolution to transform the Division into the Institute of Cell Biology of
      the National Academy of Sciences of Ukraine, which was founded in 2000 on the
      basis of the Division.

PMID- 11200446
TI  - [Metabolic engineering in design of cellular elements of biosensors].
AB  - An extended definition of the term "metabolic engineering" is given and main
      spheres of its using in fundamental studies and modern biotechnology are
      discussed in this article. Emphasis is made on specific using the approaches of
      metabolic engineering in construction of the cell elements of sensors based on
      the use of mutant and chemically modified cells of methylotrophic yeasts. This
      investigation is designed in the laboratory of Biochemical Genetics of the
      Division of Cell Regulatory Systems, A. V. Palladin Institute of Biochemistry.
      Genetic and chemical modifications have allowed to provide some directed changes
      in cell sensoring output toward methanol, ethanol and formaldehyde that result in
      enhanced selectivity and shortened time-output of the corresponding
      potentiometric and amperometric sensors.

PMID- 11200447
TI  - [History of O.V. Palladin Institute of Biochemistry of the Ukrainian National
      Academy of Sciences].

PMID- 11200448
TI  - [My first steps in science at the Institute of Biochemistry].

PMID- 11200449
TI  - [Reminiscences about my father].

PMID- 11200450
TI  - [Good examples are inherited].

PMID- 11200451
TI  - [Basic directions of research of the department of lipid biochemistry].
AB  - The review deals with the scientific activity of the Department of Biochemistry
      of Lipids of the Palladin Biochemistry Institute of the National Academy of
      Sciences of Ukraine. The estimation of the functional role of some major lipids
      and of the minor lipid components, namely, N-acylethanolamines (NAE), is the main
      problem of the scientific investigations of the Department. The role of some
      lipids in the pathogenesis of diseases accompanied by the oxidative stress was
      also studied. The Department was the first to find and identify NAE in
      neuroblastoma C1300 N18 cells. It was shown that NAE with long saturated acyl
      chains inhibited veratridine-activated fast sodium channels. NAE also activated
      uterine plasma membrane smooth muscle Ca2+, Mg(2+)-ATPase, and inhibited Fe(2+)
      induced free radical oxidation in mitochondria. The results of these
      investigations served as a basis for development of pharmacological substances
      with membrane protective properties. It was shown that, at different diseases
      accompanied by the oxidative stress, a significant change in the lipid
      composition of cell membranes occurred. Sometimes these changes were adaptive in
      character, which favored the cell viability adaptation to pathological
      conditions. The new level of regulation of adaptive reactions can be accompanied
      by the development of additive injuries of cell viability, which may be caused by
      the altered level of biologically active cell lipid components. Based on the
      results of these investigations, the preparation intended for treatment of male
      infertility was developed. The pharmacological substances intended for treatment
      of morphine abuse and acute ischemia of myocardium were created.

PMID- 11200452
TI  - [alpha-Latrotoxin as an instrument for studying neurosecretions].
AB  - alpha-Latrotoxin, a presynaptic toxin from black widow spider venom Latrodectus
      mactans tredecimguttatus, triggers exocytosis in a variety of neurosecretory
      cells both in the presence and absence of calcium in the medium. The toxin
      interacts with two types of membrane the receptors which belong to different
      families of neuronal proteins and have different structures. Calcium-dependent
      receptor of alpha-latrotoxin is identified as neurexin I alpha and belongs to the
      family of neurexins. This family is selectively expressed in nerve tissue. The
      calcium-independent receptor of alpha-latrotoxin belongs to the family of G
      protein-coupled receptors and proteins which homologous to it are found in heart,
      lung, kidney and spleen tissues. As a result of alpha-latrotoxin interaction with
      membrane receptor in the calcium medium the toxin forms the ionic channels in
      plasmalemma and enhances its calcium permeability. The effects of alpha
      latrotoxin on exocytosis in the calcium and calcium-free media and question
      concerning coupling of channel-forming and secretogenic properties of alpha
      latrotoxin are discussed.

PMID- 11200453
TI  - [Modulation of Na+-K+-ATPase by calcium ions].
AB  - The modulatory effects of calcium ions on highly active Na+, K(+)-ATPase from
      calf brain and pig kidney tissues have been studied. The inhibitory action of
      Ca2+free on this enzyme depends on the level of ATP (but not AcP). The reduction
      of pH from 7.4 to 6.0 noticeably increases, but the elevation of pH to 8.0, in
      its turn, decreases the inhibition of ATP-hydrolyzing activity by calcium. With
      the increase of K+ concentration (in contrast to Na+) the sensibilization of Na+,
      K(+)-ATPase to Ca ions is observed. In the presence of potassium ions Mg2+free
      effectively modifies the inhibitory action of Ca2+free on this enzyme. Ca2+free
      (0.16-0.4 mM) decreases the sensitivity of Na+, K(+)-ATPase to action of the
      specific inhibitor ouabain in the presence of ATP. In the presence of AcP
      (phosphatase reaction) such a change of enzyme sensitivity to ouabain isn't
      observed. The influence of membranous effects of Ca2+ on the interaction of Na+,
      K(+)-ATPase with the essential ligands and cardiosteroids is discussed.

PMID- 11200454
TI  - [Kinetics and energy aspects of the effect of incubation medium dielectric
      permeability on the catalytic and transporting activity of Mg2+-ATP-dependent
      Ca2+ pump plasma membranes].
AB  - The results suggest that changes in polarity of the incubation medium markedly
      affect the activity of transport Ca2+, Mg(2+)-ATPase solubilized from smooth
      muscle cell plasma membranes and that the electrostatic interactions between the
      enzyme active center and specific ligands (MgADP-, in particular) significantly
      contribute to the energetics of ATP hydrolysis.

PMID- 11200455
TI  - [O.V. Palladin Institute of Biochemistry of the Ukrainian National Academy of
      Sciences--75 years].
AB  - The article deals with a short record including the information about the history
      of creation and main developmental stages of the first and presently the single
      in Ukraine Palladin Institute of Biochemistry of National Academy of Sciences of
      Ukraine. The record contains the main achievements of the Institute scientific
      subdivisions for the 75 years period of their creative work in the field of the
      most urgent problems of fundamental and applied biochemistry. As well it displays
      the information about comprehensive and extensive publishing and educational
      activity conducted by the staff,, the work on training the scientific manpower of
      the highest qualification--Doctors of Science (D.Sc.) and Philosophy Doctors (Ph.
      D.), active participation of the research scientists in attracting to science the
      talented young people representing the students and school-children taking
      interest in the biological chemistry. The article shows the great role of the
      Institute famous scientists-biochemists in forming some scientific schools on
      functional biochemistry acknowledged in the world biochemistry. There are also
      some data about the each of nine scientific departments of the Institute for the
      period of last 20-25 years of their activity in the field of the most urgent
      problems of the contemporary biochemistry. These are the following Departments:
      Neurochemistry, Metabolism Regulation, Muscular Biochemistry, Protein Structure
      Functions, Coenzymes Biochemistry, Enzymes Chemistry and Biochemistry, Molecular
      Immunology, Biochemistry of Lipids, Sensor and Regulator Systems Biochemistry.
      There is also a short review regarding the history of foundation, development and
      scientific achievements of the Institute division in L'viv including four
      scientific departments: Biochemistry of Cellular Differentiation, Biochemical
      Genetics, Regulation of Low Molecular Compounds Synthesis, Regulation of Cells
      Differentiation.

PMID- 11200456
TI  - [Department of Molecular Immunology--25 years].
AB  - Department of Molecular Immunology of Palladin Institute of Biochemistry was
      founded 25 years ago as the Laboratory of Immunochemistry uniting, at the
      beginning, a small group of scientists. In 1982 the Laboratory was transformed
      into the Department of Molecular Immunology. The first research was made on
      studding the biological effect and the mechanisms of action of phosphonates and
      bisphosphonates--phosphororganic analogues of inorganic pyrophosphate or closely
      related in structure molecules having P-C bond instead of P-O bond. As a result
      the immuno-modulatory activity of methylene-bis-phosphonic acid was discovered
      and a set of immuno-vector, immuno-toxin and anti-tumour constructs were
      designed. The researchers of the Department were the first in the USSR who
      started the biochemistry of activated lymphocytes, immunochemical analysis of
      peptides and proteins, implemented immunoenzyme methods and cytofluorimetry to
      study immunocompetent cells. In particular, monoclonal and polyclonal antibodies
      were obtained and used to study the antigenic structure of neurotoxin apamin,
      cytochrome c, neurospecific proteins S-100 and 14-3-2, nicotinic acetylcholine
      receptors, pertusis and diphtheria toxins, different antigens of Mycobacterium
      bovis and of fibrin(ogen) and its fragments and others. The new site of fibrin
      polymerization was localized. The novel information about the nature of
      polyreactive immunoglobulins and their influence on the development of the
      humoral immune response was obtained. A range of reagents for immunodiagnostic
      tests were developed as the outcome of this research work. The negative effect of
      small doses of radiation on natural immunity in people working during the
      cleaning of Chernobyl nuclear plant was first demonstrated by the researchers of
      the Department in co-operation with their colleagues from a couple of Kiev
      immunology laboratories. In particular the suppression of NK cells function and
      structure was shown.

PMID- 11200457
TI  - [Mechanism of metabolic adaptation].
AB  - The paper presents results of investigations on some mechanisms of metabolic
      adaptation in mammals. There are four sections in the tissue metabolic system of
      acid-base homeostasis: polyamines as factors of metabolic adaptation;
      significance of carbon dioxide for metabolic response formation in hypobiosis;
      polyamines metabolism in hypobiosis. Peculiarities of intermediate metabolism
      have been analyzed in animal tissues under the changes in H+, CO2 and HCO3-
      concentrations. Basing on a new interpretation of the experimental data and
      detected regularity in the metabolism, conclusion on the existence of a new acid
      base homeostasis system in the tissues has been made. The results of polyamines
      metabolism investigations in the mammals under the stress have been described.
      The experimental data make us to believe that changes in polyamines synthesis and
      ODC activity in particular, is a part of stereotype nonspecific response to any
      stress impacts and one of the factors of cell metabolic adaptation. Some new data
      on mechanisms of formation and control of metabolic status of animals in the
      natural and artificial hibernation have been presented. The key idea is that in
      the state of hypobiosis the carbon dioxide (HCO3-) appears as a regulatory factor
      of metabolic adaptation, which is able to realize its action directly via
      affecting numerous biochemical events. The participation of polyamines in
      adaptive metabolic response to hybernation factors is suggested. Some
      peculiarities of ornithine decarboxilase and transglutaminase activity during the
      different stages of genuine and artificial hypobiosis have been demonstrated.

PMID- 11200458
TI  - [Department of Protein Structure and Function--Volodimir Oleksandrovich Bielitser
      School of the Ukrainian Academy of Sciences. Studies on structure of fibrin fiber
      structure and mechanism (1975-1987].
AB  - In this short historical review the records about foundation and research
      activity of the Department of Structure and Function of Protein--school of V. A.
      Belitser, Member of the National Academy of Sciences of Ukraine are presented. V.
      A. Belitser was the founder and indispensable chief of the department since the
      date of its creation (1944) till 1987. The main research interests (1975-1987) of
      the department were focused at the investigation of structure, biological
      function of the fibrinogen-fibrin system, mechanisms of the network assembly and
      of the fibrin fibers structure. Studying the molecular mechanisms of the fibrin
      fiber assembly, it was shown that the specificity of the building structure was
      shown is determined by the specific reactive sites with strong affinity of the
      molecules. The activity of the sites was investigated on protein molecules as
      well as the fragments. The physical nature of the bonds created by the active
      sites, that appearing during in the process of fibrinogen activation by thrombin,
      was revealed. Examination of the fibrin assembly in cooperation with
      electronmicroscopists and studies of the complex formation between active
      fragments and fibrin monomer were summarized. Both the fibrin monomer
      polymerization and protofibril lateral association are presented as two stages in
      the assembly of the fibrin network. In the research of the domain fibrinogen
      structure the specific sites of the fibrin assembly in each of the domains were
      found. COOH-terminal regions of the A alpha-chains play independent part in the
      fibrinogen and fibrin. That is why it is relevant to consider them as alpha C
      domains. In the free fibrinogen molecules (in solution) these domains are
      responsible for globular shape, they are linked to domains D intramolecularly.
      When fibrin assembly takes place, alpha C-domains play significant carriage role
      in fibrin molecules interaction, linking to domains D intermolecularly. The model
      of the fibrinogen molecule structure and the general scheme of the fibrin fibers
      network formation were proposed. Physico-chemical basics of a biological
      structure assembly were elucidated using the process of the fibrin self-assembly
      as an example. Much attention was devoted to the problems of practical medicine.
      The quantitative methods of fibrinogen, soluble fibrin and active
      fibrin/fibrinogen fragments estimation in blood plasma were developed.

PMID- 11200459
TI  - [Mechanism of fibrinolysis and thrombolytic therapy].
AB  - The thrombolytic treatment with plasminogen activators, such as physiological
      tissue-type plasminogen activator (t-PA), suffers from a number of significant
      limitations. There is a resistance to reperfusion and acute coronary reocclusion.
      The peculiarity of t-PA and one-chain urokinase treatment is their using in very
      high doses. Thus the process of thrombolytic therapy is proceeding with a
      deviation from the fibrinolytic mechanism, which is needs of a little quantity of
      tissue-type plasminogen activator and provides the physiologic thrombolysis
      without systemic complication. The estimation of this disaccordance suggests, the
      possible reasons of these complications.

PMID- 11200460
TI  - [Plasminogen activation by antiplasminogen monoclonal antibody IV-1C. Properties
      and mechanism of reaction].
AB  - In review the results of investigation of plasminogen(Pg) activation by
      antiplasminogen monoclonal antibody IV-1c have been presented. Antigenic
      determinant of IV-1c was localized in Val709-Gly718 site of Pg protease domain.
      IV-1c completely inhibited the Pg activation by streptokinase, but increased the
      rate of Pg activation by t-PA and urokinase. Catalytic properties of plasmin in
      complex with IV-1c were studied. It was found that IV-1c induced catalytic
      activity in Pg-IV-1c complex. It was shown that Pg and IV-1c interacts in complex
      by two-centre mechanism: IV-1c binds with Pg by paratope and by N-terminal lysine
      of gamma-chain and Pg binds to IV-1c by one of the lysine binding sites and by
      V709-G718 site of protease domain. The influence of pH, temperature, 1.5 mM Ca2+,
      Mg2+, Sr2+, Ba2+, Co2+, Ni2+ cations and 10 mM Cl-, F-, Ac-, SO4(2-), HPO4(2-)
      anions on lag and fast phases of Pg activation by VI-1c was investigated. It was
      revealed that Val709-Gly718 site was determining in Pg activation by IV-1c and
      streptokinase.

PMID- 11200461
TI  - [Effect of the mycotoxin zearalenone on the metabolism of membrane phospholipids
      of rat lymphocytes].
AB  - The data obtained have shown that a single intravenous administration of 1 ml of
      mycotoxin zearalenon alcohol solution (15 mg/ml) to rats leads to the formation
      of pronounced abnormalities in lymphocyte membranes phospholipid (PL) metabolism.
      These changes are conditioned by activation of phospholipase A2, which catalyses
      the deacylation of PL-glycerides predominantly phosphatidylcholines with the
      formation of high concentrations of lysophosphatidylcholines. On the other hand,
      intensification of deacylation processes of PL, which accompanied by the
      liberation of high quantities of unsaturated fatty acids leads to the active
      incorporation of its into the processes of lipids free radical peroxidation with
      the formation of significant quantities of lipid peroxides. Intraperitoneal
      administration of 1 ml 10% sol of sodium thiosulfate no later then 1-2 h after
      zearalenon toxic action leads to the normalization of disorders observed.

PMID- 11200462
TI  - [Biologically active substances isolated from Hypericum attenuatum Choisy].
AB  - Four dianthrones, two oxymethylanthraquinones, two reductive forms of
      anthraquinones and five flavonoids have been isolated from the plant source
      Hypericum attenuatum Choisy (Guttiferae) firstly investigated for these
      substances contents. Dianthrones pseudohypericin, protohypericin,
      protopseudohypericin, oxymethylanthraquinones frangulaemodin, frangulin,
      reductive anthraquinones emodin anthrone, emodin anthranol, and flavonoids
      quercetin, quercitrin, isoquercitrin, rutin have been identified for the first
      time. High hyperoside contents in herb of Hypericum attenuatum is established.

PMID- 11200463
TI  - [Effect of DDT on the interaction of cortisol with glucocorticoid-binding
      proteins in rat brain].
AB  - It was established that DDT is the isosteric inhibitor of cortisol interaction
      with purified rat brain glucocorticoid-binding proteins. These results were
      confirmed in the experiments in vivo on Vistar female rats from one generation.

PMID- 11200464
TI  - [Cytokine profile and fibrinogen level in blood plasma in diabetic foot under the
      action of heparin].
AB  - The investigation displayed in the article was conducted in order of estimating
      the content of interleukin-1, tumornecrotic factor and fibrinogen in the patients
      suffering from the I and II type diabetes mellitus complicated by the lower
      extremity inflammatory-necrotic process. The type II diabetes was shown to have
      these substances level as higher as the I one, increasing even more at
      administrating heparin to the patients. The manifestation of hypercoagulative
      properties of the latter, as it's postulated, is a result of increasing the
      synthesis of proinflammatory cytokines.

PMID- 11200466
TI  - [A rapid method for determining the fatty acid composition of lipid A].
AB  - Lipid A is the most conservative part of LPS. Its fatty acids composition can
      serve as an important taxonomic marker of bacteria. The isolation of LPS and
      studying their chemical composition are difficult and protracted procedure. We
      propose the rapid method of determining the prevailed fatty acids of lipid A
      without isolation of LPS from the cell. The essence of the method is in the
      release of cell from the lipids which are not components of LPS. These lipids, in
      contrast to the lipid A, are more easily extractable from the cell structures.
      The fatty acids, which prevailed in the lipid-free cells, are the structural
      components of lipid A.

PMID- 11200465
TI  - [Transport and metabolism of vitamin A].
AB  - The present paper is a review of up-to-date findings on vitamin A transport from
      intestines to target-cell and metabolism of this fat-soluble vitamin. The
      hypotheses of possible enzymes participation in the process of
      etherification/hydrolysis and oxidation/reduction of vitamin A are discussed.
      Furthermore, possible roles of cellular retinoid-binding proteins in the process
      of vitamin A transport and metabolism are reviewed.

PMID- 11200467
TI  - [Thiamine: a mechanistic model of interaction with protein].
AB  - Mechanistic model of thiamine-binding protein functioning which is based on the
      potential role of prototropic groups and hydrophobic environment around 5-beta
      hydroxyethyl substituent of ligand has been proposed. As a model the chemical
      transformations of thiamine and its structural O-acyl substituted analogues in
      the presence of ferricyanide and phosphatic buffer in pH range 7,2-7,8 were
      investigated. The oxidation to the thiochrome and thiochrome derivatives is first
      order in substrate and ferricyanide concentrations. It is found that the
      reciprocal of the pseudo-first-order rate constant increases in ferrocyanide
      concentration at the constant oxidant concentration. Rate constants and partition
      ratios for reaction of thiamine, O-benzoylthiamine, O-(4-nitrobenzoyl)thiamine, O
      (2-norbornoyl) thiamine, O-(1-norbornoyl)thiamine, O-(1-adamantoyl) thiamine, O
      (2-adamantoyl) thiamine, O-(5-methyl-1-adamantyl)acetylthiamine, O-(2
      adamantyl)acetylthiamine, O-(1-adamantyl)acetylthiamine were determined. The
      acceleration effect of hydrophobic fragment of O-acyl substituent is attributed
      to the formation of neutral tricyclic form in the step followed by electron
      transfer to ferricyanide. Mechanistic implications for possible transformation of
      thiamine in neutral tricyclic form at interaction with thiamine-binding protein
      are discussed.

PMID- 11200468
TI  - ELISA-based method for determining the affinity of bivalent antibodies of two
      specificities in a mixture.
AB  - The problem of the evaluation of the affinity for two types of bivalent
      antibodies in a mixture is considered. It is shown that the binding curve in
      appropriate coordinates can be used to compose either a system of four equations
      with four unknowns or a system of two equations with two unknown variables. The
      numerical solution of these equation systems yields affinity constants for both
      antibodies and the relationship between concentrations of antibodies studied in
      the mixture.

PMID- 11200469
TI  - [Pilot plant and experimental laboratory production. The role in biotechnology
      industry development].
AB  - A stage-phase approach can contribute to unnecessarily long product development
      time. A simultaneous approach that integrates all development resources through
      an effectively managed pilot plant can significantly shorten the product
      development cycle. An intensive development of the domestic biotechnology
      manufacturing is impossible without creation of the real pilot plant market in
      Ukraine.

PMID- 11200470
TI  - [Development of biochemistry in the Biology Department of Kharkhov State
      University. Formation of a new direction--physiology and biochemistry of aging].
AB  - The article presents some data on teaching Biochemistry at the Nature Department
      of Kharkiv Imperial University Physico-Mathematical Faculty, as well as
      restoration of biochemical education and scientific researches as a result of the
      University reorganization in the Soviet period and foundation of the Biochemistry
      Chair at the Biological Faculty in the renovated Kharkiv State University. The
      analysis of scientific biochemical investigations conducted in the Kharkiv
      University till now is revealed. The special attention is paid to development of
      such a scientific trend as age physiology and biochemistry. The article deals
      with the comprehensive information on scientific and pedagogical activity of the
      outstanding scientists such as O. V. Nagorny and I. M. Bulankin as founders of
      the Kharkiv school of age physiology and biochemistry. The work has utilized some
      archive data.

PMID- 11200472
TI  - [Features of fibronectin-dependent activation of ribosomal protein S6 kinase
      (S6K1 and S6K2)].
AB  - Integrin family of adhesion receptors play an important role in organizing the
      actin cytoskeleton and in signal transduction from the extracellular matrix. The
      previous studies have shown that exposure of fibroblast cells to extracellular
      matrix proteins activates ribosomal S6 kinase 1 (S6K1) pathway in a ligand
      dependent manner. Recently, a new, highly homologous ribosomal S6 kinase, termed
      S6K2, was identified. It has 70% amino acid identity in the overall sequence with
      S6K1, and the potential phosphorylation sites of S6K1 are conserved in S6K2.
      However, the N- and C-terminal domains of S6K2 are quite different from those of
      S6K1. In this study we have examined dynamics of fibronectin-induced activation
      of these two kinases, transiently expressed in human HEK 293 cells. Differences
      between profiles of activation of S6K1 and S6K2 were observed in the early period
      of fibronectin stimulation. Fibronectin-induced changes in S6K2 activity were
      closely correlated with phosphorylation at Ser423, which is homologues to Ser 434
      of S6K1. Although we didn't observe considerable changes in phosphorylation of
      S6K1 at Ser434, suggesting potential differences in the regulation of these
      homologous kinases upon fibronectin stimulation.

PMID- 11200471
TI  - [Riboflavin biosynthesis in yeast as a model for estimating mechanisms of
      regulating synthesis of biologically active substances].
AB  - General principles of regulation of transcription in eucaryotic cells are
      characterized. Investigations on riboflavin biosynthesis and regulation of this
      process in yeasts are summarized. The data obtained permit to consider riboflavin
      biosynthesis control as an interesting and convenient model capable to estimate
      the mechanisms various transcription factors action. These investigations are
      required in order to reveal general features of vitamins and relative compounds
      biosynthesis regulation.

PMID- 11200473
TI  - [Intracellular localization and characteristics of monophenol monooxygenase in
      the leaves of tea plants].
AB  - The intracellular localization and some properties of monophenol monooxygenase
      (MPMO) from fresh tea leaves have been studied. It has been demonstrated that
      MPMO activity is located in cytosole and chloroplasts. These two forms have
      different properties. Molecular weights of cytosole and chloroplasts MPMO are 41
      and 28 kD respectively. The chloroplasts and cytosole forms of MPMO reveal
      maximum activity at pH 5.3 and 7.1 respectively.

PMID- 11200474
TI  - [Accumulation of Ca ions in intracellular structures of rat myometrium during
      subacute, acute, and chronic administration of ethanol].
AB  - The effects of subacute, acute and chronic ethanol exposure on the activity of
      Ca(2+)-accumulating systems of mitochondria and endoplasmic reticulum in
      myometrial cells of nonpregnant estrogen-treated rats were studied. It has been
      shown that the activity of Ca(2+)-accumulating system of mitochondria was higher
      than the activity of Ca(2+)-accumulating system of endoplasmic reticulum in
      myometrial cells from control, acute and subacute treated with ethanol rats.
      Under ethanol chronical assumption both Ca(2+)-accumulation in mitochondria and
      Ca(2+)-transporting activity of endoplasmic reticulum are inhibited. In the
      latter ease Mg2+, ATP-dependent Ca(2+)-pump lost its sensitivity to oxytocin.

PMID- 11200475
TI  - [Antioxidant and biological activity of melatonin].
AB  - Neurohormone melatonin controls the circadian rhytmicity of some biological
      processes, unites the functions of nervous, endocrine and immune systems.
      Melatonin is a powerful bioantioxidant, capable to be dissolved in water and
      lipids, runs through membranes and barriers, accumulates in cell nuclei and
      protects DNA from oxidative stress. Melatonin displays immunomodulating,
      radioprotective and antitumor activities.

PMID- 11200476
TI  - [Ca2+-transporting properties of myometrial plasma cell membrane Ca2+, Mg2+
      ATPase reconstituted in liposomes].
AB  - Purified myometrium cells plasma membrane Ca2+, Mg(2+)-ATPase was reconstitute in
      liposomes in functionally active state by the method of cholate dialysis: it
      showed ATP-hydrolase activity increased by 0.8 microM A23187 average 4 times and
      it showed Mg2+, ATP-dependent Ca(2+)-transporting activity. Reconstituted system
      transported Ca2+ at an initial rate of 114.4 +/- 16.3 nmol.min-1.mg-1 with the
      stoichiometry Ca2+: ATP = 1: (3.2-3.7). Calmodulin increased by 30% the initial
      rate of Ca(2+)-accumulation by the proteoliposomes with reconstituted Ca2+,
      Mg(2+)-ATPase; 0.1 mM orthovanadate decreased by 80% Ca(2+)-accumulation by this
      system. Ca2+, Mg(2+)-ATPase reconstituted in liposomes is just Ca(2+)
      transporting ATPase of the plasma membrane. Obtained enzyme preparate can be
      utilised for study of the properties of this important energy-dependent Ca(2+)
      transporting system of smooth muscle cell.

PMID- 11200477
TI  - [Change in Ca2+ transport in myometrial plasma cell membrane in proton gradient
      dissipation].
AB  - By means of delta pH 14C-methylamine indicator the myometrium vesicle sarcolemma
      fraction was shown to be capable, while applying a "delta pH-leap", for
      developing in it a proton transmembrane gradient, dissipating in time. The proton
      gradient dissipation under Ca ions transmembrane equilibrium concentration is a
      driving force of these ions transposition against the concentration gradient. The
      blocking agents of H+ transport--Cd ions and DCCD decrease the proton-dependent
      45Ca2+ accumulation in the vesicle sarcolemma fraction. The conclusion has been
      made about the possibility of Ca2+(H(+)-exchange on the uterus smooth cells
      sarcolemma. The possible physiological value of this exchange is under
      discussion.

PMID- 11200478
TI  - Decomposition of acetylcholine with ethylene formation in vitro.  Possible free
      radical mechanism of acetylcholine action.
AB  - Experiments were designed to investigate the effect of different buffered
      solutions, Fenton reagent and hydrogen peroxide on acetylcholine decomposition
      with ethylene formation. The data of the present study suggests that
      acetylcholine is decomposed in vitro to form ethylene by interacting with the
      free radicals or in the Hofmann's splitting reaction. It is found that free
      radicals are required for the fast decomposition of acetylcholine to form
      ethylene. A general mechanism to explain the rapid biological effects that can be
      influenced by the free radicals was proposed. We have concluded that endogenous
      metabolic free radicals can be involved in the decomposition of acetylcholine as
      well in the biological activation of formed ethylene in vivo.

PMID- 11200479
TI  - Human anti-DNA secretory immunglobulins A possess endonuclease activity and they
      are able to cause the destruction of nuclear chromatin in vitro.
AB  - sIgA possessing ability to hydrolyse plasmid DNA to linear forms was purified
      from human milk by sequential chromatography on protein A-sepharose, DEAE
      Fractogel and DNA-cellulose. It was discovered that incubation of sIgA with
      nuclei of porcine embryo kidney cells permeabilized by Triton X-100 causes
      formation of electrophoretically mobile forms of nuclear nucleic acids and
      inhibition of phosphorylation of nuclear proteins. We suppose that sIgA
      possessing affinity to DNA and endonuclease activity can cause degradation of
      cell nuclear chromatin.

PMID- 11200480
TI  - [Effect of rhenium complexes with organic ligands on acid resistance of human
      erythrocytes].
AB  - The authors showed stabilizing effect of rhenium binuclear cluster compounds with
      organic ligands on erythrocytic membranes. Estimation of functional condition of
      cells was studied by a chemical fragility method. Biphase type of rhenium
      complexes concentration curves stabilization has been found out; the influence of
      organic radicals and axial substructures (Cl- and Br-) on degree of stabilization
      has been showed. Different mechanisms of interaction of the investigated
      complexes with erythrocytic are suggested.

PMID- 11200481
TI  - [Effect of N-acylethanolamines on adrenal cortex function].
AB  - The possibility of NAE to take part in the regulation of the function of adrenal
      glands was studied. It was shown that two times NAE (18:0) injection in a dose 5
      mg/kg of weight increased the content of 11-hydroxysteroids in blood of intact
      male rats. NAE caused the raise of the blood hormone content by 4 times under the
      immobilization stress. It is apparent that augment of stress response under the
      influence of NAE in vivo is explained by the activation of hypophysis-adrenal
      cortex system. In vitro NAE lowered steroidogenesis by near 40%. One can suggest
      that this decrease is caused by membranotropic properties of NAE.

PMID- 11200482
TI  - [Level of group E prostaglandins in gastric mucosa of patients with various forms
      of chronic gastritis].
AB  - There was studied prostaglandins E concentration in bioptats of gastric mucosa in
      158 patients with various forms and localization of chronic gastritis using a
      radioimmunological method. Chronic gastritis without atrophy and with mild
      atrophy showed to have decreased levels of prostaglandins E in comparison with
      the control. In the patients with atrophic gastritis with "reconstruction" of
      epithelium there was revealed an increase of prostaglandins concentration, which
      was maximal in the patients with atrophic-hyperplastic forms of the disease.

PMID- 11200483
TI  - [Activity of cytoplasmic proteinases from rat liver in Heren's carcinoma during
      tumor growth and treatment with medicinal herbs].
AB  - The dynamics of the acid and neutral proteinases general enzymes activity change
      in the hepatocytes postnuclear fraction in the rats suffering from the Heren's
      carcinoma was investigated. It was determined that in the tumor development of
      the enzyme activity level of both the acid and neutral proteinases increased 2,6
      fold. The natural preparation of the herbs (Calendula officinalis L., Echinacea
      purpurea L., Scorzonera humilis L., Aconitum moldavicum Hacq.) normalizes both
      the activity of the investigated enzymes and coefficients of the liver weights of
      the sick animals. The chemical medicinal preparation 5,6-benzcumarine-5-uracil
      normalizes the activity of the neutral cytoplasmatic proteinases and reduces the
      level of the proteolytic activity of the acid enzymes in comparison with the
      control group of the animals as well as increases of the liver weight
      coefficients.

PMID- 11200484
TI  - [Role of xanthine oxidase and xanthine dehydrogenase systems in thymocyte
      apoptosis, induced by papaverine].
AB  - It has been established that papaverine as well as other xenobiotics
      (dexamethasone and nitrosodimethylamine) [figure: see text] provoked the
      thymocyte death like apoptosis. The increase of the quantity of double-strand,
      single-strand DNA breaks and low molecular weight fragments of DNA preceded cell
      death. In papaverine-induced process of thymocyte apoptosis the total activity of
      xanthine oxidase in thymocytes strongly elevated long before their death, the
      conversion of xanthine dehydrogenase (D-form) to xanthinoxidase (O-form) and
      accumulation of O-form in the cultural medium took place. Direct stimulating
      effect of papaverine on O-form of enzyme in thymocyte lysate was revealed. The
      used digitonin thymocytes were divided into cytoplasmic and structural component
      fractions. It was shown that about 80% of total xanthinoxidase activity was
      concentrated in cytoplasma while only 20% of its activity was found in structural
      components. More higher ratio of xanthinoxidase/xanthindehydrogenase (XO/XDH) was
      observed and papaverine-induced changes of these enzyme forms activities were
      expressed more brightly in the structural components, than in the thymocyte
      cytoplasma. During the process of developing thymocytes apoptosis caused by
      papaverine the reaction of lipid peroxidation was intensified. XO-hypoxanthin
      system displaying prooxidant influence on cells increased the cytotoxic effect of
      papaverine but the presence of allopurinol or catalase and superoxidedismutase
      decreased it. Besides, cytotoxic action on thymocytes of allopurinol itself as
      well as hypoxanthin itself was revealed.

PMID- 11200485
TI  - Investigation of stillbirth.
AB  - The pathologic investigation of stillbirth is often frustrating, and may be
      viewed as unrewarding, because the reason for death of the infant frequently is
      not identifiable. This outline attempts to identify an approach to the
      examination of the stillborn and accompanying placenta, with appropriate use of
      ancillary studies that may uncover the cause of death and/or identify factors
      that could prejudice future pregnancies.

PMID- 11200486
TI  - One-month-old infant with multiple ulcers of stomach, small bowel, large bowel,
      and protein-losing enteropathy: case report.
AB  - Multiple inflammatory ulcers of the gastrointestinal tract are rare in young
      infants. Most cases are caused by infectious organisms, vasculitis, or an
      autoimmune process. We report a 1-month-old infant who was healthy until he
      presented with an inflammatory mesenteric cyst, and multiple ulcers of the
      stomach, duodenum, jejunum, ileum, and colon. Histologically, the ulcerations
      were sharply demarcated, full thickness, and filled with macrophages. He had a
      low serum albumin and IgG due to protein-losing enteropathy. He was treated with
      supportive care and immunomodulating drugs. The gastrointestinal inflammation
      resolved by 3 and 1/2 years of age. The medications were withdrawn at 5 and 1/2
      years of age he had no relapse of clinical symptoms. He continues to have
      asymptomatic mild hypoalbuminemia and low serum IgG. We could not find a report
      of a similar clinical presentation and outcome.

PMID- 11200487
TI  - Comparative immunohistochemical study of insulin-like growth factor II and
      insulin-like growth factor receptor type 1 in pediatric brain tumors.
AB  - Insulin-like growth factor (IGF)-II is an important growth factor in development
      of the central nervous system. The purpose of this study was to evaluate
      expression of IGF-II and IGF receptor type 1 (IGFR1) in various pediatric brain
      tumors. Immunohistochemistry for IGF-II and IGFR1 was performed on 15 choroid
      plexus papillomas (CPPs) including 1 atypical CPP, 2 choroid plexus carcinomas
      (CPCs), 5 anaplastic ependymomas, 7 nonanaplastic ependymomas (simply referred to
      as "ependymoma"), 5 medulloblastomas, 1 cerebral neuroblastoma, and 1 atypical
      teratoid/rhabdoid tumor (ATRT) along with 10 non-neoplastic choroid plexus and 3
      non-neoplastic ependymal linings. All non-neoplastic choroid plexus, CPPs, CPCs,
      anaplastic ependymomas, ATRT, 71% of ependymomas, and 67% of non-neoplastic
      ependymal linings showed cytoplasmic positivity for IGF-II, whereas all
      medulloblastomas and the cerebral neuroblastoma were negative for IGF-II. In
      addition to cytoplasmic positivity for IGFR1, membranous positivity was observed
      in 73% of CPPs, both CPCs, the ATRT, 22% of non-neoplastic choroid plexus, 80% of
      anaplastic ependymomas, and 29% of ependymomas, but not in any medulloblastoma,
      cerebral neuroblastoma, or non-neoplastic ependymal lining. IGF-II and IGFR1 may
      play roles in the pathogeneses of CPP, CPC, anaplastic ependymoma, ependymoma,
      and ATRT. Immunohistochemical testing for IGF-II and IGFR1 may be useful in
      differentiating ATRT, CPC, and anaplastic ependymoma from medulloblastoma and
      cerebral neuroblastoma.

PMID- 11200488
TI  - Accidental modification of Attwood's stain on decalcified preparations, yielding
      improved differentiation between woven and lamellar bone.
AB  - In an earlier report, a modification of the Attwood's stain was used to study
      sections of decalcified bone and the procedure aided in the distinction between
      lamellar and woven bone. Lamellar bone showed preferential affinity for phloxine
      (red) yet resisted differentiation with tartrazine (yellow), while woven bone
      stained well with tartrazine. In addition, osteoid seams were identified by their
      affinity for tartrazine. Differential staining was abolished by pretreatment with
      periodic acid. Recently, accidental use of potassium permanganate in an acidified
      medium of pH 1.94, instead of pH 6.44, yielded unexpected results with a much
      sharper, consistent distinction between woven and lamellar bone. This probably
      reflects changes in the noncollagenous, interfibrillary matrix proteins of bone,
      but the exact reason(s) is not known. In our view, this serendipitous
      modification represents an advance over the previous method, and has allowed us
      to study the structure of bone in some of the systemic disorders, e.g.,
      osteogenesis imperfecta, with greater ease than before. This method does,
      however, suffer the disadvantage of interfering with the intensity of the
      staining of any cartilaginous matrix, and the original application is still of
      value.

PMID- 11200489
TI  - Connective tissue growth factor expression in pediatric myofibroblastic tumors.
AB  - Human connective tissue growth factor (CTGF) is a secreted cysteine-rich peptide
      and a member of the peptide family that includes serum-induced immediate gene
      products such as a v-src-induced peptide and a putative proto-oncogene, c-src.
      CTGF is secreted by endothelial cells, fibroblasts, smooth muscle cells, and
      myofibroblasts. Its expression is increased in various human and animal fibrotic
      diseases. We hypothesized that tumors with significant fibrous and vascular
      components would exhibit increased expression of CTGF. We examined the expression
      of CTGF mRNA by in situ hybridization in 12 pediatric tumors and tumor-like
      conditions, including angiofibroma, malignant fibrous histiocytoma, infantile
      myofibromatosis, and malignant hemangiopericytoma. All the tumors showed moderate
      to intense CTGF expression in tumor cells and/or endothelial cells of the
      associated vasculature. Angiofibromas expressed CTGF only in factor VIII-positive
      endothelial cells and vascular smooth muscle cells. In contrast, infantile
      myofibromatosis, malignant hemangiopericytomas, and fibrous histiocytomas
      expressed CTGF in both endothelial cells and in vimentin-positive tumor cells,
      particularly those around the blood vessels. CTGF mRNA was not detected in the
      inflammatory cells observed in many of the tumors. The presence of CTGF in the
      endothelial cells and tumor cells around blood vessels raises the possibility
      that CTGF is involved in the pathogenesis of these myofibroblastic tumors.

PMID- 11200490
TI  - Pediatric core needle biopsy: strengths and limitations in evaluation of masses.
AB  - Needle core biopsies (NCB) are widely used in adults but are less often used for
      the evaluation of pediatric tumors. To determine the diagnostic utility of NCB
      for pediatric tumors, we performed a retrospective analysis. Fifty NCB of masses
      from 1992 to 1998, subsequent pathologic specimens, and medical records were
      reviewed. All patients were less than 21 years of age. Of the NCB 78% (39/50)
      were diagnostic of a neoplasm, 8% (4/50) were nondiagnostic in cases where a
      tumor was subsequently diagnosed, and 14% (7/50) revealed inflammatory or
      reactive lesions, with no subsequent diagnosis of a neoplasm according to medical
      record review. In cases in which a neoplasm was present, NCB was diagnostic in
      91% (39/43). For cases in which there was a previous diagnosis of a tumor, 100%
      (9/9) of NCB were diagnostic of a recurrence or metastasis. In cases of NCB for
      primary tumor diagnosis, 88% (30/34) were diagnostic. The most common problems
      encountered were related to specimen adequacy, such as insufficient tissue, crush
      artifact, and tumor necrosis. Tumor diagnoses were as follows: primitive
      neuroectodermal tumor (PNET)/Ewing sarcoma (12), malignant lymphoma/Hodgkin's
      disease (8), rhabdomyosarcoma (4), germ cell tumor (3), Wilms' tumor (3),
      neuroblastoma (1), sarcoma, not otherwise specified (4), and other neoplasms (8).
      There were no complications of the procedure. NCB of pediatric tumors is an
      effective diagnostic tool and can be used to obtain diagnostic material quickly
      and safely. NCB was diagnostic in 90% of cases in this series. When NCB provide
      sufficient material for immunohistochemical, cytogenetic, flow cytometric, and
      other ancillary studies, the diagnostic efficacy is enhanced. The major
      limitations in this series were related to sampling problems and specimen
      adequacy for comprehensive pathologic evaluation.

PMID- 11200491
TI  - Morphometric assessment of Hirschsprung's disease: associated hypoganglionosis of
      the colonic myenteric plexus.
AB  - At present, there are no generally acceptable criteria for the evaluation of
      hypoganglionosis of the myenteric plexus. The aim of this morphometrical
      investigation was to examine the most important quantitative characteristics of
      hypoganglionosis. Colon specimens from 35 children with Hirschsprung's disease
      were assessed morphometrically. Twenty specimens with Hirschsprung's disease and
      proximal hypoganglionosis of the myenteric plexus were compared with 15 specimens
      with Hirschsprung's disease and normal innervation in the proximal myenteric
      plexus. All native surgical specimens were caudocranial coiled and sectioned in a
      cryostat. Nerve cells and ganglia were selectively stained with an enzyme
      histochemical lactic dehydrogenase reaction. Morphometric measurements were done
      with an optic-electronic image analysis system. Hirschsprung's disease-associated
      hypoganglionosis of the myenteric plexus is characterized by a significant
      decrease in ganglion cross-sectional area (-56.2%) and in plexus area per mm
      colon (-53.5%). Together with these data, an increase in ganglion distance (+20%)
      was also determined, and the number of nerve cells per mm colon was decreased by 
      25.5%. The decrease in ganglion area and in the number of nerve cells per mm
      colon in the myenteric plexus proved to be the most characteristic parameters of
      a hypoganglionosis.

PMID- 11200492
TI  - Telomerase activity as a prognostic factor in neuroblastomas.
AB  - Neuroblastoma is the most common extracranial solid tumor of early childhood.
      This tumor demonstrates significant heterogeneity with respect to pathologic,
      genetic, and clinical features. The outcome varies from spontaneous regression or
      maturation to rapid progression, despite aggressive therapy. Prognostic factors
      have been found that identify those tumors which have a high probability of
      aggressive behavior; these factors include unfavorable histology, MYCN copy
      number, deletions of the short arm of chromosome 1, DNA content, and TRK-A (high
      affinity receptor protein for nerve growth factor) expression. Recent studies
      have suggested that high levels of telomerase activity also correlate with poor
      clinical outcome. We investigated this relationship in 40 patients with untreated
      neuroblastoma, using a PCR-ELISA assay for telomerase activity. In these
      patients, 23 tumors had no or minimal telomerase activity whereas 15 had high
      levels of activity. In two tumors, telomerase activity was not assessable. There
      was significant correlation between the telomerase activity and MYCN copy number,
      1p deletions, and TRK-A expression, as well as patient age, clinical stage, and
      outcome. The histological classification of the tumors was not significantly
      different between the two groups, being predominantly unfavorable by the Shimada
      classification. In addition, for 17 patients tumor tissue was assessed for
      telomerase activity post-chemotherapy. In those cases where the tumor was
      negative for telomerase activity before and after chemotherapy, the patients
      uniformly did well. In cases where the tumor was positive before and negative or
      weakly positive after treatment, two of the seven patients did well clinically.
      However, in cases that were positive after chemotherapy, all had recurrence or
      died. In conclusion, telomerase activity appears to be a prognostic factor for
      neuroblastomas. In addition, assessment of tumors post-chemotherapy may be a
      further indicator of clinical outcome.

PMID- 11200493
TI  - Human papillomavirus-11-associated recurrent respiratory papillomatosis is more
      aggressive than human papillomavirus-6-associated disease.
AB  - The aim of this study was to determine whether viral type (HPV-6 vs. HPV-11)
      could predict the clinical course of recurrent respiratory papillomatosis in
      children. Viral typing, using the polymerase chain reaction, was performed on
      laryngeal biopsies of 61 patients treated at Children's Hospital of Michigan. HPV
      6 was detected in 29 of the patients' biopsies and HPV-11 in 32 biopsies. HPV-11
      was more common among the African-American patients than among Caucasians (P =
      0.001). Patients with HPV-11 were diagnosed at a younger age (36.2 vs. 48.2
      months; P = 0.04) and were more likely to have active disease (P = 0.0311) at the
      time of this study. They tended to have longer periods of disease activity (8
      years vs. 5 years; P = 0.026), required more surgical procedures (42
      procedures/patient vs. 13.6; P = 0.02), and more procedures per patient, per year
      (2.9 vs. 5.3; P = 0.0164). Three of the patients infected with HPV-11 developed
      invasive papillomatosis and bronchogenic squamous cell carcinoma, and two of
      these patients died of disease. Our findings suggest that HPV-11 infection
      confers a more aggressive course to recurrent respiratory papillomatosis.

PMID- 11200494
TI  - Malignant melanoma in children and congenital melanocytic nevi: DNA content and
      cell cycle analysis by flow cytometry.
AB  - Malignant melanoma (MM) in children, although a rare neoplasm, can occur within a
      preexisting congenital melanocytic nevus (CMN). All the potential risk factors
      for this phenomenon are not well known, but increases in S phase and G2 + M phase
      of cell cycle, DNA aneuploidy, and cell cycle abnormalities in precursor lesions
      might be among the risk factors. Using paraffin-embedded tissue, we performed a
      retrospective analysis of DNA content, aneuploidy, and cell cycle by flow
      cytometry. Two groups of patients were analyzed: 28 children with CMN who did not
      developed MM, and 6 patients who further developed MM. In this second group,
      three patients had four biopsies done before the appearance of MM and in two
      patients biopsies were done after the appearance of MM. All CMN not associated
      with MM exhibited diploid cells only, their S phase was 11.5% (+/- 3.8), and
      their G2 + M phase was 2.5% (+/- 2.2). Among those patients who developed MM, 3/6
      had an S phase > 15.5 and a G2 + M phase > 2.3 prior to the appearance of MM. Two
      out of six patients had a tetraploid DNA when MM developed and died with a
      disseminated MM. They had an S phase > 15.5 and their G2 + M phase was > 2.5. We
      propose that evaluation of DNA content and cell cycle by flow cytometry is a
      useful method to supplement biopsy findings in children with CMN who have lesions
      suspicious of developing a MM.

PMID- 11200495
TI  - Comparison of immunohistochemistry and silver stain for the diagnosis of
      pediatric Helicobacter pylori infection in urease-negative gastric biopsies.
AB  - We compared immunohistochemical and silver stains of pediatric gastric biopsy
      sections for the identification of Helicobacter pylori infection with chronic
      inflammation and a negative urease screening test. Thirty-seven patients (age
      range 10 months to 21 years) whose gastric antral biopsies were negative for the
      rapid urease test (CLO(R)) but positive for lymphocytic infiltration were
      selected for a retrospective study. Specimens had been subjected to a rapid
      urease test (CLO(R)) and hematoxylin and eosin staining, and Dieterle silver
      staining and immunohistochemical staining specific for H. pylori were also
      performed. Twelve additional patients with urease-positive biopsies were used as
      controls. With Dieterle staining, 8/37 (22%) urease-negative biopsies contained
      organisms morphologically compatible with H. pylori, 21/37 (56%) contained
      organisms not compatible with H. pylori, and 8/37 (22%) were negative for
      organisms. Immunostaining confirmed 6/8 (75%) Dieterle-positive cases as being H.
      pylori, was negative in 2/8 (25%) Dieterle-positive cases, and was positive in
      2/8 (25%) Dieterle-negative cases. Biopsies from 8/12 (67%) urease-positive
      specimens contained organisms seen with both Dieterle and immunohistochemical
      stains, and 4/12 (33%) were negative with both stains. Although both stains
      yielded comparable results with H. pylori-positive biopsies, Dieterle staining
      was potentially confusing because of nonspecific staining of other organisms. A
      significant proportion of (CLO(R))-negative biopsies was positive for H. pylori
      with special stains. We therefore recommend the use of immunohistochemical
      staining rather than silver staining in the evaluation of urease-negative gastric
      biopsies demonstrating chronic inflammation in children.

PMID- 11200496
TI  - Ectopic cerebellum presenting as a suprasellar mass in infancy: implications for
      cerebellar development.
AB  - A 4-month-old infant with a history of nasopharyngeal teratoma developed
      progressive optic neuropathy. Neuroimaging studies demonstrated a solid,
      isointense, suprasellar mass impinging on optic nerves and chiasm superiorly. The
      mass was subtotally resected. No attachment of the mass to brain stem or
      cerebellar structures was noted. Histological examination identified the tissue
      as developing cerebellum. The cytoarchitecture and cellular constituents of the
      cerebellar tissue were only slightly distorted. All cerebellar cortical
      constituents were arranged anatomically, and an external granular cell layer was
      present superficially. The latter was actively proliferating and appropriately
      cellular for the infant's age. The clinical presentation of ectopic cerebellum as
      a suprasellar mass in an infant is highly unusual. Moreover, this example
      illustrates the ability of cerebellar tissue to mature appropriately in a site
      distant from the posterior fossa, removed from ascending and descending afferent
      projections. Intrinsic signaling mechanisms appear sufficient to direct
      histogenesis in developing cerebellar cortex.

PMID- 11200497
TI  - Large granular lymphocyte leukemia: case report of chronic neutropenia and
      rheumatoid arthritis-like symptoms in a child.
AB  - Lymphoproliferative disorders of large granular lymphocytes (LGL) are
      heterogeneous, with a clinical/pathologic spectrum ranging from a benign
      polyclonal expansion to an aggressive clonal disease. Often these
      lymphoproliferative disorders are associated with autoimmune disease. The clonal
      form of the disorder, LGL leukemia, typically occurs in older adults with a
      median age of 55 years at diagnosis. Pediatric cases are referred to in review
      articles; however, no detailed reports of T-cell LGL leukemia in children exist.
      This report illustrates a case of a child who presented initially at age 2 and
      1/2 years with psoriasis, juvenile rheumatoid arthritis-like symptoms, and
      neutropenia. Bone marrow examinations obtained throughout his course have
      demonstrated progressive hypercellularity with increased reticulin fibers and
      replacement of the normal marrow elements by lymphocytes, which were later
      identified as large granular lymphocytes. Further testing with immunophenotyping
      by flow cytometry and T-cell receptor gene rearrangement studies revealed a
      monoclonal proliferation of large granular lymphocytes and confirmed a diagnosis
      of LGL leukemia. Although rare, large granular lymphocyte leukemia should be
      included in the differential diagnosis of chronic neutropenia in children.

PMID- 11200498
TI  - Representative CGH (comparative genomic hybridization) image of an esophageal
      squamous cell carcinoma cell line, KYSE150, exhibiting marked amplifications at
      1q32 and 9p23-24.

PMID- 11200499
TI  - Naturally occurring and synthetic inhibitors of NF-kappaB functions.
AB  - Nuclear factor (NF)-kappaB is a transcription factor that induces the
      immunoglobulin kappa chain, cytokines such as interleukin (IL)-1, IL-2, IL-6, IL
      8, tumor necrosis factor (TNF)-alpha and interferon gamma, and cell adhesion
      proteins. It also induces anti-apoptotic proteins, and inhibits TNF-alpha and
      anticancer drug-induced apoptosis. Therefore, NF-kappaB function inhibitors may
      be useful as anti-inflammatory and anticancer agents. Microbial products such as
      panepoxydone, cycloepoxydon and gliotoxin are known to inhibit activation of NF
      kappaB. We have designed and synthesized new NF-kappaB inhibitors from the
      structure of an antibiotic, epoxyquinomicin C. The designed compound, DHM2EQ,
      inhibited TNF-alpha-induced activation of NF-kappaB and showed a therapeutic
      effect in mouse rheumatoid arthritis model.

PMID- 11200501
TI  - The 9-position in berberine analogs is an important determinant of DNA
      topoisomerase II inhibition.
AB  - A current model suggests that the intercalative and minor groove binding
      components of protoberberines and related compounds are important for DNA
      topoisomerase I and/or II inhibition. The significance of the 9-substituent in
      berberine on drug-topoisomerase II interactions is reported here and is based on
      a comparison of 9-ethoxycarbonyl berberine (compound 1), 9-N,N-dimethylcarbamoyl
      berberine (compound 2) and 12-bromo berberine (methoxy group at 9-position;
      compound 3) as enzyme inhibitors. Compound 1 selectively inhibited topoisomerase
      II and stabilized cleavage complexes predominantly at unique sites and some
      background sites (depending on the concentration). This agent also allowed
      partial dissociation of enzyme from the DNA in the absence of religation,
      indicating unique interactions between 1, enzyme and DNA in the ternary
      complexes. Compound 2, which had similar DNA binding properties to 1, was not a
      topoisomerase II poison in the tested concentration range. In contrast, compound
      3 was a stronger DNA binding agent but a much weaker enzyme poison both in vitro
      and in cell-based assays. The results show that the proposed drug domain for DNA
      intercalation is not a major determinant of enzyme inhibition for simple
      berberine analogs. Rather, the 9-substituent within the domain has a major
      influence, presumably by facilitating drug interaction with enzyme and/or enzyme
      DNA complexes.

PMID- 11200500
TI  - Role of DNA minor groove alkylation and DNA cross-linking in the cytotoxicity of
      polybenzamide mustards.
AB  - Interstrand DNA cross-links have been considered essential to the activity of
      current clinical DNA-alkylating antitumour drugs, which generally alkylate in the
      major groove. However, the relationship between cross-linking adducts located in
      the minor groove of DNA with cytotoxicity and antitumour activity has not been
      extensively investigated. Previous studies have shown that cross-linking ability
      is not correlated with cytotoxicity in a novel series of polybenzamide-linked
      nitrogen mustard compounds which alkylate DNA at adenines in the minor groove. In
      the present study the nature of these cross-linking adducts was explored for a
      related pair of compounds which are both highly effective cross-linkers but which
      differ in antitumour potential. Both of these drugs effectively interact with
      adenines in the minor groove, although their sequence specificity differs.
      However, the cross-linking event was not inhibited by pre-treatment with Hoechst
      33258, although this pre-treatment effectively prevented adenine alkylation. The
      primary cross-links detected may thus represent guanine N7 alkylations in the
      major groove. Whether minor groove cross-linking adducts can be formed is
      uncertain, since the effect of background guanine N7 alkylation may complicate
      analysis. The cytotoxicity of the polybenzamides may therefore be related to
      other factors such as their interaction with cellular repair systems.

PMID- 11200502
TI  - Design, synthesis and antitumor cytotoxicity of novel bis-benzimidazoles.
AB  - A series of novel bis-benzimidazoles, IIa-e, IIIa-e and IVa-g, was designed,
      synthesized and evaluated for anticancer properties. Certain additional analogs
      were also designed by introducing the p-quinone moiety, a characteristic feature
      found in mitomycin C, indolequinones and other examples of bioreductively
      activated alkylating agents. Structural changes of the bis-benzimidazole nucleus
      with various leaving groups were investigated for their effects on their
      pharmacological properties. These compounds were evaluated for their cytotoxicity
      against human cancer cell lines. The results of the studies indicate that the
      compounds IIa, IIc, IVa, IVc, IVd and IVg possess significant cytotoxic
      activities against 22 cell lines in seven cancer panels with GI50 values between
      <0.01 and 99.5 microM especially in the cases of renal cancer, CNS cancer, colon
      cancer, melanoma and breast cancer.

PMID- 11200503
TI  - The influence of lipophilicity on binding of boronated DNA-intercalating
      compounds in human glioma spheroids.
AB  - Five boronated DNA-intercalating compounds [5-ortho-carboranyl phenanthridinium
      (5-o-CP), 5-para-carboranyl phenanthridinium (5-p-CP), 6-para-carboranyl
      phenanthridinium, water-soluble boronated phenanthridinium and water-soluble
      boronated acridine (WSA1)], primarily developed for boron neutron capture therapy
      (BNCT), were analysed regarding their binding in cultured human malignant glioma
      spheroids. Comparisons were made with the corresponding DNA intercalators
      ethidium bromide and acridine orange. Octanol/phosphate buffered saline-water
      coefficients were determined for all compounds, and it was found that the most
      lipophilic (5-o-CP and 5-p-CP) were most toxic and accumulated high amounts of
      boron in monolayer cells. These compounds bound primarily in the outermost part
      of spheroids with poor penetration into the inner region, even after 2 days of
      continuous exposure. On the other hand, the most hydrophilic compound (WSA1)
      showed lower toxicity and lower boron accumulation in monolayer cells, and rapid
      binding in the inner region of spheroids. A reasonable explanation for this
      observation is that the lipophilic compounds interact mainly with lipophilic
      parts of the cells, like cellular membranes, and therefore rapidly binds to
      cells, preventing penetration and binding to cells in the deeper region of the
      spheroids. The possibility of using these compounds for BNCT are discussed.

PMID- 11200504
TI  - New potential photodynamic therapeutic anti-cancer agents: synthesis and
      characterization of demethoxy amino-substituted hypocrellins.
AB  - A novel method was used to obtain demethoxy amino-substituted hypocrellin
      derivatives. The reaction condition was mild and amino substitution occurred at
      position 2 or 11 of hypocrellins with high yield. The photophysical and
      photochemical properties of the amino-substituted hypocrellins derivatives were
      investigated, and their significantly enhanced red absorptivities and strong
      active oxygen-generating functions qualified them as promising photodynamic
      therapeutic anti-cancer agents.

PMID- 11200505
TI  - Synthesis and antimelanoma activity of analogues of N-acetyl-4-S
      cysteaminylphenol.
AB  - N-Acetyl-4-S-cysteaminylphenol (1) has been shown by Jimbow and co-workers to
      possess useful antimelanoma activity. It is an analogue of a biosynthetic
      intermediate in the pathway to melanin and probably acts as a prodrug, being
      oxidized to an o-quinone which reacts with essential enzymes containing
      sulphydryl groups resulting in interference with cell growth and proliferation.
      We have synthesized a range of analogues of 1 by varying the acyl portion of the
      amide with the intention of increasing the lipophilicity of the compounds. A
      modest increase in melanoma activity against six melanoma cell lines for these
      analogues could be correlated with increased lipophilicity. The most active of
      these compounds, N-[2-[(4-hydroxyphenyl)thiol]ethyl]cyclohexanecarboxamide (9),
      showed promising selectivity (lack of cytotoxicity) on the non-melanotic cell
      line SK-Mel-24 and on an ovarian cell line. A significant improvement in
      antimelanoma activity was observed with a new type of analogue containing three
      carbon atoms between the sulphur and nitrogen. The most active of these new
      analogues, N-[3-[(4-hydroxyphenyl)-thiolpropyl]-1-cyclohexanecarboxamide (15),
      had activity comparable to cisplatin against several cell lines and low
      cytotoxicity towards the non-melanotic cell line.

PMID- 11200506
TI  - Tetramethylpiperidine-substitution increases the antitumor activity of the
      riminophenazines for an acquired multidrug-resistant cell line.
AB  - The multidrug resistance (MDR)-neutralizing and cytotoxic properties of five
      tetramethylpiperidine (TMP)-substituted phenazines were compared with those of
      their corresponding isopropyl-substituted analogues using a P-glycoprotein (P-gp)
      expressing small cell lung cancer cell line (H69/LX4). All of the TMP-substituted
      phenazines tested outperformed their isopropyl analogues with respect to both
      cytotoxic and chemosensitizing properties, indicating the importance of TMP
      substitution when designing novel riminophenazines with increased activity
      against MDR cancer cell lines. Of the TMP-substituted phenazines tested, B4112,
      chlorinated at position 3 of the phenyl- and anilino-rings, had the most potent
      anti-cancer activity in vitro, making this agent a potential candidate for
      evaluation in experimental and clinical oncology.

PMID- 11200507
TI  - ["Minor" traumatology in primary care?].

PMID- 11200508
TI  - [Evaluation of extrinsic sleep disorders in a population in Valladolid].
AB  - OBJECTIVES: To study the prevalence of external sleep disturbances and their
      influence in sleep quality. DESIGN: Transversal descriptive study based on
      personal self-applied interview and the application of the Pittsburg Sleep
      Quality Index (PSQI) in 1053 persons selected among the over 18 year old
      population of the city of Valladolid between September 1997 and August 1998 in
      relation to different sociodemographics variables, life habits and psychiatric
      pathologies (anxiety and depression evaluated by Golberg Scale). RESULTS:
      Worsening of life quality and sleep efficiency was significantly associated to
      external disturbances such as coughing, going to the bathroom and nocturnal
      awakening and, less significantly, to pain sensation, having nightmares,
      dysthermic sensations and difficulty to breathing. Sleep external disturbances
      did not affect daytime activity but was associated to an increased hypnotic drug
      taking. INTERPRETATION: Sleep external disturbances are one of the most relevant
      and unknown variables associated to a decrease in sleep quality and,
      consequently, in life quality.

PMID- 11200509
TI  - [Process indicators and result indicators in the control of arterial
      hypertension].
AB  - OBJECTIVE: To find whether better compliance with the indicators of procedure of
      a hypertension monitoring programme guarantees better control in the final blood
      pressure figures. DESIGN: Descriptive cross-sectional study. SETTING: Gotic Area
      Health Centre, Barcelona. PATIENTS: Annual audit through random sampling of the
      computerised records of all the hypertense patients attended at the centre in
      each of 5 years (1992, n = 337; 1993, n = 318; 1994, n = 322; 1995, n = 325;
      1996, n = 325). RESULTS: 1. Procedure indicators: complete physical examination
      took place in 1996 in only 12% of cases, proportion similar to at the start of
      the development of the programme (12.2%). Completion of at least two of the three
      records of protocols (complete physical examination, ECG and analysis) dropped
      during the period and did not cover half the patients. Screening of the various
      cardiovascular risk factors (CRF) increased markedly in the 1992-1995 period. 2.
      RESULTS INDICATORS: The proportion of patients under 66 with SP and DP < 140 and
      99 mmHg went up from 23.2% in 1992 to 45.2% in 1996. In the over-65 age-group, it
      went from 58.9% in 1992 to 81.2% in 1996. CONCLUSIONS: The procedure indicators
      are still useful, in that they are necessary for designing a new hypertension
      programme. However, we must not forget that any health programme is designed in
      order to achieve good control and population impact (survival) results. The
      procedure is only an aid to reach these aims.

PMID- 11200510
TI  - [Metabolic control of diabetes mellitus en relation to the quality of the medical
      records].
AB  - OBJECTIVE: To investigate whether there is a relationship between the quality of
      the clinical history (CH) in primary care and metabolic control of patients with
      diabetes (DM). DESIGN: Retrospective and observational. SETTING: 15 health
      centres in the Segovia Area. PATIENTS: 315 diabetic patients, selected at random
      from among those with a record of the type of DM, date and outcome of at least
      one HbA1c and treatment at the time of the most recent HbA1c. RESULTS: The
      quality of the clinical histories was measured through the mean of recording of
      the following items in the 13 months previous to the most recent HbA1c: weight
      and height, peripheral pulses, sensitivity, foot examination, creatinine,
      proteinuria, microalbuminuria, glucaemia levels, back of eye, ECG, and diet,
      tobacco and alcohol counselling. Other variables that could condition the HbA1c,
      chronic pathologies and those related to DM, were gathered too. Of patients
      treated with diet or oral diabetic drugs, patients with a clinical history of <
      or = 49% quality had a mean HbA1c of 7.40%, whereas those with CH of > or = 50%
      quality had an average of 6.94% (0.46 difference; 95% CI, 0.03-0.90; p = 0.038).
      This drop was not attributable to age, gender, years of evolution or BMI
      differences. The risk of having an HbA1c > or = 7.5% is double in patients with a
      CH of < or = 49% quality than in those with CH of > or = 50% quality (OR = 2.06;
      95% CI, 1.14-3.72). In insulin-treated patients, no association between CH
      quality and HbA1c was found. CONCLUSIONS: Follow-up of the recommendations for
      clinical action is associated with better metabolic control in diabetics treated
      with diet--oral diabetic drugs. This association was not found in insulin-treated
      patients.

PMID- 11200511
TI  - [Incidence of amputaciones of the lower extremities in the population with
      diabetes mellitus in Malaga (1996-1997)].
AB  - OBJECTIVE: To find the frequency of amputations of lower limbs (ALL) with the aim
      of designing a programme to prevent ALL in people with diabetes mellitus (DM).
      DESIGN: Retrospective observation study. SETTING: Population study in Malaga and
      its province. PATIENTS: The clinical records of everyone with ALL in public or
      subsidized hospitals in the province of Malaga between January 1 1996 and
      December 31 1997 were reviewed. Traumatic or tumoural ALL were excluded.
      Cumulative incidence, relative risk (RR) of ALL and the mortality rate of people
      with DM were calculated. RESULTS: 449 ALL took place during the period studied,
      316 (70.3%) in people with DM and 133 (29.6%) in people not suffering DM. The
      incidence of ALL per 100,000 people and per year was 6.3 (CI: 4.7-7.8) in the
      population without DM and 136.1 (CI: 114.9-157.3) in people with DM. The RR of
      ALL was 21.6 (CI: 17.6-26.4) for the population with DM, with differences between
      men and women (16.8 vs. 36.1, respectively). Mean age of ALL was significantly
      greater (p < 0.05) for the population with DM (70.0 +/- 10.2 vs. 68.9 +/- 15.9
      years old). Older ALL were more numerous in both women and men in the two groups
      studied. The mortality rate, complications and mean stay in hospital were greater
      in the population with DM. CONCLUSIONS: This study confirmed the greater risk of
      ALL run by people with DM. The incidence of ALL in this study was less than in
      countries of Northern Europe, the USA and Australia, but more than in any study
      published before in Spain.

PMID- 11200512
TI  - [Evaluation of the quality of communication between levels of care through the
      inter-consultation document].
AB  - OBJECTIVES: To evaluate the quality and improvement of compliance in the inter
      consultation documents of the primary care team (PCT). DESIGN: Entire care cycle.
      SETTING: Primary care (PC). MEASUREMENTS: Dimension studied: scientific-technical
      quality. SUBJECTS: all the inter-consultation documents (ID-1) sent by PC doctors
      from Irun Health Centre to specialist clinics over a 15-day period. 223 ID-1 for
      evaluation in April 1998, and 287 for re-evaluation in October 1998. Type of
      evaluation: retrospective. SOURCE OF DATA: inter-consultation documents and
      clinical records. CRITERIA: explicit and standard. Corrective measures:
      educational (discussion of results in meeting of the PCT). RESULTS: A
      statistically significant improvement was found at the re-evaluation: basic
      personal details (91.5%-96.8%), legibility (86%-92.7%), medical history and/or
      customary medication (35.9%-50%) and symptoms (77.8%-87.2%). Good quality levels
      rose from 20.6% to 42.5%; and bad quality levels fell from 40.8% to 33.4%. 22.2%
      of our referrals received a reply. 34% of the lack of replies was because of no
      report from the specialist, 47.8% were attributed to the patient or circuit, and
      18% of the patients were awaiting test results. CONCLUSIONS: The information
      supplied in the ID-1 improved significantly after the quality cycle. Knowing our
      habitual working practice can serve to stimulate improvement. The criteria we
      complied with least were: reference to personal antecedents and/or habitual
      medication, physical examination, and therapeutic measures employed. There was a
      huge loss of information in the replies to our referrals.

PMID- 11200513
TI  - [Leisure-free time activities and walking outside their homes among the elderly
      in the province of Guadalajara].
AB  - OBJECTIVE: To find out what elderly people in the province of Guadalajara do in
      their leisure/free time and daily walking, in the supposition that these can be
      improved. DESIGN: This was a descriptive, crossover study based on a population
      group. SETTING: At community level, in the primary care context. PARTICIPANTS:
      People over 65 without cognitive deterioration and resident in the community,
      selected at random on the basis of population data bases. The sample finally
      studied was made up of 192 men and 196 women from the country-side, and 172 men
      and 220 women from an urban background. INTERVENTIONS: Everyone was interviewed
      at home or the health centre according to their preferences through a
      questionnaire, which had undergone a stability study of the replies beforehand
      through the kappa test-retest coefficient. We screened cognitive deterioration
      through the Pfeiffer test. MAIN RESULTS: In the country, 43.6% of elderly people
      (CI: 38.6-48.7) walked under half an hour a day; in the urban context, 34.4% (CI:
      29.8-39.4) did so. 24.7% of men (CI: 20.4-29.6) did so; and 51.4% of women (CI:
      46.5-56.3). The differences were significant in the two cases. 12.1% (CI: 9.1
      15.9) of elderly people in the country had no hobbies, and 9.4% (CI: 6.8-12.9) in
      the town. Among men and women, this broke down as 11.3% (CI: 8.3-15.1) and 10.1%
      (CI: 7.5-13.5). respectively. There were no significant differences. CONCLUSIONS:
      Leisure and free time activities among people over 65 in the province of
      Guadalajara must be fostered; but above all a daily walk for over half an hour
      must be encouraged.

PMID- 11200514
TI  - [Use of the rapid appraisal method for the identification of perceived needs in a
      low-class barrio in the city of Buenos Aires].
AB  - OBJECTIVE: To present rapid appraisal as a qualitative technique for researching
      the perceived needs of a population, which is valid, rapid and cheap. DESIGN:
      Qualitative method: semi-structured interviews with key informants, focus group.
      SETTING: A poor quarter with 2921 inhabitants in the city of Buenos Aires.
      PARTICIPANTS: Key informants: people resident in the area for over 10 years.
      MEASUREMENTS AND MAIN RESULTS: The main problems perceived by the community were:
      environmental pollution because of the accumulation of rubbish, alcohol and drug
      abuse among the young, and the need to extend the opening hours of the area's
      health centre. CONCLUSIONS: The needs perceived surpassed specific medical
      problems. They covered social questions, environmental problems and how to
      organise the health care system.

PMID- 11200515
TI  - [Smoking cessation from the community pharmacy].
AB  - OBJECTIVES: To evaluate the effectiveness of the intervention of the community
      pharmacist in a smoking-cessation program. DESIGN: A descriptive prospective
      study. SETTING: Two pharmacies of the Community of Madrid. PARTICIPANTS: 77
      patients who wanted to participate in the smoking-cessation program. The middle
      age of the participants were 41.6 +/- 10.8; 51.9% were male and 42.8% female.
      MEASUREMENTS AND MAIN RESULTS: The quit rates of the smoking-cessation program
      were: 1st. month 80.5%; 3rd. month 54.5%; 6th month 45.5% and 1st. year 42.8%.
      The patient who use the nicotine treatment at least two months, have more
      probability to quit smoking successfully (p < 0.05). CONCLUSIONS: The community
      pharmacy could be a good place to help people to give up smoking. Results of this
      study show that pharmacists who counsel patients in an intensive smoking
      cessation program can improve outcomes.

PMID- 11200516
TI  - [The quality of sleep associated with polypharmacy].
AB  - OBJECTIVE: Study of the association between multiple medication and the quality
      of sleep. DESIGN: Observational, cross-sectional study through two-stage sampling
      of 1053 people with a questionnaire and application of the Pittsburgh Sleep
      Quality Interview (PSQI). SETTING: Primary care. Population covered by health
      centres in the province of Valladolid. POPULATION: Adults over 18 who attended
      health centres in Valladolid province. RESULTS: As consumption of multiple drugs
      rose, there was significant deterioration in the overall quality of sleep and
      each of the following components: subjective quality, latency of sleep, duration
      of sleep, extrinsic disturbances and consumption of sleeping draughts. No
      differences were found for day-time repercussions. When psychiatric drug
      consumption was excluded from the study (to avoid the risk of bias in psychiatric
      illnesses), deterioration in the quality of sleep, on adding up the remaining
      therapeutic groups of drugs, was still found. CONCLUSIONS: The fact of consuming
      multiple drugs chronically may condition a deterioration in sleep quality, which
      will stimulate us to combat this symptom with more drugs and so further aggravate
      the problem. New prospective studies need to be undertaken to find out the
      reasons.

PMID- 11200518
TI  - [Epilepsy and psychiatry].

PMID- 11200517
TI  - [Is it legitimate the use of placebos in primary care?].

PMID- 11200519
TI  - [HIV: a task still pending].

PMID- 11200520
TI  - [Use and abuse of the prescription of anti-ulcer agents].

PMID- 11200521
TI  - [Pharmacy offices].

PMID- 11200522
TI  - [Primary care in mental health].

PMID- 11200523
TI  - Conformational dynamics in mixed alpha/beta-oligonucleotides containing polarity
      reversals: a molecular dynamics study using time-averaged restraints.
AB  - Nucleic acid duplexes featuring a single alpha-anomeric thymidine inserted into
      each DNA strand via 3'-3' and 5'-5' phosphodiester linkages exhibit local
      conformational dynamics that are not adequately depicted by conventional
      restrained molecular dynamics (rMD) methods. We have used molecular dynamics with
      time-averaged NMR restraints (MDtar) to explore its applicability to describing
      the conformational dynamics of two alpha-containing duplexes--d(GCGAAT-3'-3'
      alphaT-5'-5'-CGC)2 and d(ATGG-3'-3'-alphaT-5'-5'-GCTC) x r(gagcaccau). In
      contrast to rMD, enforcing NOE-based distance restraints over a period of time in
      MDtar rather than instantaneously results in better agreement with the
      experimental NOE and J-data. This conclusion is based on the dramatic decreases
      in average distance and coupling constant violations (delta d(av), J(rms), and
      delta J(av)) and improvements in sixth-root R-factors (R(X)). In both duplexes,
      the deoxyribose ring puckering behavior predicted independently by pseudorotation
      analysis is portrayed remarkably well using this approach compared to rMD. This
      indicates that the local dynamic behavior is encoded within the NOE data,
      although this is not obvious from the local R(X) values. In both systems, the
      backbone torsion angles comprising the 3'-3' linkage as well as the (high S-)
      sugars of the alpha-nucleotide and preceding residue (alpha - 1) are relatively
      static, while the conformations of the 5'-5' linkage and the sugar in the
      neighboring beta-nucleotide (alpha + 1) show enhanced flexibility. To reduce the
      large ensembles generated by MDtar to more manageable clusters we utilized the
      PDQPRO program. The resulting PDQPRO clusters (in both cases, 13 structures and
      associated probabilities extracted from a pool of 300 structures) adequately
      represent the structural and dynamic characteristics predicted by the
      experimental data.

PMID- 11200524
TI  - Solution NMR of proteins within polyacrylamide gels: diffusional properties and
      residual alignment by mechanical stress or embedding of oriented purple
      membranes.
AB  - The diffusive properties of biomacromolecules within the aqueous phase of
      polyacrylamide gels are described. High quality NMR spectra can be obtained under
      such conditions. As compared to water, a fivefold reduction in the translational
      diffusion constant, but only a 1.6-fold decrease (1.4-fold increase) in amide-15N
      T2 (T1) are observed for human ubiquitin within a 10% acrylamide gel. Weak
      alignment of the solute macromolecules can be achieved within such gels by
      vertical or radial compression or by the embedding of magnetically oriented
      purple membrane fragments. The methods are applied to deriveresidual dipolar
      couplings for human HIV-1 Nef and ubiquitin.

PMID- 11200525
TI  - De novo protein structure determination using sparse NMR data.
AB  - We describe a method for generating moderate to high-resolution protein
      structures using limited NMR data combined with the ab initio protein structure
      prediction method Rosetta. Peptide fragments are selected from proteins of known
      structure based on sequence similarity and consistency with chemical shift and
      NOE data. Models are built from these fragments by minimizing an energy function
      that favors hydrophobic burial, strand pairing, and satisfaction of NOE
      constraints. Models generated using this procedure with approximately 1 NOE
      constraint per residue are in some cases closer to the corresponding X-ray
      structures than the published NMR solution structures. The method requires only
      the sparse constraints available during initial stages of NMR structure
      determination, and thus holds promise for increasing the speed with which protein
      solution structures can be determined.

PMID- 11200526
TI  - Identification of the ubiquitin interfacial residues in a ubiquitin-E2 covalent
      complex.
AB  - One of the key intermediates formed during the protein ubiquitination cycle is a
      covalent complex between ubiquitin (Ub) and the conjugation enzyme, UBC1. In
      order to probe the interface between these two proteins we have formed the
      covalent complex in situ (in the NMR tube) using Ub, the catalytic domain of
      UBC1, UBC1 delta450, an activation enzyme, E1, and Mg2+-ATP. The size of the Ub
      UBC1 delta450 complex (25 kDa) and its relatively short lifetime (approximately 4
      h) makes assignment of the backbone resonances in the covalent species difficult.
      In order to monitor the formation and identify the interface in the complex we
      have used fast 1H-15N HSQC spectra to monitor the decay of 1H-15N correlations as
      a function of time until the complex formed reached about 90%. The residual peak
      intensities were used to probe the surface of interaction between Ub and UBC1
      delta450 and provided a clear surface of interaction on Ub.

PMID- 11200527
TI  - Ansig for Windows: an interactive computer program for semiautomatic assignment
      of protein NMR spectra.
AB  - Assignment of NMR spectra is a prerequisite for structure determination of
      proteins using NMR. The time spent on the assignment is comparatively long
      compared to that spent on other parts in the protein structure determination
      process, but it can be shortened by using either interactive or fully automated
      computer programs. To benefit from the advantages of both types of program we
      have developed a version of the interactive assignment program ANSIG to include
      automatized, yet user-supervised, routines. The new program includes tools for
      (i) semiautomatic sequential assignment, (ii) plotting of distances from PDB
      structure files directly in NMR spectra and (iii) statistical analysis of
      distance restraint violations with the possibility to directly zoom to violated
      NOEs in NOESY spectra.

PMID- 11200528
TI  - HNCAN pulse sequences for sequential backbone resonance assignment across proline
      residues in perdeuterated proteins.
AB  - A TROSY-based triple-resonance pulse scheme is described which correlates
      backbone 1H and 15N chemical shifts of an amino acid residue with the 15N
      chemical shifts of both the sequentially preceding and following residues. The
      sequence employs 1J(NC alpha) and 2J(NC alpha) couplings in two sequential
      magnetization transfer steps in an 'out-and-back' manner. As a result, N,N
      connectivities are obtained irrespective of whether the neighbouring amide
      nitrogens are protonated or not, which makes the experiment suitable for the
      assignment of proline resonances. Two different three-dimensional variants of the
      pulse sequence are presented which differ in sensitivity and resolution to be
      achieved in one of the nitrogen dimensions. The new method is demonstrated with
      two uniformly 2H/13C/15N-labelled proteins in the 30-kDa range.

PMID- 11200529
TI  - Lanthanide induced residual dipolar couplings for the conformational
      investigation of peripheral 15NH2 moieties.
AB  - The Ca2 calbindin protein in which one calcium has been substituted with Ce(III),
      Yb(III) and Dy(III) displays substantial alignment in high magnetic fields due to
      the high anisotropy of the metal magnetic susceptibility. This property has
      allowed the measurement of residual dipolar coupling contributions to 1J(HN) and
      2J(HH) couplings of asparagine and glutamine NH2 moieties. Such data have been
      used to aid structural characterization of these groups. The exploitation of auto
      orientation of magnetic anisotropic metalloproteins represents a step ahead in
      the investigation of the conformational space of peripheral residues that are not
      fixed by the protein folding.

PMID- 11200531
TI  - Assignment of 1H and 15N resonances of mouse lysozyme M.

PMID- 11200530
TI  - 1H and 13C NMR assignments for the glycans in glycoproteins by using 2H/13C
      labeled glucose as a metabolic precursor.
AB  - In order to understand the role of the glycans in glycoproteins in solution,
      structural information obtained by NMR spectroscopy is obviously required.
      However, the assignment of the NMR signals from the glycans in larger
      glycoproteins is still difficult, mainly due to the lack of appropriate methods
      for the assignment of the resonances originating from the glycans. By using [U
      13C6, 2H7]glucose as a metabolic precursor, we have successfully prepared a
      glycoprotein whose glycan is uniformly labeled with 13C and partially with D at
      the sugar residues. The D to H exchange ratios at the C1-C6 positions of the
      sugar residues have been proven to provide useful information for the spectral
      assignments of the glycan in the glycoprotein. This is the first report on the
      residue-specific assignment of the anomeric resonances originating from a glycan
      attached to a glycoprotein by using the metabolic incorporation of hydrogen from
      the medium into a glycan labeled with [U-13C6, 2H7]glucose.

PMID- 11200532
TI  - Backbone resonance assignment of human UBC4.

PMID- 11200533
TI  - Complete 1H, 15N and 13C assignment of the functional domain of Paracoccus
      denitrificans cytochrome c552 in the oxidized state.

PMID- 11200534
TI  - 1H, 15N, and 13C NMR resonance assignments for the Eps15 homology domain of
      Reps1.

PMID- 11200535
TI  - Sequential resonance assignments of the extracellular ligand binding domain of
      the human TGF-beta type II receptor.

PMID- 11200537
TI  - Zentralblatt fur Bakteriologie--100 years ago: first attempts and improvements of
      anaerobe techniques.

PMID- 11200536
TI  - 1H, 13C and 15N resonance assignments of the SNT PTB domain in complex with FGFR1
      peptide.

PMID- 11200538
TI  - Staphylococcal surface display and its applications.
AB  - Novel surface proteins can be introduced onto the bacterial cell surface by
      recombinant means. Here, we describe the development of such display systems for
      two food-grade bacteria, Staphylococcus carnosus and Staphylococcus xylosus, and
      present how such engineered bacteria can be used in different applications. A
      study will be described in which such staphylococci were employed as vaccine
      delivery vehicles to elicit protective antibody responses to respiratory
      syncytial virus (RSV). The use of surface-engineered staphylococci as novel
      microbial biocatalysts, as a new type of whole-cell diagnostic devices or for
      adsorption of metal ions with potential environmental or biosensor applications,
      will also be discussed.

PMID- 11200539
TI  - Outer membrane proteins as surface display systems.
AB  - Outer membrane proteins (OMPs) of gram-negative bacteria can be used as carrier
      proteins to present foreign peptide epitopes on the bacterial cell surface. They
      all have a common structural motif of a beta-barrel that is composed of a
      variable number of transmembrane beta-strands connected at the periplasmic side
      with short turns and at the outside with long surface-accessible loops. Outer
      membrane proteins occur as monomers like OmpA, or assemble into trimers like the
      porins. Foreign gene products have been fused to surface-accessible regions of
      several outer membrane proteins including the porins OmpC, PhoE and LamB,
      lipoproteins as well as the OmpA protein. Short epitopes that are inserted into
      outer membrane proteins induce epitope-specific antibody responses, and are thus
      appealing candidates for live recombinant vaccines. Also large insertions, of
      more than 100 amino acids, are in some cases tolerated and do not affect the
      overall conformation of the carrier protein. The possible applications for outer
      membrane display include recombinant vaccines, peptide library screening,
      development of biocatalysts or whole-cell adsorbents, and adhesin-receptor
      interaction studies. It is expected that in the near future, development of new
      display systems will still increase the utilization of this emerging exciting
      technology.

PMID- 11200540
TI  - Expression of type 1 and P fimbriae in situ and localisation of a uropathogenic
      Escherichia coli strain in the murine bladder and kidney.
AB  - Adhesion is an important aspect of bacterial colonisation and induction of human
      disease. Escherichia coli which infects and causes disease of the urinary tract
      expresses several adherence factors including type 1 and P fimbriae. Their
      expression has been implicated in the virulence of E. coli strains infecting the
      urinary tract, however, the evidence for the expression of these fimbriae in situ
      has been implied rather than proven. Here we describe in situ detection of E.
      coli and of fimbrial expression in urinary tract tissue. Kidneys and bladders
      were isolated from mice infected with the uropathogenic isolate E. coli AD110.
      The tissue was sectioned and subjected to DNA-rRNA hybridization and indirect
      immunofluorescent staining with antibodies against type 1 and P fimbriae.
      Sections of both kidney and bladder stained positive for bacterial cells using a
      Cy3-labelled E. coli-specific rRNA probe. The same cells in these sections also
      stained positive for type 1 or P fimbriae using fluorescein-labelled antibodies.
      Tissue taken from several different time points (2, 6, and 24 hours post
      infection) showed the presence of bacterial cells which stained positive for
      fimbrial expression. Bacteria in kidney and bladder sections were observed either
      as individual cells associated with the mucosa or as members of microcolonies.

PMID- 11200541
TI  - Phylogenetic analysis of Pasteurella multocida subspecies and molecular
      identification of feline P. multocida subsp. septica by 16S rRNA gene sequencing.
AB  - Pasteurella multocida is commonly found in the oral cavity of cats and dogs. In
      humans it is known as an opportunistic pathogen after bites from these animals.
      Phenotypic identification of P. multocida based on biochemical reactions is often
      limited and usually only done on a species level, even though 3 subspecies are
      described. For molecular taxonomy and diagnostic purposes a phylogenetic analysis
      of the three subspecies of P. multocida based on their 16S rRNA (rrs) gene
      sequence was therefore carried out. We found P. multocida subsp. septica on a
      distinguished branch on the phylogenetic tree of Pasteurellaceae, due to a 1.5%
      divergence of its rrs gene compared to the two other, more closely related
      subspecies multocida and gallicida. This phylogenetic divergence can be used for
      the identification of P. multocida subsp. septica by rrs gene determination since
      they form a phylogenetically well isolated and defined group as shown with a set
      of feline isolates. Comparison to routine phenotypic identification shows the
      advantage of the sequence-based identification over conventional methods. It is
      therefore helpful for future unambiguous identification and molecular taxonomy of
      P. multocida as well as for epidemiological investigations.

PMID- 11200542
TI  - Prevalence and polymorphism of genes encoding translocated effector proteins
      among clinical isolates of Salmonella enterica.
AB  - Pathogenic Salmonella enterica strains are capable of causing local and/or
      systemic infections. They employ two type III secretion systems to translocate an
      array of virulence-associated proteins (effector proteins) directly into the
      cytosol of target cells of the host. Earlier data had shown that changes in the
      repertoire of translocated effector proteins may contribute to the adaptation of
      Salmonella strains to new hosts and to the emergence of epidemic strains. Using
      PCR and Southern blot techniques the presence of and the polymorphism among the
      genes encoding the translocated effector proteins SopB, SopD, SopE, SopE2, SipA,
      SipB, SipC, AvrA, and SptP was studied in 71 phylogenetically well characterised
      S. enterica subspecies I (subspecies enterica) strains of the SARB collection and
      in 209 clinical and epidemic isolates of S. enterica subspecies I belonging to
      various serovars, phage types, and genotypes. All these Salmonella strains
      harbour all these respective genes with the exception of sopE and avrA which have
      been identified in only some of them. Several of the studied genes display
      genetic polymorphisms (RFLP). These RFLP patterns did not show a strict
      correlation with the genetic distance, the grouping genes in order to understand
      their role in the evolution of Salmonella as a pathogen.

PMID- 11200543
TI  - Sequence analysis and distribution in Salmonella enterica serovars of IS3-like
      elements.
AB  - The genome of Salmonella enterica serovar Enteritidis was shown to possess three
      IS3-like insertion elements, designated IS1230A, B and C, and each was cloned and
      their respective deoxynucleotide sequences determined. Mutations in elements
      IS1230A and B resulted in frameshifts in the open reading frames that encoded a
      putative transposase to be inactive. IS1230C was truncated at nucleotide 774
      relative to IS1230B and therefore did not possess the 3' terminal inverted
      repeat. The three IS1230 derivatives were closely related to each other based on
      nucleotide sequence similarity. IS1230A was located adjacent to the sef operon
      encoding SEF14 fimbriae located at minute 97 of the genome of S. Enteritidis.
      IS1230B was located adjacent to the umuDC operon at minute 42.5 on the genome,
      itself located near to one terminus of an 815-kb genome inversion of S.
      Enteritidis relative to S. Typhimurium. IS1230C was located next to attB, the
      bacteriophage P22 attachment site, and proB, encoding gamma-glutamyl phosphate
      reductase. A truncated 3' remnant of IS1230, designated IS1230T, was identified
      in a clinical isolate of S. Typhimurium DT193 strain 2391. This element was
      located next to attB adjacent to which were bacteriophage P22-like sequences.
      Southern hybridisation of total genomic DNA from eighteen phage types of S.
      Enteritidis and eighteen definitive types of S. Typhimurium showed similar, if
      not identical, restriction fragment profiles in the respective serovars when
      probed with IS1230A.

PMID- 11200544
TI  - In a medium containing glucose, lactate carbon is incorporated by gonococci
      predominantly into fatty acids and glucose carbon incorporation is increased:
      implications regarding lactate stimulation of metabolism.
AB  - The reason for stimulation by lactate of metabolism of gonococci growing in a
      medium containing glucose, which enhances pathogenicity by increasing growth
      rate, lipopolysaccharide (LPS) synthesis and protein formation, has been
      investigated. Tricine dodecylpolyacrylamide gel electrophoresis (SDS-PAGE) and
      thin layer chromatography (TLC) on homogenates of gonococci grown in this medium
      with [14C]lactate showed that lactate carbon was preferentially incorporated into
      lipid and LPS. Nuclear magnetic resonance (NMR) spectroscopy on lipid extracted
      from gonococci grown in the glucose containing medium with [13C]lactate showed
      that lactate carbon was incorporated into fatty acid moieties and not into
      ethanolamine or glycerol moieties. In contrast, NMR on lipid from gonococci grown
      with [13C]glucose indicated glucose carbon in both moieties. When unlabelled
      lactate was added, lipid synthesis from [l3C]glucose was stimulated and small
      amounts of different fatty acids were formed. The NMR data shows that
      gluconeogenesis from lactate carbon does not occur in the presence of glucose,
      suggesting that lactate is used solely for rapid production, via pyruvate, of
      acetyl CoA, the precursor not only for fatty acid synthesis but also for the
      constituents and products of the citric acid cycle, including ATP. The rapid
      formation of a high level of acetyl CoA is the probable reason for the
      stimulation of metabolism and oxygen uptake by lactate. 14C label on LPS was
      detected in its fatty acids. Most proteins that stained with silver in tricine
      SDS-PAGE were not significantly labelled by [14C]lactate in the glucose
      containing medium. Two of three appreciably labelled proteins were identified by
      N-terminal sequencing as GroEL and porin 1B, and one of the two less labelled
      proteins was similar to peroxiredoxin type proteins. There were no signs of
      specific induction of these proteins by lactate and their labelling was
      consistent with fatty acids in attached lipid.

PMID- 11200545
TI  - The multifocal electroretinogram in age-related maculopathies.
AB  - To measure and compare the multifocal electroretinogram in control group and
      patients with age-related maculopathies, 17 eyes of control subjects, 9 eyes of
      wet-form ARMD, 8 eyes of dry-form ARMD and 14 eyes of idiopathic macular hole
      were tested with VERIS Sciences 4.0. The latencies and average response densities
      of 6 ring retinal regions in control eyes were compared with those in ARMD and
      macular hole. The amplitude depression and latency prolongation were found in age
      related maculopathies. The changes of multifocal ERG were dramatic in wet-form
      ARMD and moderate in dry-form ARMD and IMH, which were correspondent with the
      pathological changes of the diseases. Our results suggest that the multifocal
      electroretinogram can be used to quantity the visual function in age-related
      maculopathies.

PMID- 11200546
TI  - Visual electrophysiology in children with tumours affecting the visual pathway.
      Case reports.
AB  - In 9 children (8-14 years of age) with orbital, suprasellar or postchiasmal
      tumours, visual loss was studied by visual electrophysiology in relation to
      ophthalmologic and neuroimaging findings. Pattern electroretinography (PERG) and
      pattern visual evoked potentials (PVEP) to full and half-field pattern-reversal
      stimulation were recorded and PERG and PVEP changes were related to the tumour
      location. PERG wave P50 attenuation was found associated with the central retinal
      dysfunction in the child with orbital rhabdomyosarcoma; PVEP wave P100 delay was
      associated with the optic nerve dysfunction in a child with retrobulbar
      chondrosarcoma and in a child with optic nerve glioma; PVEP wave P100 asymmetry
      was associated with the crossed fibers dysfunction in a child with hypothalamic
      germinoma, and PVEP wave P100 uncrossed asymmetry was associated with
      postchiasmal dysfunction in children with postchiasmal tumours (one with
      pilocytic astrocytoma and two with angioma). On the other hand, normal PERG
      suggested that there was no central retinal dysfunction in a child with
      pleomorphic adenoma of the lacrimal gland, and normal PVEP to full and half-field
      stimulation excluded visual pathway dysfunction at the chiasm in a child with
      suprasellar arachnoidal cyst. Follow-up was useful in indicating whether visual
      dysfunction was progressive or not. We conclude that PERG and PVEP findings
      contributed to understanding whether the dysfunction originated was at the
      retina, in the optic nerve, chiasm or postchiasmal pathway.

PMID- 11200547
TI  - Human photopic response to circulating glucose.
AB  - Circulating glucose was manipulated in young human volunteers with clinically
      normal vision. Fasting achieved a concentration range of 45-91 mg/dl. And sugar
      loading produced a range of 79-108 mg/dl. Glucose increased in all subjects. A
      nonparametric ANOVA provided a p=0.0005 for the significance of the concentration
      differences between group glucose concentrations under the two conditions in the
      sample. Each volunteer participated in each condition of the repeated-measures
      design. Clinical tests were completed before electroretinograms were recorded
      under photopic and scotopic adaptation conditions. Measures were made from 12
      eyes. Only photopic adaptation conditions with maximal stimuli produced
      significant results. Inter-individual differences were robust and constrained to
      reduced implicit times for b-wave peaks and 30 Hz flicker implicit times. Under
      the elevated glucose conditions. Other variables showed very strong trends. These
      results confirm and extend other human indications of photopic retinal
      sensitivity to variations within the normal range of circulating glucose
      concentrations.

PMID- 11200548
TI  - Measuring contrast sensitivity in patients with Graves' ophthalmopathy
      complicated by ocular hypertension and suspect glaucoma or dysthyroid optic
      neuropathy.
AB  - The present study compares contrast sensitivity functions of patients with
      uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated
      intraocular pressure or suspect glaucoma, and patients with dysthyroid optic
      neuropathy (DON). Aim of the study was to investigate the clinical potential for
      the contrast sensitivity functions (CSF) in distinguish between the groups.
      Contrast sensitivity measurements were obtained from twenty-seven subjects with
      endocrine ophthalmopathy. Group I included patients with uncomplicated
      ophthalmopathy (n=20 eyes); group II included patients with ophthalmopathy,
      intraocular pressure > or = 24 mmHg with and without early visual field defects,
      and no evidence of apical crowding on coronal computed tomography scan (n=14
      eyes); group III included patients with DON (n=12 eyes). Contrast thresholds were
      determined for stationary and 6.87 Hz phase-alternating gratings at eight spatial
      frequencies from 0.18 to 15.7 c/deg. Data from each group was compared with data
      from age-matched normal subjects. Observers with uncomplicated ophthalmopathy had
      normal CSFs. Eyes affected with DON showed contrast sensitivity disruption at
      overall intermediate-high spatial frequencies. Eyes with elevated intraocular
      pressure or suspect glaucoma had pronounced sensitivity loss in the low frequency
      range (0.18-0.70 c/deg) as compared to eyes with DON. This study shows that CSF
      detects visual function abnormalities noninvasively in patients with complicated
      Graves' ophthalmopathy. Results also indicate that the clinical potential for CSF
      in distinguish between patients suffering from ophthalmopathy complicated by
      ocular hypertension or suspect glaucoma and patients with DON improves when a
      temporal modulation of 6.87 Hz and gratings of low spatial frequency (< 1 c/deg)
      are used.

PMID- 11200549
TI  - Dynamic topography of pattern visual evoked potentials (PVEP) in psychogenic
      visual loss patients.
AB  - We investigated to measure the objective visual acuity using pattern visual
      evoked potentials (PVEP) to help the diagnosis with psychogenic visual loss (PVL)
      who ranged in age from 7 to 14 years old. Pattern stimuli consisted of black and
      white checkerboard patterns (39, 26, 15 and 9') with a visual angle of 8 degrees
      and a contrast level of 15%. The pattern reversal frequency was 0.7 Hz. This
      resulted in an average of 100 PVEP per session. Visual acuity of 0.1 was
      consistent with the 39' pattern, 0.2 with the 26' pattern, 0.5 with the 15'
      pattern, and 1.0 with the 9' pattern. As the results, five PVL patients could
      measure visual acuity with this method in the present study. The PVEP is useful
      in evaluating the visual acuity and helped to diagnose the PVL patients. In
      addition we used the dynamic topography to study the difference in the results of
      the PVEP. The dynamic topography obtained from the results of the PVEP was
      analyzed. The flow type of the P100 component diverged into three types
      (separated type, hollow type and localized type) in the PVL patients and the
      normal children. The localized type was observed in 59.1% of normal children and
      in 56.3% of PVL patients. While the separated type was shown in 6.8% of normal
      children and in 8.3% of PVL patients. There were not significant differences
      between the PVL patients and the normal children in each type.

PMID- 11200550
TI  - [Epidermoid cyst of the cerebellopontine angle. Report of a case].
AB  - Epidermal cysts of the cerebello-pontine angle (CPA) are lesions arising from
      epidermal remainders having an expansive and slow growth sitting on the PCA space
      or on the temporal bone. Are diagnosed approximately in the fourth life's decade
      by its deficient or irritant symptoms related to VIIth and VIIIth cranial nerves.
      It is important the nuclear magnetic resonance exam because the specific
      radiologic characteristics that distinguish these cysts from other conditions of
      CPA as neuromata or meningiomata.

PMID- 11200551
TI  - [Vertigo in the elderly: otorhinolaryngologic approach].
AB  - Dizziness is a common but little understood ailment of old people. Its presence
      is the origin of an important incapacity associated with lack of personal
      autonomy. Clinical and electronystagmographic findings of aging individuals
      enduring imbalance and coming to our Department allowed us to accept that those
      cases in which the cause could be identified it was on clinic data, being of
      scarce utility the other exams done.

PMID- 11200552
TI  - [Nasopharyngeal bacterial flora and secretory otitis in adults].
AB  - The AA. have realized a prospective study of the links between the bacterial
      flora of the nasopharynx and the secretory otitis media in grown-up people. For
      achieving this purpose nasopharyngeal smears of rhinopharyngeal samples belonging
      to 85 otitic patients and other 85 healthy adults were cultivated. Statistical
      analysis showed that the otitis cases presented with 63.6% of microorganisms
      potentially pathogenic, being the 17.6% the percentage among healthy individuals
      (p < 0.001). Microorganisms more frequently encountered were: Haemophilus
      influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Staphylococcus
      aureus. After the medical treatment those patients recovered showed an increase
      of saprophyte flora from early 36.4% till 86% (p < 0.001). It could be appreciate
      a seasonal influence in the debut of this malady specially in winter.

PMID- 11200553
TI  - [Complications of thyroid surgery. Report of 683 thyroidectomies].
AB  - Most important complications of thyroid gland surgery are recurrent paralysis
      (which usually results from section, stretching or devascularization of this
      neural branch) and parathyroid lesions resulting from unnoticed removal of more
      than two of these glands or through necrosis because deficient blood supply. We
      present a study about the complications of thyroid surgery based on the thyroid
      surgery done in our ENT Service during 1979-1998 term. An amount of 683 cases
      make the series. The 86% were female and 14% male, with a mean age of 40-50.
      Surgical techniques realized were: hemithyroidectomy (15.3%) and isthmectomy
      (2.9%). About 7.4% of patients were reoperated. Stated complications were: local
      (serohematoma 4.1%, infection 1.2%, postoperative hemorrhage 1.2%) and recurrent
      paralysis (unilateral transitory 2.6% and unilateral definitive 1.6%; there
      wasn't any case of bilateral palsy) and superior laryngeal nerve paralysis (1.4%
      as well as hypoparathyroidism (transitory 22.7% and definitive 5.3%). These
      complications were most frequent in reoperated cases and in total and subtotal
      thyroidectomies. In most of these series the incidence of recurrent palsy range
      between 1.5% and increases more than 9.5% in surgical check and the
      hypoparathyroidism incidence ranges over 25%.

PMID- 11200554
TI  - [Laryngeal cancer at the Provincial Hospital of Rosario].
AB  - The paper is an abridgement about the task and activities done by the resident's
      teamwork, under the guidelines of the chief of the Head and Neck Surgery
      Department, at Provincial Hospital of Rosario de Santa Fe (Argentina), with
      regard to epidemiology, clinical, anatomopathological and therapeutics features
      and follow-up care of laryngeal cancerous patients they treated in the Hospital.

PMID- 11200555
TI  - [Otolaryngologic disorders caused by esophageal reflux].
AB  - The authors through an accurate analysis of the literature make a synthesis of
      the most recent knowledge about the correlation existing between the distal and
      proximal gastroesophageal reflux (GER) and a series of common otolaryngologic
      symptoms whose aetiology is doubtful, in order to explain its most significative
      physiopathological and clinic aspects. The diagnostic modalities able to reveal
      the presence of the correlation and the adequacy therapy to cure the disease are
      also discussed.

PMID- 11200556
TI  - [Primary carcinoma of the trachea. Report of 2 cases].
AB  - Tumours of the trachea remain relatively rare, the incidence of tracheal
      carcinomata is less than 0.1 per cent. Tumours of the larynx and lungs are,
      respectively, 75 and 180 times more frequent than malignant lesions of windpipe.
      Two patients with primary tracheal tumours were evaluated. The present study was
      undertaken in order to describe and analyse the most pertinent clinical and
      pathologic features of tracheal carcinomas as they relate to treatment and
      prognosis.

PMID- 11200557
TI  - [Tonsillar angiofibroma].
AB  - We report in this paper a case of a tonsillar angiofibroma, whose
      histopathological features did not differ from its nasopharyngeal counterpart. In
      an exhaustive review done we have only found another one reference, in the german
      literature of such location.

PMID- 11200558
TI  - [Results of multinodular goiter surgery].
AB  - In order to assess the main complications following surgical treatment of
      multinodular goiter (total thyroidectomy) a prospective historical study was made
      in 179 patients operated between 1985 and 1997 in our Department. Permanent
      hypocalcemia was encountered in 2.2 percent of our cases and permanent recurrent
      paralyses in 0.5 percent, being null and void the mortality rate. Other
      complications evaluated include: serohematoma, postoperative bleeding, wound
      infection and pulmonary embolism. To sum up, total thyroidectomy is a relative
      safe procedure in experienced hands for both patient and surgeon.

PMID- 11200559
TI  - [Infantile facial paralysis: diagnostic and therapeutic features].
AB  - This paper deals with a series of 11 cases of peripheral unilateral facial
      paralyses affecting children under 15 years. Following parameters are reviewed:
      age, sex, side immobilized, origin, morbid antecedents, clinical and
      neurophysiological explorations (electroneurography through magnetic stimulation)
      and the evolutive course of the cases. These items are assembled in 3 sketches in
      the article. Clinical assessment of face movility is more difficult as the
      patient is younger, nevertheless electroneurography was possible in the whole
      group. Clinical restoration was complete, excepting one complicated
      cholesteatomatous patient. Some aspects concerning the etiology, diagnostic
      explorations and management of each pediatric case are discussed.

PMID- 11200560
TI  - The academic cup: part II.

PMID- 11200561
TI  - Containment of Helicobacter hepaticus by use of husbandry practices.

PMID- 11200562
TI  - Age differences in thickness of the epidermis of miniature and domestic swine.

PMID- 11200563
TI  - Helicobacter hepaticus infection triggers inflammatory bowel disease in T cell
      receptor alphabeta mutant mice.
AB  - The T cell receptor alpha chain-deficient (TCR alpha-/-) and TCR beta chain
      deficient (TCR beta-/-) mice develop chronic intestinal inflammation that
      resembles inflammatory bowel disease by 3 to 4 months of age. The objective of
      the study reported here was to determine the role of infection with the bacterial
      pathogen Helicobacter hepaticus in the pathogenesis of disease in TCR alphabeta
      mutant mice. The H. hepaticus-infected TCR alphabeta mutant mice were rederived
      by use of embryo transfer to produce Helicobacter-free animals. Helicobacter-free
      TCR alpha-/-, TCR beta-/-, and TCR alpha-/- beta-/- mice were inoculated with H.
      hepaticus. Experimentally infected mice and uninfected control mice were examined
      for intestinal lesions at 3, 6, and 9 months after inoculation. The TCR alphabeta
      mutant mice inoculated with H. hepaticus developed intestinal epithelial cell
      hyperplasia and mucosal inflammation. By 6 months after inoculation, infected
      animals had moderate cecal and colonic lesions. Helicobacter-free TCR alpha-/-
      mice, but not TCR beta-/- or TCR alpha-/- x beta-/- mice, also developed H.
      hepaticus-independent colitis by 9 months after inoculation. Infection with H.
      hepaticus is sufficient to cause chronic proliferative intestinal inflammation in
      TCR alphabeta mutant mice. However, H. hepaticus infection is not necessary for
      intestinal disease in TCR alpha-/- mice.

PMID- 11200565
TI  - Anti-Thy-1 monoclonal antibody-induced glomerulonephritis in Mongolian gerbils.
AB  - Two novel murine monoclonal antibodies (mAbs) were produced to the Thy-1 molecule
      of Mongolian gerbils (Meriones unguiculatus). These mAbs, HUSM-M.g.27 of IgG1
      isotype and HUSM-M.g.40 of IgG2a isotype, immunohistochemically reacted with the
      thymus, nervous system, and glomerular mesangium in partially different manners,
      suggesting that they recognize distinct epitopes, although they reacted with Thy
      1 antigen, with apparent molecular weight of about 25 kDa, on gerbil thymocytes.
      Mild and severe forms of mesangioproliferative nephritis after glomerular
      deposition of the antibody was observed in gerbils administered mAbs HUSM-M.g.27
      and HUSM-M.g.40, respectively, intraperitoneally, with or without guinea-pig
      serum as supplementary complement. Distinct pathogenicity and requirement of
      guinea pig serum for pathologic sequels are discussed as they relate to the rat
      model of anti-Thy-1-induced glomerulonephritis.

PMID- 11200564
TI  - Modification of immunologic and hematologic variables by method of CO2
      euthanasia.
AB  - BACKGROUND AND PURPOSE: The major goal was to determine whether variations in the
      method of CO2 euthanasia would induce significant immunologic differences.
      METHODS: Young adult C57BL/6 mice (n = 40) were euthanized, using four regimens:
      70% CO2/30% O2; 70% CO2/30% O2-->100% CO2; 100% CO2-naive chamber; and 100% CO2
      pre-charged chamber. Time to recumbency and euthanasia and body, liver, lung,
      spleen, and thymus masses were determined. Blood and spleen were further
      evaluated for leukocyte, lymphocyte, and thrombocyte counts, erythrocyte
      characteristics, distribution of lymphocyte subpopulations, spontaneous and
      mitogen-induced blastogenesis, complement activity, and cytokine production.
      RESULTS: Time to euthanasia was five- to eightfold longer in mice exposed to 70%
      CO2/30% O2 than that for any other group. There were slight increases in mean
      erythrocyte volume (MCV) and mean erythrocyte hemoglobin (MCH) for all groups,
      compared with those for the 100% CO2 pre-charged group. Circulating cytotoxic T
      (CD8+) lymphocyte percentages and numbers, and spontaneous blastogenesis of
      leukocytes in blood and spleen, also were affected by euthanasia method.
      CONCLUSIONS: The method of CO2 euthanasia can result in significant differences
      in immunologic/hematologic variables. Thus, consistency in euthanasia procedures
      may be important in accurate interpretation of research data.

PMID- 11200566
TI  - Gross and microscopic anatomy of the extraorbital lacrimal gland of the common
      marmoset (Callithrix jacchus).
AB  - PURPOSE: The lacrimal gland is often selected for microscopic examination in
      toxicologic studies. However, this gland is difficult to find within the orbit in
      marmosets at necropsy. Therefore, we examined the extraorbital lacrimal glands in
      marmosets. METHODS: The formalin-fixed craniums of four marmosets were used in a
      topographic study to confirm location of the lacrimal gland, and the results were
      applied to a routine toxicologic study in marmosets. RESULTS: The extraorbital
      lacrimal gland was located on the temporal surface of the zygomaticofrontal
      process and was covered with the temporalis muscle. The gland was easily detached
      from the surrounding tissue, and its histologic features were the same as those
      of the intraorbital lacrimal gland. CONCLUSIONS: The extraorbital lacrimal glands
      have been reported in some New World monkeys, but to the authors' knowledge, this
      is the first report in marmosets. Identification and characterization of this
      gland will be useful for toxicologic studies in marmosets.

PMID- 11200567
TI  - Experimentally induced infection with autonomous parvoviruses, minute virus of
      mice and H-1, in the African multimammate mouse (Mastomys coucha).
AB  - To determine whether the multimammate mouse (Mastomys coucha) could be used to
      evaluate rodent parvovirus-based vectors, neonates were subcutaneously inoculated
      with minute virus of mice (prototype strain, MVMp) or rat parvovirus H-1. The
      course of infection with both viruses was similar. Seroconversion occurred within
      two weeks after virus inoculation, as detected by use of hemagglutination
      inhibition assays, and antibody titers remained high for the entire observation
      period of 12 months. Viral DNA and infective virions were detected in several
      organs of inoculated animals prior to seroconversion, as measured by use of
      Southern blotting and plaque assays, respectively. Infective particles
      subsequently became undetectable, whereas viral DNA imprints persisted in
      distinct organs for at least nine months. Clinical signs of parvovirus infection
      appeared around six weeks after virus inoculation, and consisted of hemorrhages,
      stunted growth, and transient hair color changes. Sudden death occurred in a
      significant fraction of animals infected with MVMp, but not H-1 virus, at the
      time of weaning. Altogether, MVMp, which is innocuous to its natural host, the
      mouse, and H-1 virus, which is poorly pathogenic to the rat, appear to be
      pathogenic for Mastomys coucha.

PMID- 11200568
TI  - Mycoplasma pulmonis genital disease: effect of rat strain on pregnancy outcome.
AB  - BACKGROUND AND PURPOSE: Mycoplasma pulmonis is a natural pathogen of the
      respiratory and genital tracts of rats. Differential susceptibility and severity
      of the respiratory form of the disease, known as murine respiratory mycoplasmosis
      (MRM), exist between rat strains. We now report that specific rat strains vary in
      susceptibility to genital tract infection and pregnancy outcome. METHODS:
      Specific-pathogen-free (SPF) female F344, LEW, Wistar (WIS) and Sprague Dawley
      (SD) rats were intravaginally inoculated with 3 x 10(7) colony-forming units
      (CFU) of M. pulmonis strain X1048 or sterile diluent, and allowed to breed at 10
      days after inoculation. Pregnant dams and pups were necropsied within 24 hours of
      parturition. At necropsy, culture for M. pulmonis was performed on dam and pups,
      and adverse effects on pregnancy outcome were assessed by determination of the
      incidence of infertility, fetal resorption, stillbirths, changes in litter size,
      and pup birth weight. Blood from dams was collected prior to inoculation and at
      time of necropsy for measurement of IgM and IgG antibodies to M. pulmonis.
      RESULTS: At time of necropsy, WIS (50%) and SD (60%) dams had a higher frequency
      of M. pulmonis culture positivity in the genital tract than did LEW (22.2%) and
      F344 (17.6%) dams. Dams that were still infected with M. pulmonis at time of
      necropsy had various complications. The SD rats had the greatest degree of
      adverse effects on pregnancy outcome, which were: infertility, decreased litter
      size (P < or = 0.01), decreased pup birth weight (P < or = 0.01), increased
      frequency of resorptions, stillbirths (P < or = 0.05), and the highest rate of
      pup pulmonary infection (23.1%) (P < or = 0.001). Despite a 50% colonization
      rate, WIS dams were the least adversely affected. The WIS pups born from M.
      pulmonis. infected dams had slight decrease in birth weight, and only 6% had
      pulmonary infections. The LEW infected dams developed infertility and lower
      numbers of liveborn pups without evidence of vertical transmission. The F344
      infected dams had lower numbers of liveborn pups that were smaller than their
      control counterparts, and none had pulmonary infections. None of the animals had
      detectable IgM and IgG antibodies to M. pulmonis before inoculation. At time of
      necropsy, all animals inoculated with M. pulmonis developed significantly (P < or
      = 0.001) higher amounts of M. pulmonis IgG and IgM antibodies, with SD rats
      developing the highest amounts (P < or = 0.005). CONCLUSIONS: Both F344 and LEW
      rats are more resistant to vaginal inoculation with M. pulmonis than are WIS and
      SD rats. However, only SD dams suffered severe adverse effects on pregnancy
      outcome. The SD dams also had the greatest IgM and IgG antibody response to M.
      pulmonis. Our studies clearly indicate differences among rat strains in their
      susceptibility to vaginal inoculation with M. pulmonis and in secondary
      complications associated with infection. This system may be a useful model for
      determining host-specific factors that influence the outcome of natural
      mycoplasmal infections of the genital tract.

PMID- 11200569
TI  - Buprenorphine given after surgery does not alter renal ischemia/reperfusion
      injury.
AB  - BACKGROUND AND PURPOSE: Potential drugs for human acute renal failure are often
      tested in an animal model of renal ischemia/reperfusion injury. Analgesics are
      often not given after surgery because of concerns that they would alter renal
      function. Therefore, we tested whether postoperative analgesia would alter animal
      health or affect the degree of renal injury. METHODS: Mice were subjected to
      either 32 or 37 minutes of renal ischemia, given two or six doses of
      buprenorphine or vehicle at 12-hour intervals, and followed for 72 hours. In some
      animals, we measured body temperature and physical activity by use of telemetry.
      RESULTS: Animals treated with buprenorphine recovered more rapidly from surgery
      based on postoperative activity, and had a small but not significant tendency for
      faster restoration of normal body temperature. Animals treated with buprenorphine
      had less weight loss after 37 minutes of ischemia. Buprenorphine given after
      surgery did not influence the degree of renal injury after ischemia/reperfusion.
      CONCLUSIONS: Buprenorphine should be given after renal ischemia-reperfusion
      surgery because administration of the proper analgesic improved animal health
      without interfering with the renal ischemia/reperfusion model. Analgesic
      treatment at the time of the operation and 12 hours after was sufficient.
      Buprenorphine may reduce the post-surgical stress response, and thus potentially
      improve the specificity of testing for drugs that reduce or treat renal injury.

PMID- 11200570
TI  - Median effective dose determination and histologic characterization of porcine
      (Sus scrofa domestica) dermal lesions induced by 1540-nm laser radiation pulses.
AB  - BACKGROUND AND PURPOSE: Light amplification by stimulated emission of radiation
      (laser) systems operating in the so-called "eye safe" region are gaining
      widespread use in industry, medicine, and military applications. This research
      effort was geared to study the effects of laser tissue interaction on human skin
      by using in vivo porcine skin as an animal model. The goals of the study were to
      determine the median effective dose (ED50) for 1540-nm laser exposures, to
      evaluate the Yorkshire pig and the Yucatan mini-pig as animal models for laser
      exposure, and to characterize laser-induced skin lesions histologically. METHODS:
      A 1540-nm wavelength laser was used to expose multiple sites on the flanks of 10
      pigs, using 0.8-ms pulses, ranging from 7 to 96 joules (J)/cm2. Single pulses
      were delivered to the flank of Yorkshire and Yucatan pigs in a grid pattern.
      Exposure sites were evaluated immediately after exposure and at 1 hour and 24
      hours for presence of gross lesions. Representative biopsy specimens were
      collected from lesion sites for histologic evaluation at the 24-hour endpoint.
      RESULTS: The ED50 for the two breeds differed in the amount of energy required to
      induce dermal lesions. Grossly, lesions in each breed were well demarcated and
      pale gray to brightly erythematous. Microscopically, lesions had epidermal layer
      damage as cellular swelling and nuclear pyknosis, loss of cellular detail, and
      coagulation necrosis at the dermal layer. CONCLUSIONS: Findings suggest the
      presence of a different mechanism of laser-tissue damage in these two breeds.
      Photo-thermal mechanism appears to induce the skin lesions in the Yorkshire pig,
      whereas photo-thermal and photochemical mechanisms appear to be involved in
      lesion formation in the Yucatan mini-pig. All data obtained in this study will
      become part of database used by the American National Standards Institute (ANSI)
      to recommend laser safety standards for the occupational health and safety
      programs (OHSP), which will be used by industry and the military to base and
      update their current OHSP.

PMID- 11200571
TI  - Cardiopulmonary effects of sevoflurane in Garnett's greater bush baby (Otolemur
      garnettii).
AB  - PURPOSE: A study was conducted to assess the cardiopulmonary and anesthetic
      effects of sevoflurane anesthesia on Garnett's Greater Bush Baby (Otolemur
      garnettii). METHODS: Anesthesia was induced in ten animals with 8% sevoflurane
      and was maintained by use of 2.5% sevoflurane for 30 minutes. Induction and
      recovery times were recorded. Heart and respiratory rates (RR), end-tidal carbon
      dioxide concentration (ET CO2), arterial blood pressures, relative arterial blood
      oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), arterial
      partial pressure of carbon dioxide (PaCO2), and pH were monitored. Pre- and
      poststudy CBC and serum biochemical values were compared. RESULTS: Anesthesia
      induction was rapid (75+/-8.7 seconds [mean +/- SEM]) and smooth. Heart rate
      significantly increased initially, then decreased significantly over the
      remaining 30 minutes. There were no significant changes in RR, SpO2, ETCO2, or
      arterial blood pressure. The PaO2 values significantly increased in the 10- to 30
      minute samples. The PaCO2 values remained steady in the 10- to 30-minute samples.
      A significant decrease was seen in white blood count, calcium, and total protein
      (TP) values, compared with values in pre-anesthesia samples. Recovery from
      anesthesia was smooth and rapid, with extubation at 24+/-5.8 seconds.
      CONCLUSIONS: At the concentrations used in this study, sevoflurane appears to be
      a safe and effective agent for induction and maintenance of anesthesia in O.
      garnettii.

PMID- 11200572
TI  - Survey of effects of anesthesia protocols on hemodynamic variables in porcine
      cardiopulmonary resuscitation laboratory models before induction of cardiac
      arrest.
AB  - OBJECTIVE: An advantage of animal models in cardiopulmonary resuscitation (CPR)
      research is the possibility to control confounding variables that may be
      impossible to standardize in clinical trials. A neglected effect of the
      anesthesia protocol in porcine CPR studies may be its impact on hemodynamic
      variables before induction of cardiac arrest. Accordingly, the purpose of the
      study reported here was to evaluate published CPR reports with regard to their
      anesthesia protocol. METHODS: Of 100 articles that reported on laboratory models
      simulating cardiac arrest between 1987 and 1997 in peer-reviewed journals, 25 met
      inclusion criteria and were analyzed for values of coronary perfusion pressure,
      mean arterial pressure, heart rate, temperature, and cardiac index before
      induction of cardiac arrest. Subsequently, mean values for all animals in a given
      report were calculated and corrected for group size; statistical analysis was not
      performed since this was a survey only. RESULTS: Different anesthesia protocols
      resulted in a widely distributed pattern of hemodynamic variables prior to
      induction of cardiac arrest. Ranges compared with reference values were: heart
      rate, 100 to 122 beats/min versus 105+/-11 beats/min; mean arterial pressure, 68
      to 130 mm Hg versus 102+/-9 mm Hg; coronary perfusion pressure, 55 to 114 mm Hg
      (no reference value); cardiac index, 69 to 152 ml/kg/min versus 147+/-22
      ml/kg/min; body temperature, 37 to 38.5 degrees C versus 38.5+/-0.7 degrees C.
      CONCLUSION: The anesthesia protocol may have an impact on hemodynamic variables
      before induction of cardiac arrest in CPR studies.

PMID- 11200573
TI  - Retrospective analysis of an outbreak of B virus infection in a colony of
      DeBrazza's monkeys (Cercopithecus neglectus).
AB  - In 1981, an outbreak of herpetic disease developed in a colony of DeBrazza's
      monkeys (Cercopithecus neglectus). In seven of eight infected animals, clinical
      signs of infection included vesicular and ulcerative lesions on the lips, tongue,
      and/or palate. Histologic examination of lesions revealed intranuclear inclusion
      bodies, and electron microscopy revealed nucleocapsids and virions with typical
      herpesvirus morphology. Although a virus was isolated that appeared similar to
      monkey B virus, techniques available at the time did not allow precise
      identification of the virus. Analysis of serum from one surviving monkey
      collected 12 years after the outbreak revealed a pattern of reactivity
      characteristic of B virus-positive serum on the basis of results of ELISA and
      western immunoblot analysis. Polymerase chain reaction analysis of archived
      paraffin-embedded tissue specimens and molecular analysis of the one viral
      isolate obtained from a DeBrazza's monkey indicated that the virus responsible
      for the outbreak was a new genotype of B virus. Testing of sera from lion-tailed
      macaques (Macaca silenus) housed in an adjacent cage at the same zoo indicated
      that these animals harbored this virus and, thus, were the likely source of the
      virus that infected the DeBrazza's monkeys. This study documents usefulness of
      archiving samples from disease outbreaks for later analysis. In addition, this
      incident underscores the importance of considering herpes B virus infection when
      outbreaks of disease having characteristics of herpetic infections develop in
      nonhuman primates kept at institutions that also house macaques.

PMID- 11200574
TI  - Trypanosoma cruzi infection of squirrel monkeys: comparison of blood smear
      examination, commercial enzyme-linked immunosorbent assay, and polymerase chain
      reaction analysis as screening tests for evaluation of monkey-related injuries.
AB  - BACKGROUND AND PURPOSE: Wild-caught New World monkeys (NWM) from Central or South
      America are often infected with Trypanosoma species, including T. cruzi. In
      humans, T. cruzi causes Chagas' disease. Even in closed monkey colonies, T. cruzi
      can be propagated by blood-to-blood exposure, sexual activity, and transplacental
      transmission. Animal handlers and laboratory staff who deal with blood and
      tissues from infected NWM are at riskfor acquiring Chagas' disease via accidental
      exposure. METHODS: We screened 162 blood samples from wild-caught Saimiri sp.
      monkeys for Trypanosoma species infections by use of blood smear examination,
      ELISA, and polymerase chain reaction (PCR) analysis. Blood samples from 19
      employees with recent history of monkey-associated injuries also were tested.
      RESULTS: Six percent (10/162) of the monkey samples were T. cruzi positive on the
      basis of blood smear examination results, 10.4% (17/162) were positive by ELISA
      results, and 26.5% (43/162) were positive by PCR results. Other organisms
      identified by PCR analysis included T. rangeli in two animals, Plasmodium spp. in
      two animals (P. malariae confirmed by PCR results) and microfilariae in one
      animal (morphologically, Mansonella perstans). Evidence of trypanosome infection
      was not found in the 19 employee samples on the basis of results of any of the
      three aforementioned tests. CONCLUSIONS: Close attention must be paid to worker
      safety where wild-caught NWM are used. The PCR analysis has a clear advantage
      over conventional techniques (ELISA, blood smear) for screening NWM for
      trypanosome infections during quarantine and after employee injury.

PMID- 11200575
TI  - Diagnosis and management of atypical Mycobacterium spp. infections in established
      laboratory zebrafish (Brachydanio rerio) facilities.
AB  - Two established zebrafish colonies experienced increased mortality and decreased
      reproductive performance. Initial examination of several fish from one facility
      revealed hyperemic gills, petechia around the opercula, abdominal distention, and
      emaciation. Affected fish had congested liver with inflammation and multifocal
      hepatic necrosis. Large numbers of acid-fast-positive, rod-shaped bacteria were
      evident in multiple tissues and the blood. Mycobacterium fortuitum was
      subsequently isolated from several fish. Zebrafish from the second facility had
      skin erosions and ulceration along the flank just caudal to the pectoral fins.
      Large numbers of acid-fast-positive, rod-shaped bacteria were observed within the
      necrotic centers of well-demarcated, multifocal granulomas in gonads, liver, and
      peritoneum from affected fish. Mycobacterium abscessus and M. chelonae were
      isolated and identified biochemically. Definitive diagnosis in these outbreaks
      was obtained by culture on selective media. Because Mycobacterium spp. grow
      extremely slowly and positive confirmation may require 45 to 60 days,
      Mycobacterium species-specific polymerase chain reaction analysis was used to
      provide a rapid screening assay for Mycobacterium spp. as well as for
      verification of culture results. To our knowledge, this is the first
      documentation of mycobacterial infection in laboratory-maintained zebrafish and
      provides guidelines for diagnosis, management, and prevention of atypical
      mycobacteriosis in laboratory zebrafish colonies.

PMID- 11200576
TI  - Iridodialysis in a rhesus macaque: a case report.
AB  - During routine physical examination, a five-year-old male rhesus macaque (Macaca
      mulatta) was observed to have gaps in the right iris. Ophthalmic examination
      revealed inferior and superior iridodialysis with an anterior cortical cataract.
      The optic nerve head and fundus were normal. Uninvolved areas of the iris and
      anterior-chamber angle were normal on the basis of results of gonioscopy.
      Tonometry revealed normal intraocular pressure. The cause of the iridodialysis in
      this monkey's eye was not known. The animal had been housed individually since
      arrival due to requirements of the research protocol. Although the concomitant
      cataract supports a traumatic cause, there was no history of cranial or other
      ocular injuries. Trauma from fighting through the cage walls, self-trauma or
      falling inside the cage while under sedation cannot be ruled out. Multiple
      hematologic evaluations disclosed no abnormalities. This animal did not manifest
      behavioral abnormalities or any indication of pain. Therefore, treatment was not
      initiated. Intraocular pressure continues to be monitored at least semiannually.

PMID- 11200577
TI  - Disease attributed to Mycobacterium chelonae in South African clawed frogs
      (Xenopus laevis).
AB  - The fast-growing nontuberculous mycobacterial species Mycobacterium chelonae was
      isolated from six captive South African clawed frogs (Xenopus laevis) with
      chronic weight loss and nonhealing ulcerative skin lesions. Three of the M.
      chelonae isolates were evaluated to confirm the species identification using
      polymerase chain reaction restriction analysis. Disease associated with M.
      chelonae is reported mainly in people and in fish. To our knowledge, this is the
      first report of disease associated with M. chelonae in a colony of captive
      Xenopus sp.

PMID- 11200581
TI  - Assault and battery, or legitimate treatment?
AB  - In response to cases of high-handed medical interventions and treatments, a
      debate on the legal justification of operations and the relevance of patients'
      consent developed among German-speaking jurists in the 1890s. The view that
      surgery was objectively physical injury or battery, which went merely unpunished
      through the patient's consent, was highly contested among legal experts and
      firmly rejected by doctors. Various proposals to justify indicated medical
      treatment without consent were discussed. German jurisdiction, however, endorsed
      the battery theory of medical interventions and thus prepared the way for the
      concept of informed consent in medicine.

PMID- 11200583
TI  - [Medicines and thermal treatment in Pautalia, Thrace].
AB  - The city of Pautalia (Kyustendil in Bulgaria) is located near thermal springs in
      the Strymon valley (Strouma), on a site occupied from the Iron Age onward by the
      Thracian tribe of Dentheletes. The temple of Asclepios and the walls of Pautalia,
      located on the hill of Hissarlaka, as well as the roman thermae in the center of
      modern Kyustendil are among the more important archaeological vestiges in the
      area. In 1990, near the village of Dragodan, district of Kyustendil, different
      surgical instruments in bronze were unearthed in a tumulus attributed to the
      roman period (IInd century A.D.). During the excavation of another tumulus in
      1992, a truly exceptional discovery was made near the town of Kotcherinovo,
      district of Kyustendil: A variety of medicines were discovered in a small bronze
      case, dating from the roman period (IInd century A.D.). The complete results of
      the analysis of these substances and few hypotheses about their possible use are
      presented in this publication.

PMID- 11200584
TI  - Vestibular and cochlear toxicity of aminoglycosides--a review.
AB  - Recently, there have been many reports describing the efficacy of intratympanic
      aminoglycoside injection for the treatment of intractable vertigo in patients
      with Meniere's disease. However, the number of injections and the amount of drug
      injected varies, with concomitant variation in the side-effect of hearing
      deterioration. To identify drugs that are more selectively vestibulotoxic, we
      have reviewed the ototoxicity of aminoglycosides, focusing on differences between
      vestibulo- and cochleotoxicity. At present, the basis for the different effects
      of each drug is unknown. The mechanisms of vestibulo- and cochleotoxicity are
      deemed worthy of further study.

PMID- 11200585
TI  - The reinnervation of regenerated hair cells in the basilar papilla of chicks
      after kanamycin ototoxicity.
AB  - When newly hatched chicks were injected with kanamycin on 8 successive days, the
      hair cells were destroyed completely in the area 0.4 to 0.8 mm from the proximal
      end of the basilar papilla. At this time, and 1 and 7 days following the
      completion of 10 days of injections, the nerve fibres in the basilar papilla of
      chicks show no sign of injury. On the first day following 10 days kanamycin
      administration the regenerated hair cells obtained not only afferent innervation,
      but also efferent innervation. At 15 days following drug cessation, afferent
      innervation of the regenerated hair cells was already similar to the controls,
      and the thresholds measured at this time were significantly better than those at
      1 and 7 days. The chalice efferent terminals did not appear until the 60th day of
      drug cessation. Efferent innervation of the regenerated hair cells also
      approached maturity at this time. Compared with the half month after the
      completion of drug injection, the hearing of birds had no evident increase. It
      was obvious that afferent innervation of the regenerated hair cells was related
      more to the recovery of hearing than efferent innervation. The regenerated hair
      cells beginning reinnervation early and maturing were important factors
      influencing the recovery of the birds' hearing function after kanamycin
      ototoxicity.

PMID- 11200586
TI  - Development of the middle ear in neonatal chinchillas. I. Birth to 14 days.
AB  - Measures of middle-ear function in humans show large differences among neonates,
      infants, and adults. In contrast, hearing sensitivity is essentially mature at
      birth. Hypotheses that have been proposed to explain the developmental changes in
      middle-ear function include: (i) contaminating effects of the immature neonatal
      ear-canal wall and (ii) persistent fetal tissue in the ear canal, tympanic
      membrane (TM), and middle-ear space. To better understand the relationships
      between middle-ear function, hearing sensitivity and the structure of the middle
      ear, 30 chinchillas, aged 1-14 days, were studied. Middle-ear function was
      assessed by multifrequency tympanometry with probe tones ranging from 226 to
      2,000 Hz. Hearing sensitivity was measured by auditory brainstem response using
      clicks and 1, 2, 4, and 8 kHz tone bursts. Structural characteristics were
      analyzed from temporal bone histologic preparations. At all frequencies, the
      acoustic admittance of the neonatal car is very low and tympanometric patterns
      are complex and irregular, compared to adult animals. The admittance is
      essentially constant from 1 to 14 days, indicating that developmental changes
      occur over a much wider age span than that investigated here. Hearing sensitivity
      of the chinchilla appears to be mature at birth. Histologic analysis indicated
      that there were no age-related changes in TM thickness, TM diameter, distance
      from TM to promontory, and stapes footplate diameter. There were small increases
      in bone thickness, middle-ear area, mastoid bulla area, and in the perimeters of
      the middle ear and mastoid bulla. There were no significant amounts of loose
      mesenchyme or other fetal tissue in the middle-ear space.

PMID- 11200587
TI  - Mucin gene expression in cultured human middle ear epithelial cells.
AB  - For the advanced study of the cell and molecular biology of middle ear mucosa, an
      in vitro cell culture system is required. Although middle ear epithelial cells
      have been cultured from various species of laboratory animal, there have been no
      reports concerning a serial subculture system of human middle ear epithelial
      cells. In this paper, we describe the establishment of a primary culture system
      of human middle ear epithelial cells using a serum-free conditioned medium and
      the characterization of these cells by the expression of phenotypic
      characteristics of epithelial cells and mucin genes. Cultured cells were
      anchorage-dependent in terms of growth and showed a polygonal cobblestone-like
      appearance: desmosomes in the cell junction were observed by electron microscopy.
      In the immunocytochemical study, cytokeratin (epithelial cell marker) was
      expressed in all cultured cells. but von Willebrand factor (endothelial cell
      marker) was not. Unexpectedly, vimentin (fibroblast marker) was locally
      expressed, and a double stain showed the co-expression of both cytokeratin and
      vimentin in the same cell. The products of reverse transcriptase polymerase chain
      reaction from cultured cells yielded distinct bands compatible with the expected
      sizes of the MUC1, MUC2, MUC5AC and MUC5B genes. This culture system will allow
      us to prepare the cell line and to perform advanced studies of human middle ear
      mucosal biology.

PMID- 11200588
TI  - Exostoses and cavernous venous formation in the external auditory canal of the
      hooded seal as a functional physiological organ.
AB  - Exostoses of the external auditory canal (EAC) develop after protracted
      mechanical, chemical or thermal irritation in particular. This is a common
      disorder among aquatic sportsmen and has been considered unique to Man. We
      dissected and photodocumented the EACs of 5 newborn and 3 adult Hooded Seals
      (Cystophora cristata). Serial sections of the EACs were prepared for light
      microscopic evaluation after staining with haematoxylin-eosin or toluidine blue.
      All EACs exhibited a firm, broad-based. mountain peak-shaped exostosis on the
      floor of the meatus, lateral to the eardrum. In addition, the meatal skin of the
      bony EAC harboured large venous sinuses. The exostosis and venous sinuses of the
      seal EAC participate in the protection of the sensitive hearing apparatus,
      particularly the pars tensa portion of the drum, during divine.

PMID- 11200589
TI  - Effects of retinoic acid, triiodothyronine and hydrocortisone on mucin and
      lysozyme expression in cultured human middle ear epithelial cells.
AB  - Mucous hypersecretion is a major complication of otitis media and can prolong the
      disease course and increase morbidity. Mucin, a major component of mucus, is a
      macromolecular complex of glycoprotein and makes mucus viscous. Lysozyme is a
      secretory element of the middle ear mucosa. which has a non-specific and innate
      antibacterial function. We attempted to identify factors that regulate these
      secretory products and their morphological phenotype using cultured human middle
      ear epithelial cells. Cellular differentiation was induced by creating an air
      liquid interface on culture day 9 in serum-free conditioned media. Omission of
      retinoic acid (RA) caused decrease in the secretion of mucin and lysozyme, and in
      the cellular expression of MUC 2, MUC 5AC and MUC 5B mRNA. In contrast, removal
      of triiodothyronine (T3) caused an increase in the secretion of mucin and the
      level of MUC5AC mRNA. When hydrocortisone (HC) was removed from the media, the
      secretion of mucin was decreased with out an apparent change of message level.
      The expression of MUC 1 mRNA was not changed by the respective deficiency of RA.
      T3 or HC. The effect of T3 or HC on lysozyme was not significant. This study
      shows that RA, T3 and HC influence the morphological phenotype and the secretory
      function of mucin and lysozyme in cultured human middle ear epithelial cells.
      This culture system can serve as an in vitro model for study of the regulation of
      various cellular secretions in human middle ear epithelium.

PMID- 11200590
TI  - Clinicopathologic growth factors in vestibular schwannomas: a morphological and
      immunohistochemical study of 69 tumours.
AB  - Tumour growth of vestibular schwannomas is still difficult to predict. The aim of
      our study was to determine whether any defined histopathological feature was
      correlated with the clinical course. We did a retrospective study with 69
      paraffin-embedded tumours to establish whether the number of vessels, blood cells
      extravasation or degree of inflammation, all semi-quantitatively assessed, could
      be indicative of potential of growth. An immunohistochemical study was also
      performed with an endothelial marker CD34, the leukocyte common antigen CD45 and
      the estrogen and progesterone hormone receptors. All these parameters were
      correlated with patient's age, duration of symptoms (d), with a clinical growth
      index (CLI = tumour size/d). No clinical parameters proved to be predictive of
      tumour growth. Tumour size was significantly (p = 0.01) related to the number of
      vessels and we found a significant relationship between the clinical growth index
      (CLI) and total number of vessels, especially when duration of symptoms lasted
      less than 1 year (p < 0.001). However, we found no relationship between duration
      of symptoms or CLI and CD34 index. The degree of inflammation was significantly
      correlated (p = 0.007) with duration of symptoms when it lasted more than 1 year.
      The CD45 index and the semi-quantitative evaluation of the inflammation were well
      correlated (p = 0.001). No estrogen receptors antigenic site was detected and
      only seven tumours expressed progesterone receptor in a few cells without any
      significant clinical value. These results suggest that vessel density is
      determinant for sporadic acoustic neuroma growth especially for a short clinical
      course.

PMID- 11200591
TI  - The endolymphatic sac in patients with Meniere's disease: correlation between the
      MRI and the surgical findings.
AB  - The endolymphatic sac (ES) is thought to have close relations to pathogenesis of
      endolymphatic hydrops. Here is reported a retrospective study of 41 patients (42
      ears) with Meniere's disease who underwent MRI prior to endolymphatic sac
      surgery. Based on proton-density weighted image (PDI) and T2-weighted image (T2),
      the ES including an endolymphatic duct (ED) were estimated whether it was
      detectable or not. Fourteen ESs were detected on both images (Group A), 14 ESs
      were detected only on PDI (Group B), and the remaining 14 ESs were not detected
      on either image (Group D). The actual shape of the sac, obtained from surgical
      findings, was classified into three (normoplastic, atrophic, invisible).
      Seventeen ears showed normoplastic ESs and 14 showed atrophic ESs. ES was not
      detected in 11 ears during surgery, and these findings were compared with image
      classification. From the study data, normoplastic ESs tend to be observed on both
      images whereas atrophic or invisible sacs were hardly observed on T2. This
      classification of ES on MRI was thought to correlate with surgical findings and
      this correlation was statistically significant (Spearman's rank correlation
      coefficient. r(s) = 0.58, p < 0.01).

PMID- 11200592
TI  - An acoustically evoked short latency negative response in profound hearing loss
      patients.
AB  - In our auditory brainstem response (ABR) tests, a peculiar V-shaped negative wave
      at around 3 4 ms latency was observed. At present, this acoustically evoked short
      latency negative response (ASNR) is poorly understood. In order to study its
      appearance and origin, the ABR data of 3104 tests during 1980-98 were reviewed.
      The ASNR was found only in profound hearing loss ears under intense stimuli (80
      120 dB nHL). Out of the total 653 profound hearing loss patients (981 ears), the
      click-evoked ASNRs were present in 80 patients (12.3%), 117 ears (11.9%). The age
      range was from 8 months to 70 years. Demographic outcome revealed significant
      higher appearance rates in young subjects especially in the 20-30 years group.
      The ASNR was excluded from an artifact by its reproducibility over time,
      equipment and institutes. Moreover, it became absent after external auditory
      canal occlusion, which simply blocked the air conduction without any influence
      upon scalp potentials or equipment. It had neural response characteristics that
      the latency and amplitude shortened and increased respectively in response to the
      increase of stimulus intensity. Because the peculiar V-shaped waveform obviously
      differs from ABR, the ASNR was not interpreted as a potential generated from the
      conventional auditory pathway. On the other hand, the ASNR individuals were of
      good vestibular function in sharp contrast with their poor hearing. This suggests
      the probable relation between the ASNR and the vestibular system. The saccule and
      vestibular nucleus are hypothesized to be the sense organ and the origin of the
      response respectively.

PMID- 11200593
TI  - Regional cerebral blood flow during tinnitus: a PET case study with lidocaine and
      auditory stimulation.
AB  - Brain imaging of tinnitus has suggested central correlates of tinnitus
      perception. This study presents positron emission tomographic (PET) measurements
      of regional cerebral blood flow (rCBF) in a female tinnitus patient with
      bilateral left dominant tinnitus. Lidocaine infusion (75 mg during 5 min (0.2
      mg/kg/min)) resulted in a 75% reduction of tinnitus and a temporary abolition of
      the dominant tinnitus in her left ear. Regional CBF was measured in four
      conditions: i) at rest while concentrating on tinnitus, ii) following maximum
      effect of lidocaine, iii) during sound stimulation, and iv) the following day at
      rest while concentrating on tinnitus. Subtraction analyses showed that tinnitus
      was associated with increased rCBF in the left parieto-temporal auditory cortex,
      including the primary and secondary auditory cortex with a focus in the parietal
      cortex (Brodmann areas 39, 41, 42, 21, 22). Activations were also found in right
      frontal paralimbic areas (Brodmann areas 47, 49 and 15). Sound stimulation
      resulted in bilateral activation of auditory areas. It is suggested that tinnitus
      is processed in primary, secondary and integrative auditory cortical areas.
      Tinnitus perception may involve areas related to auditory attention, while
      emotional processing relates to temporofrontal paralimbic areas.

PMID- 11200594
TI  - Relationship between infiltrating cells and adhesion molecules in the nasal
      mucosa of patients with allergic rhinitis.
AB  - Antigen-induced changes of cell adhesion molecules and their relationships to
      infiltrating cells were investigated immunohistochemically in nasal mucosa of
      perennial allergic rhinitis patients. An increased expression of E-selectin and
      VCAM-1 was noted on the vascular endothelium of the nasal mucosa 15-25 h after
      the topical antigen challenge. Although there was no increased expression of ICAM
      1, we noted a positive correlation between the expression of E-selectin and ICAM
      1. The expression of E-selectin and VCAM-1 as well as ICAM-1 was revealed to be
      correlated with the number of EG2-positive cells and CD4-positive cells, but not
      with elastase-positive cells. These findings suggest that all these adhesion
      molecules play a role in the topical influxes of eosinophils and CD4-positive
      cells in allergic nasal mucosa.

PMID- 11200595
TI  - Temperature-controlled radiofrequency tissue volume reduction of the soft palate
      (somnoplasty) in the treatment of habitual snoring: results of a European
      multicenter trial.
AB  - Temperature-controlled radiofrequency tissue volume reduction of the soft palate
      has been introduced as a minimally invasive, outpatient procedure for the
      treatment of habitual snoring and mild obstructive sleep apnea. A prospective,
      non-randomized multi-center European clinical study was conducted to investigate
      the efficacy of Somnoplasty in reducing snoring. Each patient underwent a pre-
      and post-treatment full-night polysomnography. TCRFe of the soft palate (1
      midline lesion/session) was carried out under local anesthesia with a maximum of
      3 consecutive treatment sessions. Forty-five, nonapneic snorers (RDI 5.1 +/- 4.3,
      BMI 26.6 +/- 3.2 kg/m2) completed the protocol. A mean of 692.3 +/- 67.7) J was
      delivered/treatment session. There was a significant improvement in the snoring
      index 7.6 (+/- 2.1 ) vs 4.1 (+/- 2.9). p < 0.001 and in the Epworth Sleepiness
      Score 8.5 (+/- 5.0) versus 6.0 (+/- 4.3), p = 0.001. No major adverse events were
      reported and postoperative pain was minimal. Overall, 45% of patients had a post
      treatment snoring index < 3 (success) and 84% of the patients reported an
      improvement in snoring. It was concluded that Somnoplasty, following a protocol
      with I midline lesion of maximal 700 J/lesion for 1-3 treatment sessions,
      improves snoring in the majority of patients. Further studies are required to
      investigate whether treatment efficacy can be improved by utilizing multiple
      lesions/session or by increasing the amount of energy/lesion. The absence of
      serious adverse events and the findings of minimal postoperative pain support the
      use of TCRFe (Somnoplasty) as a minimally invasive surgical procedure for
      snoring.

PMID- 11200596
TI  - Pain treatment after tonsillectomy: advantages of analgesics regularly given
      compared with analgesics on demand.
AB  - The aim of the present prospective study was to evaluate pain treatment during
      the first postoperative 24 h for 40 patients (age over 18) undergoing
      tonsillectomy. Patients were divided into two groups: group A (n = 20) received
      analgesics on demand and group B (n = 20) on a regular basis. Basic pain
      treatment consisted of paracetamol 750 mg x 6 and diclofenac 50 mg x 3. Pain
      measurement was performed using a visual analogue scale (VAS): a 10 cm line with
      0 cm equalling no pain and 10 cm equalling the worst pain ever felt. The
      following parameters were studied: VAS values, the need for rescue analgesics,
      intra- and postoperative bleeding, nausea and vomiting, postoperative food intake
      and hospital time. Only 4 of 20 (20%) patients in group B needed rescue
      analgesics in the postoperative ward compared with 15 of 20 (75%) in group A (p <
      0.01, chi2 test). In group B, 13 of 20 (65%) patients could eat solid food before
      they were discharged from the ward, compared with 7 of 19 (37%) monitored
      patients in group A (p < 0.01, chi2 test). The observed VAS values were generally
      rather low in both groups. The mean value for all observed VAS values was less
      than 4 in both study groups. However, no significant difference in VAS values was
      observed between the two study groups. Our results suggest that regularly given
      postoperative pain treatment after tonsillectomy, starting intraoperatively with
      paracetamol and diclofenac, has significant advantages compared with a regimen in
      which patients receive analgesics only on demand.

PMID- 11200597
TI  - Upper airway collapsibility in habitual snorers and sleep apneics: evaluation
      with drug-induced sleep endoscopy.
AB  - Increased upper airway collapsibility has been suspected of being involved in the
      pathogenesis of sleep-related diseases. It is assumed that patients with severe
      obstructive sleep apnea syndrome (OSAS) show a stronger collapse of the upper
      airway compared with habitual snorers. It was the objective of this study to
      analyze the patterns of upper airway collapse in habitual snorers and patients
      with OSAS and to correlate these results with data from polysomnography.
      Endoscopy was carried out during drug-induced sleep (with propofol) and
      collapsibility was analyzed at two major levels (palatal and tongue base). A
      total of 207 habitual snorers and 117 patients with OSAS underwent endoscopy
      after overnight polysomnography in our sleep laboratory. In 95% of cases we were
      able to induce snoring during drug-induced sleep. The collapsibility in the area
      of the base of the tongue correlated with higher values of the respiratory
      disturbance index (RDI) as recorded by standard polysomnography. Patients with
      OSAS showed significantly stronger collapsibility compared with snorers. The
      difference was more evident at the tongue-base level. We found no significant
      correlation between the applied CPAP pressure and collapsibility in patients with
      OSAS. These results show that collapsibility at the tongue-base level is a factor
      relevant in sleep-related breathing disorders.

PMID- 11200598
TI  - Tympanic neurectomy and chronic parotitis.
AB  - The preoperative findings and operative outcome were evaluated in 49 patients who
      underwent tympanic neurectomy to treat chronic parotitis. Forty-two patients had
      chronic non-suppurative parotitis and 7 patients had chronic suppurative
      parotitis. The main symptoms prior to operation were recurrent swelling and pain
      of the parotid gland. After operation, 40 patients (82%) had relief of their
      symptoms (28 patients were totally free of symptoms and 12 patients were markedly
      improved). In 9 patients (18%) the symptoms remained the same. Three patients
      (6%) had a tympanic membrane perforation due to the operation.

PMID- 11200600
TI  - [Genetic basis for dyslipidemias].

PMID- 11200599
TI  - [Lipids, cardiovascular risk factors].

PMID- 11200601
TI  - [Oxidized LDL membrane receptors: their role in atherogenesis].

PMID- 11200602
TI  - [Atherosclerosis and arteriosclerosis of the small vessels in chronic renal
      insufficiency and after transplantation: lipid factors].
AB  - The prevalence of lipid abnormalities is very high in patients with impaired
      renal function and after transplantation. Coronary heart disease (CHD) morbidity
      and mortality are impressive in these patients. No prevention study using lipid
      lowering agents is available in this population. Thus recommendations are still
      based on pathophysiological data or extrapolated from the results reported in
      prevention studies from kidney disease-free subjects. The treatment of
      hyperlipidemia can be recommended considering the expected reduction of events
      due to CHD. The lipid targets may be those recommended in other high risk
      patients: LDL-cholesterol < 120 mg/dl and triglycerides < 150 mg/dl.
      Unfortunately, the use of both statins and fibrates noteworthy is under restraint
      in case of renal failure and immunosuppressive therapy. Prospective clinical
      trials are needed to demonstrate the effect of lipid lowering on the course of
      chronic renal failure and graft dysfunction.

PMID- 11200603
TI  - [Atherosclerosis, infection and autoimmunity].

PMID- 11200604
TI  - [Lipids, monocytes and progression of renal insufficiency].

PMID- 11200605
TI  - [Lipid anomalies during renal insufficiency: consequences on the progression of
      renal insufficiency and cardiovascular risk].

PMID- 11200606
TI  - [Factors in the progression of renal insufficiency other than dyslipidemia].

PMID- 11200607
TI  - [Dyslipidemia of diabetes and insulin resistance].

PMID- 11200608
TI  - [Atherosclerosis and hemodialysis].

PMID- 11200609
TI  - [Evaluation of cardiovascular risk during substitution management: silent
      cardiopathies].

PMID- 11200610
TI  - [Endovascular exploration of the coronary arteries].

PMID- 11200611
TI  - [Influence of dialysis membranes on lipid parameters].

PMID- 11200612
TI  - [Lipid profiles in peritoneal dialysis].

PMID- 11200614
TI  - [Role of lipids in chronic rejection].

PMID- 11200613
TI  - [Monitoring of lipid anomalies in renal transplantation].

PMID- 11200615
TI  - [Effect of immunosuppressants on lipids].

PMID- 11200616
TI  - [ipids and dysfunctional endothelium].

PMID- 11200617
TI  - [Statins and cardiovascular disease prevention: use and prospective].

PMID- 11200618
TI  - [Treatment of the dyslipidemia of chronic renal insufficiency: respective place
      of statins and diet].

PMID- 11200619
TI  - [Therapeutic management].

PMID- 11200638
TI  - [Dependence of oligomerization of influenza virus nucleoprotein on the species
      affiliation of the virus].
AB  - Comparison of human and avian influenza virus nucleoprotein (NP) oligomerization
      showed that the efficiency of NP oligomerization is different in influenza
      viruses of different origin. NP oligomerization is virtually complete in avian
      influenza viruses, while in human influenza viruses only part of monomeric NP is
      oligomerized. The authors discuss the utilization of NP oligomerization
      efficiency as a sign for identification of the origin of influenza virus.

PMID- 11200639
TI  - [Nucleotide sequence of gag and env genes of human immunodeficiency virus type 1,
      found in Russia: detection of new recombinant variants].
AB  - Phylogenetic analysis of nucleotide sequences of gag and env genes of type 1
      human immunodeficiency virus (HIV-1) variants isolated from individuals infected
      through sexual intercourse or nosocomially (by injections with nonsterile
      syringes) showed that 5 of 27 (18.5%) isolated strains were recombinants. Two
      viruses found in the Russian Far East had gagAenvE genotype, three other
      recombinants had envG genotype; gag gene of one isolate belonged to subtype A and
      gag genes of two others belonged to subtype D. Detection of new recombinant
      variants in addition to the A/B recombinant described previously shows that these
      viruses can contribute to the HIV-1 genetic variability in Russia.

PMID- 11200640
TI  - [Determination of hepatitis G virus markers in various risk groups].
AB  - Study of prevalence of hepatitis G virus (HGV) markers in different risk groups
      showed the presence of HGV RNA in 3.2% blood donors, 24.2% patients with
      hepatitis C (HCV), and 28% patients with hemophilia. HGV antibodies were detected
      in 11.3% donors, 16.0% patients with HCV, 13.4% patients with hemophilia, and
      8.5% HIV-infected subjects. Anti-E1 HGV were more often detected in the absence
      of HGV RNA. Antibodies to HGV E2 protein were significantly more often detected
      in adult HCV patients but not in adolescent patients aged 8-15 years.

PMID- 11200641
TI  - [Markers of hepatitis C and its various genotypes in patients from Novosibirsk].
AB  - Study of the prevalence of hepatitis C virus (HCV) markers in 153 patients of
      Municipal Infectious Diseases Clinical Hospital No. 1 in Novosibirsk revealed
      anti-HCV in 88.2% patients and viral RNA in 69.3% samples. For 93 Siberian HCV
      isolates 5'-UTR regions were amplified and sequenced. Comparison of these
      nucleotide sequences with databank showed that 63.4% HCV isolates belonged to
      subtype 1b, 7.5% to genotype 2, and 18.3% to genotype 3. In the rest HCV isolates
      the 5'-UTR sequences contained heretofore undescribed nucleotide substitutions,
      insertions, or deletions.

PMID- 11200642
TI  - [IgM, IgG and IgG subclass antibodies to herpes simplex virus in persons of
      different ages].
AB  - IgM, IgG antibodies to herpes simplex virus and their subclases were investigated
      in 565 subjects of different age tested at virological laboratories of St.
      Petersburg in 1996-1997. The majority of these subjects had a history of herpes
      infection and 21.5% had IgM antibodies to herpes simplex virus (HSV), marker of
      acute herpetic infection. Besides IgM, IgG1 antibodies can be referred to early
      antibodies appearing during the acute stage of herpetic infection. The
      predominant subclass was HSV IgG3 antibodies. As for IgG4, they were completely
      absent in infants aged under 1 year, were detected in 6.2% children aged under 14
      years, and were present in 12.2-12.5% adults.

PMID- 11200643
TI  - [Production of immune mediators, induced by Lassa virus, in a human mononuclear
      cell culture].
AB  - Infection of human mononuclear cells with Lassa virus leads to production of
      inflammatory cytokines (tumor necrosis factor and interleukin-1). These cytokines
      cause expression of adhesion receptors ICAM-1 and VCAM-1 by human endothelial
      cells. Mitogen-induced cell proliferation was not suppressed 1 h after infection
      of human mononuclear cells with Lassa virus in a dose of 0.01 PFU/cell. The
      capacity of cells to proliferation in response to mitogen stimulation decreased
      significantly only 4 h after infection.

PMID- 11200644
TI  - [Conformational changes in Lassa viral proteins when exposed to antibodies and
      complement].
AB  - Addition of the complement to the antigen in Lassa virus ELISA stimulated the
      sensitivity and specificity of the assay. The effect depended on the mouse Ig
      subclasses. ELISA plate sensitization with IgG2a and IgG2b increased the
      sensitivity of ELISA 8-16 times. Protein footprinting data suggest that the
      complement C1q component stimulates antibody-induced conformation changes of the
      antigen.

PMID- 11200645
TI  - [Immunogenicity of a recombinant strain of vaccinia virus, expressing a
      Venezuelan equine encephalomyelitis virus structural protein gene in peroral
      immunization].
AB  - Immunogenicity of recombinant vaccinia virus strain (VR26) expressing Venezuelan
      equine encephalomyelitis (VEE) virus structural protein genes was studied by oral
      immunization. Sera of animals immunized with VR26 contained antibodies specific
      to VEE virus, among which antibodies with virus-neutralizing activity were
      present. Evaluation of the protective efficiency of oral immunization with VR26
      demonstrated a high level of animal protection from lethal doses of VEE virus.
      Rabbits immunized orally were highly resistant (protection index 142.9) to
      intranasal infection, which is of priority importance for antiVEE vaccine.
      Comparative analysis of the results of scarification and oral immunization with
      VR26 indicates that the type of immune response depends on the method of
      immunization. These results demonstrate good prospects of oral vaccination with
      recombinant VR26 strain for immunoprophylaxis of VEE.

PMID- 11200646
TI  - [Basic results of research on AIDS in 1999].

PMID- 11200648
TI  - [Diagnostic possibilities of an immunoenzyme test-system for determining the
      spectrum of antibodies to structural and nonstructural hepatitis C virus
      antigens].
AB  - A new enzyme immunoassay EIA-HCV-Spectr test system constructed on the base of
      recombinant proteins and synthetic peptides allows separate detection of
      antibodies to E1/E2, core, HS3, NS4, and NS5 antigens of hepatitis C virus (HCV).
      The system is highly specific and more sensitive than the test systems used in
      screening studies, which allows its use as a final test for antiHCV antibodies.
      Antibodies to various HCV antigens were analyzed using this test system in
      patients with acute and chronic hepatitis C and asymptomatic donors with antiHCV.
      In acute hepatitis C during the first-second week after clinical manifestation,
      antibodies to nonstructural virus proteins are detected 3-4 times less often than
      in chronic hepatitis C. Acute hepatitis C is characterized by the presence of
      antibodies only to core antigen (66%). In chronic condition combinations of
      antibodies to structural and nonstructural HCV antigens predominate: core + NS4,
      core + NS3 + NS4, core + NS3 + NS5, core + NS4 + NS5, and core + NS3 + NS4 + NS5.
      In asymptomatic donors with antiHCV and in patients with chronic hepatitis C the
      spectra of antibodies were similar in 45.7% cases.

PMID- 11200647
TI  - [Comparative study of the reactivity, safety and immunogenicity of "Havrix"
      inactivated hepatitis A vaccine].
AB  - This paper sums up the results of controlled field clinical trials of adult and
      childhood variants of Harvix, inactivated vaccine from hepatitis A. The vaccine
      is weakly reactogenic and safe. After a single injection of Harvix-1440 vaccine
      to adults the percentage of seroconversions in previously seronegative
      individuals was 80.6%, with the mean geometrical antibody titer 119 mIU/ml. In
      children aged 3-10 years the percentage of seroconversions after a single
      injection of Harvix-720 vaccine was 100%, the mean geometrical of antibody titer
      being 427 mIU/ml. Results of laboratory control and field clinical trials
      recommend both variants of Harvix vaccine for prevention of hepatitis A in the
      Russian Federation.

PMID- 11200649
TI  - [Use of in situ hybridization and reverse transcriptase polymerase chain reaction
      in situ methods for studying infection caused by the hepatitis C virus].
AB  - Low level of hepatitis C virus (HCV) replication in hepatocytes does not provide
      reliable morphological or ultrastructural criteria for detecting an HCV infection
      by optic and electron microscopy. On the other hand, detection of cellular and
      subcellular location and tropism of HCV and comparison of virus replication in
      infected tissues with the level of viremia in patients with hepatitis C require
      modern methods, combining morphological and molecular biological aspects of
      diagnosis, such as in situ hybridization (ISH) and reverse transcription
      polymerase chain reaction in situ (RT-PCR in situ). The target for ISH is HCV
      RNA, while for RT-PCR in situ it is amplified HCV cDNA, which notably improves
      the sensitivity of hybridization.

PMID- 11200650
TI  - [Left ventriculoplasty for non-ischemic cardiomyopathy with severe heart failure
      in 70 patients].
AB  - OBJECTIVES: Treatment of cardiac failure due to non-ischemic cardiomyopathy by
      left ventriculoplasty using partial left ventriculectomy (Batista operation) or
      septal anterior ventricular exclusion was evaluated. METHODS: Left
      ventriculoplasty was performed in 70 patients (59 men and 11 women with a mean
      age of 51 years) from December 1996 to June 2000. Preoperative New York Heart
      Association (NYHA) functional class was IV in 43 patients including 29 receiving
      inotropic support, and class III in 27 patients. Nineteen patients required
      emergency surgery because of on-going shock and 51 patients were operated
      electively. Combined cardiac procedures were mitral valve reconstruction in 62
      patients (45 replacements, 17 repairs), tricuspid annuloplasty in 37, and aortic
      valve replacement in 4. The initial 24 patients underwent typical Batista
      operation regardless of myocardial viability. The other 46 patients underwent
      selective ventriculoplasty to excise or exclude the weakest part according to the
      findings of the intraoperative echo-guided volume reduction test. RESULTS: The
      intraaortic balloon pump was used in 12 patients and the left ventricular assist
      device in 2 patients. Three (5.9%) of the 51 patients who underwent elective
      operation and 12 (63.2%) of the 19 patients with emergency operation died in the
      hospital, giving an overall hospital mortality of 21.4% (15/70). Hospital
      mortality was reduced from 33.3% (8/24) in the initial 24 patients to 15.2%
      (7/46) in the recent 46 patients with the volume reduction test. Mean ejection
      fraction increased from 22.2 +/- 6.7% to 29.6 +/- 6.0%. Diastolic dimension
      decreased from 81.1 +/- 9.5 to 69.8 +/- 19.2 mm. End-diastolic and systolic
      volume indices decreased from 199.0 +/- 47.9 to 124.1 +/- 34.9 ml/m2 and from
      154.0 +/- 41.2 to 89.3 +/- 31.7 ml/m2, respectively, at one postoperative month
      in the 55 hospital survivors. The mean pulmonary capillary wedge pressure
      decreased from 25.6 +/- 7.8 to 13.6 +/- 4.5 mmHg. Serum brain natriuretic peptide
      decreased from 999 +/- 647 preoperatively to 547 +/- 362 pg/ml one month after
      the operation. Thirteen patients (18.6%) died in the late period mainly due to
      heart failure. Among the 42 survivors, 37 patients returned to NYHA functional
      class I-II, and cardiac events were rare after one postoperative year. Actuarial
      survivals at 3 years in elective and emergency operations were 71.9% and 33.3%,
      respectively. CONCLUSIONS: Left ventriculoplasty is acceptably safe for elective
      operation and clinical improvement can be obtained by proper surgical procedures
      and careful postoperative medical treatment.

PMID- 11200651
TI  - Impaired ability to secrete atrial natriuretic peptide in response to
      isoproterenol infusion in patients with dilated cardiomyopathy.
AB  - OBJECTIVES: The myocardium has 2 functions in vivo, that of pump and endocrine
      organ. Therefore, simultaneous examinations of cardiac systolic reserve and
      endocrine reserve are important in evaluating the activities of the myocardial
      cells. This study investigated the relationship between cardiac systolic reserve
      and secretion of atrial natriuretic peptide (ANP) in response to isoproterenol
      infusion in patients with dilated cardiomyopathy. METHODS: Isoproterenol was
      infused intravenously in 6 healthy individuals (control group) and 32 patients
      with dilated cardiomyopathy. The left ventricular systolic responses and plasma
      ANP concentrations were measured. RESULTS: Patients with dilated cardiomyopathy
      were classified into 2 groups: patients with a good response (change in
      fractional shortening > 7%, 17 patients) and those with a poor response (change
      in < or = 7%, 15 patients). There was no significant difference in end-diastolic
      dimension, fractional shortening, heart rate, or systolic blood pressure between
      the 2 groups of patients with dilated cardiomyopathy at rest. The resting plasma
      ANP concentration in the poor-response group (88.8 +/- 59.0 pg/ml) was
      significantly higher than that in the other 2 groups (good: 47.0 +/- 35.9 pg/ml,
      p < 0.05, control: 9.8 +/- 4.1 pg/ml, p < 0.01, respectively). The percentage
      change in ANP after isoproterenol infusion in the poor-response group (-7.1 +/-
      16.7%) was significantly less than that in the other 2 groups (good: 12.6 +/-
      27.3%, p < 0.05, control: 31.5 +/- 24.6%, p < 0.01, respectively). CONCLUSIONS:
      The resting plasma ANP concentration can be used to evaluate the cardiac systolic
      reserve in patients with dilated cardiomyopathy. Decreased myocardial systolic
      reserve is also associated with impaired ability to secrete ANP.

PMID- 11200652
TI  - [Clinical significance of coronary flow reserve in hypertrophied heart:
      comparison with Doppler index, hemodynamics and plasma natriuretic peptide
      concentrations].
AB  - OBJECTIVES: The relationship was investigated between coronary flow reserve and
      Doppler echocardiographic parameters, hemodynamic parameters and plasma
      natriuretic peptide concentrations in the hypertrophied heart. METHODS: The
      subjects were 19 patients with hypertrophied heart due to various etiologies and
      no significant coronary artery stenosis. All patients were in sinus rhythm. The
      left ventricular wall thickness, the E/A ratio in transmitral flow velocity
      pattern and the Doppler index were determined by Doppler echocardiography, and
      the plasma atrial and brain natriuretic peptide concentrations were measured. At
      cardiac catheterization, pulmonary capillary wedge pressure and left ventricular
      end-diastolic pressure were measured, and the coronary flow reserve was obtained
      by injecting intracoronary adenosine triphosphate into the left anterior
      descending artery using a Doppler guidewire. RESULTS: Coronary flow reserve in
      the patients was significantly lower than in 11 normal control subjects (2.50 +/-
      0.76 vs 3.90 +/- 0.64, p < 0.001). There were no significant correlations between
      coronary flow reserve and the left ventricular wall thickness or the E/A ratio.
      The mean value of the Doppler index in the patients was 0.48 +/- 0.10 and there
      was a significant negative correlation between coronary flow reserve and the
      Doppler index (r = -0.73, p < 0.001). The correlation between coronary flow
      reserve and left ventricular end-diastolic pressure was not significant, but
      there was a significant negative correlation between coronary flow reserve and
      pulmonary capillary wedge pressure (r = -0.64, p < 0.01). There were significant
      negative correlations between coronary flow reserve and atrial (r = -0.62, p <
      0.01), or brain natriuretic peptide concentrations (r = -0.56, p < 0.05).
      CONCLUSIONS: Coronary flow reserve may reflect overall cardiac performance
      evaluated by the Doppler index and plasma natriuretic peptide concentrations in
      the hypertrophied heart, and the measurement of coronary flow reserve may be
      useful for evaluating disease severity in patients with hypertrophied heart.

PMID- 11200653
TI  - [Effects of cilostazol in patients with bradycardiac atrial fibrillation].
AB  - OBJECTIVES: Cilostazol, an antithrombotic agent, directly and indirectly
      increases the heart rate. This study investigated whether cilostazol increases
      the heart rate, and whether it has chronotropic effects on cardiac failure in
      patients with bradycardiac atrial fibrillation. METHODS: Twelve patients (6 males
      and 6 females) with bradycardiac atrial fibrillation underwent Holter monitoring
      (24-hour total heartbeat counts and frequency of pause), echocardiography (left
      ventricular end-diastolic diameter, percentage fractional shortening), chest
      roentgenography (cardiothoracic ratio), and measurements of brain natriuretic
      peptide and atrial natriuretic peptide before and 6 months after daily oral
      administration of 100-200 mg cilostazol. RESULTS: Cilostazol administration
      increased the 24-hour total heartbeat counts from 69,685 +/- 1,690 (mean +/- SE;
      mean heart rate: 48 beats/min) to 87,352 +/- 3,123 (60), and decreased the
      frequency of pause from 362.3 +/- 72.9 to 112.3 +/- 41.0. Cardiothoracic ratio
      decreased from 55.8 +/- 1.1% to 52.5 +/- 1.1%, left ventricular end-diastolic
      diameter from 56.1 +/- 0.9 to 52.9 +/- 0.8 mm, but percentage fractional
      shortening was not significantly changed (from 33.0 +/- 2.2% to 33.7 +/- 2.1%).
      Brain natriuretic peptide decreased from 97.9 +/- 20.5 to 33.5 +/- 4.8 pg/ml, and
      atrial natriuretic peptide from 69.5 +/- 12.1 to 46.7 +/- 8.3 pg/ml. CONCLUSIONS:
      Cilostazol has beneficial effects in patients with bradycardiac atrial
      fibrillation. The increase of heart rate may be mediated by improvement of
      conductivity in the atrioventricular node and increase of coronary blood supply
      caused by dilation of vessels.

PMID- 11200654
TI  - [Clinical validation of accuracy of anatomical M-mode measurements: effect of
      harmonic imaging].
AB  - OBJECTIVES: Recent advances in ultrasound technology allow reconstruction of
      images from stored radiofrequency information and creating of M-mode
      echocardiograms along an M-mode cursor of any direction (anatomical M-mode
      echocardiography). METHODS: The accuracy of the measurements obtained by
      anatomical M-mode echocardiography was evaluated by comparing the measurements
      with those by B-mode echocardiography with or without harmonic imaging in 8
      normal subjects and 14 patients with cardiac disorders. Measurements used the
      left ventricular short-axis image in 4 different directions (0 to 6, 3 to 9, 1 to
      7 and 5 to 11 o'clock). RESULTS: Anatomical M-mode and B-mode measurements showed
      good linear relationships with correlation coefficients of 0.90 to 0.99 in any of
      the 4 directions. However, measurements in the lateral direction (3 to 9 o'clock)
      showed larger errors than those in the other directions (p < 0.05). With the use
      of harmonic imaging, the errors tended to become smaller, although it did not
      reach statistical significance. CONCLUSIONS: Anatomical M-mode echocardiography
      accurately measures the left ventricular internal diameter in any direction
      except the lateral direction. Harmonic imaging is useful to decrease the errors.

PMID- 11200656
TI  - [On the occasion of the 30th anniversary of the Japanese College of Cardiology].

PMID- 11200655
TI  - [Mitral valve tumor incidentally found after cerebral infarction].

PMID- 11200657
TI  - [Japanese College of Cardiology in the 20th century and hopes for the 21st
      century].

PMID- 11200658
TI  - [Acetyl starch as volume substitute, a possible alternative to HES].
AB  - OBJECTIVES: Pharmacokinetics and tolerability of acetyl starch (ACS) in
      comparison to hydroxyethyl starch (HES) were investigated after repeated
      intravenous infusions. METHODS AND COHORTS: A 500 ml solution of ACS (n = 8) or
      HES (n = 9) was infused to male volunteers (Age 25-42 Years) over four hours on
      five consecutive days. RESULTS: Comparing the pharmacokinetic parameters, marked
      differences were found between ACS and HES. A continuos increase of Cmax, AUC0-24
      and t1/2 over the five days caused by administration of HES was due to an
      accumulation of HES in serum. However, after administration of ACS all these
      parameters remained unaltered. The repeated infusion of 50 g ACS did not cause
      any changes of the acid-base-status. The influence of ACS on the coagulation
      parameters was comparable to that of HES and due to dilution effects. The acetic
      acid concentration increased up to 2.96 +/- 0.67 mg/dl following ACS infusion.
      The blood glucose concentration was not influenced by the infusion of HES or of
      ACS. The repeated ACS infusions were well tolerated. In contrast to HES, ACS did
      not accumulate in serum. CONCLUSION: According to these data ACS is an
      alternative to HES for volume replacement. Well-known side effects due to long
      storage of HES in tissues may not occur following application of ACS. However,
      the wide usage of ACS is restricted by the limited stability of ACS solutions at
      room temperature. ACS solutions are thus only stable during storage at lower
      temperatures.

PMID- 11200660
TI  - [Oral rapid desensitization with rifampicin].

PMID- 11200659
TI  - [Solitary fibrous thoracic wall tumor. Progression with percutaneous
      radiotherapy].
AB  - HISTORY AND CLINICAL FINDINGS: A 81-year-old patient free of pain was referred to
      the university hospital for further evaluation and therapy of tumour masses in
      the right thorax. Clinical examination revealed dullness to percussion and
      reduced breathing in the right lower lung. INVESTIGATIONS: Computed tomography
      showed an enlarged solid tumour mass attached to the thoracic cavity and pleural
      effusion on the right side. Quantification of pulmonary perfusion presented
      significant defects in the right upper and middle lobe. DIAGNOSIS, TREATMENT AND
      COURSE: The pulmonary masses were biopsied under CT-guidance. Biopsy and
      immunohistochemical findings proved a malignant solitary fibrous tumour of the
      chest wall, a mesenchymal tumour of its own entity. Because of pain in the right
      arm and because of missing other reliable therapeutic options a palliative
      irradiation was performed. The tumour did increase in size due to radiotherapy
      and a severe right ventricular heart failure occurred. The patient died 5 months
      after diagnosis has been made. Autopsy revealed a transition of tumour cells to
      sarcomatic growth. CONCLUSION: In our case we conclude an accelerated progression
      of the solitary fibrous chest wall tumour in the course of irradiation. Whether
      the development of sarcomatic growth occurred as a result of radiotherapy remains
      speculative.

PMID- 11200661
TI  - [Polygene diseases: use of inbred mice for identification of disease-relevant
      genes].

PMID- 11200662
TI  - [Diagnosis of cystic echinococcosis].

PMID- 11200663
TI  - [Treatment of risk factors in primary prevention of cerebral ischemia].

PMID- 11200664
TI  - [Forfeit of future reimbursement requests by patients from private health
      insurance].

PMID- 11200665
TI  - [Iodine deficient diet?]].

PMID- 11200666
TI  - [Life threatening hypercalcemia in a young man with ALL].
AB  - HISTORY AND ADMISSION FINDINGS: A 16-year-old man experienced fatigue, vomiting
      and diffuse abdominal pain. Since 4 days he had myalgia in both arms and legs. On
      examination only a tachycardia of 110/min was noticed. INVESTIGATIONS: Laboratory
      tests revealed hemoglobin 12.7 g/dl, leucocytes 10,300/microliter, platelets
      89,000/microliter, LDH 191 U/l, sodium 134 mmol/l, potassium 2.76 mmol/l, calcium
      4.52 mmol/l (I), creatinine 1.13 mg/dl, urea 72 mg/dl, uric acid 11.2 mg/dl. The
      levels of PTH (0 pg/ml), PTH-related peptide, vitamin D, vitamin A, IGF-1, STH, 5
      HIES and interleukin 6 were within normal limits. TNF-alpha 25.9 pg/ml (< 8.1).
      The electrocardiography revealed a sinus rythm with a QT-time of 0.28 s (= 100%).
      Multiple osteolytic bone leasions were seen in thoracic CT-scan. Abdominal
      sonography showed normal liver structure, multiple subhepatic lymph nodes without
      splenomegaly. The cytologic examination of the bone marrow demonstrated a diffuse
      infiltration by a common acute leukemia. TREATMENT AND COURSE: The rehydration
      with physiologic saline (3500 ml/d) was initiated in the ICU. Furosemide was
      added for further renal excretion. Additionally prednisone (100 mg/d) and
      calcitonin (300 I.E./d) were given. The calcium level fell within two days. No
      cardiac arrhythmia nor acute renal failure were seen. After definitive diagnosing
      the patient was treated corresponding to a specific protocol. One year later the
      relapsing ALL was diagnosed also by hypercalcemia (5.9 mmol/l). The level of TNF
      alpha before and after correction of hypercalcemia was 20 pg/ml. CONCLUSION: The
      acute treatment of hypercalcemia is independent of the underlying cause
      (rehydration with physiologic saline, renal excretion with furosemide, inhibition
      of osteoclastic activity). The main causes are hyperparathyreoidism or
      malignancys (90%). We describe TNF-alpha as a possible marker of tumoral load of
      a common ALL but we are not able to reveal a correlation between TNF-alpha and
      the calcium level.

PMID- 11200667
TI  - [AIDS--no magic (healing) in sight].

PMID- 11200668
TI  - Isolation and characterization of beta-galactosidase from Lactobacillus
      crispatus.
AB  - beta-Galactosidase was isolated from the cell-free extracts of Lactobacillus
      crispatus strain ATCC 33820 and the effects of temperature, pH, sugars and
      monovalent and divalent cations on the activity of the enzyme were examined. L.
      crispatus produced the maximum amount of enzyme when grown in MRS medium
      containing galactose (as carbon source) at 37 degrees C and pH 6.5 for 2 d,
      addition of glucose repressing enzyme production. Addition of lactose to the
      growth medium containing galactose inhibited the enzyme synthesis. The enzyme was
      active between 20 and 60 degrees C and in the pH range of 4-9. However, the
      optimum enzyme activity was at 45 degrees C and pH 6.5. The enzyme was stable up
      to 45 degrees C when incubated at various temperatures for 15 min at pH 6.5. When
      the enzyme was exposed to various pH values at 45 degrees C for 1 h, it retained
      the original activity over the pH range of 6.0-7.0. Presence of divalent cations,
      such as Fe2+ and Mn2+, in the reaction mixture increased enzyme activity, whereas
      Zn2+ was inhibitory. The Km was 1.16 mmol/L for 2-nitrophenyl-beta-D
      galactopyranose and 14.2 mmol/L for lactose.

PMID- 11200669
TI  - Effect of the carbon source on assessment of degrading bacteria with the spread
      plating technique during in situ bioremediation.
AB  - Spread-plating belongs to traditional microbiological methods employed for
      quantification of subsurface microflora during bioremediation projects in the
      Czechia. Concentration of degrading organisms is estimated from the number of
      colonies grown on agar plates supplied with contaminant as the sole carbon
      source. The data obtained during in situ bioremediation of the Dacice site
      contaminated by cutting oil suggests that changes in the composition of the
      carbon source in the subsurface may cause a discrepancy between laboratory data
      and situation in subsurface.

PMID- 11200670
TI  - Effects of increasing doses of UV-B radiation on photosynthesis and motility in
      Chlamydomonas reinhardtii.
AB  - Effects of increasing doses of UV-B radiation on photosynthetic efficiency (PE)
      and motility in Chlamydomonas reinhardtii were investigated. The exposure time
      ranged from 10 to 120 min at 0.73 W/m2 UV-B radiation. A decrease in compensation
      points (CP) was followed by an increase in PE on extending the UV-B treatment up
      to 60 min. The subsequent increase in PE was accompanied by increasing CPs.
      Enhanced doses of UV-B radiation thus have a stimulatory effect on the PE in C.
      reinhardtii. No inhibitory effects could be detected. No statistically
      significant differences in motility could be observed due to an extremely high
      variation of values.

PMID- 11200671
TI  - Postantibiotic effects of gentamicin and netilmicin on Serratia marcescens:
      effects on hydrophobicity and motility.
AB  - The impact of postantibiotic effect (PAE) of aminoglycosides (gentamicin,
      netilmicin) on cell-surface hydrophobicity and motility of a clinical isolate
      Serratia marcescens was evaluated. For the induction of PAE 2x and 4xMIC
      concentrations of both antibiotics were used. Gentamicin and netilmicin induced a
      PAE of similar duration after 2xMIC concentration (2.7 and 2.8 h, respectively).
      Both aminoglycosides demonstrated concentration-dependent PAE. At a concentration
      of 4xMIC they produced PAEs of 5.9 and 8.2 h, respectively. The evaluation of
      hydrophobic properties of S. marcescens after affecting PAE showed that both
      aminoglycosides inhibited adherence to xylene. This inhibition was also
      concentration-dependent. More expressive was netilmicin which inhibited the
      adhesion by 70.5% at 2xMIC and by 85.2% at 4xMIC. Netilmicin inhibited also the
      adhesion to nitrocellulose filter by 34.7% at 4xMIC. Exposure of the bacterial
      cells to suprainhibitory concentrations of both aminoglycosides resulted only in
      moderate inhibition of motility of strain tested compared to the unexposed cells.

PMID- 11200672
TI  - Induction of colony morphology variation in Rhodotorula gracilis by UV
      irradiation.
AB  - Nonlethal UV irradiation induced an unusually high frequency of colony morphology
      variation in Rhodotorula gracilis. The variation was not fixed but indicated
      further variability in subsequent platings. Microscopic examination of the
      cultures indicated that UV-irradiated variants had grossly varying types of
      shapes and arrangements of cells in contrast to the uniformly shaped and budding
      cells of the nonirradiated culture. Flow-cytometric analysis of a colony variant
      suggested a slightly higher proportion of cells with variable DNA content than
      the nonirradiated culture. Extensive biochemical characterization revealed only
      one difference in that the nonirradiated culture had a partial requirement for
      pantothenate while the colony variant was completely independent of this
      requirement. We speculate that UV triggers a yet unstudied means of variability
      in R. gracilis with possible accompanying recombinational events.

PMID- 11200673
TI  - Immunoelectrophoretic analysis of medium-derived antigens bound to the surface of
      Mycoplasma hominis, Mycoplasma fermentans and Ureaplasma urealyticum.
AB  - We analyzed Mycoplasma hominis, Mycoplasma fermentans and Ureaplasma urealyticum
      antigens by immunochemical methods. The immunochemical reaction showed that all
      three species bound to the surface of one medium component, which origin stemmed
      from the horse serum. This substance functioned as one of the most potent
      components of mycoplasma immunogens for all three species.

PMID- 11200674
TI  - Detection of coxsackie B virus infection using a rapid screening method.
AB  - A Western blot method (WB) was adapted for rapid screening of antibodies against
      coxsackie virus B1-B6 in sera from patients with newly diagnosed insulin
      dependent diabetes mellitus, myocarditis or febrile syndrome of suspected
      coxsackie viral aetiology. The use of a mixture of all 6 coxsackie virus B
      serotypes as the common antigen permitted a very rapid and inexpensive detection
      of antibody-positive sera for preliminary diagnosis and further detailed assay.
      Comparison of the results with those obtained in parallel run virus
      neutralization tests showed a higher sensitivity and comparable specificity of
      WB.

PMID- 11200676
TI  - Loss of virus specific epitopes on JE virus 'E' glycoprotein by acetone
      treatment.
AB  - BACKGROUND & OBJECTIVES: Some Japanese encephalitis (JE) virus strains have been
      placed in group II based on the loss of reactivity against Hs (H = HI positive; s
      = JE virus specific) group of monoclonal antibodies (MAbs) in haemagglutination
      inhibition (HI) test employing sucrose acetone (SA) extracted antigens. Also
      acetone-fixation of cells infected with some of the virus strains results in the
      loss of immunofluorescence (IF) against virus specific MAbs. The present study
      was undertaken to elucidate the effect of acetone on virus specific
      haemagglutination (HA) epitopes expressed on 'E' glycoprotein of group II strains
      of JE virus. METHODS: Porcine kidney (PS) cells were infected with JE virus
      strains (2 group I Indian strains, 5 group II strains and one neutralization
      escape variant of 733913 group I strain). HI and complement fixation (CF) tests
      were carried out employing both polyethylene glycol (PEG) precipitated and SA
      extracted antigens of JE virus. RESULTS: Employing PEG precipitated antigens,
      Indian strain G9473 showed titres ranging from 1:40 to 1:160 against all the four
      virus specific HsMAbs and strain 641686 (1:160) with one of the four MAbs (Hs-1)
      by HI test whereas their SA extracted antigens did not react at all. In contrast,
      CF was positive employing both SA and PEG antigens in the presence of all four
      HsMAbs. The reactivity shown by PEG antigens in the HI test was confirmed by
      blocking the HA activity with the respective MAb. SA antigens, though negative in
      the HI test, were positive by the blocking assay. Interestingly, some of the non
      HI MAbs which were negative against SA antigens, showed positive HI reaction with
      PEG antigens. Also, additional epitopes on Japanese (Yoken), Sri Lankan (691004)
      and two Indian (755468 and 641686) JE virus strains were detected either by
      blocking HA or surface IF. INTERPRETATION & CONCLUSIONS: It seems that the
      acetone treatment might result in HA property of the antigen which is no longer
      inhibited by an antibody in the HI test. The characterization of such labile and
      conformation-dependent epitopes is currently been undertaken to elucidate their
      role either in protection or immunopathogenesis of JE.

PMID- 11200677
TI  - Clinical implications of hepatitis G virus (HGV) infection in patients of acute
      viral hepatitis & fulminant hepatic failure.
AB  - BACKGROUND & OBJECTIVES: Viral hepatitis is a major public health problem
      especially in developing countries such as India. Hepatitis viruses A, B, C, D
      and E are all well characterized and molecularly defined agents with unequivocal
      association with human liver disease but there is evidence of hepatitis in humans
      caused by certain transmissible agents which cannot be classified with the above
      hepatotoric viruses. The role of recently discovered hepatitis G virus (HGV/GBV
      C) as an independent heaptitis agent is controversial. Recently, we have shown a
      relatively high frequency of HGV infection in fulminant hepatic failure but the
      virus was often detected in co-infection with hepatitis B or E virus. The present
      study has therefore been carried out to evaluate the clinical significance of HGV
      infection in acute viral hepatitis (AVH) and fulminant hepatic failure (FHF)
      through follow up of HGV positive patients till their clinical and biochemical
      recovery. METHODS: The study included 50 patients comprising 35 of AVH and 15 of
      FHF. These patients were evaluated on the basis of history, physical examination,
      liver function profile and serological markers for hepatitis A, B, C and E. Those
      patients serologically negative for HBV and HCV infection were further screened
      for HBV DNA and HCV RNA by PCR. All the samples were screened for presence of HGV
      RNA by RT-PCR using inner and outer primers sequences selected from NS3 helicase
      region of the HGV genome. FHF patients who died were subjected to postmortem
      liver biopsy and these biopsy specimens were also screened for HGV-RNA. Repeat
      detection of HGV-RNA was done after clinical and biochemical recovery of the
      patients. RESULTS: Of 35 AVH patients, HGV infection was detected in 5 patients
      (14.3%) while 4 of 15 patients (26.6%) in the FHF group were positive for HGV
      RNA. Five HGV positive AVH patients were followed till clinical and biochemical
      recovery and all of them tested positive for HGV-RNA at follow up (6 weeks to 6
      months). Out of 4 HGV positive FHF patients, only one survived and his repeat
      sample after clinical and biochemical recovery tested positive for HGV-RNA.
      INTERPRETATION & CONCLUSIONS: The results suggest that HGV infection does occur
      in patients of AVH and FHF and HGV viraemia persists for a long time even after
      clinical and biochemical recovery. These observations point towards a possible
      non-pathogenic role of hepatitis G virus infection.

PMID- 11200678
TI  - Analysis of serological evidence of different hepatitis viruses in acute viral
      hepatitis in prisoners in relation to risk factors.
AB  - BACKGROUND & OBJECTIVES: The present study describes an outbreak of acute viral
      hepatitis in an institutional population (inmates of a prison) with an aim to
      delineate the etiological agents of this outbreak and to analyse the clinical,
      biochemical and serological evidence of different hepatitis viruses in relation
      to risk factors. METHODS: Fifty patients of acute viral hepatitis identified
      during the outbreak were evaluated on the basis of history, clinical examination,
      risk factor distribution, biochemical profile and serological markers for
      hepatitis A-E infection. Adequate epidemiological data were collected from prison
      administration including housing of prisoners, food and water supply. RESULTS: Of
      the 50 patients, 35 (70%) had serological evidence of HEV infection. Evidence of
      HBV infection was found in 17 patients (34%), HAV infection in 2 (4%) and HCV in
      8 (16%) patients. While 16 patients (32%) had evidence of multiple viral
      infections, none of the viral markers could be detected in 8 patients (16%). One
      or more risk factor(s) could be identified in more than half of the subjects
      (26/50; 52%). There were 11 patients who gave history of more than one risk
      factor while 24 (48%) patients had none of the risk factors. INTERPRETATION &
      CONCLUSIONS: HEV was found to be the major cause of the outbreak and
      contamination of drinking water supply could be the possible source of infection.
      This outbreak was seroepidemiologically similar to other outbreaks of hepatitis
      occurring in the country with HEV being the most common cause. However, there was
      evidence of multiple viral infections, particularly HBV and HCV in the high-risk
      predisposed prison population.

PMID- 11200679
TI  - Enteroaggregative Klebsiella pneumoniae in association with childhood diarrhoea.
AB  - A total of 19 strains of Klebsiella pneumoniae isolated as sole pathogen from
      children with diarrhoea were used to study their virulence mechanism using
      different assays. Eith strains of K. pneumoniae exhibited aggregative adherence
      that was distinct from the stacked brick enteroaggregative pattern shown by
      Escherichia coli. The study suggests the presence of a new virulence mechanism in
      the pathogenesis of Klebsiella-associated diarrhoea.

PMID- 11200680
TI  - Prevalence of Trichuris trichiura in relation to socio-economic & behavioural
      determinants of exposure to infection in rural Assam.
AB  - BACKGROUND & OBJECTIVES: Stunting, anaemia, and the poor level of mental
      development are known to be associated with Trichuris trichiura infections.
      However, no information is available on the socio-environmental predictors
      relevant to Trichuris infection in rural communities. Whilst geohelminthic
      infections per se is an inevitable consequence of poor personal hygiene and
      household sanitation, the importance of specific factors in the epidemiology of
      Trichuris infection have not been formally investigated. The objective of this
      study was to explore, quantify and study different socio-environmental risk
      factors and find out their possible interaction vis-a-vis T. trichiura infection.
      METHODS: The study population consisted of 244 children (aged 15 yr and below)
      and 336 adults selected from 144 randomly selected households belonging to three
      villages of upper Assam. The prevalence rate ratio (PRR; = relative risk) and 95
      per cent confidence interval (CI) were calculated. Univariate, multivariate
      analysis using Cox's proportional hazards regression assuming constant risk
      period and a tree-based risk factor analysis, were used. RESULTS: In the overall
      multivariate model, open field defaecation, large family size, and three or more
      children in the household were found independently associated with Trichuris
      infection. Gender specific analysis revealed that in females the age was also
      independently associated with increased risk of infection whereas in males, earth
      flooring was the most significant risk factor independently associated with the
      risk of Trichuris infection. Tree-based risk factor analysis indicated
      interaction between defaecating habits of people and the source of drinking
      water. INTERPRETATION & CONCLUSIONS: Installation of pit latrines (if not
      sanitary latrines) together with provision for safe drinking water and the
      construction of cement floors would probably reduce community prevalence of T.
      trichiura effectively.

PMID- 11200675
TI  - Early expression of herpes simplex virus (HSV) proteins and reactivation of
      latent infection.
AB  - During the last decade, new data accumulated describing the early events during
      herpes simplex virus 1 (HSV-1) replication occurring before capsid formation and
      virion envelopment. The HSV virion carries its own specific transcription
      initiation factor (alpha-TIF), which functions together with other components of
      the cellular transcriptase complex to mediate virus-specific immediate early (IE)
      transcription. The virus-coded IE proteins are the transactivator and regulatory
      elements modulating early transcription and subsequent translation of
      nonstructural virus-coded proteins needed mainly for viral DNA synthesis and for
      the supply of corresponding nucleoside components. They also cooperate at the
      late transcription and translation of the virion (capsid, tegument and envelope)
      proteins. In addition, the transactivator IE proteins down-regulate their own
      transcription, while others facilitate viral mRNA processing or interfere with
      the presentation of newly synthesized virus antigens. Establishment of latency is
      closely related to the transcription of a separate category of transcripts,
      termed latency-associated (LAT). Formation of LATs occurs mainly in nondividing
      neurons which are metabolically less active and express lower levels of cellular
      transcription factors (nonpermissive cells). Expression of the stable non-spliced
      (2 kb), and especially of stable spliced (1.5 and 1.45 kb) LATs is a prerequisite
      for HSV reactivation. Different HSV genomes (from various HSV strains) do not
      undergo IE transcription at the same rate. Restricted IE transcription and the
      absence of viral DNA synthesis favors LAT formation and persistence of the
      silenced genome. Uneven levels of LAT expression and differences in the metabolic
      state of carrier neurons influence the reactivation competence. Under artificial
      or natural activation conditions, sufficient amounts of IE transactivator
      proteins and proteins promoting nucleoside metabolism are synthesized even in the
      absence of the viral alpha-TIF facilitating reactivation.

PMID- 11200681
TI  - [Genetics and urology].

PMID- 11200682
TI  - Truth and consequences.

PMID- 11200683
TI  - Dilemmas in the management of patients with arteriovenous malformations.
AB  - An arteriovenous malformation (AVM) consists of one or more arteries that drain
      through one or several small openings directly into one or more veins. The
      capillary system between arteries and veins is missing. The natural history of an
      unruptured AVM demonstrates a 1-2% bleeding rate and once ruptured a 2-4% annual
      risk of rebleeding. There is a risk of dying of AVM up to 1% per year, a 1%
      annual risk of developing de novo epilepsy, and a 1% chance of disability per
      year. Small AVMs are more likely to rupture than large AVMs. The goal of
      treatment is complete obliteration of the malformation. The risk of surgical
      treatment depends mainly on its size, location and drainage pattern. Size and
      angioarchitecture determine the risks of embolotherapy and radiotherapy. AVMs in
      Spetzler-Martin grades I-III should be treated by microneurosurgery or a
      combination of embolotherapy and microneurosurgery. They can be excised with low
      surgical mortality and morbidity. For AVMs in Spetzler-Martin grades IV and V
      staged treatment approaches such as embolotherapy followed by surgery or
      radiotherapy should be considered. Rarely is embolotherapy or radiotherapy alone
      indicated. There are AVMs in Spetzler-Martin grades IV and V that may be
      inaccessible for surgical or any other treatment, and that should be left alone.
      Prospective randomised trials on the optimal management of AVMs are lacking. All
      our knowledge on AVMs stems from open series and indirect comparisons.

PMID- 11200684
TI  - Creutzfeldt-Jakob disease: heat shock protein 70 mRNA levels in mononuclear blood
      cells and clinical study.
AB  - Prion diseases such as Creutzfeldt-Jakob disease (CJD) are associated in most
      cases with the accumulation of an unusual isoform of prion protein (PrPSC). PrPSC
      is derived from the abnormal folding of the cellular isoform of prion protein
      (PrPC). On the other hand, heat shock protein is known to ensure proper protein
      assembly and folding and to facilitate proteolytic digestion of abnormal or
      denatured proteins. Many studies have therefore hypothesized that heat shock
      protein is linked to prion disease. We examined the relationship between heat
      shock protein HSP70 and prion disease in CJD patients. HSP70 mRNA levels in
      mononuclear blood cells (MBCs) were compared in 14 CJD patients (10 confirmed by
      histo-pathological study), 12 vascular dementia (VD) patients, 16 patients with
      Parkinson's disease and dementia (PD) and 14 nondemented control subjects. The
      possible correlation between HSP70 mRNA expression levels and clinical findings
      was also evaluated. HSP70 mRNA expression levels in MBCs were measured by
      northern blotting. HSP70 mRNA levels in MBCs from patients with CJD were
      significantly higher than those from patients with VD or PD and in nondemented
      controls. Age at symptom onset, dementia severity, disease duration and
      neuroimaging grade of CJD patients were not correlated with relative HSP70 mRNA
      levels. No significant relationship between HSP70 mRNA levels and ageing was
      found. These results suggest that measurement of HSP70 mRNA in MBCs might provide
      an auxiliary tool for the diagnosis of CJD.

PMID- 11200685
TI  - Anti-alpha B-crystallin immunoreactivity in inflammatory nervous system diseases.
AB  - alpha B-Crystallin, a small heat shock protein, is an immunodominant antigen with
      increased tissue expression in demyelination. To investigate the humoral response
      against alpha B-crystallin, the sera and CSF samples of patients with multiple
      sclerosis (MS), Guillain-Barre syndrome (GBS), neuro-Behcet's disease (NBD) and
      other non-inflammatory neurological diseases (NIND) were screened by enzyme
      linked immunosorbent assay for anti-alpha B-crystallin IgG and IgM antibodies.
      Serum and CSF IgG antibody responses to alpha B-crystallin were significantly
      elevated only in NBD patients (serum IgG, NBD 1.29 +/- 0.49 vs. NIND 0.95 +/-
      0.39, P = 0.01; CSF IgG, NBD 1.22 +/- 0.64 vs. NIND 0.81 +/- 0.35, P = 0.01).
      Similarly, high serum IgM antibody titres were also detected in NBD (1.83 +/-
      0.72 vs. 1.16 +/- 0.49, P = 0.0005) and in MS (1.57 +/- 1.07, P = 0.046), whereas
      elevated CSF IgM responses were observed only in GBS (2.09 +/- 1.09 vs. 1.41 +/-
      0.7, P = 0.007). Humoral responses against alpha B-crystallin are increased in
      NBD and GBS, which may implicate this central nervous system antigen in the
      causation and pathogenesis of these inflammatory nervous system disorders.

PMID- 11200686
TI  - Genotyping of presenilin-1 polymorphism in amyotrophic lateral sclerosis.
AB  - The mechanisms underlying motor neuron degeneration in amyotrophic lateral
      sclerosis are not fully understood. Recent studies suggest that apoptosis is
      involved in the abnormal neural death that occurs in this devastating disease.
      Presenilin-1, a transmembrane protein, seems to be implicated in apoptosis. To
      determine whether presenilin-1 intron 8 polymorphism has an influence in the
      course of amyotrophic lateral sclerosis, we examined this polymorphism genotypes
      in a large group of patients (n = 72) with amyotrophic lateral sclerosis and in a
      random sample of 213 healthy individuals. The results showed a significant
      difference in genotype (P < 0.04) and allele (P < 0.03) distribution between
      patients controls. These results suggest a possible intervention of presenilin-1
      in the pathogenesis of amyotrophic lateral sclerosis.

PMID- 11200687
TI  - Neurophysiological studies in acute transverse myelitis.
AB  - A systematic evaluation of anterior horn cell, motor and sensory pathways is
      possible by electromyography (EMG), motor (MEPs) and somatosensory (SEPs) evoked
      potentials, respectively, which may provide valuable information on acute
      transverse myelitis (ATM). In a prospective hospital-based study, EMG, MEP and
      SEP studies were carried out on admission and after 3 months in 39 patients with
      ATM. All the patients also underwent detailed clinical evaluation, and spinal
      magnetic resonance imaging (MRI) was performed in 28. Outcome was defined at the
      end of 3 months as poor, partial or complete recovery on the basis of functional
      status. Spinal MRI revealed hyperintense signal changes in T2 extending for two
      segments to the entire spinal cord. Central motor conduction time to tibialis
      anterior (CMCT-TA) was more frequently abnormal (90%), followed by tibial SEP
      (77%). CMCT to abductor digiti minimi (ADM) was abnormal in 30% and median SEP in
      15% of patients. Evidence of denervation on EMG was present in 51% of patients.
      The CMCT-TA improved in 48% patients and tibial SEP in 32%. Median SEP improved
      in all patients, and CMCT-ADM remained prolonged in two. At 3 months 2 patients
      had died, and 18 had poor, 10 partial and 9 complete recovery. CMCT was
      correlated with muscle power, tone, reflex and MRI changes. Patients' outcome of
      was correlated with CMCT, SEP and EMG. These results are consistent with
      pronounced involvement of dorsal region of spinal cord in ATM. MEP is more
      frequently abnormal than SEP.

PMID- 11200688
TI  - Acute-onset painful upper limb multifocal demyelinating motor neuropathy.
AB  - We report three patients who presented with acute onset of shoulder and upper arm
      pain followed within a few days by predominantly distal upper limb weakness.
      Nerve conduction studies showed severe and unequivocal focal motor conduction
      block in the forearm and/or upper arm along with slowing of motor conduction and
      prolonged F wave responses. Only very mild changes in sensory nerve conduction
      were found. One patient made partial clinical improvement after 17 months, and
      there was a significant improvement in the degree of motor conduction block and
      the motor conduction velocities. A second patient remained unchanged after 5
      months. Idiopathic brachial neuritis (IBN) typically presents acutely with
      brachialgia and acute or subacute non-progressive weakness. Multifocal motor
      conduction block in nerves in the arm or forearm has not been described in
      patients with IBN. Multifocal motor conduction block restricted to the upper
      limbs has been described in focal chronic inflammatory demyelinating
      polyneuropathy (CIDP) and in multifocal motor neuropathy with multifocal motor
      conduction block (MMNCB). However, both these conditions have hitherto usually
      been described as largely painless chronic progressive disorders with a subacute
      onset. Our patients, with features overlapping MMNCB/CIDP and IBN, represent an
      as yet unreported clinical variant.

PMID- 11200689
TI  - Essential tremor: an overdiagnosed condition?
AB  - The diagnosis of essential tremor (ET) and its differentiation from other types
      of tremor is often difficult. In 1994 Bain et al. defined a classical phenotype
      by studying 20 patients with pure essential tremor and similarly affected family
      members in at least three generations. We assessed how many of the patients
      diagnosed by different neurologists at our institution as having ET conformed to
      this defined phenotype. We randomly selected 50 patients who were diagnosed with
      ET by any neurologist at the National Hospital for Neurology and Neurosurgery
      since the publication of the Bain et al. report, and determined the number of
      patients who had clinical features compatible with the phenotype that it had
      defined. Only 25 (50%) of these patients had ET so defined. Ten patients clearly
      had alternative diagnoses: four had clear additional dystonia, two neuropathic
      tremor, two had unilateral leg tremor, one drug-induced tremor, and one sudden
      onset after head trauma. The remaining 15 patients also had atypical features
      including myoclonus (one), onset in a body part other than the arms (six), sudden
      onset (two), rest tremor (seven), onset after the age of 65 years (four), a
      family member with an isolated head tremor (one), or reduced armswing (two). The
      diagnosis of ET is overused even among experienced neurologists, and other types
      of tremor should be considered in atypical patients before making this diagnosis.

PMID- 11200690
TI  - Sensitivity and reproducibility of volume change measurements of different brain
      portions on magnetic resonance imaging in patients with multiple sclerosis.
AB  - The course of multiple sclerosis (MS) can be monitored by measuring changes in
      brain volume, but consensus is still lacking on the best strategy to be adopted.
      We compared the reproducibility and sensitivity of volume measurements from
      different brain portions for detecting changes on magnetic resonance imaging
      (MRI) in patients with MS. T1-weighted MRI of the brain was performed in 50
      patients with relapsing-remitting MS at study entry and after an average follow
      up of 18.4 months. Using a semiautomated technique for brain parenchyma
      segmentation, the volumes of the following brain portions were measured: (a) the
      whole brain (whole-brain volume, WBV), (b) the seven slices rostral to the velum
      interpositum (seven-slice volume, SSV), (c) the central slice of the image set
      (central-slice volume, CSV) and (d) the infratentorial regions (infratentorial
      brain volume, IBV). All these measurements were carried out by a single observer
      and were repeated twice on ten randomly selected scans to test the intra-observer
      reproducibility using the four strategies. At follow-up there was a significant
      decrease in all the measures of brain volume (P ranged from 0.002 to < 0.001).
      The univariate correlations between changes in WBV, SSV, CSV and IBV were all
      statistically significant, with the exception of that between changes in CSV and
      IBV; r values ranged from 0.34 (for the WBV/IBV correlation) to 0.80 (for the
      WBV/SSV correlation). The mean intra-observer coefficient of variations were 1.9%
      for WBV, 1.5% for SSV, 2.9% for CSV and 2.2% for IBV measurements. The
      measurement of volume on a portion of brain selectively including the regions in
      which MS pathology is more diffuse is as reliable and sensitive to disease
      related changes as that on the whole brain, with significant time saving for
      processing.

PMID- 11200691
TI  - Clinical screening for ulnar nerve damage in leprosy patients.

PMID- 11200692
TI  - Lack of alpha-synuclein gene mutations in families with autosomal dominant
      Parkinson's disease in Russia.

PMID- 11200693
TI  - Intramedullary cavernous angiomas and cerebrospinal fluid oligoclonal IgG bands.

PMID- 11200694
TI  - Jaw tremor in mitochondrial disease associated with the A to G 3243 point
      mutation.

PMID- 11200695
TI  - Transitional multiple sclerosis (Schilder's disease): a case report.

PMID- 11200696
TI  - Full recovery after acute hemorrhagic leukoencephalitis (Hurst's disease).

PMID- 11200697
TI  - The Miller Fisher syndrome: neurophysiological and MRI evidence of both
      peripheral and central origin in one case.

PMID- 11200698
TI  - Pierre Marie (1853-1940).

PMID- 11200699
TI  - Role of feature space in object-based visual attention.

PMID- 11200701
TI  - What has changed with riluzole?
AB  - Riluzole, after two significant trials, was introduced as the first standard
      treatment of amyotrophic lateral clerosis (ALS) in the early 95'. After 5 years
      what has changed in the field of ALS? In the field of basic science, riluzole as
      an active drug has largely contributed to stimulate the research of the possible
      role of glutamate in the genesis of ALS. However, the apparent simplicity of the
      relation between the drug and its mechanisms has to modulated in the light of the
      negativity of other trials (gabapentin) and the display of other mechanisms of
      the disease and of the compound. Possible relation with other putative mechanisms
      of ALS, as oxydative stress or growth factors, could be (and probably are) also
      involved. In the field of its activity, riluzole has an impact on the survival
      rate which has been largely debated. Comparison with historical databases are
      supporting the results of the two initial trials. Other information have been
      published supporting the probable activity of the drug on the muscle strength
      decline, a controversial matter. They strengthen the initial data and give
      additional reasons to use riluzole as a standard treatment of patients. In the
      field of the daily care, riluzole provided a real and unique hope for ALS
      sufferers. Even if its activity is not as complete as patients would have
      expected, it provides a hope for slowing down the rate of evolution and abolishes
      the myth of "no hope, no cure" which was the leitmotiv of patients care until
      recently. We have to better define the mode of administration with regard to the
      clinical status of the patients (respiratory disorders, fatigue, stiffness). In
      the field of care givers, riluzole was one major factor which provided the basis
      for national and international collaborations either for therapeutic trials or
      for standard of care. It made possible large collaborative programs in and among
      many countries. We do hope that this impulse will continue and be stimulated by
      additional results both in the field of basic science and clinical research.

PMID- 11200702
TI  - Genetics of amyotrophic lateral sclerosis.
AB  - The genetic cause of amyotrophic lateral sclerosis (ALS) is known in a minority
      of cases. Mutations in SOD1, the gene encoding a superoxide dismutase on
      chromosome 21, are indeed found in 20% of familial ALS patients, who constitute
      only 5 or 10% of all ALS patients. In rare cases, a mutation in NFH, the gene
      encoding the heavy subunit of neurofilament, is present. Familial ALS has been
      linked to other loci but the genes involved remain to be identified. A genetic
      component is also thought to at least contribute to the pathogenesis of sporadic
      ALS. Their identification is now possible thanks to progress in molecular
      genetics.

PMID- 11200700
TI  - Treatment of amyotrophic lateral sclerosis--what is the next step?
AB  - Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease which
      was thought to be untreatable. However, recent evidence in both experimental
      animals and men indicates that antiglutamatergic strategies are the first to have
      an influence on its pathogenesis and slow down the disease process. Since the
      effect of drugs is still small, this progress cannot only be seen as a success of
      the present but must also be acknowledged as a basis for future developments. How
      will future studies be designed? They will have to take into account that the
      disease presumably has a long preclinical period and they will use a number of
      novel compounds and treatment strategies which have been shown to be effective in
      transgenic animal models. This also implies that we are likely to use a
      combination of therapies and we will try to treat patients early. The latter will
      be associated with the demand for a novel clinical attitude toward the diagnosis
      of the disease and the development of novel markers for both the preclinical
      period and the longitudinal course of the disease.

PMID- 11200703
TI  - Guidelines in motor neurone disease (MND)/amyotrophic lateral sclerosis (ALS)-
      from diagnosis to patient care.
AB  - This paper reviews the scope of current guidelines in motor neurone disease
      (MND)/amyotrophic lateral sclerosis (ALS) and examines issues which have arisen
      in the preparation of these documents. The review concludes with an evaluation of
      the impact of the guidelines which have been produced to date and looks towards
      potential future developments in this area.

PMID- 11200705
TI  - [In Process Citation]

PMID- 11200704
TI  - [In Process Citation]

PMID- 11200706
TI  - Current developments and future directions of occupational health in Malaysia.

PMID- 11200707
TI  - Retrospective review of serologic rubella activity in University Hospital Kuala
      Lumpur.
AB  - A retrospective review of rubella serological results carried out in the Virus
      Diagnostic Unit, University Hospital Kuala Lumpur (UHKL) from January 1993 to
      September 1999 showed the presence of rubella infection annually which appeared
      to increase periodically every two to three years. There was no statistical
      significant difference in the rubella positive rate between male and female
      population aged 14 to 48 years. Congenital rubella infections (CRI) occurred in
      babies delivered in UHKL yearly from 1993 to 1998 with an average incidence rate
      of 48 per 100,000 deliveries. Peaks of rubella cases appeared to be followed by
      an increase in incidence of CRI cases 6 to 9 months later. The study showed that
      only 50.8% clinically diagnosed rubella was confirmed by laboratory finding. This
      study also showed an increase of rubella activity for the months of July, August
      and September 1999 and this may herald an increase of CRI cases in the coming
      millennium.

PMID- 11200708
TI  - Intravenous followed by oral ofloxacin in the treatment of community acquired
      lower respiratory tract infections in adults requiring hospitalisation.
AB  - Forty patients were treated with ofloxacin for community acquired lower
      respiratory tract infections. Eighteen pathogens were isolated in sputum;
      Streptococcus pneumoniae (4) and Haemophilus influenzae (4) were the most common,
      followed by Klebsiella pneumoniae (3), Klebsiella spp. (2), Staphylococcus anreus
      (2), Pseudomonas spp. (2), and Pseudomonas aeruginosa (1). Ofloxacin 200 mg every
      12 hours was administered for an average of 3.7 days intravenously followed by
      5.4 days orally. Response to therapy was judged to be cure in 38 (95%; 95% C.I.,
      85%-95%) patients, failure in one (2.5%) and "indeterminate" in one (2.5%).

PMID- 11200709
TI  - Breast cancer in pregnancy--our experience with six patients in the University
      Hospital, Kuala Lumpur.
AB  - Presentation of breast cancer during pregnancy is a rare situation and one that
      requires a multidisciplinary approach involving an obstetrician, surgeon and
      oncologist. Management should be along the same principles as in non-pregnant
      patients and delay is not justifiable. Mastectomy and axillary clearance is the
      best option, followed by chemotherapy, which is safe after the first trimester.
      Radiation if required should be delayed until after delivery of the baby. We
      present here our experience with 6 patients who presented with breast cancer
      during pregnancy. Five patients refused any treatment until after delivery, while
      one underwent only a mastectomy and axillary clearance. The outcome was poor; all
      of them died between 14 months and 52 months. The poor outcome probably reflects
      the late stage at presentation in four of the patients (State 3 and 4) rather
      than the delay in treatment, while delay in treatment in the two who presented
      with early cancer (Stage 1 and 2) led to a more advanced stage after delivery.

PMID- 11200710
TI  - The efficacy of side arm traction in the reduction of supracondylar fracture
      humerus in children.
AB  - 156 consecutive children with supracondylar fracture humerus were reviewed. Of
      these, 56 children with severely displaced fractures were treated with side arm
      traction. A retrospective review revealed that a mean post-reduction Baumann
      angle of 74.2 degrees for boys and 75.9 degrees for girls; and mean post
      reduction humero-ulna angle of 11.6 degrees for boys and 12.7 degrees for girls
      was achieved. A linear correlation was noted between the duration of traction and
      the age of the patient, older patients requiring longer traction. The region
      below the line in the graph, plotting the duration of traction (y-axis) versus
      the age of the patient (x-axis) shows when the fracture is unstable; and the
      region above the line shows when the fracture is stable and can only be reduced
      by surgery. 10 children presented late; 6 presented within the unstable period
      and were successfully reduced with traction; while 4 presented stable and
      required open reduction. We conclude that traction is an acceptable and safe
      method for reduction of this fracture, and can be used to reduce late
      presentations while their fractures are still unstable.

PMID- 11200711
TI  - Autoimmune markers in young Malaysian patients with type 1 diabetes mellitus.
AB  - This study determined the prevalence and significance of autoantibodies to GAD65
      (GAD Ab), insulin (IAA), tyrosine-like phosphatase (IA2) and islet-cell (ICA) in
      a group of 213 young Malaysian Type 1 diabetics, diagnosed before the age of 40
      years. Venous blood was taken at fasting, and at 6 minutes post-glucagon (1 mg
      i.v.). IAA was detected in 47.4%, GAD Ab in 33.8%, IA2 in 8.9% and ICA in 1.4% of
      the subjects. When based on post-glucagon C-peptide level of 600 pmol/L, 172
      (80.7%) patients had inadequate pancreatic reserve, while the remainder 41(19.3%)
      showed normal response. The autoantibodies, either alone or in combination, were
      detectable in both groups of patients; higher prevalence in those with poor or no
      beta-cell function (73.3% versus 46.3%, p = 0.0001). Although the prevalence of
      GAD Ab was highest in newly diagnosed patients (< 5 years), unlike IA2 and ICA,
      the marker remained detectable in 24-25% of those patients with long-standing
      disease. Nineteen patients could probably belong to the "latent autoimmune
      diabetes in adults (LADA)" subset, where pancreatic reserve was adequate but
      patients had detectable autoantibodies and insulin-requiring. On the other hand,
      68 of the 213 patients (32%) were seronegative, but presented with near or total
      beta-cell destruction. Thus, as has also been suggested by others, there is
      indeed etiological differences between the Asian and the Caucasian Type 1
      diabetics, and, there is also the possibility that other, but unknown
      autoantigens are involved in causing the pancreatic damage.

PMID- 11200712
TI  - Asthma education: how much does it improve knowledge of childhood asthma amongst
      medical students and paramedics?
AB  - The objective of this study was to measure the knowledge of childhood asthma
      among medical students and paramedics. A previously validated questionnaire about
      childhood asthma was completed by 281 of 314, third and fifth year medical
      students at Universiti Kebangsaan Malaysia, Kuala Lumpur. Their knowledge of
      asthma was assessed during the first and last weeks of their paediatric rotation.
      A similar questionnaire was completed by 23 of 60 paramedics from various medical
      disciplines in Hospital Kuala Lumpur. They had attended a two-day seminar on
      respiratory diseases and their knowledge was assessed prior to and six weeks
      after the seminar. On the initial assessment the mean score for the final year
      medical students was 24.5, third year medical students 20.9 and paramedics 18.3.
      After intervention their mean scores increased significantly to 26.3 (p <
      0.0001), 24.6 (p < 0.0001) and 21.3 (p < 0.0001). After intervention, the final
      year medical students improved significantly in all questions except in the
      management of acute asthma. Post intervention, third year medical students showed
      a significant increase in knowledge pertaining to symptomatology,
      pathophysiology, trigger factors and prophylactic drugs used in asthma
      management. Although the knowledge of paramedics improved post intervention, they
      had major deficiencies in knowledge about pathophysiology, trigger factors,
      preventive and acute asthma therapy, side effects of asthma treatment as well as
      clinical scenarios. Improvement after intervention was only seen in six of the 31
      questions. This study demonstrated an increase in knowledge about childhood
      asthma among medical students and paramedics after a short intervention.

PMID- 11200713
TI  - An audit of inpatient case records and suggestions for improvements.
AB  - A study was carried out in Kuala Lumpur Hospital to review the adequacy of
      documentation of bio-data and clinical data including clinical examination,
      progress review, discharge process and doctor's identification in ten of our
      clinical departments. Twenty criteria were assessed in a retrospective manner to
      scrutinize the contents of medical notes and subsequently two prospective
      evaluations were conducted to see improvement in case notes documentation.
      Deficiencies were revealed in all the criteria selected. However there was a
      statistically significant improvement in the eleven clinical data criteria in the
      subsequent two evaluations. Illegibility of case note entries and an excessive
      usage of abbreviations were noted during this audit. All clinical departments and
      hospitals should carry out detailed studies into the contents of their medical
      notes.

PMID- 11200714
TI  - A comparative study on the service profiles and practice facilities among urban
      general practices in east and west Malaysia.
AB  - 1171 urban general practices in East and West Malaysia were compared regarding
      their service profiles and practice facilities. In general, practices in both
      parts put important emphasis on preventive health care. More practices in East
      Malaysia were providing hormone replacement therapy and sexually transmitted
      diseases services but less were providing intrapartum care, counselling services
      including sexual and marital counselling and problems associated with social
      deviance such as alcohol and drug abuse. Although most practices in East Malaysia
      were solo practices, they were more comprehensive in terms of the provision of
      practice facilities when compared to those in West Malaysia. A greater number of
      them had ultrasound facilities, peak flow meters, ECG machines, computers and
      blood biochemistry facilities.

PMID- 11200715
TI  - Chinese mothers intention to breastfeed, actual achievement and early postnatal
      experience.
AB  - Thirty Chinese primiparous mothers were asked during the antenatal period their
      breastfeeding intention and then interviewed at delivery and 6 weeks post
      delivery. One mother had no intention to breastfeed. Ten mothers intended
      exclusive breastfeeding for one month and 19 for 6 weeks or more. At 6 weeks post
      delivery only 4 mothers were still breastfeeding. A total of 22 (73%) did not
      achieve their initial intention. For any future pregnancy, 5 chose exclusive
      breastfeeding, 22 complementary and 3 formula feeding. Chinese primiparous
      mothers have high breastfeeding intentions but the majority do not achieve them
      and their experience has discouraged them from exclusive breastfeeding in future
      pregnancies.

PMID- 11200716
TI  - Effect of hemoglobin E on glycosylated hemoglobin determinations using different
      commercial kits.
AB  - The effect of HbE, a hemoglobin variant, on the determination of HbA1/HbA1c using
      4 commercial kits based on cation-exchange resin, cation-exchange column
      chromatography and specific antibody techniques was studied. Fifty-eight normal
      and 63 HbE heterozygous subjects were tested for HbA1 and HbA1c using 4
      commercial kits i.e. Eagles Diagnostics, Boehringer Mannehim (BM), Diastat and
      Ames DCA 2000. Analyses of the samples by the 4 kits were done within one week
      and samples were stored at 4 degrees C before analysis. The results showed that
      HbE affects the determination of glycosylated hemoglobin using cation-exchange
      based and not kits based on specific antibody techniques.

PMID- 11200717
TI  - Conventional versus endoscopic inferior turbinate reduction: technique and
      results.
AB  - Different modalities of turbinate reduction procedures are available for
      treatment of vasomotor rhinitis not responding to appropriate medical therapy.
      Amongst these, conventional inferior turbinectomy (non-endoscopic) is the most
      widely performed procedure. With the advent of nasal endoscopes, inferior
      turbinoplasty has been gaining popularity worldwide. The purpose of this study
      was to compare the post-operative complaints and hospital stay of conventional
      versus endoscopic inferior turbinate reduction techniques performed non-randomly
      on 15 and 21 patients of vasomotor rhinitis respectively from January 1998 to
      December 1999 at Hospital Universiti Kebangsaan Malaysia (HUKM). A total of 36
      patients (22 males and 14 females) with a mean age of 30.6 years underwent
      turbinate reduction procedures during this period with a post-operative follow up
      ranging from 3 months to 6.7 months (mean 3.8 months). There was a significant
      difference between the conventional and the endoscopic technique with regards to
      nasal discomfort (p = 0.05) and dry throat (p = 0.02) which was less severe when
      performed endoscopically. The average hospital stay in hours by the endoscopic
      technique was almost half compared to the conventional technique. Due to the
      improved visualisation and minimal post-operative complaints and reduced hospital
      stay, the technique of endoscopic inferior turbinoplasty is currently the
      procedure of choice at our center. In septoplasty when endoscopic instrument is
      not needed, the standard turbinate reduction procedure is still performed. The
      availability of pre and post-operative acoustic rhinomanometric evaluation will
      be helpful as an objective measurement of nasal symptoms in the near future.

PMID- 11200718
TI  - The experience with fine needle aspiration cytology in the management of palpable
      breast lumps in the University Hospital Kuala Lumpur.
AB  - A total of 676 palpable breast lumps seen in the Breast Clinic, University
      Hospital, Kuala Lumpur from August 1993 to August 1994 were subjected to fine
      needle aspiration cytology. Fifty-four were reported as inadequate, 501 benign,
      95 malignant and 26 suspicious. One hundred and eighty-seven aspirates had
      histological correlation, while 34 of the malignant aspirates had clinical
      correlation. The majority of the other 455 patients were followed up for a period
      of 60 to 72 months without any malignancies becoming apparent. For analysis, only
      the 221 cases with histological or clinical correlation were included, (the
      suspicious category was included into the positive group and the inadequate cases
      were excluded), giving a sensitivity of 91.7%, a specificity of 91.7% and a
      diagnostic accuracy of 91.7%. Breast cytology was an accurate and rapid method of
      diagnosis of breast diseases, and in a busy surgical unit with limited operating
      time, it allowed for the triage of patients with breast complaints in deciding
      which cases needed early open biopsy. A negative cytology does not exclude the
      possibility of cancer, as there was a false negative rate of 11%. However by
      utilising a diagnostic triad of clinical examination, radiological assessment and
      fine needle aspiration cytology, the risk of missing a malignancy is small.

PMID- 11200719
TI  - Delayed repair of rupture of the biceps femoris tendon--a case report.
AB  - A rare case of an isolated rupture of the biceps femoris tendon at its insertion
      to the femoral head is presented. Delayed surgical repair has not been previously
      reported. In this patient, a successful repair was carried out four months after
      the injury.

PMID- 11200720
TI  - Upper genital schistosomiasis mimicking an ovarian tumour.
AB  - Schistosomiasis is a widely prevalent disease in the world and usually involves
      the gastro-intestinal and urinary tract. The involvement of the female genital
      tract has been well-established in S. haematobium infections and is rare with S.
      japonicum infections. This case involves a Filipino female who was admitted to
      the University Hospital Kuala Lumpur for right iliac fossa pain and was diagnosed
      initially as acute appendicitis. Ultrasound showed a multi-septated pelvic cyst
      leading to a provisional diagnosis of ovarian torsion. Intraoperatively a right
      parovarian cyst was detected and removed. Histology revealed a congested cyst
      wall with areas of haemorrhage with several viable and calcified eggs of S.
      japonicum measuring 85 microns x 62 microns. Within the cystic cavity blood
      admixed with eggs were seen. Confirmation was carried out by using the indirect
      haemagglutination (IHA) test. This is a first report of upper genital
      schistosomiasis mimicking an ovarian tumour.

PMID- 11200721
TI  - Dysphagia due to anterior cervical osteophytes--a case report.
AB  - Dysphagia due to osteophytes in a young person is uncommon. We present a rare
      case of Forestier's disease causing dysphagia in a young lady without other bony
      involvement. The osteophytes were surgically removed and her symptoms resolved
      completely.

PMID- 11200722
TI  - Two cases of severe non-specific oesophageal dysmotility showing different
      response to botulinum injection therapy.
AB  - We report 2 cases where treatment of achalasia type symptoms due to severe non
      specific oesophageal dysmotility have shown symptom resolution and manometric
      improvement to intrasphincteric botulinum injections either by itself or in
      combination with oesophageal dilatation.

PMID- 11200723
TI  - Contralateral pleural effusion during chemotherapy for tuberculous pleural
      effusion.
AB  - A 25 year old woman developed a right pleural effusion 6 weeks after commencement
      of short course chemotherapy for left sided tuberculous pleural effusion. Since
      the patient improved following continuation of the same treatment, it is presumed
      to be a case of paradoxical response to anti-tuberculosis treatment.

PMID- 11200725
TI  - Neisseria meningitidis serotype W135.

PMID- 11200724
TI  - Localised nodular pulmonary amyloidosis in a patient with sicca syndrome.
AB  - A 52 year old Chinese woman with a 25 year history of sicca syndrome (primary
      Sjogrens syndrome) was investigated for 3 episodes of haemoptysis. Clinical
      examination was unremarkable except for the presence of dry eyes and xerostomia.
      Computed tomography of the chest revealed a lobulated mass in the posterior basal
      segment of the left lower lobe. Histopathological examination of this resected
      nodule confirmed the diagnosis of nodular amyloidosis. The normal radiolabelled
      serum amyloid P component scintigraphy and the absence of monoclonal plasma cell
      dyscrasia in the bone marrow strongly support the diagnosis of localised nodular
      pulmonary AL amyloidosis in this patient. Nodular pulmonary amyloidosis can be
      associated with sicca syndrome and often simulates bronchogenic carcinoma,
      bronchiectasis or pulmonary tuberculosis.

PMID- 11200726
TI  - "Non-infectious" syndromes associated with infectious agents.
AB  - Over the past two decades there has been numerous new associations between
      chronic diseases traditionally considered non-infectious with infectious agents.
      This list of diseases include peptic ulcer, coronary heart disease,
      neuropsychiatric disorders, haematological disorders and malignancies. These
      associations have been made possible through improvements in diagnostic tests
      based on molecular biology techniques. The discovery of these associations is
      important as it opens up exciting opportunities for the prevention and treatment
      of many diseases hitherto considered incurable.

PMID- 11200727
TI  - Stroke in Canada: the need for a new approach.

PMID- 11200728
TI  - Anemia and iron status in Inuit infants from northern Quebec.
AB  - The iron status and diet of Inuit infants living in northern Quebec who were part
      of a prospective cohort study was described. The prevalence of anemia (hemoglobin
      values > 2 SD below the reference mean) was 21.1% (23/109), 47.4% (55/116) and
      37.7% (46/122) at 2, 6 and 12 months, respectively. The corresponding prevalence
      of microcytic anemia was 0.0%, 4.3% and 21.3%. At 2, 6 and 12 months, iron
      deficiency anemia (serum ferritin < 10 micrograms/L coupled with anemia) was
      present in 1.3% (1/79), 24.4% (21/86) and 26.3% (25/95) of infants, respectively.
      Compared with breastfeeding, the odds ratio for iron deficiency (serum ferritin <
      10 micrograms/L) for bottle-feeding with cows' milk or low iron formula was 3.02
      (95% CI 1.25-7.27) at 6 months and 3.05 (95% CI 1.28-7.28) at 12 months. This
      study shows iron-deficiency anemia to be a problem in Inuit infants as young as 6
      months old. Breastfed infants were better protected against iron deficiency than
      infants fed cow's milk or low-iron formula.

PMID- 11200729
TI  - A systematic review of the relationship between breastfeeding and early childhood
      caries.
AB  - This systematic review investigated the relationship between early childhood
      caries (ECC) and breastfeeding. The systematic review methodology used by the
      Cochrane Collaboration was modified and adopted for this review. 28 of 151
      articles (18.5%) were relevant for the study and were rated as strong (0),
      moderate (3), weak (9) or very weak (16). Validity scores indicated whether a
      study met the reviewer's criteria for research rigour. The percentage of studies
      that received a passing score for each criterion examined were: study design
      (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%),
      dental health practices (28%) and infant feeding practices (4%). A lack of
      methodological consistency related to the study of the association of
      breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding,
      make it difficult to draw conclusions. Moderate articles indicate that
      breastfeeding for over one year and at night beyond eruption of teeth may be
      associated with ECC. Due to conflicting findings in less rigorous research
      studies, no definitive time at which an infant should be weaned was determined,
      and parents should begin an early and consistent mouth care regime.

PMID- 11200730
TI  - Child care arrangement and preschool development.
AB  - Baseline data from the Canadian National Longitudinal Survey of Children and
      Youth were used to evaluate the associations between child care arrangement and
      poor developmental attainment (PDA). A weighted total of 521,800 children aged 2
      to 3 years were studied (N = 2,709). PDA was assessed by age-standardized motor
      and social development score. Children were grouped by the predominant type of
      arrangement: care by someone in the child's own home, in another home (family
      child care), at a child care centre, or none (child care exclusive to parents).
      Controlling for socioeconomic status, biological factors and maternal
      immigration, family dysfunction, hostile parenting and low neighbourhood safety
      were correlated with PDA and positive parent-child interaction decreased the odds
      of PDA. Whereas centre child care arrangements were beneficial to development
      overall (OR = 0.41, 99% CI = 0.18, 0.93), an interaction existed between type of
      child care and maternal depression; among children with depressed mothers, centre
      child care was associated with increased odds of PDA. Findings suggest that the
      associations between child care arrangement and child development involve
      interactions of factors that influence a child's home environment. Future child
      development studies exploring these interactions are warranted.

PMID- 11200731
TI  - Patterns of health care use of injured and non-injured children.

PMID- 11200732
TI  - Health diaries for monitoring events following immunization.

PMID- 11200733
TI  - Young adults and HIV vaccine: determinants of the intention of getting immunized.
AB  - The aim of this study was to evaluate the acceptability of a hypothetical HIV
      vaccine and to identify the psychosocial determinants of the intention of
      receiving HIV immunization, based upon Ajzen's Theory of Planned Behaviour (TPB).
      Of the 136 young adults surveyed, 120 (88%) had a moderate to high intention to
      receive the HIV vaccine. A logistic regression was performed and two psychosocial
      factors from the TPB were significant predictors of the young adults' intention
      of getting HIV immunization: their attitude towards getting HIV immunization (OR
      = 4.80, CI 95% = 2.08; 13.05) and the perceived behavioural control of getting
      HIV immunization (OR = 2.52, CI 95% = 1.17; 6.05). These results show that HIV
      immunization is well accepted by young adults. This finding is particularly
      relevant because the effectiveness of HIV immunization programs will depend on an
      individual's acceptance of this vaccine. Also, our results suggest that
      psychosocial determinants can influence a young adult's decision to receive the
      HIV vaccine once it becomes available.

PMID- 11200734
TI  - A profile of cardiovascular disease in northern Ontario: public health planning
      implications.
AB  - Cardiovascular disease (CVD) is a leading cause of death in Northern Ontario and
      therefore considered an important issue. To this end, this paper examines CVD
      trends in Northern Ontario and the prevalence of known risk factors that give an
      insight into these trends. Ontario Health Survey 1990, Ontario Health Survey
      1996, Canadian Institute for Health Information (1990-95) and Vital Statistics
      (1990-95) were examined. It was determined that CVD rates in Northern Ontario
      significantly exceeded those of the province. Further, high prevalence of
      modifiable risk factors, such as smoking, fat intake, physical inactivity and
      obesity are all experienced in Northern Ontario when compared to the province.
      Planning implications, as they relate to collaboration, delivery of services,
      determinants of health, multiple risk factors and monitoring and evaluation are
      also discussed.

PMID- 11200735
TI  - The prevalence and correlates of influenza vaccination among a home care
      population.
AB  - OBJECTIVE: To estimate the prevalence and correlates of influenza vaccination in
      a Home Care population. METHODS: This was a cross-sectional investigation
      involving linkage of three population-based databases from a rural Alberta
      Regional Health Authority, i.e., the Regional immunization and the Regional home
      oxygen information systems to the Regional home care information system. The
      sample comprised 649 persons who had been admitted or discharged from the
      Regional Home Care Program in the period Oct. 1-Dec. 31, 1998. An anonymous data
      file was released to the investigators. We estimated the proportion ever
      vaccinated against influenza, the proportion vaccinated in the period Oct. 1-Dec.
      31, 1998 ("currently vaccinated"); and explored sociodemographic and program
      correlates of current vaccination. RESULTS: 67% had ever been vaccinated against
      influenza; 60.7% were currently vaccinated. Factors associated with current
      vaccination (multivariate analysis) include older age, being married, not
      receiving nursing services, district of residence and program status.
      CONCLUSIONS: Influenza vaccination rates were suboptimal. The correlates of
      vaccination suggest systems-level impediments to influenza vaccination.

PMID- 11200736
TI  - Health care needs of community-dwelling older adults.
AB  - OBJECTIVE: To identify, assess, and rank the importance of health care needs of
      community-dwelling older adults. METHOD: A structured telephone interview with
      107 respondents (physicians, direct service providers and administrators) about
      the importance of a list of 31 health care needs of older adults. Respondents
      also identified the single most important health issue facing local older adults
      now and in the next 5 to 10 years. RESULTS: The five most important health care
      needs, in descending order, are: care-giver support services, community long-term
      care services, services for people with dementia/Alzheimer's disease,
      palliative/end-of-life care, and services for cancer patients and their families.
      Community long-term care services were identified as the single most important
      health issue both now and in the next 5 to 10 years. CONCLUSION: The study
      findings should be of value to health and social service researchers, planners,
      providers and administrators regarding the needs of community-dwelling older
      adults.

PMID- 11200737
TI  - Concurrent consultations with physicians and providers of alternative care:
      results from a population-based study.
AB  - OBJECTIVE: We examined the factors related to consultations with both physicians
      and alternative practitioners, compared with visits to physicians only. METHODS:
      A telephone survey (random-digit dialling) collected information from 818 adults
      living in and around Saskatoon. Respondents reported consultations with
      alternative practitioners and physicians in the previous 12 months. RESULTS:
      Approximately one in five respondents had consulted both a physician and an
      alternative practitioner. Among respondents under 65 years of age, having one or
      more chronic medical conditions significantly increased the likelihood of
      concurrent use of care. Men, individuals suffering from back pain or migraines,
      those reporting an elevation level of distress, and those for whom spiritual
      values were important were also more likely to use both types of care.
      INTERPRETATION: Consultations with alternative care providers occur as an adjunct
      to, rather than a replacement of visits to physicians. Particular types of
      medical conditions as well as psychosocial and spiritual factors are determinants
      of concurrent use of physicians and alternative practitioners.

PMID- 11200738
TI  - Job stress and burnout among Canadian managers and nurses: an empirical
      examination.
AB  - This study examined the relationship of job stress with burnout and its three
      dimensions (emotional exhaustion, lack of accomplishment and depersonalization),
      job satisfaction, organizational commitment and psychosomatic health problems.
      Data were collected by means of a structured questionnaire from Canadian managers
      (N = 67) and nurses (N = 173). Pearson correlation and moderated multiple
      regression were used to analyze the data. Job stress was significantly correlated
      with overall burnout and its three dimensions and job satisfaction in both
      samples. In the nursing sample, job stress was also significantly correlated with
      psychosomatic health problems and organizational commitment. Moderated multiple
      regression only marginally supported the role of gender as a moderator of stress
      burnout relationship.

PMID- 11200739
TI  - Should public health workers be able to address the public's health?

PMID- 11200740
TI  - The Saskatchewan Health and Back Pain Survey: the prevalence and factors
      associated with depressive symptomatology in Saskatchewan adults.
AB  - OBJECTIVES: To determine the one-week period prevalence of depressive
      symptomatology among Saskatchewan adults and to identify sociodemographic and
      health factors associated with depressive symptomatology. METHODS: The
      Saskatchewan Health and Back Pain Survey was mailed to an age-stratified random
      sample of adults. Of the 2,184 eligible subjects, 55% (n = 1131) responded to the
      survey. We report age-standardized prevalence estimates stratified by age, gender
      and spinal pain severity. Logistic regression was used to measure the presence
      and strength of association between various factors and depressive
      symptomatology. RESULTS: 22.2% (95% CI 19.6-24.9) of adults experienced
      depressive symptomatology during the previous week, with higher rates in younger
      adults, in females, and in those with disabling spinal pain. Depressive
      symptomatology was associated with age, income, smoking, health status, gastro
      intestinal problems, headaches and spinal pain. CONCLUSIONS: Depressive
      symptomatology is common in the Saskatchewan adult population, and is related to
      age, pain severity and general health.

PMID- 11200741
TI  - Measuring population health: correlates of the Health Utilities Index among
      English and French Canadians.
AB  - This study used cross-sectional data from the 1994/95 National Population Health
      Survey (NPHS) in Canada. The objective of the study was to examine the
      relationship between several established correlates of health status in the
      general population and the Health Utilities Index (HUI), a multi-dimensional,
      preference-based measure of health status. Analyses were carried out separately
      for the English-speaking (n = 9,853) and French-speaking (n = 1,519) respondents.
      The index correlated strongly with self-ratings of health status and functional
      disability and varied as expected according to age, sex, and income. Subjects
      classified to different categories of chronic conditions reported different
      levels of health, as predicted. The HUI was also associated with the use of drugs
      and recent history of hospitalization. No major differences in the findings were
      observed between the two cultural groups. The results should be treated with
      caution due to the cross-sectional design and other methodological limitations of
      the study.

PMID- 11200742
TI  - Eye exposure to optical radiation in the glassblowing industry: an investigation
      in southern Ontario.
AB  - OBJECTIVE: To investigate if the levels of optical radiation hazards in
      glassblowing are well classified according to the hazard types defined in the
      Canadian Standards Association (CSA) standard for industrial eye protectors.
      METHODS: We carried out radiometric measurements, and questionnaire survey in 4
      university glassblowing laboratories, and 3 private studios. RESULTS: There is
      exposure to low levels of UV and IR radiation in all glassblowing operations. A
      supra-threshold IR radiation level exists in the craft glassblowing. The use of
      eye protectors is based on past experience regardless of the level of ocular
      exposure. CONCLUSIONS: Optical radiation hazards exist in both craft and
      scientific glassblowing. There seems to be an inadequate understanding about
      radiation types encountered by glassblowers.

PMID- 11200743
TI  - [How to correctly assess results of pulmonary function tests?].

PMID- 11200744
TI  - [Comparison of ventilatory efficiency in alcohol and opiate abusers].
AB  - The aim of this study was to evaluate the respiratory efficiency in alcohol and
      opiate abusers. There were 220 persons under examination: 144 alcohol abusers
      (group I), 36 opiate abusers (group II) and 40 healthy persons (control group).
      Both groups of dependent persons were treated in the Detoxication Unit of the
      Department of Clinical Toxicology CMUJ. During hospitalization the functional
      state of respiratory system was monitored. Ventilation efficiency was determined
      on the basis of the results from a "flow-volume" loop, spirometry and the
      measurements of the respiratory tract resistance in a computerised system
      Lungtest-MES company (Poland). In the examination performed directly after
      admission to the Clinic the normal respiratory efficiency was noted in 36.1% in
      ethanol abusers and 54.9% in opiate abusers. 63.9% of alcohol abusers (group I)
      and 45.1% of opiate abusers (group II) suffered from the bronchial obturation. In
      the examination performed after hospitalisation and 9 days of total abstinence in
      33.3% of the alcohol dependent patients and in 38.5% of the opiate dependent
      patients respiratory obturation was observed. The values of respiratory tract
      resistance in both groups of dependent patients in examination on admission and
      after treatment were increased compared to controls. The changes of ventilatory
      parameters can be explained mainly by withdrawal syndrom revealing that it is
      connected with initial (9 days lasting) period of controlled and total
      abstinence.

PMID- 11200745
TI  - [Comparison of respiratory regulation in alcohol and opiate abusers].
AB  - Opioid drugs and alcohol, both central nervous system depressants, may also have
      a depressive action on the brain stem centre responsible for breathing control.
      Disorders of breathing regulation are reflected in respiratory efficiency. The
      aim of this study was to evaluate the regulation of breathing by measuring the
      respiratory pattern and occlusion pressure of abusers of opiates and alcohol.
      There were 180 persons under examination: 84 alcohol abusers (group I), 36
      opiates abusers (group II) and 40 healthy persons (control group). Both groups of
      dependent persons were treated in the Detoxication Unit of the Department of
      Clinical Toxicology CMUJ. Respiratory regulation was evaluated "on line" by means
      of synchronous measurements of the respiratory pattern (according to Milic-Emili
      assumptions) and occlusion pressure P 0.1 (according to Whitlaw assumptions). The
      central respiratory drive (VT/Tin) and the timing component of the breathing
      cycle (Tin/Ttot) were simillar in both groups of abusers. In comparison to the
      control group, in the group of opiates abusers, values of VT/Tin were higher
      during examination performed after treatment, and values of Tin/Ttot were
      elevated (in group I--only before treatment; in group II--before and after
      treatment). Examination of respiratory pattern and occlusion pressure is based on
      recording spontaneous breathing, which this can be performed even in unconscious
      patients in very early stage of poisoning.

PMID- 11200746
TI  - [Expression of transforming growth factor beta 1 (TGF beta 1) and angiogenesis in
      broncho-pulmonary carcinoids].
AB  - TGF beta 1 commonly produced by normal and neoplastic human cells, has capacity
      to regulate new blood vessel formation, to establish and maintain the vessel wall
      integrity; was found to have some significance in the lung cancer prognosis.
      Tumour angiogenesis is an important factor for tumour growth and metastasis. The
      purpose of this study was to find, if the immunoexpression of TGF beta 1 has any
      significance in determination of the histologic subtypes of carcinoids?; to find,
      if TGF beta 1 has any role and relation to carcinoids angiogenesis?; and to
      explore TGF beta 1 expression and angiogenesis with respect to metastatic
      potential of carcinoids. The study was performed on 48 resected broncho-pulmonary
      carcinoids: 35 typical (TC) and 13 atypical (AC), classified according to the
      WHO. Semiquantitative analysis for TGF beta 1 was performed. Sections stained
      using monoclonal antibody against TGF beta 1 were scored in scale from 0 to 4,
      according to the percentage of positively stained cells (pc) plus percentage of
      positively stained stroma (ps). The microvessels stained with CD34 monoclonal
      antibody, were counted in 0.75 mm2 field (microvessel density--MD), using the
      computerised image analysis system SAMBA 2005 (the morphometric software). The
      histologic subtype of carcinoids was related to age of the pts (AC occurred in
      older pts than TC, p = 0.027), to the tumour size (AC were larger than TC:
      respectively--3.25 cm and 2.4 cm, p = 0.009). Lymph node metastases were
      significantly more frequent in AC than in TC (38% vs 13%, p = 0.025). 85%
      carcinoids showed TGF beta 1 expression with various intensity, mainly in the
      stroma. There was no significant correlation between TGF beta 1 expression and
      tumour size, the histologic subtype nor the lymph node metastases. The
      angiogenesis expressed as MD, was not related to histology, nor to the presence
      of lymph node metastases. There was no correlation between TGF beta 1 expression
      and angiogenesis. Shown in our study, lack of relation between TGF beta 1
      expression and angiogenesis, could support some of the published data indicating
      indirect action of TGF beta 1 on the angiogenesis. The rich vascularity found in
      carcinoids morphology could result from TGF beta 1, commonly expressed by the
      tumoural stroma. The angiogenesis nor TGF beta 1 expression do not determinate
      the carcinoids histology.

PMID- 11200747
TI  - [Prognostic value of P53 protein in cells of non-small cell lung cancer].
AB  - The aim of the study was to evaluate the prognostic relevance of p53 protein in
      non-small cell lung cancer. The 95 surgically treated patients were included (53
      patients with squamous cell carcinoma, 29--with adenocarcinoma, 5--with large
      cell carcinoma, and 8--with mixed type). The protein was assessed
      immunohistochemically with the use of monoclonal antibodies DO7, DAKO. Positive
      staining was present in 44 patients. There was no survival difference between
      groups with and without protein (median survival--36 and 33 months, respectively;
      p = 0.86). In the multivariate analysis the only characteristics with prognostic
      impact in the entire group was stage of the disease. There was no correlation
      between the expression of p53 protein and disease-free survival. These results
      indicate that there is no prognostic relevance of p53 protein in non-small cell
      lung cancer.

PMID- 11200748
TI  - [Cytokines TNF-alpha and GM-CSF in BAL from two different segments of lungs
      defined by high resolution computerized tomography (HRCT) in patients with
      sarcoidosis].
AB  - The aim of the study was to evaluate the concentrations of TNF-alpha and GM-CSF
      in double BAL (2 x 120 ml) from two different lung segments: (s.A) from upper
      lobe with the most and (s.B) from lower lobe with the least extensive involvement
      estimated by high resolution computed tomography (HRCT). Examined group consisted
      of 28 non-smoking sarcoid patients with homogenous, regular distribution of
      nodular opacities in conventional chest X-ray (14 F, 14M aged 19-54). In examined
      patients 16 had nonhomogenous distribution (ND) and 12 had regular distribution
      (RD) of HRCT changes. Eleven healthy volunteers served as controls. In patients
      with sarcoidosis we observed the significantly higher concentrations (p < 0.01)
      of TNF-alpha (3.18 pg/ml, 2.64 pg/ml) and GM-CSF (1.01 pg/ml, 0.95 pg/ml)
      respectively in BAL fluid from s.A and s.B in comparison with BAL from s.Abis and
      s.Bbis in control group (TNF-alpha: 0.46 pg/ml, 0.47 pg/ml and GM-CSF: 0.28
      pg/ml, 0.31 pg/ml respectively). Mean concentration of TNF-alpha in BAL from s.A
      (3.77 pg/ml) in ND group was significantly higher than in BAL from s.B in RD
      group (2.91 pg/ml). TNF-alpha in BAL from s.A in active sarcoidosis was higher
      than in BAL from s.A and s.B in non-active sarcoidosis. Concentrations of TNF
      alpha in BAL from both s.A and s.B correlated positively with CD4/CD8 ratio,
      percentage of lymphocytes, lymphocytes HLA-DR+ and absolute number of CD4 cells
      and negatively with CD8 cells estimated in BAL from these lung segments. In
      patients with indications to therapy the level of GM-CSF in BAL from s.A (1.44
      pg/ml) was significantly higher (p < 0.05) than in BAL from s.A (0.64 pg/ml) in
      patients without indications to treatment. We conclude that TNF-alpha and GM-CSF
      may be involved in sarcoidosis pathogenesis and TNF-alpha may be useful in
      estimation of sarcoidosis activity.

PMID- 11200749
TI  - [Usefulness of Dermatophagoides pteronyssinus allergen extract from the
      Allergopharma J.G. Company for bronchial provocation in patients with bronchial
      asthma].
AB  - The value of Dpt allergen extract, produced by Allergopharma J.G., for
      performance of the bronchial provocation test in asthmatics was evaluated. The
      studies were carried out in 40 asthmatics with positive skin prick test with Dpt.
      Bronchial provocation test was performed according to Ryan's method. After an
      allergen inhalation, an early asthmatic reaction (EAR) and late asthmatic
      reaction (LAR) may appear. The following results were observed: a dual asthmatic
      reaction (EAR and LAR)--in 19 persons, the EAR--only in 9 patients, and the LAR-
      only in 1 patient. The negative result of the provocation were found in 11
      patients. The frequency of particular patterns of the bronchial reactions was
      similar to those published before by us and other authors, with different
      allergen extracts. The allergen extract of Dpt from Allergopharma J.G. can be
      used to bronchial challenge.

PMID- 11200750
TI  - [Value of the immunochromatographic assay for detecting IgG antibodies against 38
      kDa mycobacterial antigen in diagnosis of tuberculosis].
AB  - Despite of a fast development in the techniques of rapid identification of
      mycobacteria by molecular genetic techniques, serodiagnosis may be of special
      values as non-expensive, easy to perform method. Several serodiagnostic tests,
      principally those using immunoenzymatic (ELISA) methodology are available. The
      goal of our study was to evaluate one step coloured immunochromatographic assay
      detecting IgG antibodies against antigen 38 kDa (Rapid Test TB). Our material
      consisted of 278 serum samples--tuberculosis (n = 155), healthy (n = 36),
      sarcoidosis (n = 50), lung cancer (n = 25) mycobacterial infections other than
      tuberculosis (n = 12). Tuberculosis group consisted of new culture positive cases
      (n = 66), new culture negative cases (n = 23), chronic cases (n = 43) and
      extrapulmonary TB (n = 23). Specificity of 96% and sensitivity of 54% was
      obtained. In pulmonary TB sensitivity of 50% and in extrapulmonary TB of 74% was
      obtained. In chronic cases sensitivity of 70% and in new cases of 40% was
      received. Sensitivity of 44% in new culture positive cases and 30% in new culture
      negative cases was obtained. We conclude that immunochromatographic test may be a
      very useful tool improving tuberculosis diagnosis, especially in extrapulmonary
      tuberculosis. Strip test may be an interesting alternative as it is an extremely
      simple, rapid, and cheap technique.

PMID- 11200751
TI  - [Guidelines for diagnosis and treatment of mucoviscidosis. Consensus of the
      Polish Mucoviscidosis Working Group].

PMID- 11200752
TI  - [A rare mediastinal neoplasm in the form of a hemangioma].
AB  - Hemangiomas of the mediastinum are rare tumors. They represent fewer than 0.5% of
      the mediastinal tumors. Because of their rarity, the diagnosis and treatment of
      these tumors is difficult. We present a case of venous hemangioma of the
      mediastinum in a young woman. Despite of routine examination applied in
      mediastinal tumors the appropriate diagnosis was not done by the accessible
      methods.

PMID- 11200753
TI  - [The role of human papilloma viruses (HPV) in the pathogenesis of lung
      neoplasms].

PMID- 11200754
TI  - [The role of gamma interferon in host immune response to tuberculosis].

PMID- 11200755
TI  - [Serologic methods in diagnosis of tuberculosis].

PMID- 11200756
TI  - [Hellp syndrome. Toward a definition of the length of  conservative treatment]  .

PMID- 11200757
TI  - [Maternal and perinatal morbidity and mortality associated with  hellp syndrome] 
      .
AB  - OBJECTIVES: Our purpose was to describe the effects of serious obstetric
      complications on maternal and perinatal outcome in pregnancies complicated by
      Hellp syndrome. STUDY DESIGN: Retrospective study. PATIENTS: Sixteen patients
      managed from January 1994 through December 1998 in whom pregnancy was complicated
      by Hellp Syndrome. RESULTS: The incidence of Hellp syndrome among women with
      severe preeclampsia and/or eclampsia (164 cases) was 9.7%. Fourteen cases
      occurred before and two after delivery. In nine cases, Hellp occurred before 32
      weeks of gestation and later in two other cases. Mean gestational age at delivery
      was 32.4 weeks. Serious maternal morbidity included acute renal failure (five
      cases), disseminated intravascular coagulation (two cases), pulmonary oedema (one
      case), severe ascites (five cases), pleural effusion (three cases), adult
      respiratory distress syndrome (one case). Abruptio placenta, acute renal failure
      and disseminated intravascular coagulation were always associated. Ten patients
      required transfusions with blood products. Caesarean delivery was performed in 15
      cases. General anaesthesia was used in all patients. There was one maternal death
      from multiple organ failure. Perinatal outcome was poor. Six perinatal deaths
      were related to abruptio placenta, intrauterine asphyxia and extreme prematurity.
      CONCLUSION: The high maternal and perinatal mortality and morbidity reported with
      the presence of Hellp syndrome requires maternal-fetal follow-up in a tertiary
      centre where intensive maternal and neonatal care are available.

PMID- 11200758
TI  - [Complications of difficult tracheal intubations in a  critical care unit]  .
AB  - OBJECTIVES: This study was performed in order to evaluate the frequency of DI,
      the predictive factors of DI and to list the related complications. STUDY DESIGN:
      Prospective non randomized, open study. PATIENTS AND METHODS: All patients
      intubated in the critical care unit during the five months of the study were
      included. The previous history and clinical setting of the patients, the
      conditions and the complications of intubation were collected. DI was defined
      when the procedure required more than two laryngoscopies. RESULTS: The study
      included 80 patients. The rate of DI was 22.5%. The Mallampati score (p < 0.001)
      was the only predictive factor. The frequency of complications was 25%. This rate
      was 55% for DI versus 16% for easy intubations (p < 0.001). CONCLUSION: This
      study confirms the high incidence of DI and associated complications in critical
      care. We suggest the development of airway management protocols in critical care
      unit in order to reduce the rate of DI.

PMID- 11200759
TI  - [Periodic evaluation of practices in postoperative pain  management]  .
AB  - OBJECTIVE: Periodical assessment of practices as part of a quality assurance
      program: impact on postoperative pain. PATIENTS: All patients evaluated from the
      first postoperative day during a week. METHODS: Two surveys performed at a six
      month interval after establishment of some corrective measures. Different items
      were evaluated: pre-anaesthesia information for patients, pain severity and
      satisfaction with pain treatment. Medical data were consulted concerning
      postoperative analgesic prescriptions, their realization, pain assessment by
      nurses. Between the two surveys, first survey results were presented to
      anaesthesiologists. Then guidelines for prescriptions were suggested and new
      monitoring guidelines were proposed to nurses in surgical ward. RESULTS: 94
      patients were evaluated during each survey. Patients had undergone orthopaedic,
      visceral, urology, ophthalmology and vascular surgery. Half of the patients did
      not receive information about pain before surgery. 43% of patients had a pain
      scores = 30/100 during movements; no difference was found between the two
      evaluations. Satisfaction graded as "moderate or insufficient" decreased from 22%
      (1rst survey) to 10 (2nd survey) (p < 0.05). Non steroidal anti-inflammatory
      drugs and nefopam prescriptions increased between the two surveys (p < 0.05).
      Association of three or four analgesics increased between the two surveys and
      monotherapies decreased (p < 0.05). Concordance of prescriptions with guidelines
      was 55% during first survey and 62% during the second (NS). Pain severity was not
      recorded for 36% of patients at first survey and in 18% at the second (p < 0.05).
      CONCLUSION: Although anaesthesiologists and nurses changed their practice due to
      a quality insurance program concerning postoperative pain, its consequence on the
      severity of postoperative pain was not significant.

PMID- 11200760
TI  - [Sensitivity to atracurium in the lateral abdominal muscles]  .
AB  - OBJECTIVE: To study the effect of atracurium on the electromyographic activity of
      the lateral abdominal muscles and adductor pollicis in anaesthetized subjects.
      STUDY DESIGN: Prospective, comparative, open study. PATIENTS AND METHODS: Sixteen
      patients, ASA physical status 1 or 2, undergoing elective orthopaedic surgery
      under general anaesthesia were studied. Anaesthesia was induced with
      propofol/fentanyl and orotracheal intubation performed after glottic local
      anaesthesia without using muscle relaxant. Anaesthesia was maintained with
      isoflurane/nitrous oxide/oxygen and fentanyl reinjections. Supramaximal
      percutaneous stimulations in a simple twitch mode (0.1 Hz) were applied at the
      9th-10th intercostal nerve on the posterior axillary line and at the ulnar nerve
      at the wrist. The electromyographic responses were registered using skin surface
      electrodes, placed on the D9-D10 dermatome in regard of the lateral abdominal
      muscles and of the thenar muscles. After a single bolus dose of atracurium 0.5
      mg.kg-1, the following parameters were studied: the maximum effect (Emax), the
      time for obtaining Emax (Delay) and the recovery time of 5, 10, 25, 50, 75 and
      100% of the control neuromuscular response (T5, T10, T25, T50, T75, T100).
      RESULTS: The dose of 0.5 mg.kg-1 of atracurium induced 100% block in both lateral
      abdominal muscles and adductor pollicis. Lateral abdominal muscles blockade had
      faster onset (136 +/- 4 s versus 205 +/- 29 s) and shorter recovery, T5, T10,
      T25, T50, T75 and T100 were significantly (p < 0.05) shorter than at the adductor
      pollicis. CONCLUSION: Lateral abdominal muscles blockade have faster onset and
      recovery than adductor pollicis.

PMID- 11200761
TI  - [Perioperative autotransfusion with salvage blood in cancer  surgery]  .
AB  - OBJECTIVES: Intraoperative blood cells salvage using a Cell Saver technique is
      controversial in oncologic surgery because tumor cells could be aspirated and
      reinfused to the patient. The goal of this review was to discuss the risk
      associated with this technique, and the way to minimize it. DATA SOURCES: A
      review of the literature has been made by questioning PubMed site
      (http://nbci.nlm.nih.gov) on the period of 1968 to 2000. The key words were:
      intraoperative blood salvage, blood transfusion, autologous, cancer. Cases
      reports have been excluded. STUDY SELECTION: Tumor cells aspirated and reinfused
      have been numbered in both experimental and clinical studies. In clinical
      studies, the outcome after intraoperative cells salvage/reinfusion has been
      compared to published data or historical groups of allogeneic transfusion, all in
      non randomized studies. DATA SYNTHESIS: Both experimental and clinical studies
      confirmed the presence of cancer cells in the blood either aspirated or
      reinfused. However, six clinical studies with limited number of patients did not
      show metastatic spread associated with Cell Saver. The addition of leukocyte
      filters reduces greatly this quantity of cancer cells. Irradiation of the pack
      did not destroy tumor cells but blocked their proliferative capacity. In the
      other hand, some infiltrative tumors were shown to have permanent cancer cells
      seeding, quantitatively superior to the seeding observed when a Cell Saver is
      used. CONCLUSION: It seems reasonable to use the Cell Saver in oncologic surgery,
      if possible with a leukocyte filter, not only in case of unexpected major
      bleeding (consensus), but also in programmed cases with high risk of huge
      hemorrhage.

PMID- 11200763
TI  - [Colon hernia through a defect in the iliac crest after bone  graft harvesting] 
      .
AB  - A case of a patient with an hernia through a defect in the iliac crest after bone
      graft harvesting is described. The osseous defect provides a rigid ring against
      which repeated sudden elevations in abdominal pressure can result in disruption
      of soft tissue and herniation of abdominal contents. Standard plain radiographs
      and barium studies are of limited interest and may even be misleading in
      diagnosing the herniation. Findings on computed tomography led to detection of
      this abnormality, and should be the first line exam in these cases.

PMID- 11200762
TI  - [Unusual course of a pulmonary artery catheter through a  persistent superior
      vena cava]  .
AB  - We report the unusual course of a pulmonary artery catheter through a persistent
      left-sided superior vena cava. After left subclavian vein cannulation and
      downward left-sided paramediastinum course, the Swan-Ganz catheter enters the
      right pulmonary artery. Haemodynamic monitoring was consistent with the diagnosis
      of septic shock developed by this 56-year-old woman, after cephalic
      duodenopancreatectomy. Persistent left-sided superior vena cava occurs in 0.5% of
      the population and 5-10% of patients with congenital heart diseases. It drains
      into the right atrium through the coronary sinus in 92% of cases and is
      associated with an absent right superior vena cava in 20% of cases. The left
      sided superior vena cava persists when the caudal part of the left anterior
      cardinal vein does not degenerate. A persistent left superior vena cava may be
      medically relevant during implantation of pacemaker leads or radiofrequency
      ablation, during cardiac surgery for placement of a retrograde coronary sinus
      cardioplegia catheter and during transjugular intrahepatic portosystemic shunt
      placement.

PMID- 11200764
TI  - [Treatment with danaparoid during pregnancy for a woman with a  cutenous allergy
      to low-molecular-weight heparin]  .
AB  - The authors describe a case of heparin-induced skin reaction due to two
      preparations of low molecular weight heparin in a pregnant woman. The main
      characteristics of heparin-related cutaneous allergy are reported. The use of an
      heparinoid, usually indicated for patients with heparin-induced thrombocytopenia,
      appeared to be efficient and safe for the mother and her fetus. An epidural
      analgesia was performed for labor analgesia, 24 hours after the last injection of
      danaparid of sodium.

PMID- 11200765
TI  - [Anaphylactic reactions to aprotinin: intradermal diagnostic  tests]  .
AB  - A 66-year-old patient, undergoing heart surgery, developed an anaphylactic
      reaction following the first administration of a test-dose of aprotinin. Skin
      tests were performed six months later. Prick-tests with 10(-2) and 10(-1)
      aprotinin dilutions were negative but intradermal reaction with a 10(-3) dilution
      was clearly positive. The level of aprotinin specific IgE was high, both in the
      serum obtained before surgery and in the one sampled on the day of the testing.
      As no reaction was observed during the tests, skin-testing and specific IgE
      appear to be an interesting alternative to a potentially dangerous test-dose, but
      they both need further evaluation.

PMID- 11200767
TI  - [Bronchial intubation and celioscopy: attention!]  .

PMID- 11200766
TI  - [Case report of acute intoxication from intravenous injection of  petroleum]  .
AB  - A 18-year-old patient injected intravenously 2.5 mL of paraffin oil into the
      right upper limb. It caused a local thrombophlebitis with a slow evolution. A
      collapsus occurred on the sixth day. The authors obtained a clinical recovery of
      the limb after heparine and oral anticoagulation.

PMID- 11200768
TI  - [A fatal rhabdomyolosis from an unusual etiology: Clarkson  syndrome]  .

PMID- 11200770
TI  - [Antibiotic prophylaxis for surgery]  .

PMID- 11200769
TI  - [Gas or liquid peridural puncture]  .

PMID- 11200771
TI  - [Continuing medical education and evaluation]  .

PMID- 11200772
TI  - [Cost-benefit relations of different strategies for control of  nausea and
      vomiting]  .

PMID- 11200773
TI  - Progression of premalignant MCF10AT generates heterogeneous malignant variants
      with characteristic histologic types and immunohistochemical markers.
AB  - The MCF10AT premalignant human breast epithelial cells form benign ductal
      structures in immunodeficient mice which sporadically progress to carcinoma in
      situ and invasive cancers of different histologic types. MCF10CA1 cell lines are
      malignant variants derived by serially passing small pieces of tumors in athymic
      mice before establishing cells in culture. As these MCF10CA1 variants gave rise
      to heterogeneous tumors, some cell lines were cloned. Inoculated into
      immunodeficient mice, these variants produce squamous carcinomas with an
      undifferentiated component or adenocarcinomas also with an undifferentiated
      component. Immunohistochemistry utilized antibodies against DF3, c-erbB-2, cyclin
      Dl, m keratin, p keratin, p53, B72.3 and estrogen receptor. We detected
      characteristic patterns for squamous carcinomas, for adenocarcinomas, and for
      each undifferentiated component, that is the undifferentiated components of the
      squamous and glandular carcinomas were distinct. Only adenocarcinomas were
      focally ER positive. One uncloned variant that produced cancers with a glandular
      component, MCF10CA1h, was cloned and cells were injected into mice. This clone
      produced only undifferentiated carcinomas that, compared to tumors formed by the
      parental uncloned variant, had lost ER, DF3 and c-erbB-2 expression, but more
      strongly expressed p53. Our data demonstrate the potential of the premalignant
      MCF10AT model to generate heterogeneity, including both estrogen receptor
      positive as well as estrogen receptor-negative tumors, during progression.

PMID- 11200774
TI  - Loss of heterozygosity in bilateral breast cancer.
AB  - Women who develop bilateral breast cancer at an early age are likely to harbour
      germline mutations in breast cancer susceptibility genes. The aim of this study
      was to test for concordant genetic changes in left and right breast cancer of
      young women (age < 50) with bilateral breast cancer that may suggest an inherited
      breast cancer predisposition. Microsatellite markers were used to test for loss
      of heterozygosity (LOH) in left and right tumours for 31 women with premenopausal
      bilateral breast cancer. Markers adjacent to or within candidate genes on 17p
      (p53), 17q (BRCA1), 13q (BRCA2), 11q (Ataxia Telangiectasia-ATM) and 3p (FHIT)
      were chosen. Mutational testing for BRCA1 and BRCA2 was performed for cases where
      blood was available. Concordant LOH in both left and right tumours was
      demonstrated for at least one of the markers tested in 16/31(54%) cases. Where
      allelic loss was demonstrated for both left and right breast cancer, the same
      allele was lost on each occasion. This may suggest a common mutational event.
      Four cases showed concordant loss of alleles in both left and right breast cancer
      at D17S791 (BRCA1). BRCA1 mutations were identified in two of these cases where
      blood was available. Four cases showed concordant LOH at D13S155 (BRCA2).
      Concordant LOH was further demonstrated in seven cases for D11S1778 (ATM) and
      four cases for D3S1300 (which maps to the FHIT gene), suggesting a possible role
      for these tumour suppressor genes in this subgroup of breast cancer patients. No
      concordant allelic loss was demonstrated for D17S786 suggesting that germline
      mutations in p53 are unlikely in such cases of bilateral breast cancer.

PMID- 11200775
TI  - Utilization of professional supportive care services by women with breast cancer.
AB  - This paper reports on the results of a survey of utilization of professional
      supportive care services by women with breast cancer, and on patterns of
      differential service utilization by sub-groups of patients. Study participants
      were women with invasive breast cancer diagnosed 23-36 months prior to contact
      about the study, and randomly selected from the Ontario Cancer Registry. From
      among 1,119 eligible women sent survey questionnaires, 731 returned completed
      questionnaires (65%). A total of 31% of respondents reported accessing one or
      more of the following professionals: social worker, psychologist, psychiatrist,
      dietitian, physiotherapist. Among those who responded to a question about whether
      they would have liked specific services, 34% reported that there was at least one
      professional supportive care service they would have liked to use, but were
      unable to access. Factors shown to be related to greater utilization of services
      included: younger age, higher household income, employed or student status,
      private health insurance coverage, and having received chemotherapy. Overall,
      there was a surprisingly low utilization of professional specialized supportive
      care services among women with breast cancer. Policy implications include finding
      strategies to better inform cancer patients about existing services, and ensuring
      that a core set of services are available to all patients.

PMID- 11200776
TI  - Antimitotic and cytotoxic effects of theophylline in MDA-MB-231 human breast
      cancer cells.
AB  - A variety of cancer cell lines, including MDA-MB-231 human breast cancer cells,
      exhibit mitotic inhibition by cAMP. In earlier work, we found that the
      phosphodiesterase inhibitor, theophylline, reduced the number of cells and
      altered cellular morphology. In the current study, we evaluated the effects of
      theophylline on macromolecule synthesis and indices of cell viability.
      Theophylline evoked a concentration- and time-dependent decrease in DNA
      synthesis. However, the net decrease in cell number was greater than that
      predicted solely from mitotic arrest. Assessment of protein synthesis indicated a
      second effect of theophylline separable from that on DNA synthesis. This was
      confirmed by decreased cell viability and adhesion. Exposure of the cells to the
      phosphodiesterase inhibitor, IBMX, in concentrations that produced inhibition of
      DNA synthesis equivalent to that seen with theophylline, elicited a smaller
      reduction in cell number. Theophylline also evoked specific changes in the
      expression or function of membrane-bound adenylyl cyclase activity, effects that
      are likely to contribute to sustained reactivity of these cells to other cAMP
      related inhibitors of cell proliferation, such as isoproterenol. The multiple
      pharmacologic properties of theophylline, producing mitotic inhibition,
      cytotoxicity and altered signaling in MDA-MB-231 cells, may provide insight into
      novel therapeutic strategies.

PMID- 11200777
TI  - Inflammatory breast carcinoma: pathological or clinical entity?
AB  - Inflammatory breast carcinoma (IBC) diagnosis is usually based in the presence of
      typical clinical symptoms (redness and edema in more than 2/3 of the breast),
      which are not always associated with pathologic characteristics (subdermal
      lymphatics involvement). Whether exclusively pathologic findings without clinical
      symptoms are sufficient for IBC diagnosis remains controversial. A retrospective
      analysis of 163 clinically diagnosed IBC (CIC) either with dermal lymphatics
      invasion or not, was compared with another group of 99 patients with dermal
      lymphatics invasion without clinical symptoms (occult inflammatory carcinoma)
      (OIC). The following clinical and pathological characteristics have been analyzed
      and compared: age, menopausal status, clinical axillar node involvement, symptoms
      duration before diagnosis, grade, estrogen receptors, presence of metastases at
      diagnosis, local recurrence, metastasic dissemination, disease-free (DFS) and
      overall survival (OS). Median age was younger in CIC (52.3 vs. 63.8 years; p <
      0.001). Symptom duration before diagnosis were significantly shorter in CIC (3.4
      vs. 6.8 months: p < 0.0001). Visceral (36.2% vs. 17.2%; p = 0.001) and brain
      metastases (7.4% vs. 1%; p = 0.02) was significantly more frequent in CIC.
      Negative estrogen receptors were more frequent in CIC (34.9% vs. 65.1%: p <
      0.004). Five-years DFS (25.6 vs. 51.6%; p < 0.0001) and OS (28.6 vs. 40%; p <
      0.05) were shorter in CIC. CIC (regardless of subdermal lymphatics involvement)
      must be clearly differentiated from OIC. Prognosis of CIC patients is poorer, so
      this two entities should be clearly differentiated when therepeutic results are
      reported.

PMID- 11200778
TI  - Long-term morbidity following axillary dissection in breast cancer patients-
      clinical assessment, significance for life quality and the impact of demographic,
      oncologic and therapeutic factors.
AB  - OBJECTIVE: This study describes in detail the surgery-related symptoms following
      axillary lymph node dissection in breast cancer patients and considers both their
      significance for long term quality of life and the impact of possible influencing
      factors. MATERIAL AND METHODS: Three hundred and ninety six patients were studied
      retrospectively using a self-report questionnaire and a clinical examination. The
      symptoms, numbness, pain, edema, arm strength and mobility were evaluated. The
      subjective assessment of the degree of symptom intensity was compared with
      objective measurements. The extent of surgery (number of resected nodes, level of
      dissection) as well as the influence of demographic, oncologic and adjuvant
      measures (age, time interval, number of involved nodes, chemotherapy) were
      evaluated. RESULTS: Shoulder-arm morbidity and fear of cancer recurrence were the
      most important long-term sources of distress following breast cancer surgery in
      our study population. Demographic, oncologic and therapeutic measures including
      the extent of surgery had no influence on long-term morbidity. The intensity of
      all evaluated symptoms was reported to be more severe in patients' subjective
      statements than in the results of clinical assessment. CONCLUSION: Shoulder-arm
      morbidity following axillary dissection is a frustrating polysymptomatic disease
      that seems to be relatively unaffected by therapeutic measures. The surgical
      trauma necessary for adequate tumor staging (removal of 10 lymph nodes) seems
      decisive for the postsurgery syndrome following axillary dissection. For node
      positive patients complete axillary clearing may improve tumor control without
      worsening long-termmorbidity. New techniques, such as the sentinel-node-biopsy,
      that selects patients with negative axillary status while preserving the
      integrity of axillary structures, may improve the overall morbidity.

PMID- 11200779
TI  - Effect of melatonin and linolenic acid on mammary cancer in transgenic mice with
      c-neu breast cancer oncogene.
AB  - Breast cancer is one of the most common cancers and is a leading cause of
      mortality in women. The TG.NK transgenic mouse line expresses the c-neu breast
      cancer oncogene under the control of a MMTV promoter and appears to be a useful
      animal model for evaluation of intervention strategies to delay/prevent breast
      cancer. Fiber-rich nonpurified diet (NTP-2000) and some retinoid analogues have
      been shown to significantly delay the development of mammary cancer in the TG.NK
      model. Four-week-old hemizygous TG.NK female mice with MMTV/c-neu oncogene fed
      NTP-2000 diet were gavaged with 0.05-0.2 ml of flaxseed oil as the source of
      omega-3 rich PUFA, or melatonin at 50-200 mg/kg or a combination of 0.10 ml
      flaxseed oil and 50 mg/kg melatonin in a gavage volume of 0.2 ml per mouse with
      corn oil as the vehicle for 30 weeks. The time course of the mammary tumor
      incidence pattern was advanced by flaxseed oil compared to the control. At the
      high dose (0.2 ml) of flaxseed oil, when the omega-6: omega-3 PUFA ratio was
      closer to 1, there was some delay in the growth of mammary tumors. Melatonin
      delayed the appearance of palpable tumors and the growth of the tumors with a
      dose-related statistically significant negative trend for the incidence of
      tumors. The combination of flaxseed oil and melatonin caused a significant
      decrease in the number of tumors and tumor weight per mouse compared to the
      control and to flaxseed oil but not to melatonin alone. Flaxseed oil may delay
      the growth of mammary tumors if the omega-6:omega-3 PUFA ratio of fat consumed is
      closer to 1. Melatonin has the potential to markedly delay the appearance of
      palpable mammary tumors. Studies are in progress with the TG.NK mouse model to
      understand the histological and molecular changes associated with the dose
      response pattern of mammary tumor incidence and growth after treatment with a
      broad range of doses of melatonin.

PMID- 11200780
TI  - Clinical characteristics of adolescent headache.
AB  - We evaluate clinical characteristics of headache in a group of subjects > 12
      years to assess the sensitivity and specificity of the IHS criteria. We consider
      whether age at onset may influence the clinical features. We used a semi
      structured questionnaire to examine 136 patients consecutively referred to our
      division. We considered the following subdiagnoses: IHS 1.1, 1.2, 1.7, 2.1, 2.2,
      2.3. Migrainous disorders were found to be more common than non-migrainous
      headaches. A definite diagnosis was established in 68.1% of the migrainous group
      and in 86.6% of the tension-type headache group. Unilateral location, severe
      intensity of pain, the presence of nausea, vomiting, phonophobia and photophobia
      were features which differed between migrainous and non-migrainous subjects. No
      difference was found regarding aggravation of the headache by physical activity.
      On the basis of the criterion duration of attacks < 2 hours, IHS 1.7 was found to
      differ significantly from other migraine types. With the exception of the
      presence of vomiting in migrainous patients, the age at onset was not found to be
      a factor influencing the characteristics of the headache. Diagnostic criteria for
      migraine were highly specific but poorly sensitive, and those for tension-type
      headaches highly sensitive but less specific. The sensitivity/specificity of the
      IHS criteria in adolescent migraine can be influenced by the heterogeneity of the
      clinical characteristics. In fact, the intensity, the location and the quality of
      pain were similar to those found in childhood migraine, while the concomitant
      symptoms were less frequent than in childhood and in adult migraine. Further
      studies are needed to define the degree of severity of the clinical features in
      adolescent headache and to address the question of the validity of the IHS
      criteria.

PMID- 11200782
TI  - "From 0 to 18": what happens to the child and his headache?
AB  - Prospective and retrospective studies showed that headaches (migraine and tension
      type) with childhood or adolescent onset have age-related characteristics and
      change over time, with high rate of type changing, remission or improvement. The
      reasons are unknown. On the other hand, several studies focused on factors that
      may be precursors of childhood headaches. All these factors may allow a
      developmental arc to be outlined, defining the natural history of headache from
      birth to adulthood. Familial (genetic?) influence, hyperreactivity, periodic
      syndromes and anxiety in childhood are factors that may predict headache onset,
      against the background of developmental modulation of pain. Biological and
      psychological factors are probably reciprocally involved, although the link is
      unclear. The identification of prognostic factors could allow a better framing of
      headaches and, from an integrated perspective, have important implications as
      regards clarifying the "nature" of headache.

PMID- 11200781
TI  - Headache in teenagers: comorbidity and prognosis.
AB  - A representative, prospective population sample of 1,205 7-year-old children in a
      larger Finnish city was followed for 15 years for headache and other medical
      disorders and symptoms. The comorbidity associated with headache was found to be
      higher than expected. Allergy and bronchial asthma, diabetes mellitus and
      stomachache were more common in boys than in girls, while psychiatric symptoms
      and sleep disturbances were more typical of girls than boys. The prevalence rate
      of any headache and migraine increases up to the age of 13 years, but after that
      age, a decline in the prevalence is found in boys, while girls show an increasing
      trend both in the presence and in the frequency of any headache and migraine.

PMID- 11200783
TI  - Headache in adolescents in Dutch general practice.
AB  - We set out to describe the occurrence of headache in adolescents in general
      practice, the diagnoses made, the referrals to specialised care and the role of
      psychosocial problems in idiopathic headache. Data from the Dutch national survey
      of morbidity and interventions in general practice were used. The practice
      population (103 practices) comprised 37,187 children aged 12-18 years. In 650
      episodes headache was a reason for encounter. The incidence of headache as
      presented to the GP was 69.9 per 1000 person years. The incidence in girls was
      twice as high as in boys. Half of the episodes with headache complaints were
      related to an infectious disease. The incidence rate of idiopathic headache was
      18.0 per 1000 person years. Eight percent of all headache episodes were diagnosed
      as a psychosocial problem. Of all episodes, 25% percent were diagnosed as
      idiopathic headache (i.e. headache as symptom diagnosis, tension headache or
      migraine). Of these episodes, 21% were associated with an underlying psychosocial
      problem. Referrals were made by the GP in three percent of all headache episodes
      and four percent of idiopathic headache episodes. Headache in adolescents is a
      common reason for visiting a general practice. The symptom is often associated
      with an infectious disease. The GP is aware of underlying psychosocial problems.
      Only few children are referred for specialist care.

PMID- 11200784
TI  - Hypothalamic resetting at puberty and the sexual dimorphism of migraine.
AB  - It is well known that migraine is far more represented in females than in males.
      However, this gender-related difference is present only during reproductive life
      since in prepubertal children, migraine prevalence figures are independent of
      sex. Thus, transition to puberty accounts for changes which render females more
      susceptible to migraine attacks. In females, the main driver of the hormonal
      events allowing sexual maturation is the pulsatile secretion of hypothalamic LHRH
      modulated by opioid activity. Clinical reports suggest that migraine attacks
      could be prevented by the abolition of this neurohormonal secretion. On the other
      hand, several clinical and experimental observations have focused on
      neuroendocrine systems (opiatergic, serotonergic, adrenergic) as participating in
      the constitution of the so-called "migraine trait", the biological predisposition
      in patients that would explain their sensitivity to migraine triggers. Such
      neuroendocrine secretions are mainly dependent upon hypothalamic activity where a
      sexual dimorphic nucleus has been discovered in the preoptic area. We suggest
      that the sexual dimorphism of migraine should be sought in hypothalamic networks
      related to LHRH secretion.

PMID- 11200785
TI  - Migraine associated with menstruation.
AB  - Many women report increased frequency of migraine in association with
      menstruation. The term 'menstrual' migraine is often used despite lack of an
      agreed definition. The International Headache Society has classified most
      headaches but not 'menstrual' migraine. A proposed definition is based on the
      finding that the prevalence of migraine increases on day 1 +/- 2 of the menstrual
      cycle. Attacks occurring at this time of the cycle are typically without aura.
      Effective acute therapy is the mainstay of management for menstrual and non
      menstrual attacks although there is some evidence that attacks linked to
      menstruation are less responsive to treatment compared with migraine at other
      times of the cycle. If several attacks occur throughout the cycle, standard
      prophylactic agents should be used. Women with exclusive 'menstrual' migraine may
      benefit from perimenstrual prophylaxis but this should only be instigated once
      the association between migraine and menstruation has been confirmed with
      prospective records kept for a minimum of three cycles. NSAIDs are the treatment
      of choice in reducing migraine associated with menorrhagia and/or dysmenorrhoea,
      otherwise perimenstrual oestrogen supplements using percutaneous or transdermal
      oestrogens are recommended. Combined oral contraceptives are useful for women
      requiring contraception although there is a tendency for attacks to occur during
      the pill-free interval. If these are contraindicated, depot progestogen is an
      alternative as it also inhibits ovulation and can improve migraine, provided
      amenorrhoea is achieved. Oral progestogen-only contraception has little place in
      the management of 'menstrual' migraine as it does not inhibit ovulation and is
      often associated with a disrupted menstrual cycle. Some women consulting with
      menstrual migraine are menopausal and may be considering hormone replacement
      therapy. Studies suggest that non-oral routes of delivery of oestrogen, which
      provide stable levels, are more likely to improve migraine than oral oestrogens,
      which produce variable day-to-day levels. Too low a dose of oestrogen is
      ineffective at controlling symptoms but too high a dose, particularly if coupled
      with surges of endogenous oestrogen, can trigger migraine aura. Once the route
      and dose has been optimised, continuous oestrogens can control migraine as well
      as menopausal symptoms. Additional progestogen, necessary for unhysterectomised
      women, can exacerbate migraine. To minimise this, progesterone derivatives or non
      oral routes of delivery are recommended, with continuous regimens used where
      possible.

PMID- 11200786
TI  - Central and peripheral mechanisms of migraine.
AB  - Central (cortex and upper brainstem) and peripheral (trigeminovascular)
      mechanisms are involved in the pathophysiology of migraine. We propose that
      unknown migraine triggers initiate depolarization of cortical neurons followed
      concomitantly by a transient increase in blood flow. This transient hyperemia
      spreads at a rate of 3-6 mm/min followed by hypoperfusion which is more long
      lasting. Through unknown mechanisms (probably chemical), we hypothesize that this
      wave activates or sensitizes trigeminovascular axons which is a consequence of
      neuropeptide release and neurogenic inflammation. Orthodromic conduction along
      trigeminovascular fibers transmits information centrally via the trigeminal
      caudalis and other brainstem nuclei to higher cortical structures for
      registration and modulation of nociceptive information.

PMID- 11200787
TI  - Dopaminergic hypersensitivity in migraine: clinical and genetic evidence.
AB  - Migraine is a common disorder characterized by recurrent pain attacks of mild
      severe intensity associated with autonomic and occasionally neurological
      symptoms. The migraine attack is a complex process that involves both central and
      peripheral structures. Various pathogenetic hypotheses have been proposed but the
      pathophysiology of the disease is still unknown. The study of the pathophysiology
      of migraine includes the investigation of neurotransmitter systems and their
      potential role in the development of the attack. Several studies performed since
      the '60s have demonstrated the key role of serotonin. The theory whereby
      hypersensitivity of the dopaminergic system may be involved in the pathogenesis
      of migraine has been supported by various authors on the basis of clinical,
      pharmacological and recent genic evidence. Recent neurophysiological studies
      performed using new techniques have led to a correlation of migraine with central
      nervous system disorders characterized by an altered neuronal excitability.
      Migraine seems to be characterized by a low threshold of neuronal excitability
      which is in turn regulated by genetic factors involving the dopaminergic system.
      A genetically determined hypersensitivity of the dopaminergic system may be
      involved in the onset of the migraine attack.

PMID- 11200788
TI  - Dopamine involvement in the migraine attack.
AB  - Clinical evidence and recent genetic findings seem to indicate an involvement of
      dopamine in the pathophysiology of the migraine attack. Prodromal symptomatology
      (mood changes, yawning, drowsiness, food craving), accompanying symptoms (nausea,
      vomiting, hypotension) and postdromal symptoms (mood changes, drowsiness,
      tiredness) may be related to dopaminergic activation. The dopaminergic system
      could also play a role in the headache phase, either by taking part in
      nociception mechanisms, or by regulating cerebral blood flow. A body of
      pharmacological findings seems to support this involvement. Migraine patients,
      between attacks, show a higher responsiveness to acute administration of
      dopaminergic agents. Apomorphine administration induces in migraineurs more yawns
      as well other dopaminergic symptoms e.g. nausea, vomiting, dizziness. Migraine
      has been associated with hypotension and, occasionally, with syncope.
      Bromocriptine causes severe orthostatic syndrome in migraine patients. Both
      piribedil and apomorphine markedly increase cerebral blood flow of migraine
      patients, thus indicating enhanced responsiveness of dopamine receptors which are
      involved in cerebral blood flow regulation. Interictal dopaminergic
      hypersensitivity has also been demonstrated by means of neuroendocrine tests.
      Altered dopaminergic control of prolactin secretion exists in migrainous women. L
      deprenyl, a MAO-B inhibitor, is significantly more effective in reducing
      prolactin levels in migraineurs than in controls. Taken together, these findings
      support the view that hypersensitivity of peripheral and central dopaminergic
      receptors is a specific migraine trait. Finally, a high density of lymphocytic D5
      receptors has been found in migraine sufferers, thus suggesting their
      upregulation. Therefore, the hypothesis that dopaminergic activation is a primary
      pathophysiological component in certain subtypes of migraine, namely those
      characterised by marked dopaminergic symptomatology, has been advanced. From this
      perspective, a blockade of dopaminergic hyperresponsive receptors can be
      considered as a rationale for the therapy of migraine.

PMID- 11200789
TI  - Rational migraine management: optimising treatment with the triptans.
AB  - In the last two years, a number of 5-HT1B/1D agonist triptans with enhanced
      lipophilicity (TELs) relative to the first drug of this class, sumatriptan, have
      been approved for marketing in most countries of the world (naratriptan,
      rizatriptan and zolmitriptan). In addition, at least three others are in advanced
      stage of clinical development (almotriptan, eletriptan, and frovatriptan). This
      paper sets out to review the recent data with the aim of identifying: 1) What are
      the critical differences between the TELs and sumatriptan? 2) How do the
      currently licensed TELs compare? 3) Is it possible to provide a rational approach
      to migraine therapy based on objective differences in the clinical profile of
      these new drugs? Recent randomised controlled and comparator data were reviewed,
      including the independent FDA assessment of rizatriptan. Critical differences for
      the new TELs (naratriptan, rizatriptan and zolmitriptan) which may lead to more
      rational migraine management: Both rizatriptan (10 mg) and zolmitriptan (2.5 mg
      and 5.0 mg) have demonstrated superior efficacy to sumatriptan 100 mg, and 25 and
      50 mg respectively. Therefore, for first line use either rizatriptan or
      zolmitriptan would be appropriate for moderate and severe headache. Rizatriptan
      has a more rapid onset of action than sumatriptan 100 mg. Both rizatriptan and
      zolmitriptan have a more rapid onset of action than naratriptan. Therefore, for a
      rapid onset of action either rizatriptan or zolmitriptan would be appropriate.
      Naratriptan would appear to have a lower recurrent headache rate than
      sumatriptan, rizatriptan or zolmitriptan. However, 24-hour efficacy rates for
      zolmitriptan 2.5 mg were significantly greater than for sumatriptan 25 mg and 50
      mg and were not significantly different from naratriptan. Therefore, for
      headaches of long duration and with a tendency to recur (e.g. menstrual
      headaches) either naratriptan or zolmitriptan would be appropriate. Naratriptan
      has lower reported adverse event rates comparable with placebo. This would
      support the use of naratriptan 2.5 mg in patients who have demonstrated poor
      tolerance to the "triptan type" adverse events.

PMID- 11200790
TI  - Effect of nitric oxide donors on the central nervous system--nitroglycerin
      studies in the rat.
AB  - The demonstration that nitrovasodilators act as nitric oxide (NO) donors has
      favored a resurgence of interest in this class of compounds. The demonstration of
      the different biological effects of NO in various districts, including the
      central nervous system, suggests a possible role for these substances besides
      their well-known cardiovascular activity. Among the various nitrovasodilators
      commercially available, nitroglycerin represents a well known substance to
      headache experts because of its capability to provoke spontaneous-like migraine
      attacks in headache-free migrainous subjects. Basic research has recently
      demonstrated that nitroglycerin activates a variegate set of brain nuclei
      following systemic administration via the intervention of selected
      neurotransmitters and neuromediators, with a specific time-pattern in different
      brain areas. Increasing evidence suggests that nitroglycerin-induced neuronal
      activation is mediated by multiple mechanisms that include direct neuronal and
      vascular action of nitroglycerin-derived and endogenously-synthesized NO, as well
      as indirect effects related to nitroglycerin-induced changes in cardiovascular
      and trigeminovascular systems. The study of the neurovascular effects of
      nitroglycerin in the rat provides relevant information for a better understanding
      of the pathophysiology of migraine attacks and of their triggers.

PMID- 11200791
TI  - New methods for evaluating acute treatments in migraine.
AB  - The crescendo of activities in the field of migraine therapy, has led to the
      emergence of a class of molecules, the triptans, that are similar in terms of
      their activity on serotonin receptors, but which actually differ from one
      another, as each one has its own peculiar clinical profile. A careful examination
      of their clinical activity and their validation with objective methods may
      promote the wise use of each drug, make room for new products, and allow patients
      to make their own choices.

PMID- 11200792
TI  - The effectiveness of combined oral lysine acetylsalicylate and metoclopramide
      (Migpriv) in the treatment of migraine attacks. Comparison with placebo and oral
      sumatriptan.
AB  - In two, double-blind, randomised, clinical, trials (RCTs), oral lysine
      acetylsalicylate (1620 mg, equivalent to 900 mg aspirin) combined with
      metoclopramide (10 mg) (LAS + MTC) was compared with placebo, and with oral
      sumatriptan (100 mg) in one of these RCTs. In both RCTs the LAS + MTC combination
      was superior to placebo with therapeutic gains (percentage relief after active
      treatment minus percentage relief after placebo) of 30% and 31% for the first
      treated attack. These therapeutic gains are in the same range as those found for
      100 mg oral sumatriptan, and in the comparative RCT the LAS + MTC combination was
      quite comparable to 100 mg sumatriptan, with success rates for the first attack
      of 57% and 53%, respectively.

PMID- 11200793
TI  - NSAIDs: behind the mechanisms of action.
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) are a heterogeneous group of
      compounds. These heterogeneous agents have a similar therapeutic action for the
      treatment of pain, fever and inflammation. The major mechanism of action of
      NSAIDs is the inhibition of cyclooxygenase (COX), the enzyme catalysing the
      synthesis of prostaglandins (PGs). Appropriate and effective treatment for
      migraine depends upon an accurate diagnosis. The goals of treatment are
      amelioration of the symptoms of an acute attack and prevention of further
      attacks.

PMID- 11200794
TI  - The relevance and application of disease management and pharmacoeconomics to
      migraine.
AB  - Disease management is a comprehensive approach to improving the outcomes for
      patients suffering from chronic disease. It has frequently been applied to
      diseases like diabetes and asthma but, to date, has not widely been regarded as
      particularly relevant to migraine. Yet a number of factors suggest that this view
      might usefully be reconsidered, notably the dissatisfaction with migraine control
      expressed by many patients and the inconsistencies in treatment patterns observed
      across clinical practice. Another factor is the growing range of therapeutic
      options available to manage the disorder. In this latter respect, decision-making
      must not only be governed by individual patient needs, but also by considerations
      of clinical cost effectiveness. Pharmacoeconomic analysis can play a useful role
      in determining the relative value for money offered by different treatments and
      is increasingly being applied in migraine. It is clear, however, that full
      realisation of its potential contribution requires progress to be made in a
      number of key areas, perhaps most importantly agreement on the definition of
      successful treatment.

PMID- 11200795
TI  - Headache burdens and bearers.
AB  - All elements of headache burden, and those who bear them, need to be identified
      if headache is to secure its rightful place in the priority queue for scarce
      healthcare resources. This paper sets out to do this. Illness manifesting as
      headache imposes substantial burdens on individual people and on society. Whilst
      different diagnostic categories of headache vary quantitatively in their impact,
      the elements of burden are similar for all common headaches. Migraine, being the
      most studied, is a good model. The AASH/IHS Consensus Symposium on Improving
      Migraine Management, held in Washington DC on October 2nd 1998, argued that,
      world-wide, migraine is both under-diagnosed and under-treated. Whilst improved
      allocation of healthcare resources to migraine and other headache illnesses will
      mitigate these burdens, this will not happen unless the size and full nature of
      the problem are recognised. Using rhetoric, I answer two questions: what are the
      burdens of headache, and who bears them? Migraine has a peculiar tendency to
      extend its burdens beyond attacks and to others than the immediate sufferer. In
      many cases it should be characterised as a chronic rather than episodic illness.
      Other categories of headache impose qualitatively similar and heavy and widely
      placed burdens. Healthcare resources expended on better treatment are likely to
      be repaid several-fold by savings elsewhere.

PMID- 11200796
TI  - Headache in the Diagnosis-Related Groups (DRG) era: management and
      appropriateness of admission.
AB  - Headache is an extremely common disorder which has a marked impact on the
      utilisation of healthcare resources and constitutes a considerable socio-economic
      burden. The related costs, both direct and indirect, are especially high in
      developed countries, since headache predominantly affects an economically-active
      section of the population. The Diagnosis-Related Groups (DRG) system, a method
      for reimbursing healthcare structures for patient admissions, was introduced in
      Italy in 1995. The aim of the system was to control public health expenditure and
      to promote better distribution of financial resources. Here, we report the
      results of the application of the DRG system to headache patients admitted to the
      Department of Neurology of the University of Pavia in 1996 and 1998. The
      financial analysis revealed high fixed costs (hospital running costs per days of
      hospitalisation); by contrast, the impact of the variable costs (those relating
      to the direct management of the individual patient, i.e. examinations,
      therapeutic interventions etc.) was low. It was found that reducing the number of
      days of hospitalisation increases the hospital's income and reduces the mean loss
      incurred in each DRG. It is therefore suggested that a complete approach to the
      management of headache must include educational programmes for patients and
      general practitioners, and that access to headache centres and to hospital care
      should be restricted to cases of acute, severe headache, or recurrent, chronic
      headache with/without drug abuse or dependence.

PMID- 11200797
TI  - Quality assurance system using ISO 9000 series standards to improve the
      effectiveness and efficacy of the Headache Centre.
AB  - The ISO 9000 series has been adopted as a reference standard and operating system
      for a Quality Assurance project involving all the units of the Polyclinic of
      Modena, within which the Headache Centre operates, to guarantee a clearly-defined
      standard of service to the client and the promotion of continuous quality
      improvement. The implementation of the quality system, which necessitated
      analysis and description of the process of headache diagnosis and treatment
      currently being applied, highlighted those aspects that did not conform with the
      quality objective, primarily, the long waiting list for admission. Since ready
      accessibility is a basic requisite for the quality of health care services, a new
      organisational set-up was introduced, and is still in place, with the aim of
      enabling patients who are really in need to be admitted to the Headache Centre
      without undue delay.

PMID- 11200798
TI  - Peripheral and central sensitization during migraine.
AB  - Current theories propose that the pain of migraine is caused by chemical
      activation of meningeal perivascular fibers. In an animal model of migraine, we
      have recently shown that chemical activation of meningeal primary afferent
      nociceptors that innervate the dura could lead to the following: a) peripheral
      sensitization of these nociceptors to intracranial mechanical stimulation; b)
      central sensitization of second-order trigeminovascular neurons that receive
      convergent input from the dura and skin to extracranial mechanical and thermal
      stimulation; and c) facilitated cardiovascular pressor responses that are usually
      indicative of pain. These findings provide the first set of evidence for the
      induction of peripheral and central sensitization along trigeminovascular pain
      pathways by visceral input from the intracranial dura. We propose that the
      throbbing pain of migraine is mediated mainly through peripheral and to a lesser
      extent through central sensitization, and that the development of scalp
      tenderness is mediated mainly through central sensitization.

PMID- 11200799
TI  - The search for novel migraine therapies: experimental models.
AB  - The identification and development of the potent 5-HT1B/1D agonist, sumatriptan
      has resulted in new therapeutic opportunities for the treatment of migraine and a
      number of chemically novel agents with a similar mechanism of action have been
      identified. Whilst these agents are optimised to enhance the therapeutic effect
      of sumatriptan, development of mechanistically novel therapies may provide new
      directions for the care of migraine sufferers. To develop new treatment
      paradigms, novel chemical entities should be evaluated in animal models which are
      predictive of therapeutic efficacy e.g.: in animal models where sumatriptan has
      shown activity, or the pathophysiological processes involved in the disease must
      be targeted. Therefore, investigation of mechanisms underlying cortical activity
      and its involvement in the activation of trigeminal vascular pathways may allow
      better understanding of the disease and result in the identification of new non
      triptan-like therapies.

PMID- 11200800
TI  - Pharmacology of emesis and gastrointestinal motility: implications for migraine.
AB  - This paper outlines the physiopharmacology of emesis and its gastrointestinal
      motor correlates in relation to the possible treatment strategies of a migraine
      attack. The gastrointestinal motor correlates of vomiting consist of a
      stereotyped motor response to diverse stimuli and basically include gastric
      relaxation and a series of events (intestinal motor inhibition and disruption of
      slow wave activity) in preparation for the occurrence of a retrograde giant
      contraction that propagates orally and empties intestinal contents into the
      stomach. These motor correlates always accompany vomiting, but may also appear as
      an independent phenomenon. Antidopaminergic agents, such as metoclopramide and
      domperidone, have antiemetic/prokinetic properties, block the gastrointestinal
      motor correlates of vomiting and may speed up absorption of antimigraine agents.
      The use of 5-HT4 receptor agonists may be an alternative strategy to achieve
      prokinesia during a migraine attack, although this issue still needs to be fully
      addressed by controlled studies. Sumatriptan was found to induce gastric
      relaxation and delay gastric emptying, but the impact of these effects during a
      migraine attack remains to be determined.

PMID- 11200801
TI  - A pathophysiological view of primary headaches.
AB  - The cerebral circulation is innervated by sympathetic, parasympathetic and
      sensory nerves which store a considerable number of neurotransmitters. The role
      of these has been evaluated in primary headaches. A clear association between
      head pain and the release of calcitonin gene-related peptide (CGRP) was
      demonstrated. In cluster headache and in a case of chronic paroxysmal headache
      there was in addition release of vasoactive intestinal peptide (VIP) which was
      associated with facial symptoms (nasal congestion, rhinorrhea). In parallel with
      sumatriptan treatment head pain subsided and neuropeptide release normalised.
      These data show the involvement of sensory and parasympathetic mechanisms in the
      pathophysiology of primary headaches.

PMID- 11200802
TI  - Central and peripheral mechanisms in migraine: a neurophysiological approach.
AB  - The author briefly reviews the main evidence in favour of both central and
      peripheral factors supposed to take part in the complex pathomechanisms leading
      to the activation of the trigemino-vascular system in the migraine attack.

PMID- 11200803
TI  - From neurophysiology to genetics: cortical information processing in migraine
      underlies familial influences--a novel approach.
AB  - Migraine patients show impaired cortical information processing between attacks
      with deficient habituation of pattern-reversal visual evoked potentials (VEP),
      and strong intensity dependence of auditory cortical evoked potentials (IDAP).
      This could be a genetic trait as certain genetic patterns are known for evoked
      potentials in healthy subjects. VEP-habituation and IDAP were studied in 40
      migraine patients, i.e. pairs of 20 parents and their children. We developed a
      novel approach based on Monte Carlo statistics to selectively assess vertical
      familial influences. Both groups, parents and children, were characterized by
      abnormal VEP-habituation and IDAP. However, similarity between related pairs was
      far more pronounced than similarity between unrelated pairs. Assessed with a
      novel statistical approach, familial influences proved to be highly significant
      in determining cortical information processing in migraineurs, thus supporting
      the important role of genetic factors.

PMID- 11200804
TI  - Neurophysiological evidence of increased cortical reactivity in migraine.
AB  - Cortical reactivity in migraine can be studied with evoked potentials. The
      majority of the evidence shows increased reactivity in migraine, which may be due
      to abnormal inhibition. At present, the techniques are not useful for diagnosis.
      Discrepancies between reports may be due to fluctuations in reactivity over time.
      Documenting this changing reactivity requires refinement of analysis techniques.

PMID- 11200805
TI  - Contingent negative variation as indicator of duration of migraine disease.
AB  - Amplitudes of early wave contingent negative variation (iCNV) reveal significant
      differences between migraine patients and healthy controls, indicating a lack of
      habituation and pronounced attentional functions in migraine patients. CNV
      amplitudes were recorded in 20 migraine patients. The CNV amplitudes were Pearson
      correlated with the individual duration of the migraine disease. Only iCNV
      correlates inversely with the duration (r = -.544). The data show an influence of
      duration of migraine disease on iCNV amplitudes. It is suggested that iCNV is an
      indicator of chronicity in persistent migraine.

PMID- 11200806
TI  - Clinical and para-clinical tests in the routine examination of headache patients.
AB  - Para-clinical examinations in the diagnosis and treatment control of headache
      patients vary considerably between clinics and headache centers. Among the
      neurological societies in Europe there has been a consensus that some common
      procedures and recommendations should be created. In the Fall of 1998, the
      European Federation of Neurological Societies (EFNS) commissioned a Task Force on
      Neurophysiological Tests and Imaging Procedures in Headache Patients. Members of
      the Task Force are the present authors and we have reviewed the literature on 1)
      neurophysiological tests (EEG and evoked potentials), 2) autonomic nervous system
      and clinical tests and 3) imaging and cerebrovascular tests (X-ray, CT, MR, fMRI,
      PET, SPECT and transcranial Doppler). The literature was carefully evaluated with
      respect to validity and strength of the data. The task was to reach conclusions
      about each technique in the form of guidelines for clinical use. Finally,
      selected areas for future research will be outlined. The extensive review and the
      guidelines will be published by the EFNS during 2000.

PMID- 11200807
TI  - Clinical management of young patients presenting with headache.
AB  - Headache is a common symptom in young patients and requires a clearly structured,
      individual approach. The history and the clinical examination are prerequisites
      for planning further management of the condition. The IHS classification is
      particularly useful in the differential diagnosis of idiopathic headache.
      Additional diagnostic testing should not be performed routinely, but on an
      individual basis depending on the patient's history and neurological findings.
      The acute therapy of idiopathic headache in young patients has been evaluated in
      few studies only. However, there is general agreement that (in subjects requiring
      medication) paracetamol, acetylsalicylic acid and ibuprofen are most useful for
      treating migraine attacks, whereas analgesics should widely be avoided in tension
      type headache. For the prophylaxis of migraine and tension-type headache, non
      pharmacological measures such as regulation of lifestyle, relaxation training and
      psychological or psychotherapeutic interventions are much more important than
      pharmacotherapy, which is required in a small number of patients only.

PMID- 11200808
TI  - Experimental models of migraine.
AB  - Experimental models have been developed to study various aspects of migraine.
      Here we describe the most commonly used models--mostly animal models--which led
      to the development of a pathophysiological concept of migraine. We focus on
      activation studies of the trigeminovascular system, the sphenopalatine ganglion,
      the superior sagittal sinus, the dura mater as well as blood vessels. The most
      common consequences of activation are noted and include protein extravasation,
      neuropeptide release, rCBF and diameter changes, c-fos expression and electrical
      neuronal activity. In addition, we briefly summarize the results of cortical
      spreading depression studies, as they relate to the human migraine aura. These
      models will continue to be useful to elucidate migraine pathophysiology and
      explore drug mechanisms.

PMID- 11200809
TI  - The early history of the American Society for Reproductive Immunology: a personal
      memoir.

PMID- 11200810
TI  - Inhibition of the antibody responses to rat blood transfusion antigens in mice by
      boar seminal immunosuppressive fraction.
AB  - PROBLEM: Immunosuppressive fraction of boar seminal vesicle fluid (ISF) was
      tested to muffle primary and secondary antibody responses to xenotranfusions.
      Contemporaneously, heparin non-binding fraction of seminal plasma (H- fraction),
      presumed to be identical to ISF, was used to support the results. METHOD: To
      study their similarity, ISF and H- fraction were analyzed by high-performance
      liquid chromatography and the separated proteins by N-terminal sequencing. In
      sera of mice treated with ISF or H- fraction, the productions of antibodies
      against rat erythrocytes and blood serum were evaluated by enzyme-linked
      immunosorbent assay (ELISA). The productions of IgM, IgA, and IgG subclasses were
      followed by sandwich ELISA. RESULTS: ISF and H- fraction were proved to be equal
      complexes of porcine seminal plasma (PSP) proteins PSP I and PSP II. Both
      inhibited antibody responses to rat erythrocytes and serum and the concentrations
      of IgM, IgG, IgG1 and IgG2 after the first transfusion with a long-lasting
      effect. Both suppressed the secondary antibody production if applied before the
      second transfusion. IgA and IgG3 stayed uninfluenced. ISF and H- fraction had an
      equal immunosuppressive effect. CONCLUSIONS: ISF was characterized biochemically,
      found to be identical to H- fraction, and determined to be powerful in overcoming
      unwanted exaggerated antibody responses to xenotransfusion.

PMID- 11200811
TI  - Intravenous immunoglobulin therapy influences T cell adhesion to extracellular
      matrix in women with a history of recurrent spontaneous abortions.
AB  - PROBLEM: To determine activated T cell adhesion level to extracellular matrix
      (ECM) in non-pregnant women with a history of recurrent spontaneous abortions
      (RSA). In addition, to evaluate a small-dose intravenous immunoglobulin (IVIG)
      therapy influences on T cell adhesion to ECM. METHOD OF STUDY: Phytohemaglutinin
      (PHA) or phorbol myristate acetate (PMA) activated T cell adhesion to the
      following extracellular matrix proteins: collagen IV, fibronectin and elastin
      were studied in women with the history of RSA. In addition, IVIG immunotherapy
      influence on T cell adhesion was studied. Normal T cells adhesion values were
      established in non-pregnant healthy women with the previous successful pregnancy
      outcome and in normal healthy pregnant women. RESULTS: PHA activated T cell
      adhesion to collagen IV (P = 0.04), fibronectin (P = 0.0003) nad elastin (P =
      0.02) were significantly higher in women with the history of RSA when compared to
      non-pregnant healthy women wit the previous successful pregancy outcome. IVIG
      immunotherapy normalized the T cell adhesion level and favored a successful
      pregnancy. CONCLUSIONS: Increased T cell adhesion to collagen IV, fibronectin and
      elastin characterize women with the history of RSA. Decreased T cell adhesion to
      the main extracellular matrix components of human placenta may underlie possible
      effect of IVIG action.

PMID- 11200812
TI  - Theoretical basis for herbal medicines, Tokishakuyaku-san and Sairei-to, in the
      treatment of autoimmunity-related recurrent abortion by correcting T helper-1/T
      helper-2 balance.
AB  - PROBLEM AND METHOD OF STUDY: To get insight into the basis for the empirical
      usage of herbal medicines in the treatment of recurrent abortion, we examined
      whether Tokishakuyaku-san (Toki) and Sairei-to (Sai) modulate T helper-1 (Th1)
      and T helper-2 (Th2) cytokine release from peripheral blood mononuclear cells
      (PBMCs). The effects of these medicines were investigated as related to human
      leukocyte antigen (HLA)-G, a non-classical HLA class I antigen expressed on
      trophoblasts and a putative crucial player involved in fetomaternal immune
      interplay. RESULTS: Toki and Sai increased the release of Th1 group cytokines,
      tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma while preserving the
      inhibitory effect of HLA-G on the release of these cytokines. As for Th2 group
      cytokine release, Toki was without effect in modulating interleukin (IL)-4
      release, regardless of the presence of HLA-G, whereas Sai nullified the effect of
      the presence of HLA-G to stimulate the release of IL-4 without affecting its
      release in the absence of HLA-G. CONCLUSION: Toki and Sai may have therapeutic
      potential, particularly in autoimmunity-related recurrent abortion where Th2
      response is pathologically enhanced, but not in recurrent abortion involving
      alloimmune fetomaternal derangement, a condition of, rather, an enhanced Thl
      response.

PMID- 11200813
TI  - Enhanced expression of Fas-associated proteins in decidual and trophoblastic
      tissues in pregnancy-induced hypertension.
AB  - PROBLEM: To determine if feto-placental tissues from gestations complicated by
      pregnancy-induced hypertension (PIH) have altered expression of Fas-associated
      proteins. METHOD OF STUDY: The expression of several Fas-related proteins was
      determined in fetal membranes, decidua, and placentas obtained from PIH-affected
      (n = 12, age range 32-36 weeks) and normal (n = 6, age range 37-41 weeks)
      gestations. Paraffin-embedded tissue sections were stained with specific
      monoclonal antibodies to Fas, Fas ligand (FasL), caspase-3, and bax. RESULTS: We
      observed greater expression of Fas and FasL in amnion and decidua from PIH
      affected gestations than in normal controls. Intense staining was observed only
      in the perivascular endothelium (caspase-3) and in decidual cells (bax) from PIH
      gestations. CONCLUSION: Differential expression of Fas-related proteins in fetal
      membranes, decidua, and placentas from PIH-affected gestations is consistent with
      increased apoptosis, and suggests activation of the Fas/FasL pathway in a tissue
      specific manner.

PMID- 11200814
TI  - Identification of epididymis-specific antigens using neonatal tolerization.
AB  - PROBLEM: Conventional immunization using whole sperm containing multiple antigens
      as the immunogen followed by hybridoma technology usually gives antibodies to
      antigens invariably of testicular origin, probably because of the strong
      immunogenic nature of these antigens. Therefore, an alternate approach of
      neonatal tolerization or subtractive immunization has been utilized to raise
      antibodies specific to epididymis by suppressing immune response to testicular
      antigens. METHOD OF STUDY: Neonatal mice were tolerized with testicular sperm
      proteins on days 0 and 5. These animals were then immunized with epididymal sperm
      proteins on day 21, followed by two boosters at biweekly intervals. Sera from
      these mice were used to localize epididymis-specific antigens. RESULTS: Sera from
      mice that were tolerized to testicular sperm proteins and later immunized with
      epididymal sperm proteins reacted only with epididymal proteins. CONCLUSION: The
      results of this study demonstrate that neonatal tolerization with testicular
      sperm proteins, followed by immunization with epididymal sperm proteins, enhances
      the production of antibodies to proteins exclusively of epididymal origin.

PMID- 11200815
TI  - Nitric oxide (NO) and interleukin-1beta (IL-1beta) in follicular fluid and their
      correlation with fertilization and embryo cleavage.
AB  - PROBLEM: Using an IVF model, the goal of the study was to investigate the
      relationship between follicular fluid (ff) NO and IL-1beta levels, as well as
      their correlation with fertilization of mature oocytes and embryo cleavage rates.
      METHOD OF STUDY: Follicular fluid was collected from 17 patients at the time of
      transvaginal oocyte retrieval following controlled ovarian stimulation. Oocytes
      harvested from these follicles were followed through fertilization and embryo
      cleavage. The NO metabolites nitrate/nitrite (NO3/NO2) were measured using the
      Griess reaction as an indirect assessment of NO activity. IL-1beta was measured
      using a high sensitivity ELISA system (Amersham, UK). The Student's t-test was
      utilized for unpaired data with the means considered significantly different when
      P < or = 0.05. RESULTS: Follicular fluid NO3/NO2 levels were significantly lower
      in follicles containing mature oocytes that fertilized (n = 30; 9.7 +/- 1.0
      microM), versus those that did not fertilize (n = 23; 15.4 +/- 2.4 microM; P <
      0.05). Follicles that contained oocytes that fertilized and went on to divide
      beyond the 6 cell stage had significantly lower ff levels of NO3/NO2 (n = 18; 7.5
      +/- 0.9 microM), as compared to ff that contained oocytes that did not fertilize
      or failed to develop beyond the 5 cell stage (n = 35; 14.6 +/- 1.7 microM; P <
      0.01). No correlation was found between ff NO3/NO2 levels (n = 28; 13.8 +/- 2.0
      microM) and ff IL-1beta levels (n = 28; 0.5 +/- 0.08 pg/mL). An analysis of ff IL
      1beta levels in relation to fertilization and embryo cleavage rates revealed no
      correlation. CONCLUSIONS: Lower ff NO3/NO2 levels at the time of oocyte retrieval
      are associated with adequate fertilization and embryo cleavage rates. In our IVF
      model, no correlation was found between ff IL-1beta levels and ff NO3/NO2,
      fertilization, or embryo cleavage rates.

PMID- 11200816
TI  - Expression of functional chemokine receptors of human placental cells.
AB  - PROBLEM: Chemokine receptors of placental trophoblasts possibly act as co
      receptors or alternative receptors of maternal fetal infection by HIV. To clarify
      their possible expression and the physiological roles of chemokines on human
      placentae, we studied chemokine chemokine receptor expression and the effects of
      exogenous chemokines on choriocarcinoma cell lines. MATERIALS AND METHODS:
      Placental samples were obtained from 13 placentae of various gestational ages.
      Villous tissue was mechanically dissected from samples. Trophoblasts were
      enriched by anti-human chorionic gonadotropin (hCG)-coated magnetic beads. Human
      choriocarcinoma cell lines (JAR, BeWo, JEG-3) were maintained in RPMI 1640 media
      supplemented with 10% FCS. Expression of chemokine receptors was studied by RT
      PCR. The effects of MIP-1alpha, RANTES, MCP-1 on hCG production were estimated by
      EIA. Effects of chemokines on proliferation of choriocarcinoma cell lines were
      examined by MTT assay. RESULTS: We observed mRNA expression of CCR-1, 2, 3, 4, 5
      and CXCR-1, 2, 4 in 1st trimester placental villi, CCR-I, 2, 4 and CXCR-1, 2. 4
      in 2nd trimester placental villi, CCR-1, 2, 4 and CXCR-4 in 3rd trimester
      placental villi. Using MACS enriched trophoblasts, we observed identical results.
      A choriocarcinoma cell line BeWo expressed CCR-1, 3, 4 and CXCR-1, 2, 4 while JEG
      3 and JAR expressed CCR-1, 3, 4, 5 and CXCR-1, 2, 4. Expression of the CCR-5 and
      CXCR-4 protein in choriocarcinoma cell lines and MACS-enriched trophoblats were
      confirmed by flow cytometry. Chemokine MCP-3, MIP-1alpha, RANTES mRNA were
      expressed by the 1st, 2nd and 3rd trimester placental samples and the three
      choriocarcinoma cell lines examined. MCP-1 was expressed by 1st and 2nd trimester
      placental villi. Administration of chemokines up-regulated proliferation (10(-1) 
      10 ng/mL) and hCG production (10(-1) - 10(-2)ng/ mL) of the three
      choriocarcinoma cell lines examined. CONCLUSIONS: Our results suggest possible
      roles of chemokines/chemokine receptors on placental physiology and their
      involvement in HIV transmission as alternative receptors.

PMID- 11200818
TI  - Quantitative cell and matrix changes in human humeral head osteoarthritic
      cartilage.
AB  - A new quantitative method was devised both to establish an objective standard for
      morphometric diagnosis and to determine the extent of degeneration in
      osteoarthritic cartilage. Eight normal and forty-eight osteoarthritic humeral
      heads, subsequently confirmed by light microscopy, were obtained at necropsy. The
      articular cartilage was observed in situ with a laser scanning confocal
      microscope (LSCM) and morphometric measurements determined cell density
      (cells/mm), cell volume fraction (%) and mean cell volume (microm3). The
      osteoarthritic cartilages were classified according to the following four
      characteristics: increase in thickness, increase in cell volume fraction,
      decrease in cell volume fraction, and fibrous pannus. Deviations in cell density
      and cell volume fraction from normal means were calculated as extent of
      degeneration. Our present approach aims to provide valuable clues, such as
      objective stereological information and a unique reference for biochemical and
      traditional morphological analyses, that clinicians will be able to use in
      combination with other methods in order to establish a reliable diagnosis.

PMID- 11200817
TI  - Regulation of IgE-receptor expression, IgE occupancy and secretory capacity of
      mast cells.
AB  - Mast cells play an important role in initiating and modulating allergic and
      inflammatory reactions. Their responsiveness is determined by three important
      factors: the expression of IgE receptors on the cell surface, the IgE occupancy
      of these receptors, and the intrinsic secretory capacity of the cells. In this
      review, we will summarise some findings relevant to these three aspects of mast
      cell function, and discuss possible regulatory mechanisms. It appears that the
      genetic background as well as environmental factors influence all three of these
      components of the response. T cells appear to play an important role in
      regulating the IgE-receptor expression and also, independently, the intrinsic
      secretory capacity of mast cells via an unidentified route, possibly involving
      the secretory signal transduction chain directly. IgE itself appears to have an
      important role in the regulation of IgE-receptor expression, as indicated by the
      upregulation of receptors in vitro in the presence of IgE, and the absence of IgE
      binding capacity of mast cells in IL-4 gene knockout mice, lacking IgE
      production. The IgE-receptors of mast cells are saturated to a high degree under
      different normal conditions, without an obvious relation to antigenic
      stimulation, also in athymic animals. We have suggested that this basal IgE
      content on mast cells may be the result of an antigen-independent production of
      IgE directed by the mast cells themselves and serving regulatory purposes,
      modifying the secretory response and preventing a massive possibly harmful
      degranulation.

PMID- 11200819
TI  - Erythema migrans--influence of posture. Case report.
AB  - Despite widespread awareness of the most classical clinical presentation with
      central clearing of erythema migrans, a pathognomonic sign of infection with
      Borrelia burgdorferi, diagnosis of other forms of erythema migrans remains more
      difficult. We describe a case of a patient with secondary lesions of erythema
      migrans that within three months formed a complicated pattern and affected at
      last nearly the entire lower limb of the patient. In addition, the erythema
      appeared to be posture-dependent in the way that the lesion was with central
      clearing in the supine and with homogeneous appearance in the upright position.
      The borrelial infection was confirmed by PCR sequencing that detected DNA of B.
      afzelii in the skin biopsy specimen. The lesions disappeared during antibiotic
      therapy. This case shows how posture can be important in the examination of
      patients with a suspected erythema migrans.

PMID- 11200820
TI  - Glomerular structure in lithium-induced chronic renal failure in rats.
AB  - The effects of long-term lithium administration on glomerular structure and
      intervention with angiotensin converting enzyme inhibitor (ACEI) were studied in
      rats. Male Wistar rats were fed a lithium-containing diet (Li) or control diet
      (C) for 16 weeks postnatally. Li-treated rats developed renal failure,
      hypertension and proteinuria. During the subsequent 24 weeks, subgroups were
      treated with ACEI. The kidneys were fixed by perfusion, and tissue blocks were
      serially cut for estimation of glomerular volume and glomerular characteristics
      by light microscopy. Mesangial and mesangial matrix volume fractions, surface
      density of capillary walls, basement membrane thickness and foot process width
      (FPW) were measured by electron microscopy. Glomerular volume was decreased in Li
      rats, with increased intra-individual variation. In all Li-rats, some glomeruli
      (mean 27%) were abnormal, with severe changes in only three rats. Ultrastructural
      parameters obtained by systematic sampling of three glomeruli in each rat showed
      no differences among groups. Among Li-treated animals there was a significant
      correlation between FPW and albumin excretion per unit filtration surface, and
      between filtration surface per glomerulus and inulin clearance. In conclusion,
      long-term lithium administration to newborn rats caused marked changes in
      glomerular volume which were not associated with measurable changes in structural
      parameters. No effect of ACEI-treatment was detectable.

PMID- 11200821
TI  - Resident aerobic microbiota of the adult human nasal cavity.
AB  - Recent evidence strongly suggests that the microbiota of the nasal cavity plays a
      crucial role in determining the reaction patterns of the mucosal and systemic
      immune system. However, little is known about the normal microbiota of the nasal
      cavity. The purpose of this study was to determine the microbiota in different
      parts of the nasal cavity and to develop and evaluate methods for this purpose.
      Samples were collected from 10 healthy adults by nasal washes and by swabbing of
      the mucosa through a sterile introduction device. Both methods gave results that
      were quantitatively and qualitatively reproducible, and revealed significant
      differences in the density of the nasal microbiota between individuals. The study
      revealed absence of gram-negative bacteria that are regular members of the
      commensal microbiota of the pharynx. Likewise, viridans type streptococci were
      sparsely represented. The nasal microbiota was dominated by species of the genera
      Corynebacterium, Aureobacterium, Rhodococcus, and Staphylococcus, including S.
      epidermis, S. capitis, S. hominis, S. haemolyticus, S. lugdunensis and S.
      warneri. These studies show that the microbiota of the nasal cavity of adults is
      strikingly different from that of the pharynx, and that the nasal cavity is a
      primary habitat for several species of diphtheroids recognized as opportunistic
      pathogens. Under special circumstances, single species, including IgA1 protease
      producing bacteria, may become predominant in a restricted area of the nasal
      mucosa.

PMID- 11200822
TI  - Strain differentiation in Bacteroides fragilis by RAPD and Dendron computer
      assisted gel analysis.
AB  - Batteroides fragilis is the anaerobe most frequently isolated from human
      infections. Strains of this species are not easily distinguished by phenotypic
      tests. It is important to make this distinction because virulence may vary
      between strains and because B. fragilis seems to be a heterogeneous species. The
      aim of this study was to assess the utility of randomly amplified polymorphic DNA
      (RAPD) analysis for differentiation of 46 strains of B. fragilis. Twenty-seven of
      the strains belonged to Johnson's DNA homology group I and 8 to group II, while
      11 strains had not been assigned to any of these groups (NI group). The primers
      OPA16 and 18 were chosen among 30 primers tested for optimal RAPD analysis. OPA18
      gave best discrimination, revealing a total of 15 genotypes while OPA16 gave 13.
      The gels obtained after RAPD analysis were evaluated with the Dendron computer
      assisted program. Most strains showed similarity levels (S(AB)) within 70%.
      Strain clusters thus established were not always in agreement with DNA homology
      since strains from both homology groups fell in the same cluster. Similarly,
      strains of the NI group fell among the group I and II homology strains. RAPD was
      useful for differentiation of B. fragilis strains and thus probably suitable for
      epidemiological studies. On the other hand, DNA-DNA homology, comparing the
      entire genome of strains rather than a few random priming sites, would be more
      reliable for taxonomy. Computer-assisted gel analysis made it possible to
      objectively evaluate multiple banding patterns, thereby increasing the
      reliability of the RAPD analysis.

PMID- 11200823
TI  - Complement activation reaches maximum during equilibrium between antigen and
      antibody in an in vitro model for thrombolysis with streptokinase.
AB  - Treatment with streptokinase (SK) of patients with acute myocardial infarction
      (AMI) is known to activate the complement system. In a previous investigation we
      found a great variation in the degree of complement activation taking place
      during infusion of SK in patients with AMI (range: 0-293% increase in
      pretreatment complement split product 3d (C3d) levels). In this in vitro study we
      added SK to serum with different concentrations of SK-antibodies (SK-Ab) and
      found that both the relative concentrations and the total concentrations of SK
      and Ab determined the degree of complement activation elicited by SK. This
      finding was in accordance with the Kendall-Heidelberger equation of antigen
      antibody equivalence. Furthermore, we found parallel rises in C3d and C4d,
      indicating that complement was activated via the classical pathway. A condition
      for maximal complement activation is antigen-antibody equivalence.

PMID- 11200824
TI  - Expression of topoisomerase II alpha, Ki-67 and p53 in early stage laryngeal
      carcinomas not featuring vocal cord fixation.
AB  - AIM: To determine whether topoisomerase II alpha (topoIIa) expression is an
      additional prognostic marker for less advanced stage laryngeal cancers first
      treated without surgery. Ki-67 and p53 protein levels were also assessed for
      comparison. EXPERIMENTAL DESIGN: Formalin-fixed, paraffin-embedded tumor material
      from 63 cases of squamous cell carcinoma (SCC) of the larynx (glottis, stages
      0,1,2) was immunohistochemically stained for topoIIa, Ki-67 (MIB-1) and p53 (DO
      7) and the results were compared with clinicopathologic findings. RESULTS: There
      were 7 stage 0 (TisN0M0), 33 stage I (T1N0M0), and 23 stage II (T2N0M0) SCCs with
      the TNM classification. Significant differences between carcinomas and normal
      mucosa were found for the topoIIa-LI, Ki-67-LI, and topoIIa-to-Ki-67 ratio.
      Regarding histologic grade, a significant difference in topoIIa-to-Ki-67 ratio
      was evident between well or moderately and poorly differentiated lesions. There
      were 19 cases of recurrence and 44 cases of nonrecurrence, but no significant
      differences were found for either of the indices or their ratio. No significant
      variation with p53 positivity was evident with reference to histologic
      differentiation, T-factor, clinical course, or proliferation. CONCLUSIONS: The
      results demonstrate that the topoIIa-to-Ki-67 ratio is a more sensitive parameter
      reflecting proliferation, for histologic grading of less advanced laryngeal SCCs,
      than topoIIa- or Ki-67-LIs.

PMID- 11200825
TI  - Genomic diversity of oral Candida krusei isolates as revealed by DNA
      fingerprinting and electrophoretic karyotyping.
AB  - Candida krusei is receiving increasing attention as an important human pathogen,
      especially in compromised patients, who frequently manifest with multiepisodes of
      candidosis. As there is scant information on the genetic diversity of this
      pathogen the present study was undertaken to establish its genetic profiles using
      three different typing methods: PFGE (pulsed-field gel electrophoresis), RFLP
      (restriction fragment length polymorphism), RAPD (randomly amplified polymorphic
      DNA). When 11 oral isolates of C. krusei were molecular typed by PFGE, 3 to 5
      chromosomes with sizes ranging from 1000 kb to 3000 kb per isolate were revealed.
      All isolates produced a single bright band at approximately 1,100 kb and two to
      three bands between 2,500 kb and 3,000 kb, demonstrating 5 different karyotypes.
      RFLP with HinfI yielded 9 different genotypes, while DNA fingerprinting by RAPD
      with 3 primers (RSD6 (5'GCGATCCCCA3'), RSD7 (5'AGTGAATTCG CGGTGA-GATGCC3') and
      RSD12 (5'GCATATCAATAAGC GCAGGAAAAG 3')), resulted in 8, 3 and 11 different
      genotypes, respectively. This study provides evidence hitherto unavailable on the
      genetic polymorphism of C. krusei isolates colonizing the oral niche under
      different clinical conditions. Such genotypic polymorphism should help strain
      delineation in epidemiologic surveillance of either nosocomial or community
      outbreaks of C. krusei infections.

PMID- 11200826
TI  - Endothelial and epithelial expression of sialyl Lewis(x) in squamous carcinoma of
      the tongue.
AB  - In this retrospective study we describe the immunohistochemical expression
      pattern of sLe(x) epitopes in endothelial and epithelial cells of 59 squamous
      carcinomas of the tongue, and relate this to the relative survival rates of the
      patients. Endothelial sLe(x) expression was significantly elevated in malignant
      lesions compared to normal tissues, but did not have any prognostic value for the
      relative survival rate. In contrast, epithelial sLe(x) expression was decreased
      in carcinomas compared to normal tongue. The patients whose carcinoma showed only
      moderate epithelial HECA-452 reactivity had a significantly better relative
      survival rate than the patients with tumor specimens with neglible or very high
      HECA-452 reactivity. The epithelial staining with the two other anti-sLe(x)
      antibodies (CSLEX-1 and 2F3) did not correlate with the survival rates of tongue
      carcinoma patients.

PMID- 11200828
TI  - Expression of peroxisome proliferator activated receptors (PPARs) in human hair
      follicles and PPAR alpha involvement in hair growth.
AB  - Peroxisome proliferator-activated receptors (PPARs), which belong to the nuclear
      hormone receptor superfamily, have recently been described as potent key
      regulators of epidermal development. As 1,25-dihydroxyvitamin D3, retinoic acid
      and triiodothyronine are known to exert effects on skin and hair follicle growth
      through similar receptors, we decided to investigate both the expression pattern
      of the PPAR alpha, -delta and -gamma subtypes and their role in human hair
      follicles. Using reverse transcriptase-polymerase chain reaction and
      immunohistochemistry, we established that PPAR alpha, -delta and -gamma were
      expressed in both dermal and epithelial human hair follicle cells. Additionally,
      we evaluated the dose effect of clofibrate, a PPAR alpha ligand, on the survival
      of human hair follicles in culture. A beneficial effect was observed within a
      narrow range of concentrations.

PMID- 11200827
TI  - Superantigens and their association with dermatological inflammatory diseases:
      facts and hypotheses.
AB  - Superantigens have been suggested to play an important role in the pathogenesis
      of several inflammatory skin diseases as well as systemic diseases such as atopic
      dermatitis, psoriasis, vasculitis, T-cell lymphoma and autoimmune diseases.
      Infections often precede the onset and relapse of these diseases, and antibiotic
      treatment with or without additional glucocorticosteroids and immunoglobulins is
      occasionally successful. Superantigens are microbial proteins that are able to
      stimulate up to 20% of the naive T-cell population in a non-specific way. They
      are produced by gram-positive and -negative bacteria as well as by viruses,
      parasites and yeasts. The importance of the pathogenic role of superantigens is
      determined by the potency to induce inflammation by extensive cytokine release
      after T-cell stimulation and/or T-cell-mediated cytotoxicity and, thereby, tissue
      damage. Furthermore, superantigens may be able to induce autoimmune processes by
      stimulation of autoreactive T-cells as well as autoantibody production by
      stimulation of B-cells. Among the diseases associated with superantigens, atopic
      dermatitis, guttate and chronic plaque psoriasis, as well as Kawasaki disease,
      are by far the best-characterized. Nevertheless, conflicting results have been
      obtained and formal proof of a pathogenic role of superantigens in these diseases
      is still lacking. The aim of this review is to summarize the data on
      superantigens in terms of their distribution in microorganisms, their
      interactions with the adaptive immune system and their contribution to skin
      pathology.

PMID- 11200829
TI  - Prevalence of pigmented naevi in a Swedish population living close to the Arctic
      Circle.
AB  - The prevalence of common naevi and dysplastic naevi was investigated in a Swedish
      population with a low incidence of melanoma. A total of 201 subjects aged 30-50
      years living in northern Sweden participated. The median number of common naevi
      per individual was 15, and 11% had dysplastic naevi. Higher numbers of common
      naevi were found in individuals with dysplastic naevi (median 68) and in those
      who had spent their childhood in southern Sweden (median 44). The prevalence of
      common naevi and dysplastic naevi was significantly lower than reported from a
      previously studied population in southern Sweden, with a melanoma incidence 4
      times higher than in the north. The strong variability in naevus phenotype, and
      in melanoma incidence, between different regions of Sweden seems to be due to
      different levels of sun exposure rather than to differences in constitutional
      factors.

PMID- 11200830
TI  - Effect of EMLA cream on skin thickness and subcutaneous venous diameter. A
      randomized, placebo-controlled study in children.
AB  - EMLA cream, which is used to provide analgesia prior to venepuncture, induces a
      skin-blanching reaction. This reaction may be caused by both skin hydration and
      vasoconstriction. Twenty healthy children with veins suitable for venepuncture on
      the dorsa of the hands or at the antecubital fossae had applied either EMLA cream
      or placebo cream under occlusion for 60-70 min in a randomized, double-blind,
      cross-over study. An ultrasound examination of the skin was conducted. The mean
      percentage change in vein diameter after removal of EMLA cream was not
      significant whereas, 15 min after EMLA cream removal, the decrease in the initial
      vein diameter (13.5%) was significant (p<0.01). The mean percent increase in skin
      thickness after the removal of EMLA cream was also significant (19.3%; p=0.01).
      The changes in vein diameter and skin thickness due to the application of EMLA
      cream do not seem to be of clinical importance to vein cannulation.

PMID- 11200831
TI  - Intradermal buried vertical mattress suture as sole skin closure: evaluation of
      149 cases.
AB  - Various buried suture techniques have been reported for dermatological surgery,
      but in most cases, superficial non-absorbable sutures are placed additionally.
      The aim of this study was to evaluate whether the intradermal buried vertical
      mattress suture can be safely used without additional skin suturing. Following
      149 procedures in 126 patients, the colour and dehiscence of the scar and the
      presence of hypertrophy, granulomas or keloids were analysed. The cosmetic
      results were excellent to good in 78.5%, satisfactory in 19.5% and poor in 2%.
      Single additional superficial sutures had to be placed in only 14.7%. Suture
      marks were absent. Hypertrophic scarring was significantly more frequent in scars
      sutured with polyglactine than in scars sutured with polydioxanone. Early wound
      dehiscence, secondary wound healing and infection due to missing superficial skin
      sutures did not occur. This suture technique is safe, easy and fast to perform,
      and achieves good cosmetic results without leaving suture marks.

PMID- 11200832
TI  - Longitudinal case analysis in atopic dermatitis.
AB  - The current knowledge on atopic dermatitis comes mainly from cross-sectional
      studies, which are not suited to establish time-courses or causal links in
      complex diseases. As an alternative approach, the method of longitudinal case
      analysis by the autoregressive integrated moving average (ARIMA) method has been
      introduced to investigate the pathogenesis of atopic dermatitis. The method was
      applied to the investigation of 2 patients suffering from severe and moderate
      atopic dermatitis. Disease activity, peripheral blood parameters (differential
      blood count, lymphocyte subpopulations, immunoglobulin E, eosinophilic cationic
      protein, soluble interleukin-2 receptor), mental stress and environmental factors
      were determined daily for 50 days. Both patients showed a positive correlation
      between CD4+ and CD25+ T-cells, a negative correlation between CD16/56+ natural
      killer cells and CD4+ T-cells, a negative correlation between eosinophils and
      polymorphonuclear leukocytes, and a time-shifted positive correlation of up to 2
      days between scores quantifying mental stress and disease activity. A positive
      correlation between T-cells and polymorphonuclear leukocytes, CD4+ T-cells and
      the CD45RA+ subtype, as well as a negative correlation between stress and
      eosinophils, sports and eosinophils, and sports and disease activity were found
      only in one patient with more severe atopic dermatitis. In conclusion,
      longitudinal time-series analysis might represent an interesting and adequate
      method to generate and test new hypotheses on biomedical problems which cannot be
      addressed by cross-sectional studies.

PMID- 11200833
TI  - Prevalence of atopic dermatitis in Korea.
AB  - This study was designed to estimate the prevalence and personal or family history
      of atopic dermatitis in school children in 3 areas of Korea: urban (Seoul),
      industrial (Ulsan) and rural (Chunchon). On the basis of dermatologists' physical
      examinations and the questionnaires completed by parents or guardians, the
      prevalence of atopic dermatitis was estimated to be 3.3% in the industrial area,
      6.6% in the rural area and 7.8% in the urban area. The frequency of atopic
      dermatitis decreased with age and was significantly lower in the industrial area
      than in the rural and urban areas.

PMID- 11200834
TI  - IgE antibodies to Malassezia furfur, M. sympodialis and Pityrosporum orbiculare
      in patients with atopic dermatitis, seborrheic eczema or pityriasis versicolor,
      and identification of respective allergens.
AB  - Malassezia yeasts may be a trigger factor for atopic dermatitis. Following the
      recent reclassification of the genus, the presence of specific IgE antibodies was
      examined in the sera of patients with atopic dermatitis (n = 223), pityriasis
      versicolor (n = 83), seborrheic eczema (n = 50) and hymenoptera allergy (n = 39)
      and in controls without skin diseases (n = 50). In addition to using the
      commercially available radioallergosorbent test (RAST) for Pityrosporum
      orbiculare couplings were also made against the reference strains for M. furfur
      and M. sympodialis. To characterize the specificity and molecular weight of
      corresponding epitopes identical material was used for production of an
      immunoblot. Despite high total levels of IgE, controls and patients with
      pityriasis versicolor showed no specific IgE antibodies. Six patients (12%) with
      seborrheic eczema were positive while 78 patients (35%) with atopic dermatitis
      had specific IgE antibodies in higher RAST classes that differed between the
      Malassezia species. The molecular weights of the main antigens of M. sympodialis
      and M. furfur were determined to be 15, 22, 30, 37, 40, 58, 79, 92, 99 and 124
      kDa and 15, 25, 27, 43, 58, 92, 99 and 107 kDa, respectively. Evaluated according
      to the location of their disease, patients with head and neck lesions most
      frequently showed Malassezia-specific IgE antibodies. However, there were
      differences between the Malassezia species tested, the previously used strain P.
      orbiculare being assignable to the species M. sympodialis.

PMID- 11200835
TI  - Long-term serological follow-up of patients treated for chronic cutaneous
      borreliosis or culture-positive erythema migrans.
AB  - The kinetics of antibodies to Borrelia burgdorferi following successful treatment
      of early and late cutaneous borreliosis were analysed in consecutive serum
      samples by an enzyme-linked immunosorbent assay (ELISA) technique. Twenty-three
      patients with culture positive erythema migrans were followed for 23+/-14 months:
      41% stayed seronegative, 35% showed an isolated immunoglobulin M (IgM) response,
      8% an isolated IgG response and 16% a combined IgM and IgG responses. In general,
      antibody levels peaked within the first 3 months of symptom onset, whereafter a
      gradual decline was observed within 1 year. Twenty-two patients with chronic
      cutaneous borreliosis were followed for 23+/-11 months and all patients stayed
      IgG positive. Nearly three-quarters showed a clear decline in IgG levels over the
      years, while the rest did not. After 9+/-1 years 88% of 16 patients examined were
      still IgG positive. In conclusion, treatment of erythema migrans should be
      initiated on clinical appearance as a substantial number of patients stayed
      seronegative. Treatment success may in part be monitored serologically for both
      seropositive erythema migrans and chronic cutaneous borreliosis as most patients
      show declining titres after successful treatment. However, continuously high
      titres do not necessarily indicate treatment failure.

PMID- 11200836
TI  - Primary cutaneous B-cell lymphomas of the lower limbs: a study of integrin
      expression in 11 cases.
AB  - Primary cutaneous B-cell lymphoma is a rare disease. Among the cutaneous B
      lymphomas, B-cell lymphomas of the lower limbs appear as a special subgroup with
      a prognosis that is possibly worse than that of primary cutaneous B-cell
      lymphomas located on the trunk, arms or head, with more frequent relapses. In
      addition, some recent studies indicate that the level of expression of integrins
      on tumour cells could be related to the clinical course of the disease. This
      study reports on 14 cases of primary cutaneous B-cell lymphomas of the lower
      limbs and their clinical course. A study of integrin expression by tumour cells
      was performed in 11 of these cases. With a mean follow-up of 31 months, the study
      confirmed the worse prognosis of lymphomas with a predominance of centroblasts
      and immunoblasts (3 deaths) compared with lymphomas with a predominance of
      centrocytes, as well as their higher rate of recurrence (7/11). A correlation was
      confirmed between the course of the disease and the level of expression of
      lymphocyte function-associated antigen-1, intercellular adhesion molecule-1 and
      very late antigen-4 by tumour cells.

PMID- 11200837
TI  - Onychomatricoma with misleading features.
AB  - Onychomatricoma is a rare tumour of the nail matrix with peculiar clinical and
      histological features and electron microscopic findings. We report on 5 cases
      with appearances which were misleading. Three presented as longitudinal
      melanonychia, a previously unreported observation. One case had the appearance of
      a cutaneous horn. In 3 of the 5 cases the tumour was associated with an
      onychomycosis and this may thus have been a predisposing factor in the secondary
      fungal infestation. Onychomatricoma appears as a multi-faceted tumour which can
      be mimicked by longitudinal melanonychia and/or onychomycosis.

PMID- 11200838
TI  - Lupus erythematosus panniculitis in a patient with autoimmune hepatitis.
AB  - Lupus erythematosus panniculitis (profundus), a rare variant of chronic
      panniculitis, sometimes develops during the course of discoid lupus erythematosus
      or systemic lupus erythematosus. A 61-year-old woman had suffered from autoimmune
      hepatitis type I for 5 years. Prednisolone had been administered as maintenance
      therapy and her hepatitis had been well controlled. However, asymptomatic
      erythematous indurated nodules developed symmetrically in both pre-auricular
      regions, and skin biopsy revealed lupus erythematosus panniculitis (profundus).
      Increase in dosage of prednisolone resolved the skin lesion, leaving depressed
      atrophic scars. This is the first report of lupus erythematosus panniculitis
      complicating autoimmune hepatitis.

PMID- 11200839
TI  - Coexistence of xeroderma pigmentosum with sarcoidosis and adenocarcinoma of the
      digestive organs.
AB  - Xeroderma pigmentosum has not been reported in association with any specific
      diseases except for skin malignancy. We observed a case of its coexistence with
      sarcoidosis and adenocarcinoma of the digestive organs, which has been reported
      only once in the past. A 54-year-old Japanese female with a variant type of
      xeroderma pigmentosum developed successively multiple lesions of basal cell
      carcinoma and squamous cell carcinoma on her face. Intensive metastasis studies
      led to the incidental detection of non-caseating epithelioid cell granulomas in
      one of the palpable right supraclavicular lymph nodes. Similar granulomas were
      also revealed in the excised tissue specimen of squamous cell carcinomas of her
      left cheek. She was also found to have bilateral hilar lymphadenopathy and
      chronic uveitis. Three years later, she died of colon adenocarcinoma and its
      liver metastasis.

PMID- 11200840
TI  - A two-step schedule for the treatment of actinomycotic mycetomas.
AB  - Actinomycotic mycetomas usually respond slowly to treatment with antibiotics. In
      an attempt to hasten clinical resolution, we used a 2-step regimen consisting of
      an intensive phase of therapy with penicillin, gentamycin and co-trimoxazole for
      5-7 weeks, followed by maintenance therapy with amoxicillin and co-trimoxazole.
      Seven patients were treated, all of whom showed significant reduction in
      discharge and swelling after the intensive phase. Maintenance therapy was
      continued for 2-5 months after the lesions became completely inactive. Five
      patients completed maintenance therapy, which was given for 6-16 months (mean
      10.7 months), and remained free of disease during a mean post-treatment follow-up
      period of 6.4 months. The other 2 patients also responded satisfactorily and
      continue to receive maintenance therapy. Side-effects necessitating a
      modification of the treatment schedule occurred in 2 patients but reversed on
      discontinuation of the drugs responsible. This treatment schedule produces a
      rapid clinical response during the initial, intensive phase and promotes
      compliance with the longer maintenance phase of treatment necessary to achieve a
      complete cure.

PMID- 11200841
TI  - Treatment of multiple basal cell carcinomas in the scalp with imiquimod 5% cream.

PMID- 11200842
TI  - Psoriasiform eruption and anticonvulsant drugs.

PMID- 11200844
TI  - Acquired reactive perforating collagenosis triggered by scabies infection.

PMID- 11200843
TI  - Plasma vascular endothelial growth factor levels in scleroderma are not
      correlated with disease activity.

PMID- 11200845
TI  - Acyclovir prophylaxis of recurrent herpes labialis before electrolysis.

PMID- 11200846
TI  - An unusual severe case of subcorneal pustular dermatosis treated with
      cyclosporine and prednisolone.

PMID- 11200847
TI  - Woolly hair associated with loose anagen hair.

PMID- 11200848
TI  - Leukotriene inhibitor may be effective in treatment of psoriasis.

PMID- 11200849
TI  - UVA1 cold-light phototherapy of small plaque parapsoriasis.

PMID- 11200850
TI  - Zosteriform metastasis of occult bronchogenic carcinoma.

PMID- 11200851
TI  - Lethal pancytopenia associated with chilblain lupus erythematosus.

PMID- 11200852
TI  - An unusual cause of vascular purpura: recurrent cutaneous eosinophilic
      necrotizing vasculitis.

PMID- 11200853
TI  - Hypercalcemia of malignancy associated with trichilemmal carcinoma in burn scar.

PMID- 11200854
TI  - Urticaria after administration of alendronate.

PMID- 11200855
TI  - Acanthosis nigricans with atypical localization.

PMID- 11200856
TI  - [Intersubjectivity and interpersonal relations of schizophrenics].
AB  - Original accounts of an introspectively and linguistically highly gifted
      schizophrenic woman serve as a means to reflect about the meaning of the concept
      of intersubjectivity in the sense of Husserl, the constitution of self and world
      and its failure in the schizophrenic ego disorder. Concerning general
      psychopathology, there can be attempted to propose a typology of disordered
      intersubjectivity and consequently interpersonality. Psychotherapy of
      schizophrenics means reconstruction of intersubjectivity.

PMID- 11200857
TI  - [Psychoeducational intervention for schizophrenic patients and  subsequent long
      term ambulatory care. A four-year follow-up]  .
AB  - A subset of schizophrenic inpatients and families participated in an eight
      sessions bifocal psychoeducational intervention, followed by treatment in a
      corresponding outpatient department. These patients were a part of the
      multicenter and randomized Munchner Psychosis-Information-Project (PIP). The
      course of illness in 88 patients treated in the outpatient department of the
      Technical University of Munich has been recorded in a 4-year follow-up study. 60%
      of the patients continued outpatient treatment while 40% lost contact with the
      outpatient department. Predictors for patient drop-out were assessed and the
      course of illness of both groups was compared. There was no significant
      difference between the relapse rate of the patients who dropped out (66%) and
      those who continued the long-term treatment (53%). However, within the 4-year
      period the drop-out patients had more than twice as many hospital days compared
      to the patients who maintained the outpatient treatment. The improved social
      adjustment and quality of life of these patients, along with the 50% reduction of
      readmission days demonstrates the impact of the long-term treatment in this
      study.

PMID- 11200858
TI  - [Weight gain from atypical neuroleptics--an underreported adverse effect?].
AB  - After the introduction of the so-called "atypical neuroleptics" in the clinical
      experience a marked weight gain was frequently observed in patients treated with
      some of these agents. In this review the frequency, amount and conditions of
      weight gain during the medication with 'atypical' neuroleptics were evaluated. A
      comparison is limited by the different designs and recruitment procedures of the
      reviewed studies. The available data show that the frequency as well as the
      amount of weight gain is particularly high in patients treated with clozapine,
      olanzapine, and likely also quetiapine and zotepine. Moderate changes of weight
      have been observed in the treatment with risperidone and probably also with
      amisulpride, while ziprasidone seems to induce only clinically irrelevant weight
      changes. Weight gain most frequently occurs in the first weeks of treatment.
      Underweighted patients are at highest risk to gain weight. The underlying
      pathomechanism still remains widely unclear. The relative receptor affinities of
      the atypical antipsychotics for histamine H1 as well as their quotient of 5
      HT2/D2 receptor affinity appear to be a correlate of weight gain. Furthermore,
      the induction of leptin secretion may have an important impact on weight gain in
      subjects treated with atypical neuroleptics. Although many questions concerning
      the conditions of weight gain remain unsolved, this side-effect has to be
      considered in the medication with many atypical neuroleptics, particularly in
      view of compliance in long-term treatment and possible medical complications.

PMID- 11200859
TI  - [Expectations and satisfaction of social-psychiatric services  regarding their
      collaboraton with the psychiatric hospital]  .
AB  - OBJECTIVE: Collaboration with the psychiatric hospital should be investigated
      from the viewpoint of social-psychiatric services (SpDi). METHODS: Based upon a
      content analysis of interviews with staff members of all social-psychiatric
      services working in the catchment area of a psychiatric hospital, a questionnaire
      was developed which consists 32 Items assessing expectations and satisfaction in
      6-step Likert-type scales. RESULTS: Response rate was 80% (n = 40). SpDi's staff
      express high expectations to psychiatric hospital. They assess good inpatient
      treatment, patient's information about treatment, SpDi's involvement in discharge
      planning, patient's attendance at SpDi's consulting in the hospital, and
      networking of psychiatric institutions to be very important. Differences between
      expectation and satisfaction especially refer to information of SpDi about
      client's admission, SpDi's involvement in discharge planning, and knowledge of
      hospital staff about social-psychiatric services. CONCLUSIONS: Evaluation of
      expectations and satisfaction of SpDi as an important partner of the psychiatric
      hospital allows conclusions for quality assurance of psychiatric care and offers
      concrete clues for a better collaboration at the interface of out-patient and in
      patient care being advantageous for patients.

PMID- 11200861
TI  - [Klosterkotter J, Hellmich M, Schulze-Lutter F. Is the diagnosis  of
      schizophrenic disorders already in the inital prodromal phase  before the first
      psychotic manifestation results? Fortsch Neurol  Psychiat 2000; 68: S13-S21]  .

PMID- 11200860
TI  - [Sexuality and partnership aspects of Parkinson disease. Results  of an empirical
      study of patients and their partners]  .
AB  - In a retrospective, non-randomised cross-sectional study the influence of
      Parkinson's Disease (PD) on sexuality and partnership in 2099 affected members of
      the German Parkinson Organization (dPV) were investigated. At an average age of
      65, 330 women and 1008 men had been living in partnership for an average of 37
      years. Not only sexual dysfunctions occurred both in affected women and men but
      also an evident reduction of sexual contentment on the whole. The affected
      patients mentioned specific symptoms of PD and medication as the decisive factors
      of influence on their sexuality. It was impressive that one single group of
      substances could influence sexual functions by increasing as well as decreasing
      them or having no influence at all. Furthermore different sexes in different
      genders became obvious. The information concerning their partnership situation
      given by both men and women shows that communication in general, especially
      caressing and showing feelings, are reduced since diagnosis, whereas a desire for
      mutual intimacy prevails on the same level as before.

PMID- 11200862
TI  - Prevalence of persistent asymptomatic proteinuria in HIV-infected outpatients and
      lack of correlation with viral load.
AB  - AIM: Human immunodeficiency virus-associated nephropathy (HIVAN) is projected to
      be a leading cause of end-stage renal disease (ESRD) in young African American
      men in the new millennium. Little is known about the early natural history of the
      disease, including the prevalence of asymptomatic nephropathy. The primary aim of
      this study was to define the prevalence of persistent asymptomatic proteinuria in
      a contemporary, ambulatory human immunodeficiency virus- (HIV) infected
      population. The secondary aim was to correlate the presence of persistent
      proteinuria with measures of HIV disease. METHODS: Using a readily available
      screening tool, the urine dipstick, we determined the prevalence of persistent
      asymptomatic proteinuria in the outpatient VA Connecticut (VA CT) Healthcare
      System West Haven HIV Clinic population. We compared the presence of persistent
      proteinuria with measures of HIV viral disease. RESULTS: The prevalence of
      persistent asymptomatic proteinuria was 14% (7 of 49 patients). The presence of
      persistent proteinuria was not correlated with viral load. CONCLUSIONS: A
      significant prevalence of occult renal disease exists in the asymptomatic HIV
      seropositive outpatient population and is not correlated with viral load.

PMID- 11200863
TI  - Focal segmental glomerulosclerosis in children from KwaZulu/Natal, South Africa.
AB  - AIM: The aim of this paper was to describe the clinical course, histological
      grading, response to therapies and complications of nephrotic children with focal
      segmental glomerulosclerosis (FSGS) in Durban, South Africa. METHODS: The
      demographic data, response to drug therapy, complications, renal function and
      disease status at the last hospital visit were recorded in children diagnosed as
      FSGS on histology. Biopsies were graded according to the degree of
      glomerulosclerosis and interstitial involvement. RESULTS: Seventy-five children,
      32 Indian and 43 Black were studied. FSGS as a proportion of all children seen
      with nephrotic syndrome, has risen between 1970 to 1995 from 1.8% to 20% in
      Indian children and 5% to 28% in Black children. Of those children followed for
      two years or more, the two racial groups were similar with respect to age at
      presentation, gender, histological grading, hypertension, renal outcome and
      response to therapies except for cushingoid features (p < 0.7), alopecia (p <
      0.003) and respiratory tract infections (p < 0.001) which occurred more
      frequently in Indian children. Forty-three children were followed for between 2
      16 years: 14 (10 Indian and 4 Black (p < 0.5)) (29%) had grade 1 changes, 24(13
      Indian, 11 Black (p < 0.98)) (56%) had grade 2 changes, 3 (Indian (p < 0.26))
      (7%) had grade 3 changes and 2 (Black (p < 0.17)) grade 4 changes. Over this
      period 27 (63%) had normal renal function, 6 (14%) died, 4 (9%) developed
      impaired renal function, 6 (14%) chronic renal insufficiency and 6 (14%) end
      stage renal disease. Three of the latter were transplanted. At the last hospital
      visit, Indian children had remitted more often (p < 0.6) and Black children
      suffered relapse more frequently (p < 0.03). Two children had spontaneous disease
      remission, and 5 had sustained remission following a course of prednisolone
      and/or cyclophosphamide. CONCLUSION: This, one of the largest studies of FSGS in
      children, shows a marked rise in this condition and some differences between
      Indian and Black children. The outcome in Black children was not as poor as
      anticipated.

PMID- 11200864
TI  - Membranous nephropathy associated with hepatitis B in Spanish children.
AB  - AIM: To examine retrospectively long-term evolution and treatment of pediatric
      membranous nephropathy (MN) cases associated with hepatitis B (HB) in the
      hospital "La Paz". MATERIAL AND METHODS: The clinical records of 12 children
      diagnosed with HB-associated MN in our hospital between 1970 and 1996. RESULTS:
      All patients were positive for hepatitis B surface antigen (HBsAg); 6 were tested
      for hepatitis Be antigen (HBeAg) and were also positive. At onset, all of them
      had proteinuria (8 in nephrotic range), 6 had microscopic hematuria and 4
      macroscopic hematuria. Seven of 8 children who started with a nephrotic syndrome
      received steroids and all of them were steroid-resistant. After 9.95 +/- 5.88
      years of follow-up, renal function remained normal and proteinuria and hematuria
      have disappeared in all of them. A family study for hepatitis B was carried out
      in 8 cases and 7 of them were positive. Only in one case vertical transmission
      was demonstrated; this patient remained HBeAg positive. In 7 patients, hepatic
      biopsy was performed: 3 had a chronic active hepatitis, 3 a persistent chronic
      hepatitis and one a residual acute hepatitis. CONCLUSIONS: Membranous nephropathy
      is a rare pediatric disease in our area and most of the cases are related to
      hepatitis B (HB). The outcome was excellent with and without treatment but all of
      them remained HBsAg positive.

PMID- 11200865
TI  - Development and validation of a disease extent index for Wegener's
      granulomatosis.
AB  - AIMS: The quantitative assessment of disease extent (staging) and activity
      (grading) in patients with ANCA-associated vasculitides is one prerequisite for
      the comparison of outcomes in different patient cohorts. We present a validation
      study of the Disease Extent Index (DEI). METHODS: 66 patients with Wegener's
      granulomatosis were examined to assess the validity, reliability and sensitivity
      to change of the DEI. Correlation coefficients were calculated to estimate
      associations between DEI and BVAS (Birmingham Vasculitis Activity Score), a
      previously established activity score, and between DEI and serological markers.
      RESULTS: Among patients with active disease, DEI correlated significantly with
      cANCA titer (r = 0.46), leukocyte count (r = 0.38) and platelet count (r = 0.53).
      Among patients in remission, DEI correlated significantly with cANCA titer (r =
      0.61), CRP (r = 0.47) and sIL2R (r = 0.47). Additionally, a high association of
      DEI and BVAS (r = 0.9) confirmed a rather high convergent validity. The effect
      size of DEI equals 2.37 standard deviation units and indicates a considerable
      change from active disease to remission. CONCLUSIONS: The DEI is valid, reliable,
      easy, quick to perform and highly reproducible. Although it correlates with some
      surrogate markers of disease activity and the BVAS, the DEI quantifies different
      domains of the disease than the BVAS and should therefore be used in conjunction
      with the BVAS.

PMID- 11200866
TI  - Deterioration in renal function associated with fibrate therapy.
AB  - BACKGROUND: Fibric acid derivatives (fibrates) are commonly used for the
      treatment of hyperlipidemia. A side-effect of these medications that is not well
      recognized is deterioration in renal function during therapy. This study reviewed
      a series of patients who showed such a deterioration. METHODS: The design was a
      retrospective chart review. Data extracted included creatinine, urea,
      cyclosporine levels, medical history, and medications. Charts were examined for
      other potential reasons for a change in creatinine. RESULTS: There were a total
      of 10 patients. All were males between the ages of 37 and 71. All had a history
      of renal insufficiency. Six had received a renal transplant and, of these, 5 were
      on cyclosporine. Reasons for underlying renal impairment included diabetes,
      hypertension, nephrosclerosis, and renal disease of unknown etiology. Most
      patients had risk factors for or the presence of vascular disease. The mean pre
      treatment creatinine was 182 +/- 14 micromol/l (2.1 +/- 0.2 mg/dl) (mean +/- SE),
      compared to a peak creatinine on the medication of 247 +/- 16 micromol/l (2.8 +/-
      0.2 mg/dl) (p < 0.001). The post-medication mean was 183 +/- 13 (2.1 +/- 0.1
      mg/dl) (p < 0.001 vs maximum creatinine). Urea values also increased with therapy
      and decreased following discontinuation of the fibrate. Cyclosporine levels did
      not change with treatment. All recorded creatine kinase values were within the
      normal range. CONCLUSIONS: A group of 10 men showed a reversible deterioration in
      renal function while being treated with a fibrate for hyperlipidemia. The
      mechanism involved in the deterioration in renal function is not clear. The most
      plausible mechanism is one based on renal hemodynamics, given the rapid and
      complete reversibility that was noted and the finding that most patients had risk
      factors for vascular disease. If patients with pre-existing renal dysfunction are
      to receive a trial of fibrate therapy, this should be done with caution and

PMID- 11200867
TI  - The effect of trimethoprim on potassium and uric acid metabolism in normal human
      subjects.
AB  - BACKGROUND: Trimethoprim used in combination with other antibiotics, has been
      implicated in causing hyperkalemia and hypouricemia in patients with acquired
      immune deficiency syndrome (AIDS). In experimental animal models, trimethoprim
      has been demonstrated to block sodium channels and Na+-K+-ATPase in the distal
      nephron and thus impair potassium excretion. Although the data from the
      experimental models suggest that trimethoprim reduces urinary potassium
      excretion, the retrospective clinical studies have confounding factors that
      prevent a rigorous demonstration that the hyperkalemia and hypouricemia are due
      solely to the effects of trimethoprim on solute excretion. AIM: The purpose of
      this study was to evaluate the effect of trimethoprim on potassium and uric acid
      balance in normal human subjects. METHODS: Five normal human subjects were
      admitted to the general clinical research center and placed on a fixed metabolic
      diet. After a 4-day control period, the subjects were given trimethoprim (15
      mg/kg/day) orally for 5-7 days followed by a 4-day recovery period. Free-flow
      blood samples and 24-hour urine collections were obtained daily. RESULTS:
      Treatment with trimethoprim resulted in a significant increase in plasma
      potassium concentration (4.5 +/- 0.1 versus 3.7 +/- 0.1 mmol/l, p < 0.005) and
      significant decrease in serum uric acid concentration (3.8 +/- 0.4 versus 5.6 +/-
      0.5 mg/dl, p < 0.001). Treatment with trimethoprim significantly increased the
      urinary excretion of uric acid, but did not significantly decrease potassium
      excretion during the 7-day treatment period. There was, however, a significant
      decrease in potassium excretion observed during the first 48 hours of
      trimethoprim treatment. In one subject where repeat studies were performed using
      different dosages, the effect on potassium and uric acid levels appeared to be
      dose-dependent. CONCLUSIONS: Trimethoprim increases plasma potassium
      concentration probably by reducing urinary potassium excretion. Trimethoprim
      decreases serum uric acid levels by augmenting urinary uric acid excretion. This
      uricosuric effect may be due to the ability of trimethoprim to impair urate
      reabsorption by the urate-anion exchanger in the proximal tubule.

PMID- 11200868
TI  - Expression of basic helix-loop-helix proteins in the glomeruli.
AB  - BACKGROUND: Basic helix loop helix (bHLH) proteins play a critical role in the
      differentiation of not only striated muscle cells but also adipocytes, neuron
      cells and smooth muscle cells. Previous studies have established in vitro mouse
      mesangial cells (MCs) to maintain the differentiated smooth muscle phenotype.
      MATERIALS AND METHODS: The purpose of the present study was to clone bHLH
      proteins from these MCs using the primers designed from a homologous sequence
      specific to bHLH, and to analyze the presence of bHLH proteins in normal kidney
      in vivo. From the cloning of MCs in vitro, we identified myf5 and herculin mRNA
      but not myoD. The expression of bHLH proteins in vivo was examined by
      immunohistochemistry with each specific antibody. RESULTS: The MCs in newborn
      mice possessed Id but did not express either protein herculin or myoD. On the
      other hand, mature MCs expressed both myf5 and herculin. The Id protein
      disappeared in mature glomeruli. CONCLUSION: These results suggest that bHLH
      proteins are an important factor for mature MCs in vivo.

PMID- 11200869
TI  - Potassium citrate administration ameliorates tubulointerstitial lesions in rats
      with uric acid nephropathy.
AB  - Although controversial, chronic uric acid nephropathy is a tubulointerstitial
      disease capable of developing renal function loss. On the other hand, potassium
      citrate (KCi) administration has demonstrated to be effective in calcium as well
      as uric acid nephrolithiasis therapy. Therefore, the aim of the present study was
      to evaluate the possible benefit of KCi treatment in the prevention or
      amelioration of renal interstitial damage in uric acid nephropathy. Two-month-old
      male Sprague-Dawley rats were divided into 3 groups: G1 hyperuricemic (HU), G2
      hyperuricemic + KCi (HU+KCi), and G3 KCi. G1 and G2 were fed on oxonic acid
      (inhibitor of rat liver uricase), and a uric acid supplement, during 4 weeks. G2
      and G3 were given 2% KCi in drinking water, and G1 regular tap water and standard
      rat chow. At the end of the study, renal tissue was processed for light and
      electron microscopy and immunostaining by alpha-smooth muscle actin (SMA).
      Tubulointerstitial lesions and the amount of alpha-SMA immunostaining in renal
      tissue were evaluated by histomorphometric quantitation. Rats belonging to the
      hyperuricemic groups treated with KCi (G2) showed fewer tubulointerstitial
      lesions as follows: % tubular atrophy: 1.7 +/- 0.3 versus 7.2 +/- 1.2, p < 0.05;
      inflammatory cells infiltrate (number of cells/area): 0.6 +/- 0.1 versus 2.4 +/-
      0.2, p < 0.01; % interstitial fibrosis (cortex): 3.3 +/- 0.3 versus 9.3 +/- 0.5,
      p < 0.05; % interstitial fibrosis (medulla): 5.2 +/- 0.3 versus 21.9 +/- 1.2, p <
      0.01, lower albuminuria (32.8 +/- 11.2 mg/day versus 128.5 +/- 10.4, p < 0.01),
      higher creatinine clearance ( 1.36 +/- 0.02 ml/min versus 0.74 +/- 0.01, p < 0.01
      ) and less percentage of alpha-SMA in renal tissue (1.8 +/- 0.1 versus 10.5 +/-
      1.4, p < 0.05), when compared with the hyperuricemic group not treated with KCi
      (G1). These data suggest that KCi administration could provide a substantial
      benefit in the regard to tubulointerstitial lesion and progressive renal damage.

PMID- 11200870
TI  - Chronic cyclosporin-induced nephropathy.
AB  - AIMS: There is still no consensus about the prognostic influence of chronic
      nephropathy induced by low-dose maintenance therapy with cyclosporin. Our aim was
      to investigate the prognostic effect of cyclosporin nephropathy in Japanese renal
      transplant recipients. MATERIAL: We retrospectively investigated the clinical
      records of 1,323 kidney transplant recipients who received cyclosporin at 65
      institutions in Japan from 1982 to 1991. METHOD: Renal biopsy was performed in
      461 patients. RESULTS: At 5 years and 9 years after transplantation, the patients
      who had cyclosporin nephropathy associated with immunological rejection,
      glomerulonephritis, or both showed a significantly worse prognosis than those
      with cyclosporin nephropathy alone (p < 0.01). There was no significant
      difference in the loss of renal function at 9 years after transplantation between
      patients showing no abnormalities and patients with cyclosporin nephropathy
      alone. Even when cyclosporin nephropathy was absent, the long-term prognosis was
      unfavorable in recipients with immunological rejection or glomerulonephritis.
      CONCLUSIONS: These results suggest that cyclosporin nephropathy does not
      influence the prognosis of renal transplantation in patients on low-dose
      maintenance therapy with cyclosporin.

PMID- 11200871
TI  - Albuminuria and the renin-angiotensin system gene polymorphisms in type-2
      diabetic and in normoglycemic hypertensive Chinese.
AB  - BACKGROUND: Albuminuria predicts nephropathy-related mortality in Caucasian and
      Chinese populations. The involvement of renin-angiotensin system (RAS) gene
      polymorphisms in the pathogenesis of nephropathy has been described predominantly
      in Caucasian populations. We have previously suggested that the angiotensinogen
      235T variant may be associated with nephropathy in diabetic Chinese. PATIENTS AND
      METHODS: To validate these findings and extend them to include non-diabetic
      nephropathy, we examined the association of albuminuria and gene polymorphisms of
      the angiotensinogen M235T, angiotensin-converting enzyme insertion/deletion and
      angiotensin II type I receptor A1166C polymorphisms in 614 Chinese subjects (66%
      type 2 diabetic, 16% normoglycemic hypertensives and 18% controls). RESULTS:
      Obesity and higher blood pressure were associated with albuminuria in both
      diabetes and normoglycemic hypertension. In the diabetic group, albuminuria was
      also associated with increased insulin resistance and glycemic indices, duration
      of diabetes and adverse lipid profiles. Only the ACE gene polymorphism showed
      evidence of association with albuminuria, with the D allele being less frequent
      in the normoglycemic hypertensive patients with albuminuria (25.0%) than the
      controls (41.4%) or normoalbuminuric group (39.6%) and in those hypertensives at
      increased risk (albumin-to-creatinine ratio > 5.6 mg/mmol) of end-stage renal
      disease than those at lower risk (all p < 0.05), but not in the diabetic group.
      The D allele was also less prevalent in the total (31.9%) and normoalbuminuric
      (32.2%) diabetic groups than in the controls (p < 0.05). CONCLUSION: In this
      cohort of Chinese subjects, the ACE gene polymorphism D allele was less frequent
      in normoglycemic hypertensive patients with albuminuria and in type 2 diabetes.

PMID- 11200872
TI  - Coexistence of Fabry's disease and necrotizing and crescentic glomerulonephritis.
AB  - The coexistence of Fabry's disease, an X-linked hereditary disease, and other
      renal diseases, has rarely been described in the same patient. Combined Fabry's
      disease and pauci-immune necrotizing and crescentic glomerulonephritis (NCGN) is
      hitherto unreported. We present the clinical and pathologic data of two patients
      with combined Fabry's disease and NCGN. Both patients presented with fevers of
      unknown origin and progressive renal insufficiency, however, lacked any other
      pathognomic signs of Fabry's disease such as acroparesthesias, dyshidrosis, and
      cutaneous angiokeratomas. The possible pathogenic mechanisms and causal
      relationship between the two disease processes are discussed.

PMID- 11200874
TI  - A reply to Schuck et al. Calculation of water deficit in a patient with
      hypernatremia.

PMID- 11200873
TI  - Trimethoprim-sulfamethoxazole induced aseptic meningitis in a renal transplant
      patient.
AB  - A 45-year-old man underwent renal transplant for end-stage renal disease
      complicating systemic lupus erythematosis. Within 24 hours of initiating
      Pneumocystis carinii pneumonia (PCP) prophylaxis with trimethoprim
      sulfamethoxazole (TMP-SMX) he developed fever and confusion. Cerebrospinal fluid
      examination revealed a pleocytosis but cultures were negative. The patient
      improved within three days after cessation of the TMP-SMX but symptoms recurred
      rapidly upon drug rechallenge. Drug-induced aseptic meningitis is an uncommon but
      well described clinical entity. This is the first case described in a patient
      following renal transplantation. The literature is reviewed and the clinical
      features, diagnostic challenges and possible mechanisms of TMP-SMX-induced
      aseptic meningitis are discussed. This problem may be more common in the
      transplant population than is recognized given the difficulty of diagnosis
      combined with the widespread use of TMP-SMX as PCP prophylaxis.

PMID- 11200875
TI  - A reply to Sezer et al. Diagnosis of AL amyloidosis.

PMID- 11200876
TI  - Newer immunomodulating drugs in rheumatoid arthritis may precipitate
      glomerulonephritis.

PMID- 11200877
TI  - Blurred vision as chief complaint in nephropathia epidemica.

PMID- 11200878
TI  - RPA recommendations to improve accreditation of dialysis facilities. Renal
      Physicians Association.

PMID- 11200879
TI  - Alternative methods for the production of carrier-free (66,67)Ga.
AB  - Heavy ion activation of natural cobalt foil with 52 MeV 11B4+ and 73 MeV 12C6+
      results in the formation of carrier-free (66,67)Ge and (66,67)As radionuclides,
      respectively, along with their corresponding decay products, (66,67)Ga in the
      matrix. The carrier free gallium radionuclides have been separated from the bulk
      target matrix cobalt by employing liquid-liquid extraction method using TOA as
      liquid anion exchanger.

PMID- 11200880
TI  - Multitracer techniques: applications in chemical and life sciences.
AB  - The scope and approaches of the "multitracer technique" have briefly been
      reviewed. The various aspects of the "multitracer technique" include, the methods
      of accelerator production of "multitracers" and their separation, the application
      of this technique in the study of adsorption of metal ions on solid surfaces and
      in the study of distribution of trace elements in plants and animals.

PMID- 11200881
TI  - An admonition when measuring the lipophilicity of radiotracers using counting
      techniques.
AB  - Log P measurements are a fundamental physico-chemical parameter and one of the
      cornerstones of structure activity relationships in medicinal chemistry. Despite
      the attractiveness of the method, the use of counting techniques to measure the
      log P of lipophilic radiotracers is fraught with pitfalls due to the amplifying
      effects of small quantities of radioactive impurities. For example, a radiotracer
      with a log P of 4 containing only 0.1% of a radioactive impurity with a log P of 
      1 will have an apparent log P of 3 if measured using conventional shake-flask
      partition techniques, counting the radioactivity in each phase. However, pre
      washing the radiotracer-containing organic phase with aqueous phase can, in many
      cases, allay doubts about the validity of such measurements.

PMID- 11200882
TI  - Sorption and diffusion behavior of Cs and Sr on Jih-Hsing bentonite.
AB  - Sorption and diffusion are important processes for the transport of radionuclides
      through buffer materials such as bentonite. In this study, the sorption and
      diffusion behaviors of Cs and Sr on Jih-Hsing bentonite are investigated using
      batch and through-diffusion techniques. The distribution coefficients (Kds) of Cs
      and Sr from batch experiments are approximately 1200 ml/g and 800 ml/g,
      respectively. It is found that the Freundlich isotherm model could fit the
      sorption isotherm with an equilibrium concentration of 10(-7)-10(-1) N. The
      calculated retardation factors (Rds) for samples at densities of 1.8 g/cm3, 2.0
      g/cm3 and 2.2 g/cm3 are 5685, 7744, and 11000 for Cs, and are 3790, 5162, and
      7334 for Sr. For the through-diffusion experiments on the compacted samples with
      the same densities, the corresponding apparent diffusion coefficients for Cs are
      (2.83+/-0.75) x 10(-13) m2/s, (1.97+/-0.02) x 10(-13) m2/s, and (1.91+/-0.12) x
      10(-13) m2/s, respectively. The corresponding apparent diffusion coefficients for
      Sr are (1.33+/-0.13) x 10(-13) m2/s, (1.51+/-0.15) x 10(-13) m2/s, and (1.34+/
      0.10) x 10(-13) m2/s. The Rds obtained from the diffusion experiments for sample
      densities of 1.8 g/cm3, 2.0 g/cm3 and 2.2 g/cm3 are 1166+/-355, 2113+/-123,
      2796+/-171 for Cs, and 713+/-258, 510+/-68, 846+/-158 for Sr. It appears that the
      retardation factors obtained from the diffusion experiments are about one order
      of magnitude lower than those derived from the batch experiments. The discrepancy
      and the possible explanations are discussed in the paper.

PMID- 11200883
TI  - Moderator-collimator-shielding design for neutron radiography systems using
      252Cf.
AB  - This paper is concerned with the presentation of a study of the general design of
      an optimized neutron radiography system that utilizes 252Cf. Moderation,
      collimation and shielding aspects are considered. A Monte Carlo code, MCNP, was
      used to obtain a maximum and more homogeneous neutron flux in the collimator
      outlet next to the image plane, taking into account geometric characteristics and
      an adequate radiation shielding strategy that complies with the radiological
      protection rules. Among the various moderator materials investigated, the high
      density polyethylene proved to be the most efficient, with a thermalization
      factor of 56 cm2. Using a collimator design assembly it was possible to obtain a
      normalized thermal neutron flux, at the image plane, equals 6 x 10(-6) n cm(-2)
      s(-1) at an effective collimator ratio of 7.5, or 3.2 x 10(-7) n cm(-2) s(-1) at
      an effective collimator ratio of 50. The total dose equivalent rates were
      significantly reduced by the shielding optimization process.

PMID- 11200884
TI  - Synthesis and biological evaluation of two new radiolabelled estrogens: [125I](E)
      3-methoxy-17alpha-iodovinylestra-1,3,5(10),6-tetraen-17beta-ol and.
AB  - The synthesis of two novel radiolabelled estrogen derivatives, [125I](E)-3
      methoxy-17alpha-iodovinylestra-1,3,5(10),6-tetraen-17beta-ol (E[125I]IVDE) and
      [125I](Z)-3-methoxy-17alpha-iodovinylestra-1,3,5(10),6-tetraen-17beta-ol
      (Z[125I]IVDE), was carried out aiming to study the influence of the introduction
      of a C6-C7 double bond on the biological properties of the estradiol molecule. 3
      Methoxyestra-1,3,5(10),6-tetraen-17-one was synthesised starting from a suitably
      protected estrone and subsequently converted into the 17alpha-ethynyl derivative.
      The radioiodinated derivatives were stereoselectively formed by
      radioiododestannylation of the corresponding tributylstannyl precursors. The
      biodistribution of the novel [125I]iodovinylestradiol derivatives was evaluated
      in immature female mice. Biological data indicated that the Z-isomer, owing to
      its higher in vivo uptake by the target tissue, has the preferable configuration
      for further development of similar compounds for estrogen receptor detection.

PMID- 11200885
TI  - Stabilisation of [131I]meta-iodobenzylguanidine at room temperature as organic
      extract in ethyl acetate/chloroform.
AB  - A method of purification of [131I]mIBG (diagnostic dose) by solvent extraction
      and possibility of its stabilisation by storage in ethyl acetate and chloroform
      at up to 40 degrees C for not less than 14 days is described. In order to further
      enhance the utility of this finding, the organic extract was dispensed into vials
      and dried. Vials containing such dried residue of [131I]mIBG stored at up to 40
      degrees C was also found to be stable for at least 10 days. The final product
      reconstituted as aqueous solution resulted in 90% recovery with 99% radiochemical
      purity as assessed by previously reported methods, as well as a relatively more
      rapid paper chromatography method standardised by us. These interesting findings
      promise simpler and economic packaging besides transport of diagnostic doses of
      [131I]mIBG.

PMID- 11200886
TI  - Decay of 72Ga.
AB  - The gamma-ray spectrum of 72Ge following the beta- decay of 72Ga has been studied
      using both single and gamma-gamma coincidence spectroscopy techniques. The
      energies and intensities of 110 gamma-rays have been determined, 26 of them were
      observed for the first time and 20 have been confirmed. Of the total number of
      gamma-rays observed, 95 have been placed in a proposed level scheme containing 31
      levels. This includes five new levels at 2303, 2694, 3067, 3097 and 3420 keV.

PMID- 11200887
TI  - Study of nuclear quadrupole interactions in different environments of decaying
      atoms of 75Se by sum peak method.
AB  - The sum peak intensity I400 (279 + 121 keV) relative to its singles peak
      intensity I279 or I121 has been determined in various environments of 75Se by
      gamma-gamma summing technique in a single HPGe detector. The change in intensity
      has been used to determine nuclear quadrupole interaction frequencies and
      electric field gradient components in different environments, e.g. Se-glycerol,
      Se-hydrochloric acid (HCl), Se-perchloric acid (HClO4), Se-blood samples with and
      without anti-coagulant, Se-alanine and Se-cysteine at different pH values. The
      electric field gradient is found to vary with chemical complex formation.

PMID- 11200889
TI  - Simultaneous determination of 226Ra and 210Pb in groundwater and soil samples by
      using the liquid scintillation counter-suspension gel method.
AB  - A method for the simultaneous determination of 226Ra and 210Pb in groundwater and
      soil samples by liquid scintillation counting was developed. Radium and lead were
      separated together from the samples as Ba(Ra) x PbSO4 co-precipitate, which was
      centrifuged and dissolved with 0.1 M EDTA solution (pH 9.0). Radium was separated
      as Ba(Ra)SO4 co-precipitate by adding ammonium sulfate and adjusting the pH of
      the solution to 4.2. Lead remaining in the solution was separated as PbSO4
      precipitate by adding 9 M sulfuric acid. These Ba(Ra)SO4 and PbSO4 precipitates
      were purified with EDTA solution and used for measurement. To save time and to
      make counting samples simpler, direct counting of Ba(Ra)SO4 and PbSO4
      precipitates instead of the phosphoric acid fusion method was attempted.
      Ba(Ra)SO4 and PbSO4 precipitates were suspended in the scintillation gel, and
      measured. Two liquid scintillation cocktails, Instagel XF and UltimaGold AB were
      used to prepare the counting samples. A mixture of water (40%), Instagel XF (40%)
      and UltimaGold AB (20%) formed a stable gel. Activities of 226Ra and 210Pb were
      calculated from the alpha spectrum of Ba(Ra)SO4 and beta spectrum of PbSO4,
      respectively. The long-term stability of the suspension gel was good. The
      analytical results of 226Ra and 210Pb in spiked groundwater samples were in good
      agreement with the known concentrations of 226Ra and 210Pb. The analytical values
      of 226Ra and 210Pb in the soil reference samples were within 11.5 and 1.6% of the
      relative error from the reference values, respectively.

PMID- 11200888
TI  - ESR dosimetry of 89Sr and 153Sm in bone.
AB  - The radiation absorbed dose in the rabbit bone delivered by 153Sm-EDTMP (samarium
      ethylenediaminetetra methylene diphosphonic acid) and 89SRCl2 (strontium
      chloride) was measured by means of electron spin resonance (ESR). These
      radioisotopes are used in systemic radiotherapy for palliation of painful bone
      metastases. The knowledge of the dose is important in order to avoid side effects
      to the bone marrow. The ESR radiation dose signal was calibrated by the additive
      dose method using cobalt-60 gamma rays. For 153Sm-EDTMP, the bone doses in three
      rabbits were (4 +/- 2), (5 +/- 1) and (5 +/- 2) cGy kg/MBq. For 89SrCl2, a dose
      of (2 +/- 1) cGy kg/MBq was found in one rabbit.

PMID- 11200890
TI  - Systematics for the cross-sections of the reactions (n, p), (n, alpha) and (n,
      2n) at 14.5 MeV neutrons.
AB  - Systematics are proposed for the (n, p), (n, alpha) and (n, 2n) reactions cross
      sections at 14.5 MeV neutron energy based on the statistical model, with
      consideration of the Q-value dependence and odd-even effects. The obtained
      relations are compared with other recently proposed systematics based on the
      statistical model as well as on the asymmetry parameter dependence.

PMID- 11200892
TI  - Simultaneous measurement of 89Sr and 90Sr in aqueous samples by liquid
      scintillation counting using the spectrum unfolding method.
AB  - Two radiostrontium isotopes, 89Sr and 90Sr, were measured simultaneously by
      liquid scintillation counter coupling with a full spectrum DPM counting protocol.
      Strontium was separated from the aqueous media by extraction chromatography using
      Sr-spec resin. Individual count rates were evaluated from quench correlation
      curves for 89Sr and 90Sr related with SIS and tSIE quench indicators. The method
      exhibited a counting efficiency of 95% for 89Sr and 92% for 90Sr within their
      full energy channels and gave highly precise results when the sample was counted
      within 4 h after strontium separation. Lower limits of detection were 37 mBq/l
      for 90Sr and 32 mBq/l for 89Sr with a 60 min counting time.

PMID- 11200891
TI  - A study of radon and thoron release from Egyptian building materials using
      polymeric nuclear track detectors.
AB  - The free exhalation rates of both thoron and radon, the specific activities of
      224Ra, and 226Ra, and the physical properties, such as the emanation coefficients
      and radon effective diffusion coefficient of several building material samples
      were determined using LR-115 and CR-39 polymeric nuclear track detectors. The
      free areal exhalation rate was measured by the sealed cup-technique, whereas the
      radium content was obtained by the alpha-autoradiographic method. The calibration
      coefficient for thoron measurements in air using cylindrical cup equipped with LR
      115 detector was estimated. Moreover, the calibration coefficients for
      measurements of the specific activities of 224Ra and 226Ra were also evaluated.
      New method was developed for evaluating the emanation coefficient as well as the
      diffusion coefficient of radon isotopes in the studied materials.

PMID- 11200893
TI  - Measurements and calculations of neutron spectra modified by iron slabs bombarded
      by neutrons with energies up to 14 MeV.
AB  - Neutron spectra behind iron slabs of different thicknesses have been measured in
      the energy range from 1.6 to 14 MeV using a proton recoil spectrometer and 2H(d,
      n)3He and 9Be(d, n)10B neutron sources. The measured results have been compared
      with the predicted ones using the three dimensional Monte Carlo code MCNP 4A and
      pointwise cross sections from the ENDF/B-IV and ENDF/B-VI data files. The results
      show that the ENDF/B-IV calculations are in better agreement with the experiment
      than those obtained by using the ENDF/B-VI cross section data.

PMID- 11200894
TI  - Calculations for the excitation functions of 3-26 MeV proton reactions on 66Zn,
      67Zn and 68Zn.
AB  - Calculation of excitation functions of 66Zn(p,n)66Ga, 66Zn(p,n + p)65Zn,
      66Zn(p,2n)65Ga, 67Zn(p,2n)66Ga, 68Zn(p,n)68Ga, 68Zn(p,2n)67Ga natZn(p,xn)66Ga and
      natZn(p,xn)67Ga reactions has been carried out using the statistical and pre
      equilibrium nuclear reaction models in the 3-26 MeV energy range. The
      calculational results are compared with the reported measurements and
      evaluations.

PMID- 11200895
TI  - Normalisation with coherent scatter signal: improvements in the calibration
      procedure of the 57Co-based in vivo XRF bone-Pb measurement.
AB  - The feasibility of a normalised calibration variable to account for interpatient
      variability for in vivo 57Co XRF (X-ray fluorescence) finger bone-lead
      measurements was assessed. Normalising the lead X-ray intensities to the coherent
      scatter signal was investigated by experiment and Monte Carlo simulation. The X
      ray to coherent ratios for a fixed lead concentration were within 5-10% of the
      mean, within uncertainty, over a physiologically relevant range of finger bone
      sizes and overlying tissue thicknesses. This is an acceptable level of variation
      to introduce, as it is less than the uncertainty of a typical in vivo
      measurement. Normalisation has several advantages compared with the current
      method of correcting for interpatient variation, as it eliminates the need for
      transporting extensive equipment to on-site measurements, reduces the subject
      dose by a factor of two, and increases the objectivity of the bone-Pb assessment.

PMID- 11200896
TI  - Geological influence on terrestrial gamma radiation dose rate in the Malaysian
      State of Johore.
AB  - Measurements of environmental terrestrial gamma radiation dose-rate (TGRD) have
      been made in Johore, Malaysia. The focus is on determining a relationship between
      geological type and TGRD levels. Data were compared using the one way analysis of
      variance (ANOVA), in some instances revealing significant differences between
      TGRD measurements and the underlying geological structure.

PMID- 11200897
TI  - The application of prompt-gamma neutron activation analysis to borehole logging
      for coal.
AB  - The PGNAA technique was tested for the in-situ determination of ash, Fe, Si, Al
      and density of coal seams in water-filled boreholes. The technique is also able
      to determine in situ the deformation temperature of coals for which a correlation
      exists between the deformation temperature and the percentage of Al, Si and Fe
      present in coal. The logging tool employed a 2.5 microg 252Cf neutron source.

PMID- 11200898
TI  - Atmospheric interactions at northern high latitudes from weekly Be-isotopes in
      surface air.
AB  - We present weekly 7Be (from 1972 to 1995), and weekly/seasonal 10Be (for 1994)
      data in surface air from ground level stations in Sweden with a coverage of most
      of the northern high latitudes (56 degrees-68 degrees N). Our Be data are
      regionally representative and reveal seasonal variation and coupling with
      tropospheric air mass from middle-low latitudes. The Be data also suggests a few
      percent, and sometimes episodic, incursion of stratospheric air mass. Frequent
      precipitation depletes the Be isotopes in the air, but cyclone events contribute
      to enrichments. A strong coherence between the 7Be record and short-term (monthly
      seasonal) change in solar activity is observed which introduces a new mechanism
      for driving the amplitude of seasonal variation.

PMID- 11200899
TI  - A probabilistic description of radioactive contamination: a multivariate model.
AB  - A multivariate discrete probability model is used to facilitate the description
      of gamma-ray spectroscopic data obtained from radioactively contaminated
      territory, east of the former Semipalatinsk nuclear test site in Kazakhstan. Two
      possible estimators of probabilities of interest have been considered: maximum
      likelihood and unbiased estimators. We show that unbiased estimators are much
      easier to compute. The model was used in two variants: (i) several radionuclides
      in spatially independent measurements, (ii) a single radionuclide in spatially
      dependent measurements. We show that, in both cases, it is important to take into
      account the correlation for the accurate evaluation of probabilities of interest.

PMID- 11200900
TI  - Natural radioactivity and gamma dose from Sri Lankan clay bricks used in building
      construction.
AB  - The specific radioactivity concentrations of 226Ra, 232Th and 40K have been
      determined by gamma ray spectrometry with an HPGe detector in clay brick samples
      from kiln sites located in 17 towns. The average values of the measured
      activities are 35, 72, and 585 Bq kg(-1), respectively, for the above
      radionuclides. The average estimated radium equivalent concentration is 183 Bq
      kg(-1) and is comparable with reported values for many countries in the world.
      This value and the value obtained from the criteria formula suggest that the use
      of local clay bricks do not pose a radiological hazard. The calculated average
      absorbed dose rate in air within buildings was found to be 102 nGy h(-1) while
      the population weighted indoor annual effective dose was 0.20 mSv.

PMID- 11200901
TI  - Cerebral malaria.
AB  - Cerebral malaria is a rapidly progressive potentially fatal complication of
      Plasmodium falciparum infection. It is characterized by unarousable and
      persistent coma along with symmetrical motor signs. Children, pregnant women and
      non-immune adults are more susceptible to have cerebral malaria. Several
      clinical, histopathological and laboratory studies have suggested that
      cytoadherence of parasitized erythrocytes (mechanical hypothesis), and neuronal
      injury by malarial toxin and excessive cytokine (e.g. tissue necrosis factor
      alpha) production (cytotoxic hypothesis) are possible pathogenic mechanisms.
      Several associated systemic complications like hypoglycemia, hypovolemia,
      hyperpyrexia, renal failure, bleeding disorders, anemia, lactic acidosis and
      pulmonary oedema may contribute in the pathogenesis of coma, and are responsible
      for high mortality. The meticulous supportive care along with intravenous
      administration of antimalarial drugs are corner-stone of the treatment. Quinine
      is currently, drug of choice. Artimisinin derivatives are equally effective and
      can be used by intramuscular route. In severe cases exchange blood transfusion
      may be an effective alternative. Corticosteroids has no place in the management
      of cerebral malaria. The occurrence of convulsions are common in children, these
      can be prevented with the use of single intramuscular administration of
      phenobarbitone. Despite advances in the management mortality and morbidity have
      not changed much. A large number of surviving patients are left with permanent
      neurological sequelae. There is a need to search for effective malaria prevention
      and interventional strategies to avert high mortality and morbidity associated
      with cerebral malaria.

PMID- 11200902
TI  - Cryptococcal prostatitis in a patient with chronic lymphocytic leukemia.
AB  - Cryptococcosis is a systemic mycosis usually affecting patients of
      immunodeficiency i.e. transplants recipients, patients on chemotherapy for
      neoplastic diseases and in those suffering from human immunodeficiency virus
      infection. We report a 52-year old male suffering from chronic lymphocytic
      leukemia (CLL) on chemotherapy who presented with fever and features of
      prostatism. Cryptococcus neoformans infection (CN) was diagnosed on aspiration of
      a prostatic nodule. Subsequent investigations revealed a disseminated involvement
      by cryptococcus. The case represents an unusual presentation of disseminated
      cryptococcosis.

PMID- 11200903
TI  - Strongyloides hyperinfection syndrome--an unappreciated opportunistic infection.
AB  - A case of respiratory hyperinfection syndrome which occurred in a patient on long
      term corticosteroid therapy is reported here for it's rarity. Intestinal
      infection with this parasite should be looked for and treated before the
      initiation of immunosuppressive therapy.

PMID- 11200904
TI  - Non familial juvenile polyposis presenting as chronic intestinal obstruction.
AB  - Juvenile polyps are the commonest colonic polyps seen in children and present
      most often with rectal bleed. Intussusception is an extremely rare presentation
      in juvenile polyposis (JP) syndrome. This case highlights the rare association of
      ileo-colic intussusception with non-familial Juvenile Polyposis.

PMID- 11200905
TI  - Trichosporon beigelii peritonitis in a HIV-positive patient on continuous
      ambulatory peritoneal dialysis.
AB  - Peritonitis, the commonest complication of peritoneal dialysis, is usually
      bacterial in origin. Fungal peritonitis is rarely encountered. We are reporting a
      rare case of fungal peritonitis caused by Trichosporon beigelii in a patient on
      continuous ambulatory peritoned dialysis (CAPD), who was HIV positive.

PMID- 11200906
TI  - Poems syndrome.

PMID- 11200907
TI  - Renal stone disease as extra skeletal manifestation of osteogenesis imperfecta.

PMID- 11200908
TI  - Masked myotonia presenting as recurrent head injury.

PMID- 11200910
TI  - Controversies about the statistical significance level.

PMID- 11200909
TI  - Interesting case of migraine presenting with recurrent episodes of migraine coma.

PMID- 11200911
TI  - Human leptin deficiency and resistance.

PMID- 11200912
TI  - Increased sacral angle and chronic low backache.

PMID- 11200913
TI  - Elections and nail growth: a new physical sign?

PMID- 11200914
TI  - Paroxysmal alien hand syndrome.

PMID- 11200915
TI  - Changing trends of poisoning at railway stations.

PMID- 11200916
TI  - Role of oxygen free radicals in septic shock.

PMID- 11200917
TI  - Role of oxygen free radicals in shock.
AB  - AIMS OF THE STUDY: To study lipid peroxidation, magnesium levels (Mg) in plasma
      and red cells (RBC), superoxide dismutase (SOD) and catalase (CAT) activities in
      the plasma and RBC of shock patients. METHODOLOGY: Twenty five patients with
      clinically defined septic shock and 30 healthy volunteers were selected for the
      study to study the parameters of oxidative stress. RESULTS: Septic shock patients
      had higher activities of plasma and RBC SOD and CAT activities as compared to
      control. Also, plasma Mg and malonaldehyde (MDA) levels were higher in shock
      patients as compared to controls. While, RBC Mg levels were similar in two
      groups. CONCLUSIONS: The finding of increased concentration of MDA, Mg, SOD and
      CAT in sepsis implicates oxygen free radicals in the pathophysiology and free
      radical scavengers may have a role in organ preservation.

PMID- 11200918
TI  - Role of supravital staining of urine sediment and bright field microscopy in
      diagnosis of acute renal failure in bedside medicine.
AB  - BACKGROUND: An early accurate etiological categorization of acute renal failure
      (ARF) into acute glomerulonephritis (AGN), acute tubular necrosis (ATN) and acute
      interstitial nephritis (AIN) is very important in clinical medicine. METHODS: To
      evaluate the efficacy of a simple, cheap supravital staining method developed in
      our laboratory, we examined urine of 32 cases of ARF at their initial
      presentation in oliguric phase, which were later biopsied. The stain consisted of
      1% crystal violet and 0.5% safranin in normal saline. The coverslip preparations
      of coded and stained urine sediments were examined under ordinary bright field
      microscope (BFM) by two independent observers. RESULTS: The renal biopsy showed
      12 cases of AGN, 12 ATN and 8 AIN. The diagnosis could be predicted by supravital
      staining method in 75% cases with 95% uniformity among two observers with a
      sensitivity of 85.7% for AGN followed by AIN (80%) and ATN (75%). CONCLUSION:
      Thus this simple supravital staining technique can be used with ordinary BFM for
      accurate urine sediment analysis in cases of ARF in bedside medicine.

PMID- 11200919
TI  - Ventilatory pulmonary function tests in type 1 diabetes mellitus.
AB  - OBJECTIVE: To study the ventilatory pulmonary function tests (VPFT) in type one
      diabetes mellitus and to correlate it with duration, meticulous metabolic control
      and various complications of diabetes. METHODOLOGY: Spirometric evaluation of 50
      young (15-30 years of age) type one diabetes mellitus patients was done under the
      case control longitudinal study. After recording baseline parameters patients
      were subjected to PFT. OBSERVATIONS: Degree of derangement in VPFTs was directly
      related to duration and metabolic control of diabetes. VPFT parameters such as
      FVC, FEV1, PEFR, MEF 75% and MEF 25% showed significant reduction (p = 0.009, =
      0.001, = 0.001, = 0.05 respectively). Similarly patients with HbA1c > 10% showed
      significant reduction in FVC, FEV1, PEFR and MEF 75% (p = 0.001 for each).
      Diabetic patients with complications particularly peripheral neuropathy and
      nephropathy had significant reduction in FVC, FEV1 and PEFR (p = 0.001).
      CONCLUSION: Spirometric evaluation in type one diabetes mellitus showed varying
      derangements in the different parameters of VPFTs, suggestive of dominantly
      restrictive with some obstructive pattern as indicated by significant decline in
      FVC, PEFR and MEF 75%.

PMID- 11200920
TI  - Behavioural intervention in the management of compliance in young type-I
      diabetics.
AB  - OBJECTIVES: a) To examine the efficacy of a behavioural intervention programme in
      the management of compliance in young Type I diabetics, b) To examine the
      efficacy of a behavioural management programme in enhancing metabolic control in
      young Type I diabetics, c) To examine the effect of behavioural intervention on
      level of diabetes knowledge and quality of life in young Type I diabetics.
      METHODS: A total of 40 patients (Experimental group n = 20, Control group n = 20)
      was selected from local hospitals' pediatric, endocrinology and diabetology
      units. The experimental group received 15 individual sessions of behavioural
      intervention, consisting of behavioural counseling for family and significant
      others, relaxation, diabetes education and specific behavioural and cognitive
      strategies such as reinforcement, target-setting and cognitive restructuring.
      Assessment was carried out on various psychological measures as well as the
      glycosylated hemoglobin test (HbA1), at pre and post treatment periods. RESULTS:
      The scores of the two groups were compared at post treatment point. Results
      indicate that there was significant improvement in the experimental group in
      compliance and metabolic control. There were also significant changes noted in
      the level of diabetes knowledge as well as the reported quality of life. These
      changes in compliance and metabolic control were maintained at a three month
      follow-up period. CONCLUSIONS: Behavioural intervention can be included as an
      effective adjunct to routine medical care in the management of young Type I
      diabetics, especially in the management of compliance and metabolic control,
      enhancement of knowledge and quality of life.

PMID- 11200921
TI  - Aetiology and treatment response in patients with spontaneous diabetes insipidus.
AB  - BACKGROUND: Spontaneous diabetes insipidus (DI) is an uncommon disorder. This
      study analysed aetiology and response to treatment in patients with spontaneous
      DI admitted to the endocrinology service of a teaching hospital. METHODS: Twenty
      patients were seen over a eight year period (1991-1998). The diagnosis of DI was
      confirmed in each case by the standard water deprivation test. Appropriate
      diagnostic procedures were carried out to determine aetiology. RESULTS: Sixteen
      patients had complete DI and four patients had partial DI. Eighteen had central
      DI and two nephrogenic DI. The etiology in sixteen of the eighteen patients with
      central DI included: histiocytosis--three, eosinophilic granuloma--two,
      neurosarcoidosis--three, viper-bite--one, head injury--two, germinoma--one, post
      RT--one, tuberculous meningitis--one, acute-sphenoid sinusitis--one and
      hypothalamic tumour--one. Eleven patients (61%) responded to tab. carbamazepine,
      while nine (45%) required intra-nasal DDAVP. One of the two patients with
      nephrogenic DI responded to thiazide diuretic. CONCLUSION: We identified the
      aetiology in 88% of our patients with central DI. Histiocytosis and sarcoidosis
      accounted for 40%. Most patients (61%) responded to treatment with oral
      carbamazepine, others required intra-nasal DDAVP.

PMID- 11200922
TI  - Lung function in mitral stenosis.
AB  - OBJECTIVES: The aim of this study was to look to for a relationship between
      pulmonary artery pressure (PAP), left atrial pressure (LAP), mitral valve area
      (MVA) and transmitral gradient (Gr) on the one hand and the spirometric data on
      the other, in cases of mitral stenosis. METHODS: The spirometry values measured
      were forced vital capacity (FVC), forced expiratory volume in one second and as
      percent of FVC (FEV1, FEV1/FVC%), forced expiratory flow between 25% to 75% of
      FVC (FEF 25-75%), at 50% of FVC (FEF 50%) 75% of FVC (FEF 75%) and peak
      expiratory flow rate (PEFR). The PAP, LAP, MVA and Gr were measured at
      echocardiography and cardiac catheterisation. RESULTS: Analysis of results was
      done of 60 patients in four groups divided on basis of mean PAP: Group 1 with
      least and group 4 with highest mean PAP. FVC values were reduced in direct
      proportion to PAP, LAP, MVA and Gr in three out of four groups. FEV1% as a
      percent of predicted value showed uniform reduction in all the groups, PEFR was
      moderately affected in group 1 and most severely in group 4. Values of FEV1/FVC%
      were within normal range in all the groups. FEF 25-75%, and FEF 50% showed serial
      reduction in values in keeping with the elevation of the PAP. FEF 75% was also
      moderately affected in group 1 and most severely in group 4. CONCLUSION: We found
      that a moderate restrictive defect and a small airway defect which is found in
      cases of mitral stenosis, directly correlates to the PAP, LAP, MVA and Gr. There
      was no significant involvement of the larger airways.

PMID- 11200923
TI  - Evaluation of oxidative stress before and after haemodialysis in chronic renal
      failure.
AB  - OBJECTIVE: To evaluate the oxidative stress before and after haemodialysis in
      chronic renal failure patients. METHODS: A prospective study comprising of 22
      patients of CRF who have to receive their first haemodialysis. All patients were
      subjected to standard four hours haemodialysis. The parameters of oxidative
      stress i.e. erythrocyte malonaldehyde (MDA), reduced glutathione (GSH) and
      superoxide dismutase (SOD) were measured before and after haemodialysis. RESULTS:
      The value of mean erythrocyte MDA (9.40 +/- 3.36 mumol/L) and SOD (617 +/- 64.33
      units/ml) were significantly higher in patients of CRF before haemodialysis than
      in controls (p < 0.001). The mean GSH levels were significantly lower (451 +/-
      63.91 micrograms/ml) in patients than in controls before haemodialysis (p <
      0.001). After haemodialysis MDA levels further increased (12.27 +/- 4.38
      mumol/L), SOD levels decreased (458 +/- 69.58 EU/ml) and GSH levels further
      decreased (396 +/- 41.41 micrograms/ml) (p < 0.001). CONCLUSIONS: There was an
      evidence of oxidative stress in patients of CRF before haemodialysis which
      increased further after haemodialysis, the mechanisms of which is not delineated.
      The procedural factors may be contributing in the increased oxidative stress
      after haemodialysis.

PMID- 11200924
TI  - Comparative bioavailability study of clonazepam after oral administration of two
      tablet formulations.
AB  - OBJECTIVE: To assess the bioavailability of clonazepam from two brands of 2 mg
      tablet formulations--Epitril and reference brand. METHODS: A two-way randomised
      cross-over bioavailability study was carried out in 12 healthy male volunteers.
      Coded plasma samples were analysed for levels of clonazepam by high performance
      liquid chromatography (HPLC) method. RESULTS: The mean Cmax, Tmax t1/2 beta and
      AUC (0-48) for Epitril were: 16.31 +/- 3.07 ng/mL, 1.63 +/- 0.48 h, 46.97 +/-
      12.26 h and 207.70 +/- 57.07 ng/ml.h; for reference brand were 19.75 +/- 5.95
      ng/mL, 1.42 +/- 0.29 h, 46.88 +/- 11.29 h and 215.70 +/- 50.89 ng/ml.h
      respectively. These were comparable and the differences were not statistically
      significant. CONCLUSION: Based on above pharmacokinetic parameters, Epitril was
      bioequivalent to reference brand.

PMID- 11200925
TI  - Non traumatic paraparesis: aetiological, clinical and radiological profile.
AB  - AIM OF STUDY: To study the aetiological and clinical profile of non traumatic
      paraparesis and radiological correlation with newer aids of diagnosis like CT
      scan, MRI. METHODOLOGY: Forty cases of non traumatic paraparesis admitted at Sri
      Sayaji General Hospital, Baroda were studied. The clinical, laboratory data and
      radiological features were analyzed. RESULTS: Spinal tuberculosis was commonest
      cause (30%) of paraparesis followed by acute transverse myelitis (20%) and then
      by primary spinal cord tumours (10%). Incidence of paraparesis was highest
      (32.5%) in third decade. Backache (75%), parasthesias (62.5%) were common
      symptoms accompanying paraparesis. Spasticity was present in 57.5% patients.
      Myelography showed block in 58.5% patients. CT scan following myelography exactly
      delineated the primary spinal cord tumours and confirmed diagnosis in spinal TB,
      arachnoid cysts and other compressive myelopathies. MRI, showed plaques of
      demyelination in two patients, and epidermoid cyst in one patient. CONCLUSION:
      Tuberculosis of the spine was the commonest cause of paraparesis followed by
      acute transverse myelitis. CT scan and MRI are important diagnostic aids in
      patients of paraparesis.

PMID- 11200926
TI  - Pictorial CME.

PMID- 11200927
TI  - Role of micro-nutrients and trace elements in carcinoma of larynx.
AB  - Cancer of the larynx is fourteenth most common cancer in the world. Evidence from
      case-control studies conducted in developed as well as developing countries
      suggest that specific micro-nutrients and trace elements have been implicated to
      be significantly associated with laryngeal carcinoma. The association of these
      micro-nutrients and trace elements with laryngeal cancer has been discussed in
      this review article.

PMID- 11200928
TI  - Stevens-Johnson syndrome and toxic epidermal necrolysis-challenges of recognition
      and management.
AB  - Skin adverse drug reactions (ADRs) generally present as transient erythematous
      macular/papular rashes. However these can many a times be the initial
      presentation of serious muco-cutaneous ADRs such as Stevens-Johnson syndrome
      (SJS) or toxic epidermal necrolysis (TEN). The incidence of SJS varies from 1.2
      to 6 per million patient-years and that of TEN to be 0.4 to 1.2 per million
      patient-years. The pathophysiological mechanism of SJS and TEN have not been
      fully elucidated. The aetiological factors of SJS and TEN are diverse; drugs
      being the cause in more than 80% cases of TEN and about 40-50% cases of SJS.
      Mucous membranes are affected in nearly all cases. The extent of epidermal
      sloughing may vary and forms a basis for the classification of an individual case
      as SJS or TEN. Prognosis of SJS is better than that of TEN; mortality rates being
      about 5% and 30%-40% respectively. Specific therapy for these conditions is yet
      not available. The use of systemic corticosteroids has been controversial. Early
      diagnoses can prevent/reduce the morbidity of such serious ADRs. This article
      provides a brief review of the clinical presentation and management of SJS and
      TEN.

PMID- 11200929
TI  - Clinical implications of insulin-like growth factors and their binding proteins
      in reproduction.

PMID- 11200930
TI  - Effect of calcimimetic agent, KRN568, on gastrin secretion in healthy subjects.
AB  - KRN568 is a calcimimetic compound which acts on the calcium sensing receptors
      (CaR) on the parathyroid gland to suppress secretion of PTH. A recent report has
      demonstrated that CaRs are expressed on cultured human antral gastrin cells and
      that gastrin secretion is stimulated by an increase in extracellular calcium
      level. However, the effect of KRN568 on serum gastrin levels has yet to be
      clinically assessed. We therefore studied the effect of this calcimimetic on
      gastrin secretion in healthy subjects enrolled in the phase 1 study for KRN568
      currently carried out in Japan. Single doses of KRN568, ranging from 25 mg to 400
      mg, were orally administered to 6 healthy male volunteers at fasting and after
      meal. One subject proved to be a poor metabolizer (PM) for this compound and
      showed more than 10-fold high concentrations of plasma KRN568 (fasting Cmax 90.8
      and non-fasting 83.8 ng/ml) compared to the other 5 individuals (Cmax 6.5 +/- 2.2
      and 7.4+/- 1.6 ng/ml, respectively). Plasma gastrin levels showed mild but
      apparent increase (from 30 to 125 pg/ml) in this particular subject, while there
      were no significant increases in the other five people (from 34 +/- 6 to 63 +/- 3
      pg/ml) after oral administration of 400 mg KRN568 at fasting. In the PM,
      administration of KRN568 resulted in extraordinarily high serum drug levels
      associated with transient increase of gastrin levels. This observation suggested
      that calcium-induced stimulation of gastrin secretion in human was mediated by a
      mechanism involving CaR. Potential side effects related to the increased gastrin
      secretion may be warranted in the practical use of this compound.

PMID- 11200931
TI  - Major determinants of the carotid intima-media thickness in type 2 diabetic
      patients: age and body mass index.
AB  - The present study has been designed to quantify and compare right and left
      carotid intima-media thicknesses (IMT) in type 2 diabetics and healthy controls.
      It was also intended to investigate the effects of various risk factors on the
      carotid IMT in these subjects. A total of 122 subjects; 70 patients with type 2
      diabetes and 52 non-diabetic subjects as controls, were recruited for the study.
      Right and left common carotid artery stiffness indices were assessed with
      ultrasonography in both groups. Age, body mass index (BMI), duration of diabetes,
      cigarette smoking, lipid profile including lipoprotein a, Chlamydia pneumonia
      seropositivity, glycemic indices, fasting insulin levels, serum fibrinogen levels
      and presence of hypertension, coronary artery disease, degenerative complications
      of diabetes mellitus were all assessed in order to define their role as
      determinants of carotid artery IMT. The difference between the groups regarding
      mean carotid IMT was statistically significant for the left carotid arteries (p =
      0.028) and borderline significance was found for the right carotid arteries (p =
      0.055). Age has a very strong association with carotid IMT in diabetic patients
      (p < 0.0001) with univariate analysis. According to the results of multivariate
      analysis, age and BMI were found to be the most important independent
      determinants of carotid IMT for both sides. When age was excluded from the model,
      BMI and coronary artery disease were found to have strong association with IMT on
      the right (p = 0.0036 and 0.0249) and BMI was the only significant determinant
      for the left side (p = 0.0025). This study shows that carotid IMT is greater in
      diabetic subjects compared with healthy controls. For the diabetic subjects, age,
      BMI and presence of coronary heart disease have a strong influence on the
      atherosclerotic process of the carotid arteries.

PMID- 11200932
TI  - Evaluation of factors during OGTT to correlate insulin resistance in non-diabetic
      subjects.
AB  - The correlation between various factors obtained during oral glucose tolerance
      tests (OGTT) and insulin sensitivity tests (steady state plasma glucose, SSPG
      method) were analyzed in non-diabetic subjects by Pearson's simple correlation.
      Similar data were obtained for normal as well as normal and impaired glucose
      tolerance (IGT) subjects. Three factors (AUCI(120)0AUCG(120)0, AUCI(120)0 and
      AUCI(120)60, area of under curve (AUC), insulin (I), glucose (G)) were found to
      have significant correlation (r=0.47-0.54) with SSPG, thus indicating insulin
      resistance. Those with hyperinsulinemia were noted to have insulin resistance
      with high precision (98%), but insulin resistant subjects without
      hyperinsulinemia were all judged to have normal sensitivity. These three factors
      all had high specificity (98%), but low sensitivity (21-25%) with false negative
      results being obtained in 75-78%, and false positive results in less than 2%. It
      was difficult to distinguish positive and negative for the insulin resistance by
      receiver operating characteristic (ROC) curve of I0G0. The sensitivity of which
      was 12.8% and specificity 93.8%. By ROC curve, the specificities and
      sensitivities for the proposed factors, including homeostatic model assessment
      (HOMA) product (I0G0, I0-120, G0-120, insulin and glucose at 0-120' during OGTT)
      ranged from 60 to 70%, which is far from an acceptable level of 90% or more.
      Therefore, these factors were useful to correlate insulin sensitivity with OGTT
      results in hyperinsulinemic subjects or in general non-diabetic subjects, but
      less useful when it came to identifying individual cases with insulin resistance.
      These parameters should be used only in non-diabetic subjects and their
      significance is thought to be restricted to cases with hyperinsulinemia.

PMID- 11200933
TI  - Alternate exon in the 5'-untranslated region of the human ACTH receptor gene.
AB  - The human ACTH receptor (ACTH-R) gene consists of two exons; the first encodes
      the 5'-untranslated region (UTR) and the second encodes part of the 5'-UTR, the
      entire coding region, and the whole of the 3'-UTR. While investigating the
      transcription initiation site of the human ACTH-R gene by 5'-rapid amplification
      of cDNA ends, we found a 157-bp alternate exon in the 5'-UTR. This newly
      identified exon was irrelevant to the alternate exon in the mouse ACTH-R gene
      which we reported previously.

PMID- 11200934
TI  - Growth hormone secretory dynamics over the menstrual cycle.
AB  - Whether GH secretion in women varies over the menstrual cycle is uncertain.
      Previous investigations have led to conflicting conclusions; some studies
      suggested that there is an estrogen mediated rise in GH during the periovulatory
      (PO) and luteal (L) phases whereas others indicated no change in GH axis over the
      cycle. Differences in conclusions could relate to heterogeneity of the study
      populations, GH sampling paradigms or sensitivity of the GH assays used. In order
      to investigate whether GH secretion varied over the cycle, 24-h GH profiles using
      every 10-min sampling were obtained in 6 ovulatory women during the early
      follicular (EF), PO and L phases of the cycle. The TSH response to TRH, GH
      response to GRH and fasting plasma IGF-I were measured on each occasion. There
      was a trend toward higher integrated GH concentration (IGHC) during the PO phase,
      although this difference was not statistically significant (3284+/-721 vs 4542+/
      872 vs 4071+/-699 microg/min/L; EF vs PO vs L; p=0.09). Similarly, deconvolution
      estimated GH secretion did not vary over the cycle (p=0.56). There were no
      differences in GH pulse amplitude or frequency. There were no correlations
      between IGHC and sex steroids. Serum IGF-I was constant over the cycle (272+/-38
      vs 277+/-31 vs 265+/-38 microg/L; p=0.89). The TSH response to TRH and GH
      response to GRH did not vary over the cycle. We concluded that the effect of
      changes in the ovarian steroid milieu on the GH axis during spontaneous menstrual
      cycles is minimal.

PMID- 11200935
TI  - A clinical feature of hyperlipidemia in patients with central diabetes insipidus.
AB  - In this study, we analyzed plasma lipid and lipoprotein levels before and after
      treatment with 1-desamino-8-D-arginine vasopressin (DDAVP) in subjects with
      partial and complete central diabetes insipidus (DI) in order to determine how a
      shortage and supplement of this hormone affect plasma lipid metabolism. The
      subjects consisted of 6 patients with partial and 6 with complete central DI.
      After treatment with DDAVP through nasal cavity, plasma total cholesterol (TC)
      level did not decrease either in complete or partial form. Plasma triglyceride
      (TG) levels decreased from 306+/-175 mg/dl to 198+/-91 (35% decrease, p=0.027) in
      complete form, while TG did not change significantly in partial form. A detailed
      investigation of plasma lipoprotein metabolism during treatment with DDAVP was
      carried out in 3 of the 6 subjects with complete form of DI. Lipoprotein lipase
      activity and mass in post-heparin plasma from those three subjects tended to
      increase after treatment with DDAVP, along with the complete disappearance of an
      unusual lipoprotein between low density lipoprotein (LDL) and very low density
      lipoprotein (VLDL) as analyzed by polyacrylamide gel electrophoresis. These
      results suggest that the DDAVP treatment has a favorable effect on lipid and
      lipoprotein metabolism, especially triglyceride-rich lipoproteins, either
      directly or through modifying factors contributing to lipid metabolism.

PMID- 11200936
TI  - Twenty-kilodalton human growth hormone (20K hGH) secretion from growth hormone
      secreting pituitary adenoma cells in vitro.
AB  - Circulating human growth hormone (GH) consists of several molecular isoforms.
      Increased proportion of circulating non-22K hGH and 20K hGH was reported in
      active acromegaly. In this study, we studied the release of 20K and 22K hGH from
      cultured GH-producing human pituitary adenoma cells in vitro. Pituitary adenoma
      cells obtained from 6 acromegalic patients were cultured and submitted to
      perifusion experiments. Concentrations of 20K and 22K hGH in the serum and the
      perifusion effluent were determined by specific enzyme-linked immunosorbent
      assays recently developed. The %20K value varied in a wide range from 3.58 to
      8.72% in vitro and was lower than in the serum (mean+/-SD: 6.57+/-1.88% vs 9.08+/
      2.12%, P<0.05). There was no correlation between the %20K values in vitro and in
      vivo (r=0.31, P>0.05). The in vitro secretions of 20K and 22K hGH were in
      parallel and strongly correlated (r=0.953, P<0.001). These findings suggest that
      different GH-producing pituitary adenoma cells secrete 20K hGH in variable
      amounts and that the proportion of 20K hGH in the serum might be affected by
      metabolic clearance of hGH isoforms. It was also suggested that 20K and 22K hGH
      might be secreted in toto from GH-producing human pituitary adenoma cells.

PMID- 11200937
TI  - Frequency of facial angiofibromas in Japanese patients with multiple endocrine
      neoplasia type 1.
AB  - The high frequency of cutaneous manifestations in patients with multiple
      endocrine neoplasia type 1 (MEN 1) has recently been reported. Since prevalence
      of some cutaneous diseases varies among different ethnic groups, we examined the
      frequency of facial angiofibromas in Japanese patients with familial MEN 1. Among
      27 patients with germline MEN1 gene mutation and one asymptomatic gene carrier,
      angiofibromas were identified in 43% (12/28) of the subjects. This frequency was
      significantly lower than that of Caucasian patients, but nonetheless almost
      equaled those of pituitary tumors and pancreas endocrine tumors. Angiofibromas
      should be considered as one of major manifestations in MEN 1 regardless of
      patients' ethnic origin, and clinicians should pay careful attention to the
      cutaneous lesions in patients with endocrine tumors.

PMID- 11200939
TI  - Human chorionic gonadotropin beta-subunit affects the folding and glycosylation
      of alpha-cys mutants.
AB  - Human chorionic gonadotropin (hCG) is a member of a family of heterodimeric
      glycoprotein hormones that contain a common alpha-subunit but differ in their
      hormone-specific beta-subunits. Both subunits have five and six disulfide bonds,
      respectively, which consist of cystine knot structure. It is evident from
      numerous studies that the structure of beta-subunits is rigid, whereas that of
      alpha-subunit is flexible and can be molded by a beta-subunit. Previously, we
      reported that secreted forms of a mutants where either cysteine residue in the
      disulfide bond 7-31 or 59-87 was converted to alanine contained a disulfide
      linked homodimer in addition to a monomer. To study whether the hCGbeta-subunit
      affects the conformations of alpha mutants, alpha-subunits lacking either the 7
      31 or 59-87 disulfide bond were expressed with wild-type (WT) hCGbeta in Chinese
      hamster ovary cells, and homodimer formation and glycosylation of dimerized alpha
      subunit were assessed by continuous labeling with [35S]methionine/cysteine,
      immunoprecipitation with anti-alpha or -hCGbeta serum, digestion with
      endoglycosidase-H or -F, and sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis in a non-reducing condition. Our data showed that a homodimer was
      not observed in the half-Cys mutants except one, where cysteine at position 7 was
      converted to alanine, in the presence of beta-subunit. This finding indicated
      that hCGbeta-subunit rescued the a half-Cys mutants from the formation of
      intermolecular disulfide-linked homodimer by preferentially combining with the
      alpha mutants. In both free WT and all mutants treated with endoglycosidase-H, no
      or faint bands were recognized as the same migration as seen in endoglycosidase-F
      treatment. Even in the endoglycosidase-H sensitive cases, the amount of sensitive
      alpha-subunits was less than 5% of total alpha-subunits. In contrast to free
      alpha-subunits, distinct endoglycosidase-H sensitive bands were seen in both WT
      and mutants, although the ratio was various. We concluded that hCGbeta-subunit
      affects the folding and glycosylation of the alpha-subunit mutants.

PMID- 11200938
TI  - Measurement of anti-thyroglobulin and anti-thyroid peroxidase antibodies using
      highly sensitive radioimmunoassay: an effective method for detecting asymptomatic
      focal lymphocytic thyroiditis in the elderly.
AB  - Subclinical thyroiditis or thyroid dysfunction is relatively common in the
      elderly. To estimate the effectiveness of measurement of serum levels of anti
      thyroglobulin and anti-microsomal or thyroid peroxidase antibodies for detecting
      focal lymphocytic thyroiditis (FLT) in the elderly, we examined the relationships
      between antibody titer and postmortem histological finding of the thyroid gland
      in 180 consecutive autopsies (69 women and 111 men) over 60 years of age without
      any overt clinical thyroid or collagen diseases. FLT was found in 25 cases
      (13.9%) with female predominance (21.7% in female vs. 9.0% in male). Measurements
      of serum levels of anti-thyroglobulin and anti-thyroid peroxidase antibodies by
      radioimmunoassay (TgAb and TPOAb, respectively) were compared with the
      measurements of anti-thyroglobulin and anti-microsomal antibodies by a
      hemagglutination technique (TGHA and MCHA, respectively), using sera from 25
      patients with FLT and age- and sex-matched 51 patients without FLT. Among 25
      cases with FLT, TgAb and TPOAb were positive in 17 (68%) and 12 (48%),
      respectively. There was a close relationship between degree of FLT and serum
      level of TgAb or TPOAb (P<0.0001). On the other hand, TGHA and MCHA were positive
      only in 8 (32%) and 10 (40%), respectively. TgAb and TPOAb were more sensitive
      than TGHA (68% vs. 32%, P<0.05) and MCHA (48% vs. 40%) to detect FLT. Positive
      findings in either TgAb or TPOAb significantly improved sensitivity (76%)
      compared with that of TGHA or MCHA (44%) (P<0.05). Specificities of combined
      measurements of TgAb and TPOAb (90%) were not significantly different from those
      of TGHA and MCHA (100%). These findings indicate that TgAb is a more sensitive
      method for detecting FLT and that its diagnostic sensitivity for FLT increases by
      using it in combination with TPOAb. Therefore, in the elderly without clinically
      or biochemically overt thyroid dysfunction, positive TgAb and/or TPOAb could
      imply presence of FLT, and their titers might reflect degree of inflammation.

PMID- 11200940
TI  - Self-examination of thyroid nodules.
AB  - The management of occult small thyroid nodules found by ultrasonography is
      sometimes problematic. Self-palpation may be utilized in the follow-up of these
      nodules. We developed a method of thyroid self-examination (TSE). We examined the
      size of the nodules palpable by this method by ultrasonography. In 78 patients
      examined, all 38 tumors more than 2 cm in size, whereas only one of 14 tumors
      less than or equal to 1 cm in size, were palpable. These results suggest the
      clinical usefulness of TSE in the follow-up of thyroid tumors, which are very
      common and slow-growing.

PMID- 11200941
TI  - Substitution of M398T in the second transmembrane helix of the LH receptor in a
      patient with familial male-limited precocious puberty.
AB  - Familial male-limited precocious puberty (MPP) is described in a 10 year old
      patient with typical symptoms of the disease. Sequence analysis of genomic DNA
      clearly demonstrated a heterozygous T1193C transition in exon 11 of the LH
      receptor (LHR) gene, which results in M398T substitution in the second
      transmembrane helix of the protein product of this gene. The same mutation was
      found in the patient's mother and in her brother. The grandmother and the
      relatives of the patient's father were free of the mutation. The boy was
      successfully treated with inhibitors of steroid biosynthesis and androgen
      antagonists. It is suggested that this mutation caused constitutive activation of
      the LHR, which results in excessive formation of androgens in Leydig cells and is
      responsible for the symptoms of precocious puberty in this patient. This is the
      second case of the familial form of MPP that was maternally inherited.

PMID- 11200942
TI  - Postnatal development of NADPH-diaphorase activity in the rat: the role of nitric
      oxide in the ontogeny of arginine vasopression and oxytocin.
AB  - To clarify the role of nitric oxide (NO) in the ontogeny of arginine vasopressin
      (AVP) and oxytocin (OXT) neurons in the hypothalamo-neurohypophysial system
      (HNS), we observed the coexpression pattern of NADPH-diaphorase (NADPH-d)
      activity and AVP- or OXT-immunoreactivity (IR) in the rat hypothalamus and
      posterior pituitary during the postnatal period. The enzymatic activity of NADPH
      d was observed in the supraoptic nucleus (SON), paraventricular nucleus (PVN),
      median eminence (ME) and posterior pituitary throughout the postnatal
      development. AVP-containing neurons were clearly observed from postnatal day 1 in
      both the SON and PVN, while OXT-containing neurons were recognized from postnatal
      day 14. The coexistence of NADPH-d and AVP or OXT was detected in the SON from
      postnatal day 14. At postnatal day 21, the coexpression pattern was approximately
      the same as that of the SON and PVN in adult rats. Our findings indicated that
      the expression of NADPH-d and OXT was observed from almost the same postnatal
      period in both the SON and PVN. In addition, the pattern of increased numbers of
      NADPH-d positive fibers was similar to that of OXT-immunoreactive fibers in both
      the inner layer of the ME and the posterior pituitary. A good correlation was
      thus obtained between OXT expression and NADPH-d activity in the HNS during
      postnatal development. The present study suggests that NO is more closely
      involved in the expression and regulation of secretion of OXT than AVP.

PMID- 11200943
TI  - Gender-related difference in relationship between insulin resistance and serum
      leptin level in Japanese type 2 diabetic and non-diabetic subjects.
AB  - It remains controversial whether or not a correlation exists between serum leptin
      levels and insulin resistance, and, if such a correlation does exist, whether it
      is independent of adiposity. To investigate the possible existence of an
      independent correlation, we have assessed serum leptin levels and insulin
      resistance in Japanese diabetic and non-diabetic subjects by means of Homeostatic
      Model Assessment (HOMA-R). Sixty-four Japanese patients with Type 2 diabetes
      mellitus (DM) (33 men and 31 women) and 53 sex-, age-, and body mass index (BMI)
      matched non-diabetic adults (29 men and 24 women) were enrolled. The fasting
      plasma level of glucose (FPG) and the fasting serum levels of immunoreactive
      insulin (FIRI) and leptin were determined. Multiple linear regression analysis
      demonstrated that, in both male diabetic and male non-diabetic subjects, HOMA-R
      and BMI were independently correlated with serum leptin levels. In females, BMI,
      but not HOMA-R, was correlated to the serum levels of leptin in both groups.
      There was no statistically significant difference in the partial regression
      coefficients between male diabetic and male non-diabetic subjects. These results
      suggest that the correlation of HOMA-R to the serum levels of leptin in females
      is dependent on BMI. In males, the relationship between serum leptin levels and
      the insulin resistance was not affected by the extent of glucose intolerance.

PMID- 11200944
TI  - Sympathetic overactivity in the development of eyelid retraction in a patient
      with euthyroid Graves' disease evaluated by accommodation.
AB  - It is known that measurement of accommodation is useful to evaluate the
      sympathetic activity of intraocular muscles. To find if sympathetic overactivity
      is involved in eyelid retraction in euthyroid Graves' disease, we measured
      accommodation in two patients with this disease, whose serum concentrations of
      free T3, free T4 and TSH were within reference ranges. Accommodation was measured
      with a computer-assisted infrared optometer with an iriscoder, and the results
      were expressed as the change in the eye's refractive power (in diopters) in
      response to the movement of a target beam. In patient 1, the accommodation
      amplitude was low, indicating sympathetic overactivity. This amplitude rose to
      near the reference range when timolol maleate drops were used, and the eyelid
      retraction disappeared when guanethidine drops were given. During the use of
      guanethidine drops, accommodation remained normal. In patient 2, who had normal
      accommodation, eyelid retraction did not change with guanethidine administration,
      but improved with intravenous methylprednisolone pulse therapy. These two cases
      suggested that even in euthyroid Graves' disease, eyelid retraction is caused by
      sympathetic overactivity, and pulse therapy with methylprednisolone may be
      effective for eyelid retraction when guanethidine drops are not effective.

PMID- 11200945
TI  - Genetic and endocrinological evaluations of three 46,XX patients with congenital
      lipoid adrenal hyperplasia previously reported as having presented spontaneous
      puberty.
AB  - Congenital lipoid adrenal hyperplasia (CLAH) is an autosomal recessive disorder
      characterized by impaired synthesis of adrenal and gonadal steroids. It was
      demonstrated that loss-of-function mutations in the steroidogenic acute
      regulatory protein (StAR) gene cause CLAH and that 46,XX patients with CLAH
      develop spontaneous puberty. We had reported that three 46,XX patients with CLAH
      had presented spontaneous puberty and one of the patients had developed life
      threatening ovarian cysts, before the etiology of CLAH had been clarified. In the
      present study, we analyzed their StAR gene and demonstrated mutations.
      Endocrinological examinations of the patients revealed that serum LH and FSH
      levels and their responses to the LHRH stimulation were not exaggerated before
      the onset of puberty. Serum LH levels and its response to LHRH were increased
      during puberty, whereas serum FSH levels remained within the normal range. Serum
      estradiol increased after the administration of human menopausal gonadotropins in
      the pubertal patient, suggesting that the ovary might have another system than
      StAR to facilitate cholesterol transport into the mitochondria. Although the
      patients had menstrual cycles, they remained anovulatory, and the resultant
      increased secretion of LH was speculated to be responsible for the development of
      ovarian cysts.

PMID- 11200946
TI  - Rebound hypersecretion of GH following octreotide withdrawal due to liver
      dysfunction in an acromegalic patient.
AB  - Octreotide usually induces long-acting inhibition of GH secretion without rebound
      hypersecretion. We report a patient with acromegaly who showed rebound elevation
      of GH and insulin-like growth factor-1 (IGF-1) after octreotide withdrawal. The
      patient responded remarkably to octreotide therapy with normalization of GH and
      IGF-1 and shrinkage of pituitary macroadenoma. Octreotide therapy was stopped
      when he developed liver dysfunction. GH and IGF-1 were markedly elevated for two
      weeks after cessation of octreotide.

PMID- 11200947
TI  - Impairment of early insulin response after glucose load, rather than insulin
      resistance, is responsible for postprandial hyperglycemia seen in obese type 2
      diabetes: assessment using nateglinide, a new insulin secretagogue.
AB  - The insulin secretory pattern as a phenotype of type 2 diabetes is an impairment
      in the rapid, pulsatile secretion of insulin in response to a rise in blood
      glucose after meal-intake. The restoration of endogenous rapid insulin secretion
      after oral glucose load was established for the first time by using nateglinide,
      which is a newly developed insulin secretagogue, in obese patients with type 2
      diabetes mellitus. It was clearly demonstrated that with nateglinide, serum
      insulin levels were quickly raised, and glycemic response curves were almost
      normalized with the same amount of insulin secretion during 180 min. Therefore,
      the lack of rapid, pulsatile secretion of insulin in response to glycemic rise
      after oral glucose load, rather than insulin resistance, is responsible for
      postprandial glycemic response in obese type 2 diabetes patients.

PMID- 11200948
TI  - Horner's syndrome: recovery after surgical excision of intrarhoracic benign
      multinodular goiter.

PMID- 11200949
TI  - Is physical deconditioning a perpetuating factor in chronic fatigue syndrome? A
      controlled study on maximal exercise performance and relations with fatigue,
      impairment and physical activity.
AB  - BACKGROUND: Chronic fatigue syndrome (CFS) patients often complain that physical
      exertion produces an increase of complaints, leading to a greater need for rest
      and more time spent in bed. It has been suggested that this is due to a bad
      physical fitness and that physical deconditioning is a perpetuating factor in
      CFS. Until now, studies on physical deconditioning in CFS have shown inconsistent
      results. METHODS: Twenty CFS patients and 20 matched neighbourhood controls
      performed a maximal exercise test with incremental load. Heart rate, blood
      pressure, respiratory tidal volume, O2 saturation, O2 consumption, CO2
      production, and blood-gas values of arterialized capillary blood were measured.
      Physical fitness was quantified as the difference between the actual and
      predicted ratios of maximal workload versus increase of heart rate. Fatigue,
      impairment and physical activity were assessed to study its relationship with
      physical fitness. RESULTS: There were no statistically significant differences in
      physical fitness between CFS patients and their controls. Nine CFS patients had a
      better fitness than their control. A negative relationship between physical
      fitness and fatigue was found in both groups. For CFS patients a negative
      correlation between fitness and impairment and a positive correlation between
      fitness and physical activity was found as well. Finally, it was found that more
      CFS patients than controls did not achieve a physiological limitation at maximal
      exercise. CONCLUSIONS: Physical deconditioning does not seem a perpetuating
      factor in CFS.

PMID- 11200950
TI  - Outcome of women admitted to hospital for depressive illness: factors in the
      prognosis of severe depression.
AB  - BACKGROUND: A previous study of women 9 months after discharge from in-patient
      treatment for depression found that low self-esteem as measured by a self-report
      questionnaire at admission was associated with a worse prognosis. This study
      investigates the womens' outcome more than 4 years after discharge and the
      continued prognostic relevance of self-esteem and other variables. METHOD: Fifty
      six women who had been admitted to hospital with major depression and studied in
      detail during their admission and 9 months following discharge were traced 4-5
      years later. Possible prognostic factors were investigated in relation to time to
      recovery and recurrence, and to a global outcome measure. RESULTS: In keeping
      with other published work only 16 out of 52 (31%) women had recovered and
      remained well. Fifteen out of 52 (29%) subjects had experienced depressive
      symptoms for more than 70% of the follow-up time or died from unnatural causes.
      Low self-esteem scores recorded at the initial admission correlated with slow
      recovery but not subsequent recurrence of depression. The occurrence of one or
      more life events in the year preceding admission was associated with a better
      prognosis. CONCLUSIONS: The poor long-term prognosis of many women with severe
      depression was confirmed. Social factors, such as social support and marital
      relationships were less important for prognosis than in previous studies of less
      severely ill subjects. The prognostic value of self-esteem warrants further
      investigation and appears to have therapeutic implications.

PMID- 11200951
TI  - Unemployment and suicide: a cohort analysis of social factors predicting suicide
      in the US National Longitudinal Mortality Study.
AB  - BACKGROUND: The purpose of the study was to examine the effect of employment
      status measured at baseline on the risk of suicide by years of follow-up, using a
      large nationally representative sample of the US population. METHODS: Cox
      regression models were applied to data from the National Longitudinal Mortality
      Study, based on the 1979-1989 follow-up. In estimating the effect of baseline
      employment status on suicide, adjustments were made for baseline demographic and
      socio-economic variables. RESULTS: After 3 years of follow-up, unemployed men
      were a little over twice as likely to commit suicide as their employed
      counterparts. Among men, the lower the socio-economic status, the higher the
      suicide risk. Among women, in each year of follow-up, the unemployed had a much
      higher suicide risk than the employed. After 9 years of follow-up unemployed
      women were over three times more likely to kill themselves than their employed
      counterparts. CONCLUSIONS: Unemployment is strongly related to suicide, but this
      relationship is more enduring and stronger among women. For men, the unemployment
      effect is stronger at earlier years of follow-up. In women, unemployment
      increases the risk of suicide regardless of the number of follow-up years. The
      finding with regard to women disconfirms earlier research reports suggesting that
      unemployment affects suicide only in men.

PMID- 11200952
TI  - Fitness to plead. A prospective study of the inter-relationships between expert
      opinion, legal criteria and specific symptomatology.
AB  - BACKGROUND: Psychiatrists are asked to give opinions as to fitness to plead, a
      legal concept. There is a dearth of research into fitness to plead in the UK,
      with no prospective studies and no studies involving the comparison of fit and
      unfit subjects. In particular, there have been no investigations into the meaning
      of 'unfit to plead' in terms of psychiatric symptomatology, or as to the relative
      importance of each legal fitness criterion in psychiatrists' conclusions as to
      fitness. METHOD: The study comprised a prospective evaluation of 479 consecutive
      referrals to psychiatrists at court. Individual legal fitness criteria were
      examined as predictors of unfitness. Associations of unfitness, and of individual
      legal fitness criteria, were examined with Brief Psychiatric Rating Scale (BPRS)
      symptom scores. RESULTS: The two most important of the legal criteria in clinical
      decisions as to unfitness were whether the person could follow the proceedings of
      the trial or give adequate instructions to their solicitor. The legal criteria
      concerning trial were more predictive of unfitness than those concerning plea.
      Unfitness was significantly associated with the presence of positive psychotic
      symptomatology, in particular conceptual disorganization and delusional thinking,
      but not with symptoms of anxiety, depression or withdrawal. CONCLUSION: Unfitness
      is most significantly associated with symptoms affecting comprehension and
      communication. The fitness criteria could be simplified without loss of power.
      These results, predominantly concerned with mental illness, may not generalize to
      the mentally impaired.

PMID- 11200953
TI  - Age is no kinder to the better educated: absence of an association investigated
      using latent growth techniques in a community sample.
AB  - BACKGROUND: Higher education has been posited to protect against cognitive
      decline, either because the rate of decline is slower in the more highly educated
      or the start of decline is delayed. Latent growth models provide improved
      methodology to examine this issue. METHODS: The sample consisted of 887
      participants aged 70-93 years in 1991 and followed up in 1994 and 1998. Latent
      growth models and standard regression techniques were used to examine the rate of
      cognitive decline in four cognitive measures while controlling for health status
      and sex. A delayed start model was examined by incorporating interaction effects
      in a regression model. RESULTS: Neither the latent growth models nor the
      regression techniques revealed a slower rate of decline for the more highly
      educated. The proportion of the highly educated showing no change was no larger
      than the proportion of the less well educated. There were no significant age by
      education interaction effects, no chronologically later accelerations in the rate
      of change as a function of education, and no differences in rate of decline
      between the first measurement interval and the second. CONCLUSIONS: Education may
      not protect against cognitive decline although it is associated with long-term
      individual differences in level of functioning. The discrepancy between our study
      and others may be attributable to attrition effects, follow-up length, sample
      age, scaling artefacts and negative publication bias. Most importantly, practice
      effects may favour the better educated and hence account for the supposed
      protective effect in many longitudinal studies of cognitive change.

PMID- 11200954
TI  - Diagnostic stability in subjects with multiple admissions for psychotic illness.
AB  - BACKGROUND: Although studies investigating changes in diagnosis between psychotic
      episodes have differed in design, some consistent findings have emerged. This
      study seeks to clarify and extend these findings by describing and comparing
      clinical and operationally defined diagnostic stability in a group of subjects
      with multiple episodes of functional psychotic illness. METHODS: The OPCRIT
      programme was applied to case notes of 204 subjects with multiple admissions for
      psychotic illness. Clinical and operationally defined diagnoses were compared and
      the spread and stability of diagnoses determined. RESULTS: An increase in the
      frequency of diagnosis of schizophrenia from initial to subsequent episodes was
      demonstrated. High levels of stability were found for schizophrenia (58 to 98%),
      moderate levels for affective disorders (24 to 83%), low levels for other non
      organic psychotic conditions (27 to 54%) and atypical psychosis (27 to 53%), and
      very low levels for schizoaffective disorder (5 to 39%) and other conditions (0
      to 4%). CONCLUSIONS: The stability levels for schizophrenia and affective
      disorders are adequate, but the low levels for a range of other psychotic
      conditions raise questions regarding their predictive validity.

PMID- 11200955
TI  - A factor model of the functional psychoses and the relationship of factors to
      clinical variables and brain morphology.
AB  - BACKGROUND: Despite more than 100 years of study, there remains no definitive
      diagnostic validation of the functional psychoses. Factor analysis suggests the
      presence of three or more psychopathological syndromes in functional psychoses as
      a whole. The relationship between these factors and cerebral anatomy has been
      investigated in schizophrenia only. This study aimed to address the relationship
      of symptom factors to clinically important variables and cerebral anatomy in a
      sample of psychotic patients with a spread of diagnoses. METHODS: In a sample of
      patients with functional psychoses, symptom data was obtained on four consecutive
      admissions using the OPCRIT symptom checklist. OPCRIT data was used to generate
      operational diagnoses in accordance with pre-set criteria and a principle
      components analysis was performed on symptom data. Factor loadings were compared
      between each admission to examine factor stability over time. Factor scores at
      first admission were also correlated with clinical variables obtained from
      patients' case notes. From the sample of 204 patients, 64 subjects were recruited
      and underwent an MRI scan of the brain. Regional anatomical volumes were compared
      with diagnosis and factor loadings at first admission. RESULTS: A principal
      components analysis gave a four-factor solution of 'manic', 'depressive',
      'disorganization' and 'reality distortion' factors at each admission. Factors
      showed a high degree of stability over the four admissions studied. The factors
      were significantly associated with several clinical variables. Three of the four
      factors were associated with a specific pattern of cerebral anatomy. CONCLUSIONS:
      This study suggests that factors may correspond to relatively specific disease
      processes underlying functional psychotic illness. We propose that the use of
      symptom factors may facilitate the investigation of the underlying mechanisms of
      psychotic illness.

PMID- 11200956
TI  - Dowrick et al. found no relationship between the scores on the Depression
      Attitude Questionnaire and GPs' ability to identify depressed individuals in the
      surgery.

PMID- 11200957
TI  - Ageing and mental health in a developing country: who cares? Qualitative studies
      from Goa, India.
AB  - BACKGROUND: While there is a growing body of epidemiological evidence on the
      prevalence of mental illnesses in late-life in developing countries, there is
      limited data on cultural perceptions of mental illnesses and care arrangement for
      older people. METHOD: This qualitative study used focus group discussions with
      older people and key informants to investigate the status of older people and
      concepts of late-life mental health conditions, particularly dementia and
      depression, in Goa, India. RESULTS: Vignettes of depression and dementia were
      widely recognized. However, neither condition was thought to constitute a health
      condition. Dementia was construed as a normal part of ageing and was not
      perceived as requiring medical care. Thus, primary health physicians rarely saw
      this condition in their clinical work, but community health workers frequently
      recognized individuals with dementia. Depression was a common presentation in
      primary care, but infrequently diagnosed. Both late-life mental disorders were
      attributed to abuse, neglect, or lack of love on the part of children towards a
      parent. There was evidence that the system of family care and support for older
      persons was less reliable than has been claimed. Care was often conditional upon
      the child's expectation of inheriting the parent's property. Care for those with
      dependency needs was almost entirely family-based with little or no formal
      services. Unsurprisingly, fear for the future, and in particular 'dependency
      anxiety' was commonplace among older Goans. CONCLUSIONS: There is a need to raise
      awareness about mental disorders in late-life in the community and among health
      professionals, and to improve access to appropriate health care for the elderly
      with mental illness. The study suggests directions for the future development of
      locally appropriate support services, such as involving the comprehensive network
      of community health workers.

PMID- 11200958
TI  - The molecular biology of Huntington's disease.
AB  - BACKGROUND: Huntington's disease (HD) is a fatal neurodegenerative disorder with
      an autosomal dominant mode of inheritance. It leads to progressive dementia,
      psychiatric symptoms and an incapacitating choreiform movement disorder,
      culminating in premature death. HD is caused by an increased CAG repeat number in
      a gene coding for a protein with unknown function, called huntingtin. The
      trinucleotide CAG codes for the amino acid glutamine and the expanded CAG repeats
      are translated into a series of uninterrupted glutamine residues (a polyglutamine
      tract). METHODS: This review describes the epidemiology, clinical symptomatology,
      neuropathological features and genetics of HD. The main aim is to examine
      important findings from animal and cellular models and evaluate how they have
      enriched our understanding of the pathogenesis of HD and other diseases caused by
      expanded polyglutamine tracts. RESULTS: Selective death of striatal and cortical
      neurons occurs. It is likely that the HD mutation confers a deleterious gain of
      function on the protein. Neuronal intranuclear inclusions containing huntingtin
      and ubiquitin develop in patients and transgenic mouse models of HD. Other
      proposed mechanisms contributing to neuropathology include excitotoxicity,
      oxidative stress, impaired energy metabolism, abnormal protein interactions and
      apoptosis. CONCLUSIONS: Although many interesting findings have accumulated from
      studies of HD and other polyglutamine diseases, there remain many unresolved
      issues pertaining to the exact roles of intranuclear inclusions and protein
      aggregates, the mechanisms of selective neuronal death and delayed onset of
      illness. Further knowledge in these areas will inspire the development of novel
      therapeutic strategies.

PMID- 11200959
TI  - The prevalence of depression in relation to cerebral atrophy and cognitive
      performance in 70- and 74-year-old women in Gothenburg. The Women's Health Study.
AB  - BACKGROUND: Hospital-based studies report that depression in the elderly is
      associated with brain atrophy. This notion could not be confirmed in a population
      study on 85-year-olds. We aimed to assess depression in relation to brain atrophy
      and cognition in 70- and 74-year-old women. METHODS; A representative sample of
      70- and 74-year-old women (N = 501) was examined with a psychiatric examination
      including the Mini-Mental State Examination (MMSE), measuring global cognitive
      function, and computerized tomography (CT) of the brain (N = 268). Depression was
      diagnosed according to DSM-III-R. Previous depression was diagnosed by history
      and by information from previous examinations in this 24-year longitudinal study.
      RESULTS: The prevalence of depression was 11.6%, including 8.4% with major
      depression (MDD). Among those who were currently mentally healthy, 43.0% had a
      history of previous depression. Women with current MDD had lower scores on the
      MMSE than the mentally healthy women. This association was only found in women
      with a lower level of education. Current depressives, previous depressives and
      mentally healthy women without a history of depression did not differ on CT with
      regard to brain atrophy or white matter lesions. The association between MDD and
      lower cognitive performance was independent of the association of cognitive
      performance with structural brain changes on CT. CONCLUSIONS: Brain atrophy on CT
      is not associated with depression in the general population, despite the fact
      that individuals with depression have a worse cognitive performance. The finding
      that cognitive performance was not decreased in individuals with previous
      depression suggests that cognitive dysfunction is a state phenomenon in
      depression.

PMID- 11200960
TI  - Psychiatrists' diagnoses of subthreshold depression in old age: frequency and
      correlates.
AB  - BACKGROUND: Depressive syndromes not fulfilling the criteria for specified
      disorders (subthreshold depression, SD) may be clinically important. We aimed to
      study SD in old and very old age, in comparison with subjects with no depressive
      symptoms (NDS) and subjects with major depression (MD). METHODS: A community
      based random sample of 516 subjects, age 70 to 100 years and over, stratified by
      age and sex, was examined. All participants were investigated by psychiatrists
      and by geriatricians independently. RESULTS: In 16.5% (N = 85) of the study
      subjects SD was identified. Study subjects with SD had, similarly to the subjects
      with MD, significantly more somatic diagnoses and used more somatic as well as
      psychotropic medications than the subjects with NDS. Self-ratings and observer
      ratings of depression indicated that SD was a milder depressive state than MD.
      CONCLUSIONS: Compared with MD, SD is probably a milder form of depression. The
      increased use of psychotropic medications indicates that at least a portion of
      these individuals have a disorder requiring treatment. One of the characteristics
      of SD is co-morbidity with somatic illnesses and physical disability.

PMID- 11200961
TI  - What contributes to depression in Parkinson's disease?
AB  - BACKGROUND: Depression is a common problem in patients with Parkinson's disease,
      but its mechanism is poorly understood. It is thought that neurochemical changes
      contribute to its occurrence, but it is unclear why some patients develop
      depression and others do not. Using a community-based sample of patients with
      Parkinson's disease, we investigated the contributions of impairment, disability
      and handicap to depression in Parkinson's disease. METHODS: Ninety-seven patients
      seen in a population-based study on the prevalence of Parkinson's disease
      completed the Beck Depression Inventory (BDI). Clinical and historical
      information on symptoms and complications of Parkinson's disease were obtained
      from the patients by a neurologist. In addition, clinician and patient ratings of
      disability on the Schwab and England scale were obtained and a quality of life
      questionnaire was completed. RESULTS: Moderate to severe depression (BDI > or =
      18) was reported by 19.6% of the patients. Higher depression scores were
      associated with advancing disease severity, recent self-reported deterioration,
      higher akinesia scores, a mini-mental score of < 25 and occurrence of falls.
      Disability as rated by the neurologist accounted for 34% of the variance of
      depression scores. Self-reported impairment of cognitive function and the feeling
      of stigmatization accounted for > 50% of the variance of depression scores.
      CONCLUSIONS: Depression in patients with Parkinson's disease is associated with
      advancing disease severity, recent disease deterioration and occurrence of falls.
      Regression analysis suggests that depression in Parkinson's disease is more
      strongly influenced by the patients' perceptions of handicap than by actual
      disability. The treatment of depression should therefore be targeted
      independently of treatment of the motor symptoms of Parkinson's disease, and
      consider the patients' own perception of their disease.

PMID- 11200962
TI  - Acute tryptophan depletion in schizophrenia.
AB  - BACKGROUND: Brain 5-hydroxytryptamine (5-HT) function is implicated in the
      pathophysiology of schizophrenia and the action of new generation antipsychotic
      drugs. By the method of acute tryptophan depletion (ATD) 5-HT can be selectively
      manipulated. The aim of this study was to examine the effects of ATD on symptoms,
      mood and cognition in schizophrenic patients. METHODS: Twenty-eight schizophrenic
      patients participated in a within subject, double-blind, placebo-controlled
      counterbalanced cross-over study. Patients with a concurrent DSM-IV axis I
      diagnosis were excluded. Symptoms, mood and cognitive function were evaluated
      following ATD or ingestion of a control drink. RESULTS: The depleting drink
      significantly reduced plasma total and free tryptophan. Tryptophan/LNAA ratios
      did not alter with the administration of the control drink, but differed
      significantly with ATD; however there was no significant change in tyrosine/LNAA
      ratio. ATD led to impairment in executive function that was dependent upon the
      order of administration. Tests of sustained attention, speed of processing, and
      everyday memory were not affected. No effects were observed on subjective mood
      ratings, movement disorders or PANSS scores. CONCLUSIONS: Acute tryptophan
      depletion selectively alters cognition in schizophrenia, but has no effect on
      symptoms, mood ratings or movement disorders.

PMID- 11200963
TI  - Implications of impulsive and affective symptoms for serotonin function in
      bulimia nervosa.
AB  - BACKGROUND: Bulimic, impulsive and depressive syndromes have all been associated
      with abnormalities in brain serotonin (5-hydroxytryptamine; 5-HT) mechanisms.
      METHODS: We had 26 bulimic women and 22 normal-eater women report impulsive,
      affective, self-destructive and bulimic symptoms, and then provide serial blood
      samples for measurement of: [3H]-paroxetine binding in platelets; and, prolactin
      (PRL) responses following oral meta-chlorophenylpiperazine (m-CPP). RESULTS:
      Bulimic status was associated with markedly reduced density of paroxetine-binding
      sites, modest blunting of m-CPP stimulated PRL response, and greater nausea
      following m-CPP. Biological variables did not co-vary with most
      psychopathological or eating-symptom indices. However, there were inverse
      associations (in bulimic women only) between scores indicating impulsivity
      (largely 'unreflectiveness') and density of platelet 5-HT uptake sites.
      CONCLUSIONS: Our observations link bulimia nervosa to altered 5-HT functioning,
      and suggest that there may be a relatively symptom-specific association between
      impulsivity and reduced 5-HT reuptake.

PMID- 11200964
TI  - Causal attributions for somatic sensations in patients with chronic fatigue
      syndrome and their partners.
AB  - BACKGROUND: Patients with chronic fatigue syndrome (CFS) often make somatic
      attributions for their illness which has been associated with poor outcome. A
      tendency to make somatic attributions in general may be a vulnerability factor
      for the development of CFS. METHODS: This cross-sectional study based on self
      report questionnaire data aimed to investigate the type of attributions for
      symptoms made by patients with CFS and to compare this to attributions made by
      their partners. It was hypothesized that patients with CFS would make more
      somatic attributions for their own symptoms than control subjects and that
      partners of patients with CFS would make more somatic attributions for their ill
      relative's symptoms but would be similar to controls regarding their own
      symptoms. Fifty patients with CFS were compared to 50 controls from a fracture
      clinic in the same hospital and 46 relatives living with the patients with CFS. A
      modified Symptom Interpretation Questionnaire was used to assess causal
      attributions. RESULTS: CFS patients were more likely to make somatic attributions
      for their symptoms. The relatives of patients with CFS made significantly more
      somatic attributions for symptoms in their ill relative. However, they were like
      the fracture clinic controls in terms of making predominantly normalizing
      attributions for their own symptoms. CONCLUSIONS: The data support modification
      of existing cognitive behavioural treatments for CFS to investigate whether
      addressing partners' attributions for patients' symptoms improves recovery in the
      patient. Furthermore, a tendency to make somatic attributions for symptoms may be
      a vulnerability factor for the development of CFS.

PMID- 11200965
TI  - Mortality in the offspring of individuals living along the radioactively
      contaminated Techa River: a descriptive analysis.
AB  - From 1949 onwards, radioactive waste was released into the Techa River in the
      southern Urals and the population living along the river was exposed to ionising
      radiation. Relocation of these people did not start until several years later,
      causing many individuals to be exposed to substantial doses from internal and
      external radiation. The identification and follow-up of the exposed individuals
      started more than 40 years ago and is still continuing. The Techa River offspring
      cohort (TROC) that has recently been established, comprises 10,459 children born
      to at least one parent living along the Techa River during the period 1950-1992.
      Of these children, 3,897 were born during the period of highest release, i.e.
      between 1950 and 1956 and might thus have been exposed in utero. A total of 1,103
      individuals have since died mainly due to infectious and respiratory diseases,
      injury and poisoning. Only 25 cases were identified as having died of a malignant
      condition. The radioactive contamination of the Techa River in the southern Urals
      gives a unique possibility to study the adverse effects of protracted exposure to
      ionising radiation in a large well-described cohort. The Techa River offspring
      cohort will make it possible to study the effects on those exposed in utero or
      early in life and the follow-up of the cohort in the future is, therefore, of
      great importance. Comparisons with other cohorts of humans exposed early in life,
      will increase our knowledge in this field of research.

PMID- 11200966
TI  - Comparing different methods of estimating cosmic radiation exposure of airline
      personnel.
AB  - In Europe, several studies are currently underway to investigate the cancer risk
      of pilots and cabin crew exposed to low-level ionizing radiation of cosmic
      origin. Although no individualized exposure measurements of airline personnel are
      available, exposure assessment based on job history data is feasible. However,
      there is a marked variability in the level of detail of these data between
      studies in different countries and between subcohorts in national studies raising
      the issue of comparability of exposure estimation. In this paper we investigate
      the comparability of several methods of exposure assessment in a large German
      cohort of pilots and cabin crew. We found that the correlation between the
      estimates obtained by the four approaches analysed, is relatively high, ranging
      from 0.85 to 0.97. The precision attainable in the exposure assessment is higher
      than in many other epidemiological studies but can be refined further with
      simulation studies and comparison with ongoing and future on-board measurement
      programmes.

PMID- 11200967
TI  - Extremely low frequency magnetic fields in residences in Germany. Distribution of
      measurements, comparison of two methods for assessing exposure, and predictors
      for the occurrence of magnetic fields above background level.
AB  - We examined the results of 1,835 magnetic field measurements in German residences
      conducted between November 1997 and September 1999. The measurements were part of
      an epidemiological study on the relationship between magnetic fields and
      childhood leukemia. We performed a fixed-location measurement of the magnetic
      field at 50 Hz and 16 2/3 Hz (frequency of the German railway system) over 24 h
      in the child's bedroom in the residence of each study participant. In addition,
      we conducted a second 24 h-measurement in the living room at 50 Hz, and spot
      measurements while walking through all rooms of the respective dwelling. Median
      50 Hz magnetic fields above 0.2 muT were found to be infrequent in Germany (only
      1.4% of all residences). Fields produced by high-voltage power lines (123-420 kV)
      were lower than expected: the median magnetic field was above 0.2 muT in only 8
      (32.0%) of 25 residences located 50 m or closer to a high-voltage power line
      indicating that power lines in Germany are usually run well below the maximum
      power load. We found that magnetic fields were correlated with the type of
      residence and higher magnetic fields were measured in apartment buildings. There
      was also some evidence for a positive correlation between magnetic fields and
      traffic density and an inverse association between magnetic fields and family net
      income. The 24 h-magnetic field measurements correlated well with the spot
      measurements (r>0.7). However, when dichotomized with a cut-off point of 0.2 muT,
      there was only a poor agreement between the two measurement methods. A loss of
      the strength of the association after categorization was also observed when
      comparing the arithmetic mean and median of the same 24 h-measurement. In
      summary, these analyses give a valuable overview of magnetic field distributions
      in German residences.

PMID- 11200968
TI  - Projection of cancer risks from the Japanese atomic bomb survivors to the England
      and Wales population taking into account uncertainty in risk parameters.
AB  - Generalized relative risk models, with adjustments to the relative risk for time
      after exposure and age at exposure and incorporating a linear-quadratic dose
      response, were fitted to the latest (Life Span Study Report 12) Japanese atomic
      bomb survivor cancer mortality data using Bayesian Markov Chain Monte Carlo
      methods, taking account of random errors in the DS86 dose estimates. The
      resulting uncertainty distributions in the relative risk model parameters were
      used to derive uncertainties in population cancer risks for a current UK
      population. Following an assumed administered dose of 1 Sv, leukaemia mortality
      risks were estimated to be 1.93x10(-2) Sv(-1) (95% CI 1.14, 3.38), or 0.44 years
      of life lost Sv(-1) (95% CI 0.22, 0.94). Following an assumed administered dose
      of 1 Sv, solid cancer mortality risks were calculated to be 10.36x10(-2) Sv(-1)
      (95% CI 8.41, 12.42), or 1.38 years of life lost Sv(-1) (95% CI 1.11, 1.68). In
      general, solid cancer risks were very similar to those predicted by classical
      likelihood-based methods; however, leukaemia risks were somewhat higher, by 10
      35%, than those predicted by classical likelihood-based methods. This is so in
      both cases, irrespective of whether or not adjustments are made in these
      likelihood-based fits for the effects of measurement errors, and the discrepancy
      for leukaemia tends to be greater at higher doses. Overall, cancer risks
      predicted by Bayesian Markov Chain Monte Carlo methods are similar to those
      derived by classical likelihood-based methods and which form the basis of
      established estimates of radiation-induced cancer risk.

PMID- 11200969
TI  - Analysis of lung tumour risk in radon-exposed rats: an intercomparison of multi
      step modelling.
AB  - Three carcinogenesis modelling groups have both jointly and separately applied a
      multi-step carcinogenesis model with clonal expansion to one data set of lung
      tumours in rats exposed to radon (CEA, France). This study was designed to
      investigate the differences in modelling approach and fitting procedures used by
      the three groups in detail, and to explore possible discrepancies in the results.
      Using the same model assumptions and a (linear) radiation dependence on the first
      model step only, the three groups arrived at identical best fits, proving that
      the mathematical formalisms and fitting procedures do not lead to different
      results. However, when each group was allowed to find its own preferred fit for
      this data set, all three found a significantly better, but different fit to the
      data. All solutions indicated radiation to be an initiating agent and found
      additional radiation action necessary. The character of this additional radiation
      dependence, however, could not be unambiguously pinpointed. Tumour incidence data
      were described equally well when radiation dependence was taken into account in
      clonal expansion ("promotion") or in the second mutational step
      ("transformation"); extension to three model stages also resulted in an adequate
      description. The study showed that, although the three groups used one
      carcinogenesis model in principle, different model assumptions and/or different
      methods of finding the "best fit" could result in different descriptions of
      experimental data. This implies that on statistical grounds, different
      interpretations can be given for the action that radiation had in this data set.
      Different data, i.e. other data sets with age-dependent tumour data and/or
      information from cellular radiobiology experiments, are needed to specifically
      pin down the radiation dependence in the multi-step carcinogenesis process.

PMID- 11200970
TI  - Time course solutions of the Sax-Markov binary eurejoining/misrejoining model of
      DNA double-strand breaks.
AB  - The Sax-Markov binary eurejoining/misrejoining (SMBE) model is a stochastic
      representation of Sax's breakage-and-reunion mechanism of misrejoining DNA double
      strand breaks (DSBs). In this model, to approximate DSB misrejoining
      probabilities that decrease with increasing distance, the nucleus is treated as a
      collection of eta isolated nuclear subvolumes called sites; DSB free ends within
      the same site interact with a probability that is independent of distance, and
      DSB free ends within different sites never interact. In our previous work, SMBE
      steady-state solutions were used to estimate eta from a combination of high-dose
      PFGE (pulsed-field gel electrophoresis) data and moderate-dose chromosomal
      aberration data. Here, analytic SMBE transient solutions (i.e., time courses of
      DSBs and misrejoinings) are derived and used to estimate eta from various sets of
      misrejoining DSB kinetic data. The time courses are multiexponentials with rate
      constants kappa, 6kappa, 15kappa, ... j(2j-1)kappa corresponding to different
      nuclear site states and not different types of DSBs. For example, the kappa
      component corresponds to nuclear sites with two DSB free ends and thus only one
      possible rejoining interaction, and the 6kappa component corresponds to sites
      with four DSB free ends and thus six (four choose two) potential rejoining
      interactions--four of these six potential interactions lead to a final state of
      two misrejoinings and the other two of six lead to a final state of correct
      repair (unrejoinable DSBs are not represented in the SMBE model). The SMBE time
      course solutions provide site number estimates that fall in the range of eta
      approximately equals 10-100 for premature chromosome condensation (PCC) data and
      eta approximately equals 1,000 for PFGE data.

PMID- 11200972
TI  - Effect of potassium (K) supply on the uptake of 137Cs by spring wheat (Triticum
      aestivum cv. Tonic): a lysimeter study.
AB  - A lysimeter experiment was carried out on a relatively infertile soil to examine
      the effect of potassium fertiliser application on the uptake of radiocaesium by
      spring wheat. Porous ceramic cups were used to obtain samples of soil solution.
      Results showed that the uptake of radiocaesium by spring wheat was reduced by the
      addition of potassium. However this inhibitory effect was less marked at later
      stages of plant growth due to factors such as the spatial variability of
      potassium within the soil, differences in root distribution down the soil profile
      and age-related demand for potassium by the plant. There was some evidence that a
      negative power function could be used to describe the relationship between the
      concentration of 137Cs in the plant and concentrations of potassium or 137Cs:K
      quotients in soil solution over the whole experimental period. Practical
      implications of potassium fertilisation in terms of reducing uptake of
      radiocaesium by crops are discussed.

PMID- 11200971
TI  - Biomarkers of genetic damage and inflammation in blood and bronchoalveolar lavage
      fluid among former German uranium miners: a pilot study.
AB  - Former East German uranium miners who are known to have been exposed to radon are
      estimated to be at high risk for lung carcinogenesis. Among these miners over 200
      occupationally caused lung cancer cases are expected to occur each year,
      resulting in a total of 7,000-24,000 excess lung cancer cases in the coming
      years. It is still unknown whether there is a correlation between biomarkers and
      the exposure of the uranium miners to ionizing radiation that might enable us to
      trace those miners with high lung cancer risk. The primary aim of this pilot
      study was to test the possibility of performing a biomarker study in this unique
      cohort of former uranium miners in spite of several limitations that had to be
      taken into consideration when comparing them with healthy controls, such as old
      age, age-dependent diseases and potential confounding artefacts from dissimilar
      smoking patterns. The second aim was to test a range of biomarkers for DNA damage
      and inflammation in leukocytes and bronchoalveolar fluid for their ability to
      detect biological effects. In this cohort of miners we found an increased
      frequency of chromosomal aberrations in blood lymphocytes and an increased
      prevalence of both fibronectin and tumour necrosis factor alpha in the
      bronchoalveolar fluid.

PMID- 11200973
TI  - Analysis of the contribution of forest pathways to the radiation exposure of
      different population groups in the Bryansk region of Russia.
AB  - The experience gained in the aftermath of serious radiation accidents shows that
      forests are an important source of external and internal exposure of the affected
      population. This paper presents the results of an assessment of the major
      radiological consequences for forests of Russia, most heavily contaminated after
      the Chernobyl nuclear power plant (ChNPP) accident. Illustrated in the
      Novozybkovsky district of the Russian Federation, the significance of different
      forest exposure pathways is estimated and the doses resulting from forest
      pathways are compared with the doses from agricultural products. It has been
      found that the contribution of mushrooms and berries to the internal doses of the
      population, relative to the doses from agricultural products, varied from 10-15%
      in 1987 to 40-45% in 1996. The results indicate large differences in internal
      exposure of members of the "critical groups" and "normal population", increasing
      with time after deposition. Data are presented that give information on the
      contribution of forests to the collective doses of inhabitants of the area under
      consideration. It has been shown that for 10 years after the accident (1987
      1996), the contribution of forest products to the collective dose of the rural
      population living in contaminated forests of the Novozybkovsky district, amounts
      to about 20% (213 person Sv) of the total collective dose of internal and
      external exposures. However, a potential impact of these products including the
      dose from exported products is much higher and might reach 659 person Sv. It has
      been found that in the long-term after the ChNPP accident, serious attention
      should be given to forest countermeasures, and restoration strategies should be
      selected on the basis of a combined analysis of the effectiveness of forest and
      agricultural countermeasures.

PMID- 11200974
TI  - Thermoluminescence dating of terrazzo from the monastery church of Tegernsee
      (Bavaria, Germany) using the 210 degrees C TL peak of quartz.
AB  - Thermoluminescence (TL) is one of the most important physical methods used in
      archaeometry for dating ceramics. In this study the newly developed procedures
      based on the use of the 210 degrees C TL peak of quartz were applied to well
      dated bricks of the church of the Tegernsee monastery in Bavaria. The resulting
      TL ages obtained from these well-dated bricks were used as a reference for
      selection of the suitable measurement procedure and to test the precision of the
      measurements and the accuracy of the technique. The optimized procedure was
      applied to the terrazzo fragments from the monastery church. The TL results
      provide a new understanding of the architectural history of the church. The
      improved measurement procedure including various dose evaluation techniques and
      the components of the annual dose assessment are described.

PMID- 11200976
TI  - The relationship between dietary intake, exercise, energy balance and the space
      craft environment.
AB  - Space flight is associated with the loss of skeletal muscle, principally from
      muscles with anti-gravity functions. Examination of data across different
      missions can permit a distinction to be made between true microgravity responses
      and what are mission-specific responses. Protein metabolism has been investigated
      on six missions, four short-term [Shuttle missions Space Life Sciences 1 (1991,
      SLSI), Space Life Sciences 2 (1993, SLS2), Deutsche-2 (1993, D2) and the Life and
      Microgravity Sciences (1996, LMS)] and two long-term missions (Skylab 1993 and
      NASA/MIR, 1996-1998). Measurements made include dietary intake (six missions),
      nitrogen balance (four missions), whole-body protein kinetics with [15N]glycine
      as the tracer (four missions) and cortisol excretion (three missions). Also
      available for comparison are bed rest studies with and without exercise. The
      purpose of this paper is to see what can be learnt about the muscle loss problem
      by comparing metabolic results across the six missions for which data are
      available and against bed rest. The analysis suggests that there is a linkage
      between the inability to maintain energy balance and exercise, and the connection
      is the decreased efficiency of removal of the metabolic by-products of exercise
      (heat, CO2) during space flight.

PMID- 11200975
TI  - Dietary instead of pharmacological management to counter the adverse effects of
      physiological adaptations to space flight.
AB  - The development of pharmacological counter-measures to the adverse effects of
      physiological adaptation to microgravity has received relatively more attention
      than alternatives such as dietary management. The manipulation of dietary cation
      anion balance, and its subsequent effects on acid-base metabolism, have been
      routinely used for some time in managing domestic animal health. More recently,
      dietary intake by humans of alkalinizing potassium salts has been demonstrated to
      exert profound beneficial effects on calcium balance, bone mineralization,
      predisposition to calcium oxalate nephrolithiasis, and overall nitrogen balance.
      Dietary sodium restriction has also been shown to improve calcium balance, bone
      mineralization, and the effectiveness of neurohumoral defenses against
      orthostatic hypotension. It is proposed that these simple alterations in the
      astronauts' diets may be easily implemented to lessen the adverse effects of
      physiological adaptations to space flight, and to enhance or even replace
      prescribed pharmacological counter-measures.

PMID- 11200977
TI  - Gravity and thermoregulation: metabolic changes and circadian rhythms.
AB  - Gravity appears to alter thermoregulation through changes in both the regulated
      level of body temperature and the rhythmic organization of temperature
      regulation. Gravity has been hypothesized to have an associated metabolic cost.
      Increased resting energy expenditure and dietary intake have been observed in
      animals during centrifuge experiments at hypergravity. Thus far, only animals
      have shown a corresponding reduction in metabolism in microgravity. Altered heat
      loss has been proposed as a response to altered gravitational environments, but
      remains documented only as changes in skin temperature. Changes in circadian
      timing, including the body temperature rhythm, have been shown in both
      hypergravity and microgravity, and probably contribute to alterations in sleep
      and performance. Changes in body temperature regulation may result from circadian
      disturbance, from the direct or indirect actions of gravity on the regulated
      temperature, or from changes in thermoregulatory effectors (heat production and
      heat loss) due to altered gravitational load and convective changes. To date,
      however, we have little data on the underlying thermoregulatory changes in
      altered gravity, and thus the precise mechanisms by which gravity alters
      temperature regulation remain largely unknown.

PMID- 11200978
TI  - Are energy metabolism alterations involved in cardiovascular deconditioning after
      weightlessness? An hypothesis.
AB  - The physiopathogenesis of the cardiovascular deconditioning syndrome observed
      after actual and simulated microgravity is still under debate, despite numerous
      studies conducted on the role of blood volume, hormones involved in its
      regulation, sympathetic nervous system, baroreflexes and venous compliance.
      Orthostatic intolerance, a reduced exercise capacity and an increased heart rate
      at rest characterize this syndrome. Recent data suggest, first, the presence of a
      complex loop between the sympathetic nervous system, carbohydrate metabolism
      (insulin) and leptin hormone and, second, that this loop, an overall reflection
      of energy metabolism, participates in cardiovascular regulation. After a resume
      of studies conducted on fuel homeostasis during actual and simulated
      microgravity, the possible implications of energy metabolism in the development
      of the cardiovascular deconditioning syndrome will be discussed.

PMID- 11200979
TI  - Orthostatic intolerance and the postural tachycardia syndrome: genetic and
      environment pathophysiologies. Neurolab Autonomic Team.
AB  - Orthostatic intolerance is a common problem for inbound space travelers. There is
      usually tachycardia on standing but blood pressure may be normal, low or, rarely,
      elevated. This condition is analogous to the orthostatic intolerance that occurs
      on Earth in individuals with orthostatic tachycardia, palpitations, mitral valve
      prolapse, and light-headedness. Our studies during the Neurolab mission indicated
      that sympathetic nerve traffic is raised in microgravity and that plasma
      norepinephrine is higher than baseline supine levels but lower than baseline
      upright levels. A subgroup of patients with familial orthostatic intolerance
      differ from inbound space travelers in that they have an alanine-to-to-proline
      mutation at amino acid position 457 in their norepinephrine transporter gene.
      This leads to poor clearance of norepinephrine from synapses, with consequent
      raised heart rate. Clinical features of these syndromes are presented.

PMID- 11200980
TI  - Integrated physiology in space--challenges for the future: the Bad Honnef
      Recommendations.

PMID- 11200981
TI  - Orthostatic stress is necessary to maintain the dynamic range of cardiovascular
      control in space.
AB  - In the upright position, gravity fills the low-pressure systems of human
      circulation with blood and interstitial fluid in the sections below the
      diaphragm. Without gravity one pressure component in the vessels disappears and
      the relationship between hydrostatic pressure and oncotic pressure, which
      regulates fluid passage across the capillary endothelium in the terminal vascular
      bed, shifts constantly. The visible consequences of this are a puffy face and
      "bird" legs. The plasma volume shrinks in space and the range of cardiovascular
      control is reduced. When they stand up for the first time after landing, 30-50%
      of astronauts suffer from orthostatic intolerance. It remains unclear whether
      microgravity impairs cardiovascular reflexes, or whether it is the altered volume
      status that causes the cardiovascular instability following space flight. Lower
      body negative pressure was used in several space missions to stimulate the
      cardiovascular reflexes before, during and after a space flight. The results show
      that cardiovascular reflexes are maintained in microgravity. However, the
      astronauts' volume status changed in space, towards a volume-retracted state, as
      measurements of fluid-regulating hormones have shown. It can be hypothesized that
      the control of circulation and body fluid homeostasis in humans is adapted to
      their upright posture in the Earth's gravitational field. Autonomic control
      regulates fluid distribution to maintain the blood pressure in that posture,
      which most of us have to cope with for two-thirds of the day. A determined amount
      of interstitial volume is necessary to maintain the dynamic range of
      cardiovascular control in the upright posture; otherwise orthostatic intolerance
      may occur more often.

PMID- 11200982
TI  - Renal adjustments to microgravity.
AB  - During a 10-day shuttle mission, the diuretic and natriuretic responses to an
      i.v. isotonic saline load were attenuated and plasma noradrenaline concentration
      increased after 5-6 days of microgravity compared with to those of the acute
      supine position prior to flight. Furthermore, on the Russian space station Mir,
      we have observed that renal fluid excretion in two astronauts following an oral
      water load of 600 ml was attenuated compared with that of the acute supine
      position on the ground. Since it was surprising that the renal responses to
      isotonic saline loading and to an oral water load were attenuated during space
      flight, we carried out a study in Japan employing the same water load protocol as
      in space in eight subjects after 19 days of head-down bed rest. The results
      indicate that the urinary flow rate following the water load of 600 ml is the
      same as in the acute supine position when the subjects have not been subjected to
      bed rest. This is in contrast to the results of the astronauts in space. The
      attenuated renal responses during space-flight could be explained by an increase
      in renal sympathetic nervous activity and in the elevated level of the renin
      angiotensin-aldosterone axis observed during the space shuttle flight. This space
      induced activation of antinatriuretic mechanisms could have been caused by early
      in-flight reduction in total and central blood volume. Based on our unexpected
      results from space, in future studies we will focus on the mechanisms of renal
      fluid excretion during space-flight. An experiment with the participation of
      American, European, Russian, and Japanese researchers has been selected in this
      regard for the early phase of the International Space Station.

PMID- 11200983
TI  - Body fluid regulation in micro-gravity differs from that on Earth: an overview.
AB  - Similar to the response to central hypervolemic conditions on Earth, the shift of
      blood volume from the legs to the upper part of the body in astronauts entering
      micro-gravity should, in accordance with the Henry-Gauer mechanism, mediate
      diuresis and natriuresis. However, fluid balance and kidney function experiments
      during various space missions resulted in the surprising observation that the
      responses qualitatively differ from those observed during simulations of
      hypervolemia on Earth. There is some evidence that the attenuated responses of
      the kidney while entering weightlessness, and also later during space flight, may
      be caused by augmented fluid distribution to extravascular compartments compared
      to conditions on Earth. A functional decoupling of the kidney may also contribute
      to the observation that renal responses during exposure to micro-gravity are
      consistently weaker than those during simulation experiments before space flight.
      Deficits in body mass after landing have always been interpreted as an indication
      of absolute fluid loss early during space missions. However, recent data suggest
      that body mass changes during space flight are rather the consequences of
      hypocaloric nutrition and can be overcome by improved nutrition schemes. Finally,
      sodium-retaining humoral systems are activated during space flight and may
      contribute to a new steady-state of metabolic balances with a pronounced increase
      in body sodium compared to respective conditions on Earth. A revision of the
      classical "micro-gravity fluid shift" scheme is required.

PMID- 11200984
TI  - Anaerobic exercise increases fat-free mass but not extracellular water during
      prolonged, 6 degrees-head-down bed rest.

PMID- 11200985
TI  - Head-down tilt bed rest and immune responses.
AB  - Head-down tilt bed rest (HDT) is used as a model for studying the physiological
      changes occurring in weightlessness during spaceflight. In the present study,
      eight volunteers were subjected to a strict HDT of -6 degrees for 42 days. Blood
      samples were obtained 37 and 13 days before, at days 13, 34, and 41 during, and
      12, 33, and 47 days after HDT. FACScan analysis was used to determine cell
      subpopulations. Plasma was used to quantify various circulating hormone levels.
      Whole blood and reconstituted blood were stimulated with various activators such
      as phytohaemagglutinin-P (PHA), PHA combined with phorbol-12-myristate 13-acetate
      (PMA), anti-CD2, anti-CD3, and lipopolysaccharide. Supernatants were collected
      and analysed for the interleukins IL-1beta, IL-2, IL-6, and IL-10, interferon
      gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha). The total number
      of T lymphocytes and monocytes did not change significantly, whereas the number
      of polymorphonuclear cells increased during HDT. The percentage of CD2+ and CD3+
      cells was increased at day 35 of HDT. The percentage and total number of natural
      killer cells (CD2+/CD3-/CD56+) was increased 12 days before and 14 days after
      HDT. TNF-alpha secretion did not change significantly during HDT. IL-2, IL-10 and
      IFN-gamma were increased at day 34 of HDT. IL-1beta levels were increased before
      and during HDT compared to post-HDT measurements. No significant changes were
      observed in plasma immunoglobulin, complement factors and other factors of the
      inflammatory system. Prolactin levels increased slightly but significantly at day
      35 of HDT, thyreotropin and growth hormone levels remained virtually unchanged.
      Cortisol decreased slightly but significantly over the entire duration of the
      study. The changes observed during HDT do not indicate that the immune system is
      blunted, and these changes do not seem to correlate with the duration of HDT.
      Taken together these results show that a HDT does not reproduce the changes in
      immune responses observed after spaceflight.

PMID- 11200986
TI  - Nutrient supply during recent European missions.
AB  - An inadequate nutrient intake during space flight may compromise the crewmembers'
      health status. In fact, during recent European missions (D-2, EuroMIR 94 and
      EuroMIR 95), monitoring of the astronauts' food intake revealed that they had a
      deficient energy, fluid, and calcium intake and an excessive sodium consumption
      compared to the dietary reference intakes for earthbound conditions.
      Inappropriate amounts of these nutrients have a considerable impact on body fluid
      regulation, the cardiovascular system and on calcium and bone metabolism,
      especially bone mineral density, which are all stressed by the microgravity
      environment. Provision of adequate nutrition especially when facing long-term
      space flights is therefore one of the foremost challenges. Therefore, for the
      German MIR 97 mission, we considered the data obtained from previous European
      missions to devise a constant and controlled nutrient intake that matched the
      earthbound dietary reference intake values in our experiments. Specific markers
      indicated that bone formation continually declined and bone resorption increased
      in the MIR 97 astronaut. This suggests that the nutritional criteria chosen for
      the subjects remaining on Earth may be inadequate for extended space missions.
      Therefore, more emphasis has to be placed on investigating the effects of a
      deficient nutrient intake on astronauts during exposure to microgravity, to
      manage their nutritional care appropriately during long-term missions.

PMID- 11200987
TI  - Adaptation of the human endocrine system to microgravity in the context of
      integrative physiology and ageing.
AB  - This review deals with changes occurring in space in different endocrine systems.
      Sections are dedicated to hormones involved in bone remodelling, the hypothalamic
      pituitary-adrenal axis, the hypothalamic-pituitary-thyroid axis, pancreatic
      hormones, the hypothalamic-pituitary-gonadal axis and the hypothalamic-pituitary
      somato-mammotropic system. In space, most systems - especially those regulating
      bone/muscle metabolism and reproduction - undergo changes resembling those
      observed during senescence, but recover within weeks or months after return. This
      suggests space as a possible experimental model for the study of "reversible
      ageing processes". Studying ageing through space technology might give us the
      opportunity to combine the holistic view of integrative physiology with the most
      ambitious goal of the present scientific community, i.e. to yield successful
      ageing by promoting chronic disease prevention studies and by optimizing safe,
      anti-ageing therapeutic protocols.

PMID- 11200988
TI  - Modulation of red cell mass by neocytolysis in space and on Earth.
AB  - Astronauts predictably experience anemia after return from space. Upon entering
      microgravity, the blood volume in the extremities pools centrally and plasma
      volume decreases, causing plethora and erythropoietin suppression. There ensues
      neocytolysis, selective hemolysis of the youngest circulating red cells, allowing
      rapid adaptation to the space environment but becoming maladaptive on re-entry to
      a gravitational field. The existence of this physiologic control process was
      confirmed in polycythemic high-altitude dwellers transported to sea level.
      Pathologic neocytolysis contributes to the anemia of renal failure. Understanding
      the process has implications for optimizing erythropoietin-dosing schedules and
      the therapy of other human disorders. Human and rodent models of neocytolysis are
      being created to help find out how interactions between endothelial cells,
      reticuloendothelial phagocytes and young erythrocytes are altered, and to shed
      light on the expression of surface adhesion molecules underlying this process.
      Thus, unraveling a problem for space travelers has uncovered a physiologic
      process controlling the red cell mass that can be applied to human disorders on
      Earth.

PMID- 11200990
TI  - Multiple epiphyseal dysplasia: radiographic abnormalities correlated with
      genotype.
AB  - Multiple epiphyseal dysplasia (MED) is an osteochondrodysplasia characterized
      clinically by mild short stature and early-onset degenerative joint disease and
      radiographically by epiphyseal hypoplasia/dysplasia. MED is genetically
      heterogeneous, with autosomal dominant cases resulting from mutations in at least
      three genes: the cartilage oligomeric matrix protein (COMP) gene (EDM1) and the
      COL9A2 (EDM2) and COL9A3 (EDM3) genes of type IX procollagen. We present here a
      comparison of the radiographic phenotypes of MED patients with type IX collagen
      gene mutations and those with COMP gene mutations. We reviewed radiographs from
      two patients with MED produced by COMP mutations, two families with COL9A2
      mutations, and one family with a mutation in COL9A3. The data demonstrated that
      the patients with type IX collagen defects had more severe joint involvement at
      the knees and relative hip sparing, while the patients with COMP mutations had
      significant involvement at the capital femoral epiphyses and irregular acetabuli.
      This pattern of joint involvement was consistent regardless of overall degree of
      severity of the phenotype.

PMID- 11200989
TI  - Can daily centrifugation prevent the haematocrit increase elicited by 6-degree,
      head-down tilt?
AB  - A measure to counteract the effects of low or zero gravity is required for long
      term space flight, such as the manned Mars mission scheduled by the National
      Aeronautics and Space administration (NASA) for 2014. We conducted a series of
      centrifugation experiments with humans, using a short-arm centrifuge (radius 1.8
      m, made by First Medical Co., Tokyo, Japan). We employed 6-degree, head-down tilt
      (HDT) for 4 days to simulate space flight. Ten healthy male volunteers underwent
      4-day HDT and a 2-G daily centrifuge load for 60 min in the +Gz direction and
      measurements, such as haematocrit, 24-h urine volume, body weight and
      electrocardiogram (ECG) were made. There was no significant increase in the
      haematocrit during the HDT period, although our previous studies had shown a
      significant increase during HDT. A 60-min daily load of +2 Gz appears to be
      effective in reversing the haematocrit increase due to 4-day HDT.

PMID- 11200991
TI  - Spondylo-meta-epiphyseal dysplasia, short limbs, abnormal calcification type: a
      new case with severe neurological involvement.
AB  - A case of an affected girl with spondylo-meta-epiphyseal dysplasia (SMED) is
      reported. The disease was detected at birth as a congenital dysplasia with
      generalized lesions. At 10 months of age, abnormal calcifications appeared in
      both wrists. The patient evolved with severe growth retardation and multiple
      neurological and respiratory complications, followed by death at 21 months of
      age.

PMID- 11200992
TI  - Radiographic findings and Gs-alpha bioactivity studies and mutation screening in
      acrodysostosis indicate a different etiology from pseudohypoparathyroidism.
AB  - Acrodysostosis is an uncommon skeletal dysplasia associated with nasal
      hypoplasia, midface deficiency, severe brachydactyly, and varying degrees of
      hearing loss and mental retardation. Previous publications have suggested that it
      may be difficult to distinguish acrodystostosis from pseudohypoparathyroidism on
      clinical grounds, but acrodysostosis does appear to have distinct clinical and
      radiologic findings. Spinal stenosis is an underappreciated risk in
      acrodysostosis, despite the reported loss of normal caudal widening of the lumbar
      interpediculate distance on AP spine radiographs in the original report of this
      disorder by Robinow et al., with confirmation of these radiographic findings by
      Butler et al. We report two sporadic cases of acrodysostosis, one of which
      required decompressive laminectomy for symptomatic spinal stenosis, and review 11
      cases of acrodysostosis from 9 families that were submitted to the International
      Skeletal Dysplasia Registry. The objective of this report is to determine the
      frequency and severity of spinal stenosis in patients with acrodysostosis and to
      summarize the clinical and radiographic findings of acrodysostosis in an effort
      to distinguish acrodysostosis clearly from pseudohypoparathyroidism. The pattern
      of brachydactyly differs between these two conditions, and varying degrees of
      spinal stenosis are characteristic of acrodysostosis. Both our index patients
      with acrodysostosis had normal bioactivity of the alpha subunit of the Gs
      protein, therefore indicating that acrodysostosis has a different pathogenesis
      from pseudohypoparathyroidism. Furthermore, single-strand confirmational
      polymorphism (SSCP) analysis failed to demonstrate any confirmational alterations
      in the coding exons of the Gs alpha gene. These radiographic and laboratory
      findings substantiate that acrodysostosis is clinically different from
      pseudohypoparathyroidism and that it is necessary to follow patients with
      acrodysostosis for signs of spinal stenosis.

PMID- 11200994
TI  - Schneckenbecken dysplasia, radiology, and histology.
AB  - To our knowledge this is the first report of Schneckenbecken dysplasia with the
      development of hydrops early in the second trimester. The radiological findings
      showed the typical hypoplastic iliac bones with medial extension and very
      flattened, on lateral view, oval-shaped vertebral bodies and short long bones.
      The histology showed hypercellular and hypervascular cartilage with chondrocytes
      with centrally located nucleus. The absence of the lacunar space as described
      before was also observed in some chondrocytes in our case. This male fetus was
      the product of consanguineous parents of Mediterranean origin compatible with
      autosomal recessive inheritance.

PMID- 11200993
TI  - A new form of spondyloperipheral dysplasia with facial dysmorphism, flattened
      vertebrae, hypoplastic pelvis, brachydactyly and soft tissue syndactyly.
AB  - We report the case of a 9-year-old Japanese boy with spondyloperipheral skeletal
      dysplasia associated with facial dysmorphism, pelvic abnormalities, and
      distinctive hands and feet. Radiographic manifestations included mild
      platyspondyly with posterior scalloping, small flared ilia with shallow
      acetabulae, mesomelic shortening of long bones, marked delay of carpal bone
      maturation, and brachydactyly with hypoplastic middle and terminal phalanges
      bilaterally in both hands and feet. There was bilateral soft tissue syndactyly of
      the 2nd and 3rd interdigital spaces of the hands, the 2nd interdigital space of
      the feet, with hypoplastic nails. The clinical and radiographic manifestations in
      this case appear to represent a unique type of skeletal dysplasia.

PMID- 11200995
TI  - Naumoff short-rib polydactyly syndrome compounded with Mohr oral-facial-digital
      syndrome.
AB  - A stillborn baby boy had findings of severe constitutional dwarfism with short
      limbs, short ribs, and polydactyly that were consistent with Naumoff (type III)
      short-rib polydactyly syndrome. He also had additional congenital anomalies,
      including cleft palate, notching of the upper lip, small tongue with accessory
      sublingual tissue. These oral and pharyngeal anomalies were consistent with Mohr
      (type II) oral-facial-digital syndrome. We suggest the stillborn infant
      represented a compound of Naumoff short-rib polydactyly syndrome (SRPS-III) and
      Mohr oral-facial-digital syndrome (OFDS-II).

PMID- 11200996
TI  - Cerebro-costo-mandibular syndrome.
AB  - Cerebro-costo-mandibular syndrome is a rare disorder characterized by rib
      malformations, various degrees of cerebral maldevelopment, mental deficiency,
      palatal defects, and micrognatia. This syndrome was first described in 1966. The
      majority of cases are sporadic, but a few instances of familial occurrence have
      been reported, some with an autosomal recessive pattern of inheritance. Mortality
      in early age has been high, probably mostly due to respiratory insufficiency
      secondary to rib abnormalities and flail chest. We report a mother and son with
      this disorder, suggesting autosomal dominant transmission.

PMID- 11200997
TI  - "Duplicate calcaneus": a rare developmental defect observed in several skeletal
      dysplasias.
AB  - Duplication of the calcaneus is a rarely observed radiographic finding that
      probably results from delayed coalescence of two primary calcaneal centers of
      ossification. We performed a review of 2,500 computerized cases of skeletal
      dysplasias and syndromes with bone involvement in the International Skeletal
      Dysplasia Registry, searching for those cases in which a duplicate calcaneus had
      been recorded. We found that it was a non-random feature of three skeletal
      dysplasias and groups comprising thanatophoric dysplasia and the chondrodysplasia
      punctata and short rib (polydactyly) groups. We conclude that duplication of the
      calcaneus should be considered a consistent feature of these entities and may
      reflect a more generalized developmental defect.

PMID- 11200998
TI  - Lethality in Desbuquois dysplasia: three new cases.
AB  - Three new cases of Desbuquois syndrome in two brothers and a sporadic male, all
      of whom died in early infancy, are presented to emphasize the high rate (33 %) of
      lethality in this variable, but serious skeletal dysplasia. Including the three
      presented patients and 10 of the 36 cases in the literature who died, most did so
      between birth and 7 months and from respiratory-related problems. Neonatal and
      infancy survivors should be monitored closely, particularly relative to their
      pulmonary status.

PMID- 11200999
TI  - Asynchronous asymmetric form of heterogeneous osteopetrosis: initial case
      expanded and a new case.
AB  - We have discovered additional serial radiographs and clinical information on the
      initial case of "regional osteopetrosis tarda" that has been included in several
      editions of Caffey's Pediatric X-Ray Diagnosis. A definite second case was found
      after a search of radiology teaching files of other selected medical centers and
      the International Skeletal Dysplasia Registry. Analysis of the sequential unusual
      radiographic findings of the initial case and the equivalent compelling findings
      of the second case justifies renewed attention to an asynchronous asymmetric form
      of heterogeneous osteopetrosis.

PMID- 11201000
TI  - [Recommendations by the Pediatric and Adolescent Rheumatology Study Committee on
      therapy with Etanercept (p75 TNF-alpha receptor immunoglobulin fusion protein.
      Pharmacotherapy Committee].

PMID- 11201001
TI  - [Underestimated adverse effects of non-steroidal anti-inflammatory drugs on the
      distal intestine].
AB  - NSAID-induced adverse effects are diagnosed less frequently in the distal
      intestine than in the gastroduodenal area. During long-term NSAID use, however,
      the development of life-threatening ulcerations, perforations or fibrotic
      stenoses must be expected from the middle segment of the small intestine to the
      rectum. Although the clinical symptoms are not specific, together with careful
      examination, endoscopy, contrast x-ray studies, or computed tomography they can
      provide orientation, at least with regard to stenotic processes. Diarrhea, weight
      loss, anorexia, irregular bowel movements, obstruction symptoms, ocoult blood
      loss, hypoalbuminemia, and iron deficiency may be regarded as possible signs of
      gastrointestinal adverse effects associated with long-term NSAID therapy. Except
      in the case of NSAID suppository abuse, no risk indicators are known. The
      pathogenesis of NSAID-induced adverse effects in the lower gastrointestinal tract
      has not been elucidated. As the potential of nonselective NSAIDs to cause adverse
      effects in distal segments of the small intestine cannot be reliably reduced by
      prophylactic measures in the upper gastrointestinal tract such as comedication
      with prostaglandin analogs or proton pump inhibitors, the indication for the use
      of conventional NSAIDs, in any case, must be considered with caution.

PMID- 11201002
TI  - Plasma oxytocin levels in female fibromyalgia syndrome patients.
AB  - OBJECTIVES: Fibromyalgia syndrome (FMS) is a chronic pain disorder, where 90% of
      the patients struck by the disorder are women. The neuropeptide oxytocin is known
      to have antinociceptive and analgesic, as well as anxiolytic and antidepressant
      effects, which makes this neuropeptide of interest in fibromyalgia research. The
      aim of this study was to assess oxytocin concentrations in female FMS patients
      with different hormonal status and in depressed and non-depressed patients and
      relate oxytocin concentrations to adverse symptoms as pain, stress, depression,
      anxiety and to the positive item happiness. METHODS: Thirty-nine patients and 30
      controls registered these symptoms daily during 28 days and blood samples for the
      assessment of oxytocin were drawn twice in all patients and controls. Besides the
      daily ratings, depression was also estimated with the self-rating instrument Beck
      Depression Inventory (BDI). RESULTS: Depressed patients according to the BDI
      differed significantly with low levels of oxytocin compared to the non-depressed
      patients and the controls. Low levels of oxytocin were also seen in high scoring
      pain, stress and depression patients according to the daily ratings; however,
      these subgroups were small. A negative correlation was found between the scored
      symptoms depression and anxiety and oxytocin concentration, and a positive
      correlation between the item happiness and oxytocin. The oxytocin concentration
      did not differ between the hormonally different subgroups of patients or
      controls. CONCLUSION: The results suggest that the neuropeptide oxytocin may,
      together with other neuropeptides and neurotransmitters, play a role in the
      integration of the stress axes, monoaminergic systems and the pain processing
      peptides in the pathophysiologic mechanisms responsible for the symptoms in the
      FMS.

PMID- 11201003
TI  - [Functional changes in the quadriceps femoris muscle in patients with varus
      gonarthrosis].
AB  - In osteoarthritis (OA) of the knee, arthrogenous muscle inhibition (AMI) is
      considered to be one of the reasons of quadricep muscle weakness. Its influence
      on functional impairment such as gait alterations, however, still remains
      unclear. Fourty-seven patients with knee OA (mean age 64 +/- 5.2 years, 36 women,
      11 men) and 47 age- and gender-matched healthy controls were investigated for
      voluntary activation (VA) and maximum voluntary contraction (MVC) of the
      quadricep muscle. In addition, these two parameters of AMI have been correlated
      with the extent of gait alterations. Measurement of VA and MVC were performed by
      a twitch interpolation technique; for gait analysis an optoelectronic motion
      analysis system (ELITE, Italy) was used. Quadricep MVC and VA were significantly
      lower in OA than in control knees. Moreover, in addition to reduced walking
      velocity and step cadence, gait analysis revealed significantly lower stance
      phase re-extension angles in OA patients (mean 2.7 degrees +/- 2.6) than in
      control knees (mean 10.7 degrees +/- 4.9). Hereby, in OA knees there was a
      significant correlation between MVC and VA deficits and the reduction of re
      extension angles. The work shows that knee OA is characterized by severe
      alterations of the quadricep motor function due to arthrogenous muscle
      inhibition. Hereby, quadricep AMI represents one major reason for functional
      impairment in knee OA.

PMID- 11201004
TI  - How to proceed in patients with carcinoma detected after laparoscopic
      cholecystectomy.
AB  - Carcinoma of the gallbladder is a rare disease. Gallbladder carcinoma is detected
      in less than 1% of all gallstone operations. With the introduction of
      laparoscopic surgery and the higher acceptance of this technique, gallbladders
      are now removed much earlier than they used to be. With the increase of
      cholecystectomies, the diagnosis of unexpected gallbladder carcinoma became more
      frequent. We report on how to proceed in patients with a diagnosis of gallbladder
      carcinoma and discuss the additional problems that have arisen since laparoscopic
      cholecystectomy became established. From June 1990 to December 1999, we performed
      6230 cholecystectomies in the surgical department of Moabit Hospital in Berlin.
      Of these, 42 (0.6%) were identified as carcinoma. There were 37 women and five
      men, and the mean age was 69 years. In 16 patients (39%), there was a
      preoperative suspicion of malignancy. In 26 patients (61%), malignancy was
      suspected intraoperatively or diagnosed postoperatively after pathologic
      examination of the resected gallbladder. In these patients, an open repeat
      operation was necessary in seven cases to achieve an adequate curative resection
      and staging. This involved additional liver bed resection and lymph node
      dissection of the hepatoduodenal ligament. Abdominal wall (port site) recurrence
      in the absence of distant metastasis was present only in two patients. We
      recommend removal using a bag in all gallbladders with wall thickening,
      irregularities, or scleroatrophic calcified gallbladder area. In stage Tis or T1,
      laparoscopic cholecystectomy is sufficient. In stage T2 and T3, we perform a
      repeat operation with liver bed resection and lymphadenectomy.

PMID- 11201005
TI  - Gallbladder carcinoma and surgical treatment.
AB  - Gallbladder carcinoma shows an unusual geographic and demographic distribution.
      It is relatively uncommon in Europe, but more frequent in Israel, Chile, Bolivia
      and in Southwestern Native Americans in the United States. Chronic cholecystitis,
      choledochal cysts, high body mass index, female gender, age, nicotine and
      industrial exposure to carcinogens are associated risk factors. The frequency of
      gallbladder cancer in all operations of the biliary tract is about 1-3%,
      reflecting the commonest biliary tract malignancy. Preoperative imaging,
      including ultrasound and computed tomography (CT), may reveal signs indicative of
      the presence of malignancy. However, most patients are not diagnosed prior to
      surgical intervention. Survival depends on the ability to achieve a curative
      resection, including hepatectomy and lymph node dissection in patients with local
      extended tumour according to the stage of the disease. Overall, the curative
      resection rates for gallbladder carcinoma range from 10% to 30%. Regional and
      para-aortic lymphadenectomy provides no survival benefit for patients with para
      aortic disease, which has a negative influence on prognosis equivalent to that of
      distant metastases. A survival benefit is seen only in selected patients with
      metastases limited to the regional nodes. Taking a sample biopsy of the para
      aortic nodes before starting surgery is recommended because these nodes are
      involved more frequently than expected. For those patients with unresectable
      cancer, palliative surgical, endoscopic or radiological bypass procedures can
      improve quality of life. Other approaches to the management of advanced tumours
      include systemic chemotherapy or combined chemo-radiotherapy and need further
      evaluation. Early-stage tumours are often discovered as an incidental finding
      during (laparoscopic) cholecystectomy or on histological examination of the
      gallbladder, mostly necessitating relaparotomy and extensive resection. In the
      following, management of patients with gallbladder cancer at different stages and
      situations is discussed.

PMID- 11201006
TI  - Appraisal of surgical resection of gallbladder cancer with special reference to
      lymph node dissection.
AB  - BACKGROUND: Radical lymph node dissection in surgery for advanced gallbladder
      cancer is controversial. The purpose of this study is to evaluate the role of
      lymph node dissection based on the clinico-pathologic results. PATIENTS: Seventy
      three patients who underwent radical surgery including systematic dissection of
      the N1+N2 region lymph node plus some of the para-aortic nodes were reviewed.
      RESULTS: pT1 patients had no lymph node metastasis, but pT2 and pT3/pT4 patients
      had lymph node metastasis at a rate of 50.0% (13/26) and 83.3% (25/30),
      respectively. As infiltration of the hepatoduodenal ligament (Binf) became
      severe, the rate and extent of lymph node metastasis increased. There were four 5
      year survivors with lymph node involvement. The 5-year survival rates are 77.0%
      in pN0 cases and 27.3% in pN1 cases (P<0.01). There was no difference in survival
      between pN1 and pN2 patients. However, significant differences in survival were
      observed between pN0/1 and pN2/3 patients when these patients were limited to
      Binf0/1. Examination of the recurrence pattern showed that most patients with
      pN0/1/2 had no regional lymph node recurrence, but there was para-aortic lymph
      node recurrence in patients with pN3 outside the dissected region. Significant
      prognostic factors influencing survival after surgery by multivariate analysis
      were pN2/3, pT, and residual tumor. CONCLUSION: Systematic lymph node dissection
      of N1, N2, and part of the para-aortic region improves survival in advanced
      gallbladder cancer patients, especially in those without either para-aortic lymph
      node metastases or Binf2/3.

PMID- 11201007
TI  - Primary hyperparathyroidism--early diagnosis in patients referred for thyroid
      surgery.
AB  - BACKGROUND AND AIMS: From 1986 to 1998, 190 patients presented for first-time
      operations for sporadic, non-malignant, non-multiple endocrine neplasia primary
      hyperparathyroidism. Of these patients, 54% had been classified as
      "asymptomatic", 41% as symptomatic and 5% as acute. One hundred and thirty-five
      patients (71%) were referred to us for parathyroid surgery. Fifty-five patients
      (29%) were referred for thyroid surgery with hitherto unknown
      hyperparathyroidism. This corresponds to a prevalence of primary
      hyperparathyroidism of 1% in patients referred for thyroid surgery (5450 patients
      during the same period of time). PATIENTS/METHODS: Patients referred for
      parathyroid surgery (group I, n=135) were compared with patients originally
      referred for thyroid surgery (group II, n=55). Group II was divided into group
      IIa: hyperparathyroidism preoperatively biochemically evident (n=26), and group
      IIb: borderline biochemistry, parathyroid enlargement evident at the operation
      (n=29). The groups were compared regarding clinical manifestations, serum calcium
      and parathyroid hormone, pathologic-anatomical substrates, operative
      complications and outcome. RESULTS: Renal, osseous and gastrointestinal
      manifestations were more frequent in group I than in groups IIa and IIb (P<0.05).
      However, cardiovascular and neuromuscular symptoms were present in groups IIa and
      IIb in more than one-third of patients. Patients from group IIb were younger
      (49+/-12 years) than patients from groups IIa (60+/-13 years) and I (60+/-14
      years). Adenomas were found in 85% of group I patients, in 45% of group IIa
      patients and in 21% of group IIb patients (P<0.01). In all other cases,
      hyperplasia was confirmed histologically. Serum calcium was higher in group I
      (3.0+/-0.42 mmol/l) than in groups IIa (2.63+/-0.16 mmol/l) and IIb (2.46+/-0.14
      mmol/l) (P<0.01). Serum PTH was higher in group I (median 11.0 pmol/l) than in
      groups IIa and IIb (median 7.1 and 6.4 pmol/l, respectively) (P<0.05).
      Postoperatively, hypercalcemia persisted in two patients (1.1%) belonging to
      group I, with mediastinal adenomas. Serum calcium at discharge showed no
      differences between groups (group I: 2.22+/-0.16; group IIa: 2.22+/-0.15; group
      IIb: 2.20+/-0.11 mmol/l). Recurrent laryngeal nerve paralysis occurred early
      (4.2% of "nerves at risk") and remained permanent (0.8% of "nerves at risk")
      without significant differences between groups. CONCLUSION: Diagnostic efforts
      regarding parathyroid function should be mandatory before thyroid operations.
      "Asymptomatic" patients frequently (more than 30%) present with cardiovascular
      and neuromuscular, "unspecific" symptoms. Simultaneous parathyroid exploration is
      obvious in cases with biochemically evident primary hyperparathyroidism, but
      should also be performed in patients with borderline biochemistry.

PMID- 11201008
TI  - Benign solitary fibrous tumour of the thigh: morphological, chromosomal and
      differential diagnostic aspects.
AB  - Solitary fibrous tumours (SFTs) are rare and usually benign neoplasms of
      mesenchymal origin that are often found in the visceral pleura (fibrous pleural
      tumour, FPT) or other serosal surfaces. They have also been found in soft
      tissues. We report the case of an SFT localised in the thigh of an 86-year-old
      woman. The tumour specimen was examined morphologically, immunohistochemically
      and molecular genetically, using comparative genomic hybridisation (CGH). The
      latter detects unbalanced chromosomal alterations in human neoplasms by
      competitive nucleic acid hybridisation and consecutive computer image analysis.
      The tumour consists of fibroblast-like cells, arranged in a typical "patternless
      pattern". Immunohistochemically, the tumour stained positively for vimentin,
      CD34, CD99, and focally for actin and desmin. No reaction occurred with keratin
      or S100 protein antibodies. CGH detected a single loss on chromosome 13q.

PMID- 11201009
TI  - Surgical treatment of postoperative, incidentally diagnosed small sporadic C-cell
      carcinomas of the thyroid.
AB  - BACKGROUND AND AIMS: The surgical strategy in small sporadic C-cell carcinomas of
      the thyroid that are incidentally diagnosed after goiter resection for benign
      disease is controversial. It remains unclear whether a completion thyroidectomy
      should be performed in every case. PATIENTS AND METHODS: We present nine patients
      who were operated on between October 1992 and October 1997 in whom an unexpected,
      small sporadic C-cell carcinoma (seven with pT1, two with pT2) was found in the
      postoperative histology. RESULTS: All patients were calcitonin negative and there
      were no signs of the disease being inherited (no familial history, negative RET
      proto-oncogene). No patient underwent a completion thyroidectomy. All patients
      had a follow-up with pentagastrin-stimulated calcitonin and carcinoembryonic
      antigen (CEA) 3 months, 6 months and annually after the operation. No patient
      became calcitonin positive or showed any other signs of tumor recurrence after a
      follow-up period of 2-7 years. CONCLUSION: A completion thyroidectomy is not
      necessary in small sporadic C-cell carcinoma that is incidentally diagnosed after
      resection for benign disease if there is no sign of familial cancer and if
      calcitonin is negative. A close follow-up is necessary.

PMID- 11201010
TI  - Postischemic cardiac function recovery in the isolated rat heart: effects of
      adenosine deaminase and nucleoside transport inhibition.
AB  - BACKGROUND AND AIMS: This study assessed the cardioprotective effects of
      inhibitors of adenosine metabolism in an isolated perfused rat heart model.
      Specifically, we studied the adenosine deaminase inhibitor erythro-9-(2-hydroxy-3
      nonyl)-adenine and the selective nucleoside transport inhibitor S-(p-nitrobenzyl)
      6-thioinosine, in terms of their potential to enhance protection when added to
      Bretschneider's cardioplegic solution. METHODS: Rat hearts were infused for 5 min
      with Krebs-Henseleit buffer solution (group 1), Bretschneider's cardioplegic
      solution (group 2), Bretschneider's cardioplegic solution with the addition of 25
      microM erythro-9-(2-hydroxy-3-nonyl)-adenine and 5 microM S-(p-nitrobenzyl)-6
      thioinosine (group 3), and Bretschneider's cardioplegic solution with the addtion
      of 25 microM erythro-9-(2-hydroxy-3-nonyl)-adenine only (group 4). After
      cardioplegic arrest and 45 min of ischemic storage at 25 degrees C, the
      functional recovery of the hearts was tested during 15 min of Langendorff
      reperfusion and then 45 min of working heart reperfusion. RESULTS: In relation to
      the cardioprotective effects of Bretschneider's cardioplegic solution alone, we
      observed an improved recovery of hemodynamic function of the hearts with the
      addition of both erythro-9-(2-hydroxy-3-nonyl)-adenine and S-(p-nitrobenzyl)-6
      thioinosine. However, the myocardial adenosine triphosphate (ATP) concentration
      remained unchanged. Bradycardia observed under the addition of erythro-9-(2
      hydroxy-3-nonyl)-adenine alone was prevented by the addition of S-(p-nitrobenzyl)
      6-thioinosine. CONCLUSION: A combination of both substances may be tested further
      for cardiac preservation, as it might improve the recovery from ischemia at
      moderate temperatures.

PMID- 11201011
TI  - [Interventional gerontology from the medical, institutional and social policy
      viewpoint].

PMID- 11201013
TI  - The role of ACE inhibitors in the treatment of hypertensive elderly patients.
AB  - Hypertension has a high prevalence among elderly patients. Randomised trials have
      already demonstrated that treating healthy older persons with hypertension is
      highly efficacious. Nevertheless some questions have arisen. On the one hand the
      generalizability of these trial results, particularly for older persons with
      serious medical comorbidities and poor functional status, is not clear. On the
      other hand different antihypertensive drugs have shown to be effective. Which
      drug for which patient? Even data from randomised intervention trials showing
      that the treatment affects cardiovascular morbidity and mortality, were missing,
      ACE inhibitors have been used for more than a decade to treat high blood
      pressure. For a younger population the captopril prevention project showed no
      differences between ACE inhibitors and conventional antihypertensive treatment
      (diuretics, beta-blocker) concerning the primary endpoints (myocardial
      infarction, stroke and other cardiovascular death). The STOP-2 study also
      confirmed these results for elderly patients. When treating elderly patients one
      must be aware of physiological changes with age and the comorbidities. Of
      significance among this patient group is declining renal function. Admissions for
      uraemia that are related to the use of ACE inhibitors are still commonplace,
      although many cases are preventable by monitoring renal function, but guidelines
      are still missing. Concerning the comorbidities ACE inhibitors have benefits
      compared to other antihypertensive drugs, especially in cases of heart failure,
      diabetes and coronary heart disease.

PMID- 11201012
TI  - Treatment of arterial hypertension with diuretics, beta- and calcium channel
      blockers in old patients.
AB  - Hypertension increases in prevalence with age. Population based studies suggest
      that more than 50% of people over the age of 65 years may have chronic
      hypertension. Hypertension, especially systolic hypertension, is the single most
      common, powerful, however, treatable risk factor for cardiovascular morbidity and
      mortality in the elderly. In order to assess the effectiveness of
      antihypertensive drug therapy among the elderly, with diuretics, beta-blockers
      and calcium channel blockers, a literature search was performed at the Cochrane
      Library, Medline and Excerpta medica. The Cochrane Hypertension Group identified
      14 randomised controlled trials of at least one year duration with 21,785 elderly
      subjects where diuretics, beta-blockers or calcium channel blockers were used in
      the treatment group as first line drugs. In their meta-analysis (including one
      small trial with a central acting antiadrenergic drug) there was a decrease in
      total mortality (111 vs 129 deaths) and cardiovascular morbidity and mortality
      (126 vs 177 events) within the treatment group. The three trials restricted to
      persons with isolated systolic hypertension indicated beneficial effects in the
      treatment group with regard to cardiovascular morbidity and mortality (104 vs 157
      events). Trial data on adverse effects is limited. In three studies, where
      adverse effects were reported, no substantial differences between treatment and
      control groups in measures of physical, cognitive and emotional function were
      found. Cardiovascular benefits of treatment with low dose diuretics or beta
      blockers are cleared for elderly subjects with either diastolic or isolated
      systolic hypertension. Treatment with a long-acting dihydropyridine calcium
      channel blocker shows beneficial effects in reducing cardiovascular morbidity and
      mortality for elderly people with isolated systolic hypertension. Due to
      inconsistent findings in a subgroup meta-analysis of antihypertensive drug
      treatment in very old people, the efficacy of antihypertensive treatment in these
      subjects still remains unclear.

PMID- 11201014
TI  - [Aortic valve replacement in 80- and over 80-year-old patients. Short-term and
      long-term results].
AB  - Due to demographic changes in average life expectancy, the age of patients
      undergoing cardiac surgery is increasing as well. We have reviewed the short- and
      long-term outcome in patients over 80 years of age after aortic valve
      replacement. From 01 Jan 1995 until 31 Dec 1998, 105 patients (76 women, 29 men
      between 80 and 89 years, median: 83) underwent aortic valve replacement. 42%
      presented with aortic stenosis, 58% with combined valve disease with leading
      stenosis. 53% (group A) received isolated valve replacement, 47% (group B)
      underwent myocardial revascularization as well. The in-hospital mortality rate
      was 8.9% for group A and 14.3% for group B. The follow-up time ranged between 10
      and 243 weeks (median: 112 weeks). None of the patients had to be reoperated for
      prosthetic valve dysfunction or endocarditis. Bleeding complications due to
      anticoagulant therapy were not observed. Of the 11 deaths during the follow-up
      period, 5 (45%) were cardiac in nature and 2 (18%) related to stroke. Actuarial
      survival rates for group A were 98, 95 and 88% at 1, 2 and 3 years, and for group
      B 92, 84 and 84%, respectively. Permanent nursing care was not required 1 year
      after the operation by 98% of patients in group A (2 years: 95%, 3 years: 88%)
      and by 100% of patients in group B (2 years: 95%, 3 years: 88%). At an interval
      of 1 year after the operation 98% of patients in group A had not been
      hospitalized as a result of cardiac disorders (2 years: 98%, 3 years: 94%). The
      rates for group B were 90, 82 and 82%. Compared with younger age groups, aortic
      valve replacement in patients 80 years of age and older is associated with a
      distinctly increased mortality and morbidity. However, our data suggest that
      considering the poor prognosis of conservative therapy of symptomatic aortic
      valve disease, the functional status as well as life expectancy in this age group
      seems to be positively influenced by aortic valve replacement.

PMID- 11201015
TI  - [Therapy of fecal incontinence in elderly patients: Study of a home biofeedback
      training program].
AB  - The increased prevalence of urinary and fecal incontinence is one of the most
      important factors in the loss of independence and mobility in the elderly
      population. It is also one of the major reasons for elderly people to give up
      their household and move into a nursing home. Anorectal biofeedback therapy is a
      very effective treatment for fecal incontinence. However, due to the increased
      immobility of elderly people, ambulatory biofeedback training programs which
      require the participants to leave their homes and travel to the next available
      outpatient clinic on a regular basis, especially when depending on public
      transportation, may prove particularly difficult for elderly, incontinent
      subjects. Supervised home biofeedback training programs may offer an alternative
      for those patients, who are motivated enough and not mentally impaired. Two
      different age groups of women (between 49 and 63; and between 65 and 78 years
      old) suffering from fecal incontinence due to external anal sphincter impairment,
      received a supervised home biofeedback program, after extensive anorectal
      diagnostics including manometry. The program focused on improving voluntary
      sphincter contraction. After an average of 9 months, anorectal manometry was
      repeated, and anal resting and squeeze pressure as well as minimal rectal
      perception threshold were determined. There was no effect on anal resting
      pressure and rectal perception. However, anal maximum squeeze pressure as well as
      squeeze pressure over 10 s was substantially increased with no difference between
      the age groups. CONCLUSION: Supervised home biofeedback for sphincter
      insufficiency was effective in improving the voluntary contraction of the
      anorectum in both age groups. Therefore, biofeedback home training programs may
      offer an alternative to ambulatory programs for those individuals, who are not
      mobile enough to regularly attend an outpatient clinic.

PMID- 11201016
TI  - [Senior studies at the Mannheim University in the opinion of the faculty].
AB  - For over 15 years now, the University of Mannheim has offered studies for senior
      citizens, which are conceived as an integration model. The older students take
      regular courses together with the young students. Former surveys showed large
      satisfaction of the older students with this model. As a check of these results,
      69 university teachers, who have older students in their classes, were asked
      about their experiences and their opinion on the senior citizens' studies by
      usage of a questionnaire which has been developed by Kolland for a similar
      purpose. Predominantly positive experiences are mentioned. The older students are
      seen as an enrichment rather than as a burden. Conflicts and difficulties have
      hardly appeared. The majority deny differences between older and younger
      students. A differential examination points out that older teaching staff have a
      more favorable opinion of senior citizens' studies than the younger ones. It is
      also pointed out that representatives of humanistic subjects have a more positive
      view of the older students than representatives of the empirical mathematical
      field. However, more research is needed in this area.

PMID- 11201018
TI  - [Reality of geriatric psychiatry services in a large West German city].
AB  - A comprehensive survey of psychogeriatric services was carried out as a part of
      public health planning in Solingen, a city of 165,000 inhabitants. The
      investigations consisted of extensive questionnaires and numerous interviews.
      Mental disorders are suspected in 15-20% of general practitioner's patients, in
      62% of community health care center clients and in 65.5% of the residents of
      geriatric nursing homes and old people's homes. Hardly half of the latter and
      less than 20% of the clients of community health care center are under
      psychiatric treatment. Psychiatrists reach only about half as many elderly
      persons as must be expected from epidemiological data; the rate of clinical
      psychogeriatric treatment is lower than in some other German regions. The extend
      of psychotherapy in old age is very low. Collaboration between general
      practitioners and psychiatrists should be improved; in institutions training and
      supervision are deficient.

PMID- 11201017
TI  - [Aggressive and auto-aggressive behavior of acute geriatric psychiatry admissions
      -an empirical contribution].
AB  - We investigated the extent of aggressiveness of 494 psychiatric patients at the
      time of admission. This group was divided into two subgroups according to age: 58
      patients were more than 65 years old and the remaining 436 patients were less
      than 65 years old. The two groups were similar as far as kind and frequency of
      aggressive behaviour against self or others at the time of admission were
      concerned. There was an important difference in handling the aggressive behaviour
      as this was significantly easier with the older patients. Furthermore it was
      possible to describe psychopathological profiles of risk for both allo- and
      autoaggressive behaviour. Sociodemographic factors could be identified which were
      linked with the extent of aggressive behaviour by calculating odds ratios.

PMID- 11201019
TI  - [Developoment of qualifications in German nursing care--results of current data
      analysis].
AB  - Nursing provides a service catering to the needs of the individual and, as such,
      makes its own contribution towards community health care. Apart from
      organizational and instrumental determinants, manpower resources are of central
      significance in this context. The number of staff employed in nursing, their
      qualifications and competences are all factors which fundamentally influence the
      quality and efficiency of nursing care. Based on current data, the following
      article will first describe which manpower resources are available in the
      individual nursing sectors. It will then articulate as a central theme some of
      the main problems in professional training at the various levels (general,
      advanced and further education), including Germany's comparatively new university
      and college degrees in nursing. The results of our analysis indicate, on the one
      hand, that there is movement towards an improved professional profile in nursing,
      which could be classified as optimizing manpower resources. For example, far more
      than two thirds of all nursing staff and other care workers have completed three
      year professional training courses. In addition, nursing trainees
      overproportionately graduate from junior levels of secondary schools. It may,
      furthermore, be noted that nursing continues to be in high demand as a vocational
      profession and that there has been a professional upgrade in particular at the
      teaching and leadership levels. On the other hand, however, we can make out anti
      professional developments which contribute to an impairment of manpower resources
      in nursing. A comparison of 1996 and 1999 figures shows that the number of
      qualified staff in the care of the elderly has decreased whereas the number of
      untrained staff has increased by six times. In spite of heavier work loads there
      has been no increase in the number of staff and trainees in hospital nursing over
      the past few years. And, with the introduction of statutory insurance covering
      ongoing nursing care, various semi-professional trainee programs have emerged,
      leading to a partial displacement of qualified staff. In conclusion, the authors
      will reflect on how to overcome such developments and further optimize manpower
      resources in nursing.

PMID- 11201020
TI  - [Are psychiatric illnesses adequately considered in distribution of nursing care
      levels according to the nursing care insurance law? Evaluation using a new scale
      for evaluating need for nursing care by senior citizens].
AB  - The object of our study is the evaluation of care needs of senior citizens and
      the adjustment of certain stage of care according to the German Health Care Act
      ("Pflegeversicherungsgesetz"). For assessment of care needs we developed a new
      rating scale (BPS). Factor analysis of the rating scale showed 5 dimensions: (1)
      "Psychoorganic Syndrome" (Dementia), (2) "Physical Care Needs", (3) "Lack of
      Social Skills", (4) "Aggressiveness" and (5) "Depression". The sample size is N =
      1739, mean age 82.5 years. A statistically significant partial correlation of the
      extent of care needs as indicated by the stage of care described by BPS
      dimensions was found only for dimension (2) "Physical Care Needs" (r = 0.50).
      Cluster analysis resulted in distribution of the whole sample into 6
      discriminable groups, according to their syndrome specificity (BPS profiles).
      Additionally clusters are different regarding the severity of need for care. It
      is obvious, analyzing the adjustment of stages of care within clusters, that
      psychiatric relevant disturbances contribute substantially to this adjustment.
      Nevertheless this finding is valid only for aged people, who receive regular care
      by ambulant or home services, and can not be transferred to senior citizens cared
      by their families.

PMID- 11201021
TI  - Coexistence of factor V Leiden and primary antiphospholipid syndrome: a patient
      with recurrent myocardial infarctions and thrombocytopenia.
AB  - Increased thrombin generation associated with resistance to activated protein C
      makes the latter a likely candidate for an increased risk of acute coronary
      events. Activated protein C resistance (factor V Leiden) on its own, however,
      appears to have no significant effect in this regard. We describe a case of
      recurrent myocardial infarction caused by coronary thrombosis in a patient with
      persistent thrombocytopenia who was found to have a coexistence of heterozygous
      factor V Leiden and primary antiphospholipid syndrome. Since both thrombophilic
      disorders interfere with the protein C anticoagulant system, the simultaneous
      existence of inherited and acquired resistance against activated protein C could
      account for an increased thrombophilia with manifestation in the coronary
      arteries. This case suggests that evaluation of patients who present with
      recurrent acute coronary events should also consider these coagulation defects.

PMID- 11201023
TI  - [Intravenous long-term thrombolysis of an occluded aortocoronary venous bypass
      graft].
AB  - A 41-year-old man presented with progressive unstable angina pectoris during the
      last three hours. At admission the electrocardiogram and cardiac specific enzymes
      showed no signs of ischemia. During the next 24 hours the electrocardiogram and
      cardiac enzymes developed signs of a non-Q-wave anterolateral infarction. The
      patient had known coronary artery disease and underwent aortocoronary bypass
      surgery seven years ago. Coronary angiography after admission revealed a
      chronically occluded vein graft to the right coronary artery (RCA) and a subtotal
      occlusion of the vein graft to the left anterior descending artery (LAD) with a
      TIMI flow 0-I. Because of unfavorable results of mechanical revascularization of
      occluded bypass grafts and high risk of catheter dislocation and bleeding
      complications of intracoronary local thrombolysis, the patient subsequently
      received intravenous long-term thrombolysis for 24 hours. After successful lysis
      of the thrombus the bypass graft to the LAD showed two severe stenoses but blood
      flow has returned to normal. Three days later percutaneous transluminal coronary
      angioplasty (PTCA) and stent implantation were carried out with a good primary
      angiographic result. After 6 months the patient was still asymptomatic and a
      treadmill exercise test showed no signs of ischemia.

PMID- 11201022
TI  - [New antithrombotic therapy approaches in coronary heart disease--prospects for
      gene therapy].
AB  - Despite considerable progress, pharmacological therapies have not provided a
      complete solution for common cardiovascular problems, including recurrent
      thrombosis, restenosis, and vein graft deterioration. Optimal drug dosage,
      reproducing plasma concentrations achieved in animal studies establishing proof
      of-principle, would often be too toxic to administer. Local gene therapy aims at
      overexpressing proteins that regulate the cell cycle of vascular smooth muscle
      cells, inhibit vascular smooth muscle cell migration, endow the endothelium with
      enhanced vasoprotective properties. Alternatively, some approaches tend to
      suppress gene expression of proteins believed to promote vascular smooth muscle
      cell proliferation and migration. In sharp contrast to drug treatments, local
      gene therapy limits expression of the beneficial agent to the injured vascular
      site, where it can extend the presence of this agent to weeks and, with some gene
      vectors, to many months. This review summarizes and discusses antithrombotic gene
      therapy approaches for the prevention of restenosis and late thrombosis after
      catheter-based revascularizations.

PMID- 11201024
TI  - [Neurological events in patients with atrial fibrillation: outcome and preventive
      practices].
AB  - BACKGROUND: Atrial fibrillation (AF) is associated with neurologic events
      (transient ischemic attack (TIA) and stroke). The objective of the present study
      was to determine the outcome of patients with neurological events and atrial
      fibrillation (AF) in comparison with patients in sinus rhythm (SR), and to
      investigate the primary and secondary prevention practices in patients with
      neurological events and AF. PATIENTS AND METHODS: In a prospective,
      observational, single center study in a large public, university-affiliated
      hospital all patients admitted between 1/97 and 1/98 with acute neurologic events
      were registered (n = 369). The association between outcome of neurologic events
      as assessed by survival status, functional status (Rankin scale) and severity of
      event (European Stroke Scale) and heart rhythm was investigated by use of
      logistic regression. Antithrombotic medication on admission and at discharge was
      recorded. RESULTS: The mean age of the 369 patients was 75.1 +/- 10.9 years;
      56.1% were female. A TIA was present in 26.2% and stroke in 73.8%. 287 patients
      (77.8%) were in SR and 82 in AF on admission (22.2%). In-hospital mortality was
      12.7% in all patients. In patients with AF, mortality was 23.2% and 9.8% in
      patients with SR (p = 0.0013). Patients with AF were significantly older than
      patients with SR (80.4 +/- 7.5 versus 73.5 +/- 11.2 years; p < 0.001).
      Multivariate analysis identified heart rhythm as an independent predictor of
      survival (p < 0.01). Patients with AF did suffer from a more severe neurological
      deficit on admission and at discharge than patients with SR. In 46.3% of patients
      with AF severe dependency was present (Rankin 4/5), while this was the case in
      28.5% of patients with SR (p < 0.01). The ESS score of patients with AF was 77.4
      +/- 30.6 at discharge compared to 88.1 +/- 20.3 in patients with SR (p < 0.01).
      In 50 of 82 patients (61%) AF was previously known. Of these 50 patients 36% did
      not receive any kind of antithrombotic treatment and only 12% were receiving oral
      anticoagulants before the event. Of 63 surviving patients with AF 32 did not have
      any contraindications against anticoagulation treatment. At discharge, 14 (43.8%)
      of these patients were receiving oral anticoagulants, 17 aspirin or ticlopidine
      (53.1%) and 1 patient (3.1%) no type of antithrombotic medication. CONCLUSIONS:
      Neurologic events in patients with AF are more severe and outcome is
      significantly poorer than in patients with SR. Anticoagulation as the effective
      therapy for primary and secondary prevention of neurologic events is seriously
      underused in daily practice.

PMID- 11201025
TI  - [Mechanism of induction and termination of ventricular fibrillation--significance
      of dispersion of ventricular repolarization].
AB  - It has been known for many years that ventricular fibrillation may be induced and
      terminated by electrical field stimuli. Recent experimental studies have shown
      that both fibrillation and defibrillation have a common electrophysiologic
      mechanism that is based on the interaction between the electrical field stimulus
      and ventricular repolarization. Ventricular fibrillation will be induced if the
      field stimulus is applied with the area of vulnerability, this area of
      vulnerability is defined two dimensionally by the shock coupling interval and
      shock strength, and is modified by the configuration of the shock. A field shock
      that is applied within the area of vulnerability causes heterogeneity of
      ventricular repolarization immediately after the shock (postshock dispersion),
      thereby enabling the development of circuit movements and reentry, and resulting
      in ventricular fibrillation. High energy shocks, however, that are applied above
      the area of vulnerability (i.e., above the upper limit of vulnerability) will not
      induce ventricular fibrillation due to homogeneous prolongation of repolarization
      and a resulting small postshock dispersion. In analogy, ventricular fibrillation
      will continue after unsuccessful low-energy defibrillation shocks due to high
      postshock dispersion, whereas a high-energy shock will synchronize ventricular
      repolarization, thereby causing small postshock dispersion and termination of
      ventricular fibrillation. This paper describes the relation between fibrillation,
      defibrillation and ventricular repolarization based on experimental findings. A
      possible clinical application of these findings is that the upper limit of
      vulnerability may be used as a surrogate for the defibrillation threshold. Thus,
      defibrillation threshold testing may not be necessary during future implantations
      of automatic cardioverter defibrillators.

PMID- 11201026
TI  - [Cardiac arrhythmias in targeted connexin deficient mice: significance for the
      arrhythmia field].
AB  - Intercellular communication can be mediated by gap junction channels. One channel
      is composed of two hexameric hemichannels which consist of six polypeptide
      subunits called connexines (Cx). Three different connexines were documented in
      the cardiac myocytes: Cx40, Cx43 and Cx45. The labeling by number represents the
      rounded, molecular mass of the amino acid sequences given in kD. Identical
      connexons form homotypic channels different connexons can form heterotypic
      channels. Each channel type has specific properties regarding permeability and
      electrical conductance. Beside a typical age-dependent alignment of gap junction
      channels on the surface of the cardiac myocytes, regional distribution of the
      different connexins is different at distinct parts of the mouse heart. The
      ventricular working myocardium is characterized by Cx43, whereas Cx40 and Cx45
      were not found in this region. In the atria as well as in the conduction system,
      Cx40 is the most frequently expressed. Cx45 appears to form a border zone between
      conductive and the surrounding working myocardium. In line with the localization
      and the conduction properties of distinct homotypic gap junction channels, the
      Cx43 deficient mouse is suitable for analysis of ventricular arrhythmias and the
      Cx40 deficient mouse primarily for studies of atrial arrhythmias. Increased
      ventricular conduction velocity and increased ventricular vulnerability were
      observed in the presence of a decreased number and density of Cx43 gap junction
      channels. This observation, however, is controversially discussed. Cx40
      deficiency induces an impairment of the sinuatrial, intraatrial and
      atrioventricular conduction properties and is associated with an increased atrial
      vulnerability. Transgenic mouse models and new mapping techniques for detection
      of the electrical wavefront propagation provide new insights into the mechanisms
      of arrhythmogenesis. Geneticists, clinicians and basic researchers need to
      collaborate in order to explore the clinical relevance of the new mouse models
      and their use for molecular medicine.

PMID- 11201027
TI  - [Interventional occlusion of atrial septum defects larter than 20 mm in
      diameter].
AB  - Over the last few years, various devices for the interventional closure of atrial
      septal defects (ASD) up to a diameter of 20 mm have been developed. We report our
      clinical experience in closing ASD with a diameter larger than 20 mm diameter
      with the Amplatzer Septal Occluder (ASO). METHOD: The stretched diameter of the
      ASD was measured by inflating a sizing balloon within the defect until an
      indentation in the circumference in the balloon could be observed. An ASO with a
      stent diameter 2-4 mm larger than the indentation in the circumference of the
      balloon was chosen and implanted via 9-12 French sheaths. In contrast to the
      closure of smaller defects, pullback of the device onto the atrial septum was
      only performed when the connecting stent of the ASO was completely deployed in
      order to achieve maximal centering characteristics and optimal support of the
      retention skirt of the left atrial disc on the edges of the defect. Only then was
      the right atrial disc deployed and actively configured by advancing the sheath
      and the delivery cable against the atrial septum. Implantation was only attempted
      if the atrial septal rims (except the anterior rim around the aorta) measured
      more than 7 mm by echocardiography to avoid injury or disturbance of sensitive
      intracardiac structures. After placement, the fixation of the device and the
      mechanical stability was proven by an extensive "Minnesota wiggle". The ASO was
      released only when TEE showed no or a trivial residual color flow through the
      connecting stent; otherwise repositioning was performed. RESULTS: Out of 352
      patients (P) with successful closure of interatrial defects, 70 P (age: 1.1-77.3
      years) had stretched defects larger than 20 mm diameter (median 22 mm diameter
      (20-36), 25/75% quartiles = 20/26 mm). Mean shunt size was Qp:Qs 2.1:1 (0.7
      3.9:1), mean fluoroscopy time 10.9 min (0-63). Complete closure could be achieved
      in 85.7/93.1/100% after 3 months, 1 and 2 years, respectively. Besides 3 P with
      persistent atrial fibrillation, only 5 P showed transient atrial
      tachyarrhythmias, 2 only periprocedural and 3 within the first 3 months after
      implantation were treated with beta-blocker. In one patient, an acute
      embolization of the device occurred because a diminished posterior rim was not
      visualized by a monoplane TEE probe necessitating surgical explantation and
      defect occlusion. Despite oversizing the device, no "mushrooming"
      misconfiguration were observed. CONCLUSION: Transcatheter closure of large atrial
      septal defects with the Amplatzer Septal Occluder is feasible, safe and
      effective. Risk of complications do not seem to occur more frequently than after
      closure of smaller defects if one adheres to certain sizing and implantation
      measures. The incidence of transient atrial tachyarrhythmias seems to be low.

PMID- 11201028
TI  - [Interventional treatment of congenital heart defects in infants with a body
      weight up to 2,500 grams].
AB  - BACKGROUND: Pediatricians and neonatologists are still reluctant to consider
      invasive cardiological or cardiosurgical treatment in low body weight infants
      because it is believed to considerably increase the risk. The aim of this study
      was to assess the results and complications of percutaneous transcatheter
      interventions in infants with a weight below 2.5 kilograms. METHODS:
      Retrospective analysis was undertaken for all patients with a weight below 2.5
      kilograms who underwent cardiac catheterization from 01/1994 to 04/1999. During
      this time 42 diagnostic catheterizations in 29 patients and 27 transcatheter
      interventions in 24 patients were performed. RESULTS: Surgery was replaced or
      effectively postponed in 9 (33%) out of 27 transcatheter interventions. This was
      possible for pulmonary stenosis, valvular aortic stenosis and aortic coarctation.
      A stabilization of the hemodynamic situation was possible in 14 patients. An
      antegrade pulmonary flow was established in 5, an effective interatrial shunt
      created in 5 and the arterial duct stented in 3 patients. Only 3 patients had no
      benefit from the intervention; however, there were no deaths nor hemodynamic
      complications. Arrhythmias occurred in 9% of all catheterizations and
      interventions but were transient in all cases. Femoral arterial complications
      were observed in 30% of all arterial catheterizations. CONCLUSION: Diagnostic
      cardiac catheterization and percutaneous transcatheter interventions can be
      performed with low mortality and acceptable morbidity in low weight infnats.
      Transcatheter interventions can replace surgery, postpone the necessity for
      surgery or stabilize the hemodynamic situation prior to surgery.

PMID- 11201029
TI  - [Atrial natriuretic peptide as an indicator of mild postoperative cardiac
      dysfunction after uncomplicated bypass surgery].
AB  - Plasma levels of ANP (pg/ml; radioimmunoassay) as a parameter for postischemic
      dysfunction and levels of Troponin T (TnT) (ng/ml; ELISA test) as a parameter for
      postischemic cellular damage were determined in 15 patients with coronary artery
      disease (CAD) (mean age: 58 +/- 6.1 years; 13 m, 2 w; with no history of
      myocardial infarction and no signs for congestive heart failure) prior to, during
      and after extracorporal circulation (ECC). Under standardized conditions during
      the ECC basic parameters concerning the cardial hemodynamic (heart rate (HR);
      systolic (RRsys, mmHg), diastolic pressure (RR dia, mmHg) central venous pressure
      (CVP, mmHg); left atrial pressure (LAP, mmHg); left ventricular enddiastolic
      pressure (LVEDP, mmHg)) and ECG monitoring blood samples were performed: 1) prior
      to operation (op); 2) prior to CPB; 3) 1 h CPB; 4) 5 min after CPB; 5) 1 h after
      CPB; 6) 6 h postoperative (postop); 7) 24 h postop; 8) 48 h postop; 9) 10 days
      postop. Also the left atrial diameter (LAD, mm) and the left ventricular
      enddiastolic diameter at Q (LVEDD, mm) pre- and postop were documented with m
      mode echocardiography (Echo) and ejection fraction (EF, %) was calculated. The
      bypass operations were performed with intermittent aortic cross-clamping with
      open venae cavae (CVP: 0-5 mmHg) and moderate hypothermia. For the determination
      of ANP levels and TnT levels in arterial and venous blood, a double-antibody (AB)
      radioimmunoassay and an ELISA test were used. Concerning the patients with CAD
      there was a maximal increase of ANP from preoperative 90 +/- 10 (M +/- SEM) pg/ml
      (p < 0.05) up to intraoperative 380 +/- 38 pg/ml. Ten days postop, the ANP level
      was with 262 +/- 33 pg/ml still increased threefold in comparison to the
      preoperative level. TnT showed an increase from preoperative 0.02 +/- 0.01 ng/ml
      up to intraoperative 3.44 +/- 0.47 ng/ml. Ten days postop the TnT concentration
      was at the preoperative level with 0.13 +/- 0.11 ng/ml. Five minutes after bypass
      up to 48 h postop, ANP and TnT levels were correlated (p < 0.05, r = 3.4). There
      was an increase of the LAD from preoperative 42.2 +/- 1.1 mm up to 46.8 +/- 1.2
      mm (p < 0.05) 10 days postop as determined by m-mode echo. LVEDD and EF changed
      from preoperative 51.1 +/- 0.9 mm and 73 +/- 2% to 54.5 +/- 1.2 mm and 65 +/- 4%
      10 days postop. The significant increase of TnT (172-fold) indicates the
      cellular, myocardial injury, caused by the operation without signs in ECG
      recordings and no signs of congestive heart failure. The significantly increased
      ANP level up to the 10th day postop indicate sa very sensitive prolonged,
      postischemic dysfunction, which is not compensated 10 days postop.

PMID- 11201030
TI  - [Atrial fibrillation: healing by focal high frequency catheter ablation?].
AB  - Atrial fibrillation is the most common sustained arrhythmia causing substantial
      morbidity and probably increasing the risk of death. Most commonly, it is divided
      into a paroxysmal form, when--by definition--episodes end spontaneously, or a
      persistent one that lasts and requires a medical or electrical intervention for
      its termination. It might be called permanent, when no further attempts seem to
      be indicated for its elimination. Until recently, therapeutic strategies aimed at
      preventing cardiac embolism and at restoring and maintaining sinus rhythm by
      antiarrhythmic drugs. Long-term efficacy of the latter approach is poor, since
      less than 50% of patients can be maintained in stable sinus rhythm when periods
      of more than 1 year are considered. Can atrial fibrillation be cured? More than
      ten years ago Cox and coworkers demonstrated that the surgical compartimentation
      of both atria (MAZE procedure) is able to abolish atrial fibrillation in up to
      90% of patients with chronic paroxysmal and also persistent atrial fibrillation.
      However, all studies trying to imitate the MAZE procedure by electrophysiological
      catheter-based techniques applying radiofrequency energy to produce transmural
      linear lesions were either not successful or showed a non-acceptable complication
      rate, especially a high rate of cerebrovascular accidents. The rationale behind
      the principle of compartimentation of the atria is the reduction of the critical
      atrial muscle mass necessary to facilitate fibrillation of the atria. A different
      approach aiming especially at the problem of paroxysmal atial fibrillation is
      based on the observation that there might be a "focal trigger" responsible for
      the initiation of the atrial tachyarrhythmia and that by eliminating this focal
      trigger atrial fibrillation can be avoided. This hypothesis was first verified in
      patients by Haissaguerre et al., in fact experimental creation of "focal atrial
      fibrillation" was presented by Moe and Abildskov more than 30 years ago. During
      the last 3 years the concept of curing paroxysmal atrial fibrillation by applying
      focal radiofrequency lesions was supported by the results of several groups in
      more than 200 patients: 60 to 85% of patients can be cured, but in almost half of
      the cases more than one procedure is necessary. Most interestingly--and this is a
      finding of all investigators--more than 90% of the triggering ectopic foci are
      located in the pulmonary veins or in the pulmonary vein/left atrial junction.
      This concept is also supported by surgical experience from performing pulmonary
      vein isolations during open heart surgery. Most recently, the concept of
      eliminating the trigger was extended and applied to patients with established
      persistent atrial fibrillation. Until now, it has not been well established how
      many patients with paroxysmal atrial fibrillation are "good candidates" for a
      focal RF ablation procedure, nor is the risk of the procedure well defined.
      Besides the necessity of performing a transseptal catheterization there is the
      risk of cardiac embolism and pulmonary vein stenosis. The endpoint of the
      procedure is also not well defined: instead of trying to eliminate the "trigger"
      located in a pulmonary vein, it might be safer to isolate the "arrhythmogenic
      vein". This however, is a difficult task with current catheter technologies. It
      can be expected that new catheter designs for mapping and ablation and--maybe-
      the use of alternative energy sources--e.g., ultrasound, microwave--will make the
      procedure easier and applicable to more patients with drug refractory atrial
      fibrillation.

PMID- 11201031
TI  - Malignant vascular lesions of bone: radiologic and pathologic features.
AB  - The malignant vascular tumors of bone represent an uncommon diverse group of
      tumors with widely variable clinical and radiographic presentations. Although the
      radiographic imaging features of the lytic osseous lesions typically seen with
      this group of tumors are relatively nonspecific, the propensity to develop
      multifocal disease in an anatomic region is a feature that can be helpful in
      suggesting the diagnosis of a vascular tumor. The differential diagnosis varies
      according to the age of the patient and presence of solitary or multifocal
      disease. The histologic features are variable and range from tumors with
      vasoformative features to those that mimic mesenchymal neoplasm or metastatic
      carcinoma. Familiarity with the radiographic and pathologic spectrum of disease
      is essential for making an accurate diagnosis in this diverse group of neoplasms.
      This paper will provide a review of the nomenclature for the malignant vascular
      tumors of bone and discuss the radiographic and pathologic differential
      diagnosis.

PMID- 11201032
TI  - Helical CT in the primary trauma evaluation of the cervical spine: an evidence
      based approach.
AB  - This review provides a summary of the cost-effectiveness, clinical utility,
      performance, and interpretation of screening helical cervical spine CT for trauma
      patients. Recent evidence supports the use of helical CT as a cost-effective
      method for screening the cervical spine in high-risk trauma patients. Screening
      cervical spine CT can be performed at the time of head CT to lower the cost of
      the evaluation, and when all short- and long-term costs are considered, CT may
      actually save money when compared with traditional radiographic screening. In
      addition to having higher sensitivity and specificity for cervical spine injury,
      CT screening also allows more rapid radiological clearance of the cervical spine
      than radiography. Patients who are involved in high-energy trauma, who sustain
      head injury, or who have neurological deficits are candidates for CT screening.
      Screening with CT may enhance detection of other potentially important injuries
      of the cervical region.

PMID- 11201033
TI  - MR imaging of the Achilles tendon: overlap of findings in symptomatic and
      asymptomatic individuals.
AB  - OBJECTIVE: To differentiate MR imaging characteristics of symptomatic as compared
      with asymptomatic Achilles tendons. DESIGN: 1.5 T MR images of 94 feet (88
      patients) with "abnormal" MR examinations were retrospectively evaluated and
      clinically correlated. Two masked, independent observers systematically evaluated
      for intratendon T2 signal, tendon thickness, presence of peritendonitis,
      retrocalcaneal bursal fluid volume, pre-Achilles edema, bone marrow edema at the
      Achilles insertion, and tears (interstitial, partial, complete). These findings
      were correlated with symptoms (onset and duration) and physical examination
      results (tenderness, palpable defects, increased angle of resting dorsiflexion).
      RESULTS: Of the 94 ankles, 64 ankles (32 females, 29 males) were clinically
      symptomatic. No relationship between Achilles tendon disorders and age or gender
      was identified. Asymptomatic Achilles tendons frequently demonstrated mild
      increased intratendon signal (21/30), 0.747 cm average tendon thickness,
      peritendonitis (11/30), pre-Achilles edema (12/30), and 0.104 ml average
      retrocalcaneal bursal fluid volume. Symptomatic patients had thicker tendons
      (0.877 cm), greater retrocalcaneal fluid volume (0.278 ml), more frequent tears
      (23/64), a similar frequency of peritendonitis (22/64) but less frequent pre
      Achilles edema (18/64). Sixty-four percent of the Achilles tendon tears were
      interstitial. Except for two interstitial tears in control patients, the majority
      of Achilles tears were in symptomatic patients (14/16). Only symptomatic tendons
      demonstrated partial or complete tendon tears. In addition, calcaneal edema was
      found almost exclusively in actively symptomatic patients. Thicker tendons were
      associated more often with chronic symptoms and with tears. When present in
      symptomatic patients, peritendonitis was usually associated with acute symptoms.
      The presence of pre-Achilles edema, however, did not distinguish acute from
      chronic disorders. CONCLUSION: There is significant overlap of MR findings in
      symptomatic and asymptomatic Achilles tendons. Furthermore, there is apparently a
      spectrum of disease in symptomatic tendons ranging from subtle intratendinous and
      peritendinous signal to partial and complete tendon tear.

PMID- 11201034
TI  - Malignant round cell tumours of bone: atypical clinical and imaging features.
AB  - OBJECTIVE: To describe the clinical, radiological and MRI features of six
      atypical cases of histologically proven appendicular Ewing sarcoma/primitive
      neuroectodermal tumour (PNET). DESIGN: Retrospective review of case notes and
      available imaging was carried out. PATIENTS: Six patients (4 male, 2 female; mean
      age 27 years, range 19-44 years), presenting over a 77-month period, were
      identified from the Bone Tumour Register. All had unusual clinical and imaging
      features for Ewing sarcoma/PNET. RESULTS AND CONCLUSIONS: Four tumours were
      centred on the distal femoral metaphysis, one in the proximal tibial metaphysis
      and one in the distal tibial metaphysis. Plain radiographs were available in four
      cases and showed minor cortical changes. MRI demonstrated a relatively small,
      eccentrically located intraosseous component with a large, eccentric extraosseous
      component. Extension into the epiphysis was seen in three cases and into the
      adjacent joint in two cases. Intraosseous "skip" metastases were present in three
      cases. The clinical and imaging features were atypical for conventional
      intraosseous Ewing sarcoma/PNET and the exact site of origin (intraosseous,
      periosteal or soft-tissue) was unclear.

PMID- 11201035
TI  - A comparative study of the accuracy of Ranawat's and Pierchon's methods to
      determine the centre of rotation in bilateral coxopathy.
AB  - OBJECTIVE: The objective of the study was to compare two methods (Ranawat's and
      Pierchon's) used to determine the centre of rotation of the hip and establish
      which method calculates a position nearer to the real centre of rotation.
      PATIENTS AND DESIGN: We selected 24 patients with unilateral osteoarthritis of
      the hip. The centre of rotation of the healthy hip was determined in two
      consecutive radiographic studies by superimposing a template of circles and using
      two axes as the reference lines (X-axis=teardrop line; Y-axis=a line
      perpendicular to the X-axis, drawn from the intersection of the ilio-ischiatic
      line and the teardrop line). After ensuring the stability of these references,
      both methods were applied to the same radiograph to determine which one
      established a centre of rotation nearer to the anatomical centre identified by
      the template of circles. RESULTS: When the values for the healthy hip are
      compared with those obtained using Ranawat's method, highly significant
      differences are observed for both X (P<0.0001) and Y (P<0.0001). When the results
      for the healthy hip are compared with the values obtained using Pierchon's
      method, neither the X (P=0.722 ) nor the Y values (P=0.112) show any significant
      differences. It would be advisable to use Pierchon's method to determine the
      centre of rotation during the preoperative planning for a total hip arthroplasty
      when the anatomical alteration is bilateral.

PMID- 11201036
TI  - Osteoblastoma-like osteosarcoma.
AB  - We report an osteoblastoma-like osteosarcoma in the right proximal fibula in a 22
      year-old woman. Radiographs showed an irregular osteolytic lesion from the
      metaphysis to the epiphysis in the proximal fibula with partial destruction of
      cortical bone. Tissue from a biopsy indicated a typical osteoblastoma. Curettage
      and bone graft was performed. One year after the surgery, local recurrence
      occurred, and a wide excision was performed. Histological examination of the en
      bloc surgical specimen revealed the tumor had permeated through the host bony
      trabeculae, although the nuclear atypia was not marked. Immunohistochemical
      expression of MIB-1 was detected in 9.0% of cells.

PMID- 11201037
TI  - Tunneling Schmorl's nodes in an elderly woman treated for acute lymphoblastic
      leukemia.
AB  - We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom
      serial imaging studies showed the development of multiple vertebral collapse, and
      communicating superior and inferior Schmorl's nodes creating a longitudinal
      channel ("tunneling" Schmorl's nodes) through the anterior aspect of T12 to L3
      vertebral bodies of her osteoporotic thoracolumbar spine. This was observed after
      achieving complete remission of the disease and during maintenance therapy. The
      finding is felt to be secondary to iatrogenic exacerbation of osteoporosis.

PMID- 11201038
TI  - Mid-foot reconstruction following involvement of five bones by giant cell tumor.
AB  - We report on a patient who had giant cell tumor involving multiple bones of the
      mid-foot. The tumor originated from the navicular bone, but also destroyed the
      cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor
      presented a therapeutic challenge for the surgeons. The patient was treated with
      en bloc resection and the bony defect replaced with a massive iliac crest graft
      which united within 9 months and has remained stable for 7 years without local
      recurrence, and with excellent function of the foot.

PMID- 11201039
TI  - Mandibulo-acral dysplasia.
AB  - We report on a 7 year-old-girl with mandibulo-acral dysplasia. When she was 3
      years of age it mimicked scleroderma because of skin atrophy and later on a
      Hutchinson-Gilford progeria syndrome (HGP). Acro-mandibular dysplasia was
      diagnosed because of facial hypoplasia and mandibular hypoplasia. The bilateral
      proximal mid-humeral notch seen in this case is unusual.

PMID- 11201040
TI  - The historical development of salivary research in The Netherlands.

PMID- 11201041
TI  - Delayed embryonic development of mouse masseter muscle correlates with delayed
      MyoD family expression.
AB  - While the masseter muscle is known to have several unique developmental
      characteristics as compared with other skeletal muscles, little is known about
      its myogenesis. Thus, we examined the expression of myogenic marker and of myoD
      family gene mRNA from embryonic day (E) 11 to birth. The obtained results were
      compared with our earlier results of the mouse tongue muscle, which is also
      involved in oral functions. The mRNA quantities were determined by means of the
      reverse-transcription and competitive-polymerase chain-reaction techniques. The
      expression of myogenic marker mRNA indicated that differentiation and maturation
      in the masseter began at E13 as in the tongue, and were not yet completed at
      birth, although they were completed in the tongue. The expression of myoD,
      myogenin, and myf5 mRNA peaked later in the masseter (E17) than in the tongue
      (E13). The expression of MRF4 mRNA began later in the masseter (E15) than in the
      tongue (E13). These results suggest that the delayed expression of the myoD
      family genes in the masseter correlates with delayed differentiation and
      maturation, probably due to the later functional requirements of the masseter
      than of the tongue.

PMID- 11201042
TI  - Osteoprotegerin and osteoclast differentiation factor in tooth eruption.
AB  - A critical cellular event in tooth eruption is the formation of osteoclasts that
      are needed for bone resorption to form an eruption pathway. To analyze molecular
      regulation of osteoclast formation and activation, we examined the expression of
      osteoprotegerin (OPG), an inhibitor of osteoclast formation. In vivo, the gene
      expression of OPG is reduced in the dental follicle of the first mandibular molar
      of the rat at day 3 post-natally and in the mouse at day 5. This correlates with
      the days of maximal mononuclear cell influx and osteoclast numbers in the rat and
      mouse. Thus, inhibition of OPG gene expression on these days might allow
      osteoclasts to be formed and/or activated. In vitro studies demonstrated that
      both colony-stimulating factor-1 and parathyroid hormone-related protein reduced
      OPG gene expression in follicle cells, suggesting that these are candidate
      molecules for the in vivo inhibition of OPG expression. Osteoclast
      differentiation factor (ODF) immunolocalizes to the alveolar bone stromal cells
      adjacent to the follicle, whereby it might act to stimulate fusion of the
      mononuclear cells in the follicle.

PMID- 11201043
TI  - Evidence for charge domains on developing enamel crystal surfaces.
AB  - The control of hydroxyapatite crystal initiation and growth during enamel
      development is thought to be mediated via the proteins of the extracellular
      matrix. However, the precise nature of these matrix-mineral interactions remains
      obscure. The aim of the present study was to use a combination of atomic and
      chemical force microscopy to characterize developing enamel crystal surfaces and
      to determine their relationship with endogenous enamel matrix protein
      (amelogenin). The results show regular and discrete domains of various charges or
      charge densities on the surfaces of hydroxyapatite crystals derived from the
      maturation stage of enamel development. Binding of amelogenin to individual
      crystals at physiological pH was seen to be coincident with positively charged
      surface domains. These domains may therefore provide an instructional template
      for matrix-mineral interactions. Alternatively, the alternating array of charge
      on the crystal surfaces may reflect the original relationship with, and influence
      of, matrix interaction with the crystal surfaces during crystal growth.

PMID- 11201044
TI  - Butyric-acid-induced apoptosis in murine thymocytes and splenic T- and B-cells
      occurs in the absence of p53.
AB  - Butyric acid, an extracellular metabolite from periodontopathic bacteria, induces
      apoptosis in murine thymocytes, splenic T-cells, and human Jurkat T-cells. The
      present study examines the contributions of apoptosis-related proteins (Bcl-2,
      Bcl-XL, Bax, and p21WAF1/CIP1) in the regulation of T-cell death induced by
      butyric acid, using p53 knock-out (p53-/-) and wild-type (p53+/+) mice. The
      results of a DNA fragmentation assay indicated that thymocytes, splenic T-cells,
      and B-cells from p53-/- mice were susceptible to butyric-acid-induced apoptosis
      to a degree similar to those from p53+/+ mice. Moreover, butyric acid
      significantly induced apoptosis in lymphocytes from both p53+/+ and p53-/- mice
      in a concentration- and time-dependent fashion. Experiments with fractionated
      subpopulations of splenic T-cells revealed that DNA fragmentation was equally
      observed in CD4+ and CD8+ splenic T-cells from both p53+/+ and p53-/-
      lymphocytes. Activation of caspase-3, caspase-6, and caspase-8, but not of
      caspase-1, in butyric-acid-induced T-cell apoptosis occurred regardless of the
      presence of p53. Western blotting analysis of splenic T-cells showed that butyric
      acid treatment decreased Bcl-2 and Bcl-XL expressions in p53+/+ and p53-/- cells.
      Splenic T-cells had barely detectable Bax and p21WAF1/CIP1, regardless of whether
      butyric acid and/or p53 was present. These results suggest that butyric-acid
      mediated apoptosis of murine T-cells takes place via a pathway that is
      independent of p53, and is followed by the p53-regulated proteins Bax and
      p21WAF1/CIP1, which lower the levels of the apoptosis antagonists Bcl-2 and Bcl
      XL in cells.

PMID- 11201045
TI  - Cyclooxygenase-2-dependent prostaglandin E2 down-regulates intercellular adhesion
      molecule-1 expression via EP2/EP4 receptors in interleukin-1beta-stimulated human
      gingival fibroblasts.
AB  - Prostaglandin E2 (PGE2), which exerts its actions via EP receptors (EP1, EP2,
      EP3, and EP4), is a bioactive metabolite of arachidonic acid produced by
      cyclooxygenase (COX)-1 and/or COX-2. We have previously demonstrated that PGE2
      down-regulates intercellular adhesion molecule-1 (ICAM-1) expression in
      interleukin-1beta (IL-1beta)-stimulated human gingival fibroblasts (HGF). In the
      present study, we investigated which COX was involved in down-regulation of ICAM
      1 expression by PGE2 in IL-1beta-stimulated HGF and which subtypes of EP
      receptors modulated the ICAM-1 expression. NS-398, a specific COX-2 inhibitor,
      completely inhibited PGE2 production by IL-1beta-stimulated HGF, as did
      indomethacin, a COX-1/COX-2 inhibitor. Northern blot analysis and
      immunocytochemical staining showed that mRNA and protein of COX-2 were expressed
      in IL-1beta-challenged HGF, but not in unstimulated HGF, and that the expression
      of mRNA and protein of COX-1 was similar both in unstimulated and in stimulated
      cells. NS-398 and indomethacin enhanced ICAM-1 expression in IL-1beta-challenged
      HGF. EP1, EP2, and EP4 receptor mRNA was expressed in HGF according to reverse
      transcription/polymerase chain-reaction. PGE2, 11-deoxy-PGE1 (a selective EP2/EP4
      agonist), and Butaprost (a selective EP2 agonist) attenuated IL-1beta-elicited
      ICAM-1 expression, although Butaprost was less potent than PGE2 and 11-deoxy
      PGE1. AH-23848B, an EP4 antagonist, antagonized the inhibitory effect of IL-1beta
      elicited ICAM-1 expression by PGE2. Sulprostone, an EP1/EP3 agonist, had no
      effect on IL-1beta-elicited ICAM-1 expression. Analysis of these data suggests
      that COX-2-derived PGE2 down-regulates ICAM-1 expression via EP2/EP4 receptors in
      IL-1beta-stimulated HGF.

PMID- 11201046
TI  - Collagen XII mutation disrupts matrix structure of periodontal ligament and skin.
AB  - Collagen XII has been postulated to organize the extracellular matrix (ECM)
      architecture of dense connective tissues such as the periodontal ligament (PDL)
      and skin. The objective of this study was to test this hypothesis in transgenic
      mice carrying a dominant interference mutation of collagen XII. The truncated
      alpha1(XII) collagen minigene construct MXIINC3(-), driven by the mouse alpha2(I)
      collagen promoter, was prepared and used to generate transgenic mouse lines. The
      PDL matrix fibers of molar teeth lost the ordered architecture characteristic of
      ligament tissue without noticeable inflammation. Cellular cement appeared to be
      disrupted at the PDL insertion. By confocal laser scanning microscopy, the PDL of
      transgenic mice demonstrated swollen and irregularly arranged collagen fibers
      associated with internal porosity. The skin of transgenic mice revealed the lack
      of matrix fiber structure in the papillary dermis. These results indicated that
      the dominant interference mutation of collagen XII disorganized the ECM
      architecture of PDL and skin.

PMID- 11201047
TI  - The in vivo expression of the collagenolytic matrix metalloproteinases (MMP-2, 
      8, -13, and -14) and matrilysin (MMP-7) in adult and localized juvenile
      periodontitis.
AB  - Periodontal inflammation is characterized by irreversible degradation of
      periodontal ligament collagen fibers leading to loss of tooth attachment.
      Cultured gingival keratinocytes and fibroblasts express, in vitro, various matrix
      metalloproteinases (MMPs) which can degrade fibrillar collagens. We hypothesized
      that several MMPs are also synthesized in vivo by sulcular epithelium, and
      analyzed the collagenolytic MMPs (MMP-2, -8, -13, and -14) and matrilysin (MMP-7)
      in gingival tissue specimens and gingival crevicular fluid from adult and
      localized juvenile periodontitis patients by in situ hybridization,
      immunohistochemistry, and Western immunoblotting. MMP-2, -7, -8, and -13 were
      expressed in gingival sulcular epithelium. MMP-7 and -13 were also located in
      fibroblasts and macrophages, and MMP-8 in neutrophils. MMP-8- and -13-positive
      cells/mm2 were higher in periodontitis gingiva when compared with healthy control
      tissue (p < 0.01). In periodontal diseases, gingival sulcular epithelium
      expresses several, rather than a single, collagenolytic MMPs, and this
      proteolytic cascade is evidently responsible for the tissue destruction
      characteristic of adult and juvenile periodontitis.

PMID- 11201048
TI  - Detection of a novel mutation in X-linked amelogenesis imperfecta.
AB  - Amelogenesis imperfecta (AI) is a heterogeneous group of inherited disorders of
      defective enamel formation. The major protein involved in enamel formation,
      amelogenin, is encoded by a gene located at Xp22.1-Xp22.3. This study
      investigated the molecular defect producing a combined phenotype of hypoplasia
      and hypomineralization in a family with the clinical features and inheritance
      pattern of X-linked amelogenesis imperfecta (XAI). Genomic DNA was prepared from
      buccal cells sampled from family members. The DNA was subjected to the polymerase
      chain-reaction (PCR) in the presence of a series of oligonucleotide primers
      designed to amplify all 7 exons of the amelogenin gene. Cloning and sequencing of
      the purified amplification products identified a cytosine deletion in exon VI at
      codon 119. The deletion resulted in a frameshift mutation, introducing a
      premature stop signal at codon 126, producing a truncated protein lacking the
      terminal 18 amino acids. Identifying mutations assists our understanding of the
      important functional domains within the gene, and finding another novel mutation
      emphasizes the need for family-specific diagnosis of amelogenesis imperfecta.

PMID- 11201049
TI  - An empirical test of the validity of the Oral Health Status Index (OHSI) on a
      minority population.
AB  - Disease varies in different populations based on sociodemographic variables, and
      there is limited understanding of this interaction. The purpose of this
      methodological study was to determine the validity of the Oral Health Status
      Index, a disease-based index, on a Hispanic population by comparing it with the
      NIDCR epidemiological measures of disease, with the addition of demographic and
      behavioral variables. The epidemiologic data were collected according to the
      criteria defined by the NIDCR, including: a modified Decayed Missing Filled
      Surfaces Index, gingival inflammation, calculus, and destructive periodontal
      disease measures. The demographic and behavioral variables were gathered from 240
      interviews with Hispanic adults in two community clinics. Bivariate analysis was
      used to determine relationships between the descriptive epidemiologic,
      demographic, and behavioral variables and the Oral Health Status Index (OHSI).
      There were statistically significant differences (p < 0.05) in mean OHSI scores
      among the demographic variables age, education, income, and place of birth; and
      the behavioral variables alcohol consumption, flossing, and acculturation.
      Multiple regression analysis with the OHSI as the dependent variable showed that
      the statistically significant (p < 0.001) epidemiologic predictors were:
      percentage of Decayed Teeth/Decayed, Filled Teeth; Number of Replaced
      Teeth/Missing Teeth; and millimeters of mesial attachment loss. These
      collectively explained 47.49% of the variance in the regression. The addition of
      demographic variables to the epidemiologic regression identified age (p < 0.05),
      gender (p < 0.01), and place of birth (p < 0.01) as significant predictors that
      explained an additional 4.12% of the variance, collectively bringing the total
      explained variance to 51.61%. The behavioral variables did not contribute
      significantly to predicting the OHSI regression score. The Oral Health Status
      Index in this study is validated by its correlation with both the epidemiologic
      measures and the demographic variables. This combination of variables separated
      the Hispanics into Mexicans and Central/South Americans.

PMID- 11201050
TI  - Dentists' judgment strategies on prophylactic removal of mandibular third molars.
AB  - The number of molars selected for prophylactic removal varies widely among
      general dental practitioners and oral surgeons. To understand the basis for such
      variations, we investigated two hypotheses: (1) Individual judgment strategies
      will differ concerning the use of cues (items of information), and (2) few
      dentists will integrate the cues according to evidence in the literature. To
      analyze 30 general dental practitioners' (GDPs) and 10 oral surgeons' use of cues
      in the judgment preceding the treatment decision, we used the Brunwik's lens as a
      conceptual model. The cues were the patient's age, and the angular position and
      the degree of impaction of the molar. The clinical situation was simulated by
      written case descriptions. The proportion of variation explained by the cues and
      their combinations (total model) varied between 61% and 100% and between 4% and
      76% as main effects. Two GDPs and one oral surgeon integrated the cues
      additively, i.e., any of the cues is independent of the other cues in the
      judgment. In general, the dentists integrated the cues interactively, i.e., the
      impact of one cue depends on the levels of some other cues. Even though most
      variations in judgments were accounted for by the cues, the dentists did not
      integrate the cues according to evidence in the literature and lacked insight
      into their decision-making thought processes.

PMID- 11201051
TI  - RGD peptide-induced apoptosis in human leukemia HL-60 cells requires caspase-3
      activation.
AB  - RGD motif-containing peptides have been used in various studies of cell adhesion
      and growth. We report that RGD triggered apoptosis at a concentration of 1
      mmol/L, whereas RAD-containing peptides failed to induce apoptosis in HL-60
      cells. RGD-treated cells revealed internucleosomal DNA fragmentation. Western
      blot reveals caspase-3 activation in RGD peptide-treated cells. A caspase-3
      inhibitor z-VAD-FMK completely blocked the apoptosis, but a caspase-1 inhibitor
      (Ac-YVAD-CMK) and caspase-2 inhibitor (z-VDVAD-FMK) did not block the apoptosis,
      suggesting that caspase-3 might have a critical role in the execution process of
      apoptosis induced by RGD. RGD peptides have been used extensively to inhibit
      tumor metastasis. Our results should help in further understanding the RGD
      peptide-induced apoptosis, which is important since RGD peptides have a potential
      role in therapies of the future.

PMID- 11201052
TI  - In vitro genotoxicity of terbutryn evaluated by the alkaline single-cell microgel
      electrophoresis "comet" assay.
AB  - Terbutryn, a s-triazine herbicide, is extensively used in agriculture as a
      selective pre- and postemergence control agent for most grasses and many annual
      broadleaf weeds in cereal and legume fields, and under fruit trees. Terbutryn was
      reported to degrade slowly, with half-lives of 240 and 180 days in pond and river
      sediment, respectively. The tendency of this herbicide to move from treated soils
      to water compartments through water runoff and leaching was demonstrated and
      residual amounts of terbutryn and its metabolites have been found in drinking
      water, and industrial food products, long after application. Although this
      herbicide may be regarded as a contaminant of our environment, only limited and
      inconsistent data exist concerning its genotoxic properties. In this study, the
      DNA-damaging ability of the herbicide was evaluated in the alkaline single-cell
      microgel-electrophoresis ("comet") assay by testing terbutryn in the presence of
      S9mix (rat liver homogenate containing microsomal enzymes plus cofactors)
      prepared with liver homogenate from both uninduced (basal) and aroclor 1254
      induced rats. DNA damage was recorded in freshly isolated human peripheral blood
      leukocytes. A statistically significant increase in the extent of primary DNA
      damage, more pronounced in the absence of S9mix, took place only when terbutryn
      concentrations were high (100 and 150 microg/ml), in the presence of a
      concomitant mild cytotoxic effect.

PMID- 11201053
TI  - Successful separation of apoptosis and necrosis pathways in HaCaT keratinocyte
      cells induced by UVB irradiation.
AB  - UVB irradiation can induce apoptotic, necrotic, and differentiation pathways in
      normal human keratinocytes. The present study was undertaken to determine at what
      dose of UVB each of these pathways is induced and whether these pathways are
      distinct or overlapping. We have observed that UVB induces fragmentation of DNA
      in human HaCaT keratinocytes, in a bimodal manner. Low doses of UVB, 5-20 mJ/cm2,
      increase the levels of apoptosis as shown by increased levels of fragmented DNA,
      Fas, PARP, and FasL protein, and the number of apoptotic cells as assessed by
      FACS analysis. At higher doses of UVB (20 and 30 mJ/cm2) the number of apoptotic
      cells becomes reduced, as does the amount of Fas, PARP, and FasL protein. At
      these higher doses, cell viability is decreased as measured by DNA synthesis
      (BrdU labeling) neutral red uptake, which represents an increasing necrotic
      phenotype. Expression of markers of keratinocyte differentiation, involucrin,
      keratin K1, and keratin K10, are also observed to decrease with increasing UVB
      dose. These changes are accompanied by a further increase in DNA fragmentation.
      We conclude that low doses of UVB (5-20 mJ/cm2) induced an apoptotic pathway,
      whereas increasing doses (greater than 20 mJ/cm2) of UVB produce a direct
      necrotic effect and inhibit terminal differentiation.

PMID- 11201054
TI  - UVA-induced oxidative damage in retinal pigment epithelial cells after H2O2 or
      sparfloxacin exposure.
AB  - Retinal impairment is one of the leading causes of visual loss in an aging human
      population. To explore a possible cause for retinal damage in the human
      population, we have monitored DNA oxidation in human retinal pigment epithelial
      (RPE) cells after exposure to hydrogen peroxide (H2O2) or the quinolone
      antibacterial sparfloxacin. When H2O2- or sparfloxacin-exposed cells were further
      exposed to ultraviolet A (UVA) irradiation, oxidative damage to the DNA of these
      cells was greatly increased over baseline values. This RPE+pharmaceutical-UVA
      cell system was developed to mimic in vivo retinal degeneration, seen in mouse
      studies using quinolone and UVA exposure. DNA damage produced by sparfloxacin and
      UVA in RPE cells could be remedied by the use of antioxidants, indicating a
      possible in vivo method for prevention or minimization of retinal damage in
      humans

PMID- 11201055
TI  - Inhibition of platelet function by GSTM1-null human peripheral lymphocytes
      exposed to benzo(a)pyrene-induced challenge.
AB  - Recent epidemiological studies proposed that the glutathione S-transferase (GST)
      M1-null genotype may contribute to diseases associated with oxidative stress. The
      genetic polymorphism exhibited by the GSTM1 may be an important factor in risk
      toward oxidant chemicals. In this study, we investigated the effect of GSTM1-null
      genotype in lymphocyte and oxidative stress-dependent inhibition of platelet
      aggregation. To determine whether GSTM1 deficiency is a genetic determinant of
      cell toxicity toward oxidant chemicals, lymphocytes were incubated in vitro with
      low levels of benzo(a)pyrene (BaP), cumene hydroperoxide (CumOOH), or trans
      stilbene oxide that do not decrease cell viability, and were assessed for
      oxidative damage and for the lymphocyte-dependent inhibition of platelet
      response. Malondialdehyde and carbonyl levels, and the oxidation of cisparinaric
      acid, were used as biomarkers of oxidative stress in lymphocytes. Following
      stimulation by BaP or CumOOH, when peroxidation-dependent changes in these
      parameters were compared between the GSTM1-null genotype and the positive
      genotype, no significant differences were found between the two genotypes. On the
      other hand, preincubation of the lymphocytes with BaP or CumOOH attenuated their
      inhibitory action on ADP-induced platelet aggregation. However, our results
      indicate that lymphocytes of individuals with the GSTM1-null genotype have
      greater inhibitory activity on platelet function after exposure to BaP, but not
      CumOOH, although they are not more susceptible to in vitro oxidative stress.

PMID- 11201057
TI  - Lipopolysaccharide induces distinct alterations in the microtubule cytoskeleton
      of monocytes.
AB  - Microtubules are obligate functional elements of almost all eukaryotic cells.
      They are involved in a broad range of essential cellular functions and structural
      changes of this system may trigger cell death. Recently, we have reported that
      lipopolysaccharides inhibit in vitro microtubule formation due to exclusion of
      microtubule-associated proteins. The distinct epitopes of lipopolysaccharides
      responsible for these effects and the in vivo relevance of these data are
      unknown. Therefore, this study was conducted to elucidate the effects of lipid A,
      the biologically active motif of lipopolysaccharides, on microtubule formation in
      vitro and to prove whether lipopolysaccharides affect the microtubule
      architecture of cultured human monocytes in vivo. Despite a dose- and pH
      dependent inhibition of microtubule formation by lipopolysaccharides, inhibition
      of microtubule assembly could be mimicked by lipid A. Near-infrared two-photon
      microscopy revealed that human peripheral blood monocytes accumulate
      lipopolysaccharides. A vesicular distribution pattern of lipopolysaccharides
      within the monocytes was observed. Confocal laser scanning microscopy
      demonstrated alterations in the microtubule architecture of monocytes after
      incubation with lipopolysaccharides. Lipid A seems to be responsible for the
      observed crosstalk between lipopolysaccharides and microtubule proteins.
      Furthermore, our data indicate that lipopoly-saccharides may affect the
      microtubule architecture in human monocytes after intracellular accumulation
      directly. Therefore, we conclude, that the microtubule cytoskeleton is an
      essential intracellular target for sepsis-relevant bacterial components such as
      lipopolysaccharides.

PMID- 11201056
TI  - Regulation of phenobarbital-induction of CYP2B and CYP3A genes in rat cultured
      hepatocytes: involvement of several serine/threonine protein kinases and
      phosphatases.
AB  - We investigated the involvement of diverse protein kinases and phosphatases in
      the transduction pathways elicited by phenobarbital (PB), a well-known inducer of
      some hepatic cytochromes P450 (CYP). Different inhibitors or activators of
      protein kinases or phosphatases were assessed for their ability to modulate PB
      induction of CYP2B and CYP3A mRNA expression. Rat hepatocytes in primary culture
      were treated with the test compounds one hour prior to, and then continuously, in
      the absence or presence of 1 mmol/L PB for 24 h. By northern blot analysis of
      CYP2B1/2 and 3A1/2 gene expression, we first confirmed the negative role of the
      adenosine 3':5' cyclic monophosphate (cAMP)/protein kinase A pathway and the
      positive role of some serine/threonine protein phosphatases in the mechanism of
      PB-induction. The present data further suggested that Ca2+/calmodulin-dependent
      protein kinases II (independently of Ca2+) and extracellular signal-regulated
      kinases 1/2 (ERK1/2) might function respectively as positive and negative
      regulator in the PB-induction of CYP2B and CYP3A. In contrast, protein kinases C
      and phosphatidylinositol-3-kinase did not appear to be involved, while the role
      of tyrosine kinases remained unclear. We conclude that a complex network of
      phosphorylation/dephosphorylation events might be crucial for PB-induction of rat
      CYP2B and CYP3A.

PMID- 11201058
TI  - Intentionality, systems thinking, and collaboration: lessons for leadership from
      Congress 2000.

PMID- 11201059
TI  - Continuing education meets the learning organization: the challenge of a systems
      approach to patient safety.
AB  - Since the release of the report of the Institute of Medicine on medical errors
      and patient safety in November 1999, health policy makers and health care leaders
      in several nations have sought solutions that will improve the safety of health
      care. This attention to patient safety has high-lighted the importance of a
      learning approach and a systems approach to quality measurement and improvement.
      Balanced with the need for public disclosure of performance, confidential
      reporting with feedback is one of the prime ways that nations such as the United
      States, Canada, the United Kingdom, and Australia have approached this challenge.
      In the United States, the Quality Interagency Coordination Task Force has
      convened federal agencies that are involved in health care quality improvement
      for a coordinated initiative. Based on an investment in a strong research
      foundation in health care quality measurement and improvement, there are eight
      key lessons for continuing education if it is to parlay the interest in patient
      safety into enhanced continuing education and quality improvement in learning
      health care systems. The themes for these lessons are (1) informatics for
      information, (2) guidelines as learning tools, (3) learning from opinion leaders,
      (4) learning from the patient, (5) decision support systems, (6) the team
      learning together, (7) learning organizations, and (8) just-in-time and point-of
      care delivery.

PMID- 11201060
TI  - Shifting the culture of continuing medical education: what needs to happen and
      why is it so difficult?
AB  - A revolution in health care is occurring as a result of changes in the practice
      of medicine and in society. These include changing demographics and the pattern
      of disease; new technologies; changes in health care delivery; increasing
      consumerism, patient empowerment, and autonomy; an emphasis on effectiveness and
      efficiency; and changing professional roles. The issues raised by these changes
      present challenges for the content and delivery of the whole continuum of medical
      education. The ways in which continuing medical education (CME) needs to respond
      to these challenges are outlined. The Informed Shared Decision Making (ISDM)
      Project at the University of British Columbia is used as a case study to
      illustrate some of the practical problems in providing CME that address these
      current trends in health care, is effective, and is attractive to physicians. Two
      particular problems are posed: how to respond to a demonstrated need when there
      is no perceived need on the part of physicians and how to enable change agents on
      the margins to develop allies and get ownership from stakeholders and opinion
      leaders on the inside. Two strategies for change are discussed: the substantive
      incorporation of CME into the continuum of medical education and the involvement
      of patients in the planning and delivery of CME. A final challenge is raised for
      the leaders of CME to define and agree what "shifting the culture of CME" means
      and to make a commitment of time and energy into making it happen.

PMID- 11201061
TI  - Education in the workplace for the physician: clinical management states as an
      organizing framework.
AB  - Medical educators are interested in approaches to making selected relevant
      knowledge available in the context of problem-based care. This is of value both
      during the process of care and as a means of organizing information for offline
      self-study. Four trends in health information technology are relevant to
      achieving the goal and can be expected to play a growing role in the future.
      First, health care enterprises are developing approaches for access to
      information resources related to the care of a patient, including clinical data
      and images but also communication tools, referral and other logistic tools,
      decision support, and educational materials. Second, information for patients and
      methods for patient-doctor interaction and decision making are becoming
      available. Third, computer-based methods for representation of practice
      guidelines are being developed to support applications that can incorporate their
      logic. Finally, considering patients as being in particular "clinical management
      states" (or CMSs) for specific problems, approaches are being developed to use
      guidelines as a kind of "predictive" framework to enable development of
      interfaces for problem-based clinical encounters. The guidelines for a CMS can be
      used to identify the kinds of resources specifically needed for clinical
      encounters of that type. As the above trends converge to produce problem-specific
      environments, professional specialty organizations and continuing medical
      education course designers will need to focus energies on organizing and updating
      medical knowledge to make it available in CMS-specific contexts.

PMID- 11201062
TI  - Preventing "information overdose": developing information-literate practitioners.
AB  - The practice of medicine has been transformed by the convergence of a number of
      trends and developments. These include changes in the regulatory environment,
      scientific advances, the emergence of pressures for evidence-based medicine,
      advances in pharmaceutical knowledge and manufacture, and a shift in the nature
      of the patient/provider relationship. Many of these circumstances have been
      brought about or amplified by a variety of technological innovations.
      Collectively, these changes necessitate continuing--perhaps even continuous-
      learning and adaptation on the part of both new and established practitioners. At
      the heart of this need is the explosion of information and of information
      technologies, which shows little sign of abating. However, it is not simply the
      volume of information nor even its form that poses a challenge. It is also that
      outdated, incorrect, or unproven information is as accessible as correct,
      defensible, and reliable information. Therefore, doctors must be equipped not
      only with the ability to locate information but to evaluate its relevance and
      credibility. In short, they must be "information literate." Since both
      information and the technologies that give access to it are constantly expanding,
      a practitioner can never claim to be "information literate" in any absolute or
      final sense. It is a constantly evolving attribute and, alongside biomedical,
      clinical, pharmaceutical, legislative, and other domains, needs to form part of
      the provision of continuing education. Five propositions are advanced concerning
      this particular aspect of continuing medical education, and the article concludes
      by arguing that, in the same way that educating patients is the best defense
      against accidental overdose in the pharmaceutical sense, the best way to prevent
      "information overdose" is the education of practitioners.

PMID- 11201063
TI  - Using theory and research to shape the practice of continuing professional
      development.
AB  - As research has expanded in scope and diversity, application of new ideas to the
      programs that facilitate learning and change should have grown accordingly.
      However, the gap between the theories of how and why physicians learn and change
      their practices and the practical application of these theories appears to be
      wider. The research component of research and development in continuing
      professional development appears to be strong, but the development function
      appears to be weak. This presentation will describe some of the factors that have
      led to this gap between theory and practice and suggest some actions that may be
      taken to reduce this gap. Among the factors leading to the gap are the different
      perspectives of practitioners and scholars as to the purposes of research, the
      appropriate foci of studies, and the attributes of quality of studies related to
      continuing professional development. A traditional model of research is discussed
      and analyzed for its strengths and weaknesses as they relate to writing research
      that is relevant to practitioners. The role and function of the research problem
      and the conclusions of studies are described in terms of how these two parts of a
      research report can assist in the translation of theory and evidence into the
      practice. In order to illustrate how theory may be translated into practical
      tools and procedures, the application of the theory of change and learning to the
      assessment of readiness to change is reviewed briefly. Implications of this
      experience are described and steps that may be helpful in bridging the gap
      between theory and practice will be proposed. Finally, a system of research and
      development that can ensure a tighter link between research and practice is
      proposed. The next steps to achieve this kind of system are suggested in the
      conclusions.

PMID- 11201064
TI  - Congress 2000: a continuing medical education summit with implications for the
      future.
AB  - The expectations of attendees, the evaluations of themes, and the implications
      for continuing medical education (CME) identified by "Congress 2000: A Continuing
      Medical Education Summit on the Practices, Opportunities and Priorities for the
      New Millennium" are reviewed. A vision was identified with significant
      opportunities for CME to become a more valuable partner in and contributor to
      quality health care. The vision suggests that CME should be linked more closely
      to physician learning at the point of care and that technology might be used more
      successfully to address physician-learner needs by helping them to manage volumes
      of evidence for treating patients more effectively. At the same time, health care
      outcome data to analyze the need for and measure the effectiveness of educational
      interventions should become integrated into standards of practice for CME
      providers. Continuous improvement based on research about effective learning
      processes and outcomes should become an essential construct of the CME culture.
      Implications are summarized for the profession, organizational CME providers,
      individual CME professionals, and CME research from this new vision of CME
      crafted at Congress 2000.

PMID- 11201065
TI  - Neuromagnetic localization of N15, the initial cortical response to lip stimulus.
AB  - The initial cortical response of the trigeminal somatosensory evoked magnetic
      fields was measured for electrical stimulation of the lower lip in eleven
      subjects. The stimulus frequency was 0.7 Hz and stimulus intensity was nine times
      sensory threshold. The initial contralateral response was detected in 20
      hemispheres at a latency of 14.6+/-1.3 ms and was named N15m. The equivalent
      current dipole of N15m was localized at the posterior bank of the central sulcus
      with anterior-superior orientation, and inferior to the dipole of N20m for median
      nerve stimulation.

PMID- 11201066
TI  - Postnatal expression of VEGF and its receptor flk-1 in peripheral ganglia.
AB  - The postnatal (P0-P12) and adult expression of vascular endothelial growth factor
      and its receptor flk-1 was investigated in superior cervical (SCG) and dorsal
      root ganglia (DRG) in mice by immunocytochemistry. At P0 all neurons in SCG and
      DRG contained VEGF. The number of VEGF-immunoreactive neurons in DRG but not in
      SCG, decreased postnatally and reached adult levels (34%) at P12. At P0 flk-1 was
      found in virtually all neurons in the SCG and in roughly half of the neurons in
      DRG. The number of flk-1 positive neurons then decreased and reached adult levels
      at P12. The findings demonstrate temporal changes in VEGF and flk-1 expression,
      suggesting developmental regulation of VEGF activity in peripheral ganglia.

PMID- 11201067
TI  - Interleukin-2 and interleukin-4 increase the survival of retinal ganglion cells
      in culture.
AB  - Natural cell death is a degenerative phenomenon observed during the normal
      development of the nervous system. The neuroprotective effects of cytokines
      produced by neuronal, glial or infiltrating cells on neurons have been
      extensively studied. In this work we studied the role of interleukin (IL)-2 and
      IL-4 on the survival of retinal ganglion cells (RGC) after 48 h in culture. Our
      results demonstrate that the effect of both ILs was dose-dependent and the
      treatment with either IL-2 (50 U/ml) or IL-4 (5 U/ml) induced a 2-fold increase
      in RGC survival. The effect of IL-4, but not of IL-2, was totally abolished by
      either 20 microM 5-fluoro-2'-deoxyuridine, an inhibitor of cell proliferation, or
      by 1 microM telenzepine, an inhibitor of M1 muscarinic receptor. Our results
      suggest that both cytokines could play an important role during the development
      of retinal tissue as well as during retina trauma.

PMID- 11201068
TI  - Clozapine, but not haloperidol, reverses social behavior deficit in mice during
      withdrawal from chronic phencyclidine treatment.
AB  - Phencyclidine (PCP) reduced social behavior (SB) in a dose- and time-dependent
      fashion. However, no such SB deficit was observed on repeated treatment with
      methamphetamine for 14 days. The SB deficit produced by treatment with PCP (10
      mg/kg/day) for 14 days, which persisted for 28 days after withdrawal, was
      attenuated by clozapine (10 mg/kg/day) given for 7 days, whereas haloperidol for
      7 days had no effect. Clozapine, but not haloperidol, alone at the same treatment
      dose increased SB in saline-treated mice. These results suggest that the proposed
      PCP model in mice will provide a tool to test beneficial effects of atypical
      antipsychotics on social dysfunction in schizophrenia, and contribute to our
      understanding of the mechanisms by which clozapine improves SB deficit.

PMID- 11201069
TI  - Effects of learning on cytochrome oxidase activity in cuttlefish brain.
AB  - Using cytochrome oxidase (CO) histochemistry, the effects of instrumental
      conditioning in cuttlefish central nervous system were examined. The posterior
      superior frontal lobe showed an increase of CO labelling just after training,
      whereas the anterior superior frontal lobe exhibited a decrease of CO staining 24
      h post-training. These findings provide the first metabolic evidence for the
      involvement of the superior frontal lobe in learning and memory processes in
      cuttlefish. It is concluded that CO histochemistry can be used to provide a
      functional mapping of learning-induced plasticity in cuttlefish brain.

PMID- 11201070
TI  - Phencyclidine (PCP)-induced deficits of prepulse inhibition in monkeys.
AB  - Prepulse inhibition (PPI) of the acoustic startle reflex is a measure of
      sensorimotor gating which occurs in both rodents and humans. PPI is deficient in
      severe neuropsychiatric disorders such as schizophrenia. We investigated PPI in
      10 adult monkeys (Cebus apella). Stimuli were 115 dB white noise startle pulses,
      either alone or preceded by 120 ms with a prepulse of either 8 or 16 dB above the
      70 dB background noise. Experiments included a pretreatment baseline session and
      a session following treatment with either phencyclidine (PCP, 0.12 mg/kg, i.m.)
      or saline. Comparison of peak amplitudes indicated a significant intensity
      dependent decrease in startle response that was similar to that observed in
      humans under similar experimental conditions. PCP treatment significantly
      disrupted PPI, but did not reduce responses to startle pulses alone. These
      results provide the first demonstration of PPI in monkeys. The ability of PCP to
      induce schizophrenia-like deficits in PPI suggests that PPI in nonhuman primates
      may provide an important animal model for the development of novel anti
      schizophrenia medications.

PMID- 11201071
TI  - Nitric oxide modulates articular sensory discharge and responsiveness to
      bradykinin in normal and arthritic rats in vivo.
AB  - Nitric oxide is implicated in peripheral nociceptive processing. This study
      determined the effects of the nitric oxide synthase inhibitor, L-NAME, on neural
      discharge from articular C-fibre afferents innervating normal and arthritic ankle
      joints in anaesthetized rats. Intra-arterial injection of L-NAME (10-20 mg kg(
      1)) increased neural discharge in normal and arthritic ankle joints, whereas D
      NAME (30 mg kg(-1)) had no effect. The excitation induced by L-NAME (20 mg kg(
      1)) was reduced by co-injecting the nitric oxide precursor, L-arginine (50 mg kg(
      1)). L-NAME (20 mg kg(-1)) also enhanced responsiveness to bradykinin (10 microg)
      but only in arthritic rats, whereas L-arginine (50 mg kg(-1)) reduced the
      excitation by bradykinin (30 microg) in both groups. These results provide
      evidence that nitric oxide modulates articular C-fibre activity and reduces
      responsiveness to bradykinin.

PMID- 11201072
TI  - Additive effect of mPer1 and mPer2 antisense oligonucleotides on light-induced
      phase shift.
AB  - It is well known that light induces both mPer1 and mPer2 mRNA in the
      suprachiasmatic nucleus. We have reported that mPer1 antisense oligonucleotides
      (ODNs) inhibited the light-induced phase delays of mouse locomotor rhythm. In
      this study, we asked whether both or either mPer1 or mPer2 expression is
      necessary to induce the phase shift. We examined the effects of inhibition of
      mRNA expression on light-induced phase delays of mouse circadian behavior rhythm.
      Light-induced phase delays were moderately attenuated by microinjection of mPer1
      or mPer2 antisense ODN, but not by mPer3 antisense or mPer1, mPer2 scrambled
      ODNs, whereas following simultaneous injection of both mPer1 and mPer2 antisense
      ODNs they disappeared. The present results suggest that acute induction of mPer1
      and mPer2 gene play an additive effect on photic entrainment.

PMID- 11201073
TI  - Roles for nitric oxide and arachidonic acid in the induction of heterosynaptic
      cerebellar LTD.
AB  - In cerebellar slices conjunctive pairing of parallel fibre (PF) stimulation with
      depolarization of Purkinje cells (PCs) induces a long-term depression (LTD) of PF
      synaptic transmission that spreads to unpaired PF inputs to the same cell.
      Inhibitors of NO synthase (7-nitro-indazole), soluble guanylate cyclase (ODQ) and
      PKG (KT5823) all prevented depression at each of two independent PF pathways to a
      single PC. Inhibition of NOS also unmasked a platelet activating factor (PAF)
      mediated synaptic potentiation of possible presynaptic origin. LTD was also
      prevented by the phospholipase A2 inhibitor OBAA but was rescued by co-perfusion
      with arachidonic acid. We conclude that NO and diffusible products of
      phospholipase A2 metabolism are potential mediators of the spread of cerebellar
      plasticity at the single cell level.

PMID- 11201074
TI  - Peripheral neuroglial death induced by cisplatin administration in newborn rats.
AB  - To determine the target of cytotoxicity of cisplatin (CDDP), we injected newborn
      rats with 2 mg/kg CDDP and examined the trigeminal ganglion for possible cell
      death. A nick translation method for DNA fragmentation revealed CDDP-induced
      glial cell death. DNA fragmentation was detected in both Schwann cells and
      satellite cells. Satellite cell death was observed as early as 0.5 day after
      injection, most frequent at 1-3 days and subsided thereafter. The incidence of
      neuronal death was very low and comparable to that observed in vehicle control
      rats. CDDP has selective toxicity to peripheral glial cells, though the damage
      did not culminate in cell death in adults. The glial toxicity may contribute to
      clinical symptoms of CDDP neuropathy.

PMID- 11201076
TI  - Modulation of alpha2beta4 neuronal nicotinic acetylcholine receptors by zinc.
AB  - A study was made of the modulation of nicotinic acetylcholine receptors by the
      divalent cation zinc. Rat neuronal nicotinic receptors (alpha2beta4) were
      expressed in Xenopus oocytes and membrane currents evoked by acetylcholine (ACh
      currents) were recorded using a two microelectrode voltage clamp. In non-injected
      oocytes, or in oocytes expressing alpha2beta4 receptors, Zn2+ by itself (1 microM
      4 mM) generated only very small membrane currents. In contrast, in oocytes
      expressing alpha2beta4 receptors, Zn2+ greatly and reversibly increased the ACh
      current, without affecting considerably its time course. The ACh current
      potentiation by Zn2+ was weakly dependent on the membrane potential (2.33+/-0.10
      times the control current at -100 mV vs 2.04+/-0.06 at -60 mV, suggesting that
      Zn2+ interacts with the receptor in the vestibule of the ion channel or at an
      external domain of the protein. The inward rectification of control and Zn2+
      potentiated ACh-currents was similar. We conclude that Zn2+ positively and
      reversibly modulates neuronal nicotinic receptors in a practically voltage
      independent manner and without affecting their rate of desensitization. These
      results will help to understand better the roles played by Zn2+ in brain
      functions.

PMID- 11201075
TI  - Induction of hippocampal glial cells expressing basic fibroblast growth factor
      RNA by corticosterone.
AB  - A transcriptional regulation of bFGF expression via both gluco- and
      mineralocorticoid receptors is known to exist. In the present study the glial
      nuclear fraction of bFGF transcripts was studied in sham-operated (SHAM),
      adrenalectomized (ADX), and corticosterone-treated ADX rats in subregions of the
      dorsal hippocampal formation. A substantial increase was observed in the
      population of bFGF RNA-expressing glial cells after acute corticosterone
      treatment (10 mg/kg, s.c.) in subregions of the CA1 area and the dentate gyrus
      but no changes were observed after adrenalectomy. The levels of glial nuclear
      bFGF transcripts were similar in all the experimental groups. These data suggest
      that in a subpopulation of hippocampal glial cells corticosterone regulates bFGF
      gene expression transcriptionally in an on/off manner.

PMID- 11201077
TI  - Galanin/alpha2-adrenoceptor interactions in telencephalic and diencephalic
      regions of the rat.
AB  - The aim of this study was to evaluate whether galanin could affect central alpha2
      adrenoceptors in telencephalic and diencephalic regions in the rat using
      quantitative receptor autoradiography with the alpha2 agonist radioligand [3H]p
      aminoclonidine. Galanin 1 nM significantly and substantially increased the Kd
      value of the [3H]p-aminoclonidine binding sites in the medial hypothalamus and
      amygdala by 86% (p < 0.01) and 73% (p < 0.05) respectively. The Bmax value was
      only significantly increased with 3 nM galanin in the amygdala and the medial
      hypothalamus (both p < 0.05). The antagonist M35 counteracted the increase of the
      Kd values of the alpha2-adrenoceptor agonist binding sites produced by galanin 1
      nM in the amygdala and the medial hypothalamus (both p < 0.001). These findings
      suggest the existence of an antagonistic galanin/alpha2 adrenoceptor interaction
      in the medial hypothalamus and amygdala that may be of relevance for alpha2
      adrenoceptor-regulated neuroendocrine functions and food intake.

PMID- 11201078
TI  - Action monitoring, error detection, and the basal ganglia: an ERP study.
AB  - The error negativity (Ne or ERN) is an event-related brain potential component,
      which is assumed to reflect error detection. Recently it has been hypothesized
      that the basal ganglia are assumed to play a crucial role in error detection. In
      the present study we ask whether the Ne is altered in patients with Parkinson's
      disease (PD), who have an impaired function of the basal ganglia. We recorded the
      Ne in patients and in matched controls, while they performed different tasks that
      require a relatively high cognitive control, which is supposed to pose particular
      problems on PD. The Ne was in fact smaller in the patients than in the controls
      in all tasks. Our results suggest an impairment of error detection in PD for
      different types of demanding tasks. This supports the hypothesis that the basal
      ganglia do play an important role for error detection in action monitoring.

PMID- 11201079
TI  - Calcium inhibits willardiine-induced responses in kainate receptor GluR6(Q)/KA-2.
AB  - A number of studies have demonstrated that willardiine [(S)-1-(2-amino-2
      carboxyethyl) pyrimidine-2,4-dione] is a useful agonist for the activation of
      AMPA/kainate receptors. Here we examine the effect of extracellular calcium on
      currents evoked by willardiine in HEK 293 cells expressing the GluR6(Q)/KA-2
      kainate receptor subunits. At a concentration of 1.8 mM, Ca2+ inhibited the
      currents induced by 100 microM willardiine by approximately 50%. When
      extracellular Na+ ions were replaced with Ca2+ ions there were no measurable
      inward currents. We conclude that Ca2+ inhibition of the willardiine-induced
      response is concentration dependent.

PMID- 11201080
TI  - Timbre-specific enhancement of auditory cortical representations in musicians.
AB  - Neural imaging studies have shown that the brains of skilled musicians respond
      differently to musical stimuli than do the brains of non-musicians, particularly
      for musicians who commenced practice at an early age. Whether brain attributes
      related to musical skill are attributable to musical practice or are hereditary
      traits that influence the decision to train musically is a subject of
      controversy, owing to its pedagogic implications. Here we report that auditory
      cortical representations measured neuromagnetically for tones of different timbre
      (violin and trumpet) are enhanced compared to sine tones in violinists and
      trumpeters, preferentially for timbres of the instrument of training. Timbre
      specificity is predicted by a principle of use-dependent plasticity and imposes
      new requirements on nativistic accounts of brain attributes associated with
      musical skill.

PMID- 11201081
TI  - Electron microscopic evidence for different myelination of rat septohippocampal
      fibres.
AB  - Rat septohippocampal fibres are known to originate from GABAergic parvalbumin
      containing, fast-firing, fast-conducting neurons and from cholinergic slow
      firing, slow-conducting neurons. In the present electron microscopic study, based
      on immunocytochemical demonstration of parvalbumin and choline acetyltransferase
      in transverse and horizontal septal sections, it was shown that parvalbumin
      immunoreactive fibres are myelinated, but the vast majority of cholinergic fibres
      are not. As revealed, especially in horizontal sections, the cholinergic axons
      show considerably finer calibres than parvalbumin-containing ones. These results
      confirm and extend our previous light microscopic findings. It can be concluded
      that differences in conduction velocities, presence or absence of myelin sheaths
      and differences axonal diameters are correlated in the septohippocampal pathway.

PMID- 11201082
TI  - Decrease in spinal CGRP and substance P is not related to neuropathic pain in a
      rat model.
AB  - We tested the hypothesis that the decrease in spinal levels of SP and CGRP after
      peripheral nerve injury is related to neuropathic pain. We compared two groups of
      rats, both of which were subjected to unilateral transection of the inferior and
      superior caudal trunks between the S1 and S2 spinal nerves. One group exhibited
      well-developed neuropathic signs after the nerve injury, whereas the other group
      showed poorly developed signs despite the same nerve injury. The decrease in
      immunoreactivity of CGRP and SP in the S1 dorsal horn (injured segment) was not
      significantly different between the two groups. These results suggest that the
      decrease in spinal levels of CGRP and SP after peripheral nerve injury is not
      related to neuropathic pain.

PMID- 11201083
TI  - Early loss of dendritic spines in murine scrapie revealed by confocal analysis.
AB  - Confocal analysis of dye-filled neurons has revealed a significant early loss of
      dendritic spines in a murine scrapie model in which neuron loss occurs in the
      hippocampus. An 18% loss of spines was found at 109 days, > 50 days before neuron
      loss occurs, and by 126 days a 51% spine loss was found. Spine loss is concurrent
      with synapse loss, axon terminal degeneration and a decrease in long term
      potentiation in this model. Preceding these changes is the deposition of disease
      specific PrP at 70 days, which may initiate the damage to dendritic spines and
      the subsequent degeneration of synapses. We suggest that these changes underlie
      the development of clinical disease in the transmissible spongiform
      encephalopathies.

PMID- 11201084
TI  - Effect of brain-derived neurotrophic factor on the release of substance P from
      rat spinal cord.
AB  - Brain-derived neurotrophic factor (BDNF) can produce hyperalgesia in the adult
      rat. Here we assessed whether changes in the spinal release of the nociceptive
      peptide substance P (SP) contributes to this effect. Antibody-coated microprobes
      revealed a significant basal release of SP in the dorsal horn in vivo that was
      increased following acute knee inflammation. Microinjection of BDNF into the grey
      matter (0.5 microl, 10(-5) M) altered SP release neither in rats with normal
      knees nor in rats with inflamed knee joints. In the lumbar dorsal horn slice
      preparation in vitro, superfusion with BDNF (100 ng/ml) could reduce SP release
      evoked by electrical dorsal root stimulation without modyfing SP basal outflow.
      It is unlikely, therefore, that enhanced spinal SP release mediates the
      hyperalgesic effect of BDNF.

PMID- 11201085
TI  - Intercellular action of nitric oxide increases cGMP in cerebellar Purkinje cells.
AB  - cGMP is thought to play a role in cerebellar signalling yet its production within
      Purkinje cells has never been detected. In the present study, the hydrolysis of a
      fluorescent substrate analogue, 2'-O-anthranyloyl cyclic GMP, by type 5
      phosphodiesterase was monitored within Purkinje cells in slices and in culture.
      Nitric oxide, either endogenously released from adjacent neurons or
      pharmacologically applied, accelerated the rate of hydrolysis in a manner that
      was dependent on soluble guanylyl cyclase, demonstrating that nitric oxide
      triggers cyclic GMP production in Purkinje cells, which in turn activates type 5
      phosphodiesterase. We conclude that NO acts as an intercellular messenger in the
      cerebellar cortex and that parallel fibre terminals are a probable source of
      nitric oxide.

PMID- 11201086
TI  - Transient expression of SorCS in developing telencephalic and mesencephalic
      structures of the mouse.
AB  - Here we describe the expression of a third member of the VPS10 domain containing
      receptor family, SorCS, during mouse embryonal and early postnatal nervous system
      development. SorCS is expressed in a unique transient and dynamic pattern in
      regions where cells proliferate, as well as in areas where already differentiated
      cells reside, including the cerebral cortex, the ventral tegmental area, and the
      globus pallidus. Transcripts were absent from fiber tracts hinting at a neuronal
      expression. The only exception was hybridization signals on the developing optic
      nerve correlating with the appearance of astrocytes migrating into the retina.

PMID- 11201087
TI  - Auditory event-related potentials differentiate patients with normal pressure
      hydrocephalus and patients with concomitant Alzheimer's disease verified by brain
      biopsy.
AB  - We studied 51 patients with clinical symptoms and CT findings suggesting normal
      pressure hydrocephalus (NPH). Tests included head MRI, auditory event-related
      potentials (ERPs), thorough neuropsychological testing and intraventricular
      intracranial 24 h pressure recording and infusion testing. A brain biopsy was
      also obtained to verify a concomitant dementing process (Alzheimer's disease;
      AD). Patients were divided into subgroups according to the need of shunt and the
      biopsy findings, and their ERPs were analysed blindly. The present results
      suggest that non-invasive ERPs aid in the differentiation of pure NPH from NPH
      with concomitant AD.

PMID- 11201088
TI  - Origins of spontaneous and noxious stimuli-evoked miniature EPSCs in substantia
      gelatinosa.
AB  - The origins of spontaneous and noxious stimuli-evoked glutamatergic miniature
      excitatory postsynaptic currents (mEPSCs) in substantia gelatinosa (SG) neurons
      were investigated by using whole-cell voltage-clamp technique on adult rat spinal
      cord slice. The properties of mEPSCs of SG neurons from rats either neonatally
      capsaicin-treated or sciatic nerve ligated showed no difference from those of
      intact SG neurons, indicating independence of spontaneous mEPSCs on primary
      afferent fibers. In the presence of tetrodotoxin (TTX), capsaicin, which
      noxiously stimulated fine primary afferent fibers, caused increase of the mEPSCs
      frequency, but did not affect the amplitude profiles or mean amplitudes. TTX
      affected neither the spontaneous mEPSCs nor capsaicin-induced mEPSCs frequency
      increase. The results suggest that spontaneous mEPSCs in SG are mediated by
      presynaptic spontaneous glutamate release predominantly originating from
      interneuron terminals rather than from primary afferent terminals; under noxious
      stimulation, however, mEPSCs frequency increase is mediated by primary afferent
      excitation.

PMID- 11201089
TI  - Synchronization of visual responses in the superior colliculus of awake cats.
AB  - Multi-unit responses to moving stimuli were recorded simultaneously from several
      sites in the superior colliculus of awake cats. Correlation analysis revealed
      that response synchronization was a prominent feature of visually evoked neural
      activity in both superficial and deep collicular layers. Responses at about half
      of the recordings separated by < or = 1 mm showed significant correlations. The
      synchronized responses oscillated in the gamma frequency range (30-70 Hz) which
      contrasts to conditions in anaesthetized cats where oscillations predominantly
      occurred in the alpha and beta frequency range (10-20 Hz). Response
      synchronization was most pronounced with coherent motion stimuli and broke down
      with incoherent stimuli. These results agree with previous findings on
      corticotectal synchronization and support the hypothesis that synchronization in
      the millisecond range serves to group collicular neurons into functionally
      coherent assemblies.

PMID- 11201090
TI  - Changes in spinal cholecystokinin release after peripheral axotomy.
AB  - The gene expression of cholecystokinin (CCK), a neuropeptide with anti-opioid
      properties, has been reported to be upregulated in some primary sensory neurons
      after a peripheral nerve lesion. We have recently demonstrated that the
      upregulation of CCK mRNA is not accompanied by an increased potassium-evoked
      release CCK-like immunoreactivity (CCK-LI) 2-4 weeks after a complete transection
      of the sciatic nerve. The potassium-evoked release of CCK-LI at earlier and later
      time points has, however, not been studied. The aim of the present in vivo
      microdialysis study was to monitor how the basal and stimulated extracellular
      level of CCK in the dorsal horn of the spinal cord is affected at various time
      points after a complete transection of the sciatic nerve (axotomy). During the
      first week after transection of the sciatic nerve a tendency towards an elevation
      of the potassium-induced (100 mM in the perfusion fluid) release of spinal CCK-LI
      was observed. In contrast, no potassium-induced release of CCK-LI could be
      detected 2-3 weeks and 2 months after axotomy. No significant effect was observed
      on the basal extracellular levels of CCK-LI in the dorsal horn. The present study
      provides further support for the notion that the adaptive changes in the dorsal
      horn 2 weeks and later after a deafferentiation injury do not include an
      increased release of CCK.

PMID- 11201091
TI  - Presenilin-2 (PS2) expression up-regulation in a model of retinopathy of
      prematurity and pathoangiogenesis.
AB  - Presenilin-2 (PS2; AD4), a regulator of intercellular signaling during CNS
      development and cell fate determination, appears to be involved in pathogenic
      processing of beta-amyloid precursor protein (betaAPP) into potentially
      neurotoxic beta-amyloid (Abeta) peptides. The PS2 gene promoter contains multiple
      DNA binding sites for the relatively rare hypoxia-inducible transcription factor
      HIF-1, suggesting that PS2 expression may be a sensitive indicator of decreased
      oxygen availability. We have used a cycled hypoxia/hyperoxia (10-50% O2) protocol
      followed by normoxia (20% O2) as a retinal model of retinopathy of prematurity to
      induce neovascularization (NV) in rat pups. Retinal cell nuclear extracts from
      pups undergoing hypoxia exhibited a dramatic increase in HIF-1-DNA binding,
      followed by a delayed (2-7 day) elevation of PS2 RNA message and protein. PS2
      gene activation during hypoxia may direct cellular fate towards pathoangiogenesis
      and intercellular PS2-mediated signaling dysfunction.

PMID- 11201092
TI  - Kainate-induced K+ efflux and plasma membrane depolarization in cultured
      cerebellar granule cells.
AB  - It is becoming increasingly evident that activation of ionotropic glutamate
      receptors leads to significant changes in cytosolic [K+] ([K+]c), a major
      determinant of the plasma membrane (PM) potential, Em. Since Em affects fluxes of
      key cations, such as Ca2+, it is important to precisely quantify [K+]c and Em in
      neurons exposed to glutamate receptor agonists. Here we studied the relationships
      between [K+]c and Em in primary cultures of cerebellar granule cells, and found
      that kainate elicits a rapid drop in [K+]c below 10 mM. Using patch electrodes
      containing 10 or 150 mM K+, we determined that kainate depolarizes the PM to -2
      or -28 mV, respectively. Therefore, the actual PM depolarization elicited by
      kainate is much larger than that routinely measured with K+-rich electrodes.

PMID- 11201093
TI  - Sexual pheromone or conventional odors increase extracellular lactate without
      changing glucose utilization in specific brain areas of the rat.
AB  - Brain extracellular lactate levels increase following physiological stimuli.
      Monitoring lactate levels might be a tool for detecting dynamic changes in brain
      activity. In this study we compared changes of extracellular lactate in selected
      brain areas with rates of glucose utilization as measured by the [14C]2
      deoxyglucose method, following olfactory stimulation. Conventional (green pepper
      essence, heptanal, exanal, octanal) and, above all, non-conventional (sexual
      pheromone) odors increased lactate in the rhinencephalum, but not in the
      striatum. Glucose utilization did not change in any area. This discrepancy may
      result from the different temporal resolution of the two methods employed and/or
      from the clearance of lactate, whose tissue content increases transiently
      following neuronal activation as a reflection of the initial oxygen debt.

PMID- 11201094
TI  - Temporal and spatial dependency of the ventriloquism effect.
AB  - The perception of the spatial location of an auditory stimulus can be captured by
      a spatially disparate visual stimulus, a phenomenon known as the ventriloquism
      effect. This study investigated the temporal and spatial dependency of this
      illusion. In the temporal domain, only disparities of 50-100 ms were perceived as
      simultaneous, and disparities where the visual stimulus occurred before the
      auditory stimulus were more effective in creating the illusion. In the spatial
      domain, the illusion was elicited most strongly at spatial disparities below
      spatial discrimination thresholds. There was also a significant interaction
      between temporal and spatial disparities. These results indicate that both
      temporal and spatial parameters are critical in the perception of real world
      objects in extrapersonal space.

PMID- 11201095
TI  - Keratinocyte growth factor prevents ischemia-induced delayed neuronal death in
      the hippocampal CA1 field of the gerbil brain.
AB  - Fibroblast growth factors (FGFs) are polypeptides with various biological
      activities in vivo and in vitro, and their receptors are expressed in the
      widespread and specific neuronal populations of the brain. In this study, we
      asked whether keratinocyte growth factor (KGF), one of the FGF superfamily, would
      express in the brain, and have neuroprotective against ischemic brain injury. In
      situ hybridization analysis revealed that intense silver grains for KGF mRNA are
      observed in the neuronal cells of the cerebral cortex, hippocampus and amygdala
      in gerbil brain. Continuous cerebroventricular infusion of KGF (20 microg) for a
      7 day period to gerbils starting 2 days before temporary right carotid artery
      occlusion (20 min) resulted in a higher survival rate than seen in vehicle
      treated ischemic animals. Subsequent histological examinations showed that KGF
      effectively prevented delayed neuronal death of the hippocampal CA1 region. In
      situ detection of DNA fragmentation (TUNEL staining) revealed that ischemic
      animals infused with KGF contained fewer TUNEL-positive neurons in the
      hippocampal CA1 field than those infused with vehicle alone at the forth and
      seventh day after ischemia. KGF-treated brain showed over-expression of KGF mRNA
      in the neuronal cells of the cerebral cortex, hippocampus only in the right
      hemisphere, which was the side of carotid artery occlusion, 8-10 h after
      ischemia. These findings suggest that KGF has a protective effect against
      ischemic hippocampal neuronal damage in vivo, which may provide a new therapeutic
      strategy in the survival and reconstruction of neurons in response to cerebral
      injury.

PMID- 11201096
TI  - Fetal cell grafts provide long-term protection against scrapie induced neuronal
      loss.
AB  - We have transplanted fetal neurons to prolong hippocampal pyramidal cell survival
      in a mouse scrapie model in which 50% of CA1 pyramidal cells have died by day 180
      of the 250-day incubation period. Cells prepared from embryonic PrP deficient
      mice were intracerebrally injected into infected mice on day 150 and groups
      killed on day 171 and with terminal disease. Neuron counts and CA1 depth
      measurements were made on semi-serial sections using an image analysis system.
      Both grafted groups retained more CA1 neurons than controls injected with medium
      alone, and showed greater depth of CA1 than controls. This new approach may have
      potential as a late-stage therapy for TSEs for which there are currently no
      available treatments.

PMID- 11201097
TI  - An fMRI study with written Chinese.
AB  - Event-related functional magnetic resonance imaging (ER-fMRI) was used to
      investigate how the human brain processes phonology and transforms a word's
      visual form (orthography) into phonological form during reading in logographic
      Chinese, a writing system that differs markedly from alphabetic languages. We
      found that reading aloud of irregular words produced larger MR signal intensity
      changes over extensive regions involving left infero-middle frontal cortex, left
      motor cortex, right infero-frontal gyri, bilateral anterior superior temporal
      areas, and anterior cingulate cortex. Right superior parietal lobule, the cuneus
      in bilateral visual cortex, and thalamus participated in the processing of
      irregular, but not regular, words. These findings were discussed in comparison to
      neuroimaging findings from alphabetic languages, as well as in relation to models
      of reading.

PMID- 11201098
TI  - Role of corticostriatal and nigrostriatal inputs in malonate-induced striatal
      toxicity.
AB  - The striatal neuronal loss evident following cellular metabolic compromise may be
      dependent upon the presence of glutamate and dopamine within the striatum. In
      order to investigate the relative roles of corticostriatal and nigrostriatal
      projections in malonate-induced neuronal loss, the extent of toxicity was
      quantified in animals with cortical lesions to deplete the striatum of glutamate,
      nigrostriatal lesions to deplete the striatum of dopamine, or both. We found that
      malonate-induced striatal toxicity was significantly reduced following lesions of
      either the glutamatergic or dopaminergic afferents to the striatum. The extent of
      attenuation following the loss of both inputs within the same animal was similar
      to that seen following lesions of either alone. These data suggest that malonate
      induced toxicity in the striatum depends upon the integrity of interactive
      influences from both glutamatergic and dopaminergic afferents.

PMID- 11201099
TI  - Optical responses to micro-application of GABA agonists in the embryonic chick
      brain stem.
AB  - We investigated optical responses induced by micro-application of muscimol and
      baclofen in the embryonic chick brain stem. Muscimol evoked biphasic optical
      signals which were similar to those induced by GABA. The first component was a
      dye-dependent absorption change that reflected membrane depolarization, and the
      second component was an intrinsic optical change coupled with changes in the
      membrane potential. On the other hand, baclofen did not elicit any optical
      change. The optical responses induced by muscimol persisted in the presence of
      picrotoxin and 2-hydroxysaclofen, suggesting that they contain a component which
      is not mediated by classical GABA receptors.

PMID- 11201100
TI  - Equivalent disruption of regional white matter microstructure in ageing healthy
      men and women.
AB  - Diffusion tensor imaging was used to measure regional differences in brain white
      matter microstructure (intravoxel coherence) and macrostructure (intervoxel
      coherence) and age-related differences between men and women.
      Neuropsychiatrically healthy men and women, spanning the adult age range, showed
      the same pattern of variation in regional white matter coherence. The greatest
      coherence measured was in corpus callosum, where commissural fibers have one
      primary orientation, lower in the centrum semiovale, where fibers cross from
      multiple axes, and lowest in pericallosal areas, where fibers weave and
      interstitial fluid commonly pools. Age-related declines in intravoxel coherence
      was equally strong and strikingly similar in men and women, with evidence for
      greater age-dependent deterioration in frontal than parietal regions. Degree of
      regional white matter coherence correlated with gait, balance, and
      interhemispheric transfer test scores.

PMID- 11201101
TI  - [Molecular mechanisms for preprotein translocation across the cytoplasmic
      membrane of E. coli--structure changes of SecA and SecG coupled with
      translocation].

PMID- 11201103
TI  - [Quantum chemical approach to radiation-induced DNA damage].

PMID- 11201102
TI  - [Selectins and their carbohydrate ligands in cellular recognition].

PMID- 11201104
TI  - [A vital role for glycosphingolipid synthesis during development and
      differentiation].

PMID- 11201105
TI  - [Regulation of chromatin and transcription by methyl-CpG binding proteins].

PMID- 11201106
TI  - [Laboratory evolution approach to protein engineering].

PMID- 11201107
TI  - [Genesis and mechanism of ischemia-reperfusion injuries].

PMID- 11201108
TI  - [Thyroidectomy for Graves' disease].
AB  - In the late 19th century, surgeons in central Europe attempted to perform
      thyroidectomy for Graves' disease. Theodor Billroth, Theodor Kocher, and their
      colleagues made numerous contributions to progress in surgical methods.
      Preoperative arterial ligation, lobectomy, and second-stage operations were
      performed to reduce operative mortality rates. Lobectomy and partial resection of
      the contralateral lobe were performed in the 1900s, and subtotal thyroidectomy,
      which became the standard procedure of the day, was performed in the 1920s.
      Developments in medical therapy, such as iodine (1923) and thiouracil (1943)
      administration, also decreased postoperative mortality and morbidity rates. In
      1954, radioiodine therapy was found to yield satisfactory results in achieving
      remission of Graves' disease. Currently, surgery for Graves' disease is indicated
      only in patients with large goiters or who require rapid remission.

PMID- 11201109
TI  - [The history and evolution of coronary artery bypass grafting].
AB  - It is nearly 40 years since the introduction of coronary artery bypass grafting
      (CABG) in humans. A. Carrel (1910) attempted the first CABG in animals and G.
      Murray (1954) succeeded in performing experimental CABG using the internal
      mammary artery (IMA). The first reported CABG using the IMA in humans was
      performed by R. Goetz using the sutureless technique in 1960. V. Kolessov (1964)
      performed the first sutured bypass grafting using the IMA. From 1962 to 1967,
      human CABG using autogenous saphenous vein grafts was performed by D. Sabiston
      (1962). H. Garrett (1964), D. Kahn (1966), and R. Favaloro (1967). Saphenous vein
      grafting became the most common CABG technique for the next two decades. In
      Japan, Y. Sezai et al. performed CABG using the free femoral artery, we performed
      CABG using the IMA, and S. Asada et al. performed CABG using the saphenous vein
      in 1970. In 1986, F. Loop et al. reported that the long-term survival rate of
      CABG was significantly higher when the IMA rather than the saphenous vein was
      used. IMA grafting, supplemented by the gastroepiploic artery, inferior
      epigastric artery, and radial artery, has enabled complete arterial
      revascularization to be performed in almost all patients. In the graft selection
      for CABG, the first choice is the left IMA and the second choice is the right
      IMA. The third choice is the gastroepiploic artery and/or radial artery,
      depending on the target anastomotic site, degree of stenosis, size of the distal
      graft, and in situ or free use.

PMID- 11201110
TI  - [History of breast cancer surgery and its perspectives].
AB  - At the end of the 19th century, surgical treatment of breast cancer was
      revolutionized by the introduction of the Halsted radical mastectomy. Haagensen,
      who studied under one of Halsted's students, further strengthened the foundations
      of the technique, and the Halsted operation became the standard radical breast
      cancer surgery worldwide. This may have been responsible for the persistence of
      this operation, particularly in Japan. Some Halstedian surgeons espoused the
      extended radical mastectomy or super-radical mastectomy. However, breast
      conserving surgery is now becoming the most common technique. In the early 1970s
      breakthroughs in the understanding of the biology of breast cancer led to a new
      era of adjuvant therapy. Consequently current surgical management of breast
      cancer is no longer possible without considering other therapeutic modalities.
      Consistent with this change, it should be realized that the disease is no longer
      diagnosed at the same stage as it was at the time of Halsted. Although the
      ultimate patient outcome is not likely to be influenced solely by locoregional
      treatment, surgery will continue to be employed as the most effective treatment
      modality, and every effort should be made to prevent locoregional tumor spread.

PMID- 11201111
TI  - [History and advances in the surgical treatment of lung cancer].
AB  - In 1933, Graham successfully performed one-stage pneumonectomy for lung cancer.
      Four years later, Ozawa (Japan) also performed pneumoenctomy for lung cancer.
      Unfortunately, progress in the surgical treatment of lung cancer in our country
      was interrupted by World War II. After the war, the first report of resection in
      3 cases of lung cancer was published by Ishikawa in 1949. In the 1950s, poorer
      surgical outcomes were reported from Japan in terms of resection rate or long
      term survival compared with those in Western countries. However, since the 1960s,
      there has been great progress in Japan in the treatment of lung cancer, due to
      the marked increase in the number of lung cancer patients, developments in
      endoscopy and imaging devices, and also in surgical procedures such as anatomical
      lung resection, lymph node dissection, combined resection of adjacent organs, and
      bronchoplastic surgery. Surgical mortality was over 20% in the early years.
      However, it has currently decreased to a few percent. The long-term survival rate
      for resected lung cancer patients has improved remarkably in recent years. Among
      stage IIIA cases, the optimal surgical outcome is achieved in the group
      undergoing chest wall resection for T3 N0 M0 disease. However, patients with IIIA
      N2 disease generally have a poor surgical outcome. Therefore, trials of induction
      therapy are being carried out at many institutions.

PMID- 11201112
TI  - [The history of surgical treatment for esophageal carcinoma in the 20th century
      in Japan].
AB  - In the 20th century surgical results in the treatment of esophageal carcinomas
      significantly improved in Japan. For the reason, I review the trends in
      esophageal cancer surgery in Western countries and discuss the reasons for the
      choice of surgical procedures. In Japan, esophageal cancer surgery was initiated
      with the reports of surgical results presented by Professors Seo and Osawa at the
      Congress of the Japan Surgical Society held in 1933. Subsequently, the results in
      esophageal cancer patients undergoing surgical resection were improved with the
      progress in anesthesia. Subsequent to the establishment of the Japan Society of
      Esophageal Diseases in 1965, any institutes performed esophagectomy for
      esophageal carcinomas, and the procedure accounted for less than 2% of all
      operative deaths in Japan. The main reason for this reduction in the number of
      surgical deaths was improved perioperative care for major complications
      (cardiopulmonary failure and anastomotic leakage). In particular, the surgical
      procedure for curative lymphadenectomy called three-field dissection
      significantly improved surgical prognosis. In the last 10 years, the relationship
      between the number of positive lymph nodes and surgical prognosis was
      demonstrated in advanced esophageal cancers, while endoscopic mucosal resection
      was also performed for early esophageal cancers as a curative treatment. In the
      next century, better treatment should be designed for individual patients based
      on fundamental studies and clinical trials.

PMID- 11201113
TI  - [History of gastric cancer surgery].
AB  - The successful surgical treatment of gastric cancer in 1881 was a breakthrough
      not only in gastric but also in digestive surgery. By the beginning of the 20th
      century, the modalities of gastric surgery had almost reached the present level.
      At that time, the successful resection rate was 20% and mortality rate 50% in
      patients undergoing gastrectomy for cancer. During the 30 years after World War
      II, the extent of gastric resection increased, lymphadenectomy was introduced,
      and the number of concomitant resections of organs in addition to the stomach
      also increased. Since the 1980s, modified surgery has been performed in patients
      with early-stage gastric cancer. Based on data collected by the Japanese Research
      Society for Gastric Cancer, the current resection rate is 91.3%, mortality rate
      1.0%, and 5-year survival rate 71.6% in patients with gastric cancer.

PMID- 11201114
TI  - [Historical review of colorectal cancer surgery].
AB  - The classical standard surgical technique for rectal carcinoma, abdominoperineal
      excision (Miles operation), has been gradually replaced by sphincter-saving
      surgery and more than 70% of rectal carcinomas are treated by anterior resection
      in which autosuture machines have played a major role in recent years. Wide
      lateral lymphadenectomy has been replaced by autonomic nerve preservation because
      of the high frequency of sexual and urinary dysfunction. Total mesorectal
      excision (TME) proposed by Heald et al which ignores the lateral nodes of the
      pelvic wall is the most popular technique in Western countries. The concept of
      TME is contradictory to that of wide lateral lymphadenectomy and the true merits
      of the latter should be examined in the near future. Minimally invasive surgery,
      including various procedures of local excision of low rectal tumors and
      colonoscopic polypectomy, has given great benefits to many patients. In Japan
      there seems to have been a lack of interest in adjuvant radiotherapy and
      chemoradiotherapy in the past, but they should be more seriously considered for
      the adjuvant treatment of advanced rectal carcinoma in the future.

PMID- 11201115
TI  - [Progress in surgery for hepatocellular carcinoma].
AB  - Before 1980, the surgical procedure for liver resection was limited to major
      hepatectomy. Anatomical resection for subsegmentectomy based on liver anatomy was
      established after 1980. Surgical techniques to resect nonpalpable and nonvisible
      tumors and devices to reduce blood loss in the resection plane of the liver are
      mandatory when performing subsegmentectomy. Intraoperative ultrasound has played
      a major role in the progress achieved. Hepatectomy procedures preservation of the
      inferior right hepatic vein, and preoperative portal vein embolization have also
      contributed to progress in the field of liver surgery.

PMID- 11201116
TI  - [Carcinoma of the pancreatic head].
AB  - Focusing mainly on invasive ductal carcinoma of the pancreas, the history of
      radical surgery for this type of cancer is reviewed, including
      pancreatoduodenectomy, total pancreatectomy, extended radical surgery with main
      vascular resection and extended lymphadenectomy/retroperitoneal soft-tissue
      clearance, pylorus-preserving pancreaticoduodenectomy. In addition, duodenum
      preserving pancreatic head resection, which has recently attracted attention in
      this field, as an operative technique for less-malignant, noninvasive intraductal
      papillary adenocarcinoma is also reviewed.

PMID- 11201118
TI  - [General surgery and medical history].

PMID- 11201117
TI  - [History of surgery for cholelithiasis: from the era of cholecystostomy to
      laparoscopic surgery].
AB  - Since Stalpert von der Wiel first incised the abdominal wall for bile drainage in
      a patient with an intraabdominal abscess due to gangrenous cholecystitis with
      calculi in 1684, the problems inherent in the treatment of cholelithisiasis have
      received attention from surgeons working in this field. However, the major event
      was the development of the technique of cholecystectomy by Langenbuch in 1882
      opening a new era in surgery for cholelithiasis. Subsequently numerous advances
      were made in cholecystectomy, choledochotomy, choledochoenterostomy, and
      sphincteroplasty associated with progress in the diagnostic techniques and
      instrumentation necessary to perform surgery for cholelithiasis. However, the
      outcomes of these methods were criticized, and they were gradually abandoned due
      to development of minimally invasive endoscopic or laparoscopic surgery. The
      development of laparoscopic cholecystectomy revolutionized the history of biliary
      surgery. In the 21st century, the best treatment will be available to all
      patients with the use of ultramodern technologies such as telesurgery and robotic
      surgery.

PMID- 11201119
TI  - [UNOS-selection criteria and order of priority for the candidate of liver
      transplantation].

PMID- 11201120
TI  - [Clinicopathologic study on chronic pancreatitis with diffuse irregular narrowing
      of the main pancreatic duct].
AB  - We studied the clinicopathologic features of 13 cases of chronic pancreatitis
      with diffuse irregular narrowing of the main pancreatic duct (MPD). It occurs
      frequently in relatively elder men. Diffuse irregular narrowing of the MPD and
      stenosis of the common bile duct on ERCP, and swelling of the pancreas on US/CT
      were detected in all cases. An autoimmune mechanism might be involved in the
      etiology at least in 5 patients with hypergammaglobulinemia and positive
      autoantibodies. Surgical therapy was performed in 8 patients and 3 patients were
      treated with steroids. No patients showed recurrence of pancreatitis. Histologic
      findings were characterized by diffuse lymphoplasmacytic infiltration with marked
      interstitial fibrosis in the pancreas, obliterated phlebitis of the pancreatic
      veins. Similar inflammatory process involved the bile duct and the gallbladder.
      These histologic findings were similar to those of multifocal fibrosclerosis.
      Chronic pancreatitis with diffuse irregular narrowing of the MPD is overlapped
      with autoimmune pancreatitis in many cases, but may be a variant of multifocal
      fibrosclerosis involving the pancreas in some cases.

PMID- 11201121
TI  - [A case of small cell carcinoma of esophagus successfully treated by chemotherapy
      with CPT-11 and CDDP].

PMID- 11201122
TI  - [A case of ileal atypical carcinoid with multiple liver metastasis].

PMID- 11201123
TI  - [A case of multiple gastro-intestinal angiosarcoma].

PMID- 11201124
TI  - [A case of gastro-renal-shunt induced non-cirrhotic recurrent hepatic
      encephalopathy effectually treated by balloon-occluded retrograde transvenous
      obliteration].

PMID- 11201125
TI  - [A case of hypogenesis of the median segment of the liver complicated with
      Chilaiditi syndrome].

PMID- 11201126
TI  - [A case of granulocyte-colony stimulating factor producing squamous cell
      carcinoma of the gall bladder].

PMID- 11201127
TI  - [A case of chronic pancreatitis with primary biliary cirrhosis whose diameter of
      pancreatic duct was rapidly changed].

PMID- 11201128
TI  - [Present status and prospective view in liver transplantation in Japan].

PMID- 11201129
TI  - [Study of free to total prostate specific antigen ratio in the detection of
      patients with prostate cancer].
AB  - BACKGROUND: We investigated the clinical usefulness of free to total serum
      prostate specific antigen (PSA) ratio (F/T ratio) in order to improve the
      specificity of total PSA measurement for detecting prostate cancer. METHOD: In
      this study 129 patients with total PSA level 4-20 ng/ml underwent transrectal
      ultrasound guided sextant biopsy. Serum samples were assessed for total PSA, free
      PSA and the F/T ratio calculated. All patients were pathologically diagnosed as
      benign prostatic hyperplasia or prostate cancer. RESULTS: Of 129 patients 21 had
      prostate carcinoma (PCa) and 108 had benign prostatic hyperplasia (BPH) from the
      results of prostate biopsies. The mean of total PSA were not significantly
      different between men with PCa and with BPH. The mean of free PSA for PCa was
      significantly lower than that for BPH (p = 0.043). Furthermore, the mean of F/T
      ratio was significantly different between PCa and BPH group (p = 0.0014). The F/T
      ratio had a higher specificity than total PSA at all levels of sensitivity in
      detecting prostate cancers. Sensitivity, specificity and accuracy for cancer
      detection at a cut off 0.12 was 90.4%, 51.8% and 58.1%, respectively. Also, free
      PSA was as useful as F/T ratio for cancer detection when analyzed in receiver
      operating characteristic curves analysis. When determined the cut off number of
      free PSA at 0.78 ng/ml, the sensitivity, specificity and accuracy for cancer
      detection were 61.9%, 66.7% and 65.9%, respectively. CONCLUSION: This study
      indicated that the F/T ratio and free PSA could improve the specificity without
      impairing the sensitivity for detecting PCa in patients with 4-20 ng/ml of total
      PSA.

PMID- 11201130
TI  - [An optimal follow-up protocol for renal cell carcinoma based on the occurrence
      of recurrences after surgery].
AB  - INTRODUCTION AND OBJECTIVE: The tumor biology of renal cell carcinoma (RCC)
      remains poorly understood and the prognosis of which is unpredictable. To define
      an optimal follow-up protocol in nonmetastatic RCC, tumor recurrences and the
      clinical course were assessed in the patients who had undergone nephrectomy.
      PATIENTS AND METHODS: Between March 1972 to July 1999, 265 patients with PT1-3N0
      (Nx) M 0 RCC underwent radical or partial nephrectomy. Clinicopathological
      variables were compares with the time of the first recurrence, site of metastasis
      and reason for diagnosis. RESULTS: In July 1999, the median (range) follow-up for
      the surviving patients was 50 (1-244) months. Metastases were diagnosed in 45 of
      the 265 patients (17%). Sixty percent of the patients had their metastases
      diagnosed within 3 years and 87% by 6 years. The incidence and the mean time to
      first diagnosis of recurrence were 9.0% and 43.6 months for pT1, 32.4% and 39.6
      months for pT2, and 32.7% and 25.0 months for pT3. Metastatic sites and the mean
      time of diagnosis were 40.6 months in lung (46.7%), 26.1 months in bone (17.8%),
      18.6 months in retroperitoneal organs (11.1%), 38.0 months in liver (6.7%), 51.0
      months in thyroid gland (4.4%) and 31.0 months in brain (2.2%). Most recurrence
      in lung, retroperitoneal organs and liver were incidentally diagnosed, whereas
      recurrences in bone, thyroid gland and brain had some symptoms associated with
      metastases. Incidence of lung metastasis in pT1 (9 patients, 56%) and pT2 (6,
      55%) was greater than that in PT3 (6, 33%). In contrast, incidence of abdominal
      metastasis (retroperitoneal organs and the liver) in pT3 (4 patients, 33%) was
      grater than pT1 (2, 12%) and PT2 (1, 16%). CONCLUSIONS: The results indicate that
      the risk of tumor progression and site of metastasis seemed to depend on original
      TNM stage. Therefore stage specific postoperative follow-up protocol should be
      considered. The yearly follow-up may suffice for pT1a patients after surgery. For
      pT1b and pT2 patients, the follow-up should be intense during the first 3 years
      by a routine chest X-ray. For pT3 patients, the follow-up during the first 2
      years may be important. Particularly, considering the high incidence of abdominal
      metastasis in these patients, examination by CT scan is recommended every 6
      months in the first 2 years. No need for bone scintigraphy and brain CT was
      indicated for asymptomatic patients.

PMID- 11201131
TI  - [Ischemic heart disease in patients with erectile dysfunction].
AB  - BACKGROUND: Erection is an hemodynamic event and accordingly, erectile
      dysfunction is closely related with ischemic heart diseases. Sufficient study has
      yet to be made of this relation. METHOD: Fifty-eight patients with erectile
      dysfunction participated in the present study. Intracavernous injection tests and
      color Doppler examination were conducted for assessment of erectile function. For
      patients with history of ischemic heart disease, we referred to their doctor for
      data from their examinations. For patients otherwise, chest X-rays and
      electrocardiograms in the resting position were obtained and also
      electrocardiograms following exercise. Echocardiograms, treadmill test results,
      thallium exercise scintigrams, and coronary angiograms were obtained as requires
      for diagnosis. RESULTS: Eighteen patients (31.0%) were diagnosed as ischemic
      heart disease or at high risk. Although 6 of them had been already diagnosed with
      ischemic heart disease, 12 were newly diagnosed by the exercise tests. Among
      these 18 patients 16 had one or more significant risk factors for ischemic heart
      disease such as age, hyperlipidemia, and diabetes mellitus. 3.7% of patients
      whose peak systolic velocity in the cavernous artery was equal to or exceeded 35
      cm/sec had ischemic heart disease or were at high risk. 54.8% of patients with
      peak systolic velocity of less than 35 cm/sec had ischemic heart disease or were
      at high risk. CONCLUSIONS: In erectile dysfunctional patients, incidence of
      complications with symptomatic or asymptomatic ischemic heart disease was found
      to be high. Therefore, in patients with risk factors or low peak systolic
      velocity in the cavernous artery, exercise tests should be implemented prior to
      treatment of erectile dysfunction.

PMID- 11201132
TI  - [Electromyographic study of the striated urethral sphincter by using the
      bulbocavernosus reflex: study on change of sacral reflex activity caused by
      bladder filling].
AB  - PURPOSE: The change of sacral reflex activity of the striated urethral sphincter
      in the urine storage phase is investigated using evoked potential reaction of the
      bulbocavernosus reflex (BCR). METHODS: Eleven normal male subjects and 13 male
      patients with neurogenic bladder due to suprasacral (C3-C7) spinal cord injury
      (SCI patients) were investigated. Within the SCI patients, five were complete SCI
      and 8 were incomplete SCI. BCR was elicited by electrical stimulation of dorsal
      nerve of the penis, and the evoked potential of the BCR was recorded with a
      concentric needle electrode from the periurethral striated muscle. BCR was
      performed both at empty and at filled bladder respectively, and changes of the
      amplitudes (AMP) were examined. Moreover, the changes of AMP affected by bladder
      filling were compared between the normal subjects and the SCI patients. RESULTS:
      In both the normal subjects and the SCI patients, AMP increased at the filled
      bladder as compared with that of the empty bladder. In addition, the change of
      AMP was statistically bigger in the SCI patients (a ratio of amplitude at filled
      bladder/amplitude at empty bladder: 4.73 +/- 3.90) than in the normal subjects
      (the ratio: 1.32 +/- 0.44). CONCLUSION: Sacral reflex activity was accelerated by
      bladder filling in both the normal subjects and SCI patients. And the
      acceleration in the SCI patients was more remarkable than that in the normal
      subjects. In addition to the conventional evaluation of the integrity of sacral
      reflex arc by BCR examination, the observation of changes of BCR affected by
      bladder filling may provide the information for the continuity of sacral segment
      and supraspinal micturition center.

PMID- 11201133
TI  - [A case of ectopic prostatic tissue in urinary bladder and uretero-seminal
      vesicle fistula with ipsilateral aplastic kidney].
AB  - A case of ectopic prostatic tissue in urinary bladder and uretero-seminal vesicle
      fistula with ipsilateral aplastic kidney is reported. A 29-year-old man was
      admitted to our hospital for residual sensation and perineal pain. Ultrasound
      examination revealed a cystic change in the right side of urinary bladder. C.T.
      and M.R.I. revealed a defect of a right kidney and ipsilateral ureteral dilation
      and seminal vesicle swelling. A cystscopy under lumbar anesthesia revealed a
      edematous cystic change of the right side of trigone and defect of the right
      ureteral orifice. Trans urethral resection of the wall of urinary bladder was
      simultaneously performed. And the contents of the cyst were sperum and old red
      blood cells. A retrograde ureterograph showed blind-ending ureter at L5 level and
      seminal vesicle swelling. A resected bladder tissue contained prostatic tissue.
      After operation he was free from complaints. Uretero-seminal vesicle fistula with
      ipsilater aplastic kidney is rare disease. In addition a case complicated ectopic
      prostatic tissue in urinary bladder was not reported in Japanese medical
      literature.

PMID- 11201134
TI  - [Renal cell carcinoma in acquired cystic disease of the kidney manifested by
      spontaneous renal hemorrhage].
AB  - Acquired cystic disease of the kidney (ACDK) is a common phenomenon in long-term
      adult dialysis patients with end-stage renal disease. Renal hemorrhage and
      neoplastic transformation of the cyst are two major complications of this entity
      and these two can occur independently. Here we describe a 65-year-old man with a
      history of hemodialysis-dependent end-stage renal failure for 12 years presented
      with macroscopic hematuria and right flank pain. Investigations revealed right
      massive perirenal and subcapsular hematoma with ACDK. The hemorrhagic state
      required nephrectomy of the right kidney. Histological study showed ACDK with
      massive subcapsular and perinephric hematoma containing minimal clear cell
      carcinoma region(0.5 cm in diameter). Although a causal relationship between
      renal hemorrhage and renal cell carcinoma in this patient was unproven, the
      present case suggests radical surgery can be a recommendable treatment modality
      of hemorrhagic ACDK.

PMID- 11201135
TI  - [Liver transplantation and tuberculosis].
AB  - Although liver transplantation in Japan has rapidly expanded its indication to
      adult patients, our experience and measures in posttransplant tuberculosis is
      still limited. Early posttransplant patients under immunosuppressants generally
      have a higher risk for tuberculosis and the risk in liver recipients follows that
      in lung recipients. Rejection treatment is one of the risk factors for infection,
      dissemination, and mortality of tuberculosis. Drug-induced liver injury by anti
      tuberculotic drugs and their interaction with immunosuppressants, combined
      infection, and increased susceptibility to rejection in posttransplant
      tuberculosis are major obstacles in the treatment. Evidence-based consensus in
      the diagnosis and treatment of posttransplant tuberculosis, as well as
      establishment of speedy and reliable screening method in potential organ donors,
      are in a pressing need.

PMID- 11201136
TI  - [Limits of nucleic acid amplification tests for diagnosis of smear negative
      pulmonary tuberculosis].
AB  - STUDY OBJECTIVES: To assess the usefulness of commercial kits of nucleic acid
      amplification test (NAAT) for diagnosis of smear negative (SN) pulmonary
      tuberculosis. DESIGN AND PATIENTS: Retrospective study of patients who were
      diagnosed as, or suspected of pulmonary tuberculosis during 3 years from January
      1996 to December 1998 in Fukujuji Hospital which has 100 beds for tuberculosis
      patients. MEASUREMENTS AND RESULTS: 145 smear-negative culture-positive pulmonary
      tuberculosis patients are entered to our analysis. The DNA-based amplification
      test kit (Amplicor Mycobacterium Tuberculosis Test (AMPL), Roche Diagnostic
      Systems, Basel, Switzerland) detected 39.2% (20/51, 95% confidence interval (CI):
      25.8-52.6%) of smear-negative culture-positive (SNCP) pulmonary tuberculosis
      cases. The RNA-based amplification test kit (Gen-Probe Amplified Mycobacterium
      Tuberculosis Direct Test (AMTDT), Gen-Probe Inc., San Diego, Calif., USA)
      detected 40.5% (15/37, 95% CI: 24.7-56.3%) of SNCP pulmonary tuberculosis cases.
      For both NAATs (AMPL and AMTDT), between two groups with and without the NAAT at
      diagnosis of SNCP pulmonary tuberculosis, there was statistical difference in
      culture-positive rate (proportion of positivity in sputum culture tests at
      diagnosis), but no statistical difference in maximum number of colony of
      Mycobacterium tuberculosis (MTB). When stratified for the culture-positive rate,
      adjusted sensitivity for SNCP patients was 44.2% (AMPL) and 40.4% (AMTDT)
      respectively. On the other hand, among 245 patients with sputum AMPL positive
      results during the 3 years, 8 were smear-negative culture-negative (SNCN), only
      one out of these 8 cases was judged as true active tuberculosis without
      treatment. Among 89 patients with sputum AMTDT positive results, 7 were SNCN, and
      3 out of them were judged as true active tuberculosis without treatment.
      CONCLUSION: Usefulness of commercial NAAT kits (AMPL and AMTDT) to diagnosis SN
      pulmonary tuberculosis is limited in the point of sensitivity.

PMID- 11201137
TI  - [Desensitization therapy for allergic reactions of antituberculous drugs-
      evaluation of desensitization therapy according to the guideline of the Japanese
      Society for Tuberculosis].
AB  - We prospectively evaluated the effectiveness of desensitization therapy for cases
      showing side-effects to antituberculous drugs (Isoniazid and Rifampicin)
      according to the guideline proposed by the Treatment Committee of the Japanese
      Society for Tuberculosis. Nineteen patients (23-88 years old, male 9, female 10)
      who had experienced adverse effects after receiving antituberculous drugs and
      underwent desensitization therapy between August 1998 and March 2000 were
      studied. Underlying diseases were 14 cases of pulmonary tuberculosis, 2 cases of
      cervical tuberculous lymphadenitis, 1 case of pulmonary atypical mycobacteriosis,
      1 case of pulmonary tuberculosis and tuberculous pleuritis, 1 case of pulmonary
      tuberculosis and tuberculous lymphadenitis. The regimens of treatment for
      tuberculosis were INH + RFP + EB in 8 cases, INH + RFP + EB + PZA in 7 cases, INH
      + RFP + SM in 2 cases, INH + RFP + SM + PZA in 1 case, and INH + RFP in 1 case.
      Adverse reactions were 8 cases of eruption, 7 cases of drug fever, 3 cases of
      drug fever and eruption, and 1 case of drug fever and cervical lymphadenopathy.
      The causative drugs suggested from DLST or the clinical course were RFP in 17
      cases and INH in 8 cases. The clinical effect of desensitization therapy for
      these antituberculous drugs was good in 14 out of the 17 cases (82%) for RFP, and
      in 6 out of 8 cases (75%) for INH. The effectiveness rate of the present
      desensitization therapy according to the guideline of the Japanese Society for
      Tuberculosis was almost equal to that of previous desensitization therapy, and
      the clinical results were almost same in present and previous studies despite the
      different methods of administration of the antituberculous drugs.

PMID- 11201138
TI  - [A case of pulmonary tuberculosis diagnosed by DNA amplification methods from
      transbronchial lung biopsy materials].
AB  - The hybridization assay using polymerase chain reaction (PCR) is useful for rapid
      detection of Mycobacterium tuberculosis (M. tuberculosis). A 77-year-old female
      was admitted to our hospital complaining of cough, and examination of the sputum
      culture showed M. tuberculosis. Her chest X-ray showed a variety of abnormal
      shadows, such as a cavity lesion, multiple coin lesions, and infiltrates.
      Malignant disease was also suspected to be involved, with the complication of
      pulmonary tuberculosis. Specimens were obtained by transbronchial lung biopsy
      (TBLB) from coin lesions. The hybridization assay using PCR on the TBLB specimens
      showed M. tuberculosis gene expression. She was treated with anti-tuberculous
      drugs. All shadows in her chest X-ray were improved six months after admission.
      She was remained well without recurrence for more than two years after admission.
      The hybridization assay using PCR with TBLB specimens is useful for the detection
      of M. tuberculosis.

PMID- 11201139
TI  - [Pulmonary Mycobacterium gordonae infection treated with clarithromycin].
AB  - We reported a case of 51-year-old female immunocompetent patient with pulmonary
      Mycobacterium gordonae infection. The patient complained persistent cough and
      sputum and occasionally hemosputum. Chest radiograph and computed tomography (CT)
      of the lung showed bronchiectasis and small nodules in middle lobe.
      Bronchofiberscopy was performed twice, and bronchial washing specimen repeatedly
      revealed acid-fast bacilli. The organism was identified as Mycobacterium gordonae
      by biochemical tests and direct sequence method. She was treated with
      clarithromycin (400 mg/day) over 6 months and the chest CT findings showed
      improvement. The case was considered to be sensitive to clarithromycin in vitro
      drug susceptibility test. The case suggested that clarithromycin was a useful
      therapeutic agent to Mycobacterium gordonae infection.

PMID- 11201140
TI  - [Thinking about tuberculosis in Osaka City].
AB  - The incidence rate of tuberculosis in Osaka City (104.2 per 100,000 population)
      is extremely high, namely 3 times higher than the national average. Why the
      tuberculosis situation of Osaka City is so bad? The reason could be summarized as
      follows: Before the end of the World War II (1945), it was the sequelae of high
      prevalence observed in the era of Meiji, Taisho and early years of Showa.
      However, after the World War II, especially from the Heisei era (1989-), it is
      deeply affected by the influence of socio-economic background in Japan. Osaka
      City is characterized as the city of merchants and small enterprises. And
      therefore, the city substantially has the nature of the locality that brings in
      or produces some kinds of social vulnerability such as temporary laborers and
      homeless people. Of the tuberculosis patients in Osaka City, about 20% are
      homeless. In addition, patients of the smear positive infectious tuberculosis are
      often discovered among temporary laborers who change their residences and job
      sites from place to place and contact widely with citizens. These two are the
      most difficult problems in tuberculosis control program of Osaka City. In the
      meantime, there are many citizens who are careless of their health and do not
      follow the law or social rule, and this has apparently no direct connection with
      the problems of tuberculosis. However, it might be one of the factors of an
      undesirable trend of tuberculosis in Osaka City. In order to improve such a
      unfavorable tuberculosis situation in Osaka City, effective and strong supporting
      activities to the tuberculosis program are essentially needed. And these
      activities must be done from the standpoint of health-promotion, namely, health
      education for citizens and improvement of social environmental conditions to
      maintain healthy and cultural life.

PMID- 11201141
TI  - [Molecular genetic approaches to Mycobacterium tuberculosis].
AB  - Recent progress of molecular genetics has been providing tools for new approaches
      to disease treatment and diagnosis of Mycobacterium tuberculosis. In 1998, Cole
      et al. reported the complete genome sequence of Mycobacterium tuberculosis. The
      new information will provide us the knowledge and understanding of the biology of
      Mycobacterium tuberculosis. Further, it will provide us new conception of
      diagnosis and treatment of the disease. Four topics were selected in this
      symposium. Dr. Iinuma reviewed and prospected the clinical utility of nucleic
      acid amplification methods of Mycobacterium tuberculosis. Dr. Suzuki reviewed the
      molecular mechanism of acquired resistance to anti-TB drugs and reported the
      early detection of genetic mutation by new designed DNA tip method. Dr. Takahashi
      reviewed the method of molecular epidemiology and genetic elements as a tool for
      strain differentiation of tuberculosis. Dr. Mizuguchi interpreted the essential
      feature of mycobacterial genome maps, and genes and their biological activity. He
      also reviewed the importance and the utility of the complete genome sequence of
      tuberculosis in association with pathogenecity. These topics were summarized in
      this report, based on the symposium of "Molecular genetic approaches to
      Mycobacterium tuberculosis" in the 75th annual meeting of the Japanese Society
      for Tuberculosis.

PMID- 11201142
TI  - [Estimating cost functions of cancer screening programs provided by
      municipalities].
AB  - OBJECTIVE: To estimate cost functions of cancer screening programs for stomach,
      lung, colorectal, cervical, and breast cancers provided by municipalities and to
      describe the relationship between the costs and the scale of cancer screening
      programs. METHODS: Subjects were all the municipalities in Japan. Questionnaires
      were sent to 3,182 subjects and 1,860 responses were received. Data obtained from
      questionnaires were the number of persons screened and the total cost of each
      program in the 1998 fiscal year. A cost function of each program was specified as
      a linear model, a power model, and a cubic model, and the fitness of each model
      was estimated. RESULTS: Long-run cost functions of all the cancer screening
      programs allowed better explanation of the relationship between the number of
      persons screened and the total cost than short-run cost functions. The average
      costs of stomach, colorectal, and cervical cancer screening programs increased
      and the average cost of the lung cancer screening program decreased, as the
      number of persons screened increased. The cost function of the breast cancer
      screening program could not be identified. CONCLUSIONS: It is necessary to
      estimate not only cost functions but also production functions of cancer
      screening programs using the data related to products, costs, and factors of
      production to evaluate the efficiency of cancer screening programs.

PMID- 11201143
TI  - [Some discussion on why WHO definition of health has not been revised].

PMID- 11201144
TI  - [Application of cost-effectiveness analysis of health care interventions in
      developing countries. A case study in Mauritius].
AB  - OBJECTIVE: Cost-effectiveness analysis is a tool to help inform the decision
      maker of efficient allocation of scarce health care resources and its application
      has increased in developing countries during the past decade. There are, however,
      a variety of different approaches used to calculate cost-effectiveness ratios,
      given the range and the controversies surrounding the use of some components of
      total cost, depending on the constraints faced by various decision-making bodies.
      This study is an investigation of cost-effectiveness of both currently delivered
      and prospective health interventions in Mauritius to set priorities and assess
      allocative efficiency by taking into account such constraints. METHODS: Resource
      use and unit cost data were collected from the representative health facilities
      and the Ministry of Health to estimate costs of each health intervention per
      person. Effectiveness of each intervention was estimated from the results of the
      national burden of disease study and the efficacy database compiled for this
      exercise. Several types of cost-effectiveness were calculated for each
      intervention according to its characteristics and the constraints imposed by the
      existing infrastructures and other health interventions. RESULTS: Cost
      effectiveness ratios with and without the decision maker's constraints differed
      significantly. Infrastructure-constrained average cost-effectiveness of thirteen
      currently delivered and twenty one prospective interventions ranged from $127 to
      $92,949 and from $77 to $66,302 per DALY averted, respectively. Incremental cost
      effectiveness of the prospective interventions was from $83 to $70,553. Among the
      currently delivered interventions, those for perinatal disorders, mental illness,
      and ischemic heart disease were particularly less cost-effective than the
      prospective interventions. Sensitivity analysis of both effectiveness and
      discount rates did not change the cost-effectiveness ranking significantly.
      CONCLUSION: The present study showed that cost-effectiveness ratios differ
      significantly depending on the decision maker's constraints and that an
      interpretation of each cost-effectiveness study should be made with great caution
      when implementing its results in practice. Both average cost-effectiveness of the
      currently delivered interventions and incremental cost-effectiveness of the
      prospective interventions suggest that there is an allocative inefficiency among
      the currently delivered health interventions in Mauritius and a possibility of
      enhancing allocative efficiency through introducing alternative interventions.

PMID- 11201145
TI  - [Validity of the infectious disease surveillance system on comparison of
      nationwide surveys of Kawasaki disease during a 10 year period].
AB  - PURPOSE: To verify the validity of the infectious disease surveillance system in
      Japan using data for Kawasaki disease. MATERIALS AND METHODS: Data from
      nationwide surveys of Kawasaki disease conducted by the Kawasaki Disease Research
      Committee every two years over the 10 years (120 months) from 1989 through 1998
      were used to calculate a gold standard. Then, the monthly numbers of patients
      with Kawasaki disease reported by monitoring hospitals (about 550 hospitals) to
      the surveillance system were compared with this gold standard. Each of the
      monthly numbers was standardized by division by the average monthly number of
      patients over the 120 months. Observations for 3 districts (eastern part, central
      part, and western part of Japan) were conducted as well as for the whole country.
      RESULTS: The number of patients reported to the surveillance system varied more
      widely than in the nationwide survey, but directions of the fluctuations were
      similar to the chronologic changes in nationwide numbers. Accordingly, a high
      correlation coefficient value of 0.794 was obtained (p < 0.01). Similar results
      were observed in all 3 districts. The correlation coefficients were 0.709 for the
      eastern part, 0.561 for the central part, and 0.712 for the western part,
      respectively, and all of them were of statistically significant. CONCLUSION:
      Changes in number of patients with Kawasaki disease reported to the surveillance
      system resemble the pattern of the gold standard.

PMID- 11201146
TI  - [Facsimile and Internet for provisions of information about prevalence of
      infectious disease to primary care physicians].
AB  - PURPOSES: In Japan, surveillance of infectious disease has been enforced since
      1981. Facsimile and Internet have become popularized recently, and in the present
      study we investigated the means of obtaining related information primary care
      physicians. METHODS: Questionnaires were mailed to 117 hospitals and 1,162
      clinics in Mie prefecture. Responses from 76 hospitals (65.0%) and 689 (59.3%)
      clinics were received. RESULTS: Approximately 80 percent of primary care
      physicians obtain information about this survey by bulletin. They desire to
      obtain the latest information to aid diagnosis. More than 90 percent of them have
      facsimile, and 37.6 percent of them have access to Internet. The majority of them
      prefer to receive information by facsimile. CONCLUSION: Therefore, facsimile is
      the most powerful media for such information transfer at present.

PMID- 11201147
TI  - [A study on resource based relative values for visiting nursing services].
AB  - PURPOSE: The purpose of this study was to investigate the resource based relative
      values of visiting nursing services, and to analyze the relationships between the
      relative values and the dimensions of nursing service(time, mental effort and
      physical effort). METHODS: We interviewed nurses at 20 Home-visit nursing care
      stations (HVNCS) in the Metropolitan area using the resource based relative value
      questionnaires. We asked nurses about relative values of "Total Work", and also
      measured relative weight of 3 dimensions of nursing services. Total Work was
      defined as comprehensive evaluation of nursing services, with careful
      consideration of intensity as well as duration. With the dependent variable as
      Total Work and independent variables as the 3 dimensions, multiple regression
      analyses were carried out. Furthermore we examined the degree of influence on
      Total Work by service type and individual respondent. To examine the validity of
      the results, we timed nursing services and compared the measured time with the
      answered time. RESULTS: The 107 respondents were all female and their average age
      was 36.6 years old. They had HVNCS experience of 2.2 years and 95.3% nurses had
      experience of hospital nursing. "Total Work" and 3 dimension scores were
      standardized using common logarithms. "Total Work" of every service significantly
      differed among service types. The 3 dimensions explained 54.6% of Total Work in
      the multiple regression analysis. Service type explained 3.3% of Total Work.
      Individual respondent explained 16.0% of Total Work. Answered time and measured
      time were not significantly different with nursing services. CONCLUSIONS:
      Although Total Work was somewhat influenced by individual respondent, most of
      variation was explained by 3 dimensions. Thus, it could be concluded that Total
      Work is an index of nursing resource input. A further investigation about
      influence of patients' condition on Total Work is necessary in the future.

PMID- 11201148
TI  - [Development of a scale for subjective QOL common to patients with intractable
      diseases].
AB  - OBJECTIVE: We have developed a scale for evaluating subjective quality of life
      (QOL) common to patients with intractable diseases. SUBJECTS: Two-hundred and
      forty-seven outpatients of housebound patients from 7 collaborating hospitals or
      institutions participated in preliminary surveys. The patients were diagnosed
      with one of 14 diseases targeted by the Ministry of Health and Welfare's Specific
      Disease Treatment Research Project. Two-hundred and fifty-seven outpatients or
      housebound patients of 8 collaborating hospitals or institutions participated in
      a second survey that targeted 15 diseases. METHODS: The concept of subjective QOL
      was examined, and a favorable subjective QOL score was defied as "a state in
      which patients accept their current condition and possess a high level of morale
      with no signs of anxiety, despite the presence of their disease". Sixty-six items
      were then identified and included in a preliminary survey. Three preliminary
      surveys and a second survey were then conducted. A final scale for the items was
      then decided, and the items were assessed for their reliability and validity.
      RESULTS: Nine items reflecting two factors, "acceptance" and "morale", were
      selected and assessed for their reliability and validity as follows: 1) The
      response of subjects who accepted their illness yet possessed a high level of
      morale showed a good fit with the proposed scale (Adjusted Goodness of Fit Index
      = 0.925). 2) The confidence coefficient of the re-test method for subjective QOL
      scale scores was r = 0.78 (95% con idence interval: 0.72-0.83; n = 226) nd the
      alpha coefficient was 0.822, indicating a high level of reliability. 3) A strong
      negative correlation (r = -0.76, 95% confidence interval: -0.82 to -0.69; n =
      178) was found between the subjective QOL scale scores and self-rating depression
      scale (SDS) scores, and a moderately positive correlation (r = 0.35, 95%
      confidence interval: 0.23-0.46; n = 238) was found between the subjective QOL
      scale scores and activities of daily living (ADL) scores. 4) No statistically
      significant differences were observed in the distribution of subjective QOL scale
      scores when analyzed according to sex, age group, disease, or duration of
      illness. CONCLUSIONS: We have developed a scale consisting of 9 items for
      determining the subjective QOL of patients with intractable diseases. The scale
      was confirmed to properly reflect our concept of subjective QOL, which consists
      of two factors: "acceptance" and "morale" The scale was also confirmed to be
      stable and highly reliable.

PMID- 11201149
TI  - [Successful allogeneic bone marrow transplantation following fungal liver abscess
      treatment in a patient with chronic myeloid leukemia in blastic crisis].
AB  - A 40-year-old man was diagnosed as having chronic myeloid leukemia (CML) in
      December 1990 and received busulfan and hydroxyurea. He developed myeloid blast
      crisis in February 1996. After DCMP combination chemotherapy, his disease
      reverted to chronic phase, but right hypochondrial pain developed and low-grade
      fever persisted. Abdominal CT scan revealed multiple low-density areas in the
      liver, suggestive of abscess formation. Grocott staining of a liver biopsy sample
      revealed granuloma and fungus. The patient was treated with intravenous
      amphotericin B (AMPH-B) without success. AMPH-B was then administered via a
      catheter placed in the portal vein on January 6, 1997, and an additional catheter
      placed in the hepatic artery on March 28. AMPH-B was administered through both
      catheters for more than two months, but later substituted by fluconazole because
      of renal impairment. On September 10, allogeneic bone marrow transplantation from
      the patient's HLA-identical brother was performed, despite persistence of the
      abnormal CT findings. Acute grade III GVHD developed, but there was no evidence
      of reactivation of the liver abscesses. This case demonstrates that a prior
      fungal liver abscess is not an absolute contraindication for BMT if prophylactic
      antifungal drugs are administered and careful observation is conducted.

PMID- 11201151
TI  - [Angioimmunoblastic T-cell lymphoma associated with hemophagocytic syndrome at
      onset and relapse].
AB  - A 66-year-old woman was admitted with high fever, systemic lymphadenopathy,
      hepatosplenomegaly and pancytopenia. Bone marrow aspiration showed infiltration
      of atypical lymphoid cells and hemophagocytic histiocytes. The findings of lymph
      node biopsy were compatible with angioimmunoblastic T-cell lymphoma (AILD). A
      diagnosis of lymphoma-associated hemophagocytic syndrome (LAHS) was made.
      Treatment with the THP-COP regimen achieved clinical remission except for mild
      splenomegaly, but relapse of LAHS was confirmed two years after diagnosis. The
      patient's condition deteriorated rapidly, and she died of multi-organ failure one
      month later. Autopsy revealed extended, diffuse infiltration of lymphoma cells in
      almost all organs. Numerous macrophages showing phagocytosis of erythrocytes and
      nucleated cells were found in the adrenal glands, lungs, bone marrow, spleen and
      liver. Epstein-Barr virus genomes were not detected by in situ hybridization, but
      cytotoxic molecules were immunostained with TIA-1 and granzyme B in the lymphoma
      cells. Elevated serum levels of sIL-2R, IFN-gamma, IL-6 and M-CSF were found at
      the onset and relapse of lymphoma. Overproduction of these cytokines was
      considered to have contributed to the pathogenesis of HPS.

PMID- 11201150
TI  - [Rapidly progressive fibrosis and increased CD68-positive cells in the bone
      marrow at the terminal stage of adult T-cell leukemia accompanied by polycythemia
      vera].
AB  - We report a case of adult T-cell leukemia (ATL) accompanied by polycythemia vera
      (PV) in which rapid development of myelofibrosis and clinical features of
      hemophagocytic syndrome (HPS) were observed at the terminal stage. The patient, a
      53-year-old man who was born in Oita Prefecture, Japan, was diagnosed as having
      PV in 1996. He had undergone venesection but had not received any chemotherapy.
      In June 1997, he showed systemic lymphadenopathy with positivity for serum HTLV-1
      antibody (x 10,240). Pathological findings and Southern blotting analysis for
      detection of monoclonal integration of HTLV-1 provirus DNA in a lymph node biopsy
      sample revealed that he also had acute-type ATL. Although several courses of
      chemotherapy were transiently effective, high fever, pancytopenia, increased
      serum LDH, hypoproteinemia and hyperferritinemia appeared, all of which were
      compatible with the clinical features of HPS. In addition, cytomegalovirus
      infection became evident. He died of multiple organ failure with rapid
      progression of myelofibrosis in May 1998. Detection of both increased CD68
      positive histiocytes by immunohistochemistry and iron-stained phagocytic cells in
      marrow biopsy specimens appeared to be helpful for diagnosis of HPS in this
      patient, whose marrow showed myelofibrosis with hypocellularity.

PMID- 11201152
TI  - [Development of Hodgkin's disease four years after autologous peripheral blood
      stem cell transplantation for multiple myeloma].
AB  - We report a case of Hodgkin's disease that developed 4 years after autologous
      peripheral blood stem cell transplantation (PBSCT). The patient, a 67-year-old
      Japanese male, underwent PBSCT for multiple myeloma (IgA-lambda type) under a
      conditioning regimen of carboplatin, etoposide and cyclophosphamide in June 1994
      and obtained partial remission. In January 1995, he underwent a second PBSCT
      under a conditioning regimen of high-dose melphalan and obtained complete
      remission. In December 1998, he noticed swelling of the left cervical lymph
      nodes, and Hodgkin's disease of the mixed cellularity subtype was diagnosed from
      a lymph node biopsy sample. Immunohistochemistry studies showed that the
      Hodgkin's and Reed-Sternberg cells were CD30-positive. In situ hybridization
      using EBER probes showed that these cells expressed EBER RNA transcripts,
      indicating that the tumor was associated with Epstein-Barr virus. One noteworthy
      feature was the absence of both M-component in the serum and urine, as revealed
      by immunoelectrofixation, and plasmacytosis in the bone marrow, which would have
      indicated relapse of the multiple myeloma. After chemotherapy with MOPP and ABVD,
      the Hodgkin's disease was eradicated and the patient obtained complete remission
      in May 1999.

PMID- 11201153
TI  - [Occurrence of angioimmunoblastic T-cell lymphoma six months after onset of Lyme
      disease].
AB  - A 68-year-old man, who had suffered a tick bite one week previously, consulted
      his home doctor because of fever and an erythematous rash around the bite scar.
      He underwent a skin biopsy, and Borrelia garinii was detected, from which Lyme
      disease was diagnosed. He received amoxicillin for two weeks and his symptoms
      disappeared. After 6 months he noticed swelling of his cervical, axillary and
      inguinal lymph nodes. A biopsy sample was taken from a left cervical lymph node,
      and this revealed angioimmunoblastic T-cell lymphoma. The patient achieved a
      complete remission after chemotherapy. The relationship between Lyme disease and
      lymphoma is discussed.

PMID- 11201155
TI  - [Angioimmunoblastic T-cell lymphoma presenting with rapidly increasing biclonal
      gammopathy].
AB  - A 59-year-old man was admitted to our hospital with high fever and dysphagia.
      Physical examination revealed a lingual tumor and swelling of the cervical and
      inguinal lymph nodes. A lymph node biopsy specimen revealed that the normal nodal
      architecture had been obliterated by infiltration of small, intermediate, and
      large pale lymphocytes. Arborous branching of high endothelial venules was also
      observed. Southern blotting analysis showed rearrangement of the T-cell receptor
      beta gene. A diagnosis of angioimmunoblastic T-cell lymphoma was made. Serial
      serum protein fractionation analysis showed rapidly increasing M-protein.
      Immunofixation electrophoresis indicated specific bands for IgG kappa and IgM
      lambda, confirming the presence of biclonal gammopathy. Biclonal gammopathy has
      rarely been reported in patients with angioimmunoblastic T-cell lymphoma. The
      relationship between the occurrence of biclonal gammopathy and the possible role
      of HHV-6, HHV-8 and EBV is discussed.

PMID- 11201154
TI  - [Nonmyeloablative stem cell transplantation with low-dose total body irradiation
      (200 cGy) for a 55-year-old woman with acute lymphoblastic leukemia].
AB  - We describe a 55-year-old woman with acute lymphoblastic leukemia (ALL) in the
      first remission who underwent nonmyeloablative stem cell transplantation with
      conditioning consisting of low-dose total body irradiation and postgrafting
      cyclosporine and mycophenolate mofetil. Myelosuppression was mild, but on day 28
      her bone marrow showed 8.8% lymphoblasts. We withdrew the cyclosporine, but the
      patient developed grade 2 acute GVHD and eosinophilia. The proportion of bone
      marrow lymphoblasts decreased transiently to 1.0% on day 40, but later increased
      again and the patient died on day 85. Application of this approach to patients
      with ALL needs to be examined on a large scale.

PMID- 11201156
TI  - [Idiopathic hyperammonemia following allogeneic bone marrow transplantation for
      refractory lymphoma].
AB  - Idiopathic hyperammonemia (IHA) is a rare but serious complication of stem cell
      transplantation. We report a patient with immunoblastic lymphoadenopathy-like T
      cell lymphoma who developed IHA 10 days after allogeneic bone marrow
      transplantation from an HLA-matched unrelated donor. Despite intensive supportive
      care, the patient died due to this metabolic disorder two days later. Being
      mindful of the possibility of IHA in patients who develop confusion and
      respiratory alkalosis soon after stem cell transplantation would allow earlier
      treatment and might improve the chance of survival.

PMID- 11201157
TI  - [The G protein-coupled protease receptor PAR (protease-activated receptor) as a
      novel target for drug development].
AB  - The protease-activated receptor (PAR) is the family of G protein-coupled, seven
      transmembrane domain receptors, currently consisting of four members, PARs 1-4.
      The activation of PARs occurs by proteolytic unmasking of the N-terminal cryptic
      receptor-activating tethered ligand. In the past decade since the cloning of PAR
      1, physiological roles that PARs play have been gradually understood and are now
      considered extremely extensive and important. This review describes physiological
      and/or pathophysiological roles of PARs in the circulatory, digestive,
      respiratory and central nervous systems, on the basis of our works and of those
      achieved by other research groups. The future perspective of studies on PARs is
      also discussed, focusing on the possibility of clinical application of PAR
      targeted drugs.

PMID- 11201158
TI  - Progress and problems in the prescribing/dispensing split and "divided package
      sales" by wholesalers.
AB  - Given the rapid progress of the prescribing/dispensing split, the ability of
      pharmacies to obtain and stock a small quantity of pharmaceuticals is seen as
      essential. Toho Yakuhin's experience in "divided package sales" (wholesalers open
      an original package supplied by the manufacturer and sell only a part of the
      contents) shows that the number of orders and sales amount, and the number of
      pharmacies ordering in sales have remarkably increased. One or two kinds of
      pharmaceuticals were ordered in 73% cases, and one or two units in about 50%.
      This implies that "divided package sales" are utilized to obtain rarely
      prescribed drugs. On the other hand, five or more kinds of pharmaceuticals were
      ordered in 10% of cases, and ten or more units in 17%. "Divided package sales"
      were more used for low-price drugs. These indicated that "divided package sales"
      seemed to be looked upon by pharmacies as a means of obtaining a small quantity
      of pharmaceuticals, and seemed to be used not only in an emergency but also
      routinely. There are several problems for wholesalers in operating "divided
      package sales", such as frequent delivery, delivery cost and information supply.
      Pharmacies should obtain a small quantity of pharmaceuticals by the routine
      delivery and should share the delivery cost. Pharmaceutical manufacturers'
      cooperation in printing necessary information on each immediate container will be
      useful. Though there could be alternative ways of obtaining a small quantity of
      pharmaceuticals, all of them have the matter of delivery. We believe "divided
      package sales" will contribute to this situation.

PMID- 11201159
TI  - [Antioxidative effects of fluvastatin, and its major metabolites [II]].
AB  - We investigated the antioxidative effects of fluvastatin (FV or (+/-)-FV), each
      enantiomer ((+)-FV, (-)-FV) and its major metabolites on lipid peroxidation using
      rat and human liver microsomes. The extent of NADPH induced microsomal (Ms) lipid
      peroxidation was determined by thiobarbituric acid (TBA) assay. The antioxidative
      effect of each compound was shown as the percentage of inhibition on the
      formation of TBA reactive substance (TBARS) against vehicle control. The
      antioxidative effects of alpha-tocopherol (Toc), a potent antioxidative vitamin,
      probucol (PR), a potent antioxidative drug, pravastatin (PV) and simvastatin
      (SV), HMG-CoA reductase inhibitors, were also tested. The (+/-)-FV inhibit the
      formation of TBARS by 40 to 70% depending on Ms concentrations. The antioxidative
      effects of PR and TOC were comparable to those of FV. The inhibitory effects of
      PV and SV on the formation of TBARS were less potent than (+/-)-FV, PR and TOC.
      (+)-FV, (-)-FV, and (+/-)-FV inhibited the formation of TBARS by approximately
      50% using rat hepatic microsomes. The antioxidative effects of (+)-FV was
      comparable to that of (-)-FV using human hepatic microsomes. These results
      indicated that the antioxidative effects of (+)-FV were comparable to those of (
      )-FV, although the HMG-CoA reductase inhibitory activity of (+)-FV was 30-fold
      higher than that of (-)-FV.

PMID- 11201160
TI  - [Functional analysis of phospholipase A2 receptor by gene knockout studies].
AB  - Phospholipase A2 receptor (PLA2R) is a type I transmembrane glycoprotein related
      to the C-type animal lectin family and mediates a variety of biological responses
      elicited by group IB secretory phospholipase A2 (sPLA2-IB). In the present study,
      we have shown the evidence that a novel type of sPLA2, sPLA2-X, also acts as one
      of the high-affinity ligands for mouse PLA2R. We then generated PLA2R-deficient
      mice and found that the knockout mice exhibited the resistance to an endotoxic
      shock with reduced plasma levels of proinflammatory cytokines, such as TNF-alpha
      and IL-1 beta. In situ hybridization analysis revealed that the expression of
      PLA2R transcript was markedly enhanced in type II alveolar epithelial cells and a
      subset of splenic lymphocytes in accordance with the elevated expression of sPLA2
      IB and TNF-alpha mRNAs during endotoxic shock. In addition, the elevated
      expression level of TNF-alpha transcript was significantly reduced by the
      deficiency of PLA2R, suggesting that PLA2R plays a role in the regulation of TNF
      alpha expression in these cell types. We then synthesized a specific sPLA2
      inhibitor, indoxam, which blocked the binding of sPLA2-IB and X to PLA2R. Indoxam
      was found to suppress the elevation of the plasma level of TNF-alpha and
      prolonged the survival of endotoxin-challenged mice. The inhibitory effects of
      indoxam were abolished by the deficiency of PLA2R, demonstrating the involvement
      of PLA2R in the progression of endotoxic shock. We also detected and
      characterized a soluble form of PLA2R protein in the plasma of mouse with anti
      PLA2R antibody, and showed its potential role as an endogenous sPLA2 inhibitor.
      Taken together, a series of studies with PLA2R-knockout mice have elucidated a
      critical role of PLA2R in the regulation of the development of endotoxic shock.

PMID- 11201161
TI  - [A study for functions of prostaglandin E receptor EP4 subtype by analysing
      knockout mice].
AB  - The physiological role of the prostaglandin (PG) E2 receptor EP4 subtype was
      investigated by the generation of EP4-deficient mice by gene targeting. Loss of
      the EP4 receptor was not lethal in utero, but most EP4 (-/-) neonates became pale
      and lethargic approximately 24 h after birth, and died within 72 h. Less than 5%
      of the EP4 (-/-) mice survived and grew normally more than a year. Marked
      congestion in the pulmonary capillaries were observed before death, suggesting
      that EP4 (-/-) neonates had left-sided heart failure. Histological examination
      revealed that the ductus arteriosus in dead neonates remained open, while it was
      partially closed in the survivors. In situ hybridization study showed that EP4
      mRNA was strongly expressed in the ductus. The treatment of indomethacin, an
      inhibitor of PG synthesis, on wild-type fetus induced constriction of ductus
      arteriosus, while the ductus in EP4 (-/-) fetus was insensitive to indomethacin.
      These results suggest that neonatal death is at least partly due to patent ductus
      arteriosus, and that the EP4 receptor plays a role in the regulation of the
      patency of this vessel. They also indicate that the normal function of the EP4
      receptor is essential in neonatal adaptation of the circulatory system.

PMID- 11201162
TI  - [Software development for calculation of molecular surface area and its
      application to hydrophobic interaction].
AB  - A novel method of calculating the water-accessible molecular surface area from
      the number of points generated on the molecular surface was developed. This
      method yielded a molecular surface area with high accuracy and speed. The
      molecular surface area of lecithin shows an excellent linear correlation with the
      logarithm of the critical micelle concentration for many lecithins having
      different acyl chains. The solution structure of oxyphenonium bromide estimated
      from the molecular surface area approach was close to that obtained from NMR.
      Furthermore, the change of molecular surface area, delta S(HG), with docking of
      host and guest was defined and its calculation method was developed. Because both
      the host and the guest generally consist of hydrophilic and hydrophobic atomic
      groups, delta S(HG) was divided into such four terms as delta Soo(HG), delta
      Sow(HG), delta Swo(HG), and delta Sww(HG). For instance, delta Soo(HG) is the
      decrease in surface area with contact between the hydrophobic surfaces of the
      host and the guest. When the guest molecule was moved along the symmetry axis of
      cyclodextrin (CyD), the structure of a complex having the maximum value of delta
      Soo(HG) corresponds with the crystal structure. The solution structures of
      several inclusion systems were predicted by this method. For various systems
      including alpha-CyD, beta-CyD, gamma-CyD, and aromatic and aliphatic guests, the
      maximum values of delta Soo(HG) showed a good correlation with the logarithms of
      the binding constants. This relationship will be used for the prediction of the
      binding constants for CyD and other host-guest systems.

PMID- 11201163
TI  - [Nitrogen pyramidal amides and related compounds].
AB  - A planar amide bond is a fundamental linkage in the structures of peptides and
      proteins. The rigid planarity of the amide linkage, due to a conjugation between
      carbonyl and amine groups, may be requisite for encoded protein folding and many
      other biological processes. Non-planar amides in the ground state will decode the
      significance of the planarity and rigidity of the amide linkage. We show here
      that simple amides of 7-azabicyclo[2.2.1]heptane, free from steric bias,
      including parent N-benzoyl 7-azabicyclo[2.2.1]heptane, are nitrogen-pyramidal
      amides in the crystalline state. We can suggest that pyramidalized amide nitrogen
      is a general feature and intrinsic to the 7-azabicyclo[2.2.1]heptane motif. Low
      rotational barriers of the amide C-N bond in a series of N-benzoyl amides of 7
      azabicyclo[2.2.1]heptane, compared to monocyclic amides, may imply that ground
      state nitrogen pyramidalization of the former amides also exist in solution. The
      7-azabicyclo[2.2.1]heptane motif also favors nitrogen pyramidalization of
      sulfonamides and N-nitrosoamines, which can lead to pharmacophores after
      appropriate modification.

PMID- 11201164
TI  - Clinical characteristics of asthmatic patients prescribed various beta-agonist
      metered-dose inhalers at Yamagata University Hospital.
AB  - To determine the prescription characteristics of beta-agonist metered-dose
      inhalers (MDI), we retrospectively investigated all prescriptions containing one
      of five types of beta-agonist MDIs available at Yamagata University Hospital in
      1997, as well as patients' characteristics. The total number of asthmatic
      patients was 225 (age, 11-79, mean, 47.2) in 1997. Fenoterol MDI was prescribed
      to patients who visited the hospital at regular periods and had more severe
      asthma. Isoprenaline MDI also was not prescribed for first-time patients.
      Patients who were prescribed tulobuterol MDI had mild or moderate asthma and some
      of them were only occasional or first-time visitors. Salbutamol and procaterol
      MDIs were also prescribed for first-time patients; however, tulobuterol MDI was
      the most frequently prescribed for first-time patients. Patients prescribed
      fenoterol and isoprenaline MDIs had adequate knowledge of proper asthma
      management, because sufficient information had been provided about the use of
      MDIs in the past. Patients prescribed tulobuterol MDI should be provided with
      detailed instructions because they had little knowledge of handling MDIs and self
      management of asthma as many of them were first or intermittent visitors.
      Patients prescribed salbutamol or procaterol MDIs should be evaluated regarding
      their past medications and some of them should be instructed regarding the use of
      the MDI. Although these clinical aspects might be applicable only to our
      hospital, the same or other prescription patterns will be found in other
      hospitals and/or by other physicians. Adequate instructions to individual
      patients who are prescribed a particular beta-agonist MDI should be provided by
      the medical staff, especially to outpatients, to reduce hospitalization and death
      from asthma.

PMID- 11201165
TI  - [Strain-, sex- and species-related differences of acetohexamide reductase and 20
      beta-hydroxysteroid dehydrogenase activities in liver microsomes of experimental
      animals].
AB  - We examined physiological and genetic factors affecting acetohexamide reductase
      (AHR) and 20 beta-hydroxysteroid dehydrogenase (20 beta-HSD) activities in liver
      microsomes of experimental animals. Pronounced strain-related differences were
      found in both activities of AHR and 20 beta-HSD present in liver microsomes of
      male rats. Among rat strains tested in this study, even though a Wistar-Imamichi
      (WIM) rat strain was taken to lack AHR activity, it exhibited a significant 20
      beta-HSD activity. These findings appeared to be in conflict with our conclusion
      reported so far, which AHR and 20 beta-HSD present in liver microsomes of male
      rats are identical enzymes. Thus the reason for this discrepancy was discussed.
      Furthermore, AHR and 20 beta-HSD activities were little or not observed in liver
      microsomes of female rats or male experimental animals other than the rat,
      indicating the existence of sex- and species-related differences in these two
      enzyme activities.

PMID- 11201166
TI  - [In vitro and in vivo study of regulation mechanisms of type I interleukin-1
      receptor].
AB  - Interleukin 1 (IL-1) is one of the inflammatory cytokines, which plays a pivotal
      role in both host defense and homeostasis. Its signal is transduced by type I IL
      1 receptor (IL-1RI). This report gives an insight into the regulatory mechanism
      of IL-1RI in both in vitro and in vivo. IL-1 up-regulates IL-1RI through
      prostaglandin E2 (PGE2) production on human fibroblasts. However, in the presence
      of indomethacin, IL-1 down-regulates the receptor by destabilizing IL-1 receptor
      mRNA. Type I and type II interferons (IFNs) up-regulate the expression of IL-1RI.
      This up-regulation leads to the increasing susceptibility of IL-1RI to IL-1, as
      the DNA binding of IL-1-induced NF-kappa B and the production of IL-1-induced IL
      6 from the fibroblasts are augmented by pretreatment with IFNs. On the other
      hand, the expression of cell surface IL-1RI is inhibited by tyrosine kinase
      inhibitors, herbimycin and genistein, resulting in reduction of the kinase
      activity of IRAK (IL-1 receptor associated kinase) and IL-1-induced IL-6
      production from the fibroblasts. Lipopolysaccharide (LPS) augments the expression
      of IL-1RI mRNA and cell surface molecule in the hepatocytes of mice in vivo, and
      the augmentation is mediated by the interaction of IL-1, IL-6, and of
      glucocorticoid (GC). When hepatocytes were pretreated with dexamethasone (Dex)
      and IL-6, the activation of IRAK was augmented in response to IL-1, indicating
      that IL-1 signaling is also up-regulated. In addition, IL-1 treatment ather
      combined administration of Dex and IL-6 into mice markedly increased the serum
      level of serum amyloid A. These data suggest that the expression of IL-1RI is
      regulated by inflammatory cytokines, PGE2, GC and LPS in vitro and in vivo. This
      study shows that the biological activity of IL-1 can be controlled by regulating
      the expression of IL-1RI, and therefore proposes the use of pharmaceutical drugs
      for the regulation of cytokine expression.

PMID- 11201167
TI  - [Effect of selenium on serum, hepatic and lipoprotein lipids concentration in
      rats fed on a high-cholesterol diet].
AB  - The effects of Selenium (Se) on lipid metabolism was studied in male Wistar rats
      which were fed a high-cholesterol diet (HCD) containing 1%(w/w) cholesterol and
      0.5%(w/w) cholic acid for 10 weeks. Se was orally administered at daily doses of
      0.173 mg/kg in HCD into the test rats for 10 weeks. As compared with control
      groups, Se/HCD suppressed the amounts of triglyceride (TG), total cholesterol
      (CH) and free fatty acid in the serum. Se/HCD also decreased the amounts of low
      density lipoprotein cholesterol (LDL-C) in the serum. Further-more, Se/HCD
      inhibited the amount of liver TG and CH. The activity of fatty acid synthetase in
      the HCD fed group was higher than in the Se/HCD fed group. These results suggest
      that Se may have recuperative effects for hypercholesterolemia.

PMID- 11201168
TI  - [Sensitization and crossreaction of simple coumarins].
AB  - The contact sensitization of 11 simple coumarins was examined by subcutaneous
      sensitizing of guinea pigs, and the structure-activity relationship and cross
      reactivity were investigated. Esculetin, 4-methylesculetin, and dephnetin were
      found to be strong sensitizers, and 4-hydroxy-coumarin to be a moderate
      sensitizer. Other simple coumarins tested had a weak sensitivity to mild
      sensitizers. The results suggest that the introduction of hydroxy group,
      especially adjacent substitution at the 6, 7, and 8 positions of the coumarin
      ring with two hydroxy groups, may play an important role in exhibiting the
      contact sensitization activity. The cross-reactivity was observed between
      esculetin and 4-methylesculetin, esculin or isoscoporetin, and also between
      daphnetin and 4-methylumbelliferone or umbelliferone, although there was no
      mutual cross-reactivity between esculetin and daphnetin. It is interesting to
      note that guinea pigs, which had a weak sensitivity to umbelliferone, showed a
      strong cross-reactivity to daphnetin, while those, which had a weak sensitivity
      to daphnetin, showed a weak cross-reactivity to umbelliferone. It is assumed that
      a skin-protein conjugation at 5 or 6 positions of the coumarin ring is important
      to elicit the cross-reactivity of esculetin or daphnetin groups.

PMID- 11201169
TI  - A search for chemical agents causing human cancer--lessons learned from rodent
      carcinogenicity studies.
AB  - Analysis of classical life-time rodent bioassays conducted over the past 20 years
      under conditions of Good Laboratory Practice Regulations has led to an improved
      understanding of possible factors involved in oncogenesis in humans. Improvements
      in study design coupled with more detailed pathological examinations have led to
      new insights whereby neoplastic processes can be more clearly identified and
      understood with confidence in animal models. Improvements in the ability to
      identify potential risks through continued animal testing combined with
      incorporation of advances in genetics and molecular biology in elucidating
      mechanistic factors will greatly facilitate future research efforts to identify
      causative agents of human cancer. A great deal of attention will have to be paid
      to the concept of threshold doses and exposure levels that may be required to
      achieve preneoplastic conditions or the induction of carcinogenic processes.
      Future concerns of hazards, risk assessment and the evaluation of carcinogenic
      potential will involve an amalgamation and understanding of radiological and
      biological events, especially those of carcinogenic microorganisms, the effects
      of food and air borne carcinogens, effects of pollution, exposure to xenobiotics
      and imbalances and disruption of normal biologic functioning of endogenous
      physiologically active substances, to achieve a better understanding and ultimate
      prevention of human cancer.

PMID- 11201170
TI  - No toxicity caused by organ accumulation of CPT-11 on multiple injections under
      clinical regimens in rats.
AB  - We investigated the accumulation of CPT-11 and its metabolite (SN-38) in various
      organs and toxicities on multiple injections of CPT-11 under clinical regimens in
      SD rats. CPT-11 (16.7 mg/kg equivalent to 100 mg/m2) was administered
      intravenously by a single injection, or by multiple injections in 1 course (once
      a week for three consecutive weeks) or 3 courses (1 course repeated 3 times at
      intervals of 2 weeks). There was no tendency for CPT-11 and SN-38 to accumulate
      in any organs regardless of the number of injections. Treatment-related changes
      were not observed in the general condition, body weight, hematology,
      biochemistry, and organ weights. Histopathological changes induced by CPT-11 were
      not persistent and the rats made a rapid recovery after the administrations. From
      these results, it is suggested that there is no toxicity caused by accumulation
      of CPT-11 and its active metabolite, SN-38, in organs under clinical regimens in
      rats.

PMID- 11201171
TI  - Evaluation of a 5-day Hershberger assay using young mature male rats:
      methyltestosterone and p,p'-DDE, but not fenitrothion, exhibited androgenic or
      antiandrogenic activity in vivo.
AB  - A 5-day Hershberger assay using young mature male rats to detect compounds
      interfering with androgen receptor (AR)-mediated mechanisms was evaluated for
      ability to identify p,p'-DDE (a weak AR antagonist) and methyltestosterone (MT,
      an AR agonist). Fenitrothion, an organophosphate pesticide, was also evaluated in
      this validated assay. Castrated male Crj:CD(SD)IGS rats (1 week after castration,
      11 weeks of age) were subjected to experiments. To determine a suitable value of
      testosterone propionate (TP) as a reference androgen for detection of
      antiandrogenic chemicals, castrated male rats were treated daily with TP (0,
      0.06, 0.25, 1, 4, or 16 mg/kg/day, s.c.). TP produced increases in weights of
      ventral prostate, seminal vesicles and levator ani plus bulbocavernosus muscles.
      Serum androgen level measured by RIA kit (mostly TP) were elevated in a dose
      related manner, while the weights of organs with 1 mg/kg/day of TP were nearly
      equivalent to the maximum responses (i.e., sub-maximal). One hundred mg/kg/day of
      p,p'-DDE significantly attenuated TP 0.1 mg/kg-induced increases in weights of
      seminal vesicles and muscles, and TP 1 mg/kg-induced increases in weights of
      ventral prostate, seminal vesicles and muscles, but did not affect the weight of
      these organs in either TP 16 mg/kg-treated or intact rats, demonstrating that the
      dose range of 0.1-1 mg/kg TP is suitable for reference androgen. Oral treatment
      with 100 mg/kg of MT increased the weights of ventral prostate, seminal vesicles
      and muscles as strongly as did subcutaneous injection of 1 mg/kg of TP. These
      findings demonstrate that the 5-day Hershberger assay using young mature as well
      as immature male rats is a sensitive and valid short-term screening method for
      the detection of chemicals interfering with AR-mediated mechanisms. To determine
      whether fenitrothion interferes with AR-mediated mechanisms in vivo, fenitrothion
      (0, 0.75, 1.5 or 3 mg/kg/day) was administered by gavage for 5 days to castrated
      rats for androgenicity, or to castrated rats treated with 1 mg/kg TP for
      antiandrogenicity. Treatment with fenitrothion had no adverse effects on clinical
      signs, body weight, or liver or kidney weights, but cholinesterase activities in
      the brain and erythrocytes were significantly suppressed by fenitrothion to,
      respectively, 77-81% and 66-67% of control levels. In the antiandrogenicity
      experiment, serum androgen levels of TP-treated, castrated rats did not differ
      among groups. Treatment with 100 mg/kg of p,p'-DDE as a positive control again
      significantly attenuated TP-induced increases in weights of the ventral prostate
      and seminal vesicles, while fenitrothion had no effect on the weights of any
      organs. In the androgenicity experiment, treatment with 100 mg/kg of MT
      significantly increased weights of ventral prostate, seminal vesicles and
      muscles, but fenitrothion had no effects on the weights of any of these organs.
      These findings yield no evidence that fenitrothion interferes with AR-mediated
      mechanisms in vivo, consistent with the result of several toxicological
      bioassays.

PMID- 11201172
TI  - Influences of alkaline ionized water on milk electrolyte concentrations in
      maternal rats.
AB  - We previously reported that body weight on day 14 after birth in male offspring
      of rats given alkaline ionized water (AKW) was significantly heavier than that in
      offspring of rats given tap water (TPW), but no significant difference was noted
      in milk yield and in suckled milk volume between the two groups. Additionally,
      the offspring in the AKW group and TPW group were given AKW and TPW,
      respectively, at weaning, and unexpectedly, the necrotic foci in the cardiac
      muscle were observed at the 15-week-old age in the AKW group, but not in the TPW
      group. The present study was designed to clarify the factors which are involved
      in that unusual increase of body weight and occurrence of cardiac necrosis. Eight
      dams in each group were given AKW or TPW (control) from day 0 of gestation to day
      14 of lactation. The milk samples were collected on day 14 of lactation and
      analyzed for concentrations of calcium (Ca), sodium (Na), potassium (K),
      magnesium (Mg) and chloride (Cl). The AKW and TPW were also analyzed. Ca, Na and
      K levels in milk were significantly higher in the AKW group compared to the TPW
      group. No significant difference was noted in the Mg and Cl levels between the
      two groups. These data suggested that the Ca cation of AKW enriched the Ca
      concentration of the milk and accelerated the postnatal growth of the offspring
      of rats given AKW.

PMID- 11201173
TI  - Effect of troglitazone on the liver of a Gunn rat model of genetic enzyme
      polymorphism.
AB  - There is a possibility that serious liver dysfunction rarely observed in diabetic
      patients given troglitazone is attributable to idiosyncratic abnormalities in
      liver drug-metabolism. In addition, the results of blood biochemical examinations
      in serious cases of liver dysfunction showed a tendency for a high level of total
      bilirubin (T-Bil) over a long period compared with other indicators of liver
      dysfunction. Thus, we focused on genetic variation of UDP
      glucuronosyltransferases (UGTs) that are involved in the conjugation of
      troglitazone and bilirubin. In this study, Gunn rats, which are hereditarily
      deficient in the UGT1 family of UGT isozymes, and Wistar rats, the parent strain
      of Gunn rats, were treated with troglitazone for 3 months at dose levels of 0,
      100 or 400 mg/kg to investigate two possibilities: first, whether the genetic
      deficiency in UGT1s induces an alteration of the metabolic profile of
      troglitazone followed by liver dysfunction, and second, whether the dosing of
      troglitazone to Gunn rats which show hyperbilirubinemia result in liver
      dysfunction. As a result, the metabolic profile of troglitazone in Gunn rats was
      much the same as that of Wistar rats, suggesting that genetic deficiencies in
      UGT1s did not influence the metabolic profile of troglitazone. Moreover, no
      elevation of blood biochemical parameters, such as asparate aminotransferase
      (AST) and alanine aminotransferase (ALT), or histopathological liver injuries,
      such as hepatocellular degeneration and necrosis, were observed in either strain
      of rats, and hyperbilirubinemia in Gunn rats was not aggravated by the dosing of
      troglitazone. These results strongly suggest that troglitazone was not
      metabolized by UGT1s but by other UGT isozyme (s) in rats, and that
      glucuronidation of troglitazone did not compete with glucuronidation of bilirubin
      in vivo. Thus, it is suggested that high levels of total bilirubin in patients
      with liver dysfunction induced by troglitazone are attributable to hypofunction
      due to hepatocellular injury, not to metabolic competition of bilirubin with
      troglitazone. Moreover, it is also suggested that the deficiency in the UGT1
      family of UGT isozymes itself may not be the cause of liver dysfunction
      associated with troglitazone treatment.

PMID- 11201174
TI  - Characterization of UDP-glucuronosyltransferases (UGTS) involved in the
      metabolism of troglitazone in rats and humans.
AB  - UDP-glucuronosyltransferases (UGTs) involved in troglitazone glucuronidation in
      rats and humans have been characterized to support the previous toxicity study on
      troglitazone in Gunn rats and to examine whether the UGT polymorphism or
      inhibition of bilirubin metabolism is related to the clinically reported rare
      cases of liver failure. The experiments using Gunn rats revealed that UGT1
      enzymes are not involved in troglitazone glucuronidation and that the responsible
      enzyme in rats was suggested to be UGT2B2, an androsterone UGT, by inhibition
      studies. In humans, contribution of UGT1A1 was estimated to be about 30% of the
      total troglitazone glucuronidation by UGTs, using human liver microsomes and
      recombinant UGTs. Other UGT1 and UGT2 enzymes seem to be responsible for the rest
      of the troglitazone glucuronidation in humans. The multiplicity of UGTs involved
      in troglitazone glucuronidation in humans may allow even patients lacking
      bilirubin UGT (UGT1A1) activity to produce troglitazone glucuronide. These
      observations suggest that the polymorphism of UGT is not the reason behind the
      liver failure induced by the troglitazone treatment, and troglitazone does not
      inhibit bilirubin glucuronidation in clinical treatment. In addition, the
      increased bilirubin level in the blood of patients who have troglitazone-induced
      liver failure is a consequence of liver injury and not due to inhibition of
      bilirubin glucuronidation by troglitazone.

PMID- 11201175
TI  - Comparison of sperm motility test methods (except computer-assisted sperm
      analysis) in rats under the condition of alfa-chlorohydrin treatment-
      collaborative investigation.
AB  - A comparison among rat sperm motility test methods including percent of motile
      sperm (% Motile), scoring method (Scoring), Ishii's method, Progressive Motility
      Test (PMT) and Sperm Quality Analyzer (SQA), was conducted using data gathered
      from eleven laboratories. As a unified study design, mature male rats were orally
      treated daily for approximately 1 week with alpha-chlorohydrin (ACH), which is
      known to affect the sperm motility at the epididymis, at dose levels of 2.5, 5
      and 10 mg/kg, and then subjected to more than two test methods for sperm motility
      in each laboratory. Scoring (4 or 5 grades), Ishii's method, PMT and SQA showed
      high sensitivity for the detection of the effects of ACH, which were not
      considered to be inferior to a computer-assisted sperm analyzer (CASA). Longer
      incubation time before testing was considered to contribute to detecting the
      effects of ACH. In particular, we realized that Scoring was a favorable method
      even if the demerit of poor objectivity was allowed for. Percent Motile showed
      lower sensitivity than other test methods. The differences in sensitivity between
      % Motile and other methods were considered to be based on whether the defects of
      progressive motion could be detected. Although % Motile cannot clearly judge
      whether immotile sperm are dead or alive, the value is a great help for the
      interpretation of the result from other methods. Based on the characters for
      detectability, objectivity and efficiency, the most suitable method of sperm
      motility should be selected according to the purpose of the toxicity study.

PMID- 11201176
TI  - [A case of an advanced aged Eisenmenger's syndrome].
AB  - We report a 70-year-old women with Eisenmenger's syndrome. Eisenmenger's syndrome
      with ventricular septal defect was diagnosed at another hospital when she was 32
      years old. Then, she was referred to our hospital at age 60 old and she now is
      according to the out patient in over clinic. She have mild cardiac function, NYHA
      classification, was II-M, polycythemia cell blood count 535 x 10(4) and 17.2 g/dl
      in hemoglobin. Echocardiography suggested serious Eisenmenger's syndrome. The
      left ventricle was compressed, the blood pressure of the right ventricle exceeded
      105 mmHg, and the onset of the right to left shunt flow was thought to be 250
      msec bored on the electrocardiogram Q wave. The reason why the progression of
      complicated obstructive pulmonary artery disease was slow may have been become of
      the mildness of her polycythemia, and this is presumed to be the reason for her
      long survival to age 70.

PMID- 11201177
TI  - [Difference between first appraisal and clinical estimation appraisal in a new
      social insurance system covering long-term care service--in terms of outpatients
      and inpatients].

PMID- 11201178
TI  - [Significance of abdominal ultrasonography on noticing aortic aneurysm--from
      study on diagnostic chance of aneurysm].

PMID- 11201179
TI  - [Evaluation and improvement of medical and nursing service and caregiving for the
      elderly using MDS. 2. Diagnosis and symptoms, especially diseases causing care
      requiring conditions].
AB  - Diagnoses recorded in the chapter E of Minimum Data Set (MDS) were analyzed in
      patients requiring care admitted in a geriatric hospital in Sapporo, Japan. They
      were classified as: A-diseases causing care-requiring conditions, B-their
      symptoms, and C-coexisting diseases requiring no care. Orthopedic diseases were
      not analyzed because they were not adequately recorded in MDS system. Class A
      diagnoses varied, but only five diagnoses were responsible for 3% or more of the
      total patients who required care. They were 1) Alzheimer's disease (AD), 2)
      Parkinson's disease, 3) dementia other than AD without neurological symptoms, 4)
      dementia other than AD with sequelae of stroke, and 5) sequelae of stroke without
      dementia. These diagnoses pooled represented over 90% of all patients. "Diagnoses
      and symptoms" in MDS were useful to 1) describe medical problems briefly in a
      predetermined format, 2) evaluate urgent or unstable conditions separately from
      stable diagnoses and symptoms, and 3) use common information by various
      professions, but have difficulties because 1) preselected diagnoses were few and
      unsuited to practices in Japan, 2) it is impossible to record a previous disease
      in the past that initiated the process leading to the present disabilities, and
      3) it is also impossible to record the severities of the diseases and symptoms.

PMID- 11201181
TI  - [Current and coming new era of medical informatics in the aging society].

PMID- 11201180
TI  - [Association between dementia and dietary nutrients].

PMID- 11201182
TI  - [Neurological complication with cancer].

PMID- 11201183
TI  - [Characteristics and the treatment of hypertension in the elderly].

PMID- 11201184
TI  - [Exogenous lactate sustains synaptic activity and neuronal viability, but fails
      to induce long-term potentiation (LTP)].
AB  - In Alzheimer's disease, brain glucose metabolic ratio decreases, whereas the
      brain lactate metabolic ratio increases. To investigate possible synaptic
      dysfunction in Alzheimer's disease, we examined the effects of exogenous glucose
      deprivation and replacement of glucose with lactate on the synaptic transmission,
      synaptic plasticity, and the morphological integrity of hippocampal neurons.
      Synaptic activity was estimated by the amplitude of the population spike (PS)
      recorded in the granular cell layer in the hippocampal slices from guinea pig and
      rat. Exogenous glucose deprivation caused the immediate depression of PS.
      Replacement of glucose with lactate induced transient decrease of PS, followed by
      spontaneous recovery of synaptic transmission. Neural activity recovered from
      transient glucose deprivation became resistant to the replacement of glucose with
      exogenous lactate. Glucose-supported synaptic transmission exhibited
      approximately 140% enhancement of PS (LTP). However, lactate-supported synaptic
      activity yielded approximately 110% potentiation of PS. Effects of exogenous
      glucose and lactate on the cell viability were examined by the propidum iodide
      uptake and LDH release in the organotypic hippocampal slice cultures. Hippocampal
      slice cultures incubated in medium containing 10 mM lactate suppressed the cell
      death during 48 h observation as well as those in the 10-30 mM glucose containing
      medium. These results indicate that lactate can sustain the neural transmission
      and support the morphological integrity of hippocampal neurons, but failed to
      induce LTP, which could at least in part, cause the memory impairment in
      Alzheimer's disease.

PMID- 11201186
TI  - [Analysis of dietary factors in Alzheimer's disease: clinical use of nutritional
      intervention for prevention and treatment of dementia].
AB  - To determine dietary factors involved in the pathological process of Alzheimer's
      disease (AD), we analyzed food consumption and intake of nutrients using Self
      administered Diet History Questionnaire (DHQ) developed for Japanese. Sixty four
      AD patients and 80 age-matched healthy subjects were enrolled in this study. AD
      was diagnosed according to the criteria of DSM-IV. Dietary behaviors of AD
      patients was markedly deviated from those of age-matched healthy elderly. AD
      patients disliked fish and green-yellow vegetables and took more meats than
      controls. Energy-adjusted analysis of nutrients revealed that AD patients took
      less vitamin C and carotene. Most conspicuously, AD patients took significantly
      smaller amount of n-3 polyunsaturated fatty acid (PUFA) reflecting low
      consumption of fish, and their n-6/n-3 ratio was significantly increased. These
      habits started from 3 months to 44 years before the onset of dementia, suggesting
      these dietary abnormalities are not merely the consequence of dementia. Rather,
      it implies that AD might be a life style-related disease such as coronary heart
      disease, western style diet-associated cancer and hyperallergy. To see if
      cognitive function was improved by correcting the n-6/n-3 ratio, we prescribed
      eicossapentaenoic acid (EPA), one type of n-3 PUFA, for AD patients. Cognitive
      function was evaluated using MMSE. Administration of EPA (900 mg/day) improved
      MMSE significantly with maximal effects at 3 months and the effects lasted 6
      months. However, the score of MMSE decreased after 6 months. The present study
      showed that nutritional intervention is useful for the prevention of AD, and also
      for the therapy of dementia, though it has some limitation.

PMID- 11201185
TI  - [The changes of peripheral-central nervous system interaction in Alzheimer's
      disease].
AB  - Several lines of evidence suggest that the cholinergic system in the hippocampus
      plays a pivotal roll in regulating the peripheral metabolism of glucose and
      catecholamines. The injection of cholinergic stimulators including neostigmine,
      the acetylcholine esterase inhibitor, into the third ventricle or the hippocampus
      induces the elevation of glucose or catecholamines in plasma in rats. Under
      stress conditions, release of acetylcholine in the hippocampus increases, which
      coincides with the elevation of plasma glucose and catecholamines. Age-related
      reduction in responsivity of the cholinergic system in the hippocampus has been
      well-documented. The intrahippocampal neostigmine injection induces significantly
      attenuated responses in plasma glucose and catecholamines in rats, which finding
      suggested that changes in cholinergic system activity in the hippocampus could
      result in alteration of the peripheral metabolism of glucose and catecholamines.
      In Alzheimer's disease, the most common type of dementia, degeneration of the
      hippocampal cholinergic system is one of the most robust pathological features.
      Measurement of plasma catecholamines during a fasting state in groups of
      Alzheimer's disease subjects, vascular dementia subjects, and non-demented
      control subjects showed significantly lower plasma epinephrine levels in the
      Alzheimer's disease subjects.

PMID- 11201187
TI  - [Prediction of progression in patients with mild cognitive impairment using IMP
      SPECT].
AB  - To examine the difference in functional brain imaging between mild cognitive
      impairment (MCI) and normal aging, we measured rCBF on functional brain imaging
      using 123I-IMP single photon emission computed tomography (IMP-SPECT) in 19 MCI
      patients who progressed to develop AD on follow-up and 23 probable Alzheimer's
      disease (AD) patients as well as 15 age-matched normal subjects. Baseline MMSE
      score was 25.3 (SD 1.2) in the MCI group and 17.5 (SD 3.3) in the AD group. The
      regions of interest (ROI) in the posterior cingulate gyrus, frontal, temporal and
      parietal cortices were drawn on the image of IMP-SPECT with reference to an
      individual MRI image. The rCBF ratio was calculated using ROI value in the
      cerebellum as a reference. Voxel-based analysis was also preformed using
      statistical parametric mapping (SPM). The rCBF ratio in the posterior cingulate
      gyrus was significantly reduced in the MCI group (mean 0.956, SD 0.080) and the
      AD group (mean 0.833, SD 0.118) compared to that in the normal group (mean 1.083,
      SD 0.084). In the frontal, temporal and parietal cortices, the rCBF ratio was
      significantly reduced only in the AD group compared to the normal group. At a
      fixed specificity of 80%, the diagnostic sensitivity in the discrimination
      between MCI patients and normal subjects was 80.5% when using rCBF ratio in
      posterior cingulate gyrus. In the SPM analysis, significant reduction of the rCBF
      in MCI group was observed only in the posterior cingulate gyrus, compared with
      normal subject group. Our results suggest that MCI patients presenting with a
      posterior cingulate hypoperfusion are at higher risk for transition from MCI to
      clinically recognizable AD.

PMID- 11201188
TI  - [Quantitative changes of elastin, fibrillin and collagen in abdominal aortic
      aneurysms].
AB  - To examine quantitative changes of elastin, fibrillin and collagen in abdominal
      aortic aneurysms, including ruptured abdominal aortic aneurysms (RAAA),
      inflammatory abdominal aortic aneurysms (IAAA) and abdominal aortic aneurysms
      (AAA) were measured. Items measured included the desmosine content of the aorta
      (desmosine 1) or of the elastin fraction (desmosine 2), fibrillin content in the
      aorta, hydroxyproline in the aorta, collagen percent and elastin percent, and
      were compared with control samples from the nonaneurysmal aortic segments. The
      elastin contents (desmosine 2) in RAAA, IAAA and AAA were significantly lower
      than those of controls. The content of the desmosine 2 from IAAA and AAA did not
      show a negative association with Ca. The fibrillin contents of the aorta from
      RAAA, IAAA and AAA were significantly higher than those of controls. The collagen
      content in the RAAA aorta was significantly higher than that of controls. There
      was a correlation of the ratio of fibrillin to elastin components
      (fibrillin/desmosine 1 or fibrillin/desmosine 2 or fibrillin/elastin%) and the
      ratio of collagen to elastin components (collagen/desmosine 1 or
      collagen/desmosine 2 or collagen/elastin%). These results indicated that
      increasing fibrillin and collagen might be a complementary result of decreasing
      elastin crosslinks in the aorta. This phenomenon was markedly in RAAA.

PMID- 11201189
TI  - [Analyses of factors prolonging the length of hospital stay in elderly patients
      beginning hemodialysis].
AB  - The aim of the present study is to clarify the factors causing prolongation of
      the length of hospital stay in elderly patients beginning hemodialysis. Patients
      aged over 60 years who had newly started hemodialysis (98 cases) were studied.
      These were 59 men and 39 women. The age was 73 +/- 7 years (mean +/- standard
      deviation). In each patient, the cause of renal failure (non-diabetes/diabetes),
      body mass index, comorbid conditions (cerebrovascular disease, ischemic heart
      disease, etc.), ambulation, cognitive function, urgency of the initiation of
      dialysis, occurrence of access failure, marital status, younger cohabitants, and
      the length of stay after initiation of dialysis were surveyed. The median and the
      mean of the length of stay were 37 and 49 days. Because of this disparity, a
      normal distribution of the length of stay could not be obtained. However, the
      distribution was transformed to close to normal by logarithmic conversion of the
      number of days. We used the log-converted value as the length of stay for
      statistical analyses. We investigated the influence of the differences of each
      factor on the length of stay. The subjects were divided into two groups for each
      factor. The mean and standard deviation of the length of stay was calculated
      respectively. Comparisons were carried out by unpaired t-test. Multiple
      regression analysis was also performed using background factors as explanatory
      variables, and the length of stay as a dependent variable. The factors presented
      by the nominal scale were converted to dummy variables. Eight variables in the
      unpaired t-test and seven variables in multiple regression analysis were
      statistically significant. All but one variable were common to both analyses. The
      gender was statistically significant only in the unpaired t-test. It could be
      explained by close correlation of gender with marital status. Access failure and
      urgent initiation of dialysis were dominant factors for the prolongation of the
      length of stay. Ischemic heart disease, diabetes, inability to walk, impaired
      cognitive function, and absence of a partner also prolonged the length of stay.

PMID- 11201190
TI  - [Comparison of complications in colonoscopic treatment in elderly and young
      subjects].
AB  - PURPOSE: Owing to a recent increase in incidence of colonic adenoma and
      adenocarcinoma, colonoscopic treatments for elderly subjects are performed more
      frequently. We analyzed differences in complications between elderly and young
      subjects. OBJECT AND PROCEDURE: Subjects that had been treated with colonoscopy
      at Keio Cancer Center, were divided into two groups: one group (436) consisting
      of subjects below the age of 65, the other (176) consisting of subjects 65 and
      over. We analyzed differences in symptoms, complications and pathological
      findings. RESULT: No significant statistical differences were found in the
      occurrence of adenoma and adenocarcinoma between the young and the elderly group.
      COMPLICATIONS: Pain occurred in 9.4% of the young group and 10.2% of the elderly
      group, showing no significant difference between the two groups. Bleeding
      occurred in 0.7% of the young group and 3.8% of the elderly group and ulcerative
      scars were found in two of the latter. CONCLUSION: In the elderly the
      regenerative capacity of damaged blood vessels and tissues is greatly reduced,
      therefore bleeding and ulceration occurred more frequently. It was thus concluded
      that it is very important for elderly group to rest after endoscopical mucosal
      resection, polypectomy and biopsy in order to minimize the risk of bleeding in
      the digestive tract.

PMID- 11201191
TI  - [Comparison of complications in elderly and non-elderly patients with
      neurological diseases during admission to a rehabilitation hospital].
AB  - Medical complications seen in admitted patients in a one-year period in a
      rehabilitation hospital were evaluated, and patients with neurological diseases
      were subdivided with age in order to determine trends of complications with
      occurred in the aged patients. Ninety-five of 117 patients (81.2%) suffered from
      complications, the most common were respiratory diseases, genitourinary diseases
      and psychoneurological diseases and events. Infectious diseases were very common
      throughout all ages. Significantly more cases and occasions of complications
      occurred in the aged patients (ages 65 or more, n = 59) than in the younger
      patients (aged under 65, n = 58), which suggests that complications tended to
      recur in the same patient in the aged group. Genitourinary diseases, especially
      urinary tract infection, was far more common in the aged group, predominating in
      women. Recurrences of stroke or poststroke epilepsy were more frequently seen in
      patients aged under 65. Traumas and fractures related to falls occurred more
      commonly in the aged group. Elderly patients were more susceptible to
      complications not directly related to the illness for which they were admitted.
      Complications occur quite commonly in aged patients admitted to our
      rehabilitation hospital, and careful attention should be paid to conditions
      unrelated to the illness causing admission, such as infectious diseases,
      especially for aged patients.

PMID- 11201192
TI  - [An autopsy case of dementia with Lewy bodies who showed the typical parkinsonism
      in the initial five years].
AB  - A 76-year-old man with parkinsonism and dementia was reported. He developed
      resting tremor at age 69 followed by hypokinesia, rigidity and small step gait. L
      dopa ameliorated his symptoms with no hallucinations for the initial 5 years. His
      mental level did not decrease during that period. He was admitted to our hospital
      because of dehydration and fever at age 74. Subsequently, his cognitive function
      deteriorated, with visual hallucination. Serial brain CT studies displayed a
      progressive cerebral cortical atrophy without focal lesions. He died of
      respiratory distress syndrome and disseminated coagulopathy resulting from
      pneumonia, dehydration and syndrome malin. Postmortem examination revealed a
      marked bilateral loss of melanin-containing neurons with Lewy bodies in the
      substantia nigra and locus ceruleus. Lewy bodies were also in the basal nucleus
      of Meynert, with moderate neuronal cell loss. The distribution of Lewy bodies was
      widespread in the cerebral cortical areas, corresponding to the neocortical
      subtype according to the consensus guideline for the pathologic diagnosis of
      dementia with Lewy bodies. According to the criteria of the Consortium to
      Establish a Registry for Alzheimer's Disease, the age-related plaque score in the
      present case suggested Alzheimer's disease, although cortical neurofibrillary
      changes corresponded to stage II by the criteria of Braak and Braak. These
      pathological findings established the diagnosis of dementia with Lewy bodies from
      the quantitative and distributional viewpoints. Based on recent neuropathological
      evidence, a spectral theory, which presents idiopathic Alzheimer's disease and
      Parkinson's disease as the two extremes of a spectrum of neurodegeneration, has
      been proposed. Dementia with Lewy bodies is located in the middle of this
      spectrum. Pathological evaluation based on quantitative consensus guidelines is
      important to establish the diagnosis in patients with parkinsonism and dementia,
      since neuropathological changes of Alzheimer's disease, Parkinson's disease and
      dementia with Lewy bodies are often observed in a mixed manner in these patients.

PMID- 11201193
TI  - [Health promotion movements of the 21st century in Japan "Healthy Japan 21"--the
      role and responsibility of dental professionals].

PMID- 11201194
TI  - [Alveolar ridge augmentation by tissue engineering].

PMID- 11201195
TI  - [Influence of occlusal contacts on tooth displacement].
AB  - During function, the tooth displacement path depends on occlusal contacts of the
      upper and lower teeth. Therefore, we must reconstruct occlusal relation carefully
      so as not to disturb physiological tooth displacement. In this investigation,
      tooth displacements were measured with the Displacement Transducer type M-3 in
      varying occlusal contact. The following conclusions were obtained. 1. The
      location of occlusal contacts influenced the tooth displacement of the upper
      first molar. Especially, an occlusal contact on the lingual inclination of the
      lingual cusp, buccal cusp had great influence. The tooth showed displacement
      toward the buccal direction, and it differed from the physiological tooth
      displacement path during clenching at the intercuspal position. 2. The location
      of occlusal contacts had little influence on the tooth displacement of the lower
      first molar. The tooth showed displacement toward the lingual direction. It was
      similar to the physiological tooth displacement. 3. On the upper first molar, the
      location of occlusal force influenced the Stress-Strain curve. Especially, the
      occlusal force on the buccal cusp had great influence on the amount of tooth
      displacement. 4. On the lower first molar, the location of occlusal force
      influenced the Stress-Strain curve. Especially, the occlusal force on the lingual
      cusp brought much displacement and a 2-phase displacement path, at times.
      Therefore, occlusal contacts have close relation to tooth displacement, and any
      occlusal reconstruction should harmonize with tooth displacement representing
      periodontal tissue distortion.

PMID- 11201196
TI  - [Reproduction of interocclusal relationship on stone casts].
AB  - We fabricate a prosthesis by the indirect method. To fabricate a prosthesis
      functionally harmonized with the stomatognathic system, the interocclusal
      relationship must be reproduced on stone casts as accurately as possible. In this
      study, two subjects (one male, age 28; one female, age 31) were selected, and the
      occlusal contacts of complete arch stone casts made by three different impression
      methods were observed and compared with the true occlusal contacts in the
      intercuspal position in the mouth. To take the interocclusal records, we used a
      silicone bite checker. The following results were obtained. The occlusal contact
      points reproduced on the stone casts made by a conventional custom tray and a
      stock tray were rather low; that is, the number of occlusal contact points was
      less, and the size of the occlusal contact area was smaller, than in vivo. The
      states of the occlusal contact on the casts made by the same method differed from
      each other. On the bite-impression technique, the reproduction of occlusal
      contact was superior to that of the others. The shape, area, and number of
      contact regions under 60 micrometers were similar to contact regions under 30
      micrometers in the mouth. There was no significant difference in reproduction
      between the custom tray and the stock tray. It is likely that the results were
      due to the distortion of the jaws and periodontal tissue during clenching at the
      intercuspal position, which could not be reproduced on the stone casts made by
      both the conventional custom and stock trays.

PMID- 11201197
TI  - [Questionnaire on "having a family dentist" and the status of oral health].
AB  - In 1999, we gave a Questionnaire on "having a family dentist" to 414 workers (300
      males, 114 females) at a government office. Oral health examination was also
      provided to the same subjects. The following results were obtained: 1. Female
      workers (43%) had a family dentist more often than male workers (29%), and the
      difference was significant (p < 0.01). 2. About 45% of the subjects received
      regular dental checkups at least once a year; however, half of them did not have
      a family dentist. 3. Convenience, comfort, and communication factors were the
      main reasons for choosing a particular dentist, while continuity,
      comprehensiveness, and specialty factors were not taken into consideration in
      choosing a dentist. 4. The persons who had family dentists had more FT and DMFT,
      and fewer total numbers of teeth than those without family dentists. From these
      results, it was suggested that people visited dentists with dental problems and
      received treatment repeatedly, and then they came to have family dentists. The
      habit of visiting a dentist regularly seeking checkups and prevention is not yet
      popular among Japanese adults. To improve oral health consciousness and to
      promote oral health, it should be recommended to receive regular checkups and
      oral health education by a family dentist. However, the present condition does
      not allow this system. Therefore in Japan, it should be encouraged to provide
      oral health examination and oral health education regularly at work sites, to
      improve the oral health of the adult population.

PMID- 11201198
TI  - Immunohistochemical demonstration of nerve terminals in the whole hard palate of
      rats by use of an antiserum against protein gene product 9.5 (PGP 9.5).
AB  - Sensory innervation of the entire hard palate was investigated in the rat using
      serial sections immunostained for protein gene product 9.5 (PGP 9.5), a neuronal
      marker. PGP 9.5-immunoreactive nerve endings were widely distributed in the hard
      palate, but the innervation pattern and density differed among portions. They
      were numerous at papillary protrusions including the incisal papilla,
      antemolar/intermolar rugae, and postrugal filiform papillae. Immunoreactive free
      nerve endings gathered at the summits of the connective tissue papillae, some of
      them entering deeply into the epithelium. Electron microscopy demonstrated that
      nerves in the postrugal filiform papillae reached the stratum corneum. The atrial
      region, possibly the most sensitive in the hard palate, showed unique
      innervation: its anterior part, adjacent to incisors, developed intraepithelial
      networks of fine and beaded nerves, whereas its posterior part revealed cone
      shaped nerve terminals formed on the connective tissue papillae of the atrial
      folds which comprised two lines of longitudinal flaps. Taste bud-like corpuscles
      gathered in the medial walls of the incisal canals and in the
      "Geschmacksstreifen" (taste stripes) present at the most anterior part of the
      soft palate. The hard palate of the rat is thus richly innervated, and is
      characterized by region-specific nerve endings which may be involved in mechano-
      and chemoreception in the oral cavity.

PMID- 11201199
TI  - The cytoarchitecture of the adult human parabrachial nucleus: a Nissl and Golgi
      study.
AB  - The parabrachial nucleus (PBN) plays important roles in numerous autonomic
      functions and in pain modulation. In different animal species, three main regions
      of the PBN have been identified: the m-PB, the l-PB, and the Kolliker-Fuse
      nucleus (KF). The KF has not been identified in humans. The present study used
      Nissl and Golgi-Cox material and morphoquantitative methods to investigate the
      cytoarchitectural organization of the adult human PBN, paying particular
      attention to neuronal features endowed with functional significance, i. e. the
      arborization of the neurons. The PBN neuron population is made up of elements
      which are heterogeneous in size, shape and dendritic arborization, and grouped
      into two regions, the lateral and medial PBN (l- and m-PB). It has been suggested
      that some large sized neurons located in the ventral region of the m-PB might be
      the counterpart of the KF. In the m-PB the fusiform neurons are the most numerous
      cells; in the l-PB the multipolar neurons prevail, and are particularly numerous
      in the dorsal l-PB. Since the dendritic arborization is generally the main target
      of afferent projections to a neuron, it is possible that the l-PB, and in
      particular its dorsal region, might be the main site for the endings of
      afferences to the human PBN.

PMID- 11201200
TI  - A corrosion casting/scanning electron microscope method that simultaneously
      demonstrates clear outlines of endothelial cells and three-dimensional vascular
      organization.
AB  - This paper describes a method that can definitively demonstrate endothelial cell
      boundaries on corrosion casts of arteries, veins, and capillaries. After
      perfusion with silver nitrate, a casting medium was injected into the entire
      vascular bed. The injected tissues were either exposed to light or immersed in
      the photographic developer to develop the silver halide, and corroded in a 5%
      NaOH solution at 60 degrees C overnight. Observations of the casts containing
      water in a low vacuum scanning electron microscope equipped with a cooling stage
      clearly showed endothelial cell boundaries on casts of every type of vessel as
      well as their three-dimensional architecture. The low vacuum scanning electron
      microscope images of wet casts were almost identical in quality to the back
      scattered electron images of dried casts without any coating. Secondary electron
      images of the dried casts with metal coating clearly showed endothelial cell
      outlines and nuclear imprints. The secondary electron images at high
      magnification indicated that silver granules were precipitated in the grooves
      along endothelial cell boundaries on the casts. Since this method can demonstrate
      endothelial cell boundaries of every type of vessel in addition to their three
      dimensional architecture, it will be a powerful tool for examining endothelial
      cell morphology and microvascular organization in pathological as well as normal
      tissues.

PMID- 11201201
TI  - The presence of a local immune system in the upper blind and lower part of the
      human nasolacrimal duct.
AB  - The nasolacrimal duct is exposed to exogenous agents, including potentially
      harmful microorganisms, coming from the eye surface by the lacrimal sac, and from
      the nasal cavity by the inferior meatus of the nose. The upper blind and lower
      part of the human nasolacrimal duct were examined immunohistochemically to
      ascertain the presence and localization of immunoglobulin-producing cells and the
      epithelial expression of IgA, IgM, and IgG in order to verify the possible
      antimicrobial properties of this duct. IgA-, IgM-, and IgG-positive
      immunocompetent cells were recognizable in the lamina propria of the upper blind
      and lower part of the human nasolacrimal duct, while an evident immunoreactivity
      for sIgA, IgM, and IgG was demonstrated in the cytoplasm of the apical epithelial
      cells. The results suggest that all the effector components of the mucosal immune
      system are present in that area of the human nasal mucosa next to the opening of
      the nasolacrimal duct as well as in the human lacrimal sac.

PMID- 11201202
TI  - Surface remodeling associated with vasopressin-induced membrane traffic in L6
      myogenic cells.
AB  - The plasma membrane is dynamically remodeled as a function of the cell cycle,
      motility and membrane traffic. We have previously shown that arg8-vasopressin
      (AVP) stimulation of L6 myoblasts induces the activation of phosholipase D during
      the first minutes of stimulation, and the differentiation of 1,6 myoblasts as a
      long term effect. We now report that AVP also induces two types of morphological
      responses in L6 cells within a few minutes of stimulation: exocytosis, apparent
      as uncoated pits, and the generation of membrane projections and reffles. Thus,
      such an experimental model is suitable for the study of hormone-induced
      morphological surface modifications and their regulatory mechanisms. In L6 cells,
      AVP-induced projection generation depends on the integrity of microfilaments,
      intermediate filaments, and microtubules. Moreover, projection generation and
      exocytosis appear to be independently regulated phenomena: in fact, inhibition of
      the de novo synthesis of phosphatidylcholine inhibits membrane traffic but fails
      to block projection appearance. Conversely, the latter phenomenon, unlike
      exocytosis, is mediated by PI3-kinase signaling. Thus, AVP induces two early,
      independently regulated morphological modifications in L6 cells: exocytosis,
      involved in plasma membrane phospholipid turnover, and membrane projections,
      likely involved in cell migration.

PMID- 11201203
TI  - The ultrastructure of skeletal and smooth muscle in experimental protein
      malnutrition in rats fed a low protein diet.
AB  - Light microscopy of the pectoralis muscle of rats on a low protein diet did not
      show such morphological alterations as atrophy, degeneration, or sarcoplasmic
      edema, but electron microscopy occasionally demonstrated ultrastructural changes
      only in the sarcomeres of myofibrils. In the affected sarcomeres, the Z-line was
      disrupted and often showed a jagged structure. The Z-substance with electron
      opacity was frequently present flowing along the long axis of myofibrils, here
      referred to as the streaming of Z-lines. In addition, regular striations formed
      by the reciprocal arrangement of thick and thin filaments disappeared from the
      affected sarcomeres, though these filaments were still discernible. Two or more
      consecutive sarcomeres in a single myofibril were occasionally involved in these
      changes. A further two or more neighboring sarcomeres at the same level of
      myofibrils were affected transversely by these structural alterations. On the
      other hand, the ultrastructure of the intestinal smooth muscle was not affected
      by protein deficiency. The study suggests that the ultrastructural damage induced
      by a low protein diet is attributed to the activation of endogenous protease by
      the excess leaking of Ca2+ into the cytosol as a result of lipid peroxidation of
      cell membrane by raised free radicals, owing to the depletion of glutathione
      production by protein deficiency. It also suggests that the smooth muscle cells
      differ in their susceptibility to protein deficiency from the skeletal muscle
      cells.

PMID- 11201204
TI  - Enhanced visualization of weak colloidal iron signals with Bodian's protein
      silver for demonstration of perineuronal nets of proteoglycans in the central
      nervous system.
AB  - The present study aimed for a clear visualization of faintly deposited colloidal
      iron in tissue sections for light microscopy. Paraffin blocks containing
      paraformaldehyde-fixed brain tissue from healthy adult mice were cut into
      sections 10-15 microm thick. After deparaffinization, the sections were stained
      with fine cationic iron colloid at a pH value of 1.0-1.5, and treated with a
      mixture of potassium ferrocyanide and hydrochloride for Prussian blue reaction.
      Some sections were further treated with Bodian's protein silver after the
      Prussian blue reaction. This sensitized development of Prussian blue reaction
      with Bodian's protein silver more clearly visualized the faintly deposited
      cationic colloidal irons than the demonstration by Prussian blue reaction alone,
      and allowed an enhanced visualization of the perineuronal nets of sulfated
      proteoglycans in the brain. Thus, such fine perineuronal sulfated proteoglycans
      as those in the CA3 field of the hippocampus, which are weakly stained with
      cationic iron colloid and usually overlooked by a demonstration with only a
      Prussian blue reaction, could be clearly visualized with striking contrast by the
      sensitized development with Bodian's protein silver after the Prussian blue
      reaction. Preliminary hyaluronidase digestion erased Bodian's protein silver
      development of perineuronal sulfated proteoglycans. Though some axonal fibers
      were also additionally stained with Bodian's protein silver itself, this
      sensitized development is useful to enhance such weak colloidal iron signals as
      are hardly detectable by only Prussian blue reaction.

PMID- 11201206
TI  - Kupffer cell activation and hematopoiesis in the liver of autoimmune MRL-lpr/lpr
      mice.
AB  - Hematopoiesis can be induced in the adult murine liver by the administration of
      macrophage activators. The proliferation of macrophages and extrathymic T cells
      is spontaneously induced in the liver of autoimmune MRL-lpr/lpr mice, and deeply
      involved in the development of disease. To study the role of Kupffer cell
      activation in the induction of hematopoiesis and lymphocyte proliferation in the
      liver, we histologically analysed the kinetic and spatial relationship between
      Kupffer cells and hematopoietic cells or lymphocytes. At 5 weeks of age before
      the onset of disease, there were no appreciable histological changes in the
      liver. At 7 weeks, Kupffer cells had slightly increased in number, while
      hematopoietic islands were not yet detected. When disease had fully developed at
      14 weeks, Kupffer cells were considerably increased in number and size, and
      exhibited numerous lysosomes. Hematopoietic cells of erythroid and myeloid series
      frequently appeared in the sinusoid, and lay in close apposition to Kupffer
      cells. Promyelocytes further migrated into the space of Disse to cluster there,
      being surrounded by the stellate cells (or fat-storing cells) and hepatocytes.
      After maturation, metamyelocytes and mature granulocytes were released into the
      sinusoidal circulation. Mitotic figures were detected in the cells of both
      erythroid and myeloid series. Lymphocytes proliferated in various sites such as
      in the sinusoid lumen, the space of Disse, and interlobular connective tissue,
      whether associated or not with Kupffer cells. The present results indicate that
      erythropoiesis, granulopoiesis, and lymphocyte proliferation are induced in the
      liver of MRL-lpr/lpr mice and are closely associated with Kupffer cell
      activation.

PMID- 11201205
TI  - Morphology of the glomerular nerve endings in the dorsal nasal ligament of the
      dog.
AB  - The nasal atrium appears to be an important sensory site in the dog, yet no
      literature is available concerning its nerve supply. The present paper
      demonstrates the occurrence of glomerular nerve endings in the canine nasal
      atrium, using immunohistochemistry for neurofilament protein (NFP) and for glial
      fibrillary acidic protein (GFAP). Glomerular nerve endings occurred on the
      perichondrium of the septal and the dorsal lateral nasal cartilages, and their
      terminal portions were attached with dense collagen fibril strands of the dorsal
      nasal ligament. The glomerular endings were derived from a thick parent axon
      which branched repeatedly. Complicated winding nerve fibers gave rise to numerous
      thin filamentous terminals. Accumulations of GFAP immunoreactive glial cells were
      also observed. Immunoelectron microscopy for NFP revealed several axon terminals
      in the glomerular endings which contained numerous neurofilaments and
      mitochondria and were incompletely covered by Schwann cell sheaths. The
      glomerular endings in the dog nasal vestibule are suggested to perceive tensional
      changes in the nasal dorsal ligament caused by the opening of the nostrils and to
      be involved in the reflex regulating the activity of the nasal muscles.

PMID- 11201207
TI  - Intensely negative-charged pericapillary spaces in the rat pineal gland.
AB  - Electron microscopy of ultrathin sections stained with cationic iron colloid
      revealed that the rat pineal gland is provided with wide and intensely negative
      charged pericapillary spaces. Light microscopically, the negative charging of the
      pericapillary spaces was completely eliminated by digestion with hyaluronidase
      and chondroitinase ABC. This pericapillary negative charging was also erased by
      digestion with collagenase. The results indicate that the negative charging is
      derived from sulfated proteoglycans which are bound to collagen molecules. These
      sulfated proteoglycans in the pericapillary spaces may retain numerous water
      molecules to form a tissue gel, and so act as a selective sieve regulating the
      passage of tissue molecules.

PMID- 11201208
TI  - Effects of short-term denervation and subsequent reinnervation on motor endplates
      and the soleus muscle in the rat.
AB  - The rat sciatic nerve was locally frozen, and changes in the nerve, motor
      endplates, and the soleus muscle were examined for up to 6 weeks by light and
      electron microscopy. The wet weights of denervated soleus muscles compared with
      contralateral values progressively declined to a minimum at 2 weeks after injury
      (60.7 +/- 2.5%) and began to reverse following 3 weeks. The sciatic nerve
      thoroughly degenerated after freezing. However, numerous regenerated myelinated
      and thin nerve fibers were observed at 3 weeks. They were considerably enlarged
      but still smaller than normal counterparts at 6 weeks postoperatively. Nerve
      terminals containing synaptic vesicles of endplates disappeared at day 1 and
      mostly reappeared at 3 weeks (about 70% of the endplates). All endplates examined
      were reinnervated at 4, 5, and 6 weeks. On the other hand, postsynaptic folds of
      muscle fibers seemed to be only slightly influenced by denervation or
      reinnervation. Ultrastructural alterations of myofibrils, in particular the loss
      of register, immediately appeared after denervation, spread progressively, peaked
      at 2 weeks, ameliorated following reinnervation, and became significantly
      normalized at 6 weeks after freezing. The proportion of type II fibers in the
      soleus muscle similary showed an increase and a decrease with a short delay in
      response to denervation and reinnervation, respectively. This study clearly
      demonstrated that the nerve supply affects the ultrastructural integrity of
      skeletal muscles. In addition, changes in the endplates and the soleus muscle
      evaluated in this study after short-term denervation are largely reversible
      following reinnervation.

PMID- 11201209
TI  - Rate and equilibrium constants for the epimerization of the endothelin receptor
      antagonist J-104,132 in aqueous solution.
AB  - The degradation of [5S-[5alpha,6beta,7alpha(R*)]]-2-butyl-5-(1,3-benzodioxol-5
      yl)-7-[(2-carboxypropyl)-4-methoxyphenyl]-6-dihydro-5H-cyclopenta[b]pyridine-6
      carboxylic acid (J-104,132) was studied in aqueous solution as a function of
      temperature and pH. The degradation reaction does not proceed to completion;
      rather, a stable equilibrium is attained in which approximately 2% of the
      degradate is produced. Kinetic data for the formation of the degradate are
      analyzed using an integrated form of the rate law for a reversible first-order
      reaction, and the forward and reverse rate constants and overall equilibrium
      constants are presented. Isolation and spectroscopic structural determination
      indicate that the degradate is the C7 beta-epimer of the drug. A mechanism for
      the epimerization reaction involving a novel enamine-like intermediate is
      proposed and shown to be consistent with the kinetic data. The rate and
      equilibrium constants are used to predict the room temperature stability of an
      injectable formulation of J-104,132, and these predictions are compared to actual
      data from long-term stability studies. It is concluded that the preformulation
      kinetic studies provide essential data needed for optimum drug product
      development.

PMID- 11201210
TI  - Structure-activity relationships for a collection of structurally diverse
      inhibitors of purine nucleoside phosphorylase.
AB  - Values of inhibition constants, Ki, and concentrations required for 50%
      inhibition, IC50, for a collection of structurally diverse competitive inhibitors
      of calf spleen purine nucleoside phosphorylase have been determined employing
      inosine as substrate. These values have been employed to create predictive
      quantitative structure-activity relationships (QSAR) which link structure to
      values of Ki and IC50. These QSAR models have substantial power to predict values
      and the associated uncertainties for Ki and IC50 for unknown, structurally
      diverse inhibitors of purine nucleoside phosphorylase.

PMID- 11201212
TI  - Two new aurones from marine brown alga Spatoglossum variabile.
AB  - Two new aurones, 4'-chloro-2-hydroxyaurone (1) and 4'-chloroaurone (2) were
      isolated from Spatoglossum variabile. The structures of these compounds were
      elucidated by modern spectroscopic techniques.

PMID- 11201211
TI  - Racemization kinetics of meluadrine tartrate in aqueous solution.
AB  - The kinetics of racemization of meluadrine tartrate in aqueous solution was
      investigated by HPLC, over the pH range of 1.2 to 12 at 40, 60 and 80 degrees C.
      The racemization was followed by measuring both the residual (R)-enantiomer and
      formed (S)-enantiomer of meluadrine. The pH-racemization rate profile of
      meluadrine showed a minimum racemization rate constant between pH 4 and 6, and
      the rate constant increased rapidly with decreasing pH below pH 3. In the basic
      region, the racemization rate constant showed a maximum at around pH 9. Four
      pathways of racemization of meluadrine are proposed, depending on the
      dissociation state of the phenolic and amino groups. The calculated racemization
      rate-pH profile agreed well with the observations. The values of activation
      energy (95-115 kJ/mol) suggest that a similar quinoid intermediate is involved
      throughout the pH range examined. The objective of this study is to clarify the
      racemization mechanism of benzylalcohol derivative with phenoric group. This
      study offers fundamental knowledge for the other benzylalcohol derivatives, which
      have similar moiety structure.

PMID- 11201213
TI  - Effects of structural modification of calcium spirulan, a sulfated polysaccharide
      from Spirulina platensis, on antiviral activity.
AB  - Calcium ion binding with the anionic part of a molecule was replaced with various
      metal cations and their inhibitory effects on the replication of herpes simplex
      virus type 1 were evaluated. Replacement of calcium ion with sodium and potassium
      ions maintained the antiviral activity while divalent and trivalent metal cations
      reduced the activity. Depolymerization of sodium spirulan with hydrogen peroxide
      decreased in antiviral activity as its molecular weight decreased.

PMID- 11201214
TI  - Hypnotic action of N3-substituted arabinofuranosyluracils on mice.
AB  - Methyl (2), ethyl (3), propyl (4), butyl (5), allyl (6), benzyl (7), o-, m-, p
      xylyl (8-10), and alpha-phenylethyl (11) derivatives of arabinofuranosyluracil
      (1) were synthesized and their pharmacological effects in mice were examined by
      using hypnotic activity and synergism with pentobarbital as indices for the CNS
      depressant effects. At a dose of 2.0 micromol/mouse by intracerebroventricular
      injection, the values of mean sleeping time induced by 7-11 were 144, 154, 117,
      33, and 34 min, respectively, whereas the alkyl (2-6) derivatives did not cause
      any hypnotic activity. N3-o-Xylylarabinofuranosyluracil (8) displayed the most
      potent hypnotic activity among the derivatives tested. Certain derivatives (6-11)
      significantly prolonged the pentobarbital-induced sleeping time compared to
      control. The present study indicated that substitution with benzyl and/or related
      groups on the N3-position of arabinofuranosyluracil produced CNS depressant
      effects.

PMID- 11201215
TI  - Acid mediated hydrolysis of blueberry anthocyanins.
AB  - Acid mediated hydrolysis of anthocyanins was studied using capillary zone
      electrophoresis (CZE). A commercially available wild blueberry (Bilberry) extract
      was dissolved in different concentrations of TFA (0.1, 1, 3, 9%), then was
      subjected to thermodecomposition reaction at 95 degrees C. After the reaction,
      the samples were analyzed by CZE. The hydrolysis rate of each anthocyanin and the
      formation of the aglycon were determined by the change in the peak pattern of the
      anthocyanins in the electropherogram. Each anthocyanin peak decreased time
      dependently in a first order kinetic fashion. It was revealed that the hydrolysis
      rate of each anthocyanin was determined primarily by the type of conjugated sugar
      and not by the aglycon structure. The rate constant of anthocyanin hydrolysis was
      in the following order, arabinoside>galactoside>glucoside without regard to the
      aglycon structure. The kinetic behavior of this anthocyanin hydrolysis together
      with the CZE mobility allowed us to identify an unknown CZE peak as delphinidin 3
      O-beta-arabinoside. At low TFA concentration, significant decomposition of the
      anthocyanidin nucleus occurred, but the glycoside hydrolysis predominated at high
      TFA concentration. It was further revealed that the aglycon released reacted
      successively to form polymeric products at higher TFA conditions.

PMID- 11201216
TI  - Hyaluronate depolymerization following thermal decomposition of oxytetracycline.
AB  - Depolymerization of sodium hyaluronate (HA) by tetracyclines was investigated.
      Reduction in HA molecular weight was followed by size exclusion chromatography
      with a low angle laser light scattering detector. On mixing with oxytetracycline
      hydrochloride (OTC) solution and incubating at 37 degrees C, HA was gradually
      depolymerized. OTC, a representative antibiotic, is known as a photosensitizer,
      and phototoxic side effects relevant to radicals have been reported. However, HA
      depolymerization required no irradiation. As time passed, OTC solution incubated
      at 37 degrees C got colored reddish brown, even in the dark. With reversed-phase
      HPLC separation, several peaks derived from decomposed OTC appeared. One of the
      peaks had an absorbance in the visible range. A quantitative correlation between
      the discoloration and the HA depolymerization rate was obtained. On the other
      hand, when samples were incubated below 25 degrees C, change of color was slight,
      and practically no HA depolymerization was observed after up to 4 h. Oxygen
      depletion by nitrogen saturation or addition of mannitol also prevented the
      depolymerization. Under anaerobic conditions, the color of the solution did not
      change, whereas it turned red under aerobic conditions in the presence of
      mannitol. The mannitol did not inhibit the OTC decomposition, but it preserved HA
      from damage. On the basis of the known decomposition of OTC and the results of
      HPLC separation, anhydrooxytetracycline can be proposed as the derivative causing
      HA depolymerization.

PMID- 11201217
TI  - O-ADP-Ribosylation in the NAD/NADase system: 2-alkanols as efficient substrates.
AB  - Several 2-alkanols (2-propanol, 2-butanol, 2-pentanol, etc.) were examined as
      substrates for ADP-ribosylation in the NAD/NADase enzymatic system. Even though
      these secondary alcohols have hydroxy groups that are subject to the steric
      influence of a methyl group, they were shown to be efficiently ADP-ribosylated.
      However, in the case of 3-alkanol (3-butanol), only slight ADP-ribosylation was
      observed. In this enzymatic reaction, 1,2-propanediol provided both 1-O- and 2-O
      ADP-ribosylation products in the ratio 1:1 as determined by 1H-NMR spectrometry.
      On the other hand, an equimolar mixture system of 1- and 2-propanols provided
      major 1-O- and minor 2-O-ribosylation products in the ratio 4:1. This is the
      first report of O-ADP-ribosylation of terminal secondary alcohols with the
      NAD/NADase enzymatic system.

PMID- 11201218
TI  - Hymenosides A-F, six new hemiterpene glucosides from the Japanese fern
      Hymenophyllum barbatum.
AB  - In the course of investigation of the bitter-tasting substances of the Japanese
      fern Hymenophyllum barbatum belonging to the family Hymenophyllaceae, six new
      hemiterpene glucosides called hymenosides A-F (1-6) have been isolated from the
      methanol extract, together with an acyclic bis-bibenzyl derivative, perrottetin
      H. This paper deals with the structure elucidation of the newly isolated
      glucosides.

PMID- 11201219
TI  - Synthesis of anacardic acids, 6-[8(Z),11(Z)-pentadecadienyl]salicylic acid and 6
      [8(Z),11(Z),14-pentadecatrienyl]salicylic acid.
AB  - 11-Chloro-3-methoxy-2-undecenal was synthesized from 8-bromooctanol, and an
      annelation reaction with this aldehyde and ethyl acetoacetate proceeded to give
      the ethyl 6-(8-chlorooctyl)salicylate. Ethyl 6-(8-chlorooctyl)salicylate was
      converted to ethyl 6-(7-formylheptyl)-2-methoxybenzoate through the iodide after
      protection of the phenolic hydroxyl group. Finally, the Wittig reaction with the
      aldehyde and triphenylphosphonium iodides in the presence of BuLi gave the
      methoxybenzoates, and then treatments of these methoxybenzoates with BBr3 in
      CH2Cl2 and 10% NaOH in ethanol gave 6-18(Z),11(Z)-pentadecadienyllsalicylic acid
      (anacardic acid 3) and 6-[8(Z),11(Z),14-pentadecatrienyl]salicylic acid
      (anacardic acid 4) which were isolated from plants of the anacardiaceae.

PMID- 11201220
TI  - Brominations of steroidal hormone having alpha,beta-unsaturated ketone, 17-O
      acetyltestosterone, in the presence of silver triflate.
AB  - Bromination of 17-O-acetyltestosterone (17beta-acetoxyandrost-4-en-3-one) (1) was
      performed with 1, 5, and 10 eq of Br2 in AcOH-Et2O at room temperature. In all
      cases 2alpha,6beta- (2) and 2alpha,6beta-dibromo-17beta-acetoxyandrost-4-en-3-one
      (3) were obtained, although the yields were dependent upon the conditions used.
      Bromination of compound 1 with 10 eq of Br2 in the presence of silver
      trifluoromethanesulfonate (silver triflate, AgOTf) at room temperature for 12 h
      gave 2,7alpha-dibromo- (4) and 2,4,7alpha-tribromo-17beta-acetoxy-3-hydroxy-1
      methylestra-1,3,5(10)-triene-6-one (5). The formations of the products were
      inferred on the basis of products obtained under controlled brominations of 1 in
      the presence of AgOTf, and of those obtained by the brominations of compounds 9
      13 also in the presence of AgOTf.

PMID- 11201221
TI  - Synthesis and evaluation of novel 2-oxo-1,2-dihydro-3-quinolinecarboxamide
      derivatives as potent and selective serotonin 5-HT4 receptor agonists.
AB  - A series of 8'-substituted N-(endo-8-azabicyclo[3.2.1]oct-3-yl)-1-isopropyl-2-oxo
      1,2-dihydro-3-quinolinecarboxamides were synthesized. The 5-HT4 receptor
      agonistic activity was evaluated using the isolated guinea pig ileum preparation.
      Of the compounds synthesized, N-(endo-8-(3-hydroxypropyl)-8-azabicyclo[3.2.1]oct
      3-yl)-1-isopropyl-2-oxo-1,2-dihydro-3-quinolinecarboxamide (15a, TS-951)
      exhibited the most potent serotonin 5-HT4 receptor agonistic activity. This
      compound had a high affinity for the serotonin 5-HT4 receptor although it had no
      affinities for other broad spectrum receptors. Furthermore, it remarkably
      enhanced gastrointestinal motility in conscious fed dogs without unfavorable
      effects that non-selective serotonin 5-HT4 receptor agonist has. TS-951 may be
      useful in improving gastrointestinal dysfunction.

PMID- 11201222
TI  - Design and synthesis of N-terminal cyclic motilin partial peptides: a novel pure
      motilin antagonist.
AB  - Motilin antagonist was designed and synthesized on the basis of the structure
      activity relationship analysis of porcine motilin that we reported recently. The
      drug design was performed on a specific concept to reduce a flexibility of
      peptide conformation of porcine motilin partial peptide by its cyclization. The
      cyclic peptide was synthesized using Boc (tert-butyloxycarbonyl) solid phase
      methodology, followed by cyclization using the azide procedure, and tested for
      the binding activity to motilin receptor and smooth muscle contractile activity.
      The cyclic peptides 3, 4, and 5 showed antagonistic property on contraction assay
      (pA2 [the negative logarithm of molar concentration of antagonist causing a 2
      hold shift to the right of the concentration-response curve for motilin]: 4.5,
      4.34, and 4.04, respectively, in rabbit duodenum) and no contractile activity
      even at high concentration.

PMID- 11201223
TI  - Side chain-dependent binding of antitumor indoloquinoxaline derivatives to DNA:
      comparative spectroscopic and viscometric measurements.
AB  - NCA0424 (1) and its side chain positional isomer, NCA0465 (2), are
      indoloquinoxaline derivatives with potent antitumor activity. To investigate the
      effect of side chain position for binding with DNA, the interactions of 2 with
      various B-form DNAs were studied by spectroscopic (circular dichroism (CD),
      fluorescence and UV) and viscosity measurements and were compared with those of
      1. The binding preference for the base sequence was different in each case. The
      CD spectra showed that 2 formed an asymmetric binding of indoloquinoxaline ring
      with adenine in DNA, whereas such a base selectivity was not found with 1. The
      binding features are discussed based on association constants and thermodynamic
      parameters, indicating the importance of the side chain position for binding
      specificity for DNA.

PMID- 11201224
TI  - Chiral recognition of thiaheterohelicenes by alkyl beta-D-pyranoside micelles.
      Influence of extension of helix.
AB  - Chiral recognition of alkyl beta-D-pyranoside micelles toward [7] and [5]
      heterohelicenes possessing helical structures was investigated by 1H-NMR and CD
      (circular dichroism) spectroscopy. In dodecyl maltopyranoside micellar solution,
      P and M enantiomers of tetrathia[7]heterohelicene (7TH), which have rigid and
      stable helixes, manifested different chemical shifts in their 1H-NMR spectra due
      to differences in the diastereomeric interactions, implying that the micelles
      undergo stronger recognition toward the M enantiomer than the P enantiomer. On
      the other hand, in octyl glucopyranoside micellar solution,
      trithia[5]heterohelicene (5TH) and two kinds of its derivatives which are rapidly
      equilibrated between the enantiomers in solution, gave no distinctly resolved 1H
      NMR peaks for either enantiomer even at a lowered temperature. However, these
      racemic [5]heterohelicenes in the micelles did develop induced CD absorptions
      owing to a displacement of the equilibrium, suggesting from the signs of their
      Cotton effects that the micelles prefer the M enantiomer to its antipode in
      conformity with the 1H-NMR results of 7TH.

PMID- 11201225
TI  - Solute-stationary phase interaction in gas liquid chromatography. Thermodynamic
      parameters for substituted halogenobenzene derivatives.
AB  - Thermodynamic parameters were determined by variable temperature experiments on
      the gas liquid chromatography (GLC) relative retention values, log gamma, of 3-
      and 4-substituted halogenobenzene derivatives under non-polar condition. These
      deltadeltaHdegrees(s)(R,X) had a compensational relation with the
      deltadeltaSdegrees(s)(R,X) values. The free energy change
      deltadeltaGdegrees(s)(R,X) which is estimated from the deltadeltaHdegrees(s)(R,X)
      and the deltadeltaSdegrees(s)(R,X) at 298 K is less than -23 kJ x mol(-1). The
      deltadeltaSdegrees(s)(R,X) values could be explained by translational entropy
      change for the adsorbed active complex between the solute and stationary phase.
      It is suggested that the interaction could be mainly expressed by the physical
      adsorption exclusive of hydrogen bonding. The deltadeltaGdegrees(s)(R,X) values
      for each halogen derivative have been the excellent linear lines taking the same
      slopes for the monosubstituted benzene derivatives, deltadeltaGdegrees(s)(R,X).
      The regression analyses of their intercepts were given using the descriptor
      evaluated as the molecular volume sigmaa(X) rather than sigmaM(X). The regression
      analysis for polyhalogenobenzene was also given successfully using sigmaa(Xn).

PMID- 11201226
TI  - Medicinal foodstuffs. XXI. Structures of new cucurbitane-type triterpene
      glycosides, goyaglycosides-a, -b, -c, -d, -e, -f, -g, and -h, and new oleanane
      type triterpene saponins, goyasaponins I, II, and III, from the fresh fruit of
      Japanese Momordica charantia L.
AB  - Eight cucurbitane-type triterpene glycosides called goyaglycosides-a, -b, -c, -d,
      -e, -f, -g, and -h and three oleanane-type triterpene saponins termed
      goyasaponins I, II, and III were isolated from the fresh fruit of Japanese
      Momordica charantia L. (Cucurbitaceae) together with five known cucurbitane-type
      triterpene glycosides momordicosides A, C, F1, I, and K. The structures of
      goyaglycosides and goyasaponins were elucidated on the basis of chemical and
      physicochemical evidence.

PMID- 11201227
TI  - Quantitative analysis of water dispersion conditions and pressure transmission
      characteristics of a wet kneaded mass.
AB  - In our previous paper [Watano S. et al., J. Powder Technology Japan, 37, 362-370
      (2000)], a novel compaction tester was developed to quantitatively evaluate the
      water dispersion condition of a wet kneaded mass prepared by a paddle type
      kneader. It has been demonstrated that the physical properties of pellets
      prepared by extrusion granulation after the kneading can be well predicted by the
      pressure transmission obtained through the compaction tester. This paper
      describes a more detailed investigation of the water dispersion, its mechanism
      and pressure transmission characteristics of wet kneaded masses prepared under
      various operating conditions. First, kneading by a paddle type kneader was
      conducted to prepare wet masses under various binder contents using different
      additional methods and different starting materials. Secondly, water dispersion
      and pressure transmission characteristics of wet masses were investigated. After
      the wet kneading, the wet kneaded masses were extruded through a dome type
      extruder and were dried by a fluidized bed to prepare dry pellets. The
      relationship between water dispersion and pressure transmission can be expressed
      by a single line, regardless of binder content or methods of addition. This
      implies that these parameters have no effect on the water dispersion condition of
      the wet kneaded mass prepared by a high shear paddle type kneader. Different
      water dispersion characteristics and the mechanism obtained by different starting
      materials can also be evaluated by the pressure transmission data. Properties of
      dry pellets can also be predicted by the pressure transmission. It can be
      concluded that the developed compaction tester can quantitatively evaluate the
      water dispersion condition of a wet kneaded mass and also predict properties of
      the final extruded products.

PMID- 11201228
TI  - Bioactive constituents of chinese natural medicines. VI. Moutan cortex. (2):
      structures and radical scavenging effects of suffruticosides A, B, C, D, and E
      and galloyl-oxypaeoniflorin.
AB  - Five paeonol glycosides, suffruticosides A, B, C, D, and E, and a monoterpene
      glucoside, galloyl-oxypaeoniflorin, were isolated from the glycosidic fraction of
      Chinese Moutan Cortex, the root cortex of Paeonia suffruticosa Andrews, together
      with paeonolide, apiopaeonoside, galloyl-paeoniflorin, oxypaeoniflorin, and
      paeoniflorin. The structures of five suffruticosides and galloyl-oxypaeoniflorin
      were elucidated on the basis of chemical and physicochemical evidence.
      Suffruticosides A, B, C, and D, galloyl-oxypaeoniflorin, and galloyl-paeoniflorin
      exhibited more potent radical scavenging effects than alpha-tocopherol.

PMID- 11201229
TI  - Medicinal foodstuffs. XXII. Structures of oleanane-type triterpene
      oligoglycosides, pisumsaponins I and II, and kaurane-type diterpene
      oligoglycosides, pisumosides A and B, from green peas, the immature seeds of
      Pisum sativum L.
AB  - Two new oleanane-type triterpene oligoglycosides, pisumsaponins I and II, and two
      new kaurane-type diterpene oligoglycosides, pisumosides A and B, were isolated
      from the immature seeds (green peas) of Pisum sativum L. together with
      soyasaponin I, bersimoside I, dehydrosoyasaponin I, and their 6'-methyl esters.
      The structures of pisumsaponins and pisumosides were determined on the basis of
      chemical and physicochemical evidence as 22-O-malonylsoyasapogenol B 3-O-alpha-L
      rhamnopyranosyl(1-->2)-beta-D-galactopyranosyl(1-->2)-beta-D-glucopyranosiduronic
      acid (22-O-malonylsoyasaponin I), sandosapogenol 3-O-alpha-L-rhamnopyranosyl(1-
      >2)-beta-D-galactopyranosyl(1-->2)-beta-D-glucopyranosiduronic acid, 17-O-beta-D
      glucopyranosyl-6beta,7beta,13gamma,17-tetrahydroxy-19-kauranoic acid 19-O-beta-D
      glucopyranosyl(1-->2)-beta-D-glucopyranoside, and 6beta,7beta,13beta,17
      tetrahydroxy-19-kauranoic acid 19-O-beta-D-glucopyranosyl(1-->2)-beta-D
      glucopyranoside, respectively.

PMID- 11201230
TI  - Analysis of the phase solubility diagram of a phenacetin/competitor/beta
      cyclodextrin ternary system, involving competitive inclusion complexation.
AB  - The competitive inclusion complexations in the ternary
      phenacetin/competitors/beta-cyclodextrin (beta-CyD) systems were investigated by
      the solubility method, where m-bromobenzoic acid (m-BBA) and o-toluic acid (o-TA)
      were used as competitors. The solubility changes of the drug and competitors as a
      function of beta-CyD concentration in the ternary systems were formulated using
      their stability constants and intrinsic solubilities. The decrease in solubility
      of phenacetin by the addition of competitors could be quantitatively simulated by
      the formulation, when both drug and competitor give A(L) type solubility
      diagrams. On the other hand, when one of the guests gives a B(S) type solubility
      diagram, its solubility change was clearly reflected in that of the another
      guest, i.e., phenacetin gave an A(L) type solubility diagram in the binary
      phenacetin/beta-CyD system and o-TA gave a B(S) type diagram in the binary o
      TA/beta-CyD system, but in the ternary phenacetin/o-TA/beta-CyD system, a new
      plateau region appeared in the original A(L) type diagram of phenacetin. This was
      explained by the solubilization theory of Higuchi and Connors. The solubility
      analysis of the ternary drug/competitor/CyD systems may be particularly useful
      for determination of the stability constant of a drug whose physicochemical and
      spectroscopic analyses are difficult, because they can be calculated by
      monitoring the solubility change of a competitor, without monitoring that of a
      drug. Furthermore, the present results suggest that attention should be paid to
      the type of the phase solubility diagram, as well as the magnitude of the
      stability constant and the solubility of the complex, for a rational formulation
      design of CyD complexes.

PMID- 11201231
TI  - Ten new labdane-type diterpenes from the fruit of Vitex rotundifolia.
AB  - Ten new labdane-type diterpenes were isolated from the fruit of Vitex
      rotundifolia L. (Verbenaceae), along with a known diterpene, vitexilactone. Their
      chemical structures were determined on the bases of spectroscopic data.

PMID- 11201232
TI  - The chemistry of indoles. CIII. Simple syntheses of serotonin, N-methylserotonin,
      bufotenine, 5-methoxy-N-methyltryptamine, bufobutanoic acid, N-(indol-3-yl)methyl
      5-methoxy-N-methyltryptamine, and lespedamine based on 1-hydroxyindole chemistry.
AB  - Application of regioselective nucleophilic substitution reactions of 1
      hydroxytryptamines to novel and simple syntheses of serotonin (1a), N
      methylserotonin (1b), bufotenine (1c), 5-methoxy-N-methyltryptamine (2a),
      bufobutanoic acid (3a), N-(indol-3-yl)methyl-5-methoxy-N-methyltryptamine (4),
      and lespedamine (5) are described. Effective syntheses of 5-benzyloxytryptamine
      and 1-methoxy-2-oxindoles are also reported.

PMID- 11201233
TI  - Reduction of acetals with samarium diiodide in acetonitrile in the presence of
      Lewis acids.
AB  - Transformation of acetals into ethers by partial reduction using a samarium
      diiodide-Lewis acids-acetonitrile system is described. The reaction with aromatic
      acetals occurred in good yields in the presence of aluminum chloride (2 eq)
      whereas the corresponding aliphatic, vinylic, and alkynyl derivatives did not
      afford ethers under the same conditions. Beta-elimination to give an enol ether
      becomes predominant when aliphatic acetals that possess a hydrogen at the 2
      position are treated with iodotrimethylsilane in the presence of SmI2 or SmI3.

PMID- 11201234
TI  - Recent advances in gastrointestinal pathophysiology: role of heat shock proteins
      in mucosal defense and ulcer healing.
AB  - The defense mechanism of the gastrointestinal mucosa against aggressive factors,
      such as hydrochloric acid, bile acid and non-steroidal anti-inflammatory drugs,
      mainly consists of functional, humoral and neuronal factors. Mucus-alkaline
      secretion, mucosal microcirculation, and motility act as functional factors,
      while prostaglandins and nitric oxide act as humoral factors, and capsaicin
      sensitive sensory neurons act as neuronal factors. All the above factors are
      known to contribute to mucosal protection. In recent years, heat shock proteins
      (HSPs), to include HSP70, have been implicated to be an additional factor
      utilized for the defense mechanisms of the gastrointestinal mucosa at the
      intracellular level. The expression of HSP70 and HSP47 markedly changes during
      the development and healing of chronic gastric ulcers in rats. It was revealed
      that HSC70 (a constitutive form of HSP70) is coprecipitated with cyclooxygenase-1
      and the neuronal form of nitric oxide synthase after treatment with a mild
      irritant (20% ethanol). A positive relationship between enhanced interaction of
      HSC70 with either cyclooxygenase-1 or nitric oxide synthase and mucosal
      protection against a strong irritant (100% ethanol) was observed. It was
      concluded that HSPs might contribute to mucosal defense mechanisms and ulcer
      healing, most probably through protecting key enzymes related to cytoprotection.

PMID- 11201235
TI  - Iron concentrations in human dermis assessed by microdialysis associated with
      atomic absorption spectrometry.
AB  - Until recently, the determination of metallic elements concentrations in normal
      skin, in vivo, was rare due to the lack of non-invasive techniques. Microdialysis
      has the advantage of being slightly invasive when applied to the collection in
      vivo of endogenous or exogenous substances from the skin. Iron is an active
      element in different cutaneous disorders. The aim of this work was to assess iron
      by atomic absorption spectrometry (AAS) after the collection of samples by
      microdialysis from human dermis. A first essential step, before determining the
      in vivo iron concentration in human dermis, was to establish an experimental
      protocol applicable to ex vivo as well as in vivo conditions. For this reason,
      this work deals only with the assessment of iron in ex vivo human dermis. A skin
      microdialysis technique and a calibration method, the No Net Flux, were used to
      quantify basal iron concentrations in human dermis and the same method was also
      used to determine in vitro and ex vivo iron recoveries. No differences were
      detected between in vitro and ex vivo recoveries. Ex vivo basal iron dermis
      concentrations ranged from 3.6 to 7.7 microg/l. This study shows that non
      invasive microdialysis is an efficient method for sampling iron from human skin.
      A sensitive and accurate AAS technique was able to assess low iron concentrations
      in human dermis. The strategy adopted for this work was efficient and appropriate
      for the determination of iron in human skin and experiments will be carried out
      in vivo.

PMID- 11201236
TI  - Rat small intestine muscle relaxation alkaloids from Orixa japonica leaves.
AB  - Two quinoline alkaloids, japonine (1) and eduline (2) were isolated from the
      methanol extract of the leaves of Orixa japonica as relaxants against rat small
      intestine muscle. The activity of these alkaloids was comparable to that of the
      typical muscle relaxant papaverine (4). This is also the first report of the
      isolation of eduline (2) from O. japonica.

PMID- 11201237
TI  - Inhibitory effects of ethaverine, a homologue of papaverine, on dopamine content
      in PC12 cells.
AB  - The inhibitory effects of ethaverine on dopamine content in PC12 cells were
      investigated. Ethaverine decreased dopamine content in a concentration-dependent
      manner in PC12 cells and showed 33.6% inhibition of dopamine content at a
      concentration of 1.0 microM for 24-48 h. The IC50 value of ethaverine was 1.4
      microM. Dopamine content was lowered at 6h and reached a minimal level at 12h
      after exposure to ethaverine at 2.0 microM. The decreased dopamine level was
      maintained up to 48 h and then recovered to the control level at about 72 h.
      Tyrosine hydroxylase (TH) was inhibited at 6 h following treatment with
      ethaverine in PC12 cells and the activity was maintained at a reduced level up to
      36 h (12-22% inhibition at 2.0 microM). These results indicate that ethaverine
      leads to a decrease in dopamine content by inhibition of TH activity.

PMID- 11201238
TI  - Prevention of the adverse effects of aprotinin in autologous fibrin glue.
AB  - To avoid the adverse effects of aprotinin (Apr) in autologous fibrin glue, we
      compared the inhibitory properties of four commercial anti-fibrinolytic agents
      (tranexamic acid (Tra), epsilon-aminocaproic acid (Ips), gabexate mesilate (Gab)
      and nafamostat mesilate (Naf)). The optimum conditions for the lysing of fibrin
      glue were an incubation temperature of 37 degrees C, and incubation medium
      containing urokinase at 100 U/ml and plasminogen at 100 mU/ml (for the washed
      glue), or neither (for unwashed glue). Fibrin glues without an anti-fibrinolytic
      agent were quickly lysed in the incubation medium, while those with an anti
      fibrinolytic agent were slowly lysed dose-dependently. Naf was the most potent
      inhibitor and had high affinity for the glue, but the other agents were poor
      inhibitors and had low affinity. The inhibition potency (IP) of each agent did
      not correlate with hydrophobicity, but a good correlation was obtained between
      the remaining coefficient (RC) and hydrophobicity. Naf did not affect the
      adhesive strength of the glue. These results indicate that Naf is the most
      suitable anti-fibrinolytic agent to replace Apr.

PMID- 11201239
TI  - Effects of substitution of conserved amino acid residues on the sugar-binding
      property of the tandem-repeat 32-kDa galectin of the nematode Caenorhabditis
      elegans.
AB  - The 32-kDa galectin (LEC-1) of the nematode Caenorhabditis elegans (C elegans) is
      composed of two tandemly repeated homologous sequences, each containing a
      carbohydrate-recognition domain (CRD). Using the polymerase chain reaction (PCR)
      with LEC-1 cDNA as a template and "megaprimers", we performed site-directed
      mutagenesis to substitute conserved amino acid residues in these domains. The
      resultant mutated LEC-1s were produced in E. coli, and their binding abilities
      were estimated by affinity chromatography. When one of the conserved amino acid
      residues in the first lectin domain was substituted, the binding ability of the
      mutant protein to asialofetuin-agarose was reduced but still remained. The
      binding ability of such mutants was similar to that of the recombinant half
      molecule containing the second lectin domain (Ch). However, when mutations were
      introduced into the second lectin domain, the binding ability of these mutant
      lectins to asialofetuin-agarose was significantly reduced just like the half
      recombinant molecule containing the first lectin domain (Nh). The different
      effects of the substitution of amino acid residues on the two lectin domains
      suggest that the binding properties of the two sites are different and that LEC-1
      acts as a "heterobifunctional crosslinker."

PMID- 11201240
TI  - Enhanced adhesion of oxidized mouse polymorphonuclear leukocytes to macrophages
      by a cell-surface sugar-dependent mechanism.
AB  - Mouse thioglycollate-induced peritoneal macrophages effectively, in the absence
      of serum, recognized mouse polymorphonuclear leukocytes (PMNs) mildly oxidized
      with diamide, superoxide (hypoxanthine/xanthine oxidase) or t-butyhydroperoxide,
      or modified with N-ethylmaleimide (NEM). The recognition reached a maximum when
      PMNs were treated wtih each of the reagents at relatively low concentrations, and
      the recognition was decreased on treatment with reagents at higher
      concentrations. Glutathione depletion in the diamide-oxidized PMNs may cause
      enhanced adhesion to macrophages. Sialylated sugar chains attached to a peptide
      chain in glycophorin A and sialylated poly-N-acetyllactosaminyl sugar chains in
      lactoferrin and band 3 glycoprotein effectively inhibited the increased adhesion
      of the diamide-oxidized PMNs. Enzymatic removal of sialyl residues and the
      degradation of poly-N-acetyllactosaminyl sugar chains by pretreatment of PMNs
      with neuraminidase or endo-beta-galactosidase, respectively, lost their
      increasing ability for macrophage adhesion after oxidation with diamide,
      superoxide or t-butylhydroperoxide. Clustered sialylated poly-N
      acetyllactosaminyl sugar chains on the cell surface may be involved in the
      increased adhesion of the oxidized PMNs to macrophages.

PMID- 11201241
TI  - Comparative analysis of proteoglycans synthesized by chick corneal stromal cells
      in cell culture and organ culture.
AB  - Proteoglycans (PGs) synthesized by chick corneal stromal cells in cell culture
      and organ culture were metabolically radiolabelled with [35S]sulfate (for
      glycosaminoglycans) and [3H]leucine (for core proteins). Media, cell extracts and
      organ extracts from cultures were chromatographed on DEAE-Sephacel columns and
      separated into three fractions: the pass-through fraction (Fraction 1:
      nonsulfated PGs, hardly sulfated PGs, or glycoproteins with some
      oligosaccharides), the fraction eluted with a low salt concentration (Fraction 2:
      undersulfated PGs), and the fraction eluted with a high salt concentration
      (Fraction 3: highly sulfated PGs). The PG compositions of each fraction of cell
      culture and organ culture were then compared. While the proportions of highly
      sulfated KSPG in Fractions 3 of medium and cell extract of cell culture were both
      very low compared with those of medium and organ extract of organ culture,
      respectively, the proportions of highly sulfated CS/DS PG in Fractions 3 of those
      of cell culture were higher than those of organ culture. On the other hand, the
      proportions in the 35S activities of nonsulfated or undersulfated KSPG in
      Fractions 1 and 2 of medium and cell extract of cell culture were comparable to
      those of organ culture. Furthermore, the proportions of core proteins of
      undersulfated KSPG in Fractions 2 were higher in cell culture than in organ
      culture. These results show that, when the cells are cell-cultured, the degree of
      sulfation of KS chains decreases markedly, but the syntheses of the
      glycosaminoglycan backbone and core protein are maintained.

PMID- 11201242
TI  - Expressions of bradykinin B2-receptor, kallikrein and kininogen mRNAs in the
      heart are altered in pressure-overload cardiac hypertrophy in mice.
AB  - Angiotensin-converting enzyme inhibitors prevent cardiac hypertrophy in vivo, and
      a component of this ameliorative effect has been attributed to accumulation of
      kinins in cardiac tissues. However, little is known regarding the levels of
      kallikrein-kinin components in the heart during the development of cardiac
      hypertrophy. The objectives of the present study were to define the effects of
      pressure-overload cardiac hypertrophy on cardiac levels of kininogen, kallikrein
      and bradykinin B2 receptor mRNAs. The pressure-overload induced by aortic
      constriction produced cardiac hypertrophy in mice after 14 and 28d, assessed from
      the increased ratios of heart weight to body weight and elevation of brain
      natriuretic peptide mRNA in the heart. B2 receptor mRNA rapidly decreased in the
      heart within 7 d after the operation, subsequently returning to those of sham
      operated animals. In contrast, levels of both low-molecular-weight kininogen and
      tissue kallikrein mRNAs were increased 7, 14 and 28 d after aortic constriction.
      These findings suggest that the mechanical load or stretch in cardiac tissue by
      pressue-overload rapidly produces the downregulation of B2 receptor expression
      during the initial stage which may allow the promotion of cardiac hypertrophy
      induced by a mediation of hypertophic factors such as angiotensin II, while
      upregulation of kininogen and kallikrein mRNAs during the chronic stage may lead
      to an enhancement of local kinin generation in the heart, from which further
      progression of cardiac hypertrophy during later stages may be regulated.

PMID- 11201243
TI  - SP-40,40 is a component of plasminogen activator inhibitor-1-binding protein and
      stabilizes plasminogen activator inhibitor-1 activity.
AB  - A complex of plasminogen activator inhibitor-1 (PAI-1) and PAI-1-binding protein
      (PAI-1-BP) contained S-protein (vitronectin), PAI-1 and unidentified 40-kDa
      protein on SDS-PAGE under reducing conditions. By Western-blot analysis, the 40
      kDa protein was identified as SP-40,40 using anti-SP-40,40 antibody. Therefore,
      it was thought that PAI-1-BP consisted of S-protein and SP-40,40. It is known
      that PAI-1 is a labile protein which becomes inactive during incubation at 37
      degrees C. However, after the incubation of PAI-1 with SP-40,40 at 37 degrees C
      for 1 h, PAI-1 could still form a complex with tissue plasminogen activator
      (tPA), and it inhibited plasmin formation in the mixture of plasminogen and urine
      plasminogen activator (uPA). The results clearly indicated that SP-40,40
      stabilized PAI-1 activity as well as S-protein did.

PMID- 11201244
TI  - Characterization of microsphere embolism-induced impairment of learning and
      memory function and the cholinergic system.
AB  - The impairments of learning and memory function and of the cholinergic system
      were examined in rats with microsphere embolism. Microsphere embolism was induced
      by injection of 900 microspheres with a diameter of 48 microm into the right
      internal carotid artery. The retention latency of a passive avoidance test was
      shortened and the escape latency of a water maze test was prolonged, when the
      animals were tested on the 5th to 10th day after the embolism, suggesting
      learning and memory dysfunction. Cholinergic parameters of the striatum and
      hippocampus, such as acetylcholine (ACh) content (67 and 60% decrease,
      respectively), choline acetyltransferase (ChAT) activity (45 and 56% decrease,
      respectively), and Bmax of muscarinic acetylcholine M1-receptor (43 and 37%
      decrease, respectively), were reduced on the 11th day after the embolism,
      suggesting attenuation of ACh synthesis and a decrease in the number of
      muscarinic acetylcholine M1-receptors mainly in the striatum and hippocampus.
      Areas not stained with triphenyltetrazolium chloride, an indication of
      infarction, were detected mainly in the striatum and hippocampus and partly in
      the frontal cortex on the 11th day after the embolism. The results suggest that
      an animal with microsphere embolism may be a good ischemic model with relatively
      sustained impairments of learning and memory function and of the striatal and
      hippocampal cholinergic system.

PMID- 11201245
TI  - Na+ and K+ dependence of L-glutamate-induced suppression of astrocyte stellation
      in culture.
AB  - We have recently found that L-glutamate suppresses astrocyte stellation induced
      by various stimuli, and that this effect of L-glutamate is mimicked by
      transportable glutamate uptake inhibitors. To test the possible role of the
      glutamate transporter in the regulation of astrocyte morphology, we investigated
      the Na+ and K+ dependence of this effect of L-glutamate. In astrocyte cultures
      obtained from the cerebral cortex of neonatal rats, the L-glutamate-induced
      suppression of astrocyte stellation was significantly attenuated in a low-
      Na+/high- K+ medium and by the Na+ -K+ pump inhibitor ouabain. These results
      support that astrocyte morphology is affected by the activity of the Na+ 
      dependent glutamate transporter.

PMID- 11201246
TI  - Glycyrrhetinic acid induced apoptosis in murine splenocytes.
AB  - Glycyrrhetinic acid (GA) is known to inhibit glucocorticoid metabolism inhibiting
      11beta-hydroxysteroid dehydrogenase (11beta-HSD). Moreover, GA administration to
      mice has been shown to affect the lymphoid organs through elevation of endogenous
      corticosterone concentration. The effect of GA administration on thymus has been
      demonstrated to show that considerable amounts of thymocytes undergo apoptosis by
      elevated levels of corticosterone in systemic circulation. However, the effect of
      GA administration on peripheral lymphocytes has remained unknown. In our current
      study, we demonstrated that a significant involution of spleen as well as thymus
      occurred within 24 h of a single administration of GA in mice. In addition, a
      flow cytometric analysis of the splenocytes taken from mice treated with GA
      showed a significant increase in the number of apoptotic cells which exhibited
      translocated phosphatidylserine outside the plasma membrane. Furthermore,
      considerable inhibition of 11beta-HSD activity in GA-treated mice was observed in
      liver and spleen, resulting in a significant increase in concentration of
      corticosterone in the blood. These facts showed that the apoptosis of splenocytes
      was the result of indirect effect of GA through elevated levels of
      corticosterone. We confirmed this using cultured splenocytes in vitro where no
      apoptotic effect of GA was observed. We concluded that GA administration induces
      cell death of not only thymocytes that are naive to corticosterone, but also
      splenocytes that are usually stable to its physiological concentrations.

PMID- 11201247
TI  - Hair analysis for pharmaceutical drugs. I. Effective extraction and determination
      of phenobarbital, phenytoin and their major metabolites in rat and human hair.
AB  - In order to establish an analytical method for the determination of phenobarbital
      (PB), phenytoin (PPH) and their hydroxylated metabolites in hair, animal model
      experiments were performed. Five male dark-agouti pigmented rats, aged 5 weeks,
      were intraperitoneally and orally administered PB or PPH independently at 25
      mg/kg once a day for 5 successive days. The growing back hair was collected 15d
      after the first administration. Four typical extraction methods, using NH4OH
      methanol-acetone, TFA-methanol-acetone, 1M sodium hydroxide and proteinase K,
      were evaluated using the rat hair samples containing PB or PPH. Methanol-acetone
      NH4OH (10: 10: 1) was the best extraction method from all aspects, such as high
      extraction efficiency and low noise. The analytes in the extract were methylated
      in acetonitrile with 20% tetramethylammonium hydroxide and methyliodide at 70
      degrees C for 10 min. After purification with Bond Elut Certify, the methylated
      products were analyzed by GC-MS. From rat hair, PB, p-hydroxy PB, PPH and p
      hydroxy PPH were detected at average concentrations of 26.9, trace, 4.2 and 0.4
      ng/mg with an intraperitoneal (i.p.) injection, and at 30.9, trace, 4.0 and 0.4
      ng/mg with oral administration, respectively. There was little difference in hair
      concentrations between i.p. injection and oral administration. This method was
      applied to the head hair of two patients who orally took toxic amounts of PB and
      two volunteers who orally took 100 mg of PPH daily for 5 d. The hair
      concentrations of PB in the two patients were 16.2 and 14.7 ng/mg, and those of
      PPH in the two volunteers were 3.3 and 0.1 ng/mg.

PMID- 11201248
TI  - Higher yielding isolation of kinsenoside in Anoectochilus and its
      antihyperliposis effect.
AB  - A higher concentration of kinsenoside, 3-(R)-3-beta-D-glucopyranosyloxybutanolide
      (1), was detected in the crude drug Anoectochilusformosanus, and A. koshunensis
      by HPLC analysis. A methylation reaction occurred to give methyl ester (4) when
      the lactone ring of 1 was cleaved by silica gel catalysis using methanol
      containing solvent used in the purification step resulting in difficulty to
      purify 1. To avoid the cleavage reaction, a reversed-phase or silica gel column
      without methanol was used to give a high yield of 1. In an anti-hyperliposis
      assay using high-fat diet rats, 1 significantly reduced the weights of body and
      liver, and also decreased the triglyceride level in the liver compared to those
      of control rats. On the other hand, the epimer of 1, 3-(S)-3-beta-glucopyranosy
      loxybutanolide (2), trivially named goodyeroside A, which was isolated from
      Goodyera species, had no effect for anti-hyperliposis. In aurothioglucose-induced
      obese mouse, 1 suppressed the body and liver weight increase, significantly
      ameliorated the triglyceride level in the liver, and also reduced the deposition
      of uterine fat-pads.

PMID- 11201249
TI  - Gaussian quadrature as a numerical integration method for estimating area under
      the curve.
AB  - This paper presents a numerical integration method for estimating the area under
      the curve (AUC) over the infinite time interval. This method is based on the
      Gauss-Laguerre quadrature and produces AUC estimates over the infinite time
      interval without extrapolation in a usual sense. By contrast, in traditional
      schemes, piecewise interpolation is used to obtain the area up to the final
      sampling point, and the remaining portion is extrapolated using nonlinear
      regression. In this case, there is no theoretical consistency between the
      quadrature and extrapolation. The inconsistency may cause certain problems. For
      example, the optimal sampling criterion for the former is not necessarily optimal
      for the latter. Such inconsistency does not arise in the method of this work. The
      sampling points are placed near the zeros of Laguerre polynomials so as to
      directly estimate the AUC over the infinite time interval. The sampling design
      requires no particular prior information. This is also advantageous over the
      previous strategy, which worked by minimizing the variance of estimated AUC under
      the assumptions of particular pharmacokinetic and variance functions. The
      original Gaussian quadrature is believed to be inappropriate for numerical
      integration of data because of several restrictions. In this paper, it is shown
      that, using a simple strategy for managing errors due to these restrictions, the
      method produces an estimate of AUC with practically sufficient precision. The
      efficacy of this method is finally shown by numerical simulations in which the
      bias and variance of its estimate were compared with those of the previous
      methods such as the trapezoidal, log-trapezoidal, Lagrange, and parabolas-through
      the-origin methods.

PMID- 11201250
TI  - A protective effect against undesirable increase of dihydroetorphine permeation
      through damaged skin by using pressure-sensitive adhesive tape with an ethylene
      vinyl acetate co-polymer membrane.
AB  - The release kinetics of dihydroetorphine (DHE) from pressure-sensitive adhesive
      (PSA) tape with an ethylene-vinyl acetate co-polymer (EVA) membrane as a
      diffusion-controlling membrane and its protective effect from an unpredictable
      increase in skin permeation of DHE caused by stratum corneum damage were
      investigated. The DHE flux through the EVA membrane was enhanced with the
      increase of vinyl acetate content. Although the DHE release from the PSA tape was
      proportional to the square root of the time, the release from the PSA tape
      covered with the EVA membrane was dominated by zero-order rate. The release rate
      increased by the addition of isopropyl myristate to the PSA layer, due to the
      increase of solubility and diffusivity of DHE in the PSA layer, and not a
      decrease of permeation resistance in the EVA membrane. When using the PSA tape
      with the EVA membrane, the steady-state flux of DHE through hairless rat skin
      with stratum corneum damage was not 2-fold more than that through non-damaged
      skin. Plasma DHE concentration rose promptly above 5 ng/ml after the application
      of the PSA tape onto the damaged skin in hairless rat. In contrast, when the PSA
      tape with the EVA membrane was applied onto the damaged or non-damaged skin,
      plasma concentrations in the both cases were maintained in the therapeutic range
      (0.2-1.2 ng/ml). These results suggest that the PSA tape with the EVA membrane
      can be used to protect from the unpredictable increase in skin permeation of DHE
      due to stratum corneum damage.

PMID- 11201251
TI  - Complete sequences and expression kinetics of racG, racH, racI and racJ genes in
      Dictyostelium discoideum.
AB  - We sequenced and characterized the expression patterns of the genes (racG, racH,
      racI and racJ) in the Rho-family. The nucleotide sequences of these genes suggest
      that racI would be a pseudogene, while the other genes are likely to encode
      typical Rac proteins which contain either GTP-binding domain or CAAX prenylation
      motif as observed in other members of the family. The Northern blot analyses show
      that the expression patterns of these genes are distinctively regulated during
      development. The racG gene is expressed at almost the same level from the
      vegetative to the slug stage, but the amount of its transcript gradually
      decreases after culmination. Expression of the racJ gene is undetectable at the
      vegetative stage, becomes observable at the mound stage, reaches a peak at the
      slug stage and then suddenly disappears in the culmination stage. The racH gene
      is expressed in two forms of transcripts, both of which are undetectable at the
      vegetatively growing stage but abruptly increase in amount after starvation.
      Southern blot hybridization analysis demonstrates that these transcripts were
      derived from a single copy of the gene. Such distinct kinetics of the expression
      patterns suggests that these genes would have unique roles in Dictyostelium
      development.

PMID- 11201252
TI  - Exercise improved accumulation of visceral fat and simultaneously impaired
      endothelium-dependent relaxation in old rats.
AB  - Exercise decreases plasma total cholesterol and triglycerides, and
      simultaneously, increases high density lipoprotein (HDL) cholesterol.
      Furthermore, it has been reported that exercise improves insulin resistance. As a
      result, exercise is believed to aid in preventing atherosclerosis. However, we do
      not know whether exercise protects against the development of atherosclerosis in
      the elderly. The aim of this study was to ascertain whether exercise prevented
      atherosclerosis in aorta of old rats. Exercise for three months did not affect
      plasma lipid levels but decreased accumulation of visceral fat and body weight
      without the reduction of food intake in two year old rats. Exercise also
      decreased triglycerides in liver and gastrocnemius white muscle. Exercise
      resulted in an elevation of plasma lipid peroxide (LPO) levels without affecting
      superoxide dismutase (SOD). Exercise impaired the endothelium-dependent
      relaxation of the thoracic aorta caused by acetylcholine in old rats. In summary,
      the results of our study indicate that exercise induces the reduction of visceral
      fat, body weight and triglyceride contents in tissues in old rats. These results
      seems to show that exercise improves insulin resistance. However, exercise
      simultaneously may cause impaired endothelium-dependent relaxation by elevation
      of LPO in old rats.

PMID- 11201253
TI  - Effects of peppermint (Mentha piperita L.) extracts on experimental allergic
      rhinitis in rats.
AB  - The present study was carried out to clarify the effects of extracts of the
      leaves of Mentha piperita L. on experimental allergic rhinitis. The 50% EtOH
      extract of peppermint inhibited histamine release from rat peritoneal mast cells
      induced by compound 48/80. The effect was dose-dependent and significant
      inhibition was observed at a concentration of 3 microg/ml. In addition, the 50%
      EtOH eluate separated from the 50% EtOH extract of peppermint by column
      chromatography (DIAION HP-20) was also effective in inhibiting histamine release
      at a concentration of 1 microg/ml. Nasal symptoms, sneezing and nasal rubbing
      induced by antigen challenge in actively sensitized rats were inhibited by oral
      administration of the 50% EtOH eluate. Significant inhibition of sneezing and
      nasal rubbing was observed at doses of 300 and 1000 mg/kg, p.o., respectively.
      Furthermore, the 50% EtOH eluate inhibited dye leakage into the nasal cavity of
      rats induced by antigen in a dose-dependent manner. These results suggested that
      extracts of Mentha piperita L. may be clinically effective in alleviating the
      nasal symptoms of allergic rhinitis.

PMID- 11201254
TI  - Does post-translational modification influence chaperone-like activity of alpha
      crystallin? I. Study on phosphorylation.
AB  - It is difficult to isolate derivatives of alpha-crystallin with only one type of
      post-translational modification, because this protein is subjected to several
      different types of modification. In the present study using bovine lens proteins,
      we isolated mono-phosphorylated alphaB-crystallin with no other post
      translational modifications. Using this material, we demonstrated that mono
      phosphorylation reduced the activity of alphaB-crystallin by approximately 30%.
      Our results confirmed that investigation of the correlation between chaperone
      like activities of alpha-crystallin and post-translational modification is
      important to understand the mechanism of cataract formation.

PMID- 11201255
TI  - Autotransporter proteins, evolution and redefining protein secretion: response.

PMID- 11201256
TI  - Autotransporter proteins, evolution and redefining protein secretion: response.

PMID- 11201257
TI  - Mapping of a chromosome replication origin in an archaeon: response.

PMID- 11201258
TI  - Gonococcal lipooligosaccharide: an adhesin for bacterial dissemination? Response.

PMID- 11201259
TI  - The pathology of Chlamydia pneumoniae lesions in humans and animal models.

PMID- 11201260
TI  - Dual role for cytochrome cbb3 oxidase in clinically relevant proteobacteria?

PMID- 11201261
TI  - Lipid-CD1-reactive T cells.

PMID- 11201262
TI  - Uneasy bedfellows: science and politics in the refutation of Koch's bacterial
      theory of cholera.

PMID- 11201263
TI  - Nineteenth-century medical landscapes: John H. Rauch, Frederick Law Olmsted, and
      the search for salubrity.

PMID- 11201264
TI  - The white plague goes to college: tuberculosis prevention programs in colleges
      and universities, 1920-1960.

PMID- 11201265
TI  - Beyond the "Two Psychiatries": Jack Pressman's Last Resort and the history of
      twentieth-century American psychiatry. Introduction.

PMID- 11201266
TI  - Jack Pressman and the future of the history of psychiatry.

PMID- 11201267
TI  - Toward new narratives of twentieth-century medicine.

PMID- 11201269
TI  - Fifty years of the British National Health Service: mixed messages, diverse
      interpretations.

PMID- 11201268
TI  - Therapeutics and the history of psychiatry.

PMID- 11201270
TI  - The parent trap.

PMID- 11201271
TI  - Stop stressing me.

PMID- 11201272
TI  - The skin-cancer scare. The lesion on Bill Clinton's back was easily cured, but it
      offers a stark reminder of the sun's hazards.

PMID- 11201273
TI  - Searching for the God within.

PMID- 11201274
TI  - Three-dimensional arrangement of muscle bundles in the outer layers of rodentia
      vasa deferentia.
AB  - Three-dimensional arrangement of the smooth muscle bundles of the outer layer of
      the vas deferens musculature in mammals (guinea-pigs, rats and mice) was examined
      under the scanning electron microscope (SEM) after removal of fibrous connective
      tissue elements. Muscle fibers of all examined animals formed bundles. In the
      guinea-pig, similar sized bundles extended longitudinally along the tubular vas
      deferens and branched to anastomose with branches of neighboring bundles to
      create a net which was regular in form. In the rat, longitudinal muscle bundles
      constituted an outer layer in the form of a net, which was roughly enmeshed with
      variously-sized, transverse or oblique bundles in anastomosis with underlying
      longitudinal bundles. In the mouse, longitudinal bundles of irregular thickness
      branched into many small bundles and anastomosed not only with neighboring
      bundles to create an irregular net. In both the rat and the mouse there were
      bundles extending over many other bundles to anastomose with them at a far point.
      Junctional structures were well developed between neighboring fibers. Myofibrils
      were represented as thin streaks on muscle fiber surfaces. Varicosed nerve fibers
      existed between muscle fibers and in narrow cytoplasmic grooves in all the
      examined animal species. The findings are discussed in correlation with
      electrophysiological data.

PMID- 11201275
TI  - The brain of the Nemertodermatida (Platyhelminthes) as revealed by anti-5HT and
      anti-FMRFamide immunostainings.
AB  - The taxa Nemertodermatida and Acoela have traditionally been considered closely
      related and classified as sister groups within the Acoelomorpha Ehlers 1984
      (Platyhelminthes). Recent molecular investigations have questioned their
      respective position. In this study, the 5-HT and FMRFamide immunoreactivity (IR)
      in the nervous system of two nemertodermatids, Nemertoderma westbladi and Meara
      stichopi, is described. The 5-HT immunoreactive pattern differs in the two
      nemertodermatids studied. In M. stichopi, two loose longitudinal bundles of 5-HT
      immunoreactive fibres and an basi-epidermal nerve net were observed. In N.
      westbladi the 5-HT-IR shows a ring-shaped commissural structure, different from
      the commissural brain of acoels. In both nemertodermatids, FMRFamide
      immunoreactive nerve fibres followed the 5-HT-immunoreactive fibres. It is
      demonstrated that the Nemertodermatida have neither a 'commissural brain'
      structure similar to that of the Acoela, nor a 'true', ganglionic brain and
      orthogon, typical for other Platyhelminthes. The question of the plesiomorphic or
      apomorphic nature of the nervous system in Nemertodermatida cannot yet be
      answered. The neuroanatomy of the studied worms provides no synapomorphy
      supporting the taxon Acoelomorpha.

PMID- 11201276
TI  - Structural and biochemical analysis of the parasite Gordius villoti
      (Nematomorpha, Gordiacea) cuticle.
AB  - The cuticle of the nematomorpha Gordius villoti is a proteinaceous extracellular
      structure that covers the body during the endoparasitic life in the hemocoelic
      cavity of insect hosts, and of the free-living adult animals. The ultrastructure
      of the cuticle has a complex spatial organization with several parallel layers of
      large diameter fibers, interposed thinner fibrous elements and honeycomb-shaped
      matrix surrounding the fibers. When adult isolated cuticles were partially
      solubilized by several compounds, the structure revealed a strong insolubility
      and the main fibers were always observable. HPLC and spectrophotometric assays
      carried out to investigate the presence of tyrosine cross-linking, indicated such
      a mechanism as a key-element in the hardening process of the cuticle. Such data
      strongly suggest that the Gordius cuticle contains dityrosine compounds, whose
      formation is probably mediated by endogenous peroxidase activity.

PMID- 11201277
TI  - Postnatal development of the rat intrinsic cardiac nervous system: a confocal
      laser scanning microscopy study in whole-mount atria.
AB  - We used confocal laser scanning microscopy and fluorescent immunohistochemistry
      to study the developmental pattern and distribution of specific neuronal
      phenotypes within the intrinsic cardiac nervous system in whole-mount atrial
      preparations from newborn to 5 week old rats. Individual ganglia and neuronal
      cell bodies were localized by means of two general neuronal markers: protein gene
      product 9.5 (PGP) and microtubule-associated protein two (MAP). In rats < or =2
      weeks old there were two main subpopulations of intrinsic neurons located in the
      intraatrial septum and around the origin of the superior vena cava. The more
      abundant was a population of strongly tyrosine hydroxylase (TH) immunoreactive
      (IR) neurons (10-40 microm in diameter) most of which were also PGP-IR. The
      second, less numerous (approximately 60-70% than the TH-IR group) type of neurons
      exhibited ChAT-IR which colocalized with MAP-IR. Towards the end of the second
      postnatal week and during the third, the ganglia containing these neurons became
      more numerous and their localization also included tissues around the origins of
      the inferior vena cava and the pulmonary veins, as well as both atrial walls
      close to the AV junction. During the second and third postnatal weeks, when the
      extrinsic innervation of the adrenergic and cholinergic phenotypes largely
      increases, the intrinsic innervation also changed greatly, and around the 21st
      postnatal day it appeared to acquire mature characteristics. The TH-IR neurons
      changed their characteristics and formed two types of ganglia. The larger ganglia
      containing large cells (20-40 microm in diameter) expressed TH-IR mostly close to
      their inner body surface (approximately 80-90% of identified neurons). Most of
      these neurons also expressed neuropeptide Y (NPY)-IR, specifically around their
      nuclei. The second type of small strongly TH-IR neurons (approximately 10% of all
      identified neurons) were contained in smaller groups (20-50 cells) which were
      usually embedded into much larger ganglia (100-400 cells), containing large (20
      50 microm) neurons. Unlike all other intrinsic neurons, these small TH-IR cells
      did not exhibit any PGP-IR or MAP-IR. The number of ChAT-IR neurons increased at
      this stage, reaching approximately 90% of the neurons identified by the general
      neuronal markers. These neurons were surrounded by a rich network of cholinergic
      varicose nerve fibers, some of which were likely of an extrinsic origin. We have
      also identified relatively small ganglia expressing immunoreactivity to
      vasoactive intestinal polypeptide (VIP), and to substance P (SP). The presented
      data indicate that the phenotypes of intrinsic neurons in the rat heart change
      greatly during the first month of postnatal development. This may be at least
      partially related to the development and maturation of functional extrinsic
      nervous control of the heart.

PMID- 11201278
TI  - Integumental amino acid uptake in a carnivorous predator mollusc (Sepia
      officinalis, Cephalopoda).
AB  - The epithelial cells of the integument of body, arms and tentacles of Sepia
      officinalis present on their apical membrane a well-organised brush border and
      show the morphological and histochemical characteristics of a typical absorptive
      epithelium. The ability of the integument to absorb amino acids was investigated
      both in the arms incubated in vitro and in a purified preparation of brush border
      membrane vesicles (BBMV). Autoradiographic pictures of the integument after
      incubation of the arms in sea-water with or without sodium, showed that proline
      intake was Na+-dependent, whereas leucine intake appeared to be a largely cation
      independent process. Time course experiments of labelled leucine, proline and
      lysine uptakes in BBMV evidenced that these amino acids are accumulated within
      the vesicles in the presence of an inwardly directed sodium gradient. The sodium
      driven accumulation proves that cationic and neutral amino acids are taken up by
      the apical membrane of the epithelium of Sepia integument through a secondary
      active mechanism. For leucine, a 90% inhibition of the uptake was recorded in the
      presence of a large excess of the substrate. In agreement with the
      autoradiography results, an analysis of the cation specificity transport in BBMV
      showed that leucine uptake had a low cation specificity, whereas lysine and
      proline uptakes were Na+-dependent. An excess of lysine and proline, which share
      with alanine two different transport systems in the gill epithelium of marine
      bivalves, reduced eucine uptake. The possible role of the absorptive ability of
      the integument in a carnivorous mollusc is discussed.

PMID- 11201279
TI  - Impairment of adenylate cyclase activity and G-proteins in human uterine
      leiomyoma.
AB  - The mechanisms responsible for the growth of uterine leiomyoma (a frequent cause
      of infertility in women) are largely unknown. Some data supports that cAMP plays
      a role in the growth of uterine cells but there are no reports on the status of
      the cAMP producing system in this human benign neoplasia. In this study, biopsies
      from leiomyoma and the adjacent myometrium were taken from menstruating women
      subjected to total hysterectomy for leiomyoma. Adenylate cyclase activity was
      determined by a protein-binding method, and the expression of alpha(s),
      alphai1/2, alphai3 and alphai0) G-protein subunits was analysed by immunoblot.
      The leiomyoma samples exhibited a decreased expression of as and ai1/2 with
      respect to the adjacent myometrial tissue. No differences were observed in
      alphai3 and alphaio protein expression. The basal adenylate cyclase activity as
      well as the efficacy (as assessed by the maximal stimulation levels) of either
      forskolin or, to a lesser extent, Gpp[NH]p on stimulation the enzyme activity was
      significantly lower in leiomyoma than in myometrium, whereas the potency (as
      assessed by the ED50 values) of these two agents did not vary. Present data
      indicate that the human leiomyoma is associated with low levels of cAMP. It is
      conceivable that the loss of sensitivity of adenylate cyclase to endogenous
      regulatory molecules could be related to the pathogenesis of human leiomyomas
      given that cAMP inhibits the MAP-kinase cascade in uterine tissues.

PMID- 11201280
TI  - A new model for periostracum and shell formation in Unionidae (Bivalvia,
      Mollusca).
AB  - The periostracum in Unionidae consists of two layers. The outer one is secreted
      within the periostracal groove, while the inner layer is secreted by the
      epithelium of the outer mantle fold. The periostracum reaches its maximum
      thickness at the shell edge, where it reflects onto the shell surface.
      Biomineralization begins within the inner periostracum as fibrous spheruliths,
      which grow towards the shell interior, coalesce and compete mutually, originating
      the aragonitic outer prismatic shell layer. Prisms are fibrous polycrystalline
      aggregates. Internal growth lines indicate that their growth front is limited by
      the mantle surface. Transition to nacre is gradual. The first nacreous tablets
      grow by epitaxy onto the distal ends of prism fibres. Later growth proceeds onto
      previously deposited tablets. Our model involves two alternative stages. During
      active shell secretion, the mantle edge extends to fill the extrapallial space
      and the periostracal conveyor belt switches on, with the consequential secretion
      of periostracum and shell. During periods of inactivity, only the outer
      periostracum is secreted; this forms folds at the exit of the periostracal
      groove, leaving high-rank growth lines. Layers of inner periostracum are added
      occasionally to the shell interior during prolonged periods of inactivity in
      which the mantle is retracted.

PMID- 11201281
TI  - Isolation and partial characterization of myogenic cells from mussel larvae in
      vitro.
AB  - The main finding of the present study is the discovery of the possibility of a
      morphofunctional myogenic differentiation of larval mussel cells in vitro. The
      shape and extensive cytoskeletal network of the cultured contracting cells mimic
      largely those of smooth muscle cells in vivo. However, the behavior and protein
      composition of these cells are not completely identical with those of smooth
      muscle cells. Contracting mussel cells in vitro, as well as differentiated smooth
      muscles, demonstrate both phasic and tonic contractions. The paramyosin to myosin
      ratio in the cultured mussel cells is far less than that in the muscles of
      veliger larvae and adult mussels. We have found the protein carpets with various
      adhesive characteristics determine different development pathways. Myogenic
      differentiation is only observed in spreading cells. Non-spreading adherent cells
      plated on collagen carpet show high synthetic activity but the commitment of
      contractile phenotype is inhibited. Our results confirm that the myogenic program
      established in early embryogenesis of molluscs can be realized during the
      cultivation of cells from premyogenic larval stages.

PMID- 11201282
TI  - An ultrastructural study of connective tissue in mollusc integument: I. Bivalvia.
AB  - The ultrastructure of the subepidermal connective tissue (SEC) in different areas
      of the integument of the bivalves Callista chione, Pecten jacobaeus, Mytilus
      galloprovincialis and Ostrea edulis was studied by transmission electron
      microscopy. The main organisation of the SEC was broadly similar in all species:
      the SEC was connected to the epidermis by a basement membrane and merged directly
      with the deeper connective tissue surrounding muscles. The SEC was not
      differentiated into layers like the papillary and reticular dermis of mammals,
      however, the architecture, thickness and shape of the basement membrane varied
      from species to species, as well as within species (in the foot, central or
      marginal zones of the mantle). The ultrastructure of the lamina densa was broadly
      similar to that in mammals: although basotubules and double pegs were absent,
      proteoglycans and rod-like units homologous to 'double tracks' were always
      abundant. A zone similar to the lamina lucida was irregularly present and was
      shot thorough with small protrusions of the lamina densa that connected with the
      epithelial hemidesmosomes or focal adhesions. Nevertheless zones were observed
      where the lamina densa fuse directly to the epithelial plasmamembrane. This
      variability of connection may be related to the various types of epidermal cell.
      A lamina fibroreticularis was not recognized since anchoring fibrils and
      microfibrils were not present; lamina densa protrusions into the extracellular
      matrix (ECM) of SEC characterize the connection between basement membrane and
      SEC. Collagen fibrils were small and of constant diameter and were never
      organised into fibres. Anchoring devices - similar to the anchoring plaques of
      mammalian dermis - were abundant and scattered between SEC collagen fibrils. The
      orange-pink pigmentation of C. chione seems due to electron-dense granules
      embedded within the connective ECM.

PMID- 11201283
TI  - Lipopolysaccharide-dependent induction of leech leukocytes that cross-react with
      vertebrate cellular differentiation markers.
AB  - We have designed experiments to characterise leech leukocytes that mediate
      inflammatory responses. Shortly after inflicting injury to the body wall in the
      presence of lipopolysaccharides, many cells resembling macrophages, NK cells and
      granulocytes of vertebrates and many invertebrates migrated to the lesioned area.
      Nuclei of migrating cells incorporated bromodeoxyuridine. Using human monoclonal
      antibodies, macrophage-like cells were positive for CD25, CD14, CD61, CD68, CD11b
      and CD11c. NK-like cells were positive for CD25, CD56, CD57 and CD16, and
      granulocytes were positive for CD11b and CD11c. In blots of leech extracts, the
      CD25 monoclonal antibody recognised a band of about 55 kD; the CD56 monoclonal
      antibody, two bands of about 140 and 210 kD; the CD57 monoclonal antibody, two
      bands of about 106 and 70 kD; the CD14 monoclonal antibody, a band of about 50
      kD; the CD16 monoclonal antibody, a band of about 60 kD. CD61 and CD68 both
      recognised a band of about 110 kD; CD11b recognised a band of 200 kD, and CD11c,
      a band of 180 kD.

PMID- 11201284
TI  - The MDCK cell line is made up of populations of cells with diverse resistive and
      transport properties.
AB  - The MDCK cell line has been used as a model for the renal distal tubule. When
      grown on permeable supports, the cells form tight junctions and transport sodium
      and calcium. Widely different values have, however, been obtained for resistance
      and transports by different investigators. Since the MDCK cell line is
      genetically heterogeneous, one potential reason for observed differences is the
      use of different populations of cells. Dilutional techniques have been used to
      obtain eleven MDCK cell clones. The clones exhibit a range of values for
      resistance (300-4000 ohms cm2), net Ca2+ transport (3.2-81 pmol/cm2/min) and net
      Na+ transport (0.4-6.0 nmol/cm2/min). To determine if the characteristics of
      clonal cell lines changed with increasing passage number, resistance was measured
      at relatively early and late passage number. Resistance increased with increasing
      passage number in two of six lines and decreased in one. These studies
      demonstrate that differences between previous studies may be due to differences
      in cell population, length of time since passage, and passage number. Clonal cell
      lines should provide a useful tool to investigate ion transport and mechanisms of
      regulation of transport in this model of renal distal tubule.

PMID- 11201285
TI  - Refining procedures for the administration of substances. Report of the
      BVAAWF/FRAME/RSPCA/UFAW Joint Working Group on Refinement. British Veterinary
      Association Animal Welfare Foundation/Fund for the Replacement of Animals in
      Medical Experiments/Royal Society for the Prevention of Cruelty to
      Animals/Universities Federation for Animal Welfare.

PMID- 11201286
TI  - Metabolic flux measurements across portal drained viscera, liver, kidney and
      hindquarter in mice.
AB  - A method was developed to measure metabolic fluxes across either portally-drained
      viscera (PDV) and liver or kidney and hindquarter (HQ) in anesthetized mice. The
      method includes a primed-constant infusion of ketamine-medetomidine anaesthesia
      to stabilize the mice for the surgical procedures. For measurement of metabolic
      fluxes across PDV and liver, blood sampling catheters were inserted in the
      carotid artery, portal vein and hepatic vein and infusion catheters in the
      jugular vein and mesenteric vein. For measurement of metabolic flux across kidney
      and HQ, blood sampling catheters were inserted in the carotid artery, renal vein
      and caval vein and infusion catheters in the jugular vein and abdominal aorta.
      14C-PAH was infused to enable plasma flow measurement using an indicator dilution
      method. In addition, we developed a blood sampling procedure without waste of
      blood. We measured plasma flow and metabolic fluxes across PDV, liver, kidney and
      HQ. Mean plasma flow in post-absorptive mice was: PDV: 0.9+/-0.2, liver: 1.2+/
      0.3, kidney: 1.0+/-0.1, HQ: 1.1+/-0.3 ml/10 g body weight (b.w.)/min. Significant
      glutamine release by the HQ and uptake of glutamine by the kidney and PDV was
      observed. In PDV, citrulline is produced from glutamine and is in turn used by
      the kidney for the production of arginine. In conclusion, the described model
      enables measurement of metabolic fluxes across PDV, liver, kidney and HQ in mice.
      The availability of such a small animal model allows the potential for measuring
      metabolic parameters in transgenic and knockout mice, and therefore may lead to
      an important refinement in metabolic research.

PMID- 11201287
TI  - Evaluation of individually ventilated cage systems for laboratory rodents:
      occupational health aspects.
AB  - New ventilated caging systems for laboratory animals were compared with
      conventional caging regarding allergen distribution, ergonomic suitability, cage
      environment and animal welfare. This paper presents occupational health
      evaluations. Mice were placed in individually ventilated cage (IVC) systems, a
      ventilated cabinet, and in cages on open shelves (conventional husbandry). The
      IVC systems were studied at negative and positive airflow. Aeroallergens were
      sampled on filters (n = 204, including controls) in undisturbed rooms and during
      cage changing. Concentrations of mouse urinary allergen (Mus m 1) in filter
      eluates were measured using sandwich ELISA. An ergonomic evaluation was performed
      with measurement of traction forces. Staff exposure during cage changing was high
      in all systems, range 116-4430 ng Mus m 1/m3. In undisturbed animal rooms,
      allergen levels were orders of magnitude higher when using conventional caging
      compared with ventilated systems; P < 0.001. At positive pressure both IVCs
      leaked allergen (median Mus m 1 concentration was < 0.08 ng/m3 at negative, but
      6.5 ng/m3 (IVC1) and 0.8 ng/m3 (IVC2S) at positive pressure). The IVC systems had
      ergonomic disadvantages compared with the conventional husbandry and the
      ventilated cabinet, for instance with cages in unsuitable working heights.
      Ventilated husbandry solutions reduce levels of airborne allergen substantially
      at negative pressure, but are ergonomically less suitable. To prevent allergen
      exposure during cage changing, we propose that this procedure should be performed
      under ventilated conditions. Producers and users must cooperate in optimizing
      animal caging systems for both animals and staff.

PMID- 11201288
TI  - Evaluation of individually ventilated cage systems for laboratory rodents: cage
      environment and animal health aspects.
AB  - The use of individually ventilated cage (IVC) systems has become an attractive
      housing regime of laboratory rodents. The benefits of IVC systems are,
      reportedly, a high degree of containment combined with relative ease of handling,
      and a high degree of protection from allergenes. In the present study we tested
      whether two IVC systems (BioZone VentiRack, IVC1 and Techniplast SealSafe,
      IVC2S), in which we held mature male NMRI mice, were constructed to maintain a
      constant differential pressure, positive or negative, during a prolonged period
      of time. We also measured ammonia (NH3) concentrations after about 2 weeks of
      use, and CO2 build-up during a 60 min simulated power failure situation. In
      addition, animal weight development and bite-wound frequency were recorded
      (Renstrom et al. 2000). From the present study it is concluded that the IVC1 air
      handling system provides a more uniform and balanced differential pressure than
      the IVC2S. Both systems effectively scavenge NH3 when bedding material is not
      soaked by urine. Although the IVCs are dependent on the continual function of the
      fans to work properly, it seems unlikely that CO2 concentrations increase to
      hazardous levels, as a result of a one hour power failure, with the type of cages
      used in this study. Differences in weight development and bite-wound occurrence
      were noted between the two IVC systems. Causes for these differences could not be
      established and need more investigation.

PMID- 11201289
TI  - The impact of reduced frequency of cage changes on the health of mice housed in
      ventilated cages.
AB  - Our purpose in this investigation was to determine if we could reduce cage
      changing frequency without adversely affecting the health of mice. We housed mice
      at three different cage changing frequencies: 7, 14, and 21 days, each at three
      different cage ventilation rates: 30, 60 and 100 air changes per hour (ACH), for
      a total of nine experimental conditions. For each condition, we evaluated the
      health of 12 breeding pairs and 12 breeding trios of C57BL/6J mice for 7 months.
      Health was assessed by breeding performance, weanling weight and growth, plasma
      corticosterone levels, immune function, and histological examination of selected
      organs. Over a period of 4 months, we monitored the cage microenvironment for
      ammonia and carbon dioxide concentrations, relative humidity, and temperature one
      day prior to changing the cage. The relative humidity, carbon dioxide
      concentrations, and temperature of the cages at all conditions were within
      acceptable levels. Ammonia concentrations remained below 25 ppm (parts per
      million) in most cages, but, even at higher concentrations, did not adversely
      affect the health of mice. Frequency of cage changing had only one significant
      effect; pup mortality with pair matings was greater at the cage changing
      frequency of 7 days compared with 14 or 21 days. In addition, pup mortality with
      pair matings was higher at 30 ACH compared with other ventilation rates. In
      conclusion, under the conditions of this study, cage changes once every 14 days
      and ventilation rates of 60 ACH provide optimum conditions for animal health and
      practical husbandry.

PMID- 11201290
TI  - The cage preferences of laboratory rats.
AB  - Preference tests were used to assess a range of enrichment options for rats kept
      under standard New Zealand (and similar) caging conditions. The rats did not show
      significant preferences for most of the options, over an empty cage. The
      exceptions were shredded paper, a nesting box and a semi-enriched condition
      incorporating a range of modifications. These cage modifications are recommended
      for the enrichment of laboratory rats.

PMID- 11201291
TI  - Estimates of appropriate number of rats: interaction with housing environment.
AB  - An extensive list of physiological parameters from previous experiments was re
      analysed in order to evaluate the effects of enrichment, cage type and group size
      on the within-group variation and hence on the number of animals needed in
      studies using Wistar rats. The independent factors studied in these experiments
      included the provision of aspen gnawing blocks for enrichment, solid bottom cages
      (SBCs) and grid floor cages (GFCs) and animal number per cage (varied from 1-4).
      SOLO power analysis was used to calculate the smallest number of animals (n)
      needed to detect an arbitrarily chosen 20% effect size, when significance was set
      at P = 0.05 and statistical power at 0.90. N ratios (nlarger/nsmaller) were
      calculated for the effect of enrichment, cage type and group size to compare the
      'treatment group' with the 'control group'. The n values of adrenal gland,
      interscapular brown adipose tissue (BAT) and epididymal adipose tissue (EAT)
      weights seemed to vary most, whereas final body weight (FBWJ and growth seemed to
      be the least variable ones. According to one-sample t-test, the N ratios of most
      physiological parameters differed significantly from zero (except the ones of
      FBW) indicating that n values in 'treatment' and 'control' groups were unequal.
      The results indicate that some of the physiological parameters are susceptible to
      variability attributable to environmental modifications in general whereas some
      are not. Furthermore, they suggest that the variation of different parameters may
      vary from one experiment to another and between different environments thus
      hindering the estimations of appropriate number of animals.

PMID- 11201292
TI  - Strain differences in some immune parameters can be obscured by circadian
      variations and laboratory routines: studies of male C57BL/6J, Balb/c and CB6 F1
      mice.
AB  - This is a report on the potential influence of circadian changes and laboratory
      routines on some immune parameters (thymic and splenic weights, the numbers of
      bone marrow, peripheral blood, and peritoneal leukocytes) in: (1) males of
      C57BL/6J, Balb/c, and CB6 F1 mice kept under identical laboratory conditions; (2)
      males of CB6 mice kept under the same laboratory conditions, except for opposite
      light/dark regimes, either light/dark (LD) or dark/light (DL). All the animals
      were purchased from the same supplier and adapted for 4-5 weeks to strictly
      controlled housing conditions. Some parameters were similar at certain time
      points but statistically significantly different at others due to strain-specific
      daily variations. In order to make the interstrain comparisons more reliable, the
      data collected around the day/night cycle were pooled for calculations of mean
      values. Several immune parameters of CB6 mice kept under DL conditions were
      significantly different than those in mice under the conventional LD conditions.
      In conclusion, the extrapolation of results (especially in the field of
      neuroimmunology) to other strains (or species) should be done with great caution;
      and all interstrain (interspecific) comparisons, especially those from various
      laboratories, should always be related to specific time points and laboratory
      conditions.

PMID- 11201293
TI  - The role of cyclooxygenase and lipoxygenase in cancer chemoprevention.
AB  - The involvement of prostaglandins (PGs) and other eicosanoids in the development
      of human cancer has been known for over two decades. Importantly, an increase in
      PG synthesis may influence tumor growth in human beings and experimental animals,
      and numerous studies have illustrated the effect of PG synthesis on carcinogen
      metabolism, tumor cell proliferation and metastatic potential. PGs produced by
      cyclooxygenases (COXs) are represented by a large series of compounds that mainly
      enhance cancer development and progression, acting as carcinogens or tumor
      promoters, with profound effects on carcinogenesis. Further investigations
      suggest that arachidonic acid (AA) metabolites derived from lipoxygenase (LOX)
      pathways play an important role in growth-related signal transduction, implying
      that intervention through these pathways should be useful for arresting cancer
      progression. We discuss here the implications of COX and LOX in colon,
      pancreatic, breast, prostate, lung, skin, urinary bladder and liver cancers.
      Select inhibitors of COX and LOX are described, including nonsteroidal
      antiinflammatory drugs (NSAIDs), selective COX-2 inhibitors, curcumin, tea,
      silymarin and resveratrol, as well as a method useful for evaluating inhibitors
      of COX. Although a substantial amount of additional work is required to yield a
      better understanding of the role of COX and LOX in cancer chemoprevention, it is
      clear that beneficial therapeutic effects can be realized through drug-mediated
      modulation of these metabolic pathways.

PMID- 11201294
TI  - The micronutrient indole-3-carbinol: implications for disease and
      chemoprevention.
AB  - This review provides a historical perspective for the development of indole-3
      carbinol (I-3-C) as a chemopreventive or therapeutic agent. Early experiments in
      animal models clearly showed that feeding cruciferous vegetables reduced the
      incidence of chemical carcinogenesis. Excitement was generated by the finding
      that these vegetables contained a high content of indole-containing compounds,
      and I-3-C could by itself inhibit neoplasia. The mechanism of action was linked
      primarily to the ability of I-3-C and derived substances to induce mixed-function
      oxidases and phase II antioxidant enzymes by binding and activating the aryl
      hydrocarbon receptor. Most of the literature on chemoprotection by dietary indole
      compounds relates to this mechanism of action. Other mechanisms, however, are
      notable for this class of compounds, including their ability to act as radical
      and electrophile scavengers; the various ascorbate conjugates of I-3-C
      (ascorbigens) may be important in this regard. Exciting recent findings have
      demonstrated that I-3-C and its reaction products can affect cellular signaling
      pathways, regulate the cell cycle, and decrease tumor cell properties related to
      metastasis. It does not appear that I-3-C per se is the primary active compound
      in chemoprotection or chemoprevention. Rather, I-3-C and ascorbate provide the
      parent compounds for the formation of a myriad of nonenzymatic reaction products
      that have strong biological potency. We conclude with our thoughts regarding the
      current status and future directions for the use of I-3-C and related compounds.

PMID- 11201295
TI  - Carotenoids and chronic diseases.
AB  - Chronic diseases such as cancer and cardiovascular diseases are the major causes
      of deaths in North America. Dietary intake of fruits and vegetables has been
      suggested to have protective effects against such chronic diseases. Carotenoids
      are important plant pigments which are thought to contribute towards the
      beneficial effects of fruit and vegetable consumption. This review focuses on the
      role of carotenoids and particularly lycopene in chronic diseases.

PMID- 11201296
TI  - The bioactivity of saponins: triterpenoid and steroidal glycosides.
AB  - Triterpenoid and steroidal glycosides, referred to collectively as saponins, are
      bioactive compounds present naturally in many plants. They have considerable
      potential as pharmaceutical and/or nutraceutical agents in natural or synthetic
      form. Saponins, from a variety of sources, have been shown to have
      hypocholesterolemic, anti-coagulant, anticarcinogenic, hepatoprotective,
      hypoglycemic, immunomodulatory, neuroprotective, anti-inflammatory and anti
      oxidant activity. This paper reviews saponin research of the last decade,
      focussing on developments in understanding their mechanism of action and
      structure-activity relationships. Virtually all of this work has used animal and
      in vitro models. To date there are very few human data.

PMID- 11201297
TI  - Effect of organosulfur compounds from garlic and cruciferous vegetables on drug
      metabolism enzymes.
AB  - The frequent consumption of cruciferous vegetables and garlic is associated with
      several health benefits. These foods contain organosulfur compounds that are
      known to affect the biotransformation of xenobiotics, and therefore can influence
      the toxicity and carcinogenicity of environmental chemicals. In this article, we
      review the effects of isothiocyanates and diallyl sulfide on xenobiotic
      metabolism and the enzymes involved in the process. Isothiocyanates and diallyl
      sulfide can modulate the levels of phase I and phase II drug-metabolizing enzymes
      by affecting the transcriptional rates of their genes, the turnover rates of
      specific mRNAs or enzymes, or the enzyme activity. These compounds are not
      general enzyme inhibitors or inducers. They elicit selectivity in their mode of
      action. Elucidating the mechanisms involved in the alteration of drug
      metabolizing enzymes by isothiocyanates and diallyl sulfide will increase our
      understanding of their possible effects on the biotransformation of drugs as well
      as the potential beneficial or detrimental effects of these organosulfur
      compounds.

PMID- 11201298
TI  - Molecular aspects of procyanidin biological activity: disease preventative and
      therapeutic potentials.
AB  - There is a growing interest in the utilization of procyanidins for their dietary
      and pharmacological properties. A wide spectrum of beneficial activity for human
      health has been advocated for procyanidins due, in part, to their strong
      antioxidant activity. More recently the ability of procyanidins to affect gene
      expression and cell response in vitro has been reported, providing a novel
      mechanistic perspective on the biological activity of these phytochemicals. This
      article reviews recent cellular and molecular aspects of the biological activity
      of procyandins and discusses their disease preventative and therapeutic
      potentials.

PMID- 11201299
TI  - Promotion of health by soy isoflavones: efficacy, benefit and safety concerns.
AB  - Cardiovascular diseases, osteoporosis-related hip fractures, and various cancers
      of the colon, prostate, uterus, and breast are remarkably less prevalent in Asia
      than in other industrialized countries. It is believed that the large consumption
      of soy products in Asian countries is contributory to the reduction of these
      chronic disorders. Genistein is a major isoflavone found in most soy products and
      plays an important role in the promotion of human health. Extensive
      epidemiological, in vitro, and animal studies have been performed, and most
      studies indicate that genistein has beneficial effects on a multitude of human
      disorders, including cancers, cardiovascular diseases, osteoporosis, and
      postmenopausal symptoms. To date, there is an abundance of promising studies
      supporting genistein's potential uses, but further research is still needed to
      validate its preventative and therapeutic efficacy. In addition, the adverse
      effects of genistein have drawn public attention. More studies are required to
      assess the potential detrimental effect of genistein, and a benefit-risk ratio
      should be considered before future clinical studies are performed.

PMID- 11201300
TI  - Bioavailability of flavonoids and potential bioactive forms in vivo.
AB  - Flavonoids are powerful antioxidants in vitro, but their overall functions in
      vivo have yet to be clarified, whether antioxidant, anti-inflammatory, enzyme
      inhibitor or inducer, or some other role. The reducing properties of flavonoids
      might also contribute to redox regulation in cells independently of their
      antioxidant properties. However, in order to understand their bioactivity in
      vivo, it is necessary to understand the factors influencing the absorption of
      flavonoids by the gastrointestinal tract, the nature of the conjugates and
      metabolites in the circulation and how this influences their antioxidant
      activities.

PMID- 11201301
TI  - Chemoprotection by organosulfur inducers of phase 2 enzymes: dithiolethiones and
      dithiins.
AB  - One of the major mechanisms of protection against carcinogenesis, mutagenesis,
      and other forms of toxicity mediated by carcinogens is the induction of enzymes
      involved in their metabolism, particularly phase 2 enzymes such as glutathione S
      transferases, UDP-glucuronosyl transferases, and quinone reductases. Animal
      studies indicate that induction of phase 2 enzymes is a sufficient condition for
      obtaining chemoprevention and can be achieved by administering any of a diverse
      array of naturally-occurring and synthetic chemopreventive agents. Alliaceous and
      cruciferous plants are rich in organosulfur compounds with inducer activity.
      Indeed, monitoring of enzyme induction has led to the recognition or isolation of
      novel, potent chemopreventive agents such as 1,2-dithiole-3-thiones, dithiins and
      the isothiocyanate sulforaphane. For example, oltipraz, a substituted 1,2
      dithiole-3-thione originally developed as an antischistosomal agent, possesses
      chemopreventive activity against different classes of carcinogens targeting
      multiple organs. Mechanistic studies in rodent models for chemoprevention of
      aflatoxin B1 (AFB1)-induced hepatocarcinogenesis by oltipraz indicates that
      increased expression of phase 2 genes is of central importance, although
      inhibition of phase 1 activation of aflatoxin B1 can also contribute to
      protection. Exposure of rodents to 1,2-dithiole-3-thiones triggers nuclear
      accumulation of the transcription factor Nrf2 and its enhanced binding to the
      Antioxidant Response Element, leading to transcriptional activation of a score of
      genes involved in carcinogen detoxification and attenuation of oxidative stress.
      Nrf2-deficient mice fail to induce many of these genes in response to oltipraz
      and the impact of this genotype on the chemopreventive efficacy of
      dithiolethiones is currently under investigation. To test the hypothesis that
      enzyme induction is a useful strategy for chemoprevention in humans, three key
      elements are necessary: a candidate agent, an at-risk population and modulatable
      intermediate endpoints. Towards this end, a placebo-controlled, double blind
      clinical trial of oltipraz was conducted in residents of Qidong, P.R. China who
      are exposed to dietary aflatoxins and who are at high risk for the development of
      liver cancer. Oltipraz significantly enhanced excretion of a phase 2 product,
      aflatoxin-mercapturic acid, a derivative of the aflatoxin-glutathione conjugate,
      in the urine of study participants administered 125 mg oltipraz by mouth daily.
      Administration of 500 mg oltipraz once a week led to a significant reduction in
      the excretion of the primary oxidative metabolite of AFB1, aflatoxin M1, when
      measured shortly after drug administration. While this study highlighted the
      general feasibility of inducing phase 2 enzymes in humans, a longer term
      intervention is addressing whether protective alterations in aflatoxin metabolism
      can be sustained for extended periods of time in this high-risk population. Food
      based approaches to chemoprotection, targeted both to the general population and
      high-risk individuals, offer many practical advantages compared to the use of
      pharmaceutical agents. Thus, identification and utilization of naturally
      occurring organosulfur chemoprotectors including dithiins should be a high
      priority.

PMID- 11201302
TI  - Cancer chemoprevention and apoptosis mechanisms induced by dietary polyphenolics.
AB  - This review summarises current knowledge on the various molecular chemopreventive
      or therapeutic mechanisms that may be involved when the administration of
      flavonoids or polyphenols prevented chemical carcinogenesis in animal models.
      These mechanisms can be subdivided into the following: 1) the molecular
      mechanisms involved in preventing carcinogen metabolic activation, 2) the
      molecular mechanisms for preventing tumour cell proliferation by inactivation or
      downregulation of prooxidant enzymes or signal transduction enzymes, 3) the
      molecular cell death mechanisms for the induction of tumour cell death
      (apoptosis) and the molecular mechanisms for the inhibition of isolated
      mitochondria functions. Many of the flavonoids and polyphenols found in diets,
      supplements or herbal medicine were also ranked using "accelerated cytotoxic
      mechanism screening" by a combinatorial approach utilising isolated rat
      hepatocytes. A strong correlation of an early collapse of the mitochondrial
      membrane potential and cell death was found for most of the cytotoxic polyphenols
      but did not occur with non-toxic polyphenols. This screening could prove useful
      for eliminating polyphenols that have the potential for adverse health effects
      and for selecting safe and effective polyphenolic candidates for further
      development as supplements for preventing cancer or cardiovascular disease.
      Safety concerns of flavonoid/polyphenol supplements are also reviewed.

PMID- 11201303
TI  - Effect of the grapefruit flavonoid naringin on pharmacokinetics of quinine in
      rats.
AB  - The effect of the grapefruit flavonoid naringin, an inhibitor of CYP3A4, on the
      pharmacokinetics of quinine in rats after oral or intravenous (i.v.) dosing of
      quinine was investigated. Female Wistar rats (wt 190-220 g) were used in two
      separate studies, i.e. oral and i.v. administration of quinine. The animals were
      divided into two groups, one served as control and the other group was pretreated
      with 25 mg/kg naringin once a day for 7 consecutive days before the
      pharmacokinetic study. On the study day, quinine (25 mg/kg) was administered to
      the rats by either the oral or i.v. route. Blood samples were collected at
      different times, up to 6 h after quinine administration. Plasma quinine
      concentration was assayed by HPLC. Pretreatment with naringin did not cause any
      significant change in the pharmacokinetics of quinine after the i.v. dose.
      However pretreatment with naringin led to a 208% increase in peak plasma
      concentration (Cmax), a 93% increase in time to reach Cmax (tmax), and a 152%
      increase in the area under the plasma concentration-time curve (AUC) of quinine
      after oral administration. Consequently, the oral bioavailability of quinine was
      significantly increased (p < 0.05) from 17% (control) to 42% after pretreatment
      with naringin. There was no significant difference in the elimination half-life
      (t(1/2)beta) of quinine between the two groups. These results suggest that
      pretreatment with the grapefruit flavonoid naringin is associated with increased
      oral bioavailability of quinine in rats.

PMID- 11201304
TI  - Organosulfur compounds from Allium and the chemoprevention of cancer.
AB  - Allium vegetables and their associated organosulfur constituents are extensively
      studied for their chemopreventive potential against cancer. This article
      overviews their anticarcinogenic and antigenotoxic properties. Epidemiological
      studies (mostly case-control studies) provide strong evidence that Allium
      vegetable consumption reduces the incidence of gastric and colon cancer while the
      association between Allium vegetable consumption and other cancers is less
      convincing. Furthermore, many experimental studies have demonstrated that
      organosulfur compounds and Allium extracts have inhibitory effects on
      carcinogenesis in animals. These inhibitory effects are supported by many diverse
      mechanisms, including inhibition of carcinogen formation, modulation of
      carcinogen metabolism, inhibition of mutagenesis and genotoxicity, inhibition of
      cell proliferation and increase of apoptosis, inhibition of angiogenesis, and
      immune system enhancement. Before such constituents or extracts can be used in
      chemopreventive trials, it is important to verify their lack of toxicity and to
      investigate further their precise mechanisms of action throughout the whole
      process of carcinogenesis.

PMID- 11201305
TI  - Allyl sulfides modify cell growth.
AB  - Extensive evidence points to the ability of allyl sulfides from garlic to
      suppress tumor proliferation both in vitro and in vivo. This antineoplastic
      effect is generally greater for lipid-soluble than water-soluble allyl sulfides.
      Both concentration and duration of exposure can increase the antiproliferative
      effects of lipid- and water-soluble allyl sulfides. Part of their
      antiproliferative effects may relate to an increase in membrane fluidity and a
      suppression of integrin glycoprotein IIb-IIIa mediated adhesion. Alterations in
      cholesterol, arachidonic acid, phospholipids and/or thiols may account for these
      changes in membrane function. Allyl sulfides are also recognized for their
      ability to suppress cellular proliferation by blocking cells in the G2/M phase
      and by the induction of apoptosis. This increase in the G2/M and apoptotic cell
      populations correlates with depressed p34cdc2 kinase activity, increased histone
      acetylation, increased intracellular calcium and elevated cellular peroxide
      production. While impressive pre-clinical data exist about the antineoplastic
      effects of allyl sulfur compounds, considerably more attention needs to be given
      to their effects in humans. The composition of the entire diet and a host of
      genetic/epigenetic factors will likely determine the true benefits that might
      arise from allyl sulfur compounds from garlic and other Allium foods.

PMID- 11201306
TI  - Amifostine: mechanisms of action underlying cytoprotection and chemoprevention.
AB  - Amifostine is an important drug in the new field of cytoprotection. It was
      developed by the Antiradiation Drug Development Program of the US Army Medical
      Research and Development Command as a radioprotective compound and was the first
      drug from that Program to be approved for clinical use in the protection of dose
      limiting normal tissues in patients against the damaging effects of radiation and
      chemotherapy. Its unique polyamine-like structure and attached sulfhydryl group
      give it the potential to participate in a range of cellular processes that make
      it an exciting candidate for use in both cytoprotection and chemoprevention.
      Amifostine protects against the DNA damaging effects of ionizing radiation and
      chemotherapy drug associated reactive species. It possesses anti-mutagenic and
      anti-carcinogenic properties. At the molecular level, it has been demonstrated to
      affect redox sensitive transcription factors, gene expression, chromatin
      stability, and enzymatic activity. At the cellular level it has important effects
      on growth and cell cycle progression. This review focuses on relating its unique
      chemical design to mechanisms of action that underlie its broad usefulness as
      both a cytoprotective and chemopreventive agent for use in cancer therapy.

PMID- 11201307
TI  - Determination of nicotine N-1-glucuronide, a quaternary N-glucuronide conjugate,
      in human biological samples.
AB  - [Methyl-d3]-N-1-beta-D-glucopyranosyl-(+/-)-nicotinium inner salt ((+/-)-[methyl
      d3]nicotine N-1-glucuronide) was synthesized from (+/-)-[methyl-d3]nicotine via
      reaction with methyl-2,3,4-tri-O-acetyl-1-bromodeoxy-alpha-D-glucopyranouronate,
      followed by deprotection with 1 M aqueous NaOH and purification by preparative
      TLC. Nicotine N-glucuronide was identified and determined directly in smokers'
      urine. A solid phase extraction method was used to partially isolate the material
      from urine. Subsequent determination was by thermospray-LC/MS using the synthetic
      d3-labeled nicotine N-glucuronide as internal standard. The identified urinary
      component had the same retention time as a synthetic standard and gave the same
      mass spectrum. The thermospray mass spectrum was characterized from the
      protonated molecular ion (m/z 339) and the protonated aglycone ion (m/z 163).
      Quantitative results from this direct method were compared with those from an
      indirect method, which calculated the nicotine glucuronide in the biological
      sample from the amount of nicotine released following treatment of the sample
      with the deconjugating enzyme, beta-glucuronidase. On average, the concentration
      of nicotine N-glucuronide determined by the direct method was 34% greater than
      that determined by the indirect method. Concentrations of nicotine N-glucuronide
      in urine ranged from 2.2 to 7.6 nmol/ml with a limit of detection of 1.3 nmol/ml.

PMID- 11201308
TI  - Effect of black tea on lipid peroxide and glutathione levels in female rats.
AB  - The effects of black tea (Camellia sinensis L.) on lipid peroxidation and
      glutathione (GSH) levels in carbon tetrachloride (CCl4)-treated female Wistar
      rats were examined. Two control groups and one treatment group were tested. The
      control groups were fed with a standard diet, while the black tea group was fed
      the standard diet plus 6% by weight dried black tea leaves. At the end of 2
      months, a single dose of CCl4 (1 ml/kg, i.p.) in olive oil was administered to
      rats in one of the control groups and the black tea group. They were sacrificed
      after 2 hours. Rats in the other control group were administered olive oil in a
      similar fashion. Measurements were made of lipid peroxide levels in liver and
      plasma, glutathione levels in liver, and alanine transaminase (ALT) and aspartate
      transaminase (AST) activities in plasma. Liver lipid peroxide levels, plasma ALT
      and AST activities were significantly decreased in the black tea group compared
      with the CCl4-treated control group, while plasma lipid peroxide levels were not.
      These results are parallel to those previously found with Wistar male rats.
      Glutathione levels, however, were not significantly affected, in contrast to the
      data relating to male rats, either after CCl4 or black tea treatments. The
      results of our study add to the findings that black tea attenuates CCl4-induced
      hepatic injury but also indicates the susceptibility of glutathione levels to
      endocrinological effects.

PMID- 11201309
TI  - Modelling human cytochromes P450 for evaluating drug metabolism: an update.
AB  - Cytochrome P450 (CYP) enzymes represent the major catalysts for the Phase 1
      metabolism of drugs and other xenobiotics in Mammalia, including Homo sapiens.
      There is considerable current interest in evaluating and, consequently,
      predicting the metabolic fate of new chemical entities (NCEs) via modelling
      molecular interactions with P450 constructs, such that sites of metabolism,
      particular CYP involvement and binding affinities, can be estimated. This paper
      focuses on the principles for homology modelling of typical enzyme-substrate
      interactions within the putative active sites of major P450s associated with drug
      metabolism in man. It also represents an update on previously published work in
      this journal /1/.

PMID- 11201310
TI  - Course of neuropsychological recovery from moderate-to-severe head injury: a 2
      year follow-up.
AB  - Neuropsychological outcome and recovery of a group of 91 patients with moderate
      to-severe head injuries were prospectively investigated over a 2 year period,
      with evaluations at acute hospital discharge at 6 months and 2 years post-injury.
      A group of 39 trauma patients with injuries to parts of the body other than the
      head were used as controls. The head injured group performed significantly worse
      than the control group at baseline, 6 months and 2 years post-injury. Significant
      improvement was found during the first 6 months, but also between 6 months and 2
      years post-injury. Trauma controls also performed significantly better at 6
      months post-injury compared to baseline. Differential practice effects between
      groups cause difficulties in determining recovery. Within the head injured group,
      three distinct recovery groups were identified varying as a function of coma
      length and coma-duration. The first group is comparable with the trauma controls.
      The other two groups demonstrate significant neuropsychological impairments at
      baseline, with one group showing a marked improvement over the 2 year period, and
      the other group showing only small improvement over this time period.

PMID- 11201311
TI  - Stability of employment after brain injury: a 7-year follow-up study.
AB  - Forty-three patients with severe traumatic brain injury (n = 24), cerebrovascular
      diseases (n = 15), or other acquired brain damage (n = 4) were followed-up 7-8
      years after neuropsychological rehabilitation including a vocational re-entry
      programme. Current vocational status and work history since rehabilitation were
      investigated by means of a structured interview. Before interview, the patients
      were classified on the basis of medical records into four groups: (A) patients
      with minor residual neuropsychological impairments, (B) patients with minor
      impairments but psychopathological symptoms, (C) patients with persistent
      neuropsychological impairments showing no psychopathological symptoms, and (D)
      patients with persistent impairments and psychopathological symptoms. For
      patients in group A, a good, and for those in group D, a poor long-term
      employment outcome was predicted, while no predictions were made for the
      intermediate groups. Of the 43 interviewed subjects, 16 (37%) reported a stable
      return to work at pre-morbid level and seven (16%) at a lower level. In eight
      patients (19%), persisting difficulties in maintaining work were documented.
      Twelve subjects (28%) had retired within a period of 2 years after work trial.
      The relationship between patient classification and long-term employment outcome
      was only weak. Four out of 11 patients with a good prognosis (group A)
      experienced vocational adjustment problems or had retired. Three out of 10
      patients with a poor prognosis (group D) were able to continue successfully with
      their previous jobs. These cases are described in detail. The employment outcome
      of the intermediate groups was very heterogeneous. The results suggest that
      particular attention should be paid to the long-term consequences of a reduced
      capacity for work, even if minor in degree. The success of patients despite a
      poor prognosis illustrate unsolved problems in relation to the ecological
      validity of neuropsychological measures of executive dysfunctions.

PMID- 11201312
TI  - Neuropsychological rehabilitation for traumatic brain injury: do carers benefit?
AB  - This study evaluated the effectiveness of a new rehabilitation service, compared
      with existing services, for carers of people with traumatic brain injury (TBI).
      Subjects were 96 adult carers of people consecutively admitted to two local
      hospitals. They were assigned to one of three groups: Early new service (pre
      discharge); Late new service (post-discharge); or a Control condition (existing
      services only). Individual randomization was not possible and randomization by
      hospital site was rejected because of demographic and clinical differences
      between sites. Group assignment was determined by a pre-specified timetable which
      alternated between hospitals. Two outcomes were compared at 6 months post-injury:
      carers' emotional distress and how well-informed they felt about TBI and
      available resources. Analyses adjusting for potential confounding factors
      confirmed a clinically plausible superior outcome for both intervention groups
      compared to the control group. However, these differences did not obtain
      statistical significance (p > or = 0.01). Several reasons for these findings are
      discussed, including the novelty of the new service and methodological issues
      such as statistical power. Longer term follow-up studies are required as
      psychological sequelae and, therefore, the need for intervention is known to
      increase with time and may not be most apparent during the first 6 months.

PMID- 11201313
TI  - Errors in diagnosing post-traumatic stress disorder after traumatic brain injury.
AB  - Evidence to support the view that post-traumatic stress disorder (PTSD) can occur
      after traumatic brain injury (TBI) continues to grow. However, the reported
      incidence of cases with both diagnoses ranges widely, from less than 1% to more
      than 50%. Given that the incidence of TBI is high, a more precise incidence has
      to be established if screening and treatment resources are to be considered. Are
      cases being missed or are they over-diagnosed? The single case report presented
      here does not definitively answer this question, but illustrates the potential
      shortcomings of diagnosing PTSD using questionnaire measures alone (Impact of
      Events Scale, Post-traumatic Stress Diagnostic Scale and General Health
      Questionnaire) and indicates a need for a conjoint interview which takes into
      account the common effects of TBI and the symptom overlap between PTSD and TBI.

PMID- 11201314
TI  - Location of the chronic subdural haematoma: role of the gravity and cranial
      morphology.
AB  - Chronic subdural haematoma (SDH) frequently originates from subdural hygroma
      (SDG). The cranial morphology can determine the location of SDG. Since SDG is the
      precursor of chronic SDH, the shapes of the cranium wall act an important role in
      location of chronic SDH. The authors tried to test this hypothesis. The computed
      tomographic scans or magnetic resonance images of 118 consecutive patients with
      chronic SDH were re-evaluated, and the symmetry of the cranium and location of
      the lesion were checked. The cranium was symmetrical in 55 patients (47%) and
      asymmetrical in 63 patients (53%). Chronic SDH was bilateral in 25 patients (21%)
      and unilateral in 93 patients (79%). It was more commonly bilateral in
      symmetrical craniums than in asymmetrical craniums (29.1% vs. 14.3%) (p =
      0.0496). In 63 patients with asymmetric cranium, the chronic SDH was bilateral in
      nine patients, located on the opposite side of the flat side in 38 patients, and
      located on the same side of the flat side in 17 patients. This unequal
      distribution was statistically significant (p = 0.03). In four patients, the
      haematoma originated from the acute SDH located on the same side of the flat
      side. No reason could be found in the remaining 13 patients. Chronic SDH
      originating from SDG usually locates on the opposite to the flat side of the
      skull. The shape and posture of the cranium can predict the location of chronic
      SDH, as in the SDG.

PMID- 11201315
TI  - Pre-injury crime, substance abuse, and neurobehavioural functioning after
      traumatic brain injury.
AB  - There is limited information regarding the effects of pre-injury history of
      arrest or history of substance use on neurobehavioural functioning after brain
      injury. The current study included 211 patients with traumatic brain injury, who
      were seen for a follow-up neuropsychological evaluation in an outpatient setting.
      An effort was made to distinguish between (1) patients with a history of pre
      injury arrests and patients without a history of pre-injury arrests, (2) patients
      classified as substance abusers and non-abusers, and (3) patients with and
      without a history of pre-injury illicit drug use on the basis of demographic
      characteristics, injury characteristics, and neurobehavioural functioning.
      Results indicate significant differences between patients with a history of pre
      injury arrests and patients without a history of pre-injury arrests in terms of
      demographic and injury characteristics. Differences were also noted between
      persons classified as substance abusers and non-abusers in terms of demographic
      and injury characteristics, and neurobehavioural functioning. Clinical
      implications and future research are discussed.

PMID- 11201316
TI  - Are neuropsychiatric symptoms associated with evidence of right brain injury in
      referrals to a neuropsychiatric brain injury unit?
AB  - Studies suggest that neuropsychiatric symptoms are more common in patients with
      injury to the right side of the brain. However, most studies have examined
      patients with penetrating injuries because these allow more accurate localization
      of brain damage. This study investigates whether a similar association would be
      found in patients with non-penetrating brain injuries presenting to a
      neuropsychiatric unit. Over a 2 year period, 98 referrals were examined. Damage
      was localized using routine operation notes, EEG and neuroimaging. In total, 34
      patients (35%) had a predominately right-sided injury, 33 (34%) had a left-sided
      injury and 31 (32%) had a diffuse or bilateral injury. Right-sided injuries were
      associated with hallucinations (p = 0.05), and left-sided injuries were
      associated with confabulation (p = 0.05) and lack of insight (p = 0.07). These
      results are consistent with findings from patients with penetrating head
      injuries. They suggest that evidence of the laterality of injury may be useful
      for planning the rehabilitation of patients seen in neuropsychiatric brain injury
      units.

PMID- 11201317
TI  - Attentional deficits in patients with post-concussion symptoms: a componential
      perspective.
AB  - Attentional deficits are frequently reported by patients suffering from closed
      head injuries. The majority will develop a group of clinical symptoms known as
      post-concussion symptoms or syndromes (PCS), which are characterized by a range
      of subjectively experienced symptoms including headaches, dizziness, fatigue,
      irritability, slowed thinking, and memory dysfunction. It is posited that
      attentional deficit is the crucial factor for the apparent failures of memory and
      higher cognitive functioning, and may contribute largely to difficulty in re
      integrating back into the community and resuming independent daily living. It
      also appears that there are large variations within these patients, in terms of
      both presented symptoms and neuropsychological performances. However, these
      variations in terms of attentional deficits have not been systematically
      differentiated and examined. This article aims to build up a theoretical
      framework to guide the investigation of the varieties of attentional deficits in
      patients with PCS. Current theories on attention from cognitive psychology,
      neuropsychology, cognitive neuroscience and clinical rehabilitation will be
      reviewed and integrated. It is hoped that a better understanding of the
      underlying mechanism of such defects will foster and guide the development of
      intervention.

PMID- 11201318
TI  - Universal neonatal hearing screening--parental attitudes and concern.
AB  - This study addresses parental attitudes and concern in relation to universal
      neonatal hearing screening by otoacoustic emissions (OAE) testing. The parents of
      87 children who had participated during the first year of the universal neonatal
      hearing screening programme at University Hospital, Linkoping, Sweden were
      included in the study. These children were all tested during this period and
      later cared for at three well-baby clinics (part of their primary healthcare). A
      questionnaire was given to the parents during routine medical check-ups at the
      well-baby clinics when the infants were 5-6 months of age. Ninety-five per cent
      of parents stated that they had a positive attitude towards neonatal hearing
      screening, 1% were ambivalent and 4% were negative about it. The parents wanted
      early detection of hearing loss and the possibility of early intervention. It was
      also found that screening did not disturb the children. A few parents were
      anxious due to repeated testing of their children. The information provided in
      connection with the test was found to be sufficient by 77% of parents, whereas
      11% of parents had negative comments about it (e.g. they wanted more information
      about the otoacoustic emissions technique). The general attitude among parents
      towards universal neonatal hearing screening was very positive in that they felt
      reassured by it. The risk of disturbing the parent-child relationship by early
      screening seems to be small, and could be further minimized by improved
      information and rapid and effective follow-up.

PMID- 11201319
TI  - Evidence on the efficacy of insert earphone and sound field VRA with young
      infants.
AB  - Visual reinforcement audiometry (VRA) with insert-earphone stimulus delivery
      provides a means of obtaining early ear-specific information on the auditory
      status of infants. The aim of this study was to investigate the efficacy of VRA
      in young infants, and to compare the use of sound field and insert-earphone
      stimulus presentation. VRA was performed on 41 normally developing infants aged
      between 20 and 42 weeks. Infants were tested in the sound field (n=22) and with
      insert earphones (n=19). Results showed significantly more minimum response
      levels (MRLs) obtained with sound field testing, and with older children.
      Nevertheless, in the insert-earphone group, 36% of those aged 32 weeks or more
      gave two or more MRLs, and 25% of the infants aged 25 weeks or less gave one or
      more MRLs. This study provides data from developmentally normal infants which
      confirms the efficacy of insert-earphones as well as sound field VRA with 32-42
      week-olds, with reasonable expectation of success. The data in this study also
      suggest that VRA could be usefully employed for younger infants aged
      approximately 20-26 weeks where information, although less easily obtained, may
      be of particular value to early diagnosis and habilitation.

PMID- 11201320
TI  - Children's experience of tinnitus: a preliminary survey of children presenting to
      a psychology department.
AB  - Tinnitus has been much researched within adult populations with consideration of
      prevalence as well as the impact of tinnitus on individual's lives. Although the
      literature highlights the prevalence of tinnitus in children, there is little
      information on its effects from a psychological perspective. This small-scale
      preliminary study looked at 24 children (50% with normal hearing and 50% with a
      hearing loss) who presented to the Psychology Department with troublesome
      tinnitus. In line with adult studies, preliminary results suggested that tinnitus
      can have as marked an effect on children's lives as it is reported to have on
      adults. Insomnia, emotional distress, listening and attention difficulties are
      the main psychological factors associated with tinnitus in children. These, in
      turn, may have an effect upon their school performance. Differences were found
      between children with normal hearing and those with some degree of hearing loss.
      Overall, children with normal hearing found tinnitus more troublesome and
      presented with higher levels of anxiety than those with some level of hearing
      impairment. The present study suggests that children who complain of tinnitus
      should be taken seriously. In terms of management, individual intervention
      packages were found to be useful in alleviating anxiety and other associated
      factors. Recommendations are made on areas for future research.

PMID- 11201321
TI  - Measurement of the temporal-modulation transfer function for a single listener
      with cochlear hearing loss and left-hemisphere damage.
AB  - The modulation depth required for the detection of sinusoidal amplitude
      modulation applied to a white noise carrier was measured as a function of
      modulation frequency, giving temporal modulation transfer functions (TMTFs). Five
      adult listeners with normal hearing (mean age 52 years), five elderly listeners
      with moderate cochlear hearing loss (mean age 66 years) and a single elderly
      listener (aged 73 years) with moderate cochlear hearing loss and left-hemisphere
      damage were tested in the right ear at 50 dB SL. The five elderly listeners were
      matched in audiogram with the brain-damaged listener. Modulation detection was
      systematically poorer than normal in the five elderly listeners with cochlear
      hearing loss. However, their TMTFs were lowpass in shape, as for the five normal
      hearing adult listeners. Modulation detection was much poorer in the elderly
      listener with cochlear hearing loss and left-hemisphere damage compared to the
      five normal-hearing adults and the five elderly listeners with cochlear hearing
      loss. Moreover, modulation detection was poorer at 4, 64 and 128 Hz than at 8, 16
      and 32 Hz in the brain-damaged listener, giving his TMTF a bandpass appearance.
      These results are in agreement with the hypothesis that the main factors limiting
      the ability to detect changes in the temporal-envelope of sounds are located at a
      central (retro-cochlear) level of the auditory system rather than at a peripheral
      (cochlear) level. They also suggest that the TMTF approach may prove useful in
      distinguishing peripheral and central hearing losses.

PMID- 11201322
TI  - Speech perception with steeply sloping hearing loss: effects of frequency
      transposition.
AB  - Six adults with a very steeply sloping high-frequency hearing loss listened to
      monosyllabic words in several conditions. In the first condition, their ability
      to identify phonemes with a signal-to-noise ratio of 6 dB was measured. Results
      were similar to those of normally hearing subjects listening to the same material
      through low-pass filters having comparable cut-off frequencies. In the remaining
      two conditions, four of the hearing-impaired subjects, and a control group of
      five normally hearing subjects, listened to speech in quiet with and without
      frequency transposition. The transposition lowered all speech frequencies by a
      factor of 0.6. Specific auditory training with transposed speech materials
      different from the materials used in the tests of speech perception was provided
      in 10 sessions, each of one hour's duration, which were scheduled at weekly
      intervals. Despite this training, no significant differences were found between
      the two conditions in these subjects' recognition of words. It is concluded that
      such a frequency-transposition scheme, if implemented in a wearable hearing aid,
      would be unlikely to benefit people with a sloping hearing impairment of this
      type.

PMID- 11201323
TI  - Age-related changes in the visual perception of phonologically significant
      contrasts.
AB  - The purpose of the present study was to determine whether the ability to
      speechread phonological contrasts is influenced by age. Forty-eight subjects were
      equally represented in three age groups: 8-9 years, 11-12 years and adults (20-29
      years). The Hebrew version of the Speech Pattern Contrast (HeSPAC) test was
      administered by speechreading alone. Results showed that: age influenced
      performance; performance was contrast-dependent (place contrasts highly visible,
      manner and vowel height partially visible and voicing contrast invisible);
      hierarchy of contrast performance was similar for all age groups; Hebrew and
      English differ in the visual accessibility to speech contrasts in final voicing
      only; and females were found to be poorer speechreaders than males for the
      partially visible contrasts. The results suggest that speechreading at the
      phonological level follows a developmental course. The implications of these
      findings extend to recommendations provided to children in noisy listening
      conditions, speechreading training in hearing-impaired children and those with
      central auditory processing disorders (CAPD), and to the design of sensory aids.

PMID- 11201324
TI  - Insertion gain measurements using two low-powered analogue hearing aids.
AB  - Differences between insertion gain measurements and coupler measurements were
      investigated using two different hearing aids, to assess the accuracy of hearing
      aid fitting methods which involve the use of real-ear-to-coupler differences
      (RECDs). The hearing aids used were the NHS BE19 and the Lavis X11. They were
      allocated alternately to 80 new adult hearing aid users, and insertion gain
      measurement was carried out with the allocated aid on all subjects, and with both
      hearing aids on 36 subjects. Coupler measurements were also carried out with both
      hearing aids, at two different gain settings. Comparison of the coupler
      measurements and the insertion gain measurements suggests that the differences in
      insertion gain produced by different hearing aids cannot be predicted accurately
      from the differences in coupler gain measurements produced by the same aids.
      Although the use of RECDs measured using insert earphones may accurately predict
      the real-ear performance of some models of hearing aid, this method may not
      produce equally satisfactory results with other models.

PMID- 11201325
TI  - Acoustic characteristics of reconstructed ear canal after atresia surgery.
AB  - The acoustic properties of the reconstructed ear canals of 13 patients after
      atresia surgery were investigated by comparing them with those of contralateral
      healthy ear canals. In the third post-operative month, resonant frequency,
      amplitude and bandwith of the ear canals with Q-factor were measured. Probe
      microphone measurements showed a significant shift in resonant frequency in the
      direction of the higher frequencies, and a non-significant change in bandwith in
      the atresia surgery group. The suggested reason may be a change in ear canal
      curvature, altered vibration pattern and sound-absorption characteristics of the
      skin graft lining the reconstructed ear canal.

PMID- 11201326
TI  - Population genetics of Lithuanians.
AB  - The primary objective of this article was to overview the present-day knowledge
      on genetic features of the Lithuanian population. Genetic differentiation within
      the Lithuanian population and the relationship between Lithuanians and other
      European populations was analysed by means of blood groups, serum protein
      polymorphisms and DNA markers including mtDNA. The results of the research have
      shown small differences between present-day Lithuanian ethnolinguistic groups,
      which probably go back to the prehistoric Baltic tribal structure. The Baltic
      peoples show a mixture of eastern and western genetic traits, e.g. a high
      frequency of the blood group B combined with a very high frequency of the Rh
      negative blood group. Studies of the Baltic 'tribal gene' LWb indicate the
      presence of a considerable Baltic admixture in the neighbouring Finno-Ugric and
      Slavic populations.

PMID- 11201327
TI  - Month of birth and height of Spanish middle-aged men.
AB  - We examined whether body height differs in Spain, a country having a high number
      of hours of sunlight, between middle-aged males and females born during the
      months with the longest and those born in the months with the shortest periods of
      daylight hours. We used data from a cross-sectional survey that documented
      standardized measurements of height and other variables for a 2021-person random
      multi-stage sample representative of the Spanish population aged 35-64 years. The
      relationship between height and month of birth was analysed by multiple linear
      regression, adjusting for age, occupation and type of residence. Male adults born
      in summer proved to be 1.7 cm taller than their counterparts born in winter (95%
      confidence interval 0.2-3.3 cm, p = 0.03). This relationship was most marked for
      those whose occupation was non-manual (2.1 cm, p = 0.04 vs 1.4cm, p = 0.2 in
      manual occupations). No significant (p = 0.8) or relevant (0.16 cm) summer- and
      winter-related differences in height were found in women. These results are
      compatible with the hypothesis that adult male height could be partially
      influenced by physical environmental factors such as the action of sunlight
      during the early stages of life.

PMID- 11201328
TI  - Age at natural menopause in Beirut, Lebanon: the role of reproductive and
      lifestyle factors.
AB  - PRIMARY OBJECTIVE: To determine the median age of natural menopause and factors
      associated with the timing of menopause in Beirut, Lebanon. RESEARCH DESGIN: A
      population-based sample of 298 women were interviewed using a semi-structured
      questionnaire. METHODS AND PROCEDURES: Logit analysis and logistic regression
      were used to estimate the median age and identify correlates of menopausal
      status. MAIN OUTCOMES AND RESULTS: The median age of natural menopause in Beirut,
      Lebanon is estimated to be 49.3 years. Not being currently married (odds ratio
      (OR)=4.19, 95% CI: 1.53, 11.51) and smoking (OR = 1.02 for each year of smoking,
      95% CI: 1.00, 1.05) are significantly associated with an earlier age at
      menopause. Women with menstrual bleeding longer than 5 days have later ages at
      menopause (OR = 0.50, 95% CI: 0.26, 0.97). Age at menarche, parity, education and
      socio-economic status are not statistically associated with the age at menopause.
      CONCLUSIONS: The age at natural menopause in Lebanon is comparable to median ages
      reported for women in industrialized countries (49.3-51.4). Our results emphasize
      the role of smoking in determining an earlier age at menopause and indicate that
      reproductive characteristics affect the timing of menopause.

PMID- 11201329
TI  - An assessment of biological age of males in Poland.
AB  - BACKGROUND: Studies carried out in Poland have shown that some important indices
      of growth and maturation in children, of the biological well-being during
      adulthood and the rates of premature mortality depend strongly upon the
      individual's position on the social scale. AIM: The study considers whether adult
      males of higher educational status differ from their chronological age-matches of
      lower educational status in biological age. SUBJECTS AND METHODS: The data of
      2800 occupationally active men, aged 25-65 from the 1994/1995 Polish Health
      Surveys were used. Twenty-two different measures were used. Biological age was
      assessed by the method of Borkan and Norris (Journal of Gerontology, 35, 177-184,
      1980). RESULTS: A comparison of biological age profiles of two groups of males
      based on their educational status showed that in 13 of the 22 characteristics.
      better-educated men were biologically younger than their poorer educated peers (p
      < 0.05). CONCLUSION: Better education is associated with the slowing down of the
      process of ageing, probably because it produces a healthier life-style.

PMID- 11201330
TI  - Daily rat tibial growth in vivo following hypothalamic sex reversal with neonatal
      and pubertal treatments with gonadal steroids.
AB  - A striking sex-related difference in postpubertal growth and growth hormone (GH)
      secretory pattern in the rat has been described. Although this sexual dimorphism
      seems to be determined by the neonatal effects of gonadal steroids on the
      hypothalamus, peripubertal exposure to steroids also plays an important role. In
      order to study the real influence of the hypothalamic sex and/or peripubertal
      gonadal steroids, the growth pattern of female and male rats in response to
      neonatal and peripubertal sexual steroid treatments was studied using
      microknemometry, a technique that allows non-invasive daily measurements of rat
      tibial growth rate. Neonatal steroid environment in males was modified by
      castration on day 1, whereas in females it was changed by a single neonatal
      testosterone administration on day 5 followed by castration at 13 days of age.
      From the onset of puberty to adulthood, both female and male animals received
      testosterone or estrogens, respectively. Neonatal treatment alone, i.e.
      androgenization of female and castration of male rats, were only able to induce a
      partial reversal of the original sex-dependent growth pattern. Additional
      peripubertal treatments achieved a complete change in the sex-linked growth
      pattern. Consistent with the effects observed on growth, the pituitary GH
      concentration was significantly increased in females, and diminished in males,
      when they were treated both at the neonatal and peripubertal stages. However,
      only this latter group, whose growth was more seriously compromised, showed
      decreased plasma insulin-like growth factor-I (IGF-I) levels. In conclusion, a
      complete feminization of male tibial growth pattern or masculinization of female
      pattern can only be achieved by maintaining the new steroid environment from
      puberty to adulthood.

PMID- 11201331
TI  - Longitudinal growth of Bangladeshi infants during the first year of life.
AB  - The growth in length and weight of 91 poor urban Bangladeshi infants was
      monitored at monthly intervals from birth to 1 year. At birth 18%, 22% and 8%
      were below -2.00 standard deviations of the National Center for Health Statistics
      (NCHS) height-for-age, weight-for-age and weight-for-height, respectively and at
      1 year the percentages were 40%, 40% and 7%. Infant weights over the first 6
      months associated positively with both mother's BMI and percentage body fat.
      Higher mean infant weights from 6 to 12 months were associated with both higher
      educational status of the mother and monthly family income and the latter two
      variables provided the best model for predicting weight velocity from birth to 12
      months. Internal Z-scores, corrected for day of measurement, provided clear
      evidence of catch-up/catch-down over the first 6 months with heavier and longer
      babies at birth showing catch-down while lighter and shorter babies demonstrated
      catch-up. Infants' weights were almost three times more variable than lengths.
      Monthly incremental variability of both infant weight and length increased
      sharply from 6 to 12 months with weight showing significantly more variability.
      The correlations of birth weight and length with subsequent distances and monthly
      increment revealed that the first 6 months were dominated by catch-up and catch
      down but during the latter half of the year the growth phenomena were influenced
      mainly by earlier intra-uterine or genetic effects.

PMID- 11201332
TI  - Age at menarche: secular trends and association with adult anthropometric
      measures.
AB  - BACKGROUND: Age at menarche has been used as a marker of environmental conditions
      during childhood. Previous work has shown trends of decreasing age at menarche
      throughout the 19th century, but reported trends in the 20th century have been
      less consistent. The nature of the relationship between age at menarche and adult
      life anthropometric measures may be important in understanding the importance of
      this measure on disease in later life. AIM: To establish whether mean age at
      menarche changed during the first half of the 20th century, and to determine the
      nature of associations between age at menarche and anthropometric measures in
      young adulthood. SUBJECTS AND METHODS: 3433 female students, who were born
      between 1919 and 1952 and who attended health checks at the student health
      service of the University of Glasgow between 1948 and 1968. RESULTS: Mean age at
      menarche decreased from 13.2 years in the earliest born to 12.5 years in the
      latest born students. These results were not explained by changes in socio
      demographic factors. Menarcheal age was positively associated with height and
      negatively associated with weight and BMI, results independent of socio
      demographic and behavioural factors. CONCLUSIONS: The falling age at menarche
      described here may be related to nutritional influences in the first half of the
      20th century. The influence of menarche on BMI in early adulthood may have
      important health consequences.

PMID- 11201333
TI  - Habitual physical activity of Senegalese adolescent girls under different working
      conditions, as assessed by a questionnaire and movement registration.
AB  - OBJECTIVE: The aim of this study was to measure habitual physical activity in a
      group of Sereer adolescent females from Senegal. The hypothesis tested was that
      physical activity levels of adolescent Senegalese girls differ according to
      location and living conditions and may have a negative impact on growth and
      nutritional status. DESIGN: Studies of physical activity within the framework of
      a longitudinal study of growth during puberty. METHODS: All the adolescents were
      born and had been raised in the same rural communities, but some worked as maids
      in the cities during the dry season (migrants) while the others remained in the
      villages all year round in order to help their families in daily domestic and
      agricultural tasks (non-migrants). The study was undertaken in both rural and
      urban settings on a subsample of 40 migrant and 40 non-migrant girls aged 13.4
      15.3, drawn from a cohort of 406 adolescents followed up since 1995. Nutritional
      status was estimated from anthropometric measurements; sexual maturation was
      based on stage of breast development and occurrence of menarche. Intensity and
      patterns of physical activity were derived from movement registration by
      accelerometry for a 3-day period. The nature and frequency of daily tasks were
      evaluated by questionnaires. RESULTS: As a whole, the adolescents studied here
      were smaller, thinner and less mature than girls of the same age from developed
      countries. Migrants weighed 3.5 kg more than nonmigrants and had more muscularity
      and a thicker fat subcutaneous layer. The day-to-day reliability of accelerometry
      counts was excellent (intraclass correlation coefficient: 0.90. 95% CI: 0.85
      0.93). Mean daily (24 h) physical activity counts were higher for migrants than
      for non-migrants. Migrants spent more time engaged in moderate to heavy activity
      than did non-migrants (9.3 h/24 h versus 6.1 h/24 h). Non-migrants slept or were
      inactive for a longer period than migrants (7.6h/24h versus 6.3 h/24h). They also
      rested for a longer period of the day (2.1 h/24 h versus 0.8 h/24 h). When
      examining the influence of maturational status on physical activity, there was a
      clear difference between the two groups: the less mature migrants were more
      active, whereas the reverse was true in villages, where girls at the end of
      puberty reached higher intensity indices. CONCLUSIONS AND IMPLICATIONS: In both
      situations, the activity level was high. The nutritional status of migrants was
      better despite a heavier work load. Differences could be explained by better
      living conditions and food intake in cities.

PMID- 11201334
TI  - Spray-dried microspheres containing ketoprofen formulated into capsules and
      tablets.
AB  - In this study, microspheres were prepared by a spray-drying technique using
      solutions of ketoprofen and two polymers, cellulose acetate butyrate (CAB) and
      hydroypropylmethylcellulose phthalate (HPMCP), in different weight ratios.
      Different total concentrations were used in the feed solutions: 3, 6 and 9% w/v.
      The spray-dried microparticles were characterized in terms of shape (SEM), size
      (light scattering method), production yield and encapsulation efficiency. They
      were formulated into capsules; tablets were prepared by direct compression of the
      microparticles mixed with maltose and, in some cases, hydroypropylmethylcellulose
      (HPMC). In vitro release studies were performed both at acidic and neutral pHs.
      The spray-drying process of solutions of ketoprofen with polymeric blends of
      cellulose derivatives leads to microparticles which, depending on their final
      formulation (capsules or tablets), can give a rapid or prolonged drug release.
      The formulations here described can be proposed for the oral administration of
      NSAIDs.

PMID- 11201335
TI  - Literature alerts.

PMID- 11201336
TI  - Preparation of microcapsules containing rare-earth metal elements.
AB  - Microcapsules for internal radiation therapies containing the rare-earth metal
      elements Dy, Ho and Cu with a diameter of 5-10 microm were successfully obtained
      by an interfacial polymerization method and a successive sedimentation technique
      was employed to fractionate the microcapsules. A triisocyanate monomer and
      tricresylphosphate were used for a wall forming material and a core solvent for
      the metals, respectively. The amount of the metal elements loaded was measured
      using a high frequency plasma photoemission apparatus. The beta-ray radioactivity
      of 1 mg of microcapsules irradiated with a common neutron source is estimated as
      370 microCi, which is satisfactorily strong for usual radiotherapy, when
      microcapsules containing Dy are used. Differential interference microscopy
      indicated narrow size distribution of the fractionated microcapulses.

PMID- 11201337
TI  - Improvement of encapsulation efficiency of water-in-oil-in-water emulsion with
      hypertonic inner aqueous phase.
AB  - Water-in-oil-in-water (w/o/w) emulsions encapsulating tryptophan or theophylline
      were prepared where these compounds are regarded as model drugs. The effects of
      sodium chloride on the drug entrapment into the w/o/w emulsions and on the
      separation of aqueous phases were studied. The degree of encapsulation of
      tryptophan in the w/o/w emulsion increased with the concentration of sodium
      chloride added in the inner aqueous phase, while it decreased with that in the
      outer aqueous phase. As for theophylline, although the degree increased with a
      concentration of sodium chloride in the inner phase, the effect was smaller than
      that on tryptophan. The difference in the effects between on tryptophan and on
      theophylline was attributed to their partition coefficients. Theophylline was
      easily leaked out from the inner phase to the outer aqueous phase after its
      dissolution and diffusion in the oil phase due to a higher partition coefficient.
      More than 55% of the aqueous phase was separated from the w/o/w emulsion within
      24 h, when sodium chloride was not added in the inner aqueous phase. However, the
      separation was not observed when more than 0.2M sodium chloride was added. To the
      contrary, sodium chloride added in the outer aqueous phase accelerated the
      separation. It was, therefore, concluded that sodium chloride in the inner
      aqueous phase plays an important role in suppression of the separation and in
      encapsulation of the drug which does not penetrate into the oil membrane.

PMID- 11201338
TI  - Photocatalytic activity of TiO2 particulate films prepared by depositing TiO2
      particles with various sizes.
AB  - TiO2 particles of various sizes were prepared by grinding in cyclohexanone, and
      TiO2 particulate films were obtained by depositing these TiO2 particles with
      various sizes onto a glass or quartz substrate. The effect of the particle size
      and thickness on the photocatalytic properties of the films was evaluated via
      oxidative degradation of gaseous 2-propanol. The initial rate of 2-propanol
      degradation under UV light irradiation for the films deposited with 30 nm TiO2
      particles increased with increasing film thickness up to 600 nm, and reached a
      saturated value above this film thickness. Photocatalytic activity for the films
      with thickness below 600nm was larger when smaller TiO2 particles were deposited
      onto the substrate, due to the increase in the surface area of the particulate
      films. Furthermore, saturated values of the photocatalytic activity for thick
      films were smaller for the films deposited with smaller particles, which is
      mainly attributed to the change in crystal form of the particles during the
      grinding treatment.

PMID- 11201339
TI  - Mucoadhesive chitosan-coated liposomes: characteristics and stability.
AB  - Lecithin liposomes, empty or containing FITC-dextran, were prepared by the
      ethanol injection method. Three different types of chitosans with different
      molecular weight and degrees of deacetylation were used (Seacure 113, 210 and
      311). Chitosan coating was carried out by mixing the liposomal suspension with
      the chitosan solution followed by incubation. The size of liposomes was measured
      before and after polymer coating by an image analysis technique. The mean
      diameter of liposomes containing FITC-dextran was in the size range 250-280 nm,
      whereas the size after coating was 300-330 nm, regardless of chitosan type. All
      chitosan-coated liposomes were of spherical shape and no morphological
      differences between uncoated and coated liposomes were observed. Liposomes with
      FITC-dextran, originally entrapping 50% of the marker substance taken in the
      preparation and coated in the presence of unentrapped marker substance, contained
      60-65% of the marker substance. The highest entrapment was found for liposomes
      coated with medium molecular weight chitosan. The stability of chitosan-coated
      liposomes in simulated gastric fluid was significantly higher as compared to
      uncoated liposomes. One can conclude that chitosan is stabilizing the original
      liposomal structure and protecting liposomally entrapped drug.

PMID- 11201340
TI  - Preparation of PEG-grafted immunomagnetoliposomes entrapping citrate stabilized
      magnetite particles and their application in CD34+ cell sorting.
AB  - Immunomagnetic systems have been used for positive selection of a cell fraction
      from a mixture using appropriate surface markers with satisfactory results, as
      haematopoietic CD34+ cells. This work reports on the development of poly(ethylene
      glycol)-grafted (PEG) immunoliposomes loaded with citrate-magnetite stabilized
      particles as the separation vehicles for immunomagnetic separations. The magnetic
      ferrofluid was encapsulated into PEG-liposomes by the DRV methodology. The
      magnetoliposomes had a liposomal size of approximately 450 nm and a Fe/lipid
      molar ratio of 1.52+/-0.26, and were retained in the magnetic field created by
      the MiniMACS system. Anti-CD34 immunomagnetoliposomes with 100 mAb/vesicle were
      prepared by coupling the My10 mAb and bound specifically for CD34+ KG-1a cells in
      culture and in mixtures with CD34-cells (CHO or Jurkat). The magnetic cell
      sorting was carried out in cell mixtures KG-1a/CHO or KG-1a/Jurkat with different
      initial% of CD34+ Kg-1a cells. For 10(6) positive cells and 100 microM of
      immunomagnetoliposomes, the capture efficiency was > 85% and independent of the
      starting percentage of CD34+ cells. The decrease of the final purity, when the
      starting percentage of CD34+ cells decreases and, dependent of the CD34- cell
      line used, point to the degree of non-specific cell binding of My10
      immunomagnetoliposomes as being crucial, among of the methodological aspects as
      the number of starting CD34+ cells. The CD34+ cells isolated retained the
      viability with an estimated recovery of 45-50%.

PMID- 11201341
TI  - Long-acting delivery microspheres of levo-norgestrol-poly(3-hydroxybutyrate):
      their preparation, characterization and contraceptive tests on mice.
AB  - The preparative technology for sustained release drug delivery microspheres of
      levo-norgestrol-poly(3-hydroxybutyrate) was optimized based on the in-liquid
      drying method. The formation of the drug microspheres was confirmed with
      differential thermal analysis. The appearance, particle size and distribution,
      residual CHCl3, drug content, drug release characteristics in vitro, stability
      and anticonceptive effect on mice of the microspheres were all examined. The
      average particle size was 64 microm with over 90% of the microspheres being in
      the range of 28.7-85.8 microm. The residual CHCl3 was lower than 0.001%. The drug
      release behaviour in vitro could be described by the Higuchi equation and the
      drug release t1/2 was prolonged by 1.8 times, compared with the original drug
      LNG. The microspheres were stable for 3 months and showed significant sustained
      release and anticonceptive effect in mice, and lower toxicity compared with the
      original drug.

PMID- 11201342
TI  - Effect of adding non-volatile oil as a core material for the floating
      microspheres prepared by emulsion solvent diffusion method.
AB  - Eudragit microspheres, to float in the gastrointestinal tract, were prepared to
      prolong a gastrointestinal transit time. To enhance their buoyancy, non-volatile
      oil was added to the dispersed phase. When an oil component was not miscible with
      water, over 90% was entrapped within the microspheres and prolonged the floating
      time of the microspheres. Depending on the solvent ratio, the morphologies of the
      microspheres were different and the best result was obtained when the ratio of
      dichloromethane:ethanol:isopropanol was 5:6:4. As the isopropanol portion
      increased, the time to form microspheres was delayed and the amount of fibre-like
      substance produced was decreased, due to the slow diffusion rate of the solvent.
      Compared with microspheres prepared without non-volatile oil, the release rate of
      the drug from microspheres was faster in all cases tested, except the
      microspheres containing mineral oil. The solubility of the drug in the non
      volatile oil affected the release profiles of the drugs. The non-volatile oil
      tends to decrease the glass transition temperature of prepared microspheres and
      change the release profile. The internal morphology of the microspheres was
      slightly different depending on the entrapped oil phase used. Tiny spherical
      objects were present at the inner surface of microspheres and the inside of the
      shell.

PMID- 11201343
TI  - Fatty acid substituted polyvinyl alcohol as a supporting material for microsphere
      preparation.
AB  - Polyvinyl alcohol, substituted with lauric, myristic, palmitic, and stearic acids
      at different substitution degrees was employed for the preparation of
      biodegradable microspheres containing progesterone or indomethacin. A solvent
      extraction/method was followed, starting from an oil-in-water dispersion
      containing the polymer and drug in the inner phase. Microspheres were obtained
      with high loading efficiency, whose release properties were dependent on the
      nature of the acyl substituent and the substitution degree. Kinetics approaching
      zero-order were obtained for the most hydrophile microspheres such as those based
      on the least substituted polymers and lowest molecular weight substituents. The
      hydrophilicity of these systems hindered protein absorption on their surface,
      suggesting their suitability for parenteral use.

PMID- 11201344
TI  - Controlled release of vancomycin from biodegradable microcapsules.
AB  - Poly D,L-lactic acid (PLA) and its copolymers with glycolide PLGA 90:10 and 70:30
      were polymerized under various conditions to yield polymers in the molecular
      weight range 12000-40000 daltons, as determined by gel permeation chromatography.
      Vancomycin hydrochloride was the hydrophilic drug of choice for the treatment of
      methicillin resistant Staphyloccoccal infections. It was microencapsulated in the
      synthesized polymers using water-oil-water (w/o/w) double emulsion and solvent
      evaporation. The influence of microcapsule preparation medium on product
      properties was investigated. An increase in polymer-to-drug ratio from 1:1 to 3:1
      caused an increase in the encapsulation efficiency (i.e. from 44-97% with PLGA).
      An increase in the emulsifier (PVA) molecular weight from 14-72 kD caused an
      increase in encapsulation efficiency and microcapsule size. The in vitro release
      of vancomycin from microcapsules in phosphate buffer saline (pH 7.4) was found to
      be dependent on molecular weight and copolymer type. The kinetic behaviour was
      controlled by both diffusion and degradation. Sterilization with 60Co (2.5 Mrad)
      also affected the degradation rate and release profiles. Degradation of
      microcapsules could be seen by scanning electron microscopy, by the increase in
      the release rate from PLA and by the decrease in the Tg values of microcapsules.
      In vitro bactericidal effects of the microcapsule formulations on S. aureus were
      determined with a special diffusion cell after the preparations had been
      sterilized, and were found to have bactericidal effects lasting for 4 days.

PMID- 11201345
TI  - The utilization of health care services and social services by neurotic patients
      and their service need.

PMID- 11201346
TI  - The performance of the Center for Epidemiologic Study Depression Scale (CES-D) in
      an Arab female community.
AB  - BACKGROUND: The purpose of this study was to investigate the psychometric
      properties of the Arabic version of the CES-D. METHODS: Three samples of young
      Arab females were chosen from different young female populations (n =450). The
      translated version of the CES-D, sociodemographic and risk factors questionnaires
      were applied to the above three samples. A subsample was selected (n = 30) to re
      rate the scale items and the same sample was interviewed by the SCID. The
      internal consistency and test-re-test reliability were estimated as well as the
      factor structure of the Arabic CES-D. The discriminative and criterion validity
      of the scale was also investigated using the ROC analysis. RESULTS: Seventy five
      percent (n = 350) of the subjects completed the scale. Alpha coefficient was
      found to be 0.88 and the split-half reliability was 0.83. The average re-test
      reliability (ICC = 0.59). Factor analysis yielded three factors: interpersonal
      problems, mixed affective/somatic factor and the positive affect factor. There
      was significant differences in mean total score between depressed and non
      depressed subjects as classified by SCID as well as by self-perception of
      depression and the need for treatment. ROC analysis revealed that a cut-off point
      of 21 discriminated best between depressed and non-depressed subjects
      (sensitivity= 82%, specificity = 83% with AUC of 84%). CONCLUSION: The Arabic CES
      D was found to possess reasonable reliability and reasonable discriminative and
      criterion validity.

PMID- 11201347
TI  - Mental health care in Italy: organisational structure, routine clinical activity
      and costs of a community psychiatric service in Lombardy region.
AB  - The Magenta Community Mental Health Centre (CMHC) is the public agency
      responsible for providing adult psychiatric care to about 85,000 adult residents.
      In 1995, it had 1,145 clients and incurred costs of Euro 1.9 millions. Average
      cost per patient and per adult resident were Euro 1,661 and Euro 22.2,
      respectively. These values mask large variation across diagnosis: while patients
      with schizophrenia and related disorders had an average cost of Euro 3,771, those
      with neurotic and related disorders had an average cost of Euro 439. Patients
      with schizophrenia and related disorders (28% of the patients) absorbed about 60%
      of total costs and made extensive use of several types of services (hospital,
      outpatient, domiciliary, social and rehabilitative care). Since integrating
      different types of services is the key element of Italian psychiatric care, the
      new fee-for-service system adopted by the NHS to fund providers does not appear
      appropriate, particularly for schizophrenic patients.

PMID- 11201348
TI  - Child mental health problems in Arab children: application of the strengths and
      difficulties questionnaire.
AB  - AIM: This study aimed at establishing the mental health profile among 322 Arab
      children living in the Gaza strip. METHOD: Children were selected in four age
      bands, i.e. 3, 6, 11 and 16 years of age. The relevant forms of the Strengths and
      Difficulties Questionnaire (SDQ) was completed by parents, teachers and 16-year
      olds. RESULTS: Factor analyses of the parent-related questionnaires identified
      similar general factors as in the UK-based studies of validating the SDQ. Certain
      items did not load as highly on the general factors, i.e. distractability,
      feeling scared, feeling unhappy, stealing, and being picked or bullied. Emotional
      problems items were rated differently in the pre-school group (aches, nervousness
      clinging, worries) than in previous studies. Using previous optimal cut-off
      scores, parent SDQs revealed higher rates of children with emotional and conduct
      problems falling above the 90th centile established in the UK sample, but lower
      rates according to self-report SDQs by 16-year-olds. CONCLUSIONS: Western
      categories of mental health problems did not clearly emerge from the factor
      analysis. The main difference from western epidemiological studies appeared to
      operate in parents' perceptions of emotional problems in pre-school children. The
      SDQ is very promising as a screening measure or rating scale in different
      cultural populations. However, future research should identify and establish
      indigenously meaningful constructs within this population and culture, and
      subsequently revise measures of child mental health problems.

PMID- 11201349
TI  - Help-seeking pathways among Malay psychiatric patients.
AB  - The aim of this study is to explore the help-seeking behaviour of Malay
      psychiatric patients. A semi-structured interview based on a standard proforma
      was conducted to assess help seeking process and delays for Malay psychiatric
      patients attending the psychiatric clinic for the first time. Help-seeking
      process and delays were defined. Among 134 patients evaluated in the study, 69%
      had visited traditional healers (bomoh) for the present illness before consulting
      psychiatrists. The second popular choice of treatment was medical practitioner
      and only a small percentage of them had consulted homeopathic practitioners and
      herbalists. Patients who had consulted bomohs were significantly delayed in
      getting psychiatric treatment compared with those who had not consulted them.
      Consultation of bomohs was significantly higher among married patients, those
      with major psychiatric illnesses and in family who believed in supernatural
      causes of mental illness. However, there was no significant difference in age,
      gender, educational status and occupation between patients who had consulted and
      not consulted bomoh. We concluded that majority of the Malay psychiatric patients
      had sought the traditional treatment prior to psychiatric consultation. The
      strength of social support and the belief of the patients, friends, and/or
      relatives in supernatural causes of mental illness were strongly associated with
      the rate of traditional treatment. Deep-seated cultural beliefs were major
      barrier to psychiatric treatment.

PMID- 11201350
TI  - The effects of psychotherapies: a study on patients' perception of results in an
      Italian public setting.
AB  - Enquiries centred on the perspective of users of psychiatric treatments and their
      families, has become an increasingly widespread method to improve the quality of
      treatments administered by health services. In this study, in particular, we
      examine the users' perception of the quality and variability of the effects of
      psychotherapies, the difficulties met, and the perceived help factors. The sample
      consists of 216 users of psychotherapy and 223 patients in psychiatric treatment
      with psychological support. They are outpatients, managed by the public health
      service. The questionnaires included closed ended, open-ended questions and
      scales that were previously tested on a sample of patients. The questionnaire for
      patients was anonymous and administered by researchers external to the medical
      staff. Irrespective of the diagnosis or of a concurrent pharmacological therapy,
      a high percentage of patients (75%), in both groups, feel improved. Improvement
      consist of the decrease of symptoms, a sense of feeling better, but also feeling
      grown up, more mature, having higher self-esteem and feeling more adequate in
      interpersonal relationships. This last type of result is significantly more
      frequent in the group of patients in psychotherapy. Besides these patients are
      faced with more difficulties and play more active a role while they are in
      treatment. The main difference between patients in psychotherapy and those in
      psychiatric management with psychological support is not indeed the
      identification of different perceived therapeutic factors, but rather the
      different evaluation of their relative importance. On the whole, the study seems
      to show that the effects of real psychotherapies include, beside an improvement
      of symptoms, the achievement of goals of personal growth and maturity, self
      satisfaction and an increase in self-esteem, all in accordance with a conception
      of health as well-being and self-satisfaction rather than as absence of illness.

PMID- 11201351
TI  - Predictors of post-hospital employment status for psychiatric patients in Hong
      Kong: from perceptions of rehabilitation professionals to empirical evidence.
AB  - Fifty participants with mental illness and a concrete discharge plan were
      selected from two mental hospitals in Hong Kong and assessed on their
      Psychosocial support by the Chinese Version of the Significant Others Scale,
      social vocational competence using the Workshop Behavior Checklist and the
      Vocational Social Skills Scale, medical history, work history, and demographic
      variables. At three months after discharge, the employed participants (n = 12)
      were shown to have better psychosocial support and social vocational competence
      than the unemployed participants (n = 24) by univariate comparison. The employed
      and unemployed participants did not differ in their medical and work history, and
      demographic variables. Implications of the results for rehabilitation programming
      are discussed.

PMID- 11201352
TI  - Survival and plant-prey finding by Neoseiulus fallacis (Acari: Phytoseiidae) on
      soil substrates after aerial dispersal.
AB  - In a greenhouse and in an open field, aspects of aerial and ambulatory dispersal
      of the phytoseiid mite. Neoseiulus fallacis (Garman) were studied with a focus on
      events that would occur after aerially dispersing mites had landed on soil or
      associated substrates. We measured recovery of predators on lima bean plants
      (Phaseolus lunatus L.) that were infested with the two-spotted spider mite,
      Tetranychus urticae Koch. Factors thought to affect movement and colonization
      were distance to a receiver unit from a release (landing) point, intervening soil
      surfaces such as clods, gravel, fine soil and grass, and management of soil
      surfaces such as mulching. watering or both. In the field, the effect of distance
      (0.11-1.76 m) from a landing point to a receiver unit was significant, with a
      negative log-linear relationship. Soil surfaces such as clods and management
      actions such as watering with mulching allowed for more capture of predators on
      bean plants with prey than did other treatments. Environmental conditions greatly
      affected survival of N. fallacis. Predators in the field that were present on
      bare soil suffered high mortality (ca. 90%) at fluctuating daytime conditions of
      26.4 +/- 4.8 degrees C and 56 +/- 13.4% RH. Predators only suffered 10% mortality
      in the greenhouse under the same setting, but under more controlled and favorable
      environmental conditions. Effects of environmental conditions, mode of dispersal
      and implications to biological control are discussed.

PMID- 11201353
TI  - Life cycle and parasitic interaction of the lizard-parasitizing mite Ophionyssus
      galloticolus (Acari: Gamasida: Macronyssidae), with remarks about the
      evolutionary consequences of parasitism in mites.
AB  - Wild-caught specimens of the lacertid lizard Gallotia galloti eisentrauti from
      the Canary Island of Tenerife were checked for ectoparasites. The parasitic
      gamasid mite Ophionyssus galloticolus Fain and Bannert (2000) was very abundant
      on these lizards. Additionally, parasitism by larvae of two species of
      Trombiculidae (Prostigmata: Parasitengona) was observed. O. galloticolus was
      reared in the laboratory on its natural host in order to investigate its life
      cycle, reproductive biology, and development. The life history of O. galloticolus
      is documented in detail and compared to literature data of other Ophionyssus
      species. O. galloticolus was found to be similar to other species of the same
      genus with respect to the duration of development, the precopulatory association
      of protonymphs, and the arrhenotokous development of eggs. However, it seems to
      be more tolerant towards low relative humidity and longer starvation periods than
      other Ophionyssus species. Evolutionary transformations of the life-history
      pattern of this genus and other parasitic mites in comparison to its predatory
      precursors involve a reduction or partial suppression of ontogenetic instars in
      order to decrease mortality during host-seeking phases, and a compensating
      increase in growth capacity of the remaining feeding instars facilitated by
      replacement of sclerites through elastic cuticle or by growth of new cuticle
      unrelated to a moult (neosomy).

PMID- 11201354
TI  - Detection and micro-scale isolation of a low molecular mass paralysis toxin from
      the tick, Argas (Persicargas) walkerae.
AB  - This study describes the isolation of a 11 kDa paralysis toxin from crude larval
      extracts of Argas (Persicargas) walkerae by exploiting the cross-reactivity of a
      monoclonal antibody (4B12), directed against the paralysis toxin of Rhipicephalus
      evertsi evertsi. This low molecular mass is in contrast to previous findings of a
      60-70 kDa toxin for A. (P.) walkerae, but is similar to neurotoxins isolated from
      venomous forms of the class Arachnida, which comprise the orders Araneae
      (spiders). Scorpionida (Scorpions) and Acari (ticks and mites). Since numerous
      antigenic bands, ranging between 11 and 115 kDa, were detected by the monoclonal
      antibody 4B12, the possibility of toxin-complex formation and the effect of pH on
      the latter were investigated by means of HPLC and ammonium sulphate
      precipitation. The results suggest that physiological conditions, with respect to
      pH and ionic strength, promote the formation of heterogeneous toxin-complexes
      while an acidic pH favours the formation of a more homogeneous toxin-containing
      complex. Furthermore, the effect of partially purified toxin on neurotransmitter
      release from crude rat brain synaptosomes was investigated, since tick paralysis
      toxins are hypothesised to inhibit neurotransmitter release from the presynaptic
      terminal. Both calcium-dependent, as well as calcium-independent release was
      inhibited by the toxin-containing sample.

PMID- 11201355
TI  - Host utilization and seasonal occurrence of Dermacentor species (Acari:Ixodidae)
      in Missouri, USA.
AB  - A total of 3,235 Dermacentor variabilis (Say) specimens were collected from
      birds, mammals, and by dragging vegetation, and 2,683 D. albipictus (Packard)
      ticks were collected from deer from 1993 to 1996. Peak seasonal occurrence of
      adult D. variabilis was from May through July with a precipitous decrease in
      August. Nymphal D. variabilis populations peaked in June. Peak activity of larvae
      was bimodal, with one activity peak during late summer (September) and a second
      peak in winter or early spring. The raccoon, Procyon lotor (L.), was the
      principal host of adults followed by the Virginia opossum, Didelphis virginiana
      Kerr. Rodents and the eastern cottontail rabbit, Sylvilagus floridanus (J. A.
      Allen), were the primary hosts of nymphs. The marsh rice rat, Oryzomys palustris
      (Harlan), was the principal host of larvae followed by the pine vole, Microtus
      pinetorum (Le Conte), and white-footed mouse, Peromyscus leucopus (Rafinesque).
      All stages of D. albipictus were found only on white-tailed deer, Odocoileus
      virginianus (Zimmermann). Numbers of adult and nymphal D. albipictus peaked in
      November, whereas larvae peaked in September.

PMID- 11201356
TI  - Immunization of cross-bred cattle against Hyalomma anatolicum anatolicum by
      purified antigens.
AB  - Extracts prepared from unfed larvae of Hyalomma anatolicum anatolicum were
      purified by immunoaffinity chromatography using anti-gut IgG as ligand. Affinity
      purified antigen (Aff-GHLAg) was used to immunize cross-bred (Bos taurus x B.
      indicus) calves of 6-7 months of age. Immunized calves rejected 70.6% larvae,
      54.5% nymphs and 61.9% adults. No significant changes in the engorged weight of
      females was observed; however, significant decrease in the engorgement weight of
      larvae and nymphs was recorded. There was a significant decrease in the emerging
      nymphs (p < 0.05) and adults (p < 0.01) of the tick stages fed on immunized
      animals. SDS-PAGE analysis revealed three antigenic proteins of 100, 59.4 and 37
      kDa responsible for induction of resistance in the host.

PMID- 11201357
TI  - Experimental infestation of llamas (Lama glama) with Boophilus microplus
      (Acari:Ixodidae).
AB  - Two llamas (Lama glama) were infested with approximately 20,000 Boophilus
      microplus larvae each and maintained under controlled conditions to collect the
      detached adult ticks. A total of 72 engorged and semi-engorged females were
      recovered with a mean weight of 163.0 +/- 70.6 mg. Sixty-three (87.5%) of these
      ticks oviposited and 60 (95.2%) of the egg masses produced larvae. Six of the
      heaviest females laid 18,838 eggs from which 16,545 (87.8%) hatched. These
      results show that llamas are able to maintain a population of B. microplus under
      experimental conditions. Further studies are required to determine the role of
      llamas as alternative hosts for B. microplus under field conditions.

PMID- 11201359
TI  - Attachment sites and frequency distribution of erythraeid mites, Leptus
      indianensis (Acari: Prostigmata), ectoparasitic on harvestmen, Leiobunum formosum
      (Opiliones).
AB  - Host attachment sites and frequency distribution of parasitism were investigated
      for the larval erythraeid mite Leptus indianensis parasitising a sample of 500
      harvestmen. Leiobunum formosum in Tennessee, USA. A significant difference was
      found in the number of mites attached to different body segments of the
      harvestmen with the greatest number of mites attached to femurs I-IV. Scanning
      electron microscopy revealed that the mites attached to smooth areas of the host
      integument between rows of stout setae. The frequency distribution of mites
      parasitising the harvestman population was highly clumped (Coefficient of
      Dispersion = 3.34) with a relatively small number of hosts being parasitised by
      most of the mites.

PMID- 11201360
TI  - The effect of male ticks on the feeding performance of immature stages of
      Rhipicephalus sanguineus and Amblyomma americanum (Acari: Ixodidae).
AB  - A unique group of immunoglobulin-binding proteins (IGBPs), produced by ixodid
      male ticks during the latter half of their prolonged feeding period, improves the
      feeding performance of co-feeding females. As a follow-up to this observation, we
      investigated whether male tick feeding also affects the feeding of other
      developmental stages. Immature stages of Rhipicephalus sanguineus (Latreeille)
      and Amblyomma americanum (L.) were fed on rabbits in the presence or absence of
      conspecific males. The mean weight of larvae and nymphs of both species that fed
      around males and detached from the host on the first day of dropping was
      significantly higher than when the immature ticks fed on rabbits in the absence
      of males. However, larvae of both species and nymphs of R. sanguineus that fed
      slower and detached on the second day of dropping did not show significant
      differences in weight. A similar pattern was observed for A. americanum nymphs
      although, unlike R. sanguineus, the presence of males also influenced the feeding
      performance of the nymphs that fed slowly and detached on the second day of drop
      off. The improved feeding performance demonstrated by immature ticks in the
      presence of males may be due to immunomodulatory saliva proteins, such as
      immunoglobulin-binding proteins (IGBPs) that are introduced into the co-feeding
      site. The results are considered in relation to the distribution of ixodid tick
      species on their natural hosts.

PMID- 11201358
TI  - Diseases of mites.
AB  - An overview is given of studies on diseases of mites. Knowledge of diseases of
      mites is still fragmentary but in recent years more attention has been paid to
      acaropathogens, often because of the economic importance of many mite species.
      Most research on mite pathogens concerns studies on fungal pathogens of
      eriophyoids and spider mites especially. These fungi often play an important role
      in the regulation of natural mite populations and are sometimes able to decimate
      populations of phytophagous mites. Studies are being conducted to develop some of
      these fungi as commercial acaricides. Virus diseases are known in only a few
      mites, namely, the citrus red mite and the European red mite. In both cases, non
      occluded viruses play an important role in the regulation of mite populations in
      citrus and peach orchards, respectively, but application of these viruses as
      biological control agents does not seem feasible. A putative iridovirus has been
      observed in association with Varroa mites in moribund honeybee colonies. The
      virus is probably also pathogenic for honeybees and may be transmitted to them
      through this parasitic mite. Few bacteria have been reported as pathogens of the
      Acari but in recent years research has been concentrated on intracellular
      organisms such as Wolbachia that may cause distorted sex ratios in offspring and
      incompatibility between populations. The role of these organisms in natural
      populations of spider mites is in particular discussed. The effect of Bacillus
      thuringiensis on mites is also treated in this review, although its mode of
      action in arthropods is mainly due to the presence of toxins and it is,
      therefore, not considered to be a pathogen in the true sense of the word.
      Microsporidia have been observed in several mite species especially in oribatid
      mites, although other groups of mites may also be affected. In recent years,
      Microsporidia infections in Phytoseiidae have received considerable attention, as
      they are often found in mass rearings of beneficial arthropods. They affect the
      efficacy of these predators as biological control agent of insect and mite pests.
      Microsporidia do not seem to have potential for biological control of mites.

PMID- 11201361
TI  - Declining trends in HTLV-I prevalence among blood donors in Japan.

PMID- 11201362
TI  - Decline in the positive rate of human T-lymphotropic virus type-1 (HTLV-1)
      antibodies among blood donors in Nagasaki.
AB  - OBJECTIVE: The aim of this study was to clarify the trend of the HTLV-1
      seroprevalence rate among blood donors. METHODS: Samples were screened by the
      particle agglutination test for HTLV-1 antibodies. MATERIALS: Serum from blood
      donors was screened. RESULTS: The positive rate of HTLV-1 antibodies among blood
      donors decreased from 13.14 to 0.81 % over the years from 1928 to 1983.
      CONCLUSION: A decline over the years in the positive rate of HTLV-1 antibodies
      among blood donors was revealed.

PMID- 11201363
TI  - Esophageal inflammatory pseudotumor mimicking malignancy.
AB  - A 54-year-old man with a complaint of dysphagia was found to have a prominent
      stricture in the proximal esophagus. A biopsy of the stenotic area indicated
      sarcoma, leading to subtotal esophagectomy. The surgically removed esophagus
      demonstrated a well-defined intramural mass, consisting of a mixture of
      fibroblastic cells with bland cytological appearances and inflammatory cells.
      Reflux esophagitis which was present distal to the stricture seemed to play a
      role in the development of this inflammatory pseudotumor.

PMID- 11201364
TI  - Ultrasonography of gastric volvulus: "peanut sign".
AB  - We report a case of chronic gastric volvulus in which ultrasonography (US) was
      useful. An 81-year-old woman was hospitalized due to vomiting, and upper
      gastroduodenoscopy revealed that the stomach was spirally twisted and
      constricted. An upper gastrointestinal barium study demonstrated an organoaxial
      mesenteroaxial combined type gastric volvulus. US showed constriction between the
      dilated upper stomach body and the lower stomach body similar to a "peanut".
      Thereafter, the patient's vomiting stopped and follow-up US demonstrated that the
      constriction of the stomach was loosened. Therefore, we believe that this
      characteristic US sign paralleled the symptoms of the patient.

PMID- 11201366
TI  - Vascular involvement in Behcet's disease.

PMID- 11201365
TI  - Poorly vascularized malignant insulinoma displaced the pancreatic ducts around
      the mass on endoscopic retrograde cholangiopancreatography.
AB  - A 66-year-old woman with an altered mental status caused by hypoglycemia was
      referred to Akita City Hospital. Abdominal ultrasonography (US) and endoscopic US
      revealed an isoechoic mass measuring 25 mm in the head of the pancreas.
      Endoscopic retrograde cholangiopancreatography (ERCP) revealed that the main
      pancreatic duct and its branches were displaced around the mass in the head of
      the pancreas. On arteriography, a poorly vascularized tumor was observed. Dynamic
      contrast-enhanced computed tomography (CT) showed a low-attenuation mass in the
      head of the pancreas. A pylorus-preserving pancreaticoduodenectomy was performed.
      Microscopically, the diagnosis was malignant insulinoma.

PMID- 11201367
TI  - A Japanese case of congenital hyperinsulinism with hyperammonemia due to a
      mutation in glutamate dehydrogenase (GLUD1) gene.
AB  - We describe a Japanese case of neonatal hyperinsulinism due to a de novo mutation
      (Gly446Asp) in glutamate dehydrogenase gene (GLUD1). A boy suffered from
      hypoglycemic coma with relative hyperinsulinemia on day 1 after birth, and
      received subtotal pancreatectomy. Examination of the resected pancreas revealed a
      diffuse increase in endocrine cells, consistent with 'nesidioblastosis'. He is
      now 15 years old and has exhibited mild but persistent hyperammonemia, which is a
      very unique feature of the disorder caused by GLUD1 activating mutations. He has
      also been suffering from seizures and mental retardation. Thus, GLUD1 mutations
      can be a cause of congenital hyperinsulinism in Japanese.

PMID- 11201368
TI  - Duodenal somatostatinoma and erythrocytosis in a patient with von Hippel-Lindau
      disease type 2A.
AB  - A female with von Hippel-Lindau (VHL) disease type 2A first presented with
      erythrocytosis at the age of 9 years. This patient revealed multiple
      paragangliomas at age 22. After the removal of tumors, a retinal hemangioblastoma
      developed. Our diagnosis of VHL disease type 2A was confirmed. Moreover, systemic
      examination showed a duodenal somatostatinoma. Frequent and long-term monitoring
      is important for patients with pheochromocytomas or paragangliomas, and a
      screening for VHL disease and other hereditary cancer syndromes is recommended.
      Recognition of neuroendocrine tumors as a manifestation of VHL disease permits
      earlier diagnosis and improves prognosis.

PMID- 11201369
TI  - Basedow's disease and chronic ulcerative colitis: a case report and review of the
      Japanese literature.
AB  - A case of Basedow's disease, that developed after successful treatment of
      ulcerative colitis with a total colectomy, is presented, along with a review of
      the Japanese literature on the coexistence of hyperthyroidism and ulcerative
      colitis. A 26-year-old man was referred to our department, complaining of general
      fatigue, appetite loss, and palpitation. At age 14, blood was discovered in his
      stool and a diagnosis of ulcerative colitis was made. Since then, he has been
      treated with salazosulfapyridine and prednisolone. On examination, mild
      exophthalmos and thyroid swelling were observed. Both serum free T3 and T4 levels
      were increased along with a positive TSH receptor antibody, while TSH was
      decreased. Scintigraphic and ultrasonographic examinations of the thyroid gland
      showed diffuse enlargement. Treatment with thiamazole relieved the symptoms and
      normalized the thyroid function. Although a high incidence of autoimmune thyroid
      diseases in association with ulcerative colitis has been suggested, only 6 cases
      of hyperthyroidism coexisting with ulcerative colitis have been reported in
      Japan. A common immunological process has been suggested to be implicated in the
      pathogenesis of this association, however, the exact mechanism remains unclear.

PMID- 11201370
TI  - Usefulness of the combination of pre- and intraoperative selective intraarterial
      calcium injection to detect residual insulinomas.
AB  - In a 35-year-old woman diagnosed with insulinoma selective intraarterial calcium
      injection was positive for proximal gastroduodenal artery and inferior
      pancreaticoduodenal artery involvement preoperatively. Although non-invasive
      imaging studies were negative, a mass was detected at the pancreatic uncus by
      intraoperative ultrasonography. Gastroduodenal artery calcium injection was
      performed after enucleation of the tumor. Following calcium injection, the
      insulin level was inappropriately increased and further pancreaticoduodenectomy
      was performed. After excision, another tumor was detected at the head of the
      pancreas by histopathological examination. As shown, selective intraarterial
      calcium injection is useful to localize tumors preoperatively and
      intraoperatively.

PMID- 11201371
TI  - Clinical features of fulminant hepatitis in Nagasaki Prefecture, Japan.
AB  - OBJECTIVE: Fulminant hepatitis is a rare but fatal disease. In the present study,
      we examined the changes in etiology and prognosis of fulminant hepatitis in
      Nagasaki Prefecture, Japan between 1980 to 1999. METHODS: Eighty-one patients
      with fulminant hepatitis admitted to our hospitals from 1980 to 1999 were
      examined with respect to the etiology and prognosis. RESULTS: Fulminant hepatitis
      was due to hepatitis A virus in 2 (12%) cases, hepatitis B virus in 18 (22%)
      cases, unknown etiology in 50 (62%) cases, and drug-induced in 11(14%) cases. The
      number of cases in the first half of the study (1980-1989) was 47 and that of the
      latter half (1990-1999) was 34 cases. The incidence of fulminant hepatitis type B
      also decreased from 14 cases (30%) to 4 cases (12%) during these periods. The
      overall survival rate of fulminant hepatitis was 32%; it was equal in fulminant
      hepatitis type B, fulminant hepatitis of unknown etiology and fulminant drug
      induced hepatitis. The survival rate of fulminant hepatitis type A was 100%,
      though only two cases were identified. Retrospectively, the survival rate in
      patients with a pre-encephalopathy period of < or = 10 days and aged < or = 39
      years was significantly higher than in patients > or = 40 years of age (p<0.01).
      There was no difference between the two age groups when pre-encephalopathy period
      was > or = 11 days. CONCLUSIONS: The incidence of fulminant hepatitis especially
      that of fulminant hepatitis type B in Nagasaki Prefecture has decreased in recent
      years. The survival rate is significantly higher in younger patients with a short
      pre-encephalopathy period.

PMID- 11201372
TI  - IgA nephropathy with complement deficiency.
AB  - We treated a female patient suffering from immunoglobulin A (IgA) nephropathy and
      congenital deficiency of the ninth component of the complement system (C9). She
      was admitted with hematuria and proteinuria, and the C9 deficiency was diagnosed
      based on the low hemolytic activity of 50 % of the hemolytic unit of the
      complements (CH50) and the normal C3 level in the plasma. Renal biopsy revealed
      mild mesangial proliferation, and immunofluorescence examination revealed mild
      mesangial deposits of IgA and C3 with the same distribution. We discuss the
      pathogenesis of IgA nephropathy and the role of the complements in its
      progression.

PMID- 11201373
TI  - A solitary bronchial papilloma with malignant changes.
AB  - We describe a case of solitary papilloma of the bronchus and provide a review of
      38 similar cases reported in Japan. A 70-year-old man complained of cough and
      sputum. Chest X-rays and CT scans revealed atelectasis of the right middle lobe.
      On bronchoscopy, a polypoid tumor was found at the orifice of the bronchus of the
      right middle lobe. The tumor was histologically diagnosed as a squamous papilloma
      with moderate atypia. Because of elevated tumor markers and the reported high
      incidence of malignant changes in papillomas, the tumor was endoscopically
      resected by electrosurgical snare. While this procedure resulted in improvement
      of atelectasis, the chest CT taken subsequently revealed a mass adjacent to the
      resected polypoid tumor in the middle lobe bronchus. Percutaneous needle biopsy
      followed by histopathological examination confirmed the tumor to be a squamous
      cell carcinoma. Only three cases of malignant changes in papillomas have been
      previously reported in Japan. Electrosurgical snare, which allows the
      identification of tissue at the tumor base, should be the treatment of choice
      rather than YAG laser surgery.

PMID- 11201374
TI  - Two cases of severe bronchopneumonia due to influenza A (H3N2) virus: detection
      of influenza virus gene using reverse transcription polymerase chain reaction.
AB  - We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus.
      The severity of the disease necessitated initiation of empiric therapy based on
      the present illness and clinical data on admission. Both patients were improved
      by artificial ventilation with positive end-expiratory pressures and
      administration of broad spectrum antibiotics and corticosteroids before
      confirming the diagnosis of viral bronchopneumonia using viral culture and
      serological tests. Within 24 hours, influenza A (H3N2) virus was identified by
      amplification of the pathogen genes by reverse transcription polymerase chain
      reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both
      cases. This suggests that a combination of detection methods of pathogens using
      RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at
      influenza A virus.

PMID- 11201375
TI  - Cardiac and great vessel thrombosis in Behcet's disease.
AB  - Behcet's disease (BD) is a chronic relapsing systemic vasculitis in which
      orogenital ulceration is a prominent feature. The disease affects many systems
      and causes hypercoagulability. We present a 27-year-old male patient who
      exhibited widespread great vessel thrombosis including right atrial and
      ventricular thrombi in the setting of right-sided infectious endocarditis and
      orogenital aphthous ulcerations and erythema nodosum due to BD. We reviewed the
      enigmatic prothrombotic state of BD, and discuss our prior experiences in this
      field.

PMID- 11201376
TI  - Acute congestive heart failure associated with a limited form of systemic
      sclerosis and primary biliary cirrhosis.
AB  - This is the first case of a limited form of systemic sclerosis (ISSc) associated
      with acute congestive heart failure (CHF) and primary biliary cirrhosis (PBC). A
      58-year-old woman with ISSc was admitted because of a sudden onset of CHF. The
      intravenous administration of nitroglycerine and furosemide ameliorated the
      symptoms of CHF within 24 hours. She had both anticentromere antibodies and anti
      p25 doublet/triplet antibodies to intrahepatic microsomes. Thallium scintigraphy
      at rest demonstrated significant perfusion defects in both the anteroseptal and
      inferior myocardium. A coronary angiogram revealed normal coronary arteries and
      no vasospasm was provoked by the intracoronary administration of acetylcholine.
      The present case indicates that minute care should thus be taken for the
      prevention of acute CHF even in patients with a limited form of SSc when thallium
      perfusion defects are identified.

PMID- 11201377
TI  - Device for the removal of button batteries.
AB  - OBJECTIVE: There is an increasing number of accidents by erroneous ingestion of
      button batteries in recent years; the batteries arouse the interest of infants
      because of their attractive shape and luster. The batteries remaining in the
      gastrointestinal tract and discharging electric current over a long period of
      time may induce ulceration or perforation, thus must be carefully considered the
      selection of appropriate treatment. METHODS: We remove erroneously ingested
      button batteries with two tubes with ferrite magnets nearly the same size as the
      button batteries themselves. PATIENTS: Four cases of erroneous ingestion of
      button batteries. RESULTS: We easily removed button batteries from the stomach
      within 5 minutes in all cases with two magnet-attached tubes. CONCLUSION: We
      present this battery removal device together with a literature review, because it
      seems convenient and useful.

PMID- 11201378
TI  - [Refractory non-small-cell lung cancer responding to combination chemotherapy
      with docetaxel, gemcitabine and cisplatin].
AB  - The combination of docetaxel (TXT), gemcitabine (GEM), and cisplatin (CDDP)
      produced a regression in a squamous cell carcinoma of the lung that had recurred
      after radiation therapy plus chemotherapy, and was resistant to the combination
      of carboplatin (CBDCA) with etoposide (ETP) or paclitaxel (TXL). The patient was
      a 62-year-old man with squamous cell lung cancer, which was first successfully
      treated by a combination of radiation therapy and chemotherapy, but showed local
      recurrence after 8 months. Although the recurrence was treated with CBDCA plus
      ETP and then TXL, the tumor continued to grow with symptomatic progression of
      airway stenosis. The tumor began to regress after the regimen of TXT, GEM and
      CDDP was started. This therapy achieved PR with symptomatic improvement. The
      combination of TXT, GEM and CDDP may be effective for recurrent non-small-cell
      lung carcinoma, even in patients that have failed to respond to more than one
      chemotherapy regimen.

PMID- 11201379
TI  - [Usefulness of ambulatory adjuvant chemotherapy with low-dose epirubicin in
      patients with axially-node positive breast cancer: Chiba Epirubicin Cooperative
      Study Group].
AB  - We evaluated the usefulness of adjuvant chemotherapy with low-dose epirubicin
      (EPI) as a key drug in patients with axially-node positive breast cancer. All the
      24 patients who were entered in the study between January 1991 and December 1992
      were shown histologically to have more than 4 axially-node involvement and
      underwent curable resection for the breast lesions. Twenty mg/m2 of EPI was
      administered intravenously every 4 weeks as ambulatory treatment for 1 year and 5
      fluorouracil (5-FU) and tamoxifen (TAM) were concomitantly administered at a dose
      of 150 mg/day and 20-40 mg/day, respectively, daily for 2 years. The median
      follow-up period was 70 months with a 55.1% 5-year relapse-free survival and
      67.4% 5-year survival rate. One patient developed Grade 3 nausea.vomiting,
      anorexia and general fatigue; however, the other toxicities were mild, such as
      Grade 1 leukopenia, liver dysfunction, nausea.vomiting, anorexia and general
      fatigue. This adjuvant therapy with low-dose EPI was safely administered to
      outpatients, and is considered to be useful for the treatment of axially-node
      positive breast cancer.

PMID- 11201380
TI  - [Induction of apoptosis in breast cancer cells by preoperative oral
      administration of 5-fluorouracil].
AB  - We investigated whether 5-fluorouracil (5-FU) can induce apoptosis in breast
      cancer cells. Preoperatively, 23 breast cancer patients were divided into a group
      treated with 5-FU at 200 mg/day for 2 weeks (Group A) and a non-treatment group
      (Group B), and breast cancer tissues were taken postoperatively. DNA
      fragmentation by agarose electrophoresis and the TUNEL method were used to
      investigate the induction of apoptosis. The labeling rate with Ki-67 was measured
      to study the reproductive activity of tumor cells. The involvement of p53 in the
      apoptosis decision mechanism was also studied. DNA was more fragmented in Group A
      than in Group B. The apoptosis index by the TUNEL method was 1.88 +/- 1.03 in
      Group A, which was significantly higher than 0.36 +/- 0.86 in Group B. The
      labeling rate with Ki-67 was significantly higher in Group B(62.3 +/- 21.7) than
      in Group A (29.8 +/- 16.0). There was no difference in the protein expression of
      p53 regardless of the presence or absence of DNA fragmentation. These results
      indicate that 5-FU administration induces apoptosis in breast cancer cells and
      significantly inhibits their reproductive activity. Involvement of p53 in the
      apoptosis decision mechanism was not demonstrated.

PMID- 11201381
TI  - [Patient compliance and the quality of life are well maintained in weekly
      paclitaxel and carboplatin therapy for advanced gynecologic cancers in Japanese
      women].
AB  - OBJECTIVES: To assess patient compliance and efficacy of a combination
      chemotherapy consisting of weekly administration of paclitaxel and carboplatin
      for gynecologic malignancy in Japanese women. METHODS: Fourteen ovarian and three
      uterine cancer patients received 80 mg/m2 of paclitaxel (paclitaxel) and AUC 1.5
      to 2.0 of carboplatin weekly. The toxicity was evaluated and patients' QOL was
      tested. RESULTS: Neutropenia higher than grade 3 were observed in 29.4%. Four
      patients received G-CSF support. Grade 1 neurotoxicity was seen in 76.5% of
      patients. Evaluation of QOL by EORTC-QLQC30 showed significantly better tolerance
      of a weekly than monthly regimen. Three out of four patients with lung metastasis
      showed complete disappearance of the lesions. One patient with stage IIIb
      cervical cancer underwent postchemotherapy-hysterectomy and a complete
      pathological response was confirmed. The overall response rate was 64.7%
      including patients previously treated with platinum based multidrug regimens.
      CONCLUSIONS: A weekly paclitaxel and carboplatin regimen was well tolerated by
      Japanese women. The regimen was active in over 60% of cases and it also appeared
      active in multidrug resistant cases.

PMID- 11201382
TI  - [Theoretical construction of chemotherapeutic tactics for advanced or recurrent
      gastrointestinal carcinoma].
AB  - The anti-cancer effect of 5-fluorouracil (5-FU) is significantly affected by the
      intratumoral environment. Elevated expression of thymidylate synthase (TS), the
      target enzyme of 5-FU, and a lack of reduced folate or FdUMP results in
      insufficient inhibition of TS. Further, elevated expression of DPD in the tumor
      tissue results in a lack of FdUMP. TS-1, which contains tegafur and
      dihydroxypyridine (CDHP), a potent DPD inhibitor, is a promising anticancer drug.
      Isovorin has been available in Japan since autumn 1999. In cancer patients,
      folate deficiency may be derived from increased consumption and/or absorption
      disturbance of folate. In such situations, sufficient TS inhibition cannot be
      obtained if 5-FU is administered without supplementation of reduced folate. We
      describe in detail the metabolism of those substances in relation to the
      anticancer effect of 5-FU. Further, we show the theoretical construction of first
      line and second-line chemotherapy with consideration of TS and DPD expression.

PMID- 11201383
TI  - [Efficacy of lidocaine cream in protecting against thermal stress during
      hyperthermia].
AB  - Hyperthermia is performed in combination with chemotherapy as multimodal
      treatment for recurrent and advanced cancer. It is generally believed that the
      temperature cannot be raised higher because of thermal stress. In this study, we
      examined the efficacy of lidocaine cream in protecting against thermal stress
      during hyperthermia. We devised a new local anesthetic cream containing 5%
      lidocaine. The subjects were eighteen patients with stomach cancer, liver cancer,
      or large intestine cancer. This cream was applied locally to the skin with an
      occlusive dressing for about one hour before hyperthermia was performed, and was
      wiped away just before hyperthermia. The pain scores in the treatment group were
      significantly lower than in the no-treatment group (p < 0.05). The scores for
      sensation of heat in the treatment group were lower, though not to a significant
      extent, than those in the no-treatment group. No adverse effects were observed.
      Plasma concentrations of lidocaine were lower than 0.5 microgram/ml, and
      percutaneous absorption of lidocaine from the lidocaine cream was minimal.

PMID- 11201384
TI  - [Recurrent breast cancer successfully treated with a weekly dose of paclitaxel--a
      case report].
AB  - The patient was a 46-year-old women who was treated for axillary lymph node
      recurrence of breast cancer by a variety of methods, including surgery,
      chemotherapy, and radiotherapy, but who experienced recurrences in the cervical
      and mediastinal lymph nodes and skin, and developed hydrothorax and ascites.
      Although the recurrent foci responded to 4 cycles of CAF chemotherapy, there was
      concern that the foci would become refractory or resistant to chemotherapy. The
      administration of paclitaxel was therefore initiated. The patient received a dose
      of paclitaxel once a week for 5 consecutive weeks followed by a 1-week recovery
      period (one cycle). After two cycles of the paclitaxel treatment, a marked
      shrinkage of the lymph nodes and complete resolution of the hydrothorax and
      ascites were observed. Even though the patient exhibited bone marrow suppression
      and G-CSF was administered twice for neutropenia, there were no adverse effects
      except mild alopecia, again suggesting the possibility that paclitaxel is
      effective chemotherapy for recurrent breast cancer.

PMID- 11201385
TI  - [A case of advanced gastric cancer with Virchow's and paraaortic lymph node
      metastases successfully resected after combined chemotherapy of low-dose CDDP and
      5-FU].
AB  - The patient was a 61-year-old woman who had Stage IV advanced gastric cancer with
      Virchow's and paraaortic lymph node metastases. The lesions were considered
      surgically incurable, so she was placed on neoadjuvant chemotherapy consisting of
      low-dose CDDP and 5-FU. After 3 courses of chemotherapy, the tumor had decreased
      remarkably in size and Virchow's metastasis had disappeared. She was considered
      to have a partial response (PR) and underwent distal gastrectomy.
      Histopathological examination of the primary tumor revealed that almost all
      cancer cells existed in the mucosal and submucosal layers; few had infiltrated
      the serosa. A few paraaortic lymph nodes were positive for metastasis, but a
      curative resection (Cur B) was performed. The patient received another course of
      chemotherapy after the operation. Low-dose CDDP and 5-FU therapy was associated
      with few adverse events in this case, and thought to be effective against
      advanced gastric cancer.

PMID- 11201386
TI  - [Effectiveness of high-dose, intermittent 5'-DFUR therapy for advanced gastric
      cancer].
AB  - We report a case of advanced gastric cancer with multiple liver metastases and
      peritoneal dissemination. The patient was effectively treated with high-dose 5'
      DFUR. A 52-year-old patient with advanced gastric cancer and multiple liver
      metastases, who showed a high serum level of CEA and CA19-9 underwent simple D1
      gastrectomy. Thereafter, he received per os 1,200 mg/day of 5'-DFUR
      intermittently (5 days a week) and TAI every four months postoperatively. The
      serum levels of both CEA and CA19-9 fell dramatically to within the normal range
      and were maintained thereafter until the present. The size and number of the
      liver metastases dramatically decreased, judging from CT and angiography
      findings.

PMID- 11201387
TI  - [A case of stage IV gastric cancer with multiple liver metastases and
      carcinomatous ascites responding to TS-1 for six months before progression].
AB  - We report the case of a 72-year-old male with Stage IV gastric cancer accompanied
      by multiple liver metastases and carcinomatous ascites which responded to
      chemotherapy using TS-1. Treatment of the patient with daily oral administration
      of 120 mg TS-1 for 4 weeks resulted in complete regression of the liver
      metastases and ascites, as well as a 35% reduction in the size of the primary
      lesion. After 2 cycles, the primary tumor size was reduced to 55% and serum CA19
      9 and CA125 levels were decreased to the normal ranges. This regimen was
      effective without any adverse effects, and improved the patient's QOL, for 6
      months before progression of liver lesions. The patient received chemotherapy at
      our outpatient clinic for 10 months after the first treatment, after which he
      died of peritonitis carcinomatosa. The current case suggests that TS-1 may have a
      potent therapeutic efficacy in advanced gastric cancer patients.

PMID- 11201388
TI  - [Survival of 2 years and 7 months with 5'-DFUR treatment in a patient with
      peritoneal gastric cancer recurrence].
AB  - A 79-year-old male patient with peritoneal recurrence of gastric cancer 1 year
      and 7 months after radical operation was treated by oral administration of 5'
      DFUR. After the beginning of oral administration of 5'-DFUR, he survived 2 years
      and 7 months with a good performance status and without any adverse effects. A
      very limited number of cases with long survival by the oral administration of 5'
      DFUR after peritoneal recurrence of gastric cancer have been reported. Of a total
      of 653.0 g of 5'-DFUR administrated, 436.8 g (66.9%) were given in a protocol
      consisting of daily oral 1,600 mg of 5'-DFUR for 7 consecutive days and 7 drug
      free days. This high-dose (1,053 mg/m2/day) and intermittent method of 5'-DFUR
      administration might have contributed to the long survival and good performance
      status of this patient.

PMID- 11201389
TI  - [A patient with obstructive jaundice due to recurrence after gastric cancer
      surgery responding remarkably to FLP combination therapy].
AB  - The patient was a 67-year-old man who had undergone distal gastrectomy because of
      early gastric cancer without lymph node metastasis two years earlier. The
      postoperative course was uneventful, but he was admitted again to our hospital
      because of abrupt jaundice. A CT scan of the abdomen showed obstructive jaundice
      due to the enlargement of the lymph nodes around the hepatoduodenal ligament,
      pancreas head, portal vein, and celiac axis. After percutaneous transhepatic
      cholangio-drainage (PTCD), 5 cycles of FLP combination therapy (5-fluorouracil,
      leucovorin, cisplatin) were performed. Consequently, the tumor marker level
      returned to the normal range and the shrinkage of the metastatic lymph nodes was
      remarkable. A reopening of the biliary tract was attained, so the PTCD tube could
      be removed. As an outpatient without recurrence he has received oral
      administration of uracil plus tegafur. The FLP combination therapy was effective
      for obstructive jaundice due to intraperitoneal lymph node recurrence of the
      gastric cancer.

PMID- 11201390
TI  - [Long survival in a case of unresectable hepatic metastasis from rectal carcinoma
      treated with second-look hepatectomy plus pharmacokinetic modulating chemotherapy
      (PMC)].
AB  - A 67-year-old female with rectal cancer and multiple liver metastases underwent
      low anterior resection by total mesorectal excision (TME), cholecystectomy and
      hepatic arterial cannulation in June 1995. She was treated with hepatic arterial
      infusion chemotherapy (HAI) (5-FU 600 mg/m2/day x 2 days/w) and oral UFT (400
      mg/body, 5 days/w) once a week for 6 months on an outpatient basis. As the
      metastatic foci of the liver significantly decreased (83.3%) and extrahepatic
      disease were not observed, partial resection of the liver (second-look
      hepatectomy) was performed in March 1996. She continued arterial infusion PMC and
      venous infusion PMC as an outpatient. During the follow-up period a lung
      metastasis appeared in November 1997. Her regimen was changed to modified PMC
      with MMC (mitomycin C) and CPT-11. She has been managed at our outpatient clinic
      while the lung metastasis remained but with no liver metastasis for 57 months
      after the first operation, until the present. Second-look hepatectomy and PMC
      with a two-way port system was a useful option for unresectable hepatic
      metastases from colorectal carcinoma.

PMID- 11201391
TI  - Modification of lung cancer prevention by gene-nutrient interaction.

PMID- 11201392
TI  - Cancer incidence among workers in six Norwegian aluminum plants.
AB  - OBJECTIVES: This study investigated associations between exposure to polycyclic
      aromatic hydrocarbons (PAH) and the incidence of lung, bladder, kidney, and
      pancreatic cancer among Norwegian aluminum plant workers. METHODS: Cancer
      incidence was investigated from 1953 to 1996 among 11,103 men employed for more
      than 3 years in the industry, giving 272,554 person-years during follow-up. A job
      exposure matrix was constructed to estimate exposure to particulate PAH and
      fluorides. The observed cases of cancer were compared with expected figures
      calculated from national rates. Dose-response relations were investigated by
      internal comparisons using Poisson regression and stratified analyses for
      standardized incidence ratio. Potential confounding by smoking was investigated
      in subanalyses restricted to 3 of the plants. RESULTS: The study showed an
      overall excess for bladder cancer, standardized incidence ratio 1.3 (95%
      confidence interval 1.1-1.5), which increased with increasing cumulative exposure
      to PAH and reached a relative risk of about 2 for the upper exposure category in
      the analysis with 30 years of lag time. There was no association between
      cumulative PAH exposure and lung cancer, but there were indications of an
      elevated risk of kidney cancer among the most heavily PAH-exposed persons in the
      analyses with a lag time of 30 years. For pancreatic cancer we found a higher
      incidence among the PAH-exposed persons than among the unexposed ones, but no
      clear dose-response association was found. CONCLUSIONS: The study showed an
      association between bladder cancer and exposure to PAH, but gave no support to an
      association between PAH exposure and lung cancer in the primary aluminum
      industry.

PMID- 11201393
TI  - Nonmalignant mortality among workers in six Norwegian aluminum plants.
AB  - OBJECTIVES: This study investigated the associations between exposure to
      fluorides and polycyclic aromatic hydrocarbons (PAH) and mortality from
      nonmalignant diseases among workers in the Norwegian primary aluminum industry.
      METHODS: Mortality among 10,857 men, employed for more than 3 years in 1 of 6
      aluminum plants, was investigated from 1962 to 1996, giving 239,246 person-years
      during follow-up. Ajob-exposure matrix covering all 6 plants was used to estimate
      the individual exposure to total fluorides and particulate PAH. The observed
      cause-specific deaths were compared with expected figures calculated from
      national rates. Dose-response relations were investigated by internal comparisons
      using Poisson regression and by stratified analyses for standardized mortality
      ratio. Potential confounding by smoking was investigated in subanalyses
      restricted to 3 of the plants for which information on smoking habits was
      accessible. RESULTS: Mortality from circulatory disease was slightly lower than
      expected [SMR 0.95, 95% confidence interval (95%CI) 0.9-1.0], while there was an
      increased mortality from asthma, emphysema, and chronic bronchitis combined, SMR
      1.2 (95% CI 1.0-1.5). Mortality from these diseases was associated with
      cumulative exposure to fluorides. The rate ratio in the internal analysis rose
      steadily to 2.5 (95% CI 1.5-4.3) for the upper exposure category. No association
      was observed between cumulative fluoride exposure or PAH exposure and circulatory
      mortality. CONCLUSIONS: The study showed an association between exposure to
      potroom emissions measured by fluorides and mortality from asthma, emphysema, and
      chronic bronchitis combined.

PMID- 11201394
TI  - Bladder cancer in the textile industry.
AB  - OBJECTIVES: This study examined the occupations and industries at high risk for
      bladder cancer in an area where the textile industry is plentiful and the
      incidence of the disease is very high. METHODS: A case-referent study concerning
      218 incident bladder cancer cases diagnosed during 1993-1995 in the county of
      Valles Occidental, Barcelona, was carried out. A reference group (N=344) was
      selected from municipal lists matched to the cases by age, gender, and area of
      residence. All the subjects were personally interviewed, and a complete
      occupational history was abstracted together with other sociodemographic and life
      style factors. All odds ratios (OR) and 95% confidence intervals (95% CI) were
      adjusted for age, gender, and smoking. RESULTS: No overall excess risk was found
      forever having worked in the textile industry (OR 1.13, 95% CI 0.79-1.63) nor for
      specific sectors of this industry (ie cotton, wool, silk). An excess risk was
      observed for spinners and winders employed for more than 20 years (OR 3.28, 95%
      CI 1.08-9.97) and for machine setters employed between 1960 and 1974 (OR 4.26,
      95% CI 1.09-16.7). CONCLUSIONS: The results of this study do not support the
      findings of some earlier studies for an increased bladder cancer risk in the
      textile industry. However, some elevated risks were observed among the workers
      with the highest exposures.

PMID- 11201395
TI  - Acute myeloid leukemia and clonal chromosome aberrations in relation to past
      exposure to organic solvents.
AB  - OBJECTIVES: The effects of occupational and leisure-time exposures on the risk of
      acute myeloid leukemia (AML) were investigated with emphasis on clonal chromosome
      aberrations (CCA) and morphological subtypes. METHODS: Consecutively diagnosed
      cases of AML (N=333) and 1 population referent per case were retrospectively
      included in the study. Information on worktasks, companies, and leisure-time
      activities was obtained with telephone interviews. Exposure probability and
      intensity were assessed by occupational hygienists. Associations were evaluated
      with logistic regression. RESULTS: Exposure to organic solvents was associated
      with an increased risk of AML [low exposure: OR 1.5 (95% confidence interval (95%
      CI) 1.0-2.3, moderate-high exposure: OR 2.3 (95% CI 1.0-5.0)]. For exposure to
      solvents, but not to benzene, the OR was 1.2 (95% CI 0.69-2.0) for "low" and 2.7
      (95% CI 1.0-7.3) for "moderate-high" exposure. The observed effects increased
      with intensity and duration of exposure. The estimated effects were higher for
      patients >60 years of age at the time of diagnosis. The effect of exposure to
      organic solvents was not differential with regard to morphology [except possibly
      erythroleukemia: OR 4.2, 95% CI 1.0-17 or the presence of CCA in general]. No
      increased risk for AML with complex CCA or with total or partial losses of
      chromosomes 5 or 7 were observed, but a higher risk was found for AML with
      trisomy 8 (OR 11, 95% CI 2.7-42) as the sole aberration. CONCLUSIONS: Exposure to
      organic solvents was associated with an increased risk of AML. This association
      was not due to benzene exposure alone and may be modified by age. Furthermore,
      specific associations with trisomy 8, and possibly also erythroleukemia, were
      suggested.

PMID- 11201396
TI  - Semen quality and sexual hormones in greenhouse workers.
AB  - OBJECTIVES: This study focused on determining the testicular function of
      greenhouse workers exposed to pesticides. METHODS: Semen was examined for 122 of
      199 eligible men (61%) from 30 ornamental flower greenhouses. Sperm
      concentration, morphology, and viability were measured according to World Health
      Organization guidelines, and the curvilinear sperm velocity was determined by a
      computer-assisted analysis of video recordings. Three groups were formed
      according to expert judgment of current exposure to pesticides from cultures,
      pesticide formulations, and the transfer of pesticide residues from leaves to
      hands, and also ranked according to years of work in a greenhouse. The risk
      estimates were adjusted for the effects of sexual abstinence and other
      potentially confounding factors. RESULTS: According to current exposure the
      median values of sperm concentration and the proportion of normal spermatozoa
      were 60% and 14% lower, respectively, in the high-level exposure group (N=13)
      than in the low-level group (N=44), and the values of the intermediate group fell
      in between. The adjusted differences between the high-level and low-level
      exposure groups were statistically significant, while no differences were
      observed for the viability and velocity of sperm and sexual hormones. The median
      sperm concentration was 40% lower for the men with > 10 years' experience in a
      greenhouse than for those with < 5 years' experience. The age-adjusted
      testosterone/sex-hormone-binding globulin ratio declined 1.9% (95% confidence
      interval 0.4-3.4%) per year of work. CONCLUSIONS: The results are compatible with
      the hypothesis that male fecundity may be at risk from exposure to pesticides in
      the manual handling of cultures in greenhouses.

PMID- 11201397
TI  - Spontaneous abortions among veterinarians.
AB  - OBJECTIVES: The objective of the study was to determine whether female
      veterinarians have an increased risk of spontaneous abortion and whether the
      potential risk is related to the type of work veterinarians do. METHODS: The
      investigation was a retrospective cohort study among all the female members of
      the Finnish Veterinary Association (N=549). Information on pregnancies was
      obtained from hospital records from 1973-1990. The risk of spontaneous abortion
      among the veterinarians was compared with that of all other Finnish women and
      other upper-level employees. Odds ratios from logistic regression analyses were
      used as the estimates of the risk ratios. RESULTS: The risk of spontaneous
      abortion was 10.5% for the veterinarians. In the 1970s, practicing veterinarians
      had an increased risk of spontaneous abortion as compared with other Finnish
      women (adjusted odds ratio 1.8, 95% confidence interval 1.0-3.1) or other upper
      level employees (adjusted odds ratio 2.0, 95% confidence interval 1.1-3.4). In
      the 1980s, the risk fell below that of other Finnish women. No essential
      differences were observed in the risk between the veterinarians employed in
      different occupational categories. CONCLUSIONS: The results suggest that the
      veterinarians had an increased risk of spontaneous abortion in the 1970s, but not
      in the 1980s. Factors which might have contributed to this decrease in risk
      include decreases in the prevalence and level of exposure to harmful agents,
      improvements in the occupational hygiene of the work environment, and an
      increased awareness of reproductive hazards and the use of sick leave during
      pregnancy.

PMID- 11201398
TI  - Occupational risk factors for radial tunnel syndrome in industrial workers.
AB  - OBJECTIVES: The aim of the study was to evaluate both nonoccupational and
      occupational factors associated with radial tunnel syndrome (RTS) among
      industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were
      compared with 21 referents matched for gender, age, and plant. RTS was associated
      with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household
      activities, and ergonomic and organizational characteristics of the job were
      analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion
      of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4
      56.9] more than 10 times per hour was the main biomechanical risk factor.
      Prolonged static load applied to the hand during work was strongly associated
      with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0
      45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of
      the elbow, associated with a twisted posture of the forearm, stressed the radial
      nerve at the elbow. However, personal activities, household chores, and sport and
      leisure activities were not associated with RTS. CONCLUSIONS: The study confirms
      that RTS occurs in workers performing hard manual labor that requires forceful
      and repetitive movements involving elbow extension and forearm prosupination.

PMID- 11201399
TI  - Changes in the ocular and nasal signs and symptoms of aircrews in relation to the
      ban on smoking on intercontinental flights.
AB  - OBJECTIVES: This study determined the influence of exposure to environmental
      tobacco smoke (ETS) in aircraft on measured and perceived cabin air quality
      (CAQ), symptoms, tear-film stability, nasal patency, and biomarkers in nasal
      lavage fluid. METHODS: Commercial aircrews underwent a standardized examination,
      including acoustic rhinometry, nasal lavage, and measurement of tear-film break
      up time. Eosinophilic cationic protein, myeloperoxidase, lysozyme, and albumin
      were analyzed in the nasal lavage fluid. Inflight investigations [participation
      rate 98% (N=39)] were performed on board 4 flights, 2 in each direction between
      Scandinavia and Japan. Scandinavian crew on 6 flights from Scandinavia to Japan
      participated in postflight measurements after landing [participation rate 85%
      (N=41)]. Half the flights permitted smoking on board, and the other half, 0.5
      months later, did not. Hygienic measurements showed low relative air humidity on
      board (2-10%) and a carbon dioxide concentration of <1000 ppm during 99.6% of the
      cruising time. RESULTS: The smoking ban caused a drastic reduction of respirable
      particles, from a mean of 66 (SD 56) microg/m3 to 3 (SD 0.8) microg/m3. The
      perceived CAQ was improved, and there were fewer symptoms, particularly ocular
      symptoms, headache and tiredness. Tear-film stability increased, and nasal
      patency was altered. CONCLUSIONS: Despite a high air exchange rate and spatial
      separation between smokers and nonsmokers, smoking in commercial aircraft may
      cause significant air pollution, as indicated by a large increase in respirable
      particles. This ETS exposure is associated with an increase in ocular and general
      symptoms, decreased tear-film stability, and alterations of nasal patency.

PMID- 11201400
TI  - Predictors of first nonfatal occupational injury following employment in a
      Brazilian steelworks.
AB  - OBJECTIVES: This study investigated the influence of sociodemographic and
      occupational factors on the risk of 1st injury among Brazilian steelworkers.
      METHODS: Workers 1st employed between 1 January 1977 and 31 December 1985 and
      still employed on 1 December 1983 were followed from the date of hire until 30
      October 1992. Occupational injuries were ascertained from a database. Kaplan
      Meier curves for time to 1st injury were calculated for the total cohort and for
      different subgroups. A multivariate analysis of risk factors for 1st injury was
      carried out using the Cox proportional hazards regression model. RESULTS: Forty
      one percent of the workers had > or = 1 occupational injuries, and 39% of 1st
      injuries occurred in the 1st year of employment. Lacerations, contusions,
      penetration by foreign bodies, bums, sprains, and fractures constituted the main
      diagnostic groups. Injuries to the hands, eyes, feet, arms, and legs dominated.
      Over 5% of the injured workers were on temporary disability leave (cumulative
      total 10,660 days). The probability for an occupational injury was 16% for the
      1st year, rising to 25% in the 2nd year. The risk of nonfatal injury was highest
      for laborers [hazard ratio (HR) 1.76, 95% confidence interval (95% CI) 1.35-2.29]
      and employees in the steel mill (HR 1.40, 95% CI 1.21-1.63), and inversely
      related to worker age and educational level. The risk of injury decreased
      significantly with calendar period of employment. CONCLUSIONS: Substantial
      reductions in nonfatal injuries may reflect changes in work organization,
      increased automation, and improved safety standards. Knowledge of predictors of
      work-related injury may contribute to injury prevention strategies, especially
      among newly employed workers.

PMID- 11201401
TI  - Cancer-preventive effects of sunscreens are uncertain.
AB  - Provocative findings have been published suggesting that the use of sunscreens
      may promote skin cancer. A recent meeting of international experts on the use of
      sunscreens and skin cancer was held at the International Agency for Research on
      Cancer in Lyon. The workshop concluded that the topical use of sunscreens reduces
      the risk of sunburn and that sunscreens probably prevent squamous-cell carcinoma
      of the skin when used mainly during unintentional sun exposure. No conclusion
      could be drawn about the cancer-preventive activity of topical sunscreens against
      basal-cell carcinoma and cutaneous melanoma. The use of sunscreens can extend the
      duration of intentional sun exposure, such as sunbathing. Such an extension may
      increase the risk for cutaneous melanoma. The workshop warned against relying
      solely on sunscreens for protection from ultraviolet radiation.

PMID- 11201402
TI  - The presence of atypical small acinar proliferation in prostate needle biopsy is
      predictive of carcinoma on subsequent biopsy.
AB  - OBJECTIVE: To determine the clinical significance of nondiagnostic small acini
      showing cellular atypia (atypical small acinar proliferation) in prostatic
      biopsies of patients with clinical findings suggestive of malignancy. PATIENTS
      AND METHODS: Of 331 patients who   underwent thin-core biopsy of the prostate
      over a   30-month period, 21 (6.3%) had atypical   histological features, and of
      these 17 underwent   repeat biopsy. In addition, a further 20 patients   with
      normal histology underwent repeat biopsy for   persistent abnormal clinical
      findings. The   incidence and Gleason score of carcinomas   subsequently
      diagnosed in the two groups were   compared. The predictive significance of
      patient   age, prostate specific antigen (PSA) level and   digital rectal
      examination (DRE) findings were   compared between both patient groups, those in 
      each group subsequently found to have carcinoma,   and between patients with
      malignant or normal   repeat biopsies who had either atypical or normal   initial
      biopsies. RESULTS: Nine patients with atypical histology and   four with normal
      histology on initial biopsy were   found to have carcinoma on subsequent biopsy  
      (P = 0.036). The site of carcinoma diagnosed in   the repeat biopsy frequently
      differed from that of   the initial atypical biopsy. The Gleason primary  
      pattern was not significantly different between the   groups. Neither patient
      age, PSA level nor DRE   findings differed between patients with initial   normal
      or atypical biopsy, or in these groups for   those in whom carcinoma was
      subsequently   diagnosed. These clinical features did not   distinguish between
      those with carcinoma or   normal findings on repeat biopsy who had an   initial
      atypical biopsy, while only PSA level   varied significantly in patients with
      normal or   malignant repeat biopsy in the group with an   initial normal biopsy.
      CONCLUSION: The presence of atypia on initial   biopsy is a strong predictor of
      malignancy in   subsequent biopsy specimens.

PMID- 11201403
TI  - Analysis and modelling of wear of cobalt-chrome alloys in a pin-on-plate test for
      a metal-on-metal total hip replacement.
AB  - The complex interaction between wear and bearing surfaces of two contacting
      solids was investigated in this study, with particular reference to the use of
      metal-on-metal material combinations for artificial hip joint replacements. The
      contact mechanics model was coupled with the wear model and solved simultaneously
      as a function of time for a simple case of a uniaxial pin-on-plate wear test.
      Both a spherical pin and a flat-ended spherical pin were considered. It was shown
      that the contact pressure between the pin and the plate was substantially reduced
      by the wear process, particularly during the initial running-in period and for
      the spherical pin. The theoretical prediction of the worn profiles of the pin and
      the plate was found to be in good agreement with previous experimental
      measurements by Tipper et al. in 1999.

PMID- 11201404
TI  - A hip joint simulator study using new and physiologically scratched femoral heads
      with ultra-high molecular weight polyethylene acetabular cups.
AB  - This study validates a hip joint simulator configuration as compared with other
      machines and clinical wear rates using smooth metal and ceramic femoral heads and
      ultra-high molecular weight polyethylene (UHMWPE) acetabular cups. Secondly the
      wear rate of UHMWPE cups is measured in the simulator with deliberately scratched
      cobalt-chrome heads to represent the type of mild and severe scratch damage found
      on retrieved heads. Finally, the scratching processes are described and the
      resulting scratches compared with those found in retrieved cobalt-chrome heads.
      For smooth cobalt-chrome and zirconia heads the wear rates were found to be
      statistically similar to other simulator machines and within the normal range
      found from clinical studies. An increased wear rate was found with cobalt-chrome
      heads scratched using either the diamond stylus or the bead cobalt-chrome but the
      greatest increase was with the diamond scratched heads which generated scratches
      of similar dimensions to those on retrieved heads. A greater than twofold
      increase in wear rate is reported for these heads when compared with smooth
      heads. This increased wear rate is, however, still within the limits of data from
      clinical wear studies.

PMID- 11201405
TI  - A method for the evaluation of the change in volume of retrieved acetabular cups.
AB  - Studies on retrieved hip prostheses are currently performed in order to assess
      the wear mechanisms and the overall wear rate of such artificial joints. Several
      reported studies on the survival of artificial hips have been based on the
      measurement of the amount of worn material directly on retrieved acetabular cups.
      The estimation of the change in volume, V, of the cup cavity is particularly
      difficult in the case of slight wear due to several factors of which the most
      critical is the lack of information on the unworn geometry of the cup. This paper
      presents a new measuring technique, which is described in detail and has been
      applied to estimate the wear of 65 acetabular cups harvested from revised hip
      arthroplasty. The coordinate data of several points on the articular surface are
      sampled using a coordinate measuring machine (CMM). The value of V is calculated
      mathematically from the measurements by using the hypothesis that the actual
      shape of both slightly worn and highly worn surfaces has a small departure from a
      truly spherical shape. The wear volume is estimated with reasonable accuracy
      mainly on those cups showing penetration depths greater than 0.2 mm,
      corresponding to an amount of wear greater than 100 mm3 for a 32 mm cup. The
      uncertainty in the results is estimated for each cup. The repeatability of the
      technique is studied for a case showing very slight wear. The advantages,
      disadvantages and limitations of the method are presented and discussed.

PMID- 11201406
TI  - An investigation of three-dimensional scanning of human body surfaces and its use
      in the design and manufacture of prostheses.
AB  - The capture of highly accurate data describing the complex surfaces of the human
      body may prove extremely useful in many medical situations. The data provide a
      method of measuring and recording changes to the surface of a patient's soft
      tissue. The data may be applied to computer-controlled manufacturing techniques,
      such as rapid prototyping (RP). This enables accurate physical replicas of the
      patient topography to be produced. Such models may be used as an aid in the
      design and manufacture of prostheses. This paper describes an investigation aimed
      at identifying problems that may be encountered when scanning patients and
      describes the application of the resulting data in the design and manufacture of
      facial prostheses. The results of the experiment are presented together with a
      discussion of the accuracy and potential advantages afforded by this approach.

PMID- 11201407
TI  - Finite element analysis of bone stress and strain around a distal osseointegrated
      implant for prosthetic limb attachment.
AB  - Direct skeletal attachment techniques have recently been identified as an
      alternative method for percutaneous attachment of prosthetic limbs.
      Osseointegrated implants for prosthetic attachments are subjected to a complex
      load condition. This finite element study investigates the effect of varying
      geometries of the implant on the stress and strain distribution in the area of
      the bone/implant interface. Simplified three-dimensional axisymmetric models of
      the femur and seven implants with different core diameters, external diameters,
      implant lengths and thread pitches were derived. The resulting stress and strain
      distributions were compared. The significance of each implant geometry was
      identified for improving implant design in the light of benefit to the
      bone/implant osseointegration and the bone remodelling of the femur.

PMID- 11201408
TI  - The design and testing of a composite lower limb prosthesis.
AB  - In unilateral lower limb prosthetic gait, the intact limb, together with the hip
      on the affected side, strive to compensate for the loss of the missing below-knee
      musculature. The resultant abnormal gait patterns can eventually lead to
      pathologies of the spine and other joints. The aim of this research was to design
      a trans-tibial dynamic elastic response (DER) prosthesis which could simulate the
      power generation and absorption properties of an intact foot and shank segments.
      A carbon fibre sickle-shaped prosthesis was developed in which the strain energy
      from the early part of the stride was stored, and was released again at the point
      of take-off, to simulate the action of the missing musculature. Stress analysis
      techniques were used in the design of the prosthesis, for the purposes of
      computing and maximizing the strain energy of the elements. A force transducer
      was designed into the prosthesis to verify the analysis. Video motion analyses of
      the prosthesis were carried out in order to determine the most appropriate shape
      that would reduce gait asymmetries. The research shows that biomechanical
      techniques, together with good engineering design and the selection of modern
      materials, can lead to a prosthesis which approaches the function of a natural
      foot.

PMID- 11201409
TI  - Pliable polylactide plates for guided bone regeneration: manufacturing and in
      vitro.
AB  - Three different types of pliable and bioabsorbable plates, 0.4 mm thick, were
      developed for guided bone regeneration to cover cranial defects. The processing
      (extrusion, melt-spinning, knitting and heat pressing) and in vitro degradation
      of the materials were studied. Materials used were poly-L,DL-lactide with an L/DL
      ratio of 70/30 (PLA70) and poly-L,D-lactide with an L/D ratio of 96/4 (PLA96).
      The initial tensile strengths of gamma-sterilized PLA96, PLA70 and the PLA70
      PLA96 composite plates were 45.7 +/- 3.8, 51.2 +/- 3.6 and 24.7 +/- 5.1 MPa
      respectively. The composite plates were the stiffest and lasted for more than 24
      weeks. The glass transition temperature (Tg) of both polymers decreased in vitro.
      The crystallinity of PLA96 increased tenfold within 18 weeks. For initially
      amorphous PLA70 the highest melting enthalpy was 89 J/g at 60 weeks. PLA70 became
      partially crystalline and the plates changed from transparent to white and
      swollen. Extrusion and sterilization decreased the initially different molecular
      weight (Mw) values to the same level. After 18 weeks of hydrolysis, Mw was 15,000
      Da for PLA96 and 12,000 Da for PLA70. For the components of the composite plate
      Mw was 15,000 Da for the PLA70 plate and 27,000 Da for the PLA96 mesh.
      Morphologically, all the hydrolysed plates retained, for a long period, a solid
      surface layer under which a porous structure formed. Crystalline branches and
      some single crystals were seen. The composite plates had the slowest degradation
      rate and they remained intact the longest.

PMID- 11201410
TI  - Anisotropic response of the human knee joint meniscus to unconfined compression.
AB  - The response of meniscal tissue to axial, radial and circumferential compressive
      forces was measured at physiologically relevant levels of load in eight pairs of
      human knee joint menisci. Compression was unconfined and uniaxial. Stress strain
      data were fitted to a two-parameter exponential model. The tissue was found to be
      significantly stiffer to axial compressive forces than to radial and
      circumferential forces. No significant difference was found between the responses
      to circumferential and radial forces.

PMID- 11201411
TI  - Glenohumeral contact forces.
AB  - Glenohumeral contact forces have only been calculated previously either for
      simple abduction or for athletic activities. The objective of this study was to
      determine the glenohumeral contact forces for tasks which are demanding of the
      shoulder but which would commonly be performed by older people. The functional
      tasks chosen were using the arms to stand up from and sit down into a chair,
      walking with a cane, lifting a 5 kg box to shoulder height with both hands, and
      lifting a 10 kg suitcase. The trunk angles, arm angles and hand loads of six
      healthy subjects, average age 55 years, were recorded. This information was input
      into a biomechanical computer model which optimized the muscle force distribution
      by minimizing the sum of squared muscle stresses subject to constraints on the
      maximum muscle forces and maintaining the direction of the resultant force within
      the glenoid fossa. Average contact forces ranged from 1.3 to 2.4 times body
      weight (930-1720 N), the highest force being for lifting a suitcase. This latter
      value would be even higher if lifting either a greater load or to a greater
      height. Thus, contact forces at the shoulder should not be underestimated. This
      study provides functionally relevant contact forces which can be used for
      mechanical testing or finite element modelling of shoulder prostheses.

PMID- 11201412
TI  - Development of a computer model to predict pressure generation around hip
      replacement stems.
AB  - Cemented fixation of hip replacements is the elective choice of many orthopaedic
      surgeons. The cement is an acrylic polymer which grouts the prostheses into the
      medullary cavity of the femur. Cement pressure is accepted as a significant
      parameter in determining the strength of cement/bone interfaces and hence
      preventing loosening of the prostheses. The aim of this work was to allow optimal
      design of the intramedullary stem of a hip prosthesis through knowledge of the
      flow characteristics of curing bone cement which can be used to predict pressures
      achieved during insertion of the femoral stem. The viscosity of the cement is a
      vital property determining the cement flow and hence cement interdigitation into
      bone. The apparent viscosities, nu(a), of three commercial bone cements were
      determined with respect to time by extrusion of the curing cement through a
      parallel die of known geometry under selected pressures. Theoretical models were
      developed and implemented in a computer program to describe cement flow in three
      models each of increasing complexity: (a) a simple parallel cylinder, (b) a
      tapered conical mandrel and (c) an actual femoral prosthesis, the latter models
      being complicated by extensional effects as annular areas increase. Predicted
      pressures were close to those measured experimentally, maximum pressures being in
      the range 10-160 kPa which may be compared with a threshold of 76 kPa proposed
      for effective interdigitation with cancellous bone. The theoretical model allows
      the prosthesis/bone geometry of an individual patient to be evaluated in terms of
      probable pressure distributions in the medullary cavity during cemented fixation
      and can guide stem design with reference to preparation of the medullary canal.
      It is proposed that these models may assist retrospective studies of failed
      components and contribute to implant selection, or to making informed selection
      from options in custom hip prosthesis designs to achieve optimum cement
      pressurization.

PMID- 11201413
TI  - Stress distribution in the dento-alveolar system using digital photoelasticity.
AB  - Past research has confirmed that the governing factors in cellular modelling and
      remodelling adhere to sound principles of engineering mechanics. Hence studies of
      stress distributions would provide better understanding of the functional
      adaptation of dental supporting structures. Photoelasticity is an established
      experimental tool to study whole-field stress distribution in structures
      subjected to forces. However, it has certain limitations that make its
      application in biological specimens tedious. In this investigation an advanced
      digital photoelastic system is used to visualize and study the nature of the
      stress distribution in dental supporting structures. These digital fringe
      patterns are analysed using a phase-shift technique. The present biomechanical
      study shows that dental supporting structures exhibit a characteristic stress
      distribution, promoting structural adaptation based on needs. Furthermore, the
      advantage of using a digital image processing system along with the circular
      polariscope is discussed.

PMID- 11201414
TI  - The effects of different wire and screw combinations on the stiffness of a hybrid
      external fixator.
AB  - Hybrid external fixators that use tensioned wires in the metaphysis and screws in
      the diaphysis combine the advantages of both unilateral and circular fixators and
      provide considerable flexibility in frame construction. This study aims to
      determine the effects of wire and screw combinations on the mechanical
      characteristics of such systems. Acrylic rods were used to simulate a long bone
      with a transverse fracture gap. A standard hybrid fixator design was used to
      stabilize the fracture in accordance with modern concepts with wires being used
      on one side of the fracture and screws on the other side. Twelve different wire
      and screw combinations were tested in axial compression and four-point bending in
      two planes. All the fixators tested demonstrated stiffening under increasing
      axial load, the extent of which appeared to correlate inversely with the number
      of wires used. Increasing the number of wires by one increased the axial
      stiffness by 7-16 N/mm (average 11 N/mm). The bending stiffness was largely
      controlled by the number of wires and increased by 0.42-1.03 N m/mm (average 0.74
      N m/mm) for each additional wire. The axial stiffness of fixators with three
      screws was 4-7 N/mm (average 6 N/mm) higher than those with two screws if the
      offset screw was not in use. When the offset screw was used no stiffness
      advantages were found for three screws over two screws. The use of an offset
      screw substantially increased axial stiffness (by 12-26 N/mm, average 20 N/mm)
      and is recommended for unstable fractures. The two-ring hybrid fixators with four
      wires in one ring and three screws in the other had stiffness characteristics
      similar to the conventional four-ring Ilizarov fixator. Knowledge gained
      regarding the effects of wire and screw combinations on overall stiffness will be
      helpful both in the construction of frames and in destabilization during fracture
      healing.

PMID- 11201415
TI  - Characterization of vortices using pulsed-wave Doppler ultrasound.
AB  - The detection and characterization of vortices from a Kaman vortex generator by
      means of a 20 MHz pulsed-wave Doppler ultrasound system were assessed.
      Measurements were made at different steady flowrates in a 10 mm internal diameter
      polyurethane tube, 14 mm distal to a circular cylinder of diameter 2 mm, placed
      across the tube inlet. The results were compared with those obtained with a two
      component laser Doppler anemometer system. There was generally good agreement
      between the two techniques in the measurement of convective flow velocity,
      frequency of vortex shedding and the circulation velocity of the vortices. It is
      concluded that pulsed-wave Doppler ultrasound is a suitable technique for
      investigating vortical flow structures.

PMID- 11201416
TI  - Friction in orthopaedic zirconia taper assemblies.
AB  - The torque resistance of zirconia ceramic heads/titanium taper trunnion junctions
      was tested in accordance with ISO 7206-9:1994(E); using twelve modified heads of
      32 mm diameter under representative physiological conditions. Test parameters
      studied included assembly force, vertical load during test (test load) and head
      length. Mean torque resistances measured were 8.9 N m for a 1 kN test load and 15
      N m at 4 kN test load. Coefficients of friction calculated for the torsional
      stability ranged from 0.06 to greater than 1.0. Multiple regression analysis
      confirmed that the failure torques measured were significantly dependent on test
      load (beta = 0.77; P < 0.001) whereas assembly force and head length played a
      lesser, insignificant, part in the variation. Data from push-on/pull-off tests
      were used to calculate coefficients of friction under axial loading, which were
      significantly correlated with taper angle and material. Torque testing shows
      greater variability than push-on/pull-off tests for similar combinations, and for
      zirconia heads on other tapers. The coefficients of friction measured (0.16-0.31)
      are significantly different from values typically used in stress analyses.

PMID- 11201417
TI  - Independent ambulators with high sacral myelomeningocele: the relation between
      walking kinematics and energy consumption.
AB  - The aims of this study were to determine the relation between gait kinematics
      (center of mass excursions) and measures of oxygen consumption and oxygen cost.
      Fourteen independent ambulating children with myelomeningocele (nine females,
      five males; mean age 8 years 7 months) and thirteen children with no history of
      neuromuscular disorder were evaluated. At their comfortable walking speed all
      patients exhibited oxygen cost and oxygen consumption values that exceeded the
      normal level by more than 1 SD. Pelvic obliquity demonstrated the strongest
      relation with oxygen cost which suggests that ultimately hip abductor strength
      may play a key role in energy demands during gait. Despite the exaggerated pelvic
      kinematics, vertical and horizontal center of mass excursions of the trunk and
      whole-body during the gait cycle were not significantly greater than normal
      (p>0.05). Decreased self-selected walking velocity at which many of these
      children consider comfortable and stable may be predicated on an optimal center
      of mass movement that approximates the magnitude observed in normal gait. The
      slower walking velocity decreases walking efficiency. Conversely, the increased
      center of mass movement that would accompany a faster gait would probably impose
      intolerable oxygen consumption levels. Strengthening programs that focus on the
      gluteus medius and maximus to decrease compensatory trunk and pelvic motions,
      allowing the patients to adopt a faster gait without exacerbating kinematic and
      center of mass motions and which enabled more efficient walking hold promise for
      these patients.

PMID- 11201418
TI  - Developmental patterns of rhythmic suck and swallow in preterm infants.
AB  - Twenty healthy preterm infants (gestational age 26 to 33 weeks, postmenstrual age
      [PMA] 32.1 to 39.6 weeks, postnatal age [PNA] 2.0 to 11.6 weeks) were studied
      weekly from initiation of bottle feeding until discharge, with simultaneous
      digital recordings of pharyngeal and nipple (teat) pressure and nasal thermistor
      and thoracic strain gauge readings. The percentage of sucks aggregated into
      'runs' (defined as > or = 3 sucks with < or = 2 seconds between suck peaks)
      increased over time and correlated significantly with PMA (r=0.601, p<0.001). The
      length of the sucking-runs also correlated significantly with PMA (r=0.613,
      p<0.001). The stability of sucking rhythm, defined as a function of the mean/SD
      of the suck interval, was also directly correlated with increasing PMA (r=0.503,
      p=0.002), as was increasing suck rate (r=0.379, p<0.03). None of these measures
      was correlated with PNA. Similarly, increasing PMA, but not PNA, correlated with
      a higher percentage of swallows in runs (r=0.364, p<0.03). Stability of swallow
      rhythm did not change significantly from 32 to 40 weeks' PMA. In low-risk preterm
      infants, increasing PMA is correlated with a faster and more stable sucking
      rhythm and with increasing organization into longer suck and swallow runs. Stable
      swallow rhythm appears to be established earlier than suck rhythm. The fact that
      PMA is a better predictor than PNA of these patterns lends support to the concept
      that these patterns are innate rather than learned behaviors. Quantitative
      assessment of the stability of suck and swallow rhythms in preterm infants may
      allow prediction of subsequent feeding dysfunction as well as more general
      underlying neurological impairment. Knowledge of the normal ontogeny of the
      rhythms of suck and swallow may also enable us to differentiate immature (but
      normal) feeding patterns in preterm infants from dysmature (abnormal) patterns,
      allowing more appropriate intervention measures.

PMID- 11201419
TI  - Contact and nutrient caregiving effects on newborn infant pain responses.
AB  - To understand how the 'caregiving context' could affect responses to procedural
      pain, the authors sought to determine whether (1) the combined effects of sweet
      taste and holding (caregiving contact) were greater than the effects of either
      alone, (2) any combined effects were additive or interactive, and (3) the
      interventions had similar effects on behavioral (crying and facial activity) and
      physiological (heart rate, vagal tone) responses to the heel-stick procedure in
      newborn infants in a randomized two-factorial intervention trial. Eighty-five
      normally developing newborn infants were studied with a mean gestational age of
      39.4 weeks on the 2nd or 3rd day of life. Infants were randomized in blocks of
      eight to receive (1) no holding and water taste (control participants), (2) no
      holding and sucrose taste (sucrose group), (3) holding and water taste (holding
      group), or (4) holding and sucrose taste (holding and sucrose group). Crying was
      reduced significantly by taste and holding, and the interventions combined
      additively. Facial activity was only significantly reduced by holding. For
      physiological measures, the interventions interacted with each other and
      preintervention levels to reduce heart rate and lower vagal tone more during the
      procedure in infants in whom heart rate and vagal tone were higher before
      intervention. Consequently, sweet taste and holding interventions combined in
      complex ways when acting on different behavioral and physiological response
      systems to modify stressful pain experiences. The results suggest that providing
      a caregiving context when painful procedures are performed may be a simple and
      practical method of reducing pain experience in infants, and that no one measure
      captures these effects.

PMID- 11201420
TI  - Does 'therapy' have a future?

PMID- 11201421
TI  - Feeding problems in Silver-Russell syndrome.
AB  - In order to identify the prevalence and severity of feeding problems in children
      with Silver-Russell syndrome (SRS) the feeding difficulties of 32 children with
      SRS and 32 age- and sex-matched control children were assessed using the Feeding
      Assessment Questionnaire (Harris and Booth 1992). Children's ages ranged from 2
      to 11 years, with 19 male and 13 female pairs. In a subset of matched pairs,
      parent-child interaction at mealtimes was examined using video recording; food
      intake was also assessed over a 3-day period using weighed food diaries. Children
      with SRS experienced significantly more feeding problems than children without
      growth disorders. Common feeding problems for children with SRS were poor
      appetite, fussiness, slow feeding, and problems associated with oral-motor
      dysfunction. Feeding problems did not significantly affect intake of
      kilocalories, protein, fat, or carbohydrates. Mealtime interaction between
      children with SRS and their parents was significantly more negative than
      interactions between control-group children and their parents. The focus of
      intervention packages in SRS should be to reduce negative parent-child
      interactions and reduce parental anxiety about feeding, growth, and weight.

PMID- 11201422
TI  - Randomized controlled trial of physiotherapy in 56 children with cerebral palsy
      followed for 18 months.
AB  - This study aimed to determine whether motor function and performance is better
      enhanced by intensive physiotherapy or collaborative goal-setting in children
      with cerebral palsy (CP). Participants were a convenience sample of 56 children
      with bilateral CP classified at level III or below on the Gross Motor Function
      Classification System (GMFCS), aged between 3 and 12 years. A 2 x 2 factorial
      design was used to compare the effects of routine amounts of physiotherapy with
      intensive amounts, and to compare the use of generalized aims set by the child's
      physiotherapist with the use of specific, measurable goals negotiated by the
      child's physiotherapist with each child, carer, and teacher. Following the six
      month treatment period there was a further six-month period of observation.
      Changes in motor function and performance were assessed by a masked assessor
      using the Gross Motor Function Measure (GMFM) and the Gross Motor Performance
      Measure (GMPM) at three-month intervals. There was no statistically significant
      difference in the scores achieved between intensive and routine amounts of
      therapy or between aim-directed and goal-directed therapy in either function or
      performance. Inclusion of additional covariates of age and severity levels showed
      a trend towards a statistically significant difference in children receiving
      intensive therapy during the treatment period. This advantage declined over the
      subsequent six months during which therapy had reverted to its usual amount.
      Differences in goal-setting procedures did not produce any detectable effect on
      the acquisition of gross motor function or performance.

PMID- 11201423
TI  - Classification criteria and distinction between migraine and tension-type
      headache in children.
AB  - The International Headache Society (IHS) classification system (1988) was
      developed primarily for headache disorders in adults and its validity for
      paediatric age is currently under discussion; in 1995 Seshia et al. proposed a
      revision of the criteria for migraine without aura to make diagnostic criteria
      more applicable to children. The purposes of the current study were to: (1)
      compare the IHS classification with the Seshia proposal, (2) compare the children
      affected by migraine without aura (MO) with the children affected by tension
      headache (TH) as defined by Seshia, for characteristics which are not included in
      the classification. The patients are a series of 320 children (mean age 9.9, SD
      2.6 years; 144 males, 176 females) with recurrent or chronic headaches referred
      to a headache clinic in Milan, Italy. Using the Seshia criteria instead of the
      IHS criteria a higher number of children were included in the MO category:
      bilateral pain and family history of migraine were the most important factors
      which allowed a shift of children into this category. However, with the Seshia
      classification there was no reduction in the number of unclassifiable children.
      The reason why some children could not be classified was a short duration of
      attacks; the majority of unclassifiable children were 6 years old or less. No
      relevant difference was found between children with MO and children with TH for
      the following variables: occurrence of attacks in the afternoon or evening after
      school, reduction of attacks during school holidays, full-time schooling, after
      school activities on school days, disordered daily life. On the contrary children
      with MO when compared with those with TH showed a higher number of precipitating
      factors and for the following factors a significant difference was found:
      exposure to TV or a computer, sleep deficiency, and strong emotions. Furthermore,
      children with MO showed a greater severity of attacks.

PMID- 11201424
TI  - Brain injuries in early foetal life: consequences for brain development.
AB  - Learning disability and cerebral palsy are often related to factors present
      before birth. We report three patients (two with schizencephaly, one with
      unilateral cerebellar agenesis) in whom the timing of an insult to the foetus was
      known. In the first case, the mother had a trauma at 16 weeks of pregnancy and
      schizencephaly was discovered in the male infant associated with a left
      hemiplegia. In the second child, amniocentesis performed at 16 weeks into
      pregnancy may have been responsible for the same cortical anomaly. In the third
      case, sequential foetal echographies clearly demonstrated that an apparent
      unilateral cerebellar agenesis was related to an haemorrhagic event secondary to
      cerebellar trauma that occurred at 19 weeks of pregnancy. It is suggested that
      these brain malformations are related to an ischemic mechanism or a traumatic
      event in foetal life.

PMID- 11201425
TI  - Recent advances in cortical visual impairment.

PMID- 11201426
TI  - Intrauterine growth retardation, general movements, and neurodevelopmental
      outcome: a review.

PMID- 11201427
TI  - Guillain-Barre syndrome: a patient's experience.

PMID- 11201428
TI  - Self-esteem in children with physical disabilities.

PMID- 11201429
TI  - Analysis of psychomotor development of ten children with Moebuis syndrome.

PMID- 11201431
TI  - Potential of hazelnut husks as a broiler litter material.
AB  - 1. Hazelnut husks and some other litter materials were compared for litter
      properties and their effects on broiler performance. 2. A total of 750 1-d-old
      broiler chicks were weighed and assigned at random to 1 of 5 treatments, with
      each treatment replicated 3 times. 3. The treatments were wood shavings
      (control), wheat stalks, rice hulls, hazelnut husks, and a mixture of 50% rice
      hulls and 50% hazelnut husks. 4. Although hazelnut husks were associated with
      lower body weights at 49 d of age, food efficiency mortality, carcase yield,
      breast blisters and production index were similar to birds on wood shavings.
      Hazelnut husks had the highest litter moisture. 5. The results show that hazelnut
      husks alone and when mixed with rice hulls are a potential alternative litter
      material for broiler production.

PMID- 11201430
TI  - Long term dynamics of dermanyssus gallinae in relation to mite control measures
      in aviary systems for layers.
AB  - 1. The dynamics of the poultry red mite, Dermanyssus gallinae, in aviary systems
      for layers were studied in an empirical study in Sweden between 1994 and 1997.
      Fluctuations were monitored with mite traps at monthly intervals during 3 laying
      cycles at each of 2 commercial poultry farms. 2. When mites were first detected
      in the system it then took about 5 months for the populations to reach
      equilibrium levels around which they fluctuated. Within flocks when the
      population growth was unaffected by temporary control activities, it was
      demonstrated that the mite populations were significantly denser in summer than
      in winter. 3. Current control methods had limited effects as mite populations
      were only temporarily suppressed. One exception was the control achieved with
      permethrin impregnated plastic strips, which reduced the population at
      equilibrium level to approximately 22%, compared with the previous flock. 4. The
      distribution of mites was patchy horizontally, along the aviary system, at low
      burden wlhereas it became more evenly dispersed at equilibrium. 5. Significant
      differences in vertical mite distributions that correlated with the hybrids used
      and their rearing conditions were also observed. In flocks with brown hens, mites
      gathered at the lower tiers, whereas they were found at the highest tiers in
      association with white hens. As the hens are attacked mainly at night-time the
      most likely explanation is that the mites adjust their behavioural pattern to the
      birds' roosting behaviour.

PMID- 11201432
TI  - Small intestinal development in the young chick: crypt formation and enterocyte
      proliferation and migration.
AB  - 1. Post-natch mucosal development was examined in the chick small intestinal
      epithelium using immunostaining with proliferating cell nuclear antigen (PCNA)
      and 5-bromo-2-deoxyuridine (BrdU). 2. On the day of hatching jejunal crypts were
      small and a single crypt per villus was observed. However, during the 108 h post
      hatch crypts developed rapidly branching and increasing in size, cell numbers and
      cell size. 3. Almost all epithelial cells in the small intestine of the hatching
      chick were proliferating, as indicated by PCNA and BrdU, while more than 80% of
      proliferating cells were localised in the crypts after 108 h post hatch. 4.
      Estimate of villus cell transit time using BrdU was only possible from 48 h post
      hatch when villus transit time was 72 h in the jejunum, whereas at 336 h transit
      time was 96 h. 5. In the 108 h post hatch a rapid transition occurs from total
      jejunal epithelial cell proliferation and immature crypts to a defined
      proliferative zone in the crypts, with constant division and migration.

PMID- 11201433
TI  - Genetic effects of ageing on fertility and hatchability in the first laying cycle
      of three white leghorn strains and their two-way crosses.
AB  - 1. Fertility and hatchability of 3 White Leghorn strains and their 2-way crosses
      were examined in the 1st laying cycle to evaluate the effects of ageing on mean
      heterosis, reciprocal effects, additive (A), Z-chromosomne (Z) and heterotic
      effects (H), as well as on their variances. 2. Fertility and hatchability were
      evaluated at 37, 47 and 70 weeks of age for hens housed 1 per cage in a
      randomised block design. The mean heterosis was significant over time and
      increased with advancing age for both traits. Reciprocal effects were not
      significant across periods and did not show a consistent trend with age. 3. The
      pattern of age changes in A, Z and H effects varied among strains, indicating
      genotypic differences in response to ageing. The additive, heterotic,
      environmental and phenotypic variances increased at the end of the cycle for both
      traits, except for the additive variance of hatchability, which increased until
      47 weeks of age but declined thereafter. 4. Heritability increased with age for
      fertility but did not show a consistent pattern across the cycle for
      hatchability. Genetic variance for fertility and hatchability increased at the
      end of the cycle, stggesting that improvement in performance during the 1st
      production cycle of layers could be achieved by selecting animals at older ages.

PMID- 11201434
TI  - Effects of divergent selection for incidence of tibial dyschondroplasia (TD) on
      purebred and crossbred performance. 1. TD incidence and calcium and phosphorus
      plasma concentrations.
AB  - 1. The effect of divergent selection for high (H) or low (L) incidence of tibial
      dyschondroplasia (TD) for 7 generations on blood calcium (Ca) and phosphorus (P)
      concentrations was studied. 2. The chicks used in this experiment were obtained
      from diallel crosses between H and L lines to obtain HH, HL, LH, and LL lines. A
      random-bred control (CC) line was also used. 3. The chicks were reared under
      standard management conditions. Body weight and plasma Ca and P concentrations
      were measured at 2, 4, and 7 weeks of age. Incidence of TD was recorded at 4 and
      7 weeks. 4. Although HH birds had lower body weights than the other lines, there
      was no significant effect attributable to line selection for body weight at 2, 4,
      and 7 weeks of age. 5. The LL line birds had no incidence of TD at 4 weeks of
      age; however, the incidence of TD in LL line birds was 5.3% at 7 weeks of age.
      The incidence of TD was higher in HH line birds than the other line at 4 and 7
      weeks of age. 6. Plasma Ca and P concentrations and Ca:P ratios increased with
      age. These results showed that HH line birds had higher plasma Ca, lower plasma P
      and higher Ca:P ratios than birds of the LL line.

PMID- 11201435
TI  - Effects of divergent selection for incidence of tibial dyschondroplasia (TD) on
      purebred and crossbred performance. 2. Processing yield.
AB  - 1. An experiment was conducted to determine the effect of selection for high (H)
      or low (L) incidence of tibial dyschondroplasia for 7 generations on processing
      performance of broilers. 2. Birds were obtained from diallel matings of the H and
      L lines (HH, HL, LH, and LL) and a randombred control (CC) line. Birds were
      reared to 7 weeks of age under standard management conditions. All birds were
      processed at 7 weeks of age. Body weight at 7 weeks, carcase weight, and carcase
      part weights were recorded on each bird. 3. An interaction between sire line and
      dam line was caused by lighter body and carcase weight at 7 weeks of age in HH
      birds than from the birds of the other crosses. 4. Birds by L line dams had
      heavier drumstick weights. The influences of sire line and dam line on weight of
      total breast muscle were not significant. Thigh weights and Pectoralis minor
      weights were lighter in HH line birds than those other matings. 5. Heterosis for
      body weight and for weights of carcases, drumstick and thigh was negative. Total
      breast muscle weight and P. major weight did not show significant heterosis. 6.
      It was concluded that selecting against TD does not reduce processing yield of
      broilers.

PMID- 11201436
TI  - Myofibre composition and total collagen content in M. iliotibialis lateralis and
      M. pectoralis of Silkie and White Leghorn chickens.
AB  - 1. Using adult Silkie and White Leghorn (WL) chickens, fibre composition and
      total collagen content were compared between M. iliolibialis lateralis (ITL) and
      M. pectoralis (PT). 2. Fibres were divided into type IIR and IIW showing strong
      and weak reduced nicotinamide adenine dinucleotide dehydrogenase activities,
      respectively. 3. Fibre composition differed markedly between ITL and PT muscle.
      ITL muscle was composed of both types IIR and IIW fibre but PT muscle of only
      type IIW Breed difference on composition was noted only in ITL muscle of cocks
      (type IIR; Silkie 53.8% and WL 37.0%). 4. Total collagen content was greater in
      ITL muscles and in cocks in both muscles. However, a breed difference was
      observed only in the PT muscle of hens. 5. In conclusion, the total collagen
      content was affected by muscle location within the body and by sex rather than by
      fibre composition.

PMID- 11201437
TI  - Investigation of hygiene aspects during air chilling of poultry carcases using a
      model rig.
AB  - 1. An experimental rig, designed and built to simulate conditions found in
      commercial poultry chilling systems, was used to investigate the effects of
      varying air temperature and chilling duration, and the effect of chlorinated
      water sprays, on the microbial load present on the skin and in the body cavity of
      freshly eviscerated poultry carcases; deep muscle and skin temperatures were
      monitored during chilling at three different temperatures. 2. During dry chilling
      for 2 h, total viable microbe counts (TVC) and counts of coliforms and
      pseudomonads from the body cavity fell by between half and one log unit; smaller
      reductions were observed in samples from the breast skin. 3. The situation
      changed when chlorinated water sprays (50, 100 or 250 ppm available chlorine)
      were applied for the first hour of chilling; spraying carcases enhanced the
      reduction in numbers on the skin; the effect was most pronounced with 250 ppm
      chlorine; conversely in the body cavity, the general effects of sprays was to
      increase contamination by up to one log unit. 4. There was no evidence that
      sprays increased the rate of chilling. 5. When carcases were held overnight in
      the rig at 11 degrees C after chilling, microbe counts on dry-chilled carcases
      remained stable, but increased on carcases that had been sprayed with chlorinated
      water.

PMID- 11201438
TI  - Ultrastructural analysis of the eggshell: contribution of the individual
      calcified layers and the cuticle to hatchability and egg viability in broiler
      breeders.
AB  - 1. Scanning electron microscopy was used to assess the relationship between the
      layers of the eggshell and egg viability. The relative thickness (absolute and %)
      of the mammillary, palisade, vertical crystal and cuticle layers relative to the
      total eggshell were measured over a 30-week laying period in 2 broiler breeder
      lines having different hatchability rates. 2. A significant difference in
      hatchability of 5.5% between the breeder lines was observed. However, there was
      no significant difference in either egg viability or fertility between lines. 3.
      The relative thickness of the individual calcified layers and the cuticle did not
      differ between lines. Therefore, variations in the thickness of the individual
      eggshell layers are unlikely to explain the 5.5% difference in hatchability rate
      between lines. 4. The thickness of the calcified region did not alter as the
      broiler hen aged. However, the percent contribution of each calcified layer
      significantly differed over the egg production period. 5. The cuticle was
      significantly thinner at the beginning and at the end of the laying period
      compared to 38 weeks of age. 6. No significant correlation was observed between
      egg viability and the relative thicknesses of the mamillary, palisade or cuticle
      layers. In contrast, there was a positive relationship between egg viability and
      the thickness of the vertical crystal layer. 7. The percent contribution of the
      mammillary and palisade layers was similar in the thinnest and thickest
      eggshells, suggesting conservation of the proportions of these layers independent
      of eggshell thickness.

PMID- 11201439
TI  - Growth performance and immune response of two commercial broiler strains fed
      diets containing Lactobacillus cultures and oxytetracycline under heat stress
      conditions.
AB  - 1. Hubbard x Hubbard (HH) and Shaver x Shaver (SS) chicks given a dietary
      supplement of either 50 mg/kg oxytetracycline (OTC) or 1 g/kg Lactobacillus
      culture (LC) were exposed to 36 +/- 1 degrees C for 3 h daily from day (d) 21 to
      42. 2. Prior to heat treatment, body weight (d 21) and weight gain (d 1 to d 21)
      of OTC and LC birds were greater than those fed the control diet. Chicks given LC
      had the best food efficiency followed by OTC and control birds during d 1 to d
      21. Body weight (d 1 and d 21) and weight gain (d 1 to d 21) were greater for HH
      tlhan SS chicks. 3. After 3 weeks of heat exposure, birds receiving the LC diet
      had greater body weight and weight gain, higher food intake and lower food
      efficiency than OTC and control chicks. 4. Antibody production against Newcastle
      discase vaccine on d 21 was not affected by strain or diet. On d 42, while diet
      had negligible effect on this variable among the SS broilers, HH birds fed LC had
      higher antibody production than those on the control diet. 5. Neither strain nor
      diet had a significant effect on mortality.

PMID- 11201440
TI  - Effect of excess dietary sodium, potassium, calcium and phosphorus on excreta
      moisture of laying hens.
AB  - 1. Four experiments were conducted to investigate the effects of dietary
      concentrations of sodium, potassium, calcium or phosphate on the water intake and
      excreta moisture of laying hens. A fifth experiment examined the effect on these
      variables of increasing amounts of 2 different sodium salts (chloride or
      bicarbonate) and the interactions with 2 levels of dietary phosphorus. 2. All
      experiments involved individually caged laying hens fed on diets varying in 1 or
      2 minerals in replacement for washed sand. The experimental diets contained
      mineral concentrations that either met or exceeded the expected requirement of
      the hens. The diets were given for a 7 or 8 d feeding period and food and water
      intakes were measured and excreta were collected for the last 48 h of each
      feeding period. These data were corrected for evaporative water loss to the
      environment during the collection period. 3. Increasing dietary concentrations of
      sodium, potassium or phosphorus gave linear increases (P<0.001) in the water
      intake of the laying hens and linear increases (P<0.01) in the moisture content
      of their excreta. Each 1 g/kg increase in dietary mineral increased the moisture
      content of the excreta by 9.04 (+/- 1.57), 11.95 (+/- 2.02) and 5.59 (+/- 0.31)
      g/kg (+/- standard error) for sodium, potassium and phosphorus, respectively.
      Increasing concentrations of dietary calcium did not significantly affect the
      water intakes or excreta moisture levels of the laying hens. 4. The fifth
      experiment showed that, although there was a sodium x phosphorus interaction
      (P<0.05), the effects of the 2 mineral additions were approximately additive.
      There were no significant differences (P>0.05) in water intakes or excreta
      moisture contents due to the 2 different sodium salts (chloride or bicarbonate).

PMID- 11201441
TI  - Influence of dietary fat source and copper supplementation on broiler
      performance, fatty acid profile of meat and depot fat, and on cholesterol content
      in meat.
AB  - 1. Three hundred and twenty d-old chickens were fed on a wheat/maize-soyabean
      meal diet supplemented with (i) 50 g/kg lard, (ii) 25 g/kg lard and 25 g/kg
      rapeseed oil, (iii) 50 g/kg rapeseed oil, and (iv) 50 g/kg rapeseed oil and 200
      mg copper per kg as copper sulphate pentahydrate. 2. Final weights at 39 d of age
      in chickens receiving rapeseed oil were lower by 9% than in those fed on the diet
      containing only lard (P<0.05). The fatty acids profiles of lipids extracted from
      the tissues of 10 chickens per group reflected those of the diets. 3. The
      polyunsaturated fatty acid (PUFA) content of breast muscles and abdominal fat
      (expressed as a percentage of total fatty acids) was increased and the ratio of n
      6:n-3 fatty acids was decreased by the substitution of lard by rapeseed oil
      (P<0.001). These changes were more pronounced for the adipose tissue than for
      breast muscles. 4. Copper sulphate supplementation increased the final body
      weight of chickens by 4.3% (P<0.05), reduced the saturated fatty acid (SFA)
      proportion (P<0.05) in abdominal fat and increased the PUFA:SFA ratio (P<0.05).
      The magnitude of improvement, however, was small. 5. The substitution of rapeseed
      oil for lard decreased the concentration of cholesterol in breast muscles by 13%.
      Copper supplementation further reduced the cholesterol content by 25%. Both
      effects were significant (P<0.001).

PMID- 11201442
TI  - Effect of age of turkeys on the metabolisable energy of different foodstuffs.
AB  - 1. True metabolisable energy (TME) of various foodstuffs were determined in
      turkeys at 3, 9 and 17 weeks of age. 2. TME of soyabean meal did not change with
      age but TME of wheat and maize was 13% higher in 17-week-old turkeys than in 3-
      and 9-week-old birds. 3. These differences should be taken into account when
      formulating diets for turkeys.

PMID- 11201443
TI  - Enzymes (beta-glucanase and arabinoxylanase) and/or sepiolite supplementation and
      the nutritive value of maize-barley-wheat based diets for broiler chickens.
AB  - 1. Two experiments were conducted to study the effects of crude enzyme
      preparations (beta-glucanase and arabinoxylanase) and/or 20 g/kg Sepiolite (Exal)
      on the performance and nutrient digestion of broiler chickens fed on maize-barley
      wheat based diets. 2. In experiment 1, enzymes improved daily bodyweight gain (by
      14%; P<0.001) and food:gain ratios (8%; P<0.001). Sepiolite improved bodyweight
      gain on the diets not supplemented simultaneously with enzymes (by 6% in 21-d-old
      chickens, P<0.05) but reduced it for enzymes-supplemeented diets. Changes in
      productive perfiormance with both additives were associated with changes in diet
      digestibility and nitrogen balance. 3. In experiment 2, enzyme supplementation
      reduced viscosity in jejunum and ileum and the mean retention time of digesta in
      the gut. Sepiolite inclusion significantly reduced the viscosity of jejunum
      digesta and modified the retention times of digesta in the gut, depending upon
      whether enzymes had been added. There was a decreased retention time without
      enzymes but an increase with enzyme supplementation. 4. Although different
      mechanisms are presumed for enzymes and sepiolite, both seem to counteract the
      negative effects of soluble, non-starch polysaccharides (NSP) in the diet by
      modifying jejunal viscosity and improving organic matter digestibility.

PMID- 11201444
TI  - True metabolisable energy, heat increment and net energy values of two high fibre
      foodstuffs in cockerels.
AB  - 1. The yields of true metabolisable energy (TME) and net energy (NE) from chaya
      leaf meal and wheatfeed were mcasured in tube-fed cockerels. 2. TME, 5.76 MJ/kg,
      from chava leaf meal was lower than from wheatfeed, 8.39 MJ/kg. The total heat
      increment attributable to the feeding of chaya leaf meal was 1-7 times greater
      than that of wheatfeed. 3. The net efficiency of utilisation of ME (k) from chaya
      leaf meal was 0.64, while that from wheatfeed was 0.86. The role of different
      chemical composition, especially the high fibre content of the materials, is
      discussed. 4. The metabolisable energy and net energy values derived from chava
      leaf meal represented 0.34 and 0.23 respectively of its gross energy content. The
      combination of lower TME and lower net efficiency of utilisation led to chaya
      having a NE value, 3.86 MJ/kg, which was only 0.53 that of wheatfeed.

PMID- 11201445
TI  - The effects of tannins on nutrient utilisation in the White Pekin duck.
AB  - 1. Two experiments were conducted to determine the effects of tannins on nutrient
      utilisation in the White Pekin duck. 2. Experiment 1 was a rapid nutrient balance
      assay to determine the nitrogen (N) retention and metabolisable energy (ME) of
      maize, low-tannin sorghum (P-954063) (Sorghum bicolor (L). Moench) and high
      tannin sorghum (IS-4225) cultivars for ducks. The assay lasted 120 h, with an
      initial 24 h food-deprivation period, a 48 h excreta collection period for
      endogenous losses and a 48 h excreta collection period for ingredient losses. The
      true metabolisable energy (TMEn) content was lower (P<0.05) in the high-tannin
      sorghum cultivar (13.85 MJ/kg) than the maize (14.94 MJ/kg) and the low-tannin
      sorghum cultivar (14.39 MJ/kg). True N retention was lower (P<0.05) for the high
      tannin sorghum (0.24 g) than for maize (1.33 g) and low-tannin sorghum (1.1 g).
      3. In experiment 2, the brush-border membrane vesicles technique was used to
      determine whether tannic acid caused inhibition of L-threonine transport across
      duck intestinal brush-border membrane. The brush-border membrane vesicles were
      mixed with tannic acid solutions (pH 7.4) to give gradient tannic acid
      concentrations of 0, 0.05, 0.10, 0.25, 0.50, 1.00 and 2.50%. As a fraction of the
      control (no tannic acid), the maximal inhibition of L-threonine transport (Imax)
      under the sodium-gradient condition was 77.10% (P<0.05). Under the sodium-free
      condition, the maximal inhibition of L-threonine transport (Imax) was 45.15%
      (P<0.05). 4. These results demonstrated that nutrient utilisation in the White
      Pekin duck was lower from the high-tannin sorghum cultivar than from the low
      tannin sorghum cultivar. The results also suggested that the antinutritive
      effects of tannins in foodstuffs are due partly to their inhibitory action on
      intestinal brush-border bound amino acid transporter proteins.

PMID- 11201447
TI  - Modelling the static and dynamic responses of total heat production of broiler
      chickens to step changes in air temperature and light intensity.
AB  - 1. The objective of this work was to explore the possibilities of modelling the
      static and dynamic responses of total heat production of broiler chickens to step
      changes in temperature and light intensity (light-dark alterations) using compact
      dynamic model structures. 2. Seventy-seven experiments were performed in an open
      circuit respiration chamber to measure the dynamic response of heat production to
      step variations in temperature and light (on/off). The animal responses were
      modelled using transfer function model structures. 3. It was demonstrated that
      the complex process of the dynamic response of heat production of broiler
      chickens to step changes in air temperature and light-dark alterations can be
      modelled assuming 1st order dynamics. The coefficient of determination between
      measured and simulated heat production was on average 0.83 for responses to air
      temperature and 0.93 for responses to light-dark alterations.

PMID- 11201446
TI  - Influence of esterified-glucomannan on performance and organ morphology, serum
      biochemistry and haematology in broilers exposed to individual and combined
      mycotoxicosis (aflatoxin, ochratoxin and T-2 toxin).
AB  - 1. A study was conducted to evaluate the individual and combined effects of
      aflatoxin B1 (AF), ochratoxin A (OA) and T-2 toxin (T-2) on performance, organ
      morphology serum biochemistry and haematology of broiler chickens and the
      efficacy of esterified-glucomannan (E-GM), a cell wall derivative of
      Saccharomyces cerevisiae1026 in their counteraction. 2. Two dietary inclusion
      rates of AF (0 and 0.3 mg/kg), OA (0 and 2 mg/kg), T-2 (0 and 3 mg/kg) and E-GM
      (0 and 1 g/kg) were tested in a 2 x 2 x 2 x 2 factorial manner on a total of 960
      broiler chickens from 1 to 35 d of age in an open sided deep litter pen house. 3.
      Body weight and food intake were depressed by all the mycotoxins, OA being the
      most toxic during early life. 4. Weights of kidney and adrenals were increased by
      AF and OA. Liver weight was increased by AF (17.8%), while OA increased gizzard
      weight (14.6%) and reduced bone ash content (8.1%). T-2 toxin showed no effect on
      these variables. 5. Serum cholesterol content was decreased and activity of serum
      gamma glutamyl transferase (GGT) was increased by AF and OA while serum protein
      content was decreased by AF. These effects were more pronounced at 21 d than at
      35 d of age. Inconsistent responses were seen in the other variables: blood urea
      nitrogen (BUN) content, activities of serum alanine amino transferase and
      aspertate amino transferase. Blood haemoglobin content was depressed by AF and T
      2, whereas blood coagulation time was prolonged by OA. 6. Significant
      interactions were observed between any 2 toxins for their additive effects on
      body weight, food intake, bone ash content and serum GGT activity at 21 d.
      Conversely, antagonistic interactions were observed among any 2 of the toxins for
      their effects on variables such as serum protein and serum cholesterol content.
      Simultaneous feeding of all 3 mycotoxins did not show increased toxicity above
      that seen with any 2. 7. Esterified-glucomannan increased body weight (2.26%) and
      food intake (1.6%), decreased weights of liver (32.5%) and adrenals (18.9%) and
      activity of serum GGT (8.7%), and increased serum protein (14.7%), cholesterol
      (21.9%), BUN (20.8%) and blood haemoglobin (3.1%) content, indicating its
      possible beneficial effect on mycotoxicosis in broiler chickens.

PMID- 11201448
TI  - Lack of response of laying hens to relative humidity at high ambient temperature.
AB  - 1. The effects of relative humidity (rh=40% to 70%) at high ambient temperature
      (Ta) on the performance of laying hens at different ages (8 to 10 months, Trial
      1; and 16 to 18 months, Trial 2) was evaluated. Laying hens were exposed to 25
      degrees C (control) for 3 weeks and thereafter acclimated for 1 week to 35
      degrees C and 4 different rh. 2. Body weight declined significantly in young and
      older hens exposed to 60% or 70% and 70% rh, respectively: Food intake declined
      with increasing Ta, except in the case of older hens exposed to 60% rh, for which
      it remained relatively constant. Water consumption, however, increased with
      increasing Ta but the increase was significant in young hens exposed to 70% rh
      only. 3. Egg production was not affected by the changes in Ta. However, a
      decrease in egg production was observed in older hens exposed to 60% rh. 4. Egg
      weight (EW), shell weight (SW) and shell thickness (ST) were significantly
      reduced by exposure to elevated Ta, whereas % breakage significantly increased.
      In young hens, a response to rh was exhibited in ST which was significantly
      higher in hens exposed to the low rh (40% to 45%) than in those exposed to the
      highest rh (70% to 75%). 5. It can be concluded that Ta is the main environmental
      factor affecting young and older laying hens while the effect of rh is minor.

PMID- 11201449
TI  - Effects of continuous supplementations of ascorbic acid, aspirin, vitamin E and
      selenium on some haematological parameters and serum superoxide dismutase level
      in broiler chickens.
AB  - 1. This study was conducted using male broiler chickens to determine the effects
      of ascorbic acid, aspirin, ascorbic acid+aspirin, vitamin E+selenium and ascorbic
      acid+aspirin+vitamin E+selenium supplementations on haematological parameters and
      serum superoxide dismutase concentration. 2. One hundred and twenty day-old male
      Hubbunt broiler chicks were randomly divided into 6 experimental groups of 20
      chicks each and placed in different pens. Groups 2, 3, 4, 5 and 6 were given a
      diet supplemented with ascorbic acid, aspirin (in water), ascorbic acid+aspirin,
      vitamin E+selenium and ascorbic acid+aspirin+vitamin E+selenium, respectively for
      45 d while group 1 was given a commercial broiler diet. 3. There was no
      significant effect of ascorbic acid, aspirin, ascorbic acid+aspirin, vitamin
      E+selenium supplementations on any of the haematological parameters (red blood
      cell, haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular
      haemoglobin concentration, mean corpuscular haemoglobin) in broilers but ascorbic
      acid+aspirin+vitamin E+selenium supplementation significantly decreased the white
      blood cell counts. 4. In addition to this, ascorbic acid, aspirin, ascorbic
      acid+aspirin and ascorbic acid+aspirin+vitamin E+selenium supplementations had no
      significant effect on the serum superoxide dismutase level, but vitamin
      E+selenium supplementation increased the serum superoxide dismutase level.

PMID- 11201450
TI  - Seeing is believing.

PMID- 11201451
TI  - The National Institute of Biomedical Imaging and Bioengineering Establishment
      Act: an interim report.

PMID- 11201452
TI  - In vivo imaging of gene expression:.
AB  - With the ability to readily engineer genes, create knock-in and knock-out models
      of human disease, and replace and insert genes in clinical trials of gene
      therapy, it has become clear that imaging will play a critical role in these
      fields. Imaging is particularly helpful in recording temporal and spatial
      resolution of gene expression in vivo, determining vector distribution, and,
      ultimately, understanding endogenous gene expression during disease development.
      While endeavors are under way to image targets ranging from DNA to entire
      phenotypes in vivo, this short review focuses on in vivo imaging of gene
      expression with magnetic resonance and optical techniques.

PMID- 11201453
TI  - Statistical test to assess rank-order imaging studies.
AB  - RATIONALE AND OBJECTIVES: Rank-order experiments often provide a reasonable
      method of determining whether a large-scale receiver operating characteristic
      study can be justified. The authors' purpose was to formalize a proposed method
      for analyzing rank-order imaging experiments and provide methods that can be used
      in determining sample sizes for both cases and raters. MATERIALS AND METHODS:
      Simulations were conducted to determine the adequacy of the normal approximation
      of a statistic used to test the null hypothesis of random ordering. For a
      multireader experiment, formulas are presented and guidelines are provided to
      enable investigators to determine the number of required readers (raters) and
      cases for a specific study. RESULTS: When there are at least five ordered images
      per case, 10 cases are sufficient to test a random rank order. When there are
      only three or four images for a case, 20 cases are required. The authors
      constructed tables of statistical power for selected numbers of ordered images,
      numbers of cases, and degrees of trend, and they also provide an approximation
      for use in situations that are not tabled. CONCLUSION: The statistical methods
      for analyzing rank-order experiments and estimating sample sizes for study
      planning are relatively simple to implement. The derived formulas for sample size
      estimation, when applied to typical imaging experiments, indicate that modest
      numbers of cases and readers are required for rank-order studies.

PMID- 11201454
TI  - Journal publications in radiologic education: a review of the literature, 1987
      1997.
AB  - RATIONALE AND OBJECTIVES: This study was designed to analyze articles on
      radiologic education quantitatively and qualitatively, comparing those published
      in 1987-1997 with those published in 1966-1986. MATERIALS AND METHODS: An initial
      literature search used four major databases to identify and retrieve articles
      related to radiologic education. Additional articles were identified through
      manual cross-checking of references from the original articles. All articles were
      reviewed by two radiologists as to type of article (editorial, expository,
      survey, correlational, or experimental, including preexperimental, quasi
      experimental, or true experimental), statistics used (inferential or
      descriptive), educational emphasis (medical student, resident, postgraduate, or
      other), and topic of article (philosophical or political, technology, program
      evaluation, program description, examinations, or career decisions). Interrater
      agreement was estimated by means of the kappa statistic. A chi2 test for
      independence was used to assess whether the relative distribution of articles was
      similar for the two periods. RESULTS: More articles per year were published in
      1987-1997 (n = 12.6, P < .01) compared with 1966-1986 (n = 9.2). Articles
      pertinent to radiologic resident education predominated (50.7% vs 29.9% in the
      prior study, P < .01). In both periods, most articles were expository (37.7% vs
      49.5%), and the most common topic was program description (34% vs 35%).
      Editorials decreased from 35.5% to 18.1%. Experimental studies accounted for
      12.3%, increased from 8.7%. The fastest-growing topic of study was technology
      (30.4% vs 17.5%, P < .01). CONCLUSION: The increased number of articles
      addressing radiologic education is encouraging. Although the percentage of
      experimental studies increased slightly in this period, there is still little
      empirical research in radiologic education.

PMID- 11201455
TI  - Molecular imaging in vivo with PET and SPECT.

PMID- 11201456
TI  - T1rho imaging of murine brain tumors at 4 T.
AB  - RATIONALE AND OBJECTIVES: The goal of this study was to evaluate the utility of
      T1rho weighting in magnetic resonance imaging of murine brain tumors. MATERIALS
      AND METHODS: S91 Cloudman melanoma was implanted in mouse brains (n = 4). A T2
      weighted spin-echo (SE) and a T1rho-weighted fast SE-based sequence were
      performed on a 4-T clinical imager. T2 and T1rho maps were computed. The tumor-to
      normal-tissue contrast was compared between T2-weighted, T1rho-weighted, proton
      density-weighted, and pre- and postcontrast T1-weighted SE images. RESULTS: The
      tumor-tissue contrast of the T1rho-weighted images was similar to that of the T2
      weighted images but less than that of the postcontrast T1-weighted images. The
      T1rho-weighted images provided better definition of tumor boundaries than T2
      weighted images. At spin-locking powers of 0.5 and 1.5 kHz, the T1rho of the
      tumor was 64.0 msec +/- 0.46 and 68.65 msec +/- 0.59, respectively. There was no
      significant inter- or intra-animal variation in T1rho for tumor or normal brain
      cortex. CONCLUSION: T1rho-weighted imaging performed at low spin-lock strengths
      qualitatively depicted tumor borders better than proton-density or T2-weighted
      imaging and could be useful in treatment planning when combined with other
      imaging sequences.

PMID- 11201457
TI  - Optimal electrocardiographically triggered phase for reducing motion artifact at
      electron-beam CT in the coronary artery.
AB  - RATIONALE AND OBJECTIVES: The authors performed this study to (a) investigate
      coronary movement with electron-beam computed tomography (CT) and (b) find the
      optimal electrocardiographic (ECG) triggering phase for eliminating motion
      artifact. MATERIALS AND METHODS: One hundred fifty-one patients without
      arrhythmia were examined with electron-beam CT. First, movie scans were obtained
      to create displacement and velocity graphs of coronary artery movement. Then, a
      volume scan with an exposure time of 100 msec was obtained with various ECG
      trigger settings. RESULTS: Movement patterns of coronary arteries varied with
      heart rate. Optimal triggering phase was before atrial systole (near 71% of the R
      R interval) when heart rate was slower than 68 beats per minute and at
      ventricular end systole when heart rate was fast. Rate of severe motion artifacts
      decreased from 43% to 0% when triggering was altered from 80% of the R-R interval
      to the individual optimal value. Experimental values of the optimal phase at
      different heart rates were derived, and severe motion artifact was only 3.0% with
      these values. CONCLUSION: ECG triggering set according to the heart rate enables
      a great reduction in motion artifacts at electron-beam CT with a 100-msec
      exposure time. The results may have implications for magnetic resonance imaging
      of the coronary artery.

PMID- 11201458
TI  - Quantifying the characteristics of unambiguous chest radiography reports in the
      context of pneumonia.
AB  - RATIONALE AND OBJECTIVES: The purpose of this study was to statistically identify
      some characteristics of unambiguous (ie, clear) chest radiography reports in the
      context of acute bacterial pneumonia. MATERIALS AND METHODS: Seven physicians
      individually read 292 chest radiography reports to determine if they contained
      radiologic evidence of pneumonia. Unambiguous reports were defined as those that
      physicians unanimously classified as supporting or not supporting the diagnosis
      of pneumonia. Ambiguous reports were assigned degrees of ambiguity on the basis
      of how much disagreement they caused among the physicians. Characteristics of
      unambiguous reports as described in the literature were manually quantified and
      assigned to every report. To identify characteristics that statistically
      distinguished unambiguous from ambiguous reports, the authors performed an
      ordinal logistic regression analysis for which the dependent variable was the
      number of dissenting votes the report received and the independent variables were
      the quantified characteristics of the report. RESULTS: Six independent variables
      were statistically significantly associated with unambiguous reports (P < .05).
      Three were positively associated: an interpretation of whether findings supported
      the diagnosis of pneumonia in reports with pneumonia-related observations, short
      sentences, and redundancy of pneumonia-related observations. Three were
      negatively associated: high use of uncertainty modifiers for pneumonia-related
      observations, use of only descriptive terms to describe pneumonia-related
      observations, and insufficient amount of pneumonia-related information.
      CONCLUSION: The most influential characteristic of an unambiguous chest
      radiography report was an interpretation of whether the radiograph supported the
      diagnosis of pneumonia when findings could be indicative.

PMID- 11201459
TI  - Impact of PACS on the education of radiology residents: the residents'
      perspective.
AB  - RATIONALE AND OBJECTIVES: Because digital imaging and the picture archiving and
      communication system (PACS) are replacing radiographic film, the effect of PACS
      on residents' perceptions and their educational experience was investigated.
      MATERIALS AND METHODS: Residents taking part in large diagnostic radiology
      training programs at two hospitals were surveyed. Approximately 75% of
      radiographic studies were reviewed with the use of PACS at both hospitals. Survey
      topics included technical and didactic issues based on direct and indirect
      comparison with analog (conventional film) images. RESULTS: Fifty residents were
      polled (20 respondents). The majority has been using PACS for more than 1 year
      (14 of 20, 70%) to interpret 75%-100% of cases (11 of 20, 55%). The majority
      believed that PACS improved patient care (15 of 20, 75%) and their educational
      experience (15 of 20, 75%). A minority believed that increased patient throughput
      was harmful to the educational experience (five of 20, 25%) because it permitted
      attending radiologists to review cases too quickly (four of 20, 20%). Residents
      favored PACS over hard-copy images for ease of manipulation, resolution, and
      ability to see pathologic conditions and normal anatomic characteristics.
      CONCLUSION: Residents believe that PACS has positively affected their learning
      experience and does not negatively affect the quality of resident education.

PMID- 11201460
TI  - Clinical competence assessment in radiology: introduction of an objective
      structured clinical examination in the medical school curriculum.
AB  - RATIONALE AND OBJECTIVES: Traditional oral and written examinations can be
      limited in predicting future clinical performance. Therefore Objective Structured
      Clinical Examinations (OSCEs) have been introduced in other specialties. The
      authors assessed their value in radiology. MATERIALS AND METHODS: The study
      includes 122 Harvard medical students who undertook 1-month compulsory clerkships
      at one of three hospitals (A, B, or C) in their 3rd and 4th year and a compulsory
      OSCE in their 4th year. The OSCE was constructed from five cases. Each had eight
      or nine standardized questions designed to test, within a set time, the
      perception of essential findings, their interpretation, and clinical judgment
      (maximum possible score, 100). Clerkship grades were high honors (score of 3),
      honors (score of 2), satisfactory (score of 1), and fail (score of 0). Predictors
      of OSCE scores-clerkship grade and affiliated hospital-were modeled as linear
      functions. Time elapsed between clerkship and OSCE was modeled as a nonlinear
      function. RESULTS: Although there was a positive relation between clerkship grade
      and OSCE grade, it accounted for an increase of only 5.7% in OSCE score per
      clerkship grade and did not predict performance of individual students. Students
      who trained in hospital B showed significantly higher OSCE grades. OSCE scores
      were highest when the examination was taken 8 months after the clerkship.
      CONCLUSION: The OSCE may be useful to uncover deficits in individuals and groups
      beyond the ones detected with traditional clerkship evaluations and provide
      guidance for remediation. The improved performance after additional clinical
      exposure suggests that the OSCE may be well suited to test the integration of
      radiologic and clinical knowledge.

PMID- 11201461
TI  - Why is ethics needed in the radiology curriculum?

PMID- 11201462
TI  - A3CR2 problem-solving session 2000: the teaching curriculum and the problem
      attending radiologist. American Association of Academic Chief Residents in
      Radiology.

PMID- 11201463
TI  - Feasibility and profitability of a radiology department providing trauma US as
      part of a trauma alert team.
AB  - RATIONALE AND OBJECTIVES: The purpose of this study was to assess the feasibility
      and profitability of a radiology department providing a six-point trauma
      ultrasound (US) examination for abdominal or pelvic free fluid as part of a
      trauma alert team. MATERIALS AND METHODS: The study included 191 trauma alerts,
      which generated 156 US examinations. A radiologist and a departmental
      technologist carried beepers and responded to level I and II traumas. A
      departmental secretary or technologist recorded when the responding technologist
      exited and re-entered the department and if US was performed. If performed, the
      US examination evaluated the four abdominal and pelvic quadrants and the
      suprapubic and subxiphoid regions. For 64 patients, the responding technologist
      recorded the times of the trauma alert, emergency room arrival, US start and
      finish, and return to the radiology department. RESULTS: Median response, wait,
      scan duration, and return times were 2, 8, 5, and 7 minutes, respectively. Median
      costs for the technician, physician, archiving, transcription, and equipment were
      $8.17, $30.85, $0.97, $4.80, and $41.22, respectively. Reimbursement per
      examination averaged $110.60. Sensitivity analyses that varied the time spent
      (median vs mean), US non-use rate (10%-18%), and years of depreciation (5-7
      years) yielded net results ranging from a $36.60 profit to a $6.12 loss per
      examination. CONCLUSION: A radiology department can profitably respond to trauma
      alerts and provide a six-point trauma US examination for free fluid.

PMID- 11201464
TI  - Malignant lymphoma of the central nervous system with delayed increased
      accumulation on I-123 IMP SPECT.
AB  - Ga-67 citrate scintigraphy in the management of malignant lymphomas is well
      established. It cannot, however, differentiate malignant from benign lesions
      because this agent also accumulates in benign inflammatory lesions. The authors
      present a case of increased I-123 IMP uptake on both early and delayed SPECT
      images in a patient with malignant lymphoma of the central nervous system.
      Results show that I-123 IMP SPECT can help differentiate malignant lymphoma from
      benign lesions and other malignant brain tumors.

PMID- 11201465
TI  - Clearance of Tc-99m DTPA aerosol in mismatched and matched pulmonary perfusion
      defects.
AB  - PURPOSE: To evaluate clearance changes of Tc-99m DTPA aerosol in mismatched and
      matched pulmonary perfusion defects. MATERIALS AND METHODS: Twenty-one patients
      (14 women, 7 men; mean age, 51 +/- 14 years) with possible pulmonary embolism
      were included in the study. On the day after perfusion (Q) scintigraphy with 5
      mCi Tc-99m MAA, radioaerosol inhalation scintigraphy was performed using 45 mCi
      Tc-99m DTPA. Immediately and 45 minutes after the inhalation, early and delayed
      inhalation images (EI and DI, respectively) were obtained. Group 1 included 11
      patients with mismatched defects who had a high probability of pulmonary embolism
      according to the Q/EI scan results. Group 2 included 10 patients with matched
      defects who had a low probability of PE. Contralateral normal lungs of 7 patients
      in group 2 served as controls (group 3). In groups 1 and 2, regions of interest
      were drawn over the mismatched and matched perfusion defects where they were best
      visualized, and this region of interest was mirrored to the same region on EI and
      DI images. For the control group, this was done in the contralateral normal lung.
      Mean counts in each region of interest were used for quantitative analysis, and
      the percentage clearance ratio was calculated using the following formula: early
      counts - late counts/early counts x 100. RESULTS: The average percentage
      clearances for the three groups were as follows: group 1, 37% +/- 10%; group 2,
      21% +/- 4%; group 3, 24% +/- 7%. Differences between groups 1 and 3 were
      significant, as were those between groups 1 and 2 (P < 0.05). Patients with
      mismatched perfusion defects had increased DTPA clearance compared with the
      control group and those with matched defects. CONCLUSIONS: Vascular occlusion may
      lead to impairment of the alveolar-capillary barrier and consequently an increase
      in the clearance of Tc-99m DTPA aerosol in embolized regions. Immediately after
      inhalation, Tc-99m DTPA imaging should be started in the projection where
      perfusion defects are best seen to avoid potential misinterpretation of pulmonary
      embolism.

PMID- 11201466
TI  - Radionuclide cisternography in spontaneous intracranial hypotension with
      simultaneous leaks at the cervicothoracic and lumbar levels.
AB  - This case report clearly illustrates defined simultaneous cerebrospinal fluid
      leaks at the cervicothoracic and upper lumbar areas. A 53-year-old woman without
      a remarkable medical history was hospitalized for sudden onset of severe
      headache. The headache lasted more than 1 week and standing or sitting positions
      exaggerated the symptoms, although it was relieved when the patient was
      recumbent. Radionuclide cisternography was performed using 150 MBq (4 mCi) Tc-99m
      DTPA. It revealed two cerebrospinal fluid leaks from the cervicothoracic junction
      bilaterally and the left side of the upper lumbar area. Epidural blood patching
      was tried at the lumbar level (L1-L2) and showed only a transient effect. A
      second trial of this method at the level of C7-T1 performed 2 days later resulted
      in immediate improvement of the symptoms without recurrence. The simultaneous
      cerebrospinal fluid leaks were detected successfully with radionuclide
      cisternography using Tc-99m DTPA, which provided a useful guideline for treatment
      despite the limitations of delayed scanning.

PMID- 11201467
TI  - Bone scintigraphy in testicular tumors.
AB  - PURPOSE: Testicular tumors do not occur frequently. Primary treatment is
      surgical, and radiotherapy and chemotherapy can play important roles in cases of
      metastatic disease. Bone scintigraphy is used largely for early detection of
      skeletal metastases from several tumors, and conventional radiographic studies
      are less sensitive than the nuclear technique for such a purpose. The aim of this
      study was to identify the role of bone scintigraphy in cases of testicular
      tumors, regardless of the grade. MATERIALS AND METHODS: The authors examined 28
      patients (8 to 52 years old) with proved testicular tumors using Tc-99m MDP (750
      MBq; 20 mCi) injected intravenously. Whole-body images were obtained 2 hours
      later, at 500,000 counts per image. Radiographic studies were obtained to
      investigate abnormal areas noted on scintigraphy. RESULTS: The results of bone
      scintigraphy were abnormal in seven cases, consisting of variable but diffuse
      uptake in the iliac bone on the same side as the affected testicle. MDP uptake
      was substantial in five of these patients (four seminomas, one nonseminoma; only
      two radiographic studies were abnormal), and the two other patients had moderate
      uptake of the radiopharmaceutical (two seminomas; radiographic studies were
      normal). Metastases were confirmed by biopsy in three cases. DISCUSSION: Early
      metastases from seminomas can occur through the lymphatic drainage toward the
      iliac lymph node chain. This could explain these findings. The scintigraphic
      aspects of the affected iliac bones seem characteristic. CONCLUSIONS: Early
      detection of metastases is very important to ensure the efficacy of radiotherapy
      and chemotherapy. Bone scintigraphy may play an important role in such cases and
      seems to be more sensitive than conventional radiography. Testicular tumor
      metastases should be considered when iliac involvement is observed. Paget's
      disease should be included in a differential diagnosis.

PMID- 11201468
TI  - TI-201 SPECT compared with histopathologic grade in the prognostic assessment of
      cerebral gliomas.
AB  - PURPOSE: Although TI-201 SPECT has been used to evaluate the malignant grade of
      cerebral gliomas, the gold standard continues to be histopathologic examination.
      The authors assessed and compared the prognostic abilities of the two studies
      using survival analysis. MATERIALS AND METHODS: Twenty-nine patients underwent 34
      sessions of TI-201 SPECT plus surgery for primary or recurrent cerebral gliomas
      12 to 78 months before this analysis. Using conventional survival analyses, such
      as the log-rank test, Cox regression, and the Akaike cross-tab method, the
      authors evaluated the prognostic significance of 10 variables: histopathologic
      grade, TI-201 SPECT, Tc-99m HMPAO SPECT, tumor cell viability, radionecrosis,
      neurologic defects, clinical improvement, surgery, chemotherapy, and external
      beam radiotherapy. RESULTS: TI-201 SPECT was most strongly related to prognosis,
      followed by histopathologic grade. The other variables had little prognostic
      value. The Cox stepwise selection procedure indicated that TI-201 SPECT was the
      only independent predictor of outcome, whereas histopathologic analysis was
      eliminated from the prognostic model. However, the Kaplan-Meier survival curve
      and the Akaike method indicated that histopathologically low-grade tumors were
      more closely associated with longer-term survival than were TI-201 low uptake
      tumors. CONCLUSIONS: TI-201 SPECT is not only closely correlated with the
      histopathologic grade of tumor but is a significantly better predictor of outcome
      than histopathologic grade. However, histopathologic examination may provide
      additional information on longer-term survival. TI-201 SPECT is a valuable
      procedure, especially in patients in whom a histologic diagnosis of possible
      glioma cannot be made.

PMID- 11201469
TI  - Brain SPECT used to evaluate vasospasm after subarachnoid hemorrhage: correlation
      with angiography and transcranial Doppler.
AB  - PURPOSE: The primary objective of this study was to correlate Tc-99m HMPAO and
      ethyl cysteine dimer perfusion brain SPECT imaging with angiography and
      transcranial Doppler (TCD) to identify vasospasm after subarachnoid hemorrhage.
      METHODS: A retrospective analysis of consecutive patients who had cerebral blood
      flow SPECT imaging for subarachnoid hemorrhage and aneurysm clipping was made.
      Flow velocity measurements were correlated using TCD and cerebrovascular
      angiography. RESULTS: Of the 129 patients were included in this study, 84 were
      female and 45 were male, with a mean age of 51.9 years and a median age of 51
      years (range, 9 to 84 years). Eighty-nine patients had brain SPECT evidence of
      hypoperfusion. Concordance was found between SPECT and TCD with vasospasm in 57
      of 89 (64%) patients and nonconcordance was evident in 32 patients (36%). Eleven
      patients who had concordance between SPECT and TCD had nonconcordant results of
      angiography for vasospasm. CONCLUSIONS: These findings suggest that all three
      methods are complementary to each other in the evaluation of patients with
      vasospasm after subarachnoid hemorrhage. Concordance of 64% between SPECT and TCD
      is acceptable and explicable by the differences in technique and measurement of
      cerebral blood flow compared with vascular narrowing, respectively.

PMID- 11201470
TI  - Evaluation of recurrent squamous cell carcinoma of the head and neck with FDG
      positron emission tomography.
AB  - PURPOSE: This study compared the effectiveness of fluorodeoxyglucose (FDG)
      positron emission tomography (PET) with computed tomography (CT), magnetic
      resonance imaging (MRI), or both for the assessment of recurrent squamous cell
      carcinoma of the head and neck. The value of quantifying the standardized uptake
      values (SUV) to distinguish recurrent neoplasm from inflammatory lesions and
      normal structures was also evaluated. METHODS: Forty-three patients with head and
      neck cancer were examined with F-18 FDG PET at least 4 months after their last
      course of radiation therapy (mean, 11 months). The SUVs were measured in visually
      identified regions of abnormally increased activity and were compared with the
      values in normal mucosa, the base of the tongue, and the hard palate to determine
      if an optimal cutoff value exists for diagnosing recurrence of malignant lesions.
      The final diagnosis of recurrence was made based on biopsy or at least 6 months'
      clinical follow-up. RESULTS: FDG PET correctly detected recurrence in 20 of 22
      patients who had 45 discrete lesions located in the field of the upper
      aerodigestive tract. Two false-negative and three false-positive results were
      identified. The accuracy of FDG PET was 88% (38 of 43 patients), compared with
      66% (25 of 38 patients) for CT, MRI, or both. Although there was a significant
      difference of SUVs (P = 0.0036) between the recurrent lesions and normal
      structures, the optimal cutoff values were difficult to define. CONCLUSIONS:
      Visual analysis of FDG PET is significantly more accurate in the diagnosis of
      recurrent squamous cell cancer of the head and neck than are CT or MRI. However,
      single SUV quantification does not significantly enhance efficacy.

PMID- 11201471
TI  - Unilateral proptosis with thyrotoxicosis resulting from solitary retroorbital
      soft tissue metastasis from follicular carcinoma thyroid.
AB  - Unilateral proptosis can be of neoplastic origin, even if the results of thyroid
      function tests suggest hyperthyroid disease, and it needs proper investigation
      with a computed tomographic scan of the orbit. The authors present a case of left
      sided proptosis resulting from a metastasis in the retroorbital soft tissue from
      follicular carcinoma of the thyroid. A nodular goiter involving the left lobe and
      isthmus was found. The initial thyroid function test values suggested
      hyperthyroid disease and the patient had clinical signs of toxicity. A computed
      tomographic scan of the orbit revealed a left-sided retroorbital soft tissue
      mass, part of which was resected and found be to a metastasis from follicular
      carcinoma of thyroid. Total thyroidectomy was performed and the patient was
      treated with I-131 after operation. The proptosis resolved with I-131 treatment.

PMID- 11201473
TI  - Focal intrasplenic extramedullary hematopoiesis mimicking lymphoma: diagnosis
      made using liver-spleen scintigraphy.

PMID- 11201472
TI  - Role of Tc-99m sestamibi scintigraphy in the diagnosis and surgical decision
      making process in primary hyperparathyroid disease.
AB  - PURPOSE: Ultrasound (US) and scintigraphy are used most frequently of all the
      available imaging techniques for the preoperative evaluation of patients with
      possible primary hyperparathyroid disease. The aim of this study was to assess
      the value of dual-phase Tc-99m MIBI scintigraphy compared with US in the
      detection of adenomatous or hyperplastic glands and in the surgical decision
      making process for patients with a biochemical diagnosis of primary
      hyperparathyroid disease. METHODS: Ninety-seven patients with increased levels of
      parathyroid hormone and calcium, and at least 6 months' follow-up after US and
      scintigraphy, were examined retrospectively to assess the influence of the
      diagnostic work-up on the therapeutic decision of the referring clinicians and to
      evaluate the sensitivity of these diagnostic tools in the surgically treated
      patients. Forty-eight patients underwent surgery. RESULTS: Parathyroid adenomas
      were found in 43 patients and hyperplasia in 1, whereas 4 patients had no
      evidence at surgery. The sensitivity and specificity rates were 84.4% and 95.9%
      for scintigraphy, and 66.6% and 98.6% for US, respectively. Of the 49
      nonsurgically treated patients, 35 had negative results with both MIBI and US;
      only 3 had positive findings with both imaging methods. Patients treated
      conservatively had significantly lower parathyroid hormone and serum calcium
      levels than did the patients who had surgery. CONCLUSIONS: The data suggest that
      the high sensitivity of dual-phase MIBI scintigraphy can improve the detection of
      hyperfunctioning parathyroid glands. Furthermore, despite the controversy
      surrounding the use of imaging methods in the preoperative assessment of primary
      hyperparathyroid disease, these data suggest that the decision of the clinician
      to order surgery for a patient with a moderate increase of serum PTH level may be
      influenced by the results of the imaging methods.

PMID- 11201474
TI  - Misleading thoracic Ga-67 uptake caused by splenic displacement.

PMID- 11201475
TI  - Avid Ga-67 uptake in a breast metastasis from cancer of the tongue.

PMID- 11201476
TI  - Biliary-colonic fistula diagnosed via hepatobiliary scintigraphy.

PMID- 11201477
TI  - Hepatobiliary scintigraphy showing acute complete common bile duct obstruction in
      a patient with acute hepatitis.

PMID- 11201478
TI  - Acquired hourglass gallbladder.

PMID- 11201479
TI  - Intra-arterial Tc-99m MDP injection mimicking reflex sympathetic dystrophy.

PMID- 11201480
TI  - Thoracic lymph node visualization after a peritoneal leak study.

PMID- 11201481
TI  - Esophageal inflammation evident on oral Tc-99m sulfur colloid gastroesophageal
      imaging.

PMID- 11201482
TI  - Unusual depression and Tc-99m ethyl cysteinate dimer SPECT brain uptake.

PMID- 11201483
TI  - Damaged ureter detected on a bone scan.

PMID- 11201484
TI  - Scintigraphic findings of dysplasia epiphysealis hemimelica: a case report.

PMID- 11201485
TI  - Isolated lower extremity I-131 bone marrow uptake in a runner.

PMID- 11201486
TI  - Liver uptake and increased renal uptake of Tc-99m HMDP in a patient with iron
      overload.

PMID- 11201487
TI  - Extensive bone infarct in myeloid leukemia correlation of bone scan and magnetic
      resonance imaging.

PMID- 11201488
TI  - Discrepancy between clinical symptoms and Tc-99m MDP bone scan findings before
      and after strontium-89 therapy for metastatic bone pain of prostate carcinoma.

PMID- 11201489
TI  - Radionuclide venography in inferior vena cava and iliofemoral vein obstruction.

PMID- 11201490
TI  - An unexpected pericardial effusion.

PMID- 11201491
TI  - Bilateral adrenal metastases simulating abnormal renal uptake on a Ga-67 scan.

PMID- 11201492
TI  - I-131 iodonorcholesterol uptake in adrenal hemangioma.

PMID- 11201493
TI  - Current readings in nuclear medicine.

PMID- 11201494
TI  - Tc-99m HMPAO white blood cell scintigraphy in the assessment of the extent and
      severity of an acute exacerbation of ulcerative colitis.
AB  - PURPOSE: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with
      frequent exacerbations, including the risk for toxic megacolon and severe
      complications. In very active disease, colonoscopy should not be performed to
      assess the severity and the extent of the disease. The aim of the current study
      was to determine whether Tc-99m HMPAO-labeled white blood cell (WBC) scintigraphy
      can be used as an alternative to colonoscopy to determine the extent and the
      severity of the disease in critically ill patients. METHODS: Twenty consecutive
      patients (7 women, 13 men; age 38.1 +/- 13.1 years) who had a severe attack of UC
      underwent scintigraphy on the day of admission. Leukocytes were labeled with 200
      MBq (5.35 mCi) Tc-99m HMPAO. Planar anterior and posterior imaging of the abdomen
      was performed 45 and 120 minutes after WBC reinjection. The tracer uptake in the
      different colon segments was scored visually compared with bone marrow uptake. A
      symptom score was made and C-reactive protein was measured as a serologic marker
      of inflammation. Rectosigmoidoscopy with biopsy was performed within 24 hours of
      scintigraphy. Scintigraphic, endoscopic, and histologic results were compared for
      disease activity. RESULTS: The mean symptom score was 12.7 (+/-0.7) on a scale of
      21, and mean the C-reactive protein level was 6.8 (+/-1.2) mg/l. No significant
      difference was found between the scintigraphic score of the rectum and the
      endoscopic or the histologic score. The best correlation was found with the
      latter (r = 0.66, P < 0.01). Based on the results of scintigraphy, disease
      involved the left side of the colon up to the splenic flexure in 10 patients. The
      other patients had pancolitis. CONCLUSIONS: Disease severity can be determined
      adequately by planar WBC scintigraphy in patients with severe attacks of UC.
      Because the presence and severity of disease correlates well with endoscopic and
      histologic findings, WBC scintigraphy can assess disease extent without the need
      for colonoscopy. This decreases the number and severity of complications that can
      occur in already critically ill patients.

PMID- 11201495
TI  - Interactions between effects of adrenalectomy and diet on insulin secretion in
      fa/fa Zucker rats.
AB  - Our objective was to determine if a cafeteria-type diet with increased fat
      content would block the decrease in insulin secretion induced by adrenalectomy in
      obese rats. Five week old Zucker (fa/fa) rats were adrenalectomized. One week
      later, half of the adrenalectomized groups, and age-matched, sham-operated
      animals were given a diet of 16% fat and 44% carbohydrate. Control animals were
      maintained on standard rat chow (4.6% fat and 49% carbohydrate). After 4 weeks on
      the diets, in vivo measurements included caloric intake, weight gain, plasma
      corticosterone, triglyceride, free fatty acids, and oral glucose tolerance tests.
      In vitro measurements included glucose-stimulated insulin secretion, glucose
      phosphorylating activity, islet triglyceride content, and fatty acid oxidizing
      activity of cultured islets. Generally, the cafeteria diet did not block the
      effects of adrenalectomy on in vitro insulin secretion parameters, even though in
      sham-operated animals weight gain and insulin resistance was induced by the diet
      in vivo. Adrenalectomy and the diet exerted independent effects on glucose
      phosphorylation and fatty acid oxidation in islets. In conclusion, adrenalectomy
      decreased the elevated insulin secretion in fa/fa rats. The failure of a
      cafeteria diet enriched in fat to block the adrenalectomy-mediated changes in B
      cell function indicates the importance of glucocorticoids and centrally-mediated
      effects on insulin secretion and other metabolic parameters.

PMID- 11201496
TI  - Effect of autonomic neurotransmitters on excitable gap composition in canine
      atrial flutter.
AB  - Atrial arrhythmias are believed to be influenced by autonomic nervous system
      tone. We evaluated the effects of sympathetic and parasympathetic activation on
      atrial flutter (AF1) by determining the effects of norepinephrine (NE) and
      acetylcholine (ACh) on the composition of the excitable gap. A model of reentry
      around the tricuspid valve was produced in 17 chloralose anesthetized dogs using
      a Y-shaped lesion in the intercaval area that extended to the right atrial
      appendage. Excitable gap characteristics were determined during AF1 by scanning
      diastole with a single premature extrastimulus at progressively shorter coupling
      intervals to define the reset-response curve. Measurements were made during a
      constant infusion of NE (15 microg/min) into the right coronary artery and
      repeated during ACh infusion (2 microg/min) following a 15 min recovery period.
      The excitable gap (27 +/- 1 ms) was significantly (P < 0.001) increased by NE (34
      +/- 1 ms) and ACh (50 +/- 2 ms). The fully excitable portion (7 +/- 1 ms) was
      also significantly (P < 0.001) increased by NE (17 +/- 1 ms) and ACh (43 +/- 2
      ms). We conclude that both neurotransmitters increase the safety margin of full
      excitability ahead of the wavefront, demonstrating that parasympathetic and
      sympathetic activation can facilitate the persistence of this refractory atrial
      arrhythmia.

PMID- 11201497
TI  - Perturbation of rat renal tubule transport of the organic cation amantadine in
      recent onset streptozotocin-induced diabetes and in uninephrectomy.
AB  - The effects of early-stage diabetes mellitus and uninephrectomy on the renal
      tubule transport of amantadine were investigated. Kidney tubules were isolated
      from streptozotocin-induced diabetic (+/- insulin treatment) uninephrectomized,
      and control male Sprague-Dawley rats. There were no differences in the Km of
      amantadine uptake in renal proximal and distal tubules for the imposed treatments
      compared with control values. Vmax for amantadine uptake in the proximal tubules
      of diabetic and uninephrectomized rats was higher than the respective control (P
      < 0.05). Vmax for insulin-treated diabetic rats was similar to control values but
      was lower than that for untreated diabetic rats (P < 0.05). Vmax for distal
      tubule uptake was not altered by any treatment. Structure-activity studies
      demonstrated that bicarbonate-dependent amantadine uptake was inhibited by
      glycolate and lactate, but not by propionate or alpha-, beta-, or gamma
      hydroxybutyrate. Early stage streptozotocin-induced diabetes mellitus and
      uninephrectomy induced changes in the kidney that resulted in a similar selective
      increase in proximal tubule amantadine uptake. These data represent the first
      description that experimentally induced diabetes mellitus and uninephrectomy
      modulate the function of the renal tubule organic cation (amantadine) transport
      system. Both interventions represent potential models in which phenotypic
      modulation of the renal elimination of organic cationic drugs may be achieved and
      studied.

PMID- 11201498
TI  - The mechanisms of the vulnerable window: the role of virtual electrodes and shock
      polarity.
AB  - Vulnerability and defibrillation are mechanistically dependent upon shock
      strength, polarity, and timing. We have recently demonstrated that shock-induced
      virtual electrode polarization (VEP) may induce reentry. However, it remains
      unclear how the VEP mechanism may explain the vulnerable window and polarity
      dependence of vulnerability. We used a potentiometric dye and optical mapping to
      assess the anterior epicardial electrical activity of Langendorff-perfused rabbit
      hearts (n = 7) during monophasic shocks (+/-100 V and +/-200 V, duration of 8 ms)
      applied from a transvenous defibrillation lead at various coupling intervals.
      Arrhythmias were induced in a coupling interval and shock polarity dependent
      manner: (i) anodal and cathodal shocks induced arrhythmias in 33.2 +/- 30.1% and
      53.1 +/- 39.3% cases (P < 0.01), respectively, and (ii) the vulnerable window was
      located near the T-wave. Optical maps revealed that VEP was also modulated by the
      coupling interval and shock polarity. Recovery of excitability produced by
      negative polarization, known as de-excitation, and the resulting reentry was more
      readily achieved during the relative refractory period than the absolute
      refractory period. Furthermore, anodal shocks produced wavefronts propagating in
      an inward direction with respect to the electrode, whereas cathodal shocks
      propagated in an outward direction. Wavefronts produced by anodal shocks were
      more likely to collide and annihilate each other than those caused by cathodal
      shocks. The probability of degeneration of the VEP-induced phase singularity into
      a sustained arrhythmia depends upon the gradient of VEP and the direction of the
      VEP-induced wavefront. The VEP gradient depends upon the coupling interval, while
      the direction depends upon shock polarity; these factors explain the vulnerable
      window and polarity-dependence of vulnerability, respectively.

PMID- 11201500
TI  - YC-1 enhances the responsiveness of tolerant vascular smooth muscle to glyceryl
      trinitrate.
AB  - A major limitation of the use of organic nitrates in cardiovascular medicine is
      the development of tolerance, which has been attributed, in part, to a decrease
      in their metabolic activation in the vascular smooth muscle cell. Recently, 3-(5'
      hydroxymethyl-2'-furyl)-1-benzylindazole (YC-1) was shown to potentiate vascular
      smooth muscle responsiveness to glyceryl trinitrate (GTN), sodium nitroprusside,
      and the nitric oxide donor NOC 18, in organic nitrate-naive vascular smooth
      muscle. We used GTN-tolerant rabbit aortic rings (RARs) to test the hypothesis
      that a non-vasorelaxant concentration of YC-1 enhances the ability of the
      prototypical organic nitrate GTN to relax vascular smooth muscle and elevate
      intravascular cGMP under conditions of GTN tolerance. Treatment with YC-1 (3
      microM) produced a left shift of the GTN concentration-response curve and
      decreased the EC50 value for GTN-induced relaxation in both GTN-tolerant and non
      tolerant RARs (P < 0.05). Intravascular cGMP elevation induced by GTN was
      enhanced in the presence of YC-1 in GTN-tolerant and non-tolerant RARs (P <
      0.05). These observations indicate that YC-1, or similarly acting drugs, may be
      useful in overcoming the tolerance that develops during sustained GTN therapy,
      and that its mechanism may involve enhanced cGMP formation.

PMID- 11201499
TI  - Muscarinic activation of transient inward current and contraction in canine colon
      circular smooth muscle cells.
AB  - Muscarinic receptor mediated membrane currents and contractions were studied in
      isolated canine colon circular smooth muscle cells. Carbachol (10(-5) M) evoked a
      slow transient inward current that was superimposed by a transient outward
      current at holding potentials greater than -50 mV. Carbachol contracted the cells
      by 70 +/- 2%. The effects of carbachol were blocked by atropine (10(-6) M),
      tetraethyl ammonium (20 mM), and BAPTA-AM (25 mM applied for 20 min). The inward
      current and contraction were not sensitive to diltiazem (10(-5) M), nitrendipine
      (3 x 10(-7) M), niflumic acid (10(-5) M), or N-phenylanthranilic acid (10(-4) M),
      but were gradually inhibited after repetitive stimulations in Ca2+ free solution.
      Ni2+ (2 mM) inhibited the inward current by 67 +/- 4%. The inward current
      reversed at +15 mV. The outward component could be selectively inhibited by
      iberiotoxin (20 nM) or by intracellular Cs+. Repeated stimulation in the presence
      of cyclopiazonic acid (CPA, 3 microM) inhibited the carbachol-induced outward
      current and partially inhibited contraction. CPA did not inhibit the inward
      current. In conclusion, muscarinic receptor stimulation evoked a CPA-sensitive
      calcium release that caused contraction and a CPA-insensitive transient inward
      current was activated that is primarily carried by Ca2+ ions and is sensitive to
      Ni2+.

PMID- 11201501
TI  - Effect of temperature on post-tetanic potentiation in human dorsiflexor muscles.
AB  - The effect of temperature on post-tetanic potentiation (PTP) has been examined in
      the muscles of small mammals but not in human skeletal muscle. We examined PTP in
      the ankle dorsiflexor muscles of 10 young men by evoking twitches before and
      after a 7-second tetanus at 100 Hz in a control (room air approximately 21
      degrees C) condition and after immersion of the lower leg in warm (45 degrees C)
      and cold (10 degrees C) water baths for 30 min. Exposure to cold decreased
      tetanus and pre-tetanus twitch peak torque, but increased rise time, half
      relaxation time, and muscle action potential (M-wave) amplitude; exposure to warm
      water had little effect. PTP was smallest in cold exposure 5 s post-tetanus, but
      persisted throughout the 12 min test period, whereas PTP had subsided by 6 min
      post-tetanus in control and warm exposures. M-wave amplitude initially decreased
      after exposure to warm water, recovered, then decreased again by 11 min post
      tetanus. In contrast, exposure to cold had no initial effect but did increase the
      M-wave amplitude during the last half of the 12 min test period, similar to that
      seen in the control. The greatest immediate decrease in rise time and half
      relaxation time was observed in the control; however, by 12 min post-tetanus warm
      exposure showed the greatest increase in rise time and half-relaxation time above
      pre-tetanus values. The decrease in the unpotentiated twitch torque with cooling
      in human dorsiflexors is typical for muscles with a predominance of type I (slow)
      fibres. The effect of cold on PTP is similar to that seen previously in mammalian
      muscles with a predominance of type II (fast) fibres, although the underlying
      mechanism of the cooling effect appears to differ.

PMID- 11201502
TI  - Uptake properties of lamivudine (3TC) by a continuous renal epithelial cell line.
AB  - The purpose of this study was to characterize the renal uptake properties of the
      cytidine analog and antiretroviral agent 3TC. The uptake of radiolabelled 3TC was
      measured at 37 degrees C in a continuous porcine renal epithelial cell line
      (i.e., LLC-PK1 cells) grown as a monolayer on an impermeable support. 3TC (5
      microM) uptake (37 degrees C) by the monolayer cells was saturable (Km = 1.2 +/-
      0.2 mM) but not significantly altered by various dideoxynucleoside analog drugs,
      nucleosides, and nucleoside transport inhibitors, suggesting that a nucleoside
      transporter is not involved in 3TC uptake. A number of endogenous organic cation
      probes and inhibitors significantly reduced 3TC uptake by the monolayer cells.
      Quinine, trimethoprim (TMP), and tetraethylammonium (TEA) inhibited 3TC uptake in
      a dose dependent manner with IC50 values of 0.6 mM, 0.63 mM, and 1.9 mM,
      respectively. In turn, the uptake of the typical organic cation substrate TEA was
      inhibited by high concentrations of 3TC. An outwardly directed proton gradient
      significantly increased the uptake of 3TC by the monolayer cells, suggesting the
      involvement of a proton exchange process. Conversely, in the presence of
      monensin, a Na+/H+ ionophore, the uptake of 3TC was significantly reduced. These
      results suggest that the uptake of 3TC by a cultured renal epithelium may be
      mediated by an organic cation-proton exchanger. The observed clinical interaction
      between 3TC and trimethoprim may be explained by competition for a common renal
      organic cation tubular transporter.

PMID- 11201503
TI  - Effect of transient stretch on intracellular Ca2+ during triggered propagated
      contractions in intact trabeculae.
AB  - Transient stretch of cardiac muscle during a twitch contraction may dissociate
      Ca2+ from myofilaments into the cytosol at the moment of quick release of the
      muscle. We studied the effect of stretch and quick release of trabeculae on
      changes in intracellular Ca2+ ([Ca2+]i) during triggered propagated contractions
      (TPCs). Trabeculae were dissected from the right ventricle of 9 rat hearts.
      [Ca2+]i was measured using electrophoretically injected fura-2. Force was
      measured using a silicon strain gauge and sarcomere length was measured using
      laser diffraction techniques. Reproducible TPCs (n = 13) were induced by trains
      of electrical stimuli (378 +/- 19 ms interval) for 7.5 s at [Ca2+]o of 2.0 mM
      (27.9 +/- 0.2 degrees C). The latency of the TPC force and the underlying
      increase in [Ca2+]i was calculated from the time (TimeF) between the last
      stimulus and the peak of TPC force (PeakF), or the time (TimeCa) between the last
      stimulus and the peak of the increase in [Ca2+]i during the TPCs (PeakCa). As a
      result of a 10% increase in muscle length for 150-200 ms during the last
      stimulated twitches, TimeF and TimeCa decreased and PeakF and PeakCa increased
      significantly (n = 13). In addition, transient stretch sometimes induced a twitch
      contraction subsequent to the accelerated TPC and its underlying increase in
      [Ca2+]i. These results suggest that Ca2+ binding and dissociation from the
      myofilaments by the stretch and quick release of muscle may modulate the TPC
      force and the underlying increases in [Ca2+]i and play an important role in the
      induction of arrhythmias.

PMID- 11201504
TI  - Damage induced arrhythmias: mechanisms and implications.
AB  - Little is known about the role played by non-uniform myocardial stress and strain
      distributions and by non-uniform excitation contraction coupling in mechanisms
      underlying the premature beats that initiate an arrhythmia. We will review the
      evidence in support of a mechanism in which both non-uniform contraction and
      increased Ca2+ load of cells adjacent to acutely damaged cells are essential in
      the "spontaneous" generation of Ca2+ transients during the relaxation phase of
      the electrically driven twitch. The putative mechanism of initiation of the
      propagating Ca2+ waves involves feedback of rapid length (or force) changes to
      dissociation of Ca2+ from the contractile filaments. A novel aspect of this
      concept is that these mechanically elicited Ca2+ transients induce propagating
      Ca2+ waves that travel into the adjacent normal myocardium and cause after
      depolarizations, which, in turn, may cause premature action potentials. These
      premature action potentials will further load the cells with Ca2+, which promotes
      the subsequent generation of propagating Ca2+ transients and leads to triggered
      arrhythmias. The damage-induced premature beats may also initiate re-entry
      arrhythmias in non-uniform myocardium. These observations strongly support the
      concept that abnormal cellular Ca2+ transport plays a crucial role in the
      initiation of arrhythmias in damaged and non-uniform myocardium.

PMID- 11201505
TI  - Evidence for the binding of beta-adrenoceptor blockers to microsomal Na+/K+
      ATPase in guinea pig heart preparations.
AB  - We reported in a previous study that beta-adrenoceptor blockers inhibit the Mg2+
      dependent ATP-hydrolytic function of Na+/K+-ATPase. To determine if this action
      is a result of binding of beta-blockers to the receptor sites that bind the
      digitalis glycosides, we performed displacement binding assays of eight beta
      blockers with [3H]-ouabain (OUA) in guinea pig myocardial microsomal
      preparations. In the first series of experiments, 10-200 microM of the beta
      blockers were displaced with 250 nM OUA. In the second set of experiments, 10-500
      nM of OUA was displaced using 200 microM of the beta-blockers. The drugs showed
      concentration-dependent receptor occupancy at the different OUA levels.
      Propranolol (PPN), metoprolol (MTP), and sotalol (STL) showed the strongest
      binding; nadolol (NDL), indenolol (IDN), and atenolol (ATN) had intermediate
      binding; carazolol (CRZ) and celiprolol (CLP) had the weakest binding properties.
      The results suggest that beta-blockers may compete for the same binding sites
      with ouabain in their inhibition of the Na+/K+-ATPase. These actions may
      contribute to the mechanism for some of their cardiac effects, especially their
      proarrhythmic and arrhythmogenic actions.

PMID- 11201506
TI  - Spread of Ca2+ in the sarcomere during fast and slow activation of mammalian
      cardiac myocytes.
AB  - A multi-compartment model was used to estimate Ca2+ gradients in a sarcomere of a
      cardiac myocyte. The mathematical model assumed Ca2+ release from the
      sarcoplasmic reticulum as a driving function, and calculated Ca2+ binding to
      myoplasmic buffers, Ca2+ uptake by the sarcoplasmic reticulum, and diffusion of
      Ca2+ (and the buffers). During the fast Ca2+ transient similar to those observed
      during a twitch, the model predicted a large Ca2+ gradient in the sarcomere. A
      trajectory of the instantaneous relation between spatially averaged
      concentrations of Ca2+ and the Ca2+-troponin complex showed a counterclockwise
      loop, indicating non-equilibrium Ca2+ binding to troponin. During slow changes in
      [Ca2+] with time to peaks of approximately 500 ms or longer, the gradient of
      [Ca2+] was largely dissipated and the apparent equilibrium of the Ca2+-troponin
      binding reaction was suggested with little hysteresis of the trajectory. We
      conclude that a steady-state relation between [Ca2+] and mechanical activity can
      be achieved uniformly in the sarcomere by slowing the rate of Ca2+ release from
      the sarcoplasmic reticulum.

PMID- 11201507
TI  - Total Ca2+ handling for E-C coupling in the whole heart: an integrative analysis.
AB  - We assessed total Ca2+ handling (transport, flux) in excitation-contraction (E-C)
      coupling in a beating left ventricle (LV). We developed a new integrative
      analysis method that utilizes the internal Ca2+ recirculation fraction (RF), O2
      consumption (V(O2)) for Ca2+ handling, and O2 cost of Emax (contractility index)
      of the LV. We obtained the RF from the beat constant of the exponential decay
      component of the postextrasystolic potentiation, and the O2 cost of Emax from
      V(O2) measured at different Emax. Our equation calculated the unknown total Ca2+
      handling, futile Ca2+ cycling, and Ca2+ reactivity of Emax from the RF and Ca2+
      handling V(O2). The calculated total Ca2+ handling fell between 30 and 110
      micromol/kg, depending on Emax and pathological conditions. Our method also
      allowed an assessment of futile Ca2+ cycling and Ca2+ reactivity of Emax in a
      beating LV. These data are not available using conventional methods. Our method
      can be used to better understand the pathophysiology of total Ca2+ handling in a
      beating heart.

PMID- 11201508
TI  - Progestogen effects on coronary arteries: the need for definitive clinical
      trials.

PMID- 11201510
TI  - Isoflavone-rich or isoflavone-poor soy protein does not reduce menopausal
      symptoms during 24 weeks of treatment.
AB  - OBJECTIVE: We examined the change in menopausal symptoms in response to 24 weeks
      of isoflavone-rich (80.4 mg/day) and isoflavone-poor (4.4 mg/day) soy protein
      isolate treatment in perimenopausal women. DESIGN: In this double-blind 24-week
      study, 69 women were randomized to treatment: isoflavone-rich soy protein (n =
      24), isoflavone-poor soy protein (n = 24), or whey protein control (n = 21). A
      Menopausal Index was used to assess change in hot flushes and night sweats, as
      well as other symptoms, at baseline, week 12, and week 24. RESULTS: Repeated
      measures analysis of variance indicated no treatment effect on change in hot
      flush (p = 0.18) and night sweat (p = 0.92) frequency, whereas there was a
      significant decline in hot flush (p = 0.0003) and night sweat (p = 0.0007)
      frequency with time in all treatment groups. Chi2 analyses indicated no treatment
      effect on severity of hot flushes or night sweats at any time point, as well as
      no treatment effect on frequency or severity of other vasomotor symptoms. At the
      completion of the study, we found no treatment effect on retrospective perception
      of frequency, duration, or severity of hot flushes or night sweats. Since time
      had a significant effect on symptoms with all groups reporting a decline in
      overall symptoms, this indicated either a placebo effect or simply an improvement
      in symptoms during the study. CONCLUSION: In this study, we found no evidence
      that isoflavone-rich or isoflavone-poor soy protein provided relief of vasomotor
      or of other menopausal symptoms.

PMID- 11201511
TI  - The effects of sequential combined oral 17beta-estradiol norethisterone acetate
      on insulin sensitivity and body composition in healthy postmenopausal women: a
      randomized single blind placebo-controlled study.
AB  - OBJECTIVE: The androgenic effect of progestogen, necessary in early
      postmenopausal hormone replacement therapy (HRT), may adversely affect insulin
      sensitivity as well as body fat distribution and thereby increase the
      cardiovascular risk profile. The impact of HRT with sequential combined oral
      17beta-estradiol and norethisterone acetate on insulin sensitivity and body
      composition in early menopause has not been studied. DESIGN: A randomized single
      blind placebo-controlled 6-month study of sequential combined 17beta-estradiol
      norethisterone acetate on insulin sensitivity and body composition was carried
      out. Thirty fit healthy postmenopausal women were enrolled and completed this 6
      month study. Body composition was measured by dual-energy x-ray absorptiometry
      scanning, and insulin sensitivity was measured using the euglycemic
      hyperinsulinemic clamp. Studies were undertaken at baseline and after 6 months of
      therapy. The studies were performed during the estrogen-only phase of therapy.
      RESULTS: All women demonstrated a degree of decreased insulin sensitivity that
      was not modified by 6 months of hormone replacement therapy. Body composition
      remained unchanged over 6 months. There was no alteration in total body fat or
      the distribution of body fat. The percentage of central abdominal fat (android)
      was not altered. CONCLUSION: Six months of HRT with sequential combined oral
      17beta-estradiol norethisterone acetate does not have an adverse effect on
      insulin sensitivity and does not promote an increase in weight or the more
      android distribution of body fat, which could contribute to the increased
      cardiovascular risk profile that is evident in postmenopausal women.

PMID- 11201509
TI  - Sleep in menopause: differential effects of two forms of hormone replacement
      therapy.
AB  - OBJECTIVES: The aim of the present study was to evaluate differences between two
      regimens of estrogen/progestogen replacement therapy on nocturnal sleep in
      postmenopausal women. METHODS: Twenty-one (21) postmenopausal women were studied.
      They were randomized into two treatment groups: (1) estrogen (Premarin 0.625 mg)
      and medroxyprogesterone acetate (Provera 5 mg) (n = 11) or (2) estrogen (Premarin
      0.625 mg) and oral micronized progesterone (Prometrium 200 mg) (n = 10).
      Postmenopausal women were recorded for two consecutive nights in the sleep
      laboratory at baseline and again after 6 months of treatment in a randomized
      trial. The women also had to fill out evening and morning sleep and vigilance
      questionnaires for 7 days before baseline recordings and for 23 days before month
      6 recordings. RESULTS: Sleep efficiency was found to be significantly improved in
      the micronized progesterone group. It increased by 8% (p = 0.014) with no such
      increase observed in the medroxyprogesterone acetate group. Time spent awake
      after sleep onset was also significantly improved in the micronized progesterone
      group but not in the medroxyprogesterone acetate group. On the other hand,
      menopausal symptoms and subjective measures of sleep (questionnaires) improved in
      both groups after treatment. CONCLUSION: This study suggests that
      medroxyprogesterone acetate and micronized progesterone are both effective for
      treating menopausal symptoms but that the latter might better improve the quality
      of sleep in postmenopausal women taking estrogen.

PMID- 11201512
TI  - Menopausal progesterone replacement and sleep quality.

PMID- 11201513
TI  - Symptom reports from a cohort of African American and white women in the late
      reproductive years.
AB  - OBJECTIVE: To identify symptoms experienced in a cohort of healthy women in the
      late reproductive years; to compare symptom reports between African American and
      Caucasian women; and to determine the extent to which other factors in
      reproductive health, mood and behavior, lifestyle, and demographic background are
      associated with the reported symptoms. DESIGN: A cohort of women aged 35 to 47
      years (mean age, 41 years) was identified through random digit dialing. This
      study is a cross-sectional analysis of data collected at enrollment from a subset
      of 308 women who completed daily symptom reports (DSR) for one menstrual cycle.
      Data were obtained in structured interviews and self-administered standard
      questionnaires. The associations of the study variables with symptoms as assessed
      by the DSR were examined using analysis of variance and general linear models.
      RESULTS: The African American women were significantly more likely to report in
      interview that they experienced menopausal symptoms (46% vs. 30%; p < 0.001) and
      had significantly higher ratings on the physiological symptom factor of the DSR,
      which included hot flashes, dizziness, poor coordination/clumsiness, urine leaks,
      and vaginal dryness. The DSR yielded two other factors of psychological and
      somatic symptoms. Race was associated only with the physiological symptom factor
      in the multivariable analyses. Neither race nor age were associated with
      psychological symptoms, which were predicted by current or past mood problems.
      CONCLUSIONS: Symptoms commonly associated with the menopause are experienced in
      the late reproductive years before observable changes in menstrual cycles.
      African American women reported more physiological symptoms than white women.
      These data provide an essential baseline for longitudinal study of symptoms
      associated with the ovarian decline in the perimenopausal years.

PMID- 11201514
TI  - Influence of endogenous androgens on carotid wall in postmenopausal women.
AB  - OBJECTIVE: There is increasing evidence of a direct association between normal
      androgen levels and reduced cardiovascular morbidity and mortality in women.
      After menopause the influence of estrogens declines, whereas that of androgens
      increases. Therefore, we investigated the effects of androgens on atherosclerosis
      in postmenopausal women, by using carotid artery intimal-medial thickness as a
      marker of vascular damage. DESIGN: Blood pressure, body mass index, waist-to-hip
      ratio, serum dehydroepiandrosterone sulfate, androstenedione, total and free
      testosterone, estrone, insulin, lipid profile, and glucose were evaluated in 44
      women in stable physiological menopause. All subjects underwent carotid
      ultrasound (Biosound 2000 II s.a. high-resolution unit). RESULTS: Spearman
      correlation coefficients indicated that serum androstenedione and free
      testosterone were negatively associated with several carotid intimal-medial
      thickness measures with correlation coefficients (r) ranging from 0.477 to 0.397
      (p < 0.01-0.04). Moreover, age-adjusted androstenedione and free testosterone
      highest tertiles showed intimal-medial thickness values significantly (p < 0.03
      0.05) lower than the other tertiles. There was a favorable association between
      hormones and the most important cardiovascular risk factors. This association,
      however, did not reach statistical significance. Stepwise multiple regression
      analysis showed that the inverse relationships between the hormones
      (androstenedione and free testosterone) and several intimal-medial thickness
      measures were maintained (F: 4.15-6.07, p < 0.05-0.02) after adjustment for major
      cardiovascular risk factors. CONCLUSIONS: Our data demonstrate that in
      postmenopausal women endogenous steroid precursors and androgens are inversely
      related to carotid intimal-medial thickness, an established marker of
      atherosclerosis. In addition, these hormones show favorable associations with
      cardiovascular risk factors. Therefore, our study suggests that, after menopause,
      normal androgen levels may benefit the carotid artery wall.

PMID- 11201515
TI  - Effect of medroxyprogesterone acetate and norethisterone on serum-stimulated and
      estradiol-inhibited proliferation of human coronary artery smooth muscle cells.
AB  - OBJECTIVE: The addition of progestogen to estrogen replacement therapy is thought
      to antagonize, at least in part, the beneficial effects of estrogens on the
      vasculature. The aim of this study was to investigate the effect of two
      progestogens mostly used in clinical practice on the proliferation of vascular
      smooth muscle cells, which has been demonstrated to be a crucial step in the
      development of atherosclerosis. MATERIAL AND METHODS: The effect of
      medroxyprogesterone acetate (MPA) and norethisterone (NET), which represent the
      two different classes of C21- and C19-progestogens, respectively, was
      investigated on proliferation of smooth muscle cells from human coronary artery
      in vitro. The steroids were tested in the concentration range 10(-8) to 10(-5) M,
      which is in the upper range of that reached during hormonal replacement therapy,
      and compared with control values. RESULTS: Estradiol significantly inhibited
      serum-stimulated cell growth at the concentrations 10(-6) and 10(-5) M by 18% and
      34%, respectively. MPA significantly enhanced serum-stimulated growth at the
      concentrations 10(-6) and 10(-5) M by 29% and 47%, respectively. In equimolar
      combinations of MPA and estradiol, proliferation of the cells was significantly
      stimulated at the concentrations 10(-6) and 10(-5) M by 26% and 44%,
      respectively. In contrast, NET had no significant effect on serum-stimulated cell
      growth and had no impact on the estradiol-inhibited proliferation. CONCLUSIONS:
      These data suggest that MPA may antagonize beneficial antiatherosclerotic
      estradiol effects on the vasculature, whereas NET may be neutral in this respect.
      However, these effects occurred at supraphysiological concentrations. Because
      these concentrations might be reached in the target tissues, the clinical
      relevance for treatment of patients with cardiovascular risk cannot be excluded.

PMID- 11201516
TI  - Higher values of hepatic lipase activity in postmenopause: relationship with
      atherogenic intermediate density and low density lipoproteins.
AB  - OBJECTIVE: To investigate the enzymatic activity of hepatic lipase (HL) in
      postmenopausal women (PMW) and reproductive age women (RAW); and to evaluate the
      relationship between this enzyme and the atherogenic intermediate density
      lipoproteins (IDL) and low density lipoproteins (LDL), and antiatherogenic high
      density lipoproteins (HDL) and its subfractions (HDL2 and HDL3). DESIGN: We
      studied 55 PMW receiving no hormonal treatment in a cross-sectional study in
      comparison with a control group of 55 RAW, matched by body mass index. Follicle
      stimulating hormone was > 40 mUI/ml in PMW and 3-12 mUI/ml in RAW. PMW presented
      at least 1 year of natural menopause and no more than 10 years of amenorrhea with
      E2 serum concentration < 15 pg/ml. RESULTS: HL activity was significantly higher
      in PMW versus RAW (14.0 +/- 1.4 vs. 10.9 +/- 0.4 micromol of fatty acids/ml of
      postheparin plasma, respectively, mean +/- SEM, p < 0.001). In PMW, IDL
      cholesterol showed a positive correlation with LDL cholesterol (r = 0.28, p <
      0.05), and HDL2 cholesterol was inversely correlated with HL activity (r = 0.31,
      p < 0.05). HL was positively correlated with plasma concentration of LDL
      cholesterol in both groups (r = 0.27, p < 0.05). The higher values of HL activity
      and IDL cholesterol were independent of age. CONCLUSIONS: Higher HL activity is
      associated with a more atherogenic profile in PMW.

PMID- 11201518
TI  - Prevalence of osteopenia and osteoporosis in Thai women.
AB  - OBJECTIVE: To determine the age-specific and age-adjusted prevalence of
      osteopenia and osteoporosis in pre- and postmenopausal Thai women. METHODS: This
      was a descriptive study of 1,935 Thai women ranging in age from 40 to 80 years,
      with randomly selected strata using multistage sampling and stratifying from six
      representative provinces of the country. After recruiting, all the women were
      interviewed by a well-trained interviewer using structured questionnaires. Bone
      mineral density (BMD) of lumbar spine 1-4 and nondominant hip was measured by a
      dual energy photon absorptiometer. The investigators were trained and
      standardized; inter- and intraobserver variations were measured periodically.
      Every BMD outcome was re-examined by the specialist. Age-specific prevalence of
      osteoporosis and osteopenia were determined using both Thai and Western standard
      BMD values. Age-adjusted prevalence of osteopenia and osteoporosis was calculated
      using the age-adjusted direct method. RESULTS: Using the Thai BMD reference, the
      age-specific prevalence of osteoporosis among Thai women rose progressively with
      increasing age to more than 50% after the age of 70. The age-adjusted prevalence
      of osteoporosis also rose progressively. It was 19.8%, 13.6%, and 10% for lumbar
      spine, femoral neck, and intertrochanteric. The age-adjusted prevalence of
      osteoporosis indicates the overall magnitude of that condition in the population
      or country. In our study, using a Western BMD reference resulted in a
      misleadingly high prevalence of osteoporosis in the population of Asian
      countries. CONCLUSION: It is important to calculate the age-adjusted prevalence
      of osteopenia and osteoporosis to address the overall magnitude of the problem in
      Thai women. This will allow us to predict the socioeconomic impact of preventable
      chronic conditions such as osteoporosis. The results obtained from this study are
      important data for public health policy: maximizing bone mass throughout life as
      well as detection of important risk factors is essential.

PMID- 11201517
TI  - 17Beta-estradiol inhibits proliferation of cultured vascular smooth muscle cells
      induced by lysophosphatidylcholine via a nongenomic antioxidant mechanism.
AB  - OBJECTIVE: Lysophosphatidylcholine (lysoPC), an active component of oxidized low
      density lipoprotein, stimulates proliferation of vascular smooth muscle cells
      (VSMC). We investigated the direct impact of 17beta-estradiol (E2) on the
      proliferation of VSMC from rat aorta. RESULTS: VSMC derived from both female and
      male rats expressed estrogen receptors alpha and beta. Treatments with 1% fetal
      bovine serum or 5 microM lysoPC increased the incorporation of [3H]-thymidine in
      VSMC obtained from female rats. 17Beta-E2 did not alter the response to fetal
      bovine serum, but significantly suppressed the enhanced deoxyribonucleic acid
      synthesis which had been induced by lysoPC in a dose-dependent manner (10(-4)-10(
      6) M). Estrogen also inhibited the proliferation of VSMC from male animals. ICI
      182,780, a specific estrogen receptor antagonist, and 17alpha-E2, an inactive
      form of estradiol, also decreased the mitogenic response to lysoPC in VSMC. In
      addition, N-acetyl-L-cysteine, a potent antioxidant, inhibited the lysoPC effect.
      Flow cytometric analysis using the oxidation-sensitive probe 2',7'
      dichlorofluorescin diacetate revealed that elevated intracellular formation of
      reactive oxygen species elicited with lysoPC was depressed significantly by
      17beta-E2, ICI 182,780, or 17alpha-E2 as well as by N-acetyl-L-cysteine.
      CONCLUSION: 17Beta-E2 inhibits in vitro VSMC proliferation induced by lysoPC via
      a nongenomic antioxidant mechanism.

PMID- 11201519
TI  - Hormone replacement therapy after invasive ovarian serous cystadenocarcinoma
      treatment: the effect on survival.
AB  - AIM: Our report deals with the presumed influence of hormone replacement therapy
      (HRT) on the survival of patients with invasive ovarian serous
      cystadenocarcinoma. MATERIALS AND METHODS: We selected a group of 24 patients
      with the diagnosis of invasive ovarian serous cystadenocarcinoma who were treated
      with HRT after primary surgical treatment. Each patient from the selected group
      was compared with two patients from the control group with the same diagnosis who
      did not receive HRT. The matching criteria were the age at the time of the
      diagnosis, year of the diagnosis, stage of the disease, differentiation, residual
      tumor after first operation, and disease-free interval until receiving HRT. We
      used Cox regression to calculate odds ratios as estimates of the effect of HRT on
      overall survival in the patients with invasive ovarian serous cystadenocarcinoma
      who did or did not receive HRT after diagnosis. RESULTS: HRT was started an
      average of 21 months (range, 1-25 months) after diagnosis, and lasted for an
      average of 24 months (range, 1-70 months). After taking into account the effects
      of other known prognostic factors (the age at the time of the diagnosis, stage of
      the disease, differentiation, type of operation, residual tumour before the first
      operation), the estimated risk of death in patients with invasive ovarian serous
      cystadenocarcinoma who received HRT was 0.90 (odds ratio = 0.90; 95% confidence
      interval, 0.24-5.08). CONCLUSION: The results of our small study are only
      preliminary and suggest that HRT does not have a pronounced effect on survival. A
      single center can scarcely obtain a sufficient number of such a specific group of
      cancer patients; therefore, the collaboration of different institutions,
      preferably in a randomized, controlled trial, is needed for more reliable
      results.

PMID- 11201520
TI  - Clinical effects of a standardized soy extract in postmenopausal women.

PMID- 11201521
TI  - The effects of HIV infection on endothelial function.
AB  - Endothelial dysfunction and/or injury is pivotal to the development of
      cardiovascular and inflammatory pathology. Endothelial dysfunction and/or injury
      has been described in Human Immunodeficiency Virus (HIV) infection. Elaboration
      of circulating markers of endothelial activation, such as soluble adhesion
      molecules and procoagulant proteins, occurs in HIV infection. Certain endothelial
      cells, such as those lining liver sinusoids, human umbilical vein endothelial
      cells, bone marrow stromal endothelial cells or brain microvascular endothelial
      cells, have been shown to be variably permissive for HIV infection. Entry of
      virus into endothelial cells may occur via CD4 antigen or galactosyl-ceramide
      receptors. Other mechanisms of entry including chemokine receptors have been
      proposed. Nevertheless, endothelial activation may also occur in HIV infection
      either by cytokines secreted in response to mononuclear or adventitial cell
      activation by virus or else by the effects of the secreted HIV-associated
      proteins, gp 120 (envelope glycoprotein) and Tat (transactivator of viral
      replication) on endothelium. Enhanced adhesiveness of endothelial cells,
      endothelial cell proliferation and apoptosis as well as activation of cytokine
      secretion have all been demonstrated. Synergy between select inflammatory
      cytokines and viral proteins in inducing endothelial injury has been shown. In
      HIV infection, dysfunctional or injured endothelial cells potentiate tissue
      injury, inflammation and remodeling, and accelerate the development of
      cardiovascular disease.

PMID- 11201522
TI  - Effect of high blood flow on the expression of endothelial constitutive nitric
      oxide synthase in rats with femoral arteriovenous shunts.
AB  - The effect of high blood flow on the expression of endothelial nitric oxide
      synthase has been investigated in the femoral arteriovenous shunt (AVS) rats
      created by inserting U-shaped polyurethane tubes in the left femoral arteries and
      veins. Three days after inserting the femoral AVS, the mean aortic blood flow
      rate in the abdominal aorta of the AVS rats was about 2.0 times higher than that
      in the control rats (110.0 +/- 8.4 ml/min vs 52.7 +/- 2.7 ml/min, p < 0.001). The
      competitive reverse transcriptase-polymerase chain reaction (RT-PCR) data
      revealed that the mRNA expression level of the endothelial constitutive nitric
      oxide synthase (ecNOS) was increased in the aortas of the femoral AVS rats
      compared to that in the control rats. Western blot analysis using a monoclonal
      antibody against ecNOS revealed that the ecNOS protein levels were markedly
      increased in the aortas of femoral AVS rats, but ecNOS protein levels in aortas
      without endothelium were not significantly increased. Inducible nitric oxide
      synthase (iNOS) protein was not expressed in the aortic tissues with and without
      endothelium in the control rats. This iNOS expression was not increased by the
      high blood flow in the femoral AVS rats. These findings suggest that high blood
      flow could up-regulate the expression levels of ecNOS mRNA and proteins in
      femoral arteriovenous shunt rats.

PMID- 11201523
TI  - Endothelium-dependent vasorelaxation in the aorta of transgenic mice expressing
      human apolipoprotein(a) or lipoprotein(a).
AB  - Elevated plasma level of lipoprotein(a) (Lp(a)) is a well established risk factor
      for premature atherosclerosis and coronary artery disease. Recent studies showed
      impaired endothelium-dependent vasodilatation in humans with elevated plasma
      Lp(a). However, these human studies could not determine whether (1) elevated
      Lp(a) levels alone are the cause of endothelial dysfunction (these patients had
      multiple risk factors), and (2) native or oxidatively modified Lp(a) contributes
      to endothelial dysfunction (no measurements of native/oxidized Lp(a) ratio was
      reported in humans). In order to test whether apo(a) (an essential component of
      Lp(a) which is required for binding to endothelial cells) and native Lp(a) cause
      endothelial dysfunction, in the present study we tested endothelium-dependent
      vasorelaxation in aortic rings isolated from control and transgenic male mice
      either expressing the human apo(a) gene (TgA) or both the human apo(a) and human
      apo B100 genes (TgL). The TgA mice had plasma apo(a) levels of 8.8 +/- 1.2 mg/dl
      (n=6) and the double transgenic TgL mice had plasma Lp(a) levels of 15.3 +/- 1.4
      mg/dl (n=8). Isolated aortic rings with and without endothelium were mounted in
      organ chambers and contracted with U46619 (10(-8) M) in the presence of ibuprofen
      (10(-5) M). Acetylcholine caused concentration-dependent (10(-9)-10(-5) M)
      relaxation, which could be prevented by endothelium removal and by NG-L-nitro
      arginine (10(-4) M). Basal and acetylcholine-stimulated endothelium-dependent
      relaxation and endothelium-independent relaxation to nitroglycerin (10(-6) M)
      were not significantly different in aortic rings isolated from control and TgA or
      TgL mice. Twenty-four hour incubation of aortic rings isolated from control mice
      with recombinant human apo(a) or native Lp(a) (up to 300 microg/ml) caused no
      impairment of endothelium-dependent relaxations. In contrast, incubation with
      oxidized Lp(a) (50 microg/ml) or oxidized LDL (250 microg/ml) caused significant
      suppression of acetylcholine-induced endothelium-dependent vasorelaxation. These
      results show for the first time that elevated plasma levels of apo(a) and Lp(a)
      do not cause endothelial dysfunction in transgenic mice.

PMID- 11201525
TI  - Hypoxia-reoxygenation inhibits gap junctional communication in cultured human
      umbilical vein endothelial cells.
AB  - We studied the change in gap junctional intercellular communication (GJIC) on
      human umbilical vein endothelial cells (HUVEC) under hypoxia-reoxygenation (H-R)
      conditions by the fluorescence redistribution after photobleaching (FRAP) method.
      Confluent HUVEC monolayers were exposed to hypoxia (pO2<0.1%) for 12 hours, and
      then were returned to normal atmospheric conditions for reoxygenation. Contrast
      microscopic observation showed no significant changes in the morphology of the
      HUVEC at any times after H-R. Reoxygenation following hypoxia caused time
      dependent decrease in GJIC, that is, GJIC reduction was induced after 2 hours and
      reached maximum at 4-6 hours which recovered to normal levels after 18 hours.
      Oxidant sensitive fluorescence dye assay revealed that the generation of
      intracellular free radicals increased during the first 2 hours after
      reoxygenation. Hydroxyl radical scavengers (MCI-186, DMSO) and an iron chelator
      (deferoxamine) abolished the reduction of GJIC due to H-R. However, SOD, catalase
      and probucol were essentially inactive on this reduction. These data suggest that
      ischemia-reperfusion injury may be caused by a functional defect of GJIC induced
      by reactive oxygen radicals.

PMID- 11201524
TI  - Comparison of glycyrrhetinic acid isoforms and carbenoxolone as inhibitors of
      EDHF-type relaxations mediated via gap junctions.
AB  - The vascular actions of the lipophilic gap junction inhibitors 18alpha
      glycyrrhetinic acid (18alpha-GA), 18beta-glycyrrhetinic acid (18beta-GA) and the
      water-soluble hemisuccinate derivative of 18beta-GA, carbenoxolone, were
      investigated in preconstricted rings of rabbit superior mesenteric artery. EDHF
      type relaxations to acetylcholine (ACh), observed in the presence of 300 microM
      NG-nitro-L-arginine methyl ester (L-NAME) and 10 microM indomethacin, were
      attenuated by preincubation with 18alpha-GA (to 100 microM), 18A-GA (to 10
      microM) or carbenoxolone (to 300 microM) in a concentration-dependent fashion. By
      contrast, none of these agents affected responses to sodium nitroprusside, an
      exogeneous source of NO, and relaxations evoked by ACh in the absence of L-NAME
      were attenuated by only approximately 20%. 18alpha-GA exerted no direct effect on
      vessel tone, whereas 18beta-GA and carbenoxolone caused relaxations which were
      maximal at approximately 1 and approximately 10 mM, respectively. Relaxations to
      carbenoxolone were attenuated by endothelial denudation and by incubation with L
      NAME, whereas those to 18beta-GA were unaffected. In conclusion, all three agents
      inhibit EDHF-type relaxations evoked by ACh, providing further evidence for the
      involvement of gap junctions in such responses. Unlike 18alpha-GA, carbenoxolone
      and 18beta-GA possess intrinsic vasorelaxant activity which in the case of
      carbenoxolone involves functional enhancement of NO activity in addition to
      direct effects on vascular smooth muscle.

PMID- 11201526
TI  - Regulation of endothelial barrier function by the cAMP-dependent protein kinase.
AB  - Elevation of cAMP promotes the endothelial cell (EC) barrier and protects the
      lung from edema development. Thus, we tested the hypothesis that both increases
      and decreases in PKA modulate EC function and coordinate distribution of
      regulatory, adherence, and cytoskeletal proteins. Inhibition of PKA activity by
      RpcAMPS and activation by cholera toxin was verified by assay of kemptide
      phosphorylation in digitonin permeabilized EC. Inhibition of PKA by RpcAMPS or
      overexpression of the endogenous inhibitor, PKI, decreased monolayer electrical
      impedance and exacerbated the decreases produced by agonists (thrombin and PMA).
      RpcAMPS directly increased F-actin content and organization into stress fibers,
      increased co-staining of actin with both phosphatase 2B and myosin light chain
      kinase (MLCK), caused reorganization of focal adhesions, and decreased catenin at
      cell borders. These findings are similar to those evoked by thrombin. In
      contrast, cholera toxin prevented the agonist-induced resistance decrease and
      protein redistribution. Although PKA activation attenuated thrombin-induced
      myosin light chain (MLC) phosphorylation, PKA inhibition per se did not cause MLC
      phosphorylation or affect [Ca2+]i. These studies indicate that a decrease in PKA
      activity alone can produce disruption of barrier function via mechanisms not
      involving MLCK and support a central role for cAMP/PKA in regulation of
      cytoskeletal and adhesive protein function in EC which correlates with altered
      barrier function.

PMID- 11201527
TI  - Healthy weight. A process of changing your lifestyle habits.

PMID- 11201528
TI  - Health tips. Caffeine.

PMID- 11201529
TI  - Can ginkgo biloba treat intermittent claudication?

PMID- 11201530
TI  - Another reason to stay active--youthful blood vessels.

PMID- 11201531
TI  - Chronic pain. Considering the role of medication.

PMID- 11201533
TI  - Multiple medications. How to avoid interactions.

PMID- 11201532
TI  - Atrophic vaginitis. Estrogen can help.

PMID- 11201534
TI  - I understand there's a new prescription cream that removes excess facial hair.
      Could you tell me more about it?

PMID- 11201535
TI  - I've heard the terms aerobic exercise and anaerobic exercise. What's the
      difference?

PMID- 11201536
TI  - Postpartum follow-up of hepatic calcification detected by prenatal ultrasound.
AB  - The causes of parenchymal hepatic calcification are mostly transplacental
      infection of TORCH complex, ischaemic necrosis, or tumours of foetal liver
      including haemangioma, hamartoma, teratoma, hepatoma, and hemangioendothelioma.
      Vascular pathologies like hepatic artery aneurysm, haematoma, calcified
      thromboemboli of portal vein and hepatic veins can also cause hepatic
      calcification. We present a case of hepatic calcification which was first
      diagnosed by prenatal ultrasound. In the postpartum follow-up, we observed that
      the calcifications had decreased in number and size. The causes and results of
      hepatic calcification or underlying disease are discussed with analysis of the
      literature.

PMID- 11201537
TI  - Metachronous eosinophilic granuloma of bone.
AB  - We present the case of a 4-year-old girl who developed a metachronous osseous
      lesion of the left distal femur five months after successful surgical treatment
      of an eosinophilic granuloma in the left proximal femur. After treatment of the
      second lesion with curettage, no further recurrence occurred during a follow-up
      interval of 17 months. Radiologists should be aware that additional eosinophilic
      granulomas of bone, occurring in up to four years after the initial diagnosis,
      should still be interpreted as a localized form of Langerhans'cell histiocytosis
      with a more favorable prognosis than the multifocal disseminated form, with
      involvement of organ systems other than the skeletal system.

PMID- 11201538
TI  - Percutaneous treatment of acute multiple limb ischemia.
AB  - This study evaluates the use of pulse spray pharmacomechanical thrombolysis
      (PSPMT) in combination with a low dose urokinase infusion and a possible
      secondary percutaneous treatment in the management of acute multiple limb
      ischemia. A retrospective analysis of 185 patients treated with PSPMT revealed
      eight patients with acute simultaneous ischemia of more than 1 limb. Seven
      patients presented with acute ischemia of both lower limbs; one patient presented
      with acute ischemia of the left arm and both lower limbs. All patients were
      treated using a combination of PSPMT and low dose urokinase infusion. The
      combination of PSPMT and low dose urokinase infusion was completely successful in
      6 cases. In 1 patient with bronchogenic carcinoma PSPMT failed and immediate
      surgical thrombectomy was performed. In the other patient we obtained clot
      dissolution with thrombolysis in one leg, residual clots at the popliteal level
      in the other leg however had to be removed by surgical embolectomy. Embolism was
      the cause of the occlusion in 6 patients. Atherosclerotic disease appeared to be
      the underlying cause in the other 2 patients. Atherosclerotic disease was treated
      with balloon angioplasty and stenting. In the 8 patients with multiple limb
      ischemia, combination of PSPMT, low dose urokinase infusion, and possibly
      secondary treatment was useful and constituted a valuable alternative to open
      surgery. Acute occlusion of the abdominal aorta and acute leg ischemia have a
      high mortality and amputation rate with variable results in treatment. The use of
      thrombolysis has reduced the necessity of surgery in arterial occlusive disease
      and simplifies the treatment of native artery occlusion. Especially in patients
      with long and multi-level occlusions with poor outflow, thrombolysis seems to be
      the treatment of choice. In our analysis of 8 cases with acute multiple limb
      ischemia we review our experience with the combination of pulse spray
      pharmacomechanical thrombolysis (PSPMT), low dose continuous urokinase infusion
      and a possible subsequent percutaneous treatment of the obstructing lesion. The
      final purpose was to investigate if this combination is a successful and safe
      method in the treatment of acute multiple limb ischemia.

PMID- 11201539
TI  - [Carotid endarterectomy without arteriography: only dedicated to urgent
      procedures?].
AB  - Duplex examination is presently established as a safe non-invasive and accurate
      method of evaluating patients with extracranial cerebrovascular disease which
      usually provides complete information about the extent of carotid artery
      narrowing Arteriography, in this indication, is an invasive procedure with a
      total complication rate of 3-4% with 1% of permanent stroke. If it is currently
      accepted that in emergency conditions (ictus ingravescens, pre-occlusive plaque)
      or if iodinated contrast media are contraindicated, thrombendarteriectomy can be
      performed without arteriography it could be extended to most cases. The authors
      stress the criteria to increase the number of those patients, summarize the pre
      requisites to achieve this goal, and comment on the future alternative position
      of MRA.

PMID- 11201540
TI  - Pediatric cerebrovascular disease.
AB  - Stroke in children is thought to be a rare phenomenon, but in a pediatric
      hospital, it is much more common than is expected. The development of rapid MRI
      imaging with diffusion techniques and MR spectroscopy has brought to the
      attention of both the neuroradiologists and clinicians that pediatric infarction,
      in both detection and management, are challenges for the future. Since 1995,
      cerebral diffusion has been performed at The Children's Hospital of Philadelphia
      in the evaluation of patients with acute cerebral compromise. Diffusion imaging
      looks at the motion of water molecules both intra- and extracellular, and the
      manner in which they become restricted in their motion when higher gradient
      strength is applied during the imaging sequence. Restricted diffusion is seen in
      cytotoxic edema, an early acute manifestation of ischemia/infarction. Diffusion
      studies are often positive when routine MRI and CT are as yet negative.
      Confirmation of the death of tissue is provided on proton spectroscopy by a rise
      in lactate from anaerobic glycolysis and a loss of N-acetylaspartate from
      neuronal death. Confirmation of the diffusion image findings, by mapping the
      apparent co-efficient (ADC), is also valuable. Application of these techniques,
      together with magnetic resonance angiography and magnetic resonance venography,
      is the substance of this paper.

PMID- 11201541
TI  - Renal infarction as a cause of acute flank pain.
AB  - Renal infarction results from occlusion of the main renal artery or its distal
      branches. The clinical picture depends on the extent and the rapidity of the
      occlusion. Herein, the different imaging modalities (including ultrasonography,
      computed tomography, magnetic resonance imaging, intravenous urography, and
      angiography) for diagnozing renal infarction are discussed. The key-modality is
      computed tomography. Because of the limited warm ischemia time of the kidneys
      (1.5 hours?) and the time required for diagnosis, there is no real therapeutic
      relevance in most cases.

PMID- 11201542
TI  - Helical CT without contrast in the radiological investigation of renal colic.

PMID- 11201543
TI  - The place of helical CT scanning in acute pulmonary embolism.
AB  - Pulmonary embolism is a relative common, potentially fatal disorder that
      clinicians have difficulty detecting and difficulty diagnosing. Deep venous
      thrombosis (DVT) is the most important source of thrombi. Early and accurate
      diagnosis is essential for efficient therapy. Therapy is based on long-term
      anticoagulation and has an important impact on the mortality and morbidity of
      pulmonary embolism. For the diagnosis of pulmonary embolism, the
      ventilation/perfusion (V/Q) scan is still the first examination in many
      instances. A normal V/Q scan or the combination of a low probability scan and a
      low clinical suspicion are associated with a prevalence of pulmonary embolism of
      4%. The combination of a high-probability V/Q scan and a strong clinical
      suspicion has a prevalence of pulmonary embolism of 96%. All other results should
      be considered as non-diagnostic. However, the number of non-diagnostic V/Q
      examinations can be as high as 70%. Nevertheless, an additional pulmonary
      angiography will be performed in only in 15% of these cases. In the low pre-test
      probability group (poor clinical suspicion, absence of risk factors and no
      medical history) the V/Q scan is useful as a screening test ("rule-out"
      strategy). When the pre-test probability is higher or in other cases in which
      early diagnosis is necessary ("rule-in" strategy), a contrast-enhanced spiral CT
      of the pulmonary arteries (possibly in combination with ultrasonography of the
      lower limbs) is the most accurate examination.

PMID- 11201544
TI  - Combined CT venography of the lower limbs and spiral CT angiography of pulmonary
      arteries in acute pulmonary embolism: preliminary results of a prospective study.
AB  - PURPOSE: To determine the clinical accuracy of combined CT venography (CTV) and
      spiral CT angiography (SCTA) in patients suspicious of acute pulmonary thrombo
      embolism. MATERIALS AND METHODS: 278 consecutive patients referred for SCTA for
      suspicion of acute pulmonary embolism (APE) underwent subsequent evaluation of
      the veins of the lower limbs and abdomen (CTV) within one examination without
      additional injection of contrast medium. Sixty-nine patients had no further
      study. Two hundred and nine patients were included in the study, 199 had US and
      51 phlebography (PG) within 48 hours from SCTA-CTV. The investigators were
      blinded to the results of CT. When results of CTV and US were discordant,
      phlebography was indicated. RESULTS: SCTA was positive in 89 patients, negative
      in 119 and indeterminate in 1. CTV was positive in 99 patients, negative in 103
      and indeterminate in 7. US was positive in 87 patients, negative in 97 and
      indeterminate in 15. PG was positive in 21 patients, negative in 29 and
      indeterminate in 1. Excellent correlation was found between CTV and US (k = 0.84)
      and moderate correlation between CTV and PG, and US and PG (k = 0.53).
      CONCLUSIONS: Combined SCTA and CTV is a rapid and accurate one-session
      examination in patients suspicious of acute pulmonary thrombo-embolism.

PMID- 11201545
TI  - Cervical vertebral changes caused by vertebral artery tortuosity: assessment
      using MR angiography.

PMID- 11201546
TI  - Ultrasound use in cardiothoracic surgery.
AB  - With the advent of minimally invasive surgical techniques, patients in the United
      States currently are undergoing safer, more comfortable surgical procedures than
      in the past. Traditionally, saphenous vein harvesting techniques involved open
      surgical techniques that could become sources of postoperative complications,
      including pain, poor wound healing, increased length of hospital stay, and higher
      costs for the patient and hospital. These complications were the impetus for
      developing minimally invasive techniques for vein harvesting. Minimally invasive
      saphenous vein harvesting is performed through small incisions and subcutaneous
      tunnels. The procedure offers an atraumatic conduit for the coronary artery
      bypass procedure and decreases the number of leg wound complications. Ultrasound
      devices currently offer a quick, accurate method for locating veins before
      harvest, thereby avoiding wound complications and injuries.

PMID- 11201547
TI  - Focusing on the safe, healthy workplace.

PMID- 11201548
TI  - The use of neuromodulation for treatment of urinary incontinence.
AB  - Urinary incontinence (UI) affects many people in the United States. Although the
      prevalence of UI increases with age, it should not be considered part of the
      normal aging process. Medication to relax the bladder and behavioral therapy have
      been used to treat patients suffering from UI, but they often are unsuccessful or
      poorly tolerated. Neuromodulation through sacral nerve stimulation is a minimally
      invasive surgical procedure for treatment of urge incontinence. Neuromodulation
      is becoming the next logical step at many centers for treating urge incontinence
      after the failure of more conservative measures.

PMID- 11201549
TI  - Linking philosophy, methodology, and methods in qualitative research.

PMID- 11201550
TI  - Recommended practices for reducing radiological exposure in the practice setting.

PMID- 11201551
TI  - Recommended practices for positioning the patient in the perioperative practice
      setting.

PMID- 11201552
TI  - Army nurse corps celebrates 100th anniversary.

PMID- 11201553
TI  - Crime proofing: give your clinic a thorough examination.

PMID- 11201554
TI  - Advice for condolence letters.

PMID- 11201555
TI  - Coverage of Western U accreditation questioned.

PMID- 11201556
TI  - Enjoys Dr. Osborne's articles.

PMID- 11201557
TI  - Ethical aspects of proof and "alternative" therapies.

PMID- 11201558
TI  - What is your diagnosis? Soft tissue opacification of the right maxillary sinus
      and lysis of the maxillary bone.

PMID- 11201559
TI  - Vicarious liability.

PMID- 11201560
TI  - Disaster relief management of companion animals affected by the floods of
      Hurricane Floyd.

PMID- 11201561
TI  - Comparison of tibial plateau angles in dogs with and without cranial cruciate
      ligament injuries.
AB  - OBJECTIVE: To measure and compare tibial plateau angles (TPA) of dogs with
      cranial cruciate ligament (CrCL) injuries and dogs without CrCL injuries. DESIGN:
      Prospective study. ANIMALS: 87 dogs. PROCEDURE: Stifle joints were measured from
      lateral radiographic views to determine TPA in 3 groups: group-1 dogs had CrCL
      injuries, group-1a dogs, a subgroup of group 1, had 1 unaffected stifle joint,
      and group-2 dogs had no CrCL injuries. Age, sex, breed, body weight, limb
      injured, and TPA were recorded for each dog. RESULTS: 56 stifle joints were
      measured in group-1 dogs; mean TPA was 23.76 degrees , and mean age and weight
      were 5.7 years and 37.91 kg (83.4 lb), respectively. Fourteen stifle joints were
      measured in group-1a dogs; mean TPA was 24.71 degrees , and mean age and weight
      were 5.6 years and 38.06 kg (83.8 lb), respectively. Sixty stifle joints were
      measured in group-2 dogs; mean TPA was 18.10 degrees , and mean age and weight of
      these dogs were 4.83 years and 35.85 kg (79 lb), respectively. The most common
      breeds included Labrador Retriever, Golden Retriever, and Rottweiler. The TPA of
      dogs in group 1 and group 1a were significantly greater than the TPA of dogs in
      group 2. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with CrCL injuries have a
      significantly greater TPA than dogs without CrCL injury. With further
      investigation, a normal TPA can be determined. In the future, TPA measurements
      may be used to screen dogs suspected of being susceptible to CrCL injury.

PMID- 11201562
TI  - Effect of vaccination on experimental infection with Bordetella bronchiseptica in
      dogs.
AB  - OBJECTIVE: To determine comparative efficacy of vaccines administered IM and
      intranasally, used alone or sequentially, to protect puppies from infection with
      Bordetella bronchiseptica and determine whether systemic or mucosal antibody
      response correlated with protection. DESIGN: Randomized controlled trial.
      ANIMALS: 50 specific-pathogen-free Beagle puppies. PROCEDURE: In 2 replicates of
      25 dogs each, 14-week-old puppies that were vaccinated against canine distemper
      virus and parvovirus were vaccinated against B bronchiseptica via intranasal, IM,
      intranasal-IM, or IM-intranasal administration or were unvaccinated controls.
      Puppies were challenge exposed via aerosol administration of B bronchiseptica 2
      weeks after final vaccination. Clinical variables and systemic and mucosal
      antibody responses were monitored for 10 days after challenge exposure. Puppies
      in replicate 1 were necropsied for histologic and immunohistochemical studies.
      RESULTS: Control puppies that were seronegative before challenge exposure
      developed paroxysmal coughing, signs of depression, anorexia, and fever.
      Vaccinated puppies (either vaccine) that were seronegative before challenge
      exposure had fewer clinical signs. Puppies that received both vaccines had the
      least severe clinical signs and fewest lesions in the respiratory tract.
      Vaccinated dogs had significantly higher concentrations of B bronchiseptica
      reactive antibodies in serum saliva before and after challenge. Antibody
      concentrations were negatively correlated with bacterial growth in nasal cavity
      and pharyngeal samples after challenge exposure. CONCLUSIONS AND CLINICAL
      RELEVANCE: Parenterally and intranasally administered vaccines containing B
      bronchiseptica may provide substantial protection from clinical signs of
      respiratory tract disease associated with infection by this bacterium.
      Administration of both types of vaccines in sequence afforded the greatest degree
      of protection against disease.

PMID- 11201563
TI  - Congestive heart failure associated with myxomatous degeneration of the left
      atrioventricular valve in a parakeet.
AB  - Congestive heart failure was diagnosed in a 27-year-old Indian ringneck parakeet
      with exercise-induced dyspnea. A grade IV/VI holosystolic murmur that radiated to
      the right sternal area was auscultated over the left side of the sternum.
      Radiography revealed progressive cardiomegaly, hepatomegaly, pulmonary edema, and
      accumulation of fluid within the coelomic cavity. Echocardiography revealed
      biatrial enlargement and enlargement of the right ventricle. Doppler recording
      revealed high velocity left and right atrioventricular valve regurgitation.
      Treatment with digoxin and furosemide alleviated clinical signs for approximately
      10 months. Gross postmortem examination revealed cardiac enlargement and
      eccentric hypertrophy of both ventricles on cross-section. Pulmonary congestion
      and edema, hepatomegaly, hepatic congestion, and ascites were also evident.
      Histologic examination of the heart revealed myxomatous degeneration of the left
      atrioventricular valve, muscular hypertrophy of the right atrioventricular valve,
      and biventricular chronic myofiber degeneration and necrosis.

PMID- 11201564
TI  - Nonenteric Escherichia coli isolates from dogs: 674 cases (1990-1998).
AB  - OBJECTIVE: To determine nonenteric sites associated with Escherichia coli
      isolates in dogs and the antimicrobial susceptibilities of the isolates. DESIGN:
      Retrospective study. SAMPLE POPULATION: 17,000 canine specimens. PROCEDURE:
      Medical records of 17,000 canine specimens submitted for bacteriologic culture
      were examined and the number of isolations of E coli was determined. For these
      cases, records were further examined with respect to body system involvement,
      sex, concurrent infection with other species of bacteria, and antimicrobial
      susceptibility. RESULTS: 674 E coli isolates (424 from urine, 62 from the skin,
      52 from the respiratory tract, 45 from the ear, 43 from the female reproductive
      tract, 25 from the male reproductive tract, and 23 from other organ systems) were
      identified. There was a significantly higher proportion of isolates from urine
      specimens from spayed females than from sexually intact females or males.
      Escherichia coli was isolated in pure culture from 65.9% of the specimens. Most E
      coli isolates were susceptible to norfloxacin (90%), enrofloxacin (87.5%),
      gentamicin (90.7%), and amikacin (85.9%). CONCLUSIONS AND CLINICAL RELEVANCE:
      Most nonenteric E coli infections in dogs involve the urinary tract. Amikacin,
      gentamicin, norfloxacin, and enrofloxacin have the highest efficacy against
      canine E coli isolates. For E coli isolates from dogs, in vitro susceptibility to
      commonly used antimicrobial agents has remained fairly stable during the past
      decade.

PMID- 11201565
TI  - Results of magnetic resonance imaging in dogs with vestibular disorders: 85 cases
      (1996-1999).
AB  - OBJECTIVE: To determine results of magnetic resonance (MR) imaging in dogs with
      vestibular disorders (VD) and correlate results of MR imaging with clinical
      findings. DESIGN: Retrospective study. ANIMALS: 85 dogs. PROCEDURE: Information
      on signalment, clinical signs, and presumptive lesion location was obtained from
      the medical records, and MR images were reviewed. RESULTS: 27 dogs had peripheral
      VD, 37 had central VD, and 21 had paradoxical VD. Of the 27 dogs with peripheral
      VD, 11 (41%) had MR imaging abnormalities involving the ipsilateral tympanic
      bulla compatible with otitis media (6 also had abnormalities involving the
      petrous portion of the ipsilateral temporal bone compatible with otitis interna),
      7 (26%) had MR imaging abnormalities compatible with middle ear neoplasia, 2(7%)
      had an ipsilateral cerebellopontine angle lesion, and 7 (26%) did not have MR
      imaging abnormalities. All dogs with central and paradoxical VD had abnormalities
      evident on MR images. Of the 37 dogs with central VD, 13 (35%) had an extra-axial
      lesion, 6 (16%) had an intra-axial lesion, and 18 (49%) had multiple intra-axial
      lesions. In 23 (62%) dogs with central VD, lesions on MR images corresponded with
      location suspected on the basis of clinical signs. Of the 21 dogs with
      paradoxical VD, 12 (57%) had an extra-axial lesion, 5 (24%) had an intra-axial
      lesion, and 4 (19%) had multiple intra-axial lesions. Location of lesions on MR
      images agreed with location suspected on the basis of clinical signs in 19 (90%)
      dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that MR imaging may be
      helpful in the diagnosis and treatment of VD in dogs.

PMID- 11201567
TI  - Effect of oral administration of excessive iron in adult ponies.
AB  - OBJECTIVE: To evaluate the potential of excess dietary iron to cause hepatic
      lesions similar to those described in horses with suspected iron toxicosis or
      hemochromatosis. DESIGN: Prospective study. ANIMALS: 6 adult male ponies.
      PROCEDURE: 4 ponies received 50 mg of iron/kg (22.7 mg/lb) of body weight each
      day by oral administration of ferrous sulfate, which contained 20% elemental
      iron; 2 ponies received only the carrier (applesauce). Complete blood counts,
      serum biochemical analyses, and hepatic tissue biopsies were performed, and serum
      iron concentrations were measured. Blood and tissue samples were obtained at days
      0 and 2, and at the end of weeks 1, 3, 6, and 8 after administration of iron was
      initiated. Treatment was discontinued after 8 weeks, and hepatic iron
      concentrations were measured at 28 weeks. RESULTS: Hepatic iron concentrations,
      serum iron concentrations, percentage saturation of transferrin, and serum
      ferritin concentrations were increased, compared with baseline and control
      concentrations, by week 8. Adverse clinical signs or histologic lesions in the
      liver were not detected in any ponies. At 28 weeks, hepatic iron concentrations
      had decreased. CONCLUSIONS AND CLINICAL RELEVANCE: Histologic lesions were not
      seen in the hepatic biopsy specimens obtained from the ponies treated with
      ferrous sulfate. It was concluded that it would be unlikely for iron toxicosis to
      develop in adult ponies or horses during a period of < 8 weeks when food or water
      contained increased amounts of iron. It is suspected that previous reports of
      hepatopathies in animals with hemosiderin accumulation may represent a primary
      hepatopathy with secondary hemosiderin accumulation, especially if the only
      source of iron is via oral consumption.

PMID- 11201566
TI  - Idiopathic noncirrhotic portal hypertension in dogs: 33 cases (1982-1998).
AB  - OBJECTIVE: To describe clinical signs, diagnostic findings, and outcome in dogs
      with idiopathic intrahepatic portal hypertension. DESIGN: Retrospective study.
      ANIMALS: 33 dogs. PROCEDURE: Medical records of dogs with portal hypertension of
      intra-abdominal origin were reviewed. Dogs with intra-abdominal portal
      hypertension of vascular causes or with hepatic histopathologic changes
      consistent with severe diffuse hepatobiliary disease were excluded. History and
      results of physical examination, clinicopathologic tests, diagnostic imaging
      studies, histologic examination, and treatment were summarized. Outcome was
      determined in 26 dogs. RESULTS: Dogs were referred most often because of ascites,
      intermittent vomiting or diarrhea, and polydipsia of several months' duration.
      Microcytosis, high serum alkaline phosphatase and alanine transaminase
      activities, hepatic dysfunction, urine specific gravity < or = 1.021, and
      abdominal transudate were the predominant clinicopathologic features.
      Microhepatia, abdominal effusion, and multiple anomalous venous anastomoses were
      the major findings of diagnostic imaging. Hepatic histopathologic changes were
      consistent with idiopathic noncirrhotic portal hypertension and were
      indistinguishable from those of dogs with surgically created portocaval
      anastomosis. Outcome was determined for 19 dogs released from hospital; 13 dogs
      remained healthy with mostly palliative treatment for periods of 5 months to 9
      years. CONCLUSIONS AND CLINICAL RELEVANCE: The clinical signs, clinicopathologic
      test results, portal pressure, and gross appearance of the liver of dogs with
      idiopathic noncirrhotic portal hypertension may be identical to those of dogs
      with cirrhosis; therefore liver biopsy is crucial. Because the prognosis for
      idiopathic noncirrhotic portal hypertension is generally favorable, owners of
      affected dogs should be discouraged from choosing euthanasia.

PMID- 11201568
TI  - Fistulation of the auditory tube diverticulum (guttural pouch) with a
      neodymium:yttrium-aluminum-garnet laser for treatment of chronic empyema in two
      horses.
AB  - Two horses with chronic empyema of the auditory tube diverticulum (guttural
      pouch) were refractory to medical treatment; empyema was bilateral in 1 horse and
      unilateral in the other. Both horses were treated by fistulation of the cartilage
      of the pharyngeal orifice by use of a neodymium:yttrium-aluminum-garnet laser in
      a noncontact manner. To maintain patency of the fistulae, indwelling catheters
      were placed into the openings created by the laser. For both horses, long-term
      follow-up did not reveal complications, and both owners were satisfied with
      results of the procedure. The authors recommend this procedure for horses that
      are unresponsive to medical treatment for chronic guttural pouch empyema.

PMID- 11201569
TI  - Subchondral cystic lesions of the proximal extremity of the tibia in horses: 12
      cases (1983-2000).
AB  - OBJECTIVE: To determine clinical and radiographic features of subchondral cystic
      lesions (SCL) of the proximal extremity of the tibia in horses that could be used
      to classify these lesions as being related to osteochondrosis or osteoarthritis
      and to evaluate results of surgical debridement. DESIGN: Retrospective study.
      ANIMALS: 12 horses with 14 SCL. PROCEDURE: Medical records and radiographs
      obtained before and after treatment were reviewed. RESULTS: In 6 young horses (8
      lesions), SCL were considered to be related to osteochondrosis; all involved the
      lateral tibial condyle. The remaining 6 horses were mature and had radiographic
      evidence of osteoarthritis in addition to SCL. Arthroscopic debridement was
      performed in 4 horses in which lesions were considered to be a result of
      osteochondrosis and in 3 horses with osteoarthritis. Three horses in which SCL
      were considered to be a result of osteochondrosis performed athletically after
      debridement. Two horses with moderate osteoarthritis returned to work after
      arthroscopic debridement but at a lower level of athletic performance. One horse
      with SCL related to osteochondrosis responded to medical treatment and went on to
      race. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that arthroscopic
      debridement of SCL is feasible in horses in which lesions involve the cranial
      portion of the lateral or medial tibial condyle, and that treated horses may be
      able to perform athletically.

PMID- 11201570
TI  - Risk factors for reduced postoperative fecal output in horses: 37 cases (1997
      1998).
AB  - OBJECTIVE: To determine prevalence and risk factors for development of ileus of
      the large intestine after surgery in horses, identified by reduced postoperative
      fecal output (RPFO). DESIGN: Retrospective study. ANIMALS: 37 horses that
      developed RPFO after undergoing general anesthesia for reasons unrelated to the
      gastrointestinal tract. PROCEDURE: Fecal output was obtained from medical records
      as number of defecations per 24-hour period after surgery; RPFO was defined as <
      or = 3 defecations per 24-hour period after surgery. The reference population
      included 48 horses that defecated > or = 4 times during the same period.
      Demographic, clinical, and surgical variables were evaluated for their
      association with development of RPFO by use of logistic regression analysis.
      RESULTS: Ten (12%) horses, all of which had RPFO, developed signs of colic after
      surgery. Horses > or = 5 years old that underwent orthopedic procedures of > 60
      minutes' duration and that did not receive phenylbutazone after surgery were at
      significant risk for developing RPFO. CONCLUSIONS AND CLINICAL RELEVANCE: Results
      suggest that after surgery unrelated to the gastrointestinal tract in horses,
      there is an intermediate clinical phase characterized by reduced fecal output
      preceding overt signs of colic. Recognition of RPFO may reduce morbidity and
      mortality of such horses.

PMID- 11201571
TI  - [Disagreement with an educational intervention program on breast-feeding].

PMID- 11201573
TI  - [Comment analysis of the article on hepatitis B and C].

PMID- 11201574
TI  - [The Epidemiologic Diagnostic and Reference Institute].

PMID- 11201575
TI  - Comparison among three methods for mycobacteria identification.
AB  - OBJECTIVE: To compare three methods: Biochemical tests, high-performance liquid
      chromatography (HPLC) and polymerase chain reaction-restriction fragments length
      polymorphism (PCR-RFLP), for the identification of mycobacteria, and to perform a
      cost-benefit analysis to define an optimum identification algorithm. MATERIAL AND
      METHODS: One-hundred-and-seven mycobacteria isolates were identified by the three
      methods at Instituto de Diagnostico y Referencia Epidemiologicos, between
      February of 1999 and January of 2000 and the results were compared with those of
      a reference laboratory using the Q-Cochran statistical test. RESULTS: PCR-RFLP
      was the most rapid and specific procedure but also the most expensive;
      biochemical tests excelled for identification of Mycobacterium tuberculosis, but
      were lengthy and expensive for other mycobacteria; HPLC ranked in the middle for
      price, speed and specificity. CONCLUSIONS: Considering the expected proportion of
      M. tuberculosis, the following algorithm was proposed: Initially, biochemical
      tests should be performed; if the results indicate a non-tuberculous
      mycobacteria, the isolate should be analyzed with HPLC; if results are unclear,
      the isolate should be analyzed using PCR-RFLP. Isolates showing a previously
      undescribed PCR-RFLP pattern should be characterized by DNA sequencing.

PMID- 11201576
TI  - [Salmonella serotypes identified in Mexican health services].
AB  - OBJECTIVE: To identify the different Salmonella strain serotypes isolated at
      public and private laboratories in Mexico and at the Institute for Epidemiologic
      Diagnosis and Referral (InDRE). MATERIAL AND METHODS: A total of 24,394
      Salmonella strains collected from 1972 to 1999 in public and private health
      laboratories of Mexico were analyzed with the Kauffmann-White method, using
      antisera produced by InDRE, according to Centers for Disease Control and
      Prevention (CDC, Atlanta, GA) standards; 15,843 (64.9%) samples were from human
      sources and 8,551 (35.1%) from non-human sources. RESULTS: One hundred ninety
      nine different serotypes were identified. The most frequent serotype in human
      beings was S. Typhimurium (20.4%), followed by S. Enteritidis (18.3%). In the
      past few years, the frequency of S. Enteritidis has been increasing, surpassing
      that of S. Typhimurium since 1991. Presently S. Enteritidis is the most
      frequently isolated serotype. In non-human sources, S. Derby (13.8%) and S.
      Anatum (8.5%) are the most frequent strains. CONCLUSIONS: Salmonella serotypes
      most frequently isolated in Mexico are: S. Typhimurium, S. Enteritidis, S. Derby,
      S. Agona y S. Anatum. From the epidemiologic standpoint, it is necessary to
      identify circulating and emerging Salmonella serotypes in order to target
      pertinent preventative interventions.

PMID- 11201577
TI  - [Natural Trypanosoma cruzi infection of Triatominae bugs associated with human
      habitations in Mexico ].
AB  - OBJECTIVE: To estimate the prevalence of infection with Trypanosoma cruzi in
      Triatominae species frequently found in and around Mexican dwellings, and to
      assess the frequency of Triatominae in towns by state. MATERIAL AND METHODS:
      Between January 1993 and December 1999, 5,399 Triatominae bugs from 14 states of
      Mexico, were received in the Department of Entomology of the Institute for
      Epidemiologic Diagnosis and Referral (InDRE), for taxonomic determination and
      parasitoscopical search of Trypanosoma cruzi. Results obtained between 1993 and
      1999 were analyzed globally. RESULTS: From 13 bug species associated with human
      dwellings, nine were naturally infected with T. cruzi. The highest percentage of
      infection occurred in Triatoma pallidipennis, T. picturata, Rhodnius prolixus and
      T. longipennis. Nayarit, Morelos, and Michoacan were the states with the highest
      percentage of infected bugs. The species T. dimidiata, T. gerstaeckeri, T.
      longipennis, T. mexicana and T. pallidipennis were first state records and
      Pastrongylus rufotuberculatus was a first local record. CONCLUSIONS: These
      findings stress the importance of studying the biology of Triatominae and the
      need for permanent surveillance, to allow for up-to-date distribution records of
      Triatominae species in and around human dwellings, those adapting to human
      dwellings, and frequencies of those naturally infected by T. cruzi.

PMID- 11201578
TI  - [Stature of Chilean parents and children of different ethnicity and social
      vulnerability].
AB  - OBJECTIVE: To analyze and compare the heights of first-year school children and
      their parents, according to ethnic background and socioeconomic status. MATERIAL
      AND METHODS: This is a cross-sectional study of indigenous and non-indigenous
      school children and their parents, belonging to three levels of social
      vulnerability: very high (poverty), medium, and very low. An indigenous school
      child was defined as any child having all four parental surnames of Mapuche
      origin; non-indigenous were those having Hispanic parental surname. Height was
      compared using Z scores, using WHO nutritional change reference values.
      Statistical analysis consisted in comparing differences of mean heights between
      parents and their children. Differences were assessed using Scheffe's method.
      RESULTS: Improvement in socioeconomic conditions was associated with increasing
      mean parental height (p < 0.001), except for indigenous mothers, who showed no
      height increase. Fathers from highly impoverished counties were 4 cm shorter than
      those living in very low vulnerability areas; height differences reached 2 cm
      among mothers (p < 0.001). Indigenous school children showed a positive height
      gradient with improving socioeconomic conditions (p < 0.001). This was not
      observed among non-indigenous children. When comparing parental height with
      children's height, children had a better height/age ratio than their parents (p <
      0.01). This was specially evident among indigenous school children, who had on
      average 1.4 Z scores more than their parents. CONCLUSIONS: The upward height
      gradient related to improved social conditions, and the better height/age ratio
      seen in children in comparison to their parents, regardless their ethnic
      background and level of social vulnerability, is encouraging and suggests that
      interventions directed to the poorest groups, including the indigenous
      population, must be carried out.

PMID- 11201580
TI  - [Perceptions and practices related with tuberculosis and treatment compliance in
      Chiapas, Mexico].
AB  - OBJECTIVE: To identify health perceptions and practices and non-adherence to
      therapy among tuberculosis patients. MATERIAL AND METHODS: Qualitative research
      work consisting of 11 group interviews with 62 tuberculosis patients during 1997
      1998 in the Central, Highlands, and Border Regions of Chiapas, Mexico. RESULTS:
      Perceived causes of tuberculosis included contagion via food utensils, excess
      work, malnutrition, and cold, as well as other causes unrelated to person-to
      person contagion. The resulting incapability to work resulted in an economic
      crisis for both the patients and their family members. As a result of the social
      stigma imposed by the disease, patients perceived a negative impact on their
      personal life, family, work, and community. CONCLUSIONS: Lack of knowledge
      regarding tuberculosis is an important factor in the selection of and adherence
      to different care alternatives. Inadequate care provided by health services,
      including an unsatisfactory physician-patient relationship, resulted in
      diagnostic delay and non-adherence to therapy. Education programs to promote
      basic knowledge regarding tuberculosis and its treatment are necessary in this
      region.

PMID- 11201579
TI  - [Malignant mesothelioma: clinical and radiological description of 45 cases with
      and without asbestos exposure].
AB  - OBJECTIVE: Our aim was to identify and describe the main symptoms, clinical
      presentation, and radiographic changes in malignant mesothelioma (MM) patients.
      MATERIAL AND METHODS: We reviewed the medical and X-ray records of all patients
      diagnosed with MM, admitted between 1991 and 1998 to the National Institute of
      Respiratory Diseases (INER), which is a governmental institution specialized in
      chest disease in Mexico City. The following data were collected: Age, occupation,
      asbestos exposure, latency, family history of cancer, clinical symptoms, and X
      ray changes. Data are presented as percentages by sex and age group. RESULTS: We
      found 45 cases of MM; in 80% of them a history of asbestos exposure could not be
      documented. The 51-60 years age group had the highest frequency of MM. Dispnea
      and chest pain were the presenting symptoms in most patients. Pleural effusion
      and pleural thickening were the X-ray abnormalities observed in 75% of the
      patients. CONCLUSIONS: The clinical and radiographic findings among patients with
      MM without asbestos exposure were similar to those with a history of asbestos
      exposure.

PMID- 11201581
TI  - [Diagnosis and prevalence of arterial hypertension in persons under 19 years of
      age in the city of Colima].
AB  - OBJECTIVE: To assess the prevalence of high blood pressure among young children.
      MATERIAL AND METHODS: This is a cross-sectional study, conducted in 1992 in
      Colima City, Mexico. Blood pressure readings were obtained from 400 children aged
      under 19. Statistical analysis consisted of calculation of means, variance, and
      Anova by group age. Association between age and blood pressure was assessed with
      correlation and determination coefficients. Comparisons by sex were made using
      Student's t, F, Mann-Whitney's U, and Z tests. Percentile 95th was used to define
      normal figures. RESULTS: A lineal correlation coefficient was found and confirmed
      by the determination coefficient. Groups where this association was statistically
      significant at p < 0.01 were: a) children aged under 2; b) children from 2 to 13
      years of age; and c) those over 13 years of age. High blood pressure figures for
      each group were: a) 92/50 mm/Hg; 110/70 mm/Hg; and 133/84 mm/Hg, respectively.
      CONCLUSIONS: The prevalence of high blood pressure in younger children may be 8%
      for systolic pressure and 9% for diastolic pressure.

PMID- 11201582
TI  - [Ecological studies].

PMID- 11201584
TI  - [Certification and recertification of medical specialists in public health].

PMID- 11201583
TI  - [Basic information about resources and services of the National Health System,
      1994-2000].

PMID- 11201585
TI  - [Activities of the Epidemiologic Diagnostic and Reference Institute of Mexico].

PMID- 11201586
TI  - Vascular risk factor profiles in the first phase of the Scottish Heart and
      Arterial Risk Prevention (SHARP) Survey, 1991-1996.
AB  - BACKGROUND: The SHARP survey data comprises personal information, family history,
      lifestyle and risk factor prevalence for 19,400 men and women sampled from the
      Scottish working population between 1991 and 1996. The purpose of the survey was
      the achievement of a clearer understanding of coronary risk factor prevalence in
      the working population of Scotland; the education of that population through
      counselling and advice; and a clearer appreciation of an individual's risk factor
      profile as a predictor for future events. In this paper a selection of attributes
      is explored for the information they yield about the characteristics of an
      apparently healthy population. Comparisons are drawn with earlier studies.
      METHODS: A mobile risk factor screening unit toured workplaces throughout
      Scotland and recorded information on age, sex, occupation, social class, personal
      and family history, smoking, alcohol and salt consumption, body mass index, blood
      pressure, glucose and total cholesterol. RESULTS: The variation in measured
      levels for common risk factors in a sample of apparently healthy Scottish people
      shows substantial differences from the measured variation in an unstratified
      survey. CONCLUSIONS: Across all conventional coronary risk factor measurements,
      working Scottish people are uniformly "more healthy" than the general population.
      A comparison of trend with age for male and female smokers and non-smokers in
      cholesterol level shows no difference between smokers and non-smokers; a similar
      comparison for body mass index and weight shows some consistent differences but
      without statistical significance.

PMID- 11201587
TI  - Risk factors in young patients with peripheral atherosclerosis.
AB  - BACKGROUND: Risk factors and especially the combination of multiple risk factors
      are associated with the development of atherosclerosis. Therefore, patients with
      an early manifestation of atherosclerotic disease are likely to show an
      extraordinary risk profile. We analysed the frequencies and severity of risk
      factors in young patients with manifest peripheral arterial occlusive disease as
      compared to old patients. METHODS: We analysed the risk profiles in 303 patients
      who were sent for interventional treatment of a symptomatic peripheral arterial
      occlusive disease. The risk profiles were described for different age groups (54
      patients under 50 years of age, 194 patients from 51 to 74 years, 55 patients
      over 75 years). Multiple linear regression analysis and analysis of variance were
      performed to look for age-dependent effects. RESULTS: Elevated total cholesterol,
      and triglyceride levels and nicotine abuse were more frequent in patients younger
      than 50 years. Diabetes mellitus and hypertension were more frequent in patients
      older than 75 years. The different frequencies for smoking, diabetes mellitus and
      hypertension were age-related (p<0.05). Concerning laboratory parameters such as
      HDL- and LDL-cholesterol, fibrinogen, lipoprotein(a) and homocysteine there were
      no relevant age-related differences in frequency nor in absolute values with the
      exception of the hematocrit and uric acid. The coincidence with clinically
      manifest myocardial infarction was 11.15% in the patients under 50 years compared
      to 20.6% in those aged 51-74 years and 16.4% in those over 75 years, for cerebral
      stroke it was 5.6%, 17.5% and 14.5%, respectively. Patients under 50 years with
      peripheral arterial occlusive disease and a history of myocardial infarction were
      characterised by high levels of total cholesterol, triglyceride and
      lipoprotein(a). Excluding patients with prior myocardial infarction patients did
      not show any difference in risk profile between the three age groups.
      CONCLUSIONS: In a population suffering from manifest peripheral arterial
      occlusive disease the risk profile in patients under 50 years is not different
      from that in older patients. In contrast an additional myocardial infarction in
      such a population is associated with pathological lipid profiles.

PMID- 11201588
TI  - Comparison between exercise whole body thallium imaging and ankle-brachial index
      in the detection of peripheral arterial disease.
AB  - BACKGROUND: Exercise whole body thallium imaging and rest/exercise ankle-brachial
      index can provide evidence of peripheral artery disease at the stage of
      intermittent claudication. The aim of this study was to compare both methods in
      the detection of asymptomatic peripheral artery disease. METHODS:  EXPERIMENTAL
      DESIGN: prospective non-randomised study. SETTING AND PATIENTS: general
      community, private practice, ambulatory patients referred in a Nuclear Medicine
      Department for exercise myocardial scintigraphy. Intermittent claudication was
      present in 8% of the whole study population. Coronary artery disease and diabetes
      were respectively present in 70% and 16% of the same population. MEASURES:
      rest/exercise ankle-brachial index and exercise whole body thallium imaging were
      measured in 105 patients (76 men and 29 women, mean age +/- 1 SD= 61 +/- 10 year)
      who performed a near-maximal or maximal treadmill test. Normal values of regional
      blood supply and indices of asymmetry at different levels of legs were determined
      in 14 patients with a very low probability of peripheral artery disease. RESULTS:
      The probability of peripheral artery disease was very high in 19 patients (group
      1), because of abnormal rest and/or exercise ankle-brachial index, whereas in the
      86 remaining patients, the index at rest and exercise was quite normal (group
      2).With respect to rest and/or exercise ankle-brachial index, the sensitivity,
      specificity, positive and predictive negative value of exercise scintigraphy
      abnormalities were respectively 89%, 62%, 34% and 96%. The false positive scan
      group differed from the true positive group only by sex and redistribution of
      thallium 201. The proportion of diabetic patients was the same (15%) in both
      groups. CONCLUSIONS: Exercise whole body thallium imaging might contribute
      without additional cost to the detection, functional evaluation and/or risk
      stratification of peripheral artery disease in patients who perform exercise
      myocardial scintigraphy.

PMID- 11201589
TI  - Determining the stage of organisation and natural history of venous thrombosis
      using computer analysis.
AB  - BACKGROUND: In vitro studies have shown that as the organisation of a thrombus
      progresses its ultrasound appearance becomes more echogenic. When diagnosing a
      deep vein thrombosis (DVT) using duplex ultrasound, an estimation of the degree
      of organisation of the thrombus is made by assessing its echogenicity. This
      method is purely subjective and has many pitfalls. METHODS: A study was performed
      on 100 proximal DVTs from 89 patients diagnosed by duplex ultrasound. These
      images were transferred to a computer and standardised using, the adobe
      Photoshop. The thrombus in the image frame was outlined and the grey scale median
      (GSM) calculated. The grey scale median which is a measure of the echogenicity of
      the thrombus (indicating the degree of organisation), varied considerably from
      patient to patient. RESULTS: The results show that the level of organisation of a
      thrombus on initial diagnosis is unrelated to the clinical signs or duration of
      symptoms of the patient. This has further implications when considering a therapy
      regimen based on the duration of symptoms (e.g. thrombolysis). Additionally, the
      age of the patient, predisposing factors and bulk of the thrombus appear to be
      unrelated to the value of the grey scale median at the initial visit. The initial
      grey scale median values were then compared to those at a one week's follow-up
      examination. Those with a low initial value of the grey scale median were found
      to increase, indicating further organisation, as expected. However, patients with
      higher initial grey scale median values were found to fluctuate, some increasing
      and some decreasing. The increase the grey scale median was due to a more
      homogenous appearance across the thrombus as the organisation process became more
      established. A decrease in grey scale median indicated areas of lysis occurring
      within the thrombus. CONCLUSIONS: Measuring the value of the grey scale median is
      a quantitative way of assessing the degree of organisation of a deep vein
      thrombosis. This can be used to asses the suitability of patients for various
      treatment regimen. It is also a useful means of assessing the long-term
      implications of different therapies and could aid in determining the long-term
      outcome for the patient.

PMID- 11201590
TI  - Color Doppler sonography of arteries associated with perforating veins.
AB  - BACKGROUND: It has been known for some time that perforating veins had associated
      perforating arteries. There has been no way to investigate these arteries
      preoperatively. The newer high resolution ultrasonic devices enable us to
      investigate these arteries. We are able to localize, determine the frequency, and
      measure the size of the arteries associated with perforating veins of the lower
      extremities. METHODS: All patients were studied in our clinical vascular
      laboratory. PATIENTS: 55 patients with different degrees of varicosities were
      studied. MEASURES: Each patient had their perforating veins and arteries
      investigated with a 7.5 MHz linear array transducer (Siemens, Type Elegra).
      RESULTS: 73% of the 233 perforating veins identified had an associated
      perforating artery. No preferred localization of the perforating veins was noted.
      The number of location did not correlate with the presence or absence of
      incompetence of the veins. The perforating arteries were located in close
      proximity to the perforating veins but did not go far into the subcutaneous fat.
      The maximum systolic velocity was 12+/-8 cm/sec. CONCLUSIONS: The preoperative
      detection of perforating arteries associated with perforating veins is possible
      using a color Doppler scanner. Their pathophysiological function and its relation
      to bleeding complications, wound healing and ulcer healing can be studied using
      this tool.

PMID- 11201591
TI  - The value of dipyridamole thallium scintigraphy and dobutamine stress
      echocardiography as predictors of cardiac complications following reconstruction
      of the abdominal aorta.
AB  - BACKGROUND: The aim of this study was to evaluate the ability of dipyridamole
      thallium scintigraphy and dobutamine stress echocardiography to predict cardiac
      complications following elective reconstruction of the abdominal aorta in
      patients with a stable preoperative cardiac condition and to compare this with
      information obtained from the medical history, ECG and resting echocardiography
      alone. METHODS: This evaluation was performed from January 1993 until December
      1995 as part of a prospective, randomised study in 200 patients, with a mean age
      of 65 (5% women). Dipyridamole thallium scintigraphy was performed on 195
      patients and dobutamine stress echocardiography was added to the protocol in the
      last 83 patients. Cardiac complications were defined before the start of the
      study. RESULTS: In the postoperative period 62 cardiac complications occurred
      (31%). In patients clinically suspected of having coronary artery disease the
      incidence of complications was 40% (51/126), compared to 15% (11/74) when no
      coronary pathology was suspected (p<0.001). When reversible defects were present
      on dipyridamole thallium scintigraphy the incidence of complications was 36%
      (20/55), compared to 29% (41/140) when no reversible defects had been found (NS).
      Dobutamine stress echocardiography was impossible or contraindicated in 21
      patients. In the remaining patients the incidence of complications was 71% (5/7)
      when new regional wall motion abnormalities were found, compared to 16% (9/55)
      when such abnormalities had not been detected (p<0.005). CONCLUSIONS: These data
      suggest that cardiac complications following reconstruction of the abdominal
      aorta in patients with a stable cardiac condition are best predicted by
      dobutamine stress echocardiography. Dipyridamole thallium scintigraphy, however,
      does not seem to be useful in this respect.

PMID- 11201592
TI  - Cranial nerve dysfunction following carotid endarterectomy.
AB  - BACKGROUND: Carotid endarterectomy (CEA) is the most common surgical procedure
      performed for the treatment of symptomatic carotid stenosis greater than 70%.
      Among the recognised complications, such as stroke and myocardial infarction, is
      injury to cranial nerves. METHODS: We report the incidence and follow-up of
      cranial nerve injury in 269 patients who underwent carotid endarterectomy between
      January 1994 and December 1997 at the Royal Liverpool University Hospital.
      RESULTS: Fifteen cranial nerve injuries were documented (5.6%). Seven patients
      (2.6%) had unilateral vocal cord paralysis, nine (3.3%) hypoglossal palsy, two
      (0.7%) glossopharyngeal nerve injury and one (0.4%) facial nerve palsy (marginal
      mandibular nerve). All patients showed improvement within a few weeks and none
      had residual disability at the last follow-up (two weeks to 14 months).
      CONCLUSIONS: Patients manifesting symptoms of cranial nerve dysfunction should
      undergo a thorough otolaryngological evaluation and long-term follow-up. Most
      cranial nerve injuries are transient and result from trauma during dissection,
      retraction or carotid clamping. Knowledge of cranial nerve anatomy is essential
      if the surgeon is to avoid such injuries.

PMID- 11201593
TI  - Carotid artery reconstruction for Takayasu's arteritis the necessity of all
      autogenous-vein graft policy and development of a new operation.
AB  - BACKGROUND: We have adopted an all-autogenous-vein-graft policy in carotid
      reconstruction for Takayasu arteritis, namely an ascendo-right carotid and right
      subclavian (axillary) arteries bypass using a pantaloon vein graft for patients
      all of whose arch branches are occluded, and an extra-anatomical bypass from the
      right subclavian artery for patients whose brachiocephalic artery is the only
      arch branch that remains patent. This report is to elaborate on these operations
      and to assess the long-term outcome. METHODS: Six patients were operated on
      according to this policy; (5 women, 1 man, age range: 14 to 59 years (mean: 30).
      The indications for surgery were severe cerebral ischaemia that significantly
      interfered with their daily lives. The pantaloon vein graft bypass was performed
      in four patients, and an extra-anatomical bypass in two. The specific management
      protocol to prevent the "postbypass hyperperfusion syndrome" and cerebral oedema
      included a shunt procedure to the internal carotid artery using one limb of the
      pantaloon vein graft, induced hypotension just before the completion of the
      carotid reconstruction and the administration of a glycerine-fructose solution.
      RESULTS: Cerebral ischaemic symptoms disappeared in all patients. All but one,
      who died of a ruptured thoraco-abdominal aneurysm on the 35th postoperative
      month, are living a normal life with a patent graft. No suture line complications
      have as yet been encountered (follow-up: 10 to 205 months, mean: 126 months).
      CONCLUSIONS: Carotid vein bypass for Takayasu arteritis, particularly, the
      pantaloon vein graft bypass is recommended for those of whom all aortic arch
      branches are occluded, resulting in severe brain ischaemia. Perioperative blood
      pressure control is important for prevention of the hyperperfusion syndrome.

PMID- 11201594
TI  - Colour duplex sonography-guided local lysis of occlusions in the femoro-popliteal
      region.
AB  - BACKGROUND: To evaluate colour duplex sonographic guidance of local lysis of
      occlusions in the femoropopliteal region. METHODS: Thirteen consecutive patients
      (8 female, mean age 67) with peripheral artery disease with acute and subacute
      occlusions in the superficial femoral or popliteal artery were included in this
      study. The lesions were identified by colour duplex ultrasound (Acuson 128 XP/10)
      After anterograde puncture the guidewire was advanced through the arterial
      lesions under B-mode image control. The Mewissen Infusion Catheter and a Katzen
      infusion wire were then accurately positioned within the lesion under B-mode
      image control. The fibrinolytic drugs were then inserted into the occlusions,
      initially 2.5 mg rt-PA as a bolus followed by Urokinase (50,000 IU/h) for 24
      hours. After control duplex sonography (over 24 hours) the additional angioplasty
      was performed either under fluoroscopic or exclusively under ultrasound guidance.
      RESULTS: Eleven of 13 patients with occlusions in the femoro-popliteal region
      were partially recanalised after ultrasound guided local lysis and after the
      additional angioplasties (nine under fluoroscopic and three under ultrasound
      guidance) the arteries were completely recanalised. CONCLUSIONS: Our data show
      that not only is the positioning of the catheter and the guidewire for local
      lysis exclusively under colour duplex guidance possible, but also the
      surveillance of the local lysis and the additional angioplasty. In the case of
      any complications, however, easy access to angiography should be possible.

PMID- 11201595
TI  - Patency after revision surgery for failing infrainguinal vein grafts.
AB  - BACKGROUND: Although the results of bypass surgery on arteries in the lower
      extremities have been greatly improved during the last decades, there are still a
      significant number of primary failures. In order to investigate the reasons for
      the failure of autogenous vein grafts after infrainguinal arterial bypass surgery
      and to ascertain the results of revision operations on the failing grafts, we
      conducted a clinical study. METHODS: Retrospective study on 104 patients who
      underwent infrainguinal arterial revascularisation with autogenous veins.
      RESULTS: One hundred and twenty-six bypasses were constructed in 121 limbs.
      Seventy-nine of these were for claudication and 47 for threatened limbs (rest
      pain or ischaemic tissue loss). Five-year primary and secondary patency rates
      were 69.7% and 84.9% respectively. Spliced or suture-repaired grafts had a poor
      outcome; five out of seven eventually becoming thrombosed. On the other hand,
      revision operations for failing but not yet thrombosed grafts produced good
      results; the five-year primary patency rate after these operations was 76.0%,
      whereas after single-segment primary grafting it was 72.1%. CONCLUSIONS: These
      results stress the importance of vigilant follow-up and active intervention for
      failing grafts. Poor outcome with injured vein grafts emphasizes the importance
      of meticulous vein harvesting.

PMID- 11201596
TI  - Can endothelial seeding enhance patency and inhibit neointimal hyperplasia?
      Experimental studies and clinical trial of endothelial seeded venous prostheses.
AB  - BACKGROUND: Venous prostheses have poor long-term patency; to improve this
      situation, experimental studies have been carried out. METHODS: Methods of
      endothelial cell harvesting, prosthetic seeding and implantation mainly in the
      inferior vena cava were studied in 127 dogs. Evaluations were conducted by
      angiography, gross appearance, light, scanning and transmission electron
      microscopic observations, histo-fluorescent staining, as well as
      radioimmunoassay. RESULTS: It was found that at five to ten days following
      implantation, the prosthetic endothelialisation could be reliably achieved in the
      seeded group and a 100% patency of the seeded inferior vena caval prostheses was
      attained at 100 days. The thickness of the neointima in the seeded group at 10
      and 100 days was 299 microm and 302 microm, respectively. The metabolite of PGI2
      from extrinsic arachidonic acid, 6-keto PGF1a, produced by cells from seeded
      graft was significantly higher than that from spontaneously formed cells and the
      reverse found with thromboxane B2. A temporary (one week) distal (femoral)
      arteriovenous fistula enhanced graft patency. These results indicated that the
      early endothelialisation of grafts by seeding enhanced the patency and inhibited
      intimal hyperplasia of venous prostheses. The clinical outcome was impressively
      improved from our previous experience with ten of eleven venous grafts patent
      over a follow-up period of six to nine years. These might result from the
      realization of early endothelialisation and its cells derived from seeding being
      able to produce significantly more PGI2 and less thromboxane B2. CONCLUSIONS: The
      endothelial cell seeding technique may bring us much closer to an ideal venous
      prosthesis.

PMID- 11201597
TI  - Aortic aneurysm in patients with autoimmune diseases treated with
      corticosteroids.
AB  - BACKGROUND: Aortic aneurysm is a rare but life-threatening cardiovascular
      complication in patients with autoimmune disorders. The purpose of this study was
      to clarify the characteristic clinical features and the pathological mechanism of
      aneurysmal formation in those patients treated with corticosteroids. METHODS:
      Among 429 patients operated on for abdominal aortic aneurysm during the past 10
      years, six patients with autoimmune diseases treated with corticosteroids (one
      with progressive systemic sclerosis, one with rheumatoid arthritis and four with
      systemic lupus erythematosus) were reviewed retrospectively. Their data were
      compared with those of 391 patients with atherosclerotic aneurysms with no
      autoimmune disorders. The resected aneurysmal walls of the six patients were also
      compared histopathologically with those of the last six consecutive patients in
      the control group. RESULTS: The average age of the patients with autoimmune
      disease was younger than that of the control group (53.8+/-16.6 vs 71.8+/-7.8
      years; p<0.05). Patients with autoimmune disease had received long-term
      corticosteroid therapy for 15-32 years; mean 22.2+/-6.5 years. Pathological
      examination showed that the destructive change of the medial elastic lamina in
      the autoimmune disease group was wider than that in the controls. Most patients
      had no complications in the postoperative follow-up period (5.1+/-3.2 years),
      while one patient died of rupture of a dissecting aneurysm two years after
      operation. CONCLUSIONS: Prolonged corticosteroid treatment probably plays a major
      role in the disintegration of connective tissue of the media, possibly together
      with primary aortic wall involvement and/or vasculitic damage in patients with
      autoimmune disorders, which can result in aortic aneurysmal enlargement.

PMID- 11201598
TI  - Relationship between aortic calcification and atherosclerotic disease in patients
      with abdominal aortic aneurysm.
AB  - BACKGROUND: Calcification of the aortic wall has been used as an index of the
      degree of complicated atherosclerotic plaque formation. Atherosclerosis in the
      abdominal aorta in patients with abdominal aortic aneurysm (AAA) was studied by
      measuring aortic calcification via computerised tomography. METHODS:  DESIGN:
      retrospective study. PATIENTS: preoperative computer tomography (CT) in 129 male
      patients with a mean age of 68.6 years (range: 42 to 82) undergoing elective
      aneurysmectomy. MEASUREMENTS: a conventional CT scanner was used. Aortic
      calcification was assessed at four levels: (A) the origin of the coeliac artery,
      (B) the left renal vein, (C) the maximum diameter of the aneurysm, and (D) the
      aortic bifurcation. Calcification was graded as: (0) no calcification, (1)
      calcification less than 40% of the aortic circumference, or (2) calcification
      more than 40% of the aortic circumference. The relationships between aortic
      calcification at each level and various factors related to atherosclerosis were
      analysed. RESULTS: Maximum calcification was seen at level D, followed by levels
      C, B and A, in that order. Calcification was less common in patients younger than
      50 years old. Hypertension, coronary artery disease, and peripheral vascular
      occlusive disease correlated with the incidence of aortic calcification.
      CONCLUSIONS: A correlation between aortic calcification and atherosclerotic
      disease was demonstrated in patients with abdominal aortic aneurysm.

PMID- 11201599
TI  - Submucosa of canine small intestine as an alternative medium-diameter autogenous
      arterial graft.
AB  - BACKGROUND: Small intestinal canine submucosa has been used in previous studies
      as a large diameter arterial graft and has shown acceptable patency rates. The
      aim of our experimental study was to assess its effectiveness when it is used as
      an autogenous medium-sized diameter arterial graft (5-7 mm). METHODS: Fifteen
      mongrel dogs were included and underwent laparotomy under general anaesthesia.
      The mucosa, tunica muscularis and serosa were removed from a resected intestinal
      segment. The remaining tube, which consisted of the submucosa and the basilar
      tunica mucosa, represented the experimental graft which was used to replace a
      proportional gap of the canine infrarenal aorta. Ascertainment of peripheral
      pulses, measurement of the intra-aortic pressures, aortography and in vivo/in
      situ observation before the sacrifice of the animals, were the procedures used
      for verification of the graft's patency. RESULTS: The resistance to
      thrombogenicity of the graft was considered satisfactory: nine out of 10 grafts
      remained patent for postoperative intervals ranging from one day to one year; one
      graft showed partial obstruction due to a technical perioperative error. The
      grafts showed also excellent physical characteristics (ease of handling and
      suturing, blood impermeability and durability), resistance to infection and
      showed no tendency to develop myointimal hyperplasia. CONCLUSIONS: Small
      intestinal canine submucosa showed satisfactory haemodynamic properties, long
      term patency and resistance to infection, when used as a medium-diameter arterial
      substitute.

PMID- 11201600
TI  - Extra-cranial branch of the internal carotid artery.
AB  - It has been argued in recent years that angiography is no longer essential before
      undertaking a carotid endarterectomy, relying solely on a carotid duplex scan. A
      case is presented where an extra-cranial branch of the internal carotid artery
      was found at surgery. This unexpected finding was obviated having obtained
      preoperative angiograms. Anomalies of the internal carotid artery are reviewed.

PMID- 11201601
TI  - Successful management of aortoiliac aneurysms with a quadrifurcated prosthesis.
AB  - Aortoiliac aneurysms constitute one of the main challenges facing vascular
      surgeons worldwide. We report for the first time the successful reconstruction of
      the aorta and iliac arteries with a quadrifurcated prosthesis, in a 72-year-old
      man with an infrarenal abdominal aortic aneurysm, and aneurysms of the iliac
      arteries involving both iliac bifurcations. The aortoiliac reconstruction was
      performed with a quadrifurcated knitted Dacron graft, revascularising both
      internal and external iliac arteries. In our opinion, the use of such a graft is
      recommended in aortoiliac revascularisations whenever it is advisable for the
      preservation of flow to internal iliac arteries.

PMID- 11201602
TI  - Primary aorto-oesophageal fistula due to oesophageal carcinoma. Report of a
      successfully managed case.
AB  - Aorto-oesophageal fistula is a rare but often fatal entity causing upper
      gastrointestinal bleeding. Amongst the different aetiologies described, the
      commonest is rupture of a thoracic aortic aneurysm into the oesophagus. This
      entity was first reported in 1818, and only recently have successfully treated
      cases been published. Other causes such as postoperative complications,
      tuberculosis and trauma are less common. Oesophageal malignancy perforating the
      aorta is a rarity. The authors describe a case of aortic perforation secondary to
      an oesophageal carcinoma, treated with initial success. The clinical onset was a
      massive upper gastrointestinal haemorrhage. The diagnosis, once the bleeding was
      controlled, was arrived at after CT-scanning and arteriography. A Dacron
      prosthesis was interposed into the descending thoracic aorta to restore aortic
      flow; later an oesophagectomy plus oesophagostomy and jejunostomy were carried
      out.

PMID- 11201603
TI  - Sutureless vascular reconstruction with titanium clips.

PMID- 11201604
TI  - Aggregate formation and degradation of overexpressed wild-type and mutant urate
      oxidase proteins. Quality control of organelle-destined proteins by the
      endoplasmic reticulum.
AB  - To analyze the cellular response caused by the overexpression of proteins in
      subcellular compartments, we constructed four expression clones encoding wild
      type peroxisomal urate oxidase (UO), truncated UO lacking the peroxisomal
      targeting signal (UOdC), and chimeric UOs with a mitochondrial targeting signal
      (MTS) at the N-terminus of UOdC (MUOdC) or UO (MUO). After transfection, we
      examined COS-1 and HEK293 cells by immunofluorescence and immunoelectron
      microscopy, transmission electron microscopy, and pulse-chase experiments. The
      overexpressed UO and UOdC formed large electron-dense aggregates with no limiting
      membrane in both the cytoplasm and the nucleus. The UO aggregates exhibited the
      crystalloid structure quite similar to that of rat liver peroxisomal cores,
      whereas the UOdC aggregates formed a loose mass consisting of small dense
      substructures. The overexpressed MUOdC and MUO, on the other hand, formed other
      types of aggregates which were distributed in the cytoplasm. They consisted of
      tubular and circular membrane structures, which were morphologically confirmed to
      be derived from the endoplasmic reticulum (ER). No immunolabeling signals for
      MUOdC and MUO were present free in the cytoplasm and most of them were associated
      with membrane structures, suggesting that overexpressed UO containing the MTS
      attached to the ER membranes soon after synthesis and segregated from the
      cytosolic compartment. All the UO aggregates were stained for ubiquitin antigen.
      Pulse-chase experiments in combination with proteasome inhibitors suggested that
      proteasomes did not contribute to the degradation of these products.

PMID- 11201605
TI  - Dual enhancement of double immunofluorescent signals by CARD: participation of
      ubiquitin during formation of neurofibrillary tangles.
AB  - Amplification with catalyzed reporter deposition (CARD) greatly enhances
      peroxidase signals, which has been utilized to amplify immunohistochemical
      labelings including fluorochromes. Here we describe a strategy to amplify each of
      two immunofluorescent signals without crosstalk on double-stained histological
      sections from human autopsied brains with Alzheimer's disease (AD). One of the
      two primary antibodies (anti-Abeta or anti-PHF-tau) was probed by a species
      specific secondary antibody conjugated with horseradish peroxidase (HRP), which
      was visualized by FITC-labeled tyramide. After inactivation of HRP, the other
      primary antibody was probed by another species-specific secondary antibody
      conjugated with HRP. Amplification with biotinylated tyramide was followed by
      streptavidin-conjugated Cy-5, which specifically labeled the latter epitope. It
      was found that Abeta and PHF-tau were localized to senile plaques and
      neurofibrillary tangles (NFTs), respectively, which verified lack of crosstalk on
      the double-stained section. Localization of ubiquitin and PHF-tau was looked for
      at higher magnification in NFT-bearing neurons. Although these two epitopes were
      colocalized in some neurons, ubiquitin was not always present in PHF-tau positive
      NFTs. Discrepancy between PFH-tau and ubiquitin, verified inter- and
      intracellularly, may represent different stages of NFT formation. This is the
      first report of successful CARD amplification of two different fluorescent
      signals on double-labeling immunohistochemistry, which is now proved to be
      powerful in detecting epitopes in relation to AD-related lesions. Improved
      intensity over tenfold of the two fluorescent signals without crosstalk will
      expand the application of the multilabeling method with fluorochromes.

PMID- 11201606
TI  - Immunohistochemical study of NGF and its receptors in the synovial membrane of
      the ankle joint of adjuvant-induced arthritic rats.
AB  - To study the role of nerve growth factor (NGF) in local inflammation, we
      investigated the expression of NGF and its receptors, trkA and p75, in the ankle
      joints of adjuvant-induced arthritic rats. Infiltrated mononuclear cells revealed
      a positive immunoreactivity for NGF and trkA; they were also positive for
      immunostaining for W3/25 and ED1, which mainly stain T cells and macrophages,
      respectively. Changes in the ratios of NGF-positive cells to mononuclear cells
      showed a relatively similar pattern for trkA-positive cells, which peaked at
      weeks 2 to 3 after the adjuvant injection. In double-immunofluorescence staining,
      80% and 65% of NGF-positive cells stained for W3/25 and ED1, respectively.
      Similarly, 67% and 80% of trkA-positive cells also corresponded to W3/25- and ED1
      positive cells, respectively. However, p75 immunoreactivity localized on the
      nerve fibers but not on the cells of the ankle joints. Dense meshworks of p75
      positive nerve fibers with numerous terminal varicosities were observed at weeks
      2 to 4. The present findings suggest that infiltrated mononuclear cells may
      secrete NGF in an autocrine or paracrine manner in the inflamed synovium. An
      upregulation of NGF in these mononuclear cells and an increase in density of the
      synovial nerve fibers may be involved in the development of adjuvant arthritis in
      rats.

PMID- 11201607
TI  - Immunohistochemical evaluation of endomannosidase distribution in rat tissues:
      evidence for cell type-specific expression.
AB  - Asparagine-linked oligosaccharides of glycoproteins are subject to a series of
      trimming reactions by glucosidases and mannosidases in the endoplasmic reticulum
      which result in the removal of all three glucose residues and several of the nine
      mannose residues. At present, endomannosidase represents the only processing
      enzyme which cleaves internally and provides an alternate deglucosylation
      pathway. However, in contrast to the endoplasmic reticulum residential proteins
      glucosidase I and II, endomannosidase is primarily situated in the Golgi
      apparatus of rat liver hepatocytes and hepatocyte cell lines. We have performed a
      confocal immunohistochemical study to investigate endomannosidase in various rat
      tissues and used a monoclonal antibody against Golgi mannosidase II as a marker
      for the Golgi apparatus. Although immunofluorescence for both endomannosidase and
      Golgi mannosidase II was detectable in the epithelia of many tissues, renal
      proximal tubular cells, cortex and medulla of adrenal gland, gastric mucosa, and
      Leydig cells of testis were unreactive for endomannosidase. Furthermore, the
      endothelia in all studied tissues were unreactive for endomannosidase but
      positive for Golgi mannosidase II. It is concluded that by immunohistochemistry
      endomannosidase exhibits a cell type-specific expression in rat tissues.

PMID- 11201609
TI  - Age-related appearance of tubular aggregates in the skeletal muscle of almost all
      male inbred mice.
AB  - Tubular aggregates (TAs) which have been recently observed in a few mouse
      myopathies are identical to those described in human diseases. In this study we
      show that TAs are also found in the skeletal muscle of almost all normal inbred
      mice strains. In these inbred strains of mice the presence of TAs is shown to be
      related to both age and sex. Nine different muscles were stained with the
      modified Gomori trichrome method to reveal the general morphology of the muscles.
      Anti-SERCA1 ATPase was used to confirm that the TAs were in fact accumulations of
      sarcoplasmic reticulum and anti-MyHC IIB to demonstrate that these accumulations
      were found exclusively in the type IIB muscle fibers. An ultrastructural study
      confirmed the observations revealed by light microscopy that the TAs were derived
      from the sarcoplasmic reticulum. TAs were never observed in female inbred mice
      and were only found in type IIB glycolytic muscle fibers of male inbred mice.
      Therefore when analyzing the effect of genetic knock out and knock in experiments
      on the muscle phenotype of transgenic mice one should be aware that the presence
      of these aggregates is a non-specific phenomenon induced by inbreeding.

PMID- 11201608
TI  - Localization of hepatocyte growth factor activator inhibitor type 1 in Langhans'
      cells of human placenta.
AB  - Activation of hepatocyte growth factor (HGF) is a crucial limiting step in HGF
      induced signaling pathway. The HGF activator inhibitor type 1 (HAI-1) was
      identified as a potent inhibitor of HGF activator (HGFA), a serine proteinase
      that is responsible for the activation of HGF in vivo. HAI-1 is an integral
      membrane Kunitz-type serine proteinase inhibitor, and its mRNA has been reported
      to be most abundant in the placenta. In this report, specific antibody to HAI-1
      was used in an immunohistochemical procedure to determine the localization of HAI
      I in human placenta. HAI-1 was expressed in cytotrophoblasts (Langhans' cells) of
      the double-layered trophoblastic epithelium of chorionic villi tissue, and
      syncytiotrophoblasts were almost negative. On the other hand, extravillous
      trophoblasts of cytotrophoblastic columns showed markedly decreased
      immunoreactivity, and those infiltrating into the superficial decidua membrane of
      early placenta were hardly stainable. The amnionic epithelial cells were also
      immunostained intensely. The presence of HAI-1 mRNA was also confirmed in a
      cultured human cytotrophoblastic cell line. In addition to HAI-1, low but
      distinct expression of HGFA mRNA was observed in the placenta tissue and cultured
      cytotrophoblasts by using a sensitive RT-PCR method. Since HGF plays an essential
      role in the placenta development, expression of HAI-1 and HGFA may have an
      important regulatory role in the placenta. The localization of HAI-I in the
      proliferating trophoblastic stem cells (Langhans' cells), but not in
      syncytiotrophoblasts and extravillous trophoblasts, suggest a possible role of
      HAI-1 in the proliferation of trophoblasts.

PMID- 11201610
TI  - Expression of CD44 isoforms in normal salivary gland tissue: an
      immunohistochemical and ultrastructural study.
AB  - We studied the expression of CD44 isoforms immunoreactivity in normal human
      salivary gland tissue, aiming at its full characterisation in normal epithelial
      and myoepithelial cell types. Optical immunohistochemistry techniques using
      monoclonal antibodies anti-CD44v3, CD44v4/5 and, for CD44v6, together with
      immunoelectron microscopy, were performed in serous, seromucinous and mucinous
      glands. Normal human breast and a case of lactating breast adenoma were used for
      comparative purposes and as controls. CD44v3 was positive in acinar and
      myoepithelial cells and was absent in mucin-producing cells from the different
      gland types. CD44v4/5 was consistently negative in all types of salivary tissue.
      CD44v6 was constantly positive in serous acinar cells, focally positive in basal
      cells of ducts, and myoepithelial cells consistently expressed it. At the
      ultrastructural level, CD44v6 was localised to the interdigitating processes of
      acinar cells, whenever they were not covered by basal lamina and to the cell
      membrane facing myoepithelial cells. In myoepithelial cells, immunolabelling was
      found at the membranes facing the acinar cells and in caveolae present at this
      interface. No labelling was found at cell membranes of both acinar and
      myoepithelial cells in contact with basal lamina or at the luminal aspect of the
      former. The finding of CD44v3 and v6 in myoepithelium of normal salivary glands
      may argue in favour of the role of these molecules in the regulation of growth
      and renewal of normal tissues and, potentially, on the morphogenesis of salivary
      gland neoplasms.

PMID- 11201611
TI  - Signal enhancement at the electron microscopic level using Nanogold and gold
      based autometallography.
AB  - Immunoelectron microscopy using ultrasmall gold markers is a very sensitive
      method to detect molecules at high resolution. In order to discriminate the gold
      particles in the electron microscope, enlargement of gold particles is necessary.
      So far, mostly silver ions were used for deposition onto the surface of gold
      grains. In our study, we tested the selective deposition of gold instead of
      silver ions to enlarge gold particles. This was performed following immunogold
      detection of DNA at the surface of ultrathin sections embedded in the acrylic
      resin LR White (postembedding approach). Morphometric analysis of the
      distribution of DNA in human spermatocytes revealed that the method offers very
      good specificity and sensitivity and therefore is a good alternative to the use
      of silver for signal enhancement. This technique was also applied to the
      detection of ribosomal genes in human testis at the electron microscopic level by
      in situ hybridization. Ribosomal genes were localized in peri- and intranucleolar
      chromatin as well as in the dense fibrillar component of nucleoli.

PMID- 11201613
TI  - The year 2000 in histochemistry and cell biology.

PMID- 11201612
TI  - Effects of ATP on intracellular calcium dynamics of the perineurium of peripheral
      nerve bundles.
AB  - Adenosine-5'-triphosphate (ATP) released from damaged cells can affect functions
      of adjacent cells. Injuries of peripheral tissue stimulate nerves, but effect of
      ATP on the nerve bundles is still speculative. Peripheral nerves are surrounded
      by perineurium, therefore the response of perineurium may be a first event of
      nerve stimulation at tissue injuries. The aim of the present study is to clarify
      whether the perineurium responds to ATP. To this end, we analyzed the dynamics of
      the intracellular calcium concentration ([Ca2+]i) of perineurial cells by
      confocal microscopy. ATP induced a [Ca2+]i increase of perineurial cells. Ca2+
      channel blockers and removing of extracellular Ca2+, but not thapsigargin
      pretreatment, abolished ATP-induced [Ca2+]i dynamics. This indicated that the
      [Ca2+]i increase was due to an influx of extracellular Ca2+. Adenosine-5'
      diphosphate also elicited an increase of [Ca2+]i, but P1 receptor agonists had
      few effects on [Ca2+]i dynamics. Suramin (an antagonist of P2X and P2Y receptors)
      totally inhibited ATP-induced [Ca2+]i dynamics, but reactive blue 2 (a P2Y
      receptor antagonist) did not. Uridine-5'-triphosphate (a P2Y receptor agonist)
      induced no significant change in [Ca2+]i, but alpha,beta-methylene ATP (a P2X
      receptor agonist) caused a [Ca2+]i increase. In conclusion, perineurial cells
      respond to extracellular ATP mainly via P2X receptors.

PMID- 11201614
TI  - Optimizing results of esophageal resection for benign and malignant disease.

PMID- 11201615
TI  - Reducing the use of restraints in a rural hospital.

PMID- 11201616
TI  - The one hundred greatest physicians of the twentieth century.

PMID- 11201617
TI  - Open letter to the medical community and the Kentucky State Legislature.

PMID- 11201618
TI  - Diagnosing alpha 1-antitrypsin deficiency.
AB  - Alpha 1-antitrypsin deficiency is a genetically transmitted disorder associated
      with an increased risk of emphysema and liver disease. The highest incidence
      occurs in whites of Northern European descent; the disorder affects between
      70,000 and 100,000 individuals in the United States. Most persons with alpha 1
      antitrypsin deficiency are misdiagnosed or undiagnosed. The laboratory tests used
      to screen for and diagnose the disorder are simple, inexpensive, and provide an
      opportunity to prevent the development of clinical disease through education
      about cofactor avoidance. This article provides a review of the epidemiology,
      genetics, and clinical presentation of this disorder.

PMID- 11201620
TI  - [94th French Congress of Urology. Paris, 15-19 November 2000. Abstracts].

PMID- 11201619
TI  - Avoiding Medicare fraud. Part 1.
AB  - In 1997, Congress authorized payments to nurse practitioners (NPs) for Medicare
      provided services. NP services are now reimbursed at 85% of the physician fee
      schedule. As this source of reimbursement was realized, so was a new area of
      liability for NPs. Failure to follow billing rules can result in payment denial,
      repayment of fees already paid, mandated educational activities, fines, fraud
      prosecution, loss of Medicare-billing ability, and loss of employment.
      Appropriate billing entails adhering to guidelines for selecting procedure codes
      and proper medical documentation. This article identifies high-risk areas for NPs
      who bill Medicare and provides resources for accessing additional information.

PMID- 11201621
TI  - Current status of rehabilitation, especially in patients with stroke, in Japan.
AB  - The current status of stroke rehabilitation in Japan was reviewed from the
      perspectives of epidemiology, structures, outcomes and research. Japan is the
      fastest aging society in the world, facing a rapid increase in its disabled
      population and ensuing healthcare costs. Although its mortality is decreasing,
      stroke is the most frequent cause of disability. Traditionally, stroke patients
      acutely admitted to general hospitals remained bed-ridden for months, hindering
      maximal functional gain. With more attention to the importance of rehabilitation,
      improved outcomes such as shorter length of stay, more functional gain and
      increased community discharge have resulted. Japan's healthcare system,
      characterized by universal coverage, equity and a mandatory fee schedule, has
      contributed to the world's longest life expectancy and the lowest infant
      mortality rate, but it has also lacked quality assurance. Under stringent
      economic conditions, drastic healthcare and welfare reform plans are being
      debated and pressure is mounting for more efficient stroke rehabilitation.

PMID- 11201622
TI  - Muscle performance in an urban population sample of 40- to 79-year-old men and
      women.
AB  - An urban population sample of 40 to 79-year-old men and women was investigated to
      evaluate the influence of age and activity level on muscle strength and endurance
      and to establish a reference material. During the investigation 144 persons were
      tested bilaterally, except for ankle strength, when only the right side was
      examined. Isometric muscle strength was determined in the knee extensors and
      flexors. Isokinetic (at 60 degrees/s and at 180 degrees/s) muscle strength was
      determined concentrically and eccentrically in the knee extensors and flexors.
      The dynamic and static endurance of the extensors was measured. Isometric
      strength was determined in the ankle plantar and dorsiflexor muscles. Isokinetic
      ankle plantar flexion strength was determined concentrically at 60 degrees/s with
      and without prior eccentric muscle contraction. Hand-grip strength was evaluated
      with a dynamometer. Walking velocity and the number of heel-rises were recorded.
      Physical activity level was assessed by questionnaire. Muscle biopsies were taken
      from the vastus lateralis muscle for histochemical and enzymatic analyses.
      Walking and the different muscle tests declined with age, and with a slight
      gender difference. Muscle biopsies showed a trend toward smaller muscle fibers
      with age. The results of our study can be used as reference material for clinical
      studies in different age groups.

PMID- 11201623
TI  - Changes in balance performance in physically active elderly people aged 73-80.
AB  - In our hospital in 1989 a series of 30 healthy elderly people participated in a
      study to evaluate the effect of physical training on improving balance.
      Thereafter, the majority of the people in this group continued with some kind of
      balance training. Seven years later we followed up 17 of the people who had
      participated in the original study. We wanted to evaluate the balance performance
      of these physically active elderly people (mean age 80.5 years) and compare it
      with their balance performance 7 years previously. Balance was found to be
      significantly impaired compared with 1989 in four out of six static balance
      tests. The time required to walk 30 m had increased significantly. The subjective
      ratings of vertigo and balance problems had not changed significantly, neither
      had the number of correct steps when walking forwards on one line and backwards
      between two lines. In dynamic posturography, the test with sway-referenced visual
      cues showed improved postural control, but no change in sway was seen in the
      other five sensory conditions. When sudden backward translations of the platform
      occurred, increased latencies of force response were seen.

PMID- 11201624
TI  - Use of healthcare, impact on family caregivers and patient satisfaction of
      rehabilitation at home after stroke in southwest Stockholm.
AB  - We previously conducted a randomized controlled trial in which early supported
      discharge from the Department of Neurology at Huddinge Hospital in southwest
      Stockholm with continuity of rehabilitation at home (n = 41) was compared to
      routine rehabilitation services (n = 40) for moderately disabled selected stroke
      patients. No statistical significant differences were found in patient outcome at
      3 or 6 months, but a moderately positive effect in the home rehabilitation group
      was suggested. In the present study we evaluated resource utilization of health
      and social care, impact on family caregivers during 6 months after acute stroke
      and patient satisfaction. A 50% reduction in total hospitalization (initial and
      recurrent) was observed, from 30 days in the routine rehabilitation group to 15
      days in the home rehabilitation group (p < 0.001). After discharge, the mean
      number of home visits in the home rehabilitation group was 12. In total, the
      routine rehabilitation group had a higher frequency of therapy contacts and
      daycare in outpatient care. Seventy-eight percent received help from a family
      caregiver in activities of daily living, yet only 15% had formal home help
      service. No major differences were found in use of home help service or impact on
      family caregivers in the form of time devoted to helping the patient or
      subjective well-being of spouses as per Sickness Impact Profile. Patient
      satisfaction was in favour of the home rehabilitation group, but a significant
      difference was only found in active participation in rehabilitation programme
      planning. In conclusion, early supported discharge with continuity of
      rehabilitation at home, using goal-directed functional activities based on the
      patient's personal interests, should be the rehabilitation service of choice for
      moderately disabled stroke patients fulfilling certain criteria, provided that
      further evaluation during the first year after stroke reveals no great changes in
      outcome or resource use. More research into the effectiveness and cost
      implications of early supported discharge with continuity of rehabilitation at
      home is needed in other parts of Sweden and in other countries before it can be
      asserted that the conclusions drawn from this study are applicable elsewhere.

PMID- 11201625
TI  - Feasibility of, and success in adopting a low-fat diet in coronary patients.
AB  - The aim of this study was to evaluate the feasibility of dietary counselling and
      the predictability of success in reducing fat intake to less than 20% of total
      energy in patients with symptomatic coronary heart disease. Forty-seven patients
      with coronary heart disease attended a 2-week in-house cardiac rehabilitation
      course with the main emphasis on individual dietary counselling by a
      nutritionist. Patients were followed up at 3 and 6 months. The dietary data were
      collected by means of 3-7 days food diaries. Mean fat intake decreased from 33.6
      +/- 6.2% to 24.7 +/- 5.5% of total energy intake at 3 months and to 27.0 +/- 6.9%
      (p < 0.001) at 6 months. Only 13% of the patients were able to reduce their
      dietary fat intake as recommended. Thus, reduction of > or = 20% was considered a
      good response, while reduction of < 20% was classified as poor. Forty-seven
      percent (n = 22) of the patients were good and 53% (n = 25) poor responders. It
      was not possible to predict the success rate from the baseline data. After a 2
      week intensive counselling period at the rehabilitation centre, half of the
      coronary patients were able to comply with a low-fat diet at home for 6 months.
      Long-term compliance requires further investigation.

PMID- 11201626
TI  - Validity of ambulatory accelerometry to quantify physical activity in heart
      failure.
AB  - The purpose was to assess the validity of a novel Activity Monitor to quantify
      physical activity in congestive heart failure. The Activity Monitor is based on
      long-term ambulatory monitoring of signals from body-fixed accelerometers.
      Information can be obtained on which mobility-related activity is performed,
      when, how intense, and for how long. Ten patients performed several functional
      activities. Continuous registrations of accelerometer signals were made and the
      output was compared with visual analysis of simultaneously made video recordings
      (reference method). Overall results showed an agreement between both methods of
      90%. Percentages of sensitivity and predictive value were higher than 80% for
      most activities. Overall number of transitions was determined well (Activity
      Monitor, 153; video, 149; p = 0.33). It was concluded that the Activity Monitor
      is a valid instrument to quantify several aspects of everyday physical activity
      in congestive heart failure.

PMID- 11201628
TI  - Thrombolysis in acute myocardial infarction. Present challenges.

PMID- 11201627
TI  - Thrombolytic therapy impact on prognosis after twelve months of first acute
      myocardial infarction.
AB  - INTRODUCTION AND OBJECTIVES: Thrombolytic therapy is still widely used to restore
      antegrade flow in the infarct related artery (IRA), with unquestionable benefits
      in mortality reduction of such patients. The aim of this study was to evaluate
      early (< or = 28 days) and one-year mortality of patients with a first Q wave
      myocardial infarction (Q AMI), comparing those who underwent thrombolytic therapy
      with those who did not. POPULATION AND METHODS: A retrospective study was done on
      907 patients (median age: 35 +/- 13 years, 66% male) admitted to a Coronary Unit
      with the diagnosis of first Q AMI, from January 1988 to December 1997, all in the
      same geographical area (minimum follow-up period of one year, mean follow-up 43
      +/- 37 months). We compared demographics and clinical characteristics (coronary
      risk factors, previous history of angina, MI location and evolution, cardiac
      events, 28 day and one-year mortality) of patients who underwent thrombolysis
      (group T = 355) versus those who did not undergo reperfusion therapy (group NT =
      552). RESULTS: Of these patients 39% underwent thrombolytic therapy. Group NT had
      a greater number of female patients (40% vs 25%; p < 0.001), a significantly
      higher mean age (67 +/- 12.2 vs 61 +/- 12; p < 0.001), and a higher percentage of
      diabetics (29% vs 19%; p < 0.001), in comparison to group T. The Q AMI developed
      into Killip class > or = 2 in 43% of patients in group NT and 23% in group T (p <
      0.001). A higher number of AV block (NT-13% vs T-8%; p < 0.05) and higher in
      hospital mortality (NT-14% vs T-9%; p < 0.05) was observed in patients not
      undergoing thrombolysis. The early (NT-22% vs T-12%; p < 0.001) and one-year (NT
      33% vs T-16%; p < 0.001) mortalities were significantly higher in group NT than
      in group T, even after multivariate analysis. CONCLUSIONS: 1--Patients who did
      not undergo thrombolytic therapy initially had a profile of greater severity, and
      a higher early and one-year mortality rate. 2--Those who underwent thrombolytic
      therapy presented a significantly lower mortality, a benefit that was still
      observed after one year of follow-up and after multivariate correction.

PMID- 11201629
TI  - LDL peroxidation in adolescent female gymnasts.
AB  - Physical exercise may in vivo promote an increase of free radical formation. Low
      density lipoproteins (LDL) are highly susceptible to oxidation, probably because
      of their high polyunsaturated fatty acid content, since lipid oxidation is an
      important factor in the genesis and development of atherosclerosis. The aim of
      the present study is to evaluate the effect in a group of adolescent gymnasts, of
      intense and regular physical exercise on lipid profile and redox status.
      POPULATION: All members of the Portuguese National Team of Rhythm Gymnastics
      (1996) (n = 20). METHODS: 1. Clinical evaluation 1.1 Anthropometric evaluation:
      weight, height, triceps, biceps, subscapular and supra- and supra-iliac
      skinfolds. NCHS were used as the standard of reference for weight and height, and
      Frisancho for the sum of skinfolds; 1.2. Evaluation of nutritional status
      (Quetelet body mass index) and body composition (Durnin and Siri). 2. Evaluation
      of biological parameters: a blood sample was collected after 12 hours fasting and
      24 hours detraining, to evaluate: 2.1 Lipid profile: total cholesterol, high
      (HDL) and low (LDL) density lipoproteins, triglycerides, apolipoproteins A1 and
      B, were measured using internationally recommended laboratory methods; 2.2.
      Plasma trace elements: zinc, copper and selenium, by atomic absorption; 2.3 Red
      blood cell enzymes; transmembranar reductase (TMR), metahemoglobin reductase
      (MethaHbRed) and acid phosphatase, by spectrophotometry; 2.4. Redox status: MDA
      and MDA-LDL were evaluated by spectrophotometry. 3. Evaluation of eating habits:
      24 hr recall. RESULTS: Chronological age is 14.3 +/- 1.7 years. Nutritional
      assessment shows a mean value for height near the 50th percentile (99% +/- 3.8),
      and low mean values respectively for BMI (89.3% +/- 9) and sum of triceps and
      subscapular skinfolds (51.9% +/- 14). Study of lipid profile shows low mean
      values for total cholesterol (162.3 mg/dl +/- 27.7) LDL-cholesterol (87.6 mg/dl
      +/- 22.6) and Apo B (64.4 mg/dl +/- 11.5), but high values for HDL-cholesterol
      (61.3 mg/dl +/- 14.5) and Apo A1 (173.1 mg/dl +/- 25.1). We observe higher values
      for total cholesterol and LDL-cholesterol in those with lower Cu plasmatic
      levels. We also observe a negative significative correlation between MDA-LDL and
      Zn (r = -0.469), Cu (r = -0.524) and RTM (r = -0.608). CONCLUSIONS: The AA
      concluded that in this group of gymnasts intense physical exercise induces, a
      favorable lipid profile, but a clear susceptibility to LDL peroxidation in those
      with lower plasma Cu and Zn values. It is possible that the negative correlation
      observed between MDA-LDL and TMR is caused by higher consumption of TMR induced
      by the action of exercise on the oxidative system.

PMID- 11201630
TI  - Permanent pacing in patients with congenital atrio-ventricular block--experience
      of 33 cases.
AB  - OBJECTIVES: The authors review permanent pacing in patients with congenital
      atrioventricular block (CAVB) and present their experience in permanent pacing in
      this pathology. STUDY POPULATION AND METHODS: In a population of 4,355 patients
      submitted to implantation of permanent pacing between January 1980 and January
      1998, 33 (0.75%) had CAVB. The mean age of the patient population with CAVB was
      16.7 years (aged from eleven days to 35 years); 33% were below 10 years of age;
      16 patients were male. The majority of the patients had symptoms of brain
      hypoperfusion; two patients had concomitant malignant ventricular tachyarrythmias
      (one of these with Torsade de Pointes due to congenital long QT syndrome).
      Transvenous (endocardial) pacing was used in 32 patients (two with previous
      epicardial pacing and exit block) and epicardial pacing in one. The mode of
      stimulation used was VVI in three patients, DDD in eight patients, VVIR in 14
      patients, DDDR in four patients and VDD in four. Smaller pulse generators were
      used in children of lower weight. In recent years single lead VDD systems have
      been preferred whenever technically possible. Vascular access was the left
      cephalic vein in 17 patients; the left subclavian vein in 14 patients and the
      right jugular vein in one patient. During a mean follow-up of 6.9 years, two
      patients with ventricular stimulation systems developed "Pacemaker Syndrome" and
      required a change of mode of stimulation. Lead fracture and posterior cutaneous
      necroses were observed in two other patients, who were accordingly submitted to
      surgical revision. It was deemed necessary, one year later, to increase the lead
      loop in a child with a permanent pacemaker implanted at eleven days of age. No
      other complications occurred with the other patients; replacement of the pulse
      generators was performed in an elective manner. CONCLUSIONS: CAVB is a rare
      indication for the implantation of a permanent pacemaker. In children, in the
      majority of cases, endocardial stimulation is possible in spite of the obvious
      technical difficulties due to low weight. Sequential, more physiological,
      stimulation systems should be preferred. However, VVIR stimulation systems of
      smaller dimensions can be the first choice of mode of stimulation in smaller
      children, mainly due to anatomical and technical limitations.

PMID- 11201631
TI  - Determinants of in-hospital mortality in women with acute myocardial infarction
      who underwent primary coronary angioplasty.
AB  - INTRODUCTION: According to recent data, women have a greater risk of dying from
      an acute coronary event. The determinants of this ominous prognosis are not
      completely understood. Preliminary analysis of our data suggested that this
      poorer prognosis is also observed in the subgroup of patients with acute
      myocardial infarction submitted to direct coronary angioplasty (PTCA). This
      finding prompted us to investigate gender differences and their determinants in
      this particular context. OBJECTIVE: To identify risk factors associated with the
      greater in-hospital mortality of women with acute infarction who underwent PTCA.
      METHODS: One hundred and forty-five consecutive patients with acute myocardial
      infarction who underwent direct PTCA in the same hospital were studied
      retrospectively. Data were collected from the database of the catheterisation
      laboratory and from clinical files. The following parameters were analysed: in
      hospital mortality, age, prevalence of diabetes mellitus, history of coronary
      heart disease, time elapsed from beginning of symptoms to coronary intervention,
      peak values of CK and MB-CK, number of coronary arteries with significant disease
      at angiography, culprit lesion localisation, and prevalence of shock on
      admission. For statistical analysis, cross-tabulation (Pearson x2) and comparison
      of means (Student's t test) were employed when appropriate; an error of 5% was
      admitted for the rejection of the null hypothesis. RESULTS: Women (n = 39)
      represented 26.9% of sample. In hospital mortality was 28.2% (n = 11) for women
      and 11.3% (n = 12) for men (p = 0.014). The prevalence of coronary heart disease
      before the current acute event, the time elapsed from beginning of symptoms to
      coronary intervention, and maximum values of CK and MB-CK were similar in both
      genders. Differences between women and men were found as regards the following
      variables (women vs men): age (61.7 +/- 10 vs 56.1 +/- 12.6 years), prevalence of
      left main disease (15.3 vs 1.9%) and prevalence of shock (41 vs 17%) and diabetes
      (38.7 vs 13.6%). Considering women and men who died, only disease severity as
      evaluated by the number of vessels involved distinguished both genders (p =
      0.05). CONCLUSIONS: In our experience, women admitted with acute myocardial
      infarction and treated by direct PTCA are, on average, older than men and have a
      greater prevalence of shock at admission, of left main disease and of diabetes,
      and more severe coronary artery disease. In the present series and as regard in
      hospital mortality, disease severity as evaluated by the number of vessels
      involved is the only variable that discriminates women from men.

PMID- 11201632
TI  - Reversible sympathetic vasomotor dysfunction in POTS patients.
AB  - BACKGROUND: Orthostatic intolerance refers to the development upon assuming an
      upright posture of disabling symptoms, which are partly relieved by resuming the
      supine position. Postural tachycardia syndrome (POTS) is an orthostatic
      intolerance syndrome characterized by palpitations due to excessive orthostatic
      sinus tachycardia, lightheadedness, tremor, and near-syncope. Patients usually
      undergo extensive medical, cardiac, endocrine, neurological and psychiatric
      evaluation, which usually fails to identify a specific abnormality. We
      investigated the autonomic and hemodynamic profile of POTS patients and the
      efficacy of bisoprolol and or fludrocortisone. METHODS AND RESULTS: We evaluated
      eleven female patients with POTS before and after medical treatment with a cardio
      selective beta blocker (bisoprolol) and/or fludrocortisone, and eleven age
      matched controls. Variability of heart rate and systolic blood pressure was
      assessed by Fast Fourier Transform, and spontaneous baroreceptor gain by temporal
      sequences slope and alpha index. Modelflow was used to quantify hemodynamics. All
      patients improved greatly after medication. The autonomic and hemodynamic
      impairment observed in patients with POTS, particularly after orthostatic stress,
      is treated effectively with bisoprolol and/or fludrocortisone. These results need
      further confirmation in a controlled double-blind study. CONCLUSIONS: Proper
      medical treatment dramatically improves the clinical and autonomic/hemodynamic
      disturbances observed in patients with POTS. The data support the hypothesis that
      POTS is due to a hyperadrenergic activation and/or hypovolemia during
      orthostasis.

PMID- 11201633
TI  - [The Cochrane Collaboration and the practice of evidence-based cardiology].
AB  - Evidence-based Cardiology (EBC) permits a rational and updated clinical approach
      to patients. The EBC practice needs credible, independent and scientifically
      solid information, but the sheer volume of the medical bibliography precludes
      individual solutions: we have too much information and what is relevant is sunk
      within what is irrelevant or useless. Selection, critical appraisal and synthesis
      of the best scientific evidence constitutes the basis of EBC. The Cochrane
      Collaboration is the best source of independent, updated and valid information:
      through published systematic reviews, the evidence is available in the format of
      CD-ROM, and can serve as the basis for a modern, efficient and rational
      cardiological practice.

PMID- 11201634
TI  - [Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE).
      National Registry of Interventional Electrophysiology for 1999].
AB  - Based on data supplied by the centres that execute Interventional
      Electrophysiology in Portugal, the authors performed a survey of the
      electrophysiological studies, with or without associated catheter ablation. This
      report quantifies the experience of all centres, as well as with different
      classes of ablation techniques. Furthermore, the authors performed a survey of
      implanted cardiovertor defibrillators, distinguishing their distribution among
      the different centres. They conclude that the number of centres that practice
      Interventional Arrhythmias in Portugal is continuously increasing, as well as the
      number of catheter ablations performed, although these rates have somewhat
      stabilised in the last year. The number of implanted cardiovertor defibrillators
      has also grown yearly since 1992, with a 24% increase last year, but is not yet
      close to the European average of implants per million of inhabitants.

PMID- 11201635
TI  - Mitral valve fenestration.

PMID- 11201636
TI  - Noncontiguous spinal metastases and plasmocytomas should be operated on through a
      single posterior midline approach, and circumferential decompression should be
      performed with individualized reconstruction.
AB  - BACKGROUND: In noncontiguous spinal metastatic disease, anterior or combined
      anterior-posterior surgery is an effective treatment. The objective of this study
      is to investigate whether circumferential decompression through a single-stage
      posterior midline approach with individualized spinal reconstruction can still
      achieve comparable results for functional improvement and for maintenance of
      spinal alignment in the absence of the risks associated with the more invasive
      transcavitary or combined approaches. METHOD: Seventeen patients with
      noncontiguous spinal metastases and plasmocytomas at one or two adjacent levels
      were included in this series. Circumferential decompression was obtained with
      anterior reconstruction and posterior fixation in ten patients, and with
      posterior instrumentation alone in seven patients. Postoperatively the patients
      were prospectively followed, and their functional status and spinal alignment
      were periodically evaluated. FINDINGS: Fourteen patients died from progression of
      their underlying cancer. Their mean survival time was 8 months (range: 1 to 21
      months). Three survivors were evaluated at 10, 4 and 3 months respectively. At
      one month after surgery, 14 patients (82%) showed neurological improvement. Of 10
      preoperative nonambulators, seven regained walking capacity. Five patients who
      were ambulatory with assistance improved to full functional independence. Local
      tumour recurrence was recorded in one patient after subtotal vertebrectomy for a
      plasmocytoma at L5. No other tumour recurrences were noted. In one patient a
      partial loss of correction occurred at T6 - without functional deterioration,
      however. Spinal alignment was maintained in all other patients who became or
      remained ambulatory. No major intra-operative complications or peri-operative
      deaths occurred. CSF leakage was recorded as the most common complication in four
      patients. INTERPRETATION: Circumferential decompression and spinal reconstruction
      through a single-stage posterior midline approach is feasible and effective. The
      extent of surgery can be individualized by means of this technique to the
      patient's specific problem. In patients with limited life expectancy from
      metastatic neoplastic disease, the results compare favourably with the more
      invasive anterior or combined antero-posterior procedures.

PMID- 11201637
TI  - Animal model for cerebral arteriovenous malformation.
AB  - BACKGROUND: The present study was conducted to establish an animal model for the
      investigation of the pathophysiology and haemodynamics of cerebral arteriovenous
      malformation (AVM) but also to assess therapeutic aspects. METHOD: For anatomic
      and haemodynamic reasons, dogs were chosen as the animal model. An arteriovenous
      fistula was created by interposing a segment of the superficial temporal artery
      between one of the main branches of the middle cerebral artery and the dorsal
      sagittal sinus. A temporal muscle graft supplied by this artery was implanted
      intracerebrally in the ischaemic area. FINDINGS: The angiographic and
      histopathologic findings obtained in the animal model are comparable with the
      situation found in intracerebral AVM in humans. INTERPRETATION: The animal model
      of intracerebral AVM established in this study allows for further investigation
      of the pathophysiology and dynamics of this disorder. It may help to develop
      better therapeutic options and thus improve the prognosis of affected patients.

PMID- 11201638
TI  - Statistical analysis of factors affecting the outcome of patients with ruptured
      distal anterior cerebral artery aneurysms.
AB  - The clinical factors affecting the outcome of patients with ruptured distal
      anterior cerebral artery (ACA) aneurysms were analyzed using multiple logistic
      regression analysis. The medical records were reviewed of 52 patients (57
      aneurysms) with ruptured distal ACA aneurysms operated on by the same
      neurosurgeon over 25 years. The standard policy was early surgery for patients in
      Hunt and Kosnik grades I to IV. Age, sex, Hunt and Kosnik grade, timing of
      operation, size of aneurysms, number of aneurysms, association of intracerebral
      haemorrhage (ICH), intraventricular haemorrhage, and azygos ACA, use of temporary
      clipping, occurrence of premature rupture, and presence of psychiatric change
      were investigated. Univariant analysis disclosed that clinical grade (P =
      0.0006), size of aneurysm (P = 0.005), and size of ICH (P = 0.012) affected the
      outcome of patients. Multiple logistic regression analysis found that Hunt and
      Kosnik grade (P = 0.010) and timing of operation (P = 0.033) affected the
      outcome. There was no significant relationship between long-term outcome and
      clinical factors, although a close relationship was found with Hunt and Kosnik
      grade (P = 0.071). Clinical grade and timing of the operation affected the
      outcome of patients with ruptured distal ACA aneurysms. Patients harboring ICH of
      over 3 cm diameter in poor grades should also be carefully treated.

PMID- 11201639
TI  - Early experiences of haemostasis on brain tumour surgery with Argon Plasma
      Coagulation (APC).
AB  - OBJECTIVE: We first applied a novel haemostatic strategy involving Argon Plasma
      Coagulation (APC), an innovative no-touch electrocoagulation technique in which a
      high-frequency alternating current is delivered to the tissue through ionized
      argon gas, to brain tumour surgery, and report its usefulness and limitations.
      METHODS: The APC system we used comprised an APC 300 developed by ERBE
      Elektromedizin GmbH, Germany. We applied APC to 13 brain tumours in 12 patients
      (5 meningiomas, 4 sarcomas, 2 glioblastomas, and 2 pituitary adenomas). To avoid
      unnecessary thermal injury to the tissue as much as possible, power/gas flow
      settings of 20 and 40 W were used. The impact time was varied individually but
      was around several seconds per one impact. The argon jet (1.5-4.5 L/min) clears a
      field of pooled blood and evenly conducts electrical energy to the target tissue.
      A thin and flexible probe particularly increased the usefulness of APC for
      haemostasis on deep-seated skull base tumour operations under a microscope.
      CONCLUSION: All patients were successfully treated and satisfied with the
      surgical results without any complications due to APC. APC appears to be an
      excellent alternative strategy for achieving haemostasis on vascular-rich brain
      tumour surgery, and may be valuable for the management of patients with
      coagulation defects.

PMID- 11201640
TI  - The application of image fusion in stereotactic brachytherapy of brain tumours.
AB  - BACKGROUND: The visualization of any morphological volume (i.e. CT, MRI) together
      with an additional second morphological volume (i.e. CT, MRI) or functional data
      set, which may come from SPECT or PET, is a new method for treatment planning,
      verification and follow-up of interstitial irradiation. METHOD: The authors
      present their experience on interstitial irradiation of brain tumours with
      stereotactically implanted I-125 seeds supported by image fusion. The image
      fusion was performed by the BrainLab-Target 1.13 software on Alfa 430 (Digital)
      workstation before, during, and after interstitial irradiation of brain tumours
      with Iodine125 seeds. RESULTS AND INTERPRETATION: On the basis of 20
      brachytherapeutic image fusion of stereotactic CT (slices with fiducials) with
      additional stereotactic CT, MRI, PET and SPECT images provides more accurate and
      precise target volume, more exact localization of catheters and isotope seeds
      (verification fusion), differentiation between the localization and amount of the
      necrotic and proliferating parts of the tumours and shows the volume changes in
      consequence of interstitial irradiation. The image fusion should help to improve
      the accuracy and minimize the perifocal morbidity of interstitial irradiation.

PMID- 11201641
TI  - Permanent postoperative anosmia: a serious complication of neurovascular
      decompression in the sitting position.
AB  - In posterior fossa surgery, the sitting position offers a number of advantages
      believed to outweigh complications such as air embolism and pneumatocephalus. For
      this reason, the sitting position is frequently used in neurovascular
      decompression for trigeminal neuralgia. Two years ago we reported on a previously
      undescribed complication: permanent postoperative anosmia. Following the recent
      occurrence of a second case, we conducted a nationwide survey to determine the
      frequency of this complication. Permanent postoperative anosmia following
      surgical procedures in the sitting position has been observed in 3 other
      institutions. In addition, the survey revealed that only 40% of German
      neurosurgeons still favor the sitting position for surgery of the posterior
      cranial fossa. Considering that permanent anosmia severely reduces quality of
      life, and that it can be avoided by using another position, the sitting position
      for surgical procedures in the posterior fossa should be restricted to special
      cases (e.g., brain stem tumors).

PMID- 11201642
TI  - A co-operative study: clinical characteristics of 334 Korean patients with
      moyamoya disease treated at neurosurgical institutes (1976-1994). The Korean
      Society for Cerebrovascular Disease.
AB  - A co-operative study was conducted to determine the clinical characteristics of
      patients with moyamoya disease who were diagnosed and treated at neurosurgical
      institutes in Korea before 1995. Twenty-six hospitals contributed 505 cases and
      among them, the clinical characteristics of 334 patients with definite moyamoya
      disease were evaluated. The number of patients began to increase from the late
      1980s, and after that approximately 20 patients were treated each year. There
      were two age peaks: from six to 15 and from 31 to 40 years of age. Haemorrhagic
      manifestations occurred in approximately 43% of the patients. The major clinical
      manifestations were haemorrhage in adults (62.4%) and ischaemia in children
      (61.2%). Overall 54.5% of the patients experienced decreased consciousness
      levels, mainly due to intracranial haemorrhage or cerebral infarction. In the
      patients with ischemic manifestations, the adult patients were more likely to
      have cerebral infarction than the pediatric patients (80% vs. 39%) and the
      pediatric patients were more likely to have TIA (61% vs. 25%). Thirty eight
      percent of the patients underwent bypass surgery and 53% of these procedures were
      performed bilaterally. Treatment policies, including indications for bypass
      surgery and commonly used drugs, were somewhat different according to the
      institution. Overall favorable outcome was 73%, and the most significant factor
      affecting poor outcome was haemorrhagic manifestation. This article describes the
      characteristics of 334 patients with moyamoya disease, who were diagnosed and
      treated at neurosurgical institutes in Korea before 1995.

PMID- 11201643
TI  - Elevation of nitric oxide metabolites in the cerebrospinal fluid of patients with
      moyamoya disease.
AB  - BACKGROUND: To investigate whether nitric oxide (NO) contributes to formation of
      abnormal collateral circulation in patients with moyamoya disease. METHODS:
      Cerebrospinal fluid (CSF) samples were obtained from the subarachnoid space of
      the Sylvian fissure during combined bypass surgery for moyamoya disease and kept
      frozen until NO metabolites, nitrate and nitrite, were measured using a Griess
      method. RESULTS: Compared with control CSF obtained from 18 patients with
      hemifacial spasm, unruptured aneurysm, etc., concentrations of NO metabolites in
      26 CSF samples of 18 patients with moyamoya disease were significantly higher
      (mean +/- SE; 17.6 +/- 1.2 vs. 10.5 +/- 1.0 microM, p < 0.01). In eight patients,
      the CSF samples from both the first and second operation could be obtained. NO
      metabolite concentrations (20.5 +/- 2.3 microM) in CSF obtained from the first
      surgery decreased to 15.7 +/- 1.8 microM (p < 0.01) in CSF obtained from the
      second, contralateral procedure. The cases of moyamoya disease with greater
      development of moyamoya vessels at angiographic stage 3 and 4 tended to show
      higher concentrations of NO metabolites than cases at earlier or later stages
      with a few moyamoya vessels. INTERPRETATION: Nitric oxide concentrations in CSF
      are chronically elevated in moyamoya disease, probably reflecting development of
      abnormal collateral circulation. i.e. moyamoya vessels. Vascular bypass surgery
      can reduce abnormal collateral circulation with reduced production of nitric
      oxide.

PMID- 11201644
TI  - Minor head injuries: one year experience according to the new Italian guideline.
AB  - BACKGROUND: The data concerning a consecutive series of 4,536 adult patients
      suffering from minor head injuries treated at the Department of Neurosurgery over
      a period of one year are reported. METHOD: The patients' age, sex and the
      circumstances of the injury have been taken into consideration. The patients,
      according to the new method, were divided into four groups. Group 0 (3,864
      patients) included all patients with Glasgow Coma Scale (GCS) score 15. They did
      not present any clinical features such as loss of consciousness (LOC), post
      traumatic amnesia (PTA), headache or vomiting. No risk factors (RF) such as
      coagulopaties, alcoholism, drug abuse, epilepsy, previous neurological treatment
      or disabled elderly patients were detected. Group 1 (600 patients) included
      patients with GCS score 15. The patients presented one or more clinical features
      (LOC, PTA, headache, vomiting). No RF were presented. Group 2 (24 patients)
      included patients with GCS score 14 with or without clinical features (LOC, PTA,
      headache, vomiting) and with or without RF. Group 0-1R (48 patients) included
      patients with GCS score 15 with or without clinical features (LOC, PTA, headache,
      vomiting). All of them presented RF. The presence of focal neurological signs,
      open injury and GCS score < or = 13 were considered criteria for exclusion.
      FINDINGS: All the patients from groups 1, 0-1R, 2 and 187 patients from group 0
      underwent CT scan for a total of 859 exams which are analyzed and discussed. 458
      patients were admitted and are divided as follows: 216 from group 0, 192 from
      group 1, 26 from group 0-1R and all the 24 belonging to group 2. Six patients
      were treated surgically (3 extradural haematomas, 2 lobe contusions, 1 acute
      subdural haematoma) and one of them (0.02% of the total) died (extradural
      haematoma). The patients who were not admitted were sent home with an information
      sheet after at least a six hour observation period. INTERPRETATION: The authors
      draw the conclusion that they have evaluated the applicability and efficacy of
      guidelines, developed by the study group on head injury of the Italian Society of
      Neurosurgery. A critical part of our guidelines is not only to identify all the
      intracranial lesions, but to identify patients harbouring relevant intracranial
      mass before clinical deterioration.

PMID- 11201645
TI  - Reduction of edema and infarction by Memantine and MK-801 after focal cerebral
      ischaemia and reperfusion in rat.
AB  - N-methyl-D-aspartate (NMDA) receptor antagonists have been found to be protective
      after cerebral ischemia. However most of these drugs have limited value as
      neuroprotectives in clinical therapy because of their side effects. Memantine is
      a noncompetitive NMDA receptor antagonist and it has been used for the treatment
      of various cerebral disorders with relatively few side effects. We investigated
      the beneficial effects of Memantine and compared its effect with MK-801 in a
      temporary focal cerebral ischemia model. As cerebral ischemia model three hours
      middle cerebral artery occlusion (MCAO) with intraluminal thread and three hours
      reperfusion was used. 78 male Spraque-Dawley rats were divided into three groups
      as follows: Control (Saline), treatment 1 (MK-801), and treatment 2 (Memantine)
      groups. In the treated groups, 15 minutes after MCAO, MK-801 and Memantine were
      administered in amounts of 1 mg/kg and 10 mg/kg intraperitoneally respectively.
      After a 3 hour period of reperfusion, the animals were examined for neurological
      deficits and then killed. The following values were measured; cerebral water
      content, blood brain barrier (BBB) permeability at the core and periphery of the
      ischemic hemisphere and contralateral hemisphere and infarct volumes. The
      severity of neurological deficit (p < 0.001) and infarct volume (p < 0.001) was
      reduced in both Memantine and MK-801 treated groups compared with saline treated
      groups. Memantine attenuated brain edema formation and BBB permeability at the
      periphery (p < 0.01), MK-801 both at the core (p < 0.05) and the periphery (p <
      0.01) of the ischemia. These results demonstrated that the NMDA receptor
      antagonists Memantine and MK-801 were neuroprotective when given 15 min after
      MCAO in temporary focal cerebral ischemia.

PMID- 11201646
TI  - Neuroprotective effect of melatonin on cortical impact injury in the rat.
AB  - The pineal hormone melatonin is a highly efficient physiological scavenger of
      free radicals involved in secondary brain damage. A variety of experimental
      studies have demonstrated a neuroprotective effect for melatonin, based on its
      antioxidant activity. The purpose of the present study was to investigate the
      time-dependency and a possible protective effect of exogenous melatonin in the
      cortical impact model in rats. The protective effect was quantified determining
      contusion volume, brain edema and brain water content. 45 anesthetized male
      Sprague-Dawley rats (250-350 mg) were subjected to cortical impact injury of
      moderate severity (7 m/s, deformation 2 mm). Melatonin (100 mg/kg bw i.p.), or a
      vehicle was injected 20 min before trauma, immediately after, and 1 and 2 hours
      after trauma during daytime and nighttime. Posttraumatic lesion volume using
      hematoxylin-eosin staining, hemispheric swelling, brain water content, cerebral
      perfusion pressure and intracranial pressure 24 hours after injury were
      investigated. Melatonin, given during nighttime, significantly reduced contusion
      volume corresponding to a mean reduction of contusion volume of 27% (placebo, n =
      7: 41.9 +/- 5.2 mm3, melatonin, n = 8: 30.5 +/- 4.2 mm3, p < 0.05). Given during
      daytime, the reduction in contusion volume was not significant (placebo, n = 8:
      42.1 +/- 5.1 mm3, melatonin, n = 8: 35.9 +/- 2.2 mm3, reduction of 15%, p = 0.08,
      n.s.). Hemispheric swelling was unchanged by melatonin treatment. Mean arterial
      blood pressure and rectal temperature remained stable before and after the
      cortical impact injury and injection of melatonin. This study shows that
      melatonin significantly reduces contusion volume with major effects during night.

PMID- 11201647
TI  - Amsterdam University Clinic for Neurosurgery.

PMID- 11201648
TI  - Spontaneous chronic and subacute subdural haematoma in young adults.
AB  - Spontaneous subacute and chronic haematoma in young adults is rare. It has not
      been previously reported in this age group. We present three cases of chronic and
      subacute subdural haematoma in young adults, in one of whom the diagnosis was
      certainly delayed. All three patients underwent burrhole evacuation and made a
      full neurological recovery. A cause for the haematoma was never established. The
      literature on the subject, which is scanty, is reviewed and the condition is
      briefly discussed. The aetiology remains obscure.

PMID- 11201649
TI  - Unusual occurrence of a pseudo-aneurysm of the middle cerebral artery in a
      patient with fibromuscular dysplasia.
AB  - Our patient is the first reported case of pseudo-aneurysm due to the rupture of
      an intracranial artery in the context of fibromuscular dysplasia (FMD). As we
      assume that our case is probably not unique, we conclude that this diagnosis may
      be sometimes overlooked for lack of confirmation either by surgery or autopsy.
      The retrospective study of the arteriograms suggests some clues that should be
      taken into account to foresee the existence of an intracranial pseudo-aneurysm in
      order to avoid unexpected peroperative difficulties: 1.) the rapid growth of the
      lesion within a few weeks and 2.) the unusual location of the aneurysmal neck at
      some distance from a arterial bifurcation.

PMID- 11201650
TI  - Calloso-marginal artery aneurysm missed by three angiographic studies.

PMID- 11201651
TI  - Retroclival arachnoid cyst presenting with spontaneous intracystic haemorrhage-
      case presentation.

PMID- 11201652
TI  - Stabilization of the unstable upper cervical spine in rheumatoid arthritis.

PMID- 11201653
TI  - Short course antimicrobial therapy in intracranial abscess.

PMID- 11201654
TI  - Histology of the hepatopancreas of the freshwater prawn Palaemonetes argentinus
      (Crustacea, Caridea).
AB  - The aim of this study is to describe the histological structure of the
      hepatopancreas of P. argentinus in intermoult stage in order to provide a
      baseline for future analysis of its modifications as indicator of environmental
      stress. Adults at sexual rest of both sexes were collected from Sotelo stream,
      tributary of Mar Chiquita lagoon, Argentina (38 degrees S 55 degrees W). P.
      argentinus hepatopancreas was studied by using histological techniques. The
      hepatopancreas is a bilaterally bilobed brown-yellowish organ. The structure is
      formed by a mass of blind tubules, with scarce intertubular space. Each tubule
      consists of a cylindrical epithelial layer surrounded by a basal lamina and
      myoepithelial cells. Four cellular types were recognized which represent E
      (embryonic), F (fibrillar), R (resorptive) and B (blisterlike) cells of other
      decapods. E-cells were found in mitosis and some F-cells had signs of cellular
      death. B-cells were observed in different phases of holocrine secretion and some
      groups of desquamated cells appeared at medial and proximal zones, revealing an
      important cellular turnover rate. According to these observations F, R and B
      cells are differentiated independently from E-cells.

PMID- 11201656
TI  - Effects of alpha-difluoromethylornithine on the Fas expression and apoptosis in
      Hep-2 cells.
AB  - DFMO is an irreversible inhibitor of ornithine decarboxilase (ODC), the key
      enzyme in mammalian polyamine biosynthesis, and has been shown to induce
      apoptosis. In this paper, the relation between the effects of DFMO on the
      polyamine content, apoptotic index and Fas expression in HEP-2 cells was
      determined. Fas is a type I membrane protein with a molecular mass of 45 kDa,
      which mediates apoptosis. The results suggest that the treatment with the
      polyamine inhibitor DFMO induced the expression of the surface antigen Fas, which
      could be responsible for trigger apoptosis in these cells.

PMID- 11201655
TI  - Further observations on cerebellar climbing fibers. A study by means of light
      microscopy, confocal laser scanning microscopy and scanning and transmission
      electron microscopy.
AB  - The intracortical pathways of climbing fibers were traced in several vertebrate
      cerebella using light microscopy, confocal laser scanning microscopy, scanning
      and transmission electron microscopy. They were identified as fine fibers up to
      1(micron thick, with a characteristic crossing-over bifurcation pattern. Climbing
      fiber collaterals were tridimensionally visualized forming thin climbing fiber
      glomeruli in the granular layer. Confocal laser scanning microscopy revealed
      three types of collateral processes at the interface between granular and
      Purkinje cell layers. Scanning electron microscopy showed climbing fiber
      retrograde collaterals in the molecular layer. Asymmetric synaptic contacts of
      climbing fibers with Purkinje dendritic spines and stellate neuron dendrites were
      characterized by transmission electron microscopy. Correlative microscopy allowed
      us to obtain the basic three-dimensional morphological features of climbing
      fibers in several vertebrates and to show with more accuracy a higher degree of
      lateral collateralization of these fibers within the cerebellar cortex. The
      correlative microscopy approach provides new views in the cerebellar cortex
      information processing.

PMID- 11201657
TI  - Immuno and cytochemical localization of Trypanosoma cruzi nitric oxide synthase.
AB  - The localization and subcellular distribution of Trypanosoma cruzi nitric oxide
      synthase was investigated in epimastigote cells by immunocytochemistry at
      electron and light microscope level, using a polyclonal antibody to neuronal
      nitric oxide synthase, and also, at light microscope level, by the nicotinamide
      adenine dinucleotide phosphate-diaphorase histochemical reaction. The
      immunoreactivity was ultrastructurally localized by electron microscopy in the
      inner surface of cell membranes and in free cytosolic clusters in the body,
      flagellum and apical extreme. Light microscopy showed that immunoprecipitates,
      specific for the Trypanosoma cruzi nitric oxide synthase, co-localized with the
      formazan precipitates generated by the diaphorase reaction in the same areas
      identified by electron microscopy. These results, taken together with previous
      finding from our laboratory could help to explain the involvement of the nitric
      oxide transduction pathway in T. cruzi epimastigote motility.

PMID- 11201658
TI  - Gut mucosal immunostimulation by lactic acid bacteria.
AB  - The beneficial properties of lactic acid bacteria (LAB) on human health have been
      frequently demonstrated. The interaction of LAB with the lymphoid cells
      associated to the gut to activate the mucosal immune system and the mechanisms by
      which they can exert an adjuvant effect is still unclear, as well as if this
      property is common for all the LAB. We studied the influence of the oral
      administration of different geneous of LAB such as Lactobacillus casei, L.
      acidophilus, L. rhamnosus, L. delbrueckii subsp. bulgaricus, L. plantarum,
      Lactococcus lactis and Streptococcus thermophilus. We determined if the LAB
      assayed were able to stimulate the specific, the non-specific immune response
      (inflammatory response), or both. We demonstrated that all the bacteria assayed
      were able to increase the number of IgA producing cells associated to the lamina
      propria of small intestine. This effect was dose dependent. The increase in IgA+
      producing cells was not always correlated with an increase in the CD4+ T cell
      number, indicating that some LAB assayed only induced clonal expansion of B cells
      triggered to produce IgA. Most of them, induced an increase in the number of
      cells involved in the inflammatory immune response. CD8+ T cell were diminished
      or not affected, with exception of L. plantarum that induced an increase at low
      dose. This fact would mean that LAB are unable to induce cytotoxicity mechanisms.
      We demonstrated the importance in the selection of LAB to be used as gut mucosal
      adjuvant. The different behaviours observed among them on the gut mucosal immune
      response, specially those that induce inflammatory immune response, show that not
      all the LAB can be used as oral adjuvant and that the beneficial effect of them
      can not generalized to genous or specie. The immunoadjuvant capacity would be a
      property of the strain assayed.

PMID- 11201659
TI  - Human red blood cells from prenatal hemopoiesis. Lithium flux (sodium dependent)
      asymmetry.
AB  - In red cells from umbilical cord blood it has been referred the existence of
      lithium fluxes (contralateral sodium dependent) asymmetry. On account of the
      relevancy of this transport system in some pathologies it is pertinent the study
      of its kinetics to relate normal with pathological states in which it is
      affected. Lithium fluxes--contralateral sodium dependent were determined in N
      ethylmaleimide treated neonatal red blood cells. Experimental data were fitted by
      simple Michaelis-Menten kinetics, finding Km and Vmax variables. It was shown the
      persistency of asymmetry. The independence of sulfhydryl groups (or the
      occultation of the groups involved to this inhibitor) could explain asymmetry
      persistence.

PMID- 11201660
TI  - Morphogenesis in short-term and long-term anther derived calli of Oenothera
      hookeri de vries.
AB  - Anther culture of O. hookeri on Murashige and Skoog (1962) medium supplemented
      with 2 mg l-1 2,4-dichlorophenoxyacetic acid and 2 mg-1 1-naphthaleneacetic acid
      produced callus formation. When subcultured onto medium lacking auxin, the callus
      regenerated through the organogenic pathway. Non-organogenic and organogenic
      callus was observed using histological methods after 2, 3 and 24 weeks in
      culture. Three types of calli were recognized: non-organogenic friable calli,
      organogenic friable calli with roots and organogenic hard calli with shoots. The
      microscopical sections showed striking differences in tissue organization among
      friable and compact calli. Vascular bundles were prominent in compact calli, but
      were not found in friable calli. Calli sections showed at light microscopy cells
      at two developmental stages; differentiated highly vacuolated cells and
      meristematic small isodiametric cells with densely stained cytoplasm. At electron
      microscopy level abnormal chloroplasts were present in non-organogenic calli,
      while chloroplasts were well developed in organogenic hard calli. Peroxisomes
      with paracrystalline protein bodies were abundant in both types of calli.

PMID- 11201661
TI  - Preliminary results on embryo rescue for circumventing hybridization barriers in
      Asparagus.
AB  - Garden asparagus, Asparagus officinalis, is reproductively isolated from a
      related ornamental species with potential breeding value, Asparagus densiflorus
      cv. Sprengeri, by pre- and post-zygotic barriers. The latter barrier operates at
      the endosperm level five days after pollination in A. officinalis x A.
      densiflorus crosses. To try to circumvent this barrier, in vitro embryo rescue
      using ovule and ovary cultures was tested. Controlled interspecific crosses were
      made and 2,032 ovules and 826 ovaries were cultured three days after pollination
      under various culture media and incubation conditions. Ovaries cultured for 60
      days became red (similar to mature fruits), but seed formation was incomplete.
      Transfer of ovules to other media was necessary to promote embryo development.
      The interspecific embryos increased their length from 35 microns at the
      initiation of culture to 1,900 microns after 120 days of culture, but seedlings
      were not obtained. Histological studies revealed differentiation of protoderm
      only. The possible causes of the failure of the embryos to complete
      differentiation and morphogenesis are discussed.

PMID- 11201662
TI  - Assessment of renal toxicity by analysis of regeneration of tubular epithelium in
      rats given low-dose cadmium chloride or cadmium-polluted rice for 22 months.
AB  - To determine whether low-dose oral administration of cadmium (Cd) induces renal
      toxicity, six groups of female Sprague-Dawley rats were fed a diet containing low
      amounts of CdCl2 or Cd-polluted rice at concentrations up to 40 ppm, and were
      killed after 12, 18, and 22 months (experiment 1). In addition to the
      determination of cortical Cd levels and histopathological assessment of kidneys,
      labeling indices (LIs) for proliferating cell nuclear antigen (PCNA) in the renal
      cortical tubular epithelium of Cd-treated rats were determined as a measure of
      regenerative activity. For comparison, the kidneys of rats given diets containing
      small to large amounts of CdCl2 up to 600 ppm for 4 months were similarly
      examined (experiment 2). Animals in experiment 1 demonstrated spontaneous chronic
      nephropathy and fluctuation in the tubular PCNA LI, but these findings were not
      correlated with renal Cd levels at 22 months. PCNA LI on the other hand, appeared
      to be linked to the severity of chronic nephropathy. In experiment 2, levels of
      CdCl2 of 200 ppm or more clearly induced degeneration and apoptosis of proximal
      tubules with high correlations between renal Cd levels, PCNA LI, and the severity
      of tubular degeneration. The results demonstrated that, in contrast to high-dose
      Cd administration, treatment with 40 ppm or less for 22 months did not influence
      tubular regeneration as a component of nonspecific chronic nephropathy,
      suggesting that long-term oral administration of low levels of Cd does not injure
      renal tubules in female rats.

PMID- 11201663
TI  - Low levels of cadmium chloride alter the immunoprecipitation of corneal cadherin
      complex proteins.
AB  - The effect of cadmium chloride on the immunoprecipitation of cadherin and the
      associated adherens junctional proteins, alpha- and beta-catenin, was examined in
      isolated bullfrog (Rana catesbeiana) corneas utilizing Western blot and enhanced
      chemoluminescent techniques. Application of either 1.0 microM or 75.0 microM
      CdCl2 to the corneal endothelium for 2 h markedly decreased the
      immunoprecipitation of cadherins as compared to paired control corneas.
      Immunoprecipitation of alpha-catenin was increased in response to both doses of
      CdCl2, while the immunoprecipitation of beta-catenin was little changed by either
      cadmium dose. There is accumulating evidence that cadmium may increase epithelial
      paracellular permeability by interfering with cadherin complex activity at
      intercellular junctions. The present study suggests that inorganic cadmium in low
      micromolar concentrations may decrease the integrity of the corneal endothelium,
      at least in part through a similar mechanism involving disruption of junctional
      cadherin complex function.

PMID- 11201664
TI  - Functional Cyp2e1 is required for substantial in vivo formation of 2,5
      hexanedione from n-hexane in the mouse.
AB  - Neurotoxicity of n-hexane is mediated by its metabolite 2,5-hexanedione (2,5-HD).
      Cytochrome P4502E1 (CYP2E1) has been suggested but not shown to be involved in
      the formation of the metabolite. An objective of the current study was to assess
      the essentiality of CYP2E1 for in vivo 2,5-HD formation from n-hexane. This was
      accomplished by comparing urinary levels of the gamma-diketone in n-hexane
      treated mice in which the Cyp2e1 gene has been deleted (Cyp2e1-/-) with that in n
      hexane-treated wild-type (Cyp2e1+/+) mice. 2,5-HD was detectable not as the free
      compound but as further metabolites, at levels that were comparable in both
      strains of mice, following a daily 200 mg/kg i.p. dose of the alkane for 10 days.
      Continued daily n-hexane treatment resulted in increased urinary levels of 2,5-HD
      metabolites in Cyp2e1+/+ but not in Cyp2e1-/- mice. Only in Cyp2e1+/+ mice and
      only on day 21 of n-hexane treatment was a trace level of unchanged 2,5-HD
      detected. 3-Hexanol was the only other n-hexane metabolite detected in the mice
      but its concentration was higher in Cyp2e1-/- than in Cyp2e1+/+ mice. In n-hexane
      treated rats, in contrast to mice, multiple metabolites of the alkane, including
      unchanged 2,5-HD, were detected. The results indicate that substantial in vivo
      formation of 2,5-HD from n-hexane in the mouse requires CYP2E1, and suggest that
      further detoxification of the metabolite may be very efficient in this species.

PMID- 11201665
TI  - Biotransformation of trichloroethylene in collagen gel sandwich cultures of rat
      hepatocytes.
AB  - The collagen gel sandwich culture of hepatocytes has been proposed as one of the
      most suitable culture models available for biotransformation studies of
      xenobiotics. It is a complex model which imitates the cascade of enzymatic events
      of in vivo biotransformation and allows investigation of biological endpoints
      under realistic conditions. The biotransformation of trichloroethylene (TRI) has
      been studied in this model using rat hepatocytes. Headspace gas chromatographic
      measurements revealed that hepatocytes, cultured for 4 days in this in vitro
      system, metabolised TRI into the major oxidative metabolites trichloroacetic acid
      (TCA) and trichloroethanol (TCE). Cultured hepatocytes were exposed either to
      TRI, or to TCA and TCE. Endpoints studied were albumin secretion and the
      cytochrome P450 (CYP)-dependent enzymatic activities ethoxyresorufin O-deethylase
      (EROD), pentoxyresorufin O-depentylase (PROD) and N-nitrosodimethylamine
      demethylase (NDMA). The results show that both the parent compound and its
      metabolites exert specific effects on different CYP-dependent mono-oxygenase
      activities, as seen in vivo. It is suggested that collagen gel sandwich cultures
      represent a useful in vitro model for the investigation of metabolism-linked
      toxicity studies.

PMID- 11201666
TI  - Cytochrome P450-dependent binding of 7,12-dimethylbenz[a]anthracene (DMBA) and
      benzo[a]pyrene (B[a]P) in murine heart, lung, and liver endothelial cells.
AB  - Autoradiography was used to investigate the cellular sites of irreversible
      binding of 3H-labelled 7,12-dimethylbenz[a]anthracene (DMBA) and benzo[a]pyrene
      (B[a]P) in mice. Autoradiograms obtained from solvent-extracted tape-sections
      revealed an even distribution of DMBA- and B[a]P-derived radioactivity in control
      mice lacking sites of selective binding in the tissues. In mice pretreated with a
      cytochrome P4501A (CYP1A) inducer, beta-naphthoflavone (BNF) or 3,3',4,4', 5
      pentachlorobiphenyl (PCB 126), a noticeable accumulation of bound radioactivity
      was observed in the pulmonary alveolar region. Increased labelling was also
      observed in heart tissue of induced mice. As demonstrated by microautoradiography
      of tissues from CYP1A-induced mice treated with 3H-DMBA or 3H-B[a]P in vivo,
      irreversible binding in lung tissue was present in endothelial cells of arteries
      and veins, in the alveolar septal walls, and in type 2 pneumocytes. In heart
      tissue, binding was confined to endothelial cells of arteries, capillaries and
      veins. In liver, binding was found in the hepatocytes as well as in endothelial
      cells of the portal veins, whereas no binding was seen in endothelial cells of
      the sinusoids, central veins, or arteries. These findings were confirmed in vitro
      using 3H-DMBA-exposed precision-cut slices, indicating that reactive
      intermediates of DMBA and B(a)P were formed in situ. The addition of the CYP1A
      inhibitor ellipticine abolished binding in the target endothelial cells.
      Increased endothelial binding in the lungs and liver of CYP1A-induced mice was
      concomitant with increased 7-ethoxyresorufin O-deethylase (EROD) and DMBA
      hydroxylase activity. In heart, endothelial binding was positively correlated
      with EROD, but not with DMBA hydroxylase. The results suggest that endothelial
      cells may be targets for CYP-dependent activation of such toxicants as polycyclic
      aromatic hydrocarbons. Consequently, the possibility that chemically induced
      endothelial dysfunction is a risk factor in the aetiology of cardiovascular
      disease demands consideration.

PMID- 11201668
TI  - The mercapturic acid biotransformation pathway of hexachlorobenzene is not
      involved in the induction of splenomegaly, or skin and lung lesions in the Brown
      Norway rat.
AB  - Involvement of the mercapturic acid pathway in the induction of splenomegaly and
      skin and lung pathology by hexachlorobenzene (HCB) in the rat was investigated by
      seeking to determine whether pentachloronitrobenzene (PCNB) has the same
      inflammatory effects as HCB, since both compounds are directly conjugated to
      glutathione, and further processed into the same mercapturic acid metabolites
      which are excreted via the urine. Female Brown Norway (BN/SsNO1aHsd) rats at 3 to
      4 weeks of age were orally exposed to diets with or without supplementation with
      450 mg HCB or equimolar (467 mg) or higher (934 mg) amounts of PCNB per kilogram
      of diet over 4 weeks. Gross skin lesion development and body weight gains were
      assessed during exposure and spleen and liver weights as well as histopathologic
      changes in skin and lung were assessed after exposure. After 3 weeks of exposure,
      urinary metabolites of the mercapturic acid and oxidative biotransformation
      pathways were identified using high-performance liquid chromatography (HPLC) and
      liquid chromatography-mass spectrometry (LC-MS). Oral exposure of the rats to 450
      mg/kg HCB resulted in an increase in relative spleen and liver weights as well as
      in the development of skin and lung pathology in the absence of overall liver
      toxicity. Equimolar or higher concentrations of PCNB caused none of these
      effects. Urinary levels of the mercapturic acid N-acetyl-S-(pentachlorophenyl)
      cysteine (PCP-NAC), were comparable in HCB- and PCNB-treated rats. Levels of
      closely related methylsulfide derivatives of PCP-NAC, also generated via the same
      mercapturic acid pathway, appeared to be significantly higher in PCNB- than in
      HCB-treated rats, whereas the reverse was true for the urinary levels of the
      oxidative metabolite pentachlorophenol (PCP). Thus, results indicate that
      metabolites of the mercapturic acid pathway are not involved in the induction of
      splenomegaly and skin and lung pathology caused by HCB exposure in BN rats and
      that the main urinary metabolite of HCB in these BN rats is PCP. Since PCP
      itself, as well as other cytochrome P450-derived metabolites from HCB, are not
      likely to be involved in the induction of splenomegaly and skin and lung
      pathology, it is suggested that either the parent compound HCB or as-yet
      unidentified non-P450-generated metabolites are involved in these inflammatory
      effects of HCB.

PMID- 11201667
TI  - Changed cellular membrane lipid composition and lipid peroxidation of kidney in
      rats with chronic fluorosis.
AB  - An animal model of chronic fluorosis was produced by subjecting Wistar rats to
      high doses of fluoride in drinking water for a prolonged period. Phospholipid and
      neutral lipid contents in rat kidney were then analyzed by high-performance
      liquid chromatography (HPLC), and fatty acid compositions from individual
      phospholipids were measured by gas chromatography. Lipid peroxidation was
      detected by the thiobarbituric-acid-reactive substance assay. Results showed that
      the total phospholipid content significantly decreased in the kidney of the rats
      treated with high doses of fluoride and the main species influenced were
      phosphatidylethanolamine (PE) and phosphatidylcholine (PC). Decreased proportions
      of polyunsaturated fatty acids were observed in PE and PC in kidney of fluoride
      treated animals compared to controls. No changes could be detected in the amounts
      of cholesterol and dolichol in kidneys between the rats treated with fluoride and
      controls. A significant decrease of ubiquinone in rat kidney was observed in the
      groups treated with excessive fluoride. High levels of lipid peroxidation were
      detected in kidney of the rats with fluorosis. It is plausible that the specific
      modification of lipid composition results from lipid peroxidation. The oxidative
      stress and modification of cellular membrane lipids may be involved in the
      pathogenesis of chronic fluorosis and provide a possible explanation for the
      gross system damage observed in the body, especially in soft tissues and organs.

PMID- 11201669
TI  - Cultures of exfoliated epithelial cells from different locations of the human
      urinary tract and the renal tubular system.
AB  - Exfoliated human urinary tract epithelial cells and renal tubular cells from
      urinary sediments of healthy adults, of urological patients and of internal
      patients were isolated and cultured. Cells started proliferating within 1 week
      after seeding a sediment. Proliferating cells formed colonies of different
      morphologies, designated as type-1 or type-2 cell colonies. Type-1 cell colonies
      showed irregular contours and spindle-like cells within the colonies.
      Subcultivation of type-1 cells for up to six passages was possible. Type-2 cell
      colonies showed smooth-edged contours and subcultivation was not possible. The
      epithelial character of type-1 cells was demonstrated by positive
      immunohistochemical staining for cytokeratin-7. In contrast to carbonic anhydrase
      positive stained Madin Darby canine kidney cells (MDCK), which were used as
      positive controls for renal tubular cells, type-1 cells were carbonic anhydrase
      negative on staining with the cobalt phosphate method. This indicates that type-1
      cells were not of renal tubular origin. Type-2 cells were positively stained for
      carbonic anhydrase, indicating that type-2 cells were renal tubular cells. Type-2
      cell colonies could be assigned to two subgroups with different cell forms.
      Colonies of cobblestone-like cells more often occurred than type-2 cell colonies
      with spindle-like cells, which are described in this study for the first time.
      Colonies with cobblestone-like cells formed domes (hemicysts), whereas spindle
      like type-2 cell colonies did not. Cultures of urinary sediments from healthy
      adults, elderly multimorbid patients treated with furosemide, and urological
      patients with urolithiasis treated with sulfamethoxazole/trimethoprim and/or with
      a percutaneous nephrostomy catheter were compared. In 52% of all cultured
      sediments from healthy adults, in 30% of those from multimorbid patients, and in
      75-80% of those from urological patients cells proliferated to colonies. The
      ratios of type-1 to type-2 cell colonies were 3.3:1 (healthy adults), 1.4:1
      (urological patients with urolithiasis), and 1.8:1 (urological patients with
      urolithiasis, urine was directly collected from the renal pelvis with a
      percutaneous nephrostomy catheter). Successful cultures of the urinary sediments
      from these three groups revealed means of 3 or 4 colonies, 14 colonies, and 21
      colonies, respectively. Differences in the number of colonies in relation to sex
      were observed only for the group of urological patients. It was shown that type-1
      cells were urothelial cells, which did not show morphological differences due to
      their locations of origin within the urinary tract, whereas type-2 cells were
      probably renal tubular cells. These findings offer new aspects in the culturing
      of human urothelial or kidney epithelial cells with a method based on noninvasive
      collecting of specimens and requiring only minimal culture effort. The cultures
      obtained by this method can be used for in vitro studies in toxicological and
      clinical research.

PMID- 11201670
TI  - Sweat gland toxicity induced by bis (tributyltin) oxide: an ultrastructural and X
      ray microanalysis study.
AB  - Acute toxicity of bis (tributyltin) oxide in the sweat glands in the rat footpad
      was investigated by electron microscopy and an energy-dispersive X-ray
      microanalyzer. Male Wistar rats received an intramuscular injection of 0.5 ml/kg
      bis (tributyltin) oxide. After 6-8 h, swelling of mitochondria appeared in the
      secretory cells of the sweat glands. After 12 h, the secretory cells began to
      show intracytoplasmic edema. After 16-20 h, secretory cells in some sweat glands
      showed marked hydropic degeneration with swollen cytoplasm. Using X-ray
      microanalysis, tin peaks were preferentially obtained from the swollen
      mitochondria of the affected secretory cells. Mitochondria dysfunction due to the
      toxic effects of bis (tributyltin) oxide induced changes in the secretory cells
      of rat sweat glands. After 24-48 h, the secretory portion of the sweat glands
      contained three types of cells: degenerating dark cells, regenerating cells
      carrying injured mitochondria, and light cells which were morphologically very
      similar to the cells in the transitional portion of the sweat gland. These light
      cells appeared to differentiate into active secretory cells after settling down
      in the secretory portion. Based on these observations, we concluded that the
      cells in the transitional portion could play an important role at least as
      reserve cells against secretory cell toxicity. In association with the
      regenerating process of the damaged secretory portions, increased mitotic
      activities were seen in different areas of all the dermal sweat ducts. The above
      mentioned morphological observations for cell damage and subsequent regeneration
      and renewal ofsecretory cells in sweat gland intoxication have not been reported
      so far.

PMID- 11201671
TI  - Suppression of decidual cell response induced by tributyltin chloride in
      pseudopregnant rats: a cause of early embryonic loss.
AB  - In our previous studies, tributyltin chloride (TBTCl) at doses of 16.3 mg/kg and
      above caused implantation failure (preimplantation embryonic loss) and
      postimplantation embryonic loss in rats following administration on gestational
      day (GD) 0 through GD 3 and GD 4 through GD 7, respectively. This study was
      designed to assess the effects of TBTCl on uterine function as a cause of early
      embryonic loss in pseudopregnant rats. TBTCl was given orally to pseudopregnant
      rats at doses of 4.1, 8.1, 16.3 and 32.5 mg/kg on pseudopregnant day (PPD) 0 to
      PPD 3 or 8.1, 16.3, 32.5 and 65.1 mg/kg on PPD 4 to PPD 7. The decidual cell
      response was induced by bilateral scratch trauma on PPD 4. The uterine weight on
      PPD 9 served as an index of uterine decidualization. Uterine weight and serum
      progesterone levels on PPD 9 were significantly decreased after administration of
      TBTCl at doses of 16.3 mg/kg and above on PPD 0 to PPD 3 or PPD 4 to PPD 7.
      Administration of TBTCl at doses of 8.1 mg/kg and above on PPD 0 to 3 also
      significantly decreased serum progesterone levels on PPD 4. TBTCl had no effect
      on ovarian weight and number of corpora lutea. It can be concluded that TBTCl
      suppresses the uterine decidual cell response and decreases progesterone levels,
      and these effects are responsible for early embryonic loss due to TBTCl exposure.

PMID- 11201672
TI  - Mutagenicity of N-nitrosodiethylamine in the Ames test with S. typhimurium TA1535
      is due to volatile metabolites and is not dependent on cytochrome P4502E1
      induction.
AB  - N-Nitrosodiethylamine (NDEA) is carcinogenic in all investigated animal species
      at relatively low dosages. No threshold has been detected for these carcinogenic
      effects. The substance has been extensively investigated in various in vitro
      systems, revealing only weak mutagenicity at relatively high dosages. We
      reinvestigated NDEA in the Ames test with Salmonella typhimurium TA1535 to
      establish appropriate modifications of the standard Ames test protocol, to
      achieve a dose-dependent mutagenic response at a reasonably low dose range. Two
      main modifications were evaluated. Since the metabolism of dialkylnitrosamines is
      postulated to be mainly dependent on cytochrome P4502E1, a pyrazole-induced rat
      liver S9 was applied. The second modification involved a gastight preincubation,
      since metabolites of NDEA might evaporate from the incubation mixture. Cytochrome
      P4502E1 induction in Wistar rats was achieved by pyrazole treatment. For
      comparison, a rat liver S9-fraction produced by beta-naphtoflavone/phenobarbital
      induction was used. N-Nitrosopyrrolidine served as positive control for pyrazole
      induced S9-mix with TA1535. NDEA showed no mutagenic response under all test
      conditions in the presence of pyrazole-induced S9-mix. A strong mutagenic
      response, exceeding the base rate up to 15-fold at a dose range of 25-1000
      microg/plate, was observed using beta-naphtoflavone/phenobarbital-induced S9-mix,
      gastight preincubation and TA1535. In conclusion the Ames test with gastight
      preincubation can be useful for the testing of volatile compounds or substances
      leading to gaseous metabolites. The weak response of NDEA in the Ames test
      observed previously seems mainly to be due to the volatile character of its
      mutagenic metabolites. Our results do not support the hypothesis that cytochrome
      P4502E1 is a major toxifying enzyme for the formation of Ames-test-positive
      metabolites from NDEA.

PMID- 11201673
TI  - An approach to cancer risk assessment for the food constituent 2-hexenal on the
      basis of 1,N2-propanodeoxyguanosine adducts of 2-hexenal in vivo.
AB  - 2-Hexenal is formed by plants, and humans are regularly exposed to this
      mutagenic/genotoxic compound via vegetable foods. 2-Hexenal has not been tested
      for carcinogenicity, but it forms exocyclic 1,N2-propanodeoxyguanosine adducts
      like other carcinogenic alpha,beta-unsaturated carbonyl compounds. To quantify
      the respective DNA adducts as an approach to a theoretical cancer risk
      assessment, we used a newly developed 32P-postlabelling technique based on
      nuclease P1 enrichment, allowing a detection limit of 3 adducts per 10(8)
      nucleotides. Adduct levels were measured at different doses and the covalent
      binding index (CBI) was found to be dose-dependent. This can be explained by
      glutathione depletion at higher doses. The CBI at low doses was 0.06. A
      negligible cancer risk of 1-5 per 10(7) lives was estimated on the basis of TD50
      values calculated from the correlation between CBI and TD50 of Lutz and on the
      daily intake of 2-hexenal via vegetable foods, fruit juices and black tea. A risk
      of 1.6-8.5 per 10(6) lives was estimated for the hypothetical case of glutathione
      depletion, e.g. due to consuming special medicaments. In every case, the benefit
      from eating fruit and vegetables is clearly higher than a possible low and
      unavoidable cancer risk. Utilization of 2-hexenal as a flavouring agent or as a
      fungicide, breeding fungus-resistant plants or technological gene construction of
      fungus resistance may lead to a high hypothetical cancer risk of 2-6 per 10(4)
      lives under certain circumstances which are avoidable and deserves special case
      by-case consideration.

PMID- 11201674
TI  - Tobacco and cancer.

PMID- 11201675
TI  - The rise and fall of prostate cancer.

PMID- 11201676
TI  - Assessments of physical activity and cancer risk.
AB  - The assessment of physical activity is one of the most important methodological
      issues in research into physical activity and cancer risk. A sedentary Western
      lifestyle has been observed to influence biological mechanisms promoting
      development of certain types of cancer. At present the totality of evidence
      supports a protective effect against cancers of the colon and probably the
      breast, while further data concerning carcinoma of other cancers are required.
      Thus, physical activity represents a powerful public health measure for reducing
      cancer risk. Studies of the association between physical activity and cancer risk
      have used a great variety of methods, but have most often included work and/or
      leisure time activity. Questionnaires are the method most often used and various
      components of physical activity such as type, frequency, intensity and lifetime
      physical activity have been recorded. However, the measurements used when
      assessing physical activity have been hampered by lack of accuracy as regards
      validity and reliability, missing information on the various components of
      physical activity and sparse information of lifetime exposure, and often no
      repeat assessments in cohort studies. Discrepancies between studies elaborating
      the association between physical activity and site-specific cancer risk may be
      explained through real differences or lack of information on the various
      components of physical activity (type, intensity, duration) and incomplete
      information about the cancer type studied (localization, histological type). The
      complicated nature of the variable physical activity, combined with incomplete
      understanding of the pathogenesis of most cancer and lack of knowledge regarding
      possible biological mechanisms operating between physical activity and cancer,
      warrants further studies. In these studies methodological improvements in
      measuring physical activity, combined with inclusion of physiological markers
      (heart rate, energy balance, hormonal levels, etc.) reflecting the variety of
      physical activities performed are of particular interest. Assessing biomarkers
      and intermediate steps for site-specific cancer risk may give us further insight
      into the relation between physical activity and cancer that will be of enormous
      interest for public health recommendations.

PMID- 11201678
TI  - Stomach cancer history in the siblings of patients with gastric carcinoma.
AB  - A case-control study in the population of the Eastern Black Sea region of Turkey
      was conducted to learn the incidence of stomach cancer in the siblings of
      patients with gastric carcinoma. Among 1240 patients with gastric carcinoma, 168
      had sibling(s) with a history of stomach cancer versus 19 cases in the control
      group matched according to age and gender (OR 10.07, P < 0.0001). The frequency
      of a history of stomach cancers and cancer of other organs in first- to third
      degree relatives was 60.7% and 38.0%, respectively, of 168 sibling cases with
      gastric carcinoma (P < 0.0001). Fifty-two point three per cent of sibling cases
      having a history of cancer in other organs in their relatives also reported
      stomach cancer in the same-degree relatives. The number of stomach cancers in the
      first- to third-degree relatives of sibling cases was higher than the number of
      other organ cancers in the same-degree relatives (P < 0.01). Familial clustering
      of stomach cancer was reported in 12.5% of sibling cases. The study of stomach
      cancer history in the siblings suggests: the presence of a genetic
      susceptibility, high risk of the disease occurrence in the siblings of patients,
      higher predisposition to gastric than to other organ cancers in the relatives,
      and not infrequent familial clustering.

PMID- 11201677
TI  - Diet and lung cancer: a new approach.
AB  - Lung cancer is one of major public health problems facing the world today, owing
      to the high incidence of the disease and its poor prognosis. Although the
      principal cause of lung cancer is tobacco use, smokers find it extremely
      difficult to quit the habit. Hence, there is a need to take action targeted at
      other risk factors for this disease. One such factor is diet, which is known to
      be able to raise or lower the risk of lung cancer. This paper seeks to complement
      other reviews in the field and to shed more light both on the influence that
      dietary factors may have upon the occurrence of this neoplasm and on the causes
      of this possible effect.

PMID- 11201679
TI  - Migration, socio-economic status and the risk of colorectal cancer in Italy.
AB  - To assess how the risk of cancer of the colon and rectum relates to place of
      birth and socio-economic status, we analysed data from an Italian case-control
      study. Data included 1225 cases with a recent diagnosis of cancer of the colon
      (ages 19-74 years), 728 cases of cancer of the rectum (ages 23-74 years) and 4154
      controls (ages 19-74 years), frequency-matched with cases by age and catchment
      area and admitted to hospitals for a wide spectrum of acute non-neoplastic
      conditions. Compared with residents born in the north of Italy, migrants from the
      centre and south had an odds ratio (OR) of 0.7 (95% CI 0.5-0.9) for colon cancer
      and OR of 0.9 (95% CI 0.7-1.2) for cancer of the rectum. The inverse association
      of migration with colon cancer was stronger among women (OR 0.5, 95% CI 0.4-0.8)
      than among men (OR 0.8, 95% CI 0.6-1.1), and was independent of education and
      occupation. Among migrants, the direct association between education and colon
      cancer risk was less clear than among non-migrants. In conclusion, place of
      origin played an independent role in colon cancer aetiology. Results on rectal
      cancer were less clear, although in the same direction. Among migrants, those
      less susceptible to behavioural changes (e.g. women) retained most of the benefit
      associated with their place of origin.

PMID- 11201680
TI  - Biliary lipid peroxidation products in gallbladder cancer: increased peroxidation
      or biliary stasis?
AB  - Gallbladder cancer is a common malignancy among women in India. The aetiology of
      gallbladder carcinoma is still obscure and although numerous factors have been
      implicated, none has stood the test of time. This study was carried out to
      evaluate the role of lipid peroxidation product 4-hydroxynonenal (HNE) in
      gallbladder carcinogenesis. High-performance liquid chromatography (HPLC)
      analysis was carried out in 30 bile samples obtained during laparotomy from
      patients with gallbladder cancer (n = 10), cholelithiasis (n = 10) and age- and
      sex-matched controls (n = 10). A significantly high concentration of HNE and
      lower concentration of biliary pH and electrolyte was observed in patients with
      carcinoma of the gallbladder compared with controls and patients with
      cholelithiasis. A significant correlation was also observed between biliary Na+
      and K+ (r = 0.72), biliary Ca2+ and Na+ (r = 0.69) among controls. However, there
      was no correlation between HNE, electrolytes and pH among cancer patients. An
      increased concentration of biliary HNE and decreased concentration of
      electrolytes suggest biliary stasis rather then increased peroxidation in cancer
      patients.

PMID- 11201681
TI  - Tobacco smoking and vitamin C concentration in gastric juice in healthy subjects
      and patients with Helicobacter pylori infection.
AB  - Low gastric juice total vitamin C concentration in the presence of Helicobacter
      pylori infection probably plays a role in gastric carcinogenesis. Vitamin C plays
      a role in the neutralization of various pathogenic factors connected with H.
      pylori infection, including the destruction of free radicals, which damage
      tissues and cell DNA, and inhibition of the formation of N-nitroso compounds,
      which have a strong carcinogenic activity. The aim of the study was to determine
      whether tobacco smoking had any effect on gastric juice vitamin C concentration
      in healthy subjects and in patients infected with H. pylori. Eighty-six patients
      with dyspeptic symptoms undergoing routine endoscopy entered the study after
      giving informed consent. In all patients plasma and gastric juice total vitamin C
      levels were measured by a spectrophotometric method. They were entered into four
      groups: group I (controls) - H. pylori-negative non-smokers (n = 17), group II -
      H. pylori-negative smokers (n = 16), group III - non-smokers with H. pylori
      infection (n = 21), and group IV - H. pylori-infected smokers (n = 32). In the
      control group (I) the mean gastric juice total vitamin C concentration was 17.1
      microg/ml (range 5.3-40.0 microg/ml), which was significantly higher (P < 0.05)
      than in group II (12.6 microg/ml, range 5.1-21.0 microg/ml), group III (5.8
      microg/ml range 2.1-13.7 microg/ml) and group IV (3.9 microg/ml, range 1.1-10.6
      microg/ml) (P < 0.001). Statistically significant differences also were noted
      between groups II and III (P < 0.01) and groups II and IV (P < 0.001) and between
      groups III and IV (P < 0.05). These results demonstrate that the concentration of
      vitamin C in gastric juice is significantly lower in smokers than in non-smokers.
      This was observed in healthy subjects as well as H. pylori-infected patients.
      This phenomenon may be one of the mechanisms whereby smoking contributes to the
      production of gastric lesions, impairs healing of peptic ulcers and also
      increases the recurrence rate of peptic ulcers in cases with H. pylori infection.

PMID- 11201682
TI  - Allelic polymorphism of GSTM1 and NAT2 genes modifies dietary-induced DNA damage
      in colorectal mucosa.
AB  - Typically, cancer is caused by the interaction of genetic and environmental
      factors. In colorectal carcinogenesis, diet and nutritional habits are the most
      important external risk determinants. Allelic polymorphisms of certain
      metabolizing enzymes may have an influence on cancer risk by modifying the
      concentration of active carcinogenic compounds in the body. In the present study
      we investigated the interaction between nutritional and genetic susceptibility
      factors in human colon carcinogenesis. Healthy volunteers were divided into four
      groups, based on allelic polymorphisms of N-acetyltransferase 2 and glutathione-S
      transferase M1 enzymes. Comet assay was used to determine the level of DNA strand
      breaks in exfoliated colorectal mucosal cells, following a 2-day vegetarian diet,
      and after switching to a 2-day 'high-meat' diet. The 'high-meat' diet
      statistically significantly increased the amount of single-strand breaks in rapid
      acetylators and among individuals with a GSMT1 + genotype, while it caused only a
      slight and not significant increase in the other groups. Our study emphasizes the
      importance of using susceptibility markers in cancer epidemiology, since
      environmental effects are strongly modified by these genetic factors.

PMID- 11201683
TI  - Tonsillar and other upper aerodigestive tract cancers among cervical cancer
      patients and their husbands.
AB  - The study aimed at probing the possible role of human papillomavirus (HPV)
      infection in squamous cell carcinomas of the upper aerodigestive tract, with a
      special reference to tonsillar cancer. We used the Swedish Family Cancer Database
      to analyse second cancers in the upper aerodigestive tract of women first
      diagnosed with in-situ or invasive cervical cancer. First cancers of their
      husbands were also analysed. Standardized incidence ratios (SIRs) were calculated
      for female and male cancers, adjusted for age at diagnosis, period, sex, socio
      economic status and residential area. Among women, increases were observed at
      many sites, but tonsillar cancers were increased only among women aged 50 years
      or more at diagnosis of in-situ cervical cancer (SIR 2.58). The increases at
      these sites are probably ascribed to the effects HPV, smoking, alcohol or their
      interaction. Husbands of cervical cancer patients developed an excess (SIR over
      2.00) of both tonsillar cancer (SIR 2.39 when wife with in-situ cancer and SIR
      2.72 when wife with invasive cervical cancer) and cancer of the tongue. The
      excess of tonsillar cancer among husbands of women with HPV-associated neoplastic
      lesions of the cervix supports the a priori hypothesis that HPV may be involved
      in tonsillar carcinogenesis.

PMID- 11201684
TI  - Comparison of early onco/suppressor gene expressions in peripheral leukocytes and
      potential target organs of rats exposed to the carcinogen 1-nitropyrene.
AB  - An in-vivo model has been developed to study early expressions of c-myc, Ha-ras
      oncogenes and p53 suppressor gene as biomarkers of carcinogenic exposure and/or
      tumorigenesis. In order to validate the in-vivo expression changes as biomarkers,
      rats were treated with the outdoor air pollutant carcinogen 1-nitropyrene. The
      gene expression levels were measured after 24 and 48 h in potential target
      tissues (lung, liver, lymph nodes, kidneys, spleen) and in peripheral blood
      leukocytes. Another main objective was to prove the applicability of leukocytes
      as a surrogate tissue, having a similar expression pattern of the selected genes
      upon carcinogenic exposure. The c-myc oncogene was not suitable as an early
      biomarker because of the lack or low level of its expression. However, in the
      case of the other oncogene Ha-ras and the suppressor gene p53, remarkable and
      early changes were detected in the expression signals. Similar expression
      patterns could only be detected in leukocytes and the spleen; therefore we
      continue this validation study by using other types and routes of exposure.

PMID- 11201685
TI  - Meat and nutrition, Hamburg: 17-18 October 2000.

PMID- 11201686
TI  - Our role as family physicians in vaccine safety.

PMID- 11201687
TI  - Increasing the success of antihypertensive therapy.

PMID- 11201689
TI  - A plan for patients who wish to quit smoking.

PMID- 11201688
TI  - Behavioral medicine in patients with MVP.

PMID- 11201690
TI  - Diagnostic curettage in the evaluation of ectopic pregnancy.

PMID- 11201691
TI  - Smoking and age-related macular degeneration.

PMID- 11201692
TI  - Common infections in older adults.
AB  - Infectious diseases account for one third of all deaths in people 65 years and
      older. Early detection is more difficult in the elderly because the typical signs
      and symptoms, such as fever and leukocytosis, are frequently absent. A change in
      mental status or decline in function may be the only presenting problem in an
      older patient with an infection. An estimated 90 percent of deaths resulting from
      pneumonia occur in people 65 years and older. Mortality resulting from influenza
      also occurs primarily in the elderly. Urinary tract infections are the most
      common cause of bacteremia in older adults. Asymptomatic bacteriuria occurs
      frequently in the elderly; however, antibiotic treatment does not appear to be
      efficacious. The recent rise of antibiotic-resistant bacteria (e.g., methicillin
      resistant Staphylococcus aureus and vancomycin-resistant enterococcus) is a
      particular problem in the elderly because they are exposed to infections at
      higher rates in hospital and institutional settings. Treatment of colonization
      and active infection is problematic; strict adherence to hygiene practices is
      necessary to prevent the spread of resistant organisms.

PMID- 11201693
TI  - Sleep disorders and sleep problems in childhood.
AB  - Sleep problems are common in childhood. A distinction is made between problems in
      which polysomnography is abnormal (i.e., the parasomnias, sleep apnea and
      narcolepsy) and problems that are behavioral in origin and have normal
      polysomnography. The parasomnias--sleep terrors, somnambulism and enuresis-
      appear to be related to central nervous system immaturity and are often outgrown.
      Obstructive sleep apnea syndrome (OSAS) is frequently missed in children and can
      often be cured through surgery. Behavioral sleep problems may be overcome after
      parents make interventions. Physicians can be of great assistance to these
      families by recommending techniques to parents that have been shown to be
      effective.

PMID- 11201694
TI  - Evaluation of incidental renal and adrenal masses.
AB  - Incidental renal or adrenal masses are sometimes found during imaging for
      problems unrelated to the kidneys and adrenal glands. Knowledgeable family
      physicians can reliably diagnose these masses, thereby avoiding unnecessary worry
      and procedures for their patients. A practical and cost-efficient means of
      evaluating renal lesions combines ultrasonography and computed tomographic
      scanning, with close communication between the family physician and the
      radiologist. Asymptomatic patients with simple renal cysts require no further
      evaluation. Patients with minimally complicated renal cysts can be followed
      radiographically. Magnetic resonance imaging is indicated in patients with
      indeterminate renal masses, and referral is required in patients with symptoms or
      solid masses. The need for referral of patients with adrenal masses is determined
      by careful assessment of clinical signs and symptoms, as well as the results of
      screening laboratory studies and appropriate radiologic studies. Referral is
      indicated for patients with incidental adrenal masses more than 6 cm in greatest
      diameter. Appropriate laboratory screening tests include the following: a 24-hour
      urinary free cortisol measurement for patients with evidence of Cushing's
      syndrome; a 24-hour urinary metanephrine, vanillylmandelic acid or catecholamine
      measurement for patients with evidence of pheochromocytoma; and a serum potassium
      level for patients with evidence of hyperaldosteronism.

PMID- 11201695
TI  - Management of suspected fetal macrosomia.
AB  - Fetal macrosomia, arbitrarily defined as a birth weight of more than 4,000 g (8
      lb, 13 oz) complicates more than 10 percent of all pregnancies in the United
      States. It is associated with increased risks of cesarean section and trauma to
      the birth canal and the fetus. Fetal macrosomia is difficult to predict, and
      clinical and ultrasonographic estimates of fetal weight are prone to error.
      Elective cesarean section for suspected macrosomia results in a high number of
      unnecessary procedures, and early induction of labor to limit fetal growth may
      result in a substantial increase in the cesarean section rate because of failed
      inductions. Pregnancies complicated by fetal macrosomia are best managed
      expectantly. When labor fails to progress as expected, the possibility of
      fetopelvic disproportion should be considered within the context of the best
      estimate of the fetal weight.

PMID- 11201696
TI  - Effective use of statins to prevent coronary heart disease.
AB  - Primary and secondary prevention trials have shown that use of 3-hydroxy-3
      methylglutaryl coenzyme A reductase inhibitors (also known as statins) to lower
      an elevated low-density lipoprotein cholesterol level can substantially reduce
      coronary events and death from coronary heart disease. In 1987 and 1993, the
      National Cholesterol Education Program promulgated guidelines for cholesterol
      screening and treatment. Thus far, however, primary care physicians have
      inadequately adopted these guidelines in clinical practice. A 1991 study found
      that cholesterol screening was performed in only 23 percent of patients.
      Consequently, many patients with elevated low-density lipoprotein levels and a
      high risk of primary or recurrent ischemic events remain unidentified and
      untreated. A study published in 1998 found that fewer than 15 percent of patients
      with known coronary heart disease have low-density lipoprotein levels at the
      recommended level of below 100 mg per dL (2.60 mmol per L). By identifying
      patients with elevated low-density lipoprotein levels and instituting appropriate
      lipid-lowering therapy, family physicians could help prevent cardiovascular
      events and death in many of their patients.

PMID- 11201697
TI  - Sporotrichoid lymphocutaneous infections: etiology, diagnosis and therapy.
AB  - Sporotrichoid lymphocutaneous infection is an uncommon syndrome that is often
      misdiagnosed and improperly treated. Of the several hundred cases seen each year
      in the United States, the majority are caused by Sporothrix schenckii, Nocardia
      brasiliensis, Mycobacterium marinum or Leishmania brasiliensis. The
      "sporotrichoid" disease begins at a site of distal inoculation and leads to the
      development of nodular lymphangitis. Systemic symptoms are characteristically
      absent. By recognizing the distinct pattern of nodular lymphangitis and focusing
      on the diverse but limited etiologies, the physician can obtain the appropriate
      histologic and microbiologic studies and start targeted antimicrobial therapy.
      Therapy is generally continued for two to three months after the resolution of
      cutaneous disease.

PMID- 11201698
TI  - ACIP issues updated recommendations for polio vaccine. Advisory Committee on
      Immunization Practices.

PMID- 11201700
TI  - Deep waters.

PMID- 11201701
TI  - Don't underestimate the enemy.

PMID- 11201702
TI  - The stuff of ideas.

PMID- 11201703
TI  - Harvard to spend 'hundreds of millions' on further expansion.

PMID- 11201704
TI  - Biotech sector still looking lively.

PMID- 11201705
TI  - Japanese legume project may help to fix nitrogen problem.

PMID- 11201706
TI  - South Africa reveals funding allocations for research.

PMID- 11201707
TI  - Group urges survey of antibiotics in animals.

PMID- 11201708
TI  - French museum report sparks researchers' revolt.

PMID- 11201709
TI  - Genes may solve hormone-disrupter debate.

PMID- 11201710
TI  - Spanish leader lends ear to science.

PMID- 11201711
TI  - CNN founder launches arms control initiative.

PMID- 11201712
TI  - BSE fallout sends shock waves through Germany.

PMID- 11201713
TI  - Polio's last stand.

PMID- 11201714
TI  - Funding assured for India's international biotechnology centre...

PMID- 11201715
TI  - And senior staff say there's no problem.

PMID- 11201716
TI  - Doing our best for returners to Spain.

PMID- 11201717
TI  - Difficulty in reconciling global-warming data.

PMID- 11201718
TI  - The birth of scientific reading.

PMID- 11201719
TI  - The key to the past?

PMID- 11201720
TI  - Wireless communications. Talk is cheap in the city.

PMID- 11201722
TI  - Geochemistry. New prospects for old gas.

PMID- 11201721
TI  - Diabetes. The missing link with obesity?

PMID- 11201724
TI  - Pulsars crash the magnetar party.

PMID- 11201725
TI  - Evolution. Speciation in the round.

PMID- 11201726
TI  - Cats, dogs and categories.

PMID- 11201723
TI  - RNA silencing. Diced defence.

PMID- 11201727
TI  - Water structure. Order and oddities.

PMID- 11201728
TI  - A viable herd of genetically uniform cattle.

PMID- 11201729
TI  - Topology of two-dimensional C60 domains.

PMID- 11201730
TI  - Self-recognition and the right hemisphere.

PMID- 11201731
TI  - Life, geology and snowball Earth.

PMID- 11201733
TI  - Non-detection at Venus of high-frequency radio signals characteristic of
      terrestrial lightning.
AB  - The detection of impulsive low-frequency (10 to 80 kHz) radio signals, and
      separate very-low-frequency (approximately 100 Hz) radio 'whistler' signals
      provided the first evidence for lightning in the atmosphere of Venus. Later, a
      small number of impulsive high-frequency (100 kHz to 5.6 MHz) radio signals,
      possibly due to lightning, were also detected. The existence of lightning at
      Venus has, however, remained controversial. Here we report the results of a
      search for high-frequency (0.125 to 16 MHz) radio signals during two close fly
      bys of Venus by the Cassini spacecraft. Such signals are characteristic of
      terrestrial lightning, and are commonly heard on AM (amplitude-modulated) radios
      during thunderstorms. Although the instrument easily detected signals from
      terrestrial lightning during a later fly-by of Earth (at a global flash rate
      estimated to be 70 s(-1), which is consistent with the rate expected for
      terrestrial lightning), no similar signals were detected from Venus. If lightning
      exists in the venusian atmosphere, it is either extremely rare, or very different
      from terrestrial lightning.

PMID- 11201732
TI  - The hormone resistin links obesity to diabetes.
AB  - Diabetes mellitus is a chronic disease that leads to complications including
      heart disease, stroke, kidney failure, blindness and nerve damage. Type 2
      diabetes, characterized by target-tissue resistance to insulin, is epidemic in
      industrialized societies and is strongly associated with obesity; however, the
      mechanism by which increased adiposity causes insulin resistance is unclear. Here
      we show that adipocytes secrete a unique signalling molecule, which we have named
      resistin (for resistance to insulin). Circulating resistin levels are decreased
      by the anti-diabetic drug rosiglitazone, and increased in diet-induced and
      genetic forms of obesity. Administration of anti-resistin antibody improves blood
      sugar and insulin action in mice with diet-induced obesity. Moreover, treatment
      of normal mice with recombinant resistin impairs glucose tolerance and insulin
      action. Insulin-stimulated glucose uptake by adipocytes is enhanced by
      neutralization of resistin and is reduced by resistin treatment. Resistin is thus
      a hormone that potentially links obesity to diabetes.

PMID- 11201734
TI  - Tripling the capacity of wireless communications using electromagnetic
      polarization.
AB  - Wireless communications are a fundamental part of modern information
      infrastructure. But wireless bandwidth is costly, prompting a close examination
      of the data channels available using electromagnetic waves. Classically, radio
      communications have relied on one channel per frequency, although it is well
      understood that the two polarization states of planar waves allow two distinct
      information channels; techniques such as 'polarization diversity' already take
      advantage of this. Recent work has shown that environments with scattering, such
      as urban areas or indoors, also possess independent spatial channels that can be
      used to enhance capacity greatly. In either case, the relevant signal processing
      techniques come under the heading of 'multiple-input/multiple-output'
      communications, because multiple antennae are required to access the polarization
      or spatial channels. Here we show that, in a scattering environment, an extra
      factor of three in channel capacity can be obtained, relative to the conventional
      limit using dual-polarized radio signals. The extra capacity arises because there
      are six distinguishable electric and magnetic states of polarization at a given
      point, rather than two as is usually assumed.

PMID- 11201735
TI  - Relationship between structural order and the anomalies of liquid water.
AB  - In contrast to crystalline solids--for which a precise framework exists for
      describing structure--quantifying structural order in liquids and glasses has
      proved more difficult because even though such systems possess short-range order,
      they lack long-range crystalline order. Some progress has been made using model
      systems of hard spheres, but it remains difficult to describe accurately liquids
      such as water, where directional attractions (hydrogen bonds) combine with short
      range repulsions to determine the relative orientation of neighbouring molecules
      as well as their instantaneous separation. This difficulty is particularly
      relevant when discussing the anomalous kinetic and thermodynamic properties of
      water, which have long been interpreted qualitatively in terms of underlying
      structural causes. Here we attempt to gain a quantitative understanding of these
      structure-property relationships through the study of translational and
      orientational order in a models of water. Using molecular dynamics simulations,
      we identify a structurally anomalous region--bounded by loci of maximum
      orientational order (at low densities) and minimum translational order (at high
      densities)--in which order decreases on compression, and where orientational and
      translational order are strongly coupled. This region encloses the entire range
      of temperatures and densities for which the anomalous diffusivity and thermal
      expansion coefficient of water are observed, and enables us to quantify the
      degree of structural order needed for these anomalies to occur. We also find that
      these structural, kinetic and thermodynamic anomalies constitute a cascade: they
      occur consecutively as the degree of order is increased.

PMID- 11201736
TI  - Transparent nematic phase in a liquid-crystal-based microemulsion.
AB  - Complex fluids are usually produced by mixing together several distinct
      components, the interactions between which can give rise to unusual optical and
      rheological properties of the system as a whole. For example, the properties of
      microemulsions (composed of water, oil and surfactants) are determined by the
      microscopic structural organization of the fluid that occurs owing to phase
      separation of the component elements. Here we investigate the effect of
      introducing an additional organizing factor into such a fluid system, by
      replacing the oil component of a conventional water-in-oil microemulsion with an
      intrinsically anisotropic fluid--a nematic liquid crystal. As with the
      conventional case, the fluid phase-separates into an emulsion of water
      microdroplets (stabilized by the surfactant as inverse micelles) dispersed in the
      'oil' phase. But the properties are further influenced by a significant
      directional coupling between the liquid-crystal molecules and the surfactant
      tails that emerge (essentially radially) from the micelles. The result is a
      modified bulk-liquid crystal that is an ordered nematic at the mesoscopic level,
      but which does not exhibit the strong light scattering generally associated with
      bulk nematic order: the bulk material here is essentially isotropic and thus
      transparent.

PMID- 11201737
TI  - Increased thermohaline stratification as a possible cause for an ocean anoxic
      event in the Cretaceous period.
AB  - Ocean anoxic events were periods of high carbon burial that led to drawdown of
      atmospheric carbon dioxide, lowering of bottom-water oxygen concentrations and,
      in many cases, significant biological extinction. Most ocean anoxic events are
      thought to be caused by high productivity and export of carbon from surface
      waters which is then preserved in organic-rich sediments, known as black shales.
      But the factors that triggered some of these events remain uncertain. Here we
      present stable isotope data from a mid-Cretaceous ocean anoxic event that
      occurred 112 Myr ago, and that point to increased thermohaline stratification as
      the probable cause. Ocean anoxic event 1b is associated with an increase in
      surface-water temperatures and runoff that led to decreased bottom-water
      formation and elevated carbon burial in the restricted basins of the western
      Tethys and North Atlantic. This event is in many ways similar to that which led
      to the more recent Plio-Pleistocene Mediterranean sapropels, but the greater
      geographical extent and longer duration (approximately 46 kyr) of ocean anoxic
      event 1b suggest that processes leading to such ocean anoxic events in the North
      Atlantic and western Tethys were able to act over a much larger region, and
      sequester far more carbon, than any of the Quaternary sapropels.

PMID- 11201738
TI  - 300-Myr-old magmatic CO2 in natural gas reservoirs of the west Texas Permian
      basin.
AB  - Except in regions of recent crustal extension, the dominant origin of carbon
      dioxide in fluids in sedimentary basins has been assumed to be from crustal
      organic matter or mineral reactions. Here we show, by contrast, that Rayleigh
      fractionation caused by partial degassing of a magma body can explain the CO2/3He
      ratios and delta13C(CO2) values observed in CO2-rich natural gases in the west
      Texas Val Verde basin and also the mantle 3He/22Ne ratios observed in other basin
      systems. Regional changes in CO2/3He and CO2/CH4 ratios can be explained if the
      CO2 input pre-dates methane generation in the basin, which occurred about 280 Myr
      ago. Uplift to the north of the Val Verde basin between 310 and 280 Myr ago
      appears to be the only tectonic event with appropriate timing and location to be
      the source of the magmatic CO2. Our identification of magmatic CO2 in a foreland
      basin indicates that the origin of CO2 in other mid-continent basin systems
      should be re-evaluated. Also, the inferred closed-system preservation of natural
      gas in a trapping structure for approximately 300 Myr is far longer than the
      residence time predicted by diffusion models.

PMID- 11201739
TI  - The electric Moho.
AB  - Since Mohorovicic discovered a dramatic increase in compressional seismic
      velocity at a depth of 54 km beneath the Kulpa Valley in Croatia, the 'Moho' has
      become arguably the most important seismological horizon in Earth owing to its
      role in defining the crust-mantle boundary. It is now known to be a ubiquitous
      feature of the Earth, being found beneath both the continents and the oceans, and
      is commonly assumed to separate lower-crustal mafic rocks from upper-mantle
      ultramafic rocks. Electromagnetic experiments conducted to date, however, have
      failed to detect a corresponding change in electrical conductivity at the base of
      the crust, although one might be expected on the basis of laboratory
      measurements. Here we report electromagnetic data from the Slave craton, northern
      Canada, which show a step-change in conductivity at Moho depths. Such resolution
      is possible because the Slave craton is highly anomalous, exhibiting a total
      crustal conductance of less than 1 Siemens--more than an order of magnitude
      smaller than other Archaean cratons. We also found that the conductivity of the
      uppermost continental mantle directly beneath the Moho is two orders of magnitude
      more conducting than laboratory studies on olivine would suggest, inferring that
      there must be a connected conducting phase.

PMID- 11201740
TI  - Speciation in a ring.
AB  - The evolutionary divergence of a single species into two has never been directly
      observed in nature, primarily because speciation can take a long time to occur. A
      ring species, in which a chain of intergrading populations encircles a barrier
      and the terminal forms coexist without interbreeding, provides a situation in
      which variation in space can be used to infer variation in time. Here we
      reconstruct the pathway to speciation between two reproductively isolated forms
      of greenish warbler (Phylloscopus trochiloides). These two taxa do not interbreed
      in central Siberia but are connected by a long chain of intergrading populations
      encircling the Tibetan Plateau to the south. Molecular data and climatic history
      imply that the reproductively isolated taxa came into contact following
      expansions northward around the western and eastern sides of the plateau.
      Parallel selection pressures for increased song complexity during the northward
      expansions have been accompanied by divergence in song structure. Playback
      experiments show that the two Siberian forms do not recognize each other's songs.
      Our results show how gradual divergence in a trait involved in mate choice leads
      to the formation of new species.

PMID- 11201741
TI  - Three-butterfly system provides a field test of mullerian mimicry.
AB  - In 1879, Muller proposed that two brightly coloured distasteful butterfly species
      (co-models) that share a single warning-colour pattern would benefit by spreading
      the selective burden of educating predators. The mutual benefit of sharing
      warning signals among distasteful species, so-called mullerian mimicry, is
      supported by comparative evidence, theoretical studies and laboratory
      simulations; however, to date, this key exemplar of adaptive evolution has not
      been experimentally tested in the field. To measure natural selection generated
      by mullerian mimicry, I exploited the unusual polymorphism of Heliconius cydno
      (Lepidoptera: Nymphalidae). Here I show increased survival of H. cydno morphs
      that match locally abundant monomorphic co-model species. This study demonstrates
      mullerian mimicry in the field. It also shows that mullerian mimicry with several
      co-models generates geographically divergent selection, which explains the
      existence of polymorphism in distasteful species with warning coloration.

PMID- 11201742
TI  - Identification of a receptor mediating Nogo-66 inhibition of axonal regeneration.
AB  - Nogo has been identified as a component of the central nervous system (CNS)
      myelin that prevents axonal regeneration in the adult vertebrate CNS. Analysis of
      Nogo-A has shown that an axon-inhibiting domain of 66 amino acids is expressed at
      the extracellular surface and at the endoplasmic reticulum lumen of transfected
      cells and oligodendrocytes. The acidic amino terminus of Nogo-A is detected at
      the cytosolic face of cellular membranes and may contribute to inhibition of axon
      regeneration at sites of oligodendrocyte injury. Here we show that the
      extracellular domain of Nogo (Nogo-66) inhibits axonal extension, but does not
      alter non-neuronal cell morphology. In contrast, a multivalent form of the N
      terminus of Nogo-A affects the morphology of both neurons and other cell types.
      Here we identify a brain-specific, leucine-rich-repeat protein with high affinity
      for soluble Nogo-66. Cleavage of the Nogo-66 receptor and other
      glycophosphatidylinositol-linked proteins from axonal surfaces renders neurons
      insensitive to Nogo-66. Nogo-66 receptor expression is sufficient to impart Nogo
      66 axonal inhibition to unresponsive neurons. Disruption of the interaction
      between Nogo-66 and its receptor provides the potential for enhanced recovery
      after human CNS injury.

PMID- 11201743
TI  - Maize yellow stripe1 encodes a membrane protein directly involved in Fe(III)
      uptake.
AB  - Frequently, crop plants do not take up adequate amounts of iron from the soil,
      leading to chlorosis, poor yield and decreased nutritional quality. Extremely
      limited soil bioavailability of iron has led plants to evolve two distinct uptake
      strategies: chelation, which is used by the world's principal grain crops; and
      reduction, which is used by other plant groups. The chelation strategy involves
      extrusion of low-molecular-mass secondary amino acids (mugineic acids) known as
      'phytosiderophores' which chelate sparingly soluble iron. The Fe(III)
      phytosiderophore complex is then taken up by an unknown transporter at the root
      surface. The maize yellow stripe1 (ys1) mutant is deficient in Fe(III)
      phytosiderophore uptake, therefore YS1 has been suggested to be the Fe(III)
      phytosiderophore transporter. Here we show that ys1 is a membrane protein that
      mediates iron uptake. Expression of YS1 in a yeast iron uptake mutant restores
      growth specifically on Fe(III)-phytosiderophore media. Under iron-deficient
      conditions, ys1 messenger RNA levels increase in both roots and shoots. Cloning
      of ys1 is an important step in understanding iron uptake in grasses, and has
      implications for mechanisms controlling iron homeostasis in all plants.

PMID- 11201744
TI  - CD45 is a JAK phosphatase and negatively regulates cytokine receptor signalling.
AB  - The regulation of tyrosine phosphorylation and associated signalling through
      antigen, growth-factor and cytokine receptors is mediated by the reciprocal
      activities of protein tyrosine kinases and protein tyrosine phosphatases
      (PTPases). The transmembrane PTPase CD45 is a key regulator of antigen receptor
      signalling in T and B cells. Src-family kinases have been identified as primary
      molecular targets for CD45 (ref. 4). However, CD45 is highly expressed in all
      haematopoietic lineages at all stages of development, indicating that CD45 could
      regulate other cell types and might act on additional substrates. Here we show
      that CD45 suppresses JAK (Janus kinase) kinases and negatively regulates cytokine
      receptor signalling. Targeted disruption of the cd45 gene leads to enhanced
      cytokine and interferon-receptor-mediated activation of JAKs and STAT (signal
      transducer and activators of transcription) proteins. In vitro, CD45 directly
      dephosphorylates and binds to JAKs. Functionally, CD45 negatively regulates
      interleukin-3-mediated cellular proliferation, erythropoietin-dependent
      haematopoieisis and antiviral responses in vitro and in vivo. Our data identify
      an unexpected and novel function for CD45 as a haematopoietic JAK phosphatase
      that negatively regulates cytokine receptor signalling.

PMID- 11201745
TI  - MAD2 haplo-insufficiency causes premature anaphase and chromosome instability in
      mammalian cells.
AB  - The mitotic checkpoint protein hsMad2 is required to arrest cells in mitosis when
      chromosomes are unattached to the mitotic spindle. The presence of a single,
      lagging chromosome is sufficient to activate the checkpoint, producing a delay at
      the metaphase-anaphase transition until the last spindle attachment is made.
      Complete loss of the mitotic checkpoint results in embryonic lethality owing to
      chromosome mis-segregation in various organisms. Whether partial loss of
      checkpoint control leads to more subtle rates of chromosome instability
      compatible with cell viability remains unknown. Here we report that deletion of
      one MAD2 allele results in a defective mitotic checkpoint in both human cancer
      cells and murine primary embryonic fibroblasts. Checkpoint-defective cells show
      premature sister-chromatid separation in the presence of spindle inhibitors and
      an elevated rate of chromosome mis-segregation events in the absence of these
      agents. Furthermore, Mad2+/- mice develop lung tumours at high rates after long
      latencies, implicating defects in the mitotic checkpoint in tumorigenesis.

PMID- 11201746
TI  - Pre-meiotic S phase is linked to reductional chromosome segregation and
      recombination.
AB  - Meiosis is initiated from G1 of the cell cycle and is characterized by a pre
      meiotic S phase followed by two successive nuclear divisions. The first of these,
      meiosis I, differs from mitosis in having a reductional pattern of chromosome
      segregation. Here we show that meiosis can be initiated from G2 in fission yeast
      cells by ectopically activating the meiosis-inducing network. The subsequent
      meiosis I occurs without a pre-meiotic S phase and with decreased recombination,
      and exhibits a mitotic pattern of equational chromosome segregation. The
      subsequent meiosis II results in random chromosome segregation. This behaviour is
      similar to that observed in cells lacking the meiotic cohesin Rec8 (refs 3, 4),
      which becomes associated with chromosomes at G1/S phase, including the inner
      centromere, a region that is probably critical for sister-centromere orientation.
      If the expression of Rec8 is delayed to S phase/G2, then the centromeres behave
      equationally. We propose that the presence of Rec8 in chromatin is required at
      the pre-meiotic S phase to construct centromeres that behave reductionally and
      chromosome arms capable of a high level of recombination, and that this explains
      why meiosis is initiated from G1 of the cell cycle.

PMID- 11201747
TI  - Role for a bidentate ribonuclease in the initiation step of RNA interference.
AB  - RNA interference (RNAi) is the mechanism through which double-stranded RNAs
      silence cognate genes. In plants, this can occur at both the transcriptional and
      the post-transcriptional levels; however, in animals, only post-transcriptional
      RNAi has been reported to date. In both plants and animals, RNAi is characterized
      by the presence of RNAs of about 22 nucleotides in length that are homologous to
      the gene that is being suppressed. These 22-nucleotide sequences serve as guide
      sequences that instruct a multicomponent nuclease, RISC, to destroy specific
      messenger RNAs. Here we identify an enzyme, Dicer, which can produce putative
      guide RNAs. Dicer is a member of the RNase III family of nucleases that
      specifically cleave double-stranded RNAs, and is evolutionarily conserved in
      worms, flies, plants, fungi and mammals. The enzyme has a distinctive structure,
      which includes a helicase domain and dual RNase III motifs. Dicer also contains a
      region of homology to the RDE1/QDE2/ARGONAUTE family that has been genetically
      linked to RNAi.

PMID- 11201748
TI  - A model for SOS-lesion-targeted mutations in Escherichia coli.
AB  - The UmuD'2C protein complex (Escherichia coli pol V) is a low-fidelity DNA
      polymerase (pol) that copies damaged DNA in the presence of RecA, single-stranded
      DNA binding protein (SSB) and the beta,gamma-processivity complex of E. coli pol
      III (ref. 4). Here we propose a model to explain SOS-lesion-targeted mutagenesis,
      assigning specific biochemical functions for each protein during translesion
      synthesis. (SOS lesion-targeted mutagenesis occurs when pol V is induced as part
      of the SOS response to DNA damage and incorrectly incorporates nucleotides
      opposite template lesions.) Pol V plus SSB catalyses RecA filament disassembly in
      the 3' to 5' direction on the template, ahead of the polymerase, in a reaction
      that does not involve ATP hydrolysis. Concurrent ATP-hydrolysis-driven filament
      disassembly in the 5' to 3' direction results in a bidirectional stripping of
      RecA from the template strand. The bidirectional collapse of the RecA filament
      restricts DNA synthesis by pol V to template sites that are proximal to the
      lesion, thereby minimizing the occurrence of untargeted mutations at undamaged
      template sites.

PMID- 11201749
TI  - Chi-sequence recognition and DNA translocation by single RecBCD helicase/nuclease
      molecules.
AB  - Major pathways of recombinational DNA repair in Escherichia coli require the
      RecBCD protein--a heterotrimeric, ATP-driven, DNA translocating motor enzyme.
      RecBCD combines a highly processive and exceptionally fast helicase (DNA
      unwinding) activity with a strand-specific nuclease (DNA-cleaving) activity (refs
      1, 2 and references therein). Recognition of the DNA sequence 'chi' (5'-GCTGGTGG
      3') switches the polarity of DNA cleavage and stimulates recombination at nearby
      sequences in vivo. Here we attach microscopic polystyrene beads to biotin-tagged
      RecD protein subunits and use tethered-particle light microscopy to observe
      translocation of single RecBCD molecules (with a precision of up to approximately
      30 nm at 2 Hz) and to examine the mechanism by which chi modifies enzyme
      activity. Observed translocation is unidirectional, with each molecule moving at
      a constant velocity corresponding to the population-average DNA unwinding rate.
      These observations place strong constraints on possible movement mechanisms. Bead
      release at chi is negligible, showing that the activity modification at chi does
      not require ejection of the RecD subunit from the enzyme as previously proposed;
      modification may occur through an unusual, pure conformational switch mechanism.

PMID- 11201750
TI  - Processive translocation and DNA unwinding by individual RecBCD enzyme molecules.
AB  - RecBCD enzyme is a processive DNA helicase and nuclease that participates in the
      repair of chromosomal DNA through homologous recombination. We have visualized
      directly the movement of individual RecBCD enzymes on single molecules of double
      stranded DNA (dsDNA). Detection involves the optical trapping of solitary,
      fluorescently tagged dsDNA molecules that are attached to polystyrene beads, and
      their visualization by fluorescence microscopy. Both helicase translocation and
      DNA unwinding are monitored by the displacement of fluorescent dye from the DNA
      by the enzyme. Here we show that unwinding is both continuous and processive,
      occurring at a maximum rate of 972 +/- 172 base pairs per second (0.30 microm s(
      1)), with as many as 42,300 base pairs of dsDNA unwound by a single RecBCD enzyme
      molecule. The mean behaviour of the individual RecBCD enzyme molecules
      corresponds to that observed in bulk solution.

PMID- 11201751
TI  - Crystal structure of the transcription activator BmrR bound to DNA and a drug.
AB  - The efflux of chemically diverse drugs by multidrug transporters that span the
      membrane is one mechanism of multidrug resistance in bacteria. The concentrations
      of many of these transporters are controlled by transcription regulators, such as
      BmrR in Bacillus subtilis, EmrR in Escherichia coli and QacR in Staphylococcus
      aureus. These proteins promote transporter gene expression when they bind toxic
      compounds. BmrR activates transcription of the multidrug transporter gene, bmr,
      in response to cellular invasion by certain lipophilic cationic compounds
      (drugs). BmrR belongs to the MerR family, which regulates response to stress such
      as exposure to toxic compounds or oxygen radicals in bacteria. MerR proteins have
      homologous amino-terminal DNA-binding domains but different carboxy-terminal
      domains, which enable them to bind specific 'coactivator' molecules. When bound
      to coactivator, MerR proteins upregulate transcription by reconfiguring the 19
      base-pair spacer found between the -35 and -10 promoter elements to allow
      productive interaction with RNA polymerase. Here we report the 3.0 A resolution
      structure of BmrR in complex with the drug tetraphenylphosphonium (TPP) and a 22
      base-pair oligodeoxynucleotide encompassing the bmr promoter. The structure
      reveals an unexpected mechanism for transcription activation that involves
      localized base-pair breaking, and base sliding and realignment of the -35 and -10
      operator elements.

PMID- 11201752
TI  - Synthesizing life.

PMID- 11201753
TI  - Modelling cellular behaviour.

PMID- 11201754
TI  - Pasteur's Quadrant and malnutrition.

PMID- 11201755
TI  - Actions from thoughts.

PMID- 11201756
TI  - The relationship between matter and life.

PMID- 11201757
TI  - Life's lessons in design.

PMID- 11201758
TI  - Earth systems engineering and management.

PMID- 11201759
TI  - Interfering for the good of a chemical reaction.

PMID- 11201760
TI  - Future optical and infrared telescopes.

PMID- 11201761
TI  - New physics with the Compact Linear Collider.

PMID- 11201762
TI  - Health, productivity, and occupational medicine.

PMID- 11201763
TI  - Health and productivity management: establishing key performance measures,
      benchmarks, and best practices.
AB  - Major areas considered under the rubric of health and productivity management
      (HPM) in American business include absenteeism, employee turnover, and the use of
      medical, disability, and workers' compensation programs. Until recently, few
      normative data existed for most HPM areas. To meet the need for normative
      information in HPM, a series of Consortium Benchmarking Studies were conducted.
      In the most recent application of the study, 1998 HPM costs, incidence, duration,
      and other program data were collected from 43 employers on almost one million
      workers. The median HPM costs for these organizations were $9992 per employee,
      which were distributed among group health (47%), turnover (37%), unscheduled
      absence (8%), nonoccupational disability (5%), and workers' compensation programs
      (3%). Achieving "best-practice" levels of performance (operationally defined as
      the 25th percentile for program expenditures in each HPM area) would realize
      savings of $2562 per employee (a 26% reduction). The results indicate substantial
      opportunities for improvement through effective coordination and management of
      HPM programs. Examples of best-practice activities collated from on-site visits
      to "benchmark" organizations are also reviewed.

PMID- 11201764
TI  - Alternative valuations of work loss and productivity.
AB  - In this article, we examine the indirect costs (i.e., work loss and productivity
      costs) of employee illness from the employer's perspective. We provide a
      conceptual framework to help employers consider alternative views with regard to
      assessing indirect costs and valuing the health care they purchase. First, we
      discuss the matter of perspective and how an employer should view and assess
      indirect costs. We briefly review current models of measuring indirect costs, and
      we critique these models. Then we introduce a simple, conceptual framework based
      on the ideas of health capital and labor productivity, and we lay out the effects
      of health investment on indirect costs while considering what employees desire
      and employers can provide. Finally, we offer an agenda for further research.

PMID- 11201765
TI  - Depression and work productivity: the comparative costs of treatment versus
      nontreatment.
AB  - This article discusses the impact of depression on work productivity and the
      potential for improved work performance associated with effective treatment. We
      undertook a review of the literature by means of a computer search using the
      following key terms: cost of illness, work loss, sickness absence, productivity,
      performance, and disability. Published works were considered in four categories:
      (1) naturalistic cross-sectional studies that found greater self-reported work
      impairment among depressed workers; (2) naturalistic longitudinal studies that
      found a synchrony of change between depression and work impairment; (3)
      uncontrolled treatment studies that found reduced work impairment with successful
      treatment; and (4) controlled trials that usually, but not always, found greater
      reduction in work impairment among treated patients. Observational data suggest
      that productivity gains following effective depression treatment could far exceed
      direct treatment costs. Randomized effectiveness trials are needed before we can
      conclude definitively that depression treatment results in productivity
      improvements sufficient to offset direct treatment costs.

PMID- 11201766
TI  - The impact of a worksite health promotion program on short-term disability usage.
AB  - This study examined the impact of a worksite health promotion program on short
      term disability (STD) days in a large telecommunications company. The evaluation
      used a quasi-experimental, multiple time-series design with between-group
      comparison of workdays lost due to STD to determine impact. The study period was
      3 years and included 1628 employees on STD leave. Self-selected program
      participants were compared with non-participants on net days lost at three
      assessment points: the year before the launch of the program, and each of 2 years
      post-launch. A comprehensive health promotion program was developed to reduce
      health care costs, improve employee satisfaction, and enhance the employer's
      image. Key features of the program included reimbursement for employees
      participating in the Health Risk Assessment and in wellness or fitness
      activities. Other features included occupational health services, targeted
      interventions for high-risk employees, self-care materials, and a nurse advice
      line. Results revealed no significant differences at baseline between
      participants and non-participants for net days lost while on STD leave. At the
      post-program launch, non-participants' net days lost significantly increased from
      33.2 to 38.1 when controlled for age, gender, job type, tenure, and STD category,
      whereas the participant group average net days lost decreased from 29.2 to 27.8.
      After adjusting for baseline differences, we found a 6-day difference between
      groups, which represented a 20% program impact. This study found that
      participation in a health promotion reimbursement program had a significant
      impact on average net days lost for employee STD absence. These findings
      represented potential savings in excess of $1,371,600 over a 2-year period.
      Future program evaluation efforts will address the impact on medical care costs
      related to program participation.

PMID- 11201767
TI  - Health and productivity: a role for occupational health professionals.
AB  - The impressive economic gains achieved by many nations within the past decade
      have been attributed primarily to improvements in productivity from technological
      changes. The resultant low unemployment levels, however, emphasize the importance
      of human capital in the success of any enterprise. Concurrently, some economists
      have proposed an alternative economic view regarding the relationship between
      health and income, postulating that improvements in the health of the nation's
      population have a substantial effect on its economic viability. Such a view
      directly pertains to occupational health professionals, who are often charged
      with promoting the health of the worker. Although studies relating the beneficial
      impact of occupational health on productivity and human performance are limited,
      some efforts have shown impressive effects, as measured primarily by reduced
      absenteeism. The prompt, assertive management of occupational injuries and
      illnesses and their treatment have been well documented. Illnesses not considered
      traditional occupational ailments, such as migraine headaches, allergic
      disorders, infectious diseases, and depression, offer opportunities for
      occupational health professionals to ensure an accurate diagnosis and proper
      treatment for minimizing the impact on work performance. Considerable
      opportunities exist for occupational health professionals to demonstrate the
      importance of certain services to productivity.

PMID- 11201768
TI  - Health promotion programs, modifiable health risks, and employee absenteeism.
AB  - This literature review demonstrates that the health risks and failure of
      employees to participate in fitness and health promotion programs are associated
      with higher rates of employee absenteeism. When determining how to manage
      absenteeism, employers should carefully consider the impact that health promotion
      programs can have on rates of absenteeism and other employee-related expenses.

PMID- 11201769
TI  - Health, safety, and productivity in a manufacturing environment.
AB  - The Health and Productivity Management model at International Truck and Engine
      Corporation includes the measurement, analysis, and management of the individual
      component programs affecting employee safety, health, and productivity. The key
      to the success of the program was the iterative approach used to identify the
      opportunities, develop interventions, and achieve targets through continuous
      measurement and management. In addition, the integration of multiple disciplines
      and the overall emphasis on employee productivity and its cost are key foci of
      the International Model. The program was instituted after economic and clinical
      services' analyses of data on International employees showed significant excess
      costs and a high potential for health care cost reductions based on several
      modifiable health risk factors. The company also faced significant challenges in
      the safety, workers' compensation, and disability areas. The program includes
      safety, workers' compensation, short-term disability, long-term disability,
      health care, and absenteeism. Monthly reports/analyses are sent to senior
      management, and annual goals are set with the board of directors. Economic impact
      has been documented in the categories after intervention. For example, a
      comprehensive corporate wellness effort has had a significant impact in terms of
      reducing both direct health care cost and improving productivity, measured as
      absenteeism. Workers' compensation and disability program interventions have had
      an impact on current costs, resulting in a significant reduction of financial
      liability. In the final phase of the program, all direct and indirect
      productivity costs will be quantified. The impact of the coordinated program on
      costs associated with employee health will be analyzed initially and compared
      with a "silo" approach.

PMID- 11201770
TI  - Impact of illness and its treatment on workplace costs: regulatory and
      measurement issues.
AB  - In an attempt to document a broader spectrum of the benefits of their
      pharmaceutical products, drug companies increasingly seek to include productivity
      claims in their promotional campaigns. We describe the existing regulatory
      framework of the Food and Drug Administration (FDA) for considering productivity
      claims, distinguishing between the traditional "substantial evidence" standard
      and the "competent and reliable scientific evidence" standard. But the notion of
      competent and reliable scientific evidence may itself be problematic, even when
      it is the appropriate regulatory standard, because there exists no consistent
      measurement approach across diseases, workplaces, jobs, and worker capabilities
      that is widely accepted in this emerging area of health outcomes research. We
      examine the various measurement approaches that have been used to quantify the
      impact of illness and its treatment on workplace productivity, and we describe
      some of the shortcomings associated with each alternative. This discussion
      highlights the possible difficulties faced by the FDA in reviewing productivity
      based promotional claims. Finally, we suggest possible strategies for furthering
      this field of investigation.

PMID- 11201771
TI  - The impact of allergies and allergy treatment on worker productivity.
AB  - Allergic disorders are a chronic and highly prevalent condition in the general
      population and the workforce. Their effect on workers and corporate costs go
      beyond the direct cost of treatment, as the condition can lower a worker's
      productivity. Previous research includes estimates of the decrease in
      productivity associated with allergic disorders. None of these studies, however,
      offered an objective measure of how worker productivity is affected by allergic
      disorders. In the present study, the productivity of telephone customer service
      representatives suffering from allergic disorders is examined before, during, and
      after the ragweed pollen season. In addition, these workers were surveyed as to
      the type of medication they used in response to their condition. A significant
      correlation was observed between an increase in pollen counts and a decrease in
      productivity for workers with allergies. Compared with workers without allergies,
      employees with allergies who reported using no medication showed a 10% decrease
      in productivity. No differences were observed among workers with allergies using
      different types of medications, although the medication groups had significantly
      higher productivity than the no-medication group. The expected lowered
      productivity of those workers with allergies who used sedating antihistamines may
      have been offset by their relatively lower level of symptom severity and by the
      nature of the job and the productivity measures used.

PMID- 11201772
TI  - Laser in situ keratomileusis to correct residual myopia after cataract surgery.
AB  - PURPOSE: To evaluate the effectiveness, predictability, and safety of laser in
      situ keratomileusis (LASIK) for correcting residual myopia after cataract surgery
      with intraocular lens implantation. METHODS: Twenty-two eyes of 22 patients
      underwent LASIK for the correction of residual myopia after cataract surgery.
      LASIK was carried out using the Chiron Automated Corneal Shaper and the NIDEK EC
      5000 excimer laser. In all eyes, the follow-up was 12 months. RESULTS: Before
      LASIK, 1 eye (4.5%) had an uncorrected visual acuity of 0.5 or better; 12 months
      after LASIK, 10 eyes (45.4%) achieved this level of visual acuity and 0 eyes
      achieved 1.00 or better. Before LASIK, mean refraction was -2.90 +/- 1.80 D; 12
      months after LASIK it decreased significantly to 0.40 +/- 0.60 D (P < .01). In 18
      eyes (81.8%) at 12 months after LASIK, spherical equivalent refraction was within
      +/-1.00 D of emmetropia; 11 eyes (50%) were within 0.50 D. No vision-threatening
      complications occurred. CONCLUSION: LASIK with the Automated Corneal Shaper and
      Nidek EC-5000 excimer laser was an effective, predictable, stable, and safe
      procedure for correcting residual myopia after cataract surgery. No intraocular
      lens or cataract incision related complications occurred when LASIK was performed
      at least 3 months after phacoemulsification.

PMID- 11201773
TI  - Corneal sensitivity and some properties of the tear film after laser in situ
      keratomileusis.
AB  - PURPOSE: To investigate central corneal sensitivity, lipid layer structure of the
      precorneal tear film, and tear volume after laser in situ keratomileusis (LASIK).
      METHODS: Central corneal sensitivity was measured using the Non-Contact Corneal
      Aesthesiometer. The aesthesiometer was mounted on a slit lamp and an airpulse of
      controlled pressure was directed onto the cornea. When central corneal
      sensitivity was reduced, a higher air pulse pressure was required to stimulate
      the cornea. The final central corneal sensitivity threshold measured was recorded
      in millibars. Tear lipid layer structure was assessed by optical interferometry
      and classified according to appearance using the Keeler Tearscope. Tear volume
      was measured using the phenol red cotton thread test. Subjects were recruited
      from a group of patients after LASIK who had experienced no complications (n=22).
      The average postoperative time was 14 weeks and measurements were taken on one
      eye. In bilateral cases, measurements were recorded from the right eye only.
      Average attempted correction was -6.30 D (range, -2 to -11 D). Age-matched
      controls were later recruited for central corneal sensitivity threshold (n=24). A
      second group of age-matched controls were recruited for tear volume and lipid
      layer structure (n=24). RESULTS: The median (range) was 1.1 mbars (0.2 to 4.3
      mbars) after LASIK and 0.58 mbars (0.20 to 1.3 mbars) in the controls; the
      difference was statistically significant (P = .043). The lipid layer of the tear
      film tended to be thinner in eyes after LASIK compared with controls (P = .032).
      The mean (+/- SD) tear volume was 16.9 +/- 8.3 mm after LASIK and 19.8 +/- 7.1 mm
      in controls. This difference was not statistically significant (P = .492).
      CONCLUSION: At 14 weeks postoperatively, central corneal sensitivity was below
      normal levels and the tear lipid layer was thinner. The poorer quality lipid
      layer may predispose to symptoms of dry eye after LASIK.

PMID- 11201774
TI  - Intrastomal corneal ring segments: reversibility of refractive effect.
AB  - PURPOSE: To evaluate the reversibility of refractive effect following removal of
      the ICRS (intrastromal corneal ring segments; Intacs). METHODS: Data from 34 eyes
      from which ICRS were removed during United States FDA Phase II and III clinical
      trials were evaluated with regard to segment size, loss or change of best
      spectacle-corrected visual acuity (BSCVA), any change of uncorrected visual
      acuity (UCVA), manifest spherical equivalent refraction, manifest cylinder
      refraction, stability of manifest cylinder refraction, and subjective visual
      symptoms. RESULTS: Out of 725 initial or contralateral eyes placed with the ICRS
      during Phase II and III clinical trials, segments were removed from 34 eyes
      (4.7%). Other than one (1/725, 0.1%) safety related ICRS removal, 30/725 (4.1%)
      were due to visual symptoms. ICRS removal was accomplished under topical
      anesthesia without complications in all eyes. The mean length of time the
      segments remained in the cornea after initial surgery was 10.3 +/- 5.4 months. At
      3 months after ICRS removal, 21 eyes had monitored data available and were within
      +/-1 line or 10 letters of their preoperative BSCVA. Twenty eyes (20/21, 95%)
      returned to within +/-1.00 D of their preoperative manifest spherical equivalent
      refraction. All eyes had a stable refraction at the 3-month examination after
      removal, and a manifest spherical equivalent refraction within +/-1.00 D of their
      1-month examination after removal. Nineteen eyes (19/21, 90%) returned to within
      +/-2 lines and 16 eyes (16/21, 76%) returned to within +/-1 line of preoperative
      UCVA. CONCLUSION: The ICRS (Intacs) was easily and safely removed, and eyes
      returned to preoperative refractive status within 3 months.

PMID- 11201775
TI  - Posterior chamber phakic intraocular lenses to correct high myopia: a comparative
      study between Staar and Adatomed models.
AB  - PURPOSE: To determine the feasibility of using posterior chamber phakic
      intraocular lenses (PIOLs) to treat high myopia, comparing two different models,
      Staar and Adatomed. METHODS: Twenty-four eyes from 12 patients were studied
      prospectively. A phakic Staar IOL was implanted in one eye of each patient, and
      the other eye received a phakic Adatomed IOL. Patients with uveitis or ocular
      trauma prior to ocular surgery, diabetic retinopathy, or capsular
      pseudoexfoliation were excluded. The mean preoperative spherical equivalent
      refraction was -16.00 +/- 5.05 D for the Staar group and -15.39 +/- 2.83 D for
      the Adatomed group. Average follow-up was 32.4 months (range, 19 to 46 mo) for
      the Adatomed group and 18.3 months (range, 11 to 21 mo) for the Staar group and
      included evaluation of intraocular pressure, intraocular lens pigment deposits,
      lens decentration, anterior subcapsular cataract, and visual acuity. RESULTS:
      Spectacle-corrected and uncorrected visual acuity improved in all eyes in both
      groups. No statistically significant differences in visual acuity gain were
      observed with the two materials (Student t-test, P = .08 for the Staar group and
      P = .6 for the Adatomed group), although the gain in visual acuity was somewhat
      greater with the Staar PIOLs. The difference in mean intraocular pressure before
      surgery and at last follow-up was 1.5 mmHg for the Staar group and 2.3 mmHg for
      the Adatomed group (P = .36). The incidence of lens pigment deposits was the same
      in both groups (41.66%), with deposits in 5 of the 12 eyes in both groups. The
      incidence of lens decentration was higher in the Adatomed group (5/12; 41.66%)
      than in the Staar group (2/12; 16.7%). Anterior subcapsular cataract was higher
      in the Adatomed group (4/12; 33.3%) than in the Staar group (3/12; 25%).
      CONCLUSIONS: There was a higher incidence of lens decentration and anterior
      subcapsular cataract in the Adatomed group than in the Staar group.

PMID- 11201776
TI  - Smoothness of ablation on acrylic by four different excimer lasers.
AB  - PURPOSE: There are many different excimer laser devices available for
      photoablative refractive surgery. Smoothness of ablation may vary with different
      excimer lasers systems. METHODS: Ablations were performed on
      polymethylmethacrylate (PMMA) plates of 8 x 4 x 0.5 cm, with four different
      excimer lasers: VISX-Star, Coherent Schwind Keratom I/II, Chiron Technolas
      Keracor 117C (Plano Scan), and the Nidek EC-5000, to determine and compare the
      homogeneity and smoothness of the surface. Ten -3.00 D samples, ten -6.00 D
      samples, and ten -9.00 D samples were ablated with each laser. The PMMA discs
      were examined with optical microscopy, documented by photographs, and each sample
      was measured quantitatively using a Hommel-Werkel rugosimeter. We used the same
      PMMA material throughout. RESULTS: Statistically significant differences in
      smoothness were found between the Chiron Technolas 117C and the VISX-Star, Nidek
      and VISX-Star, and Coherent Schwind and VISX-Star in the homogeneities achieved
      by ablating -3.00 D. Ablations of -6.00 D resulted in homogeneities that were
      statistically significantly different: Chiron Technolas 117C with the other three
      devices, the Nidek EC-5000 with the VISX-Star, and the Coherent-Schwind with the
      VISX-Star. In the ablations for -9.00 D, statistically significant differences in
      homogeneity were found between the Chiron Technolas 117C and Nidek, between the
      Chiron and VISX-Star, between the Coherent Schwind and VISX-Star, and between the
      Nidek and VISX-Star. The laser with the scanning spot system was smoother.
      CONCLUSION: Scanning spot technology produced smooth ablations even up to -9.00
      D.

PMID- 11201777
TI  - Comparison of laser in situ keratomileusis and photorefractive keratectomy for
      the correction of myopia of -6.00 diopters or less. Melbourne Excimer Laser
      Group.
AB  - PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis
      (LASIK) compared to photorefractive keratectomy (PRK) for the correction of low
      or moderate myopia (-0.50 to -6.00 D) at 6 months after surgery. METHODS: The
      study population comprised a non-randomized consecutive series of 622 eyes of 392
      patients who were treated with the Nidek EC-5000 excimer laser. LASIK was
      performed using the ACS Chiron microkeratome on 314 eyes and surface PRK on 308
      eyes. All patients were treated using a standard protocol, then assessed at 1, 3,
      and 6 months postoperatively. RESULTS: Forty-four percent of the LASIK group and
      67% of the PRK group attended their 6-month examination. Eighty percent of
      patients (111 eyes) after LASIK and 65% (136 eyes) after PRK had an uncorrected
      visual acuity of 20/20 or better. Spherical equivalent refraction was within +/
      0.50 D of intended refraction in 78% (109 eyes) for LASIK and 82% (170 eyes) for
      PRK. Loss of two more lines of best spectacle-corrected visual acuity at 6 months
      occurred in 1.4% (2 eyes) of the LASIK group and 1.0% (2 eyes) of the PRK group.
      CONCLUSION: At 1 month follow-up, the percentage of eyes that achieved 20/20
      uncorrected visual acuity was greater in the LASIK group than in the PRK group.
      At 6 months, visual and refractive outcomes of LASIK and PRK were similar.
      Although flap related complications occurred only after LASIK, the overall risk
      of loss of best spectacle-corrected visual acuity was not significantly greater
      than for PRK.

PMID- 11201779
TI  - Treatment of progressive or recurrent epithelial ingrowth with ethanol following
      laser in situ keratomileusis.
AB  - PURPOSE: To evaluate the use of ethanol in the treatment of progressive or
      recurrent epithelial ingrowth following laser in situ keratomileusis (LASIK).
      METHODS: Four eyes of four patients with aggressive epithelial ingrowth following
      LASIK underwent epithelial ingrowth removal with 50% ethanol. Aggressive
      epithelial ingrowth was defined as, 1) progressive enlargement on serial
      examination with an area of ingrowth involving at least 30% of the flap surface
      area, 2) epithelial ingrowth associated with stromal melting as evidence on
      clinical or topographic examination, or 3) recurrent epithelial ingrowth in the
      same area following previous removal. RESULTS: Epithelial ingrowth was removed
      successfully in all eyes. No eye lost best spectacle-corrected visual acuity. One
      eye with multiple risk factors for failure experienced nonprogressive recurrence.
      No eyes required reoperation for recurrent epithelial ingrowth. No eyes
      experienced progression of stromal melt. Regularization of corneal topography was
      observed in an eye with preoperative stromal melting. The only complication was a
      tendency for the development of diffuse lamellar keratitis. Two eyes (50%)
      experienced diffuse lamellar keratitis following epithelial ingrowth removal with
      ethanol, which resolved completely with topical corticosteroids. CONCLUSION:
      Ethanol may be a useful adjunct in the treatment of aggressive or recurrent
      epithelial ingrowth following LASIK. Cautious use with the lowest concentration
      of ethanol may prove useful in these difficult epithelial ingrowth cases.
      Randomized and prospective studies are recommended to evaluate our experience.

PMID- 11201778
TI  - Perioperative microbiologic profile of the conjunctiva in photorefractive
      keratectomy.
AB  - PURPOSE: Therapeutic soft contact lenses are used commonly as an adjunctive
      treatment after photorefractive keratectomy (PRK) to decrease postoperative pain
      caused by the movement of lids over the corneal epithelial defect and to
      facilitate epithelial healing. We assessed the microbiological profile of the
      conjunctiva of patients undergoing PRK for myopia, before and after the
      concurrent use of a therapeutic soft contact lens, and compared the effect on
      ocular bacterial colonization of prophylactic administration of topical
      tobramycin 0.3% versus ofloxacin 0.3%. METHODS: Forty-three consecutive eyes from
      37 patients underwent PRK for myopia or myopic astigmatism. Eyes were assigned
      randomly to prophylactic antibacterial treatment with either topical ofloxacin
      0.3% or tobramycin 0.3%, applied prior to surgery and three times daily after
      surgery until therapeutic soft contact lens removal. Material from the
      conjunctival sac was obtained for bacteriologic cultures prior to surgery.
      Clinical evaluation of all eyes was conducted prospectively. Three days after
      PRK, the therapeutic soft contact lenses were removed and cultured. Cultures from
      the conjunctival sac were then repeated. RESULTS: No statistically significant
      differences were observed in culture positivity between the two groups of eyes,
      in spite of some positive preoperative and postoperative cultures. Only one out
      of 43 eyes (assigned to the ofloxacin group) developed a peripheral corneal
      infiltrate. The corneal infiltrate healed completely without sequelae using
      antibiotic and corticosteroid therapy. CONCLUSIONS: The use of therapeutic soft
      contact lenses after PRK with either topical tobramycin 0.3% or ofloxacin 0.3%
      were well tolerated. However, perioperative positive conjunctival cultures were
      relatively frequent and prophylactic antibiotics should be used in the setting of
      an epithelial defect and therapeutic soft contact lens following PRK.

PMID- 11201780
TI  - Surgical treatment of keratoconus at the turn of the 20th century.
AB  - PURPOSE: This paper reviews surgical modalities for treatment of keratoconus at
      the threshold of the 20th century. METHODS: All ophthalmic literature from 1895
      until 1925 in English and German, available at the library of the Institute of
      Ophthalmology, London, United Kingdom, was studied with respect to this topic.
      RESULTS: Three thermal procedures were described; galvanocauterization with
      perforation, without perforation, and a non-contact application of heat to the
      corneal apex. Radial extension of a thermal burn to correct the minus cylinder
      represented a further modification. Excision of the conical area was suggested
      either as a lamellar dissection or as a full thickness trephination. Incision of
      the cone appeared to be less popular. In staged procedures, a combination of
      galvanocauterization, splitting of the cornea, conjunctival flap, and a
      subsequent optical iridectomy were applied. CONCLUSION: The treatment of
      keratoconus 100 years ago used refractive surgery to improve visual function by
      modifying corneal shape.

PMID- 11201781
TI  - Sabine Dausch awarded Troutman Prize for 2000.

PMID- 11201782
TI  - The cornea is not a piece of plastic.

PMID- 11201783
TI  - The cornea is not a piece of plastic.

PMID- 11201784
TI  - The cornea is not a piece of plastic.

PMID- 11201785
TI  - Cell adhesion/recognition and signal transduction through glycosphingolipid
      microdomain.
AB  - Glycosphingolipids (GSLs) and sphingomyelin in animal cells are clustered and
      organized as membrane microdomains closely associated with various signal
      transducer molecules such as cSrc, Src family kinases, small G-proteins (e.g.,
      RhoA, Ras), and focal adhesion kinase. GSL clustering in such microdomains causes
      adhesion to complementary GSLs on the surface of counterpart cells or presented
      on plastic surfaces, through carbohydrate-to-carbohydrate interaction. GSL
      dependent cell adhesion in microdomain causes activation of the signal
      transducers, leading to cell phenotypic changes. A retrospective of the
      development of this concept, and current status of our studies, are presented.

PMID- 11201786
TI  - Functional roles of glycosphingolipids in signal transduction via lipid rafts.
AB  - The formation of glycosphingolipid (GSL)-cholesterol microdomains in cell
      membranes has been proposed to function as platforms for the attachment of lipid
      modified proteins, such as glycosylphosphatidylinositol (GPI)-anchored proteins
      and src-family tyrosine kinases. The microdomains are postulated to be involved
      in GPI-anchored protein signaling via src-family kinase. Here, the functional
      roles of GSLs in signal transduction mediated by the microdomains are discussed.
      Antibodies against GSLs co-precipitate GPI-anchored proteins, src-family kinases
      and several components of the microdomains. Antibody-mediated crosslinking of
      GSLs, as well as that of GPI-anchored proteins, induces a rapid activation of src
      family kinases and a transient increase in the tyrosine phosphorylation of
      several substrates. Enzymatic degradation of GSLs reduces the activation of src
      family kinase and tyrosine phosphorylation by antibody-mediated crosslinking of
      GPI-anchored protein. Furthermore, GSLs can also modulate signal transduction of
      immunoreceptors and growth factor receptors in the microdomains. Thus, GSLs have
      important roles in signal transduction mediated by the microdomains.

PMID- 11201788
TI  - Glycosphingolipid (GSL) microdomains as attachment platforms for host pathogens
      and their toxins on intestinal epithelial cells: activation of signal
      transduction pathways and perturbations of intestinal absorption and secretion.
AB  - Glycosphingolipid (GSL)-enriched microdomains are used as cellular binding sites
      for various pathogens including viruses and bacteria. These attachment platforms
      are specifically associated with transducer molecules, so that the binding of
      host pathogens (or their toxins) to the cell surface may result in the activation
      of signal transduction pathways. In the intestinal epithelium, such pathogen
      induced dysregulations of signal transduction can elicit a severe impairment of
      enterocytic functions. In this study, we demonstrate that the interaction of a
      bacterial toxin (cholera toxin) and a viral envelope glycoprotein (HIV-1 gp120)
      with the apical plasma membrane of intestinal cells is mediated by GSL-enriched
      microdomains that are associated with G regulatory proteins. These microbial
      proteins induce a GSL-dependent increase of intestinal fluid secretion by two
      mechanisms: activation of chloride secretion and inhibition of Na+ -dependent
      glucose absorption. Taken together, these data support the view that GSL-enriched
      microdomains in the apical plasma membrane of enterocytes are involved in the
      regulation of intestinal functions.

PMID- 11201787
TI  - Lipid membrane domains in cell surface and vacuolar systems.
AB  - Detergent insoluble sphingolipid-cholesterol enriched 'raft'-like membrane
      microdomains have been implicated in a variety of biological processes including
      sorting, trafficking, and signaling. Mutant cells and knockout animals of
      sphingolipid biosynthesis are clearly useful to understand the biological roles
      of lipid components in raft-like domains. It is suggested that raft-like domains
      distribute in internal vacuolar membranes as well as plasma membranes. In
      addition to sphingolipid-cholesterol-rich membrane domains, recent studies
      suggest the existence of another lipid-membrane domain in the endocytic pathway.
      This domain is enriched with a unique phospholipid, lysobisphosphatidic acid
      (LBPA) and localized in the internal membrane of multivesicular endosome. LBPA
      rich membrane domains are involved in lipid and protein sorting within the
      endosomal system. Possible interaction between sphingolipids and LBPA in
      sphingolipid-storage disease is discussed.

PMID- 11201789
TI  - On the biogenesis of the myelin sheath: cognate polarized trafficking pathways in
      oligodendrocytes.
AB  - Oligodendrocytes, the myelinating cells of the central nervous system, are
      capable of transporting vast quantities of proteins and of lipids, in particular
      galactosphingolipids, to the myelin sheath. The sheath is continuous with the
      plasma membrane of the oligodendrocyte, but the composition of both membrane
      domains differs substantially. Given its high glycosphingolipid and cholesterol
      content the myelin sheath bears similarity to the lipid composition of the apical
      domain of a polarized cell. The question thus arises whether myelin components,
      like typical apical membrane proteins are transported by an apical-like
      trafficking mechanism to the sheath, involving a 'raft'-mediated mechanism.
      Indeed, the evidence indicates the presence of cognate apical and basolateral
      pathways in oligodendrocytes. However, all major myelin proteins do not
      participate in this pathway, and remarkably apical-like trafficking seems to be
      restricted to the oligodendrocyte cell body. In this review, we summarize the
      evidence on the existence of different trafficking pathways in the
      oligodendrocyte, and discuss possible mechanisms separating the oligodendrocyte's
      membrane domains.

PMID- 11201791
TI  - Role of glycosphingolipid microdomains in CD4-dependent HIV-1 fusion.
AB  - The fusion of HIV-1 with the plasma membrane of CD4+ cells is triggered by the
      interaction of HIV-1 surface envelope glycoprotein gp120 with the CD4 receptor,
      and requires coreceptors (CCR5 and CXCR4). Recent advances in the study of HIV-1
      entry into CD4+ cells suggest that glycosphingolipids (GSL) may also participate
      in the fusion process. GSL are organized in functional microdomains which are
      associated with specific membrane proteins such as CD4. GSL-enriched microdomains
      were purified from human lymphocytes and reconstituted as a monomolecular film at
      the air-water interface of a Langmuir film balance. Surface pressure measurements
      allowed to characterize the sequential interaction of GSL with CD4 and with
      gp120. Using this approach, we identified globotriaosylceramide (Gb3) and
      ganglioside GM3 as the main lymphocyte GSL recognized by gp120. In both cases,
      the interaction was saturable and dramatically increased by CD4. We propose that
      GSL microdomains behave as moving platforms allowing the recruitment of HIV-1
      coreceptors after the initial interaction between the viral particle and CD4.
      According to this model, the GSL microdomain may: i) stabilize the attachment of
      the virus with the cell surface through multiple low affinity interactions
      between the V3 domain of gp120 and the carbohydrate moiety of GSL, and ii) convey
      the virus to an appropriate coreceptor by moving freely in the outer leaflet of
      the plasma membrane. This model can be extrapolated to all envelope viruses (e.g.
      influenza virus) that use cell surface GSL of the host cells as receptors or
      coreceptors.

PMID- 11201790
TI  - Signaling through sphingolipid microdomains of the plasma membrane: the concept
      of signaling platform.
AB  - Transmembrane signaling requires modular interactions between signaling proteins,
      phosphorylation or dephosphorylation of the interacting protein partners and
      temporary elaboration of supramolecular structures, to convey the molecular
      information from the cell surface to the nucleus. Such signaling complexes at the
      plasma membrane are instrumental in translating the extracellular cues into
      intracellular signals for gene activation. In the most straightforward case,
      ligand binding promotes homodimerization of the transmembrane receptor which
      facilitates modular interactions between the receptor's cytoplasmic domains and
      intracellular signaling and adaptor proteins. For example, most growth factor
      receptors contain a cytoplasmic protein tyrosine kinase (PTK) domain and ligand
      mediated receptor dimerization leads to cross phosphorylation of tyrosines in the
      receptor's cytoplasmic domains, an event that initiates the signaling cascade. In
      other signaling pathways where the receptors have no intrinsic kinase activity,
      intracellular nonreceptor PTKs (i.e. Src family PTKs, JAKs) are recruited to the
      cytoplasmic domain of the engaged receptor. Execution of these initial
      phosphorylations and their translation into efficient cellular stimulation
      requires concomitant activation of diverse signaling pathways. Availability of
      stable, preassembled matrices at the plasma membrane would facilitate scaffolding
      of a large array of receptors, coreceptors, tyrosine kinases and other signaling
      and adapter proteins, as it is the case in signaling via the T cell antigen
      receptor. The concept of the signaling platform has gained usage to characterize
      the membrane structure where many different membrane-bound components need to be
      assembled in a coordinated manner to carry out signaling. The structural basis of
      the signaling platform lies in preferential assembly of certain classes of lipids
      into distinct physical and functional compartments within the plasma membrane.
      These membrane microdomains or rafts (Figure 1) serve as privileged sites where
      receptors and proximal signaling molecules optimally interact. In this review, we
      shall discuss first how signaling platforms are assembled and how receptors and
      their signaling machinery could be functionally linked in such structures. The
      second part of our review will deal with selected examples of raft-based
      signaling pathways in T lymphocytes and NK cells to illustrate the ways in which
      rafts may facilitate signaling.

PMID- 11201792
TI  - Co-localization of receptor and transducer proteins in the glycosphingolipid
      enriched, low density, detergent-insoluble membrane fraction of sea urchin sperm.
AB  - The low density, detergent-insoluble membrane fraction (LD-DIM), where
      gangliosides are likely to be highly enriched, was prepared from sperm of two sea
      urchin species, Hemicentrotus pulcherrimus and Strongylocentrotus purpuratus.
      Immunoblotting showed the presence in the LD-DIM of two receptors for egg
      ligands, a glycosylphosphatidylinositol (GPI)-anchored protein, and four proteins
      which may be involved in signal transduction. Co-immunoprecipitation revealed
      that at least three proteins, the speract receptor, the 63kDa GPI-anchored
      protein and the alpha subunit of a heterotrimeric Gs protein, are localized in
      the LD-DIM. This suggests that the LD-DIM fraction may be a membrane microdomain
      for speract-speract receptor interaction, as well as the subsequent signal
      transduction pathway involved in induction of sperm respiration, motility and
      possibly the acrosome reaction.

PMID- 11201793
TI  - Use of a photoactivable GM1 ganglioside analogue to assess lipid distribution in
      caveolae bilayer.
AB  - A new photoactivable, radioactive derivative of ganglioside GM1 has been utilized
      to assess lipid distribution in the caveolae bilayer, taking advantage of the
      ability of the glycolipid, endogenous or exogenously added, to concentrate within
      this membrane compartment and to crosslink neighboring molecules upon
      illumination. After insertion into A431 plasma membrane and photoactivation, a
      membrane-enriched and a detergent-resistant fraction, enriched in gangliosides,
      sphingomyelin and cholesterol, were isolated. While a few radioactive proteins
      were detected in the membrane-enriched fraction, only radioactive caveolin was
      detected in the detergent-resistant fraction, indicating at the same time the
      enrichment of this fraction in caveolae and the presence of ganglioside within
      this compartment. Among lipids, crosslinked phosphatidylcholine, sphingomyelin
      and cholesterol were detected in the membrane-enriched fraction, while only
      crosslinked sphingomyelin was detected in the detergent-resistant fraction. These
      results suggest the enrichment in sphingomyelin - along with ganglioside - within
      the outer leaflet, and the preferential localization of cholesterol within the
      endoplasmic leaflet, of the caveolae bilayer.

PMID- 11201794
TI  - Association of Src-family protein tyrosine kinases with sphingolipids in rat
      cerebellar granule cells differentiated in culture.
AB  - Src family kinases play a relevant role in the development and differentiation of
      neuronal cells. They are abundant in sphingolipid-enriched membrane domains of
      many cell types, and these domains are hypothesized to function in bringing
      together molecules important to signal transduction. We studied the association
      of Src family tyrosine kinases and their negative regulatory kinase, Csk, with
      sphingolipids in sphingolipid-enriched domains of rat cerebellar granule cells
      differentiated in culture. We find that c-Src, Lyn and Csk are enriched in the
      sphingolipid-enriched fraction prepared from these cells. Coimmunoprecipitation
      experiments show that these and sphingolipids are part of the same domain. Cross
      linking experiments with a photoactivable, radioactive GD1b derivative show that
      c-Src and Lyn, which are anchored to the membrane via a myristoyl chain,
      associate directly with GD1b. Csk, which is not inserted in the hydrophobic core
      of the membrane, is not photolabeled by this ganglioside. These results suggest
      that lipid-lipid, lipid-protein, and protein-protein interactions cooperate to
      maintain domain structure. We hypothesize that such interactions might play a
      role in the process of neuronal differentiation.

PMID- 11201795
TI  - Unglycosylated Trk protein does not co-localize nor associate with ganglioside
      GM1 in stable clone of PC12 cells overexpressing Trk (PCtrk cells).
AB  - Our previous studies have shown that acidic glycosphingolipid, ganglioside GM1
      (GM1), is an endogenous regulator of high affinity nerve growth factor receptor,
      Trk, which is an essential factor for the normal development and differentiation
      of neuronal cells by forming a complex with Trk. GM1 is also known to be a major
      constituent of caveola or glycosphingolipid-enriched microdomain (GEM) of the
      plasma membrane. In order to study the effect of the glycosylation of Trk on the
      formation of GM1-Trk complex and subcellular distribution of this protein, we
      generated PC12 cells stably overexpressing Trk (PCtrk). Pretreatment of this
      stable clones with tunicamycin, a potent inhibitor of N-glycosylation, caused the
      appearance of unglycosylated Trk core protein. These unglycosylated Trk can
      hardly respond to its ligand, NGF. Sucrose density gradient analysis revealed
      that unglycosylated Trk core protein was recovered in high density fractions,
      whereas most of GM1 is present in low density fractions corresponding to caveola
      or GEM fractions. Moreover, these unglycosylated Trk proteins lose their ability
      to form a complex with GM1, although GM1 is present in the same high density
      fractions. These data strongly suggest that spatial segregation of GM1 from the
      Trk protein by the inhibition of the glycosylation of Trk might be an important
      molecular mechanism for the unresponsiveness to NGF. Moreover, the binding site
      of GM1 in the Trk protein might act as an important determinant for the normal
      trafficking of the Trk protein within the cells.

PMID- 11201796
TI  - Glycosphingolipid deficiency affects functional microdomain formation in Lewis
      lung carcinoma cells.
AB  - In view of the increasing evidence that gangliosides in membrane microdomains or
      rafts are closely associated with various signal transducing molecules including
      Src family kinases, we compared rafts in two subclones of 3LL mouse lung
      carcinoma cell line, J18 and J5, characterized by high and very low GM3
      ganglioside contents, respectively. Rafts were isolated from cell lysates as low
      density detergent-insoluble microdomains (DIM) by sucrose density gradient
      centrifugation. J5 and J18 cells expressed comparable amounts of Src family
      kinases and the majority of Src kinases in both clones were concentrated in their
      DIMs, suggesting that GM3 is not necessary for DIM localization of Src kinases
      and there is no direct interaction between Src and GM3. However, the Src kinases
      were eliminated from DIMs after depletion of the major neutral GSLs of J5 cells,
      glucosylceramide and lactosylceramide, by an inhibitor of glucosylceramide
      synthase (D-PDMP), indicating that GSLs in general are required for Src kinase
      association to DIM. J5 and the D-PDMP-treated J5 cells had very similar DIM
      protein profiles and moreover cholesterol and sphingomyelin in the GSL-depleted
      cells were enriched in DIM similar to the untreated control cells. Interestingly,
      the levels of tyrosine-phosphorylated DIM proteins and cell proliferation of J5
      cells were much lower than those of J18 cells, suggesting that GM3 might be
      involved in tyrosine phosphorylation of DIM proteins required for cell growth.
      Thus, our data suggest that GSLs are essential for functional raft formation.

PMID- 11201797
TI  - Association between GM3 and CD4-Ick complex in human peripheral blood
      lymphocytes.
AB  - The aim of this study was to further elucidate our previous observation on
      molecular interaction of GM3, CD4 and p56Ick in microdomains of human peripheral
      blood lymphocytes (PBL). We analyzed GM3 distribution by immunoelectron
      microscopy and the association between GM3 and CD4-p56Ick complex by scanning
      confocal microscopy and co-immunoprecipitation experiments. Scanning confocal
      microscopy analysis showed an uneven signal distribution of GM3 molecules over
      the surface of human lymphocytes. Nearly complete colocalization areas indicated
      that CD4 molecules were distributed in GM3-enriched plasma membrane domains. Co
      immunoprecipitation experiments revealed that CD4 and p56Ick were
      immunoprecipitated by IgG anti-GM3, demonstrating that GM3 tightly binds to the
      CD4-p56Ick complex in human PBL. In order to verify whether GM3 association with
      CD4 molecules may depend on the presence of p56Ick, we analyzed this association
      in U937, a CD4 + and p56Ick negative cell line. The immunoprecipitation with anti
      GM3 revealed the presence of a 58kDa band immunostained with anti-CD4 Ab,
      suggesting that the GM3-CD4 interaction does not require its association with
      p56Ick. These findings support the view that GM3 enriched-domains may represent a
      functional multimolecular complex involved in signal transduction and cell
      activation.

PMID- 11201798
TI  - Changes in lipid and protein constituents of rafts and caveolae in multidrug
      resistant cancer cells and their functional consequences.
AB  - The carcinogenic process involves a complex series of genetic and biochemical
      changes that enables transformed cells to proliferate, migrate to secondary sites
      and, in some cases, acquire mechanisms that make cancer cells resistant to
      chemotherapy. This phenomenon in its most common form is known as multidrug
      resistance (MDR). It is usually mediated by overexpression of P-glycoprotein (P
      gp) or other plasma membrane ATPases that export cytotoxic drugs used in
      chemotherapy, thereby reducing their efficacy. However, additional adaptive
      changes are likely to be required in order to confer a full MDR phenotype. Recent
      studies have shown that acquisition of MDR is accompanied by upregulation of
      lipids and proteins that constitute lipid rafts and caveolar membranes, notably
      glucosylceramide and caveolin. These changes may be related to the fact that in
      MDR cells a significant fraction of cellular P-gp is associated with caveolin
      rich membrane domains, they may be involved in drug transport and they could have
      an impact on drug-induced apoptosis and on the phenotypic transformation of MDR
      cancer cells.

PMID- 11201799
TI  - New approaches to the study of sphingolipid enriched membrane domains: the use of
      electron microscopic autoradiography to reveal metabolically tritium labeled
      sphingolipids in cell cultures.
AB  - This paper is the first report on the use of the electron microscopy
      autoradiography technique to detect metabolically tritium labeled sphingolipids
      in intact cells in culture. To label cell sphingolipids, human fibroblasts in
      culture were fed by a 24 hours pulse, repeated 5 times, of 3 x 10(-7) M [1
      (3)H]sphingosine. [1-(3)H]sphingosine was efficently taken up by the cells and
      very rapidly used for the biosynthesis of complex sphingolipids, including
      neutral glycolipids, gangliosides, ceramide and sphingomyelin. The treatment with
      [1-(3)H]sphingosine did not induce any morphological alteration of cell
      structures, and well preserved cells, plasma membranes, and intracellular
      organelles could be observed by microscopy. Ultrathin sections from metabolic
      radiolabeled cells were coated with autoradiographic emulsion. One to four weeks
      of exposition resulted in pictures where the location of radioactive
      sphingolipids was evidenced by the characteristic appearance of silver grains as
      irregular coiled ribbons of metallic silver. Radioactive sphingolipids were found
      at the level of the plasma membranes, on the endoplasmic reticulum and inside of
      cytoplasmic vesicles. Thus, electron microscopy autoradiography is a very useful
      technique to study sphingolipid-enriched membrane domain organization and
      biosynthesis.

PMID- 11201800
TI  - Mitomycin: effects on laryngeal and tracheal stenosis, benefits, and
      complications.
AB  - The management of laryngeal and tracheal stenosis continues to challenge us,
      despite advances in surgical techniques and better understanding of the wound
      healing process. Injury to the airway mucosa is the inciting event, regardless of
      the cause of the stenosis. Mitomycin-C is an antineoplastic antibiotic that acts
      as an alkylating agent by inhibiting DNA and protein synthesis. It can inhibit
      cell division, protein synthesis, and fibroblast proliferation. Topical
      application of mitomycin-C (0.4 mg/mL) was used as an adjuvant treatment in the
      endoscopic laser management of laryngeal and tracheal stenosis in 15 patients.
      Fourteen patients (93%) have shown improvement of their airway and resolution of
      their preoperative symptoms. After a mean follow-up of 18 months, no complication
      was noted with regard to the application of mitomycin-C. This study gives
      promising findings on the efficacy and safety of mitomycin-C as an adjuvant
      treatment in the management of selected cases of laryngeal and tracheal stenosis.

PMID- 11201801
TI  - Irreversible sensorineural hearing loss as a result of azithromycin ototoxicity.
      A case report.

PMID- 11201802
TI  - Acquired total (grade 4) subglottic stenosis in children.
AB  - Pediatric acquired total subglottic stenosis (SGS) is a challenging problem. The
      management of these patients has evolved at our institution over the past 25
      years. We conducted a retrospective study to evaluate the surgical management and
      outcomes of children with grade 4 SGS. Fifty-six patients have presented with
      acquired grade 4 SGS since 1981. The causes included previous surgery (34),
      prolonged intubation (15), bums (1), and unknown causes (6). Of the 56 patients,
      44 (79%) were decannulated; 120 total procedures were performed, and 39 patients
      (70%) required more than 1 procedure for decannulation. The decannulation rate
      has risen from 67% in the 1980s to 86% in the 1990s. Patients who underwent
      cricotracheal resection (CTR) had a higher decannulation rate than patients who
      underwent laryngotracheal reconstruction (LTR) with anterior and posterior costal
      cartilage grafting (CCG) (92% versus 81%), and were less likely to need
      additional open procedures to achieve decannulation (18% versus 46%). The
      decannulation rate for children with grade 4 SGS has improved because of advances
      in surgical technique. Currently, the principal operations used at our
      institution are 1) CTR and 2) LTR with anterior and posterior CCG. There was a
      trend toward a higher decannulation rate in patients who underwent CTR, and they
      were less likely to require further reconstructive surgery before decannulation.

PMID- 11201803
TI  - Effect of in vitro irradiation of donor larynges on cyclosporine requirements and
      rejection rates in rat laryngeal transplantation.
AB  - Total lymphoid irradiation is an acknowledged adjunctive immunosuppressant in
      whole organ transplantation in humans and animals. Local irradiation administered
      for a similar purpose is at best controversial. We evaluated in vitro donor
      larynx irradiation immediately preceding laryngeal transplantation as an
      immunomodulator. Each donor larynx was pretreated with 7.34 Gy of radiation in
      vitro. After transplantation, cyclosporine was administered in doses of 5 mg/kg
      per day, 2.5 mg/kg per day, and 1 mg/kg per day for trial lengths of 15 days and
      30 days. Each of these 6 groups consisted of 10 rats per group. Earlier data have
      shown cyclosporine dosed at 5 mg/kg per day, without irradiation, administered
      for 1 month to have varied efficacy. Established histologic criteria were used to
      determine rejection patterns. All recipient rats survived the 15-day and 30-day
      trials. In all 10 rats receiving 5 mg/kg per day of cyclosporine for 15 days, the
      harvested transplanted larynges were viable without evidence of meaningful
      rejection (mild rejection). In 9 of the 10 rats receiving 5 mg/kg per day of
      cyclosporine for 30 days, the transplanted larynges displayed no meaningful
      rejection (mild rejection). In 9 of the 10 rats receiving 2.5 mg/kg per day of
      cyclosporine for 15 days, the transplanted larynges displayed no meaningful
      rejection (mild rejection). One rat receiving 2.5 mg/kg per day of cyclosporine
      for 15 days had a transplanted larynx that displayed moderate rejection. In all
      10 rats receiving 2.5 mg/kg per day of cyclosporine for 30 days, the transplanted
      larynges displayed no meaningful rejection (mild rejection). At 15 days, 5 rats
      treated with 1 mg/kg per day of cyclosporine displayed mild rejection, 2
      displayed moderate rejection, 2 displayed advanced to moderate rejection, and 1
      displayed severe rejection. At 30 days, 4 rats treated with 1 mg/kg per day of
      cyclosporine displayed moderate rejection, 2 displayed advanced to moderate
      rejection, and 4 displayed severe rejection. We conclude that pretransplantation
      in vitro irradiation of donor larynges has immunomodulatory effects, allowing
      reduced cyclosporine immunosuppression with less rejection.

PMID- 11201805
TI  - Intraoperative assessment of stapes movement.
AB  - A method is described that allows, for the first time, intraoperative vibration
      modes assessment of the acoustically stimulated stapes by means of scanning laser
      Doppler interferometry (LDI). The study was designed to answer the following
      questions: 1) Is LDI practical for taking measurements during surgery? 2) Are the
      results comparable to the findings in temporal bone preparations? and 3) Do the
      vibration characteristics of the stapes change after the posterior incudal
      ligament is detached from the incus? Seven patients with profound bilateral
      hearing loss who were undergoing cochlear implantation were included in the
      study. The measurement system was easily applicable for intraoperative
      measurements and allowed contact-free analysis with very high accuracy. No major
      differences in the results from the live human subjects and temporal bone
      preparations were observed. The stapes movement was predominantly pistonlike at
      the lower frequencies and became complex at higher frequencies. Sacrificing the
      posterior incudal ligament had no statistically significant effect on stapes
      vibration.

PMID- 11201804
TI  - Effect of mitomycin-C on vocal fold healing in a canine model.
AB  - For evaluation of the effect of topical mitomycin-C on vocal fold healing and
      return of function after surgical excision of mucosa, 6 dogs underwent suspension
      microlaryngoscopy with bilateral microflap excision of vocal fold mucosa. Topical
      mitomycin-C, a chemotherapeutic agent and a fibroblast inhibitor, was applied
      randomly to one side, with the contralateral side serving as the control.
      Laryngeal videostroboscopy (LVS) was performed on each animal before the
      operation, at 2 weeks, and before sacrifice at 4 weeks. Both functional analysis
      with LVS and histologic analysis were performed in a blinded fashion to determine
      the effect of mitomycin-C on healing. Histologic analysis was augmented with
      computer morphometrics. The LVS revealed diminished mucosal wave vibration in the
      vocal folds treated with mitomycin-C, as well as a more atrophic appearance to
      the vibratory surface. The vocal folds treated with mitomycin-C showed fewer
      fibroblasts and less collagen within the superficial layer of the lamina propria
      than the control vocal folds (p < .05, Student's t-test, paired analysis).
      Inflammatory infiltrate was not significantly different between the two sides.
      Consistent with the known suppression of fibroblast proliferation by mitomycin-C,
      the treated vocal folds showed less connective tissue response to the surgical
      injury. In contrast to the reported positive effects of mitomycin-C on tracheal
      and glottic stenosis, the observed decrease in the healing response in the
      present study had negative consequences on the vocal fold vibratory pattern.

PMID- 11201806
TI  - Malignant carotid body tumors: report of three cases.
AB  - The aim of the current report was to describe 3 cases of malignant carotid body
      tumor (CBT) and to review the literature. My clinical records of 87 CBTs in 81
      patients (6 bilateral) were reviewed, 79 of which were operated on. Three
      malignant cases were found. The first was in a 40-year-old man who presented with
      pulmonary metastases 6 years after resection of a CBT. He was treated with
      chemotherapy and interferon, but died with disseminated disease 2 years later.
      The second case was in a 56-year-old woman who had a 5-cm, fixed, hard mass in
      the upper aspect of the neck and a paralysis of the left vocal cord. This lesion
      was completely resected, and a shunt and reconstruction with a saphenous vein
      graft were performed. Pathology revealed a malignant chemodectoma with invasion
      to 2 of the 5 lymph nodes removed. Radiotherapy (50 Gy) was given after the
      operation. She is well and free of disease 68 months after the resection. The
      third case was in a 61-year-old woman who presented with an 8-cm nontender, hard,
      immobile mass in the left upper neck that displaced the left wall of the
      oropharynx toward the midline. A carotid arteriogram showed a CBT. On computed
      tomography, the tumor extended to the infratemporal fossa with no bone
      involvement. The lesion was embolized with a 40% reduction in vascularity. At
      surgical exploration, the tumor involved the sternocleidomastoid muscle and the
      lymph nodes at levels II and III, and the internal carotid artery could not be
      dissected free at the skull base, so only a partial resection was performed. This
      patient was lost to follow-up. These 3 cases are in agreement with the
      literature. Locoregional control is usually obtained with complete primary tumor
      resection and lymphadenectomy and eventual radiotherapy. Surgery with
      radiotherapy seems to be effective for isolated metastases. Current
      multidisciplinary treatments have been unsuccessful in controlling disseminated
      disease.

PMID- 11201807
TI  - Further experience with tracheojejunal shunt speech after
      pharyngolaryngoesophagectomy.
AB  - Over the past 10 years, 16 patients have undergone the tracheojejunal shunt
      operation for voice reconstruction after undergoing pharyngolaryngoesophagectomy
      with free jejunum reconstruction for advanced hypopharyngeal cancer. For the
      purpose of voice reconstruction, a 2-cm inferiorly based tracheal flap is
      obtained from the membranous part of the trachea by removing 4 cartilaginous
      tracheal rings. After the establishment of digestive continuity with the jejunal
      graft, a side-to-side anastomosis is created by approximating the incised margin
      of the jejunal mucosa to that of the tracheal flap. The tracheal flap is tubed to
      construct the tracheojejunal shunt. In addition, the incised margin of the
      jejunal serosa is sutured to the lateral wall of the shunt to reinforce the
      approximation of the shunt to the jejunal graft. Thirteen of the 16 patients
      (81%) were initially capable of voice production. The length of time during which
      tracheojejunal speech has been used ranges from 18 to 122 months, with a mean of
      55 months. During follow-up, 12 of the 13 patients (92%) have been able to
      swallow without aspiration.

PMID- 11201808
TI  - Performance characteristics of fluorescence endoscope in detection of head and
      neck cancers.
AB  - Laser-induced fluorescence endoscopy (LIFE) is a noninvasive method for detecting
      early cancers in hollow organs. A laser-induced fluorescence endoscope that was
      designed for lung imaging was investigated for its effectiveness in comparison to
      white light endoscopy (WLE) in localizing head and neck cancers. A total of 196
      images from 98 sites in 56 patients were graded into 5 levels from normal to
      definitely abnormal. A cutoff level to differentiate normal from abnormal images
      was chosen from a receiver operating characteristic curve. On this basis, LIFE
      (sensitivity, 92.86%; specificity, 78.57%) was observed to be more effective and
      reliable than WLE (sensitivity, 67.86%; specificity, 70%) in locating neoplastic
      foci and precancerous lesions. Nevertheless, WLE was helpful in presenting
      anatomic details. The reliability of LIFE varied from site to site. It excelled
      in examination of the oropharynx (sensitivity, 100%; specificity, 96.20%), but
      was less effective for lesions of the nasopharynx (sensitivity, 66.70%;
      specificity, 75.00%). In standardizing the test, interobserver variation was
      assessed, and good agreement in image interpretation was confirmed by statistical
      analysis. In conclusion, LIFE was found to be an effective and reliable tool for
      detecting head and neck cancers.

PMID- 11201809
TI  - Globosal basal cells are identified as proliferating cells in mouse olfactory
      epithelium.
AB  - Although anti-bromodeoxyuridine (BrdU) antibodies are used for detecting
      proliferating cells, they may stain proliferating cells in phases following the S
      phase, except for G1. Anti-Ki67 antibodies are widely used for detecting
      proliferating cells in all phases of the cell cycle (G1-, S-, G2-, and M-phase),
      but not in resting cells (G0-phase). Anti-cyclin D1 antibodies are used to detect
      proliferating cells in the G1-phase. The present study investigated the olfactory
      epithelium of mice by double immunostaining using antibodies to BrdU, Ki67.
      cyclin D1, and cytokeratin 14 (CK14). The cells positive to the anti-BrdU
      antibody, the anti-Ki67 antibody, and the anti-cyclin D1 antibody differed from
      the cells positive to the anti-CK14 antibody. Thus, we confirmed that the
      proliferating cells in all the phases of the cell cycle, including the G1-phase,
      were globosal basal cells, which were the precursors of the olfactory cells.

PMID- 11201810
TI  - Effects of transglottal pressure on fundamental frequency of phonation: study
      with a rubber model.
AB  - The fundamental frequency of phonation (F0) change per unit change in
      transglottal pressure (dF/dP) was studied at different extension lengths and
      masses of the vibrating part of a rubber model. The dF/dP was decreased when the
      vibrating part was extended, and also when the mass of the vibrating part was
      increased. In the former, the F0 was increased, and in the latter, the F0 was
      decreased. In humans, we have noticed that when the F0 was increased, the dF/dP
      first decreased and then increased, taking a V-shaped curve as a function of the
      F0. The present study reveals the mechanism underlying the V-shaped curve
      observed in humans.

PMID- 11201811
TI  - Endobronchial tumors in children: an uncommon clinical entity.
AB  - We performed a retrospective chart review of 10 children in whom endobronchial
      tumors were diagnosed in a tertiary-care children's medical center from 1988 to
      1998. Of the 10 patients, 6 were male and 4 were female (8 white, 1 Hispanic, 1
      African American). The mean age at presentation was 5.2 years. Eight tumors were
      benign, and 2 were malignant; 4 were on the right side, 3 were on the left side,
      and 3 were bilateral. Histologic findings included 3 bronchial papillomas, 3
      inflammatory masses, 1 endobronchial hemangioma, 1 leiomyoma, 1 mucoepidermoid
      carcinoma, and 1 bronchial carcinoid. Endobronchial tumors in children are a rare
      disorder. The diagnosis requires a high index of suspicion in children with
      atypical or chronic respiratory complaints. Newer adjuvant medical therapies and
      surgical innovations offer improved disease control in these patients, and a
      multidisciplinary approach is often warranted.

PMID- 11201812
TI  - Local recurrences following transoral laser surgery for early glottic carcinoma:
      frequency, management, and outcome.
AB  - Although transoral laser surgery (TLS) for the treatment of early stage glottic
      carcinoma is now widely used, the patterns of local recurrences, related re
      treatment methods, and results have not been documented comprehensively. Two
      hundred fifty-two patients with glottic carcinoma stage I or II were treated for
      cure with TLS alone and followed up for 24 to 139 months (mean, 62 months). Their
      charts were retrospectively reviewed to identify local recurrence patterns.
      Thirty-five patients (13.9%) presented with local recurrences or second laryngeal
      primaries 4 to 84 months (mean, 23 months) after initial treatment. Of the 161
      patients classified T1N0M0, 21 (13.0%) suffered local recurrences, and in the 91
      classified T2N0M0, 14 (15.4%) tumors recurred. If tumors recurring more than 60
      months after initial treatment are considered second primary tumors rather than
      recurrences, then only 18 (11.2%) of 161 patients classified T1N0M0 would have
      had a recurrence. However, the difference in local control between patients with
      stage I versus stage II disease would still not be significant (p = .41). Of the
      35 patients with local recurrences, 16 (45%) were managed with total
      laryngectomy, 10 (28.6%) with further TLS, 4 (11.4%) with partial laryngectomy,
      and 2 (5.7%) with radiotherapy, and 3 (8.6%) had no curative treatment.
      Accordingly, 16 patients (45.7%) with local treatment failure could be treated
      with further organ-sparing treatment methods. The actuarial overall survival,
      disease-specific survival, and organ preservation rates 5 years after the
      diagnosis of recurrent disease were 43.6%, 74.6%, and 33.7%. Transoral laser
      surgery leads to local control rates that are comparable to those found after
      radiotherapy for lesions classified T1 and leads to slightly better control rates
      for lesions classified T2, but the results are inferior to those achieved with
      conventional partial laryngectomy. However, if local recurrence occurs, then more
      re-treatment options are available after TLS as compared to initial radiotherapy
      or open surgery.

PMID- 11201813
TI  - Congenital nasal pyriform aperture stenosis: diagnosis and management of 20
      cases.
AB  - The objective of this study was to review the characteristics of congenital nasal
      pyriform aperture stenosis (CNPAS) in a series of 20 children seen between 1993
      and 1996. The diagnosis was made by physical examination and computed tomography
      scan. A single central maxillary incisor was detected in 12 cases (60%). Three
      children had morphological abnormalities of the pituitary gland shown on magnetic
      resonance imaging. One child had an antidiuretic hormone deficiency, and another
      child had a growth hormone deficiency. Two children had craniosynostoses, 1 of
      which was Apert's syndrome. All patients underwent operation by a sublabial
      approach, and 1 was referred for a columellar necrosis after nasal stenting.
      After surgery, all patients showed improvement, and the nasal stenting was
      usually removed 1 week after surgery. Follow-up revealed normal breathing. In
      conclusion, CNPAS was previously considered to be an unusual cause of nasal
      obstruction in neonates and infants. The number of cases treated recently in our
      department suggests that this newly recognized entity is more common than
      expected.

PMID- 11201814
TI  - Immunohistochemical analysis of small cell carcinoma of the head and neck: a
      report of four patients and a review of sixteen patients in the literature with
      ectopic hormone production.
AB  - Small cell carcinoma (SCC) occurs mostly in the lung, and in some patients is
      accompanied by production of ectopic hormones. Small cell carcinoma of the head
      and neck is very rare. We report 4 patients with SCC of the head and neck
      (larynx, tonsil, maxillary sinus, and parotid gland). The patient with SCC of the
      maxillary sinus demonstrated a high level of plasma serotonin and overexpression
      of parathyroid hormone; however, he did not show any related symptoms. The
      patient with SCC of the tonsil showed the syndrome of inappropriate secretion of
      antidiuretic hormone associated with antidiuretic hormone hyperproduction at the
      terminal stage. In the literature, 16 patients with SCC of the head and neck with
      ectopic hormone production have been reported. Antidiuretic hormone and
      adrenocorticotropic hormone were the hormones that caused clinical symptoms
      (paraneoplastic syndromes). We believe that the evaluation of hormonal syndromes
      is valuable for diagnosis and treatment.

PMID- 11201815
TI  - Nitric oxide mediates platelet activating factor-induced microvascular leakage in
      rat airways.
AB  - Platelet activating factor (PAF), a highly potent chemical mediator in
      inflammation and allergic reactions, induces microvascular leakage in several
      tissues. In rat airways, PAF-induced microvascular leakage is probably mediated
      by an endothelial cell receptor in the microvessels. Nitric oxide (NO), first
      identified as endothelium-derived relaxing factor, has been suggested to be a
      mediator of airway microvascular leakage. However, the role of NO in PAF-induced
      microvascular leakage in the airways has not yet been established. The aim of
      this study was to investigate the role of NO in PAF-induced microvascular leakage
      in rat nasal mucosa and trachea. We injected PAF (1 microg/kg) intravenously, and
      the amount of PAF-induced microvascular leakage was measured with extravasation
      of Evans blue dye (30 mg/kg, injected intravenously 5 minutes before the
      injection of PAF) by means of spectrophotometry and fluorescence microscopy. Five
      Sprague-Dawley rats were pretreated with NG-nitro-L-arginine methyl ester (L
      NAME; 10 mg/kg, intravenously injected 1 hour before the injection of PAF) to
      inhibit NO synthase, and control rats (n = 4) were pretreated with normal saline
      solution. The average amount of extravasated Evans blue dye was significantly
      lower in the L-NAME-pretreated rats than in the control rats (t-test, p < .01).
      Tissue sections of the L-NAME-pretreated rats clearly showed a decreased
      extravasation of Evans blue dye on fluorescence microscopy. In conclusion,
      pretreatment with L-NAME clearly inhibited PAF-induced microvascular leakage in
      the nasal mucosa and trachea of rats. This finding implies that PAF may activate
      the constitutive endothelial NO synthase in the microvessels, and that activated
      endogenous NO may mediate PAF-induced microvascular leakage in rat airways.

PMID- 11201816
TI  - Microbiology of serous otitis media in children: correlation with age and length
      of effusion.
AB  - The purpose of this study was to correlate the microbiology of serous otitis
      media in children with the duration of the condition and the patient's age.
      Aspirates of serous ear fluids from 114 children were examined for aerobic and
      anaerobic bacteria. Bacterial growth was noted in 47 patients (41%). Aerobic
      organisms only were recovered in 27 aspirates (57% of the culture-positive
      aspirates); anaerobic bacteria only in 7 (15%); and mixed aerobic and anaerobic
      bacteria in 13 (28%). A total of 83 bacterial isolates were recovered, accounting
      for 1.8 isolates per specimen (1.2 aerobes and 0.6 anaerobe). There were a total
      of 57 aerobic isolates, including Haemophilus influenzae (15 isolates),
      Streptococcus pneumoniae (13), and Staphylococcus sp (12). Twenty-six anaerobes
      were recovered, including anaerobic gram-positive cocci (10), Prevotella spp (8),
      and Propionibacterium acnes (4). The rate of positive cultures (20 of 36; 56%)
      was higher in patients younger than 2 years of age than in those older than 2
      years of age (27 of 78; 35%). Streptococcus pneumoniae and H influenzae were more
      often isolated in children younger than 2 years of age and those with effusion
      for 3 to 5 months, whereas anaerobes were recovered more often in those older
      than 2 years of age and those with effusion for 6 to 13 months. These data
      illustrate the effects of the length of effusion and age on the recovery of
      aerobic and anaerobic bacteria in serous otitis media.

PMID- 11201817
TI  - Volumetric and dimensional analysis of the guinea pig inner ear.
AB  - The objective of this study was to provide accurate volumetric data on the fluid
      spaces and soft tissue in the guinea pig inner ear by measuring all histologic
      serial sections by means of Metamorph Imaging Software at 400x to 1,000x
      magnification. The total endolymph volume of the inner ear was 4.691 mm3, of
      which 1.501 mm3 was in the cochlea, 3.090 mm3 in the vestibular labyrinth, and
      0.100 mm3 in the endolymphatic duct and sac. The total perilymph volume was
      15.938 mm3, of which 8.867 mm3 was in the cochlea and 7.071 mm3 in the vestibular
      labyrinth. The volume of the organ of Corti per millimeter length increased
      toward the apex, but the volumes of the stria vascularis, spiral ligament, and
      spiral limbus decreased. The volume of the macula utriculi was larger than that
      of the macula sacculi. The measurement of the luminal surface area of the stria
      vascularis was 3.944 mm2, and that of the vestibular dark cells was 5.772 mm2.

PMID- 11201818
TI  - Ectopic growth hormone-secreting pituitary adenoma in the sphenoid sinus.

PMID- 11201819
TI  - [Ischemic heart disease and metabolic syndrome X (family study)].
AB  - AIM: To evaluate prevalence of metabolic syndrome "X" (MS) components in the
      families of probands and their wives regarding the presence of hyperinsulinemia
      and in probands' children of both sexes regarding their having vegetovascular
      dystonia. MATERIAL AND METHODS: 92 families were selected by the proband who
      survived acute myocardial infarction (MI) at the age under 50: 92 probands (mean
      age 47 +/- 1.1 years), 57 probands' wives (mean age 47 +/- 0.7 years), 20 sons
      (mean age 18.3 +/- 0.8 years), 24 daughters (mean age 19.1 +/- 1.0 years). Two
      groups were formed: group 1 of 48 probands and 25 wives (the presence of
      hyperinsulinemia in the proband); group 2 of 44 probands and 32 their wives
      (controls with normal insulin levels). Anthropometric, arterial pressure and
      lipid-hormonal measurements were made by standard techniques. Nutrition was
      studied by random reproduction of 24-h diet. RESULTS: More factors of risk to
      develop atherosclerosis and MS"X" components in probands and their wives were
      found in group 1. More frequent in the parents were the following MS components:
      hypoalphacholesterolemia, overweight, arterial hypertension, hyperapolipoprotein
      B-emia. Vegetovascular asthenia in the probands' children predisposed to
      cardiovascular diseases is closely linked with the presence of
      hypoalphacholesterolemia, hypertriglyceridemia, overweight and arterial
      hypertension. CONCLUSION: MS "X" for probands and their wives is a "malignant"
      risk factor for cardiovascular diseases; in the presence of IHD in father,
      vegetovascular asthenia in children is a risk factor of cardiovascular disease.

PMID- 11201820
TI  - [Dynamics of changes in levels of insulin, glucagon, and C-peptide during glucose
      tolerance test in patients with coronary atherosclerosis].
AB  - AIM: To study velocity characteristics of changes in the levels of insulin,
      glucagon and C-peptide in the course of the intravenous glucose tolerance test
      (IGTT). MATERIAL AND METHODS: Glucose, insulin, glucagon and peptide levels were
      measured in the course of IGTT performed in 50 patients with coronary
      atherosclerosis (CA) who survived transmural myocardial infarction, 32
      individuals with hereditary predisposition to CA and 30 controls free of
      cardiovascular or endocrine pathology. The results were approximated using high
      degree polynomes allowing calculation of the first and second derivatives (the
      velocity and rate of its change). RESULTS: CA patients showed inhibited changes
      of blood glucose, immunoreactive insulin. The reduction of the latter lasted
      longer than that in the control group. CONCLUSION: Under urgent mobilization of
      blood glucose regulation system, CA patients develop retention of immunoreactive
      insulin.

PMID- 11201821
TI  - [Myocardial infarction in patients with non-insulin-dependent diabetes mellitus
      and dependence of the quality of life on the individual psychological type].
AB  - AIM: To examine clinical features, complications, short- and long-term outcomes
      of myocardial infarction (MI) as well as quality of life (QL) in patients with
      non-insulin-dependent diabetes mellitus (NIDDM), to analyze relations between the
      above parameters and psychologic personal traits of the patients. MATERIAL AND
      METHODS: The study entered 240 NIDDM patients with MI (the test group) and 260
      control nondiabetic MI patients. The examination was made using standard
      techniques and AMPI. RESULTS: An anginal variant of initial MI in NIDDM patients
      was registered significantly less frequently than in the controls (76.7 vs
      88.2%). The asthmatic variant occurred in 16.3 and 4.6% of the cases,
      respectively. In MI, NIDDM patients developed preinfarction and postinfarction
      angina pectoris less often than control patients (20 and 12.1% vs 71.9 and 25.7%,
      respectively). Mean psychological profile was high by AMPI scales 1, 2 and 6 in
      NIDDM patients, by scales 1, 3 and 8 in control patients. CONCLUSION: Pain
      syndrome in anginal initial MI in NIDDM patients is less pronounced and becomes
      weaker with growing duration of diabetes. Concomitant diabetes mellitus has an
      insignificant influence on deterioration of quality of life in the postinfarction
      period.

PMID- 11201822
TI  - [Thrombolytic therapy of myocardial infarction in a patient with the transplanted
      heart (case report)].

PMID- 11201823
TI  - [Long-term study of the prevalence of arterial hypertension and outcomes of
      multifactorial prophylaxis in organized groups of employees].
AB  - AIM: To evaluate trends in arterial hypertension (AH) and other risk factors and
      their changes after active prevention program. MATERIAL AND METHODS: 1382 male
      and 1555 female volunteers were included into the group of active prevention at
      the workplace vs 1024 male and 776 female controls. 5-year follow-up covered 543
      males and 569 females from the prevention group against 97 male and 119 female
      controls. 10-year follow-up covered 82 males and 191 females, 178 males and 118
      females, respectively. RESULTS: Risk factor correction produced a significant
      decrease in both systolic and diastolic BP levels, prevalence of ECG
      deteriorations, smoking habits occurrence, overweight. Overall mortality rate,
      CHD and stroke mortality were significantly less frequent in the prevention
      group. This group had also less days of temporary disability. CONCLUSION: The
      primary and secondary "in office" prevention for 5 to 10 years diminishes
      prevalence of risk factors. The temporary disability rate depends on the presence
      of arterial hypertension. The latter together with the other main risk facts
      significantly influences cardiovascular and general mortality rates.

PMID- 11201825
TI  - [Complete atrioventricular block without syncopal conditions. Implantation of the
      pacemaker or observation? (case report)].

PMID- 11201824
TI  - [Effects of manual therapy on pain reflex syndromes and various hemocoagulation
      parameters in patients with ischemic heart disease after surgical treatment].
AB  - AIM: To evaluate effects of manual therapy on clinical manifestations,
      hemocoagulation in CHD patients early after surgery. MATERIAL AND METHODS:
      Microcirculation, blood rheology, platelet count and aggregation by Born, plasma
      recalcification time according to Bergergof and Roka, plasma tolerance to heparin
      according to Gormsen, fibrinogen content by Bidwell in Andreenko's modification,
      the condition of vertebromotor segments were assessed in 68 CHD patients early
      after coronary artery bypass surgery (CABS). RESULTS: The addition of manual
      therapy to the complex of early rehabilitation measures in coronary patients
      early after CABS eliminates postoperative anginal attacks in 70% cases,
      reestablishes balance of cellular and plasma components of hemostasis, enhances
      fibrinolytic activity. CONCLUSION: The addition of manual therapy in the
      rehabilitation complex is recommended early after CABS.

PMID- 11201826
TI  - [Hydrogen peroxide--a marker for respiratory tract inflammation in patients with
      bronchial asthma].
AB  - AIM: To test H2O2 as a marker of respiratory tract inflammation in patients with
      bronchial asthma (BA). MATERIAL AND METHODS: The study entered 70 patients (20
      males and 50 females) with atopic asthma (AA) aged 18 to 62 years (mean age 32.6
      years). H2O2 concentration in the expired air (CEA) was determined
      spectrophotometrically (Gallati & Pracht, 1985), content of eosinophilic cationic
      protein (ECP) in blood--with radioimmunoassay kits (Pharmacia & Upjohn, Sweden).
      Forced expiratory volume per 1 second (FEV1) was used for assessment of severity
      of bronchial obstruction. Bronchial hyperreactivity was studied by means of the
      histamine bronchoprovocative test. RESULTS: H2O2 in CEA in BA patients was higher
      than in healthy subjects (0.127 +/- 0.010 microm/l vs 0.024 +/- 0.004 microm/l).
      H2O2 concentration significantly correlates with FEV1 (r = -0.449; p < 0.001),
      bronchial hyperreactivity to histamine (rs = -0.382; p < 0.05) and ECP in blood
      plasma(r = 0.625; p < 0.01). CONCLUSION: It was proved possible to use H2O2 in
      CEA for evaluation of respiratory inflammation in BA patients.

PMID- 11201827
TI  - [Immune status of patients with chronic bronchitis and neurocirculatory
      asthenia].
AB  - AIM: To study changes in immune system of patients with various forms of chronic
      bronchitis (CB) and neurocirculatory asthenia (NCA). MATERIAL AND METHODS:
      Neurological and immunological examinations were made in 84 patients with CB
      exacerbation and 51 control subjects. RESULTS: It was found that 60% of CB
      patients had NCA. No negative effects of NCA on immune system in CB patients were
      registered. Suppression of immune system and secondary immunodeficiency occurred
      more frequently in CB patients without signs of NCA. 40% of CB patients had
      vagotonic NCA in which immunological disorders manifested most clearly.
      CONCLUSION: Vegetative disorders in CB patients do not affect immunological
      system. Functional testing of autonomic nervous system is suggested for
      prediction of immune system condition.

PMID- 11201828
TI  - [Acid-base balance parameters of the synovial fluid in patients with early-stage
      rheumatoid arthritis].
AB  - AIM: To study changes in acid-base balance (ABB) of synovial fluid (SF) in
      rheumatoid arthritis (RA) patients in respect of the disease duration, clinical
      symptoms and treatment. MATERIAL AND METHODS: The examination of verified RA
      patients included clinical, x-ray, immunological and special tests. The patients
      received nonsteroid antiinflammatory drugs, 2 weeks later--physiotherapy followed
      by 10-day basic treatment (tauredon, methotrexate or cyclophosphamide). RESULTS:
      Before the treatment, SF acidotic shift was found in all the patients. The shift
      correlated with activity of the inflammation, serologic affiliation to the
      rheumatoid factor, presence of systemic manifestations, x-ray signs of the
      articular changes in response to the treatment. Attenuation of the inflammatory
      process accompanies an increase in SF acidotic shift. In administration of
      methotrexate SF pH was higher than in the use of other drugs. CONCLUSION:
      Adjuvant ABB correctors are recommended for RA patients.

PMID- 11201829
TI  - [Quality of life in rheumatoid arthritis patients].
AB  - AIM: To study quality of life (QL) in patients with rheumatoid arthritis (RA).
      MATERIAL AND METHODS: Questionnaire survey (MCA, BIPQ, AIMS, MHAQ) covered 190 RA
      patients (mean age 47.7 +/- 1.4 years). Many of them were group II invalids. All
      the patients had slow-progressive polyarthritis, articular and seronegative RA
      prevailed. Most of the patients had articular and seronegative RA with first
      degree activity, x-ray stage II and third-degree deficiency of the articular
      function. RESULTS: It is shown that RA patients have subnormal quality of life.
      Its deterioration was related to clinical parameters: duration of the disease and
      its activity, invalidity, X-ray stage, articular and locomotor functions,
      psychological status. Hypochondriac, apathical and neurastenic reactions to the
      disease occurred most frequently. Euphoric reaction to the disease was a positive
      factor for QL. Changes in social status were essential for QL in RA patients.
      CONCLUSION: QL is an integral indicator of health status in RA patients. It can
      be estimated basing on only one questionnaire--AIMS as it includes all the
      necessary components.

PMID- 11201830
TI  - [Anxiety disorders as psychological personality characteristics in patients with
      rheumatoid arthritis].
AB  - AIM: To study types of anxious disorders (AD) in patients with rheumatoid
      arthritis (RA) and AD correlations with clinicolaboratory indices. MATERIAL AND
      METHODS: 80 RA patients and 38 healthy subjects have undergone MMPI test.
      RESULTS: 95% of the examinees were found to have AD which seem to form in active
      participation of psychoemotional factors. Development of AD was characterised by
      internal strain, emotional stress, anxiodepressive conditions. Psychological
      profiles of AD patients were analysed. No correlations were found with
      clinicolaboratory indices: Additional correlations exist between the MMPI scales
      in AD. CONCLUSION: AD in RA patients may result in vegetative dysfunctions.

PMID- 11201832
TI  - [Antithrombogenic activity of the vascular wall, hemostasis, and rheological
      characteristics of blood in patients with unstable angina pectoris and various
      types of hyperlipoproteinemia].
AB  - AIM: To examine antithrombogenic activity of the vascular wall, some hemostatic
      and rheological properties of blood in patients with unstable angina (UA) and
      various types of hyperlipoproteinemia (HLP). MATERIAL AND METHODS: 102 UA
      patients were divided into groups by HLP types according to D. S. Frideriksen.
      Antithrombogenic properties of blood vessel wall were examined with the cuff
      test, blood rheology--with AKP-2 analyser, hemostasis and lipid metabolism--with
      standard test. RESULTS: UA patients with HLP have low antithrombogenic activity
      of vascular wall. The most noticeable shifts to hypercoagulation were found in
      patients with HLP types 2a and 2b. Blood rheology was abnormal (high red cell
      aggregation in low deformability) in patients with HLP types 2a, 2b and 4.
      CONCLUSION: Patients with UA demonstrate relationships between antithrombogenic
      activity of vascular wall, intensity of lipid metabolism, hemostasis and blood
      rheology.

PMID- 11201831
TI  - [Characteristics of cardiac and nervous system impairment in patients with
      systemic lupus erythematosus from regions with various levels of environmental
      pollution].
AB  - AIM: To characterize clinical features of systemic lupus erythematosus (SLE) in
      persons living under various environmental pollution. MATERIAL AND METHOD: Three
      groups of SLE patients living in the Orenburg region were examined: those exposed
      to intensive production pollution (n = 35 patients), exposed to mild pollution (n
      = 15), unexposed to production pollution (n = 25 patients). The pollution
      intensity was assessed by total aerogenic, water and soil pollution rates.
      RESULTS: The hair from 69 patients contained 24 chemical elements. More severe
      clinical symptoms of SLE were registered in patients living in conditions of
      intensive production pollution. These symptoms' severity directly correlated with
      the level of heavy metals in the hair of SLE patients and inversely correlated
      with hair levels of essential chemical elements. CONCLUSION: Chemical pollutants
      directly impair organs and tissues of SLE patients and indirectly do this via
      damaged immune system.

PMID- 11201833
TI  - [Angiotensin converting enzyme-angiotensin II system, atherosclerosis, and
      angiotensin-converting enzyme inhibitors].

PMID- 11201834
TI  - [Outpatient bioresonance treatment of gonarthrosis].
AB  - AIM: Comparative effectiveness of gonarthrosis treatment with standard methods
      alone and in combination with bioresonance. MATERIAL AND METHODS: The trial
      entered 75 patients with verified osteoarthrosis of the knee joints (stage I-III
      by Y. Kellgren). They were divided into two groups. 40 patients of group I
      received standard combined therapy with nonsteroid antiinflammatory drugs,
      reducers of trophic processes, physiotherapy. 35 patients of group 2 received the
      above standard therapy plus bioresonance treatment (BRT). The treatment course in
      both the groups took 5-6 weeks. There were no statistical differences between the
      groups in age, sex, duration and severity of the disease. The response was
      assessed by changes in clinical and laboratory, arthrological and
      arthrosonographic parameters before the treatment and 3, 5-6 weeks, 12 months
      after it. RESULTS: The response to treatment was significantly higher in group II
      (57.5 against 94%). Symptoms of synovitis and tendenitis relieved more also in
      group 2 (32.5 against 75%). Group 2 patients retained mild pain at rest for a
      year, while in group I pains intensified by month 6 after the treatment.
      CONCLUSION: The addition of BRT to standard therapy of gonarthrosis potentiates
      anesthetic, antiinflammatory and antiexudative effects; prolongs therapeutic
      action. BRT was well tolerated. Side effects were absent.

PMID- 11201836
TI  - [Filgrastim therapy in acute nonlymphoblastic leukemia].
AB  - AIM: To specify effects of the granulocytic colony-stimulating factor (G-CSF) in
      the treatment of acute nonlymphoblastic leukemia. MATERIAL AND METHODS: Thirteen
      patients with acute myeloid leukemia (AML) were treated in the Hematological
      Clinic of the Higher Medical Institute in Plovdiv in 1996-1998. All of them
      received a standard induction therapy with cytosin arabinoside + daunorubicin (7
      + 3 days). During the first neutropenic phase (neutrophils < 0.5 x 10(9)/l) G-CSF
      filgrastim was applied (5 microg/kg/day, s.c.) until a recovery of the neutrophil
      count reached > 1.0 x 10(9)/l and was maintained for 3 successive days. The
      control group consisting of patients matched by age, gender, an AML
      cytomorphologic variant was given the same therapy but filgrastim. RESULTS: The
      study group showed quicker recovery of the neutrophil count (12.6 vs 16.8 days),
      reduced febrile period (9.8 vs 12.4 days) and shorter duration of parenteral
      antibiotic treatment (9.8 vs 12.4 days) compared to controls. No statistically
      significant difference between both groups was found in the duration of the
      antimycotic treatment (p > 0.05). No cytological signs of aggravation of basic
      disease were absent in patients who received filgrastim. CONCLUSION:
      Administration of G-CSF in AML is useful as it promotes rapid overcoming of
      neutropenia and its complications.

PMID- 11201835
TI  - [Immunogenetic markers in hemoblastosis].
AB  - AIM: To establish for hemoblastoses general and individual associations between
      HLA genes and predisposition or resistance to malignant transformation of
      hemopoiesis. MATERIAL AND METHODS: Antigens of class I and class II genes were
      determined by microlymphocytotoxic test and DNA typing (PCR-SSP) in 30 patients
      with acute myeloblastic leukemia (AML), 47 patients with acute lymphoblastic
      leukemia (ALL), 52 patients with chronic myeloblastic leukemia (CML), 58 patients
      with lymphogranulomatosis (LGM) and 224 donors. RESULTS: HLA specificities were
      elucidated frequency of which was high in all the above nosological entities: Cw7
      (RR 2.5 to 5.22), DRB1*11 (RR 2.3 to 4.88). Frequency of antigen B5 was high in
      three diseases (RR 2.14-2.6). A number of specificities have distribution
      deviations typical for only one or two diseases (A19--AML and CML, B27--ALL,
      DRB1*08--AML). The HLA-gene was detected the frequency of which was low in three
      diseases--DRB1*07 (RR 0.39 to 0.11). Individual preventive HLA genes for AML,
      ALL, LGM were A2, B8; A1, B8, B40; DRB1*01, respectively. CONCLUSION: Cw7,
      DRB1*11, B5 are HLA-specificities marking hemopoiesis predisposition to malignant
      transformation in general. Development into a certain nosological entity depends
      on combination of general HLA-genes with markers of individual hemoblastosis.
      DRB1*07 is a general preventive gene. Preventive HLA genes can be also individual
      for the above hematological diseases.

PMID- 11201837
TI  - [Cardiac pathology in idiopathic hypereosinophilic syndrome].

PMID- 11201839
TI  - [Atopy and atopic and pseudoatopic diseases. II. The role of constitution type].

PMID- 11201838
TI  - [Effect of enalapril on clinical and metabolic characteristics in patients with
      non-insulin-dependent diabetes and arterial hypertension].

PMID- 11201841
TI  - [Results of the multicenter controlled study of the hypolipidemic drug
      polycosanol in Russia].
AB  - AIM: To compare efficacy and tolerance of polycosanol vs besafibrate in patients
      with hypercholesterolemia (HCE). MATERIAL AND METHODS: A multicenter controlled
      double blind randomised trial entered 113 patients with HCE. After 5 weeks of
      diet the patients were randomised into two groups. 59 patients of group 1
      received polycosanol (10 mg/day), 54 patients of group 2 were given besafibrate
      (400 mg/day) for 8 weeks. RESULTS: The 8-week course of treatment was completed
      by 103 patients (91%): 57(97%) patients of group 1 and 46(85%) patients of group
      2. In group 1 total cholesterol diminished by an average of 15%, LDLP cholesterol
      fell by 18%, triglycerides by 15%, while in group 2 a respective decrease was 8,
      11 and 6%. Side effects in group 1 were mild. CONCLUSION: A hypolipidemic effect
      of polycosanol in a daily dose 10 mg is superior to that of besafibrate in a
      daily dose 400 mg.

PMID- 11201840
TI  - [Prospects for pharmacological effects on renin-angiotensin and sympathetic
      nervous systems in patients with arterial hypertension].

PMID- 11201842
TI  - [Informed consent of the patient to examination and treatment (a foreign
      literature review)].

PMID- 11201843
TI  - [Carotid sinus syndrome and vasovagal syncope].

PMID- 11201844
TI  - [The role of beta2-agonists in treatment of severe acute asthma].

PMID- 11201845
TI  - Another thyroid emergency.

PMID- 11201846
TI  - Thyroid hormone regulation of apoptosis induced by retinoic acid in
      promyeloleukemic HL-60 cells: studies with retinoic acid receptor-specific and
      retinoid x receptor-specific ligands.
AB  - 3,5,3'-Triiodo-L-thyronine (T3) potentiates apoptosis during the all-trans
      retinoic acid-induced differentiation of promyeloleukemic HL-60 cells. We
      examined whether the retinoid receptor-specific thyroid hormone action is present
      during differentiation of HL-60 cells in this study. We used two distinct
      retinoid receptor agonists. T3 potentiates G1 arrest induced by Am80, a retinoic
      acid receptor (RAR)-specific agonist, but had no effect on G1 arrest induced by
      HX600, a retinoid x receptor (RXR)-specific agonist. Am80 alone induces the
      apoptosis, and T3 enhances it. Although HX600 alone fails to increase the
      apoptotic fraction, T3 enables the compounds to induce apoptosis. Am80-induced
      expression of CD11b, a marker for the differentiation, is enhanced by T3.
      However, T3 or HX600 or both do not affect the expression of CD11b. T3 does not
      alter the amount of mRNAs of various members of the bcl-2 family. T3, however,
      enhances the Am80-induced expression of bfl-1 and suppression of bcl-2. In
      contrast, T3 does not alter either bfl-1 and bcl-2 expression in the presence of
      HX600. Our observations suggest that cooperative action of T3 with an RXR
      specific ligand is different from that with an RAR ligand in cellular apoptotic
      regulation and that thyroid hormone may be available as a chemotherapeutic agent
      in acute leukemia.

PMID- 11201847
TI  - Novel TSHR germline mutation (Met463Val) masquerading as Graves' disease in a
      large Welsh kindred with hyperthyroidism.
AB  - Hereditary nonautoimmune hyperthyroidism is caused by activating germline
      mutations in the thyrotropin (TSH) receptor (TSHR) gene. We describe an extended
      Welsh kindred with toxic thyroid hyperplasia affecting 8 family members in three
      generations and a history consistent with thyrotoxicosis in a further three
      generations now deceased. A novel heterozygous germline mutation (ATG --> GTG;
      Met463Val) was identified in the second membrane spanning TSHR region in 6
      relatives with thyrotoxicosis and goiter and absence of TSHR antibodies.
      Screening of 5 additional family members led to the identification of 2 siblings
      with the mutation, who were asymptomatic at the time, although subsequent thyroid
      function tests in these children showed suppressed serum TSH and increased serum
      free triiodothyronine (FT3) and free thyroxine (FT4) concentrations. Functional
      studies of the novel TSHR germline mutation demonstrated a constitutive
      activation of the cAMP pathway, which in the thyroid controls both thyroid
      hormone production and stimulation of thyroid growth. The molecular diagnosis in
      this family has clinical implications: genetic counseling is required, and
      primary thyroid ablation should be advocated as the preferred treatment in the
      patients with the constitutively activating TSHR germline mutation.

PMID- 11201848
TI  - Carnitine is a naturally occurring inhibitor of thyroid hormone nuclear uptake.
AB  - Carnitine (3-hydroxy-4N-trimethylammoniumbutanoate) is a naturally occurring
      quaternary amine that is ubiquitous in mammalian tissues (concentrations in the
      order of mM). Based on limited studies of approximately 40 years ago, carnitine
      was considered to be a peripheral antagonist of thyroid hormone (TH) action.
      These interesting observations have not been explored. To study the biologic
      basis of this effect, we tested the following possibilities in three TH
      responsive cell lines: (1) inhibition of TH entry into cells; (2) inhibition of
      TH entry into the nucleus; (3) inhibition of TH interaction with the isolated
      nuclei; and (4) facilitated efflux of TH from cells. On a preliminary basis we
      had verified that these cell lines (human skin fibroblasts, human hepatoma cells
      HepG2, and mouse neuroblastoma cells NB 41A3) take up 14Ccarnitine; however,
      there was no 14Ccarnitine uptake into the nuclei. Concentrations of unlabeled
      carnitine as high as 100 mM did not affect (125I)T3 binding to isolated nuclei or
      exit of TH from cells, thus excluding possibilities numbered 3 and 4. At 10 mM
      camitine, (125I)T3 and (125I)T4 whole-cell uptake was inhibited by approximately
      20% in fibroblasts and in HepG2, but by approximately 5% in NB 41A3 cells.
      Inhibition of T3 nuclear uptake was evaluated in HepG2 and NB 41A3 cells. At 10
      mM carnitine, inhibition of T3 nuclear uptake was disproportionately higher,
      namely approximately 25% in neurons and 35% in hepatocytes. At 50 mM carnitine,
      there was a minimal additional decrease in whole-cell uptake of either hormone
      but a marked decrease in T3 nuclear uptake. The latter inhibition was
      approximately 60% in neurons and 70% in hepatocytes. We are aware of no inhibitor
      of TH uptake that has such a markedly different effect on the nuclear versus
      whole-cell uptake. Our data are consistent with carnitine being a peripheral
      antagonist of TH action, and they indicate a site of inhibition at or before the
      nuclear envelope.

PMID- 11201849
TI  - Epitope analysis of the human thyrotropin (TSH) receptor using monoclonal
      antibodies.
AB  - A panel of thyrotropin (TSH) receptor (TSHR) monoclonal antibodies (mAbs),
      produced using highly purified Chinese hamster ovary (CHO) cell-produced TSHR,
      has been used to study TSHR structure. All 41 mAbs recognized full-length TSHR
      containing complex carbohydrate (120 kDa), and 40 mAbs recognized full-length
      precursor-containing high mannose sugars (100 kDa). The mAbs also recognized TSHR
      cleavage products with three types of reactivity: type 1 mAbs reacting with bands
      at 70 kDa and 58 kDa, type 2 with bands at 70 kDa and 52 kDa, and type 3 with
      bands at 52 kDa and 40 kDa. Deglycosylation studies showed that the 70-kDa and 58
      kDa bands contained complex carbohydrate, whereas the 52-kDa and 40-kDa bands
      were unglycosylated. These results are consistent with TSHR cleavage occurring at
      two sites. Cleavage at both sites gives rise to glycosylated A subunit (58 kDa)
      corresponding to the extracellular domain of the receptor and nonglycosylated B
      subunit (40 kDa) corresponding to the C-terminal transmembrane domain. Cleavage
      only at site 1 gives rise to the 58-kDa A subunit and a large B subunit (52 kDa).
      Cleavage only at site 2 gives rise to a large A subunit (70 kDa) and the B
      subunit (40 kDa). Four of the mAbs inhibited 125I-labeled TSH binding to
      solubilized full-length TSHR. TSH binding was inhibited by (a) two type 3 mAbs
      reactive with the N-terminal region of the B subunit (epitopes between amino
      acids 381 and 385 and between 380 and 418, respectively) and (b) two type 2 mAbs
      reactive with epitopes on the A subunit (between amino acids 246 and 260). These
      results together with previous studies on the direct binding of TSH to the TSHR A
      subunit suggest that at least two distinct regions of the TSHR sequence,
      including one region on the A subunit and one region on the B subunit, fold
      together to form part of a complex TSH binding site.

PMID- 11201850
TI  - Matrix metalloproteinases and the thyroid.
AB  - Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade components
      of the extracellular matrix (ECM) and basement membrane. They play a critical
      role in many physiological and pathological processes, such as tumor metastasis.
      The original concept-that MMP activity during metastasis is restricted solely to
      invasion of the basement membrane and destruction of ECM components-has been
      modified to encompass multiple aspects of tumor progression: tumor establishment,
      growth, angiogenesis, intravasation, extravasation, and almost all metastatic
      steps. Moreover, the role of tissue inhibitors of matrix metalloproteinases
      (TIMPs), originally believed to exhibit anti-invasion properties solely by virtue
      of their inhibition of MMPs, has been extended to include their multiple
      biological effects, such as growth promotion. In thyroid neoplasia as well, MMPs,
      in particular MMP-2, seem to be associated with metastatic potential. It would
      seem that similar and divergent patterns regulate MMP and TIMP gene expression in
      benign and malignant human thyrocytes, in many instances in agreement with the
      concept of MMPs playing the role of stimulating, and TIMPs inhibiting cell
      invasion.

PMID- 11201851
TI  - Graves' disease by any other name?

PMID- 11201852
TI  - Disseminated thyroid autonomy or Graves' disease: reevaluation by a second
      generation TSH receptor antibody assay.
AB  - The clinical diagnosis of disseminated autonomy (DISA) can only be established by
      exclusion of Graves' disease (GD). Both hyperthyroid conditions share the same
      scintigraphic appearance and can only be distinguished from each other clinically
      either by the presence or absence of endocrine ophthalmopathy (EO) or thyrotropin
      (TSH) binding inhibiting immunoglobulins (TBIIs). The purpose of this study was
      the reevaluation of thyroid autonomies originally classified as DISAs by a second
      generation radioreceptor antibody assay (RAA) (DYNOtest TRAKhuman) (B.R.A.H.M.S.
      Diagnostika, Berlin, Germany). The analysis included 32 patients (female: n = 25,
      male: n = 7; mean age: 46 +/- 18 years) who were initially diagnosed with DISA.
      All patients were TSH receptor (TSHR) antibody (TRAb) negative by a conventional
      radioimmunoassay (RIA) (TSH-REZAK RIA) (Medipan Diagnostica, Selchow, Germany)
      during their first evaluation. The presence of EO was excluded by clinical signs
      in all patients. Surgery had been performed prior to our evaluation in 5 patients
      and after our survey in 1 patient. Four patients had been treated previously with
      131I. Ten patients were treated with thionamides during our evaluation, and 13
      had not been treated before. One hundred three patients who had either healthy
      thyroids, nontoxic goiters, or focal autonomies served as controls and were
      evaluated both by the TSH-REZAK assay and the DYNOtest TRAKhuman assay. Seven of
      thirty-two (22%) patients originally classified as DISA were TRAb positive in the
      second-generation assay. In this group, 5 of 7 patients had a total thyroid
      volume (TTV) <30 mL (positive predictive value [PPW] for TRAb positivity 71%),
      and 5 of 7 patients had a diffuse goiter (PPW for TRAb-positivity 71%). Six of
      seven patients were anti-thyroperoxidase (TPO) positive (PPW for TRAb positivity
      85%). A hypoechoid pattern on ultrasound was present by visual analysis in 3 of 7
      patients (PPW for TRAb positivity 43%). A 100% PPW for TRAb positivity could be
      obtained if a goiter <30 ml was combined with anti-TPO positivity, but this
      combination was present in only 4 of 7 (57%) patients. With the second-generation
      assay, one false positive test result was observed in the control group. Surgery
      was performed in 6 patients who were TRAb negative in both assays. In all these
      cases, the histologic findings were compatible with autonomous transformation of
      the thyroid. Our study demonstrates that a significant number (22%) of patients
      formerly classified as DISA may actually have GD. However, DISA still exists as a
      clinical entity, and its pathophysiological link to multifocal and unifocal
      autonomy should be further investigated.

PMID- 11201853
TI  - Postintervention serum TSH levels may be useful to differentiate patients who
      should undergo levothyroxine suppressive therapy after thyroid surgery for
      multinodular goiter in a region with moderate iodine deficiency.
AB  - Recent studies have raised doubts about the efficacy of the postoperative use of
      levothyroxine (LT4) suppressive doses in patients who underwent thyroid surgery
      for multinodular goiter. The purpose of this retrospective study was to examine
      the efficacy of different doses of LT4 in preventing postsurgical recurrences of
      simple multinodular goiter and to identify a marker that could be useful in
      discriminating patients with a higher risk of developing recurrence. Two hundred
      thirty-two patients (57 male, 175 female) operated for nontoxic multinodular
      goiter were divided into two groups: (I) patients with normal postsurgery
      thyrotropin (TSH) levels (0.25 to 4.5 mU/L) and (II) patients with elevated
      postsurgery TSH levels (>4.5 mU/L). All patients were subjected to replacement
      (1.3 microg LT4/kg/day) or suppressive (1.7 microg LT4/kg/day) doses of LT4, and
      they were followed for a median period of 6 years (range 2 to 12). No statistical
      difference was found for sex, age, and postsurgery serum TSH between patients
      submitted to suppressive and replacement therapy. The ultrasound (US) detection
      of new postsurgery nodules of at least 0.5 cm maximum diameter was considered a
      recurrence of disease and was found in 10% of the cases studied. Patients with
      normal postsurgery serum TSH showed a high recurrence rate (30.4%) when submitted
      to lower daily doses of LT4. In patients with elevated postsurgery serum TSH, the
      rate of nodular goiter recurrence did not vary with different types of LT4
      therapy. In conclusion, our results suggest that the postsurgical serum TSH is
      useful for prediction of nodular goiter recurrence, as it reflects the amount of
      residual functioning thyroid tissue in the cervical area. It may also be
      indicative of patients who might benefit from LT4 suppressive therapy.

PMID- 11201854
TI  - Surgical and pathological changes after percutaneous ethanol injection therapy of
      thyroid nodules.
AB  - Few data exist on the operative and pathological findings in patients having
      undergone previous percutaneous ethanol injection (PEI) therapy of thyroid
      nodules. We report here our experience with 13 patients operated on by the same
      surgical team. Two pathologists, both blinded to the previous PEI treatment,
      carried out histological evaluation. Reasons for surgery included PEI failure,
      suspicion of malignancy, and tracheal compression. The operations did not pose
      any special problem from the technical point of view, and the postoperative
      courses were uneventful. One patient who had a second operation developed
      hypoparathyroidism, and laryngeal nerve palsy was never observed. The
      histological diagnosis was hyperplastic or adenomatous nodule in 12 cases and
      papillary thyroid cancer in 1. No difficulty was found in evaluating the nodule
      capsule and surrounding vessels. In two lesions, nuclear enlargement and clearing
      were identified in thyroid follicles immediately adjacent to necrotic or scarred
      areas. These changes were considered reactive. In conclusion, patients previously
      treated by PEI were operated on without special technical problems. Histological
      diagnosis was not hindered, and there was no difficulty in ruling out malignant
      lesions. PEI, however, should be performed only by skilled operators, and
      incidental ethanol seepage throughout the nodule capsule must be carefully
      avoided.

PMID- 11201855
TI  - Graves' ophthalmopathy in the absence of elevated free thyroxine and
      triiodothyronine levels: prevalence, natural history, and thyrotropin receptor
      antibody levels.
AB  - The aims of this study were to (a) determine the prevalence of patients without
      elevated thyroid hormone levels in Graves' ophthalmopathy (GO) using current
      generation free thyroid hormone assays, (b) measure the prevalence of thyrotropin
      receptor antibodies (TRAb) in these cases, and (c) identify possible predictors
      of hyperthyroidism. Over a 30-month period, 1020 cases of thyroid eye disease
      were evaluated, of which only 19 (1.9%) met the diagnostic criteria. Ten (1%) had
      subclinical thyrotoxicosis, 7 (0.7%) were euthyroid, and 2 (0.2%) were
      hypothyroid as determined by a third-generation thyrotropin (TSH) assay. TRAb
      levels were measured in 16 of these 19 patients. The prevalence of TRAb varied
      according to the assay used. Polyethylene glycol-extracted thyroid-stimulating
      immunoglobulin (PEG-TSI), unfractionated thyroid-stimulating immunoglobulin
      (uTSI), first-generation porcine TSH-binding inhibitory immunoglobulin (pTBII),
      and second-generation human TSH-binding inhibitory immunoglobulin (hTBII) assays
      were positive in 93.8%, 50%, 18.8%, and 81.3% of patients, respectively. TRAb was
      detected by at least one method in all patients. Patients were followed up for 15
      to 45 months. Hyperthyroidism developed in 4 patients (25%). Suppressed TSH
      levels and elevated TBII were predictors of hyperthyroidism. When sensitive
      assays are used, the prevalence of GO patients without elevated thyroid hormone
      levels is extremely low. The sensitivities of assays for TRAb detection differ
      substantially in these cases. PEG extraction improves the detection rate of TSI
      (p = 0.02), and hTBII assays improve the detection of TBII in these patients (p =
      0.002). The high prevalence of TRAb in such cases supports a role for these
      antibodies in the pathogenesis of thyroid-associated eye disease.

PMID- 11201856
TI  - Diurnal thyrotropin secretion in short-term profound primary hypothyroidism: does
      it ever persist?
AB  - Circulating serum thyrotropin (TSH) levels in euthyroid humans show a definite
      circadian variation, which is maintained in both mild hyperthyroidism and mild
      hypothyroidism. Yet conflicting data exist with regard to whether this variation
      persists in at least some patients with severe primary hypothyroidism. We,
      therefore, studied the diurnal variation in serum TSH in 10 patients (age range
      20 to 84 years) with a history of thyroid failure due to prior total
      thyroidectomy and radioiodine (RAI) ablative treatment performed for thyroid
      cancer after short-term discontinuation of thyroid hormone (TH) therapy. Serum
      TSH was measured hourly for a 24-hour period. All data were normalized by
      converting the TSH values to a percentage (%), designating the 11:00 hour value
      as 100% (baseline). The average serum TSH levels were markedly elevated in all
      patients. There was no statistically significant difference between the TSH %
      values at any time during the 24-hour period when compared with baseline.
      Further, cosine regression analysis showed absence of rhythmicity in TSH % values
      over time; notably, no patient showed a variation in TSH % values > or = 15% of
      baseline. In conclusion, diurnal rhythmicity in serum TSH levels was abolished in
      a uniform cohort of patients with short-term severe primary hypothyroidism. We
      speculate that the complete lack of peripheral negative feedback input to the
      hypothalamus or pituitary or both may override the central rhythm-sustaining
      influences on TSH secretion.

PMID- 11201857
TI  - Is excessive weight gain after ablative treatment of hyperthyroidism due to
      inadequate thyroid hormone therapy?
AB  - There is controversy about the correct dose and form of thyroid hormone therapy
      for patients with hypothyroidism. Despite restoration of serum thyrotropin (TSH)
      concentrations to normal, many patients complain of excessive weight gain. We
      have compared weight at diagnosis of hyperthyroidism with that when euthyroid,
      evidenced by a stable, normal serum TSH concentration, with or without thyroxine
      (T4) replacement therapy, in patients treated with an 18-month course of
      antithyroid drugs (43 patients), surgery (56 patients), or 13I (34 patients) for
      Graves' disease. In addition, weights were recorded before and after treatment of
      25 patients with differentiated thyroid carcinoma by total thyroidectomy, 131I,
      and long-term T4 suppressive therapy, resulting in undetectable serum TSH
      concentrations. Mean weight gain in patients with Graves' disease who required T4
      replacement therapy following surgery was significantly greater than in those of
      the same age, sex, and severity of hyperthyroidism rendered euthyroid by surgery
      (3.9 kg) (p < 0.001) or at the end of a course of antithyroid drugs (4.1 kg) (p <
      0.001). Weight gain was similar in those requiring T4 replacement following
      surgery or 131T therapy (10.4 versus 10.1 kg). In contrast, ablative therapy
      combined with suppression of TSH secretion by T4 in patients with differentiated
      thyroid carcinoma did not result in weight gain. The excessive weight gain in
      patients becoming hypothyroid after destructive therapy for Graves' disease
      suggests that restoration of serum TSH to the reference range by T4 alone may
      constitute inadequate hormone replacement.

PMID- 11201858
TI  - Neutrophilia associated with anaplastic carcinoma of the thyroid: production of
      macrophage colony-stimulating factor (M-CSF) and interleukin-6.
AB  - Cancers associated with marked neutrophilia are relatively rare. We report here
      two cases of anaplastic thyroid carcinoma associated with neutrophilia. We
      measured the concentrations of granulocyte colony-stimulating factor (G-CSF),
      macrophage CSF (M-CSF), granulocyte-macrophage CSF (GM-CSF), interleukin-1alpha
      (IL-1alpha), IL-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) in sera,
      pleural effusion, cyst fluid of the thyroid carcinoma region, or culture
      supernatants of carcinoma cells. Maximum levels of elevated white blood cell
      counts reached 106.1 x 10(9)/L (neutrophils 103.0 x 10(9)/L) in case 1 and 62.3 x
      10(9)/L (neutrophils 57.9 x 10(9)/L) in case 2. Acute-phase reactants were
      elevated to various degrees, and hypercalcemia was found in both cases. IL-6, G
      CSF, and M-CSF seemed to play the principal roles in neutrophilia in case 1, and
      the elevated levels of IL-6 and M-CSF seemed to mainly contribute to neutrophilia
      in case 2. Immunohistochemical staining revealed that carcinoma cells themselves
      produce IL-6 regardless of the types of carcinoma cells. To our knowledge, this
      is the first report describing the contribution of M-CSF to neutrophilia in
      patients with thyroid carcinoma.

PMID- 11201859
TI  - Cost of Care.

PMID- 11201860
TI  - Moisture chamber for management of corneal ulcer due to Graves' ophthalmopathy.

PMID- 11201861
TI  - Parathyroid cyst fluid: discrepancy between C-terminal and intact parathyroid
      hormone assays.

PMID- 11201862
TI  - Chernobyl tumor bank.

PMID- 11201863
TI  - The new challenges for chemotherapy research.
AB  - Scientific knowledge is constantly expanding, and needs are changing; therefore,
      efforts must be made to adapt the treatment of leprosy and the manner in which it
      is implemented to the newly identified needs. Because an effective vaccine
      against leprosy remains to be identified, multidrug therapy (MDT) is the only
      tool available for leprosy control. At present, therefore, the priority is to
      make MDT available in all endemic countries for all patients, even those living
      in difficult-to-access areas. The remaining important issues in chemotherapy
      research are to improve the quality of leprosy case-finding, improve the quality
      of MDT, identify the areas in which leprosy patients are not receiving proper
      MDT, and find the means necessary to ensure delivery to all of appropriate MDT.
      The MDT regimens recommended by the World Health Organization are of too long
      duration, require correct classification of the patients as PB or MB, and rely
      upon the daily self-administration of dapsone and clofazimine to prevent
      selection of rifampicin resistant mutants among MB patients. Thus, research
      leading to the development of new drug regimens should be directed toward
      overcoming the shortcomings of the presently recommended regimens. The drugs
      required to permit use of regimens of shorter duration, that may be employed
      among both PB and MB patients, and that enable fully supervised drug
      administration may be already in hand, and the necessary clinical trials to
      confirm efficacy and acceptability should be carried out.

PMID- 11201864
TI  - The epidemiology of reactions and nerve damage.
AB  - The ALERT MDT Field Evaluation Study (AMFES) in Ethiopia, which was begun in
      1988, involves the follow-up of 594 new patients for as long as 10 years after
      completion of treatment, including 6-monthly assessments of nerve function. In
      contrast to similar studies in India and Bangladesh, the Ethiopian cohort
      presented late, had a high rate of disability at diagnosis (55%), a high rate of
      multibacillary disease (51%) and a high rate of subsequent neuropathy (43%).
      Preliminary findings include the following. One-third of the patients never
      exhibited nerve damage. True acute neuropathy has a very good prognosis when
      treated with a standard course of steroids; full recovery was observed in 88% of
      nerves. Chronic and recurrent neuropathy have a worse prognosis; these problems
      need to be identified early and managed appropriately, employing either new
      steroid regimens or new drugs. The risk factors identified in this study include,
      for neuropathy, older age, delay of diagnosis, thickened nerves at diagnosis, and
      reversal reactions. Risk factors for chronic or recurrent neuropathy include
      classification, impairment at diagnosis, and reversal and ENL reactions. Those
      factors associated with a poor outcome include impairment at diagnosis, and
      chronic or recurrent neuropathy. Various problems faced in research in the area
      of leprosy reactions and neuropathy are discussed, as are the priorities for
      research in the future.

PMID- 11201865
TI  - Steroids in leprosy type 1 (reversal) reactions: mechanisms of action and
      effectiveness.
AB  - Steroids are widely used for the treatment of leprosy reactions. The
      effectiveness of steroid treatment is variable, with only 60% of patients
      regaining nerve function. Sequential skin biopsy specimens, obtained from 15
      patients with type 1 (reversal) reactions, have been studied to document the
      cytokine profile and cellularity of the lesions. All of the patients were placed
      on a standard course of steroids after the first biopsy. Subsequent biopsies were
      performed seven, 28 and 180 days later. The specimens were stained for interferon
      gamma (IFN gamma), interleukin-12 (IL-12) and inducible nitric oxide synthase
      (iNOS). After the first biopsy, all patients were placed on a standard reducing
      course of steroids beginning at 30 mg daily. By day 7, treatment with
      prednisolone showed little effect on the cellularity and cytokine profiles.
      However, by day 28, significant decreases of IFN-gamma, IL-12 and iNOS were found
      for most patients. Some patients maintained cytokine production at day 28 and
      even at day 180. These data illustrate the strong Th1 profile of type 1
      reactional lesions, the relatively slow response to therapy, and the continuing
      activity after treatment with steroids for 180 days. The variation of individual
      responses emphasizes their importance. Additional prospective studies will be
      required to determine whether patients with high intra-lesional levels of
      cytokine are at risk of recurrent reactions. The need for studies both of
      different glucocorticoids and of other non-steroidal immunosuppressants for the
      treatment of reactions is discussed.

PMID- 11201866
TI  - Role of granulysin in immunity to leprosy.

PMID- 11201867
TI  - Potential of thalidomide and thalidomide analogues as immunomodulatory drugs in
      leprosy and leprosy reactions.

PMID- 11201868
TI  - Leprosy research and elimination.
AB  - The contribution of leprosy research to the progress being made toward
      elimination of leprosy has been critical. A major development in the promotion of
      leprosy research during the last 25 years has been the initiative taken by the
      WHO Special Programme for Research and Training in Tropical Diseases (TDR)
      through two of its scientific working groups, one on the immunology of leprosy
      (IMMLEP) and the other on the chemotherapy of leprosy (THELEP), which were set up
      in 1974 and 1976, respectively. IMMLEP and THELEP have greatly facilitated inputs
      from scientists not usually active in leprosy research. The coordinated efforts
      of IMMLEP and THELEP also facilitated goal-oriented research toward high-priority
      target areas such as an anti-leprosy vaccine and newer and better drug
      combinations for the treatment of leprosy. Whereas the prospects for a leprosy
      vaccine appeared very promising in the early years, the first vaccine produced
      did not meet expectations for several reasons. Moreover, the possibility of using
      a vaccine in leprosy is not bright, because of both the technical problems as
      well as the reduced relevance of a vaccine at a time when leprosy is becoming
      less and less common. On the other hand, the modest expectations for newer and
      better drug combinations led to multi-drug therapy (MDT) for the control of
      leprosy. It is the introduction of MDT that is credited with the current global
      reduction of leprosy and the progress thus far made toward eliminating the
      disease as a public health problem. Nevertheless, many areas in leprosy, such as
      nerve damage, remain that require major research inputs in the future.

PMID- 11201869
TI  - The role of Schwann cells, T cells and Mycobacterium leprae in the
      immunopathogenesis of nerve damage in leprosy.
AB  - Damage to peripheral nerves is the major complication of reversal (type I)
      reactions in leprosy. The underlying mechanism of nerve damage remains largely
      unresolved; however, an important role for type-1 T cells has been suggested.
      Mycobacterium leprae has a remarkable tropism for the Schwann cells that surround
      peripheral axons. Because reversal reactions in leprosy are often accompanied by
      severe and irreversible nerve destruction, and are associated with increased
      cellular immune reactivity against M. leprae, a likely immunopathogenic mechanism
      of damage to Schwann cells and peripheral nerves in leprosy is that infected
      Schwann cells process and present antigens of M. leprae to antigen-specific,
      inflammatory, type-1 T cells, and that these T cells subsequently damage and lyse
      infected Schwann cells. Previous animal studies with CD8+ T cells revealed
      evidence for the existence of such a mechanism. A similar role has been suggested
      for CD4+ T cells. These latter cells may be more important in causing nerve
      damage in vivo, given the predilection of M. leprae for Schwann cells, and the
      dominant role of CD4+, serine esterase+ Th1 cells in the lesions of leprosy.
      Antagonism of the molecular interactions among M. leprae, Schwann cells and
      inflammatory T cells may therefore provide a rational strategy for prevention of
      damage of Schwann cell and nerves in leprosy.

PMID- 11201870
TI  - Dysregulation of IL-4 expression in lepromatous leprosy patients with and without
      erythema nodosum leprosum.
AB  - In order to increase our understanding of the immunological basis of erythema
      nodosum leprosum (ENL), we studied Th-like cytokine profiles in 130 leprosy
      patients, employing both the conventional and a novel, real-time, fluorogenic
      reverse transcriptase-based PCR (RT-PCR). The concomitant expression of both Th
      like cytokines, interferon-gamma and IL-4, and the regulatory cytokines, IL-10
      and IL-12, was studied in the peripheral blood cells of leprosy patients with and
      without ENL. In the conventional RT-PCR, varied cytokine profiles were observed
      in individual patients of all clinical types. Fifty-three percent of lepromatous
      patients without ENL and 59% of tuberculoid leprosy patients showed co-expression
      of IFN gamma and IL-4, indicating a non-polarized Th 0 pattern. Of the 36
      patients with ENL, 58% demonstrated a polarized Th 1 pattern, with only 30%
      expressing both cytokines. Semiquantitative RT-PCR indicated a lower expression
      of IL-4 compared to that of IFN gamma in the lepromatous patients without ENL;
      the difference was even greater among those with ENL. The sensitive, real-time
      PCR confirmed the down-regulation of IL-4 and IL-10, with absence of IL-4 in half
      of the patients, resulting in skewing of the cytokine response toward a Th 1-like
      profile.

PMID- 11201871
TI  - Review of current research in the prevention of nerve damage in leprosy.
AB  - Nerve damage and the consequences of nerve damage set leprosy apart from other
      diseases. The irreversible motor and sensory impairments caused by leprosy lead
      to increasing secondary impairments long after the disease process has been
      arrested. Interventions that prevent, reverse or limit the impairments resulting
      from leprosy are, therefore, of the highest priority. Self-care has been
      demonstrated to be an effective means of preventing secondary tissue damage, and
      its implementation must now be encouraged within the framework of basic health
      care. Currently, a comprehensive effort has been made to address all dimensions
      of impairment of nerve function and its consequences, from prevention of both
      primary and secondary impairments to interventions in long-term nerve damage. The
      BANDS prospective study of a cohort of 2664 previously untreated leprosy patients
      in Bangladesh has provided both a valuable baseline and insight into the
      epidemiology of nerve damage in leprosy. This work has defined the numbers of
      patients who present with acute nerve damage, the numbers who are not treated,
      and the importance of the MB classification, and has described the simple
      clinical prediction rule. This study also provided the basis for the development
      of the three TRIPOD randomized clinical trials in Nepal and Bangladesh. Follow-up
      of the BANDS cohort, which is continuing, will yield more data on the natural
      history of nerve damage. The encouraging results from the TRIPOD trials of low
      dose prophylactic steroids will be followed up, to see whether the effect is
      sustained over time. The TRIPOD trials are to be completed, a trial of three
      steroid regimens in reversal reaction is to be completed, and a number of
      specific research topics within the ILEP programme, INFIR, are to be developed.

PMID- 11201872
TI  - Peripheral neuropathy in leprosy and its consequences.
AB  - Leprosy causes a 'mononeuritis multiplex' of immunological origin that results in
      autonomic, sensory and motor neuropathy. When detected and treated early, primary
      impairments may be reversible. However, 11-51% of patients do not recover. In
      addition, 33-56% of newly registered patients already have clinically detectable
      impairments, often no longer amenable to drug treatment. Among new patients, 6
      27% present with secondary impairments, such as wounds, contractures and
      shortening of digits. All patients with impairments should be taught methods to
      prevent further impairment and subsequent disability (POID). As the result of
      impairments, many people experience limitation of activities of daily living,
      which can be partially overcome with the help of assistive devices, training, and
      surgery. As a result of these limitations, because of visible impairments, or
      simply because of the diagnosis 'leprosy', many people are restricted in their
      participation in society. Many overcome activity limitations and participation
      restrictions without assistance, despite residual impairments. However, some
      require intervention, such as physical or occupational therapy, reconstructive
      surgery or temporary socioeconomic assistance. Information on these issues is not
      collected routinely, and the few tools that exist to measure the severity or
      extent of impairment have not been widely used, nor have they been used to
      generate cohort-based statistics. There are no agreed indicators for monitoring
      POID activities or rehabilitation interventions. Work in the general field of
      rehabilitation has resulted in the ICIDH-2, which provides a conceptual framework
      for rehabilitation and the entire area of 'consequences of health conditions'.
      Although experience to date is very limited, the conceptual framework appears
      appropriate to leprosy. Data on the prevalence and incidence of primary and
      secondary impairments have been reported from several countries, the link between
      impairments and activity limitations has been investigated, and a few studies of
      the magnitude of the need for rehabilitation have been reported. Research
      priorities include studies of methods to improve detection of autonomic, sensory
      and motor neuropathy; trials of alternative drugs or regimens for treating
      neuropathy; studies of the use of various POID-monitoring systems that may be
      derived from these; studies of the design and use of instruments to assess
      limitations of activities and restrictions on participation; assessments of needs
      for rehabilitation and the development of methods to do these; studies of the
      efficacy of various types of rehabilitation interventions for particular
      conditions; and studies of the cost-effectiveness of such interventions.

PMID- 11201873
TI  - Pathogenesis of nerve damage in leprosy: genetic polymorphism regulates the
      production of TNF alpha.
AB  - Studies carried out over the last decade have strongly suggested that TNF alpha
      both overtly participates in the cell-mediated immune response against
      Mycobacterium leprae, and is overproduced during reaction. In addition, reactions
      are intimately related to the onset of nerve damage. Finally, TNF alpha has been
      implicated in the pathogenesis of many human and experimental autoimmune
      peripheral neuropathies that, as in leprosy, result in demyelination and axonal
      lesions. Because of recent findings associating human TNF alpha mutant alleles at
      the -308 position with increased production of TNF alpha in many immunological
      and infectious diseases, an investigation of the role of TNF2 in predisposing
      leprosy patients to reaction has been undertaken. Analysis of 300 patients with
      leprosy--210 multibacillary and 90 paucibacillary--has shown that the percentage
      of reactional patients was similar among both carriers and non-carriers of the
      TNF2 allele. However, a separate analysis of 57 carriers of TNF2 found that
      reactions occurred much more frequently among heterozygous than among homozygous
      patients. Moreover, the frequency of neuritis was somewhat greater among the
      heterozygous patients than among the non-carriers. Enhanced serum levels of TNF
      alpha have been noted in both TNF-1 and TNF-2 mutant patients in the course of
      leprosy reaction. Our observations to date suggest that other factors not related
      to the presence of the mutant gene may lead to the TNF alpha hyper-responsiveness
      observed during reaction.

PMID- 11201874
TI  - Prophylaxis--scope and limitations.
AB  - Attempts to prevent leprosy by one or another prophylactic method began with the
      use of dapsone as a chemoprophylaxis. Following early, small-scale studies, which
      were promising, large-scale studies with dapsone and acedapsone, both among
      contacts and in the general population, demonstrated that it is possible to
      prevent the occurrence of leprosy to a modest extent. With regard to
      immunoprophylaxis, BCG had long been considered a possibility, particularly in
      view of its potential to convert the skin test reaction to lepromin. Over the
      years, major, large-scale field trials of BCG had been carried out in Uganda,
      Burma, Papua New Guinea and India. All of the studies demonstrated that BCG was
      capable of preventing leprosy. However, protective efficacy varied from around
      20% to greater than 80%. Killed Mycobacterium leprae mixed with BCG has also
      given varying results. Other vaccines based on cultivable mycobacteria have also
      been tried, and at least one of them appears promising. An approach to
      prophylaxis must take into account (a) the level of risk addressed and the
      perception of risk by the community; (b) the level of efficacy of the method of
      prophylaxis; (c) the possibility of easily identifying high-risk groups; (d) the
      operational feasibility; and (e) the focus of the prophylaxis, whether the
      individual or the community, or both. However, in view of the enormous progress
      being made towards elimination of leprosy by the widespread application of MDT,
      prophylaxis is becoming less and less relevant and less and less cost-effective,
      except in very special situations.

PMID- 11201875
TI  - Preliminary analysis of the genome sequence of Mycobacterium leprae.

PMID- 11201876
TI  - Molecular basis of the interaction of Mycobacterium leprae with peripheral nerve:
      implications for therapeutic strategies.

PMID- 11201877
TI  - Exploitation of gene knockout mice models to study the pathogenesis of leprosy.
AB  - Shepard's technique for growth of Mycobacterium leprae in the mouse footpad,
      described in 1960, and more recent studies in thymectomized-irradiated mice and
      rats, athymic nude mice, nude rats and severe combined immunodeficiency (SCID)
      mice have defined the role of T-cell mediated immunity (CMI) in leprosy. However,
      the normal mouse and the immunocompromised mouse and rat represent only elements
      of polar tuberculoid disease and polar lepromatous leprosy, respectively.
      Transgenic, knockout (KO) mice may be employed to study the roles of individual
      genes in the ability of the host to mount an effective immune response to
      pathogens, and may also allow development of mouse models for the immunologically
      unstable borderline areas of the spectrum. We are exploiting certain KO mice to
      improve our understanding of CMI to M. leprae, and to study the role of the
      microenvironment of the leprosy granuloma in pathogenesis. CGD (chronic
      granulomatous disease) mice and iNOS-KO mice lack the ability to produce reactive
      oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI),
      respectively, whereas the T cells of GKO mice are unable to produce interferon
      gamma (IFN gamma). iNOS-KO mice exhibit an enhanced capacity to form granulomas,
      and the histopathology of the infected footpad tissues of this strain share many
      elements of borderline tuberculoid disease. The macrophages of CGD mouse kill or
      inhibit multiplication of M. leprae, although they lack ROI. Multiplication of
      the organisms in the footpad is enhanced in GKO mice, although these mice retain
      some host resistance. In addition, we have been investigating supplementary,
      conditional approaches to KO mouse models. For example, the down-regulatory
      effects of local prostaglandin production can be controlled with essential fatty
      acid deficient diets or indomethacin, RNI can be blocked in CGD and GKO mice by
      treatment with aminoguanidine, NG monomethyl arginine or N6-(1-iminoethyl)-L
      lysine, and local elaboration of TNF alpha can be neutralized by anti-TNF alpha
      antibody or excess TNF alpha receptor. Other cytokines can be neutralized by
      antibody as well, broadening the range of conditional knockout models.

PMID- 11201878
TI  - Immunoprophylaxis against Mycobacterium leprae infection with subunit vaccines.
AB  - We have investigated the effect of subunit vaccines against infection with
      Mycobacterium leprae, employing DNA plasmids as the vaccine vectors, and the
      immunodominant 35 kDa protein of M. leprae as the candidate antigen. A DNA
      vaccine that expresses the M. leprae 35 kDa protein both stimulated interferon
      gamma (IFN gamma)-secreting T cells in mice, and demonstrated protection against
      M. leprae-infection of mice.

PMID- 11201879
TI  - Leprosy research--setting priorities and facilitating collaborations: a personal
      perspective.
AB  - In recent years, as the prevalence of leprosy has declined and the tuberculosis
      epidemic has gained increasing attention, leprosy research has generally taken a
      'back seat' to research in tuberculosis and other emerging and re-emerging
      infections. This has resulted as much from perceived differences of scientific
      opportunities in these fields as from differences of the disease burden. At the
      United States National Institutes of Health (NIH), research priority setting is
      typically based on a number of factors. In the case of leprosy research, the
      technical difficulties associated with this scientific area have clearly lessened
      enthusiasm for and progress in this field. Today, however, we are confronted by
      the reality of not having sufficient scientific understanding to explain a stable
      or increasing number of leprosy cases detected annually in the face of a
      dramatically decreasing total number of identified cases. We also lack adequate
      tools for diagnosis and prevention. At the same time, new molecular and cellular
      approaches and knowledge of the complete sequence of the genome of Mycobacterium
      leprae render leprosy research significantly more tractable than ever before. The
      combination of these factors has led a number of groups, including the National
      Institute of Allergy and Infectious Diseases of the NIH, to review the current
      state of knowledge in leprosy research and draft recommendations for future
      leprosy research priorities. It is clear that many of the necessary and exciting
      research activities can best be addressed through collaborations among
      investigators, with control programmes, and among countries of high and low
      endemicity.

PMID- 11201880
TI  - Research component in the global alliance.

PMID- 11201882
TI  - Approaches to studying the transmission of Mycobacterium leprae.
AB  - A collaborative study has been undertaken to establish the relationship between
      infection by Mycobacterium leprae and the development of immunity in a community
      in which multidrug therapy (MDT) has been used for more than 10 years, to
      elucidate the pathogenesis of infection in leprosy, and to develop and test an
      intervention strategy based on chemotherapy for interruption of transmission of
      the organism in the community. The first phase of the study included the
      establishment of laboratory facilities and pilot work in India. In the course of
      the second phase, the entire populations of three villages in India and one in
      Ethiopia have been surveyed, nasal swabs were obtained for detection of M. leprae
      DNA by means of the polymerase chain reaction (PCR), specimens of saliva were
      obtained for measurement of levels of anti-M. leprae IgA antibodies, and follow
      up surveys have been carried out. A double-blind trial of chemotherapy among
      subjects whose PCR was positive is proposed, to determine if the course of the
      infection can be influenced by treatment. The performance of large numbers of PCR
      tests in endemic countries has required the development of rigorous internal and
      external quality control procedures. These have shown that many batches (as many
      as 50%) fail to meet quality control criteria, and must be retested. Despite
      this, development of these methods, and their application to field studies should
      provide tools for studying the transmission of M. leprae, and direct methods of
      testing innovative interventions.

PMID- 11201881
TI  - Leprosy chemoprophylaxis in Micronesia.
AB  - A programme of chemoprophylaxis was introduced as a component of the leprosy
      control programme in the Federated States of Micronesia (FSM), beginning in 1996.
      The entire population of the country was to be screened, and a single dose of 600
      mg rifampicin, 400 mg ofloxacin and 100 mg minocycline (ROM) was to be
      administered to the entire population. Two rounds of screening the entire
      population were carried out, approximately 1 year apart, and chemoprophylaxis was
      administered at the time of each screening. Ninety percent of the population were
      screened at least once, and 55% were screened in both rounds; 87% of the
      population received at least one dose, and 54% received two doses. In the course
      of the first round, 322 new cases were detected, whereas only 80 new cases were
      detected during the second round, of whom only 12 had received chemoprophylaxis
      in the course of the first round. A third round of screening, confined to a small
      number of villages in both Chuuk and Pohnpei, in which states leprosy endemicity
      was high, was carried out approximately 2 years after the second. Only 16 new
      cases were detected during the third round of screening, whereas 102 new cases
      had been detected in this same population during the first round of screening,
      and 32 new cases during the second. Six of the 16 newly detected cases stated
      that they had been administered chemoprophylaxis at least once; however, this
      information may not be reliable.

PMID- 11201883
TI  - Strategies for pro-active case-finding in leprosy control.

PMID- 11201884
TI  - Chemoprophylaxis of leprosy in the southern Marquesas with a single 25 mg/kg dose
      of rifampicin. Results after 10 years.
AB  - In 1988, a programme of leprosy chemoprophylaxis, employing a supervised, single
      25 mg/kg dose of rifampicin, was implemented in the Southern Marquesas Islands.
      Of the 2786 inhabitants, 2751 (98.7%) were treated. In addition, 3144 South
      Marquesans living elsewhere in French Polynesia were administered the same
      chemoprophylaxis. During the following 10 years, seven leprosy patients were
      detected among those who had been administered chemoprophylaxis. Of these, two
      were very likely missed cases of leprosy, and cannot be considered a failure of
      chemoprophylaxis. The epidemiometric projection model, based on cases of leprosy
      observed in the Southern Marquesas during the 20 years preceding implementation
      of the programme, predicted that 17 leprosy cases could be expected in the South
      Marquesan population if no chemoprophylaxis were given. In fact, only five cases
      were detected in the treated population, a number significantly smaller than 17,
      suggesting that the chemoprophylaxis was 70% effective, assuming that no change
      of detection rate would have occurred without chemoprophylaxis. However, during
      the 10 years following implementation of the chemoprophylaxis programme, the
      detection rate in the Polynesian population that was not administered
      chemoprophylaxis declined by about 50%. Therefore, the effectiveness of the
      chemoprophylaxis was only 35-40%.

PMID- 11201886
TI  - South India immunoprophylaxis trial against leprosy: relevance of the findings in
      the context of trends in leprosy.

PMID- 11201885
TI  - Chemoprophylaxis against leprosy: expectations and methodology of a trial.
AB  - Because of the great efficacy of multidrug therapy (MDT), it had been hoped that
      the widespread use of MDT would bring about a rapid decrease of the incidence of
      leprosy. To the present, a decrease of incidence has not been observed, possibly
      because of the long incubation period of the disease, and because general
      implementation of MDT is still recent. Other reasons, such as environmental
      sources of infection or the role of healthy carriers in transmitting
      Mycobacterium leprae, cannot be excluded. Therefore, one must seek alternative or
      supplementary strategies, such as chemoprophylaxis. Household contacts of leprosy
      patients are at greater risk of developing leprosy than is the general
      population. Therefore, a randomized, controlled trial of chemoprophylaxis, using
      a single 10 mg/kg dose of rifampicin, or a placebo, is planned in nine projects
      in India, among the household contacts of newly detected leprosy patients. Based
      upon assumptions of a protective efficacy of the chemoprophylaxis of 50%, an
      annual incidence of 2 per 1000 contacts, a desired power of the study of 90%, and
      a level of significance of 95%, 15,000 household contacts will be allocated
      randomly by household to each arm of the study, and followed for 5 years.
      Considered as household contacts will be all persons living in the same household
      as an index case and sharing the same kitchen. Pregnant women and infants will be
      excluded. To be certain that transmission of the organisms from the index case
      cannot occur once the prophylaxis is administered, rifampicin will be
      administered 2 months after diagnosis of the index case. Diagnosis of leprosy
      will be clinical, and confirmed independently. Although household contacts
      usually constitute only a small proportion of the new patients detected in a
      control programme, their high-risk status makes them particularly appropriate for
      a study of the potential effect of chemoprophylaxis. Following the trial, one
      could evaluate the usefulness and feasibility of using the same strategy in other
      population-groups, based on the number of persons necessary to treat to prevent
      one case.

PMID- 11201887
TI  - Skin test development in leprosy: progress with first-generation skin test
      antigens, and an approach to the second generation.
AB  - One of the most urgent needs from leprosy research is a test for infection. The
      lepromin test is not suitable as a diagnostic test for leprosy, and neither the
      Rees nor the Convit soluble antigens has appeared sufficiently specific. Because
      two new antigens, MLSA-LAM and MLCwA, may not fully meet the requirements for
      specificity, we have embarked upon the preparation of a second generation of skin
      test antigens. Size-fractionated cryptozoic proteins were prepared from M. leprae
      by electroelution from preoperative sodium dodecylsulphate-polyacrylamide gel
      electrophoresis, and individual fractions were probed with polyclonal and
      monoclonal antibody reagents to identify both known and novel proteins. In
      addition, immunological responses were assessed in M. leprae-sensitized guinea
      pigs against both crude subcellular fractions (cytosol, membrane, and soluble
      cell wall proteins) and the size-fractionated cytosolic proteins. A particularly
      promising subcellular fraction is the membrane fraction of M. leprae, which
      contains many proteins unique to the organism. Clinical trials of the M. leprae
      membrane proteins are now being planned.

PMID- 11201888
TI  - Diagnostic assays for leprosy based on T-cell epitopes.
AB  - To date, only a limited number of antigens have been described as specific for
      Mycobacterium leprae, and in many cases, homologues have subsequently been shown
      to exist in mycobacteria such as M. avium and M. intracellulare. A Leprosy
      Synthetic Peptide Skin Test Initiative was established by the Steering Committee
      on the Immunology of Mycobacteria of the UNDP/World Bank/WHO Special Programme
      for Research and Training in Tropical Diseases, to investigate the potential of
      synthetic peptides that encode T-cell epitopes as diagnostic tools, which could
      be used to develop a skin-test reagent specific for leprosy. Such M. leprae
      specific peptides should have unique amino acid sequences, or significant
      sequence-dissimilarity from those in other mycobacteria. Synthetic peptides, 15
      amino acids long, were synthesised from 33 genes or open reading frames within
      the M. leprae genome. Tuberculoid leprosy patients from four leprosy-endemic
      countries, Brazil, Ethiopia, Nepal and Pakistan, were tested as subjects known to
      have been infected with M. leprae, and to make good T-cell responses to antigens
      of M. leprae; UK blood donors were used as non-exposed or non-infected subjects.
      Peptides inducing potentially specific responses in leprosy patients and not in
      UK controls, and those inducing cross-reaction responses, present in both leprosy
      patients and non-exposed, non-infected controls, were identified. A difference
      from the equivalent M. tuberculosis sequence of five or more amino acid residues
      did not, by itself, identify peptides that were M. leprae-specific, suggesting
      that many of these peptides may have homologues in environmental mycobacteria. To
      date, this approach has identified a number of peptides with greater than 90%
      specificity and 19-47% sensitivity, which are undergoing further specificity
      testing. Such peptides would have great potential as T-cell reagents with which
      to monitor exposure to M. leprae within communities, formulated either as skin
      test reagents, or as antigens for tests in vitro.

PMID- 11201889
TI  - Whole blood assays for interferon-gamma: practicalities and potential for use as
      diagnostic tests in the field.
AB  - Recent years have seen the introduction of a number of whole-blood assays, in
      which unseparated heparinized blood is stimulated with antigen either overnight
      or for as long as 6 days, and cytokine production is measured in the plasma or
      supernatant. These assays have potential for use in the field as immunodiagnostic
      assays, as they require only a small blood sample and basic laboratory
      facilities. Use of these assays in a large study of the immunological effects of
      BCG vaccination in Malawi has shown that the diluted blood, 6-day whole-blood
      assays is robust, and can be used to assess T-cell responses to both crude and
      recombinant antigens. If used with antigens specific to Mycobacterium leprae,
      these assays could be used to measure exposure of M. leprae within communities or
      populations, or to aid the early diagnosis of leprosy.

PMID- 11201890
TI  - Experience and lessons from the use of lepromin and Mycobacterium leprae-specific
      serology.
AB  - Skin testing with lepromin, which produces a delayed-type hypersensitivity
      reaction, has been used in the classification of leprosy, and a good correlation
      has been found between immunological status and the reaction to lepromin. In
      addition, the prognostic value of the lepromin test has been demonstrated. More
      recently, skin testing with two soluble antigens of Mycobacterium leprae showed
      no difference of the mean size of the reaction between household contacts and non
      contacts, indicating that these antigens are not useful for the diagnosis of
      leprosy. This and other evidence points to the need for a better skin test
      antigen capable of detecting infection of individuals by M. leprae. Whereas
      serological assays for antibodies against both PGL-1 and the 35 kDa antigen of M.
      leprae have been found to yield positive results in 90-100% of patients with
      lepromatous (BL/LL) leprosy, these assays fail to identify 40-60% of patients
      with tuberculoid (BT/TT) leprosy, because of the presence of only an
      insignificant level of antibody against components of M. leprae in these
      patients' serum, although, in many BT patients, antibody signal could be detected
      in the local lesions. These data indicate that there remains a need for a
      specific diagnostic test for leprosy.

PMID- 11201891
TI  - Use of a Mycobacterium leprae dipstick to classify patients with leprosy.

PMID- 11201892
TI  - A rapid, microplate-based assay for evaluating the activity of drugs against
      Mycobacterium leprae, employing the reduction of Alamar Blue.

PMID- 11201893
TI  - Field trials of a single dose of the combination rifampicin-ofloxacin-minocycline
      (ROM) for the treatment of paucibacillary leprosy.

PMID- 11201894
TI  - Combination of rifapentine-moxifloxacin-minocycline (PMM) for the treatment of
      leprosy.
AB  - To further the development of a multidrug regimen for treatment of leprosy that
      is suitable for monthly administration and fully supervisable, the bactericidal
      activities against Mycobacterium leprae of HMR 3647 (HMR), moxifloxacin (MXFX)
      and rifapentine (RPT) were measured by the proportional bactericide technique in
      the mouse footpad system, and compared with those of the established antileprosy
      drugs clarithromycin (CLARI), ofloxacin (OFLO) and rifampicin (RMP). Administered
      in five daily doses of 100 mg per kg body weight, HMR appeared slightly more
      bactericidal than CLARI, but the difference did not attain statistical
      significance. Administered as single doses, MXFX in a dosage of 150 mg per kg was
      more active than OFLO in the same dosage, and displayed the same level of
      activity as RMP in a dosage of 10 mg per kg; the combination MXFX-minocycline
      (MINO) (MM) was more bactericidal than the combination OFLO-MINO (OM); RPT in a
      dosage of 10 mg per kg was more bactericidal than RMP administered in the same
      dosage, and even more active than the combination RMP-OFLO-MINO (ROM); the
      combination RPT-MXFX-MINO (PMM) killed 99.9% of viable M. leprae, and was
      slightly more bactericidal than was RPT alone, indicating that the combination
      PMM showed an additive effect against M. leprae. These promising results justify
      a clinical trial among lepromatous patients, in which MM is being compared with
      OM, and PMM with ROM, in terms of efficacy and tolerance.

PMID- 11201895
TI  - Current World Health Organization-sponsored studies in the chemotherapy of
      leprosy.

PMID- 11201896
TI  - Dapsone resistance in Mycobacterium leprae.
AB  - The folP1 gene of Mycobacterium leprae, which encodes dihydropteroate synthase
      (DHPS), was studied for the presence of mutations associated with resistance to
      dapsone (DDS). When the folP1 of several DDS-resistant clinical isolates of M.
      leprae were sequenced, two missense mutations were identified. One mutation
      occurred at codon 53, substituting isoleucine for threonine in DHPS-1, and a
      second mutation occurred in codon 55, substituting arginine for proline. DNA
      sequencing of strains of M. leprae resistant to 0.01 g% DDS in the mouse diet
      revealed that 13 of 14 strains contained either the 53 or 55 folP1 mutation. None
      of the susceptible strains and only one of five strains resistant to 0.001 g% DDS
      revealed a mutation in folP1, suggesting that only high-level DDS resistance is
      associated with the mutations identified in folP1. Development and application of
      simple molecular tests to assess drug-related mutations in M. leprae could
      establish current levels of drug resistance in leprosy as a reference point for
      future monitoring of drug resistance at the global level.

PMID- 11201897
TI  - Rapid detection of resistance to rifampicin in Mycobacterium leprae.

PMID- 11201898
TI  - Consequences of leprosy and socio-economic rehabilitation.

PMID- 11201899
TI  - Implementing guidelines for socio-economic rehabilitation.

PMID- 11201900
TI  - Guidelines for social and economic rehabilitation.

PMID- 11201901
TI  - Socio-economic rehabilitation programmes of LEPRA India--methodology, results and
      application of needs-based socio-economic evaluation.
AB  - There is now a better understanding of the scope and process of rehabilitation.
      The approach recognizes the impact of leprosy on the individual, aims to
      understand the needs and concerns of those affected, their families and community
      in the rehabilitation process, and that aims to restore the person to normal
      social life. LEPRA India has undertaken socio-economic rehabilitation (SER)
      activities in its projects in Andrah Pradesh and Orissa States in India with a
      holistic approach that has been evolutionary, developmental and participatory. A
      SER Officer (SERO) was posted to each project. A plan was formulated by the SERO
      with participation of all project staff. The main emphasis of the programme was
      on active participation of the affected person in the rehabilitation process. A
      needs-assessment study was conducted in the target population using a semi
      structured questionnaire. Information was elicited about social and economic
      status, before and after the disease, and the current rehabilitation needs of the
      persons affected. The next step was meeting the needs through interventions by
      the SER staff. The impact of the programme on restoration of social and economic
      status of the affected persons was analysed. The paper stresses the importance of
      assessing the needs of persons affected by leprosy, structuring a rehabilitation
      programme with the active participation of the affected person and evaluating the
      impact of the interventions in restoring normal social and economic life.

PMID- 11201902
TI  - Making sense of rehabilitation projects: classification by objectives.
AB  - Rehabilitation of disabled persons can take many different forms according to the
      socio-cultural and political context in which it is undertaken. Some approaches
      have emphasized the restoration of the physical function of the client, while
      others have looked beyond to psychological and social well-being. Some have built
      on the expertise of professionals while others have emphasized the caring
      capacity available in the family and the community and sought to reinforce it.
      Besides providing a wide range of possible services to disabled persons,
      rehabilitation seeks to change the attitudes that prevail in society as a whole
      and promote the integration of disabled people into society with equal rights and
      opportunities. This paper reviews a range of models and approaches which have
      been put forward in the international debate on rehabilitation. Furthermore, four
      dimensions are described which can be used to characterize and define classes of
      rehabilitation projects based on the objectives that are defined for them. Thus
      types of rehabilitation projects can be distinguished. Management, evaluation and
      technical support for rehabilitation projects need to take these essential
      characteristics into account.

PMID- 11201903
TI  - The psychosocial needs of leprosy patients.

PMID- 11201904
TI  - Leprosy: between acceptance and segregation. Community behaviour towards persons
      affected by leprosy in eastern Nepal.
AB  - This study describes community behaviour towards persons affected by leprosy in
      the eastern Terai districts of Nepal. The results show that 95% of the persons
      affected by leprosy recognized by the community have visible signs such as
      wounds, swellings and deformed feet or hands. Persons affected by leprosy still
      experience negative behaviour. Motives for negative community behaviour are
      mostly found in the fact that people fear infection by germs, but fear of a curse
      from God is also mentioned. This study shows that negative community behaviour is
      still present in eastern Nepal. Leprosy is more than a disease; the disease can
      nowadays be medically cured, but the sickness of leprosy still remains. Leprosy
      control programmes should focus on prevention of impairments and disabilities,
      because it seems that a visible sign is an important trigger for negative
      community behaviour.

PMID- 11201905
TI  - Stigma reduction through group counselling of persons affected by leprosy--a
      pilot study.
AB  - Stigmatization of persons with leprosy causes the emotional harm of social,
      economic and spiritual deprivation. Individual counselling has benefits in
      addressing these psychosocial problems but is a slow process and effects few
      people at any one time. Our experience of group counselling of stigmatized
      persons achieved the following: addressing common issues to more than one person
      at a time, encouraging the unity of sufferers, developing compassion for others,
      understanding the common effects of stigmatization, and beginning to overcome its
      harmful effects.

PMID- 11201906
TI  - Gender differentials in the social and family life of leprosy patients.
AB  - A study was carried out at the Leprosy Control Unit, Government Medical College,
      Nagpur, India, to investigate gender differentials in the social and family life
      of leprosy patients. The study included 486 (268 males and 218 females) leprosy
      patients, who were diagnosed and registered at least 1 year prior to the data
      collection. It was observed that leprosy patients were isolated and refrained
      from various activities in the family. However, the effect of disease on this
      isolation was significantly greater in females as compared to males. Similarly,
      although, men and women were both affected in terms of their social life, women
      suffered more isolation and rejection from the society. The current study
      describes the gender differentials in the social and family life of leprosy
      patients in Central India.

PMID- 11201907
TI  - Delay in presentation and start of treatment in leprosy: experience in an out
      patient clinic in Nepal.
AB  - Delayed presentation is a recognized risk factor for disability in leprosy but is
      the result of complex interactions between physical, social, economic and
      psychological factors. The present study is a response to the situation in an
      outpatient clinic in Nepal where the wide variation in delay in presentation was
      a cause for concern. A purpose-written questionnaire was used to collect
      information on 166 consecutive outpatient admissions. The data included
      demographics, the first symptom of leprosy, first actions, initial help-seeking
      behaviour, the reasons for finally seeking treatment and experience with
      professional health services. Initial analysis found a relationship between delay
      in presentation and age, rural environment, leprosy classification, walking time,
      housing not shared with another person affected by leprosy, and an inappropriate
      first action. The relationship with lack of education and total travel time just
      failed to reach significance. Further analysis identified that for the study
      population initial lack of awareness of leprosy and an inappropriate first action
      were the primary contributors to delay. Extensive and effective health education
      is needed to address this situation.

PMID- 11201908
TI  - Small loan schemes: the experience of Ethiopia.

PMID- 11201909
TI  - Evaluation of a housing programme.

PMID- 11201910
TI  - Unmet needs of rehabilitation in leprosy services.

PMID- 11201911
TI  - Ophthalmologic screening of deaf students in Oregon.
AB  - PURPOSE: To determine the frequency of Usher's syndrome and other ocular disease
      in students receiving special education services for the deaf in Oregon and to
      assess the amount of existing ophthalmologic surveillance of this population. A
      special emphasis was placed on screening for Usher's syndrome. METHODS: From 1980
      1990, a prospective two-center visual screening program of 231 deaf students in
      schools throughout Oregon was conducted using an ophthalmic questionnaire,
      complete eye examinations, and electroretinography. Students were between the
      ages of 10 and 21 years and participated on a volunteer basis. Findings for
      etiology and severity of visual loss and the scope of ophthalmologic surveillance
      within this population were analyzed. RESULTS: Two hundred seventeen of the 231
      students examined received electroretinograms. Significant ocular pathology was
      found in 111 (48%) of the students. The most common diagnoses were congenital
      rubella (21%), significant uncorrected ametropia (16%), and ocular hypertension
      (9%). Five students were diagnosed with Usher's syndrome. Of the students with
      significant ocular pathology, only 37% were actively followed by an
      ophthalmologist. CONCLUSION: Deaf students in Oregon's schools had a high
      frequency of eye disease. Early diagnosis and treatment of eye disease in this
      population could benefit the quality of life of these students. This study
      alerted the providers of special education services for the deaf and the
      ophthalmologic community in Oregon of the need for better eye care for these
      students.

PMID- 11201912
TI  - Cataract surgery in children with uveitis.
AB  - PURPOSE: To report the technique and postoperative results of cataract surgery in
      children with uveitis. METHOD: Between 1988 and 1998, nine children (age range:
      2.5-11 years) who developed secondary uveitic cataract and underwent cataract
      extraction were studied retrospectively. Seven children had juvenile rheumatoid
      arthritis and two had chronic anterior uveitis of unknown etiology. The surgical
      technique was lensectomy and wide anterior vitrectomy with limbal approach, lysis
      of anterior synechiae and in some cases, peripheral iridectomy. Postoperative
      aphakia was corrected with soft contact lenses in all patients. Follow-up ranged
      from 6 months to 6 years. RESULTS: Postoperatively, visual acuity in all patients
      improved and final visual acuity ranged from 20/70 to 20/25. Significant
      intraoperative complications did not occcur in any patient. One boy with juvenile
      rheumatoid arthritis developed cystoid macular edema 1 month postoperatively,
      which was successfully managed. He also developed hypertonia 1 year later, which
      was also successfully managed. Seven of the nine children had fewer and milder
      relapses of uveitis after surgery. CONCLUSION: Cataract surgery, using the
      lensectomy-vitrectomy technique in children with uveitis, is a safe technique
      with a relatively small percentage of postoperative complications and good
      functional results.

PMID- 11201913
TI  - Comparison of visual evoked potentials in patients with psychogenic visual
      disturbance and malingering.
AB  - PURPOSE: To verify the efficiency and objectivity of the pattern visual evoked
      potential (VEP) for organic disorders of the cortical visual system. METHODS:
      This retrospective study evaluated VEP in 19 patients diagnosed with psychogenic
      visual disturbance, 7 patients with malingering, and 37 age-matched normal
      volunteers. Transient (3 reversals per second) and steady-state (12 reversals per
      second) pattern VEPs for check sizes 15' and 30', with a contrast of 80%, were
      recorded. RESULTS: The amplitudes of both transient and steady-state pattern VEPs
      were significantly increased in patients with psychogenic visual disturbance,
      while patients with malingering had significantly lower amplitudes. P100 peak
      latency was prolonged in both groups of patients. CONCLUSION: Monitoring of
      patients' fixation on the stimulus showed those with psychogenic visual
      disturbance fixated well on the stimulus, while those with malingering did not.
      This finding produced a VEP amplitude reduction in patients with malingering. The
      reason for the VEP amplitude in patients with psychogenic visual disturbance is
      unclear.

PMID- 11201914
TI  - Effects of anisometropia on binocularity.
AB  - PURPOSE: To investigate the effects of anisometropia on binocular function and
      the relationship between stereopsis and fusion in anisometropia. METHODS: Twenty
      five patients with anisometropia were studied. The manifest refraction and best
      corrected Snellen visual acuity of each patient was recorded. Patients, corrected
      with spectacles, were evaluated using Bagolini glasses, the 4-diopter (D) prism
      test, Worth four-dot test, and TNO stereotest. RESULTS: All patients indicated
      fusion by the Bagolini glasses. Although the 4-D prism test was positive in the
      anisometropic eye of all 25 patients, it was slower than the response of the
      other eye in 19 patients with reduced stereoacuity. On the distant Worth four-dot
      test, fusion response was positive in 15 patients. On theTNO test, stereoacuity
      levels were reduced or absent in 19 patients. CONCLUSION: The depth of amblyopia
      is more effective than the amount of anisometropia in causing a deterioration in
      binocularity. Even if fusion is weak, almost all patients with anisometropia have
      bifoveal fusion. Fusion becomes weak and stereoacuity decreases in proportion to
      the anisometropic amblyopia. Stereoacuity is related to the strength of fusion,
      and the TNO stereotest effectively detects those patients with significant
      anisometropic amblyopia.

PMID- 11201915
TI  - Managed care dominance.

PMID- 11201916
TI  - A 5-year old boy presented with congenital nystagmus.

PMID- 11201917
TI  - Iris hamartomas presenting without neurofibromatosis.

PMID- 11201919
TI  - Severe bilateral ocular features in Goldenhar's syndrome.

PMID- 11201918
TI  - Retinopathy due to juvenile polymyositis.

PMID- 11201920
TI  - Association of keratoconus and Mobius' syndrome.

PMID- 11201921
TI  - Bacterial endocarditis following lacrimal duct probing.

PMID- 11201922
TI  - Nursery light levels in the LIGHT-ROP study.

PMID- 11201923
TI  - Visual impairment in children with acute nontraumatic coma.
AB  - PURPOSE: To determine the incidence and severity of visual impairment in children
      following acute nontraumatic coma. METHODS: An 18-month prospective epidemiologic
      study of acute nontraumatic coma was undertaken in the former Northern NHS Region
      of England. Children aged >1 month and <16 years were included in the study if
      they had a Glasgow Coma Score of < or = 12 for >6 hours or if they died within 6
      hours of the onset of decreased levels of consciousness. For survivors,
      ophthalmologic assessments were performed 6 weeks and 12 months after
      presentation. RESULTS: Two hundred eighty-seven children were included in the
      study, of whom 127 died. Of the 137 examined survivors, 35 had visual
      abnormalities suspected by the examining neurologist during the ophthalmic
      assessment. Of these, visual impairment was confirmed in 10 children at the 6
      week assessment by the pediatric ophthalmologist. At the 1 2-month assessment,
      visual impairment remained stable in 9 children and improved in 1. CONCLUSION: In
      this study, 6.6% of children surviving acute nontraumatic coma had visual
      impairment that persisted at the 12-month follow-up examination. Incidence of
      visual impairment in acute nontraumatic coma is 0.97 per 100,000 children per
      year.

PMID- 11201924
TI  - Women's recreational ice hockey injuries.

PMID- 11201925
TI  - Involuntary psychiatric treatment is not to be decided by psychiatrists.

PMID- 11201926
TI  - Commentary: involuntary psychiatric treatment is a medical decision.

PMID- 11201927
TI  - Commentary: involuntary psychiatric treatment must be decided by the district
      psychiatrist.

PMID- 11201928
TI  - Commentary: the implications of who decides on involuntary treatment.

PMID- 11201929
TI  - Commentary: legal analysis of the Israel Psychiatric Association's proposal
      regarding compulsory hospitalization of the mentally Ill.

PMID- 11201930
TI  - The biopsychosocial model of medicine revisited: a meta-theoretical excursion.
AB  - Engel's biopsychosocial model of medicine has been widely endorsed by
      contemporary medicine, at least in theory. Yet, whereas Engel's notion refers
      mainly to physician-patient communication, the prevalent interpretation of this
      model is mainly etiological. The present meta-theoretical study examines the
      relation between the different notions of the model. Using logical analysis and
      the theory of (critical) rationality, in particular Wettersten's theory of
      (complementary) styles of rationality, it is argued that the different notions of
      the model may be complementary, rather than contradictory or incommensurable as
      usually implied by those holding them.

PMID- 11201931
TI  - Commentary: are there any inconsistencies among the notions of the
      biopsychosocial medical model?

PMID- 11201932
TI  - Oneiroid syndrome: a concept of use for western psychiatry.
AB  - Oneiroid syndrome (OS), or dream-like fantastic delusional derangement of
      consciousness, is characterized by a kaleidoscopic quality of psychopathological
      experiences, wherein reality, illusions and hallucinations are merged into one.
      It is typically accompanied by motor and, in particular, catatonic disturbances.
      This syndrome is an uncommon psychiatric state, which is hardly mentioned in
      standard psychiatric textbooks. OS is a neglected entity among DSM-oriented
      psychiatrists because it deals with a phenomenological approach in contrast to
      the European attitude, which deals with detailed clinical descriptions. Here, we
      propose detailed clinical descriptions with a number of consecutive stages of the
      OS development, illustrated by two vignettes with typical variants of oneiroid
      syndrome, in order to raise the awareness of psychiatrists who are not familiar
      with this state, and to try to open a window to the inner life of those patients
      suffering from this syndrome. These cases may also serve as illustration of
      certain principles which, when understood, may be found to lead in turn to a
      deeper knowledge of the psychopathology of other more commonplace conditions.

PMID- 11201933
TI  - Death foretold.
AB  - We briefly trace the history of a belief in the possibility that a person in
      apparent good health may accurately predict his or her own demise. The phenomenon
      is referred to as death foretold and we present presumed examples of it from the
      Bible, world literature, medical writings and newspaper reports without
      pretending to completeness. In two widely quoted scientific papers, death
      foretold is subsumed under the wider heading of decease due to psychic stress. We
      speculate on a possible link between the two, taking into consideration the fact
      that most people who prophesy their end are of an advanced age.

PMID- 11201934
TI  - Self-destructive behavior in adolescents who have not completed a process of
      mourning: case study.
AB  - The article deals with the problem of self-destructive behavior in adolescence
      through the perspective of family dynamics. Two vignettes describe an uncompleted
      process of mourning after the loss of a parent in two suicidal adolescents, a
      girl and a boy. It shows that suicidal behavior may be only a part of a long
      lasting process which is not always recognized. In both cases dysfunctional
      family relations did not allow the adolescents to deal properly with their
      feelings of responsibility, guilt and accumulated inner tension. Characteristic
      differences are shown between the girl, who is depressed and manifests somatoform
      disorder and regressive behavior, and the boy, whose unresolved conflicts and
      anxiety are manifested by conduct disorder.

PMID- 11201935
TI  - The wandering psychiatric emergency room--design, location and transformations.
AB  - We describe the changes in location and philosophy of a psychiatric emergency
      room over a period of 20 years. Four phases are described in which location,
      size, modes of access as well as internal and external boundaries reflect
      philosophies of treatment and the evolving identity of a psychiatric emergency
      room. The four phases include an early embryonic stage, a second stage involving
      rapid development of services, a third stage involving regression and
      consolidation and a fourth stage representing a fully developed independent
      service. The authors stress both external and rational considerations, such as
      mental health policies and budget, as well as unconscious irrational processes,
      which reflect the dynamic forces within the organization.

PMID- 11201936
TI  - An open trial of plant-source derived phosphatydilserine for treatment of age
      related cognitive decline.
AB  - We assessed whether the efficacy of plant-source derived phosphatydilserine (one
      of the phospholipids which play an important functional role in membrane-related
      processes in the brain) for treatment of age related cognitive decline is
      consistent with previous (placebo controlled) positive findings with bovine
      derivative of PS (BC-PS). Eighteen healthy elderly volunteers meeting Age
      Associated Memory Impairment inclusion and exclusion criteria were treated for 12
      weeks with plant-source derived phosphatydilserine (PS) (100 mg x 3/day p.o.) and
      evaluated at base line, after 6 weeks of treatment and at the end of the trial.
      Fifteen concluded the study. All but two outcome measures elicited a significant
      drug over time effect. Post-hoc paired t-tests showed that the significant effect
      was attributable to an improvement from base line to week 6 and that effect was
      maintained at week 12. These results are encouraging. However, they await double
      blind controlled verification in a large sample before suggesting that this may
      be a viable approach to the treatment of age-related cognitive decline, without
      exposing the patients to possible hazards involved in the treatment with bovine
      derivative of PS (BC-PS).

PMID- 11201937
TI  - Attitudes toward homosexuality: an overview.
AB  - In the last decade it has become clear that impairment of the psychological well
      being of homosexuals has its origin in a society that discriminates and
      stigmatizes homosexuality. The article provides some basic information on
      homosexuality and continues with an overview of current knowledge on attitudes
      toward homosexuality. It gives special attention to the situation of
      homosexuality in Israel. Limited knowledge on the situation in Israel suggests
      that although there is an increase in tolerance toward homosexuality, it is not
      universally accepted and prejudice is common.

PMID- 11201938
TI  - The influence of information on social and occupational outcome in mental illness
      on the attitudes of students in Turkey.
AB  - BACKGROUND: In this article, we have tried to evaluate the influence of a series
      of determinants of stigmatization of mental illness. METHOD: 700 final year
      students of a University in Istanbul were asked to read one of 14 different
      hypothetical case stories. The stories contained different combinations of
      characteristics assumed to play a role in stigmatization. Each vignette was
      presented to 50 students. The stories were collected after five minutes and the
      following scales were completed: Characteristics Scale and Skill Assessment
      Scale. Analysis was conducted on each scale. RESULTS: We found a statistically
      significant difference among the groups given different hypothetical cases
      (vignettes). According to the post-hoc analysis, only the subjects given the
      vignette in which social and occupational outcome information were lacking showed
      statistically significant difference from the rest of the population. CONCLUSION:
      This study suggests that information on social and occupational outcome of mental
      illness influences the general perception of the mentally ill.

PMID- 11201939
TI  - Blaming parents in infant psychiatry.

PMID- 11201940
TI  - Xeroderma pigmentosum in three consecutive siblings of a Nigerian family:
      observations on oculocutaneous manifestations in black African children.

PMID- 11201941
TI  - Multifocal electroretinographic and angiographic changes in pre-eclampsia.

PMID- 11201942
TI  - Signet ring carcinoma of the eccrine sweat gland in the eyelid, treated by
      radiotherapy alone.

PMID- 11201943
TI  - Endonasal endoscopic dacryocystorhinostomy for dacryocystocoele in a 4 month old
      infant.

PMID- 11201944
TI  - Epstein-Barr virus associated acute retinal necrosis.

PMID- 11201945
TI  - Intrascleral recurrence of uveal melanoma after transretinal "endoresection".

PMID- 11201946
TI  - Leucocoria as the presenting sign of a ciliary body melanoma in a child.

PMID- 11201947
TI  - Spontaneous extrusion of subconjuctival cysticercus cellulosae.

PMID- 11201948
TI  - Massive basal cell carcinoma in a schizophrenic patient: treatment options and
      constraints.

PMID- 11201949
TI  - Spontaneous resolution of eyeball displacement caused by maxillary sinusitis.

PMID- 11201950
TI  - Familial thrombophilia and normal tension glaucoma.

PMID- 11201951
TI  - The wide field multifocal ERG reveals a retinal defect caused by vigabatrin
      toxicity.

PMID- 11201952
TI  - Retraction of published papers.

PMID- 11201954
TI  - Desktop research--bibliographic databases and electronic journals.    .

PMID- 11201955
TI  - Prevalence of malocclusion and orthodontic treatment need in 10-year-old New
      Zealand children.
AB  - The need for orthodontic treatment was determined in a random sample of 10-year
      old Dunedin, New Zealand schoolchildren using the Dental Aesthetic Index (DAI);
      an index based on the social acceptability of dental appearance. When absent or
      unerupted teeth were disregarded, orthodontic treatment was considered to be
      "mandatory" for one-third of the children. The remaining children were almost
      equally divided into the three other treatment-need groups: "highly desirable",
      "elective", and "not necessary". The majority of the children had crowding and
      spacing in at least one incisor segment, and a molar occlusion other than Angle
      Class I. In this predominately mixed-dentition sample, more children were
      considered to need orthodontic treatment than older children in studies using the
      DAI. This raises some questions about the suitability of the DAI as a tool to
      assess orthodontic treatment need in mixed-dentition samples.

PMID- 11201956
TI  - An investigation of mandibular morphology in subjects with different vertical
      facial growth patterns.
AB  - In the present study, mandibular morphology was investigated on lateral
      cephalometric head films and dental casts of 60 subjects (30 females and 30
      males) who had different vertical facial growth patterns. The sample had a mean
      age of 13.5 years, with a range of 11 to 15.5 years. The subjects were divided
      into three groups with regard to vertical facial growth by using the SN/GoGn
      angle to define low-angle, normal, and high-angle groups. In addition, each group
      was divided into two subgroups according to sex. The effects of the SN/GoGn angle
      and gender on mandibular morphology were investigated by means of analysis of
      variances. Tan Go, IMPA, SL, and EL measurements were found to be related to
      SN/GoGn, and the measurements of Go-Gn, Symphysis depth, and Intermolar width to
      be related to sex.

PMID- 11201957
TI  - Electropalatographic and cephalometric assessment of myofunctional therapy in
      open-bite subjects.
AB  - Myofunctional therapy (MFT) is often prescribed to correct tongue-thrust
      swallowing, with the expectation that anterior open bite (AOB) will reduce
      spontaneously if a more posterior tongue posture is learned. However, MFT has not
      been subjected to systematic evaluation. Electropalatography (EPG), which is used
      in speech pathology to measure dynamic tongue function for diagnostic,
      therapeutic and research purposes, is a suitable technique for the evaluation of
      MFT. This prospective clinical study assessed the effect of tongue re-education
      therapy on tongue function and dento-facial form in AOB patients.
      Electropalatography recordings of speech and swallowing, and lateral head
      cephalometric radiographs were obtained from eight 10-year-old boys with tongue
      thrust swallowing behavior and AOB before and after a course of tongue re
      education therapy. Although differences in cephalometric measurements before and
      after therapy were small, there was some evidence of a trend for upper and lower
      incisor eruption, with concomitant reduction of the AOB. Analysis of the EPG
      speech data was inconclusive, but the swallowing data showed trends for more
      consistent and more anterior patterns of EPG contact after therapy. Comparison of
      pre- and post-therapy EPG data with data from a parallel study using a group of
      age-matched controls indicated that some "normalisation" of swallowing behaviour
      had occurred. The results of this research imply that the therapy was partially
      successful in improving tongue function during swallowing and in reducing AOB.
      Further research on a larger sample over a longer observation period is required
      for more accurate assessment of soft and hard tissue changes.

PMID- 11201958
TI  - The duration of fixed orthodontic treatment: a comparison of two groups of
      patients treated using Edgewise brackets with 0.018" and 0.022" slots.
AB  - The duration of fixed appliance Edgewise orthodontic treatment times using
      brackets with 0.018" and 0.022" slots was measured to determine whether there
      were any clinically or statistically significant differences between the two
      appliances. Sixty-four consecutively treated, fully banded patients were selected
      from two different practice locations. All 64 patients were treated by one
      clinician. Thirty-two patients (Group 1) were treated using the 0.018" slot
      bracket and 32 (Group 2) were treated using the 0.022" slot bracket. The patients
      in each group were treated to the same standard of care using the same technique.
      The mean duration of treatment for Group 1 was 20.2 months and for Group 2, 21.7
      months. Although the mean difference (1.5 months) was not clinically significant,
      it was statistically significant at p < 0.05.

PMID- 11201959
TI  - Dental changes and space gained as a result of early treatment of pseudo-Class
      III malocclusion.
AB  - This study was designed to investigate the dental changes and the space gained
      following early treatment of pseudo-Class III malocclusion, using a simple fixed
      appliance. Twenty-one consecutively treated patients who had a pseudo-Class III
      malocclusion comprised the treated group. Fifteen untreated control subjects were
      used as matched controls for the three-year follow-up after completion of
      treatment. Lateral cephalograms and study models were analysed for the treated,
      the control and the follow-up group. The arithmetic mean and standard deviation
      were calculated for each variable, and paired t-tests were performed to assess
      the effects of treatment on the treated group. The Mann-Whitney test was
      performed to evaluate the difference between the follow-up group and the control
      group. Anterior crossbites and mandibular displacements were eliminated after the
      treatment. On average, the space gained as a result of the treatment was 4.7 mm
      in the upper arch (p < 0.001 degree). Comparison of the space available as a
      result of early treatment with the space required for alignment of posterior
      segments in the upper arch of the untreated control group indicated that there
      was enough space for the eruption of the canines and premolars as a result of
      early treatment; whereas, lack of space was evident in the untreated controls. In
      conclusion, a pseudo-Class III malocclusion, proclination of the upper incisors
      and/or retroclination of the lower incisors contributed to the correction of
      anterior crossbite and the elimination of mandibular displacement. Proclination
      of the upper incisors, utilisation of leeway space, and arch-width increase
      provided the space required for eruption of the premolars and canines.

PMID- 11201960
TI  - Non-extraction treatment of a thirteen-year-old boy with a Class III skeletal
      discrepancy and severe crowding in both the upper and lower dentitions.
AB  - A thirteen-year-old boy presented with a Class III skeletal tendency in
      association with severe crowding in both the upper and lower arches. Whilst there
      was not a frank posterior crossbite, it was felt that the upper arch was narrow
      and that the lower arch was similarly constricted. Taking this into account along
      with the fact that his upper lip was flat and the nasolabial angle obtuse, it was
      decided to pursue a non-extraction treatment, with the aim of providing by
      expansion an extra 16 mm of space in the upper arch and 8 mm in the lower arch to
      accommodate the full dentition, and with a view to extracting third molar teeth
      later. This proved to be successful, albeit over an extended period of time, with
      active treatment taking nearly three and a half years. A realistic alternative
      would have been to remove four bicuspid teeth and pursue an orthodontic/surgical
      approach to treatment. In retrospect, and with the benefit of reviewing his
      records without surgical intervention, the treatment plan decided upon has been
      well justified.

PMID- 11201961
TI  - Finishing occlusion, degree of stability and the PAR index.
AB  - The occlusions of sixty-five patients, treated by one private specialist
      orthodontist with consistent philosophy and goals, were assessed according to the
      PAR Index. For each patient, pre-treatment, post-treatment and follow-up study
      models were assessed. Follow-up models were taken at least 6.5 years following
      the removal of all retention appliances. Mean-weighted PAR scores were calculated
      for the total sample and various sub-groups at each stage. Mean percentage
      changes in weighted PAR scores were also calculated. The relationships between
      the occlusal standards at the end of active treatment and at the end of the
      follow-up period, and specific diagnostic and treatment factors were then
      investigated to search for any factors that might be predictive of long-term post
      treatment occlusal stability or instability. The overall mean-weighted pre
      treatment, post-treatment and follow-up PAR scores were 25.5, 3.0 and 7.0,
      respectively. There was an 85.6 per cent decrease with treatment in the overall
      mean-weighted PAR score. This was followed by a 15.2 per cent increase in that
      overall mean during the follow-up period. In this introductory study, neither the
      PAR score at the end of active treatment, nor the amounts of occlusal change
      occurring during or after active treatment, were found to be predictive of the
      amount of post-treatment occlusal change.

PMID- 11201963
TI  - Treatment of a severe Class III skeletal discrepancy at an appropriate age.
AB  - The 13-year-old female patient presented for correction of a severe Class III
      malocclusion with a Class III skeletal pattern. This was considered an
      appropriate age for treatment as earlier treatment may have been subject to
      relapse because significant facial growth may have occurred after treatment, and
      because treatment at a later age may have required orthognathic surgery.
      Initially, maxillary expansion was provided to widen the maxilla and to free the
      circum-maxillary sutures. Maxillary protraction headgear was worn to perform
      sagittal skeletal improvement. Fixed orthodontic appliances were placed to align
      the dentition and Class III elastics were used to improve intercuspation and
      stability. Patient cooperation was crucial for success. The skeletal changes
      provided rewards that included significantly improved facial and dental
      appearance, while avoiding orthognathic surgery.

PMID- 11201962
TI  - Treatment of an "ankylosed" upper central incisor in the mixed dentition.
AB  - A ten-year-old boy presented with an unerupted upper right central incisor (UR1).
      An OPG radiograph showed a supernumerary tooth lying over its crown, preventing
      its eruption. Standard orthodontic treatment involving removal of the
      supernumerary tooth, attaching a gold chain to the UR1 and treatment with fixed
      orthodontic appliances failed to bring the tooth down, until it was found that
      tough fibrous gingival tissue entwined in the gold chain had "ankylosed" the
      tooth. Once this tissue had been removed and the wound packed open, the tooth was
      brought down successfully into occlusion.

PMID- 11201964
TI  - A comparison of retention rates of brackets with thermally-cured and light-cured
      custom bases in indirect bonding procedures.
AB  - This study compared the retention rates of thermally-cured (TC) and light-cured
      (LC) custom bases attached to metal mini-diamond brackets and clear Spirit MB
      brackets, when used in indirect bonding procedures. The custom base comprised
      either the light-cured or thermally-cured material attached to the bracket base
      and prepared in the laboratory, the whole unit later being bonded to the natural
      teeth. Thirty consecutively treated patients had fixed appliances fitted in both
      arches, with Spirit MB brackets on the maxillary anterior teeth, and metal
      brackets on the maxillary posterior and all mandibular teeth. All brackets were
      bonded using either the LC or TC method. All procedures and treatment was by the
      same operator, using identical techniques. Observation was for six months. All
      bonding failures were recorded. The results indicated no significant differences
      in the retention rates of either of the custom-base materials when used with
      metal brackets. However, the Spirit MB brackets exhibited a significantly higher
      bonding failure rate when a TC custom base was used. It was therefore concluded
      that either material could be used in the indirect bonding of metal brackets, and
      that LC custom bases should be used in the indirect bonding of Spirit MB
      brackets.

PMID- 11201965
TI  - International Journal Editors' Symposium.

PMID- 11201966
TI  - The immunohistochemical response of the rat periodontal ligament endothelium to
      an inflammatory stimulus.
AB  - Recently, inflammation has been recognised as an important co-requisite to
      orthodontic tooth movement. When such a reaction is initiated, the process of up
      regulation of certain adhesion molecules may occur, resulting in the
      extravasation of leukocytes. This may stimulate progenitor/precursor pathways and
      signals that regulate the biological responses resulting in tooth movement. We
      propose that up-regulation of leukocyte adhesion molecules occurs in response to
      orthodontic forces, resulting in circulating monocyte attraction, extravasation
      and differentiation into osteoclasts, which are responsible for bone resorption
      that results in orthodontic tooth movement. To investigate this hypothesis, it is
      necessary to determine whether periodontal ligament (PDL) endothelium responds to
      inflammatory stimuli as other organs do. We studied the normal distribution of
      endothelial adhesion molecule ICAM-1 within PDL vessels, and then the following
      exposure to an inflammatory endotoxin. The rat PDL blood vessels expressed ICAM-1
      in response to the inflammatory stimulus, similar to other organs, suggesting
      that the inflammatory responses are similar. Whether and where in the PDL
      microvascular bed orthodontic forces cause up-regulation of ICAM-1 needs to be
      established.

PMID- 11201967
TI  - Anterior open-bite malocclusion: stability of maxillary repositioning using rigid
      internal fixation.
AB  - A retrospective cephalometric study was performed to investigate the stability of
      37 non-growing anterior open-bite cases using mini-plate rigid fixation. The
      sample was divided into two groups: Group A: maxillary repositioning alone (17
      cases) and Group B: bimaxillary surgery (20 cases). Tracings were performed pre
      operatively (T1), immediately post-operatively (T2) and at a minimum of one year
      follow-up (T3) (12-90 months). In Group A, the maxilla was advanced (3.8 +/- 2.8
      mm, p < 0.01) and superiorly repositioned at PNS (2.8 +/- 2.3 mm, p < 0.001). In
      Group B, the maxilla was advanced (3.5 +/- 3.0 mm, p < 0.01) and superiorly
      repositioned at PNS (3.7 +/- 1.8 mm, p < 0.001); and the mandible (11.7 +/- 3.8
      mm, p < 0.001), with no significant change in the vertical plane (p > 0.05). Late
      relapse due to condylar remodelling or resorption was found as a cause of large
      horizontal relapse (8.0 < x < 14.0 mm) in three cases (15%), the amount being
      associated with the amount of operative advancement (r = 0.7, r-sq = 40%, p <
      0.01). It was concluded that the correction of anterior open bite by posterior
      repositioning of the maxilla using rigid fixation is a stable procedure during
      the follow-up period, and that in bimaxillary cases, post-operative stability
      depends largely on the stability of the mandibular advancement, which in turn
      relates to the amounts of advancement, the pre-operative anterior open bite and
      the mandibular plane angle.

PMID- 11201968
TI  - A comparison of two methods of assessing orthodontic treatment need in the mixed
      dentition: DAI and IOTN.
AB  - This paper assesses the unmet orthodontic treatment need in a random sample of 10
      year-old schoolchildren, using two indices: the Dental Aesthetic Index (DAI) and
      the Index of Orthodontic Treatment Need (IOTN). The DAI scores were adjusted by
      omitting the missing teeth component of the index because many children were in
      the mixed dentition with unerupted permanent teeth. Although both indices
      assessed the same number of children with malocclusions requiring orthodontic
      treatment, not all were ranked similarly by each index.

PMID- 11201970
TI  - Effectiveness and duration of two-arch fixed appliance treatment.
AB  - The aims of this study were to determine the effectiveness and duration of single
      phase two-arch fixed appliance treatment and to evaluate factors that may
      influence these two variables. Data were collected from 177 consecutively
      completed cases at the Orthodontic Department, Government Dental Clinic,
      Singapore, during a three-month period. Pre-treatment and post-treatment models
      were assessed using the Peer Assessment Rating (PAR) index. The result showed
      that two-arch fixed appliance treatment reduced the malocclusions on average by
      77.80 per cent over a period of 25 months. Multiple regression techniques
      revealed that 22 per cent of the variability in treatment effectiveness could be
      explained by the pre-treatment PAR score, the age at the start of treatment, the
      frequency of office visits and whether or not the treatment involved extractions.
      The variation in treatment duration was due to the frequency of office visits,
      the pre-treatment PAR score and whether or not the treatment involved extractions
      or headgear.

PMID- 11201969
TI  - Ultrastructural identification of cells involved in the healing of
      intramembranous bone grafts in both the presence and absence of demineralised
      intramembranous bone matrix.
AB  - Alveolar bone defects are conditions that impede the progress of orthodontic
      treatment. This study compared the mechanics of the healing of autogenous
      intramembranous (IM) bone grafts and grafts comprising a mixture of IM and
      demineralised bone matrix of autogenous intramembranous origin (DBMIM), in an
      attempt to determine the reliability of each material. Thirty-two New Zealand
      white rabbits had a single defect created in their skull. Sixteen were grafted
      with IM bone alone (Group I: autogenous IM), and the other 16 had a combined
      graft of composite IM sandwiched between two layers of DBMIM (Group II: composite
      IM-DBMIM). A third group (Group III) of eight rabbits each had two defects
      created in their skull; one defect was left empty (A: passive control) and the
      other filled with rabbit-skin collagen (B: active control). In Groups I and II,
      inflammatory cells were found to be present on Days 1 and 2 of tissue retrieval.
      The appearance of the mesenchymal cells and preosteoblasts, osteoblasts and
      osteocytes was earlier (Day 3) in Group II than in Group I (Day 5). In both
      groups, preosteoblasts, osteoblasts and osteocytes were observed with no
      cartilage at the intermediate stage. In conclusion, autogenous IM bone grafts and
      IM bone grafts in the presence of DBMIM healed through an osteogenic ossification
      route.

PMID- 11201971
TI  - In re: Di Chiro G, Schellinger D. Computed tomography of spinal cord after lumbar
      intrathecal introduction of metrizamide (computer assisted myelography).

PMID- 11201972
TI  - Absence of selective deep white matter ischemia in chronic carotid disease.

PMID- 11201973
TI  - [Benzodiazepines and pregnancy].
AB  - The use of benzodiazepines is not negligible in pregnant woman and self
      medication is considerable. To investigate the effects on the fetus of
      benzodiazepines used during pregnancy, we reviewed animal and clinical studies
      completed with observations of CRPV (Centres Regionaux de Pharmacovigilance).
      Pooled results indicate that the risk of malformations associated with first
      trimester exposure to benzodiazepines remains small. However, in a fetus exposed
      essentially to long-acting benzodiazepines on a long-term basis, neonatal
      hypotonicity, failure to feed and/or withdrawal syndrom could be observed.

PMID- 11201974
TI  - [Susceptibility of the elderly patient to hyponatremia induced by selective
      serotonin reuptake inhibitors].
AB  - Numerous spontaneous reports of the syndrome of inappropriate secretion of
      antidiuretic hormone (SIADH) have followed the increased use of selective
      serotonin reuptake inhibitors (SSRI). It has been estimated that 1 in 200
      patients treated per year developed SIADH, age and low body weight being
      particular risk factors. No clear gender effect has been detected when
      confounding factors such as body weight or antidepressant consumption are taken
      into account. Age-related susceptibility to hyponatraemia may be explained by
      physiological changes in renal and endocrine function. The high prevalence of
      polymedication and pluripathology in the elderly may be a contributing factor as
      well. To date, no study has demonstrated how SSRIs affect the regulation of
      fluid/sodium balance nor whether they have an independent effect on this
      regulation in depressed subjects.

PMID- 11201975
TI  - [Drug prescription for pregnant women in the department of the Loire]  .
AB  - A prospective drug prescription and descriptive study was undertaken in a sample
      of 214 pregnant women in the department of the Loire. This population was
      randomized using pregnancy declaration files from the French Health Care Centre.
      Data recording was retrospective. A total of 2064 drugs have been prescribed; 90
      per cent of women received at least one drug during the course of pregnancy with
      an average of 11.5 drugs per woman. Antispasmodics are mainly prescribed in the
      first trimester while vitamins, mineral supplements, antianemics and vasoactive
      agents are found in the third trimester. Prescriptions do not rise with age but
      increase in urban areas. Use of PDD/DDD (Prescribed Daily Dose/Defined Daily
      Dose) is an estimation of prescription customs. For ketoprofen, it is 1.6 in the
      last trimester, although this drug is contra-indicated.

PMID- 11201976
TI  - [Midodrine (Gutron) prescription practice at a University Hospital Center].
AB  - A historical study of the prescription of midodrine was carried out at the
      university hospital of Toulouse (France) between 1994 and 1998. The aim was to
      compare the observed prescriptions and the ideal prescriptions in accordance with
      the Summary of Product Characteristics (SPC). The analysis of 97 consecutive
      medical reports found discrepancies in prescription concerning the non-respect of
      contraindications and of potentially hazardous drug associations. Fifty-four
      (55.7 per cent) patients would have been excluded from prescription if the
      physicians had strictly respected the SPC. The inappropriate prescription of
      midodrine was associated with an increase in adverse drug reactions (ADRs). ADRs
      occurred in 34.0 per cent of cases overall and required drug discontinuation in
      15.5 per cent.

PMID- 11201977
TI  - Caffeine metabolism differences in acute hepatitis of viral and drug origin.
AB  - The 24-h urinary excretion rate of caffeine metabolites following 200 mg caffeine
      intake has been proved to be a valuable safe quantitative test of liver function.
      The pathological mechanism of acute hepatitis of viral and drug origin is
      different. In both diseases, the patient's caffeine metabolic capacity during the
      acute and the recovery period was compared. In the acute period, in both
      diseases, the strongly reduced metabolism of caffeine paralleled the variations
      of the usual biochemical tests. During the recovery period, in viral hepatitis,
      caffeine metabolism and biochemical tests returned to the normal values. In drug
      induced hepatitis during the recovery period, caffeine metabolism remained
      severely impaired at a time when biochemical tests were back to the control
      levels. This discrepancy might be due to the histological or molecular toxic
      effects of the drug(s), irrespective of cytolysis. After drug-induced hepatitis,
      a caffeine test might be used to check the total recovery or to choose an adapted
      dosage of medicines.

PMID- 11201978
TI  - [Dementia and extrapyramidal problems caused by long-term valproic acid].
AB  - Among the side-effects attributed to valproic acid (VPA), the occurrence of
      Parkinsonian syndromes and cognitive impairment is very uncommonly reported. We
      describe five cases of reversible associated Parkinsonism. These cases were
      observed in epileptic patients, 57 to 74 years old, two women and three men.
      Extrapyramidal disorders appeared after various durations of treatment (from 6
      months to 10 years). Dementia characterized by an insidious onset was associated
      in three cases and bradypsychia in one case. Brain pseudoatrophy was present in
      three patients. In all cases the signs and symptoms improved some weeks or months
      after discontinuation of VPA. In the literature some cases, usually in young
      adults or children, have been reported. In a prospective study, Armon et al.
      found various abnormal symptoms and signs related to motor and cognitive function
      impairment in patients with long-term VPA therapy. These side-effects may be
      related to a disturbance in the gabaergic pathways in the basal ganglia system.
      It is of interest to consider that delta 2-valproic acid, a metabolite of VPA, is
      especially accumulated in selected areas of the brain: the substantia nigra,
      superior and inferior colliculus, hippocampus and medulla.

PMID- 11201979
TI  - [Adverse effects of anticancer drugs: apropos of a pharmacovigilance study at a
      specialized oncology institution].
AB  - We investigated the frequency of ADRs occurring during one year (1995) in a
      French regional cancer institute. Patients with at least one ADR leading to or
      occurring during hospitalization in the institute were identified by searching
      diagnosis codes potentially related to an adverse drug reaction in the hospital
      medical database of the PMSI (Programme de medicalisation des Systemes
      d'Information). We found 435 hospitalizations relative to 285 patients (6.2 per
      cent of the whole population of inpatients in 1995 and 3.1 per cent of stays in
      1995). The total cost to treat ADRs was 1.7 per cent of the total budget of the
      hospital with a median cost of 8517 francs (mean cost: 13,271 +/- 15,330 francs).
      The highest cost was due to medical staff, blood transfusions, and anti
      infectious drugs, despite the use of prophylactic agents. These results emphasize
      the high incidence and excess costs of ADRs related to anticancer chemotherapy.

PMID- 11201980
TI  - [Attitude of the clinican toward adverse effects of protease inhibitors].
AB  - Since 1996, marketing of new drugs called protease inhibitors has revolutionized
      the treatment of patients suffering from AIDS. The side-effects of this new
      therapeutic family are quite well known but we wanted to evaluate the attitude of
      the clinician: can these adverse effects be corrected by symptomatic treatment,
      do they regress spontaneously or do they lead to an alternative PI therapy? We
      therefore carried out a retrospective survey in the Infectious Diseases
      Department of Poitiers Hospital consisting in research on files of patients (n =
      70) treated in this department (hospitalization and consultation) for any
      clinical or biological abnormality attributable to the PI. For each drug we
      determined what sort of side-effects could be found and the position adopted by
      the clinician. For 30 patients the PI was stopped and for 21 of these cases
      because of drug toxicity (gastrointestinal, neurological, renal and metabolic
      effects). The biological anomalies are quite well tolerated and regress
      spontaneously in most cases.

PMID- 11201981
TI  - [Interstitial nephropathy with intracellular pigment deposits and chronic
      bisacodyl abuse].

PMID- 11201982
TI  - Inappropriate antidiuretic hormone secretion and rhabdomyolysis associated with
      citalopram.

PMID- 11201983
TI  - [Arthralgia associated with mirtazapine].

PMID- 11201984
TI  - Mirtazapine and restless leg syndrome: a case report.

PMID- 11201985
TI  - Evaluation of vascular injury with proinflammatory cytokines, thrombomodulin and
      fibronectin in patients with primary fibromyalgia.
AB  - OBJECTIVE: Cold intolerance, cold induced peripheral vasospasm, Raynaud's
      phenomenon, livedo reticularis and immunoglobulin deposition in the skin are
      often encountered clinical and laboratory findings in patients with primary
      fibromyalgia (FM). These findings are suggestive of vascular injury. METHODS:
      Eighty patients (4 male, 76 female) with fulfilling primary FM criteria (FM (+)
      patient group), 60 patients (3 male, 57 female) with chronic musculoskeletal
      complaints but without FM (FM (-) patient control group) and 40 healthy
      volunteers (1 male, 39 female) without musculoskeletal complaints (healthy
      control group) were enrolled in this cross-sectional study. The study was carried
      out in two steps. In the first step, the clinical findings, routine laboratory
      tests, autoantibodies and radiological findings were investigated. The second
      step were consisted of the laboratory investigations of thrombomodulin and
      fibronectin as the mediators indicating vascular injury and proinflammatory
      cytokines in FM patients with Raynaud's phenomenon and/or livedo reticularis and
      in control groups. RESULTS: There were no differences between study and control
      groups with regard to laboratory, radiological and immunological (ANA, AntidsDNA,
      ENA, anticardiolipin IgG and IgM) results. No statistically significant
      differences were found in the levels of proinflammatory cytokines between FM (+)
      patient group and control groups (p > 0.05). Thrombomodulin was also shown
      statistically insignificant difference between FM (+) patient group and control
      groups (p > 0.05). However, fibronectin, another mediator of vascular injury, was
      higher in FM (+) patient group and the differences between FM (+) patients and
      each control groups were statistically significant (p < 0.0001). CONCLUSION: Our
      results were suggestive of the presence of a non-immunological vascular injury in
      FM patients with Raynaud's phenomenon and/or livedo reticularis.

PMID- 11201986
TI  - Severe disseminated BCG infection in an 8-year-old girl.
AB  - An 8-year-old girl died of sepsis due to staphylococcal infection one year and 8
      months after Bacille Calmette-Guerin (BCG) revaccination. Two months after the
      vaccination in accordance with the school health program, she was hospitalized
      with a high fever, skin rash over the face and lower limbs, and leukopenia. Her
      clinical and laboratory pictures were not compatible with those of any
      established type of immunodeficiency. The polymerase chain reaction (PCR) test
      for M. tuberculosis complex was positive for bone marrow, pleural fluid, and
      peripheral blood. The strain recovered from a mycobacterial culture of the blood
      was identical to the BCG strains with which the patient was vaccinated, based on
      restriction fragment length polymorphism (RFLP) and a pulse-field gel
      electrophoresis (PFGE) analyses of DNA. She developed finally a lung abscess due
      to staphylococcal septicemia, which was the direct cause of her death.

PMID- 11201987
TI  - Combined effect of docetaxel and cisplatin for non-small cell lung cancer cell
      lines in vitro.
AB  - Docetaxel (DOC) plus cisplatin (CDDP) is a novel combination chemotherapy for the
      treatment of advanced non-small-cell lung cancer (NSCLC). We investigated the
      combined effect of DOC with CDDP in sequence and the reverse schedule for NSCLC
      cell lines EBC-1 (squamous cell carcinoma) and RERF-LC-MS (adenocarcinoma) using
      an MTT assay and an improved isobologram method. The results showed that the
      combination of DOC and CDDP in human lung cancer cell lines was antagonistic. To
      investigate the possible mechanism of the antagonistic effect, we focused on the
      cell cycle perturbation and the inhibition of apoptosis fractions induced by
      chemotherapeutic agents. Pretreatment of CDDP significantly blocked the following
      DOC-induced apoptosis fraction. Therefore we consider that the suppression of
      apoptosis could be one of the mechanisms for antagonistic effects of combination
      chemotherapy of DOC and CDDP.

PMID- 11201988
TI  - Contact dermatitis.

PMID- 11201989
TI  - Pathogenesis and the role of Ca2+ overload during myocardial
      ischemia/reperfusion.
AB  - To study the regulation of [Na+]i and [Ca2+]i during myocardial
      ischemia/reperfusion, [Na+]i and [Ca2+]i were measured simultaneously using
      guinea pig ventricular myocytes which were dual-loaded with SBFI/AM and fluo
      3/AM. It was suggested that: (1) [Na+]i increased during metabolic inhibition
      (MI: 3.3 mM amytal and 5 microM CCCP) by both the activated Na+ influx via Na+/H+
      exchange and the suppressed Na+ extrusion via the Na+/K+ pump; (2) Na+/Ca2+
      exchange was inhibited during MI, causing the dissociation between [Na+]i and
      [Ca2+]i; (3) Na+/Ca2+ exchange could be reactivated by energy repletion,
      resulting in a significant increase in [Ca2+], Furthermore, a Ca2+ influx via the
      reverse-mode of Na+/Ca2+ exchange may play a key role in the mechanism of Ca2+
      overload on reoxygenation; and (4) cell contracture during MI was related to
      rigor due to energy depletion, while cell contracture after energy repletion was
      likely to be related to Ca2+ overload.

PMID- 11201990
TI  - Characterization of the human DNA polymerase delta catalytic subunit expressed by
      a recombinant baculovirus.
AB  - The catalytic subunit of human DNA polymerase (pol) delta, p125, was expressed in
      recombinant baculovirus-infected insect cells, separated from a baculovirus
      encoded DNA polymerase, and was purified to homogeneity by affinity trapping with
      a histidine-octapeptide at the C-terminus of p125 as the ligand. Purified p125
      showed DNA polymerase activity resembling conventionally purified calf thymus pol
      delta. However, the two differed in four ways: 1) the specific activity of
      recombinant p125 was one quarter of the calf thymus pol delta; 2) the recombinant
      p125 was relatively resistant to aphidicolin; 3) the apparent Km for dTTP of the
      recombinant p125 was estimated at 33 microM, 15-fold the value for calf thymus
      pol delta; and 4) the recombinant p125 was not stimulated by recombinant PCNA,
      while activity of calf thymus pol delta increased 150-fold in response.
      Furthermore, PCNA did not stimulate either the p125 incubated with p50, a small
      subunit of pol delta, or co-expressed with p50 in insect cells. The full length
      recombinant p125 migrated slightly faster than pol delta from human cell lines,
      Jurkat or HeLa, upon SDS-polyacrylamide gel electrophoresis, suggesting a post
      translational modification. The results indicate that in vivo assembly of the
      fully active complex of pol delta requires factors in addition to p125 and p50
      subunits, and/or a post-translational modification of p125.

PMID- 11201991
TI  - Fatty acid analysis of blood plasma of patients with Alzheimer's disease, other
      types of dementia, and cognitive impairment.
AB  - Fatty acid differences, including docosahexaenoic acid (DHA; 22:6n-3) have been
      shown in the brains of Alzheimer's patients (AD) as compared with normal age
      matched individuals. Furthermore, low serum DHA is a significant risk factor for
      the development of AD. The relative concentration of DHA and other fatty acids,
      however, in the plasma of AD patients compared with patients with other kinds of
      dementias (other dementias; OD), patients who are cognitively impaired but
      nondemented (CIND), or normal patients is not known. In this study we analyzed
      the total phospholipid, phosphatidylcholine (PC), phosphatidylethanolamine (PE),
      and lysophosphatidylcholine (lysoPC) fractions of plasma from patients diagnosed
      with AD, OD, or CIND and compared them with a group of elderly control subjects
      with normal cognitive functioning. Plasma phospholipid and PC levels of 20:5n-3,
      DHA, total n-3 fatty acids, and the n-3/n-6 ratio were lower in the AD, OD, and
      CIND groups. Plasma phospholipid 24:0 was lower in the AD, OD, and CIND groups as
      compared with the group of control patients, and total n-6 fatty acid levels were
      higher in the AD and CIND groups only. In the plasma PE fraction, levels of 20:5n
      3, DHA, and the total n-3 fatty acid levels were significantly lower in the AD,
      OD, and CIND groups. DHA levels were lower in the lysoPC fraction of CIND
      individuals only. There were no other differences in the fatty acid compositions
      of the different phospholipid fractions. Therefore, in AD, OD, and CIND
      individuals, low levels of n-3 fatty acids in the plasma may be a risk factor for
      cognitive impairment and/or dementia. Interestingly, a decreased level of plasma
      DHA was not limited to the AD patients but appears to be common in cognitive
      impairment with aging.

PMID- 11201992
TI  - In vivo evaluation of the effects of continuous exercise on skeletal muscle
      triglycerides in trained humans.
AB  - Magnetic resonance spectroscopy (1H MRS) and imaging (MRI) were used to
      investigate the effects of a bout of moderate prolonged exercise on intra (IMCL)-
      and extramyocellular lipid (EMCL) utilization in the soleus, tibialis anterior,
      and gastrocnemius muscles of five trained human subjects. MRI and 1H MRS
      measurements were obtained before and after a 90 min run on a calibrated
      treadmill at a velocity corresponding to 64 +/- 1.5% of each subjects' maximal
      rate of oxygen consumption. There were significant decreases in IMCL following
      exercise in the tibialis (pre: 22.37 +/- 4.33 vs. post: 15.16 +/- 3.25 mmol/kg
      dry wt; P < 0.01) and soleus (pre: 36.93 +/- 1.45 vs. post: 29.85 +/- 2.44
      mmol/kg dry wt; P < 0.01) muscles. There was also a decrease in the gastrocnemius
      muscle, although this did not reach the level of significance (pre: 33.78 +/-
      5.35 vs. post: 28.48 +/- 5.44 mmol/kg dry weight; P < 0.10). No significant
      changes were observed in EMCL or subcutaneous fat. In conclusion, this study
      showed that IMCL were significantly utilized in the tibialis and soleus muscles
      of aerobically endurance-trained humans. The absence of significant utilization
      of IMCL in the gastrocnemius may reflect differences in fiber type and/or
      intensity of contraction for each muscle group.

PMID- 11201993
TI  - Linoleic acid metabolism in the spontaneously diabetic rat: delta6-desaturase
      activity vs. product/precursor ratios.
AB  - The activity of delta6-desaturase of linoleic acid, a rate-limiting step in the
      formation of arachidonic acid, is decreased in animal models of severe,
      uncontrolled diabetes. The aim of the study was to measure the activity of liver
      microsomal delta6-desaturase of spontaneously diabetic BioBreeding/Edinburgh rats
      receiving subcutaneous insulin daily and of genetically related nondiabetic
      animals. The activity of delta6-desaturase was then compared with indices of
      activity (plasma lipid fatty acid product/precursor ratios) frequently used in
      human studies. Diabetic rats treated with insulin had 75 +/- 8% of the activity
      of microsomal delta6-desaturase of nondiabetic controls (P < 0.05). Insulin
      withdrawal tended to reduce the activity further (61% of control), although the
      activity did not differ from insulin-treated diabetic rats. The ratio of plasma
      phospholipid or cholesteryl ester gamma-linolenic over linoleic acid was not
      decreased in insulin-treated diabetic rats. By contrast, the ratio of gamma
      linolenic over linoleic acid of microsomes was almost three-fold higher in
      insulin-treated diabetic rats (P < 0.05). The gamma-linolenic over linoleic acid
      ratio as an index of activity gave inconsistent results in insulin-deprived rats.
      The ratio of gamma-linolenic over linoleic acid of cholesteryl esters did not
      differ between control and diabetic rats, nor did it correlate with microsomal
      delta6-desaturase activity. Furthermore, the index of delta6-desaturase activity,
      derived from the fatty acid composition of microsomal phospholipids, did not
      correlate with microsomal delta6-desaturase activity. Diabetes, even when
      controlled by regular insulin injections, reduces the metabolism of linoleic
      acid, but the effect is less than previously published. The fatty acid
      compositions of plasma and liver microsomal lipids are not reliable indices of
      delta6-desaturase activity in diabetes.

PMID- 11201994
TI  - Hepatic microsomal and peroxisomal docosahexaenoate biosynthesis during piglet
      development.
AB  - The roles of peroxisomes and microsomes on the biosynthetic pathway for
      docosahexaenoic acid (DHA) from alpha-linolenic acid (ALA) were investigated.
      Microsomes and peroxisomes were prepared from livers of fetal and neonatal
      piglets by a combination of differential and gradient layer centrifugation.
      Microsomes, peroxisomes, and combined cell fractions were incubated with [13C
      U]18:3n-3. The [M] and [M + 18] isotopomers of the fatty acids in the long-chain
      polyunsaturated fatty acid (LCPUFA) n-3 pathway were detected by gas
      chromatography-mass spectrometry. The quantity of each fatty acid was determined
      by gas chromatography, and synthesis of each fatty acid was calculated for a 30
      min period. Synthesis of DHA was not detected in combined fetal liver fractions.
      The data suggest that DHA in the fetus is probably supplied from maternal sources
      through the placenta. In either singly incubated microsomal or peroxisomal
      preparations from neonatal livers, no DHA synthesis was detected. After
      combination of the microsomal and peroxisomal fractions, DHA synthesis was
      evident and increased rapidly between birth and 2 wk of age. This is the first
      demonstration of the entire biosynthetic LCPUFA n-3 pathway in subcellular
      organelles starting from isotopically labeled ALA to the final product, DHA, with
      all the intermediates present and isotopically labeled. The primary importance of
      the data is that it unequivocally demonstrates that peroxisomes are required for
      biosynthesis of DHA from ALA.

PMID- 11201995
TI  - Dietary cholesterol induces changes in molecular species of hepatic microsomal
      phosphatidylcholine.
AB  - After 21 days on a diet containing 1 g% cholesterol and 0.5 g% cholic acid, rats
      had an increased content of cholesterol in liver microsomal lipids. In liver,
      both cholesterol content and delta9 desaturase activity increased, whereas delta6
      and delta5 desaturase activities decreased. These changes correlated with
      increases in oleic, palmitoleic, and linoleic acids and decreases in arachidonic
      and docosahexenoic acids in total microsomal lipids. Similar fatty acid changes
      were found in phosphatidylcholine (PC), the principal lipid of the microsomal
      membrane. In PC the predominant molecular fatty acid species (67% of the total)
      in the control rats were 18:0/20:4, 16:0/20:4, and 16:0/18:2; and they mainly
      determined the contribution of PC to the biophysical and biochemical properties
      of the phospholipid bilayer. The cholesterol diet decreased specifically the
      18:0/20:4 species, and to a lesser extent, 16:0/20:4 and 18:0/22:6. The 18:1
      containing species, especially 18:1/18:2 and less so 16:0/18:1 and 18:1/20:4,
      were increased. A new 18:1/18:1 species appeared. The independent effects of the
      presence of cholesterol and change of the fatty acid composition of the
      phospholipid bilayer of liver microsomes on the packing were studied by
      fluorescence methods using 6-lauroyl-2,4-dimethylaminonaphthalene, 1,6-diphenyl
      1,3,5-hexatriene and 1-(4-trimethylammonium phenyl)-6-phenyl-1,3,5-hexatriene,
      which test different parameters and depths of the bilayer. Data showed that the
      increase of cholesterol in the membrane, and not the change of the fatty acid
      composition of phospholipids, was the main determinant of the increased bulk
      packing of the bilayer. The increase of fluid oleic- and linoleic-containing
      species almost compensated for the drop in 20:4- and 22:6-containing molecules.
      But the most important effect was that the general drop in essential n-6 and n-3
      polyunsaturated fatty acids meant that this endogenous source for the needs of
      the animal decreased.

PMID- 11201997
TI  - Kinetics of 2-monoacylglycerol acyl migration in model chylomicra.
AB  - In the metabolism of triacylglycerol (TG)-rich lipoproteins, 2-monoacylglycerols
      (2-MG) are produced by lipoprotein lipase (LPL) hydrolysis of TG. The metabolic
      fate of 2-MG is not known with certainty. 2-MG that accumulate on the chylomicra
      surface have been proposed to isomerize spontaneously to 1(3)-MG, which are then
      hydrolyzed by LPL to free fatty acids and glycerol. In this study the rate and
      the effect of acyl chain saturation on the spontaneous acyl migration of 2-MG in
      in vitro model chylomicra emulsions were determined. After 1 h of incubation at
      37 degrees C, less than 20% of 2-monoolein (2-MO) or 2-monopalmitin (2-MP)
      spontaneously isomerized to 1(3)-MO or 1(3)-MP, respectively. Accordingly, it was
      concluded that spontaneous isomerization of 2-MG is not the major mechanism for 2
      MG metabolism post-TG hydrolysis in chylomicra. Isomerization rates, expressed as
      decrease in percentage of 2-MG remaining per hour, were -5.12 and -5.86 in water,
      and -0.43 and -0.41 in hexane for 2-MO and 2-MP, respectively. There was no
      significant difference between the isomerization rates of 2-MO and 2-MP. Thus, in
      the present study, saturation of the MG acyl chain did not influence spontaneous
      acyl migration in either water or hexane, but isomerization of 2-MG was faster in
      water than in hexane.

PMID- 11201996
TI  - Effect of medium-chain fatty acid positional distribution in dietary
      triacylglycerol on lymphatic lipid transport and chylomicron composition in rats.
AB  - The present study was carried out to examine if the positional distribution of
      medium-chain fatty acid (MCF) in dietary synthetic fat influences lymphatic
      transport of dietary fat and the chemical composition of chylomicrons in rats
      with permanent cannulation of thoracic duct. Four types of synthetic
      triacylglycerol were prepared: (i) sn-1 (3) MCF-sn 2 linoleic acid, (ii)
      interesterified sn-1(3) MCF-sn 2 linoleic acid, (iii) sn-2 MCF-sn-1(3) linoleic
      acid, and (iv) interesterified sn-2 MCF-sn-1(3) linoleic acid. A purified diet
      composed of equal amounts of the synthetic fat and cocoa butter was given to rats
      with permanent lymph duct cannulation. The positional distribution of MCF in the
      dietary fat had no significant effect on the lymph flow, triacylglycerol output,
      phospholipid output, lipid composition of chylomicrons, or the particle size. The
      positional distribution of MCF in the synthetic triacylglycerol was maintained in
      the chylomicron triacylglycerol. These results showed that MCF in the dietary
      triacylglycerol is transported into lymphatics and the positional distribution is
      well preserved in chylomicron triacylglycerol.

PMID- 11201998
TI  - Purification, characterization, and molecular cloning of group I phospholipases
      A2 from the gills of the red sea bream, Pagrus major.
AB  - Phospholipase A2 (PLA2) activity was investigated in various tissues of male and
      female red sea bream. In both male and female fishes, the specific activity of
      PLA2 in the gills was 70 times higher than that in other tissues, such as the
      adipose tissue, intestine, and hepatopancreas. Therefore, we tried to purify PLA2
      from the gill filaments of red sea bream to near homogeneity by sequential
      chromatography on Q-Sepharose Fast Flow, Butyl-Cellulofine, and DEAE-Sepharose
      Fast Flow columns, and by reversed-phase high-performance liquid chromatography.
      Two minor and one major PLA2, tentatively named G-1, G-2 and G-3 PLA2, were
      purified, and all showed a single band with an apparent molecular mass of
      approximately 15 kDa by sodium dodecylsulfate-polyacrylamide gel electrophoresis.
      The exact molecular mass values of G-1, G-2, and G-3 PLA2 were 14,040, 14,040 and
      14,005 Da, respectively. G-1, G-2, and G-3 PLA2 had a Cys 11 and were all
      identical in N-terminal amino acid sequences from Ala-1 to Glu-56. A full-length
      cDNA encoding G-3 PLA2 was cloned by reverse transcriptase-polymerase chain
      reaction and rapid amplification of cDNA ends methods, and G-3 PLA2 was found to
      be classified to group IB PLA2 from the deduced amino acid sequence. G-1, G-2,
      and G-3 PLA2 had a pH optimum in an alkaline region at around pH 9-10 and
      required Ca2+ essentially for enzyme activity, using a mixed-micellar
      phosphatidylcholine substrate with sodium cholate. These results demonstrate that
      three group I PLA2, G-1, G-2, and G-3 PLA2, are expressed in the gill filaments
      of red sea bream.

PMID- 11201999
TI  - Unusual lipid composition of a Bacillus sp. isolated from Lake Pomorie in
      Bulgaria.
AB  - The lipid composition of a Bacillus sp., isolated from Lake Pomorie in Bulgaria,
      was unusual and consisted of 26 different fatty acids between C12 and C26, with
      anteiso C15-C17 saturated fatty acids predominating. The furan fatty acid, 10,13
      epoxy-11-methyloctadeca-10,12-dienoic acid, was also identified, a new finding
      for this genus. The hydrocarbons consisted of 30 different monounsaturated
      hydrocarbons, between C25 and C30, with the iso-iso, iso-anteiso, anteiso
      anteiso, iso-normal, and anteiso-normal methyl branching for odd-numbered chains,
      and the iso-iso, iso-anteiso, iso-normal, and anteiso-normal methyl branching for
      even-numbered chains. The double bond positions in these hydrocarbons were
      determined by dimethyl disulfide derivatization followed by GC-MS, and the double
      bond cis configuration was confirmed by infrared spectroscopy. Some previously
      unknown hydrocarbons in bacteria, such as (Z)-3,21-dimethyl-9-tricosene, (Z)-3,21
      dimethyl-10-tricosene, (Z)-2,24-dimethyl-11-pentacosene, and (Z)-2,25-dimethyl-13
      hexacosene were identified. Sterols were detected and were based on the
      sitosterol nucleus.

PMID- 11202000
TI  - Electron microscopy may reveal structure of docosahexaenoic acid-rich oil within
      Schizochytrium sp.
AB  - Schizochytrium sp. is an algae-like microorganism utilized for commercial
      production of docosahexaenoic acid (DHA)-rich oil and dried microalgae for use as
      a source of DHA in foods, feeds, and nutritional supplements. Electron
      microscopic analysis of whole cells of Schizochytrium sp. employing sample
      preparation by high-pressure freeze substitution suggests the presence of
      secondary and tertiary semicrystalline structures of triacylglycerols within the
      oil bodies in Schizochytrium sp. A fine secondary structure consisting of
      alternating light- and dark-staining bands was observed inside the oil bodies.
      Dark bands were 29 +/- 1 A in width, and light bands were 22 +/- 1 A in width.
      The tertiary (three-dimensional) structure may be a multilayered ribbon-like
      structure which appears coiled and interlaced within the oil body. In freeze
      fracture photomicrographs, Schizochytrium oil bodies exhibited fracture planes
      with terraces averaging 52 +/- 7 A in height which could correspond to the
      combined width of two halves of two light bands and one dark band observed in the
      high-pressure freeze substitution photomicrographs. The results suggest that
      triacylglycerols within Schizochytrium sp. oil bodies may be organized in a
      triple chain-length structure. High-pressure freeze substitution electron
      micrographs of two other highly unsaturated oil-producing species of microalgae,
      Thraustochytrium sp. and Isochrysis galbana, also revealed this fine structure,
      whereas microalgae containing a higher proportion of saturated oil did not. The
      results suggest that the staining pattern is not an artifact of preparation and
      that the triple chain-length conformation of triacylglycerols in Schizochytrium
      sp. oil bodies may be caused by the unique fatty acid composition of the
      triacylglycerols.

PMID- 11202001
TI  - Lipid class composition of the protozoan Perkinsus marinus, an oyster parasite,
      and its metabolism of a fluorescent phosphatidylcholine analog.
AB  - Perkinsus marinus is one of two important protozoan parasites of the eastern
      oyster, Crassostrea virginica. The other is Haplosporidium nelsoni. Lipids
      extracted from 7-d-old in vitro cultured P. marinus meronts, incubated with
      fluorescent-labeled phosphatidylcholine (FL PC) and nonincubated P. marinus
      meronts, were analyzed by a high-performance liquid chromatography (HPLC) system
      equipped with a diol phase column, in combination with thin-layer chromatography
      coupled with a flame-ionization detector (TLC/FID), and high-performance thin
      layer chromatography (HPTLC). Various polar and neutral lipid classes were
      separated by HPLC using a two-gradient solvent system. Five polar lipid classes-
      phosphatidylcholine (PC), phosphatidylethanolamine (PE), cardiolipin (CL),
      sphingomyelin (SM), and phosphatidylserine (PS)--were identified from P. marinus
      extracts. Four neutral lipid classes--triacylglycerol (TAG), steryl ester (SE),
      cholesterol (CHO), and fatty alcohol--were distinguished. TLC/FID analysis of
      meront lipids showed that the weight percentages of PC, PE, CL, SM, PS/PI, TAG,
      SE, and CHO were 21, 10.7, 4, 2.3, 4.3, 48.7, 7.8, and 1.2%, respectively. HPLC
      and HPTLC analyses revealed the presence of two SM and PS isomers in P. marinus
      extracts. Perkinsus marinus effectively incorporated FL PC acquired from the
      medium and metabolized it to various components (i.e., free fatty acid,
      monoacylglycerol, diacylglycerol, TAG, PE, and CL). Uptake and interconversion of
      FL PC in P. marinus meronts increased with time. After 48 h the total uptake of
      fluorescence (FL) was 28.9% of the FL PC added to the medium, and 43% of the
      incorporated FL resided in TAG.

PMID- 11202002
TI  - Properties of a fluorescent bezafibrate derivative (DNS-X). A new tool to study
      peroxisome proliferation and fatty acid beta-oxidation.
AB  - The first peroxisome proliferator-activated receptor (PPAR) was cloned in 1990 by
      Issemann and Green. Many studies have reported the importance of this receptor in
      the control of gene expression of enzymes involved in lipid metabolic pathways
      including mitochondrial and peroxisomal fatty acid beta-oxidation, lipoprotein
      structure [apolipoprotein (apo) A2, apo CIII], and fatty acid synthase. By using
      radiolabeled molecules, it was shown that peroxisome proliferators bind and
      activate PPAR. As an alternative method, we developed a fluorescent dansyl (1
      dimethylaminonaphthalene-5-sulfonyl) derivative peroxisome proliferator from
      bezafibrate (DNS-X), a hypolipidemic agent that exhibits an in vitro peroxisome
      proliferative activity on rat Fao-hepatic derived cultured cells. However, until
      now, the effect of this new compound on the liver of animals and subcellular
      localization was unknown. In addition to in vivo rat studies, we present a more
      efficient large-scale technique of DNS-X purification. Treating rats (DNS-X in
      the diet at 0.3% w/w) for 6 d leads to a hepatomegaly and a marked increase in
      liver peroxisomal palmitoyl-CoA oxidase activity. We also developed a method to
      localize and quantify DNS-X in tissues or cell compartment organelles. The
      primarily cytosolic distribution of DNS-X was confirmed by direct visualization
      using fluorescence microscopy of cultured Fao cells. Finally, transfection assay
      demonstrated that DNS-X enhanced the PPAR alpha activity as well as other
      peroxisome proliferators do.

PMID- 11202003
TI  - Analysis of the addition products of alpha-tocopherol with phosphatidylcholine
      peroxyl radicals by high-performance liquid chromatography with chemiluminescent
      detection.
AB  - A chemiluminescence-based high-performance liquid chromatographic method was
      developed for the analysis of the addition products of alpha-tocopherol with
      phosphatidylcholine-peroxyl radicals (TOO-PC). The TOO-PC eluted from a reversed
      phase column was reacted with a chemiluminescent reagent consisting of a
      Cypridina luciferin analog and a lipid-soluble iron chelate in acidic methanol at
      50 degrees C, and the generated chemiluminescence was monitored. The detection
      limit for TOO-PC by this method was about 1 pmol. This method was applied to the
      detection of TOO-PC in the peroxidized membranes prepared from rabbit erythrocyte
      ghosts. When the erythrocyte ghosts were peroxidized by the addition of a water
      soluble free radical initiator, a peak corresponding to TOO-PC was detected on
      the chromatogram with chemiluminescent detection. The amount of TOO-PC in the
      erythrocyte membranes increased with the depletion of endogenous alpha
      tocopherol. The results indicate that this method proved useful for the detection
      of the TOO-PC formed by the peroxyl-radical scavenging reactions of alpha
      tocopherol in biological systems.

PMID- 11202004
TI  - Protective effect of phytic acid hydrolysis products on iron-induced lipid
      peroxidation of liposomal membranes.
AB  - Beneficial effects of dietary phytic acid (myo-inositol hexaphosphate; IP6) have
      often been explained by its strong iron ion-chelating ability, which possibly
      suppresses iron ion-induced oxidative damage in the gastrointestinal tract.
      Because phytic acid is hydrolyzed during digestion, this work aimed to know
      whether its hydrolysis products (IP2, IP3, IP4, and IP5) could still prevent iron
      ion-induced lipid peroxidation. Studies using liposomal membranes demonstrated
      that hydrolysis products containing three or more phosphate groups are able to
      inhibit iron ion-induced lipid peroxidation although their effectiveness
      decreased with dephosphorylation. Similarly, they also prevented iron ion-induced
      decomposition of phosphatidylcholine hydroperoxide. These results demonstrate
      that intermediate products of phytic acid hydrolysis still possess iron ion
      chelating ability, and thus they can probably prevent iron ion-induced lipid
      peroxidation in biological systems.

PMID- 11202005
TI  - A place in history: Paul Broca and cerebral localization.

PMID- 11202006
TI  - Liver bridging techniques in the treatment of acute liver failure.
AB  - The introduction of orthotopic liver transplantation in the management of acute
      liver failure has dramatically increased the survival rates of patients at the
      cost of removing the patient's native liver and life-long dependence on
      immunosuppression. However, it is well known that in many patients with acute
      liver failure the diseased liver has the potential to recover. Death in these
      patients is often due to increased intra-cranial pressure or infection. Liver
      bridging techniques are assigned to temporarily provide liver function and enable
      the native liver to recover in patients with acute liver failure. They represent
      an attractive alternative to conventional liver transplantation in the management
      of acute liver failure, since after recovery of the native liver the patient is
      freed from immuno-suppression with all associated side-effects and risks.
      Auxiliary liver transplantation, artificial liver support devices and hepatocyte
      transplantation represent different ways of bridging liver function in acute
      liver failure. The aim of this review is to present the ideas and principles of
      these three different liver bridging techniques. We will discuss the relative
      importance and the future potential of theses bridging techniques in the
      treatment of acute liver failure by comparing the experimental and clinical
      results.

PMID- 11202007
TI  - A new clamping technique for biomechanical testing of tendons in small animals.
      aprobst@uni-muenster.de.
AB  - When biomechanical properties of tendons are studied, the technique of clamping
      the tendons in the testing machine presents a methodological challenge,
      especially when murine tendons are examined. These short tendons tend to rupture
      at the transition line to the fixation, leading to false interpretations.
      Therefore a new clamping technique for investigation of healthy murine Achilles
      tendons (n = 50) was developed, in which the intramuscular tendon fibers were
      fixed between two paper strips and the calcaneus was wedged into a conical slot
      in a wooden block and then mounted in the testing machine (n = 20). This
      technique was compared with the conventional clamping technique that fixes both
      ends of the tendon by clamps (n = 15) and an earlier described method that used
      glue or plastic cement for the fixation of the intramuscular tendon fibers and
      calcaneus in the testing machine (n = 15). When tested by the new clamping
      technique, 17 tendons ruptured intratendinously at a mean tensile force of 8.4 +/
      1.1 N. Three Achilles tendons (17%) tore at the site of paper fixation and had
      to be excluded from investigation. Data from 73% of the measurements fixed by
      gluing had to be excluded because slippage of the proximal tendon fibers and
      contamination of the tendon with glue occurred. All the conventionally clamped
      tendons ruptured at the site of fixation at a mean tensile force of 6.1 +/- 2.3 N
      (p < .05). This was 30% lower than with the new clamping technique. Thus, the
      newly developed clamping technique enables investigators to obtain more valid
      biomechanical studies of the murine Achilles tendon.

PMID- 11202008
TI  - A comparison of collagen and PTFE patch repair in a rabbit model of congenital
      diaphragmatic hernia.
AB  - The use of prosthetic material in severe cases of congenital diaphragmatic hernia
      is complicated by infection, bowel adhesion, and patch dehiscence. We
      hypothesized that a bioprosthetic collagen patch would reduce these complications
      and be remodeled into autogenous tissue over a short period of time. Thirty-two
      New Zealand White rabbits had two 2 x 2-cm left diaphragmatic defects created.
      One of these defects was repaired with a collagen bioprosthetic patch (n = 20)
      and the other with a polytetrafluoroethylene (PTFE) patch (n = 20). Members of a
      control group (n = 12) had their defects closed primarily. The animals were then
      placed in either a 6- or 12-week survival cohort. At necrosectomy the repairs
      were assessed histologically, graded for adhesion formation, and tensiometrically
      tested. The PTFE patch was noted to have a significantly higher average adhesion
      grade than the collagen patch. The tensile strength of the two repair methods was
      statistically equivalent at both time intervals. On histologic examination the
      collagen patches were surrounded by an increased number of macrophages and
      fibroblasts. The PTFE patch exhibited no neovascularization or fibroblast
      deposition at the periphery, but had a much greater surrounding inflammatory
      response. Thus, there was evidence of early remodeling of the collagen with no
      increase in the amount of adhesions or loss of strength when compared to the
      PTFE, while the PTFE patches exhibited a more severe grade of adhesions.

PMID- 11202009
TI  - Experimental aortic stenosis and corresponding left ventricular hypertrophy in
      sheep.
AB  - Left ventricular hypertrophy (LVH) is an independent cardiac risk factor. A
      simple standard experimental model of inducing LVH for further studies using
      experimental aortic stenosis in sheep was performed. The aim of this study is to
      describe animal-specific requirements as well as perioperative therapy,
      postoperative care, and the use of echocardiography for routine follow-up
      examinations. Supracoronary aortic banding was performed in 55 female sheep at an
      age of 6 to 8 months. General anesthesia and an antero-lateral thoracotomy were
      used. The objective was to achieve pressure gradients of 20 to 30 mm Hg. In
      addition a 4th intercostal space rib window was created to improve
      echocardiographic vision. The operations were completed successfully in all
      animals. Intraoperatively, little severe arrhythmia occurred. During the follow
      up interval of 8 +/- 1.3 months, 8 animals died, due to incomplete perforation of
      the ascending aorta (3), chronic heart failure (2), pericardial cyst (1), and
      respiratory failure and infection (2). All remaining animals were amenable for
      further studies. Severe LVH was diagnosed with routine echocardiography on follow
      up. Thus, experimental aortic stenosis in sheep is a safe and relatively simple
      technique to generate stable LVH. Echocardiography is an easy tool for follow-up
      evaluations. Due to low complication rates, the sheep model is well suited for
      further research in LVH.

PMID- 11202010
TI  - An alternative to synthetic aortic grafts using jejunum.
AB  - Synthetic materials currently used for arterial grafts can provoke serious
      complications such as infection, rejection, and incomplete reendothelialization.
      Porcine small intestinal submucosa (SIS) allografts (homografts) may not share
      these disadvantages yet still may provide an effective graft alternative. This
      study was designed to provide additional information concerning the performance
      of this material when used as an allo-patch graft. A porcine model was selected
      to enable hemodynamic comparisons to the adult human physiology. Slaughterhouse
      small intestine was used to prepare the SIS graft material. A well-vascularized
      section ofjejunum was resected, rinsed, and maintained in 0.9% NaCl solution
      containing 10% gentamicin. The graft was prepared by removing the serosal layer,
      inverting the material, and discarding the mucosal surface in a similar manner.
      The remaining submucosa and stratum compactum constituted the graft material and
      was subdivided into sizes from 1.5 to 3.0 cm2 tacked to foil for manageability,
      and was returned to the gentamicin solution. The surgery was initiated with a
      femoral arterial line in the anesthetized swine, followed by isolation and
      preparation of the infrarenal aorta for grafting. Cross-clamps were applied and a
      1.0 x 1.5-cm section of aortic wall was resected. Two sides of allograft were
      freed from the foil and sewn into the aorta. Then the remaining sides were
      removed from the foil and final graft placement was completed. The graft was
      harvested at postoperative day 28 and presented for microscopic examination.
      Results confirmed that reendothelialization with neovascularization had occurred
      during this interval.

PMID- 11202011
TI  - Study of the effect of colonic mass movements on the rectosigmoid junction with
      evidence of colo-rectosigmoid junction reflex.
AB  - Mass movements of the left-sided colon bring the colonic material contained in it
      to the sigmoid colon. The cause why the colonic contents do not pass directly to
      the rectum but stop short of the rectosigmoid junction (RSJ) was studied. The
      study comprised 10 healthy volunteers (mean age 39.2 +/- 10.2 years; 8 men, 2
      women). A condomended tube was introduced into the descending colon (DC) per
      anum. The pressure response of the DC, sigmoid colon (SC), and RSJ to condom
      inflation with carbon dioxide (CO2) in increments of 10 ml was recorded by means
      of a three-channel microtip catheter. The responses were registered upon
      inflation of the upper, middle, and lower third of the DC. The test was repeated
      after individual anesthetization of the descending colon and the RSJ on separate
      days. Colonic distension with 10 and 20 ml CO2 produced no significant pressure
      changes in the DC, SC, and RSJ (p > .05); 30 ml distension effected a pressure
      rise in both the DC (p < .01) and RSJ (p < .05), but no change in the SC pressure
      (p > .05); and 40, 50, and 60 ml distension produced pressure changes similar to
      those obtained with 30 ml distension. The RSJ pressure responded to distension of
      the saline-injected but not of the anesthetized DC. Thus, the RSJ response to
      colonic distension affirms the hypothesis of the possible involvement of a
      reflex, which we term colo-RSJ reflex. This reflex seems to regulate the passage
      of stools from the colon to the rectum. Further studies are required to
      investigate its role in the diagnosis of defecation disorders.

PMID- 11202012
TI  - Development of a human to murine orthotopic xenotransplanted lung cancer model.
AB  - The goal was to develop a clinically relevant animal model that could be used to
      assess the efficacy of therapeutic interventions in lung cancer. Two cell lines,
      noncancerous control (BEAS2-B, immortalized human bronchial-epithelial cell line)
      and cancerous (BZR-T33, H-ras transformed BEAS2-B) were implanted into nude
      (athymic) mice. Two groups (n = 10 each) received dorsoscapular subcutaneous
      injection of 10(6) cells from either cell line. BEAS2-B cells were
      nontumorigenic, whereas mice with BZR-T33 cells had tumors (9,510 +/- 4,307 mm3)
      confirmed by histology, and a significantly smaller body weight (BZR-T33, 28.5 +/
      0.49 vs. BEAS2-B, 30.7 +/- 0.75 g, p < .05). The next phase evaluated
      invasion/metastasis. Two groups (n = 10 each) received 10(6) cells from either
      cell line injected into tail veins. Animals receiving BZR-T33 cells had a smaller
      body weight, palpable lung masses (67%), obvious tail masses (44%), and average
      tumor burden (1,120 +/- 115 mm3), and histology revealed invasion of lung tissue
      and interstitial hemorrhage. In development of the orthotopic xenotransplanted
      model, mice (2 groups, n = 10 each) received 10(6) cells from either cell line
      implanted into the lungs through a tracheotomy. Animals with BZR-T33 cells did
      not survive past 59 days and had a smaller body weight, increased lung weight,
      lung masses (100%), and metastatic loci (30%). Magnetic resonance imaging (MRI)
      confirmed the presence of masses in intubated live mice, later confirmed by
      histology. In summary, the H-ras transfected cell line developed lung masses
      following tail-vein injection and endotracheal seeding. Evaluation by MRI allows
      for a comprehensive model with significant potential in the study of lung cancer.

PMID- 11202014
TI  - Glycoprotein folding in the endoplasmic reticulum.
AB  - Our understanding of eukaryotic protein folding in the endoplasmic reticulum has
      increased enormously over the last 5 years. In this review, we summarize some of
      the major research themes that have captivated researchers in this field during
      the last years of the 20th century. We follow the path of a typical protein as it
      emerges from the ribosome and enters the reticular environment. While many of
      these events are shared between different polypeptide chains, we highlight some
      of the numerous differences between proteins, between cell types, and between the
      chaperones utilized by different ER glycoproteins. Finally, we consider the
      likely advances in this field as the new century unfolds and we address the
      prospect of a unified understanding of how protein folding, degradation, and
      translation are coordinated within a cell.

PMID- 11202013
TI  - Nucleotide pyrophosphatases/phosphodiesterases on the move.
AB  - Nucleotide pyrophosphatases/phosphodiesterases (NPPs) release nucleoside 5'
      monophosphates from nucleotides and their derivatives. They exist both as
      membrane proteins, with an extracellular active site, and as soluble proteins in
      body fluids. The only well-characterized NPPs are the mammalian ecto-enzymes NPP1
      (PC-1), NPP2 (autotaxin) and NPP3 (B10; gp130(RB13-6)). These are modular
      proteins consisting of a short N-terminal intracellular domain, a single
      transmembrane domain, two somatomedin-B-like domains, a catalytic domain, and a C
      terminal nuclease-like domain. The catalytic domain of NPPs is conserved from
      prokaryotes to mammals and shows remarkable structural and catalytic similarities
      with the catalytic domain of other phospho-/sulfo-coordinating enzymes such as
      alkaline phosphatases. Hydrolysis of pyrophosphate/phosphodiester bonds by NPPs
      occurs via a nucleotidylated threonine. NPPs are also known to
      auto(de)phosphorylate this active-site threonine, a process accounted for by an
      intrinsic phosphatase activity, with the phosphorylated enzyme representing the
      catalytic intermediate of the phosphatase reaction. NPP1-3 have been implicated
      in various processes, including bone mineralization, signaling by insulin and by
      nucleotides, and the differentiation and motility of cells. While it has been
      established that most of these biological effects of NPPs require a functional
      catalytic site, their physiological substrates remain to be identified.

PMID- 11202015
TI  - [Practical aspects of drug resistance in schizophrenia].
AB  - About 30-60% of patients with schizophrenia show resistance to neuroleptic
      treatment. In about 5-20% of them the resistance to antipsychotic treatment
      appears during the first therapy (primary resistance), however in the rest of
      patients, treatment resistance develops during 5 to 10 years of the illness
      (secondary resistance). In addition, another group of 5 to 20% of schizophrenics
      shows intolerance of therapeutic dosages of neuroleptic drugs. Before the
      diagnose of treatment resistance has been made, there is the need to reconfirm
      the diagnosis of schizophrenia, exclusion of other psychiatric disorders,
      assessment of patients' compliance, drug dosing, as well as pharmacokinetic and
      pharmacodynamic factors which have an impact on the therapeutic effect of
      antipsychotic treatment. Clozapine seems to be a "gold standard" for treatment of
      drug-resistant schizophrenic patients, however new atypical antipsychotics should
      be considered as a new therapeutic strategy, even before clozapine. The use of
      adjunctive treatment with carbamazepine, lithium, valproic acid, benzodiazepines
      and others, is a reasonable strategy, however dangerous drug interaction has to
      be taken into account.

PMID- 11202016
TI  - [Neuroleptics, atypical antipsychotics and "awakening"].
AB  - Clinical response to the treatment of schizophrenic patients with atypical
      antipsychotics is sometimes labeled as "awakening". However, there is no general
      agreement what this term specifically means. The wide range of definitions starts
      from withdrawal of side effects of classical neuroleptics and goes through
      psychological phenomena to the definition that postulates arresting of the
      psychotic process. The paper presents a review of different points of view on
      "awakening" phenomena as well as problems that are connected with it. Some own
      experiences and attempts at generalization are presented. They deal with new
      problems and challenges connected with treatment of patients with acute and
      chronic schizophrenia with atypical antipsychotics.

PMID- 11202017
TI  - [The role of obstetric complications in the pathogenesis of schizophrenia].
AB  - The article is a review of research data on the occurrence of pregnancy and
      delivery complications in schizophrenic patients and their possible contribution
      to developing schizophrenia in adolescence or adulthood. Many studies revealed
      that subjects who have a positive obstetric complications history are at higher
      risk of developing schizophrenia. Obstetric complications, especially those
      resulting in asphyxia, are often mentioned as possible environmental factors that
      can disturb the brain developmental processes, which can be responsible for
      developing schizophrenia in the future. Obstetric complications can act as an
      environmental pathogenic factor in some cases of schizophrenia (for example not
      genetically conditioned ones). They can also constitute an additional factor
      that, acting together with other (for example genetic factors, results in
      schizophrenia phenotype). There are still inconsistent data and many
      methodological problems concerning obstetric complications studies. The problem
      requires further investigation with improved and unified methodological
      procedures applied.

PMID- 11202018
TI  - [The selectivity, polarity and characteristic features of autistic and syntonic
      schizophrenia].
AB  - In previous papers (3, 4, 5) the author presented a hypothesis concerning
      important features of clinical picture of paranoid schizophrenia, that is
      selectivity and polarity (bipolarity). Numerous research works aimed at closer
      recognition of some differences of clinical picture of paranoid schizophrenia
      have been conducted under the author's direction. The formation of certain
      psychopathological proportions discerned by the author has been researched with
      intentionally elaborated scales. The research results have led to distinguishing
      autistic and syntonic schizophrenia.

PMID- 11202019
TI  - [Suicide in Poland as reflected by world trends].
AB  - Recent epidemiological trends in Polish suicide rates were compared and found to
      be somewhat consistent with world-wide trends. In addition, the time-series
      Polish suicide rate was consistent with some predictions made from Durkheim's
      classic theory of suicide. Finally, hypotheses about the aetiology of suicide
      were used to derive a linear regression equation to predict the Polish suicide
      rate reasonably accurately.

PMID- 11202020
TI  - [Social views of mental diseases--results of research].
AB  - Social reactions for mental diseases are very complex, because contacts between
      healthy people and the ill ones are limited in our society. People are afraid of
      all symptoms of mental disability and they think that such people should be
      isolated in closed institutions. The majority of examined people (79%) think that
      mentally disabled should be cured. People of different age and level of education
      state such opinions with the same frequency. At the same time, the majority of
      examined people (88%), admit that the knowledge about mentally disabled in our
      society is insufficient. This conviction grows simultaneously with the level of
      education of respondents. The social idea of factors, which start or condition
      the formation of mental diseases is very schematic. This idea consists of four
      main elements i.e.: genetic conditions (heredity of disease), bad conditions of
      life, everyday stress and low psychical immunity. Although the declaration of
      openness, the majority of respondents represent low tolerance to problems of
      mentally disabled and their opinions stigmatize ill people.

PMID- 11202021
TI  - [Proposal for a modified method of semantic differential diagnosis in testing for
      stereotyping of the mentally ill patient].
AB  - In the paper, a proposal of using the semantic differential (by Osgood) for the
      research on social perception of mentally ill is presented. It allows for
      investigation of the basic attributes of the stereotype of psychiatric patient:
      social character, evaluative aspect, simplification, over-generalization of the
      opinion and its stiffness. The article presents the pilot results coming from the
      research in a group of students of psychology (first year of studying), who had
      no lectures in psychiatry by that time (N = 149). The results lead to the
      conclusion that the picture of mentally ill has social character, that is--some
      of its attributes are common for a majority of responders (over 77%). They also
      confirm (with a high certainty--coming to 79%) that most of mentally ill persons
      (64-80%) are unpredictable, lost, difficult to understand, introvert,
      unconscious, not self-possessed, excitable, threatening, aggressive and violent.
      The results show that in the portrait of mentally ill negative attributes are in
      majority. This portrait--so one-sided and negative--can be one of the basic
      predictores of social rejection of mentally ill persons.

PMID- 11202022
TI  - [The situation in integrated and community-oriented psychiatric treatment
      institutions with new financial realities].
AB  - The author describes the structure and functioning of a psychiatric treatment
      institution which is integrated and community-oriented. He discusses subsequently
      its readiness to implement changes and goes through adaptation actions (which
      have taken place at the cost of stuff and quality and extent of service). The
      situation after four months of financing by health-care funds has been analysed.
      Finally, the author presents his remarks regarding the on going changes, concerns
      for the future and suggests new solutions (e.g., capitalized way of financing
      psychiatric treatment institutions).

PMID- 11202023
TI  - [Psychosis induction in sisters].
AB  - The purpose of this report is to describe induced visual hallucinations among two
      sisters. The author suggests that the first sister has probably "organic" visual
      hallucinations but the second sister has "induced" hallucinations. The paper
      describes a family of three old maids, living commonly for several years.

PMID- 11202024
TI  - [Hyperactivity and behavioral disorders in Sanfilippo A (mucopolysaccharidosis
      type IIIA)--case report and review of the literature].
AB  - Sanfilippo syndrome is one of mucopolysaccharidoses. The main symptom of this
      syndrome is regression of psychomotor development and neurological signs which
      occur between 2 and 6 years old. Unlike other mucopolysaccharidoses body
      dysmorfic features are relatively rare. Course of disease is progressive, most of
      the patients die before 20. The diagnosis is often difficult. In our opinion in
      each case presenting psychomotor regression of unknown origin metabolic disease
      should be excluded (e.g. urine analysis for mucopolysaccharides should be
      indicated). A 6 year old boy has been under psychiatric and psychological control
      since he was 3 due to psychomotor retardation, hyperactivity, autistic features,
      and behavioural disorder. In paediatric examination thickened facial features,
      coarse hair, knock-knees, short neck were noted. Genetic consultation set up the
      diagnosis of mucopolysaccharidosis type IIIA (Sanfilippo A disease).

PMID- 11202025
TI  - Renovation of contaminated building materials at a facility serving pediatric
      cancer outpatients.

PMID- 11202026
TI  - Cercopithecine herpesvirus 1 (B virus) infection resulting from ocular exposure.

PMID- 11202027
TI  - An occupation-industry matrix analysis of mesothelioma cases in Australia 1980
      1985.
AB  - Australia has one of the highest national incidences of mesothelioma in the world
      and the rate is still rising. An industry-occupation matrix analysis was
      conducted for the 858 mesothelioma cases that were reported to the Australian
      Mesothelioma Surveillance Program between 1980 and 1985. Definite, probable, or
      possible occupational exposure had occurred in 57 percent (492/858) of the
      subjects. The primary asbestos production or manufacturing industry constituted
      the largest number of cases (137/492, 27.8%), followed by shipbuilding, repair
      and demolition (114/492, 23.2%), the building industry (69/492, 14.1%), and the
      railway locomotive construction and maintenance industry (47/492, 9.6%). Laborers
      constituted 14.8 percent (n = 73) of the occupations with a history of exposure
      to asbestos, followed by carpenters (13.0%, n = 64), boilermakers (10.6%, n =
      52), and fitters/turners (8.1%, n = 40). The distribution of occupations in
      specific industries is presented in this article.

PMID- 11202028
TI  - Experimental evaluation of an environmental CAT scanning system for mapping
      chemicals in air in real-time.
AB  - An innovative method is being developed which creates real-time, two-dimensional
      maps of chemical concentrations in air for environmental and occupational
      applications. This method, we call environmental CAT scanning, combines the real
      time measuring technique of open-path Fourier transform infrared spectroscopy
      with the mapping capabilities of computed tomography to produce accurate spatial
      and temporal information about contaminant concentrations and dispersion
      patterns. With this system, a network of open-path measurements is obtained over
      an area; measurements are then processed using a tomographic algorithm to
      reconstruct the concentrations. This article describes a thorough experimental
      evaluation of an environmental CAT scanning system using a field-ready prototype
      system deployed in a room-size exposure chamber; point sample measurements were
      taken simultaneously in the chamber along with the CAT measurements. Twenty-eight
      experiments were performed using single or multiple plumes of a tracer gas in the
      chamber. Tomographic maps were compared with the point sample reference maps to
      evaluate the CAT scanning system for accuracy of concentration measurement and
      plume location. Quantitative agreement was very good; concentrations
      reconstructed with the tomographic maps agreed to within 17 percent of the point
      sample maps, and plume locations were reconstructed to within six inches of the
      plumes in the point sample maps. This technique shows real promise as a rapid and
      accurate method for mapping chemicals over large areas.

PMID- 11202029
TI  - The reliability of multiple regression and an alternative method for extracting
      task-specific exposure estimates from time-weighted average data.
AB  - The reliability of multiple regression analysis as a method for determining task
      specific exposures from multi-task time-weighted average data was evaluated in
      comparison with the alternative P-screen method. The performances of the two
      methods were tested using simulated sample data that were calculated as averages
      over six tasks, where task-specific concentrations drawn randomly from lognormal
      distributions were weighted by randomly generated task time-weights. Data sets
      consisted of 20 or 100 simulated samples. The simulated data sets conformed to
      requirements inherent in the P-screen method that at least one task be absent
      from each sample and each task be absent from at least one sample. In thousands
      of Monte Carlo trials under various conditions, the two methods were found to
      perform equally well when dichotomous task measures (occurrence/ nonoccurrence)
      were used. Combining the two methods did not improve reliability appreciably,
      suggesting that the methods are effectively equivalent when dichotomous task
      measures are used. When task durations were used as the regressors or time
      weights, multiple regression was found to be more reliable than P-screen. It is
      well recognized that incidental or fundamental collinearities between regressors
      may undermine multiple regression analyses. The P-screen-related restrictions on
      the task structure of data sets reduces the potential for problems arising from
      such collinearities. However, the use of multivariate analysis of multiple-task
      samples will always be an imperfect substitute for single-task sampling.

PMID- 11202030
TI  - Exposure to chemical agents in Swedish aluminum foundries and aluminum remelting
      plants--a comprehensive survey.
AB  - Secondary aluminum melting is mainly performed in sand, die, and static die
      casting foundries and remelting plants. In seven Swedish foundries and two
      remelting plants, the exposure and area concentrations of total dust, metals,
      organic gases, and vapors were determined mainly as daily, time-weighted averages
      (TWAs). For most combinations of jobs and agents, the exposure levels were well
      below the current threshold limits suggested by the American Conference of
      Governmental Industrial Hygienists (ACGIH). However, high exposure levels of
      mineral oil mist (geometric mean [GM] = 0.6 mg/m3) were observed in the die
      casting process, with a maximum of 4 mg/m3. The findings were similar for total
      dust (GM = 5.1 mg/m3) and crystalline quartz (GM = 0.05 mg/m3) during molding
      operations in the sand foundries, maximum air concentrations being 31 mg/m3 and
      0.22 mg/m3, respectively. Other agents which occasionally reached high exposure
      levels included furfuryl alcohol (up to 23 mg/m3 during furan binder use in sand
      foundries), aniline (up to 2.6 mg/m3 during thermal degradation of cold-box
      binders), and dimethylethylamine (up to 9 mg/m3) in the cold-box process used in
      static die-casting and sand foundries. The average aluminum exposure levels (GM =
      0.043 mg/m3) were low in all foundries, individual values not exceeding 0.94
      mg/m3. The exposures to metals were below 10 percent of their threshold limits.
      Similarly low levels were detected of polyaromatic hydrocarbons, phenol,
      formaldehyde, methylenebisphenyl diisocyanate, and phenylisocyanate. In the
      aluminum remelting plants, a few high exposure levels of total dust (GM = 1.4
      mg/m3) up to 8 mg/m3 were detected in furnace workers. Aluminum and other metals
      were well below 10 percent of their threshold limits, with the exception of a few
      high concentrations of manganese, up to 0.14 mg/m3. The between-worker
      variability (GSDB) in the foundries for total dust, aluminum, and oil mist were
      on the order of 3-4. The heterogenicity of secondary aluminum melting requires
      assessment of a wide variety of chemical agents. For certain exposures, technical
      and medical monitoring programs are still needed.

PMID- 11202031
TI  - Comparison of a direct-reading device to gravimetric methods for evaluating
      organic dust aerosols in an enclosed swine production environment.
AB  - The production of livestock in enclosed facilities has become an accepted
      practice, driven by the need for increased efficiency. Exposure to organic dusts,
      containing various bioactive components, has been identified an important risk
      factor for the high rate of lung disease found among workers in these
      environments. Assessment of organic dust exposure requires technical skills and
      instrumentation not readily available to most agricultural enterprises.
      Development of a simple, cost-effective method for measuring organic dust levels
      would be useful in evaluating and controlling exposures in these environments.
      The objective of this study was to evaluate the usefulness of the direct reading
      MIE PDM-3 Miniram for estimating organic dust concentrations in enclosed swine
      production facilities. Responses from the MIE PDM-3 Miniram were compared to
      gravimetric methods for total and inhalable dust. Total dust determinations were
      conducted in accordance with the National Institute for Occupational Safety and
      Health (NIOSH) method 0500. Inhalable particulate mass (IPM) sampling was
      conducted using SKC brand IOM (Institute of Occupational Medicine) sampling
      cassettes, which meet the American Conference of Governmental Industrial
      Hygienists ACGIH criteria for inhalable dust sampling. This study design also
      allowed for the comparison of traditional total dust method to the IPM method, in
      collecting organic dusts in an agricultural setting. Fifteen sets of side-by-side
      samples (Miniram, total dust, and IPM) were collected over a period of six months
      in a swine confinement building. There were statistically significant differences
      in the results provided by the three sampling methods. Measurements for inhalable
      dust exceeded those for total dust in eleven of fifteen samples. The Miniram time
      weighted average (TWA) response to the organic dust was always the lower of the
      three methods. A high degree of correlation was found among all three methods.
      The Miniram performed well under field conditions of varying temperature and
      humidity. The Miniram has the potential to predict the inhalable and total dust
      concentrations, assuming a correction factor for the organic dust being measured
      is applied.

PMID- 11202032
TI  - Comparison of occupational exposure using three different methods: hygiene panel,
      job exposure matrix (JEM), and self reports.
AB  - This study was undertaken to compare the agreement of occupational exposure
      assessment by a panel of occupational hygienists with a job exposure matrix and
      self-reported exposures in a community-based case-control study. We also
      investigated the intra-rater reliability and degree of attenuation of the
      hypothetical odds ratio of the panel in retrospective chemical exposure
      assessment. A panel of three occupational hygienists was recruited to assess
      exposure to chemicals for 5,620 jobs. The agreement between the panel, a job
      exposure matrix (FINJEM), and the self-reported exposures was then assessed. A
      further 172 jobs were resubmitted to the panel to assess intra-rater reliability.
      The kappa for intra-rater reliability ranged from 0.60-0.71. The agreement
      between the panel and FINJEM ranged from 0.07 to 0.46 (for similar exposures),
      and agreement between the panel and among the self-reports ranged from 0.00 to
      0.48. Agreement between hygienists when rating exposure to the same chemical
      ranged from 0.48 to 0.57. Based on these findings, the degree of exposure
      misclassification by the panel where the true odds ratio was 2 would result in
      the observed odds ratio ranging between 1.70 and 1.88. The results indicated good
      intra-rater reliability for the hygiene panel. However, the agreement among the
      panel, FINJEM, and self-reported exposures was found to be only poor to fair. The
      attenuation of the odds ratios due to exposure misclassification by the panel was
      variable and dependent upon the exposure.

PMID- 11202033
TI  - Social policy implications of research in developmental psychopathology.

PMID- 11202034
TI  - Stigma and mental disorder: conceptions of illness, public attitudes, personal
      disclosure, and social policy.
AB  - The end of the last millennium witnessed an unprecedented degree of public
      awareness regarding mental disorder as well as motivation for policy change. Like
      Sartorius, we contend that the continued stigmatization of mental illness may
      well be the central issue facing the field, as nearly all attendant issues (e.g.,
      standards of care, funding for basic and applied research efforts) emanate from
      professional, societal, and personal attitudes towards persons with aberrant
      behavior. We discuss empirical and narrative evidence for stigmatization as well
      as historical trends regarding conceptualizations of mental illness, including
      the field's increasing focus on genetic and neurobiological causes and
      determinants of mental disorder. We next define stigma explicitly, noting both
      the multiple levels (community, societal, familial, individual) through which
      stigma operates to dehumanize and delegitimize individuals with mental disorders
      and the impact of stigma across development. Key developmental psychopathology
      principles are salient in this regard. We express concern over the recent
      oversimplification of mental illness as "brain disorder," supporting instead
      transactional models which account for the dynamic interplay of genes,
      neurobiology, environment, and self across development and which are consistent
      with both compassion and societal responsibility. Finally, we consider
      educational and policy-related initiatives regarding the destigmatization of
      mental disorder. We conclude that attitudes and policy regarding mental disorder
      reflect, in microcosmic form, two crucial issues for the next century and
      millennium: (a) tolerance for diversity (vs. pressure for conformity) and (b)
      intentional direction of our species' evolution, given fast-breaking genetic
      advances.

PMID- 11202035
TI  - Developmental psychopathology and public health: past, present, and future.
AB  - Children's healthy mental development has never been the focus of long-term,
      committed public health policy in the way that early physical health and
      development have been. We discuss four types of societal response to illness
      cure, care, control, and prevention--and trace the history of public health in
      terms of its special responsibility to control and prevent disease. We identify
      four periods in the history of public health: the Sanitarian era (up to 1850),
      the Bacterial era (1850-1950), the Behavioral era (1950-present), and the
      Communitarian era (the next century). Looking at this history from the viewpoint
      of the developmental psychopathology of the first 2 decades of life, we trace
      progress in public health responses to children with mental illness, from a
      philosophy of control by isolation toward one of preventive intervention. We
      examine primary, or universal, prevention strategies that have been tried, and we
      suggest some that might be worth reconsidering.

PMID- 11202036
TI  - Welfare reform, family support, and child development: perspectives from policy
      analysis and developmental psychopathology.
AB  - This article explores the implications of recent welfare-related policy change
      for the well-being of children in low-income families, and for research
      investigating child development processes and outcomes. It provides an overview
      of current welfare-related policies and explores the implications for
      developmental researchers. The article also synthesizes early findings from
      research, highlighting both overall impacts and the more nuanced evidence that
      while families are transitioning off welfare, only a small number are
      transitioning out of poverty, and a subgroup of families at risk are not faring
      well. It then examines, from a theoretical and methodological framework, what
      developmental psychopathology might bring to the study of welfare-related impacts
      on children in the context of this complex and changing policy landscape, and
      what welfare researchers might bring to the field of developmental
      psychopathology. The article concludes with broad recommendations for both
      research and policy.

PMID- 11202037
TI  - Changes in womens' roles: impact on and social policy implications for the mental
      health of women and children.
AB  - In recent years. womens' roles have changed dramatically, prompting researchers
      to examine the impact of these changes on the development of women and children.
      In this article, we examine three major changes that women have experienced over
      the past several decades: increased participation in the paid labor force,
      changes in domestic labor and child-care patterns, and increased numbers of
      female-headed single-parent families. For each, we first describe the nature of
      the changes that have occurred over the last 50 years. We then review research
      concerning the effects of these changes on the development of women and children.
      Finally, we discuss the implications for social policy that stem from this
      research. It is broadly concluded that research informed by a developmental
      contextual perspective may contribute importantly to the development of social
      policies focused on promoting the well-being of women and children.

PMID- 11202038
TI  - Striving to do well what comes naturally: social support, developmental
      psychopathology, and social policy.
AB  - Social support can have significant stress-preventive and stress-buffering
      benefits for troubled individuals in everyday circumstances. Consequently, it is
      not surprising that many therapeutic and preventive programs enlist social
      support to address problems of child and family psychopathology, especially in
      the context of "two-generation interventions" that seek to improve child well
      being by strengthening parental functioning and parent-child relationships. Home
      visitation programs are the best known of these two-generation strategies and
      have become the focus of state-level and national efforts to support families and
      prevent harm to children. The conclusions of basic research studies on social
      support converge significantly with the findings of evaluation studies of the
      impact of home visitation programs to yield important new insights into the
      conditions in which formal social support is likely to be beneficial. or
      ineffective, in improving child and family well-being. Both basic and applied
      research literatures emphasize the importance of linking formal social support to
      informal social networks in extended families, neighborhoods, and communities,
      and attending to the complex reactions of the recipients of support and the needs
      of support providers. These studies are reviewed and evaluated to highlight the
      connections between social support, developmental psychopathology. and social
      policy.

PMID- 11202039
TI  - International adoption of institutionally reared children: research and policy.
AB  - This article summarizes the research on the developmental outcomes of
      postinstitutionalized children and discusses the implications for social policy.
      Postinstitutionalized children often reach their adoptive families with varying
      degrees of physical growth retardation, cognitive delays, and socioemotional
      problems. Many children demonstrate remarkable recovery following adoption.
      Unfortunately, some of the children continue to display significant problems that
      require professional intervention. It appears that the children's recovery may be
      influenced by their early experiences with their birth family and in
      institutional care, and there is suggestive evidence that postadoption
      experiences also play a role. These findings indicate that preadoption and
      postadoption services may support the outcome of postinstitutionalized children.

PMID- 11202040
TI  - The role of early experience in shaping behavioral and brain development and its
      implications for social policy.
AB  - This article provides a targeted review of the scientific literature on the
      effects of experience on early brain and behavioral development and later outcome
      as it pertains to risk for some forms of child psychopathology. It is argued that
      ample evidence exists indicating that the prenatal and early postnatal years
      likely represent a sensitive period with respect to the effects of stress on the
      developing nervous system and behavioral outcome, and with respect to the long
      term beneficial effects of early interventions on brain and behavioral
      development for some genetically based disorders, such as phenylketonuria and
      autism. Moreover, evidence suggests that parental mental health during the first
      years of life has a significant influence on early brain activity and behavior,
      and long-term behavioral outcome. It is concluded that, although prevention and
      early intervention efforts should not exclusively focus on the earliest years of
      development, such efforts should begin during this period. By directing such
      efforts toward promoting optimal prenatal and infant-toddler development, the
      long-term negative consequences of factors that have their greatest influences
      during early development and which set the stage for future development can be
      minimized or avoided entirely. Several recommendations for public policy and
      future research pertaining to the effects of early experience on child outcome
      are offered.

PMID- 11202041
TI  - Conceptualizing mental disorders in children: where have we been and where are we
      going?
AB  - Conceptions of mental illness in children are bound by cultural and social
      conventions of what constitutes healthy and unhealthy development. To understand
      current conceptualizations of disorders in children, we review the history of
      these conceptualizations from three intertwined perspectives: a sociopolitical
      history of American children and families, the history of the mental health
      fields and scientific disciplines involved in diagnosing children, and the
      evolution of children's role in the Diagnostic and Statistical Manual of Mental
      Disorders. We review where the field has been in its conception of childhood
      mental illness throughout the past century, where we believe it is now, and raise
      questions about the direction in which child diagnosis may be headed as we enter
      the new millennium. We conclude with social policy recommendations based on
      theory and research regarding mental disorders in children.

PMID- 11202042
TI  - Young children who commit crime: epidemiology, developmental origins, risk
      factors, early interventions, and policy implications.
AB  - An early onset of delinquency prior to age 13 years increases the risk of later
      serious, violent, and chronic offending by a factor of 2-3. Also child
      delinquents, compared to juveniles who start offending at a later age, tend to
      have longer delinquent careers. This article summarizes the report of the Office
      of Juvenile Justice and Delinquency Prevention's Study Group on Very Young
      Offenders, chaired by Rolf Loeber and David P. Farrington. The Study Group,
      consisting of 16 scholars and 23 coauthors, worked for 2 years on preparing a
      report, undertaking extensive secondary data analyses, and writing chapters in
      different speciality areas. The report consists of a state of the art review of
      the developmental background of child delinquents. The report also summarizes
      risk and protective factors in the individual, family, peer group, school, and
      neighborhood that affect that development. Lastly, the report renews relevant
      preventive and remedial interventions in the juvenile justice system, families,
      peer groups, schools. and neighborhoods, and makes a case for improvement in the
      integration of services for child delinquents. Policy recommendations are
      presented to improve methods of dealing with child delinquents by juvenile
      justice, child welfare, and mental health agencies.

PMID- 11202043
TI  - Problem behavior: the double symptom of adolescence.
AB  - In this article we address several issues regarding problem or antisocial
      behavior in adolescents. First, we discuss conceptualizations of adolescent
      problem behavior to answer the question 'What do we think we know so far?" Then,
      we briefly characterize current interventions designed to reduce these behaviors,
      and their relative success in doing so. Next, we examine earlier attempts to
      prevent and ameliorate problem behavior (including juvenile delinquency),
      situating them in the historical context of America from the turn of the century
      to World War II. Here, we attempt to answer the questions "How did we get to
      where we are?" and "How can we learn from the past?" Following this, we try to
      answer the question "Where do we go from here?" and articulate some research and
      policy implications relevant to developmental psychopathology that arise from
      these considerations. We argue that problem behavior is viewed most productively
      in its double aspect, which John Hughlings Jackson called a "double symptom,"
      with the positive aspect of the symptom reflecting adolescents' attempts to
      satisfy their developmental needs.

PMID- 11202044
TI  - Drug abuse and developmental psychopathology.
AB  - Drug abuse research and theory has become much more sophisticated over the last 2
      decades, and some of the advancements parallel concepts that are part of the
      developmental psychopathology approach. The application of the developmental
      psychopathology perspective to recent drug abuse research findings can provide a
      greater understanding of that information and point to important areas of future
      research. Among the drug abuse research areas discussed here and viewed from this
      perspective are antecedent and co-occurring psychopathological conditions and
      other problem behaviors; the diversity of the nature of, paths to, and processes
      and outcomes related to drug abuse; the role of intermediary influences; the
      interaction of individual and environmental predisposing and protective factors;
      the role of families and other social institutions in intervention; and
      developmental stage characteristics. Directions for future research are also
      discussed.

PMID- 11202045
TI  - Social policy and prevention in mental health.
AB  - This article presents policy recommendations relating to two aspects of primary
      prevention in mental health: (a) preventing adverse negative outcomes and (b)
      building health and wellness from the start and maintaining it thereafter.
      Recommendations for reducing diverse negative outcomes and end states reflect
      interconnections and bidirectional influences among physical, social
      interpersonal, cognitive-academic, and "mental health" outcomes.

PMID- 11202046
TI  - A developmental psychopathology perspective on child and adolescent treatment
      policy.
AB  - This article considers the implications of theory and research in developmental
      psychopathology for existing and emerging social policy concerning treatment of
      child and adolescent psychopathology. Based on the concept that all
      psychopathology is a process, four core principles of a developmental
      psychopathology perspective are discussed. In turn, each is applied to an
      evaluation of policy issues with implications for intervention, including mental
      health parity, treatment guidelines, mental health reimbursement, and level of
      intervention. It is concluded that social policy on treatment must be based on an
      empirically supported theory of developmental psychopathology and on evidence
      based interventions that link treatments to pathogenic processes.

PMID- 11202048
TI  - Porphyrins, porphyrin metabolism and porphyrias. I. Update.
AB  - The biosynthesis of porphyrins is one of the most conserved parthways known,
      about the same sequence of reactions taking place in all species. By associating
      different metals, porphyrins give rise to the "pigments of life": chlorophyll,
      haem and cobalamin. The unique tetrapyrrolic structure enables it to function in
      an array of reactions as a single electron carrier and as a catalyst for redox
      reactions. In this capacity, it constitutes the prosthetic group of enzymes
      participating in cellular respiration, in conversion reactions involving steroids
      and lipophilic xenobiotics, in protective mechanisms directed against oxidative
      stress and in pathways providing central messenger molecules. The formation of
      haem is accomplished by a sequence of eight dedicated enzymes encoded by
      different genes, some being active in ubiquitous as well as in erythroid
      isoforms. Large differences between the participating enzymes with regard to
      catalytic power, with low capacity steps positioned early in the catalytic chain,
      constitute a bar against substrate overloading of enzymes processing porphyrins,
      thus preventing accumulation in the body of these phototoxic compounds under
      physiological conditions. Most of the haem in the body is produced by the liver
      and bone marrow, but the mechanisms applied for the control of the synthesis
      differ between the two organs. The extremely potent hemeprotein enzymes formed in
      the liver are rapidly turned over in response to current metabolic needs. They
      have half-lives in the order of minutes or hours and are restored by fast-acting
      mechanisms for the de novo synthesis, when needed. Uninterrupted and instant
      availability of the compound is secured by acute deinhibition of the initial
      enzyme of the synthetic chain, ubiquitous 5-aminolevulinate synthase (ALAS-1), in
      response to drain of the free cellular haem pool caused by prevailing demands for
      hemeproteins or by increased catabolism of the compound. In contrast, in the
      erythroid progenitor cell the haem synthetic machinery is designed for
      uninterrupted production of huge amounts of haem for combination with globin
      chains to form hemoglobin at a steady rate. In the erythron the synthesis of the
      enzymes participating in the formation of haem is under control of
      erythropoietin, formed under hypoxic conditions. In the absence of iron, to be
      incorporated in the porphyrin formed in the last step of the synthesis, the mRNA
      of erythroid 5-aminolevulinate synthase (ALAS-2) is blocked by attachment of an
      iron-responsive element (IRE) binding cytosolic protein, and transcription of
      this key enzyme is inhibited. In humans, the genes for each of the haem synthetic
      enzymes may become the target of mutations that give rise to impaired cellular
      enzyme activity. Seven of the enzyme deficiencies are associated with
      accumulation of toxic intermediaries and with disease entities termed porphyrias.
      The acute porphyrias are characterized by attacks of neuropsychiatric symptoms,
      which may be due to a toxic surplus of the porphyrin presursor 5-aminolevulinic
      acid, or a consequence of a deficit of vital hemeproteins resulting from impaired
      synthesis of haem. In the cutaneous porphyrias, impairment of enzymatic steps
      where porphyrins are processed gives rise to solar hypersensitivity due to
      accumulation of phototoxic porphyrins in the skin. Early diagnosis, information
      to the patient regarding the nature of the illness and counselling aimed at
      avoidance of triggering factors are cornerstones in the handling of the porphyric
      diseases. Gene analysis is of incomparable diagnostic reliability in carrier
      detection, but biochemical methods must be applied in the important task of
      monitoring porphyric disease activity. In most forms of porphyria the gene
      carriers run the risk of development of associated diseases in liver or kidneys,
      a circumstance that prompts application of well-structured surveillance programs.

PMID- 11202049
TI  - Porphyrins, porphyrin metabolism and porphyrias. II. Diagnosis and monitoring in
      the acute porphyrias.
AB  - The acute porphyrias constitute a group of metabolic disorders engaging enzymes
      in the haem synthetic chain and generally following dominant inheritance
      patterns. Some gene carriers are vulnerable to a range of exogenous and
      endogenous factors, which may trigger neuropsychiatric symptoms. Early diagnosis
      is of prime importance since it makes way for counselling with the aim to block
      the development of acute, as well as late, disease. The medical and psycho-social
      consequences of a porphyria diagnosis are considerable and the freedom for
      maldiagnosis correspondingly small. The strain imposed upon the diagnostic
      process makes management in specialized laboratories necessary. Inadvertent
      handling of the diagnostic procedures in laboratories lacking in knowledge,
      experience and technical competence is repeatedly the reason for harmful
      underdiagnosis and overdiagnosis. Gene diagnosis of the carrier condition,
      principally within reach in all types of acute porphyria, is of incomparable
      versatility and accuracy. However, despite recent great achievements in the
      molecular biology of porphyric disease, genomic procedures cannot replace
      biochemical methods in monitoring the activity and progress of the disease, or
      the effects of therapy. The classical methods are also useful when it comes to
      screening for the associated disease states. In these tasks, professional
      handling of the methods and skillful interpretation of the results are of
      paramount importance. Knowledge of the limitations and pitfalls of the procedures
      is a guard against maldiagnosis, which may be fatal. In the article the main
      diagnostic challenges are discussed; the strategy for early detection of the gene
      carrier state, the recognition and surveillance of the acute porphyric crisis,
      the evaluation of subacute/subchronic symptoms, the differential diagnoses of the
      cutaneous porphyrias and the monitoring of late complications.

PMID- 11202050
TI  - Porphyrins, porphyrin metabolism, porphyrias. III. Diagnosis, care and monitoring
      in porphyria cutanea tarda--suggestions for a handling programme.
AB  - Deficiency of the fifth enzyme in haem synthesis, uroporphyrinogen decarboxylase
      (UPGD), may give rise to accumulation and excretion of poly-carboxylated
      porphyrins, as well as to clinical manifestations in the form of a phototoxic
      skin reaction and liver engagement leading to cirrhosis and hepatocellular
      cancer. The cutaneous reaction, presenting as skin fragility and blisters on
      areas exposed to sun--porphyria cutanea tarda (PCT)--develops only in individuals
      with a remaining hepatic UPGD activity less than 20% of normal. Experimental
      results and clinical observation give evidence that PCT is a multifactorial
      disease. In some individuals a 50%, decrease in UPGD activity is a consequence of
      inheritance of an allele with a mutation in the gene programming for the enzyme,
      but in these gene carriers, as well as in the other patients with overt PCT, the
      activity of the hepatic enzyme is reduced below the critical level by the action
      of specific inhibitors. In the generation of the enzyme inhibitors, iron plays a
      central role by promoting the formation of reactive oxygen species, a process
      where a specific class of cytochrome enzymes; cytochrome P450 1A (CYP4501A),
      participates. The varying individual susceptibility to development of the disease
      can be discussed in terms of differences in a spectrum of factors that affect the
      availability of the free form of this element in the liver, or its pathogenic
      action. In the article the roles of chronic viral infection, alcohol abuse and
      exposition to polyhalogenated cyclic hydrocarbons are considered in the light of
      effects on the availability of iron in the liver. Some genetic prerequisites for
      susceptibility to PCT-inducing agents are included in a tentative model for the
      disease, i.e. mutations in the UPGD gene and in the HFE gene affected in
      haemochromatosis, as well as genetically steered inducibilities of the genes
      programming for CYP4501A and the rate-limiting enzyme in haem synthesis, 5
      aminolevulinate synthase. With the pathogenic model as a basis the different
      therapeutic strategies that can be applied are discussed, and suggestions for a
      handling programme for the patient presenting with PCT put forward.

PMID- 11202047
TI  - The construct of resilience: implications for interventions and social policies.
AB  - The focus of this article is on the interface between research on resilience-a
      construct representing positive adaptation despite adversity--and the
      applications of this work to the development of interventions and social
      policies. Salient defining features of research on resilience are delineated, as
      are various advantages, limitations, and precautions linked with the application
      of the resilience framework to developing interventions. For future applied
      efforts within this tradition, a series of guiding principles are presented along
      with exemplars of existing programs based on the resilience paradigm. The article
      concludes with discussions of directions for future work in this area, with
      emphases on an enhanced interface between science and practice, and a broadened
      scope of resilience-based interventions in terms of the types of populations, and
      the types of adjustment domains, that are encompassed.

PMID- 11202051
TI  - Porphyrins, porphyrin metabolism and porphyrias. IV. Pathophysiology of
      erythyropoietic protoporphyria--diagnosis, care and monitoring of the patient.
AB  - An extremely painful cutaneous condition with no or only slight visible skin
      changes, presenting in a child or an adult as an acute reaction to sun light, is
      probably a manifestation of the porphyrin metabolic disorder erythropoietic
      protoporphyria (EPP). The disease is the result of a genetically determined
      condition where a mutation in the gene for the final enzyme in the haem synthetic
      chain, ferrochelatase, results in impaired activity of the enzyme. In some
      predisposed individuals, the condition is accompanied by heavy accumulation of
      the substrate for the deficient enzyme, i.e. of protoporphyrin. Distributing to
      the skin, and there absorbing light of certain wavelengths, the metabolite
      generates free radicals that give rise to photodynamic cell injury. The primary
      event takes place in the endothelial cells of the superficial skin capillaries,
      but complement activation and mast cell degranulation in the surrounding tissue
      follow in the process. Even if the disease is primarily dermatological the
      hepatic and psychosocial complications are features requiring close attention by
      the physician. In order to provide a basis for suggestions regarding lege artis
      protocols for the diagnosis, treatment and monitoring of the patient with EPP,
      the pathophysiology of the cutaneous and hepatic manifestations are discussed in
      some detail in the article.

PMID- 11202052
TI  - Diagnosis of variegate porphyria--hard to get?
AB  - Variegate porphyria (VP) is an inherited metabolic disease that results from the
      partial deficiency of protoporphyrinogen oxidase. In this communication we have
      used DNA technology in the diagnosis of VP and compared the results with the
      biochemical and clinical data. To date, we have diagnosed 107 VP patients using
      either biochemical or DNA techniques or both. In addition, in 106 family members
      the diagnosis of VP could be excluded. The sensitivity and specificity of the
      biochemical screening for VP were studied among 38 family members. These
      individuals were either asymptomatic (n = 19) or had experienced occasional skin
      symptoms (n = 13), acute attacks (n = 5) or both (n = 1). The sensitivity of
      urinary and fecal coproporphyrin analysis was 48% and 52%, respectively. The
      sensitivity of urinary uroporphyrin analysis was 71% and for fecal protoporphyrin
      77%. Plasma fluorescence was sensitive in symptomatic patients even in remission,
      but resulted in false negatives in four asymptomatic patients with normal
      excretion of porphyrins in the urine. In our series of mutation screening, many
      new asymptomatic patients were identified, and this demonstrated that DNA
      analysis is the only reliable way to screen (a)symptomatic patients facilitating
      correct treatment and proper genetic counselling of family members at risk.
      Biochemical analyses (e.g. plasma fluorescence, fecal protoporphyrins, urinary
      copro- and uroporphyrins, porphobilinogen and delta-aminolevulinic acid) are
      essential when the diagnosis of VP is confirmed at the symptomatic phase.

PMID- 11202053
TI  - Uroporphyrinogen decarboxylase gene mutations in Danish patients with porphyria
      cutanea tarda.
AB  - Decreased uroporphyrinogen decarboxylase (UROD) activity is a characteristic
      feature of the most common of the porphyrias, porphyria cutanea tarda (PCT). A
      subgroup of the clinically overt PCT cases is associated with mutations in the
      gene encoding UROD and inherited as an autosomal-dominant trait. In this study,
      DNAs from 53 Danish PCT patients were subjected to genetic analysis for UROD
      mutations using denaturing gradient gel electrophoresis. Eleven genetic
      variations, seven of which are possible disease causing, were identified. All but
      one of these mutations were previously unknown, lending further support to the
      assumption that PCT is a heteroallelic disease. Only 11% of the examined patients
      were previously recognized as familial PCT cases. However, possible disease
      related UROD mutations were identified in 24% of the examined patients,
      indicating that genetic analysis of PCT patients may improve differentiation
      between familial and sporadic PCT cases.

PMID- 11202054
TI  - DGGE analysis of the coproporphyrinogen oxidase gene: two new mutations in DNA
      from Danish patients with hereditary coproporphyria.
AB  - The knowledge of at least 21 different mutations and several polymorphisms in the
      coproporphyrinogen oxidase (CPO) gene demonstrates that the molecular basis of
      hereditary coproporphyria is heterogeneous. We developed a DGGE-based assay for
      the analysis of exons 2 to 7, including 14-96 nucleotides of the flanking
      intronic sequences of the CPO gene. To render it suitable for the clinical
      diagnostic laboratory, we designed the assay to allow use of identical PCR
      conditions and the same DGGE gel for analyses of all the regions. Using this
      assay, and subsequent sequencing of gene regions containing interallelic
      variations, two novel mutations in the CPO gene were identified: a missense
      mutation (607G-->A), leading to the substitution of an alanine with a threonine,
      and a nonsense mutation (1281G-->A), giving rise to a stop codon 28 codons
      upstream to the wild-type stop codon.

PMID- 11202055
TI  - Determination of porphobilinogen deaminase activity in human erythrocytes:
      pertinent factors in obtaining optimal conditions for measurements.
AB  - Determination of porphobilinogen deaminase (PBGD; EC 4.3.1.8) activity in
      erythrocytes can contribute to the identification of patients suspected of acute
      intermittent porphyria. PBGD catalyses the polymerization of four molecules of
      porphobilinogen (PBG) to the highly unstable 1-hydroxymethylbilane. The 1
      hydroxymethylbilane is transformed into uroporphyrinogen III by uroporphyrinogen
      III synthase. When this enzyme is inactivated, 1-hydroxymethylbilane cyclizes non
      enzymatically to uroporphyrinogen I, which can be oxidized to uroporphyrin I.
      PBGD activity can be measured by quantitation of uroporphyrin I formed from PBG
      under conditions where this is the only end product. The purpose of the present
      study was to define the optimal conditions for quantitating PBGD activity in
      human erythrocytes. The preanalytical factors examined were: anticoagulants and
      methods for disruption of the erythrocytes. The analytical factors examined were:
      duration of preincubation, reaction time, reaction temperature, pH, ionic
      strength and conditions for the oxidation of uroporphyrinogen I to uroporphyrin
      I. Based on the results, we propose an optimized method for determination of PBGD
      activity in erythrocytes.

PMID- 11202056
TI  - Activity and immunohistochemical localization of porphobilinogen deaminase in rat
      tissues.
AB  - Porphobilinogen deaminase (PBGD) is an enzyme involved in the synthesis of heme.
      Acute intermittent porphyria (AIP) is an inherited disease resulting from a
      reduced activity of PBGD. The symptoms seem to be due to a neurological
      dysfunction. Attacks of AIP are often provoked by conditions where the PBGD
      activity becomes insufficient as a result of an increased synthesis of heme in
      the liver. How this affects the nervous tissue is still unknown. It may well be
      that a reduced activity of PBGD in other tissues than the liver is of importance
      too. The aim of the present study was to examine the activity and the
      immunohistochemical localization of PBGD in the following tissues of wistar
      female rats: brain, heart, submandibular gland, liver, kidney, pancreas, ovary,
      stomach, duodenum, jejunum, ileum, colon and musculature. The PBGD activity
      varied considerably among the tissues. It was highest in the liver, 14 pkat/g,
      and lowest in the jejunum, 0.7 pkat/g. The immunohistochemical localization of
      PBGD was studied by antibodies raised against a 40 amino acid synthetic peptide
      that corresponds to a segment in the C-terminal part of PBGD. The study
      demonstrated that the PBGD immunoreactivity was not evenly distributed among the
      various cell types in a given tissue. Immunohistochemical reactions were
      pronounced in Kupffer cells in the liver, in smooth muscle cells of arteries and
      arterioles, in distal and collecting tubules in the kidney, in nerve axons in the
      brain and in ganglionic cells in the intestine. Especially, the
      immunohistochemical reaction in nerve cells is notable considering the nervous
      dysfunction in AIP.

PMID- 11202057
TI  - The W198X and R173W mutations in the porphobilinogen deaminase gene in acute
      intermittent porphyria have higher clinical penetrance than R167W. A population
      based study.
AB  - In northern Sweden, 468 patients with DNA-verified acute intermittent porphyria
      (AIP) were registered. A higher prevalence of manifest AIP was found in patients
      with mutations W198X and R173W when separately compared with mutation R167W,
      indicating higher clinical penetrance. Signs of increased seriousness of the
      disease were also found in patients with the W198X and R173W mutations in
      relation to the number and duration of attacks, impaired renal function and
      chronic disability. One explanation could be lower PBGD enzyme activity resulting
      from the W198X and R173W mutations than from the R167W mutation, though other
      factors might also be the cause.

PMID- 11202058
TI  - Potential health risks of radiofrequency fields from wireless telecommunication
      devices.

PMID- 11202059
TI  - Recent advances in research on radiofrequency fields and health.
AB  - Since the Royal Society of Canada report on potential health risks of
      radiofrequency (RF) fields from wireless telecommunications in the spring of
      1999, there have been several newly published reports on risks associated with
      the use of mobile phones. This article provides a summary of scientific research
      on the potential health effects of radiofrequency fields that has been reported
      since the original Royal Society report was published. This update also discusses
      several earlier results not included in the original report.

PMID- 11202060
TI  - Vascular remodeling in experimentally induced subacute canine pulmonary
      hypertension.
AB  - We quantified in vivo pulmonary vascular remodeling in a large animal model of
      pulmonary hypertension (PH). In group PH (n = 6), 3 mg/kg dehydromonocrotaline
      (DHMC) was administered to 12-week-old beagles via a right atrial injection.
      Eight weeks after DHMC in group PH, pulmonary artery pressure increased
      significantly (P < .05) from 18 +/- 2 mm Hg at baseline to 30 +/- 4 mm Hg. Medial
      wall thickness and medial wall area as a percentage of total vessel diameter or
      area was significantly higher (P < .05) in group PH (29 +/- 9% and 48 +/- 12%)
      than in a control group (n = 5) (7 +/- 1% and 14 +/- 1%). Neointimal
      proliferation was observed in 42% of pulmonary arterioles in the PH group but
      never in the control group. We conclude that a single injection of DHMC in young
      beagles, in addition to the development of moderate degrees of PH after 8 weeks,
      causes significant pulmonary vascular remodeling, with features similar to those
      observed in patients with primary PH.

PMID- 11202061
TI  - Fetal androgen exposure inhibits fetal rat lung fibroblast lipid uptake and
      release.
AB  - Fetal lung fibroblasts provide lipid substrate for type II cell surfactant
      phospholipid synthesis. This process is developmental and glucocorticoid
      dependent. Previous studies in our laboratory demonstrating sex differences in
      several aspects of lung maturation suggest that these differences may be due to
      effects of fetal androgens. Based on these studies, we hypothesized that fetal
      lung fibroblast triglyceride metabolism is determined by opposing effects of
      fetal androgens and glucocorticoids. To model the effects of androgens on fetal
      lung fibroblast triglyceride metabolism, pregnant rats were treated with
      dihydrotestosterone (DHT) 1 mg/kg/day from the days 15 to 20 of gestation, and
      changes in triglyceride content of freshly isolated fetal rat lung fibroblasts
      (FRLF) and rates of uptake and prostaglandin E2 (PGE2)-mediated release by
      cultured FRLF in response to glucocorticoids in the presence or absence of DHT in
      vitro were measured. During lung development, the triglyceride content and rate
      of uptake of female-derived FRLF increased 3.5- and 4.8-fold, respectively,
      between days 18 and 20 of gestation. From days 19 to 22, male FRLF trigyclyceride
      content and rate of uptake were lower than the content and uptake by female FRLF.
      Maternal DHT treatment inhibited the normal developmental increase in fibroblast
      triglyceride content and rate of uptake between days 19 and 22 by both male and
      female FRLF. In the absence of maternal DHT, in vitro dexamethasone stimulated
      triglyceride uptake 3-fold by day 21 in FRLF. This effect was blocked by maternal
      pretreatment with DHT. Maternal DHT exposure prevented stimulation of
      triglyceride release by PGE2. Although in vitro dexamethasone stimulated
      triglyceride release by maternal DHT-exposed fibroblasts, it did not enhance the
      response to PGE2. These data suggest that in utero exposure to androgens (1)
      delay the developmental increase in triglyceride content and (2) oppose the
      effects of glucocorticoid on cultured FRLF triglyceride uptake and PGE2-mediated
      release.

PMID- 11202062
TI  - Influence of neuropeptides on neutrophil adhesion and transmigration through a
      lung fibroblast barrier in vitro.
AB  - The lung is richly supplied with peptidergic nerves that store and secrete
      substance P (SP), vasoactive intestinal peptide (VIP), and other neuropeptides
      known to potently modulate leukocyte function in vitro and airway inflammation in
      vivo. We examined the effect of SP, VIP and the novel sensory neuropeptide
      secretoneurin (SN), as well as of interleukin (IL)-8, IL-6, IL-1 beta,
      transforming growth factor (TGF)-beta, and tumor necrosis factor (TNF), all
      associated with acute lung injury, on human neutrophil migration across a 5-mu
      pore polycarbonate filter system covered by human lung fibroblast monolayers.
      Additionally, we tested the ability of these neuropeptides to elicit neutrophil
      adhesion to fibroblast monolayers. SP, but not VIP and SN, may be important in
      directly influencing neutrophil adhesion to and subsequent migration across a
      subendothelial barrier of fibroblasts and extracellular matrix towards lung
      inflammatory sites. The effect was mainly mediated by neurokinin (NK)-1
      receptors, as evaluated by a specific NK-1 antagonist, [[(S,S)Pro-Leu(spiro-y
      lactam)]9,10, Trp11]substance P (1-11), whereas a specific NK-2 receptor
      antagonist, [Tyr5, D-Trp6,8,9, Lys10]neurokinin A (4-10), was ineffective. The SP
      analog septide and the NK-1 receptor agonist ([Sar9 Met(O2)11)SP were comparably
      effective. Furthermore, the SP effect was concentration and time dependent.
      However, the other tested neuropeptides might also affect neutrophil recruitment
      in inflammatory lung by modulating other lung cell functions. Additionally, all
      tested cytokines stimulated neutrophil transfibroblast migration in vitro, except
      IL-6. In conclusion, SP in concert with proinflammatory cytokines may regulate
      neutrophil interstitial accumulation and their traffic to the alveolar space in
      lung inflammation.

PMID- 11202063
TI  - Expression of lipoprotein receptor and apolipoprotein E genes by perinatal rat
      lipid-laden pulmonary fibroblasts.
AB  - Lipid-laden interstitial fibroblasts (LIFs) are abundant during alveolar septal
      formation in rats and accumulate droplets of neutral lipids. The mechanisms
      controlling lipid acquisition by LIFs are incompletely understood and
      accumulation varies during postnatal development, because lipid droplets are
      usually a transient phenotype. We hypothesized that plasma lipoproteins may be an
      important source of lipids and that the cells may alter their acquisition of
      lipoproteins by changing the expression of lipoprotein receptors and
      apolipoprotein E. We quantified the accumulation low-density lipoproteins (LDLs)
      and very-low-density lipoproteins (VLDLs) by LIFs and the expression of LDL and
      VLDL receptors mRNA and protein at various perinatal ages and found no
      significant age-related differences. Apolipoprotein E mRNA was maximal at
      postnatal day 15, whereas immunoreactive apolipoprotein E protein was maximal at
      gestational day 21, suggesting complex regulation. Our findings indicate that the
      age-related difference in the lipid droplet contents of LIFs is not primarily
      related to differences in LDL or VLDL receptor expression. They suggest that
      changes in the quantities of plasma lipoproteins, which are presented to LIFs in
      the lung at various perinatal ages, are more likely to be responsible for age
      related alterations in lipid droplet size and abundance.

PMID- 11202064
TI  - Phenotypic and functional differences between rat alveolar, pleural, and
      peritoneal macrophages.
AB  - Tissue macrophages (M phi) play a central and essential role in modulating the
      initiation and perpetuation of the inflammatory response. Phenotypical and
      functional differences among alveolar M phi (AM) and peritoneal M phi (PM) have
      been reported, but less is known about pleural M phi (PLM) and their ability and
      capacity to release biologically active substances. Therefore, the aim of this
      study was to determine the production of superoxide anion, nitric oxide (NO), and
      tumor necrosis factor alpha (TNF-alpha) by PLM in comparison to AM and PM in
      vitro. M phi from rats were isolated by lavage of the respective body compartment
      and characterized by evaluating the expression of the surface antigens MHC class
      II molecules, CD11b, and ED2-like antigen. Upon activation, AM produced
      significantly higher amounts of superoxide anion, NO, and TNF-alpha compared to
      PM and PLM. Taken together, the findings of this study demonstrate that rat PLM
      resemble PM more than AM in terms of production of key inflammatory mediators.

PMID- 11202065
TI  - Women's preferences for providers of and settings for Pap smears.
AB  - OBJECTIVE: To gauge women's flexibility in receiving Pap smears from someone
      other than their regular gynecologists, specifically, their general physicians.
      METHODS: A random sample of 500 English-speaking women members (age 18-80) of
      Kaiser Permanente completed a 20-minute telephone survey (72% response rate). Ten
      focus groups and 75 in-person interviews gathered qualitative information.
      RESULTS: Approximately half the surveyed women would see an unfamiliar
      gynecologist for a Pap smear (48%) and did not have a preference for the gender
      of the clinician (53%). Most women (72%) were open to seeing nurse practitioners
      if their regular gynecologists were not available. Although few women (26%) were
      initially positive about receiving Pap smears in their general medical clinics,
      half (45%) said they would prefer that to waiting for an appointment in
      gynecology. Interest was especially high (52%) among women with female rather
      than male internists or family practitioners (33%). CONCLUSIONS: Redesign efforts
      must emphasize choice in Pap smear delivery in order to increase convenience
      while respecting preferences for the existing system.

PMID- 11202066
TI  - Women in agriculture: risk and injury experiences on family farms.
AB  - OBJECTIVES: To determine the one-year incidence of nonfatal farm injuries among
      women actively engaged in farm work; to determine the distribution of these
      injuries by external cause, severity, and other characteristics; and to determine
      the potential risk factors for injuries among farm women. METHODS: A population
      based study of the occurrence of agricultural injuries during the previous year
      was conducted in a stratified, random sample of 1096 actively working farm women
      in Texas and Louisiana. Sampling pools were generated from county plat listings
      in Texas and maintained mailing lists in Louisiana; counties were selected based
      on geographical and agricultural diversity. Eligible women were interviewed by
      phone about injury occurrences and patterns. RESULTS: The cumulative one-year
      incidence of farm injuries for women in this area was 5% (95% CI = 3.7-6.3),
      based on the number of farm women injured. Lower extremities were the most
      frequently injured body parts. The leading external causes were contact with
      foreign object/substance, falls, and overdoing/lifting/hauling. Most injuries
      occurred in the summer or spring. Factors predictive of increased injury risk in
      adjusted logistic regression included working on large-animal farms, more time
      spent in farm work, persistent back pain or weakness during the previous 12
      months, driving a tractor, and hauling farm goods to market. Most women consulted
      physicians as a result of their injuries. CONCLUSION: Physicians are in a unique
      position to institute interventions to prevent risky behaviors.

PMID- 11202067
TI  - Assessment of clinical partner violence screening tools.
AB  - OBJECTIVE: To compare the Women's Experience with Battering Scale (WEB) with the
      Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify
      intimate partner violence (IPV). METHODS: We conducted a large cross-sectional
      survey of women age 18 to 65 attending one of two family practice clinics from
      1997 to 1998. All women completed both the WEB and the ISA-P and a telephone
      interview. We figured agreement estimates between the two tools, used stratified
      analyses to evaluate attributes of those more likely to screen as battered or
      physically assaulted, and compared associations between the WEB and ISA-P and a
      range of mental and physical health indicators known to be associated with IPV.
      RESULTS: 18% of 1152 eligible women surveyed had experienced IPV in a current or
      most recent intimate relationship with a male partner; 17% had been battered
      (WEB+), and 10% had been physically assaulted (ISA-P+). Had we used the ISA-P
      alone to assess IPV, we would have missed almost 45% of IPV. As anticipated, the
      ISA-P was more strongly associated with IPV-associated injuries and number of
      physician visits in the last year. The WEB was more strongly associated with self
      perceived mental health, anxiety, depression, drug abuse, and low social support.
      CONCLUSION: Clinicians need validated screening tools to rapidly and reliably
      screen patients for IPV. Most screening tools assess physical violence and injury
      without considering the more chronic experience of battering and the
      psychological terror associated with this violence. The WEB may identify more
      abused women than tools measuring physical assaults.

PMID- 11202068
TI  - Syphilis elimination: a unique time in history.

PMID- 11202069
TI  - Implementing the Institute of Medicine report on lesbian health.
AB  - The Institute of Medicine (IOM) recently published the report of its committee on
      lesbian health research priorities, which concluded that there has been little
      emphasis on and funding for research on the health of lesbians, despite the
      increased emphasis on women's health research in the 1990s. The report
      recommended additional research to determine if lesbians are at higher (or lower)
      risk for certain health problems than other women. It noted significant barriers
      to conducting lesbian health research, including lack of funding and several
      methodological issues. The IOM anticipates that the research recommended will
      benefit other populations as well. Several federal agencies in the Department of
      Health and Human Services can provide technical expertise and support to
      implement the report's recommendations, and suggestions are given here. The IOM
      report legitimizes scientific investigation into lesbian health, which should
      increase public and private research funding and the number of researchers in
      this area. A paradigm shift for lesbian health research is on the horizon, and we
      are grateful to the dedicated cadre of researchers, both published and
      unpublished, who have pioneered and persisted in this research during the past 25
      years.

PMID- 11202070
TI  - Substance abuse and mental illness: unaddressed public health issues for women.
AB  - Although women have been disproportionately affected by substance abuse and
      mental illness, these issues have received little attention. Women with substance
      abuse and mental disorders tend to experience more severe environmental, health,
      social, and economic consequences and require more costly care. The Substance
      Abuse and Mental Health Services Administration is responsible for strengthening
      the nation's health care delivery system for prevention and treatment of
      substance abuse and mental illness and addresses women's issues through its
      Women, Children, and Families Team (WCFT). The WCFT is concerned with the public
      health risks associated with substance abuse and mental disorders in women,
      including physical and sexual abuse/violence, human immunodeficiency virus and
      acquired immune deficiency syndrome, criminal justice, welfare reform, and child
      welfare.

PMID- 11202071
TI  - Women and HIV: creating an ambiance of caring.
AB  - In their study of women living with or at risk of human immunodeficiency virus
      (HIV) infection, Schuman et al found that one-third of women reported needing
      mental health care, but that only two-thirds of those in need had that need met.
      This article describes an approach to providing mental health services to women
      with HIV used in our Chicago clinic. What we call the "ambiance of caring"
      creates an atmosphere in which mental health support can be provided and
      received. A continuing respectful primary care relationship and a supportive non
      judgmental environment are the keys to success. Good communication, sensitive
      history taking, appropriate assessment tools, and direct questioning in a safe
      setting will let the patient know that you really care about what she is
      experiencing. Real-time referrals with a team of social workers, psychologists,
      and psychiatrists allow the best beginning to the therapeutic relationship. The
      next decade will provide an opportunity to address the mental health concerns of
      women with HIV--some of our society's most complex patients.

PMID- 11202072
TI  - [AIDS and anesthesia: mutual risks]  .

PMID- 11202073
TI  - [Aids and anesthesia]  .
AB  - 17 years after the discovery of HIV Aids remains an ultimately fatal disease.
      Currently no vaccine is available. The worldwide incidence of HIV-infections and
      Aids associated mortality are rising. Only in Western Europe and in the USA are
      incidence and mortality of Aids declining; mainly as a result of effective
      antiretroviral therapy. 20% to 25% of HIV-infected patients require surgery
      during their illness. The challenges for the anaesthesiologist are possible
      dysfunction of all important organs and adverse interactions between
      antiretroviral drugs and anaesthetic agents. If adequate infection control
      measures are taken the risk of occupational HIV-infection is low, but remains a
      concern in light of the consequences. Seroconversion after needlestick injury is
      ca. 0.3%, after contact with mucosa ca. 0.03%.

PMID- 11202074
TI  - [The effect of air within the infusion syringe on drug delivery  of syringe pump
      infusion systems]  .
AB  - Application of highly concentrated short-acting vasoactive drugs in the
      critically ill patient requires precisely working syringe pump systems for
      continuous intravenous drug delivery. We performed a bench study to investigate
      the consequences of small amounts of air entrapped within a 50-ml infusion
      syringe. In particular we studied the effect of entrapped air on drug delivery
      after moderate vertical displacement of the pump by 50 cm (e.g. in preparation
      for transport) and the effect on the time required to trigger the pressure alarm
      after occlusion of the infusion line. At a flow rate of 1 ml/h, lowering the
      syringe pump prolonged the zero-drug delivery time from (mean +/- SD) 4.1 +/- 0.8
      min (without air) to 6.2 +/- 0.9 (with 1 ml air) and to 13.1 +/- 0.9 min (with 2
      ml of air, p < 0.001 for all comparisons). Entrapping of 2 ml of air within the
      syringe resulted in a 2.6-fold prolongation of the occlusion alarm time after
      accidental occlusion of the infusion line and a 3-fold increase of the resulting
      infusion bolus after occlusion. Enclosed air within infusion syringes
      considerably affects the syringe compliance. It increases the susceptibility of
      constant drug delivery to vertical displacement of syringe pumps and impairs the
      occlusion alarm function. Therefore, any air in syringe of infusion pump systems
      should be carefully removed. To avoid infusion boluses of short-acting vasoactive
      drugs after accidental occlusions, the occluded infusion line should be released
      to ambient pressure first.

PMID- 11202075
TI  - [Patient-oriented anesthesia]  .
AB  - Goals of this study were to quantify patients' preferences for anaesthesia care
      and to identify what they know about various tasks of an anaesthetist. On the day
      before surgery, 122 patients scheduled for elective procedures were interviewed
      using a structured questionnaire. A reliable pain relieve and unawareness as well
      as stable vital functions have priority in patients' preferences. Patients are
      also concerned with good postoperative pain relieve and the avoidance of nausea
      and vomiting. Not important are short preoperative soberness, rapid awakening and
      initial wide awakeness. Not informed about typical tasks of an anaesthetist are
      28-51% of the patients. In order to obtain maximum patient satisfaction, a
      thorough education plus further continuous training are the essential items for a
      patient orientated health care management in anaesthesia, along with good medical
      and technical equipment. The wide spectrum of tasks of an anaesthetist must be
      better represented in order to strengthen the position of anaesthesia in the
      competition for rare resources. A postoperative visit, which is judged of 77% of
      the patients as important, offers a beginning.

PMID- 11202076
TI  - [Unilateral phrenic nerve paralysis after vertical infraclavicular  plexus block]
      .
AB  - We present a case of a rapid onset reversible phrenic nerve block following
      vertical infraclavicular blockade of the brachial plexus. Five minutes after
      injection of local anaesthetics the SpO2 fell to 80%. Oxygen supplementation was
      required during the perioperative period to maintain normoxemia. The
      postoperative X-ray showed an elevated diaphragm of the ipsilateral side. After
      five hours oxygen supply could be terminated, an X-ray control the next day
      showed normal bilateral diaphragm position.

PMID- 11202077
TI  - [Fulminant pulmonary embolism after cesarean section].
AB  - On the first day after an uneventful emergence caesarean section a 36-year-old
      woman developed circulatory collapse requiring cardiopulmonary resuscitation for
      15 minutes. After resuscitation the patient remained haemodynamically unstable
      and was clinically highly suspected to suffer from fulminant pulmonary embolism.
      In this situation the physicians caring for the patient decided to perform a
      surgical pulmonary embolectomy without previous diagnostic workup. Massive emboli
      were removed from both pulmonary arteries. Postoperatively the patient recovered
      and was transferred to a rehabilitation center without severe cerebral sequelae.

PMID- 11202078
TI  - [The historical development of intensive care in Germany.  Contemporary views.
      20. The limits of intensive care--economic  and ethical limits]  .

PMID- 11202079
TI  - [The historical development of intensive care in Germany.  Epilogue to a thematic
      review in Der Anaesthesist]  .

PMID- 11202080
TI  - [Continuous or discontinuous monitoring of sedation in the intensive care unit? 
      The effects of daily interruptions of sedation monioring in respirator  patients]
      .

PMID- 11202081
TI  - [The Nobel Prize for Medicine 2000. Communicating nerve cells]  .

PMID- 11202082
TI  - [Catecholamine therapy in sepsis]  .

PMID- 11202083
TI  - [Thromboembolytic complications. Alternative anticoagulation in HIT II].

PMID- 11202084
TI  - Audit of treatment by radiotherapy of carcinoma of the cervix in the UK in 1993:
      worse than expected results.

PMID- 11202085
TI  - Morbidity in radiotherapy practice.

PMID- 11202087
TI  - Cervical carcinoma recurring in an abdominal wall incision.
AB  - Incisional recurrence of carcinoma of the uterine cervix is very rare. We report
      two patients who developed recurrence in the abdominal wall incision after
      hysterectomy. The first patient was aged 60 years and had a FIGO Stage IB1
      cervical carcinoma treated initially by Wertheim's hysterectomy and postoperative
      radiotherapy. Nine months after surgery she developed recurrence on the abdominal
      scar, which was outside the radiation portal. She was treated with electron beam
      radiation therapy. The second patient developed an incisional recurrence 23
      months after surgery and was treated by wide excision of the mass followed by
      radiotherapy. A survey of the literature identified 12 reported cases to date
      (eight squamous cell carcinoma and four adenocarcinoma).

PMID- 11202086
TI  - National audit of the management and outcome of carcinoma of the cervix treated
      with radiotherapy in 1993.
AB  - The aim of the study was to investigate the UK prevalence of late, severe side
      effects associated with radical radiotherapy for cancer of the cervix and try to
      identify associated factors. All patients treated for cancer of the cervix with
      radical radiotherapy in 1993 were identified and retrospective case notes studied
      to determine mortality and severe complications occurring following treatment. Of
      the 55 radiotherapy departments in the UK that were treating gynaecological
      malignancy in 1993, 53 participated in the study. There were 1558 patients with
      carcinoma of the cervix receiving radical radiotherapy as part of their treatment
      regimen in 1993, whose patterns of treatment were assessed. The main outcome
      measures were the development of late severe complications as defined by the
      Franco-Italian Glossary and mortality. Of the patients receiving surgery and
      radiotherapy, 58.5% underwent Wertheim's procedure. The crude rate of late severe
      complications in all patients with cervical cancer treated with radical
      radiotherapy in 1993 was 6.1% (actuarial rate 8%) at 5 years, and only four of
      the 91 patients who developed complications died as a result of their morbidity.
      There was no significant correlation of stage, centre size, surgery or
      radiotherapeutic approach with late morbidity in univariate analysis. The overall
      survival at 5 years was 47% and was lower than that of the European data from
      FIGO's 1990-92 cohort, for all stages. Increasing FIGO stage was the only factor
      significantly associated with mortality. The absence of variables that were
      significantly associated with late complications may well be related to the
      relatively low event rate compared to the sample size. Differences in surgical
      treatment prior to radiotherapy and radiation technique may be confounding the
      comparison of outcomes. The relatively poor survival for locally advanced disease
      and the difficulty with which these data were collated indicates that national
      prospective data collection is urgently required to monitor performance and hence
      derive best practice.

PMID- 11202088
TI  - Neuroendocrine small cell carcinoma of the uterine cervix: what disease? What
      treatment? Report of ten cases and a review of the literature.
AB  - Neuroendocrine small cell carcinoma of the uterine cervix (NESCCC) is an entity
      with very aggressive behaviour. The optimal initial therapeutic approach to this
      rare disease has not yet been clearly defined. We reviewed our experience of this
      disease over the past 10 years with regard to chemosensitivity. Since 1988, ten
      patients (mean age 33 years; range 24-47) have been diagnosed with NESCCC and
      treated in our institutions. Disease stage at presentation was IA (one), IB
      (five, two with lymph node involvement), IIB (one), IIIB (one), and IV (two). One
      patient had metastatic disease at presentation; three developed metastases during
      initial treatment. Eight patients underwent surgery and eight received radiation
      therapy. Six patients received pre- or postoperative cisplatinumvepeside (PE)
      combination chemotherapy, either alone or concurrently with radiation therapy. PE
      alone as primary chemotherapy led to disease stabilization in the two patients so
      treated; concurrent PE and radiation therapy resulted in a pathological complete
      response in one patient. Eight patients relapsed within 16 months and died of
      their disease within 29 months from the initial diagnosis. Two patients are alive
      with no evidence of disease at 13 and 53 months. Our series confirms the
      previously described very poor prognosis of NESCCC, despite initial aggressive
      multidisciplinary treatment. It may be that the introduction of chemotherapy,
      especially combined primary chemoradiotherapy, might allow patients to do a
      little better, although at the moment there is no good evidence one way or the
      other.

PMID- 11202089
TI  - Optimizing the management of differentiated thyroid cancer.

PMID- 11202090
TI  - Radioiodine treatment for differentiated thyroid cancer.

PMID- 11202091
TI  - Northern Cancer Network guidelines for management of thyroid cancer.

PMID- 11202092
TI  - A pilot study of postoperative CHART and CHARTWEL in head and neck cancer.
AB  - A Phase II pilot study of continuous hyperfractionated accelerated radiotherapy
      (CHART)/CHART weekend less (CHARTWEL) was carried out in the postoperative
      treatment of patients with squamous cell carcinoma of the head and neck. Twenty
      four patients (17 male, seven female) with a median age of 64 years (range 34-80)
      were treated with postoperative radiotherapy between 1991 and 1999. All patients
      presented with primary squamous cell carcinoma, which, at surgery, had shown
      adverse pathological factors for recurrence. Intermediate risk was determined by
      the presence of two of the following factors: margins 5 mm, Stage T3/T4,
      perineural or vascular invasion, poor differentiation, oral primary, multicentric
      primary, and more than four positive lymph nodes. High-risk factors included the
      presence of extracapsular spread and/or incomplete resection margins, or the
      presence of four of the factors defining intermediate risk. The patients were
      treated using a CHART (n = 11) or a CHARTWEL (n = 13) schedule, administering a
      dose between 49.5 Gy and 54 Gy. High-risk factors were present in 18/24 patients.
      Treatment was commenced from a median time of 6.9 weeks (range 4.4-16.6) after
      radical surgery. All patients completed treatment. A confluent radiation
      mucositis occurred in 20/23 evaluable patients, which settled in 4-10 weeks after
      commencing radiotherapy. Moderate dysphagia was observed in 13 patients. Mild
      subcutaneus oedema was noted in 11 patients from 12 weeks after treatment. No
      significant late toxicity has been observed. Over a median follow up-period of 17
      months, local control has been maintained in 17 patients (71%). Seven patients
      have relapsed and died of disease. A mean survival of 24 months (range 1-84) has
      been observed. This pilot study demonstrates acceptable morbidity for
      CHART/CHARTWEL in the postoperative setting. A prospective multicentre randomized
      trial using an accelerated schedule of radiotherapy versus conventional
      fractionation for the radical postoperative treatment of primary head and neck
      cancer is currently in preparation.

PMID- 11202093
TI  - Paranasopharyngeal space involvement in nasopharyngeal cancer: detection by CT
      and MRI.
AB  - Paranasopharyngeal tumour extension (PTE) from nasopharyngeal carcinoma (NPC) is
      staged in its own subgroup in the American Joint Committee on Cancer
      classification. Most large clinical trials use computed tomography (CT) to stage
      PTE, but diagnosis relies on indirect signs of tumour invasion such as asymmetry
      of the parapharyngeal fat. Magnetic resonance imaging (MRI) has the advantage of
      directly revealing PTE because of its ability to depict the complex anatomical
      structures that form the boundary of the nasopharynx. The aim of this study was
      to compare CT and MRI in the identification of PTE and to determine whether the
      imaging modality used influenced staging of the disease. The MRI and CT scans of
      78 patients (156 parapharyngeal regions) with NPC were assessed for PTE. On MRI,
      PTE was considered to be positive when there was tumour invasion through the
      complex anatomical structures of the nasopharyngeal wall. When using CT, it was
      considered positive when there was: (1) distortion of the parapharyngeal fat
      plane; or (2) extension beyond a line drawn from the medial pterygoid plate to
      the lateral aspect of the carotid artery. CT scanning and MRI were compared. PTE
      was judged to be present in 28 of 78 (36%) patients by MRI and in 41 of 78 (53%)
      scanning by CT when using criterion 1 or 2. An analysis of the discordant
      findings revealed that MRI was positive in three sides of the nasopharynx in
      early tumour extension through the pharyngobasilar fascia but not identified with
      CT by using criterion 1 or 2. MRI was negative in 20 and 21 sides of the
      nasopharynx that were judged to be positive on CT by using criterion 1 and 2
      respectively. In these patients MRI revealed that the positive CT scan was caused
      by a large tumour compressing but not invading the parapharyngeal fat space, a
      metastatic lateral retropharyngeal node, or a combination of the two. The imaging
      modality used for staging NPC has an impact on the staging of PTE. CT scanning
      suggested the presence of PTE more frequently than MRI because of its inability
      to distinguish the primary tumour from lateral retropharyngeal nodes, and direct
      tumour invasion of the parapharyngeal region from tumour compression. The imaging
      modality and criteria used for staging PTE should be taken into consideration
      when assessing the results of clinical studies.

PMID- 11202094
TI  - Late radiation side-effects in three patients undergoing parotid irradiation for
      benign disease.
AB  - We report three patients in whom standard radiation therapy was given and serious
      late radiation damage was seen. The first patient suffered recurrent parotiditis
      and a parotid fistula. He was treated initially with 20 Gy in ten fractions via a
      300 kV field. Further irradiation was required 1 year later and 40 Gy was given
      in 2 Gy fractions by an oblique anterior and posterior wedged photon pair. Ten
      years later he developed localized temporal bone necrosis. The second patient,
      with pleomorphic salivary adenoma, developed localized temporal bone necrosis 6
      years after 60 Gy had been given using standard fractionation and technique. The
      third patient received 55 Gy in 25 fractions for a pleomorphic salivary adenoma
      and after 3 years developed temporal bone necrosis. Sixteen years later the same
      patient developed cerebellar and brainstem necrosis. All patients developed
      chronic persistent infection during or shortly after the radiation therapy, which
      increased local tissue sensitivity to late radiation damage. As a result, severe
      bone, cerebellar and brainstem necrosis was observed at doses that are normally
      considered safe. We therefore strongly recommend that any infection in a proposed
      irradiated area should be treated aggressively, with surgical debridement if
      necessary, before radiotherapy is administered, or that infection developing
      during or after irradiation is treated promptly.

PMID- 11202095
TI  - Carotid sinus syndrome secondary to head and neck malignancy: case report and
      literature review.
AB  - We report two cases of carotid sinus syndrome secondary to head and neck
      malignancy. The underlying mechanisms unique to head and neck malignancy and
      treatments of the syndrome are discussed.

PMID- 11202096
TI  - Brachial plexus traction injury following axillary node dissection.

PMID- 11202097
TI  - United Kingdom Radiation Oncology 1 Conference (UKRO 1), York, 23-25 April 2001.

PMID- 11202098
TI  - Posttraumatic stress disorder in children after the military operation "Anfal" in
      Iraqi Kurdistan.
AB  - Five years after the military operation "Anfal" in Iraqi Kurdistan, 45 families
      were randomly selected among the survivors in two displacement camps. The
      Posttraumatic Stress Symptoms for Children (PTSS-C) and the Harvard Trauma
      Questionnaire (HTQ) were administered to the oldest child and the caregiver in
      each family, respectively. Posttraumatic stress disorder (PTSD) was reported in
      87% of children and 60% of their caregivers. While childhood PTSD was only
      significantly predicted by child trauma score and the duration of captivity, it
      was neither predicted by maternal PTSD nor did it disappear after the reunion
      with the PTSD-free father. However, the small sample size makes the results
      hypotheses rather than conclusive.

PMID- 11202099
TI  - Adolescents hospitalised with deliberate self-harm: the significance of an
      intention to die.
AB  - All suicide attempters admitted to medical wards in the greater Oslo area, (n =
      91) aged 13-19 years, were dichotomised on the basis of one item in the Motives
      for Parasuicide Questionnaire (MPQ) and one item in the Suicide Intent Scale
      (SIS): if the intent was to die (n = 57), or not (n = 34). The two groups were
      compared regarding the attempt, mental health problems, and psychosocial risk
      factors. The attempt of adolescents with an intent to die were more serious,
      rated with SIS (15.7 vs. 5.7, p < 0.001), with Risk Rescue Rating (p = 0.003) or
      rated medically (p < 0.05). They were clinically more often depressed (61% vs.
      32%, p < 0.01), felt more hopeless (Hopelessness Scale) (10.8 vs. 8.2, p < 0.05),
      were less disruptive (11% vs. 32%, p < 0.05) and less often abused substances (0
      vs. 12%, p < 0.05). Both groups were equally burdened with other factors.
      Differentiation on the basis of suicidal intent delineated two groups, both with
      considerable psychosocial problems. Those with suicide intent had more
      internalising problems including depression, while those with other intents
      showed more externalising behaviour. The need for help in the group with no
      intent to die may be underestimated.

PMID- 11202100
TI  - Using DSM diagnoses for clinical, research, and administrative purposes.
AB  - DSM data are often used to build statistics on the types of patients to whom
      mental health services are offered. These statistics are normally based on broad
      categories that cluster finer subcategories for specific diagnoses. These broad
      categories can be built in a number of ways. The purpose of this study is to
      determine the effect of the choices made in forming broad DSM categories, by
      observing the resulting differences in clinical health statistics. Results based
      on 3496 clinical cases show that DSM-III-(R) classifications can be presented in
      different formats, leading to different outcomes. To avoid wrong conclusions
      based on one format, DSM statistics should always be presented in varying
      formats.

PMID- 11202101
TI  - Have the Cross-Informant Syndromes of the CBCL any practical value in identifying
      grouped ICD10 diagnoses?
AB  - 120 children referred to a child and adolescent psychiatric service in a
      university clinic were studied with the aim of deriving predictors for grouped
      ICD10 diagnoses using the CBCL Cross-Informant-Syndromes (CISs). CIS7 (Delinquent
      Behaviour) and CIS8 (Aggressive Behaviour) were shown to significantly separate
      Disruptive Behaviour Disorders from all other disorders. As cross-validation, a
      separate clinical sample of 118 children from a similar service in another part
      of the country was used to see to what extent the CIS predictors from the first
      sample held up in the second sample. Positive and Negative Predictive Powers, all
      corrected for chance, confirmed that the Disruptive Behaviour Disorder group
      could be usefully separated from all other disorders using the Delinquent
      Behaviour and the Aggressive Behaviour Cross-Informant Syndrome scores. There was
      no good evidence that Emotional (Anxiety-Mood) Disturbance could be usefully
      separated in the same way using the Anxious-Depressed Syndrome (CIS3) or any
      other syndrome. Discriminant Function Analysis showed that there was no
      significant improvement in prediction when more elaborate linear combinations of
      the syndromes were used.

PMID- 11202102
TI  - Comparing the German versions of the Strengths and Difficulties Questionnaire
      (SDQ-Deu) and the Child Behavior Checklist.
AB  - The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural
      screening questionnaire that can be completed in about 5 minutes by the parents
      and teachers of 4-16 year olds. The scores of the English version correlate well
      with those of the considerably longer Child Behavior Checklist (CBCL). The
      present study compares the German versions of the questionnaires. Both SDQ and
      CBCL were completed by the parents of 273 children drawn from psychiatric clinics
      (N = 163) and from a community sample (N = 110). The children from the community
      sample also filled in the SDQ self-report and the Youth Self Report (YSR). The
      children from the clinic sample received an ICD-10 diagnosis if applicable.
      Scores from the parent and self-rated SDQ and CBCL/YSR were highly correlated and
      equally able to distinguish between the community and clinic samples, with the
      SDQ showing significantly better results regarding the total scores. They were
      also equally able to distinguish between disorders within the clinic sample, the
      only significant difference being that the SDQ was better able to differentiate
      between children with and without hyperactivity-inattention. The study shows that
      like the English originals, the SDQ-Deu and the German CBCL are equally valid for
      most clinical and research purposes.

PMID- 11202103
TI  - The Strengths and Difficulties Questionnaire among Finnish school-aged children
      and adolescents.
AB  - The emotional and behavioural problems of 7- to 15-year-old Finnish children and
      adolescents (n = 735) were assessed in a community population by a brief
      screening instrument, the Strengths and Difficulties Questionnaire (SDQ). The
      parent-, teacher- and self-reports of the SDQ were obtained. The results show
      that for the total scores, the inter-rater agreement between the pairs of reports
      was 0.38-0.44. The internal consistency in all three questionnaires was 0.71.
      Functioning above the 90th percentile of the SDQ total difficulties scores in
      parent-, teacher- and self-reports was strongly associated with help-seeking
      variables and problematic behaviour according to parents. The correlation of the
      parental SDQ total scores and the Child Behaviour Checklist total scores was 0.75
      and the correlation of the self-report SDQ total scores with the Youth Self
      Report total scores was 0.71. The differences in sex, grade and informants of the
      SDQ total difficulties scores are reported. The study gives further evidence of
      the usefulness of the SDQ as a promising screening instrument for epidemiological
      research and clinical purposes.

PMID- 11202104
TI  - Reliability and validity of a child-specific cross-cultural instrument for
      assessing posttraumatic stress disorder.
AB  - The Posttraumatic Stress Symptoms in Children (PTSS-C) was developed as a cross
      cultural semi-structured interview to diagnose posttraumatic stress disorder
      (PTSD) and to identify PTSD-non-related posttraumatic stress symptoms in children
      after various traumatic experiences. The psychometric properties were studied in
      two different child populations in Iraqi Kurdistan (the survivors of the military
      operation "Anfal", and the orphans), in a sample of Kurdistanian refugee children
      in Sweden, and in a comparison sample of Swedish children. The instrument yielded
      satisfactory internal consistency, high interrater agreement, and excellent
      validity on cross-validation with the Child Posttraumatic Stress Disorder
      Reaction Index (CPTSD-RI) and the Diagnostic Interview for Children and
      Adolescents (DICA) according to the Diagnostic and Statistical Manual of Mental
      Disorders (DSM-IV).

PMID- 11202105
TI  - Diagnostic assessment of communicative and interactive behaviours in children
      with autism and receptive language disorder.
AB  - Children with autism and children with a severe specific receptive language
      disorder both show clear deficits in communicative language skills and in social
      relationships. In this study the usefulness of the Autism Diagnostic Observation
      Schedule (ADOS) in the differential diagnosis between these two groups of
      developmentally impaired children is assessed. 11 children with early infantile
      autism and 20 children with a specific receptive language disorder participated
      in the study. 18 children with an expressive language disorder were used as a
      control group. The ADOS was individually administered to all children by the same
      examiner. The results showed that on most of the ADOS measures the autistic
      children were clearly more deviant than the language impaired children. There
      were no significant differences between the two groups of language impaired
      children. Eight out of 11 autistic children reached the defined cut-off values on
      the measures "language and communication" and "social interaction" of the ADOS
      algorithm, whereas only three autistic children did so on the measure
      "stereotyped behaviour". None of the language-impaired children reached the cut
      off values on more than one measure. The ADOS allowed for good assessment of
      certain types of behaviour. However, to confirm the diagnosis of infantile
      autism, additional information from parents is required.

PMID- 11202106
TI  - Severely disturbed children's human figure drawings: are they unusual or just
      poor drawings?
AB  - Previous research has shown that the human figure drawings of severely disturbed
      children contain more emotional indicators than those of well-adjusted children,
      whether the well-adjusted children are of the same chronological age or are
      younger but of the same mental age as the severely disturbed children. This
      finding suggests that the disturbed children's drawings may be different rather
      than merely immature. A problem with previous research, however, is that groups
      have not been matched for drawing ability. In study 1 of this paper each drawing
      of 44 severely disturbed boys was matched with that of a normal boy according to
      its score on the Goodenough-Harris scoring system. There was no significant
      difference between the groups in the number of emotional indicators included in
      the drawings. Furthermore, in study 2, judges could not discriminate the drawings
      of the two groups. It was concluded that the differences noted in previous
      research were most likely due to the poorer drawing ability of the severely
      disturbed children rather than unusual features in their drawings.

PMID- 11202107
TI  - Case report: autistic disorder and chromosomal abnormality 46, XX duplication (4)
      p12-p13.
AB  - We report an 18-year-old female with a diagnosis of DSM-IV Autistic Disorder and
      moderate to severe mental retardation who was discovered to have a previously
      undescribed chromosomal abnormality 46, XX, duplication (4) p12-p13. We discuss
      her history and diagnosis, noting that the co-occurrence of her diagnoses have
      not previously been documented. The report adds to the literature supporting the
      argument that individuals with autistic spectrum disorders should be re-examined
      for chromosomal abnormalities.

PMID- 11202108
TI  - Stimulants in AD/HD, a controversial treatment only in Sweden?

PMID- 11202109
TI  - Diagnosis: a Janeway lesion and an Osler's node.

PMID- 11202110
TI  - Value of standard laboratory tests for the early recognition of group A beta
      hemolytic streptococcal necrotizing fasciitis.
AB  - The laboratory data for 17 patients with group A beta-hemolytic streptococcal
      necrotizing fasciitis (GAS NF) were compared with data for 145 patients
      hospitalized for cellulitis during the same period. Admission values of C
      reactive protein and creatine kinase were higher for patients in the group with
      GAS NF than for patients in the group with cellulitis (P<.001), suggesting that
      standard laboratory tests may be useful for the early differential diagnosis of
      GAS NF and cellulitis.

PMID- 11202111
TI  - Intervene more often, evaluate more carefully, build on what works.

PMID- 11202112
TI  - Effectiveness of the Indiana 4-H tractor program at instilling safe tractor
      operating behaviors and attitudes in youth.
AB  - The purpose of this research was to determine what impact the Indiana 4-H Tractor
      Program has had on safer tractor operating behavior and attitudes of participants
      and to provide recommendations for program improvement. To assess the impact, 108
      non 4-H youth who reported they operated a tractor regularly were compared with
      104 4-H Tractor Program participants. A single skilled evaluator observed each
      individual in the two groups as she/he operated a tractor through a standard
      tractor-operating course. Information on recent tractor-related injury history
      and attitudes toward tractor safety was gathered using a written survey. Results
      showed that the program has had both a perceived and demonstrable positive
      influence; however, a need for improvements was also shown. Most significant of
      the findings was that participants in the 4-H Tractor Program were observed to
      operate tractors in a safer and more skillful manner. Even though the 4-H Tractor
      Program participants reported substantially more exposure time to tractor
      operation, they did not report a significantly different injury experience in
      comparison to the non-participants. Responses from the 4-H program participants,
      however, indicated a trend toward having more tractor-related close call
      incidents. There was no significant difference between the two groups in their
      attitudes toward tractor safety. Program recommendations developed as a result of
      the study primarily related to the need for updating instructional material used
      in the 4-H Tractor Program and the need for additional training and resources for
      volunteer leaders.

PMID- 11202113
TI  - Job hazards for musculoskeletal disorders for youth working on farms.
AB  - A series of eight focus groups were convened to: (1) identify tasks and
      activities performed by youth on farms with the potential for causing non
      traumatic work-related Musculoskeletal Disorders (MSDs); (2) determine the
      participants perceptions about risks of MSDs for youths performing those tasks;
      and (3) determine other factors that might relate to MSDs for youth working on
      farms, such as possible interventions for prevention. Seventy-two farm family
      members, 40 adults and 32 farm youth aged 8-18, participated in focus groups. Ten
      questions were posed to each of the eight groups about what tasks youth perform
      on the farm, how the work is assigned, and what risk factors are associated with
      the work. There was general agreement among the adults that maturity rather than
      age is the dominant factor for determining what tasks are performed by youth
      workers on the farm. Youth, on the other hand, believed that task urgency
      dictated what jobs were assigned to youth workers. Most adults indicated that
      lifting objects, forking, or shoveling was responsible for most of the serious
      non-traumatic injuries. Bending over while working, sitting in an awkward
      position looking back at equipment from a tractor, sitting in a cramped position,
      looking down at a combine header, and long hours of work were also identified as
      potential problems. Youth described muscle aches and strains of the legs, arms,
      shoulder, back or neck as everyday occurrences. According to the youth, "If it's
      not broken, you're fine". Only basic training is provided and most respondents
      believed that youth learned best through observation. There was general agreement
      that physician recommended guidelines for assigning youth to tasks would be
      ignored unless they carried the force of the law.

PMID- 11202114
TI  - The perception of farm safety and prevention issues among the Old Order Amish in
      Lancaster County, Pennsylvania.
AB  - The purpose of this study was to explore farm safety and prevention issues within
      an Old Order Amish community. A qualitative ethnographic approach was used to
      explore perceptions of Amish adults as to the issues related to farm safety and
      prevention for their children. Access to this community was facilitated through
      two contact people who were well known in the community. Data were collected
      using semistructured interviews and recorded as field notes. Data analysis was
      done by looking for themes based on the questions asked about safety and
      prevention. From this analysis, four themes were found related to safety and
      prevention. They included education of the parents, education of the children,
      home and farm preventive measures, and enforcement of established rules. In
      addition, childhood readiness was found to be another important issue related to
      farm safety. Childhood readiness was found to have three themes, developmental
      appropriateness, parental control and supervision, and birth order of the child.
      Data from this study suggested that farm safety is a concern of the Old Order
      Amish in Lancaster County. Their perceptions of safety and prevention issues
      centered on the incidents that have occurred and are considered dangerous. It is
      important to look at the identified safety and prevention and childhood readiness
      themes to identify the most beneficial approaches for the Amish to promote safety
      on their farms.

PMID- 11202115
TI  - Finite element modeling of ROPS in static testing and rear overturns.
AB  - Even with the technological advances of the last several decades, agricultural
      production remains one of the most hazardous occupations in the United States.
      Death due to tractor rollover is a prime contributor to this hazard. Standards
      for rollover protective structures (ROPS) performance and certification have been
      developed by groups such as the Society of Automotive Engineers (SAE) and the
      American Society of Agricultural Engineers (ASAE) to combat these problems. The
      current ROPS certification standard, SAE J2194, requires either a dynamic or
      static testing sequence or both. Although some ROPS manufacturers perform both
      the dynamic and static phases of SAE J2194 testing, it is possible for a ROPS to
      be certified for field operation using static testing alone. This research
      compared ROPS deformation response from a simulated SAE J2194 static loading
      sequence to ROPS deformation response as a result of a simulated rearward tractor
      rollover. Finite element analysis techniques for plastic deformation were used to
      simulate both the static and dynamic rear rollover scenarios. Stress results from
      the rear rollover model were compared to results from simulated static testing
      per SAE J2194. Maximum stress values from simulated rear rollovers exceeded
      maximum stress values recorded during simulated static testing for half of the
      elements comprising the uprights. In the worst case, the static model
      underpredicts dynamic model results by approximately 7%. In the best case, the
      static model overpredicts dynamic model results by approximately 32%. These
      results suggest the need for additional experimental work to characterize ROPS
      stress levels during staged overturns and during testing according to the SAE
      standard.

PMID- 11202116
TI  - [Investigation of the cerebral projection of the vestibular system using positron
      emission tomography].
AB  - The authors investigated the cerebral projection of the vestibular system, using
      positron emission tomography, in right-handed subjects. Both sided cold caloric
      stimulation was used in every volunteer (n = 6). A detailed map of activated and
      deactivated brain regions is included. This portrays changes caused by vestibular
      stimulation. The contralaterally activated regions according to the stimulation
      side were: postcentral gyrus, transvers temporal gyrus, superior temporal gyrus,
      posterior part of the insula, claustrum, putamen, inferior parietal lobule,
      precentral gyrus, premotor cortex, cingulate gyrus. The ipsilaterally activated
      regions were: transvers temporal gyrus, superior temporal gyrus, inferior
      parietal lobule, posterior part of the insula. There was no hemispherial
      dominance. The activated regions partially correspond with previous results in
      the literature. It would like to be pointed out the Brodmann 6 region as the
      cortical manifestation of involuntary isometric tightening of muscles. The
      contralaterally deactivated regions were: inferior, superior and medius temporal
      gyrus, medial and medius frontal gyrus, inferior occipital gyrus, parahippocampal
      gyrus and hippocampus. Ipsilaterally deactivated regions were: superior and
      medial frontal gyrus, inferior temporal gyrus, angular gyrus, parahippocampal
      gyrus and hippocampus, fusiform and inferior occipital gyrus. There was prominent
      hemispherial dominance in the stimulated, ipsilateral side. The deactivation
      based functional connection between the hippocampus and the vestibular system was
      pointed out in such a relation for the first time in this report.

PMID- 11202117
TI  - [Increase in prevalence of childhood asthma in Budapest in relation to the air
      pollution data and the total pollen count].
AB  - The authors surveyed the prevalence of bronchial asthma in childhood in Budapest
      in 1995 and in February 1999, via questionnaires directed to paediatricians. In
      1995, replies were received from 118 paediatricians in 11 districts, who were
      responsible for the supervision of 104,087 children, of these, 1.88 +/- 0.87% had
      been diagnosed as having asthma. In 1999, replies were sent by 153 physicians in
      22 of the 23 districts, who had a total of 142,684 children under their care.
      These included 3228 asthmatics, i.e. a prevalence of 2.26 +/- 0.95%. The
      difference between the two data was highly significant (p = 0.0001). The
      prevalence increased by 20% in 4 years. The dust, CO, NO2 and SO2 concentrations
      in the air were measured constantly at 8 points in Budapest, while ozone level
      measurements were also made at 2 stations. The counts of pollens and of fungal
      elements in the air were calculated separately for Buda and for Pest. These data
      overall revealed that the level of air pollution in Budapest did not deteriorate
      in the period in question, and the pollen counts from allergizing plants did not
      rise relative to earlier years. An interesting question (though it is far from
      certain that this is a causal correlation) can be upposed whether the 13% drop in
      the number of live births in Hungary during this 4-year period can be connected
      with the 20% rise in prevalence of childhood asthma.

PMID- 11202118
TI  - [Comparative analysis of clinical and laboratory charactiristics of
      antiphospholipid syndrome].
AB  - The authors detected lupus anticoagulant and/or anticardiolipin antibodies in
      1519 patients' blood samples between 1986-1999 in 3rd Department of Internal
      Medicine of Medical School of Debrecen. Examining only the proved thrombotic
      events and fetal losses as symptoms of antiphospholipid syndrome 218 patients had
      suffered from this syndrome. Secunder antiphospholipid syndrome was the diagnosis
      in case of 420 patients, the most common in Systemic Lupus Erythematosus (288
      patients). In 704 antiphospholipid antibody positivity cases the diagnosis of
      antiphospholipid syndrome was not fulfilled. Analysing the antibodies profile of
      primary and secondary antiphospholipid syndrome in SLE, IgG type anticardiolipin
      antibody positivity was significantly higher in blood samples of SLE patients (82
      patients, p < 0.01). Among thrombotic manifestations of antiphospholipid syndrome
      cerebrovascular thrombosis were significantly higher in patients suffering from
      SLE (128 patients, p < 0.04), while the occurrence of venous thrombosis,
      thrombosis of coronary, carotic, aorta and peripheral arteries and recurrent
      abortions was not significantly different in case of primary and secondary
      antiphospholipid syndrome. Lupus anticoagulant positivity means higher risk for
      venous thrombosis (94 patients, p < 0.0001), but anticardiolipin antibody
      positivity associated with a higher risk for thrombosis of coronary, carotic,
      aorta and peripheral arteries (59 patients, p < 0.00006). Comparing IgG- and IgM
      type anticardiolipin antibody positivity the authors found significantly higher
      cerebrovascular thrombosis events in IgG-anticardiolipin group (p < 0.004).
      Sneddon syndrome were detected in 17 patients in the primary antiphospholipid
      syndrome group and in 16 cases in secundary, SLE-associated antiphospholipid
      syndrome group. One of the patients had died because of the Catastrophic
      Antiphospholipid Syndrome.

PMID- 11202120
TI  - [Laszlo Nemeth and Albert Szent-Gyorgyi. Honoring anniversaries].

PMID- 11202121
TI  - [The past, present and future of the National Medical Rehabilitation Institute].

PMID- 11202119
TI  - [Raynaud syndrome and eradication of Helicobacter pylori].
AB  - In this work, the effect of eradication of Helicobacter pylori on complaints and
      symptoms of infected, primary Raynaud's syndrome patients was studied. Altogether
      92 Helicobacter pylori positive patients with gastric complaints and with primary
      Raynaud's syndrome received eradication therapy. In this prospective study,
      before and after the eradication the severity and frequency of the complaints and
      symptoms of the patients were recorded. The eradication was performable in 89
      patients; in 75 cases the eradication was successful. In the eradicated patients
      frequency and duration of Raynaud attacks were improved related to those of the
      not eradicated group. These results might suggest a potential etiopathogenetical
      role of Helicobacter pylori infection in the pathogenesis of the primary
      Raynaud's syndrome.

PMID- 11202122
TI  - [Remembering Gyula Petranyi, member of the Hungarian Academy of Sciences].

PMID- 11202123
TI  - Attention training in the cognitive rehabilitation of schizophrenic patients: a
      review of efficacy studies.
AB  - OBJECTIVE: To review the literature on effects of attention and cognitive
      training on attentional functioning in schizophrenic patients. METHOD: Relevant
      efficacy studies were identified by literature searches (in Medline, Current
      Contents, Psyclit, and Psyndex databases) and through the reference lists of key
      papers. RESULTS: Re-examination of findings from nine methodologically adequate
      studies using computer-based or non-computer-based training procedures provided
      inconsistent results. On 16 of 35 outcome measures significant performance
      improvements were observed from pre-treatment to post-treatment but on the
      majority of the applied measures no performance improvement could be determined.
      In general, treatment effect sizes but also power of tests were low. For nearly
      all the outcome measures for which differential training effects were reported
      there also exist contradictory outcome results. CONCLUSION: There is inconclusive
      evidence that attention training is effective in schizophrenia. Longitudinal
      efficacy studies are needed in which different aspects of attention are
      systematically exercised and assessed.

PMID- 11202124
TI  - Making psychiatric epidemiology useful: the contribution of epidemiology to
      government policy.
AB  - OBJECTIVE: This paper aims to discuss the contribution of epidemiology to aspects
      of public policy that have either a direct influence on mental health and mental
      disorders, or an indirect effect by influencing environmental factors which
      influence mental health. Both kinds of public policy will need to be considered
      by governments wishing to protect, promote and improve the mental health of their
      populations. The paper draws on information from both relatively wealthy and low
      income countries. METHOD: The paper defines epidemiology and mental health
      policy, sets out the range of government policies which may have an impact on
      mental health, and explores the ways in which epidemiology may contribute to
      mental health policy in relation to service inputs, processes and outcomes as
      well as to wider government policies. The paper also examines the advantages and
      disadvantages of different sources of data. RESULTS: There are a number of
      reasons to carry out large-scale surveys of psychiatric morbidity. First,
      effective policy should address the needs of the population, which can best be
      assessed by the epidemiology and the social and economic causes and consequences
      of psychiatric morbidity. Secondly, representative information in a defined
      geographic area can document the use of existing services and can estimate the
      extent of unmet needs and the services required meeting those needs. Thirdly,
      valid information on prevalence and associated risk factors of presumed causal
      importance allow aetiological hypotheses to be generated and tested and models
      developed for prevention. Finally, by repeating community surveys, it is possible
      to monitor the health of the population and trends. Epidemiological findings
      emphasize the importance of mental health policy addressing the key role of
      primary care, the social context and social consequences of disorder, the
      importance of addressing services for children, the need to reduce premature
      mortality from suicide and from physical illness. Epidemiological findings show
      that mental health and mental disorders are related to the environment both in
      its structural physical sense and in the sense of the social processes connected
      to and influenced by particular settings. Thus epidemiology can contribute to
      general policies on employment and unemployment, housing and homelessness,
      education and women's issues. CONCLUSION: Mental health policy is increasingly
      recognized as an essential area for countries wishing to enhance their economic,
      social and human capital. Epidemiological data are a basic prerequisite to
      informing such policies. Expert professional and epidemiological advice to
      ministries is essential if policy is to be rooted in the evidence for population
      needs, risk factors, effective treatments and services, and measurement of
      outcomes. It is therefore important to develop the capacity for policy work in
      the psychiatric profession by including public health, epidemiology and policy
      placements for young psychiatrists.

PMID- 11202125
TI  - Out-patient behaviour therapy in alcoholism: relapse rates after 6 months.
AB  - OBJECTIVE: In spite of the increasing interest in out-patient treatment
      programmes for alcoholics, there still exist only a few experimental studies on
      this issue. In this still ongoing study the efficacy of different behaviour
      therapy strategies is to be examined. METHOD: One hundred and twenty patients
      were assigned randomly to non-specific supportive therapy or to two forms of
      behavioural therapy (coping skills training and cognitive therapy). Behavioural
      treatment comprised 26 weekly sessions; follow-up examinations will take place
      every 6 months over 2 years. RESULTS: Patients undergoing behavioural therapy
      showed less drop-outs and significantly higher rates of abstinence compared with
      supportive treatment. Nevertheless, statistically significant differences between
      the two behavioural therapy strategies could not be established so far.
      CONCLUSION: Preliminary results demonstrate the feasibility and efficacy of
      behaviour therapy programmes in the out-patient treatment of alcoholism.
      Furthermore, they stress the importance of professional psychiatric and
      psychotherapeutic engagement in the field of addiction.

PMID- 11202126
TI  - Out-patient behaviour therapy in alcoholism: impact of personality disorders and
      cognitive impairments.
AB  - OBJECTIVE: We investigated whether alcoholic patients with comorbid personality
      disorders and those with cognitive impairments would benefit in a different way
      from different behaviour therapy strategies. METHOD: After detoxification, 120
      alcoholics were assigned randomly to one of three out-patient treatment
      programmes comprising 'coping skills training', 'cognitive behaviour therapy' or
      unspecific supportive control therapy. Personality disorders and cognitive
      impairments were assessed at the beginning of the 6-month treatment period.
      RESULTS: The impact of concomitant personality disorders or cognitive impairments
      was generally only moderate and mainly independent from treatment condition.
      However, alcoholic patients relapsing within 6 months after detoxification showed
      a higher rate of personality disorders (especially antisocial and borderline) and
      slightly more cognitive deficits (especially in verbal memory and visuomotor
      functions) than abstainers even before therapy. CONCLUSION: The high amount of
      early relapses and drop-outs probably hindered larger differentiated treatment
      effects. Hypotheses will be retested in treatment completers using forthcoming
      follow-up data.

PMID- 11202127
TI  - Self-reported life satisfaction and recovery from depression in a 1-year
      prospective study.
AB  - OBJECTIVE: To study the relationship of a self-rated four-item life satisfaction
      scale (LS) to the self-rated 21-item Beck Depression Inventory (BDI) and the 17
      item Hamilton Rating Scale for Depression (HAMD) and to study LS changes during
      recovery from depression. METHOD: A 1-year prospective study on 188 depressive
      patients receiving standard psychiatric outpatient treatment; 137 of the patients
      had major depression. RESULTS: LS correlated strongly with BDI and HAMD. It
      explained 46.6%) of the variation in BDI at baseline and 66.2% at 12 months. LS
      improved substantially during recovery. The main recovery occurred during the
      first 6 months, the change in the LS score explaining 46.5% of the change in the
      BDI score (P < 0.001). CONCLUSION: Life satisfaction is strongly affected in
      depression, but it improves concurrently with recovery from depression. LS scale
      may prove useful in screening for those whose subjective wellbeing deserves
      attention and in assessing alleviation from depression.

PMID- 11202128
TI  - Comparison of key worker and patient assessment of needs in schizophrenic
      patients living in the community: a Nordic multicentre study.
AB  - OBJECTIVE: The present study is part of a Nordic multicentre study investigating
      the life and care situation of community samples of schizophrenic patients. The
      specific aim of the present part of the study was to examine the agreement
      between patients and their key worker concerning the presence of met and unmet
      needs in a number of life domains, and help or support given in these domains.
      METHOD: The comparisons were based on 300 matched pairs of assessments of need
      using the Camberwell Assessment of Need interview. RESULTS: The results showed
      that key workers identified slightly more needs, 6.17 vs. 5.76, a significant
      difference. There was a moderate or better agreement on the presence of a need in
      17 of 22 life domains investigated, but in only 11 life domains concerning the
      presence of an unmet need. Disagreement concerning whether the patient was given
      the right kind of help or support was even more substantial. CONCLUSION: It is
      concluded that key workers and patients disagree particularly concerning unmet
      needs and that this is potentially related to a number of factors associated with
      the key worker and patient. It is also concluded that further research is needed
      to increase the knowledge concerning the sources of this disagreement if need
      assessment is to become a valid basis for service planning and individual
      treatment planning.

PMID- 11202129
TI  - Quality of Life (QOL) of patients with Gilles de la Tourette's syndrome.
AB  - OBJECTIVE: This is the first study to investigate the Quality of Life (QOL) of
      patients with Gilles de la Tourette's Syndrome (GTS). METHOD: One hundred and
      three out-patients with GTS completed a semi-structured interview and 90 of these
      completed questionnaires screening for depression, anxiety and obsessive
      compulsive behaviour. QOL was measured with the SF-36 and the Quality of Life
      Assessment Schedule (QOLAS). RESULTS: Patients with GTS showed significantly
      worse QOL than a general population sample. They had better QOL than patients
      with intractable epilepsy as measured by the QOLAS, although the SF-36 showed
      significant differences on the subscales Role Limitation due to physical problems
      and Social Functioning only. Factors influencing QOL domains were employment
      status, tic severity, obsessive-compulsive behaviour, anxiety and depression.
      CONCLUSION: QOL is impaired in patients with GTS. Measurement of QOL could be
      used alongside conventional measurements to assess benefit of treatment. We
      recommend the QOLAS and SF-36 be used.

PMID- 11202130
TI  - Validation of psychiatric patients' statements on coercive measures.
AB  - OBJECTIVE: To investigate the accuracy of psychiatric patients' statements on
      coercive measures compared with medical file information using empirical
      methodology, and relating the statements to patients' psychopathology. METHOD:
      One hundred and forty-three in-patients were identified consecutively, and
      interviewed using a structured questionnaire. Psychopathology was measured using
      BPRS, and social functioning using GAF. Patients' statements about coercion were
      compared with information in the medical files. RESULTS: In general, patients
      stated to have been subjected to more coercion than was evident from the files.
      In particular, statements about forced medication, earlier involuntary
      commitments and present legal status showed low accordance with information in
      the files. Low accordance was related to the severity of psychopathology and
      being schizophrenic. CONCLUSION: The existence of a 'grey zone' between patients'
      and doctors' perception of coercion was confirmed. Knowledge of patients'
      psychopathology seems essential when considering medical, legal and ethical
      aspects of the use of coercion.

PMID- 11202131
TI  - Benefits from mianserin augmentation of fluoxetine in patients with major
      depression non-responders to fluoxetine alone.
AB  - OBJECTIVE: To assess, in depressed patients, the clinical benefit of mianserin
      augmentation of fluoxetine or the the benefit of switching treatment from
      fluoxetine to mianserin. METHOD: In a 6-week double-blind study we compared the
      therapeutic efficiency and tolerance of mianserin 60 mg/day (N = 34), mianserin
      60 mg/day plus fluoxetine 20 mg/day (N = 32) and continuing fluoxetine 20 mg/day
      (N = 38) in patients with major depression who did not respond to previous
      fluoxetine treatment. RESULTS: Intent-to-treat analysis showed that at week 6 the
      decrease in the Hamilton Depression rating scale score was significantly (P < or
      = 0.03) greater in the mianserin plus fluoxetine group when compared to the
      fluoxetine group (effect size 0.665). Switching from fluoxetine to mianserin gave
      intermediate results. Mianserin augmentation of fluoxetine was well tolerated.
      CONCLUSION: Mianserin augmentation of fluoxetine in patients non-responders to
      fluoxetine 20 mg/day increases response to treatment and is well tolerated.

PMID- 11202132
TI  - Thrombosis associated with physical restraints.
AB  - OBJECTIVE: Physical restraint is controversial, but still frequently used in
      psychiatric units. We describe two cases of thromboembolic phenomena, one with a
      fatal outcome, in association with physical restraint. METHOD: The world
      literature on physical restraint and thrombosis was reviewed by undertaking a
      search of electronic databases. RESULTS: To our knowledge, we are the first to
      report thrombosis associated with physical restraint. CONCLUSION: Immobilization
      and trauma to the legs while restraining a patient are adequate explanations for
      the occurrence of thrombosis. Special attention should be paid to thrombosis when
      employing restraints in psychiatric wards. Further systematic research into
      physical restraints in psychiatry is clearly needed.

PMID- 11202133
TI  - Compulsive heroin use: comorbidity, syndrome or self-medication of lupus
      erythematosus?

PMID- 11202134
TI  - Epilepsia partialis continua: clinical and electrophysiological features of adult
      patients.
AB  - In this study we reviewed the clinical, electrophysiological and neuroimaging
      data of 21 patients with epilepsia partialis continua (EPC), which is a rare form
      of epilepsy with focal motor seizures persisting hours to years. We found
      infections, cerebrovascular events and tumors as the most common causes of EPC in
      adults. SSPE was also shown as a cause of EPC. EPC in SSPE patients was resistant
      to therapies and persisted more than 1 year. EPC is usually a predictor of poor
      outcome and 29% of patients died after EPC in this study. As prognosis is usually
      bad and as response to treatment is poor in patients who had EPC, early diagnosis
      and treatment of the underlying cause is important. Although the most common
      etiologies are infections, cerebrovascular events and tumors, if EPC persists
      several months SSPE should be kept in mind as a rare cause of EPC. MRI should be
      repeated in chronic cases to show dysplastic cortex, which was shown in 1 patient
      in this study.

PMID- 11202135
TI  - The continuous rhythmic mid-temporal discharge.
AB  - This case report is of a 15-year-old male who was sent for an EEG because of
      possible staring spells and a learning disability. At times written examinations
      in school were successfully completed and at other times the patient would write
      only his name. In two EEGs 1 month apart during hyperventilation, Rhythmic Mid
      Temporal Discharges (RMTD) were activated and appeared continuously for 84
      minutes and in the second instance for 140 minutes. No maneuvers could modify the
      pattern and no clinical changes were reported by the patient. Discussion includes
      another similar case recently published and the need to test such patients in
      some way to see the subtle clinical changes that likely do occur. One compromise
      for the name of this pattern might be Rhythmic Mid-Temporal Epileptiform Activity
      (RMTEA), avoiding the term discharge, which implies a seizure state that has not
      yet been established.

PMID- 11202136
TI  - Lateralized EEG findings in patients with neuropsychiatric manifestations of
      systemic lupus erythematosus.
AB  - Routine and quantitative EEG were used to determine whether there is a
      lateralized pattern of electrophysiologic dysfunction in patients with diverse
      neuropsychiatric manifestations of SLE. Twenty consecutive patients with
      neuropsychiatric symptoms of SLE underwent 20-minute EEG recordings with an 18
      channel polygraph. Ten 1-second intervals were randomly selected for each
      patient. Once selected, the intervals were analyzed for the presence of theta and
      delta slow activity. Mapping was done by four-point interpolation around the 18
      acquired data points. On routine EEG, abnormalities were identified in 14/20
      patients with SLE. In 12/14 patients, the abnormalities were localized to the
      left temporal region. Quantitative EEG analyses revealed theta and delta slow
      activity predominantly affecting the left hemisphere in 16/19 patients with SLE.
      Taken together, these findings suggest selective involvement of the left
      hemisphere in patients with diverse neuropsychiatric manifestations of SLE.

PMID- 11202137
TI  - Frontal lobe disinhibition, Rett syndrome and attention deficit hyperactivity
      disorder.
AB  - Motor cortex hyperexcitability in Rett Syndrome (RS) has been ascribed to the
      failure of an inhibiting system arising from the frontal lobes, a system needed
      in childhood and early adolescence. It is also presumed that, on a virtually
      dysfunctional (nonstructural) basis, motor cortex hyperexcitability in ADHD is
      also due to insufficient frontal lobe inhibition ("lazy frontal lobe"). A series
      of schematic illustrations is added for the sake of easier comprehension of the
      presented concept.

PMID- 11202138
TI  - Video-EEG monitoring in respiratory chain disorders.
AB  - Subclinical epileptiform activity in patients with respiratory chain disorders
      (RCDs) has not been previously investigated by video-EEG monitoring. The purpose
      of this study was to look for the type and frequency of epileptiform activity
      during a 24 h-video-EEG recording in RCD patients. Eleven patients with RCD, 7
      women and 4 men, aged 24-72 years, underwent a clinical neurologic examination,
      blood tests, CT/MRI scans of the brain, routine scalp EEG and continuous video
      EEG monitoring over 24 consecutive hours. Ten patients had normal 24 h-video-EEG
      recordings. One of these patients had no CNS involvement; her resting EEGs showed
      diffuse background slowing. In one patient, automatic spike detection revealed 12
      spikes during a 6 hour period. Resting scalp EEG in this patient showed
      extensive, bilaterally synchronous, pseudoperiodic polyspike-waves. In
      conclusion, subclinical epileptiform activity could be recorded by 24 h-video-EEG
      monitoring in only 1 of 11 RCD patients. The single patient with subclinical
      epileptiform activity presented with intermittent myoclonic jerks.

PMID- 11202139
TI  - A case of Zellweger syndrome with extensive MRI abnormalities and unusual EEG
      findings.
AB  - Differential diagnosis in a newborn with dysmorphic features and profound
      neurologic dysfunction should include the cerebro-hepato-renal syndrome of
      Zellweger. Its distinct clinical features, markedly elevated plasma levels of
      very long chain fatty acids and characteristic radiological findings support the
      diagnosis, which can now be confirmed by genetic markers. Quite consistent
      abnormalities of the neurophysiological studies in this syndrome have also been
      reported. We report a case with typical clinical and biochemical findings in whom
      distinctive brain MRI abnormalities were found. The results of neurophysiological
      studies with an unusual EEG pattern of continuous negative vertex sharp waves and
      spikes are discussed. We believe that such a pattern could be considered as a
      pathognomonic EEG finding, especially in cases of Zellweger syndrome with
      extensive brain abnormalities and may even be closely associated with cortical
      dysplasias.

PMID- 11202140
TI  - Unilateral alpha subharmonics: a case report.
AB  - Occipital alpha subharmonics are a normal EEG variant. Unilateral occipital
      slowing, however, is associated with focal dysfunction of that particular side.
      We report a 10-year-old girl with the incidental EEG finding of unilateral
      occipital slowing. MRI of her brain was completely normal and on long-term follow
      up she remained healthy. Based on her clinical history, normal MRI of brain, and
      the character of the slow posterior rhythms, we conclude that unilateral slow
      alpha rhythm can be a normal variant akin to alpha subharmonics.

PMID- 11202141
TI  - Decreased level of EEG-vigilance in acute mania as a possible predictor for a
      rapid effect of methylphenidate: a case study.
AB  - About one third of manic patients show a decreased Electroencephalographic
      Vigilance Level (EVL). In two patients with recurrent manias the hypothesis was
      tested that the EEG may be used to predict the therapeutic response to
      methylphenidate. Patient A (with a decreased EVL) responded rapidly to
      methylphenidate with a considerable reduction of symptoms and a clear increase of
      EVL, whereas patient B (normal EVL) did not show any change, neither clinically
      nor in the EEG.

PMID- 11202142
TI  - A new-type titanium intervertebral spacer and its insertion device used in
      posterior lumbar interbody fusion.
AB  - We have recently developed a new-type trapezoid mesh cage (TPM cage) together
      with an insertion device, which for use as a new titanium mesh intervertebral
      spacer in posterior lumbar interbody fusion (PLIF). The TPM cage has sufficient
      mechanical strength, a large contact area that gives good long-term stability,
      and preserves the initial disc height to provide good balance. The insertion
      device for the TPM cage is useful not only for handling the implant but also for
      controlling the implant insertion direction. The TPM cage and its insertion
      device are promising for use in PLIF.

PMID- 11202143
TI  - Hand motion assessment and rehabilitation system.
AB  - Along with the rapid development of information technology, computers play an
      increasingly prominent and important role. One current trend is to use computers
      as instruments for physical rehabilitation. In this study, we introduce a new
      hand motion assessment and rehabilitation system. This system assesses a user's
      grip strength and records the sudden changes in air pressure through a circuit
      and A/D adapter. A PC interface transforms and saves the data in a data record
      file. The data is then compiled and combined with a patient's case history and
      keyed into a database as reference for clinical use. The system is highly
      efficient, cheap and convenient to use. Doctors can use it to monitor and analyze
      the progress of a rehabilitation program.

PMID- 11202144
TI  - The effect of elastic modulus of the backing material on the fatigue notch factor
      and stress.
AB  - In cemented acetabular cup design it is acknowledged that bone resorption and
      fatigue fracture of cement may cause the most common problems after total hip
      replacement. Previous studies have optimized the shape of metal backing (MB)
      shell used in cemented acetabular components in order to minimize the fatigue
      notch factor (Kf) in cement, whilst at the same time maximizing Kf in bone at the
      central part of acetabulum to prevent stress shielding and subsequent bone
      resorption [1]. The optimal shape was found to be thin at the edges and thick at
      the dome. The present study describes the effect of changing the elastic modulus
      of the backing material on Kf and stresses as predicted by the initial shape of
      the backing shell of (3 mm) thick, and the optimized backing shape of non-uniform
      thickness in order to find the optimal material for the backing shell. It is
      recommended to use a backing shell material with elastic modulus equals 70 GPa
      (which can be readily attained using a fiber reinforced polymer composite). It is
      shown that such a material will decrease the fatigue notch factor and the
      stresses in cement at cup edges, at the same time it will increase the stresses
      and the fatigue notch factor in bone at the central part of acetabulum. Thereby,
      reducing the possibility of fatigue fracture of cement, whilst at the same time
      decreasing the stress shielding effect and the resulting bone resorption. The
      effect of lower bone resorption and lower probability of fatigue fracture of the
      cement will also reduce the incidence of loosening and premature revision
      operations.

PMID- 11202145
TI  - Hydroxyapatite-coated bioalloy surfaces: current status and future challenges.
AB  - The present review contains salient features of the most widely used methods for
      depositing hydroxyapatite (HA) coatings on bioalloy substrates. These methods
      range from the ubiquitous plasma spraying in air to the recently introduced ion
      beam enhanced deposition technique. Special attention is paid to the residual
      stress in the coating that arises from various sources and whose magnitude
      impacts the adhesion of the coating to the substrate and, hence, the efficacy of
      the coated part (see, for example, the in vivo performance of HA-coated
      orthopaedic and dental implants). Thus, the plethora of methods for estimating
      residual stresses in HA-coated systems are critically examined. The review
      concludes with a detailed presentation of ten areas for future research work.

PMID- 11202146
TI  - Effects of clove oil-phospholipid mixtures on rheology of gum tragacanth -
      possible application for surfactant action on mucus gel simulants.
AB  - The present study evaluates the effectiveness of specialised biomaterials
      consisting of clove oil- phospholipid mixtures as possible substitute surfactants
      in diseases of altered mucus viscosity by studying their effect on the viscosity
      of mucus gel simulants in vitro. Test surfactants consisting of phospholipid
      clove oil mixtures in the ratio of 1 part of oil to 9 parts of phospholipid were
      prepared. The phospholipids used were dipalmitoyl phosphatidylcholine (PC),
      phosphatidylethanolamine (PE) and phosphatidylglycerol (PG) and binary mixtures
      of PC: PE and PC: PG in the ratio of 2 parts of PC to 3 parts of PE or PG. The
      effects of the phospholipid-clove oil mixtures on the viscosity of mucus gel
      simulant (MGS: a polymeric gel consisting predominantly of gum tragacanth and
      simulating respiratory mucus), was studied by application of steady shear rates
      ranging from 0.512 to 51.2/s in a concentric cylinder viscometer at 37 degrees C.
      The change in MGS viscosity, after incubation with surfactants, was found to have
      a non-Newtonian character and to follow the power law model with R2 values >0.8.
      The addition of clove oil-phospholipid mixtures caused a decrease in the MGS
      viscosity when compared with the effect of the phospholipid alone at low shear
      rates in case of PC, PG and PCPG. The combination of PC : PG with clove oil
      caused ratios of change in MGS viscosity < 1 i.e., caused a decrease in the MGS
      viscosity. PC: PG with clove oil was capable of lowering MGS viscosity and should
      be further researched as possible therapies for diseases of altered mucus
      rheology.

PMID- 11202147
TI  - Initial strength of highpressed extrusion poly-L-lactide screw.
AB  - We developed a poly-L-lactide material strengthened by a highpressed extrusion
      technique. The bending strength of a rod made of that material is higher than
      that of the same size rods made of poly-L-lactide strengthened by drawing
      technique, which has been used in clinical cases. The purposes of this study
      were, first to clarify if the initial strength of extrusion-strengthened poly-L
      lactide screws is higher than that of draw-strengthened poly-L-lactide screws,
      and, secondly to investigate the safe torque for driving the screws in clinical
      usage. In accordance with AO screw design, five kinds of screws were
      manufactured. In a pull-out test and a twisting test using a DYRACON blocks, the
      strength of the highpressed extrusion-strengthened poly-L-lactide material was
      also higher than that of the draw-strengthened poly-L-lactide material after
      milling into screws. In the simulation using minipig bones and the 4.5 mm psi
      cortical screws, when the thickness was below 0.5 mm, between 0.5 and 2 mm or
      over 3 mm, the break locations were in the cortical bone, the thread of the screw
      and the under head fillet respectively. In the simulation using minipig bones and
      the 4.0 mm psi cancellous screws, breakage occurred not on the screws but on the
      cancellous bone in all screws.

PMID- 11202148
TI  - Morphology and formation mechanism of hydroxyapatite coating by hydrothermal
      method on CaO-SiO2-B2O3-Na2O glass.
AB  - Hydrothermal method was used to prepare the hydroxyapatite (HA) coating on CaO
      SiO2-B2O3-Na2O glass. The phase composition, morphology and microstructure of HA
      coated glass composites were analyzed using XRD, EPMA, FT-IR and SEM techniques.
      It revealed that HA coating possessed a porous gradient construction; HA coating
      was tightly bonded with the glass substrate by the interface layer. During the
      formation of HA coating, the hydrated silica produced by the corrosion of glass
      substrate in the hydrothermal solution provided favorable sites for apatite
      nucleation. With the dissolving of HA powder and the growth of apatite small
      crystallites, Ca+, PO(4 (3-)) ions would precipitate on the surface of glass to
      form the HA coating. Silicon element released from glass reacted with calcium
      produced by the dissolution of HA to form the tight reaction layer. HA coating is
      formed by the mechanism of dissolving-ions immigrating-precipitating pattern.

PMID- 11202149
TI  - Dissolution behavior of hydroxyapatite coating by hydrothermal method: an in
      vitro study.
AB  - Hydroxyapatite (HA) coated CaO-SiO2-B2O3-Na2O glass composites prepared by a
      hydrothermal coating method were soaked in four kinds of solutions to evaluate
      the dissolution behavior and the chemical stability. 0.5 mol/l HCl and 0.5 mol/l
      HNO3 were used as acidic solution, and 5% physiological saline and sodium lactate
      compound solution as the neutral physiological solution. It was found that HA
      coated glass composites had the better chemical stability and the corroding
      resistance ability. The dissolution behavior of the HA coating was mainly
      correlated with the phase composition of the as-received HA coating and its
      microstructure as well as the pH value of the solution.

PMID- 11202150
TI  - Crystal chemistry of hydroxyapatite deposited on titanium by sputtering
      technique.
AB  - Crystalline hydroxyapatite (HA) powder was coated on titanium substrate by radio
      frequency (RF) magnetron sputtering. The coating was homogeneous thin film and
      the thickness was 1microm. Crystallinity of the HA coating was low and Ca/P ratio
      was high as 3.0. Particle sizes were 40 to approximately 100 nm, and the
      crystallite size was calculated by 30 to approximately 50 nm using an X-ray
      diffractometry (XRD) and a transmission electron microscopy (TEM). When the
      coating was heated at 800 degrees C for 1 h, the low crystalline HA grew up
      crystalline HA, and a diffraction pattern of CaO appeared. When the coating was
      immersed in pH 7.4 of bovine serum for 1 week, c-axis of HA increased.

PMID- 11202151
TI  - Comparison of the response of primary murine peritoneal macrophages and the U937
      human histiocytic cell line to challenge with in vitro generated clinically
      relevant UHMWPE particles.
AB  - The response of primary murine macrophages and the U937 human histiocytic cell
      line to challenge with clinically relevant UHMWPE wear debris of known particle
      size and dose was evaluated. Particles with mean sizes of 0.24, 0.45, 1.71, 7.62
      and 88 microm were co-cultured with cells for 24 hours prior to assessment of
      cell viability and production of the osteolytic mediators IL-1beta, IL-6,
      TNFalpha and, in supernatants from murine phagocytes, PGE2 and GM-CSF. All
      particle fractions were evaluated at particle volume (microm3) to cell number
      ratios of 10 : 1 and 100 : 1 (and, additionally, 0.1 : 1 and 1 : 1 for U937
      cells). These ratios had previously been identified as the most stimulatory and
      clinically relevant. Although the results for the cell line were highly variable,
      stimulation with phagocytosable particles (range 0.1 to 15 microm) resulted in
      enhanced levels of cytokine secretion by both murine macrophages and U937
      histiocytes. The most biologically active particles were sub-micrometre in size.
      However, U937 cells responded to wear debris at much lower particle volume to
      cell number ratios (>0.1 microm3 per cell) than the murine cells (> 10 microm3
      per cell). No GM-CSF was produced by particle or LPS stimulated murine
      macrophages. Similarly, U937 histiocytes failed to secrete any IL-1beta. Neither
      macrophage population responded to stimulation with the largest (88 microm)
      particles. These results confirm earlier findings and suggest that the size of
      UHMWPE wear particles is a critical factor in macrophage activation. Moreover,
      primary murine macrophages have been demonstrated to be a suitable model for
      studying cell-particle interactions in vitro.

PMID- 11202152
TI  - A multi-directional wear screening device and preliminary results of UHMWPE
      articulating against stainless steel.
AB  - This paper describes the design of a pin on plate rig which has been modified to
      give multi-directional motion to the test pins, resulting in elliptical and quasi
      elliptical wear paths. Such paths are closer to those seen in vivo by a femoral
      head articulating against an acetabular cup. The description of the rig is
      augmented by the results of a test of ultra high molecular weight polyethylene
      pins rubbing against stainless steel plates. with dilute bovine serum at 37
      degrees C being used as the lubricant. With standard reciprocating motion, a mean
      wear factor of 0.085 x 10(-6) mm3/N m was found, but with multi-directional
      motion, the mean wear factor increased to 1.10 x 10(-6) mm3/N m, which is very
      similar to in vivo wear factors.

PMID- 11202154
TI  - The effect of dibutyryl cyclic AMP on the expression of actin isoforms in
      astroglia.
AB  - Mammalian cells contain at least 8 actin isoforms. The functional significance
      and the mechanisms that regulate the expression of each actin isoform are not yet
      known. Using immunofluorescence staining, it was found that all astroglia in
      tissue culture express beta-actin isoform and about 86% of astroglia express
      alpha-smooth muscle actin isoform. When astroglia were treated with dibutyryl
      cyclic AMP for 4, 7, 14 and 21 days, it was found that the number of the cells
      expressing alpha-smooth muscle actin isoform progressively decreased, whereas,
      the number of the cells expressing beta-actin isoform remained constant. The
      western blot experiment showed that the amount of total alpha-smooth muscle actin
      isoform (soluble and insoluble) and of the insoluble isoform expressed by
      astroglia treated with dibutyryl cAMP decreased whereas, the amount of total and
      insoluble beta-actin isoform expressed by the same cells did not show any
      significant changes. The cells treated with the cAMP failed to migrate and to
      close the area created by the scratch wound in monolayer culture. However, the
      non-treated cells migrated and closed the area created by the scratch after 3
      days. This study shows that the astroglia have different mechanisms in regulating
      the expression of different actin isoforms and that the alpha-sm actin isoform is
      important in migration of astroglia.

PMID- 11202155
TI  - Immunohistochemical localization of type I collagen, fibronectin and tenascin C
      during embryonic osteogenesis in the dentary of mandibles and tibias in rats.
AB  - Type I collagen, fibronectin and tenascin C play an important role in regulating
      early osteoblast differentiation, but the temporal and spatial relationship of
      their localization during embryonic osteogenesis in vivo is notknown. The present
      study was designed to localize these three molecules in the dentary of mandibles
      and tibias in rat embryos using immunohistochemistry. Serial paraffin sections
      were cut and adjacent sections were processed for von Kossa staining or
      immunohistochemistry for type I collagen, fibronectin and tenascin C. In the
      dentary, tenascin C was localized within and around the mesenchymal cell
      condensation in embryos at 14 days in utero. The bone matrix at 15 days showed
      immunoreactivity for both type I collagen and fibronectin. The immunoreactivity
      of type I collagen was persistent, whereas that of fibronectin decreased with age
      of embryos. In tibias, tenascin C was localized in the perichondral mesenchymal
      tissue at 17 days. Immunoreactivity for type I collagen was persistent in the
      bone matrix, whereas the tibial bone showed little immunoreactivity for
      fibronectin at any embryonic age examined. The present study demonstrated
      characteristic localization of type I collagen, fibronectin and tenascin C during
      embryonic osteogenesis in the dentary of mandibles and tibias.

PMID- 11202156
TI  - Detection of P-glycoprotein in the nuclear envelope of multidrug resistant cells.
AB  - P-glycoprotein is a plasma membrane efflux pump which is responsible for
      multidrug resistance of many cancer cell lines. A number of studies have
      demonstrated the presence of P-glycoprotein molecules, besides on the plasma
      membrane, also in intracellular sites, such as the Golgi apparatus and the
      nucleus. In this study, the presence and function of P-glycoprotein in the
      nuclear membranes of human breast cancer cells (MCF-7 WT) and their multidrug
      resistant variants (MCF-7 DX) were investigated. Electron and confocal microscopy
      immunolabelling experiments demonstrated the presence of P-glycoprotein molecules
      in the nuclear membranes of MCF-7 DX cells. Moreover, the labelling pattern was
      strongly dependent on pH values of the incubation buffer. At physiological pH
      (7.2), a strong labelling was detected in the cytoplasm and the nuclear matrix in
      both sensitive and resistant MCF-7 cells. By raising the pH to 8.0, the P
      glycoprotein molecules were easily detected in the cytoplasm (transport vesicles
      and Golgi apparatus), plasma and nuclear membranes exclusively in MCF-7 DX cells.
      Furthermore, drug uptake and efflux studies, performed by flow cytometry on
      isolated nuclei in the presence of the P-glycoprotein inhibitor cyclosporin A,
      suggested the presence of a functional P-glycoprotein in the nuclear membrane,
      but not in the nuclear matrix, of drug resistant cells. Therefore, P-glycoprotein
      in the nuclear envelope seems to represent a further defense mechanism developed
      by resistant cells against antineoplastic agents.

PMID- 11202157
TI  - An immunocytochemical study of intrapancreatic ganglia, nerve fibres and
      neuroglandular junctions in Brockmann bodies of the tompot blenny (Blennius
      gattoruggine), a marine teleost.
AB  - The innervation of the Brockmann bodies in the teleost fish, Blennius
      gattoruggine, was studied using immunocytochemical techniques at both the light
      and electron microscopy levels. Islet innervation consisted of intrapancreatic
      ganglia, generally localized inside the rim of the exocrine tissue of the
      Brockmann bodies, in proximity to the islet, nerve fibres and nerve terminals
      with synaptic complexes. The intrapancreatic ganglia were of variable size, with
      different numbers of ganglionic cells, that appeared unipolar in section. The
      cell bodies showed immunoreactivity to galanin, oxytocin, peptide tyrosine
      tyrosine and glucagon. The extrinsic and intrinsic nerve fibres passed through
      the exocrine parenchyma and crossed the connectival septa and islet connectival
      sheath, penetrating into the islets, where they became increasingly thinner. They
      terminated on the endocrine cells with dilated nerve terminals. At least three
      types of terminals were detected, depending on the different vesicle content:
      peptidergic, cholinergic or adrenergic. They presented specialized synaptic
      structures, the neuroglandular junctions, some of which contained neurosecretory
      granules immunogold labelled by galanin antiserum. This new finding confirms the
      role of galanin as a neurotransmitter. This rich supply of innervation may be
      important in the regulation and integration of islet secretion.

PMID- 11202158
TI  - Pitfalls in the immunohistochemical localization of the cystic fibrosis
      transmembrane conductance regulator in paraffin embedded sweat glands.
AB  - Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene
      cause the hereditary disease cystic fibrosis. The most frequent mutant deltaF508
      has been shown in vitro to be retained in the endoplasmic reticulum. Ex vivo
      studies using immunohistochemical labelling in cryofixed skin biopsies have
      confirmed the mislocalization of deltaF508 CFTR in sweat glands. The purpose of
      this study was to test CFTR antibodies in paraffin-embedded skin biopsies to take
      advantage of the superior tissue preservation as compared to cryofixation. A
      panel of 7 CFTR antibodies was applied to skin sections of healthy controls and
      of cystic fibrosis patients homozygous for the deltaF508 mutation. Sweat gland
      labelling consistent with CFTR localization and different between control and
      cystic fibrosis tissue was obtained with 2 antibodies. Conventional staining
      controls confirmed the labelling specificity. The antibodies were subsequently
      tested in a series of 237 sections of 16 biopsy specimens. However, the sweat
      gland labelling pattern proved not to be dependent on CFTR genotype. This finding
      was the sole indicator of non-specificity of the staining which was revealed only
      by the size of our random sample. Our results emphasize that CFTR immunolabelling
      following formalin fixation has to be interpreted with the utmost caution.

PMID- 11202159
TI  - Immunoreactivity of six monoclonal antibodies directed against 1,25
      dihydroxyvitamin-D3 receptors in human skin.
AB  - Using confocal laser scanning microscopy, we tested the suitability of five
      monoclonal mouse antibodies (IVA7E7, IVB12G12, IVG9C11, VD2F12, and VIIID8C12)
      that had been raised against different domains of the porcine intestinal 1,25
      dihydroxyvitamin-D3 receptor (VDR), for the immunohistological detection of VDR
      in human skin. The VDR immunoreactivity of these antibodies was compared with the
      well-characterized VDR-staining pattern of the mouse monoclonal antibody 9A7gamma
      raised against chick intestinal VDR. All six antibodies revealed strong nuclear
      and qualitatively similar immunoreactivity in all cell layers of the viable
      epidermis. Our data demonstrate that the five mouse monoclonal antibodies are
      suitable for immunohistochemical detection of VDR in frozen sections. These
      antibodies show comparable staining patterns in human skin even though they had
      been raised against different functional domains of the 1,25-dihydroxyvitamin-D3
      receptor.

PMID- 11202160
TI  - Evolution in the treatment of complex blunt liver injuries.
AB  - Over the last decade, major changes in the treatment of patients with blunt liver
      injuries have occurred, specifically with the nonoperative treatment of more
      complex injuries. These major changes can be summarized as follows: 1. Patients
      with blunt liver injuries are screened expeditiously by surgeon-performed
      ultrasonography. Depending on the initial findings and response to resuscitation,
      further decisions are made regarding the further evaluation. 2. Computed
      tomographic scanning is the mainstay of diagnosis for hepatic injuries after
      blunt trauma; the initial CT findings will help the trauma surgeon to determine
      the nonoperative treatment. 3. Liver injuries of grades I through III can be
      observed safely in a monitored unit and not necessarily in an ICU setting.
      Patients with injuries of grades IV and V are best initially observed in an ICU.
      4. More than two thirds of patients with injuries of grades IV and V can be
      treated nonoperatively. However, 50% of these patients will require some type of
      interventional treatment, but not necessarily a laparotomy. 5. Initial findings
      on the CT scan can help to identify those patients who will need some type of
      interventional treatment and to identify associated injuries. 6. Elderly patients
      or patients with associated medical comorbidities can also be treated
      nonoperatively if strict guidelines are followed. 7. Complications in patients
      with complex blunt liver injuries are not uncommon. However, most of the
      complications can be safely treated by less invasive procedures.

PMID- 11202161
TI  - [Energy metabolism of free-radical and microsomal oxidation in workers engaged
      into oil-processing industry].
AB  - The authors present data on disorders of energy metabolism in erythrocytes, of
      microsomal monooxygenases and of free-radical oxidation in blood and urine of
      workers engaged into oil-processing industry. Studies revealed considerable
      changes in RBC adenyl system parameters, in chemiluminescence of blood and urine,
      in monooxygenase system. Nonspecific therapy in sanatorium appears to better
      these aspects.

PMID- 11202162
TI  - [Characteristics of work conditions in mullitic refractories production].
AB  - Specific feature of occupational medicine in highly aluminiferous mullitic
      refractories production nowadays is dust factor associated with disintegration,
      crushing and pressing of fireclays and coal clays. Therefore average shift dust
      levels increase and considerably exceed the MAC. Calcination process is
      associated with slightly exceeded MAC for sulphur dioxide and carbon dioxide and
      MAL for noise.

PMID- 11202163
TI  - [Ethics of biomedical research in occupational medicine].

PMID- 11202164
TI  - [Financial and economic principles of assessing enterprises' insurance premium
      for mandatory social worker's compensation].
AB  - The authors analyzed present enterprises' insurance premiums, pointed out the
      associated drawbacks, defined main financial and economic principles underlying
      determination of enterprise's insurance premium (principle of sufficiency,
      principle of justice, principle of collective responsibility and principle of
      stimulation).

PMID- 11202165
TI  - [Approaches to occupational evaluation of allergy danger caused by work
      conditions].
AB  - The authors defined major criteria for allergenic danger caused by work
      conditions. The criteria include sensibilizing activity, intensity of chemical
      allergen, routes of its intake, combinations and associations with other
      occupational hazards and, according to hygienic classification of work and to
      classification of chemical allergens, to importance in causing the allergic
      diseases, are assessed in points. Using the criteria, considering various
      associations of allergies and concomitant factors and their correspondence to
      occurrence and severity of immunologic and allergic disorders, clinical signs of
      allergies (including occupational), the authors specified integral scale for
      evaluation of allergenic danger caused by work conditions.

PMID- 11202166
TI  - [Occupational regulations of the use of terpene compounds in the air of the
      workplace].
AB  - Based on results of 15-years complex study, the authors present toxicological and
      hygienic characteristics of terpene compounds (with mono- and bicyclic structure)
      and their compositions. The article deals with toxicodynamics and toxicokinetics
      of terpenoids, dependence of toxic properties on the chemical structure. The
      article also touches upon studies of biologic and specific (sensibilizing
      activity, embryotoxic and gonadotropic, membranotropic) effects of terpenoids.
      Some aspects concerning hygienic regulation of terpene compounds are also
      covered.

PMID- 11202167
TI  - [The use of computer-simulated systems for risk analysis].

PMID- 11202168
TI  - [Bernardino Ramaccini].

PMID- 11202169
TI  - [Psychophysiologic tests for early diagnosis of central nervous system's chronic
      exposure to organic solvents].
AB  - The authors studied value of laboratory CNS tests in early diagnosis of chronic
      exposure to organic solvents. The tests include quantitative and qualitative
      evaluation of personal profile, higher psychic functions and bioelectric activity
      of brain. Findings are objective parameters of early CNS response to solvents-
      EEG signs characteristic for hypothalamic irritation, moderate diffuse increase
      in MMPI personal profile with secondary neurotic type and marked disorder of
      attention that is considerably influenced by nonspecific activating system of
      brain.

PMID- 11202170
TI  - Inclusion-body myositis: newest concepts of pathogenesis and relation to aging
      and Alzheimer disease.
AB  - We review the newest advances related to seeking the pathogenic mechanism(s) of
      sporadic inclusion-body myositis (s-IBM) and present the pathologic diagnostic
      criteria of s-IBM. We discuss the possible pathogenic role of several themes,
      such as 1) increased amyloid-beta precursor protein (AbetaPP) and of its fragment
      Abeta; 2) phosphorylation of tau protein; 3) oxidative stress; 4) abnormal a)
      signal-transduction, b) transcription, and c) RNA accumulation; 5)
      "junctionalization" and myogenous" denervation; and 6) lymphocytic inflammation.
      Evidence is provided supporting our hypothesis that overexpression of AbetaPP
      within the aging muscle fibers is an early upstream event causing the subsequent
      pathogenic cascade. The remarkable pathologic similarities between s-IBM muscle
      and Alzheimer disease (AD) brain are discussed, and the possible cause and
      significance are addressed.

PMID- 11202171
TI  - Amyloid deposition in diffuse plaques may or may not start at the neuronal cell
      surface membrane.

PMID- 11202172
TI  - High frequency stimulation of the subthalamic nucleus increases the extracellular
      contents of striatal dopamine in normal and partially dopaminergic denervated
      rats.
AB  - The subthalamic nucleus (STN) has come under focus in Parkinson disease (PD)
      because of recent advances in the understanding of the functional organization of
      the basal ganglia in normal and pathological conditions. Manipulations of the STN
      have been described to compensate for some imbalance in motor output of the basal
      ganglia in animal models of PD and have been proposed as a potential therapeutic
      target in humans. Indeed, high frequency stimulation (HFS) (130 Hz) of the STN
      has beneficial effects in severe parkinsonian patients but the precise mechanisms
      underlying these clinical results remain to be elucidated. To date, very little
      is known concerning the effect of HFS-STN on striatal dopaminergic transmission.
      Since it has been reported that dopaminergic medication may be reduced in PD
      patients under HFS-STN, our goal was to study the effect of HFS-STN on striatal
      dopamine (DA) transmission by using intracerebral microdialysis in normal and
      partially DA denervated rats. Our results show that HFS STN induces a significant
      increase of extracellular DA in the striatum of normal and partially DA lesioned
      rats while striatal extracellular levels of DOPAC were not affected. We conclude
      that HFS-STN acts directly and/or indirectly on striatal DA levels in control or
      partially DA lesioned rats.

PMID- 11202173
TI  - Expression pattern of CXCR3, CXCR4, and CCR3 chemokine receptors in the
      developing human brain.
AB  - Chemokine receptors are essential components of the immune and central nervous
      systems, but little is known about their distribution during development. We
      evaluated the distribution of 3 chemokine receptors: CXCR3, CXCR4, and CCR3 in
      the human developing brain. Of these, CXCR3 was the only receptor expressed in
      fetal brain at 26 wk of gestation and its expression was restricted to glial
      cells, endothelial cells, and the choroid plexus. Neuronal staining was only seen
      at term in the Purkinje cells of the cerebellum. CCR3 appeared only at term in
      both neurons and glial cells. The expression pattern of these 2 receptors in the
      late gestation and term resembled that of adults. CXCR4 could not be detected in
      the fetal brain on neurons nor on glial cells. By examining pediatric cases, we
      determined that CXCR4 expression commences sometimes between 3.5 and 4.5 yr. Two
      of the chemokine receptors examined, CCR3 and CXCR4, can be used as co-receptor
      together with CD4 for HIV entry, but neither was expressed during the second
      trimester of pregnancy. Our findings suggest that it is unlikely that CCR3 or
      CXCR4 play a major role in HIV-1 transmission in the fetal brain before 37 wk of
      gestation.

PMID- 11202174
TI  - Effects of sodium and chloride on neuronal survival after neurite transection.
AB  - An in vitro investigation was undertaken to study the roles of Na+ and Cl- in
      mammalian spinal cord (SC) neuron deterioration and death after injury involving
      physical disruption of the plasma membrane. Individual SC neurons in monolayer
      cultures were subjected to UV laser microbeam transection of a primary dendrite.
      Neurons lesioned in modified ionic environments (MIEs) where 50%-75% of the NaCl
      was replaced with sucrose had higher survival (65%-75%) than neurons lesioned in
      medium with normal (125 mM) NaCl (28%; p < 0.001). Subsequent experiments found a
      comparable increase in lesioned neuron survival in MIEs in which only Na+ was
      replaced with specific ionic substitutes; however, replacement of Cl- was not
      protective. Electron microscope examinations of neurons fixed <16 min after
      lesioning showed a dramatic decrease in vesiculation of the smooth endoplasmic
      reticulum and Golgi apparatus in the low NaCl or low Na+ MIEs. It is hypothesized
      that Na+ entry after membrane disruption may stimulate elevation of [Ca+2]i
      leading to ultrastructural disruption and death of injured neurons. The results
      of these studies suggest that a low NaCl MIE may be useful as an irrigant to
      limit damage spread and cell death within CNS tissues during surgery or after
      trauma.

PMID- 11202175
TI  - Neurons in Niemann-Pick disease type C accumulate gangliosides as well as
      unesterified cholesterol and undergo dendritic and axonal alterations.
AB  - Niemann-Pick disease type C (NPC) is a lethal neurologic storage disorder of
      children most often caused by a defect in the protein NPC1. To better understand
      the disease we thoroughly characterized the cellular and morphological
      alterations occurring in murine, feline, and human NPC. Using immunocytochemistry
      and filipin histochemistry we show that both gangliosides and unesterified
      cholesterol are differentially stored in neurons of the cerebral cortex,
      cerebellum, and hippocampus, as well as in liver. Double fluorescence labeling
      revealed that GM2 ganglioside and unesterified cholesterol were partially co
      localized in vesicular structures, and triple fluorescence labeling utilizing a
      LAMP-1 antibody identified many of these organelles as part of the late
      endosomal/lysosomal pathway. These observations, coupled with the proposed role
      of NPC1 in intracellular cholesterol movement, suggest that GM3 and GM2
      gangliosides as well as unesterified cholesterol may be retrogradely cleared from
      late endosomes/lysosomes by an NPC1-dependent mechanism. Cellular consequences of
      the NPC metabolic defect as shown by parvalbumin immunocytochemistry and rapid
      Golgi staining, respectively, revealed characteristic axonal spheroids on
      GABAergic neurons and ectopic dendritogenesis that followed a species-specific
      gradient of: mouse < feline < human. These studies suggest that the homeostatic
      regulation of gangliosides and cholesterol in neurons is mediated by NPC1 and
      that perturbations in this mechanism cause a complex neuronal storage disorder.

PMID- 11202176
TI  - Schwann cell dependence of regenerating rat sensory neurons is inversely related
      to the quality of axon growth substratum.
AB  - It is still controversial to what extent elongation of regenerating sensory axons
      depends on proliferating Schwann cells (SCs) in an injured peripheral nerve. We
      hypothesized that such regeneration was independent of SC support early after
      nerve injury, but later became SC-dependent. The sural nerve in rats was crushed,
      and freezing destroyed cells but not their basal laminae (BL) in the distal nerve
      segment. Sensory axon elongation was assessed by the nerve pinch test and their
      abundance was examined immunohistochemically. Sensory axons regenerated fairly
      rapidly during the first week even if SC migration was prevented. Thereafter,
      they ceased to elongate and withdrew until their terminals contacted the SCs
      migrating from the proximal nerve segment. Intrinsic neuronal capacity for growth
      without cell support, however, had not been lost. Rather, progressive degradation
      of the former SC BL and loss of laminin in the acellular segment arrested axon
      growth. Further elongation occurred only when SC migration was possible,
      corroborating our hypothesis. Sensory neurons continued to elongate and maintain
      their axons in spite of deteriorating growth substratum if, prior to injury the
      axons had been allowed to sprout into the denervated skin. Previous sprouting
      exposed the sensory neurons to high levels of NGF.

PMID- 11202177
TI  - Distinct differences in binding capacity to saccharide epitopes in supratentorial
      pilocytic astrocytomas, astrocytomas, anaplastic astrocytomas, and glioblastomas.
AB  - We monitored the expression of glycan-binding sites on a panel of 10 biotinylated
      neoglycoconjugates by means of quantitative computer-assisted microscopy to
      further study the molecular mechanisms in the extensive infiltration of the
      surrounding brain parenchyma by most astrocytic tumors. Three distinct
      histological compartments were analyzed for each of the 108 astrocytic tumors (15
      pilocytic astrocytomas (WHO grade I), 25 astrocytomas (WHO grade II), 30
      anaplastic astrocytomas (WHO grade III), and 38 glioblastomas (WHO grade IV)
      included in our series. These compartments were tumors (nonperivascular tumor
      astrocytes), perivascular tumor astrocytes, and blood vessel walls. Clear
      differences were observed between the pilocytic and the diffuse astrocytic
      tumors. Furthermore, malignant progression in the latter category was paralleled
      by a decrease in cells' ability to bind distinct sugar epitopes, especially the D
      GalNAc(alpha1-3)-D-GalNAc-beta1-R determinant of the Forssman pentasaccharide in
      tumors, the alpha-L-fucose in perivascular tumor areas, and the beta-D-glucose in
      tumor vessel walls. Markedly, the level of binding site expression for alpha-D
      mannose decreased in the tumors, the perivascular tumor areas, and the vessel
      walls. These glycohistochemical results imply the functional relevance of protein
      carbohydrate interactions in this tumor system.

PMID- 11202178
TI  - Matrix metalloproteinase expression and inhibition after sciatic nerve axotomy.
AB  - Wallerian degeneration is characterized by breakdown of myelin and axons with
      subsequent macrophage infiltration and removal of the degenerating nerve
      components. Proteinases of the matrix metalloproteinase (MMP) family seem to play
      an important role in demyelinating processes, since some of their members have
      been shown to cleave myelin basic protein. In the present study we investigated
      the expression of MMP-2 and MMP-9 (gelatinases A and B) during myelin removal
      after peripheral nerve trauma. After transection of the sciatic nerve an
      upregulation of MMP-2 and MMP-9 with a first peak 12 h and a second peak 48 h
      after axotomy was observed by zymography. These peaks correlate with the
      breakdown of the blood-nerve barrier, the accumulation of granulocytes, and the
      invasion of macrophages into the damaged nerves, respectively. Furthermore, MMP-2
      was found to be upregulated in the contralateral nontransected nerves.
      Immunocytochemistry for MMP-9 and in situ zymography identified MMP-reactive
      cells within the distal nerve stump. Chloracetate esterase staining was used to
      detect granulocytes, which accumulated at the transection site and were
      colocalized with the in situ zymography signal. Wallerian degeneration of the
      transected nerve could be delayed either by intraperitoneal injections of
      hydroxamate (Ro 31-9790), a nonspecific MMP inhibitor, or by local application of
      an MMP-9-specific antibody. Following these treatment strategies, a decreased
      number of invading macrophages was seen in the nerves associated with an
      increased amount of preserved myelin sheaths. These results suggest that the
      invasion of macrophages into a transected peripheral nerve is accompanied by an
      increased expression of MMPs, particularly MMP-9. Thus, MMPs may seem to play an
      important role in the breakdown of the blood-nerve barrier and subsequent cell
      recruitment from the systemic circulation into the damaged nerve.

PMID- 11202180
TI  - [Adaptive reactions of the cell as the staring point of tumor progression].

PMID- 11202179
TI  - Codeposition of cystatin C with amyloid-beta protein in the brain of Alzheimer
      disease patients.
AB  - Immunohistochemical analysis of brains of patients with Alzheimer disease (AD)
      revealed that the cysteine proteinase inhibitor cystatin C colocalizes with
      amyloid beta-protein (Abeta) in parenchymal and vascular amyloid deposits. No
      evidence of cerebral hemorrhage was observed in any of the brains studied.
      Immunoelectron microscopy demonstrated dual staining of amyloid fibrils with anti
      Abeta and anti-cystatin C antibodies. Cystatin C immunoreactivity was also
      observed in amyloid deposits in the brain of transgenic mice overexpressing human
      beta amyloid precursor protein. Massive deposition of the variant cystatin C in
      the cerebral vessels of patients with the Icelandic form of hereditary cerebral
      hemorrhage with amyloidosis is thought to be responsible for the pathological
      processes leading to stroke. Anti-cystatin C antibodies strongly labeled
      pyramidal neurons within cortical layers most prone to amyloid deposition in the
      brains of AD patients. Immunohistochemistry with antibodies against the carboxyl
      terminus of Abeta(x-42) showed intracellular immunoreactivity in the same
      neuronal subpopulation. It remains to be established whether the association of
      cystatin C to Abeta plays a primary role in amyloidogenesis of AD or is a late
      event in which the protein is bound to the previously formed Abeta amyloid
      fibrils.

PMID- 11202181
TI  - [Separation from umbilical cord blood and clinical use of hematopoietic stem
      cells].

PMID- 11202182
TI  - [Arterial chemoinfusion for treatment of unresectable malignant tumors of the
      liver].

PMID- 11202183
TI  - [The tumor-associated antigen CA-125 under normal and in pathologic conditions].

PMID- 11202184
TI  - [Mortality from malignant neoplasms in the vital statistics of Saint-Petersburg].

PMID- 11202185
TI  - [Polymorphism of the GSMT1 gene in lung cancer resistance and susceptibility].
AB  - The published studies of onco-associated genetic polymorphisms are characterized
      by insufficient interlaboratory reproducibility. The inconsistency of the results
      can be partially attributed to some characteristics of patients and control
      groups, which are used for the comparison of allele frequencies. For instance,
      many investigations involve so-called "healthy donors" as a standard. However,
      the efficiency of such a comparison can be questioned; indeed, as an individual
      life-time risk of malignancy reaches as high as 40-50%, a significant part of
      "healthy donors" would soon or later become the oncological patients. Here we
      tested the advantage of using "true" oncologically tolerant individuals as an
      additional control, e.g. tumor-free people, who succeeded to achieve an elderly
      age without signs of any neoplastic disease. GSTM1 gene polymorphism was used as
      a "positive control" for this novel design of molecular epidemiological study, as
      the GSTM1-null genotype displays slight but reproducible association with lung
      cancer risk. In the present investigation, GSTM1-deficiency was detected in 45%
      elderly tumor-free individuals, 55% healthy middle-aged donors, and 59% lung
      cancer patients. The minimal frequency (43%) of GSTM1(-) genotype was detected in
      elderly tumor-free smokers, and the maximal one (100%) was found in never-smoking
      lung cancer patients. Thus, the comparison of lung cancer patients to the "true"
      oncologically tolerant cohort (elderly tumor-free individuals, especially
      smokers) revealed more demonstrative deviations for the unfavorable genotype,
      than the traditional comparative analysis between oncological patients and
      healthy donors.

PMID- 11202186
TI  - [Multifactorial analysis of risk factors for lung cancer in the city of Tula].
AB  - A multifactorial epidemiologic study of high incidence of lung cancer was
      conducted in the city of Tula. Mathematical methods of pattern recognition were
      used. The influence of 20 factors of risk was evaluated. The leading ones were
      tobacco smoking, occupational exposure to carcinogenic substances and
      precancerous lesions in the lungs. The influence of industrial pollution on
      cancer morbidity was assessed as moderate. Mathematical estimates for
      effectiveness of correction of "controllable" risk factors were given.

PMID- 11202187
TI  - [Arterial chemoembolization for metastatic colorectal cancer in the liver].
AB  - Transcatheter hepatic artery chemoembolization (THACE) for inoperable colorectal
      carcinoma metastatic to the liver has been evaluated. Cytostatics were given to
      67 patients (Dioxadet 10-30 mg--23; Doxorubicin 40-100 mg--44) in 183 courses
      using oil and gelatin sponge (1986-1999). Response to treatment (partial decrease
      in tumor size or growth stabilization) for Dioxadet and Doxorubicin was 47 and
      66%, respectively; major complications--17% (fatalities--9%) and 11%,
      respectively. Mean survival rate was 10 and 11 months; median survival--9 and 10
      months, respectively. Repeated THACE-assisted treatment with Doxorubicin was
      followed by mean survival of 14 months, median--12; one-year survival increased
      by 77%. THACE-mediated treatment with Dioxadet proved less effective and involved
      more complications. Further research in modifications of endovascular
      intervention is needed, including their combinations with systemic treatment of
      metastatic cancer of the liver.

PMID- 11202188
TI  - [Intraepithelial mononuclear lymphocytes and progression of stomach and colon
      cancers].
AB  - Levels of intraepithelial lymphocytes were assayed in 60 bioptic samples taken
      from the stomach and colon. The pathologies included non-specific inflammation,
      benign epithelial proliferation, adenoma with grave epithelial dysplasia and
      adenocarcinoma. Among the methods used were routine histological staining, direct
      immunostaining with FITC-conjugated monoclonal antibodies against the human
      antigen CD4 and antibody Fab-fragment as well as an original procedure for DNA
      identification. In the colon, adenocarcinoma was distinquishable a high level of
      intraepithelial CD4(+) lymphocytes while, in the stomach, this was true for
      tubular adenoma with grave epithelial dysplasia, too.

PMID- 11202189
TI  - [Effect of gestagen therapy on clinical and biochemical parameters in patients
      with atypical endometrial hyperplasia].
AB  - The investigation involved 22 reproductive and menopausal women (aged 30-48) with
      atypical endometrial hyperplasia. In addition to general clinical examination,
      all the patients underwent ultrasound scanning of the organs of the small pelvis,
      hysteroscopy and diagnostic curettage for morphological examination both before
      and after treatment. All tissue samples taken before and after treatment were
      assayed for cytoplasmic and plasma-membrane receptor levels and a number of
      biochemical parameters of plasma membranes. Hormone therapy with prolonged
      release gestagen-based drugs pointed to changes which occurred in: (1) sex
      steroid reception at cytosol and plasma-membrane levels; (2) the lipids profile
      of plasma membranes, and (3) activity of membrane-related enzymes. Among the
      beneficial results of gestagen treatment was coming most of lipid profile
      parameters and plasma-membrane enzymes back to normal. However, a decrease in the
      progesterone reception level in target tissue after 3-6 month treatment may
      suggest a likelihood of development of tolerance to gestagen. The data also
      suggest that further research continue in this area of endometrial precancer.

PMID- 11202191
TI  - [Apoptosis and proliferation of epithelial cells in papillomaviral and chlamydial
      cervicitis].
AB  - Patients with chlamydial and papillomaviral cervicitis show a significantly
      higher activity of the ectocervical epithelium which is particularly pronounced
      in papillomaviral infection. This is, however, matched by progressively reduced
      apoptosis of epithelial cells which in turn suggests the possibility of
      papillomaviruses and chlamydiae contributing to inhibition of infected cells and,
      thus, paving the way for development of precancer and cancer of cervix uteri.

PMID- 11202190
TI  - [Diagnostic and prognostic significance of some laboratory indices of 
      cerebrospinal fluid in multiple myeloma].
AB  - beta 2-microglobulin (beta 2-m) and certain other characteristics of liquor have
      been followed in the course of multiple myeloma (MM) versus severity of the
      disease and its response to chemotherapy, to establish the diagnostic and
      prognostic value of these indices. Lymphocytes and plasma cells were found in
      most of 17 patients under study, who were resistant to chemotherapy and relapsed;
      they revealed regular rise in liquor pressure and cytosis. Similarly, raised
      concentrations of beta 2-m were registered. However, there was no correlation
      between blood serum-beta 2-m levels and that in cerebrospinal fluid (CSF) nor
      between CSF-beta 2-m concentration, on the one hand, and such parameters as CSF
      total protein, blood serum-beta 2-m and pathologic cytosis, on the other. In
      advanced MM, CSF-beta 2-m levels were, as a rule, abnormally higher. Our data
      suggest that, in addition to assaying CSF-total protein, severity of cytosis and
      liquor pressure as well as morphological identification of detected cells, beta 2
      m levels be followed in the course of the disease in MM patients, to make
      therapeutic correction possible. Moreover, CSF-beta 2-m level dynamics can be
      used as another factor of prognosis.

PMID- 11202192
TI  - [Chemobiokinetics of sarcolysin and its peptides with glutaminic acid].
AB  - A 14C study of chemobiokinetics of sarcolysin and its peptides of glutaminic
      acid, dosage and routes of administration was conducted in intact rats and those
      bearing Walker's carcinoma. Similar in shape for peptides, kinetic curves
      differed from those found for sarcolysin. The rates of absorption and excretion
      of sarcolysin peptides in intraperitoneal and, particularly, oral administration
      were lower than those of sarcolysin. Tumor appeared to play a role in a higher
      rate of peptide excretion. While sarcolysin and its peptides distribution in
      organs and tissues was generally identical, time of peak radioactive
      concentration build-up was different. Time needed for accumulation and excretion
      of peptides from tumor was much longer than from other organs or tissues.
      Sarcolysin went chiefly to urine while peptides--to faeces.

PMID- 11202194
TI  - [Specific response to benzo(a)pyrene treatment depending on mode of
      administration in rats].
AB  - Mathematical and statistical procedures were used to identify individual response
      in rats to benzo(a)pyrene (BP) treatment versus dose and regimen (single or
      repeated administration). Primary experimental data were suitably processed to
      exclude extreme values. A significant correlation was established between life
      span and urine level of (+/-)-trans-7,8-dihydroxy-7,8-dihydrobenzo(a)pyrene (7,8
      BP) after BP administration. It was found that, with single administration
      regimen, individual response to the carcinogenic agent correlated primarily with
      efficiency of excretion of the active forms of BP while in chronic experiment-
      with deactivation of the agent by enzymes.

PMID- 11202193
TI  - [Cyclophosphamide-induced apoptosis of murine lymphosarcoma cells in vivo].
AB  - The antitumor action of combination chemotherapy (cyclophosphamide + adriamycin +
      vincristin + prednisolone) for transplantable nitrosomethylurea-induced
      lymphosarcoma was studied in male CBA mice. Single injections of the mixture were
      followed by complete regression of tumors of up to 2 cm in diameter. The effect
      was shown to be caused by cyclophosphamide (CP) alone, by inducing apoptosis. The
      other components failed to potentiate the CD effect. Being useless, they are
      likely to cause harm by contributing to the overall toxic effect of therapy. The
      nature and duration of CP-induced remission appeared dose-dependent: on day 50 of
      the administration of 50, 100 and 150 mg/kg body, tumors were detected in 100, 55
      and 0% of the animals, respectively. Such means of apoptosis induction as
      glycocorticoid treatment and ionizing radiation did not cause complete
      regression.

PMID- 11202195
TI  - [Treatment with Miltex for metastatic skin lesions in breast cancer]  .
AB  - Miltex (miltefosine) is a new antiproliferation drug comprising phospholipid
      ingredients. It is used for topical treatment of metastatic skin lesions in
      breast cancer. Clinical trials of the drug were conducted in 11 breast cancer
      patients resistant to standard therapy. Apparent therapeutic effect (partial
      regression) was registered in 27.3% (3/11). Moderate toxic effects were generally
      confined to skin itching (36.4%) and scaling (18.2%), erythema (18.2%), and paper
      skin (45.5%).

PMID- 11202196
TI  - [Combination chemotherapy with hexamethylamine (Hexalen, Altretamine, Hexastat)
      and sarcolysine in advanced ovarian carcinoma].
AB  - Combination chemotherapy with hexamethylmelamine (hexalen, altretamine,
      hexastat), 100 mg, thrice a day, per os, 14 days (out of a 28-day course) and
      sarcolysin, 15 mg, per os, during the first 5 days of the course, was received by
      24 patients with primary advanced tumors of the ovaries, prior to or after
      cytoreductive surgery. Total apparent response to chemotherapy among 19 patients
      of the study group was 47.2%, clinically significant (plus stabilization)--94.5%,
      without significant untoward side-effects (vomiting--19%; leukopenia degree II
      III--33% and thrombocytopenia--19%). The drug proved an active component of
      combination therapy for advanced ovarian carcinoma.

PMID- 11202197
TI  - [Experience with chemotherapy for advanced pancreatic carcinoma].
AB  - The effectiveness of different regimens of chemotherapy for advanced pancreatic
      cancer was compared in 74 cases (1995-1999). 5-fluorouracil (5FU), adriamycin and
      mitomycin C (FAM) were given to 12 patients, 5FU alone--23, 5FU plus leukovorin-
      29, and gemcitabine alone--10. Metastases to the liver were detected in 42 (57%)
      patients. Partial response (40) was registered in: FAM--1 (8%); 5FU--1 (4%); 5FU
      + leukovorin--3 (10%); gemcitabine--3 (30%). Mean duration (40) was 5.4; 4; 6.1
      and 9 months, respectively. Stabilization was recorded in 17 (23%), mean duration
      -4.4 months; tumor progression--49 (66%). Toxic side-effects of all the regimens
      were insignificant. Mean survival rates following FAM, 5FU, 5FU + leukovorin were
      4.4; 4.2 and 5.6 months, respectively, while that for gemcitabine varied 3-24
      months (on average--7.9 months). Survival in patients responsive to chemotherapy
      was 9.8; remaining patients--4.7 (p (0.05). Chemotherapy for advanced pancreatic
      carcinoma is a measure of palliation; its use was followed by a 20% increase in
      survival. Gemcitabine treatment appeared most effective.

PMID- 11202198
TI  - [Plasmapheresis in radiotherapy for pancreatic cancer].
AB  - Although radiotherapy is known to improve the results of treatment for pancreatic
      carcinoma, its application is limited due to such side effects and complications
      as anemia, leuko-, thrombocytopenia and dyspeptic disorders. It was suggested
      that since these complications are primarily caused by radiotherapy itself and
      mass death of tumor cells, plasmapheresis might raise tolerance to radiation.
      This was confirmed by our experience with its use during radiotherapy course in
      22 patients with pancreatic cancer.

PMID- 11202199
TI  - [Radiologic diagnosis of outside-of-organs neck neoplasms].
AB  - To evaluate the efficiency of ultrasound (US) and computed tomography (CT) in
      diagnosis of neck neoplasms, 36 patients with 26 benign and 8 malignant tumors
      were examined. Also, 32 US-guided fine needle aspiration biopsies (FNAB) were
      performed. Both US and CT showed high efficiency in detecting neck masses but not
      in different diagnosis, except for lymphomas. However, FNAB discriminated between
      benign and malignant tumors with a sensitivity of 75%, specificity--96% and
      accuracy--90.9%.

PMID- 11202200
TI  - [Role of high-dose BEAM-chemotherapy and autologous hemopoietic stem   cell
      transplantation in the treatment of drug-resistant Hodgkin disease].
AB  - In 1995-1999, 67 patients with relapsed Hodgkin's disease or refractory to
      chemotherapy (group A--first relapse, B--primary refractory disease, and C-
      repeated relapse) received cytoreductive (dexaBEAM, DHAP) therapy followed by
      high-dose BEAM chemotherapy and autologous bone marrow or blood cell
      transplantation. Early postoperative transplant-related mortality rate was 4.5%.
      At day 100, complete remission rates were: group A--95.6%; B--74.1%; and C-
      76.5%. Survival for all patients was: overall--61.9%; event-free--43.9%; disease
      free--46%; and relapse-free survival--49.5%. Such factors as primary refractory
      disease, age over 30 years and response to cytoreductive therapy had significant
      influence on overall survival prognosis.

PMID- 11202201
TI  - [A rare case of multifocal cancer of the external epithelium and mucinous glands
      of the larynx].

PMID- 11202202
TI  - [Breast self-examination as a method of screening for breast cancer].

PMID- 11202203
TI  - [The life and work of Prof. S.A. Kholdin (25th anniversary of his death)].

PMID- 11202204
TI  - What happens when growth hormone is discontinued at completion of growth?
      Metabolic aspects.
AB  - Continuing growth hormone (GH) replacement therapy in patients with childhood
      onset GH deficiency (GHD) that persists into adulthood is an emerging issue. The
      prospective, long-term metabolic consequences of discontinuing GH therapy in
      adolescent patients with childhood-onset GHD and short stature have only recently
      been reported. These studies demonstrate that serum concentrations of total
      cholesterol, low-density lipoprotein-cholesterol and apolipoprotein B are higher
      in adolescents in whom severe GHD continues into adulthood. Upon discontinuation
      of GH therapy, serum concentrations of high-density lipoprotein-cholesterol have
      been found to decrease in patients with severe GHD and increase in patients
      regarded as GH sufficient when retested for GHD. Furthermore, total body fat and
      truncal fat mass increase after discontinuation of GH in both these patient
      groups, but more markedly in the patients with severe GHD. In adolescents with
      severe GHD persisting into adulthood, the discontinuation of GH therapy produces,
      over a period of 2 years, the accumulation of important cardiovascular risk
      factors that are associated with GHD in adults. Continuing replacement therapy
      into adulthood should therefore be considered.

PMID- 11202206
TI  - A lifetime of growth hormone deficiency: a US pediatric perspective.
AB  - At a dose of approximately 0.3 mg/kg/week, treatment with growth hormone (GH) in
      GH-deficient children achieves adult heights that are in close proximity to a
      final height SDS of -0.7 +/- 1.3 for males and -0.7 +/- 1.1 for females. Early
      diagnosis, treatment with adequate doses of GH and attention to compliance with
      therapy have contributed to these striking improvements in height gain in both
      males and females. Final heights of 171.6 +/- 8.2 cm in males and 158.5 +/- 7.1
      cm in females have been reported. There remains a considerable educational need
      with regard to the transition of patients with childhood-onset GH deficiency from
      childhood to adulthood. Re-testing of GH secretory status is but one of the
      issues; others include appropriate dosing and appropriate endocrinological
      management. Awareness of the consequences of adult GH deficiency must be
      increased further among endocrinologists, patients and insurers.

PMID- 11202207
TI  - Optimal strategy for management of pituitary disease in the growth hormone
      deficient teenager.
AB  - The optimal treatment of chronic conditions spanning pediatric and adult clinical
      practice requires the establishment of clear and robust systems for managing the
      important period of transition of care. This principle is particularly relevant
      to the treatment of ongoing pituitary dysfunction after the achievement of final
      height and, in addition to the vital component of maintaining the confidence of
      the patient, encompasses a number of considerations that are particularly
      relevant to long-term health as an adult. These considerations include the
      achievement of peak bone mass, optimization of gonadal steroid and glucocorticoid
      replacement, and determination of the need for continuing growth hormone
      replacement. It is therefore necessary to consider these issues not only from the
      standpoint of therapeutic principles but also in the context of practical
      arrangements for managing the process of transition of care. Successful
      transition can be achieved using a variety of models, and there is clearly no
      single preferable option. The most important ingredient in this process is
      awareness of the situation by both pediatric and adult endocrinologists as well
      as the development of an agreed strategy within each clinical center.

PMID- 11202205
TI  - Growth and hormone deficiency and peak bone mass.
AB  - In order to define the relationship between growth hormone (GH) and peak bone
      mass, and the importance of the role played by GH in reaching optimal peak bone
      mass, several questions, discussed in this article, have first to be answered.
      Although the answers to some of these questions are already becoming apparent,
      some await the findings of further research. It is doubtful whether the results
      of these studies, which by definition should be long-term because of the long lag
      between the end of linear growth and the attainment of peak bone mass, will soon
      be available. In the absence of evidence-based medicine one can, however,
      conclude that long-term GH replacement therapy for GH deficiency in adults has no
      deleterious effects on bone. Indeed, despite an increase in bone turnover and an
      increase in remodeling space, bone mineral density and bone mineral content have
      been shown to increase slowly over time and to the same degree in both controlled
      and uncontrolled studies.

PMID- 11202208
TI  - Ethical dilemmas in pediatric endocrinology: growth hormone for short normal
      children.
AB  - Ethical questions surrounding the administration of synthetic growth hormone (GH)
      to short normal children can be grouped into the following four categories: 1)
      appropriateness of medical treatment when no disease or biological deficiency is
      present; 2) how to proceed in the face of ambiguity or uncertainty of research
      results; 3) difficulty in weighing the risks and benefits of treatment; and 4)
      who should decide? This article seeks to determine whether GH administration to
      normal short children is properly considered an 'enhancement', and, if so,
      whether such treatment would be ethically wrong.

PMID- 11202209
TI  - Evidence-based approach to growth hormone replacement therapy in adults, with
      special emphasis on body composition.
AB  - In the past decade, a large number of controlled clinical trials have reported
      positive effects of growth hormone (GH) replacement therapy in GH-deficient
      adults. The majority of these studies have been carried out in accordance with
      the guidelines for Good Clinical Practice. The data thus accumulated offer a
      solid baseline for practicing evidence-based medicine within this area of
      endocrinology.

PMID- 11202210
TI  - Evidence-based growth hormone therapy prediction models.
AB  - Prediction models describing the response of various pathophysiological states to
      intervention can be of value in confirming a diagnosis, determining the prognosis
      and promoting compliance with treatment. The rigorous evaluation process of
      evidence-based medicine, used to assess any diagnostic test or therapeutic
      intervention, should be applied to studies reporting the development, validation
      and application of these prediction models. The models can provide only an
      estimate of the average effect to be expected, so the failure of an individual to
      exhibit an 'average' response does not necessarily imply a problem with that
      patient. Further development of the models is required to overcome inherent
      statistical problems and to allow greater applicability to the individual
      patient.

PMID- 11202211
TI  - New paradigms for growth hormone treatment in the 21st century: prediction
      models.
AB  - Inconsistent and sometimes disappointing final height outcomes in studies in
      which exogenous growth hormone (GH) was given to children with short stature
      resulting from various causes have led to attempts to determine the factors that
      influence responsiveness to GH. Many such factors have been identified, including
      the genetically determined height potential of the child, the height deficit,
      current and perinatal auxological and biological factors, and, importantly, GH
      treatment modalities. These factors vary depending on the cause of the growth
      failure and during the course of childhood and treatment with GH. Data from well
      defined large cohorts can be entered into multiple regression analyses to derive
      algorithms describing the variation in growth response during a defined period
      and the influence on this of various factors. Pharmacoepidemiologic surveys have
      been particularly useful in this regard. Algorithms with low-error SD values,
      which have included the dose of GH as a variable, can be used to predict the
      response to a putative GH dose in a similar cohort or in an individual over an
      equivalent period. A sequential series of such algorithms can be integrated to
      form a predictive model. Such a model can be used for planning a course of
      treatment, but the patient data required for entry into the model should be
      easily obtainable if the model is to have widespread utility. The development of
      such models will allow GH treatment to be better individualized and optimized for
      growth and cost outcomes. Growth prediction models will facilitate realistic
      expectations and will permit stepwise goals to be set and monitored.

PMID- 11202212
TI  - Role of insulin-like growth factor monitoring in optimizing growth hormone
      therapy.
AB  - Much has been learned over the past two decades regarding the management of
      growth hormone (GH) deficiency in children and adolescents. Current GH therapy
      under ideal circumstances enables children to attain a final height within the
      normal range and close to their target height. However, such a successful outcome
      is not always achieved and the necessity to individualize treatment according to
      the specific needs of each GH-deficient child is now well recognized. Consensus
      does not currently exist as to how to formulate individualized treatment plans.
      Nonetheless, a clear role for a biochemical, as well as an auxological,
      monitoring approach has been established. Accurate determinations of height
      velocity and interval height increase (expressed as the change in height Z-score)
      continue to be the most important parameters in monitoring the response to
      treatment. The importance of routinely monitoring serum levels of insulin-like
      growth factor-I (IGF-I) and IGF-binding protein-3 is an emerging paradigm. Firm
      roles have been established for this approach in the assurance of compliance and
      safety (particularly to avoid long-term theoretical risks). IGF monitoring also
      has important potential utility as a tool to assess and optimize the response to
      GH therapy through dose adjustments. In years to come, we expect the development
      of multiple GH treatment optimization strategies, including approaches such as
      prediction modeling, as well as serum IGF monitoring and dose adjustments, to
      evolve and improve.

PMID- 11202213
TI  - Knockout mice challenge our concepts of glucose homeostasis and the pathogenesis
      of diabetes mellitus.
AB  - The failure of insulin to stimulate muscle glucose uptake and suppress hepatic
      glucose production represents two of the fundamental pathophysiologic lesions in
      type 2 diabetes mellitus (DM). Defining insulin action at the molecular level,
      therefore, provides the critical background against which to elucidate the
      mechanisms of insulin resistance that underlie type 2 DM, obesity and many other
      disorders. Over the past two decades substantial progress has been made in
      identifying many of the molecular mechanisms involved in insulin signaling. Much
      of this progress has been due to the use of homologous recombinant gene
      targeting. The present review examines the various insights that have been
      provided by studies of knockout mice strains. Taken together, the results present
      the possibility of a unifying hypothesis for type 2 DM, in which insulin
      resistance in the beta-cell synergizes with insulin resistance in the periphery
      to produce the two classic defects of this disease: relative hypoinsulinemia and
      peripheral insulin resistance.

PMID- 11202214
TI  - Type 2 diabetes mellitus in children: pathophysiology and risk factors.
AB  - Type 2 diabetes mellitus (DM) has been considered rare in the pediatric
      population. However, over the last decade, there has been a disturbing upswing in
      the rate of diagnosis of type 2 DM in the pediatric age group, mirroring the
      increasing rates of obesity in childhood. The pathophysiology of type 2 DM
      discussed in this article focuses on the delicate balance between insulin
      sensitivity and insulin secretion. The risk factors for youth-onset type 2 DM are
      presented, with careful evaluation of their impact on insulin sensitivity versus
      insulin secretion.

PMID- 11202215
TI  - Emergence of type 2 diabetes mellitus in children: epidemiological evidence.
AB  - There have been numerous recent reports of case series of type 2 diabetes
      mellitus (DM) in American Indian, African-American, Hispanic, Asian-American and
      white children from North America. A similar phenomenon has also been described
      in several other countries. Prevalence and incidence estimates vary depending on
      the age and ethnicity of the population, but it is estimated that type 2 DM
      represents 8-45% of patients with DM currently diagnosed in large US pediatric
      centers; however, this is likely to be an underestimation and incidence is
      probably rising. The young patients diagnosed with type 2 DM in the USA were
      generally overweight, had a strong family history of type 2 DM and often had
      signs of insulin resistance. The majority belonged to ethnic groups at high risk
      for type 2 DM. More girls than boys were diagnosed. The few data on follow-up
      available suggest a high prevalence of microvascular and macrovascular
      complications among young adults who developed type 2 DM during childhood. Type 2
      DM in children has recently been recognized as a potential public health problem
      in North America. As obesity is currently on the increase in several
      industrialized or industrializing countries, a similar increase in type 2 DM in
      children may soon emerge worldwide, and this will require preventative measures.

PMID- 11202216
TI  - Treatment of type 2 diabetes mellitus in children and adolescents.
AB  - The treatment of type 2 diabetes mellitus (DM) is directed at decreasing insulin
      resistance and increasing insulin secretion. alpha-Glucosidase inhibitors slow
      carbohydrate absorption, resulting in reduced postprandial hyperglycemia;
      thiazolidinediones increase insulin sensitivity, especially in muscle and
      adipocytes; metformin decreases hepatic gluconeogenesis; sulfonylureas result in
      prolonged increases in insulin secretion; and meglitinide causes rapid, short
      lived increases in insulin secretion. A survey of 130 pediatric endocrinology
      practices in the USA and Canada indicated that 48% of children with type 2 DM
      were treated with insulin and 44% with one or more oral hypoglycemic agents
      (OHA). Of those treated with OHA, 71% received metformin, 46% sulfonylureas, 9%
      thiazolidinediones and 4% meglitinide. Similarly, in the three university-based
      diabetes centers in Florida, 50% of the children with type 2 DM were treated with
      OHA. Treatment is based on symptoms at presentation. Patients identified on
      routine testing are often treated with exercise and diet alone. Those who are
      mildly symptomatic at onset are often started on OHA. Patients with substantial
      ketosis, ketoacidosis or markedly elevated blood glucose levels are initially
      treated with insulin, followed by a tapering of the dose and the addition of an
      OHA after blood glucose control is established and symptoms subside. There are no
      studies of the efficacy or compliance with treatment for type 2 DM in
      adolescents. Treatment is currently based on the clinical experience with adults.
      Controlled clinical trials in children are essential.

PMID- 11202217
TI  - Diagnosis of maturity-onset diabetes of the young in the pediatric diabetes
      clinic.
AB  - The diagnosis of pediatric diabetes mellitus (DM) traditionally is not considered
      a diagnostic specialty. However, considerable heterogeneity in the etiology of DM
      is seen among children and adolescents, making the recognition of discrete
      subgroups of DM very important for determining prognosis and appropriate
      treatment. The subgroups that result in non-insulin-dependent DM in children are
      as follows: the 'honeymoon' phase of type 1 DM, type 2 DM, genetic syndromes
      accompanied by DM, and maturity-onset diabetes of the young (MODY). The relative
      prevalence of these different subgroups depends on the population being studied.
      In the UK, in pediatric clinics where most patients are Caucasian, MODY is over
      10 times more prevalent than type 2 DM. However, type 2 DM would predominate in a
      clinic where most children are from populations with a high prevalence of this
      condition (e.g. Asian Indians). It should be emphasized that MODY comprises two
      discrete clinical syndromes: glucokinase diabetes and transcription factor
      diabetes, the latter of which results from mutations in the genes encoding
      hepatocyte nuclear factor (HNF)-1alpha, HNF-1beta, HNF-4alpha and insulin
      promoter factor-1.

PMID- 11202218
TI  - Thrifty genotypes and phenotypes in the pathogenesis of type 2 diabetes mellitus.
AB  - Dramatically high rates of type 2 diabetes mellitus (DM) have been observed in
      historically undernourished, recently urbanized populations. A comparable model
      is the high risk of DM in individuals who were growth restrained in utero and
      subsequently catch up in size. While it is proposed that undernutrition may
      somehow adversely program metabolism, both models could also be explained by
      genotypes that promoted survival during earlier nutritional adversity but later
      add to the risk of DM. Our recent studies in a contemporary birth cohort have
      identified two different candidate thrifty genotypes. The insulin gene VNTR
      III/III genotype promotes fetal growth and historically could thereby have
      enhanced survival during infancy. In contrast, the maternally inherited 16189
      mitochondrial DNA variant is associated with restrained fetal growth and may
      therefore enhance the likelihood of maternal survival. Both genotypes are
      associated with an increased risk of adult type 2 DM in historical cohorts.
      However, the development of DM in individuals from contemporary birth cohorts may
      prove to be influenced more by genetic and other early determinants of childhood
      obesity.

PMID- 11202219
TI  - Estradiol: a protective factor in the adult brain.
AB  - Clinical studies suggest that estradiol acts as a protective factor in the adult
      brain. Postmenopausal women suffer from an increased risk of brain injury
      associated with neurodegenerative diseases such as Alzheimer's disease, and
      estrogen replacement therapy appears to decrease the risk and severity of this
      neurodegenerative condition. Studies using animal models show that estradiol
      exerts similar effects in rodents and can enhance cell survival. Therefore, we
      designed experiments to determine whether estradiol treatment can decrease brain
      injury induced by an experimental model of ischemia. Our experiments used a
      permanent middle cerebral artery occlusion model and physiological levels of
      estradiol replacement therapy. The results demonstrate that estradiol exerts
      profound protective effects against ischemic brain injury induced by cerebral
      artery occlusion and that this protective action correlates with changes in the
      level of gene expression of estradiol receptors and members of the Bcl-2 family.
      These data suggest that estrogen replacement therapy may provide important
      protection against age- and disease-related degenerative processes in the brain.

PMID- 11202221
TI  - Estrogen, bone, growth and sex: a sea change in conventional wisdom.
AB  - The discovery of a man with a homozygous mutation in the estrogen receptor alpha
      gene, which results in estrogen-receptor alpha resistance, and of males and
      females with autosomal recessive mutations in the CYP19 gene encoding aromatase,
      which leads to a failure to synthesize estrogens, has challenged conventional
      wisdom about the 'unimportant' role of estrogen in the male. For example, in the
      male, estrogen (not androgen) derived from direct testicular secretion
      (approximately 20%) and from extragonadal aromatization of testosterone and
      androstenedione (approximately 80%), is the critical sex hormone in the pubertal
      growth spurt, skeletal maturation, accrual of peak bone mass, and the maintenance
      of bone mass in the adult. Estrogen stimulates chondrogenesis in the epiphyseal
      growth plate increasing pubertal linear growth. At puberty, estrogen promotes
      skeletal maturation and the gradual, progressive closure of the epiphyseal growth
      plate, possibly as a consequence of both estrogen-induced vascular and
      osteoblastic invasion and the termination of chondrogenesis. In addition, during
      puberty and into the third decade, estrogen has an anabolic effect on the
      osteoblast and an apoptotic effect on the osteoclast, increasing bone mineral
      acquisition in axial and appendicular bone. In the adult, estrogen is important
      in maintaining the constancy of bone mass through its effects on remodeling and
      bone turnover. Establishing a role for estrogen does not exclude a direct action
      of testosterone on bone in the human male (especially on cortical bone), but this
      action is less characterized than thought in the past and is relatively minor in
      comparison with the major effect of estrogen in the male.

PMID- 11202220
TI  - Estrogen treatment and estrogen suppression: metabolic effects in adolescence.
AB  - The metabolic consequences of reaching full reproductive maturity in humans
      involve not only growth hormone (GH) and insulin-like growth factor-I, but also
      the collaborative interaction of the gonadal sex steroids. Estrogen is critical
      for completing linear growth. It also inhibits bone resorption, decreases plasma
      lipid levels and serves as an antiatherosclerotic agent. Our studies show that,
      in low doses, estrogen increases GH production, increases calcium absorption and
      decreases bone turnover; however, unlike testosterone, estrogen has no effects as
      a protein-anabolic agent, at least at the whole body level. Studies of selective
      estrogen suppression, achieved using a potent aromatase inhibitor, show that
      estrogen is the main regulator of the gonadotropin axis. In boys, selective
      aromatase blockade may have a role in delaying epiphyseal fusion. Large placebo
      controlled trials will be required to study this effect further.

PMID- 11202222
TI  - Route-dependent endocrine and metabolic effects of estrogen replacement therapy.
AB  - The route of estrogen replacement therapy has a major impact on the growth
      hormone (GH)-insulin-like growth factor-I (IGF-I) axis. Estrogen administration
      by the oral, but not the transdermal, route reduces IGF-I and increases GH levels
      in postmenopausal women. This perturbation of the GH-IGF-I axis occurs with
      different forms of estrogen treatment, indicating that the dissociation of the
      somatotropic axis and concomitant increase in GH-binding protein levels are
      intrinsic effects of the oral route of estrogen administration. In clinical
      studies, oral estrogen reduced postprandial lipid oxidation, compared with
      transdermal estrogen. Oral estrogen was also associated with a reduction in lean
      body mass and an increase in fat mass, compared with transdermal estrogen. In
      contrast, the route of estrogen therapy had no impact on carbohydrate metabolism
      or the estrogen-induced increase in bone mineral density. The findings of route
      dependent changes in body composition add a new dimension to health
      considerations concerning estrogen therapy in postmenopausal women and may have
      significant implications for estrogen replacement therapy in young hypogonadal
      females.

PMID- 11202223
TI  - Telomerase and the cellular lifespan: implications of the aging process.
AB  - The aging process has multiple causes. However, there is now substantial evidence
      consistent with the hypothesis that (i) all normal mammalian somatic cells have a
      finite capacity to replicate and (ii) that gradual cell turnover throughout the
      lifespan of a mammal eventually exhausts this finite capacity. This results in a
      gradual accumulation of senescent (irreversibly post-mitotic) cells with
      increasing age. These cells display a radically different phenotype to their
      growing counterparts, which has the potential to compromise tissue function.
      Perhaps the best evidence for this is seen in Werner's syndrome, a rare genetic
      disease, in which patients display most of the features of accelerated aging,
      together with a profoundly compromised replicative lifespan in certain tissue
      lineages. Several classes of human cells are now known to count divisions by
      monitoring the progressive attrition of chromosomal ends (telomeres), leading to
      the activation of a p53-p21waf-dependent G1 checkpoint. Ectopic expression of
      telomerase has been shown to prevent senescence in several cell types and offers
      the potential for interventions in the aging process based on tissue engineering,
      gene therapy or homeografts. However, this telomere-driven senescence mechanism
      seems to be absent from rodents, which use telomere-independent means (perhaps
      based upon p14arf) to count divisions. Similar senescence pathways are now being
      reported in humans, and this, coupled with the demonstration of tissue-specific
      telomeric loss rates, has the potential to render strategies based on the use of
      telomerase dependent on the characteristics of the target tissue. Werner's
      syndrome may provide strong clues regarding the potential limitations and
      prospects of such future treatments.

PMID- 11202224
TI  - Human aging and progeria.
AB  - The notion that all aging is ultimately cell aging is a novel hypothesis and one
      with growing support. Recent studies in genetics and cell biology are consistent
      with this view. Criticism of the model is largely reflective of inadequate
      understanding of both the model itself and human pathology. Hutchinson-Gilford
      progeria is a segmental progeria that may well be an 'epigenetic mosaic' disease
      in which certain cell lines exhibit early cell senescence, while others are
      spared. The general cell senescence model of aging offers a consistent and
      elegant explanation of both human aging and progeria. More importantly, the model
      is not only testable but implies fundamental, novel and promising therapeutic
      avenues for both progeria and more typical age-related diseases.

PMID- 11202225
TI  - A role for the somatotropic axis in neural development, injury and disease.
AB  - This review article discusses the roles of the somatotropic axis in the growth
      and development of the normal central nervous system (CNS) and during recovery
      from brain injury. Classically, the actions of pituitary-derived growth hormone
      (GH) have been reported to be primarily mediated via the induction of hepatic
      insulin-like growth factor-I (IGF-I). GH receptors (GHRs), however, have now been
      identified in many body tissues and shown to have both endocrine and local
      actions, some of which are IGF-I independent. Within the brain, GHRs are widely
      located across a range of cellular phenotypes, yet little is known regarding
      their function or endogenous ligand. It is now becoming accepted that GH, like
      IGF-I, is integrally involved in the growth and development of the normal CNS.
      Following brain injury, IGF-I mRNA is induced, primarily within reactive
      microglia. The resultant IGF-I protein appears to have a dual role, first as an
      endogenous neurotropic and anti-apoptotic agent acting directly on stressed
      cells, and second as a prohormone for generation of the N-terminal tripeptide of
      IGF-I, glycine-proline-glutamate (GPE), and the resulting des-N-(1-3)-IGF-I, both
      of which have specific neuroprotective properties. Our work on deciphering the
      upstream regulators of injury-induced IGF-I has revealed that a GH-like substance
      is strongly upregulated after brain injury and specifically associated with
      stressed neurons and glia. Subsequent to this finding, GH administered centrally
      2 hours after a hypoxic-ischemic brain injury in juvenile rats was found to
      provide significant neuroprotection, interestingly, in a spatiotemporal pattern
      distinct from the neuroprotection offered by IGF-I. The implications of these
      findings in regard to the growth, development and injury response of the CNS are
      discussed.

PMID- 11202226
TI  - Hypothalamic growth hormone-insulin-like growth factor-I axis across the human
      life span.
AB  - The activity of the growth hormone (GH)-insulin-like growth factor-I (IGF-I) axis
      undergoes marked variations across the human life span, mainly reflecting age
      related changes in the neural control of somatotroph function. IGF-I secretion
      generally reflects GH status, except in newborns, who secrete high levels of GH
      but low levels of IGF-I. Changes in the gonadal steroid milieu, particularly
      estradiol, play a major role in the enhanced activity of the GH-IGF-I axis at
      puberty and probably reflect further changes in the neuroendocrine control of
      somatotroph secretion. The change in responsiveness of somatotrophs to various
      stimuli, including GHRH, is not as marked as the spontaneous secretion of GH at
      puberty. However, in childhood, somatotrophs are unusually refractory to the
      somatostatin-mediated negative GH autofeedback mechanism. Normal children show
      normal responsiveness to the stimulatory influence of alpha-adrenergic and
      cholinergic agonists, galanin and arginine, but the activating effect of these
      stimuli on somatotroph secretion is reduced in elderly individuals, with the
      notable exception of arginine. Arginine potentiates both spontaneous and GHRH
      induced GH secretion to the same extent in normally growing children, adults and
      elderly individuals, indicating that the releasable pool of GH is generally
      preserved across the human life span. Thus, the reduction in spontaneous and GHRH
      induced GH secretion in the elderly probably reflects age-related changes in
      neurotransmitter control, leading to GHRH hypoactivity and absolute or relative
      somatostatin hyperactivity in the aged hypothalamus. Cholinergic impairment in
      the aging brain probably involves hypothalamic pathways and leads to decreased
      activity of the GH-IGF-I axis in normal and elderly individuals, as well as in
      individuals with premature brain aging. However, there is evidence indicating
      that age-related variations in the activity of the natural GH-secretagogue
      ligand(s) at the hypothalamic level could also play a role in the age-dependent
      changes in the GH-IGF-I axis.

PMID- 11202227
TI  - The lost voice: a history of the castrato.
AB  - Under the influence of testicular secretion, the male vocal cords increase in
      length by 67% in adult men compared with prepubertal boys, whereas in the female
      the increase is only 24%. This greater length and an increase in vocal cord mass
      is responsible for the lowering of pitch of the male voice during puberty. From
      the late 16th century, castration was carried out in Italy to preserve the
      unbroken male voice into adult life, but the high pitch was accompanied by fully
      grown resonating chambers and a large thoracic capacity, giving rise to the
      unique voice of the castrato. The initial stimulus for the production of castrati
      came from the Sistine Chapel in Rome, to provide singers for the complex church
      music of the time. The second reason was the coming of opera to Italy at the
      beginning of the 17th century. Boys were castrated between the ages of 7 and 9
      years, and underwent a long period of voice training. A small number became
      international opera stars, of whom the most famous was Farinelli, whose voice
      ranged over three octaves. By the end of the 18th century, fashions in opera had
      changed so that the castrati declined except in the Vatican, where the Sistine
      Chapel continued to employ castrati until 1903. The last of the castrati was
      Alessandro Moreschi, who died in 1924 and made gramophone recordings that provide
      the only direct evidence of a castrato's singing voice.

PMID- 11202228
TI  - Immunofluorescence analysis of T-cell responses in health and disease.
AB  - The use of flow cytometry to study the functional responses of T cells by
      immunofluorescent staining for intracellular cytokines and other markers is a
      growing field of clinical interest. In this article, we describe methods for the
      rapid evaluation of T-cell responses to mitogens and specific antigens and
      explore how these assays might be valuable in various clinical settings.

PMID- 11202229
TI  - Recent developments in flow cytometry.
AB  - Flow cytometry has experienced considerable expansion of available parameters
      during the last years. Various new techniques that allow the direct analysis of
      antigen-specific lymphocytes by direct labeling with antigen or according to
      functional parameters following in vitro antigen stimulation will have enormous
      impact on immunological research, diagnosis, and therapy. This article
      concentrates on the basic principles and applications of these important
      technological developments in flow cytometry and focuses on the analysis of
      specific lymphocytes.

PMID- 11202230
TI  - Complexes of serum amyloid P component and DNA in serum from healthy individuals
      and systemic lupus erythematosus patients.
AB  - Serum amyloid P component (SAP) binds in vitro to DNA; based on findings in SAP
      deficient mice it was proposed that SAP's role is to handle chromatin and DNA,
      thereby preventing formation of anti-DNA antibodies. For the first time we have
      shown the presence of Ca2+-dependent SAP-DNA complexes, measured by ELISA, in
      sera from both healthy volunteers and systemic lupus erythematosus patients
      (SLE). The concentration of SAP-DNA complexes in SLE sera was significantly lower
      than in normal sera and particularly low in sera from patients with anti-DNA
      titers exceeding 50. The complexes were dissociated by the SAP ligand heparin and
      were not demonstrable in EDTA plasma. Normal sera showed similar capacity to form
      SAP-DNA complexes with both thymus and Escherichia coli DNA, whereas
      significantly lower amounts of complexes, in particular with E. coli DNA, were
      formed in SLE sera. SLE patients with moderate to high anti-DNA titers showed a
      significant negative correlation between serum SAP's binding of E. coli DNA and
      the anti-DNA titer.

PMID- 11202231
TI  - Autoantibodies to type VII collagen have heterogeneous subclass and light chain
      compositions and their complement-activating capacities do not correlate with the
      inflammatory clinical phenotype.
AB  - Epidermolysis bullosa acquisita and bullous systemic lupus erythematosus are
      blistering skin diseases characterized by IgG autoantibodies that predominantly
      target the noncollagenous domain 1 of type VII collagen, a skin basement membrane
      component. The basic immunologic events leading to the blistering processes in
      these diseases remains unclear. We defined the subclass and light chain
      compositions of the IgG autoantibodies in 15 patients, in order to gain insight
      into the blistering mechanism. Immunofluorescence correlated the patients' in
      vivo-bound and circulating antibasement membrane autoantibodies. Four eukaryotic
      recombinant proteins, including one full-length and three truncated
      noncollagenous domain 1 proteins generated by sequential deletion of C-terminal
      amino acids, were used to perform enzyme-linked immunosorbent assay to detect the
      patients' anti-type VII collagen autoantibodies. The majority of patients'
      autoantibodies contained both complement-activating and non-complement-activating
      IgG subclasses. The presence or absence of complement-activating IgG autoantibody
      subclasses did not correlate with the inflammatory or noninflammatory clinical
      phenotype. The majority of tested sera contained both kappa and lambda light
      chain autoantibodies. All sera that reacted to the full-length noncollagenous
      domain 1 also reacted to the smallest truncated protein containing the cartilage
      matrix protein and the first three fibronectinlike repeats. The patients' anti
      type VII collagen autoantibodies, likely to be polyclonal in nature, may
      contribute to the pathogenesis of the blistering process by both complement
      dependent inflammatory injury and complement-independent mechanical disruption of
      the anchoring function of type VII collagen. The N-terminal region of the
      noncollagenous domain 1 may contain an important antigenic epitope targeted by
      the IgG autoantibodies.

PMID- 11202232
TI  - A microfilament formation inhibitor, cytochalasin strongly enhances the low
      affinity Fc epsilon receptor II (CD23) expression on the human monocyte-like cell
      line, U937.
AB  - Enhancement of the low-affinity Fc epsilon receptor (CD23) expression by
      cytochalasin was analyzed on the human monocytelike cell line, U937. The CD23
      expression on the U937 cells was enhanced at 24 hr after culture with
      cytochalasin B, D, or E, especially cytochalasin E having the most remarkable
      effect on it at the low concentration. This enhanced expression was found to be
      associated with a concomitant increase of a CD23 (about 45-kDa) protein on the
      U937 cells as assessed by Western blotting analysis. On the other hand, CD11a,
      CD18, CD31, CD49d, or CD54 was not markedly enhanced on the U937 cells by culture
      with cytochalasin E, although the mean fluorescence intensities (MFIs) of CD11a,
      CD18, and CD54 on U937 was partially up-regulated. Cell growth of U937 cultured
      with cytochalasin E was completely suppressed for 72 hr, but cell viability was
      sufficiently maintained (more than 95%). Soluble-formed CD23 (sCD23) also was
      released from the U937 cells at 24 to 72 hr after culture with cytochalasin E. In
      addition, the protein tyrosine kinase activity was detected in the U937 cells
      cultured with cytochalasin E for 24 hr using the enzyme immunoassay. Enhancement
      of the CD23 expression on the U937 cells at 24 to 72 hr cultured with
      cytochalasin E was sufficiently blocked by protein tyrosine kinase inhibitors
      herbimycin A and genistein, and a protein synthesis inhibitor, cychloheximide. On
      the other hand, protein kinase C inhibitors such as H-7 and H-8 had no effect on
      this CD23 expression. These results suggest that a mechanism underlying
      enhancement of the CD23 expression on the U937 cells cultured with cytochalasin E
      is mediated through tyrosine phosphorylation and protein synthesis.

PMID- 11202233
TI  - Exposure to topical bovine thrombin during surgery elicits a response against the
      xenogeneic carbohydrate galactose alpha1-3galactose.
AB  - Exposure of humans to topical bovine thrombin has been associated with
      development of antibodies against bovine and human coagulation factors and blood
      coagulation abnormalities. However, the nature of this humoral response is
      unknown. In this study, numerous glycoproteins in the topical bovine thrombin
      were found to contain the Gal(alpha1)-3Gal epitope, which is known to be highly
      immunogenic. More importantly, Gal(alpha1)-3Gal is recognized by natural
      antibodies that are found in all normal individuals and are known to effectively
      mediate complement activation and subsequent destruction of xenogeneic tissues.
      Thus, primary exposure of normal individuals to topical bovine thrombin is
      expected to result in an immediate immune reaction against that reagent. Further,
      following exposure to topical bovine thrombin, the levels of anti-Gal(alpha1)
      3Gal IgG rose to levels tenfold greater than the average level of natural anti
      Gal(alpha1)-3Gal IgG in naive individuals. Thus, Gal(alpha1)-3Gal in topical
      bovine thrombin accounts for, at least in part, the highly immunogenic nature of
      this reagent.

PMID- 11202234
TI  - Low in vitro production of interferon-gamma and tumor necrosis factor-alpha in
      HIV-seronegative patients with pulmonary disease caused by nontuberculous
      mycobacteria.
AB  - We studied 32 HIV-seronegative patients with pulmonary disease caused by
      nontuberculous mycobacteria (NTM). Immunologic studies included lymphocyte subset
      analysis by flow cytometry, measurement of interferon-gamma (IFN-gamma) and tumor
      necrosis factor-alpha (TNF-alpha) production following in vitro stimulation of
      diluted whole blood (DWB) and peripheral blood mononuclear cells (PBMC) by
      phytohemagglutinin (PHA), anti-CD3 as well as purified protein derivative of
      tuberculin (PPD), and in four cases with different amounts of the very
      mycobacterium, which caused disease in these patients. Data were compared to
      those of 30 HIV-seronegative patients with disease by Mycobacterium tuberculosis
      (MTb). Following alpha-CD3-stimulation of PBMC, NTM patients showed lower IFN
      gamma (P < 0.00005) and lower TNF-alpha (P < 0.02). For a subgroup of tuberculin
      skin test-positive NTM patients we found significantly lower PPD-induced IFN
      gamma releases in cultured DWB (P < 0.0002) and PBMC (P < 0.0004) compared to MTb
      patients. Data for PPD-induced TNF-alpha release for this subgroup were also
      significant (P < 0.001 and P < 0.05, respectively). The four NTM patients with
      poor PPD-induced IFN-gamma response hardly showed increased cytokine production
      on stimulation with their specific mycobacterium. The lower production capacity
      of IFN-gamma and TNF-alpha of NTM patients compared to the MTb patients points to
      an immunologic imbalance forming the basis for their increased susceptibility to
      pulmonary infections by nontuberculous mycobacteria.

PMID- 11202235
TI  - Elevation of transforming growth factor-beta1 is associated with recurrent
      miscarriage.
AB  - To investigate the significance of transforming growth factor-beta1 (TGF-beta1)
      in reproduction we have compared plasma levels in normal pregnant women and
      patients suffering miscarriages. We examined 188 normal pregnant women and 12
      pregnant women with miscarriages. Eight women with severe recurrent miscarriages
      (mean +/- SD of previous number of miscarriages; 10.4 +/- 2.4 times) were also
      examined before conception; 34 nonpregnant women served as controls. Plasma TGF
      beta1 level increased with the gestational week and returned within the normal
      range 1 month after delivery. The levels among pregnant women with miscarriages
      (mean +/- SD; 2.44 +/- 0.83 ng/ml) were significantly higher than those of
      pregnant controls (1.74 +/- 0.95 ng/ml) of matched gestational weeks; levels
      among nonpregnant women with severe recurrent miscarriages were extremely
      elevated (4.1 +/- 3.04 ng/ml) compared to the control value (1.34 +/- 0.59
      ng/ml). These data suggest that TGF-beta1 may be necessary to maintain pregnancy
      but also may be a risk factor for recurrent miscarriages.

PMID- 11202236
TI  - Cytokine analysis at the single cell level and lymphoproliferative responses to
      mycobacterial antigens in HIV-1 patients with successful virologic response to
      potent antiretrovirals.
AB  - Immunologic parameters, known to be grossly abnormal in HIV-1-infected subjects,
      were analyzed in 22 patients with sustained viral load suppression (<200
      copies/ml) following long-term highly active antiretroviral therapy (HAART).
      Responses were compared with those from 18 HIV-seronegative healthy controls.
      Persistent phenotypic alterations in patients' blood mononuclear cells were
      minimal, though the percentages of lymphocytes that could be activated to produce
      interleukin-2 (IL-2) remained severely depressed. Using lymphoproliferative
      assays, a striking deficit in the capacity of patients to respond to the common
      mycobacterial antigens and particularly to recombinant heat-shock proteins
      paralleled the absence of responses to virus p24 antigen. In view of the
      important immunoregulatory role of stress proteins, these findings reveal
      profound functional deficiencies and persistent immune dysregulation in HIV-1
      patients, despite successful HAART and a considerable recovery of CD4+ lymphocyte
      numbers. Rational immunotherapeutic approaches should be aimed to correct the
      characterized immune abnormalities.

PMID- 11202237
TI  - Umbilical cord blood transplantation in severe T-cell immunodeficiency disorders:
      two-year experience.
AB  - Hematopoietic stem cell transplantation is the treatment of choice for severe
      primary T-cell immunodeficiencies. When an HLA-identical sibling as the donor is
      not available, an alternative donor stem cell source is needed. In primary T-cell
      immunodeficiencies, T-cell-depleted HLA-haploidentical bone marrow
      transplantation has been particularly successful in reconstituting the immune
      system in many but not all of the severe T-cell immune deficiency disorders. This
      study reports the use of umbilical cord blood (UCB) stem cell transplantation in
      severe T-cell immune deficiency. Umbilical cord blood was evaluated as a stem
      cell source for immune reconstitution in children with severe primary T-cell
      immunodeficiency disorders, such as severe combined immunodeficiency syndrome
      (SCID), reticular dysgenesis, thymic dysplasia, combined immunodeficiency disease
      (CID), and Wiskott-Aldrich syndrome (WAS) when a matched sibling donor was
      unavailable. From 1/96 through 5/98, eight children received unrelated cord blood
      stem cell transplantation following a preparative regimen for the treatment of
      combined immunodeficiency diseases. The patients ranged in age from 2 weeks to 8
      years. The cord blood units were 3/6 HLA antigen matches in two children. 4/6 in
      four children, and 5/6 in two child, with molecular HLA-DR mismatch in three of
      the children. The average time for neutrophil engraftment (absolute neutrophil
      count >500/mm3) was 12 days (range 10-15 days) and the average time for platelet
      engraftment (platelet count >20,000/mm3) was 36 days (range 24-50 days). A
      patient with reticular dysgenesis failed to engraft following her first
      transplant, but fully engrafted after a second unrelated donor cord blood
      transplantation. Five of six patients exhibited grade I graft-versus-host disease
      (GvHD). while one child had grade IV skin and gut GvHD. Immunologic
      reconstitution demonstrated that cord blood stem cell transplantation resulted in
      consistent and stable T-, B- and natural killer (NK) cell development. The
      kinetics of development were such that T-cell development occurred between 60 to
      100 days. Initial T-cell engraftment consisted predominantly of CD45RO+, CD3+,
      and CD4+ T cells, and at 12 to 24 months changed to CD45RA+, CD3+, and CD4+ T
      cells, indicating de novo maturation of T cells. NK cell development occurred at
      approximately 180 days. B cells engrafted early, and study of functional B-cell
      antibody responses revealed that five of six patients in whom intravenous immune
      globulin has been discontinued have low detectable antibody responses to tetanus
      and diphtheria toxoid immunizations at 18 to 24 months posttransplantation.
      Unrelated umbilical donor cord blood is an alternative source of stem cells for
      transplantation in children with severe T-cell immune deficiency disorders when a
      suitable HLA-matched donor is not available and when a T-depleted haploidentical
      preparation is not beneficial. Benefits of UCB include rapid and reliable
      recovery of immune function, low risk of GvHD, and low viral transmission rate.

PMID- 11202238
TI  - Primary immunodeficiency diseases in Norway.
AB  - This study represents the first national epidemiological survey of primary
      immunodeficiency diseases in Norway. Uniform questionnaires were sent out in
      April 1998 to all hospital departments considered relevant. As of February 1999,
      a total of 372 patients have been registered, of whom 69 patients are deceased.
      With a population of 4.45 million people, the total prevalence of primary
      immunodeficiency diseases in Norway February 1, 1999 is 6.82 per 100000
      inhabitants. Distribution between the main immunodeficiency diagnoses is (a)
      antibody deficiencies 50.8%, (b) combined deficiencies included other
      immunodeficiency syndromes 12.4%, (c) complement deficiencies 21.0%, (d)
      phagocytic disorders 6.7%, (e) and immunodeficiency associated with other
      congenital diseases 9. 1%. Compared to previous reports from other European
      countries, there is a smaller proportion of antibody deficiencies due to few IgA
      deficiencies registered and a large proportion of complement deficiencies due to
      many patients with hereditary angioedema.

PMID- 11202240
TI  - Deciding against defibrillator replacement: second-guessing the past?

PMID- 11202241
TI  - ICD replacement: a family-based medicine approach.

PMID- 11202242
TI  - Permanent explantation of implantable cardioverter defibrillators.
AB  - Although ICD therapy is seen as an irrevocable mode of therapy in most patients,
      a small number of patients do have their devices permanently explanted. The long
      term outcome in these patients has not been described. The purpose of this single
      center study was to evaluate the long-term outcome of patients whose ICD was
      explanted and not replaced and to propose clinical variables that can be
      considered when making the decision to discontinue therapy. Ten of 323 (3.1%)
      patients in our ICD registry had their devices permanently explanted or turned
      off between 1986 and December 1998. The devices had been in place for 39 +/- 31
      months preexplant. No patient had received appropriate therapy prior to surgery,
      which was indicated for infection or lead fracture. All patients are alive and
      well 75 +/- 30 months postexplant with 1 (10%) patient requiring late
      reimplantation. We reviewed the English language literature describing ICD
      explanation without replacement. A total of 151 patients were reported in eight
      studies and were followed for up to 30 months postexplant. Excluding patients
      with terminal illness or heart transplantation 57.6% survived without
      reimplantation. In selected patients, after not using an ICD for a long period
      and when clinical circumstances justify, device therapy may be discontinued with
      some degree of safety.

PMID- 11202239
TI  - Soluble beta2-mu-associated and beta2-mu-free HLA class I heavy chain serum
      levels in interferon-alpha nonresponder chronic hepatitis C patients. Markers of
      immune activation, and response to antiviral retreatment.
AB  - The serum levels of soluble beta2-mu-associated and beta2-mu-free HLA class I
      heavy chains were determined in 28 interferon-alpha nonresponder chronic
      hepatitis C patients retreated with interferon-alpha plus ribavirin and in 70
      healthy subjects. The baseline levels of beta2-mu-associated and beta2-mu-free
      HLA class I heavy chains were significantly higher in patients than in healthy
      controls (P = 0.001). The levels of beta2-mu-associated HLA class I heavy chains
      significantly increased in responder patients with respect to nonresponders at
      the third month of treatment (P = 0.03). At the sixth month of treatment and
      after 6 months of follow up the levels of beta2-mu-associated HLA class I heavy
      chains decreased in responder patients and increased in nonresponders. The levels
      of beta2-mu-free HLA class I heavy chains showed only minor changes during and
      after treatment. We suggest that the determination of hepatitis C virus RNA
      levels combined with soluble beta2-mu-associated HLA class I heavy chains, as a
      marker of immune activation, could identify interferon-alpha non responder
      chronic hepatitis C patients most likely to respond to a retreatment with
      interferon-alpha plus ribavirin.

PMID- 11202243
TI  - Autonomic nervous system activity before and during episodes of myocardial
      ischemia in patients with stable coronary artery disease during daily life.
AB  - Spectral analysis of heart rate variability (HRV) was used to assess changes in
      the autonomic nervous system (ANS) 10 minutes before, during, and 10 minutes
      after 110 ischemic episodes (IEs) in 38 patients (25 men, age 61 +/- 10 years)
      with stable coronary artery disease. In 26 of 77 diurnal IEs (07:00-22:59) there
      were no changes in the spectral indexes (LF and HF) during the study period. In
      the remainder there was an increase in the LF:HF ratio due to HF withdrawal that
      started before the onset of the IE. All 33 nocturnal episodes also showed an
      increase in the LF:HF ratio, which was due not only to HF withdrawal, but also to
      a simultaneous increase in LF. Although it is not the only cause, the ANS plays a
      significant role in triggering IEs during daily life in patients with stable
      coronary artery disease. The common factor in all such episodes is a gradual
      withdrawal of parasympathetic tone.

PMID- 11202244
TI  - Electrocardiographic criteria for diagnosis of irregular broad complex
      tachycardia with a high sensitivity for preexcited atrial fibrillation.
AB  - AF may appear as an irregular broad complex tachycardia (BCT) if atrioventricular
      conduction occurs via an accessory pathway (preexcited AF) or if bundle branch
      block (BBB), preexistent or rate related, exists in the His-Purkinje system (BBB
      AF). While BBB-AF is relatively benign, preexcited AF may herald sudden cardiac
      death. Hence it is important that the two conditions can be reliably
      distinguished. Yet, there is no preexistent algorithms for this purpose. Griffith
      et al. previously proposed a simple algorithm for a similar problem, that of
      distinguishing the two differential diagnoses for regular BCT: VT and SVT with
      BBB, on the basis that unless the QRS morphologies in V1 and V6 are absolutely
      typical of BBB, VT will be diagnosed. The authors propose an extrapolation of
      this principle to irregular BCT by stating that, unless the QRS morphologies in
      V1 and V6 are absolutely typical of BBB, preexcited AF will be diagnosed. Seventy
      five ECGs showing irregular BCT (41 preexcited AF and 34 BBB-AF) were shown to
      two fellows in electrophysiology who were given no other information and were
      instructed to diagnose preexcited AF unless the QRS morphology pattern was
      typical of BBB. Observer 1 achieved a sensitivity of 100% (41/41) and a
      specificity of 79% (27/34), while observer 2 achieved a sensitivity of 100% and a
      specificity of 85% (29/34). By QRS morphology pattern, an average sensitivity of
      100% and specificity of 82% were achieved for the diagnosis of irregular BCT. The
      algorithm is simple and easy to implement and recommended for clinical use.

PMID- 11202245
TI  - Does an early increase in heart rate during tilting predict the results of
      passive tilt testing?
AB  - Head-up tilt testing is a useful but time-consuming procedure. If we could
      accurately predict the tilt testing results; we would be able to substantially
      shorten the duration of tilt protocol. To clarify the hypothesis that an early
      increase in heart rate (HR) during tilting can predict the passive tilt results
      in our protocol (80-degree angle for 30 minutes), we studied 115 consecutive
      patients (72 men, 43 women, mean age 46 +/- 19 years) who were clinically
      diagnosed with neurally mediated syncope. Twenty-nine (25%) patients had a
      positive tilt test (P group), whereas 86 (75%) patients had a negative test (N
      group). The early HR increase was defined as the maximum HR during the first 5
      minutes of tilting minus the resting HR before tilting. The early HR increase was
      significantly higher in the P group (23.8 +/- 9.5 beats/min) than in the N group
      (17.5 +/- 8.2 beats/min, P = 0.0008), but it was negatively correlated with the
      tilt duration to positive response (r = -0.52, P = 0.0032) and the patient age in
      the entire study population (r = 0.62, P < 0.0001). Results of multiple
      regression analysis indicated that age, tilt result, and tilt duration were
      independently associated with the early HR increase. As a result, an early HR
      increase > or = 18 beats/min, the best apparent cut-off point obtained in our
      study, was a sensitive (100%) marker for prediction of a positive response at <
      or = 15 minutes of tilting, but it showed a low specificity (61%). In conclusion,
      an early HR increase during 80-degree tilting may be only predictive for a
      positive result < or = 15 minutes because it depends on the tilt duration to a
      positive response and patient age.

PMID- 11202246
TI  - Characteristics and results of epicardial pacing in neonates and infants.
AB  - The results of epicardial pacing in infants with isolated congenital complete
      atrioventricular block (CAVB) are reported. Thirty-four patients, aged 1 day to
      20 months (22 patients < 1 month), were paced between 1988 and 1998. Thirty had
      bradycardia < 50 beats/min with symptoms in 12 patients, and 4 patients were
      paced because of associated ventricular ectopy or prolonged QT interval. In
      thirty cases, the electrodes were implanted through a left thoracotomy and
      connected to an abdominal generator; in four, the subxyphoid approach was
      preferred. Twenty-two children had dual chamber units. There was no operative
      death, but three patients died later of cardiomyopathy. Seven infants were
      reoperated for electrode displacement, infection, exit block, and pacemaker
      sensitivity. Chronic ventricular thresholds ranged from 0.3 to 2 V except in one
      case (4 V) and proper atrial sensing was lost in two cases. All children are
      doing well and the generator has lasted at least 5 years in 16 cases. In
      conclusion, epicardial pacing in infants with CAVB can be done with satisfactory
      results. There was no mortality in relation with pacing and thresholds have
      improved with the use of steroid-eluting electrodes. The deep location of the
      generator prevents cutaneous erosion and allows implantation of large units with
      a longer life duration.

PMID- 11202247
TI  - Diagnosis and ablation of atrial flutter using a high resolution, noncontact
      mapping system.
AB  - The ablation of atrial flutter can sometimes be time consuming and unsuccessful
      using conventional catheter techniques especially in patients with recurrences
      after previous ablation procedures. Simultaneous high resolution mapping from
      multiple sites may overcome some of the limitations. Therefore, a new high
      resolution noncontact mapping system was used for diagnosis and ablation of
      atrial flutter in 15 patients. The mapping system consists of a catheter-mounted
      multielectrode array, an amplifier, and a computer workstation. Far-field
      potentials recorded by the multielectrode catheter are amplified, digitized, and
      sampled at 1.2 kHz, and digitally filtered to construct high resolution
      activation maps during tachycardia. Ablation catheters can be steered to target
      sites without fluoroscopy. In 12 of the 15 patients the analysis of the
      activation sequence during tachycardia showed a counter-clockwise, and in 1 of 15
      patients a clockwise, rotating wavefront using the isthmus as part of the
      reentrant circuit. In two patients no tachycardia could be induced. In 3 of the
      15 patients with previous conventional ablation procedures the gap in the line of
      block in the isthmus region was identified and marked on the animation model. The
      isthmus in the right atrium was ablated and isthmus block verified by the mapping
      system in all patients. No complications were observed. No recurrences of atrial
      flutter occurred during follow-up of 4 +/- 1.7 months. The total procedure and
      fluoroscopy time was 171 +/- 50.0 minutes and 24 +/- 12.7 minutes, respectively.
      In conclusion, the use of the new high resolution noncontact mapping system in
      patients with right atrial flutter is safe and highly effective. In patients with
      previously failed conventional ablation procedures the use of a noncontact
      mapping system may facilitate the identification of the gap in the line of block
      in the isthmus region and reablation of atrial flutter.

PMID- 11202248
TI  - Safe and effective placement of two bipolar silicone leads in the cephalic vein
      using a hydrophilic guidewire and a split introducer.
AB  - The cephalic vein (CV) is preferable to the subclavian vein for implanting
      permanent pacing leads because of fewer complications. Unfortunately, this access
      is unusable in a substantial number of patients. This prospective study evaluates
      a technique to increase CV access for the placement of two silicone bipolar leads
      used in DDD pulse generator implants. A standard cephalic cutdown was performed
      under local anesthesia and a hydrophilic guidewire (HGW) threaded in the CV. The
      first (ventricular) bipolar lead was then introduced and positioned. When
      possible, introduction of the second (atrial) lead followed the same direct
      access. A failed introduction led to a modified procedure (MP) relying on a
      "split" introducer (8-9 Fr Plastimed) advanced with a circular motion over the
      HGW, then removal of the dilator, removal of the HGW, insertion of the pacing
      lead into the sheath with placement in the right atrium, followed by sheath
      withdrawal. Over an 18-month period, 90 consecutive patients had DDD pacemakers
      implanted. The CV was accessible in 76 (84.5%) of 90 patients and the direct
      introduction of the ventricular lead was obtained in 74 (97.4%) of these.
      Atrialization proceeded as follows: direct access CV in 14 (18%) of 76 patients,
      MP access in 54 (71%) of 76 patients, and MP failure in 8 (11%) of 76 patients.
      Overall, this approach allowed cephalic dual insertion in 68 (89%) of 76
      patients. In conclusion, the modified procedure presented in this study allows a
      dual catheterization with bipolar leads in 89% of patients when a CV is
      available. This significantly improves the success rate for dual bipolar lead
      implants in this configuration.

PMID- 11202249
TI  - Passive-fixation J-shaped versus straight leads in atrial position: comparison of
      efficacy and safety.
AB  - To compare the efficacy and safety of straight and J-shaped passive-fixation
      atrial leads we retrospectively analyzed the results of 100 consecutive
      implantations of atrial leads at one institution. There were seven cases of
      upgrades of VVIR to DDDR systems and in one case an active-fixation lead was
      chosen as a primary approach. These eight patients were excluded from the
      analysis. The final study group consisted of 92 cases (69 DDDR, 23 AAIR), 69 were
      J and 23 straight leads. The stimulation threshold, slew rate, impedance, P wave
      amplitude, and procedural time did not differ significantly between the two types
      of leads used. During the long-term follow-up of 6-53 months (30 +/- 11.9
      months), replacements using active-fixation leads were required in two patients
      with straight leads and three patients with J leads (P = NS). In addition, one J
      lead showed signs of damage (impedance > 3,000 Ohm). Long-term follow-up values
      of the stimulation thresholds and P wave amplitudes did not differ between the
      groups (P = NS). Transesophageal echocardiography performed in 13 patients
      revealed a trend toward more distal placement of straight leads within the right
      atrial appendage. In conclusion, J-shaped leads do not seem to be superior to the
      straight leads for atrial implantations.

PMID- 11202250
TI  - Improved differentiation of the ventricular evoked response from polarization by
      modification of the pacemaker impulse.
AB  - The Autocapture feature, implemented in the Microny and Regency pacemakers of St.
      Jude Medical, continuously controls the effectiveness of ventricular stimulation
      by detection of the evoked response. Proper sensing of this signal depends on the
      magnitude of the polarization, which should be minimal. Therefore, the
      conjunctive use of low polarization electrodes is recommended. Further, the
      pacing impulse of these pacemakers has a biphasic waveform consisting of a
      stimulus followed by a fast discharge pulse. This study compares polarization of
      a modified pacing impulse with the default pacing impulse, and its effect on the
      ability to activate the Autocapture function when used with different types of
      electrodes. In 45 patients, acute measurements of the polarization and the evoked
      response were performed at random on the modified pacing impulses of a custom
      designed Regency and on the default stimuli of a standard Regency. The following
      bipolar leads were used: 20 Medtronic 4024 CapSure, 12 Pacesetter 1450T, and 13
      Pacesetter 1470T. Using the default pacing impulse, polarization and evoked
      response were significantly larger with the Medtronic 4024 CapSure compared to
      the low polarization leads. The polarization to evoked response ratio was more
      frequently acceptable for activation of the Autocapture with the Pacesetter
      leads. In all leads the modified pacing impulse was characterized by
      significantly smaller polarization with the most prominent reduction in the
      Medtronic 4024 CapSure. The differences in the pacing impulse did not affect the
      evoked response. With the programmability of the fast discharge pulse, the
      requirements to activate the Autocapture function were fulfilled in 29 (94%) of
      31 patients with the modified pacing impulse, compared to 22 (71%) of 31 patients
      with the standard pacing impulse. The modified pacing impulse decreased the
      "polarization to evoked response" ratio, and by that improved the conditions for
      activation of the Autocapture function.

PMID- 11202251
TI  - Atrioventricular nodal versus atrioventricular supraventricular reentrant
      tachycardias: characterization by an integrated Doppler electrophysiological
      hemodynamic study.
AB  - During reentrant supraventricular tachycardias involving the atrioventricular
      node (AVN-SVT) or an AV bypass tract (AV-SVT), atrial pressure increases. While
      in AVN-SVT this increase relates to atrial contraction during ventricular
      systole, the mechanism remains unclear in AV-SVT. This study sought to clarify
      this mechanism. During 11 AVN-SVTs and 9 AV-SVTs, anterograde flow through the AV
      valves and retrograde flow in the pulmonary and hepatic veins were studied by
      pulsed-wave (PW) Doppler measuring the time interval between the ECG-R wave and
      (1) the end of venous retrograde flows, and (2) the beginning of valvular
      anterograde flows. The positive or negative difference between these two time
      intervals guided recognizing the atrial contraction against open or closed AV
      valves. Intracavitary pressures and cardiac index were also measured. During AVN
      SVTs, venous retrograde flows always ended before the anterograde valvular flows,
      indicating atrial contraction against closed AV valves. During AV-SVTs, pulmonary
      retrograde flow ended before the beginning of mitral anterograde flow in five
      cases, began before but ended during the anterograde flow in three cases, and
      overlapped to the anterograde flow in one case. A corresponding behavior was
      observed at the right side of the heart. In both SVTs, atrial pressures increased
      and end-diastolic ventricular pressure and cardiac index decreased similarly.
      During AVN-SVT, the atrial contraction always occurs against closed AV valves,
      and during AV-SVT it generally occurs against totally or partially closed AV
      valves, explaining similar atrial pressure and cardiac index changes in both
      SVTs.

PMID- 11202252
TI  - A comparative study on the behavior of three different automatic mode switching
      dual chamber pacemakers to intracardiac recordings of clinical atrial
      fibrillation.
AB  - Automatic mode switching (AMS) allows patients with dual chamber pacemakers who
      develop paroxysmal AF to have a controlled ventricular rate. The aim of this
      study was to (1) compare the rate-controlled behavior of three AMS algorithms in
      response to AF, in terms of speed and stability of response and resynchronization
      to sinus rhythm, and (2) compare the influence of pacemaker programming on
      optimal mode switching. We studied 17 patients (12 men, 5 women; mean age 59 +/-
      15 years) who developed AF during electrophysiological study. Unfiltered bipolar
      atrial electrograms during sinus rhythm and AF were recorded onto high fidelity
      tapes and replayed into the atrial port of three dual chamber pacemakers with
      different mode switching algorithms (Thera, Marathon, Meta). The Thera pacemaker
      uses rate smoothing, and mode switches occur when mean sensed atrial rate exceeds
      the predefined AMS rate (MR). Marathon mode switches after a programmable number
      of consecutive rapid atrial events (NR). Meta DDDR monitors the atrial rate by a
      counter for atrial cycles faster than the programmed AMS rate. It increases or
      decreases the counter if the atrial cycle length is shorter or longer than the
      programmed AMS interval, respectively. Mode switch occurs when the AF detection
      criteria are met (CR). A total of 260 rhythms were studied. NR was significantly
      faster than MR and CR (latency 2.5 +/- 3 s vs 26 +/- 7 s vs 15 +/- 22 s,
      respectively, P < 0.0001). During sustained AF, MR resulted in the most stable
      and regular ventricular rhythm compared to NR or CR. In CR, ventricular rate
      oscillated between AMS and atrial tracking (cycle length variations: 44 +/- 2 s
      vs 346 +/- 109 s vs 672 +/- 84 s, P < 0.05). At resumption of sinus rhythm, MR
      resynchronized after 143 +/- 22 s versus 3.4 +/- 0.7 s for NR and 5.9 +/- 1.1 s
      for CR, resulting in long periods of AV dissociation when a VVI/VVIR mode is used
      after AMS. Programming of atrial refractory periods did not affect AMS response,
      although the speed of AMS onset can be adjusted by programming of onset criteria
      in the Meta DDDR. AMS algorithms differ in their ability to handle recorded
      clinical atrial arrhythmias. The rapid-responding algorithm exhibits rate
      instability, whereas slow responding algorithm shows a long delay in response and
      risk of AV dissociation. Thus different instrumentation of AMS may have clinical
      implications in patients with dual chamber pacemakers who develop AF.

PMID- 11202253
TI  - Initial low temperature setting in radiofrequency catheter ablation of Wolff
      Parkinson-White syndrome.
AB  - Previous studies have shown that with low temperature testing for RF ablation of
      arrhythmias, unnecessary irreversible myocardial lesions may be avoided. In
      children admitted for RF ablation from June 1996 to May 1999, we evaluated the
      method of an initial temperature setting of 50 degrees C for a maximum of 10
      seconds. If accessory pathway block occurred, the temperature setting was
      immediately increased to 70 degrees C and continued for 45-120 seconds (group 1).
      If accessory pathway block did not occur after several attempts, subsequent
      attempts were made with initial settings at 70 degrees C-80 degrees C at the same
      or different sites (group 2). Eighty patients with Wolff-Parkinson-White syndrome
      (mean age 11 +/- 4 years) were treated using this method. Twelve patients were
      excluded for various reasons. Of the remaining 68 patients, 52 (76%) had
      successful block of the pathway at 50 degrees C; 16 patients demonstrated block
      only at the higher temperature setting of 70 degrees C-80 degrees C. There were
      no statistically significant differences between these two groups in terms of
      age, weight, and location of accessory pathways. Unsuccessful 50 degrees C test
      ablation attempts were 1.6 +/- 2.4 in group 1 and 3.1 +/- 2.9 in group 2 (P =
      0.04). Total unsuccessful attempts were 1.6 +/- 2.4 in group 1 and 8.1 +/- 7.1 in
      group 2 (P = 0.001). The time from application of RF energy to the time of AP
      block in group 1 was not significantly different from group 2. In the majority of
      children, successful RF ablation can be achieved by using a temperature setting
      of 50 degrees C, then 70 degrees C. This will prevent unnecessary permanent
      injury at unsuccessful attempt sites.

PMID- 11202254
TI  - Is dual site better than single site atrial pacing in the prevention of atrial
      fibrillation?
AB  - Long-term prevention of atrial fibrillation is not constantly realized by single
      site right atrial pacing, and the beneficial role of multisite atrial pacing is
      still being studied. Accordingly, we compared the effectiveness of dual site and
      single site atrial pacing in 83 patients (50 men, 33 women, aged 69 +/- 10
      years), who received a DDD device for primary sinus node dysfunction or
      bradycardia with documented atrial fibrillation. Inclusion criteria for dual site
      pacing were a sinus P wave > or = 120 ms and at least two episodes of documented
      paroxysmal AF in the 6 months preceding implantation. Dual site atrial pacing
      (high right atrium-coronary sinus ostium) was performed in 30 cases, and was
      compared to 53 single site paced patients, 21 with a P wave > or = 120 ms and 32
      with a P wave < 120 ms. The basic pacing rate was programmed at 68 +/- 4
      beats/min (range 60-75 beats/min). Sinus P wave (133 +/- 20 vs 95 +/- 9 ms; P <
      0.001), paced P wave (107 +/- 14 vs 99 +/- 15; P < 0.05), number of
      antiarrhythmic drugs used (2.4 +/- 1.2 vs 1.6 +/- 1.5, P < 0.05), and the
      duration of symptoms (8.1 +/- 4.5 vs 3.8 +/- 2.4 years; P < 0.001) were
      significantly higher in dual site patients. The other characteristics were
      similar. During the follow-up of 18 +/- 15 months (range 3-30 months), paroxysmal
      AF was documented in 33 patients. Among these patients, 13 developed permanent AF
      following at least one episode of paroxysmal AF. When comparing dual site
      patients and single site patients with a P wave duration > or = 120 ms,
      paroxysmal AF incidence was lower in the dual site group (9/30 patients vs 15/21
      patients, P < 0.01), as well as permanent AF (1/30 patients vs 8/21 patients, P <
      0.01). By contrast, comparison between dual site patients and the group of single
      site patients with a P wave duration < 120 ms did not evidence any significant
      differences in paroxysmal (9/30 patients vs 9/32 patients) and permanent (1/30
      patients vs 4/32 patients) AF incidences. Dual site seems better able than single
      site atrial pacing to improve the natural history of patients with a prolonged P
      wave, reducing the incidence of paroxysmal and permanent AF. No benefit could be
      expected in patients with a normal P wave duration.

PMID- 11202255
TI  - Inferior vena cava loop of the implantable cardioverter defibrillator endocardial
      lead: a possible solution of the growth problem in pediatric implantation.
AB  - The ICD is an important treatment option in adults and children with life
      threatening tachyarrhythmias. The possibility of lead displacement caused by
      growth and the lack of dedicated leads and devices poses special problems in
      pediatric ICD implantation. We describe our experience in three children in whom
      we left a redundant lead loop within the inferior vena cava (IVC) is allow for
      further growth. Since February 1998, three children underwent ICD implantation at
      our institution. A lead (screw-in) was advanced into the right ventricular apex,
      and a loop was created in the IVC by progressively withdrawing the stylet and
      pushing in the lead. Satisfactory sensing and pacing threshold values were
      obtained and a successful single 16-J defibrillation test was performed. No
      complications were encountered. After a mean follow-up of 16 months, with a mean
      increase in body weight and height of 4.1 +/- 0.5 Kg and 6.3 +/- 0.4 cm,
      respectively, chest X ray showed some release of additional lead length, in the
      absence of dislodgments, while significant changes in pacing/sensing parameters
      were not found. In conclusion, the creation of a loop within the IVC allows the
      lead to adjust for growth in children receiving an ICD. This approach is feasible
      and safe.

PMID- 11202256
TI  - Lead noise with an active-fixation defibrillation lead.
AB  - Inappropriate detection and therapy is the most common adverse effect of
      implantable cardioverter defibrillator therapy. One mechanism is lead artifact,
      which usually presents late and is due to stress and fatigue of the lead
      components. Our experience with a defibrillator lead (Endotak Endurance EZ leads,
      Models 0154/0155/0156) and its method of active fixation is described. Of 20
      implants with this lead, four patients were found to have noise that resulted in
      inappropriate detections in three. No patient received therapy as a consequence
      of these detections. The artifact appeared soon after implant and resolved in
      three of four cases by 4 weeks. None of the 16 remaining patients developed noise
      after this time. This is a unique lead problem that resolves with time, but it
      may result in inappropriate therapies and difficult management decisions in high
      risk patients with ventricular arrhythmias.

PMID- 11202257
TI  - The first reports of electrical multisite ventricular activation in humans.

PMID- 11202258
TI  - Tachycardia induced changes of atrial electrophysiological properties.

PMID- 11202259
TI  - Long RP tachycardia with RR alternation.

PMID- 11202260
TI  - Iatrogenic ventricular tachycardia from endocardial pacemaker late after repair
      of tetralogy of Fallot.
AB  - A 34-year-old woman, who had undergone radical repair for tetralogy of Fallot at
      the age of 8 years, was left with moderate-to-severe pulmonary regurgitation. VT
      developed after endocardial pacing for symptomatic pauses and atrial flutter. The
      possibility that the new VT originated from the apical endocardial lead was
      suggested by the unusual morphology of the VT, which was similar to paced.
      Surgical removal of the lead, which was deeply embedded at the same time as a
      pulmonary valve was replaced, cured the arrhythmia. This unusual cause of VT
      highlights possible risks associated with setting up a dangerous reentry circuit
      by inserting a right ventricular endocardial pacemaker lead.

PMID- 11202261
TI  - Permanent pacing from a left ventricular vein in a patient with persistent left
      and absent right superior vena cava.
AB  - Persistent left superior vena cava with coexisting absent right superior vena
      cava is rare with less than 150 cases in the literature. Various techniques for
      pacemaker implantation have been described in this situation. We report a 40-year
      old man with sinus and atrioventricular nodal dysfunction who underwent dual
      chamber pacemaker implantation. We elected to implant the ventricular electrode
      down a left ventricular branch of the coronary sinus and the lead is stable at 4
      month follow-up.

PMID- 11202262
TI  - Cardiopulmonary resuscitation during coronary vasospasm induced by tilt table
      testing.
AB  - A 65-year-old man presented to our institution with recurrent episodes of early
      morning chest discomfort and near syncope. An ergonovine provocation test
      documented a diagnosis of coronary vasospastic angina. Using our investigation of
      the syncope, a head-up tilt table test provoked a severe episode of coronary
      vasospasm that resulted in a life-threatening cardiac event. The present case
      reminds us that an elevation of ST segments on the electrocardiogram during tilt
      testing should be promptly managed as an attack of coronary vasospasm.

PMID- 11202263
TI  - Laser-assisted explantation of trapped Port-A-Cath.

PMID- 11202264
TI  - Runaway pacemaker syndrome and intermittent nonoutput as manifestations of end of
      life of a VVI pacemaker.
AB  - A case of a runaway pacemaker with intermittent nonoutput failure of a VVI
      Intermedics pacemaker is presented. This is the first report of such a phenomenon
      in that type of pacemaker with no apparent reason other than approaching battery
      end-of-life. The reported case warrants a close follow-up of patients with the
      same type of device.

PMID- 11202265
TI  - Cumulative 23-year index. Volumes 1-23, 1978-2000.

PMID- 11202266
TI  - Surgery for primary hyperparathyroidism.
AB  - OBJECTIVE: To define the role of surgery for organic primary hyperparathyroidism
      and to evaluate the diagnostic and operative methods applied. DESIGN:
      Retrospective, non-randomized, non-blinded evaluation. Case series. SETTING:
      Tertiary referral center. Department of Surgery. SUBJECTS AND METHODS: The report
      documents experience in surgical management at a single institution of 312
      patients with primary (and 498 patients with secondary) hyperparathyroidism in a
      period from 1974 to 2000. Patient symptoms, clinical features, diagnostic and
      localization methods, operative management, and postoperative results were
      evaluated by retrospective medical record review with special attention to
      surgical management strategy. RESULTS: Of 321 patients with primary
      hyperparathyroidism 312 underwent 348 operations. There were 312 primary
      procedures and 36 multiple reoperations on 25 patients. The permanent success
      rate for primary (312) operations was achieved in 287 patients (92%). The
      permanent success rate for 36 secondary reoperations was achieved in 19 out of 25
      reoperated patients (76%). The overall full recovery was obtained in 306 operated
      patients (98%). There were no postoperative emergency reoperations. There were 2
      postoperative hospital deaths (0.6%) of patients with sustained hypercalcemic
      crisis after excision one cervical adenoma, but functioning second one in
      mediastinum.

PMID- 11202267
TI  - Current management of thyroid cancer--a change of therapeutic strategy over the
      last 20 years.
AB  - A radical change of epidemiological structure of thyroid cancer incidence in
      Poland has been reported for few years. The total incidence of thyroid cancer is
      successively increasing, mostly in form of well differentiated thyroid cancer,
      especially papillary cancer. The diagnostic and therapeutic approach to thyroid
      cancer have also changed. Ultrasound guided fine needle aspiration has become the
      first choice procedure in diagnostics of thyroid cancer. Careful assessment of
      prognostic factors is no longer helpful in choice of selective surgical procedure
      in thyroid cancer as elective total thyroidectomy is widely recommended. In well
      differentiated thyroid cancer a complementary treatment with radioiodine is
      mandatory in most cases. Own experience in treatment of thyroid cancer presented
      in the paper is based on over 520 consecutive patients with thyroid cancer
      treated in a single department specialised in endocrine surgery during last 20
      years. Successive changes in epidemiological structure of thyroid cancer
      incidence as well as the evolution of diagnostic and therapeutic algorithm in
      thyroid cancer are presented in details. Radical surgical treatment of thyroid
      cancer is still a fundamental part of a complex treatment of thyroid cancer.

PMID- 11202268
TI  - Radioiodine therapy: its role in the combined treatment of differentiated thyroid
      carcinoma.

PMID- 11202269
TI  - The history of development and perspectives of breast cancer surgery.

PMID- 11202271
TI  - Life saving surgery in polytrauma patients.
AB  - Life saving surgery is the surgery which has to be performed during the acute or
      reanimation period (1 to 3 h) and during the primary or stabilisation period
      (first day surgery). During the reanimation period lifethreatening conditions are
      identified and management is begun simultaneously. Many trauma surgeons talk
      about the first "golden hours" as the time interval starting immediately after
      the injury when rapid intervention will save lives and a lack of intervention
      will result in life loss. Most common, these critical conditions are
      exsanguinating hemorrhage, acute pump failure, obstruction of airways, mechanical
      failure of ventilation or severe brain damage with tentorial herniation. During
      this period, the following acts are necessary: surgical access to live support
      systems (airway, veins), life saving decompression of body cavities,
      resuscitative thoracotomy, control of exsanguinating external hemorrhage and
      control of exsanguinating hemorrhage into the body cavities. The primary or
      stabilisation period starts when vital functions stabilise. This period consists
      of further diagnostic procedures and treatment of injuries that are not directly
      life-threatening, but which may become life endangering or severely disabling if
      not treated promptly. The priorities of the surgical treatment are: brain
      injuries, eye- and facial injuries, progressive compression of the spinal cord,
      visceral injuries, musculoskeletal injuries. By improving prehospital care, rapid
      transport and last but not least immediate life saving surgical treatment
      preventable deaths can be reduced from 20-30% to 2-9% (5).

PMID- 11202270
TI  - Lymph node mapping and sentinel lymph node biopsy for evaluation of axillary
      lymph node status in early invasive breast cancer. Our experience.
AB  - The Authors show their preliminary experience with the sentinel lymph node biopsy
      (SLNB) in clinical early invasive breast cancer (T1N0). During a period of 15
      months, forty-two patients were submitted to SLNB upon Tc99-colloid albumin
      injection and SLN identification by lymphoscintigraphy. The middle number of
      lymph nodes found in the SLNB was 1 (1-3), whereas the middle number of lymph
      nodes identified in level I/II ALND specimens was 15. The SLN was identified with
      success in all cases (100%). The axilla was positive for metastasis in 4/42
      cases. The SLN was positive in all four cases in which nodal metastasis was
      identified. The negative predictive value of SLN was 100%. The SLN was the only
      site of metastasis in 3/4 cases. The SLN pathological status accurately reflected
      the lymphatic basin status, but further investigation is needed to define the
      optimal timing of colloid injection and method of examination of the SLN.

PMID- 11202272
TI  - Modern approach to management of patients following major trauma.
AB  - Trauma remains one of the three main causes of death all over the world. In
      Poland severe trauma is also an important public health problem which should be
      fully recognised in the changing system of our health service. There is a growing
      understanding and interest in the integration of pre-hospital, in-hospital and
      rehabilitation services taking part in the management of trauma patients. The
      importance of emergency medicine departments has been found valuable in Western
      countries and should be promoted by all means in our country. Certain
      recommendations of treatment of patients following severe trauma have been
      discussed concerning anti-shock therapy, diagnostic and operative management in
      polytraumatized patients with major head trauma, thoracic and abdominal trauma
      and also operative stabilization of fractures of bones. It has been concluded
      that in our country, especially in bigger cities, patients following major trauma
      should be treated in specially designed units (centers) integrated with emergency
      medicine departments providing competent intensive therapy and surgical
      interventions of well trained trauma teams introducing optimal modern trauma
      algorithms.

PMID- 11202273
TI  - Colorectal war injuries.

PMID- 11202274
TI  - Trauma care for the year 2000.
AB  - Trauma is a third killer of modern european and world societies. Everywhere in
      Europe there is the great necessity of having an efficient emergency prehospital
      and hospital trauma care organization which will reduce mortality and invalidity
      of the trauma critical patients. Three objectives are the most important: 1)
      defining of the lines guide (e.g. ALTS) 2) continuous education and training of
      education the medical and paramedical operators (doctors, nurses, technicians,
      paramedics) 3) applying the method on organization and structural base. According
      to statements of Council of Europe, European College of Surgeons, E.A.E.S., it
      has been affirmed "In addition to General Surgery training for the surgeons
      should require a complementary training in Emergency Surgery either" concurrently
      or consecutively. As a first suggestion; the idea is to create centers of
      excellence fully equipped with all modern facilities and well trained medical
      staff. Those centers should be spread over the Europe and available round tho
      clock. Those centers should be supervised by a trained Emergency Surgeons with
      the indispensable aids and cooperation of anesthesiologist. The other very
      important factor is optimalization of patients transport towards the suitable
      trauma care center. Emergency Surgical Training should be established on three
      levels namely; 1) within the undergraduate medical curriculum 2) complementary
      training in emergency surgery during the general surgery specialization 3)
      additional theoretical and practical training for emergency nurses. There are
      many cultural and organizational differences among the "old and new" European
      Countries. The most important and special objective is the evolution of a correct
      and equal education in training care in order to improve our situation.

PMID- 11202275
TI  - Renal trauma.

PMID- 11202277
TI  - Advances in the treatment of severe fecal incontinence.

PMID- 11202276
TI  - One-day surgery in multiple trauma patients.
AB  - The aim of the authors was evaluation of influence of progress in MT procedures,
      particularly on final results of treatment, with special attention to aggressive
      one-day surgery, including definitive orthopaedic operations. The study is based
      on own material from the 2-nd Department of Surgery of the Jagellonian
      University. From almost 3000 victims of accidents with multitrauma (MT), who were
      treated between 1968 and 1997, 932 patients were selected. They were treated in
      consecutive 2-year periods in a 5-year cycle, starting from 70/71 up to 95/96.
      From 1987, the patient material has been prospectively coded. A steadily growing
      number of MT patients were stated with the only exception in 85/86 period.
      Traffic accidents were the major cause of injuries in over 2/3 of victims and men
      were predominated. Time lapse from accident to arrival became shorter. Severity
      of injuries was growing steadily as well: from 21.55 to 26.17 points of ISS
      (Injury Severity Score). At the same time percentage of operated increased from
      34.88 to 47.62, and length of stay decreased from 23.45 to 19.79 days. The most
      significant finding, however, was the fact that deep-set objective increase of
      trauma severity, mortality rate decreased twofold--from 29.07% at the beginning
      to only 14.85% at the end. The improvement resulted from progress in diagnosis
      and treatment of MT patients. Implementation of diagnostic peritoneal lavage,
      refurbishing of our intensive care unit, installment of computed tomography in
      the cases of head injuries, gradual introduction of early stabilisation of major
      fractures and routine early anticoagulant prophylactic and hyperalimentation as
      well as full standardisation of the therapeutic process--all these were the "mile
      stones" which assured reaching such satisfactory results.

PMID- 11202278
TI  - Enzyme therapy in patients with advanced colorectal cancer.

PMID- 11202280
TI  - Nutrition in cancer.

PMID- 11202279
TI  - Surgical and combined treatment of gastric cancer--own experience.
AB  - PURPOSE: In Poland, as well as all over the world, gastric cancer is still among
      the leading causes of mortality and morbidity from malignant diseases. Many
      attempts were made to improve the results of the treatment. In this paper we
      present our 25-year experience in this field. MATERIAL AND METHODS: From 1977 to
      2000 in the Clinical Department of Surgical Oncology, Medical University of Lodz,
      we treated 353 patients (males 63%; females 37%) with the diagnosis of gastric
      cancer, confirmed histologically. We analysed the age of patients, location of
      primary tumor, histologic type, stage of the disease, type of surgery, type of
      reconstruction of GI tract, type of adjuvant therapy and survival. RESULTS: In
      patients with the disease in stage I and II according to UICC Fielding
      classification, the best results were achieved. Five year survival reached 76%
      which means that early recognised gastric cancer may be cured. However, patients
      from this group constituted only 6.7% of all the treated population. In patients
      with stage III disease, 5 year survival was 34.5%. In patients with IVA stage of
      the disease (72 cases), in whom only cytoreductive-palliative surgery was
      performed, 5-year survival was 16.7%. No patient with IVB stage of the disease
      (purely palliative procedures performed) survived 5 years. Significant
      improvement of distant results was, observed in patients receiving EAP as an
      adjuvant therapy (25.1% of 5-year survivors) in comparison to control group
      patients treated solely with surgery (18.2% of 5 year survivors). In 97 patients
      after total gastrectomy, significantly lower complication rate was observed in
      patients in whom intestinal pouch was created (Hunt-Lawrence) than in patients in
      whom the pouch was not created (Roux-Y, Engel-Graham). CONCLUSION: In our
      opinion, we should consequently implement guidelines known as the "Polish
      Consensus of Gastric Cancer Treatment", like extensive radical stomach resection
      (whenever possible) with regional lymphadenectomy and adjuvant therapy.

PMID- 11202281
TI  - Double-blind pilot-study on the efficacy of enzyme therapy in advanced colorectal
      cancer.
AB  - All tested variables showed a tendency in favor for Wobe-Mugos E therapy as
      addition to standard therapy. Enzymes improve the quality of life by reducing
      cancer disease typical symptoms, they reduce side effects of chemo-/radiotherapy
      and they have a potential of prolonging life (preliminary data only).

PMID- 11202282
TI  - Primary suture vs. T-tube after common bile duct exploration (our 25 years of
      experience).
AB  - PURPOSE: The aim of our retrospective study is to return confidence in primary
      suture (PS) procedure after common bile duct exploration (CBDE). The first CBDE
      was performed in 1884 using PS. T-tube drainage was introduced 10 years later,
      and PS procedure has been abandoned today. MATERIAL AND METHODS: In the course of
      the last 25 years (1974-1999 period) 4971 cholecystectomy have been performed
      with 682 (13.5%) CBDEs. There have been 201 (30%) T-tubes, 238 (34%) PS, 219
      (32%) biliodigestive anastomosis (BDA) and only 24 (3%) papillotomies (PT)
      performed. Intraoperative choledochoscopy has been performed as a routine
      intraoperative method, too. RESULTS: In 439 patients, operated either using PS or
      T tube procedure were as follows: retained stones 6:16 (2.5%:8%), billiary
      complications 4:14 (1.6%:7%) and mortality 1:6 (0.3%:3%), respectively. PS is a
      significantly less expensive procedure, spending less medicaments, i.v. fluids, X
      ray and laboratory tests, with a shorter postoperative hospital stay. CONCLUSION:
      PS is unjustly abandoned operative procedure. The advantages of the method are
      lower complications rate as well as lower costs. Present progress in surgery,
      less operative aggression, must be considered, especially during laparoscopic
      cholecystectomy.

PMID- 11202283
TI  - Palliative treatment of gastrointestinal tumors.

PMID- 11202284
TI  - Critical overview of the current status of treatment of pancreatic cancer:
      oncological point of view.

PMID- 11202285
TI  - Long-term results of pancreatic cancer surgery.
AB  - Despite of growing incidence of pancreatic cancer and dynamic development of
      modern diagnostic methods, long-term treatment results are still unsatisfying.
      The aim of the study is the assessment of long-term outcome of pancreatic cancer
      surgery. Group of 621 patients hospitalized between 1972-1999 was analyzed.
      Pancreatic resection was performed in 34.1% (n = 212) patients, and in 65.9% (n =
      409) cases a palliative bypass procedure was carried out. Increased number of
      resective procedures (from 6.2% to 40.1%) in the recent years was observed with
      lower perioperative mortality rates (from 20% to below 5%). The analysis of the
      long-term results of surgical treatment for pancreatic cancer showed significant
      improvement of the overall 5-year survival from 4.2% to 17.1% in the recent
      years. Based on the carried out analysis the authors conclude, that pancreatic
      cancer surgery performed by the experienced surgeon improves long-term results
      lowering to minimum the rates of complications.

PMID- 11202286
TI  - Extrahepatic cholestasis: are there any "leftovers" for surgeons?

PMID- 11202287
TI  - Renal failure in acute pancreatitis. Timing of dialysis and surgery.
AB  - Despite the progress in intensive care treatment the ongoing systemic
      inflammatory response syndrome (SIRS) in patients with severe pancreatitis (SP)
      and renal failure (RF) is associated with high mortality. The aim of this lecture
      is to outline the knowledge drawn from literature and personal experience and to
      re-evaluate the management strategy of SP patients whose clinical course is
      complicated with impairment of the renal function. INCIDENCE, RISK FACTORS AND
      OUTCOME: Impaired renal function can be observed in 14-43% of patients with SP
      mostly in combination with other organ system failure. SIRS is the main culprit
      in the pathologic process. Extent of necrosis does not correlate with derangement
      of the renal function, however, infection is a serious risk factor. Mortality
      reaches 71-84% in patients with SP and RF, which requires dialysis. Risk factors
      highly associated with RF and detrimental outcomes in SP patients are advancing
      age, prior chronic disease, cardiovascular and pulmonary failure, mechanical
      ventilation, hypotension, oliguria, coma, and jaundice. SP is associated with
      increased bowel permeability, impaired visceral perfusion, retroperitoneal oedema
      and increased intraabdominal pressure, which can directly affect the renal
      function as consequence of the acute abdominal compartment syndrome (AACS).
      TREATMENT: Early aggressive resuscitation including isovolemic hemodilution with
      dextran 60, venovenouse hemofiltration, early enteral nutrition and antibiotic
      prophylaxis are of extreme importance. Surgery is indicated in SP with evidence
      of the RF when clinical course deteriorates despite intensive care, especially if
      infection is present and/or AACS develops. CONCLUSION: RF in the patients with SP
      reflects the severity of SIRS. Improvement of the visceral perfusion is the goal
      of resuscitation. Surgery is indicated in case of failed conservative treatment
      and may be successfully combined with hemodialysis.

PMID- 11202288
TI  - Chronic pancreatitis--biochemical, morphological, diagnostic and surgical
      aspects. Quality of life after surgery.

PMID- 11202289
TI  - Pathogenesis of endotoxemia and multiple organ failure in case of mechanical
      jaundice and their aggravation after the relief of cholestasis.
AB  - PURPOSE: To clarify the mechanisms of systemic endotoxemia in extrahepatic
      cholestasis and the pathogenesis of aggravation of multiorgan failure after
      external biliary drainage (EBD)--for elaborating of the curative tactics.
      MATERIALS AND METHODS: The results of experimental studies performed on 208
      Wistar rats and 90 dogs were implemented in the surgical clinic in treatment of
      150 patients with cholestasis. In experiments--Histological, Transmission and
      Scanning Electron Microscopic, and Biochemical (Malonic Dialdehide--the end
      product of Peroxide Oxidation of Lipids of cell membrane) methods have been used.
      Perfect model of EBD in cholestasis was created. In clinic--the measurement of
      Mitochondrial ferments, Bilirubin concentration, Creatinin clearance and
      Psychometric tests were used for evaluation of liver, kidney and brain functions.
      RESULTS: Destruction of 7.2% and 8.1% of villi in 6 and 7 days cholestasis and
      17.3% and 23.5% of villi consequently in 12-14 days cholestasis (compared with
      1.1%-1.4% in control [P < 0.01]) resulted in denudation of lacteals was observed.
      Malonic Dialdehide concentration is significantly increased in plasma after EBD
      in cholestasis, especially under rapid decreasing of biliary pressure.
      CONCLUSION: Gut barrier failure in cholestasis "lets" gram-negative bacteria and
      their endotoxins to penetrate the systemic circulation via the lymphatic system
      avoiding the liver filter. This process, which is partially suppressed by bile
      salts existed in lymph due to bilio-lymphatic reflux, precipices just after EBD
      with all consequences. Aggravation of hepatic failure after one-stage rapid
      biliary decompression is also promoted by activation of Peroxide Oxidation of
      Lipids (caused by blood reflow into portal system under falling the pressure in
      bile compartment) injuring the liver cells. Administration of "Duphalac" ("Solvey
      Pharmaceuticals")--with antiendotoxic, and "Plapheron LB" (Georgian Industry)-
      with anti-free-radicals properties is suggested in cholestasis not only before
      the operation, but after the biliary drainage as well.

PMID- 11202290
TI  - Risk of synchronous and metachronous liver resection for colorectal cancer
      metastases.
AB  - There is a discussion if the synchronous large bowel and liver metastatic lesions
      should be operated at the same time. It is the reason why we tried to find the
      answer based of our material. We analysed 331 liver resections due to metastatic
      lesions on the liver. In 61 cases (18.4%) the metastatic tumors were synchronous
      with large bowel tumors. The synchronic liver resections and large bowel
      resections were performed in 26 patient's (7.8%) and metachronic resection in 305
      cases (92.2%). The policy of our Department is to perform liver resection before
      large bowel resection in synchronic tumors. The morbidity in the whole material
      was 19.0%, and mortality 3.3%. The complications ratio in synchronous liver
      resection was 23.1% and 17.9% in metachronic liver resection. The mortality was
      3.9% in synchronous and 3.3% in metachronous liver resection. We concluded that
      the difference between complications and mortality in synchronous and
      metachronous liver resection was very little. That means that there is no risk of
      synchronous liver and large bowel resection.

PMID- 11202291
TI  - Portal hypertension--problems and dilemmas.

PMID- 11202292
TI  - Surgical treatment of severe necrotizing pancreatitis by the method of "open
      abdomen"--early and long-term results.
AB  - The aim of our study was the evaluation of "open abdomen" method (OAM) in
      treatment of severe acute pancreatitis. Fifty patients were treated by this
      technique in our Department from 1983 to 1999 year. Patients were retrospectively
      classified into 3 groups: with sterile pancreatic necrosis (SPN), pancreatic
      abscess(PA) and infected pancreatic necrosis(IPN). Early results embraced: number
      of local and general complications and a lot of parameters, which let to
      recognise objectively efficiency of management(time of hospital and intensive
      care unit stay, time of total parenteral nutrition, number of reoperations and
      others). These results were compared with analogical groups, in which used other
      management. Long-term results embraced the pancreatic efficiency tests in 24
      patients in period 2-16 years after surgical treatment of OAM. Based on these
      results three groups of patients were separated: 12 persons (50%) recognised
      healthy, 4 (17%) with exocrine insufficiency of pancreas and 8 (33%) with
      exocrine and endocrine insufficiency of pancreas. Our results prove that OAM is
      the efficient treatment of IPN, but it shouldn't be used in cases of PA or SPN.
      Patients after OAM need prospective monitoring of exocrine and endocrine
      pancreatic function due to serious risk of this organ dysfunction.

PMID- 11202293
TI  - Surgical and endoscopic treatment of pancreatic pseudocysts.
AB  - Not long ago surgery was the only way to treat pancreatic pseudocysts that would
      not resolve spontaneously. Nowadays minimally invasive methods are gaining
      popularity, such as percutaneous drainage, endoscopic cystogastrostomy or
      cystoduodenostomy, and endoscopic transpapillary drainage. The aim of this study
      was to evaluate these methods in comparison with conventional surgery for
      pancreatic pseudocysts. From March 1997 to July 2000 we treated at the 2nd Dep.
      of Surgery, Wroclaw Medical University, 52 patients with pancreatic pseudocysts.
      30 patients were treated surgically, 15 endoscopically, and 7 medically. For
      endoscopic treatment we chose patients with "mature" pseudocysts, with a distinct
      capsule on ultrasonography, adherent to the posterior wall of the stomach,
      clinically sterile, at least 5-15 cms in diameter. The endoscopic criterion was
      the appearance of the cyst bulging into the stomach. Surgical treatment was
      applicable for those patients who had no positive evidence of a direct contact of
      the pseudocyst and the stomach, those with cysts infected, multiple or filled
      with dense fluid. The observed complications (infection of the cyst and bleeding)
      are typically reported for the treatment of pancreatic pseudocysts. The single
      complication in the form of an inflammatory tumor of the pancreas was probably
      due to undiagnosed pancreatic necrosis. There was zero mortality in our group. In
      our opinion endoscopic cystogastrostomy with a double pigtail stent is a valuable
      alternative to conventional surgery and in selected cases can be the method of
      choice for the treatment of pancreatic pseudocysts. Conventional surgical methods
      of treatment still remain valid. They are often less hazardous as they allow full
      visual evaluation of the cyst and its neighbourhood (for the signs of necrosis).
      Surgical drainage provides secure anastomosis of the cyst with the GI tract and
      hemostasis, which may be vital in some cases.

PMID- 11202294
TI  - Endoscopy in bile ducts surgery.

PMID- 11202295
TI  - Inflammatory aneurysms of the abdominal aorta.

PMID- 11202296
TI  - Sutureless intraluminal graft for repair of high abdominal aortic aneurysm.
AB  - The aim of our study was experimental and clinical assessment of bifurcated
      grafts with ring on its main branch made of the same polyester as the prosthesis.
      This type of prosthesis facilitates quick anastomosis with the aorta through
      tying the aortic wall on the ring using a polyester tape. Experimental studies
      carried out on 18 pigs demonstrated good healing up of such a graft. The
      prosthesis was used for surgery in 8 patients with abdominal aneurysm which
      required clamping the aorta above renal arteries. The prosthesis was found to
      facilitate and accelerate making the proximal anastomosis, diminish the amount of
      blood loss, and reduces the time of the surgery, especially the time necessary
      for clamping the aorta above renal arteries which prevents renal ischaemia.

PMID- 11202297
TI  - Technique of transcervical--subxiphoid-vats "maximal" thymectomy in treatment of
      myasthenia gravis.
AB  - Operative technique of transcervical-subxiphoid-VATS thymectomy is described.
      Total sternotomy is avoided which makes the procedure less invasive without
      compromising its radicality. The operation is performed with aid of special
      device with two sternal retractors elevating the sternum from above and below and
      facilitating access to the mediastinum. The mediastinal pleura is incised
      bilaterally and exenteration of the mediastinal fat is done under control of
      video camera inserted through the thoracoscopic ports. Two team approach is
      proposed: one team, called "the cervical" team performs dissection of the neck
      and the superior mediastinum; the "subxiphoid" team removes the fat tissue of the
      anterior mediastinum. This approach makes possible reduction of the operative
      time to 1.5-2 h. No complications were noted in the group of 8 patients operated
      on by the moment of submission of the abstract.

PMID- 11202298
TI  - Surgery of rectal tumors.
AB  - The results of surgical treatment of carcinoma of the rectum have been improved
      in the last decades, because of the availability of stapling device, the
      increasing use of adjuvant or neoadjuvant treatment and the development of
      endoluminal surgery. Herein we present our thirty years experience in the
      treatment of rectal carcinoma. It deals with 690 patients operated on, 602 with
      conventional surgery (87%) and 88 with local excision (13%). As regards the first
      subgroup, in 63 patients (10.4%) the operation was considered palliative, because
      there were either hepatic metastases or residual tumor; 21% of the whole number
      had tumor in the upper third, 40% in the middle third and 39% in the lower third.
      Radical resection was performed in 538 patients (89.6%); 53% of the patients
      underwent anterior resection and 47% underwent abdomino-perineal resection.
      Ninety percent of tumors located in the lower rectum were managed with abdomino
      perineal resection and 97% of tumors located in the upper rectum were managed
      with anterior resection. Tumor of the middle rectum were treated indifferently
      with anterior resection or abdomino-perineal resection. Mortality was 4%; the
      morbidity was 33%. No statistical difference was found between anterior resection
      and Miles operation. Mean follow up is 6.8 years. Local recurrence was observed
      in 17% of patients and was more frequent after Miles operation than after
      anterior resection. The 5- and 10-year survival is respectively 53% and 43%;
      according to staging, 5-year survival is 68% for stage I, 64% for stage II, 39%
      for stage III and 9% for stage IV (p < 0.0001). As regard local excision, lesions
      usually arised from lower or middle rectum and were less than 3 cm. in the
      maximum diameter. Sixty per cent of patients received adjuvant or neoadjuvant
      treatment; we observed complete response with disappearance of the tumor in 28%
      of T2 patients. The toxicity was low: 3% of patients developed erithema and 21%
      different grades of proctitis. Mean duration of operation was 179 +/- 98 min' and
      hospitalization was less than 7 days in most of the patients. No mortality was
      recorded, while morbidity was 16% (14 patients). On pathological examination we
      observed 10 Tis (11%), 32 T1 (36%)28 T2 (32%) and 18 T3 (21%). Mean follow up is
      3.3 years; local recurrence was related to staging and was respectively 0%, 16%,
      25% and 61% (p = 0.0008). We did not observe local recurrence whenever T2
      patients had neoadjuvant treatment and negative margins at i.o. pathological
      examination. Our findings show that anterior resection represents the most
      appropriate treatment for tumors of the upper and middle rectum; Miles operation
      should be reserved to tumors located within 5 cm. from the anal verge. Small
      tumors, confined to the rectal wall, can be properly treated with local excision;
      local treatment should be always associated to preoperative chemoradiation in
      tumors involving the muscular layer of the rectal wall.

PMID- 11202299
TI  - The rectal cancer with pre-operative radiotherapy--personal experience.

PMID- 11202300
TI  - Functional results of reconstruction after subtotal or total gastrectomy.
AB  - The aim of surgical treatment of gastric cancer must be complete removal of the
      tumor including systematic lymphadenectomy. The performance of R0-resection has
      to take into consideration tumor site as well as the histomorphological type
      described by Lauren. Therefore, subtotal distal- or total gastrectomy are
      complementary operative procedures nowadays. From the oncological point of view
      proximal gastrectomy might be indicated in some situation but increased
      postoperative morbidity including severe reflux-esophagitis can be obtained.
      According to the functional outcome subtotal distal gastrectomy should be
      preferred whenever justified oncologically in comparison to total gastrectomy.
      Among the different reconstructive methods after total gastrectomy the Roux-en-Y
      technique is one of the most common procedure performed. Furthermore, some
      patients can benefit from a reconstruction of a gastric substitute and
      maintenance of duodenal passage but the superiority of this technique must be
      evaluated in further prospective studies. The question of the optimal mode of
      reconstruction of the upper gastrointestinal tract is still open.

PMID- 11202301
TI  - Local excision of rectal cancer by transanal endoscopic microsurgery (TEM)
      combined with radiotherapy: new concept of therapeutic approach.
AB  - Transanal endoscopic microsurgery (TEM), associated with preoperative
      radiotherapy in selected groups, allows minimally invasive full thickness local
      excision of rectal tumors with perirectal fat dissection. In our experience, 95
      patients with extraperitoneal rectal carcinoma underwent TEM resection for T1 (21
      cases), T2 (48 cases) and T3 (15 cases) lesions. In eleven patients the
      pathologist did not find cancer cells in the specimen (pT0) after full dose of
      radiotherapy and TEM. The postoperative results were as follows: 11 minor
      complications (11.6%), 7 leaking sutures, 3 stool incontinence and 1 rectal
      haemorrhage, that resolved with medical therapy and two major complications
      (2.1%), one rectovaginal fistula that required reoperation and one rectourethral
      fistula treated by conservative therapy. No perioperative mortality was observed.
      Mean follow up was 40 months (range 2-96 months) with 7 (7.4%) local recurrences.
      Of those, 5 patients were successfully retreated and 2 high risk patients
      underwent postoperative radiotherapy. The overall survival in T0 and T1 patients
      was 100%. The overall survival in T2 and T3 patients was 81% and 62.1%
      respectively. This study reports the application of TEM combined with
      radiotherapy in the treatment of rectal cancer in selected patients. This
      approach is feasible, safe, and appears to be effective at the present follow up,
      with preservation of normal sphincter function.

PMID- 11202302
TI  - Is follow-up of colorectal cancer cost-effective?

PMID- 11202303
TI  - Diagnosis and management of colorectal obstruction.
AB  - INTRODUCTION: Intestinal obstruction very often results in a patient's death. The
      reasons of high mortality are: 1) surgeons don't follow "golden rule", which
      presumes performing of operations within 2 hours after diagnosis is determined,
      2) delayed management, 3) the absence of reliable criteria, that can prove the
      definitive diagnosis, 4) difficulties in diagnosis. METHODS: The are basic rules
      of the modern doctrine of surgical treatment. 1. The early diagnosis. 2. The
      adequate preoperative preparation. 3. The early operative intervention. 4.
      Individual approach to the appropriate operative management and type of
      operation. 5. Active tactics in postoperative management. A large bowel
      obstraction is an emergency condition that normally requires early identification
      and surgical intervention. CONCLUSION: Ways of improving the results of
      management large bowel obstruction secondary to neoplasm are the following: 1)
      improving preparation of the intestine to the operation, 2) rational
      antibacterial therapy, 3) expansion of indications to the surgical treatment of
      tumors irrespective of the stage of disease. Methods of extra and intracorporal
      detoxication are usually used for treatment of endotoxicosis. Active treatment
      and diagnostic tactics in coordination with the described program provides a
      possibility of improving the results of treatment in this category of patients.

PMID- 11202304
TI  - Neuromodulation of vago-vagal reflex.
AB  - Functional gastrointestinal disorders are poorly understood. The lack of clear
      classification and definition of these disturbances interferes with unsatisfying
      treatment. The possible explanation has been recently looked up in the changes of
      brain-gut axis interactions. Simultaneously microelectronics has been made
      tremendous progress in the cooperation with medical sciences lately. Electronic
      microcircuits have become widely used in neurosciences because of their many
      advantages compared to standard investigational devices. Implantable microchips
      facilitate studies of nervous system allowing carrying on chronic experiments
      with minimal damage to surrounding organs. Neuromodulation of autonomic nerves
      gives promise for treatment refractory disturbances of gut motility.

PMID- 11202305
TI  - Tailoring antireflux surgery: where do we stand? A critical review of the
      literature.

PMID- 11202306
TI  - Barrett's surgery in 2000.

PMID- 11202307
TI  - Gastrointestinal motility in surgical clinic.

PMID- 11202308
TI  - Esophageal motility impairment--the cause or consequence of gastroesophageal
      reflux disease?
AB  - There are at least three, well-known, different groups of motor activity
      disturbances of the upper part of alimentary tract which can induce the
      development of gastroesophageal reflux disease (GERD) and enlarge the risk of
      excessive exposure of the esophageal mucous membrane on gastric juice and/or
      biliary contents. Most important is insufficiency of the lower esophageal
      sphincter (LES), which causes gastroesophageal reflux at 50-60% of patients
      suffering from GERD. Other reasons include impairment of stomach function
      (increase of intra-gastric pressure, late emptying and/or hypersecretion), and
      impairment of esophageal clearance. The question: does motility impairment of the
      esophagus occur primary or secondary to the gastroesophageal reflux, is still not
      enough clarified. Motor activity of the esophagus before and after the antireflux
      operation was prospectively assessed in 57 patients. Motility of the esophagus
      was determined by estimation: the efficacy of LES, general motor activity of the
      body of the esophagus and motor activity of the body during the reflux episodes,
      basing on 24-h manometry. Comparison of general pre- and postoperative data
      revealed significantly positive influence of Nissen-Rossetti fundoplication on
      improvement of motor activity of the esophagus, but the results differed in
      relation to the height of the measurements. Moreover comparison of the data
      during gastroesophageal reflux episodes revealed negative changes of the
      manometric parameters in the upper and middle esophagus. We conclude that post
      operative improvement of esophageal motility confirms the secondary dysfunction
      in the peristalsis, connected with pathological reflux. However, lack of the
      complete normalization in motor activity after operation suggests that disorder
      may partially occur as primary impairment of motor activity or as the secondary
      dysfunction, which is fixed in the course of GERD.

PMID- 11202310
TI  - An old and a new challenge in endocrine surgery: management of substernal goitre
      & endoscopic removal of adrenal tumors.

PMID- 11202309
TI  - The relationship between improved prognosis in gastric cancer patients in the
      last 25 years and changing methods of surgical and combined treatment.
AB  - BACKGROUND: Poland is among the countries with the high morbidity and mortality
      rates for gastric carcinoma (GC). The differences of GC biology depending on the
      geographical regions were suggested. In the literature, there are no reports from
      detailed clinicopathologic studies carried out in large series of GC patients in
      Poland. METHODS: Based on the prospectively collected data of 3696 GC patient
      treated surgically between 1977-1999, potentially significant prognostic factors
      were analyzed to assess their prognostic value, and their time related
      distribution during the over 20-year period of the study. RESULTS: The mean age
      of the patients was 59.0 (SD 11.6) years and ranged from 20 to 93 years. The male
      to-female ratio was 2.3. Overall cumulative 5-year survival was 0.28 (for early
      GC 0.85) and significantly increased over the period of study. Among factors
      analyzed the depth of invasion, lymph nodes status, tumor size, age, UICC-R
      classification and rate of involved to removed lymph nodes are of statistically
      significant and most important prognostic value. In the over 20-year period of
      study the rate of diffuse type carcinoma acc. to Lauren increased but the tumor
      locations did not changed significantly. The rate of early GC did not change
      throughout the period of study but number of most advanced cases decreased. Chemo
      and chemotherapy improved outcomes in some groups of patients. CONCLUSIONS: The
      basic clinicopathologic profile of Polish patients is similar to the reported in
      Western Europe and Japan, except for significantly higher early GC occurrence in
      Japan. According to the obtained results the prognosis of GC depends clearly upon
      the stage of the disease at the time of surgery. The improvement of outcomes
      during over 20 years of GC study in Poland was due to introducing better
      diagnosis and routine multimodal treatment.

PMID- 11202311
TI  - Surgical treatment of carcinoid tumours.
AB  - Carcinoid tumours are the most common endocrine tumour of the gut comprising 75%
      of appendicular tumours and a third of ileal tumours. They are also an incidental
      finding in 1% of post mortems. Carcinoid syndrome however is rare and it is
      estimated that two cases would appear in a quarter of a million population over a
      decade. We have reviewed a consecutive series of carcinoid tumours accrued from
      1976-1999 in order to further study the natural history of the disease and also
      to examine the relationship between pathological tumour size, extent of disease
      and prognosis for each tumour site. In this 19 year period 145 patients were
      treated for the disorder. The bronchus was the commonest site (35.9%) with
      appendix (24.8%) and ileal (13.8%) carcinoids comprising the majority of known
      primaries. Overall midgut carcinoids comprised 40.7% of the series with the
      carcinoid syndrome present in 20.3%. A significant group was constituted by those
      patients presenting with metastatic disease and an uncertain site of primary
      tumour (9.7%). Metastatic disease was not found on presentation or follow up in
      any patient with a foregut primary tumour less than 2 cm diameter or a midgut
      primary tumour less than 1 cm diameter; a direct correlation of size and
      metastases being found above these levels. Overall survival for all groups was
      60% at 5 years with the best prognosis being seen in patients with bronchial or
      appendicular carcinoids. Other clinical features, pathology, extent of disease
      and prognosis of carcinoid tumour will be discussed along with the role of
      current management strategies.

PMID- 11202312
TI  - Unusual pancreatic tumours.

PMID- 11202313
TI  - European Society of Surgery 4th Annual Meeting. Krakow, December 3-6, 2000.
      Abstracts.

PMID- 11202314
TI  - Transesophageal echocardiography during cardioversion of atrial fibrillation.

PMID- 11202315
TI  - Scalar versus vector electrocardiography to determine right coronary artery or
      left circumflex coronary artery occlusion in inferior wall acute myocardial
      infarction.

PMID- 11202316
TI  - Electrocardiographic lead reversal.

PMID- 11202317
TI  - ABCs of thrombolysis.

PMID- 11202318
TI  - Comparative examination of the accuracy of a mechanical and an optical system in
      CT and MRT based instrument navigation.
AB  - The aim of an intraoperative instrument navigation system is to support the
      surgeon in the localization of anatomical regions and to guide the use of
      surgical instruments. An overview of technical principles and literature reports
      on various navigation systems is provided here. The navigation accuracy (tested
      on a plastic phantom under simulated operating room conditions) of the mechanical
      Viewing Wand system and the optical SPOCS system amounts to 1 to 3 mm for
      computerized tomography (CT) data, with a significant inverse dependence on the
      layer thickness. The values for magnetic resonance tomography (MRT) data are
      significantly higher. In regard to the choice of registration points, a
      statistically inverse dependence exists between the number of points and the
      distance between the points. During the time period between autumn 1993 and mid
      1999, more than 120 clinical applications were performed. The intraoperative
      accuracy was in the range of < or = 3 mm. Registering the patient position with
      preoperatively inserted screw markers achieved accuracy values of < or = 2 mm.
      The instrument navigation technique has proved to be very advantageous for the
      spatial orientation of the surgeons. The possibility of checking resection
      borders has opened up new perspectives in tumor surgery. A quality improvement
      and a reduction of the operational risks as well as a considerable decline in the
      stress placed on the patient can be expected in the near future due the
      techniques of computer-assisted surgery.

PMID- 11202319
TI  - Extra-articular pigmented villonodular synovitis of the temporomandibular joint:
      case report and review of the literature.
AB  - Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the
      synovial tissue, that usually affects the knee, ankle and other major joints.
      Involvement of the temporomandibular joint is, however, very rare. We describe a
      new case of recurrent PVNS arising from the temporomandibular joint that was
      classified as diffuse extra-articular type and was successfully treated
      surgically. The etiology and clinical features of PVNS are discussed and the
      previously reported cases in the literature are reviewed.

PMID- 11202320
TI  - Vertical distraction of the severely resorbed mandible. The Groningen distraction
      device.
AB  - In this paper, both the surgical procedure and the clinical results of a novel
      distraction device to augment a severely resorbed anterior edentulous mandible
      are described. The distraction device is non-voluminous, and consists of two
      distraction screws and one guide screw. Two months after the last day of
      distraction, both distraction screws are replaced by endosseous implants and the
      guide screw is removed. Three months after implantation, the prosthetic treatment
      can be started. So far three patients have been treated. In all patients, the
      severely resorbed mandible (mandibular height in the canine region: 5, 6 and 7
      mm, respectively) could be sufficiently enlarged to enable reliable insertion of
      endosseous implants with a length of at least 12 mm. No complications occurred.
      Biopsies taken from the distraction site revealed formation of lamellar bone
      parallel to the distraction vector. From this preliminary study it is concluded
      that the Groningen vertical distraction device has the potential for reliable
      augmentation of the anterior segment of a severely resorbed edentulous mandible
      to enable insertion of endosseous implants with adequate length and primary
      stability.

PMID- 11202321
TI  - Recovery of mandibular motion after closed and open treatment of unilateral
      mandibular condylar process fractures.
AB  - The purpose of this study was to determine the rate of recovery of mandibular
      motion in patients treated for fractures of the mandibular condylar process. One
      hundred and thirty-six patients (111 men, 25 women), 74 treated by closed and 62
      by open methods, were included. They underwent testing of mandibular and condyle
      mobility at 6 weeks, 6 months, and 1, 2, and 3 years post surgery. Their ranges
      of motion were compared to those of 52 controls (26 men and 26 women). A jaw
      tracking device was used to assess mandibular motion. Multilevel statistical
      models were used to assess differences between groups, and to estimate rate of
      recovery in the fracture patients. In general, patients with unilateral fractures
      of the condylar process had maximum excursions that returned to normal values
      within 3 years after fracture, regardless of treatment. Patients treated open
      exhibited a faster rate of improvement in maximum interincisal opening than
      patients treated closed (0.43 mm/month vs 0.15 mm/month, respectively), but part
      of the difference was due to a significantly smaller opening after 6 weeks for
      the patients treated open (38 mm vs 42 mm, respectively). Patients treated open
      also exhibited a faster rate of improvement in maximum excursion toward the
      fracture side than patients treated closed (0.10 mm/month vs 0.04 mm/month,
      respectively). Based upon this study, patients with unilateral fractures of the
      condylar process, who are treated closed and not put into maxillomandibular
      fixation but are instructed in physical therapy, can be expected to achieve
      normal maximum excursions within 3 years after treatment. Patients treated open
      will have reduced maximum opening initially, but may reach normal levels of
      opening sooner than patients treated without surgery. Patients treated without
      surgery may have smaller than normal excursion toward the non-fracture side for
      at least 3 years after fracture, especially if their fracture was at or above the
      condylar neck. Improvement rates for other maximum excursions are similar for
      patients treated with or without surgery.

PMID- 11202322
TI  - Intraorbital bamboo foreign body in a chronic stage: case report.
AB  - A case of intra-orbital bamboo foreign body in a chronic stage is presented. This
      case seems to confirm the importance of radiological examination, including three
      dimensional computed tomography to choose the optimal surgical approach to remove
      the foreign body.

PMID- 11202323
TI  - Management of refractory osteoradionecrosis of the jaws with surgery and
      adjunctive hyperbaric oxygen therapy.
AB  - This retrospective study aimed to determine the effectiveness of surgery and
      hyperbaric oxygen (HBO) treatment in the management of refractory
      osteoradionecrosis (ORN) of the jaws. Of the 18 patients who had undergone this
      treatment, 14 patients had complete healing, 3 patients had improved and one
      patient did not show any improvement. Of the 14 patients who had complete
      healing, only 4 still had a discontinuity defect of the mandible but they
      declined additional reconstructive surgery. In conclusion, surgery/HBO therapy
      showed satisfactory results in the management of refractory ORN of the jaws.

PMID- 11202324
TI  - Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the
      facial bones.
AB  - This paper reviews all 17 cases of facial bone osteoradionecrosis (ORN) which
      were treated in Adelaide, South Australia, in a nine-year period (1987 1996).
      This was 1.2% of all cases of head and neck cancer treated with radiotherapy
      (RT). Fourteen cases received treatment following the Marx principles of staging
      and the protocols of hyperbaric oxygen plus or minus surgery. The three
      exclusions were two patients who died of recurrent cancer before treatment was
      complete and one who declined treatment. The eleven cases of mandibular ORN
      occurred within a few years of the initial RT treatment. All except one occurred
      after surgical trauma, with dental extractions being the factor in nine cases.
      All responded to HBO, with or without surgery depending on stage. The three cases
      of temporal bone ORN were all of late spontaneous onset. All were stage I and all
      responded to HBO alone. This study shows that the incidence of ORN in Adelaide is
      low, probably through use of conservative doses of RT and good preventative
      protocols. The treatment with HBO plus or minus surgery was effective.

PMID- 11202325
TI  - Pyknodysostosis--a report of two cases with a brief review of the literature.
AB  - Pyknodysostosis is a rare sclerosing bone disorder that has an autosomal dominant
      trait. It is characterized by short stature, brachycephaly, short and stubby
      fingers, open cranial sutures and fontanelle, and diffuse osteosclerosis, where
      multiple fractures of long bones and osteomyelitis of the jaw are frequent
      complications. We present a report of two cases of pyknodysostosis with evidence
      of long bone fractures and chronic suppurative osteomyelitis of the jaws in one
      of the cases. Some of the specific oral and radiological findings that are
      consistent with pyknodysostosis are reported, along with a brief review of the
      literature.

PMID- 11202326
TI  - Multiple odontomas in the facial bones. A case report.
AB  - A rare case of multiple compound odontoma involving the facial bones and erupting
      into the oral cavity of a 15-year-old Nigerian girl is presented. The
      unacceptable facial appearance and the surgical approach used makes this case
      worth reporting.

PMID- 11202327
TI  - Chondroid lipoma: a rare but diagnostically important lesion.
AB  - Chondroid lipoma is a rare benign fatty tumour that has been confused with
      liposarcoma and chondrosarcoma. We present a case in a 44-year-old man and
      highlight the features that differentiate this benign lesion from the more
      aggressive ones.

PMID- 11202328
TI  - Highly aggressive brown tumour of the maxilla as first manifestation of primary
      hyperparathyroidism.
AB  - A case is presented of a 62-year-old man with a right maxillary swelling for the
      previous three months. The lesion was expansive and osteolytic, with invasion of
      the adjacent maxillary sinus, nasal and pterygomaxillary fossae and floor of the
      orbit. Histology revealed the presence of an intrabony giant cell lesion. Blood
      tests demonstrated elevations in calcium (16.2 mg/dl) and parathyroid hormone
      (PTH) concentrations (841 pg/ml). This suggested the diagnosis of
      hyperparathyroidism initially manifesting as a brown tumour of the maxilla.
      Posterior explorations confirmed the existence of an underlying ectopic
      parathyroid adenoma as the cause of the condition.

PMID- 11202329
TI  - Salivary gland involvement as an initial presentation of Wegener's disease. A
      case report.
AB  - The case is presented of a 47-year-old woman with an 8-week history of persistent
      right ear discomfort and a 2-week history of unilateral parotid swelling, as well
      as peripheral paresis of the facial nerve. The case points to the difficulties
      encountered when Wegener's granulomatosis presents in an unusual and varied way
      which mimics a malignant tumour of the parotid gland. To our knowledge, the
      association of parotid gland involvement and facial palsy in Wegener's
      granulomatosis has not previously been described in the literature.

PMID- 11202330
TI  - Optical biopsy systems for the diagnosis and monitoring of superficial cancer and
      precancer.
AB  - Histopathology is the gold standard in the diagnosis of cancer and dysplasia.
      Screening for the disease in high-risk populations(6,15) and choosing the correct
      site for biopsy have implications for the choice of follow-up intervals and
      therapy. Sully & Field(12) suggest that molecular genetic analysis, such as the
      polymerase chain reaction, for detecting progressive loss of heterozygosity, may
      be a more accurate predictor of the clinical course of oral cancer. This
      technique is now semi-automated and compares favourably with the time taken for
      histopathology (commonly 1-2 weeks). Recent developments suggest that the
      fluorescent and spectroscopic features may distinguish diseased from healthy
      tissue, and below follows an introduction for the clinician to this fascinating
      and complex field. It is possible to obtain a diagnosis in real-time and, with
      the appropriate use of photochemicals and image enhancement, it may be possible
      to treat and monitor the effects of treatment in real-time.

PMID- 11202331
TI  - [Effectiveness coefficient for laryngographic closure of the glottis as a way of
      evaluating airway protection against aspiration of gastric contents].
AB  - Laryngographic examination was conducted on 35 men aged 45 to 65 with good
      hearing and proper pronunciation. Based on the examination, the proposed by the
      authors of this paper laryngographic closure effectiveness coefficient of the
      glottis (LCEC) was calculated as a way for evaluating protection of airways
      against the aspiration of food. Glottis occlusion serves an essential function as
      a mechanism protecting airways, especially in patients who have undergone
      horizontal supraglottic laryngectomy. The examination was conducted with the
      purpose of obtaining numerical values of LCEC, which will be treated as results
      of the controlled group during the examination of swallowing disorders in
      patients with partial laryngectomy.

PMID- 11202332
TI  - [Classification of rhinosinusitis].
AB  - Rhinosinusitis is a multifactorial disease which has been variously defined by
      far. There is a strong need among all physicians to create a commonly accepted
      classification of rhinosinusitis, providing indications for an appropriate
      evaluation, diagnosis and treatment of the disease. The goal of this review is to
      present leading definitions of different forms of rhinosinusitis as well as
      classifications based on clinical findings, temporal considerations and the
      patophysiology of rhinosinusitis.

PMID- 11202333
TI  - [Use of argon coagulation in laryngology--personal experience].
AB  - In order to remove or destroy pathological changes of mucosa or control of
      bleeding in upper respiratory tract or in upper part of alimentary tract there
      are used various surgical technics including: electrocoaggulation, cryotherapy,
      laser-therapy. Argon plasma coagulation (APC) makes a new operative technique
      which is based on physical phenomenon of high frequency electric current flow
      through ionized argon plasma. There are several advantages of APC i.e.: no
      contact between applicator and tissue, no carbonization effect, possibility to
      control the application, large surface treatment. Authors present their own
      research in APC usage at 42 patients (age average 38.2, women 16, men 26).
      Estimating preliminary results of treatment APC can be described as an
      advantageous treatment method of nasal concha hypertrophy, nose bleeding
      (including Osler disease), nasal cavity polyps and pappilomas removal.

PMID- 11202334
TI  - [Evaluation of airway protection against aspiration of gastric contents in
      patients after partial laryngectomy using the laryngographic closure
      effectiveness coefficient of the glottis/neoglottis].
AB  - Laryngographic examinations were conducted on 97 patients who had undergone
      partial laryngectomy and on 35 subjects being a control group. The study of
      effectiveness of glottis or neoglottis performed with the use of laryngograph
      showed no relation between glottis/neoglottis occlusion effectiveness index and
      intensified swallowing disorders. This shows the lack of compensating option in
      swallowing disorders with the help of a mechanism based on an efficient glottis
      or neoglottis occlusion alone.

PMID- 11202335
TI  - [Ultrasonographic intraoperative evaluation of neoplastic changes in the tongue,
      tonsil, larynx, salivary and neck masses--preliminary report].
AB  - The new diagnostic method, intraoperative ultrasound is presented. There are very
      few publications in the literature, but they mainly concern the application of
      transcutaneous ultrasound in localizing the abscesses, their puncture and
      drainage. Intraoperative imaging of tongue, tonsil, larynx tumors, submandibular
      and parotid glands and neck masses have been provided by means of a linear 7.5
      MHz probe in Poznan ENT Dept. K. Marcinkowski University of Medical Sciences. The
      application of this method is pioneer and new. The aim of the study was to
      compare the sensitivity and the specificity of preoperative, transcutaneous
      ultrasound with the intraoperative one, to assess how the new method influences
      the extensiveness of the performed procedures and sonographic-surgical
      correlation of safety margins. MATERIAL: 5 patients with parotid tumors, 4 with
      tongue, 6 with tonsil and 6 with larynx cancers have been examined. In 13 of
      them, apart from primary site diagnostics, the neck masses have been assessed.
      The imaging documentation is presented and the preliminary conclusions concerning
      the usefulness of this method have been drown.

PMID- 11202336
TI  - [Androgens and laryngeal cancer].
AB  - The article concerns relations between larynx cancer and androgenic activity in
      men. Up till now the role of androgens in laryngeal carcinogenesis has not been
      established. Authors point out to andropenia (gonadal and supracortical) in
      elderly males and its influence on larynx cancer occurrence in the course of
      aging. Results of androgen receptor studies in unchanged and neoplastic tissue of
      the vocal organ are described. There is presented data on serum androgen
      concentrations in healthy men and patients with laryngeal neoplasms. The
      necessity of further studies of the larynx cancer's hormone-dependence is
      underlined.

PMID- 11202337
TI  - [Clinical significance of cytogenetic examinations in squamous cell carcinomas of
      the head and neck].
AB  - The karyotypes of head and neck cancer usually display complex chromosomal
      aberrations. There is no specific aberration in this type of cancer, although the
      rearrangement of chromosome 11 involving the band 11q13, often with its
      amplification, seems to be significant. Unfavourable prognostic factors are
      complex karyotype, aneuploidal DNA content and the rearrangement or amplification
      of 11q13 and are associated with shorter survival. Diploid DNA content is
      prognostically favourable in this type of neoplasm.

PMID- 11202338
TI  - [Functional coordination of upper airway ciliated cells].
AB  - Generation mechanism of the "calcium wave" in ciliated cells is presented.
      Influence of this phenomenon on ciliary activity is pointed out.

PMID- 11202339
TI  - [The vestibular system and migraine in children].
AB  - Migraine in childhood is relatively common disease. Although clinical practice
      and scientific publications recognize frequent association of migraine and
      vestibular disorders, relationships have yet to be well defined. In present study
      the vestibular function was extensively tested in 20 children suffering from
      migraine. All the patients underwent complete neurootological examination
      including tonal threshold audiometry, testing of vestibulo-spinal reflexes-
      Romberg and Unterberger-Fukuda tests, Dix-Halpike test for BPPV,
      videonystagmography. On videonystagmography each patient was evaluated regarding:
      calibration, spontaneous nystagmus, gaze nystagmus, eye tracking test,
      optokinetic and positional nystagmus, and caloric testing. The same procedure
      have been performed regarding control group comprised of 15 healthy. All the
      patients with migraine presented abnormalities in vestibular testing. Analysis of
      the results showed that: functional state of structures forming both visuo-ocular
      and vestibulo-ocular structures was altered in all the migraine patients
      evaluated in the study, pathological findings suggest mainly central localisation
      of vestibular dysfunction in children suffering from migraine, the number of
      pathological VNG findings seems not to be correlated with the type of migraine.

PMID- 11202340
TI  - [Bacteriologic evaluation of middle ear fluid during the course of secretory
      otitis media in children].
AB  - Fluid collected from tympanic cavity during operation from 43 children with
      O.M.S. was subjected to bacteriological examination. After the collection, each
      sample was immediately applied to Bactec Peds Plus/F liquid medium from Becton
      Dickinson. The number of samples, where each genus and species of bacteria were
      found, was determined, as well as the number of samples where every two genus
      coexisted; also the pH genes, in which each genus was found were calculated.
      Obtained results showed that 22 species of bacteria, belonging to 6 genus lived
      in the samples. The most commonly occurring genus were Staphylococcus,
      Streptococcus and Haemophilus; the most rare genus were Moraxella and Bacillus.
      The most common species were: Haemophilus influenzae (18.6% of samples),
      Staphylococcus aureus (14.0%), Staphylococcus epidermidis (11.6%), Staphylococcus
      warneri (9.3%) and Streptococcus oralis (7.0%). Streptococcus coexisted most
      frequently with Staphylococcus and Haemophilus; Staphylococcus--with Haemophilus
      and Bacillus; Haemophilus--with Streptococcus and Staphylococcus. The pH ranges
      for the three most often found genus were: for Staphylococcus--7.7-9, for
      Streptococcus--7.7-9.3 and for Haemophilus--8.2-8.8.

PMID- 11202341
TI  - [Cytologic nasal smears in patients with mucoviscidosis].
AB  - 58 cytological smears taken from the surface of the nasal mucosa of patients with
      mucoviscidosis were analysed. In 69% of the smears prevalence of pseudostratified
      columnar epithelium was present. Squamous metaplastic changes was found in 31% of
      the smears. Many goblet cells were present in 19% of the smears.

PMID- 11202342
TI  - [Bacteriologic evaluation of otitis externa and chronic otitis media].
AB  - The authors present results of bacteriological examinations in 187 patients with
      chronic otitis media (OMC) and otitis externa treated in ENT Department, Medical
      University of Gdansk in the years 1997-1998. Ear swabs and aspirates were
      investigated for aerobes and anaerobes 254 bacterial isolates were obtained.
      Among 150 patients with OMC aerobes were isolated in 130 (86.7%) in 13 (8.5%)
      mixed aero-anaerobes flore and in 20 (19.3%) no bacterial growth was observed.
      From patients with COM there were 199 bacterial isolates among them 177 aerobes
      cultures, 13 anaerobes and 9 fungal. From the external ear canal there were 55
      cultures, among them 45 (81.8%) aerobes, 6 (10.9%) mixed aero-anerobes and 4
      (7.3%) fungal. The most frequent observed bacteria were Staphylococcus aureus,
      Pseudomonas aeruginosa and Proteus mirabilis which showed the best susceptibility
      on ciprofloxacine and amikacine.

PMID- 11202343
TI  - [Rehabilitation of benign paroxysmal positional vertigo in the experience of the
      Wroclaw Clinics].
AB  - Mechanical disturbances in inner ear in cupulo-utricular complex are the cause of
      Benign Paroxysmal Positional Vertigo (BPPV). Pharmacotherapy is ineffective in
      such cases. The results of rehabilitation with the use of Semont of Epley
      manoeuvres in 46 patients were presented. The regression of symptoms in 24 cases
      treated with the use of Semont manoeuvre was achieved in 62% and in 22 cases
      treated with the use of Epley manoeuvre in 73%. Theoretical assumptions of
      effectiveness of treatment applied were discussed on the basis of cupulolithiasis
      and canalolithiasis theories.

PMID- 11202344
TI  - [Congenital laryngomalacia in children].
AB  - Laryngomalacia is the most common cause of congenital infantile stridor which is
      respiratory in all cases. It is first noted at birth and usually resolves
      spontaneously by the age of 2 years. In severe cases it may lead to life
      threatening obstructive apnea, cor pulmonale and failure to thrive, and in these
      patients surgical intervention may be required. This anomaly has been described
      in the medical literature for over 100 years. The purpose of this study is to
      review the literature, present terminology, types of laryngomalacia, cause,
      pathogenesis and relationship with other diseases. Finally, we describe the
      possible methods of its treatment.

PMID- 11202345
TI  - [Usefulness of chromosome alteration analysis in cell lines derived from
      laryngeal tumors for evaluation of laryngeal neoplasms].
AB  - A classical cytogenetic analysis was applied to analyse karyotypes of 9 cell
      lines derived from laryngeal cancer. The most frequent aberration was a deletion
      of the whole sex chromosome Y. An abundance of somatic chromosome alterations was
      further analysed to find correlation with tumour staging and grading. A
      conventional cytogenetic analysis seems to be not sufficient to recognize
      chromosome alterations specific for a given tumor stage. On the other hand, an
      analysis in respect to histologic grading has indicated for an association
      between rearrangement of 9 chromosome and a high tumor aggressiveness. It seems
      that a combination of conventional cytogenetics with molecular methods (FISH,
      CGH) would be helpful in diagnosing of laryngeal cancer.

PMID- 11202346
TI  - [Functional hearing loss in children].
AB  - The cases of children diagnosed with pseudohypacusis in the Department of
      Pediatric Otolaryngology were presented. Probable mechanism of its pathogenesis
      was described. The main stress was put on its correct diagnosis particularly in
      children with co-existing organic changes. Diagnosis of pseudohypacusis in
      children is not problematic provided that the occurence of this disease is taken
      into consideration during diagnostic procedures.

PMID- 11202347
TI  - [A case of long-term presence of a foreign body in the esophagus].
AB  - The following long-term presence of foreign body in esophagus in psychotic
      patient. Diagnostic and treatment principles of foreign body in esophagus was
      discussed.

PMID- 11202348
TI  - [A case of maxillary neurosarcoma].
AB  - A case of neurosarcoma located in maxillary sinus is presented. The patient was
      62 years old women who complained of nasal obstruction, epistaxis and headache.
      Results of physical examination showed a giant mass filling the nasal cavity and
      maxillary sinus. The lesion was completely resected by lateral rhinotomy way.
      After the operation histopathological diagnosis was difficult, one pathologist
      recognised schwannoma benignum other one sarcoma. Finally postoperative diagnosis
      was schwannoma benignum, it was misdiagnosis. Two years later the patient was
      surgically treated again because of tumor recurrence. These time pathological
      diagnosis was neurosarcoma. Radiotherapy was done as well. The patient died 18
      months after treatment, tumor regrowth and generalization metastases was reason
      of the death.

PMID- 11202349
TI  - [Osteoma of the maxillary sinus].
AB  - Osteomas of paranasal sinuses occur mainly in frontal and ethmoid sinus, in
      maxillary or sphenoid sinus are seen very rarely. The authors present a review of
      literature and next describe a case of spongioid osteoma in 42-years old female.
      The clinical features and radiologic assessment of the disease are presented. The
      tumour was resected by Caldwell-Luc operation with very good long term result.

PMID- 11202350
TI  - [Giant osteoma of the paranasal sinuses passing into the anterior cranial fossa].
AB  - A case of giant osteoma of paranasal sinus passing into anterior cranial fossa
      was presented. The frontal craniotomy in order to removing this tumor was
      applied. In any case of such tumor the CT seems to be a necessary examination.

PMID- 11202351
TI  - [A case of malignant parapharyngeal schwannoma in a 29-year old woman].
AB  - The schwannoma malignum of parapharyngeal space is a very uncommon tumor. The
      case of the malignant neurilemmoma located in parapharyngeal space in 29-year-old
      female, is presented in the paper. The tumor was removed through the cervical
      parotid approach. The post-surgery, follow-up examinations and CT check-up did
      not reveal any traces of recurrence.

PMID- 11202352
TI  - [Teratoma in the middle ear and throat of an infant].
AB  - The authors present a case of an 8-moth-old female infant treated for prolonged
      otitis media. The inflammatory process was connected with teratoma of tympanum
      and throat. The authors discuss presumable connection of the both masses. The
      child was completely cured by surgical treatment.

PMID- 11202353
TI  - [The case of a large orbital foreign body evacuated by lateral orbitotomy using
      the Kronlein-Reese-Berk method].
AB  - The authors describe a case of patient with orbital large foreign body (glass)
      treated using Kronlein lateral orbitotomy.

PMID- 11202354
TI  - [Retained teeth in the maxilla].
AB  - Two cases of retained teeth in maxilla, very rare disease seen in
      otolaryngological practice, are described. The authors present causes of this
      pathology, symptomatology, diagnostics and treatment. Diagnosis of retained teeth
      is made mainly by radiologic investigation i.e. CT and pantomography. A review of
      literature was made.

PMID- 11202355
TI  - [About the beginnings of otolaryngology in Poland in commemoration of the 150th
      anniversary of Teodor Heryng's birthday and the 100th anniversary of the founding
      of the first Laryngology Ward in Warsaw].
AB  - In this study was remain biography of two pioneers of polish laryngology--Teodor
      Heryng and Leopold Lubliner. The first laryngological subdivision in Warsaw was
      localised in St. Roch hospital. The first full equipment laryngological division
      where was open in Jewish hospital.

PMID- 11202356
TI  - [Struggles with nasal septum malformations in the XIX century].
AB  - The maxilla-premaxilla approach to extensive nasal septum surgery performed in
      1959 by M.H. Cottle and all is a obligatory method today. The struggle with a
      nasal septum deformations from the half of eighteenth of XIX century is presented
      (S.T. Quelmaltz). The correction of nasal septum by "the compression method",
      usually the vain method performed by A. Jurasz sen., P.L-B. Guersant, M. Warren,
      E.P. Chassaignac, F. Petersen and others are described in detail. The willful
      nasal septum perforation was performed by P.F. Blondin and P.T. Rupprecht. The
      special forceps were used by A. Jurasz sen. and R. Adams. The dorsum nasal cut
      was performed by J.N. Demarquay and B.R. Langenbeck. The destruction of inferior
      nasal concha was performed by M. Mackenzie and P. Delavan. The employment of
      galvanokauterization and electrolysis by A. Jurasz sen., F.E. Voltolini, C. Miot
      and E.M. Moure is mentioned. A description of fenestrated resection of septi nasi
      by Krieg in 1886 and then modified by G. Killian is presented.

PMID- 11202357
TI  - [Training of Polish physicians in rhinolaryngology in XIX century Vienna].
AB  - The eminent Viennese rhinolaryngologists in the XIX century were: Leopold
      Schroetter, Karl Stoerk, Johann Schnitzler, Ottokar Chiari, Markus Hajek and
      others. Stroerk, the pupil of Ludwig Turck was a head of rhinolaryngological
      clinic since 1891, he was also the author of valuable papers, among other things
      on rhinoscleroma. Schnitzler, the assistant of Johann R. von Oppolzer was a head
      of Viennese polyclinic. The therapeutical nihilism in Viennese clinics is
      mentioned. Ottokar Chiari, the assistant of Schroetter was an eminent
      rhinolaryngologist. Markus Hajek was a head of otorhinolarynoglogical clinic in
      Vienna performed in 1919. Theodor Billroth, professor of surgery in Vienna was
      the first to remove the larynx for cancer in 1873.

PMID- 11202358
TI  - [Studies on pathologic changes localized in the middle ear, their influence on
      hearing impairment and choice of surgical treatment].

PMID- 11202359
TI  - Bound transcription factor suppresses photoproduct formation in the NF-kappa B
      promoter.
AB  - The relationship between purified transcription factor p50 binding and
      ultraviolet light-induced DNA damage formation in the NF-kappa B promoter element
      was investigated. The effect of bound transcription factor on cyclobutane dimer
      formation was quantified using Maxam-Gilbert analysis of irradiated substrate
      digested with T4 phage endonuclease V. Two methods were employed for cleaving (6
      4) photoproducts. Sites of (6-4) photoproducts cleaved by piperidine showed a
      general suppression in the presence of bound p50 protein similar to that observed
      for cyclobutane dimers. In contrast to piperidine, digestion with ultraviolet
      damage endonuclease (UVDE) from Saccharomyces pombe subsequent to cyclobutane
      dimer reversal by photolyase displayed a broader spectrum of damaged sites.
      Whereas some of these sites were suppressed by bound p50 protein, some remained
      unaffected and one site showed increased (6-4) photoproduct induction. These data
      illustrate the advantage of UVDE over piperidine for studying (6-4) photoproducts
      at the sequence level and suggest that this approach may be useful for
      footprinting transcription factor binding in other promoters.

PMID- 11202360
TI  - Determination by fluorimetric titration of the ionization constants of
      ciprofloxacin in solution and in the presence of liposomes.
AB  - A fluorescence titration method was applied for the determination of pKa of
      ciprofloxacin (CPX) in solution. Values of 6.18 +/- 0.05 and 8.76 +/- 0.03 were
      obtained for pKa1 and pKa2, respectively. The method was used to determine the
      ionization constants in the presence of liposomes of
      dipalmitoylphosphatidylcholine (DPPC) and DPPC with 10 mol% of
      dipalmitoylphosphatidylglycerol. A dependence on the surface charge of liposomes
      was found which supported the existence of a basic electrostatic interaction
      between CPX and the phospholipid bilayer. Both pK values for the N-4 butyl
      piperazinyl derivative (BCPX) of the parent compound were also determined in
      solution and in the presence of liposomes. The competition of both drugs for the
      same binding site as 1-anilino-8-naphtalene sulfonate demonstrate that the
      interaction is governed by electrostatic forces.

PMID- 11202361
TI  - Dose response for ultraviolet radiation A-induced focal melanocytic hyperplasia
      and nonmelanoma skin tumors in Monodelphis domestica.
AB  - Four groups of 30 dorsally shaved opossums (Monodelphis domestica) were exposed
      to graded doses of ultraviolet radiation A (UVA) (320-400 nm) three times per
      week for 90 weeks. Animals were monitored for the appearance of focal melanocytic
      hyperplasia (FMH) and nonmelanoma skin tumors (NMST) during the course of the
      exposures and for an additional 20 weeks following termination of exposures. FMH
      is the putative precursor for melanoma in the opossum. The lowest dose of UVA
      (2.5 x 10(3) J/m2) used in this study was selected based on the action spectrum
      for the induction of melanoma in a fish model. The prediction was that 2.5 x
      10(3) J/m2 would induce FMH in the opossum if the action spectra for the
      induction of FMH in the opossum and melanoma in the fish were the same. The
      highest UVA dose was 2.5 x 10(5) J/m2. Only the highest dose of UVA gave a
      statistically significant induction of FMH and NMST in the opossum. As in
      previous studies, the FMH appeared earlier than the NMST during the course of
      exposures and the final prevalence of FMH was lower than the final prevalence of
      NMST. Overall, the results of this study indicate that the efficacy of UVA to
      induce FMH in the opossum is not as great as would be predicted from the action
      spectrum for melanoma induction in a fish model.

PMID- 11202362
TI  - Multi-waveband solar irradiance on tree-shaded vertical and horizontal surfaces:
      cloud-free and partly cloudy skies.
AB  - Irradiance measurements of short wave (SW), photosynthetically active (PAR),
      ultraviolet-A (UVA) and ultraviolet-B (UVB) solar radiations were made on
      horizontal and vertical surfaces in the shade of trees under cloud-free and
      partly cloudy skies. All measurements were referenced to the irradiance of a
      horizontal surface above the canopy. For horizontal shaded surfaces under cloud
      free skies, the values of the ratio (Rh) of below- to above-canopy horizontal
      irradiance were similar for the UVA and UVB wavebands and for the SW and PAR
      wavebands. However, Rh for the UV wavebands differed from that for the PAR and SW
      wavebands. Overall, values of Rh in the shade typically varied as PAR < SW << UVA
      < UVB. The irradiance ratios for vertical surface in the shade typically varied
      as UVB > UVA = SW > PAR. In absolute terms, UVB irradiance (Ih) on tree-shaded
      horizontal surfaces increased relative to a cloud-free sky when a translucent
      cirroform cloud was in front of the sun, but decreased when the cloud was in a
      region of sky away from the sun. Translucent cirroform cloud cover also tended to
      decrease the UVB irradiance (Iv) for a shaded vertical surface (either facing the
      sun or south) relative to that under cloud-free skies, regardless of where the
      clouds were in the sky. In all other wavebands the shaded Ih and Iv increased
      under translucent cirroform cloud cover relative to cloud-free skies, regardless
      of where the clouds were in the sky.

PMID- 11202363
TI  - Fluorescence imaging and spectroscopy of ethyl nile blue A in animal models of
      (pre)malignancies.
AB  - Discrimination between normal and premalignant tissues by fluorescence imaging
      and/or spectroscopy may be enhanced by a tumor-localizing fluorescent drug. Ethyl
      Nile Blue A (EtNBA), a dye with no phototoxic activity, was investigated for this
      purpose. The pharmacokinetics and tissue-localizing properties were investigated
      in a rat palate model with chemically induced premalignant mucosal lesions (0.5
      mg/kg EtNBA intravenous [i.v.]), a hairless mouse model with UVB-induced
      premalignant skin lesions (1 mg/kg EtNBA intraperitoneal) and in a rat skin-fold
      observation chamber model on the back of a rat with a transplanted solid tumor
      (2.5 mg/kg EtNBA i.v.). Fluorescence images and spectra were recorded in vivo
      (600 nm excitation, 665-900 nm detection) and in frozen tissue sections at
      several time points after EtNBA administration. In the rat palate the EtNBA
      fluorescence was maximum almost immediately after injection, whereas in the mouse
      skin and the observation chamber the fluorescence maximum was reached between 2
      and 3 h after injection. EtNBA cleared from tissues after 8-24 h. EtNBA localizes
      in the transplantable solid tumor, but is not targeted specifically to the
      dysplastic location in the rat palate and mouse skin. However, in the rat palate
      the EtNBA fluorescence increased significantly with increasing dysplasia,
      apparently due to the increasing thickness of the upper keratinized layer of the
      epithelium where the dye was found to localize. Localization in this layer
      occurred both in the rat palate and in hairless mouse skin.

PMID- 11202364
TI  - Investigation of cross-resistance to a range of photosensitizers, hyperthermia
      and UV light in two radiation-induced fibrosarcoma cell strains resistant to
      photodynamic therapy in vitro.
AB  - Two distinct photodynamic therapy-resistant variants of the murine radiation
      induced fibrosarcoma (RIF) cell line have been isolated. One strain displayed
      relative resistance over the parental RIF-1 strain to treatment with the
      porphyrin-based compound, polyhaematoporphyrin (PHP), whereas the other strain
      displayed relative resistance over the RIF-1 strain to treatment using the
      cationic zinc (II) pyridinium-substituted phthalocyanine (PPC). The PHP-resistant
      strain did not display cross-resistance to PPC-mediated treatment, and vice
      versa. In both PDT-resistant strains, the increased resistance could not be
      attributed to altered cellular growth rate, antioxidant capacity or intracellular
      sensitizer localization. The PHP-resistant strain displayed resistance to
      treatment with both short (1 h) and extended (16 h) sensitizer incubation
      periods, which may indicate that in this strain, the resistance has arisen
      through an alteration in a membrane component. Conversely, the PPC-resistant
      strain only displayed increased resistance over the parental cells to treatment
      involving the short drug incubation, which is likely to reflect the existence of
      a threshold effect caused by the alteration of an individual cellular target.
      Each resistant strain has been compared to the parental strain in terms of
      cellular sensitivity to treatment with a range of other photosensitizers,
      hyperthermia, UV light and the anticancer agent cis-diamminedichloroplatinum. The
      PHP-resistant strain exhibited crossresistance to photosensitization treatment
      using exogenously added protoporphyrin IX, and also to treatment with the anionic
      phthalocyanine sensitizers, zinc (II) tetrasulfonated phthalocyanine and zinc
      (II) tetraglycine-substituted phthalocyanine. The PPC-resistant strain did not
      display cross-resistance to any of the treatment strategies employed in this
      investigation. The results of this investigation indicate that there are at least
      two distinct mechanisms of PDT resistance in RIF cells, and that the mechanism of
      PHP resistance may, to some extent depend, upon the physical nature of the
      sensitizer molecule.

PMID- 11202365
TI  - Decreased efficiency of trypsinization of cells following photodynamic therapy:
      evaluation of a role for tissue transglutaminase.
AB  - Identifying the cellular responses to photodynamic therapy (PDT) is important if
      the mechanisms of cellular damage are to be fully understood. The relationship
      between sensitizer, fluence rate and the removal of cells by trypsinization was
      studied using the RIF-1 cell line. Following treatment of RIF-1 cells with
      pyridinium zinc (II) phthalocyanine (PPC), or polyhaematoporphyrin at 10 mW cm-2
      (3 J cm-2), there was a significant number of cells that were not removed by
      trypsin incubation compared to controls. Decreasing the fluence rate from 10 to
      2.5 mW cm-2 resulted in a two-fold increase in the number of cells attached to
      the substratum when PPC used as sensitizer; however, with 5,10,15,20 meso
      tetra(hydroxyphenyl) chlorine (m-THPC) there was no resistance to trypsinization
      following treatment at either fluence rate. The results indicate that resistance
      of cells to trypsinization following PDT is likely to be both sensitizer and
      fluence rate dependent. Increased activity of the enzyme tissue-transglutaminase
      (tTGase) was observed following PPC-PDT, but not following m-THPC-PDT. Similar
      results were obtained using HT29 human colonic carcinoma and ECV304 human
      umbilical vein endothelial cell lines. Hamster fibrosarcoma cell (Met B) clones
      transfected with human tTGase also exhibited resistance to trypsinization
      following PPC-mediated photosensitization; however, a similar degree of
      resistance was observed in PDT-treated control Met B cells suggesting that tTGase
      activity alone was not involved in this process.

PMID- 11202366
TI  - Porphyrin bleaching and PDT-induced spectral changes are irradiance dependent in
      ALA-sensitized normal rat skin in vivo.
AB  - Photobleaching kinetics of aminolevulinic acid-induced protoporphyrin IX (PpIX)
      were measured in the normal skin of rats in vivo using a technique in which
      fluorescence spectra were corrected for the effects of tissue optical properties
      in the emission spectral window through division by reflectance spectra acquired
      in the same geometry and wavelength interval and for changes in excitation
      wavelength optical properties using diffuse reflectance measured at the
      excitation wavelength. Loss of PpIX fluorescence was monitored during
      photodynamic therapy (PDT) performed using 514 nm irradiation. Bleaching in
      response to irradiances of 1, 5 and 100 mW cm-2 was evaluated. The results
      demonstrate an irradiance dependence to the rate of photobleaching vs irradiation
      fluence, with the lowest irradiance leading to the most efficient loss of
      fluorescence. The kinetics for the accumulation of the primary fluorescent
      photoproduct of PpIX also exhibit an irradiance dependence, with greater peak
      accumulation at higher irradiance. These findings are consistent with a
      predominantly oxygen-dependent photobleaching reaction mechanism in vivo, and
      they provide spectroscopic evidence that PDT delivered at low irradiance deposits
      greater photodynamic dose for a given irradiation fluence. We also observed an
      irradiance dependence to the appearance of a fluorescence emission peak near 620
      nm, consistent with accumulation of uroporphyrin/coproporphyrin in response to
      mitochondrial damage.

PMID- 11202367
TI  - The photochemistry of flutamide and its inclusion complex with beta-cyclodextrin.
      Dramatic effect of the microenvironment on the nature and on the efficiency of
      the photodegradation pathways.
AB  - The photochemistry of the anticancer drug flutamide (FM), 2-methyl-N-[4-nitro-3
      (trifluoromethyl)phenyl]propanamide, in homogeneous media and in the beta
      cyclodextrin (beta-CD) cavity has been investigated. The photoreactivity of the
      free molecule has been rationalized on the basis of an intramolecular nitro to
      nitrite rearrangement followed by cleavage of the nitrite intermediate. The
      twisted geometry of the nitro group with respect to the aromatic plane plays a
      key role in triggering such a photoprocess. Incorporation of FM in the beta-CD
      cavity leads to dramatic effects on both the efficiency and the nature of the
      photochemical deactivation pathways of the guest molecule. A 20-fold increase in
      the FM photodecomposition quantum yield and the formation of photoproducts
      originated by both reduction of the nitro group and cleavage of the amide bond
      were observed in the presence of the macrocycle. Such a behavior cannot be
      attributed exclusively to the micropolarity of beta-CD and/or to its role as a
      reactant. The induced circular dichroism spectra and the nature of the
      photoproducts formed in these experimental conditions provide indications that
      the photoreactivity in the beta-CD microenvironment could likely be mediated by
      structural changes of FM upon complexation.

PMID- 11202368
TI  - Topically applied eicosapentaenoic acid protects against local immunosuppression
      induced by UVB irradiation, cis-urocanic acid and thymidine dinucleotides.
AB  - UVB-induced immunosuppression, a promoter of photocarcinogenesis, involves the
      formation of pyrimidine dimers and cis-urocanic acid (cis-UCA), but reactive
      oxygen species (ROS) also plays an important role. Eicosapentaenoic acid (EPA)
      can inhibit photocarcinogenesis, but due to its polyunsaturated nature it is
      susceptible to oxidative damage by ROS. The antioxidant defense system may
      therefore be challenged upon ultraviolet-B (UVB) irradiation in the presence of
      EPA. We investigated whether topically applied EPA in mice could protect against
      local immunosuppression (contact hypersensitivity response to
      dinitrofluorobenzene) induced by UVB radiation (1.5 J/cm2), or topically applied
      cis-UCA (150 nmol/cm2) or thymidine dinucleotides (pTpT) (5 nmol/cm2). The
      influence of EPA on epidermal lipid peroxidation and antioxidant status was also
      measured. UVB irradiation, cis-UCA and pTpT all caused 70% immunosuppression.
      Topical pretreatment of mice with EPA partially protected against
      immunosuppression; the EPA dose needed to accomplish this was 10 nmol/cm2 for UVB
      irradiation, 100 nmol/cm2 for cis-UCA and 1000 nmol/cm2 for pTpT. Higher EPA
      doses caused higher UVB-induced lipid peroxidation and lower vitamin C levels.
      Glutathione only decreased with the highest EPA dose whereas vitamin E was not
      decreased after UVB irradiation. In conclusion, topically applied EPA protects
      against UVB-, cis-UCA- and pTpT-induced immunosuppression and maintenance of an
      adequate antioxidant defense seems to be an important prerequisite for the
      protective action by EPA.

PMID- 11202369
TI  - Studies of all-trans-retinal as a photooxidizing agent.
AB  - The photophysical properties of all-trans-retinal (RAL) have been extensively
      studied because of the importance of the retinoids in the visual process.
      However, little information is available regarding the participation of RAL in
      photochemical transformations such as photoxidation. RAL is one of several native
      chromophores that have been suggested to act as photosensitizers of damage in the
      human retina, and this damage would likely occur through oxidative pathways. Time
      resolved and steady state techniques have been used to examine the
      photoreactivity of RAL toward several suitable substrates. The lifetime of the
      RAL triplet excited state is observed to decrease with increasing concentration
      of the well-known electron and hydrogen atom donors, 2,3,5,6-tetramethyl-1,4
      phenylenediamine (DAD), hydroquinone (HQ), methylhydroquinone (MHQ), 2,3
      dimethylhydroquinone (DMHQ) and trimethylhydroquinone (TMHQ), although the
      bimolecular rate constants for the reaction are much less than that of diffusion
      controlled (2.9 x 10(7) M-1 s-1, 1.2 x 10(5) M-1 s-1, 1.2 x 10(5) M-1 s-1, 1.5 x
      10(5) M-1 s-1 and 1.6 x 10(6) M-1 s-1, for DAD, HQ, MHQ, DMHQ and TMHQ,
      respectively). In the presence of the donors, new absorptions grow concomitant
      with the decay of the triplet excited state, and for DAD and TMHQ, the observed
      spectra are similar to the spectra of p-phenylenediamine and TMHQ radicals.
      Irradiation of RAL in argon-saturated methanol results in fairly efficient
      photobleaching of RAL and in the formation of two new compounds having absorption
      spectra that are shifted below 300 nm. Irradiation of RAL in argon-saturated
      acetonitrile also results in photobleaching of RAL, but the reaction proceeds at
      a slower rate.

PMID- 11202370
TI  - Light-induced starch degradation in non-dormant turions of Spirodela polyrhiza.
AB  - Continuous red light controls starch degradation in turions of Spirodela
      polyrhiza [Dolger, K., U. K. Tirlapur and K.-J. Appenroth [1997] Photochem.
      Photobiol. 66, 126-127 (1997)]. This light could be replaced by repeated red
      light pulses with the reciprocity law fulfilled over a large range of fluence
      rates. The effect of red light pulses repeated every 24 or 12 h for 6 days was
      reversible by subsequent far-red light pulses. In contrast, hourly applied red
      pulses were irreversible by far-red light. This discrepancy was explained by
      showing the starch degradation activity of far-red pulses themselves. The
      investigated process was categorized as a phytochrome low fluence response with
      an unusual property: requirement of light treatment for several days. A partial
      fulfillment of this requirement was obtained with a red pulse followed by a dark
      period and a 24 h continuous irradiation. These results suggest the existence of
      two separate steps in the process of starch degradation in turions: formation of
      a sprout (= sink) during the pulse-induced germination, and starch degradation in
      the storage tissue (= source) induced by the second light treatment.

PMID- 11202371
TI  - Attenuation of DNA damage in the dermis and epidermis of the albino hairless
      mouse by chronic exposure to ultraviolet-A and -B radiation.
AB  - Mammalian skin is vulnerable to the photocarcinogenic and photoaging effects of
      solar UV radiation and defends itself using a variety of photoprotective
      responses including epidermal thickening, tanning and the induction of repair and
      antiradical systems. We treated Skh-1 albino hairless mice for 60 days with
      ultraviolet-A (UVA) or ultraviolet-B (UVB) radiation and measured the frequency
      of cyclobutane pyrimidine dimers and pyrimidine(6-4)pyrimidone photoproducts
      induced by a single acute sunburn dose of UVB at different stages of the chronic
      treatment. We found that both UVA and UVB exposure produced a photoprotective
      response in the dermis and epidermis and that the degree of photoproduct
      attenuation was dependent on dose, wavelength and the type of damage induced.
      Although epidermal thickening was important, our data suggest that UV protective
      compounds other than melanin may be involved in mitigating the damaging effects
      of sunlight in the skin.

PMID- 11202372
TI  - Equal-quantum action spectra indicate fluence-rate-selective action of multiple
      photoreceptors for photomovement of the thermophilic cyanobacterium Synechococcus
      elongatus.
AB  - Unicellular thermophilic cyanobacterium Synechococcus elongatus displayed
      phototaxis on agar plate at 55 degrees C. Equal-quantum action spectra for
      phototactic migration were determined at various fluence rates using the Okazaki
      Large Spectrograph as the light source. The shapes of the action spectra
      drastically changed depending on the fluence rate of the unilateral monochromatic
      irradiation: at a low fluence rate (3 mumol/m2/s), only lights in the red region
      had significant effect; at a medium fluence rate (10 mumol/m2/s), four major
      action peaks were observed at 530 nm (green), 570 nm (yellow), 640 nm (red) and
      680 nm (red). At high fluence rates (30-90 mumol/m2/s), the former two peaks
      remained, while red peaks at 640 nm and 680 nm disappeared and, interestingly, an
      action peak around 700-740 nm (far-red) newly appeared. These results indicate
      that two or more distinct photoreceptors are involved in the phototaxis and that
      suitable photoreceptors are selectively active in response to the stimulus of
      light fluence rates. Far-red or red background lights irradiated vertically from
      above drastically inhibited phototaxis toward red light or far-red light,
      respectively. These results indicate involvement of some phytochrome(s).

PMID- 11202373
TI  - Celiotomy closure via permanent implantation of polyamide in horses.
AB  - Permanent implantation of nonabsorbable materials is appropriate in many surgical
      circumstances but is not commonly used to close equine celiotomies. This paper
      describes a simple method of continuous nonabsorbable implantation of polyamide
      suture used successfully to close 48 equine celiotomies. Forty-eight clean or
      clean-contaminated celiotomies were successfully performed over 5 years using
      this technique. The postsurgical survival observation period ranged from 1-6
      years (median 3.5 years). There were 45 long-term survivors (93.75%). Only 2
      minor implant complications (4.4%) were observed and successfully corrected. This
      study demonstrates that appropriately prepared nonabsorbable polyamide suture can
      be used for safe and cost effective closure of clean and clean-contaminated
      equine celiotomies.

PMID- 11202374
TI  - The medical management of eight horses with grade 3 rectal tears.
AB  - Eight horses with Grade 3b rectal tears of the peritoneal part of the rectum or
      small colon were treated by a combination of medical therapy and dietary
      manipulation. All of the horses developed septic peritonitis during the course of
      treatment. Medical therapy consisted of a combination of penicillin, gentamicin
      and flunixin meglumine administered parenterally, metronidazole administered
      orally and liquid paraffin administered by nasogastric tube. Some horses also
      received fluid and electrolyte therapy i.v., plasma and heparin i.v. All horses
      were maintained on a laxative diet. Six of the 8 horses recovered. Duration of
      therapy in the horses that survived was between 2 and 7 weeks. Three of the 6
      horses that recovered developed a rectal diverticulum, which did not appear to
      cause any subsequent medical problems. In the 2 horses that died, the Grade 3
      rectal tear progressed to a Grade 4 tear with subsequent faecal contamination of
      the abdomen. Manual evacuation of the cavity of the rectal tears during treatment
      and size of the tears were identified as possible causes for the progression of
      the disease in these 2 horses.

PMID- 11202375
TI  - Equine lymphocytic-plasmacytic enterocolitis: a retrospective study of 14 cases.
AB  - Lymphocytic-plasmacytic enteritis (LPE) is a morphological diagnosis given to a
      type of infiltrative intestinal disease classified within the complex of
      idiopathic inflammatory bowel disease (IBD). The purpose of this retrospective
      study was to describe the details of breed, age and sex, clinical and
      clinicopathological findings and outcome of horses diagnosed with LPE. Data were
      reported from 14 horses that had a histopathological diagnosis of LPE; the median
      age was 12 years, and there was no breed or sex predilection. Common clinical
      signs were weight loss (100%), diarrhoea (50%) and lethargy (50%).
      Hypoproteinaemia and hypoalbuminaemia were present in 6/13 (46%) and 9/12 (75%)
      horses, respectively. Results of the oral glucose tolerance tests or D-xylose
      absorption tests were abnormal in 9/12 (75%) horses and rectal mucosal biopsies
      were abnormal in 3/7 (43%) horses. Corticosteroid treatment was used
      unsuccessfully in 4 horses. All horses were subjected to euthanasia and LPE was
      diagnosed at necropsy. Diffuse thickening of the small intestine was apparent
      grossly in 10/13 (77%) horses examined. LPE is an uncommon equine intestinal
      disease that is difficult to diagnose antemortem and has a poor prognosis.

PMID- 11202376
TI  - Prognostic indicators in a Danish hospital-based population of colic horses.
AB  - A prospective survey of 528 colic horses, referred to the Large Animal Hospital
      at the Royal Veterinary and Agricultural University of Copenhagen, Denmark,
      during the period August 1994 to December 1998, was undertaken to develop a
      predictive model for application in the clinical assessment of prognosis. In the
      multivariate logistic regression analysis, 357 colic cases were used in the
      elaboration of a simple clinical-practical model consisting of degree of pain,
      packed cell volume, capillary refill time and rectal temperature. The
      relationship between rectal temperature and outcome (survival/death) has been
      regarded as linear. It has also been reported to be nonsignificant. The present
      study suggests a strong U-shaped relation, which is easily transformed into a
      linear association and readily interpretable in the clinical situation if treated
      as a deviation from 38 degrees C. Several other clinical and laboratory variables
      were strongly related to outcome in the bivariate analysis. The changes in
      sensitivity and specificity of the multivariate model, when applied as a
      prognostic test, were presented with changing cut-off values. The cut-off value
      is the level, of predicted probability of death, at which the clinical decision
      to treat or subject to euthanasia is taken. The predictive performance of the
      model was further illustrated using a mortality of 19%. The optimal accurate
      classification for both survival and death was 87%, which was attained when a cut
      off value of 86% was selected. To minimise the number of horses unnecessarily
      subjected to euthanasia, the cut-off value was increased. However, this
      simultaneously increased the number of misclassified survivors, i.e. the number
      of horses that would die despite treatment. Outcome was especially poorly
      predicted in 4 horses, as was indicated by extreme deviance residuals. In 2 of
      these horses the large residuals were attributable to sudden and severe changes
      in the course of disease. All 4 horses had changes in variable values towards
      abnormality prior to death. Repeated measurements are therefore suggested in
      order to increase the test performance in general. The prerequisites of clinical
      application of prognostic models are critically discussed. The main findings of
      the present study indicate that degree of pain, packed cell volume, capillary
      refill time and temperature deviation from 38 degrees C, used in a logistic
      regression model, offer a strong model for clinical assessment of prognosis.

PMID- 11202377
TI  - Hypercoagulation and hypofibrinolysis in horses with colic and DIC.
AB  - Changes in haemostasis in horses with colic were assessed by using specific and
      sensitive markers of coagulation and fibrinolysis activity. Blood samples from 41
      horses with severe colic and from 30 healthy control horses were tested.
      Diagnosis of DIC was based on the findings of at least 3 of 6 abnormalities:
      thrombocytopenia, prolonged clotting times (PT and APTT), increased polyclonal
      FDPs, decreased fibrinogen and decreased AT-III activity. Plasma thrombin
      antithrombin III complexes (TAT), monoclonal fibrin degradation products fragment
      D (D-dimer) and monoclonal fibrinogen degradation products (FgDP) were also
      tested by using ELISA kits. DIC was diagnosed in 16 of 41 horses with colic.
      Compared to control and non-DIC colic values, TAT was significantly (P < 0.000)
      greater in horses with colic and DIC (Control group, mean +/- s.d. 2.6 +/- 2; non
      DIC colic group, 7.5 +/- 9, and DIC colic group, 30.9 +/- 36 ng/ml). Also, D
      dimer was significantly (P < 0.000) less in the DIC group when compared to
      control and non-DIC colic values (mean +/- s.d. 677 +/- 119, 682 +/- 220 and 399
      +/- 234 ng/ml, respectively). Compared to non-DIC colic values, FgDP was
      significantly (P < 0.05) lower in the DIC group (363 +/- 111, 437 +/- 230 and 293
      +/- 187 ng/ml respectively). Both PT and APTT showed a significant positive
      correlation with TAT. DIC was more common among nonsurvivors and horses with
      ischaemic bowel. We conclude that a hypercoagulative state was detected in horses
      with colic, which was stronger in horses with colic and DIC. Hypofibrinolysis was
      present only in horses with DIC. Therefore, marked hypercoagulation together with
      hypofibrinolysis are associated with DIC in horses.

PMID- 11202378
TI  - Effect of eltenac in horses with induced endotoxaemia.
AB  - Ten horses were used in a crossover study to evaluate the effectiveness of
      eltenac against endotoxaemia. Eltenac (0.5 mg/kg bwt) or saline control was given
      i.v. then 15 min later, intravenous infusion of endotoxin was begun and continued
      for 120 min (total dose 100 ng/kg bwt). Horses were monitored for heart and
      respiratory rates, pulmonary and carotid arterial pressure and core body
      temperature. Blood was sampled at intervals for measurement of haematological
      variables and plasma concentrations of lactate, prostanoid metabolites, tumour
      necrosis factor (TNF) and stress hormones. In comparison with saline-treatment,
      use of eltenac significantly protected against endotoxin-induced changes in
      respiratory rate, core temperature, systemic arterial blood pressure (SAP),
      pulmonary arterial pressure, PCV, and plasma protein, 6-keto prostaglandin F1
      alpha, thromboxane B2, epinephrine, and cortisol concentrations. Despite
      statistical effect of eltenac on SAP, values in both treatment groups remained
      well above baseline throughout the evaluation period. Significant protective
      effect of eltenac was not found for heart rate, white blood cell count, plasma
      lactate concentration or TNF activity. On the basis of these results, it is
      expected that use of eltenac will provide clinical benefit in horses with
      naturally occurring endotoxaemia.

PMID- 11202379
TI  - Colic surgery in 206 juvenile thoroughbreds: survival and racing results.
AB  - The purpose of our study was to determine the types of lesions that cause colic
      in juvenile Thoroughbreds, factors associated with these lesions and the
      subsequent survival and athletic performance of the juveniles. The age of
      juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an
      influence on the type of lesion causing colic. The short-term survival rate
      (discharge from the hospital) after colic surgery for foals was 85% and was
      strongly influenced by the lesion causing colic. Thirteen percent of juveniles
      recovered from the first surgery experienced another severe colic episode
      requiring additional surgery or euthanasia. Eight percent of foals recovered from
      the first celiotomy developed adhesions. Adhesion formation was related to the
      initial lesion causing colic and the foals' age at the first surgery. Foals being
      suckled (15 days to 6 months) were at greatest risk for adhesions and more
      frequently required multiple surgeries. Juvenile Thoroughbreds that had a
      celiotomy were significantly less able to race (63%) than their unaffected
      siblings (82%), and age at the initial surgery was associated with the percentage
      of horses that raced. However, affected foals able to race won as much money,
      raced as often, and made as many starts as their siblings. Colic and surgical
      treatment have a negative impact on athletic performance, but the majority of
      foals discharged from the hospital after colic surgery will perform athletically
      as adults.

PMID- 11202380
TI  - Investigation of an outbreak of tapeworm-associated colic in a training yard.
AB  - A novel serological assay which measures IgG(T) specific for a 12/13 kDa protein
      of the equine tapeworm Anoplocephala perfoliata was used as part of a colic
      outbreak investigation. A training/rehabilitation yard for Thoroughbreds and
      Arabs was found to have an increasing incidence of colic over a 5 year period,
      culminating in a peak incidence of 1.15 episodes/horse year at risk. Four animals
      suffered from ileal impaction colic which necessitated surgical management. A
      case-control study design suggested a strong association between tapeworm
      infection and colic, with evidence of a dose-response relationship. Intervention,
      in the form of anticestode anthelminthics, coincided with a decrease in the
      incidence of colic and a fall in anti-12/13 kDa IgG(T) antibody levels of 8
      horses monitored post-treatment. This study demonstrates that anthelminthic
      regimens, using exclusively ivermectin, may lead to an increase in tapeworm
      infection intensity which may in turn lead to an increased incidence of colic.
      Furthermore, it provides support to the hypothesis that the risk of ileal
      impaction colic and spasmodic colic increases with tapeworm infection intensity.
      The practical application of the anti-12/13 kDa IgG(T) ELISA is demonstrated by
      this study.

PMID- 11202381
TI  - The pursuit of knowledge and where it leads us.

PMID- 11202382
TI  - Short- and long-term survival and prevalence of postoperative ileus after small
      intestinal surgery in the horse.
AB  - The records of 74 horses that recovered from anaesthesia after surgery for a
      small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%)
      had a strangulating lesion and 43 of these (68%) had a resection and anastomosis.
      Four of 11 horses (36%) without a strangulating lesion had a resection and
      anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate
      of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others.
      For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23)
      and for no resection (92%; 23/25) were superior (P < 0.05) to survival for
      jejunocaecal anastomosis (76%; 19/25). Fourteen horses (19%) had a repeat
      abdominal surgery during hospitalisation; 9 of these (64%) survived short-term.
      Postoperative ileus developed in 7/70 horses (10%) after surgery for a problem
      other than proximal enteritis, and all had a strangulating lesion. Postoperative
      ileus (POI) was more likely after a jejunocaecostomy than after other procedures,
      and did not develop after a jejunojejunostomy. Survival > 7 months was 52/69
      (75%) and for > 12 months was 39/57 (68%). The estimated prevalence of adhesions
      was 13%. Short-term survival was poorest in horses that had a jejunocaecostomy,
      but long-term survival was less affected by the anastomosis used. The sharpest
      decline in survival was during the first postoperative week and postoperative
      mortality then declined over time after surgery. A postoperative protocol that
      allowed early postoperative feeding was well tolerated. The results confirm that
      the overall prognosis after small intestinal surgery in horses is improved over
      earlier findings.

PMID- 11202383
TI  - Effect of extensive ileal resection with a large resulting mesenteric defect and
      stapled ileal stump in horses with a jejunocaecostomy: a comparison with other
      anastomotic techniques.
AB  - Extensive resection of the ileum of the horse, using automated stapling equipment
      followed by a stapled jejunocaecostomy, without closure of the mesenteric defect,
      was evaluated prospectively as a surgical treatment for lesions involving the
      distal small intestine. Of 153 horses treated surgically for colic, 10 horses
      with strangulating lesions involving the distal ileum were treated by extensive
      resection and jejunocaecal anastomosis leaving a residual mesenteric defect.
      These were compared with 12 horses with jejunoileal lesions treated by
      jejunocaecal anastomosis with closure of the mesentery, and 19 horses with distal
      jejunal lesions treated with an end-to-end jejunojejunal anastomosis and
      mesenteric closure. Long-term (> 7 months) and short-term survival, duration of
      surgery, length of intestine resected, time from completion of surgery until the
      horse first defaecated and the highest recorded postoperative plasma fibrinogen
      level were assessed. There were no significant differences between the surgical
      techniques for any of the assessed parameters, but there was a trend to
      significance with a higher death rate following discharge from the hospital when
      cases of jejunocaecal anastomosis with a residual mesenteric defect were compared
      to cases of end-to-end jejunojejunal anastomosis with closure of the mesentery (P
      = 0.06). This study suggests that a stapled distal ileal resection and
      jejunocaecal anastomosis leaving a residual mesenteric defect is a satisfactory
      technique when pathological changes necessitate resection of the distal ileum.
      However, in this study, jejunocaecal anastomosis with or without mesenteric
      closure produced inferior results compared to jejunojejunal anastomosis.

PMID- 11202384
TI  - The role of cyclooxygenase inhibitors in repair of ischaemic-injured jejunal
      mucosa in the horse.
AB  - Cyclooxygenase inhibitors are administered to horses to prevent endotoxin-induced
      elaboration of prostaglandins. However, PGE2 and PGI2 stimulate repair of injured
      intestine. There are 2 isoforms of cyclooxygenase: COX-1, which constitutively
      produces prostaglandins and COX-2, which is induced by inflammation. We
      hypothesised that the nonspecific cyclooxygenase inhibitor flunixin meglumine
      would retard repair of ischaemic intestinal injury by preventing production of
      reparative prostaglandins, whereas the selective COX-2 inhibitor, etodolac, would
      permit repair as a result of continued COX-1 prostaglandin production. Segments
      of equine jejunum were subjected to ischaemia for 1 h, and recovered for 4 h in
      Ussing chambers. In ischaemic tissue, treated with the nonspecific cyclooxygenase
      inhibitor, flunixin meglumine (2.7 x 10(-5) mol/l), production of PGE2 and PGI2
      was inhibited, and there was no evidence of recovery based on measurements of
      transepithelial resistance. Conversely, untreated ischaemic tissues or tissues
      treated with the specific COX-2 inhibitor etodolac (2.7 x 10(-5) mol/l) had
      significant elevations in PGE2 and PGI2, and significant recovery of
      transepithelial resistance. These studies suggest that specific COX-2 inhibitors
      may provide an advantageous alternative to nonspecific cyclooxygenase inhibitors
      in horses with colic.

PMID- 11202385
TI  - Putting theory into practice.

PMID- 11202386
TI  - Diagnosis and treatment of chronic recurrent caecal impaction.
AB  - Ninety-six horses with chronic recurrent caecal impaction associated with
      hypertrophy of muscle layers in the caecal base or in the whole caecum were
      examined from 1990 to 1996. Enlargement of the caecocolic orifice was completed
      surgically in 58 horses. Of those horses having surgery, 50 were discharged from
      the hospital while 8 were subjected to euthanasia at the hospital due to
      complications. Twenty-seven of the 50 horses discharged were normal at follow-up
      while 23 died or were subjected to euthanasia due to acute or recurrent colic,
      recurrent impaction in the ascending or descending colon, complete caecal muscle
      layer hypertrophy, stomach rupture or lymphosarcoma. Approximately 50% of the
      cases were successfully treated by surgical enlargement of the caecocolic
      orifice. The results suggest, on the other hand, that enlargement of the
      caecocolic orifice was not successful in treating horses with hypertrophy of the
      caecal muscle layer in the whole caecum.

PMID- 11202387
TI  - Muscle thickness and neuron density in the caecum of horses with chronic
      recurrent caecal impaction.
AB  - In this study, the hypothesis that caecal smooth muscle layers would be thinner
      and the linear neuron density of myenteric plexus greater was tested in normal
      horses compared to those with chronic recurrent caecal impaction. Four normal
      horses and 18 horses with chronic recurrent caecal impaction were subjected to
      euthanasia and 7 tissue samples were collected from each horse at different
      regions of the caecum (apex, dorsal body, cranial base, dorsal base, caudal base,
      caudal body, ventral body). Twelve horses with chronic recurrent caecal impaction
      were treated surgically. Only one tissue sample of the cranial part of the caecal
      base close to the caecocolic orifice was taken during surgery. The thickness of
      the circular muscle layer of all caecal regions measured in killed horses with
      chronic recurrent caecal impaction was significantly increased compared to the
      equivalent caecal region of normal horses. On the other hand, the longitudinal
      muscle layer was significantly thicker only in the cranial and caudal caecal base
      and in the dorsal region of the caecal body. The linear neuron densities of all
      caecal base areas and 2 caecal body regions, the caudal body region and of the
      apex, of killed horses with chronic recurrent caecal impaction were significantly
      lower compared with those in clinically normal horses. The circular muscle layer
      of all caecal regions was thickened (hypertrophied) probably as a consequence of
      chronic uncoordinated hypercontractility due to neuron deficit in the myenteric
      plexus of the caecal base.

PMID- 11202389
TI  - Caecocaecal and caecocolic intussusceptions associated with larval cyathostomosis
      in four young horses.
AB  - This report describes the clinical and pathological features of 4 horses affected
      by caecocaecal or caecocolic intussusceptions associated with larval
      cyathostomiasis. In each case, there was clinical and/or pathological evidence of
      concurrent larval cyathostomosis. They all demonstrated variable signs including
      diarrhoea, pyrexia, weight loss and subcutaneous oedema and cyathostome larvae
      were identified in the faeces of 3 of the horses. These cases highlight the need
      to consider caecal intussusceptions as a possible complication in horses affected
      by larval cyathostomosis, especially where signs of abdominal pain are severe or
      persistent.

PMID- 11202388
TI  - Caecal impactions managed surgically by typhlotomy in 10 cases (1988-1998).
AB  - Surgical management of caecal impactions has included several different
      procedures suggested over the years. Complete bypass of the caecum through an
      ileocolic or jejunocolic anastomosis has become common practice for first time
      caecal impaction management, especially when dysfunction is suspected. In our
      practice, however, caecal impactions have been managed surgically by typhlotomy
      alone and of the 10 cases (July 1988-June 1998), 9 underwent surgery for first
      time caecal impactions, received a typhlotomy, and had survived an average of 43
      months at time of case review. At the time of surgery, all were considered to
      have a dysfunctional caecum. All horses received routine postoperative care with
      the addition of anthelmintics as recovery of Anoplocephala perfoliata occurred in
      several cases. Typhlotomy should be considered an acceptable technique for
      surgical management of first time caecal impactions. Postoperative pyrantel
      pamoate and larvicidal anthelmintics should also be considered.

PMID- 11202390
TI  - Intestinal motility and impactions.

PMID- 11202391
TI  - Design and clinical use of a modified colon tray for large colon evacuation in
      the horse.
AB  - A modified colon tray to perform large colon evacuations in horses was designed.
      A funnel-shaped accessory was constructed to create a mechanical separation
      between the sterile and nonsterile part of the tray. Sterile hooks were used to
      make a temporary and stabile colostomy. Thirty horses with surgical correction of
      nonstrangulating large colon obstruction underwent a large colon evacuation with
      this modified tray. The surgical procedure was uncomplicated and resulted in a
      positive outcome in 29 horses. This less labour-intensive way to evacuate the
      large colon results in minor contamination and makes extraluminal lavage becomes
      superfluous. This modified tray is a very efficacious and practical instrument
      for emptying the large colon in horses.

PMID- 11202392
TI  - Segmental eosinophilic colitis: a review of 22 cases.
AB  - Twenty-two horses with colic, referred to the University of Liverpool Equine
      Hospital (1992-1998), were found at laparotomy to have a partial obstruction of
      the large colon caused by a segmental mural lesion located in the left dorsal
      colon. The decision to take the horses to surgery was based on rectal examination
      findings of secondary impaction and mural oedema of the large colon and turbid
      peritoneal fluid containing large numbers of neutrophils obtained by
      paracentesis. The affected segment of colon showed oedema and serosal changes
      varying from erythema to well-defined necrosis. These pathological changes were
      considered to be sufficiently severe in 16 horses to merit partial resection of
      the left colon. Histology revealed varying degrees of mucosal necrosis, marked
      submucosal oedema and infiltration with large numbers of eosinophilic leucocytes.
      No cause was identified for the lesions. Sixteen of the 18 horses discharged from
      the hospital were alive 3 months to 7 years after surgery and have returned to
      their previous type of work and level of performance. The remaining 2 horses were
      subjected to euthanasia because of a recurrence of colic but no autopsy was
      performed.

PMID- 11202393
TI  - Nephrosplenic entrapment in the horse: a retrospective study of 174 cases.
AB  - The clinical findings and outcome of 161 horses diagnosed with 174 episodes of
      nephrosplenic entrapment (NSE) were reviewed retrospectively. The median age at
      presentation was 5 years (9 months to 24 years), and duration of colic was 2-92
      h. Nasogastric reflux was present in 49 of 113 horses (43.4%) and was significant
      (> or = 21) in 32 (28.3%) horses. The recurrence rate was 13/161 (8.1%). Thirteen
      horses (13/174, 7.5%) had other lesions including small intestinal obstruction
      (4), 360 degrees large colon torsion (5), gastric rupture (2), thromboembolic
      colic (1) and small colon infarction (1). Of 115 cases, in 107 horses treated by
      surgery alone, 2 horses required a large colon resection, and 8 (8/107, 7.5%)
      horses died or were subjected to euthanasia. Twenty-six of 35 horses (74%) were
      successfully corrected by rolling under general anesthesia and, of the 9 horses
      taken to surgery after rolling, 4 had other lesions and 2 were corrected at
      surgery. Phenylephrine was used in 20 of 35 horses that were rolled and 2 horses
      required surgery after rolling with phenylephrine. Five horses were jogged after
      phenylephrine administration and all were successfully corrected. Eleven horses
      presented with the left colon located between the spleen and the body wall were
      treated successfully by fasting and/or i.v. fluids. One horse had a gastric
      rupture after rolling. The overall success rate was 92.5%. In conclusion, NSE is
      a condition associated with a good prognosis for medical or surgical correction.
      A small number of horses may have additional gastrointestinal lesions, which may
      affect outcome.

PMID- 11202394
TI  - Evaluation of uniformity of morphological injury of the large colon following
      severe colonic torsion.
AB  - This report describes the evaluation of uniformity of morphological injury of the
      large colon following severe colonic torsion in 17 horses presented to the
      Veterinary Medical Teaching Hospital. In 16 horses, twist occurred at the colonic
      base and in 1 at the sternal and diaphragmatic flexure. Eleven of the 17 horses
      were subjected to euthanasia at surgery and 6 of 17 following surgical correction
      within 4 days postoperatively. The objective of this study was to determine if
      the degree of histological changes present at the pelvic flexure were uniformly
      distributed throughout the regions of the colon involved in cases of severe
      colonic torsion.

PMID- 11202395
TI  - [Specifics of realization of general bioethical principles in military medicine].

PMID- 11202396
TI  - [Actual problems of technical and metrological support of the extreme medicine
      service in Russia].

PMID- 11202397
TI  - [Principles of diagnosis formulation based on requirements of the International
      statistical classification of diseases and health-related problems].

PMID- 11202398
TI  - [Pharmacoeconomic aspects of therapy of pneumonia in a hospital].
AB  - In the article the assessment of hospital treatment cost of patients with
      pneumonia under conditions of district military clinical hospital is given. The
      analysis of cost of complete treatment course has shown that the most expensive
      is therapy of patients with severe and moderately severe pneumonia (6083 and 4608
      rubles). Depending on pneumonia severity the treatment expenses increases on the
      average by 49%. The main treatment expenses in pneumonia under hospital
      conditions are medical-and-diagnostic, which determine the other items of
      expenditure.

PMID- 11202399
TI  - [Rotational digital subtraction angiography for selective investigation of
      autovenous aortocoronary shunts in patients with coronary heart disease].

PMID- 11202400
TI  - [The role of blood alcohol dehydrogenase in pathological alcohol involvement].
AB  - The authors have revealed the distinct parallelism between clinical state of
      patients with alcoholism, activity of alcohol dehydrogenase (ADG) in their blood
      plasma and presence of signs of pathologic inclination for alcohol (PIA). The
      marked PIA signs were accompanied by high ADG activity in blood. It permits to
      combine the presence of PIA and enzyme high activity into single pathogenetic
      mechanism and suggest that together with metabolic function ADG performs the
      receptor one. Also it is possible to assume that use of drugs decreasing ADG
      activity and restoring ethanol content in organism of patients with alcoholism
      will contribute to PIA release. Use of such drugs can become one of the safe
      methods in alcoholism therapy.

PMID- 11202401
TI  - [Therapeutic efficacy of Ruzam+ cream].

PMID- 11202402
TI  - [Infectious dermal lesions in malignant lymphomas].

PMID- 11202403
TI  - [A novel method of cystoplasty after cystectomy in cancer].
AB  - A new method of cystoplasty with free musculocutaneous graft on vascular crus was
      developed and introduced into clinical practice. This method satisfies the
      requirements necessary for artificial urinary bladder that are created from the
      segment of small intestine and considered as a "gold standard" in the treatment
      of such pathology. Good anatomic-and-functional results (urination way usual for
      the patient is remained, the volume of reservoir being created is sufficient, low
      urine pressure, anti-reflux mechanism and preservation of upper urinary tracts)
      permit to recommend the method for clinical study and use.

PMID- 11202404
TI  - [New approaches to organization and medical examination of servicemen (Experience
      of the 52d Consultative and Diagnostic Center of Department of Defence of the
      Russian Federation].
AB  - New approaches to organization and conduction of prophylactic medical examination
      of servicemen were developed, scientifically grounded and introduced into the
      practice in Consulting-and-diagnostic Center N 52 of RF MD. Owing to it the
      quality and effectiveness of prophylactic examination have increased, the real
      picture concerning the health of contingents being served (passport of health)
      was obtained, the duration of profound medical examination, financial expenses
      and trained resources for conduction of profound medical examination and regular
      medical check-up with significant improvement of their quality have minimized.

PMID- 11202405
TI  - [Mobile medical units for rendering first medical aid].

PMID- 11202406
TI  - [Modern preparations for medical prophylaxis].

PMID- 11202407
TI  - [Rights and privileges of blood donors].

PMID- 11202408
TI  - [Organization of the surgical care of the wounded during the beginning of the
      World War II].

PMID- 11202409
TI  - [N. I. Pirogov's relics in the Museum of Military Medicine (on the 190th birthday
      of N. I. Pirogov)].

PMID- 11202411
TI  - Polymorphism of gonadotropin action: clinical implications.
AB  - It has recently became apparent that the structural heterogeneity of gonadotropin
      molecules can contribute to variations of their action in different physiological
      and pathophysiological conditions. One reason for the structural variations of
      circulating gonadotropin molecules is the microheterogeneity caused by the
      variability of glycosylation of individual gonadotropin molecules. The
      carbohydrate moieties of gonadotropins are important for their intrinsic
      bioactivity, as reflected by measurement of their bioactivity to immunoreactivity
      (B/I) ratios. We have reassessed this phenomenon by improved in vitro bioassay
      and immunoassay methods, and it appears that the intrinsic bioactivity of
      gonadotropins, in particular of LH, is more constant than previously assumed.
      Many of the previously documented differences, some even considered diagnostic
      for certain clinical conditions, have turned out to be methodological artifacts.
      The first part of this review summarizes our recent findings on the B/I ratios of
      LH, with special reference to the male. The second part of this review describes
      a common polymorphism that was recently discovered in the gene of the LH beta
      subunit. The variant LH beta allele contains two point mutations, which introduce
      to LH two amino acid changes and an extra glycosylation site. The LH variant is
      common world-wide, with carrier frequency varying from 0 to 52% in various ethnic
      groups. The LH variant differs functionally from wild-type LH, and it seems to
      predispose its carriers, both men and women, to mild aberrations of reproductive
      function. It is important for the clinician to be aware of this variant LH form,
      not detected by all immunoassays, because it may explain some aberrant results of
      LH measurements in patient samples.

PMID- 11202412
TI  - Long-term administration of large doses of paracetamol impairs the reproductive
      competence of male rats.
AB  - AIM: To evaluate the antireproductive effect of paracetamol in male rats.
      METHODS: Male rats were orally administered daily with 500 mg/kg or 1000 mg/kg of
      paracetamol for 30 consecutive days. Their sexual behaviour and fertility were
      evaluated using receptive females. RESULTS: At 2 h after treatment, sexual
      behaviour was not inhibited but on day 30 both doses of paracetamol caused marked
      impairment of libido (assessed by % mounting, % intromission and % ejaculation),
      sexual vigour (number of mounts and intromissions and copulatory efficiency) or
      sexual performance (intercopulatory interval). In mating experiments, the
      fertility (in terms of quantal pregnancy, fertility index, implantation index and
      number of implants) was significantly reduced. All these effects were reversible.
      The antireproductive effect was not due to a general toxicity but due to an
      increase in pre-implantation losses resulting from oligozoospermia, impairments
      of normal and hyper-activated sperm motility, and reduction in the fertilizing
      potential of spermatozoa. CONCLUSION: Long-term use of high doses of paracetamol
      may be detrimental to male reproductive competence.

PMID- 11202414
TI  - Xenoesterogens and male infertility: myth or reality?
AB  - AIM: To evaluate the role of polychlorinated biphenyls (PCBs) as a potential
      environmental hazard in the deterioration of male fertility. METHODS: Fifty-three
      males were studied. After a thorough case history evaluation and relevant
      clinical and laboratory investigations, PCBs were estimated in the seminal plasma
      of 21 infertile men with "Unexplained Male Factor" and 32 fertile controls. Peak
      retention times of the eluants were compared with those of the commercially
      available standard PCB Mix, and the results confirmed spectrophotometrically.
      Seminal PCB concentrations were compared between i) fertile and infertile men and
      ii) men from different areas and diets. The relationship between PCB
      concentrations and measures of sperm quality such as the total motile sperm
      count, was assessed. RESULTS: PCBs were detected in seminal plasma of infertile
      men but absent from controls. Sperm quantity and quality were significantly lower
      in infertile men compared to controls. The highest average PCB concentrations
      were found in fish-eating urban dwellers, and followed in succession by fish
      eating rural dwellers, non fish-eating urban dwellers and non fish-eating rural
      dwellers. The total motile sperm counts were inversely proportional to the PCB
      concentrations and were significantly lower than those of the respective
      controls. CONCLUSION: PCBs may be instrumental in the deterioration of sperm
      quantity and quality, a contaminated fish diet being the main source of exposure.

PMID- 11202413
TI  - Effect of testicular capsulotomy on secretion of testosterone and gonadotrophins
      in rats.
AB  - AIM: In order to clarify further the mechanisms underlying the effect of
      capsulotomy on testicular function, the levels of testosterone, LH and FSH were
      observed. METHODS: Intratesticular testosterone levels and LH, FSH levels in the
      peripheral blood of normal, sham-operated and capsulotomized rats were detected
      by RIA. RESULTS: After testicular capsulotomy, there was a progressive reduction
      in the testosterone level in the testicular venous blood together with a
      progressive increase in the LH and FSH levels in the peripheral blood from
      approximately 30 days post-capsulotomy. Morphological changes were observed at 5
      10 days after capsulotomy, i.e., far ahead of the hormonal changes. CONCLUSION:
      The seminiferous tubular damage after testicular capsulotomy was not caused by
      the reduction in testosterone, and on the contrary, the hormonal change might be
      secondary to the morphological alterations. The increase in LH level most likely
      resulted from a negative feedback influence from the lowered testosterone level,
      while the increase in FSH secretion may be a feedback signal of the damaged
      seminiferous tubules.

PMID- 11202415
TI  - Production of chicken chimeras by fusing blastodermal cells with electroporation.
AB  - AIM: To establish techniques for producing somatic and germline chimeric chicken
      by transferring blastodermal cells fused with electroporation. METHODS: Stage-X
      blastodermal cells isolated from freshly laid fertile unincubated white Leghorn
      and Rhode Island red chicken eggs were fused with electroporation. The treated
      cell suspension was transferred to the recovery medium (DMEM containing 10% FBS)
      and was injected into the subgerminal cavity of recipient unincubated embryos
      (stage X). RESULTS: Of 177 recipient embryos injected with the fusing
      blastodermal cells, 6 (3.4%) survived to hatching. Somatic chimerism was examined
      in the melanocyte of the feather. The presence of feathers originating from the
      donor cell was observed in 1 bird (16.7%) out of the 6 hatched birds. After 21
      days of incubation two birds out of five embryos were subjected to polymerase
      chain reaction (PCR) analysis for W-chromosome-specific DNA for each tissue. One
      bird possessed W-chromosome-specific DNA in the stomach, and the other exhibited
      the same DNA in the left and right gonads and other tissues, but not the stomach.
      CONCLUSION: Recipient embryo having electrofused blastodermal cells yields
      somatic and germline chimeric chickens more successfully.

PMID- 11202416
TI  - Purification and characterization of rat testicular glutathione S-transferases:
      role in the synthesis of eicosanoids.
AB  - AIM: Purification of glutathione S-transferases (GSTs) from rat testis;
      separation and identification of various subunits and their role in eicosanoid
      biosynthesis. METHODS: Purification of rat testicular GSTs by affinity
      chromatography, employing S-hexylglutathione-linked epoxy-activated Sepharose 6B
      column and separation of individual subunits by reverse phase-high pressure
      liquid chromatography (RP-HPLC). Characterization of affinity purified GSTs by
      Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western
      blot analysis. The role of testicular GSTs in eicosanoid biosynthesis was
      determine by incubating GSTs with 5, 6-Leukotriene A4Me (LTA4Me) and
      prostaglandin H2(PGH2) and analyzing the products formed on HPLC/TLC. RESULTS:
      The present study reveals that majority of rat testicular GSTs are of Yb size
      (60%) with molecular weight of 27 kDa. The most predominant subunits, however,
      are GST Yn2(27%), followed by GST Yc(24%) and GST Yn1(20%). These testicular GSTs
      showed very high Leukotriene C4 (LTC4) synthase activity with 5, 6-Leukotriene
      A4Me (LTA4Me) as the substrate and prostaglandin D (PGD) synthase activity with
      prostaglandin H2(PGH2) as the substrate. CONCLUSION: Majority of rat testicular
      GSTs are Yb sized and are involved in the synthesis of eicosanoids like LTC4 and
      PGD2.

PMID- 11202417
TI  - Low dose gossypol for male contraception.
AB  - AIM: To ascertain whether the side effects of gossypol, hypokalemia and
      irreversibility, could be avoided on dose reduction. METHODS: Seventy-seven male
      volunteers were divided into 3 groups: control (22 cases), 10 mg gossypol (29
      cases) and 12.5 mg (26 cases). Serum levels of testosterone, FSH and LH were
      measured by RIA and potassium by flame photometry. Sperm counts and motility were
      examined before and regularly after treatment for the evaluation of contraceptive
      efficacy. RESULTS: The average sperm density and motility started to decrease
      significantly by the end of month 2 of medication and gradually reached the
      infertility levels (< 4 million/mL) in both treated groups. After that the 10 mg
      group was asked to take the same dose every other day for up to a total
      observation period of 16-18 months for the maintenance of infertility. Subjects
      in the 12.5 mg group did not take gossypol any more so as to observe the length
      of the loading dose required, but in a few, a maintenance dose of 12.5 mg every
      other day was instituted for a few more months. In both treated groups, none of
      the spouses was pregnant during the maintenance dose period. Serum levels of
      potassium, FSH, LH and testosterone were not significantly changed and not a
      single volunteer complained of myoasthenia. After cessation of drug
      administration, the semen data returned to pretreatment levels. CONCLUSION: A
      regimen with 10 or 12.5 mg of gossypol as the daily loading dose and 35 or 43.75
      mg as the weekly maintenance dose could induce infertility in male volunteers
      without developing hypokalemia or irreversibility.

PMID- 11202418
TI  - Inductively coupled plasma emission spectroscopic and flame photometric analysis
      of goat epididymal fluid.
AB  - AIM: The elemental composition of the epididymal luminal fluid (ELF) in adult
      goat (Capra indica) was investigated. METHODS: ELF was collected by micropuncture
      from twelve sites along the epididymal duct. The elemental contents was analyzed
      with inductively coupled plasma (ICP) emission spectroscopy, a microanalytical
      technique that can simultaneously measure many elements in minute volumes of
      sample. The Na and K concentrations were determined by flame photometry. RESULTS:
      ICP spectroscopy showed the presence of copper, calcium, nickel, iron, magnesium,
      chromium, titanium and zinc in ELF, with fluctuating levels at different sites
      along the length of the epididymis. Cadmium, cobalt, lead and manganese were not
      found. The Na+/K+ ratio was seen to be higher at the initial segments of the
      epididymis and lower at the distal. CONCLUSION: It is proposed that the observed
      characteristic distribution of elements in ELF may have far reaching implications
      in sperm maturation and storage known to occur in the epididymis.

PMID- 11202419
TI  - Cytogenetic and andrological status and ICSI-results in couples with severe male
      factor infertility.
AB  - AIM: To pursue whether cytogenetic aberrations correlate with specific
      spermatological or hormonal abnormalities. METHODS: 305 infertile couples were
      investigated. All male partners were referred to a complete andrological work-up
      with physical examination, determination of hormones, HIV testing and semen
      analysis. Cytogenetic analysis was carried out in both partners by means of
      standard techniques using cultured lymphocytes from peripheral blood. RESULTS:
      Among the 305 couples, 10 men (3.2%) and 10 women (3.2%) showed constitutional
      chromosomal aberrations, including reciprocal translocations (n = 7),
      Robertsonian translocations (n = 3), inversions (n = 3), other structural
      aberrations (n = 4) and sex chromosome aberration (n = 3). In addition to the
      impaired sperm count in most of the patients, a tendency to an increased
      proportion of spermatozoa with acrosome defect was observed. CONCLUSION:
      Chromosomal aberrations may contribute to the low fertilization and pregnancy
      rates in the infertile couples.

PMID- 11202420
TI  - Testicular vasomotion in different mammals.
AB  - Vasomotion is a rhythmical variation in arterial blood flow present in many
      different organs among them the rat testis. Vasomotion is suggested to play an
      important role for the transvascular fluid exchange and the exchange of nutrients
      over the capillary wall as well as the formation of interstitial fluid. The
      present study was undertaken to elucidate whether vasomotion is present in the
      testes of different species independent of their anatomical vascular topography.
      Blood flow in the testes of mouse, brush-tailed possum, tammar wallaby, ram and
      human was investigated by using a laser Doppler flowmeter. Vasomotion was found
      in all the species investigated.

PMID- 11202421
TI  - A clinical comparative study on effects of intracavernous injection of sodium
      nitroprusside and papaverine/phentolamine in erectile dysfunction patients.
AB  - AIM: To study the effect of intracavernous sodium nitroprusside (SNP), a nitric
      oxide (NO) donor, on penile erection. METHODS: Forty-two patients with erectile
      dysfunction (ED) were randomly assigned to receive SNP 300 micrograms or the
      control drugs (papaverine 30 mg + phentolamine 1 mg) intracavernously crosswise
      one week apart. The penile length, circumference and hardness after the
      administration of the experimental and control drugs were assessed and compared
      statistically. RESULTS: (1) There was no significant difference between the
      changes in penile length and circumference in the two occasions; (2) In 25 SNP
      and 28 control cases, the hardness of the penis was scored above 100 as evaluated
      by the Virag method (P > 0.05); (3) The duration of erection in the controls was
      longer than that in the SNP, but there were three priapism in the controls and
      not a single one in the SNP; (4) there was no apparent change in the heart rate
      and blood pressure in both occasions; other side effects were minimal except
      slight local pain in a few controls. CONCLUSION: SNP facilitates relaxation of
      the penile smooth muscle and penile erection without significant side effects.
      SNP may be used in ED patients that experience pain and priapism with
      papaverine/phentolamine.

PMID- 11202422
TI  - Penile prosthesis implantation in a transsexual neophallus.
AB  - Reconstruction surgery for a female to male transsexual usually involves
      mastectomy, hysterectomy and creating an aesthetically appealing neophallus. We
      have successfully inserted an inflatable prosthesis using the AMS CX prosthesis
      in a 45 year old transsexual, who had a large bulky neophallus constructed from
      the anterior abdominal subcutaneous fat, about 9 years ago. The single cylinder
      CX prosthesis was well anchored to the symphysis pubis using a dacron windsock
      tubing, the activation pump was placed in the dependent pouch of the right labium
      and the reservior in the usual perivesical space. The patient subsequently had
      debulking procedure using liposuction to create a more aesthetic and functional
      phallus. To date, the inflatable neophallus prosthesis is functioning well.

PMID- 11202423
TI  - Androgen receptor isoforms in human and rat prostate.
AB  - AIM: To investigate the androgen receptor (AR) isoforms and its variability of
      expression in human and rat prostatic tissues. METHODS: Human benign prostatic
      hyperplasia (BPH) and prostatic cancer tissues were obtained from patients
      undergoing prostatectomy, and rat ventral prostate was incised 3 days after
      castration. Forty-one AR-positive BPH specimens, 3 prostatic cancer specimens,
      and 6 rat prostates were used. After processing at 4 degrees C, the tissues were
      examined by means of high resolution isoelectric focusing (IEF) technique to
      determine their AR isoforms. RESULTS: From the prostatic specimens, 3 types of AR
      isoforms were detected with pI values at 6.5, 6.0, and 5.3. In human BPH tissues,
      15/41 (36.6%) specimens showed all the three types of isoforms, while 19/41
      (46.3%) showed 2 isoforms at various combinations and 7/41 (17.1%), 1 isoform.
      For the 3 prostatic cancer specimens, one showed 3 isoforms, one, 2 isoforms, and
      the other failed to show any isoform. All rat prostatic tissues showed 2 isoforms
      at different combinations. Binding of 3H-dihydrotestosterone (DHT) to the
      isoforms was inhibited by the addition of 100-fold excess of DHT or testosterone,
      but not progesterone, oestradiol or diethylstilboestrol. CONCLUSION: AR isoforms
      are different in different patients. Although their genesis is not clear, the
      therapeutic implication of the present observation appears to be interesting,
      that may help clarifying the individual differences in the response to hormonal
      therapy.

PMID- 11202424
TI  - Clinical classification of chronic prostatitis: a preliminary investigation.
AB  - AIM: To propose a practical clinical classification for the chronic prostatitis
      (CP). METHODS: The clinical features and the findings in the expressed prostatic
      secretion (EPS) in 804 cases of CP patients were retrospectively analyzed.
      RESULTS: Four types of CP were identified based on the clinical manifestations
      and the amounts of white blood cells (WBC) and lecithin in EPS. They were the
      latent type (85 cases; 10.6%), the common type (423 cases; 52.6%), the persisting
      type (104 cases; 12.9%), and the active type (192 cases, 23.9%). The therapeutic
      efficacy for these 4 subtypes were 40.4%, 76.8%, 30.8% and 37%, respectively; a
      statistical difference was noticed between the common type and the persisting
      type (P < 0.01). CONCLUSION: The method of classification proposed by the authors
      may help clinicians in the diagnosis and predicting the prognosis of CP.

PMID- 11202425
TI  - Value of herniography in the management of occult hernia and chronic groin pain
      in adults.

PMID- 11202426
TI  - Value of herniography in the management of occult hernia and chronic groin pain
      in adults.

PMID- 11202427
TI  - A problem bile duct stone.

PMID- 11202428
TI  - Clinical goverance and the vascular surgeon.

PMID- 11202430
TI  - Ribosomal proteins S3a, S13, S16, and S24 are not mutated in patients with
      Diamond-Blackfan anemia.

PMID- 11202429
TI  - Human A1 expression in acute myeloid leukemia and its relationship to Bcl-2
      expression.

PMID- 11202431
TI  - Increased frequency of HLA-DRB1*1302 haplotype in patients with nonimmune chronic
      idiopathic neutropenia of adults.

PMID- 11202432
TI  - CD15-expressing phagocytic plasma cells in a patient with multiple myeloma.

PMID- 11202433
TI  - Requirement for cytoplasmic protein synthesis during circadian peaks of
      transcription of chloroplast-encoded genes in Chlamydomonas.
AB  - Cycloheximide, an inhibitor of cytoplasmic translation, induced a rapid reduction
      of 70-80% in levels of mRNA for the chloroplast elongation factor Tu (tufA) in
      asynchronously growing Chlamydomonas. This effect was shown to be mainly
      transcriptional, and not restricted to tufA, as transcription of other
      chloroplast-encoded genes were cycloheximide-sensitive, although not all equally
      (psbA showed no more than 40% inhibition). Confirmatory evidence that the
      inhibition of chloroplast transcription was mainly due to blocking cytoplasmic
      translation was obtained with the cycloheximide-resistant mutant act1, and by
      using another translation inhibitor, anisomycin. In synchronously growing
      Chlamydomonas, chloroplast transcription is regulated by the circadian clock,
      with the daily peak occurring during the early light period. When cycloheximide
      was added during this period, transcription was inhibited, but not when it was
      added during the trough period (late light to early dark). Moreover, in
      synchronized cells switched to continuous light, the drug blocked the scheduled
      increase in tufA mRNA, but did not remove the pre-existing mRNA. These
      experiments define two functionally different types of chloroplast transcription
      in Chlamydomonas, basal (cycloheximide-insensitive) and clock-induced
      (cycloheximide-sensitive), and indicate that the relative contribution of each
      type to the overall transcription of a given gene are not identical for all
      genes. The results also provide evidence for nuclear regulation of chloroplast
      transcription, thereby obviating the need for an organellar clock, at least for
      these rhythms.

PMID- 11202434
TI  - Single amino acid substitutions at the acyl-CoA-binding domain interrupt
      14[C]palmitoyl-CoA binding of ACBP2, an Arabidopsis acyl-CoA-binding protein with
      ankyrin repeats.
AB  - Cytosolic acyl-CoA-binding proteins (ACBPs) are small proteins (ca. 10 kDa) that
      bind long-chain acyl-CoAs and are involved in the storage and intracellular
      transport of acyl-CoAs. Previously, we have characterized an Arabidopsis thaliana
      cDNA encoding a novel membrane-associated ACBP, designated ACBP1, demonstrating
      the existence of a new form of ACBP in plants (M.-L. Chye, Plant Mol. Biol. 38
      (1998) 827-838). ACBP1 likely participates in intermembrane lipid transport from
      the ER to the plasma membrane, where it could maintain a membrane-associated acyl
      pool (Chye et al., Plant J. 18 (1999) 205-214). Here we report the isolation of
      cDNAs encoding ACBP2 (Mr 38,479) that shows conservation in the acyl-CoA-binding
      domain to previously reported ACBPs, and contains ankyrin repeats at its carboxy
      terminus. These repeats, which likely mediate protein-protein interactions, could
      constitute a potential docking site in ACBP2 for an enzyme that uses acyl-CoAs as
      substrate, in vitro binding assays on recombinant (His)6-ACBP2 expressed in
      Escherichia coli show that it binds 14[C]palmitoyl-CoA preferentially to
      14[C]oleoyl-CoA. Analysis of the acyl-CoA-binding domain in ACBP2 was carried out
      by in vitro mutagenesis. Mutant forms of recombinant (His)6-ACBP2 with single
      amino acid substitutions at conserved residues within the acyl-CoA-binding domain
      were less effective in binding 14[C]palmitoyl-CoA. Northern blot analysis showed
      that the 1.6 kb ACBP2 mRNA, like that of ACBP1, is expressed in all plant organs.
      Analysis of the ACBP2 promoter revealed that, like the ACBP1 promoter, it lacks a
      TATA box suggesting the possibility of a housekeeping function for ACBP2 in plant
      lipid metabolism.

PMID- 11202435
TI  - Site-specific accumulation of a LINE-like retrotransposon in a sex chromosome of
      the dioecious plant Cannabis sativa.
AB  - Male-associated DNA sequences were analysed in hemp (Cannabis sativa L.), a
      dioecious plant with heteromorphic sex chromosomes. A male-associated DNA
      sequence in C. sativa (MADC1) and its flanking sequence encoded a reverse
      transcriptase that was strongly homologous to those of LINE-like retrotransposons
      from various plants and other organisms, as well as another open reading frame
      (ORF). Fluorescence in situ hybridization (FISH) with MADC1 as probe, which
      yielded strong signals specific for male genomic DNA in gel blot analysis,
      generated a clear doublet signal at the end of the long arm of the Y chromosome.
      FISH using pachytene chromosomes of pollen mother cells at meiotic prophase I
      revealed that pairing of X and Y chromosomes occurred at the short arm of the Y
      chromosome where MADC1 was not present. Furthermore, FISH using extended DNA
      fibers, with MADC1 and its flanking DNA as probes, revealed that 100 to 200
      copies of the retrotransposon were located in tandem on the Y chromosome. These
      results support the hypothesis that accumulation of a specific LINE-like
      retrotransposon at the terminal region of the long arm of the Y chromosome might
      be one cause of heteromorphism of sex chromosomes.

PMID- 11202436
TI  - Molecular cloning and functional expression of a stress-induced multifunctional O
      methyltransferase with pinosylvin methyltransferase activity from Scots pine
      (Pinus sylvestris L.).
AB  - Formation of pinosylvin (PS) and pinosylvin 3-O-monomethyl ether (PSM), as well
      as the activities of stilbene synthase (STS) and S-adenosyl-1-methionine
      (SAM):pinosylvin O-methyltransferase (PMT), were induced strongly in needles of
      Scots pine seedlings upon ozone treatment, as well as in cell suspension cultures
      of Scots pine upon fungal elicitation. A SAM-dependent PMT protein was purified
      and partially characterised. A cDNA encoding PMT was isolated from an ozone
      induced Scots pine cDNA library. Southern blot analysis of the genomic DNA
      suggested the presence of a gene family. The deduced protein sequence showed the
      typical highly conserved regions of O-methyltransferases (OMTs), and average
      identities of 20-56% to known OMTs. PMT expressed in Escherichia coli
      corresponded to that of purified PMT (40 kDa) from pine cell cultures. The
      recombinant enzyme catalysed the methylation of PS, caffeic acid, caffeoyl-CoA
      and quercetin. Several other substances, such as astringenin, resveratrol, 5-OH
      ferulic acid, catechol and luteolin, were also methylated. Recombinant PMT thus
      had a relatively broad substrate specificity. Treatment of 7-year old Scots pine
      trees with ozone markedly increased the PMT mRNA level. Our results show that PMT
      represents a new SAM-dependent OMT for the methylation of stress-induced
      pinosylvin in Scots pine needles.

PMID- 11202437
TI  - Spatial and temporal patterns of GUS expression directed by 5' regions of the
      Arabidopsis thaliana farnesyl diphosphate synthase genes FPS1 and FPS2.
AB  - Farnesyl diphosphate synthase (FPS), the enzyme that catalyses the synthesis of
      farnesyl diphosphate (FPP) from isopentenyl diphosphate (IPP) and dimethylallyl
      diphosphate (DMAPP), is considered a regulatory enzyme of plant isoprenoid
      biosynthesis. The promoter regions of the FPS1 and FPS2 genes controlling the
      expression of isoforms FPS1S and FPS2, respectively, were fused to the beta
      glucuronidase (GUS) reporter gene and introduced into Arabidopsis thaliana
      plants. The FPS1S:GUS gene is widely expressed in all plant tissues throughout
      development, thus supporting a role for FPS1S in the synthesis of isoprenoids
      serving basic plant cell functions. In contrast, the FPS2:GUS gene shows a
      pattern of expression restricted to specific organs at particular stages of
      development. The highest levels of GUS activity are detected in flowers,
      especially in pollen grains, from the early stages of flower development. After
      pollination, much lower levels of GUS activity are detected in the rest of floral
      organs, with the exception of the ovary valves, which remain unstained throughout
      flower development. GUS activity is also detected in developing and mature seeds.
      In roots, GUS expression is primarily detected at sites of lateral root
      initiation and in junctions between primary and secondary roots. No GUS activity
      is detected in root apical meristems. GUS expression is also observed in
      junctions between primary and secondary stems. Overall, the pattern of expression
      of FPS2:GUS suggests a role for FPS2 in the synthesis of particular isoprenoids
      with specialized functions. Functional FPS2 gene promoter deletion analysis in
      transfected protoplasts and transgenic A. thaliana plants indicate that all the
      cis-acting elements required to establish the full pattern of expression of the
      FPS2 gene are contained in a short region extending from positions -111 to +65.
      The potential regulatory role of specific sequences within this region is
      discussed.

PMID- 11202438
TI  - Methods of double-stranded RNA-mediated gene inactivation in Arabidopsis and
      their use to define an essential gene in methionine biosynthesis.
AB  - Controlled down-regulation of endogenous plant gene expression is a useful tool,
      but antisense and sense silencing lack predictability. Recent studies show that
      expression of both antisense and sense RNA together is an effective means of
      inactivating reporter and viral genes in plants. We created transgenic plants
      expressing antisense and sense RNA together in a single 'double-stranded RNA'
      (dsRNA) transcript. This approach shows great promise as a highly effective means
      for reducing gene function. With this approach, we demonstrated that the
      Arabidopsis cystathionine beta-lyase gene, which encodes a methionine
      biosynthetic enzyme, is essential for viability. Inactivation of this gene was
      rescued by the addition of methionine to the growth medium. Compared to antisense
      and sense constructs, the dsRNA construct showed a much more consistent and
      complete suppression of gene activity. Additionally, expression of a transcript
      with a spacer sequence containing an unrelated gene between antisense and sense
      luciferase gene fragments led to stronger inactivation of a second luciferase
      transgene than did constructs with a minimal spacing between sense and antisense
      fragments. However, the gene in the spacer region was neither functionally
      expressed nor functional in silencing a second, unlinked homologous transgene.

PMID- 11202439
TI  - A gene expression screen identifies EARLI1 as a novel vernalization-responsive
      gene in Arabidopsis thaliana.
AB  - Vernalization promotes early flowering in late ecotypes of Arabidopsis thaliana.
      The mechanisms of vernalization are poorly understood. A subtractive
      hybridization approach was used to isolate vernalization-responsive genes from a
      late-flowering ecotype of Arabidopsis thaliana based on the premise that
      transcript levels of such genes would increase with cold treatment and remain
      high even after removal of the vernalization stimulus. EARLI1 is the first
      Arabidopsis gene shown to be stably activated by vernalization. The abundance of
      its RNA is progressively elevated by vernalization and remains high for at least
      20 days at room temperature. The basal level of EARLI1 RNA is higher in early
      flowering ecotypes, but is increased also after vernalization. Vernalization and
      subsequent growth in long-day photoperiods have an additive or synergistic effect
      on EARLI1 activation. EARLI1 RNA levels are also transiently induced by brief
      exposures to cold, but not to abscisic acid. EARLI1 is thus a novel vernalization
      responsive gene in Arabidopsis thaliana that can be used to investigate
      vernalization-specific transcriptional regulation.

PMID- 11202440
TI  - Agrobacterium-mediated sorghum transformation.
AB  - Agrobacterium tumefaciens was used to genetically transform sorghum. Immature
      embryos of a public (P898012) and a commercial line (PHI391) of sorghum were used
      as the target explants. The Agrobacterium strain used was LBA4404 carrying a
      'Super-binary' vector with a bar gene as a selectable marker for herbicide
      resistance in the plant cells. A series of parameter tests was used to establish
      a baseline for conditions to be used in stable transformation experiments. A
      number of different transformation conditions were tested and a total of 131
      stably transformed events were produced from 6175 embryos in these two sorghum
      lines. Statistical analysis showed that the source of the embryos had a very
      significant impact on transformation efficiency, with field-grown embryos
      producing a higher transformation frequency than greenhouse-grown embryos.
      Southern blot analysis of DNA from leaf tissues of T0 plants confirmed the
      integration of the T-DNA into the sorghum genome. Mendelian segregation in the T1
      generation was confirmed by herbicide resistance screening. This is the first
      report of successful use of Agrobacterium for production of stably transformed
      sorghum plants. The Agrobacterium method we used yields a higher frequency of
      stable transformation that other methods reported previously.

PMID- 11202441
TI  - Promiscuous and specific phospholipid binding by domains in ZAC, a membrane
      associated Arabidopsis protein with an ARF GAP zinc finger and a C2 domain.
AB  - Arabidopsis proteins were predicted which share an 80 residue zinc finger domain
      known from ADP-ribosylation factor GTPase-activating proteins (ARF GAPs). One of
      these is a 37 kDa protein, designated ZAC, which has a novel domain structure in
      which the N-terminal ARF GAP domain and a C-terminal C2 domain are separated by a
      region without homology to other known proteins. Zac promoter/beta-glucuronidase
      reporter assays revealed highest expression levels in flowering tissue, rosettes
      and roots. ZAC protein was immuno-detected mainly in association with membranes
      and fractionated with Golgi and plasma membrane marker proteins. ZAC membrane
      association was confirmed in assays by a fusion between ZAC and the green
      fluorescence protein and prompted an analysis of the in vitro phospholipid
      binding ability of ZAC. Phospholipid dot-blot and liposome-binding assays
      indicated that fusion proteins containing the ZAC-C2 domain bind anionic
      phospholipids non-specifically, with some variance in Ca2+ and salt dependence.
      Similar assays demonstrated specific affinity of the ZAC N-terminal region
      (residues 1-174) for phosphatidylinositol 3-monophosphate (PI-3-P). Binding was
      dependent in part on an intact zinc finger motif, but proteins containing only
      the zinc finger domain (residues 1-105) did not bind PI-3-P. Recombinant ZAC
      possessed GTPase-activating activity on Arabidopsis ARF proteins. These data
      identify a novel PI-3-P-binding protein region and thereby provide evidence that
      this phosphoinositide is recognized as a signal in plants. A role for ZAC in the
      regulation of ARF-mediated vesicular transport in plants is discussed.

PMID- 11202442
TI  - Functional analysis of the PsbX protein by deletion of the corresponding gene in
      Synechocystis sp. PCC 6803.
AB  - The psbX gene (sml0002) coding for a 4.1 kDa protein in Photosystem II of plants
      and cyanobacteria was deleted in both wild type and in a Photosystem I-less
      mutant of the cyanobacterium Synechocystis sp. PCC 6803. Polymerase chain
      reaction and sequencing analysis showed that the mutants had completely
      segregated. Deletion of the PsbX protein does not seem to influence growth rate,
      electron transport or water oxidation ability. Whereas a high light induction of
      the psbX mRNA could be observed in wild type, deletion of the gene did not lead
      to high light sensibility. Light saturation measurements and 77K fluorescence
      measurements indicated a minor disconnection of the antenna in the deletion
      mutant. Furthermore, fluorescence induction measurements as well as immuno
      staining of the D1 protein showed that the amount of Photosystem II complexes in
      the mutants was reduced by 30%. Therefore, PsbX does not seem to be necessary for
      the Photosystem II electron transport, but directly or indirectly involved in the
      regulation of the amount of functionally active Photosystem II centres in
      Synechocystis sp. PCC 6803.

PMID- 11202443
TI  - 123I-IMT SPET: introducing another research tool into clinical neuro-oncology?

PMID- 11202444
TI  - Practice of nuclear medicine in Spain.
AB  - This survey presents the results of a poll sent to all Spanish nuclear medicine
      departments between July 1999 and March 2000, with the aim of clarifying the
      current situation of nuclear medicine in Spain. This survey is believed to be the
      first of its kind, and it is anticipated that the data will be of assistance to
      health authorities in ensuring that the needs of the population with regard to
      nuclear medicine facilities are met.

PMID- 11202445
TI  - Visualisation of serotonin-1A (5-HT1A) receptors in the central nervous system.
AB  - The 5-HT1A subtype of receptors for the neurotransmitter serotonin is
      predominantly located in the limbic forebrain and is involved in the modulation
      of emotion and the function of the hypothalamus. Since 5-HT1A receptors are
      implicated in the pathogenesis of anxiety, depression, hallucinogenic behaviour,
      motion sickness and eating disorders, they are an important target for drug
      therapy. Here, we review the radioligands which are available for visualisation
      and quantification of this important neuroreceptor in the human brain, using
      positron emission tomography (PET) or single-photon emission tomography (SPET).
      More than 20 compounds have been labelled with carbon-11 (half-life 20 min),
      fluorine-18 (half-life 109.8 min) or iodine-123 (half-life 13.2 h): structural
      analogues of the agonist, 8-OH-DPAT, structural analogues of the antagonist, WAY
      100635, and apomorphines. The most successful radioligands thus far are [carbonyl
      11C] WAY-100635 (WAY), [carbonyl-11C]desmethyl-WAY-100635 (DWAY), p-[18F]MPPF and
      [11C]robalzotan (NAD-299). The high-affinity ligands WAY and DWAY produce
      excellent images of 5-HT1A receptor distribution in the brain (even the raphe
      nuclei are visualised), but they cannot be distributed to remote facilities and
      they probably cannot be used to measure changes in endogenous serotonin. Binding
      of the moderate-affinity ligands MPPF and NAD-299 may be more sensitive to
      serotonin competition and MPPF can be distributed to PET centres within a flying
      distance of a few hours. Future research should be directed towards: (a)
      improvement of the metabolic stability in primates; (b) development of a
      fluorinated radioligand which can be produced in large quantities and (c)
      production of a radioiodinated or technetium-labelled ligand for SPET.

PMID- 11202446
TI  - SPET imaging of central muscarinic acetylcholine receptors with iodine-123
      labelled E-IQNP and Z-IQNP.
AB  - 1-Azabicyclo[2.2.2]oct-3-yl alpha-hydroxy-alpha-(1-iodo-1-propen-3-yl)-alpha
      phenylacetate (IQNP) is a muscarinic acetylcholine receptor (mAChR) antagonist
      and the racemic ligand contains eight stereoisomers. In a single-photon emission
      tomography (SPET) study in monkeys we recently confirmed that [123I]E-(R,R)-IQNP
      ([123I]E-IQNP) is a radioligand with modest selectivity for the M1 and M4
      subtypes, whereas [123I]Z-(R,R)-IQNP ([123I]Z-IQNP) is non-subtype selective. In
      the present SPET study, E- and Z-IQNP were examined in human subjects. SPET
      examination was performed on three male subjects after i.v. injection of [123I]E
      IQNP and in another three after i.v. injection of [123I]Z-IQNP. The binding
      potential (BP) for [123I]E-IQNP was calculated using several quantitative
      approaches with the cerebellum as a reference region. High-performance liquid
      chromatography was used to measure radioligand metabolism in plasma. Following
      [123I]E-IQNP, the radioactivity was high in the neocortex and striatum,
      intermediate in the thalamus and low in the pons and cerebellum, which is
      consistent with the rank order for the regional density of M1 and M4 subtypes in
      vitro. For all regions, peak equilibrium was identified within the 48-h data
      acquisition. The simplified reference tissue approach using SPET data from 0 to
      48 h was the most reliable in this limited series of subjects. Following
      injection of [123I]Z-IQNP, radioactivity was high in the neocortex and striatum,
      intermediate in the thalamus and pons and low in the cerebellum, which is in
      agreement with the density of M1, M2 and M4 subtypes as measured in vitro.
      Quantitative analyses provided indirect support for specific M2 binding of Z-IQNP
      in the cerebellum. The high selectivity of [123I]E-IQNP for M1 and M4 receptors
      allowed the use of cerebellum as a reference region devoid of specific binding,
      and may be advantageous for applied clinical studies of M1 and M4 receptors
      binding in man. [123I]Z-IQNP has potential for exploration of M2 receptor binding
      in the cerebellum.

PMID- 11202447
TI  - Exceptional brain function in musicians and the neural basis of music processing.

PMID- 11202448
TI  - 123I-IMP SPET in the diagnosis of primary central nervous system lymphoma.
AB  - We reviewed N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) single-photon emission
      tomography (SPET) images of brain tumours and assessed the usefulness of 123I-IMP
      SPET for the diagnosis of primary central nervous system (CNS) lymphoma. We
      analysed 52 tumours that showed enhancement on magnetic resonance imaging: 11
      malignant lymphomas, 3 anaplastic astrocytomas, 17 glioblastomas, 12 meningiomas,
      4 metastatic brain tumours and 5 other brain tumours. 123I-IMP uptake in the
      tumours on early (15-min) and delayed (4-h) scans was visually classified as
      high, moderate or low as compared with the contralateral brain cortex. Early and
      delayed 123I-IMP uptake ratios comparing tumours with contralateral brain cortex
      (T/N ratio) were also calculated. In malignant lymphomas, the visual uptake of
      123I-IMP was moderate to high on the delayed scans. The delayed T/N ratios were
      significantly higher than the early ratios (P<0.05) and all lymphomas, with the
      exception of one small one, had delayed ratios greater than 0.9. In non
      lymphomatous tumours, the visual uptake of 123I-IMP was low on the delayed scans.
      The delayed T/N ratios were significantly lower than the early ratios (P<0.01)
      and all non-lymphomatous tumours had delayed ratios of less than 0.8. The T/N
      ratios of lymphomas were significantly higher than those of non-lymphomatous
      tumours on both early and delayed scans (P<0.0001). These results suggest that
      123I-IMP SPET may be a useful tool in the differential diagnosis of primary CNS
      lymphoma.

PMID- 11202449
TI  - An independent evaluation of a new method for automated interpretation of lung
      scintigrams using artificial neural networks.
AB  - The purpose of this study was to evaluate a new automated method for the
      interpretation of lung perfusion scintigrams using patients from a hospital other
      than that where the method was developed, and then to compare the performance of
      the technique against that of experienced physicians. A total of 1,087
      scintigrams from patients with suspected pulmonary embolism comprised the
      training group. The test group consisted of scintigrams from 140 patients
      collected in a hospital different to that from which the training group had been
      drawn. An artificial neural network was trained using 18 automatically obtained
      features from each set of perfusion scintigrams. The image processing techniques
      included alignment to templates, construction of quotient images based on the
      perfusion/template images, and finally calculation of features describing
      segmental perfusion defects in the quotient images. The templates represented
      lungs of normal size and shape without any pathological changes. The performance
      of the neural network was compared with that of three experienced physicians who
      read the same test scintigrams according to the modified PIOPED criteria using,
      in addition to perfusion images, ventilation images when available and chest
      radiographs for all patients. Performances were measured as area under the
      receiver operating characteristic curve. The performance of the neural network
      evaluated in the test group was 0.88 (95% confidence limits 0.81-0.94). The
      performance of the three experienced experts was in the range 0.87-0.93 when
      using the perfusion images, chest radiographs and ventilation images when
      available. Perfusion scintigrams can be interpreted regarding the diagnosis of
      pulmonary embolism by the use of an automated method also in a hospital other
      than that where it was developed. The performance of this method is similar to
      that of experienced physicians even though the physicians, in addition to
      perfusion images, also had access to ventilation images for most patients and
      chest radiographs for all patients. These results show the high potential for the
      method as a clinical decision support system.

PMID- 11202450
TI  - Choice of collimator for cardiac SPET when resolution compensation is included in
      iterative reconstruction.
AB  - In clinical cardiac single-photon emission tomography (SPET) studies, collimators
      of different spatial resolution and geometric efficiency are available for
      imaging. In selecting the appropriate collimator for clinical use, there is a
      trade-off between spatial resolution, which can limit the contrast of the
      reconstructed image, and detection efficiency, which determines the noise in the
      image. Our objective was to assess which collimator is best suited for cardiac
      SPET when reconstruction is performed with and without compensation for distance
      dependent resolution (CDR). The dynamic MCAT thorax phantom was used to simulate
      180 degree technetium-99m cardiac data, acquired using either a general-purpose
      (GP) or high-resolution (HR) collimator. For GP and HR, the resolution at 15 cm
      was 11.5 mm and 9.5 mm respectively, and the corresponding relative efficiency
      was 1.0 and 0.52 respectively. Distance-dependent resolution, attenuation and
      noise were included in the projection data; scatter was not included. Ordered
      subsets expectation maximisation reconstruction (subset size 4) was performed
      with and without CDR. Results were evaluated by comparing the myocardial recovery
      coefficient and contrast between myocardium and ventricle relative to the
      original phantom, each plotted for different noise levels corresponding to
      increasing iteration number. The study demonstrated that, without CDR, HR gave
      the best results. However, for any given noise level with CDR, GP gave superior
      recovery and contrast. These findings were confirmed in a physical phantom study.
      Results suggest that improved reconstruction can be achieved using a GP
      collimator in combination with resolution compensation.

PMID- 11202451
TI  - Elastic surface contour detection for the measurement of ejection fraction in
      myocardial perfusion SPET.
AB  - The aim of this study was to investigate the use of an automated three
      dimensional myocardial contour detection method using elastic surfaces for the
      assessment of left ventricular ejection fraction (EF) from
      electrocardiographically (ECG) triggered myocardial perfusion single-photon
      emission tomography (SPET). The validity of this method was studied on the basis
      of both phantom measurements and patient studies. Phantom measurements were
      performed using an elastic phantom of the left ventricle simulating a beating
      heart, with a simulated EF ranging from 10% to 78%. The data from 27 patients who
      had undergone both ECG-triggered myocardial perfusion SPET and planar gated
      radionuclide ventriculography (RNV) were used to compare the EF derived from the
      SPET data with the automated contour detection method and the EF derived from the
      RNV data with standard analysis software. EF values as measured by RNV ranged
      from 11% to 68%. The overall accuracy of the automated contour detection method
      proved to be very high. In the phantom study the deviation of the measured EF
      from the reference values was less than 4% for all of the simulated EFs. The
      studies on the patient data yielded a correlation coefficient (Pearson) greater
      than 0.94 as compared with planar RNV. Intra- and inter-observer reproducibility
      was high, with correlation coefficients exceeding 0.97. It is concluded that the
      proposed method allows accurate, reproducible and fast measurement of the left
      ventricular EF on the basis of myocardial perfusion SPET.

PMID- 11202452
TI  - Imaging in vivo herpes simplex virus thymidine kinase gene transfer to tumour
      bearing rodents using positron emission tomography and.
AB  - Radiolabelled ganciclovir analogues have shown promise as imaging agents to
      detect herpes simplex virus thymidine kinase (HSVtk) expression. This study
      evaluated the use of positron emission tomography (PET) imaging with 9-[(3
      [18F]fluoro-1-hydroxy-2-propoxy)methyl]guanine ([18F]FHPG) to assess gene
      transfer into tumours. HSVtk-positive and HSVtk-negative cell lines were first
      treated in vitro with [18F]FHPG. To assess the efficacy of PET in detecting HSVtk
      expression following in vivo gene transfer, mice were injected intravenously with
      an adenovirus encoding HSVtk (Ad.HSVtk), a control vector (Ad.Bgl2) or saline.
      Subcutaneous human glioma xenografts were grown in mice and treated by direct
      injection of Ad.HSVtk or Ad.Bgl2. Imaging was performed 48 h after transduction.
      Similar experiments were performed using Fischer rats implanted with syngeneic
      tumours. The presence of the HSVtk protein was confirmed by immunohistochemistry.
      Biodistribution studies were also obtained in 14 naive mice. In vitro studies
      showed high and specific uptake of [18F]FHPG in HSVtk-positive cell lines, with
      an uptake ratio of up to 27:1. PET imaging and direct counting of major organs
      demonstrated HSVtk-specific tracer retention. In mice, HSVtk-positive tumours
      retained 3.4% dose/gram as compared to 0.6% for control tumours (P=0.03). They
      were clearly seen on the PET images as early as 100 min post injection. Similar
      results were obtained with syngeneic rat tumours. Biodistribution studies
      demonstrated the rapid distribution and clearance of the tracer in all major
      organs. Our results demonstrate that PET imaging of HSVtk gene transfer to
      tumours is feasible and is highly specific for HSVtk expression.

PMID- 11202453
TI  - Scintimammography with 99mTc-MIBI versus dynamic MRI for non-invasive
      characterization of breast masses.
AB  - Although mammography remains the technique of choice for the early detection of
      breast cancer, several imaging techniques, including scintimammography and
      magnetic resonance imaging (MRI), have recently been proposed as adjuncts for
      this purpose and included in many diagnostic protocols. This study was undertaken
      to assess the clinical accuracy of scintimammography with technetium-99m
      methoxyisobutylisonitrile (MIBI) and contrast-enhanced MRI in the detection of
      primary breast carcinoma in patients with equivocal mammographic findings. Forty
      nine patients with a suspicious breast mass detected either by physical
      examination or by mammography and ultrasound (US) were studied. All patients
      underwent scintimammography and dynamic contrast-enhanced MRI 1 week apart. The
      results of the two techniques were compared and correlated to the final
      diagnoses. Two independent readers reported the scans using a four-point
      confidence scale. The areas under the receiver operator characteristic (ROC)
      curves were obtained. Scintimammography showed an accuracy for tumour detection
      of 84%, with a sensitivity of 80% and a specificity of 88%. MRI showed an
      accuracy of 86%, with a sensitivity and specificity of 96% and 75%, respectively.
      Comparison of the two areas under the ROC curves showed no significant
      differences between MRI, 0.91+/-0.05 (mean+/-SD), and scintimammography, 0.88+/
      0.05 (P=0.9). It is concluded that dynamic MRI and scintimammography possess
      comparable accuracy in the diagnosis of primary breast carcinoma in patients with
      equivocal mammographic or US findings.

PMID- 11202454
TI  - 18F-DOPA positron emission tomography for tumour detection in patients with
      medullary thyroid carcinoma and elevated calcitonin levels.
AB  - In spite of the availability of numerous procedures, diagnostic imaging of tumour
      manifestations in patients with medullary thyroid carcinoma and elevated
      calcitonin levels is often difficult. In the present study, the new procedure of
      fluorine-18 dihydroxyphenylalanine positron emission tomography (18F-DOPA PET)
      was compared with the established functional and morphological imaging methods.
      After evaluation of the normal distribution of 18F-DOPA, 11 patients with
      medullary thyroid carcinoma were examined using 18F-DOPA PET. Results of 18F
      fluorodeoxyglucose (18F-FDG) PET, somatostatin receptor scintigraphy (SRS) and
      morphological tomographic imaging (CT/MRI) were available for all patients. All
      individual procedures were evaluated without reference to prior information. Data
      assessment for each patient was based on cooperation between experienced
      radiologists and specialists in nuclear medicine, who considered all the
      available findings (histological results, imaging, follow-up studies). This
      cooperation served as the gold standard against which the results of the
      individual procedures were evaluated. A total of 27 tumours were studied [three
      primary tumours (PT)/local recurrence (LR), 16 lymph node metastases (LNM) and
      eight organ metastases (OM)]. 18F-DOPA PET produced 17 true-positive findings (2
      PT/LR, 14 LNM, 1 OM), 18F-FDG PET 12 (2 PT/LR, 7 LNM, 3 OM), SRS 14 (2 PT/LR, 8
      LNM, 4 OM) and morphological imaging 22 (3 PT/LR, 11 LNM, 8 OM). The following
      sensitivities were calculated with respect to total tumour manifestations: 18F
      DOPA PET 63%, 18F-FDG PET 44%, SRS 52%, morphological imaging 81%. Thus, the
      morphological imaging procedures produce the best overall sensitivity, but the
      specificity for PT/LR (55%) and LNM (57%) was low. With respect to lymph node
      staging, the best results were obtained with 18F-DOPA PET. 18F-DOPA PET is a new
      functional imaging procedure for medullary thyroid carcinoma that seems to
      provide better results than SRS and 18F-FDG PET. Moreover, the data indicate that
      no single procedure provides adequate diagnostic certainty. Therefore, 18F-DOPA
      PET is a useful supplement to morphological diagnostic imaging, improving lymph
      node staging and enabling a more specific diagnosis of primary tumour and local
      recurrence.

PMID- 11202456
TI  - Characteristics of a new fully programmable blood sampling device for monitoring
      blood radioactivity during PET.
AB  - The first performance tests of a new fully programmable blood sampling device for
      monitoring blood radioactivity during positron emission tomography (PET) are
      described. Blood is withdrawn through 1-mm internal diameter tubing using an
      infusion pump which can be operated at rates varying from 0 to 600 ml/h. Activity
      in blood is measured by a 6-cm-thick bismuth germanate crystal connected to a
      photomultiplier tube and multichannel analyser (MCA) which are positioned within
      6 cm lead shielding. Positioning of the tubing is an exact and simple procedure.
      The minimal readout time of the MCA is 1 s. Two independent energy windows can be
      set. Operation of the pump and MCA is fully controlled by a PC, i.e. sampling
      time, interval time and pump rate can be varied at any time during the PET scan
      by user-defined scripts. A number of characteristics of the new system were
      studied, such as sensitivity, dead time, linearity, effect of background
      radiation and pump rate as a function of input pressure. In addition, dispersion
      was measured as a function of pump rate. Finally, first clinical results were
      compared with manual samples. The sensitivity equalled 0.7 and 0.2 cps/Bq for 511
      and 1022-keV 30% energy windows, respectively, and the system dead time was 500
      ns. The system remained linear within 2% with activity concentrations up to 2.5
      MBq/cc. Short-term reproducibility was better than 3% for a 1-h period. Long-term
      reproducibility was about 5% (ISD), which was mainly caused by variation in the
      diameter of the tubing. If the device was positioned in such a way that maximum
      shielding was directed towards the patient, the effects of background radiation
      from the patient on the measured activity concentration for clinically relevant
      conditions was minimal (<3%). Pump rate varied with input pressure, but remained
      constant for a given pressure. Dispersion constants smaller than 0.14 s(-1) were
      observed for pump rates higher than 300 ml/h, indicating that the system
      dispersion is small. Clinical data showed an excellent agreement to within 3%
      (ISD) between the results obtained with the new system and manual samples. With
      the continuous blood sampler radioactivity in blood can be measured accurately
      during the entire course of the PET scan. Furthermore, the system is fully
      programmable allowing adjustment of all parameters during a single PET scan.

PMID- 11202455
TI  - Activation of the growth plates on three-phase bone scintigraphy: the explanation
      for the overgrowth of fractured femurs.
AB  - Children with an uncomplicated femoral fracture, treated with superimposition of
      fragments and intentional shortening, usually develop overgrowth of the fractured
      femur and the ipsilateral tibia which may compensate for the initial shortening
      and enable the limb in question to reach a length similar to that on the normal
      side. The overgrowth is evaluated clinically and by scanography. The increased
      metabolic activity of the growth plates that support this overgrowth has not been
      documented by any laboratory method. In order to evaluate the metabolic activity
      of the growth plates, 18 patients (11 males, seven females; mean age 6.1 years)
      with fractures of the femur were studied at three different time intervals (2-5
      months, 6-12 months and 18-24 months). Three-phase bone scintigraphy was
      performed in all patients. Ten children (five males, five females; mean age 7.5
      years) who had had bone imaging for other reasons were used as the control group.
      Visual analysis of the flow and equilibrium phases was performed for the distal
      femoral and proximal tibial growth plates. Visual and semi-quantitative analyses
      of the delayed images were performed for the distal femoral and proximal and
      distal tibial growth plates. Semi-quantitative analyses yielded the following
      activity ratios: (a) the distal femoral growth plate of the fractured femur to
      the contralateral one (FR); (b) the proximal growth plate of the tibia on the
      side of the fractured femur to the contralateral one (TpR); (c) the distal growth
      plate of the tibia on the side of the fractured femur to the contralateral one
      (TdR); and (d) in the control group, the distal growth plates of both femora
      (FCG) and the proximal (TCGp) and distal (TCGd) growth plates of the tibiae.
      Visual analysis of the blood flow, equilibrium and delayed images showed
      increased activity in the distal femoral growth plates during the first and
      second time intervals, but not during the third. No significant activity changes
      were found in the proximal and distal tibial growth plates during any of the
      phases analysed. The mean and standard deviation for FR in the three time
      intervals were: FRI=1.22+/-0.27, FRII=1.17+/-0.16 and FRIII=1.09+/-0.20. FR
      values were significantly higher than in the control group (FCG=0.99+/-0.03)
      (P=0.033). The mean and standard deviation for TpR in the three time intervals
      were: TpRI=1.08+/-0.18, TpRII=0.94+/-0.09 and TpRIII=0.96+/-0.20. TpR values were
      not significantly different from those in the control group (TCGp=1.00+/-0.05).
      However, TpRI was significantly higher than TpRII (P=0.043). The mean and
      standard deviation for TdR in the three time intervals were: TdRI=1.10+/-0.41,
      TdRII=1.05+/-0.15 and TdRIII=1.13+/-0.36. TdR values were not significantly
      higher than in the control group (TCGd=1.00+/-0.04) (P=0.777). These results
      support the concept that three-phase bone imaging is able to quantify and
      determine that activation occurs in the distal femoral and proximal tibial growth
      plates of fractured femora. This phenomenon may explain the overgrowth observed
      in this injured bone structure.

PMID- 11202457
TI  - Non-uniform versus uniform attenuation correction in brain perfusion SPET of
      healthy volunteers.
AB  - Although non-uniform attenuation correction (NUAC) can supply more accurate
      absolute quantification, it is not entirely clear whether NUAC provides clear-cut
      benefits in the routine clinical practice of brain SPET imaging. The aim of this
      study was to compare the effect of NUAC versus uniform attenuation correction
      (UAC) on volume of interest (VOI)-based semi-quantification of a large age- and
      gender-stratified brain perfusion normal database. Eighty-nine healthy volunteers
      (46 females and 43 males, aged 20-81 years) underwent standardised high
      resolution single-photon emission tomography (SPET) with 925 MBq 99mTc-ethyl
      cysteinate dimer (ECD) on a Toshiba GCA-9300A camera with 153Gd or 99mTc
      transmission CT scanning. Emission images were reconstructed by filtered back
      projection and scatter corrected using the triple-energy window correction
      method. Both non-uniform Chang attenuation correction (one iteration) and uniform
      Sorenson correction (attenuation coefficient 0.09 cm(-1)) were applied. Images
      were automatically reoriented to a stereotactic template on which 35 predefined
      VOIs were defined for semi-quantification (normalisation on total VOI counts).
      Small but significant differences between relative VOI uptake values for NUAC
      versus UAC in the infratentorial region were found. VOI standard deviations were
      significantly smaller for UAC, 4.5% (range 2.6-7.5), than for NUAC, 5.0% (2.3
      9.0) (P<0.01). Higher filter roll-off values of the transmission reconstruction
      filter increased noise in the emission images and altered estimated cortical
      attenuation coefficients as well as uptake values. In conclusion, semi
      quantification based upon reconstruction with UAC results in very similar 99mTc
      ECD uptake values in healthy volunteers to those obtained with NUAC, although
      values for the infratentorial region are slightly lower. NUAC produces a slight
      increase in inter-subject variability. Further study is necessary in various
      patient populations to establish the full clinical impact of NUAC in brain
      perfusion SPET.

PMID- 11202458
TI  - 62Cu-PTSM and PET used for the assessment of angiotensin II-induced blood flow
      changes in patients with colorectal liver metastases.
AB  - The aim of this study was to establish a quantitative positron emission
      tomography (PET) method for investigating angiotensin II (AII)-induced changes in
      blood flow distribution in the liver. This was in order to evaluate the role of
      vascular manipulation applied to locoregional chemotherapy treatment in patients
      with colorectal liver metastases. The tracer selected was copper-62 (II)
      pyruvaldehyde bis-(N4-methyl)thiosemicarbazone (62Cu-PTSM), which exhibits high
      first-pass extraction and tissue retention following intra-arterial
      administration. The short half-life of the tracer and its availability from a
      62Zn/62Cu generator enabled short-interval repeat PET scans on patients in a
      single imaging session. Distribution of tracer within the liver was imaged in a
      single view using a PET camera with rotating large-area detectors. By
      optimisation of the acquisition protocol, it was possible to acquire sufficient
      data to produce good-quality images and to quantify tracer uptake with an
      accuracy of <10%. Reproducibility of the imaging method was assessed in a single
      patient in whom three consecutive 62Cu-PTSM PET scans were obtained, and in whom
      no vascular manipulation was performed. Sets of scans (before, during and
      immediately after a 45-min AII infusion) were obtained in nine patients to assess
      blood flow changes associated with prolonged vascular manipulation. Significant
      individual responses, varying in both the magnitude and the duration of flow
      change, were observed in the majority of cases (7/11 lesions; 7/9 patients).
      These findings illustrate the potential of 62Cu-PTSM and PET for pharmacological
      studies. The wide range of individual patient responses to AII infusion suggests
      that PET blood flow assessment would be of value for selecting patients in whom
      this procedure may be effective.

PMID- 11202459
TI  - End-stage glaucoma: fortunately the end may be far off.

PMID- 11202460
TI  - Corneal allograft rejection: has the time come for intravenous pulsed
      methylprednisolone? A debate.

PMID- 11202461
TI  - Management and prognosis of end-stage glaucoma.
AB  - PURPOSE: We followed, for a long term, end-stage glaucoma patients as defined by
      the level of legal blindness. METHODS: Follow up was for 7.7+/-1.8 years (range 2
      9) for 22 patients (13 men and nine women) having 32 eyes with functional vision.
      Age at exit was 74.6+/-15.5 years (range 33-89). Humphrey computerized perimetry
      and applanation tonometry were used throughout. We attempted to hold intraocular
      pressure below 15 mmHg using as much medical therapy as required. RESULTS: All
      visual fields were less than 10 degrees diameter at exit, but at entry seven eyes
      of six patients still had a field between 10 degrees and 20 degrees, the rest
      were all less than 10 degrees. Corrected visual acuity at entry was 6/9 to 6/6 in
      21 eyes of 6 patients and none had less than 6/60. At exit 16 eyes had 6/9 to 6/6
      and five eyes had less than 6/60, but no patient had complete loss of vision.
      Mean intraocular pressure (IOP) throughout was below 15 mmHg in all but four
      patients, whose (IOP) were less than 20 mmHg, using multiple medications if
      necessary. All patients had undergone prior surgery and/or laser trabeculoplasty.
      CONCLUSIONS: Even though visual loss slowly progressed, most patients with end
      stage glaucoma retained functional vision for a long period when intraocular
      pressure was held below 15 mmHg. More stringent early control of intraocular
      pressure may avoid the development of end-stage glaucoma.

PMID- 11202462
TI  - Iodine-I25 episcleral plaque therapy in uveal melanoma.
AB  - PURPOSE: To assess the efficacy of iodine-125 (I-125) episcleral plaque therapy
      in the management of uveal melanoma with regard to local control, survival, globe
      preservation and visual outcome. METHODS: Between January 1985 and January 1997,
      50 patients with the diagnosis of uveal melanoma were treated with I-125
      episcleral plaques. The mean initial tumour height was 5.5 mm (range, 2.0-9.5 mm)
      and basal diameter 9.5 mm (range, 4.0-14.5 mm). I-125 seeds with a mean activity
      of 1259.1 MBq were used. The mean apical dose was 80.5 Gy (range, 68.0-95.0 Gy).
      Scleral dose ranged from 225.0 to 940.0 Gy. Pretreatment visual acuity was 6/60
      or better in 43 patients. RESULTS: One patient was lost to follow up and excluded
      from analysis. The remaining 49 patients had a mean follow up of 39.5 months.
      There were seven local failures, with a mean duration to tumour progression of
      16.7 months. All seven patients were successfully managed with enucleation. Five
      other enucleations were performed for treatment-related complications. At the
      time of analysis, 10 patients have died, five of metastatic melanoma. Of the
      patients with preserved globes, corrected visual acuity was 6/60 or better in 31
      patients. CONCLUSIONS: Good local tumour control and survival can be achieved
      with episcleral plaque therapy. Globe preservation with useful vision was
      possible in the majority of cases. Our findings are in keeping with other
      reported series.

PMID- 11202463
TI  - Potential acuity meter results in cataract patients.
AB  - PURPOSE: To determine the ability of the potential acuity meter (PAM) to predict
      potential visual acuity through lenticular opacities in a group of cataract
      patients without significant other ocular pathology. METHODS: This prospective
      study undertook PAM measurements on each eye of 84 subjects during preoperative
      hospital visits to either A Scan or Primary Care clinics. PAM results were
      compared to best corrected visual acuity findings obtained at least 6 weeks post
      cataract extraction. RESULTS: Comparison of PAM result to visual outcome showed
      poor correlation (rho = 0.41, P = 0.0005). Using predictive estimates, 49% of
      subjects' PAM results underestimated visual outcome as determined by a difference
      of greater than 2 Snellen acuity lines in these results. Factors such as
      preoperative vision level, cataract type and pupil dilation did not significantly
      influence the predictive power of the PAM. Preoperative pinhole results were also
      correlated with visual outcome (rho = 0.42, P = 0.0006). Vison in the fellow eye
      of subjects with 6/9 or better was correlated to the PAM result indicating a
      moderate to good predictive power in 'normal' eyes. CONCLUSIONS: PAM results were
      considered to be poor for a clinical test. The results of this study indicate
      that this instrument has only a limited usefulness as part of the standard
      preoperatve examination in patients undergoing cataract extraction.

PMID- 11202464
TI  - Warfarin therapy and cataract surgery.
AB  - PURPOSE: Cataract extraction in the warfarinized patient poses special
      considerations. Warfarin will increase the haemorrhagic risk but, more
      importantly, cessation or reduction in anticoagulation may well lead to serious
      thromboembolic phenomena. The purpose of this study was to assess the impact that
      warfarinization has on cataract extraction. METHODS: One thousand consecutive
      cataract extractions performed at Christchurch Hospital between 1996 and 1998
      were reviewed. Twenty-eight patients (29 eyes) were on warfarin. Reasons for
      anticoagulation, modification to treatment regimen and postoperative outcome
      measures were available for 23 eyes or 79% of the study population. RESULTS: The
      preoperative international normalized ratio (INR) ranged from 1.00 to 2.40+/-0.37
      with a mean of 1.52. No thromboembolic phenomena occurred and four minor
      perioperative haemorrhages were noted, none of which affected the final visual
      outcome. CONCLUSIONS: If warfarin is required to counteract serious
      thromboembolic tendencies, then it should not be ceased perioperatively. The
      small numbers of perioperative haemorrhages that did occur were not visually
      significant.

PMID- 11202465
TI  - Intraretinal axon diameters of a New World primate, the marmoset (Callithrix
      jacchus).
AB  - PURPOSE: Previously, measurements of retinal ganglion cell axon diameter have
      been used to make inferences about the physiology and clinical pathology of the
      visual pathway. However, few of these studies were able to unequivocally relate
      axon diameter to retinal ganglion cell type and other associated measurements. In
      this and our previous study we have examined intraretinal axon diameters to
      determine if differences in axon diameter may help to explain conduction velocity
      measurements found previously. METHODS: Individual retinal ganglion cells of a
      New World primate, the common marmoset (Collithrix jacchus) were injected
      iontophoretically with 2% Lucifer yellow and 4% neurobiotin. Labelled cells were
      visualized by horseradish peroxidase immunohistochemistry and diaminobenzidine
      and then retinae were mounted vitreal side up on a glass slide. Cell measurements
      were made with the aid of a camera lucida attachment and computer-aided
      morphometry Axons were photographed under x 100 oil immersion and measured at a
      final magnification of x 4600. RESULTS: A sample of 62 parasol cells, 22 midget
      cells, 16 hedge cells and 11 small bistratified cells were analysed. Dendritic
      field diameter of the different cell classes showed only moderate (non
      significant) increases with eccentricity. Only the parasol cells demonstrated a
      significant increase in mean axon diameter with eccentricity. When the parasol
      class was examined more closely, it was found that only parasol cells of the
      superior, inferior and temporal retina (SIT group) showed significant positive
      correlations between different cell parameters (mean axon diameter, soma
      diameter, dendritic field diameter, eccentricity). Soma and dendritic field
      diameters of the SIT group were significantly larger than those of the nasal
      parasol cells. However, mean axon diameters of the SIT cells were not
      significantly different from nasal parasol cells. Axon diameters of nasal parasol
      cells were very variable and overlapped those of the midget and hedge cell
      classes to a large extent. CONCLUSIONS: The present data show that for marmoset
      parasol cells there may not be a clearly defined distinction between nasal and
      superior, inferior and temporal parasol cells on the basis of axon size. Of
      particular interest in the present analysis is the clear separation of superior,
      inferior and temporal parasol cells and nasal parasol cells when comparing soma
      and dendritic field diameters which is not reflected in the distribution of axon
      diameters. We suggest that changes in diameter along the length of an axon,
      differences between retinal quadrants and the variability between cells may be
      related to minimization of spatiotemporal dispersion necessary for accurate
      perception of motion within the visual world.

PMID- 11202466
TI  - Acute haemorrhagic keratoconjunctivitis following laser in situ keratomileusis.
AB  - We report two cases of acute haemorrhagic keratoconjunctivitis which occurred
      following laser in situ keratomileusis (LASIK) during an ongoing epidemic. Both
      cases underwent preoperative investigation and surgery on the same day. The
      possible sources of contamination include the paramedical staff, the contact
      instruments used for performing preoperative investigation, surgeon, nurse,
      surgical instruments and eye drops. However, the flap was intact with no haze or
      regression and at 1 year follow up, the visual acuity was maintained at 6/6 in
      both the patients. We recommend greater caution while performing contact
      investigations and strict surgical asepsis during LASIK surgery, routinely as
      well as during epidemics of conjunctivitis.

PMID- 11202467
TI  - Coexistent adenoviral keratoconjunctivitis and Acanthamoeba keratitis.
AB  - A 17-year-old youth presented with bilateral follicular conjunctivitis and
      nummular subepithelial corneal infiltrates. Failure of this to settle in an
      outpatient setting led to corneal scraping with microscopy and culturing for
      bacteria, fungi, Herpes simplex, adenovirus and Acanthamoeba as an inpatient.
      Polymerase chain reaction analysis of corneal cells was positive for adenovirus,
      and culture on live Escherichia coli-coated agar plates was positive for
      Acanthamoeba by phase contrast microscopy on day two. We conclude that
      Acanthomoeba infection can complicate adenoviral keratoconjunctivitis. This
      observation is in keeping with previously reported modes of infection by
      Acanthamoeba, whereby any epithelial breach seems to allow inoculation of the eye
      by this opportunistic organism.

PMID- 11202468
TI  - Cyanoacrylate glue for corneal perforations: a description of a surgical
      technique and a review of the literature.
AB  - The effective early application of a cyanoacrylate glue corneal patch can aid in
      the management of small corneal perforations, corneal melts and wound leaks.
      Their use gives improved visual outcomes with reduced enucleation rates (6% vs
      19%). It may also avoid the need for tectonic penetrating keratoplasty.
      Cyanoacrylate glue prevents re-epithelialization into the zone of damaged and
      naked stroma and prevents the development of the critical setting for collagenase
      production that leads to stromal melting. Cyanoacrylates also have significant
      bacteriostatic activity against gram-positive organisms. We describe a simple and
      easily reproducible method of cyanoacrylate corneal patch application, with
      neglible risk of inadvertent glue complications. It has the further advantage of
      a smooth corneal surface rather than an irregular surface as often occurs with
      direct application methods. With corneal application, the major concern is
      toxicity of cyanoacrylates through direct contact with the corneal endothelium
      and lens. Fibrin glues may be less toxic; however, they are not as readily
      available. The longer alkyl chains of currently available cyanoacrylate glues
      (e.g. Histoacryl) slows degradation significantly, limiting accumulation of
      histotoxic by-products to amounts that can be effectively eliminated by tissues.
      Vigilance in monitoring for infection/corneal infiltrate is necessary at all
      times, especially when the glue has been present for more than 6 weeks. Corneal
      patching with cyanoacrylate glue is a temporizing procedure only, buying time to
      allow healing secondary to medical treatment of the underlying condition, or
      allowing surgery to be elective and under more optimal conditions once
      inflammation has been reduced and the integrity of the globe restored.

PMID- 11202469
TI  - Family ties.

PMID- 11202470
TI  - A horrible system for everybody.

PMID- 11202471
TI  - Tobacco cessation.

PMID- 11202472
TI  - The Langston collection.

PMID- 11202473
TI  - Introduction to symposium: clinical and molecular insights from uncommon lung
      diseases.

PMID- 11202475
TI  - Lymphangioleiomyomatosis.
AB  - Lymphangioleiomyomatosis (LAM), a rare disorder of unknown cause that occurs
      almost exclusively in women of childbearing years, is characterized
      microscopically by abnormal smooth muscle proliferation in the lung, lymphatics,
      and mediastinal, abdominal and lower cervical lymph nodes. LAM is associated with
      progressive dyspnea, recurrent pneumothoraces, chylous effusions, abdominal
      tumors (angiomyolipoma), and chylous ascites. Because of the predilection of this
      disease for young women, therapies to date have mainly involved hormonal
      manipulation. Although the efficacy of these therapies has not been established,
      the clinical course is more favorable in recent studies compared with earlier
      reports.

PMID- 11202474
TI  - Polymorphisms in candidate asthma genes.
AB  - The triad of reversible airway obstruction, bronchial hyperresponsiveness, and
      airway inflammation characterizes asthma. The etiology of asthma is complex and
      involves the interaction of multiple genetic foci and a variety of environmental
      factors, such as protein allergens, chemical sensitizers, and viral or bacterial
      proteins. Candidate asthma genes have been identified that may be linked or
      associated with the asthmatic phenotype. Potential candidate asthma genes include
      cytokine genes, receptor genes, transcription factors, immune recognition genes,
      and genes regulating lipid mediator generation. Although polymorphisms within
      either the promoter or coding region of individual asthma candidate genes have
      been identified, the association between these genetic polymorphisms and the
      asthmatic phenotype remains incompletely defined. Furthermore, genetic
      polymorphisms mediating the asthmatic phenotype are rarely identified in
      individual patients. This manuscript reviews several of the specific mutations
      and polymorphisms that have been identified in candidate asthma genes, such as
      the high affinity IgE receptor, the beta2-adrenergic receptor, the interleukin-4
      promoter and receptor, the tumor necrosis factor gene, and the 5-lipoxygenase
      promoter.

PMID- 11202476
TI  - Surfactant protein B deficiency: insights into surfactant function through
      clinical surfactant protein deficiency.
AB  - Surfactant protein B (SP-B) deficiency is a disorder of surfactant function with
      complete or transient absence of SP-B in term neonates. SP-B, 1 of 4 described
      surfactant-associated proteins, plays a key role in surfactant metabolism,
      particularly in intracellular packaging of surfactant components, formation of
      tubular myelin, and the presentation of the surfactant phospholipid monolayer to
      the air-fluid interface within the alveolus. Neonates with clinical SP-B
      deficiency best demonstrate the key role of SP-B in surfactant function.
      "Classic" deficiency results in severe respiratory failure in term infants and
      death unless lung transplantation is performed. Because the initial description
      of complete deficiency secondary to a homozygous frameshift mutation in codon 121
      of the SP-B cDNA, partial deficiencies with differing genetic backgrounds and
      less severe clinical courses have been reported. These partial deficiency states
      may provide a clearer picture of genotype/phenotype relationships in SP-B
      function and surfactant metabolism. SP-B deficiency or dysfunction may be more
      common than once thought and may play a significant role in neonatal lung
      disease.

PMID- 11202477
TI  - Disorders of ciliary motility.
AB  - Clearance of mucus and other debris from the airways is achieved by 3 main
      mechanisms: mucociliary activity, coughing, and alveolar clearance. Disorders of
      ciliary structure or function results in impaired clearance, and result in
      chronic sinopulmonary disease manifested as chronic sinusitis, otitis media,
      nasal polyposis, and ultimately bronchiectasis. In addition, situs inversus,
      dextrocardia, and infertility can be associated with dysfunctional ciliary
      activity. The term primary ciliary dyskinesia has been proposed for the spectrum
      of these diseases. The term Kartagener syndrome applies to this syndrome when
      accompanied by infertility and dextrocardia or situs inversus. The more common
      types of ciliary dysmotility syndromes are characterized by missing dynein arms,
      central microtubule pairs, inner sheath, radial spokes, or nexin links. In
      addition to structural defects within the cilia, disordered ciliary beating and
      disordered ciliary arrays on epithelial cell surfaces have been described in this
      syndrome. Treatment includes rigorous lung physiotherapy, prophylactic and
      organism-specific antibiotics, and immunization against common pulmonary
      pathogens. Late stages of the disease may require surgical intervention for
      bronchiectasis or lung transplant for end-stage lung disease.

PMID- 11202478
TI  - Alpha1-antitrypsin deficiency: biological answers to clinical questions.
AB  - Alpha1-antitrypsin (alpha1AT) deficiency is a common lethal hereditary disorder
      of white persons of European descent. The condition is characterized by reduced
      serum levels of alpha1AT, a 52-kDa glycoprotein synthesized chiefly in the liver
      and, to a lesser extent, by macrophages and neutrophils. Alpha1AT acts as an
      antiprotease and is the physiological inhibitor of neutrophil serine proteases
      such as neutrophil elastase cathepsin G and proteinase 3. The clinical
      manifestations of alpha1AT deficiency occur chiefly in the lung, with a high risk
      of emphysema occurring by the third or fourth decade of life. Cigarette smoking
      accelerates the development of emphysema in persons with alpha1AT deficiency.
      There is also an increased risk of liver disease in alpha1AT deficiency, which
      occurs mostly in childhood. In this review, we will define further the diagnosis
      of alpha1AT deficiency and its clinical manifestations and describe the
      therapeutic strategies that are currently being developed to treat the hepatic
      and pulmonary disease associated with this condition.

PMID- 11202479
TI  - Common variable immunodeficiency.
AB  - Common variable immunodeficiency (CVI) is a heterogeneous immunodeficiency
      syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections,
      and a variety of immunological abnormalities. In addition to recurrent
      infections, patients with this syndrome also suffer from an increased incidence
      of autoimmune disease and malignancy. Because the spectrum of associated diseases
      is broad, patients with CVI are seen by a variety of medical specialists. In this
      review, the pathogenesis, clinical manifestations, diagnosis, and treatment of
      CVI are discussed.

PMID- 11202480
TI  - Nontuberculous mycobacteria.
AB  - The nontuberculous mycobacteria are for the most part ubiquitous environmental
      organisms that only rarely cause disease in humans. Therefore, the normal host
      defense against these organisms must be quite robust, as exposure is universal
      and disease is rare. The organisms that are most commonly encountered in clinical
      practice, Mycobacterium avium, M. intracellulare, M. kansasii, M. fortuitum, M.
      abscessus, and M. chelonae, are frequently found in water sources and soil. These
      organisms share significant structural and biochemical similarities with their
      more pathogenic relative, M. tuberculosis (MTB). Because they are of
      significantly lower pathogenicity than MTB, patients with abnormal susceptibility
      to these infections should include those with defects that may be identifiable.
      Study of these patients should lead to determination of the mechanisms underlying
      resistance to these organisms, which in turn are likely to be highly informative
      regarding host defense against these infections and their more virulent relative
      MTB. Furthermore, recognition of host factors that permit infection with
      nontuberculous mycobacteria in otherwise normal hosts will identify pathways that
      can be targeted for therapeutic intervention. Thus, the search for genetic and
      acquired susceptibility to nontuberculous mycobacteria is also a search for
      susceptibility factors for MTB as well as an opportunity to recognize endogenous
      pathways that can be exploited therapeutically.

PMID- 11202481
TI  - Pneumocystis carinii pneumonia in patients without HIV infection.
AB  - Pneumocystis carinii is an important, but sporadic, opportunistic pulmonary
      pathogen in immunosuppressed HIV seronegative persons. Historically, patients at
      highest risk for P. carinii pneumonia are included infants with severe
      malnutrition, children with primary immunodeficiencies, patients with
      hematological malignancies, and recipients of solid organ or bone marrow
      transplants. Recently, solid tumor patients, in particular those receiving high
      dose corticosteroids for brain neoplasms, and patients with inflammatory or
      collagen-vascular disorders, especially patients with Wegener granulomatosis
      receiving immunosuppressive therapy, have been identified as subgroups at
      increased risk for P. carinii pneumonia. Other factors associated with P. carinii
      pneumonia include the intensity of the immunosuppressive regimen and tapering
      doses of corticosteroids. Because P. carinii pneumonia is associated with
      significant morbidity and mortality, it is important to identify high-risk
      patient populations to administer effective chemoprophylactic agents, such as
      trimethoprim-sulfamethoxazole.

PMID- 11202482
TI  - Erdheim-Chester disease: a rare multisystem histiocytic disorder associated with
      interstitial lung disease.
AB  - Erdheim-Chester disease (ECD) is a rare multisystem histiocytosis syndrome of
      unknown cause that usually affects adults. Histiocytic infiltration of multiple
      end organs produces bone pain, xanthelasma and xanthoma, exophthalmos, diabetes
      insipidus, and interstitial lung disease. Differential diagnosis includes
      Langerhans cell histiocytosis, metabolic disorders, malignancy, and sarcoidosis.
      ECD can be diagnosed using a combination of clinical and histopathologic
      findings. Sites of involvement include lung, bone, skin, retroorbital tissue,
      central nervous system, pituitary gland, retroperitoneum, and pericardium.
      Symmetrical long bone pain with associated osteosclerotic lesions, xanthomas
      around the eyelids, exophthalmos, and/or diabetes insipidus suggest ECD.
      Approximately 35% of patients have associated lung involvement, characterized by
      interstitial accumulations of histiocytic cells and fibrosis in a predominantly
      perilymphangitic and subpleural pattern. This pattern distinguishes ECD from
      other histiocytic disorders involving the lung. The diagnosis is confirmed by
      tissue biopsies that contain histiocytes with non-Langerhans cell features. In
      general, the clinical course of patients with this disease varies, and the
      prognosis can be poor despite treatment. Clinical trials for treatment of ECD
      have not been conducted and treatment is based on anecdotal experience.

PMID- 11202483
TI  - Wegener granulomatosis.
AB  - Wegener granulomatosis (WG) is a necrotizing, granulomatous vasculitis that has a
      clinical predilection to involve the upper airways, lungs, and kidneys. Although
      the first case was reported by Klinger in 1931, Friedrich Wegener in 1936
      characterized the unique clinical and pathological features of this disease that
      subsequently came to bear his name. Vascular inflammation and occlusion leading
      to tissue ischemia is a hallmark of WG. Although strong evidence indicates that
      such blood vessel damage is immunologically mediated, the mechanisms that
      initiate this process are still largely unknown. To date, there has been no
      clearly established association with genetic factors, specific infectious agents,
      or environmental irritants, although speculation has remained that these may play
      a role in triggering the onset of disease. Until the introduction of therapy with
      cyclophosphamide (CYC) and glucocorticoids, WG was uniformly fatal. Although drug
      toxicity and disease relapse remain of concern with this regimen, it has provided
      us with a successful means of treatment and the opportunity to better understand
      this disease through long-term patient follow-up.

PMID- 11202484
TI  - Potential pathogenesis and clinical aspects of pulmonary fibrosis associated with
      rheumatoid arthritis.
AB  - Pulmonary fibrosis is an extra-articular disorder that can occur in association
      with rheumatoid arthritis. The differential diagnosis of this disorder is similar
      to that of idiopathic pulmonary fibrosis, but specific entities such as atypical
      pulmonary infections and drug-induced interstitial lung disease must be
      considered as causes of pulmonary fibrosis in patients with rheumatoid arthritis.
      Although the cause of lung fibrosis in persons with rheumatoid arthritis is
      unknown, factors that can potentially contribute to the pathogenesis of this
      pulmonary disease include genetic susceptibility, development of an altered
      immunologic response, and/or aberrant host repair processes. The clinical course
      of patients with pulmonary fibrosis and rheumatoid arthritis is heterogeneous but
      is generally insidious, chronic, and progressive. These patients respond
      unpredictably to available empiric therapeutic agents and, overall, their
      prognosis is poor; limited data suggests that the median survival time can be
      less than 4 years.

PMID- 11202485
TI  - Beryllium disease.
AB  - Berylliosis is an environmental chronic inflammatory disorder of the lung caused
      by inhalation of insoluble beryllium (Be) dusts and characterized by the
      accumulation of CD4+ T cells and macrophages in the lower respiratory tract. In
      response to Be inhalation, noncaseating granuloma formation and, eventually,
      fibrosis. The immunopathogenic process is maintained by Be-specific lung CD4+ T
      lymphocytes. Consistent with the disease immunopathology, these Be-specific T
      cells have a T-helper 1 phenotype producing interleukin-2 and interferon-gamma,
      the macrophage-activating cytokine driving the granulomatous reaction. Previous
      studies have demonstrated that the glutamic acid in position 69 of the human
      leukocyte antigen class II b chain is strongly associated with increased
      susceptibility to Be in exposed workers, suggesting that human leukocyte antigen
      gene markers may be used as epidemiological probes to identify population groups
      at higher risk.

PMID- 11202486
TI  - Clinical insights and basic science correlates in sarcoidosis.
AB  - More than a century has elapsed since the initial description of sarcoidosis, but
      critical aspects of the disorder remain poorly understood. Information obtained
      from epidemiologic observations and basic laboratory research suggests that the
      disease may represent an immunologic response to an exogenous agent in a
      genetically susceptible individual. However, a definitive etiologic role for any
      specific exogenous agent has never been proved, and a "candidate gene" underlying
      a predisposition to sarcoidosis has not yet been identified. This review presents
      an historical framework for considering available evidence regarding a
      transmissible agent in sarcoidosis and host susceptibility to the disease.

PMID- 11202487
TI  - William James and the unconscious: redressing a century-old misunderstanding.
AB  - Contrary to received wisdom in psychology, William James did not oppose
      postulating unconscious processes. This mistaken belief stems from a misreading
      of a passage in his Principles concerned with disproving the metaphysical notion
      that mental states are composed of elementary mental units. The term unconscious
      had been co-opted by individuals who supported this position. Unconscious did not
      mean then what it means now. Analysis of the rest of the Principles, his later
      works, and his reactions to the works of others reveals that James actually
      supported what we would now term unconscious processes. He even contributed to
      their study with his notions of the "fringe," "habit," and "subconscious
      incubation." Causes and effects of this misunderstanding are discussed.

PMID- 11202488
TI  - Contrasts and correlations in effect-size estimation.
AB  - This article describes procedures for presenting standardized measures of effect
      size when contrasts are used to ask focused questions of data. The simplest
      contrasts consist of comparisons of two samples (e.g., based on the independent t
      statistic). Useful effect-size indices in this situation are members of the g
      family (e.g., Hedges's g and Cohen's d) and the Pearson r. We review expressions
      for calculating these measures and for transforming them back and forth, and
      describe how to adjust formulas for obtaining g or d from t, or r from g, when
      the sample sizes are unequal. The real-life implications of d or g calculated
      from t become problematic when there are more than two groups, but the
      correlational approach is adaptable and interpretable, although more complex than
      in the case of two groups. We describe a family of four conceptually related
      correlation indices: the alerting correlation, the contrast correlation, the
      effect-size correlation, and the BESD (binomial effect-size display) correlation.
      These last three correlations are identical in the simple setting of only two
      groups, but differ when there are more than two groups.

PMID- 11202489
TI  - Amnesia is a deficit in relational memory.
AB  - Eye movements were monitored to assess memory for scenes indirectly (implicitly).
      Two eye movement-based memory phenomena were observed: (a) the repetition effect,
      a decrease in sampling of previously viewed scenes compared with new scenes,
      reflecting memory for those scenes, and (b) the relational manipulation effect,
      an increase in viewing of the regions where manipulations of relations among
      scene elements had occurred. In normal control subjects, the relational
      manipulation effect was expressed only in the absence of explicit awareness of
      the scene manipulations. Thus, memory representations of scenes contain
      information about relations among elements of the scenes, at least some of which
      is not accessible to verbal report. But amnesic patients with severe memory
      impairment failed to show the relational manipulation effect. Their failure to
      show any demonstrable memory for relations among the constituent elements of
      scenes suggests that amnesia involves a fundamental deficit in relational
      (declarative) memory processing.

PMID- 11202490
TI  - Subliminal mere exposure: specific, general, and diffuse effects.
AB  - The present research examined the possibility that repeated exposure may
      simultaneously produce specific and diffuse effects. In Study 1, participants
      were presented with 5-ms exposures of 25 stimuli each shown once (single-exposure
      condition) or with five repetitions of 5 stimuli (repeated-exposure condition).
      Participants in the repeated-exposure condition subsequently rated their own mood
      more positively than those in the single-exposure condition. Study 2 examined
      whether affect generated by subliminal repeated exposures transfers to unrelated
      stimuli. After a subliminal exposure phase, affective reactions to previously
      exposed stimuli, to new but similar stimuli, and to stimuli from a different
      category were obtained. Previously exposed stimuli were rated most positively and
      novel different stimuli least positively. All stimuli were rated more positively
      in the repeated-exposure condition than in the single-exposure condition. These
      findings suggest that affect generated by subliminal repeated exposure is
      sufficiently diffuse to influence ratings of unrelated stimuli and mood.

PMID- 11202491
TI  - Interactions between visual working memory and selective attention.
AB  - The relationship between working memory and selective attention has traditionally
      been discussed as operating in one direction: Attention filters incoming
      information, allowing only relevant information into short-term processing
      stores. This study tested the prediction that the contents of visual working
      memory also influence the guidance of selective attention. Participants held a
      sample object in working memory on each trial. Two objects, one matching the
      sample and the other novel, were then presented simultaneously. As measured by a
      probe task, attention shifted to the object matching the sample. This effect
      generalized across object type, attentional-probe task, and working memory task.
      In contrast, a matched task with no memory requirement showed the opposite
      pattern, demonstrating that this effect is not simply due to exposure to the
      sample. These results confirm a specific prediction about the influence of
      working memory contents on the guidance of attention.

PMID- 11202492
TI  - Sex differences in mathematical reasoning ability at age 13: their status 20
      years later.
AB  - Reported is the 20-year follow-up of 1,975 mathematically gifted adolescents (top
      1%) whose assessments at age 12 to 14 revealed robust gender differences in
      mathematical reasoning ability. Both sexes became exceptional achievers and
      perceived themselves as such; they reported uniformly high levels of degree
      attainment and satisfaction with both their career direction and their overall
      success. The earlier sex differences in mathematical reasoning ability did
      predict differential educational and occupational outcomes. The observed
      differences also appeared to be a function of sex differences in preferences for
      (a) inorganic versus organic disciplines and (b) a career-focused versus more
      balanced life. Because profile differences in abilities and preferences are
      longitudinally stable, males probably will remain more represented in some
      disciplines, whereas females are likely to remain more represented in others.
      These data have policy implications for higher education and the world of work.

PMID- 11202493
TI  - Group discussion as interactive dialogue or as serial monologue: the influence of
      group size.
AB  - Current models draw a broad distinction between communication as dialogue and
      communication as monologue. The two kinds of models have different implications
      for who influences whom in a group discussion. If the discussion is like
      interactive dialogue, group members should be influenced most by those with whom
      they interact in the discussion; if it is like serial monologue, they should be
      influenced most by the dominant speaker. The experiments reported here show that
      in small, 5-person groups, the communication is like dialogue and members are
      influenced most by those with whom they interact in the discussion. However, in
      large, 10-person groups, the communication is like monologue and members are
      influenced most by the dominant speaker. The difference in mode of communication
      is explained in terms of how speakers in the two sizes of groups design their
      utterances for different audiences.

PMID- 11202494
TI  - Genetic and environmental contributions to loneliness in children.
AB  - This report presents the results of the first behavioral genetic studies of
      children's loneliness. Data were collected using both an adoption design and a
      twin-sibling design. As part of the Colorado Adoption Project, 133 sibling pairs
      (69 biologically related pairs and 64 unrelated pairs in adoptive families)
      completed a general loneliness scale when they were 9, 10, 11, and 12 years old.
      As part of the San Diego Sibling Study, 142 sibling pairs (22 monozygotic twin,
      40 dizygotic twin, and 80 full-sibling pairs) between the ages of 8 and 14 years
      old completed a scale assessing loneliness at school. Both studies showed
      significant heritability and nonshared environmental influences for children's
      loneliness.

PMID- 11202495
TI  - Revisiting the perception of upside-down faces.
AB  - In two experiments, the effect of orientation on face perception was assessed.
      Using a scale from 1 (normal) to 7 (bizarre), participants rated normal,
      unaltered faces and faces in which changes had been made to spatial-relational
      properties (eyes and mouth inverted or relative position of the eyes and mouth
      altered) or to component properties (eyes whitened and teeth blackened). For
      unaltered and component-distortion faces, bizarreness ratings increased linearly
      as orientation increased from 0 degree to 180 degrees. For spatial-distortion
      faces, a discontinuity in the function relating orientation and bizarreness was
      in evidence between 90 degrees and 120 degrees. The results provide support for
      the view that there is a qualitative difference in the processing of upright and
      inverted faces due to the disproportionate effect of inversion on the encoding of
      spatial-relational information.

PMID- 11202496
TI  - How special are objects? Children's reasoning about objects, parts, and holes.
AB  - Discrete physical objects have a special status in cognitive and linguistic
      development. Infants track and enumerate objects, young children are biased to
      construe novel words as referring to objects, and, when asked to count an array
      of items, preschool children tend to count the discrete objects, even if
      explicitly asked to do otherwise. We address here the question of whether
      discrete physical objects are the only entities that have this special status, or
      whether other individuals are salient as well. In two experiments, we found that
      3-year-olds are just as good at identifying, tracking, and counting certain
      nonobject entities (holes in Experiment 1; holes and parts in Experiment 2) as
      they are with objects. These results are discussed in light of different theories
      of the nature and development of children's object bias.

PMID- 11202497
TI  - The integrity of Web-delivered experiments: can you trust the data?
AB  - Data from Web-delivered experiments conducted in browsers by remote users of
      PsychExperiments, a public on-line psychology laboratory, reveal experiment
      effects that mirror lab-based findings, even for experiments that require nearly
      millisecond accuracy of displays and responses. Textbook results are obtained not
      just for within-subjects effects, but for between-subjects effects as well. These
      results suggest that existing technology is adequate to permit Web delivery of
      many cognitive and social psychological experiments and that the added noise
      created by having participants in different settings using different computers is
      easily compensated for by the sample sizes achievable with Web delivery.

PMID- 11202498
TI  - Negotiating false memories: interviewer and rememberer characteristics relate to
      memory distortion.
AB  - In a recent study, more than half of the participants were led to create a
      partial or complete false memory for an emotional childhood event (e.g., serious
      animal attack). Using a subsample from that study, we examined the hypothesis
      that memory distortion is related to characteristics of interviewers and
      rememberers. The relations between susceptibility to memory distortion and (a)
      dissociation (Dissociative Experiences Scale) and (b) personality traits (NEO
      Five Factor Inventory) were investigated. Results indicated that participants who
      exhibited memory distortion scored significantly higher on the dissociative scale
      than their counterparts who did not exhibit memory distortion. Further,
      susceptibility to memory distortion was associated with higher extraversion
      scores in interviewers and lower extraversion scores in participants. This
      pattern of findings suggests that false memories may derive from a social
      negotiation between particular interviewers and rememberers.

PMID- 11202499
TI  - Now you see it, now you don't: explicit versus implicit measures of the
      personal/group discrimination discrepancy.
AB  - When making explicit self-report ratings, members of status- and racial-minority
      groups report less personal experience with discrimination than that encountered
      by their group--a phenomenon called the personal/group discrimination discrepancy
      (PGDD). This study provides evidence, for the first time, that the PGDD may be,
      in part, a product of the procedure used to measure it. White women and men
      completed explicit and implicit measures of personal and group discrimination
      based on sex. The PGDD surfaced among women in the explicit measures, but not in
      the implicit measures. These findings suggest that explicit and implicit measures
      might provide different assessments of experience with discrimination.

PMID- 11202500
TI  - Social dominance orientation and group context in implicit group prejudice.
AB  - We tested the joint influence of individual difference and situational factors on
      implicit group prejudice. Participants in Experiments 1 and 2 were briefly shown
      in-group or out-group pronouns prior to evaluating good or bad trait adjectives.
      Under standard conditions (Experiment 1), there was no difference between
      participants with high and low social dominance orientation (SDO), but when the
      intergroup context was made more salient (Experiment 2), high-SDO participants
      alone showed implicit group prejudice. Implications for the malleability and
      consensuality of implicit prejudice are discussed.

PMID- 11202501
TI  - [Psychotropic effect of the Astragalus mongolicus preparation].
AB  - Study of the pharmacological properties of a preparation from the plants of
      Mongolian milk vetch (Astragalus mongolicus) of the Leguminosae Juss. family
      showed evidence of a pronounced psychotropic activity. The main action components
      are the anxiolytic (tranquilizer), antidepressant, antiamnesic, and
      antiaggressive effects.

PMID- 11202503
TI  - [Comparative characteristics of cerebrovascular protective effects of mildronate,
      riboxine, and their combination during modeling of cerebral hemodynamics
      disturbance].
AB  - Hydrogen clearance, polarographic, and electric impedance measurements on
      conscious rabbits with electrodes implanted into brain cortex, thalamus, and
      hypothalamus were used to study the state of hemodynamics, oxygen and water-
      electrolyte balance on a model of the zero-gravity-induced cerebrovascular
      disorders. The preliminary administration of mildronate (10 mg/kg, p.o.) reduced
      the hemodynamics disorder and optimized the oxygen balance more significantly
      than did riboxin (5 mg/kg). Both drugs markedly decreased the level of edematous
      phenomena in the brain. The antihypoxant and antiedematous effects of mildronate
      and riboxin increased upon their combined administration.

PMID- 11202502
TI  - [Characteristics of effects of acetylene amino alcohols M-cholinoreceptor
      blockers on the dopaminergic system in Daphnia magna].
AB  - Haloperidol and dimethpromide exhibit the properties of dopamine antagonists in
      the experiments on Daphnia magna Straus (Crustaceae family). Haloperidol, in
      contrast to dimethpromide, does not significantly influence the toxic effect of
      apomorphine. It is suggested that acetylene aminoalcohol derivatives are
      selective ligands for one of the subtypes of dopamine receptors.

PMID- 11202504
TI  - [Effect of the sympathetic nervous system activation on the antifibrillatory
      efficacy of various anti-arrhythmia agents].
AB  - Experiments with a 7-min occlusion followed by reperfusion of the left coronary
      artery in narcotized rats showed that antiarrhythmic drugs of various classes-
      ethacizin (class I), AL-275 (class III), and CM-345 (class V)--produce pronounced
      antifibrillatory and antiarrhythmic effects. AL-275 and CM-345, in contrast to
      ethacizin, retained their efficacy under the conditions of isoproterenol-induced
      stimulation of beta-adrenoceptors. This difference in behavior is probably
      explained by dissimilar effects of the antiarrhythmics on the ion channels of
      cardiomyocite membranes.

PMID- 11202505
TI  - [Anti-arrhythmic effect of the sigma-receptor blocker DuP 734 in ischemia and
      myocardial reperfusion].
AB  - It has been found that in vivo pretreatment of rats with the sigma receptor
      antagonist DuP 734 (1 mg/kg) resulted in an increase in the heart tolerance to
      ischemic and reperfusion arrhythmias both in vivo and ex vivo. Administration of
      DuP 734 (1 mg/liter) directly in the perfusion solution of isolated rat heart 10
      min before total ischemia also promoted a decrease in the incidence of
      reperfusion arrhythmias. The normoxic perfusion of isolated rat heart at a dose
      of 1 mg/liter had no effect on the action potential. It was concluded that
      antiarrhythmic effect of DuP 734 might depend on the decrease in the Ca2+
      overload but not on K+ and Na+ channel blockade.

PMID- 11202506
TI  - [Effects of verapamil and gynipral on the uterine contractile activity in rats].
AB  - Verapamil and gynipral administered to pregnant rats in doses on a clinical level
      suppress the uterine contractions, which is manifested by a decrease in the
      amplitude and frequency of the biopotential. The joint administration of gynipral
      and verapamil (in half doses) resulted in a pronounced tocolytic effect.

PMID- 11202507
TI  - [Comparative study of the NMDA-blocking activity and safety of mono- and bis
      cationic compounds in animals].
AB  - Experiments on intact mice and rats showed that the monoammonium adamantyl
      containing compounds memantine, amantadine, and IEM-1958 (an N-propyl amantadine
      analog) are capable of blocking the NMDA receptors and producing the
      anticonvulsant and antihypoxant effects in the case of a systemic administration
      in doses close to toxic. The acute toxicity of these compounds upon
      intraperitoneal injections to mice is manifested in doses only 2-8 times the
      minimum effective dose level. The bis-cationic compounds (arcaine, IEM-1464, and
      IEM 1490) containing two identical cation groups, exhibit a more pronounced
      activity and higher safety as compared to those of their monocationic
      counterparts. This is explained by the ability of the bis-cationic compounds to
      block a polyamine site of the NMDA receptor. Arcaine (the polyamine site blocker)
      and IEM-1464 produce the NMDA-receptor-blocking effect and exhibit the
      anticonvulsant and antihypoxant activity in doses 5-10 times smaller as compared
      to the effective dose of memantine. At the same time, arcaine is 5 times less
      toxic than memantine. The bis-adamantyl derivative IEM-13490 is 100-150 times
      more active and has a 139 times greater therapeutic ratio than memantine.

PMID- 11202508
TI  - [Effect of chronic epaden administration on the tissue plasminogen activator
      activity in rabbits].
AB  - The chronic oral administration of epaden (a concentrate of n-3 polyunsaturated
      fatty acids, n-3 PUFA) to rabbits leads to a decrease in activity of the tissue
      type plasminogen activator (t-PA) in the blood plasma. In order to elucidate the
      mechanism of this phenomenon, the epinephrine (adrenaline) stimulated t-PA
      release in rabbits pretreated with epaden for 4 weeks was compared to that in the
      control (untreated) group. The epinephrine injections led to a reliable, albeit
      short-time, increase in the t-PA activity in both test and control groups.
      Although the base activity of t-PA in the epaden-treated group was lower than
      that in the control group, the t-PA release in the former group was more
      pronounced. In addition, the t-PA production was induced by the immobilization
      shock model in rabbits one month after beginning of the epaden administration
      (animals in the control group were subject to the shock without epaden
      pretreatment). In this test, the t-PA release was also more intense in the epaden
      treated animals. These results indicate that the dietary epaden administration
      per os reduces the basal t-PA level, but increases the agonist-induced
      plasminogen activator production.

PMID- 11202509
TI  - [Hemostimulant effect of pantohematogen in myelosuppression induced by
      cytostatics].
AB  - Pantohematogen stimulates hemopoiesis in mice with cyclophosphane induced bone
      marrow hypoplasia. The hemopoiesis recovery activated by pantohematogen is
      manifested by the granulocyte lineage hyperplasia in the bone marrow, rapid
      restoration of the polymorphonuclear leukocyte and monocyte counts in the
      peripheral blood, and the development of neutrophilia and monocytosis. The
      activation effect of pantohematogen on the bone marrow hemopoiesis is related to
      stimulating the precursor cell proliferation and differentiation and to
      increasing the functional activity of the hemopoietic microenvironment.

PMID- 11202510
TI  - [Ultrastructural changes in the pancreas of rats with acute pancreatitis after
      semax administration].
AB  - Semax favorably affects ultrastructural changes in the pancreas of rats with
      acute pancreatitis (AP): a single introduction of semax (0.1 mg/kg) into the
      pancreatic duct of rats with AP model prevents increased necrosis of the acinar
      tissues and inhibits purulent inflammation of the necrotised lobules by inducing
      their sclerosis and atrophy, thus retaining large areas of the pancreas intact.

PMID- 11202511
TI  - [Comparative study of dimephosphon and xidiphone efficacy in steroid-induced
      osteoporosis in rats].
AB  - The efficacy of dimephosphon in comparison with xydiphone was studied in rats
      with an osteoporosis model induced by prednisolone administration at a daily dose
      of 50 mg/kg over a period of 14 days. The prednisolone treatment led to an
      increase in the content of oxyproline (a marker of bone resorption), calcium, and
      inorganic phosphates in the urine. Dimephosphon (monophosphate) decreased the
      levels of oxyproline, calcium, and inorganic phosphate in the urine. Xydiphone
      (biphosphonate) equally reduced the oxyproline excretion and the calcium level in
      urine, while rather insignificantly affecting the phosphaturia. Dimephosphon
      normalized the blood calcium level, while xydiphone decreased this parameter. An
      additional advantage of dimephosphon over xydiphone was manifested by
      normalization of the body weight of test rats and the total blood protein level.

PMID- 11202512
TI  - [Potential role of the antimutagenic effect of xymedone in modification of
      immunoreactivity].
AB  - Effects of the pyrimidine derivatives of xymedone and methyluracil upon the
      induction of point mutations of the base pair substitution type in the
      Salmonella/microsome test and the frequency of chromosome aberrations in the
      lymphocytes of patients with the chronic osteomyelitis diagnosis. Xymedone more
      effectively than methyluracil inhibited the induction of point mutations by
      nitrosomethylurea. In the case of the cyclophosphane induced mutagenesis, the two
      preparations exhibited comparable antimutagen effects. Both xymedone and
      methyluracil (1.5 g/day, 10 days) reduced the (increased) frequency of
      chromosomal aberrations in the lymphocytes of patients with the chronic
      osteomyelitis diagnosis. The anticlastogenic effect of methyluracil vanished 5
      days after termination of the 10-day administration course, while xymedone
      exhibited an afteraction anticlastogenic effect over this period. Interrelation
      of the antimutagen effect and immunomodulating activity of xymedone is discussed.

PMID- 11202513
TI  - [Anti-inflammatory effect of fensulkal].
AB  - Experiments on various animals showed that fensulkal, a new phenylglyoxylic acid
      derivative, possesses a high antiinflammatory activity and low toxicity, markedly
      exceeding butadion in the therapeutic index. The mechanism of the antiphlogistic
      effect of fensulkal is due to its antagonism with respect to mediators of the
      inflammatory process and the ability of suppressing the increased permeability of
      capillaries and is partly related to the adrenal cortex. The drug is registered
      and recommended for application as antiinflammatory remedy in the form of
      ointment to be used for the treatment of some gynecological disorders.

PMID- 11202514
TI  - [Acute toxicity of bemithyl and bromithyl].
AB  - The experiments on rats showed for bemithyl LD50 = 581.48 (350.17-965.57) mg/kg
      and for bromithyl LD50 = 1750.30 (1463.07-2093.92) mg/kg (males) and 1584.29
      (1280.46-1960.22) mg/kg (females). The therapeutic ratios are 4-6 for both drugs,
      while the toxicity index is 10-15 for bemithyl and 20 <196> 22 for bromithyl. It
      was established that ergotropic effects prevail in the toxicity of bemithyl
      administered in the 20-80 mg/kg dose range, while trophotropic effects are
      dominating at doses above 100 mg/kg. Bromithyl exhibits a dose-dependent
      trophotropic effect in the entire dose range.

PMID- 11202515
TI  - [Effect of antioxidants on endotoxicosis in experimental peritonitis].
AB  - The chronic experiments on dogs with a peritonitis model showed that drugs
      possessing antioxidant properties (vitamin E, dimephosphon, xymedone) are capable
      of decreasing the inflammatory phenomena in abdominal cavity and decreasing the
      expression of endogenous intoxication, as manifested by a decrease in the plasma
      toxicity and the content of average-molecular-weight peptides and lipid
      peroxidation products. The most pronounced positive effect was observed for
      xymedone. A certain correlation between the effects of antioxidants upon
      endotoxicosis and free-radical lipid peroxidation reactions was established. This
      result suggests the therapeutic effect of antioxidants used for the treatment of
      peritonitis is related to their membrane-stabilizing ability.

PMID- 11202516
TI  - [Morphological estimation of apoptosis in preclinical studies of new drugs].
AB  - A method for morphological estimation of the thymus cell loss during apoptosis
      proposed, which can be used as a screening test in the stage of preclinical
      characterization of new biologically active compounds. Efficacy of the proposed
      method is demonstrated by evaluating the degree of apoptosis-inducing effect of
      some antitumor preparations.

PMID- 11202518
TI  - [Chronopharmacology of cardiovascular drugs].

PMID- 11202517
TI  - [Measurement of the transcapillary fluid exchange in anesthesized rats].
AB  - An experimental model was developed for the study of antiedemic drug activity in
      anesthetized rats. The effect of furosemide upon the transcapillary fluid shift
      was studied. It is shown that the character of changes in the arterio-venous
      difference of blood density in response to postural (orthostatic versus
      antiorthostatic) changes can be used to udge on the filtration and reabsorption
      processes in the microcirculation bed of hind extremities in anesthetized rats.

PMID- 11202519
TI  - [Importance of adenosine A2A receptors in resistance to complete global cerebral
      ischemia].
AB  - Selective A2A agonists (CGS 21680 and DPMA) produce a moderate neuroprotector
      effect with respect to the complete global cerebral ischemia (GCI). At the same
      time, selective A2A antagonists 8-(3-chlorostyrylcaffeine (CSC) and ZM 241385
      somewhat reduce the brain resistance to complete GCI, completely prevent the
      neuroprotector effect of CGS 21680, partly suppress the neuroprotector activity
      of adenosine and 5'-N-ethylcarboxamidoadenosine (NECA), and do not affect (CSC)
      or potentiate (ZM 241385) the neuroprotector effect of N6-cyclopentyladenosine.
      The A2A-receptors are probably mediating in the neuroprotector activity of CGS
      21680 and participating in the natural brain stability with respect to complete
      GCI, as well as in the effects of NECA and adenosine.

PMID- 11202520
TI  - Hard to swallow. The high cost of direct-to-consumer advertising.

PMID- 11202522
TI  - Drug rep advice raises gift ethics concerns.

PMID- 11202521
TI  - Closing the door on sample closets.

PMID- 11202523
TI  - Drug prices. In search of a fix.

PMID- 11202524
TI  - The Minnesota Medical Association's resolutions on pharmaceutical policy.

PMID- 11202525
TI  - Maine Rx: the act to establish fairer prescription drug prices.

PMID- 11202526
TI  - The MMA's 2001 legislative preview.

PMID- 11202527
TI  - A focus on pharmacy.

PMID- 11202528
TI  - Genome holds key to preventive medicine.

PMID- 11202529
TI  - Consumers use error rates to judge health care quality, survey shows.

PMID- 11202530
TI  - USP issues first report from medication-errors database.

PMID- 11202531
TI  - Internet use affects health care decision-making, survey confirms.

PMID- 11202532
TI  - Pharmacist shortage identified by government.

PMID- 11202533
TI  - Revising a policy on inline filtration.

PMID- 11202534
TI  - Pygeum.

PMID- 11202535
TI  - Projecting future drug expenditures--2001.
AB  - Drug cost projections for 2001 and factors that are likely to influence drug
      costs are discussed. The year 2000 introduced many new factors into the decision
      making process for drug pricing and raised new considerations regarding drug
      therapy, distribution, and costs. It is anticipated that drug costs will continue
      to increase at a rate of 11-15% in 2001. Research and development expenditures
      for new drugs continue to grow and are estimated to be $26.4 billion in 2000, but
      the number of new drug approvals, especially for new entities, has not increased
      significantly. The generic drug industry has been expanding, and sales of
      generics are expected to increase to $20 billion by 2005. Drug costs also keep
      rising, and sales may reach $243 billion by 2008; this amounts to 12.6% of total
      health care spending, compared with 8.1% in 1999. There is a trend toward
      increasing the rate of conversion of prescription drugs to nonprescription
      status; this may reduce drug budgets somewhat. 2001 will see new systems of drug
      distribution and pricing, a federal prospective pricing system for ambulatory
      care patients covered by Medicare, drug imports from foreign manufacturers, and
      states taking legal action to reduce prescription drug costs. Drug costs in 2001
      are expected to continue to increase at double-digit rates. The increase in costs
      is due to increased utilization, to new products replacing older products, and to
      price increases for drugs currently on the market.

PMID- 11202536
TI  - Regulation of the compounding of positron emission tomography drugs.
AB  - Controversial aspects of the regulatory framework for compounding drug products
      used in positron emission tomography (PET) are discussed. The Food and Drug
      Administration Modernization Act of 1997 (FDAMA), which amends the Federal Food,
      Drug, and Cosmetic Act (FFDCA), required that FDA establish approval (new drug
      application [NDA] and abbreviated new drug application [ANDA]) procedures and
      current good manufacturing practice (CGMP) requirements for PET drugs; this seems
      to conflict with differentiation between manufacturing and compounding in FFDCA.
      Compounding by pharmacists is implied in the FDAMA section on PET, but specific
      mention of "pharmacist" needs to be included. Congress apparently did not intend
      for compounded PET drugs to be regulated differently from other drugs. Although
      FDA has waived NDA and ANDA fees for three PET radiopharmaceuticals, revision of
      FDAMA to exempt PET drug products from regulations placed on manufacturing is
      needed. Without relief from the current regulations, many academic PET centers
      are likely to close; this would violate FDAMA's stated intent of making PET
      available to patients at reasonable cost. Also problematic is FDAMA's prohibition
      of compounding "regularly or in inordinate amounts" a product that is
      commercially available; the common PET radiopharmaceutical fludeoxyglucose F 18
      injection, for example, is commercially available. A sensible alternative to NDA
      or ANDA and CGMP requirements would be the enforcement of USP standards for PET
      drugs by state boards of pharmacy.

PMID- 11202537
TI  - Current role of beta-adrenergic blockers in the treatment of chronic congestive
      heart failure.
AB  - Recent findings on the use of beta-adrenergic blockers in patients with
      congestive heart failure (CHF) are reviewed. CHF is a progressive, debilitating
      disease that afflicts 4.6 million patients in the United States. Treatment has
      traditionally consisted of a diuretic, an angiotensin-converting-enzyme (ACE)
      inhibitor, and digoxin. Despite advances in ACE-inhibitor therapy, the five-year
      mortality rate remains nearly 50%. Overstimulation of the sympathetic nervous
      system is believed to contribute to mortality. Beta-blockers have recently been
      added to the standard of care for patients with New York Heart Association
      functional class II or III heart failure. Four randomized, double-blind, placebo
      controlled clinical trials were recently completed that addressed the benefits of
      beta-blockers in CHF. The overall mortality rate was reduced 65% by carvedilol,
      34% by metoprolol, and 33% by bisoprolol; all these reductions were significant
      compared with placebo, and the trials were ended early. Bucindolol, however, did
      not have a significant effect on mortality. These drugs are hepatically
      metabolized and may require dosage adjustment in hepatically impaired patients.
      Decompensation of heart failure is another consideration; a beta-blocker should
      be added only for patients with stable CHF. Dosages must be slowly adjusted to
      targeted levels. Adverse effects do not differ significantly among beta-blockers.
      In addition to their effect on mortality, beta-blockers reduce CHF-related
      morbidity, such as all-cause hospitalization. Carvedilol, metoprolol, and
      bisoprolol decrease the mortality and morbidity associated with CHF and can be
      used with limited adverse effects. The choice among these agents does not affect
      clinical outcomes; bucindolol, however, has proven ineffective.

PMID- 11202538
TI  - Beyond pharmaceutical manufacturer assistance: broadening the scope of an
      indigent drug program.
AB  - A medication assistance program at a university medical center is described. The
      program was implemented in July 1999 by the ambulatory care pharmacy at the
      University of Illinois at Chicago Medical Center (UICMC). A full-time pharmacist
      and a full-time social worker run the program, along with support from
      technicians and a student extern. The program functions like a clinic, with both
      scheduled appointments and drop-ins. Patients are referred by UICMC providers or
      may self-refer. Sources of assistance include Medicaid, Medicare Part B, several
      state programs, manufacturers' programs, drug samples, private insurance plans
      and HMOs, and the patients themselves in the form of small payments. Patients
      receive medications at UICMC's expense only as a last resort. The medication
      assistance program helped 231 patients in the six months from July to December
      1999. Program costs totaled $110,537, but $237,985 was saved. Only 13% of the
      savings came from pharmaceutical companies; 63% came from Medicaid. Experience
      with the program suggests that medication assistance initiatives should be
      structured to tap the full spectrum of resources for indigent patients, that
      programs be staffed by personnel with relevant experience, that program staff be
      prepared to work closely with patients and to follow up, and that the
      institution's charitable goods and services be restricted to patients for whom
      there are no other resources. A highly proactive medication assistance program at
      a university medical center improves the access of indigent patients to
      medications and is cost-effective.

PMID- 11202539
TI  - Health care costs associated with escalation of drug treatment in type 2 diabetes
      mellitus.
AB  - The cost of different intensities of therapy in HMO patients with type 2 diabetes
      mellitus was studied. Health care utilization data from 1995 were obtained for
      12,200 registrants from the Kaiser Permanente Northwest Diabetes Registry who had
      type 2 diabetes mellitus. The data were used to determine costs associated with
      the escalation of antidiabetic therapies in persons with type 2 diabetes
      mellitus. The total annual costs (in 1993 dollars) associated with no drug
      therapy, a sulfonylurea only, metformin, a sulfonylurea plus insulin, and insulin
      alone were $4400, $4187, $4838, $8856, and $7365, respectively. Per patient total
      costs were higher for patients who had received antidiabetic therapy in 1995 or
      previously than for those who had not ($5303 versus $4365) and for patients who
      had received insulin therapy than for those who had not ($7379 versus $4117).
      Macrovascular complications accounted for 62-89% of the cost associated with
      inpatient treatment of diabetes-related complications. The total cost of treating
      patients with type 2 diabetes mellitus at an HMO increased as antidiabetic
      therapies escalated.

PMID- 11202540
TI  - Tracking pharmacist interventions with a hand-held computer.

PMID- 11202541
TI  - Pharmaceutical manufacturer assistance programs for indigent patients: solution
      or symptom?

PMID- 11202542
TI  - Reimbursement for pharmacists' cognitive services in the inpatient setting.

PMID- 11202543
TI  - Focus group on telepharmacy.
AB  - The focus group strongly believed that telepharmacy will change the practice of
      pharmacy and that it is not a matter of if or when but how. Consumers'
      expectations and the need for efficient health care delivery will drive the use
      of technology. Pharmacists have considerable lever-age in this technological
      world because of the money associated with the use of medications. Telepharmacy
      holds great promise for the profession and should result in greater visibility of
      pharmacists and enhanced patient access to their services.

PMID- 11202544
TI  - The paratesticular region: histoanatomic and general considerations.
AB  - The paratesticular region includes the testicular collecting system, the
      testicular tunics, and spermatic cord. For the purpose of discussion in this
      issue, the rete testis is also considered part of the paratestis, although it is
      principally intratesticular in location. The embryologic origins of the
      paratesticular components and their detailed anatomic and histologic features are
      presented to provide a background to better understand the pathologic processes
      affecting the paratestis. A wide variety of cysts, hyperplasias, neoplasms, and
      tumor-like conditions may affect the paratesticular region, at times resulting in
      challenging problems in differential diagnosis. An approach to the paratesticular
      causes of an intrascrotal mass lesion is presented.

PMID- 11202545
TI  - Cysts and epithelial proliferations of the testicular collecting system
      (including rete testis).
AB  - Neoplastic and non-neoplastic proliferations of the testicular collecting system
      may be a source of diagnostic difficulty as they are rarely encountered and may
      have an appearance that leads to confusion with lesions arising in adjacent
      structures. The rete testis and epididymis are the 2 sites that are most likely
      to give rise to this unusual group of lesions. This article principally, although
      not exclusively, deals with those lesions that produce an intrascrotal mass.
      These include benign acquired or developmental cysts such as cystic dysgenesis of
      the rete testis or acquired cystic transformation of the rete testis, non
      neoplastic epithelial proliferations such as adenomatous hyperplasia of the rete
      testis or cribriform hyperplasia of the epididymis, and benign or malignant
      neoplasms. Rete testis cystadenoma, including the sertoliform variant, and
      papillary cystadenoma of the epididymis are examples of benign tumors of the
      testicular collecting system that must be considered, the latter is the more
      likely of the 2 to be encountered. Primary carcinoma of either the rete testis or
      the epididymis is a rare occurrence; these entities are considered in some detail
      to allow for their recognition and distinction from other tumors that may occur
      in this region. Our own experience with 18 unpublished cases of lesions of the
      rete is also present.

PMID- 11202546
TI  - Mesothelial lesions of the paratesticular region.
AB  - Mesothelial lesions involving the paratesticular region include mesothelial
      cysts, reactive mesothelial hyperplasia, adenomatoid tumors, benign cystic
      mesothelioma, well-differentiated papillary mesothelioma, and malignant
      mesothelioma. The diagnosis and management of these lesions are often difficult
      for surgical pathologists, surgeons, and oncologists alike. Mesothelial lesions
      are relatively uncommon and most benign and malignant tumors present as
      testicular tumors with no specific findings. A preoperative diagnosis of
      malignancy is rarely made, and there is no established effective therapy for
      malignant mesothelioma. This article reviews the clinicopathologic features of
      paratesticular mesothelial lesions with emphasis in their differential diagnosis
      and prognosis.

PMID- 11202547
TI  - Paratesticular soft tissue neoplasms.
AB  - Paratesticular soft tissue tumors are uncommon neoplasms that may present
      significant challenges for the pathologist and clinician. This article reviews
      the incidence of these rare tumors, and on the common benign and malignant
      entities that occur in this location. Key points in differential diagnosis are
      emphasized. The grading, staging, and management of patients with paratesticular
      sarcomas is also discussed.

PMID- 11202548
TI  - Miscellaneous rare paratesticular tumors.
AB  - A few uncommon but distinctive tumors may preferentially involve the paratestis.
      The 3 unusual tumors that represent the focus of this discussion are the ovarian
      type epithelial tumors (OTET), the desmoplastic small round cell tumor (DSRCT),
      and the melanotic neuroectodermal tumor of infancy (MNTI). The OTETs are
      testicular homologues of their more common namesake counterparts that arise in
      the ovary. Most frequent of these are serous tumors of borderline malignancy,
      with fewer cases of serous carcinomas or other forms of mullerian
      differentiation. DSRCT is an increasingly recognized, aggressive, "small blue
      cell" neoplasm with distinctive clinical and pathologic features. These
      polyphenotypic tumors characteristically, but not invariably, arise in intimate
      association with the serosal membrane of the peritoneal cavity and harbor a
      signature translocation-t(11;22)(p13,q12). In the paratestis they often involve
      the surface of the epididymis. The MNTI is an enigmatic, histologically
      distinctive, low-grade neoplasm occasionally encountered in the epididymis.
      Recognition of its features is essential to avoid misdiagnosis as a more
      aggressive "small blue cell" neoplasm and consequent therapeutic mismanagement.
      Primary hematopoietic tumors of the paratesticular structures are rare. There
      appears to be a tendency for young men to have low-grade lymphomas with an
      indolent course and older patients to develop higher-grade tumors. Plasmacytoma
      and granulocytic sarcoma of the paratestis are even more rare and are often
      susceptible to misinterpretation. Finally, metastatic tumors and a variety of
      other very rare neoplasms are discussed.

PMID- 11202549
TI  - Paratesticular tumor-like lesions.
AB  - The diverse non-neoplastic lesions that occur in the paratesticular region and
      may potentially mimic neoplasms are considered. These include some aspects of
      normal histology such as a cribriform pattern of the epididymis, bizarre nuclear
      atypia within epididymal epithelial cells and the presence of Leydig cells
      outside the testicular parenchyma. Inflammatory changes associated with a
      hydrocele and a variety of granulomatous and nongranulomatous infectious
      disorders may mimic a neoplasm on gross evaluation, but should be readily
      distinguished from them microscopically. This is also the case with malakoplakia
      and sarcoidosis, which rarely form a paratesticular mass. Other lesions
      considered are changes associated with vasculitis, the recently described
      entities inflammatory pseudotumor and fibromuscular hyperplasia and the well
      known processes sperm granuloma, spermatocele, vasitis nodosa, fibrous
      pseudotumor, meconium periorchitis, mesothelial hyperplasia, the testicular tumor
      of the adrenogenital syndrome, sclerosing lipogranuloma, and splenic-gonadal
      fusion. Features that aid in the microscopic distinction of these lesions from
      neoplasms are emphasized.

PMID- 11202550
TI  - Pet travel: MAFF issues proposals for reforming quarantine rules.

PMID- 11202552
TI  - Non-infectious factors associated with macroscopic and microscopic lung lesions
      in slaughter pigs from farrow-to-finish herds.
AB  - A cross-sectional epidemiological study was conducted in 150 randomly selected
      farrow-to-finish herds to investigate which non-infectious factors might act as
      risk indicators for the prevalence and severity of macroscopic and microscopic
      lung lesions in slaughter pigs. Data were collected during herd visits through
      inspections of the pigs and through interviews with the farmers. Macroscopic lung
      lesions of pneumonia and pleuritis were recorded at slaughter from 25 pigs per
      herd, and microscopic lung lesions of lymphohistiocytic infiltration were
      recorded from 10 pigs per herd. The median herd level prevalences were 24 per
      cent for pneumonia, 16 per cent for pleuritis and 60 per cent for
      lymphohistiocytic infiltration. Pneumonia lesions were negatively associated with
      pleuritis lesions and positively associated with lymphohistiocytic infiltration.
      Pleuritis lesions were negatively associated with lymphohistiocytic infiltration.
      The prevalence and the severity of pneumonia lesions were increased by a high
      frequency of purchasing gilts and by a slaughter date in January to February. The
      presence of a growing unit also increased the severity of pneumonia. The
      prevalence and the severity of pleuritis lesions were higher when there were more
      pig herds in the municipality, and when there were poor biosecurity measures, and
      their prevalence was increased by a slaughter date in January to February, and
      their severity by a slaughter date in March to April. An increase in the airspace
      stocking density in the finishing unit also increased the prevalence of
      pleuritis. The prevalence and the severity of lymphohistiocytic infiltration in
      the lung tissue were higher in herds purchasing gilts. Pigs raised in pens with
      slatted floors were also at higher risk of more severe lesions of
      lymphohistiocytic infiltration.

PMID- 11202551
TI  - Acute phase proteins in serum and milk from dairy cows with clinical mastitis.
AB  - The serum concentrations of haptoglobin, serum amyloid A and alpha1 acid
      glycoprotein were determined in serum collected from healthy dairy cows and cows
      with clinical mastitis, graded as mild (clots in milk) or moderate (clots in milk
      and visible signs of inflammation in the mammary gland/s) to assess their
      relative diagnostic value in detecting the disease. The concentrations of
      haptoglobin and serum amyloid A were also measured in milk collected from
      infected and uninfected quarters. The concentrations of haptoglobin and serum
      amyloid A were higher in the serum and milk from the cows with mild or moderate
      mastitis. The diagnostic value of haptoglobin in differentiating between healthy
      animals and those with mastitis gave sensitivities and specificities of 82 per
      cent and 94 per cent respectively with serum and 86 per cent and 100 per cent
      with milk. The diagnostic value of serum amyloid A in differentiating between
      healthy animals and those with mastitis gave sensitivities and specificities of
      83 per cent and 90 per cent with serum and 93 per cent and 100 per cent with
      milk. The diagnostic value of serum alpha1 acid glycoprotein in differentiating
      between healthy animals and those with mastitis gave sensitivities and
      specificities of 62 per cent and 91 per cent.

PMID- 11202553
TI  - Echocardiography of the normal bovine heart: technique and ultrasonographic
      appearance.
AB  - Fifty-one clinically healthy cows were examined ultrasonographically from the
      third and fourth intercostal spaces on both sides of the thorax. A 3.0 MHz
      transducer was used and the heart was examined in the caudal long, caudal short
      and cranial long axes on the right side, and in the caudal and cranial long axes
      on the left side. In each position the optimal transducer orientation and the
      images of the structures were recorded. In the caudal long axis view of the heart
      on the right (transducer positioned at the fourth intercostal space), all four
      chambers were visible with the transducer positioned 8 to 10 cm dorsal to the
      level of the olecranon. The left ventricular outflow tract, consisting of the
      aortic valve and ascending aorta, were visible in the same position with the
      transducer rotated 10 to 40 degrees clockwise. In the caudal short axis view of
      the heart on the right, the left and right ventricles were visible in cross
      section with the transducer held at right angles to the ribs in the fourth
      intercostal space, 3 to 6 cm dorsal to the olecranon and tipped slightly
      dorsally. In the cranial long axis view of the heart on the right, the right
      ventricular outflow tract, consisting of the pulmonary valve and pulmonary
      artery, was visible in the third intercostal space, 8 to 10 cm dorsal to the
      olecranon with the transducer angled craniodorsally and rotated 10 to 20 degrees
      clockwise. In the caudal long axis view of the heart on the left, the left and
      right ventricles and the left ventricular outflow tract were visible with the
      transducer placed in the fourth intercostal space. In the cranial long axis view
      on the left, the right ventricular outflow tract was visible.

PMID- 11202554
TI  - First confirmed native case of bovine spongiform encephalopathy in Denmark.

PMID- 11202555
TI  - Lack of association between retention of fetal membranes and mastitis in ewes.

PMID- 11202556
TI  - Caryospora species in a snowy owl (Nyctea scandiaca).

PMID- 11202557
TI  - Cutaneous nodular phaeohyphomycosis in five horses associated with Alternaria
      alternata infection.

PMID- 11202558
TI  - Phillips report and the origin of BSE.

PMID- 11202559
TI  - Neutering of dogs.

PMID- 11202560
TI  - Alopecia X in dogs.

PMID- 11202561
TI  - Hibernated human fetal striatal tissue: successful transplantation in a rat model
      of Huntington's disease.
AB  - The use of fresh human fetal tissue in neural transplantation presents
      considerable logistical difficulties and limits the clinical applicability of
      this promising therapy. This study compared the survival of human fetal striatal
      tissue that had been stored for 24 h in a defined hibernation medium with that of
      fresh human fetal striatal tissue following xenotransplantation in a rat model of
      Huntington's disease (HD). Six to 7 weeks postgrafting, there was no significant
      difference between fresh and hibernated grafts in volume or in various striatal
      phenotypic markers, although there was a trend towards decreased graft volume. We
      conclude that short-term hibernation of this tissue is without significant
      adverse effects on the survival of grafted human fetal striatal tissue. This has
      important implications for the practical implementation of clinical neural
      transplant programs in HD.

PMID- 11202562
TI  - The effects of taurine on hNT neurons transplanted in adult rat striatum.
AB  - Taurine acts as an antioxidant able to protect neurons from free radical-mediated
      cellular damage. Moreover, it modulates the immune response of astrocytes that
      participate in neurodegenerative processes. The objective of this study was to
      examine whether taurine can prevent or attenuate the host inflammatory response
      induced by the xenotransplantation of neurons derived from the human
      teratocarcinoma cell line (hNT neurons). Male Sprague-Dawley rats were treated IP
      with either saline or taurine. Animals from both groups were perfused on the 4th
      or 11th day and the saline or taurine was administered from the start of the
      study until the day prior to sacrifice. The brains were processed
      immunohistochemically using antibodies against glial fibrillary acidic protein
      (GFAP), microglia (OX42), and human nuclear matrix antigen (NuMA). In the saline
      group, NuMA labeling revealed small grafts on the 4th day and no surviving cells
      on the 11th day. However, in the group that received taurine there were surviving
      grafts at both time points. Strong immunoreactivity for GFAP and OX42 was
      detected in the saline group surrounding the transplant. These effects were
      reduced in animals receiving taurine. Taken together, these results demonstrated
      that taurine was able to facilitate graft survival and attenuate the immune
      response generated by the xenograft.

PMID- 11202563
TI  - A new type of biocompatible bridging structure supports axon regrowth after
      implantation into the lesioned rat optic tract.
AB  - We have developed a new type of polymer/cell/matrix implant and tested whether it
      can promote the regrowth of retinal ganglion cell (RGC) and other axons across
      surgically induced tissue defects in the CNS. The constructs, which consisted of
      2-2.5-mm-long polycarbonate tubes filled with lens capsule-derived extracellular
      matrix coated with cultured neonatal Schwann cells, were implanted into lesion
      cavities made in the left optic tract (OT) of 18-21-day-old rats. In one group,
      to promote Schwann cell proliferation and perhaps also to stimulate axon
      regrowth, basic fibroblast growth factor (bFGF) was added to the lens capsule
      matrix prior to implantation. In another group, to determine whether application
      of growth factors to the somata of cells enhances the regrowth of distally
      injured axons, the neurotrophin NT-4/5 was injected into the eye contralateral to
      the OT lesion. NT-4/5 and bFGF treatments were combined in some rats. After
      medium-term (4-10 weeks) or long-term (15-20 weeks) survivals, axon growth into
      implants was assessed immunohistochemically using a neurofilament (RT97)
      antibody. RGC axons were visualized after injection of WGA/HRP into the right
      eye. Viable Schwann cells were present in implants at all times after
      transplantation. Large numbers of RT97+ axons were consistently found within the
      bridging implants, often associated with the peripheral glia. Axons were traced
      up to 1.7 mm from the nearest CNS neuropil and there was immunohistochemical
      evidence of myelination by Schwann cells and by host oligodendrocytes. There were
      fewer RGC axons in the implants, fibers growing up to 1.6 mm from the thalamus.
      Neither NT-4/5 nor bFGF, alone or in combination, significantly increased the
      extent of RGC axon growth within the implants. A group of OT-lesioned rats was
      implanted with polymer tubes filled with 2-2.5-mm-long pieces of predegenerate
      peripheral nerve. Surprisingly, polymer/cell/matrix constructs contained
      comparatively greater numbers of RGC and other axons and supported more extensive
      axon elongation. Thus, implants of this type may potentially be useful in
      bridging large tissue defects in the CNS.

PMID- 11202564
TI  - Alginate-encapsulated producer cells: a potential new approach for the treatment
      of malignant brain tumors.
AB  - In recent years gene therapy has evolved as a new treatment for brain tumors,
      where genetically engineered cells can be used to deliver specific substances to
      target cells. However, clinical success has been limited due to insufficient gene
      transfer, lack of prolonged gene expression, and immunorejection of producer
      cells. These obstacles may be overcome by encapsulating producer cells into
      immunoisolating substances such as alginate. This may provide a stable in situ
      delivery system of specific proteins, which can interfere with tumor growth and
      differentiation. This article represents a fundamental study describing the in
      vitro and the in vivo behavior of alginate-encapsulated producer cells. The
      viability and cell cycle distribution of encapsulated NIH 3T3 cells was studied
      by confocal laser scanning microscopy (CLSM) and by flow cytometry. The CLSM
      study showed a high viability of the encapsulated NIH 3T3 cells during 9 weeks in
      culture. The flow cytometric analysis revealed a change in cellular ploidy after
      1 week in culture, with normalization in ploidy after 3 and 9 weeks. The
      production of the bacterial E. coli beta-galactosidase in alginate-encapsulated
      BT4CnVlacZ cells was studied by x-gal staining, and the cells expressed prolonged
      beta-galactosidase activity. H528 hybridoma cells producing monoclonal antibodies
      (mAbs) against the human epidermal growth factor receptor (EGFR) were
      encapsulated in alginate, and the mAb release was determined. The release of mAbs
      stabilized around 400 ng/ml/h after 12 days in vitro. To actually demonstrate
      that alginate-encapsulated H528 cells potentially inhibit a heterogeneous glioma
      cell population, cell migration from human GaMg glioma spheroids was studied
      during stimulation with EGF in the presence of encapsulated H528 cells. The
      migration in vitro was totally inhibited in the presence of H528 encapsulated
      cells. Alginate beads with H528 cells were also implanted into rat brains, and
      after 9 weeks the distribution of mAbs within the brain was studied by
      immunohistochemistry. It is shown that the alginate entrapped H528 cells produce
      mAbs inside the brain for prolonged periods and that the mAbs are distributed
      within all CSF compartments. Encapsulated producer cells represent a potential
      delivery system for specific proteins to brain tumors. Different producer cells
      may be encapsulated in alginate to target phenotypic features and
      microenvironmental factors, which may influence the progressive growth of brain
      tumors.

PMID- 11202565
TI  - Agarose enhances the viability of intraperitoneally implanted microencapsulated
      L929 fibroblasts.
AB  - To achieve immunoisolation, mouse L929 fibroblasts were encapsulated in
      approximately 400 microm poly(hydroxyethyl methacrylate-co-methyl methacrylate)
      (HEMA-MMA) microcapsules and were subsequently implanted in the peritoneal cavity
      of syngeneic C3H mice. As a baseline for the use of genetically engineered cells
      in cell encapsulation therapy, the L929 cells were transfected to express a
      secreted form of human alkaline phosphatase (SEAP). Implantation of empty
      microcapsules in a PBS suspension resulted in deformation, aggregation, and poor
      retrievability of the microcapsules. Incubation of microcapsules with medium
      containing xenogeneic horse serum prior to implantation increased the thickness
      of the fibrous tissue surrounding the microcapsules. However, immobilization of
      the microcapsules in a 4% (w/v) SeaPlaque agarose gel prior to implantation
      allowed complete recovery of the microcapsules and prevented their aggregation
      and deformation. As a result, approximately 50% of the encapsulated cells
      remained viable 21 days postimplantation. Moreover, once the viable cells were
      released from retrieved microcapsules and regrown as monolayers, they expressed
      SEAP at a level similar to their encapsulated but nonimplanted counterparts.

PMID- 11202566
TI  - Acutely sodded expanded polytetrafluoroethylene grafts produce only prostacyclin:
      a qualitative difference from saphenous veins.
AB  - Select subsets of patients require prosthetic graft material for
      revascularization. Although arterial prosthetic grafts of large caliber perform
      acceptably, grafts of <6 mm exhibit a high attrition rate. Microvessel
      endothelial sodding, a method resulting in the lining of prosthetic grafts with
      autologous endothelium, improves graft patency; however, aggressive antiplatelet
      therapy is still required, because terminating an antiplatelet regimen
      accelerates graft attrition. The present investigation was designed to address
      the acute production of vasoactive substances in microvessel endothelial cell
      sodded expanded polytetrafluoroethylene (ePTFE) grafts in an attempt to delineate
      a possible mechanism behind the continued requirement for antiplatelet therapy.
      Equal lengths of acutely sodded ePTFE grafts (canine falciform ligament source)
      and saphenous veins (SV) (canine source) were evaluated by superfusion bioassay.
      Basal secretion from ePTFE grafts relaxed the biodetector ring 1 +/- 3%, whereas
      SV relaxed the ring 10 +/- 3% (p < 0.05, ePTFE vs. SV). Relaxation with
      acetylcholine stimulation was 49 +/- 7% in grafts and 50 +/- 10% in veins (p =
      NS). Calcium ionophore stimulation produced relaxation of 37 +/- 9% from ePTFE
      grafts and 100 +/- 23% from SV (p < 0.05). Indomethacin added to perfusate
      reduced relaxations from sodded ePTFE grafts to 20.2 +/- 9.2% with acetylcholine
      stimulation and 12.5 +/- 4.3% with calcium ionophore (p < 0.05 vs. control);
      addition of N(G)-monomethyl-L-arginine (L-NMMA) had no effect on the release of
      vasoactive substances from ePTFE grafts. In contrast, relaxations of effluent
      from SV stimulated by acetylcholine and calcium ionophore were significantly
      attenuated with indomethacin and L-NMMA (p < 0.05 vs. control). Scanning electron
      microscopy demonstrated confluent endothelium in SV and a nonconfluent
      endothelial cell layer in grafts. Acutely sodded ePTFE grafts produce vasoactive
      substances that quantitatively and qualitatively differ from those produced by
      canine SV. The ePTFE grafts produce mainly prostanoids, whereas SV produce both
      nitric oxide and prostanoids. The endothelial cell isolation procedure and
      absence of immediate graft luminal confluence may contribute to the observed
      differences.

PMID- 11202567
TI  - The Cre-loxP system: a versatile tool for targeting genes in a cell- and stage
      specific manner.
AB  - Gene-targeted mice, derived from embryonic stem cells, are useful tools to study
      gene function during development. However, if the inactivation of the target gene
      results in embryonic lethality, the postdevelopmental function of the gene cannot
      be further studied. The Cre recombinase-loxP (Cre-loxP) system was developed to
      overcome this limitation as well as to confine the inactivation of the target
      gene in a cell- or tissue-specific manner. This system allows for the
      inactivation of the target gene in a single cell type, thereby allowing the
      analysis of physiological and pathophysiological consequences of the genetic
      alteration in mature animals. A unique property of the insulin gene to be
      expressed only in pancreatic beta cells has allowed using the beta-cell-specific
      rat insulin promoter (RIP) for Cre recombinase expression to inactivate genes in
      beta cells. The RIP has been used to inactivate genes in beta cells and analysis
      of these genetically altered mice has provided important information regarding
      the role of potential transcription factors and the receptors in vivo, for
      regulation of insulin gene transcription and in the development of beta cells.
      The Cre-loxP system is at a relatively early stage of development, and the
      ability of this technique to virtually target any gene in any tissue at any stage
      of development makes the study of gene function in a single cell type in vivo an
      attainable goal. It is anticipated that the continued experience with this system
      will provide an important tool to determine the role of the transcription factors
      involved in insulin gene regulation and islet cell differentiation and ultimately
      provide the basis for novel therapy to treat diabetes.

PMID- 11202568
TI  - ICAM-1 antisense oligodeoxynucleotide improves islet allograft survival and
      function.
AB  - Expression of intercellular adhesion molecule-1 (ICAM-1) and its ligand,
      leukocyte function antigen-1 (LFA-1), after pancreatic islet transplantation may
      affect both nonspecific and alloantigen-specific phases of graft destruction. We
      examined the effects of ICAM-1/LFA-1 blockade on the survival of islet
      allografts. Fresh C57BL/10 (H2h) pancreatic islets were transplanted under the
      renal subcapsular space (KC) or embolized into the liver after portal vein (PV)
      injection to C3H (H2k) mice. Recipients remained untreated or were treated for 7
      days by i.p. administration of: ICAM-1 antisense phosphorothioate
      oligodeoxynucleotide (oligo) alone; anti-1CAM-1 (alphaICAM-1) monoclonal antibody
      (mAb) alone: alphaLFA-1 mAb alone; ICAM-1 oligo/alphaLFA mAb combination;
      alphaICAM-1 mAb/alphaLFA-1 mAb combination; or control oligo IP-8997 or IP-1082.
      In some experiments, donors were pretreated with ICAM-1 oligo. Inhibition of
      single ligand with 5.0 mg/kg ICAM-1 oligo (25.1 +/- 10.3), 100 microg/daily
      alphaICAM-1 mAb (24.2 +/- 8.0 days), or 50 microg/daily alphaLFA-1 mAb (42.8 +/-
      25.9 days) prolonged the survivals of KC islet allografts in comparison with
      untreated controls (11.9 +/- 1.0 days; all p < 0.01). However, dual ICAM-1/LFA-1
      blockade with either ICAM-1 oligo/alphaLFA-1 mAb (78.3 +/- 16.5 days) or
      (alphaICAM-1 mAb/aLFA-1 mAb (65.2 +/- 31.3 days) was the most effective therapy.
      Although pretreatment of donors with ICAM-1 oligo alone was ineffective (12.2 +/-
      0.8 days; NS), a combination of donor pretreatment and recipient treatment
      started 1 day prior to grafting with ICAM-1 oligo (39.2 +/- 14.0 days) was more
      effective than the recipient treatment alone (24.6 +/- 8.8 days). Furthermore,
      ICAM-1/LFA-1 blockade improved islet function as evaluated by glucose tolerance
      test, and decreased inflammation in comparison with untreated controls. Similar
      in vivo results were obtained following PV administration of islet allografts.
      Thus, ICAM-1/LFA-1 blockade prolongs the survival of pancreatic islet allografts
      and improves their early function.

PMID- 11202569
TI  - Development and characterization of pituitary GH3 cell clones stably transfected
      with a human proinsulin cDNA.
AB  - Successful beta-cell replacement therapy in insulin-dependent (type I) diabetes
      is hindered by the scarcity of human donor tissue and by the recurrence of
      autoimmune destruction of transplanted beta cells. Availability of non-beta
      cells, capable of releasing insulin and escaping autoimmune recognition, would
      therefore be important for diabetes cell therapy. We developed rat pituitary GH3
      cells stably transfected with a furin-cleavable human proinsulin cDNA linked to
      the rat PRL promoter. Two clones (InsGH3/clone 1 and 7) were characterized in
      vitro with regard to basal and stimulated insulin release and proinsulin
      transgene expression. Mature insulin secretion was obtained in both clones,
      accounting for about 40% of total released (pro)insulin-like products.
      Immunocytochemistry of InsGH3 cells showed a cytoplasmic granular insulin
      staining that colocalized with secretogranin II (SGII) immunoreactivity. InsGH3
      cells/clone 7 contained and released in vitro significantly more insulin than
      clone 1. Secretagogue-stimulated insulin secretion was observed in both InsGH3
      clones either under static or dynamic conditions, indicating that insulin was
      targeted also to the regulated secretory pathway. Proinsulin mRNA levels were
      elevated in InsGH3 cells, being significantly higher than in betaTC3 cells.
      Moreover, proinsulin gene expression increased in response to various stimuli,
      thereby showing the regulation of the transfected gene at the transcriptional
      level. In conclusion, these data point to InsGH3 cells as a potential beta-cell
      surrogate even though additional engineering is required to instruct them to
      release insulin in response to physiologic stimulations.

PMID- 11202570
TI  - Insulin-secreting pituitary GH3 cells: a potential beta-cell surrogate for
      diabetes cell therapy.
AB  - In a companion article, we describe the engineering and characterization of
      pituitary GH3 cell clones stably transfected with a furin-cleavable human insulin
      cDNA (InsGH3 cells). This article describes the performance of InsGH3 (clones 1
      and 7) cell grafts into streptozotocin (STZ)-induced diabetic nude mice.
      Subcutaneous implantation of 2 x 10(6) InsGH3 cells resulted in the progressive
      reversal of hyperglycemia and diabetic symptoms, even though the progressive
      growth of the transplanted cells (clone 7) eventually led to glycemic levels
      below the normal mouse range. Proinsulin transgene expression was maintained in
      harvested InsGH3 grafts that, conversely, lose the expression of the prolactin
      (PRL) gene. Elevated concentrations of circulating mature human insulin were
      detected in graft recipients, demonstrating that proinsulin processing by InsGH3
      cells did occur in vivo. Histologic analysis showed that transplanted InsGH3 grew
      in forms of encapsulated tumors composed of cells with small cytoplasms weakly
      stained for the presence of insulin. Conversely, intense insulin immunoreactivity
      was detected in graft-draining venules. Compared to pancreatic betaTC3 cells,
      InsGH3 cells showed in vitro a higher rate of replication, an elevate resistance
      to apoptosis induced by serum deprivation and proinflammatory cytokines, and
      significantly higher antiapoptotic Bcl-2 protein levels. Moreover, InsGH3 cells
      were resistant to the streptozotocin toxicity that, in contrast, reduced betaTC3
      cell viability to 50-60% of controls. In conclusion, proinsulin gene expression
      and mature insulin secretion persisted in transplanted InsGH3 cells that reversed
      hyperglycemia in vivo. InsGH3 cells might represent a potential beta-cell
      surrogate because they are more resistant than pancreatic beta cells to different
      apoptotic insults and might therefore be particularly suitable for encapsulation.

PMID- 11202571
TI  - Human pancreatic islets transfected to produce an inhibitor of TNF are protected
      against destruction by human leukocytes.
AB  - The objective of this study was to determine whether transfection of human islets
      with an adenovirus construct encoding an inhibitor of tumor necrosis factor
      (TNFi) was effective at limiting damage to beta cells induced by human peripheral
      blood leukocytes (huPBL). Human islets transfected with TNFi or control islets
      were transplanted under the kidney capsule of NOD-scid mice. After a 15-day
      engraftment period, half of the mice received injections of activated huPBL and
      half received buffer injections. Islet graft function was assessed by two
      different methods, both of which use a species-specific radioimmunoassay to
      determine human insulin. In some mice, insulin production following
      intraperitoneal glucose injection was determined in serum. In other mice, total
      graft insulin content was determined by acid ethanol extraction. Histochemical
      stains were performed on some kidneys at the termination of the experiment to
      evaluate graft presence, transgene expression, and huPBL infiltration. In huPBL
      injected mice, graft performance was maintained in mice whose grafts were
      transfected with TNFi but declined substantially in control groups with sham
      transfected or beta-galactosidase transfected islet grafts. Similar results were
      obtained using either glucose-stimulated insulin release or graft insulin content
      as a measure of graft survival. There was no significant difference in graft
      function between control groups receiving buffer injections, regardless of
      whether the islets had been transfected. Human leukocytes were found in all huPBL
      groups regardless of islet transfection status. We conclude that transfection of
      human islets with an adenovirus encoding TNFi protects beta cells from
      destruction induced by human leukocytes. The local production of TNFi does not
      prevent graft infiltration by leukocytes, only the destruction of grafts by the
      infiltrating leukocytes. These results raise the possibility that local
      expression of an inhibitor of the proinflammatory cytokine TNF-alpha may also
      prevent graft failure in clinical islet transplantation.

PMID- 11202572
TI  - A large-animal model to evaluate the clinical potential of fetal pig pancreas
      fragment transplantation.
AB  - The long-term goal of this study is to assess the feasibility of using fetal pig
      pancreas fragment (FPPF) transplantation to treat patients with type I diabetes.
      Using the highly inbred Westran Pigs, our initial aim was to establish a
      rejection-free transplant model of FPPF grafted into sibling recipient pigs
      without immunosuppression. FPPFs were isolated from 80-100-day-old fetuses of
      either Westran Pigs or outbred pigs and transplanted into the thymus, spleen,
      liver, or kidney of the recipient Westran pig. Biopsies were taken from each
      transplant site at set time points and assessed histologically for islet
      viability, rejection, and endocrine function. Fifty-eight fetal donors were used
      to transplant 16 recipient pigs. A nonspecific inflammation was seen for both
      outbred and inbred FPPF donor tissue at day 3 and was considered a response to
      ischemic necrosis. However, all the transplanted outbred FPPF donor tissue was
      acutely rejected and lost by day 10-14. In contrast, inbred FPPF tissue showed
      little evidence of graft necrosis after 3 days, and growth and formation of
      epithelial islet cell nest-like structures were seen to 28 days after
      transplantation. With time after transplantation, increasing amounts of insulin
      immunoperoxidase staining was seen together with chromogranin and somatostatin
      staining. In summary, this study confirms the potential of the Westran pig to
      answer the unproven ability of fetal pancreatic tissue to reverse type I diabetes
      in a large animal model.

PMID- 11202573
TI  - Induction of allogeneic islet tolerance in a large-animal model.
AB  - For islet allotransplantation to become a therapy widely applicable to patients
      with insulin-dependent diabetes, it will be important to avoid conventional
      immunosuppression and yet maintain long-term rejection-free islet survival. This
      possibility was tested in a large-animal model using mixed allogeneic chimeras
      established using total lymphoid irradiation (TLI) and donor-specific bone marrow
      transplantation (BMTX). Four recipient sex-mismatched and DLA class II-matched
      English springer spaniels became chimeric after TLI and donor-specific BMTX.
      Subsequent donor-specific renal allografts survived for more than a year.
      Acceptance of a donor-specific skin graft and rejection of a third-party graft
      demonstrated tolerance with maintenance of immunocompetence. Pancreatic
      microfragments containing islets were refluxed into the splenic vein of the
      recipient. Purified islets were placed under the capsule of spleen and liver.
      After 75 days, recipients underwent total native pancreatectomy. All four
      chimeric pancreatectomized dogs had functioning islet grafts 75 days after
      transplantation, evidenced by a prompt rise in serum insulin levels following an
      IVGTT and histological demonstration of islet tissue at the site of
      transplantation. After removal of the transplanted islet tissue, no insulin was
      released after IVGTT. In summary, intrasplenic allogeneic canine islets
      transplanted into chimeric dogs rendered tolerant to donor MHC survive and
      function for greater than 75 days in the absence of immunosuppression. This study
      represents proof of the concept that allogeneic islet transplants have the
      potential to reverse diabetes without the use of conventional immunosuppression.

PMID- 11202574
TI  - Simultaneous pancreas-kidney (SPK) transplantation from controlled non-heart
      beating donors (NHBDs).
AB  - From January 1993 through June 1999, 18 simultaneous pancreas-kidney transplants
      (SPKs) were performed from controlled non-heart-beating donors (NHBDs) and 339
      SPKs were performed from heart-beating donors (HBDs). No difference in donor
      characteristics was noted except for warm ischemic time, which was 14.8 min
      (range 4-46 min) for NHBDs. Following transplantation, no difference in
      pancreatic function was noted; however, a higher rate of enteric conversions was
      seen in pancreas transplants from NHBDs (32% vs. 13%; p < 0.01). Hemodialysis for
      acute tubular necrosis (ATN) was higher in kidney transplants from NHBDs (22.2%
      vs. 4.1%; p = 0.009) as was discharge serum creatinine (1.7 mg/dl vs. 1.5 mg/dl;
      p < 0.05). Also, the number of patients remaining rejection free was lower for
      NHBDs and approached significance (33.3% vs. 50.1%; p = 0.07). However, no
      difference in patient survival (100% vs. 95.4%) or pancreatic (87.4% vs. 86.5%)
      and renal (86.3% vs. 86.3%) allograft survival was noted during the study period.
      Our results indicate that SPK transplantation from controlled NHBDs is a viable
      method for increasing the number of pancreas and kidney transplants available for
      transplantation.

PMID- 11202575
TI  - No evidence of infection with porcine endogenous retrovirus in recipients of
      encapsulated porcine islet xenografts.
AB  - Transplantation of pig tissues into humans has the potential for cotransferring
      pig infections. Knowledge of the epidemiology of pig infections transmissible to
      humans allows the development of risk limitation strategies at the source herd
      level, but potentially infectious pig endogenous retrovirus (PERV) is ubiquitous
      in all domestic pigs and therefore is not avoidable. Using a specific and
      sensitive RT-PCR and nested PCR for PERV nucleic acids with primers, the
      screening of pigs from New Zealand herds for the presence and expression of the
      PERV was conducted. The presence of PERV proviral DNA (pol and env region) and
      viral RNA was demonstrated in all tested pig tissues including pancreas, liver,
      spleen, brain, heart, and PBMC. Using the same assays it was established that
      different tissues (liver, spleen, and heart) of nude and nonobese diabetic (NOD)
      mice previously transplanted with nonencapsulated pig islets were PERV DNA and
      RNA negative. Alginate polylysine capsules prepared with encapsulated pig islets
      were tested for possible leakage of viral particles or viral nucleic acids. RNA
      was extracted from the supernatant of viable encapsulated pig islet cells grown
      in culture for 2 months. No evidence of PERV RNA or of cellular nucleic acids
      could be found. Two adult type I diabetic subjects were transplanted with 1 x
      10(6) neonatal pig islets encased in alginate capsules into the peritoneal
      cavity. One patient was immunosuppressed. Both showed evidence of graft function
      (up to 34% reduction in insulin dose, corresponding increase in serum pig C
      peptide) for up to 2 years. DNA and RNA were extracted from PBMC and blood plasma
      of both patients at 19 months posttransplant. No evidence of PERV proviral DNA or
      RNA could be detected. Piglet islets contain PERV DNA and RNA, but this does not
      traverse the capsules used or produce any evidence of infection in nude and
      nonobese diabetic (NOD) mice or humans.

PMID- 11202576
TI  - Beneficial effect of pancreas and kidney transplantation on advanced diabetic
      retinopathy.
AB  - In pancreas recipients with advanced diabetic eye disease, conflicting
      ophthalmologic results over different follow-up periods have been reported. In
      the present prospective study we performed ophthalmologic evaluation groups of
      type I diabetic patients: 1) normoglycemic recipients of pancreas and kidney
      grafts (group SPK, n = 43, follow-up 44.9 +/- 35.1 months), 2) pancreas and
      kidney graft recipients with nonfunctioning pancreatic graft, and recipients of
      isolated kidney graft (group K, n = 45, follow-up 60.3 +/- 34.2 months). The
      examinations were performed before transplantation, at the end of follow-up (at
      least 1 year), and in 63 recipients also at 3 years posttransplant. Visual acuity
      results at baseline and at the end of follow-up were 0.48 +/- 0.39 vs. 0.50 +/-
      0.39 in the SPK group, and 0.46 +/- 0.38 vs. 0.40 +/- 0.39 in the K group. While
      intragroup changes were not significant, the changes were significantly different
      between the groups (p < 0.05). Fundoscopic findings at the end of follow-up were
      improved, stabilized, or deteriorated in the SPK group in 21.3%, 61.7%, and
      17.0%, respectively. The respective figures for the K group were 6.1%, 48.8%, and
      45.1% (p < 0.001). Similar results were obtained when evaluating findings at 3
      years posttransplant. Before transplantation, 78% of the SPK group and 81% of the
      K group had been treated by laser. The need for additional posttransplant laser
      therapy was significantly lower in the SPK (31%) than in the K group (58%; p <
      0.001). In conclusion, pancreas transplant exerts a beneficial effect on the
      course of diabetic retinopathy even in its late stage.

PMID- 11202578
TI  - Sustained improvements in cardiac geometry and function following kidney-pancreas
      transplantation.
AB  - Kidney-pancreas (KP) transplantation has been shown to improve left ventricular
      (LV) geometry and function 6-24 months after the procedure, yet whether these
      improvements are sustained in long-term survivors has not been demonstrated. This
      study examined whether early improvements in LV geometry and function were
      sustained 3-5 years after KP transplantation. Left ventricular function and
      geometry were prospectively evaluated prior to, and at 1, 2, and 3-5 years
      posttransplant using two-dimensional, M-mode, echocardiography with Doppler
      interrogation in the parasternal and apical views. The sample included 21 KP and
      a comparison group of 12 diabetic kidney-alone (KA) recipients. Long-term (3-5
      years) data were obtained for KP recipients only. Although KA recipients had a
      longer duration of dialysis and worse diastolic function pretransplant, the
      groups were similar on other baseline measures. KA recipients experienced minimal
      improvements while KP recipients had significant improvements in cardiac function
      and geometry, both in terms of mean values and the percentage of KP recipients
      who experienced normalization posttransplant (p < 0.05). KP recipient
      improvements were also sustained at 3-5 years posttransplant on three of five
      measures, with 75% of long-term KP recipients achieving normal LV mass
      posttransplant compared with 31% pretransplant. Data indicate that significant
      impairments in cardiac geometry and function occur in diabetic KA and KP
      recipients. Though both groups experienced early improvements posttransplant, KP
      recipients achieved more dramatic and clinically significant improvements at 1,
      2, and 3-5 years posttransplant. Additional studies are needed to examine the
      relevance of these findings with regard to the cardiac morbidity and mortality of
      these patients.

PMID- 11202577
TI  - Successful suppression of the early rejection of pig islets in monkeys.
AB  - Primary nonfunction (PNF) is seen very frequently after xenogeneic
      transplantation of islets of Langerhans. In a pig-to-rat model we recently
      observed that no PNF occurs when the islets are kept in culture at 37 degrees C
      for 1-2 weeks prior to transplantation. In order to investigate the rejection
      mechanisms in a preclinical model, we transplanted cultured porcine islets under
      the capsule of both kidneys in four cynomolgous monkeys. Islets were isolated
      from adult sows by means of digestion with Liberase in University of Wisconsin
      solution (UWS). The digest was purified by a density gradient of OptiPrep in UWS.
      Highly purified (>95%) islets were cultured 1-2 weeks in RPMI. All monkeys showed
      significant titers of preformed anti-pig antibodies. The immunosuppression of the
      monkeys consisted of cyclophosphamide (Cy) (2 days), cyclosporin A (CsA), and
      prednisolone. Anticipating a fast rejection we carried out nephrectomies at
      different time points within 2 weeks after transplantation. Following unilateral
      nephrectomy, well-preserved islets with no signs of rejection were observed
      between 3 and 7 days posttransplant. Later, between days 11 and 15
      posttransplant, histology in the first three animals demonstrated no islets. In
      the fourth monkey histology on day 11 showed islets with excellent morphology and
      some small focal infiltrates. The highest CsA blood levels (around 1000 ng/ml)
      were found in animals with the best graft survival. We conclude that cultured
      porcine islets can be grafted without hyperacute rejection in monkeys with
      preformed anti-pig antibodies. In the presence of high levels of CsA only
      marginal signs of a cellular immune response were observed 11 days after
      transplantation.

PMID- 11202579
TI  - Improved solitary pancreas transplant graft survival in the modern
      immunosuppressive era.
AB  - The results of solitary pancreas (SP) transplantation have traditionally lagged
      behind those of simultaneous pancreas-kidney (SPK) transplantation. This is one
      of the chief factors that has limited the wide-scale application of SP
      transplantation in nonuremic type I diabetic patients. The purpose of this study
      is to report our present experience with SP transplantation and compare it to a
      prior experience. Twenty-three SP transplants (14 PAK, 4 PTA, and 5 PASPK)
      performed since January 1997 were compared to 56 SP transplants (53 PAK, 1 PTA,
      and 2 PASPK) performed before 1994. Between 1993 and 1997, SP transplants were
      not performed because of high morbidity in the early experience. Early SP
      transplants were performed using bladder drainage of exocrine secretions, and
      enteric drainage without a Roux-en-Y was used in the recent series. In the early
      era, immunosuppressive therapy included cyclosporine (CsA), azathioprine (AZA),
      corticosteroids, and in half of the patients, ALG or OKT3. Recent SP transplants
      received tacrolimus (TAC). mycophenolate mofetil (MMF), corticosteroids, and
      induction with either anti-thymocyte globulin (n = 9), OKT3 (n = 1), daclizumab
      (n = 5), or basiliximab (n = 8). The 1-year Kaplan-Meier patient survival was 85%
      in the early era and 100% in the recent group of patients (p = 0.08). In the
      previous era, four patients suffered significant decrement in renal function,
      necessitating dialysis or kidney transplantation following pancreas
      transplantation. All patients transplanted since 1997 maintain near prepancreas
      transplant levels of renal function (mean pretransplant serum creatinine (Cr) 1.3
      +/- 0.3 mg/dl vs, mean current Cr 1.4 +/- 0.4 mg/dl, p = NS]. The 1-year Kaplan
      Meier graft survival (insulin independence) of recent SP transplants was 87%,
      whereas for prior SP transplants it was 19% (p = 0.0001). The rate of acute
      pancreas rejection was significantly different between the two groups. Of early
      SP transplants, 76% experienced at least one rejection episode within the first
      year. In contrast, 35% of recent SP transplants suffered acute rejection during
      the same time period (p = 0.04). Current experience with SP transplantation
      demonstrates improved graft survival and reduced rejection rates with the use of
      newer immunosuppressive agents.

PMID- 11202581
TI  - Evaluation of the prenatal diagnosis of neural tube defects by fetal
      ultrasonographic examination in different centres across Europe.
AB  - OBJECTIVE: Evaluation of prenatal diagnosis of neural tube defects by ultrasound
      examination in unselected populations across Europe. SETTING: Prenatal ultrasound
      units in areas that report to contributing congenital malformation registers.
      METHODS: All cases with a suspected or confirmed neural tube defect and delivered
      within the 30 month study period were identified from 18 Congenital Malformation
      Registers from 11 European countries. Data on the pregnancy, prenatal scans,
      outcome of pregnancy, and information on different screening policies for each
      country were analysed. RESULTS: 670766 deliveries occurred in the area covered by
      the registers during the study period. A neural tube defect was diagnosed at
      delivery in 542 cases. In 84% of these, the lesion was isolated (166 anencephaly,
      252 spina bifida, 35 encephalocele). Of the 166 isolated cases with anencephaly,
      96% were correctly identified prenatally; one was missed on scan, two were
      wrongly diagnosed, and four were not scanned (sensitivity 98%). 84% of the
      prenatal diagnoses were made before 24 weeks' gestation; 86% of isolated
      anencephalic pregnancies were terminated. Of the 252 cases of isolated spina
      bifida, 171 (68%) were correctly identified prenatally; 66% of these before 24
      weeks' gestation. The diagnosis was missed on scan in 60 cases and 21 were not
      scanned (sensitivity 75%). The mean reduction in birth prevalence because of
      termination of pregnancy for spina bifida was 49% (range 6-100%). There was a
      wide variation between centres in prenatal detection rate (33-100%), termination
      of pregnancy of prenatally diagnosed cases (17-100%), and gestation both at
      diagnosis and termination of pregnancy. CONCLUSION: A high prenatal detection
      rate for anencephaly was reported by all registers. There is a large variation in
      prenatal detection and termination rates for spina bifida between centres,
      reflecting differences both in policy and culture.

PMID- 11202580
TI  - Patient survival and cardiovascular events after kidney-pancreas transplantation:
      comparison with kidney transplantation alone in uremic IDDM patients.
AB  - In diabetic patients cardiovascular morbidity and mortality is still a major
      problem. Our aim was to study the effect of kidney-pancreas transplantation on
      survival, cardiovascular events, and causes of death in diabetic type 1 uremic
      patients. Three hundred and thirty-three uremic IDDM patients were enrolled in
      our waiting list for kidney-pancreas transplantation: 107 underwent kidney
      pancreas transplantation (KP), 34 underwent kidney transplantation alone (KA),
      whereas 192 patients remained on dialysis (WL). Actuarial survival and causes of
      death were recorded over a period of 7 years. Seven-year survival rate was 75%
      for the KP group, 63% for the KA group, and 37% for the WL group (p = 0.001).
      Cardiovascular death rate was 9.8% in the KP group, 17.6% in the KA group, and
      18.1% in the WL group (KP vs. WL, p = 0.05). Rate of acute myocardial infarction
      in the KP group was lower than in the KA group (2.4% vs. 17.6%, p = 0.005) as
      well as rate of acute pulmonary edema (0.8% vs. 23.5%, p = 0.0001) and rate of
      hypertensive patients at 1 (40.9% vs. 85.0%, p = 0.0001) and at 2 years (57.6%
      vs. 80%, p = 0.03). Kidney-pancreas transplant helped to obtain euglycemia with
      positive effects on survival and cardiovascular events.

PMID- 11202582
TI  - Opportunistic screening for chlamydia infection in general practice: can we reach
      young women?
AB  - OBJECTIVE: To study opportunistic screening in primary care, in such a way that
      would include teenage women. Setting-Screening for chlamydia infection was
      offered opportunistically in eight general practices in Edinburgh to women aged <
      or = 35 years attending for cervical smear, and women aged < or = 20 years
      attending for contraception. The numbers of women eligible to be offered
      screening were 901 in the cervical smear group, and 595 in the contraception
      group. RESULTS: Effective screening rate (offered test, consented, and urine
      sample returned) was 30% for the cervical smear group compared with 23% for the
      contraception group. Among those tested, chlamydia prevalence was strongly
      associated with young age, ranging from 11.8% in those <18 years, to 0% in those
      >25 years. Number of sexual partners in past year did not improve prediction of
      infection. CONCLUSION: These findings raise concerns regarding the feasibility of
      opportunistic screening in general practice, particularly for those with highest
      prevalence of chlamydia--teenage women.

PMID- 11202583
TI  - Radiological review of incidence breast cancers.
AB  - OBJECTIVES: To examine the rate of incidence cancers detectable on review of
      previous screening mammograms using two reviewing methods. To compare the results
      with a previous study of interval cancers using the same reviewing methods.
      SETTING: Almost 50000 women are regularly invited for service screening at
      Stockholm Soder Hospital. From 1989 to 1993, 119 women were identified with
      breast cancer detected at screening and the previous round attendance (incidence
      cancer). METHODS: Screening mammograms, obtained before detection of the
      incidence cancers, were reviewed first mixed with other screening images (ratio
      1:8) and then non-mixed. Reviewers from the screening unit responsible for the
      mammograms as well as reviewers from other units interpreted all images by both
      single and double reading. RESULTS: The proportion detected on retrospective
      review varied between 5% and 50% depending on the review method used and the
      number of reviewers included to classify a case as truly identified. Generally
      more cancers were detected when non-mixed samples of mammograms were reviewed
      than when mixed samples were reviewed (mean increase 23%) and when interpreted by
      double reading compared with single reading (mean increase 14%). CONCLUSIONS: In
      an experimental retrospective set up, fewer incidence cancers were identified in
      mixed than in non-mixed review. Generally more incidence cancers were identified
      on review (22%) than previously reported for interval cancers (14%), probably
      reflecting differences in tumour biology and growth. How many women with
      potentially visible incidence cancers would have benefited from earlier tumour
      detection still needs to be evaluated.

PMID- 11202584
TI  - Radiological review of interval cancers in an Australian mammographic screening
      programme. Radiology Quality Assurance Group of BreastScreen Victoria.
AB  - OBJECTIVES: To determine the proportion and features of invasive interval cancers
      that could be considered detectable at the time of the previous screen and the
      proportion of cases that could be classified as true intervals, false negatives,
      minimal signs, or radiographically occult lesions. SETTING: BreastScreen
      Victoria, the Victorian component of the BreastScreen Australia mammography
      screening programme. METHODS: Two separate review methodologies were adopted.
      Firstly a blinded review of interval, screen detected, and normal cases was
      undertaken, followed by a confirmation exercise to determine the proportion of
      invasive interval cancers that could be considered detectable at the time of the
      previous screen. Secondly, an unblinded review was performed to classify interval
      cases as true interval, false negative, minimal signs, or radiographically
      occult. RESULTS: From the blinded review, it was estimated that 38% of interval
      cases may be considered "potentially detectable" at the time of screening.
      Comparison of the characteristics of interval and screen detected cases indicates
      that interval cases are more likely to be smaller, equivocal, ill defined masses.
      In the unblinded exercise, 41% of interval cases were classified as false
      negatives and a further 16% as minimal signs, 33% true intervals, and 10%
      radiographically occult. Of the interval cancers considered potentially
      detectable at screening, 97% were classified as false negatives in the unblinded
      review. CONCLUSIONS: This study highlights the importance of adopting staged
      review methods with both blinded and unblinded components. The blinded review and
      confirmation exercise allows the determination of the proportion of interval
      cases that could be considered potentially detectable at screening. The unblinded
      review provides an active important opportunity for professional development and
      review and a mechanism to link into the blinded review through further
      classification of interval cases.

PMID- 11202585
TI  - Predictors of non-attendance for second round mammography in an Australian
      mammographic screening programme.
AB  - OBJECTIVE: To determine the socioeconomic, cultural, and clinical predictors of
      non-attendance for second round mammography. DESIGN/PARTICIPANTS: Retrospective
      cohort study of 121 889 women aged 50-69 years who attended for first mammography
      screening in the BreastScreen Victoria programme in 1995/1996 and who were
      recommended to be invited for routine biennial mammography. Women were considered
      to be non-attenders if they had not attended for rescreening within 27 months of
      their initial screening. Relative risk (RR) was used to compare categories for
      non-attendance for second screening, and a multivariate model was fitted to
      adjust for possible confounding. SETTING: BreastScreen Victoria, a population
      based mammographic screening programme, which offers free biennial mammography to
      all women 40 years and older. The programme specifically targets women aged 50-69
      years. RESULTS: In the multivariate analysis, women from non-English speaking
      backgrounds were more likely not to attend for second round screening (RR ranged
      from 1.18 to 1.77). Indigenous women (RR 2.02, 95% confidence interval (CI) 1.61
      to 2.54) and women who reported either significant symptoms (RR 1.90, 95% CI 1.76
      to 2.05) or other breast symptoms (RR 2.25, 95% CI 2.15 to 2.36) at the time of
      first round screening were also more likely not to attend for second round
      screening. CONCLUSIONS: Women from non-English speaking backgrounds, indigenous
      women, and women who report symptoms at the time of first screening are more
      likely to not attend for second round screening. It is important to investigate
      why these women do not attend for second round screening so that services can be
      more appropriately tailored to their needs.

PMID- 11202586
TI  - Results from the UK NHS breast screening programme 1994-1999.
AB  - OBJECTIVE: To present results from the NHS breast screening programme (NHSBSP)
      from 1994 through to 1999 and to examine the extent to which interim targets are
      being achieved. METHODS: Data were collated from all screening programmes in the
      UK on standard statistical returns. Performance of the screening programme was
      evaluated using calculated targets based on comparison with the Swedish two
      counties (STC) randomised controlled trial. RESULTS: In the early years of
      screening (1988-1993), the NHS programme was detecting more DCIS but considerably
      less invasive cancers than expected, based on the STC trial. Since the screening
      year 1993/94 (1 April to 31 March) the standardised detection ratio (SDR) measure
      of the detection of invasive cancers has increased by 36% from 0.83 to 1.13. The
      SDR has been greater than 1 since 1996197 suggesting that the NHSBSP has only
      been screening as efficiently as the STC trial since this date. Uptake for
      screening has been relatively stable over time at approximately 75%. CONCLUSIONS:
      The NHSBSP has made considerable advances in performance since its inception in
      1988 and screening uptake and age standardised invasive cancer detection rates
      are (by 1999) well in excess of targets. The early years of screening were
      characterised by good uptake but a low sensitivity for the detection of invasive
      cancers. It is anticipated that the screening programme will have an increasing
      impact on breast cancer mortality, particularly in the 55-69 year age group over
      the coming years.

PMID- 11202587
TI  - Is targeted early detection for melanoma feasible? Self assessments of risk and
      attitudes to screening.
AB  - OBJECTIVES: To study the feasibility of developing targeted screening for those
      at high risk of melanoma by examining how attitudes relate to (a) acceptance of
      an invitation for a free skin check and (b) self assessed and clinically assessed
      risk factors for developing cutaneous melanoma. DESIGN: A population based cross
      sectional survey. SETTING: A general practice with a broad mix of socioeconomic
      groups in one district health authority. SUBJECTS: A total of 1600 subjects aged
      25-69 years stratified using the social deprivation score of wards were randomly
      selected from a population of 8000; 77% (1227) returned the questionnaire and 56%
      (896) attended for screening. MAIN OUTCOME MEASURES: Questionnaire measures of
      confidence in own ability to self assess risk factors for melanoma, attitudes to
      seeking medical help for skin abnormalities, and self assessment of relative risk
      of developing melanoma. RESULTS: Clinic attenders were less confident in their
      ability to self assess risk factors (p<0.005), more favourable towards seeking
      help (p<0.001), and more pessimistic about developing melanoma (p<0.001) than non
      attenders. Those from more affluent wards were more willing to seek help
      (p<0.001). Those clinically assessed as at higher risk were more pessimistic
      about developing melanoma (p<0.001) but clinical assessments were inconsistently
      related to help seeking attitudes and self assessment confidence. CONCLUSIONS:
      Barriers to the uptake of screening included greater optimism about not
      developing melanoma, confidence in self assessment, and reluctance to seek
      professional help. Such reluctance was greater in more deprived social groups.
      Targeting screening at high risk groups cannot depend on self identification and
      self referral.

PMID- 11202588
TI  - Oral cancer screening as an integral part of general health screening in Tokoname
      City, Japan.
AB  - OBJECTIVES: To measure the attendance and compliance rates in oral mucosal
      screening (OMS) offered as part of a general health screen (GHS) undertaken as an
      organised programme in Japan. METHODS: In 1996, all adults over the age of 40
      years resident in Tokoname City were invited by letter to attend a free GHS
      annually, conducted by the municipal cooperation and the medical and dental
      societies of Tokoname City. In the later years only those who attended in 1996
      were reinvited. Females aged less than 39 years were also allowed to attend if
      they wished to participate in the GHS. The GHS consisted of completion of a self
      administered questionnaire to identify past and current illnesses and any
      medications used by the screened population coupled with a routine physical
      check, chest x ray, ECG, and blood and urine examination. The GHS was programmed
      annually during the years 1996 to 1998. All those attending the GHS were invited
      to participate in an OMS conducted under the same roof by a visiting dentist
      (n=37). A referral pathway was established for screen positives requiring follow
      up. RESULTS: A total of 19 305 subjects (5955 males, 13350 females; mean age 59.2
      years; 7033 in 1996, 6289 in 1997, and 5983 in 1998) attended the GHS. Of those
      who attended the GHS, 19 056 (98.7%) attended the OMS (1.3% refused). This rate
      was fairly constant over the three years. Excluding repeat examinations, new
      cases recruited for OMS over the three years were 8723. Of those participating in
      OMS, 4269 (60.7%) attended all three years. In the cohorts examined, screening
      dentists recorded oral mucosal lesions in 5.4% in 1996, in 4.0% in 1997, and in
      2.6% in 1998. Overall, this amounted to a positive detection rate of 4.1%, or
      4.9% excluding repeat examinations. A higher prevalence of oral pre-cancer was
      recorded among male smokers. CONCLUSIONS: The overall results suggest that
      although compliance with attending a free GHS was low (26.2%) among Japanese
      subjects over 40 years of age, of those who complied 74-76% reattended annually.
      Hence a satisfactory participation rate can be obtained in Japan for OMS when
      this is coupled to a GHS conducted at the same visit.

PMID- 11202590
TI  - Revised distribution parameters for serum markers for trisomy 18.

PMID- 11202589
TI  - The potential for a selective screening strategy for abdominal aortic aneurysm.
AB  - OBJECTIVES: To investigate the feasibility of selective screening for abdominal
      aortic aneurysm (AAA) based on identification of a target group of manageable
      size defined by risk factors for AAA. SETTING: Male residents of Perth, Western
      Australia, aged 65-83 years, who participated in a randomised controlled trial of
      ultrasound screening for AAA. METHODS: Eligible men were identified from the
      electoral roll and invited to attend a screening clinic. Those who attended
      completed a questionnaire, had a limited physical examination, and underwent an
      ultrasound examination to identify the maximum diameter of the infrarenal aorta.
      Data on risk factors collected from the first 8995 men seen were used to
      calculate a multivariate risk score for the remaining 2755 men who were screened.
      Centiles of the risk score were used to define potential target groups for
      screening and the sensitivity and specificity of each of these selective
      screening strategies were calculated. We repeated the calculation separately for
      AAAs of at least 30 mm, 40 mm, and 50 mm in diameter. RESULTS: We found that
      screening half of the male population aged 65-83 years would find approximately
      75% of AAAs, regardless of their size, whereas screening only current smokers in
      this population would find approximately 20% of AAAs. CONCLUSIONS: Selective
      screening for AAA using easily recognisable risk factors is feasible but is not
      worthwhile as approximately 25% ofclinically significant cases would be missed.

PMID- 11202591
TI  - Effective quality management groups.

PMID- 11202592
TI  - Psychological impact on house staff of an initial versus subsequent emergency
      medicine rotation.
AB  - The objective of this study was to assess the psychological impact of a 4-week
      emergency medicine (EM) rotation on residents undergoing their first EM
      experience. These findings were compared to the psychological impact the rotation
      had on residents with prior EM experience. Data were obtained from a post hoc
      analysis of a previous study. Prerotation and postrotation psychological distress
      levels were assessed over a 4-week EM rotation. Anxiety and depressive symptoms
      were evaluated by the Brief Symptom Inventory and the Dissociative Experience
      Scale that together comprise a total of 14 psychometric scales. All scales were
      given at the beginning and end of the initial EM rotation for the academic year
      of 1994-1995. All information was coded and confidential. Eighteen junior
      residents (9/18 EM [50%]) were analyzed as a group and compared to 53 residents
      (34/51 EM [66%]) with prior exposure to the authors' emergency department.
      Residents doing their first EM rotation (N = 18) showed improvement in 13 of 14
      scales (P = .002). Of the 13 scales that improved, 3 improved significantly:
      Brief Symptom Inventory = anxiety (P = .002) and Dissociative Experience Scale =
      absorption (P = .001) and other (P = .001). Residents with prior EM experience (N
      = 53) displayed worsening in 9 of 13 scales (P = not significant) and no change
      in 1. Residents undergoing their first EM rotation showed a significant decrease
      in psychological distress over the 4-week period. Residents with prior EM
      experience did not show a similar change.

PMID- 11202593
TI  - Commentary: public disclosure in the health field: is there a relevant option?
AB  - Steadily increasing numbers of private, not-for-profit, and public agencies are
      releasing quality of care and financial information to enhance the market power
      of those purchasing America's health services. These sources range widely from
      the Health Plan Employer Data and Information Set (HEDIS) to the federal
      Securities and Exchange Commission (SEC). A growing interest in publicly
      disclosing performance information that concerns providers, as recently
      recommended by the Institute of Medicine (IOM) report on patient safety, until
      now has only achieved a modest impact. A major exception is in those metropolitan
      areas where acute-care facilities experience intense competition for patient
      admissions. Although the comparative quality and cost information currently
      available is for the most part in the public interest, it is concluded that, in
      the foreseeable future, these report cards as now structured will not result in
      any significant enhancement in access, improvement in quality, or reduction in
      cost. Options to encourage more public disclosure explored in this paper are
      Congress potentially passing legislation (a) to establish a Center for Patient
      Safety within the US Department of Health and Human Services as recommended by
      the recent Institute of IOM study, or (b) empowering the SEC beyond its current
      mandate to collect and disseminate all pertinent quality of care and cost
      information on every provider in the United States. The latter alternative would
      include user-friendly, comparative analyses to be provided on the Internet and
      elsewhere and would make readily available information from HEDIS, the Joint
      Commission on the Accreditation of Healthcare Organization (JCAHO), coronary
      artery bypass graft (CABG) surgery studies, cost comparisons based on Medicare
      cost reports and SEC filings, and other similar sources.

PMID- 11202594
TI  - Comparing self-reported measures of diabetes care with similar measures from a
      chart audit in a well-defined population.
AB  - The objective of this study was to compare self-reported measures of diabetes
      care with measures derived from medical records in a well-defined population.
      Diabetes measures were collected through a 1997 Behavioral Risk Factor
      Surveillance System telephone survey of American Indians living on or near 7
      Montana reservations (N = 398) and were compared with data collected from charts
      of a systematic sample of American Indians with diabetes seen in 1997 at Indian
      Health Service (IHS) facilities. Survey respondents were more likely to report a
      duration of diabetes > or = 10 years (44 vs 31%), annual dilated retinal exam (75
      vs 59%), and an influenza immunization in the past year (73 vs 57%) compared with
      estimates from the chart audit. Estimates of pneumococcal immunization (88 vs
      42%), annual cholesterol screening (86 vs 69%), and overweight, based on body
      mass index (67 vs 50%), were significantly higher from the chart audit. No
      significant differences were found between the survey respondents and the chart
      audit data for annual foot exams (65 vs 61%), annual blood pressure checks (98 vs
      93%), high cholesterol (35 vs 41%), and high blood pressure (54 vs 64%). These
      findings suggest that self-reported data may over and underestimate specific
      measures of diabetes care.

PMID- 11202595
TI  - Evaluating the implications of clinical practice guidelines for patient care.
AB  - Patient care evaluation studies have been developed by the Commission on Cancer
      of the American College of Surgeons. The studies were primarily designed to
      monitor trends in diagnosis, therapy, and outcome of specific oncologic diseases
      in hospitals and cancer centers. As they reflect the current standards of patient
      care, patient care evaluation studies have become valid tools of quality
      management in medicine. In an international pilot project that began in 1996,
      this approach was redefined to evaluate the impact of current clinical practice
      guidelines in oncology. Close cooperation between medical societies in the United
      States and Germany under the coordination of the Commission on Cancer and the
      Institute of Medical Informatics at the Justus-Liebig-University of Giessen was
      established. This infrastructure for data collection, data management, analysis,
      and interpretation of results allows for the recognition of international
      differences in patient care. Our results indicate discrepancies between current
      state-of-the-art patient care represented by clinical practice guidelines and the
      diagnostic and therapeutic procedures in the clinical routine. Patient care
      evaluation studies are designed as exploratory, not confirmatory, trials. In
      contrast with confirmatory trials, their aims may not always lead to predefined
      hypotheses. They reflect routine practice and are not the basis of the formal
      proof of efficacy, although they may contribute to the total body of relevant
      evidence. Without this comprehensive approach to evaluation, the potential of
      clinical practice guidelines to improve patient care remains unknown.

PMID- 11202596
TI  - Visual vignette: Grave's disease.

PMID- 11202597
TI  - Implementation of evidence and guidelines in clinical practice: a new field of
      research?

PMID- 11202598
TI  - The learning health care organization.

PMID- 11202599
TI  - Towards evidence-based quality improvement: perspectives from nursing practice.
AB  - This paper explores how the evidence-based practice and quality improvement
      movements are informing our understanding of what counts as quality patient care.
      Implicit in the debate is that we have understood and can manage the concept of
      patient safety. Using a true case study, the paper will illustrate how a clearer,
      more integrated understanding of safety, evidence-based practice and quality
      improvement principles can lead to more effective care. Central to this shift is
      the ability to move out of traditional, professionally bound ways of thinking to
      new systems and new ways of providing patient-centred care. Equally, how we
      generate the evidence to find out how safe or otherwise health care delivery
      systems are, must be as important an area of investigation as the search for a
      new therapy or treatment for a particular disease.

PMID- 11202600
TI  - National guidelines for Swedish neonatal nursing care: evaluation of clinical
      application.
AB  - OBJECTIVE: To evaluate the clinical application of national guidelines for
      neonatal nursing. DESIGN: Questionnaire survey. SETTING: Thirty-nine neonatal
      care units in Sweden. STUDY PARTICIPANTS: Thirty-five of 39 nurse managers at all
      Swedish neonatal care units. INTERVENTION: Thirteen clinical guidelines for
      neonatal nursing care were presented in 1997. Recommendations on evidence-based
      nursing care and auditing measures were given. Most neonatal units in Sweden
      participated in the guideline development. MAIN OUTCOME MEASURES: Extent of
      guideline application, ways in which the guidelines were used and perceived
      usefulness. RESULTS: The guidelines were applied to different extents in 30 of
      the 35 units. Almost all the guidelines were applied, especially those covering
      general nursing care. In total, 72 Quality Improvement (QI) projects were
      reported, of which 51 concerned specific topics covered in the guidelines. Twenty
      units applied the guidelines as a starting point for QI. Four units evaluated
      nursing practice against the guidelines. Four factors [Dynamic Standard Setting
      System (DySSSy) as the QI method, > or = 4 years of practice as nurse manager,
      experience of nursing research, and good staff resources] were closely related to
      a more extensive application of the guidelines. Units with both a nurse manager
      and an assistant nurse manager were more likely to have used the guidelines as
      the basis for changing clinical practice. CONCLUSIONS: The guidelines were
      successfully disseminated and diffused, but practitioner involvement in guideline
      development did not guarantee implementation. Downsizing, leadership and
      facilitation seemed to be crucial factors when getting evidence into practice.
      Limited occurrence of evaluations of clinical practice against guideline
      recommendations suggests a need for valid and user-friendly measures.

PMID- 11202601
TI  - Performance measurement for schizophrenia: adherence to guidelines for
      antipsychotic dose.
AB  - OBJECTIVE: This report describes the development, application, and exploratory
      evaluation of a clinical performance measure based on recently published
      schizophrenia guidelines for antipsychotic dose. DESIGN, SETTING, PARTICIPANTS:
      The performance measure, which assesses adherence to antipsychotic dose
      recommendations for acute schizophrenia treatment, was calculated at hospital
      discharge for 116 patients with schizophrenia who had participated in a 6-month
      outcomes study. MAIN OUTCOME MEASURE: The Brief Psychiatric Rating Scale (BPRS)
      was used to assess symptom severity at 6-month followup. RESULTS: At discharge,
      almost one-half of the patients were prescribed doses outside the recommended
      range. For the entire sample, linear regression models showed that the
      performance measure variable was not significantly associated with followup
      symptom severity (BPRS total scores). However, a significant association was
      observed for patients prescribed oral antipsychotics only (n = 69). Patients
      prescribed recommended doses had lower adjusted mean BPRS totals than patients
      prescribed doses either greater than (P < 0.05) or less than (P < 0.05)
      recommended. CONCLUSIONS: Our findings suggest that the antipsychotic dose
      performance measure may be useful for monitoring quality. It assesses a
      modifiable aspect of care for which clinical improvement is needed, and such
      improvement is likely to improve patient outcomes. Future research is needed to
      confirm our findings and to develop and test interventions to improve the quality
      of care for schizophrenia that incorporate this clinical performance measure.

PMID- 11202602
TI  - Assessing the necessity of hospital stay by means of the appropriateness
      evaluation protocol: how strong is the evidence to proceed?
AB  - OBJECTIVE: To review the Appropriateness Evaluation Protocol (AEP) with respect
      to assessing the necessity of hospital stay at the University Hospital of
      Maastricht. DESIGN: Literature search in Medline focusing on the validity,
      reliability and possibilities for intervention plus a description and the first
      results of pilot studies with a Dutch version of the Adult-Medical AEP (days of
      stay). SETTING: The University Hospital of Maastricht, a 700-bed university and
      regional hospital in the south of The Netherlands. MAIN OUTCOME MEASURES: Face,
      content, and convergent validity, and reliability in terms of overall or specific
      agreement and by kappa, of the Adult-Medical AEP when used by physicians and
      nurses. RESULTS: In comparison with other instruments, a comparatively good
      performance by the AEP has been reported in the literature. Literature review
      revealed limitations in the AEP as a general and truly valid and reliable
      instrument for assessing the necessity of hospital stay. In applying a Dutch
      version (azM-AEP) similar difficulties were encountered. CONCLUSION: Based on the
      literature review and our own findings, we conclude that the validity and
      reliability of the different versions of the AEP are not yet up to standard.
      Regarding the results of the interventions thus far, we do not encourage further
      use until additional improvements to both the instrument and the review
      conditions have been made. Perhaps a more disease-specific modulation and
      assessments based on computerized medical records could improve its applicability
      in clinical practice in general.

PMID- 11202603
TI  - An evaluation of the impact of training Honduran health care providers in
      interpersonal communication.
AB  - OBJECTIVE: To evaluate the impact of interpersonal communication (IPC) training
      on practice and patient satisfaction and to determine the acceptability of this
      training to providers in a developing country. DESIGN: The study used a pre-post
      design with treatment and control groups. Data collection methods included
      interaction analysis of audio-taped clinical encounters, patient exit interviews,
      and a self-administered questionnaire for health providers. STUDY PARTICIPANTS:
      Interaction analysis was based on an experimental group of 24 doctors and a
      control group of eight with multiple observations for each provider). Exit
      interviews were carried out with 220 pre-test patients and 218 post-test
      patients. All 87 health providers who received training responded to the self
      administered questionnaire. INTERVENTION: A brief in-service training programme
      on interpersonal communications was presented in three half-day sessions; these
      focused on overall socio-emotional communication, problem solving skills and
      counselling. MAIN OUTCOME MEASURES AND RESULTS: The IPC intervention was
      associated with more communication by trained providers (mean scores of 136.6
      versus 94.4; P = 0.001), more positive talk (15.93 versus 7.99; P = 0.001), less
      negative talk (0.11 versus 0.59; P = 0.018), more emotional talk (15.7 versus
      5.5; P = 0.021), and more medical counselling (17.3 versus 11.3; P = 0.026).
      Patients responded by communicating more (mean scores of 113.8 versus 79.6; P =
      0.011) and disclosing more medical information (54.7 versus 41.7; P = 0.002).
      Patient satisfaction ratings were higher for providers who had received the
      training and providers reported training to be relevant and useful. CONCLUSIONS:
      Further validation of IPC skills and simplification of assessment methods are
      needed if IPC is to be an area for routine monitoring and quality improvement.

PMID- 11202604
TI  - Primary health care system in transition: the patient's experience.
AB  - OBJECTIVE: To find out how Estonian people evaluate the changes in primary health
      care (PHC), how they perceive the acceptability of the new PHC system, and to
      assess patients' satisfaction with their primary care doctor. DESIGN: Face-to
      face interviews using structured questionnaires. SETTING: Estonia. STUDY
      PARTICIPANTS: A random sample of Estonian residents aged 15-74 years (n = 997).
      MAIN MEASURES: Acceptability of PHC system (accessibility, the patient
      practitioner relations, amenities, and patient's preferences) and patients'
      satisfaction with primary care doctor. RESULTS: Of the 997 respondents, 46% were
      sufficiently informed about the transition to the general practitioner (GP)-based
      PHC system; however, 45% of respondents had not personally experienced any
      changes. Of the 997 persons interviewed, 68% were registered on the patient list
      of a GCP, and 62% of those who had health problems preferred to consult the
      primary care doctor first. The waiting time for an outpatient appointment was
      brief (0-2 days). Of the 997 respondents, 68% were satisfied with their primary
      care doctor. Satisfaction was dependent on: (i) how patients evaluated the
      competence of the physician; (ii) comprehensibility of doctor's explanations; and
      (iii) comfort of the clinic. The right of patients to choose their own primary
      care doctor and having sufficient information about the changes in PHC system had
      a positive influence on the level of satisfaction. CONCLUSIONS: Patients'
      opinions are important in the evaluation of PHC. To increase the level of
      satisfaction, people need to understand the nature and intent of the primary care
      reforms. Personal choice of primary care doctor and good patient-doctor
      relationships are important factors too.

PMID- 11202605
TI  - Quality of life in multiple sclerosis: development and validation of the 'RAYS'
      scale and comparison with the SF-36.
AB  - OBJECTIVE: To develop a self-administered rating scale for quantifying quality of
      life (QoL) in multiple sclerosis (MS) patients. METHODS: The RAYS scale items
      were derived from a source of 600 questions composed by our Centre's experts from
      commonly used instruments that assess physical, psychological, and social
      familial dimensions. Prior to finalization of the RAYS QoL, candidate items were
      administered to 15 health rehabilitation professionals. Clarity, importance,
      relevance and specificity were graded for each item by every professional
      independently. Items chosen for the final version were graded as good or
      excellent on all these aspects. The Medical Outcome Study Short Form-36 (SF-36)
      was used to compare health appraisal with the RAYS scale. RESULTS: Each of the
      three subscales of the RAYS covers a different dimension (physical,
      psychological, and social-familial) and each includes 15 self-report items scored
      from 1 (best) to 4 (worse), focusing on the preceding week. Validation was
      achieved through administration of the scale to 50 randomly selected MS patients
      and to 50 age, sex-, education- and family status-matched healthy controls. All
      RAYS dimensions among MS patients reached a Cronbach's coefficient alpha > 0.8.
      Mean values for all dimensions were greater in patients than in controls (P <
      0.002). Patients scored below norms for the general population in the majority of
      the SF-36 subscales (on average 32% lower). Significant correlation was found
      between the two scales especially in the physical and social functioning
      subscales. CONCLUSION: The RAYS scale demonstrated high internal consistency and
      significant discriminative value, and is thus a suitable disease-specific tool
      for measuring QoL in MS.

PMID- 11202606
TI  - Coordination of care provision: the role of the 'handoff'.

PMID- 11202607
TI  - Actions of tachykinins within the heart and their relevance to cardiovascular
      disease.
AB  - Substance P and neurokinin A are tachykinins that are co-localized with
      calcitonin gene-related peptide (CGRP) in a unique subpopulation of cardiac
      afferent nerve fibers. These neurons are activated by nociceptive stimuli and
      exhibit both sensory and motor functions that are mediated by the tachykinins
      and/or CGRP. Sensory signals (e.g., cardiac pain) are transmitted by peptides
      released at central processes of these neurons, whereas motor functions are
      produced by the same peptides released from peripheral nerve processes. This
      review summarizes our current understanding of intracardiac actions of the
      tachykinins. The major targets for the tachykinins within the heart are the
      intrinsic cardiac ganglia and coronary arteries. Intrinsic cardiac ganglia
      contain cholinergic neurons that innervate the heart and coronary vasculature.
      Tachykinins can stimulate NK3 receptors on these neurons to increase their
      excitability and evoke spontaneous firing of action potentials. This action
      provides a mechanism whereby tachykinins can indirectly influence cardiac
      function and coronary tone. Tachykinins also have direct effects on coronary
      arteries to decrease or increase tone. Stimulation of NK1 receptors on the
      endothelium causes vasodilation mediated by nitric oxide. This effect is normally
      dominant, but NK2 receptor-mediated vasoconstriction can also occur and is
      augmented when NK1 receptors are blocked. It is proposed that these ganglion
      stimulant and vascular actions are manifest by endogenous tachykinins during
      myocardial ischemia.

PMID- 11202608
TI  - Characteristics of monkey tryptase purified from cheek pouch vascular tissues.
AB  - Tryptase purified from rat and dog tissues has been reported, although the
      characteristics of these enzymes are different from human tryptase. For
      pathophysiological studies of human tryptase, studies on species that have a
      similar tryptase to humans is needed. In this study, we purified monkey tryptase
      from cheek pouch vascular tissues using heparin affinity and gel filtration
      columns. The monkey tryptase, which had a molecular weight of 130 kDa by gel
      filtration, consisted of a tetramer of 33 kDa by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. The N-terminal sequence showed high homology
      with tryptases from other species. The optimum pH and temperature were 7.5-9.0
      and 25-40 degrees C, respectively. The enzyme was labile in high-KCl buffer, and
      the optimum KCl concentration was 0.1 M. The enzyme activity was completely
      inhibited by diisopropyl phosphorofluoridate and leupeptin but not by soybean
      trypsin inhibitor and alpha-antitrypsin. The enzyme hydrolyzed vasoactive
      intestinal peptide but did not affect angiotensin I, somatostatin and bradykinin.
      In the present study, we first isolated monkey tryptase from cheek pouch vascular
      tissues and showed that the characteristics of monkey tryptase are very similar
      to those of human tryptase.

PMID- 11202609
TI  - Effects of adrenergic alpha2-receptor agonists on urinary bladder contraction in
      conscious rats.
AB  - We investigated the effects of the adrenergic alpha2-receptor agonists clonidine,
      oxymetazoline and tizanidine on bladder contractions induced by infusing fluid
      into the bladders of conscious male rats. I.v. clonidine and oxymetazoline (both
      0.01 to 0.1 mg/kg) caused bladder hyperactivity, expressed by shortening of the
      intercontraction interval. Tizanidine (0.1 mg/kg, i.v.) caused slight shortening
      of the intercontraction interval. The rank order of potency was clonidine =
      oxymetazoline >> tizanidine. Intrathecal (i.t.) injection of 10 microg clonidine
      and oxymetazoline, and intracerebroventricular (i.c.v) injection at 15 microg,
      produced almost the same pattern of bladder hyperactivity as that observed after
      i.v. injection of these drugs (0.03 mg/kg, i.v.). For all three administration
      routes of clonidine and oxymetazoline, i.v. idazoxan (0.3 mg/kg) exerted an
      inhibitory effect on the bladder hyperactivity induced by these drugs, except
      i.c.v injection of oxymetazoline. I.t. phenylephrine (30 microg) did not change
      the intercontraction interval. Although i.c.v. phenylephrine (15 microg)
      shortened the intercontraction interval, the potency was weaker than those of
      i.c.v. clonidine and oxymetazoline (15 microg). These results suggest that
      clonidine and oxymetazoline cause bladder hyperactivity by acting at adrenergic
      alpha2 receptors in the micturition centers of the lumbosacral and supraspinal
      regions.

PMID- 11202610
TI  - Effects of S-nitroso-cysteine on proteins that regulate exocytosis in PC12 cells:
      inhibitory effects on translocation of synaptophysin and ADP-ribosylation of GTP
      binding proteins.
AB  - S-Nitroso-cysteine (SNC) inhibits Ca2+-induced noradrenaline (NA) release from
      PC12 cells. Since SNC stimulated Ca2+ mobilization from intracellular Ca2+ pools
      and SNC-induced inhibition of NA release was not washed-out, SNC may modify
      exocytosis-related proteins that overcome Ca2+ mobilization. In the present
      study, we investigated the effects of SNC on exocytosis-related proteins in PC12
      cells. Ionomycin stimulated NA release and increased the immunoreactivity of
      synaptophysin in the cytosol fraction. A 25-kDa synaptosome-associated protein
      (SNAP-25), which localizes to plasma membranes and vesicles, increased in the
      cytosol fraction after stimulation. The increases in these proteins by ionomycin
      were inhibited in PC12 cells treated with 0.6 mM SNC. Synaptobrevin and synapsin
      1 in the cytosol fraction, and syntaxin and 43 kDa growth-associated protein in
      the membrane fraction were not affected by ionomycin or SNC. Incubation of each
      protein with SNC did not affect antibody immunoreactivity. [32P]ADP-ribosylation
      of GTP-binding proteins (Gi/Go) by pertussis toxin, but not Gs by cholera toxin,
      was inhibited in SNC-treated PC12 cells and by co-addition of SNC to the assay
      mixture. These findings suggest that 1) SNC inhibits translocation of vesicles
      containing synaptophysin and SNAP-25, and 2) SNC reacts with cysteine residues in
      Gi/Go, causing inhibition of ADP-ribosylation by pertussis toxin.

PMID- 11202611
TI  - Stimulation of high-affinity GTPase activity through group II metabotropic
      glutamate receptors in rat hippocampal and striatal membranes.
AB  - The stimulation of high-affinity GTPase activity through metabotropic glutamate
      receptors (mGluRs) was pharmacologically characterized with the use of a series
      of agonists for mGluRs in rat hippocampal and striatal membranes. The
      pharmacological profile of the response was almost identical to each other
      between both brain regions. Thus, the high-affinity GTPase activities were
      stimulated by several mGluR-related compounds with the following rank order of
      potency: (2S,2'R,3'R)-2-(2',3'-dicarboxycyclopropyl)glycine (DCG-IV) =
      (2S,1'S,2'S)-2-(carboxycyclopropyl)glycine (L-CCG-I) > L-glutamate = 2R,4R-4
      aminopyrrolidine-2,4-dicarboxylate [(2R,4R)-APDC] > (S)-4-carboxy-3
      hydroxyphenylglycine [(S)-4C3HPG] = 1S,3R-1-aminocyclopentane-1,3-dicarboxylate
      [(1S,3R)-ACPD] > (S)-3-carboxy-4-hydroxyphenylglycine [(S)-3C4HPG] = ibotenate.
      The negative logarithmically transformed EC50 (pEC50) values of these compounds
      in both brain regions were significantly correlated with those reported
      previously in the cerebral cortical membranes (N. Nishi et al., Br. J.
      Pharmacol., 130, 1664-1670, 2000). On the contrary, other reagents including a
      selective group I mGluRs agonist, (RS)-3,5-dihydroxyphenylglycine [(RS)-3,5
      DHPG], and selective group III mGluRs agonists such as L(+)-2-amino-4
      phosphonobutylate (L-AP4) and L-serine-O-phosphate (L-SOP) had little or no
      effects even at the highest concentration examined. Quisqualate was also a very
      weak agonist in both regions. These results indicate that mGluR-mediated high
      affinity GTPase activity derives from the Gi proteins associated with adenylyl
      cyclase inhibition through group II mGluRs, in particular the mGluR2 subtype, in
      rat hippocampal and striatal membranes.

PMID- 11202612
TI  - Enhancement of peptone-induced gastric acid secretion in streptozotocin-induced
      diabetic rats.
AB  - We compared the acid secretory response to peptone in normal and streptozotocin
      induced diabetic rats. Animals were injected with streptozotocin and used after 5
      weeks of diabetes with blood glucose levels of >350 mg/dl. Under urethane
      anesthesia, 2 ml peptone solution (2-8%) was instilled in the stomach through an
      acute fistula every 30 min. Peptone increased acid secretion in a concentration
      dependent manner in normal rats, the maximal response being obtained at 8%.
      Likewise, the increased acid response was observed in diabetic rats, yet the
      maximal response observed at 4% was significantly greater than that in normal
      rats. In both cases, this response was inhibited potently by famotidine as well
      as YM-022 (a CCKB antagonist) and partially inhibited by atropine. Peptone
      increased luminal histamine and plasma gastrin levels in both normal and diabetic
      rats, and the former response was significantly greater in diabetic animals. The
      altered acid secretion and histamine output in diabetic rats were reverted by
      insulin treatment. Pentagastrin- but not histamine-induced acid secretion was
      also increased in diabetic rats. We conclude that peptone-induced acid secretion
      is increased in diabetic conditions. This phenomenon is insulin-dependent and
      associated with an enhanced release of histamine but not with an increased
      sensitivity of the parietal cells.

PMID- 11202614
TI  - Role of 5-HT1A receptors in a mouse passive avoidance paradigm.
AB  - The effect on memory processes of modulation of 5-HT1A receptor subtype was
      investigated in the mouse passive avoidance test. The administration of 5-HT1A
      receptor antagonists NAN-190 (1-(2-methoxyphenyl)-4-[4-2
      phthalimmido)butyl]piperazine) and WAY-100635 (N-[2-[4-(2-methoxyphenyl)-1
      piperazinyl]ethyl]-N-2-pyridinyl-cyclohexanecarboxamide) produced a dose
      dependent amnesic effect comparable to that obtained with the well-known amnesic
      agents scopolamine and dicyclomine. Pretreatment with the 5-HT1A-receptor
      agonists 8-OH-DPAT ((+/-)-8-hydroxy-dipropylaminotetralin) and 5-CT (5
      carboxamidotryptamine) dose-dependently prevented the amnesia induced by 5-HT1A
      antagonists, scopolamine, dicyclomine and exposure to an hypoxic environment. The
      antiamnesic effect exerted by 5-HT1A-receptor agonists was comparable to that
      produced by the nootropic drug piracetam and cholinesterase inhibitor
      physostigmine. At effective doses, neither 5-HT1A-receptor agonists nor 5-HT1A
      receptor antagonists produced any impairment of mouse motor coordination (rota
      rod test), spontaneous motility (Animex apparatus) and inspection activity (hole
      board). These results indicate that modulation of 5-HT1A-receptors appears to
      play an important role in the regulation of cognitive processes.

PMID- 11202613
TI  - Increase of calmodulin III gene expression by mu-opioid receptor stimulation in
      PC12 cells.
AB  - Calmodulin (CaM) is a principal multifunctional mediator of Ca2+ signaling in
      cells. It is reported that morphine increases CaM contents in mouse brain.
      However, the precise mechanism of CaM induction by morphine is unknown. We
      investigated the changes of CaM by opioid receptor stimulation in mRNA and
      protein levels. Expression of CaM was increased in dose- and time-dependent
      manners by morphine with RT-PCR assay in PC12 cells, and naloxone inhibited the
      effect of morphine. The expression was also increased with DAMGO (mu-opioid
      agonist), but not by DPDPE (delta) and U50488 (kappa). Northern blot analysis
      revealed that the CaMIII gene was responsive to morphine or DAMGO. CaM protein
      increased by DAMGO were distributed in both soluble and membranous fractions in
      the cells. Taken together, the data suggest that morphine induces the expression
      of CaMIII gene through mu-opioid receptor stimulation.

PMID- 11202615
TI  - Effects of nitric oxide on the vestibular functional recovery after unilateral
      labyrinthectomy.
AB  - The effects of nitric oxide on the vestibular function recovery following
      unilateral labyrinthectomy were studied. Male Sprague-Dawley rats treated with N
      omega-nitro-L-arginine methyl ester (L-NAME), a nitric oxide synthase (NOS)
      inhibitor, were subjected to destruction of the unilateral vestibular apparatus
      and spontaneous nystagmus was observed. To explore the role of nitric oxide on
      the potassium current, the whole cell patch clamp technique was applied on
      isolated medial vestibular nuclear neurons. The frequency of spontaneous
      nystagmus that appeared in L-NAME-treated rats was higher and maintained longer
      than in control animals. Potassium currents in the isolated medial vestibular
      nucleus were inhibited by nitric oxide liberating agents, sodium nitroprusside
      and S-nitroso-N-acetylpenicillamine. After blockade of calcium dependent
      potassium currents by high EGTA (11 mM)-containing pipette solution, sodium
      nitroprusside did not inhibit the outward potassium currents. 8-Bromoguanosine
      3,5-cyclic monophosphate, a membrane-permeable cGMP analogue, produced similar
      effects to inhibit the outward potassium currents as sodium nitroprusside. These
      results suggest that nitric oxide production after unilateral labyrinthectomy
      would help to facilitate vestibular compensation by inhibiting calcium-dependent
      potassium currents through increasing intracellular cyclic GMP, thereby
      increasing excitability in ipsilateral vestibular nuclear neurons.

PMID- 11202616
TI  - Role of Ca2+ mobilization in muscarinic receptor-mediated membrane depolarization
      in guinea pig ileal smooth muscle cells.
AB  - In single smooth muscle cells dispersed from guinea pig ileum, the muscarinic
      agonist carbachol (CCh) at 2 microM produced an oscillatory or sustained type of
      depolarization and at 100 microM, the latter type depolarization. Depletion of
      internal Ca2+ stores blocked the oscillatory response, but not the sustained
      responses to 2 microM and 100 microM CCh, although their decay after reaching the
      peak became faster. Blocking voltage-dependent Ca2+ channels (VDCCs) blocked both
      types of response to 2 microM CCh, but only slowed the initial rising phase of
      100 microM CCh responses. Combination of Ca2+ store depletion and VDCC blockade
      abolished the responses to 2 microM CCh again and decreased those to 100 microM
      CCh in peak amplitude and persistency. Combination of Ca2+ store depletion with
      removal of extracellular Ca2+ markedly reduced or abolished the 100 microM CCh
      responses. The results suggest that muscarinic depolarization of the ileal cells
      requires Ca2+ mobilization for its generation and persistence; at weak muscarinic
      stimulation, both Ca2+ entry via VDCCs and Ca2+ release from internal stores may
      contribute to the Ca2+ mobilization; and under strong muscarinic stimulation,
      Ca2+ entry pathways resistant to VDCC blockers may also contribute to it.

PMID- 11202617
TI  - Enhancement of intracellular Cl- concentrations induced by extracellular ATP in
      guinea pig ventricular muscle.
AB  - We investigated effects of extracellular ATP on intracellular chloride activities
      ([Cl-]i) and possible contribution of the Cl--HCO3- exchange to this increase in
      [Cl-]i in isolated guinea pig ventricular muscles. The [Cl-]i and intracellular
      pH (pHi) were recorded in quiescent ventricular muscles using double-barreled ion
      selective microelectrode techniques. MgATP at a concentration higher than 0.1 mM,
      induced an increase in [Cl-]i, and this increase in [Cl-]i was dependent on the
      concentration of ATP but not on the concentration of magnesium ions present in
      the perfusion solution. NaADP, but not NaAMP, at a concentration of 0.5 mM
      induced a similar increase in [Cl-]i as that induced by MgATP. However, the NaADP
      induced increase in [Cl-]i was transient and gradually returned to the control
      level even though NaADP was continuously present. Furthermore, ATP also triggered
      a transient acidification of pHi, and both increases in [Cl-]i and intracellular
      H+ induced by ATP were prevented when preparations were pretreated with stilbene
      derivatives, SITS and DIDS, or perfused with a Cl--free solution. Our findings
      showed that the increased extracellular ATP concentrations might trigger an
      increase in [Cl-]i in ventricular muscles. In light of previous studies showing
      that cardiac ischemia induced increases in extracellular nucleotide
      concentrations and [Cl-]i in ventricular muscles, we propose that ischemia
      induced accumulation of ATP concentration in the extracellular space may be an
      important factor to trigger increment of [Cl-]i during ischemic conditions.

PMID- 11202618
TI  - The functional ratio of chymase and angiotensin converting enzyme in angiotensin
      I-induced vascular contraction in monkeys, dogs and rats.
AB  - Recently, a chymase-dependent angiotensin (Ang) II-forming pathway was found in
      human cardiovascular tissues, and the significance of this pathway in the
      pathogenesis of some cardiovascular diseases was suggested. The present study
      examined the ratio of angiotensin converting enzyme (ACE) to chymase-dependent
      Ang II formation in various isolated vessels from monkeys, dogs and rats. In all
      of the examined vessels, the addition of KCl at a concentration of 50 mM could
      induce a maximal contraction. Except for monkey coronary artery and rat renal and
      femoral artery, the addition of Ang I could induce transitory contractions,
      whereas the force of contractions in these vessels was quite different. The
      sensitivity to Ang II in these vessels was similar to that for Ang I. In monkey
      gastroepiploic and mesenteric arteries, about 70% of the Ang I-induced
      contraction was suppressed by chymase inhibition, while it was suppressed about
      50% in monkey renal, femoral and carotid arteries. In dog renal arteries, about
      65% of the Ang I-induced contraction was suppressed by chymase inhibition, while
      it was suppressed by about 30% in other dog arteries. In contrast, in all rat
      arteries, Ang I-induced contractions were completely suppressed by treatment with
      ACE inhibitor alone. We concluded that regional differences in the response to
      Ang I exist in vascular tissues, and the ratio of ACE- to chymase-dependent Ang
      II formation is different in the various vessels.

PMID- 11202619
TI  - Fasting exacerbates acute pancreatitis by occlusion of the common bile duct in
      rats.
AB  - We examined the effects of fasting and non-fasting on gallstone-related acute
      pancreatitis by the occlusion of the common bile duct (OCD). We prepared a rat
      OCD-induced pancreatitis model under both fasting and non-fasting conditions, and
      we measured amylase activity in ascites as well as production of inflammatory
      cytokines and chemokines. We also examined the pathology of the pancreas,
      myeloperoxidase (MPO) activity in some tissues and mortality rates. In the fasted
      OCD group, ascites containing a large amount of amylase, interleukin 1beta (IL
      1beta), interleukin 6 (IL-6), and cytokine-induced neutrophil chemoattractant-1
      (CINC-1) as well as marked hemorrhage and necrosis of the pancreatic acinar cells
      were observed. Pulmonary MPO activity increased 3.4-fold compared to the control
      group. In the non-fasted OCD group, there was no development of ascites. Slight
      necrosis of acinar cells and slight increases in pulmonary MPO activity were
      observed. In addition, in the fasted OCD group, the cumulative mortality rate was
      50% 6 days after ligation. However, in the non-fasted OCD group, none of the
      animals died. These results suggest that gallstone-related severe pancreatitis
      depends on fasting-related structural and/or functional changes in the pancreas.
      Moreover, increased production of inflammatory cytokines and chemokines in
      ascites under fasting condition may be involved in multiple organ failure
      resulting from severe acute pancreatitis.

PMID- 11202620
TI  - Itch-associated responses of afferent nerve innervating the murine skin:
      different effects of histamine and serotonin in ICR and ddY mice.
AB  - To assess the itch-associated response of primary afferents innervating the
      murine skin in vivo, dose-response curves and time-courses for itch-scratching
      and cutaneous nerve firing responses to intradermal injections of pruritogens
      (histamine and serotonin) were compared in ICR and ddY mice. Serotonin increased
      the itch-scratch response and cutaneous nerve firing in either ICR or ddY mice.
      Histamine increased these two responses in ICR, but not ddY, mice. The dose
      response curves and time-courses for serotonin- and histamine-induced nerve
      firing were similar to those for the itch-scratch response. The results suggest
      that cutaneous nerve firing evoked by peripherally given pruritogens includes the
      itch-associated response.

PMID- 11202621
TI  - The effects of melatonin in glutamate-induced neurotoxicity of rat cerebellar
      granular cell culture.
AB  - In the present study, melatonin was tested in subsequent doses in glutamate
      induced neurotoxicity in cerebellar granular cell culture of rat pups. Glutamate
      at 10(-7) M was found to induce neuronal cell death. The dead cell score was
      2.75+/-0.7 in the control, while it was found to be 35.12+/-1.8 in the glutamate
      administered group (P<0.0001). Melatonin very potently blocked glutamate
      neurotoxicity at all doses tested, with 10(-3) M, the highest dose tested, being
      the most effective. Glutamate may exert a neuroprotective effect by blocking one
      or more steps of the oxidation cascade in neurons and this effect may be blocked
      by melatonin.

PMID- 11202622
TI  - Effect of hydrogen peroxide on guinea pig nasal mucosa vasculature.
AB  - The effect of hydrogen peroxide (H2O2) on guinea pig nasal mucosa vasculature was
      studied by in vitro assay. H2O2 elicited relaxation of guinea pig nasal mucosa
      strips precontracted with phenylephrine in a concentration-dependent manner. The
      relaxant response to H2O2 was abolished in the presence of catalase.
      Preincubation of the strips with N(G)-nitro-L-arginine methyl ester or methylene
      blue significantly attenuated the relaxant responses elicited by H2O2.
      Fluorescence caused by DAF-2 DA, a fluorescence indicator for nitric oxide, was
      observed along the nasal mucosa vasculature in response to H2O2. These results
      suggest that H2O2 induced relaxation of the guinea pig nasal mucosa vasculature
      and that this relaxation is mediated by the NO/cGMP pathway.

PMID- 11202623
TI  - Ca2+-Sensitization of contraction in the h1 calponin-deficient smooth muscle.
AB  - Role of h1 calponin on Ca2+-sensitivity of smooth muscle contraction was
      investigated using h1 calponin gene-deficient mice (CP -/-) and wild type mice
      (CP +/+). PGF2. induced a comparable force in intact aorta of CP +/+ and CP -/-.
      DPB showed similar effects to PGF2alpha. In membrane-permeabilized ileal smooth
      muscle, PDBu enhanced Ca2+-sensitivity of contraction comparably in CP +/+ and CP
      -/-. GTPgamma-S showed similar effects. Our results suggest that h1 calponin does
      not regulate Ca2+-sensitivity in the contractile mechanism of smooth muscle.

PMID- 11202624
TI  - [6 years with Annali Italiani di Medicina Interna].

PMID- 11202625
TI  - Psychological constructs associated with emotional blood pressure response and
      white coat phenomenon.
AB  - Some hypertensive and non-hypertensive subjects have a striking blood pressure
      response to a medical environment (white coat phenomenon), although it is
      unlikely that its presence, degree, and duration can be routinely predicted.
      Despite the common observation that "anxious" patients may present with this
      reaction when a physician measures their blood pressure, no psychological
      variables have thus far been linked to white coat phenomenon in formal analyses.
      Ambulatory blood pressure monitoring is a useful tool to disclose the phenomenon
      since it allows precise evaluation of repeated blood pressure measurements
      outside the medical environment. To investigate the possible relationship between
      psychological profile and white coat phenomenon, we have planned to administer a
      series of psychometric tests to 120 subjects undergoing ambulatory blood pressure
      monitoring. The present data are derived from an analysis of the first set of 70
      patients. Thirty-four subjects who presented with white coat phenomenon (defined
      as office blood pressure elevated by at least 15% over the mean 24-hour
      ambulatory blood pressure value) and 36 comparable subjects who did not have this
      reaction underwent a series of psychometric tests evaluating cognitive behavior,
      hostility, cynicism, anger, anxiety state, coping ability and strategies, and
      quality of life. Of the various psychometric tests, the scores of three relevant
      scales (healthcare-related fears, mental efficiency and behavioral disengagement)
      were significantly higher in the group of patients with white coat phenomenon,
      while in both groups, emotional instability was higher than the clinical cut-off
      point. There were no significant differences between the two groups regarding
      signs and repression of anger (anger-out and anger-in), cynicism, hostility, or
      anxiety state. Our data seem to indicate that the subjects most likely to show an
      overt blood pressure increase in the medical environment are those who evidence
      healthcare-related fears and emotional instability but are not necessarily
      anxious. They exhibit high coping skills in cognitive resolution of stressing
      situations (such as blood pressure measurement) but do not combine these
      strategies with an adequate behavioral response and do not feel that behavioral
      involvement is necessary for the management of their clinical condition.

PMID- 11202626
TI  - [3-year-survival and quality of life after out-of-hospital heart arrest].
AB  - Although the long- and short-term aspects of the outcome of advanced
      cardiopulmonary resuscitation on patients have been studied to evaluate the
      percentage of survival up to the moment of discharge from hospital, little
      information has been published concerning the patients' long-term quality of
      life. In order to verify the efficiency of our group we retrospectively evaluated
      468 subjects admitted to the Emergency Room of Rho Hospital (Milan, Italy) for
      out-of-hospital cardiac arrest that had occurred over a 90-month period. We
      studied the correlations between some variables: epidemiological (sex and age),
      objective (time required for advanced cardiopulmonary resuscitation and type of
      arrhythmias in the Emergency Room) and instrumental (left ventricular ejection
      fraction) and post-discharge survival. We also considered the state of health of
      the survivors by means of a questionnaire on their quality of life. Our data show
      that: a) 10.25% of the patients were discharged alive; b) younger men (< 65 years
      old) admitted with a ventricular fibrillation (p = 0.01) and those who had
      undergone advanced cardiopulmonary resuscitation for less than 25 min (p = 0.001)
      had a better survival rate at 3 years from discharge; c) 64% of the survivors
      have a satisfactory quality of life; d) younger age (p = 0.01) and cardiac left
      ventricular ejection fraction (> 40%) (p = 0.05) are positive predictors for
      future work capacity. In conclusion, we believe that the critical moment
      following advanced cardiopulmonary resuscitation is hospitalization because after
      discharge survival percentage abruptly increased from 10.25 to 65%.

PMID- 11202627
TI  - Apparently dominant transmission of a recessive disease: deficiency of factor VII
      in Iranian Jews.
AB  - In inherited disorders transmitted as autosomal recessive traits the children of
      affected individuals are usually asymptomatic and phenotypically normal because
      they are heterozygous for the defect. In an Iranian Jewish family with moderately
      severe deficiency of coagulation factor VII (an autosomal recessive bleeding
      disorder) the son of an affected woman was also affected. DNA analysis of the
      factor VII gene showed that this unusual situation was due to the fact that he
      inherited an abnormal allele with the Ala244Val missense mutation from both the
      homozygous mother and the heterozygous father. The parents, although not overtly
      consanguineous, belong to the same ethnic group of Iranian Jews, among whom this
      factor VII gene mutation reaches high frequencies (between 2 and 3%) in the
      heterozygous state.

PMID- 11202628
TI  - [D-dimer in the year 2000: current data and new perspectives].
AB  - D-dimer is a product of cross-linked fibrin degradation by the fibrinolytic
      system. It has been shown to be highly sensitive and moderately specific for
      venous thromboembolic disease. Thus, the most common clinical use of D-dimer
      relates to its negative predictive value for deep vein thrombosis and pulmonary
      embolism. Diagnosis, however, should not be based solely on this parameter, and
      an integrated strategy that combines clinical approach (pre-test probability), a
      non-invasive test (ultrasonography or lung scan) and D-dimer assay is highly
      recommended. Over the last years a number of studies have demonstrated that D
      dimer may also enable the prediction of the complications of atherothrombosis
      inasmuch as the data available suggest a significant association of D-dimer with
      the risk of coronary artery disease independent of classic risk factors.
      Moreover, elevated plasma D-dimer seems to be a marker of a systemic
      prothrombotic state, and anticoagulation can normalize its levels. However,
      further studies are needed to assess whether or not this parameters is of
      clinical value to predict or prevent arterial thrombotic events in the single
      patient.

PMID- 11202629
TI  - [Morphologic study of the microcirculation in connective tissue diseases].
AB  - Capillaroscopy is a non-invasive diagnostic test used to study microvascular
      abnormalities which are present in many disorders, particularly some rheumatic
      pathologies, such as connective tissue diseases. In systemic sclerosis,
      capillaroscopy allows detection of pathognomonic microvascular alterations. In
      other connective tissue diseases, including systemic lupus erythematosus,
      dermatopolymyositis, undifferentiated connective tissue diseases, and mixed
      connective tissue disease, the capillaroscopic patterns, although non-specific,
      can provide a valid support for the diagnosis. In Raynaud's phenomenon,
      capillaroscopy enables detection of early microvascular abnormalities that are
      useful for preclinical diagnosis of secondary Raynaud's phenomenon.

PMID- 11202630
TI  - Antithrombotic drugs for the secondary prevention of ischemic stroke.
AB  - On the assumption that antithrombotic drugs are able to reduce the incidence of
      any vascular event independently of where it first occurs, they are used for the
      secondary prevention of arterial vascular disease in different locations. The
      Antiplatelet Trialists' Collaboration meta-analysis has shown that the net
      benefit of antiplatelet drugs in the prevention of stroke, acute myocardial
      infarction and vascular death is about the same for patients with prior stroke or
      prior myocardial infarction. Most of the trials included in the Antiplatelet
      Trialists' Collaboration meta-analysis used aspirin, which was shown to lower the
      risk of stroke, myocardial infarction, and vascular death in patients with a
      history of transient ischemic attack or stroke. Aspirin should be given to
      patients operated on for symptomatic carotid stenosis and should be considered
      for asymptomatic patients. In a comparative study ticlopidine (500 mg) vs aspirin
      (650 mg), ticlopidine reduced the relative risk of vascular events by 9% and of
      recurrent stroke by 21%. When clopidogrel (75 mg) was compared with aspirin (325
      mg), a 7.3% relative risk reduction was seen in the stroke group (6431 patients)
      of the CAPRIE study; a reduction in hemorrhagic events, especially in
      gastrointestinal bleeding, was also seen. At variance with previous studies, the
      ESPS-2 showed an advantage when dipyridamole (400 mg) was added to aspirin (50
      mg). Oral anticoagulants are more effective than aspirin in the prevention of
      cardioembolic stroke in patients with atrial fibrillation. The higher efficacy of
      indobufen with respect to aspirin in this particular setting needs confirmation.
      Inhibition of thrombosis may be one of the mechanisms explaining the effect of
      statins in reducing both stroke and cardiac events in high-risk patients.

PMID- 11202631
TI  - [Meningococcal meningitis in the adult complicated by cutaneous necrosis:
      description of a clinical case].
AB  - Meningitis and meningococcal sepsis are emergency conditions associated with high
      mortality. The outcome is worsened by the onset of disseminated intravascular
      coagulation. This may present, particularly in children, with the clinical
      picture of purpura fulminans, characterized by extensive necrotic-hemorrhagic
      skin lesions, ischemia of the extremities and multiorgan failure. It has been
      observed that depletion of coagulation inhibitors, particularly protein C, plays
      a key role in the development of this severe complication. We describe the case
      of a woman who presented in the Emergency Room with signs of meningitis,
      drowsiness, hypotension and petechie. Bacterioscopic examination of the
      cerebrospinal fluid evidenced characteristic gram-negative diplococci. Laboratory
      data disclosed initial disseminated intravascular coagulation with low levels of
      proteins C and S. Following intravenous infusion of antibiotics, fluids and fresh
      frozen plasma, the patient's condition rapidly improved. However, multiple skin
      lesions appeared on her fingers, toes and heels. It is likely that the infusion
      of coagulation inhibitors contained in fresh frozen plasma, prevented evolution
      to full-blown purpura fulminans. The first choice treatment for purpura fulminans
      in meningococcal sepsis is infusion of protein C concentrate, which is not,
      however, currently available on the market.

PMID- 11202632
TI  - Liquorice-induced sodium retention. Merely an acquired condition of apparent
      mineralocorticoid excess? A case report.
AB  - Excessive ingestion of liquorice may result in sodium retention, hypertension,
      hypokalemia, and suppression of renin and aldosterone. Similarities between
      liquorice-induced effects and congenital apparent mineralocorticoid excess have
      recently been emphasized, as in both conditions, reduced activity of the enzyme
      11 beta-hydroxysteroid dehydrogenase type 2 allows cortisol to act as a potent
      mineralocorticoid. We report a case of generalized edema without any increase in
      blood pressure, with biochemical and hormonal features of apparent
      mineralocorticoid excess, in a young woman who had been ingesting substantial
      amounts of liquorice for several years. Liquorice-induced wide-spread edema
      without hypertension in our patient, as well as in a few other cases previously
      reported, and the more common occurrence of edema associated with hypertension
      challenge the current explanation of liquorice syndrome as a purely acquired
      apparent mineralocorticoid excess. Indeed, in both congenital apparent and true
      mineralocorticoid excess, edema is typically absent, as a result of the sodium
      escape phenomenon. As pressure-natriuresis may be an essential mechanism
      accounting for the sodium escape phenomenon, some component of liquorice could
      partially or completely oppose the circulatory response that converts liquorice
      induced sodium retention into blood pressure elevation. In patients with
      unexplained generalized edema and hypokalemia without hypertension, liquorice
      ingestion should be carefully investigated and the renin-aldosterone system
      should be assayed.

PMID- 11202633
TI  - Tetanus-like syndrome secondary to metoclopramide administration.
AB  - A case of metoclopramide-induced pseudotetanus in a 24-year-old woman is
      described. Symptoms included flexor spasms of the neck muscles, neck pain, left
      deviation of the lower jaw and tongue protrusion. Tetanus was initially
      suspected. Mydriasis, hyperhydrosis and clinical observation indicated that this
      syndrome could be caused by metoclopramide taken for gastrointestinal symptoms.
      Orphenadrine hydrochloride, diazepam and ketoprofen completely resolved the
      symptoms. Pseudotetanus presents in many different ways, and it is sometimes very
      hard to distinguish it from infective tetanus, which is very difficult to
      diagnose. Physicians using metoclopramide should be aware of its adverse effects
      and how to treat them.

PMID- 11202634
TI  - Severe postpartum hypertension and reversible cerebral angiopathy associated with
      ergot derivative (methergoline) administration.
AB  - A 36-year-old woman (gravida 2, para 2) delivered a healthy child by cesarean
      section at the 37th week of an unremarkable gestation. Blood pressure remained
      within normal range throughout the pregnancy, surgery, and for the 9 following
      days. On day 10, about 36 hours after the initiation of oral methergoline to
      suppress lactation, the patient complained of severe posterior headache, flashing
      scotomata, hypertension, tonico-clonic seizures and then homonymous left
      hemianopsia and hemiparesis. Blood pressure monitoring confirmed intermittent and
      severe hypertension. Angiography demonstrated diffuse narrowing of the small and
      medium cerebral arteries. Transcranial Doppler ultrasound examination disclosed a
      bilateral increase in mean flow velocity. Progressive normalization of blood
      pressure, obtained with labetalol and oral clonidine, was accompanied by
      amelioration of the neurological deficits until a complete recovery and
      normalization of transcranial Doppler flow velocity occurred. This case provides
      further evidences that hypertension might play a major pathogenetic role in
      reversible cerebral angiopathy. Some ergot derivatives (including methergoline)
      might trigger the initial rise in blood pressure.

PMID- 11202636
TI  - [Resolution of the Ninth (LXXII)Session of the General Meeting of the Russian
      Academy of Medical Science (RAMS) on Man and Microorganisms. Health and Disease].

PMID- 11202635
TI  - [Molecular epidemiology as a new research area in the study of natural and focal
      infections].

PMID- 11202637
TI  - [Tuberculosis in the Russian Federation is a problem of state significance].

PMID- 11202639
TI  - [Efficiency of international tuberculosis control programmes in the Tomsk
      Region].
AB  - Since 1994, international tuberculosis control programmes in the have been
      implemented in the Tomsk Region by using advanced experience in Russian
      phthisiology and foreign medicine by attracting many specialists of the British
      "Merlin" agency (London), New York Health Institute (USA). A program is financed
      from different funds of other countries (KNOW HOW, J. Soros, EU, British
      government, WHO) and from regional sources. The phthisiological doctrine has been
      changed, all tuberculosis control services in the region has been substantially
      restructured and integrated. A new concept of tuberculosis diagnosis and
      treatment has been developed. DOTS and DOTS-PLUS which form the present strategy
      of WHO to control this disease throughout the world have been developed.

PMID- 11202638
TI  - [Present-day aspects (diagnosis, clinical course and treatment) of acute
      progressive pulmonary tuberculosis].
AB  - A total of 103 patients with acute progressive pulmonary tuberculosis whose age
      ranged from 18 to 60 years were examined. Caseous pneumonic, infiltrative
      caseous, disseminated, and rapidly progressive fibrocavernous tuberculosis was
      found in 45.6, 17.5, 16.5, and 20.4% of cases, respectively. The clinical picture
      was characterized by its acute onset with significant intoxication syndrome.
      Moreover, all the patients had respiratory and immunological failure, varying
      disseminated intravascular coagulation syndrome, non-specific bronchopulmonary
      infection; some presented with pulmonary hemorrhage, spontaneous pneumothorax and
      pleural empyema. The sputum smear test was positive in all the patients. If there
      was no evidence for drug resistance, patients had a 4-month regimen using
      isoniazid, rifampicin, pyrazinamide, ethembutol, and kanamycin. In the subsequent
      10-12 months, isoniazid, rifampicin, and ethambutol were given. The patients with
      multidrug resistant tuberculosis were administered protionamide, ofloxacin,
      amikacin, supplemented by pyrazinamide and ethambutol. The combined chemotherapy
      could stop bacterial isolation in more than 80% of patients, make the process
      stable, and prepare them for planned surgical treatment. When complications
      occurred and the disease was in steady progress, salvage operations were made,
      which was the only possible way of preventing the progression of disease at times
      and of saving life in the patient.

PMID- 11202640
TI  - [Microorganisms and food. Risk and benefits].

PMID- 11202641
TI  - [Morpho-functional changes of surfactant system in pulmonary tuberculosis].
AB  - A complex study of different cellular and extracellular surfactant elements in
      the dynamics of the spontaneous course of generalized tuberculosis was made in
      240 guinea-pigs and 77 patients with different forms of active pulmonary
      tuberculosis by using electron microscopy, biochemistry, and physical chemistry.
      A diagnostic scheme was proposed for life-time assessment of surfactant in
      bronchoalveolar lavage specimens. Three degrees of changes in surfactant were
      identified; 1) adaptive rearrangement of its elements developing in local
      surfactant damages; 2) significantly impaired type 2 alveolocyte production of
      surfactant, which affects its biochemical composition and capacity of forming
      characteristic structures; 3) common morphological, biochemical, surface-active
      signs of surfactant decompensation, profound metabolic disturbances, alveolar
      epithelial destruction with cleared alveolocytes found in the lavage.

PMID- 11202642
TI  - [Role of xenobiotic biotransformation enzymes in susceptibility to bronchial
      asthma and in formation of its clinical phenotypic features].
AB  - The paper shows the impact of some mutations of CYP1A, GSTM1, GSTT1, and NAT2
      genes and different combinations of alleles of these genes on susceptibility to
      bronchial asthma and its clinical features. Passive smoking modulates these
      relationships.

PMID- 11202643
TI  - [Role of biological defects in formation and development of bronchial asthma and
      potentialities of premorbid diagnosis].
AB  - The paper considers bronchial asthma as a polygenic disease. It presents some
      data available in the literature on the role of genetic disorders in the
      development of atopic states and the authors' own findings of various biological
      defects detected in apparently healthy blood relatives of patients with bronchial
      asthma. It is concluded that premorbid diagnosis is of importance in high risk
      persons.

PMID- 11202644
TI  - [Genomic medicine in the solution of pulmonological problems].
AB  - Main points of the new direction genomic medicine and its applications to
      solution of pulmonological problems are outlined. Information on the molecular
      epidemiology of cystic fibrosis and bronchial asthma is presented. The frequency
      of major cystic fibrosis gene mutations and bronchial asthma candidate gene
      polymorphisms was defined in Siberian populations. The familial case histories of
      patients with bronchial asthma were used to assess the contribution of
      interleukine (IL4, IL5, IL9) and nitric oxide synthase (NOS3) genes to
      susceptibility to bronchial asthma.

PMID- 11202647
TI  - [Asepsis and antisepsis].

PMID- 11202645
TI  - [Ten-year activities of the Faculty for Training of Scientific and Pedagogical
      Personnel, I.M. Sechenov Moscow Medical Academy].
AB  - With the assistance and direct participation of the Presidium of the Russian
      Academy of Medical Sciences, the I. M. Sechenov Moscow Medical Academy has
      developed and introduced an unique elitist educational system to train of
      scientific and pedagogical staff at the pre- and postdiploma training stages on
      the basis of their close relationships and continuity, within whose framework a
      specially designed faculty has been successfully operating for 10 years. The
      basic principle that ensures its effective activity and solution of many didactic
      problems is the individualization and differentiation of an educational process
      by using a great diversity of reserves and organizational forms. The created
      system is unique in Russian and foreign practice. It improves the quality of
      scientific and pedagogical staff training, promotes more effective creation of
      staff reserves for the departments of higher educational establishments and
      research institutes of the Russian Academy of Medical Sciences and the Ministry
      of Health of the Russian Federation.

PMID- 11202646
TI  - [Analysis of the annual open Russian competition for the best scientific student
      work in medical science].
AB  - For over 5 years, the I. M. Sechenov Moscow Medical Academy has been the basic
      Institute for holding the open Russian competition for the best scientific
      student work in medical sciences. The Academy has developed a methodological
      basis of this competition, which allowed the practical use of its organizational
      forms by the areas of informational support, evaluation of works, awards, office
      work. The authors' skills in presentation have become an original educational
      component in addition to usual expert estimation of works and afforded to obtain
      knowledge of progress in basic science and different problems in the organization
      of researches. The original competition organizing system has raised the
      popularity of the competition and the annual number of participants from
      different medical institutes and stimulated youth's interest in researches.

PMID- 11202648
TI  - Pesticide effects on freshwater zooplankton: an ecological perspective.
AB  - The effects of pesticides on zooplankton are reviewed and their ecological
      significance is discussed. Toxicity is shown to vary depending on animal species,
      genotype, life stage, and size at birth. Natural stresses such as food shortage,
      oxygen depletion and odors of potential predators can also affect toxicity.
      Populations in the growth phase are vulnerable to pesticides but have the
      potential to recover rapidly from the damage. Pesticides may affect the
      population dynamics by controlling individual survival and reproduction, and by
      altering the sex ratio. Furthermore, toxic chemicals may control predation risk
      by changing swimming behavior and body morphology, and this in turn influences
      the population dynamics. Many zooplankton display morphological and behavioral
      responses to predators when exposed to their odor-producing chemicals. However,
      pesticides induce a maladaptive response to predator odor, and this poses an
      ecological risk. The following patterns are recognized as effects of pesticides
      at the community and ecosystem levels: (1) induction of dominance by small
      species; (2) an increase of species richness and diversity; and (3) elongation of
      the food chain and reduction of energy transfer efficiency from primary producers
      to top predators.

PMID- 11202649
TI  - Comparative metabolism of phenanthridine by carp (Cyprinus carpio) and midge
      larvae (Chironomus riparius).
AB  - Abiotic transformation of azaarenes in the environment has been analysed
      extensively, but metabolism is less well described. To further elucidate
      preliminary observations of interspecific differences in azaarene metabolism by
      aquatic organisms, phenanthridine biotransformation by midge larvae and carp was
      studied. In both experiments, 6(5H)-phenanthridinone (phenanthridone) was found
      as an important metabolite. The fish were clearly capable of metabolising
      phenanthridine, but in the midge experiment the metabolite was principally formed
      by bacteria growing on the food and not by the midges. Phenanthridone itself was
      further degraded to non-observed compounds in both experiments, due to bacteria
      and midges acting together in the midge experiment, and by carp in the fish
      experiment. Internal concentrations of phenanthridine and phenanthridone were non
      detectable in the midge larvae, but concentrations of both compounds in carp
      organs suggested a major role of bile and liver. Since phenanthridone did not
      account for all phenanthridine loss, it was suggested that, apart from
      phenanthridone degradation, other metabolic pathways may play a role. This study
      clearly demonstrates the importance of interspecies differences in metabolism,
      which should not be neglected in risk assessment.

PMID- 11202651
TI  - Increased retention of polycyclic aromatic hydrocarbons in soils induced by soil
      treatment with humic substances.
AB  - The analytical recovery of a mixture of polycyclic aromatic hydrocarbons (PAHs)
      was determined from a soil before and after oxidation with hydrogen peroxide, and
      subsequently treated with increasing amounts of an exogenous humic acid and
      subjected to different incubation periods. The release of PAHs from soil depended
      on the specific structure and physico-chemical properties of each PAH, and
      increased with additions of exogenous humic materials for both the oxidized and
      non-oxidized soil as well as with time of PAH permanence in soil. PAH recoveries
      were lower in the non-oxidized soil, thereby revealing the importance of native
      organic matter in increasing PAH retention in soils. This study shows that
      mobility of PAHs in soils can be controlled by soil conditioning with humic
      substances.

PMID- 11202650
TI  - Accumulation of silver in the liver of three species of pinnipeds.
AB  - Silver in the three species of pinnipeds [northern fur seal (Callorhinus
      ursinus), Steller sea lion (Eumetopias jubatus), and harbor seal (Phoca
      vitulina)] caught in the North Pacific Ocean were analyzed using inductively
      coupled plasma-mass spectrometry, in order to understand accumulation and
      distribution of silver in pinnipeds. In northern fur seals, relatively high
      concentrations of silver were observed in the liver and body hair. Some 70% of
      the silver burden was concentrated in the liver. Hepatic silver concentrations
      were significantly correlated to age in northern fur seals (r = 0.766, P < 0.001,
      n = 49) and Steller sea lions (r = 0.496, P < 0.01, n = 28). Levels of silver
      concentrations per wet weight (microgram g-1) in the three pinnipeds ranged from
      0.04 to 0.55 for northern fur seals, from 0.1 to 1.04 for Steller sea lions and
      from 0.03 to 0.83 for harbor seals. Silver concentrations in liver for all
      pinnipeds were significantly correlated with mercury, and selenium (P < 0.001).
      Molar ratios between silver to selenium approximated 1:180 in northern fur seals,
      1:120 in Steller sea lions, and 1:60 in harbor seals. The silver-mercury molar
      ratios were approximately 1:170 in northern fur seals, and 1:80 both in the other
      species. Increase in silver accumulation in the liver was caused by the retention
      in nuclei and mitochondria fraction together with mercury and selenium in the
      cells of northern fur seals.

PMID- 11202652
TI  - Exposure to heavy metals and infectious disease mortality in harbour porpoises
      from England and Wales.
AB  - We investigate whether long-term exposure to heavy metals, including
      immunosuppressive metals like mercury (Hg), is associated with infectious disease
      in a wild cetacean. Post-mortem investigations on 86 harbour porpoises, Phocoena
      phocoena, found dead along the coasts of England and Wales revealed that 49 of
      the porpoises were healthy when they died as a consequence of physical trauma
      (most frequently entrapment in fishing gear). In contrast, 37 porpoises died of
      infectious diseases caused by parasitic, bacterial, fungal and viral pathogens
      (most frequently pneumonia caused by lungworm and bacterial infections). We found
      that mean liver concentrations of Hg, selenium (Se), the Hg:Se molar ratio, and
      zinc (Zn) were significantly higher in the propoises that died of infectious
      disease compared to healthy porpoises that died from physical trauma. Liver
      concentrations of lead (Pb), cadmium (Cd), copper (Cu) and chromium (Cr) did not
      differ between the two groups. Hg, Se, and the Hg:Se molar ratio were also
      positively correlated with age. The association between Zn concentration and
      disease status may result from Zn redistribution in response to infection.
      Further work is required to evaluate whether chronic exposure to Hg may have
      presented a toxic challenge to the porpoises that succumbed to infectious
      disease.

PMID- 11202653
TI  - Nutrient losses by surface run-off following the application of organic manures
      to arable land. 1. Nitrogen.
AB  - Research was conducted on nitrogen (N) surface run-off losses following organic
      manure applications to land, utilising a purpose-built facility on a sloping site
      in Herefordshire under arable tillage. Different rates and timing of cattle
      slurry, farmyard manure and inorganic N and phosphorus (P) fertiliser were
      compared, over a 4-year period (1993-97). P losses from the same studies are
      reported in a separate paper. The application of cattle slurries to the silty
      clay loam soil increased the loss of solids and NH4(+)-N in surface water flow
      compared to control plots receiving inorganic fertiliser only, or no treatment,
      but had little effect on NO3(-)-N losses by this route. Results were consistent
      with other observations that rainfall events immediately after manure
      applications are particularly likely to be associated with nutrient run-off
      losses. Losses via subsurface flow (30 cm interflow) were consistently much lower
      than via surface water movement and were generally unaffected by treatment.
      Increasing slurry application rate and, in particular, slurry solids loading,
      increased solids and NH4(-)-N losses via surface run-off. The threshold, above
      which the risk of losses via surface run-off appeared to be greatly increased,
      was ca. 2.5-3.0 t/ha slurry solids, which approximates to the 50 m3/ha limit
      suggested for slurry within UK 'good agricultural practice'. Sealing of the soil
      surface by slurry solids appears to be a possible mechanism by which polluting
      surface run-off may occur following slurry application on susceptible soils.
      Total losses of NH4(+)-N and NO3(-)-N during the 4-year monitoring period were
      insignificant in agronomic terms, but average soluble N concentrations (NH4(+)-N
      + NO3(-)-N) in run-off, ranging from ca. 2.0 mg/l, up to 14.0 mg/l for the higher
      rate slurry treatments. Peak concentrations of NH4(+)-N > 30 mg/l, are such as to
      be of concern in sensitive catchments, in terms of the potential for contribution
      to accelerated eutrophication and adverse effects on freshwater biota.

PMID- 11202654
TI  - Nutrient losses by surface run-off following the application of organic manures
      to arable land. 2. Phosphorus.
AB  - Phosphorus (P) surface run-off losses were studied following organic manure
      applications to land, utilising a purpose-built facility on a sloping site in
      Herefordshire under arable tillage. Different rates and timing of cattle slurry,
      farm yard manure (FYM) and inorganic nitrogen (N) and P fertiliser were compared,
      over a 4-year period (1993-97). N losses from the same studies are reported in a
      separate paper. The application of cattle FYM and, especially slurry, to the
      silty clay loam soil increased both particulate and soluble P loss in surface
      water flow. Losses via subsurface flow (30 cm interflow) were consistently much
      lower than via surface water movement and were generally unaffected by treatment.
      Increased application of slurry solids increased all forms of P loss via surface
      run-off; the results suggested that a threshold for greatly increased risk of P
      losses via this route, as for N, occurred at ca. 2.5-3.0 t/ha solids loading.
      This approximates to the 50 m3/ha application rate limit suggested for slurry
      within UK 'good agricultural practice'. The studies also provided circumstantial
      evidence of the sealing of the soil surface by slurry solids as the major
      mechanism by which polluting surface run-off may occur following slurry
      application on susceptible soils. Losses of total and soluble P, recorded for
      each of the 4 years of experiments, reached a maximum of only up to 2 kg/ha total
      P (TP), even after slurry applications initiating run-off. Whilst these losses
      are insignificant in agronomic terms, peak concentrations of P (up to 30,000
      micrograms/l TP) in surface water during a run-off event, could be of
      considerable concern in sensitive catchments. Losses of slurry P via surface run
      off could make a significant contribution to accelerated eutrophication on entry
      to enclosed waters, particularly when combined with high concentrations of NO3(-)
      N. Restricting slurry application rates to those consistent with good agronomic
      practice, and within the limits specified in existing guidelines on good
      agricultural practice, offers the simplest and most effective control measure
      against this potentially important source of diffuse pollution.

PMID- 11202655
TI  - Effects of development time, biomass and ferromanganese oxides on nickel sorption
      by stream periphyton.
AB  - Procedurally defined periphyton frequently includes substantial quantities of
      hydrous iron (Fe) and manganese (Mn) oxides. As these oxides are strong sorbers
      of heavy metals, their presence may complicate estimation of metal
      bioaccumulation by periphyton. We examined the relationship between nickel (Ni)
      sorption and the development time, biomass, and Fe and Mn oxide content of stream
      periphyton. Development time, the time during which periphyton accrued on
      submerged tile substrata, was used to provide variation in biomass, Fe and Mn
      levels. Stream periphyton from four development times was exposed to Ni for 2 h
      in the laboratory, and then ashed. Development time was significantly associated
      with ash-free dry mass (AFDM), Fe and Mn levels (ANOVA, P < or = 0.003). Ni
      extracted by a mild reductant (hydroxylamine hydrochloride) was significantly
      associated with development time, and with AFDM, Fe and Mn levels (linear models,
      P < or = 0.0002). A subsequent acid digestion yielded similar associations with
      the same variables (linear models, P < or = 0.0001). For both extractions, AFDM
      was significantly and positively correlated with Fe (r = 0.68 and 0.89) and with
      Mn (r = 0.77 and 0.93) (Spearman rank, P < or = 0.005). These data demonstrate
      the importance of periphyton development time in influencing both metal sorption
      and levels of biomass and ferromanganese oxides. The data also suggest that metal
      contaminant levels in periphyton should not be attributed automatically to biotic
      sorption. Periphyton metal-accumulation studies conducted where ferromanganese
      oxide concentrations are elevated should address the potential metal-sorbing
      roles of Fe and Mn oxides within the periphyton matrix.

PMID- 11202656
TI  - Immunotoxicity risks associated with land-treatment of petrochemical wastes
      revealed using an in situ rodent model.
AB  - Land-treatment of petrochemical wastes is a widely used method to dispose of
      hazardous and non-hazardous waste by biodegradation. However, no comprehensive
      assessment of the impact of such disposal techniques on terrestrial ecosystems
      has been conducted. Despite the presence of suspected immunotoxicants in the
      soil, wild rodents frequently reside on these waste sites after closure or
      abandonment. We explored the seasonal sensitivity of the immune system of the
      hispid cotton rat (Sigmodon hispidus) to in situ exposures on sites land-treated
      with petrochemical wastes. Animals were monitored on five contaminated land
      treatment sites and five ecologically matched-reference sites in Oklahoma, USA,
      over two seasons (summer and winter). Most hematological parameters were not
      adversely affected by land-treatment; however, platelet counts were 26% greater
      in cotton rats from land-treatment sites compared to reference sites in winter.
      Significant treatment-related differences were observed in total serum protein
      concentrations, organ mass and organ cellularity, but these differences were not
      consistent across the five land-treatment units. Lymphoproliferative responses of
      cotton rat splenocytes stimulated in vitro were elevated for a T-cell mitogen and
      depressed for a B-cell mitogen in animals from land-treatment compared to
      reference sites. The ability of splenocytes to proliferate in response to
      interleukin-2 receptor-binding was not influenced by treatment. Total yields of
      peritoneal cells, yield of peritoneal macrophages, and yield of peritoneal
      lymphocytes were influenced to varying degrees by land-treatment. Functionally,
      in vitro metabolic activity of peritoneal macrophages was 114% greater in cotton
      rats from land-treatment sites compared to reference sites during summer. These
      results indicate that petrochemical wastes applied to soils on these five land
      treatment sites had variable immunomodulatory effects in resident cotton rats.
      Immune alterations for some assays were indicative of enhancement on some land
      treatment sites while suppressive on other land-treatment sites, which could have
      been a function of type and concentration of immunotoxicants present on each site
      and highlights the uniqueness of each land-treatment site.

PMID- 11202657
TI  - Clonal differences in copper and zinc tolerance of birch in metal-supplemented
      soils.
AB  - Metal tolerance of a range of birch clones (Betula pendula and Betula pubescens)
      originating from metal-contaminated sites in England, Wales, Belgium and Finland
      were tested in soils supplemented with several concentrations of copper (Cu) or
      zinc (Zn) (500, 2000, 5000 mg kg-1 dry wt. soil of CuSO(4).5H2O or ZnSO(4).7H2O)
      for 4 months and with sub-toxic metal supplements (500 mg CuSO4, 2000 mg ZnSO4)
      for 6 months. When grown at high concentrations of metals, severe toxicity
      symptoms (growth inhibition, chlorosis, necrosis) and clear evidence for
      differences in tolerance to this toxicity were found in a subset of the clones.
      When all clones were grown at a much lower, sub-toxic level of metal, again
      significant differences could be found between some of the clones. Clones derived
      from the same population varied greatly in their tolerance. However, the overall
      pattern of metal specificity varied in agreement with the type of soil
      contamination at the site of origin. The growth of the clones from Harjavalta
      Cu/nickel smelter area was 19% better in Cu than in Zn-supplemented soil, on
      average. The growth of clones from Maatheide Zn smelter are was 19% poorer in Cu-
      than in Zn-supplemented soil. Sensitive clones accumulated more Cu and Zn to the
      above-ground parts. Some birch clones were able to survive at about 20-fold
      higher than typical total background Cu or Zn concentrations, whereas most clones
      were able to grow without serious toxic symptoms at about 10-fold concentrations.

PMID- 11202658
TI  - The Royal College and the dying joy of learning.

PMID- 11202659
TI  - Calculating waiting times retrospectively.

PMID- 11202660
TI  - Calculating waiting times retrospectively.

PMID- 11202661
TI  - MDs, maternity leave and adopted children.

PMID- 11202662
TI  - Effect of domperidone on milk production in mothers of premature newborns: a
      randomized, double-blind, placebo-controlled trial.
AB  - BACKGROUND: Varying degrees of success have been reported with strategies to
      increase milk production when lactation is failing. The objective of this study
      was to investigate the efficacy of domperidone in augmenting milk production in
      mothers of premature newborns. METHODS: Twenty patients were randomly assigned to
      receive either domperidone or placebo for 7 days. Milk volume was measured daily.
      Domperidone levels were measured in randomly selected milk and serum samples on
      day 5 of the study. Serum prolactin levels were measured before the start of the
      study, on day 5 and on day 10 (3 days after the last dose of the study
      medication). RESULTS: Data from 16 patients were available for analysis (7 in the
      domperidone group and 9 in the placebo group). When compared with baseline
      values, the mean increase in the volume of milk production from day 2 to 7 was
      49.5 (standard deviation [SD] 29.4) mL in the domperidone group and 8.0 (SD 39.5)
      mL in the placebo group (p < 0.05); proportionally this represented an increase
      of 44.5% and 16.6% respectively. The serum prolactin levels were similar in the 2
      groups at baseline; by day 5 they were significantly higher in the domperidone
      group than in the placebo group, returning to baseline levels in both groups 3
      days after the last dose of the study medication. Very small amounts of
      domperidone were detected in the breast milk samples. INTERPRETATION: In the
      short term domperidone increases milk production in women with low milk supply
      and is detected at low levels in breast milk.

PMID- 11202664
TI  - Determinants of violence in the psychiatric emergency service.

PMID- 11202663
TI  - Undiagnosed diabetes: does it matter?
AB  - BACKGROUND: The 1998 Canadian clinical practice guidelines for the management of
      diabetes lowered the cutoff point for diagnosing diabetes mellitus from a fasting
      plasma glucose (FPG) level of 7.8 to 7.0 mmol/L. We studied the prevalence and
      clinical outcomes of undiagnosed and diagnosed diabetes within specific ranges of
      FPG among a cohort of subjects recruited in 1990. METHODS: In 1990 a
      representative sample of 2792 adult residents of Manitoba participated in the
      Manitoba Heart Health Survey, which included measurement of FPG and a question
      about each participant's past history of diabetes. Individuals who would now be
      classified as having undiagnosed diabetes under the new criteria were not
      considered as such in 1990. Through data linkage with the provincial health care
      utilization database, the use of health care by these individuals was tracked and
      compared with that of individuals whose diabetes had been diagnosed and with that
      of normoglycemic individuals over an 8-year period subsequent to the survey.
      RESULTS: The prevalence of undiagnosed diabetes in the adult population of
      Manitoba was 2.2%. Undiagnosed cases accounted for about one-third of all
      diabetes cases. Individuals with undiagnosed diabetes had an unfavourable lipid
      profile and higher blood pressure and obesity indices than normoglycemic
      individuals. Individuals who satisfied the new criteria for diabetes but remained
      undiagnosed had an additional 1.35 physician visits per year (95% confidence
      interval [95% CI] 0.93-1.96) and were more likely to be admitted to hospital at
      least once (odds ratio 1.23, 95% CI 0.40-3.79), compared with normoglycemic
      individuals. INTERPRETATION: Undiagnosed cases represent the unseen but
      clinically important burden of diabetes, with significant concurrent metabolic
      derangements and a long-term impact on health care use.

PMID- 11202665
TI  - Mass influenza vaccination in Ontario: a sensible move.

PMID- 11202666
TI  - Mass influenza vaccination in Ontario: is it worthwhile?

PMID- 11202667
TI  - Another modest proposal.

PMID- 11202668
TI  - What goes around, comes around: a history of medical tuition.
AB  - In this article the actual and relative costs of tuition at 3 Ontario medical
      schools are traced over the past 150 years. In addition, the factors that led to
      Ontario's nearly 4-decade experiment in private medical education (and to its
      eventual demise) are presented. In relative terms, tuition was stable for over a
      century, then declined (after 1960) as government support rose. Access to medical
      training for students from middle-income families may also have improved steadily
      until the late 1980s. Because there is no shortage of people wanting to become
      doctors, there seems to be no limit to the price that could be set for a medical
      education. The recent hikes in tuition have outstripped inflation and may be
      reducing accessibility to restrictive levels, similar to those that prevailed in
      the 19th century. The author invites readers to question current trends.

PMID- 11202669
TI  - Bioethics for clinicians: 21. Islamic bioethics.
AB  - Islamic bioethics derives from a combination of principles, duties and rights,
      and, to a certain extent, a call to virtue. In Islam, bioethical decision-making
      is carried out within a framework of values derived from revelation and
      tradition. It is intimately linked to the broad ethical teachings of the Qur'an
      and the tradition of the Prophet Muhammed, and thus to the interpretation of
      Islamic law. In this way, Islam has the flexibility to respond to new biomedical
      technologies. Islamic bioethics emphasizes prevention and teaches that the
      patient must be treated with respect and compassion and that the physical, mental
      and spiritual dimensions of the illness experience be taken into account. Because
      Islam shares many foundational values with Judaism and Christianity, the informed
      Canadian physician will find Islamic bioethics quite familiar. Canadian Muslims
      come from varied backgrounds and have varying degrees of religious observance.
      Physicians need to recognize this diversity and avoid a stereotypical approach to
      Muslim patients.

PMID- 11202670
TI  - Environment and health: 7. Species loss and ecosystem disruption--the
      implications for human health.

PMID- 11202671
TI  - Health care got short shrift in an election about nothing.

PMID- 11202672
TI  - WHO compares tobacco to land-mine threat, seeks international rules.

PMID- 11202673
TI  - Will Canada follow US lead on RU 486?

PMID- 11202674
TI  - Going green? Go online.

PMID- 11202676
TI  - Military's environmental medicine research pushes limits of human endurance.

PMID- 11202675
TI  - Greening of health care goal of new coalition.

PMID- 11202677
TI  - HRT and venous thromboembolism: more evidence of a link.

PMID- 11202678
TI  - Snowboarding injuries: hitting the slopes.

PMID- 11202679
TI  - Thioridazine (Mellaril) and mesoridazine (Serentil): prolongation of the QTc
      interval.

PMID- 11202680
TI  - Clopidogrel (Plavix): hematological reactions.

PMID- 11202681
TI  - Gentamicin ear drops and ototoxicity: update.

PMID- 11202682
TI  - Whither marine radioactivity studies?

PMID- 11202683
TI  - Effect of chemical pollution on forms of 137Cs, 90Sr and 239,240Pu in arctic soil
      studied by sequential extraction.
AB  - The aim of the present study was to determine the forms of 137Cs, 90Sr and
      239,240Pu occurring in different soil horizons using sequential extraction of
      samples taken from four sites located along a pollution gradient from the copper
      nickel smelter at Monchegorsk in the Kola Peninsula, Russia, and from a reference
      site in Finnish Lapland in 1997. A selective sequential-leaching procedure was
      employed using a modification of the method of Tessier, Cambell and Bisson
      ((1979). Analytical Chemistry, 51, 844-851). For 137Cs the organic (O) and
      uppermost mineral (E1) layer were studied, for 90Sr and 239,240Pu only the
      uppermost organic layer (Of). The fraction of 137Cs occurring in readily
      exchangeable form in the organic layer was about 50% at the reference site and
      decreased as a function of pollution, being 15% at the most polluted site in the
      Kola Peninsula. There was a clear positive correlation in the O layer between the
      distance from the smelter and the percentage of 137Cs extracted in the readily
      exchangeable fraction (Spearman correlation rsp = 0.7805, p = 0.0001), whereas in
      the E1 layer no correlation was evident. The distribution of 90Sr in the Of layer
      was similar at all sites, with the highest amounts occurring in exchangeable form
      and bound to organic matter, whereas stable Sr showed a somewhat different
      distribution with the highest amount in the oxide fraction. Most of the 239,240Pu
      was bound to organic matter. Chemical pollution affected the exchangeable
      fraction of 239,240Pu, which was about 1% at the most polluted site and 4-6% at
      the other sites.

PMID- 11202684
TI  - Predicting the transfer of radiocaesium from organic soils to plants using soil
      characteristics.
AB  - A model predicting plant uptake of radiocaesium based on soil characteristics is
      described. Three soil parameters required to determine radiocaesium
      bioavailability in soils are estimated in the model: the labile caesium
      distribution coefficient (kd1), K+ concentration in the soil solution [mK] and
      the soil solution-->plant radiocaesium concentration factor (CF, Bq kg-1 plant/Bq
      dm-3). These were determined as functions of soil clay content, exchangeable K+
      status, pH, NH4+ concentration and organic matter content. The effect of time on
      radiocaesium fixation was described using a previously published double
      exponential equation, modified for the effect of soil organic matter as a non
      fixing adsorbent. The model was parameterised using radiocaesium uptake data from
      two pot trials conducted separately using ryegrass (Lolium perenne) on mineral
      soils and bent grass (Agrostis capillaris) on organic soils. This resulted in a
      significant fit to the observed transfer factor (TF, Bq kg-1 plant/Bq kg-1 whole
      soil) (P < 0.001, n = 58) and soil solution K+ concentration (mK, mol dm-3) (P <
      0.001, n = 58). Without further parameterisation the model was tested against
      independent radiocaesium uptake data for barley (n = 71) using a database of
      published and unpublished information covering contamination time periods of 1.2
      10 years (transfer factors ranged from 0.001 to 0.1). The model accounted for 52%
      (n = 71, P < 0.001) of the observed variation in log transfer factor.

PMID- 11202685
TI  - Long-term studies on transfer of 137Cs from soil to vegetation and to grazing
      lambs in a mountain area in northern Sweden.
AB  - Studies were made during 1990-1997 on the transfer of 137Cs from soil to
      vegetation (herbage) and to grazing lambs on a mountain farm with an uncultivated
      grazing area of about 10 km2. The farm is situated in an area in Northern Sweden
      which was contaminated by the Chernobyl fallout in 1986. The mean concentration
      of 137Cs in the soil to a depth of 10 cm for eight sampling sites observed in the
      8-year period was 14.51 kBq/m2, while in the cut herbage the average
      concentration was 859 Bq/kg d.w. and in lamb meat 682 Bq/kg w.w. A slow vertical
      migration of 137Cs in the 0-10 cm soil layer was indicated. Although the 137Cs
      concentration in herbage gradually decreased, the concentration in lamb meat
      varied from year to year. Soil ingestion by the lambs as a pathway for activity
      transfer was shown to be negligible, while ingestion of fungi with high
      concentrations of 137Cs was demonstrated to occur, as large numbers of fungi
      spores were counted in samples of the lambs' faeces. Fungi ingestion might
      therefore partly explain the varying mean yearly 137Cs concentrations in lamb
      muscle. The mean transfer parameters were as follows: for "soil to herbage" 61.3
      Bq/kg d.w. herbage per kBq/m2 soil, for "herbage to lamb meat" 0.81 Bq/kg w.w.
      meat per Bq/kg d.w. herbage, and for "soil to lamb meat" 47.1 Bq/kg w.w. meat per
      kBq/m2 soil. A trend of decreasing values of the transfer parameter for "soil to
      herbage" indicated that 137Cs was becoming less available for root-uptake with
      time. The effective ecological half-life of 137Cs in soil, herbage and lamb meat
      was calculated to be 19, 7 and 16 years, respectively. It can be concluded that
      natural areas are vulnerable to 137Cs contamination, resulting in high
      concentrations in plants, fungi and lamb meat for a long time.

PMID- 11202686
TI  - Resuspension of coarse fuel hot particles in the Chernobyl area.
AB  - Measurements of resuspended aerosol in the Chernobyl 30-km exclusion zone have
      shown coarse fuel hot particles in the activity range 1-12 Bq 137Cs per particle.
      The particles were sampled with newly designed rotating arm impactors which
      simultaneously collect during the same experiment three samples with fuel
      particles in the size ranges larger than 3 microns, larger than 6 microns and
      larger than 9 microns in geometric diameter. The radionuclide ratios, determined
      after gamma-spectrometry, were in good agreement with the theoretical
      calculations for the radionuclide-composition of the Chernobyl Nuclear Power
      Plant at the moment of the accident and the measured hot particles in soil in the
      early years after the accident. The number concentrations of airborne hot
      particles were derived from digital autoradiography. For wind resuspension,
      maximal concentrations of 2.6 coarse hot particles per 1000 m3 and during
      agricultural activities 36 coarse hot particles per 1000 m3 were measured. The
      geometric diameter of single hot particles was estimated to be between 6 and 12
      microns.

PMID- 11202687
TI  - Physical resuspension and vertical mixing of sediments on a high energy
      continental margin (Sydney, Australia).
AB  - Four sediment cores from the continental margin adjacent to Sydney were analyzed
      for 210Pb, 137Cs, trace metals (Ag, Cd, Co, Cu, Mn, Ni, Pb, Zn), iron, dry bulk
      density, mud and moisture content. The concentrations of trace metals in the
      total sediment are low at all sites, although slightly elevated concentrations of
      Ag, Cu, Pb and Zn are present in the fine fraction of sediment (< 62.5 microns)
      near a major ocean outfall. Concentrations of trace metals in the fine fraction
      of sediment are similar in the upper 10-15 cm, indicating strong vertical mixing
      of the sediments, whereas an upward coarsening grain size in the upper 1-3 cm of
      sediment supports physical resuspension during storms. Sediment accumulation
      rates on the middle shelf adjacent to Sydney were estimated from downcore
      profiles of 210Pb and 137Cs and range between 0.2 and 0.4 cm yr-1. Although the
      mass fluxes of Cu, Pb and Zn within a distance of 2 km from the outfall (up to
      36.1, 30.8 and 86.2 micrograms cm-2 yr-1, respectively) are greater than 20 km
      north of the outfall (< 23.5 micrograms cm-2 yr-1), the low concentrations of
      trace metals in sediments near the outfall support an efficient dispersal of
      anthropogenic contaminants on this continental margin.

PMID- 11202688
TI  - Radioactive discharges from an alkaline pulp mill located in the south of Spain.
AB  - Artificial and natural radionuclides present in environmental samples (Eucalyptus
      wood and bark) can be transferred in an alkaline pulp mill and concentrated in
      the recycling process. Some part of the radionuclides can be released into the
      environment associated with the discharges from such a factory. An alkaline pulp
      mill located in the South of Spain was extensively sampled during 1993 and
      different radionuclides analysed in the collected samples. Thus the
      concentrations and fluxes of natural (40K, 226Ra, 228Ra and 228Th) and artificial
      (137Cs and 90Sr) radionuclides associated with the samples collected along the
      pulp production process are presented. It is shown that radium and thorium
      radionuclides behave similarly to strontium and calcium and, consequently,
      concentrate within the Ca-cycle. Furthermore, 40K and 137Cs are concentrated
      during the Na-cycle. Finally, the results obtained by the authors are compared
      with the levels found in similar factories, though situated in the North of
      Europe, by other researchers.

PMID- 11202690
TI  - The Swedish nuclear dilemma.

PMID- 11202689
TI  - Radionuclides in hot mineral spring waters in Jordan.
AB  - Hot mineral springs in Jordan are very attractive to people who seek physical
      healing but they are unaware of natural radioactive elements that may be
      contained in the hot mineral water. The activities of the natural radioactive
      isotopes were measured and the concentrations of the parents of their natural
      radioactive series were calculated. The measured radionuclides were 234Th, 226Ra,
      214Pb, 214Bi, 228Ac, 228Th, 212Pb, 212Bi and 208Tl. In addition the activities of
      235U and 40K were measured. The activities ranged from 0.14 to 34.8 Bq/l, while
      the concentrations of parent uranium and thorium isotopes ranged from 3.0 x 10(
      3) to 0.59 mg/l. The results were compared with those for drinking water.

PMID- 11202691
TI  - Radionuclide transfer to fruits: A critical review. Foreword.
AB  - After completion of the (Validation of Environmental Model Predictions) (VAMP)
      and (BIOspheric Model Validation Study) (BIOMOVS II) Programmes, the Division of
      Radiation and Waste Safety of the IAEA decided to promote a new co-ordinated
      research programme to continue activities in the area of biosphere modelling. As
      a result, the BIOMASS Programme on BIOsphere Modelling and ASSessment was
      launched in Vienna in October 1996. The Programme is scheduled to finish in
      October 2000. The overall objective of BIOMASS is to provide an international
      focal point in the area of biosphere assessment modelling. There are 3 Themes and
      11 working groups in BIOMASS. The objective of the Theme 3 Fruits Working Group
      is to improve understanding of the uptake and transfer of radionuclides from
      different sources to fruit. As part of the work programme, a review was
      undertaken of the experimental, field and modelling information on the transfer
      of radionuclides to fruit.

PMID- 11202692
TI  - Radionuclide transfer to fruits: a critical review. Introduction.
AB  - This paper provides a brief introduction to fruit, their definition,
      classification and geographical distribution. In the following review, the term
      "fruit" refers not to a well-defined botanical plant part but, in the
      horticultural sense, to a component of the human diet generally consumed as a
      dessert item. Plants that bear fruits cover a vast range of morphological and
      physiological traits. A generic classification of fruit-bearing plants is
      proposed for use in studies on radionuclide transfer to fruit.

PMID- 11202693
TI  - The influence of the development of temperate fruit tree species on the potential
      for their uptake of radionuclides.
AB  - This paper reviews the published literature that describes the phenological
      development of above and below ground organs of temperate fruit trees (top
      fruit), particularly with respect to apple (Malus domestica). Critical
      information is presented which is considered appropriate in developing an
      understanding of the potential for top fruit species to take up radionuclide
      contaminants from the atmosphere and the soil. Information is cited on how
      climatic and edaphic factors influence the growth and development of temperate
      fruit trees, the phenological production of their leaf area and the development
      and growth of their fruit and hence the potential for foliar and fruit uptake of
      radionuclides from the atmosphere. The study also reports on the importance of
      the distribution and phenological development of roots in the soil and the
      potential for their uptake of radionuclides from the soil. The effects of above
      and below ground management procedures, within temperate fruit orchards, on
      potential radionuclide uptake are also considered. It is concluded that the
      potential for the uptake of radionuclides by temperate fruit tree species will
      depend on a number of phenological and physiological factors. For uptake from the
      soil these factors include; root distribution and density in the soil profile,
      seasonal changes in the production and distribution of roots, and the presence
      and amount of water in the soil. These factors are themselves influenced by
      rootstock type and its growth vigour, scion type and its growth vigour, tree age,
      spacing of trees in the orchard, orchard management practices (presence or
      absence of weeds or grass under the trees) and soil type and depth. Direct uptake
      by the shoot, however, will be influenced by the climatic conditions at the time
      of exposure and the presence of foliage. Deposition and uptake are likely to
      change with leaf area development and the ability of radionuclides to penetrate
      the cuticle of the leaf changes with seasonal development. Transport of
      radionuclides to the fruit may also depend on the time of season, as the
      importance of the xylem and phloem transport routes can change with the growth
      and development of the fruit.

PMID- 11202694
TI  - The role of fruit in the diet.
AB  - Data on the production and consumption of fruit are reviewed in the context of
      modelling the transfer of radionuclides to fruit, and the assessment of the
      consequent risks to the consumers. Mean consumption rates vary widely from
      country to country, from 150 g per day fresh weight to about 500 g per day.
      Consumption also varies with age, socio-economic class, and climate. In some
      countries there is a trend towards increased consumption of fruit, associated
      with a growing interest in a healthy diet, and these trends have been associated
      with changes in the incidence of cardio-vascular diseases and some forms of
      cancer. Assessment of the effects of radionuclides in fruit needs to take into
      account the use of wild growing fruits, the increasing trade in fruit between
      countries, and the contribution from natural radionuclides in fruit.

PMID- 11202695
TI  - Transfer of radioactivity to fruit: significant radionuclides and speciation.
AB  - One of the roles of the BIOMASS Theme 3 Fruit Working Group was to identify
      significant radionuclides to support its work programme. This paper provides a
      short review of radionuclide emissions to atmosphere together with comments on
      their relative dosimetric impacts to identify those radionuclides most relevant
      to the Fruit Working Group. Speciation of the identified radionuclides is also
      discussed to identify the most likely chemical forms to which fruits might be
      exposed. It is noted that no information currently exists on radionuclide
      speciation in regard to the uptake and retention of radionuclides in fruit crops.

PMID- 11202696
TI  - Deposition of gaseous radionuclides to fruit.
AB  - 14C, 35S and 3H are released to the environment during the operation of gas
      cooled reactors and were identified as radionuclides of interest by the BIOMASS
      Fruits Working Group. This paper provides a review of the deposition, uptake,
      allocation and loss of these radionuclides with respect to fruit and conceptual
      models for gaseous radionuclides. It is concluded that the mechanisms for the
      uptake of CO35S, HTO and 14CO2 are well understood and that their deposition
      velocities have been quantified. There is also a reasonable body of work on the
      translocation of 14C once in the crop, but much less for 35S and 3H, which are
      considered to follow source-sink relationships. The loss rates of the three
      radionuclides show large differences, with tritium lost rapidly in the form of
      HTO but retained longer when converted to OBT. The losses of 14C are less and
      those of sulphur are minimal post fixation. When fruit crops alone are
      considered, the quantity of information is further reduced but predictions on
      possible behaviour of these radionuclide species can be made from the current
      knowledge.

PMID- 11202697
TI  - Aerial contamination of fruit through wet deposition and particulate dry
      deposition.
AB  - The current state of knowledge concerning the processes and pathways which lead
      to the contamination of fruit crops by non-gaseous airborne contaminants is
      reviewed. Given the wide range of fruit canopies which occur, it is necessary to
      look for generic factors which affect the contribution of each of these processes
      and pathways to distribution through the canopy, losses from the canopy back to
      the atmosphere, and the fate of particle-bound substances once attached to the
      canopy. This latter stage represents perhaps the greatest source of uncertainty
      in determining levels of contamination. For wet deposition, the controlling
      factors appear to be the ability of the canopy surface to store precipitated
      water, and the interaction of the contaminant species with the leaf cuticle,
      which appears to act as an ion exchange medium, selectively accumulating certain
      ionic species. Where possible, models and parameterisations are provided for
      these stages. A summary is given of current data requirements for those cases
      where this is not possible.

PMID- 11202698
TI  - Post-deposition transport of radionuclides in fruit.
AB  - This paper considers two main pathways for contamination of fruit by
      radionuclides: (i) absorption after deposition directly to exposed fruit
      surfaces, and (ii) absorption after deposition to other exposed plant surfaces
      followed by translocation to fruit. The aim is to collect the available
      information on fruit from temperate regions, identify the factors affecting post
      deposition processes in fruit plant systems, identify gaps in knowledge and give
      recommendations for future work. The majority of information available on above
      ground absorption and further translocation to fruit concerns 134Cs and 85Sr in
      soluble form in apple, strawberry and grapevine. In general, 85Sr is absorbed and
      translocated to a lesser extent than is 134Cs. The rate of absorption and
      translocation depends on the physiological stage and age of the plant, and varies
      between different plant species and varieties.

PMID- 11202699
TI  - Radionuclide transfer from soil to fruit.
AB  - The available literature on the transfer of radionuclides from soil to fruit has
      been reviewed with the aim of identifying the main variables and processes
      affecting the behaviour of radionuclides in fruit plants. Where available, data
      for transfer of radionuclides from soil to other components of fruit plant have
      also been collected, to help in understanding the processes of translocation and
      storage in perennial plants. Soil-to-fruit transfer factors were derived from
      agricultural ecosystems, both from temperate and subtropical or tropical zones.
      Aggregated transfer factors have also been collected from natural or semi-natural
      ecosystems. The data concern numerous fruits and various radionuclides. Soil-to
      fruit transfer is nuclide specific. The variability for a given radionuclide is
      first of all ascribable to the different properties of soils. Fruit plant species
      are very heterogeneous, varying from woody trees and shrubs to herbaceous plants.
      In temperate areas the soil-to-fruit transfer is higher in woody trees for
      caesium and in shrubs for strontium. Significant differences between the values
      obtained in temperate and subtropical and tropical regions do not necessarily
      imply that they are ascribable to climate. Transfer factors for caesium are
      higher in subtropical and tropical fruits, while those for strontium, as well as
      for plutonium and americium, in the same fruits, are lower; these results can be
      interpreted taking into account different soil characteristics.

PMID- 11202700
TI  - The effect of storage and processing on radionuclide content of fruit.
AB  - After harvesting, the activity content of fruits may still be affected by the
      manner in which they are treated. Long storage times will reduce the activity
      contents of short-lived radionuclides; preparation and/or processing may cause
      activity to be physically removed. This paper presents the results of a review of
      the available literature on these effects. Data are scarce for both storage and
      processing, the majority of information on the latter being for 137Cs and 90Sr.
      For cautious general assessments, it should be assumed that there is no delay and
      that no activity is lost on processing, especially if the fruits can be eaten
      raw. However, individual cases may require specific data if available. The use of
      storage of processing as specific counter-measures to reduce activity
      concentrations in fruits may not be acceptable to the consumer, especially where
      alternative, non-contaminated, foodstuffs are readily available.

PMID- 11202701
TI  - Models for radionuclide transfer to fruits and data requirements.
AB  - This paper presents a review of available models for radionuclide transfer to
      fruit with particular emphasis on the model types and the purpose for which they
      were developed. It is clear that the model structures that have been developed
      range from the simple to the complex and that the underlying data on which they
      are based is incomplete. The work programme of the BIOMASS Theme 3 Fruits Working
      Group includes model inter-comparison and model validation studies that will give
      an indication of the performance of the different model types discussed here. The
      models included in these comparative studies include several new and as yet
      unpublished models. In the case of fruit, there is an urgent need for data on
      changing radionuclide distribution in plant organs with time to increase
      confidence in current models.

PMID- 11202702
TI  - Reproductive impairment of sea urchins upon chronic exposure to cadmium. Part I:
      Effects on gamete quality.
AB  - Successful reproduction is a determining factor for species survival. Pollution
      may impair reproductive success of adults through effects on gamete quality.
      Reproductive impairment of the sea urchin Anthocidaris crassispina upon chronic
      (4 weeks) exposure to 0.01 and 0.1 mg l-1 Cd2+ was investigated. Criteria used
      for assessing gamete quality included sperm motility, egg morphology,
      fertilization rate and dynamics of first cleavage. A dose-response relationship
      was found between Cd2+ levels and changes in sperm motility, and percentage
      fertilization. Sperm motility, measured by computer-assisted sperm analysis,
      indicated that percent motile sperm, velocities, and percent sperm with normal
      trajectory were significantly affected by chronic exposure to > or = 0.1 mg l-1
      Cd2+. A decline in sperm motility was also accompanied by a decrease in
      fertilization success of sea urchin sperm. Width/height ratio of sea urchin eggs
      was not affected by cadmium, but larger egg sizes were found when sea urchins
      were exposed to 0.1 mg l-1 Cd2+. Male sea urchins exposed to Cd2+ produced poorer
      quality sperm, as indicated by a lower percent fertilization and lower cleavage
      rate, implying that male sea urchins were more sensitive than females to chronic
      Cd2+ exposure. Results of the present study provide an explanation of
      reproductive impairment in marine invertebrates upon chronic exposure to Cd2+.

PMID- 11202703
TI  - Mercury in feathers of Squacco Heron (Ardeola ralloides) chicks in relation to
      age, hatching order, growth, and sampling dates.
AB  - We studied the relationships between mercury content of Squacco Heron (Ardeola
      ralloides) chick body-feathers and nestling age, hatching order (seniors-juniors)
      and growth parameters, and the date of feather sampling in the Axios Delta,
      northern Greece, in 1993 (n = 75 chicks) and 1994 (n = 80). Mercury levels were
      not significantly correlated with chick age in either year of the study. Most of
      the variability in mercury (90%) was found among broods, attributable to
      differential prey selection and/or foraging habitat and patch utilization by
      parents. Within broods, juniors had significantly higher mercury loads than
      seniors in 1993, but there was no significant difference between the two in 1994.
      Correlations of nestling weight and linear measurements corrected for chick age
      and mercury concentrations were never significant and explained small amounts of
      variability in chick growth. However, linear measurements corrected for age were
      significantly higher among seniors in 1993, when those nestlings had lower
      mercury loads than their siblings. Mercury levels were unaffected by the date of
      feather collection in 1993, but exhibited a significant increase over time in
      1994. This can be attributed to a shift towards more highly contaminated habitats
      and prey types by foraging parents, resulting from seasonal changes in water
      level and vegetation cover in important foraging habitats. Feather collection
      from Squacco Heron nestlings late in the breeding season seems to be an
      appropriate method for biomonitoring mercury pollution in the Axios Delta.

PMID- 11202704
TI  - Reproductive impairment of sea urchin upon chronic exposure to cadmium. Part II:
      Effects on sperm development.
AB  - Chronic pollution may impair the reproductive success of adult organisms through
      a decrease in the quality of gametes. Our parallel study on gamete quality,
      showed that male sea urchins were more sensitive than the females towards cadmium
      pollution. The effects of chronic exposure to 0.01 and 1 ppm Cd2+ on sperm
      development of the sea urchin Anthocidaris crassispina were studied. Despite the
      fact that no significant change in gonad index was observed when sea urchins were
      exposed to both levels of Cd2+ for 4 weeks, deposition of electron-dense
      materials was conspicuous at the wall and intracellular space of male gonads.
      Apparent cytological alterations were observed in sperm cells, including changes
      in morphology of nuage in spermatogonia. The discrete, granular bodies of nuage
      were replaced by a large electron-dense body. Spermatozoa with short, incomplete
      'broken' tails (scanning electron microscope observation) or tails of
      spermatids/spermatozoa with extraordinary electron-density (transmission electron
      microscope observation) were more abundant in gonads exposed to both levels of
      Cd2+. Mitochondrial cristae deformation was observed for sperm cells at all
      stages of development. Sperm plasma membrane also became more convoluted but
      acrosome remained intact. The observed cytological distortion of sperm tails and
      mitochondria/midpiece could help to explain the decline in motility as well as
      poor perseverance in sperm produced by sea urchins exposed to cadmium observed in
      our earlier study.

PMID- 11202705
TI  - Trace metals in seagrass, algae and molluscs from an uncontaminated area in the
      Mediterranean.
AB  - The concentrations of Cd, Cr, Cu, Pb and Zn were measured in specimens of four
      marine organisms--the seagrass Posidonia oceanica (L.) Delile, the brown algae
      Padina pavonica (L.) Thivy, and the two gastropod molluscs Monodonta turbinata
      Born and Patella caerulea L.--selected as possible cosmopolitan biomonitors of
      trace metals in the Mediterranean area. The organisms were collected at five
      coastal sites in Favignana Island (Sicily, Italy), an area virtually uninfluenced
      by anthropogenic activities. In order to gain a more complete picture of both the
      environmental conditions of the experimental area and the bioaccumulation
      patterns of the selected organisms, soluble and total metal concentrations were
      determined in coastal water samples collected at the same stations. The picture
      of bioavailable metal loads in the different sites of the selected area provided
      by the four species was rather univocal. An overall trend of increased metal
      concentrations at the station in which the local harbour is located was clear. On
      the other hand, the metal concentrations recorded at the 'clean' stations
      generally fall in the range of the lowest values available in the literature and
      may be considered as useful background levels to which to refer for intraspecific
      comparison within the Mediterranean area. Implications in biomonitoring of the
      observed accumulation patterns, especially in the different tissues of Posidonia
      oceanica, are discussed.

PMID- 11202706
TI  - Photosynthesis and biomass allocation of radish cv. "Cherry Belle" in response to
      root temperature and ozone.
AB  - To determine if ozone (O3) and root zone temperature (RZT) affect plant biomass
      allocation and photosynthesis, radish (Raphanus sativus) plants were grown in
      controlled environment laboratory chambers in one of four treatments: episodic O3
      (average delivery 0.063 mumol mol-1) with RZT at 13 degrees C, episodic O3 (same
      delivery) with RZT at 18 degrees C, charcoal-filtered air with RZT at 13 degrees
      C and charcoal-filtered air with RZT at 18 degrees C. O3 reduced total biomass
      and shoot biomass of radish at 13 degrees C RZT but had no effect at 18 degrees C
      RZT. Low (13 degrees C) RZT decreased total biomass in both O3 and charcoal
      filtered air. RZT had no overall effect on biomass allocation, but O3 lowered
      root-to-shoot ratios for plants grown at 18 degrees C RZT. Photosynthesis was
      reduced for plants grown at 18 degrees C RZT and O3, but stomatal conductance was
      not affected by O3 nor RZT. These results indicate that O3 and low RZT decrease
      biomass, but that plant photosynthesis is decreased by O3 and warm RZT.

PMID- 11202707
TI  - Lead shot toxicity to passerines.
AB  - This study evaluated the toxicity of a single size 7.5 lead shot to passerines.
      No mortalities or signs of plumbism were observed in dosed cowbirds (Molothrus
      ater) fed a commercial diet, but when given a more natural diet, three of 10
      dosed birds died within 1 day. For all survivors from which shot were recovered,
      all but one excreted the shot within 24 h of dosing, whereas, the dead birds
      retained their shot. Shot erosion was significantly greater (P < 0.05) when
      weathered shot were ingested compared to new shot, and the greatest erosion was
      observed in those birds that died (2.2-9.7%). Blood lead concentrations of birds
      dosed with new shot were not significantly different (P = 0.14) from those of
      birds exposed to weathered shot. Liver lead concentrations of birds that died
      ranged from 71 to 137 ppm, dry weight. Despite the short amount of time the shot
      was retained, songbirds may absorb sufficient lead to compromise their survival.

PMID- 11202708
TI  - Effects of environmental and maternally derived methylmercury on the embryonic
      and larval stages of walleye (Stizostedion vitreum).
AB  - The effects of environmental and maternally derived methylmercury (MeHg) on the
      embryonic and larval stages of walleye (Stizostedion vitreum) were investigated
      using eggs collected during two successive spawning seasons. Eggs were collected
      from fish in a mercury (Hg)-polluted environment (Clay Lake, Ontario, Canada),
      and from fish in two relatively pristine lakes (Lakes Manitoba and Winnipeg, in
      the province of Manitoba). Both bioaccumulation of Hg into muscle and its
      mobilization into eggs was significantly higher in Clay Lake females. Maternal
      muscle MeHg concentration was positively correlated with female length and egg
      MeHg was positively correlated with muscle MeHg concentration in all three
      populations. Hatching success of eggs from all three stocks declined
      significantly with increasing waterborne MeHg (0.1-7.8 ng l-1). Hatching success
      was not significantly affected by egg MeHg concentration. Embryonic heart rate
      declined with increasing waterborne MeHg concentration, but larval growth was not
      affected. Occurrence of larval deformities was negatively correlated with size of
      female, but was not significantly correlated with MeHg in either eggs or water.
      Larval MeHg was positively correlated with the concentrations of MeHg in eggs
      demonstrating transmission of MeHg from females. Uptake of ambient MeHg was
      higher in larvae exposed to higher waterborne MeHg concentrations.

PMID- 11202709
TI  - Sources, distribution and variability of airborne trace metals in La Plata City
      area, Argentina.
AB  - Airborne particulate trace metals have been measured bimonthly during day and
      night hours in four permanent stations located in residential, industrial and
      commercial sectors of La Plata City region, to characterize the sources and
      variability of atmospheric inputs. Airborne trace metal regional averages (Pb 64
      +/- 62, Cu 30 +/- 27, Mn 26 +/- 20, Zn 273 +/- 227, Fe 1183 +/- 838, Ca 5343 +/-
      3614, Mg 1472 +/- 967, Cr 4.3 +/- 2.4, Ni 3.2 +/- 3.5 and Cd 0.41 +/- 0.42 ng/m3)
      are comparable to the values reported for not grossly polluted cities and below
      the general trend described for urban particulates. Two- and three-way analysis
      of variance and variance components tests (P < 0.05) were performed to assess the
      contribution of the diurnal (day vs. night), spatial (inter-station) and temporal
      (inter-month) components of variability. Trace metal concentrations followed the
      behavior of total suspended particles with higher concentrations during the day
      and at the Downtown station and lower at the Residential site. In general,
      spatial and temporal variations prevailed over diurnal differences. Spatial
      differences were clearly most significant for Pb, which presented higher values
      at the Downtown site reflecting the importance of motor exhaust inputs. In
      contrast, diurnal differences were more important for Mn due to increased dust
      resuspension during day hours. A seasonal trend with concentrations usually
      increasing during winter months and decreasing in spring-summer was also
      detected. Enrichment factors (EF) were calculated to evaluate anthropogenic
      versus natural element sources. High EF (21-376) were obtained for Pb, Zn, Cd and
      Cu reflecting the importance of anthropic inputs. The comparison with EF
      calculated for high-emitting vehicle particle emissions indicated that motor
      exhausts are the most important source of these elements in La Plata region. In
      contrast, the EF calculated for Mn, Cr, Ni, Ca and Mg were low (1.3-7.5)
      suggesting chiefly natural sources, i.e. soil-derived dusts.

PMID- 11202710
TI  - The relationship between trace metal contamination and stream meiofauna.
AB  - The effect of chemical contaminants on freshwater meiofaunal communities is
      poorly understood and meiofauna rarely form part of environmental impact
      assessments in fresh waters. The community composition and diversity of meiofauna
      in streams of southwest England (Cornwall) representing a gradient in trace metal
      contamination were investigated. Multivariate and univariate statistical
      techniques were used to correlate community composition, diversity and
      environmental variables. Meiofaunal communities were very different at sites with
      high compared with low metal concentrations. Copper, either singly, or in
      combination with other environmental variables (aluminium, zinc or dissolved
      organic carbon), was the most important correlate with community composition. Not
      all meiofaunal species were adversely affected by metals, however, and some taxa,
      most notably certain cyclopoid copepods, were abundant at high metal
      concentrations. Moreover, sites with high metal concentrations were not
      significantly less diverse than sites of low metal concentrations. These data
      suggest that metal contamination significantly alters the composition of stream
      meiofaunal assemblages and highlight the importance of including meiofauna in
      impact studies of fresh waters.

PMID- 11202711
TI  - Fate and effect of monoalkyl quaternary ammonium surfactants in the aquatic
      environment.
AB  - The effect of the alkyl chain of quaternary ammonium-based surfactants on their
      aquatic toxicity and aerobic biodegradability has been studied. Two families of
      monoalkylquats surfactants were selected: alkyl trimethyl ammonium and alkyl
      benzyl dimethyl ammonium halides. Acute toxicity tests on Daphnia magna and
      Photobacterium phosphoreum were carried out and EC50 values in the range of 0.1-1
      mg/l were obtained for the two series of cationic surfactants. Although the
      substitution of a benzyl group for a methyl group increases the toxicity, an
      incremental difference in toxicity between homologs of different chain length
      were not observed. Biodegradability of the different homologs was determined not
      only in standard conditions but also in coastal water, both tests yielding
      similar results. An increase in the alkyl chain length or the substitution of a
      benzyl group for a methyl group reduces the biodegradation rate. The degradation
      of these compounds in coastal waters was associated with an increase in
      bacterioplankton density, suggesting that the degradation takes place because the
      compound is used as a growth substrate.

PMID- 11202712
TI  - Rapid reductive dechlorination of atrazine by zero-valent iron under acidic
      conditions.
AB  - The dechlorination of atrazine (2-chloro-4-ethylamino-6-isopropylamino-1,3,5
      triazine) via reaction with metallic iron under low-oxygen conditions was studied
      using reaction mixture pH values of 2.0, 3.0, and 3.8. The pH control was
      achieved through addition of sulfuric acid throughout the duration of the
      reaction. The lower the pH of the reaction mixture, the faster the degradation of
      atrazine. The surface area of the sulfuric acid-treated iron particles was 0.31
      (+/- 0.01) m2 g-1 and the surface area normalized initial pseudo-first order rate
      constants (kSA, where rate = kSA x (surface area/l) x [Atrazine]) at pH values of
      2.0, 3.0, and 3.8 were equal to, respectively, 3.0 (+/- 0.4) x 10(-3) min-1 m-2
      l, 5 (+/- 3) x 10(-4) min-1 m-2 l, and 1 (+/- 1) x 10(-4) min-1 m-2 l. The
      observed products of the degradation reaction were dechlorinated atrazine (2
      ethylamino-4-isopropylamino-1,3,5-triazine) and possibly hydroxyatrazine (2
      ethylamino-4-isopropylamino-6-hydroxy-s-triazine). Triazine ring protonation may
      account, at least in part, for the observed effect of pH on atrazine
      dechlorination via metallic iron.

PMID- 11202713
TI  - Tris (4-chlorophenyl) methane and tris (4-chlorophenyl) methanol in marine
      mammals from the Estuary and Gulf of St. Lawrence.
AB  - Levels of tris (4-chlorophenyl) methanol (TCPM) and its presumed precursor tris
      (4-chlorophenyl) methane (TCPMe) are reported in marine mammals from the Estuary
      and Gulf of St. Lawrence, Canada. These compounds were measured in blubber
      samples of seals and whales using ion trap mass spectrometry (MS/MS) detection.
      Detectable concentrations of both TCPM and TCPMe were observed in all of the
      samples analysed. Concentrations of these compounds varied with species ranging
      from 1.7 to 153 and from 1.3 to 50.6 ng/g lipid wt. for TCPM and TCPMe,
      respectively. TCPM was from 1.3 to 10 times more concentrated than TCPMe. The
      highest levels of both TCPM and TCPMe were observed in adult male beluga whales
      (Delphinapterus leucas) from the St. Lawrence Estuary, while adult female beluga
      whales from the same area showed levels similar to those in the seals examined.
      Among the four seal species investigated, TCPM and TCPMe levels were the highest
      in grey (Halichoerus grypus) and hooded (Cystophora cristata) seals, and lowest
      in harp seals (Phoca groenlandica). Intermediate levels were found in harbour
      seals (Phoca vitulina); however, their concentrations might be underestimated
      considering the younger mean age of these animals. Ratios of both 4,4'-DDE/sigma
      DDT and TCPM/sigma TCP were very similar between animals from the same species.
      Strong correlations between sigma TCP and sigma DDT were also observed for each
      species of mammals, most likely indicating that both sigma TCP and sigma DDT are
      bioaccumulated in marine mammals. The relationships between sigma DDT and sigma
      TCP also demonstrate that sigma TCP are less bioaccumulated than sigma DDT by the
      marine mammal species examined.

PMID- 11202714
TI  - Comparison among air pollutants, meteorological conditions and some chemical
      parameters in the transplanted lichen Usnea amblyoclada.
AB  - The response of Usnea amblyoclada (Mull. Arg.) Zahlbr. to real concentrations of
      atmospheric pollutants measured by two automatic monitoring stations, was studied
      in Cordoba City, Argentina. The influence of different weather conditions on the
      biomonitor's response was also assessed. The concentration of chlorophyll a,
      chlorophyll b, hydroperoxy-conjugated dienes, and malondialdehyde were quantified
      in lichen thalli collected from a clean area and in transplanted thalli after 1
      month of exposure in an urban area, from April to October, 1996. The dry
      weight/fresh weight, chlorophyll b/chlorophyll a and phaeophytin a/chlorophyll a
      ratios were also calculated. Data sets were evaluated by two-way analysis of
      variance and correlation analysis. It was observed that hydroperoxy-conjugated
      dienes, malondialdehyde, chlorophylls, and pigment degradation increase during
      winter-time, when higher levels of suspended particles, non-methane hydrocarbons,
      hydrogen sulfide and ozone were also measured. These findings would be connected
      mainly with meteorological conditions, as most pollutants did not exceed
      prescribed threshold levels.

PMID- 11202715
TI  - Leaching of chromated copper arsenate wood preservatives: a review.
AB  - Recent studies have generated conflicting data regarding the bioaccumulation and
      toxicity of leachates from preservative-treated wood. Due to the scale of the
      wood preserving industry, timber treated with the most common preservative,
      chromated copper arsenate (CCA), may form a significant source of metals in the
      aquatic environment. The existing literature on leaching of CCA is reviewed, and
      the numerous factors affecting leaching rates, including pH, salinity, treatment
      and leaching test protocols are discussed. It is concluded from the literature
      that insufficient data exists regarding these effects to allow accurate
      quantification of leaching rates, and also highlights the need for standardised
      leaching protocols.

PMID- 11202716
TI  - Arsenic and mercury concentrations in major landscape components of an
      intensively cultivated watershed.
AB  - To provide an understanding of arsenic (As) and mercury (Hg) concentrations in
      soil, sediment, water, and fish tissues, samples were collected from a
      Mississippi River alluvial floodplain located in northwest Mississippi. As
      concentrations increased approximately an order of magnitude from water (5.12
      micrograms/l) to fish tissues (36.99 micrograms/kg) and an additional two orders
      of magnitude in soils, lake sediments, and wetland sediments (5728, 5614, and
      6746 micrograms/kg), respectively. Average Hg concentrations in water, soils,
      lake sediments, and fish were 2.16 micrograms/l, 55.1, 14.5 and 125
      micrograms/kg, respectively. As and Hg concentrations were within published
      ranges for uncontaminated soil, water, and sediments. As concentrations
      represented a low risk. Hg concentrations were also low but showed a greater
      tendency to concentrate in fish tissue. The dominant mode of entry of these
      materials into aquatic systems is through storm-generated runoff. Since both
      metals accompany sediments, agricultural conservation practices such as reduced
      tillage, buffer riparian strips, and bordering sediment ponds or drainage
      wetlands will minimize watershed input to aquatic systems.

PMID- 11202717
TI  - Catalytic effect of soil colloids on the reaction between CrVI and p
      methoxyphenol.
AB  - Adsorption of CrVI and p-methoxyphenol (PMP) on soil colloids at different pH
      media was studied. The resulting k1 and n of 1.89 x 10(2) and 0.53 (r2 = 0.99)
      and k2 and b of 0.13 and 1.25 x 10(3) (r2 = 0.96) were obtained from Freundlich
      (Q = k1Caqn) and Langmuir [Q = k2bCaq/(1 + k2Caq)] simulation equations,
      respectively, for CrVI adsorption on soil colloids (pH 4.20). The adsorption of
      PMP on soil colloids in pH 5.72 media was simulated by five different equations
      and the results indicated that the Fritz-Schluender one (r2 = 1.00) was the most
      suitable among them. Adsorption quantity of CrVI and PMP on colloids increased
      with increasing acidity in the pH range of 3.5-9.0. Study of CrVI adsorption
      kinetics indicated that the adsorption equilibrium of CrVI was reached rapidly
      within 2 h. In pure aqueous solution, CrVI reduction by PMP was observed only
      when the media's pH was lower than 4.0. Oxidation and reduction reaction between
      CrVI and p-methoxyphenol obviously occurred when soil colloids were involved in
      this system, even at pH > or = 7.0, which strongly suggested that minerals in
      soil colloids acted as catalysts to speed the reaction of CrVI and PMP. The
      oxidized product of PMP by CrVI, extracted by chloroform in acid media and
      analyzed by gas chromatography-mass spectrometry, was identified as benzoquinone.
      The reaction included two steps of one electron process.

PMID- 11202718
TI  - Toxicity of methyl-tert-butyl ether to freshwater organisms.
AB  - Increased input of the fuel oxygenate methyl-tert-butyl ether (MTBE) into aquatic
      systems has led to concerns about its effect(s) on aquatic life. As part of a
      study conducted by University of California scientists for the State of
      California, the Aquatic Toxicology Laboratory, UC Davis, reviewed existing
      literature on toxicity of MTBE to freshwater organisms, and new information was
      generated on chronic, developmental toxicity in fish, and potential toxicity of
      MTBE to California resident species. Depending on time of exposure and endpoint
      measured, MTBE is toxic to various aquatic organisms at concentrations of 57->
      1000 mg/l (invertebrates), and 388-2600 mg/l (vertebrates). Developmental effects
      in medaka (Oryzias latipes) were not observed at concentrations up to 480 mg/l,
      and all fish hatched and performed feeding and swimming in a normal manner.
      Bacterial assays proved most sensitive with toxicity to Salmonella typhimurium
      measured at 7.4 mg/l within 48 h. In microalgae, decreased growth was observed at
      2400 and 4800 mg/l within 5 days. MTBE does not appear to bioaccumulate in fish
      and is rapidly excreted or metabolized. Collectively, the available data suggests
      that at environmental MTBE exposure levels found in surface waters (< 0.1 mg/l)
      this compound is likely not acutely toxic to aquatic life. However, more
      information is needed on chronic and sublethal effects before we can eliminate
      the possibility of risk to aquatic communities at currently detected
      concentrations.

PMID- 11202719
TI  - Manganese toxicity as indicated by visible foliar symptoms of Japanese white
      birch (Betula platyphylla var. japonica).
AB  - For the purpose of a field diagnosis of Mn toxicity, we showed the possibility of
      using visible foliar symptoms of Japanese white birch (Betula platyphylla var.
      japonica Hara) as indicator. To examine the relationship between the expression
      of visible symptoms and leaf Mn concentrations, white birch seedlings were grown
      under four different Mn levels: 1 mg Mn l-1 as control, 10, 50 and 100 mg Mn l-1.
      Foliar symptoms of Mn toxicity for white birch were: (1) chlorosis at entire
      young leaves in the 50 and 100 mg Mn l-1 treatments; and (2) brown speckles at
      the leaf marginal and interveinal area for old leaves in the treatments greater
      than 1 mg Mn l-1. Mn preferably accumulated into the leaf marginal and
      interveinal area, where the brown speckles were observed. The mechanism
      determining the expression of symptoms seems to be associated with the
      physiological state related to leaf age as well as Mn distribution and
      concentration within a leaf.

PMID- 11202720
TI  - Biomonitoring of sporadic acidification of rivers on the basis of release of
      preloaded cadmium from the aquatic bryophyte Fontinalis antipyretica Hedw.
AB  - A technique is proposed for biomonitoring of sporadic acidification events in
      rivers. Individuals of the bioindicator species are pre-incubated with a chemical
      marker, then transplanted to the test location for the period of interest, then
      analysed for marker content; acidification events are inferred on the basis of
      the degree of reduction in marker concentration. To assess the validity of the
      proposed technique, we performed laboratory trials with the aquatic bryophyte
      Fontinalis antipyretica Hedw. as bioindicator species, and cadmium (Cd) as
      marker. The bryophytes were pre-incubated with a Cd solution, obtaining
      saturation concentrations in the extracellular compartment and near-saturation
      concentrations in the intracellular compartment. In a first series of
      experiments, Cd-preloaded bryophyte apices were maintained for 1-30 h in water of
      different pH; the results clearly indicated that the amount of Cd released is
      dependent on pH. In a second series of experiments, Cd-preloaded bryophyte apices
      were maintained for 1-24 h in water with various combinations of pH and aluminium
      (Al) concentration (Al being a highly toxic element that is typically mobilized
      in acid waters). In these experiments, pH again had a marked effect on the amount
      of Cd released, while Al concentration had no consistent effects. To facilitate
      data analysis, Davidson-type equations were fitted to the results of the second
      series of experiments, allowing prediction of medium acidity on the basis of Cd
      concentration remaining in the extracellular and intracellular compartments.

PMID- 11202721
TI  - Chemical fingerprinting applied to the evaluation of marine oil pollution in the
      coasts of Canary Islands (Spain).
AB  - Chemical fingerprinting approach to environmental assessment is illustrated in
      the evaluation of marine oil pollution in the coasts using two limpet species as
      bioindicator organisms, and based on profiles and concentrations of n-alkanes and
      aromatic hydrocarbons in their tissues. Accidental and chronic releases of
      hydrocarbons can contaminate the marine environment of the Canary Islands not
      only because of their geographical situation but also because of the very dense
      tanker traffic around. This situation affects coastal areas, fishing activities,
      tourism resort, etc. Concentrations of n-alkanes and aromatic hydrocarbons
      (polycyclic aromatic hydrocarbons and methyl-polycyclic aromatic hydrocarbons) in
      the soft tissues of the marine intertidal and subtidal limpets, Patella crenata
      and Patella ullysiponensis aspera, were evaluated. Limpet samples were collected
      at monthly intervals, at three locations on the southeast coast of Tenerife over
      a 3-year period (1991-93). Levels of hydrocarbons found in limpets are similar to
      concentrations found in unpolluted areas around the world. From application of
      principal component analysis, the interpretation of variable loading plots gives
      information on variable correlation and can be used to distinguish among
      potential sources of pollution and the ability of studied molluscs to be used as
      bioindicator organisms.

PMID- 11202722
TI  - Quantification of bioavailable nickel in sediments and toxic thresholds to
      Hyalella azteca.
AB  - Bioaccumulation and chronic toxicity of nickel (Ni) to Hyalella azteca in Ni
      spiked sediments was strongly affected by the source of sediment used. The total
      range in LC50s on a sediment concentration basis ranged over 20 fold. Differences
      in Ni toxicity generally matched differences in Ni bioaccumulation, and toxicity
      expressed on a body concentration basis varied less than three fold. Body
      concentrations, therefore, provide a much more reliable prediction of Ni toxicity
      in sediments than do concentrations in the sediment. Ni in overlying water was
      also a reliable predictor of Ni toxicity, but only in tests conducted in Imhoff
      settling cones with large (67:1) water to sediment ratios. Overlying water LC50s
      for tests in beakers varied 18 fold. Sediment and body concentrations of Ni
      tolerated by Hyalella were slightly higher in cones than in beakers. Reproduction
      was not affected significantly by Ni at concentrations below the LC50 and 10-week
      EC50s for survival and biomass production (including survival, growth and
      reproduction) were only marginally lower than 4-week EC50s (survival and growth
      only).

PMID- 11202723
TI  - Stem injection of Populus nigra with EDU to study ozone effects under field
      conditions.
AB  - EDU or ethylenediurea (N-[2-(2-oxo-1-imidazolidinyl)ethyl]-N'-phenylurea) has
      been used in experiments to assess ozone effects on vegetation under field
      conditions because it provides protection against oxidative damage. Tests have
      mainly been conducted on crop plants, but for woody species only few reports have
      provided evidence that it can be used in long-term experiments. In this study we
      tested the technique of stem injection of EDU to study the effects of ozone
      exposure on Populus nigra cv. Wolterson over one growing season. Cuttings of
      Populus nigra were grown in pots in the field and between mid-July and early
      September plants were repeatedly injected with EDU solution (5 mg/plant) or with
      water at 14-day intervals. Significant differences were found between EDU- and
      water-injected plants: water-treated plants had more foliar injury, more
      chlorotic leaves, and shedding of leaves started earlier, suggesting EDU was
      effective in preventing visible ozone injury and acceleration of senescence.
      Photosynthetic rates, measured for one leaf age, showed no differences but were
      mostly higher for the EDU-treated plants. At the end of the growing season
      diameter increment was 16% higher and there was a non-significant trend for above
      ground biomass to be increased by 9% for the EDU-treated plants. This experiment
      has provided evidence that for this clone serious ozone damage occurs at
      relatively low concentrations and that EDU can provide protection against visible
      injury, as well as against longer term growth reductions.

PMID- 11202724
TI  - Dissipation of racemic mecoprop and dichlorprop and their pure R-enantiomers in
      three calcareous soils with and without peat addition.
AB  - Two racemic herbicides, mecoprop (R,S-MCPP) and dichlorprop (R,S-DCPP), as well
      as their enantiopure R-forms, were incubated in three calcareous soils at 15
      degrees C and 80% of their field capacity to try to elucidate their behaviour in
      soil and compare the dissipation rates when racemic and enantiopure compounds are
      used. Quantitation of pesticides is made by HPLC and the R/S ratio by GC-MS. The
      inactive S-enantiomer from the racemic forms persists longer than the R-forms in
      silt and sandy loam soils, but for shorter time in the clay loam soil. The pure R
      enantiomers, both for MCPP and DCPP, after incubation in soil, are partially
      converted into their S-forms. In all cases, the dissipation of racemic and pure
      enatiomeric forms is lower in the clay loam soil than in the silt and sandy loam
      soils. The R-forms' peristence, in the three soils, is approximately two times
      lower when they are incubated alone than when they are incubated as racemic
      compounds. When peat is added, the persistence of these herbicides in the silt
      and sandy loam soils increases, while in the clay loam soil it decreases.
      Besides, in the clay loam soil, the enantiomeric ratio (ER) changes from its S
      preferential degradation to a preferential degradation of its R-form, so an
      increase in the persistence of the inactive S-form occurs.

PMID- 11202725
TI  - Factors controlling the bioaccumulation of mercury and methylmercury by the
      estuarine amphipod Leptocheirus plumulosus.
AB  - The bioaccumulation of inorganic mercury (HgI) and monomethylmercury (MMHg) by
      benthic organisms and subsequent trophic transfer couples the benthic and pelagic
      realms of aquatic systems and provides a mechanism for transfer of sedimentary
      contaminants to aquatic food chains. Experiments were performed to investigate
      the bioavailability and bioaccumulation of particle-associated HgI and MMHg by
      the estuarine amphipod Leptocheirus plumulosus to further understand the controls
      on bioaccumulation by benthic organisms. HgI and MMHg are particle reactive and
      have a strong affinity for organic matter, a potential food source for amphipods.
      Microcosm laboratory experiments were performed to determine the effects of
      organic matter on Hg bioaccumulation and to determine the major route of Hg
      uptake (i.e. sediment ingestion, uptake from water/porewater, or uptake from
      'food'). Amphipods living in organic-rich sediment spiked with Hg accumulated
      less Hg than those living in sediments with a lower organic matter content.
      Feeding had a significant impact on the amount of HgI and MMHg accumulated.
      Similarly, amphipods living in water with little organic matter accumulated more
      Hg than those living in water with a greater percentage of organic matter. MMHg
      was more readily available for uptake than HgI. Experimental results, coupled
      with results from a bioaccumulation model, suggest that accumulation of HgI and
      MMHg from sediment cannot be accurately predicted based solely on the total Hg,
      or even the MMHg, concentration of the sediment, and sediment-based
      bioaccumulation factors. All routes of exposure need to be considered in
      determining the accumulation of HgI and MMHg from sediment to benthic
      invertebrates.

PMID- 11202727
TI  - Induction of mouthpart deformities in Chironomus riparius larvae exposed to 4-n
      nonylphenol.
AB  - Chironomid mouthpart deformities have often been associated with sediment
      contamination and are, therefore, currently used to assess sediment quality.
      Deformities were only occasionally induced in laboratory bioassays. Mouthpart
      deformities results from a physiological disturbance during larval molting. In
      the past few years it has been shown that some chemicals can exert negative
      effects on both vertebrates and invertebrates at the level of endocrine
      regulation. As insect molting is hormonally regulated, we wanted to test the
      hypothesis that deformities are induced due to a hormonal disruption in the
      developmental process. The aim of the present study was to test whether the
      endocrine disrupter, 4-n-nonylphenol (4NP), induces mouthpart deformities in
      chironomids. A laboratory bioassay was performed exposing Chironomus riparius
      larvae to 10, 50 and 100 micrograms l-1 4NP. Survival of the larvae was not
      affected by the tested concentrations, but the frequency of mentum deformities
      increased significantly (P < 0.01) after exposure to 4NP.

PMID- 11202726
TI  - Effects of major nutrient additions on metal uptake in phytoplankton.
AB  - We examined the influences of major nutrients (N, P, Si) on the accumulation of
      three trace metals [Cd, Se(IV), and Zn] in four species of marine phytoplankton
      (diatom, green alga, dinoflagellate, prasinophyte). Relative metal uptake was
      quantified by the kinetic measurements of metal concentration factor over a short
      exposure period. Our study demonstrated that nutrient addition significantly
      influenced the metal uptake rate and the cell growth rate in all four
      phytoplankton species. An increase in ambient N concentration considerably
      enhanced metal uptake by the cells. The dry weight concentration factor increased
      by 2.4-14.9 times for Cd, 1.1-4.0 times for Se, and 1.1-5.4 times for Zn in all
      four phytoplankton species with an addition of 176.4 microM N. The effects of P
      or Si addition on metal uptake and cell growth were less pronounced than the
      effects of N addition. Under most circumstances the rate of metal uptake
      increased exponentially with increasing cell growth rate constant. Only Se(IV)
      uptake in the diatom Phaeodactylum tricornutum was not correlated with cell
      growth rate. Se(IV) was not accumulated by the green algae Chlorella autotrophica
      at a high P concentration (7.2 microM), but appreciable accumulation was
      documented in cells inoculated without P addition. Our study therefore
      demonstrated that nutrient enrichments in many coastal waters can considerably
      affect trace metal uptake in phytoplankton and presumably metal trophic transfer
      in marine food chains.

PMID- 11202729
TI  - Investigations of ash topography/morphology and their relationship with heavy
      metals leachability.
AB  - The leachability of heavy metals such as chromium (Cr), lead (Pb) and cadmium
      (Cd) from the ash material obtained from waste combustion was studied. The
      effects of ash surface topography and morphology on the leachability of these
      elements were examined using atomic force microscopy (AFM) and scanning electron
      microscopy (SEM). The AFM (scan size 10 x 10 microns) and SEM images of the
      simulated ash pellet obtained at various operating temperatures (1000, 1400 and
      1500 degrees C) showed significant microstructural and topographical changes. Ash
      pellets treated at 1000 degrees C contain porous and non-continuous surface. On
      the other hand, the ash pellet obtained at higher temperature (1500 degrees C)
      was found to contain a smooth, continuous and non-porous surface. The AFM height
      profile studies indicated that the top surface variation of the ash pellet at
      1000, 1400 and 1500 degrees C were found to be -40.0 to 25.5, -3.7 to 4.7 and 
      0.10 to 0.66 nm respectively. The SEM analyses also confirmed the presence of
      smooth, non-porous outer surface of ash formed at 1500 degrees C. In addition, it
      also showed the presence of compact and rigid interior for the same ash pellet.
      The leachability of the heavy metals was determined using standard toxicity
      characteristic leaching procedure (TCLP) test and the samples were analysed using
      atomic absorption spectroscopy. The results showed that the TCLP leaching ratios
      of the heavy metals were Cr = 0.30, Pb = 0.05 and Cd = 0.09 at 1000 degrees C.
      However, the ash obtained at 1400 degrees C showed negligible heavy metals
      leaching ratio while at 1500 degrees C no leachability was detected (TCLP
      concentration dropped to nondetectable levels). The use of high temperature
      treatment enabled the immobilization of heavy metals in the ash preventing their
      leaching. Such ash can be considered as a non-hazardous material for reuse or
      safe disposal.

PMID- 11202728
TI  - Cadmium accumulation in the freshwater isopod Asellus racovitzai: the relative
      importance of solute and particulate sources at trace concentrations.
AB  - A stable isotope tracer technique was used to evaluate the relative importance of
      particulates and water as respective sources of cadmium (Cd) uptake in the
      freshwater isopod Asellus racovitzai (Isopoda, Crustacea). 113Cd(NO3)2 was
      applied to the sediment at a nominal concentration of 20.0 ng g-1, and
      114Cd(NO3)2 was added to the overlying water (nominal concentration of 4.4 ng g
      1), in the same test systems. Asellids added were either free-ranging on the
      sediment surface, where they were exposed to both particulate and water sources
      of Cd, or were enclosed in dialysis 'tubes', 10 cm above the sediment surface,
      and were therefore exposed to Cd in water only. By analysis of both isotopes,
      uptake vectors could be determined simultaneously. After 7 days of exposure,
      average 114Cd concentrations in 'free' asellids were 15.6 +/- 2.0 micrograms/g,
      compared with 10.4 +/- 1.8 micrograms/g in 'tube'-held asellids (P < 0.05), i.e.
      at least 60% of accumulated 114Cd was from water. Furthermore, water-spiked 114Cd
      was accumulated in asellids to tissue concentrations that were more than four
      times greater than sediment-spiked 113Cd. When the sediment organic content was
      increased (20% peat moss), total Cd concentrations in both overlying water and
      asellids were significantly lower (P < 0.01), compared with the mineral sediment
      treatments, and Cd accumulation in tube and free asellids was similar. This study
      shows that water is an important vector of Cd accumulation in A. racovitzai, and
      factors that lower Cd concentrations in solution (such as increased organic
      content of sediment), decrease Cd bioaccumulation.

PMID- 11202730
TI  - Nutrient dynamics and the eutrophication of shallow lakes Kasumigaura (Japan),
      Donghu (PR China), and Okeechobee (USA).
AB  - We compared the nutrient dynamics of three lakes that have been heavily
      influenced by point and non-point source pollution and other human activities.
      The lakes, located in Japan (Lake Kasumigaura), People's Republic of China (Lake
      Donghu), and the USA (Lake Okeechobee), all are relatively large (> 30 km2), very
      shallow (< 4 m mean depth), and eutrophic. In all three lakes we found strong
      interactions among the sediments, water column, and human activities. Important
      processes affecting nutrient dynamics included nitrogen fixation, light
      limitation due to resuspended sediments, and intense grazing on algae by cultured
      fish. As a result of these complex interactions, simple empirical models
      developed to predict in-lake responses of total phosphorus and algal biomass to
      external nutrient loads must be used with caution. While published models may
      provide 'good' results, in terms of model output matching actual data, this may
      not be due to accurate representation of lake processes in the models. The
      variable nutrient dynamics that we observed among the three study lakes appears
      to be typical for shallow lake systems. This indicates that a greater reliance on
      lake-specific research may be required for effective management, and a lesser
      role of inter-lake generalization than is possible for deeper, dimictic lake
      systems. Furthermore, accurate predictions of management impacts in shallow
      eutrophic lakes may require the use of relatively complex deterministic modeling
      tools.

PMID- 11202731
TI  - Comparison of two biological treatment processes using attached-growth biomass
      for sanitary landfill leachate treatment.
AB  - The objective of this investigation was to compare two biological systems using
      attached-growth biomass, for treatment of leachates generated in a typical
      municipal solid waste sanitary landfill. A moving-bed biofilm process, which is a
      relatively new type of biological treatment system, has been examined. It is
      based on the use of small, free-floating polymeric (polyurethane) elements, while
      biomass is being grown and attached as biofilm on the surface of these porous
      carriers. A granular activated carbon (GAC) moving-bed biofilm process was also
      tested. This method combines both physico-chemical and biological removal
      mechanisms for the removal of pollutants. The presence of GAC offers a suitable
      porous media, which is able to adsorb both organic matter and ammonia, as well as
      to provide an appropriate surface onto which biomass can be attached and grown. A
      laboratory-scale sequencing batch reactor (SBR) was used for the examination of
      both carriers. The effects of different operation strategies on the efficiency of
      these biological treatment processes were studied in order to optimize their
      performance, especially for the removal of nitrogen compounds and of
      biodegradable organic matter. It has been found that these processes were able to
      remove nitrogen content almost completely and simultaneously, the removal of
      organic matter (expressed as BOD5 and COD), color and turbidity were sufficiently
      achieved.

PMID- 11202732
TI  - Chronic toxicity of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) in
      soil determined using the earthworm (Eisenia andrei) reproduction test.
AB  - The sublethal and chronic effects of the environmental contaminant and explosive
      octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) in artificial soil were
      assessed using the earthworm (Eisenia andrei). Based on various reproduction
      parameters (total and hatched number of cocoons, number of juveniles and their
      biomass), fecundity was reduced at the different concentrations of HMX tested
      (from 280.0 +/- 12.3 to 2502.9 +/- 230.0 mg kg-1 dry soil) in spiked artificial
      soil (LOEC: 280.0 +/- 12.3 mg kg-1 dry soil). The growth of adult E. andrei was
      also reduced at the different concentrations tested, though no mortality
      occurred, even at the highest tested concentrations. The number of juveniles
      produced was correlated with the number of total and hatched cocoons, and the
      biomass of juveniles was correlated with the number of cocoons. Pooled results of
      these and earlier studies on explosives (TNT, RDX) using the E. andrei
      reproduction test confirm that effects of HMX on cocoon production are indicative
      of some reproductive consequences (number of juvenile and their biomass), whereas
      adult growth, in general, does not correlate strongly with change in reproduction
      capacity.

PMID- 11202733
TI  - Evaluation of copper availability to plants in copper-contaminated vineyard
      soils.
AB  - The repeated use of copper (Cu) fungicides to control vine downy mildew has led
      to long-term accumulation of Cu in vineyard soils which now raises the issue of
      the potential bioavailability of Cu for various living organisms including plant
      species. The bioavailable Cu can be defined as the portion of soil Cu that can be
      taken up by roots, for a given plant species. In order to evaluate the
      bioavailability of Cu to plants, a pot experiment was conducted in glasshouse
      conditions with a crop species (maize) and 12 soils sampled in the upper horizon
      of 10 vineyard plots (total Cu ranging from 38 to 251 mg kg-1) and two woodland
      plots (control soils that had not received any Cu application; total Cu amounting
      to 20-26 mg kg-1). These soils were selected for their diverse physical (large
      range of particle size distribution) and chemical (from acid to calcareous soils)
      properties. After 35 days of growth, plant shoots were harvested for analysis.
      The roots were separated from soil particles for further analysis. The
      concentrations of Cu in the roots and aerial parts of the maize were then
      compared with the amounts of Cu extracted from the soil by a range of
      conventional extractants. Observed Cu concentrations in maize roots which have
      grown in contaminated vineyard soils were very high (between 90 and 600 mg kg-1),
      whereas Cu concentrations in the aerial parts varied only slightly and remained
      low (< 18 mg kg-1). Root Cu concentrations observed for maize increased with
      increasing total Cu content in the soil and with decreasing soil CEC. Cu
      accumulation in maize roots may be as high in calcareous soils as in acid soils,
      suggesting that soil pH had little influence. In the case of the vineyard soils
      studied, the lack of correlation found for maize between Cu concentrations in
      roots and in the aerial parts, suggests that an analysis of the aerial parts
      would not be a good indicator of plant Cu uptake, as it provides no insight into
      the real amount of Cu transferred from the soil to the plant. For maize, our
      results show that extraction with organic complexing agents (EDTA, DTPA) and
      extraction with ammonium acetate seem to provide a reasonably good estimate of
      root Cu concentration.

PMID- 11202734
TI  - Sorption of naphthalene and phenanthrene by soil humic acids.
AB  - Humic acids are a major fraction of soil organic matter (SOM), and sorption of
      hydrophobic organic chemicals by humic acids influences their behavior and fate
      in soil. A clear understanding of the sorption of organic chemicals by humic
      acids will help to determine their sorptive mechanisms in SOM and soil. In this
      paper, we determined the sorption of two hydrophobic organic compounds,
      naphthalene and phenanthrene by six pedogenetically related humic acids. These
      humic acids were extracted from different depths of a single soil profile and
      characterized by solid-state CP/MAS 13C nuclear magnetic resonance (NMR).
      Aromaticity of the humic acids increased with soil depth. Similarly, atomic
      ratios of C/H and C/O also increased with depth (from organic to mineral
      horizons). All isotherms were nonlinear. Freundlich exponents (N) ranged from
      0.87 to 0.95 for naphthalene and from 0.86 to 0.92 for phenanthrene. The N values
      of phenanthrene were consistently lower than naphthalene for a given humic acid.
      For both compounds, N values decreased with increasing aromaticity of the humic
      acids, such an inverse relationship was never reported before. These results
      support the dual-mode sorption model where partitioning occurs in both expanded
      (flexible) and condensed (rigid) domains while nonlinear sorption only in
      condensed domains of SOM. Sorption in the condensed domains may be a cause for
      slow desorption, and reduced availability and toxicity with aging.

PMID- 11202735
TI  - Measurement of symbiotic nitrogen-fixation in leguminous host-plants grown in
      heavy metal-contaminated soils amended with sewage sludge.
AB  - Rates of nitrogen fixation by Rhizobium in symbiosis with leguminous host-plants
      including white clover, broad bean and peas have been established in soils that
      have been amended experimentally with heavy metal-contaminated sewage sludges.
      Results from 15N-dilution experiments for the measurement of N2 fixation have
      shown that adverse heavy metal effects are apparent on symbiotic N2 fixation
      rates for white clover grown in inter-specific competition with ryegrass under
      mixed sward conditions, compared to white clover grown in pure sward. Further
      experiments on broad bean and pea indicated a significant, but minor-inhibitory
      metal-related effect on the rate of N2 fixation compared to untreated soils and
      soils amended with a relatively uncontaminated sludge. The implications of the
      results with respect to sludge utilisation in agriculture are discussed.

PMID- 11202736
TI  - Ozone exposure thresholds and foliar injury on forest plants in Switzerland.
AB  - Canton Ticino in southern Switzerland is exposed to some of the highest
      concentrations of tropospheric ozone in Europe. During recent field surveys in
      Canton Ticino, foliar symptoms identical to those caused by ozone have been
      documented on native tree and shrub species. In Europe, the critical ozone level
      for forest trees has been defined at an AOT40 of 10 ppm.h O3 (10 ppm.h
      accumulated exposure of ozone over a threshold of 40 ppb) during daylight hours
      over a six-month growing season. The objective of this study was to determine the
      amount of ambient ozone required to induce visible foliar symptoms on various
      forest plant species in southern Switzerland. Species were grown within eight
      open-top chambers and four open plots at the Vivaio Lattecaldo Cantonal Forest
      Nursery in Ticino, Switzerland. Species differed significantly in terms of the
      ppb.h exposures needed to cause visible symptoms. The most to least symptomatic
      species grown within open-plots in this study rank as Prunus serotina, Salix
      viminalis, Vibrnum lantana, Rhamnus cathartica, Betula pendula, Rumex
      obtusifolius, Sambucus racemosa, Morus nigra, Prunus avium, Fraxinus excelsior,
      Rhamnus frangula, Alnus viridis, Fagus sylvatica and Acer pseudoplatanus. Similar
      rankings were obtained in the non-filtered chamber plots. The ranking of species
      sensitivity closely follows AOT values for the occurrence of initial symptoms and
      symptom progression across the remainder of the exposure season. Species that
      first showed evidence of foliar injury also demonstrated the most sensitivity
      throughout the growing season, with symptoms rapidly advancing over ca. 25-30% of
      the total plant leaf surfaces by the end of the observation period. Conversely,
      those species that developed symptoms later in the season had far less total
      injury to plant foliage by the end of the observation period (1.5 to < 5% total
      leaf area injured). The current European ambient ozone standard may be
      insufficient to protect native plant species from visible foliar injury, and many
      more native species may be sensitive to ozone-induced foliar injury than are
      currently known.

PMID- 11202737
TI  - Phytoplankton responses to biomanipulated grazing pressure and nutrient additions
      -enclosure studies in unlimed and limed Lake Njupfatet, central Sweden.
AB  - Enclosure experiments aimed to assess the role of Chaoborus larvae in regulating
      lower trophic levels under natural and nutrient-enriched conditions were
      performed in situ in the dimictic, oligotrophic clearwater Lake Njupfatet,
      central Sweden. One experiment was performed before, and one after, whole-lake
      calcite treatment. In the acidic system, total planktonic biomass (TPB; the sum
      of phyto-, bacterio-, protozoo-, and metazooplankton), dominated by the
      cyanobacterium Merismopedia, was only weakly stimulated by the nutrients while
      the predator had no effect. In the limed environment, TPB increased strongly in
      response to the nutrients in combination with a negative response to the
      predator. Principally phytoplankton, but also bacterioplankton and
      protozooplankton (ciliates) were stimulated by the nutrients. It is argued that
      Merismopedia acted as a dead-end in the energy flow in the acidic system. Liming
      resulted in the disappearance of Merismopedia and this opened the flow of
      material to higher trophic levels. Since liming also led to a significant
      reduction in the concentrations of phosphorus in the lake water, it is proposed
      that a combination of liming and gentle fertilization might be used to restore
      the productivity of acidified lakes.

PMID- 11202738
TI  - The glutathione status of mature Scots pines during the third season of UV-B
      radiation exposure.
AB  - Impacts of UV-B radiation on the glutathione level were studied in mature Scots
      pine needles (Pinus sylvestris L.) during the third season of a UV-B field
      experiment. Studies were made on 4-week-old (July) to 14-week-old (September)
      current-year needles and 3-year-old needles which had their third UV-B-exposure
      season in progress. Depending on the season and the year (1996-98), the
      supplemental UV-B dose varied from 0.92 to 5.09 kJ m-2 day-1 UV-BBE compared to
      0.47-2.44 kJ m-2 day-1 UV-BBE under the ambient treatment. Fully grown UV-B
      treated current-year needles showed lower total glutathione concentrations after
      the vegetation period in September, whereas in UV-B-treated 3-year-old needles
      the total glutathione content was significantly lower and the proportion of
      oxidized glutathione (GSSG%) 56% higher in July. The significant differences in
      total glutathione in current-year needles in September and in active 3-year-old
      needles in July seem to indicate that the effect of enhanced UV-B radiation on
      glutathione status could be cumulative.

PMID- 11202739
TI  - A new flux-orientated concept to derive critical levels for ozone to protect
      vegetation.
AB  - The current European critical levels for ozone (O3) to protect crops, natural and
      semi-natural vegetation and forest trees are based on a relative small number of
      open-top chamber experiments with a very limited number of plant species.
      Therefore, the working group "Effects of Ozone on Plants" of the Commission on
      Air Pollution Prevention of the Association of German Engineers and the German
      Institute of Standardization reanalysed the literature on O3 effects on European
      plant species published between 1989 and 1999. An exposure-response relationship
      for wild plant species and agricultural crops could be derived from 30
      experiments with more than 30 species and 90 data points; the relationship for
      conifer and deciduous trees is based on 20 experiments with nine species and 50
      data points. From these relationships maximum O3 concentrations for different
      risk stages are deduced, below which the vegetation type is protected on the
      basis of the respective criteria. Because it is assumed that the fumigation
      concentrations reflect the O3 concentrations at the top of the canopy, i.e. the
      upper surface boundary of the quasi-laminar layer if the micrometeorological big
      leaf approach is applied, the application of these maximum O3 concentrations
      requires the transformation of O3 concentrations measured at a reference height
      above the canopy to the effective phytotoxic concentrations at the top of the
      canopy. Thus, the approach described in this paper is a synthesis of the
      classical concept of toxicology of air pollutants (critical concentrations) and
      the more toxicological relevant dose concept.

PMID- 11202740
TI  - Saskatoon serviceberry and ambient sulfur dioxide exposures: study sites re
      visited, 1999.
AB  - Field surveys for symptoms of foliar injury in a regional airshed that is
      influenced by a number of point sources of SOx, NOx and hydrocarbons, combined
      with foliar and soil sulfur analyses, confirmed earlier results that Saskatoon
      serviceberry (Amelanchier alnifolia Nutt.) cv. Smokey can be used as a biological
      indicator of chronic sulfur dioxide exposures, in the presence of other
      phytotoxic air pollutants such as ozone.

PMID- 11202741
TI  - Microbial cellulose decomposition in soils from a rifle range contaminated with
      heavy metals.
AB  - The objective of this study was to assess the effects of heavy metals on
      microbial decomposition of cellulose in heavy metal-contaminated soils using a
      cotton strip assay. The assay is a measure of the potential of soil
      microorganisms to decompose the plant polymer, cellulose. Cellulolytic activity
      in soil was assessed by determining the reduction in tensile strength of the
      buried cotton strips over a 25- and 45-day period. Soils were obtained from a
      rifle range that contain high levels of lead, copper and zinc. The site has been
      used for approximately 50 years, resulting in metal levels of up to 30,000 mg/kg
      of lead, 4000 mg/kg of copper and 600 mg/kg of zinc in the most contaminated
      soils. All the metal-contaminated soils had lower degradation rates than the
      uncontaminated soils tested. Among the contaminated soils, however, the heavy
      metal concentration was not the major factor in determining the loss in tensile
      strength of the cotton strips, where cellulose decomposition was governed by
      other soil physicochemical properties. Soil with a higher cation exchange
      capacity, readily oxidisable material and volatile solids content had the
      greatest loss in tensile strength of cotton strips. Microbial adaptation to the
      presence of high concentrations of soil heavy metals and reduced bioavailability
      of metals is the likely explanation for this phenomenon.

PMID- 11202742
TI  - An integrative assessment of a watershed impacted by abandoned mined land
      discharges.
AB  - The Ely Creek watershed in Lee County, VA, USA, contains an abundance of
      abandoned mined land areas with acid mine drainage (AMD) that contaminate the
      majority of the creek and its confluence into Stone Creek. Acidic pH measurements
      ranged from 2.73 to 5.2 at several stations throughout the watershed. Sediments
      had high concentrations of iron (approximately 10,000 mg kg-1), aluminum
      (approximately 1,500 mg kg-1), magnesium (approximately 400 mg kg-1) and
      manganese (approximately 150 mg kg-1), and habitat was partially to non
      supporting at half of the stations due to sedimentation. Benthic
      macroinvertebrate surveys at six of 20 stations sampled in the watershed yielded
      no macroinvertebrates, while eight others had total abundances of only one to
      nine organisms. Four reference stations contained > or = 100 organisms and at
      least 13 different taxa. Asian clam in situ toxicity testing supported field
      survey results. Laboratory, 10-day survival/impairment sediments tests with
      Daphnia magna and Chironomus tentans and 48-h water column bioassays with
      Ceriodaphnia dubia indicated environmental stress to a lesser degree. Ten
      parameters that were directly influenced by AMD through physical, chemical,
      ecological and toxicological endpoints were assimilated into an ecotoxicological
      rating (ETR) to form a score of 0-100 points for the 20 sampling stations, and
      the lower the score the greater the AMD stress. Twelve of the 15 sampling
      stations influenced by AMD received an ETR score of 13.75-57.5, which were
      categorized as severely stressed (i.e. comprised the < 60 percentile category)
      and worthy of the highest priority for future ecological restoration activities
      in the watershed.

PMID- 11202743
TI  - Measurement of ethylene emission from Japanese red pine (Pinus densiflora) under
      field conditions in NOx-polluted areas.
AB  - Emission of ethylene from the needles of Japanese red pine, Pinus densiflora, was
      measured in air-polluted areas in Hiroshima, Japan. We applied a suitable
      protocol to determine the rate of ethylene emission from the excised needles. The
      influence of excision of needles on ethylene emission was not detected during the
      first 4 h of incubation at 20 degrees C. Ethylene emissions were low in the
      unpolluted (clean) areas regardless of the altitude or season. The emission of
      stress ethylene increased with the atmospheric NO2 concentration, suggesting that
      atmospheric NOx or related substances induced the higher ethylene emission in the
      polluted areas (near urban and industrial areas). In all cases, 1-year-old
      needles emitted significantly larger amounts of ethylene than the current
      needles. Ethylene emission did not increase evenly in the polluted areas, but the
      frequency of trees emitting high ethylene increased. Therefore, threshold rates
      for the baseline ethylene emission were proposed.

PMID- 11202744
TI  - Estimating the potential for ammonia emissions from livestock excreta and
      manures.
AB  - This paper reports a desk study to quantify the total-nitrogen (N) and ammoniacal
      N contents of livestock excreta, and to compare them with estimates of N losses
      to the environment from that excreta. Inventories of ammonia (NH3), nitrous oxide
      (N2O), dinitrogen (N2), and nitric oxide emissions (NO), together with estimates
      of nitrate (NO3-) leaching and crop N uptake were collated. A balance sheet was
      constructed to determine whether our estimates of N in livestock excreta were
      consistent with current estimates of N losses and crop N uptake from that N, or
      whether emissions of N compounds from livestock excreta may have been
      underestimated. Total N excretion by livestock in England and Wales (E&W) was
      estimated as 767-816 x 10(3) t of which 487-518 x 10(3) t was estimated to be
      total ammoniacal-N (TAN). Estimates of NH3 and N2O losses during housing and
      storage were derived from the difference between the total amount of TAN in
      excreta deposited in and around buildings, and the total amount of TAN in manure
      (i.e. the excreta deposited in and around buildings after collection and storage)
      prior to spreading and were ca. 64-88 x 10(3) t. The NH3-N emission from
      livestock buildings and manure storage in E&W quoted in the UK Emission Inventory
      (Pain et al., 1999. Inventory of Ammonia Emission from UK Agriculture, 1977.
      Report of MAFF contract WAO630, IGER, North Wyke) is ca. 80 x 10(3) t. Losses
      from NO3- leaching in the season after manure application and grazing were
      estimated as 73 and 32 x 10(3) t, respectively. Other gaseous losses of N were
      estimated as ca. 54 x 10(3) t. Crop uptake of manure N was estimated to be
      between 7 and 24 x 10(3) t. For manures, estimated N losses, immobilization and
      crop uptake total 326 x 10(3) t compared with estimates of 293-319 x 10(3) t TAN
      in excreta. Total N losses and crop uptake from TAN deposited at grazing were
      estimated to be 179-199 x 10(3) t compared with ca. 224 x 10(3) t TAN excreted.
      Thus all the TAN in manures appears to be accounted for, but ca. 25-45 x 10(3) t
      of TAN in urine deposited at grazing were not, and could be an underestimated
      source of gaseous emission or nitrate leaching.

PMID- 11202745
TI  - Spatial variability in the degradation rate of isoproturon in soil.
AB  - Thirty samples of soil were taken at 50-m intersections on a grid pattern over an
      area of 250 x 200 m within a single field with nominally uniform soil
      characteristics. Incubations of isoproturon (3-(4-isopropylphenyl)-1,1
      dimethylurea) under standard conditions (15 degrees C; -33 kPa soil water
      potential) indicated considerable variation in degradation rate of the herbicide,
      with the time to 50% loss (DT50) varying from 6.5 to 30 days. The kinetics of
      degradation also varied between the sub-samples of soil. In many of them, there
      was an exponential decline in isoproturon residues; in others, exponential loss
      was followed by more rapid rates of decline; in a few soil samples, rapid rates
      of loss began shortly after the start of the incubations. In more detailed
      studies with soils from a smaller number of sub-sites (20), measurements were
      again made of isoproturon degradation rate, and the soils were analysed for
      organic matter content, pH, and nutrient status (N, P, K). Measurements were also
      made of isoproturon adsorption by the soils and of soil microbial biomass.
      Patterns of microbial metabolism were assessed using 95 substrates in Biolog GN
      plates. Soils showing rapid biodegradation were generally of higher pH and
      contained more available potassium than those showing slower degradation rates.
      They also had a larger microbial biomass and greater microbial metabolic
      diversity as determined by substrate utilisation on Biolog GN plates. The
      implications of the results for the efficacy and environmental behaviour of
      isoproturon are discussed.

PMID- 11202746
TI  - Risk based characterisation of contaminated industrial site using multivariate
      and geostatistical tools.
AB  - Human and ecological risk assessment requires the sources, distribution, mobility
      and environmental behaviour of contaminants to be investigated on a site-specific
      basis. It often deals with data sets which are relatively small and affected by
      sampling gaps. In the case of a polycyclic aromatic hydrocarbon (PAH)
      contaminated industrial site, Kriging interpolation of spatial data and principal
      component analysis (PCA) proved useful for extracting additional value from the
      data set. Kriging was adopted for assessing the horizontal and vertical
      distribution and transport of PAHs in soil. PCA was applied to PAH concentration
      and relative abundance in soil samples and interpreted on the basis of the PAH
      physico-chemical and bio-degradation properties. It revealed correlation with the
      products of a neighbouring factory and the weathering of the lighter PAHs. The
      geo- and multivariate statistical results were coupled with the previous
      hydrogeological characterisation of the site to develop a site-conceptual model
      for use in the exposure scenario modelling for risk assessment.

PMID- 11202747
TI  - Mobility of heavy metals as related to soil chemical and mineralogical
      characteristics of Brazilian soils.
AB  - In order to better understand the relationship between soil characteristics and
      mobility of some heavy metals, correlation studies were conducted in samples of
      unlimed and limed A, B and C horizons of three Brazilian soils, representative of
      the majority of the tropical soils. A number of chemical and mineralogical
      characteristics of one Oxisol and two Ultisols were related to the retardation
      factors (Rf) for zinc (Zn), cadmium (Cd), copper (Cu) and lead (Pb). The
      retardation factors, obtained in leaching column experiments, were used as an
      estimate of solute movement in the profile. Soil types and soil horizons were
      found to influence metal retardation factors which, in turn, correlated better
      with the chemical than the mineralogical soil characteristics. For the unlimed
      soil samples, the soil characteristics that significantly correlated with Zn-Rf
      and Cd-Rf were the sum of exchangeable bases (SB), and soil exchangeable (Ca-KCl)
      and non-exchangeable (Ca-HCl) calcium contents. These results showed the strong
      influence of the cation exchange phenomenon on the retention and mobility of
      these two metals. For Cu and Pb, not only SB, cation exchange capacity (CEC) and
      Ca-KCl and Ca-HCl but also the organic matter correlated well with the Rf,
      showing that complex or chelate formation may play an important role in the
      movement of these elements. The important soil chemical characteristics related
      to the retardation factors in the limed soil samples were SB for Cd, and Ca-HCl
      for Cu and Pb, suggesting that precipitation may also influence the mobility and
      retention of the latter two heavy metals in these soil samples. Soil pH
      influenced the heavy metals adsorption and movement as shown by the significant
      correlation with the retardation factors when the combined data for the unlimed
      and limed soil samples was considered.

PMID- 11202748
TI  - Induction of the P450 reporter gene system bioassay by polycyclic aromatic
      hydrocarbons in Ulsan Bay (South Korea) sediments.
AB  - Polycyclic aromatic hydrocarbons (PAHs) and induction of the P450 reporter gene
      system (RGS) for 6- and 16-h exposure periods were determined in organic extracts
      of Ulsan Bay (South Korea) sediments to assess the utility of this bioassay as a
      screening tool for PAH contamination. The sum of the concentrations of 23
      individual PAHs in 30 sediment samples (sigma PAH) based on GC-MS analysis ranged
      from 0.05 to 6.1 micrograms/g dry wt. P450 RGS fold induction ranged from 4.0 to
      320 micrograms/g based on benzo[a]pyrene toxic equivalents (BaPEq). P450 RGS
      BaPEq and the 'chemical BaPEq', defined as the sum of the products of individual
      PAH concentrations and pre-determined toxic equivalency factors, exhibited very
      strong positive correlations with sigma PAH (r2 > 0.90; P < 0.001). Fold
      induction did not increase (and in some cases decreased) after the optimal
      incubation period (6 h) for PAHs, indicating that other compounds known to induce
      the P450 RGS (e.g. chlorinated organics) were not present at levels effecting
      significant induction. This was supported by GC-ECD analysis where non-ortho and
      mono-ortho polychlorinated biphenyls (PCBs) known to be strong P450 RGS inducers
      were found to be at very low or non-detectable levels in samples with the highest
      P450 RGS responses. The profound difference in PAH profiles for the two most
      contaminated sites suggested that this assay is especially sensitive for selected
      PAHs with greater than four rings. Combined with previous results, the P450 RGS
      shows promise as a useful screening tool for predicting deleterious biological
      effects resulting from CYP1A1-inducing, sediment-associated chemicals,
      particularly high molecular weight PAHs.

PMID- 11202749
TI  - Bioaccumulation of butyltins in Dreissena polymorpha at a confined placement
      facility in Buffalo, New York.
AB  - This study involves a site characterization followed by biomonitoring with the
      zebra mussel, Dreissena polymorpha, at the Times Beach confined placement
      facility (CPF), located in Buffalo, NY. The contaminant of interest was
      tributyltin (TBT) and the degradation products dibutyltin (DBT) and monobutyltin
      (MBT). At study initiation (Day 0) TBT levels in the baseline mussels were 5.86
      +/- 0.43 ng Sn/g, DBT levels were 2.25 +/- 0.37 ng Sn/g. No MBT was detected in
      the Day 0 baseline samples. Caged reference mussels placed back in the Black Rock
      Channel Lock and retrieved on Days 19 and 34 had TBT, DBT, and MBT levels which
      did not differ significantly from the Day 0 baseline levels. Mussels placed at
      the Times Beach CPF had TBT concentrations that were significantly lower at both
      Days 19 (3.65 +/- 0.90 ng Sn/g) and 34 (3.50 +/- 1.03 ng Sn/g) than the Day 0
      baseline analysis (5.86 +/- 0.43 ng Sn/g). The results of this study indicate
      that butyltins were detected at the CPF site in the sediment (7.33 +/- 5.70 ng
      Sn/g) but not the water column (not detected at 0.01 microgram/l). In this study
      the zebra mussel was able to depurate TBT even in the presence of contaminated
      sediment. TBT may be bioaccumulated from the sediments. However, the initial
      levels in the mussels were so high, levels actually dropped as sediment-tissue
      equilibria levels were reached by the mussels.

PMID- 11202750
TI  - Effect of chlorsulfuron on growth of submerged aquatic macrophyte Potamogeton
      pectinatus (sago pondweed).
AB  - Research has been conducted on the effect of chlorsulfuron on non-target plants
      but little information is available on its effects on aquatic macrophytes.
      Potamogeton pectinatus (sago pondweed) is an ecologically important submerged
      aquatic macrophyte found in freshwater bodies. Many species of wildlife use this
      plant as a food source. The objective of this study was to measure the phytotoxic
      effects of chlorsulfuron on sago pondweed. P. pectinatus plants were exposed to
      chlorsulfuron at 0, 0.25, 0.50, 1.0, or 2.0 ppb, in an environmental growth
      chamber. Plants exposed to 0.25 ppb chlorsulfuron showed a reduction in length
      (76%), number of leaves (50%), and number of stems (50%), compared to control
      plants. A reduction (47%) was also observed in the length of stems produced by
      plants treated with > or = 0.50 ppb chlorsulfuron. Significant reductions in wet
      and dry weights, and increased mortality were observed on treatments with > or =
      1.0 ppb chlorsulfuron.

PMID- 11202752
TI  - Air pollution modeling for an industrial complex and model performance
      evaluation.
AB  - Jamshedpur, the steel city of India situated in the eastern part of India is
      affected by increasing air pollution levels as a result of concentrated
      industrial activities. The impact of NOx emissions resulting from various air
      pollution sources, viz. industries, vehicles and domestic, was estimated using
      Industrial Source Complex Short-Term gaussian dispersion model. The contribution
      of NOx concentration from industrial, vehicular and domestic sources was found to
      be 53, 40 and 7%. Further statistical analysis was carried out to evaluate the
      model performance by comparing measured and predicted NOx concentrations. The
      model performance was found good with an accuracy of about 68%.

PMID- 11202751
TI  - The otter (Lutra lutra) in Sweden--population trends in relation to sigma DDT and
      total PCB concentrations during 1968-99.
AB  - Polychlorinated biphenyl (PCB) has been suggested as the major cause of the
      European otter (Lutra lutra) population decline. This study investigates temporal
      and geographical changes in otter numbers as well as total PCB and sigma DDT
      concentrations in otters and their food in different parts of Sweden with various
      pollution impacts during three decades. In Sweden, rare species belong to the
      State and carcasses of such specimens are sent to the authorities. Two-hundred
      and eight specimens have been used to investigate temporal and spatial variation
      in the otter populations during 1968 and 1999. One-hundred and twenty-five of
      them have been chemically analysed. The population trends in northern Sweden
      coincide with the temporal trends of the contaminants. When concentrations of
      PCBs decrease in the environment, otter population increases. Neither
      aldrin/dieldrin nor mercury pollution seem to explain why the Swedish otter
      populations decreased dramatically during the 1960s-1980s. In southern Sweden
      total PCB concentrations are still high and the indications of improvement of the
      population are weak.

PMID- 11202753
TI  - Effects of elevated carbon dioxide and ozone on the growth and yield of potatoes
      (Solanum tuberosum) grown in open-top chambers.
AB  - Potato (Solanum tuberosum cv. Bintje) was grown in open-top chambers under three
      carbon dioxide (ambient and seasonal mean concentrations of 550 and 680 mumol mol
      1 CO2) and two ozone concentrations (ambient and an 8 h day-1 seasonal mean of 50
      nmol mol-1 O3) between emergence and final harvest. Periodic non-destructive
      measurements were made and destructive harvests were carried out at three key
      developmental stages (24, 49 and 101 days after emergence) to establish effects
      on growth and tuber yield. Season-long exposure to elevated O3 reduced above
      ground dry weight at final harvest by 8.4% (P < 0.05), but did not affect tuber
      yields. There was no significant interaction between CO2 and O3 for any of the
      growth and yield variables examined. Non-destructive analyses revealed no
      significant effect of elevated CO2 on plant height, leaf number or green leaf
      area ratio. However, destructive harvests at tuber initiation and 500 degrees Cd
      after emergence showed that above-ground dry weight (8 and 7% respectively) and
      tuber yield (88 and 44%) were significantly increased (P < 0.05) in the 550 mumol
      mol-1 CO2 treatment. Responses to 550 and 680 mumol mol-1 CO2 were not
      significantly different for most parameters examined, suggesting the existence of
      an upper limit to the beneficial influence of CO2 enrichment. Significant effects
      on above-ground dry weight and tuber yield were no longer apparent at final
      harvest, although tuber numbers were increased (P < 0.05) under elevated CO2,
      particularly in the smaller size categories. The results show that the O3
      treatment imposed was insufficient to reduce tuber yields and that, although
      elevated CO2 enhanced crop growth during the early stages of the season, this
      beneficial effect was not sustained to maturity.

PMID- 11202754
TI  - Mercury, cadmium, lead and selenium in ringed seals (Phoca hispida) from the
      Baltic Sea and from Svalbard.
AB  - The concentrations of mercury (Hg), cadmium (Cd), lead (Pb) and selenium (Se)
      were determined in liver, kidney and muscle samples from 20 Baltic ringed seals
      (Phoca hispida botnica) (3-32 years), and from 17 ringed seals (Phoca hispida) (0
      20 years) from Svalbard, in the Arctic. The concentrations of Hg and Se were
      considerably higher in the Baltic ringed seals, but the Cd concentrations lower
      than in the Svalbard ringed seals. There was no big geographical difference with
      respect to Pb concentrations. Se and Hg concentrations showed a significant
      positive correlation in both regions. By comparison with earlier studies on
      Baltic seals, the metal concentrations have remained at the same level since the
      1980s. Of the metals we studied, only the level of Hg in Baltic ringed seals can
      be considered high (mean 53 mg/kg, range 6.5-124 mg/kg wet wt. for liver), but
      probably not high enough to cause metal intoxication. No pathological changes
      associated with metal intoxication were observed in the seals.

PMID- 11202756
TI  - Cuban Health System offers an uncommon opportunity.

PMID- 11202755
TI  - The use of amino compounds for binding 2,4,6-trinitrotoluene in water.
AB  - Sites polluted with 2,4,6-trinitrotoluene (TNT) constitute a worldwide problem.
      In this work, chemical reactions for binding TNT to amino-compounds are proposed
      as an initial step for developing new remediation techniques to clean-up
      groundwater and soils contaminated with TNT. Indeed, addition of aniline and an
      amino acid-like cysteine caused a decrease in free TNT of 86% and 68-100%,
      respectively. Using 13C-NMR spectroscopy, it was shown that TNT chemically forms
      a Meisenheimer complex with cysteine and aniline in 1/1 (by vol.) H2O/d6-acetone.

PMID- 11202757
TI  - Psychometric properties of the VSQLQ in black patients with mild hypertension.
      Vital Signs Quality of Life Questionnaire.
AB  - The Vital Signs Quality of Life Questionnaire (VSQLQ) is a condition- and culture
      specific measure designed to assess health-related quality of life (HRQL) in
      black patients with hypertension. This study examined the instrument's
      reliability and validity when administered via personal interview to patients
      with mild systemic hypertension. Data were gathered from 304 black patients
      during the screening visit of a multicenter trial evaluating the efficacy of
      candesartan cilexetil (ATACAND). In addition to internal consistency and
      reproducibility, validity was assessed by correlating the VSQLQ with the Short
      Form-36 (SF-36). Sensitivity to sociodemographic effects and responsiveness to
      change was also examined. Cronbach's alpha levels were high (0.90, 0.92, 0.92 for
      frequency, intensity and combined scores, respectively) and the instrument was
      stable in patients reporting no health change over 8 weeks (ICC = 0.79, 0.79, and
      0.80). Correlations between the VSQLQ and the SF-36 were moderate to high (0.32
      to - 0.69) and statistically significant (p < 0.001). VSQLQ scores varied by
      gender, education, and income (p < 0.05). Patients who reported improvement in
      their general health status also reported significant improvements on the VSQLQ
      (n = 90; p < 0.05). Results support the reliability and validity of VSQLQ
      administered via personal interview to black patients with mild systemic
      hypertension.

PMID- 11202758
TI  - African-American teen smokers: issues to consider for cessation treatment.
AB  - Previous reports have indicated ethnic differences in both tobacco-related
      morbidity and treatment outcome for smoking cessation among adults. We assessed
      smoking-related characteristics in African-American and non-African American
      teenagers applying to a cessation trial. 115 teens (15.9 +/- 1.8 years, 68%
      females, 27% African-American) responded via telephone to media ads. Self
      reported sociodemographic, medical and smoking-related data were obtained to
      determine pre-eligibility for a full intake screen prior to trial participation.
      Compared to non-African American, African American teen applicants were older
      (16.4 +/- 1.7 years versus 15.6 +/- 1.6; p = 0.015), had lower Fagerstrom Test
      for Nicotine Dependence (FTND) scores (5.3 +/- 2.3 versus 6.1 +/- 1.8; p = 0.018,
      ANOVA controlling for age) and smoked fewer cigarettes on the weekend (27 +/- 16
      versus 38 +/- 17; p = 0.001). African American teens reported similar duration of
      smoking (3.3 +/- 1.4 versus 3.1 +/- 1.5 years) and time elapsed between first
      cigarette ever smoked and daily smoking (0.7 +/- 0.9 versus 0.6 +/- 0.7 years).
      African American and non-African American teens had similar motivation to quit
      scores and frequency of reported health problems (e.g., asthma, psychiatric
      conditions). These data suggest that cessation treatment programs designed for
      African American youth should include lower Fagerstrom-defined levels, and
      possibly other criteria for tobacco dependence. These observations also highlight
      the importance of ethnocultural issues in treatment research programs.

PMID- 11202759
TI  - Knowledge of the Tuskegee study and its impact on the willingness to participate
      in medical research studies.
AB  - The under-representation of racial/ethnic minorities among medical research
      participants has recently resulted in mandates for their inclusion by the
      National Institutes of Health (NIH). Therefore, there is a need to determine how
      history, attitudes, cultural beliefs, social issues, and investigator behavior
      affect minority enrollment in medical research studies. From January 1998 to
      March 1999, 179 African-American and white residents of the Detroit Primary
      Metropolitan Statistical Area (PMSA) participated in a mail and telephone survey
      designed to examine impediments to African-American participation in medical
      research studies. Chi-square tests were performed to assess differences between
      the study groups using the Survey Data Analysis Program (SUDAAN). Eighty-one
      percent of African Americans and 28% of whites had knowledge of the Tuskegee
      Study (p = <0.001). Knowledge of the Tuskegee Study resulted in less trust of
      researchers for 51% of African-Americans and 17% of whites (p = 0.02). Forty-six
      percent of African-Americans and 34% of whites indicated that their knowledge of
      the study would affect future research participation decisions (p = 0.25). Of
      these, 49% of African-Americans and 17% of whites would not be willing to
      participate in future medical research studies (p = 0.05). This study confirms
      the need for medical researchers to confront the issue of the Tuskegee Study and
      its continuing impact on African-Americans' trust of medical research studies.

PMID- 11202760
TI  - Economic and outcomes assessment of magnetic resonance imaging in the evaluation
      of headache.
AB  - We sought to evaluate the economic impact and diagnostic utility of magnetic
      resonance imaging (MRI) in the management of patients with headache and nonfocal
      physical examinations. Computerized medical records were retrospectively reviewed
      of 1,233 patients presenting for MRI of headache at our institution over a 3-year
      period (1992-1995). Patients with focal findings at physical examination, prior
      brain surgery, head trauma, or immunocompromise were excluded. A model was
      developed to assess the cost associated with the MR test results, and actual
      average institutional costs of performing an examination applied. Correlative
      statistical analysis of referring specialties and positive tests was also
      performed. Three hundred twenty-eight patients who met the above criteria were
      retained in the sample. One hundred sixty-three patients (50%) had negative MR
      test results. Of the 50% of patients with positive studies, only 5 (1.5%) had
      clinically significant MR results. The average cost of an MR examination was 517
      dollars (1998 dollars). The cost per clinically significant managed case detected
      was 34,535 dollars. No statistically significant difference was found among
      referring specialties and clinically significant MR results. Our results indicate
      that MRI of nonfocal headache yields a low percentage of positive clinically
      significant results and has limited cost-effectiveness. Referring specialty had
      no significant bearing on these outcomes, regardless of specialist experience.

PMID- 11202762
TI  - Percutaneous injuries in a high-volume podiatric surgical residency program.
AB  - Percutaneous injuries (i.e., needlesticks) are a possible occupational hazard to
      all residents performing invasive procedures. Transmission of blood-borne
      pathogens has become a potential risk in these injuries. As such, the purpose of
      this investigation was to assess the frequency and circumstances involving
      percutaneous injuries in the podiatric surgical resident. A survey of 20 present
      residents from July 1991 to July 1999 was conducted to assess percutaneous
      injuries. These residents participated in 19,505 surgical cases in this
      timeframe; 16,185 were podiatric cases and 3,347 were nonpodiatric. Using a two
      part questionnaire to assess the circumstances surrounding any percutaneous
      injury, 80% of the residents reported at least one percutaneous injury during
      their training. A total of 33 were injuries reported for the 19,505 cases. The
      incidence of injury per surgical case was 0.17% overall, and 0.14% for foot and
      ankle cases. Analysis of the data showed a median = 2, mode = 2, and a mean =
      1.63 injuries per resident with a range of 0-5. When analyzing the circumstances
      involving the injuries, most injuries were self-inflicted (66.7%), occurred
      during wound closure (72.7%), and were caused by a nonhollow bore needle or
      instrument (81.8%). Also, no correlation could be made to the time of day during
      which the procedure was performed, the year of residency training, or the number
      of cases that the resident performed that day before the injury occurred.
      Interestingly, over 67% of the injuries occurred to the resident's left hand.
      Although 97% of the injuries were reported to the employee health officer, the
      patient and resident were screened for HIV and hepatitis B or C in only 78.8% of
      the cases. In those tested, no resident was exposed to HIV or hepatitis B or C.

PMID- 11202761
TI  - Osteoradionecrosis of the mandible.
AB  - Osteoradionecrosis is a major complication of surgery or trauma in previously
      irradiated bone in the absence of tumor persistence. Radiation-induced vascular
      insufficiency rather than infection causes bone death. It occurs most commonly in
      the mandible after head and neck irradiation. Risk factors include the total
      radiation dose, modality of treatment, fraction size and dose rate, oral hygiene,
      timing of tooth extractions as well as the continued use of tobacco and alcohol.
      This condition is often painful, debilitating, and may result in significant bone
      loss. The recommended treatment guidelines are irrigation, antibiotics,
      hyperbaric oxygen therapy, and surgical techniques, including hemimandibulectomy
      and graft placements.

PMID- 11202763
TI  - In situ tibialis posterior to flexor digitorum longus tendon transfer for
      tibialis posterior tendon dysfunction: a simplified surgical approach with
      outcome of 11 patients.
AB  - Outcomes for 11 patients who underwent an in situ tibialis posterior tendon to
      flexor digitorum longus tendon side-to-side anastamosis as the sole procedure for
      stage 2 tibialis posterior tendon dysfunction were reviewed. The average follow
      up was 34.4 months. Using the American Orthopedic Foot and Ankle Society hindfoot
      rating scale, a mean improvement of 39.3 points was achieved, with preoperative
      scores of 38.8 improving to 78.1 postoperatively. Good to excellent results were
      achieved in nine patients. The in situ side-to-side anastamosis is technically
      easier to perform, has less tissue trauma, and compares favorably with other soft
      tissue procedures and reconstructions for stage 2 tibialis posterior tendon
      dysfunction. Performing this transfer alone, while leaving the flexor digitorum
      longus tendon intact, theoretically provides a stronger transfer as the length
      tension relationship of the flexor digitorum longus tendon is maintained near its
      physiologic level. The procedure can consistently restore inversion ability to
      the rearfoot and stop the progression of tibialis posterior tendon dysfunction.

PMID- 11202764
TI  - Plantar fat pad atrophy: a cause of metatarsalgia?
AB  - The aim of this prospective study was to evaluate if atrophy of the plantar fat
      pad in splay-foot deformities was a major cause of metatarsalgia. A sonographic
      method of measuring the thickness of the plantar fat pad under the second and
      third metatarsal heads was developed. The method was tested on 25 volunteers and
      the intraobserver reliability was calculated to be 97.1% for the second
      metatarsal and 96.7% for the third metatarsal. Sonographic measurement of the
      plantar fat pad was then performed on 100 symptomatic feet Pain frequency and
      pain intensity were determined by using a verbal rating scale (VRS) and a visual
      analog scale (VAS). The intermetatarsal angle 1/2 was measured and then compared
      to the thickness of the fat pad for each patient. A correlation between the
      increase of the intermetatarsal angle and the decrease of the fat pad thickness
      could not be demonstrated (r = 0.041). The frequency of metatarsalgia did not
      correlate with a decrease of the thickness of the plantar fat pad under the
      second metatarsal head (t statistic: 1.978; Durbin-Watson test: 1.999; p value =
      .0507) and the third metatarsal head (t statistic: 3.199; Durbin-Watson test:
      1.962; p value = .0019). The pain intensity showed a similar lack of correlation
      with the thickness of the plantar fat pad under the second metatarsal head (t
      statistic: 1.828; Durbin-Watson test: 2.365; p value = .0706) and the third
      metatarsal head (t statistic: 1.846; Durbin-Watson test: 2.371; p value = .0678).
      This study shows that a splay-foot deformity is not associated with a decrease of
      the thickness of the plantar fat pad. Furthermore, alterations of the thickness
      of the plantar fat pad are not relevant to the intensity and frequency of
      metatarsalgia.

PMID- 11202765
TI  - Primary soft-tissue neoplasms of the foot: the clinicopathologic features of 401
      cases.
AB  - Neoplasms of the soft tissue range from benign, indolent tumors to some of the
      most aggressive malignancies known to man. Despite exhaustive studies detailing
      their occurrence elsewhere within the body, there has been relatively little
      detailing such neoplasms arising within the soft tissues of the foot. Due to the
      relative infrequency with which malignant soft-tissue tumors occur in the foot,
      large series pertaining to this location have been difficult to assemble. To
      better elucidate the relative frequency of various benign and malignant soft
      tissue tumors of the foot, the clinicopathologic features of 401 such neoplasms
      are described. All cases were retrieved from the files of a major medical center
      which specializes in the treatment of cancer. Of the 401 cases identified, 149
      were benign, while 252 cases were of a malignant nature. The clinicopathologic
      features are summarized and descriptive statistics are applied. Special focus is
      given to the discussion of the malignant and rare tumors within this series.
      Recent concepts regarding diagnosis, prognosis, and therapy are similarly
      discussed.

PMID- 11202766
TI  - Combined cryotherapy/70% salicylic acid treatment for plantar verrucae.
AB  - Although common, warts are inconsistently treated by any single method. The
      authors present a review of the literature for various treatments with regard to
      the methodology and success rate of each treatment modality. The authors also
      present a therapeutic regimen of combined cryotherapy/ 70% salicylic acid. This
      treatment involves in-office application of the cryogenic agent and daily
      application of 70% salicylic acid by the patient. The cryotherapy was combined
      with daily patient application of salicylic acid to increase destruction of the
      verruca. In a study of 29 patients with 65 warts, the authors found this method
      successful in 58 warts in 25 patients, showing a 89.2% rate of eradication of
      verrucae in 86.2% of patients. The method is recommended due to its consistent
      efficacy in the patient population, and its relatively gentle and noninvasive
      approach.

PMID- 11202768
TI  - Chip fractures of the first metatarsal head. Primary fragment excision versus
      immobilization: a report of four cases.
AB  - Four cases of a distal lateral impaction fracture of the first metatarsal are
      presented. Two treatment schemes were implemented. In two of the patients the
      fracture fragment was removed early. The other two patients had either
      percutaneous pinning or a weightbearing cast Each case discusses the rationale
      for the selected treatment as well as the clinical outcome. All four patients
      ultimately had successful retums to full activity with a more immediate return to
      exercise for the two patients with excised fracture fragments (6-week
      difference).

PMID- 11202767
TI  - Complex foot deformities associated with soft-tissue scarring in children.
AB  - Two cases of deformities in scarred feet are presented. One case had an old, well
      healed forefoot amputation with severe equinovarus deformity, and the other had
      an equinus deformity following a burn injury 10 months prior. Both the cases were
      managed by primary release of the contracted joint capsules. The correction of
      the soft-tissue contractures was achieved by gradual distraction using the
      Ilizarov apparatus. The clinical presentation and surgical treatment of complex
      foot deformities, complicated by the presence of scar tissue, are presented.
      These cases illustrate the benefits of combining soft-tissue release with the
      Ilizarov technique of distraction histogenesis in the treatment of complicated
      foot deformities associated with scarring in pediatric patients.

PMID- 11202769
TI  - The Evans osteotomy: technique and fixation with cortical bone pin.
AB  - The use of a lamina spreader over converging pins facilitates opening of an Evans
      calcaneal osteotomy and allows for precise measurement of the recipient site. The
      technique of cortical bone pin insertion has been utilized when indicated by the
      authors a limited number of times (N = 10) and as such this will be the subject
      of a future scientific investigation. The authors feel the advantages of the
      cortical bone pins include ease of use, good resultant stability of the capital
      fragment, utilization of a material identical to that of the correcting graft, a
      more biologic form of absorbable internal fixation, and the avoidance of
      complications associated with percutaneous metallic fixation (Fig. 5).

PMID- 11202770
TI  - Youngswick-Austin procedure: the effect of plantar arm orientation on metatarsal
      head displacement.
AB  - The Youngswick-Austin metatarsal head procedure was developed to allow for
      correction of a mildly elevated metatarsal head and/or to shorten an abnormally
      long first metatarsal. However, it was difficult to accurately and consistently
      predict the amount of plantar metatarsal head displacement utilizing this
      modification of the Austin procedure. This study demonstrated, through the use of
      preoperative templates and a mathematical formula, that the angle of the plantar
      arm relative to the weightbearing surface of the foot is what dictates the amount
      of plantar metatarsal head displacement. The authors divide the angle of the
      chevron osteotomy into a dorsal and plantar arm angle and demonstrate that the
      larger the angle of the plantar arm, the greater one can plantarly displace the
      metatarsal head.

PMID- 11202771
TI  - The medicalization of women's sexuality.

PMID- 11202772
TI  - Hepatitis C.

PMID- 11202773
TI  - Hepatitis C.

PMID- 11202774
TI  - Mothers and methadone.

PMID- 11202775
TI  - The AMA takes umbrage.

PMID- 11202776
TI  - Air Force may change nurse corps admission standards.

PMID- 11202777
TI  - State of the nursing shortage.

PMID- 11202778
TI  - A victory for nurses. Needlestick prevention legislation is passed by Congress
      and signed into law.

PMID- 11202779
TI  - Complex regional pain syndrome.

PMID- 11202780
TI  - Hidden factors in occult blood testing. Foods and medications can affect results.

PMID- 11202781
TI  - Stable & able. A standardized nursing intervention protocol for patients with
      cancer redefines the relationship among patients, caretakers, and nurses.

PMID- 11202782
TI  - Emergency: Bioterrorism.

PMID- 11202783
TI  - Sexual counseling after myocardial infarction.

PMID- 11202784
TI  - Vacuum-assisted wound closure.

PMID- 11202785
TI  - Advance directives.

PMID- 11202786
TI  - A nurse's lifeline. A nursing ethics committee offers the chance to review and
      learn from ethical dilemmas.

PMID- 11202787
TI  - Post-polio syndrome.

PMID- 11202788
TI  - 'One pill makes you larger...'. Don't be seduced by pharmaceutical companies.

PMID- 11202789
TI  - A healthy environment for a healthy community. Initiating the '2,000 trees for
      2000' campaign.

PMID- 11202790
TI  - A national uprising. United actions push mandatory overtime, inadequate staffing
      to forefront.

PMID- 11202791
TI  - Your final warning. Know your rights in advance of a layoff.

PMID- 11202792
TI  - Breast cancer survival and hormone replacement therapy: a cohort analysis.
AB  - Controversy exists regarding the safety of hormone replacement therapy (HRT)
      after a diagnosis of breast cancer. The objective of this study is to perform a
      matched cohort analysis to evaluate the impact of HRT on mortality in breast
      cancer survivors. Patients with breast cancer who received HRT after diagnosis of
      breast cancer were identified. Control subjects were identified from the regional
      cancer registry. Matching criteria included age at diagnosis, stage of breast
      cancer, and year of diagnosis. Controls were selected only if they were alive at
      the time of initiation of HRT of the matched case. Only subjects not included in
      a previously reported matched analysis were selected. One hundred twenty-five
      cases were matched with 362 controls. Ninety-eight percent (123/125) of the cases
      received systemic estrogen; 90/125 (72%) also received a progestational agent.
      The median interval between diagnosis of breast cancer and initiation of HRT was
      46 months (range 0-401 months). The median duration of HRT was 22 months (range 1
      357 months). The risk of death was lower among the HRT survivors; odds ratio 0.28
      (95% confidence interval 0.11-0.71). This analysis does not suggest that HRT
      after the treatment of breast cancer is associated with an adverse outcome.

PMID- 11202793
TI  - Angiogenesis and p53 protein expression in breast cancer: prognostic roles and
      interrelationships.
AB  - The authors have analyzed, on the one hand, the prognostic impact of microvessel
      density (MVD) and p53 protein expression in patients with breast cancer, and on
      the other hand, the correlation between the microvascular pattern and the p53
      protein expression. Tumors from 120 patients whose paraffin-embedded tissue
      blocks were available were analyzed using the immunohistochemical method. MVD and
      p53 protein expression were correlated with histologic grade and tumor size,
      respectively. The patients with highly vascularized tumor (high MVD) had
      decreased overall survival (p = 0.04), whereas overexpressed p53 patients did
      not. In multivariate analysis, axillary lymph node status (p = 0.007), tumor size
      (p = 0.01), and MVD (p = 0.02) showed important prognostic influence on overall
      survival. When the simultaneous influence of MVD and p53 protein expression on
      survival were analyzed, no interrelationship was detected. The results
      demonstrate the prognostic impact of MVD on overall survival in breast cancer and
      no association between MVD and p53 protein expression.

PMID- 11202794
TI  - Analysis of the role of adjuvant chemotherapy for invasive carcinoma of the
      esophagus.
AB  - The purpose of this report is to analyze the role and optimum integration of
      chemotherapy for invasive carcinoma of the esophagus in the combined modality
      setting. The charts of 157 patients with primary invasive nonmetastatic carcinoma
      of the esophagus treated with curative intent between 1984 and 1998 were
      reviewed. Various combinations of chemotherapy (C), radiotherapy (R), and surgery
      (S) were used. Chemotherapy was multiagent (typically 5-fluorouracil [5
      FU]/cisplatin/hydroxyurea, 5-FU/cisplatin/leucovorin, or docetaxel/cisplatin) for
      all but seven patients treated with single agents. The clinical endpoints
      examined were overall survival (OS) and cause-specific survival (CSS).
      Multivariate analyses and pairwise comparisons were made for determination of the
      benefit of chemotherapy. On the multivariate analyses, only American Joint
      Committee on Cancer stage and chemotherapy were statistically significant
      determinants of both OS and CSS. Following are the results of the pairwise
      analyses: 3-year OS: (no C) versus (any C): 16% versus 27% (p = 0.02); (S) versus
      (C+S): 19% versus 34% (p = 0.35); (R) versus (C+R): 0% versus 13% (p = 0.05); (R
      + S) versus (C + R + S): 18% versus 33% (p = 0.03). The administration of
      adjuvant chemotherapy can improve survival in patients with invasive
      nonmetastatic esophageal carcinoma. This benefit appears to be greater when
      chemotherapy is given with radiotherapy (with or without surgery) than in the
      absence of radiotherapy, perhaps because of a radiosensitizing effect not
      possible when using surgery is the only local control modality.

PMID- 11202795
TI  - Postoperative endoscopic retrograde high dose-rate brachytherapy for
      cholangiocarcinoma.
AB  - Cholangiocarcinoma typically presents with disease unlikely to be completely
      resected, and prognosis remains poor. Improvements in imaging, endoscopy, and
      stenting have given rise to renewed interest in brachytherapy. Several recent
      retrospective series suggest a benefit to intraluminal brachytherapy, most
      commonly delivered by the transhepatic route. We describe a case in which
      brachytherapy was delivered via the nasobiliary route to address positive margins
      at the common bile duct stump. A custom catheter was manufactured to make the
      procedure feasible. Pertinent literature is reviewed, which supports the view
      that these malignancies benefit from high doses of radiation, if this can be
      achieved respecting normal tissue tolerance.

PMID- 11202796
TI  - Chronic systemic (hepatosplenic) candidiasis in a patient with granulocytic
      sarcoma.
AB  - Chronic systemic (hepatosplenic) candidiasis (CSC) is a syndrome of invasive
      candidiasis characterized by fever without localizing signs or symptoms. It
      occurs predominantly in patients with acute leukemia, after prolonged severe
      neutropenia. We report a young woman who underwent extensive chemotherapy for
      granulocytic sarcoma of the ovary; CSC then developed in this patient. She was
      successfully treated with fluconazole and liposomal amphotericin B. Clinical
      presentation, diagnostic problems, and the current successful treatment with
      fluconazole and liposomal amphotericin B are discussed.

PMID- 11202797
TI  - Long-term results of lipiodol-transcatheter arterial embolization with cisplatin
      or doxorubicin for unresectable hepatocellular carcinoma.
AB  - The long-term effects of Lipiodol-transcatheter arterial embolization (Lp-TAE)
      combined with cisplatin (CDDP) or doxorubicin (ADM) on unresectable
      hepatocellular carcinoma (HCC) were analyzed. Eighty-four consecutive patients
      with unresectable HCC were treated with TAE. Of the 84, 38 patients were treated
      with CDDP-Lp-TAE (CDDP group), whereas the remaining 46 patients were treated
      with ADM-Lp-TAE (ADM group). No significant difference in characteristics of
      patients and tumors was noted between the groups. CDDP (50 mg) or ADM (20-50 mg)
      was administered with Lp followed by embolization of the feeding arteries using
      gelatin sponge particles. The mean number of TAE treatments was 3.3 in the CDDP
      group and 1.9 in the ADM group (p < 0.01). The 5-year overall survival rates of
      the CDDP group and the ADM group were 19% and 6%, respectively. The overall
      survival rate of the CDDP group was significantly higher than that of the ADM
      group (p < 0.05). No serious side effects were observed in either group. CDDP-Lp
      TAE improved the prognosis of unresectable HCC compared with ADM-Lp-TAE, which
      may be attributable to the fact that CDDP-Lp-TAE treatment could be repeated more
      times than ADM-Lp-TAE.

PMID- 11202799
TI  - Patient statement of satisfaction with antiemetic treatment is related to quality
      of life.
AB  - The aim of our study was to explore the possible relationship between patient
      satisfaction with antiemetic treatment and quality of life (QoL). The study
      sample consisted of 136 chemotherapy-naive patients with breast cancer, with
      Karnofsky index 90% to 100%, scheduled to receive their first cycle of, mainly
      adjuvant, 5-fluorouracil/doxorubicin/cyclophosphamide chemotherapy. Two
      antiemetic regimens were used for the prevention of acute emesis. No antiemetic
      prophylaxis was given for delayed emesis. QoL was assessed using the Rotterdam
      Symptom Checklist (RSCL). The RSCL was completed before chemotherapy (day 1) and
      on day 5. Statement of satisfaction was given on day 5. The change in RSCL scores
      between day 5 and day 1 was calculated and compared in three subgroups of
      patients: those very satisfied (n = 55), satisfied (n = 65), and unsatisfied with
      antiemetic treatment (n = 16). Patient statement of satisfaction was related to
      psychological distress (p = 0.002), physical symptom distress (p = 0.002), and
      activity level (p = 0.002). It was also related to the control of nausea (p <
      0.01) and vomiting (p < 0.0001). We suggest that patient statement of
      satisfaction with antiemetic treatment could be an outcome measure for response
      assessment in antiemetic trials.

PMID- 11202798
TI  - Pilot study of the paclitaxel, oxaliplatin, and cisplatin combination in patients
      with advanced/recurrent ovarian cancer.
AB  - To determine the feasibility of the paclitaxel, oxaliplatin, cisplatin
      combination in advanced ovarian cancer (AOC), 15 patients with AOC (8 chemonaive,
      and 7 second-line, disease-free interval > or = 12 months) received paclitaxel
      135 mg/m2 at day 1, with oxaliplatin 100 mg/m2 and cisplatin 75 mg/m2 at day 2,
      every 3 weeks for 6 cycles. Pretreated patients received prophylactic granulocyte
      colony-stimulating factor (5 microg/kg/d, days 6-13). Seventy cycles were
      administered; median 5 (range: 2-6 cycles) in chemonaive, and 4 (range: 2-6) in
      pretreated patients. There were grades III to IV neutropenia in 77%, febrile
      neutropenia in 24%, and grades III to IV thrombocytopenia in 4% of the cycles.
      Besides neutropenia, cumulative neurosensory toxicity was also limiting although
      reversible, with National Cancer Institute Common Toxicity Criteria grades II to
      III observed in 13 patients. Three of the pretreated patients had complete
      responses (43%), three had partial responses, and one had disease stabilization.
      Six of the 8 chemonaive patients had complete responses (75%), 1 had disease
      stabilization, and 1 had disease progression. The median follow-up is 17 months
      (range: 9-20 months) in chemonaive and 41 months (range: 13-58 months) in
      pretreated patients, and time to progression has been consistently more than 12
      months, with 6 patients (5 chemonaive) still progression free (range: 15+ to 22+
      months). This active combination shows acceptable hematologic toxicity, and
      reversible cumulative neurosensory toxicity. Further clinical exploration of the
      present combination appears warranted.

PMID- 11202800
TI  - Isolated splenic metastasis from gastric carcinoma: value of CEA and CA 19-9 in
      early diagnosis: report of two cases.
AB  - We report two cases of an isolated splenic metastasis, occurring 5 and 3 years,
      respectively, after gastrectomy for gastric carcinoma. Serum carcinoembryonic
      antigen and CA 19-9 levels were evaluated preoperatively, postoperatively, and
      during the oncologic follow-up. The patients underwent splenectomy for solitary
      splenic metastasis. We conclude that the use of serum carcinoembryonic and CA 19
      9 values may help in the early diagnosis of these recurrences and splenectomy
      allows radical treatment in patients with no evidence of disseminated disease.

PMID- 11202801
TI  - Hepatic angiosarcoma occurring after cyclophosphamide therapy: case report and
      review of the literature.
AB  - A 54-year-old man with polyarteritis nodosa developed acute onset of right upper
      quadrant abdominal pain associated with a large liver mass. Transvenous liver
      biopsy revealed hepatic angiosarcoma, a rare liver tumor classically associated
      with environmental toxins. He had been treated with oral cyclophosphamide for 13
      years. A review of the literature revealed two other cases of hepatic
      angiosarcoma in patients after long-term cyclophosphamide treatment. We propose
      that cyclophosphamide be added to the list of exposures potentially associated
      with hepatic angiosarcoma.

PMID- 11202802
TI  - Dose-response relationships for radiotherapy of brain metastases: role of
      intermediate-dose stereotactic radiosurgery plus whole-brain radiotherapy.
AB  - The effects of intermediate-dose radiotherapy consisting of whole-brain
      radiotherapy (WBRT, 10 fractions of 3 Gy) plus stereotactic radiosurgery (SRS)
      were studied prospectively. Twenty-five adult patients with 31 brain metastases
      received WBRT plus linear accelerator (LINAC)-based single dose SRS with fixed
      treatment parameters (10 Gy at the isocenter, target volume enclosed by the 90%
      isodose). Median age was 63 years, median Karnofsky performance status 80%, and
      median diameter of brain metastases 2.4 cm. Fifteen patients had non-small-cell
      lung cancer. Because of some early deaths, only 26 lesions could be evaluated for
      response. We observed 1 complete and 15 partial remissions. Median time to
      progression inside or outside the SRS volume was 4.5 months. Actuarial local
      control of SRS-treated lesions was 61% at 1 year. At that time, only 37% of
      patients were free from new lesions outside the SRS volume. Median survival and
      cause-specific survival were 2.3 and 4.5 months, respectively (1-year survival
      rate 8% and 21%). Ten patients died of progressive brain metastases, 13 from
      extracranial disease progression (unknown cause of death in 2 cases). Comparable
      to SRS studies with higher doses, the majority of brain failures occurred outside
      the SRS volume and more patients died of extracranial progression than of
      uncontrolled brain metastases. Failure to improve survival can be explained by
      the high percentage of patients with extracranial metastases (52%). However, the
      present results appear less favorable than those of previous studies of SRS with
      15 Gy to 16 Gy (1-year actuarial local control rates of 66-89%). Therefore, we
      recommend SRS with 15 Gy to 16 Gy for patients whose favorable prognostic factors
      justify a boost after WBRT.

PMID- 11202803
TI  - Phase II pilot study of combined chemohormonal therapy with doxorubicin and
      estramustine in metastatic prostate cancer.
AB  - Twenty-nine patients with progressive hormone-refractory metastatic
      adenocarcinoma of the prostate were treated with daily estramustine phosphate at
      10 mg/kg, and I.V. doxorubicin 50 mg/m2 every 3 weeks. Twenty-six patients were
      evaluable. Four of seven patients with nonosseous measurable disease had partial
      responses lasting 3 to 10 months. Eleven of 19 patients with osseous metastases
      had stable disease or improvement on bone scan, 6 of these for 7 months or
      longer. Median time to progression was 20 weeks, and the median survival was 43
      weeks.

PMID- 11202804
TI  - Reversible renal toxicity resulting from high single doses of the new
      radiosensitizer gadolinium texaphyrin.
AB  - Gadolinium (III) texaphyrin (Gd-Tex) (NSC 695238) is a potential radiation
      sensitizer that selectively localizes in tumors and is detectable by magnetic
      resonance imaging (MRI). In this single-dose phase I trial, reversible renal
      injury was the dose-limiting toxicity. This report details that renal injury. A
      single intravenous dose of Gd-Tex was followed 2 hours later by radiation
      therapy. The Gd-Tex dose was escalated in 13 patient cohorts. Doses ranged from
      0.6 to 29.6 mg/kg. The maximum tolerated dosage (MTD) was 22.3 mg/kg. Three
      patients had grade II and one had grade III acute nonoliguric renal failure at
      the 22.3 and 29.6 mg/kg dose levels. The injury was always transient, and
      responded to fluid restriction and renal diet. In all patients, transient green
      discoloration including urine developed at doses > or =7.1 mg/kg. MRI studies
      demonstrated image enhancement in the liver, kidneys, and in primary and
      metastatic tumors in all patients receiving >5.4 mg/kg. It is important that the
      liver and kidneys be excluded from the radiation volume. Gd-Tex was well
      tolerated at doses below the MTD. It is important that the liver and kidneys be
      excluded from the radiation volume. We recommend that 16.7 mg/kg be used as the
      maximum single dose to obviate even low grade renal toxicity.

PMID- 11202805
TI  - Endoscopic findings in chronic lymphocytic leukemia.
AB  - Retrospective studies, based on autopsy findings, indicate that infiltration of
      the gastrointestinal tract complicates leukemia of all types and may be present
      from the esophagus to the rectum. This report presents what is believed to be the
      first reported case of a patient with chronic lymphocytic leukemia with evidence
      of esophageal, gastric, duodenal bulb, and colonic involvement confirmed by
      mucosal biopsy at endoscopy.

PMID- 11202807
TI  - Tissue polypeptide-specific antigen and carcinoembryonic antigen for early
      prediction of recurrence in lung adenocarcinoma.
AB  - Fifty patients with lung adenocarcinoma, including 20 cases with recurrence and
      30 cases without recurrence 1 year after operation, were enrolled in this study.
      The serial serum levels of tissue polypeptide-specific antigen (TPS) and
      carcinoembryonic antigen (CEA) were measured before operation and at 1 week, and
      at 1, 3, 6, 9, and 12 months after operation for early detection of recurrence.
      The results revealed that: 1) mean serum values of TPS were significantly higher
      at 1, 3, 6, 9, and 12 months after operation in 20 patients with recurrent
      adenocarcinoma, when compared with 30 patients without recurrent adenocarcinoma;
      2) mean serum values of CEA were significantly higher at 9 months and 12 months
      after operation in 20 patients with recurrent adenocarcinoma, when compared with
      30 patients without recurrent adenocarcinoma. We conclude that TPS is a better
      marker than CEA for early prediction of adenocarcinoma recurrence in lung within
      1 year after operation. However, a longer follow-up study should be encouraged.

PMID- 11202806
TI  - Phase II study of intravenous CI-958 in metastatic colorectal adenocarcinoma.
AB  - In a multicenter, phase II trial, CI-958, a benzothiopyranoindazole DNA
      intercalator, was administered to 18 patients who had not received prior
      chemotherapy for metastatic colorectal cancer. The drug was given by intravenous
      infusion at a dose of 700 mg/m2 every 21 days. There were no objective responses.
      Grades III and IV toxic effects were limited to granulocytopenia in 42% of
      courses and anemia in 5% of courses. There was one case of grade III increase in
      transaminases. Our results show that at this dose and schedule, CI-958 lacks
      activity against colorectal cancer.

PMID- 11202808
TI  - Phase I trial of paclitaxel and etoposide for recurrent ovarian carcinoma: a
      Gynecologic Oncology Group Study.
AB  - A phase I study was performed to determine the maximum tolerated doses of
      intravenous etoposide and paclitaxel for women with previously treated persistent
      or recurrent ovarian cancer. Starting doses were paclitaxel 135 mg/m2 during 24
      hours and etoposide 50 mg/m2/day for 3 consecutive days. The study was designed
      to escalate first the dose of etoposide, and then the dose of paclitaxel, in
      successive cohorts of patients. In an attempt to determine whether toxicity was
      affected by sequence of the drugs, the order of administration of the two drugs
      was reversed on alternate cycles. The starting doses of paclitaxel (135 mg/m2/24
      hours) and etoposide (50 mg/m2/day x 3) caused severe neutropenia even with the
      addition of granulocyte colony-stimulating factor, and the trial was amended to
      administer the paclitaxel during 3 hours. However, this also proved too
      myelosuppressive without growth factor support. Twenty-one women were treated. A
      complete response was observed in one of nine patients with measurable disease,
      and a major decrease in CA-125 was noted in two patients who did not have
      measurable disease. Because of the severe myelosuppression observed in most
      patients, dose reduction was often required after the first cycle. The power to
      detect sequence-dependent variation in toxicity was minimal; however, no large
      differences were observed. A combination of the usual doses of these drugs will
      be difficult to administer in patients who have received previous chemotherapy
      for ovarian cancer.

PMID- 11202809
TI  - Multicentric phase II study of cisplatin and etoposide in patients with
      metastatic carcinoma of unknown primary.
AB  - The aim of this study was to determine the efficacy and toxicity of combination
      cisplatin and etoposide chemotherapy in patients with metastatic carcinoma of
      unknown primary. Patients were treated with cisplatin (100 mg/m2 iv day 1)
      followed by etoposide (100 mg/m2 iv days 1-3) every 3 weeks for a maximum of 6
      cycles. Patients with progressive disease after two or four courses could receive
      FAC (fluorouracil, doxorubicin, and cyclophosphamide) until progression. Twenty
      five patients were entered and were assessable for response and toxicity. Fifteen
      (60%) patients had adenocarcinomas. Patients received a median of four courses.
      Toxicity was mainly hematologic including grade III/IV neutropenia. The overall
      response rate was 32%. There was no complete response, 32% partial responses, 32%
      stable disease, and 36% disease progression. Median response duration was 4
      months (range: 2-5 months). The median overall survival of the 25 patients was 8
      months. No objective response could be obtained with FAC, but 33% of patients
      achieved stabilization of the disease for at least 3 months. This cisplatin
      etoposide combination demonstrated some activity against an usually resistant
      disease.

PMID- 11202810
TI  - Methotrexate, uracil and tegafur, and leucovorin chemotherapy for patients with
      breast cancer in progression after high-dose chemotherapy with peripheral blood
      progenitor cell transplant: a phase II study.
AB  - Thirty-four patients with metastatic breast cancer (MBC) who had progression of
      disease after high-dose chemotherapy (HDCT) with peripheral blood progenitor cell
      support (PBPC) had methotrexate, uracil and tegafur (UFT), and leucovorin (MUL)
      therapy administered: methotrexate administered intramuscularly in combination
      with UFT given orally and leucovorin given orally. All patients had received
      extensive prior chemotherapy including a high-dose regimen with PBPC support. Two
      complete responses (CR) and 11 partial responses (PR) were observed (objective
      response rate: 13/34 or 38%, 95% confidence interval 22-56%). Seven additional
      patients had stable disease (SD), 4 of whom (12% of the total population) of 6
      months or longer duration, with the clinical benefit rate (CR + PR + SD of at
      least 6-month duration) reaching 50%. Median follow-up was 38 months, and the
      median time to progression and the median overall survival time from the start of
      MUL were 5.5 and 11 months, respectively. Toxicity was mainly gastrointestinal.
      Eight patients (24%) had World Health Organization grade II or greater diarrhea
      and/or enteritis and, consequently, the UFT dose was reduced. Emesis was mild and
      easily manageable with thiethylperazine given orally. The regimen did not produce
      significant myelosuppression or alopecia. In conclusion, patients with MBC retain
      chemosensitivity even when they progress after HDCT/PBPC and can be treated again
      with chemotherapy. MUL is active and well tolerated in patients with MBC
      progressing after HDCT. Further studies with this regimen, as salvage
      chemotherapy or as maintenance chemotherapy after HDCT/PBPC, would appear to be
      warranted.

PMID- 11202811
TI  - Effect of vinorelbine, ifosfamide, and cisplatin combination chemotherapy in
      advanced non-small-cell lung cancer.
AB  - Cisplatin-based chemotherapy is being tried in the treatment of nonoperable cases
      of non-small-cell lung cancer (NSCLC). However, the prognosis is unfavorable and
      to improve survival, clinical studies using various combinations of a variety of
      drugs as well as experimental material are in progress. We compared the efficacy
      and toxicities of combination chemotherapy using different doses of vinorelbine
      and ifosfamide with a constant dose of cisplatin in this study. Patients
      diagnosed with inoperable stage III or IV NSCLC between June 1997 and December
      1998 were included. Cisplatin was administered at a constant dose of 80 mg/m2 on
      day 5, whereas vinorelbine on days 1 and 5 and ifosfamide on day 5 were
      administered in one of two different doses. In arm A, vinorelbine 25 mg/m2 and
      ifosfamide 3.0 g/m2 were administered. In arm B, vinorelbine 20 mg/m2 and
      ifosfamide 2.5 g/m2 were administered. Also, we reviewed for phase II and III
      studies that test 1) cisplatin, 2) vinorelbine monotherapy, and 3)
      vinorelbine/cisplatin/ifosfamide combination chemotherapy for stage IIIb-IV non
      SCLC. Summation dose intensity (SDI) was calculated in each published and current
      study. Twenty patients in arm A and 35 patients in arm B were available for
      evaluation. There was no difference in patient activity, pathologic diagnosis,
      and differentiation or stage between the two arms. The median number of cycles
      was four in both arms. The response rate was 50% in arm A and 30% in arm B. The
      median survival times for arm A and B were 40 and 42 weeks, respectively, whereas
      the SDI was 1.94 and 1.7, respectively. More than grade III leukopenia was
      observed in 28.9% in arm A, which is more frequent than the 17.2% in arm B. There
      was a significant correlation between the SDIs and response rates and median
      survival (r2 = 0.629, p = 0.001; r2 = 0.453, p = 0.001, respectively). Although
      the follow-up period is relatively short, the survival time was similar in both
      arms. Because a high response rate may not be followed by a high survival time in
      combination chemotherapy of NSCLC, further studies on the appropriate dose of
      individual agents with regard to the relationship between response rate,
      severity, and incidence of toxicities and survival rate should be carried out.

PMID- 11202812
TI  - Effects of a single and double commercial athletic mouthpiece on expiratory peak
      flow: a pilot study.
AB  - Utilizing an Assess Peak Flow Meter, six healthy subjects with no lung disease
      volunteered to have their expiratory peak flow measured under the following five
      conditions: 1. Biting on the oral tube of the peak flow meter and lip-sealing the
      tube; 2. Using a custom built diaphragm allowing the subject to lip-seal the tube
      of the peak flow meter without biting on it; 3. Using orange wood blocks of known
      dimension bilaterally on the posterior occlusion, and a custom built diaphragm
      allowing the subject to lip-seal the oral tube of the peak flow meter without
      biting on it; 4. Using a commercial single (maxillary) athletic mouthpiece and a
      custom built diaphragm allowing the subject to lip-seal the oral tube of the peak
      flow meter without biting on it; and 5. Using a commercial double (maxillary and
      mandibular) athletic mouthpiece and a custom built diaphragm allowing the subject
      to lip-seal the oral tube of the peak flow meter without biting on it. Expiratory
      peak flow measurements were virtually the same whether the subjects bit and lip
      sealed on the oral tube of the peak flow meter, used the custom diaphragm and lip
      sealed without biting on the oral tube of the peak flow meter, or bit on the
      orange wood blocks while using the custom diaphragm and lip-sealing without
      biting on the oral tube. There was significant deterioration (p < .0001) in
      expiratory peak flow volume when either the single or double commercial athletic
      mouthpieces were employed.

PMID- 11202813
TI  - The influence of forward head posture on dental occlusion.
AB  - A well established premise in the field of craniomandibular and cervical spine
      orthopedics is that forward head posture (FHP) adversely affects mandibular
      position and therefore dental occlusion. The purpose of this study was to
      investigate the influence of FHP on the initial occlusal contact pattern (IOCP)
      in order to provide further clarification on this important topic. Thirty-nine
      healthy subjects, 10-74 years old, underwent a series of tests in which the IOCP
      was recorded in four different head positions using the T-Scan Occlusal
      Diagnostic System. Three tests each were performed in military posture (MP),
      natural sitting posture (NP), FHP, and maximal forward head posture (MFHP) for a
      total of twelve trials. A repeated measures analysis of variance failed to
      demonstrate a correlation between FHP and IOCP; however, a multiple linear
      regression analysis revealed a relationship between age and the IOCP. This study
      raises questions about the relationship between FHP and occlusion.

PMID- 11202814
TI  - Facial pain and temporomandibular disorders: an epidemiological study of the
      Northern Finland 1966 Birth Cohort.
AB  - Recent clinical studies have shown an association between temporomandibular
      disorders (TMD) and facial pain. The aim of this epidemiological study was to
      investigate the prevalence of facial pain and TMD, their relation to each other,
      and also their relation to previous traumas, occlusal factors and pain in other
      areas of the body. The study is a part of the Well-Being and Health Research of
      the Northern Finland Birth Cohort 1966 using questionnaires where data on facial
      pain, TMD symptoms, occlusal divergencies, traumas in the face and other pain
      areas of the body were registered. Data were obtained from 5696 subjects born in
      the year 1966 in northern Finland. Twelve percent of the men and 18% of the women
      had suffered from facial pain during the last year. The most often reported
      symptom of TMD was clicking of the temporomandibular joints (TMJs) (21% in men,
      28% in women), while prevalence of more severe symptoms was 13% or under. Facial
      pain was related to symptoms of TMD, as well as to traumas in the face or TMJs,
      distal occlusion and other pain areas (neck, shoulders, arms, lower back, jaws,
      tooth). The results suggest that facial pain is a usual symptom in adult
      population, and has an association with TMD, as well as with other
      musculoskeletal pain symptoms. Traumas to face and TMJs, certain occlusal factors
      and dental pathology may have a remarkable role in the etiology.

PMID- 11202815
TI  - Rotational and translational loading of the temporomandibular joint.
AB  - Following an introduction to the functional properties of a three-dimensional
      instantaneous helical axis pertaining to circular (rotatory) and linear
      (translatory) motions of the mandible, this feasibility study applied the concept
      of a mandibular average finite helical axis to the maneuver of cyclic opening and
      closing of the mouth in three healthy subjects. Through the accelerations and
      decelerations of a mandibular incisor point (instead of a mandibular condylar
      point) as well as the laws of physics, the kinetic reaction forces and reaction
      pressures in the upper and lower cavities of the temporomandibular joint (TMJ)
      were estimated over opening-closing distances of five and ten mm from centric
      occlusion. The translatory reaction pressures in the upper TMJ cavity (17-29 mm
      Hg) exceeded the rotatory reaction pressures in the lower TMJ cavity (5-12 mm
      Hg). The estimated reaction pressures were in close agreement with synovial fluid
      pressures measured in vivo in the TMJ of humans and pigs, and the biologic
      significance of frequent and/or prolonged increased TMJ hydrostatic pressures is
      discussed.

PMID- 11202816
TI  - Is NIH capable of changing the lifestyle of all TMD patients?

PMID- 11202818
TI  - Arthrogryposis multiplex congenita in a patient with limited mouth opening: a
      case report.
AB  - This report describes a case of arthrogryposis multiplex congenita and
      concomitant bruxism with limited mouth opening and pain in the temporomandibular
      joints (TMJ). A conservative treatment with a myorelaxing splint and
      physiotherapeutic exercises was prescribed resulting in improvement to the
      muscular and joint conditions and a reduction in pain.

PMID- 11202817
TI  - Better palpation of pain: reliability and validity of a new pressure pain
      protocol in TMD.
AB  - The purpose of this research was to employ a double-blind placebo control design
      of iontophoretically administered lidocaine to assess the test-retest reliability
      and validity of a magnitude matching procedure using a pressure algometer. In
      studies in the literature on assessment of pain in temporomandibular disorders
      (TMD), the pressure algometer has been found to be a reliable means of measuring
      pressure-pain threshold and a sensitive measure of treatment-response in the
      laboratory. However, previous research with this apparatus has not employed more
      sophisticated psychophysics. This study employs a magnitude matching
      psychophysical protocol to obtain a multidimensional pain report. Test-retest
      reliability over two occasions, 3-8 days apart, was found to be moderate for
      discriminability (r = .71, p < .01) but poor for response bias (r = .44). The
      validity study used iontophoresis as an anesthetic in a double-blind placebo and
      no-treatment control design. Although it was hypothesized that subjects in the
      anesthesia group would demonstrate reduced discriminability as compared with the
      control groups, no differences were found among the three groups on this measure.
      However, differences in response bias were found, with both the placebo control
      and no-treatment control groups differing from the experimental group but not
      from each other. Possible explanations and the implications of these findings are
      discussed.

PMID- 11202819
TI  - Temporomandibular disorder treatment outcomes: first report of a large-scale
      prospective clinical study.
AB  - The diagnosis and treatment of temporomandibular disorders (TMD) has been
      surrounded by considerable controversy. Clinical research in the field to date
      has been inconsistent and methodologically limited and has not firmly established
      the role of treatment interventions. This large scale, multisite study attempts
      to answer some of the questions regarding TMD diagnosis and treatment. More than
      6,500 patients are currently being analyzed and 1,212 have completed TMD therapy,
      providing the basis for comparison with 198 untreated patients. A wide variety of
      treatments have been administered from 60 practice sites, whose practitioners
      were carefully calibrated to maximize inter-rater reliability. A validated
      symptom measurement system, the TMJ Scale, was employed to assure uniform
      assessment of treatment outcomes. Treated patients reported statistically and
      clinically significant symptom improvement, while untreated patients reported
      unchanged symptom levels. Data presented here do not support the hypothesis that
      TMD patients improve spontaneously without treatment.

PMID- 11202820
TI  - Relationship between craniomandibular disorders and poor posture.
AB  - The purpose of this research was to show that a relationship between
      craniomandibular disorders (CMD) and postural abnormalities has been repeatedly
      postulated, but still remains unproven. This study was intended to test this
      hypothesis. Twenty-five CMD patients (mean age 28.2 years) were compared with 25
      gender and age matched controls (mean age 28.3 years) in a controlled,
      investigator-blinded trial. Twelve postural and ten muscle function parameters
      were examined. Measurements were separated into three subgroups, consisting of
      those variables associated with the cervical region, the trunk in the frontal
      plane, and the trunk in the sagittal plane. Within these subgroups, there was
      significantly more dysfunction in the patients, compared to control subjects
      (Mann-Whitney U test p < 0.001, p < 0.05, p < 0.01). Postural and muscle function
      abnormalities appeared to be more common in the CMD group. Since there is
      evidence of the mutual influence of posture and the craniomandibular system,
      control of body posture in CMD patients is recommended, especially if they do not
      respond to splint therapy. Whether poor posture is the reason or the result of
      CMD cannot be distinguished by the data presented here.

PMID- 11202821
TI  - Prolonged mandibular hypomobility patient with a "square mandible" configuration
      with coronoid process and angle hyperplasia.
AB  - The objective of this study was the surgical management of chronic severe
      mandibular hypomobility patients associated with square mandible morphology with
      coronoid process and angle hyperplasia, and one-year follow-up data is reported.
      Ten patients were studied. All patients were female and had a history of gradual
      severe jaw hypomobility. Clinical findings were similar to those of a "closed
      lock" patient. However, the facial appearance in these patients showed a
      characteristic square mandible facial configuration. Coronoid process thickening
      and overgrowth of the mandibular angle was evident in the radiographic findings.
      Diagnostic imaging scarcely depicted any disk derangement, but a severely limited
      jaw opening was noted in spite of acceptable excursive jaw movements. Bilateral
      coronoidotomy or coronoidectomy was done initially, and then masseter muscle
      stripping via the intraoral approach. After successful reduction of jaw
      hypomobility, a selective mandibular anglectomy was completed. Physical therapy
      began within three to five days after the surgery. Postoperatively, all patients
      were questioned about their jaw function and their subjective assessment of the
      treatment. Interincisal jaw opening was recorded with a ruler marked in
      millimeters. Bilateral coronoidotomy or coronoidectomy and masseter muscle
      stripping were done for all patients; the mandibular anglectomy was performed in
      seven of the cases at 13 sites. Simultaneous TMJ surgery was done on three joints
      for three patients. Most patients reported improvement of jaw function, and the
      patients' subjective assessment revealed an average satisfaction rate of 74.6%. A
      preoperative mean jaw opening distance of 25.6 mm increased to 36.6 mm
      postoperatively at a one-year follow-up (p < 0.05). The conclusion was that
      surgical intervention is indicated when nonsurgical treatment is unsuccessful.
      Etiology is unknown, but masseter and temporal muscle contracture associated with
      mandibular coronoid and angle hyperplasia may be a strong component of the
      pathophysiology.

PMID- 11202822
TI  - The effect of surgical treatment of the temporomandibular joint: a survey of 70
      patients.
AB  - Most patients with temporomandibular disorders (TMD) can be successfully treated
      by conservative methods, but approximately 10-20 percent have persistent
      symptoms. The aim of this study was to evaluate the signs and symptoms of TMD in
      patients treated with open surgery of the TMJ. Seventy-two patients (13 men, 59
      women, mean age 37 years, range 14-68 years) were evaluated during an eight-year
      period. Altogether 45 right TMJs and 39 left TMJs were treated, including both
      TMJs during the same operation in eight of the cases. The patients were evaluated
      at follow-up in 1997. The degree of TMD at follow-up was assessed using the
      anamnestic and clinical dysfunction Helkimo indices. Most of the patients
      reported at the follow-up that they were subjectively satisfied with the surgical
      treatment. The main clinical findings in the post surgical patients at follow-up
      were TMJ sounds and deviation of the mandible during opening. The tenderness in
      the masticatory muscles and TMJs on palpation was reduced significantly and the
      ranges of mandibular movement were improved for all the patients. The mean
      anamnestic and clinical indices decreased with a statistical significance from
      the shortest follow-up group (Group I) to the longest on group (Group IV) (p =
      0.000). The conclusion of this study was that after open surgical treatment of
      the TMJ, the patients have significantly better functioning of the masticatory
      system and reduced signs and symptoms of TMD in the long term.

PMID- 11202823
TI  - Relationship between dental occlusion and posture.
AB  - The purpose of this study is to show the effects of dental occlusion on postural
      position. Thirty subjects were divided into two groups: an experimental group who
      wore mandibular orthopedic repositioning appliances (MORA) and a control group
      who wore no oral device. All of the subjects underwent the same Fukuda
      Unterberger experimental stepping test to check their postural attitude. Any
      deviation of the subject during the test from his initial position was analyzed.
      The results seemed to confirm that altering dental occlusion by wearing an oral
      appliance could induce some fluctuations in dynamic postural attitude. The
      phenomenon occurs after prolonged wearing of a MORA. Feedback effects are gradual
      after removing the mandibular splint.

PMID- 11202824
TI  - The effects of collagen hydrolysat on symptoms of chronic fibromyalgia and
      temporomandibular joint pain.
AB  - Twenty (20) people who had medically diagnosed fibromyalgia for two to 15+ years
      participated in and completed a 90-day evaluation to determine effects of
      collagen hydrolysat on symptoms of chronic fibromyalgia, with twelve reporting
      temporomandibular joint pain. Collagen hydrolysat is a food supplement that is
      available without prescription, with no known side effects. Participants were
      evaluated initially and then at 30-, 60-, and 90-day periods. Final results were
      obtained and comparisons made. The average pain complaint levels decreased
      significantly in an overall group average, and dramatically with some
      individuals. It was concluded that patients with fibromyalgia and concurrent
      temporomandibular joint problems may gain symptomatic improvement in their
      chronic symptoms by taking collagen hydrolysat.

PMID- 11202825
TI  - A study of dentists' knowledge and beliefs regarding temporomandibular disorders
      in Korea.
AB  - The purpose of this study was to examine the knowledge and beliefs regarding TMD
      (temporomandibular disorders) held by practicing dentists in Seoul, the capital
      and largest city in Korea. Four aspects of TMD (psychophysiological, psychiatric
      disorders, chronic pain and pathophysiological) were examined. The results
      indicate that while the role of psychophysiologic factors in the etiology of TMD
      and the role of psychiatric disorders is relatively widely acknowledged in the
      practicing community, there is a high level of controversy regarding the
      pathophysiology of TMD and the appropriate diagnosis and treatment of these
      chronic conditions. The findings partially duplicate a similar survey of dentists
      in Seattle, Washington, and one survey done in Kansas in the United States.

PMID- 11202826
TI  - Orofacial pain specialty opposition. A call to "de-fragment".

PMID- 11202827
TI  - In response to John Radke's January 2000 editorial.  Dr. Gottlieb says, "beware
      of the obvious.".

PMID- 11202828
TI  - Surface electromyographic evaluation of the asymptomatic human masseter muscle
      with turns and amplitude analysis.
AB  - Electromyographic turns, or reversals of direction, per second (TS) and mean
      amplitude per turn (AT) are variables that have been widely used to assist and
      support an electrodiagnosis in neuromuscular disorders. The purpose of this study
      was to explore the feasibility of utilizing the TS and AT in conjunction with
      surface electrodes as a method for assessing masticatory muscle function. Ten
      normal subjects were instructed to exert brief isometric contractions at various
      levels, and the TS and AT were calculated from the surface electromyographic
      signals of the masseter muscle. Our results showed that the AT increased with
      contraction at all contraction levels, demonstrating a linear relationship, while
      the TS showed a nonlinear increase characterized by an initial steep rise
      followed by a plateau, which was simulated with a third polynomial function. It
      is considered that the TS and AT may provide valuable physiological information
      about the underlying mechanisms of recruitment and the firing of motor units.

PMID- 11202829
TI  - Prevalence and patterns of nocturnal bruxofacets on stabilization splints in
      temporomandibular disorder patients.
AB  - The purpose of this study was to investigate the prevalence of nocturnal bruxism,
      the characteristics of bruxofacets, and the reduction of symptoms in
      temporomandibular disorder (TMD) patients. The study involved the observation of
      bruxofacets on a stabilization splint. Twenty-six patients (22 women and 4 men,
      16-54 years of age) with signs and symptoms of TMD were given an initial
      examination before using a splint, and then at intervals of one, three, six and
      ten weeks after a stabilization splint was first used. In 88% of the patients (n
      = 23) active shiny facets or scratches caused by nocturnal bruxism appeared on
      the occlusal surface of splints within ten weeks. In 52% of the 23 patients these
      facets were created by bilateral mandibular excursions, in 35% by small lateral
      movements, and in 13% by unilateral excursions. Subjective pain and the
      Craniomandibular Index in patients had decreased after ten weeks (p < 0.001), but
      a reduction of symptoms did not differ according to the patterns of the
      bruxofacets. It was concluded that most TMD patients have a parafunctional habit,
      namely bruxism. Further research is needed to produce more convincing evidence of
      a true cause-and-effect relationship between nocturnal bruxism and TMD.

PMID- 11202830
TI  - Effects of a mandibular advancement device for the treatment of sleep apnea
      syndrome and snoring on respiratory function and sleep quality.
AB  - In this study the fabrication of a simplified mandibular advancement device for
      sleep apnea syndrome was described. Its effect on respiratory function and sleep
      quality variables was evaluated polysomnographically in 256 patients with sleep
      apnea syndrome and snoring. Polysomnographic recordings were performed twice,
      before and after insertion of the oral appliance. The mean apneahypopnea index
      (AHI) decreased significantly (p < 0.0001) with the appliance to 18.2 from 43.2
      without it. Responders defined by AHI < 10 were 54% and those defined as a 50%
      decrease of AHI were 66%. Oxygen saturation, duration of apnea, sleep efficiency,
      and total arousal were improved significantly after treatment without major side
      effects. The device improved significantly the respiratory function and sleep
      quality in patients with sleep apnea syndrome. Compliance was about 90% followed
      for 2.5 years. This appliance offers some advantages over other therapies because
      it is noninvasive, easy to fabricate, and well accepted by patients.

PMID- 11202831
TI  - A difficult path to walk.

PMID- 11202832
TI  - Another voice is heard in support of rejecting specialty status for orofacial
      pain.

PMID- 11202833
TI  - The craniocervical connection: a retrospective analysis of 300 whiplash patients
      with cervical and temporomandibular disorders.
AB  - Because the concept of whiplash as a causative factor for temporomandibular
      disorders (TMD) is highly controversial, we decided to do a retrospective
      analysis of patients treated in our office who had sustained whiplash injuries
      and were treated for cervical and temporomandibular disorders. The records of 300
      patients with TMD preceded by a motor vehicle accident were examined
      retrospectively. The most common presenting symptoms, in order, were: jaw pain,
      neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular
      joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger
      points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle
      hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical
      examination, we concluded that the TMJ and surrounding musculature should be
      examined similarly to other joints, with no preconceived notion that TMD
      pathology after whiplash is unlikely.

PMID- 11202834
TI  - An alternate technique for management of acute closed locks.
AB  - The article introduces an alternative method for manipulation and reduction of
      acute closed locks. The method is described as the Assisted Lateral Reduction
      Technique (ALRT). The authors have used the ALRT on more than 150 patients and
      found it more effective and easier to administer than the more common
      manipulation and reduction techniques (MRT) in the management of acute closed
      locks which have been extensively documented in the literature. Both techniques
      are highlighted, compared, and discussed in the article.

PMID- 11202835
TI  - Orofacial sensory changes and temporomandibular dysfunction.
AB  - Orofacial sensory changes are uncommon complaints that can coexist with
      temporomandibular dysfunction (TMD). The location, character, and intensity vary
      greatly with each individual and symptom fluctuation is not unusual for any
      patient. The etiology of orofacial sensory changes may be related to either local
      or systemic factors. Several investigators have reported that muscle entrapment
      of branches of the third division of the trigeminal nerve may result in orofacial
      sensory disruption. Different theories have been suggested to illustrate how TMD
      and trauma might be associated with these neurological changes. Additionally,
      several mechanisms exist to explain how muscle spasms may be responsible for
      nerve compression in individuals with normal anatomy and in those with anatomical
      variations. In this study, thirty subjects from a group of 282 TMD patients were
      found to have coexisting orofacial sensory disturbances and TMD. Subjects
      presenting with any neurological complaints should alert the clinician to the
      possibility that these symptoms may be the early clinical signs of serious
      disease.

PMID- 11202836
TI  - Effects of head and neck inclination on bilateral sternocleidomastoid EMG
      activity in healthy subjects and in patients with myogenic cranio-cervical
      mandibular dysfunction.
AB  - This study was conducted in order to determine the effect of head and neck
      position on bilateral electromyographic (EMG) activity of the sternocleidomastoid
      muscles. The study was performed on 16 patients with myogenic cranio-cervical
      mandibular dysfunction (CMD) and 16 healthy subjects. EMG recordings at rest and
      during swallowing of saliva and maximal voluntary clenching were performed by
      placing surface electrodes on the right and left sternocleidomastoid muscles. EMG
      activity was recorded in the left lateral decubitus position, in a darkened room
      and with the individual's eyes closed, under the following experimental
      conditions: 1. Head, neck, and body horizontally aligned; 2. Head and neck
      upwardly inclined with respect to the body, simulating the effect of a thick
      pillow, 3. Head and neck downwardly inclined with respect to the body, simulating
      the effect of a thin pillow. Variation of head and neck positions was determined
      by measuring the distance from the angle of neck and shoulder and the apex of the
      shoulder (SND = shoulder-neck distance) of each individual. Then, head and neck
      were forward or downwardly inclined with respect to the body at one-third of SND.
      A significantly higher contralateral EMG activity and a more asymmetric EMG
      activity were observed in the CMD group than in the healthy subjects (Kruskal
      Wallis Test). These results suggest a different behavior of bilateral
      sternocleidomastoid EMG activity in CMD patients than in healthy subjects
      depending on the positioning of the head and neck.

PMID- 11202837
TI  - Relationship between systemic joint laxity, TMJ hypertranslation, and intra
      articular disorders.
AB  - The aim of this study was to evaluate the correlation between general joint
      hypermobility, temporomandibular joint (TMJ) hypertranslation and signs and
      symptoms of TMJ intra-articular disorders. One hundred twenty individuals
      constituted the sample, divided into two groups: Group I (symptomatic) included
      60 patients with complaints of joint noises, pain, or jaw locking, and Group II
      (nonsymptomatic) included 60 people with no TMD complaints. The Beighton's
      hypermobility score addressed the systemic laxity while lateral x-rays taken in
      both closed and full open mouth positions measured TMJ mobility (condyle
      hypertranslation). No association was found between intra-articular disorders and
      systemic hypermobility (p > 0.05). A significant negative correlation (p < 0.05)
      was found between age and systemic hypermobility, while no correlation was
      detected between systemic and TMJ hypermobility (condyle hypertranslation).

PMID- 11202838
TI  - Effect of parafunctional clenching on temporomandibular disorder pain and
      proprioceptive awareness.
AB  - This study tested the hypothesis that parafunctional clenching increases pain,
      can lead to a diagnosis of temporomandibular disorder (TMD) pain, and can produce
      reductions in proprioceptive awareness. Twenty individuals participated in EMG
      biofeedback training sessions on the left and right temporalis and masseter
      muscles. No subjects had TMD prior to training. Subjects were randomly assigned
      to either a Decrease group, who were instructed to maintain EMG activity below 2
      microV during training, or an increase group, who were instructed to maintain EMG
      activity above 10 microV. To test the impact of parafunctional clenching on
      proprioceptive awareness, all subjects were instructed to barely touch their
      teeth together while EMG activity was recorded pre- and post-training. Three
      subjects assigned to the Increase group and no subjects assigned to the Decrease
      group were diagnosed with TMD pain following training. Self-reported pain post
      training was significantly higher for the Increase group. Parafunctional
      clenching did not affect performance in the proprioceptive test.

PMID- 11202839
TI  - Profile of TMD and Bruxer compared to TMD and nonbruxer patients regarding chief
      complaint, previous consultations, modes of therapy, and chronicity.
AB  - This comparative study by groups assesses the profiles of TMD (temporomandibular
      dysfunction) and bruxism patients and TMD-nonbruxing patients regarding chief
      complaint, previous medical and dental consultations, duration of the chief
      complaint, previous medication, and use of splints. The sample consisted of a
      group of 340 TMD patients, 275 of whom were bruxers and 65 who were nonbruxers.
      Both patients and controls were consecutive referrals over a period of five
      years. The group of TMD and Bruxer was classified according to the degree of
      severity. One hundred eight (108), 84, and 83 patients demonstrated mild,
      moderate, and severe bruxism respectively. Information gathered included a set of
      questionnaires, history of signs and symptoms, and a clinical examination. The
      most common chief complaints in TMD bruxers and nonbruxers were facial,
      temporomandibular joint, headache and/or cervical pain, and joint noises. It was
      observed that the need for medical and dental consultations increased with the
      severity of bruxism. It was also apparent in this study that the need for
      medication (analgesics, muscle relaxants, and antidepressants), increased with
      the severity of bruxism. Moderate and severe subgroups of bruxers used
      significantly more splints compared to mild bruxers and to TMD-nonbruxer
      patients. Both groups of TMD + bruxism and TMD - nonbruxism sought medical and
      dental consultations with dentists (clinicians and specialists) neurologists, and
      otolaryngologists more frequently compared to other medical professionals. Since
      the need for health services increased with the severity of bruxism, this study
      urges the need to include a protocol or questionnaire to assess the severity of
      bruxing behavior in TMD patients in order to use a customized method of
      treatment/management. This study also reinforces the point of view that different
      subgroups of TMD and bruxism do exist and suggests a differentiated therapeutic
      approach. They show previously confirmed findings that pain is the major
      complaint of TMD and bruxer patients.

PMID- 11202841
TI  - NYSTAR, New York's new organization to fund and promote academic research for the
      marketplace.

PMID- 11202840
TI  - Evaluation of the slope of the articular eminence and the transverse angle of the
      glenoid fossa in an Anatolian population.
AB  - The purpose of this study was to compare a computer-aided method specially
      programmed for the measurement of the posterior angle of the articular eminence
      with formerly used methods, to investigate the angulation differences at
      different depths of slices, and to evaluate correlation with the transverse
      angulation. Three slices (central, medial, and lateral) at various depths of the
      glenoid fossa belonging to 64 dry skulls and two measurement methods were used in
      this study. The angulation of the articular eminence were measured and the
      transverse angle of each fossa calculated. No statistical difference was found
      between the articular eminence results of the two methods. According to the
      results, the one factor ANOVA central slice was found to be statistically steeper
      than the other two slices (p < 0.05) (central = 60.33 +/- 10.19, medial = 58.26
      +/- 8.6, lateral 58.28 +/- 10.1). No correlation was found between the transverse
      angle of the inclination of the posterior slope angulation. It was concluded that
      the computer-aided method is more reliable and accurate and is much easier to use
      when compared to the manual method. An additional important finding of this study
      is that the inclination of the articular eminence should be evaluated at various
      depths of the temporomandibular joint.

PMID- 11202842
TI  - Dr. Friedman comments on Suarez article in the July issue of CRANIO in which he
      is cited as a reference.

PMID- 11202843
TI  - The trigeminal nerve. Part I: An over-view.
AB  - The trigeminal nerve is the largest and most complex of twelve cranial nerves.
      Its vast size and influence are greatly appreciated when one attempts to diagnose
      and treat patients suffering from orofacial pain and temporomandibular joint
      disorders. Without a thorough knowledge of the trigeminal nerve, the efficacy of
      diagnostic and therapeutic procedures will be very disappointing. This is the
      first of a four-part series of articles about the trigeminal nerve, a basic over
      view of both the gross and neuroanatomical structures is presented.

PMID- 11202844
TI  - The McGill Pain Questionnaire in patients with TMJ pain and with facial pain as a
      somatoform disorder.
AB  - The purpose of this study was to assess the discriminative capacity of the McGill
      Pain Questionnaire (MPQ) in patients with temporomandibular joint disorders (TMD)
      or with facial pain disorder as somatoform disorder (referred to as "atypical
      facial pain") (FP). The MPQ was administered to 57 TMD and 34 FP patients.
      Weighted MPQ item scores, subscale Pain Rating Indexes (PRI), and total Pain
      Rating Index were tested for significant differences (Student's t-test), and the
      frequency of descriptor choice was also analyzed. Furthermore, the data were
      processed through two systems based on a counter-propagation neural network: the
      Self-Organizing Map (SOM) system and a cluster-like analysis. In the FP group
      eleven MPQ item scores and five PRI scores were significantly higher than those
      of the TMJ group. There was a considerable difference in descriptor choice
      between the groups. SOM analysis and cluster-like analysis correctly
      discriminated 85% or more of the patients. In conclusion, the MPQ showed a
      consistent discriminative capacity between TMD and FP patients.

PMID- 11202845
TI  - Asymmetry of masticatory muscle activity during the closing phase of mastication.
AB  - The purpose of this study was to investigate the asymmetry of masticatory muscle
      activity between working and nonworking sides in the closing phase during
      mastication. Fifty adult subjects displaying normal oral function and occlusion
      participated in this study. Electromyographic (EMG) activity of the anterior
      temporalis and the superficial masseter muscle were recorded during mastication,
      simultaneously with motion data of the mandible. EMG activities of elevator
      muscles and their Asymmetry Index (AI) were analyzed depending on the vertical
      deviation of the lower incisal point with a two mm gap from the intercuspal
      position (ICP). EMG activities of both the anterior temporalis and the masseter
      on the working side were significantly greater than those on the nonworking side.
      Masseter muscles tended to show greater AI than the anterior temporalis muscles.
      Thus, asymmetry of the elevator muscles during mastication was a common finding
      in normal subjects. The normal range of variability of EMG activity and AI was
      confirmed in each section.

PMID- 11202846
TI  - Comparison of the effectiveness of arthrocentesis in acute and chronic closed
      lock: analysis of clinical and arthroscopic findings.
AB  - The objective of this study was to investigate the effectiveness of
      temporomandibular joint arthrocentesis in acute and chronic closed lock patients.
      Eighteen patients with closed lock of the temporomandibular joint (TMJ) were
      treated with fine needle fiber arthroscopic observation following arthrocentesis.
      Maximal mouth opening (MMO) and intensity of pain (VAS) were evaluated at
      pretreatment and each posttreatment appointment (one week, one month, three
      months following treatment). The clinical and arthroscopic findings were analyzed
      categorizing two groups into: good (A) and poor (B) groups. At pretreatment there
      was no significance relative to age or the mean MMO and VAS between the groups,
      but the mean of duration of the symptoms in group B was significantly longer than
      in group A (P < 0.03). Group B showed more severe synovitis, adhesions, and
      chondromalacia than group A (P < 0.01). Results suggest that arthrocentesis is
      more effective in closed lock of short duration where there is less severe
      synovitis, adhesions, and chondromalacia.

PMID- 11202847
TI  - Joint vibration analysis in patients with articular inflammation.
AB  - The study of articular sounds using a computerized system (SonoPAK) in patients
      with temporomandibular disorders (TMD) of inflammatory origin revealed an
      increase of vibratory energy when compared to asymptomatic individuals. The
      following conclusions were reached: 1. The amount of vibratory energy registered
      in these patients ranged from 8.50 to 57.61 Hz. The major vibrations occurred in
      the middle of the mandibular opening cycle; 2. The mean vibratory energy measured
      at less than 300 Hz was between 5.70 and 48.64 Hz and at higher than 300 Hz was
      between 3.70 and 8.99 Hz; 3. The peak amplitude in the patients with inflammation
      ranged from 0.35 to 3.96 Pascal and the peak of frequency from 83.20 to 120.20
      Hz.

PMID- 11202848
TI  - Different effects of nocturnal parafunction on the masticatory system: the Weak
      Link Theory.
AB  - It is proposed that damage to the masticatory system from intense parafunction
      can be assessed more accurately by the Weak Link Theory. The theory predicts that
      the more intense and the more prolonged the forces, the more the tendency of
      damage to either. 1. the periodontal tissue; 2. the teeth; or 3. the orofacial
      structures. To test the theory, 22 subjects were selected based on reports of
      nocturnal bruxism. Each was assessed for masticatory system breakdown on the
      Russell Periodontal Index, the Helkimo Dysfunction Index, and a Tooth Wear Index.
      A Bruxcore (Forgione, A. 1974 J Dent Res 53:127) was used to obtain an objective
      score of bruxism. Five of eleven subjects with mild bruxism scored high on only
      one index. Significantly more subjects (ten of eleven) with moderate to severe
      bruxism scored high on one index only.

PMID- 11202849
TI  - Synovial chondromatosis of the left temporomandibular joint superficially
      resembling chondrosarcoma: a case report.
AB  - A 25 year-old woman was referred to the clinic complaining of pain in the left
      temporomandibular joint (TMJ) and trismus. According to the x-ray images, a
      solitary mass was observed in the anterior pouch of the lower joint cavity. The
      mass was removed by means of a synovectomy and a diskectomy. Upon light
      microscopic examination, the tissue removed showed high cellular activity. As a
      differential diagnosis, we had to consider the possibility of chondrosarcoma
      based on the histopathological features; however, since no invasive nor
      metastatic finding was recognized, we made a diagnosis of synovial chondromatosis
      despite its rare existence. Although there has been no sign of recurrence at
      present, we plan to carefully follow up with the patient.

PMID- 11202850
TI  - Macrophages in periapical lesions.
AB  - Macrophages are major constituents of periapical granulomas. They have a central
      protective role in both innate immunity and adoptive, antigen-specific immune
      response. Macrophage activation may occur in periapical granulomas by cytokines
      produced by antigen-activated T-lymphocytes; by bacterial endotoxin, as part of
      the innate immunity; or by both these processes. Recent studies in athymic
      animals have shown that periapical granulomas may develop independently of T
      lymphocytes. This observation reveals the major role that the activated
      macrophage may have in the formation of periapical lesions. Only a few of the
      macrophages in the periapical granuloma are activated. Current studies indicate
      that these activated cells are the source of the bone-resorbing cytokines in the
      periapical granuloma. Understanding the central role of the activated macrophage
      in the formation as well as the perpetuation of periapical lesions may lead to
      the development of new diagnostic and therapeutic tools in endodontics.

PMID- 11202851
TI  - Direct and indirect time spent on care of dental trauma: a 2-year prospective
      study of children and adolescents.
AB  - The aim was to account for the total time spent by professional care-givers
      (direct time) and by patients and companions engaged as support and help
      (indirect time) to treat and otherwise attend to children and adolescents with
      dental trauma to primary and permanent teeth. The study was based on a random
      sample of 192 children and adolescents with dental traumas reported to an
      insurance company and prospectively followed up by telephone interviews over a
      period of 2 years after the trauma episode. On average, direct time represented
      16% of total time for all visits for dental trauma to permanent teeth and 11% for
      trauma to primary teeth. The most extensive type of indirect time was transport
      time, which took up 30% of the total time spent on injuries to permanent teeth
      and 36% for injuries to primary teeth. Multiple regression analysis of the impact
      of dental and demographic injury variables on the time variables showed that
      complicated trauma was associated with extended time, direct as well as indirect,
      for permanent and primary teeth injuries. Our estimate of the average relative
      increase in total time spent by patients and companions in cases of complicated
      injury to permanent teeth was 117% (95% confidence interval [CI], 52-211) for
      patients and 112% (95% CI, 42-217) for companions. For transport time a strong
      predictor was access to a dental clinic near the place of residence. Lack of
      access could extend the average transport time by 180% (95% CI, 80-335) for
      patients and 163% (95% CI, 67-317) for their companions in cases of injuries to
      primary teeth.

PMID- 11202852
TI  - Diagnosis of external root resorption using TACT (tuned-aperture computed
      tomography).
AB  - This study compared the ability of the TACT system of imaging and conventional D
      speed film to detect simulated resorptive defects in cadaver teeth and jaws.
      Mandibular human jaw blocks were prepared and then split through the teeth in a
      mesial to distal direction so that the mandibular halves could be opened and
      reassembled when necessary. One half of each of 42 teeth was extracted, and areas
      on the tooth and corresponding bone identified to be studied. The jaws were
      opened and reassembled after no defects or after defects of different sizes
      (0.25, 0.5, 1.0, 2.0 mm) were placed in the tooth and the corresponding bone at
      predetermined evaluation areas. The teeth were imaged after each stage with
      conventional D-speed film using a standard paralleling technique, and with a
      modified orthopantomograph OP100 machine using a Schick #2 size CCD sensor as the
      image receptor. The source images were registered and TACT slices were generated
      using TACT Workbench Software. Three observers were asked to identify the
      presence of resorptive defects in the conventional film group and the TACT image
      group using specific criteria. TACT imaging was statistically superior to
      conventional radiographs in detecting defects that were present (Wilcoxon matched
      pairs signed ranks test P = 0.003). This was true for all sizes of defects
      examined. There was no difference between the two modalities when a defect was
      not present.

PMID- 11202853
TI  - Leakage along warm gutta-percha fillings in the apical canals of curved roots.
AB  - The aim of this study was to investigate the leakage along the apical portion of
      warm gutta-percha obturated curved canals. Human mandibular premolars with
      single, curved (21 degrees-40 degrees) canals were prepared using the Lightspeed
      technique. Two groups of prepared canals, matched according to curvature and
      prevalence of apical transportation, were obturated by two techniques. Coronal
      gutta-percha was removed immediately after root obturation was completed to
      simulate the procedure for post space preparation. Leakage along the apical 3 mm
      of root filling was measured with a fluid transport device. Vertical condensation
      of warm gutta-percha and Pulp Canal Sealer provided less leakage than Thermafil
      plastic obturators and AH26 sealer (P = 0.002).

PMID- 11202854
TI  - An analysis of 58 traumatically intruded and surgically extruded permanent teeth.
AB  - Fifty-eight traumatically intruded and mainly surgically extruded permanent teeth
      were followed up for 3 years and 4 months (mid-term results: 29 teeth) and 9
      months (short-term results: 29 teeth) on average. Statistically, the mid-term
      results showed more cases of severe crown discoloration (54%) than the short-term
      results (9%), but no difference in pulpal and periodontal healing. Three teeth
      (5%) were lost. Factors which positively influenced pulpal healing were shallow
      intrusion depth, intact crown and immaturity of the root. Factors which
      positively influenced periodontal healing were shallow intrusion depth and
      minimal surgical manipulation. Alveolar bone healing was positively influenced
      only by shallow intrusion depth.

PMID- 11202855
TI  - Evaluation of a computer-assisted learning package on the management of
      traumatised incisors by general dental practitioners.
AB  - A computer-assisted learning program with a tutorial, self-assessment exercises
      and an expert system has been developed. Sixty-seven general dental practitioners
      were requested to evaluate the program. The results from those practitioners who
      returned the questionnaire showed that 57% found the program generally easy to
      use with the appropriate level of difficulty of tasks and content of supporting
      information, which it was felt improved their knowledge of the management of
      fractured incisors. CONCLUSION: It is worthwhile to develop such programs for the
      education of general dental practitioners. All users of this program felt that it
      was better than video, audio tapes, journals or books on the subject.

PMID- 11202856
TI  - Multiple fractures of primary molars caused by injuries to the chin: report of
      two cases.
AB  - Two cases of multiple fractures of the primary molars caused by injuries to the
      chin are presented. Clinical and radiographic examinations revealed a vertical
      fracture line in the maxillary and mandibular primary molars. Pulpotomy or
      pulpectomy treatment was performed on the affected teeth, which were then
      restored with preformed stainless steel crowns.

PMID- 11202857
TI  - Hypothermic insult to the periodontium: a model for the study of aseptic tooth
      resorption.
AB  - The aim of the current investigation was to define an animal model for the study
      of hard tissue resorption by examining the responses of the periodontal ligament
      (PDL) to both single and multiple episodes of hypothermic injury to the crowns of
      rat teeth. A group of 12 male rats weighing 200-250 g were anesthetized, and
      pellets of dry ice (CO2) were applied once to the crowns of the right first
      maxillary molars for continuous periods of 10 or 20 min. Animals were sacrificed
      at 2, 7, 14 and 28 days and tissues were processed for routine histological
      examination. A second group of eight animals and a third group of 12 animals were
      subjected to three applications of dry ice over a period of 1 week and sacrificed
      at 2 and 14 days respectively after the final application. In addition to thermal
      insult, the periodontium of teeth from a fourth group of six rats was subjected
      to mechanical trauma. Examination of the sections from the group undergoing a
      single freezing episode revealed that, by 1 week, shallow resorption lacunae had
      appeared on the root surface. These became more extensive after 14 days. At the
      same time hyaline degeneration was evident in the PDL. Within this group, teeth
      subjected to the longer 20-min application times generally showed more extensive
      injuries. By 28 days, evidence of repair was observed with reparative cementum
      beginning to line the resorption lacunae in the root dentin. Sections from
      animals subjected to multiple episodes of thermal trauma and those subjected to
      additional mechanical insult showed more extensive external root resorption than
      those from single-injury animals. It was concluded that low temperature stimuli
      applied to the crowns of rat molars were capable of eliciting a sterile
      degenerative response in the PDL which, in turn, resulted in external root
      resorption. Furthermore, the degree of this tissue injury was commensurate with
      the duration and number of exposures to the trauma. The results also indicated
      that progression of the resorptive process required periodic exposure to the
      injury, in the absence of which repair to the damaged root occurred.

PMID- 11202858
TI  - Microsurgical instruments for root-end cavity preparation following apicoectomy:
      a literature review.
AB  - Root-end cavities have traditionally been prepared by means of small round or
      inverted cone burs in a micro-handpiece. Since sonically or ultrasonically driven
      microsurgical retrotips became commercially available in the early 1990s, this
      new technique of retrograde root canal instrumentation has been established as an
      essential adjunct in periradicular surgery. At first glance, the most relevant
      clinical advantages are the enhanced access to root ends in limited working space
      and the smaller osteotomy required for surgical access because of the various
      angled designs and small size of the retrotips. However, a number of experimental
      studies comparing root-end preparations made with microsurgical tips to those
      made with burs have demonstrated other advantages of this new technique, such as
      deeper cavities that follow the original path of the root canal more closely. The
      more centered root-end preparation also lessens the risk of lateral perforation.
      In addition, the geometry of the retrotip design does not require a beveled root
      end resection for surgical access thus decreasing the number of exposed dentinal
      tubules. A controversial issue of sonic or ultrasonic root-end preparation is the
      formation of cracks or microfractures, and its implication on healing success.
      The present paper reviews experimental and clinical studies about the use of
      microsurgical retrotips in periradicular surgery and discusses many issues raised
      in previous papers.

PMID- 11202859
TI  - In vitro viability, mitogenicity and clonogenic capacity of periodontal ligament
      cells after storage in four media at room temperature.
AB  - The choice of storage medium for preserving traumatically avulsed teeth is
      important for the success of future replantation. The objective of this study was
      to compare the effectiveness of four recommended storage media (Hank's balanced
      salt solution [HBSS], culture medium, alpha minimal essential medium [alpha-MEM],
      and ViaSpan) to preserve cultured periodontal ligament fibroblasts (PDLF) at room
      temperature (22 degrees C). PDLF were obtained from explants of extracted healthy
      human teeth. Plates with confluent PDLF were soaked in the various media for 2, 8
      and 24 h at room temperature. A control group was incubated with culture medium
      at 37 degrees C. After incubation, viability of the cells was determined by
      trypan blue exclusion test. Viable cells were then analyzed for mitogenic (with
      thymidine) and clonogenic capacity (by culturing one cell/well). Viability of
      PDLF stored up to 24 h was comparable in all tested media, and the differences
      were limited to 1%-3%. PDLF stored for up to 24 h in various media had
      statistically comparable mitogenicity to the control group. After 8 h of storage,
      the differences were limited to 2%-9%, except for the alpha-MEM group which had
      23%-29% lower mitogenic capacity compared to the control group. Increasing the
      storage time up to 24 h further decreased the mitogenicity of the cells by 22%
      47%. The highest mitogenicity after 24 h of storage was found in PDLF stored in
      culture medium or HBSS, and the lowest in alpha-MEM. PDLF stored for 2-8 h in
      various media had a comparable clonogenic capacity to the control group. However,
      after 24 h, the cells' clonogenic ability dropped by 14%-66%. A similar trend of
      reduction was noted in the mitogenic and clonogenic capacity, although it was
      statistically significant only in the clonogenic capacity. Culture medium and
      ViaSpan, followed by HBSS, were the most effective in preserving the clonogenic
      capacity of PDLF after 24 h of storage. The lowest clonogenic capacity after 24 h
      of storage was in the alpha-MEM group (66%, P < 0.0025). In conclusion, culture
      medium, followed by HBSS and ViaSpan, was the most effective media for preserving
      the viability, mitogenicity and clonogenic capacity of PDLF stored for up to 24 h
      at room temperature. The lowest functional abilities were found in PDLF stored in
      alpha-MEM.

PMID- 11202860
TI  - Postoperative discomfort associated with surgical and nonsurgical endodontic
      retreatment.
AB  - Endodontic retreatment decision-making must include an appraisal of the costs of
      the different strategies proposed. In addition to direct costs, postoperative
      discomfort may have other consequences in terms of time off work, unscheduled
      visits and suffering. To establish a foundation for the appraisal of such
      indirect and intangible costs the present study was set up in which patients'
      assessments of pain and swelling after surgical and nonsurgical retreatment
      procedures were recorded. Ninety-two patients with 95 root-filled incisors and
      canine teeth exhibiting apical periodontitis were included in the study. The mode
      of retreatment was randomly assigned. Each day during the first post-treatment
      week patients assessed their degree of swelling and pain on horizontal 100-mm
      visual analog scales (VAS). The scales ranged from "no swelling" to "very severe
      swelling" and "no pain" to "intolerable pain", respectively. Consumption of self
      prescribed analgesics and time off work were also recorded. Significantly more
      patients reported discomfort after surgical retreatment than after nonsurgical
      procedures. High pain scores were most frequent on the operative day while
      swelling reached its maximum on the first postoperative day followed by
      progressive decrease both in frequency and magnitude. Postoperative symptoms
      associated with nonsurgical retreatment were less frequent but reached high VAS
      values in single cases. Analgesics were significantly more often consumed after
      periapical surgery. Patients reported absence from work mainly due to swelling
      and discoloration of the skin. This was found to occur only after surgical
      retreatment. Conclusively, surgical retreatment resulted in more discomfort and
      tended to bring about greater indirect costs than nonsurgical retreatment.

PMID- 11202861
TI  - Evaluation of the Trifecta obturating technique.
AB  - The aim of this project was to evaluate and compare the radiographic quality and
      sealability of root fillings in extracted human teeth using lateral condensation
      of gutta-percha or the Trifecta obturating system. One hundred freshly extracted
      human mature, single-rooted teeth were divided into four identical groups of 25
      teeth on the basis of root canal shape. The root canals of two groups were
      prepared in such a way as to produce a relatively parallel canal shape with
      little or no flare towards the coronal orifice. The root canals of the other two
      groups were prepared in such a way as to produce a canal shape that was
      deliberately more flared to ensure that they were wider at the orifice than at
      the endpoint of the preparation. All root canals were flushed with 17% EDTA
      solution and 2.5% NaOCl to remove the dentinal smear layer. The canals of one
      flared and one parallel group were obturated using cold lateral condensation and
      the canals of the other two groups were obturated using the Trifecta system. The
      sealability of each technique was assessed by a dye penetration method. The
      radiographic quality of obturation was determined for each canal using a 4-point
      scale. Canals filled with thermoplasticised gutta-percha had significantly less
      apical dye penetration than those obturated by lateral condensation (P < 0.001).
      Lateral condensation achieved significantly better scores for radiographic
      quality than thermoplasticised gutta-percha from both the bucco-lingual (P <
      0.001) and the mesio-distal views (P < 0.001). Root canals obturated using the
      Trifecta technique showed significantly more apical extrusion of sealer than
      those obturated by lateral condensation (P < 0.001). Under laboratory conditions
      the Trifecta technique had better sealability but poorer radiographic quality
      than lateral condensation.

PMID- 11202862
TI  - Extraradicular infection: a methodological study.
AB  - Whether bacteria live or die in periapical lesions of endodontic origin is
      debated. Sampling of periapical bacteria is difficult due to possible
      contamination from the indigenous microflora. The aim of this study was to
      examine whether bacteria were present in periapical lesions of asymptomatic teeth
      before sampling or were transferred there during sampling. Thirty patients with
      root-filled teeth and periapical radiolucencies were divided into two groups,
      each containing 15 patients. In Group 1, a marginal incision was made to explore
      the periapical lesion. In Group 2, a submarginal incision was made. Before
      incision, the gingiva and mucosa were washed with 0.2% chlorhexidine gluconate.
      Bacterial samples were taken from the mucosa before reflecting the flap, and from
      the alveolar bone and the periapical lesion immediately after. All samples were
      cultured anaerobically on all-purpose and selective media. In Group 1, 12 of the
      15 patients (80%) yielded bacteria from their mucosal samples despite the
      chlorhexidine wash. Bacterial growth was observed in all samples (100%) from the
      alveolar bone while the periapical lesions gave bacterial growth in 11 of 15
      cases (73%). In Group 2, bacteria were cultured from the mucosa in 11 of 15 (73%)
      patients. Three samples (20%) from the alveolar bone and 10 from the periapical
      lesions (67%) gave positive growth. The predominant cultivable bacteria were
      anaerobic. Phenotypic profiling, performed with the data-based API bioMerieux
      system, indicated that the sampling technique used prevented mucosal bacteria
      from reaching the exposed bone and the periapical lesions. Profiling also
      indicated that following marginal incision, bacteria from the periodontal pocket
      might have reached the underlying tissues by surgeon-released bacteremia or
      direct translocation. Most organisms detected in the periapical lesions were
      clearly different from the bacteria present at neighboring sites and appeared to
      have been there before sampling.

PMID- 11202863
TI  - Crown dilaceration of a first premolar caused by extraction of its deciduous
      predecessor: a case report.
AB  - This report describes a rare case of crown dilaceration of the mandibular first
      premolar caused by trauma during extraction of the precedent primary first molar.
      The mandibular first primary molar had been extracted at the age of 4 years 7
      months. Compared to the pre-operative radiograph, the post-operative film showed
      that the direction of the first premolar tooth germ had changed, suggesting that
      crown dilaceration had been induced by the surgical procedures during tooth
      extraction. From radiographic examinations, the premolar was considered to have
      erupted spontaneously.

PMID- 11202864
TI  - A survey of interfacial forces used during filing of root canals.
AB  - The pattern of dentine removal during endodontic instrumentation is influenced by
      many factors including the interfacial forces applied by the operator. The aim of
      this study was to investigate the influence of operators and different sizes and
      types of instruments on the magnitude of these interfacial forces. Single-rooted
      teeth were mounted on a cantilevered aluminium beam to which two pairs of single
      element strain gauges were joined in a half-bridge configuration and mounted at
      right angles to each other. The strain gauges were connected to an analogue-to
      digital converter fitted in a micro-computer via conditioning amplifiers. This
      enabled strains to be recorded over a period of time. Twenty operators
      instrumented root canals using a series of hand instruments for 1 min each. The
      mean interfacial forces used by operators demonstrated a wide variation ranging
      from 9.06 g to 149.42 g (range of forces from 0-331 g) but there was a
      consistency in the relative magnitude for each operator. The 20 operators could
      be divided into 13 groups which were significantly different (alpha = 0.05) from
      each other. There were significant differences (alpha = 0.05) between the forces
      used for each of the K-Flex files (15, 25, 35, 45, and 70), the force increasing
      with the file size. There was also a significant difference (alpha = 0.05) in the
      forces used between the Flexofile (#25) and the #25 K-Flex and Hedstrom files.
      However, there was no significant difference between the K-Flex and Hedstrom
      files.

PMID- 11202865
TI  - Protective effect of Copalite surface coating on mercury release from dental
      amalgam following treatment with carbamide peroxide.
AB  - The effect of Copalite coating on mercury release from dental amalgam following
      treatment with 10%, 20%, 30% and 40% carbamide peroxide was assessed in vitro,
      using a cold-vapour atomic absorption Mercury Analyzer System. Eighty samples of
      dental amalgam were automatically mixed in a dental amalgamator and condensed
      into silicon embedding molds. Forty amalgam samples were coated with three
      uniform layers of Copalite intermediary varnish and the other 40 samples were
      left uncoated. The coated and non-coated amalgam samples were exposed for 24 h to
      10%, 20%, 30% or 40% carbamide peroxide preparations and compared with samples
      exposed to phosphate buffer. In the non-coated samples a significant increase of
      mercury concentration in solution was found following exposure to all carbamide
      peroxide preparations tested. Mercury concentration was directly related to
      carbamide peroxide concentration. In the Copalite-coated samples, significantly
      lower concentrations of mercury in solution were found as compared to the non
      coated samples (P < 0.01). In conclusion, exposure of amalgam restorations to 10%
      40% carbamide peroxide-based bleaching agents increased the mercury release. Pre
      coating of the external amalgam surfaces with Copalite significantly reduced the
      release of mercury.

PMID- 11202866
TI  - Profile of an orthodontic patient at risk of dental trauma.
AB  - Increased overjet and inadequate lip coverage of the maxillary incisors are
      considered significant risk factors in many clinical studies. The purpose of the
      present study was to examine this issue of dental injury by actual cephalometric
      measurements in orthodontic patients. Pretreatment cephalograms (taken with lips
      in repose) of consecutive patients were used. The patients were allotted to two
      groups Group T (trauma): 56 patients who had injured their maxillary incisors
      prior to their orthodontic treatment, mean age at the start of treatment 11.9
      years (SD = 1.5); and Group C (control): 98 patients with intact maxillary
      incisors, mean age at the start of treatment 11.6 years (SD = 1.3). Twelve
      cephalometric landmarks on the soft and hard tissue profile were identified and
      digitized and the relevant dental, skeletal and soft tissue measurements
      recorded. The variables in Groups T and C were compared and their predictive
      values for possible occurrence of trauma were tested by logistic regression
      analysis. No statistically significant differences between boys and girls were
      found. Overjet or maxillary incisor exposure or interlabial gap, each as a single
      variable, could differentiate between the two groups. Logistic regression
      analysis indicated that only a small percentage (28.7%) of the dependent variable
      variation (trauma vs control) can be explained by interlabial gap, gender, upper
      incisor long axis to facial plane (degree), upper incisor long axis to
      interlabial gap and overjet.

PMID- 11202867
TI  - Comparison of different techniques for obturating experimental internal
      resorptive cavities.
AB  - Forty extracted maxillary central incisors were instrumented at the working
      length to a #50 file. The roots were sectioned transversely with a diamond disk
      at 7 mm from the anatomical apex. At the opening of the root canal of each
      section, hemicircular cavities were drilled with a specially designed bur. The
      corresponding root sections were cemented with glue, thus obtaining root canals
      with similar cavities that simulated internal resorptions. Teeth were embedded in
      plaster casts to facilitate their handling. The specimens were randomly separated
      into four groups of 10. The following obturation techniques were evaluated:
      lateral compaction (group A), hybrid technique (group B), Obtura II (group C),
      and Thermafil (group D). AH26 was used as the sealer. After obturation, the
      plaster was removed and the teeth were radiographed in buccolingual and
      mesiodistal directions to evaluate the quality of the obturation at the IRC. The
      incisors were then cut with a scalpel at the same level as the previous section,
      to examine, under a stereomicroscope, the type of material that filled the IRC.
      Obtura II gave the best results and in most of the specimens obturated with this
      technique, the IRC were filled mainly with gutta-percha. Statistical analysis of
      the data indicated that the differences between group C and the other groups were
      significant (P < 0.05).

PMID- 11202868
TI  - Traumatic dental injuries and Alpine skiing.
AB  - The purpose of this study was to determine the occurrence and type of traumatic
      dental injuries after maxillofacial injuries as a result of Alpine skiing. During
      an 8-year period (from January 1991 to December 1998) 7600 patients with facial
      injuries were registered at the Department of Oral and Maxillofacial Surgery,
      University of Innsbruck, Austria. Of 784 patients with skiing-related facial
      injuries (524 males, 260 females) 326 (41.6%) sustained injuries to 639 teeth.
      The age groups predominantly affected were between 7 and 32 years. Luxation
      injuries occurred in 338 (53%) teeth, fractures accounted for 270 tooth injuries
      (42%), and only 35 (5%) were lost at the place of the accident. Of skiers with
      traumatic dental injuries 58% had concomitant soft tissue injuries, while 23.3%
      had associated facial bone fractures. The most common causes of injury were falls
      in 42% (329 patients) and collisions with other persons in 24.1% (189 patients).
      Being hit by one's own sports equipment (11%) was the third most common cause.
      Collisions with obstacles accounted for 9% and lift accidents for 5.6% of
      injuries. The probability of suffering dentoalveolar trauma during skiing varied
      depending on the injury mechanism. There was a 2-fold risk for dentoalveolar
      trauma when colliding with objects, a 3.5-fold risk when hit by one's own
      equipment and a 8.5-fold risk during lift accidents. Dental injuries occurred in
      about 2% of all injured skiers. Dental health professionals should be aware of
      the high incidence and the distribution of dental trauma and facial injuries
      caused by skiing.

PMID- 11202869
TI  - Utilization of gutta-percha for retrograde root fillings.
AB  - Just as gutta-percha used with a root canal sealer is a recommended material for
      orthograde root fillings, it could similarly be the material of choice for
      retrograde fillings. Unfortunately, clinical accessibility and visibility do not
      always facilitate such a technique. The aim of this article is to present a new
      technique which enables retrograde fillings to be achieved with gutta-percha and
      a sealer. After the apex had been resected, a hole was drilled perpendicular to
      the plane of section of the apex about 1 mm coronally. The bucco-lingual depth
      required to reach the main canal was calculated. The cavity was then dried,
      coated with the sealer, and obturated with gutta-percha in accordance with thermo
      mechanical compaction techniques. After excess filling material had been removed,
      the gutta-percha was cold burnished and the angles of the root were smoothed.
      Clinical cases illustrating healing of the periapical tissues are shown.

PMID- 11202870
TI  - Malformations in maxillary incisors: case report of radicular palatal groove.
AB  - This report describes malformations of anterior teeth and a case of a palatal
      radicular groove in an upper lateral incisor with periodontal complications. The
      patient was first diagnosed with an endodontic problem. Endodontic treatment
      alone failed to resolve the pain. Therefore, after the palatal groove had been
      properly diagnosed, a palatal flap procedure was carried out including removal of
      the granulation tissue and careful scaling and root planing of the area with the
      groove. No odontoplasty was done. Endodontic therapy of the tooth was completed
      and periapical healing was evident. The treatment effectively reduced the
      gingival probing depth and led to an asymptomatic tooth.

PMID- 11202872
TI  - Rationale for the use of low-torque endodontic motors in root canal
      instrumentation.
AB  - Fracture of nickel-titanium rotary files is an iatrogenic error which can
      seriously jeopardize root canal therapy. If a high-torque motor is used, the
      instrument-specific limit-torque (fracture limit) is often exceeded, thus
      increasing the risk of intracanal failure. A possible solution to this problem is
      to use a low-torque endodontic motor which operates below these values. If the
      torque is set just below the limit of elasticity for each instrument, the risk of
      fracture is likely to be markedly reduced. The purpose of this paper was to
      discuss mechanical properties of NiTi rotary instruments, the rationale for
      selecting low torque values, and to use clinically a new endodontic motor (step
      motor) which operates below the limit of elasticity of each rotary file. The step
      motor was found to be helpful in reducing the risk of instrument fracture.
      Irreversible material damage (plastic deformation) and instrument fracture were
      rarely seen. Low-torque instrumentation also increased tactile sense and,
      consequently, mental awareness of rotary instrumentation.

PMID- 11202871
TI  - A multidisciplinary treatment approach to a complicated maxillary dental trauma:
      a case report.
AB  - This case report describes the treatment of an 18-year-old male who lost two
      central maxillary incisors due to dental trauma. Because of a deep overbite and
      serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a
      conventional fixed prosthesis. The vertical dimension of occlusion was increased
      using a Hawley-type appliance over a period of 1 year. When sufficient
      intermaxillary space was gained the alveolar ridge was augmented with a
      mandibular symphysis graft. Nine months later two one-stage non-submerged
      implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further
      soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were
      placed on the two implants and the lateral incisors.

PMID- 11202873
TI  - The lateral periodontal cyst: aetiology, clinical significance and diagnosis.
AB  - The lateral periodontal cyst (LPC) is a relatively uncommon but widely recognized
      odontogenic cyst of developmental origin. It is found mostly in adults and has no
      sex predilection. LPC is usually discovered during routine radiographic
      examination, is located mainly between the roots of vital mandibular canines and
      premolars, and seldom causes pain or other clinical symptoms. The defect appears
      on radiographs as a round or teardrop-shaped, well circumscribed radiolucency.
      Due to its location it can easily be misdiagnosed as a lesion of endodontic
      origin. In this paper, two cases of lateral periodontal cysts are presented. In
      the first case, the patient (woman, 62 years old) complained of an asymptomatic
      gingival swelling in the region between the right maxillary canine and premolar.
      The radiographic examination revealed a well circumscribed radiolucency with a
      radiopaque margin between the roots of the canine and premolar. The adjacent
      teeth had vital pulp. Surgical enucleation of the lesion was performed and the
      histological examination revealed that the lesion was a "lateral periodontal cyst
      of developmental origin". In the second case, the patient (women, 44 years old)
      complained of a swelling in the area of tooth 32. During radiographic examination
      a well circumscribed radiolucency between the roots of the lateral incisor and
      the canine was discovered. Surgical enucleation of the lesion was performed and
      the histological examination revealed that the lesion was a "lateral periodontal
      cyst of developmental origin".

PMID- 11202875
TI  - Radiographic analysis of the development of periapical lesions in normal rats,
      sialoadenectomized rats and sialoadenectomized-immunosuppressed rats.
AB  - The purpose of this study was to investigate and to compare radiographically the
      development of periapical lesions in the lower left first molar of normal rats,
      sialoadenectomised rats and sialoadenectomised-immunosuppressed rats. Sixty male
      Wistar rats, weighing from 170 to 200 g were utilized. The animals were divided
      equally into three groups: group I--20 normal rats; group II--20
      sialoadenectomised rats; and group III--20 sialoadenectomised-immunosuppressed
      rats. Groups II and III were sialoadenectomized using the modified Cheyne
      technique. After 2 weeks, group III was submitted to a immunosuppression regimen
      by daily subcutaneous cyclosporin A injection (10 mg/kg body weight). After 1
      week of immunosuppression for this group, the pulps of all the animals (group I,
      II and III) were exposed to the oral cavity, to produce apical periodontitis.
      Five animals of each group were killed 7, 14, 21 and 28 days after pulpal
      exposure. Their mandibles were surgically removed and radiographically analysed.
      The lesions were measured using 'Global Lab Image' software. The results showed
      predictable growth of the lesions during the experimental period. No significant
      difference was observed between the groups. It was concluded that possible
      changes in the oral flora and in the host immune response due to xerostomia
      associated or not to the immunosuppression did not alter the development of the
      periapical lesions in rats.

PMID- 11202874
TI  - Impact strength of teeth restored by fragment-bonding.
AB  - The objective of this in vitro study was to investigate the impact strength of
      anterior teeth that have been fractured and restored by bonding with a dentin
      bonding agent and a composite resin. Twenty sheep central incisors were divided
      into two groups, 10 in each. One group (intact teeth) served as the control and
      the teeth in the other group were fractured and then bonded with a bonding agent
      and a low-viscous composite resin. The specimens were tested in a modified impact
      testing machine (pendulum type). The mean impact strength of the intact teeth was
      30.6 +/- 2.16 KJ/m2 and of the bonded teeth was 30.2 +/- 1.86 KJ/m2. Statistics
      revealed that the two means were not significantly different. The results related
      well with the fracture strength obtained by loading intact and bonded teeth at
      constant but low speed until fracture. It was concluded that bonding fragments to
      the remaining tooth structure may restore the tooth to its original strength,
      measured at modest velocities of the applied force. In other words, reattaching
      the original coronal fragment of traumatised fractured anterior teeth restored
      with One-Step dentin bonding system and AEliteflo composite resin would withstand
      a second trauma to the same extent as intact teeth.

PMID- 11202876
TI  - An in vitro investigation into the cutting action of ultrasonic radicular access
      preparation instruments.
AB  - The aim of this study was to investigate the dentine cutting action of a CT4 and
      SJ4 radicular preparation inserts (Excellence in Endodontics/Analytic Technology,
      Orange, CA, USA) used in a Piezon Master 400 ultrasonic handpiece (Electro
      Medical Systems SA, Nyon, Switzerland). Calibration of the ultrasonic inserts was
      carried out at minimum, medium and maximum power settings using light microscopic
      measurement of the tip displacement amplitudes (x120 mag). Polished dentine
      samples were instrumented, at monitored loads, at the three chosen power
      settings, to produce uniform dentine cuts. The resultant dentine debris was
      collected for SEM analysis, and comparison with that produced by rotary
      instruments. The depth of dentine cut was measured at x30 magnification. Fracture
      of the SJ4 insert was noted at medium power setting. Results revealed a
      significant increase in both displacement amplitude and depth of dentine cut with
      power setting (ANOVA P < 0.001). Dentine chip size increased with power, and
      differed in structure and appearance from those produced by rotary instruments.
      In conclusion, ultrasonic cutting is influenced significantly by power setting,
      and dentine chip formation is fundamentally different to rotary instrumentation.

PMID- 11202877
TI  - The aetiology of dento-alveolar injuries and factors influencing attendance for
      emergency care of adolescents in the north west of England.
AB  - The aims of the study were to determine the main aetiological factors involved in
      injuries to anterior teeth and to identify factors influencing the attendance for
      emergency care. This information is essential, first, for planning dental health
      education programmes aimed at reducing the incidence of dental trauma and,
      second, to devise strategies for its effective treatment. Of 2022 schoolchildren
      examined for evidence of dental trauma, 696 (34%) had experienced injury and were
      interviewed regarding this injury. Of these, 403 knew about their damaged front
      tooth, but only 330 recollected the incident causing the injury. Over one third
      of accidents occurred at home and a further 25% at school. The most common cause
      of injury was falling onto a hard surface or object (34%) with accidents
      involving bicycles or other sporting activities accounting for a further 30%.
      Factors found to be significantly related to attendance for emergency care were
      experience of pain, unattractive appearance of the injured tooth and social
      classification, with children from higher income, more affluent areas being more
      likely to seek treatment. The majority of dental injuries were the result of
      genuine accidents which were almost impossible to prevent. This study highlighted
      the need for attention to be brought to parents, children, lay people and health
      care professionals that all dental injuries should be examined by a dentist, not
      just those injuries resulting in pain or poor aesthetics.

PMID- 11202878
TI  - The influence of interfacial forces and duration of filing on root canal shaping.
AB  - The aim of this study was to investigate the possible relationship between
      interfacial forces, duration of instrumentation and effectiveness of root canal
      shaping by filing. All factors were standardised except the manner of
      manipulation of the files and the dependent variables (interfacial force and
      duration of filing). The outcome measured was the final prepared canal shape. The
      study tested the hypothesis that if interfacial forces and duration of filing had
      predictive value for effective canal shaping, a relationship between them should
      be apparent. If it was not, it could be inferred that the remaining
      uncontrollable variable, "manner of file manipulation" had a dominating
      influence. 18 operators used a standard filing technique to instrument a root
      canal each in single rooted teeth matched for anatomy. The teeth were mounted in
      a custom-made transducer designed to measure laterally applied interfacial forces
      between file and dentine. The length of time taken with each instrument in the
      series was measured giving a total duration of instrumentation. The final canal
      shape measured by standardised "before" and "after" radiographic images of the
      roots was judged against an "ideal" canal shape calculated from the size of
      instruments used and based on the preliminary canal shape. Although some trends
      were revealed, no obvious relationship was demonstrated between interfacial
      force, duration of filing and final canal shape. Operators clearly used a range
      of interfacial forces characteristic for each individual and for the different
      file sizes. Both light and heavy forces could produce a satisfactory canal shape.
      Use of light or heavy forces did not obviously affect speed of preparation.
      Tactile discrimination was not dependent on use of light or heavy forces. It was
      inferred that the "manner of file manipulation" remained undefined and was
      probably the dominant factor influencing outcome of canal shaping.

PMID- 11202879
TI  - Prognosis of replanted primary incisors after injuries.
AB  - Between 1979 and 1997, 58 avulsed primary teeth were treated at the Pedodontic
      Clinic of Niigata University Dental Hospital. Among these, we replanted six
      avulsed incisors of four patients and treated two teeth of two patients replanted
      at other dental clinics. Referring to the clinical records, oral photographs and
      radiographs, we examined the injury age, cause of injury, condition of tooth
      storage, length of time until replantation, and also the prognosis after
      replantation. Three teeth of two cases remained until eruption of their permanent
      successors, and one tooth of one case remained under observation without
      extraction. Although the other four teeth of three cases resulted in extraction,
      no secondary infection was detected due to replantation. The following reasons
      were suspected for the poor prognosis of the four teeth. One avulsed tooth was
      not fixed immediately after replantation. One replanted tooth might not have been
      compatible with the alveolar socket. In the other two teeth, the periodontal
      vital tissues might have been removed before replantation. It is generally
      suggested that replantation of primary teeth is not a good option. However, from
      the present results, it was considered that replantation can be an effectual
      method when the condition of the avulsed primary tooth is suitable.

PMID- 11202881
TI  - Assessment of periradicular microbiota by DNA-DNA hybridization.
AB  - In the present study the "checkerboard" DNA-DNA hybridization technique was used
      to identify bacteria in periapical endodontic lesions of asymptomatic teeth.
      Thirty-four patients with root-filled teeth and apical periodontitis were divided
      into two groups, each containing 17 patients. In Group 1, a marginal incision was
      performed during surgery to expose the lesion, and in Group 2, a submarginal
      incision was applied. The gingiva and mucosa were swabbed with an 0.2%
      chlorhexidine gluconate solution prior to surgery. Bacterial DNA was identified
      in all samples from the two groups using 40 different whole genomic probes. The
      mean number (+/- SD) of species detected was 33.7 +/- 3.3 in Group 1 and 21.3 +/-
      6.3 in Group 2 (P < 0.001). The majority of the probe-detected bacteria were
      present in more lesions from Group 1 than from Group 2. The differences were most
      notable for Campylobacter gracilis, Porphyromonas endodontalis, Propionibacterium
      acnes, Capnocytophaga gingivalis, Fusobacterium nucleatum ssp. nucleatum,
      Fusobacterium nucleatum ssp. polymorphum, Prevotella intermedia, Treponema
      denticola, Streptococcus constellatus and Actinomyces naeslundii I. Bacterial
      species such as Actinobacillus actinomycetemcomitans and Bacteroides forsythus
      were detected in more than 60% of the lesions from both groups. Also, P.
      endodontalis was abundant in periapical tissue. The data supported the idea that
      following a marginal incision, bacteria from the periodontal pocket might reach
      the underlying tissues by surgeon-released bacteremia. The study provided solid
      evidence that bacteria invade the periapical tissue of asymptomatic teeth with
      apical periodontitis. The detection of much more bacteria with the "checkerboard"
      DNA-DNA hybridization method than has previously been recovered by anaerobic
      culture indicated that the endodontic (and periodontal) microfloras should be
      redefined using molecular methods.

PMID- 11202880
TI  - Immunologic evaluation of dental patient with history of hypersensitivity
      reaction to sodium hypochlorite.
AB  - A 12-year-old girl, with a previous history of bronchial reaction and contact
      dermatitis to sodium hypochlorite, was referred for root canal treatment.
      Complete immunologic evaluation revealed a mild hypersensitivity condition, as it
      was assessed by the RAST investigation to different allergens and the DTH
      reactivity expressed though migration inhibition test. The absence of a serious
      immunologic disregulation in the patient's immunologic profile justified the term
      'non-allergic hypersensitivity' to sodium hypochlorite to describe the condition.

PMID- 11202882
TI  - Bacteria of asymptomatic periradicular endodontic lesions identified by DNA-DNA
      hybridization.
AB  - Possible inclusion of contaminant bacteria during surgery has been problematic in
      studies of periradicular lesions of endodontic origin. Therefore, in this study,
      two different surgical techniques were compared. A second problem is that some
      difficult to cultivate species may not be detected using bacteriological methods.
      Molecular techniques may resolve this problem. DNA-DNA hybridization technology
      has the additional advantage that DNA is not amplified. The purpose of this
      investigation was to determine if bacteria from periradicular endodontic lesions
      could be identified using DNA-DNA hybridization. A full thickness intrasulcular
      mucoperiosteal (IS) flap (n = 20) or a submarginal (SM) flap (n = 16) was
      reflected in patients with asymptomatic apical periodontitis. DNA was extracted
      and incubated with 40 digoxigenin-labeled whole genomic probes. Bacterial DNA was
      detected in all 36 lesions. Seven probes were negative for all lesions. In
      patients with sinus tract communication, in teeth lacking intact full coverage
      crowns, and in patients with a history of trauma 4-13 probes provided positive
      signals. Seven probes were positive in lesions obtained by the IS, but not the SM
      technique. Two probes were in samples obtained with the SM technique, but not the
      IS. Only Bacteroides forsythus and Actinomyces naeslundii genospecies 2 were
      present in large numbers using either the IS or the SM technique. The SM flap
      technique, in combination with DNA-DNA hybridization, appeared to provide
      excellent data pertaining to periradicular bacteria. These results supported
      other studies that provide evidence of a bacterial presence and persistence in
      periradicular lesions.

PMID- 11202883
TI  - Risk evaluation and type of treatment of multiple dental trauma episodes to
      permanent teeth.
AB  - Studies have shown that some children and adolescents are effected only once with
      a dental trauma, while others seem to be accident-prone and suffer from multiple
      dental trauma episodes (MDTE). Studies have also shown that dental traumas mostly
      affect upper permanent and medial incisors. Less is known about treatment
      consequences related to teeth with repeated dental trauma episodes. The aim was
      therefore to evaluate the risk of MDTE to permanent teeth among children and
      adolescents by age and gender and to compare types of dental treatment modalities
      used for patients with one episode and those with MDTE and with single and
      repeated traumatized teeth. The study was based on a random sample of 83 Danish 6
      18-year-old children and adolescents born in 1970 who suffered from dental trauma
      episodes. All patients were followed during a 12-year period (1976-1988). Forty
      one of the patients were registered with MDTE with a range of 2-7 episodes and a
      mean of 2.9 episodes/patient (SD = 1.1). The mean age at single and MDTE was 11.4
      years (SD = 3.6) and 8.6 years (SD = 2.1), respectively. No significant
      differences were found between age at first episode and the number of MDTE per
      patient. The number of patients with MDTE was significantly higher among those
      who suffered their first trauma episode in the age interval 6-10 years than in
      the age interval 11-18 years (P < 0.001). A survival analysis showed that the
      risk of sustaining another trauma episode increased by 14.9-30.3% when the first
      trauma occurred before the age of 11, compared to 0-7.4% after the age of 10. The
      risk of sustaining multiple injuries was 8.4 times higher when the first trauma
      episode occurred at 9 years of age, compared with those occurring at age 12. The
      survival analysis also showed that for every new trauma episode, the interval
      between them became closer. Forty-five per cent of the MDTE affected teeth had
      already sustained an injury. With an increased number of trauma episodes per
      patient followed an increase in the number of follow-ups, filling therapy,
      information and prosthetics, whereas the rates of endodontics, surgery, and
      consultations were unchanged or even decreased.

PMID- 11202884
TI  - Pulp revascularization of replanted immature dog teeth after different treatment
      methods.
AB  - The purpose of the present study was to determine the effect of topical treatment
      with doxycycline and/or the application of unfilled resin to the anatomical crown
      on the occurrence of revascularization in reimplanted dog teeth. Ninety-six teeth
      in 4 young mongrel dogs were used. Eighty one teeth were atraumatically extracted
      and divided into four groups. Group 1, 17 teeth were kept dry for 5 min and then
      replanted. Group 2, 21 teeth were soaked with a freshly prepared solution of
      doxycycline (1 mg/20 mL saline) for 5 min before replantation. Group 3, 23 teeth
      were soaked with the doxycycline solution for 5 min, and then replanted. The
      crowns were coated with 2 layers of light cured unfilled resin. Group 4, 20 teeth
      were kept dry for 5 min, and then replanted. The crowns were treated as with the
      teeth in Group 3. Three months after surgery, radiographic evaluation revealed
      that 27 teeth had continued root development and 32 teeth showed arrested root
      development with periradicular pathosis. The remaining 17 teeth, which had
      arrested root development but no signs of periradicular pathosis, were all
      histologically evaluated for final assessment. The occurrence of
      revascularization according to treatment group was 29.4%, 60%, 60%, 36.8% in
      Group 1, 2, 3, and 4, respectively. A multiple logistic regression analysis in
      SAS indicated there was no significant association between vitality and dog (P =
      0.7564). Soaking for 5 min in doxycycline significantly increased the
      revascularization rate (P = 0.024) while the addition of resin to the crown did
      not result in an increased incidence of pulp revascularization (P = 0.823).

PMID- 11202885
TI  - Influence of coronal restorations on the periapical health of endodontically
      treated teeth.
AB  - The purpose of the study was to evaluate a possible relationship between the
      quality of the coronal restoration, the root canal obturation and the periapical
      status of endodontically treated teeth. Full mouth series of radiographs from
      randomly selected patient charts at the Dental Faculty, University of Oslo were
      examined. A total of 1001 endodontically treated teeth restored with a permanent
      restoration were evaluated independently by two examiners. According to a
      predetermined set of radiographic criteria, the technical quality of the root
      filling of each tooth was scored as either good (GE) or poor (PE), and the
      technical quality of the coronal restoration was scored as good (GR) or poor
      (PR). The root and the surrounding structures were then evaluated and according
      to the periradicular findings, the treatment was categorized as success or
      failure. The success rate for all endodontically treated teeth was 67.4% (n =
      1001). Teeth with root canal posts had a success rate of 70.7% (n = 527) and
      teeth without posts had a success rate of 63.6% (n = 472). The two groups with
      technically good endodontics had the highest success rates. In combination with
      technically good restorations the success rate was 81% (GE + GR, 81%) and
      combined with technically poor restorations the success rate was 71% (GE + PR,
      71%). The two groups with technically poor endodontics combined with either good
      restorations or poor restorations had significantly lower success rates (PE + GR,
      56% and PE + PR, 57%). The technical quality of the endodontic treatment as
      judged radiographically was significantly more important than the technical
      quality of the coronal restoration when the periapical status of endodontically
      treated teeth was evaluated.

PMID- 11202886
TI  - Urinary catecholamine levels and incidence of dentofacial injuries in children: a
      2-year prospective study.
AB  - Urinary catecholamines have been used to measure emotionally stressful states
      which may have an impact on dentofacial injuries. This prospective study
      investigated the hypothesis that urinary catecholamines such as epinephrine,
      norepinephrine and dopamine do not affect significantly the incidence of
      dentofacial injuries in children. As a test of this hypothesis 204 children,
      males and females, aged 8 to 10 years, were included in the study. After a first
      examination, each subject was re-examined, at one-year intervals, over a period
      of two years. Dentofacial injuries were recorded by a clinical examination and a
      questionnaire. Three 24-h urine samples, with an interval of one year between
      each, were collected and analyzed by the high performance liquid chromatography
      technique to assay the catecholamine content. Socio-economic factors were
      recorded by a questionnaire. Using the panel of data collected, the logistic
      multiple regression model was employed to test whether the incidence of
      dentofacial injuries was affected by the studied variables. The 95% probability
      level was used. Specificity and sensitivity as well as the positive and negative
      predictive rates were computed. The results showed that epinephrine had a
      significant correlation with the incidence of dentofacial injuries. Other factors
      found to have a significant impact were child's age and gender. The values of
      sensitivity and specificity were 81% and 69% respectively, while the positive and
      negative predictive rates were 68% and 82% respectively. The data, therefore,
      provided evidence that emotionally stressful states measured by the urinary
      catecholamines were prominent etiologic factors of dentofacial injury.

PMID- 11202887
TI  - Factors associated with root canal ledging during instrumentation.
AB  - The purpose of this study was to identify the presence of a ledge in 141 cases
      treated in an undergraduate clinic and in 103 cases treated by endodontists, and
      to identify the clinical factors associated with ledging. A total of 626 root
      canals were examined and the factors analyzed were canal location, tooth number
      and canal curvature. The results indicated that 51.5% of the canals treated by
      students had been ledged, whereas the percentage was 33.2% for intact pulp
      cavities treated by endodontists and 40.6% in cases of endodontic retreatment.
      Canal location was found to have an effect on the incidence of ledging as the
      mesiobuccal, mesiolingual and distal buccal root canals exhibited a significantly
      higher ledge incidence rate than the distal and palatal root canals. Canal
      curvature was the most significant variable affecting the incidence of ledging.

PMID- 11202888
TI  - Tongue piercing and associated oral and dental complications.
AB  - The insertion of metal objects into intraoral and perioral sites is growing in
      popularity. However, there are numerous oral and dental complications associated
      with tongue piercing. Fifteen patients with tongue piercings (pierced in the body
      of the tongue, anterior to the lingual frenum) attending the dental office of the
      authors, with and without complaints, were clinically and radiographically
      examined. The most common dental problem registered was chipping of teeth.
      Furthermore, two cracked teeth and four teeth with cusp fractures were also seen.
      One case of selective dental abrasion was registered. Trauma to the lingual
      anterior gingiva was the most common gingival problem. A salivary flow
      stimulating effect was only reported by 2 of the 15 individuals. None of the
      patients complained of interference with speech, mastication and swallowing. One
      case of galvanic currents produced by the appliance was registered. On the basis
      of the registered data, we concluded that patients need to be better informed of
      the potential complications associated with tongue and oral piercings, and that
      the dental profession can serve this role.

PMID- 11202889
TI  - Pulp capping with adhesive resin-based composite vs. calcium hydroxide: a review.
AB  - The results of some short-term experiments suggest that direct capping of a vital
      pulp with the modern resin-based composite systems may be as effective as capping
      with calcium hydroxide. Total cavity etching with 10% phosphoric acid seems to be
      safe for the exposed pulp, but unless annulled by calcium hydroxide 35%
      phosphoric acid may be disastrous. For hemostasis and cleaning of the pulp wound
      both sodium hypochlorite and saline seem suitable, whereas the effectiveness of a
      2% chlorhexidine solution is questionable. Although hard-setting calcium
      hydroxide cements may induce the formation of dentin bridges, they appear not to
      provide an effective long-term seal against bacterial factors. Within a few
      years, the majority of mechanically exposed and capped pulps show infection and
      necrosis due to microleakage of such capping materials and tunnel defects in the
      dentin bridges. It is unknown whether newer types of resin containing calcium
      hydroxide-products will act as a permanent barrier. The cytotoxicity of the resin
      based composites and the temperature rise during polymerisation may not be of
      concern, but microleakage, sensitisation and allergic reactions may pose
      problems. Based on available data, pulp capping with resin-based composites may
      be said to be promising, but more and long-term research is mandatory before the
      method can be recommended.

PMID- 11202890
TI  - The influence of sample dimensions on hydroxyl ion release from calcium hydroxide
      products.
AB  - The purpose of this study was to compare the rate of hydroxyl ion release from
      commercially available setting and non-setting calcium hydroxide products. The
      rate of hydroxyl ion release is important, as this has been suggested to be the
      main factor in the therapeutic activity of these products. In total, hydroxyl ion
      release was measured from 1104 samples of Dycal, Life, Calasept and Hypocal in
      solution using in vitro titration. The rate of hydroxyl ion release was measured
      for up to 14 days, using two sizes of sample surface area. The dimensions of the
      exposed sample surface area was found to be an important physical constraint to
      the hydroxyl ion release from non-setting calcium hydroxide products, whereas
      this was not found to be the case with setting products. The range in hydroxide
      activity between products was found to be 298%. In rank order of hydroxide ion
      release, from the most to the least active was: Hypocal, Calasept, Life and
      Dycal. The differences in the rate of hydroxyl ion release from these products
      may have some implications for their clinical applications. It is suggested that
      in cases where the oral healing responses have been poorer than expected, the
      size and seal of prepared cavities could have negatively influenced the
      therapeutic release of hydroxyl ions from non-setting calcium hydroxide products.

PMID- 11202891
TI  - Dentine chips produced by nickel-titanium rotary instruments.
AB  - This study aimed to compare the cross-sectional shape of two nickel-titanium
      rotary instruments, namely ProFile and Quantec files, both ISO 25, 0.06 taper,
      and sought to relate this to the chips produced by cutting dentine. A limited
      comparison was made with stainless steel engine reamers. First, five files of
      each type were sectioned transversely at 12 mm, 8 mm and 4 mm from the tip and
      examined by scanning electron microscopy. The cutting angles were assessed by a
      direct measurement technique which allowed for the inclination of a cutting edge
      to the root canal. Second, eight samples of cutting debris were collected from
      instrumentation by each type of nickel-titanium file and four samples from the
      engine reamers. The major and minor axis, area and roundness of the dentine chips
      in each sample were measured using computerized particle analysis. The results
      demonstrated that all files had a negative cutting angle which varied at the
      different levels (ProFiles range 69.4 degrees to 58.4 degrees and Quantec range
      74.8 degrees to 56.8 degrees). The consistency within files of the same type was
      good as demonstrated by low standard deviations, except for Quantec files at the
      4 mm level where higher standard deviations of 4.1 degrees and 5.5 degrees for
      the two blades were found. The chip analysis showed significant differences
      between chips produced by ProFile and Quantec files (P < 0.05). The latter were
      larger and rounder. The chips from the ProFile and the engine reamer chips were
      similar in dimension (P > 0.05). No simple relationship existed between file
      geometry and the dentine chips produced during instrumentation.

PMID- 11202892
TI  - The effect of zinc oxide-eugenol on the shear bond strength of a commonly used
      bonding system.
AB  - It has been claimed that eugenol has a detrimental effect on resin composites and
      dentin bonding systems. The aim of the present study was to examine whether zinc
      oxide-eugenol (ZOE) cement would reduce the efficacy of a bonding system. Human
      third molars were selected for the study, and cylindrical posts of a resin
      composite (Z100) were bonded vertically to a standardized flat dentinal surface,
      prepared on the buccal surface of the teeth and treated with Scotchbond Multi
      Purpose. The tooth surfaces involved were either freshly cut, or had been exposed
      to ZOE cement for 6 days, with and without a subsequent thorough cleansing with
      ethanol. The bond strength in shear was measured after 24 hours. The results
      showed that ZOE cement had no negative effect on the bond strength of the resin
      composite (Z100) to dentin when this bonding system was used. The mean shear bond
      value for the specimens covered with ZOE cement for 6 days was 28.1 MPa. For
      specimens covered with ZOE cement and cleansed with 96% ethanol, the mean shear
      bond value was 23.5 MPa. The corresponding value for the controls was 19.0 MPa.
      These findings suggested that eugenol-containing temporary filling materials may
      be used safely prior to inserting resin based restorative materials, when
      Scotchbond Multi-Purpose is employed as the bonding agent.

PMID- 11202893
TI  - Comparison of profiles of key periodontal pathogens in periodontium and
      endodontium.
AB  - Despite the established anatomical relationship between the periodontal and
      pulpal tissues, bacterial migration between endodontium and periodontium is still
      under discussion. The objective of this study was an investigation of profiles of
      periodontal pathogens in pulpal and periodontal diseases affecting the same tooth
      by means of 16S rRNA gene directed polymerase chain reaction (PCR). 31 intact
      teeth with both pulp and marginal infections were investigated. The diagnosis was
      based on clinical and radiological examination. Samples were taken from the
      gingival sulcus or periodontal pocket, respectively, with sterile paper points
      before trepanation of the teeth. After trepanation sterile paper points and
      Hedstroem files were used for taking samples from the root canal. Specific PCR
      methods were used to detect the presence of the following pathogens:
      Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Eikenella corrodens,
      Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and
      Treponema denticola. In addition, quantitative competitive PCR was used to
      determine the total bacterial count of the samples. The investigated pathogens
      were proven to be present in the endondontium in all disease categories.
      Particularly in endodontic samples of "chronic apical periodontitis" and "chronic
      adult periodontitis" profiles of the periodontal pathogens were found. The
      results confirmed that periodontal pathogens often accompany endodontic
      infections and supported the idea that the periodontic-endodontic
      interrelationships should be considered as critical pathways which might
      contribute to refractory courses of endodontic or periodontal diseases.

PMID- 11202894
TI  - Treatment of traumatic dental injuries in a cohort of 16-year-olds in northern
      Sweden.
AB  - The prevalence and yearly incidence of traumatic tooth injury between 1 and 16
      years of age have been studied in a cohort of 16-year-olds, born in 1975, and
      residing in the County of Vasterbotten. The study material comprised 3007 dental
      records from the Public Dental Health Service. Of these, 1040 contained
      information on dental injuries. Out of 1000 injured primary teeth, 32% were lost,
      either avulsed at the time of the accident or extracted due to complications. A
      majority (92%) of the extractions was performed at the first or second follow-up.
      A total of 690 tooth injury episodes had occurred in the permanent dentition,
      involving 981 teeth. In 10% of the teeth more than one diagnosis was recorded for
      the same tooth. 416 restorations were performed due to crown fractures, the
      majority at the emergency visit. 44% of the patients had to come back one or more
      times to revise the composite restoration. Complicated fractures or serious
      luxation injuries constituted only 5% of the total number of injuries in the
      permanent dentition. 77 (8%) of the traumatised teeth were treated
      endodontically. Two percent of the teeth with uncomplicated crown fractures
      required endodontic treatment due to pulp necrosis, while 28% of teeth with a
      combination of crown fractures and luxation injury were endodontically treated.
      Out of 6 avulsed incisors, 4 survived after endodontic treatment. A total of 7
      incisors were lost as a consequence of the injuries. A specialist treated 4% of
      the patients.

PMID- 11202895
TI  - Bacterial leakage in obturated root canals following the use of different
      intracanal medicaments.
AB  - The aim of this study was to examine whether intracanal medication prior to root
      canal obturation has an inhibitory effect on corono-apical penetration of
      bacteria. 93 single rooted teeth were instrumented and sterilized with ethylene
      oxide. They were assigned to three control groups and four test groups with n =
      20 each. For one week, they were dressed with different medicaments: The first
      group with a 5% chlorhexidine gel, the second with Ledermix, the third with a
      fresh mix of calcium hydroxide and water and the fourth without any medication.
      After obturation (lateral condensation, AH26) the roots were fixed between a top
      and a bottom chamber. The top chamber contained 3 mL trypticase soy broth with
      10(8) Staphylococcus epidermidis CFU's/mL, whereas the bottom chamber contained
      sterile trypticase soy broth. For one year, the mounts were incubated at 37
      degrees C. They were checked on a regular basis for turbidity in their bottom
      chambers indicating bacterial growth. None of the test samples leaked for three
      months. After one year, the calcium hydroxide group had only 6 leaking samples
      whereas the chlorhexidine group had 14, the Ledermix group 15, and the
      unmedicated group had 13 leaking samples. It may be concluded that under the
      conditions of this study, calcium hydroxide was the medicament of choice to avoid
      bacterial penetration of the root canal. Ledermix did not perform better than no
      premedication. Chlorhexidine was superior to Ledermix in the second third of the
      observation period.

PMID- 11202896
TI  - Cytotoxic effect of four root filling materials.
AB  - The aim of this study was to evaluate the cytotoxic effect of four root canal
      sealers: AH26, AH Plus, Diaket and Apexit. In the experiment two cell lines,
      human cervical carcinoma (HeLa) cells and mouse skin fibroblasts (L929), were
      used. Under aseptic conditions, the sealers were prepared according to the
      manufacturers' directions, and 0.01 mL of each material was placed in a 24-well
      plate. The sealers were covered with cell suspension. The cytotoxicity was
      estimated by determining the number of viable cells by a light microscope, as
      well as the total number of cells 24 h, 48 h and 120 h after the treatment with
      mentioned materials. The results obtained in this study showed the high
      cytotoxcity of the new AH Plus root canal sealer, which was shown to be equally
      or more toxic to the standard AH26 and Diaket materials. Apexit was the least
      toxic sealer.

PMID- 11202897
TI  - The sealing ability of an epoxy resin root canal sealer used with five gutta
      percha obturation techniques.
AB  - The purpose of the present study was to evaluate the apical sealing ability of an
      epoxy resin root canal sealer (AH-26) when used with different gutta-percha
      obturation techniques (i.e. cold lateral condensation, warm vertical
      condensation, hybrid condensation) and with Thermafil and Soft-Core obturators.
      Straight single-rooted teeth with mature apices were prepared according to the
      crown-down/step-back technique and divided in five groups of 45 teeth and one
      group of 12 control teeth. After root canal filling 15 teeth of each group were
      kept for 1 day, another 15 teeth for 1 week, and another 15 teeth for 4 months at
      37 degrees C in vacutainers in 80% relative humidity. The 237 teeth were immersed
      in india ink for 90 hours, each root was split and sectioned longitudinally, and
      the maximum extent of leakage was measured using a stereomicroscope at x6
      magnification. It became clear that leakage occurred whatever technique was
      combined with AH26 and that leakage increased with time. The amount of apical
      leakage and the number of leaking teeth in the Soft-Core obturator groups was
      significantly higher than all other 4 gutta-percha obturation techniques combined
      with AH26. In this respect, the hybrid gutta-percha condensation technique turned
      out to be superior to the four other condensation techniques.

PMID- 11202898
TI  - Bone-like tissue growth in the root canal of immature permanent teeth after
      traumatic injuries.
AB  - Following a severe traumatic incident to permanent immature teeth, the growth of
      calcified tissue in the pulp space may occasionally occur. This calcified tissue
      may be diffuse or in intimate contact with the dentine. It has been suggested
      that a wide open apex, severe damage to the root sheath, and the absence of
      infection are only some of the predisposing factors leading to this metaplasia of
      pulp tissue into bone-like tissue. Five cases are described.

PMID- 11202899
TI  - Ascaris in burned patients.

PMID- 11202900
TI  - Recent References.

PMID- 11202901
TI  - Society for the Study of Behavioural Phenotypes 10th annual meeting. Birmingham,
      United Kingdom, November 18-19, 1999. Abstracts.

PMID- 11202902
TI  - Arterial blood gas analysis during pulmonary artery catheterization: a comparison
      between two oxygen delivery systems.

PMID- 11202903
TI  - On the use of Venturi's principle to describe entrainment during jet ventilation.

PMID- 11202904
TI  - [Molecular classification of colorectal carcinoma].

PMID- 11202905
TI  - Anaesthetic Research Society Meeting. Oxford, United Kingdom, July 6-7, 2000.
      Abstracts.

PMID- 11202906
TI  - The human polo-like kinase, PLK, regulates cdc2/cyclin B through phosphorylation
      and activation of the cdc25C phosphatase.
AB  - Entry into mitosis by mammalian cells is triggered by the activation of the
      cdc2/cyclin B holoenzyme. This is accomplished by the specific dephosphorylation
      of key residues by the cdc25C phosphatase. The polo-like kinases are a family of
      serine/threonine kinases which are also implicated in the control of mitotic
      events, but their exact regulatory mechanism is not known. Recently, a Xenopus
      homologue, PLX1, was reported to phosphorylate and activate cdc25, leading to
      activation of cdc2/cyclin B. Jurkat T leukemia cells were chemically arrested and
      used to verify that PLK protein expression and its phosphorylation state is
      regulated with respect to cell cycle phase (i.e., protein is undetectable at
      G1/S, accumulates at S phase and is modified at G2/M). Herein, we show for the
      first time that endogenous human PLK protein immunoprecipitated from the G2/M
      arrested Jurkat cells directly phosphorylates human cdc25C. In addition, we
      demonstrate that recombinant human (rh) PLK also phosphorylates rhcdc25C in a
      time- and concentration-dependent manner. Phosphorylation of endogenous cdc25C
      and recombinant cdc25C by PLK resulted in the activation of the phosphatase as
      assessed by dephosphorylation of cdc2/cyclin B. These data are the first to
      demonstrate that human PLK is capable of phosphorylating and positively
      regulating human cdc25C activity, allowing cdc25C to dephosphorylate inactive
      cdc2/cyclin B. As this event is required for cell cycle progression, we define at
      least one key regulatory mode of action for human PLK in the initiation of
      mitosis.

PMID- 11202907
TI  - Effect of elite cycling on leucocyte counts.

PMID- 11202908
TI  - Essential thrombocythaemia in children: a report of nine cases.

PMID- 11202909
TI  - All-trans retinoic acid (ATRA) and tranexamic acid: a potentially fatal
      combination in acute promyelocytic leukaemia.

PMID- 11202911
TI  - Repair of the nervous system.

PMID- 11202910
TI  - Aggressive multiple modality therapy for varicella-associated purpura fulminans.

PMID- 11202912
TI  - The future of pediatric education II.

PMID- 11202913
TI  - Relapses of CMV retinitis after 2 years of highly active antiretroviral therapy.

PMID- 11202914
TI  - A large rapidly growing pilomatrixoma on a lower eyelid.

PMID- 11202915
TI  - Use of mitomycin C and r-tPA for the management of conjunctival membrane and
      cataracts in a child with conjunctivitis lignosa.

PMID- 11202916
TI  - Annular granular corneal opacity: a rare corneal stromal dystrophy or
      degeneration?

PMID- 11202917
TI  - Idiopathic tractional corectopia.

PMID- 11202918
TI  - Subhyaloid or subinternal limiting membrane haemorrhage in meningococcal
      meningitis.

PMID- 11202919
TI  - Reverse and converse ocular bobbing with synkinetic blinking and opsoclonus in a
      child with Epstein-Barr virus encephalitis after bone marrow transplant for MPS
      I.

PMID- 11202920
TI  - Retinorhexis in macular translocation.

PMID- 11202921
TI  - Acute retinal necrosis presenting with scleritis and raised intraocular pressure.

PMID- 11202922
TI  - International Poverty and Health Network.

PMID- 11202923
TI  - Case 4: bronchiolitis obliterans in a lung transplant recipient.

PMID- 11202924
TI  - Interactive Grand Rounds. Case 3: management of cyclosporine-induced hirsutism
      and gingival overgrowth in a heart transplant recipient.

PMID- 11202926
TI  - Evaluation of laparoscopic procedures in the treatment of biliary disease, gastro
      oesophageal reflux and inguinal hernia. Proceedings of a conference. Sweden,
      1997.

PMID- 11202925
TI  - Proceedings of the 7th International Course on Peritoneal Dialysis. Vicenza,
      Italy, May 23-26, 2000.

PMID- 11202927
TI  - Diagnosis: progressive multifocal leukoencephalopathy.

PMID- 11202928
TI  - [Status of the application of indicators to prove the effects of health education
      in local areas: analysis of research presentation of studies on adult and
      geriatric health at the meetings of the Japanese Public Health Association].

PMID- 11202929
TI  - Implications of CJD data need to be clear before release.

PMID- 11202930
TI  - Effect of on-site mental health professionals. Longer trials are needed.

PMID- 11202931
TI  - Treating hyperhidrosis. Iontophoresis should be tried before other treatments.

PMID- 11202932
TI  - Treating hyperhidrosis. Excision of axillary tissue may be more effective.

PMID- 11202933
TI  - Treating hyperhidrosis. Anticholinergic drugs were not mentioned.

PMID- 11202934
TI  - Treating hyperhidrosis. Treatment options must be balanced against each other.

PMID- 11202935
TI  - Quality of randomised controlled trials in head injury. More trials are needed.

PMID- 11202936
TI  - Quality of randomised controlled trials in head injury. Statistical power can be
      increased.

PMID- 11202937
TI  - Transfusion transmitted infection. Did authors systematically underestimate risks
      of transfusion?

PMID- 11202938
TI  - National service framework's financial implications are huge.

PMID- 11202939
TI  - Advance directives. Three questions should be asked.

PMID- 11202940
TI  - Advance directives. Maybe national guidelines are needed.

PMID- 11202941
TI  - Advance directives. Legal issues need clarification.

PMID- 11202942
TI  - Advance directives. Advance directives are not legally binding.

PMID- 11202943
TI  - Advance directives. Good education prepares people for death.

PMID- 11202944
TI  - Role of spironolactone in heart failure should be emphasised.

PMID- 11202945
TI  - Patient of gynaecologist who was struck off has been denied justice.

PMID- 11202946
TI  - UK and German media differ over complementary medicine.

PMID- 11202947
TI  - Nestle's violation of international marketing code. The auditors respond.

PMID- 11202948
TI  - Nestles violation of international marketing code. Nestle responds.

PMID- 11202949
TI  - Nestle's violation of international marketing code. Audit report fudges the
      issue.

PMID- 11202950
TI  - Nestle's violation of international marketing code. Similar practices take place
      in Europe.

PMID- 11202951
TI  - Unicef and baby food manufacturers. Unicef continues to base its actions and
      programmes on the best interests of the child.

PMID- 11202952
TI  - Unicef and baby food manufacturers. Compliance to the code is difficult to judge.

PMID- 11202953
TI  - Comparing health inequality in men and women. Choice of indicator is important.

PMID- 11202954
TI  - Towards explaining health inequalities.

PMID- 11202955
TI  - Sterilise in haste, repent at leisure and great expense.

PMID- 11202956
TI  - Breast feeding is a major factor in HIV transmission.

PMID- 11202957
TI  - HIV/AIDS programmes should focus on improved access.

PMID- 11202958
TI  - 'Know thy cell!' a comment on the UKCCCR guidelines for the use of cell lines.

PMID- 11202960
TI  - Annual conference of the Canadian Society of Transfusion Medicine (CSTM). Quebec
      City, 4-7 May 2000. Abstracts.

PMID- 11202959
TI  - Management of complicated and treatment-refractory ED: clinical issues and
      guidelines.

PMID- 11202961
TI  - 13th International Congress of the Hungarian Society for Microbiology. August 29
      September 1, 1999. Budapest, Hungary. Abstracts.

PMID- 11202962
TI  - The outcome of endoluminal repair of AAA with short proximal necks.

PMID- 11202963
TI  - Gene therapy to prevent vein graft stenosis--ready for prime time?

PMID- 11202964
TI  - For debate: concomitant critical coronary arterial disease and abdominal aortic
      aneurysm--timing of corrective procedures.
AB  - BACKGROUND: The high prevalence of coronary artery disease (CAD) in patients with
      abdominal aortic aneurysm (AAA) is responsible for most , 30-day mortality and
      morbidity in elective repair of AAA. The continuing debate regarding staged or
      combined surgery for AAA and CAD (coronary artery bypass grafting -CABG) in the
      small number of patients with critical degrees of both co-morbidities has not had
      a significant impact on the greater mortality and morbidity when the AAA repair
      is undertaken using the standard open operation. PATIENTS: We report four cases
      with these combined pathologies which we have managed over the last 30 months
      during which time we have developed techniques of endolumenal repair of AAA.
      CONCLUSIONS: Whilst it is not possible to make firm recommendations regarding
      management strategy owing mainly to a lack of large series reporting this unusual
      combination of co-morbidities, the options are debated on the basis of published
      anecdotal evidence as well as our own case reports. We suggest that if the AAA is
      non-tender and/or 5.5-8.0 cm, the staged approach is appropriate. If the AAA is
      tender and/or > 8.0 cm, a combined approach may be a better option in order to
      avoid the risk of AAA rupture during the interval between the operations.
      Endolumenal repair of AAA offers a further option for the staged and combined
      approach, and may be less invasive than the standard open surgery for AAA repair.

PMID- 11202965
TI  - Colorectal cancer. Preface.

PMID- 11202966
TI  - Pharmacological therapy of spinal cord injury during the acute phase.

PMID- 11202967
TI  - Caspases and neurodegenerative diseases.

PMID- 11202968
TI  - Clinical gene therapy back in the race.

PMID- 11202969
TI  - Knocking out NEMO.

PMID- 11202970
TI  - New imaging techniques for early diagnosis of Alzheimer's disease.

PMID- 11202971
TI  - Is successful gene therapy for retinal disease in sight?

PMID- 11202972
TI  - Molecular signalling in cardiovascular biology: from molecules to man.
      International symposium organized by the centre for cardiovascular biology and
      medicine, King's College, London.

PMID- 11202973
TI  - Have tumor cells learnt from microorganisms how to fool the immune system? Escape
      from immune surveillance of tumors and microorganisms: emerging mechanisms and
      shared strategies.

PMID- 11202974
TI  - Fecal colonization with vancomycin-resistant enterococci in Australia.
AB  - To assess the rate of fecal vancomycin-resistant enterococci (VRE) colon ization
      in Austalia, we examined specimens from 1,085 healthy volunteers. VRE was
      cultured from 2(0.2%) of 1,085 specimens; both were vanB Enter ococcus faecium,
      identical by pulsed-field gel electrophoresis, but with a pattern rare in
      Melbourne hospitals.

PMID- 11202975
TI  - Proceedings of the 12th International Symposium on Pediatric Surgical Research.
      Brussels, Belgium, September 3-4, 1999.

PMID- 11202976
TI  - Endemic instability for babesiosis and anaplasmosis in cattle in the Bolivian
      Chaco.

PMID- 11202977
TI  - Whither poultry disease and research?

PMID- 11202979
TI  - 22nd congress of the European Society of Cardiology, Amsterdam.

PMID- 11202978
TI  - Peripheral ameloblastic fibroma.

PMID- 11202980
TI  - 5th World Congress of the International Federation for the Surgery of Obesity.
      Genoa, Italy, September 20-23. Abstracts.

PMID- 11202981
TI  - Guidelines for laparoscopic and open surgical treatment of morbid obesity.
      American Society for Bariatric Surgery. Society of American Gastrointestinal
      Endoscopic Surgeons.

PMID- 11202982
TI  - Evolving Fontan strategy: hemi-Fontan procedure and its clinical application.

PMID- 11202983
TI  - Palliative therapy. Introduction.

PMID- 11202984
TI  - Orchestrating cell division.

PMID- 11202985
TI  - Mechanisms of joint destruction in rheumatoid arthritis.

PMID- 11202986
TI  - Bcl-2 does not inhibit cell death induced by the physiological Fas ligand:
      implications for the existence of type I and type II cells.

PMID- 11202987
TI  - Catheter ablation for atrial fibrillation and atrial flutter: from D.C. shocks to
      radiofrequency current.

PMID- 11202989
TI  - Comments on Serger et al.'s (1998, 1999) calorimetric stability studies.

PMID- 11202988
TI  - Proniosomes: a novel drug carrier preparation.
AB  - A procedure is described for producing a dry product which may be hydrated
      immediately before use to yield aqueous niosome dispersions similar to those
      produced by more cumbersome conventional methods. These 'proniosomes' minimize
      problems of niosome physical stability such as aggregation, fusion and leaking,
      and provide additional convenience in transportation, distribution, storage, and
      dosing. This report describes the preparation of dispersions of proniosome
      derived niosomes, comparison of these niosomes to conventional niosomes, and
      optimization of proniosome formulations. In addition, conventional and proniosome
      derived niosomes are compared in terms of their morphology, particle size,
      particle size distribution, and drug release performance in synthetic gastric or
      intestinal fluid. In all comparisons, proniosome-derived niosomes are as good or
      better than conventional niosomes.

PMID- 11202990
TI  - Current trends in toxicological risk assessment: perspectives from the committee
      on toxicology.

PMID- 11202991
TI  - Recent developments in neurotoxicology.

PMID- 11202992
TI  - Immunotoxicology: past, present, and future.

PMID- 11202993
TI  - Recent advances in reproductive and developmental toxicology.

PMID- 11202994
TI  - The use of transgenic animals in cancer testing.

PMID- 11202995
TI  - Recent developments in toxicology training.

PMID- 11202996
TI  - Mechanistic considerations in cancer risk assessment.

PMID- 11202997
TI  - Recent advances in genetic toxicology and their relevance to cancer risk
      assessment.

PMID- 11202998
TI  - Biologically based dose-response models for developmental toxicants: lessons from
      methylmercury.

PMID- 11202999
TI  - A unified approach to risk characterization.

PMID- 11203000
TI  - Benchmark doses for developmental toxicants.

PMID- 11203001
TI  - Epidemiologic approaches to risk assessment.

PMID- 11203002
TI  - Addressing uncertainty-lessons from probabilistic exposure analysis.

PMID- 11203003
TI  - The rise of exposure assessment among the risk sciences: an evaluation through
      case studies.

PMID- 11203004
TI  - Exposure analysis and assessment in the 21st century.

PMID- 11203005
TI  - Re: revisiting epidemiological key studies on occupational diesel exhaust
      exposure and lung cancer in truck drivers.

PMID- 11203006
TI  - Re: revisiting epidemiological key studies on occupational diesel exhaust
      exposure and lung cancer in truck drivers.

PMID- 11203007
TI  - Room temperature stable polymerase chain reaction mixture for detection of
      hepatitis B virus.

PMID- 11203008
TI  - Optimal therapeutic management of non-Q-wave myocardial infarction.

PMID- 11203009
TI  - Analysis of risk factors for the development of late hepatic artery thrombosis:
      do CREG mismatches play a role?

PMID- 11203010
TI  - Enteral feeding maintains but does not improve villous atrophy in malnourished
      patients.

PMID- 11203011
TI  - Bladder cancer mortality with aging: male/female comparison with autocorrelation
      and time frame shift.

PMID- 11203012
TI  - Carbonic anhydrase inhibitors--Part 94. 1,3,4-thiadiazole-2
      sulfonamidederivatives as antitumor agents?
AB  - Potent sulfonamide inhibitors of the zinc enzyme carbonic anhydrase (CA, EC
      4.2.1.1), derivatives of I ,3,4-thiadiazole-2-sulfonamide, possessing inhibition
      constants in the range of 10(-8)-10(-9) M against isozymes II and IV, were shown
      to act as efficient in vitro tumour cell growth inhibitors with GI(50) (molarity
      of inhibitor producing a 50% inhibition of tumour cell growth) values typically
      in the range of 0.1-30 microM against several leukaemia, non-small cell lung
      cancer, ovarian, melanoma, colon, CNS, renal, prostate and breast cancer cell
      lines. The mechanism of antitumour action with the new sulfonamides reported here
      is unknown, but it might involve either inhibition of several CA isozymes (such
      as CA IX, CA XII, CA XIV) present predominantly in tumour cell membranes,
      acidification of the intracellular environment as a consequence of CA inhibition,
      uncoupling of mitochondria and/or strong CA V inhibition, or a combination of
      several such mechanisms. Such derivatives might lead to the development of
      effective novel types of anticancer agents/therapies. ? 2000 Editions
      scientifiques et m|dicales Elsevier SAS.

PMID- 11203013
TI  - [Can even prevention be wrong? On military consciousness in medicine].

PMID- 11203014
TI  - Trends in child neuropsychology.

PMID- 11203015
TI  - Web Alert.

PMID- 11203016
TI  - Web alert. Internet guide to hypertension associations and publications.

PMID- 11203017
TI  - Web alert. Keeping up with medical news: daily health headlines on the Internet.

PMID- 11203018
TI  - Web alert. Clinical trials in hypertension: guides on the internet.

PMID- 11203019
TI  - We alert. Clinical hypertension guidelines on the web.

PMID- 11203020
TI  - Web alert.

PMID- 11203021
TI  - Web alert.

PMID- 11203022
TI  - Web alert.

PMID- 11203023
TI  - Lymphoid organogenesis. Proceedings of the workshop held at the Basel Institute
      for Immunology. 5-6 November 1999.

PMID- 11203024
TI  - [Comment on T. G. Lehmann et al.: Klippel-Trenaunay syndrome involving the
      rectum].

PMID- 11203025
TI  - Quiz case. Ulcerative colitis? Crohn's disease?

PMID- 11203027
TI  - Primary and preventive care: periodic assessments. ACOG Committee on Primary
      Care.

PMID- 11203026
TI  - Gastric uptake of nicotinic acid by bilitranslocase.

PMID- 11203028
TI  - Oral contraceptives for adolescents: benefit and safety.

PMID- 11203029
TI  - Family medicine funding crisis: opportunities and dangers. 1984.

PMID- 11203030
TI  - Long-term effects of omeprazole on the gastric mucosa.

PMID- 11203031
TI  - Long-term omeprazole treatment and risk of gastric cancer.

PMID- 11203032
TI  - Efficacy and safety of long-term omeprazole treatment.

PMID- 11203033
TI  - Molecular mechanisms of glucocorticoid resistance.

PMID- 11203034
TI  - The white plaque represents gastric mucosal metastatic calcification, which
      stains as dark deposits in the submucosa.

PMID- 11203035
TI  - The MacArthur Foundation Depression Education Program for Primary Care
      Physicians: background and rationale.
AB  - In order to improve the assessment and management of depression in general
      medical care, the John D. and Catherine T. MacArthur Foundation supported the
      development, evaluation, and dissemination of an eight-hour depression education
      program (DEP) for primary care physicians. This publication includes a paper
      describing the background and educational rationale for the program structure,
      the complete participant's workbook, and a facilitator's guide for teaching the
      program. Given in two separate four-hour workshops by a psychiatrist and a
      primary care physician, DEP is delivered to small groups of learners (about 12)
      using an interactive adult learning model and multiple teaching techniques
      including targeted yet flexible objectives, two lectures, videotape demonstration
      and discussion, role-play exercises, a focused monograph on depression, an
      interview checklist, structured assessment and outcomes tools, clinical case
      studies, and audiotape review of actual patient interviews. DEP has been shown in
      a prospective randomized trial to improve physicians' interview-ing skills as
      well as simulated-patient satisfaction scores. Over 150 PCPs in four states have
      taken DEP in more than 30 separate programs given by 24 trained facilitators.
      Participants, despite a wide diversity of background knowledge and skills, have
      uniformly reported remarkably positive learner satisfaction with all dimensions
      of the Program.

PMID- 11203037
TI  - Haloperidol-induced impotence improved by switching to olanzapine.

PMID- 11203036
TI  - The use of intravenous valproate in acute mania.

PMID- 11203038
TI  - Fibres evidence, probabilistic evaluation and collaborative test.

PMID- 11203039
TI  - Proceedings of the 2nd National Workshop on Helicobacter pylori: Management
      recommendations in India. Thrissur, Kerala, February 20, 1999.

PMID- 11203041
TI  - ECG mimicking acute myocardial infarction during heart involvement by lung
      neoplasm.

PMID- 11203040
TI  - What is the cause of lymphopenia in malaria?

PMID- 11203042
TI  - Left ventriculo-coronary communications in a double-outlet right ventricle with
      an intact ventricular septum.

PMID- 11203043
TI  - Systolic and diastolic forward flow in the left ventricular outflow tract in a
      patient with familiar restrictive cardiomyopathy.

PMID- 11203044
TI  - Lipoprotein(a), tobacco use, and risk of coronary heart disease.

PMID- 11203045
TI  - Spontaneous coronary artery dissection in old woman treated with coronary artery
      bypass graft.

PMID- 11203046
TI  - Embolizing mobile thrombus associated with prolapse and mixoid degeneration of
      the mitral valve.

PMID- 11203047
TI  - National service framework heart failure.

PMID- 11203048
TI  - Methodological errors uncovered?

PMID- 11203049
TI  - Successful emergency coronary surgery for intractable ventricular fibrillation
      without prior angiography.

PMID- 11203050
TI  - Coronary stent occlusion following strenuous exertion: is the risk actual? Is it
      preventable?

PMID- 11203051
TI  - Torsades de pointes due to multihormonal deficiency induced long QT syndrome.

PMID- 11203052
TI  - The neglected subject of biophysics.

PMID- 11203053
TI  - [The war: a risk for public health].

PMID- 11203054
TI  - [Consumption of drugs: policies and social pact].

PMID- 11203056
TI  - Spring joint meeting of the BIPP Medical Photography Group, the Royal
      Photographic Society's Medical Group and the Institute of Medical Illustrators,
      Kodak House, Hemel Hempstead, UK, April 8, 2000.

PMID- 11203055
TI  - [Screening for breast cancer: scientific evidence and the media].

PMID- 11203057
TI  - Analysis of excretory-secretory and somatic antigens of Gastrothylax crumenifer.
AB  - The excretory/secretory (ES) metabolic products released by Gastrothylax
      crumenifer (Trematoda: Digenea) during in vitro incubations and the somatic
      extract of the adult parasite were analysed using polyacrylamide gel electro
      phoresis (PAGE). Immunogenicity of ES and somatic extracts were evaluated by
      immunoblotting and ELISA using sera raised against ES and somatic antigens in
      rabbits. The electropherograms of ES and somatic extracts have been resolved into
      38 and 41 polypeptides, respectively. The apparent molecular weights of these
      polypeptides range from <29 to > 205 kDa. A total of 14 polypeptides were found
      to be common to both of the samples. The analysis of immunoblot results revealed
      22 and 27 antigenic polypeptides in ES and somatic extracts respectively. Only 11
      and 13 antigenic polypeptides were found specific to ES and tissue extract
      respectively. The molecular weights of these specific polypeptides were
      calculated to be <14.4, 16, 20, 25, 33, 42, 119, 125 and > 205 kDa for metabolic
      products and <14.4, 25, 30, 35, 78, 84 and > 205 kDa for the tissue extracts,
      respectively. Analysis of ELISA results revealed that a dilution of up to 1:3200
      of the test sera could react with the ES product. Further, when the ES antigens
      were allowed to react with antisomatic extracts in hyperimmune sera the titre of
      IgG increased up to a dilution of 1:12800. The potential importance of these
      antigens in the immunodiagnosis of amphistomiasis is discussed.

PMID- 11203058
TI  - The biology of depression.
AB  - Depression is a common psychiatric disorder prevalent in 10-15% in general
      population. To know the biology of the disease many hypotheses have been
      proposed. Genetic basis for depression is provided by family studies which show
      higher risk of depression among first degree relatives. Abnormalities in
      serotonergic activity in depression can occur in one or more levels. Other
      neurotransmitters like gamma amino butyric acid (GABA) and dopamine are also
      considered to have some role in depression. Hormonal abnormalities like
      hypercortisolaemia are found in patients with depression. Structural and
      functional neuro-imaging studies in depression suggest the involvement of brain
      in depressive disorders.

PMID- 11203060
TI  - 6th Conference of the Federation of Infection Societies. Manchester, United
      Kingdom, December 1-3, 1999. Abstracts.

PMID- 11203059
TI  - Mumfer (iron polymaltose complex) in the management of anaemia in pregnancy--an
      Indian study.

PMID- 11203061
TI  - Eclampsia and postpartal cerebral angiopathy.

PMID- 11203062
TI  - [Aspirin-induced asthma and nose diseases].

PMID- 11203063
TI  - [Approach to a borderline area: sinobronchial syndrome].

PMID- 11203064
TI  - 13th International Congress on Care of the Terminally Ill. September 25-29, 2000.
      Montreal, Canada. Abstracts.

PMID- 11203065
TI  - Regarding "The Swiss Heroin Trials: scientifically sound?".

PMID- 11203066
TI  - Regarding "The Swiss Heroin Trials: scientifically sound?".

PMID- 11203067
TI  - Regarding "The Swiss Heroin Trials: scientifically sound?".

PMID- 11203068
TI  - Regarding "The Swiss Heroin Trials: scientifically sound?".

PMID- 11203069
TI  - Regarding "The Swiss Heroin Trials: scientifically sound?".

PMID- 11203071
TI  - Re: Recognizing abnormal marker results that do not reflect disease in patients
      with germ cell tumors.

PMID- 11203070
TI  - Receptors for hepatitis C virus.

PMID- 11203072
TI  - Re: Periprostatic local anesthesia before ultrasound guided prostate biopsy.

PMID- 11203073
TI  - Re: A prospective study of the natural history of hematuria associated with
      benign prostatic hyperplasia and the effect of finasteride.

PMID- 11203074
TI  - Re: Complexed prostate specific antigen provides significant enhancement of
      specificity compared with total prostate specific antigen for detecting prostate
      cancer.

PMID- 11203075
TI  - Grading and staging of bladder carcinoma in transurethral resection specimens:
      correlation with 105 matched cystectomy specimens.

PMID- 11203076
TI  - Markers for recurrence of superficial bladder cancer: what is valid?

PMID- 11203077
TI  - Relationship between kidney size, renal injury, and renal impairment induced by
      shock wave lithotripsy.

PMID- 11203078
TI  - Routine radiologic surveillance for obstruction is not required in asymptomatic
      patients after ureteroscopy.

PMID- 11203079
TI  - Ureteropelvic junction obstruction: use of helical CT for preoperative assessment
      -comparison with intraarterial angiography.

PMID- 11203080
TI  - The 10th Clinical Cancer Research Forum.

PMID- 11203081
TI  - [Aleksandr Alekseevich Bobrov (the 150th anniversary of his birth)].

PMID- 11203082
TI  - [Aleksandr Nikolaevich Bakulev (the 110th anniversary of his birth)].

PMID- 11203083
TI  - [Walker-Warburg syndrome in adults].

PMID- 11203084
TI  - [Pediatrics 2000 Conference. 14-17 September 2000. Stuttgart, Germany.
      Abstracts].

PMID- 11203085
TI  - The AIDS epidemic: lessons learned?

PMID- 11203086
TI  - Competitiveness in science. Today, tomorrow and for ever.

PMID- 11203087
TI  - Competitiveness in science. Today, tomorrow and for ever.

PMID- 11203088
TI  - [Echinococcoses (hydatidoses) caused by Echinococcus multilocularis, E. vogeli
      and E. oligarthrus. Based on materials from the 19th International Congress on
      Hydatidology (San Carlos de Bariloche, Argentina, 20-24 September 1999)].

PMID- 11203089
TI  - [Diagnostic and therapeutic criteria for nosocomial pneumonia].

PMID- 11203090
TI  - Misinterpretation of DNA sequence data generated by polymerase chain reactions.

PMID- 11203091
TI  - Proceedings of the Oral Health Forum 2000: Improving the oral health of all New
      Zealanders. Palmerston North, New Zealand, 4-6 May 2000.

PMID- 11203092
TI  - Medical Research Ethics at the Millennium: What Have We Learned? Proceedings of a
      symposium. Bethesda, Maryland, USA. March 1998.

PMID- 11203093
TI  - Cancer resources in the United States.

PMID- 11203094
TI  - Deep vein thrombosis.

PMID- 11203095
TI  - Portals that shine. Not all physician Web portals are created equal. Here's a
      review of five leading sites and why they stand out.

PMID- 11203096
TI  - Will pay for email.

PMID- 11203097
TI  - Why are physicians still turning their backs on the Internet?

PMID- 11203098
TI  - The activities of bacterial pathogens in vivo. Papers of a discussion meeting. 20
      21 October 1999.

PMID- 11203099
TI  - [37th Annual meeting of the Society for Pediatric Radiology. Freiburg.
      Abstracts].

PMID- 11203100
TI  - What's that sound.

PMID- 11203101
TI  - Treating tobacco use and dependence: an introduction to the US Public Health
      Service Clinical Practice Guideline.

PMID- 11203102
TI  - Unusual ventilator graphics encountered following successful resuscitation from
      cardiac arrest.

PMID- 11203103
TI  - Consensus Conference on Aerosols and Delivery Devices. September 24-26, 1999,
      Bermuda.

PMID- 11203104
TI  - Considering quality of voice in early vocal cord carcinoma.

PMID- 11203105
TI  - Set-up error for conformal radiotherapy of prostate cancer.

PMID- 11203106
TI  - Microbial genomes 2000. Highlights from the American Society for Microbiology -
      Institute Pasteur Conference. Paris, France, April 11-15, 2000.

PMID- 11203107
TI  - [Prevention of the chronic complications of type 2 diabetes: A consensus from the
      Mexican Society of Nutrition and Endocrinology, the Mexican Association of
      Internal Medicine, and the Society of Nutriology].

PMID- 11203108
TI  - Diagnosis and treatment of sleep breathing disorders. Proceedings of a symposium.
      Grenoble, France, December 1998.

PMID- 11203109
TI  - [Obesitology '98. Selected papers presented at the conference organized by the
      Czech Society for the Study of Obesity and the J.E. Purkyne Medical Association
      held 23-24 October 1998 in Podebrady, Lazensky Dum].

PMID- 11203110
TI  - [Environmental hygiene: current conditions and future perspectives. Conference
      proceedings. Berlin, 9-11 June 1999].

PMID- 11203111
TI  - The challenge of fibromyalgia: new approaches. Proceedings from a symposium.
      Frankfurt, Neu-Isenburg, Germany. 25-26 November 1999.

PMID- 11203112
TI  - [Joint Congress of the Swiss Society of Rheumatology and the Swiss Society of
      Physical Therapy and Rehabilitation. Lucerne, 13-15 September 2000. Abstracts].

PMID- 11203113
TI  - [Is the "dental team" still attractive?].

PMID- 11203114
TI  - [The development of insolvency in Switzerland has become an existential threat].

PMID- 11203115
TI  - [The last bill].

PMID- 11203116
TI  - [Swiss dental fees are doing harm].

PMID- 11203117
TI  - [Prof. Peter Scharer, M. S., emeritus].

PMID- 11203118
TI  - [The identification of an unknown male corpse. Who recognizes this maxillary
      status?].

PMID- 11203119
TI  - Biologist Paul R. Ehrlich. Six billion and counting.

PMID- 11203120
TI  - [Factors affecting prognosis in penetrating wounds of the heart].

PMID- 11203121
TI  - Association between heritable connective tissue disorders and intracranial
      aneurysms.

PMID- 11203122
TI  - Thoughts about the younger generation.

PMID- 11203123
TI  - Cisternal irrigation with UK to prevent vasospasm.

PMID- 11203124
TI  - Spinal meningiomas.

PMID- 11203125
TI  - Transthoracic endoscopic sympathectomy.

PMID- 11203126
TI  - Paracetamol and asthma.

PMID- 11203127
TI  - Paracetamol and asthma.

PMID- 11203128
TI  - Paracetamol and asthma.

PMID- 11203129
TI  - Paracetamol and asthma.

PMID- 11203130
TI  - Paracetamol and asthma.

PMID- 11203131
TI  - Paracetamol and asthma.

PMID- 11203132
TI  - Paracetamol and asthma.

PMID- 11203133
TI  - Hyperventilation syndrome.

PMID- 11203134
TI  - Fibrin formation in whole blood.

PMID- 11203135
TI  - [Patents of the Russian Federation in the field of stomatology published in 1997
      2000].

PMID- 11203136
TI  - Which way is up?

PMID- 11203137
TI  - A plea to search for deletion polymorphism through genome scans in populations.

PMID- 11203138
TI  - How 'homology' entered genetics.

PMID- 11203139
TI  - Silencing survival data.

PMID- 11203141
TI  - [Recommendations by the teaching-methodology commission on otorhinolaryngology].

PMID- 11203140
TI  - Un pour tous, tous pour un.

PMID- 11203142
TI  - [Dissertations defended in 2000].

PMID- 11203143
TI  - International forum: granulocyte transfusions.

PMID- 11203144
TI  - Minocycline-induced generalized postinflammatory elastolysis.

PMID- 11203145
TI  - The effects of Ramadan fasting on blood lipid levels.

PMID- 11203146
TI  - Managed care and education.

PMID- 11203147
TI  - Do plasma melatonin concentrations decline with age?

PMID- 11203148
TI  - The Oslerian triple-threat: an endangered species? A survey of department of
      medicine chairs.

PMID- 11203149
TI  - [4th National Gynecological Conference. April 2000, Bulgaria. Abstracts].

PMID- 11203150
TI  - Iron deficiency anaemia, Helicobacter pylori infection and delayed pubertal
      growth.

PMID- 11203151
TI  - Iron status and development.

PMID- 11203152
TI  - Coeliac screening just as important!

PMID- 11203153
TI  - Consider absolute risks in SIDS prevention.

PMID- 11203154
TI  - Are we requesting too many DMSA scans?

PMID- 11203155
TI  - From wheels to feet: a dramatic response of severe chronic psoriatic arthritis to
      etanercept.

PMID- 11203156
TI  - Polymyositis, cranial neuropathy, autoimmune hepatitis, and hepatitis C.

PMID- 11203157
TI  - Apolipoprotein B signal peptide polymorphism in relation to lipids and diabetes
      in male CAD patients.

PMID- 11203158
TI  - Lipoprotein (a) and chronic obstructive pulmonary disease.

PMID- 11203159
TI  - Relationship between plasma ACE activity and the proliferative healing process in
      coronary vessel injury after coronary stenting.

PMID- 11203160
TI  - The carotid artery wall thickness in teenagers is related to their diet and the
      typical risk factors of heart disease among adults.

PMID- 11203161
TI  - Intranasal midazolam and familial dysautonomia.

PMID- 11203162
TI  - Simple and economic workstation for burn intensive care.

PMID- 11203163
TI  - Barriers to screening for intimate partner violence: time to reframe the
      question.

PMID- 11203164
TI  - Criminal justice responses to violence against women.

PMID- 11203165
TI  - Violence against women: international perspectives.

PMID- 11203166
TI  - Cover illustration: The original slit beam.

PMID- 11203167
TI  - Sudden bilateral visual loss in acute myeloid leukemia.

PMID- 11203168
TI  - Serous retinal detachment caused by leukemic choroidal infiltration during
      complete remission.

PMID- 11203169
TI  - Diplopia, ptosis, and hepatitis as presenting signs and symptoms of giant cell
      arteritis.

PMID- 11203170
TI  - Observations on time course changes of the cherry red spot in a patient with Tay
      Sachs disease.

PMID- 11203171
TI  - Effects of homozygous apolipoprotein A-1 deficiency on the cornea.

PMID- 11203172
TI  - Acquired capillary haemangioma of the eyelid in an adult treated with cutting
      diathermy.

PMID- 11203173
TI  - Idiopathic sclerosing inflammation of the orbit: a new finding of calcification.

PMID- 11203174
TI  - Therapy of subhyaloidal hemorrhage by intravitreal application of rtPA and SF(6)
      gas.

PMID- 11203175
TI  - Sebaceous gland carcinoma of the eyelid and palpebral conjunctiva in a patient
      with Muir-Torre syndrome.

PMID- 11203176
TI  - Ophthlamic features of primary oxalosis after combined liver/kidney
      transplantation.

PMID- 11203177
TI  - Retinal telangiectasis and angioid streaks.

PMID- 11203178
TI  - Sclerosing lipid granuloma of the medial canthus 30 years after dacryocystitis.

PMID- 11203179
TI  - Treatment of subhyaloid haemorrhage with intravitreal tissue plasminogen
      activator and C3F8 gas injection.

PMID- 11203180
TI  - Blunt trauma in Best's vitelliform macular dystrophy.

PMID- 11203181
TI  - Epidermoid carcinoma arising in an ocular Leishmania lesion.

PMID- 11203182
TI  - [Exudative retinal detachment in a clinical case].

PMID- 11203183
TI  - Paroxetine binding to the rat norepinephrine transporter in vivo.

PMID- 11203184
TI  - Photo quiz. Diagnosis: hydatid bone disease (cystic echinococcosis).

PMID- 11203185
TI  - Proceedings of the 2nd Joint Workshop on Cytokines in Inflammation. Lubeck,
      Germany, May 11-14, 2000.

PMID- 11203186
TI  - Interleukin-18, a proinflammatory cytokine.
AB  - Although IL-18 is an inducer of IFN-gamma and Th1 responses. IL-18 is a
      proinflammatory cytokine by several criteria. In several animal models.
      antibodies that neutralize endogenous IL-18 reduce the severity of disease.
      Endotoxin lethality is prevented by anti-IL-18. Even in models that are
      interferon-y independent, neutralization of IL-18 prolongs survival. Anti-IL-18
      also protects the liver against cellular injury induced by toxins or activated T
      cells. In models of hepatic melanoma metastasis. IL-18 blockade reduces the
      adherence of malignant cells by preventing IL-18 upregulation of vascular
      endothelial adhesion-1 molecule expression. IL-18 and IL-12 act synergistically
      to stimulate I cells and natural killer cells to produce IFN-gamma but
      neutralization of IL-18 prevents IL-12 induction of IFN-gamma. IL-18. like
      several cytokines. can be used to enhance host defense against tumors in mice a
      mechanism that is most often IFN-gamma-dependent. Nevertheless. it is the
      proinflammatory portfolio of IL-18 which likely contributes to enhanced host
      defenses. In models or arthritis, lung injury or inflammatory bowel disease,
      neutralization of IL-18 reveals the important role of this cytokine in mediating
      inflammation.

PMID- 11203187
TI  - GD3 ganglioside as an intracellular mediator of apoptosis.

PMID- 11203188
TI  - Toll like receptor family (TLT) and signalling pathway.

PMID- 11203189
TI  - Signalling of interleukin-6 type cytokines via gp130, leukemia inhibitory factor
      (LIF) receptor and oncostatin M receptor.

PMID- 11203190
TI  - Integrin-mediated regulation of cytokine and chemokine production by human
      natural killer cells.

PMID- 11203191
TI  - Chemokines and their receptors: trafficking cues for Th1 and Th2 cells.

PMID- 11203192
TI  - Regulation of cytokine transcription by common stress kinase cascades.

PMID- 11203193
TI  - NRF, a nuclear inhibitor of NF-kappaB proteins silencing interferon-beta
      promoter.
AB  - The family of NF-kappaB/rel transcription factors regulates a variety of
      promoters through specific DNA-binding sites. Consistent with the role of NF
      kappaB activation as a response to pathogens, it regulates the expression of
      immune modulating cytokines like interferon-beta3 (IFN-3). Transcriptional
      regulation of IFN-beta is characterized by strict constitutive repression and
      virus-mediated activation. A nuclear protein, called NRF (NF-kappaB repressing
      factor) silences constitutively the IFN-beta3 promoter by binding to the negative
      regulatory element (NRE). This control is achieved by a direct protein-protein
      interaction between NRF and proximal bound NF-kappaB factors preventing the
      transcriptional activation. After viral induction NRF still binds but does not
      any more exert its specific inhibition. NRE-related sequences found in a number
      of promoters like those of HIV-1, HTLV-1 and the genes of the IL-2Ralpha and IL-8
      constitute functionally related silencer elements which repress the constitutive
      enhancing activity of NF-kappaB/rel-binding sites from these promoters.

PMID- 11203194
TI  - In vitro and in vivo regulation of chemokine receptors.

PMID- 11203195
TI  - Functional organization of secondary lymphoid organs by homeostatic chemokines.

PMID- 11203196
TI  - Is platelet factor-4 a chemokine?

PMID- 11203197
TI  - Inhibition of dendritic cell costimulation associated with tolerance to
      allografts.

PMID- 11203198
TI  - Th1/Th2 cells, their associated molecules and role in pathophysiology.
AB  - Cytokines, chemokines, and/or chemokine receptors associated with type 1 T helper
      (Th1) or Th2 cells play a role in different physiological conditions, such as T
      lymphopoiesis and pregnancy, as well as in pathological conditions, such as
      unexplained recurrent abortions, proliferative glomerulonephritis, and control of
      angiogenesis.

PMID- 11203199
TI  - Modulation and termination of interleukin-6 signalling.

PMID- 11203200
TI  - Morphogenic and host protective functions executed by tumor necrosis factor
      receptors, lymphotoxin receptors and their ligands.

PMID- 11203201
TI  - IL-18 and IL-18 receptors in the development of autoimmunity.

PMID- 11203202
TI  - Different biological role and anti-tumor activity of interleukin-15 isoforms.

PMID- 11203203
TI  - No RISC, no fun: assembly of receptor-induced signalling complexes in the tumor
      necrosis factor system.

PMID- 11203204
TI  - Inhibiting the IL-4 receptor: why, how, and for whom?

PMID- 11203205
TI  - The ABL kinase inhibitor STI571 does not affect survival of hematopoietic cells
      after ionizing radiation.

PMID- 11203206
TI  - Hyperprothrombinemia may result in scquired activated protein C reistance.

PMID- 11203207
TI  - Private finance scheme for Worcester. Battle in Kidderminster is against "spin,"
      half truth, and obfuscation.

PMID- 11203208
TI  - Meta-analysis of increased inhaled steroid or addition of salmeterol in asthma.
      Researchers can learn from industry based reporting standards.

PMID- 11203209
TI  - Babies sleeping with parents and sudden infant death syndrome. Smoking may be
      residual confounder in bed sharing.

PMID- 11203210
TI  - Babies sleeping with parents and sudden infant death syndrome. Down with smoking
      and babies sleeping in separate rooms.

PMID- 11203211
TI  - Second editorial on GMC is ironic.

PMID- 11203212
TI  - Isolated systolic hypertension. Is it time for me to retire from medicine?

PMID- 11203213
TI  - Upward trend in acute anaphylaxis continued in 1998-9.

PMID- 11203214
TI  - Provision of age appropriate health services for young people has been ignored.

PMID- 11203215
TI  - Emergence of multidrug resistant pneumococci in India.

PMID- 11203216
TI  - Incidence and remission of lower urinary tract symptoms. Results have practical
      implications.

PMID- 11203217
TI  - General medical journals should have covered war in Kosovo more.

PMID- 11203218
TI  - NICE issues new guidelines on Ritalin.

PMID- 11203219
TI  - Thabo Mbeki's spokesman "dies of aids related disease".

PMID- 11203220
TI  - Threat of chemical and germ attacks overstated, report says.

PMID- 11203221
TI  - No compensation for hepatitis C patients in Scotland.

PMID- 11203222
TI  - Anticoagulation to prevent stroke in atrial fibrillation. It's still not clear
      whether results in secondary care translate to primary care.

PMID- 11203223
TI  - Anticoagulation to prevent stroke in atrial fibrillation. Cohort was younger than
      many patients with atrial fibrillation in primary care.

PMID- 11203224
TI  - General practitioners have to decide best ways of allocating their time.

PMID- 11203225
TI  - Anticoagulation to prevent stroke in atrial fibrillation. Comprehensive geriatric
      evaluation should be routine before treatment is started.

PMID- 11203226
TI  - Standard definition of child overweight and obesity worldwide. Authors' standard
      compares well with WHO standard.

PMID- 11203227
TI  - Standard definition of child overweight and obesity worldwide. Young Chinese
      people in Hong Kong are not representative of those in China.

PMID- 11203228
TI  - Standard definition of child overweight and obesity worldwide. Body mass index is
      harder to interpret in children than adults.

PMID- 11203229
TI  - Standard definition of child overweight and obesity worldwide. Reanalysis
      suggests questionable validity of new definition during puberty.

PMID- 11203231
TI  - 8th International Conference on Emergency Medicine. Boston, Massachusetts, USA. 4
      7 May 2000. Abstracts.

PMID- 11203230
TI  - Proceedings of the 2nd International Symposium on Transplantation and Gene
      Therapy. October 21-23, 1999. Idar-Oberstein, Germany.

PMID- 11203232
TI  - The generation of diversity by Haemophilus influenzae: response.

PMID- 11203233
TI  - The mycobacterial antigens 85 complex--from structure to function: response.

PMID- 11203234
TI  - Gram-negative pathogens and molecular mimicry: is there a case for mistaken
      identity? Response.

PMID- 11203235
TI  - PII: a remarkable regulatory protein.

PMID- 11203236
TI  - A mitochondrial origin for eukaryotic C2H2 zinc finger regulators?

PMID- 11203237
TI  - Significant Achievement Award. A model prison diversion program--The Criminal
      Justice-Community Outreach Department of the Montgomery County Emergency Service,
      Norristown, Pennsylvania.

PMID- 11203238
TI  - Significant Achievement Award. A rehabilitation program for inpatients in a large
      institution--The Psychosocial Rehabilitation Program at Eastern State Hospital,
      Williamsburg, Virginia.

PMID- 11203239
TI  - SAMHSA announces advances in the treatment of adolescent marijuana users.

PMID- 11203240
TI  - New study examines Americans' changing attitudes about mental health and
      treatment from 1950-1996.

PMID- 11203241
TI  - Mechanical ventilation of the newborn.

PMID- 11203242
TI  - PTV: should it be patient triggered and patient terminated ventilation?

PMID- 11203243
TI  - To trigger or not to trigger?

PMID- 11203244
TI  - Patient triggered ventilation.

PMID- 11203245
TI  - [The 2nd Symposium on The characteristics of the formation and development of
      psychophysiological functions in ontogeny (Cherkassy, 26-29 October 1999)].

PMID- 11203246
TI  - "A simple country doctor": remembering Dr. Clare Brant.

PMID- 11203247
TI  - Variation within global cigarette brands in tar, nicotine, and certain
      nitrosamines: analytic study.

PMID- 11203248
TI  - Carbon monoxide in the expired air of smokers who smoke so-called "light" brands
      of cigarettes.

PMID- 11203249
TI  - Call-in for kids.

PMID- 11203250
TI  - New cytogenetic data on bladder carcinoma cell line (CHA89) revealed by M-FISH
      analysis.

PMID- 11203251
TI  - Translocation (5;18) in a patient with myelodysplastic syndrome: refractory
      anemia with excess blasts in transformation.

PMID- 11203252
TI  - Good publication practice guideline for pharmaceutical companies.

PMID- 11203253
TI  - [Toast proposed by professor Wlodzimierz Sieradzki to Ignacy Paderewski].

PMID- 11203254
TI  - New millennium: new expectations for Alzheimer's disease?

PMID- 11203255
TI  - Immunohistochemical investigation of new suppressor oncogene p130 in oral
      squamous cell carcinoma, vol.35 (1999), 321-325.

PMID- 11203256
TI  - [Letter of Public Health Care Ministry of The Russian Federation of Jan. 31, 2000
      on "Inpatient Clinics for Involuntary Commitment of Mentally Ill"].

PMID- 11203257
TI  - [The pathology of epiconus medullaris. 1904].

PMID- 11203258
TI  - [On the training of clinical psychologists and teaching psychology in institutes
      of higher learning in Russia].

PMID- 11203259
TI  - [The role of S. S. Korsakov in the development of the Moscow psychiatric school].

PMID- 11203260
TI  - [Nikolai Vasil'evich Konovalov (on the centenary of his birth)].

PMID- 11203261
TI  - [The statement of the DGKfo on the optimal timing for the performance of
      orthodontic measures (with special reference to early orthodontic treatment).
      Deutsche Gesellschaft fur Kieferorthopadie (German Society of Orthodontics)].

PMID- 11203262
TI  - The church of Sv. Spas (St. Savoir).

PMID- 11203263
TI  - Proceedings of the 4th International Symposium on Febrile Neutropenia. December
      15-17, 1999.

PMID- 11203264
TI  - [Nuclear medicine in Latin America].

PMID- 11203265
TI  - [Scintigraphy with FDG-PET].

PMID- 11203266
TI  - The story of "story".

PMID- 11203267
TI  - The story of "story".

PMID- 11203268
TI  - Can "fighting spirit" be learned and chosen?

PMID- 11203269
TI  - Unexpected bleeding disorders: identification, diagnosis and management.

PMID- 11203270
TI  - Bioavailability of ibuprofen from matrix mini-tablets based on a mixture of
      starch and microcrystalline wax.
AB  - The bioavailability of ibuprofen from matrix mini-tablets based on
      microcrystalline wax and a starch derivative was tested. An oral dose of 300 mg
      of ibuprofen was administered to healthy volunteers (n=8) in a randomized cross
      over study design either as a commercial matrix formulation (Ibu-Slow 600) or as
      mini-tablets (filled into hard gelatin capsules). The mini-tablets consisted of
      60% ibuprofen, 15% Paracera M (wax), 22.5% DDWM (starch) and 2.5% triacetin
      (lubricant). t50% of the in vitro release was 4.5 and 5 h for the mini-tablet and
      Ibu-slow formulations, respectively. Both formulations behaved in vivo as
      sustained-release formulation; their HVDt50%Cmax value was determined at 5.6 and
      5.1 h for the mini-tablet and Ibu-slow formulations, respectively. A
      significantly higher value of Cmax was seen for the mini-tablet formulation,
      resulting in a relative bioavailability of 116 +/- 22.6% compared to the Ibu-slow
      matrix. These data demonstrate that the experimental mini-tablets can be used to
      formulate sustained-release dosage forms.

PMID- 11203271
TI  - The dissolution of urinary catheter encrustation.

PMID- 11203272
TI  - Notice of duplicate publication.

PMID- 11203273
TI  - USAN Council. List No. 432. New Names. Alefacept, darbepoetin alfa, daclizumab.

PMID- 11203274
TI  - Molecular genetics of model legumes.

PMID- 11203275
TI  - ABI3 emerges from the seed.

PMID- 11203276
TI  - Microfibril orientation in wood cells: new angles on an old topic.

PMID- 11203277
TI  - Viral sequences integrated into plant genomes.

PMID- 11203278
TI  - BRInging light to hormone receptor activation.

PMID- 11203280
TI  - ENAMEL VI. Proceedings of the 6th international symposium on the composition,
      properties and fundamental structure of tooth enamel. Lake Arrowhead, California,
      USA. May 11-15, 1997.

PMID- 11203279
TI  - ORCAstrating plant primary and secondary metabolism.

PMID- 11203281
TI  - ENAMEL VI. Proceedings of the 6th International Symposium on the composition,
      properties and fundamental structure of tooth enamel. Lake Arrowhead, California,
      USA. May 11-15, 1997.

PMID- 11203282
TI  - Web alert.

PMID- 11203283
TI  - Web alert.

PMID- 11203284
TI  - Web alert.

PMID- 11203286
TI  - Web alert.

PMID- 11203285
TI  - Web alert.

PMID- 11203287
TI  - Ventricular tachycardia catheter ablation in arrhythmogenic right ventricular
      dysplasia: a 16-year experience.
AB  - Arrhythmogenic right ventricular dysplasia (ARVD) is a structural heart disease
      affecting young adults that leads to cardiac rhythm disorders including
      supraventricular and mostly ventricular arrhythmias. Sudden death may be the
      first presentation of the disease. Ablation techniques have been used for the
      treatment of ventricular tachycardia in cases resistant to drug therapy.
      Radiofrequency is appropriate as a first approach for ventricular tachycardia
      ablation in ARVD; however, its effectiveness is less than 40% at the first
      session. Fulguration is effective for ventricular tachy-cardia ablation and
      should be used in the same session after ineffective radiofrequency ablation.
      However, fulguration requires expertise, general anesthesia, and more than one
      session in half of all patients. Radiofrequency and fulguration plus other common
      forms of treatment including pacemakers and automatic implantable cardioverter
      defibrillators provides a clinical success rate of 81% to 93% in a series of 50
      consecutive patients studied during 16 years. Earlier poor reputation of
      fulguration was the result of poorly understood technical problems concerning the
      physics and biophysics of the procedure under control with presently available
      methods. This in-depth study of a large population over a long time period
      demonstrates that fulguration should be rehabilitated.

PMID- 11203288
TI  - Biology, chemistry and therapeutic applications of nitric oxide: First
      International Conference.

PMID- 11203289
TI  - 18th Scientific meeting of the International Society of Hypertension.

PMID- 11203290
TI  - William Harvey Research Conference on PDE inhibitors: drugs with an expanding
      range of therapeutic uses.
AB  - Presentations at the William Harvey Research Conference on PDE Inhibitors
      described the molecular biology, biochemical regulation. pharmacology, and
      therapeutic utility of inhibitors of cyclic nucleotide phosphodiesterases (PDEs).
      Most of the talks focused on PDE4 and PDE5. two members of the 11-member PDE
      family that have attracted much interest over the last several years. These
      enzymes have been shown to be targets for drugs with wide-ranging clinical
      utility, including treatment of inflammation, depression, and male erectile
      dysfunction. The continued investigation of PDEs and the development of potent
      and selective inhibitors should provide even more therapeutic agents in years to
      come.

PMID- 11203291
TI  - Chemokines and chemokine receptors: disease targets for therapeutic development.
      November 15-16, 1999, McLean, VA, USA.
AB  - About a decade after discovery of IL-8, the first designated member of the
      protein family of chemotactic cytokines, about 50 of these so called 'chemokines'
      and about 15 receptors have been discovered in humans. Experimental as well as
      clinical data have identified many of the players in this network to be
      associated with various pathological phenomena. This conference discussed how
      research is closing in on chemokines as therapeutic targets as well as how
      chemokine functions might be exploited to design useful therapeutic tools.

PMID- 11203292
TI  - AACR-NCI-EORTC International Conference on Molecular Targets and Cancer
      Therapeutics.
AB  - The pace of anticancer drug discovery and development has accelerated over recent
      years based upon a better understanding of tumour biology at the molecular level.
      Modern drug development has moved from empiricism to rational design and this was
      the theme of the inaugural meeting of the AACR-NCI-EORTC International Conference
      on Molecular Targets and Cancer Therapeutics held in Washington DC, November 16 -
      19.1999. This was an excellent meeting where state of the art research in the
      areas of drug discovery, development and clinical evaluation of new cancer
      therapeutics was presented. A few of the highlights of this meeting are presented
      in this article but further details can he found in a supplement to Clinical
      Cancer Research (1999) 5:3729-3897, where all abstracts accepted for the meeting
      are published. This meeting is set to become the premier meeting for scientists
      and clinicians involved in all aspects of anticancer drug development (i.e., from
      bench to the bedside) and the next meeting will take place in Amsterdam on
      November 7-10, 2000.

PMID- 11203293
TI  - A rational basis for antiphospholipid antibody testing and selective
      immunotherapy in assisted reproduction: a rebuttal to the American Society for
      Reproductive Medicine Practice opinion. American Society for Reproductive
      Immunology Antiphospholipid Antibody Committee.

PMID- 11203294
TI  - Infrared thermographic assessment of the human scrotum.

PMID- 11203295
TI  - Luteal support in IVF using the novel vaginal progesterone gel Crinone 8%:
      results of an open-label trial in 1184 women from 16 US centers.

PMID- 11203296
TI  - Bone mineral density and Turner's syndrome--any lessons to be learned about
      "Menopausal Osteoporosis'.

PMID- 11203297
TI  - Bone mineral density and Turner's Syndrome--any lessons to be learned about
      "Menopausal Osteoporosis".

PMID- 11203298
TI  - Endometriomas: fenestration or excision?

PMID- 11203299
TI  - Antiphospholipid antibody status and IVF--debate.

PMID- 11203300
TI  - The value of laboratory accreditation.

PMID- 11203302
TI  - Parkinson's disease and other movement disorders 2000. Pavia, Italy, May 28-30,
      2000. Abstracts.

PMID- 11203301
TI  - Expression of an estrogen receptor alpha variant protein in cell lines and
      tumors.
AB  - Human estrogen receptor alpha (ER) mRNA is a mixture of wild type and
      alternatively spliced variants. Many studies have examined the potential of ER
      mRNA profiles to serve as diagnostic/prognostic cancer biomarkers, but only a few
      have attempted to correlate ER mRNA profiles with protein expression.
      Representative ER mRNA pools were reproduced from the cDNAs of MCF-7 cells, a
      human breast tumor and human uterus and translated in a protease-free environment
      by reticulocyte lysates to determine relative translation efficiencies between
      the various ER mRNA transcripts and to facilitate identification of translated
      proteins. Cell line and tumor extracts were then examined for expression of the
      ER variant proteins identified in reticulocyte lysate translations. Each of the
      ER mRNA pools were translated by reticulocyte lysates into two ER proteins with
      molecular weights of approximately 60 and 52 kD. Western immunoblotting with
      various C- and N-terminal-directed, anti-ER antibodies and comparison with
      expressed ER protein standards established that the 52 kD protein (ERDelta7P) was
      translated from the predominant splice variant mRNA in each pool, which is
      missing exon 7. The 60 kD protein contained wild type ER sequence minus 61 C
      terminal amino acids lost due to an intentional run off truncation. ERDelta7P
      expression was subsequently demonstrated in MCF-7 cells by Western immunoblotting
      with the site-directed antibodies. A protein corresponding to ERDelta7P was also
      detected in other ER positive breast tumor cell lines, and extracts of ER
      positive breast and uterine tumors. This widespread expression of ERDelta7P in
      vivo suggests that it may have some biological function. ERDelta7P may also
      affect immunohistochemical evaluation of ER positivity in tumors depending upon
      the level of its expression and the antibody used.

PMID- 11203303
TI  - Liver disease and pulmonary hypertension.

PMID- 11203304
TI  - UDCA, PBC, and biochemistry, what does normal mean?

PMID- 11203306
TI  - Losartan and renal sodium handling.

PMID- 11203305
TI  - Endoscopic gastrin test and Helicobacter pylori infection.

PMID- 11203307
TI  - Replication error phenotype in colorectal cancer.

PMID- 11203308
TI  - Fibrosing colonopathy in an adult caused by over use of pancreatic enzyme
      supplements.

PMID- 11203309
TI  - Coeliac disease and unfavourable outcome of pregnancy.

PMID- 11203310
TI  - Hepatitis E acquired in the UK.

PMID- 11203311
TI  - Acid suppression and upper GI cancer diagnosis.

PMID- 11203312
TI  - Re-epithelialisation of Barrett's oesophagus.

PMID- 11203313
TI  - Outcome of lamivudine resistant hepatitis B virus infection in liver transplant
      recipients in Singapore.

PMID- 11203314
TI  - Gastric cancer in patients with benign dyspepsia.

PMID- 11203315
TI  - [Harry Gordon (1906-1988)].

PMID- 11203316
TI  - [Mechanism of masticatory rhythm].

PMID- 11203317
TI  - [Post-traumatic change of neuronal function].

PMID- 11203318
TI  - Recommendations for the reporting of resected esophageal carcinomas. Association
      of Directors of Anatomic Surgical Pathology.

PMID- 11203319
TI  - Recommendations for the reporting of specimens containing oral cavity and
      oropharynx neoplasms. Association of Directors of Anatomic and Surgical
      Pathology.

PMID- 11203320
TI  - Recommendations for the reporting of surgical specimens containing uterine
      cervical neoplasms. Association of Directors of Anatomic and Surgical Pathology.

PMID- 11203321
TI  - Recommendations for the reporting of thyroid carcinomas. Association of Directors
      of Anatomic and Surgical Pathology.

PMID- 11203322
TI  - Nobel prizes: European Nobel Laureates in physiology and medicine (in fact in
      immunolgy).

PMID- 11203323
TI  - Murine models of Chlamydia trachomatis genital tract infection: use of mouse
      pneumonitis strain versus human strains.

PMID- 11203324
TI  - Outer surface protein A and arthritis in hamsters.

PMID- 11203325
TI  - Trasvenous permanent pacemaker implantation in neonates.

PMID- 11203326
TI  - Amiodarone-induced AV block and ventricular standstill. A forme fruste of an
      idiopathic long QT syndrome.

PMID- 11203328
TI  - Inferior vena cava obstruction secondary to permanent pacing.

PMID- 11203327
TI  - Digitoxin intoxication in a 79-year-old patient. A description of a case and
      review of the literature.

PMID- 11203329
TI  - Isolated cardiac echinococcosis in Cyprus.

PMID- 11203330
TI  - Breast cancer genetics. Implications of clinical practice.

PMID- 11203331
TI  - Breast cancer chemoprevention.

PMID- 11203332
TI  - Evidence-based clinical microbiology.

PMID- 11203333
TI  - Investigation of effects of acid citrate dextrose and EDTA on ability to
      quantitatively culture human immunodeficiency virus.

PMID- 11203334
TI  - Intrathecal use of colistin.

PMID- 11203336
TI  - 1999 Annual Meeting on Muscle and Cell Motility Physiology. Tokyo, Japan, 3-4
      December 1999. Abstracts.

PMID- 11203335
TI  - Are alternative sources of parasitic (cysticercal) antigens necessary for
      diagnosis of neurocysticercosis?

PMID- 11203337
TI  - Women's health.

PMID- 11203338
TI  - Books: review symposium on women's health. Review essay. The past, present, and
      future of long-term care--a women's issue?

PMID- 11203339
TI  - Chemical restraint.

PMID- 11203340
TI  - Who is dying, doctor or patient?

PMID- 11203342
TI  - Marital status and suicide: some common methodological problems.

PMID- 11203341
TI  - Non-Hodgkin's lymphoma and nitrate in drinking water.

PMID- 11203344
TI  - Family doctor advice and pneumococcal vaccine uptake.

PMID- 11203343
TI  - Neonatal mortality by place of delivery in Sao Paulo, Brazil.

PMID- 11203345
TI  - ESRADI abstracts.

PMID- 11203346
TI  - IARC Working group on the evaluation of carcinogenic risks to humans: ionizing
      radiation, Part I, X- and gamma- radiation and neutrons. Lyon, France, 26 May-2
      June 1999.

PMID- 11203347
TI  - A look back: the wonder drug.

PMID- 11203348
TI  - A look back: the sphygmomanometer.

PMID- 11203349
TI  - A look back: asthma.

PMID- 11203350
TI  - [Aging and work. Conclusive considerations].

PMID- 11203351
TI  - [Prevention and therapy of diabetic retinopathy].

PMID- 11203352
TI  - [Gottfried Ewald. Comments on cover picture].

PMID- 11203353
TI  - Cervical hydrosonography in pregnancy to assess cervical length by transabdominal
      ultrasound.
AB  - BACKGROUND: Some women's cervices cannot be evaluated because they are obscured
      by obesity or vertex-presenting fetuses. Measuring cervical length in these cases
      is difficult or impossible. TECHNIQUE: We hypothesized that the problem of
      obscured cervices on transabdominal ultrasound could be resolved by introducing
      sterile water into the vagina, creating a hydroacoustic window between the
      vaginal lumen and the cervix. Women with unmeasurable cervices on transabdominal
      ultrasound had repeat studies after introduction of 60 mL of sterile water into
      their vaginas, and cervical length measurements taken were compared with those
      made on transvaginal scans. EXPERIENCE: Six pregnant women were studied (four
      singleton, one twin, and one triplet pregnancy). In all cases, previously
      unidentifiable cervices were seen adequately. No complications were noted.
      Statistical analysis (kappa 0.66) suggested good correlation between
      transabdominal cervical hydrosonography and transvaginal measurements of cervical
      length. CONCLUSION: Introducing water into the vagina at transabdominal
      ultrasound can make an obscured cervix visible and measurable.

PMID- 11203355
TI  - Proceedings of the Workshop on Tick-Borne Diseases of Livestock in the
      Mediterranean Area. Palermo, 3-6 March 1999.

PMID- 11203354
TI  - Frequency of cervical smear abnormalities within 3 years of normal cytology.

PMID- 11203356
TI  - Tics and Tourette's syndrome.

PMID- 11203357
TI  - The use of hypnosis in gastroscopy.

PMID- 11203358
TI  - [Increase in perforin-positive peripheral blood lymphocytes in extrinsic and
      intrinsic asthma].
AB  - The cause of asthma which has been linked to a chronic, T-cell-mediated bronchial
      inflammation, remains unclear. A number of other T-lymphocyte-mediated, chronic
      inflammatory disorders have been associated with autoimmunity and there are data
      indicating that autoimmune phenomena might also be present in asthma. Expression
      of perforin, a cytotoxic molecule produced by lymphocytes, has been implicated in
      the pathogenesis of autoimmune disease. We therefore tested the hypothesis that
      allergic and intrinsic asthma might be associated with an increase in lymphocytes
      producing perforin by comparing the expression of intracellular perforin in
      peripheral blood lymphocytes of patients with extrinsic asthma (n = 13),
      intrinsic asthma (n = 7), and healthy (control subjects (n = 18). Lymphocytes
      were identified using flow cytometry and subdivided into CD3(+), CD4(+), CD8(+),
      CD16(+), and CD56(+) subpopulations after staining with appropriate monoclonal
      antibodies. The percentage of perforin-positive total lymphocytes as
      significantly elevated in patients with allergic as well as intrinsic asthma when
      compared with normal control subjects. Analysis of lymphocyte subpopulations also
      revealed a significant increase in the percentage of CD3(+), CD4(+), CD8(+), and
      CD56(+) cells expressing perforin in allergic asthma and a significant increase
      in the percentage of CD4(+), and CD56(+) cells in intrinsic asthma when compare
      with healthy control subjects. Perforin expression in CD4(+) cells in intrinsic
      asthma was also significantly elevated compared with allergic asthma. We conclude
      that allergic and intrinsic asthma is associated with increased expression of
      perforin in T-lymphocyte subsets.

PMID- 11203359
TI  - [Extent of our knowledge on schizophrenia].

PMID- 11203360
TI  - Severe hypothyroidism after chemotherapy and locoregional irradiation for breast
      cancer.

PMID- 11203361
TI  - [Tiazides and betablockers in the treatment of hypertension].

PMID- 11203362
TI  - [Revascularization in chronic renal failure].

PMID- 11203363
TI  - [Anticoagulant treatment in nonrheumatic atrial fibrillation].

PMID- 11203364
TI  - International symposium: Fractals 2000 in biology and medicine. Ascona,
      Switzerland, 7-11 March 2000. Abstracts.

PMID- 11203365
TI  - [The image of the dentist and the dead season].

PMID- 11203366
TI  - [Infectious diseases in the dental office].

PMID- 11203367
TI  - ["Draw me a dentist!"].

PMID- 11203368
TI  - [The information platform of the SSO (Societe Suisse d'Odonto-Stomatologie].

PMID- 11203369
TI  - [The current trends in implantology. A report on the annual meeting of the
      Societe Suisse d'Implantologie Orale (SSIO) of 6 September 2000 at Bern].

PMID- 11203370
TI  - [The social and political aspects in geriatric dentistry. A report on the SSO
      Congress at Interlaken, 7, 8 and 9 September 2000 (1). Societe Suisse d'Odonto
      Stomatologie].

PMID- 11203371
TI  - Artificial life. Boids of a feather flock together.

PMID- 11203372
TI  - Biomathematics--patterns. Spiral slime.

PMID- 11203373
TI  - Cervical disc herniation presenting with acute myelopathy.

PMID- 11203374
TI  - Evaded bioethics.

PMID- 11203375
TI  - Use of nitric oxide inhalation in COPD.

PMID- 11203376
TI  - Discovery of PAI-1 in plasma.

PMID- 11203377
TI  - Amount of paraformaldehyde for sample fixation markedly affects the quality of
      platelet assessment by flow cytometry: experience from two clinical trials.

PMID- 11203378
TI  - Masking is addictive triggering not noise.

PMID- 11203380
TI  - Bibliography of toxinology.

PMID- 11203379
TI  - 6th Panamerican Congress on Animal, Plant and Microbial Toxins of the
      International Society on Toxinology, Panamerican Section. An international
      meeting on toxins as problems, tools and solutions. 21-26 September 1998.
      Margarita Island, Venezuela. Abstracts.

PMID- 11203381
TI  - Mitochondria and chloroplasts: localized and delocalized bioenergetic
      transduction.

PMID- 11203382
TI  - Copper chaperones in bacteria: association with copper-transporting ATPases.

PMID- 11203383
TI  - The REPRO server: finding protein internal sequence repeats through the Web.

PMID- 11203384
TI  - IKKalpha-/- mice share phenotype with pupoid fetus (pf/pf) and repeated epilation
      (Er/Er) mutant mice.

PMID- 11203385
TI  - Hsp70 (DnaK)--an evolution facilitator?

PMID- 11203386
TI  - Exploring histones and their relatives with the Histone Sequence Database.

PMID- 11203387
TI  - RUMMAGE--a high-throughput sequence annotation system.

PMID- 11203388
TI  - Stochastic multidimensional hypercubes and inverse agonism.

PMID- 11203389
TI  - Forgotten target for marijuana: the endocannabinoid system in the gut.

PMID- 11203390
TI  - Astrocyte-neurone crosstalk: variants of the same language?

PMID- 11203391
TI  - Considerations about Professor Eckert's lecture on the occasion of WAA VP/Pfizer
      Award.

PMID- 11203392
TI  - [Dissertations defended in 2000].

PMID- 11203393
TI  - [A gathering of the chief pulmonary tuberculosis specialists in the branches of
      the Armed Forces, military districts and the Navy].

PMID- 11203394
TI  - [A clinical expert conference of specialists of Moscow region military medical
      commissions].

PMID- 11203395
TI  - [Dissertations defended in 2000].

PMID- 11203396
TI  - [Modern diagnostic and therapeutic technologies for infectious patients].

PMID- 11203397
TI  - Perioperative Transfusion Triggers for Red Blood Cells.
AB  - Perioperative transfusion triggers for red blood cell (RBC) transfusion include
      physiologic signs of inadequate oxygenation of the entire organism or a specific
      organ, hemoglobin (Hb) concentration and logistic aspects such as experience of
      anesthesiologists and surgeons, predictability and magnitude of blood loss and
      time required for a Hb determination and RBC delivery. At a Hb concentration <6
      g/dL a RBC transfusion may be given, however, if the patient is hemodynamically
      stable one may opt not to transfuse. With Hb concentrations between 6 g/dL and 10
      g/dL physiologic signs of inadequate oxygenation decide on RBC transfusion. In
      absence of hypovolemia signs of inadequate oxygenation include tachycardia and
      hypotension, an O2 extraction>50%, a a mixed-venous O2 partial pressure <4.3 kPa
      (32 mmHg), a decrease of O2 consumption >10% (not otherwise explained) and signs
      of locally deficient oxygenation such as myocardial ischemia. At Hb
      concentrations >10 g/dL, RBC transfusions are rarely, if ever, indicated.

PMID- 11203398
TI  - [The article by Dr. Mey et al., Therapy-refractory thrombocytopenia in chronic
      hepatitis C. Casuistics].

PMID- 11203399
TI  - [Park bench paralysis and bottle sign symptoms].

PMID- 11203400
TI  - [On the 125th anniversary of the birth of A. A. Ukhtomskii].

PMID- 11203401
TI  - "Immunization of newborns in the tropics." The Gambia, 25-27 November 1999.

PMID- 11203402
TI  - The estimation of mortality due to rotavirus infections in sub-Saharan Africa.

PMID- 11203403
TI  - Vaccine-induced antibodies by commercial test kits, the case of the Rubini mumps
      and the Edmonston-Zagreb measles vaccine strains.

PMID- 11203404
TI  - [On the 80th birthday of Evgenii Nikolaevich Sokolov].

PMID- 11203405
TI  - [Normal and impaired fracture healing].

PMID- 11203406
TI  - [Consensus meeting. Acute pancreatitis].

PMID- 11203407
TI  - Proceedings of the Nordic Oto-Laryngological Society's XXVIIth Congress. 12-15
      August 1999. Odense, Denmark.

PMID- 11203408
TI  - Experimental and clinical-therapeutic features of asthma. Proceedings from the
      international meeting in Naples, Italy. June 7-8, 1999.

PMID- 11203409
TI  - A case for co-ordinated investigation and reporting of hypersensitivity-type drug
      reactions in the UK.

PMID- 11203410
TI  - [Consensus conference: Indications for curarization in anesthesia. Saint-Mande, 8
      July 1999. Proceedings].

PMID- 11203411
TI  - [Inhaled corticosteroids and wheezing post-bronchiolitis].
AB  - OBJECTIVE: To determine whether inhaled corticosteroid therapy given for 3 months
      after mild bronchiolitis decreases the incidence and/or severity of wheezing in
      the following 12 months. DESIGN: Multicentric, single-blind, controlled,
      randomised intervention study. SETTING: Primary Health Care Centers in Lezo,
      Beraun, Andoain and Irun (Gipuzkoa, Spain). PATIENTS: Infants less than 12 months
      old (n = 94) diagnosed with mild bronchiolitis. INTERVENTION: We established two
      groups of patients: group 1 (n = 47) was treated with inhaled beclomethasone (250
      pg/12 hours) using a valved holding chamber (Babyhaler); the treatment started
      eight days after diagnosis of bronchiolitis and lasted 3 months. Group 2 (n = 47)
      received no treatment. We compared the number of wheezing episodes and their
      severity during the intervention period (3 months) and the follow-up period (12
      months) with the Students t-test and the Chi-squared test. RESULTS: We studied 89
      infants (group 1, n = 42; group 2, n = 47), 67% of whom wheezed during the study
      period (15 months). There were no significant differences between the treatment
      and the control group in the study periods. CONCLUSIONS: Inhaled beclomethasone
      given for 3 months does not significantly modify the occurrence of wheezing
      episodes during the treatment period or during the following 12 months.

PMID- 11203412
TI  - [Outpatient management of children with viral meningitis].
AB  - OBJECTIVE: To describe our experience in the extrahospitalary management of
      children with suspected viral meningitis (YM). METHOD: Between April and July
      1997. 156 children were diagnosed of YM in our hospital and 150 managed as
      outpatients, after being a few hours in our emergency department. All of them
      were suspected to have VM attending usual clinical and laboratory findings and
      were discharged with cautious instructions to demand a new assessment. We
      contacted telephonically with them one month and six months later. RESULTS: All
      the children with suspected viral meningitis and managed as outpatients had
      negative blood and CSF cultures and all of them did well. Telephonically, 104
      children (69.3%) referred transient headache or back pain. and 20 of these (13.3%
      of all the 150) came again to our hospital, and 4 required rest for a few hours
      (4-12 hours) in our observation setting. Children with suspected VM didn't go to
      school during 5.9 x 6.1 days (1-30 days) and 71 (47.3%) were absent less than 3
      days. CONCLUSION: Outpatient management of most of the children with suspected VM
      is possible. When a patient is sent home, detailed instructions must be given to
      the family.

PMID- 11203413
TI  - [Klinefelter 48 XXYY syndrome. Case report].

PMID- 11203414
TI  - [Hypermenorrhea in teenagers as a cause of iron-deficiency anemia and hospital
      admission].

PMID- 11203415
TI  - [Evaluation of a transcutaneous bilirubinometer].
AB  - OBJECTIVE: Transcutaneous bilirubinometers are useful in screening and monitoring
      neonatal hyperbilirubinemia. These instruments reduce the number of blood samples
      needed, but their validity has been questioned. The aim of this study was to
      evaluate the accuracy and reliability of a classic transcutaneous
      bilirubinometer. METHOD: Descriptive observational cross-sectional study of a sam
      ple of 117 simultaneous measurements of transcutaneous and serum bilirubin in 82
      jaundiced newborn infants. We analyzed the agreement between repeat measurements
      and measurements in different sites. We developed predictive models of serum
      bilirubin and analyzed their validity. RESULTS: All points of measurement
      displayed excellent agreement between repeat measures (intraclass correlation co
      efficient higher than 0.92). Forehead measurements had a linear correlation
      coefficient of 0.75; in the sternum II-near correlation coefficient varied
      according to the absence or presence of phototherapy (0.86 and 0.54
      respectively). The error intervals in which predictions of se-rum bilirubin were
      found were #+ 2 mg/dl for low values and #+ 4 mg/dl for high values (#> 15
      mg/dl). CONCLUSIONS: Reliability of the transcutaneous bilirubinometer evaluated
      was high, but the substantial degree of error in se-rum bilirubin make its
      accuracy questionable, especially in patients with high levels.

PMID- 11203416
TI  - [Continuing increase in the incidence of serogroup C meningococcal disease.
      Should we decide to vaccinate?].

PMID- 11203417
TI  - [Hypernatremia as postsurgical complication of hepatic hydatid cyst].

PMID- 11203418
TI  - [Sterilization in the dermatology outpatient clinic].

PMID- 11203419
TI  - [Aesthetics and mortal risk].

PMID- 11203420
TI  - Potencies of newer fluoroquinolones against Viridans group Streptococciisolated
      in 637 cases of bloodstream infection in the SENTRY Antimicrobial Surveillance
      Program (1997 to 1999): beyond Canada!

PMID- 11203421
TI  - Use of small amounts of ultrasound guided air for injections.

PMID- 11203422
TI  - Steroid psychosis after an intra-articular injection.

PMID- 11203423
TI  - Familial macrophagic myofasciitis.

PMID- 11203424
TI  - [Minimally invasive cardiac surgery].

PMID- 11203425
TI  - Cellular resistance to homocysteine: a key for longevity.

PMID- 11203426
TI  - Identification of HIV-1 in the aortic wall of AIDS patients.

PMID- 11203427
TI  - Atherosclerosis, type 1 collagen cross-linking and homocysteine.

PMID- 11203428
TI  - Acute normovolemic hemodilution.

PMID- 11203429
TI  - A possible cause of cardiovascular collapse during anesthesia: long-term use of
      St. John's Wort.

PMID- 11203430
TI  - HIV-1: molecular biology and pathogenesis.

PMID- 11203431
TI  - Proceedings of the South-Eastern Organ Procurement Foundation meeting. 16
      September 1999, Memphis, Tennessee, USA.

PMID- 11203432
TI  - Lessons learned from a full-scale bioterrorism exercise.

PMID- 11203433
TI  - Cyclooxygenases in the central nervous system: implications for treatment of
      neurological disorders.
AB  - Recognition of two isoforms of cyclooxygenase and reports that nonsteroidal anti
      inflammatory drugs may be beneficial in devastating neurological conditions such
      as Alzheimer's disease have led to increased interest in cyclooxygenase function
      in the nervous system. In the present paper we review current data on the
      multiplicity of cyclooxygenase and prostaglandin mediated effects in the central
      nervous system (CNS). We discuss CNS cells types, including neurons, glia, and
      cerebrovascular elements, where cyclooxygenases-1 and -2 are expressed under
      normal conditions or can be induced by physiological or pathological stimuli. We
      also address physiological processes such as pain sensitization, CNS inflammation
      and fever induction that are regulated or modified by cyclooxygenase activity.
      Finally, we describe potential roles of cyclooxygenase in neurological diseases
      and rationales for nonsteroidal anti-inflammatory drug use in the treatment of
      neurodegenerative disorders, stroke and CNS injury.

PMID- 11203434
TI  - Protection against ozone-induced pulmonary inflammation and cell death by
      endotoxin pretreatment in mice: role of HO-1.
AB  - Ozone is a ubiquitous air pollutant that can cause acute pulmonary inflammation
      and cell injury and may contribute to the exacerbation of chronic pulmonary
      diseases. The molecular mechanisms of ozone-induced cell injury, as well as
      protective mechanisms against ozone-injury, are not well understood. Since ozone
      is a reactive oxidant, and heme oxygenase-1 (HO-1) is an antioxidant enzyme
      induced by many oxidative stimuli, we hypothesized that HO-1 is one of the
      protective mechanisms against ozone-induced cell injury, as well as pulmonary
      inflammation. In the current study, C57Bl/6 mice were pretreated with a low level
      of endotoxin (lipopolysaccharide, LPS) (0.5 mg/kg) to induce HO-1, and 16 h later
      were exposed to 1 ppm ozone for 3 h. Endotoxin pretreatment caused a significant
      protection against ozone-induced pulmonary inflammation and cell injury in
      bronchoalveolar lavage (BAL) cells. The protection by endotoxin pretreatment
      against ozone-induced inflammation and necrosis in BAL cells was abolished by the
      cotreatment with a heme oxygenase inhibitor, tin protoporphyrin IX dichloride
      (SnPP), suggesting that HO-1 is responsible for the protection against ozone
      induced pulmonary inflammation and BAL cell necrosis. Therefore, since HO-1 is
      induced following ozone exposure, HO-1 may contribute to the development of
      cellular adaptation to chronic ozone exposure.

PMID- 11203435
TI  - Fetal cardiotocography during cesarean section.

PMID- 11203436
TI  - Endoscopic ultrasound.

PMID- 11203437
TI  - Endoscopic valvuloplasty for gastroesophageal reflux disease.

PMID- 11203438
TI  - A comparison of virtual and conventional colonoscopy for the detection of
      colorectal polyps.

PMID- 11203439
TI  - Safe, low-distortion tape touch method for fungal slide mounts.

PMID- 11203440
TI  - Evaluation of the toxicity of Solanum lycocarpum in the reproductive system of
      male mice and rats.
AB  - Powdered Solanum lycocarpum fruit is commonly used to treat diabetes, but
      apparently no studies have been conducted to evaluate potential adverse side
      effects. In the present paper the toxic effect of S. lycocarpum was evaluated in
      adult male Wistar rats and Swiss mice. The administration of an aqueous extract
      prepared using a powder obtained from the S. lycocarpum fruit at two different
      dose levels (60 mg/15 ml and 120 mg/15 ml distilled water for rats and 30 mg/15
      ml and 60 mg/15 ml distilled water for mice, twice daily for 5 days in each case)
      did not produce body weight variations in either species although a significant
      weight change was observed in some organs. Significant weight loss was observed
      only in the ventral prostate of mice receiving the high dose treatment. These
      results suggest a toxic effect of S. lycocarpum on the male reproductive system
      of the Swiss mouse, with possible antiandrogenic activity, but there was no
      apparent antifertility activity in rats at the doses given.

PMID- 11203441
TI  - [The use of acetylsalicylic acid in patients with ischemic cardiomyopathy cared
      for in Spanish emergency services (results of the EVICURE Study). Evaluacion del
      Manejo de la cardiopatia isquemica en los Servicios de Urgencias Hospitalarios of
      the Sociedad Espanola de Medicina de Urgencias y Emergencias (SEMES)].
AB  - BACKGROUND: Acetyl salicylic acid is a drug with demonstrated effectiveness in
      ischemic cardiomyopathy. The objective of our study was to know the use of this
      drug in the emergency services of Spain. PATIENTS AND METHOD: The EVICURE study
      analyzes the use of acetyl salicylic acid in 35 emergency services of Spanish
      hospitals. RESULTS: 2,168 patients were studied. Of the 473 patients with stable
      angina, 9.2% received acetyl salicylic acid before going to the hospital and
      90,7% at the arrival to the hospital, of 1,067 with unstable angina 13% received
      acetyl salicylic acid before the arrival to the hospital and 56% at the arrival
      to the hospital. Of 600 patients affected of myocardial infarction only 17%
      received acetyl salicylic acid before the arrival to the hospital and 59.8%
      received this drug in the emergency room. CONCLUSIONS: The use of acetyl
      salicylic acid in patients affected of ischemic cardiopathy assisted in the
      emergency services of Spain is improperly low.

PMID- 11203443
TI  - Hydrocephalus.

PMID- 11203442
TI  - Structural Barriers and Facilitators in HIV Prevention. Meeting proceedings.
      February 22-23, 1999.

PMID- 11203444
TI  - [Proceedings of the Berner Symposium on Pancreatic Surgery. November 1999].

PMID- 11203445
TI  - Dirk Durrer (1918-1984).

PMID- 11203446
TI  - Too many good people: not enough awards.

PMID- 11203447
TI  - 4Oth Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).

PMID- 11203448
TI  - 40th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).

PMID- 11203449
TI  - American Association for Cancer Research: dendritic cells: strategies and
      vaccines. April 1-5, 2000, San Francisco, CA, USA.
AB  - Several major sessions on dendritic cells (DCs) reflected the importance of these
      members of the immune system within cancer research. Technical hurdles to their
      routine propagation were largely overcome within the past decade, so the study of
      precursors, as well as the numerous types of dendritic cells, is the focus of
      intense research. In vitro studies were presented that described further
      refinements in dendritic cells are collected and culture. Cytokines and other
      growth factors have been analysed to assess their contribution to the ability of
      dendritic cells to intake, process and present antigen. In some instances, the
      dendritic cells themselves are genetically altered to improve their natural
      biological activity. Many studies have advanced from in vitro work and
      demonstrated utility in various animal models. Ultimately, there is the hopeful,
      steady progress into the increasing numbers of experimental immunotherapies
      against human cancer.

PMID- 11203450
TI  - American Association for Cancer Research: Clinical trials of immunotherapeutics
      and immunologic monitoring. April 1-5, 2000, San Francisco, CA, USA.
AB  - A major session at this annual gathering of the cancer researchers from around
      the globe dealt with the current state of immunotherapy for cancer. Immunotherapy
      is a form of cancer treatment that enhances its scientific promise and legitimacy
      with each passing year. As a result, this topic has become one of the most highly
      attended and anticipated of all the sessions during the AACR. This year's session
      included further progress from the laboratory to the clinic involving an ever
      increasing number of cancers. For example, brain, lung and prostate cancer are
      now as well-represented as melanoma and lymphoma at such forums. This year's
      session continued the trend of impressive biosafety of both cell- and antibody
      based vaccines. Therefore, these cancer vaccines offer optimism in treatment
      benefit as well as a minimal impact on quality of life. Lastly, the increasing
      number of clinical responses allows for true immunological monitoring, as
      scientists strive to unlock the mysteries behind what makes one patient respond
      to treatment and another progress. Several groups discussed in vitro immune
      parameters that were studied in concert with their clinical trials. Others
      discussed ways in which those in the immunotherapy community can work towards
      more reliable immune monitoring and ultimately a surrogate marker for response.

PMID- 11203451
TI  - American Association for Cancer Research: potential target antigens for cancer
      immunotherapy. April 1-5, 2000, San Francisco, CA, USA.
AB  - The 91st annual meeting of the American Association for Cancer Research (AACR)
      convened this year in San Francisco, USA. Nearly 5600 abstracts were published
      within ten broad research categories ranging from basic molecular, cellular and
      pharmaceutical research to cancer epidemiology and prevention. The largest number
      of poster presentations belonged in the 'Pharmacological and Experimental
      Therapeutics' section, followed closely by 'Molecular Biology' and 'Cell and
      Tumour Biology'. Novel tumour antigens and their potential application in cancer
      immunotherapy were displayed primarily in a section categorised as
      'Immunology/Preclinical and Clinical'. This article reports some of the
      significant tumour antigen-related studies presented at this meeting.

PMID- 11203452
TI  - The future of plasma derivatives. 17-18 April, 2000, Brussels, Belgium.
AB  - This two-day meeting was organised by Life Sciences Division of IBC Global
      Conferences Limited. It was attended by an international, multidisciplinary group
      of experts with differing expertise and perspectives on the provision of
      therapeutic products derived from human plasma. The delegates ranged from those
      involved with the collection of plasma donations, the scientists dedicated to
      improving the screening tests for virus markers, quality assurance personnel,
      clinicians, marketing and business managers, members of regulatory agencies in
      Europe and the Food and Drug Administration (FDA), providers of services to the
      industry and last, but not least, patient groups were represented. Fifteen to
      twenty countries were represented by the delegates and speakers. Although it
      might seem that the background and expertise of the audience was so wide that the
      lectures would have to be superficial, this was not the case. The whole process
      from plasma (or blood) collection to injection of a product into a patient was
      already well-known to senior members of the various organisations present and
      there is a tremendous amount of inter-dependence which enhances the necessary
      level of understanding. Nevertheless, the speakers were able to expand the
      knowledge of the delegates by their lucid and detailed presentations. The issues
      associated with development and implementation of new technologies, such as new
      NAT tests and different virus inactivation processes, were fully described. The
      spotlight also fell on the effects that changing patterns of demand for
      individual therapeutic proteins are having and will continue to have on the
      economics of the industry and on patient groups. Unlike other manufactured
      products, the raw material is the same for all plasma-derived products. Demand
      for all these products is limited by the availability of the donated plasma.
      Ideal demand for economic reasons is a balance of the extractable proteins in the
      donation. The implementation of European regulations was reviewed from the
      industry and from the regulators. Flexibility shown by the FDA in responding to
      the shortages of iv. immunoglobulins (Ig) was described, particularly with regard
      to clinical evaluation. Finally, the rationale for the need to revise the CPMP
      guidelines for clinical evaluation of certain plasma products was described as
      were the difficulties to be expected with implementation.

PMID- 11203453
TI  - SMI's 2nd Annual Superbugs and Superdrugs Conference: innovations in anti
      infectives.
AB  - The emergence of the 'Superbugs', resistant bacterial pathogens, is being
      aggressively met by the anti-infective community, both academia and industry,
      with an assortment of classical and novel approaches to control these resistant
      pathogens. The launch of improved quinolones (gatifloxacin and moxifloxacin), the
      launch of a new class of protein synthesis inhibitors (oxazolidinones; linezolid)
      and the ushering-in of the applied genomics age, all offer hope for the future
      control of resistant bacteria. The seemingly imminent development and completion
      of the first lipopeptide, daptomycin, offers great hope for the control of Gram
      positive resistant pathogens. The first cationic peptide, IB-367, designed to
      combat the niche medical need of mucositis and the development of a specific
      antistaphylococcal glycopeptide. BI-397, all will precede the first wave of
      genomic-targets-based drug candidates, as the antimicrobial genomics effort
      remains in the target identification and validation stages of early discovery.

PMID- 11203454
TI  - 9th International Conference on Obesity, NIDDM, adipogenesis and insulin
      resistance.
AB  - The 9th International Conference on Obesity, NIDDM, Adipogenesis and Insulin
      Resistance was held between 3rd and 5th April, 2000 in London, UK. The three day
      conference was attended by more than 100 delegates from both academic and
      industrial institutions. Conference topics covered the use of genetics in obesity
      and diabetes, etiology and implications of treatment for obesity, progress in
      identification of new obesity and Type 2 diabetes drug targets, islet cell
      targets, progress in drugs for insulin enhancement and sensitisation,
      adipogenesis and insulin resistance. Below are meeting highlights closely related
      to new drug developments and drug target identification in these therapeutic
      areas.

PMID- 11203455
TI  - The DOP system: a manifestation of social exclusion. A personal commentary on
      'Alcohol consumption amongst South African farm workers: a post-apartheid
      challenge, by L. London 1999'.

PMID- 11203456
TI  - Quiz case. Atypical gout arthritis.

PMID- 11203457
TI  - Consensus guidelines on management of childhood asthma in India.

PMID- 11203458
TI  - Consensus guidelines on management of childhood asthma in India: role of
      ipatropium bromide in acute episode.

PMID- 11203459
TI  - Role of Ketotifen in asthma.

PMID- 11203461
TI  - Monoamine oxidase inhibitors in rheumatoid arthritis-anti-tumor necrosis factor?

PMID- 11203460
TI  - Deferiprone for thalassemia major.

PMID- 11203462
TI  - Report of the second annual walker's cay colloqium on cancer vaccines and
      immunotherapy, March 8-11, 2000.

PMID- 11203463
TI  - The nuclear export signal within the adenovirus E4orf6 protein contributes to
      several steps in the viral life cycle.

PMID- 11203464
TI  - The antinociceptive effect of antidepressants--noradrenergic versus serotonergic
      modes of action?

PMID- 11203465
TI  - A hydrodynamic model for hindered diffusion of proteins and micelles in
      hydrogels.

PMID- 11203466
TI  - The model of Snyder et al. does not simulate graded Ca(2+) release from the
      cardiac sarcoplasmic reticulum in intact cells.

PMID- 11203467
TI  - Measuring both femora?

PMID- 11203468
TI  - [Natural medicine and its representatives].

PMID- 11203469
TI  - A provider's perspective: current issues in providing and funding complementary
      medical care.

PMID- 11203470
TI  - [Montgomery GH, DuHamel KN, Redd WH: A meta-analysis of hypnotically induced
      analgesia: How effective is hypnosis? Int J Clin Exp Hypn 2000; 48: 138-153].

PMID- 11203471
TI  - [Effectiveness of acupuncture in chronic pain--systematic overview. Ezzo J,
      Berman B, Hadhazy VA, Jadad AR, Lao L, Singh BB: Is acupuncture effective for the
      treatment of chronic pain: A systematic review. Pain 2000; 86:217-225].

PMID- 11203472
TI  - [Hui KK, Liu J, Makris N, Gollub RL, CHen AJ, Moore CI, Kennedy DN, Rosen BR,
      Kwong KK: Acupuncture modulates the limbic system and subcortical gray structures
      of the human brain: Evidence from fMRI studies in normal subjects. Hum Brain Mapp
      2000; 9: 13-25].

PMID- 11203473
TI  - [Meeting report: 1. Union congress, May 26-27 2000, Berne. Complementary medicine
      and school medicine: combined for the patient].

PMID- 11203474
TI  - [Swiss Medical Society for Phytotherapy. Mahonia aquifolium (Pursh) Nutt. as a
      dermatologic plant: pharmacologic and clinico-pharmacologic studies].

PMID- 11203476
TI  - CNS drugs III: psychotherapeutics.
AB  - This two-day symposium reviewed specific aspects of current drug development for
      psychiatric disorders. The aim was to identify how existing drugs could he
      improved and what approaches could he adopted to develop new drugs acting by
      different mechanisms. The meeting was attended by approximately 50 delegates,
      mainly from multinational pharmaceutical companies or smaller private
      biotechnology based companies with a few academic clinicians and preclinical
      scientists. The topics covered on the first day included the influence of
      genomics and proteomics on drug discovery with reference to antipsychotics, GABAA
      receptor subunit specific compounds as a route to improved anxiolytics. AMPA
      receptor modulators as add-on therapy in schizophrenia and corticotrophin
      releasing factor receptors as targets in depression. The second day placed a
      greater emphasis on drugs influencing amine neurotransmission; an aspect already
      raised on the first day by discussion of 5-HT-moduline. The main areas covered
      were how serotonergic ligands could he used with greater effect in depression and
      schizophrenia, the therapeutic value of serotonin noradrenaline uptake inhibitors
      (SNRIs) and the potential clinical value of new amine re-uptake inhibitors.
      Finally, the meeting discussed the impact of various technological advances in
      genetics. neuroimaging and psychometric testing in psychotherapeutic drug
      discovery.

PMID- 11203475
TI  - 100th American society for microbiology annual meeting.
AB  - The 100th ASM Annual Meeting, attended by approximately 10,000 delegates,
      continued the trend of concentrating on bacteria and antibacterial therapy, mixed
      with genomics and a diverse number of additional topics. Of the various
      marketable drug classes, the quinolones received attention with respect to
      susceptibility studies and several drug comparison studies. New marketable drugs
      were also of interest, especially given the reservoirs of resistance presented by
      several speakers. Drugs in development include the antibacterial daptomycin and
      protegrins and the antifungal lipodepsinonapeptides and echinocandins, to name a
      few. It is still unclear whether or not antibiotic treatment regimens for
      Chlamydia pneumonia will he necessary, as association of this bacteria with
      several chronic diseases, such as atherosclerosis and asthma, was discussed. The
      development of novel antibiotics was highlighted and the potential role that
      microbial genomics technology could play was a recurring theme. In fact, a number
      of symposia treated the increasingly popular topic of genomics in a variety of
      themes, including phenotyping arrays, transcriptional profiling, proteomics,
      expression profiling, genome sequencing, target areas or essentiality of genes
      via gene knockout systems, the role of genomics in pharmaceutical development and
      fungal genomics. Similarly, genomics plays a role in developing a deeper
      appreciation for classical areas of interest in microbial physiology, such as
      gene regulation, cell division, fatty acid biosynthesis, DNA replication and cell
      signalling. Even in the bio-inorganic field of study in microbial metabolite
      activation, genomics plays a role. The sequencing of the large gene clusters of
      the auxiliary proteins necessary to synthesise or activate the metallo-proteins
      provided insights into the mechanisms of activation of these microbial enzymes,
      including the genes for the nif gene cluster in Azotobacter vinelandii, the
      urease from Kiebsiella aerogenes and the three hydrogenases in Ralstonia
      eutropha.

PMID- 11203477
TI  - Proceedings of a workshop on self-reported outcome measures in audiological
      rehabilitation including hearing aids. Eriksholm, Denmark, September 1-3, 1999.

PMID- 11203478
TI  - Quality and outcomes assessment in gastrointestinal endoscopy. American Society
      for Gastrointestinal Endoscopy.

PMID- 11203479
TI  - Appropriate use of gastrointestinal endoscopy. American Society for
      Gastrointestinal Endoscopy.

PMID- 11203480
TI  - Modifications in endoscopic practice for pediatric patients.

PMID- 11203481
TI  - Endoscopic therapy of chronic pancreatitis. American Society for Gastrointestinal
      Endoscopy.

PMID- 11203482
TI  - Modifications in endoscopic practice for the elderly. American Society for
      Gastrointestinal Endoscopy.

PMID- 11203483
TI  - Role of endoscopic ultrasonography. American Society for Gastrointestinal
      Endoscopy.

PMID- 11203484
TI  - Technology status report evaluation. Endoscopic mucosal resection.

PMID- 11203485
TI  - Technology status evaluation report. High resolution and high-magnification
      endoscopy.

PMID- 11203486
TI  - Is Endometriosis Potentially Malignant? Proceedings of the 3rd Japan Conference
      on Endometriosis. Kanagawa, Japan, April 22, 2000.

PMID- 11203487
TI  - [Fluorescence properties and metabolic features of fluorescein].

PMID- 11203488
TI  - Modern prostate brachytherapy: prostate specific antigen results in 219 patients
      with up to 12 years of observed follow-up.

PMID- 11203489
TI  - Accuracy of diagnosis by guided biopsy of renal mass lesions classified
      indeterminate by imaging studies.

PMID- 11203490
TI  - Antenatal minimal hydronephrosis: is its follow-up an unnecessary cause of
      concern?

PMID- 11203491
TI  - Early orchiopexy: prepubertal intratubular germ cell neoplasia and fertility
      outcome.

PMID- 11203492
TI  - Resuscitation 2000. Antwerp, Belgium. Abstracts.

PMID- 11203493
TI  - Arteriovenous malformations time line: radiation therapy.

PMID- 11203494
TI  - Surgery for sphenoid sinus abscess.

PMID- 11203495
TI  - Society merger?

PMID- 11203496
TI  - Bibliography of Toxinology.

PMID- 11203497
TI  - Use of meta-analysis to draw conclusions as to relative efficacy is illegitimate
      and should not be accepted.

PMID- 11203498
TI  - Tetanus-diphtheria booster in non-responding tetanus-diphtheria vaccinees.

PMID- 11203499
TI  - Influenza season 2000/01 vaccine dose-response studies.

PMID- 11203500
TI  - Hepatitis A: how to match prevention strategies to changing epidemiology.

PMID- 11203501
TI  - More HIV resistance testing needed, according to survey.

PMID- 11203502
TI  - Broca and the beginning of modern neurosurgery.
AB  - The study presents Broca's pioneering efforts on cerebral localizations and
      craniotopography and their application on the first craniotomy based on cerebral
      localization.

PMID- 11203504
TI  - Central nervous system paracoccidioidomycosis: case report.

PMID- 11203503
TI  - Non familial episodic ataxia possibly associated with the use of nicotine: case
      report.

PMID- 11203505
TI  - Continuing Care in Adult Cardiology: Living with a Cardiac Diagnosis. Preface.

PMID- 11203506
TI  - Acute Care Cardiology, Preface.

PMID- 11203507
TI  - [One step ahead and/or two steps back?].

PMID- 11203508
TI  - Conducting geriatric dental research with cognitively impaired adults.
AB  - A growth in research focusing on the oral health of older adults has been evident
      in recent years. However, there are new and complex challenges for geriatric
      dental researchers studying the increasingly functionally dependent and
      cognitively impaired older adult population. Many geriatric dental studies have
      under-reported oral disease prevalence and incidence by excluding adults who are
      cognitively impaired and/or behaviourally difficult. To ensure representative
      samples of older adult populations are studied, traditional oral epidemiological
      protocols in studies with cognitively impaired adults, require additional
      components detailing: (1) communication and behaviour management strategies for
      cognitively impaired adults; and (2) methodologies to facilitate the completion
      of dental examinations. A description of such additional protocol components is
      presented, along with a discussion of the use of cognitive testing tools by
      dental researchers.

PMID- 11203510
TI  - Geriatric dentistry in the next millennium: opportunities for leadership in oral
      health.
AB  - "The twentieth century will be remembered chiefly, not as an age of political
      conflicts and technical inventions, but as an age in which human society dared to
      think of the health of the whole human race as a practical objective." Arnold
      Toynbee, British historian. Individuals throughout the world often view the
      passage of a new year as a time for re-evaluation of personal and/or
      professionals goals. The new millennium offers the dental profession a chance to
      view the future and observe the challenges and opportunities facing it. Professor
      Toynbee's observation is particularly poignant when one considers the
      improvements in oral health made in the last 100 years. Caries, once considered a
      ubiquitous oral disease, has been prevented in some children in developed
      countries. Research on periodontal disease continues to identify risk factors and
      the pathobiological mechanisms underlying the disease. Concurrently the
      population of the world is aging presenting new opportunities for improving oral
      health. In this paper the data on aging, chronic diseases and oral health is
      largely from the US but reflects to varying degrees other industrial countries.
      By integrating these demographic, epidemiologic and biologic data, one can paint
      a portrait of the future dental patient and their oral health needs. From this
      portrait, dental professionals can identify leadership opportunities to improve
      the oral health of an aging world population.

PMID- 11203509
TI  - Food choice by older people: the use of semi-structured interviews with open and
      closed questions.
AB  - OBJECTIVE: To evaluate difficulty chewing, consequent food choice and impacts
      using both open and closed questions within a semi-structured interview format.
      DESIGN: A cross-sectional study using a semi-structured interview (SSI) with open
      and closed questions. SETTING: Independently living people in South-West London
      interviewed in their own homes. SUBJECTS: A group of 54, edentate people (mean
      age 82, R = 60-93 years) were studied. RESULTS: Most subjects (69%) expressed
      difficulty eating at least one type of food, half were unwilling to eat the foods
      they found difficult, others were conscious of cooking longer or cutting smaller
      in order to manage these foods, although no one accepted that they overcooked
      food. There were dramatic differences in the number of subjects expressing
      difficulty to chew various foods when responding to open and closed questions.
      Roast beef proved a good discriminator in this group of predominantly English
      subjects. The importance of the questioning process was also shown by the
      discrepancy of responses between variously prepared apples and the inability of
      any subjects to bite an unpeeled apple. CONCLUSIONS: For sensitive appraisal of
      food choice it is obviously essential to assess relevant foods, for the culture
      of the group being studied. Open questions provide a way of exploring which are
      the appropriate foods and food preparation as criteria to assess perceived
      chewing ability and treatment benefit. The semi-structured interview method is
      particularly valuable for the study of older people. Closed questions provide
      different information which is also necessary to secure recall by older people.

PMID- 11203511
TI  - Oral health care among nursing home residents in Avon.
AB  - OBJECTIVE: To assess personal oral health care standards among frail, elderly and
      infirm nursing home residents prior to developing and evaluating a health
      promotion intervention. DESIGN: Descriptive survey, interview and clinical data.
      SETTING: 22 randomly selected nursing homes in the Bristol area. METHOD: 412
      residents with denture(s) and/or natural teeth, and giving informed consent to
      the study were interviewed about dental attendance and current dental problems. A
      clinical examination assessed levels of oral and denture hygiene, denture-related
      stomatitis, gingivitis, calculus and root caries. RESULTS: Less than half the
      subjects (mean age 84.5 years) were ambulant. Over 70% had not seen a dentist for
      over 5 years, and 22% reported a current dental problem. Among denture wearers,
      82% were unable to clean their dentures; staff cleaned dentures for 64%. Denture
      related stomatitis affected 33%, and unhygienic dentures were worn by 95% of
      subjects. Among dentate subjects (mean number of teeth 11.6), 75% were unable to
      clean their teeth yet none received regular assistance. On average, two-thirds of
      each tooth surface were covered in plaque. Gingivitis was moderately severe.
      Calculus was present in 82% of subjects and root caries in 63% of subjects.
      CONCLUSIONS: Most residents required help with oral health care but many did not
      receive it. Residents' levels of plaque and associated dental disease were high.
      Staff did not effectively perform oral health care appropriate to residents'
      needs. Further research to evaluate an oral health care training programme for
      care staff is planned.

PMID- 11203512
TI  - Amalgam fillings and cognitive abilities in a representative sample of the
      elderly population.
AB  - OBJECTIVES: The ongoing controversial discussion about a possible negative effect
      of amalgam fillings on the cognitive abilities and the pathogenesis dementia was
      the objective of the present study. SAMPLE: A total of 300 patients aged from 70
      to 103 years were selected from the multidisciplinary 'Berlin Aging Study'
      (BASE). The sample was heterogeneous concerning lifestyle, education and social
      prestige. According to their dental state subjects were allocated into three
      groups: edentate > or = 20 years (I) and residual teeth without (II) or with
      (III) amalgam restorations. All groups were matched for age and gender. DESIGN:
      Dental examinations and various psychiatric as well as psychological assessments
      were carried out by professionals within the protocol of the BASE. Tests were
      chosen to reveal the presence and degree of dementia and assess cognitive
      abilities such as 'perceptual speed', 'reasoning', 'memory', 'fluency' and
      'knowledge'. RESULTS: The present findings negate a correlation between the
      dental state and the pathogenesis of dementia and the physiological age-related
      decline in cognitive abilities. Thus the presence of amalgam fillings did neither
      correlate to a demented mental condition nor an impaired cognitive performance.

PMID- 11203513
TI  - Success of dental implants in elderly people--a literature review.
AB  - Implant-supported dentures seem particularly appropriate for the predicament of
      being elderly and becoming edentulous. The aim of this article was to review the
      literature on success of dental implants in elderly people. The results of two
      studies suggested that the treatment with implants can be considered safe and
      predictable for older as well as for younger patients. Three studies found no
      increased implant failure-rate in patients with a compromised medical status.
      Four studies revealed high success-rates of dental implants among groups of
      elderly people. Within the limitations of this review of the literature it can be
      concluded that old age does not seem to represent a factor of major prognostic
      significance in treatment with dental implants.

PMID- 11203514
TI  - Palliative care dentistry.
AB  - The importance of dental care is often overlooked due to the omission of the
      dentist as a member of the palliative care team. However, many terminal patients
      exhibit oral difficulties that affect their quality of life. Palliative care
      dentists must exhibit empathy and compassion, and must be excellent communicators
      Dentists can play an important role in alleviating both the physical and
      psychological pain of dying. This paper describes the role of dentistry in
      palliative care.

PMID- 11203516
TI  - Dental management of patients with Alzheimer's disease and other dementias.

PMID- 11203515
TI  - Guidelines for oral health care for long-stay patients and residents.
AB  - People in residential or continuing care have an equal right to good oral health
      as people residing in the community. Entry to residential or continuing care
      provides an opportunity to assess need, identify problems, improve oral and
      dental health thereby contributing to improved general health and quality of
      life. This document provides guidance to establish standards for oral health care
      which are appropriate to the needs, demands and choices of individuals whether
      they live in continuing or residential care (Appendix 5).

PMID- 11203517
TI  - The influence of storage solution on dentin bond durability of resin cement.
AB  - OBJECTIVES: This study was conducted to determine the influence of storage
      solution on the bond durability of three resin cements to bovine dentin over the
      period of 1 year. METHODS: Ten bovine dentin specimens were tested for shear bond
      strength with each material (Panavia 21, Kuraray Co.; BISTITE, Tokuyama Co; MASA
      Bond, Sun Medical Co.) and storage mode, listed below. Four storage environments
      were studied as follows: water changed every day for 1 year; water unchanged for
      1 year; Phosphate Buffered Saline (PBS) changed every week over 1 year; PBS
      unchanged for 1 year. Ten teeth were also tested for each material at 1 day as a
      control. The mode of failure was classified after fracture of the bonds by SEM
      observation. The means of the bond strengths were compared statistically by two
      way ANOVA and Fisher's PLSD test (p < 0.05). Results for the mode of fracture
      were analyzed using the Mann-Whitney U test. RESULTS: Although there was no
      statistical difference in the mean bond strengths between the water and PBS
      storage solutions (p > 0.05) in all cements, the results for the shear bond
      strengths in the changed storage solution groups were significantly lower than
      those where the storage solution remained unchanged (p < 0.05). There were
      statistical differences between the 1 day results and the changed water groups
      among all cements (p < 0.05). SIGNIFICANCE: The storage condition influenced the
      long-term durability of dentin bonding with resin cements.

PMID- 11203518
TI  - Dentin shear bond strength of compomers and composites.
AB  - OBJECTIVE: The aim of this study was to compare the shear bond strengths and
      fracture characteristics of two compomers bonded with a single step bonding agent
      with two modern composites, a microfil and hybrid, bonded with a fourth
      generation bonding agent. METHODS: Freshly extracted human third molars were
      sectioned parallel to the occlusal surface to expose midcoronal dentin, prepared
      with 320-grit surface finish, and bonded (N = 11 samples/group) following
      manufacturer's directions with the compomers (Dyract, DeTrey Konstanz, Germany or
      Compoglass, Vivadent, Schaan Liechtenstein) or the dentin bonding agent SMP+
      (Scotchbond Multi-Purpose Plus, 3M Dental Products, St. Paul MN) with Silux Plus
      or Z100 (3M Dental Products, St. Paul, MN). The samples were tested using a
      single plane lap shear bond strength test at 5 mm/min until failure. Statistical
      analysis was performed using ANOVA with Scheffe multiple comparison testing.
      Fracture surfaces of the debonded surfaces were examined using SEM to determine
      the failure mode of each specimen. RESULTS: Bond strengths for the compomers were
      12.7 +/- 2.9 MPa for Dyract and 8.9 +/- 4.1 MPa for Compoglass and were not
      significantly different. Bond strengths for the dentin bonded composites were
      significantly stronger than the compomer Compoglass, but were not different from
      one another, despite the use of different composites. The averages values for SMP
      + /Silux Plus and SMP + /Z100 were 15.7 +/- 4.5 MPa and 15.2 +/- 5.6 MPa,
      respectively. SEM analysis showed that all materials exhibited mixed failure
      patterns. Compoglass specimens exhibited 5 of 11 failures classified as adhesive,
      while each of the other materials showed only 1 of 11 adhesive failures.
      SIGNIFICANCE: Compomers have undergone rapid development over the last several
      years, but their bond strengths have not yet reached the same level as modern
      dentin bonded composites. Difference in composite filler type and amount had
      little influence on the bond strength determined in this work.

PMID- 11203519
TI  - Quantification of leucite concentration using X-ray diffraction.
AB  - OBJECTIVES: This study sought to evaluate the efficacy of using an X-ray
      diffractometer for the determination of leucite in Finesse, Ceramco II, and IPS
      Empress porcelains. METHODS: An internal standard, copper, was used. Two
      quantification methods are presented: (1) the generation of a calibration curve
      using peak height ratios; and (2) the generation of a calibration curve using
      peak area ratio. RESULTS: The leucite concentration obtained from the peak height
      versus concentration calibration curve was observed to be statistically different
      from leucite concentration obtained from the peak area versus concentration
      calibration curve. Other information obtained from X-ray powder diffraction
      include the lattice parameters and volume of the unit leucite cell. SIGNIFICANCE:
      The leucite contained in the dental porcelains (Finesse, Ceramco II, and Empress)
      has expanded a-lattice spacings and contracted c-lattice spacings relative to
      standard leucite. These changes in the lattice parameters resulted in a net
      expansion of the leucite cell volume.

PMID- 11203520
TI  - The influence of handling technique on the strength of phosphate-bonded
      investments.
AB  - OBJECTIVES: This study examined the influence of six handling techniques on the
      strength of four phosphate-bonded investment (PBI) materials. The size and
      distribution of pores produced by the handling techniques were investigated and
      their effect on room temperature strength determined. METHODS: Specimens were
      tested for strength using four point bend at a cross-head speed of 1 mm min-1.
      The fracture surface of randomly selected specimens was viewed through a light
      microscope to determine the pore size. A three-parameter Weibull distribution was
      used to describe strength giving values of Weibull modulus and characteristic
      strength. RESULTS: The handling technique that produced the smallest pore size
      resulted in the highest strength. Significant differences in strength (90%
      confidence level) were found between most handling techniques. The reduction of
      pore size by mechanical spatulation and setting under pressure was found to be
      the most effective method of increasing the strength of PBI. SIGNIFICANCE:
      Previous studies have related handling technique to the inclusion of air bubbles
      in dental investments but have not reported any consequent effect on strength.
      PBI materials are used in production of a range of dental appliances with a
      variety of different material forming processes and are required to withstand the
      loads applied without fracture or distortion to ensure accuracy of fit of these
      prostheses. The use of a handling technique that reduces pore size can
      significantly increase the strength of PBIs, thereby decreasing the possibility
      of die fracture or degradation.

PMID- 11203521
TI  - Mechanical properties and wear behavior of light-cured packable composite resins.
AB  - OBJECTIVES: Determination of flexural strength, flexural modulus, fracture
      toughness and wear resistance of three packable composites (Solitaire, Surefil,
      ALERT) and a packable ormocer (Definite) in comparison with an advanced hybrid
      composite (Tetric Ceram) and an ion-releasing composite (Ariston pHc). METHODS:
      Flexural strength, flexural modulus and fracture toughness of each material were
      determined in three-point bending (each test n = 10). Single-edge notched-bend
      specimens were used to evaluate the fracture toughness (K1C). Wear of the
      materials (n = 8) was determined in a pin-on-block-design with a spherical
      Degusit antagonist at 50 N vertical load and quantified by a replica technique
      using a 3D-laser scanner. Replicas were made after 6000, 10,000, 30,000 and
      50,000 load cycles. The mean wear rate (MWR (micron 3 cycle-1)) was obtained by a
      linear regression analysis in the steady-state of the time-wear-curve. All
      results were statistically analyzed with ANOVA and post hoc Tukey HSD tests (p <
      0.05). RESULTS: ALERT exhibited the highest flexural modulus (12.5 +/- 2.1 GPa)
      and K1C (2.3 +/- 0.2 MN m-3/2), but the lowest wear resistance (8275 micron 3
      cycle-1). Solitaire presented the highest wear resistance (1591 micron 3 cycle
      1), but significantly lower flexural strength (81.6 +/- 10.0 MPa), flexural
      modulus (4.4 +/- 0.3 GPa), and K1C (1.4 +/- 0.2 MN m-3/2) than all other
      materials. Surefil revealed a significantly higher flexural modulus (9.3 +/- 0.9
      GPa) and wear resistance (3028 micron 3 cycle-1) than Tetric Ceram (6.8 +/- 0.5
      GPa; 5417 micron 3 cycle-1) and Ariston pHc (7.3 +/- 0.8 GPa; 7194 micron 3 cycle
      1). SIGNIFICANCE: The tested packable composite resins differed significantly in
      their mechanical properties. This study suggested that fracture and wear behavior
      of the composite resins are highly influenced by the filler system. Overall,
      Surefil demonstrated good fracture mechanics parameters and a low wear rate.

PMID- 11203522
TI  - Depth of cure and compressive strength of dental composites cured with blue light
      emitting diodes (LEDs).
AB  - OBJECTIVE: The primary objective of this pilot study was to test the hypotheses
      that (i) depth of cure and (ii) compressive strength of dental composites cured
      with either a light emitting diode (LED) based light curing unit (LCU) or a
      conventional halogen LCU do not differ significantly. The second objective of
      this study was to characterise irradiance and the emitted light spectra for both
      LCUs to allow comparisons between the units. METHODS: Dental composite (Spectrum
      TPH, shades A2 and A4) was cured for 40 s with either a commercial halogen LCU or
      a LED LCU, respectively. The LED LCU uses 27 blue LEDs as the light source. The
      composites' depth of cure was measured for 10 samples of 4 mm diameter and 8 mm
      depth for each shade with a penetrometer. The results were compared using a
      Student's t-test. Compressive strengths were determined after 6 and 72 h, for six
      samples of 4 mm diameter and 6 mm depth for each shade after being polymerised
      for 40 s from each end of the mould. Groups were compared using a three way
      ANOVA. RESULTS: The conventional halogen LCU cured composites significantly (p <
      0.05) deeper (6.40 mm A2, 5.19 mm A4) than did the LED LCU (5.33 mm A2, 4.27 mm
      A4). Both units cured the composite deeper than required by both ISO 4049 and the
      manufacturer. A three way ANOVA showed that there were no significant differences
      in the compressive strengths of samples produced with either the LED LCU or the
      halogen LCU (p = 0.460). Significant differences in compressive strength of
      samples stored for 6 and 72 h (p = 0.0006) and of samples of different shades (p
      = 0.035) were found as confirmed by the three way ANOVA. The light spectra of
      both units differed strongly. While the halogen LCU showed a broad distribution
      of wavelengths with a power peak at 497 nm, the LED LCU emitted most of the
      generated light at 465 nm. The LED LCU produced a total irradiance of 350 mW cm-2
      whereas the halogen LCU produced a total irradiance of 755 mW cm-2. SIGNIFICANCE:
      The results showed that both units provided sufficient output to exceed minimum
      requirements in terms of composites' depth of cure according to ISO 4049 and the
      depth of cure and the composites' compressive strength stated by the
      manufacturer. Compressive strengths of dental composites cured under laboratory
      conditions with a LED LCU were statistically equivalent to those cured with a
      conventional halogen LCU. With its inherent advantages, such as a constant power
      output over the lifetime of the diodes, LED LCUs have great potential to achieve
      a clinically consistent quality of composite cure.

PMID- 11203523
TI  - Nanoleakage patterns of four dentin bonding systems.
AB  - OBJECTIVES: The purpose of this study was to evaluate the nanoleakage patterns of
      four dentin bonding systems. METHODS: The dentin bonding systems used in this
      study were: Single Bond, One Coat Bond, Prime & Bond NT/Non Rinse Conditioner
      (NRC), and PermaQuik. Flat occlusal dentin surfaces from extracted human molars
      were finished with wet 600-grit silicon carbide paper, and bonded with one of the
      dentin bonding systems. After 24 h storage at 37 degrees C in water, margins were
      finished with polishing discs and the surrounding tooth surfaces coated with nail
      varnish. The samples were immersed in a 50% (w/v) solution of silver nitrate for
      24 h, and exposed to photodeveloping solution for 8 h. The samples were cut
      longitudinally, polished, and mounted on stubs, carbon coated and observed in a
      Field Emission-SEM using backscattered electron mode. RESULTS: Different
      nanoleakage patterns were observed with the different adhesive systems. However,
      accumulations of silver particles were often noted at the base of the hybrid
      layer for all materials. Single Bond and One Coat Bond demonstrated uptake of
      silver particles both within the hybrid layer and the adhesive resin. Prime &
      Bond NT/NRC showed silver staining throughout almost the entire thickness of the
      hybrid layer. The leakage pattern of PermaQuik revealed loose silver deposition
      within the hybrid layer. The composition of each adhesive system may play a role
      in forming the different leakage patterns. SIGNIFICANCE: The current dentin
      bonding systems used in this study do not achieve perfect sealing at the
      restoration/dentin interface, which may influence the durability of the bond to
      dentin.

PMID- 11203524
TI  - Corrosion susceptibility of titanium covered by dental cements.
AB  - OBJECTIVES: The aim of this study is to determine the influence of acidic
      fluorinated cements (as glass ionomer (GI) cements) on the passivation of
      titanium, using electrochemical investigations. METHODS: We realized experimental
      electrodes that associate titanium and dental cements. Polarization resistance of
      titanium electrodes has been determined for uncovered metal and electrodes
      covered with three dental cements. Student's t-tests proved the reproducibility.
      We also compared successive voltammograms for uncovered titanium and GI covered
      titanium. RESULTS: Correct passivation was observed with zinc eugenate, but
      fluorinated GI or zinc phosphate coverage increased the corrosion susceptibility.
      SIGNIFICANCE: However there is no evidence of titanium depassivation when covered
      with cement. No clinical contraindication can be held.

PMID- 11203525
TI  - The effects of alcoholic beverages on composite wear.
AB  - OBJECTIVES: In vivo wear of composite restorative materials appears to be, in
      part, dependent on various patient factors. Specifically, consumption of
      alcoholic beverages has the potential for increasing the degradation rate. The
      hypothesis tested in this experiment was that composite wear is dependent on the
      type of alcohol-containing liquid the materials are exposed to during three-body
      abrasive wear. METHODS: To test this hypothesis, composite wear experiments were
      performed using the ACTA three-body wear machine. Abrasive slurries containing
      either beer, wine, 9 vol% ethanol or water were used during the wear experiments.
      The data were analyzed using ANOVA and Tukey's test. RESULTS: The wine and
      ethanol solutions caused significantly more wear compared to the beer and water.
      There was no significant differences in the wear between the wine and 9 vol%
      ethanol groups, and the beer groups were not significantly different from the
      water groups. Furthermore, there was no significant interaction between the
      composite type and the various abrasive slurries. SIGNIFICANCE: These results
      indicate that alcoholic beverages with at least 9 vol% ethanol will increase the
      wear of composite. The observed increase in wear of composite by the wine was
      caused primarily by the ethanol content of the wine. Other constituents in the
      wine do not appear to have an effect on composite wear. The ethanol effect was
      consistent among different composite types.

PMID- 11203526
TI  - Interface dimensions of CEREC-2 MOD inlays.
AB  - OBJECTIVES: To quantify the width of the cement interface between ceramic inlays
      generated by the CEREC-2 CAD-CAM system and the tooth, and to determine the
      effect of cement viscosity on the interface width. METHODS: Standardised MOD
      cavities were cut in 15 human premolar teeth using a custom paralleling device. A
      ceramic inlay was made with a CEREC-2 CAD-CAM machine for each tooth. The inlays
      were cemented using one of three resin-based composite systems of varying
      viscosity; a hybrid microfilled posterior composite, a compomer restorative and a
      dual-cure luting composite. The teeth were subsequently sectioned and
      measurements were taken at 21 key points with the aid of an image-analysis light
      microscopy system. RESULTS: Statistical significance tests were applied to
      examine for difference in interface dimensions at specific points within each of
      the cement-groups and amongst groups. The interface space at the occlusal walls
      has a distinct wedge shape, being narrower at the external interface (50 microns,
      SD 15) than internally (211 microns, SD 38). There is no statistically
      significant difference in the interface dimensions of the gingival floor between
      the boxes that lie above and below the CEJ. There is no statistically significant
      difference in the width of the interface at any given point between the three
      cement groups. SIGNIFICANCE: There is a significant improvement in the fit of
      CEREC-2 restorations when compared with the original CEREC system. Cements of
      varying viscosity (within the measured range) may be used for cementation of
      these inlays, without adversely affecting the width of the interface. Caution
      must be exercised with light-activated composite cements to ensure adequate
      transmission of light through the ceramic and the underlying composite cement.

PMID- 11203527
TI  - Permeability of demineralized dentin to HEMA.
AB  - OBJECTIVES: The objectives of this study were to develop a macromodel of the
      demineralized layer of dentin that is formed after acid-etching, and to determine
      if the amount of HEMA uptake was responsive to air drying. The hypothesis that
      was tested was that HEMA uptake by demineralized dentin depends upon the degree
      of expansion of the collagen fibril network. METHODS: Dentin cubes (2 x 2 x 2 mm)
      were prepared in coronal dentin from extracted unerupted human third molars. They
      were incubated in 100% HEMA for up to 1000 min and then removed and blotted free
      of excess adherent HEMA. The HEMA taken up by each cube was extracted in 2 ml of
      water for 1 hr with shaking. This was repeated and the extracts combined. HEMA
      was quantitated spectrophometrically. The dentin cubes were then demineralized in
      0.5 M EDTA for 10 days and the HEMA uptake remeasured at 1, 10, 100 and 1000 min.
      Then the cubes were air-dried and the HEMA uptake remeasured. After re-expanding
      the specimens in water, the cubes were stiffened in ascending concentrations of
      acetone of 100%, then allowed to air dry again in a more expanded state, and HEMA
      uptake was remeasured. Finally, after rehydration, the dentin cubes were "acid
      etched" for 1 or 10 min with 37 wt% phosphoric acid and HEMA uptake remeasured.
      RESULTS: Before demineralization, the dentin took up little HEMA (ca. 4.8 x 10(
      7) moles min-3) compared to after demineralization when the uptake for 10, 100
      and 1000 min was 27.4, 43.8 and 51.4 x 10(-3) moles mm-3, respectively. Acid
      etching for 1 or 10 min had no effect on HEMA uptake. Air drying produced a 72%
      volumetric shrinkage but a 97% reduction in uptake. When the demineralized matrix
      was stiffened in acetone prior to air-drying, the volumetric shrinkage was only
      27% and the HEMA uptake only fell 16% compared to the wet, fully expanded
      condition. SIGNIFICANCE: The results support the hypothesis that the uptake of
      HEMA by demineralized dentin depends on the degree of expansion of the dentin
      matrix.

PMID- 11203528
TI  - Effect of Pd or Au addition on age-hardening in AgMn-based alloys.
AB  - OBJECTIVE: The objective of this research was to characterize the age-hardening
      behavior of AgMn alloys modified with Au or Pd. These alloys are being studied as
      possible alternatives to Type III dental alloys. METHODS: The age-hardening
      reactions in Ag-37 at % Mn alloys with 5 at% Au or Pd were investigated by
      optical microscopy, electrical resistivity, X-ray diffraction and hardness tests.
      RESULTS: Optical microscopy showed no grain boundary precipitates formed after
      overaging. The maximum hardness reached by aging in all alloys is about 260 (Hv)
      and identical to that of traditional AgPdCu dental alloys. The precipitation
      reactions were retarded with the addition of 5 at% Au or Pd. X-ray diffraction
      studies suggest a fine precipitate, alpha-Mn, is dispersed within the grain
      interior. The activation energy for the precipitation reaction is 114 kJ/mol for
      the AgMn and AgMnAu alloys. This value is about one-half of the activation energy
      for volume diffusion of manganese in AgMn alloys. SIGNIFICANCE: The age
      hardenable AgMn-based alloys modified with Au or Pd can achieve hardness values
      comparable to those of traditional AgPdCu alloys. Provided the in vivo corrosion
      resistance of these alloys is adequate, they show promise as a Cu-free
      alternative material for cast restorations.

PMID- 11203529
TI  - Materials, the millennium and the mind of God.

PMID- 11203530
TI  - Inhibition of human gingival gelatinases (MMP-2 and MMP-9) by metal salts.
AB  - OBJECTIVES: The interaction between metal ions and the oral environment is a
      major subject matter in dental research. Matrix metalloproteinases (MMPs) have
      been implicated in several pathologic oral processes such as periodontal tissue
      destruction, root caries, tumour invasion and temporomandibular joint disorders.
      The aim of this work was to test the effect of Zn, Cu, Sn and Hg ions on the
      activity of the major gingival gelatinolytic MMPs. METHODS: Gingival explants
      were cultured overnight in DMEM and the activity of secreted enzymes was analyzed
      by gelatin zymography in buffers containing different metal ion concentrations.
      The major gelatinolytic proteinases present in the conditioned media were
      characterized as MMP-2 and MMP-9 by immunoprecipitation with specific antibodies.
      The eletrophoretic bands were scanned and the transmittance values were analyzed
      with the Sigmagel software (Sigma). RESULTS: ZnSO4 was a strong inhibitor of MMP
      2 (I50 = 15 microM) and MMP-9 (I50 = 40 microM), whereas CuSO4, HgSO4 and SnCl2
      showed less efficient inhibition potential. SIGNIFICANCE: Our findings show that
      the activity of oral tissue MMPs may be modulated by metal ions present in the
      oral environment. Therefore, the accumulation of metals in connective tissue may
      interfere with the formation and resorption of the extracellular matrix
      components.

PMID- 11203531
TI  - Improving the processing of high-gold metal-ceramic frameworks by a pre-firing
      heat treatment.
AB  - OBJECTIVES: High-gold metal-ceramic alloys are difficult to elaborate due to
      their soft surface. Overlappings after grinding cause porosities at the metal
      ceramic interface. Poor mechanical strength at high temperatures leads to thermal
      distortion of the framework. During firing hardness and high temperature strength
      of the alloy improve, thus improving processing. Therefore the question arises if
      by a pre-firing heat treatment hardening can be anticipated without affecting the
      mechanical strength after firing. METHODS: Four commercially available alloys
      were investigated with regard to hardness, thermal distortion, proof stress, and
      grain growth in the as-cast state, after a pre-firing heat treatment at 950
      degrees C for 10 min, after a complete firing cycle and after a combination of
      both heat treatments. Hardness was measured as HV5/30, thermal distortion by
      means of a three point bending test and proof stress according to ISO 9693: 1991.
      The results were compared by means of Student's t-test (p < 0.05). RESULTS: For
      all alloys hardness, resistance to thermal distortion, and proof stress
      significantly increased after the pre-firing heat treatment compared to the as
      cast state. When a pre-firing heat treatment was performed before the complete
      firing cycle, hardness may slightly drop, but proof stress and resistance to
      thermal distortion remained at least constant or even improved, compared to the
      results obtained after a complete firing cycle. Grain growth due to the pre
      firing heat treatment was not observed. SIGNIFICANCE: The results showed, that a
      heat treatment of high-gold frameworks performed directly after casting improves
      processing without affecting mechanical strength.

PMID- 11203532
TI  - An assessment of the influence of mixing induced variability on the bi-axial
      flexure strength of dentine porcelain discs and the implications for laboratory
      testing of porcelain specimens.
AB  - OBJECTIVES: The proportions of dentine powder and modelling fluid employed to
      produce a "creamy" porcelain slurry consistency used in veneer construction are
      assessed by the technical experience of the operator so that variability is
      inevitable. The present study investigated the implications of mixing variability
      on the slurry consistency used in the manufacture of dentine porcelain disc
      specimens for laboratory testing. METHODS: Vitadur-Alpha dentine porcelain was
      fabricated into disc specimens and the mean fracture strength, standard deviation
      and associated Weibull Moduli (m) were determined by fracturing sets of 30
      specimens prepared to different powder contents for a constant 0.33 ml of liquid
      using bi-axial flexure (ball-on-ring). RESULTS: The strength data showed
      variation in magnitude and consistency ranging from 85.1 +/- 12.9 MPa (m = 7.2 +/
      1.3) at 0.82 g to 87.3 +/- 11.9 MPa (m = 8.0 +/- 1.5) at 0.91 g and 81.9 +/-
      13.2 MPa (m = 6.7 +/- 1.2) at 1.0 g of powder. Increasing or decreasing the
      powder content of the slurry (compared with specimens condensed using 0.91 g of
      powder) resulted in an increase in porosity and a decrease in the apparent solid
      density. SIGNIFICANCE: No significant decrease in the mean bi-axial flexure
      strength or reliability of the fracture strength data was identified for the
      slurry consistencies investigated, however, the results suggested that an optimum
      consistency existed wherein consistent reproducibility of test results was
      achieved. A comparison between materials can only be achieved if specimen
      preparation occurs consistently between test centres and therefore these results
      appear to have implications for the laboratory testing of materials.

PMID- 11203533
TI  - Improved reliability of leucite reinforced glass by ion exchange.
AB  - OBJECTIVES: The aim of this study was to develop an adequate process-, proof- and
      calculation technique for the chemical strengthening of dental ceramic materials
      in order to evaluate the efficiency of this method from the engineering point of
      view. METHODS: Ion exchange examinations below glass temperature have been done
      for the dental all ceramic system IPS-Empress (Ivoclar). In addition experiments
      on specimens were undertaken, which were stored in artificial saliva for the
      period of one month after the ion exchange treatment. The efficiency of the ion
      exchange treatments has been evaluated based on the chemical composition of the
      surface layer, the residual stress distribution, the flexural- and the burst
      strength and surface hardness. In addition, Weibull statistical analysis of the
      four-point bending and burst test data provides new information about the failure
      mechanisms of chemically strengthened dental ceramics. RESULTS: The ion-exchange
      process with a potassium salt increases the reliability of the dental ceramic
      material "IPS-Empress". By the KNO3 or Tuf-Coat ion exchange treatment potassium
      ions will be implanted as clusters directly into the crystal lattice which
      results in an increase of the binding energy and hence, in a pronounced increase
      in the surface hardness. In particular the stress bearing capabilities of dental
      all ceramic restorations, which are subject to high bending stresses, i.e. dental
      crowns and dental bridges, are largely improved by the induced residual stresses.
      This increase of residual stresses did not relax significantly after a one month
      storage in artificial saliva. SIGNIFICANCE: Enhanced load limits and a more
      narrow strength distribution spectrum is considered desirable for increasing the
      clinical longevity of all ceramics.

PMID- 11203534
TI  - Mechanical properties and microstructures of glass-ionomer cements.
AB  - OBJECTIVE: The objective of this study was to determine the flexural strength
      (FS), compressive strength (CS), diametral tensile strength (DTS), Knoop hardness
      (KHN) and wear resistance of ten commercial glass-ionomer cements (GICs). The
      fracture surfaces of these cements were examined using scanning electron
      microscopic (SEM) techniques to ascertain relationships between the mechanical
      properties and microstructures of these cements. METHODS: Specimens were
      fabricated according to the instructions from each manufacturer. The FS, CS, DTS,
      KHN and wear rate were measured after conditioning the specimens for 7 d in
      distilled water at 37 degrees C. One-way analysis of variance with the post hoc
      Tukey-Kramer multiple range test was used to determine which specimen groups were
      significantly different for each test. The fracture surface of one representative
      specimen of each GIC from the FS tests was examined using a scanning electron
      microscope. RESULTS: The resin-modified GICs (RM GICs) exhibited much higher FS
      and DTS, not generally higher CS, often lower Knoop hardness and generally lower
      wear resistance, compared to the conventional GICs (C GICs). Vitremer (3M) had
      the highest values of FS and DTS; Fuji II LC (GC International) and Ketac-Molar
      (ESPE) had the highest CS; Ketac-Fil (ESPE) had the highest KHN. Ketac-Bond
      (ESPE) had the lowest FS; alpha-Silver (DMG-Hamburg) had the lowest CS. Four GICs
      (alpha-Fil (DMG-Hamburg), alpha-Silver, Ketac-Bond and Fuji II) had the lowest
      values of DTS, which were not significantly different from each other; alpha
      Silver and Ketac-Silver had the lowest values of KHN. The highest wear resistance
      was exhibited by alpha-Silver and Ketac-Fil; F2LC had the lowest wear resistance.
      The C GICs exhibited brittle behavior, whereas the RM GICs underwent substantial
      plastic deformation in compression. The more integrated the microstructure, the
      higher were the FS and DTS. Higher CS was correlated with smaller glass
      particles, and higher KHN was found where there was a combination of smaller
      glass particles and lower porosity. Larger glass particle sizes and a more
      integrated microstructure contributed to a higher wear resistance. SIGNIFICANCE:
      The mechanical properties of GICs were closely related to their microstructures.
      Factors such as the integrity of the interface between the glass particles and
      the polymer matrix, the particle size, and the number and size of voids have
      important roles in determining the mechanical properties.

PMID- 11203535
TI  - The permeability of dental procedure and examination gloves by an alcohol based
      disinfectant.
AB  - OBJECTIVES: The usage of gloves in dentistry has increased greatly over the last
      10 years and this has highlighted certain problems when gloves are being worn
      extensively. While skin irritations and allergies caused by latex proteins and
      accelerators have been the main focus of attention, dental materials such as
      disinfectants have also become known as a source of skin reactions. This study
      was performed to evaluate the permeability of various gloves by ethanol. METHODS:
      The tip of the middle finger of 13 glove brands (natural latex gloves (NLG)
      powdered or unpowdered, powdered vinyl, nitrile and synthetic elastomer) was
      exposed to 5 ml of a hand disinfectant (Desderman). After a penetration time
      ranging from 2 min to 8 h the permeation of Desderman was detected with a gas
      chromatograph. RESULTS: Only one component of the disinfectant (ethanol) could be
      detected to have gone through the gloves. After only 2 min the vinyl and one
      nitrile glove and after 10 min all glove types were permeated. Powder seemed to
      have no real influence on the penetration of ethanol. Some natural latex gloves
      showed a low rate of leakage, while vinyl and nitrile gloves were penetrated
      quickly and to a great extent. The synthetic elastomer (Biogel Neotech) was the
      only one with a significantly lower penetration even after 2-8 h. SIGNIFICANCE:
      While there are reports of adverse skin reactions to alcohol the amount of
      ethanol (up to 40 microliters after 2 h) detected in this study is much too low
      to cause irritations and certainly not toxicity, but it could possibly initiate
      allergic reactions.

PMID- 11203536
TI  - Dimensional changes and pressure of dental stones set in silicone rubber
      impressions.
AB  - OBJECTIVES: A high expansion stone has been used for improving the adaptation of
      dentures. Although the method is based on the idea to compensate for the
      processing shrinkage of the denture base resin with the high expansion stone,
      there are few studies on the expansion behavior of stones in an impression. The
      purpose of this study is to clarify the dimensional changes of stones set in
      silicone rubber impressions using two types of impression tray. METHODS:
      Impressions of a master model that represents the alveolar ridge were taken using
      a silicone impression material and the dimensional changes in the stone casts
      were measured in different directions (x, y and z-axes). Two types of impression
      tray were used, one with an open surface and the other with a closed surface. In
      order to evaluate the setting expansion of the stones and the pressure against
      the impression, stones were poured in other impressions that were taken from a
      cubic master model. The thickness of the impression was set at 2 mm. RESULTS: A
      statistical analysis showed that there were significant differences in the
      dimensional change in the vertical direction (z-axis) and horizontal directions
      (x- and y-axes) of any stone casts set in the open tray. However, there were no
      significant differences in the dimensional changes in any direction of each stone
      cast set in the closed tray. SIGNIFICANCE: The impression tray influences the
      setting expansion of stones. Stones do not uniformly expand in the open tray and
      the dimensional changes in the stone casts in the three-dimensions increases,
      when used with a high expansion stone.

PMID- 11203537
TI  - Flexural properties and impact strength of denture base polymer reinforced with
      woven glass fibers.
AB  - OBJECTIVES: The present investigation was undertaken to determine the reinforcing
      effect of woven glass fibers on deflection, flexural strength, flexural modulus
      and impact strength of acrylic denture base polymer. METHODS: Three silanized or
      unsilanized woven glass fibers were used. Specimens were made by heating the
      denture cure resin dough containing glass fibers, which were sheathed in the
      dough. Specimens with four different thicknesses and of five different types were
      made, incorporating the glass fiber. Three-point flexural test and flywheel type
      impact test were employed to determine the flexural properties and impact
      strength. RESULTS: When specimens contained unsilanized glass fiber, the flexural
      strength in specimens of 1 and 2 mm thickness and the impact strength in
      specimens of 2 mm thickness were higher than those of specimens without glass
      fiber (p < 0.01). On the contrary, the flexural strength and deflection in
      specimens reinforced with silanized glass fiber of 1 mm thickness were
      significantly higher (p < 0.01, p < 0.05) than those of unreinforced specimens.
      Further, the impact strength in specimens reinforced with silanized glass fiber
      of 2 mm thickness was significantly higher (p < 0.01) than that of unreinforced
      specimens. Statistically significant differences were found in the flexural
      strength (p < 0.05) and in the impact strength (p < 0.01) when specimens of 4 mm
      thickness were reinforced with two or three unsilanized glass fibers.
      SIGNIFICANCE: The reinforcement with glass fiber was effective in thin specimens,
      and the reinforcing effect increased with the increase of the number of glass
      fibers in the case of thick specimens.

PMID- 11203538
TI  - High pressure liquid chromatography of dentin primers and bonding agents.
AB  - OBJECTIVE: The purpose of this study was to analyse the composition of
      representative dentin primers and bonding agents, and to investigate the
      relationship between chromatographic retention times and partition coefficient
      (log P) values. METHODS: Dentin bonding systems (DBS) were analysed with reversed
      phase high-performance liquid chromatography (HPLC). The log P values were
      obtained computationally with the advanced chemistry development software.
      RESULTS: The DBS were analysed and the monomers were identified. The log P values
      were calculated and the relationship between log P and retention times for the
      monomers was described by the equation: log P = 2.436R(t) - 3.636, with a
      correlation value (r) of r = 0.9095. SIGNIFICANCE: The components of the DBS were
      successfully resolved and identified, thus illustrating the analytical power of
      HPLC regarding those systems. Also the log P values correlated with the retention
      times of monomers. Thus, they can be used as a prediction tool in future
      analysis. These findings are important for a mechanistic understanding of Primer
      and Adhesive actions in the bonding to the dentin.

PMID- 11203539
TI  - Dimensional changes of resin/ionomer restoratives in aqueous and neutral media.
AB  - OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer
      formulations from 5 min age to one month and to separate out the intrinsic
      setting shrinkage and hygroscopic expansion effects, by using non-aqueous and
      aqueous storage media, respectively. METHODS: Materials studied included: A:
      resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs];
      and controls of D: poly-acid modified composite [compomer]; and E: resin
      composite. Separate specimen groups (n = 5) were stored in different storage
      media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23
      and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height)
      were obtained via accurate mass measurements (to 10(-4) g), using Archimedes
      principle, with silicone or water also used as the Archimedean fluid. These
      measurements were made periodically over a 30 day period, post fabrication.
      RESULTS: In silicone at 23 degrees C, all materials underwent further gradual
      intrinsic shrinkage (after 5 min from mix). This was highly significant (p <
      0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded,
      indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees
      C, the shrinkage was either partially offset (materials C, D, E), or replaced by
      appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM
      GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage
      media made an important contribution to the separate analysis of the volumetric
      changes due to the on-going setting chemistry in these systems and the time
      dependent effects of an aqueous environment.

PMID- 11203540
TI  - Long-term corrosion of a Ga-containing restorative material.
AB  - OBJECTIVE: The aim was to simulate and characterize the long-term corrosion of a
      Ga-containing alloy (Galloy, SDI). METHODS: To induce corrosion, cylindrical
      specimens, 8 x 4 mm, of the material were subject to potentiostatic polarization
      at -0.1 V (SCE) in a phosphated buffered saline (PBS) solution at 20 degrees C
      for d. The current-time transients during polarization were recorded and the
      corresponding anodic charge, Q, was calculated. Parallel potentiostatic corrosion
      tests in a Cl-free PBS solution were also conducted to demonstrate the
      significance of the Cl- ion in corrosion. In addition, potentiodynamic anodic
      polarization tests were performed to characterize the overall corrosion behavior
      of the alloy in both electrolytes. The external and internal corroded layers,
      formed during potentiostatic corrosion in PBS, were measured by optical
      microscopy. SEM and EDXA were used to characterize the morphology and composition
      of the potentiostatically polarized surfaces. RESULTS: Galloy was passive in Cl
      free PBS. The Cl- ion in PBS destroyed passivity and initiated a "dissolution
      precipitation" type reaction during potentiostatic corrosion. The latter led to
      circumferential internal corrosion and growth of a layer of external corrosion
      products. The thickness of the internal and external corrosion layers was 0.77 +/
      0.07 and 0.86 +/- 0.37 mm, respectively. The Q value (89.3 +/- 13.7 C/cm2) in
      PBS was about two orders of magnitude higher than that (0.66 +/- 0.24 C/cm2) in
      Cl-free PBS. The corrosion products contained Sn, Ga, In, Cu, O and Cl.
      SIGNIFICANCE: Massive internal and external corrosion in a Cl-containing medium
      as in saliva, accumulation of corrosion products at the cavity wall, and the
      consequent stress build-up contribute to post-operative pain, tooth straining,
      marginal breakdown and fractured teeth reported with the clinical use of Galloy.

PMID- 11203542
TI  - Measurements from digital panoramic radiographs.

PMID- 11203541
TI  - Comparison of microscopy and radiography as gold standards in radiographic caries
      diagnosis.

PMID- 11203543
TI  - Susuks.

PMID- 11203544
TI  - Stability of the mucosal topography around single-tooth implants and adjacent
      teeth: 1-year results.
AB  - This study evaluated the soft tissue stability around 10 single-tooth implants.
      All cases were treated following the same protocol, which included guided bone
      regeneration and connective tissue grafting. One year after prosthesis insertion
      the soft tissue shrinkage on the buccal side of the implant crown was 0.6 mm on
      average. The soft tissue volume in the papilla area increased on average by 0.375
      mm, and none of the papillae lost volume.

PMID- 11203545
TI  - Human histologic evaluation of a bovine-derived bone xenograft in the treatment
      of periodontal osseous defects.
AB  - This study evaluated a bovine-derived bone xenograft (Bio-Oss) in the treatment
      of human periodontal osseous defects. Four patients with at least one tooth that
      had been recommended for extraction because of interproximal advanced periodontal
      disease volunteered to participate. The surgical procedure consisted of flap
      reflection, soft tissue debridement, placing a notch in calculus as a histologic
      reference point, root planing, placement of the bovine-derived xenograft and a
      bioresorbable physical barrier, and flap closure. Patients were seen every 2
      weeks for plaque control and any necessary adjunctive treatment. At 4 to 6 months
      postsurgery, 6 teeth, along with the adjacent graft site, were removed en bloc.
      Histologic observations demonstrated new bone, new cementum, and new periodontal
      ligament coronal to the reference notch in 3 of the 4 specimens. This study
      indicates that periodontal regeneration is possible following grafting with a
      bovine-derived xenograft.

PMID- 11203546
TI  - Orthodontic treatment in periodontally compromised patients: 12-year report.
AB  - This work describes the therapeutic protocol of combined orthodontic-periodontal
      treatment and evaluates the effectiveness of surgical and nonsurgical periodontal
      therapy in the maintenance of a healthy periodontal status after the orthodontic
      treatment. Surgical periodontal treatment was performed in 267 patients affected
      by severe periodontal disease, and 128 patients had nonsurgical treatment. For
      each patient the mean value of probing depth (mPPD) and the rate of positive
      bleeding on probing (%BoP) of the teeth involved in the orthodontic movement were
      registered before the start of the periodontal treatment, at the end of the
      orthodontic treatment, and 2, 4, 6, 10, and 12 years after the end of the
      orthodontic treatment. Comparison between pretreatment and posttreatment values
      and between pretreatment and follow-up values showed a decrease in mPPD and %BoP
      that was of statistical significance. The difference between posttreatment and
      follow-up values was not statistically significant. These results suggest that
      orthodontic treatment is no longer a contraindication in the therapy of severe
      adult periodontitis. In these cases orthodontics improve the possibilities of
      saving and restoring a deteriorated dentition.

PMID- 11203547
TI  - Tissue regeneration in bone defects adjacent to endosseous implants: an
      experimental pilot study.
AB  - Extraction socket defects or alveolar ridge defects may limit or restrict
      placement of implants. The present study assessed the efficacy of inducing bone
      formation with demineralized freeze-dried bone (DFDB), osteoinduction with
      hydroxyapatite (HA), and guided bone regeneration with expanded
      polytetrafluoroethylene (e-PTFE) in bone defects adjacent to endosseous implants
      in an animal model. Twenty-four implants were placed in the long bones of 3 pigs.
      After preparation of 24 cylindric acute defects adjacent to the coronal 5 mm of
      each implant, 18 of the defects were treated by DFDB, HA, or e-PTFE. The 6
      remaining defects healed spontaneously with no treatment (controls). In each pig,
      one tibia received 4 commercially pure titanium screw implants (3.75 mm x 15 mm),
      while the contralateral tibia received 4 HA-coated cylindric implants (3.25 mm x
      15 mm). Bone formation in response to the 3 treatments and control cases was
      evaluated using computer-assisted densitometric image analysis. The results
      showed that a higher density of tissue formed under e-PTFE membranes. A
      significantly greater increase in bone density was noticed in bone defects
      treated with an e-PTFE membrane vs DFDB (P = 0.04), in e-PTFE vs control sites (P
      = 0.04), and in defects treated with HA vs DFDB (P = 0.04) in HA-coated implants.
      In titanium implants the differences observed were not significant. It was also
      observed that bone regeneration in defects treated with HA differs with the type
      of implant used (titanium vs HA-coated implants), but such differences were not
      significant.

PMID- 11203548
TI  - A comparative study of root coverage obtained with an acellular dermal matrix
      versus a connective tissue graft: results of 107 recession defects in 50
      consecutively treated patients.
AB  - Obtaining root coverage has become an important part of periodontal therapy. In
      this study, 2 surgical root coverage procedures were examined. The control group
      was treated with a coronally positioned pedicle graft combined with a connective
      tissue graft. The test group was treated with a coronally positioned pedicle
      graft combined with an acellular dermal matrix. There was no statistically
      significant difference in the mean root coverage obtained (96.2% control vs 95.8%
      test). There was a statistically significant reduction in probing depth (1.2 mm
      control vs 0.7 mm test) and increase in keratinized tissue (2.0 mm control vs 1.2
      mm test) in both groups. The connective tissue graft produced a greater mean
      probing reduction and mean keratinized tissue increase than the acellular dermal
      matrix. However, this did not appear to be clinically significant. The results of
      both procedures were esthetically acceptable to the patients and clinically
      acceptable in all cases. In this study, the acellular dermal matrix and the
      connective tissue graft resulted in similar amounts of root coverage.

PMID- 11203549
TI  - Periodontal medicine in the next millennium.

PMID- 11203550
TI  - The use of demineralized freeze-dried bone-glycoprotein matrix grafts in treating
      baboon periodontal infrabony defects.
AB  - In an effort to improve regenerative capacity and establish higher levels of
      predictability, the use of a new graft material was investigated in baboon
      infrabony periodontal defects. A graft matrix composed of human demineralized
      freeze-dried bone combined with human connective tissue glycoprotein was
      implanted in 20 defects in 9 baboons. Control, debrided-only sites in the same
      animal served as a comparison. Grafted sites achieved a 1.8-mm greater reduction
      in probing depth and attachment gain compared to controls. In addition, 25.3%
      greater defect fill was found in grafted sites. Histologic analyses provided
      evidence of bone induction by the graft matrix and regeneration of new cementum,
      periodontal ligament, and bone in the grafted sites.

PMID- 11203551
TI  - Immediately loaded mandibular implant bar overdenture: a surgical and
      prosthodontic rationale.
AB  - Classical guidelines for osseointegration include a long healing time, during
      which functional load should be avoided. However, the long healing period might
      impose an intolerable situation on some patients, especially in the completely
      edentulous situation. Studies on immediately loaded implant-supported prostheses
      in completely edentulous patients have been reported, exhibiting high success
      rates comparable to conventionally loaded implants. This article describes the
      surgical and prosthodontic procedure for the immediately loaded mandibular
      implant bar overdenture as well as its clinical rationale.

PMID- 11203552
TI  - Ceramic abutments--a new era in achieving optimal esthetics in implant dentistry.
AB  - In the visible dental region in particular, implant-prosthetic restorations
      filling single-tooth gaps make exacting demands on function and esthetics. One
      crucial factor influencing the esthetic outcome is the emergence profile of the
      restoration. The introduction of aluminum oxide or zirconium oxide abutments,
      which can be milled to meet individual requirements, provides new opportunities
      for reconstruction adapted to anatomic findings. Tooth-matched coloring combined
      with customized preparation and dimensioning make for optimal mucogingival
      esthetics in implant-supported single-tooth restorations. The aim of the present
      article is to give a general survey and to illustrate the use of ceramic
      abutments with clinical case reports.

PMID- 11203553
TI  - The influence of sulfate-reducing bacteria colonization of 2 different
      bioresorbable barrier membranes for GTR. An 18-month case-controlled
      microbiologic and clinical study.
AB  - The purpose of the present microbiologic and case-controlled clinical study was
      to examine the colonization of 2 different resorbable barrier membranes by
      sulfate-reducing bacteria (SRB). The barrier membranes tested were Guidor matrix
      barrier and Resolut regenerative material. Ten patients exhibiting 3 Class II
      furcation defects and 7 intrabony defects were included in the study. The probing
      depth and the clinical attachment level at 4 surfaces per tooth were taken at the
      beginning of the study. Microbiologic samples were taken from the experimental
      sites and from the approximal sites of the adjacent teeth. Both types of
      resorbable membranes were positive for SRB colonization. The detection of SRB in
      2 of 7 intrabony defects and in all defects with furcation involvement before the
      membrane placement indicated that these organisms are a common inhabitant of
      sites showing periodontal destruction and are associated with guided tissue
      regeneration (GTR). According to the clinical criteria for healing tendencies
      used in this study, the GTR procedures were less successful in the presence of
      SRB. There were no significant clinical effects of different resorbable membrane
      materials or membrane layout on attachment level changes for either the intrabony
      defect or furcation groups after 18 months. There were no statistical differences
      for sites that became exposed to SRB when compared to sites that remained
      unexposed after 18 months. The numeric significance of SRB in relation to the
      total microbial count needs to be determined to gain insight into the ecologic
      role of membrane resorption rates.

PMID- 11203554
TI  - Histologic and clinical comparison of bilateral sinus floor elevations with and
      without barrier membrane placement in 12 patients: Part 3 of an ongoing
      prospective study.
AB  - In 1993 the Department of Implant Dentistry at New York University College of
      Dentistry began a long-term clinical, histologic, histomorphometric, and
      radiographic study of the sinus elevation procedure. One of the parameters under
      evaluation in this study is the effect of barrier membrane placement on the
      creation of vital bone in the grafted sinus cavity. This report presents a
      histologic and histomorphometric evaluation of healing with and without the
      placement of an expanded polytetrafluoroethylene (e-PTFE) barrier membrane over
      the lateral window at the time of sinus grafting. The data were collected from 12
      patients who underwent bilateral sinus elevation surgery. In each of these 12
      patients the same grafting material was used in both sinuses, making the presence
      or absence of an e-PTFE barrier membrane the only controlled variable. Under the
      conditions of this study, the results indicate that (1) placement of the barrier
      membrane tends to increase vital bone formation; (2) placement of a barrier
      membrane has a positive effect on implant survival; and (3) membrane placement
      should be considered for all sinus elevation procedures.

PMID- 11203555
TI  - A case report study of 72 consecutive Emdogain-treated intrabony periodontal
      defects: clinical and radiographic findings after 1 year.
AB  - This case report study examined the effect of adjunctive use of Emdogain in the
      treatment of intrabony periodontal defects. Seventy-two consecutively treated
      defects in sixty-one patients were included. Efficacy of treatment was evaluated
      at 12 months by assessment of probing depth reduction, probing attachment level
      gain, and radiographic bone gain from standardized radiographs. Initial pocket
      depth averaged 8.3 mm, and the mean probing attachment level was 10.0 mm. The
      mean radiographic defect depth was 5.3 mm. At 12 months, mean pocket depth
      reduction was 4.7 mm and mean probing attachment level gain was 4.2 mm.
      Radiographic bone level gain averaged 3.1 mm and defect fill averaged 70%. The
      only variables significantly affecting radiographic bone gain were bleeding on
      probing and smoking. It was concluded that Emdogain treatment of one- and two
      walled intrabony defects in a periodontal practice will result in a clinically
      significant gain of probing attachment level and radiographic bone that is
      similar to that reported in controlled clinical trials.

PMID- 11203556
TI  - Soft tissue management around implants in the esthetic zone.
AB  - The concept of overbuilding the implant site in the esthetic zone is paramount in
      creating the inconspicuous implant restoration. If teeth are congenitally
      missing, the site may be underdeveloped. Tooth extraction and trauma may lead to
      ridge deformities. The goal is to create an enhanced site for the restorative
      clinician. This site can then be molded to an ideal gingival framework. Cases are
      used to illustrate surgical and orthodontic techniques for preserving and
      overbuilding the implant site in the esthetic zone.

PMID- 11203557
TI  - The Procera AllCeram system.
AB  - The Procera AllCeram system is indicated for manufacturing all-ceramic crowns for
      single-tooth restorations in the anterior and posterior regions. In addition, it
      is possible to create metal-free superstructures on CeraOne abutments from the
      Branemark implant system or crowns on individually prepared aluminum oxide
      abutments (CerAdapt). The Procera copings, which are manufactured using computer
      aided design/manufacturing technology, are characterized by very good mechanical
      properties. Ceramic veneers tailored to the copings offer excellent esthetics,
      favorable abrasion behavior, and an ideal surface structure for non-inflammatory
      apposition of the periodontal or periimplant tissues. The present article offers
      an overview of previous scientific studies, describes clinical and laboratory
      procedures, and presents case reports.

PMID- 11203558
TI  - Effect of early exposure on the integration of dental implants in the baboon:
      Part 1--Clinical findings at uncovering.
AB  - There has been increased discussion on the advantages of a one- versus a two
      stage surgical approach in the placement of dental endosseous implants. This
      study evaluated the influence of early implant exposure on crestal bone height
      adjacent to the implant surface and Periotest values at uncovering in the baboon.
      Forty-eight implants (24 commercially pure titanium, 24 titanium alloy) were
      placed in maxillary and mandibular posterior sites in 6 baboons. Implant exposure
      was evaluated weekly for 3 weeks after implant placement. The level of bone
      adjacent to the dental implants was measured at placement from the top of the
      implant collar to the crest of the bone at the mesial, distal, buccal, and
      lingual surfaces. The maxillary sites were measured again at a 6-month
      uncovering, while the mandibular sites were measured at a 3-month uncovering.
      Periotest readings were also recorded at uncovering. Early implant exposure was
      more common in the mandible, with the majority occurring by the second week
      postplacement. There were no significant differences in the crestal bone height
      changes at uncovering between the pure titanium and alloy implants in either
      arch. In the maxilla, the changes in crestal bone height were not statistically
      different between exposed and nonexposed implants at any aspect. In the mandible,
      the difference in 3-month changes between exposed and nonexposed implants was
      significant for the distal, buccal, and lingual aspects. The overall percentage
      of implants with a Periotest reading in the "good" category was greater for the
      nonexposed sites as compared to exposed sites. The results of this study suggest
      that the two-stage surgical approach results in a better clinical outcome as
      compared to the one-stage approach in the baboon model.

PMID- 11203559
TI  - Placement of the preparation line and periodontal health--a prospective 2-year
      clinical study.
AB  - The aim of this prospective clinical 2-year study was to determine whether the
      placement of the proximal margins of crowns within the zone of the biologic width
      results in periodontal alterations. In 41 patients, 116 prepared teeth as well as
      82 unrestored, healthy contralateral teeth were examined. The following indices
      were determined before as well as 3, 6, 12, and 24 months after preparation:
      hygiene index, papillary bleeding index (PBI), and probing depth. After
      preparation, the distance between the restoration margins and the alveolar crest
      was measured with a modified periodontal probe on both proximal aspects of each
      tooth. These values were classified into 3 groups: I = < or = 1 mm between crown
      margin and alveolar crest, II = 1 to 2 mm, and III = > 2 mm. In addition,
      radiographs were taken directly after cementation of each restoration and after
      12 and 24 months. The hygiene index did not significantly vary during the
      investigation, but PBI increased in all groups. The highest PBI increase was
      found in group I; in this group, the most significant increase was found between
      3 and 6 months after preparation. The mean probing depth only increased in group
      I during the first 3 months after preparation on the mesial aspects. Only minor
      changes were found on the distal aspects of the teeth in group I and on all
      aspects in groups II and III. No alterations of the bone levels were diagnosed on
      the radiographs. These results indicate that the location of the restoration
      margins within the zone of the biologic width may impair the periodontal health
      of restored teeth.

PMID- 11203560
TI  - Surgical template for completely edentulous patients.
AB  - Implant angulation is of utmost importance for fabrication of esthetic, hygienic,
      and functional prostheses, even in the treatment of completely edentulous
      patients. Most mandibular surgical templates are not reliable because of a lack
      of stability resulting either from severe resorption of the mandible or from the
      interference of mucoperiosteal flaps elevated during surgery. This article
      describes a technique for fabrication and surgical application of a stable
      template for the completely edentulous mandible. By combining the mandibular
      template with a maxillary duplicate denture, the problem of lack of stability can
      be overcome. A consistently reliable reference for implant placement in the
      edentulous mandible, specifically in relation to implant angulation (trajectory),
      can be obtained.

PMID- 11203561
TI  - Coronal ridge augmentation in the absence of bilateral bony plates around a
      pathologically denuded implant surface.
AB  - Guided bone regeneration via an osteopromotive barrier is indicated in different
      alveolar bone deficiencies and in periimplant bone destruction around
      pathologically denuded exposed implants. Regeneration of the osseous volume is
      determined by understanding the biologic behavior response of hard and soft
      tissues in guided tissue regeneration procedures. Consequently, a meticulous
      surgical approach is mandatory to preserve wound healing cascades and tissue
      stability. However, hard tissue augmentation in the nonsupported coronal
      direction has been unpredictable. A case report is presented in which a severely
      defected ridge around a pathologically exposed functional implant combined with a
      destructive extraction site was restored and regenerated. Bovine bone mineral
      particles (Bio-Oss) served as the graft material and were followed by an expanded
      polytetrafluoroethylene (e-PTFE) occlusive membrane as a bilateral regenerative
      tissue guide. Subsequently, 2 additional implants were placed in the augmented
      hard tissue ridge.

PMID- 11203562
TI  - Immediate transmucosal implant placement: a report of 2 cases.
AB  - Immediate placement of implants into fresh extraction sockets has the advantages
      of decreasing the recommended period of healing, reducing the resorption of the
      alveolar bone, and achieving optimal esthetic results. A high rate of success
      with immediately placed implants has been reported in the literature.
      Conventional intervention involves 2 or 3 surgical visits, and this may not be
      accepted by the patient or may be of some inconvenience. The technique described
      involves only one surgical visit at which a transmucosal endosseous root-form
      implant is inserted, followed by application of a resorbable membrane.

PMID- 11203563
TI  - Periodontal medicine in the next millennium.

PMID- 11203564
TI  - Histology of a human biopsy section following the placement of a subepithelial
      connective tissue graft.
AB  - This case report histologically examines the type of attachment that can occur
      after root coverage of a long-standing facial recession defect on a maxillary
      premolar with a subepithelial connective tissue graft. Histologic findings
      suggest that various types of tissue attachment, including periodontal
      regeneration, may occur over a recession defect after placement of a
      subepithelial connective tissue graft. In the present case, it was noteworthy
      that after 1 year the greatest area of exposed root surface was covered by a
      connective tissue attachment (adhesion), which had remained intact during
      orthodontic movement and distal drifting of the tooth.

PMID- 11203565
TI  - Treatment of Class II furcations with autogenous bone grafts and e-PTFE
      membranes.
AB  - This article reports a successful clinical regimen of treatment for the Class II
      furcation defect. Twenty-eight patients with molar teeth demonstrating Class II
      furcations were treated with regenerative therapy with the goal of regenerating
      lost interradicular periodontium. The treatment selected included scaling and
      root planing, surgical flap design that would enable the flap to completely cover
      the surgical site, complete enucleation of granulation tissue, tetracycline root
      conditioning, a particulate autogenous bone graft, and an expanded
      polytetrafluoroethylene (e-PTFE) membrane. Of the twenty-eight consecutive
      patients treated, twenty-five demonstrated no postoperative clinical evidence of
      furcation invasion, for a success rate of 89%. Eleven sites were reopened 8 to 9
      months postsurgical and presented complete furcation fill with a hard, bone-like
      tissue. Three teeth were judged to be failures because clinical assessment
      revealed persistent furcation invasion. The absence of histologic evidence
      precludes the presumption that complete periodontal regeneration occurred.

PMID- 11203566
TI  - Sinus grafting with porous bone mineral (Bio-Oss) for implant placement: a 5-year
      study on 15 patients.
AB  - The efficacy of Bio-Oss as a graft material for sinus floor elevation was studied
      in 15 patients. A total of 20 sinus augmentation procedures was performed, and 6
      months later 57 implants were placed into the augmented sinuses. New bone
      formation was confirmed in biopsies of 3 patients (new bone: 21.08% +/- 7.25%
      after 6 mo, 27.55% +/- 4.88% after 12 mo; Bio-Oss: 39.17% +/- 4.36% after 6 mo,
      27.01% +/- 11.64% after 12 mo). After a mean loading period of 4.0 +/- 0.5 years
      (range 3.2 to 4.8 y), 56 implants remained in place. This study confirms Bio
      Oss's good osteoconductive properties.

PMID- 11203567
TI  - Retrospective analysis of Frialit-2 implants in the augmented sinus.
AB  - The aim of the present study was to investigate clinical and radiographic data of
      patients treated with implants in the posterior maxilla in combination with sinus
      augmentation. Study parameters included Periotest values, radiographic analysis,
      and survival/success rates up to 5 years. Clinical and radiographic criteria
      resulted in a success rate of 92.7% for sinus implants. Radiographically, the
      sinus implants showed a mean coronal bone loss of 0.5 mm at 6 months and 1.2 mm
      at 48 months. The results showed stable periimplant parameters for sinus implants
      during the observation period of 5 years. The success rates showed no significant
      differences regarding different implant-supported treatment options for the
      posterior maxillary region.

PMID- 11203568
TI  - Clinical and histologic evaluation of human gingival recession treated with a
      subepithelial connective tissue graft and enamel matrix derivative (Emdogain): a
      case report.
AB  - A mandibular canine with significant gingival recession was selected for a pilot
      study to measure the attachment modalities resulting from mucogingival surgery.
      The tooth had 6 mm of recession as measured from the cementoenamel junction to
      the gingival margin, minimal pocketing, and no keratinized gingiva. The treatment
      regimen consisted of a subepithelial connective tissue graft (SCTG) plus Emdogain
      applied to the root surface. The tooth was extracted en bloc 6 months after
      surgery and processed histologically in a buccolingual plane. The tooth
      demonstrated a 2-mm gain of attachment and a 3-mm gain in keratinized tissue. The
      histologic study evidenced the migration of the junctional epithelium 1.2 mm
      apical to the sulcus. New cementum, evidence of newly formed woven bone, and
      connective tissue fibers anchored in the new cementum were evident.

PMID- 11203569
TI  - Compressive shear strength of core materials and restoring techniques.
AB  - In this study, ninety extracted endodontically treated mandibular molars were
      mounted in acrylic resin blocks. Five groups of eighteen extracted teeth were
      prepared by two different techniques. A peripheral shelf 2 mm deep and 1.4 mm
      wide was prepared as a first technique, while TMS pins were used in the second
      group. The teeth were then restored with five different core materials: silver
      reinforced glass-ionomer, resin-modified glass-ionomer, self-cured glass-ionomer,
      polyacid-modified composite resin, and titanium-reinforced composite resin. An
      Instron testing machine was used to apply shear force at a crosshead speed of 2
      mm/min until fracture occurred. The results were obtained statistically using
      analysis of variance and least significant difference tests. According to the
      results of this study, Ti-core and composite resin were the strongest core
      materials when subjected to shear forces, and the most retentive preparation
      design was the vertical-pin design. The fractures of these materials with a
      vertical-pin design were mostly seen at the core and the tooth.

PMID- 11203570
TI  - Improved closure rate of Class III furcations using a layered GTR technique.
AB  - In this study, 24 furcation defects in 12 patients were treated by either (1) a
      polylactide resorbable membrane (Guidor) plus a polyglactin mesh (Vicryl) and
      demineralized freeze-dried bone allograft (DFDBA), or (2) a polylactide
      resorbable membrane and DFDBA. All defects were reentered after 9 months. Class
      III furcations closed 66% of the time when treated by the first method, while the
      closure rate was only 33% when treated by the second method (no polyglactin
      mesh). Defects with a vertical opening of < or = 4 mm closed 74% of the time,
      while those with vertical openings > 4 mm closed only 11% of the time.

PMID- 11203571
TI  - The single-incision palatal harvest technique: a strategy for esthetics and
      patient comfort.
AB  - The use of connective tissue grafts for root coverage and ridge augmentation is a
      proven, effective treatment modality. Complications associated with the palatal
      donor site can arise because of incomplete primary closure of the palatal wound
      or sloughing of the overlying tissue. This article presents a new technique for
      the atraumatic harvesting of connective tissue grafts from palatal donor sites.
      The main advantage of this single-incision technique is the primary closure of
      the palatal flap, resulting in less pain and sensitivity and fewer postoperative
      complications. A review of the technique and its indications, rationale, and
      limitations is presented.

PMID- 11203573
TI  - The exciting world of interdisciplinary dentistry.

PMID- 11203572
TI  - Effect of unintentional exposure of 2-stage implants upon subsequent
      osseointegration: histologic findings 6 months postloading.
AB  - The purpose of this study was to evaluate the effect of early spontaneous
      exposure of 2-stage implants upon subsequent histologic bone contact following
      occlusal loading. As part of a study comparing 2 types of metallic threaded
      implants, 48 implants (24 CPTi and 24 Ti-13Nb-13Zr) were placed in maxillary and
      mandibular posterior sites in 6 baboons. Implant exposure was evaluated at time
      of placement and at each weekly visit for the first 3 weeks, then at 1, 2, and 3
      months, and also at 6 months for the maxilla. Block sections were removed 6
      months after the implant restoration was placed into function. One third (33%) of
      the maxillary implants became exposed, while 66.5% of the mandibular implants
      became exposed, mostly at 1 to 3 weeks. For all maxillary implants, fibrous
      tissue contact in the unintentionally exposed group (20.0%) was significantly
      greater than in the group that remained submerged (7.7%). Maxillary implants
      remaining submerged exhibited more sinus contact. For all mandibular implants,
      bone contact in the exposed group (38.9%) was significantly greater than in the
      submerged group (24.3%). Similarly, exposed implants exhibited less fibrous
      tissue contact. All other parameters in both maxillary and mandibular arches were
      statistically similar when comparing unintentionally exposed implants to those
      that remained submerged. This study suggests that accidental exposure of 2-stage
      implants should result in overall similarities in postloading bone contact to 2
      stage implants that remain submerged during the early postoperative healing
      period.

PMID- 11203574
TI  - Changing periodontal paradigms: therapeutic implications.
AB  - Many paradigms concerning the epidemiology, pathogenesis, and systemic impact of
      periodontal diseases have been modified. For example, bacterial biofilms are
      essential to induce periodontitis, but their mere presence is not sufficient to
      initiate disease. It is also now recognized that the host response to these
      biofilms causes most of the destruction of the periodontal tissues.
      Codeterminants that influence the clinical severity of the disease process
      include environmental, genetic, and acquired factors. In general, the prevalence
      of advanced periodontitis and the incidence of disease progression are lower than
      previously believed. However, periodontitis remains the most common chronic
      illness. In addition, the finding that acquired systemic diseases may predispose
      individuals to periodontitis, and conversely that periodontitis may be a risk
      factor for certain systemic diseases, has expanded the scope of periodontics.
      These changed paradigms and their consequences with regard to selecting therapies
      are discussed in this review article.

PMID- 11203575
TI  - Piezoelectric surgery in implantology: a case report--a new piezoelectric ridge
      expansion technique.
AB  - The purpose of this preliminary article is to present a new surgical technique
      that, thanks to the use of modulated-frequency piezoelectric energy scalpels,
      permits the expansion of the ridge and the placement of implants in single-stage
      surgery in positions that were not previously possible with any other method. The
      technique involves the separation of the vestibular osseous flap from the palatal
      flap and the immediate positioning of the implant between the 2 cortical walls.
      The case report illustrates the ridge expansion and positioning of implants step
      by step in bone of quality 1 to 2 with only 2 to 3 mm of thickness that is
      maintained for its entire height. To obtain rapid healing, the expansion space
      that was created for the positioning of the implant was filled, following the
      concepts of tissue engineering, with bioactive glass synthetic bone graft
      material as an osteoconductive factor and autogenous platelet-rich plasma as an
      osteoinductive factor. The site was covered with a platelet-rich plasma membrane.
      A careful evaluation of the site when reopened after 3 months revealed that the
      ridge was mineralized and stabilized at a thickness of 5 mm and the implants were
      osseointegrated.

PMID- 11203576
TI  - A retrospective study of dental implants in diabetic patients.
AB  - The efficacious placement of dental implants in diabetic patients remains
      controversial. Definitive guidelines with objective criteria, including the type
      of diabetes, age of onset, and level of long-term control, have not been
      determined. In addition, few relevant literature citations assess the survival
      rate of implants in diabetic patients. Therefore, it is the purpose of this study
      to assess the success and survival rates of dental implants in diabetic patients.
      In this retrospective analysis, 215 implants placed in 40 patients at 2 clinical
      centers were evaluated. Chart reviews and interviews provided medical and implant
      data. From the analysis, 31 failures occurred, for an overall success rate of
      85.6%. Of these failures, 24 occurred within the first year of functional
      loading. The mean time of functional load was 4.05 +/- 2.6 years. When the
      success rate was analyzed by implant location, success rates for the maxilla and
      mandible were 85.5% and 85.7%, respectively. For the anterior and posterior
      regions, success rates were 83.5% and 85.6%, respectively. The lifetable analysis
      revealed a cumulative success rate of 85.7% after 6.5 years of function. Based on
      the data, the survival rate of dental implants in controlled diabetic patients is
      lower than that documented for the general population, but there is still a
      reasonable success rate. The increase in failure rate occurs during the first
      year following prosthetic loading.

PMID- 11203577
TI  - Clinical and histologic evaluation of human intrabony defects treated with an
      enamel matrix protein derivative (Emdogain).
AB  - An enamel matrix protein derivative (Emdogain) has been recently shown to promote
      periodontal regeneration in experimentally created recession-type defects.
      However, only limited histologic data from human material are available
      concerning the healing of intrabony periodontal defects following treatment with
      Emdogain. The aim of the present study was therefore to present the clinical and
      histologic results following the application of Emdogain in intrabony defects.
      Two patients with marginal periodontitis and deep intrabony defects adjacent to
      teeth scheduled for extraction were treated with Emdogain. The postoperative
      healing phase was uneventful in both cases. At 6 months following treatment,
      newly formed cementum with inserting collagen fibers was found in both specimens.
      In one case, the new attachment formation was also accompanied by bone
      neoformation. The results of this human histologic study indicate that Emdogain
      possesses the potential to stimulate new connective tissue attachment formation
      in human intrabony defects.

PMID- 11203578
TI  - Hard tissue ridge augmentation using a resorbable membrane and a particulate
      graft without complete flap closure.
AB  - Twelve patients with isolated alveolar ridge defects bordered by teeth on each
      side were treated and followed for 12 months. The treatment involved use of a
      resorbable membrane and a particulate graft without complete flap closure.
      Measurements taken at 12 months showed a significant mean osseous gain of 3.27 +/
      3.73 mm in mid-defect ridge width and an increase in height of 1.90 +/- 2.50 mm.

PMID- 11203579
TI  - Long-term evaluation of osseointegrated implants in regenerated and
      nonregenerated bone.
AB  - This investigation evaluated the predictability of dental implants subjected to
      bone regeneration procedures at the time of insertion. Fifty-two test implants
      were inserted into sites with periimplant bone defects. A calcium carbonate
      allograft material with or without a fibrin-fibronectin sealing system was used
      to fill the defects. Sixty control implants were inserted into an adequate volume
      of nonaugmented bone. Each of the 29 study patients received at least one test
      implant and one control implant. At the second-stage surgery, fill of the bone
      defect was assessed as complete or incomplete. The cumulative success rate was
      91.7% (mean follow-up 55 mo) for the test implants and 93.2% (mean follow-up 59
      mo) for the control implants. Within the test group, implants with complete bone
      fill achieved 97.6% success versus 59.1% success for implants with incomplete
      bone fill. These preliminary results suggest that implants placed with
      simultaneous bone regeneration procedures achieve long-term predictability that
      is comparable to that of implants placed in an adequate volume of bone, provided
      that complete bone fill of the periimplant defect is achieved. Long-term studies
      with other augmentation materials are needed to fully validate these findings.

PMID- 11203580
TI  - Improved bone regeneration and root coverage using a resorbable membrane with
      physically assisted cell migration and DFDBA.
AB  - Twelve patients with 2 Miller Class I or II buccal recession defects measuring >
      or = 3.0 mm were treated using the principles of guided tissue regeneration and
      followed for 12 months. The effectiveness of a polylactide (Guidor) resorbable
      membrane (GA sites) was compared to a combination treatment of polylactide
      membrane plus polyglactin root-lining mesh (Vicryl) and demineralized freeze
      dried bone allograft (DFDBA) (GVB sites) designed to enhance cell migration and
      bone regeneration. There was 90% mean soft tissue root coverage for the GVB sites
      and 78% for the GA sites. The mean osseous dehiscence area coverage with hard
      tissue was 75% for GVB sites and 30% for GA sites.

PMID- 11203581
TI  - To conserve or implant: which choice of therapy?
AB  - The longevity of teeth depends directly on the state of the periodontal tissues.
      Many etiologic factors can lead to the loss of a tooth. Tooth loss is frequently
      associated with bone resorption. The diagnosis of a condition and knowledge of
      its etiology are essential to assess the prognosis of the remaining teeth and to
      formulate the correct treatment plan. Many parameters must be investigated to
      ascertain an accurate diagnosis. An understanding of the patient's needs and the
      length and likely success of treatment guides the decision of whether to preserve
      teeth or extract them and place implants. Advanced periodontitis poses a major
      therapeutic dilemma. Judicious, strategic extractions may permit the placement of
      long implants in ideal positions.

PMID- 11203582
TI  - Clinical performance of novel-design porcelain veneers for the recovery of
      coronal volume and length.
AB  - The present study evaluated the clinical performance of bonded porcelain veneers
      (PV) restoring substantial coronal volume and length in the anterior dentition.
      Forty-eight PVs were placed in 16 patients, with systematic coverage and
      reconstitution of the incisal edge, including well-defined anterior guidance. A
      standardized protocol comprising diagnostic steps that integrate additive waxups
      and acrylic mockups was used. PVs were fabricated using feldspathic and low
      fusing porcelains in a refractory die technique. Incisal overlaps featured
      freestanding porcelain spans ranging from 1.5 to 5.5 mm. After a mean clinical
      service of 4.5 years, 13 clinical parameters for each tooth and 4 parameters that
      applied to persons were recorded. Permutation tests evaluated the effects of
      margin location, incisal edge span of porcelain, overbite, opposing contact
      location, and restoration age on ceramic failure and clinical marginal adaptation
      and seal. At recall, 100% of the veneers were satisfactory with minor
      interventions. The effect of slight marginal defects and porcelain cracking was
      negligible. Biologic, periodontal, and esthetic parameters showed excellent
      results, which were supported by 100% patient-reported satisfaction. All patients
      felt comfortable with the newly defined anterior guidance. Aging was negligible,
      and there were no significant effects of margin location (P > 0.08), incisal edge
      span of the ceramic, or overbite (P > 0.22) on ceramic failure and marginal
      performance. Minor alterations of the palatal margin, however, tended to be more
      frequent compared to facial locations, and were found especially when the
      opposing tooth contact in centric occlusion was located on the palatal margin (P
      = 0.028). Bonded ceramic restorations represent a reliable, effective procedure
      to restore extensive coronal volume and length in the anterior dentition.

PMID- 11203583
TI  - Human histologic evaluation of bioactive ceramic in the treatment of periodontal
      osseous defects.
AB  - This study examined the healing of intrabony defects around 5 teeth treated with
      bioactive glass ceramic (PerioGlas). Healing was evaluated by clinical
      measurements, radiographic observation, and histologic analysis. The protocol
      included a presurgical phase of scaling and root planing therapy, with
      measurements obtained immediately prior to the surgical procedures and after 6
      months of healing. Following therapy there was a mean of 2.7 mm of probing depth
      reduction, 2.2 mm of clinical attachment gain, and 0.5 mm of recession. The
      histologic analysis revealed healing by a long junctional epithelium with minimal
      new connective tissue attachment to the teeth, except in one case where the
      intrabony region demonstrated new cementum formation and new connective tissue
      attachment. Graft particles were found to be biocompatible, as evidenced by being
      embedded in a stroma of dense connective tissue with minimal inflammatory
      infiltrate. There was minimal new bone formation limited to the most apical
      borders of the defects. No signs of periodontal regeneration as defined by new
      cementum, periodontal ligament, and bone formation on a previously diseased root
      surface were observed. Although the clinical results are encouraging and
      radiographs evidenced radiopacities within the defects, histologic analysis
      revealed that as a periodontal grafting material, bioactive glass ceramic has
      only limited regenerative properties.

PMID- 11203584
TI  - Clinical and microbiologic study of periodontal surgery by means of apically
      positioned flaps with and without osseous recontouring.
AB  - In periodontitis lesions with interproximal craters, periodontal flap surgery
      with osseous recontouring allows more apical positioning of the soft periodontal
      tissue than flap surgery without osseous recontouring. The present study
      determined the clinical and microbiologic responses to periodontal surgery with
      and without osseous recontouring in adult periodontitis lesions with
      interproximal craters. In 7 osseous surgery patients, osteoplasty and ostectomy
      were performed from the lingual/palatal aspect to eliminate interproximal osseous
      defects and to partly mimic the original alveolar bony transition to neighboring
      teeth. In 7 nonosseous surgery patients, the surgical flap was adapted to the
      preexisting osseous level. Clinical monitoring included periodontal probing
      depth, Plaque Index, gingival bleeding index, and radiographic examination.
      Samples of the subgingival microbiota were examined. In sites treated with
      osseous surgery, mean pocket depth was 5.5 mm at baseline, 1.9 mm at 1 month, 2.0
      mm at 3 months, and 2.1 mm at 6 months. In sites not receiving osseous
      recontouring surgery, the corresponding pocket depths were 5.9 mm, 3.1 mm, 3.8
      mm, and 4.1 mm. At baseline in the osseous surgery group, Actinobacillus
      actinomycetemcomitans was recovered from one patient and Porphyromonas gingivalis
      from 5 patients; posttreatment, these microbiota were not detected in any
      patient. In the nonosseous surgery group, the presence of A actinomycetemcomitans
      increased posttreatment, and levels of P gingivalis remained essentially
      unchanged after therapy. This study suggests that in patients not receiving
      adjunctive antibiotic therapy, apically positioned flap surgery with osseous
      recontouring is more effective than apically positioned flap surgery without
      osseous recontouring in reducing periodontal pocket depth and levels of major
      periodontal pathogens.

PMID- 11203585
TI  - Simplifying management of the posterior maxilla using short, porous-surfaced
      dental implants and simultaneous indirect sinus elevation.
AB  - This article describes the use of short, porous-surfaced root-form dental
      implants and an indirect, simultaneous, osteotome-mediated sinus elevation
      procedure to restore the posterior maxilla when as little as 3 mm of bone remain
      below the sinus floor. Results with 16 patients who are part of an ongoing
      prospective clinical trial using the Endopore implant show 100% success (using
      established criteria) with a mean implant length of 6.9 mm and a mean functional
      time of 11.1 months. This treatment approach greatly simplifies the management of
      the posterior maxilla with minimal bone height below the sinus floor.

PMID- 11203586
TI  - The use of autologous growth factors in periodontal surgical therapy: platelet
      gel biotechnology--case reports.
AB  - The role of polypeptide growth factors in periodontal regeneration has been
      documented through animal and human studies. Human platelets contain platelet
      derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta) in
      their alpha granules. PDGF has been shown to play a role in periodontal
      regeneration. It has been demonstrated that TGF-beta has a very potent effect on
      cells associated with bone. The case reports presented demonstrate a new
      biotechnology in which platelet gel is used in combination with demineralized
      freeze-dried bone allografts for the treatment of periodontal osseous defects.
      The treated teeth presented with severe bone loss and a guarded prognosis.
      Platelet gel biotechnology was used as a novel treatment modality. A significant
      reduction in probing depths was noted, and radiographically significant amounts
      of new bone were visible as early as 2 months postoperative. Results up to 2
      years postoperative are presented.

PMID- 11203587
TI  - Clinical evaluation of a new resin composite crown system to eliminate
      postoperative sensitivity.
AB  - This study evaluated the long-term clinical performance of a new resin composite
      restorative system with a 4-META dentin-bonding agent to seal complete crown
      preparations prior to temporization and after permanent luting with a companion
      resin cement. Complete-coverage crown preparations were completed on 33 vital
      teeth and 5 nonvital teeth (control). The new restorative material demonstrated
      satisfactory clinical performance for the 3-year test period. The dentin-bonding
      agent and its companion resin cement successfully eliminated postoperative
      hypersensitivity in 100% of the prepared vital teeth over the 3-year term,
      suggesting excellent seal of dentinal tubules exposed by the complete-crown
      preparations.

PMID- 11203589
TI  - Histologic analysis of a fractured implant: a case report.
AB  - This study presents the histologic analysis of an implant retrieved 14 months
      after loading because of a fracture in the collar region. The implant (Biovent)
      was removed with part of the periimplant tissues, and the block was prepared
      using cutting and grinding equipment to obtain 3 sections approximately 30
      microns thick. The examination evidenced a high degree of osseointegration, with
      a bone-to-implant contact of 74% +/- 13%. The lamellar bone was dense and in
      close relation with the hydroxyapatite coating of the implant. The connection
      between the 0.4-mm hydroxyapatite coating and the metal was always very tight.
      The thickness of the metal at the break point was assessed to be 1.6 mm. Besides
      the relative weakness of the metal at the neck of the implant, other possible
      causes of failure are discussed.

PMID- 11203588
TI  - Human histologic evaluation of a bone graft combined with GTR in the treatment of
      osseous dehiscence defects: a case report.
AB  - There are many possible goals and outcomes of periodontal surgical therapy, but
      the ultimate goal is regeneration. Since the definition of periodontal
      regeneration is histologic, it is difficult to document. The purpose of this
      study was to evaluate a technique that combined a bone graft and guided tissue
      regeneration (GTR) to see if regeneration occurred. Four teeth with dehiscence
      type osseous defects that were scheduled for extraction were treated with bone
      grafts and GTR. During the surgical procedure, a notch was placed into the root
      at the apical extent of the calculus. The teeth were extracted with conservative
      block sections 7 months after the treatment. They were processed, sectioned,
      stained, and evaluated histologically. The results revealed that regeneration did
      not occur in any of the teeth treated. In 2 of the teeth new connective tissue
      attachment was formed. In these 2 teeth cementum could be seen in the notch with
      connective tissue fibers inserting into the cementum. In one of the teeth the
      junctional epithelium extended apical to the notch, while in 3 cases the
      epithelium stopped at or coronal to the notch. In this case report, no
      regeneration could be documented, but new attachment could be seen in 2 of the 4
      teeth treated.

PMID- 11203590
TI  - Perceptions of dentistry.

PMID- 11203591
TI  - Tissue engineering technology for gingival augmentation procedures: a case
      report.
AB  - Tissue engineering technology has been used in periodontal surgery. A patient who
      needed gingival augmentation prior to a single prosthetic restoration was treated
      by means of a tissue engineering technique. Results are presented in this case
      report.

PMID- 11203592
TI  - A clinical study of root surface conditioning with an EDTA gel. I. Nonsurgical
      periodontal treatment.
AB  - The present study was undertaken to investigate if subgingival administration of
      an EDTA gel has any adjunctive effect to subgingival and supragingival root
      debridement. The investigation was performed in one study center involving 6
      clinical investigators and 91 patients. The patients were selected from 2 patient
      populations: 41 were included from a consecutive referral material on a voluntary
      basis, and 50 were included from a maintenance care material at the clinic. No
      significant differences were found between the EDTA-treated and control groups
      with respect to clinical attachment gain or probing pocket depth reduction. The
      referral patients showed a significant improvement of pocket depth and attachment
      gain compared to maintenance care patients at the clinic. In multiple regression
      analyses, it was found that patients with small attachment losses at baseline
      responded better to treatment than patients with severe periodontitis. Also, in
      multivariate analyses, referral patients responded better than maintenance
      patients when controlling for other predictors.

PMID- 11203593
TI  - A clinical study of root surface conditioning with an EDTA gel. II. Surgical
      periodontal treatment.
AB  - The objective of the present trial was to assess the effect of an EDTA gel
      applied during surgical periodontal therapy on probing depth reduction and
      periodontal attachment gain, allowing for the influence on healing of smoking as
      well as postsurgical oral hygiene. For comparison, citric acid treatment and
      control surgery only were included. The investigation was performed in one study
      center involving one clinical investigator and 68 patients. The patients were
      selected from a consecutive referral material on a voluntary basis. No
      statistically significant differences between treatment groups concerning
      attachment gain or pocket depth reduction could be seen after 3 and 6 months. A
      subgroup of the sample--21 patients who scored zero on the bleeding index at 3
      and 6 months postsurgery and did not smoke--had a borderline significantly higher
      attachment gain in response to experimental treatment as well as a significant
      pocket depth reduction 6 months postsurgery when controlling for age, gender,
      Plaque Index at baseline, and treatment in multiple regression analyses. However,
      this was true not only for EDTA treatment but for citric acid and control
      treatment as well.

PMID- 11203594
TI  - Maxillary sinus floor elevation using a combination of DFDBA and bovine-derived
      porous hydroxyapatite: a preliminary histologic and histomorphometric report.
AB  - The objective of the study was to determine the osteoconductive potential of
      bovine-derived porous hydroxyapatite (HA) in combination with demineralized
      freeze-dried bone allograft (DFDBA) as an alternative to autogenous grafting in
      the maxillary sinus. The study involved 5 patients treated with 2-stage sinus
      elevation procedures using a combination of DFDBA and Osteograf/N 300 and 700.
      The healing time before implant placement ranged from 6 to 13 months. At the time
      of reentry, a bone core was harvested from each patient and processed for
      histologic and histomorphometric analysis. Woven and lamellar bone formation was
      evident in all specimens. Mean trabecular bone volume was 27.92%. The amount of
      newly formed bone was positively correlated with healing time. The range of new
      bone formation was 5.36% (6 mo) to 43.68% (12 mo). Residual HA graft particles
      were evident in all specimens, and the amount was inversely correlated with time.
      HA particles were often surrounded by an intense inflammatory infiltrate. DFDBA
      particles, largely present in the 6-month biopsy, were not recognizable in the 10
      , 12-, and 13-month specimens, suggesting complete replacement. The combination
      of Osteograf/N and DFDBA appears to be osteoconductive and may be considered a
      valid alternative to autogenous bone grafts in sinus lift procedures.
      Histomorphometric and histologic evaluation may also be used to monitor the
      status of the future implant site.

PMID- 11203595
TI  - Use of Emdogain in the treatment of deep intrabony defects: 12-month clinical
      results. Histologic and radiographic evaluation.
AB  - The objective of this study was to evaluate the application of an enamel matrix
      derivative (Emdogain) in deep periodontal pocket therapy. Twenty-one patients
      presenting intrabony and interproximal defects that could be treated with guided
      tissue regeneration were selected. The intrabony defects were divided into deep
      (< 9 mm) and very deep (> or = 9 mm) defects. Bleeding on probing, Plaque Index,
      probing pocket depth, mobility index, gingival recession, probing attachment
      level, and surgical bone level were measured at baseline. At 12 months, cases
      were reexamined and indices recorded again. The mean probing depth decreased from
      8.1 +/- 2.1 mm to 3.2 +/- 1.5 mm; attachment level decreased from 10.4 +/- 2.4 mm
      to 7.0 +/- 1.8 mm; recession increased from 2.3 +/- 1.4 mm to 3.8 +/- 1.8 mm; and
      surgical bone level decreased from 9.6 +/- 1.9 mm to 7.1 +/- 1.5 mm. No
      significant difference wa noted between bone defects with one or 2 walls, between
      local and generalized periodontitis, or between smokers and nonsmokers.
      Significant statistical difference was found, however, between deep intrabony
      defects and very deep defects when attachment gain was considered. No adverse
      reaction to the substance was noted. The good clinical results obtained were not
      confirmed by radiologic results; standardized and computerized radiographs at 12
      months did not reveal significant improvement. The histologic examination carried
      out on 2 samples did not show evidence of new attachment. Further studies are
      necessary to clarify the action mechanism and to evaluate the long-term results
      of this method.

PMID- 11203596
TI  - The use of distraction osteogenesis to induce new suprabony periodontal
      attachment in the beagle dog.
AB  - Using a technique called distraction osteogenesis (DO), orthopedic surgeons are
      capable of reconstructing 4 to 5 cm of bone and soft tissue without bone grafts
      or pedicle flap procedures. DO has been used recently to generate maxillofacial
      bone as an alternative to maxillary and mandibular osteotomies. Using DO
      methodology, this study attempted to regenerate supraalveolar buccal periodontium
      on the mandibular second, third, and fourth premolars of beagle dogs. A small but
      statistically significantly greater amount of new cementum was generated in
      experimental teeth, with no difference found between experimental and control
      groups with respect to regenerating alveolar bone. Further studies using
      modifications of this technique are warranted to explore the potential of DO as
      an alternative to conventional regenerative approaches.

PMID- 11203597
TI  - Combined periodontal-prosthodontic treatment of early-onset periodontitis--an
      alternative to implant therapy.
AB  - A variety of treatment systems should be available for patients whose dentitions
      are seriously compromised so that they may select customized treatment modalities
      that satisfactorily restore occlusal function, consider systemic conditions, and
      lessen the surgical and financial burdens. These requirements become more
      demanding when clinicians are faced with advanced cases of rapidly progressive
      periodontitis. Therefore, it is critical to establish sophisticated
      multidisciplinary treatment modalities for the successful management of these
      compromised patients. Obviously, because of various limitations, implant therapy
      cannot be the only solution. This article reports on the successful long-term
      management of seriously compromised early-onset periodontitis by a combined
      periodontal-prosthetic treatment as an alternative to implant therapy.

PMID- 11203598
TI  - Treatment of a cracked tooth with a resin-ionomer restoration and a connective
      tissue graft: a case report.
AB  - Treatment of a cracked tooth can be difficult and unpredictable. Quite often, the
      most predictable treatment possible is simply extraction. This is a case report
      of the treatment of a cracked tooth with a resin-ionomer restoration and a
      connective tissue with partial-thickness double pedicle graft. The crack was
      detected during a routine root coverage procedure using this type of graft. A
      resin-ionomer was used to repair the crack. Then, the root coverage procedure was
      completed. Complete root coverage was obtained, including the portion of the root
      that was repaired. The results remained stable and the tooth treated remained
      asymptomatic. Clinically, the treatment was a success.

PMID- 11203599
TI  - The use of a bone block graft from the chin for alveolar ridge augmentation.
AB  - Periodontal disease and tooth loss often leave the patient with an alveolar ridge
      that is less than adequate for endosseous implant placement. Alveolar bone
      grafting offers a clinically successful treatment option to regain all or some of
      this lost bone. This article describes the use of a bone block from the chin for
      the augmentation of the alveolar ridge. It relates the clinical techniques to the
      healing process in an effort to better understand the events involved.

PMID- 11203600
TI  - Resin-bonded fixed partial dentures and splints in periodontally compromised
      patients: a 10-year follow-up.
AB  - In the present study, 139 periodontally compromised patients received a complete
      periodontal treatment; in 104 cases this was followed by orthodontic treatment.
      At the end of the entire therapy, a total of 150 Maryland restorations (69 resin
      bonded fixed partial dentures and 81 resin-bonded splints) was placed and then
      followed for a period of up to 10 years (mean 6.7 y). Thirteen fixed partial
      dentures and 16 splints failed during the observation period; the 10-year
      cumulative survival rate from lifetable analysis was 76.2% (70.6% for fixed
      partial dentures and 80.7% for splints).

PMID- 11203601
TI  - Alexithymia and negative emotional conditions.

PMID- 11203602
TI  - Abnormal intracellular localization of Bax, an apoptosis inducer, in human lung
      cancer cell lines.

PMID- 11203603
TI  - An examination of the stress distribution in a soft-lined acrylic resin
      mandibular complete denture by finite element analysis.
AB  - PURPOSE: The aim of this study was to calculate the effect of a soft liner on
      stress distribution within a mandibular complete denture. Although patients have
      welcomed soft-lined complete dentures, early fracture is one of the main reasons
      for failure. To minimize and prevent prosthesis fracture, the understanding of
      the stress distribution within a prosthesis is important. MATERIALS AND METHODS:
      A 3-dimensional finite element model of a mandibular complete denture for a
      severely reduced residual alveolar ridge was constructed. The stress was
      calculated with linear static finite element analysis. The stress distribution in
      the soft-lined acrylic resin mandibular complete denture was compared with that
      of a conventional acrylic resin denture. The resulting stresses were displayed in
      terms of von Mises equivalent stress and the major principal stresses according
      to 5 different loading conditions: vertical loads in premolar, molar, and incisor
      regions; and oblique loads in premolar and molar regions. RESULTS: Oblique loads
      produced higher levels of stress in the labial notch regions than vertical loads,
      where tension was the primary mode of stress. Significantly reduced levels of von
      Mises stress were calculated in soft-liner layers under all loading conditions.
      Acrylic resin denture base portions, however, exhibited higher levels of von
      Mises stress in soft-lined complete dentures. CONCLUSION: Three-dimensional
      finite element analysis gave a realistic explanation of denture fractures and
      patient response to mandibular complete dentures with and without soft linings.
      Control of excess lateral occlusal contact might be helpful to reduce the
      probability of a fracture in soft-lined mandibular complete dentures.

PMID- 11203604
TI  - Two-unit cantilevered resin-bonded fixed partial dentures--a retrospective,
      preliminary clinical investigation.
AB  - PURPOSE: The aim of this study was to retrospectively evaluate the clinical
      retention and abutment movement of 2-unit cantilevered resin-bonded fixed partial
      dentures (FPD) that were inserted at Prince Philip Dental Hospital in Hong Kong.
      MATERIALS AND METHODS: Of 45 patients who were identified from a hospital
      computer search after receiving a 2-unit cantilevered resin-bonded FPD, 31 were
      clinically examined (33 FPDs). For each patient the following data were recorded:
      gender, age, cementation date, endodontic treatment if performed, bone support,
      tooth mobility, and FPD tipping or drifting. Data about any debonds with
      subsequent treatment and patient satisfaction on a 10-point scale were also
      recorded. RESULTS: The mean service life for the 33 prostheses was 30 +/- 18
      months, with a range of 72 days to 67 months. One prosthesis debonded, resulting
      in a clinical retention rate of 97%. No rotation, drifting, or tipping was
      observed for any of the prostheses during the short period of this study.
      CONCLUSION: Two-unit cantilevered resin-bonded FPDs are successful in the short
      term, but further research is required to determine if they offer a viable
      alternative to fixed-fixed resin-bonded FPD designs.

PMID- 11203605
TI  - Effect of accelerated aging on the color stability of cemented laminate veneers.
AB  - PURPOSE: The effect of the aging process on color stability of light-cure, dual
      cure, and self-cure resin cements used for luting laminate veneers was
      investigated in this study. MATERIALS AND METHODS: Dyract Cem (self cure),
      Twinlook (dual cure), and En Force (light cure) cements, 0.30 mm thick, were
      polymerized on laminate veneers that were 13 mm in diameter and 0.50 mm thick in
      an A2 shade. Five specimens were made for each material. The specimens were
      subjected to an accelerated aging process in a Weather-Ometer for 900 hours.
      Spectrophotometric analyses were made after 300, 600, and 900 hours of
      accelerated aging time. Overall color difference (delta E*ab) was determined
      using the CIE-LAB system for measuring small color differences. Chroma changes
      (delta C*ab) and hue differences (delta H*ab) were also determined. delta E*ab,
      delta C*ab, and delta H*ab were analyzed by one-way analysis of variance, t test
      for dependent samples, and Tukey honestly significant difference (HSD) tests.
      RESULTS: delta E*ab values determined for the materials in this study varied in
      the acceptable range of 1.9 to 2.7. Different aging times caused no significant
      differences in delta E*ab, delta C*ab, or delta H*ab values for any of the
      materials. There were no significant differences in the amount of overall color
      change among the 3 resin cements at the same aging period. Twinlook material
      showed the greatest chroma change at each aging time. The greatest hue change was
      determined for Dyract Cem material. CONCLUSION: The light-cure resin cement
      tested can be proposed as a suitable material for luting laminate veneers, but
      long-term clinical studies are necessary to verify these experimental findings.

PMID- 11203606
TI  - Prosthodontic decision making among general dentists in Sweden. III: The choice
      between fixed partial dentures and single implants.
AB  - PURPOSE: The purpose of this study was to describe how dentists evaluated the
      importance of various items related to a treatment choice between fixed partial
      dentures (FPD) and single implants, and to analyze if the differences could be
      explained by dentist-related variables such as social and demographic attributes,
      job situation, and attitudes. MATERIALS AND METHODS: Questionnaires were sent to
      a random sample of 2,059 Swedish general dentists, with a response rate of 76%.
      In the questionnaire, the choice between an FPD and a single-implant restoration
      in a clinical situation was presented. Fifteen items were constructed and the
      dentists were asked to mark on visual analogue scales the relative importance he
      or she gave the different items. The items were analyzed through principal
      components analysis, where a three-factor solution was obtained; the factors were
      labeled as "time," "health," and "comfort." The factors were run as dependent
      variables in multiple regression analyses. RESULTS: The items evaluated as most
      important were "prognosis for delivered treatment" and "patient's wish." Large
      individual differences were seen, but the differences between groups of dentists
      were small. Male dentists considered the "health" and the "comfort" factors to be
      more important compared to female dentists. The attitudinal variable "patient
      information" was significantly associated with the "time" factor and, inversely,
      with the "comfort" factor. CONCLUSION: Differences between individuals were
      great, but between groups of dentists the differences were only minor.
      Multivariately, the attitudinal variable "patient information" showed significant
      associations with the "time" and the "comfort" factors. Dentist-related variables
      explained little of the variations. The results further indicated a low personal
      knowledge concerning implant treatments. Psychologic methods might explain more
      of the individual differences in prosthodontic decision making, but these are not
      easily used in a questionnaire study.

PMID- 11203607
TI  - Angular asymmetries of the human face.
AB  - PURPOSE: The determination of an acceptable occlusal plane is essential for the
      development of esthetic prosthodontic restorations. However, since most faces are
      not symmetric, a method was developed for measuring facial angular asymmetry,
      i.e., the divergence from the vertical or horizontal of the line joining the
      midpoint of the intercanthal line and the philtrum of the lip, the interpupillary
      line, the intermeatal line, the lip commissure line, and the intercuspid line.
      MATERIALS AND METHODS: Standardized frontal images (mouth closed, smiling, and
      biting on a wooden spatula) of 100 subjects were taken using a digital camera.
      These images were downloaded into a computer, and the angles between the various
      facial lines and the horizontal were measured. The subjects were grouped by sex,
      age, and history of trauma and orthodontic treatment. RESULTS: No statistically
      significant differences were found between the mean values for each group.
      CONCLUSION: Asymmetry of the face can be measured using digital camera imaging
      and computer analysis. A range of facial asymmetries that can influence the
      choice of occlusal plane during prosthodontic treatment exists. Thus, the use of
      an occlusal plane parallel to the ala tragus and interpupillary lines, as often
      advocated by prosthodontists, may result in less than ideal esthetics in the
      final restoration.

PMID- 11203609
TI  - Welcome to the IJP in the year 2000.

PMID- 11203608
TI  - In vitro tensile bond strength of adhesive cements to new post materials.
AB  - PURPOSE: The purpose of this study was to measure the in vitro tensile bond
      strength of 3 types of adhesive resin cements to stainless steel, titanium,
      carbon fiber-reinforced resin, and zirconium oxide post materials. MATERIALS AND
      METHODS: Disks of post materials were polished to 600 grit, air abraded, and
      ultrasonically cleaned. Zirconium oxide bonding surfaces were pretreated with
      hydrofluoric acid and silanated. Bis-Core, C&B Metabond, and Panavia cements were
      bonded to the post specimens and placed in a humidor for 24 hours. Post specimens
      were debonded in tension. Means and standard deviations (n = 5) were analyzed by
      2-way analysis of variance. Tukey-Kramer intervals at the 0.05 significance level
      were calculated. Failure modes were observed. RESULTS: Panavia 21 provided the
      highest bond strengths for all types of post materials, ranging from 22 MPa
      (zirconium oxide) to 37 MPa (titanium). C&B Metabond bonded significantly more
      strongly to stainless steel (27 MPa) and titanium (22 MPa) than to zirconium
      oxide (7 MPa). Bis-Core results were the lowest, ranging from 16 MPa (stainless
      steel) to 8 MPa (zirconium oxide). In most cases, bonds to carbon fiber post
      materials were weaker than to stainless steel and titanium, but stronger than to
      zirconium oxide. In general, higher bond strengths resulted in a higher
      percentage of cohesive failures within the cement. CONCLUSION: Panavia 21
      provided the highest bond strengths to all post materials, followed by C&B
      Metabond. In most cases, adhesive resins had higher bond strengths to stainless
      steel, titanium, and carbon fiber than to zirconium oxide.

PMID- 11203610
TI  - Factors affecting the shear bond strength of bonded composite inlays.
AB  - PURPOSE: This article analyzes the influence of different pretreatments on the
      bond strength between inlays and the resin cement of three different composite
      inlay systems: Z-100, Targis, and Art Glass. MATERIALS AND METHODS: Four separate
      treatments of the composite-bonding agent interface were investigated: (1)
      untreated surface, (2) grinding, (3) sandblasting, and (4) sandblasting followed
      by silane treatment. Surface topography, roughness, and shear bond strength were
      evaluated using digital scanning electron microscopy, confocal laser scanning
      profilometry, and a Lloyd LRX equipped for shear bond testing, respectively.
      RESULTS: The bond strength is presented both with respect to composite surface
      pretreatment and with respect to different composite inlay systems. Independent
      of the composite inlay system, the sandblasted and silane-treated surface was
      found to give the highest bond strength values, followed by the sandblasted and
      ground surfaces. The untreated surface showed the lowest bond strength. For
      pretreated surfaces, Targis showed the highest (P < 0.05) bond strength values,
      followed by Art Glass and Z-100. This distribution, however, was reversed for the
      untreated interface, where Z-100 showed the highest bonding strength (P < 0.05).
      CONCLUSION: Surface pretreatment and roughness as well as the inlay material have
      an impact on the bond strength and the retention of composite inlays.

PMID- 11203611
TI  - Bond strength of denture teeth to denture base resins.
AB  - PURPOSE: The study examined the bond strength between 2 types of denture teeth
      and 3 denture base resins. The denture teeth were untreated, prepared with
      diatorics, or treated with dichloromethane, a solvent. MATERIALS AND METHODS:
      Conventional denture teeth and cross-linked denture teeth were bonded to either a
      heat-cured denture base resin, a microwave-cured denture base resin, or a pour
      type denture base resin. Compressive load was applied at 45 degrees on the
      palatal surface of each tooth until fracture. RESULTS: Conventional resin teeth
      possessed higher bond strength than cross-linked denture teeth. The heat-cured
      denture base resin significantly surpassed the microwave-cured denture base resin
      in bond strength. Both materials were better than the pour-type resin. The
      application of dichloromethane resulted in a significantly better improvement in
      bond strength compared to the use of diatorics. CONCLUSION: It is recommended
      that dichloromethane be applied on the denture teeth ridge-lap area prior to
      denture base processing.

PMID- 11203612
TI  - Surface roughness and flexural strength of self-glazed, polished, and reglazed In
      Ceram/Vitadur Alpha porcelain laminates.
AB  - PURPOSE: Because of existing controversy, the present study investigated 3
      methods for reducing surface roughness and improving the strength of porcelain
      restorations. MATERIALS AND METHODS: Ninety laminated In-Ceram/Vitadur Alpha self
      glazed porcelain disks were fabricated and randomly divided into 3 groups (n = 30
      each). Group 1 consisted of 30 of the original disks. The remaining 60 disks were
      then polished by 6 operators according to the recommendations of the American
      Academy of Esthetic Dentistry; group 2 consisted of 30 of these polished disks.
      The remaining 30 polished disks were reglazed (group 3). Average roughness values
      (Ra) of the veneers were measured by a profilometer. In each group, 20 disks were
      subjected to a flexure test, with 10 of the In-Ceram cores and 10 of the Vitadur
      Alpha veneers placed in tension. RESULTS: The Ra values were 0.5 +/- 0.1 micron,
      0.7 +/- 0.3 micron, and 0.4 +/- 0.1 micron for groups 1 to 3, respectively.
      Following one-way analysis of variance (ANOVA), Bonferroni's multiple comparison
      tests found that groups 1 and 3 were significantly smoother than the polished
      group (P < 0.001). Reglazed disks were also significantly smoother than the
      original self-glazed disks (P < 0.01). With the veneers in tension, the flexural
      strengths were 151 +/- 22 MPa, 118 +/- 22 MPa, and 172 +/- 27 MPa for group 1 to
      3, respectively. Following one-way ANOVA, Bonferroni's multiple comparison tests
      found that groups 1 and 3 were similar and were significantly stronger than the
      polished samples (P < 0.05 and P < 0.001). CONCLUSION: Reglazing polished
      porcelain surfaces significantly improved the surface texture and flexural
      strength of the materials tested.

PMID- 11203614
TI  - Future of prosthodontics, and of undergraduate and graduate training.

PMID- 11203613
TI  - The effect of placement and quantity of glass fibers on the fracture resistance
      of interim fixed partial dentures.
AB  - PURPOSE: Polymers used in interim fixed partial dentures (FPD) have recently been
      reinforced with fibers. The aim of this study was to determine the influence of
      the position of the fiber reinforcement on the fracture resistance of interim
      FPDs. In addition, the influence of quantity of fibers and the length of span of
      the FPD on the fracture resistance was investigated. MATERIALS AND METHODS: FPDs
      were fabricated from a resin mixture of polyethylmethacrylate powder and n
      butylmethacrylate liquid. Five FPDs from each group were made, and the FPDs were
      stored in water for 30 days before testing. The FPDs in the control group were
      unreinforced, and in the other groups the FPDs were reinforced either with two or
      three unidirectional continuous glass-fiber reinforcements and one woven glass
      fiber reinforcement. Different quantities of fibers were used and the fibers were
      placed in different locations in the FPD. The load was applied to the FPD by a
      steel ball placed in the cavity in the middle fossa of the pontic tooth. RESULTS:
      The load required to fracture the unreinforced FPDs varied from 372 to 1061 N.
      Mean fracture load of reinforced FPDs varied from 508 to 1297 N. One-way analysis
      of variance showed that the length of span and the quantity of fibers
      significantly affected the fracture load (P < 0.001, n = 5). By lengthening the
      span of the FPD, the reinforcing effect of glass fibers became more obvious.
      CONCLUSION: The results of this study suggest that the effectiveness of glass
      fiber reinforcement is most evident in interim FPDs with long spans and that the
      positioning of reinforcement considerably influences the strength of the FPD.

PMID- 11203615
TI  - Porcelain laminate veneers. A retrospective evaluation after 1 to 10 years of
      service: Part II--Clinical results.
AB  - PURPOSE: The objective of this study was to evaluate the clinical quality of 191
      porcelain laminate veneers and to explore the gingival response in a long-term
      survey. MATERIALS AND METHODS: The clinical examination was made by two
      calibrated examiners following modified California Dental Association/Ryge
      criteria. In addition, margin index, papillary bleeding index, sulcus probing
      depth, and increase in gingival recession were recorded. Two age groups were
      formed to evaluate the influence of wearing time upon the clinical results. The
      results were statistically evaluated using the Kaplan-Meier survival estimation
      method, Chi-squared test, and Kruskal-Wallis test. RESULTS: A failure rate of 4%
      was found. Six of the total of seven failures were seen when veneers were
      partially bonded to dentin. Marginal integrity was acceptable in 99% and was
      rated as excellent in 63%. Superficial marginal discoloration was present in 17%.
      Slight marginal recession was detected in 31%, and bleeding on probing was found
      in 25%. CONCLUSION: Porcelain laminate veneers offer a predictable and successful
      treatment modality that preserves a maximum of sound tooth structure. An
      increased risk of failure is present only when veneers are partially bonded to
      dentin. The estimated survival probability over a period of 10 years is 91%.

PMID- 11203616
TI  - Etiology and diagnosis of tooth wear: a literature review and presentation of
      selected cases.
AB  - PURPOSE: This article presents an overview of etiologies associated with tooth
      wear. MATERIALS AND METHODS: Specific types of wear based on clinical findings
      and patient history are described. RESULTS: The occurrence and pattern of tooth
      wear are related to cultural, dietary, occupational, and geographic factors.
      Examples of tooth wear related to these factors with regional specificity are
      presented. CONCLUSION: The dental practitioner should recognize the
      characteristic signs of tooth wear, as they may be the first to discuss the
      problem with the patient. Management should be based on accurate diagnosis.

PMID- 11203617
TI  - A new application for craniofacial implants: wigs.
AB  - PURPOSE: The purpose of this study was to describe a new application of
      craniofacial implants, as anchoring elements for wigs. MATERIALS AND METHODS: In
      two patients, a split-skin graft was used to close a soft tissue defect in the
      occipital, parietal, temporal, and frontal region (defect size of 10 cm x 33 cm
      and 10 cm x 14 cm). Six titanium implants were placed in each patient. Six months
      after implant placement, abutment connection was performed and titanium magnets
      were adapted. Subsequently, an implant-retained wig was constructed. RESULTS: In
      a follow-up period of between 10 and 22 months no implant failed. The
      incorporated wigs effectively retain a functionally and cosmetically successful
      craniofacial rehabilitation. CONCLUSION: Despite these successful treatments,
      further research is needed before craniofacial implants as anchoring elements for
      wigs can be considered a standard option in the rehabilitation of craniofacial
      alopecic defects.

PMID- 11203618
TI  - Bonding durability of conventional resinous denture teeth and highly crosslinked
      denture teeth to a pour-type denture base resin.
AB  - PURPOSE: The study examined the bond strength between 2 types of resin denture
      teeth and a pour-type denture base resin after thermocycling. The denture teeth
      were untreated, prepared with diatorics, or treated with a solvent,
      dichloromethane. MATERIALS AND METHODS: Conventional denture teeth and
      crosslinked denture teeth were bonded to a pour-type denture base resin.
      Compressive load was applied at 45 degrees on the palatal surface of each tooth
      until fracture. The teeth were either thermocycled or not thermocycled. Porcelain
      teeth were also tested for comparison. RESULTS: There was no significant
      difference in bond strength between the conventional resin teeth and the
      crosslinked denture teeth. Thermocycling significantly decreased the bond
      strength of the 2 types of resin teeth but had no effect on porcelain teeth. The
      application of dichloromethane significantly improved the bond strength of the 2
      types of resin teeth either before or after thermocycling. CONCLUSION: It is
      recommended that dichloromethane be applied on the denture teeth ridge-lap area
      prior to denture base processing.

PMID- 11203619
TI  - Interdental design of porcelain veneers in the presence of composite fillings:
      finite element analysis of composite shrinkage and thermal stresses.
AB  - PURPOSE: This study was conducted to optimize the interdental design (wraparound)
      of porcelain laminates bonded to teeth in the presence of preexisting composite
      fillings. MATERIALS AND METHODS: A finite element model (2-dimensional mesh
      generated from a horizontal cross section of a maxillary incisor) was used to
      evaluate the effects of luting composite shrinkage and thermal changes on the
      stress distribution within the ceramic. The mesh included 3 restorative designs
      (3 degrees of interdental wrapping) and a Class III composite filling. Curing
      contraction of the luting composite was simulated at baseline temperature (37
      degrees C). Thermal loads from 37 to 60 degrees C and from 37 to 5 degrees C were
      assessed with and without preexisting composite shrinkage. Surface tangential
      stresses were calculated at the ceramic surface and interface. RESULTS: Curing
      contraction alone generated mostly compressive stresses (peaks at 15 MPa) at both
      the ceramic surface and interface. Stresses remained compressive (peaks at 20
      MPa) when thermal changes were added, except for the conservative veneer with
      minimum wraparound, the margins of which showed potentially harmful tensile
      stress peaks (approximately 7 MPa). Deformation of the tooth-restoration complex
      tended to be more uniform for veneers with maximum wraparound. In the presence of
      thermal loads alone, opposite effects were observed on the restoration surface
      and the interface, with compressive stresses on one side (up to 13 MPa) and
      tensile stresses on the other (up to 9 MPa). This effect of proximal bending
      (explained by the nearby expansion/contraction of the composite filling) was
      attenuated by the significant reduction of the bulk of the preexisting
      interdental composite by the overlapping veneer. CONCLUSION: In the finite
      element environment, the negative effect of the nearby expanding/contracting
      composite fillings can be minimized by extending the veneer over the preexisting
      interdental restoration. Because of the precompressed state resulting from
      composite shrinkage, ceramics showed lower temperature-induced tensile stresses.

PMID- 11203620
TI  - Implant-supported mandibular overdentures retained with ball or bar attachments:
      a randomized prospective 5-year study.
AB  - PURPOSE: The aim of the present study was to evaluate the periimplant conditions
      and the maintenance requirements for implant-supported overdentures in the
      mandible retained with ball or bar attachments during a 5-year period. MATERIALS
      AND METHODS: Twenty-six completely edentulous patients had two Astra Tech dental
      implants placed in the anterior part of the mandible. The denture attachment
      system for the patients was chosen randomly by drawing lots. Eleven patients drew
      the bar attachment system and fifteen patients drew the ball attachment system.
      Plaque Index, Gingival Index, and probing pocket depth were assessed around each
      implant. Periotest values were recorded, and periodically identical intraoral
      radiographs were obtained with a specially designed film-holding device. RESULTS:
      No implants were lost from baseline to the 5-year registration. The periimplant
      conditions were very healthy after 5 years. No significant differences of the
      periimplant variables were recorded between the bar and the ball groups. During
      the first year of function, significantly more complications/repairs were
      registered in the bar group than in the ball group. In the following years, no
      significant differences were registered. The mean frequency of
      complications/repairs per patient per year was 1.0 in the bar group and 0.6 in
      the ball group during the 5-year observation period. CONCLUSION: Two implants
      with ball or bar attachment supported an overdenture in the mandible for 5 years
      with a 100% survival rate. No differences in marginal bone loss or health of the
      periimplant mucosa were observed between bar and ball attachment, but the
      frequency of technical complications/repairs per patient was higher around bar
      than ball attachments.

PMID- 11203621
TI  - Bond strength of luting cements to zirconium oxide ceramics.
AB  - PURPOSE: This study was conducted to determine the bond strength of some resin
      luting cements to zirconia ceramic. The hypothesis was that adhesive bonding
      capacity is influenced by different surface pretreatments designed for milled
      ceramic inlays. MATERIALS AND METHODS: Composite cylinders 5 mm x 5 mm were light
      cured on the ceramic surfaces for a shear test conducted in a test jig. Five
      surface treatments were studied: as received (from the milling machine),
      sandblasting with either 250- or 50-micron alumina sand, hydrofluoric acid
      treatment, and grinding with diamond burs. The tested luting cements were Panavia
      21, Twinlook, and Superbond C&B. RESULTS: All debonding occurred at the interface
      between ceramic and composite cement. Superbond demonstrated the highest bond
      strength regardless of the surface treatments. Grinding the surface with diamond
      burs improved the bonding slightly for Twinlook and Panavia 21 and also showed
      the roughest texture. Washing with hydrofluoric acid had no significant influence
      on bond strength. CONCLUSION: Bond strengths for Twinlook and Pananvia 21 were
      quite low, and only Superbond showed a bond strength reasonably acceptable for
      clinical use; however, as no standard for bond strength has been established for
      inlay therapy, the other cements cannot be rejected as luting cements for inlays.

PMID- 11203622
TI  - Roughness of denture materials: a comparative study.
AB  - PURPOSE: Surface properties of denture materials are of clinical importance since
      they may affect plaque accumulation and staining. This in vitro study
      investigated the roughness of 20 commercially available denture materials.
      MATERIALS AND METHODS: Four denture base resins, nine hard lining materials, and
      seven soft denture lining materials were evaluated for roughness. Roughness
      measurements were made using a Mitutoyo Surftest SV-400, and the mean arithmetic
      roughness values (Ra) obtained were used for the comparisons. RESULTS: The
      overall Ra values ranged from 0.7 to 7.6 microns. The denture base materials
      group exhibited Ra values from 3.4 to 7.6 microns, whereas the hard liners were
      from 0.7 to 4.4 microns. The autopolymerized and visible light-cured soft liners
      presented Ra values from 0.7 to 3.5 microns, while the heat-cured soft liners
      ranged from 3.5 to 4.0 microns. CONCLUSION: The roughness exhibited by all of the
      materials tested (Ra values greater than 0.7 micron) indicates that there is a
      possibility for plaque accumulation, since 0.2 micron is considered the threshold
      below which no further bacterial adherence can be expected.

PMID- 11203623
TI  - Water sorption and flexural properties of a composite resin cement.
AB  - PURPOSE: The aim of this study was to assess the water sorption and determine the
      influence of water on flexural properties of a composite resin cement of 2
      different viscosities. MATERIALS AND METHODS: A dual-cured composite resin cement
      of 2 different viscosities was tested according to International Standards
      Organization standards for dental composite materials. The samples tested for
      water sorption were stored in distilled water for 7 or 60 days. The samples
      tested for flexural properties were divided into 2 groups and stored either wet
      in distilled water or dry for 1, 7, or 60 days. After storage, a flexural test
      was performed with 3-point bending equipment. RESULTS: A significant increase in
      water sorption for both viscosities was registered as the storage time increased,
      but no significant difference between the 2 viscosities was recorded.
      Significantly lower strength and modulus were found for specimens that were wet
      stored for 60 days compared with the dry-stored ones, and significant changes in
      deflection at break were also registered. There were no differences in flexural
      properties between the 2 viscosities. Because of the lubricant and plasticizing
      effect of water on composite resin materials, the secant modulus and deflection
      at break seem to be valid methods to describe the complete deflection behavior.
      CONCLUSION: Water has an important effect on the flexural properties of composite
      resin cement after 60 days of storage time. No significant differences in water
      sorption and flexural properties were found between the high and low viscosities
      of the composite resin cement studied.

PMID- 11203624
TI  - Denture-induced fibrous inflammatory hyperplasia: a retrospective study in a
      school of dentistry.
AB  - PURPOSE: The aim of this study was to investigate the denture-induced fibrous
      inflammatory hyperplasia (FIH) that occurs around the borders of an ill-fitting
      denture, in relation to frequency of the lesion, age and sex distribution, length
      of denture use, and frequency of dysplasia. MATERIALS AND METHODS: A
      comprehensive review of FIH diagnosed in patients wearing dentures by the oral
      pathology diagnostic service at the University of Sao Paulo over 26 years (1971
      to 1996) was undertaken, based on retrospective analysis of the oral
      histopathologic files. RESULTS: The frequency of FIH was 15% of the total number
      of pathologies diagnosed at the service of oral pathology in that period. The
      disorder occurred predominantly in the fifth and sixth decades of life and more
      often among females, at a proportion of 5:1. The frequency of FIH was higher for
      a length of denture use of between 1 and 10 years. Dysplasia was found in 4% of
      cases. CONCLUSION: The knowledge of some aspects of FIH, especially the possible
      histologic alteration of dysplasia, supports the importance of the diagnosis and
      treatment of the lesion and suggests that any excised tissue should be submitted
      to histopathologic evaluation. Education and regular review of patients who have
      worn dentures are essential if the development of FIH is to be prevented.

PMID- 11203625
TI  - Materials for interocclusal records and their ability to reproduce a 3
      dimensional jaw relationship.
AB  - PURPOSE: The purpose of this study was to determine if accuracy and dimensional
      stability of vinyl polysiloxanes and irreversible hydrocolloids stabilized by a
      tray used for fixed prosthodontics, removable partial, and complete denture cases
      are comparable to those of waxes and record rims and if storage time (24 hours or
      6 days) affects dimensional stability of the tested materials. MATERIALS AND
      METHODS: Two waxes, two record rims, three vinyl polysiloxanes, and one
      irreversible hydrocolloid (alginate) were examined. Three pairs of master casts
      with measuring steel rods were mounted on an articulator (initial position). Five
      records were made of each material, and the upper cast was remounted after 24
      hours or 6 days so that deviations from the initial position could be measured.
      RESULTS: Vinyl polysiloxanes reinforced by a stabilization tray were the most
      accurate materials able to reproduce a settled interocclusal position. Mounting
      casts (fixed prosthodontics cases) without records gave accuracy similar to wax
      records. Record rims used for removable partial and complete denture cases
      produced lesser accuracy than vinyl polysiloxanes and irreversible hydrocolloid
      stabilized by a tray. Accuracy was not significantly affected by storage time.
      CONCLUSION: The results show that accuracy of vinyl polysiloxanes and
      irreversible hydrocolloids reinforced by a tray is superior to that of record
      rims with regard to the complete denture case and is among the most accurate with
      regard to the removable partial denture case. For fixed prosthodontics, however,
      reinforcement is unnecessary.

PMID- 11203627
TI  - A simplified technique for construction of an interim obturator for a bilateral
      total maxillectomy defect.
AB  - PURPOSE: This report describes a simplified method for construction of an interim
      obturator for a huge maxillary defect. MATERIALS AND METHODS: A medical grade
      silicone obturator was fabricated indirectly on a duplicate cast of the surgical
      defect for a patient with a bilateral total maxillectomy. This silicone obturator
      was attached to an acrylic plate by means of mushroom-like extension tags
      projecting from the fitting surface of the acrylic palatal plate. RESULTS: The
      obturator was well retained in the patient's mouth and markedly improved his
      ability to speak and swallow. CONCLUSION: This technique proved to be a simple,
      quick, and cost-effective method for construction of obturators for huge
      maxillary defects.

PMID- 11203626
TI  - A study of the bond strength and color of ultralow-fusing porcelain.
AB  - PURPOSE: The purpose of this study was to investigate the effects of different
      bonding agents, surface roughness, and acid pickling on the bond strength and
      color of ultralow-fusing porcelain fused to gold alloy. MATERIALS AND METHODS:
      Porcelain-metal specimens were made to 25 mm x 3 mm x 0.5 mm with a 1-mm
      porcelain thickness. A 3-point bending test was used to evaluate the bond
      strength. The color of the porcelain was measured using a dental chromameter, and
      the data were processed in the CIE Lab system. The color difference (delta E*)
      was calculated for the tested groups. RESULTS: Good bond strength and color could
      be achieved regardless of the use and type of bonding agent. Surface roughness
      and acid pickling had more effect on the bond strength than on color. CONCLUSION:
      The type of the bonding agent, surface roughness, and acid pickling influenced
      the bond strength but had minimal effects on the color of ultralow-fusing
      porcelain. This ultralow-fusing porcelain could produce a color closer to the
      Vita shade than the conventional low-fusing porcelain.

PMID- 11203628
TI  - Looking to the past and making choices for the future of dental education.

PMID- 11203629
TI  - International dental and prosthodontic research.

PMID- 11203630
TI  - In vitro fitting accuracy of copy-milled alumina cores and all-ceramic crowns.
AB  - PURPOSE: The purpose of this study was to evaluate the marginal and internal fit
      of alumina cores and all-ceramic crowns in a new preparation design for abutment
      teeth devised for copy milling. MATERIALS AND METHODS: Using conventional dies
      and dies from the new type of preparation design, 20 alumina cores were produced
      by copy milling, 10 cores in each die type. Also using the new type of die,
      another 10 final crowns were fabricated. Each of the 30 specimens was returned to
      its original die and embedded in epoxy resin. Each specimen was then sectioned
      labiolingually and measured for gaps at the margin, in the central area, and at
      the incisal edge. RESULTS: The alumina cores fabricated using the new type of die
      had mean gaps of 30 to 40 microns at the margins of the labial and lingual sides,
      which was significantly smaller than the gaps (67 to 130 microns) found in the
      alumina cores produced with the conventional type of die. The final crowns had
      mean gaps of 44 to 63 microns at the margins and on the inner surfaces. There was
      no significant difference in the gaps between the alumina cores produced using
      the new type of die and those found in the final crowns. CONCLUSION: The new type
      of die was effective in allowing the fabrication of all-ceramic crowns that
      provide excellent marginal and internal fit by copy milling.

PMID- 11203632
TI  - Evaluation of occlusal contacts in the dental laboratory: influence of strip
      thickness and operator experience.
AB  - PURPOSE: The purpose of this study was to evaluate the influence of recording
      strip thickness and of operator-dependent factors on the assessment of contact
      area on a cast mounted on an articulator. MATERIALS AND METHODS: Thirteen dental
      students and 13 experts (dentists and dental technicians) performed occlusal
      maneuvers on casts mounted on an articulator, using recording strips of 8- and 40
      micron thickness. Contact area, force, and time of biting relative to each group
      of operators using each type of paper were compared. RESULTS: Both groups
      obtained significantly greater contact areas with the thicker strip. Students
      applied significantly stronger but shorter bitings than experts, but obtained
      smaller contact areas, particularly with the thinner strip. In operators, the
      extension of contact markings using the 8-micron strip was closely related to the
      biting time but not to the occlusion force, while neither time nor force of
      biting had a significant influence when using the 40-micron strip. CONCLUSION:
      The assessment of occlusal contact in the dental laboratory was significantly
      influenced by paper thickness, operator experience, biting force, and time. The
      40-micron strip was less influenced by operator experience, strength, and
      duration of biting.

PMID- 11203631
TI  - A randomized 5-year clinical evaluation of 3 ceramic inlay systems.
AB  - PURPOSE: The present follow-up study aimed to evaluate the clinical quality and
      longevity of 3 ceramic inlay systems and compare them with gold inlays. MATERIALS
      AND METHODS: Twenty patients were treated with one Cerec, one Mirage, one
      Empress, and one gold inlay, respectively, inserted in a randomly selected order
      in the mandible. The inlays were examined independently by 2 calibrated examiners
      immediately after and 1, 3, and 5 years after luting. The inlays were rated using
      the California Dental Association (CDA) quality evaluation system. RESULTS: Two
      Empress inlays required replacement because of fracture between examination (Ex)
      1 and Ex 2, and 2 Empress inlays were fractured between Ex 3 and Ex 4. One Cerec
      inlay had to be recemented after 3 months, and one Cerec inlay fractured between
      Ex 3 and Ex 4 and was replaced with a gold inlay. Examination showed that the
      mismatch of color increased from 15% to 50% between Ex 1 and Ex 4 for all ceramic
      systems. Visible evidence of ditching along the margin increased from 5% at Ex 1
      to 70% at Ex 4, and an apparent discoloration of the margin between the tooth and
      the restoration was seen in 0% to 5% at Ex 1 compared to 30% to 55% at Ex 4.
      CONCLUSION: Eight percent of the ceramic inlays were fractured during the follow
      up period of 5 years. Based on the criteria of the CDA quality evaluation system,
      92% of the 60 ceramic inlays and 100% of the 20 gold inlays were rated
      satisfactory 5 years after luting.

PMID- 11203633
TI  - Strength of relined denture base polymers subjected to long-term water immersion.
AB  - PURPOSE: This study was undertaken to characterize the long-term equilibrium
      flexural strength at proportional limit (FSp) of 4 denture reline polymers
      processed onto 4 denture base polymers. MATERIALS AND METHODS: A 3-point flexural
      test was applied on rectangular specimens of each denture base polymer-denture
      reline polymer. Each specimen was immersed in water for 4 months prior to and 4
      months after reline. RESULTS: Significant differences existed among the relined
      specimens because of the denture base polymer variable, the denture reline
      polymer variable, and their interaction (P < 0.05). The descending order in FSp
      according to the denture base polymer, arranged in terms of statistical
      significance was: Acron approximately Acron MC > Triad > Palapress Vario, where
      approximately denotes no significant difference between Acron and Acron MC. The
      descending order in FSp according to the denture reline polymer, arranged in
      terms of statistical significance was: Triad > Rebaron > Rebaron LC > Tokuso
      Rebase. Significant difference existed among all of the denture reline polymers.
      CONCLUSION: The present study showed that the long-term equilibrium strengths of
      4 denture reline polymers processed onto 4 denture base polymers were different.
      The strength of the relined specimen of a denture base is dependent on the
      strength of the denture base polymer and that of the reline polymer.

PMID- 11203635
TI  - Detail reproduction, contact angles, and die hardness of elastomeric impression
      and gypsum die material combinations.
AB  - PURPOSE: This study compared surface detail parameters, interfacial contact
      angles, and die hardness for some combinations of elastomeric impression and die
      materials. MATERIALS AND METHODS: Representative polyvinyl siloxanes, polyether,
      polysulfide, and reversible hydrocolloid impression materials and Type IV, Type
      V, and resin reinforced-Type IV die materials were evaluated using a factorial
      design. For the evaluation of surface detail reproduction, the width of the
      thinnest continuous line observed and the visually observed shape of the thick
      line were determined from samples formed using a master die conforming to
      American Dental Association specification 19. The contact angle of freshly mixed
      die material on the set impression was measured using a contact angle goniometer.
      Finally, hardness of the die material was determined. After conversion of the
      data to ranks if necessary, 2-way analysis of variance with Ryan-Einot-Gabriel
      Welsch (REGWQ) multiple comparison tests where appropriate were used to determine
      statistical significance. RESULTS: The thinnest continuous line demonstrated
      statistically significant impression material effects, and the observed shape of
      the thick line showed both statistically significant impression material and die
      material effects. For both contact angle and die hardness, a statistically
      significant interaction between the impression and die materials was found.
      CONCLUSION: Although statistically significant differences in each property were
      found, no specific combination of impression and die materials was identified as
      superior to another for all surface properties studied.

PMID- 11203634
TI  - The effect of polishing on surface roughness of tissue conditioners.
AB  - PURPOSE: Surface roughness can affect microbial colonization of long-term denture
      liners, alloys, and denture acrylic. The purpose of the present study was to
      examine the effect of finishing and polishing procedures on surface roughness of
      4 temporary resilient denture liners (tissue conditioners). MATERIALS AND
      METHODS: Mean surface roughness was measured for 4 materials (Lynal, Visco-gel,
      Coe-Soft, and Functional Impression Tissue Toner [FITT]) finished in 4 ways:
      unfinished (control); polished; reduced, unpolished; and reduced, polished.
      Samples were allowed to polymerize at 37 degrees C for 24 hours, and the surface
      roughness was measured using a Mitutoyo Surftest 212. RESULTS: Mean surface
      roughness ranged from 1.8 +/- 0.8 microns for polished Lynal to 7.8 +/- 1.1
      microns for reduced, unpolished FITT. All polished samples were smoother than
      unpolished samples (including controls), whether or not the samples were reduced
      with a bur. CONCLUSION: Polished samples of tissue conditioning material had
      lower mean surface roughness measurements than control or reduced, unpolished
      samples at the 95% level of confidence. There was no difference in mean surface
      roughness measurements of control samples and unpolished samples reduced with a
      bur at the 95% level of confidence. Mean surface roughness differed significantly
      between the materials tested.

PMID- 11203637
TI  - Changes in the masticatory function of complete denture wearers after relining
      the mandibular denture with a soft denture liner.
AB  - PURPOSE: The purpose of this study was to examine changes in the masticatory
      function of complete denture wearers after relining the mandibular denture with a
      soft liner. MATERIALS AND METHODS: Conventional complete dentures were fabricated
      for 6 completely edentulous patients. One month after completing adjustments of
      the dentures, maximum biting force, masticatory performance, and electromyography
      of the masseter muscle during mastication were recorded. Chewing strokes, chewing
      time, muscular activity, and masticatory rhythm were calculated using the
      recorded electromyography. The mandibular dentures were then relined with a soft
      liner. One month after finishing adjustments of the relined dentures, the same
      tests were performed. These values were compared using a paired t test (alpha =
      0.05). RESULTS: When using the soft liner, masticatory performance and maximum
      biting force were significantly greater (P = 0.019 and P = 0.023, respectively).
      In addition, the number of chewing strokes was significantly lower (P = 0.020),
      and chewing time was reduced (P = 0.010). A more stable masticatory rhythm was
      also found in the initial chewing stage. The muscular activity tended to decrease
      after the insertion of the lined denture, but no significant difference was found
      between before and after relining. CONCLUSION: It was shown that applying a soft
      lining material to the mandibular dentures of 6 edentulous patients improved
      masticatory function with no adverse effect on the muscular task.

PMID- 11203636
TI  - Bonding to densely sintered alumina surfaces: effect of sandblasting and silica
      coating on shear bond strength of luting cements.
AB  - PURPOSE: An important determinant of the clinical success of ceramic restorations
      is the bond strength of the luting agent to the seating surface and the prepared
      tooth structures. Manufacturers of ceramic systems frequently specify both the
      luting agent and preluting treatment of the seating surface of the crown. Procera
      AllCeram is an all-ceramic crown comprising a porcelain-veneered coping of
      densely sintered, high-purity aluminum oxide. This study evaluated the shear bond
      strength of 4 luting agents: zinc-phosphate, glass-ionomer, resin-modified glass
      ionomer, and resin cement (dual cured) to Procera aluminum oxide coping material.
      The luting agents were subjected to different surface treatments: untreated,
      sandblasted, or silica coated by the Rocatec system. MATERIALS AND METHODS:
      Cylindric and cubic specimens of the coping material were luted together, and the
      shear force necessary to separate the cylinder from the cube was measured with a
      universal testing machine. The surfaces of the specimens were also analyzed.
      RESULTS: No significant differences were recorded for the shear bond strengths of
      the luting agents to the untreated aluminum oxide. Glass-ionomer and the resin
      modified glass-ionomer cements had the highest values (4.2 +/- 2.5 MPa and 4.3 +/
      1.9 MPa, respectively), and the lowest were 3.3 +/- 2.3 MPa for the resin cement
      and 3.2 +/- 1.0 MPa for the zinc-phosphate cement. Similar results were recorded
      for the sandblasted aluminum oxide surfaces, except with the glass-ionomer, which
      was significantly higher (12.9 +/- 2.4 MPa). For all 4 luting agents, the highest
      shear bond strength values were recorded for the silica-coated specimens; the
      highest was for the resin cement, at 36.2 +/- 7.8 MPa. CONCLUSION: The bond
      strengths between resin cement and aluminum oxide specimens treated by the
      Rocatec system were significantly higher than those of the other materials and
      surface treatments evaluated.

PMID- 11203638
TI  - Effects of electrobrightening on the fit surface of cobalt-chromium RPD
      frameworks.
AB  - PURPOSE: The purpose of this study was to compare 3 different electrobrightening
      techniques and 3 electrolytic solutions in their effects upon the fit surface of
      cast cobalt-chromium frameworks. MATERIALS AND METHODS: Fifty cast cobalt
      chromium frameworks, which were subsequently divided into batches of 10, were
      prepared according to a standard protocol. Three electrobrightening techniques
      were tested initially using a single brand of electrolyte (Croform) and a batch
      of 10 frameworks per technique. The loss of metal by weight was determined from
      the fit surface of each casting. The least corrosive technique of these 3 was
      used again with 2 other brands of electrolyte (Nobilium and E501) in a repetition
      of the protocol. The fit surfaces of 8 random samples cut from each batch of
      electrobrightened castings were viewed by scanning electron microscope (SEM).
      RESULTS: Statistical analysis applying a one-way analysis of variance and
      Bonferroni's multiple comparison of means test demonstrated that one immersion of
      the framework for 10 minutes at 1 amp when used in conjunction with Nobilium
      electrolyte removed the least metal (P = 0.001). The SEM study suggested that the
      Nobilium electrolyte also produced the smoothest surface. CONCLUSION:
      Electrobrightening techniques affect the amount of metal removed, and the
      electrolytic solution used influences the resultant surface.

PMID- 11203639
TI  - The prosthodontic maintenance requirements of mandibular mucosa- and implant
      supported overdentures: a review of the literature.
AB  - PURPOSE: This article presents a critical review of the literature on the
      prosthodontic maintenance requirements of mandibular mucosa- and implant
      supported overdentures. MATERIALS AND METHODS: A search of the literature
      produced 35 papers pertaining to prospective and retrospective studies. The
      relationship of these prosthodontic maintenance requirements to the axis of
      rotation treatment concept was examined. RESULTS: More often than not, 2 anterior
      mandibular implants either splinted (round or ovoid bars) or unsplinted (balls or
      magnets) have been used to evaluate this prosthodontic follow-up. Wide variation
      existed in the categories used for prosthodontic complications. Although
      principally related to alterations of overdenture contour and aspects of patrix
      and matrix maintenance, they also provide subjective information on relines and
      the rationale for avoiding overdenture fractures. These prosthodontic maintenance
      requirements undoubtedly have a direct impact on the time to retreatment of
      mandibular mucosa- and implant-supported overdentures. CONCLUSION: There appears
      to be a need for a more uniform, standardized categorization with criteria for
      determining prosthodontic success, in terms of maintenance requirements and
      complications, for mandibular mucosa- and implant-supported overdentures.
      Controlled prospective evaluations of exact prosthodontic maintenance
      requirements of mandibular overdentures using different systems are lacking and
      encouraged. There is also an absence of prospective studies on such maintenance
      requirements of mandibular overdentures using multiple round bars on 3 or 4
      implants.

PMID- 11203640
TI  - Mandibular implant-supported overdentures: a prospective evaluation of the burden
      of prosthodontic maintenance with 3 different attachment systems.
AB  - PURPOSE: A prospective study on mandibular implant-supported overdentures using
      more than 2 Branemark implants splinted with multiple round bars evaluated a
      hypothesis that unnecessary prosthodontic maintenance would result from the
      contravention of accepted biomechanical principles. MATERIALS AND METHODS: A
      randomized prospective trial on 59 edentulous patients details prosthodontic
      maintenance and complications of 52 mandibular overdentures (11 unsplinted, 41
      splinted) over a 3-year period. RESULTS: Prosthodontic maintenance was greater in
      the first year than in subsequent years, regardless of design. Comparison between
      the splinted designs with round bars revealed no statistically significant
      difference with either retentive clip activation or fractures. More than 70% of
      the retention clips in the 2-implant (single round bar) design needed activation,
      as compared to 44% of those with the 3-implant (double round bar) or 4-implant
      (triple round bar) design. Retention clip fracture occurred in 30% of patients
      with 3 or 4 implants and 16% of those with 2 implants. Relining the overdentures,
      regardless of design, revealed an excessive maintenance burden in 40% of
      overdentures. Remaking of overdentures was necessary in 21% of patients.
      CONCLUSION: Multiple round bars splinting 3 or 4 implants can still be a
      treatment concept in mandibular overdenture treatment. Results from prospective
      evaluation of this design indicate less prosthodontic maintenance of clip
      activation but more clip fractures than with 2 implants splinted with single
      round bars, although not at statistically significant levels.

PMID- 11203641
TI  - Research directions in implant prosthodontics.

PMID- 11203642
TI  - One-piece castings in fixed prosthodontics: a study of marginal adaptation using
      computerized SEM images.

PMID- 11203643
TI  - A comparison of laser-welded titanium and conventional cast frameworks supported
      by implants in the partially edentulous jaw: a 3-year prospective multicenter
      study.
AB  - PURPOSE: The purpose of this prospective multicenter study was to evaluate and
      compare the clinical performance of laser-welded titanium fixed partial implant
      supported prostheses with conventional cast frameworks. MATERIALS AND METHODS:
      Forty-two partially edentulous patients were provided with Branemark system
      implants and arranged into 2 groups. Group A was provided with a conventional
      cast framework with porcelain veneers in one side of the jaw and a laser-welded
      titanium framework with low-fusing porcelain on the other side. The patients in
      group B had an old implant prosthesis replaced by a titanium framework
      prosthesis. The patients were followed for 3 years after prosthesis placement.
      Clinical and radiographic data were collected and analyzed. RESULTS: Only one
      implant was lost, and all prostheses were still in function after 3 years. The 2
      framework designs showed similar clinical performance with few clinical
      complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%)
      fractured. Four prostheses experienced loose gold screws (6%). In group A,
      marginal bone loss was similar for both designs of prostheses, with a mean of 1.0
      mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was
      observed on average in group B. No significant relationship (P > 0.05) was
      observed between marginal bone loss and placement of prosthesis margin or
      prosthesis design. CONCLUSION: The use of laser-welded titanium frameworks seems
      to present similar clinical performance to conventional cast frameworks in
      partial implant situations after 3 years.

PMID- 11203644
TI  - Observations of interproximal contact relations during clenching.
AB  - PURPOSE: Previous studies have shown that molar teeth pulsate at rest and
      displace linguoapically during clenching at maximal intercuspation. The aim of
      this study was to investigate interproximal contact during clenching by means of
      a charge coupled device (CCD) microscope. MATERIALS AND METHODS: Two male
      subjects aged 28 years with normal dentition and occlusions were selected for in
      vivo research. Optimum contact tightness was observed at contact points that were
      defined by some resistance to the insertion of a 50-micron-thick stainless steel
      strip; however, a 110-micron strip could not be inserted there [corrected].
      Spaces between the teeth were detected using a CCD microscope on the buccal side
      by light bands emitted from the lingual side. During static observation, the
      chosen distance between the microscope and light guide was maintained using a
      special device. For dynamic observation, a palatal and lingual plate with a light
      source was fitted to each subject. Subjects were directed to clench with habitual
      occlusal force. To compare with in vivo observations, the relation between the
      width of the light band and the interproximal distance was estimated in vitro
      using 2 extracted teeth. Light bands were analyzed using software. RESULTS: In
      the 2 subjects studied, there was a 3- to 21-micron distance between adjacent
      teeth at rest, which disappeared during clenching. CONCLUSION: The results of the
      study sample examined indicate that teeth do not make contact with adjacent teeth
      at rest, but do so during clenching.

PMID- 11203647
TI  - Cytotoxic effect of methyl methacrylate on 4 cultured fibroblasts.
AB  - PURPOSE: The objective of this study was to examine the cytotoxic effect of
      methyl methacrylate (MMA) monomer on 4 mammalian fibroblasts. MATERIALS AND
      METHODS: Four cells--C3H10T1/2, L929, Balb/3T3 clone A31, and MC3T3-E1--were
      incubated for 6 days in 24-well microplates filled with 1 mL of Dulbecco's
      Modified Eagle medium containing MMA monomer that ranged from 0 to 200 mM/L.
      Cytotoxicity was evaluated by direct cell number count. RESULTS: L929 possessed
      the largest TC50 value (the amount of MMA that caused 50% cell death) (34 mM/L),
      and Balb/3T3 clone A31 had the least value (1 mM/L); C3H10T1/2 and MC3T3-E1 had
      intermediate values (25 mM/L and 16 mM/L, respectively). CONCLUSION: This study
      showed that the MMA monomer had dose-dependent cytotoxicity, which varied among
      the cells tested.

PMID- 11203646
TI  - Predicted incidence of excursive occlusal errors in common modes of articulator
      adjustment.
AB  - PURPOSE: Functional relationships between occlusal errors and articulator
      settings have been the subject of numerous investigations. It is, however, not
      known how frequently errors of a certain size occur under practical conditions.
      This study attempted to estimate the frequency of occlusal errors that can be
      expected with the different levels of registration and articulator adjustment
      that are currently used. MATERIALS AND METHODS: In 57 asymptomatic subjects,
      individual articulation parameters, including the condylar and Bennett angles,
      the spatial relation of dental arches, and the intercondylar distance, were
      determined experimentally. Tooth-guided lateral movements of the subjects' casts
      were simulated in a virtual articulator that was programmed to the individual
      parameters of each person. With respect to this reference setting, occlusal
      errors that would emerge with different modes of semi-individual adjustment were
      calculated. The intercondylar distance thereby remained fixed at 110 mm. RESULTS:
      With complete mean value setting, occlusal errors would exceed 200 microns at the
      second molar in 16% of the subjects and 300 microns in 6% of the subjects.
      Individual facebow registration of condylar angles and spatial relations would
      reduce these rates to 13% (200 microns) and 3% (300 microns). With additional
      setting of Bennett angles, occlusal errors would exceed the mentioned limits in
      no more than 1.6% and 0.1% of cases, respectively. This extensive mode of
      adjustment became, however, increasingly ineffective with higher demands for
      occlusal accuracy. CONCLUSION: Complete mean value setting is associated with a
      relatively low risk of occlusal errors exceeding tolerance limits that are widely
      accepted in practice. Compared to mean value setting, facebow registration of
      condylar angle and relations yields no profitable improvement of occlusal
      accuracy.

PMID- 11203645
TI  - Long-term marginal periimplant bone loss in edentulous patients.
AB  - PURPOSE: The aim of this study was to examine the long-term periimplant bone loss
      in patients treated with implant-supported fixed prostheses in both jaws.
      MATERIALS AND METHODS: The participants comprised 44 edentulous patients who have
      been followed for a 15-year period after treatment with a fixed implant-supported
      prosthesis in the mandible. Thirteen of them also received an implant-supported
      fixed prosthesis in the maxilla, on average 4.5 years after the mandibular
      treatment. The periimplant bone level was measured on intraoral radiographs.
      RESULTS: The long-term results of the implant treatment were successful, and only
      1% (3/273) of the implants were lost in the mandible and 7% (5/75) in the
      maxilla. All but one of the failures occurred before the connection of the
      prostheses. The mean marginal bone loss around the implants was small (less than
      1 mm for a 10-year period after implant placement), and was of similar magnitude
      in both jaws. However, the individual variation was relatively great. There was
      no significant difference in marginal bone loss between those who had a maxillary
      complete denture during the entire observation period and those who had received
      a fixed implant-supported maxillary prosthesis. Smokers lost more periimplant
      bone than did the nonsmokers; the difference was significant in the mandible but
      small and nonsignificant in the maxilla. CONCLUSION: The long-term periimplant
      bone loss was small and of similar magnitude in the mandible and the maxilla in
      subjects who had received implant-supported fixed prostheses in both jaws. The
      prosthetic status in the maxilla, i.e., complete denture or fixed implant
      supported prosthesis, had no significant influence on the mandibular periimplant
      bone loss.

PMID- 11203648
TI  - Changes in the provision of implant-supported prostheses at the Academic Centre
      for Dentistry Amsterdam (ACTA) from 1989 to 1995.
AB  - PURPOSE: Over the last decade, oral implantology has become a major treatment
      modality to aid the restoration of reduced dentitions. The present study
      monitored and quantified changes within a 5-year interval (1989-1991 [denoted as
      1990*] to 1995) in the provision of different types of implant-supported
      superstructures and characteristics of recipient patients at the Academic Centre
      for Dentistry Amsterdam (ACTA). MATERIALS AND METHODS: All patients who received
      oral implants in 1990* and in 1995 were selected, and their files (95 and 105,
      respectively) were consulted. Data of interest were retrieved retrospectively,
      compared, and statistically analyzed using Chi-squared tests. RESULTS: A number
      of statistically significant differences was apparent between these 2 periods. By
      1995 there was a threefold increase in both the number of patients and the number
      of implants placed per year. The patient group of < or = 40 years of age had
      significantly increased, from 7% to 23%. Also, in 1995 more maxillae were
      implanted than in 1990* (44% vs 26%). Whereas the majority of implanted patients
      was edentulous in 1990* (64%), the majority in 1995 was partially edentulous
      (60%). By 1995, the new technique of guided bone regeneration (GBR) using
      membranes was evidenced (no GBR in 1990* vs 33% of all patients in 1995 receiving
      some form of local GBR therapy). With respect to the type of superstructures,
      there was a strong increase in the number of single-tooth replacements (from 4%
      to 23%). In the edentulous group, the majority of superstructures in 1990 was
      fixed prostheses (64%), whereas in 1995 the majority was overdentures (71%).
      CONCLUSION: Major changes in oral implantology treatments were noticed between
      the 1990* and 1995 periods at ACTA. There is a trend toward implanting younger
      patients for partial implant-supported reconstructions using more regenerative
      procedures and with a more equal distribution in the maxilla and mandible.

PMID- 11203649
TI  - Fatigue behavior of the zinc-phosphate cement layer.
AB  - PURPOSE: Fatigue behavior of luting cement film between model fixed partial
      dentures (FPD) and their dies was investigated to gain a better understanding of
      the mechanical properties of zinc-phosphate cement. MATERIALS AND METHODS: Fifty
      six brass dies were made, half of them with grooves and half without grooves. A
      cantilever FPD for each die was cast in Au-Pd-Ag alloy. Four linear strain gauges
      were attached to the marginal portions of each retainer. The FPDs were cemented
      to the dies using zinc-phosphate cement. A fatigue test machine was used to
      cyclically load the specimens with 50 or 100 N for 5.5 x 10(5) cycles (1 Hz) in
      37 degrees C water. During the fatigue test, strain measurements were made after
      every 0.5 x 10(5) load cycles to discover if strain response was altered. After
      completion of the fatigue test, ultimate tensile strength of each specimen was
      measured and statistically analyzed by 2-way analysis of variance. RESULTS: With
      or without grooves, strain responses were the same at every periodic strain
      measurement throughout the 50-N fatigue test. For the 100-N fatigue test, strain
      responses for the specimens without grooves were different before and after
      cyclic testing, but there was no difference for the specimens with grooves. There
      were no significant differences in tensile strength among the specimens after the
      fatigue tests. CONCLUSION: No fatigue fracture was observed in zinc-phosphate
      cement film after repetitive loading. Repetitive loading may improve stress
      transmission within the zinc-phosphate cement film.

PMID- 11203650
TI  - Body movement during sleep in subjects with long-standing bruxing behavior.
AB  - PURPOSE: This study aimed to determine whether patients with long-standing
      nocturnal bruxing behavior present different body movement activity during sleep
      compared with healthy subjects. MATERIALS AND METHODS: Eleven bruxers and 8
      nonbruxers were studied in the sleep laboratory, and motor activity was detected
      with sensor pads placed under the mattress. Movements simultaneously recorded on
      videotapes were classified according to their duration and grouped in different
      types according to their characteristics. RESULTS: Subjects with bruxism had
      significantly more movements during sleep compared with controls; the difference
      was especially obvious for movements of short duration (< 5 seconds). The
      differences became significant from the fourth hour of sleep. These short
      movements were twitches, jerks, or any sudden, brusque movements of the
      extremities, but without the periodicity encountered in, for example, periodic
      limb movements during sleep. No significant relationship was found between the
      occurrence of masseter activity and movements. CONCLUSION: The findings suggest
      that subjects with nocturnal bruxism have movement disorders that are expressed
      not only as grinding or clenching of the teeth, but also as an increase of short
      duration body movements during sleep. This reinforces the hypothesis of a central
      etiology common to both bruxism and short movements during sleep.

PMID- 11203651
TI  - Effect of 180-week water storage on the flexural properties of E-glass and silica
      fiber acrylic resin composite.
AB  - PURPOSE: The aim of this study was to determine the effect of long-term water
      immersion on the flexural properties of fiber-reinforced composite. MATERIALS AND
      METHODS: Continuous, woven, silanized E-glass fibers and woven silica fibers were
      used to reinforce heat-cured and autopolymerized denture base polymers. Fibers
      were oriented at a 45-degree angle to the long axis of the test specimens.
      Control specimens were unreinforced. Dry test specimens and those stored in water
      for up to 180 weeks were tested with a 3-point loading apparatus. RESULTS:
      Ultimate transverse strength and flexural modulus of unreinforced and fiber
      reinforced composite test specimens decreased during water storage (P < 0.001,
      analysis of variance). Post hoc analysis revealed that after the storage of 4
      weeks no statistically significant reduction occurred. CONCLUSION: The results of
      this study suggest that the ultimate transverse strength of the fiber-reinforced
      composite made from E-glass fibers is reduced by approximately 27% compared to
      the dry fiber-reinforced composite. The majority of the reduction occurred during
      4 weeks of storage in water and remained approximately at that level for 180
      weeks.

PMID- 11203652
TI  - Within-subject comparison between connected and nonconnected tooth-to-implant
      fixed partial prostheses: up to 14-year follow-up study.
AB  - PURPOSE: This long-term follow-up study aimed to compare the outcome of fixed
      prostheses supported by teeth and implants and by freestanding implants only.
      MATERIALS AND METHODS: From prosthesis insertion up to 14 years (mean 6.5 y), 18
      patients were followed. Implant-supported prostheses with and without tooth
      connection were compared within the same jaw. The tooth-implant prostheses were
      supported by 30 implants and 30 teeth, and the freestanding prostheses were
      supported by 48 implants. Implant outcome, marginal bone stability, and
      mechanical complications were recorded. RESULTS: Neither implant mobility nor
      fractures of any component of the implants were observed. No prosthesis
      complications were observed, and the same applied for crown cement failure and
      intrusion of teeth. Only one periapical lesion was detected at the first follow
      up. The annual change of the marginal bone level around connected and
      freestanding implants did not differ significantly. The mean marginal bone loss
      (over the 2 groups) for the first 6 months amounted to 1.08 mm. After the first 6
      months, an annual marginal bone loss of 0.015 mm was observed. There was no
      difference between the 3 connection types (single implant connected to single
      tooth, multiple implants and/or multiple teeth connected with single connector,
      and multiple connectors) for the first 6 months or thereafter. The marginal bone
      loss (over the 3 groups) for the first 6 months was 1.15 mm. After the first 6
      months, the annual bone loss (over the 3 groups) amounted to 0.015 mm.
      CONCLUSION: Based on the results of this study, splinting teeth with implants for
      implant-supported fixed prostheses did not affect the long-term outcome in
      comparison to freestanding implants.

PMID- 11203653
TI  - Bond strength of luting cements to zirconium oxide ceramics.

PMID- 11203654
TI  - New advances in implant dentistry.

PMID- 11203655
TI  - Application of capacitively coupled electric field enhances periimplant
      osteogenesis in the dog mandible.
AB  - PURPOSE: Expeditious postoperative ingrowth of bone into dental implants is
      desired for clinically successful fixation of oral implants. The present study
      was performed to evaluate the effect of applying a capacitively coupled electric
      field (CCEF) on periimplant osteogenesis in the dog mandible. MATERIALS AND
      METHODS: Twelve adult male beagles were used in this study. All of the premolars
      on both sides of the mandible were removed from each dog. A POI (Ti-6Al-4V) 3
      piece implant (3.7 mm in diameter and 8.0 mm in length) whose surface had been
      treated with anodic oxidation was placed into each test site by self-tapping.
      Daily application of CCEF (8 h/day) was initiated on the day following the
      surgery and was continued through the day of sacrifice. A CCEF was induced by an
      external source delivering 10-Vp-p, 60-kHz sine-wave signals through an oral
      electrode plate. One side of the mandible of each dog was treated with CCEF,
      while the other side was not. On the control side, an oral electrode plate was
      attached for 8 hours per day, but CCEF was not applied. The effect of daily
      application of CCEF on the ingrowth of bone into the implant was examined at 14,
      21, or 30 days after implant placement. A fourth control group was not treated
      with CCEF and was maintained for 90 days to confirm that CCEF treatment enhances
      bone ingrowth in dental implants. RESULTS: Daily application of CCEF
      significantly increased the bone-contact ratio at days 14, 21, and 30 after
      implant placement in comparison with the respective controls. The bone-area
      ratios of the 14- and 21-day CCEF-treated groups were significantly larger than
      those of the respective controls and were similar to those of the 90-day control
      group. CONCLUSION: CCEF treatment increases periimplant osteogenesis in the dog
      mandible, confirming its usefulness in oral implantology.

PMID- 11203656
TI  - A preliminary study on a resin-modified glass-ionomer cement for transitional
      restorations and subsequent core buildups.
AB  - PURPOSE: The purpose of this study was to evaluate the serviceability of a resin
      modified glass-ionomer cement for transitional restorations and subsequent core
      buildups in endodontically treated maxillary premolars. MATERIALS AND METHODS:
      Fifty Vitremer restorations were made in 42 patients by one operator during a
      period of 5 months. After 1 year of follow up, the quality of the restorations
      was assessed for the variables occlusal contacts, proximal contacts, marginal
      adaptation, and surface roughness. Survival was estimated at 2 years of service
      either as a transitional restoration or as a core buildup. RESULTS: The
      percentage survival of the transitional restorations was 85% +/- 6%. When the
      crowned Vitremer restorations were added to the transitional restorations, the 2
      year survival was 98% +/- 2%. With respect to the quality assessment, the
      majority of the restorations showed either no or light occlusal contacts and no
      or light contacts on at least one of their proximal surfaces. Marginal integrity
      and surface roughness were considered to be suboptimal on average. CONCLUSION:
      The described restorations seem to perform adequately for a transitional period
      of 1 to 2 years. Their viability as substructures for permanent cast restorations
      remains to be tested in long-term clinical studies.

PMID- 11203657
TI  - Effect of the addition of poly(methyl methacrylate) beads on some properties of
      acrylic resin.
AB  - PURPOSE: There have been numerous attempts to improve the mechanical properties
      of acrylic resin. However, the fracture of dentures is still an unresolved
      problem. The potential advantage of self-reinforcement should be improved
      mechanical properties over the amorphous random polymer. This study investigated
      the addition of poly(methyl methacrylate) (PMMA) beads in a variety of
      percentages on a range of mechanical properties of PMMA denture base acrylic
      resin. MATERIALS AND METHODS: The transverse and impact strengths and hardness of
      acrylic resin specimens stored in water for periods of 1 week and 6 months prior
      to testing were investigated. RESULTS: The results showed that for specimens
      stored for 1 week, the addition of up to 25% beads produced a significant
      increase in the modulus of elasticity. Addition of 5% beads produced a slight but
      nonsignificant increase in the modulus of rupture, although additions of
      increasing percentages produced a decrease in the modulus of rupture. The impact
      strength was increased for 5% to 25% beads and decreased for 40% beads. The
      hardness showed only small changes. For specimens stored in water for 6 months,
      the modulus of rupture decreased with increasing percentages of beads. The
      addition of beads up to 10% significantly increased the modulus of elasticity.
      There was no significant increase in impact strength but a significant increase
      in hardness for 5% beads. CONCLUSION: The addition of PMMA beads to acrylic resin
      did not produce a substantial improvement in the mechanical properties and cannot
      be recommended as a method of reinforcement in its present form.

PMID- 11203658
TI  - Effect of surface treatments on the bond strength between composite resin and
      acrylic resin denture teeth.
AB  - PURPOSE: This investigation studied the effects of 3 surface treatments on the
      shear bond strength of a light-activated composite resin bonded to acrylic resin
      denture teeth. MATERIALS AND METHODS: The occlusal surfaces of 30 acrylic resin
      denture teeth were ground flat with up to 400-grit silicon carbide paper. Three
      different surface treatments were evaluated: (1) the flat ground surfaces were
      primed with methyl methacrylate (MMA) monomer for 180 seconds; (2) light-cured
      adhesive resin was applied and light polymerized according to the manufacturer's
      instructions; and (3) treatment 1 followed by treatment 2. The composite resin
      was packed on the prepared surfaces using a split mold. The interface between
      tooth and composite was loaded at a cross-head speed of 0.5 mm/min until failure.
      RESULTS: Analysis of variance indicated significant differences between the
      surface treatments. Results of mean comparisons using Tukey's test showed that
      significantly higher shear bond strengths were developed by bonding composite
      resin to the surfaces that were previously treated with MMA and then with the
      bonding agent when compared to the other treatments. CONCLUSION: Combined surface
      treatment of MMA monomer followed by application of light-cured adhesive resin
      provided the highest shear bond strength between composite resin and acrylic
      resin denture teeth.

PMID- 11203659
TI  - In vitro fracture force and marginal adaptation of ceramic crowns fixed on
      natural and artificial teeth.
AB  - PURPOSE: Artificial teeth made of acrylic resin or alloy are considered
      substitutes for rare caries-free human teeth in in vitro examinations. The
      purpose of this study was to compare the fracture strength and marginal
      adaptation of all-ceramic single crowns fixed to natural teeth with crowns fixed
      to artificial teeth after artificial aging. MATERIALS AND METHODS: The fracture
      force and marginal adaptation were investigated in 28 adhesively luted all
      ceramic crowns on human molars of different sizes, as well as on alloy and liquid
      crystal polymer (LCP) artificial teeth. The fracture force was determined using a
      universal testing machine, and the semiquantitative marginal adaptation was
      examined using a scanning electron microscope, in both instances after simulating
      5 years of clinical service. RESULTS: Fracture force was found to be
      significantly higher for crowns fixed on substitute materials (alloy = 1,838 N;
      LCP = 1,392 N) than for crowns on human teeth (888 N). No significant differences
      in marginal quality could be determined between the groups. All crowns showed
      marginal gaps of about 10% and perfect margins at about 90%. CONCLUSION: The high
      in vitro fracture values of all-ceramic crowns on artificial materials may lead
      to a misinterpretation of the tested restorative materials, overvaluing the
      material properties in a first preclinical estimation. Human teeth or materials
      with a comparable modulus of elasticity are therefore preferred in in vitro
      fracture tests.

PMID- 11203660
TI  - Changes in signs and symptoms of temporomandibular disorders following treatment
      with implant-supported fixed prostheses: a prospective 3-year follow up.
AB  - PURPOSE: The aim was to investigate whether the replacement of lost teeth with
      implant-supported fixed prostheses (IFP) had any influence upon the signs and
      symptoms of temporomandibular disorders (TMD). MATERIALS AND METHODS: The
      subjects comprised 78 consecutive patients referred to a specialist clinic for
      treatment with IFPs. All were examined with respect to the presence of signs and
      symptoms of TMD before the start of treatment and after 1 and 3 years. RESULTS:
      Before treatment began, 21% of the patients were found to have moderate (15%) or
      severe (5%) clinical signs of dysfunction according to the Helkimo index. These
      figures decreased numerically but not statistically significantly to 10% and 1%,
      respectively, at the 3-year follow up. Nearly half of the patients (45%) reported
      one or more subjective symptoms of TMD at the first examination. The anamnestic
      index used had decreased statistically significantly at the 3-year follow up,
      when the 5 variables composing the index had improved, but the improvement was
      statistically significant only for the variables joint sounds and pain when
      opening the mouth wide. All patients were satisfied with the treatment received.
      CONCLUSION: The results from the present investigation show that treatment with
      IFPs has a good and lasting effect on the functional status of the masticatory
      system as well as on subjective symptoms of TMD and chewing ability in the vast
      majority of patients treated.

PMID- 11203661
TI  - Tomographic evaluation of TMJ loading affected by occlusal pivots.
AB  - PURPOSE: The purpose of this study was to clarify the direction and magnitude of
      condyle displacement during clenching with occlusal pivots. Temporomandibular
      joint (TMJ) loading and flexibility and the clinical significance of orthopedic
      appliance therapy are also discussed. MATERIALS AND METHODS: Participants were 16
      volunteers with a mean age of 25.8 years. Maxillary and mandibular flat occlusal
      devices were fabricated. TMJ tomogram series were taken first with tripod support
      and then with maxillary clenched anterior pivot support and/or unilateral
      posterior pivot support. Condyle positions on the TMJ tomograms were analyzed
      using the digital subtraction technique. RESULTS: When clenching with the
      anterior pivot, the anterior reference point (A) on the mandibular condyle was
      translated 0.1 mm posteriorly (P > 0.05) and 0.2 mm superiorly (P < 0.01) from
      the tripod-support reference point. In the case of the ipsilateral posterior
      pivot, point A was rotated 1.2 degrees (P < 0.01) and was translated 0.4 mm (P <
      0.01) posteriorly and 0.18 mm superiorly (P > 0.05). CONCLUSION: Condyle
      displacement during clenching with the anterior and posterior unilateral pivot
      was found, which supports previous findings. However, the direction and magnitude
      of the displacement differed from those of previous studies using jaw-tracking
      devices, and individual values differed greatly among subjects.

PMID- 11203662
TI  - Comparison of marginal fit of 3 different metal-ceramic systems: an in vitro
      study.
AB  - PURPOSE: The aim of this study was to compare the marginal adaptation of metal
      ceramic crowns made with 3 different metal substructures. MATERIALS AND METHODS:
      Seventy-five gypsum dies were fabricated from a master steel die. They were
      randomly divided into 3 groups of 25 dies each. A metal coping was prepared on
      each die using a different technique for each group: composite alloy,
      electroforming, and cast high-noble alloy. Ceramic was baked on all of the
      samples following the same protocol and simulating the shape and size of a
      maxillary central incisor. All specimens were evaluated under a stereomicroscope
      at 200x magnification. The marginal gap was measured at 8 different points on
      each specimen before and after ceramic application and also on the master steel
      die. A total of 3,600 measurements was evaluated. The results were statistically
      elaborated by means of a t test and one-way analysis of variance (ANOVA).
      RESULTS: The ANOVA revealed a significant difference in mean marginal gap before
      and after ceramic application within each group. Electroforming (mean 32 microns)
      and high-noble alloy (mean 31 microns) showed better marginal fit after ceramic
      application and on the master steel die compared to composite alloy (mean 68
      microns; P < 0.0001). CONCLUSION: Marginal gaps are influenced by the application
      of ceramic and by the alloy used for the substructure, and the values obtained
      were within the limits of clinical acceptability (70 microns).

PMID- 11203663
TI  - Long-term analysis of biologic and technical aspects of fixed partial dentures
      with cantilevers.
AB  - PURPOSE: The aim of the present clinical study was to analyze the long-term
      treatment outcome of fixed partial dentures (FPD) with cantilevers. MATERIALS AND
      METHODS: Ninety-two patients with 115 cantilever FPDs on 239 abutment teeth were
      examined. Immediately following cementation, radiographs of the abutment teeth
      were obtained. At the follow-up examination 5 to 16 years after cementation, the
      abutment teeth were clinically and radiographically evaluated. Besides the
      assessment of periodontal parameters and vitality testing, the presence of
      carious lesions of the abutment teeth, loss of retention, fracture of bridgework,
      and fracture of abutment teeth were also recorded. The Student's t test was used
      to detect differences between abutment teeth and control teeth with natural
      crowns as well as over time within the groups. RESULTS: Plaque scores and
      bleeding on probing were low at both abutment and nonabutment teeth. Mean probing
      pocket depth and level of the clinical attachment never exceeded 3.0 mm in both
      groups. The radiographic bone levels at abutments were stable within 3% over the
      observation period. Of the 120 initially vital abutment teeth, 12 (10%) lost
      vitality during the observation period; one (1%) of the 119 initially nonvital
      abutments showed periapical pathology. Development of secondary caries was
      observed at 8% of the 239 abutment teeth. In total, 8% of the abutment teeth were
      affected by loss of retention, which made up more than half of all technical
      problems. Material fractures only occurred occasionally, affecting from 1% to
      less than 3% of the abutment teeth. Fracture of abutment teeth amounted to 3% and
      was twice as frequent at abutments adjacent to cantilevers compared to abutments
      not adjacent to cantilevers. CONCLUSION: The most frequent biologic (caries) and
      technical complications (loss of retention) made up more than half of all
      problems recorded. These problems may be at least partially avoided by performing
      optimal plaque control and by strictly observing the rules for preparation of
      retentive FPD abutments.

PMID- 11203664
TI  - Properties of an experimental mouthguard material.
AB  - PURPOSE: The purpose of the present study was to evaluate some important
      mechanical properties of an experimental silicone material (PM1) to assess its
      potential as a mouthguard material. MATERIALS AND METHODS: The hardness, tear
      strength, tensile properties, and energy absorption properties of the silicone
      material were determined and compared with those of 2 commercially available
      materials (Bioplast, a polyvinylacetate polyethylene, and Polyshield, a
      silicone). RESULTS: Bioplast was significantly harder than Polyshield and PM1.
      Polyshield was significantly harder than PM1. Bioplast had a significantly higher
      tear strength than both Polyshield and PM1. The tensile strength of Bioplast was
      significantly greater than that of Polyshield and PM1. PM1 had a significantly
      higher tensile strength than Polyshield. Bioplast had a significantly lower
      energy absorption capacity at 500 N than both Polyshield and PM1, with PM1 having
      a significantly higher value than Polyshield. At 1,000 and 1,500 N, Bioplast had
      a significantly higher energy absorption than both Polyshield and PM1.
      CONCLUSION: It was concluded that PM1 showed better energy absorption properties
      than Polyshield and better energy absorption properties than Bioplast at lower
      impact forces. PM1 was softer and had better tear and tensile properties than
      Polyshield. The results of the present study suggest that the new material has a
      good potential for use as a mouthguard material.

PMID- 11203665
TI  - Probability of fracture of all-ceramic crowns.
AB  - PURPOSE: The study compared the probability of fracture of 4 systems of all
      ceramic crowns fabricated on maxillary central incisors. MATERIALS AND METHODS:
      The 4 all-ceramic crown systems were: (1) a glass-infiltrated, sintered alumina
      system (In-Ceram) fabricated conventionally, (2) the same system with machine
      milled alumina cores (CEREC 2), (3) a heat-press, leucite-reinforced glass
      ceramic system (IPS Empress), and (4) a high-purity, high-density alumina system
      (Procera). Ten crowns of each system were fabricated and compressed at 45 degrees
      at the palatal surface until failure. The data were analyzed with the Weibull
      method. RESULTS: There were no significant differences in the probability of
      fracture among the 4 systems studied. CONCLUSION: The likelihood of fracture of
      these crown systems on central incisors should be similar.

PMID- 11203666
TI  - Retention of a posterior resin-bonded fixed partial denture with a modified
      design: an in vitro study.
AB  - PURPOSE: The aim of this study was to test in vitro the resistance of a modified
      resin-bonded fixed partial denture (RBFPD) to detachment using a laboratory setup
      simulating load fatigue of mastication forces. The effect of varying the cement
      type was also investigated. MATERIALS AND METHODS: Extracted teeth were used to
      prepare specimens each consisting of a premolar and a molar with a space
      equivalent to a molar in between. Five test groups were prepared (n = 7).
      Specimens in group 1 were prepared to receive conventional RBFPDs with proximal
      grooves, occlusal rests, and lingual wings. Specimens in groups 2 and 3 were
      prepared to receive modified RBFPDs with retentive-slot restorations. Specimens
      in group 4 were prepared to receive RBFPDs with retentive-slot restorations only,
      whereas specimens in group 5 were prepared similarly to the ones in groups 2 and
      3 but with inlay preparations instead of the retentive slots. Castings were made
      and their fit surfaces microetched. In groups 1, 2, 4, and 5 castings were
      cemented with Cement-It, whereas castings of group 3 were cemented with Panavia
      21. Slot cavities of groups 2, 3, and 4 were restored with a resin composite.
      Specimens were subjected to compressive load cycling for 230,000 cycles at 4 Hz
      under water. Castings were then separated from the abutments under tensile
      loading. RESULTS: Mean separation forces were: group 1 = 361 N, group 2 = 525 N,
      group 3 = 562 N, group 4 = 449 N, and group 5 = 417 N. Groups 2 and 3 had
      significantly higher mean separation forces than groups 1 and 5. Separation of
      castings in groups 2 and 3 was associated with a higher frequency of cohesive
      fracture of the abutments than in group 1. Adhesive failure was uncommon among
      specimens of groups 2, 3, and 4. CONCLUSION: The modified RBFPDs of groups 2 and
      3 had better potential for retention. Increased resistance to dislodgment of the
      modified RBFPDs was not directly related to the surface area of the castings, nor
      was it related to the type of resin cement, but rather to mechanical interlocking
      of the castings with the retentive-slot resin composite restorations.

PMID- 11203667
TI  - Impact of implant interdependency when evaluating success rates: a statistical
      analysis of multicenter results.

PMID- 11203668
TI  - Dental research and prosthodontics.

PMID- 11203669
TI  - Correlation between clinical scoring of secondary caries at crown margins and
      histologically assessed extent of the lesions.
AB  - PURPOSE: The aim of this study was to propose a new clinical diagnostic rating
      index for secondary caries lesions at crown margins and to correlate this index
      with histologic evaluations. MATERIALS AND METHODS: Based on criteria for the
      evaluation of root caries, a modification of secondary caries lesions at the
      crown margin (SC index) was applied; the lesion characteristics were described as
      SCO to SC4. A total of 16 crowned teeth exhibiting secondary caries were randomly
      selected. The teeth were rated and grouped according to their clinical SC grades
      (SC1 to SC4). After embedding in Technovit, the teeth were serially sectioned and
      histologic caries scores were given for each section. RESULTS: Fifty-two percent
      of the prepared margins were in cementum/dentin. Crown margins with no caries
      lesions were mainly found in teeth clinically rated as SC1 and exhibiting
      localized discolorations, whereas deep lesions were found histologically at teeth
      rated SC4. The nonparametric test according to Spearman's rank correlation
      coefficient (rho) confirmed a highly significant correlation between the clinical
      SC index and the histologic evaluation (rho = 0.87, 95% confidence interval =
      0.67 to 0.96, P < 0.01). SC1 discolorations overestimate caries lesions, whereas
      SC2 and SC4 lesions are well correlated to the percentage of histologically
      evaluated caries extension into all sections of a tooth. Lesions rated SC3
      demonstrated a high variability of caries penetration into the dentin.
      CONCLUSION: The depth of discolorations and circular lesions is clinically not
      well predictable. Clinical diagnosis for localized superficial caries and deep
      caries lesions at the crown margin correlated well with the histologic caries
      rating.

PMID- 11203670
TI  - Resin-bonded fixed partial dentures--a literature review with presentation of a
      novel approach.
AB  - PURPOSE: Resin-bonded fixed partial dentures (RBFPD) have been in our profession
      for over 20 years. The aim of this work was to provide some background about
      their development and the factors that influence their clinical longevity.
      MATERIALS AND METHODS: A recent literature search conducted using MEDLINE along
      with analysis of bibliographies of published papers revealed a considerable
      number of publications of RBFPDs since their first introduction in the mid-1970s.
      Critical analysis of these publications revealed some important and interesting
      key facts. These were divided into sections about developments in the treatment
      of the fit surface of the casting, bonding systems, and prosthesis design. A
      separate section about factors that affect the longevity of RBFPDs is included,
      along with a detailed description of preparation designs of an anterior and a
      posterior RBFPD. RESULTS: The typical design of RBFPDs is characterized by a high
      degree of conservation of tooth structure of abutments compared with designs of
      conventional fixed prostheses. While the early RBFPDs were associated with a high
      frequency of premature failure--mostly because of debonding--developments in
      preparation design and bonding techniques as well as better understanding of the
      appropriate type of metal alloy to be used and the best preparation method for
      enhanced bonding have led to significant improvements in their long-term
      survival. CONCLUSION: RBFPDs should be considered viable treatment options for
      those clinical situations that are best suited for their use. Preparation design,
      cement type, and casting alloy type as well as surface treatment are among the
      most important factors that influence longevity of RBFPDs.

PMID- 11203671
TI  - Strength and microstructure of IPS Empress 2 glass-ceramic after different
      treatments.
AB  - PURPOSE: This investigation was designed to determine whether heat pressing
      and/or simulated heat treatments affect the flexure strength and microstructure
      of the lithium disilicate glass-ceramic of the IPS Empress 2 system. MATERIALS
      AND METHODS: Four groups of the lithium disilicate glass-ceramic were prepared as
      follows: group 1 = as-received material; group 2 = heat-pressed material; group 3
      = heat-pressed and stimulated initial heat-treated material; and group 4 = heat
      pressed and simulated heat-treated material with full firings for a final
      restoration. Three-point bending tests and scanning electron microscopy (SEM)
      analysis were conducted. RESULTS: The flexure strength of group 2 was
      significantly higher than that of group 1. However, there were no significant
      differences in strength among groups 2, 3, and 4, or between groups 1 and 4. The
      SEM micrographs of the lithium disilicate glass-ceramic showed a closely packed,
      multidirectionally interlocking microstructure of numerous lithium disilicate
      crystals protruding from the glass matrix. The crystals in the glass matrix of
      the heat-pressed materials (groups 2, 3, and 4) were a little more homogeneous
      and about 2 times bigger than those of the as-received material (group 1). These
      changes of the microstructure were greatest between groups 1 and 2. However,
      there were no marked differences among groups 2, 3, and 4. CONCLUSION: Although
      there were significant increases in the strength and some changes of the
      microstructure after the heat-pressing operation, the combination of heat
      pressing and simulated subsequent heat treatments did not produce an increase of
      strength of IPS Empress 2 glass-ceramic.

PMID- 11203672
TI  - Two-body wear of dental composites under different loads.
AB  - PURPOSE: Although dental composites are excellent for restoring the appearance of
      natural tooth tissues, their relatively poor resistance to wear, especially in
      approximal and occlusal contact areas, is still a major source of concern. The
      aim of this research was to study a basic wear mechanism, under 2-body wear
      conditions, that may be integrated into our understanding of the in vitro and in
      vivo wear behavior of dental composites. MATERIALS AND METHODS: An in vitro 2
      body wear test was conducted on 2 selected ultrafine compact-filled dental
      composites under different magnitudes of sinusoidal cyclic load. The wear
      surfaces and cross sections of the wear layers were assessed using scanning
      electron microscopy (SEM) to explore the nature of the wear pattern of the dental
      composites under cyclic loading conditions. RESULTS: The wear losses of both
      composites increased with load. SEM analysis of wear surfaces and subsurface
      sections indicated that the composites tested displayed different wear mechanisms
      from low to high loads. An explanation for the wear pattern is proposed based on
      the observed wear behavior. CONCLUSION: The in vitro wear pattern of the
      ultrafine compact-filled dental composites tested is closely related to the
      applied load. Although the wear loss increased in a roughly linear relationship
      with applied load, the underlying wear mechanism involved may experience a
      significant change from low to high load conditions during wear.

PMID- 11203673
TI  - Vertical position, rotation, and tipping of molars without antagonists.
AB  - PURPOSE: There has been a general belief that permanent teeth without antagonists
      overerupt, creating, after some time, considerable clinical problems. However,
      very few studies in the literature support this statement. The purpose of this
      investigation was to examine the position of molars that had been unopposed for a
      long period and to test the hypothesis that overeruption does affect every tooth
      without an antagonist. MATERIALS AND METHODS: Fifty-three individuals were
      examined clinically, and dental casts were taken to evaluate the position of
      unopposed molars. There were 84 molars (61 in the maxilla and 23 in the mandible)
      with a documented period of at least 10 years without antagonists. Among these
      teeth, 25 molars had neither an antagonist nor a mesially adjacent tooth. A
      qualitative method was used to evaluate the position of the molars in the
      vertical direction: (1) teeth with no sign of overeruption, (2) teeth with slight
      overeruption (< 2 mm), and (3) teeth with moderate to severe overeruption (> or =
      2 mm). RESULTS: Of the 84 molars examined, 15 teeth (18%) revealed no signs of
      overeruption, 49 teeth (58%) displayed overeruption of less than 2 mm, and 20
      teeth (24%) showed moderate to severe overeruption. Individuals with molars that
      had lost their antagonists in adult age had a lower risk for overeruption than
      the other subjects examined. The existence of adjacent teeth was important for
      the position of the unopposed molar in a mesiodistal or buccolingual direction.
      Molar rotation was more frequent in the maxilla, whereas tipping was more common
      in the mandible. CONCLUSION: It is concluded that not all molars without
      antagonists overerupt, not even in a long-term perspective.

PMID- 11203675
TI  - Effects of attachment type on the mobility of implant-stabilized overdentures--an
      in vitro study.
AB  - PURPOSE: To stabilize overdentures, a wide range of attachments to implants is
      suggested. Although there is evidence that denture stability is an important
      factor for patient satisfaction, there are no data on how these attachments may
      reduce denture mobility. It was the purpose of this study to compare the effects
      of different types of attachments on the mobility of implant-stabilized
      overdentures in vitro, designing a measurement device that could also be used in
      vivo. MATERIALS AND METHODS: On an acrylic model with 2 implants in the canine
      areas, magnets were fixed to one of the implant abutments. Four Hall-effect
      devices were attached to the denture opposite the magnet, which allowed contact
      free measurements of denture movements. RESULTS: In vitro experiments loading an
      overdenture showed very small, largely insignificant differences in denture
      mobility when different bar or ball attachments were used. Geometric aspects of
      load application were more important than the choice of attachment. CONCLUSION:
      The measurements gave no guide to the choice of an attachment. The similarity of
      the attachments must be confirmed by in vivo measurements.

PMID- 11203674
TI  - Water sorption and dimensional changes of denture base polymer reinforced with
      glass fibers in continuous unidirectional and woven form.
AB  - PURPOSE: The aim of this study was to determine the dimensional accuracy and
      water sorption of a denture base polymer that was reinforced with glass fibers in
      continuous unidirectional and woven form in different weight fractions. MATERIALS
      AND METHODS: Ten rhombic brass plates were prepared with reference points, and 70
      heat-cured denture base polymer specimens were produced using these brass models.
      Ten of 70 were used for controls, and 60 were reinforced with glass fibers in
      continuous parallel and woven form. The dimensional changes of polymer and fiber
      reinforced composite specimens after processing, drying for 4 days at 37 degrees
      C, and storage in 37 degrees C water for 90 days were calculated by the change of
      the distance vector. The measurements were made between the reference points on
      the specimens and were compared with those on the brass model at 4 different
      stages. The water sorption calculations were made at 10 different time intervals
      on 70 specimens, which were immersed in a 37 degrees C distilled water bath and
      weighed. RESULTS: The polymerization shrinkage and water sorption of denture base
      polymers is lower when the specimens are reinforced with glass fibers in
      continuous unidirectional and woven form. The highest fiber content showed the
      smallest dimensional change (0.069 mm, or 0.25%), and the unreinforced group
      showed the largest change (0.139 mm, or 0.54%). Water sorption occurred mainly
      during the first 14 days. CONCLUSION: As the fiber content increases, the
      dimensional change and water sorption decrease.

PMID- 11203676
TI  - Immediate effect of occlusal contact pattern in lateral jaw position on the EMG
      activity in jaw-elevator muscles in humans.
AB  - PURPOSE: The aim of this study was to investigate the effect of experimental
      alterations of nonworking-side occlusal contacts on jaw-elevator muscle activity.
      MATERIALS AND METHODS: Individual devices were fabricated to simulate various
      lateral occlusal relationships. Twelve human subjects were asked to carry out
      submaximal lateral clenching, and electromyographic (EMG) activity of the
      masseter and anterior and posterior temporalis muscles was measured. RESULTS:
      Clenching in a lateral mandibular position under natural conditions induced an
      activity pattern with a clear dominance of the anterior and posterior temporalis
      muscles on the working side. Working-side dominance in the anterior temporalis
      was reduced moderately when an experimental nonworking-side occlusal contact was
      added. Dominance decreased dramatically when an experimental nonworking-side
      interference was added. The working-side activity in the posterior temporalis was
      also reduced dramatically by an experimental nonworking-side interference, but
      not by a nonworking-side occlusal contact. None of the experimental contact
      patterns had a significant effect on the masseter activity. CONCLUSION: These
      results suggest that the nonworking-side occlusal contacts have a significant
      effect on clenching-induced temporalis muscle activity.

PMID- 11203677
TI  - Communication during prosthodontic treatment--dentist, patient, and dental nurse.
AB  - PURPOSE: This study described and explored verbal communication during
      prosthodontic treatment. MATERIALS AND METHODS: Sixty-one patients and 15
      dentists participated. Sixty-one prosthetic treatment periods, during which fixed
      tooth- or implant-supported prostheses were placed, were followed. One visit
      during each treatment period was audio recorded. The recorded verbal
      communication was analyzed with the Roter Interaction Analysis System-dental. The
      inter-rater reliability was 95% to 97% for utterance classification and kappa =
      0.71 to 0.78 for categorization definition. RESULTS: There were 43,663 utterances
      available for analysis. Of those, 59% was dentist communication, 28% was patient
      communication, and 10% was dental nurse communication. Other persons, e.g.,
      dental technicians, contributed with 3%. The dentist-patient communication
      contained more task-focused than socioemotional behaviors. Female patients used
      socioemotional talk to a greater extent than did the male patients. Dentists and
      patients of different genders communicated more overall, especially male dentists
      with female patients. The age difference between dentist and patient had no
      effect on the amount or type of communication. The dental nurse talked slightly
      more with male patients. CONCLUSION: When different genders met there was more
      communication, and the talk was more socioemotional when the patient was female.

PMID- 11203678
TI  - Functional mandibular deformation in edentulous subjects treated with dental
      implants.
AB  - PURPOSE: The purpose of this study was to measure medial convergence,
      dorsoventral shear, and corporal rotation in the human mandible. MATERIALS AND
      METHODS: Measurements were made using custom-fabricated strain gauge displacement
      transducers in 6 edentulous subjects who had been treated with mandibular
      endosseous dental implants. These were mounted on the most distal of the
      mandibular implants on each side, and measurements were made in real time using a
      multichannel analogue/digital converter and a personal computer for data storage
      and analysis. Measurements were made while the implants were loaded, and the
      subjects opened and closed their mouths and made lateral mandibular excursions.
      Medial convergence was measured as a linear change at the site of the most distal
      implant. Dorsoventral shear was expressed as a relative rotation of the right and
      left mandibular bodies projected onto the median sagittal plane, and corporal
      rotation was expressed as the relative rotation of the most distal implant.
      RESULTS: Jaw deformation was found to occur immediately on opening and was
      related to closing forces and jaw position. Medial convergence of up to 41
      microns was observed, with values for corporal rotation of up to 6 degrees and
      dorsoventral shear of up to 19 degrees. CONCLUSION: The study demonstrated
      clinically for the first time 3 different and simultaneous patterns of functional
      mandibular deformation.

PMID- 11203679
TI  - Curing efficiency of visible light- and dual-cured denture reliners.
AB  - PURPOSE: The purpose of this study was to evaluate the curing efficiency of 8
      light- and dual-cured denture reliners. MATERIALS AND METHODS: The curing
      efficiency was measured with Fourier infrared micromultiple internal reflectance
      spectroscopy, calculating the percentage of remaining carbon double bonds on the
      top and bottom surfaces of each specimen immediately after exposure to the
      extraoral light-curing unit according to the manufacturer's instructions and
      after 1 week of storage in dark and dry conditions. Another group of specimens
      was photopolymerized initially through a denture base resin prior to the
      extraoral light-curing polymerization. Five specimens of each reliner were
      tested. RESULTS: The dual-cured reliners showed no statistically significant
      differences (P > 0.05) between top and bottom surfaces after immediate exposure
      to the light-curing unit. On the contrary, light-cured reliners revealed
      significant differences. The majority of the reliners showed reduction of the
      percentage of remaining carbon double bonds at both surfaces after 1 week of
      storage in dark and dry conditions. Photopolymerization of light-cured reliners
      through a denture base resin induced an increased amount of remaining carbon
      double bonds, whereas no effect was observed in dual-cured materials. CONCLUSION:
      Dual-cured denture liners exhibited distinct advantages over light-cured ones
      concerning the curing efficiency.

PMID- 11203680
TI  - An investigation of self-reinforced poly(methyl methacrylate) denture base
      acrylic resin using scanning electron and atomic force microscopy.
AB  - PURPOSE: The aim of this study was to examine the interfacial region of
      poly(methyl methacrylate) (PMMA) reinforced with untreated and surface-treated
      PMMA fibers in both chopped and continuous form using scanning electron and
      atomic force microscopy. MATERIALS AND METHODS: Acrylic resin specimens
      incorporating untreated and surface-treated (with butadiene styrene latex
      emulsion) PMMA fibers were examined using a scanning electron microscope and an
      atomic force microscope. RESULTS: There was evidence of random arrangement of
      untreated and surface-treated chopped fibers throughout specimens with areas of
      dense fiber aggregation and other areas containing few or no fibers. For the
      untreated and surface-treated fibers in continuous forms (a single and 2
      unidirectional layers), there was evidence of fiber displacement and buckling,
      together with variation in interfiber spacing. For the specimens containing
      surface-treated continuous fibers in a cross-ply arrangement that had
      demonstrated a substantial improvement in the modulus of rupture, there was no
      evidence of fiber buckling, and the layer of butadiene styrene was consistently
      thin and even in comparison to weaker specimens. CONCLUSION: The thickness of the
      rubber layer and the fiber arrangement (in terms of fiber displacement and
      interfiber spacing) may be important factors in the success of the reinforcement.

PMID- 11203682
TI  - Addictive behaviour of adolescents and young adults.

PMID- 11203681
TI  - Prosthetic restoration following maxillary resection without an oroantral defect:
      a case report.

PMID- 11203683
TI  - Health professions speak out against the confusing messages regarding HIV/AIDS.

PMID- 11203685
TI  - Bibliography of toxinology.

PMID- 11203684
TI  - Influence of various cytokines on the expression of CD20 on the surface of CLL
      cells in vitro.

PMID- 11203686
TI  - Reoperation results of arterial involvement  in Behcet's disease.
AB  - OBJECTIVES: to retrospectively evaluate the role of vascular interventions in
      Behcet's disease with arterial involvement. So far, little information is
      available on the surgical approach for arterial involvement in Behcet's disease.
      MATERIAL AND METHODS: between February 1989 and August 1997, among 178 patients
      with Behcet's disease referred to our clinic, vascular involvement was
      established in total of 67 patients (38%) which consisted of 59 venous (33%) and
      12 (7%) arterial involvements requiring urgent surgical intervention. Primary
      arterial lesions were occlusive in one patient, aneurysm formation in nine or
      both in four. RESULTS: twelve primary operations and 12 reoperations were
      performed. The reasons for reoperations were anastomotic aneurysms, graft
      occlusion, occlusion of native vessel, graft infection, bleeding from anastomosis
      and aortoenteric fistula. First reoperation was performed after a mean period of
      6.4 months (1-15 months). Postoperative follow-up was 12-60 months (mean 36
      months) and three patients died during follow-up. CONCLUSIONS: the   surgical
      results were not satisfactory because of progressive graft thrombosis and
      formation   of new aneurysms at the anastomosis. Aggressive medical treatment
      should be combined   when major vessel involvement occurs. All types of arterial
      punctures for angiography or   blood gases should be minimised because of the
      risk of new aneurysm formation. Surgical   intervention is indicated only in
      patients with a growing aneurysm, acute rupture or severe   ischaemia.

PMID- 11203687
TI  - Evolution of the proportions of two sigma viral types in experimental populations
      of Drosophila melanogaster.

PMID- 11203688
TI  - ACOG committee opinion. Maternal phenylketonuria. Committee on Genetics.

PMID- 11203689
TI  - Intrauterine growth restriction. Clinical management guidelines for obstetrician
      gynecologists. American College of Obstetricians and Gynecologists.

PMID- 11203690
TI  - [Functional imaging of the auditory cortex: role of magnetoencephalography].
AB  - We present the different methods for detecting cerebral activity in the auditory
      cortex. Positron emission tomography (PET) and functional MRI (fMRI) measure such
      activity indirectly by calculating the blood flow rate or the consumption of
      oxygen. The direct methods of detection record the electrical or magnetic
      activity by eletroencephalography (EEG), or magnetoencephalography (MEG),
      respectively. The aim of this study was to define the role of MEG amongst these
      different techniques using the data from recordings of evoked magnetic fields in
      5 healthy subjects. The localizations demonstrated the tonotopic organization of
      the auditory cortex, with high-pitched sounds showing a more medial cortical
      projection than low-pitched sounds. These various techniques are complementary.
      PET allows a pharmacological study of the cortex, and could be used in patients
      with cochlear implants. FMRI is non-invasive, and has a high spatial resolution.
      EEG has an excellent temporal resolution, and EEG recordings do not require major
      equipment or infrastructure. MEG has a better spatial resolution, with the same
      temporal resolution, as EEC. MEG is particularly useful in the localization of
      the cortical generators of middle-latency auditory evoked responses.

PMID- 11203691
TI  - [Parkinson's disease: diagnostic and therapeutic criteria. Short text].

PMID- 11203692
TI  - Bibliography. Current world literature. Benign prostatic hyperplasia.

PMID- 11203693
TI  - Bibliography. Current world literature. Urinary tract infections and sexually
      transmitted diseases.

PMID- 11203694
TI  - Skin cell induction of calcitonin gene-related peptide in embryonic sensory
      neurons in vitro involves activin.
AB  - Target skin cells induce the neuropeptide calcitonin gene-related peptide (CGRP)
      in naive embryonic dorsal root ganglion (DRG) neurons in vitro, but the molecular
      basis of that induction is not known. Recombinant activin or bone morphogenetic
      proteins (BMPs) dramatically increase the number of sensory neurons with CGRP and
      substance P in vitro (X. Ai et al., 1999, Mol. Cell. Neurosci. 14, 506-518).
      These experiments were designed to test if activin or BMPs accounted for the CGRP
      inductive activity by skin cells. To identify factors from skin that induce CGRP,
      we developed a bioassay in which embryonic DRG neurons isolated before peripheral
      target contact in vivo are challenged in vitro with specific factors. Conditioned
      medium from an embryonic rat skin cell line induced neuronal CGRP expression, and
      induction was blocked by follistatin, implicating transforming growth factor
      family members. Immunoblot analysis revealed that the skin cell line medium
      contained several activin and bone morphogenetic protein moieties. Antibody
      specific to activin neutralized most of the CGRP-inductive activity in skin
      conditioned medium. These data indicate that the CGRP-inductive action of skin
      cells involves activin and establish activin as a candidate regulator of this
      sensory neuropeptide phenotype during development.

PMID- 11203695
TI  - Are pioneer axons guided by regulatory gene expression domains in the zebrafish
      forebrain? High-resolution analysis of the patterning of the zebrafish brain
      during axon tract formation.
AB  - Although the principles of axon growth are well understood in vitro the
      mechanisms guiding axons in vivo are less clear.  It has been postulated that
      growing axons in the vertebrate brain follow borders of neuroepithelial cells
      expressing specific  regulatory genes. In the present study we reexamined this
      hypothesis by analysing the earliest growing axons in the  forebrain of embryonic
      zebrafish. Confocal laser scanning microscopy was used to determine the
      spatiotemporal  relationship between growing axons and the expression pattern of
      eight regulatory genes in zebrafish brain. Pioneer axons  project either
      longitudinally or dorsoventrally to establish a scaffold of axon tracts during
      this developmental period. Each  of the regulatory genes was expressed in
      stereotypical domains and the borders of some were oriented along dorsoventral
      and  longitudinal planes. However, none of these borders clearly defined the
      trajectories of pioneer axons. In two cases axons  coursed in proximity to the
      borders of shh and pax6, but only for a relatively short portion of their
      pathway. Only later  growing axons were closely apposed to the borders of some
      gene expression domains. These results suggest that pioneer  axons in the
      embryonic forebrain do not follow continuous pathways defined by the borders of
      regulatory gene expression  domains.

PMID- 11203696
TI  - The pitx2 homeobox protein is required early for endoderm formation and nodal
      signaling. .
AB  - Nodal and Nodal-related factors play fundamental roles in a number of
      developmental processes,   including mesoderm and endoderm formation, patterning
      of the anterior neural plate, and determination   of bilateral asymmetry in
      vertebrates. pitx2, a paired-like homeobox gene, has been proposed to act  
      downstream of Nodal in the gene cascade providing left-right cues to the
      developing organs. Here, we   report that pitx2 is required early in the Nodal
      signaling pathway for specification of the endodermal and   mesodermal germ
      layers. We found that pitx2 is expressed very early during Xenopus and zebrafish 
      development and in many regions where Nodal signaling is required, including the
      presumptive   mesoderm and endoderm at the blastula and gastrula stages and the
      prechordal mesoderm at later   stages. In Xenopus embryos, overexpression of
      pitx2 caused ectopic expression of goosecoid and   sox-17 and interfered with
      mesoderm formation. Overexpression of pitx2 in Xenopus animal cap   explants
      partially mimics the effects of Nodal overexpression, suggesting that pitx2 is a
      mediator of   Nodal signaling during specification of the endoderm and prechordal
      plate, but not during mesoderm   induction. We further demonstrate that pitx2 is
      induced by Nodal signaling in Xenopus animal caps and   that the early expression
      of zebrafish pitx2 is absent when the Nodal signaling pathway is inactive.  
      Inhibition of pitx2 function using a chimeric EnR-pitx2 blocked specification of
      the mesoderm and   endoderm and caused severe embryonic defects resembling those
      seen when Nodal signaling is   inhibited. Following inhibition of pitx2 function,
      the fate of ventral vegetal blastomeres was shifted from   an endodermal to a
      more mesodermal fate, an effect that was reversed by wild-type pitx2. Finally, we
      show that inhibition of pitx2 function interferes with the response of cells to
      Nodal signaling. Our results   provide direct evidence that pitx2 function is
      required for normal specification of the endodermal and   mesodermal germ layers.

PMID- 11203698
TI  - MyoD cannot compensate for the absence of myogenin during skeletal muscle
      differentiation in murine embryonic stem cells.
AB  - myogenin (-/-) mice display severe skeletal muscle defects despite expressing
      normal levels of MyoD.   The failure of MyoD to compensate for myogenin could be
      explained by distinctions in protein function   or by differences in patterns of
      gene expression. To distinguish between these two possibilities, we   compared
      the abilities of constitutively expressed myogenin and MyoD to support muscle  
      differentiation in embryoid bodies made from myogenin (-/-) ES cells.
      Differentiated embryoid bodies   from wild-type embryonic stem (ES) cells made
      extensive skeletal muscle, but embryoid bodies from   myogenin (-/-) ES cells had
      greatly attenuated muscle-forming capacity. The inability of myogenin (-/-)   ES
      cells to generate muscle was independent of endogenous MyoD expression. Skeletal
      muscle was   restored in myogenin (-/-) ES cells by constitutive expression of
      myogenin. In contrast, constitutive   expression of MyoD resulted in only
      marginal enhancement of skeletal muscle, although myocyte   numbers greatly
      increased. The results indicated that constitutive expression of MyoD led to
      enhanced   myogenic commitment of myogenin (-/-) cells but also indicated that
      committed cells were impaired in   their ability to form muscle sheets without
      myogenin. Thus, despite their relatedness, myogenin's role in   muscle formation
      is distinct from that of MyoD, and the distinction cannot be explained merely by 
      differences in their expression properties.

PMID- 11203697
TI  - Neurogenin2 expression in ventral and dorsal spinal neural tube progenitor cells
      is regulated by distinct enhancers.
AB  - The basic helix-loop-helix transcription factor Neurogenin2 (NGN2) is expressed
      in distinct populations   of neural progenitor cells within the developing
      central and peripheral nervous systems. Transgenic   mice containing ngn2/lacZ
      reporter constructs were used to study the regulation of ngn2 in the   developing
      spinal cord. ngn2/lacZ transgenic embryos containing sequence found 5' or 3' to
      the ngn2   coding region express lacZ in domains that reflect the spatial and
      temporal expression profile of   endogenous ngn2. A 4.4-kb fragment 5' of ngn2
      was sufficient to drive lacZ expression in the ventral   neural tube, whereas a
      1.0-kb fragment located 3' of ngn2 directed expression to both dorsal and  
      ventral domains. Persistent -gal activity revealed that the NGN2 progenitor cells
      in the dorsal domain   give rise to a subset of interneurons that send their
      axons to the floor plate, and the NGN2 progenitors   in the ventral domain give
      rise to a subset of motor neurons. We identified a discrete element that is  
      required for the activity of the ngn2 enhancer specifically in the ventral neural
      tube. Thus, separable   regulatory elements that direct ngn2 expression to
      distinct neural progenitor populations have been   defined.

PMID- 11203699
TI  - Expression and function of a stem cell promoter for the murine CBFalpha2 gene:
      distinct roles and regulation in natural killer and T cell development.
AB  - The Runt family transcription factor CBFalpha2 (AML1, PEBP2alphaB, or Runx1) is
      required by hematopoietic stem cells and expressed at high levels in T-lineage
      cells. In human T cells CBFalpha2 is usually transcribed from a different
      promoter (distal promoter) than in myeloid cells (proximal promoter), but the
      developmental and functional significance of this promoter switch has not been
      known. Here, we report that both coding and noncoding sequences of the distal 5'
      end are highly conserved between the human and the murine genes, and the distal
      promoter is responsible for the overwhelming majority of CBFalpha2 expression in
      murine hematopoietic stem cells as well as in T cells. Distal promoter activity
      is maintained throughout T cell development and at lower levels in B cell
      development, but downregulated in natural killer cell development. The distal N
      terminal isoform binds to functionally important regulatory sites from known
      target genes with two- to threefold higher affinity than the proximal N-terminal
      isoform. Neither full-length isoform alters growth of a myeloid cell line under
      nondifferentiating conditions, but the proximal isoform selectively delays
      mitotic arrest of the cell line under differentiating conditions, resulting in
      the generation of greater numbers of neutrophils.

PMID- 11203700
TI  - Gdf11 is a negative regulator of chondrogenesis and myogenesis in the developing
      chick limb.
AB  - GDF11, a new member of the TGF-beta gene superfamily, regulates
      anterior/posterior patterning in the   axial skeleton during mouse embryogenesis.
      Gdf11 null mice display skeletal abnormalities that appear   to represent
      anterior homeotic transformations of vertebrae consistent with high levels of
      Gdf11   expression in the primitive streak, presomitic mesoderm, and tail bud.
      However, despite strong Gdf11   expression in the limb throughout development,
      this structure does not appear to be affected in the   knockout mice. In order to
      understand this dichotomy of Gdf11 expression versus Gdf11 function, we  
      identified the chicken Gdf11 gene and studied its role during limb formation. In
      the early limb bud,   Gdf11 transcripts are detected in the subectodermal
      mesoderm at the distal tip, in a region overlapping   the progress zone. At these
      stages, Gdf11 is excluded from the central core mesenchyme where  
      precartilaginous condensations will form. Later in development, Gdf11 continues
      to be expressed in the   distal most mesenchyme and can also be detected more
      proximally, in between the forming skeletal   elements. When beads incubated in
      GDF11 protein were implanted into the early wing bud, GDF11   caused severe
      truncations of the limb that affected both the cartilage elements and the muscle.
      Limb   shortening appeared to be the result of an inhibition of chondrogenesis
      and myogenesis and using an   in vitro micromass assay, we confirmed the negative
      effects of GDF11 on both myogenic and   chondrogenic cell differentiation.
      Analysis of molecular markers of skeletal patterning revealed that   GDF11
      induced ectopic expression of Hoxd-11 and Hoxd-13, but not of Hoxa-11, Hoxa-13,
      or the Msx   genes. These data suggest that GDF11 may be involved in controlling
      the late distal expression of the   Hoxd genes during limb development and that
      misregulation of these Hox genes by excess GDF11   may cause some of the observed
      alterations in skeletal element shape. In addition, GDF11 induced the  
      expression of its own antagonist follistatin, indicating that the activity of
      GFD11 may be limited by a   negative feedback mechanism. The data from our
      studies in the chick suggest that Gdf11 plays a role   in the formation and
      development of the avian limb skeleton.

PMID- 11203701
TI  - TNF signaling via the ligand-receptor pair ectodysplasin and edar controls the
      function of epithelial signaling centers and is regulated by Wnt and activin
      during tooth organogenesis.
AB  - Ectodermal dysplasia syndromes affect the development of several organs,
      including hair, teeth, and   glands. The recent cloning of two genes responsible
      for these syndromes has led to the identification of a   novel TNF family ligand,
      ectodysplasin, and TNF receptor, edar. This has indicated a developmental  
      regulatory role for TNFs for the first time. Our in situ hybridization analysis
      of the expression of   ectodysplasin (encoded by the Tabby gene) and edar
      (encoded by the downless gene) during mouse   tooth morphogenesis showed that
      they are expressed in complementary patterns exclusively in   ectodermal tissue
      layer. Edar was expressed reiteratively in signaling centers regulating key steps
      in   morphogenesis. The analysis of the effects of eight signaling molecules in
      the TGFbeta, FGF, Hh, Wnt, and   EGF families in tooth explant cultures revealed
      that the expression of edar was induced by activinbetaA,   whereas Wnt6 induced
      ectodysplasin expression. Moreover, ectodysplasin expression was   downregulated
      in branchial arch epithelium and in tooth germs of Lef1 mutant mice, suggesting
      that   signaling by ectodysplasin is regulated by LEF-1-mediated Wnt signals. The
      analysis of the signaling   centers in tooth germs of Tabby mice (ectodysplasin
      null mutants) indicated that in the absence of   ectodysplasin the signaling
      centers were small. However, no downstream targets of ectodysplasin   signaling
      were identified among several genes expressed in the signaling centers. We
      conclude that   ectodysplasin functions as a planar signal between ectodermal
      compartments and regulates the function,   but not the induction, of epithelial
      signaling centers. This TNF signaling is tightly associated with   epithelial
      mesenchymal interactions and with other signaling pathways regulating
      organogenesis. We   suggest that activin signaling from mesenchyme induces the
      expression of the TNF receptor edar in the   epithelial signaling centers, thus
      making them responsive to Wnt-induced ectodysplasin from the nearby   ectoderm.
      This is the first demonstration of integration of the Wnt, activin, and TNF
      signaling pathways.

PMID- 11203702
TI  - Functional domains of the LIM homeodomain protein Xlim-1 involved in negative
      regulation, transactivation, and axis formation in Xenopus embryos.
AB  - The Xenopus LIM homeodomain protein Xlim-1 is specifically expressed in the
      Spemann organizer   region and assumed to play a role in the establishment of the
      body axis as a transcriptional activator. To   further elucidate the mechanism
      underlying the regulation of its transcriptional activity, we focused on the  
      region C-terminal to the homeodomain of Xlim-1 (CT239-403) and divided it into
      five regions, CCR1-5   (C-terminal conserved regions), based on similarity
      between Xlim-1 and its paralog, Xlim-5. The role of   Xlim-1 CT239-403 in the
      Spemann organizer was analyzed by assaying the axis-forming ability of a series  
      of CCR-mutated constructs in Xenopus embryos. We show that high doses of Xlim-1
      constructs deleted   of CCR1 or CCR2 initiate secondary axis formation in the
      absence of its coactivator Ldb1   (LIM-domain-binding protein 1), suggesting that
      CCR1 and CCR2 are involved in negative regulation of   Xlim-1. In contrast, while
      Xlim-1 is capable of initiating secondary axis formation at low doses in the  
      presence of Ldb1, deletion of CCR2 (aa 275-295) or substitution of five conserved
      tyrosines in CCR2 with   alanines (CCR2-5YA) abolished the activity. In addition,
      UAS-GAL4 one-hybrid reporter assays in   Xenopus showed that CCR2, but not CCR2
      5YA, with its flanking regions (aa 261-315) functions as a   transactivation
      domain when fused to the GAL4 DNA-binding domain. Finally, we show that none of
      the   known transcriptional coactivators tested (CBP, SRC-1, and TIF2) interacts
      with the Xlim-1 transactivation   domain (aa 261-315). Thus, Xlim-1 not only
      contains a unique tyrosine-rich activation domain but also   contains a negative
      regulatory domain in CT239-403, suggesting a complex regulatory mechanism  
      underlying the transcriptional activity of Xlim-1 in the organizer.

PMID- 11203703
TI  - Autonomous transition into meiosis of mouse fetal germ cells in vitro and its
      inhibition by gp130-mediated signaling.
AB  - Mouse primordial germ cells (PGCs) arrive at the urogenital ridge (UGR) at around
      10.5 days postcoitum   (dpc). They proliferate until around 13.5 dpc, then enter
      into meiosis in the female or become mitotically   arrested in the male gonads.
      In this study, meiotic transition of mouse PGCs was examined in vitro.   Female
      PGCs obtained from UGRs or genital ridges at 10.5-11.5 dpc began to express
      meiosis-specific   genes, Scp3 and Dmc1, after dissociation and cultivation on
      feeder cells for several days. Meiotic   transition into the leptotene stage was
      confirmed by the formation of axial cores. Male PGCs at 10.5-11.5   dpc and
      migratory PGCs obtained from mesenteries at 10.5 dpc also expressed Scp3 and
      formed axial   cores after several days of culture, supporting the hypothesis
      that PGCs are capable of entering meiosis   before arriving at the UGR. gp130
      mediated signaling, known to promote survival/growth of PGCs and   also to
      inhibit the differentiation of embryonic stem cells, suppressed the expression of
      Scp3 in PGCs and   inhibited the following formation of axial cores in vitro.
      This novel activity of gp130-mediated signaling may   provide some clues for the
      understanding of pluripotency of mammalian germ-line cells and/or the sex  
      differentiation of fetal germ cells.

PMID- 11203704
TI  - The Caenorhabditis elegans peb-1 gene encodes a novel DNA-binding protein
      involved in morphogenesis of the pharynx, vulva, and hindgut.
AB  - Gene expression in the Caenorhabditis elegans pharynx is regulated in part by
      organ-specific signals, which in the myo-2 gene target a regulatory sequence
      called the C sub-element. C sub-element activity requires the organ specification
      factor PHA-4, a winged-helix transcription factor expressed in all pharyngeal
      cells. To identify additional factors involved in pharyngeal organogenesis, we
      performed a yeast one-hybrid screen for C sub-element binding proteins. Here we
      describe the novel factor PEB-1, which is coexpressed with PHA-4 in many
      pharyngeal cell types, including muscles, epithelial cells, marginal cells, and
      glands, but is undetectable in the pharyngeal nervous system. PEB-1 is also
      detected outside the pharynx in cells surrounding the rectum and vulva, as well
      as in the germ line. Reduction of peb-1 function using RNAi results in
      morphological defects in the somatic tissues in which peb-1 is expressed. We have
      mapped the PEB-1 DNA-binding domain to a 158-residue region, which is unrelated
      to known DNA-binding proteins but shares some sequence similarity to the
      Drosophila Mod(mdg4) proteins. PEB-1 specifically recognizes a site in the C
      subelement that partially overlaps the PHA-4 binding site. Both the PEB-1 and the
      PHA-4 binding sites are necessary for strong C sub-element enhancer activity in
      some cells in which these factors are coexpressed. In contrast the PEB-1 site is
      dispensable for C sub-element activity in pharyngeal neurons. We propose that PEB
      1 functions with PHA-4 to activate target gene expression in cells in which they
      are coexpressed.

PMID- 11203705
TI  - Role of caspases and mitochondria in the steroid-induced programmed cell death of
      a motoneuron during metamorphosis.
AB  - Accessory planta retractor (APR) motoneurons of the hawk moth, Manduca sexta,
      undergo a   segment-specific pattern of programmed cell death (PCD) 24 to 48 h
      after pupal ecdysis (PE). Cell culture   experiments show that the PCD of APRs in
      abdominal segment 6 [APR(6)s] is a cell-autonomous   response to the steroid
      hormone 20-hydroxyecdysone (20E) and involves mitochondrial demise and cell  
      shrinkage. Twenty-four hours before PE, at stage W3-noon, APR(6)s require further
      20E exposure and   protein synthesis (as tested with cycloheximide) to undergo
      PCD, and death can be blocked by a   broad-spectrum caspase inhibitor. By PE,
      death is 20E- and protein synthesis-independent and the   caspase inhibitor
      blocks cell shrinkage but not loss of mitochondrial function. Thus, the
      commitment to   mitochondrial demise precedes the commitment to execution events.
      The phenotype of necrotic cell death   induced by a mitochondrial electron
      transfer inhibitor differs unambiguously from 20E-induced PCD. By   inducing PCD
      pharmacologically, the readiness of APR(6)s to execute PCD was found to increase
      during   the final larval instar. These data suggest that the 20E-induced PCD of
      APR(6)s includes a   premitochondrial phase which includes 20E-induced synthetic
      events and apical caspase activity, a   mitochondrial phase which culminates in
      loss of mitochondrial function, and a postmitochondrial phase   during which
      effector caspases are activated and APR(6) is destroyed.

PMID- 11203707
TI  - Left sided inferior vena cava with sinus venosus type atrial septal defect.
AB  - A patient with left sided inferior vena cava and sinus venosus type atrial septal
      defect is presented. The patient was situs solitus, had abnormal pulmonary venous
      drainage and the left sided inferior caval vein returned to its usual route after
      the renal vein junction.

PMID- 11203708
TI  - Electrocardiographic issues related to action potential phases 1 and 2 on the
      occasion of a case of accidental mild hypothermia.
AB  - A 29-year-old man was accidentally exposed to cold and his mild hypothermia
      uniquely resulted in the transient exaggeration of his normothermic
      electrocardiographic findings, which were consistent with early repolarization. A
      unifying concept of clinical entities with similar J wave and ST segment
      elevation (J-ST syndrome) is proposed.

PMID- 11203709
TI  - Variant angina with a strong spasmodic trait.
AB  - A 55-year-old man came to the hospital because of chest pain, mostly occurring in
      the early morning at rest. He had to get isosorbide dinitrate intravenously with
      continuous infusion. Following ergonovine provocation test, total occlusion of
      mid-left anterior descending artery was identified with marked elevation of ST
      segment as exercise test showed despite isosorbide dinitrate.

PMID- 11203710
TI  - Aneurysm of sinus of Valsalva with extensive dissection of interventricular
      septum and left ventricular free wall.

PMID- 11203711
TI  - Early coronary disease in diabetic male patients.

PMID- 11203712
TI  - Unruptured left ventricular pseudoaneurysm.

PMID- 11203714
TI  - Effects of video information on pre-colonoscopy anxiety and knowledge: a
      randomized trial.

PMID- 11203713
TI  - Postal consent for upper gastrointestinal endoscopy.

PMID- 11203715
TI  - Focus on... Christian Albert Theodor Billroth (1829-1894).

PMID- 11203716
TI  - Differences in umbilical venous and arterial leptin levels by mode of delivery.

PMID- 11203717
TI  - Primary psoa abscess.

PMID- 11203718
TI  - Klippel-Feil syndrome in the prehispanic population of El Hierro (Canary
      Islands).

PMID- 11203719
TI  - Haematopoietic stem cell transplantation (HSCT) in a patient with Sjogren's
      syndrome and lung malt lymphoma cured lymphoma not the autoimmune disease.

PMID- 11203720
TI  - Castleman's disease.

PMID- 11203721
TI  - Intranasal midazolam for treating febrile seizures in children. Buccal midazolam
      for childhood seizures at home preferred to rectal diazepam.

PMID- 11203723
TI  - Training overseas doctors in the United Kingdom. We need to debunk the myth about
      training. .

PMID- 11203724
TI  - Training overseas doctors in the United Kingdom. Consider moving to the US.

PMID- 11203725
TI  - Training overseas doctors in the United Kingdom. Frequency of PLAB tests should
      match available jobs.

PMID- 11203726
TI  - Orlistat associated with hypertension. Roche concludes that there is not evidence
      of a casual association.

PMID- 11203727
TI  - Orlistat associated with hypertension. Digit preference lays conclusions about
      orlistat open to doubt.

PMID- 11203728
TI  - Familial hypercholesterolaemia is underdiagnosed after AMI.

PMID- 11203729
TI  - Psychiatric disorders and risky sexual behaviour. Paper did not mention sexual
      orientation.

PMID- 11203730
TI  - Psychiatric disorders and risky sexual behavior. Risky sexual behaviour is part
      of two disorders examined. .

PMID- 11203731
TI  - Screening for medium chain acyl-CoA dehydrogenase deficiency has still not been
      evaluated. .

PMID- 11203732
TI  - Cholera sweeps through South African province. .

PMID- 11203733
TI  - "Health weather forecasts" to be piloted in England. .

PMID- 11203734
TI  - Matrix metalloproteinases and tissue inhibitors of metalloproteinases in synovial
      fluids of patients with temporomandibular joint osteoarthritis.
AB  - AIMS: Imbalance between matrix metalloproteinases (MMPs) and their inhibitors
      (TIMPs) may be involved in the breakdown of articular cartilage matrix of the
      temporomandibular joint (TMJ). In this study, MMPs, TIMPs, and MMP-1/TIMP-1
      complex levels were examined in TMJ synovial fluid samples aspirated from TMJ
      osteoarthritis (OA) patients (2 males, 8 females; mean age, 29.7 years) and
      asymptomatic control subjects (2 males, 8 females; mean age, 23.6 years) to
      determine the likelihood of increased proteolytic activity in the OA joints.
      METHODS: The various types of MMPs and TIMPs were detected by Western blotting
      with monoclonal antibodies and gelatin zymography. The MMP-1/TIMP-1 complex level
      was measured by an enzyme-linked immunosorbent assay kit. All aspirates were
      first analyzed for total protein content and then individually diluted to make
      the total protein levels equivalent. RESULTS: The mean MMP-1/TIMP-1 complex
      concentration in the synovial fluids of the OA patients was 3.92 +/- 1.39 ng/mL;
      this value was significantly lower (P < 0.05) than the value from control
      subjects (5.46 +/- 1.32 ng/mL). Matrix metalloproteinase-1 (52 kDa), MMP-3 (57
      kDa), TIMP-1 (28 kDa), and TIMP-2 (26 kDa) were detected in all of the normal and
      the OA samples. However, MMP-1 (28 kDa), MMP-2 (72 kDa), MMP-3 (45 kDa), and MMP
      9 (83 kDa) were detected in higher concentration in the OA samples. CONCLUSION:
      These findings suggest a strong association between the OA-active joints and the
      presence of biologically active forms of known tissue degradation enzymes (MMP-1,
      MMP-3, and MMP-9).

PMID- 11203735
TI  - Topical application of capsaicin for the treatment of localized pain in the
      temporomandibular joint area.
AB  - AIMS: To determine the effectiveness of topical capsaicin cream application on
      localized pain in the temporomandibular joint (TMJ) area. METHODS: A randomized,
      double-blind, placebo-controlled study was conducted on 30 patients suffering
      from unilateral pain in the TMJ area. Patients were randomly divided into
      experimental and placebo groups; they were instructed to apply 0.025% capsaicin
      cream or its vehicle to the painful TMJ area 4 times daily for 4 weeks.
      Subjective parameters of present pain, most severe pain, effect of pain on daily
      activities, and pain relief were assessed each week on a visual analog scale.
      Muscle and joint sensitivity to palpation on the painful and contralateral joints
      and maximal mouth opening (assisted/passive and non-assisted/active) were
      examined weekly by the same experienced examiner. RESULTS: Capsaicin cream
      produced no statistically significant influence on measured variables when
      compared to placebo. Both experimental and placebo groups showed statistically
      significant improvement in most variables during the experiment. CONCLUSION: The
      factor of time had a major effect in the non-specific improvement of the
      parameters assessed. The placebo effect played an important role in the treatment
      of patients with pain in the TMJ area.

PMID- 11203736
TI  - Plasma and serum serotonin levels and their relationship to orofacial pain and
      anxiety in fibromyalgia.
AB  - AIMS: Serum serotonin levels (S-5-HT) have been reported to be reduced in
      patients with fibromyalgia and to show a negative correlation with pain. We
      hypothesized that one mechanism behind this could be that platelets are activated
      to release 5-HT into the plasma compartment (P-5-HT), which then binds to
      nociceptors. The aims of this study were therefore to investigate the relation
      between P-5-HT and S-5-HT and their relationship versus orofacial pain and
      anxiety in fibromyalgia. METHODS: Twelve patients with fibromyalgia, 12 patients
      with rheumatoid arthritis, and 12 healthy individuals participated in the study.
      Pain measures used were pain intensity assessed with a visual analog scale, pain
      drawings, and influence of pain on daily living activities (ADL). The Spielberger
      State and Trait Anxiety Inventory (STAI) scale was used for self-rating of
      anxiety levels. The participants were examined clinically, and the pressure pain
      threshold (PPT) over the masseter muscle was assessed. Finally, venous blood was
      collected for analysis of P-5-HT and S-5-HT. RESULTS: The ratio between P-5-HT
      and S-5-HT was calculated to determine the relative plasma fraction of serotonin
      (RPS). Patients with fibromyalgia showed significantly lower S-5-HT than did
      patients with rheumatoid arthritis. They also showed significantly higher STAI
      scores and tender point index of orofacial muscles and significantly lower PPT
      than the healthy individuals. High RPS was associated with high ADL and STAI
      scores. CONCLUSION: This study indicates that a high level of plasma serotonin in
      relation to serum level is associated with pain discomfort and increased anxiety
      in fibromyalgia.

PMID- 11203738
TI  - Orofacial pain: quo vadis?

PMID- 11203737
TI  - Generic pain intensity scores are affected by painful comorbidity.
AB  - AIMS: To determine the degree to which the generic pain intensity rating (i.e.,
      overall and without reference to a particular body site) of facial pain patients
      being seen in a specialty setting for facial pain is influenced by painful
      comorbidity in body parts other than the face. METHODS: In this prospective
      study, 40 consecutive female temporomandibular pain patients rated their generic
      pain on a 100-mm visual analog scale. After marking all painful body sites on
      pain drawings, patients were asked to rate the pain intensity for each of the
      indicated pain sites; the patients did not have access to the generic pain
      intensity score. Pearson's correlation coefficient was used to correlate the
      generic pain intensity score with site-specific pain intensity ratings, their
      mean and maximum, and the number of pain sites. RESULTS: The medians of the
      generic, maximum, and facial pain intensity scores were 49.5, 53, and 45.5,
      respectively. The generic pain intensity rating correlated more highly with the
      intensity scores reported for the most painful body site (r2 = 0.82; P < 0.001)
      than with the average rating across all painful sites (r2 = 0.62; P < 0.001), or
      the pain intensity score in the face (r2 = 0.61; P < 0.001). The number of pain
      sites did not correlate to any statistically significant degree with the generic
      pain intensity rating (r2 = 0.006; P = 0.65). CONCLUSION: The results of this
      study suggest that the maximum visual analog scale pain intensity score, observed
      in any body location, is a better reflection of the generic pain intensity rating
      than the corresponding score of the face. To avoid over-rating or underrating of
      facial pain intensity, patients should be instructed to provide site-specific
      pain intensity scores if painful comorbidity is present.

PMID- 11203739
TI  - Personality characteristics and accompanying symptoms in temporomandibular joint
      dysfunction, headache, and facial pain.
AB  - AIMS: Patients with different facial pain/headache pathologies usually complain
      of numerous accompanying symptoms relative to systemic dysfunctions or to the
      patient's personality characteristics. The purpose of this work was: (1) to
      determine the prevalence of accompanying symptoms in groups of patients with
      temporomandibular joint (TMJ) dysfunction and other types of facial pain or
      headache disorders, (2) to assess the patients' personality characteristics and
      anxiety levels, and (3) to see whether significant differences were found between
      the groups. METHODS: Two hundred forty-three patients were considered. They had
      TMJ intracapsular disorder (TMJ, n = 71), tension-type headache (TH, n = 52),
      migraine (M, n = 68), chronic daily headache (CDH, n = 26), or facial pain
      disorder as somatoform disorder (FP, n = 26). The presence of 23 symptoms was
      assessed; the Minnesota Multiphasic Personality Inventory (MMPI) and the
      Spielberger State and Trait Anxiety Inventory (STAI) were administered and the
      relative scores were calculated. Four different MMPI clusters (depressive,
      conversive, emotional, coper) were also considered. Intergroup differences were
      assessed by Chi-square analysis, 1-way analysis of variance, Bonferroni t test,
      and a logistic regression model and then standardized for gender and age, taking
      the tension-type headache group as a common reference group. RESULTS: The TMJ
      group had: (1) a lower prevalence of almost all symptoms; (2) significantly lower
      scores of several MMPI and of state anxiety; and (3) odds ratio values < 1 for
      all symptoms except phobias and for emotional, conversive, and depressive MMPI
      profiles. The FP and CDH groups had the highest prevalence of the majority of
      symptoms and higher MMPI and STAI scale elevations. CONCLUSION: It is concluded
      that some types of headache and facial pain seem to correlate with the presence
      of a number of accompanying symptoms and with some changes in personality. These
      changes are particularly relevant in patients with chronic daily headache and
      facial pain disorder. In contrast, patients with TMJ intracapsular disorders
      tended to show a low prevalence of accompanying symptoms and a normal personality
      profile.

PMID- 11203740
TI  - Psychosocial profiles of patients with burning mouth syndrome.
AB  - AIMS: Burning mouth syndrome (BMS) is estimated to affect 1 to 5% of the adult
      population, with women experiencing symptoms more frequently than men. The
      purpose of this study was to examine the psychosocial profiles of BMS patients to
      determine whether psychologic factors are related to pain reports. Based on
      previous literature, it was hypothesized that patients with BMS would be
      characterized by clinical elevations on standardized psychologic assessment
      instruments that included the Revised Symptom Checklist (SCL-90R) and the
      Multidimensional Pain Inventory (MPI). METHODS: Thirty-three BMS patients
      completed the McGill Pain Questionnaire, MPI, and SCL-90R during their initial
      clinical evaluation session. The SCL-90R and MPI data were then summarized and
      presented in standardized format (T-scores) to enable meaningful comparisons with
      larger population samples that included both a chronic pain population and a
      normal nonclinical sample. RESULTS: The T-score for the overall pain severity on
      the MPI was 40.8 (SD 12.8). For the entire BMS sample, there was no evidence for
      significant clinical elevations on any of the SCL-90R subscales, including
      depression, anxiety, and somatization. Moreover, patients reported significantly
      fewer disruptions in normal activities as a result of their oral burning pain
      than did a large sample of chronic pain patients. CONCLUSION: These findings
      indicate that, as a group, this sample of BMS patients did not report significant
      psychologic distress. There were, however, individual cases (7 of 33, or 21%)
      where psychometric data indicated a likelihood of psychologic distress, and
      further evaluation by a competent health professional would be warranted for
      those individuals.

PMID- 11203741
TI  - Dynamic magnetic resonance imaging technique for the study of the
      temporomandibular joint.
AB  - AIMS: Echo planar imaging (EPI) is an ultrafast magnetic resonance imaging (MRI)
      technique that can scan a single frame in less than a second. The aim of this
      study was to use the EPI technique to develop a new dynamic MRI protocol for the
      temporomandibular joint (TMJ). METHODS: Basic fast-field echo and EPI pulse
      sequences were used for dynamic studies of the TMJ. The subjects were instructed
      to perform spontaneous, continuous, slow opening/closing movements without visual
      or audio feedback. Different scanning parameter settings were explored to
      optimize the results. RESULTS: With an opening/closing movement of approximately
      6 to 7 seconds per cycle, the proposed protocol yielded a good insight into the
      relative motion between condyle and disc. It was also possible to see the
      deformation of the disc during movement. CONCLUSION: The EPI technique is a non
      invasive technique that can be used for dynamic imaging study of a slow but
      continuous, uninterrupted jaw movement.

PMID- 11203742
TI  - Ninth World Congress International Association for the Study of Pain. August 22
      27, 1999 Vienna, Austria.

PMID- 11203743
TI  - The efficacy of potassium salts as agents for treating dentin hypersensitivity.
AB  - Formulations containing potassium salts (e.g., chloride, nitrate, citrate,
      oxalate) are widely used for treating dentin hypersensitivity (DH). The purpose
      of this review was to evaluate evidence for the clinical efficacy of potassium
      salts in reducing DH and also to consider the biologic basis for any effects.
      Literature searches were used to identify reports of clinical trials of potassium
      containing preparations. Searches revealed 3 trials of potassium nitrate
      solutions or gels; 2 trials of mouthwashes containing potassium nitrate or
      citrate; 6 trials of potassium oxalates; and 16 double-blind randomized trials of
      toothpastes containing potassium nitrate, chloride, or citrate. The toothpaste
      studies provided quantitative data on treatment effects. These outcome measures
      were expressed as percentage reductions in sensitivity to cold air and mechanical
      stimulation and the patients' subjective reports. Trials of topically applied
      solutions yielded inconsistent results. Potassium-containing mouthwashes produced
      significant reductions in sensitivity. All potassium-containing toothpastes
      produced a significant reduction in sensitivity to tactile and air stimuli, as
      well as subjectively reported sensitivity. In most studies, the active agent
      (potassium) was superior to the minus-active control (placebo), but a few of the
      more recent trials have demonstrated significant placebo effects. It is
      postulated that potassium ions released from toothpastes diffuse along the
      dentinal tubules to inactivate intradental nerves. However, this principle has
      never been confirmed in intact human teeth. The mechanism of the desensitizing
      effects of potassium-containing toothpastes remains uncertain at present.

PMID- 11203744
TI  - Does the ovarian cycle influence the pressure-pain threshold of the masticatory
      muscles in symptom-free women?
AB  - AIMS: To test the hypothesis that the ovarian cycle influences the pressure-pain
      threshold of the masticatory muscles. METHODS: Eighteen healthy women with a
      regular menstrual cycle (28 +/- 2 days), ranging in age from 18 to 35 years,
      participated in the study. For each subject, pressure-pain thresholds (PPTs) of
      the masseter and temporalis muscles were assessed at 4 muscular sites by means of
      an electronic algometer. Measurements were taken at 4 separate sessions across
      the menstrual cycle corresponding to the following phases: menstrual, follicular,
      periovulatory, and luteal. Menstrual cycle phases were determined by a pelvic
      ultrasonographic screening. The study was carried out in a single-blind design,
      and the initial session was randomly determined for each individual. Data
      collected were analyzed by repeated-measures analysis of variance. RESULTS: The
      findings suggest that the PPTs of several masticatory muscles (2 of 4) are
      influenced by the ovarian cycle, but to a minor extent (P < 0.05), and the
      influence is of limited clinical relevance. CONCLUSION: In healthy subjects,
      there is a link between mechanical sensitivity of the masticatory muscles and
      fluctuation of the ovarian hormones. The relationship between PPTs of the
      masticatory muscles and the ovarian cycle should be also investigated in patients
      with temporomandibular disorders and/or orofacial pain conditions.

PMID- 11203745
TI  - Somatic, affective, and pain characteristics of chronic TMD patients with sexual
      versus physical abuse histories.
AB  - AIMS: This study examined whether temporomandibular disorder (TMD) patients with
      sexual versus physical abuse histories differ in their pain report, psychological
      distress, and somatic symptoms. METHODS: Participants were 114 female TMD
      patients. The sample was divided into 3 groups based on abuse history: sexual
      abuse, physical abuse, or no abuse. Abuse histories were assessed with a
      structured clinical interview. Measures used included the McGill Pain
      Questionnaire, the State-Trait Anxiety Inventory, the Beck Depression Inventory,
      and the Pennebaker Inventory of Limbic Languidness. Group differences were
      analyzed by analysis of variance and Bonferroni post hoc comparisons. RESULTS:
      Temporomandibular disorder patients with a history of physical abuse reported
      significantly more pain, anxiety, and depressive symptoms than did patients with
      a history of sexual abuse or no history of abuse. Furthermore, the results
      suggest that TMD patients with a sexual abuse history are not significantly
      different from patients with no abuse history across the domains studied.
      CONCLUSION: Based on the differences found, it can be argued that assessment of
      physical abuse histories by appropriately trained clinicians should be a routine
      part of any multimodal assessment of female chronic TMD patients.

PMID- 11203746
TI  - Influence of biased clinician statements on patient report of referred pain.
AB  - AIMS: The purpose of this study was to examine the influence of clinician bias on
      patients' reports of referred pain. Diagnosis of temporomandibular disorders is
      dependent on subjective reports of pain and referred pain upon manual muscle
      palpation. The influence of biased clinician statements in such subjective
      reports has not been previously investigated. METHODS: Forty subjects with pain
      and who met specific inclusion criteria were randomly assigned to 1 of 2
      experimental groups. One group was subjected to a standardized biasing statement,
      while the other group was not. Tender points in the masseter muscle were then
      stimulated with a pressure algometer to the pressure-pain threshold. Subjects
      then recorded the presence or absence, location, intensity, and unpleasantness of
      any referred pain. State-trait anxiety and social desirability were also assessed
      to explore the possibility that anxiety levels or subjects' desires to please the
      experimenter influenced results. RESULTS: The biased group reported increased
      presence (P < 0.01), intensity (P < 0.001), and unpleasantness (P < 0.003) of
      referred pain as compared to the non-biased group. There were no differences
      between groups on state-trait anxiety or social desirability (P > 0.05).
      CONCLUSION: These data suggest that patient reports of pain referral may be
      subject to clinician bias, and recommendations to control this bias are offered.

PMID- 11203747
TI  - Individualized oblique-axial magnetic resonance imaging for improved
      visualization of mediolateral TMJ disc displacement.
AB  - AIMS: A new individualized oblique-axial orientation of magnetic resonance
      imaging scans of the temporomandibular joint (TMJ), corrected to be perpendicular
      to the tangent of the posterior slope of the articular eminence, has been
      proposed to improve the representation of the disc. The aim of this study was to
      evaluate the quality of the images obtained with this new type of scanning plane
      and to assess the factors that can affect the scans. METHODS: Twenty-nine TMJs
      were scanned by the use of sagittal, conventional coronal, and individualized
      oblique-axial scanning planes. On the sagittal images, the angle alpha between
      the tangent of the posterior slope of the articular eminence and the vertical was
      measured, and the disc position was evaluated. For both imaging planes, 2
      examiners, blind to the scanning techniques, counted the number of conventional
      coronal and oblique-axial scans in which the disc was visible and in which the
      medial and lateral disc borders were well demarcated and evaluated the
      mediolateral disc position. RESULTS: The individualized oblique-axial technique
      was superior to the conventional coronal technique in depicting the disc and its
      medial and lateral demarcations (paired t test, P < 0.05). The possibility of
      correct diagnosis of the mediolateral disc position and the agreement between the
      observers in this evaluation were better with the oblique-axial technique than
      with the conventional technique (P < 0.05). This was particularly evident when
      the disc was anteriorly displaced. CONCLUSION: The individualized oblique-axial
      scanning planes should be used for a better representation of the disc/condyle
      complex mediolaterally if the disc is anteriorly displaced.

PMID- 11203748
TI  - Malignancy of the parotid gland with primary symptoms of a temporomandibular
      disorder.
AB  - The purpose of this case report is to highlight the possibility that malignant
      neoplasms of the deep lobe of the parotid gland may present as a
      temporomandibular disorder (TMD). Two patients who were eventually diagnosed with
      deep-lobe parotid tumors were retrospectively analyzed clinically,
      radiographically, and pathologically. For the first patient, there was a
      prolonged delay in establishing the correct diagnosis; for the second patient the
      delay was shorter. This was done primarily by computed tomographic examination.
      Despite aggressive surgical, radiotherapeutic, and chemotherapeutic treatment,
      both patients died from their malignant disease. All clinicians who treat TMD
      must be aware of the rare possibility of deep-lobe parotid tumors presenting as a
      TMD.

PMID- 11203749
TI  - Trigeminal neuralgia due to an acoustic neuroma in the cerebellopontine angle.
AB  - This case report first reviews the intracranial tumors associated with symptoms
      of trigeminal neuralgia (TN). Among patients with TN-like symptoms, 6 to 16% are
      variously reported to have intracranial tumors. The most common cerebellopontine
      angle (CPA) tumor to cause TN-like symptoms is a benign tumor called an acoustic
      neuroma. The reported clinical symptoms of the acoustic neuroma are hearing
      deficits (60 to 97%), tinnitus (50 to 66%), vestibular disturbances (46 to 59%),
      numbness or tingling in the face (33%), headache (19 to 29%), dizziness (23%),
      facial paresis (17%), and trigeminal nerve disturbances (hypesthesia,
      paresthesia, and neuralgia) (12 to 45%). Magnetic resonance imaging with
      gadolinium enhancement or computed tomography with contrast media are each
      reported to have excellent abilities to detect intracranial tumors (92 to 93%).
      This article then reports a rare case of a young female patient who was
      mistakenly diagnosed and treated for a temporomandibular disorder but was
      subsequently found to have an acoustic neuroma located in the CPA.

PMID- 11203750
TI  - The way forward.

PMID- 11203751
TI  - Pressure-pain threshold in the human tongue.
AB  - AIMS: A new pressure algometer was used to quantify the pressure-pain threshold
      (PPT) in the human tongue. METHODS: A custom-made device controlled by software
      and a personal computer was used to measure the PPT in the anterior part of the
      tongues of 14 young, healthy subjects. The PPT was measured at 3 different rates
      of pressure application on 3 occasions, 1 week apart. Data were evaluated with
      analysis of covariance and intraclass correlations. RESULTS: The prototype device
      had linear output characteristics within the operational range. The mean PPT
      ranged from 18 to 44 g. The PPT appeared to increase approximately linearly with
      increasing rate of pressure application (P < 0.001). There were no significant
      differences in the PPT on different experimental occasions. In individual
      subjects, the PPT was reliable and uniform. There were significant inter-subject
      differences in the PPT (P < 0.001). CONCLUSION: The PPT can be measured
      consistently in the anterior part of the tongue, provided the pressure rate is
      controlled. The new-pressure algometer appears to have potential clinical utility
      for quantifying sensation in the human tongue.

PMID- 11203752
TI  - Absolute and relative facial pressure-pain thresholds in healthy individuals.
AB  - AIMS: To investigate and compare absolute pressure-pain threshold (PPT) levels
      and ratios between craniofacial test and reference sites during consecutive PPT
      recordings, as well as over a 6-month period, in healthy individuals. This study
      also investigated PPT differences between genders and the clinical usefulness of
      different reference sites in the craniofacial region. METHODS: Twelve female and
      12 male healthy individuals participated in the first examination. Six months
      later, 9 females and all of the males returned for a second examination. An
      electronic algometer was used to make 5 consecutive recordings of PPTs with a 2
      minute interval at 3 reference sites: mental protuberance (PRO), first metacarpal
      bone (MET), and frontal bone (FRO), as well as at 3 test sites: temporomandibular
      joint, masseter muscle, and temporalis muscle. RESULTS: Absolute PPTs decreased
      significantly for all test sites during the 5 recordings, while they increased
      significantly between the examinations. No ratio with FRO as a reference site
      changed significantly. The males had significantly higher absolute PPTs than the
      females at PRO and FRO sites. CONCLUSION: This study shows that absolute PPT
      levels in healthy individuals change significantly during consecutive PPT
      recordings, as well as over a 6-month period; this limits the usefulness of such
      measurements. This study also shows that the use of relative PPTs with the FRO as
      a reference site is useful, both for comparison between groups and for
      longitudinal studies.

PMID- 11203753
TI  - Sex, gender, and pain.

PMID- 11203754
TI  - Gender differences in pain.
AB  - A review of the literature on gender and clinical pain reveals a disproportionate
      representation of women receiving treatment for many pain conditions and suggests
      that women report more severe pain, more frequent pain, and pain of longer
      duration than do men. Gender differences in pain perception have also been
      extensively studied in the laboratory, and ratings of experimentally induced pain
      also show some sex disparity, with females generally reporting lower pain
      thresholds and tolerance than males. However, there is little consensus on
      whether these apparent differences reflect the way men and women respond to pain,
      differing social rules for the expression of pain, or biologic differences in the
      way noxious stimuli are processed. In this paper, our working hypothesis is that
      the higher prevalence of chronic orofacial pain in women is a result of sex
      differences in generic pain mechanisms and of as-yet unidentified factors unique
      to the craniofacial system. We will review the evidence concerning gender
      differences in the prevalence of pain conditions, with a focus on orofacial pain
      conditions. Evidence and hypotheses concerning biologic and psychosocial factors
      that could influence prevalence rates will also be discussed.

PMID- 11203755
TI  - A unified concept of idiopathic orofacial pain: pathophysiologic features.
AB  - Atypical facial pain, stomatodynia, atypical odontalgia, and some forms of
      masticatory muscle and temporomandibular joint disorders all seem to belong to
      the same group of idiopathic orofacial pain illnesses. The many common clinical
      features they display have been discussed in a preceding paper. Some of their
      common pathophysiologic mechanisms are reviewed in this article. The role of
      female hormones is suggested as a risk factor by the strong female prevalence and
      by the effects of physiologic and therapeutic modification of estrogen levels in
      patients with these pain conditions. Osteoporosis, which appears with menopause,
      and neuralgia-inducing cavitational osteonecrosis have been linked to atypical
      facial pain. Similar clinical features have also prompted a comparison between
      atypical facial pain and complex regional pain syndrome of the limbs. The
      presence of psychosocial factors is also a common feature, but it is not known
      whether these are causal or whether the pain induces the psychosocial problem.
      Local inflammatory, infectious, or mechanical irritation as well as minor nerve
      trauma are frequently reported in these conditions and can also be considered as
      risk factors. However, none of the above factors can currently be considered as
      the sole etiologic factor, and instead the following hypothesis is proposed: the
      idiopathic pain entities depend on one or several neuropathic mechanisms, the
      development of which is triggered or favored by one or several events or risk
      factors. Different neuropathic mechanisms may be at work: nociceptor
      sensitization, phenotypic changes and ectopic activity from the nociceptors,
      central sensitization possibly maintained by ongoing activity from initially
      damaged peripheral tissues, sympathetic abnormal activity, alteration of
      segmental inhibitory control, and hyper- or hypoactivity of descending controls.
      Research directions that are suggested include epidemiologic approaches to
      improve the clinical definition of these conditions, studies to test for the
      factors and mechanisms proposed, and definition of mechanism-based diagnostic and
      treatment strategies.

PMID- 11203756
TI  - Capsaicin-induced muscle hyperalgesia in the exercised and non-exercised human
      masseter muscle.
AB  - AIMS: Strong jaw muscle exercises such as tooth grinding in sleep bruxism are
      frequently believed to be a predisposing factor in myogenous types of
      temporomandibular disorders. However, it is not known whether tooth grinding in
      sleep bruxism is associated with increased sensitivity to intramuscular stimuli.
      This study therefore compared the hyperalgesic effects of an intramuscular
      injection of capsaicin into the right masseter with and without a prior
      experimental tooth-grinding exercise. METHODS: Ten healthy men participated in 2
      randomized sessions (exercise, non-exercise session) separated by 1 week. In the
      exercise session, 0.1 mL capsaicin (100 micrograms/mL) was injected into the
      right masseter immediately after 45 minutes of experimental tooth grinding. In
      the non-exercise session, the exact same paradigm was used, except that the
      experimental tooth grinding was omitted. The perceived intensity of pain evoked
      by intramuscular capsaicin was scored on a 100-mm visual analog scale (VAS). Pain
      detection thresholds (PDTs) to pressure stimuli and maximal voluntary occlusal
      force (MVOF) were measured before capsaicin injection; 5, 15, and 45 minutes
      after the injection; and once a day for the following 3 days. RESULTS: Injections
      of capsaicin into an exercised or non-exercised masseter did not cause
      significant differences in peak pain intensity on the VAS (57 +/- 6 mm in
      exercised masseter vs. 53 +/- 6 mm in non-exercised masseter; P = 0.464). The
      PDTs in the exercised masseter were significantly decreased for up to 1 day after
      the capsaicin injection (P < or = 0.038), whereas PDTs in the non-exercised
      masseter were decreased for only 5 minutes (P = 0.017). The MVOF on the right
      side was decreased 5 minutes after the capsaicin injection in both sessions (P <
      0.010). The MVOF on the left side was significantly reduced for up to 15 minutes
      after the capsaicin injection in the exercise session only (P < 0.019).
      CONCLUSION: Increased sensitivity to percutaneous pressure stimuli probably
      reflects a post-exercise muscle soreness following tooth grinding, whereas
      intramuscular sensitivity to noxious chemical stimuli immediately following
      exercise seems to be unchanged.

PMID- 11203757
TI  - Four-year longitudinal course of TMD symptoms in an adult population and the
      estimation of risk factors in relation to symptoms.
AB  - AIMS: To investigate the natural course of symptoms of temporomandibular
      disorders (TMD) in a non-patient population and to estimate the strength of the
      relationship between several hypothesized risk factors and precipitation and
      perpetuation of the symptoms. METHODS: A total of 672 randomly selected citizens
      of Okayama City was requested to answer the same self-administered questionnaire
      that they had answered 4 years earlier. The mailed questionnaire failed to reach
      58 subjects at the second survey, and 367 of the remaining subjects (59.8%)
      responded. The fluctuation of TMD symptoms was assessed by comparison of 6 pairs
      of answers for questions regarding temporomandibular joint (TMJ) pain, limitation
      of mouth opening, TMJ noise, headache, neck pain, and shoulder stiffness. Six
      factors (age under 40, female, clenching habit, history of extrinsic trauma,
      sleep disturbance, and family history of TMD) were tested for their relative risk
      in precipitating and perpetuating each TMD symptom by the use of its confidence
      interval to define significance. RESULTS: The incidence of TMD symptoms ranged
      from 6.1% (TMJ pain) to 12.9% (TMJ noise). More than half of the subjects who had
      reported TMJ and neck pain at the initial survey no longer reported these
      symptoms at the second survey, whereas TMJ noise and shoulder stiffness remained
      in more than 70% of the subjects. Individuals under 40 years old had a 3.3:1
      increased risk of precipitating TMJ noise (P < 0.01), individuals with a history
      of extrinsic trauma had a 2.85:1 increased risk of precipitating limited mouth
      opening (P < 0.01), and females had a 2.81:1 increased risk of perpetuating TMJ
      pain (P < 0.01). CONCLUSION: The possible etiologic significance of these factors
      in TMD should be validated by future research.

PMID- 11203758
TI  - The International Congress on Orofacial Pain and Temporomandibular Disorders, May
      13-14, 2000, Seoul, South Korea.

PMID- 11203759
TI  - Facing the World Wide Web.

PMID- 11203760
TI  - Masticatory strains on osseous and ligamentous components of the
      temporomandibular joint in miniature pigs.
AB  - AIMS: An animal study of functional biomechanics was undertaken to understand
      normal loading of the temporomandibular joint (TMJ) and to provide insight into
      the pathogenesis of TMJ disorders. METHODS: Bone strain and ligamentous
      deformation were measured during mastication in 26 10-month-old minipigs. Half
      the subjects had undergone a surgical disruption of the left lateral capsular and
      disc attachments to the condyle 5 to 6 weeks previously. Rosette strain gauges
      were bonded to the left lateral surfaces of the squamosal bone near the TMJ, the
      condylar neck, and the mandibular corpus below the molar region. Differential
      variable reluctance transducers (DVRTs) were placed bilaterally in the lateral
      capsular tissue of the joints. Bone strains, ligamentous deformations, and the
      electromyographic activities of the masseters and lateral pterygoids were
      recorded during natural mastication. RESULTS: In all animals on both working and
      balancing sides, mastication caused bone strains that were dominated by tension
      in the squamosal bone site and by compression in the other sites. Measurements
      from the DVRT revealed elongation of the lateral capsular tissue in the last
      phase of the power stroke and shortening in the initial phase of opening, which
      was almost simultaneous with the development of bone strain. Strain in the
      capsule ranged from 3 to 25%, with the strain of the balancing side exceeding
      that of the working side. The surgical disruption did not alter chewing side
      preference or bone strain, but a tendency toward more extensive ligamentous
      deformation on the intact side was observed. Furthermore, the ratio of masseter
      to lateral pterygoid activity was smaller on the disrupted side and larger on the
      intact side, in comparison to control pigs. CONCLUSION: Both osseous and
      ligamentous components of the TMJ are strained during mastication, and the latter
      are more deformed on the balancing side. Disruption of the lateral attachment had
      little effect on strain in the osseous components but appeared to increase strain
      in the capsule and to modify the balance of masticatory muscle activity.

PMID- 11203761
TI  - Changes in pressure-pain thresholds of the jaw muscles during a natural stressful
      condition in a group of symptom-free subjects.
AB  - AIMS: To investigate the effects of a natural emotional stressor on pressure-pain
      thresholds (PPTs) of the masticatory muscles of symptom-free subjects. METHODS:
      Sixteen healthy dental students were selected before they undertook an academic
      examination. Sixteen gender-matched students who were not exposed to an
      examination served as controls. The 2 groups of students were monitored in
      parallel on 5 separate days over a 1-month period: 2 days before the examination
      (T1), on the day of the examination (T2), 2 days after (T3), 1 month after (T4),
      and again after another 2 days (T5). On the day of the examination (T2), the
      control students were only required to complete a brief, non-demanding
      questionnaire. On each day, the following parameters were assessed: PPTs of the
      masseter, the anterior temporalis, and the Achilles tendon; state anxiety; and
      present stress (measured on a visual analog scale [VAS]). Furthermore, in the
      students undergoing the examination, venous blood samples for assessment of beta
      endorphin levels were obtained at T2 and T5. RESULTS: In the stressed students,
      the PPTs of the masticatory muscles and the Achilles tendon were significantly
      lower (analysis of variance [ANOVA], P < or = 0.02) on the day of the examination
      (T2) and on the days nearest the exam (T1, T3), and state anxiety and present
      stress were significantly higher (ANOVA, P < or = 0.003). No significant change
      was found in beta-endorphin plasma levels (P > 0.05). In the control group, PPTs,
      state anxiety, and present stress did not change significantly (ANOVA, P > 0.05).
      CONCLUSION: The results support a relationship between psychologic stress and
      pressure-pain sensitivity of the masticatory muscles.

PMID- 11203762
TI  - Reliability and characteristics of current perception thresholds in the territory
      of the infraorbital and inferior alveolar nerves.
AB  - AIMS: To estimate the intra- and interrater reliability of current perception
      threshold (CPT) evaluation, especially within the infraorbital nerve territory
      (ION) and inferior alveolar nerve territory (IAN) of the orofacial region, and to
      characterize the CPTs of ION and IAN in the normal population. METHODS:
      Electrical stimulation (at 2,000 Hz, 250 Hz, and 5 Hz) was applied to ION and IAN
      to allow for CPT evaluation in 200 subjects, all of whom were healthy, had no
      systemic diseases, and were free from symptoms and history of neuropathic
      conditions. Twenty-five of the subjects were evaluated 3 times by 2 examiners to
      test reliability, and the remaining subjects were evaluated once for normative
      data. RESULTS: The intraclass correlation coefficient of CPTs within examiner and
      between examiners ranged from 0.46 to 0.95. There were no significant differences
      between right and left sides in CPT evaluation within the ION and IAN territory.
      Gender and age did not affect the CPT values for ION and IAN in the normal
      population. There were significant differences between each of the 3 frequency
      dependent (2,000 Hz, 250 Hz, 5 Hz) measures within ION and IAN (P < 0.001).
      CONCLUSION: Evaluation of CPTs within ION and IAN revealed good intra- and
      interrater reliability. The study also provided normative data of CPTs of ION,
      IAN, and the between-site and within-site ratios of CPTs of ION and IAN. This
      should prove useful in the diagnosis of orofacial neuropathy.

PMID- 11203763
TI  - Reproducibility of temporomandibular joint clicking.
AB  - AIMS: To investigate the stability of temporomandibular joint (TMJ) clicking over
      a 10-day period and the effect of different open/close velocities on sound
      amplitude and power spectra in a group of subjects with subjectively stable
      unilateral clicking during the 3 months preceding the recordings. METHODS: Ten
      volunteers were recorded with a self-developed microcomputer-based system used in
      a previous study on asymptomatic subjects. The recordings were performed during 4
      different sessions at 3 different open/close rates in each session. The
      subjective sound intensity was measured with a 100-mm visual analog scale (VAS).
      The VAS scores, the maximum amplitudes, and the power spectra of the signals were
      tested for statistical differences among the different open/close rates and over
      the sessions. The reliability of measurements was also calculated. RESULTS: The
      maximum amplitude and the power spectra of the TMJ clicking varied between
      subjects in a broad range that differed from those reported for asymptomatic
      subjects. No statistically significant differences were found within subjects for
      the subjective VAS scores for the maximum signal amplitudes or for the power
      spectrum parameters among the open/close rates and over the 4 sessions. For all 3
      open/close rates and for the 4 sessions, a good to excellent reliability of
      measurements was determined, the values of r being mostly over 0.75. CONCLUSION:
      Within the limits of the experiment, TMJ clicking was subjectively and
      objectively stable over a period of 10 days. Therefore, the constant subjective
      perception of sound intensity was supported by the objective measurements.

PMID- 11203764
TI  - Prediction of treatment-seeking behavior in acute TMD patients: practical
      application in clinical settings.
AB  - AIMS: To determine potential differences in predictive models of acute
      temporomandibular disorder (TMD) patients divided into groups based on the
      physiologic characteristics of their TMD. METHODS: One hundred seventy-seven
      acute TMD patients were evaluated with an extensive battery that included
      biologic and psychosocial measures. Subjects were separated into 3 groups based
      on a physical exam using the Research Diagnostic Criteria for TMD (RDC): those
      with a myofascial pain diagnosis, those with either a disc displacement or other
      joint condition, and those who reported pain but did not receive an RDC Axis I
      diagnosis. Six months later, it was determined whether patients had sought
      additional treatment for relief of their symptoms. Treatment-seeking and non
      treatment-seeking groups were compared for significant differences, and
      predictive models were generated to determine the array of variables that best
      predicted treatment-seeking behavior among each of the 3 classifications of TMD
      patients used in this study. RESULTS: Among patients with a diagnosis of
      myofascial pain, gender, Multidimensional Pain Inventory (MPI) interference
      score, and MPI affective distress score accurately predicted treatment-seeking
      behavior in 76.1% of the sample. For patients with a diagnosis of disc
      displacement, arthralgia, arthritis, or arthrosis, the following variables
      predicted treatment utilization behavior in 93.6% of the sample: race, RDC graded
      chronic pain, and the introversion scale of the Minnesota Multiphasic Personality
      Inventory-2. For patients with no RDC Axis I disorder, 80.5% of the sample was
      accurately classified with regard to treatment-seeking behavior through the use
      of only the characteristic pain intensity score (i.e., mean of visual analog
      scale scores for "pain right now," "worst pain," and "average pain"). CONCLUSION:
      The factors that predict which acute TMD patients are most likely to seek
      additional treatment vary depending on the physiologic basis of their TMD. This
      suggests that acute TMD patients may benefit from different modalities of
      treatment, depending on the type of TMD with which they present.

PMID- 11203766
TI  - Moving TMJ research into the 21st century. First annual scientific meeting of the
      TMJ Association Bethesda, Maryland, May 22-23, 2000.

PMID- 11203765
TI  - A longitudinal epidemiologic study of signs and symptoms of temporomandibular
      disorders from 15 to 35 years of age.
AB  - AIMS: To study the development over 20 years of signs and symptoms of
      temporomandibular disorders (TMD) in an epidemiologic sample and to analyze
      possible correlations between these signs and symptoms and some other variables.
      METHODS: The original group comprised 135 randomly selected 15-year-old subjects
      who were examined clinically and by means of a questionnaire for signs and
      symptoms of TMD. The examination was repeated after 5, 10, and 20 years by the
      same methods. After 20 years, when the original group had reached the age of 35
      years, 124 individuals (92%) could be traced, and they were sent a questionnaire
      and invited for a clinical examination. The response rate was high: 114 subjects
      (92%) completed and returned the questionnaire, and 100 subjects (81%) attended
      the clinical examination. RESULTS: There was a substantial fluctuation of both
      reported symptoms and clinically recorded signs over the 20-year period, but
      progression to severe pain and dysfunction of the masticatory system was rare. In
      both the 15-year-old and 35-year-old subjects, 13% reported 1 or more frequent
      TMD symptoms. At age 35, only 3 subjects (3%) were classified as having severe or
      moderate clinical signs of dysfunction according to the Helkimo Index, fewer than
      in previous investigations. Women reported TMD symptoms and headache and had
      muscle tenderness and joint sounds more often than men. Correlations between the
      studied variables were mainly weak. Among the highest correlations found (rs =
      0.4) were those between reported clenching and bruxing habits and TMJ sounds and
      jaw fatigue. CONCLUSION: In this epidemiologic sample followed from age 15 to 35
      years, a substantial fluctuation of TMD signs and symptoms was found over time.
      Progression to severe pain and dysfunction was extremely rare.

PMID- 11203767
TI  - Regarding dinosaurs.

PMID- 11203768
TI  - American Academy of Gold Foil Operators. Clinician of the year award. Dr. William
      T. Pike.

PMID- 11203769
TI  - American Academy of Gold Foil Operators. Distinguished Member Award. Dr. K.
      Harris.

PMID- 11203771
TI  - Clinical evaluation of a resin-modified glass ionomer adhesive system--results at
      three years.
AB  - One hundred non-carious cervical lesions were restored with either Silux Plus or
      Estio LC resin composite using Fuji Bond LC as the bonding agent. Thirteen
      patients of mean age 60.5 years participated in the study. The retention rate at
      three years was: Silux Plus, 94%; Estio LC, 100%; total, 97%. Marginal
      discoloration of aesthetic significance was present around three restorations,
      two of which were in one patient.

PMID- 11203770
TI  - Two-year clinical performance of a polyacid-modified resin composite and a resin
      modified glass-ionomer restorative material.
AB  - This study compared the clinical performance of a polyacid-modified resin
      composite and a resin-modified glass-ionomer restorative material over two years.
      Thirty-four pairs of restorations of Compoglass and Fuji II LC were placed in
      caries-free cervical erosion/abfraction lesions without tooth preparation.
      Restorations were clinically evaluated at baseline, 6, 12, 18 and 24 months using
      modified Ryge/USPHS criteria. A significantly higher incidence of failed
      restorations was found with the polyacid-modified resin composite (p < 0.05).

PMID- 11203772
TI  - Selected mechanical properties of fluoride-releasing restorative materials.
AB  - Mechanical properties, diametral tensile strength (DTS) and flexural strength
      (FS) of six fluoride releasing materials were measured and compared. The samples
      were prepared and tested according to ISO specifications. The materials included
      a glass ionomer (Fuji IX), a resin-modified glass ionomer (Photac-Fil), two
      compomers (F 2000; Dyract AP) and two composites (Solitaire; Tetric Ceram). The
      tests were performed after the materials were stored in distilled water (DTS) and
      phosphate buffered saline solution (FS) at 37 degrees C for 24 hours and one
      week. Fluoride-releasing composite resin had the highest flexural and diametral
      tensile strengths and were statistically stronger than compomers, followed by
      resin-modified glass ionomer and conventional glass ionomer. However, a notable
      exception to this general trend was Solitaire, a fluoride-releasing composite
      resin.

PMID- 11203773
TI  - Influence of the direction of tubules on bond strength to dentin.
AB  - This study investigated the influence of the direction of dentinal tubules on
      resin-dentin tensile bond strength (mu TBS) using four commercially available
      bonding systems and observed the resin-dentin interfaces with an SEM. The dentin
      bonding systems used in this study were Clearfil Liner Bond II (LB, Kuraray),
      Imperva Fluoro Bond (FB, Shofu), Single Bond (SB, 3M) and One-Step (OS, BISCO).
      Thirty-six extracted caries-free human molars were used for micro tensile bond
      testing and eight additional teeth were used for scanning electron microscopy
      (SEM). The teeth were divided into two groups according to the direction of the
      dentinal tubules at the resin-dentin interface: a perpendicular group, in which
      the occlusal enamel was removed perpendicular to the long axis of the tooth, and
      a parallel group, in which the mesial half of the tooth was removed parallel to
      the long axis of the tooth, and the coronal dentin surface was used for bonding.
      After the flat dentin surfaces were polished with #600 silicon carbide paper,
      each surface was treated with one of the four adhesive systems according to the
      manufacturer's recommendation, then covered with resin composite (Clearfil AP-X,
      Kuraray) to provide sufficient bulk for micro-tensile bond testing. After 24
      hours in 37 degrees C water, the resin-bonded teeth were serially sliced
      perpendicular to the adhesive surface, the adhesive interface trimmed to a cross
      sectional area of 1 mm2 and subjected to tensile forces at a crosshead speed of 1
      mm/min. Statistical analysis of the tensile bond strengths were performed using
      two-way ANOVA and Fisher's PLSD test at 95% level of confidence. The tensile bond
      strength of the group with tubules parallel to the bonded interface was higher
      than that of tubules cut perpendicularly. This tendency reached statistical
      significance using SB and OS.

PMID- 11203774
TI  - Comparative in vivo and in vitro investigation of interfacial bond variability.
AB  - This comparative in vivo/in vitro study investigated the interfacial adaptation
      between dentin and composite resins in totally bonded adhesive restorations
      placed under clinical and laboratory conditions in the same tooth. Cavities were
      prepared in buccal or lingual surfaces of 47 third-molar teeth scheduled for
      extraction and randomly assigned for treatment with the following bonding
      systems/restorative materials: Clearfil Liner Bond 2/Clearfil AP-X (Group I, n =
      10), Resulcin AquaPrime + Monobond/MFR Merz (Group II, n = 9), Prime&Bond
      2.1/Dyract AP (Group III, n = 9), Scotchbond Multi-Purpose/Z-100 (Group IV, n =
      10), and Ecusit Primer AB-Mono/Ecusit (Group V, n = 9). In Group V, a thin layer
      of a low-viscous compomer (Primaflow) was interposed between the dentin and the
      composite resin during restoration placement (according to the manufacturer's
      directions). After extraction a second filling was placed in each tooth with
      identical materials in the same manner as in vivo. The restoration-dentin
      interface was evaluated in longitudinally cut sections of the specimens by SEM
      analysis, and the frequency of gap formation between restoration and dentin was
      calculated. Median percentages for the in vivo/in vitro frequency of interfacial
      gap formation were 29.2%/13.9% in Group I, 33.3%/20.0% in Group II, 40%/5.3% in
      Group III, 53.9%/30.4% in Group IV and 13.8%/0% in Group V. Comparison of gap
      formation frequency between fillings placed in vivo and in vitro revealed
      significant differences (p < 0.05) in Groups II, III and IV. However, in Groups I
      and V the internal adaptation was not significantly different between in vivo and
      in vitro applied restorations. A significant (p < 0.01) correlation (Spearman-Rho
      rank correlation coefficient) was found for the corresponding in vivo and in
      vitro fillings placed in the individual teeth with regard to interfacial gap
      formation. It was concluded that achievement of a completely gap-free internal
      adaptation between restorative material and dentin in totally bonded composite
      resin restorations is difficult to predict under in vivo as well as in vitro
      conditions.

PMID- 11203775
TI  - Inhibition of artificial secondary caries in root by fluoride-releasing
      restorative materials.
AB  - This investigation evaluated the fluoride-releasing properties of various
      fluoride-releasing restorative materials, including resin-modified glass-ionomer
      cements (Fuji ionomer TypeII LC, Photac-Fil Aplicap, Vitremer), compomers
      (Ionosit FIL, Compoglass, Dyract) and fluoride-releasing resin composites
      (Heliomolar radiopaque, Degufill mineral). The study also estimated the effects
      of those materials on the inhibition of artificial secondary caries around
      restorations using a bacterial caries-inducing system. The amount of fluoride
      released from the materials in deionized water was measured every one week for 10
      weeks. Class V cavities with the gingival margin located in the root were
      prepared in extracted human premolars and restored with each of the materials.
      The restored teeth were incubated in the bacterial artificial caries chamber, and
      the artificial lesion created around the restoration was observed
      microradiographically. The resin-modified glass-ionomer cements released the
      largest amount of fluoride and created a thick radio-opaque zone in the
      artificial lesion along the restoration-dentin interface. These results indicated
      that the fluoride-releasing restorative materials have the potential to inhibit
      secondary caries formation around restorations. Resin-modified glass-ionomer
      cements presented a particularly strong effect, compared with compomers and
      fluoride-releasing resin composites.

PMID- 11203776
TI  - Shear bond strength of four filled dentin bonding systems.
AB  - This study compared the shear bond strength of four filled dentin bonding agents
      (Prime & Bond NT, One Coat Bond, OptiBond Solo, PermaQuik1) to a conventional
      unfilled Dentin Bonding agent (3M Scotchbond Multipurpose Plus). A column of
      composite resin (Herculite XRV Restorative Resin) was bonded to human dentin
      using the five dentin-bonding systems following the manufacturers' directions.
      The specimens were thermocycled 1000 cycles from 6 to 60 degrees C. Each specimen
      was tested on an MTS machine in shear-to-failure. The data were subjected to One
      Factor ANOVA and Newman-Kuels post-hoc tests. Statistical analysis revealed that
      One Coat Bond had significantly greater shear bond strength than all other
      materials tested.

PMID- 11203777
TI  - Effect of delayed application on shear bond strength of four fifth-generation
      bonding systems.
AB  - This study compared the shear bond strength of four adhesives dispensed 10
      minutes prior to use to immediate dispensing and use. For half (40) of the
      specimens (n = 10), four different dentin bonding agents (One Coat, Bisco One
      Step, Prime & Bond 2.1 and 3M Single Bond) were used to bond a column of
      composite resin (Z100 Restorative Resin) to the dentin surface following
      manufacturers' directions and using the dentin bonding agent immediately after
      dispensing. For the remaining specimens, the same procedure was followed except
      that the dentin-bonding agent was dispensed 10 minutes prior to use. All
      specimens were tested two weeks after bonding on a MTS machine. The data obtained
      was subjected to Two-factor ANOVA and Tukey-B post-hoc tests. The statistical
      analysis showed that there was no significant difference between the control
      groups and the experimental groups, although the dentin bonding agents containing
      acetone showed a trend toward lower bond strengths when not used immediately
      after dispensing.

PMID- 11203778
TI  - In vitro evaluation of secondary caries development in enamel and root dentin
      around luted metallic restoration.
AB  - Materials that release fluoride have been recommended for patients with high
      caries risk, but there is no conclusive evidence of their effect on fixed
      prostheses abutments. This study evaluated the influence of a resin-modified
      glass-ionomer cement on in vitro caries development in enamel and root dentin
      around metallic restoration. The cervical portion of 12 human third molars were
      sectioned in four blocks that were randomly divided into four Groups (n = 12; 1
      block from each tooth/group): ZP (restoration + zinc phosphate cement), GI
      (restoration + resin-modified glass-ionomer cement), C1 (no restoration and no pH
      cycling), and C2 (no restoration and pH cycling). In ZP and GI, metallic
      restorations were luted at the crown-root junction. ZP, GI and C2 were submitted
      to a pH-cycling model. All blocks were sectioned, embedded and polished. Enamel
      and root dentin demineralization were evaluated through cross-sectional
      microhardness Knoop measures at 20 to 80 microns of depth (from the outer
      surface) and at 20 to 220 microns of distance from the cavity margins. Mineral
      loss values were calculated from Knoop hardness numbers. Data were analyzed by
      ANOVA, Tukey's test and regression analysis. Groups ZP, GI and C2 showed
      demineralization in relation to C1, which was more superficial in enamel than in
      root dentin. In root dentin, mineral loss in ZP and GI was smaller than in C2.
      Distance from the cavity margins was not significant. There was no difference
      between resin-modified glass-ionomer cement and zinc phosphate cement regarding
      artificial secondary caries development in both dental substrates.

PMID- 11203779
TI  - Microleakage at the cervical margin of composite Class II cavities with different
      restorative techniques.
AB  - This study evaluated the microleakage at the cervical margins of Class II
      composite resin restorations restored with different techniques. Slot cavities
      were prepared on both proximals of 40 unerupted third molars with one cervical
      margin located above and the other below the cementoenamel junction. The prepared
      teeth were randomly assigned to four groups and restored using the following
      techniques: (I) 3-Sited, (II) Directed-Shrinkage, (III) Resin-Modified Glass
      Ionomer Cement or a (IV) Flowable Composite as the gingival increment. All
      restorations were placed with the same bonding agent and composite resin. The
      difference among the groups was on the first increment and on its insertion and
      polymerization techniques. After restoration, the teeth were thermocycled and
      exposed to a dye. Results showed that all the techniques worked well for enamel,
      with almost no leakage. However, on cementum, all techniques demonstrated
      moderate to severe leakage.

PMID- 11203780
TI  - The effect of additional enamel etching and a flowable composite to the
      interfacial integrity of Class II adhesive composite restorations.
AB  - This in vitro study evaluated the interfacial integrity of Class II resin
      composite restorations. The influence of a flowable composite and additional
      enamel etching was also evaluated. Deep, saucer-shaped Class II cavities were
      prepared in the mesial and distal proximal surfaces of 25 extracted human molars
      and assigned to five treatment groups. The gingival margins were extended to
      approximately 1 mm above the CEJ in 40 cavities and below the CEJ in 10 cavities.
      The prepared cavities were then restored with a self-etching primer system
      (Clearfil Liner Bond II) and a hybrid resin composite (Clearfil AP-X), with and
      without a flowable composite (Protect Liner F) and additional enamel etching with
      37% phosphoric acid gel (K-etchant). After finishing, polishing and thermocycling
      (4 and 60 degrees C, x300), the samples were longitudinally sectioned through the
      restorations and resin-tooth interfaces were observed directly under a laser
      scanning microscope. Statistical analysis indicated that the use of a flowable
      composite produced significantly more (p = 0.04) gap-free resin-dentin interfaces
      than teeth restored without the flowable composite. However, both flowable
      composite and enamel etching could not prevent gap formation at enamel-resin
      interfaces and crack formation on enamel walls.

PMID- 11203782
TI  - Fracture resistance of anterior, posterior and universal light activated
      composite restoratives.
AB  - This investigation measured the fracture resistance of a wide range of currently
      available light-activated-composite restoratives. Products intended solely for
      anterior use were tested together with universal materials and products intended
      for posterior application. All materials were handled according to manufacturers'
      instructions. For products evaluated in this investigation, universal and
      posterior materials yielded higher mean torque to fracture (T) values overall in
      comparison to the anterior products. One Microfilled and two Polyglas filled
      products designated for posterior application yielded relatively modest mean
      fracture resistance values.

PMID- 11203781
TI  - Amalgam bonding: visualization and clinical implications of adhesive displacement
      during amalgam condensation.
AB  - Resin adhesive was visualized in this in vitro study of amalgam bonding using
      methylene blue dye incorporated into the resin or by scanning electron
      microscopy. Class II amalgam cavities were prepared in extracted teeth previously
      stored in buffered formalin. The preparations were then restored following
      manufacturers' instructions, but included methylene blue dissolved in ethanol
      into the adhesive resin mixture. This procedure had little effect on the setting
      time of the resin. Following condensation and carving, excess resin was
      incorporated into the body of the restorations as well as onto all adjacent
      coronal surfaces with significant occlusal and proximal accumulations. Resin also
      accumulated in significant amounts on the gingival floor of the proximal box and
      at line angles and retentive grooves within the preparation. In conclusion,
      radiological studies demonstrated that artifacts produced by resin accumulation
      at the gingival floor of the box could be mistaken for an open margin or
      recurrent caries. Other potential clinical consequences of resin residue on tooth
      surfaces are discussed, including the problem of interproximal ledges and
      occlusal discrepancies. The incorporation of a radiopaque material in the resin
      systems should be a universal requirement.

PMID- 11203783
TI  - Relationship between adhesive thickness and microtensile bond strength.
AB  - This study evaluated the effect of the thickness of the adhesive resin layer of
      two commercially available resin bonding systems on bond strengths (Single Bond
      and Liner Bond 2V). The adhesive of Single Bond contains ethanol and water as
      solvents and is applied using the moist-bonding technique. The adhesive of Liner
      Bond 2V contains no solvents and is applied after a self-etching primer
      treatment. Forty-six caries-free molars were ground flat to expose the dentin
      surface and polished with #800-grit silicon carbide paper under running water. A
      vinyl tape punched with a 6 mm diameter hole was then placed on the dentin
      surface to demarcate the area for bonding. The thickness of the adhesive resin
      layer was varied by stacking an increasing numbers of vinyl tapes together. The
      teeth were randomly divided into two groups and treated with either Clearfil
      Liner Bond 2V or Single Bond. They were further divided into subgroups according
      to the number of tapes placed on the dentin surface. After the bonding procedures
      the teeth were incrementally restored with Clearfil AP-X resin composite,
      building a 5 mm high crown to produce sufficient bulk for the microtensile bond
      test and stored in tap water at 37 degrees C for 24 hours. The teeth were then
      sectioned along their long axis into 0.7 mm thick slabs and trimmed for the
      microtensile bond test using a super-fine diamond bur. The thickness of the
      adhesive resin layer was then measured with a light microscope and the slabs
      tested in tension at a crosshead speed of 1 mm/minute. The results were subjected
      to statistical analysis by a one-way analysis of variance and linear regressions
      with 95% confidence intervals. The thickness of the Clearfil Liner Bond 2V
      adhesive layer ranged from 5 mm-1500 mm, and for Single Bond, it varied from <
      7.5 mm-430 mm. For Clearfil Liner Bond 2V, bond strengths increased significantly
      as the thickness of bonding layer increased (p < 0.05). However, the bond
      strengths of the Single Bond decreased significantly with increased thickness of
      the bonding layer (p < 0.05).

PMID- 11203784
TI  - Long-term effect of dentin primers on enamel bond strength and marginal
      adaptation.
AB  - Contamination of etched enamel with dentin adhesive systems is unavoidable in
      clinical situations. The aim of this in vitro study was to evaluate the long-term
      effect of dentin adhesives and application technique on resin composite bond
      strength and marginal adaptation to enamel. Six hundred freshly extracted
      mandibular bovine incisors were used. Three hundred teeth were flat ground, and
      the enamel was etched for 30 seconds with 32% phosphoric acid. The etched surface
      was treated by different dentin adhesive systems with and without intensive
      rubbing by use of application brushes. As a control, only the enamel adhesive
      resin was applied and air thinned. Furthermore, contamination with saliva was
      performed after the etching process. Etched and silanated CEREC blocks were
      bonded onto the enamel specimens with different adhesive resins and stored for 1
      and 365 days (37 degrees C, aqua dest). After storage, the specimens were
      thermocycled for 24 hours (1150 cycles between 5 degrees C and 55 degrees C), and
      subjected to shear bond testing. Three hundred box-shaped cavities were prepared
      on buccal surfaces of the incisors and filled with one resin composite using the
      same pretreatment modes as in the shear bond test groups. After 1 and 365 days of
      storage, a margin analysis was performed using a SEM (X200 magnification). Dentin
      adhesive systems did not show an adverse effect on long-term enamel bond strength
      and marginal adaptation. Rubbing application of the primers decreased the bond
      strength by values of approximately 20% after 24 hours and approximately 40%
      after 1 year of storage. Marginal adaptation showed 94-98% gap-free margins in
      the control and dentin adhesive system-only groups; however, after rubbing of
      primers, the proportion of gap-free margins decreased significantly to 85-88%.
      The lowest bond strength (8-10 MPa) and margin quality (49-69% gap-free margins)
      were recorded for the groups with saliva contamination.

PMID- 11203785
TI  - Bond strengths of single-bottle dentin adhesives to caries-affected dentin.
AB  - There is concern that some acidic conditioners may not be strong enough to
      adequately etch sclerotic or caries-affected dentin. The hypothesis that was
      tested was that there were no significant differences in the bond strengths of
      single-bottle bonding systems to normal or caries-affected dentin, regardless of
      the strength of the phosphoric-acid conditioner. Extracted teeth with coronal
      caries extending into mid-dentin were prepared by grinding the occlusal surface
      flat. This left a central region of caries-affected dentin surrounded by normal
      dentin. The One-Step bonding system was used to bond dentin following etching
      with 10 or 32% phosphoric acid. The Single Bond system was used after etching
      dentin with 10 or 35% phosphoric acid. After 24 hours in water, serial vertical
      sections were made through the bonded teeth to create slabs 0.7 mm thick. Each
      tooth yielded four to five slabs, some of which included normal dentin, while
      others included caries-affected dentin. Each slab was trimmed into an hourglass
      configuration to limit the test area to normal or caries-affected dentin. The
      results obtained with One-Step following etching with 10% phosphoric acid showed
      lower (P < 0.05) tensile bond strengths to caries-affected dentin compared to
      normal dentin (36.9 +/- 8.0 MPa vs 47.7 +/- 6.5 MPa, respectively). This
      difference disappeared when using 32% phosphoric acid (49.7 +/- 6.1 MPa vs 45.0
      +/- 7.2 MPa, respectively). Bonds made to caries-affected dentin with Single Bond
      were always lower than bonds to normal dentin regardless of the strength of the
      phosphoric acid. Scanning electron microscopy of polished cross sections
      sequentially challenged with acid and NaOCl revealed loss of the middle of the
      hybrid layers created by either bonding system in caries-affected dentin etched
      with 10% phosphoric acid. It is clear that 32-35% phosphoric acid is required to
      adequately etch caries-affected dentin in order to produce high bond strengths
      and well-infiltrated demineralized dentin.

PMID- 11203786
TI  - Fluoride release from three glass ionomers, a compomer, and a composite resin in
      water, artificial saliva, and lactic acid.
AB  - The amounts and the pattern of fluoride release from one metal-reinforced glass
      ionomer cement, two resin-modified glass ionomer cements, one compomer, and one
      composite resin placed in double-distilled water, artificial saliva, and lactic
      acid were evaluated in this study. Measurements of fluoride ion release were made
      for a total of 105 cylindrical specimens (10 mm in diameter and 1.5 mm in
      height). They were taken over a period of 16 weeks at the intervals of 4, 8, 12,
      and 24 hours, as well as 2, 3, 7, 14, 28, 56, and 112 days. The pattern of
      fluoride release was similar for all of the examined materials. The greatest
      amount of fluoride was released from the metal-reinforced glass ionomer Argion.
      The resin-modified glass ionomers Vitremer, Fuji II LC; the compomer Dyract; and
      the composite resin Tetric followed in ranking order. The pH of the environment
      strongly affected the fluoride release from the materials. There was a
      significant difference (P < 0.001) in the amounts of fluoride released in lactic
      acid vs water and artificial saliva, whereas, there was no significant difference
      (P > 0.05) in the amounts of fluoride released in water vs artificial saliva.

PMID- 11203787
TI  - Marginal adaption of Class V restorations with and without "softstart
      polymerization".
AB  - Polymerization shrinkage causing marginal gap formation is still a major problem
      in light curing restorations. The aim of the present study was to test the
      influence of "softstart polymerization" (prepolymerization at a low light
      intensity followed by a final cure at a high light intensity) on the marginal
      integrity of polyacid-modified resin and composite resin restorations in Class V
      cavities using a commercially available curing unit with two defined curing
      intensities. Sixty standardized Class V cavities were prepared. Twenty cavities
      at a time were filled either with a composite resin [Spectrum + Prime & Bond 2.1
      (SP)], or with polyacid-modified resins [Dyract + Prime & Bond 2.1 (DY); Hytac +
      OSB Primer (HY)]. Ten fillings of each group were either conventionally cured (40
      seconds, 800 mW/cm2), or they were cured with a lower starting intensity (10
      seconds, 150 mW/cm2) and then with the full intensity (30 seconds, 800 mW/cm2).
      Margins were evaluated before and after thermomechanical loading (TCML) by
      quantitative margin analysis. Microleakage was assessed by dye penetration. The
      softstart polymerization showed no significant influence on gap formation for
      each material and interface before and after TCML. Quantitative margin analysis
      after TCML showed significantly fewer marginal gaps at the enamel/restoration
      interface for SP (0%) compared to DY (15.5%) and HY (44.5%) using softstart
      polymerization. At the dentin/restoration interface the corresponding results for
      gap formation were 29.6% for SP, 8.5% for DY, and 21.0% for HY. These results
      were not significantly different from each other. Dye penetration was
      significantly higher for SP at the dentin/restoration interface. SP showed
      significantly more marginal swelling at the dentin/restoration interface compared
      to DY. In conclusion, softstart polymerization using a very low starting
      intensity did not improve the marginal adaptation of polyacid-modified resins or
      composite resins in Class V cavity preparations. The best marginal adaptation in
      Class V cavities at the enamel/restoration interface was achieved with SP, using
      the acid-etch technique. In dentin, however, the polyacid-modified resins showed
      a superior marginal adaptation.

PMID- 11203788
TI  - Effect of cavity form and setting expansion of refractory dies on adaptability of
      fired ceramic inlays.
AB  - The purpose of this study was to investigate the effect of cavity form and
      setting expansion of refractory die materials on the adaptability of fired
      ceramic inlays. Standardized Class I cavities with three kinds of lateral wall
      divergences (10 degrees, 20 degrees, and 30 degrees) and three kinds of surface
      roughness were prepared in epoxy resin blocks. A refractory die was prepared from
      an impression of the epoxy resin cavity, whose setting expansion ranged from 0.01
      to 1.13%. A ceramic inlay was fired on each die. The fabricated inlay was
      inserted into the epoxy resin cavity, and the interfacial distance between the
      ceramic inlay and the cavity wall at the margin was measured using a reflecting
      microscope at X100 magnification. The internal fit was measured after sectioning
      the specimen longitudinally. The results were analyzed by ANOVA and Sheffe's F
      test. Good adaptation was achieved with the smooth-surface cavity. The
      adaptability depended on the angle of the cavity divergence, and small gaps were
      observed in 20 degrees and 30 degrees cavities (P < 0.05). The inlays fabricated
      on the refractory dies with a small setting expansion demonstrated small internal
      gaps. Significantly good adaptation was achieved when the setting expansion was
      less than 0.2% (P < 0.05). The results indicated that the cavity form and the
      setting expansion of the refractory die material had significant effects on the
      adaptability of fired ceramic inlays.

PMID- 11203789
TI  - Dentin bond strength and marginal adaption after NaOCl pre-treatment.
AB  - The aim of this in vitro study was to compare the dentin bond strength and
      marginal adaptation of direct composite resins with and without additional NaOCl
      treatment after the etching process. A total of 150 cavities were prepared into
      disks of freshly extracted human third molars and filled with direct composite
      resins. Dentin adhesives of the fourth (with total etching: Scotchbond Multi
      Purpose Plus, EBS, and Solid Bond), and fifth generation (one-bottle adhesives:
      Prime&Bond 2.1, Syntac Sprint) were used in combination with corresponding
      composite resin materials. Dentin disks without cavity preparation treatment
      served as controls. After 24 hours of storage and 24 hours of thermocycling (1150
      cycles), replicas were made and push-out testing was performed. Replicas were
      examined regarding marginal adaptation using SEM (X200 magnification). In
      general, fourth-generation dentin adhesives produced better results in bond
      strength and marginal adaptation than fifth-generation one-bottle systems (P <
      0.05). Within the fourth generation, Scotchbond Multi-Purpose Plus and EBS
      achieved significantly higher push-out values and percentages of gap-free margins
      than Solid Bond (P < 0.05). After hypochlorite treatment, dentin bond strength (
      25%) and marginal adaptation (-30%) decreased significantly (P < 0.05) in all
      groups.

PMID- 11203790
TI  - Two-year clinical comparison of a microfilled and a hybrid resin-based composite
      in non-carious Class V lesions.
AB  - The purpose of this double-blind clinical trial was to compare the retention rate
      in noncarious Class V lesions of two resin-based composite restorative materials
      with contrasting stiffness. Isolation with retraction cord, pressed paper
      triangles, and cotton rolls was used to closely mimic the procedures generally
      used in a practice setting. Thirty pairs of restorations were placed, one using
      Silux Plus and one using Z100. The assignment of material was randomized, and the
      subjects were unaware of the material used. All restorations were placed with a
      fourth-generation adhesive liner, Scotchbond Multi-Purpose. Evaluations were
      performed at baseline, 6, 12, 18, and 24 months by two independent examiners
      using criteria developed by Cvar and Ryge in a forced consensus model. Examiners
      were unaware of the restoration's group identity. No difference between the
      retention rates for the two groups was found after 24 months, bringing into
      question the role that a material's stiffness plays in determining retention in a
      noncarious Class V lesion.

PMID- 11203791
TI  - Effect of dentin primer on shear bond strength of composite resin to moist and
      dry enamel.
AB  - The etched enamel-composite resin bond is the most reliable bond known to us.
      Moisture and dentin primers are the two most important variables that can
      interfere with this bond. This study investigated the effect of dentin primer on
      bond strengths of composite resin to moist and dry enamel. One hundred freshly
      extracted molar teeth were used for shear bond strength testing. The teeth were
      mounted in phenolic rings with an approximal enamel surface exposed. The exposed
      enamel surface on each tooth was flattened using 320- 400- and 600-grit silicon
      carbide papers and etched using 34-38% phosphoric acid gel. The teeth were then
      divided into 10 groups (n = 10). Four groups were assigned to each of the two
      dentin bonding systems, Scotchbond Multi-Purpose and OptiBond FL. Two groups were
      assigned to the single-bottle bonding agent (Single Bond). Each bonding system
      was tested on moist and dry enamel. OptiBond FL and Scotchbond MP were tested
      with and without the use of primer. All samples were thermocycled and tested in
      shear. Fracture analysis was performed using a binocular microscope. For scanning
      electron microscopy, approximal samples of enamel (1 mm thick) were flattened,
      etched, and bonded with and without primer on moist and dry enamel. A 1 mm-thick
      layer of Z100 was bonded to the specimens, which were then immersed in 10% HCl
      for 24 hours to dissolve the enamel. The specimens were viewed under a scanning
      electron microscope. Results indicated that the use of primer on dry enamel did
      not significantly affect (P > 0.05) shear bond strengths for the two bonding
      systems, Scotchbond MP (primed 24.10 +/- 4.83 MPa, unprimed 29.57 +/- 7.49 MPa)
      and OptiBond FL (primed 26.82 +/- 4.44, unprimed 25.66 +/- 2.95). However, the
      use of primer was found to be essential on moist enamel to obtain acceptable bond
      strengths with both Scotchbond MP (primed 25.61 +/- 10.29 MPa, unprimed 3.26 +/-
      0.95 MPa) and OptiBond FL (primed 30.28 +/- 3.49 MPa, unprimed 8.37 +/- 3.31
      MPa). Moisture on enamel did not significantly affect (P > 0.05) bond strengths
      for the single-bottle bonding agent, Single Bond (moist enamel 31.34 +/- 9.03
      MPa, dry enamel 27.93 +/- 5.41 MPa). Fracture analysis revealed that most
      fractures were adhesive or mixed, with a greater percentage being cohesive for
      the groups with dry enamel or with primer on moist enamel. Scanning electron
      micrographs corroborated the shear bond strength data. The specimens without
      primer on moist enamel showed very poor penetration of adhesive and composite
      resin into the etched enamel microporosities.

PMID- 11203792
TI  - Operative Dentistry for the new millennium: a problem specific approach to
      operative dentistry.
AB  - This paper presents an alternate view of current preclinical education in
      Operative Dentistry and suggests a course that uses a cause and appropriate
      response action rather than the traditional material specific cavity preparation.
      This approach considers caries as a disease, could foster a better understanding
      of prevention and its application in maintaining teeth for a lifetime for the
      patient, and encourage critical thinking for both student and faculty.

PMID- 11203793
TI  - Excellence in diagnosing failures: a challenge for the 21st Century.

PMID- 11203794
TI  - American Academy of Gold Foil Operators Distinguished Member Award. Dr Norman C
      Ferguson.

PMID- 11203795
TI  - Custom provisional restorations: simple, fast and accurate.

PMID- 11203797
TI  - Effectiveness of polymerization in composite restoratives claiming bulk
      placement: impact of cavity depth and exposure time.
AB  - The impact of variation of cavity depth and light-source exposure time upon the
      effectiveness of polymerization of two "bulk placement" composite restoratives
      was assessed indirectly using hardness testing. The current investigation used a
      digital microhardness tester to evaluate hardness gradient between top and bottom
      surfaces of composite specimens of various depths after different light-exposure
      times. The results showed that the effectiveness of polymerization decreased
      significantly with increased cavity depth regardless of exposure time. Increased
      exposure time increased the extent of polymerization at cavity depths of 3 to 4
      mm. Increments of the composites evaluated should be no greater than 2 mm to
      provide uniform and maximum polymerization.

PMID- 11203796
TI  - Fluoride uptake around cavity walls; two-dimensional mapping by electron probe
      microanalysis.
AB  - This study reports fluoride uptake around the cavity wall of teeth by two
      dimensional mapping. Fluoride concentration was measured using the wavelength
      dispersive x-ray analysis (WDX) method. The buccal cavity wall of a human tooth
      was coated five times with 2% sodium fluoride solution at three-day intervals for
      12 days, and then immersed in a normal saline solution at 37 degrees C. After one
      month, the tooth was bisected longitudinally through the center of the cavity
      surface perpendicular to the axial wall. On the polished surface of the cut
      tooth, the fluoride concentration was measured. Fluoride distribution maps around
      the cavity wall were drawn using a bundle of the observed analytical lines.
      Fluoride uptake from fluoride-releasing materials (conventional glass-ionomer
      cement, light-cured glass-ionomer cement, light-cured composite resin, light
      cured bonding agent) around the cavity wall was investigated using the same
      method. The maps showed higher fluoride uptake in dentin than in enamel and a
      strong location dependence of fluoride uptake in a tooth, especially in the
      dentin. Fluoride uptake from the resin was greater than that from the cement. It
      was summarized from these results that a two-dimensional map of fluoride uptake
      can provide valuable information on the cariostatic properties of fluoride
      releasing materials.

PMID- 11203799
TI  - The full gold crown: an overview.

PMID- 11203798
TI  - Bonding of amalgam restorations: existing knowledge and future prospects.
AB  - A number of laboratory and clinical studies over the last 15 years have explored
      the potential advantages of bonding amalgam to tooth surfaces. Bond strengths
      have been reported to range from 2 to 20 MPa, with higher bond strengths reported
      for filled adhesives. Most studies agree that the use of bonding results in a
      considerable reduction of microleakage, when compared with copal varnish or no
      lining. The use of bonding provides retention in vitro that is equivalent to, or
      better than, the use of mechanical undercuts. Most studies on strength of
      restored teeth report an improvement in resistance to fracture or cuspal flexing
      as measured by strain gauges. Penetration of secondary caries along the interface
      has been found to be inhibited by bonding. The mode of failure of bonded amalgams
      has generally been reported to be mixed, but predominantly between the resin and
      amalgam. In vitro studies have reported one potential problem in the
      incorporation of resin into amalgam, which may cause a decrease in strength of
      the restoration. The clinical studies of bonded amalgams that have been published
      to date are of short duration, indicating that when traditional preparations are
      used, no problems are seen with bonding, but also no advantages, as measured by
      clinical assessment criteria. However, some studies show that bonded amalgam may
      be useful for procedures where non-bonded amalgams would be expected to be lost,
      namely in preparations with little, if any, mechanical retention. It was
      concluded that, while there are various in vitro studies demonstrating that
      bonded amalgams have advantages of improved retention and tooth reinforcement and
      decreased marginal microleakage and secondary caries, the operative technique is
      more complicated and there are few advantages yet evident from clinical studies
      in conventional preparations having mechanical retentive features. However, there
      is evidence accruing from clinical studies that bonding of amalgam can be
      favorably used to extend the range of usage of amalgam to non-retentive
      conservative preparations, and toward the other extreme, as an adjunct to other
      forms of retention in large compound restorations.

PMID- 11203801
TI  - E-Z gold for repair of abraded and eroded cusp tips.

PMID- 11203802
TI  - Progress and decline.

PMID- 11203803
TI  - Durability of enamel bond strength of simplified bonding systems.
AB  - The purpose of this study was to investigate the influence of thermal cycling on
      enamel bond strength of 2-step bonding systems. The systems used were self
      etching primer systems; Imperva Fluoro Bond, Clearfil Liner Bond II, and Mac Bond
      II; and self-priming adhesive systems; One Step, OptiBond Solo, Prime & Bond 2.0,
      and Single Bond. Bovine mandibular incisors were mounted in self-curing resin and
      the facial surfaces were wet ground with #600 SiC paper. Enamel surfaces were
      treated following each manufacturer's instructions. Adhesives were applied and
      composites were condensed into a Teflon mold (phi 4 x 2 mm) and light cured.
      Bonded specimens were divided into four groups; stored in 37 degrees C water for
      24 hours, followed by thermal cycling between 5 degrees C and 60 degrees C for
      3,000, 10,000, and 30,000 cycles. Ten samples per test group were tested in shear
      mode at a crosshead speed of 1.0 mm/min. One-way ANOVAs followed by Duncan's
      multiple range test (p < 0.05) were done. For self-etching primer systems, a
      significant decrease in bond strength was observed for the thermal cycling
      groups. For the self-priming adhesive systems, a small decrease in bond strength
      was observed but no significant differences were found for thermal cycling
      groups. The changes in bond strength after thermal cycling were different between
      the bonding systems.

PMID- 11203804
TI  - Microhardness of carious deciduous dentin.
AB  - The purpose of this study was to measure the microhardness values of deciduous
      dentin and to compare the values as a function of position in the caries-affected
      layers of dentin including transparent, adjacent sound dentin, and dentin regions
      far from and not related to caries. Seven extracted or exfoliated deciduous
      anterior teeth that had dentin caries on a proximal surface were sectioned
      parallel to the long axis of the tooth. Ten sectioned and polished specimens were
      dehydrated and dried. Microhardness was measured with a Knoop indenter and
      correlated with wet-SEM micrographs. All data were statistically analyzed using a
      two-way ANOVA with subsequent Tukey-Kramer multiple comparison tests at p < 0.05.
      The hardness decreased from the dentinoenamel junction to the pulp chamber wall,
      except for the region under the caries. The hardness values of the region under
      the caries were significantly lower than those of other regions except for the
      inner region. For both the carious and sound sides, the hardness values of the
      inner region were significantly lower than those of the outer and middle regions.
      In comparing the hardness among regions in the carious and sound sides, the
      hardness of the outer, middle, and inner regions on the carious side was
      significantly lower than those in the sound side.

PMID- 11203807
TI  - Operative dentistry in the academic world.

PMID- 11203806
TI  - Polymerization shrinkage of visible-light-cured composites.
AB  - This study investigated the long-term dimensional changes of a conventional and a
      polyacid-modified composite resin and the effects of hydration on polymerization
      shrinkage. A strain-monitoring device was used to measure the linear
      polymerization shrinkage of the composites in the free state when stored in water
      at 37 degrees C or air at 26 degrees C over a one-month period. Results showed
      that the polymerization reaction of both conventional and polyacid-modified
      composite resins was accompanied by a dimensional shrinkage change. The rate of
      shrinkage for both composites was greatest during the polymerization reaction and
      continued after removal of the curing light. When stored in water, the greatest
      shrinkage was noted at one hour for both materials. This was followed by a slow
      uptake of water and expansion from one day to one month. The polyacid-modified
      composite had significantly less polymerization shrinkage than the conventional
      composite after one month of storage in water.

PMID- 11203805
TI  - Single-crystalline ceramic whisker-reinforced carboxylic acid-resin composites
      with fluoride release.
AB  - Currently available glass-ionomer, resin-modified glass-ionomer, and compomer
      materials have relatively low strength and toughness and, therefore, are
      inadequate for use in large stress-bearing posterior restorations. In the present
      study, ceramic single-crystalline whiskers were mixed with fluorosilicate glass
      particles and used as fillers to reinforce experimental carboxylic acid-resin
      composites. The carboxylic acid was a monofunctional methacryloxyethyl phthalate
      (MEP). Five mass fractions of whisker/(whisker + fluorosilicate glass), and
      corresponding resin (resin + MEP), were evaluated. Four control materials were
      also tested for comparison: a glass ionomer, a resin-modified glass ionomer, a
      compomer, and a hybrid composite resin. Flexural specimens were fabricated to
      measure the flexural strength, elastic modulus, and work-of-fracture (an
      indication of toughness). Fluoride release was measured by using a fluoride ion
      selective electrode. The properties of whisker composites depended on the
      whisker/(whisker + fluorosilicate glass) mass fraction. At a mass fraction of
      0.8, the whisker composite had a flexural strength in MPa (mean +/- sd; n = 6) of
      150 +/- 16, significantly higher than that of a glass ionomer (15 +/- 7) or a
      compomer control (89 +/- 18) (Tukey's multiple comparison test; family confidence
      coefficient = 0.95). Depending on the ratio of whisker:fluorosilicate glass, the
      whisker composites had a cumulative fluoride release up to 60% of that of a
      traditional glass ionomer. To conclude, combining ceramic whiskers and
      fluorosilicate glass in a carboxylic acid-resin matrix can result in fluoride
      releasing composites with significantly improved mechanical properties.

PMID- 11203808
TI  - The efficacy of reservoirs in bleaching trays.
AB  - Thirty patients were selected to bleach their maxillary teeth. Vacuum-formed
      trays were fabricated for the maxillary arch so that only one quadrant of
      bleaching tray had reservoirs. Nupro Gold 10% carbamide peroxide gel was given to
      patients. They were instructed to place a drop of gel in each tooth area and wear
      the trays twice a day for two-hour periods. After 10 days the patients were
      evaluated for shade changes in each quadrant. No clinical difference was observed
      in the after-shade match of the two quadrants. It appears that the addition of
      blockout spacers to create reservoirs does not increase the success of home
      bleaching.

PMID- 11203809
TI  - Three-year clinical evaluation of a polyacid-modified resin composite (Dyract).
AB  - The aim of this study was to clinically evaluate a polyacid-modified resin
      composite (Dyract; Dentsply deTrey). Forty-one Dyract restorations were placed
      (36 in noncarious cervical cavities and five in anterior approximal cavities),
      and assessed after three years. The retention rate was 97% for the cervical
      restorations; however, 16 restorations showed some degree of marginal
      discoloration, sometimes severe. Color match and surface integrity were highly
      satisfactory throughout the trial. Dyract has now been superseded by Dyract AP,
      and the manufacturers should consider recommending mandatory enamel etching.

PMID- 11203810
TI  - Short-term dentin bridging of mechanically-exposed pulps capped with adhesive
      resin systems.
AB  - Dentin bridging of 150 mechanically exposed monkey pulps to two adhesive resins
      [BondWell LC (BW); Clearfil Liner Bond II (LB)] and a calcium hydroxide cement
      [Dycal (DY)] were histopathologically evaluated at 3, 7, 14, 30, and 60 days
      after operation (n = 10). The dentin bridge structure was three-dimensionally
      reconstructed from serial sections using a computer-aided reconstruction system.
      At three and seven days, in all pulps, no necrotic tissue and slight inflammatory
      cell infiltration was observed just below the exposure site. At 14 days, spindle
      shaped fibroblast cells could be detected at the wound surface. All dentin chips
      showed reparative dentin deposition along the periphery of the wound surface.
      From this stage, the formation of secondary dentin from the pulpal wall at the
      periphery of the exposed area was recognized in all pulps. At 30 days, initial
      signs of dentin bridging were observed at the wound surface with a well-organized
      layer of odontoblastoid cells. The exposed area became occluded with a dentin
      bridge as the observation period increased. Group DY showed significantly higher
      incidence of dentin bridging than other groups at 30 days (p < 0.05). However, no
      significant difference of dentin bridge formation was found between Group DY and
      Groups BW and LB at 60 days. Bacterial penetration along the cavity walls and
      pulp tissue could not be detected in all groups. Histopathological observations
      and three-dimensional image analysis suggested that dentin bridge formation may
      occur following three patterns: (1) formed from the periphery of the residual
      dentin chip at the wound surface within 14 days, (2) formed within 14 days from
      the periphery of the cavity floor and with formation of reparative dentin by
      stimulation during the cavity preparation, and (3) formed from the wound surface
      within 30 days after exposure.

PMID- 11203811
TI  - Comparison of conventional vs self-etching adhesive bonds to caries-affected
      dentin.
AB  - The mechanism of resin adhesion to caries-affected dentin is still unclear. This
      study evaluated the interfacial morphology of two bonding systems to caries
      affected dentin, coupled with the measurement of microtensile bond strengths (mu
      TBS). Carious human molars were prepared as previously described in Nakajima and
      others (1995) and were bonded with Single Bond (SB) or FluoroBond (FB) according
      to the manufacturer's instructions, followed by creation of AP-X composite
      buildups. After one day of storage in 37 degrees C water, the teeth were serially
      sectioned vertically into 0.8 mm slabs, trimmed to yield a 1 mm2 test area, and
      tested to failure in a Bencor device used in an Instron machine operated at 1
      mm/min. Resin-dentin interfaces were observed with SEM before or after acid/base
      challenge. Bonding to normal dentin with the two bonding systems (SB and FB)
      showed tensile bond strengths significantly higher than those to caries-affected
      dentin. The moist bonding technique significantly increased bond strength of SB
      to normal and caries-affected dentin. SEM examination revealed that typical
      hybrid layer and resin tags could not be formed to caries-affected dentin. The
      results suggested that resin penetration may be prevented by occlusion of
      dentinal tubules by mineral deposits that may also impart acid-resistance to the
      intertubular matrix of caries-affected dentin.

PMID- 11203812
TI  - Effect of food-simulating liquids on surface characteristics of composite and
      polyacid-modified composite restoratives.
AB  - The chemical environment is one aspect of the oral environment that could have an
      appreciable influence on the in vivo degradation of composite resins. The effects
      of food-simulating liquids on the surface roughness and hardness of composite
      (Silux Plus, Z100, Spectrum TPH, and P50) and polyacid-modified composite resins
      (F2000 and Dyract AP) were thus investigated and compared. Sixty disks of each
      material were made. Half were used for microhardness testing and the remaining
      half for studying surface roughness using profilometry. Each group of 30 disks
      was subdivided into six groups of five and conditioned for one week as follows-
      Group 1 (control): air at 37 degrees C; Group 2: distilled water at 37 degrees C;
      Group 3: 0.02 N citric acid at 37 degrees C; Group 4: 0.02 N lactic acid at 37
      degrees C Group 5: heptane at 37 degrees C; Group 6: 50% ethanol-water solution
      at 37 degrees C. Data were analyzed using one-way ANOVA and Scheffe's test at a
      significance level of 0.05. Results showed that the surface roughness of all
      restoratives evaluated was not significantly affected by food-simulating liquids.
      No significant change in surface hardness was noted with conditioning of Spectrum
      TPH, Dyract AP, and F2000 in the various food-simulating liquids. The BIS-GMA
      based composites Silux Plus, Z100, and P50 appeared to be more susceptible to the
      softening effects of some food-simulating liquids.

PMID- 11203813
TI  - Effect of restoration size on fracture resistance of bonded amalgam restorations.
AB  - The purpose of this study was to determine the effect of restoration size on the
      fracture strength of amalgam restorations bonded with Amalgambond Plus (with
      HPA). Research has shown that this adhesive is dispersed throughout the unset
      amalgam during condensation and that a decrease in diametral tensile strength,
      proportional to the amount of adhesive incorporated into the unset amalgam, has
      resulted. Smaller cavity preparations have a higher ratio of surface area to
      volume than do larger preparations, and it was anticipated that a proportionately
      greater amount of adhesive would be incorporated into smaller amalgam
      restorations. Sixty extracted human molars were divided into four groups of 15
      teeth and mounted in tray acrylic-filled PVC cylinders. Shallow approximo
      occlusal channels were prepared in two groups. One group was restored with
      Amalgambond Plus and Tytin amalgam, the other with just Tytin amalgam. Larger
      proximo-occlusal preparations were made in the remaining two groups, then
      restored in the same fashion. Samples were stored in 37 degrees C for at least 24
      hours, then thermocycled from 5-55 degrees C 1000 times with a one-minute dwell
      time. Specimens were mounted in a Universal Testing Machine, and a chisel was
      applied to the restorations in compression mode at a crosshead speed of 5.0
      mm/minute until bulk fracture of the amalgam occurred. The results indicated no
      difference in bulk fracture strengths between large amalgam restorations restored
      with and without Amalgambond Plus. However, small amalgam restorations restored
      with Amalgambond Plus exhibited significantly greater (p < 0.025) bulk fracture
      strengths than small amalgam restorations restored without use of the adhesive.

PMID- 11203814
TI  - Edge-bevel fracture resistance of three direct-filling materials.
AB  - Edge strength is defined in this study as the resistance to fracture of the
      beveled extension normally located at the cavosurface margin of a dental
      restoration. The edge strength of direct-filling alloy restorations plays an
      important role in maintaining the integrity of margins at tooth-alloy interfaces
      during functional loading. The purpose of this study was to determine the
      relative strength of an experimental consolidated silver material in comparison
      to other direct filling materials. The method used was designed as a simulation
      for relative edge-strength clinical properties. Stainless steel dies were formed
      from disks 5 mm thick, each with a centered hole tapered (1/48) toward the bottom
      side of the disk. A 41 degrees bevel, 0.5 mm wide as viewed from above, was
      placed on the top-side of the disk. Dispersalloy (D) or Unison (U) amalgam, Z-100
      composite (C), hand-consolidated silver powder (HAg), or pneumatically
      consolidated silver powder (PAg) was used to fill the die opening. Excess was
      polished from both sides of the disk with 600-grit abrasive paper. The sample was
      loaded from the beveled side with a 3 mm-in-diameter flat-ended plunger at a rate
      of 1.0 mm/minute until failure. Failure load and total energy to failure were
      recorded and compared. Tukey's multiple comparison test (p < 0.05) ranked the
      materials (U) > (HAg) > (D) > (PAg) > (C) for fracture strength and (HAg) > (D) >
      (U) > (PAg) > (C) for fracture energy.

PMID- 11203815
TI  - The effect of depth of dentin demineralization on bond strengths and morphology
      of the hybrid layer.
AB  - Previous studies have shown that different phosphoric acid-based etchants do not
      penetrate intertubular dentin to the same depth. The purpose of this study was to
      determine the effect of different phosphoric acid-based conditioners on dentin
      shear bond strengths of three one-bottle bonding systems and to evaluate the
      corresponding interfacial ultramorphology. The null hypothesis to be tested was
      that no correlation could be established between the depth of intertubular
      demineralization and dentin shear bond strengths. The labial surface of 90 bovine
      incisors was polished to expose middle dentin. The specimens were randomly
      assigned to three one-bottle adhesive systems (n = 30): OptiBond SOLO, Permaquick
      PQ1, and Single Bond. For each adhesive system the specimens were divided into
      three subgroups of different silica-thickened etching gels (n = 10): 37.5%
      phosphoric acid gel (Kerr Gel Etchant), 35% phosphoric acid gel (Ultraetch), and
      35% phosphoric acid gel (Scotchbond Etching Gel). After 24 hours in water at 37
      degrees C, the specimens were thermocycled for 500 cycles in baths kept at 5
      degrees C and 55 degrees C and the shear bond strengths measured. The data were
      analyzed with one-way and two-way ANOVA. Further, the adhesives were applied to
      800 microns-thick bovine dentin disks (two per subgroup), which were restored
      with a low-viscosity composite resin. Six small dentin/resin sticks with a cross
      section of 1.0 mm x 1.0 mm were obtained from each bonded disk. They were then
      decalcified in a buffered solution of EDTA, fixed, stained, and sectioned in 90
      nanometer-thick slices to observe under the Transmission Electron Microscope
      (TEM). The mean shear bond strengths were not statistically different at a
      confidence level of 95%. When the means were pooled for dentin adhesive and for
      etching gel, the number of cohesive failures was greater for Permaquick PQ1 and
      for Ultraetch, respectively. Pearson's correlation coefficient showed no
      correlation between hybrid layer thickness and bond strengths. The
      ultramorphological observation showed that all materials penetrated the dentin
      and formed a hybrid layer, regardless of the etching gel used.

PMID- 11203816
TI  - The influence of blood contamination on bond strengths between dentin and an
      adhesive resin cement.
AB  - The objective of this study was to determine in which step of adherent surface
      treatments blood contamination affects the bond strength between an adhesive
      resin and dentin. The coronal part of bovine incisors was polished flat to expose
      the dentin. The specimens were randomly divided into three groups and specific
      surface treatments were applied to each group: (1) a self-etching primer
      application (SP group); (2) 38% phosphoric acid etching followed by primer (non
      HC group); (3) acid etching followed by 10% sodium hypochlorite solution
      application and primer (HC group). The dentin surface was contaminated by human
      blood before or after either step of the surface treatments. The contaminated
      surfaces were washed with water after 30-second exposure and air-dried. A
      stainless-steel rod was adhered on the dentin surface with Panavia 21 after
      completing the surface treatment(s), and the tensile bond strength was measured.
      Fifteen subgroups including control groups were tested. If blood contamination
      occurred before collagen fibers were exposed by either phosphoric acid etching or
      self-etching primer application, the contamination presented almost no influence
      on bond strength. Blood contamination of the dentin surface where collagen fibers
      had been exposed decreased the bond strength. However, when the contaminated
      collagen fibers were dissolved or when the contamination occurred after the
      exposed collagen fibers were dissolved, the bond strength was maintained. The
      bond strength was markedly decreased when the contamination occurred after the
      primer application (Scheffe's Comparison, SP group: p = 0.0003, non-HC group: p <
      0.0001), but was restored by reapplication of the self-etching primer. This study
      revealed that the effects of blood contamination on the bond strength of adhesive
      resin to dentin vary greatly depending on the adherent surface conditions.

PMID- 11203817
TI  - Effect of food-simulating liquids on the flexural strength of composite and
      polyacid-modified composite restoratives.
AB  - This study investigates the effects of food-simulating liquids on composite and
      polyacid-modified composite restoratives. Three composite (Z100, Spectrum TPH,
      and Tetric Ceram) and three polyacid-modified composite (F2000, Dyract AP, and
      Compoglass) restoratives from the same manufacturers were selected for the study.
      Flexural strength specimens (25 x 2 x 2 mm) based on ISO 4049 specifications were
      fabricated according to the manufacturers recommendations. After light
      polymerization, the specimens were removed from their molds and conditioned for
      one week at 37 degrees C in the following mediums: (1) deionized water, (2) 0.02
      M citric acid, (3) heptane, and (4) 50% ethanol-water solution. Specimens stored
      in air were used as controls. The sample size was five for each material-medium
      combination. After conditioning, the specimens were blotted dry, measured, and
      subjected to flexural strength testing using an Instron Universal Testing Machine
      with a crosshead speed of 0.05 mm/minute. With the exception of Compoglass,
      flexural strength of all restoratives after conditioning in heptane was
      significantly greater than that after conditioning in all other mediums and the
      control. Although no significant difference in flexural strength values was
      observed between the different restoratives when the materials were conditioned
      in heptane or air (control), significant differences were observed between the
      different restoratives after conditioning in aqueous solutions (water, citric
      acid, and ethanol-water solution). The flexural strengths of the composites were
      generally significantly higher than their polyacid-modified counterparts after
      conditioning in the various aqueous solutions. The detrimental effects of aqueous
      solutions on flexural strength appeared to be greater with polyacid-modified
      composite resins than with composite restoratives.

PMID- 11203818
TI  - Repair strength of etched vs silica-coated metal-ceramic and all-ceramic
      restorations.
AB  - The purpose of this in vitro study was to examine shear bond strengths of
      composite resin to metal-exposed porcelain-fused-to-metal (PFM) and all-ceramic
      restorations after silica coating or etching with 5% hydrofluoric acid (HF).
      Specimens were fabricated for each of the following groups: two all-ceramic
      materials [a feldspathic porcelain (Vita Mark II) and a leucite-reinforced glass
      ceramic (IPS Empress)], and one noble metal-ceramic (Orplid Keramik I alloy; Vita
      VMK 68 N felspathic veneer ceramic). These groups were repaired with resin
      composites after different pretreatment methods. In one metal-ceramic subgroup
      the surface exhibited a 50% metal and 50% ceramic exposure. In the silica-coating
      groups, the specimen surfaces were air abraded with silica acid-modified Al2O3
      (CoJet Sand) and treated corresponding to the porcelain repair with resin
      composite. For control groups, the surfaces were etched with 5% HF for 60 seconds
      and treated in the same way as the silica-coated groups. After 24 hours of
      storage (distilled water, 37 degrees C) and an additional 24 hours of
      thermocycling (1150 x 5 degrees C/55 degrees C) the specimens were debonded using
      a shear bond strength test (n = 15). In all groups the silica coat repair
      achieved equal or significantly higher bond strengths than did the etching
      technique (p < 0.05, Mann-Whitney U test). In the metal-exposed group, the mean
      bond strength increased from 7.3 MPa to 16.3 MPa following the silica-coat
      repair. Results indicated that silica coating represents a suitable treatment for
      the intraoral repair of the materials tested in the present study.

PMID- 11203819
TI  - Factors affecting shear bond strength of composite resin to fluorosed human
      enamel.
AB  - The aim of this work was to determine the effects of age, severity of fluorosis,
      and etching time on the shear bond strength of direct composite resin to human
      enamel. A total of 117 teeth, freshly extracted from patients in areas of Saudi
      Arabia endemic for dental fluorosis, were classified according to age (< 40 years
      and 40+ years) and severity of fluorosis, using the Thylstrup and Fejerskov
      index, TFI: TFI = 0, TFI = 1-3, and TFI = 4-6. Cylindrical composite resin
      specimens 5 mm in diameter and 3 mm high were bonded to the flattened midlabial
      enamel surfaces etched for 60 or 120 seconds and shear bond strength measured,
      using the Instron Universal Testing Machine at a crosshead speed of 0.5
      mm/minute. Shear bond strength of the resin varied between 11.2 +/- 3.6 and 21.6
      +/- 4.1 MPa. Three-way analysis of variance and Sheffe's multiple range test
      showed that the severity of fluorosis had no statistically significant effect on
      shear bond strength (p > 0.05). However, the bond was significantly stronger in
      teeth from patients < 40 years old than from those 40+ years old. Furthermore, at
      age < 40 years, shear bond strength was significantly higher in teeth etched for
      120 seconds than those etched for 60 seconds (p < 0.05), but this was not the
      case in teeth from the older patients. In teeth with TFI = 1-3, the mode of bond
      failure was predominantly mixed, but at TFI = 4-6, the bond failure was mostly
      cohesive in enamel at all ages and etching times. It is, therefore, concluded
      that both age and etching time affect the shear bond strength of composite resin
      to fluorosed human enamel.

PMID- 11203820
TI  - Rigidity and retention of ceramic root canal posts.
AB  - Ceramic root-canal posts offer potential advantages over other types with respect
      to aesthetics and biocompatibility. Any post must be sufficiently rigid and
      retentive to withstand functional forces. Ceraposts (1.2 mm coronal diameter,
      ceramic, tapering, smooth posts) and Paraposts (1.25 mm, stainless-steel,
      parallel, serrated posts) were tested for rigidity by means of a three-point
      bending test. To test retention in roots, ceramic posts were cemented using one
      of three protocols: (1) glass-ionomer cement, (2) silane coupling agent and resin
      cement, or (3) sandblasted post surface, silane coupling agent, and resin cement.
      Stainless-steel posts were cemented with resin. The tensile force required to
      dislodge the posts, following four weeks of storage in water, was recorded. Data
      were compared using Student's t-test and Mann-Whitney U analysis. Ceraposts were
      significantly more rigid than Paraposts (p < 0.001). Paraposts cemented with
      resin were significantly more strongly retained than Ceraposts following any
      cementation protocol (p < 0.001). Retention of the ceramic posts was
      significantly greater with a silane coupling agent and resin cement than with
      glass-ionomer cement (p < 0.001). Sandblasting the ceramic posts produced
      variable results and needs further investigation before it could be recommended.

PMID- 11203821
TI  - Marginal hybrid layer in Class V restorations.
AB  - The aim of this study was to evaluate the morphology of the hybrid layer
      (identified as marginal hybrid layer) along the cervical margins of Class V
      restorations using several bonding systems. Class V restorations were prepared in
      vitro at the CEJ in extracted third molars. Three different bonding systems were
      selected: Scotchbond 1 (Single Bond), Scotchbond MP, and Clearfil Liner Bond 2V.
      After finishing each restoration with disks, each margin was polished for one
      minute with polishing paste. The margins of half of the restorations were then
      treated with 10% phosphoric acid for five seconds, washed in deionized water, and
      then stored in water for 24 hours before SEM analysis. The margins of the other
      half of the restorations were treated with 10% phosphoric acid for five seconds,
      then with 1.5% NaOCl gel for two minutes to remove noninfiltrated collagen, then
      washed and stored in water for 24 hours. Each sample was gold coated and observed
      under SEM. A one-way ANOVA was performed to determine if there were any
      statistically significant differences in hybrid layer thicknesses. The thickness
      of the marginal hybrid layer measured under SEM was 1.5-2.5 microns thick in
      Scotchbond MP and Scotchbond 1 but varied from 0.0 to 12.0 microns in Clearfil
      Liner Bond 2V when observed after NaOCl postpolishing procedures. Far more
      porosities were seen in the marginal hybrid layer of Clearfil Liner Bond 2V.
      Enamel margins were free from a hybrid layer in both groups. This study
      demonstrated that collagen fibrils are not completely infiltrated by adhesive
      resin at the CEJ level along the cavorsurface margin of the restorations. The
      presence of noninfiltrated collagen along the external margins may reduce the
      sealing capability of bonding systems, leaving many open spaces and gaps, which
      may jeopardize the durability of the bond over time.

PMID- 11203822
TI  - Techniques in recording centric relation.
AB  - 1. Muscle seated centric registration is a reproducible method of obtaining
      centric relation (Wood, 1994). 2. The muscle-seated CR record provides a
      consistent, accurate, less technique-sensitive CR record of condylar position.

PMID- 11203823
TI  - Expedited custom post and core technique.

PMID- 11203824
TI  - Conservative anterior tooth replacement using fiber-reinforced composite.

PMID- 11203825
TI  - Academy of operative dentistry. Award of Excellence. Dr Bruce Brownfield Smith.

PMID- 11203826
TI  - Academy of Operative Dentistry. Hollenback Memorial Prize. Dr Frederick C
      Eichmiller.

PMID- 11203828
TI  - Class II restorations with a polyacid-modified composite resin in primary molars
      placed in a dental practice: results of a two-year clinical evaluation.
AB  - This study evaluated the two-year success rate of a hybrid composite material
      (TPH-Spectrum; Dentsply DeTrey, Konstanz, Germany) and a polyacid-modified
      composite resin (Compoglass, Vivadent, Schaan, Liechtenstein) in Class II
      restorations placed in primary molars in a dental practice. In each of 52
      children, at least two primary molars were restored. Ninety-six primary molars
      were filled with TPH-Spectrum using the total-etching technique, and 94 with
      Compoglass without acid etching prior to application of the bonding adhesive. At
      baseline, one and two years, the restorations were assessed according to the Ryge
      criteria. Forty-seven children with a total of 132 fillings (68 TPH-Spectrum, 64
      Compoglass) were evaluated after two years. The cumulative success rate after 24
      months amounted to 89.2% for the Compoglass and 89.7% for the TPH-Spectrum
      restorations. No significant differences were observed between the two materials
      with respect to color matching, cavosurface discoloration, anatomic form, margin
      integrity and caries assessment. This investigation suggests that for a period of
      two years, the hybrid composite TPH-Spectrum and the polyacid-modified composite
      resin Compoglass, are suitable materials for restoration of primary molars.

PMID- 11203827
TI  - Tooth-colored filling materials for the restoration of cervical lesions: a 24
      month follow-up study.
AB  - The recently developed resin-modified glass ionomer cements and the polyacid
      modified composites are promising alternatives to conventional materials for
      restoring cervical defects. This clinical study evaluated the clinical condition
      of cervical fillings 24 months following placement. The study subjects were 197
      cervical restorations placed on incisors, canines and premolars in 37 patients
      for restoration of erosion/non-carious lesions (69 cases), primary carious
      lesions (57 cases) and the replacement of deficient restorations (71 cases). The
      teeth were randomly divided into four groups for restoration with either Tetric
      (composite, Group A: n = 36), Dyract (compomer, Group B: n = 79), Fuji II LC
      (resin-modified glass ionomer cement, Group C: n = 51) or Photac-Fil (resin
      modified glass ionomer cement, Group D: n = 31). The evaluation was done single
      blind at baseline, 8 and 24 months after the placement of the fillings, according
      to a modified USPHS rating scale. The assessment criteria were color stability,
      anatomical form, surface texture, marginal integrity, marginal discoloration and
      loss of filling. Statistical analysis was completed using Pearson chi-square and
      Fisher's exact test at a significance level of 5% (p < 0.05). After the 24-month
      period, the composite restorations showed superior results. The compomer fillings
      demonstrated conditions that were only slightly worse. A substantial number of
      the resin-modified glass-ionomer fillings were evaluated with bravo or even
      charlie scores in respect to at least one of the criteria assessed.

PMID- 11203829
TI  - Antibacterial activity of resin adhesives, glass ionomer and resin-modified glass
      ionomer cements and a compomer in contact with dentin caries samples.
AB  - A total of 103 clinical samples of carious dentin were used to study the
      antibacterial action of different dental resin adhesive materials (Gluma 2000,
      Syntac, Prisma Universal Bond 3, Scotchbond Multi-Purpose and Prime&Bond 2.0)
      glass ionomer cements (Ketac-Cem, Ketac-Bond, Ketac-Silver, Ketac-Fil) resin
      modified glass ionomer cements (Fuji II LC, Vitremer and Vitrebond) and a
      compomer (Dyract). The agar plate diffusion method was used for the microbial
      cultures and a chlorhexidine control. The growth of the caries-producing
      microorganisms was effectively inhibited by the Vitremer and Vitrebond cements,
      and to a lesser extent by the Scotchbond Multi-Purpose adhesive system. Overall,
      there were statistically significant differences in the antibacterial activity of
      the products tested.

PMID- 11203830
TI  - The use of resin composite pins to improve retention of Class IV resin composite
      restorations.
AB  - This study evaluated the effect of an intracoronal resin composite pin on Class
      IV resin composite restorations. A control group of 16 bovine teeth was prepared
      with standardized conventional Class IV preparations. For an experimental group,
      16 similar Class IV preparations were made, with the addition of an intracoronal
      pin channel prepared with a #330 bur into the dentin. All specimens were restored
      with Herculite XRV and OptiBond according to the manufacturer's recommendations.
      After one week, specimens were placed in an Instron Universal Testing Machine and
      loaded at 90 degrees to the long axis until the restorations failed. Results
      indicated that the mean fracture load of the Class IV restoration group, with the
      resin composite pin, was 36% higher than the conventional Class IV group (p =
      0.02). An intracoronal resin composite pin may aid the retention and resistance
      form of complex resin composite restorations.

PMID- 11203831
TI  - Effect of sealant viscosity on the penetration of resin into etched human enamel.
AB  - This study was designed to investigate the relationship between the etched depth,
      penetration of sealants and marginal seal. Sixty unerupted lower first premolars
      extracted from patients for orthodontic reasons were thoroughly cleaned and
      stored in an antiseptic Ringer's solution at 4 degrees C. A "window" on the
      occlusal of 15 of the premolars, including both mesial and distal pits, was
      developed by painting nail varnish around the border of the occlusal surfaces.
      Etching was then done with 35% phosphoric acid for 60 seconds to all 60
      premolars. Five of the "window" teeth were evaluated by microradiography to
      determine the etched depth of the superficial and subsurface enamel. Five were
      prepared for SEM analysis to observe the change of the superficial etched enamel
      surface. Another five "window" teeth were embedded in epoxy resin and sectioned
      parallel to the long axis of the tooth through the fissures in order to observe
      the subsurface depth of the etch by SEM analysis. The other 45 teeth were divided
      into three groups of 15 teeth each. Fissures of each group of teeth were sealed
      using Prisma-Shield (LD Caulk), Concise White Sealant (3M Dental Products) or
      Teethmate A (Kuraray) sealants and stored in water (37 degrees C) for 24 hours.
      They were then sectioned and demineralized before being examined by a scanning
      electron microscope. Photographs of secondary electron image (SEI) were done to
      gradate the resin-infiltrated enamel and resin tags for these sealants. After SEM
      observation, the 15 samples of each applied sealant were polished to a high gloss
      again and placed in a silver nitrate solution for 24 hours before being examined
      under the SEM equipped with a back-scatter electron detector. Data were then
      analyzed using the Welch and Student t-tests. Results showed that fissured enamel
      of unerupted human lower first premolars became porous after etching with 35%
      phosphoric acid. The low viscosity sealant Teethmate A (approximately 260 mPa.s),
      penetrated fully and formed a resin-infiltrated layer in enamel beyond the etched
      depth. However, the high viscosity sealants (Prisma-Shield and Concise White
      Sealant) did not penetrate enough to ensure that the acid-etched enamel was
      infiltrated sufficiently by the sealant to insure good marginal seals.

PMID- 11203832
TI  - Bond strength of compomers to human enamel.
AB  - The study evaluated the tensile bond strength between human enamel and seven
      compomer restorative systems under different bonding conditions. Seven compomers
      were bonded to human tooth structure with and without phosphoric acid etching of
      the bonding surface, with and without the use of their recommended combined
      primer and bonding agent and with both moist and wet bond interface environments.
      Overall, the highest bond strengths to human enamel were attained using
      phosphoric acid conditioning, primers and moist bonding surfaces.

PMID- 11203833
TI  - Microleakage of light-cured resin and resin-modified glass-ionomer dentin bonding
      agents applied with co-cure vs pre-cure technique.
AB  - This in vitro study evaluated the effect of dentin bonding agents in reducing
      microleakage after three months in Class V restorations restored with Z100 resin
      composite. Materials tested were three types of resin-based dentin bonding
      agents: a multi-step (Scotchbond Multi-Purpose); a one-step (Scotchbond One
      Step); a self-etching, self-priming (Clearfil Liner Bond) and a resin-modified
      glass ionomer (GC Fuji Bond LC). Class V cavity preparations with occlusal
      margins in enamel and gingival margins in cementum were prepared both on labial
      and lingual surfaces of extracted premolar teeth. Restorations (two per tooth)
      were distributed randomly into nine test groups (n = 10) consisting of the
      various DBAs applied with co-cure and pre-cure techniques, and no dentin bonding
      as a negative control group. Samples were stored in saline for three months,
      thermocycled, stained with silver nitrate, then sectioned through the middle of
      the preparation to facilitate the removal of the composite resin restoration. For
      groups treated with the pre-cure technique, the differences between the enamel
      leakage values of SBMP-control, CFLB-control and SB1S-control subgroups were
      significant (p < 0.05). For enamel leakage values of groups treated with the co
      cure technique, the differences between the SBMP-control, SB1S-control, CFLB
      control and Fuji LC-control subgroups were significant (p < 0.05). For cementum
      leakage values of groups treated with pre-cure technique, the difference between
      the CFLB-control and the Fuji, SBMP and SB1S groups was significant (p < 0.05).
      No significant differences could be detected between the cementum leakage values
      of groups treated with the co-cure technique (p > 0.05). The differences between
      the values obtained with application of CFLB with the pre-cure and co-cure
      techniques at the cementum margins were found to be statistically significant (p
      = 0.02). No statistically significant differences could be detected between the
      pre-cure and co-cure values of the other test materials. Generally for every
      group, cementum microleakage values were greater than enamel microleakage values
      (p < 0.05). The use of Scotchbond Multi-Purpose, Scotchbond One-Step and Fuji
      Bond LC with the co-cure technique to decrease the application time did not cause
      any significant increase in microleakage. Only pre-curing using Clearfil Liner
      Bond provided better microleakage properties than the other pre-cured adhesives.

PMID- 11203834
TI  - Bond strengths of a porcelain material to different abutment substrates.
AB  - The study evaluated the bond strength values of a single-unit all-porcelain
      material luted with an adhesive-resin cement to different abutment substrates:
      amalgam, compomer, traditional glass ionomer cement, microhybrid resin composite,
      two resin composites for abutment build-up, gold, sandblasted gold, dentin and
      enamel. Syntac enamel-dentin bonding system, in combination with IPS-Empress
      porcelain material, was used. After thermal cycling, the samples were inserted
      into a Bencor jig device and sheared in a Controls testing machine. The
      statistical analysis of the differences between the bond strength values obtained
      was performed by ANOVA and the Student-Newman-Keuls multiple-comparison test. The
      type of failure at the interface was evaluated using scanning electron
      microscopy. The type of failure, such as adhesive, cohesive and adhesive
      cohesive, was correlated with bond strength values. Enamel, dentin and the two
      resin composites for crown build-up showed the highest bond strength values,
      while amalgam and gold samples showed the lowest.

PMID- 11203835
TI  - Flow characteristics and sealing ability of fissure sealants.
AB  - This study evaluated the relationship between fissure sealant viscosity, leakage
      prevention and the incidence of void formation of five commercially available pit
      and-fissure sealants. Seventy-two intact, caries free human pre-molars and molars
      were divided into six test groups of 12 teeth each. All teeth were cleaned with a
      flour of pumice prophylaxis followed by etching for 60 seconds with 37% H3PO4,
      rinsing for 30 seconds and drying with oil-free air. Five commercial, light-cured
      fissure sealants and an unfilled version of one sealant were applied following
      manufacturers' instructions. Teeth were thermal cycled for 5000 cycles from 5-50
      degrees C with a one-minute dwell time at each temperature. Silver nitrate
      staining followed by mesiodistal sectioning was performed. Leakage and void
      formation were evaluated at X50 optical magnification. Viscosity was assessed by
      syringing the fissure sealants into short pipettes, allowing free flow for 30
      seconds and then light curing for one minute. The length of unfilled capillary
      was measured with a Vernier gauge. All experimental data was subjected to a one
      way ANOVA, and where differences were detected, they were identified by a post
      hoc Tukey hsd test at a priori alpha = 0.05. Based on the conditions of the
      study, viscosity and flow characteristics had no effect on sealing ability or
      void formation.

PMID- 11203836
TI  - Three-dimensional optical profilometry analysis of surface states obtained after
      finishing sequences for three composite resins.
AB  - The operating protocols used for finishing composite resins are numerous and
      affect the success of filling from a mechanical, biological, and aesthetic point
      of view. The study determined the most favorable finishing for each of the
      composites considered. The three-dimensional optical profilometry examination was
      used to obtain qualitative and quantitative measurements of three hybrid
      composites. Tungsten carbide burs left irregularities harder to eliminate than
      those caused by diamond burs. Sof-Lex disks and the Enhance System gave good
      results for the three materials. Charisma presented a good surface regardless of
      polishing method used. Finishing Z100 and Prisma TPH required a special operating
      protocol as specified by the manufacturers. This study demonstrated that the
      finishing procedure for composite materials must be strictly followed to obtain
      optimal results. Profilometry proved to be an excellent method to study the
      surface roughness of samples.

PMID- 11203837
TI  - Microleakage of bonded amalgam restorations: effect of thermal cycling.
AB  - This study examined the effect of thermal cycling on the microleakage of bonded
      amalgam restorations. Three dental amalgam alloys and a gallium alloy were tested
      with two adhesive resin systems and copal varnish as a control. Class V cavity
      preparations were prepared on 168 freshly extracted premolars or molars. The
      preparations were placed parallel to and 1.0 mm occlusal to the cementoenamel
      junction (CEJ). Four groups of 42 teeth each were treated with one of the
      following adhesive dentin systems: Bond-It, All-Bond 2/Resinomer or a copal
      varnish (Copalite). The four groups of 42 teeth each were then restored with one
      of three dental amalgams: Orosphere Plus, Indiloy, Oralloy or a Gallium alloy
      (Galloy), resulting in 12 test groups of 14 teeth each. The specimens were stored
      in double distilled water at 37 degrees C for 24 hours. Final contouring and
      polishing of the restorations were performed under water spray. Half of the
      restorations in each group were thermocycled for 3000 cycles (5 degrees C-37
      degrees C-55 degrees C-37 degrees C) with a dwell time of 15 sec at each
      temperature. The other half were stored in double distilled water at 37 degrees C
      for 24 hours. Then all 168 restorations were stained with dye, sectioned and
      scored for microleakage. Results showed that the adhesive dentin systems reduced
      microleakage in amalgam restorations compared to copal varnish only in non
      thermocycled specimens. Statistical analysis of the results showed that there was
      an extremely significant difference (p < 0.001) in microleakage between the non
      thermocycled and the thermocycled specimens in all test groups, whereas, there
      was no significant difference (p > 0.05) among thermocycled specimens. The
      reduction of microleakage was not significantly different between Bond-It and All
      Bond 2/Resinomer in non-thermocycled specimens. Oralloy showed the most
      microleakage in the non-thermocycled groups when compared to the other alloys
      using the same adhesive liner.

PMID- 11203839
TI  - Physical properties of three packable resin-composite restorative materials.
AB  - This study evaluated selected physical properties of three packable resin
      composites (Alert, SureFil and Solitaire) and compared them to two conventional
      hybrid materials (Prodigy and Z-100). The specific properties investigated were
      diametral tensile strength, transverse strength, elastic modulus and fracture
      toughness. Following photopolymerization, specimens for each composite material
      were stored in deionized water at 37 degrees C for 35 days. A one-way ANOVA and
      Tukey's post-hoc test were employed for each property to determine whether
      significant differences occurred with respect to specific restorative materials.
      All materials had statistically similar diametral tensile strengths. Alert had
      the highest mean fracture toughness and elastic modulus but had a low mean
      transverse-strength value. SureFil exhibited good mean physical property values
      compared to both the conventional and packable materials. Solitaire had low mean
      fracture toughness, transverse strength and elastic modulus values, which could
      cause concern regarding use in posterior restorations. The packable resin
      composites tested had a wide range of mean values for the physical properties
      investigated. Generally, Alert and SureFil were superior to Solitaire and
      comparable to the hybrid materials Prodigy and Z-100, but clear discrimination
      among performance of these materials requires clinical testing.

PMID- 11203838
TI  - Technique sensitivity of dentin bonding: effect of application mistakes on bond
      strength and marginal adaptation.
AB  - This in vitro study evaluated dentin bond strength and marginal adaptation of
      direct resin composites according to the manufacturers' instructions and with
      simulated application errors. One hundred and forty cavities were prepared into
      disks of freshly extracted human third molars and filled with one resin
      composite. Dentin adhesives of the third (with self-etching primer: Syntac
      Classic), fourth (with total etching: Scotchbond Multi-Purpose Plus) and fifth
      generation (one-bottle adhesive: Prime&Bond 2.1) were used for bonding. Simulated
      application mistakes were as follows: 1) prolonged etching; 2) excessive drying
      after conditioning; 3) drying primers immediately after application and 4) drying
      primers excessively. After 21 days of storage and 24 hours thermocycling (1150
      cycles), replicas were made and push-out testing was performed. Replicas were
      examined for marginal adaptation using SEM (X200 magnification). Compared with
      values of the control groups, application errors resulted in dramatically
      decreased bond strengths and reduced percentages of gap-free margins for all
      products tested (p < 0.05). Excessive drying after conditioning exhibited
      significantly less effect for the third generation adhesive than for products
      requiring total etching/wet bonding.

PMID- 11203840
TI  - Cumulative assessment of factors leading to restorative decisions in an
      educational environment. A graphical demonstration using an in vitro case.
AB  - Even though accuracy and inter-examiner variation assessments of borderline
      restorative items have been previously reported, no attempt has been made to
      replicate the effect of cumulative, sequential diagnostic and treatment planning
      decisions. This study assesses the cumulative effect of factors indicating
      restorative needs by evaluating how readily tooth restoration was proposed on the
      basis of restoration quality and presence of caries (compared to gold standards).
      Ninety-one senior dental students in Mexico City (79% female; mean age 22.8
      years) assembled in 19 teams of five students each. They sequentially evaluated
      56 restored and unrestored posterior teeth in an in vitro model. Each student
      examined the set, removed those teeth needing restorative intervention and
      returned the remaining set for examination by a second student. When the second
      assessment was completed, the remaining teeth were turned over to the third
      teammate and so on. Teeth were subsequently assessed for restoration quality and
      enamel and dentinal caries. When a tooth showed a carious lesion, a dentinal
      lesion or a defective restoration, the likelihood of it being selected for
      restorative treatment increased. When more than one feature was present, the
      chances of the tooth being selected more frequently and earlier increased,
      accordingly. The specificity of restorative treatment needs was not excellent. A
      strong graphical association between the presence of caries and/or defects in
      restorations with proposed restorative treatment was demonstrated using a non
      quantitative research model. The more abundant these features were, the higher
      the probability appeared for a tooth to fit the clinical picture suitable for
      restorative intervention.

PMID- 11203841
TI  - Foreign body gingivitis associated with a new crown: EDX analysis and review of
      the literature.
AB  - Gingival inflammation associated with foreign bodies in connective tissue is
      termed Foreign Body Gingivitis (FBG). It is not commonly recognized by clinicians
      and has recently been described fully in the literature. It is more common in
      females, and the incidence by age follows a normal distribution, unlike
      bacterially-induced gingivitis. Most frequently, a red or red-and-white painful,
      chronic lesion, it has usually been present for less than one year and does not
      resolve with optimization of oral hygiene. It may be clinically confused with
      lichen planus. There is no gingival site predilection. Microscopically, foreign
      bodies are associated with the gingival inflammation, and elemental analysis
      suggests that they are usually derived from abrasives, and less commonly from
      restorative materials. Treatment of FBG is still unclear and its prevention is
      discussed. A case is presented in which a patient developed localized foreign
      body gingivitis after placement of a crown. Elemental analysis using energy
      dispersive X-ray microanalysis (EDX) of the foreign particles was most consistent
      with an abrasive material.

PMID- 11203842
TI  - Shade selection for composite repair of lost veneer facings.

PMID- 11203843
TI  - Buonocore Memorial Lecture. Adhesive dentistry in the 21st century.

PMID- 11203844
TI  - Clinical performance of Class II restorations in which resin composite is
      laminated over resin-modified glass-ionomer.
AB  - This study evaluated the one-year functioning of resin-composite/resin-modified
      glass-ionomer open-laminate restorations when used for restoring Class II
      cavities. It also investigated the effect of the thickness of the resin composite
      layer on the performance of such restorations. The test restorations were made of
      Vitremer glass ionomer, Scotchbond Multipurpose Plus and Z100 resin composite,
      and the control restorations were made of Z100 with Scotchbond Multipurpose Plus.
      Forty pairs of restorations were placed in 40 patients aged 16 years and over.
      The thickness of the resin composite layer was measured both clinically and in
      the laboratory using a reflex microscope. The completed restorations were
      assessed in vivo and in vitro at baseline, six-month and one-year recalls using a
      modified Ryge system. The reflex microscope measurements showed that the majority
      of restorations had a resin composite layer of more than 1.5 mm in thickness, as
      intended. At one year, 37 pairs of restorations were examined. Apart from a few
      minor problems, all performed satisfactorily. Thus, it appears that the resin
      composite/resin modified glass ionomer open laminate is a suitable technique for
      restoring Class II cavities.

PMID- 11203845
TI  - Review of bonded amalgam restorations, and assessment in a general practice over
      five years.
AB  - This study reviewed the literature on bonded amalgam restorations and assessed
      the failure, marginal fracture and marginal staining behavior of 366 Permite C
      amalgam restorations lined with five dentin bonding resins (Scotchbond 2, Panavia
      Ex, Amalgambond, Amalgambond Plus, Geristore) and a polyamide cavity varnish
      (Barrier). The restorations were placed in the posterior permanent teeth of 190
      adult patients and examined at intervals over periods of up to five years. There
      were five restoration failures (1.4%), usually from tooth fracture, involving
      Class II preparations in molar teeth. No instances of persistent pulpal
      sensitivity or recurrent caries were reported. The marginal deterioration of the
      restorations was assessed indirectly using photographs for comparison with two
      standard sets of enlarged color transparencies. Most of the marginal fracture and
      marginal staining scores were low, with little difference between the six lining
      materials at any period.

PMID- 11203846
TI  - Cervical compomer restorations: the role of cavity etching in a 48-month clinical
      evaluation.
AB  - Compomers are defined as polyacid-modified resin composites. They are supposed to
      combine the advantages of traditional glass-ionomer cements with resin
      composites. This study clinically evaluated a compomer in cervical cavities.
      Sixty cervical cavities in premolars and molars (24 with cervical caries and 36
      with abrasions) randomly divided into two groups of 30 teeth (Group 1 and Group
      2) were restored with Dyract (DeTrey-Dentsply, York, PA 17405-0872). The cavities
      of Group 2 were etched for 30 seconds with orthophosphoric acid before compomer
      application, while the Group 1 cavities received no treatment. All the
      restorations were evaluated every six months, up to 48 months: characteristics
      assessed according to USPHS-modified standards were retention, secondary caries,
      post-operative sensitivity, marginal adaptation and discoloration, color and
      wear. The Kaplan-Meier's survival analysis was performed. In both groups,
      retention was high without any statistically significant difference. No
      difference was found between the two groups for caries, post-operative
      sensitivity and wear--that all had a low incidence. Color was not perfectly
      matched, however, there was no statistically significant difference between the
      two groups. Marginal discoloration and marginal adaptation loss were
      significantly higher in non-etched group (p < 0.05). Clinically relevant failure
      required 17.2% of restorations in the non-etched group and 10% in the etched
      group to be replaced: this difference was not statistically significant. Dyract
      has an acceptable clinical behavior when used in cervical cavities. Its marginal
      adaptation is enhanced by etching.

PMID- 11203847
TI  - Fracture resistance of five pin-retained core build-up materials on teeth with
      and without extracoronal preparation.
AB  - Core build-ups should provide satisfactory strength and resistance to fracture
      both before and after crown preparation. This paper examines the resistance to
      fracture of core build-ups in different materials and the fracture resistance of
      core build-ups when these have been reduced for full crown preparation.
      Standardized core build-ups were made on groups of extracted molar teeth of
      similar size, with 10 teeth per group. Three resin-composite (prisma APH:
      Dentsply, Weybridge, UK; Ti-Core, Essential Dental Systems, NJ, US and Coradent,
      Vivadent, Liechtenstein), one cermet (Ketac-Silver, ESPE GmbH, Seefeld, Germany)
      and one amalgam material (Duralloy, Degussa Ltd, Cheshire, UK). These specimens
      were subjected to compressive force on a universal testing machine and the force
      at fracture noted. Standardized full crown preparations were made on a further
      five groups of core build-up specimens using the same materials as above. These
      prepared specimens were subjected to compressive force on a universal testing
      machine and the force to fracture noted. The results indicated that amalgam core
      build-ups demonstrated higher fracture resistance than the other materials
      examined. There was a general decrease in the fracture strength of the specimens
      following crown preparation, with the teeth restored with the amalgam core build
      ups showing a greater percentage reduction in fracture strength than the other
      materials tested. Prepared core build-ups in a hybrid composite material provided
      the highest fracture resistance. The cermet material used provided the lowest
      resistance to fracture in both the core build-up and crown preparation specimens.
      In terms of fracture resistance, no advantage was apparent in using the two
      composite materials designated as being specifically appropriate for core build
      ups.

PMID- 11203848
TI  - Influence of dentin conditioning and contamination on the marginal integrity of
      sandwich Class II restorations.
AB  - This study investigated the influence of dentin conditioning and contamination on
      the marginal adaptation of Class II sandwich restorations. Large butt-joint MOD
      cavities with cervical margins located 1 mm below the CEJ were cut into 72
      extracted human molars. Nine groups were filled using a total-bond technique with
      Z100 or a sandwich technique with either Vitremer or F2000 in combination with
      Z100. For all three material combinations three different pretreatments were
      compared: total etch, selective etch and dentin contamination with saliva and
      blood prior to primer/adhesive application. After water storage for 21 days and
      thermocycling (2000x, 5-55 degrees C) replicas were produced for quantitative
      marginal analysis in the SEM. Teeth were immersed in 0.5% basic fuchsin for 24
      hours and dried. Percent dye penetration over the total marginal length was
      analyzed in three layers using a sequential grinding technique. Statistical
      analysis was performed using a two-way ANOVA. Post-hoc analyses were carried out
      with univariate Mann-Whitney-U-tests adjusting for multiple comparisons by a
      sequentially rejective test procedure (Bonferroni-Holm) at p < 0.05. Both F2000
      and Vitremer sandwich restorations showed better marginal adaptation than Z100
      total-bond restorations with all pretreatments. Acid etching of the dentin
      significantly influenced the marginal adaptation of Z100 total-bond restorations
      and Vitremer sandwich restorations. All types of restorations showed considerable
      microleakage. On contaminated dentin, sandwich restorations showed better
      marginal integrity than total-bond restorations. Marginal adaptation did not
      correspond with microleakage in all groups. In conclusion, F2000/Z100 and
      Vitremer/Z100 sandwich restorations show better marginal adaptation than Z100
      total-bond restorations in large Class II cavities with cervical margins in
      dentin. Microleakage cannot predictably be prevented with the sandwich technique.
      Sandwich restorations seem to be less sensitive to contamination with saliva and
      blood.

PMID- 11203849
TI  - Bonded amalgam restorations: using a glass-ionomer as an adhesive liner.
AB  - Due to the lack of adhesiveness of amalgam to tooth structure, several adhesive
      cements have been utilized in bonded amalgam restorations. This study evaluated
      whether Fuji-II glass-ionomer cement is an appropriate adhesive liner in bonded
      amalgam restorations. Two adhesive composite luting cements (Amalgambond Plus and
      Panavia-21) and Copalite cavity liner were compared. The study was conducted in
      two phases. In the first part, we quantitatively assessed the tensile bond
      strengths as well as the failure modes of amalgam bonded to human dentin, using
      different adhesive liners. In each group, the flat dentin surface was treated
      with the assigned adhesive cement with a Teflon mold, followed by condensation of
      amalgam (Valiant PhD) onto it. Each group's mean tensile bond strengths were
      recorded and the statistical analysis by one way ANOVA showed no significant
      differences among groups (p > 0.05). Similar to the fracture patterns of the
      Amalgambond Plus and Panavia-21 groups, the failure mode of Fuji-II group was
      predominantly adhesive fracture. In the second part, the fracture strengths of
      amalgam restored teeth were measured using different adhesive liners. Standard
      MOD cavities were prepared in each tooth except for the intact tooth group. After
      treatment with the assigned adhesives or varnish, the cavities were restored with
      amalgam. Fracture strengths were then measured and the fractured interfaces
      examined using a scanning electron microscope. The fracture strengths of the
      intact tooth, Amalgambond Plus, Panavia-21 and Fuji-II groups were significantly
      higher than those of the Copalite and prepared cavity without restoration groups
      (p < 0.01). Accordingly, Fuji-II glass-ionomer cement, when used as an adhesive
      liner of amalgam restoration, may effectively reinforce the remaining tooth
      structure and, therefore, enhance the fracture resistance of the amalgam-restored
      teeth.

PMID- 11203850
TI  - In vivo examination of the Scotchbond Multi-Purpose Dental Adhesive System in rat
      (vitalmicroscopic study).
AB  - No data are available on the direct acute vascular effect of dental bonding
      materials on the dental pulp. This study investigated the effects of the
      components of a composite resin-bonding system on pulpal vascular diameter. Three
      groups of 10 male Sprague-Dawley rats (weighing 330 +/- 51 g) were used for this
      investigation. The first lower incisor of the rats was prepared for
      vitalmicroscopy. Changes in vessel diameter were recorded prior to, and at 5, 15,
      30 and 60 minutes after the bonding agents (with/without etching) or saline
      (control) were administered on dentin as recommended by the manufacturer. In
      control rats, the vessel diameter was elevated slightly (2.96 +/- 4.08%) during
      the whole experiment. However, in the presence of bonding materials, an
      enhancement of 12.58 +/- 7.1% without etching and 13.11 +/- 8.6% with acid
      etching was registered as the increase in vascular diameter. There were
      significant (p < 0.05) differences between the control group and those treated
      with bonding agent components. Results suggested that resin composite bonding
      agents applied to a thin layer of dentin have an acute vasodilating effect on the
      dental pulp. The clinical significance of this vascular alteration in the dental
      pulp requires further study.

PMID- 11203851
TI  - Resistance to condensation of 'condensable' resin composites as evaluated by a
      mechanical test.
AB  - This study compared the resistance-to-condensation forces of recently introduced
      condensable resin composites to that of amalgams and conventional resin
      composites. Using the flat platens of a servohydraulic testing machine,
      cylindrical specimens of each material 2.8 mm in diameter and 5.5 mm in length
      were compressed diametrally over two seconds to a thickness of 0.75 mm. Peak
      forces generated during compression were recorded. This method ranked the various
      classes of restorative material for resistance to condensation in the same order
      as most clinicians subjectively reported, with the highest forces observed with
      admixed dental amalgams, followed in order by spherical amalgams, condensable
      resin composites and conventional resin composites. Although peak forces observed
      with the condensable resin composites were generally higher than those observed
      with conventional resin composites, these were significantly lower than the peak
      forces observed with amalgams.

PMID- 11203852
TI  - Metal surface treatment: characterization and effect on composite-to-metal bond
      strength.
AB  - This study evaluated the effect of four methods of metal surface preparation and
      the use of silane on the bond strength between resin and a Noble metal alloy. SEM
      Examination and x-ray energy-dispersive spectroscopy (EDS) of the various metal
      surface treatments was also performed. One-hundred metal disks were cast in a
      Noble metal alloy (Porcelain #76). Ninety disks were polished flat and the
      surfaces received one of four abrasive treatments (n = 20). 1) Roughening with a
      diamond bur at high speed; 2) Air abrasion with an intraoral sandblaster using
      alumina particles; 3) Air abrasion with KCP-2000 and 4) Air abrasion with an
      intraoral sandblaster using silanated silica covered alumina particles (CoJet
      Sand). Half the specimens from each treatment group (n = 10) were silanated prior
      to bonding procedures (All-Bond 2 adhesive system, Pertac-Hybrid composite).
      Specimens were stored in distilled water at 37 degrees C and thermocycled prior
      to shear strength testing. The 10 remaining metal disks were used for scanning
      electron microscopy and x-ray energy-dispersive spectroscopy (EDS). Scanning
      electron microscopy examined the micromorphology of the metal surfaces produced
      by the four abrasive treatments and x-ray energy-dispersive spectroscopy (EDS) to
      evaluate changes in surface composition. Two untreated disks served as controls.
      One-way ANOVA and Tukey's HSD post-hoc test demonstrated that air abrasion with
      CoJet-Sand and silane resulted in significantly higher resin-to-metal bond
      strength than all other metal surface treatments, while roughening with a diamond
      bur produced the lowest bond strength. Resin-to-metal bond strength was similar
      for all other particle abrasive treatments with or without silane. Using silane
      significantly improved bond strength only for metal surfaces treated with CoJet
      Sand. An increase in Al concentration was observed on metal surfaces sandblasted
      with aluminum oxide, and an increase in the concentration of both Al and Si was
      observed on surfaces air-abraded with CoJet-Sand.

PMID- 11203853
TI  - Solubility and sorption of resin-based luting cements.
AB  - This study compared the seven-day water sorption, water solubility and lactic
      acid solubility of three composite cements and three resin-modified glass-ionomer
      cements. Disc-shaped specimens measuring 15 mm x 0.5 mm were prepared according
      to each manufacturer's specifications and desiccated to a constant mass.
      Specimens were then placed in distilled water at 37 degrees C for seven days.
      Acid solubility was performed in 0.01 M lactic acid. The weight changes of the
      specimens after immersion in distilled water or 0.01 M lactic acid were measured
      using an electronic analytical balance. A one-way ANOVA followed by the Ryan
      Einot-Gabriel-Welsch (REGW) multiple range test was performed on all data.
      Significant differences (p < 0.05) were found among several cements tested for
      each of the properties investigated. Due to their hydrophilic nature, all resin
      modified glass-ionomer cements showed significantly higher water sorption
      compared to composite cements.

PMID- 11203854
TI  - Post retention and post/core shear bond strength of four post systems.
AB  - As clinicians we continue to search for a post system which will give us maximum
      retention while maximizing resistance to root fracture. The introduction of
      several new post systems, with claims of high retentive and resistance to root
      fracture values, require that independent studies be performed to evaluate these
      claims. This study tested the tensile and shear dislodgment forces of four post
      designs that were luted into roots 10 mm apical of the CEJ. The Para Post Plus
      (P1) is a parallel-sided, passive design; the Para Post XT (P2) is a combination
      active/passive design; the Flexi-Post (F1) and the Flexi-Flange (F2) are active
      post designs. All systems tested were stainless steel. This study compared the
      test results of the four post designs for tensile and shear dislodgment. All
      mounted samples were loaded in tension until failure occurred. The tensile load
      was applied parallel to the long axis of the root, while the shear load was
      applied at 450 to the long axis of the root. The Flexi-Post (F1) was
      significantly different from the other three in the tensile test, however, the
      Para Post XT (P2) was significantly different to the other three in the shear
      test and had a better probability for survival in the Kaplan-Meier survival
      function test. Based on the results of this study, our recommendation is for the
      Para Post XT (P2).

PMID- 11203855
TI  - Effect of three surface sealants on marginal sealing of Class V composite resin
      restorations.
AB  - This study evaluated in vitro the effectiveness of three different surface
      sealants (Fortify, Protect-it! and Optiguard) on the marginal sealing of Class V
      light-activated composite resin restorations (Prodigy). For this purpose, 20
      sound noncarious human premolars extracted within a six-month period were
      selected. Class V cavities with the occlusal margin in enamel and cervical margin
      in cementum were prepared in both buccal and lingual surfaces. The teeth,
      randomly assigned in four groups with 10 cavities in each group, were restored
      with composite resin after applying an adhesive system (Optibond FL). After the
      finishing and polishing procedures, the restorations were covered with a specific
      surface sealant, except for the control samples, which were not sealed. After
      placing restorations, the specimens were thermocycled and immersed in a 50%
      silver nitrate solution (tracer agent) for eight hours, sectioned longitudinally
      and analyzed for leakage using an optical microscope in a blind study with three
      examiners. The marginal microleakage was evaluated at the occlusal and cervical
      interfaces and compared among the four groups using the Kruskall-Wallis and the
      Wilcoxon Tests. There was better sealing at the occlusal margin, and in this
      region, there were no statistically significant differences among the materials
      (p > 0.05). In the cervical region, Fortify and Protect-it! showed improved
      results over the Control Group, and Optiguard showed similar results to the
      Control Group (without sealing).

PMID- 11203856
TI  - Operative dentistry: the first twenty-five years.

PMID- 11203857
TI  - Leucite-reinforced glass ceramic inlays and onlays after six years: clinical
      behavior.
AB  - Ceramic inlays are an esthetic substitute for large amalgam and other metallic
      restorations. This controlled clinical study evaluated the performance of IPS
      Empress inlays and onlays with cuspal replacements and proximal margins below the
      cementoenamel junction over six years of clinical service. Six dentists placed 96
      ceramic restorations in 34 patients. Luting was accomplished using the enamel
      etch-technique, a dentin bonding system (Syntac Classic) and four different
      composite systems. The restorations were assessed by two calibrated investigators
      using modified USPHS criteria at baseline (96 restorations), one (96), two (95),
      four (89) and six years (67). Seven of the 96 restorations investigated had to be
      replaced (failure rate 7%; Kaplan-Meier): Five inlays suffered cohesive bulk
      fractures and two teeth required endodontic treatment. After six years of
      clinical service, significant deterioration (Friedman 2-way ANOVA; p < 0.05) was
      found for marginal adaptation of the remaining restorations. Ninety-four percent
      of the surviving restorations exhibited marginal deficiencies, independent of the
      luting composite. Neither the absence of enamel margins, nor cuspal replacement
      significantly affected the quality of the restorations.

PMID- 11203858
TI  - Leucite-reinforced glass ceramic inlays after six years: wear of luting
      composites.
AB  - Wear of luting composites is still an unsolved problem with adhesive inlays.
      However, only limited clinical research has been conducted regarding this
      phenomenon. This study evaluated the substance loss within the luting gap over a
      six-year period in vivo. In the course of a controlled prospective clinical
      study, 16 patients received 39 Class-II IPS Empress inlays. Variolink Low
      (Vivadent; n = 18) was used as conventional low-viscosity luting composite, the
      hybrid-type restorative resin composite Tetric (n = 21; Vivadent) was applied
      according to the ultrasonic insertion technique. The restorations were clinically
      assessed after 6, 12, 24, 36, 48 and 72 months and replicas were made. The
      contact-free occlusal areas of the replicas were scanned by use of a computer
      controlled profilometer (Perthen S3P), the analysis of the data was computed
      using a newly developed software (Xpert for Windows 95) and statistically
      analyzed with non-parametric tests. After six months all restorations exhibited
      marginal ditching. The percentage of detectable luting gap abrasion increased
      between each recall appointment (32% after six months, 48% after 12 months, 46%
      after 24 months, 55% after 36 months, 59% after 48 months and 65% after 72
      months). Except for the 48-months results, no significant difference between the
      materials used for luting was evident (p > 0.05). Between the width and the depth
      of the luting space a linear regression was computed. The quantitative evaluation
      clearly demonstrated that hopes of relevantly reduced wear of luting composites
      were not confirmed when using the higher filled luting material.

PMID- 11203859
TI  - Eight-year clinical evaluation of fired ceramic inlays.
AB  - This study evaluated the quality of fired ceramic inlay restorations consisting
      of a feldspathic porcelain system (G-Cera Cosmotech II, GC Co, Tokyo, Japan)
      after eight years in vivo. Forty-five fired ceramic inlays (for 26 premolars and
      19 molars; Class I in 12 teeth, Class II in 31 teeth and onlay in two teeth) were
      placed in 25 patients. All restorations were evaluated at the time of placement
      and at 6 months, 1, 2, 4, 6 and 8 years after placement using modified USPHS
      criteria. Replicas of the restorations were observed with a scanning electron
      microscope (SEM) to evaluate the degradation of the marginal area and wear loss
      of the restoration. Longevity was observed in 80% of the fired ceramic inlay
      restorations at eight years (Kaplan-Meier method), although it was 92% at the six
      year observation. Marginal fracture was detected in 11 restorations (22%),
      including bulk fracture in five (11%), which had first occurred during the last
      two years. Recurrent caries was observed in three (7%) cases and marginal
      discoloration in 14 (31%). SEM evaluation disclosed marginal microfractures in
      77% of the restorations, wear in 36% and wear of the resin cement along the
      margin in 74% at eight years. No significant difference was observed in each of
      these three characteristics between molars and premolars. This longitudinal eight
      year clinical observation suggested that fired ceramic inlay restorations made by
      the G-Cera Cosmotech II system are clinically acceptable. However, critical
      failure as bulk fracture may become a future problem since marginal
      disintegration was detected in 77% of the restorations from microscopic and
      macroscopic perspectives.

PMID- 11203861
TI  - Marginal seal of resin-modified glass ionomers and compomers: effect of delaying
      polishing procedure after one-day storage.
AB  - This study evaluated the effects of polishing after one-day storage in water on
      the marginal gap formation around fillings using three resin-modified glass
      ionomers, one compomer, one conventional glass ionomer, and one micro-filled
      composite as a control. The study also examined the marginal gap and bond
      strength in Teflon cavities and the flexural strength of these restorative
      materials, which may influence the marginal gap formation. Immediately after the
      setting procedure, the specimen was polished and a marginal gap of approximately
      10-25 micrometers was observed regardless of the type of restorative material
      used. In contrast, we observed no gap or a 1-2 micrometer gap width when the
      specimens were polished after one-day storage. Only Dyract did not show this
      pattern. Statistical difference was observed between immediately polishing and
      polishing after one-day storage in all materials except Dyract. Hygroscopic
      expansion, bond strength and flexural strength play important roles in reducing
      the marginal gap in tooth cavities filled with two types of glass-ionomer
      restorative materials. In contract, these properties did not play important roles
      in reducing the marginal gap width for Dyract.

PMID- 11203860
TI  - Brushing abrasion of luting cements under neutral and acidic conditions.
AB  - Four resin based materials (Compolute Aplicap, ESPE; Variolink Ultra, Vivadent;
      C&B Metabond, Parkell and Panavia 21, Kuraray), two carboxylate cements (Poly-F
      Plus, Dentsply DeTrey and Durelon Maxicap, ESPE), two glass-ionomer cements (Fuji
      I, GC and Ketac-Cem Aplicap, ESPE), one resin-modified glass ionomer cement
      (Vitremer, 3M) one polyacid-modified resin composite (Dyract Cem, Dentsply
      DeTrey) and one zinc phosphate cement (Harvard, Richter & Hoffmann) were
      investigated according to their brushing resistance after storage in neutral and
      acidic buffer solutions. For this purpose 24 cylindrical acrylic molds were each
      filled with the materials. After hardening, the samples were stored for seven
      days in 100% relative humidity and at 37 degrees C. Subsequently, they were
      ground flat and polished. Then each specimen was covered with an adhesive tape
      leaving a 4 mm wide window on the cement surface. Twelve samples of each material
      were stored for 24 hours in a buffer solution with a pH of 6.8. The remaining 12
      samples were placed in a buffer with a pH of 3.0. All specimens were then
      subjected to a three media brushing abrasion (2,000 strokes) in an automatic
      brushing machine. Storage and brushing were performed three times. After 6,000
      brushing strokes per specimen, the tape was removed. Brushing abrasion was
      measured with a computerized laser profilometer and statistically analyzed with
      ANOVA and Tukey's Standardized Range Test (p < or = 0.05). The highest brushing
      abrasion was found for the two carboxylate cements. The lowest brushing abrasion
      was found for one resin based material, Compolute Aplicap. With the exception of
      three resin-based materials, a lower pH led to a higher brushing abrasion.

PMID- 11203862
TI  - Effect of dentin deproteinization on microleakage of Class V composite
      restorations.
AB  - The role of the collagen fibers in dentin adhesion has not clearly been
      established. Therefore, this laboratory study evaluated the microleakage at resin
      dentin and resin-enamel interfaces of Class V composite restorations after
      etching enamel and dentin with phosphoric acid (H3PO4) or after etching with
      H3PO4 followed by deproteinization with 5% sodium hypochlorite (NaOCl) to prevent
      the formation of a hybrid layer. Ten extracted human molars were used to prepare
      standardized Class V cavities on both buccal and lingual surfaces. The teeth were
      randomly divided in two groups: 1) Class V cavities that were etched with H3PO4
      for 15 seconds; b) Class V cavities that were etched with H3PO4 for 15 seconds
      followed by collagen removal with 5% NaOCl for two minutes. The cavities were
      restored using the Prime & Bond 2.1 bonding system and TPH resin composite. The
      specimens were stored in water for 24 hours at 37 degrees C and thermocycled 500
      times between water baths kept at 5 degrees C and 55 degrees C. After
      thermocycling, specimens were immersed in a 0.5% aqueous solution of basic
      fuchsin for 24 hours. Three longitudinal sections of each restoration were
      obtained and examined with a stereomicroscope for qualitative evaluation of
      microleakage. The data were statistically analyzed by Mann-Whitney U and Wilcoxon
      matched pairs signed ranked tests. Extra specimens were analyzed with the
      scanning electron microscope (SEM). Occlusal margins (enamel margins) resulted in
      statistical lower degree of leakage than gingival margins (dentin/cementum
      margins) in both treatment groups. For each type of margin, there were no
      statistically significant differences between the etched and the etched and
      deproteinized groups. Under the SEM, occlusal surfaces showed no detachment
      between enamel and dentin, while dentin/cementum resulted in gap formation.

PMID- 11203863
TI  - Retentive strength of an amalgam bonding agent: chemical vs light vs dual curing.
AB  - Dentin bonding agents have been shown to enhance retention of amalgam
      restorations by mechanical means. Little research is available on which mode of
      curing may optimize amalgam bonding. This in vitro study compared the bond
      strengths exhibited by three variations of a bonding agent, each using a
      different curing mode, with two earlier versions of amalgam resin liners and
      cavity varnish. The six test groups of lining agents for amalgam restorations
      included [C] chemical-cured, [L] light-cured and [D] dual-cured versions of one
      filled adhesive resin (Clearfil Liner Bond 2V), [LF] Light-cured, Filled resin
      (Clearfil Liner Bond 2, Kuraray Co.); [LCF] Light- and Chemical-cured, Filled
      resin Clearfil Liner Bond + Protect Liner, Kuraray Co) and [V] Varnish (Copalite,
      Cooley & Cooley, Ltd). For each group, 20 Class V cavity preparations were cut in
      human molars. The preparations were 2.5 mm deep and 3 mm wide at the pulpal
      floor, with a slightly divergent taper. After treating the preparation with the
      bonding agent, a 3/4 inch, 18 gauge flat-headed wire nail was seated in the
      cavity with its head at the pulpal floor of the preparation, and Tytin amalgam
      (Kerr Corp, Romulus, MI) was condensed into the preparation around the nail. All
      restorations were stored for 24 hours in distilled water at 37 degrees C, then
      subjected to 2500 thermal cycles (8 degrees C to 58 degrees C). After one week
      the samples were tested to failure in tension using an Instron Universal Testing
      Machine (crosshead speed = 2 mm/min) and peak load (kg) was recorded. Significant
      differences in retention were found using ANOVA and the Games & Howell post hoc
      test (p = 0.05). The mean loads at failure (+/- SD) were C 13.1 (+/- 2.4), L 21.8
      (+/- 6.1), D 26.8 (+/- 7.4), LCF 23.8 (+/- 7.4), LF 21.4 (+/- 3.3) and V 2.0 (+/-
      1.8). All dentin-bonding agents exhibited significantly greater retention than
      the varnish. While the bond strengths of the dual cured (D) and the light-cured
      (L) liners were not significantly different from one another, both were
      significantly higher than the chemically-cured (C) resin liner in terms of
      retention.

PMID- 11203864
TI  - Evaluation of dental adhesive systems with amalgam and resin composite
      restorations: comparison of microleakage and bond strength results.
AB  - A variety of laboratory tests have been developed to assist in predicting the
      clinical performance of dental restorative materials. Additionally, more than one
      methodology is in use for many types of tests performed in vitro. This project
      assessed and compared results derived from two specific laboratory testing
      methods, one for bond strength and one for microleakage. Seven multi-purpose
      dental adhesives were tested with the two methodologies in both amalgam and resin
      composite restorations. Bond strength was determined with a punch-out method in
      sections of human molar dentin. Microleakage was analyzed with a digital imaging
      system (Image-Pro Plus, Version 1.3) to determine the extent of dye penetration
      in Class V preparations centered at the CEJ on both the buccal and lingual
      surfaces of human molar teeth. There were 32 treatment groups (n = 10); seven
      experimental (dental adhesives) and one control (copal varnish, 37% phosphoric
      acid) followed by restoration with either amalgam or resin composite. Specimens
      were thermocycled 500 times in 5 degrees and 55 degrees C water with a one-minute
      dwell time. Bond strength and microleakage values were determined for each group.
      ANOVA and Student-Newman-Keuls tests demonstrated an interaction between
      restorative material and adhesive system with a significant difference among
      adhesives (p < 0.05). Using a multi-purpose adhesive system resulted in both a
      statistically significant increase in bond strength and a statistically
      significant decrease in extent of microleakage (p < 0.05). The effect of the
      adhesive upon both microleakage and bond strength was greater in the resin
      composite restorations than in the amalgam restorations. Bond strength testing
      was more discriminating than microleakage evaluation in identifying differences
      among materials.

PMID- 11203865
TI  - Color stability of fluoride-containing restorative materials.
AB  - Six fluoride-releasing materials of shade A3 were tested: one glass ionomer (Fuji
      IX), one resin-modified glass ionomer (Photac-Fil), two compomers (F 2000 and
      Dyract AP) and two composites (Tetric Ceram and Solitaire). Disk-shaped specimens
      of each material were prepared according to manufacturer's instructions, polished
      and L*a*b* baseline measurements taken. Specimens were randomly divided into two
      groups and given four different treatments of UV light exposure and immersion in
      a staining solution. Chromo Meter color measurements were taken following each
      treatment. Two-way ANOVA and Duncan Multiple Range post-hoc tests were used to
      compare color changes as a function of the four treatment conditions and one-way
      ANOVA was used to compare materials for each treatment separately. The results
      showed significant difference in shade A3 between products. In general, the
      hydrophobic materials showed greater color stability and stain resistance than
      the hydrophilic materials. Tetric ceram had the best color stability and stain
      resistance, while Fuji IX had the least.

PMID- 11203866
TI  - The effect of tooth preparation on microleakage behavior.
AB  - Many factors contribute to the microleakage of a restoration. One of the more
      important is the method of cavity preparation. This study compared the
      microleakage behavior of composite restorations placed in cavities prepared by
      different techniques. It also compared and correlated the microleakage data
      produced by an electrochemical vs a staining technique. Class V cavities were
      prepared in 48 premolars by four techniques: (1) tungsten carbide bur in a high
      speed handpiece followed by acid etching; (2) air abrasion (27 microns Al2O3)
      followed by acid etching; (3) air abrasion (50 microns Al2O3) and (4) air
      abrasion (27 microns Al2O3), with n = 12 in each group. All teeth were restored
      with Prime and Bond 2.1 and Tetric Flow, then thermocycled between 5 degrees and
      55 degrees C for 5000 cycles with a one minute dwell at each temperature. After
      thermocycling, a PVC-covered Cu wire was inserted apically into the pulp chamber
      of each tooth and sealed into position. Leakage was continuously followed by a
      conductimetric method for 75 days. The teeth then were immersed in 50% AgNO3 for
      two hours, rinsed in distilled water for 60 seconds, then placed in a rapid
      photographic developer solution for two hours, followed by rinsing and sectioning
      for microscopic examination. Electrochemical data were examined by ANOVA and
      Newman-Keuls multiple comparison tests, while Kruskal-Wallis and Rank Sum
      Difference tests were used on the staining evaluations. Spearman's rho test was
      used to correlate the two test techniques. Electrochemical data for cavities
      prepared with a bur or air abrasion followed by acid etching prior to restoration
      showed significantly less (p < or = 0.05) microleakage (mean leakage currents of
      1.89 & 1.57 microA, respectively) than teeth prepared with air abrasion alone
      (mean leakage currents of 3.60 & 3.40 microA, respectively). Rank sum AgNO3
      staining data (196 & 242 vs 371 & 368) supported these findings. The correlation
      between the electrochemical and staining data was significant (p < or = 0.05) for
      all four groups of test specimens.

PMID- 11203867
TI  - Effect of finishing and polishing procedures on the surface roughness of packable
      composites.
AB  - This study examined the average surface roughness (Ra, micron) of three packable
      composites and one hybrid composite cured against mylar, before and after
      treatment with a fine finishing diamond bur, a resin finisher followed by fine
      and extrafine polishing paste, two silicone-based finishing and polishing
      systems, fine and super-fine aluminum-oxide polishing disks, a silicon carbide
      impregnated polishing brush and a surface-penetrating composite sealant.
      Additionally, the Ra was examined for one of the packable composites before and
      after treatment with a finishing carbide, prior to the finishing and polishing
      procedures detailed above. The finishing diamond significantly increased the Ra
      for all composites (ALERT, SureFil, Solitaire and Z-100). The finishing carbide
      used with SureFil (SureFil + C) also increased the Ra; however, it also produced
      surfaces up to 3.5x smoother when compared to SureFil surfaces finished with the
      diamond. Overall, Sof-Lex Contouring and Polishing Discs were able to produce the
      smoothest surfaces, followed by the Jiffy Composite Polishing Cups, the Enhance
      Composite Finishing & Polishing System/Prisma-Gloss Composite Polishing Paste,
      the Diacomp Intra-Oral Composite Polishers and the Jiffy Composite Polishing
      Brushes, respectively. The smoothest surfaces were produced using Z-100, followed
      by SureFil + C (carbide finishing bur), Solitaire, SureFil and ALERT,
      respectively. In general, Protect-It Composite Surface Sealant had little effect
      on the Ra, except with ALERT, where a slight increase in Ra was observed.

PMID- 11203868
TI  - Handpiece coolant flow rates and dental cutting.
AB  - High-speed handpieces incorporate water coolant sprays to remove cutting debris
      and minimize thermal insult to the pulp. Little data exists on optimal coolant
      flow rates during clinical procedures. This study compared the effect of
      different coolant flow rates on diamond stone cutting efficiency. Cutting studies
      were performed on Macor machinable ceramic using a previously developed test
      regimen--a KaVo high-speed handpiece at a cutting force of 91.5 g (0.9 N).
      Cutting was performed with round end tapered medium grit diamond stones under
      cooling water flow rates of 15, 20, 25, 30 and 44 ml/min, with cutting rates
      determined as the time to transect the 13 mm square cross-section of the Macor
      bar. Each bur was used for five cuts, with six burs used for each flow rate, for
      a total of 150 measurements. The data were analyzed by one-way ANOVA with a post
      hoc Scheffe test. The cutting studies indicated that diamond stone cutting rates
      increased with higher coolant flow rates over the range of 15-44 ml/min. The data
      suggest that higher coolant flow rates promote cutting efficiency.

PMID- 11203869
TI  - Effects of cavity form and setting expansion of refractory dies on adaptability
      of Class II (MO and MOD) fired ceramic inlays.
AB  - This study investigated the effects of cavity divergence and setting expansion of
      refractory die material on the adaptability of Class II (MO and MOD) fired
      ceramic inlays. Standardized Class II (MO and MOD) cavities with two kinds of
      lateral wall divergence (10 and 20 degrees) were prepared in epoxy resin blocks.
      A refractory die was prepared from an impression of the epoxy resin cavity in
      which the setting expansion ranged from 0.04 to 1.14%. A ceramic inlay was fired
      on each die. The fabricated inlay was inserted into the epoxy resin cavity, and
      the interfacial distance between the ceramic inlay and the cavity wall at the
      margin was measured using a reflecting microscope at x100 magnification. The
      internal fit was measured after sectioning the specimen longitudinally. The
      results indicate that the setting expansion of the refractory die materials and
      the divergence of the lateral walls had significant effects on the adaptability
      of Class II (MO and MOD) fired ceramic inlays. The inlays fabricated on the
      refractory dies with small setting expansion showed small internal gaps in Class
      II (MO) cavities. Significantly good adaptation was achieved when the setting
      expansion was 0.32% or less (p < 0.05). The inlays fabricated on the refractory
      dies with large setting expansion showed small internal gaps in Class II (MOD)
      cavities. Significantly good adaptation was achieved when the setting expansion
      was 0.87% and greater (p < 0.05).

PMID- 11203870
TI  - Dental care of elderly in nursing homes: perceptions of managers, nurses, and
      physicians.
AB  - Epidemiologic studies have shown that the oral health of residents in nursing
      homes is poor. This can be due to their impaired ability to maintain appropriate
      oral hygiene or to a lack of interest in oral care among those responsible for
      the care. The purpose of this study was to assess the attitudes of managers,
      caregivers, and physicians with regard to oral health care issues of their
      residents. A questionnaire sent to the managers of the 65 nursing homes in Geneva
      was returned by 47 (69%). According to the managers, 85% of the nursing homes
      organized transportation for the residents to a dental office; dental care with
      follow-up treatment was organized in 79% of the facilities; 68% of the facilities
      organized treatment for dental emergencies. Another questionnaire was distributed
      to 169 caregivers in 13 nursing homes. A majority had received no education in
      oral hygiene care of the residents. The caregivers did accept responsibility for
      oral hygiene care, but preferred to share it with a dentist responsible for the
      oral health care of the residents. Only 33% of the physicians indicated that they
      carried out a systematic examination of the oral cavity, and 20% agreed that the
      oral cavity might be an integrated part of the body. The majority of the
      physicians were in favor of more information on oral diseases and regular visits
      by a dentist; however, close collaboration with a dentist on oral health issues
      had a low priority.

PMID- 11203871
TI  - Effects of short professional mechanical tooth-cleaning (PMTC) program in young
      adults with mental disabilities.
AB  - We evaluated the usefulness of a short professional mechanical tooth-cleaning
      (PMTC) program to improve periodontal conditions and caries susceptibility in 10
      young adult patients with mental and/or physical disabilities. The PMTC program
      was carried out once on each of 6 sextants of the full mouth during 6 visits at
      two-week intervals. Even one treatment with PMTC was found to be significantly
      effective in reducing the probing depth in eight of the 10 subjects. A reduction
      in the total number of bleeding sites on probing was also clearly observed in all
      subjects. Moreover, the debris index was reduced in nine subjects by the PMTC
      program. Although caries susceptibility was improved, albeit very slowly, by
      PMTC, the Cariostat pH values showed no consistent tendency. The effects lasted
      for more than 6 weeks. Analysis of these results suggests that the PMTC program
      can be effective in adults with mental disabilities, especially in reducing
      gingival inflammation.

PMID- 11203872
TI  - Nursing directors' perceptions of the dental components of the Minimum Data Set
      (MDS) in nursing homes.
AB  - The Directors of Nursing (DON's) of all 428 nursing homes in the state of Iowa
      were sent a pre-tested questionnaire. The aim of the study was to examine the
      perceptions by nursing directors on the utility of a dental component of the
      Minimum Data Set (MDS) in identifying residents with dental problems in their
      facility. The return rate was 55.1% from the DON's. It was reported that 66.4% of
      the homes had a training program for the MDS and that in 38.0% of the homes there
      was only one person doing the assessments. The majority (76.0%) of the DON's
      stated that the MDS was useful in tracking residents and that it did help them to
      identify dental problems. When asked how often it was useful in the
      identification of dental needs, only 9% stated that it was often useful. Also,
      regarding frequency of dental appointments for the residents, a mean of 51.0% of
      residents were estimated to have received some dental care during the previous
      year (means of 33.2% at the facility, 22.4% at a dental office, and 0.4% in a
      hospital). If change is to occur, the dental profession must try to get the
      nursing home assessors to convince the nursing homes to use the
      oral/nutritional/dental sections of the MDS as they were intended under the OBRA
      regulations.

PMID- 11203873
TI  - Dental care access among individuals with Down syndrome in France.
AB  - The aim of this study was to compare levels of dental care utilization, receipt
      of dental services, and oral hygiene habits between a sample of individuals with
      Down syndrome (DS) and their siblings. Data were collected by means of a recently
      validated, French-language, questionnaire measured of oral health and its related
      problems for individuals with DS. A cross-sectional survey was undertaken of
      parents of children with DS attending a national meeting for families and carers
      of individuals with DS in France. Older individuals with DS were significantly
      more likely to visit a dentist regularly than their older non-DS siblings, but
      the group with DS was significantly less likely to have received any dental
      treatment. The group with DS was significantly more likely to have difficulty
      finding both medical and dental services. Parents were nearly twice as likely to
      report problems finding dental services for their child with DS as they were
      medical services. In a multiple logistic regression analysis within the DS group,
      it was found that older age, regular speech therapy and ophthalmology
      consultations, and reports of no difficulty finding a dentist were independently
      associated with increased odds for regular dental consultations. Analysis of the
      findings suggests that the parents of children with DS in France frequently
      encounter problems of access to oral health care and that individuals with DS are
      less likely to receive dental services than are their non-DS siblings.

PMID- 11203874
TI  - Walk-in emergency patients have always been a mixed blessing for most dental
      departments in hospitals.

PMID- 11203875
TI  - "It's not easy being green...".

PMID- 11203876
TI  - EMTALA: impact on hospital dentistry emergency services.
AB  - The Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospital
      based dental residency programs and hospital dentists to meet Federal standards
      when patients come to a hospital emergency department and need emergency dental
      services. EMTALA (42 U.S.C. 1395dd) has three key provisions which must be
      understood because of its impact on hospital emergency dental services: Medical
      Screening Requirements, Necessary Stabilizing Treatment for Emergency Medical
      Conditions, and Restricting Transfers Until the Individual is Stabilized. This
      article reviews the relevant Federal statutes, codes of Federal regulation, and
      published court cases to help practitioners understand the issues. An
      understanding of the informed consent process, including the "informed refusal"
      doctrine, as well as the dentist's obligation when patients refuse recommended
      diagnostic tests, treatment, or transfer, is important. Immunity for failure to
      obtain informed consent is sometimes appropriate under state law. Under EMTALA,
      the term "physician" applies to dentists. Recent changes clarify distinctions
      between the terms "on campus" and "off campus" related to hospital property
      emanating from the "Ravenswood" tragedy. Hospital dentists must be familiar with
      these requirements when caring for patients seeking emergency services.

PMID- 11203877
TI  - Recent advances in diabetes mellitus of interest to dentistry.
AB  - Significant changes were made in 1997 by The Expert Committee on the Diagnosis
      and Classification of Diabetes Mellitus of the American Association of Diabetes
      regarding the diagnosis and classification of diabetes mellitus. The terms
      "insulin-dependent diabetes mellitus" (IDDM) and "non-insulin-dependent diabetes
      mellitus" (NIDDM) were dropped. The new classification is, in general, based on
      etiology rather than on treatment and includes four groups: Type I (autoimmune),
      Type 2 (non-autoimmune), Other specific types, and Gestational diabetes. The
      fasting blood glucose level for diagnosis was lowered from 140 mg/dL to 126
      mg/dL. A random blood glucose of 200 mg/dL or greater in a patient with symptoms
      of diabetes is diagnostic. Each of these diagnostic tests needs to be repeated on
      a separate day. The glucose tolerance test is no longer recommended for routine
      diagnostic use. Recommendations for the screening of diabetes mellitus in
      presumably healthy individuals are presented. New advances in insulin and its
      delivery to the diabetic patient are discussed. The impact of diabetes mellitus
      on the oral cavity is updated.

PMID- 11203878
TI  - Dental caries history in nine children with chromosome 18p deletion syndrome.
AB  - Chromosome 18p deletion syndrome is caused by the deletion of a portion of
      genetic material on the short (p) arm of chromosome 18. Many of 100 prior case
      reports in the medical literature describing the dental health of subjects with
      this syndrome reported multiple caries associated with the syndrome. At the third
      annual international conference of The Chromosome 18 Registry & Research Society,
      dental examinations were carried out on nine children with chromosome 18p
      deletion syndrome and five of their unaffected siblings. The dental examination
      included an intra-oral evaluation of coronal decay and filled permanent teeth
      surfaces (DFS) and decayed and filled primary tooth surfaces (dfs) using a mouth
      mirror, explorer, and a high-intensity fiber optic light. An evaluation of the
      data revealed that five of nine children with 18p deletion syndrome (56%) were
      free of tooth decay or a history of tooth decay. Four of the nine (44%) had tooth
      decay or a history of tooth decay. The prevalence of decay was quite similar in
      the genetically unaffected siblings. Three of the five (60%) unaffected siblings
      of the children with 18p were free of tooth decay, whereas two of the five (40%)
      had tooth decay. One of the affected children had a missing mandibular left
      central incisor. None of the children had abnormally shaped teeth. The caries
      pattern seems to be similar to that reported in the NHANES III data collected in
      the United States from 1988-1991. Analysis of these preliminary data suggests
      that the risk for caries in chromosome 18p deletion syndrome may be lower than
      previously reported.

PMID- 11203879
TI  - Desensitization of the gag reflex in an adult with cerebral palsy: a case report.
AB  - Severe oral hypersensitivity and aversive oral behaviors present a significant
      barrier to dental treatment and compromise oral health status. Although several
      authors have addressed the reduction of oral hypersensitivity and aversive
      behaviors (such as gagging, retching, and vomiting) in the otherwise well dental
      patient, treatment for patients with severe disability has not been explored. The
      successful management of oral hypersensitivity and aversive behavior can have
      significant health benefits. These can be described via an outcomes paradigm as
      physical and social benefits for the patient, psychological benefits for the
      patient, carer, and practitioner, and organizational benefits for the
      institutions providing dental care and medical management. This paper summarizes
      the management of a severely disabled patient whose aversive behaviors were
      eliminated with non-invasive therapy techniques. Oral hygiene was facilitated and
      health benefits were identified across a number of domains following successful
      multi-disciplinary management.

PMID- 11203880
TI  - Non-institutionalized elderly dental patients in Israel: socio-demographics,
      health concerns, and dental anxiety.
AB  - The purpose of this study was to evaluate which factors might influence health
      care attitudes such as anxiety about dental care by older adults in Israel. The
      study population consisted of 103 non-institutionalized patients (46 men and 57
      women) over the age of 65 who attended a dental clinic that provided services for
      older adults during a one-year period. Socio-demographic information and
      information about the subjects' general health and their level of concern about
      health problems were obtained from self-reported questionnaires, while the dental
      anxiety level was found by means of a dental anxiety scale (DAS). Ninety-nine
      percent of the patients suffered from a major systemic disease such as diabetes,
      hypertension, atherosclerosis, respiratory disease, and rheumatic disease. Both
      unmarried and first-time patients expressed high anxiety scores. Patients with 12
      or fewer years of formal schooling demonstrated significantly higher dental
      anxiety. Among patients who regularly attended a synagogue or a social club,
      concern about oral health was significantly higher than for the rest (p < 0.02).
      No association was found between having dentures and gender, or between having
      dentures and level of education. The reason for visiting the clinic (inability to
      eat, pain, or esthetics) was not associated with any other health concern or with
      dental anxiety levels. This study determined that patients who were unmarried,
      less educated, or attending the facility for the first time were more likely to
      experience dental anxiety. These patients merit special consideration.

PMID- 11203881
TI  - Effect of an oral health training program on knowledge and behavior of state
      agency long-term-care surveyors.
AB  - This study examines the effect of a training program on long-term-care (LTC)
      surveyors' knowledge of factors affecting oral health and their behavior in
      citing oral health deficiencies of LTC residents. Twenty surveyors were recruited
      for the experimental group, along with a non-equivalent comparison group of 31
      surveyors. The experimental group participated in a three-hour interactive, case
      based training program. The experimental group had a significant increase in
      total knowledge (p < 0.002) post-test scores with a moderate effect size, eta 2 =
      0.115. The training program resulted in a statistically significant increase (p <
      0.0001) in oral health citation behavior for the experimental group for six
      months following training. This study provides evidence that an interactive case
      based training program can affect participants' knowledge regarding oral health
      of LTC residents and participants' oral health citation behavior. As the elderly
      population experiences an increased life expectancy with increased need for
      assistance with Activities of Daily Living (ADL), similar training programs will
      become an important factor in assessing the quality of care provided to LTC
      residents.

PMID- 11203882
TI  - Oral health needs of elderly short-term patients in a geriatric department of a
      general hospital.
AB  - The purpose of this study was to estimate the realistic dental needs of an
      elderly short-stay patient in a geriatric department. One segment of the elderly
      population at risk for whom surveillance would appear extremely important are
      those admitted temporarily to the hospital for acute or acute-on-chronic care.
      Little has been written about the oral needs of such patients. The study
      population was comprised of 468 patients of a geriatric department in a medical
      center examined by a dentist trained in gerodontics. An evaluation of the results
      showed that 65.3% needed direct oral hygiene assistance. Only 16.4% are able to
      participate in oral hygiene instruction; a few of them--6.6%--had a need of
      prosthodontic treatment. A once-weekly screening program was required to handle
      the oral problems, mainly Candida infections. Close cooperation with the ward
      staff is essential in order to develop and promote good oral hygiene for this
      very frail elderly population.

PMID- 11203883
TI  - Evaluation of an oral health education program for nursing personnel in special
      housing facilities for the elderly. Part II: Clinical aspects.
AB  - In Sweden, efforts are being made to create strategies for evaluating realistic
      dental treatment needs among the elderly, who are retaining more natural teeth.
      These strategies focus on the importance of maintaining adequate oral hygiene.
      Elderly in long-term-care facilities often depend on nursing personnel for
      carrying out daily oral hygiene procedures. Therefore, the nursing personnel's
      knowledge about and attitudes toward oral health make oral health education for
      health care professionals an important concern. The purpose of this study was to
      evaluate the clinical oral health outcome in residents after their caregivers had
      undergone a one-session, four-hour oral health education program. The study
      consisted of an intervention with a pre- and a post-test and was carried out in
      three municipalities in the southwestern part of Sweden. A newly developed oral
      health screening protocol was carried out for 170 subjects living in long-term
      care facilities both before and 3-4 months after nursing personnel had attended
      an oral health education program. Following the intervention, a statistically
      significant improvement was recorded for changes in oral mucosal color, a
      modified plaque index which measured oral hygiene status, and a mucosal index
      which recorded mucosal inflammation. This study indicated that a limited, one
      session, four-hour oral health education, offered to caregivers within long-term
      care facilities, had a positive impact on the oral health status of residents.

PMID- 11203884
TI  - Characteristics of dental emergency clinic patients with and without
      disabilities.
AB  - This study compared oral health and demographic characteristics of patients with
      and without disabilities at a dental school emergency clinic. Of 407 consecutive
      patients surveyed, 20.4% reported disabilities. Two groups matched by age and
      gender, those with disabilities (DIS, n = 79) and those without disabilities (ND,
      n = 177), were compared on questionnaire responses; two subgroups, DIS (n = 38)
      and ND (n = 44), were assessed clinically. The mean ages of the DIS and ND groups
      were 44.0 years (SD +/- 11.6) and 43.0 years (SD +/- 12.3), respectively. By chi
      squared analysis, DIS vs. ND subjects had significantly lower levels of
      education, employment, income, and dental insurance, and greater dependence on
      Government funding. In the DIS group, 79.5% were not working, while 6.4% did work
      regularly. In the ND group, the corresponding values were 30.9% and 46.9%,
      respectively. In the DIS group, 51.9% identified Medicaid acceptance as the
      reason they sought care at the clinic, while 62.7% of the subjects in the ND
      group identified the lower fee structure as the reason for clinic selection. More
      DIS than ND subjects reported dentists' unavailability and inability to manage
      the disability, lack of transportation, effect of dental problems on health, and
      referral by a health professional. DIS vs. ND subjects had significantly fewer
      sound teeth and more missing teeth. The results suggest that one in five dental
      school emergency clinic patients has disabilities.

PMID- 11203885
TI  - New information for our special care of patients with dementia.

PMID- 11203886
TI  - General anesthesia protocol for the dental patient: emphasis for older adults.
AB  - As the population ages, with increased retention of the natural dentition, there
      will be a greater responsibility for dental professionals to maintain the oral
      health of medically, behaviorally, cognitively, and physically impaired adults.
      Oral sedatives and nitrous oxide analgesia are frequently and successfully used
      for dental treatments in these patients. However, many compromised older adults
      cannot safely tolerate dental treatment with these sedative techniques in an
      outpatient setting. This paper describes the use of general anesthesia in a
      hospital environment, coordinated with medical and anesthesia specialists, that
      is a viable, safe, and effective treatment tool for providing comprehensive
      dental and oral surgical treatment for the older patient.

PMID- 11203887
TI  - Medicare, prevention, and dentistry: implications of the Institute of Medicine
      report, extending Medicare coverage for preventive and other services.

PMID- 11203888
TI  - Hospital-based dental care for persons with disabilities: a study of patient
      selection criteria.
AB  - The objective of this investigation was to generate a medical and dental profile
      of patients attending the Mount Sinai Hospital Dental Program for Persons with
      Disabilities, to determine if certain selected criteria could identify patients
      likely to require dental care in that setting. The need for dental care under
      general anesthesia was used as the prime indicator that care should be provided
      in a hospital setting. A retrospective review of all the charts of the patients
      enrolled in this hospital program was undertaken. Results indicated that patients
      who were treated in this hospital-based dental program had the following
      characteristics: moderate to profound mental retardation (39.5%), moderate to
      severe behavioral problems (31.1%), and/or a history of seizure activity (29.1%).
      Behavioral criteria appear to be the predominant reason for the provision of
      hospital-based dental care for persons with disabilities.

PMID- 11203889
TI  - The dental management of a patient with a cocaine-induced maxillofacial defect: a
      case report.
AB  - There are several dental complications associated with cocaine abuse, including
      adverse reactions to dental anesthetics, post-operative bleeding, and cellulitis,
      which can lead to necrosis of orbital, nasal, and palatal bones. Following is a
      report of the initial treatment rendered to a patient who had destroyed most of
      her hard palate over a ten-year period of cocaine abuse. There are no classic
      socio-economic or educational profiles for abusers of cocaine. Drug abuse victims
      may present as patients in any dental office. Though there are certain classic
      physiological and psychological symptoms of their condition, they may not display
      symptoms at all.

PMID- 11203890
TI  - Cleft lip and/or palate in the west of Ireland, 1980-1996.
AB  - The aim of this study was to identify and investigate care for children born,
      over a 17-year period (1980-1996), with cleft lip and/or palate (CL/P) in the
      Western Health Board region of Ireland. One hundred and six cleft-affected
      children were identified. The incidence was 1.14 per thousand (1:871) live
      births. Epidemiological findings in relation to cleft type, gender, family
      history, and location followed international trends. The establishment of a
      national Register with mandatory reporting of children with CL/P in Ireland would
      ensure greater consistency in data collection and may help improve co-ordination
      of care.

PMID- 11203891
TI  - Behavior management and communication strategies for dental professionals when
      caring for patients with dementia.
AB  - The impact of dementia and associated behavioral problems on the oral health of
      long-term-care-facility residents is increasing. The provision of oral hygiene
      care for these cognitively impaired residents is difficult and complex. Dental
      professionals and carers need good communication skills with cognitively impaired
      residents, and specific strategies for the management and prevention of their
      behavioral problems. Newer philosophies of dementia care enable dental
      professionals and carers to use more individualized and non-pharmacological
      approaches for dental treatment and preventive oral care provision. This paper
      reviews behavior management and communication strategies from the dental
      literature, and newer techniques and interventions from dementia research and
      literature.

PMID- 11203892
TI  - Dental self-care among dentate adults: contrasting problem-oriented dental
      attenders and regular dental attenders.
AB  - Self-care behaviors are common and can act as substitutes for or supplements to
      formal health care services. We tested the hypothesis that problem-oriented
      dental attenders (POAs) report more dental self-care behaviors than do regular
      dental attenders (RAs), presumably as a substitute for professional care. The
      Florida Dental Care Study is a longitudinal cohort study of changes in oral
      health, in which we measured dental self-care behaviors related to three common
      dental problems: toothache pain, bleeding gums, and tooth loss. Despite using
      less dental care, POAs were less likely to report "conventional" methods as means
      to prevent the three dental problems; however, they were more likely to report
      that homemade remedies, topical medications, or mouthwashes were ways to prevent
      or treat these problems. POAs were also more likely to believe that "nothing can
      be done" to prevent these problems. Additionally, POAs had more negative dental
      attitudes, used less dental care during follow-up, had more dental disease, were
      the only persons who extracted at least one of their own teeth, and were more
      likely to use tobacco. With the exception of dental self-extractions, no single
      self-care belief or behavior distinguished POAs from RAs, nor were POAs likely to
      have different explanations for dental problems. Instead, the pattern was one of
      modest differences on a number of items. Although POAs use less dental care, they
      do not compensate by employing more "conventional" dental self-care behaviors,
      but report being more likely to employ "unconventional" behaviors. They also are
      more likely to believe that nothing can be done to prevent dental problems.

PMID- 11203893
TI  - Oral health is not an isolated dental problem.

PMID- 11203895
TI  - Development and evaluation of a multimedia resource pack for oral health training
      of medical and nursing staff.
AB  - A resource pack has been devised for training medical and nursing staff and other
      carers in order that they may recognize oral disease and carry out routine oral
      care and treat common oral disorders. The custom-designed folding pack contains a
      videotape, a CD-ROM disc, and an A5-sized spiral-bound booklet, together with
      wall posters and a list of useful addresses. One hundred of the packs were
      distributed across Scotland to medical, nursing, and dental staff involved in
      postgraduate medical and nursing education. The packs were independently
      evaluated by an external organization through a questionnaire and also by
      telephone interviews. The pack received very positive responses, and 35% of the
      respondents reported making changes to their current practice. A long-term
      measure of success, beyond the scope of this paper, will depend on the
      measurement of improved quality of oral health care of the patients in those
      institutions where the pack has been used in training.

PMID- 11203894
TI  - The epidemiology of non-albicans Candida in oropharyngeal candidiasis in HIV
      patients.
AB  - Oropharyngeal candidiasis (OPC) is the most common fungal infection in patients
      with HIV infection. Fluconazole has been proven to be very effective in treating
      this infection, but decreased susceptibility of Candida to this drug has emerged.
      Certain non-albicans species such as C. glabrata and C. krusei are commonly less
      susceptible to fluconazole than C. albicans and are being isolated with increased
      frequency in HIV patients. The purpose of this study was to determine if the
      presence of non-albicans Candida with OPC in HIV patients had an impact on
      clinical presentation. This study shows that late-stage HIV patients have a high
      prevalence of Candida with decreased susceptibility to fluconazole, especially
      non-albicans species. OPC episodes with non-albicans isolates were more likely to
      require higher doses of fluconazole to achieve clinical cure. Also, the presence
      of non-albicans Candida was more frequently associated with severe symptoms.

PMID- 11203896
TI  - Early tooth loss due to cyclic neutropenia: long-term follow-up of one patient.
AB  - In young patients with abnormal loosening of teeth and periodontal breakdown,
      dental professionals should consider a wide range of etiological
      factors/diseases, analyze differential diagnoses, and make appropriate referrals.
      The long-term oral and dental follow-up of a female patient diagnosed in early
      infancy with cyclic neutropenia is reviewed, and recommendations for care are
      discussed.

PMID- 11203897
TI  - Assessment of objectives of post-doctoral general dentistry programs in Canada.
AB  - Objectives of hospital-based post-doctoral general dentistry programs in Canada
      were assessed by questionnaire. Seventy percent (14 of 20) of the program
      directors responded. Educational goals and objectives were assessed in
      professional skills and practice management, public health and preventive
      dentistry, oral medicine and pathology, special needs patient care, trauma and
      emergency care, restorative/prosthodontic care, endodontics,
      orthodontics/pediatric dentistry, oral surgery, periodontics, pharmacology, and
      functioning in a hospital. High rankings of proficiency were related to primary
      care, restorative/prosthodontic, endodontic, and surgical care. Emergency care,
      sedation, and pharmacology were also ranked highly. Lower rankings of proficiency
      were reported in orthodontics, aspects of public health dentistry, practice
      management, and advanced oral and maxiliofacial surgery. When the results of the
      Canadian survey were compared with those of a survey of US post-doctoral general
      dentistry programs, substantial similarity was seen. The findings support
      continuing reciprocity in accreditation standards between the Canadian and
      American Commissions on Dental Education and Dental Accreditation.

PMID- 11203898
TI  - The relationship between place BANA reactivity and clinical parameters in
      subjects with mental disabilities.
AB  - The purpose of the present investigation was to determine whether subjects
      institutionalized with mental retardation have a relationship between periodontal
      clinical parameters and the presence of the BANA-positive periodontal pathogens
      Porphyromonas gingivalls, Treponema denticola, and Bacteroides forsythus in their
      subgingival plaques. Fifty institutionalized subjects (25 patients with Down
      syndrome and 25 subjects with mental retardation) were matched with respect to
      age and sex. Periodontal clinical parameters (Bleeding on Probing, BOP; Papillary
      Bleeding Score, PBS; and Probing Depth, PD) were obtained from 6 reference teeth
      (3, 8, 14, 19, 24, 30). In addition, subgingival plaque samples taken from the
      same 6 teeth were analyzed for the presence of the BANA-positive species, by
      means of the chairside BANA test. In both the patients with Down syndrome and the
      group with mental retardation, the presence of BANA-positive plaques was
      significantly associated with bleeding on probing (p < 0.05) and increased
      probing depth (p < 0.01, Chi-square). Analysis of these data indicated that the
      BANA test could be used in combination with clinical criteria to diagnose a
      periodontopathy anaerobic infection in institutionalized subjects.

PMID- 11203899
TI  - Evaluation of a long-term oral health program by carers of children and adults
      with intellectual disabilities.
AB  - The oral health program presented here was undertaken in three French centers for
      persons with special needs. The program aimed to educate the carers about dental
      disease, to motivate them with regard to prevention, and to improve the oral
      hygiene and oral health of the residents. This study evaluated the impact of the
      program in terms of change in attitudes and behavior expressed by the carers by
      means of a questionnaire. Following demonstration of oral hygiene techniques on
      an individual basis, the number of residents who had their teeth cleaned more
      than once a day rose from 24% to 52% (p < 0.05). The percentage of carers able to
      clean both posterior and anterior teeth of their key residents increased from 24%
      to 60% (p < 0.05), and the percentage finding tooth cleaning easy increased from
      36% to 60% (non-significant). The intervention was thus deemed moderately
      successful, although the carers continued to take better care of their own oral
      health than that of the residents. The need for ongoing training is emphasized,
      both for the carers of those with special needs and for the dental profession.
      The lack of a validated means of measuring the impact of such interventions on
      care providers for this population is discussed.

PMID- 11203900
TI  - Hepatitis: still a concern?
AB  - Although some forms of viral hepatitis were identified more than 50 years ago,
      hepatitis continues to have an impact on the practice of dentistry. Possible
      transmission in the dental setting, management of the chronically ill, and legal
      issues related to treatment of infectious patients combine to emphasize that
      hepatitis is still an important issue for dental health care workers. Currently,
      7 viral forms are recognized. Those with predominantly enteral modes of
      transmission--including HAV, HEV, and HFV--are of minor concern in the dental
      environment. HBV, the most infectious blood-borne pathogen, has been largely
      controlled in this country by vaccination and the use of universal precautions.
      HDV is an incomplete virus that has HBV infection as a prerequisite. HCV is of
      great concern today for several reasons. A high percentage of HCV infections
      results in chronic disease. Most cases remain asymptomatic for an extended period
      of time, and many have no identifiable risk factors. Currently, no vaccination is
      available for HCV. Patients infected with HCV present a management challenge,
      because they may ultimately develop serious liver dysfunction. In fact, HCV
      infection is presently the most common reason for liver transplantation. By
      understanding the various forms of viral hepatitis and following recommended
      infection control and vaccination protocols, the dental healthcare worker can
      treat infected patients in a manner that is safe for both patients and dental
      health care workers.

PMID- 11203901
TI  - A combined direct dowel and indirect core technique.
AB  - The dowel-and-core restoration is indicated when inadequate tooth structure
      remains to retain an extracoronal restoration. A modified technique for
      fabricating the dowel and core combines the direct technique of forming the dowel
      in the actual channel with the indirect technique of creating an ideal core
      contour in the laboratory. This technique allows the operator to create an
      accurate and passive fit of the dowel pattern in the canal preparation. The
      technique also introduces the option of retrieving the dowel portion by utilizing
      a polyvinyl siloxane cast or liner. Further advantages of the technique are
      reduced chairside time and the ability to capitalize on the preparation of
      multiple teeth. The technique focuses efforts on achieving an accurate and
      passive fit of the dowel clinically while delegating the formation of the core to
      the laboratory.

PMID- 11203903
TI  - The laws of physics have not changed.

PMID- 11203902
TI  - A 3-year follow-up study of preformed beta-quartz glass-ceramic insert
      restorations.
AB  - OBJECTIVE: The purpose of this study was to evaluate the clinical performance of
      preformed beta-quartz glass-ceramic insert restorations. METHODS AND MATERIALS:
      Nine Class I and 30 Class II beta-quartz glass-ceramic insert restorations were
      placed in 16 patients who were seen regularly by personnel at Umea University
      Dental School. The California Dental Association criteria were used to evaluate
      the restorations at baseline, 6 months, and 1, 2, and 3 years after luting. The
      occurrence of postoperative sensitivity, the time taken to manufacture each
      restoration, and certain periodontal conditions were also evaluated. RESULTS:
      Sixty-nine percent of the restorations were rated satisfactory at the 3-year
      examination. During the follow-up period, 4 became loose and 7 were fractured or
      had flaking surfaces. Caries was registered in connection with 1 restoration.
      Excellent ratings were obtained for marginal integrity, anatomic form, surface,
      and color in 62%, 84%, 32%, and 44% of the restorations, respectively. There was
      no statistically significant difference in the occurrence of plaque and bleeding
      on probing in comparison with the controls. The mean overall time for placement
      was 38 minutes. The estimated survival rate (Kaplan-Meier) was 59% after 3.5
      years. CONCLUSION: The quality of the beta-quartz glass-ceramic restorations in
      the present study was inferior to that presented in most earlier studies of
      ceramic or resin composite posterior restorations placed in patients treated at
      university clinics. Both the technique and the beta-quartz glass-ceramic inserts
      have to be evaluated in more long-term studies to assess the possibility of their
      serving as an alternative restorative technique.

PMID- 11203904
TI  - In vitro study of needle deflection: a linear insertion technique versus a
      bidirectional rotation insertion technique.
AB  - OBJECTIVE: Deflection of dental needles during tissue penetration has been
      associated with a failure to achieve successful anesthesia. The purpose of this
      study was to determine whether needle deflection in a tissuelike substance could
      be minimized through the use of a bidirectional rotation insertion technique.
      METHOD AND MATERIALS: Three in vitro deflection test models were constructed,
      each incorporating a different tissuelike substance of a different density. Each
      substance was tested with 3 different needle sizes (30-guage, 27-gauge, and 25
      gauge). A customized dental surveyor allowed for standardized needle insertions
      to a standardized depth of 20 mm. Two different insertion techniques, a linear
      insertion technique and a newly described bidirectional rotation insertion
      technique, were tested. Radiographic analysis was performed after each insertion.
      RESULTS: The bidirectional rotation insertion technique described was
      consistently more effective in minimizing needle shaft deflection for 30-, 27-,
      and 25-gauge needles. The differences were statistically significant. Each of the
      different tissuelike substances consistently demonstrated this reduction in
      needle deflection. CONCLUSION: The factor that most greatly affects the path
      taken by a needle through a tissuelike substance is the force vectors that act on
      the needle's beveled surface. The use of a bidirectional rotation insertion
      technique minimized needle deflection, resulting in a straighter tracking path
      for 30-, 27-, and 25-gauge dental needles, in 3 different tissuelike substances
      tested in this study.

PMID- 11203905
TI  - A pilot study of 2 methods for control of dental unit biofilms.
AB  - OBJECTIVE: This pilot study was conducted to clinically evaluate 2 different
      concentrations of sodium hypochlorite for the control of dental unit biofilms and
      to evaluate the efficacy of pasteurizing dental treatment water for patient care.
      METHOD AND MATERIALS: Two dental units with no prior chemical treatment were
      retrofitted with self-contained water systems for this study. One dental unit was
      treated with 5,000 ppm of sodium hypochlorite and the other with 1,500 ppm.
      Treatment consisted of a 10-minute contact with the dental unit water lines,
      followed by a flush with a buffer solution. A pasteurizer was equipped with
      autoclavable spigots to provide dental treatment water. Heterotrophic Plate Count
      Samplers (Millipore) water sampler kits were used to quantify microbial
      contamination as absolute colony-forming units per millimeter. Scanning electron
      micrographs were taken of water line lumens to compare pretreatment and
      posttreatment biofilms. RESULTS: Pasteurized water was significantly less
      contaminated than was tap water. No significant difference in contamination was
      found between the 5,000 ppm and 1,500 ppm treatment chairs, either in the
      reservoir water or effluent water. Scanning electron micrographs demonstrated
      removal of the biofilms after sodium hypochlorite treatments, regardless of the
      concentration used. CONCLUSION: There was no significant difference between the
      abilities of 5,000- and 1,500-ppm concentrations of sodium hypochlorite to
      control contamination of dental treatment water and biofilms. Pasteurization of
      tap water can reduce contamination; this water can be used as acceptable dental
      treatment water (< 200 CFU/mL).

PMID- 11203906
TI  - Conventional cross-sectional tomographic evaluation of mandibular third molars.
AB  - OBJECTIVE: The purpose of this study was to locate the mandibular canal in
      relation to the impacted mandibular third molar by conventional cross-sectional
      tomography. METHOD AND MATERIALS: Conventional axially corrected cross-sectional
      tomograms of 347 successive impacted mandibular third molars of 234 patients
      referred for removal of the impacted teeth were acquired with a Scanora x-ray
      unit. The images were assessed for location of the mandibular canal and the
      impacted mandibular third molar. Descriptive analysis was performed. RESULTS:
      Examination of the tomograms revealed the alveolar nerve to have, in relation to
      the mandibular third molar, a lateral (buccal) course in 53.6% (n = 186), a
      course between the roots in 26.8% (n = 93), a lingual course in 13.0% (n = 45),
      and an inferior course in 6.0% (n = 21). Supplementary canals were found in 6.3%
      (n = 22). Two of the tomograms (0.6%) could not be evaluated, in 1 case because
      of incorrect patient positioning, resulting in an incorrectly adjusted transverse
      cut, and in the other case because of a mandibular carcinoma. CONCLUSION:
      Conventional axially corrected cross-sectional tomograms offer additional
      information in cases where there is a close relationship between impacted third
      molars and the alveolar nerve (superimposition of the roots and the canal,
      grooving, or a varied direction of the canal on the panoramic radiograph) and may
      contribute to a higher level of intrasurgical safety.

PMID- 11203907
TI  - Cumulative effects of successive restorative procedures on anterior crown
      flexure: intact versus veneered incisors.
AB  - OBJECTIVE: When successive restorative procedures (e.g., porcelain veneers,
      interdental resin composite restorations, and endodontic treatment) are carried
      out on the same tooth, significant effects on crown flexure can be expected.
      METHOD AND MATERIALS: Dentin-bonded porcelain veneers (experimental group) were
      assessed in vitro using functional and cyclic thermal loads. They were compared
      to natural teeth (control group) with respect to 2 parameters: coronal flexure
      (investigated using experimental strain gauges) and morphology of the tooth
      restoration interface (scanning electron microscopic evaluation). For both
      veneered and natural teeth, crown deformation was recorded at 5 sequential
      experimental steps: intact tooth (baseline), Class III cavities, Class III resin
      composite restorations, endodontic treatment, and endodontic restoration (without
      posts). RESULTS: No significant differences in crown flexure were found between
      natural and veneered incisors when compared across experimental steps. The main
      effect for experimental steps was highly significant. When averaged across all
      specimens (natural and veneered teeth), the endodontic treatment step resulted in
      the highest crown flexure (1.55x the baseline value). The unrestored Class III
      cavities and the endodontic restoration were next highest (1.30x and 1.28x the
      baseline value, respectively). The lowest crown flexures were found after
      restoration of the Class III cavities (1.13x the baseline value). No measurable
      microleakage or gaps were detected at the ceramic-resin, resin-enamel, or resin
      dentin interfaces (Optibond FL, Kerr). CONCLUSION: Each subsequent reduction in
      tooth structure resulted in a substantial increase in crown flexibility, even
      after restoration. Endodontic procedures were responsible for most of the loss in
      crown stiffness. Extensive proximal cutting and restorations seemed to minimally
      affect crown flexure. Porcelain veneers showed perfect biomimetic behavior,
      because cumulated restoration procedures had the same effect on natural and
      veneered incisors.

PMID- 11203908
TI  - Subpontic osseous hyperplasia: a case report.
AB  - Subpontic osseous hyperplasia is an ectopic growth of bone occurring on the
      edentulous ridge beneath a fixed partial denture replacing a mandibular first
      molar. A 56-year-old woman experienced an enlargement of the hard and soft
      tissues beneath the pontic region of a fixed partial denture replacing her
      mandibular left first molar. Following removal of the fixed partial denture, the
      bony enlargement was surgically removed, and the bony fragments were submitted
      for histologic analysis, which demonstrated mature lamellar bone and appositional
      growth. One year postoperatively, there has been no recurrence of the lesion. The
      possible etiologies and treatment modalities are reviewed and a rationale for
      treatment is presented.

PMID- 11203909
TI  - Clinical images in oral medicine. Encephalotrigeminal syndrome (Sturge-Weber
      disease).

PMID- 11203910
TI  - The most important impression: emotional comfort.

PMID- 11203911
TI  - Behcet's disease: dental and oral soft tissue complications.
AB  - Behcet's disease is a chronic, multisystem disorder. It has 3 primary components:
      recurrent inflammations of the eye, ulcerations of the oral mucous membranes, and
      ulcerations of the genitalia. Diagnosis of Behcet's disease relies mainly on
      history taking and clinical manifestations. This article describes the oral soft
      tissue and dental complications and the prosthetic problems encountered in a
      young patient. If dentists encounter patients with chronic ocular inflammations
      and recurrent oral mucous membrane ulcers, the index of suspicion should
      increase.

PMID- 11203912
TI  - The effect of salt-containing dentifrices on gingival inflammation.
AB  - OBJECTIVE: This study examined the effect of an alkaline, salt-containing
      toothpaste, a toothgel of similar contents, and a conventional toothpaste on
      gingival inflammation. METHOD AND MATERIALS: One hundred fifteen patients
      suffering from mild to moderate chronic gingivitis were enrolled in a double
      blind clinical study. All subjects had at least 20 teeth, probing depths of less
      than 6 mm, and a sulcular bleeding index of 50% or more. At the beginning of the
      study period, the subjects were randomly assigned to 3 study groups. The baseline
      examination recorded the number of decayed, missing, and filled teeth, an
      approximal plaque index, a sulcular bleeding index, and the gingival index.
      RESULTS: After an 8-week study period, statistically significant reductions in
      the plaque and bleeding indexes were observed in all 3 groups. There were no
      significant differences among the 3 dentifrices examined. CONCLUSION: The
      effectiveness of salt-containing dentifrices in patients with gingivitis was
      comparable to that of a conventional toothpaste.

PMID- 11203913
TI  - A comparative study of 2 fluoride-based mouthrinses.
AB  - OBJECTIVE: The purpose of this study was to compare the effectiveness of 2
      mouthrinses (conventional Meridol and alcohol-free Meridol). METHOD AND
      MATERIALS: A controlled, single-blind clinical study of 3 weeks' duration was
      conducted on 80 adult subjects in good general health and without severe
      periodontitis (probing depths no deeper than 4 mm). The mouthrinses supplemented
      regular measures of oral hygiene for the reduction of plaque and gingivitis. In
      preliminary examinations to determine general conditions of oral health,
      especially the level of plaque, gingivitis, and periodontal findings, the
      approximal plaque index, sulcular bleeding index, and gingival index were
      established for each subject. Afterward the subjects were provided with a
      professional toothcleaning, as required. Each subject was randomly provided with
      1 of the 2 mouthrinses, to be used 3 times daily in addition to routine oral
      health measures. The 3 indexes were reevaluated after 3 weeks; in addition, an
      optional stain index was employed. RESULTS: In both subject groups, a
      statistically significant reduction in plaque accumulation, as well as a
      reduction in inflammation and the tendency to bleeding, was observed. Reversible
      staining of the teeth and tongue was observed in fewer than one third of the
      subjects in both groups. CONCLUSION: Comparison of the 2 Meridol mouthrinses
      revealed no difference in effectiveness related to the alcohol content.

PMID- 11203914
TI  - Use of an existing post to rerestore an endodontically treated tooth with a new
      post-and-core complex and crown: a case report.
AB  - Replacement of a post-and-core restoration that has failed because of caries or
      fracture presents a restorative challenge to the general dentist. This case
      report describes a new technique that enables the utilization of an unremovable
      preexisting post in the fabrication of a new post-and-core complex. This complex
      served as a foundation for a restoration that restored form and function to the
      patient's dentition.

PMID- 11203915
TI  - Crown fractures: effectiveness of current enamel-dentin adhesives in reattachment
      of fractured fragments.
AB  - OBJECTIVE: The introduction of the current enamel-dentin adhesives has simplified
      the reattachment of fractured dentinal fragments. The objective of this study was
      to determine the strength needed to detach coronal fragments reattached with the
      most recent adhesives. METHOD AND MATERIALS: A complete coronal fracture was
      caused on the incisal one third of 40 noncarious maxillary and mandibular lateral
      and central incisors. Each fractured coronal fragment was reattached to its tooth
      with the enamel-dentin adhesive Scotchbond MP, All-Bond 2, Dentastic, or One-Step
      (10 specimens each). RESULTS: There was no statistically significant difference
      between 2 similar fourth-generation adhesives that use orthophosphoric acid as
      etchant (Dentastic and All-Bond 2) and a fourth-generation adhesive that uses
      maleic acid as etchant (Scotchbond MP). The values obtained with the fifth
      generation adhesive (One-Step) were significantly inferior to those obtained with
      the other 3 enamel-dentin adhesives. CONCLUSION: In the reattachment of fractured
      tooth fragments, fourth-generation adhesives can guarantee a bonding force
      stronger than fifth-generation adhesives.

PMID- 11203916
TI  - Intramuscular hemangiomas.

PMID- 11203917
TI  - Anesthesia technique needs more testing.

PMID- 11203918
TI  - Direct pressure provisionalization technique: a new open-tray technique for
      complete-arch rehabilitations.
AB  - An innovative direct technique that improves the accuracy of provisional acrylic
      resin restorations is introduced. A custom impression tray is modified to
      facilitate complete occlusal closure. This open tray is used to make an accurate
      overimpression prior to beginning tooth preparation procedures. Following tooth
      preparation, the acrylic resin-filled overimpression is returned to its intraoral
      position, and the patient occludes into the previously indexed impression
      material. The pressure overimpression technique is offered as an expedient
      technique for improving the accuracy of provisional restorations.

PMID- 11203919
TI  - Recurrent aphthous stomatitis.
AB  - Etiology and Epidemiology: The Greek term aphthai was initially used in relation
      to disorders of the mouth and is credited to Hippocrates (460-370 BC). Today,
      recurrent aphthous ulceration, or recurrent aphthous stomatitis (RAS), is
      recognized as the most common oral mucosal disease known to human beings.
      Considerable research attention has been devoted to elucidating the causes of
      RAS; local and systemic conditions, and genetic, immunologic, and infectious
      microbial factors all have been identified as potential etiopathogenic agents
      (Table 1). However, to date, no principal etiology has been discovered.
      Epidemiologic studies indicate that the prevalence of RAS is between 2% and 50%
      in the general population; most estimates fall between 5% and 25%. In selected
      groups, such as medical and dental students, it has been observed with a
      frequency as high as 50% to 60%. The peak age of onset for RAS is between 10 and
      19 years. After childhood and adolescence, it may continue throughout the entire
      human lifespan without geographic or age-, sex-, or race-related preference.

PMID- 11203920
TI  - To treat, or not to treat.

PMID- 11203921
TI  - Assuring restorative integrity in extensive posterior resin composite
      restorations: pushing the envelope.
AB  - Clinicians are increasingly being called on to satisfy the restorative demands of
      patients who request tooth-colored restorations but are unable to afford an
      optimum indirect restorative option. Consequently, in clinical practice, the
      limits of the direct posterior resin composite technique are being stretched.
      There is a need for techniques that will satisfy the complex variables of
      clinical practice and allow for successful utilization of posterior resin
      composite in large cavity preparations. The objective of this article is to
      explain the rationale behind the materials and techniques involved in the
      delivery of these complicated restorations.

PMID- 11203922
TI  - Secondary caries: a literature review with case reports.
AB  - The clinical diagnosis of secondary caries is by far the most common reason for
      replacement of restorations, but the scientific basis for the diagnosis is
      meager. The purpose of this article is to review the literature on secondary
      (recurrent) caries and present case reports to document the problems encountered
      in the clinical diagnosis of secondary caries. The literature on secondary caries
      was critically reviewed and subdivided into clinical diagnosis, location of
      secondary lesions, histopathology, microleakage, and microbiology. The case
      reports included restorations that were scheduled to be replaced because of
      secondary caries or stained margins of composite restorations. The lesions were
      photographed preoperatively and postoperatively. Based on the limited literature
      available, secondary caries appears to be a localized lesion similar or identical
      to primary caries. It is most often localized gingivally on restorations. Narrow
      gaps, crevices, ditches, and "microleakage" do not lead to secondary caries, but
      wide voids may. Secondary caries is difficult to diagnose clinically. Consistency
      or hardness and discoloration of dentin and enamel are the best parameters.
      Secondary caries is the same as primary caries located at the margin of a
      restoration.

PMID- 11203923
TI  - One-year clinical evaluation of compomer restorations placed in general practice.
AB  - OBJECTIVE: This study evaluated the in-service performance, after 1 year, of a
      sample of F2000 compomer restorations placed by 10 general dental practitioners
      as part of handling evaluation of this material. METHOD AND MATERIALS: Five
      general dental practitioners who participated in the handling evaluation were
      asked to cooperate in the 1-year assessment of the restorations. The
      practitioners were requested to contact patients and inquire if they were willing
      to attend at a specified time for examination of their restorations by a trained
      evaluator who would travel to the various practice locations. A total of 84
      restorations were presented for examination. The mean age of the restorations at
      examination was 14 months. The restorations were assessed for anatomic form,
      marginal adaptation, surface roughness, sensitivity or discomfort, gingival
      condition, and presence or absence of secondary caries. RESULTS: Eighty-two
      restorations were intact. No secondary caries was detected. Optimal scores were
      obtained in a high proportion of the assessments. All patients reported
      satisfaction with the restorations, both in appearance and surface texture, and
      no symptoms were reported. CONCLUSION: The F2000 compomer restorations, placed in
      conjunction with its bonding system in general practice conditions, were found to
      be performing satisfactorily after 1 year.

PMID- 11203924
TI  - A new prosthodontic technique for fabricating cement-retained implant-supported
      prostheses.
AB  - This article describes a new technique for fabricating cement-retained implant
      supported prostheses. The technique involves cementation of the prostheses over
      customized gold cylinders. Access channels are incorporated in the prostheses to
      allow future access of the gold screws. This technique can be used in various
      clinical situations to achieve total passive fit of the framework without
      compromising retrievability. The technique overcomes the problems encountered
      with other previously advocated methods for constructing such prostheses. In
      addition, maintenance of the resulting prostheses is uncomplicated.

PMID- 11203925
TI  - Developing cementoblastoma: case report and update of differential diagnosis.
AB  - The benign cementoblastoma is a rare odontogenic tumor that tends to occur in the
      jaws of young people. It is most commonly characterized as a circumscribed
      radiopaque mass attached to the tooth roots and rimmed by a thin radiolucent
      zone. Early lesions, however, are radiolucent and can be confused with periapical
      conditions resulting from nonvital teeth. The tumor is seldom recognized until it
      produces pain or expansion of the jaw. If the diagnosis is established early, the
      tooth can be saved by endodontic treatment followed by apical root resection and
      surgical enucleation of the tumor. This case report documents the origin,
      development, and unlimited growth potential of a cementoblastoma. Radiographs
      taken at yearly intervals reveal an initial widening of the periodontal ligament
      space that grew into a 3-cm mixed radiolucent and radiopaque tumor over a 4-year
      period. The differential diagnosis and some criteria to help distinguish the
      cementoblastoma from similar-appearing lesions are reviewed.

PMID- 11203926
TI  - Effect of xerostomic medications on stimulated salivary flow rate in patients
      with Sjogren's syndrome.
AB  - OBJECTIVE: The purpose of this study was to examine the effect of xerostomic
      medications on the salivary output of patients with Sjogren's syndrome. METHOD
      AND MATERIALS: Of 62 patients evaluated in this study, 23 were not using
      medication, and 39 were using between 1 and 6 medications with xerostomic side
      effect. RESULTS: The mean +/- SEM stimulated parotid output was 0.33 +/- 0.07
      mL/min per gland for patients who were not using medication and 0.33 +/- 0.04
      mL/min per gland for patients using (1 to 6) medications. Analyses did not reveal
      a significant difference in salivary output between these groups. The salivary
      output of patients using various numbers of medications (1 or 2; 3 or 4; 5 or 6)
      was also compared. Analysis revealed no significant difference in salivary output
      related to the number of xerostomic medications used. CONCLUSION: The use of
      xerostomic medications may not necessarily affect stimulated parotid flow rate in
      patients with Sjogren's syndrome. These results suggested that gustatory
      stimulation may be adequate to overcome the inhibitory effect induced by
      xerostomic medications.

PMID- 11203927
TI  - Effect of 3 medicaments on the dimensional accuracy and surface detail
      reproduction of polyvinyl siloxane impressions.
AB  - OBJECTIVE: The purpose of this study was to determine the effect of retraction
      cord medicaments (aluminum chloride, ferric sulfate, and ferric subsulfate/ferric
      sulfate) on the dimensional accuracy and surface detail reproduction of polyvinyl
      siloxane impressions. METHOD AND MATERIALS: Polyvinyl siloxane impressions were
      made of standardized metal dies (American Dental Association [ADA] specification
      No. 19) treated with 1 of the 3 retraction cord medicaments. Dimensional accuracy
      was evaluated by comparing the average length of a line in the impressions to the
      standard die. Surface detail reproduction was evaluated by viewing the
      impressions under low-angle illumination at x10 magnification. Reproduction was
      considered satisfactory if 2 of 3 horizontal lines were reproduced continuously.
      The dies were also evaluated under the microscope before the impression was made.
      RESULTS: The medicaments did not significantly effect the dimensional accuracy;
      mean shrinkage was within ADA guidelines in the treatment groups. All of the
      medicaments had an adverse effect on surface detail reproduction. These effects
      were statistically significant compared to the untreated control. CONCLUSION:
      Although the changes in dimensional accuracy were within ADA guidelines, the
      surface detail reproduction was modified such that the impression would be
      considered clinically unacceptable. For optimal results, care must taken to
      remove all traces of these retraction cord medicaments prior to recording of a
      polyvinyl siloxane impression.

PMID- 11203928
TI  - Profiles of professionalism.

PMID- 11203929
TI  - Enamel etching and glass-ionomer sealants.

PMID- 11203930
TI  - The axial bevel technique: a new technique for extensive posterior resin
      composite restorations.
AB  - The objective of this article is to introduce a new preparation design that
      utilizes external axial bevels and a resin placement technique that involves
      selective application of 2 resins of different viscosity to optimize marginal
      integrity in large Class II restorations. The rationale behind the intricate
      application of material and procedural manipulations involved in the delivery of
      these complicated restorations is discussed.

PMID- 11203931
TI  - Direct pulp capping with a dentin adhesive resin system in children's permanent
      teeth after traumatic injuries: case reports.
AB  - Traumatic injuries in the permanent teeth of children and adolescents are one of
      the most frequent causes of dental treatment. The article presents the use of an
      enamel and dentin adhesive resin system, Syntac, and resin composite materials,
      Tetric and Variolink, as materials of choice for direct pulp capping after
      traumatic pulpal exposure (Ellis Class III). Exposed pulp in 10 patients was
      covered with Syntac and then Tetric and Variolink after etching of dental tissues
      with phosphoric acid. The follow-up period was from 12 to 48 months. In 1
      patient, the treatment was a failure. In the remaining 9 patients, no signs or
      symptoms of pulpal inflammation or necrosis were observed during the clinical
      examination.

PMID- 11203932
TI  - Design features that may influence bacterial plaque retention: a retrospective
      analysis of failed implants.
AB  - OBJECTIVE: The purpose of this study was to conduct a postmortem examination of
      retrieved failed dental implants to identify design characteristics that may have
      contributed to premature loss. METHOD AND MATERIALS: Forty-five failed implants
      retrieved from 40 patients with no significant risk factors for implant failure
      (e.g., history of smoking or diabetes) were examined by scanning electron
      microscopy. All implants were placed by general dentists or periodontists in
      private practice and had functioned for an average of 4 years. RESULTS: Several
      design features of currently used implants present plaque-retentive areas. Plaque
      accumulation occurred along the implant-transmucosal abutment interfaces,
      transmucosal abutment-prosthesis interfaces, implant-prosthesis interfaces, and
      on surfaces of the abutment, the implant, and the prosthesis. The size of the
      microgap between the various components, the degree of surface roughness of the
      restorations and abutments, the exposure of plasma-sprayed coatings and threaded
      surfaces of implants, and overcontouring of implant restorations contributed to
      plaque accumulation and provided an ideal environment for bacterial colonization.
      CONCLUSION: These implant features may be key precipitating or exacerbating
      factors in the development of peri-implant inflammation, predisposing patients to
      implant failure.

PMID- 11203933
TI  - Effects of different exposure values on diagnostic accuracy of digital images.
AB  - OBJECTIVE: The aim of this in vitro study was to compare the effects of different
      exposure values on the image clarity of 3 digital radiographic systems and 1
      conventional direct-exposure emulsion x-ray film. METHOD AND MATERIALS: Three
      digital radiographic systems, Digora, RVG, and Sidexis, were compared with the
      conventional dental x-ray film, Ektaspeed Plus. A medullary bone fragment and
      human teeth were radiographed with varying voltage, exposure time, and focus
      receptor distance. Clinical criteria to evaluate image clarity were detail
      resolution, sharpness, contrast resolution, and artifacts of the different tooth
      and jaw structures. RESULTS: The optimal exposure times for digital imaging
      varied between 0.02 and 0.13 seconds and depended on the objects and the imaging
      systems. Optimal resolution was obtained when a voltage of 60 kV was used. The
      focus-receptor distance of 33 to 40 cm resulted in the best contrast and
      sharpness. Digital images did not always provide the detail resolution or
      sharpness achieved by conventional radiographs. CONCLUSION: The recommended
      exposure time for digital images amounted to approximately half the time needed
      for conventional film. Digital images had to be modified by adjusting the
      contrast and brightness to optimize the visibility of the areas to be diagnosed.

PMID- 11203934
TI  - Fluoride release from a polyacid-modified resin composite and 3 resin-modified
      glass-ionomer materials.
AB  - OBJECTIVES: The purposes of this study were to compare the fluoride ion release
      from a freshly mixed polyacid-modified resin composite, or "compomer" (Dyract),
      and 3 resin-modified glass-ionomer cements (Fuji II LC, Photac-Fil, and Vitremer)
      and to compare the use of 3 units for measuring fluoride release. METHOD AND
      MATERIALS: Five specimens (3.0 x 2.7 mm) of each material were prepared. The
      specimens were placed in polypropylene vials with 2 mL of deionized water and
      stored at 37 degrees C. The solutions were replaced weekly and the levels of
      fluoride ions were analyzed at days 1, 7, and 30 and subsequently every 28 days
      for 253 days. Fluoride measurements were carried out using a fluoride ion
      selective electrode connected to a pH ion-selective electrode meter. Fluoride ion
      release was measured in parts per million, micrograms per square centimeter, and
      micrograms per cubic millimeter. RESULTS: Fuji II LC, Photac-Fil, and Vitremer
      showed high initial release values, which decreased exponentially and then showed
      a slow decline during the ensuing time. Dyract released significantly less
      fluoride ions during the first 84 days than did the 3 resin-modified glass
      ionomer cements and maintained this low level of release throughout the study
      period. The amounts of fluoride ion release measured at any time interval varied
      with the units of measurement chosen, but the pattern of release remained the
      same. CONCLUSION: There was a wide variation in the amounts of fluoride ions
      released from related products, but the patterns of release were similar and
      unaffected by the units of measurement used.

PMID- 11203935
TI  - Biomechanics of cervical tooth structure lesions and their restoration.
AB  - OBJECTIVE: The purpose of this study was to evaluate photoelastically the effects
      of a cervical tooth structure lesion and its restoration on stress distribution
      within a tooth. METHOD AND MATERIALS: Three-dimensional composite models of a
      maxillary first premolar with a buccal cervical lesion were fabricated. Two types
      of cervical lesion were tested: one was wedge shaped and had a sharp line angle
      at the apex of the lesion, and the other was more rounded and saucer shaped.
      Vertical loads of 10 lb were applied to the unrestored and restored models at the
      tip of the buccal cusp, the tip of the lingual cusp, and the center of the
      occlusal surface. The resulting stresses within the tooth model were monitored
      and recorded photographically in the field of a circular polariscope arrangement.
      RESULTS: In the unrestored situation, stress concentrated at the apex of the
      lesion, regardless of the lesion configuration. However, the sharper, wedge
      shaped lesion demonstrated a more severe stress concentration. In the restored
      situation, stress around the lesion apex and the lingual cervical lesion
      decreased, while stresses at the gingival and occlusal margins of the lesion
      increased, compared with the unrestored situation. These tendencies were most
      obvious when the buccal cusp was loaded. CONCLUSION: The presence of a cervical
      lesion changed occlusal load-induced stress distribution and concentrated stress
      at the apex of the lesion. The shape and dimension of the lesion governed the
      severity of stress concentration. Restoration of the cervical lesion relieved
      concentrated stress at the apex of the lesion.

PMID- 11203936
TI  - Clinical indications for altering vertical dimension of occlusion. Functional and
      biologic considerations for reconstruction of the dental occlusion.

PMID- 11203937
TI  - Clinical indications for altering vertical dimension of occlusion. Objective vs
      subjective methods for determining vertical dimension of occlusion.

PMID- 11203938
TI  - Kaposi's sarcoma.

PMID- 11203939
TI  - Periodontics: the hub around which the rest of dentistry turns.

PMID- 11203940
TI  - Clinical evaluation of bleaching agents of different concentrations.
AB  - OBJECTIVE: The purpose of this study was to evaluate the degree of color change,
      any rebound effect, and sensitivities associated with using 2 different
      concentrations of carbamide peroxide in vivo. METHOD AND MATERIALS: Twenty-five
      subjects used 10% and 15% agents in trays for 14 days on different sides of their
      maxillary arches. Subjects returned in 3 days and at 1, 2, 3, and 6 weeks for
      evaluation of color change and rebound effect. Shade matching, photographic
      means, and a colorimeter were used for evaluation. Subjects self-reported
      gingival and tooth sensitivity on a scale of 1 (no sensitivity) to 5 (severe
      sensitivity). RESULTS: After 2 weeks, delta L*, delta a*, delta b*, delta E* and
      delta shade guide rank means for the 10% whitening agent were 6.50, -1.37, -4.63,
      8.79, and -15.40, respectively; for the 15% agent, they were 8.72, -1.63, -5.90,
      11.03, and -16.59, respectively. After 6 weeks, delta L*, delta a*, delta b*,
      delta E*, and delta shade guide rank means for the 10% whitening agent were 3.04,
      -0.99, -3.19, 5.13, and -13.13, respectively; for the 15% agent, they were 3.48, 
      1.01, -3.60, 5.58, and -13.65, respectively. Means for gingival sensitivity were
      1.18 and 1.21 for the 10% and 15% agents, respectively; means for tooth
      sensitivity were 1.21 and 1.26 for the 10% and 15% agents, respectively.
      CONCLUSION: All 3 methods of evaluation revealed a significant difference in the
      tooth lightness achieved by 10% and 15% products at 2 weeks but no significant
      difference at 6 weeks. No statistically significant difference was found in
      gingival or tooth sensitivity.

PMID- 11203941
TI  - Extracoronal resilient attachments in distal-extension removable partial
      dentures.
AB  - Esthetics is often compromised in patients who wear removable partial dentures
      with metal clasps placed on anterior teeth. Clinical procedures are presented for
      a new design of a removable partial denture that improves esthetics and function
      through a new dental attachment. The extracoronal resilient attachment system
      offers vertical resiliency and universal stress relief for use where a resilient
      prosthesis is indicated. The removable partial denture retained by these
      attachments provides esthetics, vertical resiliency, and easy replacement of worn
      attachments.

PMID- 11203942
TI  - A preliminary comparative study of the guided tissue regeneration and free
      gingival graft procedures for adjacent facial root coverage.
AB  - OBJECTIVE: The purpose of this study was to compare the clinical efficacy of
      guided tissue regeneration with expanded polytetrafluoroethylene membranes to
      that of free gingival graft for treatment of adjacent facial gingival recession.
      METHOD AND MATERIALS: Eight adjacent gingival recession sites with Miller class I
      or II defects containing at least a maxillary or mandibular canine were selected
      in 6 patients. Four recession sites in 3 patients were treated with guided tissue
      regeneration, and the other 4 sites in the remaining 3 patients were treated with
      free gingival graft. Probing depth, gingival recession, attachment level, width
      of keratinized gingiva, and root coverage were recorded before surgery (baseline)
      and 6 months and 1 year postoperatively. RESULTS: Statistically significant
      improvements were found for gingival recession, attachment level, and root
      coverage from baseline to 6 months and 1 year postoperatively in both groups.
      Both procedures produced the same average reduction in gingival recession, gain
      in attachment level, and amount of root coverage after 1 year. Probing depths did
      not differ between groups throughout the study. The width of keratinized gingiva
      was significantly greater in the grafted group than in the guided tissue
      regeneration group. CONCLUSION: Both procedures produced the same average amount
      of root coverage, reduction in gingival recession, and gain in clinical
      attachment. The guided tissue regeneration procedure provided a better esthetic
      appearance without any difference in gingival color or architecture in cases of
      adjacent facial gingival recession.

PMID- 11203943
TI  - Intrusion injuries of primary incisors. Part I: Review and management.
AB  - Intrusion injuries commonly occur in the primary dentition. They can be described
      as luxation injuries resulting from an axially directed impact, which drives the
      tooth deeper into the alveolar socket. The impact results in compression of and
      damage to the periodontal ligament as well as injury to the pulp of the intruded
      incisor. In addition to rendering treatment to the intruded primary tooth, the
      dentist must also be aware of the possibility of an injury to the developing
      permanent teeth germs located in close proximity to the roots of the injured
      primary teeth. This review will discuss the characteristics, implications, and
      management of intrusion injuries of primary incisors.

PMID- 11203944
TI  - Intrusion injuries of primary incisors. Part II: Sequelae affecting the intruded
      primary incisors.
AB  - Luxation injuries to incisors, including intrusive displacement, occur with a
      high frequency in the primary dentition. Intrusion injuries are associated with
      damage to the pulpal and periodontal structures and possible fracture of the
      alveolar bone. The pulpal tissue of the intruded tooth sustains a severe shock
      during displacement, which may be reflected later by sequelae ranging from mild
      discoloration to pulpal necrosis and infection. Disintegration of pulpal tissue
      may result in periapical tissue inflammation, which in turn may induce
      developmental disturbances in the germ of the permanent successor tooth.
      Additionally, severe injury to the periodontal ligament during intrusion may lead
      to ankylosis of the primary incisor and consequently to delayed or ectopic
      eruption of its permanent successor. This article will review the possible
      sequelae affecting primary incisors following their intrusion.

PMID- 11203945
TI  - Treatment of a palatal groove-related periodontal bone defect.

PMID- 11203946
TI  - A comparison of the marginal and internal adaptation of amalgam and resin
      composite restorations in small to moderate-sized Class II preparations of
      conventional design.
AB  - OBJECTIVE: The purpose of this study was to compare the marginal and internal
      adaptation of a non-gamma-2 amalgam and an ultrafine compact-filled light-cured
      composite in small to moderate-sized Class II restorations of conventional
      design. METHOD AND MATERIALS: Fifty recently extracted human premolar and
      permanent molar teeth were selected for the study. The teeth were restored with
      either a non-gamma-2 amalgam alloy or a light-cured resin composite. The marginal
      adaptation of the restorative materials to the proximal surface outline form of
      each preparation was assessed. The mean percentages of perfect margins, marginal
      fissuring, and underfilled margins for the 2 restorative materials were recorded
      and statistically analyzed. RESULTS: Both materials performed equally well in the
      buccal and lingual segments of the proximal box. At the cervical margin, the
      resin composite restorations showed a significantly greater number of imperfect
      margins and marginal fissuring. The incidence of underfilled margins was low for
      both restorative materials even at the cervical margin. CONCLUSION: Although
      there was some cause for concern about the marginal adaptation of the resin
      composite restorations along the cervical margin, the findings support
      contemporary teaching that small to moderately sized conventional Class II
      preparations may justifiably be restored with an appropriate resin composite.

PMID- 11203947
TI  - Bond strengths of nonrinsing adhesives.
AB  - OBJECTIVE: The purpose of this study was to determine enamel and dentin bond
      strengths of a nonrinsing "all-in-one" adhesive and of a nonrinsing conditioner
      combined with a 1-bottle adhesive. METHOD AND MATERIALS: Specimens were obtained
      from 240 bovine teeth ground to expose enamel or dentin surfaces. Ten enamel and
      10 dentin specimens were randomly assigned to each of 12 different combinations
      of adhesive system (Prompt L-Pop; no etch + Prime & Bond NT; NRC + Prime & Bond
      NT; 36% phosphoric acid + Prime & Bond NT; no etch + Prime & Bond 2.1; 36%
      phosphoric acid + Prime & Bond 2.1) and restorative material (resin composite;
      polyacid-modified resin composite ["compomer"]). After the application of the
      adhesive system, a No. 5 gelatin capsule filled with the restorative material was
      seated against the enamel or dentin surface. After 24 hours in distilled water at
      37 degrees C, the specimens were thermocycled and the shear bond strengths were
      measured. RESULTS: For resin composite, etching with phosphoric acid resulted in
      the highest bond strengths to enamel. For compomer, the highest enamel bond
      strengths were achieved with both phosphoric acid and Prompt L-Pop. Treating
      dentin with Prime & Bond NT without etching provided the highest mean bond
      strength for composite. For compomer, treating dentin with Prime & Bond NT
      resulted in the highest mean bond strengths, regardless of the conditioner.
      CONCLUSION: Compomer and resin composite exhibited statistically similar bond
      strengths. Bond strengths to dentin were significantly lower than those to
      enamel.

PMID- 11203948
TI  - Oral lesions secondary to fellatio.

PMID- 11203949
TI  - Improving dentist-patient relations.

PMID- 11203950
TI  - Dentoalveolar trauma: can you manage it?

PMID- 11203951
TI  - Infection control.

PMID- 11203952
TI  - Classification for minimal intervention.

PMID- 11203953
TI  - Intrusion injuries of primary incisors. Part III:   Effects on the permanent
      successors.
AB  - Intrusion injuries of the primary dentition are highly associated with
      developmental disturbances of their successor teeth. The age of the child at the
      time of injury, the direction and severity of the intrusion, and the presence of
      alveolar bone fracture are important variables influencing the effect of primary
      tooth intrusion on the developing permanent germ. The developmental defects of
      the permanent successor tooth range from mild alteration in enamel mineralization
      to severe sequestration of the developing germ. This article will review the
      developmental anomalies of the permanent incisors induced by intrusion injuries
      of their predecessors.

PMID- 11203954
TI  - Clinical considerations for reattachment of tooth fragments.
AB  - Trauma to anterior teeth is relatively common among children and teenagers; it
      has been estimated that approximately one quarter of the population under the age
      of 18 years sustain traumatic injury in the form of anterior crown fracture.
      Reattachment of a fractured fragment to the remaining tooth can provide
      esthetically pleasing results provided that the fragment is available. In this
      report, a systematic clinical approach through evaluation of periodontal,
      endodontic, coronal, and occlusal aspects is presented to help dentists analyze
      the factors affecting selection of techniques and materials. In addition, use of
      adhesive materials for tooth fragment reattachment is illustrated. Modifications
      of the reattachment process, including placement of veneer and radicular post,
      are also discussed.

PMID- 11203955
TI  - A modified indirect working die technique for fabricating provisional
      restorations for multiple teeth.
AB  - The "modified" indirect working die technique is introduced. The technique
      expands the capabilities of the indirect working die technique, which features
      flexible removable dies for fabricating provisional restorations. The modified
      technique is distinguished by its potential for restoring multiple teeth, up to
      and including the complete arch, by utilizing a complete-arch impression tray to
      which a simple modification is made. It is an accurate, timesaving, and
      laborsaving method for fabricating provisional restorations.

PMID- 11203956
TI  - Amelogenesis imperfecta: functional and esthetic restoration of a severely
      compromised dentition.
AB  - The treatment of patients with severe forms of amelogenesis imperfecta presents
      an interesting challenge to the dental team. A 16-year-old girl presented with a
      severely compromised occlusion and poor esthetics that had lowered her self
      esteem. Preoperative investigations included the determination of completion of
      growth, an accurate diagnostic waxup, and an evaluation of clinical crown
      lengths. Periodontal full-flap surgery was planned to lengthen clinical crowns
      and create gingival harmony. This was to be followed by placement of 28 complete
      crowns to restore occlusal function and gain a pleasing esthetic result. All
      porcelain crowns were placed from premolar to premolar in each arch (20 crowns),
      and porcelain-fused-to-metal crowns were placed on each molar tooth in each arch
      (8 crowns). The final treatment result provided this patient with a mutually
      protective occlusion and with esthetics that greatly enhanced her self-image.

PMID- 11203957
TI  - Biologic restoration of primary anterior teeth.

PMID- 11203958
TI  - Overgrowth of a costochondral graft in temporomandibular joint reconstructive
      surgery: an uncommon complication.
AB  - A 16-year-old girl had a history of unilateral ankylosis of the temporomandibular
      joint, which was reconstructed with an autogenous costochondral graft. About 2.5
      years after surgery, the patient presented with overgrowth of the costochondral
      graft, resulting in deviation of the jaw toward the unaffected side.

PMID- 11203959
TI  - Hereditary gingival fibromatosis: review of the literature and a case report.
AB  - Hereditary gingival fibromatosis is a proliferative fibrous lesion of the
      gingival tissue that causes esthetic and functional problems. Both genetically
      and pharmacologically induced forms of gingival fibromatosis exist. This paper
      reports a case of severe generalized hereditary gingival fibromatosis in a 5-year
      old girl. Treatment consisted of surgical removal of the hyperplastic fibrous
      tissue in a series of conventional gingivectomies. Postoperative examination 36
      months after the final procedure revealed no signs of recurrence.

PMID- 11203960
TI  - Frequency of oral manifestations in children infected with human immunodeficiency
      virus.
AB  - OBJECTIVE: The main objective of this study was to investigate the frequency of
      oral manifestations in children with acquired immunodeficiency syndrome. It also
      attempted to correlate the presence of lesions with the patient's degree of
      immunosuppression, as measured by the T4/T8 ratio. METHOD AND MATERIALS: Oral
      examinations were performed in 51 children with acquired immunodeficiency
      syndrome for a 2-year period. A questionnaire used in this investigation was
      based on the children's classification proposed by the Centers for Disease
      Control in 1987. The children's T4/T8 ratios were obtained from their medical
      files. RESULTS: Pseudomembranous candidiasis was the most common lesion, found in
      21.57% of the children. Salivary gland disease was present in 19.61% of patients.
      Erythematous candidiasis was observed in 5.88%, and linear gingival erythema and
      oral hairy leukoplakia were both observed in 1.96% of children. Children with a
      T4/T8 ratio < 0.5 were more prone to development of pseudomembranous candidiasis.
      CONCLUSION: Pseudomembranous candidiasis was the most common type of oral lesion
      in human immunodeficiency virus-positive children with acquired immunodeficiency
      syndrome. There was a relationship between the frequency of oral manifestations
      and the patient's T4/T8 ratio.

PMID- 11203961
TI  - Quality assessment of marginal sealing using 7 dentin adhesive systems.
AB  - OBJECTIVE: The goal of this investigation was to assess in vitro the quality of
      marginal sealing of composite-dentin adhesive systems and human dentin. METHOD
      AND MATERIALS: Forty intact human premolars and third molars were extracted from
      subjects of both sexes and of different ages. After the enamel layer was removed,
      a Class V cavity was formed on the buccal surface, and a wedge cavity was formed
      on the lingual surface. These were restored with resin composite materials and
      their corresponding dentin adhesive systems. The quality of marginal sealing was
      evaluated by assessing the linear penetration of silver nitrate dye. RESULTS: The
      best marginal sealing between composite materials and the cavity walls, in both
      wedge erosions and Class V cavities, was provided by Scotchbond Multi
      Purpose/Valux and Syntac/Helioprogres systems. Dye penetration was slightly
      greater with the XR-Bond/Herculite, Gluma/Pekafill, and Superlux Universal Bond
      2/Superlux Solar systems. The greatest microleakage was observed in
      Tripton/Opalux and Denthesive/Charisma specimens. CONCLUSION: The use of an
      adhesive system and the corresponding resin composite does not eliminate
      microleakage completely when the cavity margins are in dentin.

PMID- 11203962
TI  - Microleakage of a condensable resin composite: an in vitro investigation.
AB  - OBJECTIVE: The purpose of this investigation was to evaluate microleakage in
      Class II cavities restored with the condensable resin composite SureFil, placed
      with or without a liner and 1 of 2 different dentin bonding agents. METHOD AND
      MATERIALS: Extracted noncarious human teeth were randomly divided into 4 groups
      of 15 each and restored according to manufacturer's instructions: group 1,
      SureFil and Prime & Bond NT; group 2, SureFil and PQ1; group 3, SureFil,
      PermaFlow, and PQ1; group 4, Heliomolar and Syntac Single-Component (control).
      Specimens were stored in 37 degrees C water for 24 hours. All specimens were
      thermocycled between 5 degrees C and 55 degrees C for 500 cycles. Each specimen
      was immersed in 0.2% basic fuchsin dye for 24 hours and then sectioned
      longitudinally and horizontally. Dye penetration at enamel and cementum margins
      were viewed at x30 magnification by 2 independent, calibrated evaluators.
      Specimens exhibiting dye penetration > or = 0.1 mm beyond the cavosurface margin
      were considered to have leakage. RESULTS: Chi-square tests revealed no
      statistically significant differences in the presence of microleakage when all
      groups were analyzed together. However, 2 by 2 comparisons revealed that group 3
      had significantly fewer specimens with microleakage than did group 1, 2, or 4.
      CONCLUSION: To limit microleakage, a flowable composite should be used as a liner
      when a condensable composite material is used.

PMID- 11203963
TI  - Simple ways to reduce patient anxiety.

PMID- 11203964
TI  - Pyogenic granuloma (pregnancy tumor).

PMID- 11203965
TI  - Dentistry's social responsibility: the persistent voice.

PMID- 11203966
TI  - Tunnel restorations placed in routine practice and observed for 24 to 54 months.
AB  - OBJECTIVE: The purpose of this study was to evaluate the feasibility and
      performance of tunnel restorations placed in routine public dental service.
      METHOD AND MATERIALS: A total of 420 small approximal lesions received tunnel
      restorations 12 general practitioners. Three hundred two restorations in 179
      patients were available for evaluation after a minimum period of 24 months. The
      restorations were evaluated by modified US Public Health Service criteria.
      RESULTS: After service periods up to 54 months, 57% of the restorations were
      found to be clinically and radiographically acceptable. The remainder had already
      been replaced or were assessed as unacceptable. High levels of carious activity
      and internal-type preparations resulted in the poorest prognosis. The success
      rates varied considerably among the operators, but these differences did not
      reach statistical significance. CONCLUSION: The indications for use of the tunnel
      restoration technique for the treatment of primary approximal lesions seem to be
      limited at present. Partial tunnel restorations may have a somewhat better
      prognosis than the internal tunnels, but high carious activity has a detrimental
      effect. Tunnel restorations may be considered for particularly cooperative
      patients with a low caries rate as a semipermanent treatment for small lesions.

PMID- 11203967
TI  - Cervical dentin hypersensitivity. Part I: The air indexing method.
AB  - The purpose of this article is to introduce an objective method for quantifying
      cervical dentin hypersensitivity. Air emissions from a standard air-water syringe
      or a syringe with a Fluid Control Block are directed toward the cervices of teeth
      at a 45-degree angle to the long axis of test teeth from a distance of 0.5 cm for
      0.5 to 1.0 second. An air indexing method has been developed to quantify
      threshold patient response values for individual teeth to this defined air
      stimulus. The air indexing method, using the Fluid Control Block, offers the
      clinician objective information to compare cervical dentin hypersensitivity
      before and after treatment for this common, painful condition.

PMID- 11203968
TI  - Cervical dentin hypersensitivity. Part II: Associations with abfractive lesions.
AB  - OBJECTIVE: The purpose of this retrospective study was to evaluate the
      association between cervical dentin hypersensitivity and the presence of
      abfractive lesions. METHOD AND MATERIALS: Written records and study casts for 250
      active-care patients, selected alphabetically, were analyzed for the clinical
      detection of abfractive lesions and cervical dentin hypersensitivity from 1979
      until 1996. Clinical diagnosis of abfractive lesions was made according to
      existing literature descriptions of these hard tissue lesions. Cervical dentin
      hypersensitivity was diagnosed when a verified positive threshold patient
      response was found during tooth evaluation by the air indexing method. Patient
      groups I and II were formed solely on the basis of the presence or absence,
      respectively, of a verified positive threshold patient response of cervical
      dentin to air. RESULTS: A significant association was found between air-indexed
      cervical hypersensitivity and the presence of abfractive lesions. The primary
      locations for both cervical hypersensitivity and abfractive lesions were the
      buccal surfaces of posterior teeth. CONCLUSION: This long-term retrospective
      study found a positive association between cervical dentin hypersensitivity and
      abfractive lesions. The correlative nature of this study suggests the need for
      further investigation.

PMID- 11203969
TI  - An alternative hypothesis from veterinary science for the pathogenesis of
      noncarious cervical lesions.
AB  - An alternative hypothesis to abrasion and erosion for the pathogenesis of
      noncarious cervical lesions was put forward in 1984; the so-called occlusal
      theory suggested that tensile stresses from occlusal overload could be involved
      in the pathogenesis of noncarious cervical lesions and that bending stresses
      applied to teeth could cause disruption of the surface enamel, resulting in
      increased susceptibility to dissolution and abrasion at the affected sites and in
      the development of wedge-shaped lesions. This theory has gained increased
      acceptance in recent years, although absolute scientific evidence has been scant.
      These lesions also occur in animals, in particular, the domestic cat, in which
      they are called feline odontoclastic resorptive lesions. A variety of theories
      about pathogenesis of these lesions have been put forward, but there is some
      evidence that occlusal overload may be a contributory factor in the development
      of an inflammatory response in the periodontal membrane and the presence of
      enzymes associated with resorption in the gingival crevice. Further investigation
      may help define a common etiology between the pathogenesis of feline
      odontoclastic resorptive lesions and noncarious cervical lesions.

PMID- 11203970
TI  - Soft tissue management in oral implantology: a review of surgical techniques for
      shaping an esthetic and functional peri-implant soft tissue structure.
AB  - Along with osseointegration and restoration of function, the patient's subjective
      satisfaction with the esthetic result is a touchstone of the success of implant
      therapy. Although esthetic restoration of natural teeth can be achieved routinely
      through appropriate tooth preparation and a natural-looking design on the part of
      the dental laboratory, the road to success is much more complicated with
      implants, because of atrophy of bone and mucosa. Surgical techniques, paths of
      incision, and useful instruments for implant therapy are described, from implant
      placement to exposure. These methods help to provide durable, functional, and
      esthetic results.

PMID- 11203972
TI  - Dental restorations: choose carefully.

PMID- 11203971
TI  - Shear bond strength, microleakage, and confocal studies of 4 amalgam alloy
      bonding agents.
AB  - OBJECTIVE: This study was undertaken to determine the relative shear bond
      strengths and microleakage of 4 bonding agents to dentin and amalgam and to
      investigate the bonding to dentin through confocal laser scanning microscopy.
      METHOD AND MATERIALS: Sixty noncarious molars were restored with 1 of 4 different
      systems, and the shear bond strengths were determined. For the microleakage
      study, Class V amalgam restorations were placed in 60 noncarious teeth. The
      specimens were thermocycled, the teeth were sectioned, and dye penetration was
      assessed. For confocal examinations, the first component of the bonding adhesives
      was labeled with rhodamine B. Each of the adhesives was applied to 3 dentin
      specimens, which were examined under a confocal laser scanning microscope
      RESULTS: Of the 4 restorative systems tested, AmalgamBond Plus + HPA and Prime &
      Bond 2.1/base-catalyst showed significantly higher shear bond strengths. Prime &
      Bond 2.1/base-catalyst had the lowest microleakage value, which was significantly
      lower than that of AmalgamBond Plus + HPA and AmalgamBond Plus. AmalgamBond Plus
      + HPA had the highest variation in both the bond strength and microleakage
      values. Confocal laser scanning microscopy revealed tag formation, penetration of
      the bonding agents deep into the tubules, and hybrid layer formation for all 4
      bonding systems. CONCLUSION: The 2 best systems, Prime & Bond 2.1/base-catalyst
      and, to a lesser extent, AmalgamBond Plus + HPA, utilized a supplemental bonding
      agent.

PMID- 11203973
TI  - Minimal intervention: a new concept for operative dentistry.
AB  - The term minimal intervention is relatively new in dentistry and has been
      introduced to suggest to the profession that it is time for change in the
      principles of operative dentistry. The disease should be treated first; the
      surgical approach should be undertaken only as a last resort and then with the
      removal of as little natural tooth structure as possible. This article discusses
      the advances in techniques and materials that have led to change and attempts to
      put them into perspective. Treatment should begin with identification and
      elimination of the disease. There will then be a need for limited restoration of
      actual cavitation arising from demineralization of the tooth crown. Restorations,
      per se, will not prevent or eliminate disease. Caries is a bacterial infection
      and, until the microflora is controlled, all restorations are at risk of further
      demineralization in remaining tooth structure. This leads to the continuum of
      replacement dentistry that keeps the profession occupied for much of its
      productive time. If this cycle is to be broken, the profession must first
      acknowledge the primacy of prevention.

PMID- 11203974
TI  - Minimal intervention: early lesions.
AB  - The use of modified cavity designs for the treatment of initial carious lesions
      can be justified on the grounds that, because no restorative material can
      adequately replace natural tooth structure for the long term, preservation of
      natural tooth structure is important. It is apparent that it is possible to
      remineralize and heal demineralized tooth structure to some degree. Therefore,
      neither enamel nor dentin should be removed simply because it has lost calcium
      and phosphate ions as a result of acid attack. The older surgical approach to
      cavity design was adopted in the absence of adhesive techniques and on the basis
      of Black's principle of "extension for prevention," but this theory is no longer
      tenable. The current availability of adhesive bioactive restorative materials
      makes it possible to maintain areas of tooth structure even though they appear to
      be undermined and weakened. Thus, the concept of geometric designs for prescribed
      cavities is no longer valid. The purpose of this article is to describe a series
      of simplified, modified cavity designs for small initial lesions; preservation of
      natural tooth structure is the principle objective of these designs.

PMID- 11203975
TI  - Bondable reinforcement ribbon: clinical applications.
AB  - Bondable reinforcement ribbon can be used in dentistry to splint periodontally
      involved teeth, to provide postorthodontic splinting, to reinforce provisional
      prostheses, and to fabricate direct adhesive prostheses. Four cases illustrate
      esthetically and functionally successful use of reinforced ribbon.

PMID- 11203976
TI  - Esthetic gingival recontouring--a plea for honesty.
AB  - There continues to be a tremendous amount of confusion in the dental literature
      and among practitioners regarding the diagnosis and treatment of gingival
      discontinuities. The purpose of this article is to present a rationale for
      gingival recontouring, illustrated by a case report. A patient requested gingival
      recontouring. Because the preoperative evaluation was inadequate, a simple
      gingivectomy procedure was performed. After healing, the tissue had rebounded to
      its preoperative levels. The patient was then evaluated more comprehensively, and
      gingival recontouring was accomplished with a mucoperiosteal flap and osseous
      recontouring. The tissue subsequently healed at the correct position and remained
      stable. To reliably perform gingival recontouring procedures, the dentist must
      have a clear understanding of the biologic width. By using diagnostic bone
      sounding, the practitioner can determine the appropriate surgical procedure that
      will ensure an esthetic and stable postoperative result.

PMID- 11203977
TI  - Direct resin composite veneers: masking the dark prepared enamel surface.
AB  - A technique for manufacturing direct resin composite veneers is presented.
      Described are the advantages of using an acrylic resin matrix, made before the
      preparation is begun, to copy anatomic details. An additional step to mask
      previously prepared dark enamel with opaquers is also described. The advantages
      and limitations of the procedures are discussed.

PMID- 11203978
TI  - Simplified adhesion of compomers in pediatric dentistry.
AB  - A self-etching adhesive agent for bonding polyacid-modified resin-based composite
      materials ("compomers") to enamel and dentin is now available. The Prompt L-Pop
      system simplifies and hastens dental bonding procedures and has proved itself
      useful in many adhesive dentistry applications. This article describes the
      bonding system and shows clinical examples of its use in children and teenagers.
      The concept will have further application in adhesive dentistry with introduction
      of a new formulation of Prompt, to be used with traditional resin-based composite
      materials.

PMID- 11203979
TI  - Resin-modified glass-ionomer restorations and in vitro secondary caries formation
      in coronal enamel.
AB  - OBJECTIVE: The purpose of this laboratory study was to compare the effects of a
      resin-modified glass ionomer and a resin composite restorative material on
      secondary caries formation in coronal enamel. METHOD AND MATERIALS: Twelve caries
      free molars were sectioned into tooth quarters. Coronal cavities were prepared
      and then restored with either a resin-modified glass-ionomer material
      (mesiobuccal and mesiolingual tooth quarters), or a resin composite (distobuccal
      and distolingual tooth quarters). Caries like lesions were created, and secondary
      caries was examined by polarized light microscopy following lesion initiation and
      progression periods. RESULTS: The resin-modified glass-ionomer specimens had
      significantly shallower primary surface lesions at both the lesion initiation
      (35% shallower) and progression (45% shallower) periods than did the resin
      composite specimens. There were significantly fewer wall lesions (3-fold and 2
      fold fewer following lesion initiation and progression, respectively) in the
      resin-modified glass-ionomer group than in the resin composite group. CONCLUSION:
      Resin-modified glass-ionomer restorations reduce the susceptibility of unrestored
      adjacent enamel surfaces and cavosurfaces to a constant cariogenic challenge. The
      caries resistance imparted to the surface enamel and cavosurface is most likely
      due to the fluoride release from the resin-modified glass-ionomer material.

PMID- 11203980
TI  - Pulpotomy reconsidered: application of an adhesive system to pulpotomized
      permanent primate pulps.
AB  - OBJECTIVE: This study was undertaken to compare the healing response of permanent
      primate pulps to pulpotomy procedures following hemorrhage control and adhesive
      hybridization to their response after conventional treatments. METHOD AND
      MATERIALS: Forty-two cavities were placed throughout the dentitions of 4 adult
      monkeys. In 24 teeth, following mechanical bur exposure and pulpotomy, hemorrhage
      was controlled with application of 3% sodium hypochlorite. The cavity was rinsed
      and the enamel-dentin-pulp surface was restored with an adhesive system for 6 and
      7 months. Calcium hydroxide, formocresol, and resin-modified glass-ionomer cement
      were placed as conventional treatments in 18 teeth for 70 days and cavities were
      sealed with resin-modified glass-ionomer cement. Following perfusion fixation,
      tissues were demineralized, sectioned, stained, and histologically graded using
      defined criteria. RESULTS: Of 24 adhesive system pulps, 10 showed no or minimal
      pulpal response, 1 showed an acute response, 6 showed a chronic response, 2
      showed a severe response, and 5 showed compartmentalized zones of localized
      necrosis. Only 8 adhesive system pulps showed stained bacteria associated with
      inflamed tissues. Thirteen adhesive system pulps showed dentin bridging directly
      at the adhesive system interface. Calcium hydroxide-treated specimens showed
      healing and dentin formation, while resin-modified glass-ionomer cement and
      formocresol treatments failed to result in any bridging. Apical tissues in all
      adhesive-treated specimens showed normal pulps and primary odontoblasts along
      their entire walls. CONCLUSION: Permanent pulps without periapical radiolucencies
      may survive pulpotomy, provided that hemorrhage is properly controlled and the
      pulp-restoration interface is hybridized to exclude all microleakage.

PMID- 11203981
TI  - Osteosarcoma.

PMID- 11203982
TI  - Improving dentist-patient relations.

PMID- 11203983
TI  - Failure to diagnose: can it happen to you?

PMID- 11203984
TI  - Treatment option for dentoalveolar trauma.

PMID- 11203985
TI  - Design principles for cantilevered resin-bonded fixed partial dentures.
AB  - Recent clinical studies show 2-unit cantilevered resin-bonded fixed partial
      dentures to be as retentive or more retentive than their fixed-fixed
      counterparts. The fact that the 2-unit prosthesis is successful adds value to the
      clinical use of resin-bonded fixed partial dentures because the single-abutment
      prosthesis is even simpler and more cost effective than fixed-fixed designs.
      However, there is no evidence-based information relating to design principles for
      abutment preparation and framework design for the single-abutment, single
      retainer prosthesis. The aim of this report is to suggest principles of design
      for the 2-unit cantilevered fixed partial denture, based on information gained
      from studies on fixed-fixed designs.

PMID- 11203986
TI  - Minimal intervention: advanced lesions.
AB  - Minimal intervention techniques are generally considered in relation to initial
      carious lesions. However, it appears logical to apply the same principles to
      extensive cavities as well as to the replacement of failed existing restorations.
      As the cavity becomes larger, there is an increasing need to consider protection
      of remaining cusps because they become seriously weakened by loss of the central
      core of the crown and therefore become subject to the development of splits at
      the base. However, it is possible to develop a protective cavity design without
      undue sacrifice of remaining tooth structure, at the same time that maintenance
      of occlusal anatomy and correct contact with the opposing arch are ensured. For
      larger cavities, special consideration needs to be given to the strength of the
      restorative material. Glass ionomer is relatively brittle and should not be
      exposed to undue occlusal load. Resin composites cannot be regarded as universal
      in their physical properties, and placement is time-consuming. A lamination
      technique is often useful, combining the advantages of both glass ionomer and
      resin composite. Amalgam should not be entirely discarded as an option because it
      has greater strength than both glass ionomer and resin composite and is still
      useful for the restoration of extensive cavities and for protection and retention
      of weakened cusps. Minimal intervention principles, designed to limit the loss of
      natural tooth structure, should be applied to all restorative dentistry. None of
      the available restorative materials is entirely satisfactory in the long term.

PMID- 11203987
TI  - Clinical evaluation of polyacid-modified resin composite posterior restorations:
      one-year results.
AB  - OBJECTIVE: The aim of this investigation was to evaluate the clinical performance
      of a new compomer restorative system, Dyract AP, placed in combination with Non
      Rinse Conditioner and Prime & Bond NT in permanent posterior teeth. METHOD AND
      MATERIALS: Fifty Class II and 41 Class I restorations were placed in 39 patients
      by 1 dentist. The restorations were evaluated directly, with modified US Public
      Health Service criteria, and indirectly, with color slides and polyvinyl siloxane
      impressions, at baseline and 6 months and 1 year after placement. Preoperative
      and 1-year postoperative bitewing radiographs were also taken. RESULTS: All 82
      restorations available for 1-year evaluation were in situ. No postoperative
      sensitivity or pulpal problems were reported. Four Class II restorations (4.9%)
      failed because of partial fracture or recurrent caries. The percentages of Alfa
      score for each criterion were color match, 95.1%; marginal discoloration, 57.3%;
      marginal integrity, 35.4%; anatomic form, 98.8%; and surface texture, 91.5%. The
      average wear rate of Dyract AP was low (18.5 +/- 11.7 microns at 6 months and
      35.7 +/- 13.6 microns at 12 months). CONCLUSION: The excellent handling
      characteristics, the good clinical performance, and the improved wear resistance
      suggest that this compomer will provide reliable direct tooth-colored
      restorations in stress-bearing areas.

PMID- 11203988
TI  - Establishing the differential diagnosis of neck lesions.
AB  - A thorough physical examination of the head and neck should be included as part
      of the evaluation of every dental patient. Although they most often represent a
      self-limited inflammation, a benign neoplasm, or a congenital anomaly, neck
      lesions can also be malignant. Because the pathologic lesions that can arise in
      the neck are varied and diverse, the diagnostic thought process should be orderly
      and inclusive so that a reasonable differential diagnosis can be established and
      prompt, effective treatment can be rendered.

PMID- 11203989
TI  - Oral rehabilitation of a hypohidrotic ectodermal dysplasia patient: a 6-year
      follow-up.
AB  - This case report describes the oral rehabilitation of a female child with
      hypohidrotic ectodermal dysplasia over a 6-year time period. It demonstrates the
      need for periodic modification and replacement of a prosthesis, an orthodontic
      appliance, and a gingivoplasty. Although the initial treatment plan was
      considered to be a compromise due to limited cooperation, an improvement was
      observed in the patient's social behavior as a consequence of her dental
      treatment. The effects of unavoidable changes in the dental team over 6 years are
      also discussed.

PMID- 11203990
TI  - Dental photography in support of patient documentation and communication.
AB  - Intraoral conditions, which in the course of dental treatment are subject to
      change, can be recorded in detail by means of photography. Pictures provide an
      improved documentation and the option of monitoring particular situations over
      longer periods of time. We propose a standardized preoperative 35-mm photographic
      series. For intraoral photography, special intraoral mirrors and lip-and-cheek
      retractors are modified as needed. Macro 35-mm cameras with macro flash are by
      now well-established. Such equipment combined with the technique outlined in this
      report make standardized photographic documentation possible without mouth-angle
      retractors and mirror rims obstructing the view.

PMID- 11203991
TI  - Light energy transmission through cured resin composite and human dentin.
AB  - OBJECTIVE: This study determined the amount of light energy transmitted through
      various densities of cured resin composite and human dentin when 2 different
      light intensities were used. METHOD AND MATERIALS: The maximum light energy
      (mW/cm2) transmitted through disks (0.46 to 5.85 mm thick) of 7 resin composites
      and human dentin was measured when either a Standard or a Turbo light guide was
      attached to a curing light. The effects of the 2 light guides, the specimen
      thickness, and type of specimen dentin on light energy transmission were
      determined. RESULTS: The mean light energy reading at the surface of the
      specimens was 682.1 mW/cm2 with the Standard light guide and 1,014 mW/cm2 with
      the Turbo light guide. For all the specimens, there was an exponential decrease
      in light energy transmitted as the specimen thickness increased. The analysis of
      covariance showed that the specimen, thickness, and light guide all had a
      statistically significant effect. Significantly more light energy (about 42%) was
      transmitted through the specimens when the Turbo light guide was used.
      CONCLUSION: When the Turbo light guide was used, about 42% more light energy was
      transmitted through the cured composite specimens. There was an exponential
      decrease in the light energy transmitted through 7 resin composites and dentin as
      the specimen thickness increased.

PMID- 11203992
TI  - Use of a compomer in Class V restoration: a microleakage study.
AB  - OBJECTIVE: The purpose of this investigation was to evaluate the microleakage of
      Class V lesions restored with a compomer material (Dyractflow) using 2 single
      bottle bonding systems. METHOD AND MATERIALS: Sixty-four Class V cavity
      preparations were made on 32 sound, extracted human premolars, 1 preparation on
      the facial surface and 1 on the lingual surface. Teeth were then randomly divided
      into 2 groups. Group 1, which served as the control group, was restored as
      follows: group 1a, facial surface with PQ1 single-bottle bonding system plus TPH
      resin composite; group 1b, lingual surface with Prime & Bond NT single-bottle
      bonding system plus TPH. Group 2 was restored as follows: group 2a, facial
      surface with PQ1 plus Dyractflow compomer material; group 2b, lingual surface
      with Prime & Bond NT plus Dyractflow. After 24 hours of storage in water and
      subsequent thermocycling, each specimen was immersed in 0.2% basic fuchsin dye
      for 24 hours. The teeth were sectioned longitudinally and horizontally, and dye
      penetration at enamel and cementum margins was viewed at x30 magnification by 2
      independently calibrated evaluators. Specimens were evaluated as either having
      leaked or not having leaked. RESULTS: No statistically significant differences in
      microleakage were noted between group 1 and group 2 specimens. CONCLUSION: Both
      single-bottle bonding systems, PQ1 and Prime & Bond NT, demonstrated equal
      effectiveness in reducing microleakage beneath compomer and composite
      restorations.

PMID- 11203993
TI  - John E. Echternacht: practitioner and community leader.
AB  - For Minnesota dentists with long memories, Dr Jack Echternacht is a legendary
      figure. He graduated from the University of Minnesota School of Dentistry in
      1943. Except for a 3-year enlistment in the Navy during World War II, he has made
      his home and his professional life in Brainerd, on the edge of Minnesota's lake
      country. A few years after he started his general practice, reports began to
      appear about the striking reduction of dental caries in children's teeth when
      fluoride was placed in the drinking water. Excited by these prospects for better
      oral health, Dr Echternacht led a Chamber of Commerce initiative in 1954 to
      introduce fluoride into Brainerd's water supply. What seemed at first an easy
      victory turned into a 30-year struggle. Dr Echternacht's determination,
      persistence, and leadership during this fight for fluoridation led to his
      selection as a moral model in dentistry.

PMID- 11203994
TI  - Polymerization lights--light energy and wavelength.

PMID- 11203995
TI  - Rosacea.

PMID- 11203996
TI  - International implications of "oral health in America: a report of the Surgeon
      General".

PMID- 11203998
TI  - Restoring teeth that are endodontically treated through existing crowns. Part I:
      Survey of pulpal status on access.
AB  - OBJECTIVE: The purpose of this study was to identify the pulpal findings
      encountered by practitioners when accessing complete-coverage crowns that require
      nonsurgical root canal treatment and the relevance of coronal leakage to the
      success of the RTC. METHOD AND MATERIALS: The survey package consisted of a cover
      letter stating the instructions, rationale, and purpose for the questionnaire, a
      questionnaire with 8 short-answer questions, and a stamped, self-addressed
      envelope. A randomized sample of active dentists (300 general practitioners, 300
      prosthodontists, and 300 endodontists) was selected. Collected data were analyzed
      with the chi-square test. RESULTS: A 60% response rate was obtained.
      Statistically significant differences were found among the practitioner groups,
      depending on the question. General practitioners and endodontists obtain access
      through crowns and maintain these crowns as final restoration significantly more
      often than do prosthodontists. Practitioners responded that teeth with complete
      crowns require nonsurgical root canal treatment after 5 to 10 years. CONCLUSION:
      Respondents believe that leakage must be addressed when endodontic access
      cavities in artificial crowns are restored after nonsurgical root canal
      treatment. General practitioners perform nonsurgical root canal treatment more
      frequently than do prosthodontists. Practitioners indicated that when teeth with
      complete crowns require nonsurgical root canal treatment, treatment is most often
      performed 5 to 10 years after placement of the crown.

PMID- 11203997
TI  - The Cerec 3--a quantum leap for computer-aided restorations: initial clinical
      results.
AB  - The Cerec 3 system simplifies and accelerates the fabrication of ceramic inlays,
      onlays, veneers, and quarter, half, and complete crowns for anterior and
      posterior teeth. Cerec 3 software simplifies occlusal and functional
      registration. Proper occlusion is established accurately and quickly; manual
      adjustment is reduced to a minimum. The separate grinding device, working true to
      morphologic detail and with fine surface quality, is connected to the optical
      unit by radio control. Equipped with a laser scanner, it can also be used for
      indirect application through a standard personal computer. The Cerec 3 system is
      network and multimedia ready and, in combination with an intraoral color
      videocamera or a digital radiography unit, can be used for patient education and
      for user training. The Cerec 3 system thus is a diagnostic, restorative,
      training, and documentation center for the dental practice.

PMID- 11203999
TI  - Restoring teeth that are endodontically treated through existing crowns. Part II:
      Survey of restorative materials commonly used.
AB  - OBJECTIVE: A survey was undertaken to categorize the materials used for the
      restoration of endodontic access openings through complete-coverage crowns after
      completion of nonsurgical root canal treatment. METHOD AND MATERIALS: The survey
      package consisted of a cover letter stating instructions, rationale, and purpose
      for the questionnaire, a questionnaire of 8 short-answer questions, and a
      stamped, self-addressed envelope. A randomized sample of active dentists (300
      general practitioners, 300 prosthodontists, and 300 endodontists), was selected.
      Collected data were analyzed with the chi-square analysis. RESULTS: Most general
      practitioners (93%), endodontists (61%), and prosthodontists (75%) reported that
      they frequently or always permanently restore teeth after nonsurgical root canal
      treatment. Empress was the all-ceramic system used most commonly by
      prosthodontists (42%) and general practitioners (38%). A statistically
      significant difference in restorative material preference was found (P < 0.0001),
      depending on the type of crown used. CONCLUSION: Amalgam alone and in combination
      with bonding agents are materials of choice for restoration of access openings
      through all-metal complete crowns, while resin composite is the choice for all
      types of complete crowns involving porcelain. Endodontists preferred "other"
      materials.

PMID- 11204000
TI  - Wine, alcohol, and oral health, with special emphasis on dental erosion.
AB  - Wine is an essential component of the Mediterranean diet. Its consumption is
      increasing in many industrialized countries due to effective marketing. Wine may
      also have effects in the oral cavity mainly due to its acidity and alcohol
      content. This article briefly describes some effects of wine, both beneficial and
      detrimental, on oral and general health. In particular, the effect of wine on
      tooth enamel is demonstrated.

PMID- 11204001
TI  - Teaching of posterior resin-based composite restorations in Brazilian dental
      schools.
AB  - OBJECTIVE: The purpose of this study was to evaluate the teaching program of
      Class I and Class II resin-based composite (RBC) restorations in Brazilian dental
      schools and to observe if any differences were found from similar surveys
      conducted in North American, European, and Japanese dental schools. METHOD AND
      MATERIALS: A questionnaire containing 15 questions was distributed to 92
      Brazilian dental schools, and 64 (70%) schools returned the questionnaire. The
      questions inquired the amount of time the curriculum dedicated to teaching of
      posterior RBC restorations, future expectation regarding the teaching time,
      limitation in extension of the occlusal width and the proximal box in Class II,
      contraindications for placing posterior RBC restorations, protocol for using
      bases and liners, brand of bonding agents and RBC used, instruments and
      techniques employed for finishing, cost relative to amalgam restorations, and
      biologic reactions related to the use of posterior RBC. The responses were
      calculated as percentages based on the number of schools that responded to the
      questionnaire. Where appropriate, the Chi-squared test and the Fisher exact test
      were used for statistical analysis. RESULTS: Of the dental schools that
      responded, 88% dedicated 10% to 50% of the teaching time in operative dentistry
      to posterior RBC restorations. A significant correlation (P = 0.041) was found
      between the percentage of time dedicated to the teaching of posterior RBC
      restorations and the higher cost of posterior RBC compared to amalgam
      restorations. Resin-based composite restorations cost 30% to 70% more than
      amalgam restorations in the 40% of dental schools that charged a fee. Posterior
      composites for large restorations in molars were used by 14% of the dental
      schools. Base and liner were not placed by 10% of dental schools in deep Class I
      or Class II RBC restorations. One school did not recommend acid etching of the
      dentin. CONCLUSION: No major differences were found in the teaching philosophy of
      posterior RBC restorations by comparing the Brazilian data to the data from
      similar surveys done in North America, Japan, and Europe.

PMID- 11204002
TI  - In vitro evaluation of the biocompatibility of dental alloys: fibronectin
      expression patterns and relationships to cellular proliferation rates.
AB  - OBJECTIVE: This short-term (72- to 96-hour) in vitro study on fibroblasts
      evaluated the biocompatibility of 3 single-phase dental alloys by determining
      cellular proliferation rates and the expression of a glycoprotein, fibronectin,
      which is involved in cellular adhesion processes. METHOD AND MATERIALS: Flow 2002
      fibroblasts were cultured together with 3 single-phase dental alloys of different
      composition. Proliferation rates were determined by 5-bromodeoxyuridine
      incorporation. Fibronectin expression was determined by indirect
      immunofluorescence. RESULTS: At 72 hours, cells cultured with the alloy
      containing the lowest amount of noble elements (gold, platinum, and palladium)
      and the highest amount of silver exhibited significantly less proliferation than
      did controls. At 96 hours, only cultures with the alloy containing the greatest
      amount of noble elements behaved in a way similar to controls. Fibronectin
      organization in fibrils and in focal adhesions was correlated to higher cellular
      proliferation rates. CONCLUSION: Fibronectin organization could be a useful tool
      to determine the biocompatibility of dental alloys. Among the noble elements,
      palladium by itself exhibits very good biocompatibility. These indications could
      be useful for practitioners in the choice of the best alloy for specific clinical
      applications.

PMID- 11204003
TI  - Laboratory evaluation of a metal-priming agent for adhesive bonding.
AB  - OBJECTIVE: The purpose of this laboratory study was to determine the bond
      strength of a base metal alloy to a high-noble alloy and amalgam when a new
      chemical adhesion promoter was used in conjunction with a resin cement. METHOD
      AND MATERIALS: Specimens of high-noble alloy and amalgam were prepared in epoxy
      filled rings. Base metal cylinders were cast. The ends of the cylinders and the
      metal bonding substrates were wet ground and air abraded with aluminum oxide. The
      base metal cylinders were cemented with Panavia 21 resin cement after application
      of 1 of the following to the high-noble and amalgam metal surfaces: (1) Alloy
      Primer, (2) ED Primer, (3) Alloy Primer and ED Primer, or (4) tin plating. Bond
      values were determined after 24 hours' storage and after 3 months' storage and
      thermocycling. RESULTS: At both 24 hours and 3 months, tin plating yielded the
      highest bond strengths to a high-noble alloy, but the value for the Alloy Primer
      groups was not significantly lower. There was no statistically significant
      difference between the 24-hour and 3-month values within the 4 treatment
      regimens. CONCLUSION: Treatment of amalgam or high-noble alloy with either tin
      plating or Alloy Primer before bonding with Panavia 21 resin cement yielded
      equivalent bond strengths to a base metal alloy. ED Primer was not an effective
      metal primer. There was no advantage to combining Alloy Primer and ED Primer.

PMID- 11204004
TI  - Hugo A. Owens: dentist, civil rights leader, politician.
AB  - For 44 years Dr Hugo A. Owens was a distinguished practitioner and community
      leader in Portsmouth and Chesapeake, Virginia, and also served for a time as
      president of the National Dental Association. Besides his proclivity for
      dentistry, he was driven by two other passions: politics and civil rights. In
      1970 he was one of the first African Americans ever elected to the Chesapeake
      City Council. He was reelected for the next term and appointed vice mayor, a
      position he held for 8 years. His political successes were preceded by his
      activities as a civil rights leader, which began in 1950 and lasted through the
      1960s. In a remarkable series of negotiations and litigations, Dr Owens was the
      prime mover in the desegregation of the city of Portsmouth. In all three
      "careers," Dr Owens used dentistry as a home base for the expression of his
      activist philosophy of providing help for others when they were unable to help
      themselves.

PMID- 11204005
TI  - Improving dentist-patient relations.

PMID- 11204006
TI  - Fibrous dysplasia.

PMID- 11204007
TI  - [Coronary angioplasty compared with aortocoronary bypass in patients with
      multivascular coronary disease].
AB  - Over the past two decades the use of angioplasty has rapidly expanded. As
      technology and experience have advanced, operators are increasingly faced with
      two-vessel and three-vessel disease. Coronary artery bypass graft surgery and
      coronary balloon angioplasty are two possible approaches for patients with
      multivessel coronary disease. Randomized trials comparing these two different
      procedures have found no difference in early as well as late mortality between
      assigned treatment groups. The Bypass Angioplasty Revascularization Investigation
      (BARI) showed a better long-term outcome with coronary artery bypass in the
      subgroup of patients with treated diabetes (35% died within 5 years after
      angioplasty compared with 19% who underwent surgery). Repeat revascularization
      was more common after angioplasty. Surgery offers more complete
      revascularization, but morbidity is higher; angioplasty is less invasive but
      patients are more likely to need another revascularization procedure mainly
      related to the occurrence of restenosis. Restenosis is often associated with the
      recurrence of symptoms requiring further revascularization. The use of stents and
      inhibitors of glycoprotein IIb/IIIa, minimally invasive surgical techniques and
      all-arterial grafting have the potential to change the scenery of coronary artery
      revascularization in the next few years.

PMID- 11204008
TI  - [Myocardial metabolism of calcium in heart failure: from physiology to new
      therapeutic perspectives].
AB  - Development of heart failure is associated with an impairment of intracellular
      calcium handling. The precise mechanisms involved are still obscure. When
      membrane depolarization occurs, a small amount of extracellular calcium enters
      the intracellular milieu through the L-type channels. Such "trigger" calcium acts
      on specific receptors of the sarcoplasmic reticulum, that, in turn, according to
      the so-called calcium entry-calcium release mechanism, allows the release of a
      larger amount of calcium from the sarcoplasmic reticulum. Removal of calcium from
      the cytosol is the key event of the diastolic phase. Calcium removal from cytosol
      occurs through specific membrane pumps. Recent therapeutic approaches involving
      gene targeting of calcium pumps have yielded promising results. Specifically,
      increased levels of SERCA 2 in the myocardium have shown to enhance cardiac
      contractility under normal circumstances and in experimental heart failure.
      Future research is needed to confirm these findings in human heart failure.

PMID- 11204009
TI  - [Social costs of syncope].
AB  - Syncope is a common syndrome that increases in prevalence with the aging of the
      population. The causes of this common symptom are multiple and the costs for the
      evaluation and treatment of syncope are enormous, especially with the use of
      highly technological approaches. Even when syncope is the expression of benign
      diseases, it may be the cause of significant morbidity for injuries, fractures
      and subsequent functional impairment, which particularly for elderly patients,
      matches that of other common chronic diseases. Finally, we cannot ignore the
      social costs caused by the reduction of working hours for diagnostic and
      therapeutic procedures and the subsequent loss of productivity.

PMID- 11204010
TI  - [Long-term clinical assessment of single-lead VDD electric stimulation].
AB  - BACKGROUND: During the last decade single lead VDD pacing has been progressively
      affirmed as an electrotherapy of choice in patients with advanced
      atrioventricular block without alterations of the sinus function. It combines the
      benefits of P-synchronous ventricular pacing with an easy implant procedure when
      compared to the conventional DDD approach. The aim of this study was to evaluate
      the validity of such an approach in a large population of patients, all implanted
      in a single center. METHODS: From 1987 up to now, 317 patients, all affected by
      advanced atrioventricular block and without sinus node dysfunction, were
      implanted in our center with a single lead VDD pacemaker. During follow-up the
      persistence of a proper atrioventricular synchronization was assessed and
      evaluated. RESULTS: The mean follow-up was 3.9 +/- 2.7 years/patient (range 6-138
      months). The 94.6% of implanted systems maintained the normal VDD pacing
      function. Permanent reprogramming in VVI mode was necessary in 17 patients
      (5.36%); in 12 (3.78%) because of chronic atrial fibrillation and in 5 (1.63%)
      for loss of atrial sensing. The percentage of atrial synchronization was optimal
      (> 98%) and acceptable (> 95%) in 81% and 19% of patients, respectively. Episodes
      of paroxysmal atrial fibrillation occurred in 3 patients. Neither inhibition by
      myopotentials nor occurrence of sinus node disease was observed during follow-up.
      These results are in accordance with those reported by previous studies,
      performed on a smaller population or on a multicenter basis, and are comparable
      with the results reported for conventional DDD pacemaker. CONCLUSIONS: Our
      results confirm the high reliability of the single lead VDD pacing system
      concerning the long-term persistence of a proper atrioventricular
      synchronization. Data showed above enforce our opinion that this pacing approach
      should be considered the treatment of choice in patients with advanced
      atrioventricular block and preserved sinus node function.

PMID- 11204011
TI  - [Bentall-DeBono intervention: 8 years of clinical experience].
AB  - BACKGROUND: Annulo-aortic ectasia is a dilation of the aortic root with the
      involvement of the Valsalva sinuses. In 1968 Bentall and DeBono proposed to
      replace the aortic valve, the Valsalva sinuses and the ascending aorta with a
      composite tube graft containing aortic valve prosthesis. Consequently coronary
      ostia had to be reimplanted on the prosthetic tube. Recently the use of new
      materials has resulted in a more acceptable operative risk, and postoperative
      bleeding and late mortality have been reduced. METHODS: From January 1991 to
      December 1998, 44 out of 241 patients were operated on with the Bentall-DeBono
      procedure, affected by dissecting or expansive aneurysm of the ascending aorta.
      Of the 44 patients (35 males, 9 females, mean age 53.7 years), 3 presented with
      acute aortic dissection, 5 were asymptomatic, 10 were in NYHA functional class
      II, 14 in class III, 9 in class IV, and 2 in CCS class 4; 1 patient had
      dysphonia; 37 patients presented with isolated aortic regurgitation, and 7
      associated aortic valvular stenosis. The diagnosis of acute dissection was made
      by transesophageal echocardiography and that of expansive aneurysm by thorax
      helical computed tomographic scanning and/or magnetic resonance imaging and
      cardiac catheterization. Follow-up was obtained in 100% of the patients for an
      average of 23 +/- 20.9 months (range 4-79 months). RESULTS: Four patients (9%)
      died; in 4 patients (9%) postoperative bleeding needed reoperation, in 5 (11.4%)
      a permanent pacemaker for atrioventricular block was implanted, and 1 patient
      (2.3%) had transient hemiparesis. At univariate analysis predictive factors for
      operative risk were NYHA functional class IV (p < 0.005) and atherosclerotic
      etiology (p < 0.05). At follow-up 7 late deaths occurred for an actuarial
      survival at 24 months of 75 +/- 9%. Causes were sudden death in 3 patients,
      cardiac failure in 3 and stroke in 1 patient; 31 surviving patients (94%) were in
      NYHA functional class I and 2 patients in class II (6%). CONCLUSIONS: The Bentall
      DeBono procedure involves moderate risk with good results; clinical presentation
      and associated valvular pathology influence early and mid-term results.

PMID- 11204012
TI  - [Detection and assessment of myocardial stunning with perfusion tomographic
      scintigraphy using gated SPECT].
AB  - BACKGROUND: Gated-SPECT using 99mTc-labeled flow tracers provides the
      simultaneous assessment of global and regional myocardial perfusion and function.
      The aim of this study was to identify patients with stress-induced postischemic
      stunning, among those with reversible stress perfusion defects, and patients with
      artifactual defects among those with fixed defects, in order to assess the value
      of the functional data provided by gated acquisition of perfusion imaging in the
      characterization of ischemia. METHODS: We studied 221 consecutive patients who
      underwent conventional diagnostic dual day stress/rest gated-SPECT following
      injection of 925 MBq of 99mTc-tetrofosmin using a dual head SPECT camera, 115 of
      whom (52%) showed reversible perfusion defects, and 66 (30%) fixed defects.
      Perfusion was analyzed on ungated images using 20 segments scored on a 5-point
      scale (0 = normal, 4 = no uptake), while wall thickening was assessed visually on
      stress/rest end-systolic images using a 4-point score (0 = normal, 3 = absence of
      wall thickening). Left ventricular ejection fraction and volumes were calculated
      using an automatic algorithm (quantitative gated-SPECT). Fifty-two out of 221
      (23.5%) patients underwent coronary angiography. RESULTS: In 40/115 (35%)
      patients with reversible perfusion defects, post-stress left ventricular ejection
      fraction was > 5% lower than that at rest (Group A: stunned), whereas in the
      remaining 75 patients, post-stress left ventricular ejection fraction was either
      +/- 5% or greater than that at rest (Group B: non-stunned). Peak exercise angina
      and ischemic electrocardiographic response to exercise were present in 79 and 58%
      respectively of Group A patients and in 33 and 39% of Group B patients. The
      number of patients with multivessel disease was significantly higher in Group A
      compared to Group B (58 vs 41%, p < 0.05). The total stress and rest perfusion
      scores were significantly higher in Group A than in Group B (p < 0.01); even the
      total stress wall thickening score was significantly higher in Group A (p <
      0.001). As for global parameters, post-stress end-systolic volume was
      significantly higher in the stunned group (p < 0.05). In 40 out of 66 (60.5%)
      patients without reversible ischemia fixed defects were judged to be ischemic
      (Group C), while in 26/66 (39.5%) they were attributed to attenuation artifacts
      (Group D). Eighty percent of Group C patients had a previous myocardial
      infarction against none of Group D. Stress/rest perfusion and wall thickening
      scores were significantly higher in Group C than in Group D. CONCLUSIONS: Gated
      SPECT myocardial perfusion evaluation allowed us to identify a subgroup of post
      stress stunned coronary artery diseased patients. The post-stress left
      ventricular ejection fraction reduction in this population seems to be due to the
      increase in end-systolic volume. The stunned patients showed more severe
      perfusion defects and wall thickening abnormalities.

PMID- 11204013
TI  - [Left atrial myxoma. Clinical and surgical features in 26 surgically treated
      cases].
AB  - BACKGROUND: Left atrial myxomas are the most common benign intracardiac tumors.
      The aim of this study was to compare our experience with the data reported in the
      literature. METHODS: Between May 1985 and August 1999, 26 patients (8 males, 18
      females) with left atrial myxomas underwent surgical resection of these tumors at
      the Department of Cardiac Surgery, Ospedali Riuniti of Bergamo (Italy). Symptoms
      included congestive heart failure, dyspnea, arrhythmias, chest pain and syncope.
      Diagnosis was established preoperatively in all patients by echocardiography and
      angiocardiography was performed in 8 cases. All tumors were excised with a wide
      margin of uninvolved atrial septum. Two patients underwent concomitant coronary
      artery bypass. RESULTS: There was 1 early death due to irreversible ventricular
      fibrillation. Follow-up was completed for the 25 late survivals. Three patients
      died, years after operation, due to extracardiac causes. One patients had
      recurrence of the tumor, which was successfully removed 4 years after initial
      operation. All other patients are asymptomatic and free from disease.
      CONCLUSIONS: Operation for left atrial myxoma can be undertaken solely on the
      basis of echocardiographic findings, but coronary angiography should be performed
      in older patients who are at risk for coronary artery disease. Surgical excision
      of left atrial myxomas must be performed as soon as possible after diagnosis is
      established because of the high risk of valvular obstruction or systemic
      embolization. Biatrial approach allows for the inspection of the four cardiac
      chambers, limits manipulation of the mass, and facilitates the complete excision
      of the tumor. Thus, surgical intervention can be curative for patients with left
      atrial myxomas and most of these can expect an excellent outcome. Since late
      recurrence, although rare, has been reported, especially in familial myxomas,
      long-term clinical and echocardiographic follow-up is recommended.

PMID- 11204014
TI  - [Efficacy of treatment with rt-PA of massive pulmonary embolism in patients with
      contraindications for thrombolytic therapy].
AB  - Pulmonary embolism is a life-threatening condition that is accompanied by
      significant morbidity and mortality. In massive pulmonary embolism, where
      restoration of pulmonary arterial flow is urgently required, the only options
      available are surgical thromboembolectomy and/or thrombolytic therapy.
      Unfortunately, a large part of thromboembolic diseases is also considered as an
      absolute or relative contraindication to thrombolysis. The purpose of this paper
      was to emphasize the possibility of new thrombolytic agents of disregarding,
      according to circumstances, the contraindications to thrombolytic treatment.

PMID- 11204015
TI  - [Right pleural effusion in aortic dissecting aneurysm].
AB  - Right hemorrhagic pleural effusion may be a presenting sign of thoracic aortic
      dissecting aneurysm. We describe 2 cases of massive right hemorrhagic pleural
      effusion and dissection of the descending aorta (type B) detected at tomographic
      scan. Transesophageal echocardiography ruled out a retrograde dissection of the
      ascending aorta. Right hemorrhagic pleural effusion is an unusual clinical
      presentation in thoracic aorta dissection and, up to now, the underling
      pathophysiology of this sign has not been defined yet.

PMID- 11204016
TI  - [Guidelines on the appropriate use of non-invasive diagnostic techniques].

PMID- 11204017
TI  - [Comparative study of the effect of ACE-inhibition, angiotensin II antagonism,
      and calcium channel blockade on flow-mediated vasodilation in patients with
      coronary disease (BANFF study].

PMID- 11204018
TI  - [Association of serology with the endovascular presence of Chlamydia pneumoniae
      and cytomegalovirus in coronary artery and vein graft disease].

PMID- 11204019
TI  - [Infections, inflammation, and the risk of coronary heart disease].

PMID- 11204020
TI  - [Estimation of contribution of changes in coronary care to improving survival,
      event rates, and coronary heart disease mortality across the WHO MONICA Project
      populations].

PMID- 11204021
TI  - [Prevention of rejection in cardiac transplantation by blockade of the
      interleukin-2 receptor with a monoclonal antibody].

PMID- 11204022
TI  - [Efficacy of implantable cardioverter-defibrillators for the prevention of sudden
      death in patients with hypertrophic cardiomyopathy].

PMID- 11204023
TI  - [Guidelines: diverse value of Manzoni's "proclamations"?].

PMID- 11204024
TI  - Molecular structure and function of erythrocyte blood group antigens.

PMID- 11204025
TI  - Complications of autologous hematopoietic stem cell transplantation.
AB  - Myeloablative therapy followed by autologous hematopoietic stem cell (HSC)
      transplantation is a therapeutic option proposed for a variety of hematological
      and non-hematological diseases. However, although mortality due to this procedure
      is steadily decreasing, patients are still exposed to the risk of a number of
      complications negatively affecting their expectancy or quality of life. Adverse
      events due to HSC harvesting are rare and generally reversible. The early post
      transplant complications include infections, mucositis, hepatic veno-occlusive
      disease and various acute organ toxicities. Immune derangement is a leading cause
      of most late events, such as viral or fungal infections, auto-immune
      manifestations and secondary neoplasms, of which secondary AML/MDS are the most
      commonly reported. In line with the favoured pathogenetic explanation, neoplastic
      clones previously established during conventional treatment are harvested and
      reinfused at the time of autografting. Other late effects are single organ
      dysfunction due to the underlying disease and treatment toxicities combined with
      infectious and post-infectious phenomena. The lungs, heart, CNS and reproductive
      system are the most investigated targets, but no clinical patterns have been
      identified as specific for autografting.

PMID- 11204026
TI  - Hodgkin's disease in the elderly: a single institution retrospective study of 40
      patients aged 65 or over.
AB  - Out of 485 patients with Hodgkin's disease (HD) treated in our institution
      between 1970-1998, 40 (8.2%) patients aged 65 or over at the date of the first
      presentation were examined retrospectively. The localization of the disease was
      more frequently infradiaphragmatic and rarely mediastinal in the elderly. The
      time that elapsed from the first clinical sign to the diagnosis of HD was twice
      as long as that in the young patient population. Since the first treatment was
      often inadequate and due to severe associated diseases, therapeutic and overall
      survival results in this patient population were less favourable than in the case
      of young patients. However, the relapse-free survival rate of the elderly
      patients treated successfully did not differ from that of the young patient
      population. Complete healing should be the final aim of treatment in the aged
      population, while the status of the patient, associated diseases and life
      expectancy not related with HD should also be taken into consideration. Besides
      the search for effective and less toxic treatment strategies and supportive
      therapy, more frequent and overall patient follow-up and care is of great
      importance.

PMID- 11204027
TI  - Lymphokine-activated killer (LAK) cells and cytokines synergize to kill clonal
      cells in acute myeloid leukemia (AML) in vitro.
AB  - We studied the influence of autologous lymphokine-activated-killer (LAK) cells on
      the survival of clonal and CD34-positive bone marrow (BM) cells from patients
      with acute myeloid leukemia (AML) in a coculture assay in vitro. (1) LAK cells
      were grown in the presence of IL-2, in some cases additionally with IL-6. (2)
      These cytotoxic cells were cocultured with (untreated or cytokine pretreated) AML
      BM cells obtained at different stages of the disease. Therefore BM cells were (a)
      either frozen in liquid nitrogen or (b) precultured for 14 days with cytokines:
      IL-1beta, IL-3, IL-6, erythropoietin (EPO), stem cell factor (SCF) with
      ('Cytok1') or without granulocyte macrophage colony stimulating factor (GM-CSF)
      ('Cytok2') or with no added cytokines ('ISC/FCS') as a control. (3) Southern blot
      analysis was used to detect clonal BM cells. At diagnosis, 76 of 151 cases (50%)
      studied showed clonal gene rearrangements in marker genes. (4) Southern blot
      analysis and flow cytometry were used to compare the amount of clonal and CD34
      positive BM cells before and after coculture procedures. Coculture experiments
      with untreated BM and autologous LAK cells led to a reduction of clonal cells in
      2 of 5 cases at diagnosis, in 11 of 17 BM samples in complete remission but not
      in the one case studied at relapse. Similar results were found if precultured AML
      cells (with or without cytokines) were cocultivated with LAK cells. However the
      cytotoxic effect of LAK cells was more pronounced if cytokines (especially GM-CSF
      and SCF) were comprised. Our data indicate, that (1) clonality in AML can be
      demonstrated by Southern blot analysis; (2) CD34 positive cells in AML are
      clonal, gene rearranged cells; (3) clonal cell populations persist in BM during
      complete remission and relapse in most of the patients; (4) incubation of AML-BM
      cells with LAK cells lead to a reduction of clonal, rearranged cells in 11 of 17
      AML cases in complete remission, but only in 2 of 6 cases at diagnosis or
      relapse; (5) AML cells can be sensitized to theLAK cell treatment by
      preincubation of AML-BM cells with cytokines (IL-1beta, IL-3, IL-6, SCF, EPO and
      GM-CSF) or by adding SCF to the coculture conditions. Southern blot analysis and
      flow cytometry are appropriate methods to detect and quantify leukemic disease.
      Cytokines and LAK cells synergize to kill AML blasts in vitro. This is a feasible
      approach to immunotherapy of AML and merits further investigations.

PMID- 11204028
TI  - Effects of a membrane-metallopeptidase blocking agent thiorphan in long-term
      cultures of human bone marrow.
AB  - Thiorphan [(DL-3-mercapto-2-benzylpropanoyl)-glycine], a drug blocking the
      activity of membrane metalloendopeptidase EC 3.4.24.11 (CD10, CALLA), was added
      to long-term cultures of human bone marrow. Progression of the cultures was
      assessed by cell counts, cytology and clonogenic (GM-CFU) ability of the non
      adherent cells in the supernatant and by morphology of the adherent stromal
      layer. A stimulatory effect on hematopoiesis was noted.

PMID- 11204029
TI  - Catastrophic antiphospholipid syndrome in cancer.
AB  - Antiphospholipid syndrome is characterized by the presence of antiphospholipid
      antibodies resulting in arterial and venous thromboembolism. Apart from primary
      cases, this syndrome is often associated with autoimmune diseases. Around 50
      cases of catastrophic antiphospholipid antibody syndrome have been reported as
      yet. Authors describe the first case of catastrophic antiphospholipid syndrome
      associated with gastric cancer. Apart from presenting the clinical case, authors
      also discuss the possible pathomechanism of this associated disorder including
      the role of immunological factors, as well as antiphospholipid antibodies.

PMID- 11204030
TI  - Leg ulcer in hydroxyurea-treated patients.
AB  - A cutaneous ulcer is a lesser known complication of hydroxyurea treatment. Out of
      39 patients [18 polycythaemia vera (PV), 13 essential thrombocythaemia (ET), 4
      chronic myeloid leukemia (CML), 4 undefined myeloproliferative diseases (MPD)]
      treated with hydroxyurea, 6 (4ET, 1PV, 1CML) developed a cutaneous ulcer during a
      period of less that 2 years' treatment. In all but one of the patients the ulcers
      were situated in the ankle region. At the time of onset of ulceration, none of
      them had extreme values in their peripheral blood counts. All had one or more of
      the predisposing factors such as minor trauma or mild varicosity. None of the
      patients had any alteration in arterial or venous circulation when examined by
      non-invasive means. No hyperviscosity was found as measured by capillary
      viscosimeter. The ulcers were cured in three patients without discontinuation of
      the drug. One patient later developed an ulcer on the other leg. The ulcers
      healed in two patients only after having stopped the hydroxyurea medication. One
      patient still had the ulcer when she succumbed to the underlying CML in
      transformation. In conclusion, cutaneous, ulceration of the leg is relatively
      common during hydroxyurea therapy. Predisposing factors are also involved in its
      development. Its healing does not necessarily require the discontinuation of the
      drug.

PMID- 11204031
TI  - Iron stores in multi-transfused thalassaemic patients seem not to be influenced
      by the HLA system.
AB  - The HLA-A and -B antigens of 99 Greek patients with transfusion dependent
      homozygous beta thalassaemia were determined. The HLA antigen distribution in
      thalassaemic patients with a severe transfusion siderosis and in patients without
      signs of siderosis were compared to that of 400 healthy unrelated controls from
      the same population. There is an increase of HLA-B 14 antigen in both groups of
      thalassaemics as compared with the controls. No significant difference exists in
      the distribution of all the other HLA antigens between the two sub-groups of
      thalassaemics or with the controls.

PMID- 11204032
TI  - Osteolytic lesions as a presenting sign of acute myeloid leukemia.
AB  - Osteolytic lesions rarely occur in acute myeloid leukemia (AML). We reported an
      atypical form of the disease, with marrow fibrosis and osteolytic lesions, in a
      17-year-old patient, whose main symptom was lumbar pain. Diagnosis of AML was
      established by bone marrow and lymph node histological analysis. Computed
      tomography (CT) scan and 99mTc-MDP bone scintyscan revealed osteolytic lesions.
      After remission-induction, bone marrow aspirate and biopsy showed no evidence of
      leukemic infiltration, nevertheless bone abnormalities persisted on 99mTc-MDP
      bone scintyscan, suggesting residual disease. Suspect bone areas were irradiated
      with symptomatic improvement and 99mTc-MDP bone scintyscan showed the appearance
      of more condensed bone compared with the pre-radiotherapy pattern. Twelve months
      later he was readmitted to the hospital due to relapse of AML and died of sepsis
      within a few weeks. This report illustrates the usefulness of histological
      studies to establish diagnosis of AML in atypical cases, as well as the
      importance of CT scan and bone scintigraphy scan for the identification of
      osteolytic lesions. It also provides additional data as evidence that although
      osteolytic lesions indicate an adverse prognosis in AML, local irradiation
      results symptomatic relief.

PMID- 11204033
TI  - A commentary: the impact of the IEEE TRANSACTIONS ON REHABILITATION ENGINEERING
      on the field of rehabilitation engineering and science.
AB  - The IEEE TRANSACTIONS ON REHABILITATION ENGINEERING, founded 8.5 years ago, has
      survived, thrived, been of high quality, attracted the best authors in its field
      and related fields, been the publication of choice for manuscript submission in
      the rehabilitation engineering and related science area, possessed a wide and
      international distribution and loyal readership, been oft-cited, been financially
      sound, and made a marked impact on the field of Rehabilitation Engineering.

PMID- 11204034
TI  - Optimal spatial filtering of single trial EEG during imagined hand movement.
AB  - The development of an electroencephalograph (EEG)-based brain-computer interface
      (BCI) requires rapid and reliable discrimination of EEG patterns, e.g.,
      associated with imaginary movement. One-sided hand movement imagination results
      in EEG changes located at contra- and ipsilateral central areas. We demonstrate
      that spatial filters for multichannel EEG effectively extract discriminatory
      information from two populations of single-trial EEG, recorded during left- and
      right-hand movement imagery. The best classification results for three subjects
      are 90.8%, 92.7%, and 99.7%. The spatial filters are estimated from a set of data
      by the method of common spatial patterns and reflect the specific activation of
      cortical areas. The method performs a weighting of the electrodes according to
      their importance for the classification task. The high recognition rates and
      computational simplicity make it a promising method for an EEG-based brain
      computer interface.

PMID- 11204035
TI  - Real-time EEG analysis with subject-specific spatial patterns for a brain
      computer interface (BCI).
AB  - Electroencephalogram (EEG) recordings during right and left motor imagery allow
      one to establish a new communication channel for, e.g., patients with amyotrophic
      lateral sclerosis. Such an EEG-based brain-computer interface (BCI) can be used
      to develop a simple binary response for the control of a device. Three subjects
      participated in a series of on-line sessions to test if it is possible to use
      common spatial patterns to analyze EEG in real time in order to give feedback to
      the subjects. Furthermore, the classification accuracy that can be achieved after
      only three days of training was investigated. The patterns are estimated from a
      set of multichannel EEG data by the method of common spatial patterns and reflect
      the specific activation of cortical areas. By construction, common spatial
      patterns weight each electrode according to its importance to the discrimination
      task and suppress noise in individual channels by using correlations between
      neighboring electrodes. Experiments with three subjects resulted in an error rate
      of 2, 6 and 14% during on-line discrimination of left- and right-hand motor
      imagery after three days of training and make common spatial patterns a promising
      method for an EEG-based brain-computer interface.

PMID- 11204036
TI  - Using time-dependent neural networks for EEG classification.
AB  - This paper compares two different topologies of neural networks. They are used to
      classify single trial electroencephalograph (EEG) data from a brain-computer
      interface (BCI). A short introduction to time series classification is given, and
      the used classifiers are described. Standard multilayer perceptrons (MLPs) are
      used as a standard method for classification. They are compared to finite impulse
      response (FIR) MLPs, which use FIR filters instead of static weights to allow
      temporal processing inside the classifier. A theoretical comparison of the two
      architectures is presented. The results of a BCI experiment with three different
      subjects are given and discussed. These results demonstrate the higher
      performance of the FIR MLP compared with the standard MLP.

PMID- 11204037
TI  - Implantable selective stimulator to improve bladder voiding: design and chronic
      experiments in dogs.
AB  - Among the treatments to enhance the bladder voiding, the sacral roots
      neurostimulation is one of the most promising techniques. The electrostimulation
      of sacral nerves provokes a simultaneous contraction of the detrusor muscle as
      well as the external urethral sphincter (EUS). A new simplified-architecture
      implantable stimulator with its wireless controller have been designed to
      investigate high-frequency inhibition stimulation strategies. This innovative
      technique based on high-frequency inhibition reduces sphincter activity during
      stimulation. Low-frequency current pulses also applied to the sacral roots
      induces contraction of the detrusor muscle resulting in low pressure voiding.
      Chronic experiments were carried out on ten male mongrel paraplegic dogs. One
      cuff electrode was implanted along with each stimulator for eight months. The
      animals were stimulated twice a day using the prototypes of our implantable
      selective stimulator while voided and residual urine volume were measured during
      the procedure. These experiments revealed that the proposed stimulation strategy
      enhances bladder voiding by more than 50% in comparison with low-frequency only
      stimulation. The residual urine volume was reduced to an average of 9% and low
      pressure micturition was achieved as shown by weekly cystourethrogram.

PMID- 11204038
TI  - EMG-based prediction of shoulder and elbow kinematics in able-bodied and spinal
      cord injured individuals.
AB  - We have evaluated the ability of a time-delayed artificial neural network (TDANN)
      to predict shoulder and elbow motions using only electromyographic (EMG) signals
      recorded from six shoulder and elbow muscles as inputs, both in able-bodied
      subjects and in subjects with tetraplegia arising from C5 spinal cord injury. For
      able-bodied subjects, all four joint angles (elbow flexion-extension and shoulder
      horizontal flexion-extension, elevation-depression, and internal-external
      rotation) were predicted with average root-mean-square (rms) errors of less than
      20 degrees during movements of widely different complexities performed at
      different speeds and with different hand loads. The corresponding angular
      velocities and angular accelerations were predicted with even lower relative
      errors. For individuals with C5 tetraplegia, the absolute rms errors of the joint
      angles, velocities, and accelerations were actually smaller than for able-bodied
      subjects, but the relative errors were similar when the smaller movement ranges
      of the C5 subjects were taken into account. These results indicate that the EMG
      signals from shoulder and elbow muscles contain a significant amount of
      information about arm moVement kinematics that could be exploited to develop
      advanced control systems for augmenting or restoring shoulder and elbow movements
      to individuals with tetraplegia using functional neuromuscular stimulation of
      paralyzed muscles.

PMID- 11204039
TI  - Determination of generic body-seat interface shapes by cluster analysis.
AB  - The purpose of this study was to determine typical or generic shape patterns of
      the buttock-seat interface for elderly wheelchair users. The group of subjects
      was composed of 30 elderly people (aged 65 or older) and the shapes of the body
      seat interface were measured by the electronic shape sensor (ESS). By analyzing
      the dissimilarity in geometrical shape descriptors or parameters, four distinct
      generic shapes were identified by means of the cluster analysis method. The
      results suggest that the generic shapes were mainly characterized by the lateral
      symmetry of the shapes. The determination of elderly people's seat interface
      shapes into distinct clusters may lead to a more comprehensive understanding of
      the seat support interface and more effective seat cushion designs.

PMID- 11204040
TI  - A navigation system for increasing the autonomy and the security of powered
      wheelchairs.
AB  - Assistive technology is an emerging area where some robotic devices can be used
      to strengthen the residual abilities of individuals with motor disabilities or to
      substitute their missing function thus helping them to gain a level of
      independence at least in the activities of daily living. This paper presents the
      design of a navigation system and its integration with a commercial powered
      wheelchair. The navigation system provides the commercial wheelchair with a set
      of functions which increase the autonomy of elderly and people with motor
      disabilities. In general, a robot device must be adapted to assistive
      applications in such a way as to be easily managed by the user. Users, especially
      young ones, prefer to directly control the robotic device and this aspect of
      usability has to be managed without affecting the security and efficiency of the
      navigation module. These aspects have been considered as specifications for the
      navigation module of powered wheelchairs. Different autonomy levels of the
      navigation module and proper user interfaces have been developed. Two autonomy
      levels have been designed. Simple collision avoidance is also implemented in
      order to stop the mobile base when an obstacle is detected. The preliminary
      technical tests performed on the navigation system have shown satisfactory
      results in terms of security and response time. A modular solution for the
      navigation module was considered in order to simplify the adaptation of the
      module to different powered wheelchairs.

PMID- 11204041
TI  - Electrotactile adaptation on the abdomen: preliminary results.
AB  - Electrotactile (electrocutaneous) stimulation at currents greater than sensation
      threshold causes sensory adaptation, which temporarily raises the sensation
      threshold and reduces the perceived magnitude of stimulation. After 15 min of
      moderately intense exposure to a conditioning stimulus (10 s on, 10 s off), the
      sensation threshold elevation for seven observers was 60-270%, depending on the
      current, frequency, and number of pulses in the burst structure of the
      conditioning stimulus. Increases in any of these parameters increased the
      sensation threshold elevation. Adaptation and recovery were each complete in
      approximately 15 min.

PMID- 11204042
TI  - WARD: a pneumatic system for body weight relief in gait rehabilitation.
AB  - The paper presents Walking Assistance and Rehabilitation Device (WARD), a system
      for walking rehabilitation devised to relieve the patient of his/her body weight
      of a constant and prescribed amount by externally supporting the subject at the
      upper trunk and pelvis level by means of a harness. The system is based on a
      pneumatic actuator that has proved to be effective at maintaining a constant
      relief force. The constancy of this force that should be maintained even under
      high body weight support (BWS) conditions (70-80% of body weight) seems to be
      important for a correct motor pattern. A law has been identified that may be
      useful to adjust walking speed as a function of the prescribed BWS. WARD is
      simple to construct, practical to use, and has been characterized on healthy
      subjects.

PMID- 11204043
TI  - The use of selective electrical stimulation of the quadriceps to improve standing
      function in paraplegia.
AB  - Persons with spinal cord injury (SCI) can benefit significantly from functional
      neuromuscular stimulation (FNS) systems for standing if manual tasks can be
      performed while upright. Using FNS to sufficiently activate the knee extensors to
      rise from a sitting position often results in inadvertent activation of the
      rectus femoris and/or sartorius, which flex the hip. In this study, intramuscular
      electrodes implanted in the vastus lateralis and medialis of four subjects with
      SCI were used to activate these muscles individually and simultaneously to
      measure knee extension moment. Support forces applied to the arms and feet were
      measured while upright to quantify the effects of recruiting rectus femoris
      and/or sartorius. In three of the four subjects, vastus lateralis, by itself,
      generated adequate knee extension moment for rising from a chair and to maintain
      static standing. Simultaneous activation of the vastus lateralis and medialis
      using a bifurcated electrode generated adequate knee extension moment in one
      subject, and was within 10% of the required moment in another. While upright,
      activation of the rectus femoris resulted in arm support force increases of 4-11%
      body weight, while deactivation resulted in arm support force decreases of 6-9%
      body weight. The results indicate that selective activation of the vastus
      lateralis, individually or in combination with vastus medialis, can improve
      current FNS standing systems by reducing the arm support forces required to
      remain upright.

PMID- 11204044
TI  - Patient-driven control of FES-supported standing up and sitting down:
      experimental results.
AB  - A patient-driven control strategy for standing-up and sitting-down was
      experimentally tested on two paraplegic patients by applying functional
      electrical stimulation (FES) to the quadriceps muscle. The strategy--also known
      as "patient-driven motion reinforcement" (PDMR)--was developed by computer
      simulations reported in a former study. It is based on an inverse dynamic model
      (IDM) that predicts the stimulation pattern required to maintain the movement as
      it is initiated by the patient's voluntary effort. For reasons of safety and
      weight relief, the movement was supported by a seesaw construction. After some
      practice the patients were able to influence the stimulator output and to control
      the movement by their voluntary effort. Consequently, no pre-programmed reference
      trajectory was required. As a positive side effect, upper body effort could be
      minimized compared to trials without FES. To achieve a satisfactory performance
      of the PDMR controller a careful parameter identification of the inverse dynamic
      model was fundamental.

PMID- 11204045
TI  - Pain: a bridge linking anesthesiology and sleep research.

PMID- 11204046
TI  - Beta/Gamma EEG activity in patients with primary and secondary insomnia and good
      sleeper controls.
AB  - STUDY OBJECTIVE: Several studies have shown that patients with insomnia exhibit
      elevated levels of Beta EEG activity (14-35 Hz) at or around sleep onset and
      during NREM sleep. In this study, we evaluated 1) the extent to which high
      frequency EEG activity is limited to the 14-32 Hz domain, 2) whether high
      frequency EEG activity (HFA) is associated with discrepancies between subjective
      and PSG measures of sleep continuity, and 3) the extent to which high frequency
      EEG activity occurs in patients with primary, as opposed to secondary, insomnia.
      DESIGN: Three groups (n=9 per group) were compared: Primary Insomnia, Insomnia
      secondary to Major Depression, and Good Sleeper Controls. Groups were matched for
      age, sex and body mass. Average spectral profiles were created for each NREM
      cycle after removing waking and movement epochs and epochs containing micro- or
      mini-arousals. SETTING: Sleep Research Laboratory PATIENTS OR PARTICIPANTS:
      Patients with primary and secondary insomnia INTERVENTIONS: N/A. MEASUREMENTS AND
      RESULTS: Subjects with Primary Insomnia exhibited more average NREM activity for
      Beta-1 (14-20Hz), Beta-2 (20-35Hz) and Gamma activity (35-45Hz) than the other
      two groups (p.<.01). Group differences were also suggestive for Omega activity
      (45.0-125Hz) (p.<.10), with MDD subjects tending to exhibit more activity than
      the other groups. Correlational analyses revealed that average NREM Beta-1 and
      Beta-2 activity tended to be negatively correlated with subjective-objective
      discrepancy measures for total sleep time and sleep latency. CONCLUSIONS: Our
      results confirm that Beta activity is increased in Primary Insomnia. In addition,
      our data suggest that high frequency activity in patients with Primary Insomnia
      is limited to the Beta/Gamma range (14-45 Hz), and is negatively associated with
      the perception of sleep.

PMID- 11204047
TI  - Paradoxical sleep is characterized by uncoupled gamma activity between frontal
      and perceptual cortical regions.
AB  - STUDY OBJECTIVES: Coherent activity of fast activity has been postulated to be a
      common language of the brain involved in the processing of information and in
      integration of spatially separated but temporally correlated stimuli into whole
      events. Any disruption affecting temporality would result in distortion of
      cognitive activity. Dreaming during paradoxical sleep (PS) shows cognitive
      alterations that mimic frontal lobe dysfunction. Decreased temporal coupling of
      EEG between frontal and perceptual regions was hypothesized. The main objective
      was to explore temporal relationships of fast activity among these regions.
      DESIGN: N/A. SETTING: N/A. PARTICIPANTS: 8 young adults. INTERVENTIONS: N/A.
      MEASUREMENTS AND RESULTS: Interhemispheric (INTERr) and intrahemispheric (INTRAr)
      EEG correlation spectra (1-50 Hz) were obtained for wakefulness, stage 2, stage
      4, and PS during the second night spent at the laboratory. INTERr showed a
      significant overall increase during sleep in comparison to wakefulness, whereas
      INTRAr of fast activity (27-48 Hz) between frontal-perceptual regions (F-P, F-O,
      F-T, Fp-P, Fp-T) decreased exclusively during PS while INTRAr among perceptual
      regions (P-O, P-T, O-T) maintained wakefulness values. CONCLUSIONS: Present
      results demonstrate state- and frequency-dependent shifts on temporal coupling.
      The hypothesized decrease in correlation of fast activity between frontal and
      perceptual regions during PS was confirmed. This decrease of temporal coupling
      might underlie the loss of voluntary direction of thinking and congruence with
      social and temporal context and the lack of judgment and passive acceptance of
      bizarreness during PS dreaming. The wakefulness levels in correlation of fast
      activity among perceptual regions might explain perceptual acuity during PS
      dreaming.

PMID- 11204048
TI  - Effects of sleep on spinal nociceptive reflexes in humans.
AB  - Controversy continues to surround the monosynaptic and polysynaptic spinal
      reflexes during the different stages of sleep. In animal studies both of these
      reflexes were found to be depressed during desynchronized sleep. In humans, the H
      reflex was unchanged whereas the second component of the nociceptive flexion
      reflex was increased. However, abolition of the H reflex and F waves during REM
      sleep has also been reported. The aim of this investigation was to examine the
      effects of different sleep stages on the polysynaptic nociceptive flexion reflex.
      Six healthy volunteers were studied. The RIII reflex was studied according to
      Willer's method (1977) during the different stages of NREM and REM sleep. The
      RIII reflex threshold was found to increase during stage 2 of NREM sleep. It
      remained higher during stages 3 and 4. During REM sleep a further increase in the
      reflex threshold was observed. The reflex latency was prolonged during stage 4 of
      NREM sleep. There was evidence of further latency prolongation during REM sleep.
      It was also during REM sleep that the maximum increase in the amplitude and
      duration of the reflex were recorded.

PMID- 11204049
TI  - Spontaneous spike activity of spinoreticular tract neurons during sleep and
      wakefulness.
AB  - Sleep mentation studies infer that pain sensation in humans may be reduced during
      active REM sleep. However, to provide a mechanistic explanation for this
      phenomenon, few, if any neurophysiological studies have been performed at the
      lumbar level from neurons comprising classical pain pathways during sleep and
      wakefulness. The spinoreticular tract is one such classical pathway that has been
      implicated in the rostral transmission of nociceptive information. The present
      study was performed to determine if the activity of spinoreticular tract (SRT)
      neurons is dependent upon behavioral state. Accordingly, extracellular recording
      techniques were used to monitor the activity of identified SRT neurons in
      unanesthetized chronic cats during sleep and wakefulness. The ongoing spike
      activity of SRT neurons was found to be relatively uniform when the states of
      quiet wakefulness and quiet sleep were compared. However, during active sleep,
      the majority of the SRT neurons sampled underwent a sustained reduction in spike
      activity. Marked facilitation of SRT cell activity occurred in a few instances.
      These data provide the first unitary evidence supporting earlier evoked
      potential, psychophysical and clinical studies that ascending sensory information
      in a classical pain pathway is regulated in a state-dependent fashion.

PMID- 11204050
TI  - Propofol action in both spinal cord and brain blunts electroencephalographic
      responses to noxious stimulation in goats.
AB  - STUDY OBJECTIVES: Anesthetics, including propofol, depress the
      electroencephalogram (EEG) and neuronal activity in the midbrain reticular
      formation (MRF). Because propofol has anesthetic effects in the spinal cord, we
      hypothesized that it would indirectly depress EEG and MRF neuronal responses to
      noxious stimulation in part by a spinal cord action. DESIGN: Six goats were
      anesthetized with isoflurane and the jugular veins and carotid arteries were
      isolated to permit cranial bypass and differential propofol delivery. A noxious
      mechanical stimulus was applied to the distal forelimb while recording bifrontal
      EEG and MRF single-unit activities. Propofol was separately administered to the
      cranial (0.08 +/- 0.06 mg/kg) and torso circulations (4 mg/kg) and the noxious
      stimulus applied at 1,5, 10, and 15 min after each injection. SETTING: N/A.
      PATIENTS OR PARTICIPANTS: N/A. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS:
      Noxious stimulation decreased total power (TP) from 96 +/- 33, microV2/Hz to 38
      +/- 20microV2/Hz, (mean +/- SD) and increased spectral edge frequency (SEF) from
      10 +/- 3 Hz to 19 +/- 5 Hz (p<0.01). Propofol administered to the torso prevented
      stimulus-evoked changes in TP (121+/- 80 microV2/Hz, 121 +/- 74 microV2/Hz, 114
      +/- 74 microV2/Hz at 1,5, and 10 min respectively, p<0.01 compared to control
      evoked response) and SEF (11 +/- 6Hz, 9 +/- 2Hz, 10 +/- 6Hz, and 12 +/- 5Hz at 1,
      5, 10 and 15 min, respectively, p<0.001 compared to control evoked response).
      Propofol administered to the cranial circulation significantly blunted the EEG
      and MRF response, while torso-administered propofol had slight effects on MRF
      responses. CONCLUSIONS: Propofol blunted the EEG response to noxious stimulation
      in part via a subcortical action.

PMID- 11204051
TI  - Nociceptive responsiveness during slow-wave sleep and waking in the rat.
AB  - Brainstem neurons that are thought to modulate pain are reported to have state
      dependent discharge rates. Yet, the effect of behavioral state upon nociceptive
      transmission has not been well studied. Therefore, we examined responses to
      noxious thermal stimulation of the rat hindpaw presented during different
      behavioral states. Noxious thermal stimuli were applied to rats as they
      spontaneously cycled through waking and sleeping states. Two different methods of
      heating the paw - a focused light bulb ("radiant heat") and a CO2 laser ("laser
      heat")-were employed. Regardless of the heating method used, rats withdrew from
      noxious thermal stimulation when it was applied in each behavioral state tested.
      When rats were tested with radiant heat, the withdrawal latency from noxious heat
      was shorter during slow-wave sleep than during waking. In contrast, when tested
      with laser heat, there was no difference in either the response latency or
      magnitude evoked by noxious heat across sleep/wake states. Despite the fact that
      rats withdrew from noxious heat (using either method of application) applied
      during sleep, the rats quickly returned to sleep afterwards. The latency to sleep
      after noxious stimulation was significantly greater during waking than during
      sleeping. The behavioral response to noxious thermal stimulation includes both an
      initial motor withdrawal which is enhanced during sleep and arousal or alerting
      which is suppressed during sleep. Therefore, pain evokes at least two distinct
      reactions that are differentially modulated across sleep/wake cycles.

PMID- 11204052
TI  - Postoperative sleep disturbance: influences of opioids and pain in humans.
AB  - STUDY OBJECTIVES: To test the hypothesis that opioids and pain contribute
      independently to postoperative sleep disturbance, 10 women undergoing surgery
      requiring a low abdominal incision for treatment of benign gynecologic conditions
      were randomized to receive either epidural opioid (fentanyl) (n=6) or epidural
      local anesthetic (bupivacaine) (n=4) for intraoperative and postoperative
      analgesia. DESIGN: N/A. SETTING: N/A. PATIENTS OR PARTICIPANTS: N/A.
      INTERVENTIONS: N/A. MEASUREMENTS: Polysomnography was performed in a standard
      patient room on the preoperative and first three postoperative nights. Pain at
      rest and with coughing was evaluated using a visual-analogue pain scale each
      evening and morning. RESULTS: On the first postoperative night, rapid eye
      movement (REM) sleep was abolished in all patients. On the third postoperative
      night, the mean +/- SE REM sleep time increased significantly (p=.003) to 9.8% +/
      3.1% in the fentanyl group, and 12.9% +/- 3.8% in the bupivacaine group.
      Conversely, light non-REM (NREM) sleep (%stage 1 + %stage 2) was higher on the
      first postoperative night and significantly lower on the third postoperative
      night (p=0.011). Between group comparison revealed only that the mean % slow-wave
      sleep (SWS) in the fentanyl group (6.0%, 2.0%, and 14.7%) was different from the
      bupivacaine group (7.8%, 9.1%, and 10.6%) in the postoperative period after
      adjusting for the preoperative night % SWS (p=0.021). Pain was well controlled in
      all patients, but was slightly better controlled in the fentanyl group than in
      the bupivacaine group on postoperative night 2 (p=0.024). There was no
      statistically significant association between pain score and any
      polysomnographically defined stage. CONCLUSION: Postoperative patients suffer a
      profound sleep disturbance even when opioids are avoided and pain is well
      controlled.

PMID- 11204053
TI  - Factors altering the sleep of burned children.
AB  - Although few studies have been conducted on burn patients, they indicate that
      sleep of burned children is altered. We suggest in this review, on the basis of
      the limited data available that factors contributing to sleep disruption in
      burned individuals may be broadly categorized as pathophysiological responses to
      the injury, the pain and discomfort experienced by the patient and medications
      used to treat these symptoms, and the physical environment in the Burns Intensive
      Care Unit. The responses to thermal injury include alterations in circulating
      neuropeptides, hormones, and immune-active substances, many of which are known to
      regulate/modulate sleep. Medications for the management of pain and for treating
      symptoms of various injury-induced stress and anxiety disorders may also alter
      sleep. Finally, frequent disruptions of the patient by medical staff is but one
      of the many environmental factors that may contribute to disrupted sleep. Severe
      burns induce a hypermetabolic response that may result in peripheral wasting,
      that depletes substrates necessary for tissue repair, and is associated with
      reduced growth hormone. Burn-induced growth hormone insufficiency is aggressively
      treated to counteract peripheral wasting and to aid in wound healing of skin
      graft donor sites. We speculate that improvement of sleep quality would result in
      a less severe reduction in growth hormone due to the well documented relationship
      between slow-wave sleep onset and growth hormone secretion. Such improvement in
      spontaneous growth hormone secretion patterns may aid in recovery by supporting
      tissue repair and by minimizing the hypermetabolic response to thermal injury.
      The experiments to test such hypotheses remain to be conducted, yet the results
      of such experiments may provide the basis for beginning to answer the question of
      whether or not sleep aids in recovery from injury.

PMID- 11204054
TI  - G protein activation in rat ponto-mesencephalic nuclei is enhanced by combined
      treatment with a mu opioid and an adenosine A1 receptor agonist.
AB  - STUDY OBJECTIVES: Opioids delivered to the pons inhibit REM sleep, whereas
      pontine administration of adenosine enhances REM sleep. In other brain areas
      opioids and adenosine interact to produce antinociception. Adenosine A1 receptors
      and mu opioid receptors each activate Gi/Go proteins. This study tested the
      hypothesis that combined treatment with the adenosine A1 receptor agonist SPA and
      the mu opioid agonist DAMGO would enhance G protein activation to a greater level
      than produced by either agonist alone. G protein activation was quantified in
      seven brainstem regions regulating sleep and nociception. This study also tested
      the hypothesis that G protein activation caused by SPA would be concentration
      dependent and blocked by the adenosine A1 receptor antagonist DPCPX. DESIGN:
      Activation of G proteins was assessed autoradiographically by agonist stimulation
      of [35S]GTPgammaS binding in slide-mounted sections of rat brainstem. G protein
      activation was quantified in nCi/g tissue for pontine reticular formation, dorsal
      raphe, ventrolateral and dorsomedial periaqueductal gray, and laterodorsal and
      pedunculopontine tegmental nuclei. SETTING: N/A. PATIENTS OR PARTICIPANTS: N/A.
      MEASUREMENTS AND RESULTS: Combined treatment with SPA and DAMGO caused a
      partially additive increase in G protein activation that was significantly
      (p<0.01) greater than G protein activation caused by either agonist alone.
      Treatment with SPA alone caused a concentration dependent (p<0.001) increase in
      [35S]GTPgammaS binding that was blocked by DPCPX. CONCLUSION: Agonist activation
      of adenosine A1 receptors stimulates G proteins in brainstem nuclei regulating
      sleep and nociception. In these same nuclei, G protein activation by combined
      treatment with DAMGO and SPA was partially additive, suggesting that mu opioid
      and adenosine A1 receptors activate some common G protein pools.

PMID- 11204055
TI  - Orexin (hypocretin)-like immunoreactivity in the cat hypothalamus: a light and
      electron microscopic study.
AB  - Orexin-A-like immunoreactive (OrA-ir) neurons and terminals in the cat
      hypothalamus were examined using immunohistochemical techniques. OrA-ir neurons
      were found principally in the lateral hypothalamic area (LHA) at the level of the
      tuberal cinereum and in the dorsal and posterior hypothalamic areas. In the LHA
      the majority of the neurons were located dorsal and lateral to the fornix; a
      small number of OrA-ir neurons were also present in other regions of the
      hypothalamus. OrA-ir fibers with varicose terminals were detected in almost all
      hypothalamic regions. The high density of fibers was located in the
      suprachiasmatic nucleus, the infundibular nucleus (INF), the tuberomamillary
      nucleus (TM) and the supra- and pre-mamillary nuclei. Ultrastructural analysis
      revealed that OrA-ir neurons in the LHA receive abundant input from non
      immunoreactive terminals. These terminals, which contained many small, clear,
      round vesicles with a few large, dense core vesicles, made asymmetrical synaptic
      contacts with OrA-ir dendrites, indicating that the activity of orexin neurons is
      under excitatory control. On the other hand, the terminals of OrA-ir neurons also
      made asymmetrical synaptic contact with dendrites in the LHA, the INF and the TM.
      The dendrites in the LHA were both non-immunoreactive and OrA-ir; conversely, the
      dendrites in the INF and the TM were non-immunoreactive. In these regions, OrA-ir
      terminals contained many small, clear, round vesicles with few large, dense core
      vesicles, suggesting that orexinergic neurons also provide excitatory input to
      other neurons in these regions.

PMID- 11204056
TI  - The investigation of K-complex and vertex sharp wave activity in response to mid
      inspiratory occlusions and complete obstructions to breathing during NREM sleep.
AB  - STUDY OBJECTIVES: To determine whether the cortical response to mid-inspiratory
      occlusions can be used as a model of the cortical response to obstructive events
      during sleep; and to determine whether the vertex sharp wave (VSW) and K-complex
      are exclusive contributors to the N350 and N550 components respectively of the
      stage 2 sleep event-related potential. DESIGN: Two types of respiratory stimuli
      were used to elicit evoked potential responses during stage 2 NREM sleep. These
      were mid-inspiratory occlusions and complete breath obstructions. Trials were
      grouped according to the type of phasic response elicited; isolated K-complex
      (KC), VSW associated with a K-complex (VSW/KC), isolated VSW, and no evoked
      response (other). Evoked responses were averaged separately within these
      categories. SETTING: Data were collected in the University of Melbourne Sleep
      Laboratory. PARTICIPANTS: Six young healthy male adults. INTERVENTIONS: N/A.
      MEASUREMENTS AND RESULTS: Data were recorded from 29 scalp sites referenced to
      linked ears. Mask pressure (Pm) and airflow were also recorded. Intra-thoracic
      pressure, as indicated by Pm, reached a more negative level following complete
      obstructions than brief occlusions. However, both types of respiratory stimuli
      elicited the two late latency components. Although latency varied across the two
      respiratory conditions in a manner consistent with the intra-thoracic pressure
      rise time differences, the elicitation characteristics and topographic
      distribution of these components did not vary across the two types of stimuli. In
      addition, an N350 was only present in the average for those categories that
      included VSWs, while an N550 was only present in those categories that contained
      K-complexes. CONCLUSIONS: Mid-inspiratory occlusions can be used as a model of
      obstructive events. VSWs contribute exclusively to the N350 component, while K
      complexes contribute exclusively to the N550 component.

PMID- 11204057
TI  - Effect of sleep position and sleep stage on the collapsibility of the upper
      airways in patients with sleep apnea.
AB  - Collapsibility of the upper airways has been identified as an important
      pathogenic factor in obstructive sleep apnea (OSA). Objective measures of
      collapsibility are pharyngeal critical pressure (Pcrit) and resistance of the
      upstream segment (Rus). To systematically determine the effects of sleep stage
      and body position we investigated 16 male subjects suffering from OSA. We
      compared the measures in light sleep, slow-wave sleep, REM sleep and supine vs.
      lateral positions. The pressure-flow relationship of the upper airways has been
      evaluated by simultaneous readings of maximal inspiratory airflow (Vimax) and
      nasal pressure (p-nCPAP). With two-factor repeated measures ANOVA on those 7
      patients which had all 6 situations we found a significant influence of body
      position on Pcrit (p<0.05) whereas there was no significant influence of sleep
      stage and no significant interaction between body position and sleep stage. When
      comparing the body positions Pcrit was higher in the supine than in the lateral
      positions. During light sleep Pcrit decreased from 0.6 +/- 0.8 cm H2O (supine) to
      -2.2 +/- 3.6 cm H2O (lateral) (p<0.01), during slow-wave sleep Pcrit decreased
      from 0.3 +/- 1.4 cm H2O (supine) to -1.7 +/- 2.6 (lateral) (p<0.05) and during
      REM sleep it decreased from 1.2 +/- 1.5 cm H2O to -2.0 +/- 2.2 cm H2O (p<0.05).
      Changes in Rus revealed no body position nor sleep-stage dependence. Comparing
      the different body positions Rus was only significantly higher in the lateral
      position during REM sleep (p<0.05). The results indicate that collapsibility of
      the upper airways is not mediated by sleep stages but is strongly influenced by
      body position. As a consequence lower nCPAP pressure is needed during lateral
      positions compared to supine positions.

PMID- 11204058
TI  - The association of sleep-disordered breathing and sleep symptoms with quality of
      life in the Sleep Heart Health Study.
AB  - This study assessed the extent to which sleep-disordered breathing (SDB),
      difficulty initiating and maintaining sleep (DIMS), and excessive daytime
      sleepiness (EDS) were associated with impairment of quality of life (QoL) using
      the SF-36. Participants (n=5,816; mean age=63 years; 52.5% women) were enrolled
      in the nation-wide population-based Sleep Heart Health Study (SHHS) implemented
      to investigate sleep-disordered breathing as a risk factor in the development of
      cardiovascular disease. Each transformed SF-36 scale was analyzed independently
      using multiple logistic regression analysis with sleep and other potential
      confounding variables (e.g., age, ethnicity) included as independent variables.
      Men (11.6%) were significantly more likely to have SDB compared to women (5.6%),
      while women (42.4%) were significantly more likely to report DIMS than men
      (32.5%). Vitality was the sole SF-36 scale to have a linear association with the
      clinical categories of SDB (mild, moderate, severe SDB). However, individuals
      with severe SDB indicated significantly poorer QoL on several SF-36 scales. Both
      DIMS and EDS were strongly associated with reduced QoL even after adjusting for
      confounding variables for both sexes. Findings suggest 1) mild to moderate SDB is
      associated with reduced vitality, while severe SDB is more broadly associated
      with poorer QoL, 2) subjective sleep symptoms are comprehensively associated with
      poorer QoL, and 3) SF-36 mean score profiles for SDB and sleep symptoms are
      equivalent to other chronic diseases in the U.S. general population.

PMID- 11204059
TI  - Communication is often illusory.

PMID- 11204060
TI  - Argon laser curing of fluoride-releasing pit and fissure sealant: in vitro caries
      development.
AB  - The purpose of this study was to compare the effect of argon laser polymerization
      of a visible-light-cured, fluoride-releasing pit and fissure sealant on caries
      development in vitro. A total of twelve caries-free premolar and molar teeth was
      selected, and underwent a fluoride-free prophylaxis and soft tissue debridement.
      Cavity preparations were placed in buccal and lingual surfaces. Lingual cavity
      preparations were filled with the fluoride-releasing sealant (UltraSealXTplus,
      Ultradent) and visible light cured per the manufacturer's recommendation. Buccal
      preparations were filled with the fluoride-releasing sealant and argon laser
      cured (231 mW, 12 J/cm2 for 10 seconds). Following sealant placement, the teeth
      were sectioned into buccal and lingual halves. An acid-resistant varnish was
      placed leaving a 1 mm rim of exposed surface enamel adjacent to the sealant. The
      specimens were then thermocycled in synthetic saliva (500 cycles, 5 to 50 degrees
      C). In vitro caries lesions were formed (2.2 mM Ca, 2.2 mM PO4, 50 mM acetic
      acid, 5 ppm fluoride, pH 3.95). Longitudinal sections (five sections per tooth
      half) were obtained and evaluated by polarized light microscopy for mean outer
      surface lesion depths and frequency of wall lesions. Mean primary surface (outer)
      lesion depth was significantly decreased (ANOVA, DMR, P < .05) for the fluoride
      releasing sealant with argon laser polymerization (152 +/- 16 um) when compared
      with visible light curing (211 +/- 23 um). Likewise, wall lesion frequency was
      substantially reduced for the argon laser polymerized sealants (17 percent) when
      compared with that for the visible light polymerized sealants (24 percent, ANOVA,
      DMR, P < .05). Argon laser polymerization of a fluoride-releasing pit and fissure
      sealant improved caries resistance markedly in the surface enamel adjacent to the
      sealant material. Argon laser curing enhanced the caries protective ability of
      the sealant along the enamel-resin cavosurface, as noted by a decrease in wall
      lesion frequency. Argon laser polymerization provides further caries protection
      against a cariogenic challenge over that afforded by fluoride-releasing sealants.
      Caries development around a sealant material may be hampered by the combination
      of fluoride release from the sealant and argon laser polymerization.

PMID- 11204061
TI  - Vitremer restorative cement for children: three clinicians' observations in three
      pediatric dental practices.
AB  - BACKGROUND: The authors retrospectively evaluated the clinical performance of a
      resin-modified glass ionomer cement as a Class I, Class II, Class III, and Class
      V restorative material in primary teeth. METHODS: Three hundred and six patients
      that had received 864 resin-modified glass ionomer restorations, which had been
      in the mouth for a minimum of three years, were included in this evaluation.
      RESULTS: The results demonstrated an overall 93.4 percent restoration success
      rate, Class I restorations presenting a 92.6 percent success. Class II
      restorations presenting a 93.4 percent success, Class III restorations presenting
      a 100 percent success and Class V restorations presenting a 98 percent success,
      respectively. CONCLUSIONS: The resin-modified glass ionomer cement functioned
      well as a Class I, Class II, Class III, and Class V restorative material in the
      primary dentition. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement
      restorative material functions well for Class I, Class II, Class III, and Class V
      restorations in primary teeth.

PMID- 11204062
TI  - Chlorhexidine varnishes prevent gingivitis in adolescents.
AB  - BACKGROUND: Chlorhexidine, a cationic anti-microbial agent, prevents gingivitis
      by inhibiting plaque accumulation. Gingivitis is the most predominant form of
      periodontal disease in children and adolescents. The purpose of this study was to
      determine the effects of a chlorhexidine varnish on the gingival status of
      adolescents. METHODS: The subjects of this study were 10-15 years old adolescents
      randomly divided into a control (C) and a treatment (T) group, n = 53 and n = 57,
      respectively. After restoration of all caries lesions, a prophylaxis was given to
      both C and T groups. A 10 percent chlorhexidine varnish was applied to the entire
      dentition of T subjects at BL; and one week and three months thereafter. One
      calibrated examiner determined blindly the Gingival Index (GI) of all subjects.
      RESULTS: The average percentage of sites per subject with GI scores of 2 or 3 at
      BL, and after three and six months for the T group were, respectively, 3.68 +/-
      7.13, 0.71 +/- 2.43 and 0.16 +/- 0.62. The corresponding values for the C group
      were 2.11 +/- 3.68, 1.27 +/- 2.94 and 1.59 +/- 5.20. Profile analysis revealed
      that over a 6-month period subjects of T group had significantly fewer sites with
      GI scores 2 and 3 than subjects in the C group (p = 0.025). CONCLUSIONS: It is
      concluded that the professional application of a chlorhexidine varnish
      significantly improved the gingival health of adolescents over a 6-month period.

PMID- 11204063
TI  - Histomorphologic changes in the gingiva and pulp of overretained primary teeth.
AB  - This study examined the influence of overretention on the tissues of human
      primary teeth. The range of overretention was two to thirty-two years. Light
      microscopy and computerized morphometry were utilized for histologic assessment
      of twenty-five sites of twenty-one teeth. Dentinoclasts were found on the
      resorbing root surface of nine teeth; polymorphonuclear leucocytes were found in
      the pulp of fourteen teeth; and monocytes were present in all pulps. The apical
      and coronal ends of the junctional epithelium were apical to the cemento-enamel
      junction in eighteen and fourteen teeth, respectively. Significant correlations
      were found between the extent of overretention and gingival height, the length of
      the junctional epithelium and the extent of apical migration of the junctional
      epithelium. Present and previous findings indicate that odontoclastic activity in
      the pulp is reduced with overretention; and while at the beginning of
      overretention there is a lower percentage of pulps with polymorphonuclear
      leucocytes in the pulp, with an extended period of overretention an increase in
      this percentage takes place.

PMID- 11204064
TI  - Caries prediction and indicators using a pediatric risk assessment teaching tool.
AB  - The goals of this study were to determine both predictability and risk indicators
      in a young pediatric population seen in a dental school clinic using a Caries
      Risk Assessment teaching tool. Assigned risk categories and factors for 140
      patients were analyzed for relationships with future caries development using
      Logistic Regression (p < 0.01) and Chi-square analysis (p < 0.05). Among the
      group developing caries, variables and disease were analyzed using ANOVA
      Independent Samples Test (p < 0.05). Assigned-risk categories were significantly
      predictive with odds ratios (OR) of Moderate- and High-risk developing new caries
      being 5.41 and 28.64 respectively when compared with Low-risk. Significant risk
      indicators were diet, oral hygiene and the presence of caries and
      decalcifications. The risk assessment tool used in this study predicted future
      caries development. Through this method of assessment, caries risk indicators in
      the population studied were determined to be diet, oral hygiene and past caries
      experience.

PMID- 11204065
TI  - Deinstitutionalization of children with mental retardation: what of dental
      services?
AB  - During the past thirty years there has been marked deinstitutionalization from
      large state facilities for youngsters and adults with mental retardation and
      developmental disabilities. In the past, dental (and general medical) services
      were provided in the institutions by an in-house staff. Increased numbers of
      former residents now live in small community units. These local residents must
      now rely on community dental practitioners for needed preventive and restorative
      services. The current status of these services (or lack there of) is reviewed,
      together with relevant concerns.

PMID- 11204066
TI  - Dentist participation in a public-private partnership to increase Medicaid
      participation and access for children from low income families.
AB  - The purpose of this research is to solicit feedback from dental society members
      involved in a program (Access to Baby and Child Dentistry, ABCD) to provide care
      for children receiving Medicaid benefits, and to gain an understanding of dentist
      participation. We investigated whether general dentists who were participants in
      ABCD were more fully integrated into the dental society profession and community,
      and whether they demonstrated greater interest in children. Dentists were
      stratified regarding ABCD participation and randomly selected to be interviewed
      (N = 40). The majority thought it appropriate for general dentists to care for
      very young children. Participants found fewer problems in fee levels in Medicaid,
      but there was no difference in an index of fees between the groups. Participants
      were no more active in the dental society, and few differences existed between
      the groups regarding other aspects of personal or professional life. Dentists
      participating in ABCD to improve access had a good experience and have positive
      views of the program. This may encourage other nonspecialist colleagues to
      participate in programs for children.

PMID- 11204067
TI  - Dentists' ranking of Medicaid reimbursement rates as a measure of their pediatric
      Medicaid participation.
AB  - The objective of the study was to determine the usefulness of dentists' ranking
      of Medicaid reimbursement rates as a measure of their participation in the
      Medicaid program for children. Data were obtained from two mail-in questionnaire
      surveys of Connecticut dentists, before and after an increase in Medicaid
      reimbursement rates for children. Dentists ranked acceptability of Medicaid
      reimbursement rates on a seven-point index, while their participation in the
      Medicaid program was assessed by whether they acknowledged treating Medicaid
      children and were currently accepting new Medicaid children into their practices.
      There was a significant difference (p < 0.0001) in the dentists' ranking of
      Medicaid reimbursement rates following the rate increase indicating that the
      index was responsive. Acceptance of new Medicaid children into dental practices
      was a better measure of active participation in the Medicaid program. Following
      the increase in Medicaid reimbursement rates, dentists ranking it as
      acceptable/equivocal were more likely (p < 0.02) to accept new Medicaid children
      into their practices. In conclusion, the index of dentists' ranking of Medicaid
      reimbursement rates was a responsive and valid measure of their participation in
      the Medicaid program.

PMID- 11204068
TI  - Would you believe that during the 1990s, applications to pediatric dental
      training programs more than doubled?
AB  - A review of application to (and enrollment in) pediatric dental programs
      indicates increasing dental student graduate interest (particularly by female
      graduates) in this specialty. Except for black student representation, enrollment
      in pediatric dentistry training programs increasingly represents the ethnic and
      racial distribution of the general population.

PMID- 11204069
TI  - Impaired dentofacial development after radiotherapy of a non-Hodgkin lymphoma:
      report of case.
AB  - Since the advances in therapy of childhood malignancies have improved life
      expectancy attention is now increasingly focused on the long-term effects of
      antineoplastic therapy. Developmental abnormalities due to antineoplastic therapy
      have been claimed to preferentially occur in children treated before the age of
      six years. This report of a case demonstrates severe developmental disturbances
      following radiotherapy of a cervical non-Hodgkin lymphoma at the age of eight
      years. The morphological changes included microdontia, root shortening, blunting
      and thinning as well as mandibular hypoplasia.

PMID- 11204070
TI  - Dental findings in Morquio syndrome (mucopolysaccharidoses type IVa).
AB  - Morquio syndrome is a disorder of mucopolysaccharide metabolism with specific
      skeletal features. The clinical and radiographic appearance of the teeth
      resembles hypoplastic amelogenesis imperfecta with thin enamel of normal
      radiodensity. The dental practitioner has a part to play in collaboration with
      medical colleagues in the recognition and diagnosis of this condition.

PMID- 11204071
TI  - Concealed accessory pathway with long conduction times and incremental
      properties: a case report.
AB  - Concealed AP with Slow and Incremental Conduction. We report a peculiar form of
      permanent junctional reciprocating tachycardia that occurs only during daytime
      and physical activity. ECG obtained during tachycardia showed an unusual
      progressive shortening of the ventriculoatrial (VA) interval that was maximal at
      the first complex and shortest at the last one before block occurred, always at
      the accessory pathway level. This phenomenon has not been previously described
      and appears to be a reverse type of Wenckebach block. It was observed during
      salvos of spontaneous tachycardia and could be reproduced by right ventricular
      pacing. The accessory pathway was ablated successfully at the right posteroseptal
      region, close to the coronary sinus ostium. After ablation, there was no VA
      conduction, and tachycardia did not recur during a 9-month follow-up period.

PMID- 11204072
TI  - Vasospastic angina accompanied by Brugada-type electrocardiographic
      abnormalities.
AB  - Brugada Syndrome and Vasospastic Angina. We present two patients with vasospastic
      angina and Brugada-type ECG abnormalities. The first patient complained of chest
      pain, and transient ST segment elevation was confirmed on ECG. Coronary angiogram
      showed no organic stenosis. The second patient had syncopal episodes following
      anginal chest pain, and the same symptoms were reproduced by intracoronary
      acetylcholine injection that induced vasospasm. In both patients, ECG at rest
      showed ST segment elevation in leads V1 and V2 and a right bundle branch block
      pattern that were accentuated by a Class I antiarrhythmic drug. Ventricular
      fibrillation also was induced by programmed electrical stimulation.
      Susceptibility to ventricular fibrillation can be modulated by the interaction of
      coronary vasospasm with Brugada syndrome or vice versa; therefore, it is
      important to study the clinical implications of the coexistence of the two
      diseases in such patients.

PMID- 11204073
TI  - Prevention of sudden death in heart failure.

PMID- 11204074
TI  - A long RP tachycardia: what is the tachycardia mechanism?

PMID- 11204075
TI  - Intracardiac tuberculoma causing "idiopathic" ventricular tachycardia in a
      patient without detectable heart disease.

PMID- 11204076
TI  - High incidence of focal atrial fibrillation (AF) from the right atrium (RA).

PMID- 11204077
TI  - How do I prolong QT? Let me count the ways.

PMID- 11204078
TI  - Electroanatomic characterization of conduction barriers in sinus/atrially paced
      rhythm and association with intra-atrial reentrant tachycardia circuits following
      congenital heart disease surgery.
AB  - INTRODUCTION: The electrophysiologic mechanism of intra-atrial reentrant
      tachycardia (IART) is generally thought to be a macroreentrant circuit revolving
      around a nonconductive or highly anisotropic barrier. However, the electrical and
      anatomic substrate that supports these circuits has been incompletely defined.
      Our objectives were to characterize the atria of patients with IART using
      electroanatomic mapping in sinus or atrially paced rhythm and to determine
      whether electrical barriers identified in sinus/atrially paced rhythm are
      associated with IART circuits. METHODS AND RESULTS: Eighteen patients with IART
      and a remote history of repaired or palliated congenital heart disease were
      studied [8 biventricular repair, 8 single ventricle palliation (7 Fontan), and 2
      Mustard repair]. Thirteen patients had a right AV valve. In sinus/atrially paced
      rhythm, electrical evidence of a crista terminalis was identified in 11 patients,
      an atriotomy in 12, and > or = 1 right atrial free-wall scar in 11. In 26 IART
      circuits characterized, 12 used the right AV valve as a central obstacle, 6 used
      a right atrial free-wall scar, 3 used an atriotomy, 3 used the crista terminalis,
      and 2 circuits used an atrial septal scar. All central obstacles used by IART
      circuits were identified in sinus/atrially paced rhythm. CONCLUSION: The crista
      terminalis, atriotomy, and right atrial scars can be identified in patients with
      repaired congenital heart disease by electroanatomic mapping in sinus/atrially
      paced rhythm. These conduction barriers frequently function as the central
      obstacle for IART. Demonstration of such features may help focus investigational
      mapping without reliance on spontaneous initiation of the tachycardia.

PMID- 11204079
TI  - Relatively benign clinical course in asymptomatic patients with brugada-type
      electrocardiogram without family history of sudden death.
AB  - INTRODUCTION: The incidence of sudden death or ventricular fibrillation (VF) in
      asymptomatic Brugada syndrome patients with a family history of sudden death is
      reported to be very high. However, there are few reports on the prognosis of
      asymptomatic Brugada syndrome patients without a family history of sudden death.
      METHODS AND RESULTS: Eleven patients (all male; mean age 40.5 +/- 9.6 years,
      range 26 to 56) with asymptomatic Brugada-type ECG who had no family history of
      sudden death were evaluated. The degrees of ST segment elevation and conduction
      delay on signal-averaged ECG (SAECG) before and after pilsicainide were evaluated
      in all 11 patients. VF inducibility by ventricular electrical stimulation also
      was evaluated in 8 of 11 patients. Patients were followed for a period of 9 to 84
      months (mean 42.5 +/- 21.6). The J point level was increased (V1: 0.19 +/- 0.09
      mV to 0.36 +/- 0.23 mV; V2: 0.31 +/- 0.12 mV to 0.67 +/- 0.35 mV) by
      pilsicainide. Conduction delay was increased (total QRS: 112.2 +/- 6.3 msec to
      131.7 +/- 6.3 msec; under 40 microV: 42.0 +/- 8.5 msec to 52.7 +/- 12.7 msec;
      last 40 msec: 17.4 +/- 5.9 microV to 10.4 +/- 6.1 microV) on SAECG by
      pilsicainide. VF was induced in only 1 of 8 patients. None of the patients had
      syncope or sudden death during a mean follow-up of 42.5 +/- 21.6 months.
      CONCLUSION: This study suggests that asymptomatic patients with Brugada-type ECG
      who have no family history of sudden death have a relatively benign clinical
      course.

PMID- 11204080
TI  - Reversal of deteriorated fractal behavior of heart rate variability by beta
      blocker therapy in patients with advanced congestive heart failure.
AB  - INTRODUCTION: The slope of the power spectrum in heart rate variability (HRV)
      reflects the fractal or scaling behavior in HR dynamics and recently was
      confirmed as an independent predictor of postmyocardial infarction survival.
      Whether or not the new measurement in HRV foresees the functional evolution in
      patients with advanced congestive heart failure treated by beta blockers is
      unclear. METHODS AND RESULTS: Sequential 24-hour Holter ECG recordings were
      obtained at baseline, and 1 and 3 months after addition of atenolol therapy for
      advanced congestive heart failure in 10 patients. The slope and intercept of the
      regression line of power-law behavior, the short- and intermediate-term of
      detrended fluctuated analysis (DFA), the approximate entropy (ApEn), and the
      standard frequency spectra of the 24-hour HRV were compared sequentially as well
      as with those in 12 age-matched normal controls. The results showed that the
      slope (-1.70 +/- 0.45 vs -1.22 +/- 0.21; P < 0.05) and the intercept (5.11 +/-
      0.46 vs 5.62 +/- 0.24; P < 0.05) of the regression line of power-law behavior and
      the short-term DFA (for 4 to 11 beats) (0.78 +/- 0.18 vs 1.13 +/- 0.21; P < 0.05)
      increased after 3 months of atenolol treatment. However, the change in
      intermediate-term DFA (>11 beats) and ApEn was not apparent (1.24 +/- 0.21 vs
      1.22 +/- 0.15 and 1.34 +/- 0.14 vs 1.36 +/- 0.11; both P > 0.05). The evolution
      of the slope or intercept of the regression line of the HRV power spectrum did
      not correlate with the echocardiographic or clinical cardiac function, or with
      the frequency spectral components of the HRV (P > 0.05). CONCLUSION: Additional
      beta-blocker therapy upregulated the fractal behavior control of the HRV in
      patients with advanced congestive heart failure. The improvement was independent
      of subjective and objective global cardiac performance.

PMID- 11204081
TI  - Broken fractals: where's the break?

PMID- 11204082
TI  - Differential modulation of electrocardiographic indices of ventricular
      repolarization dispersion depending on the site of pacing during premature
      stimulation.
AB  - INTRODUCTION: Dispersion of ventricular repolarization has been shown to increase
      with premature stimulation. Moreover, a straight correlation between the amount
      of dispersion of repolarization and the vulnerability to ventricular fibrillation
      was reported. On the other hand, differences between right ventricular (RV) and
      left ventricular (LV) fibrillation threshold have been reported. However, no data
      exist regarding the influence of the site of stimulation on modulation of
      dispersion of repolarization. METHODS AND RESULTS: In the present study, several
      ECG indices of dispersion of repolarization, as a function of the coupling
      interval and the site of stimulation, were evaluated in a modified Langendorff
      perfused rabbit heart (n = 12), with a 5 x 8 array of a simulated body surface
      unipolar lead system. As the coupling interval was shortened, a biphasic
      modulation of dispersion of repolarization was found when stimuli were elicited
      at the LV. In contrast, when the heart was paced from the RV, the dispersion
      increased monotonically as coupling interval was shortened. CONCLUSION: A
      differential behavior of the modulation of dispersion of repolarization was found
      as a function of the site of stimulation.

PMID- 11204083
TI  - Effects of simultaneous atrioventricular pacing on atrial refractoriness and
      atrial fibrillation inducibility: role of atrial mechanoelectrical feedback.
AB  - INTRODUCTION: The purpose of this study was to evaluate the effects of an acute
      increase in atrial pressure on refractoriness (mechanoelectrical feedback) and
      the vulnerability to atrial fibrillation (AF) and to investigate the effects of
      autonomic blockade and verapamil on mechanoelectrical feedback in humans. METHODS
      AND RESULTS: Right atrial pressure and effective refractory period (ERP) at the
      right atrial appendage (RAA) and high right atrial septum were measured during
      sinus rhythm, and during atrial and simultaneous AV pacing at a cycle length of
      300 msec, either in the absence (n = 25) or presence (n = 22) of pharmacologic
      autonomic blockade. In another 15 patients, the protocol was performed before and
      after infusion of verapamil 0.15 mg/kg. In the absence of autonomic blockade, AV
      pacing resulted in a higher mean right atrial pressure (11.7 +/- 3.3 vs 4.3 +/-
      3.0 mmHg, P < 0.001) and a shorter atrial RAA ERP (144 +/- 23 msec vs 161 +/- 21
      msec; P < 0.001) compared with atrial pacing; AF was induced more often during AV
      pacing (87%) than during atrial pacing (20%) and was related directly to the
      right atrial pressure (r = 0.39, P = 0.004) and indirectly to the RAA ERP (r = 
      0.42, P < 0.001). The susceptibility to sustained AF was greatly enhanced by
      autonomic blockade. Verapamil markedly attenuated the shortening of ERP and the
      propensity for AF that occurred during simultaneous AV pacing. CONCLUSION: An
      acute increase in atrial pressure during tachycardia is associated with
      shortening of atrial refractoriness and a propensity for AF, i.e., atrial
      mechanoelectrical feedback, which may be enhanced by autonomic blockade and
      attenuated by calcium channel blockade.

PMID- 11204084
TI  - Electrical remodeling of the atria as a consequence of atrial stretch.

PMID- 11204085
TI  - Late occurrence of heart block after radiofrequency catheter ablation of the
      septal region: clinical follow-up and outcome.
AB  - INTRODUCTION: There are few data regarding the occurrence of delayed heart block
      at least 24 hours after radiofrequency catheter ablation (RFCA) of AV nodal
      reentry or posteroseptal accessory pathways (APs). We investigated the late
      occurrence of heart block in this population, the clinical outcome, and whether
      findings at electrophysiologic study could have predicted its development.
      METHODS AND RESULTS: Two of 418 patients with AV nodal reentry undergoing RFCA
      using a posterior approach and 1 of 54 patients with RFCA of a posteroseptal AP
      developed late heart block. Anterograde and retrograde AV nodal conduction before
      and after RFCA were normal. Patients received 12, 15, and 32 RFCA lesions,
      respectively, using a mean maximum power of 44 W. The RFCA sites were the
      posterior septum for posteroseptal AP and the posterior and mid-septum for
      patients with AV nodal reentry, with no His electrogram ever recorded at the
      ablation site. During RFCA, junctional tachycardia occurred with 1:1 VA
      conduction in the patient with a posteroseptal AP, but occasional intermittent
      single retrograde blocked complexes were present in both patients with AV nodal
      reentry. No rapid junctional tachycardia or >1 consecutive retrograde blocked
      complex was ever observed during RFCA. Persistent high-degree AV block with
      junctional escape developed 2 days after RFCA in the posteroseptal AP patient. A
      permanent pacemaker was implanted, and normal conduction was noted 16 days after
      RFCA. Both patients with AV nodal reentry complained of fatigue, mainly on
      exertion, 3 to 4 days after RFCA, and ECG-documented exercise-induced variable AV
      block was obtained. Because heart block resolved in our initial patient, a
      prolonged monitoring period was allowed. Symptoms disappeared at 13 and 8 days,
      and a follow-up treadmill test showed normal PR interval and no heart block. No
      recurrence of heart block has been seen in any of these three patients.
      CONCLUSION: Late unexpected heart block after RFCA of AV nodal reentry and
      posteroseptal AP is rare, often resolves uneventfully in 1 to 2 weeks, and no
      specific electrophysiologic findings predicted its occurrence. Prolonged clinical
      observation is preferable to immediate pacemaker implantation in such patients.

PMID- 11204087
TI  - Role of structural complexities of septal tissue in maintaining ventricular
      fibrillation in isolated, perfused canine ventricle.
AB  - INTRODUCTION: It is unclear how the patterns of wavelet propagation during
      ventricular fibrillation (VF) vary between structurally different tissues. We
      hypothesized that the structural complexities of septal tissue influence the
      maintenance of reentrant wavelets in the ventricle. METHODS AND RESULTS:
      Endocardial activation patterns during VF were analyzed in the isolated, perfused
      canine right ventricular (RV) free wall (n = 9), interventricular septum (n = 5),
      and left ventricular (LV) free wall (n = 6) using a computerized mapping system
      (2-mm resolution) with 120-msec consecutive windows. Each tissue sample was cut
      progressively to reduce the tissue mass until the VF was terminated. More
      wavelets were seen in the septa than in the RV and LV free walls at baseline (P =
      0.004), and VF in the septa displayed a shorter cycle length than in the RV and
      LV free walls (P = 0.017). As the tissue mass decreased, VF became successively
      more organized in all regions: the number of wavelets decreased and the cycle
      length of VF lengthened. Single and "figure-of-eight" stationary, reentrant
      wavelets often were mapped after tissue mass reduction in the RV free walls and
      rarely in the LV free walls, but they were not observed in the septa. Less
      critical mass was required to maintain VF in the septa than in the RV and LV free
      walls (P = 0.0006). Gross anatomic and histologic examinations indicated that the
      tissue structure of the septa is more complex than that of the RV and LV free
      walls. CONCLUSION: VF activation patterns with progressive reduction of tissue
      mass differ for the septum and the ventricular free walls. The structural
      complexities of the septal tissue influence the maintenance of fibrillation in
      the ventricle.

PMID- 11204086
TI  - Transient ST segment elevation in right precordial leads induced by psychotropic
      drugs: relationship to the Brugada syndrome.
AB  - Psychotropic Drugs and ST Segment Elevation. Transient ST segment elevation in
      right precordial leads with use of psychotropic drugs is reported in two cases of
      overdose and one case of therapeutic administration. Flecainide did not reproduce
      ST segment elevation. The relationship of these abnormalities to the Brugada
      syndrome and the electrophysiologic hypothesis are discussed.

PMID- 11204088
TI  - Asymptomatic patients with a brugada electrocardiogram: are they at risk?

PMID- 11204089
TI  - Pacing during ventricular fibrillation: factors influencing the ability to
      capture.
AB  - INTRODUCTION: Recent studies showed that pacing atrial and ventricular
      fibrillation (VF) is possible. The studies presented here determined which
      parameters influence the efficacy of a pacing train to capture fibrillating
      ventricular myocardium. Electrode type, current strength, order of pacing trains,
      polarity, and VF morphology preceding the pacing trains were investigated.
      METHODS AND RESULTS: A 504-electrode recording plaque sutured to the right
      ventricle of pig hearts was used to record the activations of VF and those
      resulting from the pacing stimulation. Capture of VF by pacing was determined by
      observing an animated display of the first temporal derivative of the
      electrograms. A series of electrodes in a line captured the heart more frequently
      during VF than did a point electrode. Increasing the current strength to 10 x
      diastolic pacing threshold increased the incidence of capture, but increasing
      this strength further did not. The second or third train of 40 stimuli had
      greater capture rates than did the first train during the same VF episode. Anodal
      and cathodal unipolar, and bipolar stimulation were equally efficacious in
      capturing VF. VF activation during the 1-second interval preceding pacing was
      more organized for pacing trains that captured than those that did not. The
      highest incidence of capture, 46% to 61% of pacing trains, occurred with a line
      of electrodes at 10 x diastolic pacing threshold delivered by the second or third
      train. CONCLUSION: The probability of a pacing train capturing fibrillating
      myocardium can be influenced by the pacing protocol parameters.

PMID- 11204090
TI  - Verapamil prevents stretch-induced shortening of atrial effective refractory
      period in langendorff-perfused rabbit heart.
AB  - INTRODUCTION: Atrial dilation and rapid pacing reduce atrial effective refractory
      periods (AERPs), thereby increasing the susceptibility to sustained atrial
      fibrillation (AF) in Langendorff-perfused rabbit hearts. It is unclear whether
      similar pathophysiologic mechanisms are operative in short-term
      electrophysiologic changes caused by dilation and rapid pacing. Therefore, we
      analyzed whether both forms of short-term electrophysiologic changes are
      similarly affected by pharmacologic interventions acting on different potential
      mechanisms underlying these changes. METHODS AND RESULTS: Thirty Langendorff
      perfused rabbit hearts underwent a protocol with stepwise increase of intra
      atrial pressure from 0 to 12 cm H2O followed by 10 minutes of rapid pacing at 4
      cm H2O. The protocol was repeated after addition of glibenclamide (10 micromol/L,
      n = 7), cariporide (1 micromol/L, n = 7), or verapamil (1 micromol/L, n = 9). In
      the basal state, increase of intra-atrial pressure from 0 to 12 cm H2O decreased
      AERPs from 85 +/- 11 to 55 +/- 9 msec (P < 0.01), rapid pacing at low intra
      atrial pressure (4 cmH2O) decreased AERP to a similar extent, from 81 +/- 11 to
      60 +/- 10 (P < 0.01). At higher intra-atrial pressure, decrease of AERP was more
      pronounced (10 cm H2O: 37 +/- 2 msec) (n = 7). Addition of verapamil decreased
      basal AERP from 86 +/- 10 msec to 68 +/- 11 msec (P < 0.05). Short-term
      electrophysiologic changes due to atrial dilation were abolished; changes due to
      rapid pacing were reduced but still present. Glibenclamide and cariporide had no
      significant effect. CONCLUSION: Langendorff-perfused rabbit heart is a suitable
      model for studying short-term electrophysiologic changes due to both rapid pacing
      and atrial dilation. AERPs are shortened to a similar extent by both mechanisms,
      whereas a combination of the two leads to more pronounced AERP reduction. Calcium
      overload plays a crucial role in short-term electrophysiologic changes caused by
      atrial dilation, whereas atrial ischemia or acidosis has no significant impact.

PMID- 11204091
TI  - Sympathetic activation enhances QT prolongation by quinidine.
AB  - INTRODUCTION: Salt restriction results in endogenous sympathetic activation, and
      we previously showed that plasma concentrations of quinidine measured after oral
      drug administration are increased during a low-salt diet. However, it is not
      known whether, independent of effects on plasma concentration, the extent to
      which quinidine prolongs the QT interval also is modulated by changes in
      endogenous sympathetic activity. METHODS AND RESULTS: In these studies, we
      evaluated quinidine concentration-QT relations during low-salt (10 mEq/day for 8
      days) and high-salt (400 mEq/day for 8 days) diets, with or without beta blockade
      in normal volunteers. In the absence of beta blockade, the concentration
      producing a fixed (15%) increase in QTc was significantly lower with salt
      restriction: 1.2 +/- 0.4 microg/mL (low salt) versus 2.2 +/- 0.4 microg/mL (high
      salt) (P < 0.01). With beta blockade, this difference was abolished: 1.9 +/- 0.3
      microg/mL (low salt + beta blockade) versus 2.1 +/- 0.3 microg/mL (high salt +
      beta blockade). QT morphologic abnormalities including bifid T waves and U waves
      were abolished with beta-adrenergic blockade. CONCLUSION: Sympathetic activation
      by a low-salt diet not only modulates drug disposition but also increases
      sensitivity to drug-induced QT prolongation.

PMID- 11204093
TI  - Sequential effects in naming: a time-criterion account.
AB  - S. J. Lupker, P. Brown, and L. Colombo (1997) reported that target naming
      latencies are strongly affected by the difficulty of the other stimuli in a trial
      block, an effect they attributed to readers' strategic use of a time criterion to
      guide responding. In the present research, the authors asked whether there are
      also trial-by-trial ("sequential") effects by examining naming latency as a
      function of the difficulty of the preceding stimulus. In Experiment 1, both
      nonwords and high-frequency regular words were named more rapidly following a
      word than a nonword. Experiments 2, 3, and 4 were parallel experiments involving
      a variety of stimulus types (e.g., high- and low-frequency inconsistent words,
      easy and hard nonwords). In all cases, similar sequential effects were observed
      (i.e., all stimulus types had shorter latencies following an easier-to-name than
      a harder-to-name stimulus). In terms of the time-criterion account, criterion
      placement appears to be affected by the relative difficulty of the preceding
      stimulus in a way that is independent of stimulus type.

PMID- 11204092
TI  - Species plays an important role in drug-induced prolongation of action potential
      duration and early afterdepolarizations in isolated Purkinje fibers.
AB  - INTRODUCTION: Although isolated Purkinje fibers (PFs) often are used to evaluate
      the electrophysiologic effects of new drugs in terms of prolongation of action
      potential duration (APD) and induction of early afterdepolarizations (EADs),
      species differences in this respect remain elusive. We evaluated potential
      species-specific differences in drug-induced prolongation of APD and EADs in
      isolated PF from various species. METHODS AND RESULTS: Using a microelectrode
      technique, PFs (n = 7 to 11 per species) were isolated from hearts of rabbits,
      guinea pigs, dogs, swine, goats, or sheep, superperfused in Tyrode's solution
      with dofetilide (1 x 10(-8) M) or quinidine (1 x 10(-5) M) for 25 minutes, and
      stimulated at 1 Hz for 20 minutes and at 0.2 Hz for another 5 minutes. Dofetilide
      increased APD at 90% repolarization (APD90) at 1 Hz by 83% (rabbit), 24% (guinea
      pig), 65% (dogs), 18% (swine), 61% (goat), and 30% (sheep), and prolonged APD90
      at 0.2 Hz by 187% (rabbit), 31% (guinea pig), 154% (dog), 17% (swine), 61%
      (goat), and 8% (sheep). Similarly, quinidine changed APD90 by 93% (rabbit), 0%
      (guinea pig), 16% (dog), -3% (swine), 0% (goat), and -24% (sheep) at 1 Hz, and by
      124% (rabbit), 15% (guinea pig), 53% (dog), 17% (swine), 11% (goat), and -39%
      (sheep) at 0.2 Hz in PF. During superfusion of dofetilide or quinidine, EADs
      occurred in most preparations in rabbit PFs at 0.2 Hz, but not in any of the PFs
      from other species at 0.2 Hz. CONCLUSION: Our study demonstrates that species
      plays an important role in the response of PF to drug-induced prolongation of APD
      and EADs. Rabbit PFs constitute the most sensitive model for detecting drug
      induced, potential long APD and proarrhythmogenic effects in vitro.

PMID- 11204094
TI  - Homophone effects in lexical decision.
AB  - The role of phonology in word recognition was investigated in 6 lexical-decision
      experiments involving homophones (e.g., MAID-MADE). The authors' goal was to
      determine whether homophone effects arise in the lexical-decision task and, if
      so, in what situations they arise, with a specific focus on the question of
      whether the presence of pseudohomophone foils (e.g., BRANE) causes homophone
      effects to be eliminated because of strategic deemphasis of phonological
      processing. All 6 experiments showed significant homophone effects, which were
      not eliminated by the presence of pseudohomophone foils. The authors propose that
      homophone effects in lexical decision are due to the nature of feedback from
      phonology to orthography.

PMID- 11204095
TI  - The discrepancy-attribution hypothesis: II. Expectation, uncertainty, surprise,
      and feelings of familiarity.
AB  - In the accompanying article (B. W. A. Whittlesea & L. D. Williams, 2001),
      surprising violation of an expectation was observed to cause an illusion of
      familiarity. The authors interpreted that evidence as support for the discrepancy
      attribution hypothesis. This article extended the scope of that hypothesis,
      investigating the consequences of surprising validation of expectations. Subjects
      were shown recognition probes as completions of sentence stems. Their
      expectations were manipulated by presenting predictive, nonpredictive, and
      inconsistent stems. Predictive stems caused an illusion of familiarity, but only
      when the subjects also experienced uncertainty about the outcome. That is, as
      predicted by the discrepancy-attribution hypothesis, feelings of familiarity
      occurred only when processing of a recognition target caused surprise. The
      article provides a discussion of the ways in which a perception of discrepancy
      can come about, as well as the origin and nature of unconscious expectations.

PMID- 11204096
TI  - Telling stories: the perils and promise of using verbal reports to study math
      strategies.
AB  - The problem size effect in adult arithmetic performance is generally attributed
      to direct retrieval processes operating on a network representation in long-term
      memory. J. LeFevre and her colleagues (J. LeFevre, J. Bisanz, et al., 1996; J.
      LeFevre, G. S. Sadesky, & J. Bisanz, 1996) challenged this explanation using
      verbal report evidence that adults also use time consuming nonretrieval
      strategies to solve simple addition and multiplication. The authors replicated J.
      LeFevre and colleagues' methods, but added instructional biasing and silent
      control conditions to test these methods. Both reaction time and report results
      suggest that LeFevre and colleagues' conclusions about nonretrieval frequency may
      have been influenced by instructions that revealed the experimental hypothesis
      and affected participants' strategy reports. Obtaining evidence about adult
      strategy use in simple arithmetic will require understanding instructional demand
      and appropriate report methodology.

PMID- 11204097
TI  - Information processing and insight: a process model of performance on the nine
      dot and related problems.
AB  - The 9-dot problem is widely regarded as a difficult insight problem. The authors
      present a detailed information-processing model to explain its difficulty, based
      on maximization and progress-monitoring heuristics with lookahead. In Experiments
      1 and 2, the model predicted performance for the 9-dot and related problems.
      Experiment 3 supported an extension of the model that accounts for insightful
      moves. Experiments 4 and 5 provided a critical test of model predictions versus
      those of previous accounts. On the basis of these findings, the authors claim
      that insight problem solving can be modeled within a means-ends analysis
      framework. Maximization and progress-monitoring heuristics are the source of
      problem difficulty, but also create the conditions necessary for insightful moves
      to be sought. Furthermore, they promote the discovery and retention of promising
      states that meet the progress-monitoring criterion and attenuate the problem
      space.

PMID- 11204098
TI  - Meaning and modality: influences of context, semantic memory organization, and
      perceptual predictability on picture processing.
AB  - Using event-related potentials (ERPs), the authors investigated the influences of
      sentence context, semantic memory organization, and perceptual predictability on
      picture processing. Participants read pairs of highly or weakly constraining
      sentences that ended with (a) the expected item, (b) an unexpected item from the
      expected semantic category, or (c) an unexpected item from an unexpected
      category. Pictures were unfamiliar in Experiment 1 but preexposed in Experiment
      2. ERPs to pictures reflected both contextual fit and memory organization, as do
      ERPs to words in the same contexts (K. D. Federmeier & M. Kutas, 1999). However,
      different response patterns were observed to pictures than to words. Some of
      these arose from perceptual predictability differences, whereas others seem to
      reflect true modality-based differences in semantic feature activation. Although
      words and pictures may share semantic memory, the authors' results show that
      semantic processing is not amodal.

PMID- 11204099
TI  - Learning new word meanings from context: a study of eye movements.
AB  - This study examined how readers establish the meaning of a new word from the
      sentence context during silent reading. Readers' eye movements were monitored
      while they read pairs of sentences containing a target word, context, and a word
      related to the target word. The target word varied in familiarity (high, low, or
      novel). The context varied in informativeness about the meaning of the target
      word (informative or neutral). The amount of time readers spent on the context
      depended on both the familiarity of the target word and the informativeness of
      the context. Readers spent additional time on the related word only when the
      context was neutral and the target was novel. These results indicate that readers
      were able to determine which areas of text were relevant and used the information
      to infer a meaning for the novel word.

PMID- 11204100
TI  - Relation and lexical priming during the interpretation of noun-noun combinations.
AB  - This research indicates that recent exposure to a similar combination (e.g., oil
      moisturizer or surgery treatment) influences the processing of a subsequent
      combination (e.g., oil treatment) by increasing the availability of the lexical
      entries for the modifier and head noun, and by altering the availability of the
      relation used to link the two nouns. The amount of lexical and relational priming
      obtained depends on whether the modifier or head noun is in common between the
      prime and target. The head noun prime yields more lexical priming than does the
      modifier prime and this finding suggests that the head noun is more strongly
      activated than the modifier. In contrast, relation priming is obtained only from
      the modifier prime and this finding is consistent with the CARIN theory (C. L.
      Gagne & E. J. Shoben, 1997) but inconsistent with schema-based theories of
      conceptual combination (e.g., G. L. Murphy, 1988; E. J. Wisniewski, 1996).

PMID- 11204101
TI  - Testing two theories of conceptual combination: alignment versus diagnosticity in
      the comprehension and production of combined concepts.
AB  - People often interpret novel noun-noun combinations by transferring a property
      from one constituent concept of the combination to the other. Two theories make
      different predictions about these "property" interpretations. Dual-process theory
      predicts that properties transferred will be alignable differences of the
      concepts being combined. Constraint theory predicts that properties transferred
      will be diagnostic properties of the concepts in which they originate. An
      experimental study tested these contrasting predictions in interpretation
      comprehension and interpretation production tasks. The results showed that
      participants reliably preferred diagnostic property interpretations, whether
      alignable or nonalignable, in both tasks. There was no reliable preference for
      alignable interpretations in either task. This confirms constraint theory's
      predictions about property interpretations and goes against the predictions of
      dual-process theory.

PMID- 11204102
TI  - On the necessity of alignment: reply to Costello and Keane (2001).
AB  - In their article, "Testing two theories of conceptual combination: Alignment
      versus diagnosticity in the comprehension and production of combined concepts,"
      F. J. Costello and M. T. Keane (2001) evaluate the role of alignment in the
      interpretation of noun-noun combinations. They found that participants were not
      strongly biased to prefer and produce interpretations with alignable differences.
      Instead, participants sometimes preferred and produced interpretations with
      nonalignable differences. These results are surprising given that most research
      has found advantages of alignable differences over nonalignable differences.
      Costello and Keane also found that feature diagnosticity better predicted their
      results, and they concluded that alignment does not play an important role in
      conceptual combination. However, drawing on recent work, the author of the
      present article gives an alternative interpretation of Costello and Keane's
      results, showing that alignment is crucial in conceptual combination. The author
      also shows that the dual-process model accounts for their results.

PMID- 11204103
TI  - Entropy and variability discrimination.
AB  - Two experiments examined college students' discrimination of complex visual
      displays that involved different degrees of variability or "entropy." Displays
      depicted 16 black and white line drawings of various types (e.g., a brain, a
      clock, a hand); the participants were required to classify a display in terms of
      its variability (e.g., a low-variability display contains many identical items,
      whereas a high-variability display contains few identical items). The
      participants' accuracy and reaction time scores on a 2-alternative forced-choice
      discrimination disclosed that people can and do use entropy to classify different
      levels of visual display variability. Individuals differed in their use of
      absolute rather than relative entropy.

PMID- 11204104
TI  - Representational momentum and Michotte's (1946/1963) "launching effect" paradigm.
AB  - In A. Michotte's (1946/1963) launching effect, a moving launcher contacts a
      stationary target, and then the launcher becomes stationary and the target begins
      to move. In this experiment, observers viewed modifications of a launching effect
      display, and displacement in memory for the location of targets was measured.
      Forward displacement of targets in launching effect displays was decreased
      relative to that of targets (a) that were presented in isolation and either moved
      at a constant fast or slow velocity or decelerated or (b) that moved in a
      direction orthogonal to previous motion of the launcher. Possible explanations
      involving a deceleration of motion or landmark attraction effects were ruled out.
      Displacement patterns were consistent with naive impetus theory and the
      hypothesis that observers believed impetus from the launcher was imparted to the
      target and then dissipated.

PMID- 11204105
TI  - The discrepancy-attribution hypothesis: I. The heuristic basis of feelings of
      familiarity.
AB  - B. W. A. Whittlesea and L. D. Williams (1998, 2000) proposed the discrepancy
      attribution hypothesis to explain the source of feelings of familiarity. By that
      hypothesis, people chronically evaluate the coherence of their processing. When
      the quality of processing is perceived as being discrepant from that which could
      be expected, people engage in an attributional process; the feeling of
      familiarity occurs when perceived discrepancy is attributed to prior experience.
      In the present article, the authors provide convergent evidence for that
      hypothesis and show that it can also explain feelings of familiarity for
      nonlinguistic stimuli. They demonstrate that the perception of discrepancy is not
      automatic but instead depends critically on the attitude that people adopt toward
      their processing, given the task and context. The connection between the
      discrepancy-attribution hypothesis and the "revelation effect" is also explored
      (e.g., D. L. Westerman & R. L. Greene, 1996).

PMID- 11204106
TI  - The combined contributions of the cue-familiarity and accessibility heuristics to
      feelings of knowing.
AB  - A model for the basis of feeling of knowing (FOK) is proposed, which combines 2
      apparently competing accounts, cue familiarity (L. M. Reder, 1987), and
      accessibility (A. Koriat, 1993). Both cue familiarity and accessibility are
      assumed to contribute asynchronously to FOK, but whereas the effects of
      familiarity occur early, those of accessibility occur later and only when cue
      familiarity is sufficiently high to drive the interrogation of memory for
      potential answers. General information questions were used to orthogonally
      manipulate cue familiarity and accessibility. As expected, both familiarity and
      accessibility enhanced FOK judgments, but the effects of accessibility were found
      mostly when familiarity was high. This interactive pattern was replicated when
      FOK judgments were delayed but not when they were immediate. The results support
      the proposed cascaded model of FOK but also imply a differentiation between 2
      variants of the accessibility heuristic.

PMID- 11204107
TI  - von Restorff revisited: isolation, generation, and memory for order.
AB  - The effects of isolation and generation on memory for order were investigated in
      4 experiments. Experiments 1 and 2 examined the effect of isolation on order
      retention. Previous investigations in this area have yielded equivocal results.
      Experiments 1 and 2 revealed that isolation enhances memory for order: Isolated
      items were repositioned more accurately than comparable items in control lists.
      Experiments 3 and 4 investigated the effect of generation on order retention.
      These experiments revealed that generation can enhance, disrupt, or have no
      effect on memory for order, depending on the relative number of generated items
      appearing within a list. Implications of these results for general theoretical
      accounts of isolation effects in memory are discussed. A simplified version of
      the feature model (J. S. Nairne, 1990) is shown to provide a general account of
      isolation effects.

PMID- 11204108
TI  - Using temporal information to construct, update, and retrieve situation models of
      narratives.
AB  - Four experiments explored how readers use temporal information to construct and
      update situation models and retrieve them from memory. In Experiment 1, readers
      spontaneously constructed temporal and spatial situation models of single
      sentences. In Experiment 2, temporal inconsistencies caused problems in updating
      situation models similar to those observed previously for other dimensions of
      situation models. In Experiment 3, merely implied temporal order information was
      inferred from narratives, affecting comprehension of later sentences like
      explicitly stated order information. Moreover, inconsistent temporal order
      information prevented the creation and storage in memory of an integrated
      situation model. In Experiment 4, a temporal inconsistency increased processing
      time even if readers were unable to report the inconsistency. These results
      confirm the significance of the temporal dimension of situation models.

PMID- 11204109
TI  - Selecting one among many referents in spatial situation models.
AB  - Five experiments related anaphor resolution to a classic memory variable, namely,
      interference created by multiple uses of a given object-concept, and by spatial
      distance of the referent from the reader's focus of attention. Participants
      memorized a diagram of a building with rooms containing objects, and then read
      narratives describing characters' activities there. Reading was self-paced word
      by word. Accessibility was measured by readers' time to understand anaphoric
      sentences containing a definite noun phrase referring to an object in its room.
      Spatial distance between the object and the current focus of attention increased
      reading times for names of the object, the room, and sentence wrap-up. Multiple
      examples of a target-object increased its reading time only if they were
      scattered across different rooms. An associative model of memory retrieval during
      text comprehension was used to interpret the complex pattern of results.

PMID- 11204110
TI  - Proper-name processing: are proper names pure referencing expressions?
AB  - Theoretical models of proper-name processing have been primarily derived from
      studies of people's names; however, they are thought to generalize to all classes
      of proper name. Five experiments are reported that use repetition priming to
      compare different classes of proper names. It was found that for people's names
      and landmark names, (a) production of a name in response to seeing a picture
      primed a subsequent familiarity decision to the same item's written name and (b)
      similarly, making a familiarity decision to an auditory presentation of a name
      primed a familiarity decision to the same item's written name. No comparable
      facilitation was found for the country-name stimuli. The presence of this
      specific facilitation was attributed to the nature of connectivity between
      conceptual and lexical representations. Theoretical views that proper names are
      unique, meaningless labels and that they are pure referencing expressions are
      evaluated.

PMID- 11204111
TI  - Estimation of electron absorbed fractions in the extrathoracic airways.
AB  - Dose calculations using the respiratory tract model presented in Publication 66
      of the International Commission on Radiological Protection (ICRP) frequently
      predict that the basal cells of the anterior portion of the nose, the
      extrathoracic region ET1 of the model, are the most highly irradiated tissue of
      the body. The dose to the basal cells is averaged over a layer of tissue 10
      microm thick located at a depth of 40 microm into the airway. Reported here are
      the results of a series of absorbed fraction calculations undertaken to compare
      with values tabulated in ICRP Publication 66. The Monte Carlo code MCNP4B and the
      geometric model of the ET1 region specified in Publication 66 were used in the
      calculations. Although some calculated differences are evident between the two
      sets of absorbed fractions, typically less than 20%, the calculations confirm
      that the electron absorbed fractions tabulated in Publication 66 are not
      responsible for the high estimates of the ET1 dose.

PMID- 11204112
TI  - The measurement of radiation levels in Australian zircon milling plants.
AB  - The processing of zircon often involves grinding it to a fine powder known as
      zircon flour. As the resulting particles are small they may be inhaled if they
      become airborne and, since they contain some uranium and thorium, deliver
      radiation doses to workers. Theoretical estimates and measured radiation exposure
      in Australian zircon milling plants are reported in this paper. Theoretical
      doses, calculated in this work, indicate a potential maximum dose to workers of
      5.5 mSv y(-1). Measured doses, based on normal work practices, vary in different
      plants from 0.66 mSv to 1.03 mSv y(-1) and suggest that in the dustiest
      Australian zircon milling plants the maximum dose would be of the order of 1 mSv
      y(-1). Measurements, which focused on the dustiest operations, indicate an upper
      limit of dose of about 3 mSv y(-1). Based on the theoretical and measured doses
      not exceeding 6 mSv y(-1), workers would not be designated as Category A workers,
      and probably would not be designated Category B workers, exceeding 1 mSv y(-1),
      under the guidelines of a EURATOM Directive.

PMID- 11204113
TI  - Natural radioactivity in the soil samples of Coastal Karnataka of South India.
AB  - Studies on radiation level and radionuclide distribution in the region of Coastal
      Karnataka, India, were undertaken. The purpose of this study is to provide
      baseline data on radiation level and radionuclide distribution in the region for
      the future assessment of the impact of the nuclear and thermal power stations
      that are being set up in the region. Further, this study may reveal information
      on the transportation of radionuclides in the environment. The external gamma
      dose rates in air have been measured throughout Coastal Karnataka using a
      sensitive plastic scintillometer. The measured dose rates include both
      terrestrial and cosmic ray components. The gamma dose rates in air range from 26
      to 174 nGy h(-1) with a median value of 74 nGy h(-1). The activities of naturally
      occurring radionuclides in the soil samples of the region were measured using
      HPGe gamma ray spectrometry, and the resulting doses in air were calculated. The
      activity of 40K varies from 61.0 to 316.7 Bq kg(-1) with a median of 117.5 Bq kg(
      1); the activity of 226Ra varies from 20.1 to 62.3 Bq kg(-1) with a median value
      35.0 Bq kg(-1) and that of 232Th from 14.3 to 48.6 Bq kg(-1) with a median value
      of 29.8 Bq kg(-1). The mean absorbed dose rate in air due to naturally occurring
      radionuclides is found to be 41.5 nGy h(-1). In addition to this, the
      correlations between 226Ra and 40K, 232Th and 40K, and 226Ra and 232Th were
      computed from the results of the concentration of these naturally occurring
      radionuclides. A weak correlation was observed between 226Ra and 40K and between
      232Th and 40K while a moderately good correlation was observed between 226Ra and
      232Th. The results of these systematic investigations are presented and discussed
      in this paper.

PMID- 11204114
TI  - A dosimetric model for determining the effectiveness of soil covers for
      phosphogypsum waste piles.
AB  - Phosphogypsum (PG) is a by-product of the phosphoric acid production process that
      contains high concentrations of U-series radionuclides. PG piles formed during
      the last 30 years cover about 1,200 hectares and are located close to the town of
      Huelva (Spain) on a salt-marsh. The regional government of Andalusia restored the
      area beginning in 1990 by covering it with a 25-cm-thick layer of natural soil.
      With this restoration, the external gamma-dose rate in the zone has decreased
      drastically, approaching near environmental background values. This conclusion is
      based on results obtained through in-situ monitoring measurements and through a
      dosimetric model developed for that particular radiation source. As the model
      uses average parameters of the studied site, its output does not show a
      correlation point by point with the in-situ monitoring measurements. However, a
      good agreement is observed in average values over the covered piles. The model
      gives an average dose rate of 0.41 mGy y(-1) and the in situ monitoring 0.40 mGy
      y(-1). Based on this model, it is possible to calculate the necessary thickness
      of soil to reduce the dosimetric contribution from a similar extension of PG
      until the desired level is reached. In our conditions, in a 25-cm-thick soil,
      about 0.19 mGy y(-1) is the increase produced by the PG layer in relation to an
      infinitum soil layer. Consequently, no radiological concern exists in the
      restored zones with respect to the external gamma radiation.

PMID- 11204115
TI  - Depth dose-equivalent and effective energies of photoneutrons generated by 6-18
      MV X-ray beams for radiotherapy.
AB  - Photoneutron production was investigated on Siemens KD 2 and Varian Clinac
      accelerators operating in the 6-18 MV range. Neutron dose equivalent rates were
      measured on the surface of a water phantom at the isocenter of the accelerators
      and also inside the phantom at depths of 1, 5, and 10 cm and off-axis distances
      of 0, 20, and 50 cm. Superheated drop detectors based on dichlorofluoromethane
      and etched-track detectors with boronated converters were employed in this study.
      The energy response of these detectors permits a direct measurement of dose
      equivalent without prior knowledge of the neutron energy spectra. Dose equivalent
      rates were assessed using the Q(L) relationship from ICRP publication 60, as well
      as using earlier data from ICRP publication 21. This permitted both a comparison
      with previously published data and an assessment of the impact of the recent ICRP
      recommendations--which were found to increase the dose equivalent levels by about
      30%. In addition, the depth corresponding to 50% of maximum dose equivalent,
      dH50, was determined along the central axis of the beams and at 50 cm off-axis.
      Monte Carlo neutron transport calculations were performed to determine the depth
      dose equivalent distributions in a phantom irradiated with monoenergetic
      neutrons. Effective energies of the photoneutron spectra were then estimated by
      comparing our measured dH50 values to those calculated for monoenergetic
      neutrons. It was found that the effective photoneutron energy is 1.8-2.1 MeV
      within the 10-18 MV x-ray beams, and it is 0.5-0.8 MeV for photoneutrons
      transmitted through the accelerator head. Data from this work cover most of the x
      ray beam energies in clinical use and permit an assessment of integral dose
      values as well as specific organ doses to a radiotherapy patient.

PMID- 11204116
TI  - Epithelial damage thresholds for multiple-pulse exposures to 80 ns pulses of CO2
      laser radiation.
AB  - Corneal epithelial damage thresholds for exposures to 80 ns pulses of 10.6 microm
      infrared radiation produced by a CO2-TEA laser were investigated. Thresholds were
      determined for sequences of 1, 2, 8, 32, 128, and 1,024 pulses at pulse
      repetition frequencies of 10 and 16 Hz. Threshold damage is correlated by an
      empirical power law of the form EDth = CN(-alpha) in which EDth, is the threshold
      radiant exposure per pulse, and N is the number of pulses. The constants C and
      alpha are similar for the two pulse repetition frequencies. For the combined data
      set, C = 2,955 J m(-2) pulse(-1) (295.5 mJ cm(-2) pulse(-1) and alpha = 0.178.
      This value of the constant C is within 5% of the measured damage threshold for a
      single 80 ns pulse exposure. Temperature calculations reveal that the maximum
      temperature increase on the beam axis, 10 microm beneath the anterior tear
      surface, resulting from the different threshold exposures is constant to within
      +/-10% of the mean values. This result is consistent with a critical temperature
      damage model. Damage threshold measurements on cooled corneas indicate that the
      damage mechanism indeed has a substantial thermal component.

PMID- 11204118
TI  - Evaluation of scatter contribution from shielding materials used in scatter
      measurements for calibration range characterization.
AB  - The contribution of scatter from the shielding material used in scatter
      measurements at the Ohio Emergency Management Agency was evaluated. This was
      accomplished by comparing physical measurements with results generated by
      detectors modeled in the Monte Carlo shielding code, MCNP4B. The high purity
      germanium (HPGe) detector model was improved by using radiographs to more
      accurately represent the detector geometry, including a model of the lithium
      contact transition region, and considering the effects of the non-uniform
      electric field in the germanium crystal. Photons scattered from the shielding
      material were found to contribute 4.25% of the total scatter recorded by the HPGe
      detector (thus contributing only 0.26% of the total dose) at a point 5 m from a
      1.35 GBq (36.4 mCi) 137Cs source.

PMID- 11204117
TI  - Monitoring methods and dose assessment for internal exposures involving mixed
      fission and activation products containing actinides.
AB  - Internal dose assessment for intakes of radionuclide mixtures is a difficult
      task. When the radionuclide mixture contains both the easy to detect gamma
      emitters, e.g., 60Co and 95Zr, and difficult to detect alpha emitters such as
      239Pu and 241Am, a single monitoring method, such as in-vivo counting, is
      inadequate for detection and dose assessment. Recent experience with task related
      monitoring for such radionuclide mixtures at Ontario Power Generation CANDU
      nuclear power plants has offered an opportunity to review this topic and suggest
      a strategy for monitoring that involves a combination of in-vivo and in-vitro
      methods. Using the radionuclide composition data in a mixture from an actual case
      as an example, this paper describes a monitoring strategy for mixed fission and
      activation products, including the advantages and pitfalls of reliance on
      surrogate radionuclides for signaling the presence of actinides in the mixture.
      The described monitoring strategy is consistent with the recommendations of ICRP
      Publication 78, which advocates a "combination of techniques so as to make the
      best possible evaluation of an unusual situation, for example, a programme of
      both body activity and excreta measurements." The use of experience and
      professional judgement for interpreting the combined in-vivo and in-vitro data
      for interim and ultimate intake and dose assessment is discussed and emphasized.

PMID- 11204119
TI  - Absorbed dose to the adult male and female brain from 18F-fluorodeoxyglucose.
AB  - The absorbed doses to adult male and female brains from 18F-fluorodeoxyglucose
      were investigated. A total of eight male and six female patients undergoing
      clinical positron tomography brain scans were included in this study. This
      patient population allowed for a comparison of the absorbed dose to the brain in
      men and women. For each patient, time-activity curves for the brain were
      generated, yielding cumulated activity measurements for the entire organ. From
      these cumulated activities the average residence times for both male and female
      subjects were calculated and then multiplied by the S-values from the MIRDOSE 3.1
      software program for absorbed dose estimates. The average absorbed dose per
      administered activity to the adult male brain was found to be 4.2 x 10(-2) mGy
      MBq(-1), which is lower than that found for the adult female brain of 5.3 x 10(
      2) mGy MBq(-1). Six of the male and all six female subjects were each studied on
      two separate occasions, allowing for an analysis of within-subject variability.
      The average variation in the self-dose for all 12 patients was found to be within
      14%, suggesting that in most cases this method of obtaining a single dose
      estimate is precise.

PMID- 11204120
TI  - Radiological findings of accidental radiation injury of the fingers: a case
      report.
AB  - This case report describes the medical follow-up of a 46-y-old (at the time of
      exposure) man who in 1971 accidentally exposed the fingers of his right hand to
      gamma-ray radiation from an iridium source that was used for nondestructive
      testing [estimated radiation dose: 26 Gy to 90 Gy (2,600 rad to 9,000 rad)]. No
      prominent acute injury was detected except for leukocytopenia (800 mm(-3)) and
      thrombocytopenia (15,000 mm(-3)). Three years later, the first, second, and third
      fingers presented repeated infection and started to develop contracture. Twenty
      two years after exposure, he underwent amputation of the first and second
      fingers, and a toe graft was done. Radiological examinations prior to and
      following the operation revealed atrophic change of the finger bones and arterial
      injuries. Angiographic findings coincided with the region and extent of radiation
      injury of the fingers, which indicates that arterial damage is involved in the
      development of this chronic disorder.

PMID- 11204121
TI  - Individual biodosimetry at the natural radiation background level.
AB  - The present note describes new advancements to a valued tool in retrospective
      biodosimetry that lower the threshold of detection of radiation dose to 29 mGy.
      The advanced method is based on the electron paramagnetic resonance measurements
      of stable radiation-induced radicals in tooth enamel. Earlier this method had
      been used only for reconstruction of high radiation doses obtained accidentally.
      New opportunity of reconstruction of doses lower than 100 mGy opens a new realm
      of possibilities for assessing the health effects of ionizing radiation at the
      natural radiation background level.

PMID- 11204122
TI  - Chest wall thickness measurements and the dosimetric implications for male
      workers in the uranium industry.
AB  - The Human Monitoring Laboratory has measured the chest wall thickness and adipose
      mass fraction of a group of workers at a Canadian uranium refinery, a conversion
      plant, and a fuel fabrication site using ultrasound. A site-specific biometric
      equation has been developed for these workers, who seem to be somewhat larger
      than other workers reported in the literature. Chest wall thickness is a very
      important modifier on lung counting efficiency and these data have been put into
      the perspective of the impending Canadian dose limits that will reduce the limit
      of occupationally exposed workers to 100 mSv in a 5-y period with a maximum of 50
      mSv in any one year. The sensitivity of the germanium and phoswich based lung
      counting systems have been compared. Over a range of chest wall thickness of 1.6
      cm to 6.0 cm and using a 30-min counting time, the achievable MDA's lie in the
      range of 6.7 mg to 19.1 mg or 6.7 mg to 30 mg with a two-phoswich-detector array
      or a germanium lung counting system, respectively. Depending on chest wall
      thickness, these achievable MDA's are close to, or exceed, the predicted amounts
      of natural uranium that will remain in the lung (absorption type M and S) after
      an intake equivalent to the Annual Limit on Intake that corresponds to 20 mSv.
      Neither system is sufficiently sensitive to detect an intake of Type S natural
      uranium in a worker with a chest wall thickness that corresponds to the average
      (3.73 cm) if it occurred more than 7 d prior to the lung count.

PMID- 11204123
TI  - Radiation from medical procedures: corrections to a consequential book review.

PMID- 11204124
TI  - Specific activity concept.

PMID- 11204125
TI  - The evolution of Candida species and fluconazole susceptibility among oral and
      vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive
      and at-risk HIV-seronegative women.
AB  - Antifungal agents can effectively treat mucosal candidiasis; however, their use
      can lead to colonization with less susceptible species and to resistance among
      normally susceptible strains. Oral and vaginal Candida isolates obtained at 3
      points over 2 years from human immunodeficiency virus (HIV)-seropositive and at
      risk HIV-seronegative women were identified by species and were evaluated for in
      vitro fluconazole susceptibility. Prevalence of non-C. albicans strains increased
      over time, and these strains were more likely among women reporting current
      antifungal use. Among C. albicans isolates, resistance was rare, with no evidence
      for progressive reduction in susceptibility over time. Among non-C. albicans
      isolates, reduced susceptibility occurred frequently and increased with time. HIV
      seropositive women were more likely to have non-C. albicans isolates with reduced
      susceptibility as were women reporting current antifungal use. This evolution and
      section of mucosa-colonizing Candida species with reduced susceptibility could
      play a critical early role in the development of antifungal resistance among C.
      albicans isolates responsible for refractory candidiasis.

PMID- 11204126
TI  - Virus neutralizing antibodies against a panel of 18 BVDV isolates in calves
      vaccinated with Rispoval RS-BVD.
AB  - Seven of nine colostrum-deprived calves, free from infection with bovine virus
      diarrhoea virus (BVDV), were vaccinated with Rispoval RS-BVD on two occasions, 21
      days apart, while the other two were kept as BVDV infection controls. The virus
      neutralizing (VN) serum antibodies induced by vaccination were tested for their
      ability to neutralize 18 European BVDV isolates, including laboratory reference
      strains and recent field isolates, both cytopathic and non-cytopathic biotypes as
      well as genotypes I and II. The strains were isolated in Belgium, France, Germany
      and the United Kingdom. While there were large variations in the vaccine-induced
      VN titres of the individual calves against all the strains, e.g. the titres
      against Osloss NCP, the European reference strain ranged from 1.7 to 6.7
      (1:log2), serum from each animal was capable of neutralizing between nine and all
      18 of the strains tested. Nevertheless, from the results of this study, it can be
      concluded that in colostrum-deprived BVDV seronegative calves, Rispoval RS-BVD
      can stimulate the production of VN antibodies capable of neutralizing a wide
      range of antigenically diverse European isolates of BVDV, including genotypes I
      and II.

PMID- 11204127
TI  - Relationship between the amounts of antibodies to Actinobacillus pleuropneumoniae
      serotype 2 detected in blood serum and in fluids collected from muscles of pigs.
AB  - An indirect ELISA method, previously used to detect antibodies to Actinobacillus
      pleuropneumoniae serotype 2 in serum of pigs, was further developed aiming to
      measure antibodies to the microbe in muscle fluids. Serum and muscle fluid were
      collected from Specific Pathogen Free (SPF) pigs as well as from SPF pigs
      challenged with A. pleuropneumoniae which were either treated with effective
      antibiotics or left as infected controls. The antibody responses measured in
      serum correlated well to the clinical signs of respiratory disease observed and
      to pathological lesions found at necropsy performed 17 days post-infection. The
      amounts of antibodies monitored in serum and in muscle fluid collected from the
      diaphragm and the thigh, respectively, were compared. Higher concentrations of
      antibodies were assessed in serum than in diaphragm fluid, which in turn
      contained more antibodies per ml than fluid collected from the thigh. The amount
      of antibodies to A. pleuropneumoniae measured in fluid from the diaphragm diluted
      1/50 correlated well with the quantity measured in serum diluted 1/1000 (r2 =
      0.87; P < 0.001). When validated by using serum antibody responses as a standard,
      the specificity of the ELISA employed in fluid from the diaphragm was found to be
      100%. The sensitivity was determined to be 88% when calculated on seropositive
      pigs (A450 = 0.3 in serum diluted 1/1000). That figure increased to 97% if
      calculated on pigs expressing pronounced amounts of serum antibodies (A450 > or =
      0.5).

PMID- 11204128
TI  - Epidemiology of ovine Campylobacter infection determined by numerical analysis of
      electrophoretic protein profiles.
AB  - The relationship of 50 Campylobacter strains isolated from aborted ovine
      foetuses, and the faeces of sheep, cattle and chickens were determined by
      numerical analysis of electrophoretic (SDS-PAGE) protein profiles. Comparison of
      protein patterns by numerical methods revealed differences between C. fetus ssp.
      fetus, C. jejuni, and C. coli strains as well as heterogeneity among isolates
      from different outbreaks. Isolates from each farm produced a distinct cluster and
      flocks from different locations were found to be infected with relatively
      different strains. In most cases, protein patterns of ovine foetal isolates were
      very similar to those of ovine faecal isolates. Ovine isolates of C. fetus ssp.
      fetus, C. jejuni and C. coli gave similar protein patterns to the corresponding
      Campylobacter species isolated from cattle or chicken, on the same farm. Thus, it
      was concluded that certain protein types of ovine Campylobacter strains were more
      likely associated with local areas, and Campylobacter strains causing ovine
      abortions are distributed in the environment more widely than assumed to date.

PMID- 11204129
TI  - Effect of long-term oral administration of an immunostimulant diet on innate
      immunity in sea bass (Dicentrarchus labrax).
AB  - Immunostimulants represent a modern and promising tool in aquaculture, enhancing
      the resistance of cultured fish to disease and stress. This study investigated
      the effect of a combination of dietary glucans, alpha-tocopherol and ascorbic
      acid on the innate immune response of cultured sea bass (Dicentrarchus labrax).
      After 5 weeks of adaptation on a commercial diet containing 100 p.p.m. ascorbic
      acid and 200 p.p.m. alpha-tocopherol, sea bass were switched to a diet
      supplemented with 2% beta-1.3/beta-1.6 glucans and ascorbic acid and alpha
      tocopherol at 500 p.p.m. The supplemented diet was given at 2% of body weight per
      day over a 2-week period, every 3 months. Plasma lysozyme concentration, content
      and distribution of major plasma proteins and complement activity were measured
      prior to feeding the supplemented diet and after 40 weeks. Alternative pathways
      of complement activation and lysozyme activity were both significantly enhanced
      in fish fed on glucans and elevated doses of vitamins. No significant differences
      were observed in protein content or in albumin/globulin ratio. Compared to
      lysozyme activity, which showed marked individual variation, complement-mediated
      haemolytic activity has been shown to be a more reliable indicator of sea bass
      immunocompetence. Further studies are in progress to clarify the effect of each
      dietary component on the innate immune response and disease resistance.

PMID- 11204130
TI  - A study of the ability of a TK-negative and gI/gE-negative pseudorabies virus
      (PRV) mutant inoculated by different routes to protect pigs against PRV
      infection.
AB  - The capacity of a TK-negative (TK-) and gI/gE-negative (gI/gE-) pseudorabies
      virus (PRV) mutant to protect pigs against Aujeszky's disease carried out by
      experimental infection with a virulent PRV strain, was tested. There were three
      groups, each of four susceptible pigs which were inoculated twice by two
      different schedules. Group 1 received the modified virus by the intradermal
      (first inoculation)-intramuscular (second inoculation) routes; group 2 was
      treated by the intranasal (first inoculation)-intramuscular (second inoculation)
      routes. The third group was left untreated as the control. All of the pigs were
      challenged intranasally with a virulent PRV strain and they were subsequently
      injected with dexamethasone. Two pigs in each group were necropsied on days 5 and
      15 after dexamethasone inoculation. The challenge exposure resulted in mild
      clinical signs, increase in growth and a shorter period of virus shedding in
      vaccinated pigs, whereas the control group showed severe signs of Aujeszky's
      disease. No difference in the titre of the virulent virus which was excreted by
      pigs of all three groups, was observed and all animals seroconverted. Both the
      mutant strain and the wild-type virus established a latent infection although
      only the latter was reactivated and shed. Slight lesions were observed in target
      tissues of the vaccinated animals and no significant differences were detected
      between the two inoculation schedules.

PMID- 11204131
TI  - Histopathological and immunohistochemical study of lambs experimentally infected
      with Fasciola hepatica and Schistosoma bovis.
AB  - The aim of this study was to investigate the cross-resistance between Fasciola
      hepatica and Schistosoma bovis in lambs assessing parasitologic, gross
      pathologic, histopathologic and immunohistochemical changes in liver and small
      intestine. Thirty Castellana breed lambs were divided into five comparable groups
      and exposed to F. hepatical S. bovis (group F/S), S. bovis/F. hepatica (group
      S/F), S. bovis (group S) or F. hepatica (group F) and six unexposed lambs were
      used as non-infected controls (group C). Primary patent infection with F.
      hepatica induced a lower number of schistosome eggs and a higher number of
      lymphocytes in intestinal and liver schistosome egg-induced granulomas in group
      F/S than in the groups S/F and S, liver damage being mainly attributed to F.
      hepatica. S. bovis infection followed by challenge with F. hepatica particularly
      increased the severity of the most significant liver alterations
      (cholangiohepatitis by F. hepatica and mesoendophlebitis by S. bovis) and F.
      hepatica seemed not to have an influence on established S. bovis infection. In
      addition, immunohistochemical results suggested that the predominant local immune
      response in both double-infected groups was different, being mainly a cell
      mediated immune response in group F/S and a mucosal response in group S/F.

PMID- 11204132
TI  - Apoptosis in feline panleukopenia and canine parvovirus enteritis.
AB  - Tissue samples of cats and dogs with panleukopenia and parvovirus enteritis,
      respectively, were examined for the presence of viral antigen-positive cells and
      apoptotic cells by immunohistochemistry and by TUNEL assay (Terminal Transferase
      Mediated dUTP Nick End Labelling). Compared to control animals, infected cats and
      dogs generally had more TUNEL-positive cells. Cell types positive for parvovirus
      antigen, for example digestive tract epithelial and mesenchymal cells, and
      lymphocytes and macrophages in lymphoid tissues were also positive for TUNEL
      signals. Occasionally, TUNEL signal and viral antigen were present in the same
      tissue areas, suggesting a direct viral trigger of apoptosis. More frequently,
      however, there was no complete overlap of antigen and TUNEL-positive areas. The
      results of this study indicate that apoptotic cell death contributes
      significantly to the widespread tissue damage of parvovirus infection in cats and
      dogs.

PMID- 11204133
TI  - Clostridium botulinum and bio-compost. A contribution to the analysis of
      potential health hazards caused by bio-waste recycling.
AB  - Bio-waste recycling and the production and use of bio-compost are politically
      encouraged in Europe. Quality control takes no consideration of pathogenic
      anaerobic spore formers, e.g. Clostridium botulinum. A protocol for health hazard
      analysis concerning this pathogen has been developed. Samples of marketed bio
      compost were tested and results showed that about 50% of the tested samples
      contained C. botulinum. For the first time it has been shown that the use of bio
      compost represents a health hazard to humans and animals, especially in the
      future when spores will have accumulated in the environment. The use of household
      bio-waste collected in 'bio-bins' is apparently one factor involved in the
      production of contaminated compost end-products. Environmental factors in the
      propagation of C. botulinum are discussed. The improvement of bio-waste recycling
      technology and management should be encouraged in order to minimize the health
      hazard caused by contaminated bio-compost.

PMID- 11204134
TI  - A serological survey on erysipelas in chickens by growth agglutination test.
AB  - From March to April 1992, 200 culled chickens sent to an abattoir in Tokyo, Japan
      were examined for the presence of growth agglutinating antibody in the serum. In
      the serological survey, 11 (5.5%) of 200 chicken sera had high growth
      agglutination titres against Erysipelothrix rhusiopathiae, ranging from 1:16 to
      1:128. These findings indicate a high rate of erysipelas infection among chickens
      in the field.

PMID- 11204135
TI  - Studies on oral health in mentally retarded adults.
AB  - During the last decades, a new policy involving normalisation, integration,
      equality and deinstitutionalisation of mentally retarded (MR) individuals has
      been accepted in Sweden. Consequently, many institutions have been closed and an
      increased number of people with MR are now integrated into the Swedish community.
      The general aim of this thesis was to investigate if a greater degree of
      independence for MR adults influenced the prevalence of oral diseases. MATERIAL
      AND METHODS: The caries incidence and prevalence, number of remaining teeth,
      incidence of tooth mortality and interproximal bone loss were investigated in a
      group of MR adults, aged 21-40 years, all with protracted, regular preventive
      dental care. The studied variables were related to living arrangements and degree
      of MR, and were followed during 8.5 years (Papers I, II and VI). Incidence and
      reasons for tooth mortality were studied during 10 years in institutionalised MR
      individuals (Paper III). In connection with the closing-down of an institution
      for MR adults, the changes of oral hygiene habits, sucrose intake and oral
      microbiological flora were studied in the new integrated living (Papers IV and
      V). RESULTS: Less restrictive living arrangements and mild forms of MR were
      correlated to a high caries prevalence in persons with MR. After 8.5 years, the
      caries incidence had decreased in all subjects, but persons with mild MR and
      those who lived integrated still had a higher caries prevalence than other MR
      adults. With the exception of subjects with Down syndrome, the interproximal bone
      loss during 8.5 years was similar or lower compared to normal Swedish
      populations. Institutionalised MR subjects had lost an average of 3.72 teeth
      during 10 years. Periodontitis was the main reason for tooth mortality. Persons
      who cooperated well with dental treatment and those who used neuroleptics lost
      fewer teeth during the 10-year period compared to other MR individuals. The
      proportion of subjects with high levels of mutans streptococci and subjects who
      showed growth of P. intermedia/P. nigrescens decreased after
      deinstitutionalisation, and less subjects consumed sucrose frequently. The oral
      hygiene routines, and the levels of lactobacilli, P. gingivalis and A.
      actinomycetemcomitans were not influenced by the change in living arrangements. A
      simplified saliva sampling method, involving licking directly on the bacteria
      culture, was developed to count lactobacilli in saliva when delivering whole
      saliva was impossible. CONCLUSIONS: Less restrictive living and a mild degree of
      MR were correlated to a high caries prevalence. Subjects with poor ability to
      cooperate with dental treatment and those with Down syndrome have an obvious risk
      of deteriorated oral health. However, compared to normal Swedish populations, the
      MR subjects studied in this thesis had, after several years of regular dental
      care, satisfactory oral health.

PMID- 11204136
TI  - From magic to science: a journey throughout Latin American medical mycology.
AB  - The start of Latin America's love story with fungi may be placed in pre-Hispanic
      times when the use of fungi in both ritual ceremonies and daily life were common
      to the native civilizations. But the medical mycology discipline in Latin America
      started at the end of the 19th Century. At that time, scholars such as A.
      Posadas, R. Seeber, A. Lutz and P. Almeida, discovered agents of fungal diseases,
      the study of which has influenced the regional research ever since. Heirs to them
      are the researchers that today thrive in regional Universities and Research
      Institutes. Two current initiatives improve cooperation among Latin American
      medical mycologists. First, the periodical organization of International
      Paracoccidioidomycosis Meetings (seven so far, from 1979 to 1999); second, the
      creation of the Latin American Association for Mycology in 1991 (three
      Congresses, from 1993 to 1999). Latin American publications have increased in
      international specialized journals such as that from our Society (ISHAM) (from 8%
      in 1967 to 19% in 1999), and the Iberoamerican Journal of Mycology (Revista
      Iberoamericana de Micologia; > 40% from 1997 to 1999). In addition, Latin
      American participation at ISHAM International Congresses has risen from 6.9% in
      1975 to 21.3% in 1997, and 43.2% at the 14th ISHAM Congress, held for the first
      time in a Latin American country, Argentina. A significant contribution of women
      to the scientific establishment of Latin American medical mycology (e.g., 45% of
      Latin American papers vs. 18% of other regions published in Journal of Medical
      and Veterinary Mycology in 1987, had women as authors or coauthors) suggests a
      better academic consideration of Latin American women against their counterparts
      in the developed world. Taken together, all these figures reflect the enthusiasm
      of our Latin American colleagues in the field, despite the difficulties that
      afflict our region, and affect our work.

PMID- 11204137
TI  - Pathogenesis II: fungal responses to host responses: interaction of host cells
      with fungi.
AB  - Most of our knowledge concerning the virulence determinants of pathogenic fungi
      comes from the infected host, mainly from animal models and more recently from in
      vitro studies with cell cultures. The fungi usually present intra- and/or
      extracellular host-parasite interfaces, with the parasitism phenomenon dependent
      on complementary surface molecules. Among living organisms, this has been
      characterized as a cohabitation event, where the fungus is able to recognize
      specific host tissues acting as an attractant, creating stable conditions for its
      survival. Several fungi pathogenic for humans and animals have evolved special
      strategies to deliver elements to their cellular targets that may be relevant to
      their pathogenicity. Most of these pathogens express surface factors that mediate
      binding to host cells either directly or indirectly, in the latter case binding
      to host adhesion components such as extracellular matrix (ECM) proteins, which
      act as 'interlinking' molecules. The entry of the pathogen into the host cell is
      initiated by fungal adherence to the cell surface, which generates an uptake
      signal that may induce its cytoplasmic internalization. Once this is
      accomplished, some fungi are able to alter the host cytoskeletal architecture, as
      manifested by a rearrangement of microtubule and microfilament proteins, and this
      can also induce epithelial host cells to become apoptotic. It is possible that
      fungal pathogens induce modulation of different host cell pathways in order to
      evade host defences and to foster their own proliferation. For a number of
      pathogens, the ability to bind ECM glycoproteins, the capability of
      internalization and the induction of apoptosis are considered important factors
      in virulence. Furthermore, specific recognition between fungal parasites and
      their host cell targets may be mediated by the interaction of carbohydrate
      binding proteins, e.g., lectins on the surface of one type of cell, probably a
      parasite, that combine with complementary sugars on the surface of host-cell.
      These interactions supply precise models to study putative adhesins and receptor
      containing molecules in the context of the fungus-host interface. The recognition
      of the host molecules by fungi such as Aspergillus fumigatus, Paracoccidioides
      brasiliensis and Histoplasma capsulatum, and their molecular mechanisms of
      adhesion and invasion, are reviewed in this paper.

PMID- 11204139
TI  - Conventional versus molecular diagnostic tests.
AB  - In this session, emphasis was placed on the diagnosis of various mycoses through
      the identification of antibodies and antigens in sera, as well as on new
      techniques to properly identify medically important fungi through molecular
      biological procedures. The use of restriction fragment length polymorphism (RFLP)
      on fungal mitochondrial DNA (mtDNA) has enabled the identification of different
      strains of Sporothrix schenkii, several dermatophytes, Candida spp. and black
      fungi according to their species-specific mtDNA-RFLP patterns. In some species,
      distinct specific types where found in relation to the geographic origin of the
      patients. These particular molecular diagnostic tests are useful in the
      identification of strains and in epidemiological studies. An account of the
      applications of serological methods in the diagnosis of paracoccidioidomycosis
      was presented. Serology has been used in the identification of
      paracoccidioidomycosis using a specific, sensitive and rapid antibody-based
      immunodiagnosis method. Using the gp43 antigen, the diagnostic coverage of
      inmunodifussion has been improved from the 93-95% achieved with crude antigens,
      to 100% in an enzyme-linked immunodiffusion assay capture test. Cross-reactions
      were eliminated by treatment of the antigen with sodium metaperiodate. Antibody
      detection is useful, especially in paracoccidioidomycosis and histoplasmosis.

PMID- 11204138
TI  - Candida albicans: adherence, signaling and virulence.
AB  - The focus of this symposium was to present new information on the morphogenesis
      of Candida albicans, particularly how it relates to signal transduction pathways
      and other genes involved in the regulation of morphogenesis. In addition, we
      discuss the role of adherence and colonization of the oral cavity by the organism
      and discuss the role of mannan as an adhesin that recognizes the human red blood
      cell. C. albicans utilizes at least two signal pathways to regulate its
      conversion from a yeast form to filamentous growth (hyphae). One of these two
      pathways is similar to the Saccharomyces cerevisiae pseudohyphal/mating pathway,
      which utilizes the regulatory protein, Cphlp. The other pathway is not totally
      defined but requires a second regulatory protein, referred to as Efg1p. Other
      signal pathways may exist, which include a two-component histidine kinase and
      response regulator proteins. The latter pathway(s) may include proteins such as
      Chk1p, Ssk1p, Shi1p and Cos1p/Nik1p. Mutations in strains, which specifically
      target these proteins, result in morphogenesis defects and avirulence or
      attenuation of strains. A growth regulatory gene has also been recently defined
      whose expression is associated with growth cessation and which appears to be a
      necessary prerequisite in conversion of the organism to a filamentous growth
      form. Starvation of yeast cells induces exponentially grown cells (and usually
      non-germinative) to germinate. This phenomenon is also observed in cells that are
      transiently treated with metabolic inhibitors. During each of these treatments
      (starvation, metabolic inhibition), expression of a growth regulatory gene (CGRI)
      increases. Adherence of C. albicans to host cells and tissues is complex; several
      proteins, which appear to have host recognition functions, have been defined. In
      the oral cavity, C. albicans selectively adheres to salivary proteins, which are
      absorbed to many oral surfaces. This mechanism enables the cells to colonize
      surfaces of the oral cavity. An understanding of these interactions may lead to
      strategies to prevent oral disease. Mannan from C. albicans may provide a host
      recognition function for C. albicans. Recent experiments indicate that mannan
      binds to human red blood cells and causes hemolysis. Binding of mannan to the
      band 3 protein of human red blood cells has been established. This activity may
      be associated with the ability of the organism to utilize hemoglobin (and iron).

PMID- 11204140
TI  - Non-culture based diagnostic tests for mycotic infections.
AB  - Non-culture methods being developed and evaluated for mycotic infections include
      polymerase chain reaction (PCR), galactomannan (GM) antigenemia, Western blot
      (WB) to detect antibodies, and detection of the fungal metabolites D-arabinitol
      and (1,3)-beta-D-glucan. Sample preparation for PCR from blood specimens depends
      on fractionation of peripheral blood, its pre-incubation in blood culture broth,
      or a total DNA method, which does not rely on fractionation, or pre-incubation.
      Targets for PCR of fungi in the 18S or ITS2 subunits of the ribosomal RNA genes
      facilitated the design of Aspergillus and Candida genus and species probes.
      Amplicons were identified using PCR-enzyme linked immunosorbent assay (ELISA) or
      reverse line-blot formats. A pilot study indicated that PCR tests on blood
      specimens were positive at least once in patients with confirmed invasive
      aspergillosis (IA). When serum-PCR and serum-GM tests were compared in IA
      patients, antigenemia was more often positive. PCR detected Aspergillus DNA in
      bronchoalveolar lavage specimens from patients at risk even when cultures were
      negative. D-Arabinitol can be detected as a marker of candidiasis with gas
      chromatography-mass spectrometry or enzyme dependent-fluorometry. Each method can
      differentiate the microbial D- and host L-enantiomers. (1,3)-beta-D-Glucan is
      produced by most genera of pathogenic fungi and can be detected in plasma by the
      'G-test'. In patients with febrile neutropenia the efficacy of azole therapy
      correlated with plasma (1,3)-beta-D-glucan concentrations of > or = 10 pg ml(-1).
      The diagnosis of early acute pulmonary histoplasmosis can be improved by a WB
      test utilizing deglycosylated M antigen, a 94-kDa glycoprotein. The identity of M
      antigen as a catalase was deduced from the sequence of the cloned gene. PCR
      identification of Histoplasma capsulatum cultures was accomplished with primer
      pairs selected from H and M antigen gene sequences.

PMID- 11204141
TI  - Clinical applications of non-culture based methods for the diagnosis and
      management of opportunistic and endemic mycoses.
AB  - Nonculture based methods for the detection of infections caused by fungal
      pathogens are becoming more important tools in the management of infected
      patients. Detection of fungal antigens and DNA appear to be the most promising in
      this respect for both opportunistic and endemic mycoses. In this article we
      present an overview of the most recent developments in nonculture based methods
      and examine their value in clinical practice.

PMID- 11204142
TI  - Toxigenic fungi: which are important?
AB  - Growth of commonly occurring filamentous fungi in foods may result in production
      of mycotoxins, which can cause a variety of ill effects in humans, from allergic
      responses to immunosuppression and cancer. According to experts, five kinds of
      mycotoxins are important in human health around the world: aflatoxins, ochratoxin
      A, fumonisins, certain trichothecenes, and zearalenone. These toxins are produced
      by only a few species of fungi, in a limited range of commodities. Aflatoxins are
      potent carcinogens, produced by Aspergillus flavus and A. parasiticus in peanuts,
      maize and some other nuts and oilseeds. Ochratoxin A is a kidney toxin and
      probable carcinogen. It is produced by Penicillium verrucosum in cereal grains in
      cold climates, by A. carbonarius in grapes, wines and vine fruits, and by A.
      ochraceus sometimes in coffee beans. Fumonisins, which may cause oesophageal
      cancer, are formed by Fusarium moniliforme and F. proliferatum, but only in
      maize. Trichothecenes are highly immunosuppressive and zearalenone causes
      oestrogenic effects; both are produced by F. graminearum and related species.
      Current reporting probably underestimates the effect of mycotoxins as a cause of
      human mortality.

PMID- 11204143
TI  - Epidemiology: surveillance of fungal infections.
AB  - Surveillance for fungal diseases is essential to improve our understanding of
      their epidemiology and to enable research and prevention efforts to be
      prioritized. In order to conduct better surveillance for fungal diseases, it is
      important to develop more accurate and timely diagnostic tests, to follow
      rigorous epidemiological methods and to have adequate support from public health
      agencies and the pharmaceutical industry. Investigations of nosocomial and
      community outbreaks of fungal infection have also resulted in a better
      understanding of the sources and routes of transmission of these diseases, and of
      the risk factors for infection. This has led to more effective prevention and
      control strategies. In addition, outbreak investigations have offered excellent
      opportunities to develop new molecular sub-typing methods, and to evaluate and
      validate older ones. For example, results obtained from a global epidemiological
      study of the genomic structure of Cryptococcus neoformans have led to a better
      understanding of the epidemiology of cryptococcosis. Similarly, a study of
      variations in the genotype of Trichophyton rubrum has found that patients may
      become infected with multiple strains, which has important implications for study
      design when looking at the epidemiology of dermatophyte infections.

PMID- 11204144
TI  - Epidemiology of tinea capitis.
AB  - This paper addresses the changing epidemiology of tinea capitis in the USA and in
      Europe that has occurred over the last several decades. Several dermatophytes are
      involved in the etiology, and the primary etiological agents of tinea capitis are
      limited to the genera Microsporum and Trichophyton. In addition, the sources of
      these infections are discussed and although geophilic dermatophytes occur
      worldwide, anthropophilic species and some zoophilic fungi may be geographically
      restricted, depending on host range. For example, tinea capitis due to geophilic
      organisms is rare in the USA.

PMID- 11204145
TI  - Molecular typing of pathogenic fungi.
AB  - In this Round Table, the application of several methods of molecular typing were
      discussed in reference to four important pathogenic fungi: Coccidioides immitis,
      Histoplasma capsulatum, Candida albicans and Paracoccidioides brasiliensis. Among
      the different methods the following were discussed: restriction fragment length
      polymorphisms (RFLP), single nucleotide polymorphisms, random amplified
      polymorphic DNA (RAPD), polymerase chain reaction (PCR)-RFLP and microsatellites.
      By means of these methods, several important biological questions related to
      speciation, mode of reproduction and population genetics could be approached. The
      basic information obtained from this approach has implications in the
      understanding of these pathogenic fungi in relation to their behavior and the
      development of pathogenic features, such as resistance to antimicrobials and
      virulence factors used for colonization of mammalian hosts. The knowledge
      obtained from these studies could also be used for the development of innovative
      diagnostic methods, as well as for novel therapeutic approaches and production of
      vaccines.

PMID- 11204146
TI  - Deep Candida infections in the neutropenic and non-neutropenic host: an ISHAM
      symposium.
AB  - A symposium was held on May 8, 2000 to discuss the management of deep infections
      with Candida species. Among the findings discussed were the following. Candiduria
      is most often benign, though it occurs in patients with serious underlying
      diseases. Candida species are now the fourth most common cause of nosocomial
      bloodstream infections, usually arising from an intravenous catheter. Candida
      albicans represents only 50-60% of the isolates. There has been no change in the
      frequency of fluconazole resistance in C. albicans but some of the other species
      now being isolated from blood are constitutively more resistant to this drug.
      Nevertheless, for most non-neutropenic patients with candidemia, fluconazole is a
      reasonable choice for initial therapy. In the neutropenic patient, candidemia is
      now uncommon. Deep candida infections in neutropenic patients are usually being
      treated empirically with an amphotericin B formulation. Hepatosplenic candidiasis
      is usually detected only after recovery from neutropenia but can be suspected by
      imaging techniques. Improved diagnostic techniques for deep candidiasis in the
      neutropenic patient remain a critical requirement.

PMID- 11204147
TI  - Cryptococcosis: clinical and biological aspects.
AB  - The incidence of cryptococcosis rose dramatically with the advent of the acquired
      immune deficiency syndrome (AIDS) epidemic in the early 1980s until the early
      1990s. The frequency of cryptococcosis has been declining since mid 1990s in
      Europe and America due to the development of more effective antiretroviral
      therapy and prophylactic treatment regimens designed to prevent fungal
      infections. The disease, however, is still recognized as one of the most common
      life-threatening opportunistic fungal infections in immunocompromised patients,
      particularly among those infected with human immunodeficiency virus (HIV). For
      this reason, research interest in clinical and biological aspects of the disease
      remains high. In addition to previously embarked areas of research, the
      cryptococcal research community has taken advantage of the current sequencing
      technology and initiated genome sequencing of Cryptococcus neoformans var.
      neoformans. This review includes various areas of research interest ranging from
      pathobiology, biochemistry and immunology, to genomics.

PMID- 11204148
TI  - Invasive aspergillosis.
AB  - Acute invasive aspergillosis (IA) is a devastating disease. Early diagnosis
      allowing an early treatment may improve the prognosis. However, this goal remains
      difficult to achieve. When diagnosis is confirmed it is often already too late.
      Galactomannan antigen detection and DNA detection are under clinical evaluation
      to improve early diagnosis and management of treatment. Despite antifungal
      treatment mortality rate is still high. Clinical resistance is more often due to
      the intensity of immunodepression than to high minimum inhibitory concentrations
      to antifungal agents; however, resistance to itraconazole may occur in rare
      instances. Beside acute IA, a chronic form of this infection may be seen as
      chronic necrotizing pulmonary aspergillosis or chronic invasive sinusitis. Other
      sites of infection have been described. The patients are immunocompetent or
      present minor alteration of their immunity or of anatomic structure of the
      infected site. Among patients with solid organ transplantation, lung and liver
      transplant patients are at the highest risk of developing IA. A high degree of
      awareness and efforts for an early diagnosis may participate to improve the poor
      prognosis.

PMID- 11204149
TI  - Emerging pathogens.
AB  - The ever increasing numbers of immunosuppressed individuals has led to a
      significant increase in the incidence of opportunistic infections, particularly
      those caused by fungi. The epidemiology of infections caused by the common fungal
      pathogens such as Candida albicans, Cryptococcus neoformans and Aspergillus
      fumigatus has been well documented. However, in addition to these, a number of
      species which have previously been unrecognized (e.g., C. dubliniensis) or have
      previously been assumed to be non-pathogenic (e.g., Saccharomyces cerevisiae,
      Scedosporium spp. and Fusarium spp.) have emerged as agents of human disease.
      Since these species have only been identified recently as human pathogens, their
      role in disease is poorly understood. In most cases, identification of these
      species is problematic and therefore their epidemiology has yet to be elucidated
      adequately. In addition, several of these species fail to respond to conventional
      antifungal therapies. In this article, we describe the emergence of two separate
      yeast species (C. dubliniensis and S. cerevisiae) and two separate groups of
      moulds (Scedosporium prolificans and Fusarium spp.), as human pathogens. It is
      apparent from what we already know, that much work has yet to be performed before
      we have a clear understanding of how these species cause disease and most
      importantly how they can be controlled.

PMID- 11204150
TI  - Pneumocystis infections: the iceberg?
AB  - Pneumocystis carinii pneumonia (PCP) is a well-recognized lung disease of
      immunocompromised patients, but the real impact of Pneumocystis infection in
      humans remains to be discovered. Pneumocystis represents probably one of the more
      frequent infectious agents faced by humans. Seroconversion revealed P. carinii
      primary infection in > 90% of infants and small children, but the infection
      source and the clinical or pathological changes associated with this first
      contact with the parasite remain unknown. Pneumocystis organisms are atypical
      microfungi able to attach specifically to type-I alveolar epithelial cells, and
      to proliferate, provoking severe pneumonitis. A deep impairment of cell-mediated
      immunity associated with changes in pulmonary surfactant make it possible for
      Pneumocystis to grow within the host. Alveolar type-II cell hypertrophy,
      macrophagic infiltrate and intra-alveolar foamy eosinophilic material are the
      most typical changes. CD4+ T-lymphocytes and interferon play a major role in host
      defense against P. carinii. Alveolar macrophages phagocytose P. carinii via the
      macrophage-mannose receptor and produce reactive free-radicals and nitric oxide
      under Pneumocystis stimulation. Furthermore, PCP is associated with an early
      decrease of surfactant phospholipids, increased hydrophilic surfactant protein
      (SP) levels and decreased hydrophobic SPs. Normal surfactant improves PCP, and
      consistently, it inhibits the parasite growth. New detection tools have revealed
      that hospitalized patients can be latently infected with Pneumocystis and that
      immunocompetent hosts develop transient Pneumocystis infections. Pneumocystis
      organisms circulate in human populations, being able to infect hosts with diverse
      susceptibility levels. In fact, airborne Pneumocystis infection can display a
      large spectrum of clinical presentations and most likely, we recognize at present
      only the tip of the iceberg.

PMID- 11204151
TI  - New aspects of some endemic mycoses.
AB  - The treatment of mycetomas varies according to their etiological agents and the
      clinical state of the patient. For the treatment of eumycetomas, the azole
      derivatives are the drugs of choice, with itraconazole rendering better results
      than ketoconazole and presenting better tolerance. Actinomycetomas are treated
      according to different therapeutic schemes: dapsone plus sulfamethoxazol
      trimethoprim (SMT), and streptomycin or amikacin or amoxicillin plus clavulanic
      acid. The first therapeutic scheme is very useful in the treatment of Nocardia
      mycetoma, while the association of amikacin plus SMT is the best treatment for
      those cases produced by Actinomadura madurae. Ciprofloxacin is a very useful drug
      for the treatment of actinomycotic mycetomas with bone lesions. Although there
      are several criteria for evaluating clinical outcome there is no accepted
      criterion of cure. During the 1990s, there was a remarkable increase in the
      incidence of coccidioidomycosis in California, USA. An almost ten-fold increase
      in the number of cases was registered during 1992 and 1993 over the usual
      incidence. A gradual reduction in coccidioidomycosis cases was observed in the
      late 1990s. This particular coccidioidomycosis outbreak took place in areas of
      low endemicity, as well as in those of usual high endemicity. Among the factors
      believed to have influenced this phenomenon were a drought followed by abundant
      winter/spring rainfall, increased immigration of susceptible individuals,
      increase in excavation/construction work and a better diagnosis of the infection,
      particularly in the last part of the decade. The majority of patients presented
      the usual clinical manifestations of symptomatic primary infection but an unusual
      number of cases with acute respiratory failure were observed.

PMID- 11204152
TI  - Black fungi: clinical and pathogenic approaches.
AB  - Data are presented on the clinically relevant black yeasts and their relatives,
      i.e., members of the Ascomycete order Chaetothyriales. In order to understand the
      pathology of these fungi it is essential to know their natural ecological niche.
      From a relatively low degree of molecular variability of the black yeast
      Exophiala dermatitidis, potential agent of brain infections in patients from East
      Asia, it is concluded that this species is an emerging pathogen, currently going
      through a process of active speciation. It is found to be an oligotrophic fungus
      in hot, moist environments, such as steambaths. Cladophialophora-, Fonsecaea- and
      Ramichloridium-like strains, known in humans as agents of chromoblastomycosis,
      are frequently found on rotten plant material, but the fungal molecular diversity
      in the environment is much higher than that on the human patient, so that it is
      difficult to trace the etiological agents of the disease with precision. This
      approach has been successful with Cladophialophora carrionii, of which cells
      resembling muriform cells, the tissue form of chromoblastomycosis, were found to
      occur in drying spines of cacti. Phagocytosis assays provide a method to
      distinguish between pathogens and non-pathogens, as the killing rates of strict
      saprobes proved to be consistently higher than of those species frequently known
      as agents of disease. The therapeutic possibilities for patients with
      chromoblastomycosis are reviewed.

PMID- 11204153
TI  - Mycoses in the transplanted patient.
AB  - The incidence of invasive fungal infection (IFI) has increased considerably over
      the past 20 years, and transplant recipients are at especially high risk for
      fungal infections owing to their overall immunosuppressed condition. Organ
      transplantation procedures were incorporated as a therapeutic option for many
      patients who lacked the normal functions of organs such as the heart, liver,
      kidney, lung, pancreas and small bowel. The prevalence of IFI in solid organ
      transplant (SOTR) patients ranges from 5 to 50% in kidney and liver transplants,
      respectively. In bone marrow transplant (BMT) patients, IFI are major causes of
      morbidity and mortality due to the protracted neutropenic period and graft-versus
      host disease. Candida spp. and Aspergillus spp. account for >80% of fungal
      episodes in both SOTR and BMT. The development of new immunosuppressive agents,
      new prophylaxis strategies (as pre-emptive therapy) and the improvement in
      surgical techniques led to increase survival of transplant recipients. In this
      session, a clear and concise update of the recent advances in the laboratory
      diagnosis of candidiasis and aspergillosis in this kind of patients was
      presented. However, we still need to establish more rapid, sensitive and specific
      methods for IFI diagnosis. Representatives of the 'Subcomision de Infecciones en
      el Paciente Neutropenico y Transplantado (SIPNYT)' de la Sociedad Argentina de
      Infectologia (SADI), presented the results of an unusual multicenter study both
      retrospective and descriptive studies of IFI in SOTR and BMT patients in
      Argentina. In addition, a study of IFI in 1,861 SOTR patients from four centers
      and the analysis of IFI in 2,066 BMT patients from all 12 BMT centers from
      Argentina was presented. From these studies it can be concluded that 'all
      transplant recipients are not the same' and that they should be stratified
      according to their different risk degrees in order to determine the best
      prophylaxis and treatment strategies.

PMID- 11204154
TI  - Mycoses in AIDS.
AB  - Major changes are occurring in the epidemiology of opportunistic infections (OI)
      in patients with acquired immune deficiency syndrome (AIDS) and treated with
      highly active antiretroviral therapy (HAART). A marked decrease of minor and
      major OI was observed and clinical resistance of thrush to antifungal agents
      became extremely rare. Primary and secondary prophylaxis against Pneumocystis
      carinii infections can be stopped; however, the situation is less clear for other
      OI such as cryptococcosis or endemic mycoses. The epidemiology is dramatically
      different in the countries which cannot afford the cost of HAART for the majority
      of patients, such as South Africa. These topics will be discussed in this paper.

PMID- 11204155
TI  - Mycoses associated with AIDS in the Third World.
AB  - Despite advances in diagnosis and treatment, the epidemiological status of the
      human immunodeficiency virus (HIV) infection is far from under control in most of
      the developing world. Sub-Saharan Africa, Southeast Asia and India show increased
      rates of new infections. In Latin America and the Caribbean there were 1.6
      million estimated cases of HIV-infected patients at the end of 1997. Fungal
      diseases have been one of the most relevant diagnoses in relation to the acquired
      immunodeficiency syndrome (AIDS). Infections due to Candida species and
      Cryptococcus neoformans var. neoformans are common worldwide. Histoplasma
      capsulatum, Coccidioides immitis and Penicillium marneffei are important causes
      of disease in endemic areas. Infection due to Sporothrix schenckii, Blastomyces
      dermatitidis and Paracoccidioides brasiliensis are uncommon even where they are
      endemic. Phaeohyphomycetes, hyalohyphomycetes and zygomycetes are still rare as a
      cause of disease among AIDS patients. However, agents pertaining to these groups,
      such as Aspergillus spp., have an increasing incidence. Superficial mycoses due
      to dermatophytes have special features from epidemiological, clinical and
      therapeutic points of view.

PMID- 11204156
TI  - The efficacy of acquired humoral and cellular immunity in the prevention and
      therapy of experimental fungal infections.
AB  - In the past two decades, numerous studies have documented the importance of
      acquired immunity for host defense against invasive fungal infections. There is
      widespread consensus in the field of medical mycology that cellular immunity is
      critical for successful host defense against fungi. However, in recent years
      several studies have established the potential efficacy of humoral immunity in
      host protection against two major fungal pathogens: Candida albicans and
      Cryptococcus neoformans. For C. albicans, antibodies to mannan, proteases and a
      heat shock proteins have been associated with protection against infection.
      Furthermore, anti-idiotypic antibodies to antibodies recognizing killer toxin
      from Pichia anomala and mimicking natural anti-killer toxin receptor antibodies
      can protect against C. albicans and other microorganisms. For C. neoformans,
      antibodies to the capsular glucuronoxylomannan have been shown to mediate
      protection in animal models of infection. Vaccines that induce protective
      antibodies have been shown to protect against experimental C. albicans and C.
      neoformans infection. In contrast, humoral immunity has not yet been demonstrated
      to mediate protection against Coccidioides immitis. For C. immitis, protection
      against infection is thought to rely on T cell mediated immunity, and the
      emphasis is on identifying the antigens that stimulate protective cellular immune
      responses and several candidate vaccines have been identified. These results
      provide encouragement for the view that acquired immune responses can be
      mobilized for the prevention and treatment of fungal infections.

PMID- 11204157
TI  - In vitro antifungal susceptibility methods and clinical implications of
      antifungal resistance.
AB  - As new antifungal agents are introduced for the treatment of infections caused by
      yeasts and filamentous fungi (moulds), it is important that reliable methods are
      available for the in vitro testing of both new and established agents. The
      ultimate goal of in vitro testing is the prediction of the clinical outcome of
      therapy. The use of the M27-A procedures that were developed by the US National
      Committee for Clinical Laboratory Standards (NCCLS) has led to increased
      interlaboratory agreement of minimum inhibitory concentrations (MICs) for yeasts
      and has facilitated the establishment of interpretive breakpoints for fluconazole
      and itraconazole. The clinical relevance and limitations of these breakpoints are
      discussed elsewhere. The focus of this paper is to review the advantages and
      disadvantages of the available methods for antifungal susceptibility testing of
      yeasts and moulds as well as the clinical implications of in vitro antifungal
      resistance.

PMID- 11204158
TI  - Combined treatment: antifungal drugs with antibodies, cytokines or drugs.
AB  - To improve present results with antifungal drugs, modulation of the host immune
      response is being explored. Human phagocytes of various lineages work
      cooperatively in vitro with antifungal drugs to inhibit or kill fungal pathogens,
      and this activity is augmented by several recombinant cytokines. Monoclonal
      antibodies against the cryptococcal capsule have been shown to act as an adjunct
      in enhancing the outcome of cryptococcosis in animal models. This approach is now
      being pursued in systematic clinical trials. In experimental candidiasis, several
      manipulations of the immune system, via administration of cytokines, gene
      deletion or antibodies to cytokines, have been shown to significantly affect
      survival and fungal clearance in vivo. This approach has already been
      demonstrated to be of benefit with recombinant human granulocyte-colony
      stimulating factor adjunct therapy of human candidiasis. Combining antifungal
      drugs of different classes may enhance their therapeutic effect.

PMID- 11204159
TI  - New advances in antifungal treatment.
AB  - Clinical aspects of treatment of invasive aspergillosis, infections caused by
      dematiaceous fungi, and mycoses caused by endemic, dimorphic fungi, are described
      in this review.

PMID- 11204160
TI  - Antifungal compounds: controversies, queries and conclusions.
AB  - A new session in this Congress was the development of a discussion panel
      regarding controversies and queries about the main topics of treatment and
      prophylaxis of severe systemic mycoses. Experts presenting each side of three
      controversial areas provided an interchange of ideas and clarified those areas
      where there remain substantial disagreements. Some common recommendations have
      been made, and some differences persist. The contents of this session are
      compiled in this paper. Due to the limitations of space, this paper presents the
      most relevant parts of each presentation. The large and up-to-date list of
      references should be useful to gain a better understanding of these subjects.

PMID- 11204161
TI  - Training medical myocologists in developing countries.
AB  - Although there has over recent years been a marked rise in the incidence of
      serious fungal infections, many of which are prevalent in developing countries,
      few facilities exist for diagnosis and research in medical mycology. In most
      countries, medical mycology is not taught adequately to medical students and
      consequently there is little awareness of the importance of fungal infections.
      Model teaching programmes need to be developed. Practical knowledge of mycoses,
      their diagnosis and treatment and also basic mycology can be disseminated through
      well-constructed courses and workshops. Formalized training in mycology research
      also needs to be introduced. To achieve all of this, expertise and additional
      resources need to be made available. In this regard, ISHAM can and should help.

PMID- 11204162
TI  - New targets and delivery systems for antifungal therapy.
AB  - Development of new approaches for treatment of invasive fungal infections
      encompasses new delivery systems for approved and investigational compounds, as
      well as exploiting the cell membrane, cell wall and virulence factors as putative
      antifungal targets. Novel delivery systems consisting of cyclodextrins,
      cochleates, nanoparticles/nanospheres and long circulating ('stealth') liposomes,
      substantially modulate the pharmacokinetics of existing compounds, and may also
      be useful to enhance the delivery of antifungal agents to sites of infection.
      Further insights into the structure-activity relationship of the antifungal
      triazoles that target the biosynthesis of ergosterol in the fungal cell membrane
      have led to the development of highly potent broad spectrum agents, including
      posaconazole, ravuconazole and voriconazole. Similarly, a novel generation of
      cell-wall active semisynthetic echinocandin 1,3 beta-glucan inhibitors
      (caspofungin, FK463, and VER-002) has entered clinical development. These agents
      have potent and broad-spectrum activity against Candida spp, and potentially
      useful activity against Aspergillus spp. and Pneumocystis carinii. The ongoing
      convergence of the fields of molecular pathogenesis, antifungal pharmacology and
      vaccine development will afford the opportunity to develop novel targets to
      complement the existing antifungal armamentarium.

PMID- 11204163
TI  - Mycotoxins and toxigenic fungi.
AB  - Mycotoxins and the fungi that produce them are of increasing importance as causes
      of human illness, but the diseases produced remain poorly understood at the
      clinical level. This paper explores four aspects: the increase of interest in
      ochratoxin A, factors affecting mycotoxin production, toxicology of the major
      mycotoxins, and the identification of Penicillium species which cause food
      spoilage and are important in indoor air.

PMID- 11204164
TI  - Prominent animal mycoses from various regions of the world.
AB  - The mycoses selected for presentation in this section are relatively common
      diseases of companion animals or livestock in certain areas of the world.
      Malasseziosis is arguably the most frequent mycosis of dogs (as otitis externa
      and dermatitis) throughout the world, although its diagnosis is often overlooked.
      Protothecosis is also geographically widespread, particularly in cattle where
      severe mastitis is a result of adventitious infection from the environment. In
      contrast, coccidioidomycosis and pythiosis are geographically limited in their
      occurrence (coccidioidomycosis by geographic region and pythiosis by climate),
      but within regions where they do occur, their presence in animals is not unusual.
      It was our intention to review recent developments in each of these diseases.

PMID- 11204165
TI  - Natural pathogens of laboratory animals and their effects on research.
AB  - The natural fungal pathogens of laboratory animals such as rabbits and guinea
      pigs are mainly dermatophyte species, most commonly Trichophyton mentagrophytes
      and also, less frequently Microsporum gypseum and M. canis. However, the
      incidences of infection and clinical disease are low in well-managed animal
      facilities. Young or immunocompromised rabbits are thought to be most
      susceptible. Dermatophytes infect the epidermis and adnexal structures, including
      hair follicles and shafts, usually on or around the head, and cause pruritus,
      patchy alopecia, erythema and crusting. Histopathological changes in the
      underlying skin occur and these changes could confound histological studies
      involving the skin. Yeast infections usually due to Candida spp. have been
      reported occasionally in laboratory animals. In this paper, the role of rodents
      in the evaluation of topical antifungal agents, dermatophytosis and two species
      of Candida, which are natural pathogens of laboratory animals, are discussed in
      relation to their effects on research. Pneumocystis carinii, an inhabitant of the
      respiratory tract of laboratory mice and rats, is a pathogen only under
      conditions of induced or inherent immunodeficiency. Infected mice and rats are
      likely to develop severe pneumocystosis following immunosuppression and will be
      rendered unsuitable for most experimental purposes.

PMID- 11204166
TI  - Clues to the presence of pathogenic fungi in certain environments.
AB  - The presence of various pathogenic fungi in rather unsuspected hosts and
      environments has always attracted the attention of the scientific community.
      Reports on the putative role of animals in fungal infections of humans bear
      important consequences on public health as well as on the understanding of fungal
      ecology. Fungi are ubiquitous in nature and their great capacity for adaptation
      allows them to survive and indeed, to thrive, in plants, trees and other natural
      substrata. Nonetheless, we are just beginning to learn the significance that
      these diverse fungal habitats have on the increasing number of immunosuppressed
      individuals. The accidental or permanent presence of fungi in animals, plants,
      soils and watercourses should not be taken too lightly because they constitute
      the source where potential pathogens will be contracted. If those fungal habitats
      that carry the largest risks of exposure could be defined, if seasonal variations
      in the production of infectious propagules could be determined, and if their mode
      of transmission were to be assessed, it would be possible to develop protective
      measures in order to avoid human infection. Additionally, unsuspected avenues for
      the exploration of fungal survival strategies would be opened, thus enhancing our
      capacity to react properly to their advancing limits. This paper explores several
      ecological connections between human pathogenic fungi and certain animals, trees,
      waterways and degraded organic materials. The occurrence of such connections in
      highly endemic areas will hopefully furnish more precise clues to fungal habitats
      and allow the design of control programs aimed at avoiding human infection.

PMID- 11204167
TI  - Fungal morphogenesis and virulence.
AB  - Phenotypic variability in pathogenic fungi has long been correlated with
      virulence, but specific genetic and molecular mechanisms are only recently being
      unraveled. Fungal morphogenesis, reflecting the expression of several regulated
      genes, and the capacity of the rising forms or phases to cause disease has been
      focused on at the XIVth Congress of the International Society for Human and
      Animal Mycology. Three experimental models of pathogenic fungi have been
      discussed. In Cryptococcus neoformans, phenotypic variability or switching
      represents controlled and programmed changes rather than random mutations.
      Evaluated phenotypic traits were the capsular polysaccharide, cell and colony
      morphology and virulence. In the dimorphic Paracoccidioides brasiliensis, the
      serine-thiol proteinase from the yeast phase cleaves the main components of the
      basal membrane, thus being potentially relevant in fungal dissemination. In
      Candida albicans, relationships between adhesion proteins and those of
      lymphocytes and neutrophils are related to fungal pathogenicity. Regulation of
      the directional growth of hyphae and its tropic responses are correlated with the
      invasive potential of C. albicans.

PMID- 11204168
TI  - Knockout mice as experimental models of virulence.
AB  - Infection models with animals whose immune systems have been selectively altered
      by neutralization of endogenous cytokines or by deletion of a gene have provided
      a valuable means to study the function of cells or cytokines in the context of
      complex multidimensional interactions. In particular, knockout mice have allowed
      a deeper insight into the in vivo performance of antifungal innate and acquired
      immunity, whose interplay is considered fundamental in the general defense
      against infections. It is conceivable that such an integrated view of effector
      and regulatory immune mechanisms operating in opportunistic fungal infections
      would facilitate the search for cells, cytokines and molecular pathways that are
      essential to control fungal infectivity or oppose fungus-associated
      immunopathology.

PMID- 11204169
TI  - The lipophilic yeasts: state of the art and prospects.
AB  - Malassezia yeasts (lipophilic yeasts), have been classified to include seven
      species. Although molecular methods such as sequencing of RNA and karyotyping
      were used to determine the species, traditional techniques are also being
      explored for their identification. These include studies of morphology and the
      utilization of individual lipids. Reports now show the predominance of individual
      species recovered from normal skin and from patients with diseases such as
      pityriasis versicolor and seborrhoeic dermatitis. The majority of systemic
      infections reported have been in the bloodstream of premature neonates. Clusters
      of cases have occurred and molecular techniques employed to study the
      epidemiology. With the development of discriminatory methods to determine
      individual species and strains present in disease and in nature, our
      understanding of the pathogenicity and the epidemiology of this genus can be
      advanced.

PMID- 11204170
TI  - Pathogenesis I: interactions of host cells and fungi.
AB  - The interactions of host cells and fungi during infection represent a complex
      interplay. Although T helper 1 (Th1)-mediated immunity is primarily responsible
      for acquired resistance to Paracoccidioides brasiliensis, studies have
      demonstrated that polymorphonuclear neutrophils play a critical role in providing
      an early resistance to this organism. One study has shown that the invasiveness
      of Candida albicans requires adherence, particularly to endothelial cells, which
      in turn are stimulated to express various cell-markers and pro-inflammatory
      cytokines as part of a proactive resistance to invasion. Somewhat in contrast to
      infection with C. albicans, it has been shown that the capsular
      glucuronoxylomannan of Cryptococcus neoformans causes the shedding of host-cell
      adherence molecules (L-selectins) needed for the migration of host-inflammatory
      cells to sites of infection and likely explains, in part, the reduced host
      inflammatory response to this organism. Resistance to aspergillosis is often
      associated with the immune status of the host. In one set of studies, it has been
      demonstrated that lymphocytes have little direct effect on the organism, but that
      antigen-presenting dendritic cells stimulate the production of Th1 cytokines,
      suggesting a positive role for the dendritic cell in host-response. Similarly,
      another study has shown that among the regulatory cytokine networks that Th2
      associated cytokines (e.g., interleukin-10) likely play a detrimental role in the
      resistance of the host to Aspergillus fumigatus.

PMID- 11204171
TI  - Mechanical circulatory support systems--a review.
AB  - Congestive Heart Failure (CHF) is a major health problem with a high mortality
      rate. Its ultimate therapy, heart transplantation, is limited by the shortage of
      donor hearts. Since decades researchers have been working to solve this problem
      by developing Mechanical Circulatory Support Systems (MCSS) that can replace or
      assist the failing heart. Short-term and intermediate-term ventricular assist
      devices are used nowadays frequently to bridge patients with severe heart failure
      to recovery. Long-term ventricular assist devices (VADs) and Total Artificial
      Hearts (TAHs) are used increasingly as a bridge to heart transplantations or as
      permanent circulatory support in patients with end-stage heart failure that are
      contraindicated for heart transplantation. The early TAHs and VADs were mainly
      driven from an external pneumatic drive unit. The latest generation TAHs and long
      term assist devices are electrically powered, ultracompact, totally implantable,
      and have small wearable drive/control consoles, allowing patients to return to
      their daily activities. The article categorizes and reviews the development of
      MCSS, highlights the medical indications and contraindications of pump
      implantation, advantages and disadvantages of the various systems, and results of
      animal and clinical studies.

PMID- 11204173
TI  - Cost effectiveness analysis of BMD referral for DXA using ultrasound as a
      selective pre-screen in a group of women with low trauma Colles' fractures.
AB  - Measurements of bone density (BMD) are central to the World Health Organisation
      (WHO) approach to the definition of osteoporosis. Dual energy X- ray
      absorptiometry (DXA) remains the gold standard technique for measuring the bone
      mineral density (BMD) but Quantitative Ultrasound (QUS) is an attractive
      alternative method of bone assessment because it is easy to use and relatively
      inexpensive. It has been suggested that QUS could be used as a selective
      population pre-screen, to maximise the cost effectiveness of referral for DXA
      assessment of BMD. We set out to examine how such an approach might perform in
      the assessment of women with low trauma Colles' fracture. In 46 women aged 50-80
      (mean 67) years we used DXA to measure BMD at lumbar spine and hip, and heel bone
      ultrasound to measure Broad Band Attenuation (BUA) and Velocity of Sound (VOS).
      We calculated local costs of pounds sterling 45 for DXA and pounds sterling 15
      for QUS. We identified a BUA threshold of 60 dB/MHz as most cost effective as pre
      screen, and calculated a sensitivity of 93% and specificity of 84% in identifying
      those subjects who were subsequently identified as having osteoporosis by DXA.
      DXA assessment of all patients had a cost of pounds sterling 77 per osteoporotic
      subject identified. We examined the cost-effectiveness of using QUS as a pre
      screen, only referring subjects for more expensive DXA assessment if BUA was less
      than 60 dB/MHz. However this approach had no advantage, still costing pounds
      sterling 78 per osteoporotic subject identified. QUS assessment does not appear
      cost-effective as a pre-screen for DXA, even in this high risk group of women
      with low trauma Colles' fracture. A QUS pre-screen would only be cost-effective
      if the scan could be performed at a substantially lower cost.

PMID- 11204172
TI  - Phenotypical characterization of c-kit receptor deficient mouse femora using non
      destructive high-resolution imaging techniques and biomechanical testing.
AB  - OBJECTIVE: Pathological processes in bone can lead to fatal health consequences.
      Therefore, it is important to study factors that possibly influence the activity
      of bone cells. The mast cell is a normal component of bone, storing and producing
      many potent bioactive substances. One of the most important factors to influence
      mast cell number, function, and phenotype is the c-kit ligand. A defect of the c
      kit receptor leads to mast cell deficiency. In literature oversight, evidence for
      the importance of mast cells in skeletal homeostasis is compiled. METHODS: To
      investigate the influence of c-kit receptor deficiency on bone mass, geometry,
      microstructure, and strength, 30 femora of profoundly c-kit receptor deficient
      mouse mutants and 30 control group animals aged 8-20 weeks were phenotypically
      characterized using peripheral quantitative computed tomography (pQCT), micro
      computed tomography (microCT) and 3-point-bending. RESULTS: The femora of the c
      kit receptor and therefore mast cell deficient animals were significantly altered
      in bone mass and geometry but not in bone density and microstructure. The mutants
      had a lighter femur with a thinner shape. The lower load bearing capacity of the
      femora of mast cell deficient mouse mutants is more likely explained by the
      smaller amount of bone material than due to a change in intrinsic material
      properties. TECHNICAL CONSIDERATIONS: With the little dimensions of mouse bones,
      it is of prime importance to have precise methods to phenotypically characterize
      the bone. The pQCT allows the separate assessment and analysis of trabecular and
      cortical bone density, as well as a statement about bone geometry. Beyond it, the
      microCT-technique delivers a 3-D analysis of bone microstructure, which so far
      was only achieved with 2-D histomorphometry. microCT is an efficient alternative
      to destructive histological preparations allowing further biomechanical testing
      of the same specimens to also deliver measures for bone strength.

PMID- 11204174
TI  - Arousal norms for children age 5-16 years based on home polysomnography.
AB  - Fragmentation of sleep by brief arousals has become an acknowledged aspect of
      poor quality sleep but there is a shortage of normative data on such arousals,
      especially for children. Norms for arousals (defined according to American Sleep
      Disorders Association criteria) were compiled for 61 children age 5-16 years
      using the Oxford Medilog system for a single night of home polysomnography. No
      significant differences were seen between the five age subgroups considered in
      average number of arousals per hour of sleep although individual differences were
      apparent at each age level and arousal duration was somewhat longer at younger
      ages. The low arousal rates in the children studied are in keeping with other
      evidence that arousal rates increase throughout life. Boys were no different from
      girls in either arousal frequency or duration. Arousal frequency was correlated
      with PSG awakenings but only to a modest extent. These new normative values
      should be useful in clinical practice and research for the assessment of the
      quality of children's sleep.

PMID- 11204175
TI  - Content-based retrieval of breast cancer biopsy slides.
AB  - The Biopsy Analysis Support System (BASS), previously used for image analysis of
      immunohistochemically stained sections of breast carcinoma, has been extended to
      include indexing and content-based retrieval of biopsy slide images from a
      database of 57 captured cases. Images from histopathological biopsy slides are
      described and these are accessed in terms of the properties of either individual
      nuclei or groups of cell nuclei present in the slide. Visual similarity of cases
      is specified in terms of a diagnostic index, commonly known as the H-score, which
      incorporates the heterogeneity of nuclear staining intensity, as well as the
      percentage of nuclei staining at specific intensities. The system provides a
      platform that can be exploited in telepathology and teleconsultation, but further
      research is needed to explore its full potential and accuracy in a diagnostic
      clinical environment.

PMID- 11204176
TI  - Reengineering the biomedical-equipment procurement process through an integrated
      management information system.
AB  - The design of each new hospital site is typically preceded by decisions on the
      most appropriate level of biomedical equipment which significantly influences the
      layout of the hospital departments which are under construction. The most
      appropriate biomedical equipment should ideally be decided upon considering a
      series of demographic and social parameters of the hospital and international
      regulations and standards. This information should ultimately be distilled to
      proper technical specifications. This paper proposes a streamlined management
      process related to the procurement of biomedical equipment for new hospital sites
      or for those under expansion. The new management process aims to increase the
      efficiency of the experts involved in the definition of the most appropriate
      level of equipment and its technical specifications. It also addresses all
      aspects of the biomedical equipment-selection cycle, including the evaluation of
      the bids submitted by the equipment suppliers. The proposed process is assisted
      by a management information system, which integrates all related data-handling
      operations. It provides extensive decision-support facilities to the expert and a
      platform for the support of knowledge re-use in the field of biomedical-equipment
      selection.

PMID- 11204177
TI  - Differentiation in murine mastocytoma induced by macrophage gangliosides.
AB  - In the membrane of mouse macrophages two gangliosides were detected which inhibit
      the division of murine mastocytoma P815 tumor cells. The two gangliosides were
      incorporated into the cytoplasmatic membrane of mastocytoma cells. The
      concentration necessary to achieve a complete inhibition of P815 tumor cell
      division is about 1 microM for both effective gangliosides. Macrophage
      ganglioside-induced inhibition of cell division is accompanied by morphological
      changes of the mastocytoma cells. While the cells are rounding, their diameter
      increases and serotonin and granules appear in the cytoplasm of the enlarged
      cells. Our findings suggest that macrophage gangliosides may differentiate
      mastocytoma cells into mast cells.

PMID- 11204178
TI  - Flight and molecular modeling study on the response of codling moth, Cydia
      pomonella (Lepidoptera: Tortricidae) to (E,E)-8,10-dodecadien-1-ol and its
      geometrical isomers.
AB  - In a previous study we have reported that both (E,Z)-8,10-dodecadienol (E,Z) and
      (Z,Z)-8,10-dodecadienol (Z,Z) isomers inhibit the attraction of male codling
      moth, Cydia pomonella L. when added to (E,E)-8,10-dodecadienol (E,E) while the
      (Z,E)-8,10-dodecadienol (Z,E) isomer induces slight increase in the number of
      males attracted to the pheromone source. In the present study, we have tested the
      behavioral activity of the individual geometrical isomers E,Z; Z,E and Z,Z. A few
      number of codling moth males flew to the Z,E-isomer while the other two isomers
      (i.e. E,Z and Z,Z) did not elicit any upwind orientation. Analysis of the flight
      behavior to the E,E- and Z,E-isomer showed significant differences in most of the
      flight parameters evaluated. Based on the biological observations and molecular
      modeling, we suggest that the behavioral activity of the Z,E-isomer is due to
      presence of specific receptors for this isomer on male antennae and not to its
      structural resemblance to the E,E-isomer. These results underline the importance
      of the Z,E-isomer in sex attraction of male codling moth.

PMID- 11204179
TI  - Phenolic constituents from the lichen Parmotrema stuppeum (Nyl.) Hale and their
      antioxidant activity.
AB  - Lichen, Parmotrema stuppeum (P. stuppeum) was successively extracted with benzene
      and acetone. Both the extracts were fractionated on 1% oxalic acid impregnated
      silica gel column to obtain four phenolic compounds. The structures of compounds
      were identified by 1H and 13C NMR spectra as methyl orsenillate, orsenillic acid,
      atranorin and lecanoric acid respectively. Antioxidant activity of benzene
      extract, acetone extract and isolated compounds were evaluated in a beta-carotene
      linoleate model system. The pure compounds showed moderate antioxidant activity.
      This is the first report on the isolation and characterisation of compounds from
      the lichen P. stuppeum as well as on their antioxidant activity.

PMID- 11204180
TI  - Iseluxine: a novel isoquinolinone alkaloid from Iseia luxurians.
AB  - A novel isoquinolinone alkaloid, iseluxine (1), has been isolated from the
      epigeal parts of Iseia luxurians (MORIC.) O'DONELL (Convolvulaceae), a climber
      indigenous to the tropical Americas. Structural elucidation was achieved by HRMS,
      1H NMR, 13C NMR, and HMBC spectroscopy. N- and/or O-methyl derivatives of 1 are
      already known from certain Magnoliidae families, e.g., the Fumariaceae, the
      Lauraceae, or the Papaveraceae. Iseluxine, the "missing link" in the biosynthesis
      of these methyl derivatives from dopamine, is the first isoquinolinone alkaloid
      characterized by a catechol substructure.

PMID- 11204181
TI  - Furanoheliangolides from leaves of Neurolaena macrocephala.
AB  - Six sesquiterpene lactones, two new (3 and 6) and four known (1, 2, 4 and 5) were
      isolated from the leaves of the Mexican Neurolaena macrocephala (Asteraceae). The
      furanoheliangolide 6, containing 4beta,5-dihydro-9alpha-hydroxy-atripliciolide as
      basic structure, was found for the first time in nature. The chemotaxonomic
      importance of this phytochemical work is discussed.

PMID- 11204182
TI  - Antibacterial activity of Citrus reticulata peel extracts.
AB  - Citrus peels were successively extracted with hexane, chloroform and acetone
      using a soxhlet extractor. The hexane and chloroform extracts were fractionated
      into alcohol-soluble and alcohol-insoluble fractions. These fractions were tested
      against different gram positive and gram negative bacteria. The EtOH-soluble
      fraction was found to be most effective. Fractionation of EtOH-soluble fraction
      on silica gel column yielded three polymethoxylated flavones, namely
      desmethylnobiletin, nobiletin and tangeretin. Their structures were confirmed by
      UV, 1H, 13C NMR and mass spectral studies. The findings indicated a potential of
      these natural compounds as biopreservatives in food applications.

PMID- 11204183
TI  - Seasonal variations in the harpagoside content of Scrophularia scorodonia L.
AB  - Seasonal variations on the content of harpagoside in Scrophularia scorodonia L.
      (Scrophulariaceae) were investigated using plants collected monthly from January
      to December in 1995. During growth of this species the percentage of harpagoside
      was the highest during the maximum development of the plant, specially in July.
      Harpagoside levels differed among leaves, stems and flowers of S. scorodonia.
      Leaves were distinguished from other plant parts by higher levels of harpagoside.
      Drying at ambient temperature influenced the yield of harpagoside compared with
      the results of plant drying by microwave.

PMID- 11204184
TI  - Probing stimulants from the rice plant towards the smaller brown planthopper,
      Laodelphax striatellus (FALLEN) (Homoptera: Delphacidae).
AB  - When adult males of the smaller brown planthopper, Laodelphax striatellus were
      fed on 2% crude rice (leaf and stem) extract containing 15% sucrose there were
      characteristic stylet sheaths deposited on parafilm membrane. Further bioassays
      with the butanol-soluble fr. of the extract revealed that it is highly effective
      for the insects. When the butanol fr. was charged on an ODS open column and
      eluted in sequence with 20, 40 and 100% methanol in water, the ODS-40% methanol
      fr. was shown as the most effective one. Further separation of the ODS-40%
      methanol fr. resulted in six effective components. These components acted to
      stimulate very high probing response on L. striatellus only when they are
      combined. This activity was found to be similar to those of the ODS-40% methanol
      fr. and the original crude rice plant extract. Two of the active components were
      identified as tricin 5-O-glucoside and tricin 7-O-glucoside, respectively,
      through spectroscopic analyses.

PMID- 11204185
TI  - A pyoverdin from Pseudomonas sp. CFML 95-275.
AB  - From Pseudomonas sp. CFML 95-275 a pyoverdin was isolated with a cyclopeptidic
      substructure. It could be shown that this pyoverdin is identical with one
      obtained from Pseudomonas fluorescens BTP 7 for which a lactone structure had
      been deduced from the interpretation of a FAB spectrum. The elucidation of the
      correct structure of the pyoverdin is described.

PMID- 11204186
TI  - The cooccurrence of different biflavonoid types in Pilotrichella flexilis.
AB  - From Pilotrichella flexilis various flavonoids have been isolated. This species
      contains in contrast to P. cuspidata not only 3',3'''-binaringenin and related
      compounds, but also some hitherto unknown biflavonoids based on eriodictyol and
      aureusidin. The structures of two new compounds are elucidated spectroscopically.
      Possible causes for the differences of the flavonoid patterns between the two
      species of the genus Pilotrichella are discussed.

PMID- 11204187
TI  - Triflavones and a biflavone from the moss Rhizogonium distichum.
AB  - From gametophytes of Rhizogonium distichum have been isolated the biflavone
      dicranolomin and five triluteolins. Two of the triluteolins, which were named
      rhizogoniumtriluteolin and distichumtriluteolin, were new compounds; their
      structures have been elucidated spectroscopically.

PMID- 11204188
TI  - Megistolactone, a new alkaloid from Sarcomelicope megistophylla.
AB  - A new quinolone alkaloid, megistolactone (1) was isolated from the bark of
      Sarcomelicope megistophylla. Its structure has been elucidated on the basis of MS
      and NMR data. From a biogenetic point of view, this compound should be considered
      as an oxidation product of 1,2,3,4-tetra-O-subsituted acridone alkaloids, which
      are also present in the bark.

PMID- 11204189
TI  - Polyphenolic compounds from Plantago lagopus L.
AB  - In the present study we report the isolation of a phenylpropanoid glucoside,
      plantamajoside, together with rosmarinic acid, chlorogenic acid and luteolin-7-O
      monoglucoside. This is the first report of these compounds from Plantago lagopus.

PMID- 11204190
TI  - Alkylresorcinols in fruit pulp and leaves of Ginkgo biloba L.
AB  - These studies were undertaken to characterise resorcinolic lipids (5-n
      alk(en)ylresorcinols) composition and to determine their seasonal fluctuations in
      fruit pulp and leaves of Ginkgo biloba L. Resorcinolic lipid concentrations were
      consistently higher in fruit pulp than in leaves. In pulp, several mono- and di
      unsaturated homologs of alkylresorcinols were the predominant group of analysed
      lipids. Contrary to the fruit pulp, only 5-n-pentadecylresorcinol was
      demonstrated in leaves. Initially, the alkylresorcinol's content both in pulp and
      leaves increased until June-July and decreased following seeds ripening. This
      trend continued until senescence of leaves in late September and October.

PMID- 11204191
TI  - Antimicrobial activities of Ferulago essential oils.
AB  - Essential oils from Ferulago asparagifolia Boiss., F. galbanifera (Miller) W.
      Koch, F. humilis Boiss. (Endemic), F. trachycarpa Boiss. growing in Turkey were
      evaluated against 15 microorganisms for their antifungal and antibacterial
      activity using an agar tube dilution and microdilution broth susceptibility
      assay, respectively. The essential oil compositions were investigated by GC/MS.
      Inhibitory effects against Escherichia coli, Enterobacter aerogenes, Candida
      albicans, Gaeumannomyces graminis var. tritici, Sclerotium rolfsii and Fusarium
      moniliforme were remarkable. Results are discussed in comparison with the
      chemical composition of the essential oils.

PMID- 11204193
TI  - Two new flavonol glycosides as DNA topoisomerase I poisons.
AB  - Flavonoids are secondary plant metabolites whose anticancer properties are
      actually being studied from an epidemiological and pharmacological point of view.
      They are believed to be implicated in the lower risk of some forms of cancer
      observed in Asian countries, due to their capacity to control cell proliferation,
      to act on certain regulatory enzymes as protein kinases or topoisomerases. Based
      on these precedents, three flavonols isolated from a cytotoxic butanol extract
      from Retama sphaerocarpa Boissier have been assessed to study their topoisomerase
      I and II activity. Two new rhamnazin glycosides were found to have the ability to
      stabilize the cleavage complex human DNA topoisomerase I at concentrations in the
      100-250 microM range, acting as topoisomersase I poisons.

PMID- 11204192
TI  - Degradation of anthracene by bacteria isolated from oil polluted tropical soils.
AB  - Four bacteria, identified as Pseudomonas aeruginosa, Alcaligenes eutrophus,
      Bacillus subtilis and Micrococcus luteus were isolated from crude oil polluted
      soils using anthracene as the sole carbon and energy source. All the organisms
      utilized n-hexadecane, n-tetradecane, diesel oil, engine oil and naphthalene as
      sole carbon sources. None could utilize hexane, cycloheptane, xylene, benzene,
      toluene, phenol, fluoranthene,and kerosene as carbon sources. Highest cell
      density obtained with 0.1% (w/v) anthracene were 4.5 x 10(7) (cfu/ml), 8.6 x
      10(6) (cfu/ml), 5.4 x 10(6) and 2.4 x 10(6) (cfu/ml) respectively, for P.
      aeruginosa, A. eutrophus, B. subtilis and M. luteus after 30 days incubation.
      Growth of the organisms on a Nigerian crude oil resulted in a residual oil
      concentration of 22.2%, 33.3%, 39.3%, 44% and 91.7% respectively, for P.
      aeruginosa, A. eutrophus, B. subtilis, M. luteus and the noninoculated control on
      the 14 th day. Ring fission enzymes of the meta pathway were detected in induced
      cells of P. aeruginosa and A. eutrophus while ortho pathway enzymes were detected
      in B. subtilis and M. luteus. P. aeruginosa and A. eutrophus had specific
      catechol-2,3-dioxygenase activities of 3.8 +/- 0.183 and 0.64 +/- 0.032
      micromol/min x mg protein respectively while catechol-1,2-dioxygenase activities
      of 1.95 +/- 0.029 and 1.89 +/- 0.026 micromol/min x mg protein were detected in
      B. subtilis and M. luteus respectively. This work, highlights the capability of
      these unreported tropical strains of A. eutrophus, B. subtilis and M. luteus as
      anthracene degraders.

PMID- 11204194
TI  - Fatty acid oxidizing activity in a red marine alga, Porphyra sp.
AB  - A crude enzyme solution prepared from fronds of Porphyra sp. showed remarkable
      oxygen uptake activity when linoleic acid was added as a substrate. Fatty acid
      oxidizing activity was mainly present in the soluble fraction of the crude
      homogenate. The activity was purified 769-fold from mature fronds by ammonium
      sulfate fractionation, ion-exchange and hydrophobic chromatography. SDS-PAGE
      analysis of the purified proteins indicated that its subunit size was about 13
      kDa. Gel filtration chromatography equipped with a photodiode array detector
      revealed that the activity was associated with a protein having a molecular
      weight of 12,500-13,000. It eluted with a chromophore having the maximum
      absorbance at 417 nm, thus, the protein was suggested to be a heme protein. The
      spectrophotometric property of the protein was highly similar to that of
      cytochrome c suggesting that it has heme c as a prosthetic group. The protein
      showed highest oxygenation activity against linoleic acid, and alpha-linolenic
      acid and arachidonic acid followed, but oleic acid could not be oxidized. From
      linoleic acid the protein formed 9- and 13-hydroperoxides to the same extent, and
      both were shown to be racemic. These results showed that the oxidizing activity
      is accountable to a cytochrome, but not to a typical lipoxygenase.

PMID- 11204195
TI  - Production of xanthones with free radical scavenging properties, emodin and
      sclerotiorin by the cultured lichen mycobionts of Pyrenula japonica.
AB  - From the cultures of the spore-derived mycobionts of the lichen Pyrenula
      japonica, two new xanthones, 1,8-dihydroxy-3-hydroxymethyl-5-methoxyxanthone and
      1,2,8-trihydroxy-5-methoxy-3-methylxanthone, were isolated along with 1,7
      dihydroxy-3-methylxanthone, 1,5,8-trihydroxy-3-methylxanthone, 1,8-dihydroxy-5
      methoxy-3-methylxanthone, emodin and sclerotiorin. Their structures were
      determined by spectroscopic methods. Sclerotiorin was isolated for the first time
      from lichen mycobionts. Radical scavenging activities of the isolated xanthones
      were also studied.

PMID- 11204196
TI  - A direct, highly sensitive fluorometric assay for a microsomal cytochrome P450
      mediated O-demethylation using a novel coumarin analog as substrate.
AB  - A highly sensitive fluorometric assay for the determination of monooxygenase
      activity in liver microsomes is described. The assay is based on the use of 3
      chloro-7-methoxy-4-methylcoumarin which is demethylated to 3-chloro-7-hydroxy-4
      methylcoumarin. The rate of formation of 3-chloro-7-hydroxy-4-methylcoumarin was
      recorded as an increase of fluorescence (lambdaA = 380 nm, lambdaF = 480 nm) with
      time. When 3-chloro-7-methoxy-4-methylcoumarin was incubated in the presence of
      MgCl2 and NADPH with rat liver microsomes, a continuous increase of the
      fluorescence could be measured. The reaction proceeded linearly for about 10 min
      and at least up to a concentration of 0.1 mg/ml of microsomal protein. Besides 3
      chloro-7-hydroxy-4-methylcoumarin a hydroxylated derivative of the substrate was
      formed as a second metabolite during the incubation. Using an excitation
      wavelength of 380 nm and a fluorescence/emission wavelength of 480 nm, the
      fluorescence of this substance (lambdaA = 338 nm, lambdaF = 422 nm) amounted only
      to about 1% of the fluorescence of the main product. The use of 3-chloro-7
      methoxy-4-methylcoumarin as substrate enables the fluorometric determination of
      the O-dealkylation activity of a cytochrome P450-dependent monooxygenase system
      in rat liver which is inducible by phenobarbital but not by 3-methylcholanthrene.

PMID- 11204197
TI  - Removal of magnesium by Mg-dechelatase is a major step in the chlorophyll
      degrading pathway in Ginkgo biloba in the process of autumnal tints.
AB  - Autumnal tints are one of the most manifest and fascinating natural phenomena,
      but the mechanism of chlorophyll (Chl)-breakdown in deciduous trees has not been
      fully elucidated. In this study, we analyzed the composition of Chl-related
      compounds and determined the activities of initial Chl-degrading enzymes in
      Ginkgo leaves at various stages in the process of autumnal coloring. Only
      pheophytin a (Pheo a, Mg-free Chl a) was detected in yellow leaves by HPLC
      analysis, and the activity of Mg-dechelatase in yellow leaves was found to be
      higher than in green leaves. These findings showed that the removal of magnesium
      from Chl a occurred in advance of dephytylation in the Ginkgo.

PMID- 11204198
TI  - Interrelation between cyanophycin synthesis, L-arginine catabolism and
      photosynthesis in the cyanobacterium Synechocystis sp. strain PCC 6803.
AB  - Ultrastructural and immunocytochemical investigations gave evidence that
      cyanophycin (multi-L-arginyl-poly-L-aspartate) granules accumulate in the
      cyanobacterium Synechocystis sp. strain PCC 6803 under nutrient deficient growth
      conditions, especially under phosphate limitation. Besides nutrient deficiency,
      growth of Synechocystis PCC 6803 on L-arginine or L-asparagine as sole N-source
      also led to high increase of cyanophycin synthesis, while growth on the
      combination of L-arginine or L-asparagine with nitrate only caused minor
      cyanophycin accumulation. Growth of Synechocystis PCC 6803 on L-arginine as sole
      N-source caused substantial morphological and physiological changes, such as
      severe thylakoid membrane degradation with partial loss of pigments and
      photosynthetic activity leading to a phenotype almost like that seen under
      nutrient deficiency. In contrast to the wild type, the PsbO-free Synechocystis
      PCC 6803 mutant could grow on L-arginine as sole N-source with only minor
      morphological and physiological changes. Due to its fairly balanced growth, the
      mutant accumulated only few cyanophycin granules. L-arginine degrading activity
      (measured as ornithine and ammonium formation) was high in the PsbO-free mutant
      but not in the wild type when cells were grown on L-arginine as sole N-source. In
      both cells types the L-arginine degrading activity was high (although in the PsbO
      free mutant about twice as high as in wild type), when cells were grown on L
      arginine in combination with nitrate, and as expected very low when cells were
      grown on nitrate as sole N-source. Thus, net cyanophycin accumulation in
      Synechocystis PCC 6803 is regulated by the relative concentration of L-arginine
      to the total nitrogen pool, and the intracellular L-arginine concentration is
      greatly influenced by the activity of the L-arginine degrading enzyme system
      which in part is regulated by the activity status of photosystem II. These
      results suggest a complex interrelation between cyanophycin synthesis, L-arginine
      catabolism, and in addition photosynthesis in Synechocystis PCC 6803.

PMID- 11204199
TI  - A study on the heterogeneity of the light-harvesting complex II from
      Ectothiorhodospira sp. after acid/chaotropic treatment.
AB  - The light-harvesting complex II of the purple bacteria has two strong near
      infrared electronic absorption bands, around 800 (B800) and 850 (B850) nm,
      arising from the Qy transitions of bacteriochlorophyll a. It was previously
      reported that under some specific acid/chaotropic conditions the B850
      bacteriochlorophylls of the light-harvesting complex II of Ectothiorhodospira sp.
      are strongly reorganised. Part of these pigments absorbs at 843 nm while another
      set absorbs around 858 nm. The current work should investigate whether a mix of
      two different complexes could generate the 843- and 858-nm bands. Acid/chaotropic
      conditions inducing the reorganisation of B850 were reproduced on a sample bound
      to an ionic-exchange column. The chromatographic pattern was found strongly
      homogeneous. The findings indicate that the heterogeneity of the reorganised B850
      results from two forms of differently structured bacteriochlorophylls bound to
      the same polypeptide backbone.

PMID- 11204200
TI  - Transport of resistance-inducing sterols in phloem sap of barley.
AB  - After root application of [7alpha-3H]-7beta-hydroxysitosterol and [3alpha,6beta
      3H2]-6alpha-hydroxylathosterol these sterols could be detected in the leaves and
      phloem sap feeding aphids. These results imply that the phloem sap is a sterol
      transport system in barley plants.

PMID- 11204201
TI  - Wound-induced respiration and pyrophosphate:fructose-6-phosphate
      phosphotransferase in potato tubers.
AB  - A seven fold increase in the rate of respiratory O2 uptake was observed 24 h
      after slicing of potato tuber disks. The maximum activity of
      pyrophosphate:fructose-6-phosphate phosphotransferase (PFP) was 5-7 times greater
      than that of ATP-dependent phosphofructokinase (PFK) in fresh or aged potato
      slices. Thus, PFP may participate in glycolysis which supplies respiratory
      substrate in potato tubers. The PFP activity of desalted extracts determined in
      the absence of fructose-2,6-bisphosphate (F2,6BP) increased by 4.5 fold 24 h
      after slicing. However, maximal PFP activity determined with saturating (1
      microM) F2,6BP was not changed. The Ka values of PFP for F2,6BP was lowered from
      33 to 7 nM after 24 h of aging treatment. This increased susceptibility of the
      PFP activity to its allosteric activator, F2,6BP, may be involved in the
      increased respiration in wounded disks of potato tubers. Immunoblotting
      experiments indicated that both the alpha (66 kDa) and the beta (60 kDa) subunits
      of PFP were present in fresh or 24 h aged tuber slices.

PMID- 11204203
TI  - 10-Hydroxystearic acid--identified after homogenization of tissue--is derived
      from bacteria.
AB  - 10-Hydroxystearic acid seems to be widely distributed in nature: Bacteria
      generate it by hydroxylation of oleic acid, but it was found also as constituent
      of plants, in cancer cell cultures and in mammalian tissue homogenates.
      Investigation of 10-hydroxystearic acid, obtained from mammalian tissue
      homogenates, revealed its identity with that of bacteria. Thus not 10
      hydroxystearic acid is widely distributed in nature but its producers: bacteria.
      When biological material is processed in aqueous media, lipases are activated,
      these cleave membrane phospholipids. Thus liberated oleic acid is the substrate
      for widespread bacteria which are introduced into the media when the work up
      procedure is done in not sterile surrounding. The bacteria transform then oleic
      acid to 10R-hydroxystearic acid.

PMID- 11204202
TI  - The role of lipid peroxidation in aluminium toxicity in soybean cell suspension
      cultures.
AB  - The primary reactions leading to Al toxicity in plant cells have not yet been
      elucidated. We used soybean (Glycine max [L.] Merr.) cell suspension cultures to
      address the question whether lipid peroxidation plays an important role in Al
      toxicity. Upon transfer to an Al-containing culture medium with a calculated Al3+
      activity of 15 microM soybean cells showed a distinct and longtime increase in
      lipid peroxidation within 4 h. At the same time a drastic loss of cell viability
      was observed. Butylated hydroxyanisole (BHA) and N,N'-diphenyl-p-phenylenediamine
      (DPPD), two lipophilic antioxidants, were able to almost completely suppress
      lipid peroxidation in Al-treated cells at a concentration of 20 microM. This
      effect was dose-dependent for DPPD and was observed at minimum concentrations of
      1-2 microM. When lipid peroxidation was suppressed by DPPD or BHA cell viability
      remained high even in the presence of toxic Al concentrations. These results
      suggest that Al-induced enhancement of lipid peroxidation is a decisive factor
      for Al toxicity in suspension cultured soybean cells.

PMID- 11204204
TI  - Enzymatic hydrolysis of carotenoid fatty acid esters of red pepper (Capsicum
      annuum L.) by a lipase from Candida rugosa.
AB  - Analyses of red pepper extracts which had been pretreated with lipase type VII
      (EC 3.1.1.3.) from Candida rugosa showed for the first time pepper carotenoid
      esters to be substrates of this enzyme. However, the extent of enzymatic
      hydrolysis depends on the respective carotenoid and was not quantitative compared
      to chemical saponification. After enzymatic cleavage, 67-89% of total capsanthin,
      61-65% of total zeaxanthin, 70-81% of total beta-cryptoxanthin and 70-86% of
      total violaxanthin were detected in free form. Nevertheless, the method described
      here offers the possibility to cleave in part several carotenoid esters
      originating from red pepper quickly and under comparatively mild reaction
      conditions. Replacement of the generally performed alkaline hydrolysis by
      enzymatic cleavage allows the resulting product to be used in food industry as
      "natural" coloring agent e.g. to colour cheese and jellies.

PMID- 11204205
TI  - Antioxidative activity of some quaternary ammonium salts incorporated into
      erythrocyte membranes.
AB  - The antioxidative activity of two series of amphiphilic compounds from a group of
      quaternary ammonium salts has been investigated. They were so-called bifunctional
      surfactants synthesized to be used as common pesticides or as antioxidants. The
      latter application was to be ensured by providing the compounds studied with an
      antioxidant group. Studies on antioxidative possibilities of those compounds were
      performed on pig erythrocytes. Due to their hydrophobic parts, they anchor in the
      erythrocyte membrane and influence the degree of lipid oxidation in the
      erythrocyte membrane subjected to UV radiation. It was found that compounds of
      both series decreased the oxidation of the membrane lipids. The inhibition of
      this oxidation increased with the length of their hydrophobic chains up to
      fourteen carbon atoms. The compounds of the longest hydrophobic chains showed a
      somewhat weaker antioxidative activity. Of the two series studied compounds were
      more effective having bromide ions as counterions. The corresponding compounds of
      a second series (chlorides) protected erythrocyte significantly weaker against
      oxidation. The effect of the compounds on fluidity of the erythrocyte membrane
      has been studied in order to explain the oxidation results. Change in fluidity of
      the erythrocyte ghost membranes was found also dependent on length of the
      hydrophobic part of the compounds and was more pronounced in the case of bromide
      surfactants. The final conclusion is that the compounds studied can be
      succesfully used as antioxidant agents of good efficacy.

PMID- 11204206
TI  - Transformations of 12,13-epoxy-11-hydroxy-9-octadecenoic acid and 4,5-epoxy-N
      acetylsphingosine by incubation with liver homogenate and liver microsomes.
AB  - Transformation of 12,13-epoxy-11-hydroxy-9-octadecenoic acid and 4,5-epoxy-N
      acetylsphingosine by addition of porcine liver homogenate and human liver
      microsomes, respectively was investigated. Both epoxides were converted to
      corresponding dioles by porcine liver homogenate, but not by human liver
      microsomes, suggesting location of the hydrolyzing enzymes not in the microsomes,
      but within the cell wall.

PMID- 11204207
TI  - PCR-based identification of Bacillus thuringiensis isolated from soil samples in
      Nigeria.
AB  - Six isolates of Bacillus thuringiensis isolated from soil samples confirmed to be
      toxic to mosquito larvae were differentiated using a PCR-Based technique. Three
      of these isolates initially identified using a serological technique were further
      differentiated with the PCR amplification of the delta-endotoxin target
      sequences. Using the total DNA of isolates as template, at least four isolates
      yielded amplicons one or all the crystal protein genes, cryI a, b, c, or II with
      sizes ranging from 238-1070 bp. None of these isolates yielded an amplicon for
      any of Cry IV A, B and D tested. Of the four isolates identified by PCR technique
      one isolate remained unidentified by serology.

PMID- 11204208
TI  - Cyanophora paradoxa: nucleotide sequence and phylogeny of the nucleus encoded
      muroplast fructose-1,6-bisphosphate aldolase.
AB  - Immunoscreening of a C. paradoxa expression library against water soluble
      muroplast ("cyanelle") proteins resulted in isolation of a clone encoding the
      nucleus-encoded muroplast class-II fructose-1,6-bisphosphate aldolase (class-II
      FBA). Its nucleotide sequence was determined. The 1432 bp insert, derived from a
      single-copy gene transcript, bears a reading frame of 1206 bp in length,
      representing 402 amino acids with 346 amino acids of mature protein. The leading
      amino acids match structural features necessary for precursor import across
      chloroplast envelope membranes. In phylogenetic tree topology, the investigated
      mature FBA clusters within type B FBAs with Synechocystis sp. as nearest
      neighbor. This is the first report of a Type B class-II FBA sequence of plastids.

PMID- 11204209
TI  - Determination of phenolic flame-retardants in human plasma using solid-phase
      extraction and gas chromatography-electron-capture mass spectrometry.
AB  - A method for determination of phenolic flame-retardants in human plasma utilizing
      solid-phase extraction (SPE) and gas chromatography with electron-capture mass
      spectrometric detection (GC-ECMS), has been developed. The plasma lipids were
      decomposed by application of concentrated sulphuric acid directly on the
      polystyrene-divinylbenzene SPE column. The method has been validated for 2,4,6
      tribromophenol (TriBP), pentabromophenol (PeBP), tetrachlorobisphenol-A (TCBP-A)
      and tetrabromobisphenol-A (TBBP-A) in the concentration range 1.2-25, 0.4-40, 4
      200 and 4-200 pg g(-1) plasma, respectively. The average absolute recovery of the
      analytes ranged from 51 to 85%. Tetrabromo-o-cresol and chlorotribromobisphenol-A
      were found suitable as internal standards, and the average recovery of the
      analytes relative to the internal standards was in the range 93-107%. The
      repeatability of the method was in the range 4-30% relative standard deviation.
      The estimated detection limits of TriBP, PeBP, TCBP-A and TBBP-A were 0.3, 0.4,
      3.0 and 0.8 pg g(-1) plasma, respectively. The method has been used for analysis
      of plasma samples from potentially occupationally exposed human individuals.

PMID- 11204210
TI  - New procedures for glycophorin A purification with high yield and high purity.
AB  - Glycophorin A (GPA) is the major glycoprotein of the human erythrocyte membrane.
      It is known to form, in SDS gels as well as in a membrane environment,
      homodimers, and also heterodimers with the homologous molecule Glycophorin B
      (GPB). It is shown in this report that the propensity of GPA to dimerize with GPB
      precludes satisfactory preparation with high yield of pure GPA using classical
      techniques including SEC and RPLC. It was demonstrated using multiple angle light
      scattering that GPA is eluted from RPLC columns as dimers. A convenient procedure
      was devised which allowed us to get pure GPA with high yield. This procedure
      consists of selectively blocking GPA-GPB heterodimer formation by selective
      modification of Cysteine 50 of GPB before RPLC.

PMID- 11204211
TI  - Determination of scopolamine in human serum and microdialysis samples by liquid
      chromatography-tandem mass spectrometry.
AB  - A liquid chromatographic-tandem mass spectrometric (LC-MS-MS) method with a rapid
      and simple sample preparation was developed for the determination of scopolamine
      in biological fluids. Scopolamine and the internal standard atropine in serum
      samples were extracted and cleaned up by using an automated solid phase
      extraction method. Microdialysis samples were directly injected into the LC-MS
      system. The mass spectrometer was operated in the multi reaction monitoring mode.
      A good linear response over the range of 20 pg/ml to 5 ng/ml was demonstrated.
      The accuracy for added scopolamine ranged from 95.0 to 104.0%. The lower limit of
      quantification was 20 pg/ml. This method is suitable for pharmacokinetic studies.

PMID- 11204212
TI  - Detection of a mixed-backbone oligonucleotide (GEM 231) in liver and tumor
      tissues by capillary electrophoresis.
AB  - A simple, rapid and sensitive method has been developed and validated for the
      analysis of a mixed-backbone oligonucleotide (GEM 231) in tumor tissues. The
      analysis was performed using a capillary electrophoresis (CE) system with UV
      detection. An extended light path (bubble cell) capillary column of 64.5 cm
      (effective length 56 cm) x 50 microm I.D. is used as the separation column. The
      optimized chromatographic conditions were background electrolyte: sodium borate
      buffer (60 mM, pH 9.1), electrokinetic injection: 10 s, applied voltage: 30 kV,
      detection at lambda = 210 nm. A linear relationship was observed between the peak
      area and the amount of GEM 231 in the range of 1.0-1000 microg/ml. The lower
      detection limit of the drug was 100 pg with an average recovery of about 75 +/-
      5%. The inter-day and intra-day relative standard deviations were <10%. Assay
      validation studies revealed that CE method is reproducible and specific for the
      determination of GEM 231 in tissue homogenates with a run time of less than 5
      min.

PMID- 11204213
TI  - Quantitative determination of L-775,606, a selective 5-hydroxytryptamine 1D
      agonist, in rat plasma using automated sample preparation and detection by liquid
      chromatography-tandem mass spectrometry.
AB  - L-775,606 is under investigation as a selective 5-hydroxytryptamine 1D agonist
      for the treatment of migraine. A reliable and sensitive method for the analysis
      of L-775,606 in plasma was required in order to support preclinical evaluation of
      this compound. A semi-automated sample preparation method using the Beckman
      Biomek 2000 workstation to perform all liquid handling tasks has been
      established. The sample analysis was performed using HPLC-MS-MS with a cycle time
      of 3.5 min per sample. Intra- and inter-day assay accuracy and precision are
      excellent with a calibration range of 1-2000 ng/ml and a reproducible limit of
      quantification of 1 ng/ml.

PMID- 11204214
TI  - A sensitive high-performance liquid chromatographic method using electrochemical
      detection for the analysis of olanzapine and desmethylolanzapine in plasma of
      schizophrenic patients using a new solid-phase extraction procedure.
AB  - A high-performance liquid chromatographic method with amperometric detection for
      the analysis of the novel antipsychotic drug olanzapine and its metabolite
      desmethylolanzapine in human plasma has been developed. The analysis was carried
      out on a reversed-phase column (C8, 150 x 4.6 mm I.D., 5 microm) using
      acetonitrile-phosphate buffer, pH 3.8, as the mobile phase. The detection voltage
      was + 800 mV and the cell and column temperature was 30 degrees C. The flow-rate
      was 1.2 ml min(-1). Linear responses were obtained between 5 and 150 ng ml(-1),
      with repeatability <3.3%. A careful pretreatment of the biological samples was
      implemented by means of solid-phase extraction (SPE) on C8 cartridges. The method
      requires 500 microl of plasma for one complete analysis. Absolute recovery
      exceeded 97% for both olanzapine and desmethylolanzapine, and the detection limit
      was 1 ng ml(-1) for both analytes. Repeatability, intermediate precision and
      accuracy were satisfactory. This sensitive and selective method has been
      successfully applied to therapeutic drug monitoring in schizophrenic patients
      treated with Zyprexa tablets.

PMID- 11204215
TI  - Improved use of the [13C]octanoic acid breath test as intra-individual parameter
      to study the effect of a prokinetic drug on gastric emptying in preterm infants
      with oral feeding intolerance.
AB  - The [13C]octanoic acid breath test was used for the measurement of differences in
      gastric emptying in preterm infants for the evaluation of pharmacological
      therapy. In order to perform a good intra-individual comparison of the gastric
      emptying in preterm infants under non-standardisable test conditions, we adjusted
      t1/2 for variations in non-recovered label (=label retention) and introduced an
      "effective half 13CO2 breath excretion time" t1/2eff = t1/2/m expressed as min
      per percentage of the cumulative dose recovered. In a pilot study, we
      investigated the action of the gastrointestinal prokinetic drug cisapride on
      gastric emptying in seven premature infants, of whom four suffered from gastric
      stasis and three had constipation. The postnatal age and weight at the start of
      treatment ranged from 15 to 64 days and from 815 to 1635 g, respectively. All
      infants received the standard formula for premature infants (Nenatal, Nutricia).
      Cisapride was administered orally 0.2 mg/kg, four times daily. The changes in
      gastrointestinal motility were studied using the total bowel transit time of
      carmine red. After 7 days of treatment in all children, the gastric emptying
      coefficient and the half 13CO2 breath excretion time adjusted for label retention
      were improved (n=7, the gastric emptying coefficient range before treatment was
      1.69-3.34 (mean 2.59 +/- 0.80) and after treatment it was 2.79-3.76 (mean 3.28 +/
      0.30); the half 13CO2 breath excretion time adjusted for label retention range
      before treatment was 3.0-14.7 min/% dose (mean 7.0 +/- 5.0) and after treatment
      2.6-4.0 min/% dose (mean 3.1 +/- 0.6). The total bowel transit time was only
      slightly improved in two patients (n=7, mean total bowel transit time before:
      23.7 h compared to mean total bowel transit time after 7 days of treatment: 35.5
      h). Side effects during cisapride treatment were not seen. We conclude that in
      premature infants cisapride is effective in shortening gastric emptying time and
      reducing gastric stasis; the therapeutic role in constipation has to be further
      investigated.

PMID- 11204216
TI  - Liquid chromatographic assay for simultaneous determination of abacavir and
      mycophenolic acid in human plasma using dual spectrophotometric detection.
AB  - A combined bio-analytical assay for abacavir, a reversed transcriptase inhibitor,
      and mycophenolic acid (MPA), based on reversed-phase liquid chromatography and
      both ultraviolet (UV) absorption and fluorescence detection, is reported. Both
      analytes are extracted from plasma with acetonitrile. After centrifugation,
      evaporation of the supernatant and reconstitution in water, the sample is
      injected into the chromatograph. Abacavir is detected using UV detection at 285
      nm and MPA spectrofluorometrically at 345 and 430 nm for excitation and emission,
      respectively. The method has been validated in the 80-2000 ng/ml range for
      abacavir and in the 10-10,000 ng/ml range for MPA for 200-microl plasma samples.
      The lower limits of quantification are 80 and 10 ng/ml for abacavir and MPA,
      respectively. Precisions and accuracies are < or = 8% in the valid concentration
      ranges of both analytes.

PMID- 11204217
TI  - High-performance liquid chromatographic-tandem mass spectrometric determination
      of 3-hydroxypropylmercapturic acid in human urine.
AB  - A sensitive and specific high-performance liquid chromatographic-tandem mass
      spectrometric (HPLC-MS-MS) method was developed for the determination of 3
      hydroxypropylmercapturic acid (3-HPMA) in human urine. Samples were extracted
      using ENV+ cartridges and then injected onto a C8 Superspher Select B column with
      acetonitrile and formic acid as eluent (5:95, v/v). N-Acetylcysteine was used as
      internal standard for HPLC-MS-MS. Linearity was given in the tested range of 50
      5000 ng/ml urine. The limit of quantification was 50 ng/ml. Precision, as C.V.,
      in the tested range of 50-5000 ng/ml was 1.47-6.04%. Accuracy ranged from 87 to
      114%. 3-HPMA was stable in human urine at 37 degrees C for 24 h. The method was
      able to quantify 3-HPMA in urine of non-smokers and smokers.

PMID- 11204218
TI  - Simultaneous determination of cefotaxime and desacetylcefotaxime in human plasma
      and cerebrospinal fluid by high-performance liquid chromatography.
AB  - A simple and sensitive HPLC method for the simultaneous determination of
      cefotaxime (I) and desacetylcefotaxime (II) in human plasma and cerebrospinal
      fluid (CSF) is described. The assay involves deproteinisation and subsequent
      separation on a reversed-phase HPLC column, with ultraviolet detection at 262 nm.
      Retention times were 6.8 and 2.2 min for cefotaxime and desacetylcefotaxime,
      respectively. Average recoveries for the analytes were 78% (I) and 88% (II) from
      both matrices. Linear responses were observed over a wide range (0.58-940
      microg/ml for (I) in plasma, 0.80-55.8 microg/ml for (I) in CSF, 0.54-148
      microg/ml for (II) in plasma and 0.50-36.0 microg/ml for (II) in CSF).

PMID- 11204219
TI  - Optimised determination of clobazam in human plasma with extraction and high
      performance liquid chromatography analysis.
AB  - The analysis of clobazam by high-performance liquid chromatography and UV
      detection is described herein. After adding an internal standard, 600 microl of
      plasma were extracted under basic conditions onto disposable cartridges packed
      with celite. The organic extract was then evaporated to dryness and the residue
      reconstituted in 200 microl of mobile phase. A 20 microl aliquot was injected
      into chromatograph. The HPLC system was equipped with an Ultrasphere C8
      analytical column coupled with an UV detector set at 235 nm. The mobile phase was
      an acetate buffer 20 mM, pH 5.5, containing acetonitrile and triethylamine
      70:30:0.01 (v/v); the flow-rate was 1.8 ml/min. Using this method, clobazam can
      be detected with a sensitivity limit of 6 ng/ml and the RSD% intra- and inter
      assay were lower than 5%. For its ruggedness and reliability, the proposed method
      is particularly suitable for therapeutic drug monitoring in epilepsy.

PMID- 11204220
TI  - Determination of 5-fluorouracil in environmental samples by solid-phase
      extraction and high-performance liquid chromatography with ultraviolet detection.
AB  - 5-Fluorouracil (5-FU) is one of the most widely used antineoplastic drugs. It can
      be therefore considered to be a model compound for the identification of exposure
      routes during preparation and administration of cytostatic agents, especially for
      nucleoside analogue drugs. In this study, an HPLC-UV method was validated for
      determination of 5-FU in wipe samples by direct analysis of the aqueous solutions
      and in air samples by using solid-phase extraction (SPE). When samples were pre
      treated on styrene-divinylbenzene resin SPE columns, a 20-fold preconcentration
      of the analyte was achieved. As regards air samples, correlation coefficients
      were always higher than 0.998 and the limit of detection was assessed at 15 ng on
      filter. In order to verify the reliability of these procedures, 5-chlorouracil
      was used as internal standard. The procedure presented here has been applied to
      the environmental monitoring of occupational exposed subjects. The amount of 5-FU
      ranged from 0.043 to 0.23 microg/m3 in air samples and from 0.2 to 470.1
      microg/dm2 in wipe samples. 5-FU was also detected on the internal side of the
      gloves (0.07 to 3.77 microg/pair of gloves).

PMID- 11204221
TI  - Determination of urine catecholamines by capillary electrophoresis with dual
      electrode amperometric detection.
AB  - Demonstrated in this study is that without pretreatment and preconcentration
      nanomolar-level catecholamines in human urine samples can be quantitatively
      determined with ease by utilizing capillary electrophoresis coupled with
      amperometric detection. The detector employs a parallel-opposed dual-electrode
      scheme assembled with an on-capillary electrode and a disk electrode and takes
      advantage of the redox cycling of analytes between the two working electrodes to
      improve the limit of detection. The matrix effect of urine samples significantly
      decreases the detection sensitivity from that obtained in standard solutions.
      Therefore, calibration curves derived from standard solutions cannot be used in
      quantitative determination of catecholamines. Methods of standard addition and
      internal standard have been studied. The results suggest that isoproterenol is a
      good internal standard to facilitate the measurements of dopamine, epinephrine,
      and norepinephrine in human urine samples.

PMID- 11204222
TI  - Simple and sensitive high-performance liquid chromatographic method for the
      determination of 1,5-benzodiazepine clobazam and its active metabolite N
      desmethylclobazam in human serum and urine with application to 1,4
      benzodiazepines analysis.
AB  - A HPLC-UV determination of clobazam and N-desmethylclobazam in human serum and
      urine is presented. After simple liquid-liquid extraction with dichloromethane
      the compounds and an internal standard diazepam were separated on a Supelcosil LC
      8-DB column at ambient temperature under isocratic conditions using the mobile
      phase: CH3CN-water-0.5 M KH2PO4-H3PO4 (440:540:20:0.4, v/v and 360:580:60:0.4,
      v/v for serum and urine, respectively). The detection was performed at 228 nm
      with limits of quantification of 2 ng/ml for serum and 1 ng/ml for urine.
      Relative standard deviations for intra- and inter-assay precision were found
      below 8% for both compounds for all the tested concentrations. The described
      procedure may be easily adapted for several 1,4-benzodiazepines.

PMID- 11204223
TI  - Avidin-biotin-immobilized liposome column for chromatographic fluorescence on
      line analysis of solute-membrane interactions.
AB  - Unilamellar liposomes with entrapped fluorescent dye calcein were stably
      immobilized in gel beads by avidin-biotin-binding. The immobilized liposomes
      remained extremely stable upon storage and chromatographic runs. The immobilized
      calcein-entrapped liposomes were utilized for fluorescent analysis of solute
      membrane interactions, which in some cases are too weak to be detected by
      chromatographic retardation. A liposome column was used as a sensitive probe to
      detect the interactions of membranes with pharmaceutical drugs, peptides and
      proteins. Retardation of the solutes was monitored using a UV detector.
      Perturbation of the membranes, reflected as leakage of the entrapped calcein by
      some of the solutes, can thus be detected on-line using a flow-fluorescent
      detector. For the amphiphilic drugs or synthetic peptides, perturbation of
      membranes became more pronounced when the retardation (hydrophobicity) of the
      molecules increased. On the other hand, in the case of positively-charged
      peptides, polylysine, or partially denatured bovine carbonic anhydrase,
      significant dye leakage from the liposomes was observed although the retardation
      was hardly to be measured. Weak protein-membrane interactions can thus be assumed
      from the large leakage of calcein from the liposomes. This provides additional
      useful information for solute-membrane interactions, as perturbation of the
      membranes was also indicated by avidin-biotin-immobilized liposome chromatography
      (ILC).

PMID- 11204224
TI  - On-line deproteinization by adsorption of proteins on a polyethylene powder pre
      column for the determination of Na, K, Mg and Ca in human serum by high
      performance liquid chromatography.
AB  - Deproteinization of human serum was carried out on-line using a polyethylene
      powder cartridge as pre-column. The serum sample, after dilution, was injected
      into the chromatograph, and when passing through the cartridge the proteins were
      adsorbed by the polyethylene. A protein-free eluate was carried to the analytical
      column while the pre-column was washed with methanol and water to elute the
      adsorbed proteins by changing the pump channels. After washing, the pre-column
      was conditioned with the eluent to receive the next sample. Deproteinization was
      evaluated off- and on-line using pooled serum, and testing the protein residue
      after passing through a polyethylene cartridge with the Comassie Brilliant Blue
      reaction. Parameters such as serum volume, eluent and washing solution were
      investigated. Sodium, potassium, magnesium and calcium determinations were
      performed by high-performance liquid chromatography with conductimetric
      detection. The proposed method is suitable for the determination of these cations
      in serum samples without further treatments. The total analysis time was about 20
      min and a linear range from 0.3 to 1.2 mg/l for sodium, potassium, magnesium and
      calcium was observed. The method was characterized by a precision of about 95%
      and recoveries from spiked samples were between 96 and 102%. The results for
      serum samples analysed by the proposed method were compared with photometry and
      atomic absorption spectrometry.

PMID- 11204225
TI  - Analysis of histidine and urocanic acid isomers by reversed-phase high
      performance liquid chromatography.
AB  - The qualitative separation performance of a C18, C8 and C4 reversed-phase column
      was investigated for the separation of histidine and its metabolites histamine, 1
      methyihistamine and trans- and cis-urocanic acid. Trans- and cis-urocanic acid
      were baseline separated from their precursor histidine on all three columns using
      isocratic elution with a mobile phase composed of 0.01 M aqueous TEAP pH 3.0 and
      acetonitrile at a ratio of 98:2 (v/v). However, histidine was not separated from
      histamine and 1-methyihistamine. Selecting the C8 column and introducing 0.005 M
      of the ion pairing reagent 1-octanesulfonic acid sodium salt into the aqueous
      solution and acetonitrile at a ratio of 90:10 (v/v), significantly improved the
      separation. The separation was also followed by a change in the retention times
      and the order of elution. The sequence of elution was histidine, cis-urocanic
      acid, trans-urocanic acid, histamine and 1-methylhistamine with retention times
      of 5.58 +/- 0.07, 7.03 +/- 0.15, 7.92 +/- 0.18, 18.77 +/- 0.24 and 20.79 +/- 0.21
      min (mean +/- SD; n=5). The separation on the C8 column in the presence of the
      ion-pairing reagent was further improved with gradient elution that resulted in a
      reduction in the retention times and elution volumes of histamine and 1
      methylhistamine. The detection limits of histidine and trans-urocanic acid at a
      wavelength of 210 nm and an injection volume of 0.05 ml were 5 x 10(-8) mol l(-1)
      (n=3). The kinetic of the in-vitro conversion of trans- into the cis-isomer after
      UV irradiation was depending on the time of exposure and the energy of the light
      source. UVB light induced a significantly faster conversion than UVA light. TUCA
      and cUCA samples kept at -25 degrees C were stable for up to 50 weeks. Samples,
      eluted from human skin showed various concentrations of histidine and trans- and
      cis-urocanic acid with an average of 1.69 +/- 0.33 x 10(-5) mol l(-1), 1.17 +/-
      0.43 x 10(-5) mol l(-1) and 1.67 +/- 0.33 x 10(-5) mol l(-1), respectively (n=8).

PMID- 11204226
TI  - Quantification of urine 17-ketosteroid sulfates and glucuronides by high
      performance liquid chromatography-ion trap mass spectroscopy.
AB  - The measurement of androgen steroids has been utilized as a clinical indicator of
      adrenal function, androgen abuse, and as a prediction of general health or
      biological aging. An improved high-performance liquid chromatography-ion trap
      mass spectroscopic method with sonic spray ionization (SSI) technology for the
      quantification of individual urinary 17-ketosteroid sulfates and glucuronides was
      developed and validated. Sample preparation was simplified using a C18 cartridge
      followed by direct injection onto a reversed-phase HPLC column. Individual 17
      ketosteroid from 63 urinary specimens collected in a 24-h period was measured. 17
      Ketosteroid conjugates, total 17-KS-S and the ratio of total 17-KS-S to
      creatinine referred to herein as the Anabolic/Catabolic Index (ACI) showed
      statistically significant negative correlations with age.

PMID- 11204227
TI  - Measurement and pharmacokinetic analysis of unbound ceftazidime in rat blood
      using microdialysis and microbore liquid chromatography.
AB  - To evaluate the biodisposition of ceftazidime in rat blood, a rapid and simple
      microbore liquid chromatographic technique together with a microdialysis sampling
      technique were developed. This method involves an on-line design for blood
      dialysate directly injected into a microbore liquid chromatographic system. The
      chromatographic conditions consisted of a mobile phase of methanol-acetonitrile
      100 mM monosodium phosphoric acid (pH 3.0) (10:10:80, v/v/v) pumped through a
      microbore reversed-phase column at a flow-rate of 0.05 ml/min. With the detection
      wavelength set at 254 nm, a good linear correlation was observed between the peak
      area and the ceftazidime concentration at 0.1 to 50 microg/ml (r=0.999).
      Microdialysis probes, being custom-made, were screened for acceptable in vivo
      recovery while chromatographic resolution and detection were validated for
      response linearity, as well as intra-day and inter-day variabilities. This method
      was then applied to the pharmacokinetic profiling of ceftazidime in blood
      following intravenous 50 mg/kg administration to rats. The pharmacokinetics was
      calculated from the corrected data for dialysate concentrations of ceftazidime
      versus time. This method has been used to study ceftazidime pharmacokinetics in
      rats and has proven to be rapid and reproducible.

PMID- 11204228
TI  - Highly sensitive determination of TS-962 (HL-004), a novel acyl-CoA:cholesterol
      acyltransferase inhibitor, in rat and rabbit plasma by liquid chromatography and
      atmospheric pressure chemical ionization-tandem mass spectrometry combined with a
      column-switching technique.
AB  - A quantitative bioanalytical method with excellent specificity using liquid
      chromatography (LC) atmospheric pressure chemical ionization-tandem mass
      spectrometry (APCI-MS-MS) combined with a column-switching technique has been
      developed for the highly sensitive and reliable determination of TS-962 (HL-004),
      a novel acyl-CoA:cholesterol acyltransferase (ACAT) inhibitor, in rat and rabbit
      plasma. The method involves protein precipitation of a 25-microl aliquot of
      plasma sample with eight volumes of methanol containing a deuterium-labeled
      internal standard, the direct injection of a methanolic supernatant into the
      analytical instrumentation with no sample evaporation and reconstitution steps,
      automated on-line clean-up on a C18 short trapping column (10 mm x 4.0 mm I.D.)
      followed by separation on a C18 analytical column (50 mm x 4.6 mm I.D.), and
      detection with APCI-MS-MS using m/z 448 ([M+H]+) as a precursor ion and m/z 178
      as a product ion in a selected reaction monitoring mode. The lower limit of
      quantification was 1 ng/ml, and good linearity of the calibration graph was
      obtained in the range of 1 to approximately 490 ng/ml with excellent reliability.
      The developed method enabled pharmacokinetic profiles to be determined for rats
      and rabbits with sequential plasma collection from an individual animal.

PMID- 11204229
TI  - Artificial neural networks in liquid chromatography: efficient and improved
      quantitative structure-retention relationship models.
AB  - The application of the principal neural network architecture, namely the
      multilayer perceptron (MLP), has been developed for obtaining sufficient
      quantitative structure-retention relationships (QSRR) with high accuracy. The
      present study is an extension to the excellent study of Cserhati et al. [LC-GC
      Int., 11 (1998) 240] for the retention behavior of solutes based on their
      structure. To this end, a dataset of 25 substances as solutes to two different
      stationary phases (polyethylene-silica and polyethylene-alumina) were analyzed to
      their structural descriptors and related to their retention behavior as expressed
      by the logarithms of their capacity factors (log k'). The results were compared
      to those of Cserhati et al. who studied the same problem using as many as ten
      different equations based on multiple regression analysis. In the present study a
      series of new and improved algorithms other than the 'old-fashioned' and
      problematic steepest descent were examined for training the MLP networks. The
      proposed methods led to substantial gain in both the prediction ability and the
      computation speed of the resulting models. For the development and evaluation of
      the artificial neural network (ANN) systems the same (eight) descriptors proposed
      by Cserhati were used also in this study. Furthermore, the results were compared
      to those produced from classical linear multivariate regression such as partial
      least squares regression (PLS). Some of the proposed ANN models diminished the
      number of outliers, during their implementation to unseen data (solutes), to
      zero.

PMID- 11204230
TI  - Chelated mercury as a ligand in immobilized metal ion affinity chromatography of
      proteins.
AB  - Chelation of mercuric ions by an iminodiacetate-Sepharose gel was evaluated. The
      retentive properties of iminodiacetate-Sepharose gel column was studied towards
      proteins varying the composition of eluting systems from 2-mercaptoethanol to
      NaCl and imidazole, determining also the extent of mercury leaching. It was
      demonstrated that chelated mercury contained free sites for interaction with
      proteins such as bromelain and recombinant human granulocyte colony stimulating
      factor from E. coli. The extraction of the latter by chromatography of its
      inclusion bodies solution on Hg(II)-loaded Sepharose-iminodiacetate gel was also
      evaluated.

PMID- 11204231
TI  - Comparative studies of recombinant human granulocyte-colony stimulating factor,
      its Ser-17 and (His)6-tagged forms interaction with metal ions by means of
      immobilized metal ion affinity partitioning. Effect of chelated nickel and
      mercuric ions on extraction and refolding of proteins from inclusion bodies.
AB  - The chelation capability of the reactive dye Light Resistant Yellow 2KT towards
      metal ions, particularly mercury(II) was evaluated in the pH range 5.0-7.0, and
      it was shown that the dye-Hg(II) complex has a free site for the interaction with
      human recombinant granulocyte-colony stimulating factor (rhG-CSF) from
      Escherichia coli. Affinity partitioning of three rhG-CSF forms--native, rhG
      CSF[Cys17--->Ser17] and (His)6-rhG-CSF was studied in aqueous two-phase systems,
      which contained metal ions--Cu(II), Ni(II) and Hg(II)--chelated by dye
      poly(ethylene glycol) at pH 5.0 and 7.0, in the presence or absence of many
      selected agents. It was determined, that chelated Ni(II) ions exhibited stronger
      interaction with the hexahistidine-tagged protein form, while the extraction
      power of Cu(II) ions was found to be of comparable order of magnitude for all
      three protein forms at pH 7.0. A comparative study of rhG-CSF and both its forms
      partitioning in the presence of chelated Hg(II) ions at pH 7.0 and 5.0 revealed
      possible direct interaction between Hg(II) ions and unpaired Cys-17 of rhG-CSF.
      The partitioning of three rhG-CSF forms inclusion body extract was studied in the
      presence of chelated Ni(II) and Hg(II) ions thus explaining the efficiency of
      targeted proteins renaturation gained upon their inclusion body forms
      interactions with chelated metal ions.

PMID- 11204233
TI  - On-line membrane extraction liquid chromatography for monitoring semi-volatile
      organics in aqueous matrices.
AB  - Membrane extraction is an attractive alternative to conventional extraction
      methods, such as liquid-liquid extraction and solid phase extraction, because the
      analytes can be isolated in a continuous fashion. On-line detection can be
      carried out using a suitable analytical instrument. The objective of this study
      is to study the enrichment of semi-volatile organic compounds (SVOCs) from an
      aqueous matrix by on-line membrane extraction, to be followed by liquid
      chromatographic (ME-LC) analysis for continuous monitoring. The membrane serves
      as an interface across which liquid-liquid extraction takes place. The SVOCs
      transfer from the aqueous phase and are concentrated in an organic extractant.
      The enriched solvent is intermittently injected into an HPLC for analysis. In
      this paper, the enrichment into the organic phase under different operating
      conditions and the performance characteristics of the instrumentation are
      presented.

PMID- 11204232
TI  - Development of an automated on-line solid-phase extraction-high-performance
      liquid chromatographic method for the analysis of aniline, phenol, caffeine and
      various selected substituted aniline and phenol compounds in aqueous matrices.
AB  - A fully automated solid-phase extraction (SPE)-high-performance liquid
      chromatographic method has been developed for the simultaneous analysis of
      substituted anilines and phenols in aqueous matrices at the low- to sub-microg/l
      level. Diode array and electrochemical detection operated in tandem mode were
      used for analyte detection. Two new polymeric sorbent materials (Hysphere-GP and
      Hysphere-SH) were evaluated for the on-line SPE of substituted anilines and
      phenols from aqueous matrices and their performance was compared with the PRP-1
      and PLRP-S sorbents. Hysphere-GP sorbent packed in 10 x 2 mm cartridges was found
      to give better results in terms of sensitivity and selectivity of the overall
      analytical method. The proposed analytical method was validated for the analysis
      of these compounds in Axios river water that receives industrial, communal and
      agricultural wastes. The detection limits for all the compounds range between
      0.05 and 0.2 microg/l, except for aniline and phenol which have detection limits
      of 0.5 and 1 microg/l, respectively (aniline detected by electrochemical
      detection). The recoveries for all the compounds are higher than 75% except for
      aniline (6%), phenol (50%) and 3-chlorophenol (67%). Finally, in order to
      evaluate the efficiency of the Hysphere-GP (10 x 2 mm) cartridges for sample
      stabilization and storage, the stability of the compounds of interest at the
      sorbed state onto these cartridges has been evaluated under three different
      temperature regimes (deep freeze, refrigeration, 20 degrees C).

PMID- 11204234
TI  - High-performance liquid chromatographic determination of linoleic acid peroxide
      derived radicals using electrochemical detection.
AB  - High-performance liquid chromatography-electrochemical detection (HPLC-ED) was
      applied to detect 13-hydroperoxide octadecadienoic acid (13-HPODE)-derived
      radicals such as the pentyl radical and octanoic acid radical. The 13-HPODE
      derived radicals were successfully detected using HPLC-ED by the combined use of
      the spin-trapping technique with alpha-(4-pyridyl-1-oxide)-N-tert-butylnitrone (4
      POBN). The 4-POBN-pentyl radical adduct was detected at the retention time of
      18.2 +/- 0.3 min on the elution profile of HPLC-ED with an ODS column (15 cm x
      4.6 mm I.D.) using a flow-rate of 1.0 ml/min with 50 mM ammonium acetate in 29%
      (v/v) aqueous acetonitrile. The 4-POBN-octanoic acid radical adduct was also
      detected at the retention time of 13.7 +/- 0.7 min using a flow-rate of 1.0
      ml/min with 50 mM ammonium acetate in 14% (v/v) aqueous acetonitrile. The
      concentrations of the 4-POBN radical adducts were determined using HPLC-ED
      without an internal standard. HPLC-ED is 100 times as sensitive as HPLC-electron
      spin resonance (ESR) under the ESR and ED conditions employed here. Even 1.8 pmol
      of the 4-POBN-pentyl (or octanoic acid) radical adduct was detectable using

PMID- 11204235
TI  - Determination of 16beta-hydroxystanozolol in urine and faeces by liquid
      chromatography-multiple mass spectrometry.
AB  - This paper describes the optimisation of the detection of stanozolol and its
      major metabolite 16beta-hydroxystanozolol in faeces and urine from cattle. Faeces
      are extracted directly with diisopropyl ether. Urine is first submitted to an
      enzymatic hydrolysis and then extracted over a modified diatomaceous earth column
      (Chem-Elut) with a mixture of diisopropyl ether-isooctane. In a final step an
      acidic back extraction is performed. For the LC-MS-MS detection two approaches
      are discussed. In a first approach the final extract is detected without
      derivatization, while the second approach makes use of a derivatization step for
      16beta-hydroxystanozolol. While the MS-MS spectrum without derivatization
      exhibits extensive fragmentation, the spectrum of the derivative shows two
      abundant diagnostic ions with much more reproducible ion ratios. The
      derivatization method and the method without derivatization enable the detection
      of 16beta-hydroxystanozolol up to 0.03 microg l(-1) in urine and 0.07 microg kg(
      1) in faeces. Until now there is no literature available for the detection of
      16beta-hydroxystanozolol in faeces and urine at the ppt level.

PMID- 11204236
TI  - Pair-wise interactions by gas chromatography. VII. Interaction free enthalpies of
      solutes with secondary alcohol groups.
AB  - A polar type liquid having a secondary alcohol substituent on a branched alkane
      skeleton, SOH, was used as stationary phase. The molecules of this stationary
      phase are nearly isomorphous and isochor with those of the branched alkane, C78,
      elected as standard, i.e., the molecules of both solvents have nearly the same
      form and the same size. Partition properties of 158 chosen molecular probes were
      measured by gas chromatography on SOH and on an SOH-C78 mixture having a volume
      fraction of thetaOH = 0.5. Based on the resulting data an interaction free
      enthalpy could be calculated, i.e., the additional effect of the secondary
      alcohol to partition. Comparison with data determined earlier on another member
      of this solvent family, POH, having a primary alcohol as interacting group gives
      information about the effect of steric hindrance on polar type solute-solvent
      interaction free energies.

PMID- 11204237
TI  - Observation of exchangeable protons by high-performance liquid chromatography
      nuclear magnetic resonance spectroscopy and high-performance liquid
      chromatography-electrospray ionization mass spectrometry: a useful tool for the
      hyphenated analysis of natural products.
AB  - The first high-performance liquid chromatography-nuclear magnetic resonance (HPLC
      NMR) investigation of exchangeable protons of low-molecular-mass natural products
      is reported. Model alkaloids or crude plant extracts were dissolved in 2H2O-1H2O
      MeCN (deuterium oxide-water-acetonitrile) or 2H2O-MeCN and, after direct
      injection or chromatographic separation, examined in a 60-microl NMR flow probe.
      Exchangeable amino protons initially detected by HPLC-electrospray ionization
      mass spectrometry were subsequently identified and investigated by stop-flow 1H
      NMR, two-dimensional (2D) total correlation spectroscopy (TOCSY), and 2D nuclear
      Overhauser effect spectroscopy (NOESY). These experiments extend the
      applicability of HPLC-NMR for the investigation and structure elucidation of
      natural products.

PMID- 11204238
TI  - Immunoaffinity column clean-up prior to thin-layer chromatography for the
      determination of aflatoxins in various food matrices.
AB  - A one-dimensional TLC method to determine aflatoxins (B1, B2, G1, G2) in various
      food matrices was elaborated which abstains fully on the use of chlorinated
      solvents. It implements an immunoaffinity clean-up step after extraction with
      methanol. The aflatoxins were quantified by densitometry. The method has shown to
      be rapid and efficient. In-house performance characteristics were established.
      The limit of quantification was found to be significantly lower than current
      regulatory limits for aflatoxin control outside and within the European
      Community. The obtained recovery and precision data gave a strong indication,
      that the method is likely to give satisfactory performance if tested in a future
      collaborative trial.

PMID- 11204239
TI  - Development and validation of a high-performance liquid chromatographic method
      for the determination of clomazone residues in surface water.
AB  - A method is described for the determination of clomazone residues in surface
      water by high-performance liquid chromatography with UV detection. The method
      involves solid-phase extraction with C18 extraction tubes. Clomazone was
      separated on a C18 column with a mobile phase of methanol-water (65:35, v/v) at
      pH 4.0 and a flow-rate of 1.0 ml/min. After optimization of the extraction and
      separation conditions, the method was validated. The method developed can be used
      for determination of clomazone in surface water, at the limit of 0.1 mcirog/l set
      by the European Union drinking water directive, with a 400-fold preconcentration.

PMID- 11204240
TI  - Development of a simplified densitometer for the determination of aflatoxins by
      thin-layer chromatography.
AB  - A simple, miniaturised and low power consuming (battery, fully semiconductor
      based) detector cell (SeBaDeC) was developed for the densitometric measurement of
      aflatoxins on TLC plates. A UV-light emitting diode (UV-LED) with a peak emission
      wavelength of 370 nm was used for fluorescence excitation, while a photo diode
      with a peak sensitivity of 440 nm in combination with a 418 nm cut-off filter was
      applied for detecting the fluorescence intensity. The resulting signal was
      further amplified by means of a commonly used operational amplifier integrated
      circuit (OA) and directly converted into a digital signal with a simple analogue
      digital-converter (ADC). This signal was recorded at the serial (RS232) port of a
      portable PC and processed with a spreadsheet program. The software used for data
      recording is freeware and available in its source code, and the long lifetime of
      the UV-LED (up to 10 000 h) permits a maintenance free application of this
      device. This simplified device has shown to be able to detect concentrations of
      aflatoxins of 1 ng, thus offering a cheap and sensitive alternative to currently
      available TCL scanners.

PMID- 11204241
TI  - Development of an ex vivo model to investigate the effects of altered
      haemodynamics on human bypass grafts.
AB  - The insertion of vein grafts into the arterial circulation may contribute to
      vessel wall thickening and accelerated atherosclerosis, a common feature of late
      vein graft failure. We aimed to develop a model suitable for investigation of the
      effects of altered haemodynamics on human saphenous vein following its
      implantation into the arterial circulation. Segments of human saphenous vein
      obtained from patients undergoing coronary artery bypass surgery were sutured at
      each end to PTFE and placed into a flow system. Pressure and flow rates to
      stimulate the arterial and venous systems were achieved. A theoretical model of
      the flow chamber was created and computational fluid dynamics software (FLOTRAN,
      Swanson Analysis Systems) was used to determine the flow profile within the
      model. In summary, a flow model has been developed to investigate the effect of
      altered haemodynamics on the molecular and pathological changes that occur in
      vein grafts incorporated into the arterial circulation.

PMID- 11204242
TI  - Effects of asymmetric branch flow rates on aerosol deposition in bifurcating
      airways.
AB  - Representative double bifurcation airway models with asymmetric branch flow rate
      ratios, caused by spatially different downstream impedances or a carinal tumour
      in one branch, have been considered. For steady laminar inhalation of a dilute
      micron-particle suspension, i.e. 500 < or = Re < or = 2000 and 0.02 < or = St <
      or = 0.12, air flow fields, aerosol distributions, and wall particle
      concentrations have been simulated with a user-enhanced finite-volume code and an
      off-line particle tracking routine. Particle deposition efficiencies are shown
      for both asymmetric branch flow rate cases, i.e. unobstructed and tumour-induced.

PMID- 11204243
TI  - Numerical study of unsteady stenosis flow: parametric evaluation of power-law
      model.
AB  - Currently the best indicator for surgical treatment of arterio-sclerosis is the
      degree of stenosis. Although X-ray angiography is currently the standard, cost
      and morbidity are distinct disadvantages. By modelling stenosis and studying its
      biofluid mechanics, one can apply its results in the field of arterial disease
      research. This formed the motivation for this work. A non-Newtonian (power law)
      incompressible Navier-Stokes (N-S) solver was developed using the method of
      operator splitting and artificial compressibility. The vehicle used is the
      computational fluid dynamics (CFD) numerical library FASTFLO. The power-law model
      developed is then used to do a parametric study of the effect of 'n' on blood
      flow mechanics where 'n' is the power index that determines the haematocrit of
      blood. A pulsatile pressure wave over a cardiac cycle of a second was used to
      simulate transient flow over a hypothetical two-dimensional stenotic geometry. By
      comparing the different velocity pressure, wall shear stress and viscosity
      profiles, it has been found when 'n' increases, the vortex formation and peak
      wall shear stress decreases (magnitudes of < 1.5 Pa). Since the formation of
      vortices and low oscillatory wall shear stress on the stenotic wall is
      detrimental to the well-being of the arterial tract, it can therefore be inferred
      that there might be a relationship between the diseased state of blood (power
      law) and early genesis of atherosclerosis. However, the conclusion of this paper
      marks the advent of new research directions in this field of study.

PMID- 11204245
TI  - Development and evaluation of a two-dimensional electrocutaneous cognitive
      feedback system for use in paraplegic standing.
AB  - Fatigue of electrically activated paralysed muscles is a major factor limiting
      the duration of functional electrical stimulation (FES) supported paraplegic
      standing. Fatigue can be significantly delayed by changing the posture. Since
      paralysed individuals are deprived of proprio- and exteroception from the lower
      limbs they are not aware of the posture and loading of their paralysed legs. If
      suitable cognitive feedback (CF) information about posture in the sagittal and
      frontal planes is provided, they might be able to successfully exercise posture
      switching. A two-dimensional electrocutaneous CF system was developed. Relative
      limb loading and the location of the weighted centre of pressure were selected as
      informational variables. Discrete encoding schemes in the form of spatial and
      frequency codes were employed and the informational signals were divided into
      three sub-regions. The ability to correctly interpret the CF was investigated
      using one- and two-dimension tracking tests in three paralysed subjects, each of
      whom were studied over five consecutive days. All three subjects were able to use
      the CF in one-dimension tests. Two subjects could do the same also in two
      dimension tests. The encoding scheme which was developed to communicate the
      selected biomechanical variables proved to be easily understood and thus
      appropriate for use in paraplegic standing.

PMID- 11204244
TI  - Automatic adjustment of biphasic pulse duration in transthoracic defibrillation.
AB  - Many studies have proven that biphasic defibrillation pulses are more efficient
      than the damped sinusoid monopolar waveform. Transthoracic resistance was shown
      to change during the two phases. On the other hand, it was proven that
      transthoracic resistance plays an important role in the defibrillation process,
      yielding the current for selected energy or voltage. Pre-shock measurement of the
      resistance may lead to improved selection. Stabilized current defibrillators are
      of low stored-to-delivered energy ratio. Therefore, automatic dynamic adjustment
      of some defibrillator parameters with respect to transthoracic resistance changes
      seems rational. An approach is known for modifying the pulse duration, in order
      to deliver a selected energy. A method is proposed here and an experimental
      defibrillator is developed for dynamic pulse duration adjustment with the purpose
      of obtaining a desired optimal time-course of the cardiac cell transmembrane
      potential.

PMID- 11204246
TI  - How to produce a pulsatile flow with low haemolysis?
AB  - It is evident that a pulsatile flow is important for blood circulation because
      the flow pulsatility can reduce the resistance of peripheral vessels. It is
      difficult, however, to produce a pulsatile flow with an impeller pump, since
      blood damage will occur when a pulsatile flow is produced. Further investigation
      has revealed that the main factor for blood damage is turbulence shear, which
      tears the membranes of red blood cells, resulting in free release of haemoglobin
      into the plasma, and consequently leads to haemolysis. Therefore, the question
      for developing a pulsatile impeller blood pump is: how to produce a pulsatile
      flow with low haemolysis? The authors have successively developed a pulsatile
      axial pump and a pulsatile centrifugal pump. In the pulsatile axial pump, the
      impeller reciprocates axially and rotates simultaneously. The reciprocation is
      driven by a pneumatic device and the rotation by a dc motor. For a pressure of 40
      mm Hg pulsatility, about 50 mm axial reciprocating amplitude of the impeller is
      desirable. In order to reduce the axial amplitude, the pump inlet and the
      impeller both have cone-shaped heads, and the gap between the impeller and the
      inlet pipe changes by only 2 mm, that is the impeller reciprocates up to 2 mm and
      a pressure pulsatility of 40 mm Hg can be produced. As the impeller rotates with
      a constant speed, low turbulence in the pump may be expected. In the centrifugal
      pulsatile pump, the impeller changes its rotating speed periodically; the
      turbulence is reduced by designing an impeller with twisted vanes which enable
      the blood flow to change its direction rather than its magnitude during the
      periodic change of the rotating speed. In this way, a pulsatile flow is produced
      and the turbulence is minimized. Compared to the axial pulsatile pump, the
      centrifugal pulsatile pump needs only one driver and thus has more application
      possibilities. The centrifugal pulsatile pump has been used in animal
      experiments. The pump assisted the circulation of calves for several months
      without harm to the blood elements and the organ functions of the experimental
      animal. The experiments demonstrated that the pulsatile impeller pump is the most
      efficient pump for assisting heart recovery, because it can produce a pulsatile
      flow like a diaphragm pump and has no back flow as occurs in a non-pulsatile
      rotary pump; the former reduces the circulatory resistance and the latter
      increases the diastole pressure in aorta and thus increases the perfusion of
      coronary arteries of the natural heart.

PMID- 11204247
TI  - Rotational laxity after anterior cruciate ligament injury by kinematic evaluation
      of clinical tests.
AB  - Despite the numerous studies on anterior cruciate ligament biomechanics and
      clinical tests, some disagreements still exist in the literature on the role of
      ACL in restraining rotations and which kinematic test after ACL injuries is the
      most suitable to evaluate this instability. This work analyses the capability of
      passive clinical and stress tests to detect an ACL state quantifying rotational
      instability. The study was conducted on animal knees with a new protocol. We
      found that an internal-external stress test can give a useful indication on the
      ACL state when used to estimate the side to side differences while varus-valgus
      laxity and secondary motions in standard kinematic tests did not seem to be
      affected by ACL injury. The kinematic protocol performed could be used intra
      operatively to quantify rotations, allowing a more accurate evaluation of knee
      instability to guide surgical reconstruction and improve its final outcome.

PMID- 11204248
TI  - Defining T cell receptors which recognise the immunodominant epitope of the
      gastric autoantigen, the H/K ATPase beta-subunit.
AB  - We have previously shown that autoimmune gastritis can be elicited in mice by
      immunisation with the gastric parietal cell H/K ATPase alphabeta heterodimer,
      and, furthermore, have identified the H/K ATPase beta-subunit epitope, H/Kbeta253
      277 as the dominant epitope of the gastric H/K ATPase. Using gastric H/K ATPase
      immunised mice, here we have generated two T cell hybridomas specific for the
      H/Kbeta253-277 peptide, namely 4B11.F4.5 and 1E4.C1. Hybridoma 4B11.F4.5 uses
      Valpha8 and Vbeta8.2 TCR chains and 1E4.C1 uses Valpha9 and V1beta8.3 chains.
      Although both hybridomas are specific for H/Kbeta253-277, T cell assays using
      overlapping 14-mers of the 25-mer epitope showed that the two autoreactive TCRs
      recognise different regions of the 25-mer. The TCR from 1E4.C1 has been used to
      generate a TCR beta-chain transgenic mouse. >80% of peripheral CD4+ T cells
      utilise the Vbeta8.3 transgene. As expected, 1E4-TCR beta-chain transgenic mice
      are susceptible to neonatal thymectomy induced autoimmune gastritis. While none
      of the 1E4-TCR beta chain transgenic mice spontaneously developed a destructive
      gastritis, a minority (20%) of the transgenic mice developed a non-invasive and
      non-destructive gastritis. This suggests that the pathogenic T cells are
      maintained in a tolerant state in the periphery of the transgenic mice.

PMID- 11204249
TI  - Sequence analysis of human endogenous retrovirus clone 4-1 in systemic lupus
      erythematosus.
AB  - Human endogenous retroviruses (HERV) have emerged as a possible cause of systemic
      lupus erythematosus (SLE). We previously detected serum antibodies to the gag
      region of HERV clone 4-1 in patients with SLE, but not in normal volunteers. In
      the present study, we detected clone 4-1 messenger RNA (mRNA) in peripheral blood
      mononuclear cells (PBMC) from SLE patients and performed sequence analysis of the
      cDNA or genomic DNA from clone 4-1 in these patients. Clone 4-1 mRNA was detected
      in all of the SLE patients tested, although it was not found in normal controls.
      Sequence analysis of clone 4-1 in these SLE patients revealed inactivation of the
      stop codons in part of the gag region. In addition, a computer search of current
      sequence libraries revealed that the clone 4-1 gag genomic DNA from SLE patients
      was more highly homologous with the clone 4-1 sequence in chromosome 11 from
      normal individuals when compared with the sequence of clone 4-1 integrated in the
      other chromosomes. It is possible that transcription of clone 4-1 from chromosome
      11 occurs in SLE, and that the stop codon inactivation contributes to the
      translation of clone 4-1 gag proteins in patients with this disease.

PMID- 11204250
TI  - Immunoreactivity to various human cytochrome P450 proteins of sera from patients
      with autoimmune hepatitis, chronic hepatitis B, and chronic hepatitis C.
AB  - Numerous human Cytochrome P450 enzymes (CYPs) associated with 'phase I' drug
      metabolism have been identified. Among them, CYP2D6 is thought to be the major
      target autoantigen to anti-liver kidney microsome (LKM)-1 autoantibody, a
      characteristic feature of autoimmune hepatitis (AIH) type II. In this study, we
      were able to clone CYP2D6 cDNA from a human liver cDNA library and express the
      CYP2D6 recombinant protein, and also to prepare four other representative human
      CYP proteins (CYP1A2, 2C9, 2E1, and 3A4). These preparations were used to assay
      the immunoreactivity of patients with AIH type I (n=35) and type II (n=9). As
      comparison groups, sera from patients with chronic hepatitis B (n=15), chronic
      hepatitis C (n=55; 24 anti-LKM-1-positive, 31 anti-LKM-1-negative), and from
      normal controls (n=30) were included. The five CYP proteins did not react with
      sera from normal controls nor from patients with chronic hepatitis B. CYP2D6
      reacted with sera from 100% (9/9) of AIH type II patients, 79% (19/24) of
      patients with anti-LKM-1-positive chronic hepatitis C, and 6.5% (2/31) of
      patients with anti-LKM-1-negative chronic hepatitis C. In contrast, CYP1A2
      reacted with serum from one patient with AIH type I, CYP2E1 reacted with sera
      from two patients with AIH type I, one patient with anti-LKM-1-positive chronic
      hepatitis C, and two patients with anti-LKM-1-negative chronic hepatitis C, and
      CYP3A4 reacted with sera from one patient with AIH type II and one patient with
      anti-LKM-1-positive chronic hepatitis C. CYP2C9 did not react with any of the
      sera included in this study. From these results, it is suggested that CYPs other
      than CYP2D6 can function as immunotargets in certain disease conditions.

PMID- 11204252
TI  - A possible pathogenic role of CD8+ T cells and their derived cytokine, IL-16, in
      SLE.
AB  - Current investigations into the role of CD8+ T cells and their derived cytokine,
      interleukin (IL)-16, in the induction of CD4+ T cell abnormalities in systemic
      lupus erythematosus (SLE) were reviewed and discussed on the basis of results
      mainly obtained in our laboratory.

PMID- 11204251
TI  - Analysis of chromosome 6q in Basque families with type 1 diabetes. GEPV-N. Basque
      Navarre Endocrinology and Paediatric Group.
AB  - Over the last few years several studies of linkage between non-HLA loci and type
      1 diabetes mellitus have mapped several putative susceptibility genes on
      chromosome 6q; in fact, positive evidence of linkage and/or association of IDDM5
      (6q25), IDDM8 (6q27) and IDDM15 (6q21) with type 1 diabetes has been reported. We
      have studied these loci in diabetic families of Basque origin, a genetically
      homogeneous population, to avoid artifactual association results due to admixture
      within the sample analysed. Statistical analyses of linkage were performed using
      a transmission disequilibrium test (TDT). We could not confirm linkage for IDDM5,
      IDDM8 and IDDM15 in our population, possibly due to population-specific
      differences in genetic susceptibility and/or environmental triggering factors to
      type 1 diabetes.

PMID- 11204253
TI  - CD30:CD30 ligand interactions in the immune response.

PMID- 11204254
TI  - Enhanced mutational activity and disturbed selection of mutations in V(H) gene
      rearrangements in a patient with systemic lupus erythematosus.
AB  - To determine the impact of somatic hypermutation and selective influences on the
      V(H) gene repertoire in SLE, the mutational frequency and pattern of mutations in
      nonproductively and productively rearranged V(H) genes obtained from genomic DNA
      of individual CD19+ B cells were analyzed in a patient with SLE. The mutational
      frequencies of nonproductive (6.54 x 10(-2)) as well as of productive (4.38 x 10(
      2)) V(H) rearrangements were significantly higher in the SLE patient than in
      normal controls (3.8 x 10(-2), p<0.001 and 3.3 x 10(-2); p<0.001, respectively).
      Analysis of nonproductive rearrangements documented only minor abnormalities of
      the targeting of the mutator in the SLE patient. The majority of "mutational hot
      spots", although different than in normals, appeared in the CDRs and an increased
      frequency of mutations in RGYW/WRCY sequences was observed. Moreover, no biases
      in base pair changes were found in the nonproductive repertoire. In contrast,
      there was a selection against A and T mutations and towards G mutations within
      the productive repertoire. Importantly, there were no significant differences in
      the R/S ratios of mutations within the FRs between the nonproductive and
      productive repertoire consistent with abnormalities in elimination of B cells
      expressing V(H) genes with these mutations. The result of this abnormality was a
      significantly higher R/S ratio of the V(H)genes in the productive repertoire of
      the SLE patient compared to normals (p<0.05). These data indicate that the
      mutational machinery was markedly enhanced in this SLE patient but exhibited
      nearly normal targeting, whereas selective influences were abnormal. These
      findings suggest that both enhanced mutational activity and disturbances in
      selection may have played a role in the emergence of autoreactivity in this SLE
      patient.

PMID- 11204255
TI  - Balanitis xerotica obliterans--a review.
AB  - Balanitis xerotica obliterans (BXO) is a scarcely known disease, wrongly
      considered rare. With a high degree of suspicion and histologic examination, the
      condition will prove to be much more frequent than one generally believes. The
      etiology of the condition is unknown at present. Many cases of BXO occurring
      after circumcision may be cases of secondary phimosis due to BXO not being
      recognized at the time of surgery. Most of the cases of BXO are seen in the third
      to fifth decades of life, even though they may occur at the extremes of age.
      Biopsy of the lesions is not essential in all cases and is indicated to
      differentiate from penile cancer and in atypical cases. Early diagnosis and
      treatment of BXO are very important in preventing the urological complications of
      the diseases such as urethral stricture. Treatment of BXO depends on the anatomic
      location of the lesions and their extent and severity, together with the rapidity
      of progression of the disease process. The treatment may vary from topical
      corticosteroids, laser vaporization in early cases to meatoplasty and
      urethroplasty in extensive cases. Topical pharmacotherapy is useful in the early
      stages to reduce the initial symptoms and slow down the progression, but is not
      effective in all cases and is not the curative treatment of disease. Meatal
      stenosis, phimosis, scar adhesions, fissures, erosions of glans and prepuce and
      involvement of the urethra are indications for surgical treatment. Surgery seems
      to be the only treatment that can relieve the symptoms of advanced disease.
      Modified circumcision, with total removal of inner preputial layer, definitively
      relieves phimosis without any recurrence. Meatotomy will not prevent the
      recurrence of meatal stenosis. Excision of the scleroatrophic tract and grafting
      of the glans base, coronal sulcus, and the end of the shaft give a complete
      relief of pain during erection and intercourse in circumcised patients with
      balanopreputial adhesions and restore the elasticity of the skin of penile shaft.
      These procedures have been shown to yield excellent functional results during a
      follow-up period of up to 4 years. BXO involving anterior urethra can be treated
      by 2-stage urethroplasty or substitution urethroplasty. The complete excision of
      the stricture and flap urethroplasty seems to be better than a 2-stage procedure.
      However, at the present time, it is not possible to say that surgery can
      completely resolve this chronic and progressive disease. Despite many reports in
      the literature of cases of BXO associated with squamous cell carcinoma, the
      etiologic relationship between the two conditions is uncertain.

PMID- 11204256
TI  - Suramin administration is associated with a decrease in serum calcium levels.
AB  - Suramin has been shown to have an effect on bone resorption in in vitro models.
      It is not clear if a similar effect is seen in patients treated with suramin. The
      clinical effect of suramin treatment on total serum calcium was examined in two
      groups of patients with hormone-refractory prostate cancer. In all, 28 patients
      in group 1 were examined within 2 weeks before and 2 weeks after suramin
      treatment and 72 patients in group 2 were examined within 2 weeks before, during,
      and after treatment with suramin. In addition, calcium controls spiked with
      suramin were run in three different commercially available assays for evaluation
      of the effect of suramin dose on calcium determination. Group 1 patients showed a
      decrease in serum calcium after treatment with suramin. The mean uncorrected
      serum calcium level was 2.29 +/- 0.025 mmol/l before treatment and 2.09 +/- 0.025
      mmol/l after treatment (P < 0.0001, paired Wilcoxon test). The mean serum calcium
      value corrected for albumin was 2.33 +/- 0.02 mmol/l before treatment and 2.24 +/
      0.02 mmol/l after treatment (P = 0.0022, paired Wilcoxon test). Group 2 patients
      also displayed a decrease in serum calcium after treatment with suramin. The mean
      baseline value was 2.23 mmol/l (median 2.26 mmol/l, range 1.20-2.54 mmol/l). The
      mean level of serum calcium corrected for albumin as determined at the end of
      treatment was 2.14 mmol/l (median 2.16 mmol/l, range 0.98 2.46 mmol/l). In all,
      48 patients for whom pre- and post-treatment values were available for analysis
      displayed a median calcium decrease of 0.09 mmol/l (P = 0.0005, Wilcoxon signed
      rank test for the null hypothesis of no change). For 68 patients in group 2, data
      on serial serum calcium measurements during treatment were available for
      analysis. A projected median decrease in serum calcium of 0.06 mmol/l (range 0.43
      to 0.72 mmol/l) over an 8-week interval of suramin therapy was found. Overall, 47
      of the 68 slopes were negative (P = 0.0022, Wilcoxon signed-rank test). Nine
      patients were treated with suramin for less than 6 weeks. These patients' calcium
      levels were significantly higher than those of 50 patients treated for longer
      periods (median value 2.24 versus 2.16 mmol/l, P = 0.035, Wilcoxon rank-sum
      test). No correlation was found between suramin dose and calcium level using the
      Kodak Ektachem, Hitachi 914, or Synchron Clinical System CX3 method. In
      conclusion, suramin treatment was consistently associated with decreases in serum
      calcium in two groups of patients with hormone-refractory cancer. Suramin placed
      in calcium controls did not affect calcium determination using three commercially
      available methods.

PMID- 11204257
TI  - Intermittent androgen deprivation (IAD) in patients with biochemical failure
      after radical retropubic prostatectomy (RRP) for clinically localized prostate
      cancer.
AB  - We report a study in which our objective was to analyze the clinical response
      during IAD in patients with biochemical failure after RRP for clinically
      localized prostate cancer. Between February 1994 and May 1996, 34 patients who
      exhibited a primary postoperative decrease in PSA to below the detection limit
      after RRP and then showed PSA progression during follow-up were included as group
      1 and 17 patients in whom PSA did not decrease after RRP were included as group
      2. Patients were offered IAD when PSA progressed over 0.4 ng/ml in group 1 and
      over 4.0 ng/ml in group 2. Median follow-up is 184 weeks in group 1 and 206 weeks
      in group 2. The median time "off" therapy increased from 25% (1st cycle) to 68.7%
      (5th cycle) of the entire cycle in group 1 and from 33.3% to 58.3% in group 2.
      Nine out of 12 cases with Gleason score > or =8 failed to respond to IAD and all
      developed metastatic and/or local failure. No case with Gleason score <7 failed
      to respond to IAD. Our conclusions suggest that IAD may be effective in patients
      with biochemical progression after RRP. In our experience, Gleason score seems to
      be an important variable.

PMID- 11204258
TI  - Clinical application of NMP22 and urinary cytology in patients with hematuria or
      a history of urothelial carcinoma.
AB  - For evaluation of the clinical application of immunoassay for nuclear matrix
      protein 22 (NMP22 immunoassay) and urinary cytology for early diagnosis and
      detection of bladder cancer in patients with hematuria and/or a previous history
      of bladder cancer, 209 urine samples obtained from 137 patients presenting
      episodes of hematuria or a history of bladder cancer were assayed for NMP22
      levels and/or prepared for cytology examination. Biopsy was performed when any
      visible tumor was identified during cystoscopy examination. The median NMP22
      concentrations measured in samples taken from patients with active bladder
      cancer, from patients with a history of bladder cancer but no active disease,
      from patients with hematuria, and from healthy volunteers were 18.95, 5.45, 6.39,
      and 3.75 U/ml, respectively. The urinary NMP22 level recorded for patients with
      urothelial carcinoma was significantly higher than that noted for individuals
      without active disease. The sensitivity of the NMP22 assay and of urinary
      cytology in diagnosing bladder cancer was 69% and 67%, respectively. In contrast,
      the specificity of these two diagnostic modalities reached 72% and 93%,
      respectively. The NMP22 assay is slightly more sensitive but less specific than
      urinary cytology in detecting bladder cancer. This study indicates that
      determination of urinary NMP22 levels is a useful and noninvasive tool for the
      detection of bladder cancer because of its high sensitivity. The urinary NMP22
      assay may be used as a first-line routine screening method; however, it cannot
      replace the use of urinary cytology because of its lower specificity.

PMID- 11204259
TI  - Prostatic expression of human 5alpha-reductase type 2 during finasteride therapy:
      a randomized, double-blind, placebo-controlled study.
AB  - This study was aimed at exploring the effect of finasteride, a non-steroidal
      competitive inhibitor of the enzyme 5alpha-reductase, on 5alpha-reductase type 2
      at the mRNA level in human prostate, using an in situ hybridization technique.
      After randomization, 10 men with benign prostatic hyperplasia (BPH) received oral
      finasteride (5 mg daily) and five men with BPH received placebo daily. Careful
      clinical examination was carried out and 2 biopsy samples were taken
      transrectally before the treatment and after 3, 6, and 12 months of treatment. In
      situ hybridization was carried out and expression of 5alpha-reductase type 2 mRNA
      was measured. The results showed that finasteride treatment had no permanent
      effect on expression of 5alpha-reductase type 2 in prostatic epithelium, compared
      with placebo treatment. Expression varied during treatment, but there was no
      clear tendency in this expression. The signal was localized in the epithelial
      cells. We conclude that finasteride treatment had no clear effect on human 5alpha
      reductase type 2 expression in the prostate.

PMID- 11204260
TI  - Quality of micturition in male patients with orthotopic neobladder replacement.
AB  - We evaluated the quality of micturition in patients with orthotopic neobladder
      replacement. In the present study, 58 patients who had undergone orthotopic
      neobladder replacement following cystectomy were enrolled. The quality of
      micturition was evaluated by means of uroflowmetry, a self-administered
      questionnaire and a 24-h frequency-volume chart. The questionnaire consisted of
      26 questions concerning storage (9 questions), evacuation of urine (9), patient's
      satisfaction with neobladder (3), limitations in daily life (3) and pain (2). In
      addition, 11 of the questions were followed immediately by a question concerning
      inconvenience to the patients. The mean follow-up period was 35 months (range 6
      80). On uroflowmetry, the mean peak flow rate was 13.5 ml/s with a low average
      flow rate (mean: 5.7 ml/s), and the voiding time was considerably prolonged
      (mean: 70.2 s). According to the frequency-volume chart and questionnaire
      responses, although the frequency and tidal volume of micturition were normal,
      the majority of patients were conscious of retarded, intermittent, prolonged, and
      weak stream and of straining during voiding. Diurnal or nocturnal incontinence
      was noticed subjectively in as many as 69% of the patients. However, the degree
      of urine leakage was minimal. In spite of the fact that 66% of the patients
      replied that their micturition status was worse than before surgery and that 69%
      of the patients felt dissatisfied, the degree of inconvenience was low in every
      item and the limitations in daily life were minimal. Although micturition in
      patients with neobladder replacement appeared to be of lower quality than that in
      normal subjects and was considered by many to be unsatisfactory, most patients
      were able to adjust themselves to it without significant inconvenience.

PMID- 11204261
TI  - Improvement of health outcomes after continued implementation of a clinical
      pathway for radical nephrectomy.
AB  - The clinical pathway is an important tool for outcome management. We evaluated
      the overall effects of the continued implementation of a clinical pathway for
      radical nephrectomy on the length of hospital stay, admission charges, and the
      quality of medical care. The data obtained from the second-year implementation
      (group 3) of the clinical pathway were compared with the data from the first-year
      implementation (group 2) and the year preceding implementation (group 1). Thirty
      seven consecutive patients with renal cell carcinoma underwent radical
      nephrectomy in group 1, 47 in group 2, and 55 in group 3; all were enrolled in
      this study. The length of hospital stay, average admission charges, and 8 quality
      indicators were measured in these patients. We also evaluated the variances in
      the implementation of the clinical pathway. The mean length of stay decreased by
      14.0% (P = 0.0048) in group 2, and by 15.8% (P= 0.0014) in group 3, when compared
      to group 1. The total admission charges significantly decreased by 19.0% (P =
      0.001) in group 2, and by 27.9% (P < 0.0001) in group 3, compared to the charges
      for group 1. A continued decrease in charges for operation and anesthesia,
      laboratory, pharmacy, and others were found 2 years after implementation of the
      clinical pathway. Among the 8 quality indicators, 2 were continuously improved in
      the second-year implementation of the clinical pathway, 2 were improved
      significantly in the second-year implementation only, and 4 showed no significant
      change at all. Variances from the clinical pathway decreased significantly after
      continued implementation. Continued implementation of the clinical pathway for
      radical nephrectomy can improve a physician's practice continuously by decreasing
      the length of hospital stay, admission charges, and variances, and by improving
      quality. However, the improved results after implementation of the clinical
      pathway should be maintained carefully to assure good health care.

PMID- 11204262
TI  - Inhibition of uropathogenic biofilm growth on silicone rubber in human urine by
      lactobacilli--a teleologic approach.
AB  - The ability of three Lactobacillus strains to inhibit the adhesion and growth of
      naturally occurring uropathogens on silicone rubber was investigated in human
      urine. The importance of biosurfactant production by Lactobacillus in
      discouraging uropathogen growth was determined in relation to the binding
      affinities of the lactobacilli for silicone rubber. L. fermentum B54 markedly
      inhibited uropathogen growth on the silicone rubber disks after 8 days for all
      five men included in the study, albeit to various extents ranging from 77% to
      100%. In urine from women, however, this inhibition was less clear, as it was
      absent for two of the four women participating in this study. L. casei rhamnosus
      36 completely discouraged uropathogen growth on the disks after 8 days for three
      of the four women, whereas its effect in urine from men was less pronounced
      (inhibition ranged from 48% to 100% and was absent for one man). L. casei
      rhamnosus ATCC 7469T was the least inhibitory Lactobacillus strain tested and
      inhibition was absent for a number of both male and female participants, possibly
      as a result of the low binding affinity of this strain for silicone rubber and of
      its inability to release biosurfactants. We conclude that the inhibition of
      uropathogen growth is dependent on the Lactobacillus strain involved, and for L.
      fermentum B54 it was demonstrated to be sex-related. Hence, inhibition must be
      considered a multifactorial process.

PMID- 11204263
TI  - Hemodynamic insult by vascular risk factors and pharmacologic erection in men
      with erectile dysfunction: Doppler sonography study.
AB  - To evaluate the penodynamic impact of known vascular risk factors in men with
      erectile dysfunction, we obtained thorough medical histories covering diabetes,
      hypertension, heart disease and hypercholesterolemia, alcohol ingestion, and
      smoking in 265 consecutive patients. We also measured their penile hemodynamic
      parameters by color duplex ultrasonography after intracavernous prostaglandin E1
      injection. In patients with vascular risk factors there was a statistically
      significant decrease in the peak systolic velocity and increase in the end
      diastolic velocity of the cavernosal artery (P < 0.01). Those men who had
      diabetes had higher average end-diastolic velocities and lower resistance indices
      (P < 0.01). Smoking and alcohol use also affected penile hemodynamics (P < 0.05).
      These data confirm that vascular risk factors do increase the likelihood of
      vasculogenic impotence and that diabetes plays a major role in veno-occlusive
      dysfunction in the penis.

PMID- 11204264
TI  - Pilot study of the transdermal application of testosterone gel to the penile skin
      for the treatment of hypogonadotropic men with erectile dysfunction.
AB  - Androgens influence important central and peripheral mechanisms of the erectile
      system. The relevance of a moderate decrease of serum testosterone level for
      erectile dysfunction (ED) has not been clarified so far. The aim of our study was
      to offer an easy transcutaneous method of androgen application. A previous study
      on the pharmacokinetic profile of the testosterone gel applied, showed marked
      elevation of the serum levels of testosterone. In our study, 46 hypogonadal
      patients with ED and total lack of vaginal penetration applied testosterone gel
      (4 mg/day; supplied by Azupharma, Germany) to the penile skin twice a day over 6
      8 weeks, after a run-in period with placebo gel of 2 weeks. All patients showed
      decreased testosterone serum levels (<3 ng/ml) in at least two morning samples
      over a period of 3 weeks before treatment. Psychogenic etiology was excluded by a
      sexual psychologist. Patient age was 37-69 years (mean 53.5). Three patients
      (6.5%) responded to placebo in the run-in phase and were withdrawn from further
      treatment. Fifteen patients (32.6%) showed improved erection, allowing
      penetration and sexual intercourse. Twenty-eight patients (60.9%) did not respond
      to therapy. Local genital skin irritation was not observed. Elevation of
      peripheral testosterone was not correlated to a positive therapy response. A
      success-rate of 32.6% in this group of patients after exclusion of psychogenic
      patients and placebo-responders seems to justify further investigations. A
      medication period of 6-8 weeks is most probably too short to induce imaginable
      regenerative effects of testosterone on the erectile system. We therefore suggest
      that future double-blind and placebo-controlled studies should be designed for a
      minimum of 3 months. Testosterone gel may be a cost effective form of androgen
      administration.

PMID- 11204265
TI  - 1999 rerun of the 1996 German Urinary Incontinence Survey: will doctors ever ask?
AB  - The German Incontinence Relief Society and supporting companies have been
      conducting numerous urinary incontinence awareness and continuing medical
      education campaigns. However, comparison of results from an epidemiologic survey
      involving 6,607 over-50-year-old patients in 1996 and a similar investigation
      among 6,481 patients in the same age group in 1999 reveals that German physicians
      are now even less likely to address this taboo subject, thus withholding
      appropriate care from incontinent patients. Possible reasons for this alarming
      development include the financial restraints imposed on German doctors in private
      practice and a lack of appreciation of the problems associated with incontinence
      among health policymakers.

PMID- 11204267
TI  - Diagnosis and management of incidental ureterocele during the treatment of
      clinically localized prostate cancer.
AB  - Two instances of simultaneous diagnosis of prostate cancer and ureterocele were
      recently identified. In one patient an ectopic ureterocele in a duplex system
      with an obstructed upper pole was unroofed at the time of radical prostatectomy.
      Surgical excision of the ureterocele wall provided decompression of the
      obstructed system. In a second patient, bilateral intravesical ureteroceles
      associated with normal renal units were left untreated. Complications were not
      associated with the untreated ureteroceles. On rare occasions a ureterocele may
      be discovered incidentally during the evaluation of patients with prostate
      cancer. When radical prostatectomy is planned, treatment of the ureteroceles
      should be determined by the ureterocele's size, anatomic configuration, and
      location and by the degree of obstruction of the affected renal unit. Surgical
      excision of the ureterocele at the time of radical prostatectomy may be the best
      approach for patients requiring treatment.

PMID- 11204266
TI  - Initial clinical experience with the selective phosphodiesterase-I isoenzyme
      inhibitor vinpocetine in the treatment of urge incontinence and low compliance
      bladder.
AB  - Current pharmacological treatment modalities for urge incontinence and low
      compliance bladder are limited by a low clinical efficacy and the significant
      side effects of the standard drugs available. Previous in vitro studies indicated
      a possible functional relevance of the intracellular phosphodiesterase (PDE)-1
      isoenzyme in the regulation of human detrusor smooth muscle contractility. We
      therefore investigated the effect of the PDE-1 inhibitor vinpocetine in
      nonresponders to standard pharmacological therapy. In 11/19 patients (57.9%)
      clinical symptoms and/or urodynamic parameters were improved. Although these
      initial data are preliminary, they represent the first evidence that isoenzyme
      selective PDE inhibition may be a novel approach to the treatment of lower
      urinary tract disorders.

PMID- 11204268
TI  - Synchronus renal cell carcinoma and Bellini duct carcinoma: a case report on a
      rare coincidence.
AB  - Bellini duct carcinoma or collecting duct carcinoma (CDC) is a rare but
      aggressive primary renal neoplasm. The coexistence of two synchronous neoplasms
      in the same kidney is highly infrequent. As a result, it is hardly surprising
      that there are no references to renal cell carcinoma (RCC) combined with CDC of
      the same kidney in the literature. Histology and immunohistochemistry are
      important tools for differentiating between the two types of tumors involved. We
      present the first case of a synchronous occurrence of RCC and CDC of the same
      kidney.

PMID- 11204269
TI  - Endocytosis of uncleaved tumor necrosis factor-alpha in macrophages.
AB  - Activated monocytes and macrophages secrete the inflammatory cytokine tumor
      necrosis factor-alpha (TNF-alpha). TNF-alpha is produced as a 26 kd transmembrane
      protein that is cleaved to release a 17 kd soluble protein. TNF-alpha in both
      forms is biologically active. The intracellular trafficking of membrane
      associated TNF-alpha in lipopolysaccharide-activated mouse macrophages was
      assessed after treatment with the metalloprotease inhibitor BB-3103, which
      prevents the cleavage of pro-TNF-alpha. Immunoprecipitation and
      immunofluorescence studies showed sustained expression of cell-associated TNF
      alpha in the presence of the inhibitor. Cell immunoreactivity and surface
      biotinylation revealed that uncleaved TNF-alpha accumulated on the cell surface
      and was endocytosed, appearing in intracellular vesicles. Perturbation of post
      Golgi traffic blocked the surface expression of 26 kd TNF-alpha. Tracking a bolus
      of TNF-alpha over time in cycloheximide-treated cells confirmed that uncleaved
      TNF-alpha is first transported to the cell surface and subsequently endocytosed.
      Vesicular structures immunoreactive for TNF-alpha were identified as endosomes by
      double labeling. The secretory and membrane-associated endocytic trafficking of
      TNF-alpha provides a mechanism for modulating the quantity of biologically active
      26 kd TNF-alpha expressed on macrophages, allowing regulation of paracrine and
      autocrine responses.

PMID- 11204270
TI  - Cell lineage analysis during liver development using the spf(ash)-heterozygous
      mouse.
AB  - Biliary epithelial cells differentiate from periportal hepatoblasts during fetal
      mouse liver development. It remains to be determined whether each hepatoblast is
      equivalent for differentiation into hepatocytes and biliary epithelial cells in
      normal liver development. To resolve this question, the mosaic pattern of
      ornithine transcarbamylase (OTC) expression was analyzed in the hepatoblast
      population of spf(ash) (sparse-fur with abnormal skin and hair)-heterozygous
      fetal mouse livers, in which random inactivation of either the X chromosome
      carrying the spf(ash) gene (causing OTC deficiency) or its wild-type gene occurs.
      Aggregates (patches) of OTC-positive hepatoblasts showed very complex patterns,
      and their shapes and size distributions were similar in sections from periportal
      regions and nonperiportal regions of the fetal liver in which bile duct
      differentiation by periportal hepatoblasts occurred. Average sizes of periportal
      patches were larger than those of nonperiportal patches because of the presence
      of more hemopoietic cells in the latter region. The OTC mosaicism in periportal
      bile duct progenitors and hepatoblast islands of other liver parenchyma was also
      similar. These results suggest that the growth patterns of hepatoblasts are
      similar in both periportal and nonperiportal regions. Isolated three-dimensional
      patches comprising hepatoblasts giving rise to only biliary epithelial cells or
      hepatoblasts giving rise to both hepatocytes and biliary epithelial cells were
      observed in periportal regions. In nonperiportal regions, patches consisting of
      hepatoblasts differentiating into hepatocytes were also seen. Thus, it is likely
      that there are three lineages for the developmental fates of hepatoblasts:
      hepatoblasts giving rise to only biliary epithelial cells, hepatoblasts giving
      rise to only hepatocytes, and hepatoblasts giving rise to both of them.

PMID- 11204272
TI  - Expression of nitric oxide synthases and nitrotyrosine during blood-brain barrier
      breakdown and repair after cold injury.
AB  - This study was undertaken to determine whether the blood-brain barrier (BBB)
      breakdown and cerebral edema occurring post-trauma are associated with
      overexpression of the endothelial (e) and inducible (i) nitric oxide synthases
      (NOS), enzymes responsible for nitric oxide (NO) biosynthesis. These enzymes were
      determined quantitatively at the mRNA level and qualitatively at the protein
      level in the rat cerebral cortical cold injury model, during a period up to 6
      days post-injury. In addition, peroxynitrite generation at the lesion site was
      detected by immunolocalization of nitrotyrosine as a marker of NO-superoxide
      interactions. These studies were correlated with the permeability status of the
      BBB by immunohistochemical detection of endogenous fibronectin extravasation in
      the same brains. BBB breakdown was immediate in lesion vessels, it was present as
      early as 10 minutes post-lesion and delayed in perilesional vessels that showed
      maximal BBB breakdown between 2-4 days. The BBB was restored to normal at 6 days
      post-lesion. An increase in both eNOS and iNOS mRNA was observed at the lesion
      site as compared with the contralateral hemisphere at 12 hours, 2 days, and 4
      days. The mRNA returned to resting levels by 6 days. Increased eNOS protein was
      observed in the endothelium of permeable perilesional vessels and neovessels and
      in the endothelium of the hyperplastic pial vessels overlying the lesion site.
      iNOS protein was observed initially in polymorphonuclear leukocytes at the lesion
      site and later in macrophages, endothelial cells, and the smooth muscle cells of
      the overlying pial vessels. Furthermore, nitrotyrosine was demonstrated at the
      lesion site up to 5 days. Up-regulation of the NO synthases at both the mRNA and
      protein level accompanied by presence of nitrotyrosine during BBB breakdown and
      angiogenesis suggests that NO has a role in the pathogenesis of these processes.

PMID- 11204271
TI  - Cell invasion is affected by differential expression of the urokinase plasminogen
      activator/urokinase plasminogen activator receptor system in muscle satellite
      cells from normal and dystrophic patients.
AB  - The aim of this study was to evaluate the differential expression and the
      function in cell movement and proliferation of the urokinase plasminogen
      activator (u-PA) system in muscle satellite cells (MSC) of normal individuals and
      patients with Duchenne muscular dystrophy (DMD). By immunoenzymatic, zymographic,
      and radioligand binding methods and by quantitative polymerase chain reaction of
      the specific mRNA we have shown that both normal and DMD MSC produce u-PA and the
      plasminogen activator inhibitor-1 and express u-PA receptors (u-PAR). During the
      proliferation phase of their growth-differentiation program, MSC from DMD
      patients show more u-PAR than their normal counterpart, produce more plasminogen
      activator inhibitor-1, and release low amounts of u-PA into the culture medium.
      By Boyden chamber Matrigel invasion assays we have shown that normal MSC are more
      prone than DMD cells to spontaneous invasion but, when subjected to a chemotactic
      gradient of u-PA, DMD MSC sense the ligand much better and to a greater extent
      than normal MSC. u-PA also stimulates proliferation of MSC, but no difference is
      observable between normal and DMD patients. Antagonization of u-PA/u-PAR
      interaction with specific anti-u-PA and anti-u-PAR monoclonal antibodies and with
      antisense oligonucleotides inhibiting u-PAR expression indicates that u-PA/u-PAR
      interaction is required in spontaneous and u-PA-induced invasion, as well as in u
      PA-induced proliferation.

PMID- 11204273
TI  - Effect of angiogenic and antiangiogenic compounds on the outgrowth of capillary
      structures from fetal mouse bone explants.
AB  - Fetal mouse metatarsals are well-known models to study cartilage differentiation
      and osteoclastic resorption. We show here the outgrowth of PECAM-1 positive
      tubelike structures from the bone rudiments. This feature can be used to study
      angiogenesis in vitro. The area of outgrowth significantly increased with culture
      time, as shown by computerized image analysis of PECAM-1 positive tubelike
      structures. Treatment with recombinant human vascular endothelial growth factor
      (rhVEGF-A) stimulated the formation of tubelike structures. Treatment of explants
      with the angiogenesis inhibitor endostatin, the chemokine IP-10, and the
      thalidomide derivative phatolyl glutamic acid (PG-acid) resulted in an inhibition
      of the formation of PECAM-1 positive tubelike structures of 48.8% (+/- 4%), 50.2%
      (+/- 12%), and 80.8% (+/- 3%), respectively. Outgrowth of tubelike structures was
      partly dependent on endogenous VEGF-A because treatment with anti-mVEGF-A and
      truncated VEGF receptor 1 (soluble fms-like tyrosine kinase 1, sFIt1) strongly
      inhibited the formation of tubelike structures 74% (+/- 4%) and 38% (+/- 5%),
      respectively. Neither onset of tube formation nor total area of tubelike
      structures were changed when metatarsals were cultured on a fibrin gel or
      collagen type I gel. Tube formation required activation of matrix
      metalloproteinases because treatment of the bones with an inhibitor of matrix
      metalloproteinases completely inhibited migration and tube formation, whereas
      treatment with an inhibitor of plasmin had no effect. In conclusion, we describe
      a new in vitro model to study angiogenesis that can be used to test the
      angiogenic or antiangiogenic potential of novel test compounds that also combines
      the multicellularity of in vivo assays with the accessibility and flexibility of
      in vitro assays.

PMID- 11204274
TI  - Variations of proline-rich kinase Pyk2 expression correlate with prostate cancer
      progression.
AB  - Proline-rich kinase 2 (Pyk2), also known as CAKbeta (cell adhesion kinase beta),
      is a cytoplasmic tyrosine kinase that is structurally related to focal adhesion
      kinase. Pyk2 is expressed in different cell types including brain cells,
      fibroblasts, platelets, and other hemopoietic cells. Pyk2 is rapidly tyrosine
      phosphorylated in response to diverse extracellular signals acting via different
      post receptor pathways. We have investigated whether this protein kinase is
      functionally expressed in normal and neoplastic prostate tissues. In this study,
      we demonstrate that Pyk2 is expressed only in normal epithelial prostate tissue
      and in benign prostatic hyperplasia, whereas its expression progressively
      declines with an increasing grade of malignancy of prostate cancer.

PMID- 11204275
TI  - Fibroblast growth factor 2 activation of stromal cell vascular endothelial growth
      factor expression and angiogenesis.
AB  - Angiogenesis is a key component of human cancer progression and metastasis. In an
      effort to recapitulate early events in tumor-induced angiogenesis, we have
      employed a subcutaneous Matrigel implant model using immunodeficient mice as
      hosts. Matrigel-containing fibroblast growth factor 2 (FGF-2; 1.2 microg/ml)
      induced stromal cell infiltration into the Matrigel/skin interface within 4 days
      and maximal neovascularization at 7 days. Cells staining positive for the
      endothelial cell marker, platelet-endothelial cell adhesion molecule 1 (PECAM-1),
      were present in neovessels and in isolated cells within the Matrigel matrix.
      Immunohistochemical analysis revealed high levels of vascular endothelial growth
      factor (VEGF) deposited in the stromal interface present only in the FGF-2
      containing but not in control Matrigel implants. VEGF expression was confirmed
      with in situ hybridization. High VEGF mRNA levels were observed in the
      infiltrating stromal cells but not in endothelial or endothelial precursors as
      defined by PECAM-1 staining. In vitro analysis of FGF-2-treated embryonic
      fibroblasts, Balb/c 3T3 cells, showed an induction of VEGF transcription, mRNA
      synthesis, and protein secretion as defined by transcriptional reporter, Northern
      blot, and ELISA assays. The FGF-2-induced VEGF expression was not dependent on
      select matrix adherence or signaling components because VEGF mRNA expression
      induced by FGF-2 was equally activated on serum, basement membrane, and
      fibronectin matrix substrates. Systemic application of anti-VEGF antibodies
      significantly repressed FGF-2-induced angiogenesis over control antibody by 88%
      (p < 0.001). These data support an FGF-2 angiogenic model that is dependent on
      endothelial cell activation, stromal cell infiltration, and VEGF expression by
      the infiltrating stromal cell population.

PMID- 11204276
TI  - Promoter hypermethylation of the RB1 gene in glioblastomas.
AB  - Loss of expression of the retinoblastoma gene (RB1) has been shown to occur in up
      to 25% of glioblastomas (WHO Grade IV). To elucidate the underlying mechanism, we
      assessed RB1 promoter hypermethylation using methylation-specific polymerase
      chain reaction and RB1 expression by immunohistochemistry in 35 primary (de novo)
      glioblastomas and in 21 secondary glioblastomas that had progressed from low
      grade diffuse astrocytoma (WHO Grade II) or anaplastic astrocytoma (WHO Grade
      III). Promoter hypermethylation was significantly more frequent in secondary (9
      of 21, 43%) than in primary glioblastomas (5 of 35, 14%; p = 0.0258). There was a
      clear correlation between loss of RB1 expression and promoter hypermethylation.
      In the majority of glioblastomas with loss of RB1 expression, there was promoter
      hypermethylation (11 of 13, 85%), whereas 93% of tumors with RB1 expression had a
      normal RB1 gene status (p < 0.0001). In three glioblastomas, areas with and
      without RB1 expression were microdissected; promoter hypermethylation was
      detected only in areas lacking RB1 expression. In patients with multiple
      biopsies, methylation of the RB1 promoter was not detectable in the less
      malignant precursor lesions, ie, low-grade diffuse and anaplastic astrocytoma.
      These results indicate that promoter hypermethylation is a late event during
      astrocytoma progression and is the major mechanism underlying loss of RB1
      expression in glioblastomas.

PMID- 11204277
TI  - Localization of tissue transglutaminase in human carotid and coronary artery
      atherosclerosis: implications for plaque stability and progression.
AB  - Although atherosclerosis progresses in an indolent state for decades, the rupture
      of plaques creates acute ischemic syndromes that may culminate in myocardial
      infarction and stroke. Mechanical forces and matrix metalloproteinase activity
      initiate plaque rupture, whereas tissue inhibitors of metalloproteinases have an
      important (albeit indirect) role in plaque stabilization. In this paper, an
      enzyme that could directly stabilize the plaque is described. Tissue
      transglutaminase (TG) catalyzes the formation of epsilon(gamma-glutamyl)lysine
      isopeptide bonds that are resistant to enzymatic, mechanical, and chemical
      degradation. We performed immunohistochemistry for TG in atherosclerotic human
      coronary and carotid arteries. TG was most prominent along the luminal
      endothelium and in the medium of the vessels with a distribution mirroring that
      of smooth muscle cells. Variable, often prominent, immunoreactivity for TG was
      also seen in the intima, especially in regions with significant
      neovascularization. Additionally, TG was detected in fibrous caps and near the
      "shoulder regions" of some plaques. A monoclonal antibody to the transglutaminase
      product epsilon(gamma-glutamyl)lysine isopeptide demonstrated co-localization
      with TG antigen. Transglutaminase activity was found in 6 of 14 coronary artery
      atherectomy samples. Cross-linking of TG substrates such as fibrinogen,
      fibronectin, vitronectin, collagen type I, and protease inhibitors stabilized the
      plaque. Furthermore, the activation of transforming growth factor-beta-1 by TG
      might be an additional mechanism for the promotion of plaque stabilization and
      progression by increasing the synthesis of extracellular matrix components.

PMID- 11204278
TI  - Fas-induced apoptosis is a rare event in Sjogren's syndrome.
AB  - The aim of this study was to perform a controlled in situ analysis on the
      incidence of apoptosis, investigate the expression of apoptosis-mediating
      proteins, and determine the frequency of apoptotic CD4+ and CD8+ T cells in
      Sjogren's syndrome (SS). The study was extended to patients with atrophy-fibrosis
      (AF) not related to SS, as well as to a control group. Immunohistochemistry and
      the terminal deoxynucleotidyl transferase mediated dUTP digoxigenin nick end
      labeling (TUNEL) method were applied to study the Fas and FasL expression and the
      incidence of apoptosis in salivary glands (SG) from patients with primary and
      secondary SS, AF, and controls. These methods were also combined to enable
      simultaneous detection of apoptotic and CD4+ or CD8+ T cells. Despite abundant
      expression of Fas and FasL in SS SG, apoptotic cells were not exceeding 1% in the
      foci of infiltrating mononuclear cells (IMC). Double staining showed that the
      frequency of apoptosis was low among both CD4+ and CD8+ T cells. Only a few
      TUNEL+ epithelial cells were found in all patient groups. Fas was expressed
      predominantly on SS IMC, single SS epithelial cells, and a few normal acinar
      cells, but not in AF SG. Although FasL was present on SS and AF IMC and
      epithelial cells, it was rarely detected in normal tissue. Consequently we
      demonstrate that Fas-induced apoptosis among SS SG is a rare event. Our findings
      support an earlier hypothesis indicating that IMC seem to be able to escape
      apoptosis, resulting in foci of inflammatory cells. Notably, however, no obvious
      correlation can be drawn to previous studies where a high incidence of apoptosis
      of epithelial cells was proposed as an important mechanism leading to decreased
      glandular function, which is a hallmark of SS.

PMID- 11204279
TI  - Hugo Wolfgang Moser--an excellent "science dealer".

PMID- 11204280
TI  - X-Linked adrenoleukodystrophy: overview and prognosis as a function of age and
      brain magnetic resonance imaging abnormality. A study involving 372 patients.
AB  - The phenotypic expression of X-linked adrenoleukodystrophy (X-ALD) ranges from
      the rapidly progressive childhood cerebral form to the milder
      adrenomyeloneuropathy (AMN) in adults. It is not possible to predict phenotype by
      mutation analysis or biochemical assays. This study reports on 372 patients
      ranging in age from less than 3 years to adulthood, who have been followed at the
      Kennedy Krieger Institute. With the aim of determining whether a method could be
      developed to predict clinical course by analysis of data available at time of
      first contact, the patients were subdivided into 18 subgroups on the basis of age
      and the extent of brain magnetic resonance (MRI) abnormality utilizing the MRI
      scoring system devised by Loes et al. Scores to grade degree of neurologic and
      neuropsychologic impairment were also developed. There was strong correlation
      between MRI and the neurology and neuropsychology scores at baseline. Information
      based exclusively on age and MRI score at time of first contact was highly
      predictive of future clinical course and should aid the evaluation of the effects
      of bone marrow transplantation and the selection of patients for this procedure,
      as well as the evaluation of other therapies that may be developed in the future.

PMID- 11204281
TI  - Early neurological signs in preterm infants with unilateral intraparenchymal
      echodensity.
AB  - The aim of the study was to document the early developmental course of
      neurological signs in a group of preterm infants at risk for hemiplegia due to
      unilateral intraparenchymal echodensity (UIPE). Sixteen preterm infants with UIPE
      and sixteen controls were given serial neurological examinations, according to
      the protocols currently adopted in the different NICUs of the project. Moreover,
      the quality assessment of their general movements (GMs) was assessed subsequently
      from videotapes, from birth until around four months postterm. At two years, 12
      of the UIPE infants showed hemiplegia and one suffered from asymmetrical
      diplegia. The findings of the traditional neurological examination were abnormal
      for the large majority of the UIPE infants, although normal findings were also
      recorded in some cases, especially during the preterm period. Asymmetries were
      found after term age in nine UIPE and in two control infants. From the first
      observation onwards, all infants with UIPE showed bilaterally abnormal GMs and in
      those with unfavourable outcome fidgety movements (FMs) were absent. At the FMs
      period (9-16 weeks postterm), all infants with subsequent hemiplegia showed
      asymmetry of distal segmental movements which were reduced or absent on the side
      contralateral to the lesion. CONCLUSIONS: Unilateral brain lesions induce clear
      neurological signs and abnormal GMs in particular, although these abnormalities
      are not initially asymmetrical. A reduction of segmental movements on one side of
      the body during the third month postterm is highly predictive of hemiplegia.

PMID- 11204282
TI  - Monozygotic twins with fetal akinesia: the importance of clinicopathological work
      up in predicting risks of recurrence.
AB  - Fetal Akinesia Deformation Sequence (FADS) or Pena-Shokeir Sequence is a
      heterogeneous group of disorders in which prolonged decrease or absence of fetal
      movements results in a series of deformational anomalies: multiple contractures,
      pulmonary hypoplasia, craniofacial anomalies, polyhydramnios, intrauterine growth
      retardation, and short umbilical cord. Three sets of monozygotic twins, and their
      affected sibs, are presented. Detailed pathological work-up established that the
      two pairs of twins concordant for FADS were of myogenic etiology while the set
      discordant was due to anoxic-ischemic damage. In the myogenic cases, the rate of
      recurrence was high, in agreement with the findings from the study on
      arthrogryposis multiplex congenita of myogenic origin. In light of these
      findings, in sporadic cases of myogenic FADS, counselling, a recurrence risk of
      25% seems prudent. In neurogenic cases associated with primary cerebral
      malformations, there are cases cited in the literature that are clearly recessive
      as indicated by affected sibs, but many reported are isolated occurrences.
      Therefore, in this scenario, giving a recurrent risk of 10-15% appears
      appropriate. In light of autosomal recessive spinal muscular atrophy and reports
      of familial FADS due to primary anterior horn cell loss, counselling a 25% risk
      seems prudent. In cases due to anoxic-ischemic damage, offering a low recurrent
      risk of 1% appears justified.

PMID- 11204283
TI  - The pyramidal tract in congenital hemiparesis: relationship between morphology
      and function in periventricular lesions.
AB  - Three-dimensional MRI data sets were obtained from 12 young adult patients with
      congenital spastic hemiparesis caused by unilateral periventricular white matter
      lesions. The impact of these lesions on corticospinal projections to the upper
      and lower extremities was assessed on reconstructed semi-coronal planes following
      anatomical landmarks of somatotopic organization in the precentral gyrus and in
      the internal capsule: a more anterior plane running through the hand-knob of the
      precentral gyrus and the anterior portion of the posterior limb of the internal
      capsule representing projections to the upper extremity, and a more posterior
      plane running through the top of the precentral gyrus and the middle portion of
      the posterior limb of the internal capsule representing projections to the lower
      extremity. In addition, the total lesion extent was determined volumetrically,
      and Wallerian degeneration was assessed qualitatively in the internal capsule and
      quantitatively by measuring brainstem asymmetry. We found a strong correlation
      between motor dysfunction of the upper and lower limb and the lateral extent of
      the periventricular lesion measured on the respective semi-coronal planes. The
      total lesion volume and the degree of Wallerian degeneration correlated less
      strongly, both reaching statistical significance only with motor impairment of
      the hand.

PMID- 11204285
TI  - Peculiar respiratory response observed during sleep-onset REM sleep of an infant
      with Ondine's curse.
AB  - We treated an infant with congenital central hypoventilation syndrome ("Ondine's
      curse"). She was cyanotic and given ventilatory support at the first hour after
      birth. An investigation of sleep state and respiration performed at the age of 3
      months led to this diagnosis. Hypoventilation persisted in all sleep stages, with
      the most severely reduced tidal volumes occurring during delta-wave sleep (stages
      3 and 4). In addition, severe secondary reduction in tidal volumes occurred in
      sleep-onset REM sleep. This phenomenon was absent in non sleep-onset REM sleep.
      At 4 months of age, her respiratory treatment was successfully converted to
      positive-pressure ventilation via a nasal mask, thus avoiding tracheotomy. This
      transition to noninvasive ventilatory support dramatically improved her quality
      of life during wakefulness. This report may be a clue to discuss the function of
      sleep-onset REM sleep seen in the early stage of life and suggests that nasal
      mask ventilation is a viable option in selected cases with congenital central
      hypoventilation syndrome (CCHS).

PMID- 11204284
TI  - Brain migration disorder and T-cell activation deficiency associated with
      abnormal signaling through TCR/CD3 complex and hyperactivity of Fyn tyrosine
      kinase.
AB  - In this study we report on a patient affected by a brain migration disorder and a
      T-cell activation deficiency presumably inherited as an autosomal recessive
      trait. The immunological evaluation revealed that the mitogen stimulation failed
      to induce a proper up-regulation of membrane expression of T-cell activation
      markers, and cell proliferation. This functional impairment was associated with
      abnormalities of the signal transduction process that follows T-cell receptor
      stimulation. A constitutive hyperphosphorylation of the Fyn tyrosine kinase was
      documented. This is the first report on a T-cell signaling abnormality associated
      with a developmental brain disorder. Whether the alteration of Fyn, which plays a
      role in both neurological and immunological systems, is responsible for either
      disorder remains to be elucidated.

PMID- 11204286
TI  - Intermittent falls and fecal incontinence as a manifestation of epileptic
      negative myoclonus in idiopathic partial epilepsy of childhood.
AB  - We report two children, suffering from idiopathic partial epilepsy, who started
      to present, in the same period of time, with epileptic negative myoclonus (ENM)
      in one lower limb and fecal incontinence (FI). Polygraphic recordings showed that
      ENM was associated with paroxysmal activities distributed over the vertex region.
      Both ENM and FI disappeared when ethosuximide treatment was started. We
      hypothesize that, in our patients, ENM in one lower limb and FI depended on a
      transitory impairment, caused by epileptic activity that altered the
      functionality of nearby cortical areas, located in fronto-mesial regions,
      involved in the control of the muscular tone of the lower limbs and of the pelvic
      floor muscles.

PMID- 11204287
TI  - Single convulsive seizure as isolated neurological complication of mycoplasma
      pneumoniae infection.

PMID- 11204288
TI  - Antihypertensive pharmacogenetics: getting the right drug into the right patient.
AB  - Pharmacogenetic investigation seeks to identify genetic factors that contribute
      to interpatient and interdrug variation in responses to antihypertensive drug
      therapy. Classical studies have characterized single gene polymorphisms of drug
      metabolizing enzymes that are responsible for large interindividual differences
      in pharmacokinetic responses to several antihypertensive drugs. Progress is being
      made using candidate gene and genome scanning approaches to identify and
      characterize many additional genes influencing pharmacodynamic mechanisms that
      contribute to interindividual differences in responses to antihypertensive drug
      therapy. Knowledge of polymorphic variation in these genes will help to predict
      individual patients' blood pressure responses to antihypertensive drug therapy
      and may also provide new insights into molecular mechanisms responsible for
      elevation of blood pressure.

PMID- 11204289
TI  - Serum aldosterone changes during hyperinsulinemia are correlated to body mass
      index and insulin sensitivity in patients with essential hypertension.
AB  - OBJECTIVE: To measure the effects of hyperinsulinemia on serum electrolyte status
      and associated hormones, and on serum free fatty acid (FFA) concentrations, in
      patients with essential hypertension. DESIGN AND METHODS: The serum electrolyte
      status (Na, K, Ca, ionized Ca, Mg, P, pH) and associated hormones [plasma renin
      activity (PRA), serum parathyroid hormone (PTH) and aldosterone concentrations],
      and FFA were measured during an euglycemic hyperinsulinemic clamp test in 49
      patients with untreated essential hypertension. RESULTS: Serum potassium,
      phosphate, PTH, and FFA concentrations decreased during hyperinsulinemia, while
      serum ionized calcium concentration, pH, and PRA increased significantly (P <
      0.05). The changes in serum potassium and magnesium were both inversely related
      to the insulin-mediated glucose uptake (r= -0.62, P< 0.0001; r= -0.31, P< 0.05,
      respectively). Both body mass index (BMI) and insulin-mediated glucose disposal
      were significantly correlated to the changes in serum aldosterone concentration
      during hyperinsulinemia (r = 0.41, P < 0.01; r = -0.40, P < 0.01, respectively).
      The change in serum aldosterone during the clamp test was not significantly
      related to the change in PRA, but tended to correlate to the change in potassium
      concentration (r= 0.25, P= 0.10). A less pronounced reduction in FFA during
      induced hyperinsulinemia was associated with low insulin sensitivity (r= -0.35,
      P< 0.05). CONCLUSION: Hypertensive patients with normal BMI and a more pronounced
      glucose uptake showed a larger serum potassium decline and lowered aldosterone
      concentrations during induced euglycemic hyperinsulinemia. Insulin-resistant
      patients showed a less pronounced reduction in FFA during hyperinsulinemia. The
      observations in the present study may indicate that alterations in aldosterone
      and FFA metabolism might be linked to the insulin resistance metabolic syndrome.

PMID- 11204291
TI  - Prognostic implications of the compensatory nature of left ventricular mass in
      arterial hypertension.
AB  - OBJECTIVE: To test whether inappropriate echocardiographic left ventricular (LV)
      mass (i.e. higher than predicted by individual body size, sex and cardiac load
      [delta%LVM]) is associated with an increased rate of cardiovascular events, and
      whether values of LV mass lower than appropriate confer protection. DESIGN:
      Prospective, longitudinal. SETTING: Institutional, hospital outpatient clinic.
      PATIENTS: A total of 294 hypertensive patients, 84 with inappropriate and 21 with
      low LV mass (lower than appropriate). MAIN OUTCOME MEASURES: Cardiovascular fatal
      and non-fatal events. RESULTS: Baseline delta%LVM was higher in patients with
      follow-up total (n = 50) or fatal (n = 14) events than in event-free survivors
      (all P < 0.0001) and predicted events independently of age and systolic pressure
      (all P < 0.0001). Although the performance was not better than with use of more
      traditional definition of LV hypertrophy, delta%LVM remained a predictor even in
      the subgroup of 126 patients (32 total events, 13 deaths) with clear-cut LV
      hypertrophy (P < 0.009). Patients with low LV mass exhibited supranormal LV
      chamber and midwall function, slightly higher heart rate and higher cardiac index
      (all P< 0.01). These patients had the same rate of events as those with
      appropriate LV mass. CONCLUSIONS: In hypertensive patients, increase in LV mass
      beyond values required to compensate cardiac workload at a given body size and
      sex predicts cardiovascular risk independently of age and blood pressure, in the
      whole population as well as in the subset of patients with LV hypertrophy.
      Hypertensive patients with levels of LV mass lower than needed to compensate
      cardiac workload exhibit hyperdynamic circulatory status and the same risk
      pattern as patients with higher values of LV mass, possibly due to activation of
      the sympathetic system.

PMID- 11204290
TI  - Quinapril treatment enhances vascular sensitivity to insulin.
AB  - OBJECTIVE: Insulin-mediated vasodilation has been shown to be impaired with
      hypertension and aggravated by dietary sodium restriction. Whether vascular
      insulin resistance in this setting could be improved by antihypertensive therapy
      was unknown. Therefore, we determined the effect of therapy with an angiotensin
      converting enzyme inhibitor, on vascular sensitivity to insulin in hypertensive
      subjects fed a sodium-restricted diet. DESIGN AND METHODS: The effects of 3
      months of therapy with quinapril on vascular sensitivity to insulin was assessed
      in 11 hypertensive subjects using a randomized, placebo-controlled, double-blind
      design. Vascular sensitivity to insulin was assessed by determination of the
      insulin ED50 from dorsal hand vein linear variable differential transformer in
      phenylephrine-preconstricted vessels. Subjects were maintained on a 75 mmol/day
      sodium diet for 3 days prior to each study. RESULTS: Quinapril therapy
      significantly improved vascular sensitivity to insulin, as assessed by a decrease
      in the ED50 for insulin (ED50 insulin: placebo = 501 +/- 189 [muU/ min; quinapril
      = 276 +/- 100 muU/min P < 0.05). Isoproterenol-mediated relaxation was also
      enhanced by quinapril treatment (maximal isoproterenol-mediated relaxation:
      Placebo = 92 +/- 15% of baseline distension; Quinapril = 151 +/- 31% P < 0.05).
      CONCLUSIONS: The current study suggests the hypothesis that the ACE-inhibitor
      quinapril has beneficial effects on vascular function in general, and on insulin
      mediated vascular responses, in particular.

PMID- 11204292
TI  - Relation of left ventricular geometry and function to systemic hemodynamics in
      hypertension: the LIFE Study. Losartan Intervention For Endpoint Reduction in
      Hypertension Study.
AB  - OBJECTIVES: To clarify the relations of systemic hemodynamics to left ventricular
      (LV) geometric patterns in patients with moderate hypertension and target organ
      damage. BACKGROUND: LV geometry stratifies risk in hypertension, but relations of
      LV geometry to systemic hemodynamic patterns in moderately severe hypertension
      have not been fully elucidated. DESIGN: Cross-sectional case-control study.
      SETTING: Baseline findings in the echocardiographic substudy of the Losartan
      Intervention For Endpoint Reduction in Hypertension Study (LIFE) and in a
      normotensive reference group. PATIENTS/PARTICIPANTS: Nine hundred and sixty-four
      patients with Stage I-II hypertension and LV hypertrophy by Cornell voltage
      duration criteria ((SV3 + RaVL [+ 6 mm in women]) x QRS > 2440 mm x ms) or
      modified Sokolow- Lyon voltage criteria (SV1 + RV5/RV6 > 38 mm), and 366
      apparently normal adults. INTERVENTIONS: None. METHODS: Two-dimensional and
      Doppler echocardiograms were used to classify hypertensive patients into groups
      with normal geometry, concentric remodelling and concentric and eccentric
      hypertrophy, and to measure stroke volume (SV), cardiac output, peripheral
      resistance and pulse pressure/SV as a measure of arterial stiffness. Comparisons
      were adjusted for covariates by general linear model with the Sidak post-hoc test
      RESULTS: Mean SV was higher in patients with eccentric hypertrophy (83 ml/beat)
      and lower with concentric remodeling (68 ml/beat) than in normal adults (73 ml/
      beat). Cardiac output was highest in patients with eccentric LV hypertrophy and
      lower with concentric remodeling than eccentric hypertrophy; mean pressure and
      peripheral resistance were equally high in all hypertensive subgroups, whereas
      pulse pressure/SV was most elevated (by a mean of 47% versus reference subjects)
      with concentric remodeling and least so (mean + 15%) with eccentric hypertrophy.
      In multivariate analysis (Multiple R + 0.68), LV mass was independently related
      to higher systolic pressure, older age, SV, male gender and body mass index (all
      P< 0.001). Relative wall thickness was independently related (Multiple R + 0.50)
      to older age, higher systolic pressure, lower SV (all P< 0.001) and higher body
      mass index (P + 0.007). SV and cardiac output were lower in patients with low
      stress-corrected midwall shortening. CONCLUSION: In patients with moderate
      hypertension and ECG LV hypertrophy, the levels of SV and pulse pressure/ SV, are
      associated with, and may be stimuli to different LV geometric phenotypes.

PMID- 11204293
TI  - Factors affecting the difference between screening and home blood pressure
      measurements: the Ohasama Study.
AB  - OBJECTIVE: To establish the factors affecting the difference between screening
      and home blood pressure measurements. DESIGN: A cross-sectional study. SETTING:
      General population in a rural Japanese community, Ohasama, Japan. PARTICIPANTS:
      There were 1,789 community-based subjects aged > or =40 years, for whom blood
      pressure was measured at screening site (screening blood pressure) and at home
      (home blood pressure). RESULTS: Multiple stepwise regression analysis of all
      subjects demonstrated that screening pulse pressure was positively associated
      with the difference between screening and home blood pressure measurements for
      systolic blood pressure. Age, the use of antihypertensive medication, and smoking
      status were negatively associated with the difference between measurements of
      both systolic and diastolic blood pressure. CONCLUSION: We have demonstrated that
      age, smoking, antihypertensive medication, and screening pulse pressure are
      independent predictors of the magnitude of the difference between screening and
      home blood pressure measurements, suggesting that the necessity to consider these
      factors, for the detection of the subjects who may be inappropriately treated or
      misjudged following screening blood pressure measurements.

PMID- 11204294
TI  - Indexation of left ventricular mass in adults with a novel approximation for fat
      free mass.
AB  - BACKGROUND: Indexation to fat-free mass (FFM) seems to be the best option for
      adjusting left ventricular (LV) mass. However, measurements of FFM are frequently
      not available. OBJECTIVES: To define the relation of FFM with commonly available
      anthropometric measures in order to derive an approximation formula of FFM that
      can be used for valid indexation of LV mass. SUBJECTS AND METHODS: A total of
      1,371 subjects from a community survey were examined by echocardiography to
      measure LV mass and by bioelectrical impedance analyses (BIA) for the
      determination of FFM. An approximation of FFM was generated in a healthy subgroup
      of 213 men and 291 women by non-linear regression techniques. RESULTS: Compared
      with body height, height2.0, height2.7, (the superscripts following weight and
      height are raised powers used as a more appropriate method for indexing LV mass)
      or body surface area, FFM measured by BIA in the healthy subgroups was best
      predicted by gender-specific equations of the form: FFM = 5.1 x height1.14 x
      weight0.41 for men and FFM = 5.34 x height1.47 x weight0.33 for women. In the
      healthy reference group, indexation of LV mass for BIA-determined FFM and
      approximated FFM (FFMa), respectively, equally eliminated gender differences in
      LV mass and markedly reduced the influence of body mass index without affecting
      the associations between blood pressure and LV mass. Validation of FFMa in two
      independent population-based samples, aged 52 to 67 years, of the same source
      population confirmed that LV mass indexed by FFMa produced results that were
      highly consistent with those obtained with indexation by BIA-determined FFM.
      CONCLUSIONS: We propose a novel approximation of FFM based on exponentials of
      body height and weight. It performed well in the indexation of LV mass in middle
      aged men and women of this study. Evaluation of the equation in other populations
      should be awaited before its use is recommended in situations where direct
      determination of FFM is not possible.

PMID- 11204295
TI  - Influence of gender and family history of hypertension on autonomic control of
      heart rate, diastolic function and brain natriuretic peptide.
AB  - OBJECTIVE: To verify in a unitary view whether autonomic control of heart rate
      and cardiac structure and function are modified early in offspring of
      hypertensive families. METHODS AND RESULTS: We selected 87 age- and sex-matched
      young normotensive subjects with (n = 45) and without (n = 42) a family history
      of hypertension who underwent evaluations of arterial pressure, time-domain
      parameters of autonomic heart rate control (24-h ECG monitoring), spectral
      baroreflex sensitivity, left ventricular geometry and function (echo-Doppler) and
      plasma brain natriuretic peptide levels (BNP). The group with a family history of
      hypertension significantly differed from their counterparts for systolic pressure
      (119 +/- 11 versus 114 +/- 9 mmHg, P< 0.05), heart rate (RR interval, 766 +/- 64
      versus 810 +/- 93 ms, P< 0.05), heart rate variability [the standard deviation of
      normal RR intervals (SDNN), 147 +/- 29 versus 171 +/- 33 ms, P < 0.051, diastolic
      function (isovolumetric relaxation time, 65 +/- 9 versus 60 +/- 8 ms, P< 0.05)
      and BNP (23 +/- 13 versus 37 +/- 10 pg/ml, P< 0.05). Baroreflex sensitivity
      values did not differ between the two groups. When gender was considered, all the
      above-mentioned measures, as well as baroreflex sensitivity, were significantly
      different between males with and without a family history of hypertension but not
      between females, except for BNP, which was lower in males and females with a
      history of hypertension (males, 24 +/- 11 versus 38 +/- 8 pg/ml, P< 0.01; females
      21 +/- 14 versus 36 +/- 13 pg/ml, P < 0.05). CONCLUSIONS: Male, but not female,
      hypertensive offspring have modified diastolic function and autonomic control of
      heart rate; BNP is the only parameter able to characterize hypertensive offspring
      independently from the influence of gender. This provides the hypothesis that the
      impaired production of this hormone could play a primary role in the pre
      hypertensive state.

PMID- 11204296
TI  - Which is more important for the efficiency of hypertension treatment:
      hypertension stage, type of drug or therapeutic compliance?
AB  - OBJECTIVES: Hypertensive patients are a heterogeneous population that can be
      distributed in groups showing different cardiovascular risk and benefit from
      treatment. This study examines the cost-effectiveness of arterial hypertension
      treatment by age, sex, arterial hypertension stage, type of drug used and level
      of treatment compliance. DESIGN: Markov models combining absolute risks for
      stroke, coronary heart disease and all causes of death with relative risks from
      clinical trials and observational studies. Data on health costs were collected
      from hospitals and primary care settings in the Basque Country (Spain). RESULTS:
      Cost-effectiveness ratios vary from 34,516 euros/quality adjusted life year
      (QALY) gained in 30-year-old women to 3,307 euros/QALY in 80-year-old men. A
      treatment compliance of 50% increases these values to 45,270 and 4,905
      euros/QALY, respectively. Treatment of arterial hypertension stage II shows lower
      ratios (19,798 euros/QALY in 30-year-old women and 1,918 euros/QALY in 80-year
      old persons). Cost-effectiveness ratios for arterial hypertension stage I vary
      from 645 euros/QALY in 80-year-old men for diuretics to 47,325 euros/QALY in 30
      year-old women for inhibitors of the angiotensin converting enzyme. CONCLUSIONS:
      There are large variations in the cost-effectiveness of arterial hypertension
      treatment depending on age, sex, arterial hypertension stage, drug used and
      compliance. Improvement of treatment compliance yields the greatest gain both in
      effectiveness and efficiency.

PMID- 11204297
TI  - The baroreflex bandwagon: time to get off?

PMID- 11204298
TI  - Effect of oral magnesium supplementation on blood pressure, platelet aggregation
      and calcium handling in deoxycorticosterone acetate-induced hypertension in rats.

PMID- 11204299
TI  - Growth in utero and blood pressure levels in the next generation.

PMID- 11204300
TI  - Cardiovascular responsivity to stress in adolescents with and without
      persistently elevated blood pressure.
AB  - OBJECTIVES: The goal of this study was to compare the cardiovascular responses to
      behavioural stressors of three groups of adolescents who differed in blood
      pressure status across assessments. DESIGN: Casual blood pressure of adolescents
      who were identified as having elevated blood pressure during a school screen was
      re-evaluated in the laboratory. The adolescents were classified into two groups:
      (i) those with consistently elevated blood pressure across school and laboratory
      assessments and (i) those with labile blood pressure whose blood pressure in the
      laboratory was below 130/80 mmHg. A comparison group of adolescents with
      consistently normal blood pressure was also included. METHODS: Cardiovascular
      parameters were assessed during rest and during two behavioural stressors, the
      evaluated speaking task and the mirror tracing task. RESULTS: Adolescents with
      elevated blood pressure were more vascularly responsive across stressors than
      adolescents with labile blood pressure, who, in turn, were more reactive than
      adolescents with normal blood pressure. CONCLUSIONS: These results suggest that
      vascular reactivity to behavioural stressors may be useful in predicting risk of
      hypertension because of its sensitivity in distinguishing adolescents with
      consistently elevated blood pressure from those with labile blood pressure and
      those with normal blood pressure.

PMID- 11204301
TI  - Maternal nutrition during gestation and blood pressure in later life.
AB  - OBJECTIVE: To assess the link between maternal diet during pregnancy and blood
      pressure of the offspring. DESIGN: Follow-up study. SETTING: A university
      hospital in Amsterdam, The Netherlands. PARTICIPANTS: People born at term as
      singletons between November 1943 and February 1947. MAIN OUTCOME MEASURE: Blood
      pressure at adult age. RESULTS: Adult blood pressure was not associated with
      protein, carbohydrate or fat intake during any period of gestation. We found,
      however, after adjustment for sex that the systolic blood pressure decreased by
      0.6 mmHg (0.1-1.1) for every 1% increase in protein/carbohydrate ratio in the
      third trimester. This association was present both in people who had been exposed
      to the famine during gestation as well as in those who had not been exposed. The
      association between protein/carbohydrate ratio in the third trimester and adult
      blood pressure was furthermore independent of maternal weight gain and final
      weight, and birth weight [increase for every 1% increase in protein/carbohydrate
      ratio 0.6 mmHg (0.0-1.2)]. Adjustment for adult characteristics such as body mass
      index, smoking and socio-economic status did not affect the observed association
      appreciably [adjusted increase 0.5 mmHg (0.0-1.0)]. CONCLUSION: Adult blood
      pressure seems to be affected by small variations in the balance of macro
      nutrients in the maternal diet during gestation rather than by relatively large
      variations in the absolute amounts.

PMID- 11204302
TI  - Blood pressure and mortality during an up to 32-year follow-up.
AB  - BACKGROUND: Elevated blood pressure is an established risk factor of
      cardiovascular diseases, but there is a constant debate whether the association
      is continuous or with a threshold. METHODS: During the 1960s (1964 onwards),
      3,267 initially healthy male business executives (born 1919-1934) participated in
      voluntary health check-ups with measurements of cardiovascular disease risk
      factors. At baseline none of the men were on antihypertensive medication.
      Mortality follow-up was performed using national registers up to 31 December,
      1995. Follow-up total and cardiovascular mortality was related to systolic (by 10
      mmHg) and diastolic (by 5 mmHg, Korotkoff's 4th phase) blood pressure at
      baseline. Analyses were adjusted for age, body mass index, smoking and serum
      cholesterol. RESULTS: During an up to 32-year follow-up, there were 701 deaths,
      234 (33.4%) of them due to coronary heart disease, 49 (7.0%) to stroke, 42 (6.0%)
      to other cardiovascular diseases and 204 (29.1%) to cancer. Total mortality
      curves of the whole cohort (all age groups) were flat until 131-140 mmHg
      (systolic) and 81-85 (diastolic) and increased thereafter. Among men who smoked
      and had baseline serum cholesterol > 6.5 mmol/l (n = 986), the risk of death
      increased progressively with systolic blood pressure, whereas among non-smoking
      normocholesterolaemic men (n = 504) the association was J-shaped, i.e. higher
      mortality at < or = 110 mmHg than between 111-150 mmHg and a more consistent rise
      from 151-160 mmHg. The curves were essentially similar for cardiovascular
      mortality. The results were supported by analyses where major cardiovascular risk
      factors were controlled. CONCLUSION: During a truly long-term follow-up, the
      relationship between systolic blood pressure and mortality was initially flat up
      to 131-140 mmHg although a linear relationship is suggested in men with other
      cardiovascular risk factors.

PMID- 11204303
TI  - Hypertension in four African-origin populations: current 'Rule of Halves',
      quality of blood pressure control and attributable risk of cardiovascular
      disease.
AB  - OBJECTIVE: To assess the public health burden from high blood pressure and the
      current status of its detection and management in four African-origin populations
      at emerging or high cardiovascular risk. DESIGN: Cross-site comparison using
      standardized measurement and techniques. SETTING: Rural and urban Cameroon;
      Jamaica; Manchester, Britain. SUBJECTS: Representative population samples in each
      setting. African-Caribbeans (80% of Jamaican origin) and a local European sample
      in Manchester. MAIN OUTCOME MEASURES: Cross-site age-adjusted prevalence;
      population attributable risk. RESULTS: Among 1,587 men and 2,087 women, age
      adjusted rates of blood pressure > or =160 or 95 mmHg or its treatment rose from
      5% in rural to 17% in urban Cameroon, despite young mean ages, to 21% in Jamaica
      and 29% in Caribbeans in Britain. Treatment rates reached 34% in urban Cameroon,
      and 69% in Jamaican- and British-Caribbean-origin women. Sub-optimal blood
      pressure control (> 140 and 90 mmHg) on treatment reached 88% in European women.
      Population attributable risks (or fractions) indicated that up to 22% of
      premature all-cause, and 45% of stroke mortality could be reduced by appropriate
      detection and treatment. Additional benefit on just strokes occurring on
      treatment could be up to 47% (e.g. in both urban Cameroon men and European women)
      from tighter blood pressure control on therapy. Cheap, effective therapy is
      available. CONCLUSION: With mortality risk now higher from non-communicable than
      communicable diseases in sub-Saharan Africa and elsewhere, systematic
      measurement, detection and genuine control of hypertension once treated can go
      hand-in-hand with other adult health programmes in primary care. Cost
      implications are not great. The data from this collaborative study suggest that
      such efforts should be well rewarded.

PMID- 11204304
TI  - Angiotensin converting enzyme genetic polymorphism is not associated with
      hypertension in a cross-sectional sample of a Japanese population: the Shibata
      Study.
AB  - BACKGROUND: The studies on the association of deletion/ insertion (D/I)
      polymorphism of angiotensin converting enzyme (ACE) gene with blood pressure and
      hypertension reported contradictory results. Because there was no population
      based study in Japan, we examine the hypothesized association in a cross
      sectional sample of a Japanese cohort. METHODS AND RESULTS: The blood pressure of
      464 men and 876 women aged 40-80 years was measured, and their DNA was analyzed
      for ACE D/I genotypes. The prevalence of the D allele was 38.7 and 39.2% in men
      and women, respectively (overall 39%). There was a tendency for higher covariate
      (age, body mass index, albuminuria, hematocrit, alcohol consumption, smoking,
      diabetes mellitus, ischemic heart disease and antihypertensive medication)
      adjusted mean levels of diastolic blood pressure for the DD genotype in men but
      not in women. However, this tendency disappeared after dichotomization of blood
      pressure into diagnostic categories (normotension and hypertension). Results did
      not differ when the subjects were divided into two age groups (< or = 59 and > or
      = 60 years). Covariate-adjusted odds ratios for hypertension for presence of the
      D allele were close to the null value of one. ACE genetic variation accounted for
      only 0.1 and 0.7% of the inter-individual variation in systolic and diastolic
      blood pressure in men. These estimates were 0.2 and 0.1%, respectively, in women.
      CONCLUSION: Although there is a tendency of higher diastolic blood pressure in
      men with DD genotypes, there is no convincing evidence that ACE genotypes are
      associated with hypertension in this Japanese population.

PMID- 11204305
TI  - Linkage of hypertension to chromosome 2q14-q23 in Chinese families.
AB  - OBJECTIVES: To identify chromosome regions containing hypertension susceptibility
      genes in Chinese. SUBJECTS AND METHODS: A three-stage study was carried out in
      Chinese siblings ascertained through outpatient clinics. In the first stage, 283
      affected sib-pairs from 79 nuclear families were subjected to a genome-wide scan
      with 240 microsatellite marker loci. The second stage focused on chromosome 2
      with additional markers resulting in an average distance of 5 cM and used an
      independent sample of 637 affected sib-pairs from 161 families. In the third
      stage, a fine-scale mapping study on the suggestive region was performed in an
      independent set of 777 affected sib-pairs from 106 families. Fourteen markers
      were used with an average distance less than 2 cM. Non-parametric linkage
      analyses (NPL), parametric linkage analyses and transmission-disequilibrium tests
      were used to assess evidence for linkage and association. RESULTS: Three markers
      (D2S168 at 27.06 cM, D2S151 at 152.04 cM and D2S142 at 161.26 cM) on chromosome 2
      with suggestive linkage to hypertension susceptibility genes were identified in
      the genome-wide scan. In stage II, the suggestive region around D2S151 and D2S142
      was replicated, while the linkage around D2S168 was not. In the stage III fine
      scale mapping study, multipoint linkage analyses showed LOD scores greater than
      2.0 throughout a region between 157.16 cM and 162.46 cM (all P < 0.001) with a
      maximum peak of 2.24 (P= 0.00067) at 160.52 cM. We also observed a NPL Z-score
      peak of 3.27 at 157.55 cM (P= 0.00086). CONCLUSIONS: The results of a suggestive
      region on chromosome 2q14-q23 (D2S112-D2S2370) were consistent between each of
      the three studies. Interestingly, this region overlaps a syntenic region that
      contains blood pressure quantitative trait loci identified in rat models of
      hypertension. These data suggest that the region near D2S142 and D2S151 deserves
      to be further screened for hypertension susceptibility genes.

PMID- 11204306
TI  - Impaired ceramide signalling in spontaneously hypertensive rat vascular smooth
      muscle: a possible mechanism for augmented cell proliferation.
AB  - OBJECTIVES: In hypertension, the vascular wall undergoes morphological changes
      that alter mechanical responses to vasoactive substances. Ceramide is a recently
      identified second messenger synthesized in response to cytokines such as tumour
      necrosis factor alpha (TNF-alpha). It has been previously demonstrated that
      vascular smooth muscle cells (VSMC) from genetically hypertensive rats
      proliferate at a higher rate than those of normotensive origin. We tested the
      hypothesis that the ceramide pathway is impaired in VSMC from spontaneously
      hypertensive rats (SHR). DESIGN: VSMC were isolated from aortae of SHR and from
      Wistar-Kyoto (WKY) rats. Ceramide levels were measured under baseline and agonist
      stimulated conditions and cell proliferation was monitored. METHODS: Cell
      proliferation was determined by cell counting. Ceramide levels were determined
      via radioactive labelling, high-performance thin-layer chromatography and
      phosphorimaging. Relative mRNA levels of neutral sphingomyelinase were determined
      using semi-quantitative polymerase chain reaction (PCR). RESULTS: Basal ceramide
      levels in untreated cells were lower in cells from SHR compared to WKY rats.
      During chronic treatment with TNF-alpha, ceramide levels increased in WKY rat
      cells but remained unchanged in cells from SHR. TNF-alpha treatment had an
      inhibitory effect on WKY rat VSMC proliferation, but stimulated proliferation in
      cells from SHR. Short-term incubation with TNF-alpha resulted in a greater
      increase in ceramide in cells from WKY rats than those from SHR. Semiquantitative
      PCR analysis indicated that neutral sphingomyelinase mRNA may be reduced in SHR
      VSMC. CONCLUSIONS: We conclude that ceramide synthesis is impaired in vascular
      smooth muscle from SHR and may contribute to increased VSMC proliferation in
      hypertension.

PMID- 11204307
TI  - Effects of physical training of the dominant arm on ipsilateral radial artery
      distensibility and structure.
AB  - BACKGROUND: Exercise training induces cardiovascular changes that are both
      generalized and restricted to the microcirculation of the tissues more actively
      involved in the exercise itself. Whether the local effect of exercise extends to
      larger arteries is unknown, however. METHODS: In the right and left upper limb of
      17 right-handed subjects performing an asymmetric training of the upper limbs
      (hammer throwers and baseball players) and 16 age-matched sedentary controls, we
      continuously measured radial artery diameter, distensibility and wall thickness
      by an echotracking and a beat-to-beat finger blood pressure device. Arterial
      distensibility was calculated by the arctangent model of Langewouters and
      expressed as continuous values from diastolic to systolic blood pressure.
      Measurements were made: (1) in baseline conditions; (2) after release from
      prolonged proximal ischaemia; and (3) after an increase in radial artery blood
      flow caused by a short (4 min) distal ischaemia to determine the endothelial
      involvement in the training-induced change in arterial distensibility. RESULTS:
      In athletes the radial artery distensibility was markedly greater in the right
      than in the left arm, the latter showing values slightly greater than those seen
      in the two arms of sedentary subjects. In both arms and groups radial artery
      distensibility increased markedly after prolonged ischaemia, the between arm and
      group differences being preserved, however. The radial artery response to distal
      short ischaemia was, on the other hand, similar in the two arms of the athletes,
      although greater in these subjects than in the sedentary ones. Radial artery wall
      thickness was greater in the trained than in the untrained arm of athletes, both
      values being greater than in sedentary subjects. CONCLUSIONS: Asymmetrical
      training of the upper limbs is accompanied by a greater distensibility of the
      middle-sized arteries of the more trained side. This is not associated with
      asymmetrical changes in endothelial structure or function. It is associated with
      a greater wall thickness in the trained side, suggesting that, at least in part,
      a training-induced asymmetrical change in wall structure (possibly with a
      predominance of more distensible tissues such as elastine and smooth muscle) is
      responsible.

PMID- 11204308
TI  - Systolic and pulse blood pressures (but not diastolic blood pressure and serum
      cholesterol) are associated with alterations in carotid intima-media thickness in
      the moderately hypercholesterolaemic hypertensive patients of the Plaque
      Hypertension Lipid Lowering Italian Study. PHYLLIS study group.
AB  - OBJECTIVE: The Plaque Hypertension Lipid Lowering Italian Study (PHYLLIS), is the
      first study in patients with hypertension (diastolic blood pressure (DBP) 95-115
      mmHg; systolic blood pressure (SBP) 150-210 mmHg), moderate hypercholesterolaemia
      (LDL-cholesterol 4.14-5.17 mmol/l (160-200 mg/dl) and initial carotid artery
      alterations (maximum intima-media thickness (IMT) Tmax > or = 1.3 mm). The
      primary objective of PHYLLIS is investigating whether in these patients
      administration of an angiotensin converting enzyme inhibitor, fosinopril, and a
      statin, pravastatin, is more effective than administration of a diuretic and a
      lipid-lowering diet in retarding or regressing alterations in carotid IMT. While
      the study is in progress, baseline data are here reported to clarify the
      association of various risk factors with carotid IMT in these medium-high risk
      hypertensive patients. METHODS: Patients numbering 508 have been randomized to
      PHYLLIS by 13 peripheral units, in Italy. Age was (mean +/- SD) 58.4 +/- 6.7
      years, males were 40.2%, current smokers 16.5%, means +/- SD of serum total, low
      density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol and
      triglycerides concentrations were 6.79 +/- 0.67, 4.69 +/- 0.51, 1.37 +/- 0.38,
      1.59 +/- 0.64 mmol/l (262.4 +/- 25.8, 181.3 +/- 19.8, 53.0 +/- 14.6, 141.0 +/-
      56.7 mg/ dl). Means +/- SD of clinic sitting SBP/DBP were 159.8 +/- 9.0/98.3 +/-
      4.2 mmHg. 483 of the 508 patients also had 24 h ambulatory BP monitoring, edited
      and read at a centralized unit (mean +/- SD 24 h SBP/DBP averages 136.3 +/-
      14.1/84.0 +/- 10.0 mmHg). Quantitative B-mode ultrasound (Biosound 2000 II 5A,
      Biosound, Indianapolis, Indiana, USA) recordings of carotid arteries were taken
      by certified sonographers in the peripheral units and tracings were all read at a
      central unit. CBMmax (mean IMT of eight sites at common carotids and
      bifurcations) was 1.21 +/- 0.17; Mmax (mean of 12 sites also including internal
      carotids) 1.16 +/- 0.17, and Tmax (single maximum) 1.85 +/- 0.48 mm. RESULTS:
      Ambulatory SBP and pulse pressure (PP) (24 h, daytime, night-time averages) and
      their variability indices (24 h SD) were always significantly correlated with
      CBMmax and Mmax (P0.01 -0.001), and the correlations remained significant after
      adjustment for age, gender and smoking. No measurement of DBP was ever associated
      with any IMT measurement. Likewise, no lipid variable was found associated with
      any IMT measurement. CONCLUSIONS: Baseline data from PHYLLIS indicate that in
      this population of hypertensive patients with moderate hypercholesterolaemia, SBP
      and PP are with age among the most significant factors associated with carotid
      artery alterations. However, the narrow range of inclusion LDL-cholesterol and
      DBP values may have obscured an additional role of these variables.

PMID- 11204310
TI  - Insulin resistance in hypertensives: effect of salt sensitivity, renin status and
      sodium intake.
AB  - OBJECTIVE: Homeostasis Model Assessment (HOMA index) is predictive of insulin
      sensitivity in normal and diabetic patients. This study was designed to see if
      insulin resistance in hypertensives, measured using the HOMA index, differs,
      based on salt sensitivity, renin status and sodium intake. METHODS: Fasting
      insulin and glucose were determined in subsets of 426 essential hypertensives,
      and normotensives. HOMA was calculated as fasting glucose (mmol) x fasting
      insulin (muU/ml)/22.5. RESULTS: Four hundred and twenty-six essential
      hypertensives and normotensives from four HERMES centers form the basis of this
      report. There was no difference in the HOMA index between hypertensives and
      normotensives (P= 0.291) or between hypertensives grouped according to blood
      pressure salt sensitivity (P = 0.153). However, when essential hypertensives were
      subgrouped by renin status, the low-renin group had significantly lower (P< 0.01)
      HOMA index than the normal/high-renin group. When normal/high-renin group was
      divided into modulators and non-modulators, the nonmodulators had significantly
      higher HOMA index (P< 0.001) than other hypertensive subsets. The effect of
      sodium intake on the HOMA index was significant only for non-modulators (P<
      0.002), with salt restriction increasing insulin resistance. CONCLUSION: Insulin
      sensitivity differs among subsets of essential hypertension, non-modulators being
      most insulin resistant and the low-renin subset insulin sensitive. Salt
      restriction might have an adverse effect on insulin sensitivity in non
      modulators. The reduction in cardiovascular risk seen in low-renin hypertensives
      may be related to their increased insulin sensitivity; in contrast, the
      clustering of cardiovascular risk factors seen in nonmodulators may be due to
      increased insulin resistance.

PMID- 11204311
TI  - [A centennial of "The Interpretation of Dreams"].

PMID- 11204309
TI  - High salt intake and the brain renin--angiotensin system in Dahl salt-sensitive
      rats.
AB  - OBJECTIVES: To assess changes in the activity of the brain renin-angiotensin
      system during (i) the development of salt-sensitive hypertension; and (ii) the
      prevention of salt-sensitive hypertension by blocking brain 'ouabain'. METHODS:
      In protocol I, angiotensin converting enzyme (ACE) mRNA and activity and
      angiotensin I and II levels were assessed in the hypothalamus and pons of Dahl
      salt-sensitive (Dahl S) and salt-resistant (Dahl R) rats on regular (120 micromol
      Na+ per g) or high (1370 micromol Na+ per g) salt diet from 4-6 weeks or 4-9
      weeks of age. In protocol II, ACE mRNA and activity were assessed in the
      hypothalamus and pons in Dahl S on regular or high salt treated with
      intracerebroventricular (i.c.v.) Fab fragments blocking brain 'ouabain' or gamma
      globulins, and in Dahl R on high or regular salt ACE mRNA was assessed by
      quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) assay and
      angiotensin I and II by radioimmunoassay after high-performance liquid
      chromatography. In protocol III, effects of i.c.v. angiotensin I and i.c.v.
      bradykinin on renal sympathetic nerve activity (RSNA), heart rate and blood
      pressure before and after i.c.v. captopril were assessed in Dahl S and R rats on
      regular or high salt intake from 4-8 weeks of age. RESULTS: High salt diet caused
      a gradual, but marked increase in blood pressure in Dahl S but not Dahl R rats.
      Dahl S rats showed small but significant increases in ACE mRNA in the
      hypothalamus on regular salt diet. In Dahl S rats on high salt diet for 2 or 5
      weeks ACE mRNA levels significantly increased in both hypothalamus and pons,
      compared with Dahl R rats on either diet or Dahl S rats on regular diet. After 5
      weeks of high salt diet, ACE mRNA levels in the hypothalamus in Dahl S rats were
      almost three-fold higher and in the pons two-fold higher than in Dahl R rats on
      either diet or Dahl S on regular salt diet. High salt diet also increased ACE
      activity of the hypothalamus and pons in Dahl S but not Dahl R. Consistent with
      this increased ACE activity, central responses to angiotensin I were clearly
      enhanced and to bradykinin markedly diminished in Dahl S on high salt intake.
      Chronic blockade of brain 'ouabain' by i.c.v. Fab fragments prevented the
      increases in blood pressure, ACE mRNA and activity in the hypothalamus and pons
      by high salt intake in Dahl S rats. Angiotensin I levels in the hypothalamus and
      pons were similar in both groups of rats and there were no significant changes
      caused by high salt diet in Dahl S and R rats. On regular salt intake angiotensin
      II levels in the hypothalamus of Dahl S rats showed a significant decrease as
      compared with Dahl R rats on regular salt diet, and were similar in the pons of
      the two strains. High salt intake did not affect angiotensin II levels in either
      hypothalamus or pons in Dahl S and R rats. CONCLUSIONS: These results indicate
      that high salt intake increases blood pressure, ACE expression and activity in
      the hypothalamus and pons of Dahl S rats without a parallel increase in
      angiotensin II levels. Effects of high salt intake on ACE mRNA and activity
      appear to be secondary to activation of brain 'ouabain'.

PMID- 11204312
TI  - [Atypical neuroleptics: new approaches to drug therapy of schizophrenic
      disorders].
AB  - The introduction of conventional antipsychotics revolutionized the management of
      psychotic disorders in the 1950s. The use of these agents has been marked by
      several shortcomings, including their association with severe motor disturbances
      and their limited efficacy in treating the negative and cognitive symptoms of
      schizophrenia. Patients noncompliance has largely been the result of subjectively
      distressing extrapyramidal motor side-effects (EPMS). It was therefore necessary
      to develop antipsychotic drugs with selective pharmacological profiles, e.g.
      limbic selectivity. A defining characteristic of atypical neuroleptics is a
      higher ratio of serotonin receptor blockade to D2 receptor blockade. Their
      primary advantage is their superior side-effect profile. The implications of EPMS
      reduction touch several domains of pathology in schizophrenia such as short- and
      long-term movement disorders, noncompliance, relapse rate, negative symptoms and
      cognitive dysfunction. Novel antipsychotics may represent the second
      pharmacological revolution in the treatment of psychotic disorders. There is,
      however, still a need for a critical evaluation of the risk-benefit-ratio of
      differing atypical agents.

PMID- 11204313
TI  - [Unusual cause of leg venous thrombosis in a 20-year-old man].

PMID- 11204314
TI  - [Bed rest after lumbar puncture: a nation-wide survey in Austria].
AB  - BACKGROUND: Recommendations in medical textbooks concerning bed rest after lumbar
      puncture to prevent postpunctional headache vary between immediate mobilisation
      and 24 hours bed rest. AIM OF THE STUDY: The aim of the study was to evaluate the
      current practice in neurological departments. METHODS: We contacted all
      neurological departments in Austria by fax and asked about standards concerning
      bed rest after lumbar puncture and about the number of punctures per month.
      RESULTS: 28 out of 32 departments replied (88%). Fifty percent (n = 14) of the
      departments recommend 24 hours bed rest after lumbar puncture, recommendations of
      the other departments vary between immediate mobilisation (one department) and 16
      hours bed rest. CONCLUSION: Current practice concerning bed rest after lumbar
      puncture varies widely in Austria and most patients are confined to bed for
      several hours. Even though there is evidence that bed rest does not prevent post
      lumbar puncture headache, there is so far no systematic review published in the
      medical literature.

PMID- 11204315
TI  - The value of serum CA 125 for the management of tubo-ovarian abscesses.
AB  - OBJECTIVE: The aim of this study was to compare the value of CA 125, ESR and CRP
      in predicting the outcome of tubo-ovarian abscess (TOA) treatment and to
      investigate whether TOA treatment could be improved by following the dynamics of
      CA 125 serum levels. STUDY DESIGN: This prospective study included 36 patients
      with unilateral TOA, confirmed on the basis of history and physical examination,
      laboratory findings, and ultrasound (US) investigation. Venous blood samples for
      estimation of serum CA 125, CRP, and ESR were taken on hospital admission and
      then every 5 days. On day 20, the success of treatment was evaluated by clinical
      and sonographical re-assessment, and the patients were divided into two groups:
      those with complete regression of the TOA and those with residual inflammatory
      disease. Statistical analysis was performed by nonparametric Mann-Whitney U-test
      with multiple regression. RESULTS: On admission, CA 125 levels were increased (>
      16.7 U/ml) in 32 patients (88.9%). The CA 125 level amounted to 55.7 U/ml on the
      average. A significant difference in CA 125 values between the above mentioned
      two groups was observed from day 10 of treatment onwards (p = 0.00015). On
      comparison of ESR, CRP, and CA 125, the latter had the highest predictive value
      for disease outcome after day 10 (p < 0.0011), while at the time of diagnosis,
      ESR proved more reliable in predicting the outcome. CONCLUSIONS: The dynamics of
      serum CA 125 allow an objective evaluation of the course and outcome of TOA, in
      combination with clinical parametres and US investigation.

PMID- 11204316
TI  - [Multiple organ failure following inhalation of butane gas: a case report].
AB  - Most cases of acute poisoning by butane and other volatile compounds occur in
      young people as a consequence of substance abuse by inhalation. Clinical symptoms
      are caused by asphyxia and mainly affect the cardiovascular, respiratory and
      central nervous system. There are also reported deaths from intoxication of
      butane inhalation, mostly by cardiac arrhythmia. We report the case of a healthy
      14 year-old boy who inhaled butane gas from an aerosol can for refilling
      cigarette lighters. Despite successful resuscitation and defibrillation, he died
      two days later from multiple organ failure involving the central nervous system,
      cardiovascular system, pulmonary system and the liver. Although such incidents
      are rare in middle European countries, emergency and intensive care medicine
      staff should be instructed on the consequences and management of butane gas
      poisoning.

PMID- 11204318
TI  - Can it be worse? On the sub-Saharan HIV/AIDS epidemic at the beginning of the new
      millennium.
AB  - According to the data in the relevant literature, it seems that at the millennium
      the worldwide HIV/AIDS epidemic shows no decline. In the most heavily affected
      area of tropical (sub-Saharan) Africa the situation is getting worse. There is a
      number of factors which are responsible for this situation. Considering the lack
      of necessary funds, it is evident that the most important task is a vigorous
      health education.

PMID- 11204317
TI  - [Hemorrhagic diathesis as initial symptom of stomach carcinoma].
AB  - BACKGROUND: Microangiopathic hemolytic anemia (MAHA) and disseminated intravasal
      coagulation (DIC) as initial paraneoplastic symptoms of a solid tumor present a
      rare clinical situation. CASE REPORT: In 1998 a female patient was admitted due
      to multiple thrombosis, thrombocytopenia and fever. The initial diagnostic
      procedures revealed peri-aortic lymphomas and a tumor bulk (7 x 8 cm) in the
      upper abdomen. Gastroscopy revealed a 2 cm ulcer at the back side of the gastric
      corpus. Histologically, a signet-ring cell carcinoma was diagnosed. Final
      diagnosis stated a multilocular metastasising gastric cancer with infiltration of
      bone, peritoneum and dura and signet-cell infiltration of the bone marrow.
      Hematologic investigation in view of multiple paraneoplastic thrombosis revealed
      a microangiopathic hemolytic anemia associated with disseminated intravasal
      coagulation. Parallel to initial symptomatic therapy of coagulopathy, systemic
      cytostatic therapy with CDDP and VP-16 was initiated. In addition, radiotherapy
      of the brain was performed. After histologic confirmation of the diagnosis,
      weekly therapy with 5-FU (2600 mg/m2) and folinic acid (500 mg/m2) according to
      the Ardalan protocol was performed. After first signs of moderate response,
      oxaliplatin (60 mg/m2, day 1) was added. Although the chemotherapy dose had to be
      reduced due to prolonged neutropenia, the disturbances of hemostasis resolved
      completely resulting in reduced substitution rates with fresh frozen plasma (FFP)
      and platelets. Unfortunately, the patient died at home due to pulmonary embolism.
      CONCLUSION: Tumor-associated hemostaseologic alteration requires immediate
      substitution of FFP and platelets. However, it should be followed by specific
      therapy of malignancy, since tumor-induced metabolites (e.g. mucin) maintain the
      alteration of hemostasis. Chemotherapy may therefore be the best strategy to
      prevent complications such as MAHA and DIC.

PMID- 11204319
TI  - [The role of pharmacotherapy for treatment of obesity in adults].
AB  - Obesity is one of the pathologies with ever-increasing prevalence in modern
      societies. Its occurrence is strongly associated with increased risk of
      developing diabetes mellitus, atherosclerosis, hypertension, stroke, heart and
      respiratory failure, breast, prostate and gut cancer, gall stones, arthropathy.
      Obesity is common in Polish population. Obesity treatment is difficult and
      frustrating. It consists of several parts like diet, increased physical activity,
      lifestyle changes, drug therapy and surgery. However, obesity treatment is very
      often a failure, mostly because of discouraging long-term results and the
      necessity of intensive patient's involvement in the therapy. For many patients
      and doctors weight-decreasing agents look promising. The groups of anti-obesity
      drugs are presented in the article, with special reference to serotoninergic
      agents and intestinal lipase inhibitors. The prospects for new anti-obesity
      agents are discussed. Nevertheless, despite intensive research on obesity, we are
      still waiting for the development of an effective and safe drugs helping lose
      weight.

PMID- 11204320
TI  - [Predominance of multidrug resistant strains with reduced susceptibility to
      fusidic acid among methicillin-resistant Staphylococcus aureus strains (MRSA)
      isolated in the Gdansk region].
AB  - The aim of the present study was to follow the changes in the drug resistance
      among the methicillin-resistant Staphylococcus aureus strains (MRSA) isolated
      from clinical samples in various hospitals during 8 years, with particular
      consideration of Gdansk area. The study was carried out on 225 strains of MRSA
      from which 95 were isolated in the years 1990-1995 and 130 in the years 1997
      1998. The drug susceptibility was determined by the disc-diffusion method. The
      sensitivity to fusidic acid was determined by both disc-diffusion method and
      minimal inhibitory concentration (MIC) using agar dilutions. The results obtained
      show that in 1997-1998 in the hospitals of Gdansk area have been appeared MRSA
      strains which have not occurred before. These strains were intermediately
      sensitive or resistant to fusidic acid and simultaneously resistant to
      doxycycline, gentamicin, erythromycin, clindamycin, ciprofloxacin and rifampin.
      They represented 66.2% of all MRSA strains isolated in 1997-1998 and were present
      in majority of the hospitals monitored. Only in this group of staphylococci the
      strains additionally resistant to mupirocin (6.2%) occurred. Among the MRSA
      strains with reduced susceptibility to fusidic acid 64.4% were intermediately
      sensitive (MIC 8-16 mg/L) and 15.4% were resistant to this drug (MIC > 16). In
      1997-1998 the percentages of MRSA strains resistant to rifampin, clindamycin and
      ciprofloxacin increased significantly from 12.6% to 90.8%, from 42.1% to 92.3%
      and from 18.9% to 92.3% respectively. The percentage of the chloramphenicol
      resistant strains decreased from 14.7% to 0.8%. Like in 1990-1995, the MRSA
      strains resistant to vancomycin and teicoplanin were not found out in the same
      period of time.

PMID- 11204321
TI  - [Risk factors for inner ear diseases].
AB  - The aim of this study was to evaluate the occurrence of obesity and arterial
      hypertension in patients suffering from vertigo, and/or tinnitus and/or hearing
      loss of unknown origin. 48 patients (25 women and 23 men) were included into this
      study. All patients had a negative previous medical history of any metabolic,
      cardiovascular or neurological disorders. Our results were compared to the
      control group of 31 healthy persons (16 women and 15 men). All subjects had a
      complete neurootologic examination, appropriate audiometric and vestibular
      studies. In most cases inner ear pathology was recognised. BMI, systolic and
      diastolic blood pressure were measured in all cases. Patients were overweight
      significantly more often comparing to the control group. Systolic and diastolic
      hypertension was found significantly more often in men from the patients than
      control group.

PMID- 11204322
TI  - [Procalcitonin in diagnosis of purulent and aseptic meningitis in children].
AB  - Procalcitonin (PCT) is a new indicator of the systemic response to severe
      infections. To evaluate clinical usefulness of serum procalcitonin measurements
      in the differential diagnosis of purulent versus aseptic meningitis in children
      was the aim of the study. Fifteen children (aged 1 month-14 years) with purulent
      meningitis and 12 children (aged 6 months-12 years) with aseptic meningitis were
      included into the study. Serum PCT concentration was measured on admission by
      immunoluminometric assay. Thirty healthy controls (aged 3 months-14 years) were
      also enrolled into the study. Serum PCT concentration was above 0.5 ng/ml in 14
      out of 15 children with purulent meningitis (range 0.0-95.2 ng/ml; arrhythmetic
      mean--28.2 ng/ml). In all children with aseptic meningitis (range 0.0-0.3 ng/ml;
      mean--0.1 ng/ml) as well as in healthy controls (range 0.0-0.3 ng/ml; mean--0.1
      ng/ml) serum PCT was below 0.5 ng/ml. CONCLUSION: Elevated serum PCT
      concentration in child with meningitis suggests bacterial aetiology.

PMID- 11204323
TI  - [Apolipoprotein E(ApoE)and tau protein in Alzheimer type dementia].
AB  - In 45 patients meeting NINCDS-ARDRA criteria for probably diagnosis of Alzheimer
      disease (AD), ApoE genotype and tau protein level in cerebro-spinal fluid (CSF)
      were determined. Frequency of e4 allele occurrence in group of AD patients was
      73.3% and showed high statistic significance in comparison with control group.
      Increase of tau protein level in CSF was also statistically significant. No
      correlation in ApoE allele and tau protein level in CSF was revealed. The authors
      emphasize the usefulness of tau protein level measurement and determination of
      ApoE allele in diagnosis of Alzheimer disease.

PMID- 11204324
TI  - [Early results of patient rehabilitation after anterior cruciate ligament
      reconstruction].
AB  - In the Orthopedic Department of the Upper-Silesian Rehabilitation Center "Repty"
      in Ustron 54 patients have been rehabilitated after a plasty of the anterior
      cruciate ligament and transplantation of 1/3 middle part of the patellar ligament
      with two osseous blocks at each end. The rehabilitation was conducted according
      to the scheme worked out in our department. The results of the rehabilitation
      were assessed by the objective and subjective methods (for example the
      goniometric pendulum test, the modified Lysholm's scale, the WAS questionnaire).
      The patients had been divided randomly into two comparative study groups that
      were subject to exactly the same rehabilitation scheme, but one of the group was
      additionally provided with the impulsive magnetic field therapy. A satisfactory
      improvement was observed in both groups of patients. There was no significant
      advantage of additional treatment with the impulsive magnetic field.

PMID- 11204325
TI  - [Laparoscopic splenectomy with a postero-lateral approach in patients with
      idiopathic thrombocytopenic purpura].
AB  - The aim of the study is presentation of operative technique and early results of
      laparoscopic splenectomy in 15 cases of idiopathic thrombocytopenic purpura (ITP)
      patients resistant to typical steroid therapy. There were 7 women and 8 men in
      age 16-58 years (mean 32.6 years). Preoperative investigations revealed accessory
      spleens in two patients. Platelets count at the time of qualifying patients to
      splenectomy varied from 7-35 g/L and after preoperative treatment (prednisone 1
      mg/kg--6 patients, methylprednisone 25 mg/kg--5 patients, immunoglobulins 2.0/kg-
      2 patients, immunoglobulins and methylprednisone--2 patients) varied from 36-205
      g/L. Splenic length was from 8-17 cm. The lateral approach and 4-5 ports were
      utilized in all cases. Pneumoperitoneum with value of 12-14 mmHg of carbon
      dioxide was created using an open technique. First step of the procedure was to
      free spleno-colic ligament, then spleno-reno attachment. In all cases the hilus
      artery, vein and short gastric vessels were clipped and divided by Endo GIA
      stapler 30 or 60 mm and clips. Spleens were removed from the abdomen cavity in
      the plastic bag after manual/forceps crushing inside the bag. Intraoperative
      bleeding occurred in 2 patients (20%). Blood loss was about 800 and 1000 ml
      respectively. The mean operative time was 170 min (140-300 min). Spleen weight
      was 210 g average. In 3 cases conversion to open approach was needed because of
      injury of splenic vessels (2 pts.) and difficulty in removing spleen--in 1
      patient. Post operative course was uneventful in every 10 patients. Mean hospital
      stay was 5.8 days. Increase in platelet count was observed in 14 patients on the
      second postoperative day to 60-291 g/L. One patient did not response as expected.
      No early postoperative complications were observed. CONCLUSION: Laparoscopic
      splenectomy may be considered as a safe and feasible procedure in selected
      patients with ITP without long-term improvement after typical conservative
      treatment.

PMID- 11204326
TI  - [Analysis of general and hemorrhagic complications after treatment of acute
      proximal deep venous thrombosis of the legs treated with anticoagulants,
      streptokinase and thrombectomy].
AB  - The aim of the study was to present general and haemorrhagic complications in 164
      patients with acute DVT in ilio-femoral segment treated with different methods of
      pharmacological (heparins, streptokinase) and surgical (venous thrombectomy with
      temporary arterio-venous fistulae) therapy. There were no fatal complications in
      48 UH or LMWH treated patients. One patient bled from stress stomach, one
      developed intramuscular haematoma, one mild pulmonary embolism and one rise of
      body. Among 84 patients treated with SK five fatal bleeding complications were
      recorded. From other non fatal complications we recorded one GI bleeding, one
      splenic rupture and three massive intramuscular haematoma. Three patients died in
      the early post thrombectomy period. Non fatal complications included one wound
      haematoma, two wound infection and one with marginal necrosis. The use of LMWH or
      UH treatment in acute ilio-femoral venous thrombosis is save as the frequency of
      massive bleeding and serious general complications is rather low. Fatal
      haemorrhagic episodes are the major hazards of thrombolytic therapy. Venous
      thrombectomy with temporary arterio-venous fistula may provide a good chance for
      treatment of acute proximal DVT associated with complete occlusion of the lumen
      of affected veins in patients with severe ischemic venous thrombosis or with
      contraindications to heparin treatment.

PMID- 11204327
TI  - [Single sigmoidoscopy for screening of colorectal cancer].
AB  - Once-only sigmoideoscopy of person aged 57 is successful and safe method of
      screening of colorectal cancer. However acceptance of invitation to screening was
      about 25%. Because of that we postulated once-only sigmoideoscopy screening for
      patients aged 57 hospitalized from other than digestive tract neoplasms causes.

PMID- 11204328
TI  - [Care of the frail elderly in population studies].
AB  - The paper is one of the publications presenting the Polish part of the study on
      the EASY-Care questionnaire. The study was carried out as the multi-centre
      project "Supporting Clinical Outcomes in Primary Care of the Elderly". The EASY
      Care Questionnaire is an instrument to assess the health care needs and social
      situation of older people for use in primary care. OBJECTIVES: To identify the
      main providers of help to the frail community-dwelling elderly people aged 75
      years and over. DESIGN: Cross-sectional questionnaire study, survey. SETTING:
      Community-dwelling elderly people living in the administrative borders one of the
      community health care centres in Bialystok-city. PARTICIPANTS: 117 randomly
      selected people aged 75 years and over; the interviewers were doctors and nurses,
      serving the studied area. MEASUREMENTS: Elderly Assessment System EASY-Care,
      version 1997,98. RESULTS: 81 persons of the studied group (69.2%) were ADL
      dependent. Most of the elderly people in need of care were women, more often with
      the suspicion of depression and with cognitive impairment. Most of the caregivers
      (80%) of the frail community-dwelling elderly people 75 and over were family
      members living together (42%), living apart (21%) or it was wife/husband (17%).
      Almost 10% of the ADL-dependent elderly had no carer at all. The category of
      carers fulfilling all of the needs of the care recipient were more often the
      spouse. The role of the public care providers was marginal. CONCLUSIONS: The
      family is still the basic source of support and the central element in the care
      system for the elderly in Poland. The family is insufficiently supported by
      formal and informal carers.

PMID- 11204329
TI  - [Acute hepatitis caused by cytomegalovirus].
AB  - Cytomegalovirus (CMV) is widespread. In most cases CMV infection is asymptomatic.
      The most significant clinical syndrome is mononucleosis and hepatitis. We report
      a case of 38 old woman with CMV hepatitis associated with erysipelas.

PMID- 11204330
TI  - [Argon plasma coagulation in a patient with early diagnosis of gastric
      carcinoma].
AB  - Argon plasma coagulation (APC) has been introduced for the local endoscopic
      treatment of gastrointestinal malignancy recently. It is mainly used as a
      palliative therapy, especially in case of stenosis. Despite a lot of publications
      concerning APC the clinical usefulness of this method in a small malignant tumors
      remains unclear. The patient with early diagnosed carcinoma of gastric,
      efficiently treated using argon plasma coagulation is described.

PMID- 11204331
TI  - [A patient with abdominal actinomycosis--diagnostic problems].
AB  - The difficulties in diagnosis of abdominal actinomycosis are presented. Clinical
      manifestations and colonoscopy suggested malignancy. Final diagnosis was made on
      the basis of pathological assessment of resected sigmoid. Authors underline that
      in case of "negative" pathomorphological results of material obtained during
      endoscopy from lesions suspected, benign disease should be consider including
      anctinomycosis and intraoperative pathomorphological examination should be
      performed.

PMID- 11204332
TI  - [Use of cefuroxime axetil in clinical practice].
AB  - This study summarizes the actual recommendations for cefuroxime axetil treatment
      in dermatology and general medicine. These include the well known clinical
      efficacies in therapy of upper and lower respiratory tract infections,
      genitourinary tract infections and skin and soft tissue infections, but also
      connective tissue diseases, such as morphea and SCLE. Though the immunomodulatory
      activity of the drug should be established by further controlled studies, there
      are some limited literature data, which show the modulatory effect of cefuroxime
      axetil on the lymphocyte proliferation and the production of selected cytokines.

PMID- 11204333
TI  - [Interactions between food and drugs. 1. Malabsorption].
AB  - The paper overviews food-drug interactions. The part 1 reviews the interactions
      of foods with the many different agents which occur at the level of absorption,
      considering the mechanisms involved. The food-drug interactions can cause an
      increase, decrease, or delay in the bioavailability of the drugs. There is an
      aspect of therapy which may have an important clinical repercussion, which it
      must not be forgotten.

PMID- 11204334
TI  - [Interactions between food and drugs. 2. Disturbances of drug metabolism and
      synergistic mode of action].
AB  - The paper overviews food-drug interactions. The part 2 reviews the interactions
      of foods with the drugs which occur at the level of metabolism. Concomitant
      intake with food increases or decreases the concentrations of many agents in
      humans. The effect seems to be mediated mainly by suppression of the cytochrome
      P450 in the liver and in the small intestine wall. This results in a diminished
      first pass metabolism with higher bioavailability and increased maximal
      concentrations of substrates of this enzyme. To avoid the interactions many drugs
      should not be taken with the meal and citrus juices, particularly grapefruit
      juice.

PMID- 11204335
TI  - [Munchausen's syndrome by proxy--a malignant form of child abuse].
AB  - Munchhausen syndrome by proxy is a malignant form of child abuse in which illness
      in a child is fabricated and/or induced by a parent. It can result in serious
      illness and even death of the child and it is difficult to detect. The authors
      give a significant amount of literature examples. They try to find out the
      difference in ways of hurting by perpetrators. Various types of personalities and
      emotional disturbances in Munchhausen on proxy syndrome are shown. Child
      maltreatment and Munchhausen by proxy syndrome need to be part of the
      differential diagnosis when the clinical picture is atypical or does not appear
      medically plausible.

PMID- 11204336
TI  - [Hyperprolactinemia--unappreciated clinical problem].
AB  - In the study, in concise way, actual knowledge concerning hyperprolactinemia was
      presented. Its causes, clinical symptoms, diagnostic proceeding, methods of
      treatment and prognosis were discussed.

PMID- 11204337
TI  - [Primary hyperparathyroidism treated surgically].
AB  - Primary hyperparathyroidism is a systemic disease, more and more frequently
      recognized-concerning 1 to 3% of the population. Statistically appears in 1 of
      1000 adults, with significant advantage of women. In Poland every year about 30
      new cases are noticed and incidence increases with an age. In spite of
      significant advance of the knowledge, it still makes a lot of diagnostic
      troubles. It appears to be non-specific illness, characterised by just one
      symptom, mainly urolithiasis, sometimes chronic ulcer disease, chronic
      pancreatitis, arterial hypertension, disorders of the movement or psychic
      disorders. Parathyroid adenoma which is the main reason of the disease is usually
      single and small, multiple and bigger ones are found exceptionally. In about 2%
      of cases they are localized in mediastinum. In the article the basic symptoms,
      diagnostic and therapeutic problems were shown, especially concerning surgical
      treatment which is safe, radical and efficacious method when performed by
      experienced surgical team and the conduct from choice on primary and secondary
      hyperparathyroidism.

PMID- 11204338
TI  - [Anetoderma--a clinical and therapeutic problem].
AB  - Current views on etiopathogenesis of anetoderma have been presented on the
      grounds of literature data. Disorders of elastin metabolism are distinctive for
      the disease causing elastin fibres becoming disintegrated and atrophied. Apart
      from mechanism of anetoderma plaques evolution clinical observation and full
      diagnostication of systemic collagenosis seems to be important. Despite of
      numerous therapeutic trials it appears that medication of anetoderma lesions is
      inefficacious.

PMID- 11204339
TI  - Recent life events, social adjustment, and suicide attempts in patients with
      major depression and borderline personality disorder.
AB  - This study investigated the impact of recent life events and social adjustment on
      suicide attempter status in 34 patients with major depression, 24 patients with
      borderline personality disorder, and 22 patients with co-morbid major depression
      and borderline personality disorder. Suicide attempters reported more recent life
      events and scored lower on a measure of social adjustment in their families and
      overall social adjustment, compared with non-attempters. Borderline disordered
      and borderline or depressed patients were more likely to have attempted suicide
      than patients with major depression only. Recent life events did not predict
      attempter status. Lower social adjustment in the immediate family and lower
      overall social adjustment were predictive of suicide attempter classification,
      regardless of diagnosis. Borderline disordered patients low on overall social
      adjustment were over 16 times more likely to have attempted suicide than patients
      diagnosed with major depression only. Recent life events may elevate suicide risk
      in groups already at high risk for suicide completion, whereas high levels of
      social adjustment may be protective against stress-related suicidal behavior.

PMID- 11204340
TI  - Recollections of conflict with parents and family support in the personality
      disorders.
AB  - This study examined the relationships between personality disorders and
      retrospective reports of family support and conflict with parents. Participants
      were 798 United States Air Force recruits who were participating in a larger
      program of research on the peer assessment of personality disorders.
      Correlational analyses revealed consistent but modest associations between
      personality disorder features and both measures of family adversity. Borderline,
      antisocial, and paranoid features maintained small, unique associations after
      controlling for the general component of personality disorder. Further analyses,
      however, showed that differences among the correlations between personality
      disorder traits and family adversity measures account for little explained
      variance. In general, it does not appear that individual personality disorders
      have unique relations with retrospective reports of family adversity. Instead,
      the relation between personality disorders and family adversity seems to depend
      on a component common to all personality disorders.

PMID- 11204341
TI  - Emotional responses in patients with borderline as compared with avoidant
      personality disorder.
AB  - The aim of this study was to assess psychophysiological affect correlates, in
      addition to the usual self-report in borderline personality disorder (BPD)
      compared with avoidant personality disorder (APD) and normal controls (NCs), when
      responding to standardized experimental stimuli. In 24 BPD female patients, 23
      APD female patients, and 27 female NCs, skin conductance response (SCR), heart
      rate (HR) change, and startle response were recorded while the subjects viewed
      slides with emotional content. Neither the self-report nor the
      psychophysiological data supported the hypothesis that affective responses of BPD
      individuals are generally stronger than those with APD. BPD patients showed no
      potentiation of the affective modulation of the startle reflex and their
      electrodermal reactivity was lower than in either the APD subjects or the NCs.
      The hypothesis of a general affective hyperresponsivity could not be confirmed.
      Low somatic arousal in BPD can interfere with the anticipation of signal stimuli
      and may explain the exaggerated openness borderline personalities show to
      stimuli, particularly in interpersonal situations.

PMID- 11204342
TI  - A study of temperament and personality in anorexia and bulimia nervosa.
AB  - Although temperament and personality traits could influence the development and
      course of eating disorders, only a few studies examined the similarities and
      differences in personality between anorexia and bulimia nervosa. We compared 72
      patients with DSM-IV eating disorders and 30 healthy controls. Dimensions of
      personality and personality disorders were evaluated with the Eysenck's EPQ,
      Cloninger's TCI, and the SCID-II questionnaires. The rates of impulsivity and
      clinical features were evaluated using specific rating scales. A comorbid
      personality disorder was found in 61.8% of patients with eating disorder.
      Avoidant personality disorder appeared was relatively common in anorexia nervosa
      restricting type; borderline personality disorder was most frequent in bulimia
      nervosa and the binge eating-purging type of anorexia nervosa. From a dimensional
      perspective, anorexic patients presented high scores in the dimension of
      persistence. Higher harm avoidance and impulsivity was found in bulimic patients.
      The overall eating disorders group presented high scores in neuroticism and low
      scores in self-directedness. Eating disorder patients have heterogeneous features
      of temperament and personality traits. Cluster C personality disorders seem more
      common in anorexia nervosa restricting type and impulsive personality features
      are associated with bulimic symptoms. Impulsivity seems to be a key aspect of
      temperament of bulimic patients, whereas anorexic symptoms are linked to
      persistent temperament traits.

PMID- 11204343
TI  - The developmental profile: preliminary results on interrater reliability and
      construct validity.
AB  - This study presents the preliminary results of research into the interrater
      reliability and construct validity of the Developmental Profile (DP). In the DP a
      number of developmental lines, such as Object-Relations, Self-Images, and Problem
      Solving Capacities, are assessed and classified according to the level of
      functioning. A total of 108 profiles were assessed, drawn from three different
      categories of patients. The weighted kappa values for interrater reliability were
      sufficient. On the adaptive level, but also on the maladaptive levels Symbiosis
      and Resistance, significant differences were found between psychiatric patients,
      "normal controls" (dental patients) and somatic patients. No differences were
      recorded between the latter two groups. The conclusion is that the DP is a
      promising instrument, of which the reliability and validity has to be further
      investigated in order to contribute to scientific support for psychodynamic
      theory formation.

PMID- 11204344
TI  - Hypervigilance in borderline disorder: a test with the emotional Stroop paradigm.
AB  - The hypothesis of cognitive theories of hypervigilance for signs of danger in
      Borderline Personality Disorder (BPD) was tested with the emotional Stroop task.
      BPD patients (n = 15), Cluster C personality disorder (PD) patients (n = 12), and
      nonpatient controls (n = 15) diagnosed with SCID-I and SCID-II interviews color
      named emotional and nonemotional words presented in three colors on a personal
      computer screen, first in a subliminal condition (words presented for a very
      short, individually calibrated time followed by a mask to prevent conscious
      recognition of the word) and then in a supraliminal condition. Four classes of
      negative words were used, including three classes of BPD-specific words (negative
      views of others, sexual abuse-related words, negative self-descriptors) and one
      class of general negative words that was unrelated to BPD pathology. In contrast
      to the nonpatient controls, both BPD and Cluster C patients showed interference
      caused by supraliminally presented emotional words. There was no difference
      between the clinical groups and there was no evidence for specificity of the
      effect for certain stimulus classes. The subliminal Stroop failed to yield any
      significant effect. Results are interpreted as evidence for the presence of a
      relatively crude hypervigilance for any emotionally negative stimulus in both BPD
      and Cluster C PDs.

PMID- 11204345
TI  - Genetic variation of the glutamate transporter EAAT2 gene and vulnerability to
      alcohol dependence.
AB  - Glutamate-mediated excitatory pathways play an important role in the pathogenesis
      of alcohol dependence. The present association study tested the candidate gene
      hypothesis that variation of the gene encoding the astroglial glutamate
      transporter EAAT2 confers vulnerability to alcohol dependence. Genotypes of a
      silent G603A nucleotide exchange in exon 5 of the EAAT2 gene were assessed in 565
      subjects of German descent, comprising 342 alcohol-dependent subjects and 223
      control subjects. Two more homogeneous subgroups of alcoholics were selected: (1)
      112 alcoholics with a history of alcohol withdrawal seizure or delirium; and (2)
      54 alcoholics with an antisocial personality disorder. The Tridimensional
      Personality Questionnaire was applied to assess personality dimensions in 106
      alcohol-dependent males. The allele frequencies of the G603A polymorphism did not
      differ significantly between the control subjects and either the entire sample of
      alcoholics or the alcoholics with severe physiological withdrawal symptoms.
      Without correction for multiple testing, there was a significant increase of the
      frequency of the A603 allele in the antisocial alcoholics compared with either
      the control subjects [chi2 = 4.587, 1 degree of freedom (df), P = 0.032] or the
      alcoholics without ASPD (chi2 = 4.968, 1 df, P = 0.026). The personality trait of
      Harm Avoidance was significantly lower in alcoholics carrying the A603 allele
      compared with those lacking it (U-test; P = 0.009). These two consistent lines of
      evidence suggest that genetic variation of the EAAT2 gene confers vulnerability
      to risk-taking behavior in alcoholics.

PMID- 11204346
TI  - An association between a polymorphism of the tryptophan hydroxylase gene and
      aggression in schizophrenia and schizoaffective disorder.
AB  - Serotonergic pathways have been implicated in impulsive and aggressive behavior.
      Polymorphisms in the regulatory region of the serotonin transporter (5-HTT), in
      intron 7 of the tryptophan hydroxylase (TPH) gene and in the MAOA gene were
      previously reported to be associated with mood and anxiety disorders, impulsivity
      and aggression. In this study, we analyzed these polymorphisms in men and women
      with schizophrenia or schizoaffective disorder (n = 84) who met our criteria for
      violence (history of two or more assaults on others) or nonviolence (no history
      of either assaultive or threatening behavior). In males, a modest association
      between TPH genotype and history of violence (chi-square test = 6.703, degrees of
      freedom = 2, P = 0.035) was not statistically significant after correction for
      multiple comparisons (corrected P = 0.21). The TPH L allele was more frequent in
      violent males (chi-square = 5.323, degrees of freedom = 1, P = 0.021) but this
      difference also failed to withstand correction (corrected P = 0.126). No
      significant associations were found for either the 5-HTT or MAOA polymorphisms in
      males or females. These results tend to support previous reports by New et al.
      (1996; 1998) of an association between the TPH L allele and impulsive aggression
      in males with personality disorder, but larger studies are needed.

PMID- 11204347
TI  - Suicidal behavior in patients with schizophrenia is related to COMT polymorphism.
AB  - A common functional polymorphism that results in a three- to four-fold difference
      in catechol-O-methyltransferase (COMT) enzyme activity has been related to
      psychiatric disorders such as ultra-ultra rapid cycling bipolar disorder, drug
      abuse and alcoholism (Lachman et al., 1996a; Karayiorgou et al., 1997;
      Vandenbergh et al., 1997; Papolos et al., 1998; Tiihonen et al., 1999). Several
      studies have also reported associations between the allele encoding the low
      enzyme activity COMT variant (L allele) and other-directed aggression (Strous et
      al., 1997; Lachman et al., 1998; Kotler et al., 1999) in schizophrenic and
      schizoaffective patients. The current study investigated whether the COMT L
      allele is also associated with suicide attempts in schizophrenic and
      schizoaffective patients. COMT genotypes were determined and history of suicide
      attempts was retrospectively investigated in a Finnish sample (n = 94) and a US
      sample (n = 54). Significant associations were observed between COMT genotype and
      suicide; specifically, history of violent suicide attempts. The COMT L allele was
      more frequent in subjects who had attempted suicide by violent means. These
      associations were significant in males but not females. These findings support a
      common neurobiological substrate for self- and other-directed aggression, and
      suggest that catecholaminergic alterations may contribute to these behaviors in
      schizophrenic and schizoaffective patients.

PMID- 11204348
TI  - Pleiotropy of the serotonin transporter gene for seasonality and neuroticism.
AB  - Pleiotropy refers to the ability of a single gene to influence multiple traits. A
      polymorphism in the regulatory region of the serotonin transporter gene (5
      HTTLPR) has previously been found to be associated both with the personality
      trait of neuroticism and with seasonal changes in mood and behavior, or
      seasonality. Hypothesizing that the contribution of the serotonin transporter
      gene to seasonality is specific, i.e. independent of neuroticism, we measured 5
      HTTLPR genotypes and both psychological traits in 236 healthy volunteers. The
      results indicated that the 5-HTTLPR contributions to variation in the two traits
      are largely independent; approximately three-quarters of the effect of the gene
      on seasonality are not related to its effects on neuroticism. Moreover, the gene
      has a larger effect on the covariation between neuroticism and seasonality than
      it does on either trait alone. Sibling-pair analysis confirmed that the effects
      of the 5-HTTLPR are due to genetic pleiotropy rather than population
      stratification.

PMID- 11204349
TI  - Non-association of dopamine D4 and D2 receptor genes with personality in healthy
      individuals.
AB  - Recently, different research groups reported conflicting results with regard to
      an association of dopamine 4 receptor (DRD4) genotypes and the personality
      dimension of novelty seeking (NS). High scores for NS seemed to be associated
      with long alleles of a DRD4 polymorphism. Furthermore, an association between
      personality traits and the dopamine 2 (DRD2) receptor gene was reported. NS and
      persistence (PS) high scores seemed to be associated with alleles of DRD2. We
      examined 109 (78 female and 31 male) normal healthy individuals using Cloninger's
      Temperament and Character Inventory (TCI) in order to replicate these findings.
      We genotyped a 48 base pair variable number of tandem repeats (from two to eight
      repeats) polymorphism in the third exon of DRD4 and a Cys311Ser polymorphism in
      exon 7 of DRD2. We tested alleles and genotypes of DRD4 (allele 7 absent or
      present; genotype 4,4 versus 4,7), and Ser/Cys and Cys/Cys genotypes of DRD2 for
      associations with TCI values. NS and the alleles and genotypes of DRD4 did not
      show any association. In associating the genotypes of DRD2 with TCI scales (NS,
      harm avoidance, reward dependence and PS), we also found no association. Recent
      findings associating NS with DRD4 could not be replicated. With regard to DRD2,
      we tested a different polymorphism as published recently and could not find an
      association of TCI scales with the gene. The present results therefore do not
      provide evidence that the DRD2 and DRD4 receptor genes contribute a common and
      relevant effect to personality traits.

PMID- 11204350
TI  - A contribution to genome-wide association studies: search for susceptibility loci
      for schizophrenia using DNA microsatellite markers on chromosomes 19, 20, 21 and
      22.
AB  - As an initial step for genome-wide association studies, we sought an association
      between schizophrenia and 34 microsatellite markers on chromosomes 19, 20, 21 and
      22 by a case-control design. The samples examined for an association were 168
      schizophrenic patients and 146 control subjects in the Japanese population. The
      allele distribution of the 34 loci differed significantly between Japanese and
      French populations. Significant deviation from the Hardy-Weinberg equilibrium was
      observed at D19S209 and D21S1256 in the control subjects. Case-control
      comparisons of the initial screening revealed a significant difference in allele
      frequency at D20S95 and a trend of difference at D20S118. To confirm these
      possible associations, additional samples consisting of 110 schizophrenic
      patients and 116 control subjects were examined, and an association between
      D20S95 and schizophrenia was confirmed (corrected P value after Bonferroni
      correction, 0.00035). D20S95 is located close to the gene (CHGB) encoding
      chromogranin B. These findings suggest that CHGB could be an important candidate
      gene involved in the development of schizophrenia.

PMID- 11204351
TI  - Lack of association in Japanese patients between neuroleptic malignant syndrome
      and a debrisoquine 4-hydroxylase genotype with low enzyme activity.
AB  - Decreased activity of debrisoquine 4-hydroxylase (CYP2D6), which participates in
      hepatic metabolism of several frequently used neuroleptics and antidepressants,
      is inherited as an autosomal recessive trait through polymorphic CYP2D6 gene
      alleles. In eastern Orientals, a C --> T substitution at nucleotide 188
      (Pro34Ser) is primarily responsible for decreased ability to metabolize CYP2D6
      substrates. We therefore studied a possible association between neuroleptic
      malignant syndrome (NMS) and the C188T mutation. We examined the frequency of the
      C188T mutation by polymerase chain reaction and restriction fragment length
      polymorphism analysis in 36 Japanese patients previously diagnosed with NMS and
      107 neuroleptic-treated schizophrenic patients with no NMS history. The C188T
      allele frequency was 0.417 in NMS patients and 0.463 in patients without NMS. No
      significant allele or genotype associations were observed. We cannot conclude
      that low CYP2D6 activity genotype causes susceptibility to NMS in Japanese
      patients.

PMID- 11204352
TI  - Association study of a cannabinoid receptor gene (CNR1) polymorphism and
      schizophrenia.
AB  - Cannabis can induce schizophrenic-like symptoms in healthy individuals. A
      principal active ingredient of cannabis, delta-9-tetrahydrocannabinol, acts in
      the brain on a specific receptor, termed the cannabinoid receptor 1 (CNR1). The
      human gene for CNR1 is mapped to chromosome 6q14-15, and linkage studies have
      produced evidence for a schizophrenia-susceptibility locus in this region. To
      explore a possible role for CNR1 in the pathogenesis of schizophrenic disorders,
      we used an association study to genotype the CNR1 polymorphism for 127
      schizophrenic patients and 146 control subjects. The results demonstrate no
      association between CNR1 genotypes and schizophrenic disorders (P = 0.409), with
      these negative findings suggesting that, for Chinese populations, the (AAT)n
      triplet repeat in the promoter region of the CNR1 gene is not directly involved
      in the pathogenesis of schizophrenic disorders.

PMID- 11204353
TI  - Oesophageal candidosis in intensive care patients.
AB  - We conducted upper intestinoscopies in 124 intensive care patients, six of whom
      had oesophageal candidosis. Of these, two also had Candida plaque in the stomach.
      The patients at the intensive care unit (ICU) had a mean Apache-II score of 26.7;
      whereas the score was 29.5 in patients with Candida oesophagitis. A significant
      increase of Candida antibodies was found in 59 of 124 patients (47.6%), including
      all patients with oesophageal candidosis. Presumably, mycotic infections of other
      sites were present. The severity by which mucous membranes were affected
      correlated well with microscopically evident invasiveness.

PMID- 11204354
TI  - Identification of medically important Aspergillus species by single strand
      conformational polymorphism (SSCP) of the PCR-amplified intergenic spacer region.
AB  - The amplified 5.8S RNA coding DNA with the neighbouring internal transcribed
      spacers ITS I and ITS II (ITS I--5.8S rDNA--ITS II) of 27 culture collection
      strains of Aspergillus fumigatus, Aspergillus flavus, Aspergillus nidulans,
      Aspergillus niger, and Aspergillus terreus were investigated by single strand
      conformational polymorphism (SSCP) analysis. All strains showed a polymerase gel
      electrophoresis (PCR) product of 0.6 kb. Separation of DNA single strands of the
      PCR product in an acrylamide-bisacrylamide gel containing formamide SSCP resulted
      in individual patterns for each of the species. A minor variability within the
      species A. fumigatus and A. flavus did not affect the correct species
      identification. The results were confirmed when investigating 55 wild strains
      from patients and the environment. It is concluded that the analysis of the
      amplified ITS I--5.8S rDNA--ITS II region by SSCP allows the differentiation of
      the medically most relevant aspergilli. As the method does not require
      morphologically fully developed fungal colonies, it yields species diagnosis
      faster than the conventional macroscopic and microscopic identification.

PMID- 11204355
TI  - Strain specificity of yeasts isolated from different locations of women suffering
      from vaginal candidosis, and their partners.
AB  - Sexual partners often harbour identical yeast strains in the vagina, in the
      orointestinal tract and in semen in cases of recurrent vulvovaginal candidoses.
      Specimen were collected from vagina, oral cavity and faeces of the patients, and
      from semen, oral cavity and faeces of their male partners. Mycological cultures
      were grown on Sabouraud glucose-agar and, if positive, specified by Candida-ID
      Agar (BioMerieux), by formation of chlamydospores on rice agar, and by
      biochemotyping with the System Walkaway (Dade) or the API-32C system
      (BioMerieux). A polymerase chain reaction finger-printing technique with the T3B
      oligonucleotide as single primer was used for strain typing. Candida albicans was
      isolated from the vagina of 18 out of 21 patients, the vagina of one patient
      harboured a strain of Candida glabrata. The cultures obtained from vagina, oral
      cavity and faeces were genetically identical in 12 patients. From the partners of
      15 patients C. albicans was cultured in at least one of the clinical samples.
      Identical strains were observed for eight of 15 couples, whereas four of these
      identical strains were cultured from semen. Further prospective investigations
      will prove whether a consequent treatment of both partners will eradicate
      identical yeast strains and will be able to improve the results of treatment in
      such women.

PMID- 11204356
TI  - Acute vaginal candidosis model in the immunocompromized rat to evaluate delivery
      systems for antimycotics.
AB  - A rat model of vaginal candidosis, suitable for screening new antifungal
      compounds or novel formulations was developed and validated. Two strains of
      Candida albicans, different inoculation schedules, quantitative assays for fungal
      burden and the necessity for immunosuppression were tested. The infection was
      evaluated clinically and histologically by fungal counts from the vaginal
      discharge. The animals without immunosuppression did not sustain the infection
      beyond 2-3 days, however, after immunosuppression with cyclophosphamide, the
      infection can be maintained for about 2 weeks and is suitable for the testing of
      topical antifungal therapies.

PMID- 11204357
TI  - In vitro susceptibilities of Paracoccidioides brasiliensis yeast form to
      antifungal drugs.
AB  - A total of 12 Paracoccidioides brasiliensis yeast form strains, including
      clinical and environmental isolates, were tested for their susceptibilities to
      amphotericin B, ketoconazole, fluconazole, and itraconazole. The tests were
      determined using a broth macrodilution procedure. In general, there was a
      remarkable homogeneity of results for all strains, and comparable MICs were found
      for environmental and clinical isolates.

PMID- 11204358
TI  - A new species, Phialophora europaea, causing superficial infections in humans.
AB  - A new species, Phialophora europaea, member of the P. verrucosa complex, is
      introduced. It is distinguished from existing species by reduced, flaring
      phialidic collarettes and inability to assimilate melibiose as sole source of
      carbon. Analysis of ITS1 and 2 rDNA of six strains attributed to the species show
      it to be clearly individualized. All strains originated from cutaneous and nail
      infections of humans in North-western Europe. A key to morphologically similar
      taxa is provided.

PMID- 11204360
TI  - Case report and review. Onychomycosis due to Candida parapsilosis.
AB  - We report a case of onychomycosis with melanonychia due to Candida parapsilosis
      alone. Candida parapsilosis is now identified in the great majority of candidal
      onychomycosis, mainly in association with other yeasts. The criteria allowing the
      distinction between invasion and colonization, the risk factors and the treatment
      of C. parapsilosis onychomycosis are discussed.

PMID- 11204359
TI  - Usefulness of 1% terbinafine HCl (Lamisil) cream for hyperkeratotic-type tinea
      pedis and its transfer into the horny layer.
AB  - The usefulness of 1% terbinafine HCl (Lamisil) cream for hyperkeratotic-type
      tinea pedis and its transfer into the horny layer were evaluated. Of the 36
      patients enrolled in the study, 35 were retained for analysis and one was
      excluded due to inappropriate drug application. Hyperkeratotic-type tinea pedis
      was classified into three types: true hyperkeratotic-type, partial hyperkeratotic
      type, and quasi-hyperkeratotic type. The overall clinical improvement rate was
      95.5% (100% for true-, 80% for partial- and 96.2% for quasi-hyperkeratotic type).
      The overall fungal eradication rate was 88.6% (75% for true-, 100% for partial-
      and 88.5% for quasi-hyperkeratotic type). The overall efficacy rate was 88.6%
      (75% for true-, 100% for partial- and 88.5% for quasi-hyperkeratotic type). No
      adverse reactions were reported. Drug concentrations in the horny layer were
      170.3, 228.5 and 249.2 ng mg-1, respectively, 2, 4 and 12 weeks after starting
      the treatment. These concentrations are more than 50,000 times higher than the
      minimum inhibitory concentrations of terbinafine for dermatophytes. These
      findings indicate that terbinafine HCl (Lamisil) cream is very useful for
      refractory hyperkeratotic-type tinea pedis when administered alone. The
      pharmacokinetic data also support the clinical and mycological findings.

PMID- 11204361
TI  - Further comments on Malassezia species from dogs and cats.

PMID- 11204362
TI  - Should a patient with a brain tumor receive anticoagulation for a thromboembolic
      event?

PMID- 11204363
TI  - Radiofrequency ablation of the pulmonary veins: can it stop atrial fibrillation
      at its source?
AB  - Recent work from France indicates that many cases of atrial fibrillation arise
      from foci of rapidly firing cells, most of which are located not within the atria
      but within the pulmonary veins. Armed with this new knowledge, we are pursuing
      strategies of permanently preventing atrial fibrillation by destroying these foci
      using radiofrequency ablation.

PMID- 11204364
TI  - An elderly woman with drug-induced coma in winter.

PMID- 11204365
TI  - Diagnosing interstitial lung disease: a practical approach to a difficult
      problem.
AB  - Interstitial lung disease has a variety of causes: environmental, infectious,
      autoimmune, and drug-related. Accurate diagnosis is essential because the
      prognosis and treatment of the disease varies widely depending on the cause.
      However, the respiratory symptoms and pulmonary radiographic picture of these
      various causes of interstitial lung disease are often similar, making the
      diagnosis of its cause confusing and frustrating. The practical, algorithmic
      approach to diagnosis outlined here identifies key diagnostic clues in the
      patient's history, physical exam, and radiographic findings.

PMID- 11204366
TI  - Heart failure disease management: a team approach.
AB  - Patients with heart failure do better if they are treated in a formal heart
      failure disease-management program than if they receive standard care: their
      hospitalization rates and costs of treatment are lower, and their functional
      status is higher. The programs feature close coordination between primary care
      givers, subspecialty consultants, and nurses with specialty training in the
      nuances of heart failure management. Aggressive medical therapy must be coupled
      with patient education and rapid response to early identified problems. This
      article reviews the principles of heart failure disease-management programs and
      cites evidence that they are beneficial.

PMID- 11204367
TI  - What the internist needs to know about infertility.
AB  - Primary care physicians can manage two thirds of cases of suspected infertility.
      Assisted reproductive technology can help in many cases of pelvic adhesive
      disease, although the effectiveness of these procedures declines significantly
      with patient age. Testing for ovarian reserve is an important first step for many
      patients who are considering infertility treatment. Some causes of infertility
      are associated with significant medical problems such as diabetes and abnormal
      lipids; these should be assessed and a long-term management plan implemented.

PMID- 11204368
TI  - Spiral CT for lung cancer screening: is it ready for prime time?
AB  - Low-dose spiral computed tomography (CT) shows promise as a screening test for
      lung cancer, as it detects many more malignant pulmonary nodules than does
      standard plain radiography of the chest. Yet until more data are available we
      need to temper our enthusiasm. No studies have yet determined if using low-dose
      spiral CT as a screening test will lead to lower mortality rates. This paper
      reviews the issue of lung cancer screening and low-dose spiral CT.

PMID- 11204369
TI  - Preventive medicine and screening.

PMID- 11204370
TI  - Low-dose spiral CT for lung cancer screening.

PMID- 11204372
TI  - At a glance. Reducing tobacco use: a report of the Surgeon General--2000.

PMID- 11204371
TI  - Should all college-bound freshmen receive meningococcal vaccine?

PMID- 11204373
TI  - Management of advanced/metastatic prostate cancer: 2000 update.
AB  - Over the past several years, the clinical presentation of prostate cancer has
      evolved so that more patients than ever before are presenting with clinically
      localized disease. However, a significant number of men continue to present with
      locally advanced or metastatic prostate cancer, or go on to develop metastasis
      after failing local therapies. Despite our better understanding of the biological
      principles and newer therapies, metastatic prostate cancer remains a lethal
      disease. Androgen ablation continues to be the first, most effective line of
      treatment for advanced/metastatic prostate cancer. Newer chemotherapy
      combinations with increasing activity are being identified in hormone-resistant
      prostate cancer. Based on novel targets, new treatment strategies are being
      developed and incorporated into clinical trials. Ultimately, the impact of these
      evolving treatments on advanced/hormone-resistant prostate cancer can best be
      assessed by well-designed phase III trials, many of which are now being launched
      or awaiting completion.

PMID- 11204374
TI  - Clinical trials referral resource. Current clinical trials in pediatric acute
      lymphoblastic leukemia.

PMID- 11204375
TI  - Aging and cancer.
AB  - The world's population is aging. Older age is associated with an increase in the
      incidence of cancer, especially cancer of the breast, lung, prostate, and colon.
      The management of older patients with cancer is biased by the simple fact of
      their chronologic age. Underscreening, understaging, less aggressive therapy,
      lack of participation in clinical trials, or no treatment at all reflect this
      bias. Although an age-related reduction in the physiologic function of many
      organs occurs with age, these are not contraindications to treatment with
      surgery, radiation therapy, or chemotherapy. Chronologic age alone should not be
      used as a guide for cancer management. Rather, physiologic function or existence
      of comorbid conditions should be major factors in determining treatment. As a
      result of the impending need for improved cancer management in older persons, a
      new subspecialty is evolving: geriatric oncology. This field stresses an
      important interaction between geriatricians and oncologists, development of
      research directed at the problems of cancer in older persons, and education at
      all levels with respect to cancer prevention, cancer detection, and cancer
      therapy. Physicians and oncologists need to be prepared for the projected
      increase of cancer in older persons.

PMID- 11204376
TI  - Pharmacology of antineoplastic agents in older cancer patients.
AB  - The fastest growing segment of the US population is the group over the age of 65
      years. In the next 30 years, this group will comprise over 20% of the population.
      Because 60% of all cancers occur in this age group, there will be an expected
      rise in the total cancer burden. Emerging data will better guide the use of
      chemotherapy in older patients. Studies will be presented discussing the
      pharmacokinetics of a number of chemotherapeutic agents, with an emphasis on
      those that have come into use over the past few years. Many of these agents seem
      to have a beneficial therapeutic index, particularly in regard to elderly
      patients. There has also been a rising trend in the use of oral chemotherapy.
      This change was fueled by patient preferences, quality-of-life issues, and the
      need to decrease the cost of chemotherapy administration. Factors that must be
      taken into consideration with oral administration of chemotherapy include
      limitations of the saturability of absorption, patient compliance, and the
      pharmacokinetic and pharmacodynamic changes that occur in elderly patients.
      Interpatient variability and drug metabolism, particularly age-related changes in
      drug metabolism, have been studied. The cytochrome P450 system is particularly
      important in this context. Safe administration of chemotherapy requires careful
      attention to the physiologic changes occurring with age and dose adjustments to
      compensate for end-organ (i.e., renal and hepatic) dysfunction. These adjustments
      will be discussed for specific drugs. Complementary and alternative therapies
      will also be presented.

PMID- 11204377
TI  - Value of antigliadin antibodies (AGA) in latent coeliac disease (CD).
AB  - BACKGROUND: The term latent coeliac disease (CD) is applied to patients who were
      previously shown to have a normal jejunal mucosa on a free diet. The aim of this
      study was to determine whether a high AGA value in the serum of patients with
      coeliac symptoms can also be regarded by itself, without typical mucosal atrophy,
      as a marker of latent CD, as some authors suggest in relatives of celiac
      patients. METHODS: We observed 31 patients with suspected CD and pathological
      values of serum IgA ang IgG AGA. In all we performed intestinal biopsy, assayed
      antiendomisium antibodies (AEA) in serum, AGA IgA, IgG, and IgM in duodenal
      jejunal fluid and in some of the lymphocytcs CD3+ gamma/delta+ in the lamina
      propria of the intestinal mucosa. RESULTS: In this study only pathological values
      of serum AGA without mucosa atrophy don't seem to be markers of latent CD, but an
      aspecific allergic response. CONCLUSIONS: As shown by other authors serum AEA,
      intestinal fluid AGA IgM and lamina propria lymphocytes CD3+ gamma/delta+ seem
      markers of latent CD.

PMID- 11204378
TI  - [Head injuries in children. Considerations on 3,715 consecutive cases].
AB  - BACKGROUND: The authors present their personal experience of 3715 cases of head
      injury in pediatric patients, occurring during the last three years (1997-1999),
      admitted to the Emergency ward at the "Anna Meyer" children's hospital in
      Florence. METHODS: A prospective study was made, starting from the evaluation
      made by the paediatric surgeon and following the subsequent diagnostic and
      clinical course. Depending on the severity of injury, this took the form of
      immediate discharge with a written sheet of instructions, "short observation" (up
      to 12 hours) in an Emergency ward and/or admission to neurosurgery or general
      medicine or to intensive care. The authors also analyse the diagnostic and
      instrumental tests carried out at the various stages (cranial X-ray, direct
      cranial CT, EEG) and the specialist consultations required (neurosurgery,
      neurology, paediatrics, resuscitation). Data for injured children transferred
      from other hospitals for neurosurgery were excluded from the study which only
      included patients examined primarily at our hospital. If admitted for more than
      48 hours, a neurosurgical outpatient check-up was programmed one week later. In
      more severe cases, patients were admitted to day hospital between six months and
      one year later. RESULTS: Injuries were minor in 91% of cases and the age of
      patients ranged between 5 days and 14 years; moreover, 60% of the patients
      observed were male. Only 1.5% of cases seen in Emergency were admitted to
      hospital and 8.4% of all head injuries, with a total stay of between 1 and 6
      days. There were 4 deaths in severely polytraumatised patients. There was only
      one case of firearm injury which was not fatal. Head X-rays were performed in
      13.4% of patients showing evidence of fracture in 19.1% of cases. Direct cranial
      CT was performed in 10.2% of cases with pathological findings in 23.9% of cases.
      Neurosurgery was performed in one of the 5.9% patients admitted to hospital. The
      late sequelae to head injury included one case of epilepsy that occurred 7 months
      after injury. CONCLUSIONS: Anamnesis showed that the most frequent reason leading
      to head injury was lack of adult supervision and that the majority of severe
      injuries were caused by road accidents, both as pedestrians and as passengers.
      Lastly, the authors emphasise the importance of recognising and correctly
      treating so-called secondary cerebral damage, which has a non-immediate onset but
      is potentially severe, and identifying the risk factors for head injury in order
      to reduce the incidence and severity.

PMID- 11204379
TI  - Obstructive sleep apnea in children.
AB  - Obstructive sleep apnea (OSA) is a frequent albeit underdiagnosed condition in
      children, which if left untreated may lead to substantial morbidity. Important
      recent advances in the understanding of the pathophysiological mechanisms
      underlying OSA in children have been coupled with improved approaches towards the
      diagnosis and management of OSA. This review provides a detailed and current
      description of OSA in children, and focuses on the integrative elements necessary
      for increasing the awareness and diagnostic yield of the community practitioner.

PMID- 11204380
TI  - [Treatment of bronchial asthma in chidren].
AB  - Asthma is a condition characterised by airways inflammation and bronchial
      hyperresponsiveness to specific and aspecific spasmogens associated with
      reversible airways obstruction. The bronchomotor tone is the result of an
      interaction between neurotransmitter release and local mediators. The efferent
      neurohumoral pathways to the muscular, vascular and glandular element include
      parasympathetic nerves, sympathetic nerves, and non-adrenergic non-cholinergic
      (NANC) neurotransmission. It is currently recognised that the alteration of these
      mechanisms can induce bronchial hyperresponsiveness that represents a
      characteristic feature of asthma. Asthma is common in children and its prevalence
      in this age group is increasing. The current therapy of asthma involves the use
      of anti-inflammatory drugs to control the underlying process (causal therapy) and
      the use of bronchodilators that provide rapid relief of bronchoconstriction
      (symptomatic therapy). The bronchodilators are represented by beta 2 adrenergic
      agonists, methylxanthines and anti-cholinergic drugs; the anti-inflammatory drugs
      are represented by corticosteroids, antileukotrienes and chromones. Other new
      therapies being studied include anti-immunoglobulin E, anti IL-5 agents,
      endothelin receptor antagonists, and others.

PMID- 11204381
TI  - Early onset neonatal sepsis due to Neisseria meningitidis B.
AB  - The onset of meningococcal infection in the first 72 hours after birth has only
      been reported on a few occasions; The authors describe a case where it was
      confirmed that the bacteria responsible, Neisseria meningitidis group B, grew in
      the newborn's blood and in the mother's lochia. The transmission mechanisms are
      also reviewed.

PMID- 11204382
TI  - [Major social diseases].

PMID- 11204383
TI  - Hemisternotomy approach for aortic and mitral valve surgery.
AB  - After exploring several less invasive approaches for cardiac valve surgery, we
      have concluded that the partial upper sternotomy is the incision of choice for
      minimally invasive aortic and mitral valve surgery. From March 1997 to January
      1999, 827 patients had cardiac valve surgery using this approach; 462 had mitral
      valve procedures and 365 had aortic valve procedures. Of those having mitral
      valve surgery, 87% had mitral valve repair. Aortic valve surgery included
      replacement with stented bioprostheses (38%), allografts (29%), and mechanical
      prostheses (10%); in addition, 23% had aortic valve repair. Operative mortality
      was 0.8%. Conversion to full sternotomy was necessary in 2.4%. Blood use was low
      with 80% of patients receiving no blood transfusions. We conclude that all
      primary mitral and aortic procedures can be accomplished safely via partial upper
      sternotomy.

PMID- 11204384
TI  - Minimally invasive direct access heart valve surgery.
AB  - We review our experience with minimally invasive direct access (MIDA) heart valve
      surgery in 518 patients. Two hundred fifty-two patients underwent MIDA aortic
      valve replacement (AVR) or repair and 266 underwent MIDA mitral valve repair or
      replacement. Among the 250 AVRs, 157 (63%) were men, aged 63.2 +/- 14.6 years,
      NYHA functional Class 2.4 +/- 0.8. The surgical approach was right parasternal in
      36 (14%) or upper hemisternotomy in 216 (86%). There were four (2%) operative
      deaths. Perioperative complications included 14 (5.6%) reexplorations for
      bleeding, 7 (3%) chest wound infections, 5 (2%) strokes, and 1 (0.4%) external
      iliac vein injury. Follow-up was complete in 193 (77%) patients, with a mean
      follow-up of 12 +/- 8 months. Late complications included 2 (0.8%) nonfatal
      myocardial infarctions, 4 (2%) reoperations for, respectively, 2 pericardial
      complications, 1 paravalvar leak, and 1 infected valve. There were five (2%) late
      deaths from congestive heart failure, pneumonia, hemorrhage, aneurysm, and
      cancer. Mean follow-up NYHA Class was 1.4 +/- 0.6. For the 266 mitral patients,
      145 (54.5%) were men, age 58.7 +/- 13.6 years, functional Class 2.3 +/- 0.5. The
      surgical approach was right parasternal in 195 (73%), lower hemisternotomy in 53
      (20%), right submammary thoracotomy in 9 (3.4%), or full sternotomy through a
      small skin incision in 9 (3.4%). There were 2 (0.8%) operative deaths.
      Perioperative complications included 4 (1.5%) reoperations for bleeding, 4 (1.5%)
      strokes, and 5 (2%) wound infections, and 3 (1%) ascending aortic complications.
      Follow-up was complete in 202 (76%) patients with a mean follow-up of 9.5 +/- 6.4
      months. Late complications included one (0.4%) nonfatal myocardial infarction and
      three (1%) reoperations all converting repairs to replacements. There were three
      (1%) late deaths from suicide, pneumonia, and sudden death, respectively. Mean
      follow-up NYHA functional Class was 1.3 +/- 0.5. We conclude that MIDA heart
      valve surgery is safe and effective for the majority of patients requiring
      isolated elective aortic or mitral valve surgery.

PMID- 11204385
TI  - Antagonist's view of minimally invasive heart valve surgery.

PMID- 11204386
TI  - Cardiac valve operations using a partial sternotomy (lower half) technique.
AB  - BACKGROUND AND AIM: Operations on cardiac valves are being performed more
      frequently through smaller incisions than traditional midline sternotomy. A
      variety of alternate incisions have been used, but most of the interest appears
      to focus on partial sternotomy. The purpose of the study was to review results
      using a partial lower sternotomy for cardiac valve operations. METHODS: A
      standard partial lower one-half or two-thirds sternotomy was used for cardiac
      valve operations in 112 patients. The sternum was divided transversely in the
      third or second intercostal space and vertically from that point through the
      xyphoid process. Standard instruments and retraction devices were used. This
      incision provided adequate exposure for even complex operations to be performed.
      Small cannulae were placed into the aorta and heart through the primary incision
      for cardiopulmonary bypass. Vacuum-assisted venous drainage was used. RESULTS:
      Seventy-four single valve operations were performed. There were 35 double valve
      and 5 triple valve operations (35.4%) performed. Operative mortality (5.3%) and
      major complication rates were comparable to full the sternotomy approach.
      CONCLUSIONS: Partial sternotomy (lower half) provides a smaller incision through
      which virtually all cardiac valve operations may be performed. Results achieved
      with this approach are similar to those associated with full sternotomy. The
      smaller incision is appreciated by patients.

PMID- 11204387
TI  - Three-year follow-up after port-access mitral valve surgery.
AB  - INTRODUCTION: After the promising early results with Port-Access mitral valve
      (MV) surgery, the mid-term results were evaluated. METHODS: Among 31 patients
      receiving this surgery, there were two subgroups (A and B). The 14 patients in
      group A (7 men, 7 women, 64.0 +/- 12.8 years, LVEF 0.62 +/- 0.118) received the
      procedure exactly as proposed by Heartport. The 17 patients in group B (6 men, 11
      women, 63.0 +/- 11.48 years, LVEF 0.61 +/- 0.117) received a modified technique
      for a less complex procedure. The underlying diseases were MV insufficiency (n =
      14), MV stenosis (n = 9), and combined MV disease (n = 8). One female patient had
      a partial atrial ventricular canal. RESULTS: Perioperative mortality was 3.2%.
      Survival at 39.0 +/- 6.3 months (median +/- SEM) was 93.5%. Two patients required
      intraoperative inotropic and mechanical support (intra-aortic balloon pump
      [IABP]). One of these two patients died on postoperative day 3 due to low cardiac
      output syndrome. All ther patients survived the procedure. Twenty-four patients
      underwent MV replacement, 7 patients received MV repair, and 1 patient received,
      in addition, ASD repair. In group B, operative time, ICU stay, and
      hospitalization was shorter. CONCLUSIONS: Good early results after Port-Access MV
      surgery were confirmed by equal mid-term results. The patients are satisfied with
      the surgical and the cosmetic results, however, Port-Access MV surgery still has
      to prove superior outcome compared to conventional MV surgery. In selected cases
      a true reduction of the surgical trauma is possible.

PMID- 11204388
TI  - Minimally invasive video-assisted mitral valve surgery: from Port-Access towards
      a totally endoscopic procedure.
AB  - Right thoracotomy is an alternative to mid-sternotomy for left atrium access. The
      Port-Access approach is an option that reduces the skin incision and obviates rib
      spreading. PATIENTS AND METHODS: From February 1997 until November 1999, 121
      patients underwent mitral valve surgery through a right antero-lateral
      thoracotomy using the Heartport cardiopulmonary bypass (CPB) system. Mean age was
      60 years (31-84). Most patients had normal ejection fractions and were in NYHA
      Class II or III. Seventy-five patients had valve repair (62%) and 46 (38%) had
      valve replacement. Pathologies were myxoid (n = 80), rheumatic (n = 30), chronic
      endocarditis (n = 5), annular dilatation (n = 3), sclerotic (n = 1), ingrowing
      myxoma (n = 1), and one closure of a paravalvular leak. RESULTS: Two patients had
      conversion to sternotomy for aortic dissection (one died) with the Endo-Aortic
      Clamp, and two others for peripheral vascular problems. One patient died at
      postoperative day 1 after reoperation for failed repair, another with double
      valve surgery on postoperative day 4 after two revisions for bleeding. Twelve
      underwent revision for bleeding (10%). Three had prolonged ICU stay for
      respiratory insufficiency. Two late valve replacements for endocarditis occurred.
      Echographic control revealed residual insufficiencies (grade 1-2) in two valvular
      repairs. There were neither paravalvular leaks nor myocardial infarcts. There
      were no cerebrovascular accidents due to embolic phenomena. Mean ICU and hospital
      stay were 2.1 and 8.7 days, with a major difference between the first 30 patients
      and those who followed. CONCLUSION: Port-Access mitral valve surgery can be a
      valid alternative to conventional sternotomy and seems to be an important
      improvement in minimally invasive cardiac surgery.

PMID- 11204389
TI  - Cardiac surgery: the future is minimal!

PMID- 11204390
TI  - Minimally invasive videoscopic mitral valve surgery: the current role of surgical
      robotics.
AB  - OBJECTIVE: Recently, the efficacy of video-assisted mitral valve surgery has been
      demonstrated. The evolution of this technology has been relatively rapid. In this
      article we review this development and predict the future of endoscopic and
      robotic-enabling technology for cardiac valve operations. METHODS: A new video
      assisted mitral valve operation is described and results discussed. The majority
      of each valve operation was done through assisted vision and near endoscopically.
      Cardiopulmonary bypass was established via femoral cannulation, and blood
      cardioplegic arrest induced using a new percutaneous, transthoracic cross-clamp.
      A 5 to 6-cm minithoracotomy was used in each patient. Videoscopy was helpful for
      suture placement, chord reconstruction, leaflet resection, knot tying, and valve
      ring or prosthesis positioning. A voice-activated robotic arm was used to direct
      the camera in many instances. RESULTS: Thus far a total of 110 patients have
      undergone this operation successfully with a 0.9% operative mortality. Our early
      series (N = 31), published with cost data, is reviewed in detail. Cardiopulmonary
      perfusion and cross-clamp times for all 100 patients were longer than for
      conventional sternotomy patients at 158 +/- 3.9 and 110 +/- 3.6 minutes,
      respectively, versus 121 +/- 4.6 and 90 +/- 4.6 (N = 105); however, there have
      been less complications. Operative, perfusion, and arrest times have fallen
      progressively to 144 +/- 4.5 and 90 +/- 4.5, respectively (N = 55 Aesop 3000
      cases). Complex repairs and replacements have become routine with anterior
      leaflet pathology addressed. Bleeding, ventilatory times, blood transfusions, and
      hospital stay have been reduced. One patient required reoperation for a
      technically failed repair and two renal patients had late endocarditis. We have
      used voice-activated, robotic (Aesop 3000) assistance for camera control in 51 of
      these patients. This addition has decreased camera motion artifact and lens
      cleaning, while providing direct "cerebral-eye" tracking of instruments for the
      surgeon. We were the first in the United States to apply the DaVinci articulated
      wrist robot to do a complete mitral repair and have done multiple repair with
      this articulated wrist device. CONCLUSIONS: From this and other work reviewed, we
      conclude that video-assisted and computer-assisted robotic techniques are safe
      and may be the pathway to truly endoscopic mitral valve operations. We are
      encouraged regarding the use of this new technology for mitral valve operations.

PMID- 11204391
TI  - The micro-mitral operation comparing the Port-Access technique and the
      transthoracic clamp technique.
AB  - BACKGROUND: Several minimally invasive approaches to the mitral valve have been
      described, including parasternal incision and right anterolateral thoracotomy.
      MATERIAL AND METHODS: Since September 1996, 58 patients underwent minimally
      invasive mitral valve surgery at our institution through a right anterolateral
      minithoractomy. Two different techniques were used for institution of
      cardiopulmonary bypass (CPB) and aortic clamping: in the Port-Access group (group
      A) patients had femoro-femoral cannulation with a special arterial cannula to
      introduce an endoaortic balloon clamp (n = 23). The second group (group B) of
      patients underwent femoro-femoral CPB as well in combination with a specially
      designed transthoracic aortic clamp (Chitwood technique, n = 35). Patients were
      assigned to either technique in a nonrandomized fashion. Demographics were
      similar in both groups. RESULTS: In group A, 4 valves were replaced, 19 patients
      had mitral valve repair. In group B, 7 patients had valve replacement and 28
      patients underwent mitral repair. Four patients in group A were converted to
      Chitwood technique due to endoclamp dysfunction. Operating time, CPB time, cross
      clamp time, and postoperative blood loss were lower in group B (operating time
      295 +/- 83 min vs. 236 +/- 63.9 min; CPB min 167.6 = 64.9 min vs. 137.6 +/- 38.2
      min; cross-clamp time 105.9 +/- 51.7 min vs. 78.9 +/- 25.2 min; postoperative
      blood loss 584 +/- 428 mL vs. 323 +/- 209 mL [p < 0.05]). Clinical outcome
      regarding postoperative mechanical ventilatilation time, hospital stay and
      hospital mortality was not different between groups. CONCLUSIONS: Minimally
      invasive mitral valve procedures via right anterolateral minithoracotomy,
      including complex valve repair, can be performed successfully using either
      technique. However, the Chitwood technique provides better intraoperative
      handling with shorter operation time and less postoperative blood loss.
      Additionally, costs of a procedure are less using the Chitwood technique compared
      to the Port-Access technique.

PMID- 11204392
TI  - The Leipzig experience with robotic valve surgery.
AB  - OBJECTIVES: The study describes the single-center experience using robot-assisted
      videoscopic mitral valve surgery and the early results with a remote
      telemanipulator-assisted approach for mitral valve repair. MATERIAL AND METHODS:
      Out of a series of 230 patients who underwent minimally invasive mitral valve
      surgery, in 167 patients surgery was performed with the use of robotic
      assistance. A voice-controlled robotic arm was used for videoscopic guidance in
      152 cases. Most recently, a computer-enhanced telemanipulator was used in 15
      patients to perform the operation remotely. RESULTS: The mitral valve was
      repaired in 117 and replaced in all other patients. The voice-controlled robotic
      arm (AESOP 3000) facilitated videoscopic-assisted mitral valve surgery. The
      procedure was completed without the need for an additional assistant as "solo
      surgery." Additional procedures like radiofrequency ablation and tricuspid valve
      repair were performed in 21 and 4 patients, respectively. Duration of bypass and
      clamp time was comparable to conventional procedures (107 A 34 and 50 A 16 min,
      respectively). Hospital mortality was 1.2%. Using the da Vinci telemanipulation
      system, remote mitral valve repair was successfully performed in 13 of 15
      patients. CONCLUSION: Robotic-assisted less invasive mitral valve surgery has
      evolved to a reliable technique with reproducible results for primary operations
      and for reoperations. Robotic assistance has enabled a solo surgery approach. The
      combination with radiofrequency ablation (Mini Maze) in patients with chronic
      atrial fibrillation has proven to be beneficial. The use of telemanipulation
      systems for remote mitral valve surgery is promising, but a number of problems
      have to be solved before the introduction of a closed chest mitral valve
      procedure.

PMID- 11204393
TI  - Video assistance in minimal access mitral valve surgery.

PMID- 11204394
TI  - Generation of human bipedal locomotion by a bio-mimetic neuro-musculo-skeletal
      model.
AB  - To emulate the actual neuro-control mechanism of human bipedal locomotion, an
      anatomically and physiologically based neuro-musculo-skeletal model is developed.
      The human musculo-skeletal system is constructed as seven rigid links in a
      sagittal plane, with a total of nine principal muscles. The nervous system
      consists of an alpha motoneuron and proprioceptors such as a muscle spindle and a
      Golgi tendon organ for each muscle. At the motoneurons, feedback signals from the
      proprioceptors are integrated with the signal induced by foot-ground contact and
      input from the rhythm pattern generator; a muscle activation signal is produced
      accordingly. Weights of connection in the neural network are optimized using a
      genetic algorithm, thus maximizing walking distance and minimizing energy
      consumption. The generated walking pattern is in remarkably good agreement with
      that of actual human walking, indicating that the locomotory pattern could be
      generated automatically, according to the musculoskeletal structures and the
      connections of the peripheral nervous system, particularly due to the reciprocal
      innervation in the muscle spindles. Using the proposed model, the flow of sensory
      motor information during locomotion is estimated and a possible neuro-control
      mechanism is discussed.

PMID- 11204395
TI  - Competitive anatomical and physiological plasticity: a neurotrophic bridge.
AB  - Understanding the mechanisms of competitive synaptic plasticity, both anatomical
      and physiological, is of central importance to developmental neuroscience.
      Neurotrophic factors (NTFs) are implicated at almost every level of synaptic
      plasticity, from rapid physiological effects to slower anatomical effects, in
      addition to being implicated in competitive plasticity. Previously, we have built
      and analysed a mathematical model of anatomical synaptic plasticity based on
      competition for neurotrophic support. Here, we extend our work to build a
      combined, anatomical and physiological model. We find that, in order to
      understand the mechanisms of competitive physiological plasticity, we must
      postulate a central role for the change in expression of NTF receptors (NTFRs) on
      afferent synaptic terminals. Only by supposing that the expression of NTFRs is
      governed by NTF uptake do we find that physiological plasticity is competitive in
      character. We perform a fixed point analysis that establishes when afferent
      segregation is possible as a function of the parameters in the model, and
      simulate the model numerically to shed further light on its properties. A very
      clear prediction emerges from our model: that, as the efficacy of a terminal that
      is destined to be retracted due to competitive interactions reduces to zero, the
      NTFRs on that terminal should be down-regulated. Furthermore, our model requires
      that this reduction in synaptic efficacy never occurs significantly before the
      down-regulation in NTFRs. Such a prediction should be testable, and renders our
      model capable of being invalidated, in contrast to many other models of synaptic
      competition, which merely impose rather than seek to illuminate the
      quintessential feature of developmental synaptic plasticity.

PMID- 11204396
TI  - The economy of the shape of limbed animals.
AB  - A simple, high-level wire-minimization model appears to drive the relationship
      between animal limb number and body-to-limb proportion in some animals across at
      least seven phyla: annelids, arthropods, cnidarians, echinoderms, molluscs,
      tardigrades and vertebrates. Given an animal's body-to-limb proportion, the model
      enables one to estimate the animal's number of limbs, and vice versa. Informally,
      the model states that a limbed animal's large-scale morphology is set so as to
      maximize its number of limbs subject to the constraint that there is not a more
      economical shape which reaches out to the same places. A consequence of animals
      conforming to the model is that their large-scale morphology is "minimally
      wired." Just as wire minimization is important in artificial information
      processing devices, it is hypothesized that one reason why animals' large-scale
      morphologies conform to a save-wire principle is to minimize the system-wide
      information processing times.

PMID- 11204397
TI  - Estimating statistics of neuronal dynamics via Markov chains.
AB  - We present an efficient computational method for estimating the mean and variance
      of interspike intervals defined by the timing of spikes in typical orbits of one
      dimensional neuronal maps. This is equivalent to finding the mean and variance of
      return times of orbits to particular regions of phase space. Rather than
      computing estimates directly from time series, the system is modelled as a finite
      state Markov chain to extract stationary behaviour in the form of invariant
      measures and average absorption times. Ergodic-theoretic formulae are then
      applied to produce the estimates without the need to generate orbits directly.
      The approach may be applied to both deterministic and randomly forced systems.

PMID- 11204398
TI  - Combined Hebbian development of geniculocortical and lateral connectivity in a
      model of primary visual cortex.
AB  - We present a network model of visual map development in layer 4 of primary visual
      cortex. Our model comprises excitatory and inhibitory spiking neurons. The input
      to the network consists of correlated spike trains to mimick the activity of
      neurons in the lateral geniculate nucleus (LGN). An activity-driven Hebbian
      learning mechanism governs the development of both the network's lateral
      connectivity and feedforward projections from LGN to cortex. Plasticity of
      inhibitory synapses has been included into the model so as to control overall
      cortical activity. Even without feedforward input, Hebbian modification of the
      excitatory lateral connections can lead to the development of an intracortical
      orientation map. We have found that such an intracortical map can guide the
      development of feedforward connections from LGN to cortical simple cells so that
      the structure of the final feedforward orientation map is predetermined by the
      intracortical map. In a scenario in which left- and right-eye geniculocortical
      inputs develop sequentially one after the other, the resulting maps are therefore
      very similar, provided the intracortical connectivity remains unaltered. This may
      explain the outcome of so-called reverse lid-suture experiments, where animals
      are reared so that both eyes never receive input at the same time, but the
      orientation maps measured separately for the two eyes are nevertheless nearly
      identical.

PMID- 11204399
TI  - Silicon synaptic depression.
AB  - The recent quantitative description of activity-dependent depression in the
      synaptic transmission between cortical neurons has lead to many interesting
      suggestions of possible computational implications. Based on a simple biological
      model, we have constructed an analog circuit that emulates the properties of
      short-term depressing synapses. The circuit comprises only seven transistors and
      two capacitors per synapse, and is able to reproduce computational features of
      depressing synapses such as the 1/F law, the detection of long intervals of
      presynaptic silence and the sensitivity to redistribution of presynaptic firing
      rates. It provides a useful basis for implementing neural networks with dynamical
      synapses.

PMID- 11204400
TI  - Detection of simple radially symmetric targets: further evidence for the matched
      filter processing scheme in human pattern detection.
AB  - The detection of small radially symmetric targets was studied using a
      subthreshold summation paradigm. Small disc and disc-like patterns with diameters
      up to 0.60 were used for superposition on Bessel functions of zero order,
      subthreshold contrast and various spatial frequencies. Contrast interrelation
      functions prove linear over the whole range of contrasts used for the Bessel
      functions while their slopes show systematic variation with spatial frequency. An
      extrapolation of sensitivity from the slopes reveals that sensitivity can be
      predicted by a simple model assuming detection to be mediated by a transfer
      function made up as a cascade of an even bandpass function and the disc pattern
      spectrum, as has been found previously using one dimensional luminance
      distributions. Problems concerning the formation of pattern-specific radial
      symmetric filters are discussed.

PMID- 11204401
TI  - Topology selection by chaotic neurons of a pyloric central pattern generator.
AB  - The pyloric Central Pattern Generator (CPG) in the lobster has an architecture in
      which every neuron receives at least one connection from another member of the
      CPG. We call this a "non-open" network topology. An "open" topology, where at
      least one neuron does not receive synapses from any other CPG member, is found
      neither in the pyloric nor in the gastric mill CPG. Here we investigate a
      possible reason for this topological structure using the ability to perform a
      biologically functional task as a measure of the efficacy of the network. When
      the CPG is composed of model neurons that exhibit regular membrane voltage
      oscillations, open topologies are as able to maximize this functionality as non
      open topologies. When we replace these models by neurons which exhibit chaotic
      membrane voltage oscillations, the functional criterion selects non-open
      topologies. As isolated neurons from invertebrate CPGs are known in some cases to
      undergo chaotic oscillations, this suggests that there is a biological basis for
      the class of non-open network topologies that we observe.

PMID- 11204402
TI  - Interaction of the body, head, and eyes during walking and turning.
AB  - Body, head, and eye movements were measured in five subjects during straight
      walking and while turning corners. The purpose was to determine how well the head
      and eyes followed the linear trajectory of the body in space and whether head
      orientation followed changes in the gravito-inertial acceleration vector (GIA).
      Head and body movements were measured with a video-based motion analysis system
      and horizontal, vertical, and torsional eye movements with video-oculography.
      During straight walking, there was lateral body motion at the stride frequency,
      which was at half the frequency of stepping. The GIA oscillated about the
      direction of heading, according to the acceleration and deceleration associated
      with heel strike and toe flexion, and the body yawed in concert with stepping.
      Despite the linear and rotatory motions of the head and body, the head pointed
      along the forward motion of the body during straight walking. The head pitch/roll
      component appeared to compensate for vertical and horizontal acceleration of the
      head rather than orienting to the tilt of the GIA or anticipating it. When
      turning corners, subjects walked on a 50-cm radius over two steps or on a 200-cm
      radius in five to seven steps. Maximum centripetal accelerations in sharp turns
      were ca.0.4 g, which tilted the GIA ca.21 degrees with regard to the heading.
      This was anticipated by a roll tilt of the head of up to 8 degrees. The eyes
      rolled 1-1.5 degrees and moved down into the direction of linear acceleration
      during the tilts of the GIA. Yaw head deviations moved smoothly through the turn,
      anticipating the shift in lateral body trajectory by as much as 25 degrees. The
      trunk did not anticipate the change in trajectory. Thus, in contrast to straight
      walking, the tilt axes of the head and the GIA tended to align during turns. Gaze
      was stable in space during the slow phases and jumped forward in saccades along
      the trajectory, leading it by larger angles when the angular velocity of turning
      was greater. The anticipatory roll head movements during turning are likely to be
      utilized to overcome inertial forces that would destabilize balance during
      turning. The data show that compensatory eye, head, and body movements stabilize
      gaze during straight walking, while orienting mechanisms direct the eyes, head,
      and body to tilts of the GIA in space during turning.

PMID- 11204404
TI  - Neurons with large bilateral receptive fields in monkey prelunate gyrus.
AB  - In single-cell recordings from the dorsocaudal part of the prelunate gyrus of an
      alert monkey (Macaca fascicularis) we found neurons with unexpectedly large
      receptive fields (RFs) that spread bilaterally into the contra- and ipsilateral
      visual fields. These neurons (n=82) appeared to be clustered in the periphery of
      V4. They were surrounded by neurons with relatively small (3-10 degrees) and
      unilateral RFs in the contralateral field with properties similar to those
      previously described for neurons in area V4. Bilateral RFs extended over large
      parts of the lower visual field but always spared the fovea. Receptive fields
      typically revealed two foci of maximal responsiveness that were arranged
      symmetrically in the ipsi- and contralateral fields. Twenty-six cells did not
      respond to stimuli along the vertical meridian; these neurons had two distinct
      RFs. The preference for stimulus orientation, color, or motion was similar in all
      parts of these large RFs.

PMID- 11204403
TI  - Distribution of the neurotrophin receptors p75 and trkB in peripheral
      mechanoreceptors; observations on changes after injury.
AB  - The neurotrophin family mediates effects of growth, cell differentiation and cell
      death through low- and high-affinity transmembrane receptors. The Pacinian
      corpuscle (PC) is the largest peripheral mechanoreceptor in mammals and was
      studied by immuno-histochemistry and immuno-electron microscopy with regard to
      the distribution of neurotrophin receptors, p75; p140 trkA, p145 trkB and 145
      trkC. TrkA- and trkC-like immunoreactivity (IR) was not expressed in rat and cat
      PCs. Developing and adult animals expressed p75 and trkB in lamellar cells of the
      PC. The inner core cells, thought to be specialised Schwann cells, demonstrated
      an injury-induced increased immuno-labelling for trk B. Perineurial-derived outer
      core cells were reactive to p75 after injury similar to the perineurium of distal
      nerve stumps. Inner core cells of PCs behaved as leptomeningeal cells with regard
      to trkB. Outer core lamellar cells of PCs behaved as perineurial cells with
      regard to p75. A role for brain-derived neurotrophic factor is proposed in the
      development and nerve regeneration of PCs via an anterograde messenger transfer
      through p75 and trkB.

PMID- 11204405
TI  - Conditioning of heteronymous H reflex in human temporalis muscle by stimulation
      of perioral afferents.
AB  - A heteronymous H reflex in the temporalis muscle can be elicited by selective
      stimulation of the masseteric nerve. The present study aimed at defining the
      optimal amplitude of the H reflex to detect inhibitory changes induced by
      stimulation of the perioral afferents and at providing new information on the
      control of masticatory muscles. Sixteen healthy volunteers participated in the
      experiment. A conditioning stimulus (CS) to the perioral skin was applied at
      various delays before an ipsilateral selective masseteric nerve stimulation (test
      stimulus: TS) while the subject was clenching the teeth at 25% of the maximal
      voluntary contraction. Two intensities of CS and TS were employed, high and low.
      The peak-to-peak amplitude of the H reflex (TS) and the root-mean-square value of
      the preceding electromyography were measured and the data analyzed by three-way
      analysis of variance and Tukey's posthoc tests. For both intensities used the
      heteronymous H reflex in the temporalis muscle was significantly decreased by
      prior activation of perioral afferents for delays from 5 to 60 ms. With a delay
      of 5 and 35 ms the preceding EMG level was not changed, while it was reduced at
      20 and 60 ms delay. The intensities used to elicit the heteronymous H reflex of
      the temporalis muscle were appropriate to detect a reduction in motoneuron
      excitability. The reduction in the H reflex without a change in the preceding EMG
      at 5 and 35 ms delays could be due to presynaptic inhibition of the masseteric
      afferents exerted by the ipsilateral perioral afferents.

PMID- 11204406
TI  - Orientation of the opposition axis in mentally simulated grasping.
AB  - Five normal subjects were tested in a simulated grasping task. A cylindrical
      container filled with water was placed on the center of a horizontal monitor
      screen. Subjects used a precision grip formed by the thumb and index finger of
      their right hand. After a preliminary run during which the container was present,
      it was replaced by an image of the upper surface of the cylinder appearing on the
      horizontal computer screen on which the real cylinder was placed during the
      preliminary run. In each trial the image was marked with two contact points which
      defined an opposition axis in various orientations with respect to the frontal
      plane. The subjects' task consisted, once shown a stimulus, of judging as quickly
      as possible whether the previously experienced action of grasping the container
      full of water and pouring the water out would be easy, difficult or impossible
      with the fingers placed according to the opposition axis indicated on the circle.
      Response times were found to be longer for the grasps judged to be more difficult
      due to the orientation and position of the opposition axis. In a control
      experiment, three subjects actually performed the grasps with different
      orientations and positions of the opposition axis. The effects of these
      parameters on response time followed the same trends as during simulated
      movements. This result shows that simulated hand movements take into account the
      same biomechanical limitations as actually performed movements.

PMID- 11204407
TI  - Spatial- and verbal-memory improvement by cold-water caloric stimulation in
      healthy subjects.
AB  - We investigated the effects of unilateral cold-water vestibular stimulation on
      healthy subjects' performance in two cognitive tasks known to be differentially
      mediated by the two cerebral hemispheres. In a first experiment (right-hemisphere
      task), subjects memorized object-location associations while being stimulated
      with cold water in the left ear or right ear or not at all (control group). In
      the second experiment (left-hemisphere task), subjects memorized a list of
      sequentially presented function words while being stimulated in the same manner
      as the subjects in the first experiment. A recall phase followed each encoding
      phase. In the first experiment, subjects who had been stimulated in the left ear
      recalled the object locations significantly faster than subjects who had been
      stimulated in the right ear and those in the control group. The second experiment
      yielded the reverse pattern: correct word recognition was faster for subjects who
      had been stimulated in the right ear than for subjects stimulated in the left ear
      and those of the control group. We suggest that unilateral caloric stimulation
      leads to a selective activation of contralateral cerebral structures and speeds
      up cognitive processes mediated by these structures. These results are discussed
      with respect to findings in neglect patients and functional-imaging studies in
      healthy subjects.

PMID- 11204408
TI  - Somatosensory attunement to the rigid body laws.
AB  - In the most general case, haptic perception of an object's heaviness is most
      likely the perception of the object's resistance to movement, determined jointly
      by the object's mass and mass distribution. In two experiments with occluded
      objects wielded freely in three dimensions, we showed additive effects on
      perceived heaviness of mass and the inertia tensor. Our manipulations of the
      inertia tensor were directed specifically at the volume and symmetry of the
      inertia ellipsoid, quantities that can be understood as important to controlling
      the level and patterning of muscular forces, respectively. Ellipsoid volume and
      symmetry were found to have separate effects on perceptual reports of heaviness
      that were invariant over different tensors. Independent sensitivities to
      translational inertia and particular characterizations of rotational inertia
      suggest specialized somatosensory attunement to the rigid body laws.

PMID- 11204409
TI  - The visual-oculomotor striatum of the cat: functional relationship to the
      superior colliculus.
AB  - The visual-recipient sector of the cat striatum receives corticostriate input
      from over 15 higher visual and oculomotor-related areas of the cortex and appears
      homologous with the physiologically characterized region of mixed visual and
      oculomotor inputs within the primate caudate nucleus. This area in the cat
      involves the dorsolateral caudate and a strip of the caudal putamen. In a first
      series of experiments, the former was injected with a retrograde tracer in
      several cats. Thalamostriate cells were found in extensive regions, including the
      intralaminar nuclei, certain motor-related nuclei, and, most notably, across much
      of the extrageniculate visual thalamus. In another set of experiments,
      anterograde tracers were also injected into the superior colliculus (SC), and
      labeled tectothalamic fibers were observed in all thalamic sites projecting to
      the visual-recipient striatum. These findings highlight for the first time the
      need for the SC to be considered in models of thalamostriate and
      visual/oculomotor-striatal function(s). Moreover, the data bring to light the
      fact that basal-ganglia outflow reaching the SC via striatonigro-nigrotectal
      circuitry is well positioned to modulate ascending tecto-thalamic-thalamostriatal
      signals destined for the visual-recipient striatum.

PMID- 11204410
TI  - Generalized induction of 72-kDa heat-shock protein after transient focal ischemia
      in rat brain.
AB  - The time course of 72-kDa heat-shock protein (hsp72) induction was evaluated by
      immunoblotting in cerebral cortex, striatum, hippocampus, cerebellum, liver, and
      kidney of rats subjected to 60-min focal cerebral ischemia following proximal
      unilateral occlusion of the right middle cerebral artery (MCA). Neurological
      examinations indicated that maximum deficits in reflex and sensorimotor functions
      occurred 24-48 h after reperfusion (40% lower than baseline), while significant
      recovery occurred at 72 h (33% higher than 48 h). hsp72 was present in all
      tissues at 6 h. The regions perfused by the occluded MCA showed a higher
      induction than the corresponding contralateral ones. hsp72 reached its maximum
      level in ipsilateral cerebral cortex and striatum at 24 h, whereas in the
      contralateral cortex and cerebellum the protein reached its maximum expression at
      48 h, that is 24 h before functional recovery. This delay suggests a role of the
      protein in plastic events sustaining neurological recovery.

PMID- 11204411
TI  - Metabotropic glutamate receptors modify ionotropic glutamate responses in
      neocortical pyramidal cells and interneurons.
AB  - In neocortex glutamate activates ionotropic and metabotropic receptors (mGluRs).
      Whole-cell current-clamp recordings in the in vitro rat auditory cortex at 32
      degrees C were used to explore the role that mGluRs have in regulation of
      AMPA/kainate, NMDA, and GABA receptor-mediated synaptic transmission. Our
      findings are: (a) The fast EPSP (AMPA/kainate), slow EPSP (NMDA), and IPSPs
      (GABAA, GABAB), elicited in pyramidal neurons are reduced in the presence of
      (1S,3R)-ACPD (mGluR agonist) with greatest effect on the slow IPSP>fast
      IPSP>>fast EPSP. The effect is likely the result of ACPD acting at presynaptic
      mGluRs because the probability of release of glutamate and GABA is reduced in the
      presence of ACPD, intracellular infusion of a G protein antagonist (GDPPS) did
      not block the effect of ACPD, nor were iontophoretic kainic acid or NMDA-induced
      depolarizations reduced by ACPD. (b) The slow EPSP is enhanced following washout
      of ACPD and enhancement is not due to disinhibition because it is present in the
      absence of IPSPs, but if IPSPs are present, its magnitude can be influenced.
      Iontophoretic NMDA responses are enhanced in the presence of ACPD, an effect
      blocked by GDPbetaS and heparin (intracellular inositol 1,4,5-trisphosphate
      receptor antagonist). Taken together, this evidence suggests that enhancement is
      a result of group I postsynaptic mGluR activation. (c) In fast-spiking cells ACPD
      reduces the EPSP (AMPA/kainate and NMDA-mediated). This action is likely
      presynaptic because it persists when GDPbetaS is in the cells. (d) The rate of
      spike discharge recorded from fast-spiking cells is accelerated in ACPD but does
      not change in the presence of GDPbetaS, suggesting a postsynaptic effect. Our
      data indicate that mGluRs can influence neocortical synaptic transmission in
      complex ways by acting presynaptically and postsynaptically.

PMID- 11204412
TI  - Intermediate cerebellum and conditioned eyeblinks. Parallel involvement in
      eyeblinks and tonic eyelid closure.
AB  - The intermediate cerebellum (the intermediate cerebellar cortex and interposed
      nuclei) and associated brainstem circuits are essential for the acquisition and
      expression of classically conditioned eyeblinks in the rabbit. The purpose of the
      present experiment was to determine whether these circuits are also involved in
      adaptive eyelid closure learned in an instrumental paradigm. For that purpose,
      rabbits with unrestrained eyelids were trained in two tasks: (1) classical
      conditioning of the eyeblink; and (2) a new instrumental task in which they
      avoided delivery of an aversive stimulus by maintaining tonic eyelid closure. To
      examine the involvement of the intermediate cerebellum in these two types of
      learned behavior, the cerebellar interposed nuclei were injected with the GABAA
      agonist muscimol and with the GABAA antagonist picrotoxin. Inactivating the
      interposed nuclei with muscimol abolished classically conditioned eyeblinks and
      severely affected the rabbit's capacity to maintain tonic eyelid closure. On the
      other hand, reducing inhibition with picrotoxin failed to interrupt the learned
      responses and increased the amplitude of eyelid closure. These data indicate that
      the cerebellar interposed nuclei control both phasic classically conditioned
      eyeblinks and tonic instrumental eyelid closure. To account for this new finding,
      a "hybrid" hypothesis combining the cerebellar learning hypothesis and the
      performance hypothesis is proposed.

PMID- 11204413
TI  - Projections from ventrolateral hypothalamic neurons containing progesterone
      receptors and somatostatin to the midbrain central gray in the female guinea pig.
AB  - The goal of this study was to determine, by combining retrograde fluorescent
      tract tracing with double immunocytochemistry, whether neurons immunoreactive
      (IR) for both progesterone receptors (PR) and somatostatin (SOM) in the guinea
      pig ventrolateral nucleus (VL) send their axons directly to the midbrain.
      Unilateral microinjections of true blue (TB) fluorescent dye were made into the
      midbrain central gray (MCG) of ovariectomized animals primed with estradiol to
      induce PR and injected intracerebroventricularly with colchicine to visualize SOM
      IR neurons. The highest number of PR/SOM-IR neurons in the VL that projected to
      the midbrain was found when the fluorescent retrograde tracer was confined to the
      lateral region of the MCG at the mid-rostrocaudal level. More specifically, 29%
      of the progesterone target neurons containing SOM detected in the VL projected
      directly to the midbrain, accounting for 7% of the PR-IR neurons and for 9% of
      the SOM-IR neurons. These triple-labeled cells were found throughout the extent
      of the VL. Double-labeled cells also sent axons to the MCG and were either PR-IR
      (14%) or SOM-IR (12%). These results provide morphological evidence that a subset
      of the PR-IR neurons expressing SOM in the VL have long projections to the
      midbrain and suggest that the SOM system may modulate neural circuits involved in
      the regulation of steroid-influenced behaviors and neuroendocrine functions.

PMID- 11204414
TI  - Origins and violations of the 2/3 power law in rhythmic three-dimensional arm
      movements.
AB  - The 2/3 power law, the nonlinear relationship between tangential velocity and
      radius of curvature of the end-effector trajectory, is thought to be a
      fundamental constraint of the central nervous system in the formation of rhythmic
      endpoint trajectories. However, studies on the 2/3 power law have been confined
      largely to planar drawing patterns of relatively small size. With the hypothesis
      that this strategy overlooks nonlinear effects that are constitutive in movement
      generation, the present experiments tested the validity of the power law in
      elliptical patterns that were not confined to a planar surface and which were
      performed by the unconstrained 7-degrees of freedom (DOF) arm, with significant
      variations in pattern size and workspace orientation. Data were recorded from
      five human subjects where the seven joint angles and the endpoint trajectories
      were analyzed. Additionally, an anthropomorphic 7-DOF robot arm served as a
      "control subject" whose endpoint trajectories were generated on the basis of the
      human joint angle data, modeled as simple harmonic oscillations. Analyses of the
      endpoint trajectories demonstrate that the power law is systematically violated
      with increasing pattern size, in both exponent and the goodness of fit. The
      origins of these violations can be explained analytically based on smooth,
      rhythmic trajectory formation and the kinematic structure of the human arm. We
      conclude that, in unconstrained rhythmic movements, the power law seems to be a
      by-product of a movement system that favors smooth trajectories, and that it is
      unlikely to serve as a primary movement-generating principle. Our data rather
      suggest that subjects employed smooth oscillatory pattern generators in joint
      space to realize the required movement patterns.

PMID- 11204415
TI  - The ability to execute saccades on the basis of efference copy: impairments in
      double-step saccade performance in children with developmental co-ordination
      disorder.
AB  - The double-step saccade task (DSST) was used to test the hypothesis that children
      with developmental co-ordination disorder (DCD) who experience deficits in motor
      imagery have difficulty processing the visual spatial consequences of intended
      movements using efference copy signals. In order to ensure that the second
      saccade in the DSST was executed in the absence of visual cues and had to be
      programmed on the basis of extra-retinal information (efference copy), we
      analysed only those double-step ensembles where latency plus duration of first
      saccades was greater than 240 ms (total presentation time of the targets). No
      significant differences between DCD and control children were evident on measures
      of latency of first saccades, intersaccadic interval and first saccade error. As
      predicted, children with DCD who have impaired motor imagery demonstrated
      specific deficits on the DSST where efference copy had been used to program the
      saccade sequence. More specifically, these children were less accurate in terms
      of final eye position on second saccades. Our results raise the possibility that
      abnormalities in the processing of efference copy signals could underlie motor
      clumsiness in the majority of children with DCD. Furthermore, the origin of this
      deficit in efference copy probably exists at the level of the parietal lobe.

PMID- 11204416
TI  - Horizontal ocular vergence and the three-dimensional response to whole-body roll
      motion.
AB  - We evaluated the human binocular response to roll motion in the dark and during
      visual fixation with horizontal convergence. Six normal human subjects were
      exposed to manually driven, whole-body rotation about an earth-vertical, naso
      occipital axis, under two conditions: (I) oscillation at 0.4 Hz (peak velocity
      69+/-3.8 degree/s) in the dark, and whilst fixating an axial light-emitting diode
      at 48 cm ('near') and at 206 cm ('far'); (II) constant velocity rotation (56.5+/
      3.1 degree/s) for 40 s, clockwise and counter-clockwise, in the dark, and sudden
      stops. Eye and head movements were monitored using scleral search coils. In head
      fixed, angular velocity coordinates roll motion always evoked conjugate ocular
      torsion, with small conjugate horizontal and disconjugate vertical components.
      The resultant binocular eye responses were rotations about convergent axes.
      During oscillation with target fixation the convergence of the rotation axes was
      larger than that predicted by target geometry, producing disconjugate
      oscillations of vertical gaze about the target ('skewing'). Fast-phase eye
      movements were primarily resetting rotations about the same convergent rotation
      axes as the slow phases, but the small vertical velocity components had
      oscillatory, asymmetrical profiles. In response to velocity steps the slow-phase
      eye velocity decayed exponentially with time constants of 4.5+/-1.5 s for the
      torsional component and 5.8+/-1.9 s for the 'vertical vergence' component (right
      eye-left eye recordings). We conclude that in normal human subjects dynamic
      vertical canal stimulation with horizontal gaze convergence evokes rotation of
      the eyes about convergent axes and a small skewing of the eyes.

PMID- 11204417
TI  - Chronic intracerebroventricular exposure to beta-amyloid(1-40) impairs object
      recognition but does not affect spontaneous locomotor activity or sensorimotor
      gating in the rat.
AB  - This study examined the cognitive effects of chronic in vivo exposure to beta
      amyloid(1-40) via the intracerebroventricular route on two distinct paradigms.
      The first test evaluated a form of early attentional control referred to as
      sensorimotor gating in which an antecedent weak prepulse stimulus modulates the
      reactivity to a subsequent startle-eliciting stimulus. The second test utilized
      the spontaneous preference for a novel object over that of a familiar one in rats
      as a measure of object recognition memory. We found that beta-amyloid exposure
      leads to a severe deficit in the object memory test but spares sensorimotor
      gating. Moreover, unlike the water maze deficit induced by beta-amyloid (Nag et
      al., in preparation), the deficit on object recognition was resistant to
      amelioration by systemic physostigmine treatment at a dose of 0.06 mg/kg per day
      intraperitoneally. The present results add to previous reports that beta-amyloid
      exposure can lead to deficits on hippocampal lesion sensitive tasks, suggesting
      that dysfunction of the rhinal cortices in addition to that of the
      septohippocampal system is implicated in beta-amyloid-induced behavioral
      impairments. It therefore lends support to the hypothesis that beta-amyloid
      exposure can lead to severe impairment across multiple memory systems.

PMID- 11204418
TI  - Good maintenance of exercise-induced bone gain with decreased training of female
      tennis and squash players: a prospective 5-year follow-up study of young and old
      starters and controls.
AB  - This prospective 5-year follow-up study of 64 adult female racquet sports players
      and 27 controls assessed the changes in the playing-to-nonplaying arm bone
      mineral content (BMC) differences to answer three questions: (1) Are training
      induced bone gains lost with decreased training? (2) Is the bone response to
      decreased training different if the playing career has been started before or at
      puberty rather than after it? (3) Are the possible bone changes related to the
      changes in training? The players were divided into two groups according to the
      starting age of their tennis or squash playing. The mean starting age was 10.5
      years (SD, 2.2) among the players who had started training before or at menarche
      (young starters; n = 36) while 26.4 years (SD, 8.0) among those players who had
      begun training a minimum of 1 year after menarche (old starters; n = 28). At
      baseline of the 5-year follow-up, the mean age of the young starters was 21.6
      years (SD, 7.6) and that of old starters was 39.4 years (SD, 10.5). During the
      follow-up, the young starters had reduced the average training frequency from 4.7
      times a week (2.7) to 1.4 times a week (1.3) and the old starters from 4.0 times
      a week (1.4) to 2.0 times a week (1.4), respectively. The 5-year follow-up
      revealed that despite reduced training the exercise-induced bone gain was well
      maintained in both groups of players regardless of their clearly different
      starting age of activity and different amount of exercise-induced bone gain. The
      gain was still 1.3-2.2 times greater in favor of the young starters (at the
      follow-up, the dominant-to-nondominant arm BMC difference was 22% [8.4] in the
      humeral shaft of the young starters versus 10% [3.8] in the old starters, and
      3.5% [2.4] in controls). In the players, changes in training were only weakly
      related to changes in the side-to-side BMC difference (r(s) = 0.05-0.34, all NS),
      and this was true even among the players who had stopped training completely a
      minimum 1 year before the follow-up. In conclusion, if controlled interventions
      will confirm our findings that an exercise-induced bone gain can be well
      maintained with decreased activity and that the maintenance of the bone gain is
      independent of the starting age of activity, exercise can be recommended for
      preventing osteoporosis and related fractures.

PMID- 11204419
TI  - Exercise maintains bone mass, but do people maintain exercise?

PMID- 11204420
TI  - Variation in bone biomechanical properties, microstructure, and density in BXH
      recombinant inbred mice.
AB  - To test the hypothesis that factors associated with bone strength (i.e.,
      volumetric bone mineral density [vBMD], geometry, and microstructure) have
      heritable components, we exploited the 12 BXH recombinant inbred (RI) strains of
      mice derived from C57BL/6J (B6; low bone mass) and C3H/HeJ (C3H; high bone mass)
      progenitor strains. The femurs and lumbar vertebrae from each BXH RI strain were
      characterized for phenotypes of vBMD, microstructural, biomechanical, and
      geometrical properties. Methods included bending (femur) and compression
      (vertebra) testing, peripheral quantitative computed tomography (pQCT), and
      microcomputed tomography (microCT). Segregation patterns of femoral and vertebral
      biomechanical properties among the BXH RI strains suggested polygenic regulation.
      Femoral biomechanical properties were strongly associated with femoral width in
      the anteroposterior (AP) direction and cortical thickness--geometric properties
      with complex genetic regulation. Vertebral vBMD and biomechanical properties
      measured in BXH RI strains showed a greater variability than either B6 or C3H
      progenitors, suggesting both progenitor strains have independent subsets of genes
      that yield similar vBMD and strength. The microCT and pQCT data suggested that
      the distribution of vertebral mineral into cortical and trabecular compartments
      is regulated genetically. Although the B6 and C3H progenitors had similar
      vertebral strength, their vertebral structures were markedly different: B6 had
      good trabecular bone structure and modest cortical bone mineral content (BMC),
      whereas C3H had high cortical BMC combined with a deficiency in trabecular
      structure. These structural traits segregated independently in the BXH RI
      strains. Finally, vertebral strength was not correlated consistently with femoral
      strength among the BXH RI strains, suggesting genetic regulation of bone strength
      is site specific.

PMID- 11204421
TI  - Localization of estrogen receptor beta protein expression in adult human bone.
AB  - Evidence suggests that the newly described estrogen receptor beta (ER-beta) may
      be important for estrogen (17beta-estradiol) action on the skeleton, but its
      cellular localization in adult human bone requires clarification. We addressed
      this by using indirect immunoperoxidase with a novel affinity purified polyclonal
      antibody to human ER-beta, raised to hinge domain (D) sequences from the human
      receptor. Bone was demineralized in 20% EDTA and all biopsy specimens were
      formalin-fixed and wax-embedded. Vigorous retrieval was essential for ER-beta
      detection. In sections (5 microm) of benign prostate hyperplasia, used as
      positive control, clear nuclear immunoreactivity was seen in glandular epithelial
      cells, with a 1:500 dilution of ER-beta40. For bone sections, optimal antibody
      dilutions were 1:100-1:250. We found that in normal bone (from graft operations),
      in fracture callus from both men and women (>25 years old), pagetic bone,
      osteophytes, and secondary hyperparathyroid bone, all from older patients, ER
      beta was expressed clearly in osteoclast nuclei, with little cytoplasmic
      immunoreactivity. Nuclear immunoreactivity was still prominent in osteoclasts,
      with antibody diluted 1:500, although it faded in other cells. Osteoblasts, in
      areas of active bone formation or bone remodeling, also expressed ER-beta, as did
      some osteocytes. However, hypertrophic chondrocytes were negative, unlike
      mesenchymal cells, adjacent to the osteogenesis. Megakaryocytes and some
      capillary blood vessels cells were receptor positive. All ER-beta expression was
      blocked totally by preincubation of antibody with antigen. We conclude that ER
      beta is expressed in cells of osteoblast lineage and in osteoclasts. The latter
      appear relatively abundant in this receptor and this might provide a means for
      direct action of estrogen on osteoclasts.

PMID- 11204422
TI  - Transcriptional induction of matrix metalloproteinase-13 (collagenase-3) by
      1alpha,25-dihydroxyvitamin D3 in mouse osteoblastic MC3T3-E1 cells.
AB  - The removal of unmineralized matrix from the bone surface is essential for the
      initiation of osteoclastic bone resorption because osteoclasts cannot attach to
      the unmineralized osteoid. Matrix metalloproteinases (MMPs) are known to digest
      bone matrix. We recently reported that among the MMPs expressed in mouse
      osteoblastic cells, MMP-13 (collagenase-3) was the one most predominantly up
      regulated by bone resorbing factors including 1alpha,25-dihydroxyvitamin D3
      [1alpha,25(OH)2D3]. In this study, we examined the mechanism of regulation of MMP
      13 expression by 1alpha,25(OH)2D3 in mouse osteoblastic MC3T3-E1 cells.
      1Alpha,25(OH)2D3 increased steady-state messenger RNA (mRNA) and protein levels
      of MMP-13. De novo protein synthesis was essential for the induction because
      cycloheximide (CHX) decreased the effect of 1alpha,25(OH)2D3 on the MMP-13 mRNA
      level. 1Alpha,25(OH)2D3 did not alter the decay of MMP-13 mRNA in
      transcriptionally arrested MC3T3-E1 cells; however, it increased the MMP-13
      heterogeneous nuclear RNA (hnRNA) level and MMP-13 transcriptional rate. The
      binding activity of nuclear extracts to the AP-1 binding site, but not to the
      Cbfa1 binding site, in the MMP-13 promoter region was up-regulated by
      1alpha,25(OH)2D3, suggesting the mediation of AP-1 in this transcriptional
      induction. To determine the contribution of MMPs to bone resorption by
      1alpha,25(OH)2D3, the inhibitory effect of BB94, an MMP inhibitor, on resorbed
      pit formation by mouse crude osteoclastic cells was examined on either an
      uncoated or collagen-coated dentine slice. BB94 did not prevent resorbed pit
      formation on uncoated dentine whereas it did on collagen-coated dentine. We
      therefore propose that the transcriptional induction of MMP-13 in osteoblastic
      cells may contribute to the degradation of unmineralized matrix on the bone
      surface as an early step of bone resorption by 1alpha,25(OH)2D3.

PMID- 11204423
TI  - Bioactive glass stimulates in vitro osteoblast differentiation and creates a
      favorable template for bone tissue formation.
AB  - In this study, we have investigated the behavior of fetal rat osteoblasts
      cultured on bioactive glasses with 55 wt% silica content (55S) and on a bioinert
      glass (60S) used either in the form of granules or in the form of disks. In the
      presence of Bioglass granules (55 wt% silica content), phase contrast microscopy
      permitted step-by-step visualization of the formation of bone nodules in contact
      with the particles. Ultrastructural observations of undecalcified sections
      revealed the presence of an electron-dense layer composed of needle-shaped
      crystals at the periphery of the material that seemed to act as a nucleating
      surface for biological crystals. Furthermore, energy dispersive X-ray (EDX)
      analysis and electron diffraction patterns showed that this interface contains
      calcium (Ca) and phosphorus (P) and was highly crystalline. When rat bone cells
      were cultured on 55S disks, scanning electron microscopic (SEM) observations
      revealed that cells attached, spread to all substrata, and formed multilayered
      nodular structures by day 10 in culture. Furthermore, cytoenzymatic localization
      of alkaline phosphatase (ALP) and immunolabeling with bone sialoprotein antibody
      revealed a positive staining for the bone nodules formed in cultures on 55S. In
      addition, the specific activity of ALP determined biochemically was significantly
      higher in 55S cultures than in the controls. SEM observations of the material
      surfaces after scraping off the cell layers showed that mineralized bone nodules
      remained attached on 55S surfaces but not on 60S. X-ray microanalysis indicated
      the presence of Ca and P in this bone tissue. The 55S/bone interfaces also were
      analyzed on transverse sections. The interfacial analysis showed a firm bone
      bonding to the 55S surface through an intervening apatite layer, confirmed by the
      X-ray mappings. All these results indicate the importance of the surface
      composition in supporting differentiation of osteogenic cells and the subsequent
      apposition of bone matrix allowing a strong bond of the bioactive materials to
      bone.

PMID- 11204424
TI  - Parathyroid hormone enhances fluid shear-induced [Ca2+]i signaling in
      osteoblastic cells through activation of mechanosensitive and voltage-sensitive
      Ca2+ channels.
AB  - Osteoblasts respond to both fluid shear and parathyroid hormone (PTH) with a
      rapid increase in intracellular calcium concentration ([Ca2+]i). Because both
      stimuli modulate the kinetics of the mechanosensitive cation channel (MSCC), we
      postulated PTH would enhance the [Ca2+]i response to fluid shear by increasing
      the sensitivity of MSCCs. After a 3-minute preflow at 1 dyne/cm2, MC3T3-E1 cells
      were subjected to various levels of shear and changes in [Ca2+]i were assessed
      using Fura-2. Pretreatment with 50 nM bovine PTH(1-34) [bPTH(1-34)] significantly
      enhanced the shear magnitude-dependent increase in [Ca2+]i. Gadolinium (Gd3+), an
      MSCC blocker, significantly inhibited the mean peak [Ca2+]i response to shear and
      shear + bPTH(1-34). Nifedipine (Nif), an L-type voltage-sensitive Ca2+ channel
      (VSCC) blocker, also significantly reduced the [Ca2+]i response to shear + bPTH(1
      34), but not to shear alone, suggesting VSCC activation plays an interactive role
      in the action of these stimuli together. Activation of either the protein kinase
      C (PKC) or protein kinase A (PKA) pathways with specific agonists indicated that
      PKC activation did not alter the Ca2+ response to shear, whereas PKA activation
      significantly increased the [Ca2+]i response to lower magnitudes of shear. bPTH(1
      34), which activates both pathways, induced the greatest [Ca2+]i response at each
      level of shear, suggesting an interaction of these pathways in this response.
      These data indicate that PTH significantly enhances the [Ca2+]i response to shear
      primarily via PKA modulation of the MSCC and VSCC.

PMID- 11204425
TI  - Expression of functional gap junctions and regulation by fluid flow in osteocyte
      like MLO-Y4 cells.
AB  - Osteocytes are thought to be mechanosensory cells that respond to mechanical
      stress by sending signals to other bone cells to initiate bone remodeling. An
      osteocyte-like cell line MLO-Y4 provides a model system to examine whether gap
      junctions participate in the regulation of osteocyte function and signaling by
      mechanical stress. In this study, we show that MLO-Y4 cells are coupled and that
      gap junction channels mediate this coupling. Biochemical analyses show that
      connexin 43 (Cx43) is a major gap junction protein expressed in MLO-Y4 cells and
      approximately 5% of Cx43 protein is phosphorylated. MLO-Y4 cells were exposed to
      mechanical stress using a parallel plate flow chamber to model bone fluid flow
      shear stress. Fluid flow increased significantly the length of the dendritic
      processes, a morphological characteristic of osteocytes. A redistribution of the
      gap junction protein, Cx43 also was observed from a location circling the nucleus
      to punctate spots in the cytoplasm and in the dendritic processes. "Scrape
      loading" dye transfer analyses showed that fluid flow increased intercellular
      coupling and increased the number of cells coupled immediately after fluid flow
      treatment, in direct proportion to shear stress magnitude. Although intercellular
      coupling continued to increase, stimulation of Cx43 protein expression during the
      poststress period was found to be biphasic. Cx43 protein was elevated 30 minutes
      after application of stress but decreased at 24 h poststress. Pulsating fluid
      flow had a similar stimulatory effect as steady fluid flow on gap junctions.
      However, this stimulatory effect in osteocyte-like cells was not observed in
      osteoblast-like 2T3 cells. Together, these results show that fluid flow has
      stimulatory effects on osteocyte-like MLO-Y4 cells with early effects on cellular
      morphology, opening of gap junctions, and redistribution of Cx43 protein and
      delayed effects on Cx43 protein expression. The high expression of Cx43 and its
      location in the cytoplasm also suggest that Cx43 may have unknown functions in
      addition to forming gap junctions. These studies indicate that gap junctions may
      serve as channels for signals generated by osteocytes in response to mechanical
      loading.

PMID- 11204426
TI  - The transition of cadherin expression in osteoblast differentiation from
      mesenchymal cells: consistent expression of cadherin-11 in osteoblast lineage.
AB  - Osteoblasts are derived originally from pluripotent mesenchymal stem cells on
      migration into the bone matrix. To elucidate the contribution of classical
      cadherins in this differentiation pathway, we developed a new protocol for their
      analysis and studied their specific expressions in various cell lines of the
      mesenchymal lineage, including osteoblasts. N-cadherin was expressed
      constitutively in all cell lines examined except an osteocyte-like cell line
      whereas cadherin-11 was expressed selectively in preosteoblast and preadipocyte
      cell lines. P-cadherin also was expressed in primary cultures of calvarial cells
      and mature osteoblasts at a relatively low level compared with N-cadherin and
      cadherin-11. M-cadherin was expressed only in a premyoblast cell line. We
      observed the transition of cadherin expression from M-cadherin to cadherin-11 in
      the premyoblast cell line when osteogenic differentiation was induced by
      treatment with bone morphogenetic protein 2 (BMP-2), while the expression of N
      cadherin remained unchanged. In contrast, when a preadipocyte cell line, which
      shows a similar pattern of cadherin expression to osteoblasts, was induced to
      undergo adipogenic differentiation, the expression of N-cadherin and cadherin-11
      was decreased. These observations characterize the cadherin expression profile of
      mesenchymal lineage cells, especially osteoblasts, which regularly express
      cadherin-11. Cadherin-11 may affect cell sorting, alignment, and separation
      through differentiation.

PMID- 11204427
TI  - The dose-response effects of ethanol on the human fetal osteoblastic cell line.
AB  - Alcohol is a risk factor for the development of osteoporosis, especially in men.
      Chronic alcohol abuse decreases bone mass, which contributes to the increased
      incidence of fractures. To better understand the mechanism of action of ethanol
      on bone metabolism, we have studied the dose-response effects of ethanol on
      conditionally immortalized human fetal osteoblasts (hFOB) in culture. Ethanol
      treatment had no significant effects on osteoblast number after 1 day or 7 days.
      Ethanol treatment did not reduce type I collagen protein levels at either time
      point at any dose but slightly reduced alkaline phosphatase activity after 7
      days. The messenger RNA (mRNA) levels for alkaline phosphatase, type I collagen,
      and osteonectin were unaltered by 24 h of ethanol treatment but a high dose (200
      mM) reduced mRNA levels for the two bone matrix proteins after 7 days. Ethanol
      treatment led to dose-dependent increases in transforming growth factor beta1
      (TGF-beta1) mRNA levels and decreases in TGF-beta2 mRNA levels. The concentration
      of ethanol in the medium decreased with time because of evaporation but there was
      little degradation caused by metabolism. These results, which show that cultured
      osteoblasts are less sensitive than osteoblasts in vivo, suggest that the
      pronounced inhibitory effects of ethanol on bone formation are not caused by
      direct cell toxicity.

PMID- 11204428
TI  - Bone mineralization and osteoblast differentiation are negatively modulated by
      integrin alpha(v)beta3.
AB  - Numerous bone matrix proteins can interact with alpha(v)-containing integrins
      including alpha(v)beta3. To elucidate the net effects of the interaction between
      these proteins and alpha(v)beta3 on osteoblast function, we developed a murine
      osteoblastic cell line that overexpressed human alpha(v)beta3. Human
      alpha(v)beta3-integrin was expressed on cell membrane, in which its presence did
      not alter the surface level of endogenous mouse alpha(v)beta3. The expressed
      human alpha(v)beta3 was functional because cell adhesion to osteopontin was
      increased and this increment was abolished by antibody against human
      alpha(v)beta3. The proliferation rate of cells overexpressing alpha(v)beta3
      (alpha(v)beta3-cells) was increased whereas matrix mineralization was decreased.
      To elucidate the mechanisms leading to inhibition of matrix mineralization, the
      expression of proteins important for mineralization was analyzed. Alkaline
      phosphatase activity and the expression of osteocalcin, type I collagen, and bone
      sialoprotein (BSP) were decreased whereas osteopontin was stimulated in
      alpha(v)beta3-cells. The regulation of osteopontin, osteocalcin, and BSP
      expression was mediated via transcriptional mechanism because their promoter
      activities were altered. Examination of molecules involved in integrin signaling
      indicated that activator protein-1 (AP-1) and extracellular signal-regulated
      kinase (Erk) activities were enhanced whereas c-jun N-terminal kinase (JNK)
      activity was decreased in alpha(v)beta3-cells. The activity of p38 and the levels
      of focal adhesion kinase (FAK) and vinculin were not altered. Moreover, the
      adhesions of alpha(v)beta3-cells to type I collagen and fibronectin were
      inhibited, which was attributed to decreased beta1-integrin levels on cell
      surface. In conclusion, overexpressing alpha(v)beta3-integrin in osteoblasts
      stimulated cell proliferation but retarded differentiation, which were derived
      via altered integrin-matrix interactions, signal transduction, and matrix protein
      expression.

PMID- 11204429
TI  - Localizational alterations of calcium, phosphorus, and calcification-related
      organics such as proteoglycans and alkaline phosphatase during bone
      calcification.
AB  - To further approach the mechanisms of bone calcification, embryonic rat calvariae
      were observed at electron microscopic level by the means of fine structures and
      various cytochemical localizations, including nonspecific proteoglycan (PG)
      stained by cuprolinic blue (CB), decorin, chondroitin sulfate, hyaluronan, and
      alkaline phosphatase (ALP), as well as the elemental mapping of calcium (Ca) and
      phosphorus (P) by energy-filtering transmission electron microscopy (EFTEM). In
      the calvariae, calcification advanced as the distance from osteoblasts increased.
      Closer to the osteoblasts, the osteoid was marked by an abundance of CB-positive
      PGs around collagen fibrils. After crystallization within matrix vesicles,
      calcified nodules formed and expanded, creating a coherent calcified matrix. The
      sizes of CB-positive PG-like structures diminished as calcification proceeded.
      Although small CB-positive structures were accumulated in early stage-calcified
      nodules, they were localized along the periphery of larger calcified nodules.
      Cytochemical tests for decorin, chondroitin sulfate, and hyaluronan determined
      their presence in the areas around collagen fibrils of the osteoid, as well as in
      and around calcified nodules, whereas ALP was found in the matrix vesicles, as
      well as in and around the calcified nodules. Ca tended to localize at the PG
      sites, while P often mapped to the collagen fibril structures, in the uncalcified
      matrix. In contrast, Ca/P colocalization was visible in and around the calcified
      nodules, where ALP and smaller CB-positive structures were observed. The
      difference in the localization patterns of Ca and P in uncalcified areas may
      limit the local [Ca2+][PO4(3-)] product, leading to the general inhibition of
      hydroxyapatite crystallization. The downsizing of CB-positive structures
      suggested enzymatic fragmentation of PGs. Such structural alterations would
      contribute to the preservation and transport of calcium. ALP possesses the
      ability to boost local phosphate anion concentration. Therefore, structurally
      altered PGs and ALP may cooperate in Ca/P colocalization, thus promoting bone
      calcification.

PMID- 11204431
TI  - A novel cell culture model of chondrocyte differentiation during mammalian
      endochondral ossification.
AB  - Endochondral ossification (EO) occurs in the growth plate where chondrocytes pass
      through discrete stages of proliferation, maturation, hypertrophy, and
      calcification. We have developed and characterized a novel bovine cell culture
      model of EO that mirrors these events and will facilitate in vitro studies on
      factors controlling chondrocyte differentiation. Chondrocytes derived from the
      epiphyses of long bones of fetal calves were treated with 5-azacytidine (aza-C)
      for 48 h. Cultures were maintained subsequently without aza-C and harvested at
      selected time points for analyses of growth and differentiation status. A
      chondrocytic phenotype associated with an extensive extracellular matrix rich in
      proteoglycans and collagen types II and VI was observed in aza-C-treated and 
      untreated cultures. aza-C-treated cultures were characterized by studying the
      expression of several markers of chondrocyte differentiation. Parathyroid hormone
      related protein (PTHrP) and its receptor, both markers of maturation, were
      expressed at days 5-9. Type X collagen, which is restricted to the stage of
      hypertrophy, was expressed from day 11 onward. Hypertrophy was confirmed by a 14
      fold increase in cell size by day 15 and an increased synthesis of alkaline
      phosphatase during the hypertrophic period (days 14-28). The addition of PTHrP to
      aza-C-treated cultures at day 14 led to the down-regulation of type X collagen by
      6-fold, showing type X collagen expression is under the control of PTHrP as in
      vivo. These findings show that aza-C can induce fetal bovine epiphyseal
      chondrocytes to differentiate in culture in a manner consistent with that which
      occurs during the EO process in vivo.

PMID- 11204430
TI  - Strontium ranelate increases cartilage matrix formation.
AB  - Based on previous studies showing that strontium ranelate (S12911) modulates bone
      loss in osteoporosis, it could be hypothesized that this drug also is effective
      on cartilage degradation in osteoarthritis (OA). This was investigated in vitro
      on normal and OA human chondrocytes treated or not treated with interleukin-1beta
      (IL-1beta). This model mimics, in vitro, the imbalance between chondroformation
      and chondroresorption processes observed in vivo in OA cartilage. Chondrocytes
      were isolated from cartilage by enzymatic digestion and cultured for 24-72 h with
      10(-4)-10(-3) M strontium ranelate, 10(-3) M calcium ranelate, or 2 x 10(-3) M
      SrCl2 with or without IL-1beta or insulin-like growth factor I (IGF-I).
      Stromelysin activity and stromelysin quantitation were assayed by
      spectrofluorometry and enzyme amplified sensitivity immunoassay (EASIA),
      respectively. Proteoglycans (PG) were quantified using a radioimmunoassay. Newly
      synthesized glycosaminoglycans (GAGs) were quantified by labeled sulfate
      (Na2(35)SO4) incorporation. This method allowed the PG size after exclusion
      chromatography to be determined. Strontium ranelate, calcium ranelate, and SrCl2
      did not modify stromelysin synthesis even in the presence of IL-1beta. Calcium
      ranelate induced stromelysin activation whereas strontium compounds were
      ineffective. Strontium ranelate and SrCl2 both strongly stimulated PG production
      suggesting an ionic effect of strontium independent of the organic moiety.
      Moreover, 10(-3) M strontium ranelate increased the stimulatory effect of IGF-I
      (10(-9) M) on PG synthesis but did not reverse the inhibitory effect of IL-1beta.
      Strontium ranelate strongly stimulates human cartilage matrix formation in vitro
      by a direct ionic effect without stimulating the chondroresorption processes.
      This finding provides a preclinical basis for in vivo testing of strontium
      ranelate in OA.

PMID- 11204432
TI  - Antagonism of the osteoclast vitronectin receptor with an orally active
      nonpeptide inhibitor prevents cancellous bone loss in the ovariectomized rat.
AB  - An orally active, nonpeptide Arg-Gly-Asp (RGD) mimetic alpha(v)beta3 antagonist,
      (S)-3-Oxo-8-[2-[6-(methylamino)-pyridin-2-yl]-1-ethoxy]-2-(2,2,2-trifluoroethyl)
      2,3,4,5-tetrahydro-1H-2-benzazepine-4-acetic acid (compound 1), has been
      generated, which prevented net bone loss and inhibited cancellous bone turnover
      in vivo. The compound binds alpha(v)beta3 and the closely related integrin
      alpha(v)beta5 with low nanomolar affinity but binds only weakly to the related
      integrins alpha(IIb)beta3, and alpha5beta1. Compound 1 inhibited alpha(v)beta3
      mediated cell adhesion with an IC50 = 3 nM. More importantly, the compound
      inhibited human osteoclast-mediated bone resorption in vitro with an IC50 = 11
      nM. In vivo, compound 1 inhibited bone resorption in a dose-dependent fashion, in
      the acute thyroparathyroidectomized (TPTX) rat model of bone resorption with a
      circulating EC50 approximately 20 microM. When dosed orally at 30 mg/kg twice a
      day (b.i.d.) in the chronic ovariectomy (OVX)-induced rat model of osteopenia,
      compound 1 also prevented bone loss. At doses ranging from 3 to 30 mg/kg b.i.d.,
      compound 1 partially prevented the OVX-induced increase in urinary
      deoxypyridinoline. In addition, the compound prevented the OVX-induced reduction
      in cancellous bone volume (BV), trabecular number (Tb.N), and trabecular
      thickness (Tb.Th), as assessed by quantitative microcomputerized tomography
      (microCT) and static histomorphometry. Furthermore, both the 10-mg/kg and 30
      mg/kg doses of compound prevented the OVX-induced increase in bone turnover, as
      measured by percent osteoid perimeter (%O.Pm). Together, these data indicate that
      the alpha(v)beta3 antagonist compound 1 inhibits OVX-induced bone loss.
      Mechanistically, compound 1 prevents bone loss in vivo by inhibiting osteoclast
      mediated bone resorption, ultimately preventing cancellous bone turnover.

PMID- 11204433
TI  - T cell activation induces human osteoclast formation via receptor activator of
      nuclear factor kappaB ligand-dependent and -independent mechanisms.
AB  - In unstimulated conditions, osteoclast (OC) formation is regulated by stromal
      cell production of the key osteoclastogenic factors receptor activator of nuclear
      factor kappaB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF).
      However, the mechanisms of accelerated osteoclastogenesis and bone loss
      characteristic of inflammatory conditions are poorly understood but appear to
      involve T cells. In addition, the mechanism by which OCs arise spontaneously in
      cultures of peripheral blood mononuclear cells in the absence of stromal cells or
      added cytokines remains unclear. Using a stromal cell free human osteoclast
      generating system, we investigated the ability of activated T cells to support
      osteoclastogenesis. We show that when activated by phytohemagglutinin-P (PHA), T
      cells (both CD4+ and CD8+) stimulate human OC formation in vitro. Although both
      soluble M-CSF and RANKL were detected in activated T cell supernatants, the
      presence of M-CSF was not essential for macrophage survival or RANKL-dependent
      osteoclast formation, suggesting that other soluble T cell-derived factors were
      capable of substituting for this cytokine. We also found that saturating
      concentrations of osteoprotegerin (OPG) failed to neutralize 30% of the observed
      OC formation and that T cell conditioned medium (CM) could superinduce
      osteoclastogenesis in cultures of purified monocytes maximally stimulated by
      RANKL and M-CSF. Together, these data suggest that activated T cells support
      osteoclastogenesis via RANKL-dependent and -independent mechanisms. Although not
      relevant for T cell-induced osteoclastogenesis, secretion of soluble M-CSF is a
      previously undescribed property of activated T cells.

PMID- 11204434
TI  - Efficacy of etanercept for wear debris-induced osteolysis.
AB  - A major limitation of total joint arthroplasty is that up to 20% of patients
      require revision surgery to correct prosthetic loosening. Aseptic loosening is
      believed to result from the phagocytosis of wear debris particles by macrophages,
      which secrete proinflammatory cytokines that stimulate osteolysis. Tumor necrosis
      factor alpha (TNF-alpha) has been shown to be one of the prominent cytokines in
      this cascade and to be involved critically in the generation of particle-induced
      osteolysis. Etanercept is a soluble inhibitor of TNF-alpha, which is widely used
      for the treatment of rheumatoid arthritis. Here, we show this agent's ability to
      prevent wear debris-induced osteolysis. In vitro we show that Etanercept can
      inhibit directly osteoclastic bone resorption in a bone wafer pit assay, as well
      as cytokine production from titanium (Ti)-stimulated macrophages. Using a
      quantitative in vivo model of wear debris-induced osteolysis, we show that
      Etanercept prevents bone resorption and osteoclastogenesis. In mice treated with
      Etanercept at the time of osteolysis induction, bone resorption and osteoclast
      numbers were reduced to background levels in both normal and human TNF-alpha
      (hTNF-alpha) transgenic mice. In an effort to evaluate its effect on established
      osteolysis, Etanercept was administered 5 days after Ti implantation, and we
      observed that further osteolysis was prevented. These data support the concept
      that TNF-alpha is involved critically in osteoclastogenesis and bone resorption
      during periprosthetic osteolysis and suggest that soluble TNF-alpha inhibitors
      may be useful as therapeutic agents for the treatment of prosthetic loosening in
      humans.

PMID- 11204435
TI  - The effect of a single dose of osteoprotegerin in postmenopausal women.
AB  - Osteoprotegerin (OPG), a tumor necrosis factor (TNF) receptor family member, is a
      critical regulator of bone resorption. It is an important inhibitor of the
      terminal differentiation and activation of osteoclasts. This randomized, double
      blind, placebo-controlled, sequential dose escalation study was conducted in
      postmenopausal women to determine the effect of a single subcutaneous (s.c.) dose
      of OPG on bone resorption as indicated by the biochemical markers, urinary N
      telopeptide (NTX) and deoxypyridinoline (DPD), which are stable collagen
      degradation products. NTX levels decreased within 12 h after OPG administration.
      At the highest dose administered (3.0 mg/kg), a mean percent decrease in NTX of
      approximately 80% was observed 4 days after dosing. Six weeks after dosing a mean
      decrease of 14% in NTX was observed. The levels of bone-specific alkaline
      phosphatase (BSAP), a marker of bone formation, did not change for approximately
      3 weeks after dosing. Thereafter, a modest decrease, reaching approximately 30%
      at 6 weeks, was observed in the 3.0-mg/kg dose group. The rapid decrease from
      baseline in NTX and delayed decrease in BSAP indicated that OPG acted primarily
      on osteoclasts to decrease bone resorption. OPG injections are well tolerated.
      This study, for the first time, indicates that a single s.c. injection of OPG is
      effective in rapidly and profoundly reducing bone turnover for a sustained period
      and that OPG therefore may be effective in treatment of bone diseases
      characterized by increased bone resorption such as osteoporosis.

PMID- 11204436
TI  - Indapamide, a thiazide-like diuretic, decreases bone resorption in vitro.
AB  - We recently showed that indapamide (IDP), a thiazide-related diuretic, increases
      bone mass and decreases bone resorption in spontaneously hypertensive rats
      supplemented with sodium. In the present study, we evaluated the in vitro effects
      of this diuretic on bone cells, as well as those of hydrochlorothiazide (HCTZ),
      the reference thiazide, and acetazolamide (AZ), a carbonic anhydrase (CA)
      inhibitor. We showed that 10(-4) M IDP and 10(-4) M AZ, as well as 10(-5) M
      pamidronate (APD), decreased bone resorption in organ cultures and in cocultures
      of osteoblast-like cells and bone marrow cells in the presence of 10(-8) M 1,25
      dihydroxyvitamin D3 [1,25(OH)2D3]. We investigated the mechanism of this
      antiresorptive effect of IDP; IDP decreased osteoclast differentiation as the
      number of osteoclasts developing in coculture of marrow and osteoblast-like cells
      was decreased markedly. We then investigated whether IDP affected osteoblast-like
      cells because these cells are involved in the osteoclast differentiation. Indeed,
      IDP increased osteoblast-like cell proliferation and alkaline phosphatase (ALP)
      expression. Nevertheless, it did not modify the colony-stimulating factor 1 (CSF
      1) production by these cells. In addition, osteoblast-like cells expressed the
      Na+/Cl- cotransporter that is necessary for the renal action of thiazide
      diuretics, but IDP inhibited bone resorption in mice lacking this cotransporter,
      so the inhibition of bone resorption and osteoclast differentiation did not
      involve this pathway. Thus, we hypothesized that IDP may act directly on cells of
      the osteoclast lineage. We observed that resorption pits produced by spleen cells
      cultured in the presence of soluble osteoclast differentiation factor (sODF) and
      CSF-1 were decreased by 10(-4) M IDP as well as 10(-5) M APD. In conclusion, in
      vitro IDP increased osteoblast proliferation and decreased bone resorption at
      least in part by decreasing osteoclast differentiation via a direct effect on
      hematopoietic precursors.

PMID- 11204437
TI  - Genetic contribution to bone metabolism, calcium excretion, and vitamin D and
      parathyroid hormone regulation.
AB  - A classical twin study was performed to assess the relative contribution of
      genetic and environmental factors to bone metabolism, calcium homeostasis, and
      the hormones regulating them. It was examined further whether the genetic effect
      is menopause dependent. The subjects were 2136 adult twins (98.3% female): 384
      monozygotic (MZ) and 684 dizygotic (DZ) twin pairs. The intraclass correlations
      were calculated, and maximum likelihood model fitting was used to estimate
      genetic and environmental variance components. The intraclass correlations for
      all of the variables assessed were higher in MZ twin pairs. The heritabilities
      (95% CIs) obtained from model fitting for hormones regulating bone metabolism and
      calcium homeostasis were parathyroid hormone (PTH), 60% (54-65%); 25
      hydroxyvitamin D [25(OH)D]; 43% (28-57%), 1,25-hydroxyvitamin D [1,25(OH)], 65%
      (53-74%); and vitamin D binding protein 62% (56-66%). The heritabilities (95%
      CIs) for markers of bone formation also were assessed; bone-specific alkaline
      phosphatase (BSAP), 74% (67-80%), and osteocalcin, 29% (14-44%); marker of bone
      resorption deoxypyridinoline (DPD), 58% (52-64%); and measure of calcium
      homeostasis 24 h urine calcium, creatinine (Cr), 52% (41-61%). The magnitude of
      genetic influence differed with menopause for most variables. This study provides
      evidence for the importance of genetic factors in determining bone resorption and
      formation, calcium excretion, and the hormones regulating these processes. It
      shows for the first time a clear genetic effect on bone resorption in
      premenopausal women and the regulation of PTH, vitamin D metabolism, and calcium
      excretion. The genes controlling bone hormones and markers are likely to be
      useful therapeutic and diagnostic targets.

PMID- 11204438
TI  - Interaction between the vitamin D receptor gene and collagen type Ialpha1 gene in
      susceptibility for fracture.
AB  - Osteoporosis is a common disease with a strong genetic component. Polymorphisms
      in the vitamin D receptor (VDR) gene have been implicated in osteoporosis but
      explain only a small part of the genetic effect on bone mineral density (BMD)
      while their effect on fractures is still uncertain. Recently, a G to T
      polymorphism in an Sp1 site in the collagen type Ialpha1 (COLIA1) gene was found
      to be associated with reduced BMD and with increased fracture risk. To analyze
      the combined influence of polymorphisms in the VDR gene and the COLIA1 gene in
      determining the susceptibility to osteoporotic fracture, we studied 1004
      postmenopausal women. The "baT" VDR haplotype, constructed from three adjacent
      restriction fragment length polymorphisms, was found to be overrepresented among
      fracture cases (p = 0.009). This corresponded to an odds ratio (OR) of 1.8 (95%
      CI, 1.0-3.3) for heterozygous carriers and 2.6 (95% CI, 1.4-5.0) for homozygous
      carriers of the risk haplotype. The effect was similar for vertebral and
      nonvertebral fractures and, most importantly, independent of BMD. We observed
      significant interaction (p = 0.03) between VDR and COLIA1 genotype effects.
      Fracture risk was not VDR genotype-dependent in the COLIA1 "reference" group
      (genotype GG) while in the COLIA1 "risk" group (genotypes GT and TT) the risk of
      fracture was 2.1 (95% CI, 1.0-4.4) for heterozygous and 4.4 (95% CI, 2.0-9.4) for
      homozygous carriers of the VDR risk haplotype. We conclude that both the VDR and
      the COLIA1 polymorphisms are genetic markers for osteoporotic fracture in women,
      independent of BMD. Our data indicate that interlocus interaction is likely to be
      an important component of osteoporotic fracture risk.

PMID- 11204439
TI  - Postnatal and pubertal skeletal changes contribute predominantly to the
      differences in peak bone density between C3H/HeJ and C57BL/6J mice.
AB  - Previous studies have shown that 60-70% of variance in peak bone density is
      determined genetically. The higher the peak bone density, the less likely an
      individual is to eventually develop osteoporosis. Therefore, the amount of bone
      accrued during postnatal and pubertal growth is an important determining factor
      in the development of osteoporosis. We evaluated the contribution of skeletal
      changes before, during, and after puberty to the development of peak bone density
      in C3H/HeJ (C3H) and C57BL/6J (B6) mice. Volumetric bone density and geometric
      parameters at the middiaphysis of femora were measured by peripheral quantitative
      computed tomography (pQCT) from days 7 to 56. Additionally, biochemical markers
      of bone remodeling in serum and bone extracts were quantified. Both B6 and C3H
      mice showed similar body and femoral weights. B6 mice had greater middiaphyseal
      total bone area and thinner cortices than did C3H mice. Within strains, males had
      thicker cortices than did females. C3H mice accumulated more minerals throughout
      the study, with the most rapid accumulation occurring postnatally (days 7-23) and
      during pubertal maturation (days 23-31). C3H mice had higher volumetric bone
      density as early as day 7, compared with B6 mice. Higher serum insulin-like
      growth factor I (IGF-I) was present in C3H mice postnatally at day 7 and day 14.
      Until day 31, B6 male and female mice had significantly higher serum osteocalcin
      than C3H male and female mice, respectively. Alkaline phosphatase (ALP) was found
      to be significantly higher in the bone extract of C3H mice compared with B6 mice
      at day 14. These data are consistent with and support the hypothesis that the
      greater amount of bone accrued during postnatal and pubertal growth in C3H mice
      compared with B6 mice may be caused by increased cortical thickness, increased
      endosteal bone formation, and decreased endosteal bone resorption.

PMID- 11204440
TI  - The influence of growth hormone deficiency, growth hormone replacement therapy,
      and other aspects of hypopituitarism on fracture rate and bone mineral density. .
AB  - To assess the influence of factors affecting fracture risk and bone density in
      adult hypopituitary patients with growth hormone deficiency (GHD), data from a
      large-scale pharmacoepidemiological survey (the Pharmacia & Upjohn International
      Metabolic Database [KIMS]) were analyzed and compared with data from a control
      population (the European Vertebral Osteoporosis Study [EVOS]). The KIMS group
      consisted of 2084 patients (1112 men and 972 women) with various types of
      pituitary disease and EVOS consisted of 1176 individuals (581 men and 595 women).
      Fracture and bone mineral density (BMD) data were available from 2024 patients
      from the KIMS group and 392 patients from EVOS. The prevalence of fractures in
      patients with hypopituitarism was 2.66 times that in the non-GH-deficient EVOS
      population. Adult-onset hypopituitarism with GHD was associated with a higher
      fracture risk than childhood-onset disease, and patients with isolated GHD had a
      similar prevalence of fractures to those with multiple pituitary hormone
      deficiencies. Hormonal replacement therapy with L-thyroxine, glucocorticoids, and
      sex steroids did not affect the risk of fracture in KIMS patients. In addition,
      fracture rates in KIMS were independent of body mass index (BMI) and the country
      of origin. However, smoking was associated with a higher fracture rate in this
      group. In summary, this is the first large-scale analysis to support the
      hypothesis of an increased fracture risk in adult patients with hypopituitarism
      and GHD. This increased risk appears to be attributable to GHD alone, rather than
      to other pituitary hormone deficiencies or to their replacement therapy.

PMID- 11204441
TI  - Quantitative ultrasound and bone mineral density are equally strongly associated
      with risk factors for osteoporosis.
AB  - Because resources do not allow all women to be screened for osteoporosis,
      clinical risk factors are often used to identify those individuals at increased
      risk of fracture who are then assessed by bone densitometry. The aim of this
      study was to compare calcaneal quantitative ultrasound (QUS) and axial bone
      mineral density (BMD) T and Z scores in a large group of women, some with no
      clinical risk factors and others with one or more risk factors for osteoporosis.
      The study population consisted of 1115 pre- and postmenopausal women. A subgroup
      of 530 women was used to construct reference data for calculating T and Z scores.
      A total of 786 women was found to have one or more of the following risk factors:
      (i) atraumatic fracture since the age of 25 years, (ii) report of X-ray
      osteopenia, (iii) predisposing medical condition or use of therapy known to
      affect bone metabolism, (iv) premature menopause before the age of 45 years or a
      history of amenorrhea of longer than 6 months duration, (v) family history of
      osteoporosis, (vi) body mass index (BMI) <20 kg/m2, and (vii) current smoking
      habit. Calcaneal broadband ultrasound attenuation (BUA) and speed of sound (SOS)
      measurements were performed on a Hologic Sahara and a DTUone and BMD was measured
      at the spine and hip using dual-energy X-ray absorptiometry (DXA). The Z score
      decrements associated with the seven risk factors calculated using multivariate
      regression analysis were similar for QUS and BMD measurements. Z score decrements
      (mean of BMD and QUS measurements combined) associated with a history of
      atraumatic fracture (-0.67), X-ray osteopenia (-0.36), a family history of
      osteoporosis (-0.23), and a low BMI (-0.53) were all statistically significant
      compared with women with no risk factors. Z score decrements associated with a
      medical condition or use of therapy known to affect bone metabolism, a premature
      menopause or prolonged amenorrhea, or those who were current smokers were not
      significantly different from zero. As the number of risk factors present in each
      individual increased, the mean Z score decrements became more negative,
      increasing from -0.28 for women with one risk factor to -1.19 for those with four
      or more risk factors. QUS and BMD measurements yielded similar mean Z scores for
      women with one, two, three, or more than four risk factors. Using the World
      Health Organization (WHO) criteria to diagnose osteoporosis for BMD measurements
      and revised diagnostic criteria for QUS, approximately one-third of
      postmenopausal women aged 50+ years with clinical risk factors were classified as
      osteoporotic compared with only 12% of women without clinical risk factors. Over
      two-thirds of postmenopausal women with risk factors were classified as
      osteopenic or osteoporotic and approximately 28% were classified as normal. The
      proportion of women classified into each diagnostic category was similar for BMD
      and QUS. In conclusion, clinical risk factors for osteoporosis affected calcaneal
      BUA and SOS Z score measurements to the same extent as axial BMD Z score
      measurements. Provided revised diagnostic criteria are adopted for QUS, similar
      proportions of postmenopausal women are identified as osteopenic or osteoporotic
      as with BMD.

PMID- 11204442
TI  - Inaccuracies inherent in patient-specific dual-energy X-ray absorptiometry bone
      mineral density measurements: comprehensive phantom-based evaluation.
AB  - An extensive series of dual-energy X-ray absorptiometry (DXA) scans and dual
      polyenergetic X-ray simulation studies of 150 different phantom arrays were
      carried out to evaluate quantitatively the extent of systematic inaccuracies
      inherent in DXA in vivo bone mineral density (BMD). These measurements are
      particularly relevant to lumbar vertebral and proximal femoral sites. The
      phantoms were specially fabricated near perfect absorptiometric representations
      of bone material, red marrow (RM) and yellow marrow (YM), and extraosseous
      mixtures of fat (F) and lean muscle that spanned the full range of soft tissue
      anthropometrics encountered clinically. In each case, the DXA-measured BMD values
      obtained using Hologic, Lunar, and Norland densitometers were found to be
      virtually the same and to be in excellent agreement with the corresponding
      quantitative simulation study BMD results. Comparisons of the known phantom BMD
      values and DXA-measured BMD in each case allowed the BMD inaccuracies to be
      evaluated. These present findings show that these ubiquitous inaccuracies in DXA
      BMD methodology are of in vivo soft tissue anthropometric genesis. It is found
      that patient-specific DXA-measured in vivo BMD inaccuracies as high as 20% or
      more can be readily anticipated clinically, particularly in cases of osteopenic,
      osteoporotic, and elderly patients. As these inaccuracies exceed considerably DXA
      precision errors, they may compromise patient-specific evaluations of fracture
      risk and, in prospective studies, mask or exaggerate clinically significant true
      changes in BMD. It is concluded that the magnitudes and variability of inherent
      inaccuracies in DXA-measured in vivo BMD underscore the need for prudence and
      circumspection in interpretations and assessments of DXA-based clinical studies.

PMID- 11204443
TI  - Nitric oxide up-regulates DNA-binding activity of nuclear factor-kappaB in
      macrophages stimulated with silica and inflammatory stimulants.
AB  - Nitric oxide (NO), a reactive nitrogen species, plays an important role in
      inflammatory lung damage. In the present study, we investigated the role of NO in
      DNA-binding activity of NF-kappaB in macrophages stimulated with silica or other
      inflammatory stimulants. Treatment of mouse macrophages (RAW264.7 cells) with a
      selective inhibitor of inducible nitric oxide synthase (iNOS), L-N6-(1
      iminoethyl) lysine (L-NIL), or a nonselective iNOS inhibitor, N omega-nitro-L
      arginine methylester (L-NAME), resulted in inhibition of silica-induced nitric
      oxide production as well as silica-induced NF-kappaB activation. L-NIL also
      effectively inhibited NF-kappaB activation induced by other inflammatory
      stimulants, such as lipopolysaccharide (LPS) or muramyl dipeptide (MDP). These
      inhibitory effects of L-NIL and L-NAME on silica- or LPS-induced NF-kappaB
      activation were also observed in primary rat alveolar macrophages. Furthermore,
      NO generating compounds, such as sodium nitroprusside (SNP) and 3
      morpholinosydnonimine (SIN-1), caused a dose-dependent increase in NF-kappaB
      activation, which was positively correlated with the level of NO production.
      Specific inhibitors of protein tyrosine kinase, such as genistein and AG494,
      prevented NF-kappaB activation in SNP- or SIN-1 treated cells, suggesting
      involvement of tyrosine kinase in the NO signaling pathway leading to NF-kappaB
      activation. In contrast, inhibitors of protein kinase C or A, such as
      staurosporine or H89, had no inhibitory effect on SIN-1 induced NF-kappaB
      activation. Metalloporphyrins, such as tetrakis (N-methyl-4'-pyridyl)
      porphyrinato iron (III) (Fe-TMPyP) and Zn-TMPyP which are known to alter NO
      dependent activity, markedly inhibited silica- and LPS-induced NF-kappaB
      activation. The results suggest that NF-kappaB activation in macrophages can be
      induced under certain conditions by nitric oxide and that nitric oxide produced
      by phagocytes exposed to inflammatory agents may up-regulate the activation of NF
      kappaB.

PMID- 11204444
TI  - Mechanical stretch augments PDGF receptor beta expression and protein tyrosine
      phosphorylation in pulmonary artery tissue and smooth muscle cells.
AB  - With regard to the mechanotransduction mechanisms of vasculature involved in
      hypertensive diseases, we aimed to identify tyrosine-phosphorylated proteins in
      pulmonary artery that responded to mechanical stress. Mechanical stretch
      simultaneously augmented protein-tyrosine phosphorylation in p55, p95, p105,
      p115, p130, p165, p180 in pulmonary artery tissue and pulmonary artery-derived
      smooth muscle cells (PASMC), whereas p115 and p55 were preferentially
      phosphorylated by the stretch in endothelial cells (PAEC). A series of
      experiments designed to characterize these proteins indicated that p115 and p180
      were focal adhesion kinase (FAK) and platelet-derived growth factor receptor beta
      (PDGF-Rbeta), respectively, and that stretch augmented the surface-expression of
      PDGF-Rbeta in PASMC but not in PAEC. Moreover, a significant increase in the
      steady-state mRNA level for PDGF-Rbeta was observed in the pulmonary artery of
      rats with monocrotaline-induced pulmonary hypertension, where the artery should
      be overstretched due to increasing pulmonary arterial blood pressure. These
      results suggest that stretch-induced overexpression of cell-surface PDGF-Rbeta as
      well as augmentation of yrosine phosphorylation of proteins including FAK in
      PASMC might be involved in the mechanotransduction of pulmonary artery.

PMID- 11204445
TI  - Ontogenic profile of some antioxidants and lipid peroxidation in human placental
      and fetal tissues.
AB  - Reactive oxygen species (ROS) pose a serious threat to maternal and fetal health
      during pregnancy. However, there is little information on the oxidative damage
      caused by ROS and its protection during prenatal life. The present study
      highlights the status of various antioxidants in human placental and fetal
      tissues at different phases of gestation. The activity profile of scavenging
      enzymes, superoxide dismutase, catalase, glutathione peroxidase and glutathione
      reductase as well as the concentrations of non-enzymatic antioxidants, ascorbic
      acid, alpha-tocopherol, bilirubin and glutathione have been determined in human
      placental whole homogenate, placental brush border membrane and fetal liver over
      gestational periods ranging from 6 weeks of pregnancy till birth. The ontogenic
      profile of lipid peroxidation, a marker of oxidative damage has also been
      investigated in the feto-placental system. Catalase, superoxide dismutase and
      glutathione reductase activities increased significantly, but glutathione
      peroxidase activity remained almost the same throughout development. Except alpha
      tocopherol and bilirubin, the concentrations of other non-enzymic scavengers
      followed a significant increasing trend with advancement of pregnancy. Results
      indicate that there is gradual suppression of lipoperoxide formation with the
      progress of gestation to protect the fetus against oxygen toxicity.

PMID- 11204446
TI  - Hexokinase 'binding sites' of normal and tumoral human brain mitochondria.
AB  - Interaction of type I hexokinase (HK-I) with the mitochondria obtained from the
      biopsy specimens of normal and tumoral human brain tissues was studied in the
      present investigation. This effort was undertaken with the aim of exploring
      possible differences in the mode of association of the enzyme with the outer
      mitochondrial membrane in the described sources. Results indicate that the two
      'sites' for binding of HK-I suggested in the literature, based on extensive
      studies carried out on rat brain mitochondria, are similarly present in the human
      brain mitochondria. Differences in the microenvironments of HK binding, as
      reflected by the presented data, are suggested to be of importance in regulation
      of the catalytic potential of the bound enzyme. The real metabolic significance
      of this association in relation to cancer and its practical importance would need
      further investigation.

PMID- 11204447
TI  - Chlamydia pneumoniae infection significantly exacerbates aortic atherosclerosis
      in an LDLR-/- mouse model within six months.
AB  - We have previously shown that infection with the C. pneumoniae AR39 strain once
      monthly for 9 consecutive months significantly exacerbated atherosclerosis in
      mice with LDL receptor deficiency (LDLR-/-) in the presence of a high cholesterol
      diet. To further optimize the LDLR-/- mouse model for studying the mechanisms of
      C. pneumoniae atherogenesis, we have tested a different infection protocol with
      intranasal inoculation twice monthly for 6 consecutive months in the present
      study. We found that C. pneumoniae infection for 6 months was sufficient to
      produce a 130%, significantly greater exacerbation of aortic atherosclerosis in
      LDLR-/- mice in the presence of a high cholesterol diet. Mice receiving a high
      cholesterol diet alone displayed a lesion area index of 18.2 +/- 6.1 (S.D.) while
      mice treated with both the high cholesterol diet and C. pneumoniae infection had
      a lesion area index of 41.8 +/- 15.2 (S.D.). However, the chlamydial infection
      did not significantly alter the mouse serum total cholesterol or the LDL levels
      induced by the high cholesterol diet. This study not only confirms our previous
      findings that C. pneumoniae infection can exacerbate aortic atherosclerosis
      lesion in the LDLR-/- mice, but also further optimizes the LDLR-/- mouse model
      for future mechanism studies.

PMID- 11204448
TI  - Salutary effect of tedisamil on post-ischemic recovery rat heart: involvement of
      sarcolemmal (Na,K)-ATPase.
AB  - The in vitro effect of tedisamil on the specific activity and kinetic parameters
      of the sarcolemmal (Na,K)-ATPase as well as its ex vivo effect on the (Na,K)
      ATPase in the isolated, perfused rat hearts was determined. Five micromol/l of
      tedisamil was added 5 min before the onset of 30 min global normothermic ischemia
      followed by 10 min reperfusion. At the conditions of its maximal cardioprotective
      effect (heart rate reduction, improved postischemic recovery of left ventricular
      developed pressure), the hearts were immediately used for isolation of
      sarcolemmal vesicles. In vitro, 1-100 micromol/l of tedisamil produced a
      concentration-dependent stimulatory effect on (Na,K)-ATPase activity, with a peak
      seen at 20 micromol/l (p < 0.01), while Mg-dependent ATPase was almost unchanged.
      Kinetic analysis revealed a significant increase in the affinity of the Na
      binding sites on ATPase molecule at 20 micromol/l of tedisamil. These biochemical
      findings were confirmed by cytochemistry. Moreover, ex vivo experiments revealed
      that tedisamil rendered the sarcolemmal (Na,K)-ATPase activity to be a more
      resistant to detrimental effects of ischemia. In conclusion, the cardioprotective
      action of tedisamil was accompanied with a better preservation of the specific
      activity of (Na,K)-ATPase.

PMID- 11204449
TI  - The regulation of CoA-independent transacylation reactions in neuronal nuclei by
      lysophospholipid, free fatty acid, and lysophospholipase: the control of nuclear
      lyso platelet-activating factor metabolism.
AB  - CoA-independent transacylase activities generating alkylacylglycerophosphocholine
      (AAGPC) from alkylglycerophosphocholine (1-alkyl GPC) were considerably enriched
      in neuronal nuclei isolated from rabbit cerebral cortex. Specific nuclear
      transacylation activities were 13 times the corresponding microsomal values.
      Several lysophospholipids, notably 1-acyl glycerophosphocholine (1-acyl GPC), 1
      alkenyl GPC and 1-alkenyl GPE (1-alkenyl glycerophosphoethanolamine) inhibited
      the transacylation of 1-alkyl GPC. The inhibitory effects of 1-acyl GPC were seen
      in the presence of MAFP (methyl arachidonoylfluorophosphonate) or free oleate,
      compounds that inhibit neuronal nuclear lysophospholipase. When neuronal nuclei
      were preincubated with 1-alkyl GPC, the radioactive AAGPC product served as donor
      in transacylation reactions, to generate 1-alkyl GPC. In these nuclear reactions,
      1-palmitoyl GPE and 1-palmitoyl GPC appeared to be poor acceptor substrates, when
      compared with corresponding 1-alkyl and 1-alkenyl analogues. The presence of free
      oleate or MAFP in the reactions containing 1-acyl GPC boosted the release of 1
      alkyl GPC from AAGPC. These observations are of particular relevance to brain
      ischemia in which lysophospholipid, free fatty acid, and platelet-activating
      factor (PAF) levels rise dramatically. PAF can be made by the nuclear acetylation
      of 1-alkyl GPC, which is formed by nuclear transacylation mechanisms. Yet
      transacylase also removes 1-alkyl GPC, and thus this enzyme activity can regulate
      1-alkyl GPC availability. Our observations indicate that lysophospholipids
      promote the formation of 1-alkyl GPC from nuclear AAGPC via transacylation, while
      free fatty acid likely prolongs the lifetime of 1-acyl lysophospholipids
      substrates by lysophospholipase inhibition. Similarly, once 1-alkyl GPC is
      formed, other lysophospholipids effectively compete with this 1-alkyl analogue
      and reduce its conversion back to AAGPC by transacylation. Free oleate, in this
      case, sustains 1-acyl lysophospholipid inhibitors of 1-alkyl GPC transacylation.
      Thus the cycle of transacylation may favour 1-alkyl GPC formation during
      ischemia, increasing levels of 1-alkyl GPC for nuclear acetylation reactions and
      PAF formation. The nuclear generation of PAF is of considerable importance as PAF
      can play regulatory roles in transcription events associated with inflammation.

PMID- 11204450
TI  - Free radicals, cytokines and nitric oxide in cardiac failure and myocardial
      infarction.
AB  - Myocardial infarction is the most common cause of congestive cardiac failure.
      Free radicals, cytokines, nitric oxide (NO) and antioxidants play a major role
      both in atherosclerosis and myocardial damage and preservation. In the early
      stages of atherosclerosis, neutrophils and monocytes infiltrate the intima and
      generate free radicals which damage the endothelial cells. As a result,
      production of NO and prostacyclin by the endothelial cells declines, which have
      cardioprotective actions. This also has relevance to the beneficial action of
      aspirin since, it can modulate both prostanoid and L-arginine-NO systems and NF
      kB translocation. In both acute myocardial infarction and chronic congestive
      cardiac failure, the plasma levels of various inflammatory mediators such as
      interleukins and tumour necrosis factor-alpha (TNFalpha) are elevated. TNFalpha,
      produced by the inflammatory cells and the myocardium, can suppress myocardial
      contractility and induce the production of free radicals, which in turn can
      further damage the myocardium. Transforming growth factor beta (TGFbeta),
      polyunsaturated fatty acids and the glucose-insulin-potassium regimen can
      antagonize the harmful actions of TNFalpha and protect the myocardium. This
      explains why efforts made to reduce the levels of pro-inflammatory cytokines have
      beneficial action and preserve the myocardium.

PMID- 11204451
TI  - Green fluorescent protein as a marker for monitoring activity of stress-inducible
      hsp70 rat gene promoter.
AB  - Murine melanoma cells B16(F10) were stably transfected with a plasmid containing
      GFP gene linked to rat stress-inducible hsp70.1 gene promoter. Transfected cells
      show in vitro variable basal levels of fluorescence depending on stress response
      induced at physiological temperature by growth conditions. Lack of manipulations
      except medium change resulted in reduction of cellular fluorescence. GFP
      expression in experimental murine tumors dropped to levels undetectable at
      physiological temperature. Heat shock induced significant fluorescence of tumor
      cells both in vitro and in vivo. GFP protein could be a useful marker for studies
      of mammalian hsp70i gene promoters.

PMID- 11204452
TI  - Gender-related differences in proliferative response of cardiac fibroblasts to
      hypoxia: effects of estrogen.
AB  - Ischemic heart disease is more prevalent in men than in women. The remodeling of
      extracellular matrix, is a structural correlate of heart failure of ischemic
      origin and proliferation of cardiac fibroblasts is a key factor in this
      remodeling. We asked if proliferative response of male and female cardiac
      fibroblasts is differentially susceptible to hypoxia. DNA synthesis, using 3H
      thymidine incorporation was compared under hypoxia (2% O2) in cardiac fibroblasts
      obtained from adult, age-matched male and female rat heart. In female cells DNA
      synthesis remained unchanged under hypoxia and this resistance was dependent on
      tyrosine kinase activation, as it was abolished in the presence of genistein, a
      tyrosine kinase inhibitor. Male cells, on the other hand, were susceptible to
      hypoxia and their DNA synthesis was reduced significantly (70%, (p < 0.0001).
      This effect was partially reversed by inhibition of tyrosine kinase. Western
      analysis showed a higher abundance of tyrosine phosphorylated proteins in male
      cells compared to female cells as well as differences in molecular weight of
      basal and hypoxia-induced tyrosine-phosphorylated proteins between male and
      female cells. The presence of estrogen (17-beta estradiol, 10 nM) altered the
      response of both cells to hypoxia. In female cells the combined effect of hypoxia
      and estrogen led to inhibition of DNA synthesis, whereas in male cells estrogen
      partially reversed the hypoxia-induced inhibition of DNA synthesis (37% (p <
      0.01) inhibition in the presence of estrogen vs. 70% (p < 0.0001) inhibition in
      the absence of estrogen). The effects of estrogen in male and female cells were
      mediated via estrogen receptors as they were reversed by the pure anti-estrogen,
      ICI 182,780. Western analysis of cell lysate showed hypoxia-induced increase in
      the level of estrogen receptor beta in both male and female cells. Gel shift
      analysis showed hypoxia-induced increase in cytoplasmic ERE (estrogen response
      element)-binding activity and decrease in nuclear ERE-binding in male cells. In
      female cells cytoplasmic and nuclear ERE-binding activities remained unchanged
      under hypoxia. Together, these data demonstrate that while female cells are
      resistant to hypoxia-induced inhibition in DNA synthesis, male cells are
      susceptible; intracellular pathways involving tyrosine phosphorylation are
      involved in the response of both cells; and estrogen, via estrogen-receptor
      dependent mechanisms, differentially alters the response of male and female cells
      to hypoxia.

PMID- 11204453
TI  - Myocardial ischemic preconditioning and mitochondrial F1F0-ATPase activity.
AB  - A short period of ischemia followed by reperfusion (ischemic preconditioning) is
      known to trigger mechanisms that contribute to the prevention of ATP depletion.
      In ischemic conditions, most of the ATP hydrolysis can be attributed to
      mitochondrial F1F0-ATPase (ATP synthase). The purpose of the present study was to
      examine the effect of myocardial ischemic preconditioning on the kinetics of ATP
      hydrolysis by F1F0-ATPase. Preconditioning was accomplished by three 3-min
      periods of global ischemia separated by 3 min of reperfusion. Steady state ATP
      hydrolysis rates in both control and preconditioned mitochondria were not
      significantly different. This suggests that a large influence of the enzyme on
      the preconditioning mechanism may be excluded. However, the time required by the
      reaction to reach the steady state rate was increased in the preconditioned group
      before sustained ischemia, and it was even more enhanced in the first 5 min of
      reperfusion (101 +/- 3.0 sec in preconditioned vs. 83.4 +/- 4.4 sec in controls,
      p < 0.05). These results suggest that this transient increase in activation time
      may contribute to the cardioprotection by slowing the ATP depletion in the very
      critical early phase of post-ischemic reperfusion.

PMID- 11204454
TI  - Role of anaerobiosis in virulence of Salmonella typhimurium.
AB  - Intestinal pathogens are exposed to various stress conditions during their
      infectious cycle. Anaerobiosis, one of such hostile condition, is offered by the
      host within gut and intestinal lumen, where survival, multiplication and entry
      into intestinal epithelial cells is priority for the invading pathogen. In the
      present study, a virulent strain of S. typhimurium (1402/84) was grown under
      anaerobic conditions and its virulence characteristics such as host cell binding,
      penetration and intracellular survival were compared with aerobic S. typhimurium.
      Anaerobically grown S. typhimurium showed significantly higher binding to
      immobilized mice enterocytes and intestinal mucus as compared to bacteria grown
      aerobically. Anaerobic bacteria also showed an early penetration of mucus and
      subsequent binding to underlying immobilized enterocytes, in vitro. Anaerobic S.
      typhimurium exhibited increased intracellular survival within spleen macrophages
      of mice and caused significantly higher fluid accumulation in ligated rabbit
      ileal loops as compared to aerobic bacteria. LD50 of anaerobic S. typhimurium was
      also observed to be 2 fold lower when compared to aerobic bacteria. Cell surface
      hydrophobicity of anaerobic S. typhimurium was also found to be significantly
      higher than aerobic bacteria. Thus, it appears that exposure of S. typhimurium to
      anaerobiosis results in its enhanced virulence, adhesion and penetration of host
      cells.

PMID- 11204455
TI  - Paracrine effects of a uterine agglutinin are mediated via the sialic acids
      present in the rat uterine endometrium.
AB  - A 32 kDa estrogen-induced, sialic acid-specific agglutinin (P-SAS) was isolated
      from rat endometrium in its proestrus stage. To investigate the functional
      importance of P-SAS in the uterine milieu, specific binding assays were carried
      out with 125I-labeled P-SAS and different cellular components of the uterus
      (epithelial, stromal and myometrial cells), that were isolated from different
      stages of the estrus cycle. The results indicate that although the protein is
      secreted from the epithelial cells in the estrogenic phase, it binds specifically
      to the stromal cells, especially to those isolated from the diestrus stage of the
      estrus cycle. The specific binding, however, is seen to decrease with the
      progression of pregnancy. Scatchard analysis performed with varying amounts of
      125I-P-SAS in the presence of excess cold P-SAS revealed that the binding occurs
      with a Ka = 1.69 x 10(8) M(-1). As P-SAS binds specifically to sialic acids on
      the stromal cell surface, further characterization of the sialic acid molecule to
      which P-SAS binds was carried out by gas liquid chromatography (GLC). The studies
      revealed that P-SAS preferentially binds to N-glycolylneuraminic acid, which is
      attached to the penultimate sugar of the stromal cell surface glycoprotein chain
      via alpha2,6 linkage. As P-SAS is further known to be mitogenic, the effect of P
      SAS on cultured stromal cells was studied in vitro. The growth regulatory assays
      revealed that P-SAS induced 3H-thymidine uptake by stromal cells in culture.
      Thus, from the above observations, paracrine effects of P-SAS on the stromal
      cells and on the subsequent growth and development of the uterus can be assumed.

PMID- 11204456
TI  - Suppression of inositol phosphate release by cardiac myocytes isolated from fish
      oil-fed pigs.
AB  - Fatty acid composition of cardiac myocytes and release of inositol phosphates in
      pigs fed a fish oil supplemented diet was examined. Two groups of female pigs
      were fed diets supplemented with either 50 g/kg diet beef tallow (as control) or
      50 g/kg diet fish oil (MaxEPA) rich in n-3 fatty acids. After 6 weeks of
      supplementation, the pigs were anesthetized and hearts were removed. Cardiac
      myocytes were isolated, lipid extracted and separated into non-polar and polar
      lipids by thin-layer chromatography. Fatty acid composition of individual neutral
      and polar lipid classes were examined by gas chromatography. To study the effect
      of membrane phospholipid modification on the phospholipase C (PLC) mediated
      release of inositol phosphates, cardiac myocytes were labelled with 4 microCi/mL
      myo-[2-(3)H]inositol for 48 h. After stimulation with epinephrine and
      phenylephrine, the water soluble [3H]inositol products were extracted, separated
      from [3H]inositol and [3H]glycerophosphoinositol by chromatography on Dowex AG 1
      X8 and quantitated by scintillation counting. Cardiac myocytes isolated from fish
      oil-fed pigs had higher levels of n-3 polyunsaturated fatty acid in the non
      esterified fatty acid and phospholipid fraction. Similarly, these cardiac
      myocytes had increased level of n-3 fatty and decreased n-6 fatty acids in all
      the phospholipid fractions, PE, PC, P1 and PS (p < 0.05). After stimulation, the
      levels of [3H]inositol trisphosphate (IP3) and [3H]inositol tetrakisphosphate
      (IP4) in cardiac myocytes isolated from fish oil-fed pigs were significantly
      reduced (p < 0.05) compared to myocytes isolated from beef tallow fed-pigs. This
      study for the first time has utilised adult cardiac myocytes to demonstrate the
      effect of n-3 PUFA supplementation on cardiac myocyte phospholipid fatty acid
      composition and release of second messengers.

PMID- 11204457
TI  - Regulation of Na/K-ATPase beta1-subunit gene expression by ouabain and other
      hypertrophic stimuli in neonatal rat cardiac myocytes.
AB  - Partial inhibition of Na/K-ATPase by ouabain causes hypertrophic growth and
      regulates several early and late response genes, including that of Na/K-ATPase
      alpha3 subunit, in cultured neonatal rat cardiac myocytes. The aim of this work
      was to determine whether ouabain and other hypertrophic stimuli affect Na/K
      ATPase beta1 subunit gene expression. When myocytes were exposed to non-toxic
      concentrations of ouabain, ouabain increased beta1 subunit mRNA in a dose- and
      time-dependent manner. Like the alpha3 gene, beta1 mRNA was also regulated by
      several other well-known hypertrophic stimuli including phenylephrine, a phorbol
      ester, endothelin-1, and insulin-like growth factor, suggesting involvement of
      growth signals in regulation of beta1 expression. Ouabain failed to increase
      beta1 subunit mRNA in the presence of actinomycin D. Using a luciferase reporter
      gene that is directed by the 5'-flanking region of the beta1 subunit gene,
      transient transfection assay showed that ouabain augmented the expression of
      luciferase. These data support the proposition that ouabain regulates the beta1
      subunit through a transcriptional mechanism. The effect of ouabain on beta1
      subunit induction, like that on alpha3 repression, was dependent on extracellular
      Ca2+ and on calmodulin. Inhibitions of PKC, Ras, and MEK, however, had different
      quantitive effects on ouabain-induced regulations of beta1 and alpha3 subunits.
      The findings show that partial inhibition of Na/K-ATPase activates multiple
      signaling pathways that regulate growth-related genes, including those of two
      subunit isoforms of Na/K-ATPase, in a gene-specific manner.

PMID- 11204458
TI  - Neuronal glycolytic pathway impairment induced by HIV envelope glycoprotein
      gp120.
AB  - Neurological impairment is a common feature of Acquired Immunodeficiency Syndrome
      (AIDS); functional alterations have been reported both in central and peripheral
      nervous system and the Human Immunodeficiency Virus (HIV) envelope glycoprotein
      gp120 has been proposed as a neurotoxin acting through a calcium-dependent
      mechanism. On the other hand it has been reported that gp120 treatment also
      induce about a 20% decrease in the cerebral glucose utilization and in the
      cellular ATP levels. The reported observations were performed on experimental
      system where also non-neuronal cells where present; in order to evaluate whether
      a direct interaction between HIV proteins and neuronal cells takes place, we used
      a neuroblastoma cultures where only neuronal cells are present. We analysed the
      effects of gp120 on the N18TG2 neuroblastoma clone. Treatments were performed
      both on growing and confluent cultures. Short time treatment with gp120 of
      confluent cultures causes a 25% reduction in the level of neuron-specific
      enolase, resulting in a similar decrease of oxygen consumption. Long time
      exposure of growing cells also causes a reduction in cell survival. Furthermore,
      using a membrane-specific fluorescent probe we observed that gp120 produces an
      increase of membrane trafficking. These observations suggest a direct interaction
      between the viral envelope protein and neuronal cells, which results in an
      alteration of glycolytic metabolism. This alteration may be related to the
      neurologic impairments observed in AIDS patients.

PMID- 11204461
TI  - Selenium, boron, and germanium deficiency in the etiology of Kashin-Beck disease.
AB  - Concentrations of selenium (Se), boron (B), and germanium (Ge) were determined in
      scalp hair of children with Kashin-Beck disease (KBD), in healthy children in KBD
      disease endemic areas, and in healthy children in non-KBD areas. Mean Se, B, and
      Ge concentrations were low in children with KBD; in hair of healthy children in
      KBD areas, Se levels were normal but B and Ge levels were lower than in KBD-free
      areas. The hair levels of B and Ge were unaffected by selenium supplementation.
      It is suggested that B and Ge deficiency may be contributing factors in the
      etiology of KBD.

PMID- 11204459
TI  - Altered ornithine decarboxylase and S-adenosylmethionine decarboxylase expression
      and regulation in mouse fibroblasts transformed with oncogenes or constitutively
      active Mitogen-Activated Protein (MAP) kinase kinase.
AB  - In the present study, the expression and the regulation of ornithine
      decarboxylase (ODC) and S-adenosylmethionine decarboxylase (SAMDC) was examined
      in a series of oncogene transformed cell lines. The expression of both ODC and
      SAMDC was found to correlate with the nature of the oncogene expressed and with
      the resulting cellular phenotype expressed. This study demonstrates, for the
      first time, that the expression of both ODC and SAMDC increases as a function of
      cellular transformation and, in particular, as a function of malignant
      progression. Ras transformed cells were shown to express a unique regulatory
      mechanism whereby a co-ordinate up-regulation of the expression of both ODC and
      SAMDC occurs (via post-transcriptional stabilization of their mRNA transcripts)
      in the presence of protein synthesis inhibition. Altered expression (and
      regulation) of both ODC and SAMDC is suggested to constitute an important part of
      an altered growth regulatory program inherent to oncogene transformed cells, in
      particular, to transformed cells capable of malignant progression.

PMID- 11204460
TI  - The Translocon-Associated Protein beta (TRAPbeta) in zebrafish embryogenesis. I.
      Enhanced expression of transcripts in notochord and hatching gland precursors.
AB  - The normal translocation of nascent polypeptides into the lumen of the
      endoplasmic reticulum (ER) is thought to be aided in part by a translocon
      associated protein (TRAP) complex consisting of 4 protein subunits. The
      association of mature proteins with the ER and Golgi, or other intracellular
      locales, such as lysosomes, depends on the initial targeting of the nascent
      polypeptide to the ER membrane. A similar scenario must also exist for proteins
      destined for secretion. We have identified a member of the TRAP complex using a
      two hybrid screen to isolate proteins that bind to zebrafish (Danio) Ran binding
      protein 1. The polypeptide predicted from the largest open reading frame contains
      183 amino acids with a 86 and 87% sequence identity to the TRAPbeta subunits in
      human and chicken, respectively. Sequence analysis identified a cleavable amino
      terminal signal peptide in the zebrafish TRAPbeta subunit and a region of the
      protein spans the membrane of the endoplasmic reticulum. A reverse transcriptase
      polymerase chain reaction assay showed that TRAPbeta mRNA is expressed in the
      developing zebrafish embryo. TRAPbeta mRNA is maternally supplied to the egg and
      is expressed constitutively throughout development and in the adult. This pattern
      of expression indicates that the message encoding part of the machinery targeting
      nascent polypeptides to the ER lumen is available at the onset of embryogenesis
      when the rate of translation increases exponentially over that occurring in the
      oocyte. In situ hybridization was used to test whether or not TRAPbeta
      transcripts might become localized and/or enriched in the developing embryo.
      Homogeneous staining is seen in the blastula and early gastrula stages. At mid-to
      late gastrula stages, however, the message becomes enriched in the developing
      notochord and polster, or hatching gland rudiment. The TRAPbeta gene, mapped
      using the LN54 mouse-zebrafish radiation hybrid panel to linkage group 19,
      resides next to a gene (Z15451) which has sequence homology to notch2 and
      vascular endothelial growth factor. TRAPbeta, however, does not appear to belong
      to a group of genes which are syntenic with orthologues or paralogues on human
      chromosomes.

PMID- 11204462
TI  - Selenium deficiency and hypothyroidism: a new etiology in the differential
      diagnosis of hypothyroidism in children.
AB  - Three female children presented with different clinical symptoms that could be
      related to impaired thyroid function. They underwent an accurate pediatric
      endocrinologic diagnosis. Laboratory tests revealed no pathological findings,
      except latent hypothyroidism and selenium deficiency. Hypothyroidism was
      diagnosed by elevated basal TSH and by a pathological i.v.-TRH-stimulation test.
      After treating the children with sodium selenite orally for 4 wk, their
      metabolism had returned to normal and we saw a marked improvement of all clinical
      symptoms. For the first time, we have been able to describe hypothyroidism caused
      exclusively by selenium deficiency, the pathophysiology of which may be expressed
      as a malfunction of human 5'-deiodinases.

PMID- 11204463
TI  - The apparent effect of iron supplementation on serum selenium levels in teenage
      pregnancy.
AB  - Numerous studies have suggested a significant role of selenium in the prevention
      of gynecological carcinoma. These were epidemiological and prospective in humans
      and therapeutic in laboratory animals. However, no studies have been reported
      regarding the normal serum selenium levels during pregnancy. The maternal total
      blood volume increases 30-50% during the second and third trimesters, resulting
      in lower measured serum levels for those metabolites, which are not increased
      significantly during pregnancy. A longitudinal study of the serum selenium levels
      in teenage pregnancy during the last two trimesters and 3 mo postpartum showed
      progressive elevation from 49 +/- 7 microg/dL after the 32nd week of pregnancy to
      114 +/- 7 microg/dL at term, which was statistically significant (p < or =
      0.001). Prenatal supplementation with 18 mg of iron per day prevented this
      elevation. The results of this study suggest that serum selenium levels in women
      normally double during pregnancy and this doubling is prevented by the minimal
      daily supplementation of 18 mg of iron, which may be due to increased absorption
      of selenium into the erythrocytes and incorporation into the glutathione
      peroxidase enzyme.

PMID- 11204464
TI  - Content of non-mercury-associated selenium in human tissues.
AB  - Recent studies have shown that at a higher mercury (Hg) burden, the molar ratio
      of selenium (Se) and Hg in tissues tends to approximate 1:1 by the formation of
      biologically largely inert adducts. From the toxicological standpoint, this
      trapping of free Hg is welcome. However, this binding of Se to Hg reduces the
      portion of Se in tissues, which is available for the formation of essential
      selenoenzymes like glutathione peroxidase, type I deiodase, and so forth and
      could result in a relative deficiency of Se. Therefore, we tried to determine the
      concentration of non-Hg-associated Se in several human tissues. As there is no
      proved trace method for the speciation of non-Hg-bound and Hg-bound Se in
      tissues, the total concentrations of Hg and Se were determined and the portion of
      non-Hg-associated Se was calculated by the difference of the molar concentrations
      of Se and Hg. For this investigation, the following tissues were obtained by
      autopsy from 133 adults: kidney cortex, thyroid gland, liver, spleen, cerebrum
      cortex, and pituitary gland. In no case was an occupational Hg burden known. The
      results confirm the assumption of a 1:1 association of Hg and Se in human
      tissues. The mean concentration of non-Hg-bound Se was calculated to 576
      microg/kg in the kidney cortex, 363 microg/kg in the thyroid gland, 308 microg/kg
      in the liver, 205 microg/kg in the spleen, 111 microg/kg in the cerebrum cortex,
      and 545 microg/kg in the pituitary gland. In none of the cases under
      investigation in any tissue was the molar Se/Hg ratio below 1. This means that a
      total deficiency of non-Hg-bound Se could not be seen in this normal population,
      even at a higher Hg burden. Nevertheless, at a suboptimal Se supply like in
      Germany, any reduction of the part of Se, which is available for the formation of
      essential seleno-enzymes, should be avoided. Therefore, any additional Hg burden
      such as from dental amalgam should to be considered critically. The different
      distribution of Hg and Se in the body confirms that there is a controlled
      hierarchy in the Se supply of different organs, which tries to prevent a Se
      deficiency in organs with essential seleno-enzymes like the thyroid gland even
      under an suboptimal Se supply.

PMID- 11204465
TI  - Hyperlipidemia and type I 5'-monodeiodinase activity: regulation by selenium
      supplementation in rabbits.
AB  - Male New Zealand White rabbits were divided into three groups: (I) control, (II)
      high-fat-diet (HFD) fed, and (III) HFD fed + selenium supplemented. After 3 mo of
      treatment, there was a significant increase in serum cholesterol and
      triglycerides in the HFD-fed group as compared to the control. However in the
      selenium (Se)-supplemented group, the levels of serum cholesterol and
      triglycerides were significantly less as compared to group II. HFD feeding
      resulted in decreased serum Se levels, but supplementation of dietary Se along
      with HFD, as in group III, showed an apparent increase in its levels. The Se
      dependent glutathione peroxidase (GSH-Px) activity in the liver and the aorta
      increased significantly in HFD-fed animals and also showed an additional
      significant increase on Se supplementation. Both serum T3 and T4 levels showed a
      significant decrease on HFD feeding. However, supplementation of Se led to a
      significant increase in the levels of these parameters viz-a-viz HFD-fed animals.
      HFD feeding significantly decreased the activity of type I iodothyronine 5'
      deiodinase (5'-DI) in the liver from group II rats. On supplementation of Se
      along with HFD, the activity increased in the liver. However, there was no
      significant change in its activity in the aorta. The 5'-DI activity in the
      thyroid showed an opposite trend in comparison with peripheral tissues (i.e.,
      liver). The important finding of this study is that in the hyperlipidemic state,
      deiodinase in the thyroid behaves in a different manner as compared to its
      activity in extrathyroidal tissues.

PMID- 11204466
TI  - Effect of dietary copper on selenium toxicity in Fischer 344 rats.
AB  - The purpose of this study was to investigate the ameliorating effects of dietary
      copper supplementation on selenium toxicity. Nine groups (n = 6) of weanling
      Fischer 344 female rats were randomly assigned to treatment groups and fed diets
      containing nontoxic levels of copper as CuCl2 and/or selenium as selenite or
      selenocystamine. Weight gain, liver and spleen weights, plasma lipid
      peroxidation, and liver selenium and copper content were analyzed after the 6-wk
      treatment period. Concentrations of up to 10 times the daily lethal dose of
      dietary selenium were well tolerated in rats supplemented with dietary copper. As
      the dietary level of selenium was increased, the ratio of selenium to copper
      measured in the liver decreased. In the groups of rats in which dietary copper
      supplementation was absent and dietary selenium was supplemented, copper stores
      in the liver remained unchanged from control values. Copper's protective effects
      from dietary selenium toxicity may come from the formation of a copper-selenide
      complex that renders both selenium and copper metabolically unavailable and
      nontoxic.

PMID- 11204467
TI  - Selenium altered the levels of lipids, lipid peroxidation, and sulfhydryl groups
      in straitum and thalamus of rat.
AB  - The effect of sodium selenite (0.05, 0.1, and 0.2 mg/kg body weight, i.p.) on the
      lipid levels (total lipids, phospholipids, cholesterol, gangliosides),
      thiobarbituric acid reactive substance (TBARS), and sulfhydryl group (-SH) in the
      striatum and thalamus of a male Wistar rat was studied after 7 d of treatment.
      The level of total lipids and cholesterol was significantly and dose-dependently
      elevated in the striatum and thalamus with 0.1 and 0.2 mg/kg of sodium selenite.
      However, the cholesterol level was significantly increased only with 0.2 mg/kg of
      sodium selenite in the thalamus. The level of phospholipids and gangliosides was
      more significant with 0.1 mg/kg of sodium selenite as compared to 0.2 mg. No
      significant alteration on the gangliosides level was observed in the thalamus
      with various doses of sodium selenite although the elevation with 0.2 mg dose was
      25.9%. The content of TBARS was elevated dose dependently in striatum, but its
      level was depleted significantly with 0.1-mg/kg dose of sodium selenite in the
      thalamus. The level of the -SH group was significantly depleted in the striatum
      with 0.1-mg/kg dose of sodium selenite; conversely, this dose has significantly
      elevated the levels of -SH group in the thalamus.

PMID- 11204468
TI  - Microcalorimetric study of the toxic effect of sodium selenite on the
      mitochondria metabolism of Carassius auratus liver.
AB  - The fundamental thermogenesis curves of the metabolic process of liver
      mitochondria from Carassius auratus and the toxic effect of Na2SeO3 on it were
      studied by using an LKB-2277 bioactivity monitor, ampoule method, at 28 degrees
      C. From the thermogenesis curves, the thermokinetic equations were established
      under different conditions. The kinetics show that a low concentration of Na2SeO3
      (1-4 mg/L) had promoting action on the metabolism process of Carassius aurantus
      liver mitochondria, but that a high concentration of Na2SeO3 (8-16 mg/L)
      inhibited the mitochondria metabolism.

PMID- 11204469
TI  - Bioavailability and possible benefits of wheat intake naturally enriched with
      selenium and its products.
AB  - Bioavailability and possible benefits of wheat intake naturally enriched with
      selenium and its products was tested. Wheat obtained by application of an
      original combination and procedure for foliar supplementation of plants with Se
      was characterized on the average by five times higher content of Se, the main
      form being L-(+)-selenomethionine (SeMet). Substitution of Se-deficient wheat by
      wheat naturally enriched with Se and its products contributed to the increase of
      daily intake on the average by 18 microg (12-35 microg) in volunteers, which is
      more than 50% of the average daily intake. Six weeks after the beginning of its
      application, increased daily intake of Se brought about the increase of its
      concentration in the plasma of the examined persons by 53%, in their erythrocytes
      by 37%, in their hair by 44%, and in their urine by 54%. This result was
      comparable to the effect obtained in the course of an 8-wk daily intake of
      supplements with 100 microg Se in the form of enriched bakery yeast. Analysis of
      glutathione peroxidase (GSH-Px) activity in blood, thiobarbituric acid reactive
      substances (TBARS) in plasma, lipid parameters (total cholesterol, high-density
      lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides),
      and glucose in serum of volunteers showed that the increased Se intake induced
      increased GSH-Px activity in blood and decreased concentrations of TBARS, lipid
      parameters, and glucose in blood. Using only one crop (wheat enriched with Se),
      the existing deficiency of Se in our population can be alleviated. In this way,
      one-fourth of our population with lower Se intake than 21 microg/d will satisfy
      basal requirements, whereas one-half will become moderately deficient in Se
      instead of distinctly deficient in Se.

PMID- 11204470
TI  - An external-sample liquid scintillation counting for 75Se and its application to
      selenoprotein detection.
AB  - An external-sample liquid scintillation (LS) counting for the gamma emitter 75Se
      has been developed. An expressly designed well-type LS vial and a 2,5
      diphenyoxazole-1,4-bis(5-phenyl-2-oxazoyl)-benzene-xylene solution containing 35%
      tertrabutylzinn allow 75Se to be counted in a standard LS counter with counting
      efficiency up to 43.2%, much higher than that of conventional LS counting method.
      This external sample LS has a good count rate linearity and exhibits low
      background count rates. After in vivo labeling with [75Se]selenite, 75Se
      distributions and the Se-containing proteins present in tissues of male rat were
      investigated by means of sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, external-sample LS and gamma-detector. Eight Se-containing
      proteins or protein subunits were detected to be Se-containing proteins or
      protein subunits in arterial wall, and their apparent molecular masses (Mr) were
      76.4, 67.0, 57.4, 30.3, 25.4, 22.7, 21.7, and 15.1 kDa, respectively. In
      addition, eight 75Se-labeled proteins (Mr: 66.8, 57.0, 43.1, 30.0, 24.8, 19.8,
      18.0, and 14.8 kDa) were found in brain homogenates, and nine 75Se-labeled
      proteins (Mr: 117.0, 78.0, 66.6, 57.2, 43.0, 38.1, 25.0, 20.1, and 18.0 kDa) were
      detected in testis homogenates. Some of them should be new biologically important
      selenoproteins that have not been identified so far.

PMID- 11204471
TI  - Immune-mediated hemolytic anemia: 70 cases (1988-1996).

PMID- 11204472
TI  - The use of a Nd:Yag laser for treatment of feline osteoclastic resorptive
      lesions.

PMID- 11204473
TI  - Pericardial effusion and pericardiocentesis in a guinea pig (Cavia porcellus).
AB  - A three-year-old, female guinea pig (Cavia porcellus) presented for acute dyspnea
      and weakness. Radiographs and echocardiography were consistent with a diagnosis
      of pericardial effusion and heart failure secondary to cardiac tamponade.
      Ultrasound-guided pericardiocentesis was performed, and clinical signs rapidly
      improved. Serial echocardiography and radiographs demonstrated normalization of
      cardiac function over the subsequent six months.

PMID- 11204474
TI  - Anatomy of the lumbosacral spinal cord in rabbits.
AB  - This study provides an accurate, anatomical description of the rabbit's
      lumbosacral spinal cord. Following humane euthanasia, 64 rabbits were
      radiographed and dissected. The number of thoracic (T) and lumbar (L) vertebrae
      was 12T/7L in 43.8%, 13T/6L in 32.8%, and 13T/7L in 23.4% in the 64 rabbits
      studied. The 13th ribs were rudimentary, asymmetric, or both in 15 animals. The
      spinal cord terminated within the second sacral vertebra (S2) in 79.3%, within
      the first sacral vertebra (S1) in 19.0%, and within the third sacral vertebra
      (S3) in 1.7% of the sample. Spinal nerve contributions to the femoral, obturator,
      sciatic, and pudendal nerves were determined. Formulas to predict the termination
      of the cord relative to the vertebral column were established. Age, weight, sex,
      and method of preparation did not show a significant correlation with the length
      of the spinal cord.

PMID- 11204475
TI  - Chylous abdominal effusion in a cat with feline infectious peritonitis.
AB  - A 10-year-old cat was diagnosed with chyloperitoneum based on the effusion
      characteristics. Feline coronavirus serology was positive. The owner declined
      further evaluation and elected euthanasia. Necropsy revealed vasculitis with
      multifocal areas of necrosis and lymphocytic-plasmacytic inflammation in multiple
      solid organs, most likely due to feline infectious peritonitis (FIP).
      Immunohistochemistry was negative for FIP antigen. Notwithstanding, the final
      diagnosis of FIP was based on the characteristic histopathological lesions.
      Underlying causes of chyloperitoneum in cats and humans are discussed, and
      possible pathogenesis of the chyloperitoneum in association with a vasculitis
      such as FIP is discussed.

PMID- 11204476
TI  - Canine Rocky Mountain Spotted fever: a retrospective study of 30 cases.
AB  - Rocky Mountain spotted fever (RMSF) was diagnosed in 30 dogs examined at North
      Carolina State University, Veterinary Teaching Hospital between 1984 and 1997.
      Historical, physical examination, and laboratory abnormalities were reviewed.
      Diagnostic criteria included a four-fold rise in antibody titer to Rickettsia
      rickettsii (R. rickettsii) (n=15) or a single R. rickettsii antibody titer of
      1:1,024 or greater (n=15; when this initial titer was determined one week or more
      after the onset of clinical signs). Fifteen (50%) dogs were greater than seven
      years of age, and 13 (43%) dogs were between two and seven years of age. There
      was no sex predilection. Only five (17%) dogs had a history of known tick
      exposure. Presumably due to delayed diagnosis, dogs with antibody titers of
      1:1,024 or greater at the time of presentation had a higher incidence of more
      severe neurological dysfunction (e.g., ataxia, hyperesthesia, vestibular disease,
      and seizures) and cutaneous lesions (e.g., hyperemia, edema, petechiae,
      ecchymoses, and necrosis). Laboratory findings included anemia, leukocytosis
      accompanied by toxic granulation of neutrophils, hypoalbuminemia, and coagulation
      abnormalities; signs were generally more severe in the 15 dogs with R. rickettsii
      antibody titers of 1:1,024 or greater at the time of presentation. Twelve (40%)
      dogs in this study were severely thrombocytopenic (less than 75 x10(3)
      platelets/microl; reference range, 200 to 450 x 10(3)/microl), without clinical
      evidence of fulminant disseminated intravascular coagulation. In this study, the
      survival rate following R. rickettsii infection was 100%.

PMID- 11204477
TI  - Pancreatitis in a cat demonstrating pancreatic duct dilatation
      ultrasonographically.
AB  - A 17-year-old, castrated male domestic shorthair cat presented with nonspecific
      clinical findings of three days' duration. Complete blood counts and serum
      biochemistry profiles revealed evidence of hepatic dysfunction. Ultrasonographic
      evaluation revealed abnormalities consistent with pancreatitis, with suspected
      pancreatic duct dilatation in the left limb of the pancreas. Surgery and eventual
      necropsy confirmed a diagnosis of pancreatitis, along with pancreatic duct
      dilatation. Dilatation of the pancreatic duct may be another ultrasonographic
      change to look for when suspecting feline pancreatitis.

PMID- 11204478
TI  - Electrocardiographic findings in dogs with motor vehicle-related trauma.
AB  - Motor vehicle-related injury is the most common form of trauma incurred by dogs,
      and cardiac arrhythmias are a well-recognized complication. Although
      posttraumatic arrhythmias are often observed, little is known regarding their
      frequency. This study utilized continuous ambulatory electrocardiography (i.e.,
      Holter monitoring) to describe the cardiac rhythm disturbances in 30 dogs
      sustaining trauma in motor vehicle accidents. Ventricular ectopy was identified
      by Holter monitoring in 29 of 30 dogs, although the initial electrocardiogram
      (EKG) only documented ventricular ectopic complexes (VECs) in four dogs.
      Ventricular ectopy was infrequent in most dogs (i.e., 62% of the dogs had less
      than 100 VECs per day for the entire study), but 16% developed frequent
      arrhythmias (greater than 4,000 VECs per day). In all cases, the VECs were
      observed within 24 hours of injury. Forty-three percent of dogs had at least one
      episode of ventricular tachycardia, including several dogs that had an overall
      infrequent rate of VECs (i.e., less than 100 or 100 to 1,000 VECs per day).
      Although baseline EKGs are useful in identifying arrhythmias in most dogs, the
      length of the recording should be increased to improve the likelihood of
      observing an abnormal EKG event. Most importantly, additional EKGs should be
      obtained or continuous EKG monitoring should be performed in dogs that display
      clinical signs that could be attributed to ventricular arrhythmias.

PMID- 11204479
TI  - Possible causal association of idiopathic inflammatory bowel disease with
      thrombocytopenia in the dog.
AB  - Extraintestinal manifestations of inflammatory bowel disease (IBD) are commonly
      observed in humans but are poorly documented in companion animals.
      Thrombocytopenia is an uncommon but well-documented extraintestinal hematological
      abnormality in humans; however, there are no previous reports of IBD and
      concurrent thrombocytopenia in the veterinary literature. Seven dogs having
      idiopathic IBD and concurrent thrombocytopenia were identified and evaluated
      retrospectively (this represents an incidence of 2.5% in the authors' IBD
      population). Obvious known causes for thrombocytopenia were eliminated by
      diagnostic testing as deemed appropriate by the clinician of record.
      Thrombocytopenia resolved with treatment for the IBD in some but not all
      patients. This is similar to reports in humans. Thrombocytopenia typically
      appears to be subclinical, and the severity does not correlate with the degree of
      intestinal inflammation defined histopathologically. However, quantitative
      platelet counts should be monitored during IBD therapy, as additional
      immunosuppression may be required to treat thrombocytopenia, despite resolution
      of gastrointestinal signs. It is speculated that thrombocytopenia may be causally
      associated with canine IBD, possibly secondary to immune stimulation from lumenal
      bacterial antigens, altered immunological regulation, or both.

PMID- 11204480
TI  - Arthroscopic removal and curettage of osteochondrosis lesions on the lateral and
      medial trochlear ridges of the talus in two dogs.
AB  - Osteochondrosis lesions in the tibiotarsal joint were treated arthroscopically in
      two dogs. One dog had unilateral osteochondrosis of the dorsal aspect of the
      lateral trochlear ridge of the talus. The second dog had bilateral
      osteochondrosis of the plantar aspect of the medial trochlear ridge of the talus.
      Removal of all osteochondral fragments (i.e., joint mice) and debridement and
      curettage of the remaining talar defects were accomplished arthroscopically. Both
      dogs had excellent short-term outcomes.

PMID- 11204481
TI  - Chylothorax in a dog with pulmonary lymphangiosarcoma.
AB  - Lymphangiosarcoma of the pulmonary pleura was found to be the cause of persistent
      chylothorax in an eight-year-old, intact male golden retriever. After a two-month
      course of medical management, a lymphangiogram and thoracic duct ligation were
      performed with the objective of decreasing further effusion. At surgery, gross
      lung pathology was biopsied and yielded a histopathological diagnosis of
      pulmonary pleural lymphangiosarcoma. A relatively rare tumor, lymphangiosarcoma
      of the pulmonary pleura has not previously been documented as a source of
      chylothorax in the dog.

PMID- 11204482
TI  - Surgical treatment of septic peritonitis without abdominal drainage in 28 dogs.
AB  - The purpose of this study was to evaluate the surgical outcomes of 28 dogs with
      generalized septic peritonitis treated without postoperative abdominal drainage.
      The overall mortality rate was 46%, with most cases of peritonitis being caused
      by leakage of the gastrointestinal tract (75%). Etiology of peritonitis,
      abdominal cytopathology, total white blood cell count, packed cell volume, total
      protein, and results of serum biochemistries were not statistically different
      between survivors and nonsurvivors. The mortality rate of 46% is similar to other
      studies in which the abdomen was left open postoperatively for the management of
      septic peritonitis, although more advanced medical treatment than that used in
      earlier studies may have positively affected the outcome. The results of this
      study show that closure of the abdomen after the source of contamination has been
      successfully corrected, in combination with thorough intraoperative peritoneal
      lavage and appropriate postoperative medical management, may be an acceptable
      alternative method for the management of septic peritonitis.

PMID- 11204483
TI  - Surgical treatment of adrenocortical tumors: 21 cases (1990-1996).
AB  - Twenty-four adrenocortical tumors were surgically removed from 21 dogs.
      Histopathological examination confirmed 18 carcinomas and six adenomas. Four dogs
      died in the perioperative period. Fifteen of the 17 dogs that survived the
      perioperative period had long-term resolution of their clinical signs. Two dogs
      with incompletely resected tumors were treated with mitotane to control their
      clinical signs. Overall median Kaplan-Meier life-table survival for dogs with
      carcinomas was 778 days (range, one to 1,593 days). Median survival for dogs with
      adenomas was not reached (range, 11 to 730 days). Histopathological diagnosis,
      histopathological cellular features, age of the dog, and tumor size were not
      prognostic of outcome.

PMID- 11204484
TI  - Historical perspectives: 1966.

PMID- 11204485
TI  - Hematological and TGF-beta variations after whole-body proton irradiation.
AB  - The acute effects of proton whole-body irradiation on five bone-marrow-derived
      cell types and transforming growth factor-beta 1 (TGF-beta 1) were examined and
      compared to the effects of photons (60Co). C57BL/6 mice were exposed to 3 Gy (0.4
      Gy/min) protons at spread-out Bragg peak (SOBP), protons at entry (E), or 60Co
      and euthanized on days 0.5-17 thereafter. 60Co-irradiated animals had decreased
      erythrocytes, hemoglobin and hematocrit at 12 hours post-exposure; depression was
      not noted in proton (SOBP or E)-irradiated groups until day 4. Significantly
      decreased leukocyte counts were observed at this same time in all irradiated
      groups, with lymphocyte loss being greater than that of monocytes, and the
      depression was generally maintained. In contrast, the levels of neutrophils and
      thrombocytes fluctuated, especially during the first week; significant
      differences were noted among irradiated groups in neutrophil levels. Plasma TGF
      beta 1 was elevated on day 7 in the 60Co, but not proton, irradiated mice.
      Collectively, the data show that dramatic and persistent changes occurred in all
      irradiated groups. However, few differences in assay results were seen between
      animals exposed to protons (SOBP or E) or photons, as well as between the groups
      irradiated with either of the two regions of the proton Bragg curve.

PMID- 11204487
TI  - Immunohistochemical studies on tenascin in extrahepatic bile duct remnants of
      biliary atresia.
AB  - The expression of tenascin in the extrahepatic bile duct remnants in biliary
      atresia was investigated using an immunohistochemical method. Tenascin is thought
      to be a marker of repair of injured tissues based on an immunohistochemical study
      of a variety of tissues. Twenty-three specimens were obtained from 23 cases (2
      correctable type and 21 non-correctable type) of biliary atresia at the time of
      the definitive operation. Positive tenascin staining was observed in matrices
      surrounding degenerated epithelium of the bile ductules in the obliterated
      extrahepatic bile duct. Regarding the correlation between the size of the bile
      ductule and the degree of positive staining, the larger diameter bile ductules
      tended to show a higher degree of positive staining. Furthermore, regarding the
      correlation between the degeneration of epithelium and the degree of staining,
      the bile ductules with the more significantly denuded epithelium tended to show a
      higher degree of positive staining. In some specimens classified as non
      correctable type, a lumen larger than 1 millimeter in diameter without epithelium
      was observed. This ductule itself was thought to be the original extrahepatic
      bile duct because strong tenascin staining was observed surrounding this lumen.
      These findings suggested that the extrahepatic bile duct might be obliterated
      after the completion of the hepatobiliary tree system and the bile ductules in
      the obliterated extrahepatic bile duct might be degenerated in order of their
      size.

PMID- 11204486
TI  - Acute pancreatitis associated with administration of a nitric oxide synthase
      inhibitor in tumor-bearing dogs.
AB  - BACKGROUND: Nitric oxide synthase (NOS) inhibitors have been investigated as
      potential cytotoxic agents to treat tumors lacking p53 function. Furthermore,
      their ability to reduce tumor blood flow can be combined with drugs that are
      specifically designed to kill cells that are hypoxic or to improve temperatures
      during local heat (hyperthermia) treatment of tumors. This paper reports the
      unexpected development of acute pancreatitis in two tumor-bearing pet dogs that
      were treated with the NOS inhibitor, NG-nitro-L-arginine methyl ester (L-NAME)
      during administration of local hyperthermia. METHODS: Prior to the use of L-NAME
      in tumor-bearing dogs, purpose-bred beagles were studied. Following induction of
      inhalation anesthesia, local hyperthermia was applied to either normal thigh
      muscle (beagles) or tumors (tumor-bearing dogs). Once a thermal steady state was
      achieved, L-NAME was administered and temperature monitoring continued. Animals
      were observed after treatment for evidence of toxicity. RESULTS: The beagles
      tolerated the treatment well, with no side effects noted either clinically or by
      routine CBC or blood chemistry analyses. In contrast, the first two tumor-bearing
      dogs accrued onto the phase I study developed acute pancreatitis in the immediate
      post-treatment period which necessitated hospitalization and intensive care. The
      trial was stopped. Both dogs had intercurrent risk factors which predisposed them
      to development of pancreatitis, although neither had a history of symptoms of
      pancreatitis at the time the hyperthermia + L-NAME treatment was given.
      CONCLUSIONS: We conclude that caution should be exercised when considering NOS
      inhibition for cancer treatment. Careful evaluation of history and health status
      as well as recognition of potential risk factors may be key in avoiding
      potentially fatal complications. This study demonstrates the value of performing
      potentially harmful treatments in tumor-bearing dogs prior to introduction into
      the human clinic.

PMID- 11204488
TI  - Oxidative stress of red blood cells during Bacillus Calmette-Guerin intravesical
      instillations.
AB  - Although Bacillus Calmette-Guerin (BCG) intravesical instillation is widely
      accepted as a very effective modality in treating bladder carcinoma in situ, and
      in preventing superficial bladder cancer recurrence, its mechanism of action is
      not yet fully understood. The antitumor effects of BCG are mostly related to
      local immunological events but a systemic activation of the immune system cannot
      be excluded. The objective of the present study was to estimate the systemic
      production of oxidants during intravesical BCG treatment. Systemic production of
      oxidants was estimated by assessing the red blood cells (RBC) oxidative stress in
      twelve patients undergoing BCG immunotherapy for bladder carcinoma in situ. RBC
      oxidative stress induced by peroxynitrite was determined by luminol-enhanced
      chemiluminescence. During the treatment period, the RBC oxidative stress revealed
      a biphasic curve of changes: after an initial 5-fold increase, it dropped to
      pretreatment levels following the 4th instillation. Intravesical BCG
      administration induced systemic production of oxygen free radicals that may
      reflect a systemic activation of the immune system.

PMID- 11204489
TI  - Oncogene activation and tumor suppressor gene inactivation find their sites of
      expression in the changes in time and space of the age-adjusted cancer incidence
      rate.
AB  - The purpose of the present investigation is to elucidate the relation between the
      distribution pattern of the age-adjusted incidence rate (AAIR) changes in time
      and space of 15 tumors of bothe sexes and the locations of centers of centripetal
      (oncogene type) and centrifugal-(tumoe suppressor gene type) forces. The fitness
      of the observed log AAIR data sets to the oncogene type- and the tumor suppressor
      gene type-equilibrium models and the locations of 2 force centers were calculated
      by applying the least square method of Gauss to log AAIR pair data series with
      and without topological data manipulations, which are so designed as to let log
      AAIR pair data series fit to 2 variant (x, y) frameworks, the Rect-coordinates
      and the Para-coordinates. The 2 variant (x, y) coordinates are defined each as an
      (x, y) framework with its X axis crossed at a right angle to the regression line
      of the original log AAIR data (the Rect-coordinates) and as another framework
      with its X axis run in parallel with the regression line of the original log AAIR
      pair data series (the Para-coordinates). The fitness test of log AAIR data series
      to either the oncogene activation type equilibrium model (r = -1.000) or the
      tumor suppressor gene inactivation type (r = 1.000) was conducted for each of the
      male-female type pair data and the female-male type data, for each of log AAIR
      changes in space and log AAIR changes in time, and for each of the 3 (x, y)
      frameworks in a given neoplasia of both sexes. The results obtained are given as
      follows: 1) The positivity rates of the fitness test to the oncogene type
      equilibrium model and the tumor suppressor gene type model were each 63.3% and
      56.7% with the log AAIR changes in space, and 73.3% and 73.3% with log AAIR
      changes in time, as tested in 15 human neoplasias of both sexes. 2) Evidence was
      presented to indicate that the clearance of oncogene activation and tumor
      suppressor gene inactivation is the sine qua non premise of carciniogenesis. 3)
      The r profile in which the correlation coefficient r, a measure of fitness to the
      2 equilibrium models, is converted to either +(r > 0) or -(0 > r) for each of the
      original-, the Rect-, and the Para-coordinates was found to be informative in
      identifying a group of tumors with sex discrimination of cancer risk (log AAIR
      changes in space) or another group of environmental hormone-linked tumors (log
      AAIR changes in time and space)--a finding to indicate that the r-profile of a
      given tumor, when compared with other neoplasias, may provide a clue to
      investigating the biological behavior of the tumor. 4) The recent risk increase
      of skin cancer of both sexes, being classified as an example of environmental
      hormone-linked neoplasias, was found to commit its ascension of cancer risk along
      the direction of the centrifugal forces of the time- and space-linked tumor
      suppressor gene inactivation plotted in the 2-dimension diagram. In conclusion,
      the centripetal force of oncogene activation and centrifugal force of tumor
      suppressor gene inactivation found their sites of expression in the distribution
      pattern of a cancer risk parameter, log AAIR, of a given neoplasias of both sexes
      on the 2-dimension diagram. The application of the least square method of Gauss
      to the log AAIR changes in time and space, and also with and without topological
      modulations of the original sets, when presented in terms of the r-profile, was
      found to be informative in understanding behavioral characteristics of human
      neoplaisias.

PMID- 11204490
TI  - Development of a saliva sampling method and a rocket immunoelectrophoretic assay
      for quantification of salivary IgA in the squirrel monkey (Saimiri sciureus).
AB  - There has long been the requirement for a marker of well being and chronic stress
      that is, itself, unaffected by the transient stressors associated with sampling.
      Work done in the human, the rat and the dog suggests that salivary IgA may fulfil
      these criteria. This is the first report on the establishment of a saliva
      sampling technique and immunoelectrophoretic assay for quantification of
      secretory Immunoglobulin A (s-IgA) in the squirrel monkey (Saimiri sciureus). A
      safe and effective sampling method is described, as well as a detailed
      description of an accurate rocket immunoelectrophoretic assay developed for this
      study. Preliminary results demonstrate a large intra-individual variation, as
      well as inter-individual variation in s-IgA levels between successive days. This
      indicates that if stress is associated with decreased s-IgA levels in the
      squirrel monkey, the usefulness of s-IgA as a stress marker may be limited
      because analyses of large numbers of samples may be necessary in order to obtain
      significance.

PMID- 11204491
TI  - Blood levels of ruthenium following repeated treatments with the antimetastatic
      compound NAMI-A in healthy beagle dogs.
AB  - NAMI-A is a new generation ruthenium compound which is entering phase-I clinical
      trials anti-metastatic agent. This study analyses the effects of the i.v.
      injection of NAMI-A to healthy Beagle dogs at increasing doses from 0.4 (low) 4
      (mid) and 8 (high) mg/kg/day, given for 5 consecutive days. Only mild signs of
      toxicity, consisting of emesis and mucoid faeces, from which animals completely
      recovered, occurred during treatment at the high dose. Decay of ruthenium
      concentration from the whole blood, 24 hr after 5-days treatment, was lower than
      that observed after 1-day treatment. T1/2 was about 20-23 hr, or slightly longer
      when the animals were hydrated with tap water prior to treatment; Cltot was 21-22
      ml*hr-1, decreasing to 13 ml*hr-1 after hydration and increasing to 34 ml*hr-1
      with the high dose. AUC was proportional to the dose used. Thus NAMI-A is well
      tolerated by healthy dogs with blood levels comparable to those obtained in mice
      treated with an about 10-times higher daily dose.

PMID- 11204492
TI  - Subtyping of cytomegalovirus strains obtained from immunocompetent children.
AB  - We analyzed 33 clinical isolates of cytomegalovirus (CMV) obtained from
      immunocompetent Japanese children. DNA was extracted from infected MRC-5 cells
      and we amplified CMV glycoprotein-B (gB), major IE (MIE), DNA polymerase and
      glycoprotein-H (gH) genes using PCR. Among the 33 clinical isolates, 24 were
      identified as gB group 1, one as group 2, 6 as group 3, and 2 as simultaneous
      infections with group 1 and group 3 strains. Clinical isolates of CMV have also
      been classified into 18 MIE, 8 DNA polymerase and 15 gH genotype patterns by
      restriction fragment length polymorphism (RFLP). RFLP analysis is useful in
      molecular epidemiological studies of CMV infection in immunocompetent
      individuals.

PMID- 11204493
TI  - The effect of humoral immunity against adducted benzo[a]pyrene on DNA damage
      elicited by acute carcinogen exposure in Swiss mice.
AB  - Immunoglobulins G (lgG) specific for benzo[a]pyrene-DNA adducts were elicited in
      Swiss mice by repeated subcutaneous injections of a high molecular weight
      benzo[a]pyrene-DNA conjugate-adjuvant mix. The immunization procedure resulted in
      the production of specific antibodies against adducted benzo[a]pyrene B[a]P in
      all treated animals. One week after completion of the immunization procedure,
      groups of ten immunized and ten non immunized female mice were treated by single
      intraperitoneal injection with two different doses of B[a]P. The mice were
      sacrificed 48 hours after treatment, and both liver and bone marrow cells were
      isolated for subsequent determinations of DNA binding and micronucleus induction,
      respectively. Covalent benzo[a]pyrene adducts in liver DNA were detected by
      competitive ELISA and the incidence of micronucleated polychromatic erythrocytes
      was evaluated by scoring one thousand cells per animal. The determination of DNA
      adducts in liver revealed significantly (p < 0.05) lower levels of B[a]P adducts
      in immunized mice compared to non-immunized animals at both doses, whereas no
      significant difference was observed between controls. Administration of
      benzo[a]pyrene produced moderate, dose-related increases in the incidence of
      micronucleated polychromatic erythrocytes in all treated groups, with no
      significant difference between immunized and non-immunized mice. The decrease of
      covalent DNA adducts in the liver of immunized mice suggests that the specific
      humoral immunity elicited by repeated carcinogen exposure may act as a relevant
      modulating factor in chemical carcinogenesis.

PMID- 11204494
TI  - Divergent synergic effects in carcinogenesis initiation by simultaneous exposure
      to two genotoxic carcinogens.
AB  - Carcinogenesis is a complex and multistep process starting from initiation to
      tumor progression. Synergistic mechanisms can occur at every step of the process.
      The aim of this work was to provide information about the effect of chemical
      carcinogens which, if administered in combination, result in positive as well as
      negative synergistic effects. In order to evaluate whether for some carcinogens
      synergism occurs at the initiation step, we compared the effects of
      Ethylmethanesulfonate (EMS) on Benzo[a]pyrene (BP)-DNA adducts formation in the
      liver and lung of male Swiss mice treated for seven days by i.p. dose of EMS (1.2
      mg/Kg b.w.) alone or by simultaneous administration of three doses of BP (25, 50,
      100 mg/Kg b.w.) injected i.p. or the first day of treatment. A group of Swiss
      mice was treated by BP alone. At it was demonstrated in our laboratory that
      previous immunization toward BP influences the adduct levels of this carcinogen
      (14), the same treatments (BaP alone and BaP with EMS) were carried out in mice
      previously immunized toward BP. Liver and lung 1 BP-DNA adducts were detected in
      all the groups treated by both BP and EMS as compared to the group treated with
      BP alone. The EMS-BP association in non-immunized mice showed an antagonistic
      effect in the liver and a synergistic effect in the lung. In immunized mice a
      synergistic effect was obtained in both liver and lung. Moreover, the efficiency
      of both the synergistic and antagonistic effect, depended on BP dose of
      treatment. It is reasonable to draw the conclusion that simultaneous exposure to
      BP and EMS leads to different organ-specific and dose-dependent effects. This
      first preliminary result showed that the pattern of the interaction between
      genotoxic carcinogens is more complex that was foreseen, even at the stage of DNA
      adducts formation.

PMID- 11204495
TI  - Radiation induced early nuclear changes in cytologic brush specimens from the
      upper aerodigestive tract.
AB  - OBJECTIVE: To evaluate the feasibility of DNA image cytometry to assess radiation
      induced early nuclear changes in cytologic smears from the upper aerodigestive
      tract. METHODS: 100 cytologic brush specimens from 50 postoperatively irradiated
      patients with upper aerodigestive tract carcinoma were examined Smears were taken
      from clinically inconspicuous mucosa from the former tumor site and from a
      control region (contralateral side). Cellular DNA was quantified using the CAS
      200 image analysis system on Feulgen stained slides. DNA histograms were
      evaluated using the coefficient of variation (CV), the DNA index (DI), the 2c
      deviation index (2cDI) and the 2.5c exceeding rate (2.5cER). RESULTS: All
      specimens from the control region were diploid. Forty-six smears from the former
      tumor region were diploid and in four cases non-diploid cells were found. Single
      cells with a DNA content exceeding 5c ('5c exceeding events'), were identified in
      three non-diploid and six diploid smears from the former tumor region.
      CONCLUSION: DNA analysis is a useful tool in detecting early nuclear changes
      preceding morphologic changes.

PMID- 11204496
TI  - Experimental inoculation of laboratory animals with samples collected from
      sarcoidal patients and molecular diagnostic evaluation of the results.
AB  - Studies on the implication of mycobacteria in the pathogenesis of sarcoidosis
      have generated conflicting results. In an attempt to further elucidate the
      etiology of the disease, we obtained broncho-alveolar lavage (BAL) samples from
      sarcoidal patients, which were subsequently used for intra-tracheal inoculation
      of a group of rabbits. Patients were characterized as sarcoidal on the grounds of
      clinical, radiographic, histological and microbiological testing. Four months
      following inoculation, lung and alveolar lymph node specimens were collected from
      the animals and were examined by means of histology and microbiology, as well as
      by a polymerase chain reaction (PCR) assay, targeted to DNA sequences of the
      Mycobacterium tuberculosis and Mycobacterium avium complexes. All of the twenty
      five BAL-inoculated rabbits revealed evidence of lobar pneumonia, with thirteen
      developing lesions of non-caseous granulomatous inflammation, similar to those
      observed in sarcoidal patients. Microbiological cultivation of lung and alveolar
      lymph node material, Zihl-Neelsen staining of corresponding tissue sections and
      PCR analysis of extracted DNA yielded no evidence of mycobacterial infection.
      Identical processing of biopsies originating from the martyrs, formerly
      inoculated with drinking water or disinfected BAL, revealed no pathological
      signs. Our findings suggest that BAL samples from patients with sarcoidosis may
      carry an agent that produces a disease characterized by similar histological
      lesions in rabbits. However, culture, and PCR, could not identify this agent as a
      member of Mycobacterium tuberculosis, or Mycobacterium avium complexes.

PMID- 11204497
TI  - Dietary administration of tannic acid lowers plasminogen activator activity in
      the liver of C3H hepatoma bearing male mice.
AB  - BACKGROUND: This study was undertaken to investigate if low-dose dietary
      administration of tannic acid exerts its chemopreventive activity on
      hepatocarcinogenesis in male C3H mice through changes of plasminogen activator
      activity (PAA), plasminogen activator inhibition (PAI) or plasmin inhibition (Pl)
      in the liver of C3H hepatoma bearing male mice. MATERIALS AND METHODS: Tannic
      acid was administered in the drinking water of hepatoma bearing C3H mice, in a
      concentration of 0.0075% (group B), 0.015% (group C) and 0.03% (group D) for 9
      months. PAA, PAI and PI were measured by spectrophotometric methods in
      macroscopically healthy liver regions. RESULTS: Tannic acid induced a decrease of
      PAA (53%) and an increase of PAIs (50%) in the livers of group D while tannic
      acid received mice showed a dramatic decrease in liver carcinomas incidence (0%
      vs 33.3% in the control group). CONCLUSION: The decrease of PAA in the liver of
      C3H hepatoma bearing male mice, might be correlated with the chemopreventive
      activity of tannic acid in hepatoma development.

PMID- 11204498
TI  - The role of apoptosis in normal ontogenesis and solid human neoplasms.
AB  - Mammalian cells are capable of committing "active suicide" or apoptosis in
      response to specialized pathological mechanisms employing a phylogenetically
      developed intrinsic program of death, triggered by signal transduction through
      specific receptors. Changes in cellular structure such as: 1) condensation of the
      nuclear (chromatin) and cytoplasmic structures (especially the mitochondria); 2)
      blebbing of the cell membrane; 3) characteristic swelling of the endoplasmic
      reticulum; and 4) fragmentation of the cells in membrane bound apoptotic bodies,
      are the dramatic signs of total cell destruction. Apoptosis requires energy in
      the from of ATP, indicating that programmed cell death (PCD), as opposed to
      necrosis, is an energy dependent, active physiological and pathophysiological
      phenomenon. During this immunocytochemical study, we observed the presence of PCD
      in the prenatal thymus and various human neoplastically transformed tissues.
      During the intrauterine ontogenesis, in thymocytes or resting T lymphocytes, p53
      tumor suppressor protein was identified to be a critical mediator of PCD in
      response to DNA damage. The cellular interaction of immature, cortical thymocytes
      (characterized by a double positive CD4+CD8+TCRlow immunophenotype-IP) with
      thymic RE cells induces positive selection of T lymphocytes that recognize, but
      are not activated, by self-MHC molecules (tolerance induction). Double positive
      CD4+CD8+CD3- thymocytes undergo FasL-mediated apoptosis, while CD4+CD8+CD3+ cells
      use the CD3 mediated pathway of PCD. Two step, apoptotic cell death is mainly
      restricted to the CD4+CD8+TCR dull thymocyte subpopulation. T-lymphocytes which
      do not undergo positive selection are killed by apoptosis in response to a number
      of intrinsic and extrinsic factors, such as chemical toxins, viral infections, X-
      and UV irradiation, mild hyperthermia, the actions of various hormones,
      extracellular survival factors, calcium ionophores (such as A23187), various
      chemotherapeutic drugs (adriamycin, actinomycin D, etc) and antibodies directed
      to the CD3-TCR (T cell receptor) complex. Immature thymocytes also undergo a
      second selective process, so-called negative selection, when thymic stromal cells
      eliminate autoreactive T lymphocytes. As a typical model of embryonal neoplasms,
      we observed 34 childhood PNET/MED tissues samples. A systematic observation for
      the presence of apoptosis related markers (especially FasR) and cells in PCD was
      carried out. A strong expression (intensity of staining: "A"--the highest
      possible; number of stained neoplastic cells: +++ to ++++, between 50% to 90%) of
      FasR was detected. We also observed 42 childhood glial tumors, divided as
      follows: 6 pilocytic ASTRs; 14 low grade ASTRs; 16 anaplastic ASTRs; and 6 GBMs.
      The GBMs represent an end-stage brain tumor IP dedifferentiation of glial origin.
      During the immunocytochemical screening of these 42 childhood ASTRs, we detected
      strong expression (intensity of staining: "A"--the highest possible; number of
      stained cells: ++ to ++++, between 20% to 90%) of FasR, employing 4 microns
      thick, formalin fixed, paraffin-wax embedded tissue slides. FasR expression was
      rated high, 70% to 90% on the tumor cells in pylocytic ASTRs, lowered to 50% to
      60% on the neoplastic cells in low grade ASTRs, even lower between 30% to 40% in
      anaplastic ASTRs and significantly lower, between 20% to 35% on the
      neoplastically transformed cells of GBM tissues. The presence of apoptotic
      neoplastic cells was also regularly detected in other human adult neoplasms, such
      as thyroid, pancreatic, hepatocellular, gastric, colon, breast, ovarian,
      prostata, and renal cell carcinomas, as well as, in Hodgkin and non-Hodgkin
      lymphomas and some sarcomas. The expression of apoptosis related cell surface
      molecules on the surface of both neoplastically transformed cells and on tumor
      cell specific, cytotoxic T lymphocyte (CTL) surfaces (FasR-FasL system) raises a
      distinct possibility of active PCD induction in CTL by tumor cells. Juxtacrine
      interactions between CTL and neoplastically transformed cells, coupled with
      observations that tumor cells can modulate the intracellular, signaling domains
      of cell surface receptors to elicit responses quite often contrary to the
      expected, may even provide a way for CTL to enhance the proliferation and
      dedifferentiation of cancer cells. Adoptive cellular immunotherapies employing
      CTL raised against autologous neoplastically transformed cells in vitro should be
      employed in the control of minimal residual disease following surgical resection
      of the primary malignant growth.

PMID- 11204499
TI  - Hepatitis C virus infection mimicking primary Sjogren syndrome. A clinical and
      immunologic description of 35 cases.
AB  - Hepatitis C virus (HCV) infection is emerging as an extremely common and
      insidiously progressive liver disease that is often associated with several
      extrahepatic manifestations. In 1992, a possible relationship between Sjogren
      syndrome (SS) and patients with HCV infection was first postulated. Subsequently,
      several studies demonstrated that a "true" SS, with similar clinical and
      histologic features to those observed in primary SS, may occur in some patients
      with chronic HCV infection. We report the clinical and immunologic
      characteristics of 35 patients with chronic HCV infection and a well-documented
      diagnosis of SS. Compared with 60 patients with primary SS who tested negative
      for HCV antibodies, SS-HCV patients showed a higher mean age (65.9 yr versus 61.5
      yr, p = 0.04), a lower prevalence of parotidomegaly (17% versus 47%, p = 0.004),
      and a higher prevalence of liver involvement (94% versus 3%, p < 0.001).
      Moreover, those patients with HCV-related SS showed a higher prevalence of anti
      parietal cell gastric antibodies (31% versus 13%, p = 0.03), antimitochondrial
      antibodies (14% versus 2%, p = 0.02), cryoglobulinemia (60% versus 10%, p <
      0.001), hypocomplementemia (60% versus 8%, p < 0.001), and a lower prevalence of
      anti-Ro/SS-A (17% versus 38%, p = 0.03). The "true" SS observed in some patients
      with HCV may be considered 1 of the extrahepatic manifestations of HCV, and we
      suggest that HCV infection can be considered as an exclusion criterion for the
      diagnosis of primary SS.

PMID- 11204500
TI  - Physiology and pharmacology of iodized oil in goiter prophylaxis.
AB  - Thyroid complications resulting from excess iodide such as thyrotoxicosis,
      thyroiditis, sialadenitis, or hypothyroidism are much rarer after iodine
      supplementation with Lipiodol than with KI. They do not militate against its
      widespread use in endemic goiter populations, especially in pregnant women.
      However, patients with multinodular goiter should not be treated or should be
      treated only under careful observation. When Lipiodol-induced thyrotoxicosis
      occurs it tends to be mild or even subclinical and self-limited. If treatment is
      required, potassium perchlorate with or without thionamides is recommended.
      Iodide goiter has not been seen after Lipiodol supplementation, nor has
      thyroiditis. Sialadenitis occurs rarely. Iodide derived from Lipiodol readily
      enters the fetus, possibly by active transport, and theoretically endangers the
      fetus because autoregulation of the fetal thyroid occurs late during gestation.
      Despite the difficulty in distinguishing iodide goiter from iodide deficiency
      goiter of the newborn, no cases of neonatal iodide goiter have been reported.
      Possible mechanisms of thyroid inhibition by excess iodide are briefly discussed.
      The use of locally produced iodized plant oils is recommended for financial
      reasons as well as for the benefits derived from local participation.

PMID- 11204501
TI  - The Schnitzler syndrome. Four new cases and review of the literature.
AB  - The Schnitzler syndrome is characterized by a chronic urticarial eruption with a
      monoclonal IgM gammopathy. The other signs of the syndrome include intermittent
      elevated fever, joint and/or bone pain with radiologic evidence of
      osteosclerosis, palpable lymph nodes, enlarged liver and/or spleen, elevated
      erythrocyte sedimentation rate, and leukocytosis. The mean delay to diagnosis is
      more than 5 years, and this syndrome is of concern to internists and many medical
      specialists. Patients with this syndrome are often initially considered to have
      lymphoma or adult-onset Still disease, which are the main differential diagnoses.
      However, hypocomplementic urticarial vasculitis, systemic lupus erythematosus,
      cryoglobulinemia, acquired C1 inhibitor deficiency, hyper IgD syndrome, chronic
      infantile neurologic cutaneous and articular (CINCA) syndrome, and Muckle-Wells
      syndrome should also be excluded, because diagnosis relies on a combination of
      clinical and biologic signs and there is no specific marker of the disease. The
      disease pursues a chronic course, and no remissions have yet been reported.
      Disabling skin rash, fever, and musculoskeletal involvement are the most frequent
      complications. Severe anemia of chronic disease is another serious complication.
      The most harmful complication, however, is evolution to an authentic
      lymphoplasmacytic malignancy, which occurs in at least 15% of patients. This
      hematologic transformation can occur more than 20 years after the first signs of
      the disease, thus patients deserve long-term follow-up. Treatment is symptomatic
      and unsatisfactory. The skin rash is unresponsive to treatment, and nonsteroidal
      antiinflammatory drugs, antihistamines, dapsone, colchicine, and psoralens and
      ultraviolet A (PUVA) therapy give inconstant results. Fever, arthralgia, and bone
      pain often respond to nonsteroidal antiinflammatory drugs. In some patients,
      these symptoms and/or the presence of severe inflammatory anemia require steroids
      and/or immunosuppressive treatment, which ameliorate inflammatory symptoms but do
      not change the course of the skin rash.

PMID- 11204502
TI  - Bilateral massive adrenal hemorrhage. Assessment of putative risk factors by the
      case-control method.
AB  - Case reports and case series have identified putative risk factors for the
      development of bilateral massive adrenal hemorrhage (BMAH) in humans. The anatomy
      and physiology of the adrenal gland allow development of a model to fit the
      pathophysiology behind these risk factors. Until now, these risk factors were not
      systematically tested using analytical epidemiologic studies. A case-control
      study was undertaken using sources of cases and controls from multiple teaching
      hospitals in Ontario, Canada. The results of multivariate logistic regression
      indicated that thrombocytopenia (odds ratio [OR] = 14.6, 95% confidence intervals
      [CI] = 3.0-70.1, p < 0.001), heparin exposure of any route or type beyond 3 days
      (4-6 days: OR = 17.0, CI = 1.9-154.6; > 6 days: OR = 33.5, CI = 4.3-262.6; p <
      0.001), and sepsis (OR = 6.3, CI = 1.2-32.2, p = 0.019) were most strongly and
      independently associated with development of BMAH. Another weaker positive
      association included invasive radiologic procedure (OR = 4.4, CI = 0.9-22.1, p =
      0.055). Neither major surgery or duration of hospitalization were independent
      risk factors. Although coronary artery disease and possibly diabetes and
      hypertension appeared to be markers for lower risk of BMAH, this may be a result
      of bias introduced by using hospital controls ("Berkson bias"), as the effect was
      not explained by a protective effect of vasoactive medications. Thus, a picture
      of the high-risk patient should include a patient who has been treated with
      heparin (any route or type) beyond 3 days and has had thrombocytopenia (not
      necessarily induced by heparin) during the course of an illness. If the setting
      includes unexplained abdominal, chest, or back pain; fever; confusion;
      hypotension or shock; abrupt anemia; or electrolyte disorders, clinicians should
      not hesitate to cover empirically with lifesaving glucocorticoids while awaiting
      results of confirmatory tests.

PMID- 11204503
TI  - Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non-HIV
      infected patients. A comparative study.
AB  - Visceral leishmaniasis is an endemic infection in Mediterranean countries, where
      it has become a frequent complication of acquired immunodeficiency syndrome
      (AIDS). The incidence of visceral leishmaniasis is increasing in Spain due to
      human immunodeficiency virus (HIV)-related cases, but some aspects of its
      epidemiology, clinical features, and management remain unknown. In addition, no
      comparative clinical studies about the disease in HIV-infected and non-HIV
      infected patients have been reported. During a 24-year period, 120 cases of
      visceral leishmaniasis were diagnosed at our institution and 80 (66%) were
      associated with HIV infection. The mean age at diagnosis was higher in HIV
      infected that in non-HIV-infected patients (33.2 versus 23.2 yr; p = 0.002), but
      the male/female ratio was similar in both groups. The main risk factor for HIV
      infection was intravenous drug abuse (78.7%). The clinical presentation of
      leishmaniasis was similar in both groups, but HIV-infected patients had a lower
      frequency of splenomegaly than HIV-negative individuals (80.8% versus 97.4%; p =
      0.02). HIV-infected patients had a greater frequency and degree of leukopenia,
      lymphocytopenia, and thrombocytopenia. Most of them were profoundly
      immunosuppressed (mean CD4+ lymphocyte count, 90 cells/mm3) at the time of
      diagnosis of leishmaniasis, and 53.7% had AIDS. The sensitivity of serologic
      studies for Leishmania was significantly lower in HIV-infected than in non-HIV
      infected patients (50% versus 80%; p < 0.001), but the diagnostic yield of bone
      marrow aspirate (67.1% versus 79.4%) and bone marrow culture (62.9% versus 66.6%)
      was similar in both groups. After initial treatment, the response rate was
      significantly lower in HIV-infected than in non-HIV-infected individuals (54.8%
      versus 89.7%; p = 0.001). The relapse rate was 46.2% and 7.5%, respectively (p <
      0.001). Secondary prophylaxis with antimonial compounds or amphotericin B seems
      to be useful in preventing relapses in HIV-infected patients. The mortality rate
      was higher (53.7% versus 7.5%; p < 0.001) and the median survival time shorter
      (25 versus > 160 mo; p < 0.001) in AIDS patients than in HIV-negative
      individuals. Although leishmaniasis could contribute to death in a significant
      number of HIV-infected patients, it was the main cause of death in only a few of
      them. The CD4+ lymphocyte count and the use of highly active antiretroviral
      therapy and secondary prophylaxis for leishmaniasis were the most significant
      prognostic factors for survival in AIDS patients. Visceral leishmaniasis behaves
      as an opportunistic infection in HIV-infected individuals and should be
      considered as an AIDS-defining disease.

PMID- 11204505
TI  - Participatory medicine.

PMID- 11204504
TI  - Rheumatic manifestations of infective endocarditis in non-addicts. A 12-year
      study.
AB  - Infective endocarditis (IE) is due to a microbial infection of the heart valves
      or of the endocardium in close proximity to either congenital or acquired cardiac
      defects. This infection is associated with a high risk of complications.
      Rheumatic manifestations are known to be frequent complications of IE.
      Controversy, however, frequently exists about the actual incidence of these
      complications. This may be due to the small number of series describing the
      frequency and type of rheumatic manifestations, the absence of uniform criteria
      used for the diagnosis of IE, and the fact that some studies on rheumatic
      manifestations in IE have been described from tertiary referral centers, which
      implicates associated problems of referral bias and uncertainty of denominator
      population. To investigate further the incidence, clinical spectrum, and outcome
      of patients with IE and rheumatic manifestations, we examined the features of
      patients diagnosed with clinically definite IE according to the Duke
      classification criteria at the single reference hospital for a defined population
      in northwestern Spain during a 12-year period. Between 1987 and 1998, 100
      consecutive patients had 110 episodes of clinically definite IE. Rheumatic
      manifestations were observed in 46 of the 110 episodes (41.8%). As in other
      western countries, they occurred more commonly in men aged in their 50s. The most
      frequent valve involved was the aortic (43.5%) followed by the mitral valve
      (30.4%). Myalgia was a frequent symptom. Peripheral arthritis, generally as
      monoarthritis, was clinically evident in 15 cases (13.6%), and sacroiliitis in 1
      patient. Low back pain was described in 14 cases (12.7%). Septic discitis was
      observed in 2 cases, and biopsy-proved cutaneous leukocytoclastic vasculitis was
      found in 4 cases. Other conditions such as trochanteric bursitis and polymyalgia
      were observed in 2 and 1 case, respectively. Apart from a significantly higher
      frequency of hematuria and a trend to lower serum complement levels in patients
      with rheumatic complications, no differences in clinical features, laboratory
      tests, or microbiologic blood culture results were found between cases with IE
      with or without rheumatic manifestations. Also, although patients with rheumatic
      manifestations had more embolic complications, the inhospital mortality rate in
      patients with rheumatic manifestations was not significantly different from that
      of the rest of the patients. The present study supports the claim that rheumatic
      complications are frequent in patients with clinically definite IE from southern
      Europe. The presence of musculoskeletal or vasculitic manifestations may be of
      some help, as warning signs, for the recognition of patients with severe disease
      who require rapid diagnosis and therapy.

PMID- 11204506
TI  - Quality of life of psoriasis patients.

PMID- 11204507
TI  - Water barrier function: what's new?

PMID- 11204508
TI  - Topical revitalization of body skin.

PMID- 11204509
TI  - Chronic radiation dermatitis: what's new in management?

PMID- 11204510
TI  - Pustulosis palmaris et plantaris.

PMID- 11204511
TI  - Blastomycosis: what's new?

PMID- 11204512
TI  - Cellulite: a review.
AB  - Gynoid lipodystrophy (cellulite) is an extremely controversial topic. A lack of
      knowledge regarding specific aetiopathogenic factors, as well as the opportunism
      of some professionals and the media, has fuelled debate regarding the scientific
      basis of this condition. This article reviews the clinical, epidemiological,
      histopathological and therapeutic aspects of cellulite.

PMID- 11204513
TI  - Adhesion molecule profiles in atopic dermatitis vs. allergic contact dermatitis:
      pharmacological modulation by cetirizine.
AB  - BACKGROUND: Experimental data suggest that there is an imbalance between Th1 and
      Th2 cells in atopic dermatitis (AD) skin compared to allergic contact dermatitis
      (ACD). This imbalance (Th2 and Th1 predominance, respectively) implies the
      production of different cytokines in these two conditions leading to different
      expression of adhesion molecules on skin endothelial cells. OBJECTIVE: The
      expression of VCAM-1 (IL-4/Th2-dependent) and ICAM-1 (INF-gamma/IL-1) on dermal
      vessels was compared in six patients with AD and six patients with ACD. The
      effect of cetirizine, a highly selective H1-receptor antagonist on the
      expressions was studied. METHODS: Six patients with AD were challenged with
      Dermatophagoides pteronyssimus (DPT patch tests applied to clinically normal
      skin) and six patients with ACD challenged in the same way with allergens of the
      European standard series. Skin biopsies at challenged sites were performed before
      and 6, 24 and 48 h after challenge. The experiment was carried out under double
      blind cross-over conditions during a 4-day treatment with a placebo and
      cetirizine. RESULTS: In AD patients, the scores for both VCAM-1 and ICAM-1 were
      high before and after challenge. In ACD patients, the ICAM-1 score was high at
      each experimental time, but the VCAM-1 score, which was significantly lower
      before challenge, increased at 6, 24 and 48 h after challenge. The administration
      of cetirizine significantly reduced the VCAM-1 expression in AD patients at each
      experimental time. CONCLUSION: It is concluded that the increased VCAM-1
      expression in AD patients compared to ACD may reflect greater IL-4 and/or IL-13
      production in situ. The study also confirms the existence of a modulating effect
      of cetirizine in vivo on adhesion molecule expression.

PMID- 11204514
TI  - The depression, anxiety, life satisfaction and affective expression levels in
      psoriasis patients.
AB  - OBJECTIVE: The aim of this study was to determine the effect of stressful life
      events on the onset and exacerbation of psoriasis, depression, anxiety, life
      satisfaction and affective expression levels in psoriasis patients and
      psychological risk factors related to psoriasis. METHOD: Fifty psoriasis patients
      were examined dermatologically and psychiatrically and then administered the Beck
      Depression Inventory (BDI), Spielberger State-Trait Anxiety Scale (STAI I-II),
      Life Satisfaction Scale (LSS), Courtauld Emotional Control Scale (CECS) and Body
      Image Satisfaction Scale (BIS). Symptom severity was measured by the Psoriasis
      Area Severity Index (PASI). RESULTS: Thirty-four patients declared that they had
      had a psychologically stressful life event in the last 3 months prior to the
      beginning of the illness. The mean PASI score was 1.75+/-1.65; BDI score 13.58+/
      6.11; STAI-I score 39.54+/-9.18, STAI-II score 46.58+/-8.05; LSS score 9.18+/
      4.39; CECS score 51.64+/-9.75; BIS score 93.74+/-16.67. CONCLUSION: Psoriasis
      patients reported significantly higher degrees of depression and more body
      cathexis problems than controls. In addition, the risk for developing psoriasis
      increased significantly in patients with moderate and severe depression. We also
      found a relationship between symptom severity and low affective expression and
      high BDI scores in this study. These findings suggest that the relationship
      between psoriasis and psychological problems can be reciprocal and requires
      further investigation.

PMID- 11204515
TI  - Incorporation of ceramide 3B in dermatocosmetic emulsions: effect on the
      transepidermal water loss of sodium lauryl sulphate-damaged skin.
AB  - BACKGROUND: In previous work we reported on the efficacy of cosmetic body lotions
      enriched with skin-identical lipids to reduce the transepidermal water loss
      (TEWL) of ageing and sodium lauryl sulphate (SLS)-damaged skin. The observations
      made depended on the experimental design and clearly raised the question of the
      importance of the galenic formulation of skin ceramide-containing products.
      OBJECTIVES: The aim of the present work was to study the different galenic forms
      in which ceramide 3B (0.2% w/v) can be incorporated into common o/w emulsions. In
      addition, we investigated whether supplementation of skin care products with
      ceramide 3B enriched with penetration enhancers and coemulsifiers could exert a
      beneficial effect on barrier function, done by measuring their effects on the
      TEWL of SLS-induced scaly skin. RESULTS: We found that the technique of
      incorporating ceramide 3B into the o/w emulsions was important for their final
      stability. However, no additional positive effect on the TEWL values of SLS
      damaged skin could be observed when the efficacy of the ceramide-containing
      emulsions was compared with that of proper controls. CONCLUSIONS: Although
      suitable galenic formulas were developed, no positive effect on TEWL could be
      observed when ceramide 3B was added in a final concentration of 0.2% (w/v) to
      different o/w emulsions and applied to SLS-damaged skin.

PMID- 11204516
TI  - Topical revitalization of body skin.
AB  - Topical treatments for the body are beneficial for photoageing as well as for
      specific disease processes, such as scars or striae. Every patient should
      topically apply photoprotectants in order to prevent photodamage to the skin.
      Tretinoin can improve body skin and has a documented use in striae. Alpha-hydroxy
      acids can restore body skin when used on a regular basis. Antioxidants may be of
      benefit. Scars can be improved with a variety of topically applied agents ranging
      from silicone gel sheeting to super-potent topical steroids. Chemical peeling for
      the body can improve the skin with the use of alpha- or beta-hydroxy acids. While
      topical therapy can improve body skin, adjunctive surgical therapy may be needed
      to correct body skin disorders or concerns fully.

PMID- 11204517
TI  - Biosurgery in wound healing--the renaissance of maggot therapy.
AB  - Chronic wounds are a challenge for modern health care. A basic principle of
      treatment is the removal of sloughy, necrotic, devitalized tissue to prevent
      wound infection and delayed healing. Biosurgery (syn. maggot or larval therapy)
      is a promising adjunct to the whole spectrum of topical treatment methods, in
      particular for debridement. The term 'biosurgery' describes the use of living
      maggots on wounds to remove devitalized tissue, decrease the risk of infection
      and improve wound healing. The present paper gives a brief review of history,
      entomology, biochemistry and medical indications of biosurgery and the practical
      handling of maggots. We also provide some clinical data from the literature and
      our own experience in a wound care unit. Biosurgery is an effective and safe
      treatment option for debridement and disinfection.

PMID- 11204518
TI  - Lepromatous leprosy in an HIV-positive patient in Spain.
AB  - We report a 35-year-old HIV-positive male affected by lepromatous leprosy which,
      to our knowledge, is the first case of its kind in Spain. The relationship
      between the two conditions is discussed.

PMID- 11204519
TI  - Radiation therapy for extensive actinic keratosis.
AB  - Actinic keratosis in the most common premalignant keratotic tumour of sun-exposed
      skin. A 66-year-old man developed a large actinic keratosis on his scalp, which
      did not respond to conventional treatment. Fractionated radiotherapy with a
      cumulative dose of 28 Gy resulted in complete remission without relapse during a
      14-month follow-up. In older subjects in whom conventional treatment fails, low
      dose fractionated radiation therapy is an effective alternative method.

PMID- 11204520
TI  - Activation of cutaneous sarcoidosis following Mycobacterium marinum infection of
      skin.
AB  - Sarcoidosis has long been associated with mycobacterial infection, especially
      with Mycobacterium tuberculosis, although a causal association has not been
      proven. Atypical mycobacteria have also been implicated in causing sarcoidosis,
      but there is as yet no conclusive evidence. We report the activation of cutaneous
      sarcoidosis following infection with M. marinum, raising further questions about
      the role of these bacteria in causing this chronic granulomatous disorder.

PMID- 11204521
TI  - Photodynamic therapy for in situ squamous cell carcinoma on chronic radiation
      dermatitis after photosensitization with 5-aminolaevulinic acid.
AB  - The accessibility of the skin to light treatment, as well as the developments
      made by dermatologists in photodynamic therapy (PDT), creates an exciting
      apportunity to include it as a part of our standard therapeutic armamentarium. We
      report a 63-year-old man with an in situ squamous cell carcinoma located on a
      chronic radiodermitis area in a finger, treated successfully with PDT. PDT
      appears to be a viable alternative to conventional therapy for in situ squamous
      cell carcinoma as well as for other superficial tumours of the skin.

PMID- 11204522
TI  - Type A Niemann-Pick disease.
AB  - Niemann-Pick disease (NPD) represents a type of lysosomal storage diseases in
      which sphingomyelin accumulates in the histocytes and reticuloendothelial cells
      of the spleen, liver, lymph nodes, bone marrow and central nervous system. We
      report a child with massive hepatosplenomegaly, lymphadenopathy, mental
      retardation and widespread papulonodular lesions. His clinical features conform
      to the type A subgroup of NPD.

PMID- 11204523
TI  - Recurrent R156H mutation of KRT10 in a Japanese family with bullous congenital
      ichthyosiform erythroderma.
AB  - Recently, mutations of keratin 1 gene (KRT1) and keratin 10 gene (KRT10) have
      been reported in various patients with bullous congenital ichthyosiform
      erythroderma (BCIE). The substitution of arginine (R) to histidine (H) at amino
      acid residue 156 (R156H) of coiled 1A region is one of the most frequent
      mutations of KRT10. In this study, we searched for a mutation in KRT1 and KRT10
      in a Japanese family with BCIE and detected mutation R156H in KRT10. Our search
      led to the detection of R156H. This mutation was not detected in 50 normal
      individuals. These results confirmed that codon 156 is a frequently mutated site,
      and that R156H in KRT10 is likely also to be a mutation hotspot in Japanese
      patients with BCIE.

PMID- 11204524
TI  - Basal cell carcinoma on the dorsum of the hand: report of 11 cases.
AB  - BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy,
      although the appearance on the dorsum of the hand appears to be rare. OBJECTIVES:
      The purpose of this study was to identify and describe patients with BCC of the
      dorsum of the hand in a large cohort of BCC patients and to provide a review of
      the literature. METHODS: Eleven patients with a BCC on the dorsum of the hand
      were identified. Information on age at diagnosis, sex, treatment and follow up,
      presence of additional malignancies, etc., was gathered from medical records.
      RESULTS: Between January 1985 and December 1995, 2990 BCCs were registered, of
      which 11 were located on the dorsal aspect of the hand (0.37%). Nine patients
      were male and most patients had a history of multiple skin malignancies. Most of
      the BCCs were nodular or had a nodular component. Solar elastosis was frequently
      seen. The percentage of 0.37% compares well with BCC located on the dorsum of the
      hand in other studies, but also with other parts of the body per skin surface
      area (except the face and neck area). CONCLUSIONS: The density of BCC on the
      dorsum of the hand is much lower than in the face and neck area but compares well
      with other parts of the body.

PMID- 11204525
TI  - Lycopenaemia.
AB  - Over the last few years, carotenoids have been studied extensively for their
      antioxidant activity and the supposed protective effects against cancer, in
      particular those of the digestive tract. Consumption of carotenoids as anti
      ageing agents is also widely diffuse. Moreover, the diffusion of slimming and
      vegetarian diets, and thus the consumption of fruit and vegetables, which contain
      large amount of carotenoids, is increasing. On the other hand, the excessive
      dietary intake of carotenoid-containing foods may cause different afflictions
      characterized by a 'yellow-orange' discoloration of the skin. One of these
      carotenoids, the lycopene, present in high concentrations in tomatoes, may cause
      a rare cutaneous disease called lycopenaemia.

PMID- 11204526
TI  - Pityriasis rosea associated with herpesvirus 7 DNA.

PMID- 11204527
TI  - Cellular neurothekeoma on the left auricle.

PMID- 11204528
TI  - Exacerbation of chronic large plaque psoriasis associated with Olanzepine
      therapy.

PMID- 11204529
TI  - Bullous pemphigoid in a psoriatic patient.

PMID- 11204530
TI  - A case of herpes zoster misdiagnosed and treated as unstable angina pectoris.

PMID- 11204531
TI  - Tuberculosis verrucosa cutis (TBVC).

PMID- 11204532
TI  - Treatment of oral condylomata acuminata in a HIV-1 patient with bleomycin.

PMID- 11204533
TI  - Extragenital pigmented lichen sclerosus.

PMID- 11204534
TI  - Epidermolytic hyperkeratosis (bullous ichthyosis).

PMID- 11204535
TI  - Primary antiphospholipid syndrome: an aggressive case.

PMID- 11204536
TI  - A useful criterion of cure in pemphigus vulgaris.

PMID- 11204537
TI  - Sweet's syndrome with eruption of pustulosis palmaris.

PMID- 11204538
TI  - Importance of visible lunula in healthy and diseased fingernail plates.

PMID- 11204539
TI  - Disseminated mucocutaneous blastomycosis in a immunocompetent Indian patient.

PMID- 11204540
TI  - Predicted wall shear rate gradients in T-type arteriolar bifurcations.
AB  - The purpose of this study was to examine the theoretical impact of the local
      bifurcation geometry on the shear rate gradient in a divergent arteriolar-type
      bifurcation. Newtonian flow through an arteriolar bifurcation was modeled using 3
      dimensional computational fluid dynamics (CFD). Branching angles of 30 degrees,
      50 degrees, 70 degrees, 90 degrees, 110 degrees, 130 degrees, and 150 degrees
      were studied at a Reynolds number (Re) of 0.01 in seven separate models. Both the
      flow split (30%) and the branch to main vessel diameter ratio (4/5) were held
      constant. Velocity profiles were predicted to deviate significantly from a
      parabolic form, both immediately before and after the branch. This deviation was
      shown to be a function of the local bifurcation geometry of each model, which
      consisted of a branching angle and associated feed-branch intersection shape.
      Immediately before and after the branch, the shear rate along the lateral
      branching wall was predicted to exceed (5-fold) that calculated for fully
      developed flow in the feed. In vivo data were from the anesthetized
      (pentobarbital, 70 mg/kg) hamster cremaster muscle preparation. Red blood cells
      were used as flow markers in arteriolar branch points (n = 74) show that a
      significant gradient in shear rate occurs at the locations and branch shapes
      predicted by the computational model. Thus, for low Re divergent flow, the
      gradient in shear rate measured for non-Newtonian conditions, is approximated by
      a finite element fluid dynamics model of Newtonian flow.

PMID- 11204541
TI  - Flow around cells adhered to a microvessel wall. I. Fluid stresses and forces
      acting on the cells.
AB  - To evaluate the fluid forces acting on cells adhered to a microvessel wall, we
      numerically studied the flow field around adherent cells and the distribution of
      the stresses on their surfaces. For simplicity, the cells were modeled as rigid
      particles attached to a wall of a circular cylindrical tube regularly in the flow
      direction, in a row or two rows. It was found that not the detailed shape of the
      model cells but their height from the vessel wall is a key determinant of the
      fluid forces and torque acting on them. In both arrangements of one row and two
      rows, the axial spacing between neighboring adherent cells significantly affects
      the distributions of the stresses on them, which results in drastic variations of
      the fluid forces with the axial spacing and the relative positions with respect
      to their neighboring cells. The drag force acting on an adherent cell in the
      vessel was evaluated to be larger than the value in the 2D chamber flow at the
      same wall shear stress, mainly due to much larger variations of the pressure
      distribution on the cell surface in the vessel flow.

PMID- 11204542
TI  - Correlated expression of adhesive properties for both white and red blood cells
      during inflammation.
AB  - The state of leukocyte and erythrocyte adhesiveness/aggregation was determined in
      the peripheral blood of 382 patients with infection/inflammation as well as in 72
      controls by using a simple slide test and image analysis. A highly significant
      correlation (r = 0.4, n = 455, p < 0.001) was found between the state of
      leukocyte and erythrocyte adhesiveness/aggregation. The extent of both leukocyte
      and erythrocyte aggregation correlated with the concentration of fibrinogen.
      Significant aggregation of leukocytes with erythrocytes was noted as well. We
      conclude that both leukocyte and erythrocyte aggregation occur in the peripheral
      blood of patients with infection/inflammation. Such cell aggregation, which might
      have detrimental rheological consequences, can be detected by using our novel
      technique.

PMID- 11204543
TI  - Visualization of flow-dependent concentration polarization of macromolecules at
      the surface of a cultured endothelial cell monolayer by means of fluorescence
      microscopy.
AB  - To substantiate the occurrence of flow-dependent concentration or depletion of
      atherogenic lipoproteins, which has been theoretically predicted to take place at
      a blood/endothelium boundary, we have studied the effects of perfusion pressure
      and wall shear rate on the accumulation and uptake of microspheres by cultured
      vascular endothelial cells in a monolayer. The study was carried out by flowing a
      cell culture medium containing fetal calf serum and fluorescent microspheres
      through a parallel-plate flow chamber having a cultured bovine aortic endothelial
      cell (BAEC) monolayer on one wall of the chamber. The microspheres had a nominal
      diameter of 19 nm, approximately the same as that of low-density lipoproteins,
      and thus served as models and tracers of plasma proteins and lipoproteins.
      Experiments were carried out in steady flow in the physiological range of wall
      shear rate and water filtration velocity at the monolayer, while monitoring the
      intensity of fluorescence of the spheres accumulated at and taken up by the
      endothelial cells. It was found that in a perfusate containing only fluorescent
      microspheres, due to increased phagocytic activity of the endothelial cells, the
      intensity of fluorescence which reflected the number of the microspheres taken up
      by the endothelial cells, increased almost linearly with time and independently
      of wall shear rate. However, with perfusates containing fetal calf serum, this
      abnormal phenomenon did not occur, and the intensity of fluorescence increased
      with increasing perfusion pressure and decreasing wall shear rate. It was also
      found that the number of fluorescent microspheres accumulated at and taken up by
      the BAEC monolayer was shear-dependent only at low wall shear rates, and
      increased sharply when the flow rate was reduced to zero. These results provided
      solid experimental evidence that flow-dependent concentration or depletion of
      macromolecules occurs at the luminal surface of the endothelium at physiological
      wall shear rates and water filtration velocities, and strongly supports the
      hypothesis that flow-dependent concentration polarization of lipoproteins plays
      an important role in the localization of atherosclerosis and intimal hyperplasia
      in man by facilitating the uptake of atherogenic lipoproteins by endothelial
      cells.

PMID- 11204545
TI  - Rheological evidence of the gelation behavior of hyaluronan-gellan mixtures.
AB  - It was found that solutions of calcium hyaluronate (CaHA) (0.1 to approximately
      0.5 wt%) could form a gel by mixing with solutions of sodium type gellan (0.1 to
      approximately 0.5 wt%), although neither polymer by itself forms a gel at low
      concentrations (0.1 to approximately 0.5 wt% in this experiment). The rheological
      properties of CaHA-gellan mixtures were investigated by dynamic and steady shear
      measurements. Both storage shear modulus G' and loss shear modulus G'' for CaHA
      gellan mixtures increased with increasing time, and tended to an equilibrium
      value after 1 h. After reaching steady values of G' and G", the frequency
      dependence of G' and G'' was observed. G' was always larger than G'' in the
      accessible frequency range from 10(-2) to 10(2) rad/s. The effects of pH and
      calcium ions were examined. Gel formation of the mixtures was promoted by
      decreasing pH and adding from 0.01 to 0.1 M calcium ions, but excessive calcium
      ions weakened the gel.

PMID- 11204544
TI  - Biomechanical and morphometric properties of the arterial wall referenced to the
      zero-stress state in experimental diabetes.
AB  - Morphometric and passive biomechanical properties were studied in isolated
      segments of the thoracic and abdominal aorta, left common carotid artery, left
      femoral artery and the left pulmonary artery in 20 non-diabetic and 28
      streptozotocin (STZ)-induced diabetic rats. The diabetic and non-diabetic rats
      were divided into groups living 1, 4, 8, and 12 weeks after the induction of
      diabetes (n = 7 for each diabetic group) or sham injection (n = 5 for each
      group). The mechanical test was performed as a distension experiment where the
      proximal end of the arterial segment was connected via a tube to the container
      used for applying pressures to the segment and the distal end was left free. The
      vessel diameter and length were obtained from digitized images of the arterial
      segments at pre-selected pressures and at no-load and zero-stress states.
      Circumferential and longitudinal stresses (force per area) and strains
      (deformation) were computed from the length, diameter and pressure data and from
      the zero-stress state data. The zero-stress state was obtained by cutting vessel
      rings radially causing the rings to open up into a sector. Diabetes was
      associated with pronounced morphometric changes, e.g., wall thickness. With
      respect to the biomechanical data, the opening angle increased and reached a
      plateau in 4 weeks after which it decreased again (p < 0.05). The opening angle
      was smallest in the thoracic aorta and largest in the pulmonary artery.
      Furthermore, it was found that the circumferential stiffness of the arteries
      studied increased with the duration of diabetes. In the longitudinal direction
      significant differences were found 8 weeks after injection of STZ in all arteries
      except the pulmonary artery. In the 12 weeks group, the femoral artery was
      stiffest in the circumferential direction whereas the thoracic aorta was stiffest
      in the longitudinal direction. The accumulated serum glucose level correlated
      with the arterial wall thickness and elastic modulus (correlation coefficient
      between 0.56 and 0.81).

PMID- 11204546
TI  - Osmotic fragility of the erythrocyte membrane: characterization by modeling of
      the transmittance curve as a function of the NaCl concentration.
AB  - The theoretical extinction of blood suspensions submitted to a slow dialysis is
      analyzed in terms of their NaCl concentration. The model involves two adjustable
      parameters, chi and K, related to swelling and hemolysis. During swelling, the
      erythrocyte volume is supposed to vary linearly with the saline concentration.
      During hemolysis, an exponential decay of the hemoglobin concentration in the
      erythrocyte is used. The theoretical transmittance curves are consistent with the
      measurements carried out at a wavelength of 0.808 microm on native and incubated
      blood samples. Chi and K are relevant parameters to characterize quantitatively
      the fragility of the erythrocyte membrane. The effect of a non ideal character of
      the hemoglobin solutions and of normal distributions of chi and K is also
      discussed.

PMID- 11204547
TI  - Aggregation behavior and electrophoretic mobility of red blood cells in various
      mammalian species.
AB  - Differences of red blood cell (RBC) aggregation among various mammalian species
      has been previously reported for whole blood, for RBC in autologous plasma, and
      for washed RBC re-suspended in polymer solutions. The latter observation implies
      the role of cellular factors, yet comparative studies of such factors are
      relatively limited. The present study thus investigated RBC aggregation and RBC
      electrophoretic mobility (EPM) for guinea pigs, rabbits, rats, humans and horses;
      RBC were re-suspended in isotonic 500 kDa dextran solutions for the EPM and
      aggregation measurements, with aggregation studies also done in autologous
      plasma. Salient results included: (1) species-specific RBC aggregation in both
      plasma and dextran (horse > human > rat > rabbit approximately = guinea pig) with
      a significant correlation between aggregation in the two media; (2) similar EPM
      values in PBS for rat, human and horse, a lower value for guinea pig, and a
      markedly reduced EPM for rabbit RBC; (3) EPM values in dextran with a rank order
      identical to that for cells in PBS; (4) relative EPM results indicating formation
      of a polymer-poor, low viscosity depletion layer at the RBC surface (greatest
      depletion for horse RBC). EPM-aggregation correlations were evident and generally
      consistent with the Depletion Model for aggregation, yet did not fully explain
      differences between species; additional studies at various ionic strengths and
      with various dextran fractions thus seem warranted.

PMID- 11204548
TI  - Dielectric approach to investigation of erythrocyte aggregation. II. Kinetics of
      erythrocyte aggregation-disaggregation in quiescent and flowing blood.
AB  - A method based on dielectric properties of dispersed systems was applied to
      investigate the kinetics of RBC aggregation and the break-up of the aggregates.
      Experimentally, this method consists of measuring the capacitance at a frequency
      in the beginning of the beta-dispersion. Two experimental protocols were used to
      investigate the aggregation process. In the first case, blood samples were fully
      dispersed and then the flow was decreased or stopped to promote RBC aggregation.
      It was found that the initial phases of RBC aggregation are not affected by the
      shear rate. This finding indicates that RBC aggregation is a slow coagulation
      process. In the second case, RBCs aggregated under flow conditions at different
      shear rates and after the capacitance reached plateau levels, the flow was
      ceased. The steady-state capacitance of the quiescent blood and the kinetics of
      RBC aggregation after stoppage of shearing depend on the prior shear rate. To
      clarify the reasons for this effect, the kinetics of the disaggregation process
      was studied. In these experiments, time courses of the capacitance were recorded
      under different flow conditions and then a higher shear stress was applied to
      break up RBC aggregates. It was found that the kinetics of the disaggregation
      process depend on both the prior and current shear stresses. Results obtained in
      this study and their analysis show that the kinetics of RBC aggregation in stasis
      consists of two consecutive phases: At the onset, red blood cells interact face
      to-face to form linear aggregates and then, after an accumulation of an
      appropriate concentration of these aggregates, branched rouleaux are formed via
      reactions of ends of the linear rouleaux with sides of other rouleaux (face-to
      side interactions). Branching points are broken by low shear stresses whereas
      dispersion of the linear rouleaux requires significantly higher energy.

PMID- 11204549
TI  - Antidotes--inappropriate timely availability.
AB  - The aim of this study was to determine the availability of antidotes to poisons
      in Wales and the South West of England. A stocklist of antidotes that are
      available to accident and emergency departments was requested and was compared
      with recommendations from the International Programme on Chemical Safety (IPCS).
      Chief pharmacists were invited to complete a short questionnaire regarding
      knowledge of existing guidelines. Thirty-four of 43 centres replied (response
      rate 77%). No department held all 36 antidotes (mean 13, range 7-33). All
      departments held antidotes that were frequently used. Ninety-one percent of
      departments held one cyanide antidote. Eighty-eight percent held one heavy metal
      chelating agent. The remaining antidotes were variably stocked. New agents such
      as 4-methylpyrazole, hydroxocobalamin and the heavy metal chelating agents DMSA
      and DMPS were infrequently held. Twenty of 34 chief pharmacists were unfamiliar
      with existing UK guidelines. A trend exists whereby larger departments stocked
      more antidotes. Some antidotes to poisons are not available in a timely fashion
      in Wales and the South West of England. There is a lack of awareness of existing
      guidelines. New recommendations relevant to clinical need and local practice
      should ideally be developed.

PMID- 11204550
TI  - Dose-dependent toxicity of diphenhydramine overdose.
AB  - BACKGROUND: Diphenhydramine (DPHM) overdose is a frequent cause of acute
      poisoning. Although its clinical features are well known, information about the
      dose-dependent toxicity of DPHM is still scarce. The objective of this study was
      to investigate the dose-dependent toxicity of DPHM in patients with acute DPHM
      poisoning. METHODS: We have analyzed retrospectively all well-documented cases
      with DPHM monointoxications reported by physicians to the Swiss Toxicological
      Information Centre (STIC) between January 1984 and April 1996. In addition, a
      prospective study focusing on ingested DPHM doses and severity of symptoms was
      performed between May 1996 and December 1998. RESULTS: The retrospective and
      prospective studies included 232 and 50 patients with DPHM monointoxications,
      respectively. In both studies, mild symptoms (somnolence, anticholinergic signs,
      tachycardia, nausea/vomiting) occurred in 55-64%, moderate symptoms (isolated and
      spontaneously resolving agitation, confusion, hallucinations and ECG
      disturbances) in 22-27% and severe symptoms (delirium/psychosis, seizures, coma)
      in 14-18% of patients. Moderate symptoms occurred above ingested doses of 0.3 g
      DPHM. For severe symptoms the critical dose limit was 1.0 g DPHM. Although the
      frequency of delirium/psychosis remained constant or even decreased, coma and
      seizures were significantly (p<0.05) more frequent in the >1.5-g compared with
      the 1.0- to 1.5-g-dose group. CONCLUSIONS: These data demonstrate a clear dose
      dependent acute toxicity of DPHM. They indicate that only patients with DPHM
      ingestions above 1.0 g are at risk for the development of severe symptoms and,
      therefore, should be hospitalized. Thus, the results contribute to the data basis
      required for a cost effective management of patients with DPHM overdose.

PMID- 11204551
TI  - Assessment of thyroid function in pesticide formulators.
AB  - Thirty male pesticide formulators exposed to the dust and liquid formulation of
      endosulfan, quinalphos, chlorpyriphos, monocrotophos, lindane, parathion,
      phorate, and fenvalerate and 20 comparable control subjects from the same area of
      study were examined for the evaluation of thyroid function tests. The level of
      TSH was elevated (about 28%) in pesticide formulators as compared to a control
      group, but the increase was statistically insignificant. Based on the individual
      TSH measurement, 3 of 30 formulators had isolated elevated levels of TSH and seem
      to have acquired sub-clinical hypothyroidism; five had TSH values slightly
      elevated to the upper boarder line (4.03 muIU/ml); and the majority of
      formulators (N= 22) had TSH values in the normal range varying from 1.29 to 3.9
      muIU/ml. Total T3 was suppressed significantly (P< 0.01) in formulators, while
      marginal decrease (about 7%) was noticed in T4 level. This study indicated
      thyroid function impairment in few pesticide formulators.

PMID- 11204552
TI  - Effects of antioxidants and a caspase inhibitor on chloramphenicol-induced
      toxicity of human bone marrow and HL-60 cells.
AB  - Chloramphenicol (CAP), a board spectrum antibiotic widely used in many developing
      countries, has toxic side effects on bone marrow, the most serious of which is
      aplastic anemia. Recent studies suggest that effects of CAP on suppressing
      hematopoietic colony formation may be abrogated by antioxidants. In addition,
      there is preliminary evidence that CAP induces apoptosis in hemopoietic stem
      cells, leading to aplastic anemia. We have been unable to demonstrate the
      protective effects of a variety of antioxidants on CAP-induced suppression of
      burst-forming unit erythroid (BFU-E) and colony-forming unit granulocyte/monocyte
      (CFU-GM). Using flow cytometry, we have, however, confirmed that CAP can induce
      apoptosis in purified human bone marrow CD34+ cells. We also showed that a
      caspase inhibitor, Z-VAD.fmk, can ameliorate the apoptotic-inducing effects of
      CAP in the HL-60 cell line.

PMID- 11204553
TI  - Rates of spontaneous reactivation and aging of acetylcholinesterase in human
      erythrocytes after inhibition by organophosphorus pesticides.
AB  - The in vitro rates of spontaneous reactivation and aging in human erythrocyte
      acetylcholinesterase were studied after inhibition by a dimethoxy (R1R2) and
      diethoxy substituted (R1R2) organophosphate pesticide (OP) of general structure
      R1R2P(O)X. These have been compared with data for human plasma cholinesterase
      previously reported using a similar methodology. A significantly slower rate of
      aging for erythrocyte acetylcholinesterase was found compared to plasma
      cholinesterase, whether inhibited by dimethoxy or diethoxy substituted OPs. For
      diethoxy OPs the rate of spontaneous reactivation of the inhibited plasma enzyme
      was significantly slower than for the inhibited red cell enzyme. This
      acetylcholinesterase, and previously published plasma cholinesterase, data
      suggest that in practise a blood sample taken 30-40 h after significant acute OP
      exposure will still show inhibition in either plasma or erythrocyte
      cholinesterase when analysed, but that any inhibited plasma enzyme is more likely
      to be in the aged form. In contrast a substantial proportion of the erythrocyte
      acetylcholinesterase is found unaged and therefore sensitive to reactivation by
      oximes. Samples from an occupational exposure where depressions in plasma or
      erythrocyte cholinesterase activity from baseline measurements were reactivated
      ex vivo using the oxime 2-PAM support this hypothesis. These data also confirm
      that the plasma enzyme is a more sensitive than erythrocyte acetylcholinesterase
      as an indicator of OP exposure and thus the potential value of ex vivo oxime
      reactivation of erythrocyte acetylcholinesterase in a blood sample to indicate
      subclinical OP exposure may be limited. However, this study is too small to draw
      conclusions on the sensitivity of ex vivo oxime reactivation of
      acetylcholinesterase as a novel biomarker of excessive OP absorption. Given that
      there is a better relationship between anticholinergic symptoms and red cell
      acetylcholinesterase inhibition, and that the slower resynthesis rate of any aged
      or inhibited red cell enzyme may be interpretatively useful when venepuncture is
      delayed, it is suggested that red cell acetylcholinesterase activity does have a
      place in monitoring potential OP exposure.

PMID- 11204555
TI  - Effect of thiamine on the cadmium-chelating capacity of thiol compounds.
AB  - The influence of thiamine on the efficacy of meso-2,3-dimercaptosuccinic acid
      (DMSA), diethyldimercapto succinate (DEDMS), alpha mercapto-beta-(2-furyl)
      acrylic acid (MFA) and alpha-mercapto-beta-(2-thienyl) acrylic acid (MTA) to
      mobilize cadmium and reverse cadmium-induced biochemical alterations was
      investigated in cadmium-exposed rats. The thiamine coadministration enhanced the
      efficacy of MFA and MTA in reducing hepatic and renal burden of cadmium and that
      of DMSA and DEDMS in mobilizing hepatic cadmium. It also improved the efficacy of
      DMSA, DEDMS and MFA in reversing the cadmium-induced increase in urinary alkaline
      phosphatase and aspartate and alanine amino transaminases. The combined treatment
      with thiamine and DMSA or MFA restricted the urinary loss of zinc and that with
      thiamine and DEDMS reduced the loss of fecal copper, a general effect of
      chelation. In conclusion, the administration of thiamine during chelation therapy
      in cadmium poisoning may be beneficial and more effective than thiol chelating
      agents alone, which needs to be confirmed in humans.

PMID- 11204554
TI  - Isoniazid- and rifampicin-induced oxidative hepatic injury--protection by N
      acetylcysteine.
AB  - The role of N-acetylcysteine (NAC), a glutathione (GSH) precursor, was
      investigated in protection against isoniazid- (INH) and rifampicin- (RIF) induced
      oxidative hepatic injury in young Wistar rats. The hepatotoxic dose of INH and
      RIF was 50 mg kg(-1) day(-1) each and the hepatoprotective dose of NAC was 100 mg
      kg(-1) day(-1). All drugs were administered intraperitoneally (i.p.) in sterile
      water (4.0 ml kg(-1) day(-1)) over a period of 3 weeks. Status of
      oxidative/antioxidative profiles was the mechanistic approach to assess the
      hepatotoxicity and/or hepatoprotection. The oxidative injury in INH-RIF co
      exposed animals was closely associated with significant decline of GSH and
      related thiols, as well as with compromised antioxidant enzyme system. The
      oxidative stress was further supported by increased lipid peroxidation observed
      in these animals. The co-administration of NAC prevented the induction of
      oxidative stress in INH-RIF co-exposed animals. The amelioration of oxidative
      stress by NAC was faithfully reflected as normal morphology in these animals,
      except the presence of mild degree of portal triaditis in one animal co-exposed
      to INH-RIF and NAC. In contrast, the animals co-exposed to INH-RIF alone showed
      histological lesions which ranged from intralobular inflammation to patchy
      necrosis. These results suggest that INH-RIF-induced oxidative injury can be
      prevented by supporting the cellular antioxidant defense mechanism by NAC.

PMID- 11204556
TI  - Plasma absorption and ultrastructural changes of rat testicular cells induced by
      lindane.
AB  - This paper describes, for the first time, how topical application in rats of a
      commercial preparation of lindane widely used in public health, at similar doses
      and routes of administration as in humans, leads to rapid absorption and
      accumulation of lindane in the testes. An early peak of absorption was detected
      in plasma 6 h after topical treatment of male Wistar rats with a commercial
      preparation of 1% lindane (Plomurol). Higher plasma levels were observed after
      repetitive doses of 60 mg/kg b.w., the amount recommended for the treatment of
      scabies and pediculosis in humans in several countries. A residue level of 7.4 +/
      0.67 microg/g was found in testicular tissue 6 h after a single daily topical
      application for 4 consecutive days. The ultrastructural study of testicular
      interstitial cells exposed to dermal application of lindane (Plomurol) revealed
      widespread damage of a great number of Leydig cells, some of which were
      completely disintegrated.

PMID- 11204558
TI  - TAFI meets the sticky ends.

PMID- 11204557
TI  - Frequency and Markov chain analysis of amino acid sequences of mouse p53.
AB  - The amino acid sequence of mouse p53 was measured according to two- and three
      amino-acid sequences. The measured frequency and probability were compared with
      predicted frequency and probability. Of 389 two-amino-acid sequences in mouse
      p53,85 (21.851%) and 27 (6.941%) sequences can be explained by the predicted
      frequency and probability according to a purelyrandom mechanism. Of 188 non
      appearing two-amino-acid sequences in mouse p53, 86 (45.745%) and 32 (17.021%)
      can be explained by the predicted frequency and probability according to a purely
      random mechanism; no more than two-amino-acid sequences in mouse p53 can be
      explained by a purely random mechanism.

PMID- 11204559
TI  - Molecular mechanism of type I congenital heparin cofactor (HC) II deficiency
      caused by a missense mutation at reactive P2 site: HC II Tokushima.
AB  - We found a 66-year-old Japanese patient with type I congenital heparin cofactor
      (HC) II deficiency manifesting multiple atherosclerotic lesions. To investigate
      the molecular pathogenesis of our patient, we performed sequencing analysis and
      expressed recombinant human wild-type and mutant HC II molecules in COS-1 and CHO
      K1 cells. Sequencing analysis following amplification of each of all 5 exons and
      its flanking region showed a single C to T transition at nucleotide position
      12,854 in exon 5, which changed a Pro443 codon (CCG) to Leu codon (CTG). Because
      this mutation generates a new Bhv I site, the Bbv I digestion pattern of the PCR
      amplified exon 5 fragments from each family member was analyzed. In all cases,
      the patterns were consistent with the activities and antigen levels of plasma HC
      I1 in those members. Transient transfection, metabolic labeling and pulse-chase
      experiments followed by immunoprecipitation analysis showed that the recombinant
      mutant HC II molecules were secreted from COS-1 cells in reduced amounts compared
      with the wild-type, and that an enhanced intracellular association of the mutant
      molecules with a chaperone, GRP78/BiP, was observed in CHO-K1 cells. Northern
      blot analysis indicated that the mutant HC I1 mRNA was transcribed at a similar
      level as that of wild-type. Immunohistochemical staining of the transfected cells
      revealed that COS-1 cells expressing the mutant HC II molecules were stained
      mainly in the perinuclear area. We conclude that the impaired secretion of the
      mutant HC II molecules, due to intracellular degradation, is the molecular
      pathogenesis of type I congenital HC II deficiency caused by a Pro443 to Leu
      mutation at reactive P2 site.

PMID- 11204560
TI  - Fibrinogen Matsumoto V: a variant with Aalpha19 Arg-->Gly (AGG-->GGG). Comparison
      between fibrin polymerization stimulated by thrombin or reptilase and fibrin
      monomer polymerization.
AB  - Fibrinogen Matsumoto V (M-V) is a dysfibrinogen identified in a 52-year-old woman
      with systemic lupus erythematous. The triplet AGG encoding the amino acid residue
      Aalpha19 was replaced by GGG, resulting in the substitution of Arg-->Gly. Residue
      Aalpha19 has been shown to be one of the most important amino acids in the so
      called 'A' site or alpha-chain knob. The thrombin-catalyzed release of
      fibrinopeptide A from M-V fibrinogen was only slightly delayed yet release of
      fibrinopeptide B was significantly delayed. Both thrombin-catalyzed fibrin
      polymerization and fibrin monomer polymerization were markedly impaired compared
      to normal fibrinogen. In addition, reptilase-catalyzed fibrin polymerization of M
      V was much more impaired than thrombin-catalyzed fibrin polymerization. These
      results indicate 'B' and/or 'b' site of M-V fibrinogen play a more important role
      in thrombin-catalyzed fibrin polymerization than that of normal control
      fibrinogen.

PMID- 11204561
TI  - Antithrombotic efficacy in a rat model of the low molecular weight heparin,
      reviparin sodium, administered by the oral route.
AB  - Previous studies in rats show that unfractionated heparin and the low molecular
      weight heparin logiparin have a dose-dependent antithrombotic effect and are
      found in endothelium and plasma when administered orally. Objectives of the
      present study were to determine if similar evidence of absorption could be
      observed with oral reviparin sodium. Thrombosis incidence was determined 4 h
      after application of 10% formalin in methanol to the exposed jugular vein. A dose
      dependent antithrombotic effect was observed when 0.01 to 7.5 mg/kg (20
      rats/group) was administered by stomach tube immediately following thrombus
      initiation. Thrombotic incidence was also significantly reduced when 0.025 mg/kg
      was given 4 and 2 h prior to, immediately after, and 2 and 3 h following thrombus
      initiation. Reviparin was recovered from endothelium and plasma in trace amounts
      at all doses. At 0.025 mg/kg, peak aortic endothelial reviparin concentrations
      were found at 1 and 2 h and peak plasma anti-Xa activity was detected at 2 h.
      Trace amounts of plasma TFPI were found only at 8 h after administration. Dose
      dependent antithrombotic activity and recovery from endothelium and plasma
      support the hypothesis that orally administered reviparin sodium is absorbed.

PMID- 11204562
TI  - Factor XII-dependent contact activation on endothelial cells and binding proteins
      gC1qR and cytokeratin 1.
AB  - Although proteins of the kinin-forming pathway are bound along the surface of
      endothelial cells, the mechanism of activation of this proteolytic cascade is
      unclear. Endothelial cell surface proteins, gC1qR and cytokeratin 1, are capable
      of binding Factor XII and high molecular weight kininogen (HK) in a zinc
      dependent reaction thus we considered the possibility that these proteins might
      catalyze initiation of the cascade. Incubation of Factor XII, prekallikrein, and
      HK with gC1qR or cytokeratin 1 leads to a zinc-dependent and Factor XII-dependent
      conversion of prekallikrein to kallikrein. We also demonstrate that normal plasma
      is capable of activating upon interaction with the cells whereas plasma deficient
      in Factor XII, prekallikrein and HK do not activate. Normal plasma activation was
      inhibitable by antibody to gC1qR and cytokeratin 1. Thus, gC1qR and cytokeratin
      1, represent potential initiating surfaces for activation of the plasma kinin
      forming cascade and may do so as a result of their expression along cell
      surfaces.

PMID- 11204563
TI  - Immunological assay for the determination of procarboxypeptidase U antigen levels
      in human plasma.
AB  - The importance of carboxypeptidase U as a novel regulator of the fibrinolytic
      rate has attracted a lot of interest recently. In the present work, an ELISA was
      developed using polyclonal antibodies raised against recombinant proCPU,
      expressed in DON cells. The assay determines the antigen concentration of the
      zymogen of carboxypeptidase U, procarboxypeptidase U, in human citrated plasma or
      EDTA plasma. No interference is observed with plasma carboxypeptidase N. The
      assay is very reproducible (within-run: 4.6% CV, between-run: 6.8% CV). In a
      group of 479 healthy individuals the mean proCPU antigen concentration is 13.4
      microg/ml (SD 2.5 microg/ml). A good correlation is found with the functional
      procarboxypeptidase U assay described earlier (r = 0.82, p < 0.0001) (Schatteman
      K, Goossens F, Scharpe S, Neels H, Hendriks D Clin Chem 1999: 45: 807-813). The
      significant correlation between the proCPU antigen concentration and the 50% clot
      lysis time stresses its importance as a player in fibrinolysis control.

PMID- 11204564
TI  - Mechanism of the immune response to human factor VIII in murine hemophilia A.
AB  - Mice genetically deficient in factor VII (fVIII) are a model of hemophilia A. As
      a first step to reproduce in this mouse model what occurs over time in hemophilia
      A patients treated with human fVIII (hfVIII), we have investigated the time
      course and the characteristics of their immune response to hfVIII, after multiple
      intravenous injections. Anti-hfVIII antibodies appeared after four to five
      injections. They were IgG1 and to a lesser extent IgG2, indicating that they were
      induced by both Th2 and Th1 cells. Inhibitors appeared after six injections. CD4+
      enriched splenocytes from hfVIII-treated mice proliferated in response to fVIII
      and secreted IL-10: in a few mice they secreted also IFN-gamma and in one mouse
      IL-4, but never IL-2. A hfVIII-specific T cell line derived from hfVIII-treated
      mice secreted both IL-4 and IFN-gamma, suggesting that it included both Th1 and
      Th2 cells. CD4+ enriched splenocytes of hfIII-treated mice recognized all hfVIII
      domains. Thus, hemophilic mice develop an immune response to hfVIII administered
      intravenously similar to that of hemophilia A patients. Their anti-hfVIII
      antibodies can be inhibitors and belong to IgG subclasses homologous to those of
      inhibitors in hemophilic patients; their anti-hfVIII CD4+ cells recognize a
      complex repertoire and both Th1 and Th2 cytokines, and especially IL-10, may
      drive the antibody synthesis.

PMID- 11204565
TI  - CD63 associates with the alphaIIb beta3 integrin-CD9 complex on the surface of
      activated platelets.
AB  - The tetraspanins are integral membrane proteins expressed on cell surface and
      granular membranes of hematopoietic cells and have been identified in multi
      molecular complexes with specific integrins. In resting platelets, CD63, a member
      of the tetraspanin superfamily, is present in dense granule and lysosomal
      membranes and, following platelet activation, translocates to the plasma
      membrane. In the present study, platelet activation by thrombin leads to
      incorporation of CD63 into the Triton-insoluble actin cytoskeletal fraction. This
      incorporation was inhibited by preincubation of platelets with RGDS or EGTA and
      did not occur in platelets from a patient with Glanzmann's thrombasthenia,
      suggesting that it was dependent upon alphaIIbbeta3. In activated platelets, the
      anti-CD63 MoAb, D545, co-immunoprecipitated CD63 with other surface-labeled
      proteins, including alphaIIbbeta3 and another tetraspanin, CD9. The association
      of CD63 with CD9 and alphaIIbbeta3, was not inhibited by preincubation of
      platelets with RGDS or EGTA. D545 did not inhibit the adhesion of activated
      platelets to purified extracellular matrix proteins, but significantly decreased
      adhesion of thrombin-activated platelets to neutrophils in a rosetting assay.
      D545 also caused disaggregation of platelets stimulated by ADP, but had no effect
      on aggregation induced by other agonists. These results are consistent with the
      proposal that CD63 becomes part of an alphaIIbbeta3-CD9-CD63 integrin-tetraspanin
      complex in activated platelets--an association that may modulate the function of
      alphaIIbbeta3-dependent interaction with other cells such as neutrophils.

PMID- 11204566
TI  - Expression of translation initiation factors elF-4E and elF-2alpha and a
      potential physiologic role of continuous protein synthesis in human platelets.
AB  - It is generally believed that platelets do not have a functionally significant
      protein synthetic machinery. However, our analysis demonstrated that normal bone
      marrow megakaryocytes express high levels of translation initiation factors eIF
      4E and eIF-2alpha and the expression of these protein synthesis initiation
      factors is continued in platelets (as determined by immunohistochemistry and
      Western blot analysis). Both eIF-4E and eIF-2alpha are key regulators of protein
      synthesis. The eIF-4E is a rate-limiting part of a multisubunit complex, eIF-4F,
      that binds to the 5' cap structure present in virtually all eukaryotic mRNAs, and
      carries out transfer of mRNAs to ribosomes for translation. Translation
      initiation factor eIF-2alpha is also a rate-limiting protein which associates
      with two other proteins to form an eIF-2 initiation factor complex responsible
      for the transfer of initiator methionyl-tRNA to the 40S ribosomal subunit. We
      confirm that expression of eIF-4E and eIF-2alpha is biologically relevant in that
      platelets continue protein synthesis, albeit at a 16 times lower rate than WBC
      (as determined by 35S-labeled amino acid incorporation, SDS-PAGE and
      scintillation counting). Finally, we determined that protein synthesis inhibitors
      (puromycin and emetine) attenuate the platelet aggregation response to a
      combination of ADP and epinephrine, but potentiate the response to collagen. Our
      data are consistent with the existence of different signal transducing pathways
      mediating the response to ADP/epinephrine and collagen. We suggest that the
      ADP/epinephrine response is positively affected by continuously synthesized
      proteins, while the response to collagen is modulated by continuously produced
      inhibitory proteins. Taken together, our results suggest that continuous protein
      synthesis is important for platelet function and its role in platelet physiology
      and pathophysiology deserves further study.

PMID- 11204567
TI  - Platelets exposed to elevated levels of endogenous thrombopoietin in vivo have a
      reduced response to megakaryocyte growth and development factor in vitro.
AB  - Thrombopoietin (TPO), or megakaryocyte growth and development factor (MGDF), has
      been shown to potentiate the sensitivity of normal human platelets to various
      agonists in vitro. The present study investigated the functional and biochemical
      properties of platelets from mice rendered thrombocytopenic by sublethal
      irradiation with regard to the reactivity to recombinant murine MGDF (rmMGDF) in
      vitro. During the course of reversible thrombocytopenia following irradiation,
      platelets from irradiated mice which had lower platelet counts and reciprocally
      higher plasma TPO levels showed lower reactivity to rmMGDF in agonist-induced
      platelet aggregation. Intravenous injections of recombinant soluble murine c-Mpl
      (sMpl), which has the ability to capture TPO, after irradiation restored the
      reactivity of platelets at the platelet nadir to rmMGDF. On the other hand,
      platelets prepared from normal mice 3 h after a single intravenous injection of
      pegylated rmMGDF did not respond to rmMGDF. There was a marked decrease in c-Mpl
      and Janus kinase 2 (JAK2) in platelets from irradiated mice at the platelet
      nadir. Similar results were observed with platelets from mice administered
      pegylated rmMGDF. JAK2 was only moderately decreased, however, in platelets from
      mice given sMpl after irradiation. These results indicate that exposure of
      platelets to increased endogenous TPO levels in vivo in thrombocytopenic mice
      leads to a reduction in the platelet reactivity to rmMGDF in vitro. Further,
      these results suggest that the c-Mpl-mediated signaling pathway, which is
      essential for the priming effect of rmMGDF, is defective in thrombocytopenic
      murine platelets.

PMID- 11204568
TI  - Lack of in vivo function of CD31 in vascular thrombosis.
AB  - A murine model of endothelial cell injury-based vascular thrombosis was used to
      test the role of platelet-endothelial cell adhesion molecule-1 (PECAM-1, CD31) in
      blood cell aggregate formation and vessel occlusion in vivo. Photochemically
      induced thrombus formation was analyzed in detail using intravital fluorescence
      microscopy of individual microvessels in cremaster muscle preparations of CD31
      deficient and wildtype mice. In venules, epi-illumination induced rapid thrombus
      formation with first platelet deposition after 0.56 +/- 0.11 min and complete
      vessel occlusion within 5.05 +/- 0.45 min. In arterioles, thrombus formation was
      markedly delayed with first platelet deposition after 3.03 +/- 0.47 min and
      complete vessel occlusion within 10.04 +/- 1.26 min. Kinetics of thrombus
      formation in both venules (first platelet deposition: 0.52 +/- 0.1 min; vessel
      occlusion: 5.03 +/- 0.52 min) and arterioles (first platelet deposition: 3.06 +/-
      0.68 min; vessel occlusion: 10.02 +/- 1.38 min) of CD31-deficient mice was found
      almost identical compared with that in wildtype animals. Tail bleeding time was
      233 +/- 24 s in wildtype and 243 +/- 32 s in CD31-deficient mice. Moreover, CD31
      deficient and wildtype mice revealed comparable interaction of leukocytes to
      endothelium. This study shows for the first time in vivo that CD31 is not
      critically involved in blood cell thrombus formation upon endothelial cell
      injury.

PMID- 11204569
TI  - Serum prostaglandin D synthase level after coronary angioplasty may predict
      occurrence of restenosis.
AB  - Lipocalin-type prostaglandin D synthase (L-PGDS), which is responsible for the
      biosynthesis of PGD2, has recently been found to be present in the
      atherosclerotic plaque of the human coronary artery and also to be secreted in
      human serum. We measured the serum L-PGDS level and compared it with the
      expressions of the platelet membrane surface glycoprotein and neutrophil adhesion
      molecule in patients undergoing PTCA. The L-PGDS level significantly decreased (P
      < 0.01) and the platelet surface expression of CD62P (P-selectin) significantly
      increased (P < 0.01) immediately after PTCA in the coronary sinus blood. Both
      changes were inversely correlated (R = -0.72, P < 0.001). Although the L-PGDS
      level in the coronary sinus blood remained equivalent to the baseline level in
      patients who experienced restenosis, the level increased over the baseline level
      (P < 0.01) at 48 h after PTCA in patients without restenosis. Neutrophil surface
      expression of CD11b (alpha subunit of Mac-1) significantly increased at 24 h (P <
      0.01) to 48 h (P < 0.001) after PTCA in the coronary sinus blood in patients with
      restenosis but the change showed less significant in patients without restenosis.
      The changes in the L-PGDS level and the CD11b expression at 48 h after PTCA were
      inversely correlated (R = -0.55, P < 0.05). An increased serum L-PGDS level at 48
      h after PTCA possibly predicts the avoidance of late restenosis. It is suggested
      that reduction in PGD2 synthesis triggers platelet activation and that a
      subsequent increase in the PGD2 synthesis suppresses inflammatory reaction at the
      intervention site indicated by neutrophil activation and inhibits development of
      restenosis. Pharmacological or biological intervention that increases endogenous
      PGD2 synthesis should be tested as a new strategy to prevent restenosis.

PMID- 11204571
TI  - Exogenous factors from animal sources that induce platelet aggregation.

PMID- 11204570
TI  - Expression of vascular endothelial growth factor in human monocyte/macrophages
      stimulated with lipopolysaccharide.
AB  - Vascular endothelial growth factor (VEGF) is a mitogen for endothelial cells. We
      have studied the production of VEGF by human macrophages in response to
      lipopolysaccharide (LPS). Macrophages stimulated with LPS expressed VEGF mRNA and
      protein in concentration- and time-dependent manners. The LPS-induced expression
      of VEGF was inhibited by cycloheximide pretreatment, which suggested that
      synthesis of certain factor(s) is required for the LPS activity. The induction of
      VEGF was also suppressed by SB203580, an inhibitor of p38 mitogen-activated
      protein (MAP) kinase. These results suggest that the LPS-induced VEGF expression
      depends on the p38-mediated expression of c-Jun, which constitutes the AP-1
      complex and binds to the AP-1 site in the VEGF promoter. Pretreatment of the
      cells with dexamethasone did not affect the LPS-induced upregulation of VEGF mRNA
      but strongly inhibited VEGF protein production, and the involvement of
      posttranscriptional regulation on VEGF expression by dexamethasone was suggested.
      The conditioned medium of LPS-stimulated macrophages enhanced the growth of
      cultured endothelial cells and it was inhibited by an antibody against VEGF. We
      conclude that macrophages produce VEGF in response to the stimulation with LPS,
      which may be partly mediated by the p38 MAP kinase pathway.

PMID- 11204572
TI  - Exogenous inhibitors of platelet aggregation from animal sources.

PMID- 11204573
TI  - Circulating procoagulant microparticles in women with unexplained pregnancy loss:
      a new insight.
AB  - One of the frequently proposed mechanisms for pregnancy losses refers to
      uteroplacental thrombosis. However the contribution of classical thrombotic risk
      factors remains questionable and, if real, does not account for a large number of
      pregnancy losses. The aim of this study was to investigate the presence of
      circulating procoagulant microparticles, a new marker of cell activation already
      associated with various prothrombotic clinical settings. Microparticles were
      assessed by an original prothrombinase assay on platelet depleted plasma obtained
      from 74 women with a history of pregnancy loss without apparent cause and 50
      controls. Patients were studied at least 2 months after the last obstetrical
      event and were classified into 2 groups: 49 women with at least 3 consecutive
      spontaneous abortions at or before the 10th postmenstrual week and 25 with at
      least one fetal death beyond the 10th postmenstrual week. Among the 74 patients,
      41 had increased levels of circulating microparticles, 29 belonging to the group
      of early pregnancy loss (59%) and 12 to the group of late pregnancy loss (48%).
      The high prevalence of increased levels of procoagulant microparticles in both
      groups makes this new marker very promising for the understanding, follow up and
      therapeutical handling of pregnancy loss.

PMID- 11204574
TI  - The role of the glycoprotein IIb fibrinogen receptor subunit T2622G gene
      polymorphism (HPA-3) on coronary artery disease and acute myocardial infarction.

PMID- 11204575
TI  - Von Willebrand factor does not vary during normal menstrual cycle.

PMID- 11204576
TI  - A rapid assay for the vWF protease.

PMID- 11204577
TI  - Performances of the VIDAS D-dimer new assay for the exclusion of venous
      thromboembolism.

PMID- 11204578
TI  - Relationships between homocysteine, folate and vitamin B12 levels with the
      methylenetetrahydrofolate reductase polymorphism, in Indians from Western
      Venezuela.

PMID- 11204579
TI  - A rebuttal--the Rsal polymorphism in the alpha-fibrinogen gene and response of
      plasma fibrinogen to physical training.

PMID- 11204580
TI  - Effects of fluvastatin and bezafibrate combination on plasma fibrinogen, t
      plasminogen activator inhibitor and C reactive protein levels in coronary artery
      disease patients with mixed hyperlipidaemia (FACT Study)--a rebuttal.

PMID- 11204581
TI  - Stroke in young adults: the role of paradoxical embolism.
AB  - Stroke in young adults may be devastating and frequently no cause can be found.
      However, there is ample literature to suggest an association between cryptogenic
      stroke in young people and paradoxical embolisation via a venous to arterial
      circulation shunt (v-aCS), commonly due to patent foramen ovale (PFO). Although
      paradoxical embolisation is assumed to be a rare event, this review suggests that
      it is an important or even dominant cause of stroke in young people and that a
      transcranial Doppler (TCD) technique may be the investigation of choice to
      identify v-aCS.

PMID- 11204582
TI  - Procoagulant microparticles: new insights and opportunities in pregnancy loss?

PMID- 11204583
TI  - The Glasgow Outcome, APCR and Lipid (GOAL) Pregnancy Study: significance of
      pregnancy associated activated protein C resistance.
AB  - Activated protein C (APC) resistance secondary to Factor V Leiden (FVL) is
      associated with pregnancy failure and pre-eclampsia (PET). In non-pregnant
      subjects, the degree of resistance to APC relates to venous thrombosis risk. In
      pregnancy, resistance to APC occurs in the absence of FVL. We investigated, in an
      unselected prospective longitudinal study of 1,671 pregnant, non-FVL subjects,
      the relationship of the APC sensitivity ratio (APC:SR) with demographic variables
      and pregnancy outcome. Lower APC:SR values at 7-16 weeks gestation were observed
      in subjects who subsequently developed PET (median APC:SR 2.55, IQR 2.29-2.70 vs
      2.69, IQR 2.48-2.93, Mann-Whitney U-test p = 0.003) in the current pregnancy. An
      APC:SR < the median (2.69) at 7-16 weeks was associated with a 2.95-fold
      increased risk (CI95 1.2-7.4) of PET in the current pregnancy. No relationship
      between the APC:SR, at any gestation, and fetal loss was observed. An inverse
      correlation between the APC:SR and birth weight was noted. Higher APC:SRs were
      observed in blood group O subjects and smokers. An inverse relationship of the
      APC:SR with age, diastolic blood pressure and total serum cholesterol was
      observed.

PMID- 11204584
TI  - Anti-alphavbeta3 antibodies in chronic immune thrombocytopenic purpura.
AB  - In chronic immune thrombocytopenic purpura (ITP), anti-GPIIb-IIIa (alphaIIbbeta3)
      autoantibodies have been detected in serum and/or platelet-associated IgG (PAIgG)
      and considered as one of the major causes. We examined whether anti-alphavbeta3
      antibodies might be present in ITP cases because of the similarity between
      alphavbeta3 and GPIIb-IIIa (alphaIIbbeta3). Modified antigen capture ELISA (MACE)
      using human umbilical vein endothelial cells (HUVEC) showed the presence of serum
      anti-alphavbeta3 antibodies in 23 of 80 ITP patients (29%). Cross-adsorption
      studies between platelets and HUVEC demonstrated that most of anti-alphavbeta3
      and anti-GPIIb-IIIa antibodies exclusively reacted with alphavbeta3 and GPIIb
      IIIa, respectively. Platelet-associated anti-GPIIb-IIIa antibodies did not react
      with alphavbeta3, either. Interestingly, patients having anti-alphavbeta3
      antibodies showed significantly lower platelet counts than negative patients.
      These results indicate the serum anti-alphavbeta3 antibodies are different ones
      from the classical anti-GPIIb-IIIa (alphaIIbbeta3) antibodies and would provide a
      new insight into the pathophysiology of ITP as well as the autoantigenic epitopes
      on beta3 integrins.

PMID- 11204585
TI  - Acute deep vein thrombosis: early mobilization does not increase the frequency of
      pulmonary embolism.
AB  - Outpatient treatment for acute symptomatic deep vein thrombosis (DVT) was shown
      to be safe for most patients. However, little is known whether patients treated
      on an outpatient basis were ambulating or predominantly resting, a factor which
      may be decisive for the outcome. In the present study 129 DVT patients were
      randomized to either strict immobilization for 4 days or to ambulate for > or = 4
      hours per day under supervision in order to show, whether the old concept of
      temporary immobilization is superior to early mobilization or not. The DVT
      diagnosis was based on duplex sonography; all patients were screened for PE at
      baseline and at day 4 by pulmonary ventilation-perfusion scanning, and were
      followed up for a total of 3 months. Clinically, changes in leg circumferences
      and leg pain were evaluated. The frequency of PE at baseline was 53.0% and 44.9%
      in the immobile and the mobile groups, respectively. During the 4 days
      observation period new PEs were found in 10.0% and in 14.4% of the immobilized
      and the ambulating patients (delta 4.4%; 95% CI -0.5 to 13.8; chi2 = 0.596, p =
      0.44). The occurrence of new PE was related to the presence of PE at baseline but
      not to other potential predictors. The magnitude of a decrease in leg
      circumferences and leg pain was comparable in both groups. No patient died during
      the 4 day observation period. The total 3 month mortality rate was 3.9% (5
      patients; 2 from the immobile, 3 from the ambulating group). All 5 patient
      suffered from malignancies. The results of this study show in accordance with the
      trial hypothesis that, regarding the frequency of PE, immobilization is not
      superior to early mobilization, suggesting that early mobilization is safe.

PMID- 11204586
TI  - Similar effects of atorvastatin, simvastatin and pravastatin on thrombogenic and
      inflammatory parameters in patients with hypercholesterolemia.
AB  - BACKGROUND: Previous studies have suggested that statins exert beneficial effects
      beyond their favorable lipid lowering effect. Particularly, the modification of
      thrombus formation and degradation, alteration in inflammatory response, plaque
      stabilization and improved endothelial function are thought to be responsible for
      additional reduction of morbidity and mortality due to cardiovascular events. To
      date, however, it is still unclear whether these effects are elicited by all
      statins. METHODS AND RESULTS: We set out to compare in a controlled, randomized,
      double-blind study design the effects of almost equieffective cholesterol
      lowering doses of three chemically and pharmacokinetically different statins
      (atorvastatin, simvastatin, pravastatin) on hemostatic and inflammatory markers
      in 99 hypercholesterolemic patients. At entry and 3 months after onset of statin
      therapy plasma cholesterol and von Willebrand factor antigen (vWf-Ag),
      fibrinogen, d-dimer, prothrombin fragment 1+2 (F1.2) and C-reactive protein (CRP)
      were measured. The effect on plasma values of F1.2, vWf-Ag, d-dimer and CRP was
      not significantly different between the three treatment groups. The effect of
      simvastatin on fibrinogen (p = 0.005) was more pronounced than the effects of
      atorvastatin (p = 0.48 n.s.) and pravastatin (p = 0.15 n.s.). Plasma levels of
      F1.2 and vWf-Ag (when data of all statins were pooled) were significantly reduced
      by 7% and 10% versus baseline, respectively. No significant reduction was
      observed for d-dimer (p = 0.26) and CRP (p = 0.5). Total plasma cholesterol
      levels decreased significantly (p < 0.0001 in all groups) between 22% and 29%
      compared to baseline. CONCLUSION: The present study shows similar short-term (3
      months) effects of atorvastatin, simvastatin and pravastatin on selected
      hemostatic and inflammatory parameters in plasma in patients with
      hypercholesterolemia. Thus, chemical and pharmacological differences between
      statins appear to exert no major influence on these parameters.

PMID- 11204587
TI  - Regulation of fibrinolysis in plasma by TAFI and protein C is dependent on the
      concentration of thrombomodulin.
AB  - Thrombin activatable fibrinolysis inhibitor (TAFI) is a carboxypeptidase B-like
      proenzyme, that after activation down regulates fibrinolysis. TAFI is activated
      by thrombin in the presence of the cofactor thrombomodulin (TM). By stimulation
      of TAFI activation TM down regulates fibrinolysis, however TM is also a cofactor
      in the activation of protein C. Activated protein C (APC) can up regulate
      fibrinolysis by limitine the activation of TAFI via the attenuation of thrombin
      production. We studied these counteracting fibrinolytic properties of TM in
      plasma by measuring the activation of TAFI during tissue factor induced
      coagulation. TAFI activation was stimulated at low concentrations of TM but
      decreased at higher concentrations of TM. Similarly, the clot lysis times
      increased at low concentrations of TM but decreased at higher concentrations of
      TM. The reduction of TAFI activation at high TM concentrations was found to be
      dependent on a functional protein C pathway. The concentration of TM is therefore
      an important factor in the regulation of TAFI activation and in the regulation of
      fibrinolysis. High concentrations of TM result in up regulation of fibrinolysis,
      whereas low concentrations of TM have a down regulatory effect on fibrinolysis.
      These results suggest that fibrinolysis might be differentially regulated by TM
      in different parts of the body depending on the local TM concentration in the
      vasculature.

PMID- 11204588
TI  - Costs of outpatient anticoagulant treatment in patients with cerebral and
      peripheral arterial occlusive disease.
AB  - BACKGROUND AND OBJECTIVE: Knowledge of the costs of oral anticoagulant (AC)
      treatment may be relevant for resource allocation. Also, the incremental costs
      may be compared with other treatments for health care policy decisions. In this
      report, we have assessed actual costs of anticoagulant therapy in anticoagulation
      clinics (AC-clinic) in three different settings in the Netherlands. METHODS:
      Costs of anticoagulant drug supply and costs as a result of INR-adjustment
      procedures were estimated. We compared the total costs of treatment in patients
      treated after minor cerebral ischaemia in the Stroke Prevention in Reversible
      Ischemia Trial (SPIRIT) and in patients treated because of peripheral arterial
      occlusive disease in the Dutch Bypass Oral anticoagulants or Aspirin Trial (BOA).
      RESULTS: Costs of monitoring ranged between Euro 6.44 and Euro 9.87 per visit for
      monitoring at the AC-clinic and at home, respectively. The annual costs of
      administering anticoagulant drugs ranged between Euro 83 (phenprocoumon) and 107
      (acenocoumarol). Variation in the overall actual annual costs of AC treatment was
      caused by the number of monitoring visits, the distribution of home and clinic
      visits and, to a lesser extent, the medication used. Annual costs of AC therapy
      for patients in SPIRIT was Euro 239 and for patients in BOA Euro 312. Overall
      costs of anticoagulant therapy were about 3 to 4-fold higher than standard
      treatment with aspirin. CONCLUSIONS: Although the actual costs of anticoagulant
      therapy may be substantially higher than that of other antithrombotic therapies,
      its cost-effectiveness depends highly on efficacy.

PMID- 11204589
TI  - Some patients with antiphospholipid syndrome express hitherto undescribed
      antibodies to cardiolipin-binding proteins.
AB  - Contrary to infective anticardiolipin (aCL) antibodies, autoimmune aCL antibodies
      react with phospholipids (PL) mainly via binding to the plasma glycoprotein
      cofactor beta2-Glycoprotein I (beta2GPI). While there is a well-documented link
      between the risk of thrombosis and the presence of beta2GPI-dependent
      anticardiolipin antibodies, the pathological impact of other antiphospholipid
      antibodies is less clear. By means of cardiolipin affinity-chromatography, we
      isolated and identified 3 CL-binding proteins, complement component C4,
      complement factor H and a kallikrein-sensitive glycoprotein, and tested for the
      presence of autoantibodies against these proteins in patients with
      antiphospholipid syndrome (APS), systemic lupus erythematosus (SLE) and other
      autoimmune diseases. High titers of autoantibodies to C4 as compared to age- and
      sex-matched healthy controls were present in 3 of 26 patients with APS, and weak
      titers were found in 2 of 26 patients with SLE and in none of 26 patients with
      other autoimmune diseases. Autoantibodies to complement factor H were found in 4
      APS, 3 SLE and none of the other autoimmune patients. Autoantibodies to
      kallikrein-sensitive glycoprotein were detected in 6 APS patients, 1 SLE patient,
      and 1 patient with another autoimmune disease. A close relationship between these
      antibodies was found, suggesting their origin from a common macromolecular
      complex. However, no relationship with anti-beta2GPI antibodies was found, with
      the three patients with higher levels of autoantibodies having a low titer of
      anti-beta2GPI antibodies. In conclusion, some patients with APS harbor
      circulating antibodies to other CL-binding proteins which might be useful to
      further characterize these patients.

PMID- 11204590
TI  - High levels of adhesion molecules are associated with impaired endothelium
      dependent vasodilation in patients with peripheral arterial disease.
AB  - Soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cellular
      adhesion molecule-1 (sVCAM-1) were measured alongside flow-mediated vasodilation
      (FMD) in 34 patients with intermittent claudication and 14 control subjects.
      Patients with plasma sICAM-1 >253 ng/mL (median value) showed lower FMD than
      those with sICAM-1 < 253 ng/mL (5.6 +/- 1.8% vs 9.6 +/- 4.2%, p < 0.01).
      Similarly, in the 17 patients with plasma sVCAM-1 > 414 ng/mL, FMD was lower than
      in the remaining 17 patients (6.1 +/- 1.9% vs 9.2 +/- 4.5%, p < 0.05).
      Additionally, when endothelial dysfunction was defined as FMD < or = 5.5%,
      patients with FMD below this value had higher plasma concentrations of sICAM-1
      and sVCAM-1 than those with FMD > 5.5%. Therefore, our findings indicate a close
      association between elevated plasma levels of adhesion molecules and endothelial
      dysfunction. As impaired endothelial function is one of the first steps in
      atherogenesis, our findings have clinical relevance since they serve as the basis
      for further evaluation of sICAM-1 and sVCAM-1 as potential plasma markers for
      progression of atherosclerosis in a population at high risk.

PMID- 11204591
TI  - Gene-environment and gene-gene interaction in the determination of plasma
      homocysteine levels in healthy middle-aged men.
AB  - Healthy middle-aged men (n = 1,470) from eight general practices across Britain
      were examined for plasma total homocysteine levels and genotyped for the A222V
      polymorphism in the methylene-tetrahydrofolate (MTHFR) gene, the 68 bp insertion
      polymorphism in exon 8 of the cystathionine b synthase (CBS) gene and the D919G
      polymorphism in the methionine synthase (MS) gene. The median value for plasma
      homocysteine was 11.90 micromol/l (25-75% Interquartile range 10.10-14.20) for
      the whole sample. Smokers had significantly higher homocysteine levels than non
      smokers (12.90 vs 11.70 micromol/l and p < 0.00005) and levels significantly
      differed according to folate (p-value < 0.00005), with men in the lowest quartile
      of folate having the highest median homocysteine levels. Genotype at all three
      loci was associated with differences in plasma homocysteine level. Individuals
      homozygous for the MTHFR V222 allele had 1.6 micromol/l higher median
      homocysteine levels when compared to the other two genotypes (p < 0.00005), while
      for the CBS and MS genes, individuals carrying one or more of the rare alleles
      had lower median homocysteine than individuals homozygous for the common allele
      (0.80 micromol/l, p < 0.03, and 0.70 micromol/l, p < 0.04 respectively). The
      raising effect associated with homozygosity for the V222 allele was greater in
      men in the lowest quartile of folate (interaction between folate and genotype p =
      0.02), but none of the genotype effects was significantly modulated by B12
      levels. While the raising effects of V222 and MS D919 homozygosity on
      homocysteine level were essentially additive, the homocysteine lowering effect
      associated with the CBS 68bp allele was seen most strongly in men homozygous for
      the V222 allele (MTHFR-CBS genotype interaction p = 0.03) and the D919 allele (MS
      CBS interaction p = 0.09). Age, folate, B12 and smoking explained 13.48% of the
      variance while the three genotypes combined and with interaction terms explained
      only an additional 2.63%. This interaction between CBS genotype and MTHFR and MS
      genotype points to a key role of the CBS transulphuration pathway in the
      metabolism of homocysteine that may be particularly important as a compensatory
      mechanism in subjects with low dietary folate.

PMID- 11204592
TI  - Functional properties of factor V and factor Va encoded by the R2-gene.
AB  - Carriership of the factor V (FV) gene marked by the R2-haplotype, a series of
      linked polymorphisms encoding several amino acid changes in FV, is associated
      with mild resistance to activated protein C (APC) and with an increased risk of
      thrombosis. We compared the functional properties of normal FV(a) and R2-FV(a) in
      model systems and in plasma. FV and R2-FV were equally well activated by thrombin
      and expressed identical cofactor activities in prothrombin activation. Rate
      constants of APC-catalyzed inactivation of FVa and R2-FVa were similar both with
      and without protein S. However, significant differences were observed between
      haemostatic parameters determined in plasma from homozygous carriers of the R2
      gene (n = 5) and age-matched non-carriers (n = 19). Plasma from R2-carriers
      contained significantly lower FV levels and the ratio of the two FV isoforms (FV1
      and FV2) was shifted in favor of FV1. The FV2/FV1 ratio was 1.4 (95% CI = 1.3
      1.5) in homozygous carriers of R2 and 2.8 (95% CI = 2.5-3.1) in controls (p <
      0.00001). In an APC resistance test which quantifies the cofactor activity of FV
      in APC-catalyzed FVIII(a) inactivation, homozygous R2-carriers had significantly
      lower (p < 0.00001) APC sensitivity ratios (APCsr = 1.54, 95% CI = 1.48-1.60)
      than controls (APCsr = 2.17, 95% CI = 2.05-2.28). This indicates that R2-FV has
      reduced cofactor activity in APC-catalyzed FVIII(a) inactivation. The changes of
      the relative amounts of FV1 and FV2 in carriers of the R2-gene will result in
      increased thrombin formation in the presence of APC and may provide a mechanistic
      explanation for the increased thrombotic risk associated with the R2-haplotype.

PMID- 11204593
TI  - Genetic screening of candidate genes for a prothrombotic interaction with type I
      protein C deficiency in a large kindred.
AB  - The incomplete penetrance of thrombosis in familial protein C deficiency suggests
      disease occurs when this deficit is combined with additional abnormalities in the
      hemostatic system. The pattern of inherited thrombophilia in the Vermont II
      kindred, which is affected by a clinically dominant type I protein C deficiency,
      provides strong evidence for a second unidentified gene that segregates
      independently of protein C deficiency and increases susceptibility to thrombosis.
      To test the second gene hypothesis, thirty-four candidate genes for proteins
      involved in hemostasis or inflammation were tested as the unknown defect, using
      highly polymorphic short tandem repeat (STR) markers in an informative subset (n
      = 31) of the kindred. The genes considered are; alpha-fibrinogen, beta
      fibrinogen, gamma-fibrinogen, prothrombin, tissue factor, factor V, protein S,
      complement component 4 binding protein, factor XI, factor XII, factor XIIIa,
      factor XIIIb, histidine rich glycoprotein, high molecular weight kininogen,
      kallikrein, von Willebrands factor, platelet factor 4, thrombospondin,
      antithrombin III, alpha-1-antitrypsin, thrombomodulin, plasminogen, tissue
      plasminogen activator, urokinase plasminogen activator, plasminogen activator
      inhibitor-1, plasminogen activator inhibitor-2, protein C inhibitor, alpha-2
      plasmin inhibitor, kallistatin, lipoprotein a, interleukin 6, interleukin 1,
      cystathionine-beta-synthase, and methylenetetrahydrofolate reductase. Mutations
      in many of these genes have been previously established as independent risk
      factors for thrombosis. However, linkage analysis provided no evidence to
      implicate any of the candidate genes as the second inherited factor that promotes
      thrombophilia in this kindred.

PMID- 11204594
TI  - Genetic regulation of plasma levels of vitamin K-dependent proteins involved in
      hematostatis: results from the GAIT Project. Genetic Analysis of Idiopathic
      Thrombophilia.
AB  - Vitamin K-dependent proteins play a critical role in hemostasis. We have analysed
      the genetic and environmental correlations between measures of several vitamin K
      dependent proteins in 21 Spanish extended families, including 397 individuals.
      Plasma functional levels of factors II, VII, IX, X, protein C and functional
      protein S were assayed in an automated coagulometer. Antigenic levels of total
      and free protein S were measured using an ELISA method. A maximum likelihood
      based covariance decomposition analysis was used to assess the heritability of
      each trait and the genetic and environmental correlations between all possible
      pairs. All of the plasma levels had a significant genetic component
      (heritability) ranging from 22% to 52% of the phenotypic variance. Among the 28
      possible pairs of genetic correlations, 18 were significant at a level of p <
      0.05 and six exhibited a p-value between 0.05 and 0.10. Positive environmental
      correlation was observed for 25 of the pairs (p < 0.05). We conclude that genetic
      effects account for a large proportion of the observed phenotypic variation in
      vitamin K-dependent proteins. Some of the genes appear to pleiotropically
      influence all of these traits, since most pairs of phenotypes exhibit significant
      genetic correlation. However, since these phenotypes show a high degree of
      environmental correlation, it is also likely that the same environmental factors
      influence them co-jointly.

PMID- 11204595
TI  - Structural and functional characteristics of the B-domain-deleted recombinant
      factor VIII protein, r-VIII SQ.
AB  - Recombinant factor VIII SQ (r-VIII SQ), ReFacto, is a recombinant factor VIII
      product similar to the smallest active factor VIII protein found in plasma
      derived factor VIII (p-VIII) concentrates. The protein comprises two polypeptide
      chains of 80 and 90 kDa and lacks the major part of the heavily glycosylated B
      domain i.e. amino acids Gln744 to Ser1637. r-VIII SQ retains six potential
      glycosylation sites for N-linked oligosaccharides at asparagine residues 41, 239,
      582, 1685, 1810 and 2118. We describe a thorough comparison of the
      characteristics of r-VIII SQ with those of p-VIII. The primary and secondary
      structures of r-VIII SQ were in good agreement with that of B-domain-deleted p
      VIII (p-VIII-LMW) as shown by SDS-PAGE, Western blotting with antifactor VIII
      antibodies, tryptic mapping, amino acid sequence analysis and circular dichroism
      spectroscopy. A few divergences also existed. Thus r-VIII SQ was shown to contain
      a small amount of the single chain primary translation product of 170 kDa and
      also the product specific sequence of 14 amino acids, the SQ-link, in the C
      terminal end of the 90 kDa chain. It was shown that r-VIII SQ had a high specific
      activity of about 14,000 IU VIII:C/mg as determined by use of a chromogenic
      substrate assay. The r-VIII SQ protein was comparable to p-VIII forms with a
      retained B-domain, in terms of potency measured by a chromogenic substrate or a
      two-stage clotting assay, in interactions with thrombin, and with activated
      protein C (APC) in combination with Protein S. The ability of r-VIII SQ to
      participate as a cofactor in factor Xa generation in a mixture of factors IXa and
      X, phospholipid and calcium was in conformity with that of p-VIII. Furthermore r
      VIII SQ had a good binding capacity for phospholipid vesicles and von Willebrand
      factor (vWF) as shown in gel filtration studies. The same kinetics in binding to
      von Willebrand factor was found for r-VIII SQ and p-VIII as determined by real
      time biospecific interaction analysis (BIA) with use of the BIAcore instrument.
      The apparent association rate constant was 4 x 10(6) M(-1)s(-1). Two dissociation
      rate constants were found, 1 X 10(-2)s(-1) and 4 x 10(-4)s(-1). The results
      extend the present knowledge that the factor VIII B-domain is dispensable for the
      factor VIII cofactor function in hemostasis.

PMID- 11204596
TI  - Dermatology: 2001.

PMID- 11204597
TI  - Recurrent lumbosacral herpes simplex in the bedridden hospitalized patient.
AB  - A clinical variant of genital herpes simplex virus (HSV) infection, recurrent
      lumbosacral HSV, occurs in bedridden hospitalized patients. We want to call
      attention to an uncommon pattern of HSV infection in the hospitalized bedridden
      patient seen by the dermatology consultation service in a large university
      hospital. HSV is characterized by a mixture of recurrent groups of herpetic
      vesicles in all stages of development, with multiple, persistent hyperpigmented
      patches bilaterally distributed over the lumbosacral (buttocks) area.

PMID- 11204598
TI  - Perioral dermatitis: an acneiform eruption.

PMID- 11204599
TI  - Botanical briefs: the scourge of India--Parthenium hysterophorus L.

PMID- 11204600
TI  - Benign lymphangioendothelioma manifested clinically as actinic keratosis.
AB  - Benign lymphangioendothelioma is an acquired lymphangiectatic lesion that must be
      recognized and differentiated from angiosarcoma, early Kaposi's sarcoma, and
      lymphangioma circumscriptum. We report the case of a 68-year-old woman with the
      clinical presentation of a possible actinic keratosis and the typical histologic
      findings of benign lymphangioendothelioma and an overlying actinic keratosis.

PMID- 11204601
TI  - A case of lichen striatus following Blaschko lines.
AB  - We present a case of lichen striatus (LS) in a 36-year-old woman with skin
      lesions on the right side of the chest distributed along Blaschko lines that
      showed a swirling s-shaped pattern. The differential diagnosis of LS includes a
      variety of nevoid and acquired conditions following Blaschko lines, particularly
      acquired relapsing self-healing Blaschko dermatitis. The extent to which these 2
      conditions overlap remains contentious.

PMID- 11204602
TI  - Dissecting cellulitis in a white male: a case report and review of the
      literature.
AB  - Dissecting cellulitis is an uncommon, chronic, progressive suppurative disease of
      unknown etiology. It is characterized by painful papules and nodules,
      interconnecting sinus tracts, purulent drainage, and scarring alopecia. This
      disease predominately affects young black men, but is rarely reported in white
      males. The refractory nature of this process makes treatment difficult. We report
      a case of dissecting cellulitis in a white male, which responded to oral
      isotretinoin.

PMID- 11204603
TI  - Recurrent disseminated herpes zoster and cytomegalic perianal ulcer: a case
      report and review of the literature.
AB  - We describe a patient with lymphocytic leukemia who developed multiple,
      disseminated, vesiculopustular eruptions in combination with perianal ulcer. Four
      years earlier, she had a herpes zoster (HZ) infection involving the ophthalmic
      division of her left trigeminal nerve with subsequent postherpetic neuralgia that
      was treated with steroids. After the studies, we concluded that the patient had a
      recurrent disseminated HZ infection and perianal ulcer caused by cytomegalovirus
      (CMV).

PMID- 11204604
TI  - Carbamazepine hypersensitivity syndrome mimicking mycosis fungoides.
AB  - We report a case of a patient who experienced a generalized skin rash with
      systemic involvement 2 months after beginning carbamazepine treatment for
      trigeminal neuralgia. Skin biopsy specimens suggest mycosis fungoides. Complete
      remission of the clinical and pathologic changes after drug discontinuation and
      the positive result of carbamazepine from an epicutaneous test suggest a
      diagnosis of pseudolymphoma due to carbamazepine.

PMID- 11204605
TI  - Generalized seborrheic dermatitis in an immunodeficient newborn.
AB  - We report the case of a female infant with failure to thrive, generalized
      seborrheic dermatitis, and intermittent diarrhea. Results of laboratory
      investigation revealed low serum immunoglobulin G IgG levels. She failed to gain
      additional weight and experienced recurrent infection. She died 3 months later.

PMID- 11204606
TI  - Cutis photo quiz. Lupus erythematosus and dermatomyositis.

PMID- 11204607
TI  - Squamous cell carcinoma of the nail bed: is finger predominance another clue to
      etiology? A report of 5 cases.
AB  - Although squamous cell carcinoma (SCC) is commonly found on sun-exposed skin, the
      occurrence of this malignancy in the nail bed is rare. We report 5 cases of SCC
      of the nail bed and suggest that the disproportionate number of neoplasms of this
      type on the second, third, and fourth fingers, combined with the known
      relationship of SCC and human papillomavirus (HPV), is evidence that most SCC of
      the nail bed result from contact with HPV. Moreover, we suggest that patients who
      present with new, verrucous lesions of the nail bed and have a history of
      cervical dysplasia, cervical carcinoma, or condyloma acuminata undergo diagnostic
      biopsy as opposed to traditional destructive therapy for a lesion presumed
      benign.

PMID- 11204608
TI  - Persistent peripheral eosinophilia and cutaneous non-Hodgkin's lymphoma: a case
      report and review of the literature.
AB  - Peripheral eosinophilia can be the presenting sign in many cutaneous diseases but
      is often missed as a marker of a serious undiagnosed underlying disease such as
      atopic dermatitis, urticaria, drug eruption, bullous pemphigoid, inflammatory
      bowel disease, helminthic infection, Churg-Strauss syndrome, rheumatoid
      arthritis, or lymphoma. We report a case of non-Hodgkin's lymphoma presenting as
      persistent eosinophilia with a diffuse nodular cutaneous eruption.

PMID- 11204609
TI  - Giant basal cell carcinoma and cigarette smoking.
AB  - Several recent studies have linked cigarette smoking to an increased risk of
      squamous cell skin cancer, but previous studies have found no correlation between
      smoking and basal cell carcinoma. This article is a retrospective chart review of
      200 patients who had Mohs' surgery for basal cell carcinoma at the Mayo Clinic in
      Rochester, Minnesota, between 1986 and 1990. In patients with tumors less than or
      equal to 1.0 cm, 30% were smokers. In patients with tumors 1.1 to 2.0 cm, 42%
      were smokers. In patients with tumors 2.1 to 4.9 cm, 56% were smokers; and in
      patients with tumors greater than or equal to 5.0 cm, 50% were smokers. Cigarette
      smoking is associated with an increased prevalence of basal cell carcinomas
      larger than 1.0 cm in diameter.

PMID- 11204610
TI  - Cutaneous infection with Mycobacterium xenopi.

PMID- 11204611
TI  - Sutureless vasovasostomy using new vascular closure staples in rats.
AB  - To evaluate the efficacy of sutureless vasovasostomy using vascular closure
      staples, 20 male Sprague-Dawley rats were used for the study. In each rat, a
      sutureless vasovasostomy using vascular closure staples was performed on a
      randomly selected side, and a conventional end-to-end microsutured anastomosis
      was performed on the opposite side. Operation time was significantly shorter for
      sutureless vasovasostomy using vascular staples (p < .001). Four weeks after the
      surgery, however, patency rate and granuloma formation were not different for
      conventional end-to-end vasovasostomy vs. sutureless vasovasostomy. These
      findings suggest that sutureless vasovasostomy is simple to perform and requires
      fewer special technical skills. This procedure may provide an alternative to the
      conventional vasovasostomy.

PMID- 11204612
TI  - Sperm aggregation by water extracts from two Bursera species.
AB  - Some plants have more than the common utility value, as is the case of some
      members of the Bursera species such as the Mexican copal, a plant used for
      worship. Water extracts of several plants have vaginal contraceptive properties.
      The authors evaluated the sperm agglutinating activity of two Bursera species on
      human and boar sperm. Extracts from stems and leaves were obtained. Capacitated
      sperm samples were used in all cases. There were different agglutinating
      capacities, which were not observed in the vehicle-only samples. The most
      frequent sperm agglutination response was that involving the heads. Agglutinating
      activity was higher from stem- than leaf-derived extracts. The results indicate
      that proteins present in the extracts are responsible for the aggregation of
      sperm heads.

PMID- 11204613
TI  - Transillumination to evaluate spermatogenesis: effect of testosterone enanthate
      in adult male rats.
AB  - The present study has been designed to determine which stages of seminiferous
      cycle were modified by in vivo intramuscular administration of one or two doses
      of 25 mg of testosterone enanthate. Testicular weight was significantly reduced
      after treatment with two doses of testosterone enanthate (p < .05). Assessment of
      total lengths of stages per 100 mm of seminiferous tubules scored by
      transillumination showed that testosterone enanthate increased significantly the
      length of stages VI-VII, but it reduced total lengths of stages I, XII, and XIII
      XIV. A dose-dependent reduction in the absolute and relative frequency of stage I
      was observed with testosterone enanthate treatment, whereas stages VI-VII were
      significantly increased. Analysis of relative frequencies of stages showed that
      stages XIII-XIV and stages I-V were significantly below the control value (1),
      whereas stages VI-VIII were over 1. In summary, results of the present study
      showed that transillumination is an adequate technique to assess the effect of
      drugs on spermatogenesis, and that testosterone enanthate modifies the pattern of
      the stages of the seminiferous epithelium cycle, before testicular weight is
      affected.

PMID- 11204614
TI  - Evidence for the binding of a human sperm component with diaphanous protein.
AB  - The YWK-II component of human sperm membrane is related to the betaA4-amyloid
      precursor protein (APP) of Alzheimer's disease. A yeast 2-hybrid system was used
      to screen a mouse testis cDNA expression library for potential ligands capable of
      interacting with the extracellular domain of the YWK-II component. One of the
      bound proteins was identified as hDIA1, which has 96% identity with p140mDia.
      These proteins are members of the formin homology family and participate in
      cytokinesis and organization of the actin cytoskeleton. By interacting with these
      diaphanous proteins, the YWK-II component may be involved in germ cell
      differentiation and in the structural formation of the acrosome.

PMID- 11204615
TI  - Computerized semen analysis (CASA): effect of semen concentration and chamber
      depth on measurements.
AB  - The purpose of this study was to examine the influence of sample concentration
      and chamber depth on the performance of a real-time analysis computer-assisted
      semen analysis system, the Hobson Sperm Tracker. Fresh semen samples were
      provided by patients or donors who attended the author's clinic. The samples were
      used to estimate total concentration, percentage motility, and sperm kinematics.
      A considerable variation was found in total concentration and motility recordings
      between manual and computerized analysis, which was more profound in high-density
      samples (>80 x 10(6) sperm/mL). The sperm motion parameters were significantly
      different between low- and high-density samples. This difference could not have
      been due to sample variation since it was also observed after 1:10 dilution of
      dense samples. The results indicate that a real-time analysis system can be used
      clinically for semen analysis over a wide range of sperm concentration. However,
      high sperm concentration can distort sperm count, motility, and sperm kinematics
      recordings.

PMID- 11204616
TI  - Cisplatin-induced germ cell apoptosis in mouse testes.
AB  - The purpose of this study was to investigate whether exposure of male mice to
      cisplatin induces apoptosis in male germ cells and the possible role of apoptosis
      in cisplatin-induced testicular damage. Forty-eight male BALB/c mice were divided
      into cisplatin and control groups. The mice from the cisplatin group received a
      single intraperitoneal injection of cisplatin of either 1, 5, or 10 mg/kg. The
      control group received a single intraperitoneal injection of saline alone. The
      testes were removed on days 1, 3, and 7 after cisplatin administration,
      respectively. Following histological examination, apoptotic indices (AIs) were
      measured within seminiferous tubules of the mouse testes by terminal
      deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. A low
      incidence of spontaneous apoptosis was observed in controls, particularly in
      spermatogonia and spermatocytes of the mouse testes. After cisplatin
      administration, both increased Als and decreased spermatozoa and spermatids were
      found in the seminiferous tubules of the mouse testes. Cisplatin-induced
      apoptosis was found in spermatogonia, spermatocytes, and spermatids of the mouse
      testes. In comparison to the control values, AIs increased 2.6- to 6.8-fold in
      cisplatin-treated mouse testes. AIs reached the highest level on day 1 following
      1 mg/ kg, on day 3 following 5 mg/kg, and on day 7 following treatment of 10
      mg/kg cisplatin. The study showed that cisplatin-induced germ cell apoptosis in
      the mouse testes was related to both the dose response and the time course of
      response. It is suggested that cisplatin-induced germ cell apoptosis may result
      in decreased spermatogenesis, and the higher dose of cisplatin may delay the
      occurrence of apoptosis in the mouse testes.

PMID- 11204617
TI  - Morphological alterations and intratubular lipid inclusions as indicative of
      spermatogenic damage in cimetidine-treated rats.
AB  - Doses of cimetidine (50 mg/kg b/w) were administered to adult male Wistar rats
      over 52 consecutive days. Besides plasma testosterone levels, morphological and
      morphometric aspects of the seminiferous tubules as well as histochemical
      analysis of the lipid content by oil red O were emphasized. Abnormal tubules
      exhibiting disorganization of their cellular association, loss of germ cells, and
      multinucleated giant spermatids were usually found. Significant reductions of
      testis weight and tubular diameter at specific stages (VII-IX), as well as lack
      of contact between Sertoli cells and spermatids in tubules at stage IX, suggest a
      possible interference of cimetidine on the histoarchitecture of the seminiferous
      epithelium. The dense concentration of lipid inclusions in tubules at
      postspermiation stages indicates phagocytosis and degradation of germ cells.
      Since no change in serum testosterone levels was verified in cimetidine-treated
      rats, the authors could not exclude the possibility that besides an
      antiandrogenic effect, other biochemical factors necessary for normal
      spermatogenesis could be involved in the testicular alterations.

PMID- 11204618
TI  - Postnatal changes in the calcium binding proteins of mouse testis.
AB  - To define the changes in calcium-binding proteins (CBPs) of mouse testis during
      postnatal development, testicular protein extracts were analyzed by mobility
      shift after Ca2+ binding (MSACB) in the 2-dimensional SDS-PAGE. In the adult
      testis extracts, 29 kinds of protein spots showed mobility shift in the gel
      containing Ca2+. Among them, 2 spots showed nonspecific mobility shift and 4
      spots showed Zn2+ shift. Drastic changes in expression of high-Mr CBPs (Mr > 25
      kDa) were observed in testis 3 weeks after birth, suggesting that their
      expressions were developmentally changed. There was no obvious difference in the
      qualitative patterns of CBP between 4-week-old testis and adult testis. There was
      a large mass of CBPs (Mr = 20-25 kDa) expressed constitutively in testis
      throughout the postnatal development. Degree of MSACB (Mr on the diagonal line/Mr
      of shifted point in Ca2+ gel) of each spot was in the range of 1.1-1.7 in 12%
      acrylamide gel. These results suggest that changes in CBPs of testis are closely
      related with progression of spermatogenesis in mouse testis.

PMID- 11204619
TI  - Magnesium in human semen: possible role in premature ejaculation.
AB  - Although magnesium is involved in many biological process and it is found higher
      levels in semen than serum, its role in human semen has not been elucidated. This
      investigation was conducted to evaluate the relationship between premature
      ejaculation and the levels of seminal magnesium. The levels of magnesium, zinc,
      copper, and selenium were evaluated with an atomic absorption spectrophotometer
      in serum and seminal plasma in 3 groups of men: (a) normal sperm parameters (15)
      (b) oligoasthenozoospermia (15), and genuine premature ejaculation (9). There
      were normal serum and semen levels of all the elements in the three groups, but
      significantly lower seminal plasma magnesium levels in men with premature
      ejaculation. The hormonal profile, body mass index (BMI) had no association with
      premature ejaculation. Decreased levels of magnesium gives rise to
      vasoconstriction from increased thromboxane level, increased endothelial
      intracellular Ca2+, and decreased nitric oxide. This may lead to premature
      emission and ejaculation processes. Magnesium is probably involved in semen
      transport. More research into the role of magnesium in the male physiology of
      reproductive tract, especially its association with premature ejaculation, is
      advocated.

PMID- 11204620
TI  - The effect of an infertility diagnosis on treatment-related stresses.
AB  - The purpose of this study was to determine the effect of an infertility diagnosis
      on treatment-related stresses. One hundred infertile Chinese couples participated
      in this study. Three structured questionnaires were used to analyze the
      differences between husbands and wives. As a group wives appear to experience
      significantly more stress from infertility tests and treatment than their
      husbands, regardless of whether female infertility was present. Husbands with
      mixed or idiopathic infertility experienced less stress to infertility than
      husbands with only male infertility or female infertility. Wives with mixed or
      idiopathic infertility experienced less stress to infertility than wives with
      only a female infertility. Marital duration, time in treatment, and the number of
      AIH or IVF procedures were positively related to the wives' stress level, whereas
      only number of IVF procedures was positively related to the husbands' stress
      level. Interventions to enhance the infertility treatment experience are
      suggested.

PMID- 11204621
TI  - Epididymal scanning electron microscopy study in hypothyroid rats.
AB  - The purpose of this research was to investigate, using scanning electron
      microscopy, the effect of hypothyroidism on the ultrastructure of the rat cauda
      epididymis. Thyroidectomy was obtained by ip injection of 270 muCi of 131I per
      rat. One month later, several portions of cauda epididymis were examined.
      Morphological and physiological differences were detected in the cauda epididymis
      of the hypothyroid animals when compared to the control normal rats. The
      hypothyroid condition was associated with important changes in the luminal
      surface of the cauda epididymis epithelium. Broken, oblique, and loss of
      stereocilia, denuded epithelial cells, and flattening of the tubule were
      observed. The results confirm that hypothyroidism causes marked structural
      changes in the cauda ductus epididymis and could be adversely affect sperm
      maturation motility.

PMID- 11204622
TI  - Reevaluation of testicular biopsies of males with nonobstructive azoospermia in
      assisted reproductive technology.
AB  - Spermatogenesis was investigated in seminiferous tubules of 100 males with
      nonobstructive azoospermia. Forty-four (44%) cases had Sertoli-cell-only
      syndrome, 23 (23%) had spermatogonium in the tubules, 17 (17%) had primary
      spermatocyte in the tubules, and 16 (16%) had round or late spermatid in the
      tubules. No cases showed secondary spermatocyte present in the tubules. The mean
      serum follicle-stimulating hormone (FSH) in males with nonobstructive azoospermia
      was significantly higher than that in males with obstructive azoospermia (p <
      .001). The mean concentrations of serum FSH in cases with Sertoli-cell-only
      syndrome and spermatogonium in the tubules were significantly higher than those
      in cases with primary spermatocyte and spermatid in the tubules (p < .05-.001).
      The results indicate that the evaluation of testicular histology using the type
      of germ cells present in seminiferous tubules is available for assisted
      reproductive technology.

PMID- 11204623
TI  - [Apoptosis during spinal cord trauma: prospects for pharmacological correction].
AB  - Spinal trauma is a serious problem of modern medicine. The morphological studies
      illustrate the presence of two alternative pathways of cell destruction in the
      injured spinal cord: immediate necrotic damage and delayed apoptotic destruction
      of cells. The apoptosis continues for about 14 days after trauma, and it involves
      both neurons and glia on a significant distance from the traumatic zone. In this
      review, the basic stages of apoptosis in spinal cord, biochemical regulation of
      this process, and methods for its detection are considered. The fact, that
      apoptosis is a normal cell death process, and that it has reversible stages
      allows to consider a possibility of pharmacological correction of apoptosis. The
      special attention is paid to anti-apoptotic therapy with the use of antisense
      oligodeoxynucleotides and to the perspectives of gene therapy.

PMID- 11204624
TI  - [Limited proteolysis of integrin alpha v beta3 from human placenta].
AB  - Purification of alpha v beta 3 integrin from human placenta with successive usage
      of two affinity sorbents--immobilized monoclonal antibodies to alpha v beta 3
      integrin and immobilized RGD-containing decapeptide allowed to purify this
      integrin's partially degraded fraction, that was nevertheless able to interact
      with its ligand. During the incubation of partially degraded alpha v beta 3
      integrin at 37 degrees C its further degradation went on. Addition of serine
      proteinase inhibitors: (phenylmethilsulfonyl fluoride, leupeptin and aprotinin)
      completely suppressed integrin further degradation of alpha v beta 3. In
      preparations of intact and partially degraded alpha v beta 3 integrin specific
      activity of two serine proteinases--urokinase and dipeptidilpeptidase IV--was
      discovered. alpha v beta 3 integrin, undergoing limited proteolysis, had lesser
      affinity towards RGD peptide, that intact integrin. The results show, that alpha
      v beta 3 integrin from human placenta co-purifies with serine proteinases. It is
      suggested that a definite part of functionally active alpha v beta 3 integrin,
      extracted from human placenta by triton X-100, forms a stable complex with serine
      proteinases.

PMID- 11204625
TI  - [Biochemical and genetic diagnosis of Gaucher disease and its phenotypical
      heterogeneity].
AB  - A biochemical study of three patients with clinical symptoms of Gaucher disease
      was carried out. Two of them had a significant deficiency of beta
      glucocerebrosidase activity (a primary enzyme defect) in leukocytes and an
      enormous increasing of chitotriosidase activity in blood plasma that confirmed
      the diagnosis of Gaucher disease. Some differences in stability of mutant enzymes
      were found in these two cases. Mutation analysis revealed two point mutations-
      N370S and L444P in beta-glucocerebrosidase gene of both patients. Correlation
      between clinical picture, peculiarities of enzymatic defect and genetic status of
      patients is discussed. The influence of some epigenetic factors on phenotypic
      manifestation of the disease is supposed.

PMID- 11204626
TI  - [Metabolism of catecholamines in children with attention deficit syndrome with
      hyperactivity].
AB  - The aim of research was to study catecholamine excretion peculiarities of the
      children with attention deficit hyperactivity disorder (ADHD). 25 children at the
      age of 7-9 years took part in this research. High-pressure liquid chromatography
      (HPLC) was used for measuring the content of catecholamine. The content of
      catecholamine was defined in the morning samples of urine. The examination
      showed, that ADHD children had the basal level of epinephrine and norepinephrine
      more than the normal control in 3.9 and 5.4 times. After cognitive tests the
      content of norepinephrine reduced in the ADHD group in 2.1 times in the
      comparison with normal control. On the contrary content of epinephrine increased
      in 2.8 times. CONCLUSION: Simpatico-adrenal system hyperactivity (especially it's
      adrenals component) characterized ADHD children.

PMID- 11204627
TI  - [Prediction of binding affinities of protein-ligand complexes using nonlinear
      models].
AB  - A network model for prediction of the free energy changes in protein-ligand
      complexes has been developed. The 150 complexes of different nature were used as
      a training set. The computational physics-chemical parameters of these complexes
      were used as independent variables. Both classical models of multiple linear
      regression and several network models with one hidden layer were created and the
      best was chosen. Significant improvement was shown for network model prediction
      quality in comparison with classical model of multiple linear regression (R2 on
      training--0.81 and 0.54; R2 on "leave-one-out" procedure--0.74 and 0.52
      respectively).

PMID- 11204628
TI  - [Comprehensive system of rehabilitation of handicapped children with movement
      disorders].
AB  - A procedure is proposed for comprehensive rehabilitation of children with mental
      and somatic abnormalities. The rehabilitation programme contains three sections:
      expert diagnostic, corrective-reparative, and professional orientational ones.
      The results of testing the procedure in health care facilities are given.

PMID- 11204630
TI  - [Use of computerized psychodiagnostic methods for occupational orientation of
      adolescents with scoliosis].
AB  - The paper deals with the characteristic features and problems of professional
      self-determination in adolescents with scoliosis, studied by using computer and
      project psychological methods. A complex of methods revealed the following
      psychological characteristics in the adolescents of the study group: emotional
      and-motivational direction, adequacy of job choice, mental tension, self
      assessment, possible pain symptoms in neurotic disorders.

PMID- 11204629
TI  - [Comprehensive assessment of psychophysiologic parameters in drug addicts as a
      method of necessary individualization of therapeutic measures].
AB  - In Russia, the basic trends in the development of narcology are represented
      mainly by three lines of studies: biological, clinical, and sociopsychological
      ones. The use of currently available methods and techniques for analyzing motor
      activity, facial expression, speech makes it possible to rather clearly stratify
      the contingents of patients, especially in the context of adequate application of
      therapeutical regimens and approaches.

PMID- 11204631
TI  - [Diagnosis of mental retardation in children by the reaction time recording
      method].
AB  - The paper deals with the use computer-aided recording the time of visual and
      motor responses to estimate the severity of mental retardation (MR) in children.
      It presents standard temporary indices of simple and two differential responses
      and data on children with MR, obtained by an original computer procedure. In
      mentally retarded children, the time of responses has been shown to significantly
      differ from the standard values; the children make more mistakes in
      differentiation. The children with MR of cerebral organic genesis were found to
      fall behind in forming differential responses to a greater extent whereas those
      with MR of polygenic etiology did in forming both simple and differential
      responses equally.

PMID- 11204632
TI  - [Analysis of psychomotor activity in children with spastic infantile cerebral
      palsy by using the computer-assisted test system "Rhythmotest"].
AB  - The paper considers how to obtain quantitative characteristics of sensomotor
      responses while tracing, learning, and reproducing rhythmical stimuli of
      different frequency and modality which can be used to assess psychomotor
      activity, perception, attention, short-term memory in schoolchildren with
      infantile cerebral paralysis. The results of examinations of children with this
      condition are given and analyzed.

PMID- 11204633
TI  - [Features of spectral structure of tremor in children 5-6 years of age in health
      and in some neuromuscular diseases].
AB  - The paper shows the informative value of a tremor signal to detect abnormalities
      in the formation of the neuromuscular system. Recording of the tremor signal was
      made with a piezoaccelerometric transducer, followed by its spectral analysis.
      The results of examinations of healthy children and children with various
      abnormalities were presented and discussed. The paper shows it possible to use
      spectral analysis of tremor in the development of treatment policy for children
      with congenital talipes.

PMID- 11204634
TI  - [Health-promoting technologies of the 21st century: realities and prospects].
AB  - The paper outlines present-day progress and prospects of new-generation health
      promoting technologies by automatic control over physical condition and by
      drawing up individual health-promoting physical exercises and elaborating a
      basically new approach to evaluating the physical condition of each specific
      human being with regard to the naturally different qualities of individuals in
      the population. The authors propose a family of computer-aided diagnostically
      recommended expert systems which provide not only new possibilities of improving
      physical education, but can be used in solving other tasks of health-promotion.

PMID- 11204635
TI  - [Mental health of children and adolescents and present-day tasks of organizing
      specialized mental care].
AB  - The paper analyzes the characteristics of the mental health status of children
      and adolescents by taking into account drug abuse and mental health in
      schoolchildren. The specific features of care delivered to children with
      intellectual impairments are considered.

PMID- 11204636
TI  - [Assessment of learning capacity by electroencephalographic parameters].
AB  - Problems in the objective assessment of intellectual endowments are considered.
      In the authors' opinion, electroencephalographic (EEG) parameters are one of
      their measures. An examination of about 300 schoolchildren revealed signs of a
      correlation of EEG parameters with study progress. The methods and results of the
      examination are presented.

PMID- 11204637
TI  - [Methodological problems in the use of information technologies in physical
      education].
AB  - The paper considers methodological problems in the use of computer technologies
      in physical education by applying diagnostic and consulting systems, educational
      and educational-and-training process automation systems, and control and self
      control programmes for athletes and others.

PMID- 11204638
TI  - [Use of a bilateral stabilographic platform in the diagnosis and rehabilitation
      of movement disorders at the clinic of nervous system diseases].
AB  - The paper presents the results of the study whose aims were to reveal the
      specific features of vertical posture maintenance in patients with various motor
      disorders by using a computer stabilographic complex with a bilateral platform,
      to draw up computer rehabilitative programmes that take into account the detected
      features of posture stability disorders in these groups of patients, to evaluate
      the efficiency of use of programmes drawn up to train vertical posture stability
      in the rehabilitation of patients with motor disorders of various origin.

PMID- 11204639
TI  - [Use of computer test systems in the study of age-specific features of higher
      brain dysfunctions].
AB  - The paper covers the results of the study whose aim was to determine the
      quantitative and structural features of neurological and neuropsychological
      disorders in elderly patients with normotensive hydrocephalus and dyscirculatory
      encephalopathy from neuropsychological findings and by means of computer test
      systems.

PMID- 11204640
TI  - [Dynamics of child's cognitive development in transition to schooling].
AB  - Intensive maturation of arbitrary attention occurs in the making of higher mental
      functions in children in transition to schooling. The study has yielded standard
      indices of changes in some higher mental functions at the age of 6-8 years, which
      makes it possible to make a timely objective diagnosis in mental and neurological
      practice to predict the child's development, and to provide a required complex of
      medical and pedagogical corrective measures.

PMID- 11204641
TI  - [Computer-assisted stabilometric, diagnostic and rehabilitating complex
      "Stabilotest"].
AB  - Study of the movement of the human body gravity center projection to the
      horizontal plane (the stabilometric method) is widely used in neurologic,
      orthopedic, mental, physiological, and other studies. The paper reflects
      principles in construction and examples of using the stabilometric method as a
      software package intended for the diagnosis and rehabilitation of motor
      dysfunctions in regulating the vertical posture in practical medicine and
      researches.

PMID- 11204642
TI  - [Radiotherapy: metrological provision].
AB  - The accuracy of delivering the dose of radiation during the therapy is determined
      by many factors. Its enhancement requires substantial material costs. All the
      requirements for enhancing the accuracy are shown to be outrageous as the
      proportion of negative results of treatment virtually does not vary with the
      dosimetric and technical equipping of radiation therapy. This must alter its
      technical equipping policy without increasing the requirements for the accuracy
      of dosimetric measurements.

PMID- 11204643
TI  - [Current informational technologies in the structure of medical and psychological
      tasks of school education].
AB  - Prospects for equipment of present-day school with computing machinery allow
      fresh approaches to be applied to the improvement of means for diagnosis and
      health prophylaxis in children and to professional orientation. Automatic systems
      have been developed for diagnosing diseases and monitoring the sociomental health
      of children and the adaptation of junior and middle schoolchildren to school
      activities. The systems provide a real way of successfully following the
      development of major mental functions for prenosological diagnosis of detected
      abnormalities and their subsequent correction. An automatic system for
      professional orientation of middle- and senior-form pupils has been devised on
      the basis of mental diagnostic testing of the schoolchildren's professional
      orientation, interests, inclinations, psychophysiological and personality traits.

PMID- 11204644
TI  - [The smooth endoplasmic reticulum develops in mesophyll cells of early-spring
      ephemerals].
AB  - A study was made of the mesophyll cell ultrastructure of early-spring ephemerals
      Scilla sibirica, Crocus vernus, Galanthus caucasicus, G. plicatus, Leucojum
      vernum, Muscari szovitsianum, Ornithogalum balansae of summer-vegetating. Scilla
      scilloides and of S. sibirica growing in greenhouse. The highly developed smooth
      endoplasmic reticulum (SER) was a distinctive feature of the early-spring
      ephemeral mesophyll cell during leaf growth (cell expansion). Direct connections
      of SER-compartments with the tonoplast were found (SER and vacuole cavities were
      continuous). On running through the cytosol the SER tubules were in close contact
      with the plasma membrane. SER was not found during the same period of cell
      expansion in summer-vegetating Scilla scilloides and S. sibirica growing in
      greenhouse, as well as in mature cells of all investigated plants. The role of
      SER in the adaptation of early-spring ephemerals to drastic temperature
      fluctuations is discussed.

PMID- 11204645
TI  - [Reorganization of the chloroplast thylakoid system during decay of acquired
      thermotolerance of photosynthesis and aging of wheat leaves].
AB  - A 3 hours heating at 39 degrees C of 14-day old wheat plants increases the
      termotolerance of photosynthesis, and also the length and number of thylakoids in
      chloroplast in mature leaves. The acquired termotolerance disappears within 10
      days. Simultaneously the intensity of photosynthesis and the length of thylakoids
      decrease. Reduction of photosynthesis ability and of thylakoid membranes occurs
      in the first leaves of non-hardened plants during 14-29 days after sowing. The
      intensity of photosynthesis in plants of both variants positively correlates with
      the length of grana membranes and with the total length of membranes of all
      thylakoids. Besides, a positive correlation was detected between the intensity of
      photosynthesis and the share of small (2-7 thylakoids) grana and the length of
      their membranes in non-hardened plants. The level of thermotolerance of
      photosynthesis in leaves in heat hardened plants correlates positively with the
      length of grana membranes and with the total length of all thylakoid membranes
      and the share of small grana.

PMID- 11204646
TI  - [Ultrastructure of bacteroid-containing tissue of Pisum sativum L. peas having
      various regulatory mechanisms of nodulation].
AB  - The infected root nodule cells of Pisum sativum cvs. Torsdag, Rondo and its
      supernodulating mutant nod3 have been investigated by transmission electron
      microscopy and morphometrically. Torsdag and nod3 developed effective nodules,
      when grown with or without nitrates in the growth medium. The nodules developed
      by Rondo were ineffective in the presence of nitrates, and otherwise effective.
      An obvious similarity in the fine structure of bacteroid tissue of root nodules
      has been observed in Torgsdag (Nod5) and the supernodulating mutant nod3, both
      forms being nitrate-tolerant, but nodulation being controlled by different
      genetic systems. The statistical processing results showed significant
      differences in the respective morphometric parameters of nodule cells between the
      plants grown according to either scheme: with and without nitrates. Combined
      nitrogen is likely to affect the ratio of symbionts in the infected nodule cells
      of cultivars with nitrate-tolerant nodulation.

PMID- 11204648
TI  - [Rodlet cells of fish in calcium deficiency in the external environment].
AB  - The ultrastructure of rodlet cells from the heat kidney of the carp Cyprinus
      carpio L. and tilapia Oreochromis mossambicus Peters has been studied. All the
      investigated cells displayed a common structure. The number of rodlet cells
      increased after exposure of fishes in Ca(2+)-free water or in the water
      supplemented with NH4+ or Cd2+. The latter were found to suppress Ca(2+)
      absorption from the environment.

PMID- 11204647
TI  - [Cajal bodies in nuclei of oocytes from the scorpion fly Panorpa communis].
AB  - The absence of nucleoli and rRNA synthesis in oocyte nuclei of the scorpion fly,
      Panorpa communis, was demonstrated using hybridization in situ. The
      immunocytochemical characteristics of a single large nuclear body of P. communis
      oocytes has been done which enabled us to recognize this structure as a Cajal
      body (CB). A marker of CBs coilin was detected in CBs of P. communis oocytes in
      addition to Sm-epitope of small nuclear RNPs (snRNPs), trimethylguanosine cap of
      snRNAs, and non-snRNP splicing factor, SC35. Besides, inactive
      hyperphosphorylated and nonphosphorylated forms of RNA polymerase II were also
      found in CBs. We put forward a suposition on possible roles of CBs in P. communis
      oocytes. On the one hand, CBs take part in the storage of RNA transcription and
      processing components to be used later during embryogenesis. On the other hand,
      they provide the primary assembly and redistribution of pre-mRNA transcription
      and processing components of the oocyte itself.

PMID- 11204649
TI  - [Induction of apoptosis in murine myeloma cells NS0/1, transfected with the gene
      for the basic heat shock protein HSP70i].
AB  - Murine myelomas are rare cell variants deficient in inducible isoform of Hsp70
      that protects cells from injury. In these cells Hsp70 is absent and is not
      induced under stress conditions. In this study myeloma cells NS0/1 were
      transfected with hsp70, and their susceptibility to apoptosis was challenged by
      serum deprivation or hydrogen peroxide. Expression of Hsp70 in NS0/1 cells made
      them more resistant to apoptosis in serum-free medium but did not affect their
      response to hydrogen peroxide. Hsp70 involvement in the protection of myeloma
      cells from apoptosis caused by different agents is discussed.

PMID- 11204650
TI  - [Noninduced single-stranded breaks in DNA in murine F9 teratocarcinoma cells].
AB  - Our previous study demonstrated the high incidence of non-induced DNA single
      strand breaks (SSB) in preimplantation mouse embryo genom (Patkin et al., 1994).
      F9 mouse teratocarcinoma cell line is an in vitro model for early embryonal
      differentiation, since F9 cells remind in many respects the inner cell mass cells
      of mouse blastocyst and are capable of differentiation under retinoic acid (RA)
      and dibutyryl cAMP (db-cAMP) treatment. Using gap filling reaction of F9
      metaphase chromosomes and single-cell DNA electrophoresis, we have observed
      multiple SSB in undifferentiated F9 cells as well as in F9 cells at the early
      steps of RA-induced differentiation (days of RA treatment), but not in terminally
      differentiated F9 cells and in mouse embryonal fibroblasts. Rad51 nuclear protein
      that binds specifically single stranded DNA is highly expressed in all cells of
      undifferentiated F9 population and is not expressed in terminally differentiated
      F9 population. Multiple SSB could lead to enhanced rate of sister chromatid
      exchanges (SCE) in F9 cells. In undifferentiated F9 population the level of SCE
      was 9.6 +/- 0.44 per metaphase, that was not higher than in NIH 3T3 cell line.
      However, RA treatment for 48 h led to rising the SCE level up to 16.68 +/- 0.72
      followed by its decrease to the initial rate by 72 h of RA treatment. Since the
      enhanced level of SSB in undifferentiated F9 cells and in mouse blastocyst does
      not normally lead to chromosomal instability, we consider SSB to be a natural
      consequence of fast-going DNA replication in these cells.

PMID- 11204651
TI  - [Effect of the C-terminal actin-binding sites of caldesmon on the interaction of
      actin with myosin].
AB  - TRITC-phalloidin or FITC-labeled F-actin of ghost muscle fibers was bound to
      tropomyosin and C-terminal recombinant fragments of caldesmon CaDH1 (residues 506
      793) or CaDH2 (residues 683-767). After that the fibers were decorated with
      myosin subfragment 1. In the absence of caldesmon fragments, subfragment 1
      interaction with F-actin caused changes in parameters of polarized fluorescence,
      that were typical of "strong" binding of myosin heads to F-actin and of the
      "switched on" conformational state of actin. CaDH1 inhibited, whereas CaDH2
      activated the effect of subfragment 1. It is suggested that C-terminal part of
      caldesmon may modulate the transition of F-actin subunits from the "switched on"
      to the "switched off" state.

PMID- 11204652
TI  - [Features of formation of phases of dual-phase polymeric system in the presence
      of collagen I, laminin I, and their mixtures].
AB  - A study was made of the phase formation kinetics of a two-phase aqueous polymer
      system, consisting of 7.8% (w/w) dextran-500 and 4.6% (w/w) polyethylene glycol
      6000, in the presence of various concentrations of collagen (0.07-0.20 mg/ml),
      laminin I (0.01-0.03 mg/ml) and their mixture. The phase formation was evaluated
      by registration of its optical density on a spectrophotometer. The obtained two
      phase polymer system optical density curves and also the partitioning
      coefficients for the studied objects depend on surface properties of these
      objects. It has been shown that the surface properties of collagen I and laminin
      I differ according to differences in their molecules conformations, and that the
      phase formation kinetics points to their interaction during a mutual partitioning
      of these proteins in the system. The authors made a conclusion that collagen I
      and laminin I in the two-phase polymer system conditions could make complexes.

PMID- 11204654
TI  - [Effect of certain lectins on platelet aggregation in healthy people].
AB  - A study was made of the ability of some plant lectins, which bind specifically to
      different carbohydrate determinants of glycoproteins, to induce the platelet
      aggregation in healthy humans. It has been shown that phytohemagglutinin (PHA)
      and wheat germ agglutinin (MGA) induce a more marked platelet aggregation than
      concanvalin A (Con A). Lens culinaris agglutinin (LCA) had a slight aggregate
      activity. It was pointed at different roles played by carbohydrate determinants
      of platelet glycoproteins in fulfilling their aggregation function.

PMID- 11204655
TI  - [Internuclear chromosomal bridges and nuclei with protrusions in cellular
      populations of rat PA-23 rhabdomyosarcoma].
AB  - Internuclear chromosome bridges (CB) and nuclear protrusions (NP) were
      investigated in cell populations of RA-23 rat rhabdomyosarcoma. A morphological
      classification of different types of CB and NP has been offered. The obtained
      data suggest a morphological similarity between CB and NP. It is likely that NP
      could arise from CB after its break. So, NPs may be regarded as remains of broken
      CB.

PMID- 11204653
TI  - [External signals can induce stable increase in frequency of cell death in
      populations].
AB  - Relatively weak radiation and some other external actions, producing no "forced"
      cell death, trigger some intracellular mechanisms in various unicellular
      organisms (amoebae, ciliates, yeasts) and in the studied mammalian cells (rat
      vascular endotheliocytes). These mechanisms provide spasmodic changes: massive
      transition of cell populations into a stationary alternative state which is
      characterized by an increased predisposition to cell death, in comparison with
      the initial level. This phenomenon is considered as a particular, widely spread
      in nature form of genetic control of cell death frequency populations.

PMID- 11204656
TI  - [Mode of serotype inheritance in exoconjugant progeny of the ciliate Dileptus
      anser].
AB  - Two clones of Dileptus anser, originally isolated from natural reservoirs and
      referred to below as B and D clones, were found to display different serotypes,
      when cultured under identical laboratory conditions. On being tested with two
      different polyclonal rabbit immune sera against each particular clone (the
      classic immobilization test) these clones showed no cross-reaction. At a standard
      dilution (1:50) and at a standard exposure time (4 h), either of the two immune
      sera immobilized 100% or commonly 0% of homologous and heterologous clone cells,
      respectively. In addition, the difference in serotypes was confirmed by the
      immunofluorescence analysis. By crossing (conjugation) between B (mating type I)
      and D (mating type III) cells, exconjugant F1 clones were obtained. Their
      serotypes were then tested (the same immobilization test) with antisera against
      both the "parental" clones: some clones were tested before their sexual
      maturation in ca. one month after conjugation, while others were examined in
      approximately 4 months after conjugation, i.e. after reaching maturity. Each of
      the F1 clones could react with both immune sera, which means that they possessed
      the intermediate, "hybrid" phenotype. Five different F1 clones were selected, and
      each of them was back-crossed to both "parental" clones, B and D. We succeeded in
      raising 25 exconjugant F2 (B1, to be more exact) clones from F1 x B crosses and
      26 clones from F1 x D crosses. The conventional testing of these clones in 5-10
      weeks after conjugation provided quite unexpected results, since among them no
      segregation for "parental" serotypes was observed. Each of the 51 tested clones
      demonstrated the "hybrid" serotype--seemingly the same as that of F1 clones. Such
      a non-Mendelian inheritance of the character is hardly to explain from the
      standard, canonical assumptions on the genetic control of serotype difference
      between original "parental" clones (different alleles in one locus? different
      loci?). Also it does not seem likely that the absence of segregation could result
      from differential survival of various phenotypes in F2 (although the total
      viability of exconjugant clones appeared rather low). The above data obviously
      need further confirmations and experimental analyses. We attempt to discuss the
      obtained results in terms of the epigene hypothesis (Tchuraev, 1975) and in
      relation to the epigenetic control of serotype expression in species of the
      Paramecium aurelia complex and in Tetrahymena thermophila, which are "the chosen
      few" subjects in ciliate genetics.

PMID- 11204657
TI  - Safety of oxaliplatin in the treatment of colorectal cancer.
AB  - The new platinum compound oxaliplatin (Eloxatin) appears to have activity, either
      alone or in combination, as both first- and second-line therapy for advanced
      colorectal cancer. Unlike other platinum derivatives, it is not associated with
      significant nephrotoxicity or ototoxicity. The addition of oxaliplatin at 85
      mg/m2 to a fluorouracil/leucovorin-based regimen administered every 2 weeks is
      well tolerated. The incidence of diarrhea and stomatitis increases with the
      addition of oxaliplatin, but can be managed by adjusting the dose. There is also
      a significantly higher incidence of grade 3 or 4 neutropenia with oxaliplatin.
      Neutropenic febrile complications are rare. The occurrence of other hematologic,
      hepatic, or renal toxicities does not increase when oxaliplatin is added to
      fluorouracil-based regimens. Unlike other agents used for the treatment of
      colorectal cancer, oxaliplatin causes acute and chronic neurosensory symptoms.
      These acute symptoms are managed by taking precautions (e.g., avoid cold
      drinks/food for a few days following treatment). Cumulative neurotoxicity is the
      dose-limiting toxicity associated with oxaliplatin treatment. This toxicity
      appears reversible with discontinuation of the drug and typically occurs well
      after the onset of tumor response.

PMID- 11204658
TI  - Second-line therapy in colorectal cancer.
AB  - Second-line therapy is a relatively new concept for gastrointestinal oncologists.
      Although retreatment with fluorouracil (5-FU) is common, offering colorectal
      cancer patients a different chemotherapeutic agent as second-line therapy is a
      fairly recent strategy. The focus of this article is on the use and efficacy of
      oxaliplatin (Eloxatin) as second-line therapy for colorectal cancer. As such,
      this article will present very limited data on the toxicity of oxaliplatin
      regimens.

PMID- 11204659
TI  - NCI cooperative research and development agreements.
AB  - The Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute
      (NCI) currently sponsors more than 160 Investigational New Drug applications
      (INDs), and is involved in approximately 1,600 active protocols. It is also
      currently involved in more than 50 collaborative agreements with pharmaceutical
      companies. These agreements consist of cooperative research and development
      agreements (CRADAs) and clinical trials agreements (CTAs). A CRADA is a detailed
      contract between the NCI and a pharmaceutical company for the clinical co
      development of an investigational agent, and may include preclinical development
      that stipulates terms for a broader scope of research than that covered by a CTA.
      The CTEP/Investigational Drug Branch is currently involved in a number of
      oxaliplatin (Eloxatin) protocols under the CRADA program.

PMID- 11204661
TI  - Oxaliplatin in tumors other than colorectal cancer.
AB  - Oxaliplatin (Eloxatin) has demonstrated significant activity in a variety of
      tumor types in addition to colorectal cancer. Several studies have reported on
      the effectiveness of oxaliplatin as single-agent treatment or in combination with
      cisplatin (Platinol) or paclitaxel (Taxol) in pretreated advanced ovarian cancer
      patients, with promising data reported for the combination of oxaliplatin and
      cisplatin as first-line therapy. Other small studies have shown the activity of
      single-agent oxaliplatin in anthracycline-resistant metastatic breast cancer and
      refractory non-Hodgkin's lymphoma. Data have also demonstrated the activity of
      oxaliplatin in combination with gemcitabine (Gemzar) in advanced pancreatic
      cancer. In recurrent germ-cell cancer, a "biplatin" regimen of oxaliplatin plus
      cisplatin was found to be effective salvage therapy. Data from these studies
      indicate that oxaliplatin is active in both platinum-resistant disease and in
      tumor types that have previously been unresponsive to platinum treatment.
      Moreover, it enhances the effect of cisplatin or carboplatin, which is a striking
      demonstration of differing mechanisms of action. Ongoing and planned trials will
      evaluate the efficacy of oxaliplatin in other disease settings and combinations.

PMID- 11204660
TI  - Oxaliplatin with 5-FU or as a single agent in advanced/metastatic colorectal
      cancer.
AB  - No adequate second- or third-line therapy is available in the United States for
      patients with metastatic colorectal cancer and disease progression following
      treatment with fluorouracil (5-FU)-based therapy and an irinotecan (CPT-11,
      Camptosar)-containing regimen, or a combination of the two. Oxaliplatin
      (Eloxatin), a new platinum analog, has demonstrated high activity in the
      treatment of colorectal cancer, especially when combined with 5-FU and
      leucovorin. The combination of oxaliplatin and 5-FU/leucovorin has been approved
      in Europe for the first- and second-line treatment of colorectal cancer. This
      compassionate-use study was initiated because of the unavailability of the agent
      in the United States and inadequate US safety data. The following review
      summarizes data from this ongoing study, the primary focus of which is to provide
      oxaliplatin for compassionate use until it receives US Food and Drug
      Administration approval and becomes available commercially.

PMID- 11204662
TI  - Rectal cancer: integrating oxaliplatin into chemoradiation studies.
AB  - The current standard of care for patients with stage T3 rectal cancer is adjuvant
      combined-modality treatment with radiation and fluorouracil (5-FU)-based
      chemotherapy. Although data from randomized phase III trials comparing
      preoperative and postoperative combined-modality therapy are lacking,
      preoperative therapy is an option in T3 disease and can be considered the
      standard of care for T4 disease. Given its effects in reducing systemic disease
      in stage IV rectal cancer and its potential for radiosensitization of target
      tumors, oxaliplatin (Eloxatin), a new cytotoxic agent from the diaminocyclohexane
      platinum family, is being evaluated in preoperative combined-modality regimens in
      a Cancer and Leukemia Group B (CALGB) phase I/II study (protocol 89901) in T4
      disease and an Eastern Cooperative Group (ECOG) phase I study (E-1297) in locally
      advanced T3 or T4 disease.

PMID- 11204663
TI  - Oxaliplatin in colorectal cancer: current studies.
AB  - One of the more promising chemotherapeutic agents for patients with metastatic
      colorectal cancer is oxaliplatin (Eloxatin), a third-generation platinum
      derivative with a unique mechanism of action. Preclinical studies corroborated by
      results from early trials suggested that oxaliplatin could be particularly
      advantageous when used in combination with fluorouracil (5-FU)/leucovorin. In
      addition, early studies of oxaliplatin as monotherapy showed clear activity
      similar in magnitude to that observed with other active agents. When administered
      as neoadjuvant therapy in patients with unresectable liver metastases, the
      responses were substantial enough for some patients to undergo potentially
      curative hepatic resection. These trials also demonstrated a reasonable safety
      profile for oxaliplatin. In light of the accumulating data on the use of
      oxaliplatin in advanced colorectal cancer, the North Central Cancer Treatment
      Group (NCCTG) and other cooperative groups developed trials to further define the
      specific therapeutic roles and optimal regimens of oxaliplatin combined with 5-FU
      and leucovorin, as well as other agents. A number of studies are underway in the
      United States, including the three-arm NCCTG N9741 trial in patients with
      previously untreated metastatic colorectal cancer, the NCCTG N9841 trial in
      patients who progressed on 5-FU/leucovorin, and the National Surgical Adjuvant
      Breast and Bowel Project (NSABP) C-07 adjuvant trial for stage II and III
      colorectal cancer.

PMID- 11204664
TI  - Intrahepatic therapy for resected hepatic metastases from colorectal carcinoma.
AB  - A significant number of patients with colorectal cancer will present with hepatic
      metastases as their only site of metastatic disease. Surgical resection in
      patients with a limited number of metastases will lead to long-term survival in
      up to one-third. However, following surgery, many of these patients will relapse
      within the liver, and many will develop extrahepatic metastases. The use of
      hepatic artery infusion alternating with systemic therapy has proven to reduce
      the risk of recurrent disease and improve survival. Impressive response rates
      have been achieved with the combination of oxaliplatin and fluorouracil (5-FU) in
      patients with metastatic colorectal carcinoma. In one trial, this combination
      resulted in significant tumor shrinkage allowing resection of previously
      unresectable hepatic metastases. Given the promising activity of oxaliplatin
      (Eloxatin), 5-FU, and leucovorin, a trial is now in development to assess the
      efficacy of this combination when used together with hepatic artery infusion.

PMID- 11204665
TI  - Novel combinations with oxaliplatin.
AB  - Oxaliplatin (Eloxatin) is a novel antineoplastic platinum derivative that may
      exert its cytotoxic effects by blocking DNA replication/transcription, thus
      resulting in cell death in proliferating cells, as well as apoptosis. Oxaliplatin
      is often more potent than other platinums such as cisplatin (Platinol) in vitro,
      and shows greater efficacy in preclinical studies against many tumor cell lines,
      including some that are resistant to cisplatin and carboplatin (Paraplatin).
      Oxaliplatin is approved for use with the fluoropyrimidines in the treatment of
      metastatic colorectal cancer in Asia, Latin America, and Europe. In light of the
      broad efficacy of oxaliplatin in several solid tumors and the encouraging
      preclinical data on combination therapy with novel agents (e.g., thymidylate
      synthase inhibitors, epidermal growth factor-receptor antagonists, microtubule
      interactive agents), this article will review the published literature on novel
      combinations that have been tested in the laboratory and/or the clinic.

PMID- 11204666
TI  - Efficacy of oxaliplatin in the treatment of colorectal cancer.
AB  - Colorectal cancer is one of the leading causes of cancer death. The mainstay of
      chemotherapy in colorectal cancer patients for the past 40 years has been
      fluorouracil (5-FU). Oxaliplatin (Eloxatin) is a novel platinum compound with
      promising activity in colorectal cancer. As a single agent, oxaliplatin has
      produced response rates of 12% to 24% in patients with previously untreated
      advanced colorectal cancer, and 10% to 11% in patients with relapsed or
      refractory advanced colorectal cancer. In phase II trials, oxaliplatin combined
      with 5-FU, with or without leucovorin, was associated with response rates of 60%
      and higher when used as front-line therapy, and when used in patients with
      relapsed or refractory advanced colorectal cancer, response rates ranged from 25%
      to 50%. In the front-line setting, two randomized trials of 5-FU and leucovorin,
      with or without oxaliplatin, demonstrated that the addition of oxaliplatin
      significantly increases response rate and time to tumor progression, but not
      survival, over 5-FU plus leucovorin alone. The reasons for this discrepancy are
      unclear, and several possibilities are being considered. Additional phase III
      trials are underway to clarify the contribution of oxaliplatin in the treatment
      of patients with locally advanced and metastatic colorectal cancer.

PMID- 11204668
TI  - Thalidomide in solid tumors: the London experience.
AB  - Investigators at the Royal Marsden Hospital and University College in London have
      studied thalidomide (Thalomid) as both low-dose (100 mg orally, every night) and
      high-dose (600 mg, given as 300 mg twice per day) therapy for patients with a
      variety of solid tumors. In the phase II low-dose study, responses were
      disappointing in patients with melanoma, ovarian cancer, and breast cancer.
      Results for patients with renal-cell carcinoma were more encouraging. A case
      study of a patient with metastatic renal-cell carcinoma in the lung and lymph
      nodes in the low-dose thalidomide study illustrates that (1) responses may be
      very slow; (2) the palliative response is separate from the overall response,
      occurs much earlier, and is not consistent with an antiangiogenic action; and (3)
      peripheral neuropathy is a manageable side effect. Besides peripheral neuropathy,
      patients can experience severe constipation (even on low doses) as well as
      headache, edema, and skin rash for which treatment recommendations can be made.
      Anecdotal benefits of thalidomide include enhanced or maintained appetite,
      improved sleeping, and reduced sweating. The high-dose study has been submitted
      for publication.

PMID- 11204667
TI  - Thalidomide in multiple myeloma.
AB  - Recent evidence suggests that angiogenesis is increased in multiple myeloma and
      has prognostic value in the disease. Based on the increased angiogenesis observed
      in myeloma, thalidomide (Thalomid) has been studied as antiangiogenic therapy.
      Although its mechanism of action in myeloma is unclear, several trials show that
      thalidomide is active in 25% to 35% of patients with relapsed myeloma. Since many
      patients who respond have failed other active regimens, including
      transplantation, these results are impressive. Major toxicities include
      constipation, sedation, skin rash, fatigue, and peripheral neuropathy. Studies
      are ongoing to determine its role as initial treatment for myeloma. Trials are
      also underway combining thalidomide with other active agents. This article
      summarizes the current status of thalidomide therapy in myeloma.

PMID- 11204669
TI  - Development of angiogenesis inhibition as therapy for prostate cancer.
AB  - Angiogenesis is essential to prostate cancer progression. The first study of
      antiangiogenic therapy in patients with locally advanced prostate cancer at The
      University of Texas M. D. Anderson Cancer Center showed that preoperative
      treatment with a fumagillin analog was safe. Microvascular density correlated
      with Gleason score, but marked intertumoral and intratumoral changes were
      observed. Clinical experience with thalidomide (Thalomid), which inhibits
      angiogenesis induced by both vascular endothelial growth factor and basic
      fibroblast growth factor, has included observation of "clinical improvement" in
      patients with androgen-independent prostate cancer and anecdotal responses in
      patients with metastatic disease refractory to chemotherapy. In an effort to
      assess the in vivo effect of thalidomide in prostate carcinoma, we have initiated
      a study of neoadjuvant thalidomide treatment in patients with locally advanced
      prostate cancer that is to include serial ultrasonographic and pathologic
      evaluation, as well as serial collection of serum/urine markers that may prove
      useful surrogate markers of antiangiogenic activity. We have also initiated a
      phase I/II trial of thalidomide, paclitaxel (Taxol), and estramustine (Emcyt) in
      patients with metastatic androgen-independent prostate cancer progressing after
      up to two courses of chemotherapy.

PMID- 11204670
TI  - New approaches in the treatment of metastatic melanoma: thalidomide and
      temozolomide.
AB  - Although melanoma is a relatively chemoresistant malignancy, systemic
      chemotherapy remains the primary treatment for metastatic melanoma. The
      observation of vasculogenic mimicry in aggressive melanoma has prompted
      investigation into using an antiangiogenic agent to enhance the antitumor
      activity of chemotherapy in metastatic melanoma. Thalidomide (Thalomid) exhibits
      antiangiogenic activity and other biological modulatory effects that may provide
      additive or synergistic antitumor effects when given concurrently with
      chemotherapy. A phase I/II study of thalidomide and temozolomide in the treatment
      of metastatic melanoma is in progress. Preliminary results of this combination
      therapy have shown significant antitumor activity, including some striking
      responses in brain metastases.

PMID- 11204671
TI  - Irinotecan and thalidomide in metastatic colorectal cancer.
AB  - Fifteen patients with metastatic colorectal cancer were treated with irinotecan
      (CPT-11, Camptosar) at 300 to 350 mg/m2 every 21 days and thalidomide (Thalomid)
      at 400 mg/d. Of the 15 patients, 11 were in a pilot study and 4 were in an
      ongoing phase II protocol. There were 12 men and 3 women, with a median age of 56
      years (range: 29 to 79 years). Patients were treated with a median of three
      cycles (range: one to eight cycles). The four patients enrolled in the formal
      protocol were not evaluable for response at the time of this report. Of the 11
      patients in the pilot study, 10 were evaluable for response; there were two
      complete responses, two partial responses, and six progressions. Investigators
      noted a remarkable absence of grade 3/4 gastrointestinal toxicities, and
      concluded that further testing of the complete response and toxicity profile of
      the irinotecan/thalidomide regimen was warranted.

PMID- 11204672
TI  - Thalidomide for recurrent renal-cell cancer in a 40-year-old man.
AB  - A pilot study was performed at The University of Texas M. D. Anderson Cancer
      Center to determine the feasibility of using thalidomide in a population of renal
      cell carcinoma patients who had progressive disease despite chemotherapy and
      immunotherapy. Metastatic renal-cell carcinoma patients with adequate oral
      function were entered onto a study after signing an internal review board
      approved informed consent. There were no exclusion criteria for prior therapy.
      Nineteen previously treated patients and one untreated patient with progressive
      renal-cell carcinoma received oral thalidomide as a single agent. The starting
      dose was 200 mg and the dose was increased by 100 to 200 mg every week until it
      reached 1,200 mg/d. Response was assessed on the basis of a radiographic
      reduction of the metastatic sites involved. A case report describing one of the
      patients involved in the pilot trial is included.

PMID- 11204674
TI  - Factors related to relapse after Le Fort I maxillary advancement osteotomy in
      patients with cleft lip and palate.
AB  - OBJECTIVE: To identify factors associated with relapse after maxillary
      advancement in cleft lip and palate patient. SUBJECTS: Seventy-one cleft lip and
      palate patients underwent Le Fort I maxillary advancement osteotomy between 1988
      and 1998, and 58 patients (42 unilateral cleft and 16 bilateral cleft) with
      complete data were investigated for relapse by clinical and cephalometric
      analysis. The clinical follow-up period ranged from 1.5 to 8.5 years (mean 2.5
      years). RESULTS: Horizontal advancement averaged 6.9 mm. There was a significant
      correlation between surgical movement and postoperative relapse in both the
      horizontal and vertical planes. In vertical repositioning, 15 patients had
      maxillary intrusion and 31 had inferior repositioning. There was a significant
      difference between the intrusion group and the inferior repositioning group.
      There was a significant correlation between surgical and postoperative rotation
      regardless of the direction. Other factors were evaluated by the horizontal
      relapse rate. Type of cleft and the rate of relapse were statistically
      associated. A relapse was more likely to occur in patients with bilateral cleft.
      There were no significant associations with the rate of relapse in type of
      operations or previous alveolar bone grafting. There was no significant
      correlation between the rate of relapse and the number of missing anterior teeth,
      postoperative overbite and overjet, and age at operation. Four of 71 patients
      experienced major relapse, and 3 of them underwent jaw surgery again.
      CONCLUSIONS: Based on clinical and cephalometric analysis, two-jaw surgery should
      be performed in cases of severe maxillary hypoplasia, and overcorrection may be
      useful in inferior repositioning or surgical rotation. Special attention should
      be paid to the patient with bilateral cleft, multiple missing teeth, or shallow
      postoperative overbite.

PMID- 11204675
TI  - Secondary bone grafting of alveolar clefts: a densitometric comparison of iliac
      crest and tibial bone grafts.
AB  - OBJECTIVE: To evaluate changes in the optical density of secondary alveolar cleft
      bone grafts obtained from two different donor sites over time and to determine
      whether one donor site gives a higher recipient bone density than the other.
      METHODS: A prospective study was performed evaluating 40 healthy patients with
      congenital cleft lip and palate undergoing secondary alveolar bone grafting, 20
      (14 boys and 6 girls) having iliac crest and 20 (12 boys and 8 girls) receiving
      tibial bone grafts. Bone harvest and grafting was carried out by one operator
      (G.P.). Optical density of iliac and tibial grafts measured using a computerized
      densitometer, was compared at 6 days, 6 weeks, and 3 months. Due to interference
      from orthodontic appliances, optical density measurements for 16 subjects were
      not possible, and these patients were excluded from the study. The length of
      hospital stay postoperatively for both grafting procedures were recorded.
      RESULTS: A significant decrease in relative bone density was demonstrated during
      the 3-month postoperative period in both iliac and tibial bone graft groups (p <
      .05). The difference in densities between iliac crest and tibial groups were not
      significantly different at any of the time points (paired t test, p > .05).
      Subjects undergoing iliac crest grafts stayed an average of 5 days in the
      hospital postoperatively, compared with subjects with tibial grafts who stayed an
      average of 3 days postoperatively. CONCLUSION: Optical density measurements of
      bone grafted into alveolar clefts, reported here for the first time, provide a
      valuable objective assessment of graft progress. Tibial and iliac crest grafts
      gave similar optical densities at recipient sites over the first 3 months. Iliac
      crest grafts required significantly longer postoperative stay; an important
      consideration in selecting donor sites for secondary bone grafting.

PMID- 11204676
TI  - Hypodontia in hemifacial microsomia.
AB  - OBJECTIVE: The purpose of this study was twofold: (1) to describe the patterns of
      missing teeth in patients with hemifacial microsomia (HFM) and (2) to compare the
      prevalence of missing teeth in subjects with HFM with a group of unaffected
      subjects. STUDY DESIGN: A descriptive study was conducted comparing HFM subjects
      with a group of patients selected from an orthodontic clinic. METHODS: The
      prevalence of missing teeth was assessed by evaluation of panoramic radiographs.
      At the time of the study, records of 125 patients with HFM were available from
      the Craniofacial Center at Boston's Children's Hospital. Seventy-six met
      inclusion criteria for radiographic analysis of hypodontia. Fifty-two patients
      met inclusion criteria into the comparison study in which the prevalence of
      hypodontia was compared with a group of patients from the Department of
      Orthodontics at Harvard School of Dental Medicine. A Fisher's exact test was
      conducted to test the hypothesis that HFM patients have a greater prevalence of
      missing teeth than individuals without the anomaly. A chi-square test for trend
      was conducted to determine whether hypodontia was more prevalent with increasing
      severity of the mandibular deformity in HFM. RESULTS: Hypodontia was more common
      among HFM patients (26.9%) versus the comparison group in which no missing teeth
      were recorded (p < .0001). Additionally, the degree of hypodontia was correlated
      with the grade of mandibular hypoplasia (p = .024). CONCLUSION: Hypodontia was
      found to be more prevalent in patients with HFM than in comparison subjects,
      possibly indicating an etiologic link between the two conditions.

PMID- 11204677
TI  - Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory
      Group (CSAG) Study. Part 1: background and methodology.
AB  - OBJECTIVE: To review the history of cleft care in the United Kingdom and the
      rationale and methodology of a national study. DESIGN: Descriptive overview to
      introduce this series of papers. SETTING: Fifty National Health Service cleft
      teams. PATIENTS/PARTICIPANTS: Two age cohorts, 5-year-olds and 12-year-olds, with
      nonsyndromic complete unilateral cleft lip and palate and their parents. MAIN
      OUTCOME MEASURES: Facial development and appearance, quality of bone grafts,
      speech, oral health and patient/parent satisfaction. CONCLUSIONS: The case for a
      national assessment of cleft care is made. The methodology of the cross-sectional
      outcome study is described, together with a survey of training for recently
      appointed clinicians.

PMID- 11204678
TI  - Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory
      Group (CSAG) Study. Part 2: dentofacial outcomes and patient satisfaction.
AB  - OBJECTIVE: To describe facial development and appearance, quality of bone grafts,
      oral health, and patient/parent satisfaction, with clinical outcome, for children
      in two age cohorts born with unilateral cleft lip and palate (UCLP) throughout
      the United Kingdom. DESIGN: Cross-sectional outcome study. SETTING: Fifty
      National Health Service cleft centers. PARTICIPANTS: Children born with complete
      UCLP between April 1, 1982, and March 31, 1984, (12-year-olds) and April 1, 1989,
      and March 31, 1991 (5-year-olds). Data were collected for 239 5-year-olds and 218
      12-year-olds. The parents of these children were also interviewed to determine
      levels of satisfaction with care received. MAIN OUTCOME MEASURES: Skeletal
      pattern, dental arch relationship, success of alveolar bone grafting, facial
      appearance, oral health status, and patient/parent satisfaction. RESULTS: Nearly
      40% of 5- and 12-year-olds had poor dental arch relations, and 70% of 12-year
      olds had midface retrusion. Fifteen percent of 12-year-olds had not received an
      alveolar bone graft, and only 58% of bone grafts that had been undertaken were
      successful. Twenty percent of 12-year-olds and 40% of 5-year-olds had untreated
      dental caries. Less than one-third of subjects had a good facial appearance as
      judged by a panel of experts. Levels of patient and parent satisfaction were
      generally high. CONCLUSION: A rigorous evaluation of cleft care in the United
      Kingdom reveals disappointing outcomes.

PMID- 11204679
TI  - Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory
      Group (CSAG) Study. Part 3: speech outcomes.
AB  - OBJECTIVE: To summarize speech outcomes in children born with unilateral cleft
      lip and palate (UCLP) throughout the United Kingdom. DESIGN: Prospective
      descriptive study on a cross-sectional sample of children. PATIENTS/PARTICIPANTS:
      Data were collected for 238 5-year-olds (born between April 1, 1989, and March
      31, 1991) and 218 12-year-olds (born between April 1, 1982, and March 31, 1984)
      with complete UCLP. MAIN OUTCOMES: Ratings of intelligibility, nasality, "speech
      cleft type characteristics" and speech therapy intervention. CONCLUSIONS:
      Nineteen percent of 5-year-olds and 4% of 12-year-olds were judged to be
      impossible to understand or just intelligible to strangers. Thirty-four percent
      of 5-year-olds and 17% of 12-year-olds had at least one serious error of
      consonant production. Eighteen percent of 5-year-olds and 12-year-olds had
      consistent hypernasality of mild, moderate, or severe degree. Approximately two
      thirds of both age groups had undergone speech therapy.

PMID- 11204680
TI  - Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory
      Group (CSAG) Study. Part 4: outcome comparisons, training, and conclusions.
AB  - OBJECTIVE: A critical appraisal of cleft care in the United Kingdom. DESIGN:
      Retrospective comparative study. SETTING: All National Health Service cleft
      centers in the United Kingdom. PATIENTS/PARTICIPANTS: Children born with
      unilateral complete clefts of the lip and palate between April 1, 1982, and March
      31, 1984 (12-year-olds), and April 1, 1989, and March 31, 1991 (5-year-olds).
      Newly appointed and senior cleft clinicians. MAIN OUTCOME MEASURES: Skeletal
      pattern, dental arch relationship, success of alveolar bone grafting, dental
      health, facial appearance, oral health status, patient/parent satisfaction.
      CONCLUSIONS: This paper highlights the poor outcomes for the fragmented cleft
      care in the United Kingdom, compared with European centers. There is an urgent
      need for a review of structure, organization, and training.

PMID- 11204681
TI  - Cleft lip and palate management by U.K. consultant oral and maxillofacial
      surgeons: a national survey.
AB  - OBJECTIVE: Following the report of the Clinical Standards Advisory Group (CSAG),
      a national survey of U.K. consultant oral and maxillofacial surgeons was
      performed to determine the current cleft lip and palate practice of this group
      prior to the implementation of proposed radical changes in the delivery of cleft
      services. The views of these surgeons regarding the proposed changes was also
      sought. DESIGN: An anonymous postal questionnaire sent to all 266 consultants in
      the U.K., which requested information on the practice of cleft surgery during a
      defined 1-year period (March 1997 through February 1998). It included the numbers
      and types of procedures performed, the involvement of multidisciplinary care,
      research and audit activity, and questions regarding the implementation of CSAG.
      RESULTS: One hundred ninety-one replies (72% response rate). Seventy-three
      surgeons were actively involved with mainly secondary cleft surgery. A varied
      number and range of procedures were undertaken, with most surgeons performing
      less than five of each procedure per year. Audit and research activity was 26%.
      The majority of both noncleft and cleft surgeons agreed with proposals made by
      CSAG (except for cleft osteotomy procedures). CONCLUSIONS: In the U.K. at
      present, there are many oral and maxillofacial surgeons performing mainly
      secondary cleft surgery; overall, the number of procedures performed by these
      surgeons per year is small. Intraspecialty referral is suggested to further
      improve patient outcome.

PMID- 11204682
TI  - Comparison between the palatal configurations in complete and incomplete
      unilateral cleft lip and palate infants under 18 months of age.
AB  - OBJECTIVE: The purpose of this study was to examine the three-dimensional
      characteristics of the palatal configurations in incomplete unilateral cleft lip
      and palate (UCLP) patients and to determine whether there are differences in the
      effect of early orthopedic treatment between complete and incomplete UCLP
      patients. DESIGN: Eight infants with incomplete UCLP and 12 infants with complete
      UCLP, selected at random, wore Hotz plates, and 8 other infants with complete
      UCLP did not. Palatal impressions were taken of these patients immediately after
      birth and at 1, 2, 3, 4 (just before cheiloplasty), 6, and 18 months of age (just
      before palatoplasty). Using our measuring system, the palatal casts were measured
      and compared three-dimensionally. RESULTS AND CONCLUSIONS: The palate of the
      incomplete UCLP patients measured immediately after birth, compared with complete
      UCLP, showed: (1) smaller posterior arch width; (2) sagittal arch length did not
      differ; (3) incisal point was located more mesially; (4) the gap between the
      alveolar arch forms of the major and minor segments was smaller; and (5) the
      curvature of the palatal surface forward the nasal cavity in the minor segment
      was less. At 18 months of age, the following characteristics could be observed:
      (1) the difference observed at birth in the posterior arch width between the
      incomplete and complete UCLP infants vanished; (2) a significant difference in
      the location of the incisal point was observed only between the incomplete UCLP
      infants and the complete UCLP infants with a Hotz plate; and (3) the curvature
      was less in the incomplete UCLP infants than in the complete UCLP infants.
      Furthermore, the morphological change of the palatal surface was less in the
      incomplete UCLP infants than in the complete UCLP infants. This suggested that
      any influence of the Hotz appliance might be less in incomplete UCLP than in
      complete UCLP.

PMID- 11204683
TI  - What information do parents of newborns with cleft lip, palate, or both want to
      know?
AB  - BACKGROUND: The unexpected birth of a baby with a cleft lip and palate (CL/P) is
      a shocking and traumatic experience, generating anxiety for parents as well as
      the attendant health care team. Parents frequently leave the hospital with many
      unanswered questions because health care professionals do not educate them
      adequately. OBJECTIVE: To determine what information these parents felt was
      "critical" for them during the immediate newborn period and to determine how the
      "informer" was perceived during these encounters. DESIGN: Retrospective, self
      administered questionnaire. SUBJECTS AND METHODS: Biologic parents of children
      with isolated CL/P aged 6 years and younger were surveyed. The questionnaire
      asked parents whether they remembered discussing diagnosis, prognosis,
      management, home care, and psychosocial issues. Parents were also asked to rank
      how "critical" it would have been for the "informer" to have discussed certain
      issues with them during this first day. RESULTS: Parents gave the highest
      priority to feeding and learning to identify illness in their baby; 95% wanted to
      be shown all normal aspects of their baby's exam, and 87% wanted to be told that
      the CL/P was not their fault. Usage of proper terminology to describe abnormal
      findings and receiving assurance that their child was not in pain were also
      important. Unfortunately, many parents reported that the informers did not
      address these issues. CONCLUSIONS: Parents of newborns with CL/P want basic
      information in the immediate newborn period, especially regarding feeding and
      recognizing illness. These data suggest that informers are not adequately
      discussing these issues with parents.

PMID- 11204684
TI  - Reliability of listener transcriptions of compensatory articulations.
AB  - OBJECTIVE: This study examined the ability of speech-language pathologists to
      transcribe compensatory articulation errors. DESIGN: Speech-language pathologists
      phonetically transcribed audiorecordings of 130 monosyllabic words, 70 of which
      contained compensatory articulations. PARTICIPANTS: The participants for this
      study were two groups of 10 speech-language pathologists. Group I included speech
      language pathologists who were experienced in evaluating children with cleft
      palate, and group II speech-language pathologists were not. RESULTS: Marked
      variability was evident across listeners, with percentages of agreement ranging
      from 19 to 71 (mean agreement = 41%). The experienced listeners performed
      significantly better on the transcription task than the inexperienced listeners,
      but poor interjudge agreement was evident across both groups. CONCLUSIONS: The
      results of this study suggest that speech-language pathologists may differ in
      their understanding of the auditory perceptual characteristics of compensatory
      articulations. The results underscore the need for increased training and
      standardization of transcription procedures.

PMID- 11204685
TI  - Different cleft conditions, facial appearance, and speech: relationship to
      psychological variables.
AB  - OBJECTIVE: The purpose of this investigation was to study the adjustment and
      learning characteristics of children with different types of clefts. The
      hypotheses were that there may be different relationships among cleft variables
      (speech and appearance) according to the cleft types. DESIGN: The study compared
      three cleft groups on behavior rating, anxiety scales, depression scales, and
      self-perception (analyses of variance) and examined the influence of facial and
      speech ratings on self-perception (multiple regression analyses). SETTING: All
      patients were treated at a university hospital cleft palate clinic. PATIENTS:
      Sixty-five children aged 8 years to 17 years were selected based on nonsyndromic
      cleft (unilateral cleft lip and palate [ULP], bilateral cleft lip and palate
      [BLP], and cleft palate only [CPO]) and no significant neurological condition or
      hearing loss. RESULTS: The findings indicated children with CPO showed greater
      problems with parent- and teacher-reported depression, anxiety, and learning
      related to speech than children with ULP or BLP. The later two groups showed
      fewer problems and a greater relationship of problem to facial appearance. The
      children with ULP self-reported lower levels of depression than the other two
      groups. CONCLUSIONS: Children with cleft show relatively good overall adjustment,
      but some problems appear related to speech and facial appearance. Subgroups may
      need to be studied separately.

PMID- 11204686
TI  - Oral clefts and vitamin supplementation.
AB  - OBJECTIVES: The evidence linking low levels of folic acid and orofacial clefting
      (OFC) is presently equivocal. There is stronger evidence for the role of folic
      acid supplementation in protection against the occurrence and recurrence of
      neural tube defects. The present investigation tested the hypotheses that cleft
      lip, cleft palate, or both are inversely associated with maternal intake of
      dietary and supplemental vitamins during the periconceptional period and first 4
      months of pregnancy in a Brazilian population. DESIGN: A population-based, case
      control study of cleft lip with or without cleft palate (CL(P)) and isolated
      cleft palate (CP) in a Brazilian population. In structured interviews, case
      histories were taken from the mothers of a consecutive sample of 450 infants born
      with nonsyndromic OFC. RESULTS: Mothers who had children with CL(P) were less
      likely to have been supplemented during the periconceptional period. The
      statistical significance of the difference in prevalence of the use of
      supplements between mothers of patients and of controls was greater for the CL(P)
      group: p < .05 for CP and p < .001 for CL(P). Multivariate analysis confirmed
      this finding of a protective effect for both types of orofacial cleft.
      CONCLUSIONS: The use of vitamin supplements in the first 4 months of pregnancy
      was suggestive of a protective effect against the occurrence of CP and CL(P) in
      this population. The significance of an association between multivitamin
      supplementation and OFC and the possible role of gene/environment interaction are
      discussed.

PMID- 11204687
TI  - Furlow palatoplasty to restore velopharyngeal competence following tonsillectomy
      avulsion of a pharyngeal flap.
AB  - OBJECTIVE: We report the successful use of a Furlow palatoplasty to salvage
      velopharyngeal competence following iatrogenic avulsion of a pharyngeal flap that
      had been previously established to treat velopharyngeal insufficiency associated
      with a submucous cleft palate. INTERVENTION: A tonsillectomy, conducted by a
      surgeon unaffiliated with a cleft palate team, was used to remove enlarged
      tonsils that had developed after pharyngeal flap surgery and extended into the
      lateral ports causing nasal obstruction and hypernasality because of mechanical
      interference with port closure. A posttonsillectomy evaluation revealed avulsion
      of the pharyngeal flap, which was successfully treated using a Furlow
      palatoplasty. CONCLUSIONS: To our knowledge, this is the first report of
      iatrogenic avulsion of a pharyngeal flap caused by tonsillectomy. Based on a
      review of the literature and this case experience, we would conclude that
      tonsillectomy should not be regarded as a routine procedure in patients
      previously treated with a pharyngeal flap. If required, it should be performed by
      a skilled otolaryngologist, preferably one affiliated with a multidisciplinary
      cleft palate team who is familiar with pharyngoplasty surgery. Finally, our
      experience would suggest that the Furlow palatoplasty is sufficiently robust to
      be used as a secondary salvage procedure to restore velopharyngeal sufficiency
      following iatrogenic avulsion of a pharyngeal flap.

PMID- 11204688
TI  - Calf removal improves conception rates to the Ovsynch and CO-Synch protocols.
AB  - Beef cows (n = 473) from two locations were stratified by breed, postpartum
      interval, age, and AI sire and were randomly allotted to one of four treatments
      for synchronization of ovulation. Ovulation synchronization protocols included
      the Ovsynch protocol with (n = 114) or without (n = 123) 48-h calf removal from d
      7 to 9 (d 0 = 1st GnRH injection) or the CO-Synch protocol with (n = 119) or
      without (n = 117) 48-h calf removal from d 7 to 9. The Ovsynch protocol included
      administration of GnRH (100 microg; i.m.) on d 0, PGF2alpha (25 mg; i.m.) on d 7,
      GnRH (100 microg; i.m.) on d 9, and timed insemination on d 10. The CO-Synch
      protocol included administration of GnRH (100 microg; i.m.) on d 0, PGF2alpha (25
      mg; i.m.) on d 7, and GnRH (100 microg; i.m.) with timed insemination on d 9.
      Blood samples were collected from all cows on d -10 and d 0 for analysis of serum
      progesterone. Cows with at least one serum progesterone concentration greater
      than 1 ng/mL were considered to be cyclic at the time of treatment. Conception
      rates of cows that received the CO-Synch + calf removal, Ovsynch + calf removal,
      CO-Synch, or Ovsynch protocol (63, 61, 54, and 52%, respectively) were not
      different (P = 0.50). Conception rates were not different (P = 0.80) among CO
      Synch- and Ovsynch-treated cows; however, both estrual status and 48-h calf
      removal affected conception rates. Conception rates of cyclic cows (66%) were
      greater (P = 0.01) than those of anestrous cows (53%), regardless of which
      synchronization protocol was used. When data were pooled across synchronization
      protocol, conception rates of cows with 48-h calf removal (62%) were greater (P =
      0.09) than conception rates of cows without calf removal (53%). The CO-Synch +
      calf removal protocol induces a fertile ovulation in cyclic and anestrous cows,
      requires handling cattle just three times, results in high conception rates from
      timed insemination, and should be a useful program for synchronization of
      ovulation in beef cows.

PMID- 11204689
TI  - Recombinant bovine somatotropin (rbST) increases size and proportion of fast
      glycolytic muscle fibers in semitendinosus muscle of creep-fed steers.
AB  - The objective of this study was to determine the effect of recombinant bovine
      somatotropin (rbST) on muscle fiber histology and histochemistry in creep-fed
      beef steers. Crossbred steer calves were assigned to one of two treatment groups:
      control (sham-injected; n = 12) or rbST-injected (0.09 mg x kg(-1) x d(-1); n =
      12). Calves were injected every 14 d starting at d 28 of age until weaning at 205
      d of age. Biopsies of the semitendinosus muscle were performed on d 100, and
      slaughter samples of semitendinosus muscle were collected for muscle fiber
      analyses on d 206. The rbST-treated calves had larger (P = 0.045) fast-twitch
      glycolytic (FG) fibers [2,564 +/- 10 vs 2,351 +/- 11 microm2 cross-sectional
      area, respectively] than controls. No differences (P = 0.36) between rbST-treated
      and control steers in cross-sectional area were detected for slow-twitch
      oxidative (SO) [1,192 +/- 20 vs 1,148 +/- 22 microm2, respectively] or fast
      twitch-oxidative-glycolytic (FOG) fibers [1,484 +/- 35 vs 1,403 +/- 38 microm2,
      respectively]. The percentage distribution for FOG fibers was greater for control
      calves than for the rbST-treated calves (38.4 vs 34.9 +/- 0.1%, respectively; P =
      0.014), whereas the percentage distribution for FG fibers was greater in the rbST
      treated calves than for control calves (53.5 vs 48.4 +/- 0.2%, respectively; P =
      0.03). The percentage distribution for SO fibers tended to be greater for the
      control calves than for the rbST-treated calves (13.1 vs 11.7 +/- 0.1%,
      respectively; P = 0.07). The percentage of FG fibers increased with age (45.4 vs
      56.6 +/- 0.8%, respectively; P = 0.001), whereas the percentage distribution of
      SO (14.3 vs 10.5 +/- 0.5%, respectively) and FOG fibers (40.3 vs 32.9 +/- 0.7%,
      respectively) decreased (P = 0.001) from d 100 to d 206. The increased
      longissimus muscle area and dissectable lean tissue in rbST-treated calves are
      associated with a greater percentage of FG fibers, which possess larger cross
      sectional areas than the other fibers.

PMID- 11204690
TI  - Predicting percentage of intramuscular fat using two types of real-time
      ultrasound equipment.
AB  - In the present study, 500 steers were used to develop models for predicting the
      percentage of intramuscular fat (PIMF) in live beef cattle. Before slaughter,
      steers were scanned across the 11th and 13th ribs using Aloka 500V (AL-500) and
      Classic Scanner 200 (CS-200) machines. Four to five images were collected per
      individual steer using each machine. After slaughter, a cross-sectional slice of
      the longissimus muscle from the 12th rib facing was used for chemical extraction
      to determine actual carcass percentage of intramuscular fat (CPIMF). Texture
      analysis software was used by two interpreters to select a region for
      determination of image parameters, which included Fourier, gradient, histogram,
      and co-occurrence parameters. Four prediction models were developed separately
      for each of AL-500 and CS-200 based on images captured by the respective
      machines. These included models developed without transformation of CPIMF (Model
      I), models based on logarithmic transformation of CPIMF (Model II), ridge
      regression procedure (Model III), and principal component regression procedure
      (Model IV). Model R2 and root mean square error of AL-500 Models I, II, III, and
      IV were 0.72, 0.84%; 0.72, 0.85%; 0.69, 0.91%; and 0.71, 0.86%; respectively. The
      corresponding R2 and root mean square error values of CS-200 Models I, II, III,
      and IV were 0.68, 0.87%; 0.70, 0.85%; 0.64, 0.94%; and 0.65, 0.91%; respectively.
      Initially, AL-500 and CS-200 prediction models were validated separately on an
      independent data set from 71 feedlot steers. The overall mean bias, standard
      error of prediction, and rank correlation coefficient across the four AL-500
      models were 0.42%, 0.84%, and 0.88, respectively. For the four CS-200 models, the
      corresponding overall mean values were 0.67%, 0.81%, and 0.91, respectively. In a
      second validation test, only Model II of AL-500 and CS-200 was evaluated
      separately based on data from 24 feedlot steers. The overall mean bias, absolute
      difference, and standard error of prediction of AL-500 Model II were 0.71, 0.92,
      and 0.98%. For CS-200 Model II, the corresponding values were 0.59, 0.97, and
      1.03%. Both AL-500 and CS-200 equipment can be used to accurately predict PIMF in
      live cattle. Further improvement in the accuracy of prediction equations could be
      achieved through increasing the development data set and the variation in PIMF of
      cattle used.

PMID- 11204691
TI  - Carcass traits, cut yields, and compositional end points in high-lean-yielding
      pork carcasses: effects of 10th rib backfat and loin eye area.
AB  - Pork carcasses (n = 133) were used to investigate the influence of carcass
      fatness and muscling on composition and yields of pork primal and subprimal cuts
      fabricated to varying levels of s.c. fat. Carcasses were selected from commercial
      packing plants in the southeastern United States, using a 3 x 3 factorial
      arrangement with three levels of 10th rib backfat depth (< 2.03, 2.03 to 2.54,
      and > 2.54 cm) and three levels of loin eye area (LEA; < 35.5, 35.5 to 41.9, and
      > 41.9 cm2). Sides from the selected carcasses were shipped to the University of
      Georgia for carcass data collection by trained USDA-AMS and University of Georgia
      personnel and fabrication. Sides were fabricated to four lean cuts (picnic
      shoulder, Boston butt, loin, and ham) and the skinned belly. The four lean cuts
      were further fabricated into boneless cuts with s.c. fat trim levels of 0.64,
      0.32, and 0 cm. The percentages of four lean cuts, boneless cuts (four lean cuts
      plus skinned, trimmed belly) at 0.64, 0.32, and 0 cm s.c. fat, fat-free lean, and
      total fat were calculated. Data were analyzed using a least squares fixed effects
      model, with the main effects of 10th rib backfat and LEA and their interaction.
      Fatness and muscling traits increased (P < 0.05) as 10th rib backfat and LEA
      category increased, respectively. However, fat depth measures were not affected
      greatly by LEA category, nor were muscling measures greatly affected by backfat
      category. The percentage yield of cuts decreased (P < 0.05) as backfat category
      increased. Cut yields from the picnic shoulder, Boston butt, and belly were not
      affected (P > 0.05) by LEA category, whereas the yield of boneless loin and ham
      increased (P < 0.05) as LEA category increased. Compositionally, the percentage
      of four lean cuts, boneless cuts at varying trim levels, and fat-free lean
      decreased incrementally (P < 0.05) as backfat depth increased, whereas parentage
      total fat and USDA grade increased (P < 0.05) as backfat depth increased. As LEA
      increased, percentage boneless cuts trimmed to 0.32 and 0 cm s.c. fat and fat
      free lean increased and total fat decreased; however, the difference was only
      significant in the smallest LEA category. Collectively, these data show that
      decreased carcass fatness plays a greater role in increasing primal and subprimal
      cut yields and carcass composition than muscling even in lean, heavily muscled
      carcasses.

PMID- 11204692
TI  - Intermuscular variation in tenderness: association with the ubiquitous and muscle
      specific calpains.
AB  - The biochemistry of intermuscular variation in tenderness is not fully
      understood. To investigate the role of the calpains in this process we performed
      two experiments using bovine and ovine species. In the bovine experiment, two
      distinct muscles, longissimus thoracis et lumborum (LT) and psoas major (PM),
      were used. In the ovine experiment, four muscles, LT, PM, semimembranosus (SM),
      and semitendinosus (ST), were used. Muscles were sampled at death for the
      determination of the steady-state mRNA level of calpains and calpastatin and the
      activities of calpain 1, 2, and calpastatin. Muscles were also sampled to
      determine the temporal changes in pH, tenderness, and the activity of the
      ubiquitous calpain system during postmortem aging. The results of the relative
      rate of tenderization in both species was found to be related to muscle type; LT
      had the highest value in both species. Within species, the mRNA steady-state
      levels of calpain 1 and calpastatin were similar in various bovine and ovine
      muscles. Bovine calpain 2 mRNA level was significantly lower in the LT than in
      the PM. Ovine calpain 2 mRNA level was lower, but not significantly different, in
      the LT compared to the other muscles. The mRNA level of bovine calpain 3 was
      significantly higher in the LT muscle than in the PM. In the ovine, the mRNA
      level of calpain 3 was highest in the LT, followed by SM, PM, and ST. Results on
      the activity of the ubiquitous calpain system in various muscles at death were
      dependent on muscle type and species. Temporal changes in the activity of
      calpains and calpastatin during the first 24 h of postmortem aging were similar
      in the muscles studied: calpain 1 and calpastatin declined significantly and
      calpain 2 remained relatively unchanged. The temporal changes in muscle pH in
      both experiments indicated that the extent and rate of pH decline during aging
      was related to muscle type. Correlation analysis between the relative rate of
      tenderization and mRNA expression of calpains revealed a strong relationship with
      calpain 3 in both species.

PMID- 11204693
TI  - Manipulation of cattle growth to target carcass quality.
AB  - Two trials were conducted to determine the effects of breed type, backgrounding
      program, and backfat end point (USBFEP) as determined by ultrasound on the
      performance and carcass characteristics of feedlot steers. Trial 1 utilized 144
      large-framed Charolais- (304.6 +/- 16.3 kg) and 144 medium-framed Hereford-cross
      steers (294.8 +/- 20.9 kg). Trial 2 utilized 88 medium-framed Angus (289.5 +/-
      15.0 kg), 88 large-framed Charolais- (299.8 +/- 17.7 kg), and 88 medium-framed
      Hereford-cross (291.1 +/- 20.9 kg) steers. Within breed type, short- (70 d) or
      long-term (126 d) backgrounding programs (Trial 1) and 6- or 12-mm USBFEP (Trials
      1 and 2) were assigned. In both trials, carcass size was greater (P < 0.05) for
      the large-framed Charolais-cross steers, longer backgrounding, and fatter USBFEP
      treatments. Lean meat yield was greater (P < 0.05) for Charolais- than Hereford
      cross steers (Trial 1) and for the leaner USBFEP (Trials 1 and 2). Marbling was
      greater (P < 0.05) for Angus- (Trial 2) and Charolais- (Trials 1 and 2) than
      Hereford-cross steers (Trials 1 and 2) and for the fatter end point (Trials 1 and
      2). It was concluded that breed type, backgrounding program, and USBFEP were
      effective in altering growth and could be used to target carcass traits of
      interest for value-based marketing programs.

PMID- 11204694
TI  - Effect of supplemental vitamins and trace minerals on performance and carcass
      quality in finishing pigs.
AB  - Two trials with finishing pigs (PIC line 355 x Camborough 22) were conducted to
      evaluate the effects of vitamin and trace mineral (VTM) supplement deletions on
      performance, carcass quality, and tissue nutrient levels. Trial 1, a 3 x 2
      factorial arrangement of treatments involving three VTM supplement regimens and
      two stress regimens, was conducted for 12 wk with 252 pigs (mixed sex). Average
      initial weight of pigs was 54 kg. The VTM regimens consisted of control (adequate
      level of VTM throughout trial), VTM deleted for the final 6 wk, and VTM deleted
      for entire 12 wk of the trial. The stress regimens consisted of leaving half the
      treatments in their original location or moving the other half of the treatments
      to a new pen location every 3 wk. There were three replications (pens) per
      treatment with 14 pigs per pen (0.80 m2). Diets were medicated with bacitracin
      methylene disalicylate. Overall, there were no treatment differences (P > 0.05)
      for ADG, ADFI, gain:feed ratio, longissimus muscle area, or last-rib backfat.
      However, there was a greater than 75% decrease (P < 0.001) in vitamin E content
      of longissimus muscle from deleting VTM for 6 or 12 wk. Trial 2, a 3 x 2
      factorial arrangement of treatments involving three VTM regimens and two genders,
      was conducted for 12 wk with 306 pigs. Average initial weight of pigs was 58 kg.
      The VTM regimens were identical to those used in Trial 1. Each treatment
      consisted of three gender replications of 17 pigs per pen (0.66 m2), and all
      diets were unmedicated. Overall, pigs fed diets without VTM for 12 wk had lower
      (P < 0.06) ADG than those fed the control diets. Vitamin E content of the ham
      muscle was reduced by greater than 50% (P < 0.001) when pigs were fed diets
      without VTM for 6 or 12 wk compared with those fed the control diet.
      Concentrations of copper in ham muscle were reduced (P < 0.05) in pigs fed diets
      without VTM. These data suggest that deleting VTM during the finishing stage
      markedly lowers the vitamin E content of pork muscle.

PMID- 11204695
TI  - Effects of dietary fermentable carbohydrates on energy metabolism in group-housed
      sows.
AB  - The effect of dietary nonstarch polysaccharide (NSP) content on the metabolic
      rate in group-housed sows was studied. Twelve groups of six nonpregnant sows were
      each fed one of four experimental diets similar in composition except for the
      starch and NSP content. Exchanging sugar beet pulp silage (SBPS) for tapioca
      created the difference in starch and NSP ratio in the diet. On a DM basis, diets
      contained 0, 10, 20, or 30% SBPS. Sows were group-housed and fed at 1.30 times
      the assumed maintenance energy requirements. Nitrogen and energy balances were
      measured per group during a 7-d experimental period, which was preceded by a 33-d
      adaptation period. Both digestibility and metabolizability of energy decreased
      with increasing dietary SBPS content (P < 0.05). Heat production and energy
      retention were unaffected by the exchange of starch for NSP (P > 0.1). Based on
      energy retention data and apparent fecal digestibilities of crude protein, crude
      fat, starch, and NSP, the estimated net energy value of fermented NSP was 13.4
      kJ/g. The present study shows that group-housed sows are capable of using energy
      from fermented NSP (i.e., NSP from SBPS) as efficiently as energy from digested
      starch (i.e., starch from tapioca).

PMID- 11204697
TI  - Gross anatomical and histomorphometric characteristics of the oviduct and uterus
      during the pubertal transition in sheep.
AB  - Gross anatomical and histometric characteristics of oviducts and uteri were
      evaluated during the pubertal transition in ewe lambs. Lambs were hysterectomized
      prepubertally (PP; n = 10) or 26 +/- 2 h after onset of first (FE; n = 13) or
      third estrus (TE; n = 12), or estrus in mature pluriparous ewes (ME; n = 4).
      Gross characteristics included diameters, lengths, and weights of oviducts;
      diameters of uterine cornua; and weights of uteri. Histometric characteristics of
      ampullae, isthmi, and uterine cornua included epithelial cell volume, total
      luminal surface area, and total number of cells per ampulla or isthmus and area
      of the muscularis. Side of the reproductive tract did not affect (P > 0.10) any
      gross or histometric characteristic. Gross uterine characteristics increased (P <
      0.05) dramatically between PP ewes and FE ewes, and then increased (P < 0.05) to
      a lesser degree between FE and TE ewes, and again (P < 0.05) between TE and ME
      ewes. Histological characteristics of uteri followed a similar developmental
      pattern: large changes (P < 0.05) between PP and FE ewes, slight increases
      between FE and TE ewes, and no change (P > 0.10) between TE and ME ewes.
      Oviductal weight and length showed little change (P > 0.10) at puberty or by
      third estrus, but they were greater (P < 0.05) in ME ewes than in the other
      groups. The diameters of ampullae increased (P < 0.05) at puberty, showed no
      change between FE and TE ewes, and were greatest (P < 0.05) in mature ewes. These
      changes seemed to be due to increases (P < 0.05) in mucosal cell height and
      muscularis area at puberty, and to muscularis area and submucosal thickness
      between TE and ME ewes. The surface area of the ampullae increased (P < 0.05) at
      puberty or by third estrus in a linear manner between PP, FE, TE, and ME ewes.
      The diameters of isthmi did not change (P > 0.10) at puberty but increased (P <
      0.05) between FE and TE, and were greatest (P < 0.05) in ME ewes. The
      histological characteristics of isthmi followed the pattern observed in the
      ampullae. However, the surface area of the isthmi showed no change (P > 0.10) at
      puberty or by third estrus and was largest (P < 0.05) in ME ewes. Results of this
      study indicate that gross morphological characteristics of uteri and oviducts
      increase at puberty with either slight increases or changes after two estrous
      cycles. This relationship is also reflected by histological characteristics of
      these organs during the pubertal transition of sheep.

PMID- 11204696
TI  - Uptake and excretion of organochlorine compounds in neonatal calves.
AB  - Intestinal absorption mechanisms of young calves change rapidly during the first
      24 h postpartum and subsequently effect the absorption efficiencies of a wide
      range of compounds. This study was conducted to determine absorption efficiencies
      of (p,p'-dichlorodiphenyl)dichloroethylene (DDE), 2,2',4,4',5,5'
      hexachlorobiphenyl (PCB-153), and 1,2,3,4,6,7,8,9-octachlorodibenzo-p-dioxin
      (OCDD) when administered in colostrum to neonatal calves. Four male Holstein
      calves were given a single oral dose containing 100 mg each of DDE, PCB-153, and
      OCDD either 1 h (n = 2) or 65 h (n = 2) postpartum to determine whether time of
      exposure influenced the rate or extent of absorption. Another male calf received
      100 mg each of DDE and OCDD 1 h postpartum. One gram of chromic oxide (Cr2O3) was
      administered as a digestion marker to dosed calves. Two male calves, receiving
      only colostrum, served as controls. Serum IgG concentrations indicated that the 1
      h calves absorbed 20 to 37% of the ingested IgG and 65-h calves < 2%; therefore,
      the gut absorption mechanisms had changed by 65 h. Plasma DDE, PCB-153, and OCDD
      profiles did not differ based on time of exposure, suggesting that their
      mechanism of absorption was not influenced by the changing gut. Trapezoidal area
      under the curve to the last time point values indicated that, during the trial,
      relative plasma organochlorine concentrations amounted to PCB-153 > DDE > OCDD.
      Tissue concentrations were similar across treatment groups, with DDE and PCB-153
      residues concentrating in adipose tissue and OCDD in the liver. Absorption
      efficiencies, calculated from fecal recoveries, were >97%, >74%, and >72% for
      DDE, PCB-153, and OCDD, respectively. These doses of DDE, PCB-153, and OCDD (2.5
      +/- 0.1 mg/kg) did not produce signs of toxicosis based on detailed clinical
      observations, serum clinical chemistry, and gross and histological observations
      at necropsy. The results of this study indicate that DDE, PCB-153, and OCDD were
      absorbed and distributed similarly in calves exposed 1 or 65 h postpartum and did
      not induce toxicosis when administered in combination at these concentrations.

PMID- 11204698
TI  - Endocrine relationships of Meishan and White composite females after weaning and
      during the luteal phase of the estrous cycle.
AB  - Endocrine differences between European crossbred and Chinese Meishan females have
      been somewhat modest. Indwelling jugular cannulas were placed in Meishan (n = 7)
      and White composite (n = 6) multiparous sows before weaning, and blood was
      sampled from 4 h before to 240 h after removal of litters. Temporal changes in
      FSH, triiodothyronine (T3), and tetraiodothyronine (T4) after weaning differed
      between Meishan and White composite sows. Plasma cortisol concentrations were
      higher in Meishan sows than in White composite sows (P < 0.01), but there were no
      temporal differences between breeds after weaning. Other hormones monitored
      (prolactin, GH, IGF-I, and inhibin) were not different between breeds. In the
      second experiment, Meishan gilts (n = 7) and sows (n = 7) and White composite
      sows (n = 9) were cannulated during the luteal phase of the estrous cycle and
      sampled after treatments consisting of GnRH (15 and 150 ng/kg BW), ovariectomy,
      estradiol cypionate challenge after ovariectomy (10 microg/kg BW), and GnRH
      antagonist. In response to GnRH challenge, White composite sows had elevated (P <
      0.05) concentrations of gonadotropins compared with Meishan. Cortisol
      concentrations were elevated in Meishan as compared with White composite females
      (P < 0.01) but unaffected by GnRH treatment. After ovariectomy, LH concentrations
      increased 3 h sooner in White composite than in Meishan females. After GnRH
      antagonist, declines in gonadotropins were comparable in both breeds, but LH
      increased in Meishan females by 20 h but not until after 54 h in White composite
      females. White composite females demonstrated only a short decline in FSH in
      response to the GnRH antagonist, but Meishan females had a prolonged decline in
      FSH concentrations. Consistently elevated cortisol concentrations in Meishan
      females may positively impact ovarian function; thus, the assumption that high
      plasma cortisol concentration as an index of stress that impairs reproductive
      function should be reevaluated in swine. There were few endocrine differences
      that would relate to or explain increased ovulation rates found in the Meishan
      breed; thus, other mechanisms must exist to explain the increase in ovarian
      function in the Meishan breed.

PMID- 11204699
TI  - Intravenous infusion of iron and tetrahydrofolate does not influence intrauterine
      uteroferrin and secreted folate-binding protein content in swine.
AB  - The effect of exogenous iron and folate on reproductive performance in swine is
      equivocal. However, the effect of exogenous iron and folate on secretion of their
      respective uterine transport proteins has never been reported. Twenty gilts were
      infused (n = 5 per treatment) with either 1) saline, 2) alpha-tocopherol, 3)
      alpha-tocopherol plus iron citrate, or 4) alpha-tocopherol plus tetrahydrofolate
      on d 11 to 14 of pregnancy. Intravenous infusion of iron citrate and
      tetrahydrofolate increased (P < 0.05) plasma iron and folate, respectively, for 6
      to 8 h after treatment. Treatments had no effect on uterine content of
      uteroferrin or secreted folate-binding protein in uterine flushings obtained on d
      15 of pregnancy. These data suggest that uterine secretion of uteroferrin and
      secreted folate-binding protein are not influenced by plasma levels of iron and
      folate, respectively, and may provide an explanation for the equivocal effect of
      iron and folate treatment on reproductive performance in gilts.

PMID- 11204700
TI  - Effects of grain sorghum planting density and processing method on nutrient
      digestibility and retention by ruminants.
AB  - Grain sorghum grown in 38-cm rows (high density [HD]) or 76-cm rows (normal
      density [ND]) was treated as follows: steam-flaked (SF), high-moisture-harvested
      followed by rolling and ensiling (HM), or dry-rolled (DR). Resulting grains were
      evaluated using lambs in two 5 x 5 Latin square digestion trials. Treatment diets
      contained either SF-HD, SF-ND, HM-HD, HM-ND, or DR-ND grain sorghum in two
      trials; a 90 or a 60% concentrate diet was fed in each trial. High-density
      planting increased (P < 0.10) the apparent absorption of P relative to ND
      planting for both 60 and 90% concentrate diets. Steam flaking decreased (P <
      0.10) the apparent absorption of P in the 90% concentrate diet and decreased (P <
      0.10) the apparent absorption of N in both the 90 and 60% concentrate diets.
      Despite differences in N digestibility, steam flaking and HM ensiling resulted in
      similar (P > 0.10) N retention as a percentage of N intake in both trials.
      However, changes in the distribution of N between feces and urine among
      processing methods could affect N content of manure and alter nutrient management
      strategies. These results indicate that both planting density and grain
      processing can alter the apparent absorption of grain sorghum P by ruminants.
      Furthermore, it seems that grain processing can alter the route of N excretion in
      ruminants without changing total N retention.

PMID- 11204701
TI  - Effect of excess degradable intake protein on early embryonic development,
      ovarian steroids, and blood urea nitrogen on days 2, 3, 4, and 5 of the estrous
      cycle in mature ewes.
AB  - Two trials were conducted to determine whether feeding excess degradable intake
      protein (DIP) during a synchronized estrous cycle and the first 5 d after
      breeding alters early embryonic development, ovarian steroids, or BUN
      concentrations in ewes. Ewes were group-fed in Trial 1 (T1) and individually fed
      in Trial 2 (T2) either 100 (control; T1, n = 15; T2, n = 12) or 200% (high
      protein; T1, n = 16; T2, n = 12) of the NRC protein recommendation for
      maintenance during a synchronized estrous cycle until surgery in the next cycle.
      Ampullae (AMP), isthmi (IST), and uterine horns (UT) of high-protein and control
      ewes were removed on d 2 (T1), 3 (T2), 4 (T1), or 5 (T2) after breeding. In T1,
      jugular blood samples were taken once daily starting on d 2 of the synchronized
      cycle, and in T2 on d 2, 9, 15, 16, and 17, and in both trials from estrus (d 0)
      to the day of surgery. Ampullae, IST, and UT flushings were examined
      microscopically for the presence of embryos, embryo condition, and embryo cell
      number. There was no trial x treatment interaction (P > or = 0.10), so data for
      both trials were pooled. Concentrations of BUN were higher (P < 0.05) in high
      protein-fed ewes than in control ewes during the synchronized cycle and the first
      5 d of the next cycle. Progesterone concentrations of the synchronized cycle did
      not differ (P > 0.10) between treatments. During the first 5 d of the next cycle,
      estradiol-17beta concentrations were lower (P = 0.06) in high-protein-fed than in
      control ewes. Progesterone increased (P < 0.05) to higher concentrations by d 5
      in high-protein-fed ewes than in control ewes. More (P < 0.05) embryos were found
      in AMP of high-protein-fed ewes than in AMP of control ewes on d 4. Fewer (P =
      0.05) embryos were found in UT of high-protein-fed ewes than in UT of control
      ewes on d 4. More embryos were found in UT of high-protein-fed ewes than in UT of
      control ewes on d 5. Fewer (P = 0.05) embryos were found in IST of high-protein
      ewes than in the IST of control ewes on d 5. Embryos of high-protein-fed ewes had
      more (P < 0.05) cells than embryos from control fed ewes on d 5. Feeding ewes
      excess DIP protein during an estrous cycle and the first 5 d after breeding
      initially impeded embryo transport; thereafter, embryo transport and development
      through the oviduct was accelerated.

PMID- 11204703
TI  - Preference by sheep and goats among hay of eight tall fescue cultivars.
AB  - Grazing ruminants use both visual cues and taste in selecting their diet.
      Preference during grazing may not be the same when forage is dried for hay and
      cut into lengths prior to feeding in confinement. Eight cultivars of tall fescue
      (Festuca arundinacea Schreb.), previously evaluated for preference while grazed,
      were harvested three times over a period of 2 yr. The hays were air-dried, baled,
      and passed through a hydraulic bale processor prior to feeding. Five experiments
      were conducted. All three harvests were evaluated with sheep and the last two
      also with goats, using six animals each time. During an adaptation phase, hays
      were offered alone as meals. In the experimental phase, every possible pair of
      hays (28 pairs) was presented for a meal. Data were analyzed by multidimensional
      scaling and by traditional analyses. Preference was significant among cultivars
      in all experiments. Multidimensional scaling showed that selection was based on
      two criteria with two dimensions being significant. Sheep preferred KENHY
      followed by KENTUCKY 31 and STARGRAZER but preferenced against BARCEL. HIMAG, MO
      96, and C1 were intermediate and MOZARK was variable. Goats were similar to sheep
      in preferring KENHY followed by STARGRAZER and selected against MOZARK and
      BARCEL. KENTUCKY 31, HIMAG, MO-96, and C1 were intermediate. In all five
      experiments, the general association was positive for available carbohydrate
      fractions and negative for fiber fractions that contribute to cell wall rigidity.

PMID- 11204702
TI  - Effects of different patterns of feed restriction and insulin treatment during
      the luteal phase on reproductive, metabolic, and endocrine parameters in cyclic
      gilts.
AB  - The objectives of the present study were 1) to study potential effects of
      previous nutritional treatment on developmental competence of early fertilized
      oocytes in vitro; 2) to study responses to insulin treatment during the period of
      feed restriction in the late luteal phase which has deleterious effects on
      subsequent fertility; and 3) to establish the metabolic and endocrine status of
      gilts during treatment and the subsequent periestrous period. Nineteen trios of
      littermate gilts were subjected to feed restriction during the first (RH) or
      second (HR) week of the estrous cycle. A second group of HR gilts received
      injections of long-acting insulin during their period of feed restriction (HR+I).
      Intensive sampling was performed in a subgroup of 23 animals on d 15 and 16 of
      the cycle for analyses of endocrine (gonadotropins and steroid hormones) and
      metabolic (insulin, IGF-I, leptin, total triiodothyronine [T3], and free T3)
      variables. Gilts were checked for estrus every 6 h, and time of ovulation was
      monitored by transcutaneous ultrasonography. Surgeries were performed 12 to 20 h
      after ovulation, and the early-fertilized oocytes recovered were cultured in
      vitro under standardized conditions. There was no treatment effect on the
      developmental competence of fertilized oocytes in vitro; however, ovulation rate
      was increased in HR+I gilts. No effect of treatment was observed on plasma leptin
      and IGF-I concentrations on d 15 and 16. However, HR+I gilts had higher (P <
      0.05) postprandial insulin and lower (P < 0.05) postprandial total and free T3 on
      d 15. Plasma concentrations of LH, FSH, and progesterone on d 15 and 16 and
      plasma estradiol concentrations on d 16 were not affected by previous nutritional
      or insulin treatment. In the periestrous period, plasma concentrations of LH,
      FSH, and estradiol were higher (P < 0.05) in RH and HR+I, and the rise in plasma
      progesterone after the LH surge was lower (P < 0.05), than in HR gilts. No effect
      of treatment was observed on plasma concentrations of metabolic hormones, except
      on plasma leptin concentrations, which were higher (P < 0.05) at the time of the
      LH surge in RH gilts. These results suggest that feed restriction during the late
      luteal phase may have deleterious effects on ovarian function in the periestrous
      period, which may be counteracted by insulin.

PMID- 11204704
TI  - Effect of ruminal vs postruminal administration of degradable protein on
      utilization of low-quality forage by beef steers.
AB  - An experiment was designed to determine the effects of ruminal and postruminal
      infusions of ruminally degradable protein (casein) on intake and digestion of low
      quality hay by beef steers. Twelve ruminally fistulated Angus x Hereford steers
      (initial BW = 563 kg) were blocked by weight and assigned to one of three
      treatments: control (C; hay only) or hay plus ruminal (R) or postruminal (P)
      infusion of 400 g/d of sodium caseinate. The trial consisted of five periods: 1)
      10-d adaptation to the hay diet; 2) 7-d measurement of hay intake (without
      infusions); 3) 10-d adaptation to protein infusion treatments (intake
      measurements continued); 4) 7-d measurement of hay intake and digestibility
      (infusions continued); and 5) 3-d ruminal sampling period (infusions continued).
      Steers were given ad libitum access to tallgrass-prairie hay (3.4% CP, 76.6% NDF)
      throughout the study. Casein was administered once daily before feeding, either
      directly into the rumen or via anchored infusion lines into the abomasum. Hay
      intake was increased by supplementation (P < 0.01). Ruminal infusion elicited a
      greater (P = 0.04) increase in hay intake than postruminal infusion. Intake
      tended (P = 0.11) to be lower in period 4 than in period 2 for control steers but
      was greater in period 4 than in period 2 (P < or = 0.03) for both R and P steers.
      The increase in intake between periods 2 and 4 was greater for R than for P
      steers (P = 0.03). Supplementation improved diet OM digestion (P = 0.04) but not
      NDF digestion (P = 0.18); however, greater relative error for NDF digestion may
      have limited the ability to elucidate significant treatment effects. There were
      no differences in either OM digestion (P = 0.42) or NDF digestion (P = 0.35)
      between R and P steers. Plasma urea N at 0 and 3 h after feeding on the last day
      of the experiment was lower (P = 0.05) for C than for R and P steers, but no
      difference (P = 0.48) was evident between R and P steers. Ruminal ammonia N
      levels also were increased by supplementation (P < 0.01), with a much larger
      increase for R than for P steers (P < 0.01). Total VFA concentrations were not
      affected (P = 0.21) by treatment, but R steers exhibited lower proportions of
      acetate and higher proportions of isobutyrate, valerate, and isovalerate than P
      steers (P < 0.01). In conclusion, ruminal and postruminal infusion of a
      degradable protein source improved forage utilization, although the response in
      forage OM intake and total digestible OM intake was greater for ruminal infusion
      than for postruminal infusion.

PMID- 11204705
TI  - Dietary fat supplementation effects on in vitro nutrient disappearance and in
      vivo nutrient intake and total tract digestibility by horses.
AB  - Addition of fat to the diet of the equine is a popular method of increasing
      energy density of the diet while reducing feed intake. Reducing feed intake is of
      interest to race horse trainers because additional feed is seen as additional
      weight and, therefore, a hindrance to performance. Limited information is
      available regarding the interactions of fat with other dietary components,
      particularly fiber, in the equine digestive system. The effect of dietary fat on
      in vitro nutrient disappearance in equine cecal fluid was studied in Exp. 1 using
      a split-plot design within a 2 x 2 Latin square. Two ponies were fed alfalfa
      (ALF) alone or alfalfa plus 100 g/d corn oil. Five substrates were used to
      determine in vitro DM disappearance, OM disappearance, NDF disappearance, and
      total dietary fiber (TDF) disappearance. The substrates included: ALF, tall
      fescue (TF), red clover (RC), soybean hulls (SBH), and rolled oats (RO). Fat
      supplementation did not affect in vitro DM, OM, or NDF disappearance. Addition of
      fat to the diet increased (P < 0.05) the disappearance of NDF in RO. Among
      substrates, in vitro DM and OM disappearance were highest (P < 0.05) for RO,
      followed by SBH, ALF, RC, and TF. In vitro NDF and TDF disappearance were highest
      (P < 0.05) for SBH, followed by RO, ALF, RC, and TF. In Exp. 2, the effects of
      varying levels of fat on nutrient intake and total tract digestibility were
      examined using a 4 x 4 Latin square design. Four mature mares were fed a 60%
      forage-40% concentrate diet containing different concentrations of fat: 0%
      supplemental fat control (C); 5% supplemental corn oil (5% CO); 10% supplemental
      corn oil (10% CO); or 15% supplemental corn oil (15% CO). Treatment did not
      affect intake of the concentrate portion of the diet or CP, gross energy, or NDF
      intake. Mares consuming the C diet had the highest (P < 0.05) intake of alfalfa
      cubes, DM, and OM, followed by those on the 10, 5, and 15% CO treatments,
      respectively. Treatment did not affect nutrient digestibility. Mares consuming
      the 15% CO diet had the highest (P < 0.05) fat digestibility, whereas those
      consuming C had the lowest fat digestibility. Fat in the form of CO generally had
      little effect on in vitro and in vivo nutrient digestibilities in horses.

PMID- 11204706
TI  - The effect of energy supplementation on nitrogen utilization in lactating dairy
      cows fed grass silage diets.
AB  - An experiment was conducted to examine the effect that various isoenergetic
      diets, containing different quantities of soluble carbohydrate and fiber and
      different types of starch, have on nitrogen (N) balances. Six lactating dairy
      cows in early to midlactation consuming grass silage diets with not less than 600
      g/kg total DMI as forage were used in the experiment. Four concentrates were
      prepared that had higher amounts of either fiber, soluble sugars, corn (low
      degradable starch source), or barley (high degradable starch source). Overall N
      utilization by the cows was poor, rarely exceeding 0.30 g milk N/g of dietary N
      intake. Fecal N outputs accounted for more than half of total N excreted in all
      treatments except for diets supplemented with high degradable starch, in which
      urinary N excretion was significantly higher compared with the other treatments.
      Milk yield was unaffected by concentrate type, averaging 19.9 kg/d, but milk
      protein content decreased from 32.9 for starch-based diets to 30.9 and 30.0 g/kg
      for the soluble sugar- and fiber-based diets, respectively. The efficiency of N
      utilization improved in the low degradable starch treatment, which had lower N
      excretion (65%) and higher protein concentration in milk. Furthermore, feeding
      cows corn-based concentrates reduced urinary N excretion by almost 30% compared
      with barley-based concentrates; therefore, feeding corn-based diets is
      recommended for the reduction of nitrogen pollution in lactating dairy cows.

PMID- 11204707
TI  - The effect of protein supplementation on nitrogen utilization in lactating dairy
      cows fed grass silage diets.
AB  - The study set out to examine the effects of supplementing grass silage with
      various levels of protein concentration and degradability on dietary nitrogen (N)
      excretion in lactating dairy cows consuming at least 60% forage. Six
      Holstein/Friesian cows in early to midlactation were offered six diets comprising
      two levels of crude protein (210 and 290 g/kg DM) and three levels of protein
      degradability in the concentrate achieved using different amounts of untreated or
      formaldehyde-treated soybean meal. Despite a difference of almost 100 g/d in N
      intake, apparent fecal and milk N outputs were not significantly affected.
      Protein degradability also had no effect on N outputs in feces and milk. However,
      there was a major effect of both level and degradability of CP on urinary N
      output. Moreover, an interaction between level and degradability of CP was
      detected, such that the rate at which urinary N increases with increasing CP
      degradability was higher on the high-CP than on the low-CP diet. A low level of
      protein (150 g/kg DM in the diet) and medium to low rumen-degradable protein
      supplements provided a significant reduction in N excretion without compromising
      lactational performance (mean 24.8 kg/d), in terms of both milk yield and
      composition. This study also demonstrated that a high efficiency of N utilization
      could be achieved on low-CP diets (supplying less than 400 g N/d), with feces
      being the main route of N excretion, whereas an exponential excretion of urinary
      N was observed as N intake exceeded 400 g N/d.

PMID- 11204709
TI  - Efficient computation of genotype probabilities for loci with many alleles: I.
      Allelic peeling.
AB  - Genetic marker data are likely to be obtained from a relatively small proportion
      of the individuals in many livestock populations. Information from genetic
      markers can be extrapolated to related individuals without marker data by
      computing genotype probabilities using an algorithm referred to as peeling.
      However, genetic markers may have many alleles and the number of computations in
      traditional peeling algorithms is proportional to the number of alleles raised to
      the sixth or eighth power, depending on pedigree structure. An alternative
      algorithm for computing genotype probabilities of marker loci with many alleles
      in large, nonlooped pedigrees with incomplete marker data is presented. The
      algorithm is based on recursive computations depending on alleles instead of
      genotypes, as in traditional peeling algorithms. The number of computations in
      the allelic peeling algorithm presented here is proportional to the square of the
      number of alleles, which makes this algorithm more computationally efficient than
      traditional peeling for loci with many alleles. Memory requirements are roughly
      proportional to the number of individuals in the pedigree and the number of
      alleles. The recursive allelic peeling algorithm cannot be applied to pedigrees
      that include full sibs or loops. However, it is a preliminary step toward a more
      complex and encompassing iterative approach to be described in a companion paper.

PMID- 11204708
TI  - Effects of L-carnitine on nitrogen retention and blood metabolites of growing
      steers and performance of finishing steers.
AB  - Two experiments were conducted to evaluate L-carnitine supplementation to cattle
      fed grain-based diets. In Exp. 1, seven Angus-cross steers (216 kg) were used in
      a 7 x 4 incomplete Latin square experiment to evaluate the effects of
      supplemental L-carnitine on N balance and blood metabolites. Steers were fed a
      corn-based diet (17.5% CP) at 2.5% of BW. Treatments were 0, 0.25, 0.5, 1.0, 1.5,
      2.0, and 3.0 g/d of supplemental carnitine. The 18-d periods included 13 d for
      adaptation and 5 d for collection of feces and urine. Blood was collected before
      feeding and 3 and 6 h after feeding on d 18 of each period. Dry matter intakes
      tended to be highest when 1.5 g/d of carnitine was supplied, but N retention was
      not affected by carnitine and averaged 29.3 g/d. Plasma carnitine concentrations
      and urinary excretion increased with increasing carnitine supply, indicating that
      at least some of the carnitine escaped ruminal degradation and was absorbed by
      the steers. Plasma concentrations of NEFA demonstrated a treatment x time
      interaction; they decreased linearly in response to carnitine before feeding but
      increased linearly in response to carnitine at 6 h after feeding. Serum insulin
      and plasma glucagon, IGF-I, cholesterol, triglyceride, and amino acids were not
      affected by carnitine. Plasma concentrations of glucose, glycerol, urea, and beta
      hydroxybutyrate all were increased by some of the levels of carnitine
      supplementation, but results for these measurements did not follow easily
      described patterns and seemed to be related to differences in DMI. In Exp. 2, 95
      crossbred steers (357 kg initial BW) were fed finishing diets (14.5% CP) for 129
      d. Diets were based on steam-flaked corn and contained 6% alfalfa and 4% tallow.
      Feed intakes, gains, and feed efficiencies were not affected by supplementation
      with 2 g/d L-carnitine. However, steers receiving L-carnitine tended to have
      fatter carcasses, as indicated by tendencies (P < 0.2) for thicker backfat,
      higher marbling scores, and higher yield grades. In conclusion, carnitine
      supplementation did not alter lean deposition in growing steers but it did alter
      plasma NEFA concentrations of growing steers fed a corn-based diet and also
      seemed to increase fat deposition in finishing cattle.

PMID- 11204711
TI  - Evaluation of the 1996 NRC beef model under western Canadian environmental
      conditions.
AB  - Two feedlot trials were conducted to evaluate the 1996 NRC beef model under
      western Canadian conditions. In the first trial, 144 Charolais- (304.6 +/- 16.3
      kg) and 144 Hereford- (295.1 +/- 20.8 kg) cross steers were used, whereas the
      second trial used 88 Angus- (289.7 +/- 15.0 kg), 88 Charolais- (299.8 +/- 17.9
      kg), and 88 Hereford- (291.1 +/- 20.9 kg) cross steers. Diets were based on
      barley silage, rolled barley grain, canola meal, and cereal straw and were
      analyzed according to the 1996 NRC methodologies. Animal performance and
      environmental data were collected for 24 pens of steers per trial for the
      backgrounding and finishing periods. Levels 1 and 2 of the 1996 NRC model were
      used to generate predictions of DMI and ADG for each pen. Results showed that
      actual finishing DMI was accurately predicted for Trial 1 and for the combined
      trials but not for Trial 2. Predicted ADG was lower (P < 0.05) than actual ADG
      for all feeding periods except Level 1 of the Trial 1 finishing period. All ADG
      residuals were significant (P < 0.05), indicating inaccurate prediction of ADG in
      all feeding periods. The 1996 NRC model consistently predicted that protein was
      not limiting gain. Further investigations and model refinement regarding animal
      energy requirements under cold weather conditions and effects of limit feeding
      are required to increase the accuracy of the 1996 NRC model in predicting animal
      performance.

PMID- 11204710
TI  - Zinc and copper status in ewes supplemented with sulfate- and amino acid
      complexed forms of zinc and copper.
AB  - Thirty 6-yr-old Targhee ewes were randomly allotted to one of five supplemental
      treatments to evaluate supplementation effects on liver and fecal Zn and Cu
      concentrations and serum alkaline phosphatase activity: 1) control, 2) Zn
      complex, 3) Zn and Cu (ZnCu) complex, 4) Zn sulfate, and 5) ZnCu sulfates.
      Supplements were administered daily in gelatin capsules for 56 d. Liver biopsies
      and serum samples were collected every 14 d starting on d 0. Supplemental Zn and
      Cu levels were formulated to provide 90 mg/kg Zn and 10 mg/kg Cu, respectively,
      on a daily dry matter intake basis. Form (complex vs sulfate) x type (Zn vs ZnCu)
      interactions were not detected (P > 0.35). Therefore, contrast statements were
      used to make the following treatment comparisons: 1) control vs supplement, 2) Zn
      vs ZnCu, and 3) complex vs sulfate. Ewe BW at the end of the study (P = 0.09) and
      ewe BW change from beginning to end of the study (P = 0.07) were greater for
      supplemented than control ewes. Body weight and BW change did not differ between
      sulfate and complex (P > 0.39) or Zn- and ZnCu- (P > 0.40) supplemented ewes.
      Liver Cu concentrations did not differ (P = 0.41) between control and
      supplemented ewes. Liver Cu concentrations were higher (P < 0.10) for ewes
      supplemented with ZnCu than Zn and complex than sulfate forms of supplement.
      Liver Zn concentration tended (P = 0.13) to be higher in ZnCu than Zn
      supplemented ewes. Liver and fecal Zn concentration were higher (P < 0.06) in
      ewes fed complex than sulfate supplements. However, serum alkaline phosphatase
      activity tended (P = 0.12) to be greater in ewes fed sulfate than complex
      supplements. Supplementing mature ewes with complexed minerals resulted in higher
      concentrations of Zn and Cu in the liver. In addition, supplemental Cu tended to
      increase concentrations of Zn in the livers of ewes; however, high levels of
      supplemental Zn did not negatively impact liver Cu concentrations.

PMID- 11204712
TI  - Efficient computation of genotype probabilities for loci with many alleles: II.
      Iterative method for large, complex pedigrees.
AB  - An algorithm for computing genotype probabilities for marker loci with many
      alleles in large, complex pedigrees with missing marker data is presented. The
      algorithm can also be used to calculate grandparental origin probabilities, which
      summarize the segregation pattern and are useful for mapping quantitative trait
      loci. The algorithm is iterative and is based on peeling on alleles instead of
      the traditional peeling on genotypes. This makes the algorithm more
      computationally efficient for loci with many alleles. The algorithm is
      approximate in pedigrees that contain loops, including loops generated by full
      sibs. The algorithm has no restrictions on pedigree structure or missing marker
      phenotypes, although together those factors affect the degree of approximation.
      In livestock pedigrees with dense marker data, the degree of approximation may be
      minimal. The algorithm can be used with an incomplete penetrance model for marker
      loci. Thus, it takes into account the possibility of marker scoring errors and
      helps to identify them. The algorithm provides a computationally feasible method
      to analyze genetic marker data in large, complex livestock pedigrees.

PMID- 11204713
TI  - Genetic (co)variances for calving difficulty score in composite and parental
      populations of beef cattle: I. Calving difficulty score, birth weight, weaning
      weight, and postweaning gain.
AB  - Heritability of 2-yr-old heifer calving difficulty score was estimated in nine
      purebred and three composite populations with a total of 5,986 calving difficulty
      scores from 520 sires and 388 maternal grandsires. Estimates were 0.43 for direct
      (calf) genetic effects and 0.23 for maternal (heifer) genetic effects. The
      correlation between direct and maternal effects was -0.26. Direct effects were
      strongly positively correlated with birth weight and moderately correlated with
      200-d weight and postweaning gain. Smaller negative correlations of maternal
      calving difficulty with direct effects of birth weight, weaning weight, and
      postweaning gain were estimated. Calving difficulty was scored from 1 to 7.
      Predicted heritabilities using seven optimal scores were similar to those using
      four scores. The predicted heritability using only two categories was reduced
      23%. Phenotypic and direct genetic variance increased with increasing average
      population calving difficulty score. The estimated direct and maternal
      heritabilities for 2-yr-old calving difficulty score were larger than many
      literature estimates. These estimates suggested substantial variance for direct
      and maternal genetic effects. The direct effects of 2-yr-old calving difficulty
      score seemed to be much more closely tied to birth weight than were maternal
      effects.

PMID- 11204714
TI  - Effect of oxygen inhalation at birth on the reduction of early postnatal
      mortality in pigs.
AB  - Asphyxia during delivery is considered a main cause of stillbirth in pigs, but
      piglets suffering from intermittent asphyxia during delivery are also less viable
      at birth and less prone to adapt to extrauterine life. In an effort to improve
      pig viability, one attractive solution would be to increase oxygen supply through
      oxygen inhalation by the newborn pig. The objective of this study was to test
      effects of oxygen inhalation immediately after birth on various physiological
      parameters and piglet survival. The experiment was performed on 252 Pietrain x
      Large White piglets, half of them reoxygenated immediately after birth. They were
      maintained during 20 min in a chamber where oxygen concentration was monitored at
      40% and were then put back with the sow and the control pigs. Oxygen inhalation
      affected piglet metabolism. Through stimulation of oxidative metabolism
      (reduction of circulating levels of lactate) and lowering of the level of
      postnatal hypothermia (particularly for the lightest pigs), oxygen inhalation
      increased piglet viability and reduced mortality during the 1st d of life by 75%
      (2 vs 8%). No additional effects were observed during the following days and
      overall mortality between birth and weaning at 21 d was reduced from 12 to 8%.

PMID- 11204715
TI  - Genetic (co)variances for calving difficulty score in composite and parental
      populations of beef cattle: II. Reproductive, skeletal, and carcass traits.
AB  - There is limited genetic information relating calving difficulty and body weights
      to other productive and reproductive traits. Such information is useful for
      specifying selection criteria and for predicting economic consequences of
      selection. Genetic, maternal, and environmental covariances of six productive and
      reproductive measurements with calving difficulty, birth weight, 200-d weight,
      and 168-d postweaning gain were estimated in 12 experimental populations of
      cattle. Calf (direct) genetic effects resulting in longer gestation length were
      associated with increased calving difficulty and birth weight. Maternal genetic
      effects of increased gestation length and heavier birth weight were significantly
      associated. Lighter birth weight and reduced calving difficulty were associated
      with earlier heifer age at puberty. Increases in direct genetic effects of
      calving difficulty, 200-d weight, and postweaning gain were associated with a
      small increase in direct effect of scrotal circumference. Increased direct
      genetic effects of scrotal circumference were correlated with maternal effects
      decreasing calving difficulty and increasing 200-d weight. Direct effects of the
      skeletal measurements, yearling hip height, and heifer pelvic area were
      positively correlated with direct effects of calving difficulty, birth weight,
      200-d weight, and postweaning gain, positively correlated with maternal effects
      for birth weight and 200-d weight, and negatively correlated with maternal
      calving difficulty. Percentage of retail product was positively associated with
      calving difficulty and negatively associated with 168-d gain. Predicted genetic
      change in calving difficulty resulting from one standard deviation of selection
      for either calving difficulty score or birth weight was much larger than for any
      other traits. Selection for 200-d weight, 168-d postweaning gain, hip height,
      pelvic area, or scrotal circumference was predicted to have opposite effects on
      direct and maternal calving difficulty. Estimated genetic correlations indicate
      some small to moderate relationships between calving difficulty and the measured
      productive and reproductive traits. However, selection for reduced calving
      difficulty should be based on calving difficulty score and(or) birth weight
      because of their superiority in predicted genetic change.

PMID- 11204716
TI  - Candidate gene analysis for loci affecting litter size and ovulation rate in
      swine.
AB  - A candidate gene approach was used to determine whether specific loci explain
      responses in ovulation rate (OR) and number of fully formed (FF), live (NBA),
      stillborn, and mummified pigs at birth observed in two lines selected for
      ovulation rate and litter size compared with a randomly selected control line.
      Line IOL was selected for an index of OR and embryonic survival for eight
      generations, followed by eight generations of two-stage selection for OR and
      litter size. Line C was selected at random for 16 generations. Line COL, derived
      from line C at Generation 8, underwent eight generations of two-stage selection.
      Lines IOL and C differed in mean EBV by 6.1 ova and 4.7 FF, whereas lines COL and
      C differed by 2.2 ova and 2.9 FF. Pigs of Generation 7 of two-stage selection
      lines were genotyped for the retinol binding protein 4 (RBP4, n = 190) and
      epidermal growth factor (EGF, n = 189) loci, whereas pigs of Generations 7 and 8
      were genotyped for the estrogen receptor (ESR, n = 523), prolactin receptor
      (PRLR, n = 524), follicle-stimulating hormone beta (FSHbeta, n = 520), and
      prostaglandin-endoperoxide synthase 2 (PTGS2, n = 523) loci. Based on chi-square
      analysis for homogeneity of genotypic frequencies, distributions for PRLR,
      FSHbeta, and PTGS2 were different among lines (P < 0.005). Differences in gene
      frequencies between IOL vs C and COL vs C were 0.33 +/- 0.25 and 0.16 +/- 0.26
      for PRLR, 0.35 +/- 0.20 and 0.15 +/- 0.24 for FSHbeta, and 0.16 +/- 0.16 and 0.08
      +/- 0.18 for PTGS2. Although these differences are consistent with a model of
      selection acting on these loci, estimates of additive and dominance effects at
      these loci did not differ from zero (P > 0.05), and several of them had signs
      inconsistent with the changes in allele frequencies. We were not able to find
      significant associations between the polymorphic markers and phenotypes studied;
      however, we cannot rule out that other genetic variation within these candidate
      genes has an effect on the traits studied.

PMID- 11204717
TI  - Putative quantitative trait locus affecting birth weight on bovine chromosome 2.
AB  - A genome scan for chromosomal regions influencing birth weight was performed
      using 151 progeny of a single Hereford x composite bull and 170 microsatellite
      markers spanning 2.497 morgans on 29 bovine autosomes. A QTL was identified at
      the telomeric end of bovine chromosome 2 (maximum effect at 114 cM) accounting
      for approximately 2.8 kg of birth weight or 0.64 residual standard deviations
      (after adjustment for sex of calf, age of dam, and breed of dam). No significant
      effect on growth from birth to weaning was detected in this region. The presence
      of this QTL within a resource herd composed of breeds common to the Northern
      Great Plains provides an opportunity to initiate marker-assisted selection to
      reduce birth weight with minimal effect on postnatal growth. Thus, potentially
      the amount and degree of dystocia can be reduced and the economic loss associated
      with calving difficulty lessened without compromise of subsequent growth
      performance. In addition, this finding indicates that significant genetic
      variation for birth weight (and presumably other production-related traits)
      exists within herds composed of commercially adapted Bos taurus germplasm.

PMID- 11204718
TI  - Belly-nosing in early-weaned piglets is not influenced by diet quality or the
      presence of milk in the diet.
AB  - Early weaning of piglets can lead to an increase in belly-nosing and other oral
      nasal behavior (nosing, chewing, or sucking other piglets), but the causative
      factors involved in these behavior patterns are largely unknown. Because these
      behavior patterns resemble massaging the udder and sucking, they may be
      associated with feeding. The objectives of this study were to determine any
      effect of diet quality or the presence of milk in the diet on belly-nosing
      behavior of piglets weaned at 14 to 18 d. During the first 2 wk after weaning,
      piglets were fed diets differing in quality and inclusion of milk products. Six
      replicates of eight piglets per replicate, blocked by initial body weight, (n =
      192) were offered one of four dietary treatments: HQM: high quality, high in milk
      products; HQ: high quality, no milk products; PQ: poor quality, no milk products;
      HQ+MR: high quality, no milk products (as HQ) sprayed with milk replacer five
      times daily. Thereafter, the piglets were fed a standard nursery diet. Feed
      intake was measured daily for wk 1 and again at the end of wk 2. Behavior was
      recorded every 5 min during two 4-h periods on d 2 to 7, 10, 14, 17 and 21 after
      weaning. Dietary treatment influenced ADFI and ADG during wk 1. Average daily
      feed intake (P < 0.05) and ADG (P < 0.05) of piglets on PQ were less than those
      of piglets on the other treatments. During wk 2, ADFI (P > 0.10) and ADG (P >
      0.10) were the same across all treatments. Overall, ADFI was not influenced by
      the inclusion of milk products in the diet or the addition of milk replacer (P >
      0.10); however, ADG was. Piglets on HQM had higher ADG than those on HQ during wk
      2 (P < 0.05) and 3 after weaning (P < 0.05). However, milk replacer did not
      influence ADG (P > 0.10). Although the dietary treatments did affect ADFI and
      ADG, there were no effects on any behavior pattern recorded, including time spent
      at the feeder (P > 0.10). Lower weight-for-age piglets performed more oral-nasal
      behavior, in total, than higher weight-for-age piglets (P < 0.03). Neither
      feeding a poor-quality diet nor the presence of milk in the diet had an effect on
      belly-nosing or other oral-nasal behavior patterns during the first 3 wk after
      weaning. Belly-nosing does not seem to be associated with feeding.

PMID- 11204719
TI  - Influence of a high ambient temperature on lipid metabolism in the growing pig.
AB  - Because pigs are fatter when they are heat-stressed, it was hypothesized that
      lipid metabolism is enhanced in heat-stressed pigs. To test this hypothesis, an
      experiment was conducted to determine the influence of a high ambient temperature
      on the level of plasma lipids, thyroid hormones, lipoprotein lipase activity, and
      on the composition of very low density lipoproteins (VLDL) and chylomicrons in
      the growing pig. Twelve Large White x Landrace castrated male pigs with an
      initial weight of 20 +/- 0.6 kg were allotted to one of the following treatments:
      1) ambient temperature of 31 degrees C, with ad libitum access to feed or 2)
      ambient temperature of 20 degrees C and fed the amount consumed by those kept at
      31 degrees C until 35 kg BW. Ambient temperature did not affect piglet
      performance. Compared to that in pigs kept at 20 degrees C, in pigs kept at 31
      degrees C the lipid content of backfat was 26% higher and the proportion of flare
      fat was increased by more than twofold (P < 0.001). Lipoprotein lipase activity
      was increased more than twofold in backfat and nearly twofold in leaf fat at 31
      vs 20 degrees C (P < 0.001). In warmth-exposed (31 degrees C), feed-restricted
      pigs, the plasma level of triiodothyronine was 30% lower than at 20 degrees C (P
      < 0.001), whereas VLDL-lipid concentration was more than fourfold higher, and
      plasma concentrations of NEFA and triglycerides were 2.6- and 3.6-fold higher,
      respectively (P < 0.001). In conclusion, the chronic exposure of growing pigs to
      a high ambient temperature enhances lipid metabolism in both the liver (VLDL
      production) and the adipose tissue (lipoprotein lipase activity). Consequently,
      plasma triglyceride uptake and storage are facilitated in the adipose tissue,
      which results in greater fatness.

PMID- 11204720
TI  - Effects of repeated cross-fosterings on preweaning behavior and growth
      performance of piglets and on maternal behavior of sows.
AB  - Extensive cross-fostering is widely used in early-weaning units in order to
      standardize and improve body weight at weaning. However, young suckling piglets
      develop teat fidelity and repeated cross-fosterings could go against this
      behavior. This experiment was therefore conducted to compare the behavior and
      growth of 13 control and 14 fostered litters. Once every 3 d (from d 1 to 16 of
      lactation), all piglets were weighed and three piglets were switched between two
      fostered litters. Their unfostered littermates were called residents. Behavior
      was recorded for 2 h after weighing and(or) adoption and during one nursing
      period 24 h later. Fights were more frequent (P < 0.05) in treated than in
      control litters during and between nursings at all ages of adoption except d 1.
      Most fights occurred between resident and fostered piglets (P < 0.001), except at
      d 1. Fights during nursing were still more frequent in treated than in control
      litters 24 h after adoption (P < 0.02), except at d 1 and 16. More piglets had
      skin lacerations in treated than in control litters except at d 1 (P < 0.05), and
      scratches were more frequent in fostered than in resident piglets at d 1 (P =
      0.07), 7, 13, and 16 (P < 0.01). At all ages except d 1, failed nursings and
      snaps at piglets were more frequent in fostered than in control litters (P <
      0.05), most snaps being directed at adopted piglets (P < 0.001). In fostered
      litters, sows spent 15 to 30% less time lying on their sides at d 4, 7, 13, and
      16 (P < 0.05). Finally, adopted piglets were 13% lighter than controls at weaning
      (P < 0.001), whereas residents were heavier than adopted piglets (P < 0.05) but
      lighter than controls (P = 0.1). These data demonstrate that cross-fostering done
      repeatedly during lactation is stressful for piglets and sows and does not
      improve body weight at weaning.

PMID- 11204722
TI  - [Time rediscovered].

PMID- 11204721
TI  - Coordinate expression of matrix-degrading proteinases and their activators and
      inhibitors in bovine skeletal muscle.
AB  - Matrix metalloproteinases (MMP) responsible for degradation of connective tissue
      are found in most tissues. The MMP are regulated at the levels of transcription,
      zymogen activation by plasmin or membrane-type- (MT) MMP, and control of enzyme
      activity by tissue inhibitors of metalloproteinases (TIMP). Whole bovine skeletal
      muscle showed multiple MMP activities on gelatin zymography and also expressed
      mRNA encoding MMP-1, -2, -9, -14, and -16, tissue inhibitors of metalloproteinase
      (TIMP)-1, -2, and -3 and plasminogen activator and its receptor. Purified
      intramuscular fibroblasts and myogenic cell culture derived from satellite cells
      expressed most or all of these elements. Statistical analysis (n = 35) revealed a
      strong positive correlation among the mRNA levels of several elements of the MMP
      system, including MMP-2, MMP-14, TIMP-1, -2, and -3 (r = 0.614 to 0.930, P <
      0.0001). Our results provide an extensive profile of an extracellular proteolytic
      cascade involving MMP in skeletal muscle and suggest that 1) the activation
      cascades of muscle MMP may be initiated by both plasmin and membrane-type MMP; 2)
      a group of genes involved in the same "arm" of zymogen activation are coexpressed
      in this tissue; and 3) skeletal muscle cells, in addition to the intramuscular
      fibroblasts, express an extensive complement of MMP and related proteins.

PMID- 11204723
TI  - [Sociocultural dimension of epilepsy (kirikirimasien) in a Bambara rural area
      (Mali)].
AB  - The anthropological study of kirikirimasien (epilepsy) in Mali constitutes an
      integral part of a research programme devoted to the epidemiology of epilepsy and
      onchocerciasis in Mali. This programme is run jointly by scientists of the Ecole
      Nationale de Medecine et de Pharmacie (National School of Medicine and Pharmacy)
      of Bamako, Mali, and the Faculte de Medecine (Faculty of Medicine) of Marseilles,
      France. Preliminary results of the anthropological study are presented, based on
      the qualitative analysis of 132 interviews, conducted over 6 months. Those
      interviewed were mainly persons affected by kirikirimasien, but included members
      of the family circle, traditional healers, and outsiders as well. Participatory
      interview techniques used the national language bambara. The interviews were
      unstructured and semi-structured so as to identify themes in the bambara language
      concerning kirikirimasien. Two dominant trends were identified, concerning the
      aetiology and nosography of the disease, and the social dimension of
      kirikirimasien, respectively. In terms of aetiology and nosography, diagnosis,
      contamination and appelation are--in order of priority--the most important
      aspects of the disease. Yet the social dimension of kirikirimasien appears
      largely to surpass its aetiological and nosographic aspects. The social dimension
      is crucial to the anthropological understanding of kirikirimasien. This was amply
      illustrated by various references which arose during the interviews. First, how
      is the notion of contamination represented and which practices are associated
      with it? Second, invalidity and handicap appear to play an essential role in the
      way people deal with the disease. The notion of tolerance in the bambara
      environment is also addressed, mainly through a spatial study of the adherence of
      the person affected by the disease (family, village and outsiders). The third
      part of the study deals with the social understanding of kirikirimasien and looks
      at how those affected are cared for, both within their social setting and in
      terms of seeking treatment.

PMID- 11204724
TI  - [Sociocultural aspects of epilepsy in Madagascar. K.A.P. survey carried out in
      Antananarivo].
AB  - A general population survey on knowledge, attitudes and practices (K.A.P.)
      concerning epilepsy was conducted from 1st July to 31st December 1997 in
      Antananarivo, a region representative of ecological and cultural patterns of the
      Malagasy "Highlands". The sample, randomly selected according to the two-step
      cluster method, recruited 1392 men and women aged 18 years and older who were
      interviewed with a 16-item questionnaire. Knowledge and practices have
      significantly evolved since 1983, when a similar study was conducted. More
      natural explanations are given for the condition and health-care seeking is more
      common. However, popular attitudes towards the epileptic patient remain
      contradictory: the majority of those interviewed claimed to be tolerant; work and
      marriage could be envisaged for the epileptic patient, but not total freedom of
      movement nor regular school attendance. A more active popularisation of the
      disease thus appears to be necessary. Since some 60% of people had a radio,
      broadcasting and church involvement would be the most effective means towards
      this end. Traditional practicer do not seem to have an overwhelming influence;
      rather, healthcare seeking behaviour was determined by the availability of
      service, the efficacy of the intervention and cost. To be representative of
      Madagascar as a whole, our data should be compared to those of other surveys in
      more culturally enclosed and disadvantaged areas.

PMID- 11204725
TI  - [Clinical and epidemiological aspects of traditional therapeutic scarification in
      epilepsy in Togo].
AB  - One of the major problems of epilepsy in Africa are its social implications.
      Prejudice against the disease is common and epileptics are marginalised. Epilepsy
      is concealed from all non-family members. The very pronunciation of the word
      "falling disease" (as epilepsy is called) is taboo, the disease being regarded as
      supernatural. This unfavourable context introduces considerable bias in hospital
      and population-based studies. Traditional doctors are consulted by patients
      especially when they have such a "supernatural" disease. Traditional
      scarifications are used for the treatment of epileptics in Togo. We examined the
      skin of 36,000 patients in the neurological department of Lome's teaching
      hospital between 1985 and 1995 and conducted a similar, population-based study on
      about 20,000 inhabitants in the Kloto district of south-western Togo and on
      10,000 inhabitants in the Tone district of northern Togo. Interviews with 40,000
      traditional doctors revealed that forehead scarifications are characteristic of
      epilepsy treatment. More than 80% of epileptics have forehead scarifications.
      When the seizures are rare, scarifications are slim, short (1-3 mm), near the
      roots of hair on the forehead and concealed; but when they are frequent, known by
      many people, scarifications are large, long, visible on forehead, the patient
      showing the sign of his social sentence.. On the skin of epileptics in Togo, is
      written the diagnosis of his affection. It only needs to look at it.

PMID- 11204726
TI  - Clinical and electro-clinical classification of epileptic seizure in west Uganda.
AB  - When compared to that of industralised countries, the prevalence of epilepsy in
      developing countries has generally been found to be higher and in some areas
      extremely high rates of up to 57 cases per 1000 inhabitants have been reported.
      The reasons for this difference are still widely unknown and detailed
      epidemiological as well as clinical data are scarce, especially from rural
      Africa. The present study was conducted in western Uganda, in an area of high
      epilepsy prevalence, known to be endemic for onchocerciasis. The seizures of all
      91 epilepsy patients diagnosed in this area over the period of two years were
      classified according to the criteria of the International League against
      Epilepsy. Based on seizure description alone, the predominant seizure was
      classified as generalised in 57 patients (63%), as partial in 22 (24%) and
      unclassified in 12 (13%). An EEG record was analysed in 55 out of 91 patients,
      showing focal epileptiform activity (EA) in 12, multifocal EA in 9 and primarily
      generalised EA in 6 patients. When in addition to clinical information, the EEG
      results in the 27 patients with EA were taken in consideration for seizure
      classification, the proportion of partial seizures increased to 78% (n = 21);
      inversely the proportion of generalised seizures fell to 22% (n = 6). The
      predominance of partial seizures would be compatible with a localised brain
      lesion as a frequent cause for epileptic seizures in the study area. The findings
      further corroborate recent observations from several African countries of an
      association between epilepsy and onchocerciasis.

PMID- 11204727
TI  - [Stabilized epilepsy in three adult cases of pachygyria].
AB  - In complex malformations of the neocortex due to neuronal migration disorders,
      epilepsy is usually intractable and is observed in childhood. The study of such
      malformations in adults is rare. Three adult cases are described with easily
      treated epilepsy controlled by one or two anti-epilectic drugs. A brain CAT-scan
      of these three patients showed pachygyria (macrogyria) sometimes associated with
      other malformations and disorders of neurone migration. These three 28, 40 and 53
      year-old-patients (one woman and two men) were mentally disturbed with complex
      neurological disturbances and confined to a wheelchair. Their epilepsy had began
      in childhood and stabilised as these patients became adults. We raised the
      question as to whether this is in fact the long-term outcome for epileptic
      patients with pachygyria. The outcome of such epilepsy due to pachygyria could be
      better than initially supposed.

PMID- 11204728
TI  - [Questionnaire in a study of epilepsy in tropical countries].
AB  - The purpose of this questionnaire is to standardize information on the epilepsy
      studies. It was developed through collaborative work involving the Institute of
      Neurological Epidemiology and Tropical Neurology of Limoges (France), the Pan
      African Association of Neurological Sciences and the International League Against
      Epilepsy (Commission on Tropical Diseases, 1993-1997).

PMID- 11204729
TI  - [Anti-ribosomal antibodies during hepatitis C].
AB  - We report the case of a young Tunisian woman hospitalised for reasons of general
      ill health. A immunological check-up revealed autoimmune disturbances and in
      particular anti-ribosomal P antibodies. We discuss the possible relation of these
      antibodies to the hepatitis C infection from which the patient was also
      suffering.

PMID- 11204730
TI  - [Bacteriological and epidemiological data on Streptococcus pneumoniae in the
      hospital of southern Reunion Island].
AB  - We studied the epidemiology of Streptococcus pneumoniae in southern Reunion
      Island from 1993 to 1998. Data were collected from the Centre hospitalier Sud
      Reunion. Incidence of pneumonia was calculated by applying published ratios to
      two different types of data (bacteriological, clinical). Survey of pneumococci
      showed that antimicrobial resistance of S. pneumoniae to penicillin G appeared in
      1994 and reached high levels in 1998. We confirmed the increase of multiresistant
      strains among penicillin resistant S. pneumoniae. Serotyping the penicillin
      resistant S. pneumoniae has shown that these strains belonged to serogroups 9,
      14, 19, 23. The MIC determined in PRP showed that imipenem was the most active
      agent among beta-lactamin antibiotics followed by ceftriaxone. Strains with high
      resistance to amoxicillin are rare. Annual incidence of meningitis was almost 0.4
      per 100,000 inhabitants. Estimation of pneumonia incidence was between 44 and 78
      per 100,000 inhabitants. Incidence in Reunion Island is twice to three times
      lower than the incidence in France. Death rate from pneumoniae (10%) is similar
      to that in France. In the course of the study, the number of isolated S.
      pneumoniae increased. Changing socio-economic conditions are probably associated
      with the emergence of PRP since 1994 and the increase in numbers of infections.
      Pneumococcal infections in Reunion Island are becoming a public health problem of
      the same importance as in France.

PMID- 11204731
TI  - [Esophageal tuberculosis: an unusual localization in an immunocompetent patient].
AB  - Oesophageal tuberculosis is a rare localisation for extrapulmonary tuberculosis.
      This report describes the case of a 30-year-old immunocompetent woman with
      dysphagia, fever and weight loss. Endoscopic examination revealed an ulcerated
      lesion in the third part of the oesophagus strongly suggesting oesophageal
      carcinoma. Histologic samples showed epithelioid cells granuloma in the
      submucosa. Diagnosis was later confirmed by acid-fast bacilli positive gastric
      aspirates and a positive Mantoux test using the tuberculin reaction. Barium
      swallow revealed a narrowing in the third oesophagus. A chest x-ray revealed a
      infiltrated lesion and a mediastinal lymph node. The patient was put on
      antitubercular treatment. On follow-up after 3 months, dysphagia, fever, weight
      loss had disappeared and the ulcerated lesion of oesophagus had improved. The
      subsequent course of the patient is not known, since she was lost to follow-up.

PMID- 11204732
TI  - [Pulmonary amebiasis and tuberculosis association. Two case reports in
      Libreville, Gabon].
AB  - Amoebiasis and tuberculosis are common in Gabon. International travel, cultural
      exchanges, changing immigration and climate of tropical provide an ideal
      environment for these pathogenic organisms. However, the unexpected survival of
      these two pathologies in the same patient is exceptional.

PMID- 11204733
TI  - [A 2500 year-old patient. Nosological study of a statue of the Nok culture,
      Nigeria].
AB  - The authors describe a terra cotta statue of the Nok culture (Nigeria) dating
      from between 450 and 50 B. C. Amongst thousands of the same origin, this statue
      is the only one representing a pathological state of cirrhosis, aetiology of
      which may be viral, parasitological or iatrogenic. Although no precise diagnosis
      can be made, this statue pays tribute to the power of observation of the artist
      who conceived it.

PMID- 11204734
TI  - [Acute intoxication with "sobi-lobi" (Datura). Four cases in Niger].
AB  - The datura (Datura stramonium, Datura metel) belongs to a group of plants from
      the solanacies variety and can be the cause of voluntary intoxication. In Nigher,
      its flowers and seeds are used for their hallucinogenic properties. Its alcaloids
      have an atropine-like effect. We are reporting here the first four cases of
      voluntary intoxication among teenagers in Niamey (Republic of Niger). The
      symptoms, which happened to be identical for the four patients, lead us quickly
      towards the possibility of a collective intoxication. During the questioning, the
      patients admitted they had smoked the plant's dried flowers, but also they drunk
      an herbal tea mixed with datura seeds. Symptoms are comparable to that of
      intoxications caused by atropine. Neurological signs are the main symptoms
      (agitation, delirium, disorientation, hallucination, mydriasis, retention of
      urine...). The others noticeable signs are: fever, dry mouth, tachycardia,
      thirstiness. The evolution was favourable as the patients left the hospital
      between D2 and D4. Those clinical features are compared to the literature items,
      which are inexistent in western Africa. The prognosis may be fatal, especially
      for the child and during massive intoxications meant to be autolystic or
      toxicomaniac. The recovery when possible leads usually to no sequels however
      sever the clinical picture is. The consultation of the population enabled us to
      comprehend that datura is known and consumed for its hallucinogenic proprieties.
      The therapeutic guidance is described and prevention suggested.

PMID- 11204735
TI  - [Words from the other side].

PMID- 11204736
TI  - Site-specific drug delivery in the gastrointestinal tract.
AB  - In recent years there has been a significant increase in available strategies for
      site-specific delivery in the gastrointestinal tract both to maximize a
      therapeutic response and to reduce side effects. However, in only a few instances
      has there been close attention paid to how these products will perform in the
      heterogeneous environment of the human gut. Targeted oral delivery requires a
      multidisciplinary approach to research, involving contributions not only from
      polymer and pharmaceutical scientists but also from experts in gastroenterology
      and product evaluation. The objective of this article is, therefore, to examine
      our current understanding of human gastrointestinal physiology and to review the
      current "state of the art" of available targeting strategies. Emphasis will be
      placed on human data and, in particular, the interaction between the delivery
      system and the gastrointestinal tract, as assessed by product visualization
      studies.

PMID- 11204737
TI  - Enhancement of transdermal drug delivery: chemical and physical approaches.
AB  - Transdermal drug delivery has been intensively studied over the last two decades
      because of the many advantages offered by this route of administration. However,
      the number of drugs used in transdermal drug delivery systems has been somewhat
      limited, in part resulting from the formidable barrier to drug permeation
      presented by the upper layer of the skin, the stratum corneum. In order to
      overcome this, different strategies have been implemented to render the skin more
      permeable to drugs. These strategies include both chemical and physical
      approaches. In this review, we outline the enhancing activities and mechanisms of
      action of some of the more extensively studied chemical penetration enhancers
      (oxazolidinones, propylene glycol, and epidermal enzymes). In addition, we
      discuss novel physical strategies, such as the use of microneedles or
      electroporation.

PMID- 11204738
TI  - Expression and regulation of prostaglandin E receptor subtype mRNAs in rat
      sensory ganglia and spinal cord in response to peripheral inflammation.
AB  - Prostaglandins are known to act via seven transmembrane domain receptors to exert
      actions on both peripheral and central neurons resulting in changes in neuronal
      excitability. Prostaglandin E2, the prostaglandin most often associated with
      inflammation, itself acts on a family of closely related receptors, the EP
      receptors. Using semi-quantitative reverse transcription polymerase chain
      reaction (RT-PCR), we have shown that rat primary afferent neurons express the
      mRNA for all EP receptor subtypes, and that some, but not all EP receptor subtype
      mRNAs are down-regulated in sensory neurons in response to an acute peripheral
      inflammation. We also show for the first time that all EP receptor subtype mRNAs
      are expressed in rat lumbar spinal cord. Spinal cord EP receptor subtype mRNAs
      are also regulated in acute inflammation in a pattern distinct from the changes
      seen in sensory ganglia in response to the same inflammatory stimulus.

PMID- 11204739
TI  - Transcriptional regulation of prostaglandin-H-synthase-1 in the amnion-derived
      AV3 cell line.
AB  - Prostaglandin-H-synthase-1 (PGHS-1), while constitutively expressed in most
      tissues, increases in abundance in human gestational membranes at term. This
      suggests that PGHS-1 may be up-regulated in preparation for labor, and thus might
      be a key determinant in timing labor onset. We conducted transient transfection
      experiments in amnion-derived AV3 cells utilizing pPGHS1CAT to identify
      substances that might regulate PGHS-1 expression in amnion. Transforming growth
      factor-beta (1 ng/ml) and 15-deoxy-delta(12,14) prostaglandin J2 (1 microM)
      significantly (P < 0.05) (33% and 44% respectively) increased PGHS-1 promoter
      activity. The activity decreased significantly (P < 0.05) in response to
      interleukin-1 (IL-1)beta (1 ng/ml) (45%), tumor necrosis factor (TNF)-alpha (50
      ng/ml) (34%), epidermal growth factor (10 ng/ml) (54%), phorbol myristate acetate
      (10 nM) (70%), IL-4 (10 ng/ml) (50%), IL-8 (100 ng/ml) (72%) and Activin A (25
      ng/ml) (32%). Whether this degree of change in promoter activity leads to
      physiologically relevant alterations in the amounts of PGHS-1 present in cells
      remains to be determined.

PMID- 11204740
TI  - Growth hormone, but not luteinizing hormone, acts with luteal peptides on
      prostaglandin F2alpha and progesterone secretion by bovine corpora lutea in
      vitro.
AB  - Prostaglandin F2alpha (PGF2alpha) is a major physiological luteolysin in the cow.
      However, injection of PGF2alpha before day 5 (day 0 = estrus) of the estrous
      cycle dose not induce luteolysis. On the other hand, the early corpus luteum (CL)
      actively produces PGF2alpha. This indicates that luteal PGF2alpha may play a key
      role in the refractoriness to PGF2alpha injected during the early luteal phase
      when angiogenesis is active in the CL. Thus, this study aimed to investigate the
      possible interaction between pituitary hormones and local factors (luteal
      peptides) on secretion of PGF2alpha and progesterone (P) by the early bovine CL,
      and to evaluate the effect of growth hormone (GH) as well as its interactions on
      production of PGF2alpha in the developing CL. A RT-PCR analysis revealed that
      mRNA for GH receptor in CL was fully expressed from early in the luteal phase
      throughout the estrous cycle, while luteinizing hormone (LH) receptor mRNA was
      expressed less by the early and regressing CL than those at mid or late luteal
      phases (P < 0.05). For the stimulation test, an in vitro microdialysis system
      (MDS) was used as a model. Each bovine early CL (days 3-4) was implanted with the
      MDS, and maintained in an organ culture chamber. The infusion of GH, insulin-like
      growth factor-I (IGF-I) and oxytocin (OT) increased (P < 0.05) PGF2alpha and P
      release. In contrast, LH had no effect (P > 0.05) on PGF2alpha secretion and
      little effect on P release. Unexpectedly, there was no distinct interaction
      between pituitary hormones and luteal peptides on secretion of PGF2alpha and P.
      These results indicate that GH is a more powerful stimulator of PGF2alpha and P
      production in the early bovine CL than LH and suggest that GH and luteal
      peptides, IGF-1 and OT, contribute to maintenance of elevated PGF2alpha
      production in the developing bovine CL.

PMID- 11204741
TI  - Characterization of the murine epidermal 12/15-lipoxygenase.
AB  - The murine lipoxygenase (LO) family consists of at least seven members classified
      according to the HETE (hydroxyeicosatetraenoic acid) metabolite generated during
      arachidonic acid metabolism and the site of tissue expression. At present there
      are four 12-lipoxygenases that are functionally distinct, vary in cell and tissue
      distribution, catalytic activity and each are products of separate, linked genes.
      They are "platelet-type" 12-LO (P-12LO), "leukocyte-type" 12-LO (L-12LO),
      "epidermal-type" 12-LO (e-12LO) and the most recently discovered 12(R)-LO. In
      this report we characterize e-12LO, which was overexpressed in the
      baculovirus/insect cell expression system. The enzyme functions as a dual
      specificity 12/15-lipoxygenase with a 12-HETE/15-HETE product ratio of
      approximately 6:1 with arachidonic acid as substrate. Several other
      polyunsaturated fatty acids served as substrates for e-12LO such as gamma
      linolenic, dihomo-gamma-linolenic and eicosapentaenoic acids. A green fluorescent
      protein/e-12LO fusion protein was localized to the cytosol of transfected HEK 293
      cells. The e-12LO gene was expressed in mouse oocytes and early embryos. Western
      blot analysis revealed high level expression in postnatal day 3 mouse epidermal
      lysates. Together these data suggest that e-12LO plays a role in normal epidermal
      function and as yet an undiscovered role in early development.

PMID- 11204742
TI  - Spectrophotometric determination of benazepril in tablets.
AB  - A simple and sensitive spectrophotometric method has been developed for the
      determination of benazepril HCl in pharmaceutical formulations. The method is
      based on the reaction of the drug with potassium permanganate in the presence of
      sodium hydroxide to produce a bluish-green colored species measurable at 609.4
      nm. The absorbance-concentration plot is linear over the range 1-8 microg ml(-1)
      with minimum detectability of 0.1 microg ml(-1) (2.17 x 10(-7) M). The molar
      absorptivity was 4.07 x 10(4) l mol(-1) cm(-1) with correlation coefficient (n =
      6) of 0.9991. The different experimental parameters affecting the development and
      stability of the color were studied carefully and optimized. The proposed method
      was applied successfully to the determination of benazepril in its dosage forms,
      the percentage recoveries +/- SD (n = 9) were 99.79 +/- 1.40 and 100.50 +/- 1.48
      for tablets containing 10 and 20 mg, respectively. The results obtained were in
      good agreement with those obtained using a reference spectrophotometric method.
      The proposed method could be applied to the determination of benazepril in
      presence of the co-formulated drug, hydrochlorothiazide. A proposal of the
      reaction pathway was presented.

PMID- 11204743
TI  - Enhanced release of solid dispersions of etodolac in polyethylene glycol.
AB  - This work examines the release of etodolac from various molecular weight
      fractions of polyethylene glycol (PEG) solid dispersions. Solid dispersions of
      etodolac were prepared in different molar ratios of drug/carrier by using solvent
      and melting methods. The release rate of etodolac from the resulting complexes
      was determined from dissolution studies by use of USP dissolution apparatus 2
      (paddle method). The physical state and drug:PEG interaction of solid dispersions
      and physical mixtures were characterized by X-ray diffraction (XRD), infrared
      spectroscopy (IR) and differential scanning calorimetry (DSC). The dissolution
      rate of etodolac is increased in all of the solid dispersion systems compared to
      that of the pure drug and physical mixtures. The solid dispersion compound
      prepared in the molar ratio of 1:5 by the solvent method was found to have the
      fastest dissolution profile. The physical properties did not change after 9
      months storage in normal conditions.

PMID- 11204744
TI  - Synthesis of N-[4-(propyl)cyclohexyl]-amides with anti-inflammatory and analgesic
      activities.
AB  - Seventeen (un)substituted N-[4-(propyl)cyclohexyl]-amides (6a-h, 7a-h and 8) were
      synthesized and tested as anti-inflammatory and analgesic agents. The
      substituents on the aromatic ring were chosen in order to study the influence of
      electron-withdrawing or electron-donating residues, that change the electronic
      density on the aromatic moiety. The pharmacological results allow drawing some
      preliminary considerations on structure-activity relationships.

PMID- 11204745
TI  - High-performance liquid chromatography-mass spectrometric analysis of furosemide
      in plasma and its use in pharmacokinetic studies.
AB  - This study presents a rapid, specific and sensitive high-performance liquid
      chromatography-mass spectrometric (LC-MS) assay for the determination of
      furosemide in human plasma using diclofenac as an internal standard (IS). Both
      compounds were extracted from human plasma with ethyl acetate at pH 1 and were
      chromatographed using Shim-Pack GLC-CN column and a mobile phase consisting of
      acetonitrile and 20 mM ammonium acetate buffer solution pH 7, 4:1 (v/v) at a flow
      rate 1 ml min(-1). Furosemide and IS were detected by mass spectrometer operated
      in the negative single ion monitoring mode using APCI as an ionization process at
      m/z 329.2 and 294.1, respectively. The assay linearity of furosemide was
      confirmed over the range 50-2,000 ng ml(-1). Detection limit for furosemide in
      plasma was 10 ng ml(-1). The selected concentration range corresponds well with
      the plasma concentrations of furosemide for pharmacokinetic study. Intraday and
      interday relative standard deviations were 1.3-4.7 and 2.7-11.5%, respectively.
      The extraction recovery percentages of furosemide and IS from plasma were in the
      range 89.3-97.1%. The developed LC-MS procedure was applied for the determination
      of the pharmacokinetic parameters of furosemide after an oral administration of
      tablet formulation (40 mg) to two healthy male volunteers. The calculated
      parameters were in good agreement with the reported values.

PMID- 11204746
TI  - Synthesis and cytotoxic activity of 2-dialkylaminoethylamino substituted
      xanthenone and thioxanthenone derivatives.
AB  - The synthesis and biological evaluation of some new pyranoxanthenones and
      pyranothioxanthenones, substituted with flexible amino side-chains, and their
      evaluation as potential antitumor agents is described. The cytotoxic activity of
      the compounds and their eventual selective effect on a phase of the cell cycle
      were evaluated in vitro, using the murine lymphocytic L1210 leukemia cell line.
      The new aminoderivatives exhibited highly potent cytotoxicity against the
      leukemia L1210 cell line when compared to acronycine. All the compounds induced a
      partial accumulation of cells in the G2 + M phase of the cell cycle.

PMID- 11204747
TI  - Synthesis, 5-HT1A and 5-HT2A receptor affinity of new 1-phenylpiperazinylpropyl
      derivatives of purine-2,6- and pyrrolidine-2,5-diones.
AB  - Two series of 1-phenylpiperazinylpropyl derivatives 10, 11, 16, 17 and 19-24,
      structurally related to previously described 5-HT1A or 5-HT2A ligands 4 and 1,
      respectively, were synthesized and their binding properties were determined.
      Structural modifications which involved 1,3-diazepine ring opening in 4
      (compounds 10, 11, 15, 16) and replacement of spiroalkyl moiety in 1 by aryl
      substituent (19-24) did not improve binding affinity and selectivity of the
      tested compounds. The results showed, however, that the diazepine ring present in
      4 or spiroalkyl ring in 1 are important for high 5-HT1A or 5-HT2A binding
      affinity and selectivity of these compounds.

PMID- 11204748
TI  - Synthesis and microbiological activity of some N-(o-hydroxyphenyl)benzamides and
      phenylacetamides as the possible metabolites of antimicrobial active
      benzoxazoles: part II.
AB  - The synthesis of some N-(o-hydroxyphenyl)benzamides and benzacetamides (2a-2p) in
      order to determine their in vitro antimicrobial activity against two Gram
      positive bacteria, three Gram-negative bacteria and the fungus Candida albicans
      is described. The new compounds were compared with several control drugs. The
      derivative 2g, 4-amino-N-(o-hydroxyphenyl)benzamide, was found active at an MIC
      value of 25 microg/ml against the Gram-negative microorganism Klebsiella
      pneumoniae. Most of the compounds exhibited antibacterial activity at an MIC
      value of 25 microg/ml against Pseudomonas aureginosa. For the antifungal activity
      against C. albicans, compounds 2e, 2h and 2m were found more active than the
      other derivatives (MIC 12.5 microg/ml). The antimicrobial activity of some of
      these benzamide and phenylacetamide derivatives (2a, 2b, 2f, 2g, 2h and 2k),
      possible metabolites of benzoxazoles, was also compared with that of the cyclic
      analogues 3-8. Compound 2f possesses two dilutions better antifungal activity
      than its cyclic analogue the benzoxazole derivative 5 against C. albicans, while
      having one dilution better antibacterial activity against Streptococcus faecalis
      and K. pneumoniae.

PMID- 11204749
TI  - Dissolution tests of benazepril-HCl and hydrochlorothiazide in commercial
      tablets: comparison of spectroscopic and high performance liquid chromatography
      methods.
AB  - Simple, rapid and reliable spectroscopic methods (absorbance ratio and Vierordt)
      were compared with HPLC for quantitative determination in dissolution tests of
      benazepril-HCl (BNZ) and hydrochlorothiazide (HCT) in commercial tablets. A 249
      nm wavelength was chosen as the isosbestic point in the absorbance ratio method,
      and the absorbance ratios A236/A249 nm for BNZ and A269/A249 nm for HCT were used
      for calculation of regression equations. For the Vierordt method, A1(1) values
      (%1.1 cm) obtained at 236 and 269 nm for both substances were used for
      quantitative analyses of BNZ and HCT. In the HPLC method, simultaneous
      determination of BNZ and HCT from dissolution medium was achieved using the
      mobile phase containing phosphate buffer (0.01 M, pH 6.2) and acetonitrile
      (65:35) on a Supelcocil LC-18 (4.6 x 250, 5.6 mm) reversed phase column.
      Dissolution tests of commercial tablets were carried out according to USP XXII
      paddle method in 0.1 N HCl at 50 rpm at 37 +/- 0.5 degrees C. Comparison of the
      dissolution data from the HPLC and two spectroscopic methods indicated that
      spectroscopic and HPLC methods were in good correlation with each other.
      Therefore, it was concluded that both spectroscopic methods as well as HPLC can
      be used in routine analyses of BNZ and HCT in dissolution tests of commercial
      tablets.

PMID- 11204750
TI  - Building a pharmacophore model for a novel class of antitubercular compounds.
AB  - Starting from a set of 32 antitubercular compounds, for the first time a three
      dimensional pharmacophore model has been derived through a computational approach
      based on CATALYST software. The model proved to be able to identify compounds
      belonging to classes of molecules already reported as antitubercular agents.

PMID- 11204751
TI  - Isolation and bioactivities of epidioxysterol from the tunicate Cynthia savignyi.
AB  - From a hexane extract of the tunicate Cynthia savignyi, collected in Morocco,
      epidioxysterol or 5,8-alpha-epidioxy-5alpha-cholest-6-en-3beta-ol has been
      isolated. This is the first example of epidioxysterol found in the tunicate C.
      savignyi. The structure of epidioxysterol has been characterised by NMR data (1H,
      13C and 2D). Epidioxysterol possesses antifungal activity against three tomato
      pathogenic fungi: Botrytis cinerea, Fusarium oxysporum and Verticillium albo
      atrum and antibacterial activity against Agrobacterium tumefaciens, Escherichia
      coli, Staphylococcusfaecalis, Staphylococcus aureus and Pseudomonas aeruginosa
      and cytotoxicity against Artemia salina larvae.

PMID- 11204753
TI  - 4,5-Dihydroisoxazoles: testing of antimicrobial activity.
AB  - In the 1,3-dipolar cycloaddition of aliphatic nitrile to selected olefins, a
      series of 4,5-dihydroisoxazoles substituted with various functional groups,
      ester, carbonyl and ethereal, was obtained. These compounds were investigated for
      antimicrobial activity on chosen strains.

PMID- 11204752
TI  - O-[2-hydroxy-3-(dialkylamino)propyl]ethers of (+)-1,7,7-trimethyl
      bicyclo[2.2.1]heptan-2-one oxime (camphor oxime) with analgesic and
      antiarrhythmic activities.
AB  - A novel series of O-[2-hydroxy-3-(dialkylamino)propyl]ethers of (+)-camphor oxime
      was prepared and tested for its cardiovascular, analgesic and anti-inflammatory
      properties. No significant anti-inflammatory and hypotensive activities were
      displayed by any of the compounds, whereas several of them are reasonably active
      as antiarrhythmic and analgesic agents.

PMID- 11204754
TI  - Phytochemical study and anti-inflammatory properties of Lampaya hieronymi Schum.
      ex Moldenke.
AB  - The chemical study of aerial parts of Lampaya hieronymi Schum. ex Moldenke
      yielded oleanolic acid, epi-oleanolic acid, epi-maslinic acid, 4'7
      dimethoxyapigenin, p-hydroxyacetophenone, and p-hydroxyacetophenone-beta
      glucoside. In searching for natural products as potential anti-inflammatory
      agents, all the compounds, except 4'7-dimethoxyapigenin were evaluated in vivo
      for their ability to inhibit acute inflammation. Our studies demonstrated that p
      hydroxyacetophenone and the triterpenes produced protective effects in
      carrageenan induced paw edema in mouse, at 1-3 h and 3-5 h, respectively, after
      the injection of carrageenan. These results indicated that their effects might
      correlate with the release of histamine, serotonin, kinin and prostaglandins.

PMID- 11204755
TI  - Anatomic and functional lesions resulting in partial or complete upper airway
      obstruction.

PMID- 11204756
TI  - Obstructive diseases of the trachea.

PMID- 11204757
TI  - Case of the season. Desmoplastic small round cell tumor.

PMID- 11204758
TI  - Bronchiectasis: current clinical and imaging concepts.

PMID- 11204759
TI  - HRCT of obliterative bronchiolitis and other small airways diseases.

PMID- 11204760
TI  - Clinical aspects of obstructive lung disease.
AB  - Obstructive pulmonary diseases are diverse with an extensive differential
      diagnosis. Most cases can be diagnosed after a systematic evaluation that
      includes detailed history, physical examination, routine laboratory testing,
      radiologic and pulmonary physiologic tests. More specific studies are indicated
      only in a few patients.

PMID- 11204761
TI  - Radiography and computed tomography of chronic obstructive pulmonary disease.

PMID- 11204762
TI  - Actinoplanes capillaceus sp. nov., a new species of the genus Actinoplanes.
AB  - Two motile actinomycete strains, K95-5561T and K95-5562, were isolated from a
      soil sample collected at Sayama City, Saitama Prefecture, Japan. They produced
      bell shaped spore vesicles (sporangia) with hairy surfaces on substrate hyphae.
      When released into water, the sporangiospores became motile by a tuft of polar
      flagella. The chemotaxonomic and morphological characteristics together with 16S
      rRNA gene sequence data indicated that the two isolates belonged to the genus
      Actinoplanes. The two strains were assigned to a single species on the basis of
      phenotypic, notably cultural, morphological and physiological characteristics,
      and DNA-DNA pairing data. The two strains were distinguished from representatives
      of all validly described species of Actinoplanes using a combination of genotypic
      and phenotypic properties. It is, therefore, proposed that strains K95-5561 and
      K95-5562 be recognized as a new species of the genus Actinoplanes with the name
      Actinoplanes capillaceus sp. nov. The type strain of the species is strain K95
      5561T (=JCM 10268T =IFO 16408T). The invalidly proposed species 'Ampullariella
      cylindrica', 'Ampullariella pekinensis' and 'Ampullariella pilifera' were
      assigned to Actinoplanes capillaceus on the basis of genotypic and phenotypic
      data.

PMID- 11204763
TI  - Electron microscopy of the K2 killer effect of Saccharomyces cerevisiae T206 on a
      mesophilic wine yeast.
AB  - A mesophilic wine yeast, Saccharomyces cerevisiae CSIR Y217 K-R- was subjected to
      the K2 killer effect of Saccharomyces cerevisiae T206 K+R+ in a liquid grape
      medium. The lethal effect of the K2 mycoviral toxin was confirmed by methylene
      blue staining. Scanning electron microscopy of cells from challenge experiments
      revealed rippled cell surfaces, accompanied by cracks and pores, while those
      unaffected by the toxin, as in the control experiments, showed a smooth surface.
      Transmission electron microscopy revealed that the toxin damaged the cell wall
      structure and perturbed cytoplasmic membranes to a limited extent.

PMID- 11204764
TI  - Phylogenetic analysis of Bacillus subtilis and related taxa based on partial gyrA
      gene sequences.
AB  - Partial gyrA sequences were determined for twelve strains belonging to Bacillus
      amyloliquefaciens, B. atrophaeus, B. licheniformis, B. mojavensis, B. subtilis
      subsp. subtilis, B. subtilis subsp. spizizenii and B. vallismortis. The average
      nucleotide and translated amino acid similarities for the seven type strains were
      83.7 and 95.1%, respectively, whereas the corresponding value for the 16S rRNA
      sequences was 99.1%. All of the type strains were sharply separated; the closest
      relationship was found between B. atrophaeus and B. mojavensis which shared a
      nucleotide similarity of 95.8%. Phylogenetic trees were inferred from gyrA
      nucleotide sequences using the neighbor-joining, Fitch-Margoliash and maximum
      parsimony algorithms. The test strains were divided into four groups, which
      generally reflected results previously reported in restriction digest and DNA-DNA
      hybridization studies. It is concluded from the comparative sequence analysis
      that the gyrA sequences provide a firm framework for the rapid and accurate
      classification and identification of Bacillus subtilis and related taxa.

PMID- 11204765
TI  - Screening of basidiomycetes for antimicrobial activities.
AB  - As a part of a screening programme developed to evaluate the antimicrobial
      activity of basidiomycetes, 317 isolates representing 204 species collected in
      Spain were screened against a range of human clinical pathogens and laboratory
      controls. Extracts from 45% of the isolates, representing 109 species, showed
      antimicrobial activity. Antibacterial activity was more pronounced than
      antifungal activity. The proportion of extracts from basidiomycetes showing
      antimicrobial activity was similar to or above that obtained for representative
      orders of Ascomycetes, such as Pezizales and Xylariales, but lower than that
      produced by members of the orders Diaporthales, Eurotiales, Hypocreales,
      Leotiales and Sordariales. Suprageneric taxa (orders and families) did not show
      pronounced differences in their antimicrobial activities though such differences
      were observed at the genus level, suggesting that the ability to produce these
      bioactive compounds is not homogenously distributed amongst the basidiomycetes.
      Isolates from some species showed large differences in their ability to produce
      metabolites with antimicrobial activity, possibly reflecting genetic differences
      at the infraspecific level.

PMID- 11204766
TI  - Characterization by molecular cloning and sequencing of the gene encoding an
      aminopeptidase from Listeria monocytogenes.
AB  - The pepC gene of Listeria monocytogenes encodes aminopeptidase C that is
      predicted to share 72% amino acid sequence similarity and 53% sequence identity
      with the cysteine aminopeptidase PepC from Lactococcus lactis. The gene product
      also shows strong similarity to aminopeptidase C from Streptococcus thermophilus
      and Lactobacillus helveticus, and to a cysteine proteinase/bleomycin hydrolase
      from Saccharomyces cerevisiae. The enzyme from L. monocytogenes displayed broad N
      terminal hydrolytic activity, with a similar substrate specificity to its lactic
      acid bacterial counterpart. The inhibition spectrum shows a great deal of
      similarity with enzymes from the family of lactic acid bacteria. In addition, one
      of the clones studied contained DNA sequences that could encode a regulatory
      protein of the deoR helix-turn-helix DNA binding protein family. The organization
      of the locus, designated pep, is presented along with the characterization of the
      gene products of the pep locus.

PMID- 11204767
TI  - Exserohilum israeli, a new species isolated from soil from Timna Park (Israel),
      and its physiological properties.
AB  - Fungi isolated from soil in Timna Park (Israel) were found to belong to a new
      species of Exserohilum for which the name Erserohilum israeli sp. nov. is
      proposed. The main physiological properties of members of this species are
      discussed and the influence of temperature and copper concentrations on the
      growth and morphology of the fungus were investigated.

PMID- 11204768
TI  - Synergistic effects of low doses of histatin 5 and its analogues on amphotericin
      B anti-mycotic activity.
AB  - The increase in the use of antifungal agents for prophylaxis and therapy has led
      to the development of antifungal drug resistance. Drug combinations may prevent
      or delay resistance development. The aim of the present study was to investigate
      whether naturally and designed cationic antifungal peptides act synergistically
      with commonly used antimycotics. No enhanced activity was found upon addition of
      dhvar4, a designed analogue of the human salivary peptide histatin 5, or PGLa to
      fluconazole or 5-flucytosine, respectively. In contrast, strong synergism of
      amphotericin B with the peptides was found against several Aspergillus, Candida,
      and Cryptococcus strains, and against an amphotericin B-resistant C. albicans
      laboratory mutant in the standardised broth microdilution assays according to the
      NCCLS standard method M27-T. Amphotericin B showed synergism with dhvar5, another
      designed analogue of histatin 5, and with magainin 2 against all seven tested
      strains. Combinations of amphotericin B with histatin 5, dhvar4, and PGLa showed
      synergism against four of the seven strains. The growth inhibitory activity of
      amphotericin B was enhanced by sub-MIC concentrations of peptide, but its
      haemolytic activity remained unaffected, suggesting that its cytotoxicity to host
      cells was not increased and that peptides may be suitable candidates for
      combination therapy.

PMID- 11204769
TI  - Application of a method incorporating differential centrifugation for selective
      isolation of motile actinomycetes in soil and plant litter.
AB  - The present paper describes a simple enrichment technique which enables rapid and
      selective isolation of diverse zoosporic actinomycete genera directly from soil
      and plant litter. This technique, designated the rehydration and centrifugation
      (RC) method, consists of immersing the air-dried source material in 10 mM
      phosphate buffer containing 10% soil extract, letting the preparation stand at 30
      degrees C for 90 min, followed by centrifugation of the fluid at 1,500 x g for 20
      min. Portions of the supernatant containing actinomycete zoospores are plated on
      the humic acid-vitamin agar which is supplemented with nalidixic acid and
      trimethoprim as the selective inhibitors for Gram-negative bacteria and bacilli.
      The phosphate buffer-soil extract solution significantly promoted liberation of
      motile zoospores from the source material. The centrifugation stage greatly
      eliminated streptomycetes and other non-motile actinomycetes from the liquid
      phase, thereby facilitating selective growth of rare, motile actinomycetes on the
      isolation plates subsequent to inoculation. Ten different soil and leaf-litter
      samples, taken from fields, forests, and stream banks, were examined. The RC
      method consistently achieved preferential isolation of motile actinomycetes in
      all samples, which accounted for 37-86% of the total microbial population
      recovered. The most frequently isolated motile actinomycetes were Actinoplanes
      and Dactylosporangium. Strains of Actinokineospora, Catenuloplanes and
      Kineosporia were also recovered, depending on the nature of the samples examined.
      Other motile actinomycetes that were occasionally isolated in small numbers
      included Actinosynnema, Geodermatophilus and Sporichthya.

PMID- 11204770
TI  - Pseudohyphal growth is induced in Saccharomyces cerevisiae by a combination of
      stress and cAMP signalling.
AB  - In Saccharomyces cerevisiae pseudohyphae formation may be triggered by nitrogen
      deprivation and is stimulated by cAMP. It was observed that even in a medium with
      an adequate nitrogen supply, cAMP can induce pseudohyphal growth when S.
      cerevisiae uses ethanol as carbon source. This led us to investigate the effects
      of the carbon source and of a variety of stresses on yeast morphology.
      Pseudohyphae formation and invasive growth were observed in a rich medium (YP)
      with poor carbon sources such as lactate or ethanol. External cAMP was required
      for the morphogenetic transition in one genetic background, but was dispensable
      in strain sigma 1278b which has been shown to have an overactive Ras2/cAMP
      pathway. Pseudohyphal growth and invasiveness also took place in YPD plates when
      the yeast was subjected to different stresses: a mild heat-stress (37 degrees C),
      an osmotic stress (1 m NACl), or addition of compounds which affect the lipid
      bilayer organization of the cell membrane (aliphatic alcohols at 2%) or alter the
      glucan structure of the cell wall (Congo red). We conclude that pseudohyphal
      growth is a physiological response not only to starvation but also to a stressful
      environment; it appears to require the coordinate action of a MAP kinase cascade
      and a cAMP-dependent pathway.

PMID- 11204771
TI  - Characterisation of a lipomannan lipoglycan from the mycolic acid containing
      actinomycete Dietzia maris.
AB  - Lipoglycans such as the mycobacterial lipoarabinomannans (LAM) are important cell
      envelope components of actinomycetes. To further our understanding of the
      diversity of these enigmatic macromolecules the lipoglycan composition of Dietzia
      maris has been investigated. Phenol-water extraction and hydrophobic interaction
      chromatography were used to purify a lipoglycan which was unusually small and
      predominantly lipomannan in nature. The presence of minor levels of arabinose
      along with components consistent with the presence of a phosphatidylinositol
      anchor suggest that this lipoglycan is a novel representative of the
      lipomannan/LAM structural archetype. This was further supported by the observed
      cross-reaction of the D. maris lipoglycan with an antiserum raised against LAM
      from Mycobacterium tuberculosis. These findings reveal a previously unsuspected
      diversity in the lipoglycan composition of the mycolic acid containing
      actinomycetes and are further discussed in relation to the apparent absence of
      phosphatidylinositolmannoside glycolipids in D. maris.

PMID- 11204772
TI  - Sibling differences in cell death of the fission yeast, Schizosaccharomyces
      pombe, exposed to stress conditions.

PMID- 11204774
TI  - PTK1, a mitogen-activated-protein kinase gene, is required for conidiation,
      appressorium formation, and pathogenicity of Pyrenophora teres on barley.
AB  - Mitogen-activated protein kinases (MAPKs) are a group of protein kinases that
      execute a wide variety of roles in cellular signal transduction pathways such as
      osmoregulation, cell wall biosynthesis, growth, and differentiation. A polymerase
      chain reaction (PCR) with degenerate primers based on conserved regions of known
      MAPKs was used to clone the MAPK gene PTK1 from the leaf pathogen Pyrenophora
      teres (anamorph Drechslera teres), the causal agent of net blotch of barley
      (Hordeum vulgare L.). The predicted amino acid sequence shows high homology with
      MAPKs from other phytopathogenic fungi. The gene is present in the genome as a
      single copy. PTK1 is expressed during in vitro growth on complete medium, under
      conidiation-inducing conditions and during infection of barley leaves, as shown
      by reverse transcription-PCR studies. In order to assess the role of PTK1 in the
      life cycle of P. teres, targeted gene disruption was conducted. Mutants carrying
      an interrupted copy of the gene were deficient in conidiation, did not form
      appressoria on glass surfaces or on barley leaves, lost their ability to infect
      barley leaves, and could not colonize host tissues following artificial wounding.

PMID- 11204773
TI  - Production of antimicrobial defensin in Nicotiana benthamiana with a potato virus
      X vector.
AB  - A recombinant plasmid, pTXS.TH, was constructed to express the gene-encoding
      wasabi (Wasabia japonica) defensin with the potato virus X (PVX) vector. pTXS.TH
      allows the expression of defensin in the host Nicotiana benthamiana, and the
      defensin protein WT1 can be purified from virus-infected leaves by heat treatment
      and affinity chromatography. WT1 exhibits strong antifungal activity toward the
      phytopathogenic fungi Magnaporthe grisea (50% inhibitory concentration [IC50] = 5
      microg/ml) and Botrytis cinerea (IC50 = 20 microg/ml) but is weakly active
      against the phytopathogenic bacterium Pseudomonas cichorii. This virus-mediated
      expression system is a rapid and efficient method to produce and characterize
      antimicrobial proteins in plants. It is particularly useful for the study of
      proteins that are difficult to produce with other expression systems.

PMID- 11204775
TI  - Tobamoviral movement protein transiently expressed in a single epidermal cell
      functions beyond multiple plasmodesmata and spreads multicellularly in an
      infection-coupled manner.
AB  - Cell-to-cell movement of a plant virus requires expression of the movement
      protein (MP). It has not been fully elucidated, however, how the MP functions in
      primary infected cells. With the use of a microprojectile bombardment-mediated
      DNA infection system for Tomato mosaic virus (ToMV), we found that the
      cotransfected ToMV MP gene exerts its effects in the initially infected cells and
      in their surrounding cells to achieve multicellular spread of movement-defective
      ToMV. Five other tobamoviral MPs examined also transcomplemented the movement
      defective phenotype of ToMV, but the Cucumber mosaic virus 3a MP did not.
      Together with the cell-to-cell movement of the mutant virus, a fusion between the
      MP and an enhanced green fluorescent protein variant (EGFP) expressed in trans
      was distributed multicellularly and localized primarily in plasmodesmata between
      infected cells. In contrast, in noninfected sites the MP-EGFP fusion accumulated
      predominantly inside the bombarded cells as irregularly shaped aggregates, and
      only a minute amount of the fusion was found in plasmodesmata. Thus, the behavior
      of ToMV MP is greatly modulated in the presence of a replicating virus and it is
      highly likely that the MP spreads in the infection sites, coordinating with the
      cell-to-cell movement of the viral genome.

PMID- 11204776
TI  - Characterization of small GTPases Cdc42 and Rac and the relationship between
      Cdc42 and actin cytoskeleton in vegetative and ectomycorrhizal hyphae of Suillus
      bovinus.
AB  - This work reports the isolation and molecular characterization of CDC42 and RAC1
      cDNAs from the ectomycorrhiza forming filamentous homobasidiomycete Suillus
      bovinus. Previously, no RAC gene was described from filamentous fungi and no
      CDC42 gene was described from homobasidiomycetes. Southern hybridization with
      SbCDC42 and SbRAC1 cDNAs indicated that the S. bovinus genome contains only one
      CDC42 and one RAC1 gene. The predicted amino acid sequence of SbRaclp is 77%
      identical with the Rac1B protein of chick, whereas SbCdc42p is most identical
      with Schizosaccharomyces pombe Cdc42p, showing 88% identity. In the predicted
      amino acid sequences of SbRaclp and SbCdc42p, the five guanine nucleotide binding
      regions, switch I and II, and the effector domain are highly identical to those
      known in other small GTPases. These domain structures suggest that in S. bovinus,
      SbRac1p and SbCdc42p function as molecular switches regulating the organization
      of actin cytoskeleton, similar to yeasts and mammals. SbRAC1 and SbCDC42 were
      expressed in vegetative and ectomycorrhizal hyphae, and SbCdc42p was detected in
      ectomycorrhiza-forming hyphae if growth and differentiation of the symbiotic
      hyphae took place. Cdc42p and actin were localized at the tips of S. bovinus
      vegetative hyphae. Similar to yeast, in filamentous fungi Cdc42p may be necessary
      to maintain the actin cytoskeleton at hyphal tips, making the polarized growth of
      the hyphae possible. In developing ectomycorrhiza, Cdc42p and actin were
      visualized in association with plasma membrane in swollen cells typical to the
      symbiotic hyphae. The role of Cdc42p and actin in regulation of the growth
      pattern and morphogenesis of ectomycorrhizal hyphae is discussed.

PMID- 11204777
TI  - Functional analysis of the type III effectors AvrRpt2 and AvrRpm1 of Pseudomonas
      syringae with the use of a single-copy genomic integration system.
AB  - Gram-negative phytopathogenic bacteria require a type III secretion apparatus for
      pathogenesis, presumably to deliver Avr effector proteins directly into plant
      cells. To extend previous studies of Avr effectors that employed plasmids
      encoding Avr proteins, we developed a system that permits the integration of any
      gene into the Pseudomonas syringae genome in single copy. With this system, we
      confirmed earlier findings showing that P. syringae pv. maculicola strain
      PsmES4326 expressing the AvrRpt2 effector induces a resistance response in plants
      with the cognate R gene, RPS2. Chromosomally located avrRpt2, however, provoked a
      stronger resistance response than that observed with plasmid-expressed AvrRpt2 in
      RPS2+ plants. Additionally, chromosomal expression of AvrRpt2 conferred a fitness
      advantage on P. syringae grown in rps2- plants, aiding in growth within leaves
      and escape to leaf surfaces that was difficult to detect with plasmid-borne
      avrRpt2. Finally, with the use of the genomic integration system, we found that a
      chimeric protein composed of the N terminus of the heterologous AvrRpml effector
      and the C-terminal effector region of AvrRpt2 was delivered to plant cells.
      Because the C terminus of AvrRpt2 cannot translocate into plant cells on its own,
      this indicates that the N-terminal region can direct secretion and translocation
      during an infection, which supports the view that Avr proteins have a modular
      design. This work establishes a readily manipulatable system to study type III
      effectors in a biologically realistic context.

PMID- 11204778
TI  - Exploring infection of wheat and carbohydrate metabolism in Mycosphaerella
      graminicola transformants with differentially regulated green fluorescent protein
      expression.
AB  - A Mycosphaerella graminicola strain transformed with the green fluorescent
      protein (GFP) downstream of either a carbon source-repressed promoter or a
      constitutive promoter was used to investigate in situ carbohydrate uptake during
      penetration of the fungus in wheat leaves. The promoter region of the acu-3 gene
      from Neurospora crassa encoding isocitrate lyase was used as a carbon source
      repressed promoter. The promoter region of the Aspergillus nidulans gpdA gene
      encoding glyceraldehyde-3-phosphate dehydrogenase was used as a constitutive
      promoter. Fluorometric measurement of GFP gene expression in liquid cultures of
      acu-3-regulated transformants indicated that the N. crassa acu-3 promoter
      functions in M. graminicola as it does in N. crassa, i.e., acetate induced and
      carbon source repressed. Glucose, fructose, and saccharose triggered the
      repression, whereas mannitol, xylose, and cell wall polysaccharides did not.
      Monitoring the GFP level during fungal infection of wheat leaves revealed that
      acu-3 promoter repression occurred after penetration until sporulation, when
      newly differentiated pycnidiospores fluoresced. The use of GFP transformants also
      allowed clear visualization of M. graminicola pathogenesis. No appressoria were
      formed, but penetration at cell junctions was observed. These results give new
      insight into the biotrophic status of M. graminicola.

PMID- 11204779
TI  - Maize ribosome-inactivating protein inhibits normal development of Aspergillus
      nidulans and Aspergillus flavus.
AB  - The abundant maize kernel ribosome-inactivating protein 1 (RIP1) was tested for
      antifungal activity against Aspergillus nidulans and Aspergillus flavus. A
      microculture assay was developed to monitor fungal growth and development after
      treatment of conidia with RIP1 or control proteins. A striking decrease in hyphal
      proliferation was observed when conidia of A. nidulans, a genetically well
      characterized nonpathogenic species, were treated with RIP1 protein. Treatment
      with a RIP1 mutant protein that lacked enzymatic ribosome-inactivating activity
      caused no observable effects. RIP1 treatment of conidia from the maize pathogen
      A. flavus resulted in increased hyphal branching. Examination of the branched
      hyphae after Congo red staining revealed only one growing hyphal tip per
      conidium. These results indicate that both fungi were affected by RIP1 treatment,
      but the lysis seen with treatment of A. nidulans was apparently avoided by A.
      flavus. A developmental time course revealed that both fungal species were
      affected by RIP1 at the postdivisional growth stage. The inhibitory activity of
      RIP1 against normal fungal growth is consistent with a biological function to
      protect the seed from fungal invasion.

PMID- 11204780
TI  - Lotus japonicus forms early senescent root nodules with Rhizobium etli.
AB  - Mesorhizobium loti and Rhizobium etli are microsymbionts of the Lotus and
      Phaseolus spp., respectively, and secrete essentially the same Nod factors. Lotus
      japonicus efficiently formed root nodules with R. etli CE3, irrespective of the
      presence or absence of a flavonoid-independent transcription activator nodD gene.
      On a nitrogen-free medium, however, the host plant inoculated with R. etli showed
      a severe nitrogen deficiency symptom. Initially, the nodules formed with R. etli
      were pale pink and leghemoglobin mRNA was detectable at significant levels.
      Nevertheless, the nodules became greenish with time. Acetylene-reduction activity
      of nodules formed with R. etli was comparable with that formed by M. loti 3 weeks
      postinoculation, but thereafter it decreased rapidly. The nodules formed with R.
      etli contained much more starch granules than those formed with M. loti. R. etli
      developed into bacteroids in the L. japonicus nodules, although the density of
      bacteroids in the infected cells was lower than that in the nodules formed with
      M. loti. The nodules formed with R. etli were of the early senescence type, in
      that membrane structures were drastically disintegrated in the infected cells of
      the greenish nodules. Thus, L. japonicus started and then ceased a symbiotic
      relationship with R. etli at the final stage.

PMID- 11204781
TI  - Mutational analysis of the Arabidopsis RPS2 disease resistance gene and the
      corresponding pseudomonas syringae avrRpt2 avirulence gene.
AB  - Plants have evolved a large number of disease resistance genes that encode
      proteins containing conserved structural motifs that function to recognize
      pathogen signals and to initiate defense responses. The Arabidopsis RPS2 gene
      encodes a protein representative of the nucleotide-binding site-leucine-rich
      repeat (NBS-LRR) class of plant resistance proteins. RPS2 specifically recognizes
      Pseudomonas syringae pv. tomato strains expressing the avrRpt2 gene and initiates
      defense responses to bacteria carrying avrRpt2, including a hypersensitive cell
      death response (HR). We present an in planta mutagenesis experiment that resulted
      in the isolation of a series of rps2 and avrRpt2 alleles that disrupt the RPS2
      avrRpt2 gene-for-gene interaction. Seven novel avrRpt2 alleles incapable of
      eliciting an RPS2-dependent HR all encode proteins with lesions in the C-terminal
      portion of AvrRpt2 previously shown to be sufficient for RPS2 recognition. Ten
      novel rps2 alleles were characterized with mutations in the NBS and the LRR.
      Several of these alleles code for point mutations in motifs that are conserved
      among NBS-LRR resistance genes, including the third LRR, which suggests the
      importance of these motifs for resistance gene function.

PMID- 11204782
TI  - De novo cortical cell division triggered by the phytopathogen Rhodococcus
      fascians in tobacco.
AB  - Plant growth, development, and morphology can be affected by several
      environmental stimuli and by specific interactions with phytopathogens. In many
      cases, plants respond to pathogenic stimuli by adapting their hormone levels.
      Here, the interaction between the phytopathogen Rhodococcus fascians and one of
      its host plants, tobacco, was analyzed phenotypically and molecularly. To
      elucidate the basis of the cell division modulation and shoot primordia
      initiation caused by R. fascians, tobacco plants were infected at leaf axils and
      shoot apices. Adventitious meristems that gave rise to multiple-shoot primordia
      (leafy galls) were formed. The use of a transgenic line carrying the mitotic
      CycB1 promoter fused to the reporter gene coding for beta-glucuronidase from
      Escherichia coli (uidA), revealed that stem cortical cells were stimulated to
      divide in an initial phase of the leafy gall ontogenesis. Local cytokinin and
      auxin levels throughout the infection process as well as modulation of expression
      of the cell cycle regulator gene Nicta;CycD3;2 are discussed.

PMID- 11204783
TI  - Replicase-derived resistance against pea early browning virus in Nicotiana
      benthamiana is an unstable resistance based upon posttranscriptional gene
      silencing.
AB  - Virus resistance in Nicotiana benthamiana plants containing a translatable Pea
      early browning virus (PEBV) 54K sequence from the 201K replicase gene has been
      reported previously. Resistant plants contain multiple transgene copies divided
      between two loci. Analysis of a genetic series containing the two loci in
      separate homozygous or heterozygous condition suggest that only one of the loci
      is necessary to induce the resistance. The resistance observed in R2 and R3
      generations of lines containing both transgene loci in homozygous condition
      became less consistent in R4 and R5 generations. This inversely correlated with
      steady-state transgene transcript levels of the segregating populations. The use
      of recombinant Potato virus X vectors carrying PEBV 54K sequences showed that the
      resistance is based upon posttranscriptional gene silencing, is non-strand
      specific, and recognizes 3' located sequences within the PEBV 54K sequence.

PMID- 11204784
TI  - Isolation of a Xanthomonas oryzae pv. oryzae flagellar operon region and
      molecular characterization of flhF.
AB  - An 8.1-kb DNA fragment from Xanthomonas oryzae pv. oryzae that contains six open
      reading frames (ORF) was cloned. The ORF encodes proteins similar to flagellar
      proteins FlhB, FlhA, FlhF, and FliA, plus two proteins of unknown function,
      ORF234 and ORF319, from Bacillus subtilis and other organisms. These ORF have a
      similar genomic organization to those of their homologs in other bacteria.
      TheflhF gene product, FlhF, has a GTP-binding motif conserved in its homologs.
      Unlike its homologs, however, X. oryzae pv. oryzae FlhF carries two transmembrane
      like domains. Insertional mutations of theflhF gene with the omega cassette or
      the kanamycin resistance gene significantly retard but do not abolish the
      motility of the bacteria. Complementation of the mutants with the wild-type flhF
      gene restored the motility. The X. oryzae pv. oryzae FlhF interacts with itself;
      the disease resistance gene product XA21; and a protein homologous to the Pill
      protein of Pseudomonas aeruginosa, XooPilL, in the yeast two-hybrid system. The
      biological relevance of these interactions remains to be determined.

PMID- 11204785
TI  - The induction of tomato leucine aminopeptidase genes (LapA) after Pseudomonas
      syringae pv. tomato infection is primarily a wound response triggered by
      coronatine.
AB  - Tomato plants constitutively express a neutral leucine aminopeptidase (LAP-N) and
      an acidic LAP (LAP-A) during floral development and in leaves in response to
      insect infestation, wounding, and Pseudomonas syringae pv. tomato infection. To
      assess the physiological roles of LAP-A, a LapA-antisense construct (35S:asLapA1)
      was introduced into tomato. The 35S:asLapA1 plants had greatly reduced or showed
      undetectable levels of LAP-A and LAP-N proteins in healthy and wounded leaves and
      during floral development. Despite the loss of these aminopeptidases, no global
      changes in protein profiles were noted. The 35S:asLapA1 plants also exhibited no
      significant alteration in floral development and did not impact the growth and
      development of Manduca sexta and P. syringae pv. tomato growth rates during
      compatible or incompatible infections. To investigate the mechanism underlying
      the strong induction of LapA upon P. syringae pv. tomato infection, LapA
      expression was monitored after infection with coronatine-producing and -deficient
      P. syringae pv. tomato strains. LapA RNA and activity were detected only with the
      coronatine-producing P. syringae pv. tomato strain. Coronatine treatment of
      excised shoots caused increases in RNAs for jasmonic acid (JA)-regulated wound
      response genes (LapA and pin2) but did not influence expression of a JA-regulated
      pathogenesis-related protein gene (PR-1). These results indicated that coronatine
      mimicked the wound response but was insufficient to activate JA-regulated PR
      genes.

PMID- 11204786
TI  - Catharanthus roseus genes regulated differentially by mollicute infections.
AB  - A differential display of mRNAs was used to isolate periwinkle cDNAs
      differentially expressed following infection with one of three mollicutes:
      Spiroplasma citri, Candidatus Phytoplasma aurantifolia, and stolbur phytoplasma.
      Twenty-four differentially expressed cDNAs were characterized by Northern blots
      and sequence analysis. Eight of them had homologies with genes in databanks
      coding for proteins involved in photosynthesis, sugar transport, response to
      stress, or pathways of phytosterol synthesis. The regulation of these genes in
      periwinkle plants infected by additional phloem-restricted bacteria showed that
      they were not specific to a given mollicute, but correlations with particular
      symptoms could be established. Expression of transketolase was down regulated
      following infection with a pathogenic strain of S. citri. No down regulation was
      observed for the nonphytopathogenic mutant GMT553, which is deficient for
      fructose utilization.

PMID- 11204787
TI  - Immunogold labeling of Hrp pili of Pseudomonas syringae pv. tomato assembled in
      minimal medium and in planta.
AB  - Hypersensitive reaction and pathogenicity (hrp) genes are required for
      Pseudomonas syringae pv. tomato (Pst) DC3000 to cause disease in susceptible
      tomato and Arabidopsis thaliana plants and to elicit the hypersensitive response
      in resistant plants. The hrp genes encode a type III protein secretion system
      known as the Hrp system, which in Pst DC3000 secretes HrpA, HrpZ, HrpW, and
      AvrPto and assembles a surface appendage, named the Hrp pilus, in hrp-gene
      inducing minimal medium. HrpA has been suggested to be the Hrp pilus structural
      protein on the basis of copurification and mutational analyses. In this study, we
      show that an antibody against HrpA efficiently labeled Hrp pili, whereas
      antibodies against HrpW and HrpZ did not. Immunogold labeling of bacteria
      infected Arabidopsis thaliana leaf tissue with an Hrp pilus antibody revealed a
      characteristic lineup of gold particles around bacteria and/or at the bacterium
      plant contact site. These results confirm that HrpA is the major structural
      protein of the Hrp pilus and provide evidence that Hrp pili are assembled in
      vitro and in planta.

PMID- 11204788
TI  - Overcoming host- and pathogen-mediated resistance in tomato and tobacco maps to
      the M RNA of Tomato spotted wilt virus.
AB  - A viral genetic system was used to map the determinants of the ability of Tomato
      spotted wilt virus (TSWV) to overcome the R gene (Sw-5) in tomato and the
      resistance conferred by the nucleocapsid gene of TSWV (N gene) in tobacco. A
      complete set of reassortant genotypes was generated from TSWV isolates A and D.
      TSWV-A was able to overcome the Sw-5 gene in tomato and the TSWV N gene in
      tobacco, whereas TSWV-D was repressed by both forms of resistance. The ability to
      overcome both forms of resistance was associated with the M RNA segment of TSWV-A
      (M(A)). Overcoming the Sw-5 gene was linked solely to the presence of M(A), and
      the ability of M(A) to overcome the TSWV N gene was modified by the L RNA and the
      S RNA of TSWV-A, which is consistent with previous reports that suggest that the
      nucleocapsid gene is not the primary determinant for overcoming the nucleocapsid
      mediated resistance. Sequence analysis of the M RNA segment of TSWV-A, -D, and
      the type isolate BR-01 revealed multiple differences in the coding and noncoding
      regions, which prevented identification of the resistance-breaking nucleotide
      sequences.

PMID- 11204789
TI  - The Rhizobium etli argC gene is essential for Arginine biosynthesis and
      nodulation of Phaseolus vulgaris.
AB  - A Tn5-induced mutant strain (CTNUX5) of Rhizobium etli unable to grow with
      ammonium as the sole nitrogen source was isolated and characterized. Sequence
      analysis showed that Tn5 is inserted into an argC-homologous gene. Unlike its
      wild-type parent (strain CE3), the mutant strain CTNUX5 had an absolute
      dependency on arginine to grow. The argC gene was cloned from the wild-type
      strain CE3, and the resulting plasmid, pAR207, after transformation was shown to
      relieve the arginine auxotrophy of strain CTNUX5. Unlike strain CE3 or CTNUX5
      pAR207, strain CTNUX5 showed undetectable levels of N-acetyl-gamma
      glutamylphosphate reductase activity. Unless arginine was added to the growth
      medium, strain CTNUX5 was unable to produce flavonoid-inducible lipo-chitin
      oligosaccharides (nodulation factors) and to induce nodules or nodulelike
      structures on the roots of Phaseolus vulgaris.

PMID- 11204790
TI  - Mucoid mutants of the biocontrol strain pseudomonas fluorescens CHA0 show
      increased ability in biofilm formation on mycorrhizal and nonmycorrhizal carrot
      roots.
AB  - Extracellular polysaccharides play an important role in the formation of
      bacterial biofilms. We tested the biofilm-forming ability of two mutant strains
      with increased production of acidic extracellular polysaccharides compared with
      the wild-type biocontrol strain Pseudomonas fluorescens CHA0. The anchoring of
      bacteria to axenic nonmycorrhizal and mycorrhizal roots as well as on
      extraradical mycelium of the arbuscular mycorrhizal fungus Glomus intraradices
      was investigated. The nonmucoid wild-type strain P. fluorescens CHA0 adhered very
      little on all surfaces, whereas both mucoid strains formed a dense and patchy
      bacterial layer on the roots and fungal structures. Increased adhesive properties
      of plant-growth-promoting bacteria may lead to more stable interactions in mixed
      inocula and the rhizosphere.

PMID- 11204791
TI  - Transient accumulation of jasmonic acid during the synchronized hypersensitive
      cell death in Tobacco mosaic virus-infected tobacco leaves.
AB  - Jasmonic acid (JA) transiently accumulated during temperature-dependent
      synchronous necrotic lesion formation in Tobacco mosaic virus-infected tobacco
      leaves. The accumulation of JA was preceded by activation of a tobacco mitogen
      activated protein kinase, WIPK, which functions upstream of JA in wound signal
      transduction pathways.

PMID- 11204792
TI  - Biomechanics of elastic resistance in therapeutic exercise programs.

PMID- 11204793
TI  - Electromyographic analysis of quadriceps fatigue after anterior cruciate ligament
      reconstruction.
AB  - STUDY DESIGN: Prospective, observational study. OBJECTIVES: To document changes
      in surface electromyographic activity during sustained maximum quadriceps
      contractions in patients before and 5 weeks after anterior cruciate ligament
      (ACL) reconstruction. BACKGROUND: Quadriceps weakness after injury and
      reconstruction of the ACL is well documented. The effect of weakness on muscle
      fatigue, however, is not well understood. METHODS AND MEASURES: Electromyographic
      signals were recorded from the vastus lateralis, vastus medialis, and rectus
      femoris muscles during 30-second maximum isometric contractions at 30 degrees, in
      42 patients preoperatively and 5 weeks postoperatively. Signal amplitude was
      quantified by integrating the rectified signal (iEMG) for the initial and final 5
      seconds and comparing the involved and uninvolved sides. Median frequency (MF)
      was computed from 4,096 point fast Fourier Transforms performed at the beginning
      and end of the 30-second contractions. RESULTS: Patients had moderate
      preoperative quadriceps weakness (16% deficit) and gross postoperative weakness
      (41% deficit). Weakness was associated with deficits in both MF and iEMG (r =
      0.69-0.67). During the preoperative fatigue test, torque declined similarly on
      the involved and uninvolved sides (significant fatigue effect). During the
      postoperative fatigue tests, however, torque increased on the involved side and
      declined on the uninvolved side (significant side by fatigue interaction). For
      the initial 5 seconds, MF was lower on the involved than the uninvolved side but
      subsequently showed a smaller decline over 30 seconds preoperatively and
      postoperatively (significant side by fatigue interactions). IEMG was lower on the
      involved side preoperatively and postoperatively. During the fatigue tests, iEMG
      increased similarly in the involved and uninvolved sides both preoperatively and
      postoperatively. CONCLUSION: Quadriceps endurance exercises are not indicated
      after ACL reconstruction. Quadriceps weakness after ACL reconstruction was
      associated with fatigue resistance. Lower initial MF and smaller decline in MF
      during sustained contraction is consistent with fast-twitch fiber atrophy and
      explains fatigue resistance.

PMID- 11204794
TI  - Anterior tibial translation during different isokinetic quadriceps torque in
      anterior cruciate ligament deficient and nonimpaired individuals.
AB  - STUDY DESIGN: Factorial quasi-experimental design. OBJECTIVES: To quantify the
      effect of different levels of isokinetic concentric and eccentric knee extensor
      torques on the anterior tibial translation in subjects with anterior cruciate
      ligament (ACL) deficiency. Electromyogram (EMG) activity of 4 leg muscles was
      recorded in order to detect any co-activation of extensors and flexors.
      BACKGROUND: The rehabilitation after an ACL injury is of importance for the
      functional outcome of the patient. In order to construct a rehabilitation program
      after that injury, it is important to understand the in vivo relationships
      between muscle force and tibial translation. METHODS AND MEASURES: Twelve
      patients with unilateral ACL injury and 11 uninjured volunteers performed 36
      repetitions of a quadriceps contraction at different isokinetic concentric and
      eccentric torque levels, on a KinCom machine (60 degrees x s(-1)), with
      simultaneous recordings of tibial translation (CA-4000) and EMG activity from
      quadriceps and hamstrings muscles. Tibial translations and EMG levels were
      normalized to the maximum of each subject. RESULTS: The individual anterior
      tibial translation increased with increased quadriceps torque in a similar manner
      in both quadriceps contraction modes in all legs tested. During concentric mode,
      translation was similar in all groups, but during eccentric mode, the mean
      translation was 38% larger in the ACL injured knees. No quadriceps-hamstrings co
      activation occurred in any test or group. CONCLUSIONS: An ACL deficient knee can
      limit the translation within a normal space during concentric muscle activity but
      not during eccentric activity. That limitation depends on other mechanisms than
      hamstrings co-activation.

PMID- 11204795
TI  - Ultrasound assessment of atherosclerotic vessel wall changes: reproducibility of
      intima-media thickness measurements in carotid and femoral arteries.
AB  - RATIONALE AND OBJECTIVES: Ultrasonography is widely used in cardiovascular
      research to quantify early atherosclerotic vessel wall changes. In this article,
      we examined the short- and long-term reproducibility of this technique in the
      common carotid artery, carotid bifurcation, common femoral artery, and
      superficial femoral artery. Furthermore, we assessed the effect of progressed
      atherosclerosis on reproducibility. METHODS: Repeated ultrasound examinations
      were performed by one observer on 15 healthy individuals and 18 patients
      suffering from coronary heart disease. Intima-media thickness was determined by B
      mode ultrasonography. The examinations were repeated by the same observer after a
      short time interval (short-term) and after a few weeks (long-term) and expressed
      as the mean difference between the measurements and the coefficient of variation
      (CV). RESULTS: The reproducibility of the intima-media thickness determination
      turned out to be best in the common carotid artery and the superficial femoral
      artery when performed in healthy controls (CV 5.6% and 5.5%, respectively).
      Reproducibility was less in patients with clinical atherosclerosis; this
      especially affected the reliability of the superficial femoral artery measurement
      (CV in healthy controls was 5.5%; in coronary heart disease patients, 17.5 %).
      The reliability of the intima-media thickness measurements in the common carotid
      artery (CV in healthy controls was 5.6%; in coronary heart disease patients,
      9.5%) proved to be least affected by progressed atherosclerosis. A longer time
      interval between measurements did not affect the reproducibility of intima-media
      thickness measurements in healthy controls, whereas in the patients it led to
      some decrease of reproducibility and to a major decrease in reproducibility of
      the superficial femoral artery measurements (CV changed from 12.7% to 17.5%).
      CONCLUSIONS: Ultrasonography is a reliable and accurate technique to determine
      intima-media thickness in superficial arteries. In studies in which the intima
      media thickness determination is used as a marker for generalized and coronary
      atherosclerosis, the common carotid artery should always be included, whereas the
      benefit of inclusion of other arteries depends on age and the expected extent of
      atherosclerosis in the individuals studied.

PMID- 11204796
TI  - MR imaging of the small bowel with a true-FISP sequence after enteroclysis with
      water solution.
AB  - RATIONALE AND OBJECTIVES: To evaluate a novel MR enteroclysis technique for small
      bowel imaging. METHODS: Twenty-one patients with suspected small-bowel disease
      underwent both MR and conventional enteroclysis. MR enteroclysis was performed by
      injecting an iso-osmotic water solution through a nasojejunal catheter with a
      flow rate of 80 to 150 mL/min. A maximum of 2 L of water solution was
      administered. A dynamic heavily T2-weighted single-shot turbo spin-echo sequence
      was applied in coronal orientation to monitor the bowel filling and adequate
      distention. Twelve 4-mm-thick slices were acquired by using a true fast imaging
      with steady-state precession (true-FISP) sequence during an 18-second breath-hold
      interval. Small-bowel distention, wall conspicuity, homogeneity of opacification,
      and the presence of artifacts were subjectively evaluated by two reviewers using
      five-point scales. RESULTS: Chemical shift artifacts were low and ghost artifacts
      were absent. Susceptibility artifacts were more prominent in the ileum; motion
      artifacts were low in the jejunum, ileum, and ileocecal area. Homogeneity of
      opacification was very good in the jejunum, good to very good in the ileum, and
      good in the ileocecal area. Distention was very good to excellent in the jejunum
      and ileum and very good in the ileocecal area. Wall conspicuity was very good to
      excellent in the jejunum and ileum. CONCLUSIONS: MR enteroclysis with the true
      FISP sequence produced high-quality images of the small bowel. Further clinical
      studies are required to determine the clinical efficacy of the new technique
      compared with conventional enteroclysis.

PMID- 11204797
TI  - MR imaging of changes of the growth plate after partial physeal removal and fat
      graft interposition in rabbits.
AB  - RATIONALE AND OBJECTIVES: The most important complication of skeletal injuries
      involving the growth plate is growth disturbance. The purpose of this study was
      to evaluate MR features of growth plate modification after fat graft
      interposition in growth plate injury and to correlate these findings with
      pathological findings. METHODS: A growth plate injury model was used in 12
      skeletally immature rabbits. A longitudinal drill hole 5 mm in diameter was
      created in the central part of the growth plate in the distal femur, bilaterally.
      One side was filled with autologous fat, and the contralateral defect was left
      empty as a control. Magnetic resonance imaging was obtained 1, 3, and 6 months
      after surgery, and routine histological study was performed. The authors
      evaluated sequential changes in MR images and the histological basis of MR
      findings. RESULTS: In grafted femur, the signal intensity of the grafted area was
      lower than that of the surrounding bone on T2-weighted images at 1 month. The
      growth plate defect at 3 to 6 months was modified and had a proximally tapering
      appearance. The ratio of the growth plate defect was smaller in the grafted femur
      than in the control femur after surgery. Histologically, the fat-grafted area was
      replaced by fibrous connective tissue. In the control femur, a bony bridge was
      rectangular in the longitudinal direction and showed isosignal intensity with a
      rim of low signal intensity on T1-weighted imaging. Histologically, the defect
      was filled with mature fatty marrow with new bone formation in the control femur.
      CONCLUSIONS: The proximally pointing appearance and the low signal intensity of
      the grafted area on MR suggested fibrous degeneration of grafted fat that
      prevented solid bony bridge formation in experimentally induced growth plate
      injury.

PMID- 11204798
TI  - Direct measurement of sound velocity in various specimens of breast tissue.
AB  - RATIONALE AND OBJECTIVES: Previous studies using ultrasound CT or clinical
      amplitude/velocity reconstruction imaging ultrasound may indicate that cancers
      differ from normal breast tissue by increased sound velocity. However, only
      limited experience with direct measurements of sound velocity exists. This study
      aimed to investigate sound velocity measured directly in a variety of breast
      specimens. METHODS: Sound velocity was measured directly by forceps in fresh
      breast specimens chosen to contain one type of tissue only. Eighty specimens (31
      cancers, 18 benign changes of glandular/fibrous tissue, 22 fatty tissues, 5
      fibroadenomas, 2 compound tissues, 1 phylloides tumor, and 1 inflammation) were
      analyzed. RESULTS: Ultrasound velocities in carcinoma, benign changes,
      fibroadenoma, inflammation, and the phylloides tumor were very similar, with
      almost complete overlap. In contrary, the ultrasound velocity of fatty tissue was
      significantly lower. Compound tissues containing fat had an intermediate sound
      velocity. CONCLUSIONS: Sound velocity may add complementary information to
      echogenicity (B-scan). Because fat lobules exhibit low ultrasound velocity and
      carcinomas do not, a locally exact combination of ultrasound velocity information
      and reflexivity information should allow improved breast cancer detection by
      ultrasound.

PMID- 11204799
TI  - Noninvasive measurement of pulmonary vascular resistances by assessment of
      cardiac output and pulmonary transit time.
AB  - RATIONALE AND OBJECTIVES: Pulmonary vascular resistance is of special interest in
      many diseases. Usually it is determined invasively by catheterization, but
      cardiac output and pulmonary transit time can be ascertained by several
      noninvasive methods. METHODS: Fourteen heart recipients (age 34-71 years) were
      examined by electron-beam CT of the heart. Cine and flow studies were performed
      using a total of 60 mL of contrast and a breath-hold of 20 seconds. RESULTS: A
      mathematical model for calculating pulmonary vascular resistances from
      noninvasively measured cardiac outputs and pulmonary transit times was developed.
      Right-sided heart catheterization served as the reference method. CONCLUSIONS:
      The formula created seems to allow a clinically valid estimate of pulmonary
      vascular resistance from noninvasively acquired data.

PMID- 11204800
TI  - Development of echogenic, plasmid-incorporated, tissue-targeted cationic
      liposomes that can be used for directed gene delivery.
AB  - RATIONALE AND OBJECTIVES: Echogenic antibody-conjugated anionic liposomes have
      been developed that allow directed tissue targeting and acoustic enhancement.
      These are not efficient for gene delivery. A cationic formulation that allows
      directed gene delivery while retaining acoustic properties may provide more
      efficient transfection. METHODS: Cationic liposomes were prepared and acoustic
      reflectivity was determined. Anti-fibrinogen-conjugated liposomes were laid on
      fibrin-coated slides and adherence was quantified using fluorescence techniques.
      Liposomes were combined with a reporter gene and plated on cell cultures. Human
      umbilical vein endothelial cells were stimulated to upregulate intercellular
      adhesion molecule-1 (ICAM-1) and were treated with anti-ICAM-1-conjugated
      liposomes, and gene expression was quantified. RESULTS: Cationic liposomes
      retained their acoustic reflectivity and demonstrated specific adherence to
      fibrin under flow conditions. Significant transfection of human umbilical vein
      endothelial cells was demonstrated, with higher gene expression seen with
      specific antibody-conjugated liposomes. CONCLUSIONS: Novel acoustic cationic
      liposomes have been developed that can be antibody conjugated for site-specific
      adherence and directed cell modification. This presents exciting potential for a
      vector that allows tissue enhancement and targeted gene delivery.

PMID- 11204801
TI  - MR evaluation of stent patency: in vitro test of 22 metallic stents and the
      possibility of determining their patency by MR angiography.
AB  - RATIONALE AND OBJECTIVES: To determine the extent to which visualization of
      intrastent anatomy in stents of different composition and design is possible by
      using contrast-enhanced MR angiography. METHODS: Twenty-two MR-compatible stents,
      most of which had a diameter of 8 mm, were positioned in a phantom filled with
      aqueous gadolinium solution. Coronal and axial spoiled three-dimensional gradient
      echo sequences were performed. Images were acquired with stents positioned at
      varying angulations to the main magnetic field B0. Profiles orthogonal to the
      stent axis allowed measurement of artifact sizes independent of window width and
      center. RESULTS: Oriented along B0, the Cragg, Corvita, Passager, Wallstent,
      Strecker, Impag, Perflex, and ZA stents allowed visualization of more than 48% of
      the lumen. The Memotherm, Smart, and Jostent SelfX stents showed a prominent
      reduction of the inner lumen to below 41%. The lumina of the covered Jostent,
      Palmaz, Sinus, and Symphony stents were completely obscured. The Impag, Perflex,
      and Strecker tantalum stents showed growing artifact sizes and a lumen reduction
      of at least 40% with increasing angulation to B0. CONCLUSIONS. Evaluation of the
      inner stent lumen by applying contrast-enhanced, three-dimensional gradient-echo
      sequences is not possible for the majority of stents because of their large
      artifacts. These depend on the stent type and orientation to B0. Even stents made
      of nitinol and cobalt alloys only allow qualitative patency assessment but no
      quantification of stenosis.

PMID- 11204802
TI  - Bile reflux and oesophagitis.
AB  - Duodenal contents, and especially bile acids and trypsin, are noxious to the
      oesophageal mucosa, their damaging potential depending on pH. Various
      methodologies have been used to measure duodenogastric or duodenogastro
      oesophageal reflux, all of them having technical limitations. Controversy exists
      as to the extent of duodenogastric reflux in GORD. Reflux of both acid and
      duodenal contents into the oesophagus increases with worsening of oesophagitis.
      Experimental data suggest that bile acids and trypsin are noxious to the
      oesophageal mucosa and that their damaging potential depends on pH. The injurious
      concentrations are, however, higher than those usually observed in the human
      oesophagus. Direct measurement of bile acids and trypsin is difficult and various
      methodologies have been used to measure duodenogastric or duodenogastro
      oesophageal reflux, all of them having technical limitations. Whereas available
      data as to the extent of duodenogastric reflux in gastro-oesophageal reflux
      disease (GORD) are controversial, most observations show that reflux of both acid
      and duodenal contents into the oesophagus increases with worsening of
      oesophagitis. Furthermore, acid and duodenal contents occur simultaneously in
      most reflux episodes. In this issue of the journal, Marshall et al. report that
      exposure of the gastric fundus to duodenal contents as assessed by bilirubin
      monitoring is similar in GORD patients with varying degrees of oesophageal
      mucosal injury and in healthy controls.

PMID- 11204803
TI  - Overexpression of co-stimulatory molecules in peripheral mononuclear cells of
      Helicobacter pylori-positive peptic ulcer patients: possible difference in host
      responsiveness compared with non-ulcer patients.
AB  - BACKGROUND/AIM: Helicobacter pylori is the principal cause of gastritis and
      peptic ulcer disease. However, H. pylori-positive patients do not always have
      peptic ulcer. This study was carried out in order to determine the difference in
      host immune reaction to H. pylori between patients with peptic ulcer and those
      without. METHODS: Ten H. pylori-positive patients with peptic ulcer, 10 H. pylori
      positive non-ulcer patients, and 10 healthy volunteers were examined for
      expression of surface molecules in peripheral blood mononuclear cells. The
      surface molecules were stained with immunofluorescence-labelled specific
      antibodies and analysed by flow cytometry. RESULTS: More mononuclear cells
      expressed molecules ICAM-1, VLA-4, Leu-M3 in H. pylori-positive ulcer patients
      than in non-ulcer patients and healthy volunteers. There were also more cells
      expressing CD28, SLe(x), CD4, HLA-DR, and NU-B2 in H. pylori-positive ulcer
      patients than in non-ulcer patients and healthy volunteers. There were fewer
      cells expressing CD8 in H. pylori-positive ulcer patients than in non-ulcer
      patients and healthy volunteers. CONCLUSION: H. pylori infection may cause
      immunological reactions which are reflected in peripheral mononuclear cells.
      However, the activity and characteristics of peripheral mononuclear cells, in
      terms of expression of adhesion molecules, may differ between ulcer and non-ulcer
      patients who are infected with H. pylori.

PMID- 11204804
TI  - Does Helicobacter pylori affect gastric mucin expression? Relationship between
      gastric antral mucin expression and H. pylori colonization.
AB  - BACKGROUND/OBJECTIVE: Helicobacter pylori colonizes the gastric mucous gel layer,
      the surface epithelium and glands. It has been shown that H. pylori infection
      causes aberrant expression of gastric mucins MUC 5 and MUC 6. This study aimed to
      determine the distribution of MUC 5 and MUC 6 in the gastric antrum of dyspeptic
      patients, and to investigate changes in this pattern in the presence of H. pylori
      and after successful eradication. MATERIALS AND METHODS: Gastric antrum biopsy
      specimens were examined by immunohistochemistry for mucin gene (MUC 5 and MUC 6)
      expression. Polyclonal antibodies were used to detect amino acid tandem repeats
      of each protein. A scoring system (0-3) was used to assess staining intensity at
      three sites: foveola, mucous neck cells and glands. H. pylori status was
      determined by histology and rapid urease test, and considered positive or
      negative when both tests were positive or negative, respectively. The study
      included 49 patients positive for H. pylori, in 36 of whom successful eradication
      was performed, and 11 H. pylori-negative patients. RESULTS: There was a gradient
      of MUC 5 expression, higher to lower, from the surface to the glands, which was
      more pronounced before eradication. Increased MUC 5 synthesis in the mucous neck
      cells and in the glands was found after H. pylori eradication (P = 0.016). MUC 6
      was synthesized in the glands more than in the mucous neck cells or foveola. MUC
      6 was also secreted into the lumen and probably comprised the superficial part of
      the unstirred mucous layer. CONCLUSION: The change in MUC 5 synthesis may reflect
      H. pylori colonization.

PMID- 11204805
TI  - Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in
      man.
AB  - OBJECTIVE: The supernatant of Lactobacillus johnsonii La1 culture was shown to be
      bactericidal and to have a partial, acid-independent suppressive effect on
      Helicobacter pylori in humans. The aim of the present study was to investigate
      the effect of L. johnsonii La1-acidified milk (LC-1) on H. pylori infection.
      DESIGN AND METHODS: Fifty-three volunteers infected with H. pylori as determined
      by positive 13C-urea breath test and positive serology were randomized to receive
      either LC-1 or a placebo 180 ml twice a day for 3 weeks. All subjects also
      received clarithromycin 500 mg bid during the last two weeks of acidified milk
      therapy. Oesophagogastroduodenoscopy and biopsies were performed at inclusion and
      repeated 4-8 weeks after the end of the treatment. H. pylori infection was
      confirmed by urease test and histology. H. pylori density and inflammation were
      scored using a modified Sydney classification. RESULTS: LC-1 ingestion induced a
      decrease in H. pylori density in the antrum (P= 0.02) and the corpus (P= 0.04).
      LC-1 also reduced inflammation and gastritis activity in the antrum (P= 0.02 and
      P= 0.01, respectively) and of activity in the corpus (P= 0.02). Clarithromycin
      eradicated H. pylori in 26% of the subjects; LC-1 did not improve the antibiotic
      effect. CONCLUSION: These results suggest that H. pylori infection and gastritis
      can be down-regulated by LC-1.

PMID- 11204807
TI  - Chronic idiopathic constipation: a psychological enquiry.
AB  - BACKGROUND: Intractable idiopathic constipation in women is often associated with
      psychosocial problems. AIMS: To determine the past and current psychological
      factors associated with slow and normal transit constipation. PATIENTS: Twenty
      eight consecutive patients referred for biofeedback treatment were interviewed
      before the procedure. All were women. Transit studies revealed that 12 had slow
      transit constipation (STC) and 16 had normal transit constipation (NTC). METHODS:
      Patients were assessed for evidence of previous and current psychiatric diagnoses
      using a standardized diagnostic interview schedule. A full family and social
      history was noted. Self-rating scales were used to measure psychological
      distress, abnormal attitudes to eating and current psychosocial functioning.
      RESULTS: The mean age of the 28 patients was 38.2 years (SD = 10.8) with a mean
      duration of symptoms of 17.5 years (SD = 16.9). Seventeen (61%) had a current
      psychiatric disorder and 18 (64%) a previous episode of psychiatric illness. The
      mean age of the 16 NTC patients was 38.4 years (SD = 10.1) with a mean duration
      of symptoms of 12.4 years (SD = 15.9). By contrast, the 12 STC patients had a
      much longer mean duration of constipation (24.3 years; SD = 16.4), a mean age of
      37.9 years (SD = 12.1), with half having an onset in childhood. The STC patients
      reported more psychosocial distress on the rating scales than those with NTC, and
      only one did not experience some form of adverse life event or gynaecological
      procedure in the 6 months before the onset of constipation. Eleven (39%) of the
      28 women had had a hysterectomy at a mean age of 36 years, but only four (14%)
      reported a history of sexual abuse. Of the nine (32%) patients who reported
      markedly distorted attitudes to food, six had NTC and three had STC. CONCLUSIONS:
      Of consecutive patients undergoing psychological assessment for intractable
      constipation, three fifths had evidence of current, and two thirds a previous,
      affective disorder. One third reported distorted attitudes to food. Although STC
      is a chronic disorder accompanied by high rates of psychological distress, it
      does not appear to be associated with gross functional impairment. We suggest
      that patients who present to surgical departments with chronic intractable
      constipation should routinely have a psychological assessment.

PMID- 11204806
TI  - 123Iodine-labelled anti-VCAM-1 antibody scintigraphy in the assessment of
      experimental colitis.
AB  - OBJECTIVES: To evaluate the usefulness of 123I-labelled anti-vascular cell
      adhesion molecule-1 (VCAM-1) monoclonal antibody (MAb) scintigraphy in the
      assessment of colonic inflammatory damage. DESIGN: Colitis was induced by
      intracolonic administration of 30 mg trinitrobenzenesulphonic acid in 0.5 ml of
      50% (v/v) ethanol. Rats injected with vehicle served as controls. Animals were
      studied at day 7 after induction of colitis. METHODS: Scintigraphy was performed
      in control and trinitrobenzenesulphonic acid-induced colitic rats 2, 4 and 24 h
      after intravenous administration of 123I-anti-VCAM-1 MAb. Scintigraphic uptake
      was quantified in selected areas on scintigraphs. Animals were killed, tissue
      123I radioactivity accumulation was measured, and accumulation of anti-VCAM-1 MAb
      in each organ was calculated. 99mTc-hexamethyl propylene amine oxime-labelled
      leucocyte scintigraphy was performed in additional groups of animals for
      comparison. RESULTS: Colonic tracer uptake was visible in scans of colitic, but
      not control animals. Quantification of scintigraphic uptake in the colon was
      significantly higher in colitic rats than in control animals (P< 0.0001). The
      specificity of the increase was demonstrated by lack of 123I-labelled non-binding
      MAb uptake in the colon, and by displacement of 123I-anti-VCAM-1 MAb colonic
      uptake by pre-treatment with unlabelled MAb. Accumulation of anti-VCAM-1 MAb in
      the colon of colitic rats was eightfold higher than in control animals. Strong
      correlations were found between quantification of scintigraphic uptake, anti-VCAM
      1 MAb accumulation, histological damage and myeloperoxidase activity in the
      colon. CONCLUSION: 123I-labelled anti-VCAM-1 MAb scintigraphy allows an accurate
      evaluation of colonic inflammatory damage in trinitrobenzenesulphonic acid
      induced colitis, suggesting a potential role for this imaging technique in the
      assessment of human IBD.

PMID- 11204808
TI  - The polymorphism at position  -174 of the IL-6 gene is not associated with
      inflammatory bowel disease.
AB  - OBJECTIVE: Inflammatory bowel diseases (IBD) are multifactorial disorders,
      characterized by failure to limit the inflammatory response to luminal antigens.
      Genetic factors play an important role in the pathogenesis, but little is known
      about the accountable genes. Increased secretion of pro-inflammatory cytokines
      appears crucial in the initiation of the inflammatory response. METHODS: To
      evaluate the role of the IL-6 gene in IBD, a functionally relevant polymorphism
      in the promoter region (G/C at position -174) has been genotyped in 169 patients
      with Crohn's disease (CD), 133 patients with ulcerative colitis (UC) and 440
      healthy controls by using restriction fragment length polymorphism (RFLP)
      analysis. RESULTS: No significant differences were apparent in the allele,
      genotype and carrier frequencies between patients and controls. CONCLUSION: High
      secretion of IL-6 does not seem to play a major role in the genetic
      predisposition to IBD.

PMID- 11204809
TI  - Oxidative damage in alcoholic liver disease.
AB  - OBJECTIVE: The metabolic effects of alcohol are due both to its direct action and
      to that of its first metabolite, and can also be connected with the changes in
      redox state. Differences in ethanol distribution, bioavailability and hepatic
      metabolism can provide insight into the protective and predisposing factors in
      alcoholism, as well as gender differences of alcohol toxicity. Oxidative stress
      occurs following various conditions of ethanol consumption. DESIGN: Twenty-six
      Caucasian patients with alcoholism and 32 healthy, abstinent controls of both
      sexes were investigated with special regard to reduction-oxidation status and ad
      hoc free-radical-antioxidant balance. METHOD: Plasma free SH-group concentration,
      H-donating ability, and reducing power property were measured by simple
      spectrophotometric methods. Total scavenger capacity was determined by a newly
      developed chemiluminometric method in plasma and erythrocytes. RESULTS:
      Alcoholics showed a decrease of free SH-group concentration, hydrogen-donating
      ability and an increase of reducing power property in plasma. A decreased total
      scavenger capacity of erythrocytes and plasma of alcoholic patients, combined
      with gender differences, could be detected. CONCLUSIONS: Alcoholic dependence
      causes gradual exhaustion of the antioxidant capacity of erythrocytes, therefore
      this non-invasive measurement may be useful as a follow-up of the evolution of
      alcoholic liver disease. The results also suggest a gender susceptibility of
      alcohol toxicity.

PMID- 11204811
TI  - Diagnostic value of plasma chromogranin A in neuroendocrine tumours.
AB  - AIM: The aim of this study was to assess the value of plasma chromogranin A
      (CgA), a protein produced by neuroendocrine cells, in the diagnosis of
      neuroendocrine tumours. METHODS: Eighty subjects with neuroendocrine tumours were
      studied. Thirty-four had carcinoids, 21 nonfunctioning endocrine pancreatic
      tumours, 17 multiple endocrine neoplasia type 1 (MEN 1) (six of these also had
      gastrinomas), and eight had functioning pancreatic tumours (four gastrinomas, two
      glucagonomas, two somatostatinomas). Twenty-eight healthy subjects were studied
      as controls. A fasting plasma sample was obtained from each subject, and CgA
      plasma levels were measured by the ELISA method using a kit (Dako A/S, Denmark).
      RESULTS: In control subjects, plasma CgA values were below 5 U/l. Among the
      patients, 20 of the 34 with carcinoid tumours, 12 of the 21 with nonfunctioning
      pancreatic tumours, nine of the 17 with MEN 1 (including the six with
      gastrinomas), and the four gastrinomas of the eight functioning pancreatic
      tumours, i.e. overall, 45 of the 80 patients (56.3%) had abnormally high CgA
      values (22-961 U/l). Most of the patients with elevated CgA values, except nine
      of the 10 with gastrinomas, had multiple liver metastasis. CONCLUSIONS: The
      results show that the diagnostic value of plasma CgA in neuroendocrine tumours is
      relatively low; it may be of some interest only in patients with advanced disease
      and liver metastasis. Gastrinoma seems to be an exception, because in this tumour
      high CgA values are generally found even in the absence of liver metastasis.

PMID- 11204810
TI  - The extent of duodenogastric reflux in gastro-oesophageal reflux disease.
AB  - BACKGROUND: It is known that duodenogastro-oesophageal reflux (DGOR) increases
      with worsening gastro-oesophageal reflux disease (GORD). It is unclear whether
      this is accompanied by increasing duodenogastric reflux (DGR). OBJECTIVE: To
      investigate the extent of DGR in a control group and 66 patients with GORD, using
      the technique of ambulatory gastric bilirubin monitoring. METHODS: Sixty-six
      patients with reflux symptoms (30 grade 0 or 1 oesophagitis (group 1), 16 grade 2
      or 3 oesophagitis (group 2), 20 Barrett's oesophagus (group 3)) and 17 healthy
      controls were studied. All underwent oesophageal manometry followed by 24-h
      ambulatory oesophageal and gastric pH monitoring and gastric bilirubin
      monitoring. RESULTS: Median per cent total oesophageal acid exposure (pH < 4) was
      significantly less in the control group (0.6%) than in group 1 (2.8%, P< 0.05)
      and groups 2 and 3 (7.5% and 7.8% respectively, P< 0.001). There was no
      significant difference between any group in median per cent total time gastric pH
      was greater than 4. There was no significant difference in median per cent total
      gastric bilirubin exposure (absorbance > 0.14) between any group. However, in
      each group gastric bilirubin exposure was greater in the supine position than the
      upright position, being significantly greater in the control group (P< 0.05) and
      group 1 (P < 0.001). CONCLUSIONS: Gastric bilirubin exposure is similar across
      the spectrum of GORD severity. It is greater in the supine than in the upright
      position.

PMID- 11204812
TI  - Gastric outlet obstruction caused by a giant gastroduodenal artery aneurysm: a
      case report.
AB  - Gastric outlet (GO) obstruction in an adult is usually caused by intrinsic
      gastric or duodenal lesions or pancreatic tumours. This study describes a case of
      a 77-year-old man who developed GO obstruction due to extrinsic compression from
      a large gastroduodenal artery aneurysm under rupture. This cause of GO
      obstruction has never previously been reported in the literature.

PMID- 11204813
TI  - Successful treatment of bleeding due to ileal varices in a patient with
      hepatocellular carcinoma.
AB  - This case report concerns a 62-year-old female who was known to have cirrhosis.
      An endoscopic examination showed no evidence of haemorrhaging due to either
      oesophageal or gastric varices. Angiographic studies demonstrated extravasation
      from the ileal varices. There was a prominent arterio-portal shunt in the liver,
      and the shunt was considered to be a contributing factor to induce portal
      hypertension and variceal bleeding in the ileum. Therefore, transcatheter
      arterial embolization was performed, but was unsuccessful. As a result, the
      patient underwent a laparotomy, and a dilatating ileocaecal vein and a
      communicating ovarian vein were selectively ligated. Following the procedure, the
      haemorrhaging stopped and she then recovered. The patient is doing well 21 months
      after surgery at the time of writing.

PMID- 11204814
TI  - Risperidone-induced cholestatic hepatitis.
AB  - Risperidone, a widely used atypical and potent neuroleptic drug, is assumed to
      induce fewer hepatic side-effects than phenothiazine anti-psychotics. Recently,
      we observed a case of risperidone-induced cholestatic hepatotoxicity. A 37-year
      old male developed a rapid increase in liver enzymes and cholestatic parameters
      after starting treatment with risperidone for paranoid psychosis. Work-up for
      other potential aetiologies was negative. The results of a percutaneous liver
      biopsy were consistent with drug-induced liver injury and cholestasis. Over the
      course of one month after the discontinuance of all anti-psychotic agents, the
      liver function test results returned to near-normal values. This observation
      supports the need to monitor cholestatic parameters in addition to liver function
      enzymes during initiation and the first weeks of risperidone intake.

PMID- 11204815
TI  - Inadvertent diclofenac rechallenge from generic and non-generic prescribing,
      leading to liver transplantation for fulminant liver failure.
AB  - This case report describes fulminant hepatic failure in a 53-year-old female
      caused by inadvertent rechallenging with diclofenac, treated by orthotopic liver
      transplantation. The case also illustrates the hazards of using both generic and
      non-generic drug prescribing, with drugs that are known to be toxic. The
      literature on non-steroidal anti-inflammatory drugs and hepatoxicity is reviewed.

PMID- 11204816
TI  - A case of successful management of portosystemic shunt with autosomal dominant
      polycystic kidney disease by balloon-occluded retrograde transvenous obliteration
      and partial splenic embolization.
AB  - We describe a patient with autosomal dominant polycystic kidney disease who was
      successfully managed for severe abdominal distension, impaired liver function and
      a portosystemic shunt by interventional therapies. The patient's intra-hepatic
      portal vein was compressed and narrowed by multiple liver cysts, which resulted
      in a decrease of the portal blood flow and portal hypertension due to a huge
      gastro-renal shunt These haemodynamic changes were assumed to contribute to
      insufficient protein synthesis in the liver. Therefore, we first repeatedly
      performed minocycline hydrochloride instillations to treat the multiple liver
      cysts. Then, we conducted a partial splenic embolization to prevent elevation of
      the portal vein pressure prior to balloon-occluded retrograde transvenous
      obliteration which was performed to increase the portal blood flow. The portal
      blood flow markedly increased, and protein synthesis in the liver also recovered
      and the clinical symptoms improved. The patient has been monitored for more than
      two years up to the present and her liver function parameters have remained
      within the normal range. Renal insufficiency is known to be a major prognostic
      factor in autosomal dominant polycystic kidney disease. In some cases, however,
      liver involvement with multiple cysts may result in a fatal outcome. In such
      cases, interventional therapies, as provided to this patient, should be
      considered.

PMID- 11204817
TI  - Elemental diet in the treatment of refractory coeliac disease.
AB  - A minority of patients with coeliac disease do not improve in spite of strictly
      adhering to gluten-free diet and are considered to have developed refractory
      disease. Such patients are usually treated with steroid and/or immunosuppressive
      agents but these are not without serious side effects. Herein, we present a
      patient with refractory coeliac disease in whom remarkable clinical and
      histological improvement was achieved on elemental diet. Elemental diet should be
      considered as a treatment option in such patients.

PMID- 11204818
TI  - Variceal bleeding and portal hypertensive gastropathy.
AB  - Cirrhosis can be the end stage of any chronic liver disease. At the time of
      diagnosis of cirrhosis varices are present in about 60% of decompensated and 30%
      of compensated patients. The risk factors for the first episode of variceal
      bleeding in cirrhotic patients are the severity of liver dysfunction, large size
      of varices and the presence of endoscopic red colour signs but only one-third of
      patients who have variceal haemorrhage have the above risk factors. Recent
      interest has been directed at identifying haemodynamic factors that may reflect
      the pathophysiological changes which lead to variceal bleeding, e.g. it has been
      confirmed that no bleeding occurs if HVPG falls below 12 mmHg and also a
      hypothesis has been put forward in which bacterial infection is considered a
      trigger for bleeding. Pharmacological treatment with beta-blockers is safe,
      effective and is the standard long-term treatment for the prevention of
      recurrence of variceal bleeding. Combination of beta-blockers with isosorbide-5
      mononitrate needs further testing in randomized controlled trials. The use of
      haemodynamic targets for reduction in HVPG response needs further study, and
      surrogate markers of pressure response need evaluation. If endoscopic treatment
      is chosen, variceal ligation is the modality of choice. The combination of
      simultaneous variceal ligation and sclerotherapy does not offer any benefit.
      However, the use of additional sclerotherapy for the complete eradication of
      small varices after variceal ligation needs to be evaluated. The results of
      current prospective randomized controlled trials comparing variceal ligation with
      pharmacological treatment are awaited with great interest. Finally, the use of
      transjugular intrahepatic portosystemic shunt (TIPS) for the secondary prevention
      of variceal bleeding is not substantiated by current data, as survival is not
      improved and because of its worse cost-benefit profile compared to other
      treatments. In contrast, there still is a role for the selective surgical shunts
      in the modern management of portal hypertension. The ideal patients should be
      well compensated cirrhotics, who have had troublesome bleeding - either who have
      failed at least one other modality of therapy (drugs or ligation), have bled from
      gastric varices despite medical or endoscopic therapy, or live far from suitable
      medical services. Recently, ligation has been compared to beta-blockers for
      primary prophylaxis but so far there is no good evidence to recommend banding for
      primary prophylaxis, if beta-blockers can be given.

PMID- 11204819
TI  - Tissue restoration, tissue engineering and regenerative medicine.
AB  - Recently, thanks to the rapid progress of new technologies in cell modulation,
      extracellular matrix fabrication and synthetic polymers mimicking bodily
      structures, the self-regeneration of bodily defects by host tissue has been
      considered by many researchers. The conventional science of art in biomaterials
      has been concerned with restoring damaged tissue using non-biological materials
      such as metals, ceramics and synthetic polymers. To overcome the limitations of
      using such non-viable materials, several attempts to construct artificial organs
      mimicking natural tissue by combining modulated cells with extracellular matrix
      hybridized synthetic polymers have produced many worthy results with biologically
      functioning artificial tissues. The process involved in manufacturing
      biomaterials mimicking living tissue is generally called tissue engineering.
      However recently, the extension of knowledge about cell biology and embryology
      has naturally moved the focus from tissue restoration to tissue regeneration.
      Especially, embryonic and mesenchymal stem cells are attractive resources due to
      their potential for the differentiation of various tissue cells in response to
      signal transduction mediated by cytokines. Although no one knows yet what is the
      exact factor responsible for a stem cell's ability to differentiate between
      specific cells to generate specific tissue, what has been agreed is that
      delivering stem cells into the body provides a strong potential for the
      regeneration of tissue. In this review, the historical issues and future
      possibilities involved in medical tissue restoration and tissue regeneration are
      discussed.

PMID- 11204820
TI  - Tissue engineering in the twenty-first century.
AB  - In the 20th century, free tissue transfers have been successfully introduced
      using microvascular anastomosis techniques. Transplants not only include whole
      organs such as the kidney, liver and lung, but also bone, muscle and skin.
      However, there are a limited number of organs available for transplantation. This
      leads to the patient not only suffering from the malfunctioning tissue or organ,
      but also from the psychological trauma of an indefinite waiting period. The
      rapidly evolving field of tissue engineering is beginning to have an impact on
      free tissue transfers including organ. Small biopsy specimens can be grown into a
      large number of cells. These cultured cells can then be seeded onto biodegradable
      polymers, which serve several purposes. Firstly, the polymers function as a cell
      delivery system that enables the transplantation of a large numbers of cells into
      an organism. Secondly, they create a three-dimensional space for cell growth and
      serve as a template, thereby providing a structure for the extracellular matrix.
      These approaches have been demonstrated as practical strategies for the
      reconstruction of many tissues such as the liver, intestines, heart valve
      leaflets, bone and cartilage.

PMID- 11204821
TI  - Cellular signaling in tissue regeneration.
AB  - With recent progress in stem cell-based research, there has been tremendous
      interest in stem cell-based tissue regeneration. Stem cells can be differentiated
      into specialized cells/tissues by growth factors and cytokines. These small
      molecules are thought to play an important role in both wound healing and tissue
      regeneration. However, their biological activity and signal transduction during
      tissue regeneration are poorly understood. With recent advances in signal
      transduction by growth factors, the receptor kinases and G protein-coupled
      receptors, an understanding in the underlying mechanism of how these factors
      regulate tissue regeneration beginning to take place. In this review, the
      potential underlying mechanisms of growth factor signaling in normal tissue
      regeneration and chronic wound healing is discussed. Thus, it is an aim to
      provide a basis for designing more specific therapies for tissue regeneration in
      the near future.

PMID- 11204822
TI  - Cytokine delivery and tissue engineering.
AB  - Tissue engineering has been applied to various tissues, and particularly
      significant progress has been made in the areas of skin, cartilage, and bone
      regeneration. Inclusion of bioactive factors into the synthetic scaffolds has
      been suggested as one of the possible tissue engineering strategies. The growth
      factors are polypeptides that transmit signals to modulate cellular activities.
      They have short half-lives, for example, platelet-derived growth factor (PDGF),
      isolated from platelets, has a half life of less than 2 minutes when injected
      intravenously. Extended biological activity and the controlled release of growth
      factor are achieved by incorporating growth factor into the polymeric device.
      This review will focus on growth factor delivery for tissue engineering.
      Particular examples will be given whereby growth factors are delivered from a
      tissue-engineered device to facilitate wound healing and tissue repair.

PMID- 11204823
TI  - Biodegradable poly (lactic acid) microspheres for drug delivery systems.
AB  - In connection with aim of maximizing the bio-availability of conventional drugs
      with minimum side-effects, new drug delivery systems (DDS) continue to attracted
      much attention. The controlled or sustained release of drugs represents one such
      approach, and in this regard report upon a study of DDS using biodegradable
      polymers which include poly (lactic acid) (PLA), poly (glycolic acid), and their
      copolymers (PLGA). Much attention is being paid to the controlled release of bio
      active agents from microcapsules and microspheres made of biodegradable polymers,
      such as lactic acid homopolymers, as well as copolymers of glycolic acid. (11-21)
      Microcapsules or microspheres are injectable and able to provide pre-programmed
      durations of action, offering several advantages over the conventional dosage
      forms. This article reviews the results of a work program conducted in
      collaboration with a medical doctor upon DDS using biodegradable microspheres,
      such as PLA and PLGA.

PMID- 11204824
TI  - Tissue engineering a blood vessel substitute: the role of biomechanics.
AB  - The engineering of a functional blood vessel substitute has for a quarter of a
      century been a "holy grail" within the cardiovascular research community. Such a
      substitute must exhibit long term patency, and the critical issues in this area
      in many ways are influenced by biomechanics. One of the requirements is that it
      must be non-thrombogenic, which requires an "endothelial-like" inner lining. It
      also must have mechanical strength, i.e. a burst pressure, sufficient to operate
      at arterial pressures. Ideally, however, it must be more than this. It also must
      have viscoelastic properties that match those of the native vessel being
      replaced. Finally, if it is to be able to adapt to changing blood flow
      conditions, it must exhibit vasoactivity, a function which in and of itself can
      be viewed as biomechanical in nature. To achieve this requires having, as part of
      the construct, vascular smooth muscle cells, which are contractile in nature and
      oriented in a circumferential direction. Only if an engineered blood vessel
      substitute possesses all of these functional characteristics, can one say that
      the functionality exhibited by a native vessel is being mimicked.

PMID- 11204825
TI  - In vitro model of atherosclerosis using coculture of arterial wall cells and
      macrophage.
AB  - In order to determine the precise mechanism of the interactions between different
      types of cells, which are common phenomena in tissues and organs, the importance
      of coculture techniques are becoming increasingly important. In the area of
      cardiology, artificial arteries have been developed, based on the understanding
      of physiological communication of the arterial smooth muscle cells (SMC),
      endothelial cells (EC), and the extracellular matrix (ECM). In the study of
      atherosclerosis, the modification of low-density lipoprotein (LDL), which result
      in the recruitment and accumulation of white blood cells, especially,
      monocytes/macrophages, and foam cell formation, are hypothesized. Although there
      are well known animal models, an in vitro model of atherogenesis with a precisely
      known atherogenesis mechanism has not yet been developed. In this paper, an
      arterial wall reconstruction model using rabbit primary cultivated aortic SMCs
      and ECs, was shown. In addition, human peripheral monocytes were used and the
      transmigration of monocytes was observed by scanning electron and laser confocal
      microscopy. Monocyte differentiation into macrophages was shown by
      immunohistochemistry and comprehensive gene expression analysis. With the
      modified form of LDL, the macrophages were observed to accumulate lipids with a
      foamy appearance and differentiate into the foam cells in the ECM between the ECs
      and SMCs in the area of our coculture model.

PMID- 11204826
TI  - Art of replacing craniofacial bone defects.
AB  - In the history of medicine, many surgeons have been tried to reconstruct lost
      tissue and correct deformity, attempts to use implant materials have probably
      paralleled those involving autogenous tissue. Recently there has been an
      acceleration in the understanding of the requirements and potentials of implant
      materials caused by collaboration between material scientists, biomaterials
      engineers, clinicians, and clinical investigators. Alloplastic materials have
      become an essential part of reconstructing the function and contour of the
      craniofacial skeleton. Bone is a specialized form of connective tissue, which
      provides support, and protects vital and delicate organs. Bone is embryologically
      derived from mesenchymal tissue through membranous and endochondral ossification.
      In the clinical field, the need for bone graft has been increased due to trauma,
      tumor, craniosynostosis, and pure esthetic bone surgery. Various types of bone
      grafts have been used to repair craniofacial bone defects over many years, but
      the autogenous graft has many disadvantages, such as, limited donor sites, donor
      morbidity, pain, growth deformity and resorption. Many surgeons working in a
      number of centers around the world have created substitutes and simpler methods
      for bone replacement. As the alloplatic bone substitute has been advanced, many
      synthetic substitutes are replaced by bone in vivo over time. The ideal material
      should be cost effective, non-toxic, non-antigenic, non-carcinogenic, and inert
      in the body fluids, be easily shaped at the operating table, and maintain its
      desired form and consistency in situ. This article reviews several of the more
      commonly used materials for craniofacial reconstruction and summarizes their
      mechanical properties and clinical aspects.

PMID- 11204827
TI  - An overview of cartilage tissue engineering.
AB  - Articular cartilage regeneration refers to the formation of new tissue that is
      indistinguishable from the native articular cartilage with respect to zonal
      organization, biochemical composition, and mechanical properties. Due to a
      limited capacity to repair cartilage, scar tissue frequently has a poorly
      organized structure and lacks the functional characteristics of normal cartilage.
      The degree of success to date achieved using a purely cell- or biological-based
      approach has been modest. Potentially the development of a hybrid strategy,
      whereby, chondrocytes or chondrogenic stem cells are combined with a matrix,
      making cartilage in vitro, which is then subsequently transplanted, offers a
      route towards a new successful treatment modality. The success of this approach
      depends upon the material being biocompatible, processable into a suitable three
      dimensional structure and eventually biodegradable without harmful effects. In
      addition, the material should have a sufficient porosity to facilitate high cell
      loading and tissue ingrowth, and it should be able to support cell proliferation,
      differentiation, and function. The cell-polymer-bioreactor system provides a
      basis for studying the structural and functional properties of the cartilaginous
      matrix during its development, because tissue concentrations of glycosaminoglycan
      and collagen can be modulated by altering the conditions of tissue cultivation.

PMID- 11204828
TI  - Tissue-engineered human living skin substitutes: development and clinical
      application.
AB  - The skin acts as a barrier to exogenous substances, pathogens, and trauma. Skin
      defects caused by burns, venous ulcer, diabetic ulcer, or acute injury
      occasionally induce life-threatening situations. Tissue engineering provides an
      alternative for autologous or allogeneic tissue transplantation, which is
      required because of donor site limitations and the risks of transmitting
      infection. Currently, skin substitutes are made of only extracellular matrix,
      mainly cells, or combination of cells and matrices. New biotechnological
      approaches have led to the development of the skin equivalent, the closest match
      yet to native human skin in terms of histological and functional properties. This
      review article focuses upon the development of the in vitro and in vivo epidermis
      and dermis and their clinical applications.

PMID- 11204829
TI  - Tissue engineering of urinary organs.
AB  - Tissue engineering can serve as an alternative treatment for a malfunctioning or
      lost organ. Isolated and expanded cells adhere to a temporary scaffold,
      proliferate, and secrete their own extracellular matrices (ECM) replacing the
      biodegrading scaffold. The genitourinary system, composed of the kidney, ureter,
      bladder, urethra, and genital organs, is exposed to a variety of possible injury
      sites from the time of fetal development. All the urinary organs are mainly
      composed of smooth muscle and uroepithelial cells and which may be approached by
      tissue engineering techniques. A large number of materials, including naturally
      derived and synthetic polymers have been utilized to fabricate prostheses for the
      genitourinary system. Usually, whenever there is a lack of native urologic
      tissue, reconstruction is considered with native non-urologic tissue, such as,
      gastrointestinal segments, or skin or mucosa from multiple body sites.
      Engineering tissues using selective cell transplantation may provide a means to
      create functional new genitourinary tissues. This review concerns urinary tissues
      reconstructed with bladder uroepithelial cells and smooth muscle cells (SMCs)
      implanted on biodegradable polymer matrices.

PMID- 11204830
TI  - Tissue engineering applications in the genitourinary tract system.
AB  - The concept of cell transplantation using tissue engineering techniques has
      provided numerous possibilities in the area of urologic tissue reconstruction.
      Tissue engineering applications in the genitourinary tract system have been
      investigated in almost every tissue in order to improve, restore and replace
      existing tissue function. Although most reconstructive efforts still remain in
      the experimental stage, several technologies have been transferred to the bedside
      with satisfactory outcome. In this article, we describe tissue engineering
      approaches attempted in the genitourinary system for reconstruction.

PMID- 11204831
TI  - Temperature-Responsive surface for novel co-culture systems of hepatocytes with
      endothelial cells: 2-D patterned and double layered co-cultures.
AB  - We have developed two novel cell co-culture system, without any on cell type
      combination limitation, utilizing a polymer surface which is temperature
      sensitive with respect to its cell adhesion characteristics. One system involves
      a patterned co-culture of primary hepatocytes with endothelial cells utilizing
      patterned masked of the electron-beam cured, temperature-responsive polymer, poly
      (N-isopropylacrylamide) (PIPAAm) by masked electron beam irradiation. Hepatocytes
      were cultured to confluency at 37 degrees C on these surfaces. When the culture
      temperature was reduced below 32 degrees C, cells detached from the PIPAAm
      grafted areas without any need for trypsin. Endothelial cells were then seeded
      onto the same surfaces at 37 degrees C. These subsequently seeded endothelial
      cells adhered only to the now-exposed PIPAAm-grafted domains and could be co
      cultured with the hepatocytes initially seeded at 37 degrees C in well-ordered
      patterns. The other system involves a double layered co-culture obtained by
      overlaying endothelial cell sheets of the designed shape onto hepatocyte
      monolayers. The endothelial cells adhered and proliferated on the PIPAAm-grafted
      surface, as on polystyrene tissue culture dishes at 37 degrees C. By reducing the
      temperature, confluent monolayers of cells detached from the PIPAAm surfaces
      without trypsin. Because the recovered cells maintained intact cell-cell
      junctions together with deposited extracellular matrix, the harvested endothelial
      cell sheets, with designed shapes, were transferable and readily adhered to
      hepatocyte monolayers. Stable double layered cell sheets could be co-cultivated.
      These two co-culture methods enabled long-term co-culture of primary hepatocytes
      with endothelial cells. Hepatocytes so co-cultured with endothelial cells
      maintained their differentiated functions, such as albumin synthesis for
      unexpectedly long periods. These novel two co-culture systems offer promising
      techniques for basic biologic researches upon intercellular communications, and
      for the clinical applications of tissue engineered constructs.

PMID- 11204832
TI  - Re-Engineering the liver with natural biomaterials.
AB  - The extensive regenerative capacity of hepatocytes and the key roles of the liver
      in metabolic processes have generated interest in the liver as an appropriate
      target for cell and gene therapy. If cells were considered as natural
      biomaterials, then liver cell transplantation would fall within the general field
      of bioengineering. While unmodified hepatocytes engraft in the liver and ectopic
      sites, biological modifications and optimization of bioengineered systems would
      facilitate engraftment and survival of transplanted cells, especially in ectopic
      locations. Acute liver failure, chronic liver disease and metabolic deficiency
      states are among the conditions that can potentially be treated by cell
      transplantation. In acute liver failure, cell transplantation into the liver,
      along with the creation of an extrahepatic reservoir of cells might be required
      because engraftment and proliferation of transplanted cells in the liver needs
      time. In other situations, gradual liver repopulation alone might well be
      effective without additional manipulations.

PMID- 11204833
TI  - Transplantation of neural stem cells: cellular & gene therapy for hypoxic
      ischemic brain injury.
AB  - We have tracked the response of host and transplanted neural progenitors or stem
      cells to hypoxic-ischemic (HI) brain injury, and explored the therapeutic
      potential of neural stem cells (NSCs) injected into mice brains subjected to
      focal HI injury. Such cells may integrace appropriately into the degenerating
      central nervous system (CNS), and showed robust engraftment and foreign gene
      expression within the region of HI inury. They appeared to have migrated
      preferentially to the site of ischemia, experienced limited proliferation, and
      differentiated into neural cells lost to injury, trying to repopulate the damaged
      brain area. The transplantation of exogenous NSCs may, in fact, augment a natural
      self-repair process in which the damaged CNS "attempts" to mobilize its own pool
      of stem cells. Providing additional NSCs and trophic factors may optimize this
      response. Therefore, NSCs may provide a novel approach to reconstituting brains
      damaged by HI brain injury. Preliminary data in animal models of stroke lends
      support to these hypotheses.

PMID- 11204834
TI  - Viability evaluation of engineered tissues.
AB  - Biohybrid artificial organs encompass all devices capable of substituting for an
      organ or tissue function and are fabricated from both synthetic materials and
      living cells. The viability of engineered tissue could be related to the
      viability of implanted cells. The system of viability assay for mammalian cell
      culture can be applied to the determination of cell viability for engineered
      tissue. This review explores various methods of cell viability assay which can be
      applied to the viability evaluation of engineered tissue. The major criteria
      employed in viability assays include survival and growth in tissue culture,
      functional assay, metabolite incorporation, structural altercation, and membrane
      integrity. Each viability assay method is based on different definitions of cell
      viability, and has inherent advantages and disadvantages. In order to be able to
      assess the viability of cells with one assay method, it is desirable to compare
      the viability measurements from various assays derived from different criteria.

PMID- 11204835
TI  - Estrogen and brain function.

PMID- 11204836
TI  - [Prevention of fetomaternal alloimmunization].

PMID- 11204837
TI  - [Prevention of fetal hemolytic disease: it is time to take action].
AB  - In spite of the progress made since 1970 in specific prevention by anti-rhesus
      immunoglobulins, and improved management of at-risk pregnancies, allo
      immunization due to the erythrocytic Rh 1 antigen (formerly known as Rhesus D or
      Rh D) remains widespread. In fact, anti-Rh 1 antibodies currently constitute over
      one-third of the immune antibodies detected after pregnancy. The prevention of
      allo-immunization against the Rh 1 antigen is therefore still problematical, and
      concerns approximately one pregnant woman in seven. The etiology and pathology of
      fetal hemolytic disease have been recalled, and the treatment approach during
      pregnancy and delivery has been carefully examined. Tests for quantifying the
      risk of fetomaternal hemorrhage have also been described. This approach aims at
      improving the methods of preventing allo-immunization (e.g., during pregnancy and
      delivery) and the efficacy of treatment. It is also stated that if the necessary
      preventive action is not taken in cases of allo-immunization due to to the Rh 1
      antigen, this should be considered a grave medical fault.

PMID- 11204838
TI  - [Hereditary polymorphonuclear neutrophil deficiencies].
AB  - Rare hereditary deficiencies have been described which affect each functional
      stage of polymorphonuclear neutrophils. They almost invariably lead to recurrent
      acute infection. Among the abnormalities involving adhesion and motility, the
      following can be noted: the Buckley syndrome; and leucocyte type 1 and 2 adhesion
      deficiencies, respectively caused by a deficiency in membrane expression of beta
      2 integrin CD11/CD18, and sialyl lewis X. Granulation system abnormalities
      include relatively non-symptomatic myeloperoxidase deficiency, specific
      granulation deficiency or the Chediak-Higashi syndrome with the presence of giant
      lysosomal granulations. Chronic or familial septic granulomatosis constitutes the
      main disease described due to the oxidative PMN burst connected with the
      functional impairment of one of the constituents of NADPH oxidase (with an
      incidence of one in 5.10(6) to one in 10(6) births) The transmission is X-linked,
      or autosomal recessive depending on the mutation. The antenatal detection of the
      X-linked component, gp91 phox, can be made in suspected carrier mothers. In
      addition to the standard treatment (Bactrim and Itraconazole), bone marrow
      transplantation may also be carried out, and in future gene therapy may be
      introduced.

PMID- 11204839
TI  - [Bacterial contamination of platelet concentrates by Propionibacterium acnes].
AB  - In this study, three incidents of platelet contamination by Proprionibacterium
      acnes and an investigation of the transfusion process have been reported, which
      occurred at the Nord-Pas-de-Calais Blood Center over a period of several months.
      P. acnes is a bacterium that is present in the cutaneous flora; it does not
      produce any toxin, and is rarely considered as a pathogenic agent; its occurrence
      is widespread, in particular in those regions that are rich in sebum (face, back,
      scalp), and it is extremely apparent during adolescence. The three incidents
      occurred following the transfusion of a pool of leucodepleted platelet
      concentrates obtained from immunodeficient patients. The clinical outcome was in
      all cases positive. It was considered that the bacterial contamination of
      platelet concentrates could reflect insufficient skin disinfection at the site of
      the venipuncture and a minimal bacterial risk involving the blood collection
      procedure.

PMID- 11204840
TI  - [Laboratory testing for venous thromboembolism].
AB  - Evaluation of inherited thrombophilia in patients with venous thromboembolism
      includes testing for functional activity of antithrombin, protein C and protein
      S, and resistance to activated protein C (factor V Leiden), which can be assessed
      with plasma and DNA-based assays. The antiphospholipid syndrome is an acquired
      disorder related to the development of antibodies against phospholipid-protein
      complexes. Testing for the antiphospholipid syndrome includes measurement of
      antibodies to phospholipid-protein complexes by immunoassay or by detecting
      interference of anti-phospholipid antibodies in sensitive phospholipid-based
      assays. Other genetic risk factors have been listed, including a common
      polymorphism in prothrombin gene (3'-untranslated region) related to an increase
      of prothrombin level (> 115%) and a common polymorphism in the methylene
      tetrahydrofolate reductase (enzyme involved in homocysteine metabolism) gene
      related to a mild increase of homocysteine blood level. More recently high
      plasmatic levels of factor VIII (> 150%) or factor XI (> 120%), not related so
      far to a molecular defect, have been identified as risk factors for deep vein
      thrombosis. As a candidate gene, factor XIII gene polymorphisms are under
      investigation. Beside the acquired or genetic risk factors involved in
      thrombophilia, the gene-environment interactions are of importance in the onset
      of thrombosis.

PMID- 11204841
TI  - [Transfusion in patients with hemoglobinopathies].
AB  - A-Thalassemia involves a production deficiency concerning the synthesis of alpha
      globin chains, and beta-thalassemia involves the beta-globin chains. Only a few
      patients in France are affected by the major form of thalassemia (certain types
      of homozygotic beta-thalassemia). Also, the systematic screening of 'at-risk'
      couples and prenatal diagnosis has helped to considerably reduce the incidence of
      new cases. The decision to perform regular blood transfusions is made when Hb
      levels fall below values that are compatible with normal activity. Hb levels
      above 10 g/dL permit normal educational, recreational and professional activity.
      This level is generally maintained via a 15 mL/kg erythrocyte concentrate
      supplement every three weeks, or 20 mL/kg every four weeks. However, the
      appearance of antierythrocytic autoantibodies is possible, and this may also
      result in an increase in blood transfusion requirements. In intermediate
      thalassemia patients, residual Hb levels are maintained at between 7 and 10 g/dL,
      and transfusion of erythrocyte concentrates is only made in the case of
      aggravation of chronic anemia or when there are signs of intolerance to chronic
      anemia. In France, there is relatively large population of patients with sickle
      cell disease. Blood transfusion is a major element in the treatment of these
      patients. Simple transfusion is performed in cases of a lack of iron or folates,
      increased hemolysis, splenic sequestration or parvovirus 19 infection. The target
      hematocrit should mostly remain at the patient's baseline value. Exchange
      transfusions are not performed on a regular basis, but only in cases of stroke or
      other severe vaso-occlusive events, or when a patient has to be prepared for
      surgery. A minority of subjects are involved in chronic blood transfusion, which
      is used mostly to prevent cerebrovascular accidents but also in cases of cardiac,
      renal, or respiratory insufficiency. There is an increased prevalence of
      antierythrocytic alloimmunization in sickle cell patients, most probably because
      of the discrepancies in red cell antigens between mainly Caucasian blood donors
      and Afro-Caribbean recipients.

PMID- 11204842
TI  - [Blood transfusion audit methodology: the auditors, reference systems and audit
      guidelines].
AB  - The audit has become an essential aspect of the blood transfusion sector, and is
      a management tool that should be used judiciously. The main types of audit that
      can be envisaged in blood transfusion are the following: operational audit
      concerning a predetermined activity; systems quality audit; competence audit,
      combining the operational audit on a specific activity with quality management,
      e.g., laboratory accreditation; audit of the environmental management system; and
      social audit involving the organization of an activity and the management of
      human resources. However, the main type of audit considered in this article is
      the conformity audit, which in this context does not refer to internal control
      but to conformity with an internal guideline issued by the French National Blood
      Service. All audits are carried out on the basis of a predescribed method
      (contained in ISO 10 011). The audit is a system of investigation, evaluation and
      measurement, and also a means of continuous assessment and therefore improvement.
      The audit is based on set guidelines, but in fact consists of determining the
      difference between the directions given and what has actually been done. Auditing
      requires operational rigor and integrity, and has now become a profession in its
      own right.

PMID- 11204843
TI  - Surface-bounded growth modeling applied to human mandibles.
AB  - From a set of longitudinal three-dimensional scans of the same anatomical
      structure, we have accurately modeled the temporal shape and size changes using a
      linear shape model. On a total of 31 computed tomography scans of the mandible
      from six patients, 14,851 semilandmarks are found automatically using shape
      features and a new algorithm called geometry-constrained diffusion. The
      semilandmarks are mapped into Procrustes space. Principal component analysis
      extracts a one-dimensional subspace, which is used to construct a linear growth
      model. The worst case mean modeling error in a cross validation study is 3.7 mm.

PMID- 11204844
TI  - Medical image segmentation using analysis of isolable-contour maps.
AB  - A common challenge for automated segmentation techniques is differentiation
      between images of close objects that have similar intensities, whose boundaries
      are often blurred due to partial-volume effects. We propose a novel approach to
      segmentation of two-dimensional images, which addresses this challenge. Our
      method, which we call intrinsic shape for segmentation (ISeg), analyzes isolabel
      contour maps to identify coherent regions that correspond to major objects. ISeg
      generates an isolabel-contour map for an image by multilevel thresholding with a
      fine partition of the intensity range. ISeg detects object boundaries by
      comparing the shape of neighboring isolabel contours from the map. ISeg requires
      only little effort from users; it does not require construction of shape models
      of target objects. In a formal validation with computed-tomography angiography
      data, we showed that ISeg was more robust than conventional thresholding, and
      that ISeg's results were comparable to results of manual tracing.

PMID- 11204845
TI  - Penalized weighted least-squares image reconstruction for dual energy X-ray
      transmission tomography.
AB  - We present a dual-energy (DE) transmission computed tomography (CT)
      reconstruction method. It is statistically motivated and features nonnegativity
      constraints in the density domain. A penalized weighted least squares (PWLS)
      objective function has been chosen to handle the non-Poisson noise added by
      amorphous silicon (aSi:H) detectors. A Gauss-Seidel algorithm has been used to
      minimize the objective function. The behavior of the method in terms of
      bias/standard deviation tradeoff has been compared to that of a DE method that is
      based on filtered back projection (FBP). The advantages of the DE PWLS method are
      largest for high noise and/or low flux cases. Qualitative results suggest this as
      well. Also, the reconstructed images of an object with opaque regions are
      presented. Possible applications of the method are: attenuation correction for
      positron emission tomography (PET) images, various quantitative computed
      tomography (QCT) methods such as bone mineral densitometry (BMD), and the removal
      of metal streak artifacts.

PMID- 11204846
TI  - Design and evaluation of a system for microscope-assisted guided interventions
      (MAGI).
AB  - The problem of providing surgical navigation using image overlays on the
      operative scene can be split into four main tasks--calibration of the optical
      system; registration of preoperative images to the patient; system and patient
      tracking, and display using a suitable visualization scheme. To achieve a
      convincing result in the magnified microscope view a very high alignment accuracy
      is required. We have simulated an entire image overlay system to establish the
      most significant sources of error and improved each of the stages involved. The
      microscope calibration process has been automated. We have introduced bone
      implanted markers for registration and incorporated a locking acrylic dental
      stent (LADS) for patient tracking. The LADS can also provide a less-invasive
      registration device with mean target error of 0.7 mm in volunteer experiments.
      These improvements have significantly increased the alignment accuracy of our
      overlays. Phantom accuracy is 0.3-0.5 mm and clinical overlay errors were 0.5-1.0
      mm on the bone fiducials and 0.5-4 mm on target structures. We have improved the
      graphical representation of the stereo overlays. The resulting system provides
      three-dimensional surgical navigation for microscope-assisted guided
      interventions (MAGI).

PMID- 11204847
TI  - Maximum-likelihood transmission image reconstruction for overlapping transmission
      beams.
AB  - In many transmission imaging geometries, the transmitted "beams" of photons
      overlap on the detector, such that a detector element may record photons that
      originated in different sources or source locations and thus traversed different
      paths through the object. Examples include systems based on scanning line sources
      or on multiple parallel rod sources. The overlap of these beams has been
      disregarded by both conventional analytical reconstruction methods as well as by
      previous statistical reconstruction methods. We propose a new algorithm for
      statistical image reconstruction of attenuation maps that explicitly accounts for
      overlapping beams in transmission scans. The algorithm is guaranteed to
      monotonically increase the objective function at each iteration. The availability
      of this algorithm enables the possibility of deliberately increasing the beam
      overlap so as to increase count rates. Simulated single photon emission
      tomography transmission scans based on a multiple line source array demonstrate
      that the proposed method yields improved resolution/noise tradeoffs relative to
      "conventional" reconstruction algorithms, both statistical and nonstatistical.

PMID- 11204848
TI  - Surface interpolation from sparse cross sections using region correspondence.
AB  - The ability to estimate a surface from a set of cross sections allows calculation
      of the enclosed volume and the display of the surface in three-dimensions. This
      process has increasingly been used to derive useful information from medical
      data. However, extracting the cross sections (segmenting) can be very difficult,
      and automatic segmentation methods are not sufficiently robust to handle all
      situations. Hence, it is an advantage if the surface reconstruction algorithm can
      work effectively on a small number of cross sections. In addition, cross sections
      of medical data are often quite complex. Shape-based interpolation is a simple
      and elegant solution to this problem, although it has known limitations when
      handling complex shapes. In this paper, the shape-based interpolation paradigm is
      extended to interpolate a surface through sparse, complex cross sections,
      providing a significant improvement over our previously published maximal disc
      guided interpolation. The performance of this algorithm is demonstrated on
      various types of medical data (X-ray computed tomography, magnetic resonance
      imaging and three-dimensional ultrasound). Although the correspondence problem in
      general remains unsolved, it is demonstrated that correct surfaces can be
      estimated from a limited amount of real data, through the use of region rather
      than object correspondence.

PMID- 11204849
TI  - Accurate alignment of functional EPI data to anatomical MRI using a physics-based
      distortion model.
AB  - Mapping of functional magnetic resonance imaging (fMRI) to conventional
      anatomical MRI is a valuable step in the interpretation of fMRI activations. One
      of the main limits on the accuracy of this alignment arises from differences in
      the geometric distortion induced by magnetic field inhomogeneity. This paper
      describes an approach to the registration of echo planar image (EPI) data to
      conventional anatomical images which takes into account this difference in
      geometric distortion. We make use of an additional spin echo EPI image and use
      the known signal conservation in spin echo distortion to derive a specialized
      multimodality nonrigid registration algorithm. We also examine a plausible
      modification using log-intensity evaluation of the criterion to provide increased
      sensitivity in areas of low EPI signal. A phantom-based imaging experiment is
      used to evaluate the behavior of the different criteria, comparing nonrigid
      displacement estimates to those provided by a imagnetic field mapping
      acquisition. The algorithm is then applied to a range of nine brain imaging
      studies illustrating global and local improvement in the anatomical alignment and
      localization of fMRI activations.

PMID- 11204851
TI  - Texture analysis for classification of cervix lesions.
AB  - This paper presents a generalized statistical texture analysis technique for
      characterizing and recognizing typical, diagnostically most important, vascular
      patterns relating to cervical lesions from colposcopic images. The contributions
      of the research include: 1) the introduction of a generalized texture analysis
      technique based on the combination of the conventional statistical and structural
      textural analysis approaches by using a statistical description of geometric
      primitives; 2) the introduction of a set of textural measures that capture the
      specific characteristics of cervical textures as perceived by human. Experimental
      study with real images demonstrated the feasibility and promising of the proposed
      approach in discriminating between cervical texture patterns indicative of
      different stages of cervical lesions.

PMID- 11204850
TI  - Border detection on digitized skin tumor images.
AB  - A radial search technique is presented for detecting skin tumor borders in
      clinical dermatology images. First, it includes two rounds of radial search based
      on the same tumor center. The first-round search is independent, and the second
      round search is knowledge-based tracking. Then a rescan with a new center is used
      to solve the blind-spot problem. The algorithm is tested on model images with
      excellent performance, and on 300 real clinical images with a satisfactory
      result.

PMID- 11204852
TI  - Regularized color clustering in medical image database.
AB  - A regularized color clustering algorithm is proposed to solve the color
      clustering problem in medical image database. By incorporating both measures of
      cluster separability and cluster compactness, regularized color clustering allows
      the automatic extraction of significant color groups with varying populations.
      Experimental results in different color spaces show that the regularized color
      clustering gives superior results in extracting significant distinct/abnormal
      color clusters without significant increases in cluster compactness. Furthermore,
      results of color clustering in different color spaces show that the LUV color
      space is more suitable for color clustering. Methods for selecting the
      regularization constants have also been suggested.

PMID- 11204853
TI  - Microalbuminuria: prognostic marker of cardiovascular disease in essential
      hypertension.

PMID- 11204854
TI  - Methicillin-resistant Staphyloccocus aureus: evaluation of five selective media.
AB  - This study evaluates the performance in isolating methicillin-resistant
      Staphylococcus aureus (MRSA) of three media: the reduced salt formulation of
      mannitol salt agar plus oxacillin (MMSAO); CHROMagar Staph aureus plus
      ciprofloxacin (CHRAC); and Halifax MRSA medium (HMO), against the previously
      recommended mannitol salt agar (7% salt) plus oxacillin (OMSAO) and Baird-Parker
      medium plus ciprofloxacin (BPC). MRSA screening swabs were plated out onto the
      five selective media and the plates examined at 24 and 48 h. Suspected colonies
      were confirmed as MRSA by detection of heat-labile DNase, coagulase and/or
      protein A, and by confirming resistance to methicillin. Of 719 specimens
      examined, 191 grew MRSA on at least one medium. The relative sensitivities of the
      five media at 48 h were as follows: BPC, 94%; CHRAC, 70%; OMSAO, 61%; HMO, 56%;
      and MMSAO, 46%. In addition, BPC gave the least number of unnecessary
      investigations for non-MRSA isolates. The current advantage of BPC when
      performing direct culture for MRSA was confirmed. The other ciprofloxacin
      containing medium also produced reasonable results. Of the two mannitol salt agar
      media, the formulation with 7% salt gave better results. HMO proved unreliable at
      isolating MRSA.

PMID- 11204855
TI  - Effects of fish-oil constituents and plasma lipids on fibrinolysis in vitro.
AB  - An association between consumption of fish or fish oils and a reduction in
      coronary heart disease was established in the 1980s. The mechanisms underpinning
      this effect have been investigated extensively, with the focus on a reduction in
      platelet adhesiveness and a lowering of plasma concentrations of low-density
      lipoprotein (LDL)-cholesterol. Possible effects on fibrinolysis have received
      less attention and produced conflicting data. The present study evaluates such
      effects under chemically restricted conditions in vitro, in a system that, based
      on studies with haemostatically active drugs of known mechanisms, appears to have
      some relevance to the in vivo situation. Eicosapentaenoic acid (EPA)--one of the
      major constituents of fish oil--produced a statistically significant (P < 0.05)
      enhancement of fibrinolysis, when added before formation of the fibrin clot, but
      generally had the reverse effect when added afterwards. Docosahexaenoic acid
      (DHA)--the other major constituent of fish oil--had a dramatic inhibitory effect
      on clot formation, when added prior to clot formation, and inhibited lysis when
      added after the clot was formed. Maxepa (Seven Seas Ltd.)--a concentrate of EPA
      and DHA, and the pharmaceutical equivalent of fish oils--did not influence
      fibrinolysis, when added prior to clot formation. When added after the clot had
      formed, however, it produced significant (P < 0.05) and dose-dependent effects
      that varied from enhancement to inhibition. Similarly, both high-density
      lipoprotein (HDL)- and LDL-cholesterol, when added after clot formation, produced
      significant (P < 0.05) concentration-dependent effects that varied from
      enhancement of fibrinolysis (at the lower concentrations tested) to inhibition at
      higher concentrations. Our findings suggest that the effects of fish oil and
      lipids are more complex than simple enhancement or inhibition of fibrinolysis.
      Rather, the benefits may depend both on their concentration and whether they are
      present before or after the fibrin clots are formed.

PMID- 11204856
TI  - Protein determination in cerebrospinal fluid by protein dye-binding assay.
AB  - In this study, Coomassie brilliant blue (CBB) and pyrogallol red/molybdate (PRM)
      protein dye-binding assays for total protein determination in cerebrospinal fluid
      (CSF) are compared. Using human albumin (HA) as a protein calibrator, protein
      concentration in CSF samples (n = 73) ranged from 55-1960 mg/L (median: 315 mg/L)
      with the CBB assay, and from 95-2450 mg/L (median: 395 mg/L) with the PRM assay.
      Linear regression analysis indicated yCBB = 0.824xPRM - 8 (r = 0.99). The
      discrepancy between the values was investigated by comparing the response of the
      two assays to different proteins. Compared with HA, the PRM assay showed a more
      uniform response to human albumin/globulin (A/G) and bovine gamma globulin (G)
      than did the CBB assay, but it gave high colour yields with bovine myelin basic
      protein. When CSF was assayed using A/G as a protein calibrator, agreement
      between the methods improved (yCBB = 0.960xPRM + 0 [r = 0.99]), indicating that
      comparability is dictated by the choice of protein calibrator. Of the two assays
      studied, the PRM assay is recommended for CSF protein determination because it
      gives a more uniform and linear response to human albumin and globulin over a
      wider working range.

PMID- 11204857
TI  - Microalbuminuria in essential hypertension: clinical and biochemical profile.
AB  - This study aims to evaluate the clinical and biochemical profile associated with
      the presence of microalbuminuria in a group of essential hypertensive patients
      referred to a hypertension clinic. A total of 188 non-diabetic, untreated
      essential hypertensive patients (100 men, 88 women) aged 55.8 +/- 11.7 years are
      studied. Urinary albumin excretion was determined in two 24-h urine collections.
      Clinical and biochemical evaluations and 24-h ambulatory blood pressure (BP)
      monitoring were performed at baseline. Forty-two patients (22.3%) showed an
      increased urinary albumin excretion rate (20-200 micrograms/min). These patients
      showed significantly higher values (P < 0.01) for 24-h, daytime and night-time
      systolic and diastolic BP, compared with essential hypertensives with normal
      urinary albumin excretion. However, nocturnal reduction in BP did not differ
      between the groups. Furthermore, patients with microalbuminuria showed
      significantly higher (P < 0.01) creatinine, serum uric acid and triglycerides, as
      well as lower high-density lipoprotein (HDL)-cholesterol. In a multiple logistic
      regression analysis, a 24-h systolic BP > 140 mmHg (odds ratio: 3.19; 95%
      confidence interval [CI 95%]: 1.44-7.06) and a serum creatinine > 88 mumol/L
      (odds ratio: 3.08; CI 95%: 1.39-6.84) were the two factors associated
      independently with increased urinary albumin excretion. We conclude that, in
      essential hypertensive patients, the presence of microalbuminuria is associated
      with elevated BP, but not with its circadian pattern. Likewise, microalbuminuria
      is associated with the degree of renal impairment, and with increased uric acid
      and triglycerides and decreased HDL-cholesterol.

PMID- 11204858
TI  - Detection of the beta s gene: an evaluation of the solubility test against
      automated chromatography and haemoglobin electrophoresis.
AB  - The solubility test is evaluated against automated high-performance liquid
      chromatography (HPLC) and haemoglobin (Hb) electrophoresis for its efficacy in
      screening for the beta s gene in population groups in remote areas. Blood samples
      taken from 3246 individuals from the tribal populations of the Dhule and
      Gadchiroli districts of Maharashtra state were analysed by all three methods. The
      solubility test detected 871 out of 932 individuals positive for the beta s gene
      by HPLC and Hb electrophoresis, and showed an overall sensitivity of 93.8% and
      specificity of 100%, with a positive predictive value of 100% and negative
      predictive value of 97.4%. Both HPLC and Hb electrophoresis are relatively
      expensive and not available in most laboratories in remote tribal areas, where
      the frequency of the beta s gene is very high. We conclude that the solubility
      test could be used for preliminary screening to determine the prevalence of the
      beta s gene in different population groups, particularly in remote areas where
      other facilities are not available. Individuals who test positive for the beta s
      gene by the solubility test require further investigation by either HPLC or Hb
      electrophoresis.

PMID- 11204859
TI  - Mycoplasma detection in cell cultures: a comparison of four methods.
AB  - Mycoplasma is a common contaminant of tissue culture samples. Infection is
      persistent, difficult to detect and diagnose, and very difficult to cure. The
      concentration of mycoplasma in infected cultures can be as high as 10(7) colony
      forming units per mL, and their presence can change many of the cell reactions,
      including altering cell growth rate, inducing morphological changes or cell
      transformation, and mimicking virus infection. Therefore, it should be assumed
      that a mycoplasma-contaminated cell line may be significantly influenced in every
      respect, and, thus, experimental data derived from such a cell line is likely to
      be invalid. Contamination is not obvious, either macroscopically or
      microscopically; thus, routine mycoplasma testing is essential for any cell
      culture laboratory. Many of the testing procedures developed so far are time
      consuming, expensive, inconclusive and unsuitable for screening large numbers of
      test specimens. This study compares DNA staining, enzyme-linked immunosorbent
      assay (ELISA), polymerase chain reaction (PCR) and PCR ELISA, to determine which
      is the best procedure for routine assessment of cell cultures. All four methods
      gave reproducible results with both infected and non-infected cell lines. Both
      ELISA methods were easy to perform, reproducible and easily interpreted.

PMID- 11204860
TI  - Internal quality control in virology: validation of immunoassays using a personal
      computer spreadsheet.
AB  - Design of a spreadsheet to evaluate the performance of internal quality control
      sera used for the validation of immunoassays in virology is described. Developed
      using Microsoft Excel 97, it can set target limits and analyse control data by
      application of Westgard quality control rules. It also provides a permanent
      record of all relevant information concerning each assay run, including action
      taken to rectify unacceptable performance.

PMID- 11204861
TI  - Vitek automated identification and susceptibility testing system: introduction
      into a busy clinical bacteriology laboratory.

PMID- 11204862
TI  - Bimodal role for divalent cations in the mechanism of EDTA cytolysis.

PMID- 11204863
TI  - Haemochromatosis mutation analysis in a normal Irish population.

PMID- 11204864
TI  - Small-colony variants of Staphylococcus aureus.
AB  - Staphylococcus aureus remains a versatile and dangerous pathogen. Small-colony
      variants (SCVs) of S. aureus are a naturally occurring sub-population, first
      described nearly 100 years ago. These variants, of which there are different
      classes, grow slowly and have many atypical characteristics thought to be due to
      defective electron transport, and include minute colony forms. SCVs have been
      isolated from sites of infection, particularly persistent recurrent ones (e.g. in
      chronic osteomyelitis and cystic fibrosis), and also may arise following exposure
      to certain antibiotics. During infection the intraendothelial-cell milieu
      stimulates the formation of SCVs, which can better survive the assault of cell
      mediated immunity. SCV phenotypes produce less tissue damage than normal
      staphylococci. Although microscopic morphology and Gram's staining of SCVs are
      normal, clinical microbiology laboratories may fail to detect them because of
      their very slow growth. The full extent of the role of S. aureus SCVs in clinical
      disease, and the most appropriate means of identifying such strains or testing to
      predict the clinical usefulness of therapeutic regimens, remains unknown. Failure
      to recover SCVs results in a major susceptibility reporting error, as the more
      resistant component of the infection will not have been reported. No controlled
      trials of therapy have been conducted, and, thus, optimal therapy has yet to be
      defined. However, SCVs are resistant to aminoglycoside antibiotics, and may be
      resistant to trimethoprim-sulphmethoxazole. The effectiveness of cell-wall-active
      antibiotics is reduced. SCVs are transmissible, and current infection control
      recommendations for normal S. aureus infections are appropriate.

PMID- 11204865
TI  - Diagnostic applications of cystatin C.
AB  - Cysteine proteases are proteolytic enzymes involved in many pathological
      processes and found in the lysosomes of cells; examples include the cathepsins B,
      H and L. The role of cysteine proteases is crucial in normal cellular metabolism,
      being fundamental to intracellular protein turnover, degradation of collagen, and
      cleaving of precursor proteins. Cysteine protease inhibitors, of which the
      cystatin superfamily are one example, constitute the final regulatory step in the
      control of cysteine proteases. Currently, cystatin C is the most frequently
      investigated family member and is involved in processes such as tumour invasion
      and metastasis, inflammatory processes and some neurological diseases. In such
      diseases the emphasis is placed on the fine balance and regulation of both the
      cysteine proteases and their inhibitors, with an imbalance resulting in a
      pathological state. In addition, the constant serum concentration of cystatin C
      means it has possible application as a replacement for creatinine in the
      measurement of glomerular filtration rate. To date, several assays have been
      developed and studies show a promising future for its use in the medical
      laboratory, and not just as a research tool. This review of cystatin C includes a
      brief history of its discovery and characterisation, provides a guide to some of
      the processes in which its role is fundamental, and highlights developments in
      its use as a clinical biomarker in the disease processes discussed.

PMID- 11204866
TI  - Microbiological safety cabinets: selection, installation, testing and use.
AB  - In the last quarter of the 20th century, there was much confusion and uncertainty
      amongst microbiologists and managers about the choice, installation, testing and
      use of the various types of microbiological safety cabinet. This review clarifies
      these issues, with reference to the latest standards and safe procedures.

PMID- 11204867
TI  - Thermus aquaticus (Taq) error rates and REP-PCR.

PMID- 11204868
TI  - RhD typing and the significance of Du.

PMID- 11204869
TI  - Fugitive discharges and waste disposal: the discussion continues.

PMID- 11204870
TI  - Fugitive discharges and waste disposal: the discussion continues.

PMID- 11204871
TI  - Time-of-day effects of ethanol consumption on EEG topography and cognitive event
      related potential in adult males.
AB  - Time-of-day effects of ethanol consumption on EEG topography and cognitive event
      related potential in adult males were studied. Ethanol (0.5 g/kg) or control
      drink was orally administered to nine healthy males at 10:00 and 18:00. The alpha
      2 amplitude was significantly lower than that of the control at 0.5, 2.5 and 4.5
      hours after ethanol consumption in the morning. These effects were observed in
      the left hemisphere and were only found after consumption in the morning. The
      subjectively rated attention was significantly lower than that of the control at
      0.5 and 2.5 hours after ethanol consumption in the morning and at 0.5 hours after
      ethanol consumption in the evening. In contrast, the search speed of serial
      search task and P300 amplitude was significantly lower than that of the control
      at 2.5 hours after ethanol consumption in the evening. These results demonstrate
      that effects of ethanol are dependent on time-of-day of consumption. Ethanol
      consumption significantly lowered the alpha 2 amplitude when consumed in the
      morning, and lowered P300 amplitude when consumed in the evening.

PMID- 11204872
TI  - Autonomic response specificity during motor imagery.
AB  - It has been reported that activation of autonomic effectors during mental
      simulation of voluntary motor actions (motor imagery: MI) may be explained by two
      different factors, i.e., functions of preparation or anticipation of actual
      exercise (motor anticipation) and the central motor programming/planning which
      acts during actual motor action (motor programming). This study was designed to
      clarify how these factors participate during MI, utilizing two mental tasks with
      high mental stress, i.e., MI and mental arithmetic (MA). Several autonomic
      effectors' responses were compared between MI of a 500 m speed skating sprint and
      MA. Subjects were eight 18 to 25 year old young male speed skate athletes, all of
      them could easily and vividly imagine a 500 m speed skating sprint. Duration of
      the MI ranged from 35 to 38 sec and these were very close to each subject's
      actual best record (means of absolute differences were less than 0.6 sec, i.e.,
      less than 1.7% relatively). A significant decrease of skin resistance (SR),
      increases of heart rate (HR) and respiration rate were observed in both MI and MA
      when compared to each control resting level (excluding one subject for
      respiration rate during MI). SR decreased during MI (mean and SD of 8 subjects:
      45.9 +/- 17.7%) and MA (39.7 +/- 16.8%), with no significant differences between
      MI and MA (t = 1.29, by paired t-test). HR increased significantly above control
      values in MA (10.3 +/- 4.3%) and MI (44.3 +/- 18.8%). However, the increase
      during MA was significantly smaller (t = 4.99, p < 0.001) than in MI. Respiratory
      rate increased significantly in both MI (46.5 +/- 30.9%) and MA (27.7 +/- 14.6%),
      with no significant difference between MI and MA (t = 1.82) due to the large
      individual variation in MI. The frequency of respiration was fairly regular
      during MA, but quite irregular during MI (similar to those during actual motor
      actions). The central nervous system which acts in MI may possess the function of
      activation of target effectors which play an important role in actual exercise,
      on the basis of incremental vigilance level induced by the function of motor
      anticipation.

PMID- 11204873
TI  - Reliability and validity of the questionnaire to determine the biosocial rhythms
      of daily living in the disabled elderly.
AB  - The questionnaire to determine the biosocial rhythms of daily living in the
      disabled elderly was newly developed. This questionnaire was aimed to evaluate a
      state of synchronization of biological rhythms in the disabled elderly. Eighteen
      items of the questionnaire relating to the synchronization of biological rhythms
      were finally selected by the test-retest method that was conducted for 68
      disabled elderly living in a community with a duration of one year. The factor
      analysis showed that the questionnaire consisted of five factors: outdoor
      activities, ultradian rhythms, subjective evaluation of health status, social
      support, and sleep habits. The cumulative contribution rate of five factors was
      53.2%. Reliability of the questionnaire was confirmed by a calculation of the
      Equal-length Spearman-Brown coefficients ranging from 0.60 to 0.80. Regarding the
      construct validity of the questionnaire, results of factor analysis showed five
      factors that were consistent with the synchronizers known in chronobiology. The
      total score of the questionnaire was significantly correlated to Barthel Index
      score and the competence score, suggesting that it partly reflects the activities
      of daily living of the disabled elderly. We conclude that a new questionnaire to
      determine the biosocial rhythm of daily living in the disabled elderly is useful
      to evaluate the biosocial synchronization of the disabled elderly because of its
      high reliability and validity.

PMID- 11204874
TI  - Prolonged swimming exercise training induce hypophosphatemic osteopenia in stroke
      prone spontaneously hypertensive rats (SHRSP).
AB  - Stroke-prone spontaneously hypertensive rats (SHRSP) induce spontaneous
      osteoporosis. To elucidate the specific characteristics of bone metabolism, the
      SHRSP was compared with age matched Wistar-Kyoto (WKY) rats. We investigated the
      effects of prolonged swimming exercise training on bone mineral density (BMD) and
      metabolism in the SHRSP. Seven-week-old male SHRSP and WKY were divided into
      three groups; the sedentary control WKY group (n = 6, WKY), the sedentary control
      SHRSP group (n = 6, SP) and the swimming exercise training SHRSP group (n = 6,
      SWIM) (in pool with 60 min./day, 5 days/week for 12 weeks). The femoral BMD, bone
      mineral content (BMC), strength, Ca and P contents (%) of SHRSP were
      approximately 17, 27, 25, 20 and 9%, respectively, lower than that of WKY (p <
      0.001). Serum alkaline phosphatase (AlP) had not changed between both of SP and
      WKY, but tartrate-resistant acid phosphatase (TrAcP) of SP approximately 3-fold
      higher than that of WKY (p < 0.05). Both serum calcium (Ca) and intact
      parathyroid hormone (i-PTH) were similar between SP and WKY. However, serum
      phosphate (P) of SP was approximately 18% lower than that of WKY (N.S.). These
      results suggested that SHRSP induces osteopenia by the bone turnover of the
      promoted osteoclast activity with disturbed phosphate homeostasis. On the other
      hand, the femoral BMD and strength were approximately 7% and 20%, respectively,
      decreased in the SWIM (p < 0.001), and femoral bone Ca and P contents (%) were
      also approximately 11% and 14%, respectively, lower than that of SP (p < 0.001).
      There were no significant difference between SWIM and SP on serum Ca, but serum P
      of SWIM was significantly lower than that of SP (p < 0.05). These results
      suggested that the prolonged swimming exercise training in the SHRSP induces more
      cruelly hypophosphatemia, and leading to osteopenia eventually. We conclude that
      SHRSP induces osteopenia with disturbance of phosphate homeostasis, and the
      prolonged swimming exercise in the SHRSP might deteriorate hypophosphatemia and
      osteopenia.

PMID- 11204875
TI  - Effects of exercise conditioning on vital age in hyperlipidemic women.
AB  - We attempted to determine the effectiveness of exercise prescription for women
      with hyperlipidemia (HL), because some HL women showed no significant improvement
      in serum lipid and lipoprotein profiles despite the continuation of exercise
      conditioning. We therefore tested the hypothesis that exercise can be clinically
      beneficial even when there are no alterations in total cholesterol (TC), low
      density lipoprotein cholesterol (LDLC), and/or triglycerides (TG). Twenty-three
      women with HL (aged 54.3 +/- 7.6 yr) participated in our outpatient-supervised
      exercise conditioning program for 90 minutes each session, twice a week for 1
      year, and also did home-based exercise three days a week. Vital age (VA) is a
      useful index for assessing functional status, especially the risk of coronary
      heart disease (CHD) and is computed from 11 independent variables measured not
      only when a person is at rest but also during exercise. Although TC and LDLC did
      not change significantly after the exercise conditioning, TG decreased
      significantly (P < 0.05). Furthermore, when we computed the corrected VA (VAc)
      assuming no changes in TC, LDLC, and TG, VAc was found to decrease significantly
      from 64.0 +/- 9.9 yr to 58.4 +/- 9.0 yr (P < 0.05). In conclusion, these results
      indicate the effectiveness of exercise conditioning on risk of CHD in HL women,
      irrespective of alterations in the concentrations of serum lipid and lipoprotein.

PMID- 11204876
TI  - Reduced oxidative DNA damage by vegetable juice intake: a controlled trial.

PMID- 11204877
TI  - Host response and Histoplasma capsulatum/macrophage molecular interactions.
AB  - Histoplasma capsulatum is the etiological agent of histoplasmosis, a chronic
      respiratory infection that is generally asymptomatic in healthy individuals, but
      severe or fatal in patients who are immunosuppressed or otherwise debilitated. H.
      capsulatum is found as a mould in soil and becomes a pathogenic yeast in the
      mammalian host. The first line of defense that H. capsulatum faces during host
      invasion is the attack of polymorphonuclear neutrophils and resident macrophages.
      In animal models, once phagocytosed, H. capsulatum is not killed by fusion of the
      phago-lysosomes, instead it multiplies within non-activated macrophages and
      destroys them. Upon induction of cell-mediated immunity, cytokines activate
      macrophages and destroy the yeast cells. Some aspects of the fungus-macrophage
      interaction have been elucidated, and it is clear that some of the mechanisms by
      which H. capsulatum escapes the lethal effects of this very hostile environment,
      involve the regulation of specific genes. Recently, using the differential
      display reverse transcriptase polymerase chain reaction technique, a number of H.
      capsulatum genes that are induced after the yeasts are ingested by macrophages
      have been identified. However, the mechanisms that underlie the capacity of H.
      capsulatum to adapt to the new environmental conditions present in macrophages
      remain to be clarified.

PMID- 11204878
TI  - Immunoregulation by capsular components of Cryptococcus neoformans.
AB  - Cryptococcus neoformans is an encapsulated yeast that is pathogenic for humans.
      The capsule is a major virulence factor composed mainly of glucuronoxylomannan
      (GXM) and two minor constituents, galactoxylomannan, and mannoprotein (MP). A
      hallmark of disseminated cryptococcosis is the presence of high concentrations of
      GXM in body fluids of infected hosts. GXM provides a critical negative signal for
      T cell activation and neutrophil migration at the site of the inflammatory
      process. There is also strong evidence that MP promotes critical events
      associated with protective responses such as delayed type hypersensitivity and
      presumably a T helper type 1 response. The contrasting roles of GXM and MP in
      regulation of the immune response to C. neoformans offer a promising template for
      a successful approach to intervention, by scavenging GXM to attenuate its
      negative signals, while preserving the positive effects of MP.

PMID- 11204879
TI  - Local Th1/Th2 cytokine production during experimental vaginal candidiasis:
      potential importance of transforming growth factor-beta.
AB  - Host defense mechanisms against vaginal Candida albicans infections are poorly
      understood. Despite the protective role of T helper (Th)1-type cell-mediated
      immunity (CMI) against mucosal C. albicans infections, studies using an estrogen
      dependent murine model of vaginal candidiasis have shown a lack of effect of
      systemic Th1-type CMI against a vaginal C. albicans infection, and a lack of
      changes in local T cells during infection. In the present study, the local Thl-
      (interleukin [IL]-2, interferon [IFN]-gamma and IL-12) and Th2- (IL-4, IL-10 and
      transforming growth factor [TGF]-beta1) type cytokines were evaluated in vaginal
      tissue during an experimental C. albicans infection. Results showed constitutive
      expression of TGF-beta1 in vaginal tissue of naive mice that was two-fold higher
      than the levels of the other cytokines examined. These high levels of TGF-beta1
      were further increased as a result of pseudoestrus and/or infection, and were
      corroborated at the messenger RNA level. Furthermore, the levels of TGF-beta in
      naive or infected mice were significantly higher in the vagina compared to other
      areas of the genital tract. Finally, TGF-beta1 predominated as well in the
      draining, but not non-draining, lymph nodes during infection. These results
      suggest that TGF-beta1, a potent immunoregulatory cytokine, may be important in
      the lack of demonstrable CMI at the vaginal mucosa against C. albicans.

PMID- 11204880
TI  - Mitochondrial DNA analysis of Sporothrix schenckii in South Africa and Australia.
AB  - Clinical isolates of Sporothrix schenckii were investigated for mitochondrial DNA
      (mtDNA) types using restriction fragment length polymorphism patterns with
      HaeIII. The 62isolates in South Africa comprised Types 3 (9.7%), 4 (1.6%), 11
      (9.7%), 17 (77.4%) and 23 (1.6%) while the 23 Australian isolates comprised Types
      3 (26.0%), 4 (56.5%), 7 (8.6%) and 21 (8.6%). In a phylogenetic tree based on the
      sequence divergence of mtDNA, the mtDNA types were clustered into two groups, A
      and B. The results suggested that isolates in South Africa mainly belong to Group
      A and isolates in Australia mainly belong to Group B.

PMID- 11204881
TI  - RFLP analysis reveals marked geographical isolation between strains of
      Paracoccidioides brasiliensis.
AB  - Restriction fragment length polymorphism (RFLP) was performed on 32 isolates of
      the pathogenic fungus Paracoccidioides brasiliensis from geographically separated
      regions of South America. The use of HinfI and HincII gave clear RFLP patterns,
      for which high discriminatory indices could be calculated. Computational analysis
      of the RFLP patterns for the 32 isolates suggested that at least five groups of
      strains existed, each of which was geographically distinct and corresponded
      closely with present country borders. These results underline the belief that P.
      brasiliensis infections are acquired from exogenous sources and that this fungus
      occupies specialist endemic niches within the natural environment.

PMID- 11204882
TI  - Lipid peroxidation by alveolar macrophages challenged with Cryptococcus
      neoformans, Candida albicans or Aspergillus fumigatus.
AB  - Increased formation of oxygen radicals has previously been shown for alveolar
      macrophages (AM) challenged with Cryptococcus neoformans cells opsonized with
      fresh serum or polyclonal immunoglobulin G. AM show similar responses to Candida
      albicans or Aspergillus fumigatus. Oxygen radicals are capable of damaging
      various macromolecules, including lipids. In the present study, lipid
      peroxidation (LPO) caused by AM incubated with the fungi was examined in the
      presence and absence of lung surfactant. The level of malonaldehyde was used as
      an indicator of LPO. AM damage was examined by electron microscopy (EM), by
      trypan blue exclusion and by counting the AM loss from culture dish to
      supernatant. Stimulation of AM by each fungus increased cellular LPO but did not
      affect AM viability. A slight surfactant LPO induced by AM alone was shown with
      significantly increased values after addition of each fungus. EM studies showed
      that dense lipid droplets, presumably consisting of oxidized lipids, were
      ingested in high amounts together with C. neoformans cells that had been
      opsonized in fresh serum, and in low amounts in combination with C. albicans.
      These processes were accompanied by increased numbers of AM in the supernatants.
      LPO and detachment of AM were counteracted by vitamin E. In the lungs, AM exposed
      to one of these fungal pathogens might promote peroxidation of surfactant lipids.

PMID- 11204883
TI  - Pneumocystis carinii pneumonia in a Yorkshire terrier dog.
AB  - A 14-month-old male Yorkshire terrier was presented to the Autonomous University
      of Barcelona Veterinary Teaching Hospital because of a history of chronic non
      productive cough and acute dyspnea. A follow-up radiograph revealed a diffuse,
      bilaterally interstitial-alveolar lung disease with presence of air bronchograms.
      The dog died 5 h after admission with severe dyspnea. Histological sections of
      the necropsy specimens revealed the presence of characteristic Pneumocystis
      carinii cysts within alveolar spaces. A diagnosis of P. carinii pneumonia (PCP)
      was made on the basis of these results. To our knowledge, PCP has not been
      described in a Yorkshire terrier dog.

PMID- 11204884
TI  - Road accidents in Slovenia involving a pedestrian, cyclist or motorcyclist and a
      car.
AB  - We analyse the group of road traffic accidents in Slovenia in which a car driver
      and a pedestrian, cyclist or motorcyclist are involved. At the beginning some
      basic data are presented from the available database on traffic accidents. The
      selected group is then analysed by use of the logistic regression method. Based
      on the obtained results, some guidelines for transport policy action--aimed at
      decreasing the number of accidents with severe injury or fatality--are
      identified.

PMID- 11204885
TI  - An evaluation of a suburban railway pedestrian crossing safety programme.
AB  - This study evaluated a programme of educational and environmental (access
      prevention) interventions designed to reduce the incidence of illegal and unsafe
      crossing of the rail corridor at a suburban station in Auckland, New Zealand.
      Immediately after the programme of interventions, the proportion of those
      crossing the rail corridor by walking across the tracks directly rather than
      using the nearby overbridge had decreased substantially. Three months later, the
      decrease was even greater. However, the educational and environmental
      interventions were introduced simultaneously so that the effects of each could
      not be separated; nor could other unmeasured factors be ruled out. Anonymous
      surveys administered immediately before and 3 months after the interventions
      indicated that while awareness of the illegality of walking across the tracks had
      increased slightly, perception of risk had not changed. This suggests that the
      educational interventions may have had less effect than the access prevention
      measures.

PMID- 11204886
TI  - Age and gender patterns in motor vehicle crash injuries: importance of type of
      crash and occupant role.
AB  - To evaluate the interaction of gender, age, type of crash, and occupant role in
      motor vehicle crash injuries leading to hospitalization, we analyzed 1997
      Wisconsin hospital discharge data for patients with primary E-code diagnoses of
      motor vehicle injuries. The overall ratio of males to females (M/F ratio)
      hospitalized for motor vehicle crash injuries was 1.33 (95% confidence interval
      (CI): 1.26-1.41). The M/F ratio varied by type of crash and differed for
      passengers and drivers. For injuries sustained in collisions between vehicles,
      the M/F ratio was 0.96 (95% CI: 0.87-1.05); in loss of control accidents the M/F
      ratio was 1.95 (95% CI: 1.76-2.17). Within each type of crash, the M/F ratio for
      drivers was similar to that for the entire type; the M/F ratio for passengers was
      about half of the type total. Expressed as rates of hospitalization per 100,000
      people in the general population, hospitalizations of drivers in collisions with
      another motor vehicle increased steeply in males, but not in females, beginning
      at about age 70. For drivers in loss of control crashes, male rates exceeded
      female rates in all age groups, with peaks in the groups 15-24 and 85-89. For
      passengers, injury rates from collisions with other motor vehicles were greater
      for females, especially in the elderly, and injury rates from loss of control
      crashes were similar for both genders, with peaks at 15-24 and 85-94. The higher
      fatality of men in loss of control motor vehicle crashes, compared to women,
      suggests an important area for further investigation.

PMID- 11204887
TI  - Pedestrian fatalities and alcohol.
AB  - Since the share of alcohol-positive victims has been reported not to show the
      same reduction in pedestrian fatalities as in other 'road users', this study
      analysed pedestrian fatalities with special emphasis on the presence of alcohol.
      Autopsied pedestrian fatalities (286 victims) in northern Sweden from 1977 to
      1995 were investigated, using autopsy and police reports. Blood alcohol was
      detected in 19% of the fatalities, with a median concentration of 1.6 g/l. The
      proportion of test-positive victims did not change significantly during the
      period of study. Males more often tested positive for alcohol than females (24
      vs. 11%). Further, the test-positive victims had a lower mean age (49 vs. 59
      years) and the proportion of test-positive victims was higher during weekends and
      nights. Pedestrian fatalities testing positive for alcohol differ from those
      testing negative in several respects. The public should be enlightened of the
      fact that drinking is a risk not only among users of motor vehicles, but also
      among pedestrians. Separation of pedestrians from motor vehicles by, e.g. fences,
      is of greatest importance.

PMID- 11204888
TI  - Variations of the level of vigilance and of behavioural activities during
      simulated automobile driving.
AB  - During a monotonous activity, certain behaviours occur that are not necessary to
      the performance of the task. These are subsidiary or collateral activities. Our
      purpose was to find out if the number of these behaviours tends to increase
      during a monotonous and prolonged activity. A study was carried out with 17
      subjects performing a 2-h car drive on the Vigilance Analysis Driving Simulator.
      An analysis of the drivers' behaviour and of their state of vigilance allowed us
      to confirm the existence of a relation between the occurrence of these behaviours
      and the variations of the level of arousal. In addition, we determined for all
      produced behaviours, those that preceded, those that coincided with, and those
      that followed low vigilance phenomena. These results were interpreted in terms of
      behavioural signs, precursory of low vigilance, indicative of low vigilance, or
      reactivating the driver.

PMID- 11204889
TI  - Fatal traffic accidents among trailer truck drivers and accident causes as viewed
      by other truck drivers.
AB  - Causality factors, the responsibility of the driver and driver fatigue-related
      factors were studied in fatal two-vehicle accidents where a trailer truck driver
      was involved during the period of 1991-1997 (n = 337). In addition, 251 long-haul
      truck drivers were surveyed in order to study their views regarding contributing
      factors in accidents involving trucks and the development of possible
      countermeasure against driver fatigue. Trailer truck drivers were principally
      responsible for 16% of all the accidents. Younger driver age and driving during
      evening hours were significant predictors of being principally responsible. In
      addition, the probability of being principally responsible for the accident
      increased by a factor of over three if the driver had a chronic illness.
      Prolonged driving preceding the accident, accident history or traffic offence
      history did not have a significant effect. Only 2% of the drivers were estimated
      to have fallen asleep while driving just prior to the accident, and altogether 4%
      of the drivers had been tired prior to the accident. Of the drivers 13% had
      however, been driving over 10 h preceding the accident (which has been criminally
      punishably in Finland since 1995 under the EC regulation) but no individual
      factors had a significant effect in predicting prolonged driving. The surveyed
      views regarding causes of truck accidents correspond well with the accident
      analysis. Accidents were viewed as being most often caused by other road users
      and driver fatigue was viewed to be no more than the fifth (out of eight) common
      cause of accidents. The probability of viewing fatigue as a more common cause
      increased significantly if the driver had experienced fatigue-related problems
      while driving. However, nearly half of the surveyed truck drivers expressed a
      negative view towards developing a technological countermeasure against driver
      fatigue. The negative view was not related to personal experiences of fatigue
      related problems while driving.

PMID- 11204890
TI  - Multiple state hazard models and workers' compensation claims: an examination of
      workers compensation data from Ontario.
AB  - The recurrent nature of some workplace injuries has led some researchers to
      conclude that the first absence from work does not provide an accurate picture of
      an individual's claim, or employment history, after a workplace injury. In this
      paper I estimate a multiple state hazard which estimates the transitions between
      spells where the individual receives workers' compensation benefits and spells
      where the individual does not receive any workers' compensation benefits. I apply
      this model to a sample of claims from Ontario's Workplace Safety and Insurance
      Board.

PMID- 11204891
TI  - Factors associated with parental safe road behaviour as a pedestrian with young
      children in metropolitan New South Wales, Australia.
AB  - A cross-sectional population-based randomised telephone survey of parents with
      children aged between 5 and 12 years was conducted to investigate factors
      associated with safe road behaviour of parents as pedestrians with their young
      children in Sydney metropolitan and near by cities in New South Wales, Australia.
      Parental perception of the road environment as hazardous associated significantly
      with their safe road behaviour as pedestrian while with their children. This held
      true even after adjusting for the non-English speaking background and the age of
      the child. Knowledge of road rules, on the other hand, was not associated with
      parental safe road behaviour. The results of this study suggested that parental
      safe road behaviour require much attention in future research and in programme
      development. The perception of the road environment is a very important factor in
      motivating safe road behaviour. This should be taken into consideration in
      designing road safety campaigns.

PMID- 11204892
TI  - A linkage study of Western Australian drink driving arrests and road crash
      records.
AB  - Records of drivers in all reported road crashes occurring in Western Australia
      between 1987 and 1995 were linked with records of all drink driving arrests in
      the same period. About 7% of all drink driving arrests occurred because of a road
      crash. Differences were observed between these drink-driving crashes and other
      types of road crashes. Drink driving crashes tended to be more severe than those
      not involving alcohol. Serious crashes (involving fatalities or hospitalisations)
      accounted for 20% of alcohol-related crashes, but only 6% of all crashes reported
      over the study period. From another perspective, crash-related drink-driving
      arrests were more likely than routine enforcement arrests to involve younger (18
      35 years) and older (65 years and over) drink drivers. Routine enforcement
      arrests, on the other hand, were likely to involve a greater proportion of
      Aboriginal drivers.

PMID- 11204893
TI  - Novice drink drivers, recidivism and crash involvement.
AB  - A group of drink drivers with no prior arrest for drink driving was selected from
      drink driving arrest records originating in Western Australia between 1987 and
      1995. These drink-driving records were linked to road crash records for the same
      period. The analysis of these combined records focussed on the sequence of
      driving events (i.e., arrests, crashes and arrests resulting from crashes) and
      the present article explores the relationship in time between known drink driving
      incidents and crash involvement. Using multi-variate survival analysis, it was
      found that if a driver's first drink driving offence resulted from a road crash,
      especially if this occurred at a younger age, he/she was significantly more
      likely to drink, drive and crash again.

PMID- 11204894
TI  - Relationship of parent driving records to the driving records of their children.
AB  - Many studies have shown that young driver crash rates can be influenced by such
      factors as lifestyle characteristics and licensing systems. However, the
      influence of parents on their teenage children's crash and violation rates has
      not received much attention. The present study used data from the North Carolina
      driver history file to match the crash and violation records of young drivers
      between the ages of 18 and 21 with those of their parents. Results indicate that
      children's driving records in the first few years of licensure are related to the
      driving records of their parents. Children whose parents had three or more
      crashes on their record were 22% more likely to have had at least one crash
      compared with children whose parents had no crashes. Likewise, children whose
      parents had three or more violations were 38% more likely to have had a violation
      compared with children whose parents had none. Logistic regression models showed
      that these relationships held when controlling for household type and child
      gender.

PMID- 11204895
TI  - Restraint use patterns for older child passengers in Michigan.
AB  - The purpose of the present study was to conduct the first statewide direct
      observation survey of restraint use designed specifically for older child
      passengers (4-15 years of age). We also sought to determine the factors that were
      related to belt use by older child passengers in Michigan so that effective
      programs could be developed to promote use of restraint devices in this age
      group. The study found that older child restraint use was about 58% statewide.
      Restraint use was highest in regions where overall belt use was higher, when the
      driver was using a safety belt, in sport utility vehicles and vans/minivans, and
      in the front-right seating position. No difference in restraint use was found for
      the day of week, the sex of the child, or the type of site where data was
      collected. The study provides the largest scale analysis to date on older child
      occupant restraint use patterns. The data provide some much needed empirical data
      on the restraint use patterns of older child passengers for development of theory
      to better understand and predict lack of restraint use in this age group.

PMID- 11204896
TI  - Are aggressive people aggressive drivers? A study of the relationship between
      self-reported general aggressiveness, driver anger and aggressive driving.
AB  - In this study the relationships among self-reported general aggressiveness,
      impulsiveness, driver anger, and aggressive responses to anger-provoking
      situations on the road were studied. The British version of a driver anger scale
      (UK DAS), aggression questionnaire (AQ), and an impulsiveness questionnaire (I7)
      together with background questions (gender, age, annual mileage) were
      administered to a sample of 270 British drivers. Variation in strength of
      correlations between anger and aggressive reactions in the 21 UK DAS items showed
      that the relationship between driver anger and aggression depends in part on the
      characteristics of the situation. In addition, three path models for describing
      the relationships among the measures were constructed separately for women and
      men. The models suggested that the effects of verbal aggressiveness on self
      reported driver aggression were mediated by driver anger whereas physical
      aggressiveness was directly related to aggressive behaviour. Age was negatively
      related to both driver anger and aggression among men whereas annual mileage was
      negatively related to aggression among women. The models constructed indicate
      that aggressive driver behaviour is a complex phenomenon with a range of
      psychological causes.

PMID- 11204897
TI  - Effects of low-dose alcohol exposure on simulated merchant ship piloting by
      maritime cadets.
AB  - The US Department of Transportation (DOT) regulates on-the-job alcohol use by
      operators of certain categories of commercial transport. For aircraft, trains,
      and commercial vessels, operators are subject to sanctions for having > or = 0.04
      g% blood alcohol concentration (BAC). This study examines the effects of alcohol
      (between 0.04 and 0.05 g% BAC) on simulated merchant ship handling. A two-group
      randomized factorial design was used to compare beverage alcohol to placebo while
      controlling for baseline performance on a previous day. The study was conducted
      in the Maritime Simulation Center at Maine Maritime Academy, Castine, ME.
      Participants were 38 volunteer deck officer cadets in their junior or senior
      year, at least 21 years of age, with previous experience on a bridge simulator.
      Following a baseline trial on Day 1, on Day 2 participants were randomized to
      receive alcohol (0.6 g/kg for males and 0.5 g/kg for females) or placebo. After
      allowing time for absorption, participants completed a bridge simulator task. For
      baseline and performance trials, participants were randomized to one of four
      bridge simulator scenarios, each representing passage of a fully loaded container
      vessel through a channel with commercial traffic. The aggregate scenario score
      given by blinded maritime educators measured performance. A main effect for
      alcohol was found indicating that performance was significantly impaired by this
      low dose of alcohol relative to performance in the placebo condition. These
      findings are consistent with current federal regulations that limit low-dose
      alcohol exposure for the operators of commercial transport vehicles. Further
      research is required to determine effects at lower BACs.

PMID- 11204898
TI  - Accident prototypical scenarios, a tool for road safety research and diagnostic
      studies.
AB  - The concept of prototypical accident scenario has been used since the late 1980s
      in French road safety research. A prototypical scenario can be defined as a
      prototype of the accident process corresponding to a series of accidents which
      are similar in terms of the chain of facts and causal relationships found
      throughout the various accident stages. This concept provides a means of
      combining and generalising the knowledge obtained from accident case studies,
      based on in-depth investigation methods or on detailed analyses of police
      reports. Applications of this concept are developed in both the field of traffic
      accident research and safety studies (diagnoses) in preparation for engineering
      measures or local safety policies. This paper presents the prototypical scenario
      concept, its theoretical background, and the way it is used for safety research
      and studies.

PMID- 11204899
TI  - The relative effectiveness of a hidden versus a visible speed camera programme.
AB  - Overtly operated mobile speed cameras have been used in New Zealand since late
      1993. Their operation has been confined to specific sites (called 'speed camera
      areas') which are mainly road sections with a record of speed-related crashes. A
      trial of hidden speed cameras began in mid-1997 in 100 km/h speed limit areas in
      one of New Zealand's four Police regions. This trial was still in progress at the
      time of writing and the current paper reports the results of an evaluation of the
      first year of the trial. During that period, the hidden cameras and related
      publicity were found (compared with the generally highly visible speed camera
      enforcement in the rest of New Zealand) to be associated with net falls in
      speeds, crashes and casualties both in speed camera areas and on 100 km/h speed
      limit roads generally. There were initial changes in public attitudes in response
      to the programme that later largely reverted to pre-trial levels. Compared with
      the localised effect of visible cameras on speeds and crashes mainly in speed
      camera areas, the hidden cameras had a more general effect on all roads. As
      further crash, speed and attitude data become available, the longer-term effects
      of the hidden camera programme will be evaluated.

PMID- 11204900
TI  - Passengers' injuries reflected carriage interior at the railway accident in
      Mundelstrup, Denmark.
AB  - On 1st March 1994, a passenger train with a speed of 85 km/h ran into the rear
      end of a stopped passenger train north of Aarhus, Denmark. No fatalities
      occurred. Questionnaires were sent to passengers and crew and 113 of 128 (88%)
      answered. In the stopped train 32% (9/28) of the sitting passengers compared with
      12% (9/76) in the moving train had symptons corresponding to a whiplash lesion.
      Only the chairs in the moving train had head rests which might explain the
      observed difference. In the rest section of the moving train with all seats
      facing the same direction 81% (13/16) of the sitting passengers had face injuries
      compared to 13% (8/60) in the rest of the train. The higher incidence in the rest
      section was caused by folding tables at the back of the seats. Serious thoraco
      abdominal injuries were only seen in one patient despite the fact that 37
      passengers were thrown againsts tables between the seats in the second class
      section of the moving train. The tables were fragile and usually gave way. In
      conclusion, carriage interior has a major influence on personal injuries at
      railway accidents.

PMID- 11204901
TI  - The secrets of involvement, Part II.

PMID- 11204902
TI  - A handy interviewing tool.

PMID- 11204903
TI  - State-of-the-art exhaust hood.

PMID- 11204904
TI  - Taking out violence.
AB  - An analysis of how consequences impact your company from inside or outside will
      enable you to prevent the situations that can build up until they explode into
      violence. Specific skill enhancement on the use of feedback and consequences will
      broaden the base of involvement and foster early intervention opportunities
      before things get out of control. Understanding how consequences influence
      behavior also can improve self-management efforts. When these strategies are
      coupled with security hardware and appropriate policies, we can once again help
      our managers and employees work without fear of violence.

PMID- 11204905
TI  - Solving the language barrier.

PMID- 11204906
TI  - Compliance and procurement in the e-age.

PMID- 11204907
TI  - Slips & falls on the manufacturing floor.

PMID- 11204908
TI  - From conversation to commitment.

PMID- 11204909
TI  - Automation paves the way to improved gas monitoring.

PMID- 11204910
TI  - The basics for smaller businesses.

PMID- 11204911
TI  - Making sense of hand protection.

PMID- 11204912
TI  - Building employee enthusiasm.

PMID- 11204913
TI  - Ryder gets it done.

PMID- 11204914
TI  - Reducing the severity of MSDs in manufacturing.

PMID- 11204915
TI  - It's all in the adjustments.

PMID- 11204916
TI  - Revitalizing your ergonomics program.

PMID- 11204917
TI  - Jeffress's big bang.

PMID- 11204918
TI  - [Epidemiology of nosocomial infections in pediatrics].
AB  - The overall incidence of nosocomial infections (NI) in pediatrics ranges between
      2.3% to 12.6%. They have great variations according to age (7-12% under 1 year of
      age vs 1.5-4% after ten years of age), and the nature of the unit (3-26% in
      intensive care units vs 1-4% in general pediatrics). The main sites of infection
      are in children gastrointestinal infections (10-35% of NI) and bacteremia (10-23%
      of NI) whereas in adults urinary tract infections (31.7 to 35%) and respiratory
      infections (19 to 25%) are the most frequent. Viruses represent 22-27% of the
      isolated pathogens, and Gram positive cocci 31-50% (half of them are coagulase
      negative staphylococci). The most frequent Gram negative bacilli are Pseudomonas
      aeruginosa (9-15%), E. coli (6-16%) and Klebsiella pneumoniae (3-5%). Candida
      represent 3% of isolated pathogens in NI. The proportion of methicilline
      resistant Staphylococcus aureus is lower in children than in adults. The
      prevalence of methicillin resistance of CNS is however close to that observed in
      adults, as is the multiresistance of Gram negative bacilli (Klebsiella). Candida
      infections seem an emerging problem in paediatrics. These results underline the
      necessity to limit the antimicrobial therapy in children as in adults.

PMID- 11204919
TI  - [Epidemiology of viral nosocomial infections in pediatrics].
AB  - Nosocomial viral infections account for at least 5% of the total of NI and reach
      23% in pediatric wards. The nosocomial infection (NI) incidence rate varies from
      0.59 to 0.72 per 100 patients in pediatric wards. Many viruses have been
      associated with NI in pediatric wards. Rotavirus and respiratory syncytial virus
      (RSV) are the most frequent. Other viruses frequently identified are:
      calicivirus, adenovirus, astrovirus, influenza et para-influenza, rhinovirus and
      coronavirus. Asymptomatic infections occur frequently. The period of
      communicability varies and depends on the virus. It often begins before the
      clinical signs appear and ends after the healing. Viral shedding may be
      intermittent. Children and hospital environment and less frequently hospital
      staff are the main source for the virus. Poor handwashing results in direct
      spread to patient or self-inoculation even for respiratory viruses like RSV and
      rhinovirus. The main risk factors for NI are prolonged hospital stay, past
      history of prematurity and low age. Immunocompromised patients constitute a
      special high-risk group. Understaffing is also a risk factor. Minimal infective
      doses depend on the route of inoculation and the kind of virus. Low doses are for
      example sufficient for rotavirus, adenovirus and calicivirus. Viral inactivation
      is all the more easy when there is an envelope. Handwashing and appropriate
      isolation (technical and geographical) are the mainstay of prevention of viral
      NI. Vaccines are promising, especially for rotavirus.

PMID- 11204920
TI  - [Nosocomial infections in immunocompromised children].
AB  - Immunocompromised children are at high risk for developing nosocomial infections
      which may cause significant morbidity and mortality in this population. In
      paediatric oncology, reported prevalence of nosocomial infections varies from 10
      to 20%. Major predisposing factors are neutropenia, central venous catheter,
      corticosteroid therapy and hospital construction or renovation for invasive
      aspergillosis. The management of patients with febrile neutropenia should take
      into account the previous history of infection and the microbiologic environment
      of each department. Nowadays, Gram positives infections are predominant, but
      fungal infections remain a major threat. In organ transplant recipients, wound
      infections are the main early problems, followed by viral infections often due to
      the donor CMV seropositivity. In HIV-infected children, nosocomial infections are
      difficult to define, and can implicate unusual pathogens. In general, adapted
      preventive infection control strategy warrants prospective studies.

PMID- 11204921
TI  - [Nosocomial infections in mother and child: specific risks in the labour ward].
AB  - Nosocomial infection is a frequent and potentially lethal complication in
      obstetrics. The incidence of this complication may be underscored and an accurate
      surveillance system must be used in each obstetrics unit for infection control.
      This surveillance system should also identify the patients at risk for infection
      in order to improve prevention efforts. beta-lactam-sensitive streptococcus is
      often involved in obstetrical infections and a short antibio-prophylaxis is
      indicated in most obstetrical procedures. Disinfection strategy, guidelines for
      clinical practice and control charts should be established in each obstetrics
      unit to prevent nosocomial infections.

PMID- 11204922
TI  - [Efficacity of antiseptic products].
AB  - Chemical antiseptics are used in specified conditions. This work studied the
      actual standards to evaluate the activity of antiseptics. Afterward, the main
      indications of antiseptics are summarized.

PMID- 11204923
TI  - [Nosocomial infections in pediatrics. Problems and perspectives].
AB  - High incidence of nosocomial infections in children is largely explained by
      immunodeficiency, particularly in newborns. Central venous catheter is the main
      risk factor and coagulase negative staphylococcus the main pathogen in cause.
      Large variations of nosocomial infection incidences are observed by Nososcomial
      Infection Surveillance Networks and depend on the pediatric speciality. The
      highest rate is observed in neonatal intensive care, where incidence density of
      catheter-related sepsis varies from four to 23 infections for 1000 catheter-days.
      Local surveillance in each ward, risk factors and knowledge of bacterial
      epidemiology allow the development of rational preventive and therapeutic
      protocols. However, prophylactic use of vancomycin is dangerous and
      immunoglobulins are inefficient.

PMID- 11204924
TI  - [Recent developments of spoligotyping as applied to the study of epidemiology,
      biodiversity and molecular phylogeny of the Mycobacterium tuberculosis complex].
AB  - Spoligotyping (for 'spacer-oligonucleotide-typing'), a rapid method for
      genotyping of Mycobacterium tuberculosis complex using the principle of reverse
      hybridization, is based on the structure of the direct repeat (DR) locus. The DR
      locus is made up of a variable number of 36 bp DR repeats that are separated by
      unique inter-DR sequences of 35 to 41 bp. Fast and highly discriminatory,
      spoligotyping is an useful alternative to the IS6110-RFLP reference method for
      molecular typing of M. tuberculosis, in particular for isolates possessing five
      or few copies of IS6110. In this paper, we review the state of the art of
      spoligotyping through its main current applications. After a brief introduction
      to the principle of the technique and its description, we successively review
      recently published results concerning the molecular epidemiology of tuberculosis
      in humans and cattle, and discuss the main genotyping strategies currently in use
      to fingerprint the M. tuberculosis complex organisms. We also describe the recent
      applications of spoligotyping to study ancient DNA and report on recent
      developments of this technique to study the biodiversity of the M. tuberculosis
      complex, its contribution towards improved taxonomy and phylogenetics of the M.
      tuberculosis complex. Last but not least, potential applications of spoligotyping
      to study DNA recombination mechanisms are also discussed.

PMID- 11204925
TI  - [Comparative antibacterial activity of cefotaxime, ceftazidime and cefepime with
      regard to different strains of Enterobacter aerogenes selected for their
      resistance to third generation cephalosporins].
AB  - After being confronted with the isolation in our laboratory of numerous
      antibiotic-multiresistant Enterobacter aerogenes strains, we studied the in vitro
      antimicrobial activity of cefotaxime, ceftazidime, and cefepime alone or in
      association with sulbactam. For that, we selected 67 isolates according to their
      low level of susceptibility to cefotaxime. First, we deduced from a synergy test
      in presence of clavulanic acid and cloxacillin the production of an extended
      spectrum beta-lactamase (ESBL) and/or an overproduction of a chromosomal
      cephalosporinase. Three groups of strains were thus defined: one group of ESBL
      strains, another group of overproducing strains of chromosomal cephalosporinase,
      and a last group that produced the two types of enzymes. Minimal inhibitory
      concentrations (MICs) of each cephalosporin alone or in presence of 8 mg/L of
      sulbactam, gentamicin or amikacin were measured. Our results demonstrated the
      best activity of cefepime: MICs were low with a value inferior to 4 mg/L
      independently of the type of beta-lactamase. They were lower than 0.5 mg/L in
      presence of sulbactam against ESBL-producing strains. The cephalosporins could be
      used in association with aminoglycosides according to their susceptibility.

PMID- 11204926
TI  - [Veterinary use of antibiotics and resistance in man: what relation?].
AB  - Early in the 1950's antibiotic therapy was introduced in humans, as well as in
      animals. In 1997 48% of the total European antibiotic sales were intended to
      veterinary use. However, there are significant differences between antibiotic
      classes regarding either administered quantities or intent for use, e.g. growth
      factor or therapeutic use. Furthermore, food chain or direct contact may be
      responsible for antimicrobial resistance through animal-to-human transmission.
      Although various preventive measures were implemented during the past years,
      evidence of public health risks has been demonstrated. This should lead to better
      use of antibiotic therapy not only in animal husbandry but also in medical
      practice.

PMID- 11204927
TI  - [Organic pig farming: what about parasitic infections?].
AB  - The parasitological problems that may arise in organic pig farming are discussed.
      The rearing of pigs outdoors increases substantially the chances that several
      parasite species will complete their life cycle. Moreover, zoonoses may play an
      important role. Parasite species that may cause problems are discussed, as are
      control measures, when possible.

PMID- 11204928
TI  - [Protocol for post partum cows].

PMID- 11204929
TI  - [BSE testing in the Netherlands].

PMID- 11204930
TI  - [Artificial insemination].

PMID- 11204931
TI  - Evidence based medicine, RCTs and their natural enemies: the clinical
      pharmacologist's role.

PMID- 11204932
TI  - Drug-related visits to the medical emergency department: a prospective study from
      India.
AB  - OBJECTIVE: To analyze the contribution of adverse drug events (ADEs) to the
      overall number of visits to the medical emergency and to determine the proportion
      of events leading to hospital admissions. PATIENTS AND METHODS: All visits to the
      medical emergency were recorded in a prospective, non-interventional design study
      over a period of 8 months. The ADEs were divided into 5 categories: adverse drug
      reactions (ADRs), drug interactions, patient non-compliance, physician non
      compliance, and drug overdose. The cases were then followed-up to assess the
      prorportion of ADEs lead to hospitaliztion. RESULTS: A total of 4764 patients
      were included in the study. 5.9% of all visits were considered to be drug
      related. The highest percentage of ADEs was observed in the age group less than
      20 and more than 80 years. ADRs accounted for 45% of all ADEs, followed by
      patient non-compliance (28%). Patient and physician non-compliance were the main
      causes of drug-related hospital admissions. 52% of all ADE-related visits and 55%
      of ADE-related admissions were considered to be preventable. Non-steroidal
      antiinflammatory agents, oral hypoglycemics and antitubercular drugs were
      responsible for 37% of all ADRs. Non-compliance was mainly seen in hypertensives,
      asthmatics and epileptics. CONCLUSION: ADEs account for a sizable proportion of
      all visits to a medical emergency unit and some are serious enough to require
      hospitaliztion. A large number of ADE-related visits and admissions are
      preventable which highlights the importance of public education on the proper use
      of drugs, and also the need for regulation of the practice of unregistered
      medical practitioners in developing countries.

PMID- 11204933
TI  - Effect of calcium antagonists on stress-induced rise in blood pressure and heart
      rate: a double-blind, placebo-controlled study.
AB  - OBJECTIVE: The current study was designed to evaluate the effect of treatment
      with calcium antagonists on stress-induced increases in blood pressure and heart
      rate. SUBIECTS, MATERIAL AND METHODS: Two models of stress were chosen, cold
      stress and isometric handgrip exercise. Six healthy volunteers were randomized to
      receive amlodipine (5 mg), lacidipine (4 mg) for a two-day period in a double
      blind, crossover design. Thirty hypertensive patients received the same treatment
      for a period of one week in a double-blind, parallel design. The effects of
      stress on blood pressure and heart rate were taken at baseline and after drug
      treatment. RESULTS: Cold stress and handgrip exercise significantly increased the
      systolic and diastolic blood pressure as well as the heart rate. In normotensive
      volunteers, the resting heart rate and blood pressure were not altered by the
      drugs. The increase in systolic and diastolic blood pressure produced by cold
      stress and isometric exercise were unchanged by amlodipine and lacidipine. In
      hypertensive patients, both drugs reduced the resting blood pressure (p < 0.05).
      As in normotensive individuals, the pressor response to stress was not altered by
      the drugs. CONCLUSION: Cold stress and handgrip exercise produced a significant
      rise in blood pressure and heart rate in normotensive volunteers and patients
      with hypertension. Cardiovascular reactivity to cold stress and handgrip exercise
      is not altered by the administration ofamlodipine and lacidipine.

PMID- 11204934
TI  - Caffeine metabolism in a group of 67 patients with primary biliary cirrhosis.
AB  - OBJECTIVE: To evaluate the polygenic regulated caffeine metabolism in a group of
      67 patients with a documented primary biliary cirrhosis (PBC) classified
      according to the histologic stage proposed by Scheuer. METHODS: Over a 14-year
      period, drug liver metabolism, using caffeine as a probe drug, has been
      systematically carried out in addition to the usual clinical, histological and
      biochemical investigations performed in patients with PBC. The "Caffeine test"
      consisted of a 200 mg caffeine oral intake. Urines were collected over 24 hours:
      caffeine (137X), 1-7-dimethylxanthine (17X), 1-3-dimethylxanthine (13X), 1-3
      dimethylurate (13U), 3-7-dimethylxanthine (37X), 1-7-dimethylurate (17U), 1
      methylxanthine (1X), 1-methylurate (1U), 7-methylxanthine (7X), 3-methylxanthine
      (3X), and 5-acetylamino-6-formylamino-3-methyluracyl (AFMU) were analyzed by high
      performance liquid chromatography (HPLC). Total and individual metabolite urinary
      elimination rates were expressed in micromol/24 hours. Enzyme activities were
      evaluated from the following urinary metabolite ratios: (AFMU+1U+1X)/17U for
      CYP1A2, 17U/17X for CYP2A6, AFMU/(AFMU+U+ 1X) for NAT-2, 1U/1X for XO. RESULTS:
      Compared to healthy subjects, patients with PBC presented a reduced metabolism of
      caffeine due to a decreased CYP1A2 activity, all the more important since the
      patients had an advanced histological stage. This picture was nearly identical to
      the observed picture in chronic liver diseases from various origins. PBC affected
      the various metabolic pathways of caffeine in a differential manner. CYP1A2
      activity was decreased but XO and mainly CYP2A6 activities were increased as
      shown by the raised urinary ratio 17U/total metabolite elimination. In contrast
      to the described loss of bimodality of the NAT-2 index distribution in patients
      with alcoholic cirrhosis, we found a clear-cut, bimodal distribution in patients
      with PBC, without a high incidence of slow acetylator status. CONCLUSION:
      Metabolism of caffeine is strongly and differentially disturbed in patients with
      PBC and apparently not exactly in the same way as that in alcoholic cirrhosis
      which is more often taken as an index of chronic liver disease. This suggests the
      need for caution with medicines whose metabolism is under polygenic regulation.
      Because of the relationships between caffeine metabolism modifications and
      histological stages, the caffeine test might be used along with the usual tests
      to safely follow-up the evolution of the disease.

PMID- 11204935
TI  - Piroxicam concentrations in plasma and synovial fluid after a single dose of
      piroxicam-beta-cyclodextrin.
AB  - AIMS: The efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in rheumatic
      diseases depends on their concentrations within the joint. We determined
      piroxicam concentrations in plasma and synovial fluid (SF) after a single oral
      dose of 20 mg in the form of one tablet of piroxicam-beta-cyclodextrin. METHODS:
      45 patients, aged 21 to 84 years, presenting with an effusion of the knee,
      related to degenerative or inflammatory joint disease, were included in this
      study after having given their written consent. One blood and one SF sample were
      drawn concomitantly in each patient from 0.5 to 48 h after NSAID administration.
      Piroxicam assays were performed by high performance liquid chromatography.
      Pharmacokinetic parameters were obtained from the mean plasma and synovial
      concentrations measured at various sampling times. RESULTS: The peak
      concentration was higher in plasma (2.51+/-0.25 microg/ml) than in SF (1.31+/
      0.76 microg/ml), but the elimination half-life was much longer in SF (90.7 h)
      than in plasma (32.5 h). The SF/plasma area under the concentration-time curve
      ratio (evaluating the quantity of NSAID transferred from the blood to the joint)
      was equal to 0.39. CONCLUSIONS: Piroxicam contained in piroxicam-beta
      cyclodextrin diffused well into the SF where its pharmacokinetic profile
      corresponded to that of a long half-life NSAID.

PMID- 11204936
TI  - Estimated coefficient of variation values for sample size planning in
      bioequivalence studies.
AB  - OBJECTIVE: The aim of the present communication is to provide information
      regarding the intrasubject coefficent of variation obtained from 30
      bioequivalence studies covering 16 drugs which can be used for estimation of
      sample size. Additionally, an attempt was also made to estimate the test power of
      each of the studies conducted. METHODS: The intrasubject coefficient of variation
      was estimated from the residual mean square error obtained from analysis of
      variance of the parameters AUC0-infinity, Cmax and Cmax/AUC0-infinity after
      logarithmic transformation. The test power in the analyses of the above
      parameters was subsequently estimated using nomograms provided by Diletti et al.
      [1991]. RESULTS AND CONCLUSION: Thirty products covering 16 drugs were studied in
      which 22 were immediate-release (including one dispersible tablet) and 8 were
      sustained-release formulations. The intrasubject coefficient of variation for the
      parameter AUC0-infinity was smaller than Cmax, and hence considerably more
      studies were able to attain a power of greater than 80% using 12 volunteers for
      the AUC0-infinity, compared to the Cmax. However, the variability in the Cmax
      could be reduced by using the parameter Cmax/ AUC0-infinity, and thus, provide a
      more realistic estimation of sample size, since the latter reflects only the rate
      of absorption and not both the rate and extent as in the case of Cmax [Endrenyi
      et al. 1991].

PMID- 11204937
TI  - Antiviral drugs in chronic hepatitis B: review and meta-analysis.
AB  - Many researchers have attempted to identify the drugs capable of acting on the
      viral replication cycle and maintaining clinical remission in chronic hepatitis
      B. We evaluated the efficacy of antiviral drugs in chronic hepatitis B, by
      examination of 20 controlled and non-controlled trials conducted between 1985 and
      1996. In chronic hepatitis B, adenine arabinoside and its monophosphate did not
      achieve satisfactory results, even though combination therapy with cortisone
      seemed to achieve very good results (remission rates ranging from 45% to 66% in
      patients treated). Lamivudine did not seem to furnish lasting effects in chronic
      hepatitis B, because many patients relapse after suspension of the treatment due
      to the appearance of HBV variants resistant to the drug. Contrasting results were
      observed with famciclovir. Treatment of chronic hepatitis B, with this drug
      seemed capable of reducing HBV-DNA serum levels by a mean of 50% compared to
      pretreatment values, with normal alanine aminotransferase levels in about 30% of
      treated patients. Ganciclovir treatment of chronic hepatitis B seemed to furnish
      good, but transient, results. Even if no antiviral drug represented a valid
      alternative to interferon, antivirals may become the drugs of choice in chronic
      hepatitis B, because they are aimed at the etiology of disease.

PMID- 11204938
TI  - Bioequivalence and relative bioavailability of three estradiol and norethisterone
      acetate-containing hormone replacement therapy tablets.
AB  - OBJECTIVE: The primary objective was to demonstrate bioequivalence between the
      estrogen components ofActivelle (1 mg estradiol (E2) + 0.5 mg norethisterone
      acetate (NETA)) and the combined phase of Novofem (1 mg E2 + 1 mg NETA) and
      between the NETA components of the combined phase of Novofem (1 mg E2 + 1 mg
      NETA) and Trisequens (2 mg E2 + 1 mg NETA). SUBJECTS, MATERIALS AND METHODS: The
      study design was double-blind, randomized, three-way, balanced six-sequence cross
      over. The washout period was 14 days between treatments. Single doses of the
      above-described tablets were administered in the morning following an overnight
      fast to 24 healthy postmenopausal or bilaterally oophorectomized women. Plasma
      concentration profiles of E2, estrone (E1; pharmacologically active metabolite of
      E2) and norethindrone (NET: NET was determined since NETA is very rapidly
      metabolized to NET) were measured over 72 h, and 36 h, respectively. For the two
      former substances a baseline correction was performed by subtracting the mean of
      two predose measurements from the concentrations measured after dosing. RESULTS:
      One subject dropped out of the study, completing only one treatment sequence;
      therefore, the results are based on 23 subjects. The baseline-corrected E2 and E1
      AUC0-t (Novofem)/AUC0-t (Activelle) ratios were 105% and 100%, respectively; and
      the Cmax ratios 100% and 105%, respectively. Identical median tmax was observed
      for E2 (6 h) and for E1 (5 h). The NET AUC0-t (Novofem)/AUC0-t (Trisequens) ratio
      was 95%, and the corresponding Cmax ratio 98%. The median tmax for Novofem was
      0.75 h and for Trisequens 1.0 h. CONCLUSION: Bioequivalence was demonstrated for
      E2, E1 and NET in accordance with the study objectives.

PMID- 11204939
TI  - Use of charge-transfer complex formation for the spectrophotometric determination
      of nortriptyline.
AB  - Three simple and selective methods are proposed for the determination of
      nortriptyline hydrochloride in bulk form and in tablets. The first two methods
      are based on the formation of charge-transfer complexes between the drug base as
      a n-donor and quinhydrone or p-chloranil as pi-acceptor. The products exhibit
      absorption maxima at 497 and 560 nm in acetonitrile for quinhydrone and p
      chloranil, respectively. The third method is based on the interaction of N
      alkylvinylamine formed from the condensation of the free secondary amine group
      and acetaldehyde with p-chloranil to give a vinylamino substituted quinone. The
      coloured product exhibits an absorption maximum at 650 nm in dioxane. All
      variables were studied to optimize reaction conditions. Beer's law was obeyed and
      the relative standard deviations were found to be less than 1.5%. The methods
      have been applied to the analysis of nortriptyline hydrochloride in the bulk drug
      and in tablets.

PMID- 11204940
TI  - Synthesis and calcium antagonistic activity of 2,6,6-trimethyl-3
      carbomethoxy(ethoxy)-4-aryl-1,4,5,6,7,8-hexahydroquinoline derivatives.
AB  - Twelve new 2,6,6-trimethyl-3-carbomethoxy(ethoxy)-4-aryl-1,4.5,6.7,8
      hexahydroquinoline derivatives have been prepared. Their structures were
      confirmed by IR, 1H NMR, mass and elemental analysis. The calcium antagonistic
      activity of these compounds was tested in rat aortic rings precontracted with 30
      mM K+. The compounds IVa, IVc, IVe, IVf, IVh-l induced concentration dependent
      relaxation response in precontracted aortic rings. The concentrations that cause
      50% relaxation of K+-contraction were also calculated for the compounds IVe, IVf,
      IVj. According to pharmacological results, compound IVl exert the most activity
      and compound IVc has been found to be least active in this series. The methyl
      ester derivatives carrying mono halogensubstitutent in the phenyl ring, the
      activity order is F > Br > Cl. Replacement of the substituted phenyl ring with
      the pyridine ring increases the activity.

PMID- 11204941
TI  - 3H-[1,2]Dithiolo[3,4-b]pyridine-3-thione and its derivatives synthesis and
      antimicrobial activity.
AB  - A series of 2-substituted isothiazolo[5,4-b]pyridine-3(2H)-thiones,
      isothiazolo[5,4-b]pyridin-3(2H)-ones, N-substituted 2-sulfanylnicotinamides and
      the corresponding carbothioamide derivatives were synthesized and evaluated for
      their antimicrobial activity against several strains of Gram+ and Gram- bacteria
      and fungi. Chemical syntheses were resumed into a comprehensive cyclic route that
      enables the reversible conversion for each derivative of the series considered.
      Among the tested compounds the N-(aralkyl)-2-sulfanylnicotinamides show the
      highest fungitoxicity (MIC = 1.25-5 microg/ml). The best activity towards Gram
      positive bacteria was in the range of 2.5-5 microg/ml. Activity against Gram
      negative bacteria was generally very poor for all compounds.

PMID- 11204942
TI  - Kinetic spectrophotometric determination of ampicillin and amoxicillin in dosage
      forms.
AB  - A kinetic spectrophotometric method has been developed for the determination of
      ampicillin (I) and amoxicillin (II). The method involves hydrolysis of the
      antibiotics with 1.0 M HCl, neutralization with 1.0 M NaOH followed by addition
      of palladium(II) chloride in the presence of 2 M KCl. The produced yellow colour
      is measured at 335 nm. The proposed method is valid over the concentration range
      8-40 microg/ml and 10-40 microg/ml for I and II respectively with minimum
      detectability of 0.73 microg/ml and 0.76 microg/ml for I and II respectively. The
      determination of the studied compounds adopting the fixed concentration method is
      feasible with the calibration equations obtained, but the fixed time method has
      been found to be more applicable. The proposed method was applied to commercial
      dosage forms and the results obtained were in good agreement with those given by
      USP method.

PMID- 11204943
TI  - Simultaneous determination of benzocaine and cetylpiridinium chloride in tablets
      by first-derivative spectrophotometric method.
AB  - A new spectrophotometric method for the simultaneous determination of benzocaine
      and cetylpiridinium chloride in pharmaceutical tablets, which does not require
      any preliminary separation or treatment of the samples, is described. The
      quantitative determination of both drugs was carried out using the first
      derivative values measured at 231.40 and 310.00 nm for benzocaine and at 220.70
      nm for cetylpiridinium chloride using the zero-crossing method. The calibration
      graphs were linear in the ranges from 10 to 25 mg/l of benzocaine and from 4 to
      20 mg/l of cetylpiridinium chloride. The developed method was successfully
      applied for the assay of pharmaceutical tablets and proved to be simple,
      sensitive and selective. Thermogravimetric techniques, Karl Fischer and loss on
      drying were also used for a stoichiometric evaluation of the substances studied.

PMID- 11204944
TI  - Voltammetric determination of N,N'-dinitrosopiperazine in simulated gastric
      juice.
AB  - A voltammetric method has been developed for the determination of N,N'
      dinitrosopiperazine (DNPZ) in simulated gastric juice. The method is based on
      measuring the differential pulse polarographic peak produced in pH 3 Britton
      Robinson buffer. A well defined, diffusion-controlled cathodic wave was obtained
      at -0.77 V versus Ag/AgCl over the range 0.4-24 microg/ml with minimum
      detectability (S/N = 2) of 0.072 microg/ml (5 x 10(-7) M). The proposed method
      was successfully applied to study the possible in vivo production of the nitroso
      derivatives of piperazine under the standard nitrosation reaction conditions
      recommended by WHO. The method has some distinct advantages over the reported GC
      methods.

PMID- 11204945
TI  - Physico-chemical and solid-state characterization of secnidazole.
AB  - Secnidazole (hydroxy-2-propyl)-l-methyl-2-nitro-5-imidazole) is an antimicrobic
      agent. This drug has pharmacological activity against intestinal and hepatic
      amebiasis, giardiasis and vaginal trichomoniasis. This paper shows the
      physicochemical parameters of secnidazole determined during a preformulation
      study. The determination of the apparent partition coefficient and the profile of
      solubility in dependence of pH demonstrate the basic characteristic of the drug.
      The dissolution assay was performed to evaluate its behavior in water. For this
      purpose, a new spectrophotometric method, which was linear from 5 to 15
      microg/ml, sensitive, precise, accurate and selective, was validated to assay the
      bulk drug. The evaluation of higroscopicity revealed that the drug is unstable
      above 54% of relative humidity. Rheological properties, such as porosity, tapped
      and bulk densities and percentage of compressibility were calculated. Results
      show a bad rheological characteristic for this drug. DSC curves do not show any
      physical interaction between the drug and the excipients in the compatibility
      studies.

PMID- 11204946
TI  - 4-Hydroxycoumarin in heterocyclic synthesis. Part III. Synthesis of some new
      pyrano[2,3-d]pyrimidine, 2-substitute.
AB  - The synthesis of new [1]benzopyrano[3',4':5,6]pyrano[2,3-d]pyrimidines and
      related heterocycles has been reported. The key intermediate 2-amino-3-cyano-4
      methyl-4H,5H-pyrano[3,2-c][1]benzopyran-5-one (3) was obtained in one pot
      synthesis from the reaction of 4-hydroxycoumarin and acetaldehyde-malononitrile
      (2). The antimicrobial screening was performed for some of the synthesized
      compounds.

PMID- 11204947
TI  - Synthesis and antimicrobial activity of some new 4-hydroxy-2H- 1,4-benzoxazin
      3(4H)-ones.
AB  - Some 4-hydroxy-2H-1,4-benzoxazin-3(4H)-ones were synthesized and evaluated for
      their antimicrobial activities against Staphylococcus aureus, Escherichia coli
      and Candida albicans. Compounds 9, and 10 exhibited the best activity against
      Candida albicans.

PMID- 11204948
TI  - Synthesis, anti-inflammatory and antimicrobial activities of new 1,2,4
      oxadiazoles peptidomimetics.
AB  - A new series of 1,2,4-oxadizoles 6a-g have been synthesised in good yields using
      the peptide synthesis strategy. The prepared compounds were tested for anti
      inflammatory and antimicrobial activities. The anti-inflammatory activities were
      determined in the rat paw oedema induced by carrageenin. Compounds 6a, c, f and g
      (i.v.) significantly inhibited the rat paw oedema induced by carrageenin
      depending upon the dose employed. The compounds were also evaluated for their in
      vitro antimicrobial activity. Some compounds were found to have significant
      activity against Gram positive and Gram negative microorganisms.

PMID- 11204949
TI  - Quinazoline derivatives with antitubercular activity.
AB  - 4-Quinazolinol was prepared by the reaction of anthranilic acid and formamide.
      The hydroxy group was converted into the thiol function by treatment with
      phosphorus(V)sulfide, and the subsequent alkylation of the thiol group was
      carried out with alkylhalides under the conditions of phase-transfer catalysis.
      The structure of the substances was confirmed by 1H, 13C NMR, IR, and MS. Most of
      the synthesized compounds exhibited antimycobacterial activity against the
      strains of Mycobacterium tuberculosis, Mycobacerium avium, Mycobacterium
      fortuitum, Mycobacterium kansasii and Mycobacterium intracellulare. 4-(S
      Butylthio)quinazoline (3c) was even more active than isoniazide against atypical
      strains of mycobacteria.

PMID- 11204950
TI  - Structure-activity relationships for the analgesic activity of gallic acid
      derivatives.
AB  - Values of ID50 for a collection of structurally-related gallic acid derivatives
      have been employed to create a predictive quantitative structure-activity
      relationship (QSAR) which links structure to values of analgesic activity. The
      QSAR model developed has substantial predictive power for the design of novel
      gallic acid derivatives having improved analgesic potency.

PMID- 11204952
TI  - Nature and Nurture in Epilepsy and Psychiatry: Implications for New Treatment
      Strategies. Proceedings of a meeting. Oslo, Norway, June-July 2000.

PMID- 11204953
TI  - Inflammatory bowel disease.

PMID- 11204951
TI  - Prolidase-activated prodrug for cancer chemotherapy cytotoxic activity of proline
      analogue of chlorambucil in breast cancer MCF-7 cells.
AB  - Although prolidase [EC 3.4.13.9] is found in normal cells, substantially
      increased levels are found in some neoplastic tissues. Because prolidase
      possesses the ability to hydrolyse imido bonds of various low molecular weight
      compounds coupled to L-proline, we hypothesized that coupling of L-proline
      through an imido bond to anticancer drugs might create prodrugs which would be
      locally activated by tumour-associated prolidase and consequently would be less
      toxic to normal cells that evoke lower prolidase activity. To test this concept
      we have synthesized a conjugate of chlorambucil-proline (CH-pro) as a possible
      prodrug. Treatment of this prodrug with prolidase generated the L-proline and the
      free drug, demonstrating its substrate susceptibility to prolidase. We have
      compared several aspects of biological actions of chlorambucil (CH) and its
      prodrug in breast cancer MCF-7 cells. IC50 values for chlorambucil and for CH-pro
      in DNA synthesis were found to be 54 and 16 microM, respectively. CH-pro also
      exhibited a lesser ability to inhibit collagen biosynthesis in breast cancer MCF
      7 cells compared to the free drug. The IC50 values for chlorambucil and for CH
      pro in collagen biosynthesis were found to be about 32 and 80 microM,
      respectively. This suggests that the targeting of prolidase may serve as a
      potential strategy for converting antineoplastic prodrugs.

PMID- 11204954
TI  - Surgical options for ulcerative colitis.

PMID- 11204955
TI  - Gastric cancer in Iceland. What is the current status? Survival of 193 patients
      operated on for cure, 1980-1995.
AB  - OBJECTIVE: The incidence of gastric cancer has been decreasing in the last
      decades. Nevertheless, gastric cancer is still a substantial health problem in
      Iceland. The aim of this study was to analyze the survival of patients with
      gastric cancer operated on for cure. MATERIAL AND METHODS: We reviewed all
      medical files for above-mentioned patients, operated on at the National
      University Hospital in Reykjavik and the Quarter District Hospital of Akureyri
      during 1980-1995. The study was divided into three periods: 1980-1985, 1986-1990
      and 1991-1995. The five-year survival for each study period and for the whole
      group was evaluated. RESULTS: The study group included 193 patients between the
      ages of 21-96 (median 71). The five-year survival for the whole group was 28%
      (26% 1980-1985, 22% 1986-1990, 35% 1991-1995). Despite longer survival during the
      last period, it was not statistically significant (p = 0.16). The major survival
      factor of gastric cancer was the stage of the disease at diagnosis. A greater
      number of patients were at stage IA during 1991-1995. The complication rate was
      rather high or 31% and the hospital mortality was 6.7%. CONCLUSION: The survival
      of patients with gastric cancer operated on for cure was low in Iceland but
      comparable to that in other countries. During the last years, the survival has
      been rising, and fortunately, more were diagnosed at a lower stage of the
      disease. These operations have a considerable risk and the hospital mortality was
      substantial.

PMID- 11204956
TI  - Survival after surgery for gastric cancer in patients over 70 years of age.
AB  - BACKGROUND AND AIMS: The increase of the elderly population in western societies
      will result in a considerable increase of gastric cancer patients older than 70
      years requiring surgery. However, higher postoperative morbidity and mortality
      rates after major surgery in the elderly are well recognized. The aim of this
      study was to evaluate the risk factors of mortality and predictors of survival in
      elderly patients with gastric cancer. METHODOLOGY: We reviewed the data of the
      165 patients evaluated for gastric cancer surgery in the Oulu University Hospital
      from January 1985 till December 1994 and made a computer analysis. RESULTS:
      Postoperative mortality was 12% both after all laparotomies and after all
      resections, and 6% after radical resections. Mortality after radical resection
      did not associate significantly with any clinical variable but morbidity was
      associated with the number of coexistent diseases. The median and cumulative 5
      year survivals after radical resections were 40 months and 38%. Survival was
      closely related to diagnostic delay, preoperative loss of weight, two or more
      coexistent disease, location of tumor, and recurrence in univariate analysis, but
      multivariate analysis showed only preoperative weight loss and recurrent disease
      to be independent predictors of survival. CONCLUSIONS: Age alone is not a risk
      factor for postoperative mortality or a predictor of survival among elderly
      patients with gastric cancer. Early detection of malignancy and careful
      preoperative evaluation of the patients referred for resection are needed to
      improve survival.

PMID- 11204957
TI  - Clinicopathological study of mucinous gastric carcinoma.
AB  - BACKGROUND AND AIMS: Mucinous gastric carcinoma (MUC) is relatively a rare
      subtype of gastric carcinoma, and there has been considerable controversiy over
      the prognosis of this type of carcinoma. In this study we tried to analyze the
      clinicopathological differences between MUC and other types of gastric carcinoma
      (non-MUC) and determine whether MUC is associated with a worse prognosis than non
      MUC. MATERIAL AND METHODS: We reviewed 645 patients with pathologically confirmed
      gastric cancer who underwent gastrectomy in our facility during the period from
      1975 through 1997. Among them, 20 patients (3.1%) had gastric carcinoma with
      (MUC), and 625 patients had it without extracellular mucin (non-MUC). In
      addition, we classified MUC into two groups (well-differentiated type; 7 cases
      and poorly differentiated type; 9 cases) and analyzed the differences between
      them. RESULTS: The MUC tumors were more often located in the lower and the upper
      third of the stomach (MUC: 55% and 25%, non-mUC: 41% and 18%, respectively). The
      patients with MUC had more serosal invasion (t3 plus t4; MUC: 45%, non-MUC: 18%),
      more-invasive carcinoma (Type 3 plus 4; MUC: 60%, non-MUC: 36%) and more lymph
      node involvement (MUC: 45%, non-MUC: 38%) than the patients with non-MUC. The
      patients with MUC were more advanced in stage at the time of diagnosis (Stage III
      plus IV; MUC: 50%, non-MUC: 26%) and had a higher peritoneal dissemination rate
      (MUC: 30%, non-MUC: 12%) and a lower curability rate (MUC: 60%, non-MUC: 78%)
      than the patients with non-MUC. The mean size of tumors in MUC (7.4 cm) was
      larger than that of non-MUC (5.5 cm). Therefore, the overall 5-year survival rate
      for MUC patients (33%) was lower than that for non-MUC patients (64%). There were
      no significant differences between well-differentiated and poorly differentiated
      subtypes of MUC except for the curability and peritoneal dissemination rates.
      CONCLUSIONS: The overall survival rate for patients with MUC was worse than that
      for patients with non-MUC. The poor prognosis was correlated with more advanced
      stage at diagnosis and more frequent serosal invasion. These results suggest the
      need to diagnose patients with MUC in the early stage of cancer and that in the
      case of the advanced stage, wide excision of the surrounding tissues and
      aggressive lymph-node dissection will be needed.

PMID- 11204958
TI  - Pancreatic injuries in children.
AB  - AIMS: There are several different philosophies in the diagnostics of blunt
      abdominal trauma (BAT), yet none of them has been shown to be superior, although
      enhanced computed tomography (CT) and diagnostic ultrasonography (US) seem to be
      the most used methods today. Treatment of pancreatic injury (PI) in children is a
      matter of controversy, whether operative treatment is needed and to what extent.
      MATERIAL AND METHODS: Seventeen pancreatic injuries were found in a retrospective
      analysis of 111 paediatric patients, aged 2-14 years, who underwent a laparotomy
      because of BAT, between 1968 and 1995 in Turku University Central Hospital. The
      number of non-operated BAT patients was calculated as 287. RESULTS: During the
      past two decades, the number of BATs and operations diminished by more than two
      thirds, but the number of PIs remained the same. Twelve acute operations led to
      four pancreatic resections, two external drainages and two explorations. PI was
      present but not the main reason for operation in four cases. Five PIs were
      operated on later due to postraumatic pseudocyst of the pancreas. CONCLUSIONS: PI
      was rare (15%) in laparotomies done because of BAT, operations which have
      diminished by 74% during the last twenty years. When PI was found, a variety of
      operative procedures was needed.

PMID- 11204959
TI  - Abdominal disorders arising from 71 Meckel's diverticulum.
AB  - BACKGROUND AND AIMS: The study was done to investigate the frequency of Meckel's
      diverticulum, and its manifestations as the cause of abdominal disorders.
      MATERIAL AND METHODS: The material consisted of 71 patients with Meckel's
      diverticulum treated in our hospital during the years 1988-1998. From the
      material the age and sex were analyzed as well the outcome of patients. The
      histological findings of diverticulectomies were evaluated. RESULTS: In a
      retrospective analysis 46 males (65.5%) and 25 females (34.5%) were found. At the
      same eleven-year study period Meckel's diverticulum was found during 55 out of
      3758 appendicectomies (1.5%). The age of patients ranged from 11 months to 87
      years (mean 30.4 years). Preoperatively the diagnosis was made in three cases:
      two patients with TC-99m scanning and one patient with intestinal passage
      radiography. 46 Meckel's diverticles were asymptomatic, but 25 (34.5%) cases were
      symptomatic. Nine patients had ulcer in the diverticulum, which was perforated in
      five cases. Eight patients had intestinal occlusion, five patients had Meckel's
      diverticulitis, two patients had invagination, and in one case a sharp piece of
      plastic material had perforated the Meckel's diverticulum. CONCLUSION: Meckel's
      diverticulum should be searched in the laparotomy due to acute abdomen. It can be
      the cause of serious abdominal complications.

PMID- 11204960
TI  - Trends of vascular service in a well defined geographical area in 1990's.
AB  - BACKGROUND AND AIMS: The treatment policy of vascular surgical patients has
      undergone changes in the last decade. The aim of this study was to evaluate
      development of vascular service in a well defined geographical area, the district
      of Tampere University Hospital. MATERIAL AND METHODS: This population based study
      is established on the vascular registry. During the eight year period (1990-1997)
      totally 5019 procedures had been registered, 3363 vascular surgical operations
      and 1656 endovascular interventions. This data was analysed retrospectively.
      RESULTS: The annual amount of vascular surgical procedures was in average 959 per
      million inhabitants and the amount of endovascular procedures 474 per million
      inhabitants during the period and the trend was slightly increasing. The mean age
      of surgical patients increased significantly during the eight year period, from
      63.6 to 66.6 years, while the mean age of endovascular patients remained fairly
      stable over the whole period. The proportion of critical limb ischaemia as an
      indication for surgical procedure increased during the period from 7.3% to 16.6%
      (p < 0.001). In the same time also the amount of femoropopliteal and femorodistal
      bypasses as a treatment of CLI increased significantly (p < 0.001). Further, the
      proportion of surgical procedures compared to the endovascular procedures in the
      treatment of CLI increased constantly over the 8-year period from 25% to 61% (p <
      0.001). The absolute amount of access surgery increased over the period and the
      mean age of these patients increased significantly. The median of hospital stay
      decreased during the eight year period in the surgical group from 9 days to 6
      days and in the endovascular group from 2 days to 1 day. CONCLUSIONS: The main
      changes have been the increased mean age of patients, their shortened hospital
      stay and the increasing surgical activity on patients with CLI and the larger
      number of patients with need for vascular access.

PMID- 11204961
TI  - Long term prognosis of medullary thyroid carcinoma in 39 patients.
AB  - BACKGROUND AND AIMS: Thyroidectomy and radical cervical lymph node dissection
      have been suggested as primary and secondary operations aimed at achieving
      biochemical cure in cases of medullary thyroid carcinoma (MTC). The purpose of
      this study was to find out behaviour of MTC in long-term follow-up, and to
      estimate possible difference in biological virulence between sporadic MTC and MTC
      in MEN2A. MATERIAL AND METHODS: From 1967 through 1994, 39 patients with MTC,
      including 9 patients with hereditary disease, were operated on at the Second
      Department of Surgery, Helsinki University Central Hospital. Enlarged lymph nodes
      were dissected selectively. The main outcome measure was carcinoma-specific
      survival. RESULTS: In sporadic MTC, ten-year carcinoma-specific survival was
      57.9% (95% CI 39.1%-76.7%) and ten-year survival after reoperation due to
      lymphatic node recurrence was 51.4% (CI 18.7%-84.2%). The presence of distant
      metastases at diagnosis (p = 0.0001) and extrathyroidal growth of the primary
      tumor (p = 0.0008) were independent predictors of carcinoma-specific survival in
      the Cox model. The risk ratio of sporadic MTC to MTC in MEN2A was 5.40 (CI 0.67
      43.2) after adjusting the survival time for the size of the primary tumor.
      CONCLUSION: Distant metastases and the local extrathyroidal extent of the primary
      tumor have a significant effect on the prognosis of MTC, lymphatic node
      metastases and other clinical factors being less important. The biological
      virulence of sporadic MTC may be clinically significantly higher than that of MTC
      in MEN2A.

PMID- 11204962
TI  - Results of surgical treatment of unresolved Osgood-Schlatter lesion.
AB  - BACKGROUND AND AIMS: We present our experience with surgical treatment of
      unresolved, painful, late Osgood-Schlatter disease. MATERIAL AND METHODS: In 70
      operations performed in 67 patients (in three bilaterally) an ossicle under the
      distal patellar tendon was removed in 62 cases. In eight cases, excision of the
      prominent tibial tubercle and/or drilling of the epiphysis was performed.
      Additional procedures, such as rasping of the uneven anterior tibial surface,
      excision of inflammed bursa or the devitalized portion of the tendon, were done
      21 times. Most patients were athletes or physically active young people. The mean
      age was 19.6 years. 54 operations were done on males and 16 on females. They had
      been followed preoperatively for 18 months and after surgery 2.2 years. RESULTS:
      The final results were excellent or good in 56, moderate in 9, poor in 3 and
      unknown in 2 cases. CONCLUSIONS: Osgood-Schlatter's disease may leave an ossicle
      under the distal patellar tendon, a prominent tibial tubercle or an uneven
      surface of anterior superior tibia. These may lead to pain and disability due to
      recurrent injuries or athletic exercises. Surgical treatment gives good results
      in chronic unresolved cases.

PMID- 11204963
TI  - Posttraumatic limb shortening: treatment with the Ilizarov distraction device.
AB  - BACKGROUND AND AIMS: Limb length inequality is not only a cosmetic problem, it is
      also a functional concern. The aim of the study was to analyse the cases of limb
      lengthening after their posttraumatic shortening. The study design is descriptive
      and comparative. MATERIAL AND METHODS: During the years 1979-1994 14 patients
      between 4-18 years of age were treated. Limb shortening was the result of
      premature closure of physeal plate and severe traumas with large bone defects.
      Ilizarov external devices for limb lengthening were used. The lengthening index
      was counted. The patients were divided into four groups: minor lengthening, bone
      transport, femoral lengthening, lengthening with using bone allografting.
      RESULTS: In group I the lengthening index was 29.9 days per centimetre (d/cm), in
      group II 21.7 d/cm, in group III 33.5 d/cm, in group IV 20.5 d/cm. The
      complication rate was 28%: 14% "minor" and 14% "major"-stiffness, wound necrosis.
      None of them affected the final result. In almost all cases the lengthening index
      was below 30 d/cm. CONCLUSIONS: The result of limb lengthening is not predictable
      in every separate case. Multiple lengthening may act on bone regeneration
      capacity.

PMID- 11204964
TI  - Study of straight metatarsal osteotomy for the treatment of plantar callosities.
AB  - BACKGROUND AND AIMS: [corrected] To evaluate the outcome of transverse distal
      metatarsal osteotomies for intractable plantar callosity without hammer toe
      deformity and associated toe corns. MATERIAL AND METHODS: Twenty-five plantar
      callosities were treated in 19 feet of 13 patients (mean age 48 years, 5 male, 8
      female) with transverse distal metatarsal osteotomy. RESULTS: Twenty-four of the
      osteotomies united primarily, one after revision. After a 7-year follow-up, 23 of
      the callosities had healed, two of them after an oblique reosteotomy. Eight
      hammer toe deformities had developed in the involved rays of four feet. Eight
      plantar callosities had developed outside the operated rays in five feet. Hallux
      valgus was a frequent finding in both operated and non-operated feet. CONCLUSION:
      It seems that transverse distal metatarsal osteotomy is an effective treatment of
      intractable plantar callosities. Harmful hammer toe deformities and transfer
      lesions below adjacent metatarsal heads tend to develop over time.

PMID- 11204965
TI  - Tourniquet-induced enmg changes in arthroscopic anterior cruciate ligament
      reconstruction. A comparison of low and high-pressure tourniquet systems.
AB  - BACKGROUND AND AIMS: The use of a tourniquet during surgery is associated with a
      risk of neurological disorders. We compared whether a new tourniquet system using
      low pressure (250 mmHg) is safer than a standard tourniquet system using higher
      inflation pressure (350 mmHg). MATERIALS AND METHODS: Thirty-one patients (ASA I
      II), ages 16-48 years, were studied with ENMG preoperatively and 3 weeks
      postoperatively following arthroscopic anterior cruciate ligament reconstruction.
      Tourniquet times varied between 30 and 146 min. RESULTS: Postoperative slowing of
      motor and sensory conduction was observed, as well as an increase of the minimum
      peroneal F-response and tibial H-reflex latencies. The sensory amplitude of the
      sural nerve decreased. Vastus medialis of the quadriceps femoris muscle showed a
      reduced interference pattern in ENMG in maximal voluntary effort postoperatively.
      No differences were found in measured results between the low and high pressure
      tourniquet systems. CONCLUSIONS: Slight postoperative ENMG alterations were
      demonstrated but the use of both tourniquet systems is safe within the limit of
      tourniquet times of less than 2 h.

PMID- 11204966
TI  - Treatment of infection and non-union after bilateral complicated proximal tibial
      fracture.
AB  - BACKGROUND AND AIMS: Complicated tibial fractures form a great challenge for
      orthopaedic surgeons. Non-unions and infections are more common in complicated
      than in closed fractures. In the present study, we describe a patient case
      treated for non-union combined to chronic osteomyelitis after bilateral open
      proximal tibial fractures. MATERIAL AND METHODS: A female patient born in 1946
      was multi-traumatised, when a car hit her as a pedestrian. She went through
      multiple operations of both tibias due to bilateral complicated proximal
      fractures. Fractures were stabilised at first with internal fixation, which had
      to be changed to external fixation due to infection of both sides. During the
      last operative step a commercial bone graft based on hydroxyapatite and bovine
      type I fibrillar collagen/tricalcium phosphate ceramic (Collagraft) mixed with
      autogenous bone marrow was applied. RESULTS: Fractures united after 28 (right
      tibia) and 22 (left tibia) months of follow-up. At the final follow-up visit 55
      months after the initial accident patient walked without any aid and showed no
      signs of an infection. CONCLUSIONS: The use of commercial mixed xeno-/autogenous
      bone graft may provide a feasible alternative in complicated chronic non-unions
      of the tibia even when an infection is present, especially when autogenous bone
      is not easily available after previous attempts of bone grafting.

PMID- 11204967
TI  - How to do sentinel node biopsy in breast cancer.

PMID- 11204968
TI  - A new method for surgical consultations with videoconference.
AB  - BACKGROUND: The aim of our prospective study was to examine the technical ability
      and the medical suitability of a realtime teleconferencing system in surgical
      consultations. METHOD: A personal computer-based-videoconferencing system was
      used over an architecture of the IP (Internet Protocol) over ATM (Asynchronous
      Transfer Mode) area network connecting Satakunta Central Hospital, Pori with a
      health center in the community of Noormarkku (15 km apart from Pori). A document
      camera was used for transfering the radiographs and paper documents. The material
      consisted of 50 patients who needed surgical consultation. The patients were
      examined by a physician in the health center of Noormarkku, and the surgeon
      interviewed and observed the physical examination with the aid of teleconference.
      RESULTS: Technically the videoconferencing system functioned reliably, and the
      visual quality of the videopicture was good after more powerful personal
      computers (Pentium II with a 266 MHz prosessor and 64 Megabits RAM-memory) were
      changed for the videoconferencing system. All patients, except one, saved the
      travelling to the face-to-face appointment because they got a definite decision
      of the treatment already at the videoconsultation. According to the opinion of
      the consulting surgeon, the decision which was made in the teleconference was
      good or very good, except in one case very poor. The physicians of the health
      centers were satisfied both with the decisions of the treatment of their patients
      and with the educational effect of a consultation where two physicians are
      present at the same time. All patients thought that it was good to be in
      consultation with two doctors. CONCLUSION: Surgical videoconsultations are a
      reliable method and a real alternative to sending a patient to a distant place
      for consultation.

PMID- 11204970
TI  - Insertions, substitutions, and the origin of microsatellites.
AB  - This paper uses data from the Human Gene Mutation Database to contrast two
      hypotheses for the origin of short DNA repeats: substitutions and insertions that
      duplicate adjacent sequences. Because substitutions are much more common than
      insertions, they are the dominant source of new 2-repeat loci. Insertions are
      rarer, but over 70% of the 2-4 base insertion mutations are duplications of
      adjacent sequences, and over half of these generate new repeat regions.
      Insertions contribute fewer new repeat loci than substitutions, but their
      relative importance increases rapidly with repeat number so that all new 4-5
      repeat mutations come from insertions, as do all 3-repeat mutations of
      tetranucleotide repeats. This suggests that the process of repeat duplication
      that dominates microsatellite evolution at high repeat numbers is also important
      very early in microsatellite evolution. This result sheds light on the puzzle of
      the origin of short tandem repeats. It also suggests that most short insertion
      mutations derive from a slippage-like process during replication.

PMID- 11204969
TI  - Developmental expression of the 412 retrotransposon in natural populations of D.
      melanogaster and D. simulans.
AB  - We analysed the pattern of expression of retrotransposon 412 through
      developmental stages in various populations of Drosophila simulans and D.
      melanogaster differing in 412 copy number. We found that the 412 expression
      pattern varied greatly between populations of both species, indicating that such
      patterns were not entirely species-specific. In D. simulans, total transcripts
      increased with number of 412 copies in the chromosomes when this number was low,
      and then decreased for high copy numbers. D. melanogaster, which has a higher 412
      copy number than D. simulans, had overall a lower global 412 expression, but
      again showed variation in 412 expression pattern between populations. These
      results suggest that in populations of D. simulans with low 412 copy number, the
      expression pattern of this element depends not only on copy number but also on
      host cellular regulatory sequences near which the elements were inserted. In D.
      simulans populations with high copy number overall transcription was on the
      contrary globally repressed, as observed in D. melanogaster. A population from
      Canberra (Australia) which had a very high 412 copy number was found to be
      associated with very high expression of 412 over all developmental stages,
      suggesting that the above 412 expression regulation processes are overcome in
      this population sample. The analysis of hybrids between geographically distinct
      populations of D. simulans showed that 412 expression was trans-regulated
      differently according to developmental stages, implying complex interactions
      between the 412 element and stage-specific host genes.

PMID- 11204971
TI  - Growth temperature and genetic variability of wing dimensions in Drosophila:
      opposite trends in two sibling species.
AB  - Thirteen linear wing dimensions were measured in 10 isofemale lines of Drosophila
      melanogaster and D. simulans grown at seven constant temperatures from 12 to 31
      degrees C. Within-line (environmental) variability, estimated by the within-line
      coefficient of variation (CVw), exhibited similar variation patterns in the two
      species, that is higher values at extreme (low or high) temperatures. The
      magnitude of variation was, however, greater in D. simulans, which appears to be
      more responsive to thermal change. A clear hyperbolic relationship between trait
      mean value and CVw was also observed in both species, arising from measurement
      errors which are relatively more pronounced on shorter traits. Genetic
      variability was analysed by considering both the genetic CV (CVg, evolvability)
      and isofemale line heritability (intraclass correlation). Both parameters
      provided independent information, as shown by a lack of correlation between them.
      Moreover, CVg was negatively correlated with trait mean value, while heritability
      showed a positive correlation. With respect to thermal environment, both
      parameters exhibited similar reaction patterns which contrasted the two species.
      Genetic variability in D. melanogaster followed a convex reaction norm, with
      higher values at extreme (high or low) temperatures, and this observation agrees
      with previous independent investigations. Surprisingly, D. simulans revealed an
      opposite pattern, with a maximum genetic variability in the middle of the range.
      Such data point to the danger of drawing general conclusions from the analysis of
      a single species.

PMID- 11204972
TI  - Evolution of reduced pre-adult viability and larval growth rate in laboratory
      populations of Drosophila melanogaster selected for shorter development time.
AB  - Four large (n > 1000) populations of Drosophila melanogaster, derived from
      control populations maintained on a 3 week discrete generation cycle, were
      subjected to selection for fast development and early reproduction. Egg to
      eclosion survivorship and development time and dry weight at eclosion were
      monitored every 10 generations. Over 70 generations of selection, development
      time in the selected populations decreased by approximately 36 h relative to
      controls, a 20% decline. The difference in male and female development time was
      also reduced in the selected populations. Flies from the selected populations
      were increasingly lighter at eclosion than controls, with the reduction in dry
      weight at eclosion over 70 generations of selection being approximately 45% in
      males and 39% in females. Larval growth rate (dry weight at eclosion/development
      time) was also reduced in the selected lines over 70 generations, relative to
      controls, by approximately 32% in males and 24% in females. However, part of this
      relative reduction was due to an increase in growth rate of the controls
      populations, presumably an expression of adaptation to conditions in our
      laboratory. After 50 generations of selection had elapsed, a considerable and
      increasing pre-adult viability cost to faster development became apparent, with
      viability in the selected populations being about 22% less than that of controls
      at generation 70 of selection.

PMID- 11204973
TI  - Comparison of genetic variability and parentage in different ploidy classes of
      the Japanese oyster Crassostrea gigas.
AB  - Chemical treatments with cytochalasin B were used to induce triploidy in the
      progeny of a mass fertilization of 3 male and 7 female Crassostrea gigas parents.
      Triploids were produced either by retention of the first (meiosis I (MI)
      triploids) or the second (meiosis II (MII) triploids) polar bodies. These
      animals, together with their diploid siblings, were divided for two experiments.
      One set was used to compare physiological performance, and the other set deployed
      to compare growth in two different natural environments. For both experiments,
      genetic variability in different ploidy classes was estimated using three
      microsatellite loci and eight allozyme loci. The microsatellite loci were highly
      polymorphic, allowing independent confirmation of ploidy status and the
      unambiguous identification of parentage for each oyster. Significant differences
      in parentage were found between ploidy classes, despite the fact they originated
      from the same mass fertilization. This indicates that the assumptions of a common
      genetic background among random samples of animals taken from the same mass
      fertilization may not be generally valid. Knowledge of parentage also allowed the
      more accurate scoring of allozyme loci. As expected, triploids were found to be
      significantly more polymorphic than diploids. However, MI triploids were not
      significantly more polymorphic than MII triploids. MII triploid genotypes were
      used to estimate recombination rates between loci and their centromeres. These
      rates varied between 0.29 and 0.71, indicating only moderate chiasma
      interference.

PMID- 11204974
TI  - Separate effects of triploidy, parentage and genomic diversity upon feeding
      behaviour, metabolic efficiency and net energy balance in the Pacific oyster
      Crassostrea gigas.
AB  - Triploid oysters were induced using cytochalasin B upon retention of either the
      first (meiosis I triploids) or the second (meiosis II triploids) polar body in
      embryos from a single cohort derived from mixed parentage. Allozyme and
      microsatellite assays enabled the confirmation of both parentage and triploidy
      status in each oyster. Comparison of meiosis I triploids, meiosis II triploids
      and diploid siblings established that improved physiological performance in
      triploids was associated with increased allelic variation, rather than with the
      quantitative dosage effects of ploidy status. An unidentified maternal influence
      also interacted with genotype. Among full sibs, allelic variation measured as
      multi-locus enzyme heterozygosity accounted for up to 42% of the variance in
      physiological performance; significant positive influences were identified upon
      feeding rate, absorption efficiency, net energy balance and growth efficiency (=
      net energy balance divided by energy absorbed). Whilst allelic variation was
      greater in both meiosis I and meiosis II triploids than in diploid siblings, both
      allelic variation and net energy balance were highest in triploids induced at
      meiosis I. This suggests that it may be preferable to induce triploidy by
      blocking meiosis I, rather than meiosis II as has traditionally been undertaken
      during commercial breeding programmes.

PMID- 11204975
TI  - Quantitative genetic models for the balance between migration and stabilizing
      selection.
AB  - The evolution of a quantitative trait subject to stabilizing selection and
      immigration, with the immigrants deviating from the local optimum, is considered
      under a number of different models of the underlying genetic basis of the trait.
      By comparing exact predictions under the infinitesimal model obtained using
      numerical methods with predictions of a simplified approximate model based on
      ignoring linkage disequilibrium, the increase in the expressed genetic variance
      as a result of linkage disequilibrium generated by migration is shown to be
      relatively small and negligible, provided that the genetic variance relative to
      the squared deviation of immigrants from the local optimum is sufficiently large
      or selection and migration is sufficiently weak. Deviation from normality is
      shown to be less important by comparing predictions of the infinitesimal model
      with a model presupposing normality. For a more realistic symmetric model,
      involving a finite number of loci only, no linkage and equal effects and
      frequencies across loci, additional changes in the genetic variance arise as a
      result of changes in underlying allele frequencies. Again, provided that the
      genetic variance relative to the squared deviation of the immigrants from the
      local optimum is small, the difference between the predictions of infinitesimal
      and the symmetric model are small unless the number of loci is very small.
      However, if the genetic variance relative to the squared deviation of the
      immigrants from the local optimum is large, or if selection and migration are
      strong, both linkage disequilibrium and changes in the genetic variance as a
      result of changes in underlying allele frequencies become important.

PMID- 11204976
TI  - Maintenance of genetic variation in phenotypic plasticity: the role of
      environmental variation.
AB  - We study genetic variation in phenotypic plasticity maintained by a balance
      between mutation and weak stabilizing selection. We consider linear reaction
      norms allowing for spatial and/or temporal variation in the environments of
      development and selection. We show that the overall genetic variation maintained
      does not depend on whether the trait is plastic or not. The genetic variances in
      height and slope of a linear reaction norm, and their covariance, are predicted
      to decrease with the variation in the environment. Non-pleiotropic loci
      influencing either height or slope are expected to decrease the genetic variance
      in slope relative to that in height. Decrease in the ratio of genetic variance in
      slope to genetic variance in height with increasing variation in the environment
      presents a test for the presence of loci that only influence the slope, and not
      the height. We use data on Drosophila to test the theory. In seven of eight pair
      wise comparisons genetic variation in reaction norm is higher in a less variable
      environment than in a more variable environment, which is in accord with the
      model's predictions.

PMID- 11204977
TI  - Power of quantitative trait locus mapping for polygenic binary traits using
      generalized and regression interval mapping in multi-family half-sib designs.
AB  - A generalized interval mapping (GIM) method to map quantitative trait loci (QTL)
      for binary polygenic traits in a multi-family half-sib design is developed based
      on threshold theory and implemented using a Newton-Raphson algorithm. Statistical
      power and bias of QTL mapping for binary traits by GIM is compared with linear
      regression interval mapping (RIM) using simulation. Data on 20 paternal half-sib
      families were simulated with two genetic markers that bracketed an additive QTL.
      Data simulated and analysed were: (1) data on the underlying normally distributed
      liability (NDL) scale, (2) binary data created by truncating NDL data based on
      three thresholds yielding data sets with three different incidences, and (3) NDL
      data with polygenic and QTL effects reduced by a proportion equal to the ratio of
      the heritabilities on the binary versus NDL scale (reduced-NDL). Binary data were
      simulated with and without systematic environmental (herd) effects in an
      unbalanced design. GIM and RIM gave similar power to detect the QTL and similar
      estimates of QTL location, effects and variances. Presence of fixed effects
      caused differences in bias between RIM and GIM, where GIM showed smaller bias
      which was affected less by incidence. The original NDL data had higher power and
      lower bias in QTL parameter estimates than binary and reduced-NDL data. RIM for
      reduced-NDL and binary data gave similar power and estimates of QTL parameters,
      indicating that the impact of the binary nature of data on QTL analysis is
      equivalent to its impact on heritability.

PMID- 11204978
TI  - A DNA marker for the duplicated cytosolic PGI genes in sheep's fescue (Festuca
      ovina L.).
AB  - Active duplicate PgiC genes in sheep's fescue, Festuca ovina, are associated with
      a PCR marker of specific length (about 370 bp, of which 231 are in an intron).
      Using this marker, the frequency of plants with duplicate genes is estimated to
      be about 10% in a population from southern Sweden. The close molecular similarity
      between the electrophoretically different duplicated genes is in accordance with
      the conclusion reached earlier that they are indeed alleles at the same locus.

PMID- 11204979
TI  - Estimation of microsatellite mutation rates in Drosophila melanogaster.
AB  - Microsatellite mutations were studied in a set of 175 mutation accumulation
      lines, all of them independently derived from a completely homozygous population
      of Drosophila melanogaster and maintained under strong inbreeding during 80
      generations. We assayed 28 microsatellites and detected two mutations. One
      mutation consisted of a single addition of a dinucleotide repeat and the other
      was a deletion of five trinucleotide repeats. The average mutation rate was 5.1 x
      10(-6), in full agreement with previous estimates from two different sets of
      mutation accumulation lines.

PMID- 11204980
TI  - Diagnosis of esophagogastric tumors.
AB  - The incidence of esophageal tumors, and of adenocarcinoma in particular, has
      risen markedly in recent years in the developed countries. The use of a variety
      of histopathological and biological markers is now offering promising prospects
      for the future. Vertical tumor invasion, intratumoral microvessel density,
      antimucin monoclonal antibodies, flow cytometry, telomerase activity, and
      overexpression of cyclin D1 have been correlated with the staging and prognosis
      of esophageal carcinomas. By combining these markers with Lugol staining, a
      practical new method of staging esophageal tumors may become available in the
      coming years. As is well known, Barrett's mucosa is a preneoplastic condition.
      Discussions in the literature concerning short forms of Barrett's esophagus and
      their relationship to inflammation of the gastric cardia appear to describe two
      different scenarios--a gastroesophageal reflux condition for short forms of
      Barrett's esophagus, and an inflammatory phenomenon (perhaps unrelated to
      Helicobacter pylori infection) for inflammation of the gastric cardia. Cost
      benefit studies of follow-up procedures in Barrett's esophagus have yet to be
      conducted, and considerable efforts--mainly using biological markers--are being
      made to identify those patients who are at greatest risk. Although the frequency
      of gastric tumors has declined in recent years, many as yet unclear aspects of
      these tumors have been studied. Technological progress has not led to substantial
      changes in the diagnostic procedures used, although autofluorescence methods and
      three-dimensional reconstruction have been analyzed. Laparoscopy, preferably
      combined with the use of ultrasound probes, may be a valuable tool for staging.
      The suggestion that endoscopy should be avoided in young patients (the "treat but
      do not scope" approach) has been seriously questioned, as it may lead to early
      cancer being overlooked. There is thought to be an intermediate stage of gastric
      cancer (between the early and advanced stages) in which the muscularis propria,
      but not the serosa, is invaded. Endoscopic ultrasonography is becoming
      increasingly established as a basic tool for the staging of gastric cancer.
      Gastric MALT lymphoma can be cured by H. pylori eradication therapy in many
      cases, but there is still uncertainty regarding the limitations of this approach.

PMID- 11204981
TI  - Carcinoid tumor of the choledochus mimicking a bile-duct stone during endoscopic
      ultrasonography and endoscopic retrograde cholangiography.

PMID- 11204982
TI  - Secondary aortoduodenal fistula mimicking submucosal tumor.

PMID- 11204983
TI  - Nonvariceal upper gastrointestinal bleeding.
AB  - Gastroduodenal ulcerations still account for the majority of nonvariceal
      gastrointestinal hemorrhage. The causative roles of Helicobacter pylori and
      nonsteroidal anti-inflammatory drugs (NSAIDs) are still being discussed, but the
      role of H. pylori appears less significant in the complicated ulcers, while
      NSAIDs are increasingly implicated. The two factors do not appear to potentiate
      each other, and some data suggest that H. pylori should not be eradicated in the
      context of an NSAID-related ulcer hemorrhage. The role of triage and risk
      assessment was highlighted in several of last year's publications, and increasing
      attention has been given to the cost aspects of peptic ulcer bleeding. There have
      been few comparative therapeutic trials, but several reports from Japan make a
      case for ethanol injection as an alternative to other injection agents. However,
      a randomized comparative trial is needed to further define the role of this
      technique. Radiological embolization techniques and minimally invasive surgery
      are increasingly becoming viable options in patients with complex cases, and a
      multidisciplinary approach is perhaps even more crucial today than ever before.

PMID- 11204984
TI  - Small-intestinal endoscopy.
AB  - A small imaging capsule without cables, wires, or external connections has been
      developed for exploration of the small bowel. This swallowable device is
      propelled by peristalsis through the intestinal tract, and transmits data to a
      nearby receiver that captures video images on a regular basis. This technology
      will soon be available throughout the world, and it promises to revolutionize
      deep endoscopy of the small bowel. Sonde enteroscopy will be laid to rest
      forever. There continues to be considerable interest in the use of push
      enteroscopy in the investigation of obscure gastrointestinal bleeding. Physicians
      are beginning to rely more on intraoperative enteroscopy, because of its high
      degree of accuracy and its ability to provide visualization of the entire small
      bowel in selected patients in whom the bleeding source cannot be diagnosed, but
      who require blood transfusions.

PMID- 11204985
TI  - Therapeutic biliary endoscopy.
AB  - Therapeutic biliary endoscopy is continuing to evolve; some small but important
      developments were seen during the last year. Competing techniques are continuing
      to develop.

PMID- 11204987
TI  - Colon polyps and cancer.
AB  - During 1999-2000, a number of important issues related to endoscopy and
      colorectal polyps and cancer were investigated. Several papers consider whether
      flat adenomas with high malignant potential are as common in the West as in
      Japan. Clinical series indicate that signs of rectal bleeding are more predictive
      of colorectal cancer than gastrointestinal symptoms. Colonoscopy is more accurate
      than double-contrast barium enema for detecting polyps, and virtual colonoscopy
      is a promising new diagnostic and screening technique. Primary prevention dietary
      studies using adenoma recurrence as an end point yield negative results.
      Surveillance colonoscopy protects individuals in families with hereditary
      nonpolyposis colorectal cancer, but gastroenterologists continue to perform
      cancer surveillance in patients with ulcerative colitis in an inconsistent
      manner. Screening for colorectal neoplasia with fecal occult blood tests and
      flexible sigmoidoscopy is being better defined and promoted, although many now
      advocate direct colonoscopy screening based on increasing indirect evidence of
      efficacy. Better methods of treating large sessile neoplasms are being developed
      and evaluated, and follow-up surveillance for adenoma patients increasingly is
      being tailored to individual patient risk.

PMID- 11204986
TI  - Therapeutic pancreatic endoscopy.
AB  - Therapeutic endoscopy in pancreatitis has included biliary or pancreatic
      sphincterotomy, or both, for microlithiasis and sphincter dysfunction.
      Alternatively, endoscopic treatment has been used to treat ductal disruption,
      including external or internal fistulas (high amylase effusions, pancreatic
      ascites, pancreaticoenteric communications, or pseudocysts). Finally, endoscopy
      has been used to treat obstructive disease, including both stones and strictures.
      This article reviews the state of the art in this field over the past year.
      Unfortunately, this is an area in which the appropriate approaches are still
      poorly defined, and prospective studies randomly assigning patients to endoscopic
      treatment in comparison with medical or surgical therapy remain few and far
      between.

PMID- 11204988
TI  - Diagnostic laparoscopy.
AB  - The value of surgical laparoscopy for various therapeutic interventions has been
      well established. In recent years, the interest of gastroenterologists in this
      method has revived, since laparoscopy can provide additional information for the
      staging of oncological and liver diseases. The introduction of miniature lenses
      may have contributed to this process, and an increasing number of physicians are
      using minilaparoscopy due to its safety and easy handling. Surgical studies have
      mainly focused on the evaluation of laparoscopic ultrasound for the detection of
      liver and lymph-node metastases. In specialized centers, laparoscopic ultrasound
      is also used for the estimation of locoregional pancreatic tumor spread, but the
      diagnostic impact of the method, particularly in colorectal carcinoma, still
      remains to be determined. Remarkably, the number of publications from
      gastroenterology departments has tended to increase in comparison with last
      year's review.

PMID- 11204989
TI  - Effect of variable stiffness colonoscopes on cecal intubation times for routine
      colonoscopy by an experienced examiner in sedated patients.
AB  - BACKGROUND AND STUDY AIMS: Variable-stiffness colonoscopes allow passage of the
      rectosigmoid colon in a flexible mode, followed by stiffening to prevent looping.
      This feature might allow faster cecal intubation. PATIENTS AND METHODS:
      Consecutive patients without previous colonic or rectal resection, inflammatory
      bowel disease, or anticipated need for either a pediatric or standard insertion
      tube were evaluated. Four Olympus colonoscopes, including a standard "adult"
      insertion-tube diameter variable-stiffness colonoscope (VSA), a pediatric
      variable-stiffness colonoscope (VSP), a standard "adult" colonoscope (CF-140)
      (SA), and a standard "pediatric" colonoscope (PCF-140) (SP) were used in
      rotation. RESULTS: Among 358 consecutive patients, 99.2% of exams were complete
      to the cecum. The stiffening device was activated in 61% and 80% of the adult and
      pediatric variable-stiffness examinations, respectively. The examiner judged the
      device to be very useful, somewhat useful, and of no help in 46%, 44%, and 10% of
      VSA colonoscope examinations and 55%, 33%, and 12% of VSP colonoscope
      examinations. However, the mean cecal insertion time was 4.04 minutes, with no
      difference between the four colonoscopes (P=0.98). The percentage of intubations
      in < 2 minutes was 15.4%, 2-3 minutes 25.9%, 3-4 minutes 19.1%, 4-5 minutes
      16.0%, and >5 minutes 23.7%, with no significant difference between the
      colonoscopes. CONCLUSIONS: Variable-stiffness colonoscopes were frequently judged
      useful by an experienced examiner but did not impact cecal intubation times in
      sedated patients. Additional studies by other experienced and inexperienced
      examiners, as well as evaluation of additional technical improvements and
      evaluation in unsedated patients, are needed.

PMID- 11204990
TI  - Clinical results and development of variable-stiffness video colonoscopes.
AB  - BACKGROUND AND STUDY AIMS: This study was designed to assess the usefulness of
      variable-stiffness video colonoscopes, compared with conventional videoscopes.
      PATIENTS AND METHODS: The first prototype XCF-QAY1 and the latter prototype XCF
      Q240A1 used in this study can be varied to 4 levels of stiffness of tube
      insertion during examination. In 352 consecutive colonoscopic examinations
      performed using these and two conventional scopes, the following data were
      recorded: time for intubation to the cecum, frequency of changes in the patients'
      posture, frequency of abdominal pressure attempts, and pain score. The degree of
      stiffness of the insertion tube and the examiners' impressions score were
      recorded only in procedures where the variable-stiffness scopes were used.
      RESULTS: There was no significant difference between colonoscopes in the pain
      score. Total colonoscopy rate was 97.4%. The frequency of usage of the varying
      stiffness control in the colon according to site was as follows: descending
      colon, 57.3%; transverse colon, 32.8%, sigmoid colon, 7.6%; and ascending colon,
      2.3%. A significant difference in the mean time for intubation to the cecum
      between the XCF-Q240A1 and conventional scopes was observed. Moreover, there were
      significant differences in the frequency of abdominal pressure attempts and
      changes in the patient's posture between conventional scopes and the new scopes.
      CONCLUSIONS: These results suggest that only one scope, the XCF-Q240A1, is needed
      for any colonic examination by any examiner.

PMID- 11204991
TI  - The variable-stiffness colonoscope: "too stiff or not too stiff, that is the
      question"--a new twist to the plot.

PMID- 11204992
TI  - Lugol chromoendoscopy for esophageal squamous cell cancer.

PMID- 11204993
TI  - Ulcer and gastritis.
AB  - Recent progress in the area of ulcer and gastritis is still dominated by findings
      and reports on Helicobacter pylori and nonsteroidal anti-inflammatory drugs,
      which in turn are the two major causes of peptic ulcers. Although the prevalence
      of H. pylori is declining in most developed countries, it is still contributing
      to a significant proportion of peptic ulcers globally. The interrelationship of
      H. pylori gastritis in patients with gastroesophageal reflux has become more
      apparent. H. pylori-induced gastric body gastritis is associated with reduced
      acid production, and thus with reduced reflux and esophagitis. The controversies
      regarding the interactions between H. pylori and NSAIDs have still not been
      settled. With the availability of the new COX-2-specific inhibitors, the current
      scenario of NSAID-related gastroduodenal complications will certainly change.
      Short-term usage of these agents has significantly reduced the incidence of
      endoscopic ulcers, but the benefits in terms of clinical outcomes, such as
      bleeding or perforation, remain to be determined. This review summarizes the
      recent literature on peptic ulcer and gastritis.

PMID- 11204994
TI  - An old lady with pencil-thin stool.

PMID- 11204995
TI  - Two cases of colonic adenomatous polyps accompanied by a migrated surgical
      suture.
AB  - A 56-year-old man and a 70-year-old woman, with histories of left colectomy and
      appendectomy respectively, were admitted to our hospital. In both cases,
      colonoscopy showed a pedunculated colonic polyp in the ascending colon, and a
      silk suture became visible in the stalk during polypectomy. The histological
      diagnosis was adenoma. These two cases constitute the first report of colonic
      adenomatous polyps accompanied by suture migration.

PMID- 11204996
TI  - Small-bowel occlusion after operative laparoscopy: our experience and review of
      the literature.
AB  - Bowel complications as a consequence of laparoscopic surgery are usually due to
      direct injuries; on the other hand, bowel occlusion is a rarely described event.
      We have retrospectively analyzed our data in this field. Out of 2652
      laparoscopies performed between July 1996 and March 2000, three cases of small
      bowel occlusion were observed. Two cases were due to bowel hernia through a 5-mm
      trocar port incision, the third was a consequence of an adhesion between the
      ileum and lost fragment of myoma. Two cases were treated laparoscopically, while
      in the third a laparotomy was required. At the time of writing, all the patients
      are well after a mean follow-up of 6 months. It appears important to also perform
      closure of the fascia and peritoneum after a 5-mm trocar port incision where
      there has been extensive manipulation.

PMID- 11204997
TI  - Biliopancreatic fistulas complicating pancreatic pseudocysts: a report of three
      cases demonstrated by endoscopic retrograde cholangiopancreatography.
AB  - Three patients were found to have fistulation of the pancreatic and common bile
      ducts, complicating chronic pancreatitis in one patient and acute pancreatitis in
      two patients. Closure of the fistula was achieved with biliary and pancreatic
      stenting in one patient; the other two patients were treated surgically because
      endoscopic treatment had failed. The clinical and radiological features of this
      exceptional complication are presented, with a brief review of the topic.

PMID- 11204998
TI  - Does the use of propofol require a specialist anesthetist?

PMID- 11204999
TI  - Biliocutaneous fistula following biliary stent migration.

PMID- 11205000
TI  - 98 unusual cases and technical notes.

PMID- 11205001
TI  - Sengstaken balloon tamponade for life-threatening pouch hemorrhage after
      laparoscopic gastric banding.

PMID- 11205003
TI  - Conjugated organometallic polymers containing Vollhardt's cyclobutadiene complex:
      aggregation and morphologies.
AB  - Organometallic polymers were prepared by acyclic diyne metathesis (ADIMET) or by
      Pd-catalyzed coupling of 1,3-diethynylcyclobutadiene(cyclopentadienyl)cobalt with
      a suitably substituted diiodobenzene. The polymers obtained by Heck coupling show
      a degree of polymerization (Pn) of 20-60. The monomers for ADIMET were made by
      the Pd-catalyzed coupling of [1,3-bis(trimethylsilylethynyl)-2,4
      bis(trimethylsilyl)cyclobutadiene](cyclopentadienyl)cobalt to 1-bromo-2,5-dialkyl
      4-propynylbenzenes in the presence of KOH in yields of 40-48%. The monomers carry
      hexyl, ethylhexyl, and (S)-3,7-dimethyloctyl side chains. Polymerization of the
      propynylated monomers furnishes organometallic polymers with a Pn of up to 230
      arylene-ethynylene units. The polymers were fully characterized by polarizing
      microscopy, transmission electron microscopy, circular dichroism, differential
      scanning calorimetry, and X-ray diffraction (XRD). They show nematic, lyotropic
      liquid crystalline phases as well as chiroptical properties from which
      aggregation in poor solvents and in the solid state can be concluded. Lamellar or
      irregular honeycomb-shaped morphologies in these organometallic polymers can be
      detected by electron microscopy.

PMID- 11205002
TI  - A systematic examination of the morphogenesis of calcium carbonate in the
      presence of a double-hydrophilic block copolymer.
AB  - In this paper, a systematic study of the influence of various experimental
      parameters on the morphology and size of CaCO3 crystals after room-temperature
      crystallization from water in the presence of poly(ethylene glycol)-block
      poly(methacrylic acid) (PEG-b-PMAA) is presented. The pH of the solution, the
      block copolymer concentration, and the ratio [polymer]/[CaCO3] turned out to be
      important parameters for the morphogenesis of CaCO3, whereas a moderate increase
      of the ionic strength (0.016 M) had no influence. Depending on the experimental
      conditions, the crystal morphologies can be tuned from calcite rhombohedra via
      rods, ellipsoids or dumbbells to spheres. A morphology map is presented which
      allows the prediction of the crystal morphology from a combination of pH, and
      CaCO3 and polymer concentration. Morphologies reported in literature for the same
      system but under different crystallization conditions agree well with the
      predictions from the morphology map. A closer examination of the growth of
      polycrystalline macroscopic CaCO3 spheres by TEM and time-resolved dynamic light
      scattering showed that CaCO3 macrocrystals are formed from strings of aggregated
      amorphous nanoparticles and then recrystallize as dumbbell-shaped or spherical
      calcite macrocrystal.

PMID- 11205004
TI  - Simple syntheses, structural diversity, and Tishchenko reaction catalysis of
      neutral homoleptic rare earth(II or III) 3,5-di-tert-butylpyrazolates--the
      structures of.
AB  - The homoleptic rare-earth pyrazolate complexes [Sc(tBu2pz)3], [Ln2(tBu2pz)6] (Ln
      = La, Nd, Sm, Lu), [Eu4(tBu2pz)8] and the mixed oxidation state species
      [Yb2(tBu2pz)5] (tBu2pz = 3,5-di-tert-butylpyrazolate) have been prepared by a
      simple reaction between the corresponding rare-earth metal and 3,5-di-tert
      butylpyrazole, in the presence of mercury, at elevated temperatures. In addition,
      [Yb2(tBu2pz)6] was prepared by redox transmetallation/ligand exchange between
      ytterbium, diphenylmercury(II) and tBu2pzH in toluene, whilst the same reactants
      in toluene under different conditions or in diethyl ether gave [Yb2(tBu2pz)5].
      The complexes of the trivalent lanthanoids display dimeric structures
      [Ln2(tBu2pz)6] (Ln = La, Nd, Yb, Lu) with chelating eta2-terminal and eta2:eta2
      bridging pyrazolate coordination. The considerably smaller Sc3+ ion forms
      monomeric [Sc(tBu2pz)3] of putative D3h molecular symmetry, with pyrazolate
      ligands solely eta2-bonded. [Eu4(tBu2pz)8] is a structurally remarkable
      tetranuclear EuII complex with two types of europium centres in a linear array.
      The outer two are bonded to one terminal and two bridging pyrazolates, and the
      inner two are coordinated by four bridging ligands. Unprecedented mu-eta5:eta2
      pyrazolate ligation is observed, with each outer Eu2+ sandwiched between two eta5
      bonded pyrazolate groups, which are also eta2-linked to an inner Eu2+. The two
      inner Eu2+ ions are linked together by two equally occupied components of each of
      two symmetry related, disordered pyrazolate groups with one component eta4:eta2
      bridging and one eta3:eta2 bridging. [La2(tBu2pz)6] has also been shown to be a
      Tishchenko reaction catalyst with several organic substrates.

PMID- 11205005
TI  - Spectroelectrochemical characterisation of poly[Ni(saltMe)]-modified electrodes.
AB  - Electrogenerated polymers based on the nickel(II) complex 2,3-dimethyl-N,N'
      bis(salicylidene)butane-2,3-diaminatonickel(II), poly[Ni(saltMe)], were
      characterised by in situ FTIR and UV/Vis spectroscopy and ex-situ EPR
      spectroscopy in order to gain insights into film structure, electronic states and
      charge conduction. The role of the nickel ions during film oxidation was probed
      by using EPR to study naturally abundant Ni and 61Ni-enriched polymers. The data
      from all the spectroscopic techniques are consistent, and clearly indicate that
      polymerisation and redox switching are associated with oxidative ligand based
      processes; coulometry suggests that one positive charge was delocalised through
      each monomer unit. EPR provided evidence for the non-direct involvement of the
      metal in polymer oxidation: the polymer is best described as a polyphenylene-type
      compound (conducting polymer), rather than an aggregation of nickel complexes
      (redox polymer), and the main charge carriers are identified as polarons. An
      explanation for the high electrochemical stability and conductivity of
      poly[Ni(saltMe)] with respect to that of poly[Ni(salen)] is proposed. based on
      stereochemical repulsion between monomeric units; this can impose a less compact
      supramolecular structure on polymers with bulkier substituents.

PMID- 11205006
TI  - The importance of dihydrogen complexes HnGe(H2)+ (n=0,1) to the chemistry of
      cationic germanium hydrides: advanced theoretical and mass spectrometric
      analysis.
AB  - Investigations of [Ge,Hn]-/0/- (n = 2,3) have been performed using a four-sector
      mass spectrometer. The results reveal that the complexes HnGe(H2)+ (n = 0,1) play
      an important role in the unimolecular dissociation of the metastable cations.
      Theoretical calculations support the experimental observations in most instances,
      and the established view that the global minimum of [Ge,H2]+ is an inserted
      structure may need reexamination; CCSD(T,full)/cc-pVTZ//CCSD(T)/6-311 ++ G(d,p)
      and B3LYP/cc-pVTZ studies of three low-lying cation states (2A1 HGeH+, 2B2
      Ge(H2)+ and 2B1 Ge(H2)+) indicate a very small energy difference (ca. 4 kcal mol(
      1)) between 2A1 HGeH+ and 2B2 Ge(H2)+; B3LYP favours the ion-molecule complex,
      whereas coupled-cluster calculations favour the inserted structure for the global
      minimum. Single-point multireference (MR) averaged coupled-pair functional and MR
      configuration interaction calculations give conflicting results regarding the
      global minimum. We also present theoretical evidence indicating that the orbital
      crossing point implicated in the spin-allowed metastable dissociation HGeH+* -->
      Ge(H2)+* --> Ge+ + H2 lies above the H-loss asymptote. Thus, a quantum-mechanical
      tunneling mechanism is invoked to explain the preponderance of the H2-loss signal
      for the metastable ion.

PMID- 11205007
TI  - Synthesis of enantiopure homoallylic ethers by reagent controlled facial
      selective allylation of chiral ketones.
AB  - The stereoselective allylation of chiral methyl ketones to give tertiary
      homoallylic ethers, which can easily be transformed into homoallylic alcohols, is
      described. Reaction of the enantiopure ketones 8a-d and the racemic ketones 26a-d
      with the norpseudoephedrine derivative 2 or ent-2 and allylsilane in the presence
      of a catalytic amount of trifluoromethanesulfonic acid, led to a series of
      homoallylic ethers with good to excellent diastereoselectivity (85:15 to > 97:3).
      The allylation is reagent controlled and nearly independent from the stereogenic
      centers in the substrates. A partial kinetic resolution was observed using the
      racemic ketones 26a-d. In the reaction of the chiral ketones 8a-d with the
      achiral reagents ethoxytrimethylsilane and allylsilane only a low
      diastereoselectivity was observed.

PMID- 11205008
TI  - The gas-phase reaction between hydroxide ion and methyl formate: a theoretical
      analysis of the energy surface and product distribution.
AB  - The potential energy surface for the prototype solvent-free ester hydrolysis
      reaction: OH- +HCOOCH3 --> products has been characterized by high level ab
      initio calculations of MP4/6-311 + G(2df,2p)//MP2/6-31 + G(d) quality. These
      calculations reveal that the approach of an OH- ion leads to the formation of two
      distinct ion-molecule complexes: 1) the MS1 species with the hydroxide ion
      hydrogen bonded to the methyl group of the ester, and 2) the MS4 moiety resulting
      from proton abstraction of the formyl hydrogen by the hydroxide ion and formation
      of a three-body complex of water, methoxide ion and carbon monoxide. The first
      complex reacts to generate formate anion and methanol products through the well
      known B(AC)2 and S(N)2 mechanisms. RRKM calculations predict that these pathways
      will occur with a relative contribution of 85% and 15% at 298.15 K, in excellent
      agreement with experimentally measured values of 87% and 13%, respectively. The
      second complex reacts by loss of carbon monoxide to yield the water-methoxide
      complex through a single minimum potential surface and is the preferred pathway
      in the gas-phase. This water-methoxide adduct can further dissociate if the
      reactants have excess energy. These results provide clear evidence that the
      preferred pathways for ester hydrolysis in solution are dictated by solvation of
      the hydroxide ion.

PMID- 11205010
TI  - Polycationic (mixed) core-shell dendrimers for binding and delivery of
      inorganic/organic substrates.
AB  - The convergent synthesis of a series of polycationic aryl ether dendrimers has
      been accomplished by a convenient procedure involving quantitative
      quaternarization of aryl(poly)amine core molecules. The series has been expanded
      to the preparation of the first polycationic, mixed core-shell dendrimer. All
      these dendrimers consist of an apolar core with a peripheral ionic layer which is
      surrounded by a less polar layer of dendritic wedges. These cationic,
      macromolecular species have been investigated for their ability to form
      assemblies with (anionic) guest molecules. The results obtained from UV/Vis and
      NMR spectroscopies, and MALDI-TOF-MS demonstrate that all the cationic sites
      throughout the dendrimer core are involved in ion pair formation with anionic
      guests giving predefined guest/host ratios up to 24. The large NMR spectroscopic
      shifts of resonances correlated with the groupings located in the core of the
      dendrimers, together with the relaxation time data indicate that the anionic
      guests are associated with the cationic core of these dendrimers. The X-ray
      molecular structure of the octacationic, tetra-arylsilane model derivative
      [Si(C6H3[CH2NMe3](2)-3,5)4]8+. 8I- shows that the iodide counterions are
      primarily located near the polycationic sphere. The new polycationic dendrimers
      have been investigated for their catalytic phase-transfer behavior and substrate
      delivery over a nanofiltration membrane.

PMID- 11205009
TI  - Comb-type cationic copolymer expedites DNA strand exchange while stabilizing DNA
      duplex.
AB  - The accelerating effect of cationic substances on the DNA strand exchange
      reaction between a 20 bp DNA duplex and its complementary single strand was
      studied. A polycationic comb-type copolymer, that consists of a poly(L-lysine)
      backbone and a dextran graft chain (PLL-g-Dex) and known to stabilize triplex
      DNA, expedites the strand exchange reaction under physiological relevant
      conditions. Electrostatically a small excess of the copolymer let to a 300-1500
      fold increase in the DNA strand exchange while large excess of spermine or
      cetyltrimethylammonium bromide, a cationic detergent known to promote markedly
      hybridization of complementary DNA strands, shows only a slight effect. The
      efficacy of the copolymer was not affected by a 10 mM Mg2+ concentration. Notably
      the copolymer promotes the strand exchange reaction while it stabilizes double
      stranded DNA. The stabilization of strand exchange intermediates consisting of
      the parent duplex and the single strand by the copolymer is believed to be
      responsible for the observed acceleration behavior.

PMID- 11205011
TI  - The effect of pH on the reactions of catalytically important RhI complexes in
      aqueous solution: reaction of [RhCl(tppms)3] and trans-[RhCl(CO)(tppms)2] with
      hydrogen (TPPMS = mono-sulfonated triphenylphosphine).  .
AB  - Hydrolysis and hydrogenation of [RhCl(tppms)3] (1) and trans-[RhCl(CO)(tppms)2]
      (2) was studied in aqueous solutions in a wide pH range (2 < pH < 11) in the
      presence of excess TPPMS (3-diphenylphosphinyl-benzenesulfonic acid sodium salt).
      In acidic solutions hydrogenation of 1 yields a mixture of cis-mer- and cis-fac
      [RhClH2(tppms)3] (3a,b) while in strongly basic solutions [RhH(H2O)(tppms)3] (4)
      is obtained, the midpoint of the equilibrium between these hydride species being
      at pH 8.2. The paper gives the first successful 1H and 31P NMR spectroscopic
      characterization of a water soluble rhodium(I)-monohydride (4) bearing only
      monodentate phosphine ligands. Hydrolysis of 2 is negligible below pH 9 and its
      hydrogenation results in formation of [Rh(CO)H(tppms)3] (5), which is an analogue
      to the well known and industrially used hydroformylation catalyst
      [Rh(CO)H(tppts)3] (6) (TPPTS = 3,3',3''-phosphinetriyltris(benzenesulfonic acid)
      trisodium salt). It was shown by pH-potentiometric measurements that formation of
      5 is strongly pH dependent in the pH 5-9 range, this gives an explanation for the
      observed but previously unexplained pH dependence of several hydroformylation
      reactions. Conversely, the effect of pH on the rate of hydrogenation of maleic
      and fumaric acid catalyzed by 1 in the 2 < pH < 7 range can be adequately
      described by considering solely the changes in the ionization state of these
      substrates. All these results warrant the use of buffered (pH-controlled)
      solutions for aqueous organometallic catalysis.

PMID- 11205012
TI  - Hydrothermal synthesis, X-ray structure and complex magnetic behaviour of
      Ba4(C2O4)Cl2[[Fe(C2O4)(OH)]4].
AB  - Hydrothermal reaction of iron(III) chloride, barium chloride and sodium oxalate
      in a narrow stoichiometry range produces the title compound
      Ba4(C2O4)Cl2[[Fe(C2O4)(OH)]4] (1). This new iron(II) oxalate crystallises in the
      tetragonal space group P42/mnm: a = 13.811(3), c = 7.026(2) A. The structure
      consists of parallel chains of mu2-hydroxy-bridged iron(II) ions. These are
      connected by bridging oxalates to form an anionic framework with large channels
      that contain the remaining barium, chloride and oxalate counter ions.
      Magnetisation studies on an oriented single crystal of 1 revealed a magnetic
      phase transition at 32 K and a strong easy-plane anisotropy at all temperatures.
      Above Tc the compound behaves as an S = 2XY antiferromagnetic chain, showing a
      broad maximum in the susceptibility at about 70 K. We determined the intrachain
      coupling J and the interchain coupling J' to be -7 cm(-1) and +0.4 cm(-1),
      respectively. The low-temperature phase is an ordered antiferromagnetic state.
      Zero- and longitudinal-field muon spin-rotation/relaxation studies support this
      interpretation; below Tc oscillations in the muon spin-autocorrelation function
      are observed giving unambiguous evidence for a non-zero sublattice magnetisation
      and proof of a long-range magnetically ordered state.

PMID- 11205013
TI  - Importance of packing coefficients of host cavities in the isomerization of open
      host frameworks: guest-size-dependent isomerization in cholic acid inclusion
      crystals with monosubstituted benzenes.
AB  - The crystal structures of inclusion compounds of cholic acid (CA) with 28
      monosubstituted benzenes have been systematically investigated. All of the
      crystals belong to the monoclinic space group P2(1) and have bilayer structures
      with one-dimensional molecular channels that can include guest compounds. They
      are classified into four types of host frameworks that depend on the
      conformations and stacking modes of the host compound. The host frameworks and
      the host-guest ratios depend primarily on the molecular volumes of the guest
      compounds. The packing coefficient of the host cavity (PCcavity), which is the
      volume ratio of the guest compound to the host cavity, is used to clarify the
      relationship between the guest volume and isomerization of the host frameworks.
      The value of PCcavity, for stable inclusion compounds lies in the range of 55
      70%. Compounds out of this range induce isomerization of the host frameworks. The
      packing coefficients of other host-guest compounds, in which the guest components
      are included in the host cavities through steric dimensions and van der Waals
      forces, are also in this range. These results indicate that PCcavity is a useful
      parameter correlation for guest recognition and isomerization of the host
      frameworks.

PMID- 11205014
TI  - X-H (X = C, N, O, P, S) bond activations induced by beta-heterosubstituted
      zirconaindenes.
AB  - The azazirconacyclopentene-substituted phosphines 3 and 4 have been found to
      activate the C-H bonds of acetylenic systems, such as methylpropiolate,
      diphenylphosphinoacetylene and phenylacetylene, or of methylene compounds, such
      as malonitrile and diethylmalonate, to give complexes 5a-c, 6a and 6b. C-H bond
      activation also takes place with vinylacetate. Similar reactions with amines,
      alcohols, enolisable ketones, phenols, phosphonates, thiols and a second
      generation SH-terminated dendrimer lead through X-H bond activation (X = N, O, P,
      S) to new complexes 8a-c, 9, 12 a,b, 13, 14a-c, 15, 16a and 16b. The
      azazirconacyclopentene-substituted amine 20 reacts to form analogous complexes.
      Zr-X bonds of these complexes (X = C, N, O, S) can be cleaved with
      diphenylchlorophosphine to give P-X phosphorus derivatives in high yield.

PMID- 11205015
TI  - Synthesis of clustered glycoside-antigen conjugates by two one-pot, orthogonal,
      chemoselective ligation reactions: scope and limitations.
AB  - Major histocompatibility class II antigens have been bound to clustered
      glycosides for selective targeting of the dendritic cell mannose receptor. Di-,
      tetra-, and octavalent glycoside-antigen conjugates have been obtained after two,
      orthogonal, hydrazone/thioether ligations, performed by using thio derivatives of
      D-mannose, D-galactose, or D(-)-quinic acid, glyoxylyl (or hydrazino)-N
      chloroacetylated lysinyl trees, and N-terminal hydrazino (or glyoxylyl) peptide
      antigens. Successful one-pot condensations have been developed to account for the
      nature of the antigens and the valency of the trees.

PMID- 11205016
TI  - Influence of topology on the long-range electron-transfer phenomenon.
AB  - Intramolecular electron-transfer phenomena in the radical anions derived from the
      partial reduction of diradicals (E,E)-p-divinylbenzene-beta,beta'-ylene bis(4
      tetradecachlorotriphenylmethyl) diradical (1) and (E,E)-m-divinylbenzene
      beta,beta'-ylene bis(4-tetradecachlorotriphenylmethyl) diradical (2) have been
      studied by optical and ESR spectroscopy. The synthetic methodology used allows
      for complete control of the geometry of diradicals 1 and 2, which have para and
      meta topologies, respectively, as well as of their E/Z isomerism. This fact is
      used to show the influence of the different topologies on the ease of electron
      transfer, which is larger for the para than for the meta isomer, in which a small
      or negligible electronic coupling is observed. A related monoradical compound (E)
      bis(pentachlorophenyl)[4-(4-bromophenyl-beta-styryl)-2,3,5,6-tetrachlorophenyl]
      methyl radical (3), which has only one such redox site, has also been obtained
      and studied for comparison purposes.

PMID- 11205017
TI  - A potentiometric and 51V NMR study of the aqueous H+/H2VO4-/H2O2/L-alpha-alanyl-L
      histidine system.
AB  - The speciation in the quaternary aqueous H+/H2VO4-/H2O2/L-alpha-alanyl-L
      histidine (Ah) system has been determined from quantitative 51V NMR measurements
      and potentiometric data (glass electrode). The study was performed in 0.150 M
      Na(Cl) medium at 25 degrees C. Data were evaluated with the computer program
      LAKE, which is able to treat combined EMF and NMR data. The pKa values for Ah
      were determined as 8.06, 6.72 and 2.64. In the ternary H+/H2VO4-/Ah system, two
      complexes, (H+)p(H2VO4-)q(Ah)r, for which (p, q, r) values of (0, 1, 1) and (1,
      1, 1) with log beta(0,1,1) = 2.52 +/- 0.03 and log beta(1,1,1) = 9.40 +/- 0.05
      (pKa = 6.88), respectively, explain all data. The errors given are 3sigma. In the
      quaternary H+/H2VO4-/H2O2/Ah system, eight complexes were determined in addition
      to all binary and ternary complexes, four with a V/X/Ah ratio 1:1:1 and four with
      a ratio 1:2:1 (X = peroxo ligand). VX2Ah2- and VX2Ah- (pKa = 8.19) are the main
      complexes and predominate in the pH range 5 to 9. Three additional minor species
      have also been found but their compositions could not be determined owing to
      their small amounts. Equilibria are slow, significant decomposition of peroxide
      occurs only in acidic solutions. Data in the pH range 5 to 10 have been used for
      the LAKE calculations. Chemical shifts, compositions, and formation constants for
      the eight quaternary complexes are given, and equilibrium conditions are
      illustrated in distribution diagrams. Structural proposals for VX2Ah2- and VX2Ah-
      are made from 1H and 13C NMR measurements.

PMID- 11205018
TI  - Synthesis, characterisation, crystal structures, reactivity, and electrochemistry
      of ruthenium-nitrido, ruthenium-cobalt-imido and ruthenapyrrolidone carbonyl
      clusters containing alkyne ligands.
AB  - Thermolysis of [Ru3(CO)9(mu3-NOMe)(mu3-eta2-PhC2Ph)] (1) with two equivalents of
      [Cp*Co(CO)2] in THF afforded four new clusters, brown [Ru5(CO)8(mu-CO)3(eta5
      C5Me5)(mu5-N)(mu4-eta2-PhC2Ph)] (2), green [Ru3Co2(CO)7(mu3-CO)(eta5-C5Me5)2(mu3
      NH)[mu4-eta8-C6H4-C(H)C(Ph)]] (3), orange [Ru3(CO)7(mu-eta6-C5Me4CH2)[mu-eta3
      PhC2(Ph)C(O)N(OMe)]] (4) and pale yellow [Ru2(CO)6[mu-eta3-PhC2(Ph)C(O)N(OMe)]]
      (5). Cluster 2 is a pentaruthenium mu5-nitrido complex, in which the five metal
      atoms are arranged in a novel "spiked" square-planar metal skeleton with a
      quadruply bridging alkyne ligand. The mu5-nitrido N atom exhibits an unusually
      low frequency chemical shift in its 15N NMR spectrum. Cluster 3 contains a
      triangular Ru2Co-imido moiety linked to a ruthenium-cobaltocene through the mu4
      eta8-C6H4C(H)C(Ph) ligand. Clusters 4 and 5 are both metallapyrrolidone
      complexes, in which interaction of diphenylacetylene with CO and the NOMe nitrene
      moiety were observed. In 4, one methyl group of the Cp* ring is activated and
      interacts with a ruthenium atom. The "distorted" Ru3Co butterfly nitrido complex
      [Ru3Co(CO)5(eta5-C5Me5)(mu4-N)(mu3-eta2-PhC2Ph)(mu-I)2I] (6) was isolated from
      the reaction of 1 with [Cp*Co(CO)I2] heated under reflux in THF, in which a Ru-Ru
      wing edge is missing. Two bridging and one terminal iodides were found to be
      placed along the two Ru-Ru wing edges and at a hinge Ru atom, respectively. The
      redox properties of the selected compounds in this study were investigated by
      using cyclic voltammetry and controlled potential coulometry. 15N magnetic
      resonance spectroscopy studies were also performed on these clusters.

PMID- 11205019
TI  - The concept of docking and protecting groups in biohydroxylation.
AB  - The hydroxylation of unactivated carbon atoms employing methods developed in the
      realms of classical organic chemistry is difficult to achieve and the processes
      available lack the degree of chemo-, regio- and enantioselectivity required for
      organic synthesis. To improve this situation, the concept of docking/protecting
      groups should enable the organic chemist to employ biohydroxylation as an easy
      tool for preparative work. Similar to the common practice of using protective
      groups in organic chemistry, a docking/protecting (d/p) group is introduced
      first, then the biotransformation is performed, and finally the d/p group is
      removed. The aim of this concept is not only to avoid time consuming
      microorganism screening methods, but also to improve hydroxylation position
      predictability, prevent undesired side reactions, aid substrate detection, and
      product recovery. This approach is successfully applied to carboxylic acids,
      ketones, aldehydes, and alcohols.

PMID- 11205020
TI  - Synthesis and metal binding properties of salicylate-, catecholate-, and
      hydroxypyridinonate-functionalized dendrimers.
AB  - The synthesis, characterization, and metal-binding studies of chelate
      functionalized dendrimers is reported. Salicylate, catecholate, and
      hydroxypyridinonate bidentate chelators have been coupled to the surface of both
      poly(propyleneimine) (Astramol) and poly(amidoamine) (Starburst, PAMAM)
      dendrimers up to the fifth generation (64 endgroups). A general method has been
      developed for the facile and high quality chromatographic purification of
      poly(propyleneimine) and poly(amidoamine) dendrimer derivatives. One- and two
      dimensional (TOCSY) 1H NMR experiments and electrospray ionization mass
      spectrometry (ESI-MS) have confirmed the exhaustive coupling of these chelators
      to the primary amine functionalities of the dendrimers. Spectrophotometric
      titrations were used to investigate the metal binding ability of these
      macrochelates. Spectral analysis shows that ferric iron binding to these ligands
      is localized to the chelating endgroups. The ability of these dendritic polymers
      to bind large numbers of metal ions may lead to applications as metal
      sequestering agents for waste remediation technologies.

PMID- 11205021
TI  - Synthesis, structure, and magnetic properties of three new one-dimensional
      nickel(II) complexes: new magnetic model for the first one-dimensional S = 1
      complex with alternating ferro-ferromagnetic coupling.
AB  - Three new one-dimensional nickel(II) complexes with the formulas trans-[Ni(N
      Eten)2(mu1.3-N3)]n(ClO4)n (1), trans-[Ni(N-Eten)2(mu1.3-N3)]n(PF6)n (2), and cis
      [Ni(N-Eten)(mu1.1-N3)2]n (3) (N-Eten = N-Ethylethylenediamine) were synthesized
      and characterized. Complex 1 has the P2(1)/c space group and consists of a
      structurally and magnetically alternating one-dimensional antiferromagnetic
      system with end-to-end azido bridges. Compound 2 has the P1 space group and has
      alternate units in its structure but consists of a magnetically uniform one
      dimensional antiferromagnetic system with end-to-end azido bridges. Complex 3 has
      the I2/a space group and may be described as a structurally and magnetically
      alternating one-dimensional ferromagnetic system with double azido bridged
      ligands in an end-on coordination mode. The chi(M)T versus T plots for compound 3
      suggest an intramolecular ferromagnetic interaction between adjacent NiII ions
      and metamagnetism at low temperature (below 10 K). The magnetization measurements
      versus applied field confirm this metamagnetic ordering. In order to describe the
      magnetic data of this compound we developed a general formula for the magnetic
      susceptibility of the isotropic ferro-ferromagnetic S = 1 Heisenberg chain in
      terms of the alternation parameter alpha (= J2/J1); this assumed a variation of
      chi(M)T versus the length N.

PMID- 11205022
TI  - [DOTA-bis(amide)]lanthanide complexes: NMR evidence for differences in water
      molecule exchange rates for coordination isomers.
AB  - Two derivatives of 1,4,7,10-tetraazacyclododecane with trans-acetate and trans
      amide side-chain ligating groups have been prepared and their complexes with
      lanthanide cations examined by multinuclear NMR spectroscopy. These lanthanide
      complexes exist in aqueous solution as a mixture of slowly interconverting
      coordination isomers with 1H chemical shifts similar to those reported previously
      for the major (M) and minor (m) forms of the tetraacetate ([Ln(dota)]-) and
      tetraamide ([Ln(dtma)]3+) complexes. As in the [Ln(dota)]- and [Ln(dtma)]3+
      complexes, the m/M ratio proved to be a sensitive function of lanthanide size and
      temperature. An analysis of 1H hyperfine shifts in spectra of the Yb3+ complexes
      revealed significant differences between the axial (D1) and non-axial (D2)
      components of the magnetic susceptibility tensor anisotropy in the m and M
      coordination isomers and the energetics of ring inversion and m <==> M
      isomerization as determined by two-dimensional exchange spectroscopy (EXSY).
      (17)O shift data for the Dy3+ complexes showed that both have one inner-sphere
      water molecule. A temperature-dependent (17)O NMR study of bulk water linewidths
      for solutions of the Gd3+ complexes provided direct evidence for differences in
      water exchange rates for the two coordination isomers. The bound-water lifetimes
      (tauM298) in the M and m isomers of the Gd3+ complexes ranged from 1.4-2.4 micros
      and 3-14 ns, respectively. This indicates that 1) the inner-sphere water
      lifetimes for the complexes with a single positive charge reported here are
      considerably shorter for both coordination isomers than the corresponding values
      for the [Gd(dtma)]3+ complex with three positive charges, and 2) the difference
      in water lifetimes for M and m isomers in these two series is magnified in the
      [Gd[dota-bis(amide)]] complexes. This feature highlights the remarkable role of
      both charge and molecular geometry in determining the exchange rate of the
      coordinated water.

PMID- 11205023
TI  - Mild and efficient flavin-catalyzed H2O2 oxidations.
AB  - Based on a previously discovered method for amine oxidations using flavins as
      catalysts and hydrogen peroxide as oxidant, a comparative kinetic study using NMR
      spectroscopy was undertaken with a series of flavins for amine and thioether
      oxidations. Included in this series is the newly prepared 7,8-difluoro-1,3
      dimethyl-5-ethyl-5,10-dihydroalloxazine. This study shows that flavins, which
      bear electron-donating groups on the aromatic ring and/or the N-10 position, are
      less active and are deactivated during the course of the reaction. Moreover,
      flavins that are alkylated at the N-1 position instead of the N-10 position and
      having either no substituents or electron-withdrawing groups on the aromatic
      ring, remain the most active and stable.

PMID- 11205024
TI  - Self-assembly and selective guest binding of three-dimensional open-framework
      solids from a macrocyclic complex as a trifunctional metal building block.
AB  - The nickel(II) hexaazamacrocyclic complex (1) containing pendant pyridine groups
      has been synthesized by the one-pot template condensation reaction of amine and
      formaldehyde. From the self-assembly of 1 with deprotonated cis,cis-1,3,5
      cyclohexanetricarboxylic acid, H2CTC- and CTC3-, three-dimensional supramolecular
      open-frameworks of [Ni(C20H32N8)][C6H9(COOH)2(COO)]2 x 4H2O (2) and
      [Ni(C20H32N8)]3[C6H9(COO)3]2 x 16H2O (3), respectively, have been constructed.
      The solids 2 and 3 are insoluble in all solvents. X-ray crystal structure of 2
      indicates that each nickel(II) macrocyclic complex binds two H2CTC- ions in trans
      position and two pendant pyridine groups of the macrocyclic complex are involved
      in hydrogen-bonding interactions with the hydroxy groups of H2CTC- belonging to
      the neighboring macrocyclic complexes, which provides the beltlike one
      dimensional chain composed of rectangular synthons. The one-dimensional chains
      are linked together through lattice water molecules by the hydrogen-bonding
      interactions to generate two-dimensional networks, which are again connected to
      each other by the offset pi-pi stacking interactions between the pendant pyridine
      rings to give rise to a three-dimensional structure in which channels are
      present. The X-ray crystal structure of 3 indicates that each nickel(II)
      macrocyclic unit binds two CTC3- ions in trans position and each CTC3- ion
      coordinates three nickel(II) macrocyclic complexes to form a two-dimensional
      layer, in which pendant pyridine rings are involved in the hydrogen bonding and
      the herringbone pi-pi interaction. Between the layers, the pendant pyridine rings
      belonging to the neighboring layers participate in the offset pi-pi stacking
      interactions, which gives rise to a three-dimensional network structure. The
      network creates channels running parallel to the a, b, and c axes, which are
      filled with guest water molecules. The X-ray powder diffraction patterns indicate
      that the frameworks of 2 and 3 are deformed upon removal of water guests but
      restored upon rebinding of water. The host solids 2 and 3 bind [Cu(NH3)4](ClO4)2
      in MeCN with a binding constant (Kf) of 210 M(-1) and 710 M(-1), respectively,
      while they do not bind [Cu(en)2](ClO4)2 (en = ethylenediamine). The dried solids
      of 2 and 3 do not interact with benzene and toluene, but they differentiate
      methanol, ethanol, and phenol in toluene solvent with the Kf values of 42, 14,
      and 12 M(-1), respectively, for 2, and 13, 8.2, and 8.9 M(-1), respectively, for
      3. In terms of binding sites for guest molecules, the solid 3 has greater
      capacity than the solid 2.

PMID- 11205025
TI  - Hydraphile channels: models for transmembrane, cation-conducting transporters.
AB  - A completely synthetic, non-peptide channel has been prepared and shown to
      conduct cations across a phospholipid bilayer membrane. Studies have been
      undertaken to assess the compound's location within the bilayer and to better
      understand its function. These studies are described along with background on the
      design and concept of the channel.

PMID- 11205026
TI  - Discovery through total synthesis: a retrospective on the himastatin problem.
AB  - A total synthesis of a structure proposed for himastatin was accomplished. The
      non-identity of the fully synthetic material with himastatin necessitated a
      revision of the assigned structure. Confirmation of the revised stereostructure
      was subsequently confirmed through total synthesis. Among the achievements during
      this effort were i) stereospecific routes to both anti-cis and syn-cis
      pyrrolindoline substructures; ii) a practical synthesis to 5-hydroxypiperazic
      acid in enantiomerically pure form; iii) a Stille coupling leading to a complex
      bi-indole moiety, and iv) efficient protecting group management throughout the
      evolving depsipeptide domain. The outlines for a biological pharmacophore have
      been delineated. The alternating D- and L-substituents in the 6-mer as well as
      the biaryl linkage connecting the two identical subunits are critical for
      maintaining biological activity. This pattern is simulated in another antibiotic,
      and suggests a possible structural trend for future SAR investigations.

PMID- 11205027
TI  - Inulin as a carrier for contrast agents in magnetic resonance imaging.
AB  - Magnetic resonance angiography (MRA) has put forth an impetus for the development
      of macromolecular GdIII complexes that have a prolonged lifetime in the vascular
      system. Herein, we report the synthesis and GdIII complexation of a new sugar
      conjugate based on inulin and the DO3A ligand (DO3A = 1,4,7,10
      tetraazacyclododecan-1,4,7-triacetic acid). Two API-DO3ASQ conjugates (API = O
      (aminopropyl)inulin, SQ = squaric acid = 3,4-dihydroxy-3-cyclobutene-1,2-dione)
      with different degrees of substitution (ds = 0.7 and ds = 1.5) were prepared from
      API by using the diethyl ester of squaric acid as a linking agent for the DO3A
      chelate. The efficacies of the resulting GdIII compounds were evaluated by
      investigation of their water 1H longitudinal-relaxation-rate enhancements at
      variable field (NMRD). A dramatic increase in relaxivity was observed in the more
      highly substituted conjugate (ds = 1.5); this prompted us to do a variable
      temperature (17)O study in order to further characterize the relaxation
      parameters involved in this system. [Gd(API-DO3ASQ)] shows promising properties
      for application as a contrast agent for MRI.

PMID- 11205028
TI  - Towards a correlation of absolute configuration and chiroptical properties of
      alkyl aryl sulfoxides: a coupled-oscillator foundation of the empirical Mislow
      rule?
AB  - The absorption and circular dichroism (CD) data for a series of alkyl aryl
      sulfoxides 1-16 of known S configuration have been analyzed. The strong
      bathochromic effect exerted by the nitro group in the para position of the phenyl
      sulfoxides indicates that the sulfur atom acts as an electron donor moiety
      towards the phenyl ring. Such behavior requires a significant 2p(C)-3sp3(S)
      overlap, and therefore the phenyl (and p-substituted phenyl) sulfoxides 1-12, as
      well as the 2-naphthyl sulfoxides 15 and 16, must assume a conformation which
      permits such orbital overlap. The steric effect of the peri hydrogen in 1
      naphthyl-substituted compounds 13 and 14 does not allow a conformation of this
      type, and in these compounds the above-mentioned 2p(C) and 3sp3(S) orbitals are
      positioned in almost orthogonal planes. This conformational difference is clearly
      shown by the absorption spectra: compounds 1-12, 15, and 16 show the lowest
      energy sigma --> sigma* transition of the sulfoxide chromophore at approximately
      250 nm, indicating the existence of a conjugated S=O chromophore. In contrast,
      the corresponding absorption in 13 and 14 occurs at about 200 nm, indicating the
      presence of an isolated S=O chromophore. The CD spectra of 13 and 14 show a
      negative, couplet-like feature between 250 and 200 nm. This spectral feature can
      be interpreted in terms of exciton coupling between the allowed sigma --> sigma*
      transition of the isolated S=O chromophore at 200 nm and the 1B transition of the
      naphthalene chromophore. In fact, the Harada-Nakanishi rule predicts a negative
      CD couplet for an S-configured sulfoxide in the conformation found by UV
      analysis, as found experimentally. The CD spectrum of 13 is quantitatively
      reproduced by DeVoe coupled-oscillator calculations, strongly implying that a
      coupled-oscillator mechanism is operative in determining the optical activity of
      13 and 14. This approach has also tentatively been extended to the conjugated
      sulfoxides 1-12, taking into account the coupling of the benzene chromophore 1La
      transition with the sigma --> sigma* transition of the S=O chromophore. In this
      case the Harada-Nakanishi rule also predicts a negative CD couplet for the S
      configured sulfoxides, as found experimentally.

PMID- 11205029
TI  - Synthesis of the enantiomers of 6-deoxy-myo-inositol 1,3,4,5-tetrakisphosphate,
      structural analogues of myo-inositol 1,3,4,5-tetrakisphosphate.
AB  - D-myo-Inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4] is produced rapidly
      from the established second messenger D-myo-inositol 1,4,5-trisphosphate
      [Ins(1,4,5)P4] in stimulated cells. Despite extensive investigations, in
      particular concerning its potential role in mediating cellular Ca2+ influx, no
      exact cellular function has been described for this inositol phosphate; however,
      binding sites have been identified in a number of tissues and it has been shown
      to act synergistically with Ins(1,4,5)P3. To assist in the elucidation of the
      mechanism of action and structural requirements within the Ins(1,3,4,5)P4 moiety
      that are necessary for recognition and activation of the receptor, structural
      analogues of this tetrakisphosphate are required. Routes for the synthesis of
      racemic 6-deoxy-myo-inositol 1,3,4,5-tetrakisphosphate [6-deoxy-DL
      Ins(1,3,4,5)P4] and the chiral antipodes D- and L-6-deoxy-myo-inositol 1,3,4,5
      tetrakisphosphate are described here. The racemic tetrakisphosphate was
      synthesised from DL-1,2-O-isopropylidene-myo-inositol in eight steps.
      Deoxygenation at C-6 was achieved following the Barton-McCombie procedure. Both
      chiral tetrakisphosphates were synthesised through resolution of racemic cis-diol
      6-deoxy-1,4,5-tri-O-p-methoxybenzyl-myo-inositol with the chiral auxiliary (S)
      (+)-O-acetylmandelic acid. Absolute configuration was confirmed by synthesis of
      the known D-6-deoxy-myo-inositol. Both D-6-deoxy-Ins(1,3,4,5)P4 and its
      enantiomer will be useful tools to unravel the enigmatic role of Ins(1,3,4,5)P4
      in the polyphosphoinositide pathway of signal transduction.

PMID- 11205030
TI  - Supramolecular detection of metal ion binding: ligand conformational control of
      cholesteric induction in nematic liquid crystalline phases.
AB  - Tripodal tetradentate ligands may act as chemosensor molecules. Their ability to
      torque a nematic into a cholesteric phase increases upon complexation with copper
      ion. Moreover, changes in overall shape of the complexes induced by different
      metals and counter ions were transferred sensitively to the supramolecular level,
      observed by proportionate changes in the degree of twisting. Modification of the
      oxidation state of the metal center also gave large changes in twisting power;
      this suggests potential application in electrochemical molecular switches. The
      handedness of the induced cholesteric phase is related to the stereochemistry of
      the ligand: The small amount of chiral dopant needed for the LC technique (less
      than 2 nmol) suggests the possible determination of the absolute configuration of
      the parent primary amines of the ligands.

PMID- 11205031
TI  - Aza-[3,3]-Claisen enolate rearrangement in vinylaziridines: stereoselective
      synthesis of mono-, di-, and trisubstituted seven-membered lactams.
AB  - Several 2,3-disubstituted vinylaziridines have been N-acylated and subjected to
      LiHMDS in THF at -78 degrees C. Upon warming to room temperature, the resulting
      amide enolates underwent a highly stereoselective [3,3]-sigmatropic rearrangement
      to give mono-, di-, and trisubstituted seven-membered lactams in good yields. The
      scope and limitations of the process have been investigated by using variously
      substituted vinylaziridines. A kinetically controlled process proceeding through
      a six-membered boatlike transition state assembly has been invoked to explain the
      stereochemical outcome of the reaction.

PMID- 11205032
TI  - Synthesis, mesomorphism, and unusual magnetic behaviour of lanthanide complexes
      with perfluorinated counterions.
AB  - Lanthanide complexes of the Schiff base ligand 4-dodecyloxy-N-hexadecyl-2
      hydroxybenzaldimine and with perfluorinated alkyl sulfate counterions were
      synthesised. All of the metal complexes show a smectic A mesophase. The viscosity
      of this mesophase is much lower than that of analogous compounds with nitrate or
      alkyl sulfate counterions. The behaviour of these new highly anisotropic
      molecular magnetic materials was studied using high-temperature X-ray
      measurements in an external magnetic field and temperature-dependent magnetic
      susceptibility measurements. The mu(eff)-versus-temperature curve is more
      comparable with those expected for nematic phases than for smectic phases. The
      luminescence spectrum of a EuIII compound shows that the values of the second
      rank crystal field parameters are very large. The huge magnetic anisotropy can be
      related to this strong crystal-field perturbation.

PMID- 11205033
TI  - [Cajal and neuroscience in the eve of the third millenium].
AB  - This is a brief history of the birth of Neuroscience as an independent branch of
      knowledge. The importance of Cajal's contribution to the structuralization of
      modern Neuroscience is described. Outstanding contributions to Neuroscience of
      the last century, particularly the Decade of the Brain, are summarized. The
      reason for the huge increase and interest in neuroscientific studies are given.
      Finally, I emphasize the challenge that multidisciplinary study and
      interinstitutional collaboration pose to advancing our knowledge of the human
      brain. The second part of the talk demonstrated the validity of Cajal's work in
      modern Neuroscience insisting on three aspects: 1) the microscopic study of the
      Mammalian central nervous system, 2) the neurogenesis and development of the
      nervous system and 3) the degeneration, regeneration and plasticity of the
      central nervous system. I conclude that Cajal's timeliness is reflected by the
      fact that there are few problems in modern Neuroscience which Cajal did not
      address at one time or other.

PMID- 11205034
TI  - [Prognostic value of optic morphometry in colorectal cancer].
AB  - In many types of cancer, certain morphometric characteristic of tumor cells
      correlate with patient survival. Our observations suggested that the survival of
      patients with colorectal carcinomas is negatively correlated with tumor-cell
      nucleus size. METHODS: We investigated relationships between postsurgery survival
      and nucleus morphometric in 90 patients who had undergone resection for a
      colorectal tumor. The nucleus-size variables considered were maximum diameter,
      minimum diameter, perimeter, area, and form factor (means for 100 nuclei from
      each patient were used in all cases). RESULTS: Our results confirmed that
      patients with large maximum nucleus diameter (where large = greater than the
      first quartile) have significantly worse survival than patients with smaller
      maximum nucleus diameter (mean survival, 28 vs. 43 months). Similar results were
      obtained for the other nucleus-size variables. Stepwise Cox regression analysis
      was then performed, with postsurgery survival time as the dependent variable and
      the following candidate independent variables: age, gender. Dukes class, degree
      of histologic differentiation, the various nucleus-size variables, and relative
      frequencies of different nucleus shapes (spherical, oval, cylindrical, fusiform,
      and irregular). The variables selected for the prognostic model were Dukes class,
      relative frequency of irregular nuclei, and maximum nucleus diameter.
      CONCLUSIONS: These findings indicated that nucleus size and shape are useful
      predictors of survival. Even in Dukes class is known, consideration of nucleus
      size and shape significantly improves prediction of survival.

PMID- 11205035
TI  - [Criteria for the extension of gastric and lymphatic resection in gastric cancer
      surgery].
AB  - After a brief historical review where are pointed out the circuMstances of the
      first successful gastrectomy performed by Billroth (Billroth I),
      gastroenteroanastomosis by Wolfler, Wolfler and Roux in-Y anastomosis, Billroth
      II reconstruction and types and techniques of lymphadenectomies, it is exposed
      the author's experience over 927 gastric cancer, cardias included, explaining the
      surgical technique performed: gastrectomy according to size, tumor localization
      and D1 lymphadectomy, evaluating to perform a D2 during operation, obtaining an
      overlife of 56% after 5 years when tumor was only placed in the stomach, and only
      of 19% when N1 lymph-nodes where affected and 6% if invasion reached N2 group.
      Overlife of cardias cancer has moved between 11 and 20%. Some comments are made
      on the surgeon evaluation of the lymp-nodes afectation and on the advantages and
      disadvantages of performing a radical or standard lymphadenectomy.

PMID- 11205037
TI  - [Decision making: biological bases and limitations].
AB  - In the human brain, simple molecules and complex circuits are constantly making
      decisions which are indispensable for our survival and also to accomplish a
      variety of daily activities such as walking, memorizing, conversing, composing
      music, painting or poetry.... All are the result of the integration of many
      neural systems that perceive many and simultaneous visual, tactile, auditory
      and/or mental stimuli. Once synthetized, they are immediately transmitted to the
      corresponding executive systems, thus completing the fascinating functional loop
      of decision-making: a) perception of stimuli or information which originate in
      the environment, b) selection and elaboration of the decision which is considered
      more appropriate or attractive according to personal experience or intuition and
      c) execution. If these neural nets have been damaged or haven failed to develop
      the mechanisms of facilitation or inhibition that govern them become unbalanced.
      If inhibition is reduced, excessive and violent behaviour is expressed as in
      patients suffering from manic phases. Conversely, if inhibition is excessive,
      decision making mechanisms are not operative. In either case, behaviour is not
      "reasonable" and does not follow prototypical patterns. All these processes must
      be the consequence of a constant molecular activity full of micro-decisions whose
      effectiveness depends on the histological and biochemical integrity of the
      neurons. This microenvironment is responsible for all types of decisions of all
      forms of life and represents one of the fundamental successes of evolution.

PMID- 11205036
TI  - [New concepts on atrial fibrillation].
AB  - Atrial Fibrillation (AF) is the most common sustained arrhythmia in humans. AF
      has a self-perpetuating nature. Perpetuation has been attributed to shortening of
      atrial action potential duration (APD) and APD adaptation to rate, the so called
      atrial electrical remodeling. There is evidence that alterations in gene
      expression of proteins involved in the Ca handling may be, at least partly,
      responsible for AF-induced electrical remodeling. This review focus on the
      possible cellular mechanisms involved in atrial remodeling, followed by a brief
      description of new therapeutic approaches that target the development of the
      arrhythmogenic substrate, rather than simply attacking the final
      electrophysiologic environment.

PMID- 11205038
TI  - [The myth of "tabula rasa"].
AB  - The history of the philosophy has witnessed a controversy between those who
      maintain that the human being is born with inherited knowledge and those who
      assert that the mind of man is like a "tabula rasa", a tablet on which nothing
      has been written. Recent experiments have shown that the last group was wrong.
      The human being is born endowed with certain types of knowledge which were
      already present in those animals which preceded us in the evolution. The fear of
      snakes, the number sense and the recognition of familiar faces are three typical
      examples among others.

PMID- 11205039
TI  - [Estrogens and breast cancer].
AB  - After a short bibliographical revision on the estrogen action in the genesis of
      mammarian cancer, it can be accepted that they can only act under the analyzed
      circumstances. For these reasons, it is advised that the Substitutive Hormonal
      Therapy (SHT) during menopause with estrogens should not be extended for more
      than five years, nor should it be given to women over 60 years of age. SHT
      combined with progesterone protects against endometrial cancer, but increases the
      relative risk of mammarian cancer. It should not be prescribed for
      hysterectomized patients who should follow previous advices. Both types of SHT
      should be avoided by hypertensive women treated with calcium blockers and women
      have familiar records of mamarian cancer.

PMID- 11205041
TI  - [Historical and clinical aspects of prolonged pregnancy].
AB  - The author analyses the subject of prolonged pregnancy from two perspectives.
      Firstly, the current Clinical view, and secondly, looking far back into the past,
      a perspective which offers historical considerations. The Medical and Legal
      aspects of the matter are approached historically (130 B.C., Alfonso el Sabio).
      The French, English, and Spanish jurisprudence is approached from the perspective
      of the 20th century. Pregnancy duration is analysed in the human species as well
      as in various other animal species. Other factors also taken into account include
      the start of the birth process, seen from the viewpoint of the sixties up to the
      current neuro-endocrine knowledge. The author concludes by presenting a synopsis
      of the current means available for precisely determining the true length of
      pregnancy.

PMID- 11205042
TI  - [Potential therapeutic usefulness of cannabis and cannabinoids].
AB  - Diseases in which Cannabis and cannabinoids have demonstrated some medicinal
      putative properties are: nausea and vomiting associated with cancer chemotherapy,
      muscle spasticity (multiple sclerosis, movement disorders), pain, anorexia,
      epilepsy, glaucoma, bronchial asthma, neuroegenerative diseases, cancer, etc.
      Although some of the current data comes from clinical controlled essays, the
      majority are based on anecdotic reports. Basic pharmacokinetic and
      pharmacodynamic studies and more extensive controlled clinical essays with higher
      number of patients and long term studies are necessary to consider these
      compounds useful since a therapeutical point of view.

PMID- 11205043
TI  - [Pediatric problems of the children of immigrants in Spain].
AB  - The author, Consultant and Expert in Maternal and Child Health of the WHO in
      Africa and Europe, after a complete study of the Spanish demography, the country
      with the lower natality in all the world, arrives to the conclusion that Spain is
      the country with more possibilities for the immigration from Africa, Latino
      America and Philippines. So, is absolutely necessary that Spanish paediatricians
      know the troubles and diseases of the children of these groups as a way for their
      integration.

PMID- 11205044
TI  - [Evidence-based nuclear medicine and experience-based nuclear medicine].
AB  - The basis and methods of Evidence-Based medicine (EBM) and its applications in
      Nuclear Medicine (NM) are described. EBM criteria are contrasted with clinical
      experience. Some NM Meta-analysis and Systematic Reviews are described. The
      methods of redefining the probability through diagnostic tests and the methods of
      Decision Analysis and of Cost-Efficiency Studies applied to NM are described.
      Finally a Series of proposals to improve the application of EBM to NM are
      presented.

PMID- 11205045
TI  - [The problem of truth in psychiatry].
AB  - Psychiatry has forgotten too early about the problem of truth (Zutt). In the
      first treatises on delusions, these are described as pathological errors, as
      mistakes in the ability to judge reality. For French psychiatry, delusions are
      false ideas of pathological origin, resistant to logical argumentation that alter
      the ability to judge reality, a concept still present in DSM-IV, in which it is
      defined as wrong beliefs that normality imply a wrong interpretation of
      perceptions of experiences. As a consequence, delusions are classified according
      to its contents. German psychiatry however seeks for the structures underlying to
      all delusions, some authors have even defended the notion of a single psychosis.
      The Heidelberg School, so well analyzed by Lain, developed a psychopathology
      which dismantled the notion of delusion then accepted (falseness is a relative
      and accessory notion and the lack of information plays an important role, as well
      as cultural and religious factors). K. Schneider describes the two forms of
      delusion: delusional perception and delusional occurrence. Both concepts have
      been criticized, therefore it is necessary to consider truth as a process and not
      as a state and to take into account the contributions of the philosophy of
      science and psychoanalysis. The concept of truth of Aristotle (the adaptation of
      the logos to the thing) is the one that has prevailed along history. But, for
      Heidegger the truth as aletheia (the process of revealing) is deeper and allows,
      applied to psychopathology, the connection of truth, liberty and relationship
      between human beings. As a consequence, the error of delusion, its lack of
      liberty, is also a lack of communication. The process of getting closer to truth
      is marked by an ethical attitude of tolerance.

PMID- 11205046
TI  - Intracellular regulation of inward rectifier K+ channels.
AB  - Inward rectifier potassium (Kir) channels comprise a relatively young gene family
      of ion channels whose first member was isolated in 1993. A common property its
      members share is a strong dependence on intracellular regulators such as
      polyamines, nucleotides, phospholipids, kinases, pH and guanosine-triphosphate
      binding proteins (G-proteins). The physiological role of Kir channels is to
      modulate the excitability and secretion of potassium (K+) to maintain K+
      homeostasis, under the control of various intracellular second messengers.
      Structurally, Kir channels are assembled from four alpha-subunits each carrying
      the prototypic K+-channel pore region lined by two transmembrane segments with
      intracellular N- and C-termini. The exact molecular mechanism of Kir channel
      gating by intracellular second messengers is of considerable biophysical
      interest. Recent studies have gained significant insight into the molecular
      mechanism of intracellular regulation by pH. This review illustrates the various
      modes of regulation of this class of ion channel and the present knowledge of the
      underlying molecular mechanisms.

PMID- 11205047
TI  - Restoration of cardiac transient outward potassium current by norepinephrine in
      diabetic rats.
AB  - In cardiac ventricle, the density of the transient outward potassium current,
      Ito, is clearly related to sympathetic nervous system integrity. This sympathetic
      regulation of Ito expression may be greatly significant to the genesis of cardiac
      complications of several diseases such us diabetes mellitus. Autonomic
      neuropathy, including cardiac neuropathy, is a complication of chronic diabetes.
      The objective of the present study was to identify the possible role of cardiac
      sympathetic neuropathy in the reduction of Ito current density in diabetic
      ventricular myocardium. Thus, we employed the patch-clamp technique to test
      whether Ito can be restored in diabetic myocytes incubated with norepinephrine.
      We also measured, using HPLC, the catecholamine content of the stellate ganglion,
      which is responsible for cardiac sympathetic innervation, in normal and diabetic
      animals. The main result of the present study was to show that a 24-h incubation
      of diabetic cells with norepinephrine restores Ito density to control values. The
      restoration of Ito current density by norepinephrine suggests that the diabetes
      induced reduction of Ito is at least partially attributable to a reduced trophic
      effect of norepinephrine on the expression of Ito.

PMID- 11205048
TI  - Rapid cooling-induced contractures in rat skinned skeletal muscle fibres
      originate from sarcoplasmic reticulum Ca2+ release through ryanodine and inositol
      trisphosphate receptors.
AB  - Previous reports have shown that cooling striated muscles induces contractile
      responses that are related to Ca2+ release from the sarcoplasmic reticulum.
      However, the effect of cooling has generally been studied in the presence of
      pharmacological agents that potentiate rapid cooling-induced contractures. The
      present study shows that in saponin-skinned rat skeletal muscle preparations, a
      drop in temperature from 22 degrees C to 2 degrees C per se induces a contracture
      which relaxes on return to 22 degrees C. In fast-twitch fibres, rapid cooling
      induced contractures are fully blocked by ryanodine, an inhibitor of ryanodine
      receptors. By contrast, in slow-twitch fibres, ryanodine partially inhibits the
      rapid cooling-induced contractile response, leaving a residual tension that
      dissipates after application of inositol 1,4,5-trisphosphate (InsP3). At low
      concentrations, heparin, an inhibitor of InsP3 receptors, decreases rapid cooling
      induced contractures in both types of muscle. The present results suggest that in
      skeletal muscle, rapid cooling-induced contractures are due to both ryanodine
      sensitive and InsP3-sensitive Ca2+ release from the sarcoplasmic reticulum.

PMID- 11205049
TI  - pH regulation in isolated in vitro perfused rat colonic crypts.
AB  - We investigated disorders and regulation of cytosolic pH (pHi) in isolated
      perfused crypts from rat distal colon using the pH-sensitive dye BCECF. This
      preparation allows distinct examination of either luminal or basolateral
      transport. The effects of luminal weak organic acids and bases on pHi were
      examined. The physiological concentrations of both luminal CO2/HCO3- and acetic
      acid/acetate acidified pHi significantly, but less than when applied from the
      basolateral side. Corresponding changes (luminal versus basolateral) in pHi were 
      0.17+/-0.04 versus -0.39+/-0.04, (n=8) and -0.15+/-0.02 versus -0.41+/-0.04,
      (n=8), respectively. Basolateral versus luminal application of NH3/NH4+ led to a
      more marked change in pHi, namely 0.35+/-0.03 versus 0.008+/-0.007 pH units,
      (n=19). The luminal perfusion of NH3/NH4+ was controlled by applying fura-2 acid
      to the luminal side and at the same time recording fura-2-specific fluorescence.
      Hence, the influence of luminal acid/base on colonic pHi homeostasis was limited.
      To examine pHi regulation, we investigated the recovery from an intracellular
      acid load using the NH3/NH4+ pulse method. Recovery was completely dependent on
      basolateral Na+, indicating that luminal acid/base transport does not play a
      major role in pHi homeostasis. The basolateral transporters involved in pHi
      recovery are probably the EIPA- and HOE694-inhibitable (IC50=0.2 and 2
      micromol/l, respectively) Na+/H+ exchanger NHE1 and the DIDS-inhibitable Na+
      dependent HCO3- importer.

PMID- 11205050
TI  - Osmolyte and Na+ transport balances of rat hepatocytes as a function of
      hypertonic stress.
AB  - The initial event in the regulatory volume increase (RVI) of rat hepatocytes is
      an influx of Na+ that is then exchanged for K+ via stimulation of Na+/K+
      adenosine triphosphatase (ATPase). In this study, we analysed the activation
      pattern of the Na+ transporters underlying RVI as a function of the degree of
      hypertonic stress. In confluent primary cultures, four hypertonic conditions were
      tested (changes from 300 to 327, 360, 400 or 450 mosmol/l) and the activities of
      Na+ conductance, Na+/H+ antiport, Na+-K+-2Cl- symport and Na+/K+-ATPase were
      quantified using intracellular microelectrodes, microfluorometry and time
      dependent, furosemide- or ouabain-sensitive 86Rb+ uptake, respectively. Neither
      Na+ conductance nor Na+-K+-2Cl- symport responded to 327 mosmol/A. At 360, 400
      and 450 mosmol/l, uptake via these transporters would lead to increases of cell
      Na+ by 33.0, 49.0 and 49.0 and by 4.5, 10.4 and 9.2 mmol/l per 10 min,
      respectively. In contrast, Na+/H+ antiport exhibited 65% of its maximal
      activation already at 327 mosmol/l. At the four osmolarities tested, this
      transporter would augment cell Na+ by 6.9, 8.9, 9.8 and 10.6 mmol/l per 10 min.
      The sums of Na+ import were consistent with the amounts of Na+ exported via
      Na+/K+-ATPase plus the actual increases of cell Na+ (21.2, 58.5, 63.6 and 68.3
      mmol/l per 10 min and 2.2, 4.0, 6.3 and 8.2 mmol/l, respectively). In addition,
      these elevations of cell Na+ plus the increases of cell K+ (via Na+/K+-ATPase)
      that amounted to 5.0, 6.5, 17.5 and 18.4 mmol/l were consistent with the
      increases of intracellular osmotic (cationic) activity of 2.5, 11.5, 21.0 and
      28.5 mmol/l, respectively, computed from RVI data. It is concluded that the
      principle of rat hepatocyte RVI, i.e. an initial uptake of Na+ that is then
      exchanged for K+ via Na+/K+-ATPase, is realized over the entire range of 9-50%
      hypertonicity tested. The set-point for the activation of RVI clearly lies below
      327 mosmol/l. Na+/H+ antiport is the most sensitive Na+ importer involved in RVI,
      whereas Na+ conductance plays the prominent role from 360 mosmol/l upwards.

PMID- 11205051
TI  - Voltage-driven p-aminohippurate, chloride, and urate transport in porcine renal
      brush-border membrane vesicles.
AB  - p-Aminohippurate (PAH) and urate are secreted into the proximal tubule lumen
      across the brush-border membrane. Here we used brush-border membrane vesicles
      from pig kidney to study PAH and urate transport. Efflux and influx of [3H]PAH
      were influenced by K+-diffusion potentials indicating electrogenic PAH transport.
      An outside>inside PAH concentration difference accelerated voltage-sensitive, Na+
      coupled D-glucose uptake as efficiently as did an outside>inside Cl-
      concentration difference, suggesting comparable conductances for PAH and Cl- in
      brush-border membrane vesicles. Up to 1 mM of the uricosurics indacrinone,
      tienilic acid, losartan and probenecid, as well as of the stilbenes, DIDS and
      SITS, and of the loop diuretics furosemide and bumetanide inhibited voltage
      driven PAH uptake, but not, or only slightly, voltage-driven Cl- uptake. Voltage
      driven [14C]urate uptake, however, was inhibited by 0.1 mM DIDS, 0.2 mM losartan
      and 0.5 mM probenecid to a similar extent as [3H]PAH uptake. One millimolar
      pyrazinoic acid, oxonate, xanthine and adenosine inhibited neither [3H]PAH nor
      [14C]urate uptake. These results suggest that PAH and urate share an anion
      conductance which is distinct from the Cl- conductance and is probably not the
      same as a recently identified urate channel (Leal-Pinto E et a]. J Biol Chem
      272:617-625, 1997).

PMID- 11205052
TI  - Nitric oxide has no beneficial effects on ion transport defects in cystic
      fibrosis human nasal epithelium.
AB  - Nitric oxide (NO) has been reported to activate Cl- secretion via the cystic
      fibrosis transmembrane conductance regulator (CFTR) and inhibit epithelial Na+
      absorption mediated by amiloride-sensitive epithelial Na+ channels (ENaC). These
      ion transport systems are defective in cystic fibrosis (CF): Cl- secretion by
      CFTR is impaired and Na+ absorption by ENaC is dramatically increased. By
      activating CFTR and depressing ENaC, NO is a potentially beneficial therapeutic
      agent for ion transport defects in human CF respiratory epithelia. To assess the
      effects of NO on human respiratory epithelial cells, the NO donors sodium
      nitroprusside (SNP) and spermine NONOate were applied to primary cultured nasal
      cells, surgically obtained from non-CF and CF patients. Measurements of
      transepithelial short-circuit current (ISC) showed that NO has no inhibitory
      potency against amiloride-sensitive nasal ENaC (nENaC) or amiloride-insensitive
      Na+-absorbing mechanisms in non-CF and CF epithelia. Furthermore, NO had no
      stimulatory effect on Cl- secretion by CFTR or any other Cl- conductance pathway
      in either tissue. Although NO elevated the intracellular Ca2+ concentration, we
      did not detect any activation of Ca2+-dependent Cl- channels. These results
      demonstrate that NO has no beneficial effect on CF epithelial cells of the upper
      airways.

PMID- 11205053
TI  - Calcitonin gene-related peptide suppresses the transient outward current in rat
      ventricular myocytes.
AB  - The effects of calcitonin gene-related peptide (CGRP) on the transient outward
      current (Ito) and the L-type calcium current (ICa,L) were investigated in
      isolated rat ventricular cardiomyocytes using the whole-cell, patch-clamp
      technique. CGRP influenced neither the amplitude nor the time course of ICa,L. On
      the other hand, at all membrane potentials at which a significant Ito was
      elicited, CGRP decreased its amplitude. The effect on Ito was completely
      reversible and independent of membrane potential. The steady-state activation and
      inactivation curves of Ito were not influenced by CGRP. The time course of Ito
      inactivation was satisfactorily fitted by two exponentials. Both the fast and the
      slow time constants of inactivation were voltage independent and were not
      influenced by CGRP. The effect of CGRP on Ito was concentration dependent with
      half-maximum inhibition at 99 nM. Chelerythrine, a selective inhibitor of protein
      kinase C, prevented the effect of CGRP on Ito. The data indicate that CGRP
      suppresses Ito in a concentration-dependent, but membrane potential-independent
      manner and that the effect is probably mediated via a protein kinase C-dependent
      pathway.

PMID- 11205054
TI  - Effects of endothelin-1 on calcium and potassium currents in undiseased human
      ventricular myocytes.
AB  - Endothelins have been reported to exert a wide range of electrophysiological
      effects in mammalian cardiac cells. These results are controversial and human
      data are not available. Our aim was to study the effects of endothelin-1 (ET-1, 8
      nmol/l) on the L-type calcium current (ICa-L) and various potassium currents
      (rapid component of the delayed rectifier, IKr; transient outward current, Ito;
      and the inward rectifier K current, IK1) in isolated human ventricular
      cardiomyocytes. Cells were obtained from undiseased donor hearts using
      collagenase digestion via the segment perfusion technique. The whole-cell
      configuration of the patch-clamp technique was applied to measure ionic currents
      at 37 degrees C. ET-1 significantly decreased peak ICa-L from 10.2+/-0.6 to 6.8+/
      0.8 pA/pF at +5 mV (66.7% of control, P<0.05, n=5). This reduction of peak
      current was accompanied by a lengthening of inactivation. The voltage dependence
      of steady-state activation and inactivation was not altered by ET- 1. IKr,
      measured as tail current amplitudes at 40 mV, decreased from 0.31+/-0.02 to
      0.06+/-0.02 pA/pF (20.3% of control, P<0.05, n=4) after exposure to ET-1. ET-1
      failed to change the peak amplitude of Ito, measured at +50 mV (9.3+/-4.6 and
      9.0+/-4.4 pA/pF before and after ET-1, respectively), or steady-state IK1
      amplitude, measured at the end of a 400-ms hyperpolarization to -100 mV (3.6+/
      1.4 and 3.7+/-1.4 pA/pF, n=4). The present results indicate that in undiseased
      human ventricular myocytes ET-1 inhibits both ICa-L and IKr; however, the degree
      of suppression of the two currents is different.

PMID- 11205055
TI  - The three mechanisms of intracellular chloride accumulation in vascular smooth
      muscle of human umbilical and placental arteries.
AB  - Recordings of membrane potential (Em) and intracellular [Cl-] ([Cl-]i) were made
      from the smooth muscle of human umbilical and placental arteries, using double
      barrelled, ion-sensitive microelectrodes. In both arteries, [Cl-]i was above
      equilibrium with Em. In the umbilical artery, [Cl-]i was 33.8+/-0.9 mM (+/-SD,
      n=19) and Em -54.9+/-1.3 mV and in the placental artery respectively 35.1+/-0.7
      mM (n=17) and -50.6+/-0.9 mV. In both arteries, [Cl-]i was reduced and Em
      hyperpolarised significantly by successive additions of 100 microM 4,4'
      diisothiocyanatodihydrostilbene-2,2'-disulphonic acid (DIDS), 10 microM
      bumetanide and 1 mM acetazolamide, thus revealing the presence of Cl-/HCO3-
      exchange, (Na+K+Cl) cotransport and "pump III". In the presence of all three
      inhibitors, [Cl-]i was in equilibrium with Em. As in earlier studies on rat
      arterial smooth and cardiac muscle, pump III was unaffected by DIDS, bumetanide,
      metolazone and the removal of Na+, partly inhibited by chlorothiazide and fully
      inhibited by ethacrynic acid. The results are discussed in terms of the
      possibility that of chloride accumulating systems may regulate vasomotor tone in
      the foetoplacental unit.

PMID- 11205056
TI  - Expression of the Na+/glucose co-transporter (SGLT1) in the intestine of domestic
      and wild ruminants.
AB  - The activity and abundance of the Na+/glucose co-transporter (SGLT1) was assessed
      in brush-border-membrane vesicles (BBMV) isolated from the intestine of grass-
      and roughage- (GR) consuming ruminants (sheep and dairy cattle), during the
      transition from the pre-ruminant to the mature ruminant state. The abundance of
      SGLT1 messenger ribonucleic acid (mRNA) was also compared in the intestinal
      tissue of the same animals. The dramatic developmental decline in the activity
      and expression of SGLT1 appears to be typical of GR-consuming ruminants and is
      coincident with the significant decline in the levels of lumenal monosaccharides.
      Expression of the ovine SGLT1 complementary deoxyribonucleic acid (cDNA) in
      Xenopus laevis oocytes confirmed that the isolated cDNA encodes for a functional
      Na+/glucose co-transporter. Determination of a bovine intestinal SGLT1 protein
      sequence (amino acids 347-658) indicated 99% similarity to the ovine SGLT1
      protein with differences in the carboxyl terminus. In contrast to GR-consuming
      ruminants, the abundance of SGLT1 protein and SGLT1 mRNA remained significantly
      high in the intestine of ruminants in both the intermediate-mixed (IM) feeding
      goat and fallow deer and the concentrate-selecting (CS) moose and roe deer,
      dietary groups correlating with the availability of monosaccharides in the
      intestinal lumen.

PMID- 11205057
TI  - The harmonization of physiology teaching: a tool for its recognition in European
      countries.

PMID- 11205058
TI  - The influence of beta-adrenergic activation on noradrenergic alpha1 activation of
      rabbit afferent arterioles.
AB  - The aim of the present investigation was to examine the effect of beta-adrenergic
      stimulation on smooth muscle calcium concentration ([Ca2+]i) in resting
      conditions and after administration of norepinephrine (NE) to stimulate alpha
      adrenoceptors in isolated rabbit afferent arterioles loaded with the calcium
      sensitive fluorescent probe fura-2. [Ca2+]i was evaluated in the proximal and
      distal parts of the arterioles. NE (4x10(-7) M) increased [Ca2+]i in both these
      regions. The alpha1-adrenoceptor antagonist prazosin (10(-7) M) totally abolished
      the NE-induced increase in [Ca2+]i, while the alpha2-adrenoceptor antagonist
      yohimbine (5x10(-7) M) had no influence on the response to NE. When beta
      adrenoceptors were stimulated, using isoproterenol (10(-7) M), the NE-induced
      increase in [Ca2+]i was significantly lower in both regions. Activation of beta
      adrenoceptors with isoproterenol did not affect the [Ca2+]i increase in response
      to depolarization with K+. Since beta-adrenoceptor stimulation raises the smooth
      muscle cell levels of cAMP, an adenylate cyclase stimulator, forskolin (10(-5) M)
      was administered prior to NE application. This maneuver also blunted the increase
      in [Ca2+]i in both regions. We conclude that the calcium response to NE in the
      isolated rabbit afferent arteriole is mediated by an alpha1-adrenoceptor. beta
      Adrenoceptor stimulation and forskolin blunt the increase in [Ca2+]i induced by
      NE stimulation, indicating that cAMP counteracts the NE-induced activation of
      alpha1-adrenoceptors.

PMID- 11205059
TI  - A new transducer based on the evanescent field effect for high-resolution
      displacement and force measurements.
AB  - A new transducer, using the effect of frustrated total internal reflection of
      electromagnetic waves, was developed for displacement and force measurements in
      muscle research. The physical theory for this effect predicts the formation of an
      evanescent electromagnetic field in the gap between two separated optical
      surfaces. This evanescent electromagnetic field enables the transmission of light
      across the gap between the two media, an effect not contained in ray optics
      formalism. In the apparatus described here, the optical surfaces were obtained by
      bevelling 2 optical fibres to angles higher than the specific critical angle of
      the media used. Since the amount of transmitted light depends strongly on the
      distance between the surfaces, very small forces are detectable if one fibre is
      used as a cantilever. To test the transducer a small myofibrillar bundle (20
      microm diameter) was mounted isometrically on it and contraction activated by
      release of "caged" Ca2+. Force and displacement steps of 180-220 nN and 9-11 nm
      respectively were measured with resolutions of 10 nN and 288 pm, respectively.
      From theoretical and practical considerations, it is expected that the presented
      principle will be able to achieve even much higher sensitivity for the
      determination of force (better than picoNewton) and distance (femtometre).

PMID- 11205060
TI  - Modulation of voltage-dependent facilitation of the T-type calcium current by
      sodium ion in isolated frog atrial cells.
AB  - Sodium ions have been reported to alter the permeation properties of L- and N
      type Ca2+ channels. Here in frog atrial cardiomyocytes under whole-cell patch
      clamp conditions, we have examined the effects of lowering the external Na+
      concentration on the amplitude of T-type Ca2+ current, ICaT, and on the relief of
      its steady-state inactivation by large depolarizing prepulses, ICaT facilitation.
      A partial reduction in Na+ ion concentration did not significantly alter ICaT
      amplitude elicited at -50 mV. However, after a large depolarization, low- Na+
      solutions enhanced the relief of inactivation and induced ICaT facilitation. This
      facilitation occurred independently of the divalent charge carrier, high
      intracellular Ca2+ buffering or the intracellular Na+ content. Its effects were
      additional to the beta-adrenergic effects mediated by a decrease of Gi/o-protein
      inhibitory tone. In Ca2+-free solution the very large T-type current, then
      carried by Na+ ions, showed only a weak relief of inactivation. In conclusion,
      ICaT facilitation--which, as previously reported, is modulated by the transient
      voltage-dependent relief of Gi-protein inhibitory tone--is further enhanced in a
      low-Na+ solution. In Ca2+-free solution, relief of inactivation due to re
      openings dependent on the divalent charge carrier is improbable. It thus appears
      that for a short while after a large depolarization, external Na+ compete with
      Ca2+ ions on permeation-controlling sites, so as to modulate channel re-openings
      and thus the amplitude of voltage-facilitated ICaT independently of the control
      exerted by the inhibitory G-protein.

PMID- 11205061
TI  - Evidence that aquaporin-8 is located in the basolateral membrane of rat
      submandibular gland acinar cells.
AB  - It is possible that, during primary saliva formation, aquaporins (AQPs)
      facilitate transcellular water flow across acinar cells to the lumina of salivary
      glands. In the rat submandibular gland (rSMG) AQP5 is localized in the apical
      membranes of acinar cells. The presence of a basolateral AQP in the same cell
      type has not been reported. We have therefore used immunofluorescence confocal
      microscopy to determine the subcellular localization of a newly discovered
      aquaporin, AQP8, in rSMG epithelial cells. The antibodies we used were made
      against the amino- or carboxyl-terminus (anti-rAQP8NT and anti-rAQP8CT,
      respectively) of an AQP8 cloned from rat pancreas and liver (rAQP8). Two lines of
      evidence suggest that both antibodies are suitable for immunolocalization
      studies. First, results of immunofluorescence confocal microscopy studies show
      that both antibodies bind to the plasma membranes of 293 cells infected with an
      adenovirus encoding rAQP8. Second, results of immunoblots of membranes from
      infected cells suggest that both antibodies bind to glycosylated and non
      glycosylated forms of rAQP8. When tested in frozen sections of rSMG, we could not
      detect the binding of anti-rAQP8NT to any membranes. In contrast, anti-rAQP8CT
      binds to the basolateral membranes of acinar (but not ductal) epithelia,
      suggesting that rAQP8 resides in the basolateral membranes of acinar cells. Lack
      of anti-rAQPNT binding to basolateral membranes suggests that this epitope is not
      available in the membranes. Our evidence for the basolateral localization of
      rAQP8 in acinar cells, coupled with previous findings that AQP5 is localized
      apically in the same cells, raises the possibility that water crosses the acinar
      epithelium through these channels during primary saliva formation.

PMID- 11205062
TI  - Presence and possible role of the spliced isoform of the P2X1 receptor in rat
      vascular smooth muscle cells.
AB  - An alternatively spliced isoform of the P2X1 receptor (P2X1a) was cloned from rat
      mesenteric artery. The spliced isoform does not have the 27 amino acids that are
      in the middle of the putative extracellular loop domain of the P2X1 original
      subunit (P2X1). Reverse transcriptase polymerase chain reaction (RT-PCR) revealed
      co-localization of P2X1a mRNA and P2X1 mRNA in vascular and other smooth muscle
      tissues and heart, but not in the spinal cord. In HEK293 cells transfected with
      P2X1 cDNA, ATP (1 microM) evoked an inward current which strongly desensitized,
      and an intense signal for GFP (green fluorescent protein) fused with P2X1 was
      detected at the membrane. Neither of these results was obtained in HEK293 cells
      expressing P2X1a alone. The fluorescent GFP signal was detected at the membrane
      when GFP-fused P2X1a was co-expressed with P2X1, and no significant difference in
      the ATP-activated current was noted between cells expressing P2X1 and those
      coexpressing P2X1 and P2X1a. These results indicate that the 27-amino-acid
      sequence (175-201) is important for protein trafficking to the membrane and for
      the formation of a functional P2X1 receptor. Our results also show that P2X1a is
      transported to the membrane when P2X1a is co-expressed with P2X1, although the co
      expression of P2X1a does not modify the channel's current properties.

PMID- 11205063
TI  - cAMP- and cGMP-independent stretch-induced changes in the contraction of rat
      atrium.
AB  - The stretch-induced changes in contraction force, cAMP and cGMP in isolated rat
      left atrium were studied. Increasing the diastolic intra-atrial pressure from 1
      cmH2O to 8 cmH2O caused an immediate (<500 ms) increase in contraction force, the
      magnitude of which was 2.24+/-0.29 (n=6) times the force elicited by 1 cmH2O.
      This was followed by a slower, gradual increase of the force, which was maximal 8
      min after the stretch (4.33+/-0.31, n=6). These phenomena were not accompanied by
      changes in the cAMP (n=24) or cGMP (n=24) concentrations within the tissue at any
      duration of stretch tested (2, 8, 20 and 36 min, n=6 at each time point).
      Furthermore, it was estimated that if the beta-adrenergic receptor agonist
      isoprenaline (100 nM) was used to produce an increase of the contraction force of
      the same magnitude as that induced by stretch, the cAMP concentration was greater
      (4.20+/-0.29 pmol/mg, n=5, P<0.001) when compared to that produced after 20 min
      of stretch (2.69+/-0.12 pmol/mg, n=6). Even without significantly changing the
      cGMP concentration, isoprenaline significantly increased the [cAMP]/[cGMP] ratio
      (3.4+/-0.36, n=5, P<0.01) compared to stretch (1.95+/-0.14, n=6). This result
      shows that in the rat atrium stretch does not regulate the production or
      breakdown of cyclic nucleotides (cAMP or cGMP). Thus it seems very unlikely that
      the effects of stretch on rat atrium function are caused by cAMP or cGMP.

PMID- 11205064
TI  - Hormones increase mRNA of cyclic-nucleotide-gated cation channels in airway
      epithelia.
AB  - Previous studies have shown that the mRNA of cyclic-nucleotide-gated nonselective
      cation (CNG) channels is expressed in rat airway epithelia and that these
      channels contribute to sodium-mediated short-circuit currents in cultured rat
      tracheal epithelia. Patch-clamp studies from human A549 cells indicate that these
      channels contribute to cGMP-stimulated L-cis-diltiazem- and dichlorobenzamil
      inhibited whole-cell sodium currents. This study demonstrates that mRNA for
      primary and secondary subunits of CNG channels, halphaCNG1 and hbetaCNG1
      respectively, are expressed in several human airway cell lines, including normal
      and cystic fibrosis bronchial airway cells, in normal and cystic fibrosis
      tracheal airway cell lines and nasal polyp tissue from a cystic fibrosis patient.
      The mRNA of ralphaCNG1 in rat lung increased in response to increased circulating
      glucocorticoids and decreased in animals with lowered circulating glucocorticoids
      after aminoglutethimide treatment. Likewise the mRNA of halphaCNG1 increased in
      the presence of glucocorticoids in cultured alveolar airway cells. The mRNA of
      alphaCNG1 in rat lung was also increased in response to a low-salt diet and
      lowered in animals fed a high-salt diet. Likewise the mRNA of alphaCNG1 was
      increased in response to increased aldosterone and decreased in animals given
      spironolactone. These results suggest that mRNA for alphaCNG1 increases in
      response to elevated glucocorticoids or mineralocorticoids. Because alphaCNG1 is
      a functional sodium entry channel in both rat and human airway epithelial cells,
      if channel protein is also elevated this channel could mediate an increase in
      sodium absorption across lung epithelia in response to circulating hormones.

PMID- 11205065
TI  - Differential lusitropic responsiveness to beta-adrenergic stimulation in rat
      atrial and ventricular cardiac myocytes.
AB  - Cardiac myocyte relaxation is brought about mainly through Ca2+ uptake into the
      sarcoplasmic reticulum (SR) by a Ca2+-ATPase isoform, SERCA2a. Its activity is
      modulated by another protein, phospholamban (PLB). The levels of both proteins
      differ in some mammals between atrial and ventricular myocardium and this may
      lead to differences in relaxation, especially under stimulatory conditions. At a
      concentration of 100 nM, the beta-adrenergic agonist isoprenaline (ISO)
      accelerates the relaxation of rat papillary muscle more than that of the left
      atria (16.4 versus 4.0% hastening of time to 50% relaxation, respectively).
      Ventricular myocytes were 24.7% quicker in reaching 50% of their diastolic length
      after contraction when treated with ISO compared to atrial myocytes, which were
      only 3.6% faster. Ca2+ fluorescence transients were also abbreviated in
      ventricular compared to atrial myocytes exposed to ISO (41.9 versus 25.2%
      hastening of time to 50% peak Ca2+ respectively). Ca2+ uptake into ventricular SR
      vesicles was increased by 13% in the presence of protein kinase A while that into
      atrial SR vesicles remained unaffected. Western blotting analysis revealed 23%
      less SERCA2a protein, but 76% more PLB in ventricular compared to atrial tissue.
      We conclude that the distinct levels of SERCA2a and PLB in ventricular and atrial
      myocardium are responsible for the differential modulation of the relaxation
      process arising from beta-adrenergic stimulation in single rat atrial and
      ventricular myocytes.

PMID- 11205066
TI  - Flunarizine pretreatment attenuates hyperthermia-induced extravasation in rats.
AB  - Previous work has established that there is an increase in endothelial
      permeability in hyperthermic rats. This work assessed the potential of the
      calcium channel blocker (E)-1-bis(4-fluorophenyl)methyl-4-(3-phenyl-2
      propenyl)piperazine dihydrochloride (flunarizine) as a pretreatment to ameliorate
      this extravasation. Five groups of male rats (n=12 rats per group, 400-500 g)
      were given 0, 0.3, 1, 2, or 3 mg/kg flunarizine (FL0, FL0.3, FL1, FL2, and FL3,
      respectively) by gavage 30 min prior to induction of hyperthermia. Hyperthermia
      was achieved by placing unrestrained animals in their own cages in a chamber
      maintained at 41.5 degrees C until a core temperature (Tc) of 42.6 degrees C was
      attained. Then, 25 mg/kg of Evans blue in saline was administered via a jugular
      cannula. After 15 min the animals were anesthetized, exsanguinated, tissues
      removed and washed in saline, and Evans blue extracted with formamide. As the
      dose of flunarizine was increased, there was a significant (P<0.05) reduction of
      Evans blue recovered from the liver, kidney, lung, spleen, and intestinal tissue.
      Endurance time in the heat to reach a Tc of 42.6 degrees C increased
      significantly from 194+/-39 min (mean+/-SD) with FL0 to 275+/-33 min with FL1,
      but decreased again with FL2 (206+/-42) and FL3 (199+/-60). Thus, flunarizine
      pretreatment attenuated hyperthermia-induced extravasation, and 1 mg/kg
      flunarizine markedly increased the tolerance time to heat exposure.

PMID- 11205067
TI  - Acute differential regulation by corticosteroids of epithelial sodium channel
      subunit and Nedd4 mRNA levels in the distal colon.
AB  - The molecular mechanisms by which corticosteroids affect fluid and electrolyte
      balance have yet to be fully elucidated. The apical amiloride-sensitive
      electrogenic epithelial sodium channel (ENaC) has been shown to have a central
      role in corticosteroid-mediated sodium transport in the distal colon. The acute
      response of the alpha-, beta- and gammaENaC subunit genes to a single parenteral
      dose of aldosterone or dexamethasone was examined in the rat distal colon in
      vivo. The response of the Nedd4 gene, whose product is involved in channel
      turnover, was also examined. Whilst the alphaENaC and Nedd4 genes showed no
      significant response to either steroid, both the beta- and gammaENaC mRNA levels
      were increased acutely by both aldosterone and dexamethasone. The gammaENaC mRNA
      appears to have a very short half-life. Use of the highly selective
      glucocorticoid receptor agonist RU28362 confirmed that the response was mediated
      by both the mineralocorticoid and glucocorticoid receptors.

PMID- 11205068
TI  - Glue solvent inhalation impairs host resistance to Mycobacterium bovis-induced
      infection in hamsters.
AB  - Industrial organic solvents present in glue are among the common used
      psychotropic drugs in Brazil and perhaps worldwide; but few data are available
      concerning the toxic effects of glue sniffing, with almost no information about
      immunotoxicity. This seems interesting because several drugs and environmental
      chemicals are recognized as potential immunotoxicants. The present study
      investigated the effects of forced inhalation of a toluene/n-hexane 1:1 mixture
      on hamster resistance to Mycobacterium bovis. Adult hamsters were divided at
      random into 3 equal groups. Animals of Groups E and E inhaled the mixture of
      toluene/n-hexane twice daily for 37 d. Group C was placed for the same period of
      time in identical chambers free of solvents. Two days after the beginning of the
      experiment, Groups E and C were injected ip with 0.5 ml of an activated
      suspension of M. bovis; Group E received the same volume of a control solution.
      Hamsters inhaling the toluene/n-hexane mixture (E) exhibited increased weight
      loss, increased scores of M. bovis colony forming units isolated from liver, lung
      and spleen, increased granulomatous areas in the liver, lung and spleen.
      Inhalation of the toluene/n-hexane mixture for 37 d also increased serum cortisol
      compared to control hamsters. Tuberculosis is an infection with an intracellular
      bacterium in which sensitivity is determined mainly by host response. The present
      data demonstrated impaired defense against M. bovis in hamsters inhaling a
      toluene/n-hexane mixture for 37 d. Since macrophages are the architectural and
      functional units of the granulomas in tuberculosis, and no data were found about
      glue solvent effects on cellular immunity, the present data suggest an indirect
      effect of glue solvents on macrophage/lymphocyte activity via stress induction
      and central nervous system stimulation of hormonal (ACTH/cortisol) secretion
      and/or autonomic nervous system activity.

PMID- 11205069
TI  - Ferrous sulfate adsorption by activated charcoal.
AB  - Although activated charcoal is thought to not appreciably adsorb iron salts,
      previous in vitro work indicates some adsorption of iron. This study
      characterized the adsorptive capacity of activated charcoal for ferrous sulfate
      at 3 pH environments. Langmuir adsorption isotherms were determined with a fixed
      amount of iron in the reaction vessels. Activated charcoal USP (20, 40, 60, 80,
      100, or 120 mg) was placed in plastic tubes to which were added 1 of 3 different
      simulated gastrointestinal fluids (pH = 1.5, 4.5, or 7.5) and 1.49% ferrous
      sulfate in water. The reaction vessels were agitated and immersed in a water bath
      at 37 C for 30 min. Each series was performed in triplicate. Following
      temperature eQuilibration filtration yielded an aliquot that was assayed for iron
      by atomic absorption spectrophotometry. Adsorptive capacities (mean +/- SD) of
      activated charcoal for ferrous sulfate (mg elemental iron/g charcoal) at pH 4.5
      (102.96+/-4.49) and pH 7.5 (100.94+/-19.02) were higher (P<0.01) than at pH 1.5 (
      0.01+/-0.26). At pH 1.5 iron was not appreciably adsorbed by activated charcoal.
      Activated charcoal adsorbed ferrous sulfate to a greater extent at pH
      environments where iron is typically absorbed from the gastrointestinal tract.
      These results indicate that activated charcoal may prove an effective therapy for
      acute iron poisoning and further investigation is warranted.

PMID- 11205070
TI  - Systemic toxicity from repeated cutaneous contact with 2,4-pentanedione.
AB  - 2,4-Pentanedione (2,4 PD; CAS Number 123-54-6) is an industrial chemical with
      potential for skin contact. Repeated exposure studies by peroral and inhalation
      routes have shown central neurotoxicity and possible effects on the immune
      system. To determine the likelihood for systemic toxicity by cutaneous contact
      with 2,4-PD, a short-term repeated skin contact study was conducted in New
      Zealand white rabbits. The planned protocol was for dosing, with 0.5, 1.0 and 1.5
      ml undiluted 2,4-PD by 6 h occlusive contact/d for 9 d; these were equivalent to
      dosages of 244, 975 and 1463 mg/kg/d. A dosage-related skin irritation was seen
      macroscopically and by light microscopy, which was minimal at the low dosage.
      Mortalities occurred at the mid (1/6 males, 3/6 females) and high dosages (5/12
      males, 7/12 females), with deaths between the 2nd and 5th dosing day. In view of
      these mortalities and signs, dosing of the mid and high dose animals was
      discontinued, and survivors were kept to the end of the dosing period. Signs at
      the mid and high dosage included hypoactivity, tremors, convulsions,
      uncoordinated movements and prostration, and appeared between the 2nd and 4th
      dose. Body weight gain and food consumption were reduced for the mid and high
      dosage groups. Increased hemoglobin, hematocrit and erythrocyte counts may have
      been associated with dehydration, and increased heterophil count with cutaneous
      inflammation. Several serum biochemical changes reflected cutaneous irritation,
      and high creatine kinase activity was probably a consequence of convulsions.
      Immune effects included decreased lymphocyte counts and lymphoid necrosis in
      spleen and thymus. Central neuropathology in the mid and high dosages was seen as
      hemorrhages and neuronal degeneration, the latter principally in piriform cortex,
      globus pallidus and hippocampus. No peripheral neuropathy was present. 244
      mg/kg/d was the no-effects dosage for systemic toxicity. This study confirmed a
      potential for systemic toxicity, principally central neurotoxicity, from
      percutaneous absorption of 2,4-PD.

PMID- 11205071
TI  - Cholinesterase activity:muscarinic receptor ratios in canine and feline brains.
AB  - In response to findings that brain cholinesterase (ChE): muscarinic cholinergic
      receptor density (mChR) ratio is highly conserved between bird species (I), this
      study investigated the conservation of brain ChE:mChR between 2 mammalian
      species. Whole brains of 7 normal greyhounds, 14 normal non-greyhound dogs, and 8
      normal cats, were assayed for ChE, mChR and protein. The same assays were made on
      cerebrum, cerebellum and brainstem from the greyhounds and 6 of the non-greyhound
      dogs. The Ellman assay was used to measure serum ChE activity, mChR were labelled
      with tritiated quinuclidinyl benzilate, and protein was measured by Lowry assay.
      Brain ChE:mChR was not highly conserved between the species. There was a
      statistically significant difference in brain mChR between greyhounds and non
      greyhounds but this did not translate to a statistically significant difference
      in mean ChE:mChR. Measurement of ChE:mChR is unlikely to be useful in endangered
      carnivores for which normal ChE levels are unknown, because it cannot be assumed
      that endangered species would have the same ChE:mChR as their domestic relatives.

PMID- 11205072
TI  - Squamous epithelial proliferation in the jaws of mink fed diets containing
      3,3',4,4',5-pentachlorobiphenyl (PCB 126) or 2,3,7,8-tetrachlorodibenzo-P-dioxin
      (TCDD).
AB  - Previous research has shown that ingestion of 3,3',4,4',5-pentachlorobiphenyl
      (PCB 126) by juvenile mink (kits) caused a lesion in the mandible and maxilla
      that consisted of proliferation of sQuamous epithelium in the periodontal
      ligament, osteolysis of adjacent alveolar bone, and loose and displaced teeth.
      Similar, but less severe changes, developed in adult mink fed 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD). The present study was conducted to compare
      similarities and differences of the lesion within the jaws of mink fed these 2
      polyhalogenated hydrocarbons. Diets containing 24 ppb PCB 126 or 2.4 ppb TCDD
      were fed to 6-w-old kits for 36 d. Similar diets were fed to 12-w-old kits for 35
      d. Some of these mink were then fed untreated feed for an additional 50 d. All
      mink treated with PCB 126 or TCDD had reductions in body weight gains which were
      more severe in the 6-w-old kits than the 12-week-old kits. By 28 days of
      exposure, many of the 6- and 12-week-old mink treated with PCB 126 or TCDD had
      loose and displaced incisor teeth. Canine teeth were grossly more prominant.
      Radiographs showed maxillary and mandibular osteolysis with lysis of the lamina
      dura in treated mink. Withdrawal of the toxicants from the diets of the 12-w-old
      mink failed to alleviate the lesions, which continued to be progressively more
      severe.

PMID- 11205073
TI  - Anagallis arvensis poisoning in cattle and sheep in Uruguay.
AB  - Outbreaks of Anagallis arvensis poisoning were observed from 1994 to 1998 in
      cattle and sheep in Uruguay during December and January. Cattle morbidity varied
      between 3.2 and 53.2% and lethality 42.6 and 100%. Sheep morbidity was 2.8 to
      42.9% and lethality 81.3 to 100%. Nine outbreaks occurred on barley and wheat
      stubble, and 1 in a field previousy ploughed but not cultivated. Clinical signs
      were weakness, staggers, diarrhea (sometimes bloody), coma, and death. Serum
      levels of creatinine and urea were elevated. Gross lesions were characterized by
      sc petechiae, fluid in body cavities, mesenteric and perirenal edema, yellowish
      or pale kidneys with petechiae on the cortex, esophageal erosive lesions or
      ulcers, and hemorrhagic abomasitis and enteritis. Severe nephrosis was observed
      histologically. The green plant collected in a field where an outbreak occurred
      was administered to 2 sheep at doses of 160 and 224 g/kg bw and produced clinical
      signs and pathology similar to those observed in field cases.

PMID- 11205074
TI  - Paraquat poisoning in a family.
AB  - A familial occurrence of acute paraquat (PQ) poisoning is reported. The mother
      administered a PQ solution to their 3 children aged 8 y, 6 y and 15 mo and then
      ingested an unknown amount of the herbicide herself. In the absence of history or
      diagnostic signs, the poisoning was initially misdiagnosed as gastroenteritis.
      Thirty h after the ingestions, serum PQ concentrations of the children were 60,
      <6 and 25 ng/ml respectively. Hemoperfusion was performed on all patients, and 2
      of the children also received plasmapheresis and erythropheresis. The 3 children
      recovered fully but the mother died. According to these patients' data, the
      extracorporeal techniques had little effect on PQ removal, and the decreases in
      serum PQ were related to its urinary excretion.

PMID- 11205075
TI  - Intermediate syndrome secondary to ingestion of chlorpiriphos.
AB  - A rural-area resident male patient deliberately ingested chlorpiriphos, an
      organophosphate insecticide. Although presented with cholinergic symptoms
      initially, he suffered general condition deterioration after 4 d characterized by
      muscular weakness, hypotonia, arreflexia and recumbent dyspnea requiring
      ventilatory support. These clinical manifestations occur from liposoluble
      organophosphates or metabolites with long-lasting half time, causeing delayed
      inhibition of acetylcholinesterase and subsequent burn out of the neuromuscular
      junction from acetylcholine overstimulation.

PMID- 11205076
TI  - A fatal case of apparent water hemlock poisoning.
AB  - A 14-y-o North American native boy died 20 h after ingesting "wild carrot". He
      was gathering edible plants with his family on Canadian Thanksgiving. A sample of
      the plant he ingested couldn't be positively identified but it contained
      cicutoxin on chromatography. Bioassay caused death in mice which demonstrated
      clinical signs similar to water hemlock (Cicuta maculata) poisonings. Cicutoxin
      could not be demonstrated in postmortem tissue or gastric lavage. The boy's
      clinical signs and laboratory tests were consistent with other reported cases of
      this poisoning.

PMID- 11205077
TI  - Field observations of Ateleia glazioviana poisoning in cattle in Southern Brazil.
AB  - Ateleia glazioviana is an important poisonous plant from southern Brazil. Heavy
      losses in cattle from this region occur each year due to ingestion of the plant.
      The epidemiological, clinical, gross and histopathological features of A.
      glazioviana poisoning in cattle are described here from a 5-year field survey in
      southern Brazil. A. glazioviana poisoning in cattle induces 3 clinical
      presentations: abortions, disease characterized by lethargy, and cardiac failure.
      The latter is associated with marked necrosis and fibrosis of the myocardium and
      can cause sudden death or congestive heart failure.

PMID- 11205078
TI  - Prolonged coma and loss of brainstem reflexes following amitriptyline overdose.
AB  - Severe tricyclic antidepressant (TCA) overdose is generally manifested by
      cardiovascular and/or central nervous system toxicity. Although the majority of
      patients who are comatose following these overdoses regain consciousness within
      24 h, this case had 5-days of coma with associated loss of brainstem reflexes.
      Severe central nervous system depression can occur as a sole manifestation of TCA
      overdose without concomitant cardiovascular toxicity.

PMID- 11205079
TI  - Implementation of Toxicall: impact on documentation.
AB  - On January 1, 1999, the Washington Poison Center implemented Toxicall; 6 mo later
      we measured its impact on time devoted by staff for telephone interchange,
      information retrieval from other than Poisindex, and documentation, and to
      compare it with prior studies of our conventional paper-pencil system. Previous
      "time and motion" studies over the past decade, using random alarm devices
      (Devilbiss Electronics) provided data for comparative purposes. We developed a
      computer-based alarm system for timing and station selection and for recording
      observed behaviors. Over a 6-w period, 211 calls were analyzed; the percentage of
      time involved for each call was compared to a 1993 study. An increased, rather
      than anticipated decreased, documentation effort was observed (p< 0.05), but
      staff participation in activities other than those listed fell dramatically
      suggesting increased staff efficiency. Although documentation efforts consume so
      much time, Toxicall provided the non-debatable benefit of eliminating illegible
      staff handwriting!

PMID- 11205080
TI  - Decoding "drug imprints" at the millennium: a proposal to increase accuracy and
      reduce costs.
AB  - The State of Washington mandated the use of imprints on all prescription drugs in
      1980 and for "OTC's" in 1991. The FDA implemented federal requirements in 1995.
      Unfortunately, the FDA permitted the continued use of symbols, logotypes, and
      trademarks as code components, limiting the use of automated recognition systems.
      Analyses of several week-long samples of phone inquiries documented imprinting
      calls, the staff's ability to respond with an identification, the information
      sources used, and apparent reasons for any failure. In the first week we received
      666 decoding requests, which when projected for the year amounted to > 25,000
      calls. A review of 1999 data exceeded that number. Staff was able to reach drug
      identification in 93.8% of inquiries. Uninterpretable symbols and absence of code
      listings contributed to the 36 failures. Projecting over the US suggested as many
      as 1.25 million calls costing poison centers $25 million/y. A touch-tone
      telephone or website response system could permit automated responses. Neither
      solution is feasible without the elimination of symbols or logotypes when using
      an exclusively alpha-numeric code.

PMID- 11205081
TI  - Pulmonary diseases caused by airborne contaminants in swine confinement
      buildings.
AB  - Exposure to toxic gases and particles or dusts while working or living in
      confinement animal systems pose a pulmonary health hazard. The severity of lung
      impairment from exposure to such environment is investigated using intratracheal
      instillation, intratracheal nebulization, and inhalation procedures. Ability to
      deliver particles with intratracheal instillation that are evenly distributed
      throughout the lung depends on the material used for injection. Pulmonary
      histopathology reflects anatomic changes following inhalation or instillation of
      chemicals or particles. Endobronchial saline washings of bronchioles and alveoli
      allow measurement of markers of pulmonary inflammation such as total nucleated
      cell (leukocyte) counts and those of macrophages, neutrophils and lymphocytes;
      TNF-alpha, and collagen concentration are used to further evaluate pulmonary
      response to endotoxin or dust exposure. Alveolar epithelial cells have an
      important role in clearing pulmonary fluid and maintaining the structure of lung
      tissue. After repeated exposure, damage to epithelial cells may result in their
      death, causing edema and collagen deposition that may lead to fibrosis.

PMID- 11205082
TI  - Quoth the EPA--ever less!

PMID- 11205083
TI  - Agonistic and antagonistic effects of zearalenone, an etrogenic mycotoxin, on
      SKN, HHUA, and HepG2 human cancer cell lines.
AB  - Zearalenone (ZEA) is a nonsteroidal estrogenic compound mainly produced by the
      molds Fusarium graminearium and Fusarium culmorum found in a variety of host
      plants and soil debris around the world. ZEA is usualy non-lethal to animals but
      is important to livestock producers because its hyperestrogenic effects adversely
      influence the reproductive performance of animals. There have been suggestions of
      possible involvement of ZEA in the progression of breast malignancies and tumors
      of the female reproductive tract in humans. The toxic or stimulatory effects of
      ZEA and its metabolites alpha-zearalenol and 17-beta-estradiol on SKN, HHUAand
      HepG2 cells were studied using rapid colorimetric MTT assay. In general, both
      concentrations of 17-beta-estradiol (100M and 10 nM) were toxic to SKN and HHUA
      cell cultures. Both ZEA and alpha-zearalenol stimulated the proliferation of SKN
      and HHUA cells. On HepG2 cells, lower concentrations (10 nM) of 17-beta-estradiol
      and higher concentrations (100 microM) of ZEA exhibited toxic effects, whereas
      treatment with higher concentrations of 17-beta-estradiol and lower concentration
      of ZEA did not show toxic effects. A dose dependent antagonistic effect was
      observed when the cell cultures were pre-incubated with ICI 182,780, a synthetic
      estrogen receptor blocker, before estradiol or mycotoxin treatments.

PMID- 11205084
TI  - The concept of placebo and general practice. Is it time to avoid the word
      placebo?

PMID- 11205085
TI  - Report from University of Bristol.

PMID- 11205086
TI  - Significant event auditing.
AB  - Significant event auditing has been described for 5 years and it is slowly
      gaining credibility as an effective method of quality assurance in British
      general practice. This paper describes what it is, what its background is, how it
      is done and whether it is effective. While it needs a positive team culture - and
      therefore may not suit every practice - where it is used it appears to be a
      useful adjunct to a clinical audit programme.

PMID- 11205087
TI  - Screening for hearing and visual loss among elderly with questionnaires and
      tests: which method is the most convincing for action?
AB  - OBJECTIVE: To examine the extent to which self-report and performance-based
      measures identify the same people, and also whether one of these methods any more
      than the other induces the general practitioner (GP) to offer a patient help?
      DESIGN: Comparison of tests and questionnaire in a screening programme for
      hearing and visual loss. SETTING: Twelve general practices in the western part of
      The Netherlands. PATIENTS: 1121 people 75 years of age and older. MAIN OUTCOME
      MEASURES: Hearing loss according to the whispered voice test and two questions
      (Q1, Q2) and visual loss according to the Snellen and low vision charts and two
      questions (Q3, Q4). The extent to which test and questions influence the GP's
      judgment regarding intervention is calculated using logistic regression. RESULTS:
      For hearing loss, the concordance of the whispered voice test with Q1 was 67%,
      and with Q2, 71%. For visual loss, the concordance of the Snellen chart with Q3
      was 79% and of the Low Vision Chart with Q4, 69%. For hearing loss, the results
      of the test were noticeably more significant for the GP in offering help than the
      answers to the questions, and for visual loss the results of the Snellen chart
      slightly more convincing than the answers to the questions. CONCLUSION: When in a
      screening programme with simple instruments for visual and hearing loss the
      choice has to be made between questionnaire and tests, the tests will be the best
      choice.

PMID- 11205088
TI  - Clinical findings in a population with back pain. Relation to one-year outcome
      and long-term sick leave.
AB  - OBJECTIVE: To investigate whether physical examination findings can be used in
      predicting recovery from back pain and new episodes of sick leave. DESIGN: One
      year prospective study of a single cohort. SETTINGS: Semi-rural Swedish county.
      POPULATION: A cross-section of a general population with back pain (207 women,
      176 men) between 20 and 59 years of age. MAIN OUTCOME MEASURES: Cumulative
      incidence of sick leave due to back pain, cumulative incidence of sick leave due
      to back pain > 30 days, incidence of recovery from back pain. RESULTS: For
      recovery from pain, the absence of tenderness in the trapezius muscle (OR 0.33;
      CI 0.1-0.5) was predictive. New sick leave was predicted by tenderness in the
      trapezius muscle (OR 2.67; CI 1.5-4.9), and had a tendency to be associated with
      a flattened lumbar lordosis and a restricted cervical range of motion. For long
      term sick leave, the same findings and also observation of scoliosis (OR 3.44; CI
      1.1-10.5) were predictive. CONCLUSION: There are subgroups with back pain
      predisposed to development of more persistent symptoms and a higher risk for sick
      listing.

PMID- 11205089
TI  - Effects on physicians' sick-listing practice of an administrative reform
      narrowing sick-listing benefits.
AB  - OBJECTIVE: To find out whether administrative changes regulating sick-listing
      benefits affect sick-listing practice among physicians in hospitals and primary
      health care. SETTING: New sick-listing cases from four social security offices in
      mid-Sweden. DESIGN: A natural experiment design was used with a sample of newly
      started sick-listed cases collected 6 months before a sick-listing reform and a
      further sample taken 6 months after. The data were collected in a 1-year follow
      up period in both samples. MAIN OUTCOME MEASURES: Net days of sick-listing and
      percentage partial sick-listings. Compliance by doctors in providing information
      asked for in sickness certification forms. RESULTS: Doctors filled in the forms
      more completely after the reform than they did before it. There was an inverse
      correlation between completeness of information and length of sick-listing. When
      potential confounding factors were taken into account, no change was seen in the
      proportion of partial sick-listing, in the mean number of net days of sick
      listing or in the distribution of length of sick-listing periods. The proportion
      of all sick-listings made by general practitioners increased. CONCLUSIONS:
      Administrative changes restricting sick-listing benefits did change some aspects
      of sick-listing practice but had no effect on length of sick-listing.

PMID- 11205090
TI  - Wound management for 287 patients with chronic leg ulcers demands 12 full-time
      nurses. Leg ulcer epidemiology and care in a well-defined population in southern
      Sweden.
AB  - OBJECTIVE: To study the prevalence, aetiology and treatment of chronic leg and
      foot ulcers, and to estimate the nurse's time in wound management. DESIGN: A
      structured questionnaire with 19 questions about chronic ulcers and wound
      management was sent to all district and community nurses in the county during 1
      week in March 1998. A similar questionnaire has been administered regularly since
      1986. SETTING: Primary and community care in the county of Blekinge, Sweden, with
      a population of 1,51,610. PATIENTS: 287 patients with chronic leg and foot ulcers
      were identified during the week studied. MAIN OUTCOME MEASURES: Prevalence of leg
      and foot ulcers, ulcer aetiology, treatment of ulcers and wound management time.
      RESULTS: The estimated prevalence of chronic leg and foot ulcers was 0.19%.
      Venous ulcers were the most common (38%), of which 87% were treated with some
      form of compression therapy. Seven percent of the nurse's workload was devoted to
      ulcer care. During the period 1986 to 1998, ulcers with missing or unknown
      aetiology decreased from 31% to 6% and ulcers with a duration of more than 2
      years from 44% to 27%, while treatment time per ulcer decreased from 2.1 to 1.7
      hours/week. CONCLUSION: Monitoring standards for ulcer aetiology through repeated
      questionnaires seems to ensure more accurate diagnoses. Thorough and detailed
      information about treatment time documents the workload for wound management.

PMID- 11205091
TI  - Drug treatment of heart failure--do nursing-home residents deserve better?
AB  - OBJECTIVE: To describe and assess drug treatment of heart failure (HF) in nursing
      home residents. DESIGN: Descriptive cross-sectional study. Individual patient
      information was obtained from the medical records and drug-dispensing cards.
      SETTING: Nursing homes in Bergen, Norway. MAIN OUTCOME MEASURES: Demographic
      data, diagnostic data (main diagnoses, diagnostic indications for the drugs
      used), medications (drugs, dosage and duration of use). RESULTS: Data were
      gathered from 23 of 27 obtainable institutions representing 1552 residents (86%
      of the Bergen nursing-home population); 469 (30%) of the residents used drugs for
      HF, the majority of whom (293 patients) were treated with furosemide only.
      Supplementary angiotensin-converting enzyme (ACE) inhibitors (predominantly in
      sub-target doses) were provided to 17% of the HF patients. About one out of four
      used drug combinations which we considered to be potentially harmful for HF
      patients. CONCLUSIONS: ACE inhibitors are probably under-utilised for HF in
      nursing-home residents. Potentially harmful drug combinations commonly occur.
      Both diagnosis and drug treatment for HF should be challenged in the nursing-home
      setting.

PMID- 11205092
TI  - How well are patients with atherosclerotic disease treated? Secondary prevention
      in primary care.
AB  - OBJECTIVE: To examine changing trends in the field of secondary prevention of
      atherosclerotic disease in Norwegian general practice. DESIGN: A multipractice
      survey of consecutive patients with atherosclerotic disease consulting general
      practitioners in 1994/95 compared with a similar survey in 1996/97. SETTING:
      Primary health care. SUBJECTS: 707 patients attending 31 general practitioners in
      1994/95 and 1353 patients attending 63 general practitioners in 1996/97. MAIN
      OUTCOME MEASURES: The patients were examined and interviewed for risk factors and
      pharmacological treatment. RESULTS: In 1994/95, 18% of the patients had been
      prescribed a lipid-lowering agent as opposed to 55% in the later survey.
      Consequently, the average level of LDL cholesterol in the 1996/97 population was
      19% lower than in the 1994/95 population (3.8 mmol/l vs 4.7 mmol/l), which may
      imply a marked risk reduction. Aspirin and beta-blockers were prescribed to
      approximately 50% of the patients in both surveys. Diabetic patients had the same
      drug prescription rate and lipid profile as non-diabetics. In both surveys, about
      25% of the patients were smokers. CONCLUSION: Secondary prevention in the
      majority of patients with atherosclerotic disease though ameliorating is still
      unsatisfactory. More attention is needed to achieve and sustain treatment goals.

PMID- 11205093
TI  - Effectiveness of a co-ordinated nation-wide programme to improve influenza
      immunisation rates in The Netherlands.
AB  - OBJECTIVE: To assess t he effectiveness of a nation-widemultifaceted intervention
      programme involving general practitioners (GPs) on influenza immunisation
      practice. DESIGN: Pragmatic before-after trial using pre- and post-measurement
      questionnaires. SETTING AND SUBJECTS: Random sample of Dutch general practices.
      INTERVENTION: During a 2.5-year period (1995-1997) a variety of methods was
      implemented to enhance physician adoption of the immunisation guideline,
      including employment of facilitators, information-based methods, small-group
      consensus meetings, individual instructions and introduction of supportive
      computer software. MAIN OUTCOME MEASURES: Influenza immunisation practice and
      influenza vaccine uptake. RESULTS: In 988 practices all influenza vaccination
      characteristics markedly improved from 1995 to 1997. The most significant changes
      were found in computerised marking of high-risk patients (from 54% to 82% of
      practices), computerised selection (41% to 77%) and sending personal reminders
      (40% to 77%). Vaccine uptake increased from 9% to 16% of the practice population
      (78% increase, p < 0.001). Uptake was most prominent in urban and single-handed
      practices and in those with more patients insured through the National Health
      Service, low GP workload and low baseline uptake. CONCLUSION: Our data suggest
      that a co-ordinated approach involving primary care physicians can succeed in
      enlarging the public health impact of a population-based preventive measure.

PMID- 11205094
TI  - Standardised procedures can improve the validity of susceptibility testing of
      uropathogenic bacteria in general practice.
AB  - OBJECTIVE: To investigate whether the validity of susceptibility testing in
      general practice would improve when preceded by an intervention. INTERVENTION:
      Instruction in standardised susceptibility testing procedures given by laboratory
      instructors. METHOD: Urine specimens containing monocultures of typical
      uropathogenic bacteria were sent to 23 general practices before and after the
      intervention. Practices performed susceptibility testing by the Sensicult and the
      Iso-Res agar methods and the validity of the results before and after the
      intervention was compared. Results from susceptibility testing at the
      bacteriological laboratory, Odense University Hospital, were used as gold
      standard. RESULTS: The median frequency of correct results increased from 82% to
      98% for susceptibility testing based on Sensicult (p = 0.001) and from 90% to 96%
      based on Iso-Res agar (p = 0.05). CONCLUSION: The validity of susceptibility
      testing in general practice improves when preceded by instruction in standardised
      procedures.

PMID- 11205095
TI  - Smoking cessation. A comparative, randomised study between management in general
      practice and the behavioural programme SmokEnders.
AB  - OBJECTIVE: To compare the effectiveness of two different stop smoking
      interventions. DESIGN: A randomised, controlled trial. Results based on intention
      to treat. SETTING: Three towns in the south-eastern part of Norway.
      INTERVENTIONS: Visits to GP for "practice as usual" (GP group) or participation
      in the behavioural programme SmokEnders (SE group) with follow-up 2 weeks, 2
      months and 1 year after an agreed stopping date. SUBJECTS: 139 smokers recruited
      through open invitation. MAIN OUTCOME MEASURE: Self-reported smoking stop rate 2
      weeks, 2 months and 1 year after an agreed stopping date, completed with
      biochemical indicators by the 1-year registration. RESULTS: Two weeks after the
      agreed cessation date, 10/70 (14%) of the GP group and 46/69 (67%) of the SE
      group had stopped smoking. After 2 months, 9/70 (13%) in the GP group and 37/69
      (54%) in the SE group were non-smokers. One year after cessation 5/70 (7%) in the
      GP group and 21/69 (30%) in the SE group were non-smokers. CONCLUSIONS: Both
      interventions were effective as measured by the smoking cessation rate. However,
      the intervention in the SE group was considerably more effective than in the GP
      group, which suffered from a sizeable number of drop-outs.

PMID- 11205096
TI  - Quality improvement in primary health care using computerised journal,
      exemplified by a smoking cessation programme for diabetic patients.
AB  - OBJECTIVE: To study the possibility of using the computerised journal for quality
      improvement in diabetes care. DESIGN: The computerised journal was used to reach
      all diabetic smokers aged 30-75 years and to invite them to a structured smoking
      cessation programme. The follow-up time was 18 months. SETTING: Habo, a Swedish
      community with 9600 inhabitants, with one primary health care centre. SUBJECTS:
      147 subjects, aged 30-75 years, were registered with the diagnosis of diabetes
      mellitus in the computerised journal at the primary health care centre.
      Altogetber 25 of these patients were registered as smokers in the journal. All of
      them were invited to a smoking cessation group. RESULTS: Information about
      smoking habits in the journal was available for all but 11%. After 18 months'
      follow-up, 9 of the 14 patients (64%) who started in the smoking cessation group
      had become non-smokers. Of those 11 subjects who did not attend the group, 6 had
      stopped smoking during the follow-up time in spite of not participating in the
      structured programme. CONCLUSION: The computerised journal is a useful tool for
      quality improvement, giving the opportunity for directed preventive efforts on
      selected patient groups.

PMID- 11205097
TI  - Author index to volume 85, 2000.

PMID- 11205098
TI  - Deletions near the N-terminus of HIV-1 Rev reduce RNA binding affinity and
      dominantly interfere with Rev function irrespective of the RNA target.
AB  - The contributions of the near N-terminal residues of Rev protein of HIV were
      investigated by analyzing N-terminal deletions of Rev in the context of a Rev/MS
      C fusion protein that can bind and activate both the Rev responsive element (RRE)
      and the MS2 phage translational operator RNAs. Rev/MS-C fusion proteins deleted
      for residues 3-19 of Rev retained trans-activation potential for both RRE and MS2
      targets. Coincidentally, peptides spanning residues 17-87 or 22-85 were
      functionally competent for trans-activation of RRE containing HIV-1 gag mRNA.
      Deletion of residues 18-24 of Rev in the Rev/MS-C fusion protein abolished the
      activation potential for both RRE and MS2 targets, although this mutant was
      competent for specific RNA binding, protein multimerization, and nuclear and
      nucleolar localization. Four mutants dominantly interfering with Rev activation
      of RRE were mapped near the N-terminus of Rev; (i) between residues 18 and 24,
      (ii) 25-34, (iii) 43-50, and (iv) 51-60. Of these, the mutant lacking residues 18
      24 was a novel trans-dominant inhibitor of Rev and Rev/MS-C for activation of RRE
      or MS2 RNA, while the oligomerization domain mutants mapping between residues 25
      34 or 51-60 inhibited the activation of RRE rather than MS2 RNA.

PMID- 11205099
TI  - Cloning and sequencing of columbid circovirus (coCV), a new circovirus from
      pigeons.
AB  - The complete nucleotide sequence of columbid circovirus (CoCV) isolated from
      pigeons is described. CoCV was amplified using a consensus primer PCR approach
      directed against conserved sequences within the rep genes of vertebrate
      circoviruses. The genome of CoCV is circular and 2037 nt in size. It displays 55%
      homology to the genome of psittacine beak and feather disease virus and is more
      distantly related (< 40% homology) to porcine circovirus type 1 and 2. Two major
      open reading frames were identified, encoding the replicase and the putative
      capsid protein of CoCV. A region similar to the origin of replication of other
      circoviruses was found: it encompasses a stem-loop structure with the nonamer 5'
      TAGTATTAC, conserved in circo-, nano- and geminiviruses. Phylogenetic analyses
      suggest classification of CoCV as member of the genus Circovirus of the virus
      family Circoviridae.

PMID- 11205100
TI  - Isolation and characterization of simian immunodeficiency virus variants that are
      resistant to nonnucleoside reverse transcriptase inhibitors.
AB  - Non-nucleoside reverse transcriptase inhibitors (NNRTIs) act quite specifically
      on human immunodeficiency virus type 1 (HIV-1). In general, they are not
      effective on human immunodeficiency virus type 2 (HIV-2) or simian
      immunodeficiency virus (SIV). Only SIV strains from African green monkeys are
      sensitive to several NNRTIs. Here we isolated NNRTI- and 3TC-resistant SIVagm
      variants. Viruses resistant to delavirdine contained V112I and M231I
      substitutions, while those resistant to 3TC contained a M 185I substitution.
      These amino acids are highly conserved in HIV-1, HIV-2, SIVmac and SIVagm, and
      the M184I (M185I in SIVagm) substitution was observed in 3TC-resistant HIV-1 and
      SIVmac. The roles of the observed mutations in NNRTI-resistance of SIVagm and HIV
      1 were further confirmed by site-directed mutagenesis. The present results have
      provided a new insight into the common mechanism of sensitivity of HIV- 1 and
      SIVagm to NNRTIs.

PMID- 11205101
TI  - Mutational analysis of the NIa protease from pepper vein banding potyvirus.
AB  - The nuclear inclusion protein a (NIa) protease plays an important role in the
      life cycle of potyviruses by processing the viral polyprotein into functional
      proteins. For functional characterization, the NIa protease from Pepper vein
      banding potyvir s (PVBV) was overexpressed in Escherichia coli and purified.
      Using a recombinant polyprotein substrate containing the nuclear inclusion
      protein b (NIb)-coat protein (CP) cleavage site, a trans-cleavage assay was
      developed for the NIa protease. The polyprotein substrate also possessed the
      cleavage site between NIa and NIb, in addition to the NIb-CP site. However, no
      trans-cleavage by the NIa protease between NIa and NIb was detected indicating
      that the cleavage between NIa and NIb under natural conditions would be by a cis
      cleavage reaction. Site-specific mutations of the conserved residues D81, D90,
      C110, T146, C151 and H167 were performed to investigate their roles in the
      catalytic process of the protease. Such an analysis has revealed that D81 and
      C151 constitute two of the catalytic triad residues in the NIa protease, D90 and
      C110 are not essential for catalysis, and T146 and H167 are probably involved in
      binding to Gln at the P1 position of the substrate.

PMID- 11205102
TI  - Molecular characterization of Hop latent virus and phylogenetic relationships
      among viruses closely related to carlaviruses.
AB  - The complete nucleotide sequence of the hop latent virus (HpLV) genome was
      determined. The viral RNA genome is 8,612 nucleotides long, excluding the poly(A)
      tail, and contains six open reading frames (ORFs), which encode putative proteins
      of 224-kDa (ORF 1), 25-kDa (ORF 2), 11-kDa (ORF 3), 7-kDa (ORF 4), 34-kDa (ORF
      5), and 12-kDa (ORF 6). ORF 5 encodes the coat protein as demonstrated by N
      terminal sequencing of three proteolytic peptides derived from the virus
      particle. The genome organization of HpLV is similar to that of other species in
      the genus Carlavirus, and the overall sequence of HpLV is more similar to that of
      Potato virus M than to sequences of other carlaviruses reported to date. The
      amino acid sequences of the putative methyltransferase, RNA helicase, and RNA
      dependent RNA polymerase encoded in ORF 1 and an 'accessory' helicase encoded in
      ORF 2 of the HpLV genome were compared with those of viruses in the 'tymo'
      lineage: the genera Carlavirus, Potexvirus, Allexivirus, Foveavirus, Trichovirus,
      Capillovirus, Vitivirus, and Tymovirus. The phylogenetic relationships among the
      viruses in these genera are discussed. This is the first molecular
      characterization of a carlavirus infecting hop plants.

PMID- 11205104
TI  - Genomic organization of Helicoverpa armigera single-nucleocapsid
      nucleopolyhedrovirus.
AB  - The genome organization of the Helicoverpa armigera single-nucleocapsid
      nucleopolyhedrovirus (HearNPV) was investigated and compared to that of other
      baculoviruses. A detailed physical map was constructed for the restriction
      enzymes BamHI, BglII, EcoRI, HindIII, KpnI, PstI, SacI and XhoI. The 130.1
      kilobase pairs (kb) long viral genome was cloned as restriction fragments into a
      plasmid library, which covered 97.5% of the viral genome. From this plasmid
      library about 45 kb of dispersed sequence information was generated. Fifty-three
      putative open reading frames (ORFs) with homology to ORFs of other baculoviruses
      were identified and their location on the genome of HearNPV was determined. The
      arrangement of the ORFs along the HearNPV genome is significantly different from
      the multiple-nucleocapsid NPVs, AcMNPV, BmNPV and OpMNPV, which have a highly
      collinear genome, and the granulovirus XcGV. In contrast the genomes of HearNPV
      and SeMNPV are highly collinear. This close relatedness between an MNPV and an
      SNPV is supported by the phylogeny of specific genes of these two viruses and
      suggests that the morphotype (S or M) is only a taxonomic and not a phylogenetic
      denominator. The data presented here also give further support to the view that
      the gene distribution along baculovirus genomes can be used as a character to
      describe baculovirus relatedness independent of gene phylogeny. Five homologous
      regions (hrs) were located on the genome of HearNPV. This is also the first
      report of the existence of hrs in SNPVs and this observation suggests that hrs
      are a common feature of baculovirus genomes.

PMID- 11205103
TI  - Studies on feline CD8+ T cell non-cytolytic anti-feline immunodeficiency virus
      (FIV) activity.
AB  - CD8+ T cells in FIV-infected cats inhibit feline immunodeficiency virus (FIV)
      replication by producing a soluble factor(s). In the present study, four SPF cats
      were experimentally infected with FIV. The period during which the anti-FIV
      activity of CD8+ T cells became detectable was investigated, and the presence or
      absence of this activity in the lymph nodes and spleen was examined. Furthermore,
      we investigated which step(s) of the FIV replication cycle are affected by this
      antiviral activity. This antiviral activity became detectable five weeks after
      FIV infection in early cases, and it was simultaneous with or one week after the
      induction of humoral immunity. All cats having CD8+ T cells with anti-FIV
      activity in the peripheral blood also possessed CD8+ T cells with anti-FIV
      activity in the lymph nodes. In contrast, CD8+ T cells from the spleens of some,
      but not all cats showed anti-FIV activity. CD8+ T cell-depleted peripheral blood
      mononuclear cells were cultured and reconstituted with CD8+ T cells on day 12 of
      culture after confirming FIV replication. The number of FIV proviral DNA copies
      in the cells did not change, but the amount of FIV p24 antigen production in the
      culture supernatant and the number of FIV mRNA copies in the cells decreased.
      These findings suggested that CD8+ T cell anti-FIV activity acts at the level of
      FIV mRNA synthesis from the FIV proviral DNA, inhibiting FIV replication by a non
      cytolytic mechanism.

PMID- 11205105
TI  - Development of a plant-derived subunit vaccine candidate against hepatitis C
      virus.
AB  - Hepatitis C virus (HCV) is a major cause of acute and chronic hepatitis with over
      180 million cases worldwide. Vaccine development for HCV has been difficult.
      Presently, the virus cannot be grown in tissue culture and there is no vaccine or
      effective therapy against this virus. In this research, we describe the
      development of an experimental plant-derived subunit vaccine against HCV. A
      tobamoviral vector was engineered to encode a consensus sequence of hypervariable
      region 1 (HVR1), a potential neutralizing epitope of HCV, genetically fused to
      the C-terminal of the B subunit of cholera toxin (CTB). This epitope was selected
      from among the amino acid sequences of HVR1 "mimotopes" previously derived by
      phage display technology. The nucleotide sequence encoding this epitope was
      designed utilizing optimal plant codons. This mimotope is capable of inducing
      cross-neutralizing antibodies against different variants of the virus. Plants
      infected with recombinant tobacco mosaic virus (TMV) engineered to express the
      HVR1/CTB chimeric protein, contained intact TMV particles and produced the HVR1
      consensus peptide fused to the functionally active, pentameric B subunit of
      cholera toxin. Plant-derived HVR1/CTB reacted with HVR1-specific monoclonal
      antibodies and immune sera from individuals infected with virus from four of the
      major genotypes of HCV. Intranasal immunization of mice with a crude plant
      extract containing the recombinant HVR1/CTB protein elicited both anti-CTB serum
      antibody and anti-HVR1 serum antibody which specifically bound to HCV virus-like
      particles. Using plant-virus transient expression to produce this unique chimeric
      antigen will facilitate the development and production of an experimental HCV
      vaccine. A plant-derived recombinant HCV vaccine can potentially reduce expenses
      normally associated with production and delivery of conventional vaccines.

PMID- 11205106
TI  - Nucleotide sequences and mutations of the 5'-nontranslated region (5'NTR) of
      natural isolates of an epidemic echovirus 11' (prime).
AB  - An echovirus 11' (prime) virus caused an epidemic in Hungary in 1989. The leading
      clinical form of the diseases was myocarditis. Hemorrhagic hepatitis syndroms
      were also caused, however, with lethal outcome in 13 newborn babies. Altogether
      386 children suffered from registered clinical disease. No accumulation of serous
      meningitis cases and intrauterine death were observed during the epidemic, and
      the monovalent oral poliovirus vaccination campaign has prevented the further
      circulation of the virus. The 5'-nontranslated region (5'-NTR) of 12 natural
      isolates were sequenced (nucleotides: 260-577). The 5'-NTR was found to be
      different from that of the prototype Gregory strain (X80059) of EV11 (less than
      90% identity), but related to the swine vesicular disease virus (D16364) SVDV and
      EV9 (X92886) as indicated by the best fitting dendogram. The examination of the
      variable nucleotides in the internal ribosomal entry site (IRES) revealed, that
      the nucleotide sequence of a region of the epidemic 5'-NTR was identical to that
      of coxsackievirus B2. Five of the epidemic isolates were found to carry
      mutations. Seven EV11' IRES elements possessed identical sequences indicating,
      that the virus has evolved before its arrival to Hungary. The comparative
      examination of the suboptimal secondary structures revealed, that no one of the
      mutations affected the secondary structure of stem-loop structures IV and V in
      the IRES elements. Although it has been shown previously, that the echovirus
      group is genetically coherent and related to coxsackie B viruses the sequence
      differences in the epidemic isolates resulted in profound modification of the
      central stem (residues 477-529) of stem-loop structure No.V known to be affecting
      neurovirulence of polioviruses. Two alternate cloverleaf (stem-loop) structures
      were also recognised (nucleotides 376 to 460 and 540 to 565) which seem to mask
      both regions of the IRES element complementary to the 3'-end of the 18 S rRNA
      (460 to 466 and 561 to 570), thus probably diminishing initiation of translation.
      The possible biological importance of the alternative cloverleaf structures is
      supported by the fact that neither the 17 variable nucleotides nor the two
      mutations of epidemic isolates within the regions seem to modify the predicted
      alternative secondary structures in EV11, SVDV and CBV1-4.

PMID- 11205107
TI  - Immune responses and cytokine induction in the development of severe hepatitis
      during acute infections with murine cytomegalovirus.
AB  - Salivary gland-derived murine cytomegalovirus (SGV) infections of mice have been
      widely used as models of human cytomegalovirus infections and in the study of CMV
      biology. Still, many aspects of SGV pathogenesis are not clearly defined. Fatal
      and non-fatal SGV infections were investigated to characterize pathogenetic
      correlates of mortality and to assess the role of the immune response in disease
      progression. Suppression of immune responses was observed in both lethal and
      sublethal infections. Depletion of immune cell populations in spleen, however,
      correlated with severe CMV-induced hepatitis and mortality. In addition, T cell
      depletion studies indicated a requirement for this immune cell subset in control
      of liver damage and survival of infected mice. Examination of cytokine responses
      revealed a previously undescribed shock-like syndrome in lethally-infected mice
      characterized by high levels of tumor necrosis factor alpha and interferon gamma.
      Furthermore, the sites of tumor necrosis factor alpha gene induction did not
      strictly correlate with either viral load or the sites of tissue damage during
      infection. Taken together, these findings define the pathogenetic progression of
      disease as it relates to disease outcome and suggests that organ-specific
      differences in cytokine induction play a significant role in the late stages of
      acute lethal MCMV infections.

PMID- 11205108
TI  - Equine herpesvirus 9 induced lethal encephalomyelitis in experimentally infected
      goats.
AB  - The pathogenicity of a new neurotropic equine herpesvirus 9 (EHV-9) formerly
      designated gazelle herpesvirus 1 was evaluated using the goat as a representative
      of domesticated ruminants. Two goats inoculated intranasally with EHV-9 showed
      salivation, teeth grinding and other neurological disorders on day 8 post
      inoculation. One goat died 30 min after the onset of clinical signs and the other
      was sacrificed 3 h after the sudden onset of teeth grinding and foamy salivation.
      EHV-9 was recovered from peripheral white blood cells, the olfactory bulbs and
      brain, nasal swabs, concha, and lungs. Neuropathological lesions were located in
      the olfactory bulbs, cerebrum, midbrain and medulla oblongata with degeneration
      and necrosis of neurons, rarefaction, perivascular infiltration of mononuclear
      cells, and nodal glial reaction. EHV-9 antigen was detected in neurons in the
      lesions. These findings indicated that EHV-9 is highly pathogenic with high
      neurotropism for goats.

PMID- 11205109
TI  - An Ophiovirus isolated from lettuce with big-vein symptoms.
AB  - Big-vein is a widespread and damaging disease of lettuce, transmitted through
      soil by the chytrid fungus Olpidium brassicae, and generally supposed to be
      caused by Lettuce big-vein virus (LBVV; genus Varicosavirus). This virus is
      reported to have rigid rod-shaped particles, a divided double-stranded RNA
      genome, and one capsid protein of 48 kD, but has not been isolated or rigorously
      shown to cause the disease. We provide evidence that a totally different virus,
      here named Mirafiori lettuce virus (MiLV), is also very frequently associated
      with lettuce showing big-vein symptoms. MiLV was mechanically transmissible from
      lettuce to Chenopodium quinoa and to several other herbaceous test plants. The
      virus was partially purified, and an antiserum prepared, which did not react with
      LBVV particles in decoration tests. As reported for LBVV, MiLV was labile, soil
      transmitted and had a single capsid protein of 48 kD, but the particles
      morphologically resembled those of ophioviruses, and like these, MiLV had a
      genome of three RNA segments approximately 8.5, 1.9 and 1.7 kb in size. MiLV
      preparations reacted strongly in Western blots and in ISEM with antiserum to
      Tulip mild mottle mosaic virus, an ophiovirus from Japan also apparently Olpidium
      transmitted. They reacted weakly but clearly in Western blots with antiserum to
      Ranunculus white mottle virus, another ophiovirus. When lettuce seedlings were
      mechanically inoculated with crude or partially purified extracts from MiLV
      infected test plants, many became systemically infected with MiLV and some
      developed big-vein symptoms. Such plants did not react in ELISA using an LBVV
      antiserum or an antiserum to tobacco stunt virus, and varicosavirus-like
      particles were never seen in them in the EM after negative staining. We conclude
      that MiLV is a hitherto undescribed virus assignable to the genus Ophiovirus. The
      cause or causes of lettuce big-vein disease and the properties of LBVV may need
      to be re-evaluated in light of our results.

PMID- 11205110
TI  - Genetic composition and complexity of virus populations at tungro-endemic and
      outbreak rice sites.
AB  - We have recently demonstrated the geographic isolation of rice tungro bacilliform
      virus (RTBV) populations in the tungro-endemic provinces of Isabela and North
      Cotabato, Philippines. In this study, we examined the genetic structure of the
      virus populations at the tungro-outbreak sites of Lanao del Norte, a province
      adjacent to North Cotabato. We also analyzed the virus populations at the tungro
      endemic sites of Subang, Indonesia, and Dien Khanh, Vietnam. Total DNA extracts
      from 274 isolates were digested with EcoRV restriction enzyme and hybridized with
      a full-length probe of RTBV. In the total population, 22 EcoRV-restricted genome
      profiles (genotypes) were identified. Although overlapping genotypes could be
      observed, the outbreak sites of Lanao del Norte had a genotype combination
      distinct from that of Subang or Dien Khanh but a genotype combination similar to
      that identified earlier from North Cotabato, the adjacent endemic province.
      Sequence analysis of the intergenic region and part of the ORF1 RTBV genome from
      randomly selected genotypes confirms the geographic clustering of RTBV genotypes
      and, combined with restriction analysis, the results suggest a fragmented spatial
      distribution of RTBV local populations in the three countries. Because RTBV
      depends on rice tungro spherical virus (RTSV) for transmission, the population
      dynamics of both tungro viruses were then examined at the endemic and outbreak
      sites within the Philippines. The RTBV genotypes and the coat protein RTSV
      genotypes were used as indicators for virus diversity. A shift in population
      structure of both viruses was observed at the outbreak sites with a reduced RTBV
      but increased RTSV gene diversity.

PMID- 11205111
TI  - Evidence for two distinct subgroups of alfalfa mosaic virus (AMV) from france and
      italy and their relationships with other AMV strains Brief report.
AB  - The nucleotide sequence of the putative coat protein open reading frame of seven
      previously uncharacterized AMV strains from Italy and France was determined and
      aligned with comparable sequences of other AMV strains (425 L, 425 M, YSMV, S,
      VRU, 15/64 and Da). The data set of AMV sequences was used to determine
      phylogenetic relationships by both a stochastic (stationary Markov model) and a
      deterministic method (maximum-parsimony) of analysis. The topology of the trees
      obtained with the two methods was essentially the same showing that all AMV
      strains clustered in two monophyletic groups. Close clustering of Italian strains
      in subgroup I and of French strains in subgroup II seems to suggests the effect
      of geographic distinctiveness of evolutionary dynamics of these AMV strains. This
      separation did not correlate with differences in host range or symptoms (necrotic
      or non necrotic) induced in tomato but rather it reflected variations in the
      amino acid sequence of their CP, which might be related to structural properties
      of virus particles. A simple and rapid procedure based on the reverse
      transcriptase-polymerase chain reaction (RT-PCR) followed by ezymatic digestion
      (RFLP) was developed to identify and classify AMV isolates into the two
      subgroups. The method applied to a number of other AMV isolates from Italy and
      France supported their division in two distinct subgroups. This RT-PCR RFLP
      method may be useful way to investigate the dynamics of AMV populations in
      nature.

PMID- 11205112
TI  - Amplification and analysis of DNA flanking known sequences of a novel herpesvirus
      from green turtles with fibropapilloma Brief report.
AB  - A 1,632-bp fragment, flanking the original 483-bp region of the DNA polymerase
      gene of a novel herpesvirus found in tissues of green turtles (Chelonia mydas)
      with fibropapilloma, was amplified from the circularized EcoRI-cut DNA extracted
      from tumor tissues by inverse PCR. The resultant 2,019-bp partial sequence of the
      DNA polymerase gene of the newfound herpesvirus, including the original 483-bp
      region, showed a high degree of homology at both the nucleotide and amino acid
      levels with that of other human and animal herpesviruses. Phylogenetic analysis
      confirmed that this novel herpesvirus belonged to the Alphaherpesvirinae
      subfamily.

PMID- 11205113
TI  - Characterisation of IE and UL5 gene products of equine herpesvirus 1 using DNA
      inoculation of mice.
AB  - The equine herpesvirus 1 (EHV-1) strain HVS25A regulatory genes IE and UL5,
      encoding homologues of herpes simplex virus 1 (HSV-1) ICP4 and ICP27
      respectively, were cloned into a eukaryotic expression vector and the DNA
      injected intramuscularly into mice. Antibodies produced in this way detected the
      IE or UL5 gene products as diffuse material in nuclei of RK13 cells transfected
      with the individual genes but as discrete punctate or large aggregates in RK13
      cells infected with EHV-1. Western blotting on EHV-1 infected RK13 cells showed
      multiple IE products of 120-200 kDa and a UL5 product of 52 kDa. Inoculation with
      plasmids expressing EHV-1 IE or UL5 provided limited protection against EHV-1
      challenge in mice as determined by increased virus clearance from lungs on day 2
      post-challenge and a reduction in severity of lung histopathology. However, this
      protection was relatively weak compared with that provided by inoculation of DNA
      encoding EHV-1 glycoprotein D (gD), possibly reflecting the importance of
      neutralising antibody in this model.

PMID- 11205114
TI  - Influenza chemotherapy: a review of the present state of art and of new drugs in
      development.
AB  - Influenza is worldwide one of the deadliest infectious diseases. Lethal influenza
      mutants can unpredictably arise, as in the 1918 pandemic, or in the 1997 Hong
      Kong influenza outbreak. Vaccines are today the only protective prophylactic
      agents, and development of potent new anti-influenza drugs of therapeutic
      effectiveness appears urgent. It is the aim of the present review, to summarize
      and discuss the different investigational approaches to this goal. In Medline-
      and several internet virology database-searches, numerous citations were
      compiled, and selected according to their relevance to the different topics
      discussed. The antiviral agents are classified according to their target in the
      viral replication cycle: proteolytic activation of haemagglutinin, attachment of
      the virus to specific cell-surface receptors, endocytosis and fusion with the
      endosomal membrane, uncoating of the nucleocapsid, multiplication, i.e. synthesis
      of viral RNA and mRNA, and release of the new virus generation from the host cell
      surface. Potential drugs, directed towards each of these replication steps are
      described with respect to their mechanism of action, antiviral activity, toxic
      side effects and induction of resistance. The most promising candidates for safe
      and potent new influenza drugs, are antiviral agents, directed towards a virus
      specific, well conserved target, such as inhibitors of virus-cell fusion,
      inhibitors of RNA transcriptase and endonuclease, and inhibitors of
      neuraminidase. It can be hoped that in the near future potent and therapeutically
      effective anti-influenza drugs will be available.

PMID- 11205115
TI  - Molecular characterization of a new potyvirus infecting sunflower.
AB  - We have sequenced 1873 nucleotides from the 3'-end region of a sunflower
      potyvirus genome including the 3'-NIb protein coding region (813 nucleotides),
      the entire coat protein coding region (807 nucleotides) and 3'-NCR (253
      nucleotides), excluding the poly (A) tail. Amino acids identity of the whole CP
      between the sunflower virus and Potyvirus members ranged from 49.5% (SCMV) to
      81.5% (PVY-NsNr), and the core ranged from 55% (TVMV) to 87% (PVY-NsNr; PepMoV).
      The 3'-NCR nucleotides showed 38.7% homology to PeSMV and 61% to PepMoV-C. The
      sequence of 3' end region and analysis of phylogenetic relationships suggest this
      sunflower virus could belong to PVY subgroup and the name of "sunflower chlorotic
      mottle virus" (SuCMoV) is proposed. This is the first report on the partial
      nucleotide sequence of a potyvirus infecting sunflower.

PMID- 11205116
TI  - Latent herpes simplex virus-1 infection in SCID mice transferred with immune
      CD4+T cells: a new model for latency.
AB  - In C.B-17 severe combined immunodeficiency (SCID) mice, corneal challenge with
      herpes simplex virus-1 (HSV-1) KOS strain usually leads to fatal encephalitis.
      With the transfer of T cells from immunized BALB/c mice, these SCID mice
      developed a latent HSV-1 infection. In order to determine the responsible T cell
      subset, fractionated immune T cells were transferred. Those SCID mice transferred
      with immune CD4+T cell-enriched fraction developed latent HSV-1 infection in
      their trigeminal ganglia. Their splenocytes had an increased percentage of CD4+T
      cells and showed a proliferative response against HSV-1. The transfer of CD8+T
      cells increased survival in the acute infection, but their engraftment seemed
      less needed for latency than that of CD4+T cells. Mice that received immune serum
      survived without developing latent HSV-1 infection. Some latently infected SCID
      mice had anti-HSV antibodies while others did not, indicating that the
      engraftment of antibody-producing B cells was not required for latency. Thus,
      immune CD4+T cells were important for the survival of SCID mice with latent HSV-1
      infection. This animal model should be useful for investigation of
      latency/reactivation of HSV-1.

PMID- 11205117
TI  - Sequence variants and functional analysis of human papillomavirus type 16 E5 gene
      in clinical specimens.
AB  - Previously, we found that the E5 protein can be expressed in HPV-16 infected
      precancerous lesions and cervical cancer. In this study, we investigated the
      presence of sequence variants of E5 in HPV-16 infected tissues. Toward this end,
      we amplified the E5 gene by polymerase chain reaction from 29 HPV-16 infected
      tissues including eight normal tissues, seven high grade neoplastic tissues (high
      grade squamous intraepithelial lesions (HSIL) and 14 cervical cancer tissues.
      Sequence analysis demonstrated that there were three mutational hot spots at
      positions 3979, 4042, and 4077 of the HPV-16 DNA; these and other mutations
      resulted in six variants in the E5 sequence. This resulted in four E5 protein
      mutants, named WTE5 [wild type E5 protein], 14E5, 21E5 and 56E5. Functional
      analysis of these four mutant proteins revealed that the transforming activities
      of 14E5, 21E5 and 56E5 were 0.95, 0.59, and 0.89 fold of WTE5, respectively.
      Although E5 was expressed in all of the HSIL and cervical cancer tissues, but in
      only one of the eight normal tissues tested, only WT E5 protein was found in HSIL
      while in cervical cancer tissues both WT and mutant E5 proteins were detected.
      Since these E5 proteins exhibited the same in vitro transforming activity, these
      data suggest that expression of E5 is important in development and progression
      toward malignancy but mutation of E5 does not affect the transformation process.

PMID- 11205118
TI  - Development and evaluation of a complementation-dependent gene delivery system
      based on cucumber mosaic virus.
AB  - To engineer cucumber mosaic virus (CMV-Ix) into a gene vector, genome component
      RNA 3 of the virus was modified and split into two sub-components, RNA 3A and RNA
      3B. In RNA 3A, the open reading frame of the movement protein (MP) was replaced
      by a reporter gene encoding the green fluorescent protein (GFP), to monitor virus
      replication and movement. In RNA 3B, the coat protein (CP) gene was eliminated
      and a multiple cloning site (MCS) was created for foreign gene insertion. Each
      sub-component alone is defective and relies on its companion sub-component to
      restore full RNA 3 function. The vector system was evaluated for its ability to
      deliver and express the bacterial beta-glucuronidase (GUS) gene and a modified
      bean yellow mosaic virus coat protein (BYMV-CP) gene in Nicotiana benthamiana
      plants. Results showed that the engineered virus was able to move from cell to
      cell in the inoculated leaf and enter the minor veins of the inoculated leaf.
      Foreign gene expression was detected in the inoculated leaves. However,
      intermolecular recombination between RNA 3A and 3B occurred frequently,
      preventing efficient systemic expression of the foreign gene(s). Modifications
      and further evaluations are being undertaken to improve the gene delivery system.

PMID- 11205119
TI  - Full-length sequence of a Canadian porcine reproductive and respiratory syndrome
      virus (PRRSV) isolate.
AB  - Presently, one of the most economically important pathogens affecting swine is
      the porcine reproductive and respiratory syndrome virus (PRRSV). This virus is
      prevalent in herds throughout the world and continues to pose a significant
      threat as newer and more virulent disease phenotypes emerge. In this report we
      describe the full-length nucleotide sequence of a Canadian PRRSV isolate,
      designated PA8. A consecutive sequence of 15,411 nucleotides was obtained from a
      set of overlapping cDNA clones. In order to determine the extent of genetic
      variation among isolates recovered from swine in Canada and the US, as well as to
      understand the molecular mechanisms governing the evolution of PRRSV, the full
      length sequence of PA8 was compared with that of two US isolates, VR2332 and
      16244B. The genomic sequence of PA8 shared 98.2% and 99.2% identity with 16244B
      and VR2332, respectively. The untranslated regions (UTR) at the 5' and 3' ends of
      the genome were very well conserved. Notable exceptions include an eight
      nucleotide difference at the 5' end of the 5' UTR of VR2332 relative to PA8 and
      16244B and a two nucleotide difference in the 3' UTR of PA8 relative to VR2332
      and 16244B. In contrast to PA8 and VR2332, 16244B possessed two nucleotide
      differences within the RNA pseudoknot structure of the ribosomal frameshift
      region between open reading frame (ORF)1a and ORF1b. Amino acid differences were
      distributed throughout the genome, however they appeared to be most extensive in
      Nsp1beta and ORF5 of the nonstructural and structural coding regions,
      respectively, suggesting that the evolutionary pressure to conserve these viral
      genes is somewhat lower.

PMID- 11205120
TI  - Zucchini green mottle mosaic virus is a new tobamovirus; comparison of its coat
      protein gene with that of kyuri green mottle mosaic virus.
AB  - A novel virus we call zucchini green mottle mosaic virus (ZGMMV) was isolated
      from zucchini squash and its properties were determined. The size and shape of
      its virions, and other properties suggest that the virus is a tobamovirus. The
      coat protein (CP) genes of ZGMMV and kyuri green mottle mosaic virus (KGMMV),
      which also infects zucchini squash plants, were cloned and their nucleotides
      sequences were determined. The CP genes of ZGMMV and KGMMV are composed of 161
      amino acid residues, and they share 77.6% amino acid identity. Western blot
      analysis showed that the two viruses are serologically related but not identical.
      Comparison of the sequences with those of sixteen other tobamoviruses revealed
      that the two viruses had much higher identity to cucumber green mottle mosaic
      virus (CGMMV), another tobamovirus infectious to cucurbit plants, than other
      tobamoviruses. The nucleotide and amino acid sequences of ZGMMV were from 29.5 to
      78.4% and from 29.3 to 77.6% identical, respectively, to those of other
      tobamoviruses. The predicted virion assembly origins of the two tobamoviruses
      were located in the CP region of the genomic RNAs, and the predicted secondary
      structures were more similar to that of CGMMV than those of other tobamoviruses.
      The seventeen tobamo-viruses could be classified into three main subgroups based
      on the phylogenetic tree analysis on the CP gene, and ZGMMV and KGMMV formed a
      third subgroup together with CGMMV and sunn-hemp mosaic virus (SHMV). These
      results show that ZGMMV is a previously unknown member of the Tobamovirus genus.

PMID- 11205121
TI  - Antibody responses to respiratory coronavirus infections of cattle during
      shipping fever pathogenesis.
AB  - Antibody responses against respiratory bovine coronavirus (RBCV) infections were
      monitored in cattle from the onset of a naturally occurring severe shipping fever
      (SF) epizootic to complete recovery of affected cattle or fatal outcomes. The
      infection with RBCV was detected in nasal secretions of 86 cattle, and 81 of them
      developed acute respiratory tract disease, including fatal pneumonia. Cattle
      nasally shedding RBCV at the beginning of the epizootic experienced
      characteristic primary immune responses with specific antibodies for
      hemagglutinin-esterase (HE) and spike (S) glycoproteins. Virus shedding in nasal
      secretions of the majority of the cattle ceased between days 7 and 14 with the
      appearance of HE- and S-specific antibodies. Nasal samples and lung tissues from
      9 of the 10 fatal cases had high titers of RBCV, but these cattle had only IgM
      responses to RBCV infections. Cattle remaining negative in RBCV isolation tests
      entered this epizootic with antibodies against HE and S. Protection against
      respiratory tract disease was apparently associated with high level of opsonic
      and virus-neutralizing IgG2. The HE and S glycoproteins were recognized earliest
      by the bovine immune system while the N protein induced antibody responses during
      the later stage of initial infection and the early stage of reinfection. The
      membrane (M) glycoprotein was the least immunogenic of the major viral structural
      proteins.

PMID- 11205122
TI  - Characterization of four isolates of Bombyx mori nucleopolyhedrovirus.
AB  - Bombyx mori nucleopolyhedroviruses (BmNPVs), isolated from a sericultural Korean
      farm, were purified and characterized by their DNA restriction pattern, virus
      replication, polyhedra production and gene structures. The EcoR I and Sal I
      fragments showed similar overall patterns with minor difference but
      distinguishable patterns in each isolate. There was no significant difference in
      the virus replication pattern, yield of total polyhedra production and polyhedra
      morphology, but the yield of released polyhedra by BmNPV-K1 in Bm5 cells was 2 to
      5 times higher than that of other isolates. In comparative studies of p10 gene,
      BmNPV-K1 and K3 had same structure and they encoded a protein consisting of 94
      amino acids. Although BmNPV-K2 encoded the same length of amino acids with BmNPV
      K1 and K3, it had different structure, and BmNPV-K4 had the p10 gene encoding 70
      amino acids.

PMID- 11205123
TI  - Characterization of a bovine herpesvirus type 4 isolated from the spinal cord of
      a cow with astasia.
AB  - A bovine herpesvirus (BHV) strain designated B11-41, was recently isolated from
      the spinal cord of a cow with astasia. By BHV type specific polymerase chain
      reaction (PCR), a BHV-4 specific fragment was amplified from the DNA of strain
      B11-41. The nucleotide sequence of the PCR product revealed high homologies
      (98.4% and 99.8%) with those of two BHV-4 strains (Movar 33/63 and 86-068). The
      BamHI restriction endonuclease cleavage patterns of the B11-41 were more similar
      to those of BHV-4 than those of other types of BHV. BHV-4 is divided into two
      groups, European and American. The EcoRI, and BamHI, and HindIII restriction
      endonuclease analysis demonstrated that strain B11-41 was closely related to the
      American type of BHV-4. It was concluded that B11-41 was identified as a BHV-4
      that belongs to the American group. Additionally, the results of this study may
      indicate that the nervous system is one of the sites of viral latency in natural
      infection.

PMID- 11205124
TI  - EHV-1 glycoprotein D (EHV-1 gD) is required for virus entry and cell-cell fusion,
      and an EHV-1 gD deletion mutant induces a protective immune response in mice.
AB  - Insertional mutagenesis was used to construct an equine herpesvirus 1 (EHV-1)
      mutant in which the open reading frame for glycoprotein D was replaced by a lacZ
      cassette. This gD deletion mutant (delta gD EHV-1) was unable to infect normally
      permissive RK cells in culture, but could be propagated in an EHV-1 gD-expressing
      cell line (RK/gD). Phenotypically complemented delta gD EHV-1 was able to infect
      RK cells, but did not spread to form syncytial plaques as seen with wild type EHV
      1 or with delta gD EHV-1 infection of RK/gD cell cultures. Therefore EHV-1 gD is
      required for virus entry and for cell-cell fusion. The phenotypically
      complemented delta gD EHV-1 had very low pathogenicity in a mouse model of EHV-1
      respiratory disease, compared to a fully replication-competent EHV-1 reporter
      virus (lacZ62/63 EHV-1). Intranasal or intramuscular inoculation of mice with
      delta gD EHV-1 induced protective immune responses that were similar to those
      elicited in mice inoculated with lacZ62/63 EHV-1 and greater than those following
      inoculation with UV-inactivated virus.

PMID- 11205125
TI  - Altered local and systemic spread of movement deficient virus in transgenic
      tobacco plants expressing the cucumber mosaic virus 3a protein.
AB  - The 3a protein encoded by RNA 3 of cucumber mosaic virus has been identified as
      the viral cell-to-cell movement protein. The constitutive expression in
      transgenic tobacco plants of 3a protein from a subgroup I strain was able to
      complement in trans the short distance movement of a 3a defective CMV mutant
      belonging to a different taxonomic subgroup. This ability was dependent upon the
      accumulation levels of the 3a protein in transgenic tobacco plants. However, an
      initial delay in viral accumulation and spread of the defective virus as compared
      to the wild type virus was determined in complementation tests. Furthermore, a
      reduction in disease symptoms as well as a different pattern of systemic viral
      distribution from those of the wild type virus was detected. These results show
      that the early events in viral infection affect the long distance spread of the
      virus. Finally, the wild type virus moved faster in the 3a protein-expressing
      plants than in control plants, thus indicating that the constitutive expression
      of the 3a protein favours long-distance viral spread.

PMID- 11205126
TI  - Human rotavirus HCR3 possesses a genomic RNA constellation indistinguishable from
      that of feline and canine rotaviruses.
AB  - Infection and spread of group A rotaviruses under natural conditions are mostly
      limited to one animal host species. However, rare molecular evidence exists for
      interspecies transmission by whole virions of animal rotaviruses to humans. Human
      rotavirus strain HCR3, which was isolated in 1984 from a healthy infant in
      Philadelphia, U.S.A. was shown by RNA-RNA hybridization to form 11 hybrid bands
      with feline rotavirus strain FRV64 and canine rotavirus strains CU-1 and K9, but
      not with rotaviruses commonly found in humans. Thus, HCR3 was concluded to be
      originally a rotavirus circulating in cats and dogs and accidental interspecies
      transmission by whole virions to humans was likely to have occurred in the past.

PMID- 11205127
TI  - Murine gammaherpesvirus M11 gene product inhibits apoptosis and is expressed
      during virus persistence.
AB  - The murine gammaherpesvirus (MHV-68) M11 gene encodes a protein with BH1 domain
      homology to Bcl-2. We found that the M11 gene product (MHVBcl-2) protected murine
      epithelial cells from TNF-alpha induced apoptosis. M11 was transcribed during
      early lytic infection in vitro. During early infection of mice, M11 message was
      detected in spleen and lung along with lytic cycle messages. During persistence,
      lytic cycle gene expression was undetectable but M11 RNA was still present. This
      suggests that MHVBcl-2 promotes virus survival by protecting not only
      productively infected but also persistently infected cells from apoptotic death.

PMID- 11205128
TI  - Experimental infection of colostrum deprived piglets with porcine circovirus 2
      (PCV2) and porcine reproductive and respiratory syndrome virus (PRRSV)
      potentiates PCV2 replication.
AB  - Experimental infection of colostrum-deprived (CD) pigs with a combined inoculum
      of porcine circovirus 2 (PCV2) and porcine reproductive and respiratory syndrome
      virus (PRRSV) potentiated the replication and distribution of PCV2 virus, when
      compared with pigs inoculated with PCV2 alone. The replication and distribution
      of PRRSV in dually infected pigs was not enhanced, when compared to pigs
      inoculated with PRRSV alone. The mechanisms involved in the potentiation of PCV2
      replication in PCV2/PRRSV and PCV2/porcine parvovirus (PPV) dually infected pigs
      may relate to the fact that monocyte/macrophage cell types are common targets of
      these 3 viruses.

PMID- 11205129
TI  - Improving permissive infection of human cytomegalovirus in cell culture.
AB  - Changes in human cytomegalovirus (HCMV) titre occurring under different
      conditions were studied using plaque assay. No significant change in titre was
      found using primary embryonic fibroblasts or primary foreskin fibroblasts, or
      with the addition of dexamethasone to the medium. Significant increases in titre
      were found when standard cultures were pre-incubated in medium containing DEAE
      dextran and/or calcium chloride. However, DEAE-dextran and/or calcium chloride
      had no significant effect on HCMV detection using the shell vial assay, possibly
      because enhancement affects permissive infection, but not surface expression of
      viral antigens. DEAE-dextran and calcium chloride can be included in the medium
      of standard cultures as a means of obtaining higher titres of HCMV, and are
      particularly useful for isolates that are difficult to culture.

PMID- 11205130
TI  - The post-Loeffler era: contribution of German virologists.

PMID- 11205131
TI  - XV Courses of the Italian Neurological Society. Milan, September 23-27, 2000.
      Abstracts.

PMID- 11205132
TI  - The L-DOPA story revisited. Further surprises to be expected?
AB  - L-DOPA therapy for Parkinson's disease is one of the major achievements of
      twentieth century neurology; Parkinson's disease was the first in which specific
      neurochemical deficits in defined brain regions were identified, and thus for
      which a rational, chemical therapy could be developed, ushering in the era of
      clinical neurochemistry. The contributions of Birkmayer and Hornykiewicz
      (Vienna), Barbeau and Sourkes (Montreal) and of Cotzias (New York) to this story
      are well-known. Almost completely forgotten, on the other hand, is a paper
      presented by the Japanese neurologist Isamu Sano in 1960 which reported what is
      probably the first attempt to treat Parkinson's disease patients with DOPA. This
      is all the more remarkable as the author was also responsible for one of the key
      papers which led to the use of DOPA in Parkinson's disease by other workers.
      Despite the negative outcome of his experience with L-DOPA, Sano deserves to be
      remembered as one of the pioneers in catecholamine research, having been the
      first to map dopamine levels in the human brain, and identified the reduction of
      dopamine levels in the substantia nigra and striatum in Parkinson's disease.

PMID- 11205133
TI  - Importance of familial Parkinson's disease and parkinsonism to the understanding
      of nigral degeneration in sporadic Parkinson's disease.
AB  - We review here familial Parkinson's disease (PD) from clinical as well as
      molecular genetic aspects. The contribution of genetic factors to the
      pathogenesis of PD is supported by the demonstration of the high concordance in
      twins, increased risk among relatives of PD patients in case control and family
      studies, and the existence of familial PD and parkinsonism based on single gene
      defects. Recently, several genes have been mapped and/or identified in patients
      with familial PD. Alpha-synuclein is involved in a rare dominant form of familial
      PD with dopa responsive parkinsonian features and Lewy body positive pathology.
      In contrast, parkin is responsible for autosomal recessive form of early-onset PD
      with Lewy body-negative pathology. This form is identified world-wide among
      patients with young-onset PD. Furthermore, ubiquitin carboxy terminal hydrolase
      L1 gene is responsible for an autosomal dominant form of typical PD, although
      only a single family has so far been identified with a mutation of this gene, and
      tau has been identified as a causative gene for frontotemporal dementia and
      parkinsonism. In addition, five other chromosome loci have been identified to be
      linked to familial PD or dystonia-parkinsonism. The presence of different loci or
      different causative genes indicates that PD is not a single entity but a highly
      heterogeneous. Identification and elucidation of the causative genes should
      enhance our understanding of the pathogenesis of sporadic PD.

PMID- 11205135
TI  - Monitoring neuroprotection and restorative therapies in Parkinson's disease with
      PET.
AB  - In this article the role of functional imaging (PET and SPECT) as a surrogate
      marker for following the progression of Parkinson's disease (PD) is discussed.
      The potential value of PET and SPECT for assessing the efficacy of putative
      neuroprotective agents in PD is considered and a review of 18F-dopa PET findings
      in transplantation trials involving implantation of human and procine fetal
      mesencephalic tissue is presented. It is concluded that functional imaging
      provides a valuable adjunct to clinical assessment when judging the efficacy of
      neuroprotective and restorative approaches to PD.

PMID- 11205134
TI  - cDNA microarray to study gene expression of dopaminergic neurodegeneration and
      neuroprotection in MPTP and 6-hydroxydopamine models: implications for idiopathic
      Parkinson's disease.
AB  - cDNA microarray membranes comprising 1,200 different gene fragments have been
      employed to identify gene expression profile in MPTP-induced nigro striatal
      dopamine neurodegeneration and its protection with Rapomorphine. Both MPTP (N
      methyl-4-phenyl-1,2,3,6-tetrahydropyridine) and R-apomorphine (R-APO) induced
      alterations in specific patterns of gene expression. MPTP altered the expression
      of 49 different genes involved in oxidative stress (oxidative stress-induced
      protein A 170, cytochrome P450 1A1 and Osp94), inflammation (cytotoxic cytokines,
      eg: IL-1, IL-6, TNF-alpha), protective cytokines (IL-10), glutamate receptors
      (NMDA but not AMPA receptors), neurotrophic factors (GDNF, EGF), nitric oxide
      synthase and transferrin receptor, as determined by microarray membrane
      hybridization. Furthermore, an additional cascade of further, yet undefined
      events, also occurred (cell cycle regulators and signal transduction factors),
      that might act in parallel to oxidative stress (OS) and inflammation, to converge
      eventually into a common pathway leading to neurodegeneration. R-APO, previously
      shown by us to protect against MPTP neurotoxicity, prevented the over expression
      of several genes known to participate in cell death. cDNA microarrays will
      provide new prospects to study and identify various mechanism of
      neurodegeneration and neuroprotection not feasible with conventional biochemical
      procedures, as well as new prospects to develop effective neuroprotective drugs.

PMID- 11205136
TI  - Common properties for propargylamines of enhancing superoxide dismutase and
      catalase activities in the dopaminergic system in the rat: implications for the
      life prolonging effect of (-)deprenyl.
AB  - (-)Deprenyl has been reported to prolong the life span of different animal
      species. Further, the drug effectively increases antioxidant enzyme activities
      such as superoxide dismutase (SOD) and catalase (CAT) in brain dopaminergic
      regions. We have found that the effect of the drug on antioxidant enzyme
      activities is highly dose dependent, increasing with an increasing dose, however,
      a higher dose becomes less effective and an excessive dose becomes adversely
      effective. Most importantly, an optimal dose for the effect varies widely
      depending on animal species, strain, sex, age and duration of the treatment,
      which may at least partly explain discrepancies reported among different studies
      in the past. From the parallelism of the dose-effect relationship of the drug
      between life span extension and increasing endogenous antioxidant enzyme
      activity, we have suggested that the above two effects of (-)deprenyl may be
      causally related. This review summarizes our past series of studies and also
      reports our very recent observation that other propargylamines such as rasagiline
      and (R)-N-(2-heptyl)-N-methylpropagylamine (R-2HMP) also share the property of
      enhancing antioxidant enzyme activities. Further, our most recent study has found
      that these propargylamines increase antioxidant enzyme activities not only in
      brain dopaminergic regions but in extra-brain dopaminergic tissues such as the
      heart and kidneys. These observations are discussed in relation to the life
      prolonging effect of (-)deprenyl reported in the past.

PMID- 11205137
TI  - TV3326, a novel neuroprotective drug with cholinesterase and monoamine oxidase
      inhibitory activities for the treatment of Alzheimer's disease.
AB  - TV3326, [(N-propargyl-(3R) aminoindan-5-yl)-ethyl methyl carbamate] is a novel
      aminoindan derivative of the selective irreversible monoamine oxidase (MAO)-B
      inhibitor, rasagiline (N-propargyl-(1R)-aminoindan), possessing both
      cholinesterase (ChE) and MAO-inhibitory activity. In doses of 35-100
      micromoles/kg administered orally to rats, it inhibits ChE by 25-40% and
      antagonises scopolamine-induced impairments in spatial memory. After daily
      administration of 75 micromoles/kg for 2 weeks, TV3326 does not show any motor
      stimulant effects but significantly reduces immobility in the forced swim test,
      an action consistent with that of known antidepressants. This could result from
      more than 70% inhibition of both MAO-A and B in the brain that occurs under these
      conditions, since it is not shared by the S-isomer, TV3279, which does not block
      MAO. TV3326 also shows selectivity for brain MAO, even after 2 months of daily
      administration, with little or no effect on the enzyme in the intestinal tract
      and liver. This reduces the likelihood of it producing the "cheese effect" if
      administered with tyramine-containing foods or beverages. TV3326 and TV3279
      protect against ischemia-induced cytotoxicity in PC12 cells and reduce the
      oedema, deficits in motor function and memory after closed head injury in mice.
      These neuroprotective effects do not result from MAO inhibition. The
      pharmacological actions of TV3326 could be of clinical importance for the
      treatment of AD, and the drug is currently in development for this purpose.

PMID- 11205138
TI  - Neurotoxins induce apoptosis in dopamine neurons: protection by N-propargylamine
      1(R)- and (S)-aminoindan, rasagiline and TV1022.
AB  - In Parkinson's disease, apoptosis was proposed to cause cell death in nigral
      dopamine neurons. An endogenous dopaminergic neurotoxin, N-methyl(R)salsolinol,
      stereo-selectively induced apoptosis in human neuroblastoma SH-SY5Y cells. In
      this paper the intracellular mechanism of apoptosis was studied using N
      methyl(R)salsolinol, 6-hydroxydopamine and peroxynitrite as inducers of
      apoptosis. Apoptotic cascade was initiated by opening of mitochondrial
      permeability transition pore, as shown by collapse of mitochondrial membrane
      potential, deltapsim. Apoptosis was executed by caspase 3 activation, followed by
      DNA fragmentation, which was antagonized by overexpressed Bcl-2. Propargylamines
      were found to protect the cells from apoptosis, and rasagiline, a selective
      irreversible inhibitor of type B monoamine oxidase was the most potent to prevent
      the cell death. Rasagiline preserved deltapsim, which was proved also in isolated
      mitochondria, and rasagiline completely suppressed the activation of caspases and
      DNA fragmentation. These results suggest that mitochondria regulate apoptotic
      process, which may be a target of neuroprotection by rasagiline.

PMID- 11205139
TI  - Homocysteine and alcoholism.
AB  - Chronic alcohol consumption can induce alterations in the function and morphology
      of most if not all brain systems and structures. However, the exact mechanism of
      brain damage in alcoholics remains unknown. Partial recovery of brain function
      with abstinence suggests that a proportion of the deficits must be functional in
      origin (i.e. plastic changes of nerve cells) while neuronal loss from selected
      brain regions indicates permanent and irreversible damage. There is growing
      evidence that chronic alcoholism is associated with a derangement in the sulfur
      amino acid metabolism. Recently, it has been shown that excitatory amino acid
      (EAA) neurotransmitters and homocysteine levels are elevated in patients who
      underwent withdrawal from alcohol. Furthermore, it has been found that
      homocysteine induces neuronal cell damage by stimulating NMDA receptors as well
      as by producing free radicals. Homocysteine neurotoxicity via overstimulation of
      N-methyl-D-aspartate receptors may contribute to the pathogenesis of both brain
      shrinkage and withdrawal seizures linked to alcoholism.

PMID- 11205140
TI  - Neurorescuing effects of the GAPDH ligand CGP 3466B.
AB  - (-)-Deprenyl, used for the treatment of Parkinson's disease, was reported to
      possess neurorescuing/antiapoptotic effects independent of its MAO-B inhibiting
      properties. It is metabolized to (-)-desmethyldeprenyl, which seems to be the
      active principle, and further to (-)-amphetamine and (-)-methamphetamine, which
      antagonize its rescuing effects. These complications may explain the limited
      neurorescuing potential of (-)-deprenyl observed clinically. CGP 3466
      (dibenzo[b,f]oxepin-10-ylmethyl-methyl-prop-2-ynyl-amine), structurally related
      to (-)-deprenyl, exhibits virtually no MAO-B nor MAO-A inhibiting properties and
      is not metabolized to amphetamines. It was shown to bind to glyceraldehyde-3
      phosphate dehydrogenase, a glycolytic enzyme with multiple other functions
      including an involvement in apoptosis, and shows neurorescuing properties
      qualitatively similar to, but about 100-fold more potent than those of (-)
      deprenyl in several in vitro and in vivo paradigms. In concentrations ranging
      from 10(-13)-10(-5) M, it rescues partially differentiated PC12 cells from
      apoptosis induced by trophic withdrawal, cerebellar granule cells from apoptosis
      induced by cytosine arabinoside, rat embryonic mesencephalic dopaminergic cells
      from death caused by MPP+, and PAJU human neuroblastoma cells from death caused
      by rotenone. However, it did not affect apoptosis elicited by a variety of agents
      in rapidly proliferating cells from thymus or skin or in liver or kidney cells.
      In vivo, it rescued facial motor neuron cell bodies in rat pups after axotomy,
      rat hippocampal CA1 neurons after transient ischemia/hypoxia, and mouse nigral
      dopaminergic cell bodies from death induced by MPTP, in doses ranging between
      0.0003 and 0.1 mg/kg p.o. or s.c., depending on the model. It also partially
      prevented the loss of tyrosine hydroxylase immunoreactivity in the substantia
      nigra of 6-OHDA-lesioned rats and improved motor function in these animals.
      Moreover, it prolonged the life-span of progressive motor neuronopathy (pmn) mice
      (a model for ALS), preserved their body weight and improved their motor
      performance. This was accompanied by a decreased loss of motor neurons and motor
      neuron fibers, and protection of mitochondria. The active concentration- or dose
      ranges in the different in vitro and in vivo paradigms were remarkably similar.
      In several paradigms, bell-shaped dose-response curves were observed, the
      rescuing effect being lost above about 1 mg/kg, a fact that must be considered in
      clinical investigations.

PMID- 11205141
TI  - The enigma of cell death in neurodegenerative disorders.
AB  - Progressive cell loss in specific neuronal populations is the pathological
      hallmark of neurodegenerative diseases, but its mechanisms remain unresolved.
      Apoptotic cell death has been implicated as a major mechanism in Alzheimer
      disease (AD), Parkinson disease (PD) and other neurodegenerative disorders.
      However, DNA fragmentation in human brain as a sign of neuronal cell injury is
      too frequent to account for the continuous loss in these slowly progressive
      diseases. In a series of autopsy confirmed cases of AD, PD, related disorders,
      and age-matched controls, DNA fragmentation using the TUNEL method, an array of
      apoptosis-related proteins (ARP), proto-oncogenes, and activated caspase-3, the
      key enzyme of late-stage apoptosis, were examined. In AD, a considerable number
      of hippocampal neurons and glial cells showed DNA fragmentation with a 3- to 6
      fold increase related to neurofibrillary tangles and amyloid deposits, but only 1
      in 2.600 to 5.600 neurons displayed apoptotic morphology and cytoplasmic
      immunoreactivity for activated caspase-3, whereas no neurons were labeled in age
      matched controls. caspase-3 immunoreactivity was seen in granules of cells with
      granulovacuolar degeneration, in around 25% co-localized with early cytoplasmic
      deposition of tau-protein. In progressive supranuclear palsy, only single neurons
      and several oligodendrocytes in brainstem, some with tau-deposits, were TUNEL
      positive and expressed both ARPs and activated caspase-3. In PD, dementia with
      Lewy bodies, multisystem atrophy (MSA), and corticobasal degeneration, TUNEL
      positivity and expression of ARPs or activated caspase-3 were only seen in
      microglia and oligodendrocytes with cytoplasmic inclusions, but not in neurons.
      These data provide evidence for extremely rare apoptotic neuronal death in AD and
      PSP compatible with the progression of neuronal degeneration in these chronic
      diseases. Apoptosis mainly involves reactive microglia and oligodendroglia, the
      latter often involved by deposits of insoluble fibrillary proteins, while
      alternative mechanisms of neuronal death may occur. Susceptible cell populations
      in a proapoptotic environment show increased vulnerability towards metabolic or
      other noxious factors, with autophagy as a possible protective mechanism in early
      stages of programmed cell death. The intracellular cascade leading to cell death
      still awaits elucidation.

PMID- 11205142
TI  - The neuroprotective effects of CGP 3466B in the best in vivo model of Parkinson's
      disease, the bilaterally MPTP-treated rhesus monkey.
AB  - The propargylamine CGP 3466B prevents dopamine cell death both in vitro and in
      rodent models of Parkinson's disease. The present study investigates the efficacy
      of this compound to prevent the behavioral consequences of dopaminergic cell
      death in the best animal model of Parkinson's disease, the bilaterally MPTP
      treated monkey. Rhesus monkeys were bilaterally treated with MPTP, using a two
      step procedure: 2.50 mg MPTP was infused into the left carotid artery followed by
      a second bolus of 1.25 mg into the right carotid artery, 8 weeks later.
      Subcutaneous injection of either 0.014 mg/kg CGP 3466B (n = 4) or its solvent
      (distilled water; n = 4), twice daily for fourteen days, started two hours after
      the second MPTP infusion. A Parkinson rating scale was assessed for the
      evaluation of the effects. After the first MPTP treatment, the monkeys developed
      mild to moderate parkinsonian symptoms. The second MPTP treatment strongly
      increased the severity of Parkinson scores in all control monkeys, as assessed on
      day 3, 7, 14, 21, 28 and 35 after the second MPTP treatment. In contrast, CGP
      3466B nearly completely prevented the increase of parkinsonian symptoms after the
      second MPTP treatment. The therapeutic effects of CGP 3466B were still present
      after a washout period of 3 weeks, implying that the effects were not
      symptomatic. These data are the first to show that the systemic administration of
      CGP 3466B is able to prevent the development of MPTP-induced motor symptoms in
      primates. This compound may have great value for inhibiting the progression of
      the neurodegenerative process in patients with Parkinson's disease.

PMID- 11205143
TI  - Neurotrophic effects of central nicotinic receptor activation.
AB  - A growing number of data have shown that compounds interacting with neuronal
      nicotinic acetylcholine receptors (nAChRs) have, both in vivo and in vitro, the
      potential to be neuroprotective and that treatment with nAChR agonists elicit
      long-lasting improvement of cognitive performance in a variety of behavioural
      tests in rats, monkeys and humans. Epidemiological and clinical studies suggested
      also a potential neuroprotective/trophic role of (-)-nicotine in
      neurodegenerative disease, such as Alzheimer's disease and Parkinson's disease.
      This neuroprotective/trophic role of nAChR activation has been mainly mediated by
      alpha7 and alpha4beta2 nAChR subtypes, as evidenced using selective nAChR
      antagonists, and by potent nAChR agonists recently found displaying efficacy
      and/or larger selective affinities than (-)-nicotine for neuronal nAChR subtypes.
      A neurotrophic factor gene regulation by nAChR signalling has been taken into
      consideration as a possible mechanism involved in neuroprotective/trophic effects
      of nAChR activation and has given evidence that the fibroblast growth factor (FGF
      2) gene is a target for nAChR signalling. These findings suggested that FGF-2
      could be involved, in view of its neurotrophic functions, in nAChR mechanisms
      mediating neuronal survival, trophism and plasticity.

PMID- 11205144
TI  - Regulation of neuronal cell death and differentiation by NGF and IAP family
      members.
AB  - Nerve growth factor (NGF) and other neurotrophins were identified because of
      their trophic role for distinct populations of neurons in the peripheral nervous
      system. We know that neuronal cell death is regulated by a genetically encoded
      programme, called apoptosis, that is conserved from worms to humans.
      Dysregulation of this programme is thought to contribute to neurodegenerative
      diseases which are characterized by the loss of neurons. This article will review
      recent findings about the motoneuron disease spinal muscular atrophy (SMA). Two
      closely linked candidate genes for SMA, the SMN (survival motor neuron) gene and
      the NAIP (neuronal apoptosis inhibitory protein) gene have been reported. The SMN
      protein forms a complex with several other proteins and this complex containing
      SMN plays a critical role in the assembly of spliceosomes and in pre-mRNA
      splicing. NAIP, c-IAP1 (inhibitor of apoptosis-1), c-IAP2, X-IAP and survivin
      comprise the mammalian inhibitor of apoptosis family. Its members can protect
      mammalian cells from apoptosis induced by a variety of stimuli. Some of the IAP
      molecules have been shown to interact both with cell signalling molecules and
      with specific caspases but details concerning their cellular role are only
      incompletely characterized.

PMID- 11205145
TI  - Insulin-like growth factor-1 (IGF-1): a neuroprotective trophic factor acting via
      the Akt kinase pathway.
AB  - Insulin-like growth factor-I (IGF-I) is a pleiotropic polypeptide with a wide
      range of actions in both central and peripheral nervous sytems. Over the past few
      years, we studied the trophic as well as neuromodulatory roles of IGF-I in the
      brain. Accumulated evidence indicates that IGF-I, apart from regulating growth
      and development, protects neurons against cell death induced by amyloidogenic
      derivatives, glucose or serum deprivation via the activation of intracellular
      pathways implicating phosphatidylinositide 3/Akt kinase, winged-helix family of
      transcription factor FKHRL1 phosphorylation or production of free radicals. The
      effects of IGF-I on neuroprotection, glucose metabolism and activity-dependent
      plasticity suggest the potential usefulness of this growth factor or related
      mimetics in the treatment of Alzheimer's disease and other neurodegenerative
      disorders.

PMID- 11205146
TI  - GDF-15/MIC-1 a novel member of the TGF-beta superfamily.
AB  - We have cloned, expressed, and raised antibodies against a novel member of the
      TGF-beta superfamily, growth/differentiation factor-15 (GDF-15). The predicted
      protein is identical to macrophage inhibitory cytokine-1 (MIC-1), which was
      discovered simultaneously. GDF-15 is a more distant member of the TGF-beta
      superfamily and does not belong to one of the known TGF-beta subfamilies. In the
      CNS, GDF-15/MIC-1 mRNA is abundantly expressed by the choroid plexus. In addition
      we have preliminary evidence that GDF-15/MIC-1 is a potent trophic factor for
      selected classes of neurons in vitro and in vivo. Thus, GDF-15 is a novel
      neurotrophic factor with prospects for the treatment of disorders of the CNS.

PMID- 11205148
TI  - Psychiatric complications in Parkinson's disease.
AB  - Parkinson's disease (PD) is caused by an abnormal degeneration of the dopamine
      (DA) producing cells in the substantia nigra (SN) and ventral tegmentum area
      (VTA) in combination with a varying decay of the noradrenergic (locus coeruleus),
      cholinergic forebrain (nucleus basalis of Meynert) and serotoninergic (dorsal
      raphe nuclei) systems, leading to a multitude of motor and non-motor behavioral
      disturbances, known as parkinsonism. Normally, main dopamine depletion is
      restricted to the SN region with manifest (non)motor behavioral abnormalities
      caused by the inability to spontaneously switch between intern-cued cortical
      behavioral programmes. Clinical symptoms comprise motoric abnormalities, though
      subtle cognitive disturbances as well as psychological dysfunction with loss of
      mental flexibility and reactive depressive symptoms might be seen. These symptoms
      might be compensated in part by externally-cued behavior.

PMID- 11205147
TI  - Changes in cytokines and neurotrophins in Parkinson's disease.
AB  - Degeneration of the dopamine (DA) neurons of the substantia nigra pars compacta
      and the resulting loss of nerve terminals accompanied by DA deficiency in the
      striatum are responsible for most of the movement disturbances called
      parkinsonism, observed in Parkinson's disease (PD). One hypothesis of the cause
      of degeneration of the nigrostriatal DA neurons is that PD is caused by
      programmed cell death (apoptosis) due to increased levels of cytokines and/or
      decreased ones of neurotrophins. We and other workers found markedly increased
      levels of cytokines, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)
      1beta, IL-2, IL-4, IL-6, transforming growth factor (TFG)-alpha, TGF-beta1, and
      TGF-beta2, and decreased ones of neurotrophins, such as brain-derived
      neurotrophic factor (BDNF) and nerve growth factor (NGF), in the nigrostriatal DA
      regions and ventricular and lumbar cerebrospinal fluid of PD patients.
      Furthermore, the levels of TNF-alpha receptor R1 (TNF-R1, p55), bcl-2, soluble
      Fas (sFas), and the activities of caspase-1 and caspase-3 were also elevated in
      the nigrostriatal DA regions in PD. In experimental animal models of PD, IL-1beta
      level was increased and NGF one decreased in the striatum of 1-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonian mice, and TNF-alpha level
      was increased in the substantia nigra and striatum of the 6-hydroxydopamine
      (6OHDA)-injected side of hemiparkinsonian rats. L-DOPA alone or together with
      6OHDA does not increase the level of TNF-alpha in the brain in vivo. Increased
      levels of proinflammatory cytokines, cytokine receptors and caspase activities,
      and reduced levels of neurotrophins in the nigrostriatal region in PD patients,
      and in MPTP- and 6OHDA-produced parkinsonian animals suggest increased immune
      reactivity and programmed cell death (apoptosis) of neuronal and/or glial cells.
      These data indicate the presence of such proapoptotic environment in the
      substantia nigra in PD that may induce increased vulnerability of neuronal or
      glial cells towards a variety of neurotoxic factors. The probable causative
      linkage among the increased levels of proinflammatory cytokines and the decreased
      levels of neurotrophins, candidate parkinsonism-producing neurotoxins such as
      isoquinoline neurotoxins (Review; Nagatsu, 1997), and the genetic susceptibility
      to toxic factors, remains for further investigation in the molecular mechanism of
      PD. The increased cytokine levels, decreased neurotrophin ones, and the possible
      immune response in the nigrostriatal region in PD indicate new neuroprotective
      therapy including nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin,
      immunosuppressive or immunophilin-binding drugs such as FK-506, and drugs
      increasing neurotrophins.

PMID- 11205149
TI  - Dementia with Lewy bodies: prevalence, clinical spectrum and natural history.
AB  - The article summarises history, terminology, the clinical and neuropathological
      diagnostic criteria, neurochemical and genetic findings, sensitivity and
      specificity of the clinical diagnostic criteria, prevalence, demographical data
      and nosology, differential diagnosis, and therapy of dementia with Lewy bodies
      (DLB). DLB shares clinical symptoms of Parkinson's disease and dementia of the
      Alzheimer-type (DAT). However, DLB is also different to PD and DAT (less tremor
      and asymmetry of the motor symptoms, more falls, and less favourable response to
      L-Dopa than PD; in contrast to DAT marked cognitive fluctuations and phases of
      reduced alertness, hallucinations and delirium). There are genetic similarities
      to DAT and PD in terms of common genetic risk factors. A genetic cause of the
      disease has so far not been detected. Whether or not DLB is a disease entity or
      an association of diseases (Lewy body disease and DAT) has so far not been
      elucidated. Clinical distinction from DAT and PD has clinical importance because
      of different therapeutic and prognostic implications. Studies are needed to
      standardize the treatment of motor, cognitive, psychiatric and vegetative
      symptoms.

PMID- 11205150
TI  - Neuronal degeneration and reorganization: a mutual principle in pathological and
      in healthy interactions of limbic and prefrontal circuits.
AB  - Based on developmental principles and insights from animal research about
      neuroplasticity in cell assemblies, this article is to propose a view of
      plasticity that promotes a link between hippocampal and prefrontal structure and
      function. Both the mitotic activity (counting of BrdU-labeled cells) in
      hippocampal dentatus and the maturation of dopamine fibres (quantitative
      immunochemistry of mesoprefrontal projection) in the prefrontal cortex proved to
      be a measurable combination for investigating the complex chain of events that
      relate activity dependent neuroplasticity to normal as well as to pathological
      maturational processes. With our animal model we demonstrate that both rearing
      conditions and neuroactive substances can effectively interfere with
      developmental plasticity and induce a malfunctional adaptation of prefrontal
      structures and neurotransmitter systems (dopamine, GABA). In the hippocampal
      dentatus, where ontogenetic plasticity proved to be preserved by continued neuro-
      and synaptogenesis, serious damage can be internalized without simultaneous
      disruption of neural dynamics offering an approach to reverse dysfunctional
      reorganization in the prefrontal cortex.

PMID- 11205151
TI  - Depression in alpha-synucleinopathies: prevalence, pathophysiology and treatment.
AB  - Parkinson's disease (PD), dementia with Lewy bodies (DLB) and multiple system
      atrophy (MSA) are increasingly recognized as alpha-synucleinopathies, i.e.
      neurodegenerative disorders that share a common subcellular pathology
      characterized by alpha-synuclein abnormal aggregation. In the present review we
      focus on depression in alpha-synucleinopathies, discussing epidemiological,
      pathophysiological and treatment aspects of this frequently disabling clinical
      feature which may occur in PD, DLB and MSA alike.

PMID- 11205152
TI  - The serotonin transporter in Alzheimer's and Parkinson's disease.
AB  - The etiology of late-onset Alzheimer's disease (AD) and idiopathic Parkinson's
      disease (PD) is not known. In both disorders there is an extensive degeneration
      of serotonergic neurons, with corresponding losses of the serotonin (5HT)
      transporter (5HTT), which is responsible for the reuptake of 5HT from the
      synaptic cleft. An increasing body of evidence indicates that allelic variation
      of the 5HTT gene promoter (5HTT gene-linked polymorphic region, 5HTTLPR)
      determines high or low 5HT uptake in normal human brain. Association studies show
      that the low-activity allele of the 5HTTLPR is a risk factor for late-onset AD.
      In PD, the 5HTTLPR influences the risk of developing depression, a common symptom
      in PD patients. A compromised serotonergic system thus plays an important role in
      the pathophysiology of both AD and PD.

PMID- 11205153
TI  - Immunopathogenic and clinical relevance of antibodies against myelin
      oligodendrocyte glycoprotein (MOG) in Multiple Sclerosis.
AB  - Recent neuropathological findings identified four distinct immunopathogenic
      pathways of demyelination and tissue destruction in the most common inflammatory
      demyelinating central nervous system disorder, Multiple Sclerosis. One of this
      neuropathological subtypes is characterised by features of antibody-mediated
      demyelination. A role of anti-myelin antibodies in the disease evolution of
      multiple sclerosis has been suggested already for a long time, however, their
      pathogenetic and clinical relevance is not understood yet. This present article
      will discuss recently published and some preliminary data on the immunopathogenic
      role of antibodies against myelin oligodendrocyte glycoprotein (MOG) and other
      myelin/nonmyelin targets in multiple sclerosis, as well as possible clinical
      implications for prognosis and therapy in the future.

PMID- 11205154
TI  - Lessons from studies of antigen-specific T cell responses in Multiple Sclerosis.
AB  - Multiple Sclerosis (MS) is considered a T cell-mediated autoimmune disease of
      central nervous system myelin. Based on elegant experiments in an animal model of
      MS, experimental allergic encephalomyelitis (EAE), a number of myelin proteins
      and peptides derived from these can induce inflammatory demyelinating lesions.
      Recent studies with transgenic mice expressing human HLA-DR molecules and a
      myelin basic protein (MBP)-specific T cell receptor as well as data from a phase
      II clinical trial with an altered peptide ligand based on MBP peptide (83-99)
      provide convincing evidence that the pathogenetic concepts which largely stem
      from the above EAE studies are valid in MS, too.

PMID- 11205155
TI  - Impaired iron homeostasis in Parkinson's disease.
AB  - Despite physiological systems designed to achieve iron homeostasis, increased
      concentrations of brain iron have been demonstrated in a range of
      neurodegenerative diseases. These including the parkinsonian syndromes, the
      trinucleotide repeat disorders and the dementia syndromes. The increased brain
      iron is confined to those brain regions most affected by the degeneration
      characteristic of the particular disorder and is suggested to stimulate cell
      damage via oxidative mechanisms. Changes in central iron homeostasis have been
      most closely investigated in PD, as this disorder is well characterised both
      clinically and pathologically. PD is associated with a significant increase in
      iron in the degenerating substantia nigra (SN) and is measureable in living PD
      patients and in post-mortem brain. This increase, however, occurs only in the
      advanced stages of the disease, suggesting that this phenonoma may be a
      secondary, rather than a primary initiating event, a hypothesis also supported by
      evidence from animal experiments. The source of the increased iron is unknown but
      a variety of changes in iron homeostasis have been identified in PD, both in the
      brain and in the periphery. The possibility that an increased amount of iron may
      be transported into the SN is supported by data demonstrating that one form of
      the iron-binding glycoprotein transferrin family, lactotransferrin, is increased
      in surviving neurons in the SN in the PD brain and that this change is associated
      with increased numbers of lactotransferrin receptors on neurons and microvessels
      in the parkinsonian SN. These changes could represent one mechanism by which iron
      might concentrate within the PD SN. Alternatively, the measured increased in iron
      might result from a redistribution of ferritin iron stores. Ferritin is located
      in glial cells while the degenerating neurons do not stain positive for ferritin.
      As free radicals are highly reactive, it is unlikely that glial-derived free
      radicals diffuse across the intracellular space in sufficent quantities to damage
      neuronal constituents. If intracellular iron release contributes to neuronal
      damage it seems more probable that an intraneuronal iron source is responsible
      for oxidant-mediated damage. Such a iron source is neuromelanin (NM), a dark
      coloured pigment found in the dopaminergic neurons of the human SN. In the normal
      brain, NM has the ability to bind a variety of metals, including iron, and
      increased NM-bound iron is reported in the parkinsonian SN. The consequences of
      these phenomena for the cell have not yet been clarified. In the absence of
      significant quantities of iron NM can act as an antioxidant, in that it can
      interact with and inactivate free radicals. On the other hand, in the presence of
      iron NM appears to act as a proxidant, increasing the rate of free radical
      production and thus the oxidative load within the vulnerable neurons. Given that
      increased iron is only apparent in the advanced stages of the disease it is
      unlikely that NM is of importance for the primary aetiology of PD. A localised
      increase in tissue iron and its interaction with NM may be, however, important as
      a secondary mechanism by increasing the oxidative load on the cell, thereby
      driving neurodegeneration.

PMID- 11205156
TI  - Glutamate excitotoxicity--a mechanism for axonal damage and oligodendrocyte death
      in Multiple Sclerosis?
AB  - Glutamate excitotoxicity mediated by the AMPA/kainate-type of glutamate receptors
      is known not only to damage neurons but also the myelin-producing cell of the
      central nervous system (CNS), the oligodendrocyte. In Multiple Sclerosis (MS),
      myelin, oligodendrocytes and axons are lost or damaged as a result of an
      inflammatory attack on the CNS. Activated immune cells produce glutamate in large
      quantities by deamidating glutamine via glutaminase. Thus, we hypothesized that
      during inflammation in MS, glutamate excitotoxicity may contribute to the lesion.
      This was addressed by treating mice sensitized to develop acute experimental
      autoimmune encephalomyelitis (EAE) with an AMPA/kainate antagonist, NBQX.
      Treatment resulted in substantial amelioration of disease, increased
      oligodendrocyte survival and reduced axonal damage, as indicated by the levels of
      dephosphorylated neurofilament-H. Despite the clinical differences, NBQX
      treatment had no effect on lesion size and did not reduce the degree of CNS
      inflammation. In addition, NBQX did not alter the proliferative activity of
      antigen-primed T cells in vitro, further indicating a lack of effect at the level
      of the immune system. In separate studies, infiltrating immune cells present in
      perivascular cuffs, commonly the site of entry for invading immune cells, were
      found to express glutaminase in abundance, supporting the production of glutamate
      in inflammatory lesions. Thus, glutamate excitotoxicity appears to be an
      important mechanism in autoimmune demyelination and its prevention with
      AMPA/kainate antagonists may prove to be an effective therapy for MS.

PMID- 11205157
TI  - Evidence for enhanced neuro-inflammatory processes in neurodegenerative diseases
      and the action of nitrones as potential therapeutics.
AB  - A brief review is presented on observations leading to the current notions
      regarding neuro-inflammatory processes. The greatest focus is on Alzheimer's
      disease (AD) since this is where the most convincing data has been obtained. A
      brief summary of observations on the neuroprotective action of alpha-phenyl-tert
      butyl-nitrone (PBN) as well as results of research designed to understand its
      mechanism of action is presented. We hypothesize that the mechanism of action of
      PBN involves inhibition of signal transduction processes, which are involved in
      the upregulation of genes mediated by pro-inflammatory cytokines and H2O2 that
      cause formation of toxic gene products. Results from recent experiments on Kainic
      acid (KA) mediated brain damage are provided to suggest the validity of the in
      vivo action of PBN to inhibit neuro-inflammatory processes. The accumulating
      scientific facts are helping to provide concepts that may become the basis for
      novel therapeutic approaches to the treatment of several neurodegenerative
      diseases.

PMID- 11205158
TI  - The molecular mechanism of dopamine-induced apoptosis: identification and
      characterization of genes that mediate dopamine toxicity.
AB  - Parkinson's disease (PD) is a progressive neurological disorder caused by rather
      selective degeneration of the dopaminergic (DA) neurons in the substantia nigra.
      Though subject to intensive research, the etiology of this nigral neuronal loss
      is still enigmatic and treatment is basically symptomatic. The current major
      hypothesis suggests that nigral neuronal death in PD is due to excessive
      oxidative stress generated by auto- and enzymatic oxidation of the endogenous
      neurotransmitter dopamine (DA), the formation of neuromelanin and presence of
      high concentrations of iron. We have found that DA toxicity is mediated through
      its oxidative metabolites. Whereas thiol-containing antioxidants provided marked
      protection against DA toxicity, ascorbic acid accelerated DA-induced death. Using
      the differential display approach, we sought to isolate and characterize genes
      whose expression is altered in response to DA toxicity. We found an upregulation
      of the collapsin response mediator protein (CRM) and TCP-1delta in sympathetic
      neurons, which undergo dopamine-induced apoptosis. The isolation of these genes
      led us to examine the expression and activity of CRM and TCP-1delta related
      genes. Indeed, we found a significant induction of mRNAs of the secreted
      collapsin-1 and the mitochondrial stress protein HSP60. Antibodies directed
      against collapsin-1 provided marked and prolonged protection of several neuronal
      cell types from dopamine-induced apoptosis. In a parallel study, using antisense
      technology, we found that inhibition of TCP-1delta expression significantly
      reduced DA-induced neuronal death. These findings suggest a functional role for
      collapsin-1 and TCP-1delta as positive mediators of DA-induced neuronal
      apoptosis.

PMID- 11205159
TI  - Glyceraldehyde-3-phosphate dehydrogenase in neurodegeneration and apoptosis
      signaling.
AB  - Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a well-studied glycolytic
      enzyme that plays a key role in energy metabolism. GAPDH catalyzes the conversion
      of glyceraldehyde-3-phosphate to 1,3-bisphosphoglycerate in the glycolytic
      pathway. As part of the conversion, GAPDH converts NAD+ to the high-energy
      electron carrier NADH. GAPDH has been referred to as a "housekeeping" protein and
      based on the view that GAPDH gene expression remains constant under changing
      cellular conditions, the levels of GAPDH mRNA have frequently been used to
      normalize northern blots. In recent years, that view has changed since GAPDH is
      now known to contribute to a number of diverse cellular functions unrelated to
      glycolysis. Normative functions of GAPDH now include nuclear RNA export, DNA
      replication, DNA repair, exocytotic membrane fusion, cytoskeletal organization
      and phosphotransferase activity. Pathologically, GAPDH has been implicated in
      apoptosis, neurodegenerative disease, prostate cancer and viral pathogenesis (see
      Sirover (1999) for a recent review of GAPDH functions). Most recently, it has
      been shown that GAPDH is a target for deprenyl related compounds (Carlile et al.,
      2000; Kragten et al., 1998) and may contribute to the neuroprotection offered by
      those compounds.

PMID- 11205160
TI  - Feline panleukopenia virus revisited: molecular characteristics and pathological
      lesions associated with three recent isolates.
AB  - The low incidence of clinical signs or pathological lesions compatible with
      feline panleukopenia in cats has created the perception among practitioners that
      the disease has disappeared since the emergence of canine parvovirus type 2 in
      the late 1970s. Three parvoviruses that were recently isolated from a domestic
      cat and 2 cheetahs in cell culture or detected by means of the polymerase chain
      reaction were shown to be typical feline parvoviruses. Phylogenetic comparison
      with other FPV isolates did not reveal a particular African cluster.

PMID- 11205161
TI  - A study to evaluate the field efficacy of ivermectin, fenbendazole and pyrantel
      pamoate, with preliminary observations on the efficacy of doramectin, as
      anthelmintics in horses.
AB  - The efficacy of ivermectin, fenbendazole, pyrantel pamoate and doramectin was
      evaluated under field conditions at 2 sites in the Free State Province of South
      Africa. The study involved 25 horses at each site, divided into 5 groups of equal
      size. Ivermectin, fenbendazole and pyrantel pamoate were administered orally at
      doses of 0.2, 10 and 19 mg/kg respectively. Doramectin was administered by
      intramuscular injection at a dose of 0.2 mg/kg. Treatment efficacy was based on
      the mean faecal egg count reduction 14 days post treatment. At site A a faecal
      egg count reduction of 100% was found after treatment with ivermectin,
      fenbendazole and doramectin. A 96.1% reduction was found after treatment with
      pyrantel pamoate. At site B ivermectin and doramectin produced a 100% reduction
      in faecal egg counts, fenbendazole produced an 80.8% reduction and pyrantel
      pamoate a 94.1% reduction. Doramectin produced a 100% reduction in faecal egg
      counts at both sites, despite not being registered for use in horses. In
      addition, the results indicated reduced efficacy of fenbendazole at site B, which
      suggested benzimidazole resistance. Larval cultures showed that cyathostomes
      accounted for between 86 and 96% of pre-treatment parasite burdens at both sites.
      Other helminths identified in the faecal samples were Strongylus spp. and
      Trichostrongylus axei.

PMID- 11205162
TI  - A preliminary evaluation of a sheep blowfly trap in the Western Cape.
AB  - An insecticide-free sheep blowfly trapping system, utilising a synthetic lure,
      was evaluated at 4 localities in the Western Cape. Control sites, where no
      suppression was practised, were identified for each locality. The blowfly
      population was monitored for 48 hours monthly at each of the localities. Five to
      7 suppression traps at the respective localities were identified for this
      purpose. Three to 10 traps were set monthly for monitoring in the control areas.
      Trapping resulted in the suppression (P < 0.01) of the Lucilia population at
      Caledon, where a large area of approximately 50 km2 was trapped. The suppression
      area of all the localities was < or =850 ha. At Elsenburg, blowfly numbers were
      low. There was a strong suggestion of a general reduction in the Lucilia numbers
      at this locality. Trapping failed to reduce Lucilia numbers at Tygerhoek and
      Langgewens. Lack of control over the influx of Lucilia from adjacent sheep
      producing areas probably contributed to this result. The observed response at
      Elsenburg was probably due to its situation in a predominantly wine-growing area.
      Most of the blowflies recovered from the control traps during the month with the
      highest yield at the respective localities belonged to the genus Lucilia. The
      results obtained at Caledon and published reports suggest that large-scale
      trapping of Lucilia spp. may play a role in an integrated pest management system
      for blowflies.

PMID- 11205163
TI  - Clinical, cardiopulmonary and haemocytological effects of xylazine in goats after
      acute exposure to different environmental temperature and humidity conditions.
AB  - This study was carried out to assess the influence of xylazine administration on
      clinical, cardiopulmonary and haemocytological variables after acute exposure to
      different environmental conditions. Xylazine hydrochloride was administered
      intravenously at 0.1 mg/kg body mass to 6 clinically healthy, castrated male
      goats. All animals were exposed for 60 min to 3 sets of climatic conditions: 14
      degrees C, 33% relative humidity; 24 degrees C, 55% RH, and 34 degrees C, 65% RH.
      The variables that were measured for a period of 60 min after xylazine
      administration were sedation, analgesia, salivation, urination, ventilation rate,
      heart-rate, mean arterial blood pressure, oesophageal temperature, haematocrit,
      mean corpuscular volume and mean corpuscular haemoglobin concentration. Xylazine
      induced sedation, analgesia, salivation and urination independently of the 3
      environmental conditions. Environment had no influence on the onset, duration and
      recovery from sedation. In the 14 degrees C environment, xylazine resulted in a
      significant decrease in ventilation and heart-rate from baseline values.
      Significant changes in mean arterial blood pressure, haemoglobin concentration,
      mean corpuscular volume, haematocrit and red cell count were observed in the 3
      environments. Total plasma protein was significantly altered at 24 degrees C and
      34 degrees C. Acute exposure of goats to different environmental conditions had
      no significant influence on the clinical, cardiopulmonary and haemocytological
      variables. Physiological changes induced by xylazine were therefore independent
      of the environment.

PMID- 11205164
TI  - Characteristics and performance of village animal health workers and veterinary
      assistants in northern Malawi.
AB  - Fourty-two village animal health workers called keymen (KM) and 84 veterinary
      assistants (VA) involved in a Basic Animal Health Service (BAHS) Programme in
      northern Malawi were interviewed during 1998. The general characteristics and
      perceptions of both groups were analysed using uni- and multivariate techniques.
      Detailed sales and treatment patterns of six KM and 12 VA were evaluated for the
      period September 1996 to August 1997. Results indicated an overall job
      satisfaction for 82% of KM and 83 % of VA. Estimated weekly involvement in
      livestock service delivery, particularly of KM, was 3.7 days on average. Total
      annual drug sales of KM and VA between 1996 and 1997 on average were equivalent
      to US$ 124 and US$ 218 respectively. Most livestock remedies were issued for
      treatment of calves, followed by adult cattle, chickens and small ruminants. The
      changes suggested by VA and KM in order to improve field performance focused on
      regular refresher training by the BAHS programme.

PMID- 11205165
TI  - Routine veterinary anaesthetic management practices in South Africa.
AB  - A survey of the routine anaesthetic management of dogs and cats during
      sterilisation by veterinarians in South Africa was conducted. This report
      describes the premedication, induction and maintenance agents most commonly used
      in dogs and cats. Information about monitoring of patients during the procedure
      and who is responsible for induction of anaesthesia and monitoring was obtained.
      Questionnaires were analysed with regard to demographic data, practice size,
      continuing education, the number of surgical procedures and sterilisations
      performed per week and an estimate of yearly mortality. Acetylpromazine is the
      most commonly used premedication in dogs and xylazine in cats. Thiopentone in
      dogs and alphaxalone/alphadolone in cats were the induction agents most commonly
      used. Alphaxalone/alphadolone in cats and halothane in dogs are the most commonly
      used maintenance agents. Records of anaesthesia are poorly kept and monitoring of
      patients is poorly performed. Respiratory rate is the parameter most commonly
      monitored (90.7%), and in most cases is the sole parameter. On average 10.34 +/-
      8.25 cats were operated per week, of which 5.45 +/- 5.60 were sterilised; 17.79
      +/- 11.61 dogs were operated per week, of which 8.65 +/- 7.10 were sterilised. In
      total, 190 patients died under anaesthesia, a mortality rate of 1:1,243. Just
      over 50% of practitioners had attended continuing education courses during their
      careers.

PMID- 11205166
TI  - The spread of weeds into sensitive areas by seeds in horse faeces.
AB  - The possible spread by horse faeces of plants that may become weeds in sensitive
      areas was investigated. It was found that the period 24-48 hours after ingestion
      of seeds included in rations was the retention time for seeds passing through the
      digestive system of the horse. The ability of seeds to germinate was not
      influenced by exposure to digestive fluids or sea-water. A feeding regime of
      compound feeds is suggested.

PMID- 11205167
TI  - Ectoparasites of dogs belonging to people in resource-poor communities in North
      West Province, South Africa.
AB  - A total of 344 dogs belonging to people in resource-poor communities in North
      West Province, South Africa, was examined for ectoparasites, and all visible
      arthropods were collected from the left side of each dog. By doubling these
      numbers it was estimated that the dogs harboured 14,724 ixodid ticks, belonging
      to 6 species, 1,028 fleas, belonging to 2 species, and 26 lice. Haemaphysalis
      leachi accounted for 420 and Rhipicephalus sanguineus for 14,226 of the ticks.
      Pure infestations of H. leachi were present on 14 dogs and of R. sanguineus on
      172 dogs. Small numbers of Amblyomma hebraeum, R. appendiciulatus, R. evertsi
      evertsi and R. simus were also collected. The predominance of R. sanguitneus
      accounts for the high prevalence of canine ehrlichiosis (Ehrlichia canis) within
      the survey region, compared to canine babesiosis (Babesia canis), which is
      transmitted by H. leachi, and is a much rarer disease.

PMID- 11205168
TI  - Survey of canine babesiosis in South Africa.
AB  - A questionnaire, designed to obtain qualitative information on a number of
      variables concerning canine babesiosis (biliary fever) in South Africa, was sent
      to 510 veterinary practices in late 1993. Of the 157 practices that responded,
      all were presented with cases of babesiosis and most were situated in Gauteng,
      the Western Cape and KwaZulu-Natal. Apart from the Western Cape, a winter
      rainfall region, the prevalence of babesiosis cases in dogs was highest in
      summer. Most of the respondent practices treated between 1,000 and 5,000 sick
      dogs that included 100 to 500 babesiosis cases each year. Respondents identified
      cerebral babesiosis, enterorrhagia, 'red' or haemoconcentrated babesiosis, acute
      renal failure and pulmonary babesiosis or 'shock lung', amongst others, as the
      most prevalent forms of complicated ('atypical') babesiosis. Diminazene,
      imidocarb and trypan blue were the most popular antibabesials. Trypan blue was
      most often used in shocked patients, whereas diminazene and imidocarb were
      preferred when there was a high parasitaemia in the absence of shock. At least 19
      antibabesial treatment regimens were used in practices. These comprised the use
      of single doses of antibabesial drugs; split doses with repeat injections, and
      combined drug variations, some of which are undesirable due to possible
      sterilisation of Babesia infection or potential toxicity. Side-effects were most
      commonly associated with imidocarb use. Ninety-six percent of respondents used
      supportive treatment (e.g. corticosteroids, vitamins and 'liver support') in all
      cases of babesiosis. The use of blood transfusion as supportive treatment varied
      according to practice and severity of the case. Most practices never cross
      matched blood to be transfused, and transfusion reactions were rare. Diminazene
      was most frequently incriminated in cases where drug 'resistance' or relapses
      occurred. Cerebral and 'red' cases resulted in high mortality. Treatment of
      babesiosis costs the dog-owning public in South Africa more than R20 million each
      year. Information on the distribution and possible complicating role of Ehrlichia
      canis was obtained. Development of a vaccine was the first research priority
      identified.

PMID- 11205169
TI  - Helicopter-based censusing of domestic dogs in Gauteng Province, South Africa.
AB  - Decision support in veterinary epidemiology often depends on density estimates of
      domestic animals. These estimates are usually based on ground surveys of various
      types. Ground surveys are difficult to undertake in the informal housing
      settlements that are frequently encountered in developing countries. In addition,
      they are time-consuming and expensive. In this study, field experience in
      enumerating wildlife from helicopters was used to count domestic animals in
      Gauteng Province, South Africa. Data for domestic dogs are analysed for precision
      and accuracy and the technique evaluated in terms of its value for decision
      support.

PMID- 11205170
TI  - The measurement of glucocorticoid concentrations in the serum and faeces of
      captive African elephants (Loxodonta africana) after ACTH stimulation.
AB  - Conventionally, the assessment of adrenal responses to stress relies on blood
      sample collection. However, blood collection from animals is impossible without
      restraint or immobilisation that influences results. This study was undertaken to
      validate recently established enzyme immunoassays that measure faecal
      glucocorticoid metabolites in elephants, and to perform a preliminary
      investigation into the biological relevance of this non-invasive method for use
      in assessing the degree of stress in this species. Four juvenile African
      elephants were injected i.m. with 2.15 mg synthetic adrenocorticotrophic hormone
      (Synacthen, Novartis, Switzerland). Blood and faecal samples were collected over
      4 h and 7 d respectively. Concentrations of serum cortisol and faecal cortisol
      metabolites were determined using immunoassay. Variability of basal and peak
      values in blood and faeces was observed among the elephants. After ACTH
      injection, serum cortisol concentrations increased by 400-700%. An 11
      oxoaetiocholanolone enzyme immunoassay (EIA) proved best suited to measure
      cortisol metabolites (11,17-dioxoandrostanes) when compared to a cortisol and
      corticosterone EIA in faecal samples. Concentrations of faecal 11,17
      dioxoandrostanes increased by 570-1070%, reaching peak levels after 20.0-25.5 h.
      Greater levels of glucocorticoid metabolites were measured in faecal samples from
      elephants kept in small enclosures compared to levels in the faeces of animals
      ranging over a larger area. The results of this preliminary study suggest that
      non-invasive faecal monitoring of glucocorticoid metabolites is useful in
      investigating adrenal activity in African elephants.

PMID- 11205172
TI  - Bovine mastitis therapy and why it fails.
AB  - Treatment of bovine mastitis depends on the cause, the clinical manifestation and
      the antibiotic susceptibility of the agent. Mastitis therapy is commonly
      unsuccessful owing to pathological changes that occur in the udder parenchyma as
      a result of the inflammatory reaction to mastitogenic bacteria, pharmacokinetic
      properties of antimicrobial mastitis drugs, mastitogenic bacterial and related
      factors, and poor animal husbandry and veterinary interventions.

PMID- 11205171
TI  - Dirofilaria repens in a cat with acute liver failure.
AB  - Acute liver failure was diagnosed in a 12-year-old cat. Fine needle aspirate
      cytology revealed high numbers of unsheathed microfilariae and a hepatocellular
      reaction with no evidence of bacterial infection. The microfilariae were
      identified as those of Dirofilaria repens by acid phosphatase staining. The high
      number of microfilariae seen in both the blood and the liver aspirate samples as
      well as the favourable response to ivermectin amongst other drugs administered,
      is suggestive that D. repens was the cause of the liver insult. A positive result
      obtained with an antigen-capture ELISA (Dirochek) for Dirofilaria immitis antigen
      was interpreted as false. This is the 1st report of Dirofilaria repens for South
      Africa.

PMID- 11205173
TI  - [Hepatitis C].

PMID- 11205174
TI  - [Epidemiology and transmission of hepatitic C].
AB  - Infections with the hepatitis C virus (HCV) are pandemic, and the WHO estimates a
      world-wide prevalence of 3%. In Middle Europe approximately 1% of the population
      are infected, mostly with genotype 1 (85% in Austria). Since the discovery of HCV
      in 1989 and the introduction of the HCV antibody test in 1990, mainly chronic
      asymptomatic cases were diagnosed. In developed countries, chronic hepatitis C is
      the most prominent cause for liver cirrhosis, hepatocellular carcinoma, and liver
      transplantation. In former years, transmission of HCV was predominantly
      iatrogenic, e.g. by blood transfusions before 1990, blood products such as
      coagulation factors in hemophiliacs or anti-D-globuline in rhesus
      incompatibility, parenteral anti-schistosomal treatment in Egypt, contaminated
      endoscopes or cardiac surgery. Today, sporadic transmission is more prevalent,
      mostly in drug addicts via needle sharing, and seldom by needle-stick injuries in
      medical personnel, vertical transmission from mother to baby, tattooing,
      piercing, or razor sharing. Given the lack of a prophylactic HCV vaccine,
      preventive measures are very important such as screening of blood products by
      PCR, use of disposable instruments. or procurement of drug addicts with single
      use syringes and needles.

PMID- 11205175
TI  - [Virology of hepatitis C virus].
AB  - Hepatitis C virus (HCV) along with hepatitis G virus are members of the
      hepacivirus genus of the flavi-viridae family to which the flavi- and pestis
      viruses also belong. The HCV genome has only one ORF which is flanked by a 5' and
      3' noncoding region. The ORF encodes for a single polyprotein, which is stepwise
      cleaved into the 3 structural proteins, core (C), envelope 1 and 2 (E1,2) as well
      as into 7 non-structural proteins (p7, NS2, NS3, NS4A, NS4B, NS5A, NS5B). The
      proteolytic active NS3 plays a central role in this processing. Whereas
      expectations for development of an HCV vaccine are not very optimistic today,
      there is great hope in new therapeutic possibilities by inhibition of NS3
      function. HCV is highly variable. In the liver and serum of a single patient,
      genetically slightly different virus particles (quasispecies) can be found.
      Worldwide, hepatitis C virus has been classified into genotypes and subtypes.
      This differentiation is not only important epidemiologically, but also has
      biological and therapeutical implications.

PMID- 11205176
TI  - [Clinical aspects, course and extrahepatic manifestations of hepatitis C].
AB  - Hepatitis C virus infection occasionally causes acute icteric hepatitis. However,
      primary infection is usually asymptomatic. Viral clearance occurs only in 20%;
      most patients develop a chronic hepatitis, which tends to be hardly symptomatic
      for many years. The risk of progression to cirrhosis, hepatocellular carcinoma
      and end-stage liver disease is associated with the severity of histopathological
      changes, and is increased by additional factors, such as excessive alcohol intake
      or coinfection with hepatitis B virus and HIV. Immunologically mediated
      extrahepatic manifestations of hepatitis C, in particular essential mixed
      cryoglobulinemia, can often be observed. Occasionally, they lead to fatal
      complications.

PMID- 11205177
TI  - [Laboratory diagnosis of hepatitis C virus infection].
AB  - In Austria, the prevalence of hepatitis C virus infections is 0.7% (17).
      Exclusion of a putative infection as well as diagnosis and continuous monitoring
      of HCV-disease produce considerable costs for the health system. How many and
      which patients with HCV infection will acquire life-threatening complications is
      by far not clear. Also, the causes for viral persistence and liver-complications
      remain obscure. For certain, complex interactions of viral and immunological
      mechanisms will determine the individual outcome of the disease (1). These
      considerations pose decisive demands on clinical diagnostics for HCV infections
      to be dealt with in detail: methods for qualitative detection of an infection as
      well as for analysis of subtypes and for quantitative determination of viral
      copies; monitoring of therapy; estimation of the progress of the disease and/or
      efficacy of therapy.

PMID- 11205178
TI  - [Differential chronic hepatitis diagnosis].
AB  - Chronic hepatitis comprises a group of disorders of the liver exhibiting a
      chronic necroinflammatory process that differs in etiology, clinical course and
      treatment strategies. A diagnosis of chronic hepatitis is usually made when
      inflammation and liver cell necrosis persist for longer than 6 months. Clinical
      manifestations range from asymptomatic patients to those with advanced hepatic
      failure. Both sexes and all age groups are affected. Chronic hepatitis may emerge
      as a sequelae of hepatitis C and less often after hepatitis B. Both diseases are
      treatable and require rapid and exact diagnosis. The differential diagnosis must
      exclude autoimmune hepatitis, chronic steatohepatitis, congenital metabolic
      hepatopathies and drug-induced hepatopathies. Laboratory tests, histologic
      investigations and clinical differential diagnosis must exclude other causes of
      chronic liver disease.

PMID- 11205179
TI  - [Therapy of chronic hepatitis C].
AB  - Interferon-alpha is still the only drug with antiviral activity against the
      hepatitis C virus. However, if the outcome of treatment is measured by highly
      sensitive virologic test, sustained response rates to interferon monotherapy are
      low, especially in patients infected with subtype 1 (3-10%). Therefore better
      therapies are needed. The combination of interferon with ribavirin is a major
      advance. Although the precise mode of action of ribavirin is unknown, it seems to
      decrease relapse rates after successful treatment. By combination therapy, 30% of
      patients with subtype 1 and 65% with subtype 3 had a sustained response. Further
      improvements can be expected from high-dose induction therapy and from long
      acting pegylated interferons. Nonresponders may benefit from antifibrotic agents,
      like long-term interferon therapy, IL-10 or silymarin.

PMID- 11205180
TI  - A randomised prospective study to evaluate a rapid HIV-antibody assay in the
      management of cases of percutaneous exposure amongst health care workers.
AB  - A rapid start of post-exposure prophylaxis with an antiretroviral regime is
      recommended after percutaneous exposure to blood from an HIV-positive source.
      Since the HIV-antibody status of the source is usually not known at the time of
      injury, antiretroviral treatment is started pending the results of HIV testing of
      the source. A randomised prospective study was designed to compare the use of a
      rapid-screening assay in the management of cases of percutaneous exposure with
      the conventional procedure. Prior to the comparative study, the accuracy of a
      rapid-screening assay performed by non-laboratory trained personnel was
      evaluated. 123 blinded HIV-positive and HIV-negative samples were correctly
      identified. In a randomised comparison with the conventional procedure, the
      application of the rapid-screening assay resulted in a significant reduction of
      psychological stress, drug use and cost. The estimated net benefit per case was
      CHF 93.-(62 US$). This study strongly supports the use of the rapid-screening
      assay in the management of post-exposure prophylaxis for HIV after percutaneous
      exposure in health care workers.

PMID- 11205181
TI  - Factors affecting the efficiency of aerosol therapy with pressurised metered-dose
      inhalers through plastic spacers.
AB  - AIM: The main objective of this study was to compare the in vitro delivery of
      salbutamol from a chlorofluorocarbon(CFC)-propelled pressurised metered-dose
      inhaler (pMDI) versus a newly developed hydrofluoroalkane(HFA)-propelled pMDI
      through various spacers. In addition, we aimed to study the effect on
      bronchodilator response when using an optimal pMDI/spacer combination for aerosol
      delivery compared to a suboptimal combination. METHODS: Particle size
      distribution and output from salbutamol pMDIs containing either CFC propellants
      (Ventolin) or HFA propellants (Airomir) were measured using a multistage liquid
      impinger (MSLI) and compared to that through both detergent-coated (non-static)
      or untreated (static) large volume (Nebuhaler, Volumatic) and small volume
      (Aerochamber) plastic spacers. Flow-volume curves (FEV1) were obtained from
      twelve asthmatic children with known significant bronchodilator response (8
      males), aged 13-17 years, randomly inhaling salbutamol from a CFC-pMDI through a
      static spacer (Nebuhaler) and from an HFA-pMDI through a non-static spacer
      (Nebuhaler). RESULTS: In vitro output of particles in the respirable range (< 6.8
      microns) from HFA-pMDIs was significantly higher than that from CFC-pMDIs using
      various spacers. Removal of electrostatic charge increased output from CFC- and
      HFA-pMDIs through all spacers by 17-82%. The mean (SD) bronchodilator response
      after inhalation of salbutamol from a CFC-pMDI through a static spacer was 7.1%
      (6.3%) compared to 17.5% (7.9%) after inhalation from an HFA-pMDI through a non
      static spacer (p = 0.002). CONCLUSIONS: Use of a newly developed HFA-propelled
      pMDI greatly improves drug delivery through spacers compared to a CFC-propelled
      pMDI. However, electrostatic charge in plastic spacers remains the key
      determinant limiting delivery of salbutamol from a pMDI through spacers, and can
      be reduced by soaking the spacer in a household detergent. Using an optimal
      pMDI/spacer combination leads to a significantly improved bronchodilator
      response.

PMID- 11205182
TI  - Effects of voluntary hyperventilation on glucose, free fatty acids and several
      glucostatic hormones.
AB  - BACKGROUND: The aim of the present study was to measure the influence of a
      defined period of standardised voluntary hyperventilation on the levels of
      glucose, free fatty acids and several glucose regulating hormones in healthy
      volunteers. STUDY DESIGN: Eight healthy male subjects were submitted to 20
      minutes of controlled hyperventilation and blood levels of glucose, free fatty
      acids, insulin, glucagon, cortisol, catecholamines and pCO2 were measured before,
      immediately after and 20 minutes after the end of the hyperventilation period.
      RESULTS: The hyperventilation led to a significant increase in all above
      mentioned parameters, except for glucose, where the effect was negligible.
      CONCLUSIONS: In view of the frequency of accompanying hyperventilation in a great
      variety of diseases and notably in some intensive care patients we postulate that
      pitfalls in the interpretation of plasma values of substances involved in glucose
      metabolism may be avoided by simultaneous determination of arterial pCO2.

PMID- 11205183
TI  - Myocardial angiogenesis induction with bone protein derived growth factors
      (animal experiment).
AB  - Myocardial angiogenesis induction with vascular growth factors constitutes a
      potential strategy for patients whose coronary artery disease is refractory to
      conventional treatment. The importance of angiogenesis in bone formation has led
      to the development of growth factors derived from bovine bone protein. Twelve
      pigs (mean weight, 73 +/- 3 kg) were chosen for the study. In the first group (n
      = 6, growth factor group) five 100 micrograms boluses of growth factors derived
      from bovine bone protein, diluted in Povidone 5%, were injected in the lateral
      wall of the left ventricle. In the second group (n = 6, control group), the same
      operation was performed but only the diluting agent was injected. All the animals
      were sacrificed after 28 days and the vascular density of the left lateral wall
      (expressed as the number of vascular structures per mm2) as well as the area of
      blood vessel profiles per myocardial area analysed were determined histologically
      with a computerised system. The growth factor group had a capillary density which
      was significantly higher than that of the control group: 12.6 +/- 0.9/mm2 vs 4.8
      +/- 0.5/mm2 (p < 0.01). The same holds true for the arteriolar density: 1 +/-
      0.2/mm2 vs 0.3 +/- 0.1/mm2 (p < 0.01). The surface ratios of blood vessel
      profiles per myocardial area were 4900 +/- 800 micron 2/mm2 and 1550 +/- 400
      micron 2/mm2 (p < 0.01) respectively. In this experimental model, bovine bone
      protein derived growth factors induce a significant neovascularisation in healthy
      myocardium, and appear therefore as promising candidates for therapeutic
      angiogenesis.

PMID- 11205184
TI  - Gene therapy of cancer.
AB  - Gene therapy was initially thought of as a means to correct single gene defects
      in hereditary disease. In the meantime, cancer has become by far the most
      important indication for gene therapy in clinical trials. In the foreseeable
      future, the best way to achieve reasonable intratumoral concentrations of a
      transgene with available vectors is direct intratumoral injection with or without
      the aid of various techniques such as endoscopy or CT-guidance. At present, viral
      and non-viral methods of gene transfer are used either in vivo or ex vivo/in
      vitro. The most important viral vectors currently in use in clinical trials
      comprise retroviruses, adenoviruses, adeno-associated viruses, and herpes
      viruses. None of the available vectors satisfies all the criteria of an ideal
      gene therapeutic system, and vectors with only minimal residues of their parent
      viruses ("gutless vectors") as well as completely "synthetic viral vectors" will
      gain more and more importance in the future. Non-viral gene therapy methods
      include liposomes, injection of vector-free DNA ("naked DNA"), protein-DNA
      complexes, delivery by "gene gun," calcium-phosphate precipitation,
      electroporation, and intracellular microinjection of DNA. The first clinical
      trial of gene therapy for cancer was performed in 1991 in patients with melanoma,
      and since then more than 5000 patients have been treated worldwide in more than
      400 clinical protocols. With the exception of a case of fatal toxicity in a young
      man with hereditary liver disease treated intrahepatically with high doses of
      adenovirus, side effects have been rare and usually mild in all these studies and
      expression of the transgene could be demonstrated in patients in vivo. However,
      despite anecdotal reports of therapeutic responses in some patients, unequivocal
      proof of clinical efficacy is still lacking for most of the varied approaches to
      gene therapy in humans. As well as our only fragmentary understanding of the
      molecular pathophysiology of many diseases, the principal reason for the present
      lack of clinical success of gene therapy is the very low transduction and
      expression efficiency in vivo of available vectors. Despite the complexities of
      gene therapy for cancer, the numerous different approaches can be subdivided into
      three basic concepts: (1) strengthening of the immune response against a tumour,
      (2) repair of cell cycle defects caused by losses of tumour suppressor genes or
      inappropriate activation of oncogenes, and (3) suicide gene strategies. In
      addition, the importance of gene marker studies and gene therapeutic protection
      of normal tissue are briefly covered in this review.

PMID- 11205185
TI  - [Image of the month. Mitral valve prolapse].

PMID- 11205186
TI  - [Pharma clinics. How I treat...dental emergencies in general practice].
AB  - Counselling and drug prescription are the only means for the phycisian to manage
      dental emergencies. Among these, some are infection related: pulpitis, apical and
      periodontal abscesses, acute necrotizing ulcerative gingivitis and alveolitis.
      Urgent medical treatment includes antibiotics, mouth rinses and analgesics except
      for pulpitis (pain caused by thermal stimuli) for which analgesics alone are
      prescribed. Infection non related dental emergencies are: hemorrhage for which
      the best treatment is compression; trauma, mainly dental avulsion for which
      reimplantation must be done as soon as possible; acute TMD such as open lock
      which can be reduced by the Nelaton handling.

PMID- 11205187
TI  - [Clinical case of the month. Unilateral exophthalmos].
AB  - This paper describes two cases of unilateral exophtalmos and reviews the
      diagnostic and therapeutic approach to this clinical entity.

PMID- 11205188
TI  - [Pneumocystis carinii pneumonia in a child without immunodepression].
AB  - We report the case of a 5 1/2 month baby with an atypical pneumonia. The PCR
      revealed a Pneumocystis carinii pneumonia. The complementary approach failed to
      show any immunosuppression. We will discuss the aetiology, physiopathology and
      treatment of Pneumocystis carnii pneumonia, particularly in cases without
      immunosuppression. We will also recall the importance of this disease in AIDS.

PMID- 11205189
TI  - [Gitelman syndrome: a rare cause of hypokalemia].
AB  - We report a case of hypokaliemia whose origin is a urinary potassium loss
      associated with syndrome of Gitelman. The syndrome of Gitelman is a rare familiar
      autosomal recessive nephropathy. We will discuss the pathophysiology of this
      syndrome and differential diagnoses.

PMID- 11205190
TI  - [Self instruction, multiple choice questions. Daily management of diabetes in
      children and adolescents].
AB  - The practitioner has usually relatively little experience in the daily management
      of pediatric diabetes, a complex issue due to multiple factors and individual
      variability. Seventeen multiple choice questions are proposed, which have been
      created for an interactive teaching session (see next article). For each
      question, a single answer is considered to be the most or the only correct one.
      This answer is given after the questions together with a brief comment about some
      of the proposed answers. The objective for the reader is self-teaching. The
      questions are not intended for self-evaluation.

PMID- 11205191
TI  - [Multiple choice questionnaires: use in electronic group teaching].
AB  - Based on a continuing education session on childhood and adolescent diabetes, the
      strategy of electronic vote system is presented and illustrated using multiple
      choice questions given in the previous article.

PMID- 11205192
TI  - [Anorexia nervosa in boys].
AB  - Anorexia nervosa is a severe and potentially fatal disorder that generally
      affects adolescent girls. However, a small number of boys also suffer from
      anorexia nervosa. Through an analysis of a series of studies and articles, a
      synthesis of male anorexia nervosa is offered, with emphasis on the differences
      of the illness between boys and girls. A clinical case is provided as an
      illustration of this article.

PMID- 11205193
TI  - [How I investigate...atypical cutaneous mycobacteriosis].
AB  - Atypical mycobacterioses affecting the skin are diverse and their treatments are
      different as well. These diseases show an increasing prevalence. The
      contamination occurs from the environment while interhuman transmission does not
      occur.

PMID- 11205194
TI  - [Meeting report. "MIRACL" study of "Myocardial Ischemia Reduction with Aggressive
      Cholesterol Lowering"].
AB  - The results of the "MIRACL" trial ("Myocardial Ischemia Reduction with Aggressive
      Cholesterol Lowering") were presented at the recent annual meeting of the
      American Heart Association in New Orleans last November 2000. This study
      demonstrates that atorvastatin, at a daily dose of 80 mg starting within the
      first 24 to 96 hours after an acute coronary event (unstable angina or non-Q-wave
      acute myocardial infarction) and maintained for 4 months, improves the
      cardiovascular prognosis by decreasing the combined risk of death (any cause),
      nonfatal myocardial infarction, resuscitated cardiac arrest and worsening angina
      with new objective evidence of ischemia requiring urgent hospitalization (-16%
      versus placebo, p < 0.05).

PMID- 11205195
TI  - Phase II trial of chronomodulated infusion of 5-fluorouracil and folinic acid in
      metastatic colorectal cancer.
AB  - Forty three patients with metastatic colorectal cancer (MCC) received a daily
      administration of 5-fluorouracil (600 mg/m2/d at the first course, 700 mg/m2/d at
      the second and 800 mg/m2/d at the third course), and l-folinic acid (150 mg/m2/d)
      or dl-folinic acid (300 mg/m2/d) both chronomodulated from 22:00 to 10.00 am with
      peak delivery rate at 4.00 for 5 days every 21 days. Only severe mucositis and
      diarrhea occurred in 19 courses (5.7% Gr 3; 0.6% Gr 4) in 14 patients. Objective
      response (OR) was evaluated in 40 patients because of one toxicity and two early
      progressions. No OR was observed in the 15 previously-treated patients versus
      28.5% (8/28) partial responses in chemotherapy naive patients; overall the median
      survival was 13 months. These results without toxicity and with low OR rate
      indicate the necessing of a more intensive treatment and confirm the place of
      oxaliplatin in the chemotherapy of MCC.

PMID- 11205196
TI  - Serial determinations of aminoterminal propeptide of type III procollagen
      (PIIINP) and prognosis in ovarian cancer; comparison to CA125.
AB  - During malignant growth many changes take place in the metabolism of fibrillar
      type III collagens in the connective tissues. The aminoterminal propeptide of
      type III procollagen (PIIINP) has been found to be often elevated in ovarian
      cancer. In the present study the prognostic value of serum PIIINP concentration
      in epithelial ovarian cancer is evaluated in relation to serum CA125. Fifty-six
      women were enrolled in the study. Serial venous blood samples were taken
      preoperatively and 6, 9 and 12 months after operation for PIIINP and CA125
      determinations. The results were correlated to the three-year survival. In Kaplan
      Meier survival analysis the preoperative (P = 0.0422), 9-month (P = 0.0062) and
      12-month (P = 0.0062) serum PIIINP concentration distinguished between the
      patients with good and poor prognosis while CA125 did so only at 9- (P = 0.0005)
      and 12-month (P < 0.0001) follow-up. In the multivariate analysis the independent
      predictors of prognosis were the preoperative PIIINP and 12-month CA125
      concentrations. The percentage changes in serum PIIINP concentration did not
      differentiate the patients with good or poor prognosis at any time point, whereas
      the changes in CA125 concentration significantly divided the patients into two
      prognostic groups during the second half of the postoperative year. We found that
      PIIINP and CA125 are complementary to each other as predictors of prognosis in
      epithelial ovarian cancer as preoperative PIIINP was better than CA125 and 1-year
      CA125 better than PIIINP in this function.

PMID- 11205197
TI  - Tissue polypeptide specific antigen (TPS) as a tumor marker in nasopharyngeal
      carcinoma.
AB  - Tissue polypeptide specific antigen (TPS) is a new tumor marker that indicates
      tumor proliferative rate rather than tumor burden. The purpose of this study is
      to assess the clinical value of TPS in patients with nasopharyngeal carcinoma
      (NPC). Serum levels of TPS were measured in 60 patients with untreated NPC
      including 36 squamous cell carcinomas (SCC) and 24 undifferentiated carcinomas.
      NPC patients were separated into different subgroups based on the International
      Union Against Cancer (UICC) TNM classification system. Forty three healthy
      subjects without any evidence of malignancy or other systemic diseases were
      included as controls. The results showed that (1) the mean serum TPS level of the
      NPC patients was significantly higher than that of the healthy controls, (2) the
      mean serum TPS level of NPC patients with SCC was significantly higher than
      patients with undifferentiated carcinomas, (3) the mean serum TPS levels of NPC
      patients with higher TNM stages were significantly higher than those with lower
      TNM stages, (4) the overall diagnostic sensitivity of TPS for NPC is 58.3%, and
      (5) the overall diagnostic sensitivities of TPS in NPC patients with
      undifferentiated carcinomas and higher TNM stages were significantly higher than
      those with SCC and lower TNM stages. In conclusion, our results suggest that TPS
      may have a potential clinical role as a valuable tumor marker for NPC.

PMID- 11205199
TI  - HPV testing: where are we now?
AB  - OBJECTIVES: 1) To assess if HPV (human papillomavirus)-DNA testing using the
      presently available technology offers any advantage over the utilization of the
      traditional Pap-smear as a screening tool for women at risk for cervical pre
      cancers. 2) To assess if the HPV-DNA test is a valuable intermediate triage
      method for patients with Pap-smears demonstrating ASCUS (Abnormal Squamous Cells
      of Undetermined Significance) or LG-SIL (Low-Grade Squamous Intraepithelial
      Lesions) in order to better select those patients who would maximally benefit
      from colposcopy, thus, using clinical resources in an efficient way. MATERIAL AND
      METHODS: Review of the peer reviewed literature between 1992 and June 2000
      regarding: 1) new and innovative approaches for cervical cancer screening and
      prevention; 2) advances in management protocols of ASCUS and LG-SIL with the
      introduction of HPV-DNA test. RESULTS: HPV-DNA testing in association with the
      Pap (Papanicolau) smear performed either conventionally or, preferably, with the
      new liquid based cytology is a valuable adjunct with high sensitivity and
      acceptable specificity rates in defining those patients most likely to
      demonstrate HG-SIL (High-Grade Squamous Intraepithelial Lesions) at the time of
      colposcopy. CONCLUSION: At present available evidence indicates that the best
      reason for performing HPV-DNA testing is the triage of selected patients with
      ASCUS and in specific settings with LG-SIL. Ongoing clinical studies may
      demonstrate additional advantages for this technology when used in a screening
      application.

PMID- 11205200
TI  - Optimum duration of oral adjuvant chemotherapy of HCFU for colorectal cancer;
      review of 5-year follow-up.
AB  - PURPOSE: To investigate the optimal duration of oral HCFU administration for
      minimization of side effects induced by long-term administration. PATIENTS AND
      METHODS: In total, 155 patients allocated to two groups of different duration of
      the therapy were reviewed: twice or three times per day doses of oral HCFU (8
      mg/Kg body weight/day) for 3 months vs. 12 months. RESULTS: Though statistically
      significant difference was not found in cumulative survival and disease-free
      rates between the groups due to so many violations of duration of therapy, when
      reanalyzing the variables in order of real duration of therapy, those rates were
      significantly higher in patients treated for 300 and more days than less than 300
      days (g-Wilcoxon test: p < 0.04). No significant difference was observed in the
      background factors between the groups. CONCLUSION: At least 300 days is suggested
      to be necessary to obtain the optimal effectiveness of adjuvant chemotherapy for
      curatively resected colorectal cancer.

PMID- 11205198
TI  - Importance of 5-fluorouracil dose-intensity in a double randomised trial on
      adjuvant portal and systemic chemotherapy for Dukes B2 and C colorectal cancer.
AB  - 366 patients fully resected from a Dukes B2 or C colorectal cancer were
      randomised to receive 6 courses of systemic chemotherapy comprising either 5
      fluorouracil (5 FU) alone (arm A: 450 mg/m2/day-5/21 days) or combined folinic
      acid (FOL) and 5 FU (arm B: respectively 200 mg/m2 racemic form or 100 mg/m2-l
      form and 370 mg/m2/day-5/21 days). 173 patients had also been initially
      randomised to receive one course of intraportal chemotherapy just after surgery
      or no portal treatment. Oral levamisole (150 mg/day; 3 days every other week) was
      given to all patients for one year. A significantly higher incidence of leuco
      granulocytopenia was observed in the arm A (5 FU alone) inducing more frequent
      dose delays and adaptations as well as levamisole's withdrawal. Then dose
      intensities and dose-intensity products were lower in this arm but the dose
      intensity expressed in mg/m2/week remained higher (631 +/- 107 vs 557 +/- 99; p <
      0.001). The median follow-up in the study was 4.5 years. Relapse free (RFS) and
      overall survivals (OAS) were prolonged in the 5 FU alone group peculiarly in
      those patients who had not been randomised for portal treatment. Curves diverged
      progressively with longer follows-up (at 8 years; RFS in arm A: 67-71% vs 59-53%
      in arm B; OAS in arm A: 72-74% vs 56-46% in arm B). Patients suffering from a
      colon or a Dukes C cancer benefited the most from the treatment with 5 FU alone.
      The results are discussed in the light of other recent adjuvant trials. Well
      dosed 5 FU over a short period of time without folinic acid may be a valuable and
      inexpensive adjuvant treatment for colorectal cancer. Levamisole may no longer be
      recommended in this setting.

PMID- 11205201
TI  - Neuroblastoma producing spinal cord compression: rapid relief with low dose of
      radiation.
AB  - Symptomatic spinal cord compression requires emergency treatment to alleviate
      symptoms and to avoid irreversible damage. We describe a successful decompression
      by low dose radiation to a progressing neuroblastoma in a child. Magnetic
      resonance imaging post radiation should be performed to assess the response of
      the tumor to radiation.

PMID- 11205202
TI  - DNA cytofluorometric analysis of benign and malignant nerve sheath tumors.
AB  - The present study was undertaken to examine the ploidy patterns of benign and
      malignant nerve sheath tumors using PI-DNA cytofluorometry and to clarify the
      relationship between the ploidy patterns and pathological findings for these
      lesions. The benign nerve sheath tumors (schwannomas and neurofibromas) were
      found to be dipolid or to be euploid-polyploidization, with a few DNA synthetic
      cells. The number of polyploid cells increased with increase in the frequency of
      cells with large and atypical nuclei in histology, regardless of the natures of
      cellular arrangements. Malignant schwannomas were composed of many polyploid and
      aneuploid cells with DNA synthetic cells, indicating their active cell
      proliferation. Thus, benign nerve sheath tumors exhibited low-proliferative
      ploidy patterns that were clearly different from those of malignant nerve sheath
      tumors. As Takeshita has already stated, it is difficult to ascertain why some of
      the neurogenic tumors show euploid-polyploidization (19). Further investigations
      will be needed in this direction. Finally, it is clear from the results of this
      study that the cytofluorometric analysis mentioned above is useful for assessing
      malignancy and that it may be useful for predicting prognosis of nerve sheath
      tumors.

PMID- 11205203
TI  - Recurrent intussusception of the sigmoid colon caused by a transanal protruding
      sessile tubulo-villous malignant polyp.
AB  - We report a case of a 35 year-old woman with a large malignant sessile tubulo
      villous polyp of the proximal end of a dolico-sigmoid colon causing
      intussusception and transanal prolapsing. The diagnosis presented some
      difficulties being the intussusception intermittent. The clinical feature had
      been initially misdiagnosed for a very large bleeding polyp (5 cm in size),
      protruding out of the anus with a long pedicle in the rectum. The histology of
      multiple bioptic samples of the lesion revealed malignancy. Conventional
      radiologic studies (plain x-rays, barium enema) after metal clips had been placed
      on the head of the polyp before it rose up the colon, led to the correct
      diagnosis without, nevertheless, documenting intussusception. An elective
      surgical resection of the dolico-sigmoid colon allowed the correct diagnosis and
      the curative treatment of the colonic intussusception and the malignancy.

PMID- 11205204
TI  - Clinical behavior of solitary fibrous tumors of the pleura. An
      immunohistochemical study.
AB  - Localized fibrous tumors of the pleura are uncommon, generally asymptomatic and
      usually have a benign behavior even if in a few cases a malignant variant can be
      observed. We report 11 cases of localized pleural neoplasms submitted to surgical
      resection during the period 1987-1996. The differentiation between the localized
      fibrous as well as the less frequent localized malignant mesothelioma has been
      researched employing cyto-histopathologic and immunohistochemical assays. For the
      purpose of identifying solitary fibrous tumors of pleura that will behave in
      malignant manner, we applied the more recent criteria of specific
      immunohistochemical stains, microvessel density and proliferation mdex. All
      solitary fibrous tumors resulted positive for Vimentin and negative for
      Cytokeratin. Among these forms, high cellularity and microvessel density, high
      expression of Ki 67 and CD31 and negativity of CD34 prognostic factors for a poor
      prognosis.

PMID- 11205205
TI  - Immunoregulatory effects of the antitumor polysaccharide lentinan on Th1/Th2
      balance in patients with digestive cancers.
AB  - BACKGROUND: Recent studies demonstrated that patients with advanced cancer may
      have impaired cell-mediated immunity caused by an imbalance between Th1 and Th2
      responses. We evaluated the ability of lentinan (LNT) to modulate Th1 and Th2
      responses in patients with digestive cancers. METHODS: Peripheral blood samples
      were collected preoperatively from 28 patients with digestive cancers before and
      after intravenous administration of LNT (2 mg x 3 times/week). The proportions of
      CD4+ T-cells producing intracellular cytokines were determined with flow
      cytometry. RESULTS: After LNT treatment, CD4+ IFN-gamma+ T-cell percentages
      increased significantly (p < 0.05), whereas CD4+ IL-4+ T-cell and CD4+ IL-6+ T
      cell percentages decreased significantly (p < 0.02). No significant change
      occurred in proportions of CD4+ IL-10+ T-cells. The after/before LNT treatment
      percentages ratio of CD4+ IFN-gamma+ T-cells correlated negatively with that of
      CD4+ IL-4+ T-cells (p < 0.01). The after/before treatment percentage ratio of
      CD4+ IL-4+ T-cells correlated positively with that of CD4+ IL-6+ T-cells (p <
      0.05). CONCLUSION: LNT apparently can cancel Th2-dominant condition in patients
      with digestive cancers and may improve the balance between Th1 and Th2.

PMID- 11205206
TI  - Radiation and low dose adriamycin for the treatment of carcinoma of the
      hypopharynx.
AB  - PURPOSE: To evaluate the utility of adriamycin in radiation therapy for
      hypopharyngeal cancer. PATIENTS AND METHODS: Forty-five patients with
      hypopharyngeal carcinoma without distant metastasis were treated. Adriamycin was
      administered i.v. and weekly (15 mg i.v./once a week, median 64 mg) concurrently
      with radiation therapy to 38 patients, 76% (34 out of 45) of whom were in an
      advanced stage (III or IV). RESULTS: Overall survival, cause specific survival
      and local control rates at 5 years were respectively, 49%, 66% and 69% and better
      than results obtained in the 1970's. Radiation therapy achieved an 84% (38 out of
      45) response rate at 40 Gy. Treatment without voice function loss was attained
      for 16 patients, consisting of 15 local CR (all T1 and 12 out of 26 T2 tumors) by
      radical radiation therapy and one posterior wall resection for a T2 tumor.
      Overall and cause specific survival rates were 57% and 91% at 5 years. Twenty
      patients who underwent further surgery showed 69% overall and 74% cause specific
      survival rates. The remaining nine patients, who lost local control, died within
      16 months. In 18 patients with T2 cancer originating from the pyriform sinus, 69%
      local control was obtained for patients using adriamycin compared with 20% for
      patients without adriamycin (p = 0.17). No severe side effect from the addition
      of adriamycin has been found so far. CONCLUSIONS: Radiation therapy using low
      dose adriamycin with or without follow-up surgery is safe and has potential to be
      a good option.

PMID- 11205208
TI  - Mismatch repair deficiency in sporadic synchronous colorectal cancer.
AB  - BACKGROUND: Hereditary non-polyposis colorectal cancer (HNPCC) patients
      frequently develop synchronous colorectal cancer (SCRC) which also occurs
      sporadically in other patients. Recent studies on microsatellite instability
      (MSI) in sporadic SCRC diverge completely in their findings (0%-100%). In the
      present study MSI and mismatch repair (MMR) proteins were evaluated according to
      standardised criteria (exclusion of a family history, MSI analysed according to
      NCI recommendations) METHODS: Paraffin embedded sections of SCRC of 30 patients
      were evaluated for MSI and the loss of protein expression of hMLH1 and hMSH2.
      RESULTS: 3 out of 30 (10%) patients exhibited MSI-H which 5 out of 30 (17%)
      showed MSI-L. Loss of protein expression of either hMLH1 or hMSH2 was found in
      all cases of MSI-H and none of the MSI-L cancers. CONCLUSION: MSI is found in
      sporadic cases of SCRC to about the same extent as it is mentioned in the
      literature on sporadic single colorectal cancers. Immunohistochemistry with
      mismatch repair proteins could be used as a pre-screening for MMR deficiency in
      sporadic SCRC.

PMID- 11205207
TI  - Phase I study of docetaxel administered by bi-weekly infusion to patients with
      metastatic breast cancer.
AB  - BACKGROUND: To find a more convenient and tolerable schedule than the tri-weekly
      or weekly schedules, we conducted a dose escalation study of bi-weekly docetaxel.
      MATERIALS AND METHODS: Between March 1998 and June 1999, 16 patients entered this
      phase I study. The starting dose was 40 mg/m2, with planned dose escalation to
      45, 50 and 55 mg/m2, in consecutive patient cohorts. Patients continued to
      receive the assigned treatment at the same dose level bi-weekly, provided that
      they did not develop progressive disease, refuse further treatment, or experience
      unacceptable toxicity. RESULTS: Grade 4 neutropenia lasting for more 4 days was
      seen at dose level 3 in all three patients. Only one patient who had previously
      received intensive chemotherapy required granulocyte colony stimulating factor (G
      CSF) to prevent neutropenic fever and there were no actual episodes of
      neutropenic fever. Grade 3 asthenia and Grade 3 elevation of serum glutamic
      oxaloacetic transaminase were noted in only one patient treated at a dose of 40
      mg/m2. Grade 3 skin toxicity and grade 2 elevation of serum glutamic oxaloacetic
      transaminase were seen in only one patient treated at a dose of 55 mg/m.
      Cumulative toxicity was not severe in all patients. Although grade 3 and/or grade
      4 neutropenia were noted in eight patients (50%), all except one who received
      treatment at dose of 55 mg/m2 did not need G-CSF. Nail toxicity and peripheral
      edema seemed to be related to the number of treatment cycles. Severe fatigue and
      asthenia were never seen in all patients. CONCLUSION: 1) The maximum-tolerated
      dose of docetaxel when administered by this bi-weekly schedule was 55 mg/m2; 2)
      Docetaxel administered on a bi-weekly basis well tolerated.

PMID- 11205209
TI  - Desmoplastic response in scirrhous gastric carcinoma: imbalance between collagen
      synthesis and degradation.
AB  - BACKGROUND: Scirrhous gastric carcinoma is characterized by a marked deposition
      of collagen in the stroma and has a very poor prognosis. MATERIALS AND METHODS:
      To elucidate the fibrotic mechanism in scirrhous gastric carcinoma, we measured
      the activities of the collagen synthetic enzyme, prolyl 4-hydroxylase (P4H) and
      the collagen degrading enzymes, interstitial collagenase and type IV collagenase,
      in tissue from patients with advanced gastric carcinoma. Concentrations of P4H
      and tissue inhibitor of metalloproteinases-1 (TIMP-1) in the sera of patients
      with gastric carcinoma were measured using sandwich enzyme immunoassay systems.
      We performed immunohistochemical analysis for TIMP-1. RESULTS: Enzyme activities
      of P4H, interstitial collagenase and type IV collagenase in the tumor samples of
      scirrhous gastric carcinoma were significantly lower than those of non-scirrhous
      gastric carcinoma (p < 0.01). Serum concentration of TIMP-1 in patients with
      diffuse type carcinoma was significantly higher than in patients with intestinal
      type carcinoma and control subjects (p < 0.05). We demonstrated stromal
      expression of TIMP-1 in scirrhous gastric carcinoma tissue. CONCLUSION: These
      data suggest that decreased collagenase activity and increased expression of TIMP
      1 would result in collagen deposition in scirrhous gastric carcinoma tissue.

PMID- 11205210
TI  - Immunocytochemical detection of circulating esophageal carcinoma cells by
      immunomagnetic separation.
AB  - BACKGROUND: Recent developments in detection of micrometastasis have revealed a
      considerable incidence of systemic disease in patients who would previously have
      been diagnosed as having solid tumours only. The purpose of this study was to
      investigate the prevalence and clinical significance of circulating carcinoma
      cells in patients with esophageal squamous cell carcinoma (ESCC). MATERIALS AND
      METHODS: Peripheral blood samples from 47 primary ESCC patients were enriched by
      immunomagnetic separation (IMS) using Ber-EP4-conjugated beads (Dynabeads anti
      epithelial cell) and immunostained with an anti-cytokeratin (anti-CK) antibody.
      We assayed samples from 12 patients to compare the detection of CK-reactive cells
      using IMS with the detection of CK 19 mRNA using a reverse transcriptase
      polymerase chain reaction (RT-PCR) method. RESULTS: CK-reactive cells were
      observed in 18 out of 47 patients (38%). The detection rate was closely
      correlated with the stage of disease (TNM stage) (p = 0.0017). In 33 patients who
      underwent esophagectomy, 4 out of 7 patients (57%) positive for CK cells and only
      2 out of 26 patients (7.7%) negative suffered from recurrence in the distant
      lymph nodes or lungs (p = 0.0108). When IMS and RT-PCR were compared, all 3
      samples that were CK-positive by IMS had CK 19 mRNA detected by RT-PCR. However,
      the other 4 samples with CK 19 mRNA by RT-PCR were negative for CK cells by IMS.
      Of 7 patients positive for CK-reactive cells before chemotherapy or
      chemoradiotherapy, 4 patients negative after treatment survived but 3 patients
      who remained positive died within 6 months. CONCLUSION: Immunocytochemical
      detection of circulating carcinoma cells by IMS may be a specific method for the
      diagnosis of systemic disease and for monitoring treatment response.

PMID- 11205211
TI  - Oral polio vaccine and human cancer: a reassessment of SV40 as a contaminant
      based upon legal documents.
AB  - To date, the scientific literature and research examining SV40 and cancer-related
      diseases has been based upon an assumption that SV40 was not present in any
      poliovirus vaccine administered in the United States and was removed from the
      killed polio vaccine by 1963. The basis for this presumption has been that the
      regulations for live oral polio vaccine required that SV40 be removed from the
      seeds and monovalent pools ultimately produced in the manufacturing process. The
      Division of Biologic Standards permitted an additional two tissue culture
      passages--from three to five--in order to allow manufacturers the ability to
      remove this contaminant from the oral poliovirus vaccines then awaiting
      licensure. The confirmation of the removal by one drug manufacturer, Lederle, has
      been made public at an international symposium in January 1997, where its
      representatives stated that all of Lederle's seeds had been tested and screened
      to assure that it was free from SV40 virus. However, in litigation involving the
      Lederle oral polio vaccine, the manufacturer's internal documents failed to
      reveal such removal in all of the seeds. The absence of confirmatory testing of
      the seeds, as well as testimony of a Lederle manager, indicate that this claim of
      removal of SV40 and the testing for SV40 in all the seeds cannot be fully
      substantiated. These legal documents and testimony indicate that the scientific
      community should not be content with prior assumptions that SV40 could not have
      been in the oral polio vaccine. Only further investigation by outside scientific
      and independent researchers who can review the test results claimed in the
      January 1997 meeting and who can conduct their own independent evaluations by
      testing all the seeds and individual mono-valent pools will assure that SV40 has
      not been present in commercially sold oral poliovirus vaccine manufactured by
      Lederle.

PMID- 11205212
TI  - Sensitivity of serum tumor markers CEA and CA 15-3 in breast cancer recurrences
      and correlation with different prognostic factors.
AB  - The aim of this study was to evaluate the correlation between serum tumor markers
      CEA and CA 15-3 in breast cancer (BC) patients with disease relapse and different
      prognostic parameters at first operation. Sixty-two women (median age 55 years,
      range 35-83 years) who had undergone curative surgery for pT1-2 pN0-1 M0 breast
      cancer developed local recurrences, distant metastases or contralateral BC during
      a median relapse time of 53 months (range 25-149 months). Sensitivity of CEA, CA
      15-3, and CEA + CA 15-3 together was 40.3%, 41.9% and 59.7%, respectively. No
      correlation (p = NS) was found between tumor markers sensitivity and type of
      recurrence, surgical procedure, histologic subtypes and hormone receptors rate.
      CEA significantly (p < 0.01) correlated with the size of the tumor and axillary
      node status and CA 15-3 with the age of the patients. In conclusion, CEA and CA
      15-3 should be considered complementary in detecting BC recurrences but their
      sensitivity is low and independent of the majority of the prognostic parameters
      that may be considered before relapse.

PMID- 11205213
TI  - The use erythrocyte glutathione as a predictive marker for malignant melanoma.
AB  - BACKGROUND: Glutathione (GSH) may provide defense against reactive oxygen species
      (ROS) generated by ultraviolet radiation. Furthermore, some authors have
      demonstrated a relationship between the GSH of peripheral blood erythrocytes
      (GSHe) and resistance to chemotherapy. PATIENTS & METHODS: To observe the
      influence of GSH on the genesis and evolution of Malignant Melanoma (MM), we
      assessed the concentration of GSH in erythrocytes (GSHe) in MM patients (n = 566)
      and controls (n = 164) by the method of Beutler (1963). RESULTS: No differences
      were found between the two groups (5.94 +/- 1.61 cases vs 6.08 +/- 1.49 mmol/gr
      Hb, controls; p > 0.05). Fifty seven patients with poor evolution (disease-free
      survival < 2 years) had higher GSH levels than the remaining patients (6.35 +/-
      1.83 vs 5.83 +/- 1.62 mmol/g Hb; p < 0.01). GSHe increased significantly after
      antineoplastic therapy (4.75 +/- 1.26 vs 7.73 +/- 1.39 mmoVg Hb; p < 0.001), thus
      indicating a possible role in chemoresistance. 2 CONCLUSIONS: GSHe is not related
      to the risk of developing MM. GSHe may be related to the evolution of MM, being
      higher in patients who suffer relapse or metastasis. GSHe increases significantly
      during cytostatic treatment.

PMID- 11205214
TI  - Villous and serrated adenomatous growth bordering carcinomas in inflammatory
      bowel disease.
AB  - The histologic phenotype of the dysplastic lesion juxtaposing colorectal
      carcinomas was assessed in 100 consecutive colectomy specimens: in 50 patients
      with inflammatory bowel disease (IBD) and in 50 controls (non-IBD patients).
      Adenomatous growths (AG) were regarded both Dysplasia Associated Lesion or Mass
      (DALM) and sporadic adenomas. AGs juxtaposing carcinomas were found in 76% (n =
      38) of the IBD cases: 52.3% (20 out of 38) were villous, 28.9% (11 out of 38)
      serrated, 5.3% (2 out of 38) tubular and the remaining 13.2% (5 out of 38) were
      mixed AGs. Juxtaposing AGs (sporadic adenomas) were also found in 58% (n = 29) of
      the control cases: 51.7% (15 out of 29) were villous, 6.9% (2 out of 29) tubular,
      3.4% (1 out of 9) serrated and the remaining 37.9% (11 out of 29) were mixed. The
      majority or 81.2% (31 out of 38) of the dysplastic lesions juxtaposing IBD
      carcinomas were villous or serrated AGs, but only 55.1% (16 out of 29) in control
      cases. Serrated AGs in particular accounted for nearly 29% of the non-invasive
      dysplastic lesions abutting IBD carcinomas but only for 3% in control specimens.
      It would appear that villous and serrated AGs are the most common non-invasive
      neoplastic lesions from which IBD carcinomas originate.

PMID- 11205215
TI  - Beta-2-microglobulin (beta 2M) as a tumor marker in nasopharyngeal carcinoma.
AB  - The purpose of this study was to assess the clinical value of serum beta-2
      microglobulin (beta 2M) in patients with nasopharyngeal carcinoma (NPC). beta 2M
      levels were assayed in 145 Taiwanese patients with untreated NPC, including 100
      squamous cell carcinomas (SCC) and 45 undifferentiated carcinomas. The 145 NPC
      patients were separated into different subgroups based on the International Union
      Against Cancer (UICC) TNM classification system. In addition, 50 healthy subjects
      without any evidence of malignancy or other systemic diseases were included as
      controls. The results showed that (1) the mean serum, beta 2M level of the 145
      NPC patients was higher than that of the 50 healthy controls and (2) the mean
      serum beta 2M levels of NPC patients who were male, older, with SCC, with higher
      TNM stages, and with a shorter survival time were higher than those patients who
      were female, younger, with undifferentiated carcinomas, with lower TNM stages,
      and with a longer survival time. However, none of the differences were
      significant. In addition, the overall detecting sensitivity of beta 2M for NPC
      was only 24.1%, and the detecting sensitivities in NPC patients who were male,
      older, with SCC, with higher TNM stages, and with a shorter survival time were
      higher than those of patients who were female, younger, with undifferentiated
      carcinomas, with lower TNM stages, and with a longer survival time. However,
      these differences also were not significant. In conclusion, our results suggest
      the beta 2M may have limited clinical potential as a valuable tumor marker for
      NPC.

PMID- 11205216
TI  - Serum level of angiogenin in breast cancer.
AB  - OBJECTIVE: Angiogenin (ANG), a potent inducer of neovascularization, is secreted
      by some types of human tumor cells and appears crucial for their growth. This
      study was designed with the aim to investigate any correlation between the serum
      angiogenin and the clinicopathological variables and furthermore evaluate the
      prognostic value of serum angiogenin in patients with breast cancer. MATERIAL AND
      METHODS: Sixty-four consecutive patients with invasive breast cancer undergoing
      surgery were prospectively included and evaluated. Venous blood samples were
      collected before surgery. Sera were obtained by centrifugation and stored at -70
      degrees C until assayed. The control group consisted of 16 patients with benign
      breast tumor (8 with fibrocystic disease and 8 with fibroadenoma). Serum
      concentration of angiogenin was measured by the quantitative sandwich enzyme
      immunoassay technique. The data on primary tumor staging, age, estrogen receptor,
      lymph node status, distant metastases and TNM staging were reviewed and recorded.
      RESULTS: The mean value of serum angiogenin in patients with invasive breast
      cancer was 2123.95 +/- 324.34 pg/ml and that of control group were 2108.16 +/-
      398.20 pg/ml (fibrocystic disease) and 2010.27 +/- 318.40 pg/ml (fibroadenoma).
      The difference was not significant (p = 0.66). Furthermore, with univariate
      analysis, there were no significant differences in serum angiogenin levels
      between the subgroups of the above-mentioned clinicopathological variables.
      CONCLUSION: Serum angiogenin levels did not appear as a meaningful prognostic
      parameter for invasive breast cancer.

PMID- 11205217
TI  - Colorectal cancer trends by anatomic sides, age and staging. A twenty-year study
      of 1412 Greek cases.
AB  - The purpose of this study was to investigate whether Greek patients, suffering
      from colorectal adenocarcinoma, showed the same changes in the side distribution,
      as has been observed in the patients of many western countries. We
      retrospectively analysed 1412 consecutive cases of colorectal adenocarcinoma
      admitted to our institute over in a twenty-year period. The side distribution,
      the staging and the grade were evaluated in correlation with the age. We found
      that the number of patients with colorectal adenocarcinoma has steadily
      increased. The right-sided colonic carcinomas remained stable over the years in
      the total number of cases, however, for the elderly patients (age > 65 years),
      there was trend of gradual but steady increase in the incidence. We did not
      observe any evidence of earlier diagnosis in recent years. We conclude that a
      delayed but similar trend in the incidence and distribution of colorectal
      adenocarcinoma is present in Greek patients. The maintenance of the traditional
      dietary habits could change the pattern.

PMID- 11205218
TI  - Parameters that influence the outcome of nausea and emesis in cisplatin based
      chemotherapy.
AB  - Some factors have demonstrated an influence on emesis and antiemetic response. In
      order to study these factors, 306 patients (pts) entered this study receiving
      cisplatin based combination chemotherapy (CT) (100 mg/m3, with ondansetron (8 mg,
      3 times daily for 4 days) as the only antiemetic treatment. Known factors that
      influence the result of antiemetic therapy such as age, sex, performance status
      (Karnofsky), site of primary tumor, weight loss, anxiety, depression,
      psychological problems related to CT (psychological PRC) etc, were included in
      the evaluation. We evaluated the number of vomits, retches and nausea. The
      existence of psychological PRC was found to be a prominent factor for the
      development of nausea and emesis, being at the same time strongly associated with
      scaling variables (Gralla, retching and nausea grading) used to measure the
      severity of nausea and emesis (p = 0.001). Stress was also a significant
      predictor; patients with stress had an almost two times higher probability to
      develop nausea or retching compared to patients without stress indications (p =
      0.001), while the occurrence of retching was marginal. Younger patients (less
      than 40 years old) were found to be almost three times more susceptible to
      retching compared to older patients (more than 40 years old) (P 0.006). With all
      possible evaluations, we concluded that significant factors are psychological
      PRC, stress and age. In conclusion, three factors, age, stress and psychological
      PRC, should be taken seriously into consideration in the design of future trials
      evaluating antiemetic treatment, as well as in the every-day clinical practice,
      in order to provide patients with a better quality of life during emetogenic CT.

PMID- 11205219
TI  - Whey protein concentrate (WPC) and glutathione modulation in cancer treatment.
AB  - The glutathione (GSH) antioxidant system is foremost among the cellular
      protective mechanisms. Depletion of this small molecule is a common consequence
      of increased formation of reactive oxygen species during increased cellular
      activities. This phenomenon can occur in the lymphocytes during the development
      of the immune response and in the muscular cells during strenuous exercise. It is
      not surprising that so much research has been done, and is still being done on
      this small tripeptide molecule. Whey protein concentrate has been shown to
      represent an effective and safe cysteine donor for GSH replenishment during GSH
      depletion in immune deficiency states. Cysteine is the crucial limiting amino
      acid for intracellular GSH synthesis. Animal experiments showed that the
      concentrates of whey proteins also exhibit anti-carcinogenesis and anticancer
      activity. They do this via their effect on increasing GSH concentration in
      relevant tissues, and may have anti-tumor effect on low volume of tumor via
      stimulation of immunity through the GSH pathway. It is considered that oxygen
      radical generation is frequently a critical step in carcinogenesis, hence the
      effect of GSH on free radicals as well as carcinogen detoxification, could be
      important in inhibiting carcinogenesis induced by a number of different
      mechanisms. Case reports are presented which strongly suggest an anti-tumor
      effect of a whey protein dietary supplement in some urogenital cancers. This non
      toxic dietary intervention, which is not based on the principles of current
      cancer chemotherapy, will hopefully attract the attention of laboratory and
      clinical oncologists.

PMID- 11205221
TI  - Long-term survival of a patient with fallopian tube cancer presenting with a
      supraclavicular mass.
AB  - BACKGROUND: Five-year survival of patients with stage IV cancer of the fallopian
      tube is poor. Furthermore, patients with gynecological cancers presenting with a
      supraclavicular mass generally have an unfavorable prognosis. CASE REPORT: We
      describe a 70-year-old patient who presented with a left supraclavicular mass.
      The mass was removed and histology showed metastatic papillary adenocarcinoma
      strongly suggestive of papillary serous carcinoma. Abdominal hysterectomy and
      salpingo-oophorectomy showed a primary carcinoma of the fallopian tube.
      Postoperatively the patient received six cycles of carboplatin-based chemotherapy
      and is alive and well with no evidence of disease 5 years and 10 months after the
      primary diagnosis. CONCLUSION: Surgery and adjuvant carboplatin-based
      chemotherapy seem justified even in older patients with fallopian tube cancer and
      distant metastasis at the time of diagnosis.

PMID- 11205220
TI  - p53 status is neither a predictive nor a prognostic variable in patients with
      advanced ovarian cancer treated with a paclitaxel-based regimen.
AB  - BACKGROUND: The aim of this study was to assess the relationship between p53
      status and the clinical outcome of patients with advanced ovarian cancer treated
      with a paclitaxel-based regimen. PATIENTS AND METHODS: The investigation was
      conducted on 38 patients with FIGO stage III-IV ovarian cancer from whom tumor
      tissue samples for p53 protein immunostaining were obtained during initial
      cytoreductive surgery. All these patients subsequently received six cycles of
      first-line combination chemotherapy with paclitaxel 175 mg/m2 (3-hour infusion)
      plus carboplatin AUC 6 with or without epidoxorubicin 75 mg/m2. RESULTS: Positive
      p53 immunostaining was detected in tissue samples collected from 24 (63.2%)
      ovarian cancers. A clinical complete response was obtained in 14 (58.3%) of the
      24 patients with positive p53 immunostaining compared to 9 (64.3%) of the 14
      patients with negative p53 immunostaining (p = 0.717). A pathological complete
      response was found in 6 (25.0%) of the former compared to 4 (28.6%) of the latter
      (p = 0.956). Similarly, survival did not correlate with p53 status (p = 0.1271).
      DISCUSSION: p53 status seems to be neither a predictive nor a prognostic variable
      in patients with advanced ovarian cancer treated with a paclitaxel-based regimen.
      These results are consistent with experimental data showing that paclitaxel
      cytotoxicity in ovarian cancer is likely to be mediated by a p53-independent
      pathway.

PMID- 11205222
TI  - Hibernoma, an uncommon tumor as a differential diagnosis of liposarcoma of the
      thigh.
AB  - Hibernomas are benign tumors derived from brown fat of hibernating animals and of
      human infants. The pathogenesis and malignant potential of hibernomas remain
      unclear. They occur generally in adults with a peak incidence in the third decade
      and with a predominance in women. However, the lesions may have an heterogeneous
      presentation that may mimic liposarcomas on MRI. Our report presents a case of
      hibernoma of the thigh whose the diagnosis initially suggested that it was a
      mixed liposarcoma with myxoid and well differentiated components.

PMID- 11205223
TI  - Ectopic lobular breast cancer of the vulva.
AB  - BACKGROUND: Primary breast cancer of the vulvar region is a rare tumor entity.
      Only 12 cases have been published so far in the literature. PATIENT AND METHODS:
      We report on a case of a 60-year old woman with an invasive lobular breast cancer
      localized to the vulva. The woman with elevated CA 15-3 and CEA markers underwent
      local wide excision of the tumor and bilateral inguinal lymphonodectomy, adjuvant
      anthracycline containing chemotherapy and locoregional irradiation including both
      inguinal regions and subsequent endocrine therapy with tamoxifen. RESULTS: The
      resected specimen showed an estrogen receptor-positive diffuse infiltrating
      lobular breast cancer of the vulva with metastases in both groins. Original
      tissue of the breast adjacent to the malignant vulvar transformation was lacking.
      Imaging of the breast was lacking any pathology. Our patient has been followed up
      for 20 months without any signs of progressive disease. CONCLUSION: Due to the
      rare occurrence, we are not able to give general guidelines for the treatment of
      ectopic breast cancer. However, adjustment of treatment to the therapeutic
      recommendations for orthotopic breast cancer seems reasonable and effective.

PMID- 11205224
TI  - Expression of multidrug resistance-related markers in gastric cancer.
AB  - BACKGROUND: To detect the expression of glutathione S-transferase Pi(GST-pi),
      multidrug resistance-associated protein (MRP), lung-resistance protein(LRP),
      multidrug resistance gene1 (MDR1) and MGr1 antigen(MGr1-Ag) in the patients with
      primary gastric cancer and without any prior chemotherapy and to evaluate the
      correlations between them. PATIENTS AND METHODS: The expression of GST-pi, MRP,
      LRP and MDR1 in cancer tissue and the adjacent non-cancerous tissue from 50
      patients was examined by semiquantitative reverse transcription-polymerase chain
      reaction (RT-PCR). The expression of MGr1-Ag in these tissues was also examined
      by immunohistochemistry. RESULTS: The positive rate of GST-pi mRNA, MRP mRNA, LRP
      mRNA, MDR1mRNA and MGr1-Ag in gastric cancer tissue was 36.00%, 12.00%, 10.00%,
      10.00% and 18.00% respectively. The overall positive rate of their expression was
      58.00%. Clinicopathological factors were not significantly related to their
      expression. No significant correlation was observed between these markers.
      CONCLUSION: These MDR markers are differently over-expressed and no coexpression
      exists in gastric cancer. MGr1-Ag was a novel MDR protein.

PMID- 11205225
TI  - A new cell proliferating marker: cytosolic thymidine kinase as compared to
      proliferating cell nuclear antigen in patients with colorectal carcinoma.
AB  - BACKGROUND: Proliferation markers are necessary for reliable diagnosis. Here we
      have presented for the first time thymidine kinase 1 (TK1) as a proliferative
      tumor marker for colorectal carcinoma. PATIENTS AND METHODS: Expression of TK1 in
      54 colorectal lesions and 20 colorectal adenoma lesions was detected by
      immunohistochemistry technique (ABC). Proliferating Cell Nuclear Antigen (PCNA)
      was run in parallel. RESULTS: TK1-Labelling Index (LI) (65%) was higher than PCNA
      LI (52%) in the malignant lesions, although not significantly different (p =
      0.1717) between them. TK1-LI as well as PCNA-LI showed significant differences
      between colorectal carcinoma and colorectal adenoma (TK1 p = 0.0005, PCNA p =
      0.0005). Both TK1-LI and PCNA were significantly different in respect to tumor
      stages (TK1 p = 0.0002, PCNA p = 0.0284). However, only TK1-LI showed significant
      difference in respect to tumor grades (p = 0.014), but not PCNA-LI (p = 0.132).
      CONCLUSION: TK1-LI showed more potential as a proliferating marker in colorectal
      carcinoma than PCNA-LI, especially for evaluating high-risk tumor grade and
      advanced stage in colorectal carcinoma.

PMID- 11205226
TI  - Transdermal fentanyl in cancer patients with moderate-to-severe pain: a
      prospective examination.
AB  - BACKGROUND: [corrected] The aim of the study was to evaluate prospectively the
      analgesic efficacy, toxicity and acceptability of the transdermal fentanyl
      therapeutic system (TTS-F) in Greek cancer patients with moderate-to-severe pain.
      METHODS: Forty-eight patients participated in the study: 34 were men and 14
      women, mean age was 63, and all but 2 had advanced stage (IV) cancer. Patients
      received TTS-F for a period of 8 weeks. Doses ranged from 25 to 225 micrograms/h.
      Thirty-three patients completed the study. RESULTS: Data indicated statistically
      significant lower pain scores on both NRS and EORTC QLQ-C30 at all follow-ups
      compared to baseline. In addition, the vast majority of the patients found the
      transdermal system easy to use and reported as being satisfied or highly
      satisfied with it. The only observed side-effect was vomiting. CONCLUSION: In
      summary, transdermal fentanyl appeared an acceptable, safe and effective method
      of managing chronic pain induced by malignancies.

PMID- 11205227
TI  - Epidoxorubicin and paclitaxel as primary chemotherapy for T > 3 cm and T4 breast
      cancer patients.
AB  - The Anthracyclines/Taxanes combination is often used in adjuvant and advanced
      breast cancer. PURPOSE: To evaluate the toxicity and pathological response of
      sequential epidoxorubicin/paclitaxel combination as primary chemotherapy for T >
      3 cm and T4 breast cancer patients. PATIENTS AND METHODS: Forty-eight patients
      with T2 > 3 cm, T3 and T4 breast tumours were treated with Epidoxorubicin (90
      mg/m2, i.v.) on day one and paclitaxel (200 mg/m2 over 3 hours) on day 2 every 21
      days for four courses. After the fourth cycle the patients underwent modified
      radical mastectomy or quadrantectomy plus axillary lymph node dissection followed
      by six courses of intravenous CMF regimen (days 1 and 8, every 4 weeks).
      Radiotherapy was given to patients undergoing conservative surgery or with T4
      cancers. Tamoxifen was administered in ER or PgR positive patients. RESULTS: Out
      of the 48 patients enrolled into this trial, 43 were evaluable for toxicity and
      pathological response. Primary chemotherapy with epidoxorubicin and paclitaxel
      was well tolerated: no heart toxicity was observed during primary chemotherapy
      and follow-up. Primary toxicity consisted of myalgia, grade 1 neuropathy and
      grade 3 alopecia. Disappearance of invasive tumours in the breast with node
      negative was observed in 11.6% of patients: pathological partial response was
      shown in 56% of patients. On the whole major pathological response was achieved
      in 67% of our series: in the remaining 33% we found a stable disease or a size
      reduction less than 50%. No progressive disease was observed. Conservative
      surgery was performed in 64.5% of T2 and T3 tumours. CONCLUSION: These
      preliminary data showed that the epidoxorubicin/paclitaxel combination was safe
      and effective as primary chemotherapy for patients with T > 3 cm and T4 breast
      cancer patients.

PMID- 11205228
TI  - Radiotherapy alone in elderly patients with medically inoperable stage IIIA and
      IIIB non-small cell lung cancer.
AB  - BACKGROUND: We have analysed our experience with medically inoperable IIIA and
      IIIB elderly patients (aged > or = 70 years), treated with radiotherapy alone, to
      better define the potential benefit of this approach. MATERIALS AND METHODS: From
      1992 to 1995, 41 patients with NSCLC (Non Small Cell Lunc Cancer), stage III,
      aged > or = 70 years were irradiated with curative intent. RESULTS: Median follow
      up was 20 months (range 9-53). The 2 year OS (Overall Survival) and DFS (Disease
      Free Survival) were respectively 27% and 14.6% for all patients. Patients
      presenting weight loss > 10% experienced 14% OS at 24 months compared to 58% for
      those without weight loss (p = 0.0027). A 64% OS at 24 months was seen in
      patients with tumor size less than 4 cm compared to 7% of patients with tumor
      size > 4 cm (p = 0.0009). CONCLUSION: Radiotherapy is a good management for
      locally advanced NSCLC in the elderly patients assuring good quality of life,
      high rates of relief of symptoms and OS and DFS similar to those obtained with
      chemotherapy and chemotherapy plus radiotherapy.

PMID- 11205229
TI  - Cell cycle-related phosphatases CDC25A and B expression correlates with survival
      in ovarian cancer patients.
AB  - Alterations in cell cycle regulating proteins are common in many cancer types.
      Recent data suggest a possible link between CDC25 phosphatases overexpression and
      malignancy. Our objective was to evaluate the expression of the three cell cycle
      related phosphatases CDC25A, CDC25B and CDC25C in patients with ovarian cancer.
      All the patients had a minimal follow up of three years. CDC25A, CDC25B and
      CDC25C expression were investigated by immunohistochemistry in 106 patients with
      ovarian cancer. CDC25A and CDC25B were found expressed in almost all the samples
      analyzed, while CDC25C was undetectable in more than 80% of the patients. The low
      evaluable data on CDC25C expression, did not allow any association between the
      expression of this phosphatase and prognosis. The expression of CDC25A and CDC25B
      showed some evidences of association with a poor prognosis (p = 0.034 and p =
      0.058 respectively). This relationship was independent of other factors such as
      tumor grade, histotype, stage and residual tumor after surgery. In the same
      patients the examined parameters (residual tumor, grade, stage and histotype) did
      show the expected relation with survival. The results indicate that high CDC25A
      and CDC25B expression is related to a worse prognosis in ovarian cancer patients.
      CDC25 phosphatases expression can be regarded as a possible prognostic factor for
      ovarian cancer and these proteins should be evaluated as potential molecular
      targets of novel drugs against this human neoplasm.

PMID- 11205230
TI  - Hereditary common cancers: molecular and clinical genetics.
AB  - This review focuses on the functional role and structural features of the genes
      involved in common hereditary cancers. Most of these tumors are sporadic and the
      genetic alterations responsible for their genesis take place over several cell
      generations; nevertheless, 5 to 10% of the human tumors are hereditary, with a
      rapid development. Cancer susceptibility genes have been classified as
      "gatekeepers" (e.g. RB1, ki-ras) and "caretakers" (e.g. hMLH1 and hMSH2, BRCA1).
      The first step in identifying individuals at high risk of developing a specific
      inherited form of cancer, and who should therefore undergo genetic tests, is the
      detailed construction of family history (an accurate cancer family history that
      includes at least three generation pedigrees, an appropriate cancer risk
      assessment and an effective genetic counseling). At present, the most useful
      methods of risk assessment are those performed on the following genes: BRCA1 and
      BRCA2 especially for hereditary breast and ovarian cancer, hMLH1 and hMSH2 for
      hereditary non polyposis colorectal cancer, APC for familial adenomatous
      polyposis, ret for medullary thyroid carcinoma, p53 for the Li-Fraumeni syndrome,
      p16 for melanoma and RB1 for retinoblastoma. In conclusion, the development of
      new diagnostic tests will permit a more accurate assessment of risk in
      individuals who have not so far shown any sign or symptom of the disease.

PMID- 11205231
TI  - Macrophage infiltration and angiogenesis in endometrial cancer.
AB  - The aim of this study was to determine whether tumor-associated macrophages
      (TAMs) infiltration correlates with clinicopathological factors including
      microvessel, counts and clinical outcome in endometrial cancer. Overall 56 out of
      the 109 endometrial cancers (51.4%) expressed distinct tumor-associated
      macrophages infiltration in their tumor stroma. Tumor-associated macrophages
      infiltration was significantly high in tumors with deep myometrial invasion, high
      grade and elderly patients. Microvessel counts strongly correlated with tumor
      associated macrophages infiltration in tumor stroma (p = 0.0002). However, tumor
      associated macrophages infiltration was not a prognostic factor. In conclusion,
      tumor-associated macrophages may play a crucial role in the promotion of
      angiogenesis, but can not be used to prodict prognosis of patients with
      endometrial cancer.

PMID- 11205232
TI  - Frequent loss of p16 protein expression and high proliferative activity (Ki-67)
      in malignant melanoma from black Africans.
AB  - Malignant melanomas in black Africans are predominantly located on the lower
      extremities. Since their biological features have not been well focused, we
      studied 28 such cases with special reference to proliferative activity (Ki-67
      expression), p16 and p53 staining, as well as microvessel density, all known to
      be involved in the progression of melanomas among whites. The findings were
      related to clinico-pathological characteristics. The tumours had a median
      thickness of 6.4 mm, ulceration was present in 71%, and vascular invasion in 36%,
      indicating the presence of advanced and aggressive melanomas. Further, loss of
      p16 protein expression was found in 50%, and high proliferative activity was
      present (median 41%). In contrast, strong p53 staining was rare (11%), although
      most tumours showed low-level positivity. Angiogenesis, as estimated by
      microvessel density, was significantly associated with vascular invasion (p =
      0.022), supporting its role in the progression of these tumours. Thus, our
      findings indicate that melanomas located on the lower extremities in black
      Africans show several features of aggressiveness; in particular, the
      proliferative activity was high, and p16 alterations was frequent as evidenced by
      loss of protein staining. Our findings also indicated that the diagnosis is
      delayed among black Africans.

PMID- 11205233
TI  - Clinicopathological significance of p53 and p21 expression in the surgical
      treatment of laryngeal carcinoma.
AB  - BACKGROUND: This study aimed at resolving the clinicopathological significance of
      p53 and p21 expression in patients undergoing surgical treatment for laryngeal
      carcinoma. MATERIALS AND METHODS: p53 and p21 expression were studied by
      immunohistochemical method on surgical specimens of 193 patients. The expressions
      of p53 and p21 were correlated with the clinicopathological data. RESULTS: Of the
      193 tumors, 60% had positive p53 expression and 46% had positive p21 expression.
      Nodal metastasis was significantly correlated with p53 overexpression,
      supraglottic involvement and moderate- to poor-differentiation of the tumor.
      There was significant cumulative effect with increasing risk of nodal metastasis
      with increasing number of risk factors: 0% without any risk factor, 13% with 1
      risk factor, 37% with 2 risk factors and 55% with all 3 risk factors. CONCLUSION:
      Positive expressions p53 and p21 were common in laryngeal carcinoma.
      Overexpression of p53 but not p21 was associated with nodal metastasis. The use
      of p53 expression has added value in providing more accurate prognostic analysis
      of risk of nodal metastasis in conjunction with site of tumor involvement and
      tumor grade.

PMID- 11205234
TI  - A mesocolic leiomyosarcoma metastatic to the breast: case report and review of
      the literature.
AB  - This report describes a patient with mesocolic leiomyosarcoma, initially treated
      by excisional surgery. One year later the patient developed breast and hepatic
      metastases. To our knowledge, metastasis of leiomyosarcoma to the breast has not
      been previously reported in the literature. The discussion covers unusual sites
      for metastases of primary leiomyosarcomas and those tumors that most commonly
      give rise to breast metastases. Certain rare primary tumors of the breast related
      to the family of sarcomas are also brought to the attention of the reader. These
      may or may not have malignant characteristics. In the light of the differences in
      prognosis and treatment, recognition and precise diagnosis is of importance.

PMID- 11205235
TI  - Fluorescent location of malignant cells in fine needle aspirates.
AB  - Malignant cells in fine needle aspirates possess a cell surface protease which
      can be targeted with fluorescent affinity probes. Cells with active GB exhibit
      cell surface fluorescence when stained with such affinity probes. The nuclei of
      all cells on the slides can be counterstained with a nuclear fluorescent stain.
      Malignant cells are then located by their cell surface fluorescence and their
      diagnosis confirmed by examining their fluorescent nuclei. Normal cells and
      benign cells exhibit no cell surface fluorescence and can be ignored. This
      technique can be used to rapidly select cells of cytological interest in FNA
      samples obtained routinely and might be adapted for automated screening of FNA.

PMID- 11205236
TI  - Multiple endocrine neoplasia (MEN)--an overview and case report--patient with
      sporadic bilateral pheochromocytoma, hyperparathyroidism and marfanoid habitus.
AB  - The multiple endocrine neoplasia syndromes are divided into two categories: MEN
      type I and MEN type II. The MEN type II syndrome is further divided into MEN IIa
      and MEN IIb. The syndromes are characterized by benign and malignant changes in
      two or more endocrine organs, as well as incidental changes in nervous, muscular
      and connective tissue. Two main forms can be distinguished: the MEN-I syndrome
      with hyperplasia of the parathyroid gland, accompanied by islet cell tumor and
      pituitary adenoma; the MEN-II syndrome with medullary thyroid carcinoma in
      combination with bilateral pheochromocytoma and hyperplasia of the parathyroid
      gland (MEN IIa), while type IIb is characterized by the additional appearance of
      neurocutaneous manifestations without primary hyperparathyroidism.
      Characteristics shared by these syndromes include the involved cell type, most of
      the tumors are composed of one or more specific polypeptide- and biogenic amine
      producing cell types (APUD--amine precursor uptake and decarboxylation). The
      second characteristic is the increased incidence in certain families. The
      hereditary component is autosomal dominant with variable expression but high
      penetrance. Mechanisms of tumorigenesis differ in these syndromes. While MEN I is
      caused by an inherited mutation of a tumor suppressor gene, menin, located on the
      long arm of chromosome 11, MEN II is caused by activation of the RET proto
      oncogene. We have reported the case of a young man exhibiting bilateral
      pheochromocytoma. In addition, the patient showed mild primary
      hyperparathyroidism and marfanoid habitus, all these stigmata usually being part
      of the MEN-II syndrome. Although this described patient showed a phenotypic
      mixture of the MEN-IIa and MEN-IIb syndrome, the genetic analysis for MEN II and
      von-Hippel-Lindau gene did not reveal any pathologic mutations, the endocrine
      disorders described here are not related to multiple endocrine neoplasia
      syndromes.

PMID- 11205237
TI  - Disaccordance between estimation of endometrial thickness as measured by
      transvaginal ultrasound compared with hysteroscopy and directed biopsy in breast
      cancer patients treated with tamoxifen.
AB  - OBJECTIVE: To estimate endometrial thickness by transvaginal ultrasound technique
      (TVU) in patients treated with tamoxifen; and to compare the results with
      hysteroscopy and directed biopsy, and to relate the findings to curettage
      material. METHODS: Fifty-four women, over 50 years of age at the time of their
      primary breast cancer operation and scheduled for adjuvant treatment of
      tamoxifen, were investigated. If the endometrium measured 8 mm or more (35
      patients) hysteroscopy and directed biopsy was performed. RESULTS: In the 35
      patients, hysteroscopy and curretage revealed polyps in 18 cases (51.4%),
      proliferation in 1 case (2.9%) and atrophy in 16 cases (45.7%). In 54.3% (19
      cases) of the patients the histopathological finding was a polyp or benign
      proliferation of the endometrium in agreement with the thickened endometrium seen
      with TVU. In the remaining 45.7% (16 cases) of the patients a thickened
      endometrium by transvaginal ultrasound was false positive as the hysteroscopic
      and subsequent histopathological diagnosis only showed atrofia of the uterine
      endometrium. CONCLUSIONS: In almost half of the patients the TVU gave a
      misleading picture concerning the condition of the endometrium. Changes in the
      myometrium and related connective tissue could be misinterpreted by the
      ultrasound technique as changes in the endometrium. These results may confirm the
      theory that stimulation and changes by antiestrogenic treatment of the uterine
      tissue is not only restricted to the endometrium. In patients with thickened
      endometrium measured by TVU, a dilatation and curettage is not sufficient, as TVU
      has not the ability to differentiate between endometrial polyps and myometrial
      changes. A hysteroscopy and directed biopsy could therefore be performed.

PMID- 11205238
TI  - Reactive oxygen and nitrogen species: efficient, selective, and interactive
      signals during intercellular induction of apoptosis.
AB  - During intercellular induction of apoptosis, transformed fibroblasts are
      specifically eliminated by their nontransformed neighbours. This potential
      control step of oncogenesis is based on a sophisticated system of
      interdependencies and interactions of reactive oxygen and nitrogen species.
      Activated nontransformed effector cells release a novel peroxidase and nitric
      oxide. Superoxide anions generated extracellularly by transformed cells
      participate in intercellular signalling and also determine transformed cells as
      selective targets for intercellular induction of apoptosis. The interaction of
      these molecules results in two major signalling pathways, which are based on
      HOCl/hydroxyl radicals and on NO/peroxynitrite. In addition, involvement of
      nitrylchloride seems to be conceivable in an alternative pathway.
      Hydrogenperoxide plays a central and ambivalent role by fostering the
      HOCl/hydroxyl radical pathway and by inhibiting the NO/peroxynitrite pathway. The
      interaction of ROS and RNS during intercellular induction of apoptosis seems to
      represent a general signalling concept utilized by several natural antitumor
      systems.

PMID- 11205239
TI  - Altered response to thyroid hormones by breast and ovarian cancer cells.
AB  - BACKGROUND: In this study, L-thyroxine (T4), 3',3,5-triiodo-L-thyronine (T3), 3,5
      diiodo-L-thyronine (T2), reverse T3; 3',5',3-triiodo-L-thyronine (RT3) and
      transferrin were added to breast cancer cell lines Hs 578T, MDA-MB-231, MDA-MB
      468, and T-47D and ovarian cancer cell line OVCAR-3 to test the response to cell
      proliferation. MATERIALS AND METHODS: Breast and ovarian cancer cell lines were
      placed in serum-free medium prior to addition of effector. Proliferation was
      determined by thymidine incorporation. For Northern analysis, RNA was isolated
      and c-fos, cjun and TIEG expression assessed. RESULTS: No compound provided
      uniform results across all cell lines. T2 inhibited proliferation in Hs 578T and
      MDA-MB-468, had no effect in MDA-MB-231 and OVCAR-3, and stimulated proliferation
      in T-47D cells. T3 inhibited proliferation in all cell lines except T-47D in
      which two-state behavior occurred, with increased proliferation at low
      concentrations (< or = 10(-6) M) and decreased proliferation at high
      concentrations (> or = 10(-5) M). RT3 inhibited proliferation in Hs 578T, MDA-MB
      231, and T-47D but had no effect in MDA-MB-468 and OVCAR-3. T4 inhibited
      proliferation in Hs 578T, MDA-MB-231, and MDA-MB-468 and had two-state behavior
      in T-47D and OVCAR-3. Finally, transferrin increased proliferation only in OVCAR
      3 cells. Protooncogene expression was increased by both transferrin and T4 in the
      cell lines tested. CONCLUSIONS: Correlation of iodines and proliferative
      responses were used to determine "essential" iodines necessary to produce the
      observed effect. Interaction between these cancer cells and non-physiological
      concentrations of thyroid hormone can be explained by thyroid hormone receptors
      with altered binding properties. Thus, interaction of thyroid hormones and cancer
      cells may differ from what occurs with normal cells.

PMID- 11205240
TI  - TRAG-3, a novel cancer/testis antigen, is overexpressed in the majority of
      melanoma cell lines and malignant melanoma.
AB  - BACKGROUND: We have identified a novel cancer/testis antigen, TRAG-3, (Taxol
      Resistance Associated Gene-3) that was initially discovered in search for new
      genes involved in drug resistance by differential display. Early study of TRAG-3
      revealed minimal to absent expression in various normal tissues and over
      expression in many carcinoma cell lines including several melanoma lines.
      MATERIALS AND METHODS: Northern and RT-PCR technologies were used to evaluate
      TRAG-3 expression in numerous cell lines and tumor tissue. RESULTS: Analysis of a
      wider panel of normal tissues, 32 melanoma cell lines and 4 malignant melanomas
      demonstrates TRAG-3 expression in 25 of the 32 melanoma cell lines (78%) and four
      of four of the malignant melanoma tumors (100%). Of the additional eight normal
      tissues screened, expression was present in normal testis but absent in all other
      tissues. RT-PCR evaluation of TRAG-3 reveals two transcripts in many carcinoma
      cell lines with sequencing of these products demonstrating the 799 bp TRAG-3
      transcript and a second alternatively spliced transcript, TRAG-3long TRAG-3 maps
      to band Xq28 within a MAGE gene complex, however sequence analysis demonstrates
      that TRAG-3 is not homologous to other known cancer/testis antigens. CONCLUSION:
      TRAG-3 appears to be a novel cancer/testis antigen.

PMID- 11205241
TI  - Apurinic/apyrimidinic endonuclease expression in pediatric yolk sac tumors.
AB  - BACKGROUND: The enzyme apurinic/apyriminidic endonuclease/redox factor 1
      (Ape1/ref1), a key protein in the base excision repair pathway, displays repair
      and redox activity. We examined the role of Ape1/ref1 and a protein it regulates,
      hypoxia inducible factor 1 alpha (HIF-1 alpha) in pediatric yolk sac tumors.
      PATIENTS AND METHODS: Using an immunohistochemical evaluation, 16 pediatric yolk
      sac tumors were evaluated for Ape1/ref1 and HIF-1 alpha expression. Samples were
      obtained from archival tissue. RESULTS: We demonstrated high levels of expression
      of Ape1/ref1 in 14/16 of the tumors. This expression was limited to the nucleus
      of the viable portion of each tumor. High levels of HIF-1 alpha expression was
      noted in half of the same tumors and localized to both the nucleus and cytoplasm
      of the viable tumor. CONCLUSIONS: The high levels of expression of Ape1/ref1 in
      this group of chemosensitive tumors may be related to the subcellular location or
      redox regulatory activity of one of the other factors controlled by Ape1/ref1.

PMID- 11205242
TI  - Prostate cancer cell adhesion to quiescent endothelial cells is not mediated by
      beta-1 integrin subunit.
AB  - BACKGROUND: Previous studies have reported that tumor cells' adhesion to
      quiescent endothelial cell is mediated by beta-1 integrins. The aim of this study
      was to determine the role beta-1 integrins play in prostate cancer cell adhesion
      to human bone marrow endothelial cells (HBME) and human aortic endothelial cells
      (HAEC). MATERIALS AND METHODS: A well described blocking antibody to beta-1
      integrin subunit was used in adhesion assays to determine the role of beta-1
      integrin subunit in the adhesion of PC-3 cells to both HBME cells and HAEC.
      RESULTS: Antibody to the beta-1 integrin subunit failed to reduce PC-3 adhesion
      to HBME and HAEC, yet this same antibody significantly reduced adhesion of PC-3
      cells to fibronectin coated wells. CONCLUSIONS: The data suggest that metastasis
      of prostate cancer cells to bone may be mediated, in part, by preferential
      adhesion to HBME cells; but beta-1 integrins most likely are not involved in this
      interaction.

PMID- 11205243
TI  - Perilesional IL-2 treatment of a VX2 head-and-neck cancer model can induce a
      systemic anti-tumour activity.
AB  - BACKGROUND: Head-and-neck cancer is associated with impaired cell-mediated immune
      reactivity. A rabbit model with VX2 Squamous Cell Carcinoma transplanted into
      both auricles was used to test the effects of a regimen for local Interleukin 2
      (IL-2) therapy, optimal in murine tumour models. MATERIALS AND METHODS: Peri
      tumoural IL-2 treatment started when one of the tumours exceeded 2 cm2 and
      consisted of 100,000 or 300,000 Chiron Units IL-2 or only solvent during 5
      consecutive days. RESULTS: In 4 out of 12 (33%) rabbits the treated primary
      tumours regressed completely, simultaneously with the non-treated contra-lateral
      tumours. Also metastases in draining lymph nodes of both treated and untreated
      primary tumours regressed in three of these animals. Tumour cells injected in the
      cured animals were rejected. The histology of the regressing tumours in cured
      cases showed an active granulomatous reaction with a histiocytic response,
      splitting up of tumour islands, and fibrinoid obstruction of blood vessels.
      CONCLUSION: These findings showed local and systemic therapeutic effects of this
      local IL-2 regimen in a VX2 head-and-neck cancer model.

PMID- 11205244
TI  - Apoptosis induced by inhibitors of nucleotide synthesis in deoxyadenosine
      resistant leukemia L1210 cells that lack p53 expression.
AB  - An L1210 cell line (Y8) selected for resistance to deoxyadenosine contains
      ribonucleotide reductase that is not subject to inhibition by dATP. In addition,
      the Y8 cells have other phenotypic expressions that include increased sensitivity
      to apoptosis induced by various agents such as radiation, doxorubicin, anisomycin
      and roscovitine. The Y8 cells were found to be more sensitive to apoptosis
      induced by methotrexate (MTX), tiazofurin (TZ), deoxyguanosine (dGuo) and N
      (phosphonoacetyl)-L-aspartate (PALA). Deoxyguanosine, at concentrations that did
      not cause apoptosis in the Y8 cells, prevented the apoptotic response of the Y8
      cells to MTX and TZ. Deoxycytidine had no effect. Since caspase-3 activation is
      involved in apoptotic pathways, the effects of the caspase-3 inhibitor, Ac-DEVD
      CHO, were studied on the dGuo-, MTX- or TZ-induced apoptosis in the Y8 cells. Ac
      DEVD-CHO caused a marked decrease in the fraction of cells in the early phase of
      apoptosis. However, there was a corresponding increase in the fraction of cells
      in the late apoptotic/necrotic stages of cell death. This is in marked contrast
      to the dGuo-induced decrease in apoptosis seen in the MTX- and TZ-treated Y8
      cells in which there were no increases in the late apoptotic/necrotic fraction of
      cells. These data show that alterations of nucleotide pools in the Y8 cells cause
      marked increases in the apoptotic response which may indicate that the Y8 cells
      are much more susceptible to the effects of misincorporation of nucleotides into
      DNA than are the parental WT L1210 cells.

PMID- 11205245
TI  - Chemoprevention with triphenylselenonium chloride in selenium-deficient rats.
AB  - Cancer chemoprevention by high levels of selenium, including compounds like
      sodium selenite or selenomethionine, is generally not accompanied by increases in
      known selenoenzymes. There has been no information on whether selenoenzymes are
      obligatory mediators of the anticarcinogenic effect of selenium. Our previous
      experience with triphenylselenonium chloride suggests that it might be an ideal
      agent for studying selenium chemoprevention while simultaneously precluding the
      synthesis of selenoenzymes. Triphenylselenonium chloride has excellent tumor
      inhibitory activity but does not support the repletion of selenoenzymes in
      animals that have been deprived of a bioavailable form of selenium. In the
      present experiments, we evaluated the efficacy of mammary cancer protection by
      this compound in rats fed either a selenite-deficient (< 0.01 ppm Se) or selenite
      adequate (0.1 ppm Se) diet. We also measured the activities of liver glutathione
      peroxidase and thioredoxin reductase as markers of selenium bioavailability in
      these different treatment conditions. In carcinogen-treated control animals not
      receiving triphenylselenonium chloride, mammary tumor incidence and the total
      number of tumors were similar between the selenite-deficient and selenite
      adequate groups. Thus the correction of selenium deficiency by the addition of
      0.1 ppm Se as selenite did not have detectable anticarcinogenic effects.
      Supplementation of triphenylselenonium chloride at a level of 30 ppm Se
      suppressed mammary tumorigenesis by approximately 50% regardless of dietary
      selenium nutritional status. However, this supplement had little effect on tissue
      selenium levels and did not increase liver glutathione peroxidase or thioredoxin
      reductase activities. In contrast, a level of 0.1 ppm Se as selenite did not
      affect mammary tumorigenesis but markedly increased tissue selenium
      concentrations and selenoenzyme activities. It is concluded that
      triphenylselenonium chloride does not release inorganic selenium for
      selenoprotein synthesis and that its anticancer activity involves mechanisms that
      are probably intrinsic to the compound. This study also shows for the first time
      that selenium chemoprevention is possible in an environment of severely depressed
      selenoenzyme expression. Thus selenium chemoprevention efficacy can be separated
      experimentally from selenoprotein synthesis using this model system.

PMID- 11205247
TI  - Cytotoxic activity of steroidal saponins against human oral tumor cell lines.
AB  - Three steroidal saponins showed higher cytotoxicity against human oral squamous
      cell carcinoma cell lines (HSC-2), as compared with normal human gingival
      fibroblasts HGF. Tumor specificity of saponins exceeded that of tannins and
      flavonoids. Agarose gel electrophoresis showed that saponins failed to induce
      internucleosomal DNA fragmentation, but produced large DNA fragments in both HSC
      2 cells and human promyelocytic leukemic HL-60 cells. In contrast to
      epigallocatechin gallate or gallic acid, cytotoxic activity of saponins was not
      significantly affected by metals (Co2+, Cu2+, Fe3+) nor by antioxidants (sodium
      ascorbate, N-acetyl-L-cysteine, catalase). Furthermore, saponins did not produce
      radicals (detected by ESR spectroscopy) nor oxidation potential (measured by NO
      monitor). These data suggest that an oxidation-mediated mechanism is not involved
      in the cytotoxicity induced by steroidal saponins.

PMID- 11205246
TI  - Differential effect of camptothecin treatment on topoisomerase II alpha
      expression in ML-1 and HL-60 leukemia cell lines.
AB  - Derivatives of camptothecin, an inhibitor of human TOP1, are increasingly being
      used in treatment of cancers, including leukemia. Sequential combination therapy
      with inhibitors of TOP2 holds potential promise. Binding of p53 has been shown to
      inhibit transcription of TOP2 alpha. Down-regulation of TOP2 alpha gene
      expression by the camptothecin induced DNA damage response may adversely affect
      the effectiveness of sequential therapy. To address this question, two leukemia
      cell lines, ML-1 (with wild type p53) and HL-60 (p53 null) were treated with
      camptothecin to induce similar degree of apoptosis and residual survival. Western
      blot analysis indicated rapid induction of p53 in ML-1 followed by significant
      decrease of TOP2 alpha mRNA and protein levels. The expression level of TOP2
      alpha in HL60 did not decrease after camptothecin treatment. These results
      demonstrated that induction of p53 by camptothecin treatment can lead to a
      decreased level of TOP2 alpha and should be considered in design of combination
      therapy.

PMID- 11205248
TI  - Combination of pGL1-TNF-alpha gene and radiation (proton and gamma-ray) therapy
      against brain tumor.
AB  - The major goal of this study was to determine if treatment with the newly
      constructed plasmid vector for tumor necrosis factor-alpha (pGL1-TNF-alpha) could
      enhance the radiation-induced growth reduction of C6 rat glioma. In addition, two
      different forms of ionizing radiation (gamma-rays and protons) were utilized.
      Body and spleen mass, leukocyte blastogenesis, and flow cytometry analysis of
      cell populations in blood and spleen were performed to detect toxicity, if any,
      and to identify mechanisms that may correlate with the anti-tumor action of
      combination therapy. C6 tumor cells were implanted subcutaneously into athymic
      mice and allowed to become established before treatment initiation. pGL1-TNF
      alpha was injected into the implanted tumors, which were then irradiated 16-18 hr
      later; each modality was administered three times over 8-9 days. The addition of
      pGL1-TNF-alpha significantly enhanced the anti-tumor effect of radiation (p <
      0.05). The effect was more than additive, since pGL1-TNF-alpha alone did not slow
      tumor progression and radiation alone had only a modest effect. Administration of
      pGL1-TNF-alpha together with proton radiation resulted in tumor volumes that were
      23% smaller than those following pGL1-TNF-alpha + gamma-ray treatment; a similar
      differential in tumor size was observed in the groups receiving only radiation.
      Body weights and blood and spleen cell analyses did not reveal treatment-related
      toxicity. High basal proliferation of blood leukocytes and increased B cell
      levels in the spleen were associated with pGL1-TNF-alpha + 60Co (gamma-radiation)
      or proton treatment. Overall, the results suggest that the pGL1-TNF
      alpha/radiation combination is effective and safe under the conditions employed.
      This is the first study to combine gene and proton radiation therapy and to show,
      under controlled experimental conditions, that proton radiation may have a
      greater effect against malignant tumors compared to the same physical dose of
      gamma-radiation.

PMID- 11205249
TI  - Evaluation of D-methionine as a cytoprotectant in cisplatin treatment of an
      animal model for ovarian cancer.
AB  - BACKGROUND: To evaluate the use of D-methionine(D-met) as a cytoprotectant in the
      context of clinically relevant doses of cisplatin. MATERIALS AND METHODS: Forty
      five Fischer rats were injected intraperitoneally with 10(6) NuTu-19 cells and
      treated as follows: group 1 was the control group and received no treatment,
      group 2 received cisplatin 4 mg/kg and group 3 received cisplatin 4 mg/kg plus D
      met. There were two groups that received high dose cisplatin. Group 4 received
      cisplatin 8 mg/kg and group 5 received cisplatin 8 mg/kg plus D-met. Treatment
      was initiated four weeks after injection of the NuTu-19 cells, and consisted of
      four weekly intraperitoneal injections. Serum BUN and creatinine levels in the
      high dose groups evaluated nephrotoxicity and clinical outcome was measured by
      mean survival using Kaplan Meier analysis. RESULTS: There were no significant
      elevations in serum BUN or creatinine levels in any of the rats treated with high
      dose cisplatin. In the animals given cisplatin 8 mg/kg plus D-met, death from
      toxicity was prevented and all animals completed four treatments. In contrast,
      only two animals in group 4 (cisplatin 8 mg/kg alone) completed 4 treatments.
      There was a significant improvement in survival for the animals given D-met. (p =
      .0001) In all treated groups except for group 4, there was an improvement in
      survival compared to the control group. When comparing groups 2 and 3 (4 mg/kg +/
      D-met), there was a subjective decrease in tumor response for group 3 but mean
      survival was not statistically different. (91 vs. 81 days; p = 0.07) A comparison
      of groups 2 and 5 revealed no survival benefit using high dose cisplatin with D
      met. (91 vs. 79 days; p = 0.10). CONCLUSIONS: Our results indicate that D
      methionine provides cytoprotection against cisplatin toxicity without significant
      compromise of antitumor activity. All though D-methionine allowed for significant
      dose intensification of cisplatin above standard doses, there was no survival
      advantage noted in this group of animals. The indications for its use in the
      treatment of ovarian cancer remain to be determined.

PMID- 11205250
TI  - Cyanoguanidine CHS 828 induces programmed cell death with apoptotic features in
      human breast cancer cells in vitro.
AB  - The cyanoguanidine CHS 828 was recently shown to possess potent anti-tumour
      effects both in vitro and in vivo. The exact mechanism of action of CHS 828 is
      not known, but recent results have indicated that induction of programmed cell
      death may be one mechanism by which CHS 828 exerts its anti-tumour effects. To
      investigate this aspect in more detail, we studied the effect of CHS 828 and the
      reference compound Taxol beta on programmed cell death in human breast cancer
      cells in vitro. Both compounds were found to induce DNA fragmentation in the
      cells. However, microscopic examination of the cells demonstrated that CHS 828
      and Taxol triggered different types of cell death. In the CHS 828-treated
      cultures most cells were found to be Annexin-V positive, indicating that these
      cells were early apoptotic cells, while no morphological characteristics of
      classical apoptosis were seen. In contrast, the cells in the Taxol-treated
      cultures displayed morphological features characteristic of classical apoptotic
      cells, but no Annexin-V positive cells could be observed. These findings together
      with the previously reported potent effects of CHS 828 on tumour cells, makes CHS
      828 a promising new agent for the treatment of cancer patients.

PMID- 11205251
TI  - Immunohistochemical expression of Bcl-2 protein in breast lesions: correlation
      with Bax, p53, Rb, C-erbB-2, EGFR and proliferation indices.
AB  - Expression of bcl-2 protein was investigated and correlated with Bax, p53 and Rb
      proteins, c-erbB-2, EGFR and the proliferation indices PCNA, Ki-67 and MIB1 as
      well as with the conventional clinicopathological parameters in 95 cases for
      breast cancer tissue and 20 cases of benign hyperplastic lesions. Bcl-2 and Bax
      proteins immunoreactivity was detected in normal, hyperplastic and neoplastic
      breast epithelium. Expression of the bcl-2 protein was detected in 40% of
      carcinomas (> 10% positive neoplastic cells) and 85.2% of the benign hyperplastic
      lesions. Bax protein expression was detected in 8.1% of the carcinomas and 5.3%
      in the hyperplastic group. Rb and p53 proteins were detected in 75.5% and 45.5%
      of carcinomas. No relationship was observed between bcl-2 expression and
      patient's age, tumour size, tumour type and grade, lymph node status, Rb protein
      expression and proliferation indices. However, a strong positive relationship was
      detected between bcl-2 and Bax (p = 0.008), estrogen (ER) (p = 0.007) and
      progesterone receptors' (PgR) status (p = 0.0003). An inverse correlation with
      p53 protein (p = 0.004) was detected. Furthermore, a strong correlation was also
      observed between pRb and p53 (p = 0.001). The results indicate that in breast
      cancer bcl-2 protein expression may be under hormonal control. Since the
      expression is bcl-2 protein was inversely correlated with p53 protein expression,
      we suggest that bcl-2 may be related with favourable outcome in breast cancer.

PMID- 11205252
TI  - Anti-invasive effect of contortrostatin, a snake venom disintegrin, and TNF-alpha
      on malignant glioma cells.
AB  - BACKGROUND: The snake venom disintegrin contortrostatin has been shown to bind to
      integrins alpha IIb beta 3, alpha v beta 3, alpha v beta 5, and alpha 5 beta 1
      and to exert an anti-tumor activity in vitro and in vivo. The cytokine TNF-alpha
      has been demonstrated to have anti-invasive properties in vitro. MATERIALS AND
      METHODS: The human glioblastoma cell line T98G was treated with controtrostatin
      or colloidal gold-TNF-alpha (CG-TNF-alpha) alone, or in combination. Vitronectin-
      and fibronectin-dependent adhesion of untreated and treated glioma cells was
      studied and compared. Invasion through a reconstituted basement membrane
      (Matrigel) was also examined. RESULTS: Although both contortrostatin and CG-TNF
      alpha inhibited invasion of T98G cells through Matrigel, the mechanism of
      inhibition appears to be different. Contortrostatin significantly decreased cell
      adhesion to vitronectin and fibronectin; CG-TNF-alpha did not. Contortrostatin
      binds to T98G integrins in an RGD-dependent manner, whereas protein kinase C
      (PKC) appears to be involved in CG-TNF-alpha actions, leading to inhibition of
      cell invasion. The efficiency of contortrostatin in inhibiting cell invasion was
      enhanced by combination with CG-TNF-alpha. CONCLUSION: The combined use of
      contortrostatin and CG-TNF-alpha may have potential for malignant glioma therapy
      by effectively inhibiting glioma cell invasion.

PMID- 11205253
TI  - Comparisons of the pharmacokinetics and the leukopenia and thrombocytopenia grade
      after administration of irinotecan and 5-fluorouracil in combination to rats.
AB  - BACKGROUND: Irinotecan (CPT-11) has been used recently for the treatment of
      several cancers in combination with 5-fluorouracil (5-FU). Preliminary data on
      this combination therapy in humans demonstrated no drug interactions between CPT
      11 (or its metabolite, SN-38) and 5-FU however, because there is so little
      information on the combination, the possibility for an interaction still exists.
      MATERIAL AND METHODS: CPT-11 and 5-FU were injected intravenously into rats and
      the pharmacokinetics of CPT-11 and SN-38 and alternations in blood cell count
      were investigated. RESULTS: In the group of rats administered 5-FU prior to CPT
      11, the area under the concentration-time curve (AUC) of CPT-11 was approximately
      eight-fold larger compared with the group administered CPT-11 prior to 5-FU. On
      the other hand, the grade of leukocytopenia or thrombocytopenia was not
      significantly different among the two groups. CONCLUSION: In rats, the conversion
      of CPT-11 into SN-38 is possibly delayed by prior administration of 5-FU.

PMID- 11205254
TI  - NF-kappa B does not modulate sensitivity of renal carcinoma cells to TNF alpha
      related apoptosis-inducing ligand (TRAIL).
AB  - BACKGROUND: Immune cells express TNF-related apoptosis-inducing ligand (TRAIL)
      and may play an important role in controlling the growth of renal cancer. For
      this reason we examined the potential cytotoxic and intracellular signaling
      effects of TRAIL on several renal cancer cell (RCC) lines. METHODS: Cytotoxicity
      was determined using an MTS tetrazolium based assay. Death receptor expression
      was measured by reverse-transcription polymerase chain reaction. Immunoblot
      analysis was used to measure cFLIP, caspase-8 and phosphorylated JNK and p38.
      Activation of NF-kappa B was determined by electrophoretic mobility shift assays.
      RESULTS: Two RCC lines were highly sensitive to TRAIL-induced cell death, two
      were of intermediate sensitivity, and two were insensitive. Sensitivity to TRAIL
      stimulated apoptosis did not correlate with expression of death receptors, decoy
      receptors, or expression of the caspase-8-inhibitory protein cFLIP. Neither
      activation or inhibition of the NF-kappa B signal transduction pathway protected
      sensitive cells from TRAIL-induced cell death. CONCLUSIONS: NF-kappa B, although
      stimulated in these cell lines, does not play a role in the sensitivity of RCC to
      TRAIL and could play other functions in TRAIL signaling.

PMID- 11205255
TI  - In vitro antiproliferative activity of a medium-chain triglyceride solution of
      1,25-dihydroxyvitamin D3 in HepG2 cells.
AB  - BACKGROUND: Successful targeted delivery of 1,25-dihydroxyvitamin D3 [1,25-D3]
      for the treatment of liver cancer would necessitate the use of an appropriate
      delivery agent. MATERIALS AND METHODS: Using liver cancer cell line HepG2 in
      culture, we examined, the possibility of using medium-chain triglyceride (MCT) as
      a solvent for targeted delivery of 1,25-D3. The drug was made up in either the
      medium or first dissolved in MCT and subsequently diluted in the medium. Cells
      were exposed for 1 (acute) or 5 days (chronic) to the 2 different formulations of
      the drug and cell proliferation was measured by [3H]thymidine and cell count
      methods. RESULTS: In chronic experiments, exposure of cells to the MCT containing
      formulation of 1,25-D3 led to significantly greater inhibition of cell
      proliferation. In the acute experiments where, 1 day 1,25-D3 treatment was
      followed by 4 days of incubation with normal medium (no drug, no MCT), inhibition
      of proliferation was more than 2 fold greater in cells exposed to the 1,25-D3/MCT
      preparation. CONCLUSION: These results indicate that, 1,25-D3 dissolved in MCT
      probably accumulates and then acts as a sustained release drug depot formulation,
      in which case it may have potential for the regional treatment of liver tumors.

PMID- 11205256
TI  - Reversal of multidrug resistance of tumor cells.
AB  - Drug resistance to chemotherapy is rapidly emerging. Resistance to one drug
      carries over resistance to unrelated anticancer drugs leading to multidrug
      resistance (MDR). A major factor of MDR is P-glycoprotein (P-gp) mediated ABC
      transport found in many eukaryotic cells. P-gp acts as a drug eMux pump. The mdr1
      gene involved in P-gp 170 protein production is localized in the human chromosome
      7 band p2 1.0-21.1. Point mutations after cross-resistance patterns. A variety of
      stimuli increase the expression of the mdr1 gene: lowered extracellular pH, heat
      shock, arsenite, cytotoxic agents, anticancer drugs, transfection with oncogenes,
      HIV-I, and UV-irradiation. An alternative hypothesis to the efflux pump claims
      that P-gp modifies the intracellular environment to reduce accumulation of
      anticancer drugs in cancer cells by creating ionic or proton gradients.
      Chemosensitizers that block P-gp drug extrusion are generally lipid-soluble at
      physiological pH, possess a basic nitrogen atom and at least two co-planar rings.
      P-gp blocking does not depend on drug chirality. This opens the way of treating P
      gp related MDR with chiral versions of drugs relatively harmless in terms of side
      effects. We believe that resistance modifiers combined with cytostatics will
      chemotherapeutically be more effective for cancer patients.

PMID- 11205257
TI  - Antitumour effect of L-2,4 diaminobutyric acid on a hepatoma cell line.
AB  - Pharmacological treatment of malignant disease is often insufficient highlighting
      the need for more efficient treatment based on new principles. We have observed
      that the amino acid analogue diaminobutyric acid (DAB), accumulates in malignant
      cells apparently without saturation kinetics, leading to hyperosmosis and
      subsequently to cell lysis. In the first in vitro part of the present study
      hepatoma cells were incubated with DAB in miniwells in the presence or absence of
      physiological amino acids. In the in vivo part malignant cells were inoculated
      into rat liver after laparotomy. The tumour was treated by continuous infusion of
      DAB via a catheter, the tip of which was placed in the center of the tumour. DAB
      had a significant antitumour effect both in vitro and in vivo. The principle of
      action of DAB as an antitumour agent is unique and therefore would be the ideal
      partner to practically any other cytostatic drug for a combined treatment to
      achieve a synergistic effect.

PMID- 11205258
TI  - Induction of apoptosis by JTE-522, a specific cyclooxygenase-2 inhibitor, in
      human gastric cancer cell lines.
AB  - An increased expression of cyclooxygenase (COX)-2 has been observed in various
      cancers including gastric cancer. Although specific COX-2 inhibitors have a
      chemopreventive effect on colon cancer, their molecular mechanisms remain
      unclear. To clarify these mechanisms, we investigated the effects of JTE-522, a
      newly developed COX-2-specific inhibitor, on gastric cancer cell lines (MKN28 and
      MKN45). The baseline levels of COX-2 expression were higher in MKN45 than in
      MKN28. JTE-522 obviously suppressed the levels of COX-2 mRNA, COX-2 protein and
      PGE2 at a dose of 250 microM in both cancer cells. Apoptosis was induced at 24
      hours after treatment with JTE-522 (250 microM) in both cancer cells. To
      determine the mechanisms of apoptosis induction by JTE-522, the time course of
      the cell cycle and the apoptosis-related protein levels were examined. An
      increase in the G1 phase and a decrease in the S phase were observed prior to
      apoptosis. Moreover, an increase of c-myc protein and a decrease of bcl-2 protein
      were observed in both cells treated with JTE-522. These findings suggested that
      JTE-522 could induce apoptosis by blocking the cell cycle, enhancing c-myc
      expression and diminishing bcl-2 expression. JTE-522 also suppressed
      proliferation activity in both cell lines. These effects of JTE-522 were more
      dramatic in MKN45 than in MKN28. Since JTE-522 strongly suppresses cell growth by
      inducing apoptosis in gastric cancer cell lines, it may therefore serve as a
      chemopreventive agent.

PMID- 11205259
TI  - Antiproliferative effects of small fruit juices on several cancer cell lines.
AB  - Juices prepared from small fruits, mainly growing in the northern part of Japan,
      were studied in an attempt to explore the feasibility of an assay that screens
      cytotoxic properties. Screening of 43 small fruit juices indicated that Actinidia
      polygama Maxim., Rosa rugosa Thunb., Vaccinium smallii A. Gray and Sorbus
      sambucifolia Roem, strongly inhibited the proliferation of all cancer cell lines
      examined and yet these juices were substantially less cytotoxic toward normal
      human cell lines.

PMID- 11205260
TI  - Inhibitory effect of dietary inulin or oligofructose on the development of cancer
      metastases.
AB  - The possible influence of continuous dietary treatment with 15% inulin or
      oligofructose on the development of lung metastases of a transplantable liver
      tumor in young male C3H mice was investigated. Microscopical examination
      demonstrated a distinct inhibitory effect of this dietary treatment on the
      development of lung metastases of this tumor. There were 59% of mice bearing lung
      metastases in the control group, 36% in the inulin fed group and 35% in the
      oligofructose fed group. The total number of lung metastases was 37 in the
      control group, 18 in inulin fed and 6 in oligofructose fed mice. Several
      possible, mechanisms hypothetically involved in this astonishing inhibition of
      the development of lung metastases by dietary treatment with inulin or
      oligofructose are discussed.

PMID- 11205261
TI  - Polysaccharides extracted from human tubercle bacilli (specific substance of
      Maruyama) reduces carcinogenesis in murine ulcerative colitis.
AB  - Polysaccharides extracted from human tubercle bacilli (specific substance of
      Maruyama) have been clinically applied in patients with malignant diseases in
      Japan and other countries. It is known that increased colorectal carcinogenesis
      occurs in patients with ulcerative colitis. The repeated mucosal necrosis
      regeneration sequence in chronic ulcerative colitis induced with 3 % dextran
      sulfate sodium led to colorectal carcinogenesis in azoxymethane-pretreated mice.
      Simultaneously multiple injections with the polysaccharides reduced the increases
      in thymidylate synthase and thymidine kinase activities and a number of
      bromodeoxyuridine-incorporated S-phase cells in colorectal tissues resulted in
      the reduction of tumorous regions with high-grade dysplasia.

PMID- 11205262
TI  - CD44 expression and MMP-2 secretion by mouse glioma cells: effect of interferon
      and anti-CD44 antibody.
AB  - We have previously reported that invasiveness of mouse glioma G-26, which
      expresses CD44 adhesion molecule, was inhibited in vitro following treatment with
      anti-CD44 antibody or mouse interferon alpha/beta (MuIFN alpha/beta). Here, we
      evaluated whether the expression of transmembrane CD44 adhesion molecule and/or
      secretion of extracellular matrix metalloproteinases (MMPs) were affected when
      glioma cell invasion was inhibited. Flow cytometric evaluation of CD44 adhesion
      molecule expression in G-26 glioma using anti-CD44 antibody, confirmed that G-26
      cells were CD44+. Following 3-day treatment with MuIFN alpha/beta at 8 x 10(2) or
      8 x 10(3) IU/ml of glioma cells, the expression of CD44 was not significantly
      affected as reflected by CD44+ cell number and fluorescence intensity. The
      pretreatment of glioma cells for 1 day with anti-CD44 antibody resulted in a 30
      60% decrease of CD44 expression. This coincided with significantly (p < 0.05)
      lower cell activity as judged by MTT assay for mitochondrial activity. The
      zymographic evaluation of MMP activity in the G-26 glioma cell culture showed a
      high level of the active form of MMP-2. This level of MMP-2 was decreased
      following 3 day treatment of G-26 glioma cells with either 8 x 10(2) or 8 x 10(3)
      IU/ml of MuIFN alpha/beta but only the latter concentration produced
      statistically significant 55% decrease. However, following a 1 day treatment of G
      26 glioma cells with anti-CD44 antibody, the level of active MMP-2 form was not
      significantly affected. These findings indicate that while the inhibitory effect
      of IFN on glioma invasion was accompanied by a decreased level of the active form
      of MMP-2 released extracellularly, the expression of the transmembrane CD44
      adhesion molecule was not affected. Conversely, anti-CD44 antibody pretreatment
      of G-26 glioma, which led to the inhibition of glioma invasion, resulted in
      decreased CD44 expression and lower cell activity but had no effect on the MMP-2.

PMID- 11205264
TI  - Thymidine phosphorylase activity in transitional cell cancer: relation to
      histological parameters and chemosensitivity to fluorouracil-related drugs.
AB  - BACKGROUND: Thymidine phosphorylase (TdR-Pase) is an essential enzyme for the
      metabolism of fluorouracil-related drugs and it is also recognized as a potent
      angiogenic factor. We measured the TdR-Pase activity in human transitional cell
      cancers (TCCs) of the urinary tract to assess the relationship between TdR-Pase
      activity and degree of tumor malignancy. Furthermore, we investigated the
      relationship between TdR-Pase activity and chemosensitivity to fluorouracil
      related drugs. MATERIALS AND METHODS: Sixty-two TCC tissues and 12 normal bladder
      tissues were obtained. TdR-Pase activity was measured with the enzyme-linked
      immunosorbent assay. The in vitro histoculture drug response assay was also
      performed to investigate tumor sensitivity to 5-fluorouracil (5-FU) and
      doxifluridine (5'-DFUR). RESULTS: The TdR-Pase activity of TCCs was three-fold
      higher than that of normal tissues. The TdR-Pase activity increased along with
      the histological grade, and the TdR-Pase activity of invasive cancers was
      significantly higher than that of superficial cancers. However, TdR-Pase showed
      no relationship with the sensitivity to 5-FU or 5'DFUR. CONCLUSION: A high TdR
      Pase activity in human TCCs was confirmed to predict a high tumor grade and
      stage. However, the anti-tumor effect of fluorouracil-related drugs was
      independent of the TdR-Pase activity.

PMID- 11205263
TI  - Cytotoxic activity of polyprenylalcohols and vitamin K2 derivatives.
AB  - Cytotoxic activity of 9 polyprenylalcohols and 6 vitamin K2 derivatives (MK-1 to
      MK-6) with various lengths of prenyl units was investigated. Among these
      compounds, geranylgeraniol with 4 prenyl units, and MK-2 with 2 prenyl units,
      showed the highest cytotoxic activity against human oral tumor cell lines (HSC-2,
      HSG), without induction of internucleosomal DNA fragmentation. Higher molecular
      weight compounds showed selective cytotoxicity against tumor cell lines than
      normal human gingival fibroblasts HGF. ESR spectroscopy showed that all
      polyprenylalcohols did not produce radical, nor scavenged O2- generated by
      hypoxanthine and xanthine oxidase reaction, and only slightly enhanced the
      radical intensity of sodium ascorbate. Vitamin K2 derivatives scavenged O2- more
      efficiently, but did not produce radical (except MK-3) and only slightly modified
      the ascorbate radical intensity. Cytotoxic activity of these compounds might be
      affected by the molecular weight, hydrophobicity, van der Waals area and
      stabilization of hydration of the molecule.

PMID- 11205265
TI  - Overexpression of p27 protein in human breast cancer correlates with in vitro
      resistance to doxorubicin and mitomycin C.
AB  - BACKGROUND: The cycle regulatory protein p27, an inhibitor of cyclin-dependent
      kinase (CDK), has been attributed a role in resistance to cancer chemotherapy.
      However, the predictive value of p27 for chemosensitivity of breast cancer is
      still unclear. We therefore analyzed the in vitro chemosensitivity to a series of
      anticancer agents in fresh breast cancer specimens and correlated it with the
      respective expression levels of p27. MATERIALS AND METHODS: The expression of p27
      protein was examined immunohistochemically in 119 patients with primary breast
      cancer. The in vitro chemosensitivity was assessed by the histoculture drug
      response assay (HDRA) using mitomycin C (MMC), 5-fluorouracil (5-Fu), Doxorubicin
      (DXR), cisplatin (CDDP) and cyclophosphamide (CPA). RESULTS: Fifty-six (47%) of
      the 119 patients demonstrated p27 overexpression. The susceptibility of DXR and
      MMC in tumors with high p27 expression was significantly higher than that in
      tumors with low p27 expression. CONCLUSION: Immunohistochemical results regarding
      p27 might be therapeutically useful as an indicator of response to DXR and/or MMC
      based adjuvant chemotherapy for breast cancer.

PMID- 11205266
TI  - Biological activity of feijoa peel extracts.
AB  - Fractionated extracts of Feijoa peels were studied for cytotoxic activity, anti
      human immunodeficiency virus (HIV) activity and antibacterial activity. Two most
      cytotoxic fractions A3 of acetone extract and M2 of methanol extract had potent
      inhibitory activity against Gram-positive and Gram-negative bacteria as well as
      fungi tested. Fraction A4 of acetone extract showed multidrug resistance (MDR)
      reversal activity comparable with that of verapamil (positive control). These
      results indicate the therapeutic value of Feijoa peel extracts as potential
      antimicrobial and MDR-modulating agents.

PMID- 11205267
TI  - Inhibition of invasion and lymph node metastasis of gastrointestinal cancer cells
      by R-94138, a matrix metalloproteinase inhibitor.
AB  - BACKGROUND: MMPs have been implicated in the process of metastasis. Matlystatin
      analogue, called R-94138, isolated from Actinomadura atramentaria, has been
      reported to inhibit the activity of MMP-2 and -9 specifically. In this study, we
      investigated the effect of R-94138 on the invasive and lymphnodal metastatic
      ability of gastric cancer cells. MATERIALS AND METHODS: Three gastric cancer cell
      lines, MKN-28, MKN-45, MKN-74, and two colorectal cancer cell lines, HT-29, and
      LS174T were used. The invasion ability of these cell lines were assayed with R
      94138 at the required concentration in vitro. The In vivo effect of R-94138 on
      lymphnode metastasis was examined passaged by orthotopic implantation. RESULTS:
      All cell lines revealed activity of both 72 and 92 kDa forms of MMPs by gelatin
      zymography. R-94138 significantly inhibited the invasiveness of all of these
      cells to the extracellular matrix. The number of lymph node metastases and the
      amount of body weight loss were significantly decreased by intraperitoneal
      administration of R-94138. CONCLUSION: MMP inhibitor, R-94138, has a possible
      application in adjunctive therapy for lymph node metastasis in gastric carcinoma.

PMID- 11205268
TI  - Quercetin-induced apoptosis in the monoblastoid cell line U937 in vitro and the
      regulation of heat shock proteins expression.
AB  - Quercetin, a widely distributed plant flavonoid, inhibits the growth of tumor
      cells and the expression of heat shock proteins. In this study, we examined
      quercetin-induced apoptosis of U937 cells in vitro and the regulation of heat
      shock proteins expression. The quercetin-induced apoptosis was demonstrated to be
      dose- and time-dependent. Flow cytometry analysis revealed that sub-G1 peak
      appeared at 12 hours, 24 hours and 48 hours respectively when treated with 50 mM
      of quercetin and at 6 hours, 12 hours, 24 hours and 48 hours with 100 mM of
      quercetin. Agarose gel electrophoresis demonstrated a typical ladder-like pattern
      of DNA fragments in the same time intervals with 50 mM of quercetin and at 6
      hours only with 100 mM of quercetin. The distribution of DNA contents showed that
      U937 cells were accumulated mainly at G2/M phase when incubated with 50 mM of
      quercetin for 24 hours and 48 hours. There was no specific effect on cell cycle
      distribution at 100 mM of quercetin. On exposure to 100 mM of quercetin, the
      inhibition of hsp27 and hsp70 expression was observed from 12 hours to 48 hours
      and 6 hours to 48 hours respectively. The inhibition of hsp90 expression was not
      found eiyher at 50 mM or 100 mM of quercetin exposure. When incubated with 50 mM
      of quercetin, there was no inhibitory effect on hsp27, hsp70 and hsp90 expression
      by the Western blot analysis. These results suggested that it is dependent on the
      dose and exposure time of quercetin to induce apoptosis of U937 cells in vitro,
      to affect the cell cycle distribution and to regulate the expression of hsp27 and
      hsp70.

PMID- 11205269
TI  - Failure of detection of the tyrosine to histidine substitution at the residue 33
      of thymidylate synthase in human colorectal cancer. A preliminary study.
AB  - Structural changes in the macromolecular targets of pharmacological agents can
      result in alterations in the efficacy of these agents. In previous studies Berger
      et al. (1) identified a variant structural form of thymidylate synthase (TS) that
      is associated with relative resistance to 5-fluoro-2'-deoxyuridine, in a human
      colonic tumor cell line. They observed that expression of the variant TS, which
      differs from the normal form by a tyrosine to histidine substitution at residue
      33, confers a 4-fold level of drug resistance in mammalian cells, as well as in
      bacteria. Now we report on the use of RT-PCR techniques to see if that variant TS
      form could be present in human samples from patients who underwent surgery for
      primary colorectal cancer and been previously untreated and to try to find
      relationships between that hypothetical variant TS form and the 5-Fluorouracil
      treatment. The possible role of Tyr-33 in 5-fluoropyrimidine-mediated inhibition
      of TS is discussed.

PMID- 11205270
TI  - The prognostic significance of autoantibodies against dsDNA in patients with
      colorectal adenocarcinoma.
AB  - BACKGROUND: The tumors of the gastrointestinal system have been associated with
      various immune disorders. The goal of this study was to correlate the presence of
      the anti-dsDNA autoantibodies in the serum of patients with colorectal
      adenocarcinoma suffering from the prognosis of their disease. PATIENTS AND
      METHODS: We investigated 55 patients with colorectal adenocarcinoma, 26 patients
      with benign surgical disease and 40 healthy volunteers for the presence of anti
      dsDNA autoantibodies pre-operatively and one month post-operatively, with an
      ELISA technique. RESULTS: The difference of prevalence of anti-dsDNA antibodies
      between the group of cancer patients and the two control groups was statistically
      significant (p < 0.001). After a 3-year follow-up, the difference of incidence of
      the recurrences between the positive and the negative group for anti-dsDNA
      autoantibodies of the CA patients was statistically significant (P < 0.01).
      CONCLUSION: The presence of anti-dsDNA autoantibodies in patients with colorectal
      cancer indicated a better outcome of the course of the disease.

PMID- 11205271
TI  - N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride) (W-7) causes
      increases in intracellular free Ca2+ levels in bladder female transitional
      carcinoma (BFTC) cells.
AB  - The effect of N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride)
      (W-7), a widely used calmodulin inhibitor, on intracellular free Ca2+ levels
      ([Ca2+]i) in bladder female transitional cancer (BFTC) cells was examined using
      fura-2 as a Ca2+ dye. W-7 (10-1000 microM) caused an increase in [Ca2+]i in a
      concentration-dependent manner with an EC50 of 75 microM. The [Ca2+]i response
      was composed of an initial rise and a sustained plateau without significant
      decaying during the measurement of 250 seconds. Extracellular Ca2+ removal
      dramatically decreased the Ca2+ signals by 50-90%. W-7 (100 microM) failed to
      induce a [Ca2+]i increase in Ca(2+)-free medium after pretreatment with
      thapsigargin (1 microM), an endoplasmic reticulum Ca2+ pump inhibitor;
      conversely, W-7 pretreatment abolished the Ca2+ release induced by thapsigargin.
      Addition of 3 mM Ca2+ increased [Ca2+]i after preincubation with 100 microM W-7
      in Ca(2+)-free medium. W-7-induced Ca2+ release was not altered by inhibiting
      phospholipase C with 2 microM 1-(6-((17b-3-methoxyestra-1,3,5 (10)-trien-17
      yl)amino)hexyl)-1H-pyrrole-2,5-dione) (U73122). Together, this study shows that W
      7 caused [Ca2+]i increases in human bladder cancer cells by releasing
      intracellular Ca2+ from the endoplasmic reticulum and also by causing
      extracellular Ca2+ influx with the later playing a dominant role. The W-7-induced
      intracellular Ca2+ release was uncoupled to a prior elevation in intracellular
      levels of inositol 1,4,5-trisphosphate (IP3).

PMID- 11205272
TI  - Retinoic acid modulates stem cell factor secretion by human neuroblastoma cell
      lines.
AB  - The hemopoietin stem cell factor (SCF) and its receptor c-kit are expressed in
      some tumoral cells, including neuroblastoma (NB) cells. We have investigated the
      effect of retinoic acid (RA), one of the most active differentiating agents on
      human NB cells, on the SCF production by human neuroblastoma cell lines. SCF
      concentration was determined by immunoenzymatic assay in the supernatants of
      seven neuroblastoma cell lines. All cell lines except one showed detectable
      amounts of SCF in the supernatant in basal culture conditions. A progressive
      increase pattern of the SCF concentration over time, was common to all SCF
      secreting cell lines, both unstimulated and RA-stimulated. Moreover, after 48 and
      72 hours-exposure to RA, SCF concentrations were higher than in the untreated
      controls (p < 0.01). Membrane SCF mRNA isoform was also detected by reverse
      transcription polymerase chain reaction. These effects demonstrated that RA,
      besides inducing neuronal differentiation, enhanced SCF production in
      neuroblastoma cell lines.

PMID- 11205273
TI  - Culture conditions modulate cell phenotype and cause selection of subpopulations
      in PC3 prostate cancer cell line.
AB  - PC3 cell line contains different cell variants. A first variant grows as
      spherical multicellular aggregates and shows anchorage-independent growth. A
      second variant grows as single small rounds and shows anchorage-dependent growth
      without cell spreading. A third variant, representing the most abundant
      population, grows as adherent cells. These populations differ in alpha 2 beta 1
      and alpha 3 beta 1 integrin expression with low levels in the suspended (S)
      cells, intermediate in partially adherent (R) cells and high in adherent cells
      (A). TPA, which up-regulates the expression of beta 1 integrins, increases
      invasiveness of cells. In addition, PC3 variants differ in MMP9 and uPA secretion
      and activity. High levels of TIMP1 and PAI1 present in S variant reduce MMP9 and
      uPA activities, respectively. In conclusion, PC3 cell line shows variants with
      strong phenotypic heterogeneity reflecting also the in vitro culture condition.
      Our observations may explain some of the contradictions in the literature.
      Therefore, the data obtained with this line should be evaluated more carefully,
      considering morphological and functional characteristics of the possible variants
      in the cell population. However, this heterogeneity may represent a good model in
      the study of tumor progression.

PMID- 11205275
TI  - The constitutive production of colony stimulating factor 1 by invasive human
      breast cancer cells.
AB  - Colony Stimulating Factor 1 (CSF-1) and its receptor, the c-fms proto-oncogene
      product, are expressed in normal and malignant tissues. The many actions of CSF-1
      include induction of urokinase-type plasminogen activator (uPA), a serine
      protease involved in extracellular matrix degradation. To explore the role of CSF
      1 in breast cancer progression, we evaluated the expression of CSF-1, c fms, and
      uPA in human breast cancer cell lines well-characterized for differing degrees of
      invasive, metastatic capability. The more invasive cell lines expressed elevated
      levels of CSF-1 by Northern analysis and ELISA. Increased uPA expression was
      noted in these same cell lines. CSF-1 receptor mRNA transcripts and protein were
      demonstrable in the different cell lines. These data suggest a role for CSF-1 in
      the autocrine and paracrine regulation of tumor progression in breast cancer.

PMID- 11205274
TI  - Modulation of molecular marker expression by induction chemotherapy in locally
      advanced breast cancer: correlation with the response to therapy and the
      expression of MDR1 and LRP.
AB  - PURPOSE: To assess if molecular markers are able to predict the response to
      induction chemotherapy in locally advanced breast cancer, and if any variation in
      their expression is associated with the degree of axillary lymph node invasion.
      METHODS: Between 1995 and 1999, 48 patients with locally advanced breast cancer
      were submitted to induction chemotherapy at Fundacion Tejerina--Centro de
      Patologia de la Mama, Madrid, Spain. The patients carried either tumors larger
      than 5 cm in diameter with clinically positive axillary nodes, T4a or T4b tumors
      regardless of size, or inflammatory carcinomas. All received between 3 and 6
      cycles of CAF standard polychemotherapy (Cyclophosphamide, Doxorubicin and 5
      Fluorouracil) with the exception of one patient, who received CMF therapy
      (Cyclophosphamide, Methotrexate and 5-Fluorouracil), and another one, who
      received Taxotere-Doxorubicin. After completion of their induction chemotherapy
      scheme, 1 patient showed a "complete clinical response" (CCR, with disappearance
      of all clinical and radiological signs of tumor presence), 36 (75.0%) patients
      showed a "partial response" (PR, > 50%), 10 (20.8%) showed "no response" (NR, <
      50%), and finally one progressed under treatment. Core biopsies were performed in
      all cases prior to treatment for histological diagnosis which allowed for the
      determination of the following parameters by means of immunohistochemistry:
      hormone receptors (ER and PR), oncogenes and tumor suppressor genes (c-erb-B2 and
      p53) and the proliferation marker Ki67. Initial tumor size, histologic and
      nuclear grade and histologic variety were also included as variables of the
      study. After chemotherapy, 37 patients were submitted to a rescue mastectomy at
      our center. The same aforementioned parameters were determined once again on the
      operative specimen, together with MDR1 expression (using two different
      antibodies) and LRP expression. As outcome variables, objective response to
      treatment and the presence of invaded axillary nodes were considered. RESULTS:
      Only the expression of the proliferation-associated Ki67 antigen, as well as
      nuclear grade were affected significantly (p < 0.05) by the previous
      chemotherapeutic treatment. All other studied parameters showed no significant
      change in expression. More disappointingly, even, none of the studied variables
      showed any significant power for predicting either an objective response to
      treatment, or the presence of invaded axillary nodes at surgery. Both outcome end
      points were also unrelated to each other. Overexpression of the multidrug
      resistance gene or the LRP gene, finally, showed no correlation whatsoever with
      the previous response to chemotherapy. CONCLUSION: According to these results,
      the parameters employed by us are of no practical use for predicting the response
      to treatment or the presence of invaded nodes at rescue surgery in locally
      advanced breast cancer. Clinical and surgical assessment remain thus the mainstay
      of treatment for this group of patients.

PMID- 11205276
TI  - Encapsulation of vinblastine into new liposome formulations prepared from
      triticum (wheat germ) lipids and its activity against human leukemic cell lines.
AB  - Liposomes prepared from lipids isolated from Triticum sp. (wheat germ) were used
      to investigate the percentage of Vinblastine encapsulation and its retention into
      liposomes. The wheat germ total lipids (TL) were extracted by the Bligh-Dyer
      method and the lipid classes have been isolated using chromatographic techniques.
      The type of lipids and their percentage content have been examined by TLC coupled
      with an FID (latroscan). Two liposomal formulations, i.e., I and II, with
      encapsulated vinblastine, and formulation III (empty liposomes) have been
      prepared by thin film hydration method. The cytotoxic/cytostatic activity of
      these liposomal formulations have been examined against nine human leukemic cell
      lines. The results showed that the percentage content of vinblastine into
      liposomes I and II depended on the lipid composition and it was greater into
      formulation II (> 90%). The retention of the drug into liposomes was studied and
      found to be time-dependent at 37 degrees C. For the cytotoxic/cytostatic
      activity, the parameters GI50, TGI, LC50 were estimated according to the
      instructions given by the NCI. The results show that formulation III (empty
      liposomes), exhibited a growth inhibiting activity, against the most tested cell
      lines. Formulation II showed mean of LC50 at 124.6 nM, mean of TGI at 71.6 nM and
      mean of GI50 at 30.8 nM.

PMID- 11205277
TI  - Antiproliferative and anticarcinogenic effects of an aqueous preparation of Abies
      alba and Viscum album se abies, on a L-1210 malignant cell line and tumor-bearing
      Wistar rats.
AB  - Extracts of plants have been widely tested for possible anticarcinogenic
      properties. In the present study a traditional remedy, consisting of an aqueous
      extract of mixed parts of the tree Abies alba and its mistletoe Viscum album se
      abies was tested on benzo(alpha)pyrene(BaP)-induced tumors in Wistar rats and on
      the L-1210 malignant cell line. Two main groups of male Wistar rats
      subcutaneously injected by 10 mg of BaP, a dose inducing 100% carcinogenesis, a
      control group (C-G, 15 rats) and a treatment group(TR-G, 18 rats), were used for
      the study. Five animals bearing BaP-induced tumors were also tested (TR-1-G).
      Animals of the TR-G were orally administered with the aqueous extract at doses of
      50 ml/kg b.w, from the day of BaP injection and of the TR-1-G, from the 120th day
      of injection, till death. L-1210 malignant cells in cultivation, were
      administered with a powder obtained by condensation and lyophilization of the
      extract, at various concentrations and cytotoxicity was measured by the
      microculture tetrazolium assay. Autopsy of the rats, revealed metastasis in the
      lungs of the animals of all groups and the tumors developed were histologically
      identified as leiomyosarcomas. The results indicated that the extract of the
      above plants possess anticarcinogenic effects, documented by: a) its
      antiproliferative effects on L-1210 cells (IC50 = 49.6 +/- 1.4 micrograms/ml), b)
      the significant prolongation of life and reduction of tumor growth rate of the
      animals of the TR-G in comparison to the C-G, c) the inhibition by 16.6% of tumor
      induction in the TR-G and d) the prolongation of life and the necrotic effects of
      the extract on the tumors of the animals in the TR-1-G. The antiproliferative
      effects of the Abies alba and Viscum album se abies extract may be due to the
      lectins and thionins contained in Viscum album, as well as to the monoterpenes
      contained in Abies alba. Soft tissue tumors sensitive to the extract, are
      widespread among human organs, even in larynx, and are usually resistant to
      chemotherapy.

PMID- 11205278
TI  - Induction of estradiol synthesis by probucol in the adenocarcinoma cells of an
      ovarian clear cell tumor.
AB  - BACKGROUND: Clear cell tumor of Mullerian organs have characteristic
      intracellular structures with numerous small mitochondria, free ribosomes,
      lamellae of granular endoplasmic reticulum and intracytoplasmic glycogen
      granules, but synthesize no estrogens under ordinary conditions. MATERIALS AND
      METHODS: Cells from an ovarian clear cell tumor cultured with 10 micrograms/ml of
      the antioxidant probucol released more estradiol into the medium than cells
      cultured without probucol. Immunocytological analysis revealed the predominance
      of estradiol in the adenocarcinoma cells cultured with probucol. RESULTS: There
      was no difference in the distribution of low-density lipoprotein receptors in
      adenocarcinoma cells according to whether they had been cultured with or without
      probucol. Cytochemical analysis showed that hydroxylation of estrone was
      accelerated in the adenocarcinoma cells cultured with probucol as compared to the
      cells cultured without probucol. CONCLUSION: Probucol is thought to have an
      unknown function in the acceleration of hydroxylation of steroids in some types
      of cells with estrogen-producing potential.

PMID- 11205279
TI  - Oolong tea polyphenol extract induces apoptosis in human stomach cancer cells.
AB  - The exposure of human stomach cancer KATO III cells to oolong tea polyphenol
      extact [OTPE] containing oolong tea polyphenol trimer [OTP trimer] as a main
      component, led to both growth inhibition and the induction of apoptosis.
      Morphological change showing apoptotic bodies was observed in the cells treated
      with OTPE. The fragmentation by OTPE of DNA to oligonucleosomalsized fragments
      that are characteristics of apoptosis was observed to be concentration- and time
      dependent. These data suggest that the growth inhibition by OTPE results from the
      induction of apoptosis in the KATO III cells.

PMID- 11205280
TI  - Metallothionein expression prevents apoptosis. II: Evaluation of the role of
      metallothionein expression on the chemotherapy-induced apoptosis during the
      treatment of acute leukemia.
AB  - Metallothioneins (MT) are low molecular weight cysteine-rich proteins, present in
      a wide variety of eukaryotes. Although their physiological function is not
      entirely understood, recently it was found that in vitro human MTs (hMTs)
      expression prevents apoptosis. In the present study, the apoptosis preventing
      effect of hMTs is evaluated in vivo, in order to correlate the apoptotic effect
      of chemotherapy during the treatment of acute leukemia with the expression of
      hMTs. The expression of hMTs was studied immunocytochemically in bone marrow
      smears and peripheral blood cytocentrifugations of 47 children with acute
      leukemia at diagnosis and during treatment. Apoptosis was quantitatively studied
      in peripheral blood samples during the induction therapy. Eighteen cases were
      found to be positive for hMTs expression at diagnosis and the mean apoptosis
      curve of these cases showed maximal effect on the second day of treatment, the
      apoptotic action of chemotherapy being completed on the tenth day. The mean
      apoptosis curve of the hMTs negative cases (29 cases) showed maximal effect on
      the first day of treatment and the apoptotic action of chemotherapy was completed
      on the sixth day. When considering the day on which the maximal apoptotic effect
      appeared and the day on which the apoptotic action of treatment was completed,
      the results indicated retardation of the chemotherapy-induced apoptosis dependent
      on hMTs expression, as a result of resistance to treatment. Furthermore, the
      study of hMTs expression during treatment, showed that although the apoptotic
      action of chemotherapy eliminates blast cells, a cell population positive for
      hMTs survived and increased during treatment, since they were able to escape
      apoptotic cell death. These findings, indicated that in vivo, hMTs constitute a
      cellular protective mechanism preventing chemotherapy-induced apoptosis, thus
      regulating the response of patients to treatment.

PMID- 11205281
TI  - Prognostic significance of TGF beta 1 and TGF beta 3 in human breast carcinoma.
AB  - Transforming growth factor beta s (TGF beta s) are multifunctional growth factors
      which show differential expression both temporally and spatially and exert
      pleiotropic effects during carcinogenesis. Although all three mammalian isoforms
      of TGF beta share considerable sequence similarity, they appear to have distinct
      functions in health and disease, such as embryogenesis, wound healing and
      tumourigenesis. Much of our knowledge about the relationship between TGF beta s
      and breast cancer is based on publications on TGF beta 1 but the role of TGF beta
      3 in the progression of breast cancer has not been well documented. In the
      present study, the expression of TGF beta 1 and TGF beta 3 was assessed by
      immunohistochemistry. Of the 153 invasive breast cancer tissues, TGF beta 1 was
      expressed strongly in 25 and moderately in 98 cases. The immunoreactivity of TGF
      beta 3 was comparable with TGF beta 1, which was expressed strongly in 21 and
      moderately in 104 cases. The two isoforms were coexpressed in 111 (72.5%) tumours
      and were absent in 16 cases (10%). Immunostaining for TGFb3 but not TGF beta 1
      was inversely correlated with overall survival (p = 0.0204). When combined with
      lymph node involvement, TGFb3 became an even more significant prognostic factor
      for overall survival (p = 0.0003), i.e. patients with node metastasis and
      positive TGFb3 expression had a worse prognosis: the risk of death for these
      patients was thirteen-fold greater than those who had no node involvement. The
      fact that it has been reported previously that high TGF beta 3 plasma levels in
      patients with untreated early stage breast cancer were correlated with subsequent
      lymph node metastasis and it was observed in the present study too, that TGF beta
      3 expression in breast tumours was an independent predictor of overall survival,
      led us to suggest that the simultaneous measurement of TGF beta 3 in plasma and
      its expression in resected tumour tissues in the same cohort of patients may
      prove to be an important parameter in assessing tumour progression.

PMID- 11205282
TI  - Telomerase inhibitors.
AB  - Telomerase is attracting great interest as a target for anticancer research
      because telomerase activity is present in most malignant cells, but undetectable
      in most normal somatic cells. The antisense approach has been widely exploited
      and directed to telomerase RNA, chiefly the template region. Ribozymes have been
      less investigated. Agents that stabilize folded G-quadruplex structures also
      inhibit telomerase. Inhibitory agents from many chemical classes have been
      identified, many through screening, but their specificity of action is in doubt.
      A specific inhibitor is expected to immediately inhibit activity but not cell
      division, produce telomerase shortening over multiple generations, and ultimately
      produce end-to-end chromosomal fusion and growth arrest.

PMID- 11205283
TI  - Structure activity relationship of antiproliferative N-acyl-beta-alanine amides.
AB  - Starting from the antiproliferative N-homofarnesoyl-beta-alanine amide 1 as a
      lead structure we have demonstrated that the homofarnesoyl residue of 1 can be
      replaced by several aliphatic and aromatic acyl moieties which offer advantages
      in terms of availability and stability over the original homofarnesoyl residue.
      The N-(2,3-dimethylphenyl) aminosulfonylphenyl moiety of 1 turned out to be
      essential for antiproliferative activity and cannot be replaced without complete
      loss of activity.

PMID- 11205284
TI  - Rational design of platinum chemotherapeutic drugs: hydrophobicity increases
      cytotoxicity.
AB  - BACKGROUND: Malignant glioma are often resistant to cisplatin. Numerous chemical
      modifications have been made to overcome this limitation. Analyzing such novel
      compounds, we previously hypothesized, that hydrophobicity improves the
      cytotoxicity of NH3 substituted platinum agents. MATERIALS AND METHODS: Testing
      this hypothesis, we synthesized further eight novel platinum agents, substituting
      the NH3 groups with various pyridyl ring systems. The cytotoxicity was measured
      in MTT tests using the cisplatin resistant human U25 1 malignant glioma cell line
      as a model. Solubility was measured in water using flameless atomic absorption
      spectroscopy. RESULTS: Cytotoxicity correlated significantly with low water
      solubility. The relation of cells surviving 72-hours of 1 OuM drug exposure was
      best described by a logarithmic formula: Surviving cells (% of control) = 6.4 +
      38.4 log (water solubility in mg Pt/L) Adding an oximgroup to the aromatic
      substitute decreased cytotoxicity. CONCLUSIONS: These data confirmed that
      increased hydophobicity increases cytotoxicity in this group. This might be
      caused by better cellular penetration, or by shielding of DNA-adducts from repair
      processes. The data created a further hypothesis: A positive mesomeric effect as
      characteristic for the oxim-group might decrease DNA binding, a negative
      mesomeric might improve it.

PMID- 11205285
TI  - Aspirin enhances multidrug resistance gene 1 expression in human Molt-4 T
      lymphoma cells.
AB  - BACKGROUND: We recently found that aspirin induces the expression of P
      glycoprotein (P-gp), a protein mediating drug resistance, in human prostate
      cancer cells. The purpose of this study was to evaluate the effect of aspirin on
      the expression of P-gp in a different human cancer type, i.e., T lymphoma.
      Furthermore, we analyzed this effect at the level of the gene encoding P-gp,
      MDR1, and of the transcription factor (NF-IL6), regulating this gene. MATERIALS
      AND METHODS: NF-IL6 was assayed by the electrophoretic mobility shift assay, MDR1
      mRNA was assayed by the reverse transcriptase polymerase chain reaction (RT-PCR),
      and P-gp was assayed by Western blotting. RESULTS: aspirin, at plasma attainable
      levels, induced NF-IL6 DNA-binding activity, and increased MDR1 mRNA expression
      (by up to 140%), as well as the expression of P-gp, in Molt-4 cells. CONCLUSIONS:
      This study suggests that treatment with aspirin induces a cellular signal
      culminating in the enhancement of P-gp expression in T lymphoma Molt-4 cells.

PMID- 11205286
TI  - Interferon-gamma increases IL-6 production in human glioblastoma cell lines.
AB  - BACKGROUND: Various immunotherapeutical approaches are presently evaluated for
      their efficacy to eradicate glioma cells. Complicating the concepts, these tumors
      secrete cytokines which modulate the immune response. MATERIALS & METHODS: We
      analyzed the influence of interferon gamma (IFN-gamma) on the cytokine production
      and IFN-gamma receptor expression in T98G and U87-MG human glioma cells. RESULTS:
      The IFN-gamma receptors were own-regulated after IFN-gamma treatment. Secretion
      of interleukin-6 (IL-6) protein was elevated by factors of 6.4 in T98G cells and
      5.2 in U87-MG. Other cytokines were increased as well, but less constantly: IL-8,
      and VEGF were elevated significantly only in T98G, but not in U87-MG. Increases
      of IL-1 beta, IL-1 alpha and TGF beta-2 were only detectable at the mRNA level.
      TNF was not detectable in any of the cell lines, and TGF-beta, alpha FGF and HG
      were not influenced by IFN-gamma. CONCLUSION: IL-6 produced by glioma cells in
      response to IFN-gamma might support immune eradication of glioma cells.

PMID- 11205287
TI  - Mapping of genetic deletions on the long arm of chromosome 22 in human pancreatic
      adenocarcinomas.
AB  - The molecular mechanisms of carcinogenesis in pancreatic cancer are still poorly
      understood, although the inactivation of tumor suppressor genes at multiple loci
      is suspected. We investigated the loss of heterozygosity (LOH) on chromosome 22
      in pancreatic cancer by means of a PCR-based microsatellite analysis of archival
      paraffin-embedded histological sections in order to better define deleted
      region(s) and to test whether the NF-2 gene is involved. Using a panel of
      thirteen markers that spanned the long arm of chromosome 22, loss of
      heterozygosity was identified for at least one locus in 37% of investigated
      pancreatic adenocarcinomas. These deletions are clustered into two separate areas
      of the chromosome 22--one proximal to the NF-2 gene and one distal. The NF-2 gene
      itself is not involved. These regions are likely locations of tumor suppressor
      genes that may contribute to the development of pancreatic cancer.

PMID- 11205288
TI  - Heat shock protein expression in human gliomas.
AB  - BACKGROUND: Heat shock proteins (HSP) are cytoprotective, antiapoptotic proteins
      which may predict clinical prognosis in various types of cancer. Here, we asked
      whether the differential response to radiochemotherapy and different overall
      prognosis for astrocytic and oligodendroglial tumours can be accounted for by
      differences in HSP expression. MATERIAL AND METHODS: We examined aB-crystallin,
      HSP27, HSP70, HSC70 (HSP73) and HSP90 expression in 44 human gliomas (5
      anaplastic and 5 low-grade astrocytomas, 5 anaplastic and 5 low-grade
      oligodendrogliomas and 24 glioblastomas) by immunohistochemistry. RESULTS: HSP
      were expressed in the tumour parenchyma of all high-grade and most low-grade
      gliomas, including oligodendrogliomas. Endothelial cells were more often positive
      for HSC70 and HSP90, but more often negative for HSP27, in glioblastomas than in
      the other tumours. HSP were also observed in macrophages/microglial cells, but
      not in a tumour-specific pattern. CONCLUSION: Different patterns of HSP
      expression seem not to account for the differential response of these tumours to
      adjuvant cytotoxic therapy.

PMID- 11205289
TI  - Restoration of wild-type p53 activity enhances the sensitivity of pleural
      metastasis to cisplatin through an apoptotic mechanism.
AB  - We attempted to develop a new strategy of gene transfer in human metastatic cells
      avoiding viral vectors. We demonstrated the feasibility of the nlsLacZ gene
      liposome (DOTAP) complex transfection in lung cancer cell lines H358 and Calu-1
      carrying homozygous deletion of p53 and in primary cultures of human pleural
      metastatic tumor cells (n = 10). The efficiency of transfection in pleural cells
      was high with a mean of 78 +/- 22% (range 40-100%) compared to H358 (30%) and
      Calu-1 cells (50%). In this study, we report that growth of pC53-SN3-transfected
      Calu-1 and pleural metastatic cells was greatly suppressed whereas neither
      liposomes or Neo-gene affected cells growth. We tempted to determine whether
      restoration of wtp53 increased the chemosensitivity of cells that normally lack
      p53 expression. The pC53-SN3 transfected cells (H358 and Calu-1) were more
      sensitive to CDDP than the parental cells by 14 and 1.2 fold, respectively. In
      addition, the sensitization ratio due to the transfection of wtp53 in pleural
      cells (n = 6) varied from 1.2 to 6 fold. This sensitization remained even 21 days
      after transfection and was accompanied by increase of p53 positive cells and of
      the proportion of apoptotic bodies. In conclusion our results suggested that
      DOTAP is an efficient vector for mediating gene transfer in pleural metastatic
      cells offering advantages compared to viral vectors, while tumor suppressor genes
      such as p53 may be good candidates in combination with conventional therapy with
      CDDP that could be further developed for their use in local cancer gene therapy.

PMID- 11205290
TI  - Thymic humoral factor-gamma 2 augments immune cell response and exerts antitumor
      activity in murine model systems.
AB  - The immunomodulatory and antimetastatic/antitumor activity of thymic humoral
      factor-gamma 2 (THF-gamma 2) was evaluated in BALB/c-mice. Daily subcutaneous
      applications (7 consecutive days, 20, 200 ng of THF-gamma 2 per injection/mouse)
      upregulated counts of thymocytes and peripheral blood cells in tumor bearing
      mice. To check the influence of THF-gamma 2 treatment on the growth of
      experimental metastases, RAW 117 H10 lymphosarcoma cells or L-1 sarcoma cells
      were intravenously inoculated into BALB/c-mice to establish liver or lung
      metastases, respectively. Local tumor growth was induced by subcutaneous
      injection of L-1 sarcoma cells. THF-gamma 2 was subcutaneously administered daily
      for 7 consecutive days starting 24 hrs after tumor cell challenge. Organ
      colonization as well as local tumor growth were investigated on day 14 after
      tumor cell inoculation and demonstrated a statistically significant (p < 0.05)
      reduction of experimental liver and lung metastases and local tumor growth for
      THF-gamma 2 treated mice.

PMID- 11205291
TI  - Up-regulation of cyclin B1 and cdc2 expression during 9-nitrocamptothecin-induced
      regression of DU145 prostate tumor.
AB  - BACKGROUND: We investigated changes in the content and subcellular localization
      of the cell cycle regulators, cyclin B1 and cyclin-dependent kinase cdc2, in
      human prostate DU145 tumor and cultured cells treated with the anticancer drug 9
      nitrocamptothecin (9NC). MATERIALS AND METHODS: Proteins of interest were
      identified by Western blot methodology using specific antibodies. RESULTS: The
      cyclin B1 and cdc2 contents were dramatically elevated in biopsies of DU145 tumor
      regressing upon 9NC-treatment. In vitro, 9NC-induced apoptosis of DU145 cells was
      associated with up-regulation of expression and nuclear accumulation of cyclin B1
      and cdc2. No changes were observed in cyclins A and E and the cyclin-dependent
      kinase cdk2 in 9NC-treated DU145 tumor and cultured cells. CONCLUSION: 9NC
      induced apoptosis in DU145 cells in vivo and in vitro is associated with up
      regulation of expression and nuclear localization of cyclin B1 and cdc2.

PMID- 11205292
TI  - In vitro screening of antitumour agents for cardiotoxicity by means of isolated
      mouse left atria.
AB  - Cardiotoxicity, a side-effect that can occur after treatment with an anticancer
      drug, has severe clinical implications. Therefore, a model is desired to screen
      new anticancer drugs or drug combinations for possible cardiotoxic side-effects.
      In the present study we tested the applicability of the electrically stimulated
      isolated mouse left atrium model using a wide range of anticancer drugs with
      known cardiotoxicity. It appeared that the cardiotoxicity observed in our model,
      i.e. the negative or positive inotropic effects of the drugs on the isolated
      atrium, corresponded with the observed cardiotoxicity in animals and/or humans.
      It is therefore concluded that our model can be used to wam for possible
      cardiotoxic side-effects of anticancer drugs in vivo.

PMID- 11205294
TI  - Treatment of metastatic hormone-refractory prostate adenocarcinoma (MatLyLu) in
      Copenhagen rats with micro-osmotic interleukin-2 pumps.
AB  - BACKGROUND: We studied the influence of interleukin-2 (IL-2) therapy on tumor
      growth and prevention of metastasis in metastatic, hormone-refractory prostatic
      carcinoma (PCa) in an animal model orthotopically (ortho) and subcutaneously
      (s.c.). MATERIALS AND METHODS: 75 juvenile male Copenhagen rats were divided into
      five groups of 15 rats each. MatLyLu-PCa (MLL) was implanted ortho (n = 30) in 2
      groups or s.c. (n = 30) in 2 groups and were treated locally at the tumor site
      with micro-osmotic pumps. The rats in 2 groups received IL-2 pumps with 36 x
      10(6) IU of IL-2 and the rats in 2 other groups were treated with pumps
      delivering albumin only as a control. The rats in the last group received ortho
      MLL and s.c. IL-2 (n = 15). Survival time was then monitored. RESULTS: Prostatic
      tumor was found in all ortho animals. Additionally lymphogenic and pulmonary
      metastasis was found in all animals. The orthotopic and s.c. IL-2-treated groups
      showed a statistically significantly increased survival compared with the
      orthotopic and s.c. albumin-treated groups. When treating the ortho MLL with s.c.
      IL-2 there was still a statistically significant longer survival than in the
      control groups. CONCLUSION: IL-2 therapy significantly reduces tumor growth of
      rats with metastatic, hormone-refractory prostatic cancer MatLyLu.

PMID- 11205293
TI  - An elevated serum level of transforming growth factor-beta 1 (TGF-beta 1)
      significantly correlated with lymph node metastasis and poor prognosis in
      patients with gastric carcinoma.
AB  - BACKGROUND: Overexpression of transforming growth factor beta s (TGF-beta s),
      multifunctional polypeptides, have been reported in the tissue of various types
      of carcinomas, including gastric carcinoma. To our knowledge, serum levels of TGF
      beta 1 have not previously been examined in patients with gastric carcinoma as a
      possible indicator of prognosis. METHODS: Preoperative serum levels of TGF-beta 1
      were measured in 111 patients with gastric carcinoma by an enzyme-linked
      immunosorbent assay. RESULTS: An elevated level of TGF-beta 1 was significantly
      correlated with lymph node metastasis and poor prognosis. Moreover, the
      preoperative serum levels of TGF-beta 1 in patients with peritoneal recurrence
      were significantly higher than those in patients both with lymph node recurrence
      and without recurrence. CONCLUSION: The serum level of TGF-beta 1 might be useful
      for predicting recurrence patterns and prognosis in patients with gastric
      carcinoma.

PMID- 11205295
TI  - Analysis of the DNA mismatch repair proteins expression in malignant melanomas.
AB  - The importance of properly functioning DNA mismatch repair has been shown in
      several tumour types both hereditary and sporadic, but not yet in malignant
      melanomas. The aim of this study was to examine the expression of DNA mismatch
      repair genes (MLH1, MSH2, PMS1 and PMS2) in primary melanomas and to define their
      possible prognostic impact in 106 primary melanomas. MLH1 was found in 64 and
      MSH2 in 61 out of 106 melanomas. PMS1 and PMS2 proteins were present in 69 and 67
      tumours, respectively. Loss of the expression of DNA mismatch repair proteins
      correlated with the increase of Clark levels. Cox regression analysis
      demonstrated some prognostic significance for PMS1 (forward p = 0.0018 and
      backward selections p = 0.0277), MLH1 (only forward selection p = 0.0081) and
      MSH2 (only backward selection p = 0.0115).

PMID- 11205297
TI  - Magnetic resonance spectroscopy and fluorescence microscopy to investigate mobile
      lipids in sensitive, resistant and reverting K562 cells and their membranes.
AB  - The erythroleukaemic K562 cell line and its adriamycin resistant counterpart were
      used to study resistance, its reversion and their consequences on the levels and
      localisation of lipids detected in proton nuclear magnetic resonance (NMR)
      spectra. On whole cells, the mobile lipids giving rise to a NMR signal were
      significantly decreased in the resistant cells when compared to the sensitive
      ones; these lipids recovered partially in the reverting cells. According to the
      spinlattice relaxation times (T1), the lipids detected appeared to be in a
      similar environment in sensitive and reverting cells. In membrane-enriched
      fractions, mobile lipid levels were not significantly different in the sensitive
      and reverting cell lines but decreased in resistant ones. Moreover, lipid
      droplets stained with a fluorescent Nile red lipophilic probe showed the presence
      of highly fluorescent particles in the samples in which NMR detected high levels
      of mobile lipids. These results suggest the participation of cytosolic lipid
      droplets in NMR signals in drug sensitive and reverting cells and open the
      question of the relative roles of these droplets and of the membrane lipids in
      the lipid metabolic pathways associated with drug resistance in cancer cells.

PMID- 11205296
TI  - Peritoneal mesothelial cells as a significant source of ascitic immunostimulatory
      protein 90K.
AB  - The tumor associated antigen 90K is known to possess cytokine-like modulatory
      properties on the cellular immune system, whereby accessory cells are the primary
      target of this molecule. In 67 ovarian cancer patients presenting with
      significant amounts of ascites, immunostimulatory protein 90K was detected in all
      ascitic fluid samples examined. Furthermore, 90K levels correlated to ascitic s
      IL-2R content. To elucidate the source of protein 90K in ascitic fluid; its in
      vitro release was investigated in primary cultured normal human peritoneal
      mesothelial cells (HPMC). Peritoneal mesothelium was found to produce five-fold
      more 90K than ovarian cancer cells. Release of protein 90K was significantly
      increased by treatment with IFN-gamma in both mesothelial and ovarian cancer
      cells. In contrast neither IL-1 beta nor TNF-alpha treatment consistently
      influenced the secretion of 90K in either cell type.

PMID- 11205298
TI  - Angiogenesis and vasodilation in skin warts. Association with HPV infection.
AB  - BACKGROUND: Angiogenesis is required for tumour growth. Since human
      papillomavirus (HPV) infection is associated with the development of neoplastic
      lesions, the aim of this study was to determine the possible association between
      HPV infection and angiogenesis in benign tumours. MATERIALS AND METHODS:
      Specimens of skin warts which were either negative for HPV types 1, 2, 3 and 4
      (HPV-ve; n = 15), or positive for HPV2 (HPV+ve; n = 19) were compared with normal
      skin (NS, n = 10). Vascularity and inflammation were assessed in consecutive
      sections. vWF-positive blood vessels were classified as small or large using a
      cut-off value of 50 microns diameter. RESULTS: Vascularity values for small
      vessels increased significantly from NS to HPV-ve warts and from HPV-ve to HPV+ve
      warts. Large vessels were found only in warts and their abundance was not related
      to HPV status. No significant association was found between vascularity and
      inflammation or between vascularity values for small and large vessels.
      CONCLUSIONS: The development of skin warts is accompanied by angiogenesis and
      vasodilation and these two processes may be independently regulated. Further
      increased angiogenesis, but not vasodilation, is associated with the presence of
      HPV type 2 DNA.

PMID- 11205299
TI  - TRAIL-R2 is not correlated with p53 status and is rarely mutated in non-small
      cell lung cancer.
AB  - BACKGROUND: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)
      receptors play an important role in regulating apoptosis. Recently, it was shown
      that the expression of TRAIL-R2, also known as KILLER, Trick or DR5, can be
      induced by either DNA damage or overexpression of a wild-type p53 transgene,
      suggesting a role for p53 in the death-signaling pathway. Furthermore, mutations
      in the death domain of TRAIL-R2 were reported in 10.6% of non-small cell lung
      cancer (NSCLC) patients in a Korean population, suggesting a role for TRAIL-R2 in
      lung tumorigenesis. MATERIALS AND METHODS: To determine the association between
      expression of TRAIL-R2 and p53 mutation status in lung cancers, we compared the
      two events in 20 small-cell lung cancer (SCLC) cell lines, 20 NSCLC cell lines,
      and 30 primary NSCLC tumors. We also sequenced the death domain of TRAIL-R2 in a
      total of 100 primary NSCLC. RESULTS: Lack of TRAIL-R2 expression was found in
      eight of 20 (40%) SCLC cell lines and in eleven of 20 (55%) NSCLC cell lines.
      Interestingly, in primary NSCLC, TRAIL-R2 was overexpressed in seven (23%) of the
      30 tumors tested, and all primary tumors expressed TRAIL-R2. No association was
      found between the expression status of TRAIL-R2 and p53 mutation status in
      primary NSCLC tumors, SCLC cell lines or NSCLC cell lines. Further analysis of
      the death domain of TRAIL-R2 failed to identify any mutation in 100 primary NSCLC
      tumors. CONCLUSIONS: Our data indicate that the expression profile of TRAIL-R2 is
      significantly different in lung cancer cell lines and primary tumors, that the
      expression of TRAIL-R2 is independent from p53 mutation status and that mutations
      in the death domain of TRAIL-R2 play a minimal role in NSCLCs in white Americans.

PMID- 11205300
TI  - Effect of amifostine on neuroblastoma during high dose chemotherapy: in vivo and
      in vitro investigations.
AB  - Amifostine (Ethyol, WR-2721) has been clinically used in combination with high
      dose therapy of neuroblastoma stage 4 with melphalan, carboplatin and VP-16 in 14
      patients. The amifostine group was compared to a historical control group of 24
      comparably-treated patients. There were no significant differences regarding the
      time of hematological recovery, the duration of hospitalization, the duration of
      antibiotic treatment and the extent of renal toxicity. However, in contrast to
      four patients of the control group, no patient in the amifostine group developed
      such severe mucositis that artificial ventilation became necessary. Pretreatment
      of neuroblastoma cell lines for 30 minutes with amifostine and the free thiol(WR
      1065) did not reduce the cytotoxic effects of melphalan, carboplatin and VP-16.
      Evidence was obtained that the uptake of the activated thiol could be achieved by
      a polyamine transporter. Taken together, the data do not support the use of
      amifostine in high dose chemotherapy of neuroblastoma prior to autologous stem
      cell transplantation. However, amifostine may be more effective in conventional
      neuroblastoma therapy where protection of bone marrow stem cells is necessary.

PMID- 11205301
TI  - SV40 sequences in human osteosarcoma of German origin.
AB  - Simian virus 40 (SV40) is a dsDNA polyomavirus that induces osteosarcomas and
      mesotheliomas in hamsters and transforms many types of cells in tissue culture,
      including human cells. Osteosarcoma is a bone malignancy with multiple molecular
      lesions underlining progression from normal bone to osteosarcoma. Recent
      investigations have identified SV40 DNA sequences in osteosarcomas, suggesting
      that SV40 may contribute to tumor development. However, these studies also
      demonstrated that geographical differences exist between SV40 and tumor
      association. Our study analyzed 46 frozen German tumor specimens (42
      osteosarcomas and 4 sarcomas initially suspected to be osteosarcomas) for the
      presence of SV40 DNA sequences by using PCR. Two different primer sets amplifying
      a 573 bp region of SV40 Tag gene with the complete intron sequence (SV.for
      2/SV.rev) and a 172 bp region with no intron sequence (SV.5/SV.6) were used. DNA
      sequencing analysis verified the results. No SV40 sequences could be detected
      using the primer set SV.for 2/SV.rev, while 2 out of 42 osteosarcoma specimens
      and 1 out of 4 poorly-differentiated tumor specimens contained SV40 sequences,
      using the primer set SV.5/SV.6. From one of these two positive osteosarcomas,
      multiple tumor biopsies taken at different times during the dissection, including
      metastasis, tested positive for SV40. These results indicated that in Germany,
      only rare osteosarcomas can be linked to SV40. These results support previous
      findings involving geographical differences in the presence of SV40. Finally, the
      specific detection of SV40 sequences with multiple specimens from one of the two
      patients and the absence of SV40 sequences in all other samples underscores the
      specificity and reproducibility of this investigation and ruled out PCR
      contamination.

PMID- 11205302
TI  - Effect of iron chelator, hydroxyl radical scavenger and cytochrome P450
      inhibitors on the cytotoxicity of cisplatin to tumor cells.
AB  - BACKGROUND: Iron catalyzed reactive oxygen metabolites (ROM) are important
      mediators in cisplatin (CP)-induced nephrotoxicity, and cytochrome P450 (CYP) is
      the major source of this iron. Iron chelators, hydroxyl radical scavengers and
      CYP inhibitors have shown marked protection. MATERIAL AND METHODS: This study was
      designed to determine whether these agents affect the tumoricidal efficacy of CP
      to LLC-WRC 256 tumor cells. RESULTS: CP was cytotoxic to the tumor cells in a
      dose and time dependent manner. Iron chelator, hydroxyl radical scavenger and CYP
      inhibitors did not reduce the cytotoxic effect of CP. Exposure of the tumor cells
      to CP did not increase the catalytic iron release and the generation of hydroxyl
      radical. Both CYP activity and content in the tumor cells were less than 10% of
      that in the rat liver. CONCLUSION: We speculate that iron chelator, hydroxyl
      radical scavenger and CYP inhibitors do not alter the antitumor efficacy of CP.

PMID- 11205303
TI  - The impact of expression of the metastasis suppressor protein KAI1 on prognosis
      in invasive squamous cell cervical cancer.
AB  - OBJECTIVES: Loss of KAI1 protein is a frequent event in various types of cancer
      and has been reported to be associated with increased rate of metastasis and
      shorter survival time. METHODS: Expression of KAI1 and p53 was
      immunohistochemically determined in 75 biopsy specimens from patients with
      primary irradiated, invasive squamous cell cervical cancer and 30 cases with CIN
      I-III. RESULTS: In invasive cancer, 22 cases showed strong expression, 42 cases
      down-regulation, and 11 cases no expression of KAI1. All specimens with CIN I
      showed strong KAI1 expression, while in CIN II and III down-regulation was
      observed in 45% of cases. There was no significant correlation of KAI1 expression
      with clinical and histopathological parameters. No influence of KAI1 expression
      on prognosis was observed. CONCLUSIONS: KAI1-down-regulation is a frequent event
      in cervical cancer occurring early in carcinogenesis. KAI1 expression did not
      influence the prognosis of patients with primary irradiated cervical cancer.

PMID- 11205304
TI  - Detection of DNA-strand breaks in cells treated with F 11782, a catalytic
      inhibitor of topoisomerases I and II.
AB  - F 11782, or 2", 3"-bis pentafluorophenoxyacetyl-4',6'-ethylidene-beta-D glucoside
      of 4'-phosphate-4'-dimethylepipodophyllotoxin 2N-methyl glucamine salt, is a
      novel fluorinated lipophylic epipodophylloid which has proven cytotoxic activity
      in vitro and has shown markedly superior antitumour activity in vivo compared to
      etoposide in various experimental tumour models. However, the precise
      mechanism(s) of cytotoxicity of F 11782 remains to be defined. In this study, the
      DNA damaging activity of F 11782 was investigated in GCT27 and C6S cells using,
      respectively the fluorescence enhancement assay and the technique of DNA alkaline
      elution. All the results obtained were consistent with induction of DNA damage by
      F 11782. No evidence of any stabilisation of DNA-topoisomerase cleavable
      complexes though was obtained with this catalytic inhibitor. Furthermore, such
      induction of DNA damage has not been reported with other known catalytic
      topoisomerase inhibitors and so it appears to be unique to F 11782.

PMID- 11205305
TI  - Cytostatic, cytotoxic and protein tyrosine kinase inhibitory activity of ursolic
      acid in A431 human tumor cells.
AB  - The effect of the tritepene, ursolic acid, on the proliferation of A431 human
      epidermoid carcinoma cells was studied. According to our investigations, ursolic
      acid is a potent inhibitor of A431 cell growth. Ursolic acid markedly reduced
      A431 cell growth in a time- and dose-dependent manner. We found a good
      correlation between the results of direct cell counting and the MTT test. During
      long periods of drug exposure, ursolic acid exhibited both cytotoxic and
      cytostatic activity. The effect was partially reversible on drug removal. The
      greatest cytotoxicity was observed both in the trypan blue test and in the MTT
      test at 50 mM. Investigations on tyrosine kinase inhibition were performed by
      biochemical and cellular assays on A431 cells. Ursolic acid inhibited tyrosine
      kinase activity of A431 cells in biochemical assay in a dose-dependent manner
      with an IC50 of 24 mM. In cellular assay, when A431 cells were pretreated with
      ursolic acid for 24, 48 and 168 hours at various concentrations (5, 10, 20, 30
      and 50 mM), lower values of IC50 were measured: 6.8 microM for 24 hours, 5.2 mM
      for 48 hours and 1.4 mM for 168 hours. The results suggest that ursolic acid
      exerts an antiproliferative effect through the inhibition of tyrosine kinase
      enzymes.

PMID- 11205306
TI  - Prognostic value of E-cadherin, beta-catenin, P120ctn in patients with
      transitional cell bladder cancer.
AB  - BACKGROUND: Loss of E-cadherin-catenin mediated adhesion is known to play a major
      role in tumour progression in many human carcinomas. MATERIALS AND METHODS: By
      means of immunohistochemistry, we have investigated the expression of E-cadherin,
      beta-catenin and p120ctn in 102 transitional cell bladder carcinomas (TCCs) and
      statistically analysed these expressions with known clinicopathological
      parameters and patient survival. RESULTS: Abnormal expression of E-cadherin, beta
      catenin and p120ctn was associated with high grade and high stage of TCCs (p <
      0.001). Abnormal beta-catenin expression demonstrated a statistically significant
      correlation with poor patient survival (p = 0.03) while abnormal E-cadherin
      expression was associated with poor survival in patients with muscle invasive
      TCCs (p = 0.025). However, in multivariate statistical analysis a suggestive
      association with poor survival was observed only for E-cadherin (p = 0.06).
      Simultaneous abnormal expression of all the molecules demonstrated an association
      of suggestive significance with poor patient survival (p = 0.07). CONCLUSION: E
      cadherin expression may be a useful prognostic marker in patients with invasive
      TCCs.

PMID- 11205307
TI  - Heat shock protein-90, IL-6 and IL-10 in bladder cancer.
AB  - The progression of transitional-cell carcinomas of the bladder is associated with
      changes in general and local immune status. To understand the factors involved in
      the progression of transitional cell carcinoma and in the maintenance of an
      efficient anti-tumoural response, in this study we investigated by
      immunohistochemistry expression of HSP-90, IL-6 and IL-10 proteins in 56 surgical
      specimens obtained from superficial and deeply invasive bladder carcinomas. Of
      the 56 bladder carcinoma 52 (92.9%) expressed HSP-90, 48 (85.7%) IL-6 and 45
      (80.3%) IL-10. High-grade and muscle-invasive tumours contained significantly
      higher levels of HSP-90 and IL-6 antibodies than low-grade and superficial
      tumours (p < 0.05). Linear regression showed a significant correlation between
      HSP-90 and IL-10 (p = 0.022) but not between HSP-90 and IL-6, or IL-6 and IL-10
      expression. The variable quantities of HSP-90, IL-6 and IL-10 in the high-grade
      bladder carcinomas studied suggest that these proteins have independent
      functional roles and may be the immunogenic targets for an anti-tumoural
      response.

PMID- 11205308
TI  - The effects of gossypol on the invasiveness of MAT-LyLu cells and MAT-LyLu cells
      from the metastasized lungs of MAT-LyLu-bearing Copenhagen rats.
AB  - Recently, we isolated a novel subline of the MAT-LyLu cell line from the
      metastasized lungs of MAT-LyLu-bearing Copenhagen rats (MLL cells). In this
      study, we compared the MLL cells to the parental MAT-LyLu cells with respect to
      invasive ability, mRNA expression level for the nm23 metastasis suppressor gene,
      and response to gossypol (GP), a natural compound with documented
      antiproliferative and antimetastatic activity, in an in vitro invasion assay. ML
      cells were isolated from mechanically dissociated metastasized lungs from MAT
      LuLu-bearing Copenhagen rats. Comparisons of the invasive ability and steady
      state levels of nm23 mRNA between MLL and MAT-LuLu cells were determined by in
      vitro invasion assay and RT-PCR, respectively. The results show that MLL cells
      display a higher penetration percentage than MAT-LyLu cells in the in vitro
      invasion assay. Furthermore, RT-PCR revealed that MLL cells possess lower steady
      state levels of nm23 mRNA than MAT-LyLu cells, suggesting a molecular basis for
      the observed differences in in vitro invasive ability. Finally, both MLL and MAT
      LyLu cells were susceptible to gossypol, which induced dose-dependent inhibition
      of invasive activity. These results report the isolation of a novel, more highly
      invasive subline of the MAT-LyLu cell line that is as susceptible to the
      inhibitory effects of gossypol as the parental MAT-LyLu cells. The MLL cells, in
      combination with the parental MAT-LyLu cells, can be valuable tools for
      investigating the biology and behavior of metastatic cells and their response to
      chemotherapeutic/preventive agents.

PMID- 11205309
TI  - Different transendothelial migration behaviour pattern of blood monocytes derived
      from patients with benign and malignant diseases of the breast.
AB  - BACKGROUND: In this study we compared the expression of selected monocyte surface
      antigens with the potential to transmigrate through an endothelial layer before
      and after surgery from breast cancer patients (CA) and patients with benign
      disease of the breast (BE). MATERIALS AND METHODS: Transmigration capacity of
      mononuclear cells was determined after isolation by Ficoll density gradient,
      layered over human umbilical vein endothelial cells and cultured in a two chamber
      plate added with fMLP as a chemotactic stimulus. We determined monocyte phenotye
      (HLA-DR, FcgRI/CD64, CR1/CD11b and LFA-1/CD11a) and the phagocytosis of E. coli
      by flow cytometry. RESULTS: Before surgery blood monocytes had an equal
      expression of the measured surface antigens, but were different in regard to
      their interaction with endothelial cells. Monocytes derived from CA had a higher
      transmigration potency than those of BE. Moreover, the migration through the
      endothelial cell layer created different populations of monocytes. Surgical
      stress modified transmigrated monocytes of BE into the direction of monocytes
      from CA. Phagocytic capacity of peripheral blood monocytes from CA was
      significantly diminished and was further reduced after surgery when measured in
      transmigrated cells. CONCLUSION: Our study shows that monocytes from CA and BE
      can be discriminated in regard to their interaction with endothelial cells.

PMID- 11205310
TI  - Physiological mechanisms of radiation sensitization by pentoxifylline.
AB  - The aim of this study was to investigate whether multiple injections (daily for 5
      days) of the hemorheological agent pentoxifylline (PTX) affected tumor
      physiological parameters (i.e., tumor pO2, tumor pH, and tumor interstitial fluid
      pressure) during the tumor growth of FSaII murine fibrosarcoma in C3H mice. The
      radiation sensitization by multiple injections of PTX (daily for 5 days) was also
      studied. Following multiple administrations of PTX, PTX significantly improved
      tumor oxygenation in all sizes of tumors tested. Our results showed that the
      elevated tumor interstitial fluid pressure (TIFP) in solid tumors could be
      reduced by PTX. Based on our results with the improvement in tumor
      pathophysiology, PTX may be of use during tumor therapies in which the outcome
      may be detrimentally affected by the presence of hypoxia. As anticipated,
      multiple injections of PTX with fractionated x-irradiation prolonged the
      radiation-induced growth delay in FSaII tumors, producing an enhancement ratio of
      1.8 of the growth delay at 15 days. However, we did not observe any alteration in
      cellular oxygen consumption (QO2) after the treatment with PTX. Therefore, we
      concluded that PTX-induced radiosensitization was due to an increase in tumor
      pO2, not a reduction in QO2.

PMID- 11205311
TI  - Tempicol-3, a novel piperidine-N-oxide stable radical and antioxidant, with low
      toxicity acts as apoptosis inducer and cell proliferation modifier of Yoshida
      Sarcoma cells in vivo.
AB  - The novel nitroxyl, Tempicol-3 (nitroxide-N-oxide) was synthesized and its
      capacity to act as a scavenger of hydroxyl radicals was tested. The concentration
      dependent reducibility of this novel compound was also examined and compared with
      those of previously characterized nitroxides, Tempo and Tempace. The cytotoxicity
      of Tempicol-3 in vitro was measured by the modified tetrazolium assay (MTT),
      using, model cells for neoplastic phenotype (mouse NIH 3T3 fibroblast line). The
      ability of Tempicol-3 to act as an antitumor agent in vivo was also investigated
      in a pharmacological test, using rats bearing 3-day old Yoshida Sarcoma
      (promotion phase of the disease). Our results clearly indicated that Tempicol-3
      acts as an effective and promising hydroxyl radical scavenger-antioxidant.
      Structure- and concentration-dependent bioreduction of Tempicol-3 by ascorbic
      acid may account for some of its biological effects, causing modulation of the
      antioxidant status of cells. The presence of one nitrone moiety per molecule of
      Tempicol-3 caused a significant decrease in nitroxide cytotoxicity as compared
      with Tempo, in vitro. The results clearly confirmed that the toxic effect could
      result either from the presence or structure of substituent(s) at position 4 of
      the free radical piperidine moiety. It can be stated that Tempicol-3 is a
      lowtoxicity nitroxide, which could be effective in providing antioxidative
      activity. We have also observed that lowtoxic Tempicol-3, at m.e.d. (minimal
      effective dose) suppressed tumorigenesis, acting as a cell proliferation modifier
      and apoptosis inducer in vivo. This work provides the base for further
      investigations on nitroxide-N-oxide derivatives since the serious question
      remains to be solved as to what is the molecular mechanism of action of the
      nitroxide-N-oxides.

PMID- 11205312
TI  - Immunohistochemical expression of the p53, p21/Waf-1, Rb, p16 and Ki67 proteins
      in multiple myeloma.
AB  - The aim of this study was to investigate the immunohistochemical expression of
      the proteins p53, Waf-l/p21, Rb, p16 and Ki67 in 38 cases of multiple myelomas
      (MM) and 4 cases of solitary extramedullary plasmacytomas in relation to the
      tumor histological grade and stage. In bone marrow (BM) biopsies from MM,
      overexpression of p53 and p21 proteins, in comparison to plasma cell infiltrates
      in non-pathological bone marrow, was detected in 13 out of 38 and 21 out of 38
      cases, respectively. The combined immunoexpression of p53 and p21 proteins in the
      38 cases of MM showed the following patterns: a) p53+/p21+ (13 cases) b) p53
      /p21+ (8 cases) and c) p53-/p21- (17 cases). Rb, p16 and Ki67 proteins were
      detected in tumor cells in all 38 cases and their expression increased
      proportionally to tumor grade. The 4 cases of solitary extramedullary
      plasmacytomas showed the p53+/p21+ pattern in 2 cases and the p53-/p21+ pattern
      in 2 cases, all of them displaying Rb, p16 and Ki67 expression in tumor cells.
      The pattern p53+/p21+ might represent cases with wild-type p53 able to induce p21
      expression. However, in previous studies p53 mutations were reported in about 3
      10% of MM, and they were strongly associated with advanced disease. Thus, in some
      p53+/p21+ cases associated with high p53 expression and advanced disease, p53
      gene cannot be excluded and up-regulation of p21 expression may be p53-
      independent. P53 overexpression correlated with increased tumor grade (p <
      0.005), advanced histological stage (p < 0.001) and Ki67 expression in more than
      10% of tumor cells (p < 0.001). Since increase in Ki67 expression also correlated
      with increased tumor grade (p < 0.001) and advanced histological stage (p <
      0.001), these findings suggest that impairment of the p53 growth control pathway
      is associated with tumor progression in MM. Thus, p53 and Ki67 immunostaining in
      routine BM biopsies may be helpful for the detection of MM with potentially
      aggressive behavior. Overexpression of p21 in MM correlated with higher Ki67
      expression (p < 0.005), suggesting that the p21 function of arresting cell-cycle
      is impaired. Ki-67 expression in MM increased in parallel with p16 (p < 0.001)
      and Rb expression (p < 0.001). Rb expression could represent a growth control
      response which, however, might not be able to induce growth arrest in view of the
      parallel increase in Ki67 expression and of previous findings showing that Rb
      protein in MM cells is expressed mostly in its phosphorylated form.

PMID- 11205313
TI  - PSC 833 induces apoptosis in drug-sensitive human leukemia cell line and
      modulates resistance to paclitaxel in its multidrug-resistant variant.
AB  - BACKGROUND: The non-immunosuppressive cyclosporine analog PSC 833 has been shown
      to reverse multidrug-resistance of neoplastic cells including the MDR-1 gene
      coded P-glycoprotein (P-gp)-mediated cells resistant to paclitaxel. MATERIALS AND
      METHODS: Apoptosis was demonstrated in drug-sensitive HL-60 and multidrug
      resistant human promyelocytic leukemia HL-60/ADR (MRP) and HL-60/VCR (MDR-1)
      cells in vitro with the aid of flow cytometry, DNA analysis and western blotting.
      RESULTS: The techniques used herein determined accumulation of paclitaxel/PSC 833
      induced apoptotic cells with sub-G0 (hypodiploid) DNA content and blocked in the
      G2/M phase of the cell cycle, internucleosomal DNA fragmentation, poly (ADP
      ribose) polymerase cleavage, Bcl-2 modulation and Bax up-regulation, without any
      significant alterations in the levels of Bcl-xL, CD95/Fas or Fas-L proteins.
      CONCLUSION: Drug resistance modulator PSC 833 abolished the P-gp-mediated
      multidrug-resistance to paclitaxel and paclitaxel-induced apoptosis in human
      myeloid leukemia (HL-60/VCR) cells in vitro. Furthermore, PSC 833 alone induced
      apoptosis in parental drug-sensitive leukemia cells, but not in both multidrug
      resistant sublines studied.

PMID- 11205314
TI  - Suicide gene therapy of ovarian cancer: an experimental study in rats using
      retroviral-mediated transfer of herpes simplex virus thymidine kinase gene.
AB  - BACKGROUND: This study evaluated the potential of gene therapy against ovarian
      cancer usin the retroviral transfer of the herpes simplex type 1 thymidine kinase
      gene (HSV1-TK) followed by ganciclovir treatment. MATERIALS AND METHODS: The
      sensitivity of 4 different ovarian cancer cell lines (rat ar human) to in vitro
      infection by recombinant retroviruses were evaluated. Then, their HSV1-TK
      expressing derivatives were tested for their sensitivity to ganciclovir. One of
      them, DMBA-OC-1-TK+ was used to generate experimental ovarian cancer in 13 WKY
      female rats. After 14 days, tl rats received ganciclovir for 12 days (n = 6). The
      results were expressed in mean +/- ES and were evaluated with the Mann-Whitney
      test. RESULTS: All cell lines analyzed in this study were sensitive to retroviral
      mediated gene transfer although with significant variations. The HSV 1-TK
      expressing derivatives of these cells were 300 7,000-fold more sensitive to
      ganciclovir, than the parental cells. The ganciclovir dramatically reduced the
      size of HSV1-TK+ tumors compared to untreated control rats (0 mm3 vs 2,594 mm3, p
      < 0.001) with complete tumor regression and residual fibrotic scars on
      pathological examination. Control tumors showed a poorly-differentiated
      epithelial adenocarcinoma of the ovary. CONCLUSION: In a clinical perspective,
      the good tolerance and the significant anti-tumoral effects of retroviral
      mediated transfer of HSV1-TK gene in animals were encouraging. It remains to set
      up gene transfer methods that will allow efficient targeting of the ovarian
      cancer in vivo.

PMID- 11205315
TI  - Stability, toxicity and cytotoxicity of a cupric complex towards cultured CaCo-2
      cells.
AB  - The human colon adenocarcinoma-derived cell line CaCo-2 was used as a model
      system to study the effects of copper (II), tetradentate N-alkyl ligand (H2L) and
      their complex. The stimulatory effect of the complex was obtained with lower
      concentrations from 10(-7) to 10(-17) mol.L-1, while inhibiting effects occur
      from 10(-4) to 10(-6) mol.L-1. According to this study, copper (II) and free
      ligand were toxic for cultured cells. Our data suggested that the complex,
      according to our toxicity assays in mice, could be used as an antimitotic agent.

PMID- 11205316
TI  - Synergistic effect of the angiogenesis inhibitor TNP-470 and tumor necrosis
      factor (TNF) on Bomirski Ab melanoma in hamsters.
AB  - Bomirski Ab transplantable melanoma bearing hamsters were treated with
      angiogenesis inhibitor TNP-470 or with rat tumor necrosis factor (TNF) at doses
      of 20 micrograms and 40 micrograms or with both TNP-470 and TNF at a dose of 20
      micrograms each. The size of the growing tumor was measured everyday from the day
      when it was palpable. After the death of the animals the final size of their
      tumors was measured and the number and localisation of metastasis were
      determined. It was found that the rate of tumor growth was lowest in the group of
      animals treated with TNF at a dose of 40 micrograms and in the group of animals
      treated with TNP-470 and TNF at a dose of 20 micrograms. The frequency of
      metastasis was different in the experimental groups although their location was
      similar. The longest living animals belonged to the group treated with both TNP
      470 and TNF. The results of the investigation indicate that TNP-470 and TNF act
      in a synergistic way that allows a decrease in the effective dose of TNF thus
      diminishing its noxious side effects.

PMID- 11205317
TI  - Technique and feasibility of a dual staining method for estrogen receptors and
      AgNORs.
AB  - A new staining method for dual demonstration of Estrogen receptors (ER) and
      argyrophilc Nucleolus-Organizer Regions (AgNORs) was developed. To rule out
      possible reciprocal effects, serial slides of 10 invasive ductale breast cancers
      were stained with either the single staining method or the simultaneous ER/AgNOR
      staining method and investigated comparatively. By measuring the slides with the
      image analysis system AMBA, reciprocal effects could be excluded. It was proven
      that dual staining of both markers results in a reproducible and specific
      staining result. We concluded that it is justified to measure AgNORs in
      immunohistochemically stained cells.

PMID- 11205318
TI  - Different proliferation patterns in breast cancer: AgNOR measurements in ER
      negative and ER-positive tumor cells.
AB  - The relation between estrogen receptors (ER) and argyrophilic nucleolar organizer
      regions (AgNORs) in situ within human breast cancer cells was analyzed. For AgNOR
      measurements in 49 invasive breast carcinomas, a new reproducible staining method
      for dual demonstration of ER and AgNORs was applied. Quantitative AgNOR variables
      were determined in ER-positive and ER-negative tumor cells by digital image
      analysis. The relationships between AgNOR parameters of ER-positive and ER
      negative cells and other prognostic factors of breast cancer [Bloom-Richardson
      Grading and growth fraction (Ki-67 index)] were investigated. A higher AgNOR
      content in ER-negative cells and a special clustering phenomenon in ER-positive
      tumor cells were found. Correlation with other criteria of malignant potential
      could be exclusively demonstrated for ER-negative cells. ER-negative cells of
      breast cancer can be characterized as the more malignant and possibly prognosis
      dictating cell fraction. Thus, ER-negative cells probably contribute more to the
      progression of the tumor disease and furthermore to the prognosis than ER
      positive cells. We recommend measurement AgNORs exclusively in ER-negative cells
      of breast cancer.

PMID- 11205319
TI  - Restriction enzyme analysis of DNA methylation in "condensed" chromatin of Ha-ras
      transformed NIH 3T3 cells.
AB  - Increased amounts of chromatin condensation (i.e., localized areas of high DNA
      density, or chromatin higher order packing state) have been described in NIH 3T3
      cells transformed with the Ha-ras oncogene. The structural basis for this
      oncogene-mediated alteration in nuclear organization is unknown. Since DNA
      methylation is likely to be involved in regulating the nucleosomal level of DNA
      packaging, we studied the role of DNA methylation in higher-order chromatin
      organization induced by Ha-ras. CpG-methylated DNA content was estimated in
      "condensed" chromatin of Ha-ras-transformed NIH 3T3 cell lines which differ in
      ras expression and ras-induced metastatic ability but present approximately the
      same values of "condensed" chromatin areas. The question posed was that if DNA
      methylation were involved with the chromatin higher-order organization induced by
      Ha-ras in these cell lines, the methylated DNA density in the "condensed"
      chromatin would also be the same. The DNA evaluation was performed by video image
      analysis in Feulgen-stained cells previously subjected to treatment with Msp I
      and Hpa II restriction enzymes, which distinguish between methylated and non
      methylated DNA. The amount of methylated CpG sequences not digested by Hpa II in
      "condensed" chromatin regions was found to vary in the studied ras-transformed
      cell lines. DNA CpG methylation status is thus suggested not to be involved with
      the higher order chromatin condensation induced by ras transformation in the
      mentioned NIH 3T3 cell lines.

PMID- 11205320
TI  - Topography of genetic loci in tissue samples: towards new diagnostic tool using
      interphase FISH and high-resolution image analysis techniques.
AB  - Using single and dual colour fluorescence in situ hybridisation (FISH) combined
      with image analysis techniques the topographic characteristics of genes and
      centromeres in nuclei of human colon tissue cells were investigated. The
      distributions of distances from the centre-of-nucleus to genes (centromeres) and
      from genes to genes (centromeres to centromeres) were studied in normal colon
      tissue cells found in the neighbourhood of tumour samples, in tumour cell line HT
      29 and in promyelocytic HL-60 cell line for comparison. Our results show that the
      topography of genetic loci determined in 3D-fixed cell tissue corresponds to that
      obtained for 2D-fixed cells separated from the tissue. The distributions of the
      centre-of-nucleus to gene (centromere) distances and gene to gene (centromere to
      centromere) distances and their average values are different for various genetic
      loci but similar for normal colon tissue cells, HT-29 colon tumour cell line and
      HL-60 promyelocytic cell line. It suggests that the arrangement of genetic loci
      in cell nucleus is conserved in different types of human cells. The
      investigations of trisomic loci in HT-29 cells revealed that the location of the
      third genetic element is not different from the location of two homologues in
      diploid cells. We have shown that the topographic parameters used in our
      experiments for different genetic elements are not tissue or tumour specific. In
      order to validate high-resolution cytometry for oncology, further investigations
      should include more precise parameters reflecting the state of chromatin in the
      neighbourhood of critical oncogenes or tumour suppresser genes.

PMID- 11205321
TI  - Malignancy-associated changes in breast tissue detected by image cytometry.
AB  - In several tissues, nuclear differences have been described in normal-appearing
      cells from patients with invasive carcinomas compared to cases without invasive
      carcinoma, a phenomenon known as malignancy-associated changes (MACs). The aim of
      this study was to determine the presence of malignancy-associated changes in
      breast tissue. Image cytometry was performed on Feulgen stained tissue sections
      of patients with usual ductal hyperplasia with (n = 30) or without (n = 41)
      adjacent invasive breast carcinoma. Nuclear features of normal-appearing cells as
      well as of usual ductal hyperplastic cells were separately compared between the
      two groups. Many features of normal-appearing epithelial cells were significantly
      different between cases with and without invasive cancer. Significant differences
      were also found by measuring ductal hyperplastic nuclei instead of normal
      appearing nuclei. Cases with or without cancer could be distinguished with a
      classification accuracy of 80% by discriminant analysis using 2 nuclear features
      derived from ductal hyperplastic cells. In conclusion, image cytometry on breast
      tissue sections shows that malignancy-associated changes can be found in normal
      as well as in usual ductal hyperplastic breast cells. This could be clinically
      relevant for the detection of occult breast cancer, for the prediction of risk in
      these lesions, and to monitor the effect of chemopreventive agents.

PMID- 11205322
TI  - Chromosomal composition of aneuploid clones with different DNA contents in head
      and neck squamous cell carcinomas as determined by combined flow cytometry and
      fluorescence in situ hybridization.
AB  - Studies with DNA flow cytometry (FCM) have shown that DNA contents of aneuploid
      tumour clones vary in a wide range. The aim of this study was to analyse whether
      homologous chromosomal changes exist despite the individual differences that may
      be of general relevance for the development of gross aneuploidy in squamous cell
      carcinomas of the head and neck. Fluorescence in situ hybridization (FISH) with
      13 centromere-specific DNA probes was applied to 3 diploid and 11 aneuploid
      tumours with DNA indices ranging between 0.8 and 2.2. Disomic and monosomic cell
      populations were prevalent findings in DNA-diploid tumours. Polysomies were
      common in aneuploid tumours. Different degrees of aneusomy for identical
      chromosomes were recurrent features in aneuploid tumours. FISH signal
      heterogeneity was identified for all chromosomes. The mean number of aneusomic
      cell populations identified for DNA-aneuploid tumours ranged between 1.6 for
      chromosome 17 and 3.1 for chromosome 3. Inconsistencies between FISH and FCM data
      may indicate that centromere-specific DNA probes identify gains and losses of
      marker DNA due to complex karyotypic rearrangements rather than absolute changes
      in chromosome numbers. Overall, there was no evidence of the critical involvement
      of particular chromosomes in the development of different DNA contents.

PMID- 11205323
TI  - Reverse genetic studies of homologous DNA recombination using the chicken B
      lymphocyte line, DT40.
AB  - DT40 is an avian leucosis virus-transformed chicken B-lymphocyte line which
      exhibits high ratios of targeted to random integration of transfected DNA
      constructs. This efficient targeted integration may be related to the ongoing
      diversification of the variable segment of the immunoglobulin gene through
      homologous DNA recombination-controlled gene conversion. DT40s are a convenient
      model system for making gene-targeted mutants. Another advantage is the relative
      tractability of these cells, which makes it possible to disrupt multiple genes in
      a single cell and to generate conditionally gene-targeted mutants including
      temperature-sensitive mutants. There are strong phenotypic similarities between
      murine and DT40 mutants of various genes involved in DNA recombination. These
      similarities confirm that the DT40 cell line is a reasonable model for the
      analysis of vertebrate DNA recombination, despite obvious concerns associated
      with the use of a transformed cell line, which may have certain cell-line
      specific characteristics. Here we describe our studies of homologous DNA
      recombination in vertebrate somatic cells using reverse genetics in DT40 cells.

PMID- 11205324
TI  - Indirect and direct evidence for DNA double-strand breaks in hypermutating
      immunoglobulin genes.
AB  - The generation of a diverse antigen receptor repertoire is fundamental for the
      functionality of the adaptive immune system. While the V(D)J recombination
      process that generates the primary antigen receptor repertoire is understood in
      great detail, it is still unclear by which mechanism immunoglobulin (Ig) genes
      are further diversified by somatic hypermutation. Using mouse strains that carry
      a non-functional, pre-defined V(H)D(H)J(H) gene segment in their IgH locus we
      demonstrate DNA double-strand breaks (DSBs) in and around V(H)D(H)J(H) in B cells
      undergoing somatic hypermutation. The generation of these DSBs depends on
      transcriptional activity, and their distribution along the V(H)D(H)J(H) segment
      parallels that of point mutations in the hypermutation domain. Furthermore,
      similar to hot spots of somatic hypermutation, 50-60% of all DSBs occur
      preferentially at RGYW motifs. DSBs may transiently dissociate the Ig promoter
      from the intronic enhancer to block further transcription and to initiate an
      error-prone non-homologous DSB repair pathway. In accord with this model large
      deletions are frequently produced, along with point mutations, in a V(H)D(H)J(H)
      segment inserted together with its promoter into the IgH locus in inverted
      orientation. Our data suggest that DSBs are reaction intermediates of the
      mechanism underlying somatic hypermutation.

PMID- 11205325
TI  - Somatic hypermutation of immunoglobulin and non-immunoglobulin genes.
AB  - Somatic hypermutation (SHM) of immunoglobulin (Ig) genes is a highly specific
      mechanism restricted to B lymphocytes during only a few cell generations. Data
      presented here suggest that transcription of the target genes is required, but
      not sufficient for SHM. Presumably, cis-acting elements, such as those present in
      the Ig enhancers, are required to target a mutator factor (MuF) to Ig and human
      BCL-6 genes. It is postulated that the MuF travels with the transcribing RNA
      polymerase and is deposited on the target gene when the polymerase pauses. Point
      mutations, and rare deletions and insertions, are created by the combined actions
      of MuF and certain DNA polymerases. A subset of the mutations is corrected during
      SHM by DNA mismatch repair.

PMID- 11205326
TI  - In vivo and in vitro studies of immunoglobulin gene somatic hypermutation.
AB  - Following antigen encounter, two distinct processes modify immunoglobulin genes.
      The variable region is diversified by somatic hypermutation while the constant
      region may be changed by class-switch recombination. Although both genetic events
      can occur concurrently within germinal centre B cells, there are examples of each
      occurring independently of the other. Here we compare the contributions of class
      switch recombination and somatic hypermutation to the diversification of the
      serum immunoglobulin repertoire and review evidence that suggests that, despite
      clear differences, the two processes may share some aspects of their mechanism in
      common.

PMID- 11205328
TI  - Mutagenesis in eukaryotes dependent on DNA polymerase zeta and Rev1p.
AB  - DNA polymerase zeta (Pol zeta) and Rev1p carry out translesion replication in
      budding yeast, Saccharomyces cerevisiae, and are jointly responsible for almost
      all base pair substitution and frameshift mutations induced by DNA damage in this
      organism. In addition, Pol zeta is responsible for the majority of spontaneous
      mutations in yeast and has been proposed as the enzyme responsible for somatic
      hypermutability. Pol zeta, a non-processive enzyme that lacks a 3' to 5'
      exonuclease proofreading activity, is composed of Rev3p, the catalytic subunit,
      and a second subunit encoded by REV7. In keeping with its role, extension by Pol
      zeta is relatively tolerant of abnormal DNA structure at the primer terminus and
      is much more capable of extension from terminal mismatches than yeast DNA
      polymerase alpha (Pol alpha). Rev1p is a bifunctional enzyme that possesses a
      deoxycytidyl transferase activity that incorporates deoxycytidyl opposite abasic
      sites in the template and a second, at present poorly defined, activity that is
      required for the bypass of a variety of lesions as well as abasic sites. Human
      homologues of the yeast REV1 and REV3 have been identified and, based on the
      phenotype of cells producing antisense RNA to one or other of these genes, their
      products appear also to be employed in translation replication and spontaneous
      mutagenesis. We suggest that Pol zeta is best regarded as a replication enzyme,
      albeit one that is used only intermittently, that promotes extension at forks the
      progress of which is blocked for any reason, whether the presence of an unedited
      terminal mismatch or unrepaired DNA lesion.

PMID- 11205327
TI  - Hypermutation in bacteria and other cellular systems.
AB  - A temporary state of hypermutation can in principle arise through an increase in
      the rate of polymerase errors (which may or may not be triggered by template
      damage) and/or through abrogation of fidelity mechanisms such as proofreading and
      mismatch correction. In bacteria there are numerous examples of transient mutator
      states, often occurring as a consequence of stress. They may be targeted to
      certain regions of the DNA, for example by transcription or by recombination. The
      initial errors are made by various DNA polymerases which vary in their error
      proneness: several are inducible and are under the control of the SOS system.
      There are several structurally related polymerases in mammals that have recently
      come to light and that have unusual properties, such as the ability to carry out
      'accurate' translesion synthesis opposite sites of template damage or the
      possession of exceedingly high misincorporation rates. In bacteria the initial
      errors may be genuinely spontaneous polymerase errors or they may be triggered by
      damage to the template strand, for example as a result of attack by active
      oxidative species such as singlet oxygen. In mammalian cells, hypermutable states
      persisting for many generations have been shown to be induced by various agents,
      not all of them DNA damaging agents. A hypermutable state induced by ionizing
      radiation in male germ cells in the mouse results in a high rate of sequence
      errors in certain unstable minisatellite loci; the mechanism is unclear but
      believed to be associated with recombination events.

PMID- 11205329
TI  - A new class of errant DNA polymerases provides candidates for somatic
      hypermutation.
AB  - The mechanism of somatic hypermutation of the immunoglobulin genes remains a
      mystery after nearly 30 years of intensive research in the field. While many
      clues to the process have been discovered in terms of the genetic elements
      required in the immunoglobulin genes, the key enzymatic players that mediate the
      introduction of mutations into the variable region are unknown. The recent wave
      of newly discovered eukaryotic DNA polymerases have given a fresh supply of
      potential candidates and a renewed vigour in the search for the elusive mutator
      factor governing affinity maturation. In this paper, we discuss the relevant
      genetic and biochemical evidence known to date regarding both somatic
      hypermutation and the new DNA polymerases and address how the two fields can be
      brought together to identify the strongest candidates for further study. In
      particular we discuss evidence for the in vitro biochemical misincorporation
      properties of human Rad30B/Pol iota and how it compares to the in vivo somatic
      hypermutation spectra.

PMID- 11205330
TI  - Altered spectra of hypermutation in DNA repair-deficient mice.
AB  - Affinity maturation of the humoral immune response is based on the ability of
      immunoglobulin variable genes to undergo a process of rapid and extensive somatic
      mutation followed by antigenic selection for antibodies with higher affinity.
      While the behaviour of this somatic hypermutation phenomenon has been well
      characterized over the last 20 years, the molecular mechanism responsible for
      inserting mutations has remained shrouded. To better understand this mechanism,
      we studied the interplay between hypermutation and other DNA associated
      activities such as DNA repair. There was no effect on the frequency and pattern
      of hypermutation in mice deficient for nucleotide excision repair, base excision
      repair and ataxia-telangiectasia mutated gene repair of double strand breaks.
      However, variable genes from mice lacking some components of mismatch repair had
      an increased frequency of tandem mutations and had more mutations of G and C
      nucleotides. These results suggest that the DNA polymerase(s) involved in the
      hypermutation pathway produces a unique spectra of mutations, which is then
      altered by mismatch repair and antigenic selection. We, also describe the
      differential pattern of expression of some nuclear DNA polymerases in
      hypermutating versus non-hypermutating B lymphocytes. The rapidly dividing
      germinal centre B cells expressed DNA polymerases alpha, beta, delta, epsilon and
      zeta, whereas the resting non-germinal centre cells did not express polymerases
      alpha or epsilon at detectable levels, although they did express polymerases
      beta, delta and zeta. The lack of expression of polymerase epsilon in the non
      germinal centre cells suggests that this enzyme has a critical role in
      chromosomal replication but does not participate in DNA repair in these cells.

PMID- 11205331
TI  - DNA polymerase iota and related rad30-like enzymes.
AB  - Until recently, the molecular mechanisms of translesion DNA synthesis (TLS), a
      process whereby a damaged base is used as a template for continued replication,
      was poorly understood. This area of scientific research has, however, been
      revolutionized by the finding that proteins long implicated in TLS are, in fact,
      DNA polymerases. Members of this so-called UmuC/DinB/Rev1/Rad30 superfamily of
      polymerases have been identified in prokaryotes, eukaryotes and archaea.
      Biochemical studies with the highly purified polymerases reveal that some, but
      not all, can traverse blocking lesions in template DNA. All of them share a
      common feature, however, in that they exhibit low fidelity when replicating
      undamaged DNA. Of particular interest to us is the Rad30 subfamily of polymerases
      found exclusively in eukaryotes. Humans possess two Rad30 paralogs, Rad30A and
      Rad30B. The RAD30A gene encodes DNA polymerase eta and defects in the protein
      lead to the xeroderma pigmentosum variant (XP-V) phenotype in humans. Very
      recently RAD30B has also been shown to encode a novel DNA polymerase, designated
      as Pol iota. Based upon in vitro studies, it appears that Pol iota has the lowest
      fidelity of any eukaryotic polymerase studied to date and we speculate as to the
      possible cellular functions of such a remarkably error-prone DNA polymerase.

PMID- 11205332
TI  - The reverse transcriptase model of somatic hypermutation.
AB  - The evidence supporting the reverse transcriptase model of somatic hypermutation
      is critically reviewed. The model provides a coherent explanation for many
      apparently unrelated findings. We also show that the somatic hypermutation
      pattern in the human BCL-6 gene can be interpreted in terms of the reverse
      transcriptase model and the notion of feedback of somatically mutated sequences
      to the germline over evolutionary time.

PMID- 11205333
TI  - Evolution and the molecular basis of somatic hypermutation of antigen receptor
      genes.
AB  - Somatic hypermutation of immunoglobulin genes occurs in many vertebrates
      including sharks, frogs, camels, humans and mice. Similarities among species
      reveal a common mechanism and these include the AGC/T sequence hot spot,
      preponderance of base substitutions, a bias towards transitions and strand bias.
      There are some differences among species, however, that may unveil layers of the
      mechanism. These include a G:C bias in frog and shark IgM but not in nurse shark
      antigen receptor (NAR), a high frequency of doublets in NAR hypermutation, and
      the co-occurrence of somatic hypermutation with gene conversion in some species.
      Here we argue that some of the similarities and differences among species are
      best explained by error-prone DNA synthesis by the translesion synthesis DNA
      polymerase zeta (Pol zeta) and, as suggested by others, induction of DNA
      synthesis by DNA breaks in antigen receptor variable genes. Finally, targeting of
      the variable genes is probably obtained via transcription-related elements, and
      it is the targeting phase of somatic hypermutation that is the most likely to
      reveal molecules unique to adaptive immunity.

PMID- 11205335
TI  - Molecular definition of the germinal centre stage of B-cell differentiation.
AB  - Genomic-scale gene expression analysis provides views of biological processes as
      a whole that are difficult to obtain using traditional single-gene experimental
      approaches. In the case of differentiating systems, gene expression profiting can
      define a stage of differentiation by the characteristic expression of hundreds of
      genes. Using specialized DNA microarrays termed 'Lymphochips', gene expression
      during mature B-cell differentiation has been defined. Germinal centre B cells
      represent a stage of differentiation that can be defined by a gene expression
      signature that is not shared by other highly proliferative B-cell populations
      such as mitogenically activated peripheral blood B cells. The germinal centre
      gene expression signature is maintained to a significant degree in lymphoma cell
      lines derived from this stage of differentiation, demonstrating that this gene
      expression programme does not require ongoing interactions with other germinal
      centre cell types. Analysis of representative cDNA libraries prepared from
      resting and activated peripheral blood B cells, germinal centre centroblasts,
      centrocytes and tonsillar memory B cells has confirmed and extended the results
      of DNA microarray gene expression analysis.

PMID- 11205336
TI  - Transcription, beta-like DNA polymerases and hypermutation.
AB  - This paper discusses two aspects of immunoglobulin (Ig) gene hypermutation. In
      the first approach, a transcription termination signal is introduced in an Ig
      light chain transgene acting as a mutation substrate, and transgenic lines are
      generated with control and mutant transgenes integrated in tandem. Analysis of
      transcription levels and mutation frequencies between mutant and control
      transgenes clearly dissociates transcription elongation and mutation, and
      therefore argues against models whereby specific pausing of the RNA polymerase
      during V gene transcription would trigger an error-prone repair process. The
      second part reports the identification of two novel beta-like DNA polymerases
      named Pol lambda and Pol mu, one of which (Pol mu) represents a good candidate
      for the Ig mutase due to its higher lymphoid expression and its similarity with
      the lymphoid enzyme terminal deoxynucleotidyl transferase. Peculiar features of
      the expression of this gene, including an unusual splicing variability and a
      splicing inhibition in response to DNA-damaging agents, are discussed.

PMID- 11205334
TI  - Somatic hypermutation and B-cell lymphoma.
AB  - During the B-cell response to T-cell-dependent antigens, the B cells undergo a
      rapid proliferative phase in the germinal centre. This is accompanied by the
      introduction of mutations into the immunoglobulin (Ig) variable region (V) genes.
      The B cells are then selected according to the affinity of the encoded
      immunoglobulin for antigen, resulting in affinity maturation of the response.
      Analysis of mutations in IgV genes has given insight into the history of
      individual B cells and their malignancies. In most cases, analysis of mutations
      confirms classifications of B-cell lineage designated by studies of cellular
      morphology and surface antigen expression. However, of particular interest is the
      subdivision of groups of malignancies by analysis of somatic hypermutation. It is
      now apparent that there are two subsets of chronic lymphocytic leukaemia (CLL),
      one with a low load of mutations and poor prognosis. and one with a heavy load of
      mutations with a much more favourable prognosis. In addition, in Burkitt's
      lymphoma, sporadic and endemic subtypes are now considered possibly to have a
      different pathogenesis, reflected in differences in the numbers of mutations.
      Hodgkin's disease, which was a mystery for many years, has now been shown to be a
      B-cell tumour. Although in many cases the Ig genes are crippled by somatic
      hypermutation, it is thought that failure to express Ig is more likely to be
      associated with problems of transcription. It has been proposed that the
      distribution of mutations in a B-cell lymphoma can be used to determine whether a
      lymphoma is selected. We have investigated the load and distribution of mutations
      in one group of lymphomas--marginal zone B-cell lymphomas of mucosa-associated
      lymphoid tissues (MALT-type lymphoma), which are dependent on Helicobacter pylori
      for disease progression, to investigate the limits of information that can be
      derived from such studies. Comparison of the load of mutations demonstrates that
      these tumours have approximately the same load of mutations as normal mucosal
      marginal zone B cells from the Peyer's patches and mucosal plasma cells. This is
      consistent with the origin of these cells from mucosal marginal zone B cells with
      plasma cell differentiation. To investigate selection in MALT lymphomas we
      compared a region of the framework region three in ten MALT lymphomas which use
      the V(H4) family, with the same codons in groups of V(H4) genes that are out of
      frame between V and J. The latter accumulate mutations but are not used and are
      not selected. A group of V(H4) genes are in-frame between V and J were also
      included for comparison. There were no obvious differences in the distribution of
      mutations between the groups of genes; the same hot spots and cold spots were
      apparent in each. In the MALT lymphomas, selection was apparent in the framework
      regions only and the tendency was to conserve. We therefore feel that there is
      selection to conserve antibody structure and that this does not reflect selection
      for antigen. We do not believe that antigen selection can be deduced reliably
      from sequence information alone. It is possible that somatic hypermutation could
      be a cause of malignancy since it has been shown that the process may generate
      DNA strand breaks and is known to be able to generate insertions and deletions.
      Such events may mediate the translocation of genes--a process that is pivotal in
      the evolution of many lymphomas.

PMID- 11205337
TI  - DNA polymerase mu, a candidate hypermutase?
AB  - A novel DNA polymerase (Pol mu) has been recently identified in human cells. The
      amino-acid sequence of Pol mu is 42% identical to that of terminal
      deoxynucleotidyl transferase (TdT), a DNA-independent DNA polymerase that
      contributes to antigen-receptor diversity. In this paper we review the evidence
      supporting the role of Pol mu in somatic hypermutation of immunoglobulin genes, a
      T-dependent process that selectively occurs at germinal centres: (i) preferential
      expression in secondary lymphoid organs; (ii) expression associated to developing
      germinal centres; and (iii) very low base discrimination during DNA-dependent DNA
      polymerization by Pol mu, a mutator phenotype enormously accentuated by the
      presence of activating Mn2+ ions. Moreover, its similarity to TdT, together with
      extrapolation to the crystal structure of DNA polymerase beta complexed (Pol
      beta) with DNA, allows us to discuss the structural basis for the unprecedented
      error proneness of Pol mu, and to predict that Pol mu is structurally well suited
      to participate also in DNA end-filling steps occurring both during V(D)J
      recombination and repair of DNA double-strand breaks that are processed by non
      homologous end-joining.

PMID- 11205339
TI  - Motor learning through the combination of primitives.
AB  - In this paper we discuss a new perspective on how the central nervous system
      (CNS) represents and solves some of the most fundamental computational problems
      of motor control. In particular, we consider the task of transforming a planned
      limb movement into an adequate set of motor commands. To carry out this task the
      CNS must solve a complex inverse dynamic problem. This problem involves the
      transformation from a desired motion to the forces that are needed to drive the
      limb. The inverse dynamic problem is a hard computational challenge because of
      the need to coordinate multiple limb segments and because of the continuous
      changes in the mechanical properties of the limbs and of the environment with
      which they come in contact. A number of studies of motor learning have provided
      support for the idea that the CNS creates, updates and exploits internal
      representations of limb dynamics in order to deal with the complexity of inverse
      dynamics. Here we discuss how such internal representations are likely to be
      built by combining the modular primitives in the spinal cord as well as other
      building blocks found in higher brain structures. Experimental studies on
      spinalized frogs and rats have led to the conclusion that the premotor circuits
      within the spinal cord are organized into a set of discrete modules. Each module,
      when activated, induces a specific force field and the simultaneous activation of
      multiple modules leads to the vectorial combination of the corresponding fields.
      We regard these force fields as computational primitives that are used by the CNS
      for generating a rich grammar of motor behaviours.

PMID- 11205341
TI  - Illustrating cerebral function: the iconography of arrows.
AB  - For over a century the arrow has appeared in illustrations of cerebral function,
      yet the implications of using such symbols have not been previously considered.
      This review seeks to outline the nature, evolution, applications and limitations
      of this deceptively simple graphic device when it is used to picture functions of
      the brain. The arrow is found to have been used in several different ways: as a
      means of endowing anatomical structures with functional properties; as a method
      of displaying neural function either in free-standing form or in a structural or
      spatial framework; as a device for correlating functional data with underlying
      brain topography; and as a technique for linking functions of the brain with the
      world outside and with various philosophical concepts. For many of these uses the
      essential feature of the arrow is its directional characteristic. In contrast to
      the line, it is direction that enables the arrow to display information about
      time, which in turn can be exploited to depict functional rather than structural
      data. However, the use of the arrow is fraught with difficulties. It is often
      unclear whether an arrow has been used to illustrate fact, hypothesis, impression
      or possibility, or merely to provide a decorative flourish. Furthermore, the
      powerful symbolic nature of the arrow can so easily confer a spurious validity on
      the conjectural. Increasingly now there are insuperable difficulties when
      attempting to illustrate complex mechanisms of brain function. In the iconography
      of cerebral function, therefore, arrows with all their ambiguities may in certain
      circumstances become superseded by more non-representational symbols such as the
      abstract devices of the computational neuroscientist.

PMID- 11205338
TI  - The functions of the proprioceptors of the eye muscles.
AB  - This article sets out to present a fairly comprehensive review of our knowledge
      about the functions of the receptors that have been found in the extraocular
      muscles--the six muscles that move each eye of vertebrates in its orbit--of all
      the animals in which they have been sought, including Man. Since their discovery
      at the beginning of the 20th century these receptors have, at various times, been
      credited with important roles in the control of eye movement and the construction
      of extrapersonal space and have also been denied any function whatsoever.
      Experiments intended to study the actions of eye muscle receptors and, even more
      so, opinions (and indeed polemic) derived from these observations have been
      influenced by the changing fashions and beliefs about the more general question
      of how limb position and movement is detected by the brain and which signals
      contribute to those aspects of this that are perceived (kinaesthesis). But the
      conclusions drawn from studies on the eye have also influenced beliefs about the
      mechanisms of kinaesthesis and, arguably, this influence has been even larger
      than that in the converse direction. Experimental evidence accumulated over
      rather more than a century is set out and discussed. It supports the view that,
      at the beginning of the 21st century, there are excellent grounds for believing
      that the receptors in the extraocular muscles are indeed proprioceptors, that is
      to say that the signals that they send into the brain are used to provide
      information about the position and movement of the eye in the orbit. It seems
      that this information is important in the control of eye movements of at least
      some types, and in the determination by the brain of the direction of gaze and
      the relationship of the organism to its environment. In addition, signals from
      these receptors in the eye muscles are seen to be necessary for the development
      of normal mechanisms of visual analysis in the mammalian visual cortex and for
      both the development and maintenance of normal visuomotor behaviour. Man is among
      those vertebrates to whose brains eye muscle proprioceptive signals provide
      information apparently used in normal sensorimotor functions; these include
      various aspects of perception, and of the control of eye movement. It is possible
      that abnormalities of the eye muscle proprioceptors and their signals may play a
      part in the genesis of some types of human squint (strabismus); conversely
      studies of patients with squint in the course of their surgical or
      pharmacological treatment have yielded much interesting evidence about the
      central actions of the proprioceptive signals from the extraocular muscles. The
      results of experiments on the eye have played a large part in the historical
      controversy, now in at least its third century, about the origin of signals that
      inform the brain about movement of parts of the body. Some of these results, and
      more of the interpretations of them, now need to be critically re-examined. The
      re-examination in the light of recent experiments that is presented here does not
      support many of the conclusions confidently drawn in the past and leads to both
      new insights and fresh questions about the roles of information from motor
      signals flowing out of the brain and that from signals from the peripheral
      receptors flowing into it. There remain many lacunae in our knowledge and filling
      some of these will, it is contended, be essential to advance our understanding
      further. It is argued that such understanding of eye muscle proprioception is a
      necessary part of the understanding of the physiology and pathophysiology of eye
      movement control and that it is also essential to an account of how organisms,
      including Man, build and maintain knowledge of their relationship to the external
      visual world. The eye would seem to provide a uniquely favourable system in which
      to study the way in which information derived within the brain about motor
      actions may interact with signals flowing in from peripheral receptors. The
      review is constructed in relatively independent sections that deal with
      particular topics. It ends with a fairly brief piece in which the author sets out
      some personal views about what has been achieved recently and what most
      immediately needs to be done. It also suggests some lines of study that appear to
      the author to be important for the future.

PMID- 11205340
TI  - Abnormalities in the awareness and control of action.
AB  - Much of the functioning of the motor system occurs without awareness.
      Nevertheless, we are aware of some aspects of the current state of the system and
      we can prepare and make movements in the imagination. These mental
      representations of the actual and possible states of the system are based on two
      sources: sensory signals from skin and muscles, and the stream of motor commands
      that have been issued to the system. Damage to the neural substrates of the motor
      system can lead to abnormalities in the awareness of action as well as defects in
      the control of action. We provide a framework for understanding how these various
      abnormalities of awareness can arise. Patients with phantom limbs or with
      anosognosia experience the illusion that they can move their limbs. We suggest
      that these representations of movement are based on streams of motor commands
      rather than sensory signals. Patients with utilization behaviour or with
      delusions of control can no longer properly link their intentions to their
      actions. In these cases the impairment lies in the representation of intended
      movements. The location of the neural damage associated with these disorders
      suggests that representations of the current and predicted state of the motor
      system are in parietal cortex, while representations of intended actions are
      found in prefrontal and premotor cortex.

PMID- 11205343
TI  - The Croonian Lecture 2000. Nicotinic acetylcholine receptor and the structural
      basis of fast synaptic transmission.
AB  - Communication in the nervous system takes place at chemical and electrical
      synapses, where neurotransmitter-gated ion channels, such as the nicotinic
      acetylcholine (ACh) receptor, and gap junction channels control propagation of
      electrical signals from one cell to the next. Newly developed electron
      crystallographic methods have revealed the structures of these channels trapped
      in open as well as closed states, suggesting how they work. The ACh receptor has
      large vestibules extending from the membrane which shape the ACh-binding pockets
      and facilitate selective transport of cations across a narrow membrane-spanning
      pore. When ACh enters the pockets it triggers a concerted conformational change
      that opens the pore by destabilizing a gate in the middle of the membrane made by
      a ring of pore-lining alpha-helical segmets. The alternative 'open' configuration
      of pore-lining segments reshapes the lumen and creates new surfaces, allowing the
      ions to pass through. The gap junction channel uses a similar structural
      mechanism, involving coordinated rearrangements of alpha-helical segments in the
      plane of the membrane, to open its pore.

PMID- 11205344
TI  - Causality in medicine: the case of tumours and viruses.
AB  - Clarification of the aetiology of chronic human diseases such as atherosclerosis
      or cancer is one of the dominant topics in contemporary medical research. It is
      believed that identification of the causal factors will enable more efficient
      prevention and diagnosis of these diseases and, in some instances, also permit
      more effective therapy. The task is difficult because of the multistep and
      multifactorial origin of these diseases. A special case in contemporary
      aetiological studies is definition of the role of viruses in the pathogenesis of
      human cancer. Virus-associated cancer develops only in a small minority of
      infected subjects, which implies that, if the virus does play a role in the
      pathogenesis of the malignancy, other factors must also be involved. In this
      paper the author attempts to review the present methodological approaches to
      aetiological studies of chronic diseases, discusses the role of criteria for
      identifying causal relationships and proposes guidelines that might help to
      determine the role of viruses in human cancer.

PMID- 11205345
TI  - The omnivorous Tyrolean Iceman: colon contents (meat, cereals, pollen, moss and
      whipworm) and stable isotope analyses.
AB  - The contents of the colon of the Tyrolean Iceman who lived ca. 5300 years ago
      include muscle fibres, cereal remains, a diversity of pollen, and most notably
      that of the hop hornbeam (Ostrya carpinifolia) retaining cellular contents, as
      well as a moss leaf (Neckera complanata) and eggs of the parasitic whipworm
      (Trichuris trichiura). Based almost solely on stable isotope analyses and
      ignoring the work on the colon contents, two recently published papers on the
      Iceman's diet draw ill-founded conclusions about vegetarianism and even veganism.
      Neither the pollen nor the moss is likely to have been deliberately consumed as
      food by the Iceman. All the available evidence concerning the Iceman's broad
      based diet is reviewed and the significance of the colon contents for matters
      other than assessment of food intake is outlined.

PMID- 11205342
TI  - Zonal organization of the mammalian main and accessory olfactory systems.
AB  - Zonal organization is one of the characteristic features observed in both main
      and accessory olfactory systems. In the main olfactory system, most of the
      odorant receptors are classified into four groups according to their zonal
      expression patterns in the olfactory epithelium. Each group of odorant receptors
      is expressed by sensory neurons distributed within one of four circumscribed
      zones. Olfactory sensory neurons in a given zone of the epithelium project their
      axons to the glomeruli in a corresponding zone of the main olfactory bulb.
      Glomeruli in the same zone tend to represent similar odorant receptors having
      similar tuning specificity to odorants. Vomeronasal receptors (or pheromone
      receptors) are classified into two groups in the accessory olfactory system. Each
      group of receptors is expressed by vomeronasal sensory neurons in either the
      apical or basal zone of the vomeronasal epithelium. Sensory neurons in the apical
      zone project their axons to the rostral zone of the accessory olfactory bulb and
      form synaptic connections with mitral tufted cells belonging to the rostral zone.
      Signals originated from basal zone sensory neurons are sent to mitral tufted
      cells in the caudal zone of the accessory olfactory bulb. We discuss functional
      implications of the zonal organization in both main and accessory olfactory
      systems.

PMID- 11205346
TI  - Effects of metapopulation processes on measures of genetic diversity.
AB  - Many species persist as a metapopulation under a balance between the local
      extinction of subpopulations or demes and their recolonization through dispersal
      from occupied patches. Here we review the growing body of literature dealing with
      the genetic consequences of such population turnover. We focus our attention
      principally on theoretical studies of a classical metapopulation with a 'finite
      island' model of population structure, rather than on 'continent-island' models
      or 'source-sink' models. In particular, we concern ourselves with the subset of
      geographically subdivided population models in which it is assumed that all demes
      are liable to extinction from time to time and that all demes receive immigrants.
      Early studies of the genetic effects of population turnover focused on population
      differentiation, such as measured by F(ST). A key advantage of F(ST) over
      absolute measures of diversity is its relative independence of the mutation
      process, so that different genes in the same species may be compared. Another
      advantage is that F(ST) will usually equilibrate more quickly following
      perturbations than will absolute levels of diversity. However, because F(ST) is a
      ratio of between-population differentiation to total diversity, the genetic
      effects of metapopulation processes may be difficult to interpret in terms of
      F(ST) on its own, so that the analysis of absolute measures of diversity in
      addition is likely to be informative. While population turnover may either
      increase or decrease F(ST), depending on the mode of colonization, recurrent
      extinction and recolonization is expected always to reduce levels of both within
      population and species-wide diversity (piS and piT, respectively). One corollary
      of this is that piS cannot be used as an unbiased estimate of the scaled mutation
      rate, theta, as it can, with some assumptions about the migration process, in
      species whose demes do not fluctuate in size. The reduction of piT in response to
      population turnover reflects shortened mean coalescent times, although the
      distribution of coalescence times under extinction colonization equilibrium is
      not yet known. Finally, we review current understanding of the effect of
      metapopulation dynamics on the effective population size.

PMID- 11205347
TI  - An adaptive model of sensory integration in a dynamic environment applied to
      human stance control.
AB  - An adaptive estimator model of human spatial orientation is presented. The
      adaptive model dynamically weights sensory error signals. More specific, the
      model weights the difference between expected and actual sensory signals as a
      function of environmental conditions. The model does not require any changes in
      model parameters. Differences with existing models of spatial orientation are
      that: (1) environmental conditions are not specified but estimated, (2) the
      sensor noise characteristics are the only parameters supplied by the model
      designer, (3) history-dependent effects and mental resources can be modelled, and
      (4) vestibular thresholds are not included in the model; instead vestibular
      related threshold effects are predicted by the model. The model was applied to
      human stance control and evaluated with results of a visually induced sway
      experiment. From these experiments it is known that the amplitude of visually
      induced sway reaches a saturation level as the stimulus level increases. This
      saturation level is higher when the support base is sway referenced. For subjects
      experiencing vestibular loss, these saturation effects do not occur. Unknown
      sensory noise characteristics were found by matching model predictions with these
      experimental results. Using only five model parameters, far more than five data
      points were successfully predicted. Model predictions showed that both the
      saturation levels are vestibular related since removal of the vestibular organs
      in the model removed the saturation effects, as was also shown in the e
      xperiments. It seems that the nature of these vestibular-related threshold
      effects is not physical, since in the model no threshold is included. The model
      results suggest that vestibular-related thresholds are the result of the
      processing of noisy sensory and motor output signals. Model analysis suggests
      that, especially for slow and small movements, the environment postural
      orientation can not be estimated optimally, which causes sensory illusions. The
      model also confirms the experimental finding that postural orientation is history
      dependent and can be shaped by instruction or mental knowledge. In addition the
      model predicts that: (1) vestibular-loss patients cannot handle sensory
      conflicting situations and will fall down, (2) during sinusoidal support-base
      translations vestibular function is needed to prevent falling, (3) loss of
      somatosensory information from the feet results in larger postural sway for
      sinusoidal support-base translations, and (4) loss of vestibular function results
      in falling for large support-base rotations with the eyes closed. These
      predictions are in agreement with experimental results.

PMID- 11205348
TI  - Neural network analysis of the pattern of functional connectivity between
      cerebral areas in schizophrenia.
AB  - Recent evidence suggests that the core abnormality of cerebral function in
      schizophrenia is a disruption of functional connectivity between diverse cerebral
      sites. Functional connectivity is defined as the correlation between neuronal
      activity at remote sites. It can be measured using functional imaging techniques
      such as positron emission tomography (PET). This paper reports an analysis using
      a neural network to discriminate between the patterns of functional connectivity
      in schizophrenic patients and healthy subjects. The data was derived from a PET
      study of regional cerebral blood flow during word generation in 6 healthy
      subjects and 16 schizophrenic patients with established illness, in whom the
      clinical diagnosis could be made with confidence. After training on data from two
      healthy subjects and seven schizophrenic patients, the neural network
      successfully assigned all members of a test set of four healthy subjects and nine
      schizophrenic patients to the correct diagnostic category. While this result
      should be interpreted with caution on account of the small sample size, it
      indicates that neural network analysis is potentially of value in the diagnosis
      of schizophrenia.

PMID- 11205349
TI  - Hippocampal rhythm generation: gamma-related theta-frequency resonance in CA3
      interneurons.
AB  - During different behavioral states different population activities are present in
      the hippocampal formation. These activities are not independent: sharp waves
      often occur together with high-frequency ripples, and gamma-frequency activity is
      usually superimposed on theta oscillations. There is both experimental and
      theoretical evidence supporting the notion that gamma oscillation is generated
      intrahippocampally, but there is no generally accepted view about the origin of
      theta waves. Precise timing of population bursts of pyramidal cells may be due to
      a synchronized external drive. Membrane potential oscillations recorded in the
      septum are unlikely to fulfill this purpose because they are not coherent enough.
      We investigated the prospects of an intrahippocampal mechanism supplying
      pyramidal cells with theta frequency periodic inhibition, by studying a model of
      a network of hippocampal inhibitory interneurons. As shown previously,
      interneulrons are capable of generating synchronized gamnma-requency action
      potential oscillations. Exciting the neurons by periodic current injection, the
      system could either be entrained in an oscillation with the frequency of the
      inducing current or exhibit in-phase periodic changes at the frequency of single
      cell (and network) activity. Simulations that used spatially inhomogeneous
      stimulus currents showed antiphase frequency changes across cells, which resulted
      in a periodic decrease in the synchrony of the network. As this periodic change
      in synchrony occurred in the theta frequency range, our network should be able to
      exhibit the theta-frequency weakening of inhibition of pyramidal cells, thus
      offering a possible mechanism for intrahippocampal theta generation.

PMID- 11205350
TI  - Analysis of the reflexive feedback control loop during posture maintenance.
AB  - In previous work it has been shown in posture experiments of the human arm that
      reflexive dynamics were substantial for narrow-band stochastic force
      disturbances. The estimated reflex gains varied substantially with the frequency
      content of the disturbances. The present study analyses a simplified linear model
      of the reflexive feedback control loop, to provide an explanation for the
      observed behaviour. The model describes co-activation and reflexive feedback. The
      task instruction 'minimize the displacements' is represented mathematically by a
      cost function that is minimized by adjusting the parameters of the model. Small
      amplitude displacements allow the system to be analysed with a quasilinear
      approach. The optimization results clarify the limited effectiveness of reflexive
      feedback on the system's closed-loop behaviour, which emanates from the time
      delay present in the reflex loops. For low-frequency inputs less than 5 Hz,
      boundary-stable solutions with high reflex gains are predicted to be optimal.
      Input frequencies near the system's eigenfrequency (about 5 Hz), however, would
      be amplified and result in oscillatory behaviour. As long as the disturbance does
      not excite these frequencies, boundary stability will be optimal. The predicted
      reflex gains show a striking similarity with the estimated reflex gains from the
      experimental study. The present model analysis also provides a clear explanation
      for the negative reflex gains, estimated for near-sinusoidal inputs beyond 1.5
      Hz.

PMID- 11205351
TI  - Optimal posture control of a musculo-skeletal arm model.
AB  - In this paper maximal performance posture control of the human arm is
      investigated by means of model simulations. Recent experiments (F.C.T. van der
      Helm, submitted, 2000) have shown that the reflexive feedback during postural
      control varies with the bandwidth of the applied force disturbances. This paper
      focusses on the influence of the frequency content of force disturbances on the
      reflexive feedback gains by means of optimization. The arm is modelled by a
      nonlinear musculo-skeletal model with two degrees of freedom and six muscles. To
      facilitate the optimization of the model parameters, the arm model is linearized.
      A performance criterion is minimized for stochastic force disturbances in a two
      step procedure: (1) optimization of static muscle activations using an additional
      energy criterion to obtain a unique and energy-efficient solution; antid (2)
      optimization of reflex gains using an additional control effort criterion to
      obtain a unique solution. The optimization reveals that for the given task and
      posture, the shoulder muscles have the largest contribution, whereas the bi
      articular muscles have a relatively small contribution to the behaviour. The
      dynamics at the endpoint level are estimated so that a comparison can be made
      with the experiments. Compared to the experiments, the intrinsic damping of the
      model is relatively large (about 150%), whereas the intrinsic stiffness is
      relatively small (about 60%). These differences can be attributed to unmodelled
      mechanical effects of crossbridges in Hill-type muscle models. The optimized
      reflex gains show remarkable similarities with the values found in the
      experiments, implying that humans can adjust their reflexive feedback gains in an
      optimal way, weighting the performance and energy. The approach in this paper
      could be useful in the study of various posture tasks, for example in the
      prediction of the relation between the control parameters of various musculo
      skeletal models and different experimental variables.

PMID- 11205352
TI  - The efficient learner.
AB  - The research to be reported examines the concept of efficiency, defined as the
      relation of metabolic energy expended to mechanical work done. The development of
      movement coordination was investigated in the context of the hypothesis that an
      increase in coordination would be accompanied by a parallel reduction in overall
      energy expenditure, relative to the increase in energy expenditure demanded by
      improvements in work output. The task involved learning to make cyclical, slalom
      like, ski movements on a ski apparatus. Development of coordination was indexed
      by changes in the timing of forcing while on-line measurements of oxygen
      consumption were used as indices of energy expenditure. Six female volunteers
      served as subjects in nine training sessions. The change in the coordination
      pattern, between the subject and the apparatus, as indexed by the development of
      the phase lag, was paralleled by an improvement in efficiency. It was concluded
      that learning the skill used in this study involves a search by the system for
      perception-action couplings (phase relations in the present study) that require
      minimal energy expenditure.

PMID- 11205353
TI  - High curvature and jerk analyses of arm ataxia.
AB  - We investigated high curvature analysis (HCA) and integrated absolute jerk (IAJ)
      for differrentiating healthy and cerebellopathy (CB) patients performing pointing
      tasks. Seventeen CB patients and seventeen healthy controls were required to move
      a pointer at their preferred pace between two 50.8 cm laterally spaced targets
      while standing with theirarm extended in front of their body. HCA was used to
      quantify the frequency of sharp turns in the horizontal-plane (anterior-posterior
      and medio-lateral) velocity trajectory of the hand-held pointer. IAJ was
      assesssed by integration of absolute jerk (second time derivative of velocity)
      time histories in the anterior-posterior and medio-lateral directions. HCA scores
      and IAJ scores were then compared between CB patients and healthy controls; for
      both analyses, higher scores indicateless smooth movements. We hypothesized that
      CB patients would have less smooth movement trajectories than healthy controls
      due to upper extremity ataxia asssociated with cerebellar disease and
      degeneration. We found that CB patients had higher HCA scores than healthy
      controls (P = 0.014). Although CB patients had higher IAJ scores in both anterior
      posterior (P = 0.060)and medio-lateral (P = 0.231) directions compared to the
      healthy controls, the differences were not significant. The difference in
      sensitivity between the HCA andthe IAJ analysis might be explained by primitive
      neural activation commands, ubiquitous though only evident with some cerebellar
      dysfunctions, which produce submovements which are themselves minimal jerk
      curves. We conclude that HCA may be a useful tool for quantifying upper extremity
      ataxia in CB patients performing a repeated pointing task.

PMID- 11205354
TI  - Dynamics of two electrically coupled chaotic neurons: experimental observations
      and model analysis.
AB  - Conductance-based models of neurons from the lobster stomatogastric ganglion
      (STG) have been developed to understand the observed chaotic behavior of
      individual STG neurons. These models identify an additional slow dynamical
      process calcium exchange and storage in the endoplasmic reticulum as a
      biologically plausible source for the observed chaos in the oscillations of these
      cells. In this paper we test these ideas further by exploring the dynamical
      behavior when two model neurons are coupled by electrical or gap junction
      connections. We compare in detail the model results to the laboratory
      measurements of electrically-coupled neurons that we reported earlier. The
      experiments on the biological neurons varied the strength of the effective
      coupling by applying a parallel, artificial synapse, which changed both the
      magnitude and polar-of the conductance between the neurons. We observed a
      sequence of bifarctions that took the neurons from strongly synchronized in-phase
      behavior. through uncorrelated chaotic oscillations to strongly synchronized and
      now regular out-of-phase behavior. The model calculations reproduce these
      observations quantitatively, indicating that slow subcellular processes could
      account for the mechanisms involved in the synchronization and regularization of
      the otherwise individual chaotic activities.

PMID- 11205355
TI  - The natural history of multiple sclerosis.
AB  - The natural history of chronic diseases is generally poorly understood. Multiple
      sclerosis is one of the best-studied diseases and we outline here some of the
      information obtained from 25,000 patient-years of observation. This population
      based cohort received almost no treatment and certainly none known to alter the
      long-term natural course of the illness. There is a possibility that such data
      will prove useful in new generation clinical trials which are observational in
      nature.

PMID- 11205356
TI  - Usefulness of Bayesian graphical models for early prediction of disease
      progression in multiple sclerosis.
AB  - Previous studies of possible prognostic indicators for multiple sclerosis have
      been based on "classic" Cox's proportional hazards regression model, as well as
      on equivalent or simpler approaches, restricting their attention to variables
      measured either at disease onset or at a few points during follow-up. The aim of
      our study was to analyse the risk of reaching secondary progression in MS
      patients with a relapsing-remitting initial course, using two different
      statistical approaches: a Cox's proportional-hazards model and a Bayesian latent
      variable model with Markov chain Monte Carlo methods of computation. In
      comparison with a standard statistical approach, our model is advantageous
      because, exploiting all the information gleaned from the patient as it is
      gradually made available, it is capable to detect even small prognostic effects.

PMID- 11205357
TI  - Age at onset in multiple sclerosis.
AB  - Age at onset of multiple sclerosis (MS) can vary from childhood to adult life.
      Many reports have been carried out over the years concerning the role of age at
      onset in determining the disease outcome. In a sporadic MS population of 1463
      patients with homogeneous clinical and demographic features, derived from three
      Italian neurological centres (Bari, Cagliari and Sassari), we analysed the
      relative weights of current age and age at onset on disease severity according to
      the expanded disability status scale (EDSS) score, by fixing the disease
      duration. The results of present study demonstrate that clinical disability in MS
      is influenced by the patient's age (p < 0.01) and not by the age at onset.
      Therefore, these data do not confirm the hypothesis that an early age at onset
      should be considered a favourable prognostic factor of the disease outcome.

PMID- 11205358
TI  - A prospective study on the prognosis of multiple sclerosis.
AB  - Two hundred and twenty-four patients at their first diagnosis of multiple
      sclerosis (MS) were prospectively followed for a mean period of 9.78 years. We
      considered as endpoints the time to reach non-reversible disability levels
      corresponding to EDSS scores of 4.0 and 6.0, and the beginning of a secondary
      progressive phase in the relapsing-remitting subgroup of patients. An initially
      progressive course and higher basal EDSS scores proved to be the best predictors
      of unfavorable prognosis. A greater number of functional systems involved at
      onset as well as higher residual deficits in pyramidal, visual, sphincteric and
      cerebellar systems were other factors predictive of a poor outcome, whereas
      sensory system involvement turned out to be favorable. A longer first inter
      attack interval was associated with a better prognosis. However, overall number
      of relapses in the first two years of the disease was of no prognostic value. The
      presence of oligoclonal banding in the cerebrospinal fluid and a cerebral MRI
      exam strongly suggestive or suggestive of MS in the early phases of the disease
      were associated with a higher probability of a worse outcome.

PMID- 11205359
TI  - Prognosis of multiple sclerosis: environmental factors.
AB  - Epidemiological data have suggested a role for environmental factors in multiple
      sclerosis etiology. Infectious diseases, exposure to toxins, immunizations,
      nutritional and hormonal variables, and trauma are the most studied and
      biologically plausible risk factors for MS. Their putative role in determining or
      simply triggering MS development in genetically prone subjects suggests a
      possible involvement of the same factors in modulating the subsequent behavior of
      the disease and its prognosis.

PMID- 11205360
TI  - Is multiple sclerosis severity a genetically influenced trait?
AB  - Multiple sclerosis (MS), an inflammatory demyelinating disease of the central
      nervous system of unknown pathogenesis, is a complex disease with a
      multifactorial etiology determined by both genetic and environmental factors. The
      pathological entity MS has a wide phenotype, and also the severity of the disease
      is widely variable. Clinical heterogeneity of the disease might arise from
      different genotype-phenotype interactions. Results of recent studies and theories
      about the modifying role of different genes in the course and the severity of MS
      are here discussed.

PMID- 11205361
TI  - Trauma, stress and multiple sclerosis.
AB  - It has been suggested that physical trauma, involving the cervical spinal cord or
      the brain, and psychological stress may precede MS onset or may influence the
      disease course, although this hypothesis has mainly come from anecdotal case
      reports or small uncontrolled or controlled studies. So far there are no studies
      providing a clear causative relationship between physical trauma (especially head
      trauma) and MS onset, exacerbation or progression of the disease. On the other
      hand, recent MRI and experimental studies, supporting the important role of
      nervous and immune system interactions, particularly by the hypothalamic
      pituitary-adrenal axis and by the sympathetic nervous pathways, seem to
      demonstrate a significant correlation between stress and MS exacerbations.
      Further frequent MRI and immunological evaluations should be warranted to
      objectively document the temporal association between stress and clinical and/or
      sub-clinical disease activity.

PMID- 11205362
TI  - Prognostic factors in multiple sclerosis: role of intercurrent infections and
      vaccinations against influenza and hepatitis B.
AB  - Since the first historical description of multiple sclerosis (MS) it has been
      known that febrile illnesses frequently trigger relapses of the disease. In spite
      of this knowledge, vaccination against influenza has been hampered for a long
      period by neurologists on the basis of anecdotal cases of post-vaccination
      encephalomyelitis. Randomized, double-blind, placebo-controlled studies during
      the past decade have shown that influenza vaccination of MS patients neither
      increases the relapse rate nor worsens the course of the disease. In contrast,
      the reduction of viral infection episodes leads to a lower number of
      exacerbations of MS. Influenza vaccination is safe and should be recommended to
      MS patients in order to avoid attacks of the disease. After publication of case
      reports of hepatitis B (HB) vaccination followed by onset of MS, a media-driven
      scare campaign mainly in France was conducted. The French health authorities
      decided to suspend routine vaccination of adolescents in schools, invoking the
      "principle of precaution". This fact has caused widespread confusion and concern
      about the HB vaccination. Epidemiological studies in large populations have
      recently been performed to investigate a possible link between HB vaccination and
      MS: all results argue against a causal relation between HB vaccine and MS or
      other demyelinating diseases. Since the vaccination provides complete protection
      against hepatitis B and its severe long-term complications, the World Health
      Organization recommends continuing the implementation of the HB vaccination
      programs.

PMID- 11205363
TI  - The prognostic value of age, gender, pregnancy and endocrine factors in multiple
      sclerosis.
AB  - The evolution of multiple sclerosis at the time of diagnosis remains
      unpredictable since a reliable prognostic marker is not yet available.
      Nevertheless, a series of useful prognostic indicators have been singled out from
      epidemiological studies. Young age at onset, female gender, relapsing/remitting
      course, and sensitive or visual disturbances as initial symptoms are considered
      favourable prognostic factors. Conversely, late age at onset, male gender,
      progressive course, and pyramidal or cerebellar symptoms at the first episode
      predict an unfavourable evolution. Another prognostic indicator has been
      recognized in pregnancy: although the overall effect of pregnancy on short-term
      MS course is neutral, in the long-term it seems to protect from disease
      progression. Most prognostic indicators seem to act through the neuro-endocrine
      immune network, modulating the immune response in the context of the Th1/Th2
      paradigm.

PMID- 11205364
TI  - Early onset multiple sclerosis.
AB  - Multiple sclerosis (MS) onset is usually in adult life (age 20-40 years).
      Discordant data have been reported concerning the frequency of early onset MS
      (EOMS) that ranges from 2.7% to 5%, whereas there is a general agreement on
      prevalence of female sex, particularly after puberty. The initial symptoms in
      EOMS are frequently characterized by visual loss whereas the other functional
      systems are involved with a variable frequency. Literature data show that EOMS
      tends to have a relapsing-remitting course, a high rate of recovery from the
      initial attack, a long time interval between the first and second attacks and a
      slow progression rate. A poor prognosis is reported in a few cases of EOMS and
      seems to be related to number of relapses and to the delay between the first and
      second attacks.

PMID- 11205365
TI  - The prognosis of idiopathic optic neuritis.
AB  - We evaluated the risk of developing clinically definite multiple sclerosis (CDMS)
      after acute isolated optic neuritis in 102 patients in a follow-up study
      (duration 6.5 +/- 2.0 years). The probability of CDMS was 13% after 2 years, 30%
      after 4 years, 38% after 6 years, and 49% after 8 and 10 years. CDMS occurred in
      42 (59%) of 71 patients with brain lesions detected with magnetic resonance
      imaging (MRI). No patient with normal MRI exam developed the disease. Patients
      with 3 or more MRI-detected lesions presented a shorter first interattack
      interval and a higher relapse rate compared to subjects with only 1 or 2 lesions.
      The predictive value of CSF examination and of evoked potentials was poor.

PMID- 11205366
TI  - Immunological markers in multiple sclerosis.
AB  - Multiple sclerosis (MS) is characterized by the presence in the central nervous
      system (CNS) of perivascular inflammatory infiltrates containing, among others,
      autoreactive T cells and activated macrophages. These observations indicate that
      MS is a T cell-mediated CNS-confined chronic inflammatory demyelinating disease
      in which the ultimate effector cell is the activated macrophage. The inflammatory
      process, leading to patchy demyelination and axonal loss, is mainly sustained by
      pro-inflammatory cytokines that, along with chemokines, adhesion molecules and
      metalloproteases, modulate at different levels the pathogenic process underlying
      MS. Due to their central role in MS pathogenesis, "inflammatory" molecules might
      represent suitable peripheral markers of disease (disease-trait) and/or disease
      activity (state-trait). However, reliable disease-trait or state-trait
      immunological markers for MS have not yet been identified. The intrinsic
      characteristics of these molecules (i.e. autocrine/paracrine activity, short half
      life, redundancy) may in part explain their inconsistency as disease markers.
      Additionally, the unreliability of methodologies and the lack of careful patient
      stratification can also, at least in part, account for the unsatisfactory results
      so far obtained.

PMID- 11205367
TI  - The role of magnetization transfer and diffusion-weighted MRI in the
      understanding of multiple sclerosis evolution.
AB  - Conventional magnetic resonance imaging (MRI) has markedly increased our ability
      to detect the macroscopic abnormalities of the brain and spinal cord in patients
      with multiple sclerosis (MS). Magnetization transfer imaging and diffusion
      weighted imaging have the potential to provide relevant and complementary
      information on the structural changes occurring within and outside these lesions
      and are contributing significantly to our understanding of the mechanisms leading
      to the accumulation of irreversible neurological disability in MS patients. The
      present review will summarize the major results achieved with the application of
      these two MR techniques to the assessment of the evolution of MS.

PMID- 11205368
TI  - Imaging axonal damage in multiple sclerosis by means of MR spectroscopy.
AB  - Axonal damage in multiple sclerosis has become an important issue. This has been
      emphasized by recent in vivo proton magnetic resonance (MR) spectroscopy and in
      vitro pathology studies that have found axonal damage in both lesions and the
      surrounding normal-appearing white matter. In particular, proton MR spectroscopy,
      by monitoring levels of N-acetylaspartate (a putative marker of axonal
      integrity), has been particularly illuminating, as the extent of axonal injury
      associated with white matter inflammation and demyelination had not been well
      appreciated from classical pathology studies. Recent MR data demonstrate that
      cerebral axonal damage begins and contributes to disability from the earliest
      stages of the disease. This implies that the apparently primary role of axonal
      damage and loss in the pathogenesis of the disease should be given due
      importance, and argues for the early treatment of multiple sclerosis with agents
      directed not only against inflammation, but also towards axonal protection.

PMID- 11205369
TI  - Evoked potentials in monitoring multiple sclerosis.
AB  - The usefulness of evoked potentials (EPs) in the diagnosis of multiple sclerosis
      is limited by its relatively low sensitivity to subclinical lesions. However,
      they are still a good tool to assess the integrity of afferent and efferent
      pathways and to quantify the severity of white matter involvement. Transversal
      and longitudinal studies have demonstrated good correlation between EP
      abnormalities and disability, suggesting that multimodal evoked potentials could
      be useful in monitoring the disease evolution in single patients and as surrogate
      end points in clinical trials.

PMID- 11205370
TI  - Prognosis-modifying therapy in multiple sclerosis.
AB  - The neurologist's views on disease therapy have changed over recent years from
      nihilism to reasonable optimism, thanks to the development of MS-specific
      therapies (interferon beta and COP-1) and to the remarkable advances in the
      understanding of the pathogenesis of the disease. Available immunological,
      clinical and pathological data suggest that the early treatment of RRMS patients
      with immunomodulatory drugs could be more advantageous compared to treatment
      started later in the disease course. The early reduction of relapse rate as well
      as of the extent of pathological lesions, should be the strategy for patients
      particularly in the first phases of the disease. Early treatment has a robust
      rationale both in prevention of irreversible pathological changes and in reducing
      clinical and MRI activity with favorable prognostic implications. For the near
      future, interferon beta and COP-1 seem to be the pharmacological agents best
      qualified to be utilized for this purpose.

PMID- 11205371
TI  - Joint Annual Meeting 2000 of the German and Dutch Societies of Immunology.
      Dusseldorf, November 29-December 2, 2000. Abstracts.

PMID- 11205372
TI  - Two-color flow cytometric analysis of preterm and term newborn lymphocytes.
AB  - Immune system maturation proceeds postnatally in humans. Therefore, newborns,
      especially those of a lower gestational age, are not fully immunocompetent and
      are more likely to acquire perinatal infections. In order to investigate the
      neonatal immune system status, the major lymphocyte subpopulations were studied
      in newborns of different gestational age, comparing term newborns and adults. The
      cord blood from 66 newborns and the peripheral blood from 23 adults were analyzed
      using fluorochrome labelled monoclonal antibodies and two-color flow cytometry.
      The newborns were divided into three groups according to their gestational age.
      Ten prematures were under 32 weeks of gestation, 35 were of 32-37 weeks and there
      were 21 term newborns. The percentage of cytotoxic T lymphocytes (CD4 CD8+) was
      lower in term newborns as compared to the adult controls (17.8 versus 30.3%), and
      so were the percentages of activated T lymphocytes (CD3+Ia+; 0.3 versus 3.7%),
      cytotoxic non-MHC restricted T lymphocytes (CD3+CD16+CD56+; 0.2 versus 1.8%) and
      NK cells (CD3-CD16+CD56+; 4.8 versus 15.5%). On the contrary, the proportions of
      unlabelled cells were increased in term cord blood. The expression of CD45R0
      marker on neonatal lymphocytes was very low (1%). In comparison to the higher
      gestation newborns, the lower gestation prematures had reduced percentages of T
      lymphocytes (CD3+; 43 versus 65%), mostly helper T lymphocytes (CD4+CD8-; 35
      versus 50%), and increased percentages of unlabelled cells. The percentages of NK
      cells (CD3+CD16+CD56+) and B lymphocytes (CD3-CD19+; CD3-Ia+) did not differ
      among the tested newborn groups. There were no significant differences in major
      lymphocyte subpopulations between the group of highest-gestation prematures and
      the group of term newborns that differed significantly when compared to adults.
      The lowest-gestation newborns showed the most immature lymphocyte phenotype with
      the highest percentages of unlabelled cells.

PMID- 11205373
TI  - Bifidobacterium adolescentis modulates the specific immune response to another
      human gut bacterium, Bacteroides thetaiotaomicron, in gnotobiotic rats.
AB  - In order to investigate the capability of an autochthonous bacterium to modulate
      the host's immune response against the indigenous microfiora, the immunogenicity
      of two selected bacterial species of the human gut was investigated in a
      gnotobiotic rat model. Germ-free (GF) rats were monoassociated with either
      Bifidobacterium (B.) adolescentis or Bacteroides (B.) thetaiotaomicron and the
      development of bacteria-specific IgG and IgA in serum and specific secretory IgA
      (sIgA) in feces of the animals were measured. Knowing the antibody levels in
      gnotobiotic rats induced by monoassociation, we subsequently diassociated two
      groups of rats in order to investigate the impact of B. adolescentis on the
      immune reaction against B. thetaiotaomicron. One group was diassociated
      simultaneously with B. adolescentis and B. thetaiotaomicron, the second group was
      diassociated with these bacteria in sequence. In contrast to B. thetaiotaomicron,
      B. adolescentis was not able to induce a systemic immune response in
      monoassociated animals as evident from serum IgG and IgA. However, both bacterial
      species challenged the mucosal immune system as indicated by an increase in sIgA
      in the feces. The specific immune response to B. thetaiotaomicron was
      significantly lower in diassociated animals than in animals monoassociated with
      B. thetaiotaomicron. This effect was more pronounced in the rats, that had been
      associated sequentially. The presence of B. adolescentis down-regulated the
      humoral immunity to B. thetaiotaomicron.

PMID- 11205374
TI  - Ineffective elimination of Leishmania major by inflammatory (MRP14-positive)
      subtype of monocytic cells.
AB  - Myeloid-related protein (MRP) 14, an intracellular protein involved in calcium
      dependent activation of myeloid cells, presents a differentiation marker for a
      subtype of macrophages. In experimental leishmaniasis, BALB/c mice succumb to
      visceral dissemination after infection with L. major, due to a Th2 cell response,
      while C57Bl/6 mice develop protective immunity associated with a Th1 cell
      response. We have previously shown that resistance in (C57Bl/6 mice was also
      associated with a significantly lower percentage of MRP14-positive cells in the
      infiltrate than in susceptible BALB/c mice. In C57Bl/6 mice, weekly injections of
      bone marrow (BM) cells enriched with MRP14-positive cells (d1 of culture) did not
      reverse, but prolonged the course of infection, associated with increased local
      parasite spread. In BALB/c mice a single dose of an antiphlogistic agent
      (dexamethasone or lipoxygenase inhibitor) was associated with reduction of
      infiltrating MRP14-positive cells and also with a decrease of parasite loads in
      footpads, lymph nodes as well as spleens, and with delayed progression of
      disease, Double labeling experiments in vitro revealed that at least 43.1% of
      MRP14-positive mononuclear cells in BM cultures (8h) had phagocytosed parasites
      after 4 h of co-incubation. Activation by IFN-gamma (20 U/ml) for 24h and 48h did
      not significantly reduce parasite load in these cells. In contrast, 77.0% of
      F4/80-positive macrophages (6d of culture) were infected with L. major parasites
      and these cells responded to activation with IFN-gamma (20 U/ml) with significant
      reduction of parasite load (25.3%). The protein MRP14 did not have an effect on
      parasite survival in vitro. Thus, the impaired capability of MRP14-positive cells
      to kill L. major upon stimulation may be one reason for the adverse course of
      infection observed with their increased appearance.

PMID- 11205375
TI  - Inflammation marker 7,8-dihydroneopterin induces apoptosis of neurons and glial
      cells: a potential contribution to neurodegenerative processes.
AB  - Since neopterin is elevated in the cerebrospinal fluid of patients with
      inflammatory neurological disorders we investigated the source of neopterin in
      the brain and a possible contribution of biological active pteridines to the
      development of brain lesions. Astrocytic, neuronal and microglial cell lines were
      shown to be negative for neopterin production even after stimulation with
      interferon-gamma (IFN-gamma) indicating that infiltrating monocytes/macrophages
      might be responsible for neopterin level in CNS. Whereas neopterin did not affect
      viability of brain cells, its derivative 7,8-dihydroneopterin (7,8-DHN) induced
      dose-dependently cellular apoptosis in astrocytes and neurons probably via
      enhancement of nitric oxide synthase (iNOS) expression. This mechanism might
      represent a possible link between inflammation in the brain and
      neurodegeneration.

PMID- 11205376
TI  - LPS stimulation of TNF-receptor deficient macrophages: a differential role for
      TNF-alpha autocrine signaling in the induction of cytokine and nitric oxide
      production.
AB  - To evaluate the role of autocrine TNF-alpha signaling in macrophage activation,
      immortalized macrophages from normal mice (B6/J2) and from mice containing gene
      targeted disruptions of the type 1 and type 2 TNF-receptor genes (TRN) were
      stimulated under CD14-dependent or serum-free conditions. Although the B6/J2 and
      TRN clones mounted similar nitric oxide responses to LPS in the presence of
      serum, the TRN macrophages responded poorly when stimulated with LPS under serum
      free conditions. LPS stimulation of TRN and B6/J2 under serum-free conditions
      resulted in equivalent levels of IL-1beta, TNF-alpha, and iNOS gene expression.
      However, Western blot analysis revealed that iNOS protein production by TRN was 2
      fold lower than that produced by B6/J2. These results indicate that autocrine TNF
      alpha stimulation contributes to the signaling pathways initiated by ligation of
      LPS receptors in the absence of LBP and is involved in iNOS post-transcriptional
      regulation.

PMID- 11205377
TI  - Superantigen-dependent accelerated death of bovine neutrophilic granulocytes in
      vitro is mediated by blood mononuclear cells.
AB  - While classical interactions of bacterial superantigens (SAgs) with antigen
      presenting cells and T cells have been studied intensively, the potential
      interactions of SAgs with granulocytes (PMNs) have gained much less attention. We
      investigated if in the bovine system SAgs have any direct or indirect influence
      on the fate of granulocytes, which are among those cells primarily responsible
      for the elimination of superantigen-producing bacteria. The tested SAgs (SEA,
      SEB) had no apparent direct effect on PMN viability (neutrophils and
      eosinophils). However, in the presence of blood mononuclear cells (MNCs), SAgs
      led to an accelerated death of neutrophils but not of eosinophils. Compared to
      medium controls, in SAg-stimulated cultures only about 20-50% of the neutrophils
      survived after 24 hours in vitro. Accelerated death of neutrophils required the
      presence of at least 10% MNC and started between 2.5-24 h after initiation of the
      co-culture between MNC and PMN. Minimal effective SEA concentrations ranged
      between 10-100 pg/l (SEB 0.1-10 ng/l). The effect could be mimicked by culture
      supernatants of SAg-stimulated MNCs, suggesting that direct cell-cell
      interactions are not required for the killing. In the human system, where we
      tested the role of TNF-alpha, an antibody specific for this cytokine was not able
      to abolish the death of human neutrophils. Brefeldin A, an inhibitor of golgi
      transport and cytokine secretion, which blocked the SAg-induced activation of
      bovine MNC did not abolish the killing of neutrophils. Blocking of nitric oxide
      generation or PGE2 synthesis also could not alter the SAg-induced killing of
      bovine neutrophils. The observed indirect negative effects of SAgs on neutrophils
      may provide new insights in mechanisms by which superantigens modulate the hosts
      immune response.

PMID- 11205378
TI  - Superantigen disruption of CD8+ T and B lymphocyte homeostasis.
AB  - Superantigens (SAgs) activate TH cells and induce their differentiation into
      cytokine-producing effector cells. Supranormal cytokine production is
      characteristic of SAg-induced polyclonal TH activation. Study of this interaction
      has focused upon TH cell function to the relative exclusion of other lymphocyte
      populations. SAgs also impact cells dependent upon TH cells for their
      differentiation and disrupt the normal homeostasis of the immune system. In this
      report, several changes in lymphocyte biology that result from SAg activation of
      TH cells are described. SCID mice, reconstituted with the SAg-expressing cells of
      DBA/2J mice, were employed as secondary recipients of SAg-reactive TH cells.
      Significant increases in serum IgM and IgG2a production were noted after the
      transfer of SAg-reactive It cells. Both B and CD8 T lymphocyte numbers increased
      with those of CD8 T cells surpassing levels found in normal mice. These results
      illustrate the ability of the TH-SAg interaction to disrupt B and CD8+ T
      lymphocyte homeostasis.

PMID- 11205379
TI  - Contact dermatitis from white flower embrocation.

PMID- 11205380
TI  - Fixed drug eruption due to scopolia extract.

PMID- 11205381
TI  - Hyperpigmentation and contact dermatitis due to Juglans regia.

PMID- 11205382
TI  - Allergic nickel and chromate hand dermatitis induced by orthopaedic metal
      implant.

PMID- 11205383
TI  - Allergic contact dermatitis from benzocaine ointment during treatment of herpes
      zoster.

PMID- 11205384
TI  - Unusual clinical presentation in a case of contact dermatitis due to
      corticosteroids diagnosed by ROAT.

PMID- 11205385
TI  - Eczema herpeticum in parthenium dermatitis.

PMID- 11205386
TI  - Aziridine hardener--a new sensitizer in the dyeing of leather.

PMID- 11205387
TI  - Occupational allergic contact dermatitis from formaldehyde resin in clothing.

PMID- 11205389
TI  - Dermatitis around tracheostomies due to cleansing tissues.

PMID- 11205388
TI  - Localized aquagenic urticaria dependent on saline concentration.

PMID- 11205390
TI  - Allergic contact dermatitis from estradiol and norethisterone acetate in a
      transdermal hormonal patch.

PMID- 11205391
TI  - Erythema-multiforme-like eruption from amoxycillin and allopurinol.

PMID- 11205392
TI  - Acute generalized exanthematous pustulosis induced by amoxycillin with
      clavulanate.

PMID- 11205393
TI  - Allergic contact dermatitis due to guava tea.

PMID- 11205394
TI  - Optician's occupational allergic contact dermatitis, paresthesia and paronychia
      caused by anaerobic acrylic sealants.

PMID- 11205395
TI  - Allergic contact dermatitis from zinc ricinoleate in a deodorant and glyceryl
      ricinoleate in a lipstick.

PMID- 11205396
TI  - 182 patients with occupational allergic epoxy contact dermatitis over 22 years.

PMID- 11205397
TI  - Increase in hydration and protective function of horny layer by glycerol and a
      W/O emulsion: are these effects maintained during long-term use?

PMID- 11205398
TI  - Chemical load as a factor in skin sensitization risk assessment: rodent versus
      man.

PMID- 11205399
TI  - Contact allergy to miripirium chloride in Depo-Medrol.

PMID- 11205400
TI  - Contact dermatitis from sodium metabisulfite in a baker.

PMID- 11205401
TI  - Recalcitrant allergic contact dermatitis from azathioprine tablets.

PMID- 11205402
TI  - Occupational sensitization to methoxysilane in fibreglass production.

PMID- 11205403
TI  - Sensitive skin is not a subclinical expression of contact allergy.

PMID- 11205404
TI  - Osmaron B is a rare occupational, but a frequent cosmetic, allergen.

PMID- 11205405
TI  - Legislative and preventive measures related to contact dermatitis.
AB  - Legislation can be a useful tool in the prevention of contact dermatitis. This is
      particularly true for dermatitis due to exposure to the many contact allergens
      that are chemical substances in products. A brief review is given of the most
      important European legislation--the EU Nickel Directive, the Cosmetics Directive,
      the Hazardous Substances Directive and the Hazardous Preparations Directive--and
      of some national regulations and standardization projects. It is concluded that
      it is essential that experts on contact dermatitis support, with their expert
      knowledge, national and European authorities.

PMID- 11205406
TI  - Investigation of the threshold for allergic reactivity to chromium.
AB  - Allergy to chromium is relatively common, often in association with exposure to
      cement or in leather manufacture. However, in certain locations, there appears to
      be a relatively large cohort of chromium-sensitive individuals whose allergy
      cannot be explained by these common sources. In particular, this group include
      Israeli housewives with persistent hand eczema and concomitant patch test
      positivity to chromium. The causation of their allergy has been linked with
      relatively high levels of chromium contamination in household products. To
      provide further information in respect of the definition of safe levels for such
      products, we examined 17 chromium-allergic individuals to determine their
      threshold for reaction under closed patch test and repeated open application test
      (ROAT) conditions. The data derived indicated that, on normal skin, the patch
      test threshold was 10 ppm chromium; in the presence of an irritant (sodium lauryl
      sulfate) the threshold was closer to 1 ppm, 2/17 subjects giving 1+ reactions at
      this concentration. In the more realistic exposure conditions of the ROAT, 8/14
      individuals failed to react to 50 ppm, whilst 3/15 reacted to 5 ppm.
      Interestingly, there was very poor correlation between patch test sensitivity and
      ROAT sensitivity. To ensure the large majority of chromium-allergic individuals
      do not suffer elicitation of their allergy, as well as to limit the development
      of new chromium-sensitive subjects, it is recommended that household products
      adhere to a previously published standard of a maximum limit of 5 ppm, with an
      ultimate target of 1 ppm contamination by chromium.

PMID- 11205407
TI  - Reduction of use of latex gloves in food handlers: an intervention study.
AB  - Frequent latex glove use is a risk factor for the development of latex allergy.
      With the increase in latex glove use, latex allergy has become more prevalent.
      There are a number of occupational groups in which the use of latex gloves is
      both inappropriate and even hazardous, including food handlers, where the hazard
      relates particularly to their latex-sensitive customers. The aim of this study
      was to assess both the use of latex gloves by food handlers and the impact of an
      intervention study on reducing latex glove use. This was done at the Queen
      Victoria Market in Melbourne, Australia. We found that 10 out of 30 stalls (33%)
      used latex gloves, and that following a short education program, this was reduced
      to 1 stall (3%, p=0.006). The potential to reduce latex glove use by using this
      intervention study was 93% (95% confidence interval of 54%-100%). We recommend
      that food handlers be educated during their training, not only about hygiene
      issues, but also about the appropriate type of glove to wear, in order to prevent
      both the development of a new occupational group at risk of becoming allergic to
      latex, but more importantly to protect their latex-sensitive customers.

PMID- 11205408
TI  - Results of a quality of life questionnaire in a patch test clinic population.
AB  - There has been increasing interest in quality of life outcomes, but there has
      been little reported on this topic for individuals with contact dermatitis. The
      objectives of this study were (i) to pilot a dermatology-specific quality of life
      instrument to assess its acceptability in a patch test clinic population, (ii) to
      see the effects of contact dermatitis on the patients' lives and (iii) to
      determine what factors may influence quality of life outcomes in this population.
      A dermatology-specific quality of life instrument was modified and used for 339
      patients undergoing patch testing in a contact dermatitis clinic. The most common
      effect was pain or itching in 61%. Approximately 1/3 noted embarrassment,
      interference with work, or sleep disturbance. Other concerns were reported by
      less than 25% of the population. On multivariate analysis, the key factor
      influencing most outcomes was hand involvement. The instrument was well accepted
      by the clinic population and is now being used in a prospective study of
      outcomes. In the population assessed, it demonstrated the effects of disease.
      Analysis suggests that a key factor influencing these quality of life outcomes is
      hand involvement.

PMID- 11205409
TI  - The prevention of occupational hand dermatitis in bakers, confectioners and
      employees in the catering trades. Preliminary results of a skin prevention
      program.
AB  - Occupational skin diseases (OSD) are among the most frequent occupational
      diseases (OD). Compared to other occupations, bakers, confectioners and employees
      in the catering trades are at a high risk of developing OSD. In January 1999, the
      interdisciplinary Skin Disease Prevention Program in the Baking, Hotel and
      Catering Industries (SDPP) conducted by the Department of Dermatology and
      Allergology at the Friedrich Schiller University, Jena, in cooperation with the
      Research Center for Applied System Safety and Industrial Medicine, Erfurt, and
      the technical experts at the Social Insurance for the Food Industry and Related
      Professions (Berufsgenossenschaft fur Nahrungsmittel und Gaststatten--(BGN)),
      Erfurt, was initiated. Following detailed analysis of the occupational exposure
      of the employees and their personal occupational disease history, the patients'
      diagnosis and therapy was re-evaluated and supplemented if necessary. Individual
      skin care and protection regimes were demonstrated and practically trained. Skin
      care and protection products were supplied. Skin-care and protection seminars
      were offered to volunteering participants. From January to December 1999, 29
      affected employees were examined in the OSD clinic. 22 employees (76%) suffered
      from irritant contact dermatitis. The follow-up data of 11 employees are
      available. In 8 employees (73%), the skin disease improved or disappeared.
      Moreover, in 1 employee (9%), the skin condition was stabilized even though he
      continued working. In only 2 employees (18%) did the skin condition worsen. These
      preliminary results showed that most of the OSD were due to lack of or unsuitable
      skin care and protection. The program will be extended to cover a larger number
      of food industry employees with OSD.

PMID- 11205410
TI  - Occupational skin diseases in national servicemen and military personnel in
      Singapore, 1989-1999.
AB  - This is a study of occupational skin disease among military personnel and
      conscripts in Singapore. All military personnel and conscripts diagnosed with
      occupational dermatoses in the National Skin Centre, Singapore, between 1989-1999
      were studied retrospectively. Conscripts and regulars comprised 7.3% of all
      occupational skin disease patients seen. All were male, with a mean age of 23
      years. Irritant contact dermatitis was more common than allergic contact
      dermatitis, by 4.4:1. The most common vocations associated with occupational skin
      diseases are those involving vehicle repairs and maintenance (48%) and food
      handling (19%). The most common irritants were oil/grease (66%), wet work (23%)
      and solvents (18%). The most common allergens were food (40%) and chromates
      (20%). Military personnel and conscripts make up a significant proportion of
      occupational skin disease patients seen in Singapore.

PMID- 11205411
TI  - Contact urticaria from rice.
AB  - A 30-year-old man with atopic dermatitis had had erythema and itching of the
      hands after washing rice in water, though he had always eaten cooked rice without
      problems. Handling test with water used to wash regular rice was performed on
      abraded hands, and produced urticarial erythema after several minutes.
      Applications of water used to wash allergen-reduced rice were negative for
      urticarial reaction. Prick test with water used to wash regular rice was +++.
      However prick test reaction with water used to wash allergen-reduced rice was +.
      Histamine-release test of regular rice-washing water was grade 3 and that of
      allergen-reduced rice grade 1. In immunoblotting analysis with regular rice
      washing water, there were no bands with this patient. These results suggest that
      the allergen responsible for contact urticaria in this patient might be water
      soluble, heat-unstable, and not contained in allergen-reduced rice.

PMID- 11205412
TI  - Irritant contact dermatitis caused by needle-like calcium oxalate crystals,
      raphides, in Agave tequilana among workers in tequila distilleries and agave
      plantations.
AB  - It was found that needle-like calcium oxalate crystals, raphides, are found
      abundantly in all tissues of Agave tequilana plants; thus, 1 droplet (0.03 ml) of
      juice pressed from leaves contains 100-150 crystals, 30-500 microm in length,
      sharpened at both ends. In tequila distilleries, 5/6 of the workers who handle
      the agave stems have experienced the characteristic irritation. In contrast, only
      1/3 of workers in agave plantations who harvest agave plants, complain of the
      irritation. It is confirmed that all the irritation suffered in both distilleries
      and plantations takes place at bodily locations where the plants come into
      contact with the worker's skin in the course of their work.

PMID- 11205413
TI  - Allergic contact dermatitis at the application site of an electrosurgical
      earthing plate occurring in a windscreen repairer.

PMID- 11205414
TI  - Contact allergy to epoxy resin based on diglycidyl ether of bisphenol F.

PMID- 11205415
TI  - What is a "low dose" of d-amphetamine for inducing behavioral effects in
      laboratory rats?
AB  - BACKGROUND: Because of the amphetamines' abuse potential and capability of
      exacerbating or inducing mood and psychotic disturbances, investigations of the
      behavioral effects of amphetamines commonly involve non-human animals, with the
      laboratory rat being by far the most common species used. Although investigators
      of the behavioral effects of amphetamine in rats sometimes refer to doses used as
      being "low", "moderate", "high", etc., it is not clear in what sense these terms
      apply. OBJECTIVES: To develop an operational definition of a low dose of
      amphetamine in rats, we reviewed studies that assessed the behavioral effects of
      dextroamphetamine (d-AMP) in rats in which some subset of doses, administered SC,
      IM or IP, was described as being "low". We then used the results of these studies
      to establish what the lowest effective dose ranges were across a variety of
      behavioral domains and compared these doses and their effects with those obtained
      with normal, healthy adult humans. RESULTS: While the range of the lowest doses
      used in the studies with rats was quite broad (0.025-2.0 mg/kg), the median
      lowest effective doses observed (in the studies using doses of 0.125 mg/kg or
      less) were between 0.125 and 0.165 mg/kg across the behavioral domains of
      consummatory behavior, unconditioned or spontaneous behavior, learned behavior,
      and drug discriminative control. This range of doses was also found to be
      comparable to the lowest behaviorally effective doses of d-AMP (SC or PO) in
      normal human adults, which suggests that the sensitivity to the behavioral
      effects of amphetamine in these two species is fairly comparable. CONCLUSIONS:
      Because of their ability to alter a wide variety of behaviors in rats, we
      conclude that low doses of d-AMP are in the 0.1-0.4 mg/kg range. Doses within
      this range typically: 1) constitute the ED50 in most drug
      discrimination/generalization procedures; 2) increase a variety of consummatory
      behaviors; 3) increase a variety of unconditioned or spontaneous motor
      activities; 4) increase low rate schedule-controlled behavior while exerting
      variable effects on high rate schedule controlled behavior; and 5) improve
      performance on some choice tasks, particularly those requiring sustained
      attention. Our analyses also indicate that, with respect to behavior,
      investigators do not always agree on what constitutes a low dose of amphetamine
      in rats and that doses assumed to be low for this species often are relatively
      high.

PMID- 11205416
TI  - Involvement of D2 dopamine receptors in the opposing effects of two CCK-B
      agonists in a spatial recognition memory task: role of the anterior nucleus
      accumbens.
AB  - RATIONALE: A previous study in the rat has shown that systemic injection of two
      CCK-B agonists, BC264 and BC197, induced opposing effects on the retrieval phase
      of a spatial recognition memory task. OBJECTIVE: The present study was designed
      to investigate the mechanisms underlying these effects at the level of the
      dopaminergic system. METHODS: Rats were injected IPly with BC264 (0.3 microg/kg)
      or BC197 (30 microg/kg) and with D1 or D2 agonists and antagonists. The cognitive
      performances of rat were analysed on the retrieval phase of a spatial recognition
      memory task. The extracellular levels of dopamine were quantified in the anterior
      nucleus accumbens after injection of BC197 (3, 30 and 300 microg/kg IP), using
      the microdialysis technique on freely moving rats. Local injection of the D2
      antagonist, sulpiride (2.5 ng/microl) was performed in the anterior nucleus
      accumbens and the cognitive performances analysed following systemic injection of
      BC264 (0.3 microg/kg). RESULTS: The improvement and the impairment of performance
      induced respectively by BC264 and BC197 were suppressed by peripheral
      administration of sulpiride, showing that these opposing effects were both
      mediated by the stimulation of D2-like receptors. However, different dopaminergic
      pathways seem to be involved in the effects of the two CCK-B agonists. Indeed,
      systemic administration of BC197 did not induce the increase of extracellular
      dopamine levels observed with BC264. Furthermore, local injection of sulpiride,
      in the anterior nucleus accumbens, completely suppressed the cognitive enhancing
      effect of BC264. CONCLUSION: These findings suggest that the D2-mediated deficit
      in the performance induced by BC197 involves brain structures other than the
      anterior nucleus accumbens. They also demonstrate a critical role of dopaminergic
      transmission within the anterior nucleus accumbens in the improving effect
      induced by BC264 in a spatial memory task.

PMID- 11205417
TI  - Pain and negative affect: evidence the inverse benzodiazepine agonist DMCM
      inhibits pain and learning in rats.
AB  - RATIONALE: The anxiogenic DMCM, an inverse benzodiazepine agonist, was used to
      explore the relationship between negative affective states and pain. Past work
      suggests that the outcome obtained may depend on both the intensity of the
      affective state and the way in which pain is inferred. OBJECTIVES: The present
      study was designed to test the impact of relatively low doses of DMCM on multiple
      measures of pain reactivity and learning. METHODS: In experiment 1, systemic
      injections of 0.00, 0.015, 0.06, and 0.25 mg/kg DMCM were administered before
      vocalization and tail movements were assessed in response to a gradually
      incremented shock and radiant heat stimulus. Experiment 2 tested the effects of
      DMCM on Pavlovian conditioning. DMCM-treated subjects experienced a context
      paired with an aversive unconditioned stimulus (US) and conditioned freezing was
      assessed the next day. RESULTS: Experiment 1 showed that DMCM inhibits both a
      spinal nociceptive reflex (tail-flick to heat) and a supraspinal measure of pain
      (vocalization to shock). Because these inhibitory effects could reflect a
      disruption in motor function, experiment 2 employed a remote test based on
      Pavlovian conditioning. A moderate dose of DMCM undermined learning, implying
      that the drug decreased the affective impact of the aversive US. CONCLUSIONS:
      DMCM induces hypoalgesia on a wide range of assays. Furthermore,
      pharmacologically inducing a negative affective state blocks Pavlovian fear
      conditioning. It is suggested that DMCM induces a state of panic and that this
      state inhibits pain.

PMID- 11205418
TI  - Scopolamine fails to diminish chronic haloperidol-induced purposeless chewing in
      rats.
AB  - Chronic haloperidol treatment for 4-12 months gradually induces spontaneous,
      irregular, purposeless oral chewing movements (CMs), apparently involuntary, in
      some but not all treated rats. Based on phenomenologic and pharmacologic
      similarities, this laboratory preparation has been used as an animal model of
      tardive dyskinesia (TD), which is the human hyperkinetic motor syndrome
      associated with chronic antipsychotic administration. This putative animal model
      has received the most severe challenge to its validity by claims that its oral
      movements can be suppressed by anticholinergic treatments, since resistance to
      anticholinergic suppression is an accepted pharmacologic feature of TD. In this
      experiment, we challenged a group of haloperidol-treated rats with CMs using
      three doses of scopolamine (0.1, 0.3, 1.0 mg/kg) and placebo and rated the change
      in dyskinetic movements. Each scopolamine dose reduced CMs by a similar
      magnitude, without any dose effect; the saline dose also reduced CMs to an
      equivalent degree. Therefore, we concluded that some component of the experiment,
      not the scopolamine, reduced the CMs. The handling component of the procedure was
      identified as a likely confound, and we tested this further. Rats with CMs were
      handled at several levels of "severity"; and the dyskinesias were rated at 1 and
      3 h later. CMs were reduced by the experimental handling, in relation to the
      strength of the handling. Minimal handling produced modest CM reductions with
      quick recovery; whereas, the "strongest" handling plus the placebo injection
      produced the greatest CM reduction, evident over 3 h, resembling the CM
      reductions seen in the scopolamine and placebo experiment. Overall, these results
      suggest that anticholinergic drugs do not suppress chronic haloperidol-induced
      rat CMs. However, the movements are sensitive to stressful handling situations,
      and diminish with stress. In both of these characteristics, rat CMs resemble
      human TD, further supporting a role for this model in studies of human TD.

PMID- 11205419
TI  - Cognitive performance and serotonergic function in users of ecstasy.
AB  - RATIONALE: (+/-) 3,4-Methylenedioxymethamphetamine (MDMA or "ecstasy") has been
      shown to cause long term damage to serotonergic cerebral neurons in animals. The
      neurotoxic effects in humans are less clear and little is known about the
      functional consequences, although some studies suggest memory impairment. Given
      the widespread use of MDMA, our lack of knowledge raises concerns. OBJECTIVE: We
      investigated, in humans, the relation between past use of ecstasy and cognitive
      performance as well as serotonergic function. METHODS: Two groups of 21 males
      with moderate and heavy recreational use of MDMA, respectively, and a control
      group of 20 males without use of MDMA were compared. All were from the same
      subculture. Reaction time, direct recall, and recognition were assessed.
      Serotonergic function was measured by the neuro-endocrine response to a placebo
      controlled, crossover challenge with dexfenfluramine. RESULTS: Ecstasy users
      showed a broad pattern of statistically significant, but clinically small,
      impairment of memory and prolonged reaction times. Heavy users were affected
      stronger than moderate users. Release of cortisol but not of prolactin after
      dexfenfluramine administration was significantly reduced in both groups of
      ecstasy users compared with the controls. Analyses of covariance showed that
      likely confounding variables including recent exposure to ecstasy, psychosocial
      profiles and use of other drugs did not explain the differences found between the
      groups. CONCLUSIONS: These results provide further evidence that use of ecstasy
      may be associated with impairment of memory and of serotonergic function. These
      findings are compatible with neurotoxicity of ecstasy as shown in animals.

PMID- 11205420
TI  - Evidence that orexin-A-evoked grooming in the rat is mediated by orexin-1 (OX1)
      receptors, with downstream 5-HT2C receptor involvement.
AB  - RATIONALE: Orexins A and B have recently been discovered and shown to be derived
      from preproorexin, primarily expressed in the rat hypothalamus. Orexin-A has been
      ascribed a number of in vivo functions in the rat after intracerebroventricular
      (ICV) administration, including hyperphagia, neuroendocrine modulation and, most
      recently, evidence for a behavioural response characterised by an increase in
      grooming. OBJECTIVES: Here, we have investigated the orexin-receptor subtypes
      involved in the grooming response to orexin-A (3 microg, ICV) in the rat.
      METHODS: Male rats, habituated to clear Perspex behavioural observation boxes,
      were pretreated with antagonists with mixed selectivity for OX1, OX2, 5-HT2B and
      5-HT2C receptor subtypes prior to the administration of orexin-A and the intense
      grooming response elicited by this peptide assessed. RESULTS: Pretreatment of
      rats with a mixed OX1/5-HT2B/2C receptor antagonist 1-(4-methylsulfanylphenyl)-3
      quinolin-4-ylurea (SB-284422), revealed a significant, but incomplete, blockade
      of orexin-A-induced grooming. Despite the low potency of orexin-A at 5-HT2B and 5
      HT2C receptors in vitro (pKi<5), studies were undertaken to determine whether
      downstream 5-HT2B or 5-HT2C receptors mediate in the grooming-elicited by orexin
      A. Whilst the selective 5-HT2B receptor antagonist, SB-215505 (3 mg/kg, PO, 5
      HT2B, pKi=8.58; OX1, pKB < 5.15) failed to effect orexin-A-induced grooming, the
      selective 5-HT2C receptor antagonist, SB-242084 (1 mg/kg, IP, 5-HT2C, pKi = 8.95;
      OX1, pKB < 5.1) potently antagonised the grooming response to this peptide. This
      suggested that the partial blockade of orexin-A-induced grooming obtained with SB
      284422 might be attributable to its 5-HT2C and/or OX1 receptor blocking activity.
      However, complete blockade of orexin-A-induced grooming by the subsequently
      identified selective OX1 receptor antagonist 1-(2-methylbenzoxazol-6-yl)-3
      [1,5]naphthyridin-4-yl urea hydrochloride, SB-334867-A (OX1, pKB = 7.4; OX2, pKB
      = 5.7), devoid of appreciable affinity for either 5-HT2B (pKi < 5.3) or 5-HT2C
      (pKi < 5.4) receptors, provides the first definitive evidence that a central
      behavioural effect of orexin-A (grooming) is mediated by OX1 receptors.
      CONCLUSIONS: This data suggests that orexin-A indirectly activates 5-HT2C
      receptors downstream from OX1 receptors to elicit grooming in the rat. The use of
      SB-334867-A in vivo will enable the role of OX,1 receptors within the rat central
      nervous system to be further characterised.

PMID- 11205422
TI  - Anxiolytic properties of botanical extracts in the chick social separation-stress
      procedure.
AB  - RATIONALE: The recent growth in sales of natural products labeled as dietary
      supplements in the United States has renewed scientific interest in the study of
      the therapeutic effects of multi-component botanical products. OBJECTIVES: This
      study sought to determine whether botanical extracts derived from the Rutaceae
      family, Acori graminei, the Magnoliaceae family, Alchemilla vulgaris and Primula
      veris, which had previously been identified in bioassays as having potential
      anxiolytic activity, were active in the chick social separation-stress procedure.
      METHODS: Eight-day-old chicks received IP injections of test articles 30 min
      before being tested in the presence of two social companions or in isolation for
      a 3-min observation period. Dependent measures were: a) latency to adopt a
      ventral recumbent posture to index sedation, b) number of vocalizations to index
      separation-distress and c) a composite pain score (comprised of footlift
      frequency and footlift duration in response to 50 microl of 0.10% formalin
      injected into the plantar surface of the foot) to index stress-induced analgesia.
      RESULTS: Proprietal extracts NPS00033 from the Rutaceae plant family and NPS00039
      (Relora) from the Magnoliaceae plant family screened positive in this chick model
      without causing sedation. CONCLUSIONS: These results suggest that botanical
      extracts Relora and NPS00033 may be useful in modulating anxiety states.

PMID- 11205421
TI  - Effects of centrally administered orexin-B and orexin-A: a role for orexin-1
      receptors in orexin-B-induced hyperactivity.
AB  - RATIONALE: Orexin-A and orexin-B are hypothalamic neuropeptides derived from a
      130-amino acid precursor, prepro-orexin, and are potent agonists at both the
      orexin-1 (OX1) and orexin-2 (OX2) receptors. Orexin-A has been ascribed a number
      of in vivo functions in the rat after intracerebroventricular (ICV)
      administration, including hyperphagia, neuroendocrine modulation and a role in
      the regulation of sleep-wake function. The in vivo role of orexin-B is not as
      clear. OBJECTIVES: To investigate the behavioural, endocrine and neurochemical
      effects of orexin-B in in-vivo tests. In a number of experiments, these effects
      were compared with those of orexin-A. METHODS: Experiments were carried out in
      male, Sprague-Dawley rats with a guide cannula directed towards the lateral
      ventricle. The effects of orexin-B (ICV) upon grooming behaviour were compared
      with those of orexin-A. The effects of orexin-B upon the motor activity response
      to both novel and familiar environments were assessed in an automated activity
      monitor. Orexin-B was tested upon startle reactivity and body temperature.
      Further, plasma hormones and [DOPAC+ HVA]/[DA] and [5-HIAA]/[5-HT] ratios in six
      brain areas were measured 40 min post-orexin-B or orexin-A. RESULTS: The clearest
      behavioural response to orexin-B was increased motor activity in both novel and
      familiar environments. Orexin-B-induced hyperactivity was blocked by an OX1
      receptor antagonist, SB-334867-A, implicating OX1 receptors in this behavioural
      response. In common with orexin-A, orexin-B reduced plasma prolactin and failed
      to influence startle reactivity. However, in contrast with orexin-A, orexin-B
      increased head grooming but failed to cause a robust whole body grooming response
      or increase plasma corticosterone levels. Further, orexin-B, but not orexin-A,
      increased plasma TSH and increased hypothalamic and striatal [5-HIAA]/[5-HT]
      ratios. CONCLUSIONS: The present study has demonstrated a number of behavioural,
      neuroendocrine and neurochemical effects of orexin-B that distinguish it from
      orexin-A. Further, we have demonstrated a role for OX1 receptors in the actions
      of orexin-B upon motor activity.

PMID- 11205423
TI  - Individual differences in preferences for and responses to four nicotine
      replacement products.
AB  - RATIONALE: With several different forms of nicotine replacement therapy available
      for smokers, it is useful to know about factors that may influence choice of
      form. OBJECTIVE: To examine factors associated with preference for different
      nicotine replacement products and effectiveness of these products. The simple
      comparison of success rates between the products has been reported previously.
      METHODS: Five hundred and four smokers were invited to rank order four products
      (gum, patch, nasal spray and inhaler) in terms of preference and were then
      randomly allocated to receive one of the products for a smoking cessation
      attempt. They were followed up 1 week, 4 weeks, 12 weeks and 15 weeks later.
      Ratings of the products were repeated 1 week after the quit date. Mood and
      physical symptoms were assessed at baseline and at each follow-up visit. Urges to
      smoke were assessed at all post-quit date sessions. Abstinence was assessed by
      self-report with expired air carbon monoxide verification. RESULTS: The patch was
      the most popular product initially, followed by the spray and inhaler and then
      the gum. The difference was greater for women than men. However, all smokers
      quickly came to like whichever product they had been allocated. Smokers who
      initially preferred the spray or inhaler were heavier smokers than those who
      preferred the gum or patch. Prior experience of the gum was associated with lower
      initial preference for it, but did not affect outcome. Prior experience with the
      patch had no effect on preference or outcome. Being allocated to the preferred
      product did not increase success at stopping smoking. Women were more successful
      at stopping smoking on the inhaler than the gum. Among highly dependent smokers,
      those on the inhaler had a lower relapse rate than those on the other products.
      CONCLUSIONS: Regardless of initial preferences, whether patients obtain their
      preferred form of NRT or one selected for them did not seem to affect outcome.
      This may be because smokers came to like particular products as they got used to
      them. Other things being equal, women may be better advised to use inhaler rather
      than gum and men vice versa.

PMID- 11205424
TI  - Gender-related differences in response to placebo in benzodiazepine withdrawal: a
      single-blind pilot study.
AB  - RATIONALE: Benzodiazepines have dependency-producing properties, and the majority
      of patients who are prescribed benzodiazepines and are treated for benzodiazepine
      dependency are women. Inability to cope with withdrawal symptoms may lead to
      continued consumption of benzodiazepines, often with the development of tolerance
      and dose escalation as a consequence. OBJECTIVE: In the present study we analyzed
      gender-related differences in reactions to placebo injections in a placebo
      controlled study of the effects of the benzodiazepine antagonist flumazenil among
      patients previously treated for benzodiazepine dependency and healthy controls.
      METHODS: Ten patients and ten controls (five males and five females in each
      group) received two placebo injections (separated by 15 min) on two separate
      occasions (1-13 weeks apart). The patients had been benzodiazepine free for 47 (4
      266) weeks on the first occasion. Subjective ratings of symptoms, thought to be
      important during/after withdrawal of benzodiazepines, were made before and after
      each injection, as well as registrations of blood pressure and heart rate.
      RESULTS: An overall difference existed between previously benzodiazepine
      dependent subjects and healthy controls, with patients scoring higher on negative
      and somatic aggregates and lower on a positive aggregate. A four-way interaction
      (group x gender x occasion x time) was found for negative and somatic aggregates,
      which could mainly be explained by the reactions of female patients. Thus,
      females had the highest base-line ratings and were the only group that showed a
      significant reduction in symptom ratings after placebo injections on the first
      occasion. Gender differences were also found for systolic and diastolic blood
      pressure. There was no significant response to placebo among male patients or for
      controls (males or females) for ratings of any variable. CONCLUSIONS: The results
      suggest that there might be gender-specific differences in reactions to placebo
      injections, with female patients being more affected. Arguments for and against
      explanatory factors such as expectation, provider factors, habituation,
      regression toward the mean, and reduction of anxiety are presented.

PMID- 11205425
TI  - Relationship between plasma risperidone and 9-hydroxyrisperidone concentrations
      and clinical response in patients with schizophrenia.
AB  - RATIONALE: Evaluation of relationships between serum antipsychotic drug
      concentrations and clinical response may provide valuable information for
      rational dosage adjustments. For risperidone, this relationship has been little
      investigated to date. OBJECTIVE: To assess the relationship between plasma
      concentrations of risperidone and its active 9-hydroxy-metabolite (9-OH
      risperidone) and clinical response in schizophrenic patients who experienced an
      acute exacerbation of the disorder. METHODS: Forty-two patients (30 males, 12
      females, age 24-60 years) were given risperidone at dosages ranging from 4 to 9
      mg/day for 6 weeks. The design of the study was open and risperidone dosage could
      be adjusted individually according to clinical response. Steady-state plasma
      concentrations of risperidone and its 9-hydroxymetabolite were measured after 4
      and 6 weeks using a specific HPLC assay. Psychopathological state was assessed at
      baseline and at weeks 2, 4, and 6 by means of the positive and negative syndrome
      scale (PANSS), and patients were considered responders if they showed a greater
      than 20% reduction in total PANSS score at final evaluation compared with
      baseline. RESULTS: Mean plasma concentrations of risperidone, 9-OH-risperidone,
      and active moiety (sum of risperidone and 9-OH-risperidone concentrations) did
      not differ between responders (n = 28) and non-responders (n = 14). No
      correlation between plasma levels and percent decrease in total PANSS score was
      found for risperidone (rs = -0.187, NS), 9-OH-risperidone (rs = 0.246, NS), and
      active moiety (rs = 0.249, NS). Active moiety concentrations in plasma were
      higher (P < 0.001) in patients developing clinically significant parkinsonian
      symptoms (n = 7) than in those with minimal (n = 7) or no drug-induced
      parkinsonism (n = 28). CONCLUSIONS: In chronic schizophrenic patients
      experiencing an acute exacerbation of the disorder, plasma levels of risperidone
      and its active metabolite correlate with the occurrence of parkinsonian side
      effects, whereas no significant correlation appears to exist with the degree of
      clinical improvement.

PMID- 11205426
TI  - Three sets of diagnostic criteria for major depression and correlations with
      serotonin-induced platelet calcium mobilization in cancer patients.
AB  - OBJECTIVE: Enhanced serotonin-induced platelet calcium mobilization has been
      proposed to be a biological marker for the pathophysiology of major depression in
      physically healthy patients. To determine the most appropriate method of
      diagnosing major depression in cancer patients, we compared serotonin-induced
      platelet calcium mobilization between patients with and without major depression
      diagnosed according to three different sets of diagnostic criteria (inclusive,
      substitutive and exclusive). METHODS: Among the cancer patients referred to our
      institution between June 1997 and March 1998, 24 patients diagnosed as having
      major depression according to the inclusive approach (in which the nine
      traditional symptoms of major depression contribute towards the diagnosis of
      depression regardless of its presumed etiology) participated in the study.
      Serotonininduced platelet calcium mobilization was examined in these patients and
      in the same number of non-depressed controls matched for age, sex, cancer stage
      and cancer site. The depressed patients were then re-evaluated using substitutive
      and exclusive criteria, and calcium mobilization comparisons with the relevant
      controls were repeated. RESULTS: Compared with the controls, an enhanced
      serotonin-induced platelet calcium response was only observed in the patients
      with major depression according to the exclusive criteria. No significant
      enhancement was observed when the inclusive or substitutive approaches were used.
      CONCLUSION: These findings, based on the use of enhanced serotonin-induced
      platelet calcium mobilization as a biological marker, suggest that the exclusive
      approach might be the most valid and appropriate method of diagnosing major
      depression in cancer patients, while the inclusive and substitutive approaches
      might overestimate the occurrence of major depression in these patients.

PMID- 11205427
TI  - Effects of abstinence and smoking on information processing in adolescent
      smokers.
AB  - RATIONALE: Although adolescent smokers appear to display some of the hallmark
      features of dependence, the biological and behavioral effects of smoking in this
      population are poorly understood. OBJECTIVES: This study aimed to define
      empirically the effects of abstinence and smoking in adolescent smokers, using
      indices validated in adult smokers. METHODS: Subjects were 16 young novice
      smokers (five male, 11 female), ages 14-18 years. A modified Stroop task measured
      the ability to inhibit attention to smoking-related cues; the classic Stroop task
      measured the ability to inhibit a pre-potent response (i.e. reading a word); a
      rapid information processing (RIP) task measured vigilance. RESULTS: Abstinence
      increased and smoking decreased the intrusiveness of smoking cues. Parallel
      effects were seen in commission errors on the RIP task. These effects were
      restricted to heavier smokers (>11 cigarettes/day). Subjective withdrawal effects
      predicted the intrusiveness of smoking words during abstinence. The number of
      cigarettes smoked per day predicted the beneficial effect of smoking on the
      classic as well as modified Stroop tasks. The physiological effects of abstinence
      and smoking predicted RIP performance. CONCLUSIONS: Abstinence impairs and
      smoking improves inhibitory information processing in young novice smokers in a
      manner similar to adult smokers. Daily frequency of smoking is a critical
      moderator of these effects.

PMID- 11205428
TI  - Improved incidental memory with nicotine after semantic processing, but not after
      phonological processing.
AB  - RATIONALE: A number of lines of evidence suggest that a nicotinic cholinergic
      system is mediating attentional processing. However, the evidence is less clear
      for a nicotinic system being involved in mnemonic processing. OBJECTIVES: The
      present study investigated the effects of nicotine on memory using a depth of
      processing paradigm. METHODS: A double-blind design was used with participants (n
      = 40) smoking either a nicotine containing cigarette (n = 20) and a denicotinized
      cigarette (n = 20). After smoking, each set of these participants was further
      subdivided into two groups (n = 10 for each). One group were presented with a
      series of trials each beginning with the presentation of a "decision word" which
      they had to say whether it represented something which was living or non-living
      (semantic-orienting). The second group had to say whether the word had one
      syllable or two syllables (phonological or non-semantic orienting condition).
      This decision was followed by a word in coloured ink whose colour participants
      were required to name as quickly as possible. On completion of the whole task the
      participants were given an unexpected free recall test. RESULTS: The nicotine
      containing cigarette reduced the latencies for decision-making and colour naming
      in comparison with the denicotinized cigarette. The free recall test showed that
      nicotine-containing cigarette increased the number of words remembered, but only
      for the semantic-orienting condition and not the non-semantic condition.
      CONCLUSIONS: There is a nicotinic cholinergic system that mediates effortful
      processing. It can be deployed for attentional processing, including the
      associative processing required for memory encoding.

PMID- 11205429
TI  - Fluoxetine in the treatment of Huntington's disease.
AB  - RATIONALE: Recent reports suggest the possible efficacy of selective serotonin
      reuptake inhibitors (SSRIs) in treating particular symptoms of Huntington's
      disease (HD), such as aggressiveness and agitation. However, predictive features
      to identify HD subjects who may benefit from this treatment have not been
      established. OBJECTIVES: Two individuals from a large HD pedigree with a very
      high prevalence of obsessive-compulsive disorder (OCD) have been treated with
      fluoxetine, an SSRI. We aimed at testing whether the co-occurrence of the two
      disorders in this pedigree might have some underlying pathogenic similarities,
      maybe also resulting in a good response of HD symptoms to the anti-obsessional
      drug fluoxetine. METHODS: Each patient was evaluated, started on fluoxetine
      treatment, and then reassessed monthly with: (a) the HD motor rating scale, to
      rate the impairment of movement, and (b) the mini mental state examination, for a
      cognitive ascertainment. They had a complete psychiatric and neurologic
      examination as well. RESULTS: Both subjects showed an excellent response to
      fluoxetine. One patient exhibited improvement of the motor and behavioral
      components of the disorder, while the other improved also in the cognitive domain
      of HD. The best response was shown by the individual suffering from OCD in her
      youth. The amelioration in these two patients has been maintained for 2 and 6
      years, respectively, whereas the course of HD is that of a progressive
      deterioration. CONCLUSIONS: Firm conclusions to explain these results cannot be
      drawn. However, a hypothetical involvement of the serotonergic system, suggested
      by the excess of OCD in the pedigree, seems supported by the response of these
      two individuals to fluoxetine. It may be worth further exploring the value of the
      psychiatric picture in selecting the appropriate treatment for at least some
      cases of HD.

PMID- 11205430
TI  - Synergistic efects of opioid and cannabinoid antagonists on food intake.
AB  - RATIONALE: Central cannabinoid systems have been implicated in appetite
      regulation through the hyperphagic effects of exogenous and endogenous
      cannabinoids. These effects may involve activation of reward systems and be
      mediated in part by opioidergic processes. OBJECTIVE: Cannabinoid-opioid
      interactions in feeding were examined by testing the combined effects on food
      intake of sub-anorectic doses of selective antagonists for CB1 and opioid
      receptors. METHODS: Male rats (n = 8) received subcutaneous injections of
      naloxone (0, 0.1, 0.5, 1.0 mg/kg) and SR141716 (0, 0.1, 0.5, 1.0 mg/kg) before l
      h, nocturnal food (chow) intake tests. RESULTS: Neither naloxone nor SR141716
      reliably affected feeding when administered alone. By contrast, combined
      administration of the two antagonists significantly suppressed chow intake at
      each dose combination. Joint administration of the highest doses of each
      antagonist suppressed intake by 73%, a significantly greater effect than produced
      by either naloxone (32%) or SR141716 alone (17%). CONCLUSION: The data reveal a
      synergistic interaction between the effects of naloxone and SR141716 on feeding,
      provide further evidence of important functional relationships between endogenous
      cannabinoid and opioid systems, and strengthen the postulated role for
      endocannabinoids in reward processes contributing to the normal control of
      appetite.

PMID- 11205432
TI  - Kinetics of hydroxyapatite precipitation at pH 10 to 11.
AB  - The mechanism and kinetics of hydroxyapatite (HAP) precipitation from aqueous
      solution at the conditions of pH 10-11 and at calcium ion concentrations of more
      than 0.5 mol/l were investigated. The results show that the reaction undergoes
      the following process: transferring from octacalcium phosphate (OCP) to amorphous
      calcium phosphate (ACP) rapidly, and then from ACP to calcium-deficient
      hydroxyapatite (DAP) and HAP. DAP was the non-stoichiometric material that ACP
      converts to HAP. Reaction temperature greatly affects the reaction rate of the
      conversion from ACP to HAP. It takes about 24 h to form pure-phase HAP at 25
      degrees C while it takes only 5 min at 60 degrees C. The temperature also has a
      great deal of influence on the particle size and morphology of precipitated
      hydroxyapatite. The reaction of transformation from ACP to DAP was second order
      and the activation energy was 95 kJ/mol (22.7 kCal/mol) and therefore it was
      inferred that the conversion reaction was a surface control process.

PMID- 11205431
TI  - Allelic variation in the 5-HT2C receptor (HT2RC) and the increase in slow wave
      sleep produced by olanzapine.

PMID- 11205433
TI  - Analysis of products diffused into UHMWPE prosthetic components in vivo.
AB  - Ten UHMWPE hip inserts, five ethylene oxide and five gamma-ray sterilised in air,
      were retrieved during surgical revision after aseptic failure. Time in situ
      varied from 6 to 23 years. First implant was carried out for degenerative
      arthritis in all cases. The retrieved inserts were cut into two parts
      perpendicular to the articulate surface and a series of 150 microm thick slices
      were obtained from the cross-section. These were studied by FTIR microscopy and
      the absorbed products were extracted with cyclohexane for identification by GC/MS
      and Py/GC/MS. All retrieved UHMWPE components, independent of the sterilisation
      method, showed species adsorbed on the surface, which were mainly synovial liquid
      protein components. In addition, species such as cholesterol, fatty esters of
      cholesterol and squalene, also originating from synovial liquid, were found in
      the bulk. The concentration of the different species varies depending on the
      individual patient.

PMID- 11205434
TI  - Cytotoxicity of dental composite components and mercury compounds in pulmonary
      cells.
AB  - The cytotoxic potentials of the dental composite components
      triethyleneglycoldimethacrylate (TEGDMA) and 2-hydroxy-ethylmethacrylate (HEMA)
      as well as mercuric chloride (HgCl2) and methyl mercury chloride (MeHgCl) were
      investigated. Proliferating A549 and L2 cell monolayers were cultured in the
      absence or presence of composite components or mercurials. Twenty-four hours
      later the tetrazolium salt XTT (sodium 3'-[1-phenyl-aminocarbonyl)-3,4
      tetrazolium]bis(4-methoxy-6-nitro)benzenesulphonic acid) was added. Formazan
      formation was quantified using a microtiter plate reader. EC50 values were
      obtained as half-maximum-effect concentrations from fitted curves. EC50 values
      were in A549 cells (mean values +/- standard deviation; n = 12; micromol/l); HEMA
      8854+/-1882; TEGDMA 1821+/-529; HgCl2 41+/-7 and MeHgCl 27+/-3. EC50 values in L2
      cells were: HEMA 191+/-28; TEGDMA 112+/-16; HgCl2 25+/-6 and MeHgCl 8+/-6. All
      tested substances induced a dose-dependent loss of viability in A549 and L2 cells
      after 24 h. The EC50 values of both mercurials were significantly (p < 0.05)
      lower compared to the values of both composite components. TEGDMA was about 5
      fold (A549 cells) and about 2-fold (L2 cells) more toxic compared to HEMA. It is
      to be assumed that the risk of lung cell damage by dental composite components is
      even more unlikely.

PMID- 11205435
TI  - A novel pH-sensitive membrane from chitosan--TEOS IPN; preparation and its drug
      permeation characteristics.
AB  - A novel organic-inorganic composite membrane was prepared, using tetra ethyl
      ortho silicate (TEOS) as an inorganic material and chitosan as an organic
      compound. Equilibrium and oscillatory swelling studies were conducted to
      investigate swelling behaviors of the membrane according to the pH of the
      swelling medium. Drug permeation experiments were also performed in phosphate
      buffer solution of the pH of 2.5 and 7.5, respectively. Lidocaine HCl, sodium
      salicylate and 4-acetamidophenol were selected as model drugs to examine the
      effect of ionic property of drug on the permeation behavior. The effects of
      membrane composition and the external pH on the swelling and the drug permeation
      behavior of IPN membrane could be summarized as follows; chitosan incorporated
      into TEOS IPN swelled at pH 2.5 while shrunk at pH 7.5. This swelling behavior
      was completely reversible and the membrane responded rapidly to the change in
      environmental pH condition. According to swelling behavior, an increase in pH
      from 2.5 to 7.5 yielded an increase in the rate of drug permeation because of the
      shrinking of the incorporated chitosan in TEOS IPN, while decrease in pH resulted
      in low permeation rate. The optimal TEOS-chitosan ratio for maximum pH
      sensitivity existed and drug permeation was influenced not only with the external
      pH but also with the ionic interactions between the drug and membrane.

PMID- 11205436
TI  - A preliminary in vitro study on the fabrication and tissue engineering
      applications of a novel chitosan bilayer material as a scaffold of human neofetal
      dermal fibroblasts.
AB  - The bilayer structure of chitosan film and sponge was designed as a scaffold of
      skin tissue engineering and a dermis substitute. It was processed successively
      via the formation of a dense chitosan film by casting method and a porous
      chitosan sponge by lyophilization. The dry thickness of the film layer was 19.6
      microm and that of the sponge layer was controlled at 60-80 microm. Porogens such
      as sodium chloride, glucose, and sucrose were used to create large pores of the
      chitosan sponge layer. Human neofetal dermal fibroblasts were seeded in the
      chitosan sponge layer and cultured for 4 weeks. It was found that the cells could
      grow and proliferate well in an extended shape on the flat bottom of large pores
      with 15-100 microm width and in spherical form on the rough pore walls or at the
      edges of micropores less than 5 microm. Fibroblasts after the culture could bind
      tightly with the sponge layer via newly formed extracellular matrices to give a
      living cell-matrix-chitosan composite. The bilayer chitosan material remained
      stable in shape and size during the cell culture. The results suggested that the
      bilayer chitosan material would be an alternative of collagen materials which was
      obviously contracted during cell culture.

PMID- 11205437
TI  - Osteoblast growth on titanium foils coated with hydroxyapatite by pulsed laser
      ablation.
AB  - Pulsed laser ablation is a new method for deposition of thin layers of
      hydroxyapatite (HA) on to biomaterial surfaces. In this paper, we report activity
      and morphology of osteoblasts grown on HA surfaces fabricated using different
      laser conditions. Two sets of films were deposited from dense HA targets, at
      three different laser fluences: 3, 6 and 9 Jcm(-2). One set of the surfaces was
      annealed at 575 degrees C to increase the crystallinity of the deposited films.
      Primary human osteoblasts were seeded onto the material surfaces and cytoskeletal
      actin organisation was examined using confocal laser scanning microscopy. The
      annealed surfaces supported greater cell attachment and more defined cytoskeletal
      actin organisation. Cell activity, measured using the alamar Blue assay, was also
      found to be significantly higher on the annealed samples. In addition, our
      results show distinct trends that correlate with the laser fluence used for
      deposition. The cell activity increases with increasing fluence. This pattern was
      repeated for alkaline phosphatase production by the cells. Differences in cell
      spreading were apparent which were correlated with the fluence used to deposit
      the HA. The optimum surface for initial attachment and spreading of osteoblasts
      was one of the HA films deposited using 9 J cm(-2) laser fluence and subsequently
      annealed at 575 degrees C.

PMID- 11205438
TI  - Coagulation and complement activation.
AB  - The purpose of this investigation was to assess the effect of heparin coating of
      a new stent construction (Stent Graft, Jomed Implantate GmbH, Germany) on
      platelet and coagulation activity. METHODS: Stent grafts with an ePTFE membrane
      interfoliated between two stents were deployed in tubings to form Chandler loops.
      Fresh human blood with a low concentration of heparin was rotated for 1 h, then
      collected and used for measurements of platelet number, thrombin-antithrombin
      complex (TAT), CD11b, C3a and C5b-9. There were five study groups: Group 1,
      conventional unmodified stents (n = 8); Group 2, untreated stent grafts (n = 8);
      Group 3, heparin-coated stents and untreated membrane (n = 7); Group 4, heparin
      coated stents and membrane (n = 8); Group 5, heparin-coated PVC tubings with no
      stents (n = 8). RESULTS: There was a significant drop in platelet count, increase
      in TAT-values and CD11b expression in Groups 1-3 but not in Group 4 compared to
      Group 5. Examination by scanning electron microscopy revealed extensive
      activation on non-modified stents but almost no deposition of thrombotic material
      on heparin-modified stent grafts. CONCLUSIONS: With unmodified stents and
      membrane there were signs of significant activation of platelets and coagulation.
      In contrast, the heparin-coated stent graft induced much less alterations,
      indicating improved blood compatibility.

PMID- 11205439
TI  - In vivo comparison of bioactive glass particles in rabbits.
AB  - Bioglass particles of the compositions 45s5, 52s and 55s were implanted in the
      distal femoral epiphysis of rabbits. Animals were sacrificed at 7, 28, and 84 d
      postoperatively and specimens investigated using light microscopy and
      histomorphometry. Bone bonding occurred in a zentripetal fashion and fastest for
      45s5. Bone formation was hampered at the core of the implantation bed where bone
      bonding showed a peak at 28d and diminished at 84d (except for 55s). This went
      along with a significant increase in numerous multinuclear giant cells (MNGC).
      Implantation model, particle size and surface-area-to-volume ratio are discussed
      as possible parameters determining bone regeneration.

PMID- 11205440
TI  - Protein release from physically crosslinked hydrogels of the PLA/PEO/PLA triblock
      copolymer-type.
AB  - A series of PLA/PEO/PLA triblock copolymers was prepared by ring opening
      polymerization of rac-lactide in the presence of various di-hydroxyl poly
      (ethylene glycol)s, using CaH2 as a biocompatible initiator. Hydrogels were
      prepared by a phase separation method consisting of introducing small amounts of
      water over solutions of the copolymers in a biocompatible organic solvent, namely
      tetraglycol [poly(ethylene glycol monotetrahydrofurfuryl ether)]. The resulting
      hydrogels appeared much more hydrophilic than the rather tough hydrogels formed
      by swelling of dry tablets or films processed from the same copolymers. The phase
      separation-derived hydrogels were soft enough to be injected through a trochar.
      Two proteins, namely bovine serum albumine (BSA) and fibrinogen, were physically
      entrapped in these hydrogels by mixing with the polymer solutions before gel
      formation. This procedure appeared to be protein-respecting according to circular
      dichroism analysis on the released BSA. Dramatically different release profiles
      were obtained for the two proteins. In the case of BSA, the release depended on
      the quantity of protein incorporated in the hydrogel and presented a parabolic
      type profile, in agreement with the behaviors of diffusion-controlled monolitic
      drug delivery devices. In contrast, almost linear release profiles were observed
      in the case of fibrinogen, the hydrogels behaving like a reservoir drug delivery
      system. These findings are tentatively interpreted in terms of gel-protein
      compatibility in the case of BSA and gel-protein incompatibility in the case of
      fibrinogen.

PMID- 11205441
TI  - Properties of crosslinked ultra-high-molecular-weight polyethylene.
AB  - Substantially reducing the rate of generation of wear particles at the surfaces
      of ultra-high-molecular-weight polyethylene (UHMWPE) orthopedic implant bearing
      components, in vivo, is widely regarded as one of the most formidable challenges
      in modern arthroplasty. In the light of this, much research attention has been
      paid to the myriad of endogenous and exogenous factors that have been postulated
      to affect this wear rate, one such factor being the polymer itself. In recent
      years, there has been a resurgence of interest in crosslinking the polymer as a
      way of improving its properties that are considered relevant to its use for
      fabricating bearing components. Such properties include wear resistance, fatigue
      life, and fatigue crack propagation rate. Although a large volume of literature
      exists on the topic on the impact of crosslinking on the properties of UHMWPE, no
      critical appraisal of this literature has been published. This is one of the
      goals of the present article, which emphasizes three aspects. The first is the
      trade-off between improvement in wear resistance and depreciation in other
      mechanical and physical properties. The second aspect is the presentation of a
      method of estimating the optimal value of a crosslinking process variable (such
      as dose in radiation-induced crosslinking) that takes into account this trade
      off. The third aspect is the description of a collection of under- and unexplored
      research areas in the field of crosslinked UHMWPE, such as the role of starting
      resin on the properties of the crosslinked polymer, and the in vitro evaluation
      of the wear rate of crosslinked tibial inserts and other bearing components that,
      in vivo, are subjected to nearly unidirectional motion.

PMID- 11205442
TI  - Child speech and language assessment and measurement.
AB  - The necessity of using standardized and norm-referenced tests in assessing speech
      and language of impaired children has now been recognized. Thus it seems useful
      to summarize based on the literature principles for founding such testing
      methods. These include: a) the necessity for a neuropsycholinguistic model that
      allows the speech-language pathologist to relate the observed linguistic behavior
      to underlying language processes, b) the knowledge of the psychometric
      characteristics required for language tests, and c) a discussion of some of the
      difficulties or controversed points from clinical practice. Among these latter
      the following are discussed: 1) measurement versus clinical observation, 2)
      screening versus exhaustive assessment, 3) language linguistic aspects versus
      pragmatic dimension, 4) formal tasks versus spontaneous language analysis, 5)
      linguistic versus metalinguistic assessment, 6) "knowledge-dependent" versus
      "processing-dependent" tests, 7) early detection of at risk children versus
      diagnosis of developmental language disorders. Diagnosticians are advised to be
      aware of the principles to respect when assessing child language.

PMID- 11205443
TI  - Cleft palate speech.
AB  - Cleft palate is a known pathology but there exists a lot of controversy about the
      therapy. The aim of this paper is to give a brief overview of the pathology
      itself and its consequences particularly in speech. At this point the velar and
      velopharyngeal function are stressed.

PMID- 11205444
TI  - Congenital CMV-infection and hearing loss.
AB  - CMV (cytomegalovirus) is one of the Herpesviridae, known for their potential for
      latency and reactivation. The sequelae of fetal infection are diverse: chronic
      stage of early fetal infection with brain anomalies, symptomatic late fetal
      infection with hepatitis and thrombocytopenia and asymptomatic infection. With
      any of these clinical phenotypes, permanent hearing loss is possible. CMV
      infection is the only relevant viral cause of perinatal hearing loss because
      rubella, measles and mumps have become rare due to vaccination. Recent studies
      have suggested beneficial effects on outcome of i.v. ganciclovir treatment in
      symptomatic cases. We have recently taken the challenge of treating asymptomatic
      newborns on the basis of active sonographic brain lesions in order to prevent
      labyrinth destruction. We would also like to stress the importance of suspecting
      children with congenital hearing loss, or hearing loss that develops in the first
      year of life, of having an asymptomatic congenital CMV-infection. Follow up in
      the first years of life is necessary in these children because further
      progression of hearing loss is possible.

PMID- 11205445
TI  - Results of cerebellopontine space imaging by magnetic resonance during one year.
AB  - The authors present the results of a retrospective study concerning 231 magnetic
      resonance imaging (MRI) of the cerellopontine space requested by the otologists
      of the department between September 1996 and September 1997. The motives of
      imaging were sensorineural hearing loss (44%), vertigo and unsteadiness (25.5%),
      tinnitus (16.5%) and other (13%). The MRI was abnormal in 18% of the cases and
      the diagnosis of acoustic schwannoma was made in 10% of the cases.

PMID- 11205446
TI  - What future in the 21st century for tibial bone allografts in ossicular chain
      reconstruction: the state of the issue.
AB  - After using tibial cortical bone allografts in reconstructing the middle ear over
      a period of ten years, the authors analyze their results. They compare the
      functional and anatomical outcome at 4 years of 24 patients who received this
      allografts with a series of 25 patients who underwent incus transposition.
      Results were analyzed in two different ways: the Air Bone Gap and the Glasgow
      Benefit Plot. The discussion addresses the techniques used to reduce risks of
      iatrogenic transmission of viruses and prions, the current legislation in Belgium
      and the comparative costs, after refunding of the various reconstruction
      materials. The authors conclude that, because the present-day preparation
      techniques offer a certain security with regard to transmission risks and because
      of its numerous advantages (mechanical properties, tolerance, cost and
      availability), tibial cortical bone still has a promising future.

PMID- 11205447
TI  - Effectiveness of a structured questionnaire for diagnosis of Meniere's disease in
      the first visit.
AB  - A structured questionnaire of vertigo (SQV) was used to search patients with
      Meniere's disease (MD) in the first visit. One-hundred consecutive outpatients
      that complained of dizziness or vertigo were studied. Diagnosis of MD was
      accepted if three investigators independently recorded it among a list of 29
      diagnostic categories after reviewing the SQV. The AAO criteria for definite MD
      defined by the Committee on Hearing and Equilibrium after 10 months or more of
      follow-up were the gold standard to contrast questionnaire-based diagnosis. Seven
      patients were considered as MD with the SQV. The sensitivity (Sn), specificity
      (Sp) and positive predictive value of the SQV for definite MD were 80%, 97% and
      57% respectively, being the false positive rate 3%. The probability for diagnosis
      of definite MD using the SQV in the first visit was 58% in a set up with a 5% of
      prevalence. The best predictor selected by all investigators was the presence of
      hearing loss (Sn 100%, Sp 85%, positive likelihood ratio 6.67). Because of the
      high specificity, the SQV of vertigo results a useful test to advance the
      diagnosis of definite MD.

PMID- 11205448
TI  - Clinical advantage of abscess tonsillectomy in peritonsillar abscess.
AB  - At the moment, regardless of the prevalence of the peritonsillar abscess (PTA), a
      definite protocol concerning the treatment of PTA has not yet been established
      and the treatment remains controversial. In the treatment of PTA the two most
      used therapeutic approaches are compared in this short study carried out on 16
      patients. A group of patients presenting PTA received an abscess tonsillectomy
      (AT) is compared with another group treated with aspiration and subsequently
      operated on with interval tonsillectomy (IT). The results show obviously that the
      abscess tonsillectomy is better than the interval tonsillectomy in every aspect
      of treatment. The hospitalization time and global costs are also reduced. So when
      a young person has PTA and once the indication of tonsillectomy is posed, the
      operation has to be carried out "a chaud".

PMID- 11205449
TI  - Intradermal tests with vasomotor agents in perennial non-allergic rhinitis.
AB  - Nasal reactivity in non-allergic rhinitis patients is well known, but the skin
      reactivity of these patients is less examined. The aim of this prospective study
      was to examine the skin reactivity to four vasomotor agents in healthy subjects
      and perennial non-allergic rhinitis patients and to determine whether rhinitis
      patients differ from healthy subjects or not. Seventy four perennial non-allergic
      rhinitis patients and fourty two healthy subjects were undergone to intradermal
      testing with papaverine (5 mg/ml), metacholine (0.02, 0.2 and 2.0 mg/ml),
      histamine (0.01, 0.1 and 10.0 micrograms/ml) and compound 48/80 (0.01, 0.1, 1.0
      and 10.0 micrograms/ml). It was found that the frequency of pathological skin
      reactivity to papaverine in perennial non-allergic rhinitis patients (34%) was
      significantly greater (p = 0.007) then in healthy subjects (9.5%). There was no
      significant difference for metacholine, histamine, compound 48/80 and saline
      between these two groups. The frequency of the total pathological skin reactivity
      to vasomotor agents, singly and in combinations, in perennial non-allergic
      rhinitis patients (80%) was significantly greater (p = 1.8.10(-6)) then in
      healthy subjects (33%). These findings suggest that the pathological skin
      reactivity to vasomotor agents is a feature of perennial non-allergic rhinitis
      patients as well as healthy subjects and indicate that a difference in the skin
      reactivity between these groups is noticed.

PMID- 11205450
TI  - The antrochoanal polyp.
AB  - The antrochoanal polyp is a particular pathology of nasal fossae and sinuses.
      Since the first description made by Killian, several pathogenic mechanisms and
      surgical techniques have been reported. The polyp exeresis is classically made
      using the Caldwell-Luc approach. The aim of our study is to lay stress on the
      interest of endonasal surgery compared to other surgical procedures. Between 1996
      and 1998, we operated on 12 cases by endonasal approach. Diagnosis is made upon
      clinical, CT-scan and pathological data. In all cases, an extended middle
      meatotomy is performed. In 3 cases, it is associated with an inferior meatotomy.
      The polyp pedicle is systematically coagulated at level of its maxillary
      implantation area. No recurrence, nor operative complication are noted. The
      average follow-up is 12 months.

PMID- 11205451
TI  - Testicular tumor metastatic to the nose. A case report.
AB  - In this paper we present an uncommon tumor found in the nasal cavity, the result
      of a metastasis from primary tumor of testis (embryonal carcinoma) in a young
      patient of 24 years of age. For this uncommon tumor we discuss the case with the
      Greek and foreign bibliography.

PMID- 11205452
TI  - Aneurysmal bone cyst of the zygoma. A case report and review of the literature.
AB  - Aneurysmal bone cyst is a cystic vascular osseous tumor. It is rare in the
      craniofacial area; it is even rarer in the zygoma. A case of aneurysmal bone cyst
      of the zygoma was presented. Its pathogenesis, clinical and radiological features
      and treatment options were discussed under the view of the literature.

PMID- 11205453
TI  - Upper airways locations of plasmocytoma.
AB  - We report one case of extramedullary plasmocytoma located in the nasopharynx.
      After 8 years, the tumor recurred in the same location and 3 years later, the
      patient develop a multiple myeloma. Three clinical and pathological entities of
      plasmocytoma are described: multiple myeloma, solitary bone plasmocytoma and
      extramedullary plasmocytoma. When histological examination show plasmocytoma,
      further examinations can or not reveal a multiple myeloma. In 80% of cases,
      extramedullary plasmocytoma occur in the upper respiratory tract. This
      development of multiple myeloma from extramedullary plasmocytoma is seen in 5 to
      32% of patients and sometimes an extremely long time is required for the change
      to occur. The treatments are surgery and radiation in the absence of generalized
      disease.

PMID- 11205454
TI  - Cervical lymphadenitis and cat scratch disease (CSD): an overlooked disease?
AB  - Cat Scratch Disease (CSD) is a benign disease characterized by regional
      lymphadenopathy affecting most frequently the head and neck region in children
      and young adults. In the present paper, the authors describe four cases of CSD
      focusing on clinical history, diagnostic management and therapy. The main germ
      responsible for this lymph node disease is Bartonella henselae. Diagnosis is
      based on history, serology and histological findings. Clinical evolution is
      generally favorable despite the fact that complications occur in about 5% to 13%
      of patients including encephalitis, hepatitis and Parinaud's oculoglandular
      syndrome. Antibiotic treatment is only considered for highly symptomatic
      patients. Surgical excision of the lymphadenopathy is useful to establish the
      diagnosis when serology is not available and/or when the adenopathy become
      fluctuating. The authors emphasize the increasing incidence of patients with CSD
      in the ENT population and the algorithm for CSD disease affecting the cervical
      lymph nodes.

PMID- 11205455
TI  - A national cancer plan for the UK.

PMID- 11205456
TI  - Assessing the quality of economic evaluations of health care interventions.

PMID- 11205457
TI  - Predictors of outcome in cancer patients with candidemia.
AB  - BACKGROUND: Hematogenous candidiasis is associated with a substantial mortality
      and morbidity in critically ill patients. Candidemia is the best marker for
      hematogenous infection; therefore, most studies have examined the outcome of
      candidemia. However, few have focused on the predictors of outcome in cancer
      patients with candidemia. MATERIALS AND METHODS: We conducted a MEDLINE search
      for all study reports published from 1974 to 1999 on candidemia and prognostic
      factors including predictors of mortality. Ten articles that provided sufficient
      data were evaluated in detail. RESULTS: The overall mortality rate was reported
      to be 33%-75%. Univariate analyses identified severity of underlying disease,
      performance status, neutropenia, Candida species, source of candidemia and the
      extent of visceral involvement as important prognostic variables. In multivariate
      analyses, however, only host factors and extent of infection (rather than
      infecting Candida species) were predictive of mortality. CONCLUSIONS: Older age,
      poor performance status, presence and persistence of neutropenia, and extensive
      organ involvement with candidiasis are the most important prognostic factors for
      candidemia in cancer patients.

PMID- 11205458
TI  - Chemotherapy in advanced androgen-independent prostate cancer 1990-1999: a decade
      of progress?
AB  - BACKGROUND AND PURPOSE: A great number of clinical research studies have been
      reported in the field of chemotherapy for advanced androgen-independent prostate
      cancer during the last ten years. The aims of the present review were to assess
      their impact on management of the disease and on survival of patients. METHODS:
      The review of full published reports was facilited by the use of a MEDLINE
      computer search. RESULTS: Clinical research studies have focused on defining
      guidelines for eligibility criteria and accurate endpoints for patients to be
      enrolled onto clinical trials and developing new agents or combination of drugs
      including estramustine phosphate. Any combination of current chemotherapy has no
      impact on overall survival of patients. Among drugs in development, only the
      promising activity observed with docetaxel deserves randomized trials to assess
      its impact on survival. The major innovative advance of the 90s is the
      demonstration of the impact of chemotherapy (mitoxantrone + prednisone) on
      quality of life as compared to prednisone alone. A greater and longer-lasting
      improvement in quality of life along with a concomitant decrease in costs was
      observed. CONCLUSIONS: At the present time, chemotherapy should be considered as
      a palliative treatment in patients with symptomatic androgen-independent disease.
      The enrollment of patients into clinical trials dealing with quality of life as
      primary endpoint is strongly solicited. A standard methodology should be used in
      phase II trials with a primary goal of selection of agents which should progress
      to randomized trials using survival as an endpoint. Hopefully new specific
      strategies targeted to reverse the molecular changes that underlie prostate
      tumorigenesis should rapidly impact the multimodality management of AIPC in the
      third millenium.

PMID- 11205459
TI  - A phase II trial of docetaxel in platinum pre-treated patients with advanced
      epithelial ovarian cancer: a Japanese cooperative study.
AB  - BACKGROUND: This phase II study was conducted to evaluate the efficacy and
      toxicity of docetaxel in Japanese patients with advanced ovarian cancer. PATIENTS
      AND METHODS: Docetaxel was administered at a dose of 70 mg/m2 intravenously to
      patients with platinum pretreated advanced ovarian cancer. Treatment was repeated
      every three weeks. No routine corticosteroid premedication was given. RESULTS:
      Ninety patients with advanced ovarian cancer were entered and sixty were
      assessable for response. The overall response rate was 28% in the assessable
      patients (95% confidence interval (95% CI): 17.54%-41.4%). CA125 responses were
      seen in 8 (24%) of 34 assessable patients for CA125 criteria. The 36 platinum
      refractory patients had a response rate of 25% compared with 33% in the platinum
      sensitive patients. The predominant toxicity was neutropenia, with 86% of the
      patients experiencing grade 3 or 4. Hypersensitivity reactions occurred in 37% of
      the patients and were not life threatening. Edema was mild and infrequent.
      CONCLUSION: Docetaxel at 70 mg/m2 demonstrated effectiveness as a treatment of
      both platinum-sensitive and platinum-refractory ovarian cancer patients, with a
      low incidence of severe hypersensitivity reactions and edema.

PMID- 11205460
TI  - Second cancers after adjuvant tamoxifen therapy for breast cancer in Japan.
AB  - BACKGROUND: Women treated with tamoxifen for breast cancer are at increased risk
      of endometrial cancer. We conducted a retrospective cohort study to evaluate the
      risk of second primary cancers after adjuvant tamoxifen therapy for breast cancer
      in Japan. PATIENTS AND METHODS: The subjects of the study were 6148 women who had
      been diagnosed with stage I, II, or IIIA unilateral primary breast cancer and had
      received surgical treatment during the period from January 1982 through December
      1990 at nine institutions in Japan. The information on each patient was obtained
      from medical records or a prospectively compiled computer database at each
      institution. RESULTS: Of the 6148 women, 3588 (58.4%) were administered tamoxifen
      as an adjuvant treatment and 2560 (41.6%) were not administered. Median follow-up
      periods were 7.64 years for tamoxifen-treated patients and 8.10 years for non
      tamoxifen-treated patients, respectively. The duration of tamoxifen treatment was
      mostly two years or less (80.7%), and few patients received tamoxifen for more
      than five years. The cumulative incidence rates of all second cancers at 10 years
      were 4.61% and 4.09% among tamoxifen-treated and non-tamoxifen-treated patients
      (P = 0.62), respectively, and the incidence rate ratio (IRR) for all second
      cancers was 1.06 (95% confidence interval (CI): 0.77-1.47) after adjustment of
      several covariates. The numbers of endometrial cancers was 9 and 3 among
      tamoxifen-treated and non-tamoxifen-treated patients, respectively, and the IRR
      was 2.37 (95% CI: 0.64-8.77, P = 0.20). Of the 12 patients who developed
      endometrial cancer, 4 died of cancer (for 3 of them, the cause of death was
      breast cancer), and the other 8 patients were alive as of March 1996. Stomach
      cancer was the most frequent second cancer and the IRR was 1.34 (95% CI: 0.76
      2.38, P = 0.31). There was no substantial increase in any other type of
      gastrointestinal cancer such as colorectal and liver cancers among tamoxifen
      treated patients. CONCLUSIONS: The incidence and risk of second primary cancers
      associated with tamoxifen therapy is low. The potential benefit of adjuvant
      tamoxifen therapy in breast cancer patients outweighs the risk of second primary
      cancers for Japanese breast cancer patients.

PMID- 11205461
TI  - ErbB2 status and the benefit from two or five years of adjuvant tamoxifen in
      postmenopausal early stage breast cancer.
AB  - AIM: We aimed to study the importance of erbB2 status in early stage
      postmenopausal breast cancer for patients who participated in a trial of five vs.
      two years of adjuvant tamoxifen. PATIENTS AND METHODS: We analysed the erbB2
      status of the tumours from 577 patients participating in the trial, either by a
      DNA amplification assay (n = 181) or by measurement of the protein level with
      flow cytometry (n = 396). RESULTS: ErbB2 was overexpressed or gene amplified in
      102 of the patients (18%). Overall, erbB2-positive patients had a significantly
      lower recurrence-free probability than others, 62% at five years as compared to
      83%, and showed a significantly decreased breast cancer survival rate (P =
      0.0007). ErbB2 status was significantly associated with recurrence and death in
      Cox multivariate analysis, adjusting for nodal status, tumour size and estrogen
      receptor status. The relative risk of recurrence (RR) for five vs. two years of
      tamoxifen was analysed in relation to erbB2 status for patients still disease
      free two years after surgery. Whereas erbB2-negative patients showed significant
      benefit from prolonged treatment (RR = 0.62, 95% confidence interval (95% CI):
      0.42-0.93), no benefit was evident for erbB2-positive patients (RR = 1.1, 95% CI:
      0.41-3.2). When the same analysis was restricted to ER-positive patients a
      similar difference in relative hazard was obtained but the difference was not
      strictly significant (P = 0.065). CONCLUSIONS: For early stage breast cancer
      patients treated with adjuvant tamoxifen, overexpression of erbB2 is an
      independent marker of poor prognosis. The results suggest that overexpression
      decreases the benefit from prolonged tamoxifen treatment.

PMID- 11205463
TI  - Infusional ECarboF in patients with advanced breast cancer: a very active and
      well-tolerated out-patient regimen.
AB  - We performed a trial using the combination of epirubicin 50 mg/m2/day 1,
      carboplatinum AUC 5/day 1 and continuous 5-fluorouracil (5-FU) 200 mg/m2/day
      (every 4 weeks for 6 months) to confirm the efficacy and low toxicity profile of
      this regimen in breast cancer. In 51 patients with metastatic (n = 33) or locally
      advanced (n = 18) breast cancer the overall response rate was 86% (95% confidence
      interval (95% CI): 73%-94%): 94% in locally advanced and 81% metastatic disease.
      Grade 3-4 toxicity was low: 4% of patients presented with febrile neutropenia,
      16% with severe palmar-plantar syndrome, 10% with Port-a-cath thrombosis. This
      study confirms the high efficacy of infusional 5-FU-based regimens and justifies
      further research into novel promising oral 5-FU derivatives.

PMID- 11205462
TI  - Follicular large cell lymphoma: long-term follow-up of 62 patients treated
      between 1973-1981.
AB  - PURPOSE: Investigators disagree on whether follicular large cell lymphoma (FLCL)
      behaves like other follicular lymphomas, with no plateau in the survival curve,
      or as a more aggressive but potentially curable lymphoma. We reported in 1984
      results for 62 FLCL patients treated at our institution; the current report
      updates those results. PATIENTS AND METHODS: Sixty-two patients referred from
      1973-1981, including fifteen (24%) patients with Ann Arbor stage I-II and forty
      seven (76%) with stage III-IV FLCL. Seven patients received radiation (XRT)
      alone, forty patients XRT and chemotherapy, and fifteen patients received
      chemotherapy alone. RESULTS: The median follow-up was 14.7 years. The median
      survival was 5.1 years, with 21% alive at 15 years. The failure-free survival
      (FFS) at 10 years was 31%. Univariate analysis revealed that age, Ann Arbor
      stage, and the International Index correlated with survival. Performance status,
      number of platelets, and LDH correlated with failure-free survival. CONCLUSIONS:
      FLCL responds to doxorubicin-based regimens similarly to diffuse large cell
      lymphoma. Patients with FLCL have the potential for prolonged failure-free
      survival. Variables that predict the survival in aggressive lymphomas apply as
      well in this type of lymphoma.

PMID- 11205464
TI  - Hepatic arterial 5-fluorouracil in patients with liver metastases of colorectal
      cancer: single-centre experience in 145 patients.
AB  - BACKGROUND: Hepatic arterial chemotherapy for liver metastases of colorectal
      cancer is still under discussion. Mainly because of the technical complications
      of this mode of treatment and the lack of a survival benefit in randomized
      studies. We performed an analysis of hepatic arterial 5-fluorouracil (5-FU)
      chemotherapy in 145 consecutive patients treated at a single institution.
      PATIENTS AND METHODS: One hundred forty-five patients with inoperable liver
      metastases from colorectal cancer were included. 5-FU, 1000 mg/m2/day continuous
      infusion for five days every three weeks, was delivered in the hepatic artery by
      percutaneous catheter or arterial access device. RESULTS: The response rate was
      34% for all patients, 40% in patients with extrahepatic disease, and 15% in
      patients with i.v. 5-FU-based pretreatment. TTP and OS for all patients were 7.5
      and 14.3 months, respectively. In patients with extrahepatic disease or i.v. 5-FU
      based pretreatment, OS was significantly shorter compared to patients without
      extrahepatic disease or 5-FU-based pretreatment (9.7 vs. 19.3 months and 10.1 vs.
      17.4 months, respectively), forty-seven percent of patients stopped treatment
      because of a complication. Complications most often seen in patients with
      arterial ports were hepatic artery thrombosis (48%) and dislocation of the
      catheter (22%). CONCLUSIONS: The results of our analysis are in line with
      previous phase III studies. Extrahepatic disease and i.v. 5-FU-based pretreatment
      were prognostic for reduced OS. The complication rate of hepatic arterial
      delivery was worrisome. although, no negative impact on survival could be
      established. There is a strong need for improvement of hepatic arterial delivery
      methods before further evaluation of hepatic arterial

PMID- 11205465
TI  - Autoimmune hemolytic anemia in patients with non-Hodgkin's lymphoma:
      characteristics and significance.
AB  - BACKGROUND: The occurrence of autoimmune hemolytic anemia (AIHA) in patients with
      non-Hodgkin's lymphoma (NHL) is well known. However, there is lack of information
      in the literature in terms of the significance and impact of such phenomenon on
      the clinical course of these patients. PATIENTS AND METHODS: We analyzed the
      clinical and laboratory features, course and response of 16 patients with non
      Hodgkin's lymphoma (NHL) and autoimmune hemolytic anemia (AIHA). Patients with
      small lymphocytic lymphoma and angioimmunoblastic lymphadenopathy with
      dysproteinemia were excluded from the analysis. The significance of certain
      parameters, such as cell type (B- vs. T-cell), stage of NHL and presence of serum
      monoclonal immunoglobulin were examined. The cohort consisted of 501 patients
      with NHL evaluated during the study period. RESULTS: The response rate for the
      group of patients with NHL/AIHA and for the cohort was 44% and 62%, respectively;
      P = 0.0138. T-cell histology was overrepresented in the patients with AIHA/NHL
      (33% vs. 14%; P = 0.048). The occurrence of AIHA was not statistically
      significant among the four stages of NHL (P = 0.722), while a significantly
      higher proportion of patients with AIHA had serum monoclonol gammopathy when
      compared to the cohort (25% vs. 8%; P = 0.03). The patients with NHL who did not
      develop AIHA had better overall survival and median survival compared to the
      NHL/AIHA group (P = 0.006 and P = 0.0001, respectively). CONCLUSIONS: The study
      provides for the first time a descriptive clinicopathologic analysis of patients
      with AIHA and NHL. Certain pathologic and laboratory features were more likely to
      be associated with the occurrence of AIHA in patients with NHL. Most importantly,
      was the adverse impact of AIHA on the survival of patients with NHL. Therefore,
      this finding should be taken in consideration when risk-stratifying patients with
      NHL.

PMID- 11205466
TI  - A phase I dose escalation study of the matrix metalloproteinase inhibitor BAY 12
      9566 administered orally in patients with advanced solid tumours.
AB  - BACKGROUND: This phase I study was performed to evaluate the safety,
      tolerability, and efficacy of the oral matrix metalloproteinase inhibitor BAY 12
      9566 in patients with advanced solid tumours, and to identify the maximum
      tolerated dose and dose for use in subsequent studies. PATIENTS AND METHODS: BAY
      12-9566 was administered to 29 patients at doses ranging from 100 mg o.d. to 1600
      mg (given either 400 mg q.i.d. or 800 mg b.i.d.). Blood samples for
      pharmacokinetic analyses were drawn on days 1-5, day 15 and days 29 and 30.
      Patients were continued on daily oral treatment of BAY 12-9566 until a dose
      limiting toxicity or tumour progression occurred. RESULTS: A maximum tolerated
      dose was not defined because plasma levels of BAY 12-9566 could not be
      sufficiently increased, even with escalating doses of drug. Pharmacokinetic
      analysis suggested that absorption was saturable at higher doses. The predominant
      toxicities related to drug were asymptomatic reversible effects on platelets and
      transaminases and mild anemia. There were no significant musculoskeletal
      toxicities. No objective responses were seen at the doses tested, but stable
      disease was observed in some patients based on tumour measurements. CONCLUSIONS:
      The recommended dose of BAY 12-9566 for further studies is 800 mg b.i.d. as this
      dose provides maximal plasma levels that can be achieved with a convenient dosing
      schedule for a chronically administered oral agent.

PMID- 11205467
TI  - High-dose therapy with autologous stem-cell transplantation (ASCT) after first
      progression prolonged survival of follicular lymphoma patients included in the
      prospective GELF 86 protocol.
AB  - BACKGROUND: Among the 566 patients with follicular lymphomas (FL) included in the
      GELF 86 prospective trials from October 1986 to September 1995, 372 with
      progressive/relapsing disease were analyzed retrospectively to identify
      prognostic factors at first relapse. PATIENTS AND METHODS: For progressive FL,
      patients received mono- (22%) or polychemotherapy (78%) followed by high-dose
      therapy (HDT) with ASCT for 83 patients (22%). The median time to progression
      from initial treatment was 23 months (range 3-102 months) and 24% of documented
      patients (52 of 217) had histological transformation (HT). Salvage therapy
      produced an overall response in 64% of patients and the five-year survival from
      progression was 42%. RESULTS: For patients who underwent HDT with ASCT compared
      to standard treatment, five-year freedom from second failure was at 42% vs. 16%
      (P = 0.0001) and five-year survival was 58% vs. 38% (P = 0.0005), respectively.
      The benefit of HDT and ASCT remained if we consider only patients less than 65
      years (five-year survival at 60% vs. 40%; P = 0.001). Multivariate analysis of
      parameters significant according to univariate analysis found that no ASCT at
      first progression, age at relapse > 50 years, progression on-therapy were
      adversely significant on survival. CONCLUSIONS: HDTwith ASCT compared to standard
      treatment prolonged remission and survival after first progression of FL
      patients.

PMID- 11205468
TI  - Reporting and dissemination of industry versus non-profit sponsored economic
      analyses of six novel drugs used in oncology.
AB  - PURPOSE: Our prior study found that pharmaceutical-sponsored and non-profit
      sponsored analyses differed in their published assessments of the economic value
      of six new oncology drugs. In this study, we expand on our earlier findings and
      evaluate the association between funding source and 1) characteristics of the
      published study report and 2) journal type for dissemination of the previously
      evaluated economic studies. METHODS: We reviewed the published cost-effectiveness
      literature for hematopoietic colony stimulating factors, 5-HT3 antagonist
      antiemetics. and taxanes. Two blinded investigators rated specific aspects of
      study reporting based on the US Public Health Service Panel on Cost-effectiveness
      in Health and Medicine criteria. Dissemination strategies were evaluated using
      impact factor scores from the Science Citation Index. RESULTS: The operational
      aspects of pharmaceutical-sponsored study reporting were better overall than
      those associated with non-profit sponsored studies. Specifically, pharmaceutical
      sponsored studies were more likely to be reported based on data obtained from
      randomized clinical trials or detailed cost-models (90% vs. 70%), to include
      descriptions of the source of cost differences (90% vs. 79%), to state whether
      the study was carried out from a societal, governmental, or insurer perspective
      (70% vs. 42%), and to clearly indicate the time-period over which costs were
      evaluated (65% vs. 50%). Nonprofit sponsored studies were more likely than
      pharmaceutical sponsored studies to report the generalizability of the findings,
      including being more likely to include information about how the data could be
      extrapolated to other clinical settings (58% vs. 35%), to include statements on
      the statistical significance of the findings (38% vs. 20%), and to clearly
      outline the cost per unit and data sources for the cost analyses (67% vs. 45%). A
      similar percent of pharmaceutical and non-profit sponsored studies reported
      background and conclusions with about 80% providing literature comparisons of the
      results (about 80%) and two thirds to three fourths discussing the limitations of
      the finding (75% for pharmaceutical-sponsored and 67% for non-profit sponsored
      studies). Most studies were published in low impact factor peer-reviewed
      journals, and journal impact factor scores were similar between pharmaceutical
      and nonprofit sponsored studies. CONCLUSIONS: Upon reviewing the entire
      pharmacoeconomic literature for six new oncology drugs, we identified differences
      in study reporting, but not in types of journals where studies were published,
      between pharmaceutical-sponsored and non-profit sponsored studies. These results,
      particularly the observed differences in data generalizability, may account in
      part for our previous finding of lower likelihood of reporting unfavorable
      conclusions in pharmaceutical-sponsored studies.

PMID- 11205469
TI  - Doxorubicin-based adjuvant chemotherapy in elderly breast cancer patients: the
      M.D. Anderson experience, with long-term follow-up.
AB  - BACKGROUND: The purpose of this study was to evaluate the clinical outcome of
      doxorubicin-based adjuvant chemotherapy in elderly breast cancer patients and to
      compare results in elderly patients with those in younger patients. PATIENTS AND
      METHODS: We retrospectively reviewed the records of all patients aged 50 years or
      older treated in trials of doxorubicin-based adjuvant chemotherapy between 1974
      and 1988. Old age was not an exclusion criterion for these trials. Patient
      characteristics, hematologic and nonhematologic side effects, patterns of
      recurrence, and causes of death were determined for patients aged 50-64 years and
      for patients aged 65 years or older, and results were compared between these two
      groups. Kaplan-Meier survival curves were plotted, and tested by the generalized
      Wilcoxon test. RESULTS: A total of 390 patients aged 50 years or older were
      treated with doxorubicin-based adjuvant chemotherapy during the study period. Of
      these, 325 were aged 50-64 years (group 1), and 65 were aged 65 years or older
      (group 2). The median follow-up period for group 1 was 185 months (range 29-272+
      months), and the median follow-up period for group 2 was 169 months (range 128
      240+ months). There were no statistically significant differences between the two
      groups with respect to performance status, hormone receptor profile, tumor size,
      nodal status, or type of locoregional therapy. There also were no statistically
      significant differences between the two groups in recurrence patterns, disease
      free survival, or overall survival. The granulocyte and platelet nadirs of cycles
      1, 3, and 6 were similar between the two groups. No cumulative hematologic side
      effects were seen in either group. The occurrence of second malignancies was
      extremely low in both groups. In both groups, the majority of deaths were due to
      progression of disease. CONCLUSIONS: Adjuvant doxorubicin-based chemotherapy is
      well tolerated in elderly breast cancer patients who have good performance status
      and normal cardiac ejection fraction. Adjuvant doxorubicin-based chemotherapy in
      these patients results in disease-free and overall survival rates similar to
      those seen in younger patients.

PMID- 11205470
TI  - Phase II clinical trials of cisplatin-then-paclitaxel and paclitaxel-then
      cisplatin in patients with previously untreated advanced epithelial ovarian
      cancer.
AB  - PURPOSE: To examine the activity and safety of two sequentially scheduled
      chemotherapy regimens comprising four cycles of paclitaxel (pctx) 200 mg/m2/3
      hours then four cycles ofcisplatin (cisDDP) 100 mg/m2, and vice versa, in
      patients with previously untreated advanced ovarian cancer. PATIENTS AND METHODS:
      Between January 1994 and February 1996, we recruited 30 patients to the pctx-then
      cisDDP regimen and 29 to cisDDP-then-pctx, in parallel phase II trials. RESULTS:
      Both regimens were predictably active with responses seen in 22 of 30 patients
      (OR 74%; CR 27%, PR 47%) treated with pctx-then-cisDDP, as against 13 of 21
      patients (OR 62%; CR 38%, PR 24%) treated with cisDDP-then-pctx. The OR rate to
      four cycles of pctx (induction) was 43%, with 27% disease progression; the OR to
      four cycles of cisDDP (induction) was 57%, with 5% progression. However,
      progression rates across both induction and consolidation phases were 16% (pctx
      then-cisDDP) and 29% (cisDDP-then-pctx). Both regimens were unacceptably
      neurotoxic. II patients suffering grade 3 sensory neurotoxicity (5 on pctx-then
      cisDDP, 6 on cisDDP-then-pctx) and 20 having grade 3 deafness (9 on pctx- then
      cisDDP, 11 on cisDDP-then-pctx). CONCLUSION: The activity of these sequential
      regimens justifies their further development using the less neurotoxic platinum
      analogue carboplatin, perhaps combining paclitaxel with other platinum non-cross
      resistant drugs.

PMID- 11205471
TI  - Pancreatic metastasis of a pleuropulmonary blastoma in an adult.
AB  - Pleuropulmonary blastoma (PPB) is a rare dysontogenetic tumor that usually
      develops in the first decade of life and has been recognized as a distinct
      clinico-pathological entity different from the ordinary pulmonary blastoma of
      adulthood. Since the tumor grows aggressively and tends to metastasize early,
      physicians have to be aware of late onset of symptoms and uncommon
      manifestations. We report a case of PPB in a young adult and its recurrence in
      the pancreas after primary surgical treatment and adjuvant chemotherapy. Keeping
      in mind the moderate prognosis of PPB in children, accurate assessment and
      treatment of PPB require a team approach of oncology, radiology and surgery to
      establish new therapeutic guidelines in the future.

PMID- 11205472
TI  - Interferon-alpha as first-line therapy for treatment of multicentric Castleman's
      disease.

PMID- 11205473
TI  - Radiation myositis: the possible role of gemcitabine.

PMID- 11205474
TI  - Docetaxel and cisplatin in head and neck cancer.

PMID- 11205475
TI  - Axillary sentinel node biopsy under local anaesthesia in early breast cancer.

PMID- 11205476
TI  - [German publications in leading English language journals].
AB  - BACKGROUND AND OBJECTIVE: The per capita publication output of German medical
      research is low compared not only to the English-speaking nations but also to
      Austria and Switzerland. We assessed the publications from German universities in
      the leading English language general medical journals: New England Journal of
      Medicine (NEJM), Lancet, Journal of the American Medical Association (JAMA), and
      British Medical Journal (BMJ). METHODS: Medline (1988-5/2000) was searched for
      journal-articles with German origin published in the above journals and manually
      classified as to institution and speciality. RESULTS: 372 publications from
      Germany were found. 216 had been published in Lancet, 87 in NEJM, 52 in BMJ, and
      17 in JAMA. 58 were excluded (2 from British military hospitals in Germany, 2
      from pharmaceutical companies, 2 from physician associations, 18 from non
      university basic research institutions or government agencies, 3 from non-medical
      university departments, 30 from non-university hospitals, 1 from a transfusion
      service of the German Red Cross). The remaining 314 publications were from 34
      universities. The most speciality was internal Medicine with 140 university
      publications, the most represented university was the Ludwig-Maximilians
      University in Munich with 43 publications. 5 universities had no publications in
      the analysed journals. CONCLUSION: Large differences were found between the
      German universities with respect to publications in the leading English Language
      general medical journals.

PMID- 11205477
TI  - [Anaplastic astrocytomas of the medulla oblongata. A rare differential diagnosis
      in orthostatic hypotension].
AB  - HISTORY AND PHYSICAL EXAMINATION: A 39-year-old women was admitted for evaluation
      of dizziness and hypotension. During standing the blood pressure dropped from
      130/80 to 80/40 mmHg. Ten weeks before admission she had recurrent cerebral
      convulsions. Neurological evaluation showed a slight left hemiparesis. Computed
      tomography of the brain revealed a 1.5 +/- 1 cm cyst in the left tempral region.
      It was thought that the cause of the recurrent convulsions was alcohol abuse.
      During the next few weeks orthostatic hypotension increased and she was not able
      to work. INVESTIGATIONS: At admission abnormal findings included hypotension,
      horizontal nystagmus, and deviation of the soft palate to the right. After the
      patient was brought to an upright position during standardized passive tilt
      testing she showed a defect in the sympathetic limb of the baroreceptor reflex
      arc. Head magnetic resonance tomography showed a signal-enhancing tumour in the
      cervicomedullary region. TREATMENT AND CLINICAL COURSE: Before a planned biopsy
      could be performed the patient died of respiratory arrest. Postmortem examination
      revealed an anaplastic grade III astrocytoma extending form the pons to the
      medulla oblongata. CONCLUSION: Upright tilting leads to pooling of blood in the
      legs. One of the normal compensatory responses is a reflex tachycardia which our
      patient did not show as a sign of an afferent defect. Patients with orthostatic
      hypotension as a prominent symptom should be investigated with a standardized
      tilt test. In special patients, additional neurological investigations are
      necessary.

PMID- 11205478
TI  - [Coronary bypass surgery in May-Hegglin anomaly].
AB  - HISTORY: Twelve years prior to hospitalization because of a severe bleeding, a 70
      year old patient was diagnosed with a May-Hegglin anomaly, which is a rare
      autosomal dominant inherited form of thrombocytopenia. INVESTIGATIONS: The blood
      smear contained signs of the May-Hegglin anomaly: Dohle's inclusion bodies and
      giant platelets. Platelet counts were around 30 G/l. Coronary angiography
      revealed a highly severe left main stenosis. TREATMENT AND COURSE: Even using
      maximum drug therapy, angina pectoris could not be stabilized. Therefore
      emergency coronary artery bypass grafting had to be performed. Before skin
      incision 3 micrograms/kg DDAVP (Desmopressin) were administered and after
      extracorporeal circulation 8 units of platelets were transfused. In addition,
      perioperative coagulation management was performed according to usual standards.
      There were no bleeding complications. The patient could leave the clinic after 11
      days in stable condition. CONCLUSION: Patients showing May-Hegglin anomaly, even
      with serious thrombocytopenia, can be operated using extracorporal circulation
      without a high risk of bleeding.

PMID- 11205479
TI  - [Spring water in hospitals--an alternative drinking water concerns with processed
      mineral water?].

PMID- 11205480
TI  - [Treatment of cystic echinococcosis].

PMID- 11205481
TI  - [Herpes B infection in humans].

PMID- 11205482
TI  - [Fairness for women scientists and physicians: lessons from   the Massachusetts
      Institute of Technology (MIT)].

PMID- 11205483
TI  - [Disturbances in cholesterol metabolism].

PMID- 11205484
TI  - Vitamin C and vitamin E supplement use and colorectal cancer mortality in a large
      American Cancer Society cohort.
AB  - Some recent epidemiological studies have suggested that use of vitamin C or
      vitamin E supplements, both of which are important antioxidants, may
      substantially reduce the risk of colon or colorectal cancer. We examined the
      association between colorectal cancer mortality and use of individual vitamin C
      and E supplements in the American Cancer Society's Cancer Prevention Study II
      cohort. We used proportional hazards modeling to estimate rate ratios among
      711,891 men and women in the United States who completed a self-administered
      questionnaire at study enrollment in 1982, had no history of cancer, and were
      followed for mortality through 1996. During the 14 years of follow-up, 4404
      deaths from colorectal cancer occurred. After adjustment for multiple colorectal
      cancer risk factors, regular use of vitamin C or E supplements, even long-term
      use, was not associated with colorectal cancer mortality. The combined-sex rate
      ratios were 0.89 [95% confidence interval (CI), 0.73-1.09] for 10 or more years
      of vitamin C use and 1.08 (95% CI, 0.85-1.38) for 10 or more years of vitamin E
      use. In subgroup analyses, use of vitamin C supplements for 10 or more years was
      associated with decreased risk of colorectal cancer mortality before age 65 years
      (rate ratio = 0.48; 95% CI, 0.28-0.81) and decreased risk of rectal cancer
      mortality at any age (rate ratio = 0.40; 95% CI, 0.20-0.80). Our results do not
      support a substantial effect of vitamin C or E supplement use on overall
      colorectal cancer mortality.

PMID- 11205485
TI  - Reducing bioavailable sex hormones through a comprehensive change in diet: the
      diet and androgens (DIANA) randomized trial.
AB  - High serum levels of testosterone and estradiol, the bioavailability of which may
      be increased by Western dietary habits, seem to be important risk factors for
      postmenopausal breast cancer. We hypothesized that an ad libitum diet low in
      animal fat and refined carbohydrates and rich in low-glycemic-index foods,
      monounsaturated and n-3 polyunsaturated fatty acids, and phytoestrogens, might
      favorably modify the hormonal profile of postmenopausal women. One hundred and
      four postmenopausal women selected from 312 healthy volunteers on the basis of
      high serum testosterone levels were randomized to dietary intervention or
      control. The intervention included intensive dietary counseling and specially
      prepared group meals twice a week over 4.5 months. Changes in serum levels of
      testosterone, estradiol, and sex hormone-binding globulin were the main outcome
      measures. In the intervention group, sex hormone-binding globulin increased
      significantly (from 36.0 to 45.1 nmol/liter) compared with the control group (25
      versus 4%,; P < 0.0001) and serum testosterone decreased (from 0.41 to 0.33
      ng/ml; -20 versus -7% in control group; P = 0.0038). Serum estradiol also
      decreased, but the change was not significant. The dietary intervention group
      also significantly decreased body weight (4.06 kg versus 0.54 kg in the control
      group), waist:hip ratio, total cholesterol, fasting glucose level, and area under
      insulin curve after oral glucose tolerance test. A radical modification in diet
      designed to reduce insulin resistance and also involving increased phytoestrogen
      intake decreases the bioavailability of serum sex hormones in hyperandrogenic
      postmenopausal women. Additional studies are needed to determine whether such
      effects can reduce the risk of developing breast cancer.

PMID- 11205486
TI  - Diet and cancer: one view at the start of the millennium.
AB  - The large differences in cancer rates among countries, striking changes in these
      rates among migrating populations, and rapid changes over time within countries
      indicate that some aspect of lifestyle or environment is largely responsible for
      the common cancers in Western countries. Dietary fat has been hypothesized to be
      the key factor because national consumption is correlated with the international
      differences, but these correlations are potentially confounded by other aspects
      of Western lifestyles. Detailed analyses in large prospective studies have not
      supported an important role of dietary fat. Instead, positive energy balance,
      reflected in early age at menarche and weight gain as an adult, is an important
      determinant of breast and colon cancers, consistent with numerous studies in
      animals. Physical inactivity has also been shown to be a risk factor for these
      diseases, and in part accounts for the international differences in cancer rates.
      Although the percentage of calories from fat in the diet does not appear related
      to risk of colon cancer, greater risks have been seen with higher consumption of
      red meat, suggesting that factors other than fat per se may be important. In many
      case-control studies a high consumption of fruits and vegetables has been
      associated with reduced risks of numerous cancers, but recent prospective studies
      suggest these associations may have been overstated. Among the factors in fruits
      and vegetables that have been examined in relation to cancer risk, present data
      most strongly support a benefit of higher folic acid consumption in reducing
      risks of colon and breast cancers. These findings have been bolstered by an
      association between incidence of colon cancer and a polymorphism in the gene for
      methylenetetrahydrofolate reductase, an enzyme involved in folic acid metabolism.
      The benefits of folic acid appear strongest among persons who regularly consume
      alcohol, which itself is associated with risk of these cancers. Numerous other
      aspects of diet are hypothesized to influence the risks of cancers in Western
      countries, but for the moment the evidence is unclear. Two decades of effort in
      developing, evaluating, and refining methods of dietary assessment have laid the
      groundwork for further insights into the role of diet in cancer etiology that
      will emerge from the more than 30 large prospective studies that are currently
      underway.

PMID- 11205487
TI  - Factors associated with perceived risk in automotive employees at increased risk
      of colorectal cancer.
AB  - Risk perception may be an important motivator of health-related behaviors. To
      develop effective risk communication messages, it is important to understand both
      the patterns of association between perceived risk and health-related behaviors
      as well as the correlates of risk perception. Very little is known about whether
      correlates of risk perception are similar in cross-sectional data compared with
      prospective data. Furthermore, there are scant data on consistency of correlates
      of risk perception across groups who vary in objective medical risk. If
      correlates differ, it would underscore the need to tailor intervention messages
      based on subgroup characteristics as well as increase awareness of the
      limitations of basing intervention messages only on cross-sectional data. We
      analyzed data on a subset of 5042 employees who participated in The Next Step
      Trial, a randomized health promotion trial to encourage colorectal cancer
      screening and dietary change. We restricted our analysis to only those automotive
      workers who were white, male, and did not have colorectal cancer (4477/5042) and
      who returned surveys both at baseline (2,684/4,477) and at year 2 of follow-up
      (1955/2684). Initial analyses detected interactions between a history of polyps
      and several of the other covariates. Therefore, univariate and multivariable
      analyses were conducted separately for men with and without a personal history of
      colorectal polyps. Within each of the four subgroups (those with or without
      polyps in the baseline or follow-up analyses), we examined associations between
      perceived risk measured at baseline (cross-sectional analyses) and at year 2 of
      follow-up (prospective analyses) in relation to intervention group status,
      demographic, medical history, psychosocial, and worksite characteristics measured
      at baseline. To assess the predictive ability of the models, we computed
      sensitivity and specificity as measures of each model's ability to correctly
      classify men into their respective subgroup. Although there was no association
      between perceived risk and intervention group status in the four subgroups
      analyzed, we included intervention group status as a covariate in all analyses.
      At baseline (cross-sectional analyses) among men with and without a history of
      polyps, perceived risk was positively associated with family history of
      colorectal polyps or cancer, family support for screening, and worry about being
      diagnosed with colorectal cancer. In addition, for men without polyps, perceived
      risk was positively associated with being a current smoker. At year 2 of follow
      up (prospective analyses) for men with and without polyps, perceived risk at year
      2 was positively associated with family history and baseline perceived risk and
      was negatively associated with having a normal screening examination or no
      examinations during the trial. In addition, for men with polyps, perceived risk
      was positively associated with belief in the salience and coherence of screening
      and with intention to be screened and was negatively associated with access to
      screening at the worksite. Specificity was higher than sensitivity in three of
      four subgroups and was >65% in all subgroups. Except for family history, messages
      to influence perceived risk would emphasize different factors, depending on
      whether associations were based on baseline or follow-up data and depending on
      whether men reported a personal history of polyps. For example, although
      intervention messages using baseline data would emphasize the same factors for
      men with or without polyps, messages based on follow-up data would emphasize
      psychosocial characteristics, such as salience and coherence of screening and
      intention for men with a history of polyps but not for men without. Our findings
      support the need to delineate subgroups in the study population to target and
      tailor health-related messages based on respondent characteristics. Our findings
      also underscore the need to base health-related messages on prospective data as
      well as cross-sectional data to better address health-related beliefs and
      behaviors.

PMID- 11205488
TI  - High-risk and multiple human papillomavirus infections associated with cervical
      abnormalities in Japanese women.
AB  - To estimate the risk of human papillomavirus (HPV) infection for cervical
      malignancies, we conducted a case-control study in Japan. Abnormal cervical cell
      (366) and normal cell samples (1562) were tested for the presence of HPV DNA
      using a new PCR-based test (LCR-E7 PCR). When single HPV infections were
      considered, 26 different HPV types were identified in normal cervices and in low
      grade squamous intraepithelial lesions (LSIL); whereas HPV-16, -18, -31, -33, 
      35, -45, -51, -52, -56, -58 and -67 were detected in high-grade squamous
      intraepithelial lesions (HSIL) and in squamous cell carcinoma (SCC) of the
      cervix, and HPV-16 and -18 were detected in cervical adenocarcinoma. HPV-6 and 
      11 were detected in condyloma acuminatum tissue. In HSIL and SCC, HPV-16 was the
      most prevalent type and HPV-51, -52, and -58 were the next most prevalent;
      whereas HPV-39, -59, and -68 were not detected. Analysis by odds ratio (OR)
      revealed that HPV-11, -39, -42, -44, -53, -59, -62, and -66 (HPV-66: OR,139; 95%
      confidence interval (CI) = 6.7-168) were associated with LSIL; HPV-16, -18, -31, 
      51, -52 and -58 (HPV-16: OR, 69; 95%CI = 36-131) were associated with SCC; and
      HPV-16 and -18 (OR, 94; 95% CI = 28-317) were associated with adenocarcinoma.
      Multiple HPV infection was associated with LSIL (OR, 24; 95%CI = 13-44), HSIL
      (OR, 16; 95%CI = 8.4-32), and SCC (OR, 8.3; 95%CI = 3.2-22), although the
      prevalence decreased with the grade of the lesions. All results suggest that HPV
      6 and -11 are condyloma types, HPV-16, -18, -31, -51, -52, -58, and perhaps -33, 
      35, -45, -56, and -67, are the high-risk HPV types, and many other types are LSIL
      associated types in Japan. HPV typing and detection of multiple HPV infections in
      clinical samples may be useful as surrogate markers for cervical cell
      abnormalities.

PMID- 11205489
TI  - Phase I pharmacokinetic study of tea polyphenols following single-dose
      administration of epigallocatechin gallate and polyphenon E.
AB  - Green tea has been shown to exhibit cancer-preventive activities in preclinical
      studies. Its principal active components include epigallocatechin gallate (EGCG),
      epigallocatechin (EGC), epicatechin (EC), and epicatechin gallate, of which EGCG
      is the most abundant and possesses the most potent antioxidative activity. We
      performed a Phase I pharmacokinetic study to determine the systemic availability
      of green tea catechins after single oral dose administration of EGCG and
      Polyphenon E (decaffeinated green tea catechin mixture). Twenty healthy subjects
      (five subjects/dose level) were randomly assigned to one of the dose levels (200,
      400, 600, and 800 mg based on EGCG content). All subjects were randomly crossed
      over to receive the two catechin formulations at the same dose level. Blood and
      urine samples were collected for up to 24 h after oral administration of the
      study medication. Tea catechin concentrations in plasma and urine samples were
      determined using high-performance liquid chromatography with the coulometric
      electrode array detection system. After EGCG versus Polyphenon E administration,
      the mean area under the plasma concentration-time curves (AUC) of unchanged EGCG
      were 22.5 versus 21.9, 35.4 versus 52.2, 101.9 versus 79.7, and 167.1 versus
      161.4 min x microg/ml at the 200-, 400-, 600-, and 800-mg dose levels,
      respectively. EGC and EC were not detected in plasma after EGCG administration
      and were present at low/undetectable levels after Polyphenon E administration.
      High concentrations of EGC and EC glucuronide/sulfate conjugates were found in
      plasma and urine samples after Polyphenon E administration. There were no
      significant differences in the pharmacokinetic characteristics of EGCG between
      the two study medications. The AUC and maximum plasma concentration (Cmax) of
      EGCG after the 800-mg dose of EGCG were found to be significantly higher than
      those after the 200- and 400-mg dose. The AUC and Cmax of EGCG after the 800-mg
      dose of Polyphenon E were significantly higher than those after the three lower
      doses. We conclude that the two catechin formulations resulted in similar plasma
      EGCG levels. EGC and EC were present in the body after the Polyphenon E
      administration; however, they were present predominantly in conjugated forms. The
      systemic availability of EGCG increased at higher doses, possibly due to
      saturable presystemic elimination of orally administered green tea polyphenols.

PMID- 11205490
TI  - Saliva as a medium for investigating intra- and interindividual differences in
      sex hormone levels in premenopausal women.
AB  - Repeated measurement of ovarian steroids in saliva could provide an advantage in
      studies estimating long-term sex steroid exposure in premenopausal women, by
      reducing the measurement error associated with collection of serum or urine
      samples. We previously reported on characteristics of ultrasensitive RIAs adapted
      for extraction-free measurement of estradiol (E2) and progesterone (PG) in
      saliva. The purpose of the present study was to evaluate the consistency of E2
      and PG levels in saliva in the same women across menstrual cycles, and to compare
      this with the variation observed between women. We also evaluated the effect of
      altering the number of consecutive daily samples considered and the method for
      locating a particular cycle day in relation to ovulation (day 0). Study
      participants included 12 healthy women who provided daily saliva samples for two
      consecutive, ovulatory menstrual cycles. A single midluteal serum sample was
      collected 7-8 days after detection of a luteinizing hormone (LH) peak in urine.
      We plotted individual cycle profiles and computed intraclass correlation
      coefficients (ICC) for various definitions of peak and cumulative daily hormone
      level. For peak PG, determined as the maximal running 3-day mean, ICC was 0.68.
      For cumulative PG, based on 8 consecutive cycle days (+2 to +9), ICCs were 0.72
      0.76 when reverse dating LH peak or rise in salivary PG determined day 0. For E2,
      ICCs ranged from 0.74 to 0.79 by various dating methods for the 5 preovulatory
      days (-4-0), and from 0.85 to 0.92 for the 15 days about the center of the cycle
      (-6 to +8). With exclusion of just the first 5 days of the cycle, the ICC for E2
      was 0.91. For both E2 and PG, selection of 5 or 7 days for the estimation of the
      midluteal mean level provided separation of within and between subject variance
      that was comparable with a LH-timed serum sample. These results indicate that
      daily saliva samples can be combined to clarify the interindividual differences
      in E2 and PG levels in premenopausal women, and that these interindividual
      differences may be greater than previously imagined.

PMID- 11205491
TI  - The repeatability of serum carotenoid, retinoid, and tocopherol concentrations in
      specimens of blood collected 15 years apart.
AB  - Community-wide programs to collect blood for a research serum bank were carried
      out in Washington County, Maryland in 1974 and 1989. Of the 8395 persons who
      participated in both programs, 64 were controls in a nested case-control study of
      the association of antioxidant micronutrients with subsequent breast cancer, and
      30 and 166 were controls in similar studies of lung and prostate cancer. Assay
      results for five carotenoids, two retinoids, and two tocopherols in samples of
      blood collected 15 years apart were thus available for comparisons of
      micronutrient concentrations. The mean Spearman rank order correlation
      coefficient for all comparisons was 0.44, with two coefficients greater than 0.60
      and two less than 0.30. Blood pressure readings at the two blood collections had
      a mean rank order correlation coefficient of 0.46. Because blood pressure
      readings in 1974 were shown to be significantly predictive of atherosclerosis 15
      18 years later, the present results suggest that ranked concentrations of
      antioxidant micronutrients from a single sample are sufficiently representative
      to be used as predictors of subsequent concentrations and are thus suitable for
      assessment as risk factors for subsequent illnesses.

PMID- 11205492
TI  - Hypomethylation of p53 in peripheral blood DNA is associated with the development
      of lung cancer.
AB  - Alterations in DNA methylation have been associated with cancers at almost all
      tumor sites and represent one of the most consistent changes in neoplastic cells.
      The underlying etiological mechanisms for alteration of DNA methylation patterns
      are not understood, but experimental studies in animals suggest potential
      environmental and genetic influences. The purpose of this study was to
      investigate whether DNA hypomethylation in peripheral blood DNA (potentially
      representing status at the lung) was associated with increased risk for the
      development of lung cancer. We evaluated genome-wide and p53 gene-specific
      hypomethylation in 100 lung cancer cases and controls selected from a large
      clinical trial of male smokers, the Alpha-Tocopherol, Beta-Carotene Cancer
      Prevention Study. Genome-wide methylation status was assessed using the in vitro
      methyl acceptance capacity assay and p53 gene-specific methylation status using
      the HpaII quantitative PCR assay. Hypomethylation was evaluated as a risk factor
      using multivariate conditional logistic regression analyses. Genome-wide
      methylation status was unrelated to lung cancer risk; the odds ratio was 1.25 and
      the 95% confidence interval was 0.48-3.21 for those in the highest versus lowest
      quartile of hypomethylation status. Hypomethylation of the p53 gene in exons 5-8,
      the hypermutable region, was associated with a 2-fold increased risk for lung
      cancer (odds ratio, 2.20; 95% confidence interval, 1.04-4.65), whereas there was
      no risk increase for hypomethylation at exons 2-4, a region of the gene not known
      for its mutability or functional significance in cancer. Our results indicate
      that hypomethylation status within exons 5-8 of p53 from peripheral lymphocyte
      DNA may be a relevant predictor of lung cancer among male smokers.

PMID- 11205493
TI  - Histological classification of gastric adenocarcinoma for epidemiological
      research: concordance between pathologists.
AB  - Epidemiology of gastric adenocarcinoma suggests that intestinal-type and diffuse
      type cancers develop through distinct causal pathways. To examine the differences
      in risk factors and molecular changes between the histological types, reliable
      data on histological typing are essential. We evaluated the concordance between
      two pathologists in assessment of 95 gastric adenocarcinomas for Lauren
      classification and tumor grade. Two pathologists, each blinded to the other's
      assessment, reviewed H&E-stained slides of gastric tumor. The responses of the
      two pathologists for histological type were considered as concordant if they fell
      on one of the three categories (intestinal type, diffuse type, or other). Tumor
      grade was classified into three categories (well, moderately, or poorly
      differentiated). The pathologists agreed on the classification of histological
      type for 71 of 92 (77%) tumors. Kappa coefficient was 0.59 (95% confidence
      interval, 0.44-0.73). Concordance for tumor grade was 87%, with a kappa
      coefficient of 0.72 (95% confidence interval, 0.57-0.87). Both observed
      concordance and kappa coefficient for histological type and tumor grade were
      similar across three calendar periods of study. Interobserver agreement was
      virtually identical between tumors with biopsy specimens only and those with
      surgical specimens. Although the level of disagreement for histological type
      observed in this study is comparable with that in other studies, the resulting
      misclassification would lead to the reduction in observed differences in
      prevalence and odds ratio estimates between two histological types.

PMID- 11205496
TI  - Disposable, stable media for reproducible surface-enhanced Raman spectroscopy.
AB  - Large numbers of identical and stable SE(R)RS [surface-enhanced (resonance)
      Raman]-active media, which are convenient to handle and manipulate but
      sufficiently inexpensive that they can be used once and then discarded, have been
      prepared by isolating nanoparticles from Ag and Au sols in hydrophilic polymer
      gels. The preparation simply involves mixing a suitable polymer with the sol to
      give a viscous suspension that can be coated onto a substrate and dried to form a
      hard translucent film. The films remain inactive until they are treated with
      aqueous analyte solution, which causes the film to swell and brings the analyte
      into contact with the active metal particles. The swollen films give strong SERS
      spectra which are effectively identical to those obtained from simple sols. The
      advantage of this method is that the dried polymers can be stored indefinitely
      before use and that they give a high degree of spectral reproducibility.

PMID- 11205495
TI  - Breast cancer risk and "delayed" primary Epstein-Barr virus infection.
AB  - Parallel to its established causal association with both infectious mononucleosis
      (IM) and young adulthood Hodgkin disease (YAHD), we propose a hypothesis that
      "delayed" primary EBV infection (i.e., primary infection occurring during
      adolescence or adulthood) is associated with elevated breast cancer risk. We
      evaluated this hypothesis with two investigations, one descriptive and the other
      analytic. The descriptive study used international/United States cancer registry
      data to assess the association between incidence rates of breast cancer and those
      of YAHD. The incidence rates of the seemingly unrelated neoplasms were strongly
      correlated (correlation coefficients of 0.74 and 0.88 for international and
      United States data, respectively; these were higher than the correlation
      coefficients of YAHD with two other cancers that we considered). Populations with
      higher incidence rates corresponded to those with higher likelihood of delayed
      primary EBV infection. The analytical study was based on a population-based case
      control study of breast cancer in middle-aged women. Age-adjusted odds ratios of
      breast cancer in women who reported a history of IM, relative to women who did
      not, increased monotonically from 0.55 [95% confidence interval (CI), 0.05-6.17]
      for women with 0-9 years of age at IM onset to 2.67 (CI, 1.04-6.89) for women
      with > or =25 years of age at IM onset (P = 0.016). An older age at
      tonsillectomy, another surrogate of delayed EBV exposure, was also associated
      with increased risk of breast cancer: odds ratios, 0.92 (CI, 0.57-1.48) and 1.76
      (CI, 1.15-2.69) for women with tonsillectomy at 0-4 years of age and > or =15
      years of age, respectively (P = 0.018). Adjusting for additional potential
      confounders did not modify the associations appreciably. The implications of the
      findings and a potential biological mechanism are presented.

PMID- 11205494
TI  - KRAS mutations are not predictive for progression of preneoplastic gastric
      lesions.
AB  - Individuals with atrophic gastritis (n = 863) were recruited to participate in a
      chemoprevention trial in Narino, Columbia. The volunteers were randomly assigned
      to intervention therapies, which included antibiotic treatment for Helicobacter
      pylori infection, and then daily dietary supplementation with antioxidant
      micronutrients in a 2(3) factorial design. Biopsies were obtained according to a
      specified protocol from designated areas in the stomach for each individual at
      baseline (before intervention therapy), at year 3, and at year 6. A systematic
      sample of 160 participants was selected from each of the eight treatment
      combinations, and the first exon of KRAS was examined for mutations. At year 3,
      the data indicated that individuals with KRAS mutations in their baseline
      premalignant stomach biopsies were 3.74 times as likely to progress to a higher
      premalignant stage than those who lacked baseline mutations (P = 0.04; C. Gong et
      al., Cancer Epidemiol. Biomark. Prevy. 8:167-171, 1999). However, after 6 years,
      baseline KRAS mutations failed to predict histological progression. Also, KRAS
      mutation in 72-month biopsies did not predict histological progression.

PMID- 11205497
TI  - A new fluorimetric method for the determination of formaldehyde in air based on
      the liquid droplet sampling technique.
AB  - A new, simple, sensitive, selective and in-field fluorimetric method for the
      determination of formaldehyde is proposed. The reaction of formaldehyde with
      hydralazine in acidic medium, heating on a boiling water-bath for 25 min,
      produces s-triazolo[3,4-a]phthalazine (Tri-P). The fluorescence intensity of the
      product formed (Tri-P) was determined at lambda em = 389 nm with lambda ex = 236
      nm. The fluorescence intensity is linear over a formaldehyde concentration range
      of 1.2-33.0 micrograms l-1. The proposed method was applied successfully to the
      determination of formaldehyde sampled from the atmosphere using the liquid
      droplet technique. Formaldehyde vapour in a wind tunnel was produced by a mean of
      permeater. A linear curve was obtained between the concentration in the wind
      tunnel and that in the droplet. The detection limit for formaldehyde was 2.0
      micrograms l-1 with RSDs varying from 3 to 12% in ambient air, using a droplet
      correction solution (boric acid and hydralazine). The effect of interfering
      substances on the determination shows that most cations and anions did not
      interfere. The results obtained were satisfactory compared with a reference
      method.

PMID- 11205498
TI  - Determination of Co(II) by chemiluminescence after in situ electrochemical pre
      separation on a flow-through mercury film electrode.
AB  - A novel method of electrochemical pre-separation of Co(II) before detection by
      chemiluminescence is reported together with the associated instrumentation. The
      Co(II) ions were selectively pre-separated on a mercury film electrode (MFE) by
      on-line reduction, then the accumulated metal was oxidised and selectively
      stripped back into the flowing solution as Co(II). These secondary ions were
      quantified as a result of their catalytic activity on the chemiluminescent
      reaction between luminol and hydrogen peroxide that was also induced on-line. The
      whole sequence was carried out in an automated flow-through system, in which the
      electrochemical pre-separation of metals was performed in either continuous flow
      or flow injection analysis (FIA) regimes. The scope of the method, both in terms
      of selectivity and sensitivity, has been demonstrated and the quantitative
      determination of Co(II) by the proposed method has been investigated. For a
      period of continuous flow pre-separation of 4 min, the calibration curve for
      Co(II) was linear up to a concentration of 100 micrograms l-1, the relative
      standard deviation was 4% at the 20 micrograms l-1 level and the limit of
      detection was 0.5 microgram l-1 (at the 3 sigma level). The method was applied to
      the determination of the cobalt content in a high purity iron sample.

PMID- 11205499
TI  - The generation of concentration gradients using electroosmotic flow in micro
      reactors allowing stereoselective chemical synthesis.
AB  - The stereoselective control of chemical reactions has been achieved by applying
      electrical fields in a micro reactor generating controlled concentration
      gradients of the reagent streams. The chemistry based upon well-established
      Wittig synthesis was carried out in a micro reactor device fabricated in
      borosilicate glass using photolithographic and wet etching techniques. The
      selectivity of the cis (Z) to trans (E) isomeric ratio in the product synthesised
      was controlled by varying the applied voltages to the reagent reservoirs within
      the micro reactor. This subsequently altered the relative reagent concentrations
      within the device resulting in Z/E ratios in the range 0.57-5.21. By comparison,
      a traditional batch method based on the same reaction length, concentration,
      solvent and stoichiometry (i.e., 1.0:1.5:1.0 reagent ratios) gave a Z/E in the
      range 2.8-3.0. However, when the stoichiometric ratios were varied up to ten
      times as much, the Z/E ratios varied in accordance to the micro reactor i.e.,
      when the aldehyde is in excess, the Z isomer predominates whereas when the
      aldehyde is in low concentrations, the E isomer is the more favourable form. Thus
      indicating that localised concentration gradients generated by careful flow
      control due to the diffusion limited non-turbulent mixing regime within a micro
      reactor, leads to the observed stereo selectivity for the cis and trans isomers.

PMID- 11205500
TI  - Sampling of kidneys from cattle and pigs for cadmium analysis.
AB  - Cadmium accumulates in proximal tubule cells causing a gradient of cadmium
      through the kidney, which is important to consider when sampling kidney tissue
      for cadmium analysis. In this study different sampling techniques of cattle and
      pig kidneys have been tested. Cadmium was determined by dry ashing-FAAS
      (detection limit 6.0 micrograms l-1, BCR (Community Bureau of Reference) No. 186
      3.1 +/- 0.17 mg kg-1 (mean +/- s), laboratory quality sample (LQS) 495 +/- 17
      micrograms kg-1) and microwave digestion-graphite furnace AAS (detection limit
      0.24 microgram l-1, BCR No. 186 2.7 +/- 0.16 mg kg-1, LQS 444 +/- 14 micrograms
      kg-1) in homogenates, slices, and in cortex, intermediate and medulla zones of
      bovine and porcine kidneys. The bovine kidney lobulus cortex, intermediate zone,
      and medulla contained 70, 28 and 2% of the total cadmium content, and the
      relative weights of the zones were 53, 35 and 12%, respectively. The cadmium
      concentration in bovine cortex, intermediate zone and medulla was 1.37 +/- 7,
      0.79 +/- 0.06 and 0.10 +/- 0.06 times the calculated homogenate concentration.
      Pig renal cortex, intermediate zone and medulla, contained 73, 26 and 0.5%
      respectively of the total cadmium content, and the relative weights were 63, 36
      and 2.4%, respectively. The cadmium concentration in porcine cortex, intermediate
      zone and medulla was 1.14 +/- 0.05, 0.78 +/- 0.09 and 0.23 +/- 0.11 times the
      calculated homogenate concentration. Freezing of pig kidney caused a slight
      redistribution of cadmium from cortex to medulla. The results show that sampling
      technique is of greater importance for the determination of cadmium in bovine
      kidney than in pig kidney. A well described method for sampling of kidney is
      necessary to make it possible to compare results. To detect small differences in
      renal Cd levels between groups, as, e.g., in the case of biological monitoring of
      Cd exposure, sampling of the outer cortex is suggested as an optimal method.

PMID- 11205501
TI  - Continuous and stopped flow injection for catalytic determination of total iodine
      in urine.
AB  - This paper describes the use of flow injection (FI) techniques for the
      determination of iodine in urine, based on the catalytic effect of iodide in the
      redox reaction between Ce(IV) and As(III). The proposed procedures minimize
      errors in the conventional batch method arising from the reading of absorbance at
      a fixed time after addition of Ce(IV) reagent. Two FI systems, for the continuous
      and stopped modes of operation were assembled. In the continuous-FI system, a
      thermostated bath was used to increase the sensitivity. However this is not
      necessary for the stopped-FI system. The two systems are comparable in terms of
      sensitivity, sample throughput and detection limit. The continuous-FI and the
      stopped-FI exhibited detection limits (3 sigma) of 2.3 and 3 micrograms I l-1
      respectively. Both systems have equal sample throughputs of 35 samples h-1.
      Calibration plots for both techniques are linear. The FI procedures provide very
      short analysis times compared to the batch procedure. Using the linear regression
      test, there is no significant difference between the results from the four
      methods, i.e., continuous-FI, stopped-FI, conventional method and ICP-MS. The
      proposed methods are readily applicable for automation and can be an alternative
      to the conventional procedure for the survey of the iodine deficiency disorder. A
      condition for sample digestion is also proposed to reduce the amount of chloric
      acid required for complete digestion. Kinetic information of the reaction can
      also be obtained from the stopped flow mode.

PMID- 11205502
TI  - Use of the correct blank test in the determination of COD and AOX in bleached
      kraft mill D stage effluents.
AB  - A study of four types of blank, two of which (the placebo blank and the method
      blank) are amenable to direct measurements and the other two [the total Youden
      blank (TYB) and system blank] to extrapolation, revealed the need to use a
      correct blank test, the TYB, in order to eliminate the constant error component.
      The conclusions drawn here are demonstrated for the microcoulometric
      determination of adsorbable organic halogen (AOX), according to Scandinavian
      standard SCAN-W 9:89, and in the spectrophotometric determination of chemical
      oxygen demand (COD) following a closed reflux spectrophotometric method. These
      environmental analytical parameters (AOX and COD) were determined in two
      different bleached kraft mill effluents: one from stage D (100% ClO2) of the
      bleaching sequence AOD of the elemental chlorine-free type and the other for the
      chlorination step, the first in the conventional sequence (D20C80)(E0)D1D2,
      applied to kraft pulp from Populus spp.

PMID- 11205503
TI  - Electric field-induced mobilisation of multiphase solution systems based on the
      nitration of benzene in a micro reactor.
AB  - This paper describes the electric field-induced flow characteristics of
      multiphase solutions in a micro reactor device using the nitration of benzene as
      a model process. Photolithographic and wet etching techniques were used to
      fabricate the micro reactor (channels, 200 microns id, 100 microns deep) in a
      borosilicate glass substrate. The results focus specifically on the flow
      parameters of reagents/reactants (i.e., voltage, solution concentration and pH
      ranges and current-voltage relationships) used in this study. The benzene was
      introduced and mobilised by electroosmotic flow (EOF), as a microemulsion using
      an appropriate surfactant (sodium dodecyl sulfate), whilst the nitronium ions,
      produced in situ from mixed H2SO4-HNO3 (the nitrating agent), underwent
      electrophoretic-induced (electrokinetic) mobility. A co-surfactant, butan-1-ol,
      was used owing to (a) its relative solubility in the aqueous surfactant solution,
      (b) its ability to aid the solubilization of benzene, (c) the provision of a
      water-rich (oil-in-water) rather than oil-rich (water-in-oil) microemulsion
      system and (d) its lack of significant adverse effects on the EOF. The optimum
      conditions used for the nitration of benzene within the micro reactor were a run
      of the microemulsion as main reagent stream, then three 30 s segmented injections
      of mixed acid, with a 5 s push of the microemulsion into the system after each
      injection, and then a 60 s stopped-flow reaction time before driving reaction
      product segments to a collection reservoir.

PMID- 11205504
TI  - Microfabricated reactors for on-chip heterogeneous catalysis.
AB  - Microfabricated devices constructed from glass and polydimethylsiloxane with
      integral heaters are described, which can be used for heterogeneous catalysis
      reactions. Sulfated zirconia is used as the catalyst in an open channel reactor,
      with either a syringe pump or electroosmotic flow being used to deliver the
      reactants. The results clearly demonstrate that very high conversion efficiencies
      are possible, however, the thermodynamics of the reactions are the same as in
      bulk systems. Ethanol and hexanol are dehydrated to ethene and hexene,
      respectively, with conversion efficiencies approaching 100%, and the
      esterification of ethanol is investigated. Yields of approximately 30% ethyl
      acetate are obtained by gas chromatographic analysis. This is the first time such
      a method for fabricating a catalyst micro reactor has been reported, yet it
      demonstrates sufficient robustness and resistance to leakage. The use of
      electroosmotic flow in a heated catalyst reactor is a significant advancement in
      reactor design.

PMID- 11205505
TI  - Microchip-based synthesis and analysis: control of multicomponent reaction
      products and intermediates.
AB  - A miniaturised-SYNthesis and Total Analysis System (mu SYNTAS) was used for the
      solution-phase synthesis and on-line analysis (TOF-MS) of Ugi multicomponent
      reaction (MCR) products. This approach provides an unusually high degree of
      control of the MCR and delivers detailed, novel information on reaction
      intermediates in real-time. Specifically, the Ugi 4 component condensation (4CC)
      involving the reaction of an amine, acid, aldehyde and isocyanide species was
      performed at room temperature in a controllable fashion. Furthermore, observation
      of the nitrilium intermediate, cyclohexyl(2-piperidin-1-ylethylidyne)ammonium
      chloride, is presented for the first time.

PMID- 11205506
TI  - Altering the selectivity of inorganic anion separations using electrostatic
      capillary electrophoresis.
AB  - A new method for altering the selectivity of inorganic anion separations in
      capillary electrophoresis is described. Addition of the zwitterionic surfactant 
      3-(N,N-dimethyldodecylammonio)propane sulfonate (DDAPS) to the background
      electrolyte modifies the migration order via electrostatic ion chromatography
      type interactions. Variation of the DDAPS surfactant concentration from 4 to 120
      mM monotonically alters the selectivity from electrophoretic mobility based to
      that of electrostatic ion chromatography, without increasing Joule heating. This
      technique was applied to the determination of nitrate, nitrite, bromide and
      iodide in artificial seawater. Detection limits for the anions in 1:5 diluted
      seawater were 11, 5, 7 and 11 microM, respectively.

PMID- 11205507
TI  - Fluorimetric determination of isatin in human urine and serum by liquid
      chromatography postcolumn photoirradiation.
AB  - For the fluorimetric determination of isatin in human urine and serum, HPLC
      postcolumn photoirradiation using a mobile phase has been developed. Isatin in
      the urine or serum sample was separated on a Capcell Pak C1 column (250 x 4.6 mm
      id). The mobile phase consisted of 70 mmol l-1 phosphate buffer (pH 7.2)
      tetrahydrofuran (85 + 15% v/v) containing 5 mmol l-1 hydrogen peroxide, which was
      irradiated with germicidal light to induce fluorescence (lambda ex 302 nm, lambda
      em 418 nm). The addition of tetrahydrofuran to the mobile phase led to the peaks
      showing good separation as well as increased sensitivity. The calibration graph
      for isatin was linear over the range of 0.16-10.7 ng. The pretreatment of the
      acidified urine or serum samples consisted of diluting steps or deproteinizing
      steps using perchloric acid, respectively. The mean recovery of isatin from urine
      and serum was greater than 94%.

PMID- 11205509
TI  - Enhanced surface plasmon resonance immunosensing using a streptavidin
      biotinylated protein complex.
AB  - In this paper, we present a novel strategy for improving the sensitivity of
      surface plasmon resonance immunosensing using a streptavidin-biotinylated protein
      complex. This amplification strategy is based on the construction of a molecular
      complex between streptavidin and biotin labeled protein. The complex can be
      formed in a cross-linking network of molecules so that the amplification of the
      response signal will be realized due to the big molecular size of the complex.
      The results show that the amplification strategy causes a dramatic improvement of
      the detection sensitivity. hIgG protein could be detected in the range of 0.005
      10 micrograms ml-1.

PMID- 11205508
TI  - Tris(2,2'-bipyridine)ruthenium(II) electrogenerated chemiluminescence of alkaloid
      type drugs with solid phase extraction sample preparation.
AB  - An electrogenerated chemiluminescence (ECL) method for the determination of
      pethidine, atropine, homatropine and cocaine is described. The optimum conditions
      were found to be similar for all of these compounds although the ECL emission
      intensity for cocaine was an order of magnitude lower than for pethidine due to
      their different chemical structures. Linear calibrations were obtained for all
      the compounds at pH 10 in borate buffer (0.05 mol l-1) at 1.3 V. Limits of
      detection of 6.8 x 10(-8), 2.2 x 10(-7), 3.2 x 10(-7) and 6.5 x 10(-7) mol l-1,
      respectively, were achieved for pethidine, atropine, homatropine and cocaine in
      standard solutions. Solid-phase extraction was used to separate the drugs from
      their matrix and the method was applied to the determination of spiked urine
      samples. The limits of quantitation for pethidine, atropine, homatropine and
      cocaine in urine were 1.0 x 10(-6), 2.0 x 10(-6), 2.0 x 10(-6) and 4.0 x 10(-6)
      mol l-1, respectively, with recoveries of between 90 and 110%.

PMID- 11205510
TI  - Determination of low concentrations of benzene in urine using multi-dimensional
      gas chromatography.
AB  - A method for the determination of benzene in urine of occupationally or
      environmentally exposed persons was developed. The method was based on dynamic
      headspace, preconcentration on a solid sorbent, followed by thermal desorption
      and gas chromatographic determination. To achieve sufficient selectivity, we used
      multi-dimensional gas chromatography in combination with the inexpensive and
      robust flame ionisation detector. The limit of detection was 7 ng l-1 and the
      limit of quantification was 23 ng l-1. The linearity was good (correlation
      coefficient 0.999) in the range examined (20-4000 ng l-1) and the repeatability
      was 9%. The average recovery at low concentrations (20-400 ng l-1) was 86%.
      Analysis of a certified reference material of benzene in water, traceable to
      NIST, did not differ significantly from the certified value. Samples, frozen (-20
      degrees C) in glass bottles sealed with Teflon-silicon septa, were stable for 1
      year and refrigerated samples (4 degrees C) for at least 1 week. Loss of benzene
      during the collection and transfer of urine was investigated and found to be
      acceptable. The method is a cost effective and robust alternative to GC-MS and
      permits reliable quantification of occupational exposure and, in most cases, also
      of urine concentrations that can be expected from environmental exposure.

PMID- 11205511
TI  - Gas chromatographic determination of pesticides in vegetable samples by
      sequential positive and negative chemical ionization and tandem mass
      spectrometric fragmentation using an ion trap analyser.
AB  - A selective and sensitive chromatographic method is described for the
      determination of nine organochlorine and organophosphorus pesticides in vegetable
      samples by gas chromatography-mass spectrometry. The proposed method combines the
      use of positive and negative chemical ionisation and tandem mass spectrometric
      fragmentation, resulting in a significant increase in selectivity and allowing
      the simultaneous confirmation and quantification of trace levels of pesticides in
      complex vegetable matrices. Parameters relative to ionisation and fragmentation
      processes were optimised to obtain maximum sensitivity. Repeatability and
      reproducibility studies yielded relative standard deviations lower than 25% in
      all cases. Identification criteria, such as retention time and relative abundance
      of characteristic product ions, were also evaluated in order to guarantee the
      correct identification of the target compounds. The method was applied to real
      vegetable samples to demonstrate its use in routine analysis.

PMID- 11205512
TI  - Searching the Porphyromonas gingivalis genome with peptide fragmentation mass
      spectra.
AB  - An approach is described for genomic database searching based on experimentally
      observed proteolytic fragments, e.g., isolated from 1D or 2D gels or analyzed
      directly, that can be applied to unfinished prokaryotic genomic data in the
      absence of annotations or previously assigned open reading frames (ORFs). This
      variation on the database search is in contrast to the more familiar use of
      peptide mass spectral fragmentation data to search fully annotated inferred
      protein databases, e.g., OWL or SWISS-PROT. We compared the SEQUEST search
      results from a six reading frame translation of the Porphyromonas gingivalis
      genome DNA sequence with those from computationally derived ORFs created using
      publicly available genomics software tools. The ORF approach eliminated many of
      the artifacts present in output from the six reading frame search. The method was
      applied to uninterpreted tandem mass spectrometric data derived from proteins
      secreted by the periodontal pathogen Porphyromonas gingivalis in response to the
      gingival epithelial cell environment, a model system for the study of host
      pathogen interactions relevant to human periodontal disease.

PMID- 11205513
TI  - Measurement of 237Np in environmental water samples by accelerator mass
      spectrometry.
AB  - Accelerator mass spectrometry (AMS) was used to measure 237Np in environmental
      water samples extracted from Irish Sea sediments. The samples were of limited
      volume (approximately 700 ml) and of low activity (0.06-0.79 mBq l-1; 2.30-30.3
      pg l-1). AMS proved to have the required sensitivity for measuring these samples,
      and was in principle capable of measuring much smaller amounts, as low as 0.4
      microBq (3.9 x 10(7) atoms). However, the background level in the procedural
      blanks showed that there was a systematic low level 237Np contamination of each
      sample, arising from the 239Np yield monitor used in the separations procedure,
      which effectively increased the detection limit of these analyses.

PMID- 11205514
TI  - Electrochemical detection of sequence-specific DNA using a DNA probe labeled with
      aminoferrocene and chitosan modified electrode immobilized with ssDNA.
AB  - The electrochemical detection of sequence-specific DNA using a DNA probe labeled
      with aminoferrocene (AFC) is reported. Sample ssDNA was immobilized on a chitosan
      modified glassy carbon electrode. A sequence-known DNA with 256 bp [obtained by
      polymerase chain reaction (PCR)] was successfully labeled with the electro-active
      reagent AFC by 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide for the first time.
      This DNA probe labeled with AFC was applied to hybridize with a sequence-unknown
      DNA sample. Only the complementary sequence (cDNA) could form a double-stranded
      DNA (dsDNA) with the DNA probe labeled with AFC. The anodic peak currents (ipa)
      of the AFC bound to the dsDNA by differential pulse voltammetry were used for the
      determination of cDNA. The ipa of AFC was linearly related to the concentration
      of cDNA sequence between 1.0 x 10(-8) and 6.0 x 10(-6) mol L-1. The detection
      limit was 2.0 x 10(-9) mol L-1 using 3 sigma (where sigma is the standard
      deviation of blank solution, n = 11). The probe showed high sensitivity and
      selectivity.

PMID- 11205515
TI  - Immunodetection of lactosylated proteins as a useful tool to determine heat
      treatment in milk samples.
AB  - This paper reports the optimisation of a competitive immunoassay (ELISA) to
      detect lactosylated proteins in milk samples. The assay employs monoclonal
      antibodies for lactosylated proteins produced in our laboratory and requires no
      pre-treatment of the samples other than a dilution step. Monoclonal antibodies
      were fully characterised in terms of selectivity and cross-reactivity with
      structurally related molecules and used in a competitive assay format with
      lactosylated standard proteins (lactosylated ovalbumin). The detection limit for
      lactosylated ovalbumin was 0.015 microgram ml-1 and the working range was from
      0.010 to 40 micrograms ml-1. The data obtained indicate that the ELISA developed
      is applicable to diluted milk samples and is able to distinguish between milk
      samples that have undergone different heat treatments (UHT and pasteurised milk).

PMID- 11205516
TI  - The preparation of a series of nitrostilbene ester compounds using micro reactor
      technology.
AB  - The synthesis of stilbene esters using Wittig chemistry has been used to
      illustrate the generic diversity micro reactors offer in terms of chemical
      control and rapid method development. The micro reactor consisted of a 'T' design
      based on channel geometries 200 microns wide and 100 microns deep, etched into
      borosilicate glass and sealed with a borosilicate top plate using a thermal
      bonding technique. The movement of the reagent and products was achieved using
      electroosmotic flow (EOF), assisted by the incorporation of micro porous silica
      frits within the micro-channels to allow accurate solution control. To optimise
      the operating conditions methyl 4-formylbenzoate, premixed with sodium methoxide,
      was reacted with 2-nitrobenzyl-triphenylphosphonium bromide in dry degassed MeOH
      using flow conditions for both reagents of 0.40 microL min-1 for 20 min. A
      product yield of 70% (2:1 reaction stoichiometry with the aldehyde in excess) was
      obtained representing a 10% increase compared with the traditional batch
      synthesis. To demonstrate the capability of micro reactors to perform atom
      efficient synthesis a series of experiments based on an injection methodology
      (optimised to 30 s) were performed in the micro reactor at 1:1 stoichiometry
      resulting in a yield of 59%. Finally, the capability of micro reactors to perform
      a series of analogue reactions was investigated. The yields for a further three
      aldehydes indicated that the technology will be suitable for the development of
      automated device to support the generation of combinatorial libraries and rapid
      high throughput synthetic methods.

PMID- 11205517
TI  - High sensitivity microgravimetric biosensor for qualitative and quantitative
      diagnostic detection of polychlorinated dibenzo-p-dioxins.
AB  - A piezoelectric immunosensor system was developed for the rapid detection of
      polychlorinated dibenzo-p-dioxins (PCDDs). The system uses a competitive
      inhibition enzyme immunoassay (EIA) based on a mouse monoclonal antibody that is
      specific for 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) and a conjugate
      of a dioxin-like competitor coupled to the enzyme horseradish peroxidase (HRP).
      The anti-dioxin antibody was deposited on a 10 MHz AT-cut quartz crystal
      resonator modified with a self-assembly monolayer of dithiobis-N-succinimidyl
      propionate. PCDDs at different concentrations in the range 0.001-10 ng mL-1 were
      mixed with a constant amount of HRP-conjugated competitor. The frequency
      responses due to the adsorption of the mixed samples on the biosensor surface
      were measured. The results show that 2,3,7,8-TCDD can be quantitatively detected
      with the developed immunosensor in the concentration range 0.01-1.3 ng mL-1.
      Cross-reactivities of the biosensor to various PCDD congeners were also
      investigated. The sensitivity and selectivity of the quartz crystal microbalance
      (QCM) biosensor is comparable to EIA and ELISA methods in the detection of
      polychlorinated dibenzo-p-dioxins. The developed QCM immunosensing system offers
      significant improvements in speed, sample throughout and cost for the qualitative
      and quantitative detection of PCDDs compared with GC-MS.

PMID- 11205518
TI  - Flow injection potentiometric determination of pipazethate hydrochloride.
AB  - New plastic membrane electrodes for pipazethate hydrochloride based on
      pipazethatium phosphotungstate, pipazethatium phosphomolybdate and a mixture of
      the two were prepared. The electrodes were fully characterized in terms of
      composition, life span, pH and temperature and were then applied to the
      potentiometric determination of the pipazethate ion in its pure state and
      pharmaceutical preparations under batch and flow injection conditions. The
      selectivity of the electrodes towards many inorganic cations, sugars and amino
      acids was also tested.

PMID- 11205519
TI  - Electrochemical titrations of thiosulfate, sulfite, dichromate and permanganate
      using dual microband electrodes.
AB  - Applications of titration using dual gold microband electrodes in generator
      collector mode are presented. The main advantage is that the method dispenses
      with the need for accurate volume measurements and reagent preparation: rather
      than balancing of molar amounts, the fluxes of analyte and titrant are balanced
      instead. The titrant is generated electrochemically and the end-point is detected
      amperometrically by the appearance of a current due to the presence of the
      titrant at the other band. The aim is to show the versatility and capability of
      the method that employs disposable mass-produced electrodes and uses pulsed
      motion of the electrode before a measurement to renew the boundary conditions.
      The titration of ascorbic acid (vitamin C) with ferricyanide, which has been a
      model system, was extended to the determination of thiosulfate and sulfite with
      iodine and the determination of dichromate and permanganate with iron(II). The
      accuracy, limited by the present fabrication reproducibility of the disposable
      electrodes, is +/- 10%. The results demonstrate that the method is effective even
      with a very simple set-up, and the actual time needed for common titrations is
      significantly decreased. These examples demonstrate a comprehensive basis for
      further development and applications, including standard titrations in industry.

PMID- 11205520
TI  - Multivariate data analysis of quality parameters in drinking water.
AB  - The quality of water destined for human consumption has been treated as a
      multivariate property. Since most of the quality parameters are obtained by
      applying analytical methods, the routine analytical laboratory (responsible for
      the accuracy of analytical data) has been treated as a process system for water
      quality estimation. Multivariate tools, based on principal component analysis
      (PCA) and partial least squares (PLS) regression, are used in the present paper
      to: (i) study the main factors of the latent data structure and (ii) characterize
      the water samples and the analytical methods in terms of multivariate quality
      control (MQC). Such tools could warn of both possible health risks related to
      anomalous sample composition and failures in the analytical methods.

PMID- 11205521
TI  - Characterization of Galician (N.W. Spain) quality brand potatoes: a comparison
      study of several pattern recognition techniques.
AB  - Authenticity is an important food quality criterion and rapid methods to
      guarantee it are widely demanded by food producers, processors, consumers and
      regulatory bodies. The objective of this work was to develop a classification
      system in order to confirm the authenticity of Galician potatoes with a Certified
      Brand of Origin and Quality (CBOQ) 'Denominacion Especifica: Patata de Galicia'
      and to differentiate them from other potatoes that did not have this CBOQ. Ten
      selected metals were determined by atomic spectroscopy in 102 potato samples
      which were divided into two categories: CBOQ and non-CBOQ potatoes. Multivariate
      chemometric techniques, such as cluster analysis and principal component
      analysis, were applied to perform a preliminary study of the data structure. Four
      supervised pattern recognition procedures [including linear discriminant analysis
      (LDA), K-nearest neighbours (KNN), soft independent modelling of class analogy
      (SIMCA) and multilayer feed-forward neural networks (MLF-ANN)] were used to
      classify samples into the two categories considered on the basis of the chemical
      data. Results for LDA, KNN and MLF-ANN are acceptable for the non-CBOQ class,
      whereas SIMCA showed better recognition and prediction abilities for the CBOQ
      class. A more sophisticated neural network approach performed by the combination
      of the self-organizing with adaptive neighbourhood network (SOAN) and MLF network
      was employed to optimize the classification. Using this combined method,
      excellent performance in terms of classification and prediction abilities was
      obtained for the two categories with a success rate ranging from 98 to 100%. The
      metal profiles provided sufficient information to enable classification rules to
      be developed for identifying potatoes according to their origin brand based on
      SOAN-MLF neural networks.

PMID- 11205522
TI  - A help or a hindrance? The impact of job training on the employment status of
      disadvantaged women.
AB  - The objective of this study is to evaluate whether welfare-sponsored, government
      funded job training helps participants improve their employment status. The
      negligible effects found in prior studies may be due to design limitations or
      inherent flaws in job training programs and therefore do not necessarily
      contradict human capital theory. The present study uses longitudinal and
      representative data, dynamic modeling techniques, an appropriate counterfactual,
      and important contextual variables to assess the likelihood of obtaining
      employment for job training participants and nonparticipants. It also describes
      the types of jobs women obtain by examining wages, industry, occupation, and
      labor union membership. Whereas some of the results support prior research, the
      focus is on the unique contributions of this study, which include a differential
      training effect for full- and part-time workers and a detailed analysis of macro
      structural variables, which are rarely included in studies of labor supply.

PMID- 11205523
TI  - Statistical power for nonequivalent pretest-posttest designs. The impact of
      change-score versus ANCOVA models.
AB  - Nonequivalent controlled pretest-posttest designs are central to evaluation
      science, yet no practical and unified approach for estimating power in the two
      most widely used analytic approaches to these designs exists. This article fills
      the gap by presenting and comparing useful, unified power formulas for ANCOVA and
      change-score analyses, indicating the implications of each on sample-size
      requirements. The authors close with practical recommendations for evaluators.
      Mathematical details and a simple spreadsheet approach are included in
      appendices.

PMID- 11205524
TI  - The Community Readiness Survey. Development and initial validation.
AB  - This article reports on the development and evaluation of a mail survey measuring
      population attitudes toward substance use of potential receptivity of communities
      to different prevention efforts. The Community Readiness Survey was designed
      through a series of prevention practitioner and consultant meetings and focus
      groups. Psychometric evaluation revealed five distinct domains: perception of
      alcohol, tobacco, or other drug problem; support for prevention; permissive
      attitudes toward teen substance use; perception of adolescent access; and
      perception of community commitment. Evidence of construct validity was
      demonstrated by the small but significant relationships between selected scale
      scores and community readiness as evaluated by prevention planners.

PMID- 11205525
TI  - Middle school reform through data and dialogue. Collaborative evaluation with 17
      leadership teams.
AB  - This report describes a 2-year, longitudinal study of one school district's
      effort to link site-based, collaborative evaluation with formal, centralized
      program evaluation. Participants formed a research team in partnership with a
      local university. Team members assisted leadership teams in identifying issues
      for informal, site-based assessments and then used the information to monitor
      progress toward established goals. Participants collaborated in designing and
      conducting informal assessments of student achievement, school climate and
      safety, discipline, and parent involvement. Leadership teams used these data in
      developing their school improvement plans. Researchers and administrators used
      these data to revise the districtwide survey. At the end of the 2-year cycle,
      analysis of school improvement plans showed that collaborative evaluation is
      creating a connection between dialogue and data. These 17 middle schools are
      approaching school improvement in a more integrated fashion by actively involving
      key stakeholders (students, parents, and teachers) in the evaluation process.

PMID- 11205526
TI  - Aging and feature search: the effect of search area.
AB  - The preattentive system involves the rapid parallel processing of visual
      information in the visual scene so that attention can be directed to meaningful
      objects and locations in the environment. This study used the feature search
      methodology to examine whether there are aging-related deficits in parallel
      processing capabilities when older adults are required to visually search a large
      area of the visual field. Like young subjects, older subjects displayed flat,
      near-zero slopes for the Reaction Time x Set Size function when searching over a
      broad area (30 degrees radius) of the visual field, implying parallel processing
      of the visual display. These same older subjects exhibited impairment in another
      task, also dependent on parallel processing, performed over the same broad field
      area; this task, called the useful field of view test, has more complex task
      demands. Results imply that aging-related breakdowns of parallel processing over
      a large visual field area are not likely to emerge when required responses are
      simple, there is only one task to perform, and there is no limitation on visual
      inspection time.

PMID- 11205527
TI  - The locus of age x health-related physical fitness interactions in serial choice
      responding as a function of task complexity: central processing or motor
      function?
AB  - The extent to which health-related physical fitness (HRF) attenuates age
      differences in psychomotor speed as a function of task complexity was examined in
      a sample of 48 men. Physiological measures were used to assign participants to
      fitness group (n1-4- = 12): young less fit (mean age = 25.83 years), young fitter
      (mean age = 25.08 years), old less fit (mean age = 71.83 years), old fitter (mean
      age = 66.75 years). A serial choice reaction time (RT) task was used in which
      three conditions of two, four, or eight choices were administered. RTs for the
      choice and motor components of the task were recorded separately. A significant
      Age x HRF interaction was found in relation to choice RT but not motor time;
      older less fit individuals underperformed older fitter participants, and younger
      adults regardless of fitness level. This interaction remained significant having
      statistically controlled for motor function, suggesting benefits to central
      processing. The strength of this interaction did not increase as a function of
      task complexity. The findings suggest an association between HRF and psychomotor
      speed, and support the view that physically active lifestyles should be
      encouraged among older adults.

PMID- 11205528
TI  - Overall vigilance and sustained attention decrements in healthy aging.
AB  - Age differences in sustained attention were investigated using a high-event rate
      digit-discrimination task at 6 levels of stimulus degradation (lasting 8.1 min
      each). Twenty-one young, 21 middle-aged, and 20 old healthy subjects were
      studied. Overall sensitivity (d') was equivalent in all groups. Although all
      subjects showed a sensitivity decrement over blocks, there were no age-related
      differences in sustained attention capacity. All subjects had larger decrements
      in d' over blocks at higher degradation levels. However, the performance
      decrement at higher degradation levels was equivalent in all groups, indicating
      similar decrement rates in sensitivity with increasing demands on effortful
      processing. These results indicate that overall levels of vigilance and the
      ability to sustain attention over time are equivalent in all groups under
      conditions requiring both automatic (low-degradation) and effortful (high
      degradation) stimulus processing.

PMID- 11205529
TI  - Goal-setting, self-efficacy, and memory performance in older and younger adults.
AB  - Research in field and laboratory settings has shown that goals lead to improved
      self-efficacy and performance, especially when individuals also receive positive
      feedback. The present study extended goal-setting theory to examine self-set
      goals and feedback in relation to younger and older adults' memory performance
      and self-efficacy. Following a baseline recall trial, participants completed
      three shopping list recall trials. Half of the participants were instructed to
      set goals for the three experimental trials, and half in each goal condition
      received performance feedback after each trial. Young adults' self-efficacy,
      clustering, and recall exceeded that of older adults. Goal setting increased self
      efficacy for younger but not older adults, and it did not affect performance.
      Younger adults and participants in the feedback condition increased their goals
      across trials, as did participants for whom feedback indicated success. These
      data provide a first look at the motivational impact of feedback and self-set
      recall goals in memory aging. Additional study is needed to understand the
      interactive effects of type of feedback, memory task difficulty, and type of goal
      setting at different ages.

PMID- 11205530
TI  - Perceived work environment and cognitive style.
AB  - Differences in perceived work environment are examined by age, gender, and
      occupation type, along with whether cognitive style predicts perceived work
      environment. The sample consists of 2185 men and women ranging in age from 21 to
      93 years. Perceived work environment was measured using Moos's Work Environment
      Scale (WES) for the subscales of Autonomy, Control, and Innovation. The Test of
      Behavioral Rigidity (TBR) was used to measure cognitive style. Findings indicate
      significant mean level differences in perceived work environment based on gender,
      age, and occupation type. Hierarchical regression analyses indicated that
      perceived work environment predicted concurrent cognitive style beyond
      demographic variables.

PMID- 11205531
TI  - Temporal control of rhythmic performance: a comparison between young and old
      adults.
AB  - Young (20-30-year-old) and older (60-76-year-old) adults were tested on two
      measures of rhythmic performance. The first involved tapping at the subject's own
      preferred rate, a measure of so-called internal tempo. Over five sessions of
      testing, tapping rates were consistently and significantly slower on average in
      the older subjects than the younger ones, but rates were not relatively more
      variable in older subjects (i.e., coefficients of variation, standard
      deviation/mean, did not differ between the older and young people). In addition,
      both old and younger subjects performed on a synchronized-tapping and
      continuation task of the type used by Wing and Kristofferson (1973, Perception
      and Psychophysics, 14, 3-12). Target interresponse times were 300, 400, 500, 600,
      and 700 ms, and in all cases interresponse intervals produced by both the old and
      young adults matched the target times very closely. Wing and Kristofferson's
      analytical procedure was used to decompose tapping variance into that
      attributable to timing processes and that resulting from motor implementation of
      the timing signal. Both sorts of variance increased with increasing target
      interresponse time (with timer variance increasing most markedly), but no
      difference was found in either type of variance in comparisons between the old
      and younger subjects. If the internal tempo measure directly reflects the speed
      of internal timing processes, the data suggest that such processes are slower,
      but not relatively more variable, in older than younger subjects (consistent with
      some previous evidence and speculation), but that the calibration of performance
      forced by the synchronization task will make such an age-related difference in
      "internal clock speed" unobservable on synchronized-tapping tasks.

PMID- 11205532
TI  - Bioaccumulation of polychlorinated biphenyls (PCBs) and dichlorodiphenylethane
      (DDE) methyl sulfones in tissues of seal and dolphin morbillivirus epizootic
      victims.
AB  - Polychlorinated biphenyl (PCB) and dichlorodiphenylethane (DDE) methyl sulfone
      (MSF) metabolites possess high affinities for binding two homologous 16,000 Da
      homodimeric receptor proteins in the lung (Clara cell secretory protein, CCSP)
      and the uterus (uteroglobin, UG), leading to selective bioaccumulation of MSFs in
      these tissues. As marine mammals are highly exposed to organochlorines,
      concentrations of PCBs, PCB MSFs, DDT, and DDE MSF were analyzed in blubber,
      lung, and uterus samples from harbor seal (Phoca vitulina) and striped dolphin
      (Stenella coeruleoalba) morbillivirus epizootic victims to investigate uterine
      and lung MSF accumulation. Mean uterus concentrations of PCB MSFs and DDE MSF in
      harbor seals were 0.61 and 0.04 microg/g lipid weight and in striped dolphins
      0.05 and 0.01 microg/g lipid weight. Mean lung concentrations of PCB MSFs and DDE
      MSF in harbor seals were 0.96 and 0.02 microg/g lipid weight and in striped
      dolphins 0.16 and 0.01 microg/g lipid weight. To ascertain whether uterine and
      lung bioaccumulation of MSFs is possible due to the presence of CCSP and UG in
      seals, CCSP and UG proteins in uterine flushings and in uterine and lung and
      epithelial tissue from Baltic gray and ringed seals were characterized using gel
      electrophoresis and Western blotting techniques. UG- and CCSP-like proteins with
      molecular weights of 16,000 Da were resolved in all samples. This is the first
      demonstration of this protein in any marine mammalian species. The toxicological
      implications of MSF binding with UG and CCSP in marine mammals are discussed.

PMID- 11205533
TI  - Chrysotile asbestos fibers detected in the newborn pups following gavage feeding
      of pregnant mice.
AB  - Female pregnant mice were fed chrysotile asbestos suspension by gavage to
      determine whether there is transfer of fibers to the fetuses. Groups of mice were
      given 2 doses of either 50 microg chrysotile suspension in 0.2 ml sterile normal
      saline (treated), or 0.2 ml saline (control), and were allowed to mate 2 d later.
      After pregnancy was confirmed, the treated and control groups received 2
      additional doses of chrysotile asbestos or saline on gestational d 7 and 12. Both
      groups were allowed to deliver naturally, and the pups were sacrificed at 8, 1,
      19, or 20 d after birth. The lungs and liver of two pups from each mother were
      processed for fiber counts using electron microscopy and energy-dispersive x-ray
      analysis (EDXA). All pups of the treated group had chrysotile fibers, while none
      were present in pups from controls. The mean fiber count of the lungs of treated
      group of pups was 780 fibers/g, and the mean fiber count of the liver was 214
      fibers/g. Mean length of the fibers in the lung and liver was 18.48 microm and
      18.30 microm, respectively. The fibers were thin, measuring 0.42 microm and 0.33
      microm in the lung and liver, respectively. There was no significant difference
      in the weight gain between the treated and control group of pups. The postnatal
      fetal mortality of the 2 groups, 8.2% for the treated and 4.5% for the control
      group, were not statistically significant. To our knowledge, this is the first
      animal study to demonstrate that oral ingestion of chrysotile asbestos during
      pregnancy results in transfer of asbestos fibers to the fetuses.

PMID- 11205534
TI  - Effects of diquat, an aquatic herbicide, on the development of mallard embryos.
AB  - Bipyridylium herbicides produce embryotoxic and teratogenic effects in dipteran,
      amphibian, avian, and mammalian organisms. Diquat dibromide, a bipyridylium
      compound, is commonly used as an aquatic herbicide. Mallard (Anas platyrhynchos)
      eggs were exposed to diquat by immersing the eggs for 10 s in solutions of 0.88,
      3.5, 7, 14, or 56 g/L on either d 4 or 21 of incubation. Application of diquat on
      d 4 yielded an estimated LC50 of 19.5 g/L through 18 d of incubation, and 9.6 g/L
      through hatching. Body and organ weights, and bone lengths of hatchlings did not
      differ between control and treatment groups with the exception of a slight
      increase in brain weight in the 14 g/L group. Malformations in diquat-treated
      embryos included defects of the brain, eye, bill, limb, and pelvis; skeletal
      scoliosis; and incomplete ossification. Subcutaneous edema was also present.
      Significant manifestations of oxidative stress were apparent in hatchlings and
      included increased hepatic thiobarbituric acid-reactive substances (TBARS) (lipid
      peroxidation) and decreased brain reduced glutathione (GSH). Brain protein-bound
      sulfhydryls (PBSH) increased. Diquat applied on d 21 of incubation yielded an
      estimated LC50 of 12.6 g/L through hatching. Exposure at this late stage of
      development did not produce deformities. Body and organ weights and, bone lengths
      of hatchlings did not differ between control and treatment groups. Significant
      manifestations of oxidative stress in hatchlings included decreased brain GSH,
      increased oxidized glutathione (GSSG), and ratio of GSSG to GSH. This study
      suggests that concentrations of diquat commonly used for aquatic weed control,
      when based upon the dilution effect of average water depth of the application
      area, would probably have little impact on mallard embryos. However,
      concentrations applied above ground to weeds and cattails along ditches could
      adversely affect the survival and development of mallard embryos, and presumably
      other avian species nesting in such habitats.

PMID- 11205535
TI  - Lipid peroxidation in rat adrenal glands after administration cadmium and role of
      essential metals.
AB  - The aim of this study was to investigate the effects of cadmium-induced
      peroxidative damage to rat adrenals. Cadmium significantly increased adrenal
      lipid peroxidation in a dose- and time-related manner. Cadmium-induced lipid
      peroxidation was accompanied by a marked elevation in adrenal iron (Fe) levels,
      in particular the free elemental form. Chelation of Fe with deferoxamine
      decreased the cadmium effect on lipid peroxidation. Selenium (Se) was also
      effective in inhibiting Cd-induced adrenal lipid peroxidation. Data indicate that
      Cd-induced lipid peroxidation in rat adrenals may be dependent upon Fe and Se
      levels in this tissue.

PMID- 11205536
TI  - Bioindication of heavy metals with aquatic macrophytes: the case of a stream
      polluted with power plant sewages in Poland.
AB  - The Kozi Brod (left tributary of the Biala Przemsza, east of Katowice) flows in a
      highly industrial coal-mining area dominated by the power plant of Siersza.
      Concentrations of the microelements nickel (Ni), chromium (Cr), cobalt (Co), zinc
      (Zn), manganese (Mn), lead (Pb), cadmium (Cd), copper (Cu), barium (Ba), aluminum
      (Al), vanadium (V), and strontium (Sr), as well as the macronutrients nitrogen
      (N), phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), and
      sulfur (S), were measured in water and plants of the Kozi Brod. The collected
      plants were: Myosotis palustris L. Nathorst, Galium palustre L., Mentha
      rotundifolia L. Huds., Mentha aquatica L., Berula erecta (Huds.) Coville,
      Cardamine amara L., Epilobium angustifolium L., Geranium palustre L., Lysimachia
      vulgaris L., Crepis paludosa L. Much., Calitriche verna L., Solanum dulcamara L.,
      and the aquatic moss Hygrohypnum ochraceum (Turn.) Loesk. These plants were used
      to evaluate the spatial distribution of elements in the Kozi Brod and contained
      elevated levels of Co, Cd, Zn, Ni, Mn, Al, Pb, and Cu. Significant correlations
      between concentrations of Cd, Zn, and Mn in water and plants indicate the
      potential of these species for pollution monitoring.

PMID- 11205537
TI  - Pulmonary responses to single versus multiple intratracheal instillations of
      silica in rats.
AB  - The pulmonary toxicity of particles is often studied using a single intratracheal
      instillation of the material. It was hypothesized that smaller multiple
      intratracheal administrations of silica would result in differences in pulmonary
      responses as compared to a single large intratracheal administration. In the
      first of a series of experiments, the pulmonary responses in male F344 rats to a
      single intratracheal instillation of crystalline silica (5 mg/100 g body weight)
      given on d 0 were compared with those resulting from 5 consecutive daily
      intratracheal administrations of the dust (1 mg/100 g body weight/d) with the
      initial dose given on d 0. Controls received saline intratracheally. In the
      second experiment, the dose was reduced to 1 mg/100 g body weight for the single
      dose protocol and 0.2 mg/100 g body weight/d for 5 consecutive days for the
      multiple-dose protocol. In both experiments, responses were assessed on d 14. In
      the third experiment, the doses were the same as the first experiment, but the
      responses were assessed on d 28. The indices of toxicity were cellular
      differentials recovered by bronchoalveolar lavage, which is an index of
      inflammation, and the level of albumin in the bronchoalveolar lavage fluid, a
      measure of damage to the capillary-epithelial barrier. At the higher dose of
      silica, similar levels of inflammation and lung damage were evident in both
      dosing protocols. Less severe responses occurred at the lower dose. The
      comparative pattern between the single and multiple dosing protocols was similar
      in all three experiments. Since only minor differences were noted in the
      pulmonary responses when the responses to the single- and multiple-dose protocols
      were compared, data indicate that the multiple-dose protocol does not offer any
      advantages over the single-dose protocol.

PMID- 11205538
TI  - [Prevalence of multiple sclerosis in Colombia].
AB  - INTRODUCTION: Multiple sclerosis (MS) is the commonest demyelinating condition of
      the nervous system. It is characterized by numerous demyelinating areas or
      plaques of demyelination which are found dispersed throughout the nervous system.
      It has been shown that MS is less frequent in tropical regions than in
      subtropical regions. In Latin America particularly, there are some studies which
      show this phenomenon. However, in Colombia no studies of prevalence of MS have
      been done. OBJECTIVE: To determine the prevalence of multiple sclerosis in five
      provinces of Colombia (Antioquia, Caldas, Santander, Risaralda and Bolivar).
      PATIENTS AND METHODS: The capture-recapture method was used for two sources to
      determine the number of cases defined on the criteria of Poser et al seen between
      July 1995 and June 2000. RESULTS: The prevalence (cases of MS per 100,000
      inhabitants) varied between 1.48 in Antioquia (95% CI 1.12; 1.78) and 4.98 in
      Risaralda (95% CI 3.52; 6.43). Seventy two percent were women. The regions
      included in this study represented 25% of the population of Colombia.
      CONCLUSIONS: There is a low prevalence of MS which is as expected in tropical
      areas. Persons with MS in these regions may be very useful in the study of other
      factors involved in the aetiology of MS (genetic). The capture-recapture method
      is an excellent tool for carrying out prevalence studies since it is cheap and
      requires little time.

PMID- 11205539
TI  - [Visual field changes secondary to vigabatrin treatment].
AB  - INTRODUCTION: Vigabatrin is an effective antiepileptic drug for treatment of
      partial crises with or without generalization. It acts by increasing GABA levels
      by irreversible inhibition of the enzyme GABA-transaminase. In recent years there
      have been several reports published on the appearance of alterations of the
      visual fields of patients treated with this drug. OBJECTIVE: To study the
      prevalence and characteristics of the visual field changes associated with
      vigabatrin treatment in an adult epilepsy clinic. PATIENTS AND METHODS:
      Ophthalmological examination, consisting of questions about eye symptoms, study
      of the fundus oculi, Humphrey-type campimetry, protocol 30-2, visual evoked
      potentials and electroretinogram were done on a group of 10 patients on long-term
      vigabatrin treatment. RESULTS: Six of the ten patients (60%) had campimetric
      alterations, which were serious in two cases (20%). Only the two patients with
      severe field defects complained of sight changes when questioned and their
      complaints were mainly of repeatedly bumping into things. In two patients (20%)
      there was pallor of the optic nerve. In both cases, the patients with severe
      field defects showed alterations on the electroretinogram. Visual evoked
      potentials were normal in all cases. CONCLUSIONS: There is a very high prevalence
      of visual field defects in patients on long-term treatment with vigabatrin.
      Clinical ophthalmological signs are not usually seen until advanced stages.
      Pallor of the optic nerve was seen in a group of patients. It is very important
      that serial campimetric studies are done for early detection of such alterations.

PMID- 11205540
TI  - [Parkinson's disease, side affected and depression].
AB  - INTRODUCTION: Depression is a state of mind often associated with Parkinson's
      disease, which is not correlated with the stage of the disease or the response to
      treatment with L-dopa. It has been suggested that patients with right-sided
      Parkinsonism have more depression than those with left-sided. OBJECTIVE: To
      assess whether patients whose dominant side is affected primarily have more
      depression than those whose non-dominant side is affected; and to evaluate
      whether when the dominant side is more affected this is accompanied by greater
      deterioration on the scale of everyday activities (ADLS) and on the motor part of
      the unified scale for evaluation of Parkinsonism (UPDRSm). PATIENTS AND METHODS:
      The study group was formed of 63 patients with Parkinsonism at stage 1 or 1.5
      (Hoehn and Yahr), with an average age of 66.17 years. They were divided into two
      groups. Those who received L-dopa (Dopa group) and those who were newly-diagnosed
      patients (Naive group). They were evaluated on the Hamilton test, UPDRSm and ADLs
      scale. We used Wilcoxon's nonparametric sum of ranges test taking p < 0.01 as
      significant. RESULTS: The indexes of depression were greater, in both groups, in
      the patients whose dominant side was affected (p < 0.001). There were no
      differences in UPDRSm or ADLs. CONCLUSIONS: The patients with Parkinson's disease
      whose dominant side is primarily affected have worse depression. The depression
      seems originate in the dominant hemisphere.

PMID- 11205541
TI  - [Factorial structure of the executive functions in young university students].
AB  - INTRODUCTION: Several studies have proposed a multiple dimensional theoretical
      model for executive function. OBJECTIVE: To identify the factor structure of the
      executive function in a sample of young university students of different
      modalities of learning in their careers. METHODS: 100 participants of both sexes,
      age 16 to-21-year old and normal Full Scale IQ were selected in a randomized and
      representative approach from private universities of Medellin Colombia. They were
      student of verbal, visuospatial and mathematical careers. A executive function
      assessment battery were applied, which included: Wisconsin Card Sorting Test
      (WCST), Trail Making Test (TMT) A and B, verbal fluency test (FAS) by phonologic
      and semantic guides, and Stroop test. RESULTS: A structure of four factor was
      found, which explained 74.9% of variance. Factors were: 1. Organization and
      flexibility, which explained 26.6% of variance; 2. Processing speed, 19.7%; 3.
      Inhibitory control, 15.1%; and 4. Verbal fluency 13.4%. CONCLUSION: A multiple
      factor structure of the executive function in young university students was
      demonstrated.

PMID- 11205542
TI  - [Cerebellar hematomas: a surgically treatable stroke].
AB  - INTRODUCTION: Spontaneous cerebellar hematomas make up nearly 10% of the
      intracranial intraparenchymatous hemorrhages. In recent years several algorithms
      have been published for the management of these patients. OBJECTIVE: To study the
      type of treatment, conservative or operative, and the main prognostic factors.
      PATIENTS AND METHODS: We present a retrospective analysis of 52 cases of
      spontaneous cerebellar hematomas diagnosed over the past 10 years in the Hospital
      General de Galicia. We studied the clinical and radiological factors with the
      greatest effect on prognosis and the approach to treatment. RESULTS: We found a
      male/female ration of 2/3. The age of 90.3% of our patients was over 60 years.
      Arterial hypertension had previously been diagnosed in 55.7% of the cases. The
      clinical picture was characterized by the profile of a stroke with headache
      (90.3%), vomiting (63.4%) and impaired consciousness (50%) being the commonest
      presenting symptoms. The most important factors in prognosis were the level of
      consciousness and the size of the hematoma. The prognosis was worse in cases with
      hydrocephalus, intraventricular hemorrhage or extension of the hematoma towards
      the midline. Neither age, sex nor the previous diagnosis of arterial hypertension
      were of importance in prognosis. Mortality was 25%. CONCLUSIONS: The spontaneous
      cerebellar hematomas typically affect patients over the age of 60 years and
      present with headache and vomiting of sudden onset. In our series the major
      prognostic factors were the size of the hematoma and level of consciousness, and
      treatment was given in accordance with this.

PMID- 11205543
TI  - [Medium and large acoustic neurinomas with normal tonal audiometry at the moment
      of diagnosis].
AB  - INTRODUCTION: Early diagnosis of an acoustic neurinoma for any possible treatment
      is important, especially in view of the relationship between surgical morbidity
      and the size of the tumour. The commonest presenting symptom of these tumors is
      unilateral perceptive deafness. However, between 4 and 12% are diagnosed before
      deafness occurs, although they may be large in size. Therefore one should
      remember other symptoms which lead to suspicion of these tumors, and have
      diagnostic guidelines available to allow the earliest possible detection.
      PATIENTS AND METHODS: We report four cases of acoustic neurinoma or vestibular
      schwannoma of medium or large size in which audiological studies did not at first
      give rise to suspicion of the presence of this tumour, since audition was
      considered to be normal at conversation frequencies (500 to 3,000 Hertz) for the
      age of the patient or who had an audiometry curve with symmetrical deafness in
      both ears. CONCLUSION: We evaluated the diagnostic importance of the tests done
      and compared the results with data published in the literature.

PMID- 11205544
TI  - [Multiband spectral analysis and standardized markers of the slope of pediatric
      electroencephalograms].
AB  - INTRODUCTION: The infantile electroencephalogram has been studied in connection
      with many cognitive disabilities. Although normal resting infantile bioelectric
      recordings are known, the cortical distribution of electroencephalographic
      frequencies during other sensory and/or cognitive mental processes is less well
      known. OBJECTIVE: Our interest is based on the description of EEGs of a
      homogeneous sample of healthy children and their relation to intellectual
      activities. MATERIAL AND METHODS: The sample studied was made up of 13 healthy
      children with an average age of 9.3 +/- 1.3 years, on whom two types of tests of
      attention were done. One of the tasks was a simple auditory memory test and
      consisted of the spoken repetition of a series of numbers previously heard, which
      was of variable length. The second test consisted of the identification and
      crossing out of one face of a series of three faces, which included one which was
      different from the others. The methodology chosen was electroencephalographic
      measurement in the frequency and temporal domains. RESULTS AND CONCLUSIONS: There
      was a relative increase in beta frequencies in all cortical sites which was
      significant in T3 and T4 with the auditory test and in all electrodes with the
      visual test. During auditory testing reduction in the alpha frequency was
      observed in frontotemporal regions. The greatest cortical variations of beta
      frequency occurred, in the facial test, in the electrodes O2, T6, O1, T5 and T3.
      The values of Hjorth complexity obtained varied within the interval 1 to 3, which
      was a considerably lower interval than that found in adult populations.

PMID- 11205545
TI  - [Our experience with the programmable Codman-Medos valve: review of 125 shunts].
AB  - INTRODUCTION: Programmable valves are a possible solution in cases of excessive
      or insufficient draining. OBJECTIVE: To report our experience with these shunts
      and clarify concepts. PATIENTS AND METHODS: We have implanted 125 Codman-Medos
      programmable devices in 118 patients. The most frequent indication was secondary
      hydrocephalus, particularly due to obstruction by a tumour, and primary
      hydrocephalus. They were also used in cases of benign intracranial hypertension,
      CSF fistulas and arachnoid cysts. Most valves were inserted frontally, under
      antibiotic prophylaxis. RESULTS: Excluding patients with a follow-up of less than
      three months, the average follow-up was 14.63 +/- 9.07 months, with clinical
      improvement in 80%. There was 0% mortality in relation to surgery. The initial
      average pressure was 121.84 +/- 24.74 mmH2O and after 52 reprogrammings done in
      36 (30%) of the patients, the final average pressure was 124.96 +/- 30.58 mmH2O.
      Reprogramming was done for the management of symptoms and to avoid subdural
      hygromas. We have observed no clinical signs of unprogramming. There were 29
      complications which were treated by reprogramming in 7 cases and surgically in
      the remainder. CONCLUSIONS: We recommend frontal insertion, with a long
      peritoneal catheter, mainly in patients with hydrocephalus secondary to stenosis
      of the aqueduct of Sylvius, benign intracranial hypertension, after head injury
      and Arnold-Chiari malformation. The initial pressure is difficult to determine
      but tends to be average or high. Reprogramming is particularly useful in the
      treatment of subdural hygromas. We have observed no clinical signs of
      unprogramming. Complications tend to be due to surgical technique rather than the
      particular shunt used.

PMID- 11205546
TI  - [Early assessment in perinatal hypoxia. Prognostic markers].
AB  - INTRODUCTION: Perinatal asphyxia and its neurological signs are the most
      important cause of brain damage and neurological sequelae in full term newborn
      babies. Neuroprotection treatments currently being investigated promise to reduce
      such sequelae, but these treatments are not without risk and the patients
      involved should be selected. OBJECTIVE: To analyze a scale composed of variables
      recorded from the start of delivery until the fourth hour of life, comparing the
      neurological evolution of the patients. By means of this scale we aim to
      establish a criterion for the selection of neonates with acute perinatal
      asphyxia, who would benefit from neuroprotector treatment. PATIENTS AND METHODS:
      A retrospective study was made of 50 patients with the diagnosis of perinatal
      asphyxia. Our scale was formed of the following variables: intrauterine
      meconiorrhexis, pathological cardiotocographic recordings, resuscitation at
      birth, Apgar score at five minutes, pH of the umbilical artery blood,
      neurological examination, multisystemic involvement, seizures, persistent
      metabolic acidosis and need for mechanical ventilation during the first hours of
      life. The patients were followed up for at least one year by means of periodical
      studies (neurological examination and evaluation of psychomotor development
      according to the Brunnet Lezinne test). For statistical analysis we used the chi
      squared test, Fisher's exact test, Kruskal-Wallis test and the area beneath the
      ROC curve. RESULTS AND CONCLUSIONS: The scale presented constitutes a rapid, easy
      method which is statistically significant for the selection of perinatal asphyxia
      of high neurological risk which would benefit from neuroprotector treatment after
      the event.

PMID- 11205547
TI  - [Falling backward: atypical sign of iodiopathic Parkison's disease. Use of
      intravenous apomorphine as a diagnostic test].
AB  - INTRODUCTION: The differential diagnosis of a parkinsonian syndrome is extensive
      and complex. In most cases, however, a detailed clinical examination will help to
      differentiate between idiopathic Parkinson's disease (IPD) and other causes of
      parkinsonism. PATIENTS AND METHODS: 10 patients with an average age of 65.1 years
      (range 60-70), of whom 6 were men and 4 women were referred to our department
      with a diagnosis of IPD and history of backwards falls. The average duration of
      disease was 4.7 years (range 4-7). All 10 patients had at presentation a severe
      akinetic-rigid syndrome with no other symptoms of IPD. I.v. apomorphine (APO) was
      administered to each of them at a rate of 8.9 mg/hr (range 15.3 mg/hr) for an
      average time of 5.4 hours (range: 3-10 hours). RESULTS: The improvement of the
      akinetic-rigid state in six of the patients during the i.v. infusion with APO
      helped to elicit signs that are atypical of IPD (ataxia and postural
      instability). Three of the patients did not respond to i.v. APO and one of them
      could not be evaluated, as he did not tolerate the infusion. Oral Dopa challenge
      or s/c APO bolus has not been as successful in helping to differentiate IPD from
      other parkinsonian syndromes. CONCLUSIONS: The prompt detection of postural
      instability or retropopulsion is necessary in order to diagnose atypical
      parkinsonian syndromes. In difficult cases, continuous i.v. APO will improve the
      akinetic-rigid state and facilitate the detection of atypical signs. The
      pharmacokinetic characteristics of APO, and the advantage of it being possible to
      administer the drug i.v. in a few hours increases the viability of this test.

PMID- 11205548
TI  - [Value of the MSH classification in the hemiplegic stroke patient].
AB  - INTRODUCTION: The functional prognosis of patients should be known when planning
      their rehabilitation treatment. OBJECTIVE: To find the prognostic value of the
      MSH classification for hemiplegic patients, which is based on the clinical
      deficits seen after the stroke, and to distinguish between the M group (motor
      deficit), MS group (motor and sensory deficits) and the MSH group (motor, sensory
      and homonymous deficits). PATIENTS AND METHODS: A prospective analytical study
      was made of the hemiplegic patients admitted consecutively to the Rehabilitation
      Department after strokes. The initial examination was made 17 days (CI: 15-19)
      after the stroke. Satisfactory functional results were considered to be obtaining
      a Barthel index of > 90 together with the ability to walk unaided on level ground
      six months after the stroke. RESULTS: Of the 55 patients finally included in the
      study, 23 were in group M (41.8%) 21 in group MS (38.1%) and 11 patients in group
      MSH (20.1%). Walking ability and function in the different cohorts showed a
      statistically significant difference. Whilst 96% of the patients with pure
      hemiparesia (group M) attained a satisfactory degree of independence in walking,
      only 54% of the patients with three associated deficits (MSH) achieved this. Even
      more difference was found with acquired functional independence, since whilst 82%
      of group M attained a good degree of autonomy in carrying out everyday
      activities, only 18% of the MSH group achieved this. The remaining patients (MS
      group) had intermediate results. CONCLUSION: The MSH classification is, soon
      after having a stroke, a useful means of determining the functional prognosis of
      hemiplegic patients.

PMID- 11205549
TI  - [Cardioembolic infarction: clinical course and characteristics].
AB  - INTRODUCTION: Approximately 20% of all ischemic strokes are due to cardioembolism
      and occur more frequently in the younger patients. Our objective was to determine
      the clinical characteristics and course of cardioembolic infarcts (ICCE)
      comparing them with infarcts due to other aetiologies (ICNCE). PATIENTS AND
      METHODS: We made a prospective study of 354 patients admitted to hospital over a
      period of one year, after excluding transient ischaemia and
      parenchymatous/subarachnoid hemorrhage. Two groups were established: ICCE (29.4%)
      and ICNCE (70.6%), comparing age, sex, risk factors and course of the illness.
      Subsequently a study lasing two years was done to assess the recurrence rate.
      RESULTS: The ICCE patients were older (75.89 compared with 72.58, p = 0.004),
      often know the exact time of onset of their symptoms (p = 0.015) and usually are
      admitted to hospital during the first six hours of their illness (p = 0.01).
      There was a significantly higher incidence of ischemic cardiopathy or auricular
      fibrillation (p = 0.0052); p = 0.005); more complications arose (p = 0.000); stay
      in hospital was longer (13.62 as compared to 11.8 days; p = 0.035), there was a
      lower weekly BI score (p = 0.0023) and higher mortality (p = 0.000). In the
      subgroup of 70 patients evaluated two years later 11 cases recurred, with no
      difference observed between the anticoagulant and anti-aggregant groups.
      CONCLUSION: The ICCE occurs in older patients, they develop worse neurological
      defects, have a worse short-term prognosis, develop more complications and have
      significantly greater mortality.

PMID- 11205550
TI  - [Electro-clinical concordance for childhood absence epilepsy in monozygotic
      twins].
AB  - INTRODUCTION AND OBJECTIVE: The objective of the study was to analyze the EEG
      tracings during the seizures of two monozygotic twins, shown on molecular
      analysis, diagnosed as having infantile epilepsy with absences. The recordings
      are particularly interesting since the genotypes of the patients are identical.
      This allowed comparison between the similarities and differences in discharges so
      that they could be better defined. RESULTS: The 3 Hz spike and wave complexes
      were the same as the classical descriptions in typical absences. No 'W' spike and
      wave complexes morphology, discharge fragmentation or light induction of the
      discharges were observed. There was some differences in the duration of absences,
      which were much shorter in one twin girl. The duration of the seizures was
      variable, and sometimes similar to that described as characteristic in other
      types of generalized idiopathic epilepsies with absences. It would seem therefore
      that the duration of the seizure is not a criterion for differentiation between
      the different types of generalized idiopathic epilepsies. CONCLUSION:
      Concordance, both clinical and of seizure EEG recordings in our patients
      confirmed that there is a specific electroclinical phenotype in infantile
      epilepsy with absences, although individual variations may also occur.

PMID- 11205551
TI  - [Lyell syndrome associated with lamotrigine].
AB  - INTRODUCTION: Lamotrigine (LTG) is a new antiepileptic of habitual use in
      monotherapy as much in partial epileptic as in generalised, which presents among
      other adverse effects: slight rashes and less frequently severe rashes such as
      Stevens-Johnson syndrome and Lyell syndrome or toxic epidermal necrolysis, above
      all in combination with valproate (VPA). CLINICAL CASE: A 44-yr-old woman in
      toxico-alcoholic epileptic treatment with VPA, showed a neutropenia possibly of
      secondary type which it was intended to change to LTG, following an ascending
      dose of LTG joined to a descending dose of VPA. In the sixth treatment week, the
      patient developed an erythematous rash which after a week of solar exposure,
      presented temperature, general discomfort, and in the head, on the front and back
      part of the thoracic and upper and lower limbs, erythematous lesions with scabbed
      areas, loosening epidermis areas with a positive Nikolsky sign and severe mucous
      membrane involvement, being diagnostic of Lyell syndrome. The lesions got slowly
      better with serum therapy, antibiotherapy, parenteral corticoids and topical
      treatments. CONCLUSIONS: There is a probability of severe rash associated with
      lamotrigine which has to be taken into account, and we advise patients to
      suppress the medication when they present a minimum rash.

PMID- 11205552
TI  - [Fluctuation in bilateral thalamic infarction: diffusion study using magnetic
      resonance].
AB  - INTRODUCTION: Bilateral paramedian thalamic infarcts are uncommon. The most
      frequent clinical manifestations are acute impairment of consciousness,
      oculomotor abnormalities and cognitive disturbances. A fluctuating course has not
      been previously reported. CLINICAL CASE: A 66 year-old woman with a past history
      of arterial hypertension and diabetes was admitted to our hospital presenting
      four episodes of decreased consciousness and vertical gaze paresis. Neurological
      examination between episodes was unremarkable. Diffusion-weighted magnetic
      resonance imaging revealed high-signal lesions in both paramedian thalamic areas.
      CONCLUSIONS: Fluctuating impairment of consciousness may be a clinical
      presentation of bilateral paramedian thalamic infarction. Atheromatous occlusion
      of the mouth of the paramedian thalamic penetrating artery is the most common
      cause. Neurological findings and diffusion-weighted images may help to define the
      extension and the underlying pathophysiological mechanism.

PMID- 11205553
TI  - [Backache as the initial symptom of adrenomyeloneuropathy].
AB  - INTRODUCTION: Adrenoleukodystrophy is a paroxysmal disorder, with recessive
      linking to the X chromosome, characterized biochemically by the accumulation of
      extra-long-chain fatty acids. Six phenotypes are distinguished: pre-symptomatic,
      infantile, adolescent and adult cerebral forms, adrenomyeloneuropathy and
      isolated Addison's disease. We describe a patient with adrenomyeloneuropathy in
      whom the presenting symptom was lumbago. CLINICAL CASE: A 23 year old man with no
      significant previous clinical history complained of having lumbago for over two
      years. On examination he had pyramidal signs and reduced epicritic sensitivity of
      the legs. Laboratory investigations showed adrenal failure, increased plasma
      extra-long-chain fatty acids concentration, mononuclear cells and fibroblasts. On
      MR there was a hyperintense lesion of the genu of the corpus callosum. SSEP were
      pathological while the electroneurogram showed bilateral increase in latency of
      the F wave. The patient was diagnosed as having adrenomyeloneuropathy and
      treatment started with hydrocortisone, a diet low in extra-long-chain fatty acids
      and 'Lorenzo's oil'. The lumbago gradually disappeared while the plasma extra
      long-chain fatty acids concentration dropped. The oil was stopped because of
      moderate thrombocytopenia, and treatment was started with lovastatin 40 mg/day.
      Two years later the patient has no lumbago and is neurologically stable.
      CONCLUSIONS: The lumbago associated with adrenomyeloneuropathy is probably due to
      demyelination of the spinal tracts. Although lumbago is usually a benign
      condition, a careful history and examination is necessary in all such cases.

PMID- 11205554
TI  - [Review of Creutzfeldt-Jakob disease and other prion diseases].
AB  - INTRODUCTION: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive dementia
      syndrome which is probably caused by prions. The annual incidence of this disease
      is 1/1,000,000. Most cases are sporadic in type, although 10-15% are familial.
      The total incidence of CJD has not changed following the epidemic due to a new
      variant (nv-CJD); however, this has led to greater awareness of the subject.
      OBJECTIVE: To review current scientific knowledge of CJD. DEVELOPMENT: A search
      was made for relevant literature using MEDLINE. The criteria proposed for
      diagnosis of CJD include the presence of progressive dementia and at least two of
      the following characteristics: 1. Myoclonias, 2. Cortical blindness, 3.
      Pyramidal, extrapyramidal or cerebellar signs, 4. Akinetic mutism, or 5 Abnormal
      EEG. Laboratory and neuroimaging investigations may also help in diagnosis of
      CJD, although neuropathological confirmation is necessary for definite diagnosis.
      Two promising methods of pre mortem diagnosis of CJD are determination of 14-3-3
      protein in the cerebrospinal fluid, in the case of sporadic CJD, and biopsy of
      the palatine tonsil in the case of nv-CJD. The physiopathology of CJD seems to be
      centred on the proteins forming prions, which are glycoproteins found in the
      plasmatic membrane and are very often expressed in the neurons, particularly at
      neuromuscular junctions and synapses. The pathological form resists proteolytic
      degradation, so that they accumulate in the CNS. The precise neurotoxic mechanism
      of these proteins is still not clear. CONCLUSIONS: There is still no treatment
      for CJD. Further studies of the physiopathological mechanisms of prion diseases
      may help in the development of treatment to delay the progress of this disease.

PMID- 11205555
TI  - [Classification of the astrocytic gliomas. Brief comments].
AB  - INTRODUCTION: Gliomas make up approximately 50% of the primary brain tumors of
      the central nervous system in adults. Astrocytes from between 70 and 75% of these
      tumors. Historically grading these has been very controversial, in spite of its
      importance for prognosis and planning treatment. DEVELOPMENT: We have reviewed
      existing proposals for the classification of astroglial neoplasias, from the
      initial studies to the latest classification by the World Health Organization.
      All have pursued the objective of finding the histopathological grade of the
      neoplasm to relate it to survival and predict prognosis. CONCLUSION: Further
      knowledge of these tumors is the aim of professionals and others interested in
      the subject, in the difficult course of finding better and more efficient
      treatment for these patients.

PMID- 11205556
TI  - [Epilepsy and permission to drive].
AB  - INTRODUCTION: At the present time it has become a social necessity for most
      people to be able to drive a motor vehicle. For this reason, obtention of a
      driving license is continuously regulated so as to be adapted to the
      psychophysical aptitudes required at any given moment, since these vary with
      medical and social advances. DEVELOPMENT: We review the doctrine on this subject
      in some of the major countries, finding that far from having similar criteria,
      there is disparity even between different jurisdictions of the same country. In
      Spain epilepsy is regulated regarding the difficulty in obtaining a driving
      license in the General Regulation for Drivers (RD 772/1997). We consider this in
      detail. CONCLUSIONS: We try to unify criteria regarding the periods free of
      seizures, modifying the language with respect to some of these, validity of the
      license, analysis of the medical report and its responsibility in case of third
      party injury in a road accident. We propose open debate to clarify these terms.

PMID- 11205557
TI  - [Neuropsychological evaluation of the cognitive deficits in infection by human
      immunodeficiency virus type 1 (HIV-1)].
AB  - INTRODUCTION: In addition to its ability to infect immune system cells, the human
      immunodeficiency virus type-1 (HIV-1), possesses neurotropism, that is, the virus
      is able to enter the central nervous system, even in patients without
      opportunistic brain neoplasia or infection. DEVELOPMENT: To date, two different
      neurologic syndrome have been recognized: one of them being mild in nature (HIV-1
      associated minor cognitive/motor disorder), the other being severe (HIV-1
      associated dementia complex). These syndromes are known to cause impairment in
      different cognitive domains, as well as psychiatric and motor complaints. Here we
      review the different neuropsychologic tests, experimental computerized procedures
      (reaction time) and examination of the different types of ocular movements, which
      have been used from 1981 until now, with particular emphasis on the most commonly
      used neuropsychologic test batteries. Our results suggest that both
      neuropsychologic test batteries and reaction time procedures and ocular movement
      examination show that, as expected, the cognitive impairment is more commonly
      found in HIV-1-associated dementia complex patients as compared with those with
      HIV-1-associted minor cognitive/motor disorder. In the latter syndrome, cognitive
      impairment severity correlates well to disease stage, defined according to
      criteria by the Centers for Disease Control. However, there continues to be an
      important controversy as to the occurrence of cognitive deficit in the earliest
      HIV-1 infection stages (medically asymptomatic stage), probably due to lack of
      sensibility and specificity of neuropsychologic tests and other procedures used
      to detect cognitive impairment in earliest stages. CONCLUSION: There is a need
      for improving specificity and sensibility of neuropsychologic measurements
      currently used to detect cognitive impairment in HIV-1 infected patients in
      medically asymptomatic stage.

PMID- 11205558
TI  - [The nervous system: important protagonist in systemic cancer].

PMID- 11205559
TI  - [Special aspects of the neuro-complications of cancer].

PMID- 11205560
TI  - [Notes on the history of neurological paraneoplastic syndromes].

PMID- 11205561
TI  - [Paraneoplastic syndromes in otoneuro-ophthalmology].
AB  - INTRODUCTION AND OBJECTIVE: The so-called neurological paraneoplastic syndromes
      (NPNS) are a group of diseases of the central nervous system of unknown etiology
      which are seen almost exclusively in patients with cancer. We review the main
      NPNS paying particular attention to those with ophthalmological and otological
      features. DEVELOPMENT: Certain neuro-ophthalmological findings may constitute, at
      least partly, some paraneoplastic syndromes. There are alterations of vision in
      paraneoplastic retinopathy and in optic neuritis of paraneoplastic origin. The
      latter, unlike the retinopathy, usually coexists with involvement of other
      structures of the nervous system. Oculomotor function is affected in the
      opsoclonus-myoclonus syndrome. Diplopia and/or ophthalmoplegia may be a
      predominant or initial symptom, in patients with paraneoplastic neurological
      degeneration or brainstem encephalitis. In the Lambert-Eaton syndrome and in
      paraneoplastic encephalomyelitis, may have blurred vision and alterations of the
      pupil. Cases of paraneoplastic uveitis have also been described. Paraneoplastic
      otological involvement is less frequent. Patients with sensorineural deafness in
      the context of a paraneoplastic encephalomyelitis have been reported. In the NPNS
      vertigo is caused by cerebellar or brainstem lesions and not by lesions of
      peripheral organs. When nystagmus occurs in a NPNS it may be of various types and
      is due to involvement of structures in the brain stem or cerebellum. CONCLUSIONS:
      The diagnosis of NPNS in patients with no known cancer is important because it
      may lead to the detection of an occult cancer which is localized or scarcely
      extended, and therefore is still potentially treatable. Oto-neuro
      ophthalmological manifestations may be the first or only symptom of presentation
      of a paraneoplastic neurological clinical picture.

PMID- 11205562
TI  - [Paraneoplastic cerebral syndromes with oto-neuro-ophthalomologic
      manifestations].
AB  - OBJECTIVE: To review the paraneoplastic neurologic syndromes associated with
      otoneurophthalmologic manifestations. DEVELOPMENT: Paraneoplastic
      otoneurophthalmologic syndromes usually result from encephalitis of the brainstem
      and/or cerebellar degeneration. They can develop in association with various
      immunological responses against onconeuronal proteins (e.g. anti-Hu, anti-Ri,
      anti-Yo, anti-Ma, anti-Ta and anti-Tr) or with immunological mechanisms against
      unknown antigens. The eye movement abnormalities may have a supranuclear, nuclear
      or internuclear origin. There is no ocular movement abnormality which can be
      considered pathognomonic of a paraneoplastic disorder, but opsoclonus-myoclonus
      of infancy is often associated with neuroblastoma. The association of hearing
      loss and paraneoplastic sensory neuronopathy suggests that in some patients the
      neurosensory deafness result from involvement of the ganglia of Corti and/or the
      cochlear nuclei in the brain stem. The management of these syndromes depends on
      their rapid identification as paraneoplastic disorders and on the early diagnosis
      and treatment of the cancer. Patients with anti-Ta (or anti Ma-2) antibodies may
      improve with treatment of the cancer, usually a germ-cell tumor of the testis.
      Paraneoplastic opsoclonus-myoclonus of infancy usually improves with treatment
      that combines chemotherapy, steroids, and intravenous immunoglobulins, although
      neurological sequelae (psychomotor and language retardation) are frequent.
      CONCLUSIONS: There are several paraneoplastic neurologic syndromes that may
      present with otoneurophthalmologic symptoms. Detection of antineuronal antibodies
      facilitates the early identification of some of these syndromes and associated
      tumors. In general, the management of these syndromes is based on treatment of
      the associated cancer.

PMID- 11205563
TI  - [Spinal cord paraneoplastic syndromes].
AB  - OBJECTIVE: We reviewed the bibliography of various paraneoplastic syndromes which
      may show spinal involvement. DEVELOPMENT: Paraneoplastic sensory neuropathy,
      myelitis and rigidity syndromes may present alone or as part of a generalized
      syndrome of paraneoplastic encephalomyelitis/sensory neuronopathy, usually
      associated with small cell cancer of the lung and anti-Hu antibodies. Amyotrophic
      lateral sclerosis and subacute necrotizing myelopathy of paraneoplastic origin
      are very rare, although casual association of these conditions with cancer cannot
      be ruled out. Subacute motor neuronopathy is linked to lymphoproliferative
      syndromes and breast cancer has been reported associated with cases of primary
      lateral sclerosis and the stiff man syndrome. CONCLUSIONS: Various conditions of
      paraneoplastic origin may affect the spinal cord. Neurological symptoms may
      precede the diagnosis of neoplasia, are serious and do not usually respond to
      either immunosuppressive treatment or treatment of the underlying neoplasm,
      although there are exceptions. The presence of specific antibodies in some cases
      facilitates early diagnosis and shows the importance of immune mechanisms in
      these diseases. The paraneoplastic motor neuron syndromes may present atypically:
      at early or late age, be of slow evolution and associated with raised protein
      levels of the cerebrospinal fluid or with paraproteinemia.

PMID- 11205564
TI  - [Paraneoplastic syndromes with peripheral nerve involvement].
AB  - OBJECTIVE: To review the paraneoplastic complications described affecting the
      peripheral nervous system. DEVELOPMENT: Different types of tumors, especially
      secretory carcinomas and some lymphomas may affect the peripheral nerves, and
      this may often precede clinical signs of the tumor. Depending on the clinical
      features we may consider sensory neuropathies, motor neuropathies, senso-motor
      neuropathies, autonomic neuropathies, mononeuritis, and neuromyotonia. They may
      present in an isolated form or as part of a more generalized involvement of the
      nervous system. CONCLUSIONS: The presence of certain anti-Hu antibodies, which
      act against nerves or antibodies which attack the voltage-dependent potassium
      channels in a peripheral nervous system disorder make one suspect a
      paraneoplastic origin.

PMID- 11205565
TI  - [Paraneoplastic diseases of the motor end-plate and muscle].
AB  - INTRODUCTION: Some forms of myasthenia gravis and many cases of Eaton-Lambert
      syndrome are disorders of neuromuscular transmission possibly of paraneoplastic
      origin. Paraneoplastic necrotizing myopathy and some cases of inflammatory
      myopathy (polymyositis-dermatomyositis) are paraneoplastic myopathies.
      DEVELOPMENT: These are all autoimmune processes. The diagnosis is clinical, based
      mainly on the characteristics of the muscle weakness and motor disorders,
      confirmed by serological methods (demonstration of antibodies) pharmacological
      and electromyographic tests, by imaging studies and in some cases biopsy.
      Treatment includes specific symptomatic measures (aimed at correcting the defect
      in neuromuscular transmission in the myasthenic syndromes, reducing axonal auto
      excitability in the neuromuscular hyperexcitability syndromes, etc.) and
      pathogenic treatment (basically immunosuppression). A search for the hidden
      tumour should also be part of the diagnostic investigation. The paraneoplastic
      disease may remit if the associated tumour is treated.

PMID- 11205566
TI  - [Meningeal carcinomatosis].
AB  - INTRODUCTION: Meningeal carcinomatosis is a serious complication of solid tumors,
      particularly adenocarcinomas of breast, lung and melanoma. OBJECTIVE: In this
      paper we present a review of the bibliography on this disease, with particular
      emphasis on etiopathogenic, clinical--especially otoneurophthalmological-
      diagnostic and therapeutic aspects. DEVELOPMENT: Meningeal carcinomatosis
      presents in advanced stages of cancer and has an ominous prognosis with average
      untreated survival of from four to six weeks. Its frequency has increased in
      recent years since patients with systemic cancer now live longer. The
      characteristic of the disease is involvement of various levels of the nervous
      system, including encephalic, cranial or spinal nerve and spinal symptoms. Sudden
      loss of vision or hearing which may progress rapidly may be the initial sign of
      the disease. Neuroimaging studies (computerized axial tomography, magnetic
      resonance and isotope studies of cerebrospinal fluid flow) are necessary to
      evaluate associated metastases and detect obstruction of cerebrospinal fluid
      flow. Positive cerebrospinal fluid cytological findings confirm the diagnosis.
      Treatment should be tailored to the individual according to the clinical
      condition and nature of the tumour and should combine intrathecal chemotherapy
      and local radiotherapy, although recent studies have shown good results with
      systemic chemotherapy. CONCLUSION: A high degree of clinical suspicion is
      necessary for diagnosis of this uncommon disease, with neurological signs show to
      be present at different levels and the finding of malignant cells in the
      cerebrospinal fluid for confirmation of the diagnosis.

PMID- 11205567
TI  - [Cerebral metastasis].
AB  - INTRODUCTION: Cancer and its metastatic complications are one of the most
      important types of disease due to their high morbidity and mortality (nearly
      100%). In spite of the blood-brain barrier, the brain is one of the main targets.
      Paradoxically, the incidence of cerebral metastases (CM) has increased due to the
      progress of medical science. The clinical features of CM are particularly seen in
      otoneurophthalmology (ONO). OBJECTIVE: To review the pathophysiology, etiology,
      prognosis, complementary tests and clinical features of the CM, particularly the
      findings of most importance in ONO. MATERIAL AND METHODS: Data on MC was obtained
      from MEDLINE and Cancerlit for the period 1991 to 2000. The cases of CM seen in
      three hospitals of different communities and levels of healthcare are also
      reviewed. RESULTS: The CM are mainly situated in the cortical and juxtacortical
      zones, causing seizures which together with headache and mental and focal motor
      syndromes, make up the main clinical findings. Cancer of the lung and breast are
      the main causes of CM, whilst cancer of the prostate metastasizes more to the
      base of the skull and spinal coverings. Melanoma has the greatest tendency to
      metastasize. In spite of surgery, radiotherapy and chemotherapy the average
      survival with CM is three months. CONCLUSIONS: CM is a diagnosis which should be
      considered in patients of middle age or older. The lung is the most usual site of
      origin. In spite of the dreadful prognosis, the doctor plays a decisive part in
      both aggressive and palliative measures.

PMID- 11205568
TI  - [Surgical treatment of brain metastases].
AB  - INTRODUCTION: Up to 40% of the patients with cancer have cerebral metastases, so
      that their incidence in the general population reaches 0.15%. Different
      treatments for metastases have been described. Most aim to eradicate one or
      several metastases so as to improve the quality of life and life expectancy of
      the patients. DEVELOPMENT: The main factors determining the prognosis and
      indication for surgery are age, functional state and extent of the neoplastic
      disease. The presence of more than one metastasis does not contraindicate
      surgery. CONCLUSIONS: The development of new surgical techniques over the past
      twenty years has led to a reduction in operative morbidity and mortality. Surgery
      followed by holocranial radiotherapy is still the method of choice for the
      treatment of metastases. In cases in which surgical treatment is not indicated,
      radiosurgery may be done.

PMID- 11205569
TI  - [Cerebrovascular disease in the cancer patient].
AB  - OBJECTIVE: To make an up-to-date review of the literature on cerebrovascular
      disease of the patient with cancer. DEVELOPMENT: Approximately 15% of the
      patients with cancer have cerebrovascular disease. The frequency of cerebral
      infarcts is similar to that of cerebral hemorrhage. The commonest mechanisms of
      cerebral ischemia are atherosclerosis, non-bacterial thrombotic endocarditis,
      disseminated intravascular coagulation, infection, tumour embolism and thrombosis
      of the longitudinal venous sinuses. The most usual mechanisms of cerebral
      hemorrhage are intratumoural hemorrhage, hypertensive hemorrhage and the
      coagulopathies. In the Stroke Register of the Hospital del Sagrat Cor in
      Barcelona, of a total of 1,099 patients with their first cerebrovascular episode,
      in 14 patients the stroke (12 infarcts and two intracerebral hemorrhages) were
      the form of onset of a previously unrecognised hematological disorder. The
      hematological neoplasias were the commonest form of hematological disorders,
      mainly essential thrombocythemia, which was diagnosed in six patients.
      CONCLUSIONS: The clinical management and care of patients with stroke and cancer
      differ from that of patients with stroke alone, since the cause is different from
      that of non-neoplastic patients.

PMID- 11205571
TI  - [Metastatic and paraneoplastic lesions of the optic nerve].
AB  - We review the involvement of the optic nerve in distinct neoplastic disorders and
      differentiate the metastases from the paraneoplastic disorders. We also review
      and discuss the role of malignant lymphoreticular disorders, solid tumors and
      meningeal carcinomatosis in relation to the changes in the optic nerve caused by
      these conditions.

PMID- 11205570
TI  - [Infectious and metabolic nervous system complications of systemic cancer].
AB  - OBJECTIVE: To review the incidence and causes of the infections and metabolic
      diseases of the nervous system in patients with systemic neoplasias. DEVELOPMENT:
      Patients with immunodeficiency, particularly those with hematological neoplasias
      and persons treated with immunosuppressive drugs have a considerable tendency to
      infection due to opportunist germs. Infections of the nervous system are
      relatively rare (0.02%-1%) and the commonest neoplasms are lymphomas, especially
      those of Hodgkin type and lymphosarcomas. The most frequent infections are caused
      by the herpes virus, meningitis due to Listeria monocytogenes and the meningitis
      due to fungi (Aspergillus, Candida and Cryptococcus). Cerebral abscesses,
      although rarer, are relatively common and are caused by gram negative bacteria,
      fungi and toxoplasmosis. In recent years there has been a notable increase in the
      number of patients diagnosed as having progressive multifocal leukoencephalopathy
      due to the possibility of carrying out studies to detect the DNA of the JC virus
      by polymerase chain reaction techniques. Empirical treatment of patients with
      neurological infections and systemic cancer should be started following the
      guidelines for immunodepressed patients. The metabolic complications of these
      patients are mainly due to hormone overproduction, hydroelectrolytic changes and
      vitamin deficits, which in general cause alterations of mental function of the
      confusion state type. CONCLUSION: In all patients with an infection or metabolic
      complication involving the nervous system, the presence of a systemic neoplasm
      makes it necessary to vary both the diagnostic approach and the empirical
      therapeutic measures taken.

PMID- 11205572
TI  - [Intraocular manifestations of systemic cancer].
AB  - Systemic cancer may present intraocular features in three forms: as a sign of the
      presence of lymphoreticular tumors, of solid tumors or as a paraneoplastic
      syndrome.

PMID- 11205573
TI  - [Orbital metastasis in the adult].
AB  - Metastases to the orbit are uncommon in adults and form a small proportion of the
      diseases of the orbit. In the orbit, metastases cause symptoms due to the space
      occupying effect or to infiltration of the structures within the orbit.

PMID- 11205574
TI  - [Ophthalmological manifestations of systemic cancer in childhood].
AB  - Metastases to the orbit in childhood may be due to solid tumors such as a
      neuroblastoma or Ewing's tumor. The lymphoreticular diseases are also a major
      cause of metastases to the eye in children.

PMID- 11205575
TI  - [Metastasis of systemic origin in otorhinolaryngology].
AB  - INTRODUCTION: In the upper respiratory-digestive tract cancer is always primary.
      Such cancer is very common, but other extremely rare secondary cancers may be
      found. DEVELOPMENT: We studied our own patients and some published in the
      literature: cancer of the kidney with metastases in the paranasal sinuses and
      cancer of the breast metastasizing to the temporal bone. We review the
      bibliography on these rare metastases. CONCLUSIONS: In all cases of
      otorhinolaryngological cancer a detailed history should be taken, with special
      reference to previous neoplasms. It is particularly important to study and review
      any history of renal, breast or prostate tumors with regard to the primary tumor
      and the receptor organs of metastases, the paranasal sinuses and temporal bones.
      The most difficult problem occurs when the primary tumor is present but
      undiagnosed. Therefore, in all cases of cancer of the paranasal sinuses and
      temporal bones, before treatment is started the kidney, prostate, breast and
      other organs above and below the diaphragm where tumor may be present should be
      examined. The prognosis of these metastases, which are almost always fatal, is
      very poor so that often treatment is only palliative rather than aggressive.

PMID- 11205577
TI  - [Non-Hodgkin's lymphomas: current aspects].
AB  - OBJECTIVE: We wish to briefly review current knowledge of non-Hodgkin lymphomas
      (NHL) with special emphasis on aspects of interest in ophthalmology,
      otorhinolaryngology and neurology. DEVELOPMENT: We analyze the historical
      evolution of the classification of the NHL and refer to that recently devised by
      the World Health Organization. Amongst the numerous conditions forming part of
      this group of disorders we refer to the main data (clinical, immunophenotype,
      cytogenetics and of molecular biology) relative to the five most important types:
      1. Follicular lymphoma; 2. Diffuse large cell lymphoma; 3. 'Mantle' cell
      lymphoma; 4. MALT lymphoma (mucosa associated lymphoid tissue), and 5. Peripheral
      T lymphoma. Then we describe the types and clinical forms of NHL in
      ophthalmology, otorhinolaryngology and neurology. Finally we consider the recent
      advances in prognosis (international index, biological markers) and treatment
      (new types of polychemotherapy, eradication of Helicobacter pylori, transplant of
      hemopoietic progenitors, monoclonal antibodies and anti-sense treatment of these
      conditions. CONCLUSIONS: The NHL form a group of conditions in which the annual
      increase in recent years has been over 4%. With considerable frequency these
      tumors are found from the beginning or during their course in otorhinological and
      ophthalmic tissues, or in the nervous system; in the latter case, apart from
      direct tumour expression they may also cause paraneoplastic manifestations.

PMID- 11205576
TI  - [Oncologic treatment of oto-neuro-ophthalmological metastases and their
      complications].
AB  - INTRODUCTION: Cerebral metastases and the sequelae of their treatment are the
      major cause of neurological symptoms in patients with cancer. OBJECTIVE: In this
      article we review the oto-neuro-ophthalmological complications of the treatment
      of metastases with radiotherapy and/or chemotherapy. DEVELOPMENT: When speaking
      of the iatrogenic diseases caused by radiotherapy treatment of metastases, it is
      important to emphasize that the major complications of this form of treatment are
      seen in the long term, in general, months or years later. When dealing with
      incurable diseases, such as most metastatic cancers, the benefit/risk balance of
      each therapeutic option has to be taken into account. Thus we have a population
      of patients with symptoms secondary to metastatic involvement, and with an
      overall life expectancy which may be measured in months. The oto-neuro
      ophthalmological toxicity of the chemotherapy may present as an infrequent and
      unexpected complication or as a usual, expected secondary effect of the drug
      used. A large variety of drugs are used for the systemic control of cancer
      (cystostatic drugs, hormones and modifiers of the biological response) which, in
      one way or another, may cause neurological signs. CONCLUSION: The increasingly
      frequent use of high dose chemotherapy and of the combined use of chemotherapy
      and radiotherapy mean that these types of toxicity have become common clinical
      syndromes in current oncological practices.

PMID- 11205578
TI  - [Spontaneous cervical epidural hematoma].

PMID- 11205579
TI  - The resonance frequencies on mechanically pre-stressed ultrasonic
      piezotransducers.
AB  - The piezotransducers employed in high power ultrasound are composed of
      piezoelectric ceramics and metallic pieces. These transducers are mechanically
      pre-stressed in order to avoid the ceramic fractures when high voltage is applied
      under resonance. The resonance and anti-resonance frequencies are shifted
      depending on the level of applied mechanical pre-stressing. This paper discusses
      some causes of this shifting on a experimental study. The discussion takes into
      account the variations on characteristic parameters of the ceramics and the
      acoustic coupling between parts of the transducer.

PMID- 11205583
TI  - A multiple focused probe approach for high intensity focused ultrasound based
      surgery.
AB  - To produce deep-seated surgical lesions using ultrasound requires high power and
      intensity levels at the target sites. Conventionally, large transducers are used
      which require big apertures and so are generally suitable only for extra
      corporeal access. Such transducers also result in strong off-focus maxima, where
      the resulting hot spots can destroy normal tissue whilst deep-seated large tissue
      volumes are being ablated. This paper describes a new approach in which it is
      proposed that multiple probes are used simultaneously, each at a relatively low
      power, to result in an overlapping focused region of high temperature without
      strong off-focus hot spots. Robotic techniques could be used to move the
      individual probes in coordination to sweep out the desired region of tissue
      ablation. Simulation and planning are the key to quality prediction for high
      intensity focused ultrasound (HIFU). Simplified two-dimensional and three
      dimensional models of HIFU probes have been developed to study the
      characteristics of various multi-probe configurations. Preliminary simulation
      results show that the multi-probe system can be arranged successfully to minimise
      off-focus hot spots. Experimental results are presented which validate the
      modality and confirm this positive finding. Further prediction studies and
      planning will be necessary to achieve the most appropriate desired treatment, by
      varying the pulse duration and spacing.

PMID- 11205588
TI  - The mechanical pre-stressing in ultrasonic piezotransducers.
AB  - Composed piezotransducers submitted to mechanical pre-stressing present shifts on
      resonance and anti-resonance frequencies. Changes on characteristic parameters of
      the ceramic and in the coupling between the parts of the transducer can be the
      causes for this behavior. In applications where the level of pre-stressing is low
      (up to 50 MPa) the parameters of the ceramic are not altered, therefore, the
      shifting on frequencies are attributed to coupling between parts. This paper
      describes a mathematical model to explain this effect based on difference of
      effective cross-section between transducers parts under pre-stressing. The
      results show a proportional relation between pre-stressing and effective coupling
      of the parts.

PMID- 11205589
TI  - Push, pull, divide or destroy.

PMID- 11205590
TI  - Health sector decentralization and management: developing a district general
      policy on management.

PMID- 11205591
TI  - Successful treatment of scabies with oral ivermectin in Nigeria.
AB  - Currently, several topical scabicides are available but there is yet no oral or
      parenteral drug which has been established for the treatment of scabies in
      Nigeria. Ivermectin which is a modified avermectin, known to be an
      ectoparasiticidal agent in animals, has been used in adults for systemic
      parasitosis. In Nigeria, 25% benzyl benzoate is being extensively used for the
      treatment of scabies in adults. It is effective and readily available. The
      present study was carried out to evaluate the efficacy and safety of ivermectin
      in the treatment of patients with scabies at the skin clinic of the University of
      Nigeria Teaching Hospital, Enugu. Fifty-eight patients with scabies were
      recruited for the study; 13 (22.4%) were children aged between 5-14 years. Oral
      ivermectin was given in a single dose of 200 [microg/kg body weight to 29
      patients. The remaining 29 patients had to apply 25% benzyl benzoate emulsion.
      All patients received a full physical and dermatological examination prior to
      onset of treatment and weekly for 4 weeks. Skin scrapings were taken to confirm
      the diagnosis of scabies. There was a 93% resolution of pruritus with ivermectin
      and 48% with benzyl benzoate. No side effects were observed with ivermectin. Our
      results show that oral ivermectin is a promising, effective and safe alternative
      in both children and adults of Nigeria when compared to 25% benzyl benzoate
      topical application.

PMID- 11205593
TI  - Lymphoedema.

PMID- 11205592
TI  - Field trial of the RTM dipstick method for the rapid diagnosis of malaria based
      on the detection of Plasmodium falciparum HRP-2 antigen in whole blood.
AB  - The performance of the Quorum RapidTest Malaria (RTM) dipstick method that
      detects Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) antigen in whole
      blood was evaluated in a malaria endemic area. Results were compared with
      conventional Giemsa-stained blood films. Of 306 people tested 37.9% (116/306)
      were found to be parasitaemic; of these 66.4% (77/116) were P. vivax and 32.8%
      (38/116) were P. falciparum infections. There was only one (0.9%) mixed P.
      falciparum plus P. vivax infection. The RTM test was positive in 35/36 patients
      with P. falciparum identified on blood smear examination, resulting in a
      sensitivity of 97.2% [95% confidence interval (CI): 91.6-102.8%]. Specificity was
      96.3% (95% CI: 93.9-98.6%). The RTM test had a positive predictive value of 77.8%
      (95% CI: 65.7-89.9%) and a negative predictive value of 99.6% (95% CI: 98.4
      100.8%). Of the 10 false positives, seven reported recent malaria episode and
      treatment, indicating persistence of antigenaemia. If these were assumed truly
      infected, the positive predictive value is increased to 93.3% (95% CI: 85.8
      100.8%). The RTM test was positive in all seven P. falciparum infections with
      gametocytes and one mixed infection, but was negative in all falciparum
      gametocytes and relapsing fever cases. All but one P. vivax infection gave
      negative result on the RTM test. The RTM test missed one patient with
      parasitaemia. The test is highly sensitive and specific requiring no instrument
      or trained personnel. It appears to be a very useful tool for rapid diagnosis of
      malaria, especially in the rural health institutions with limited diagnostic
      facilities.

PMID- 11205594
TI  - Improving immunization coverage in rural areas of Ecuador: a cost-effectiveness
      analysis.
AB  - This study describes the costs and outcomes of two different immunization
      strategies used by the district level of the Ministry of Health carried out
      between 1993 and 1995 in Low-Napo area, Napo, Ecuador. One was centrally planned
      and managed by the District Hospital (DH) and the other planned and implemented
      together with community health workers (CHW). Immunization costs were estimated
      directly from survey records and communication of the Ministry of Health.
      Outcomes information was abstracted from the vaccination statistics of the Napo
      Province Health Department for 1993/1995. Community health workers strategy
      immunized 113 children with an average cost of US $32 per child. District
      Hospital strategy had an average cost of US $777.6 per immunized child.Thus, CHWs
      strategy is more effective and less costly than the DH strategy. This study shows
      that in order to maximize the cost-effectiveness of immunization, it is important
      to involve community participation in both planning and implementation.
      Continuous follow-up and evaluation of the immunization programme and further
      research on vaccine efficacy are necessary in order to maintain these results.

PMID- 11205595
TI  - Colostomy in neonates with a massively distended abdomen due to an imperforate
      anus.
AB  - A simple technique of intraoperative decompression and colostomy in neonates with
      a massively distended abdomen is described. With this technique, the handling of
      distended bowel becomes easier and peritoneal contamination by meconeum is also
      prevented.

PMID- 11205596
TI  - Associated morbidities in children with sickle-cell anaemia presenting with
      severe anaemia in a malarious area.
AB  - A prospective study of 104 consecutive cases of patients with sickle-cell anaemia
      (SCA) presenting with severe anaemia (packed cell volume < or = 15%) was carried
      out in the Children's Emergency Ward of the University College Hospital, Ibadan,
      in 1991. The patients were classified according to the type of anaemic crisis, by
      physical findings, serum bilirubin and reticulocyte counts. Other investigations
      included a blood film for malaria parasites, blood culture, radiological
      investigation and lumbar puncture when necessary. The most common problems
      associated with SCA patients in anaemic crisis were malaria and bacterial
      infections--68 (66%) and 18 (17.3%) of cases, respectively. Acute chest syndrome
      was significantly more frequent in patients with hyperhaemolytic and acute
      splenic sequestration crisis compared with aplastic crisis (P < 0.05). Conjugated
      hyperbilirubinaemia was also significantly more frequent among patients with
      hyperhaemolytic crisis compared with all other anaemic crises (chi2 = 13.18, P =
      0.001). The overall case fatality was 86.5/1,000 SCAs, with no fatalities in
      those with aplastic crisis. There were complications in six of the nine
      mortalities. Co-existing bacterial infections and conjugated hyperbilirubinaemia
      were associated with increased morbidity and mortality in patients with anaemic
      crisis. Patients with SCA crisis should have early evaluation and prompt
      treatment for associated infections.

PMID- 11205597
TI  - Complications of chronic arsenic poisoning.

PMID- 11205598
TI  - Service improves performance of unattended draw-over halothane vaporizers.
AB  - The accuracy of the output halothane concentration of seven draw-over halothane
      vaporizers (TEC, Ohmeda) which were delivered in 1986 to Malawi was investigated.
      They had not been serviced for the past 8 years. The output was studied at dial
      settings of 0.5%, 1%, 2%, 3%, 4%, and 5% at minute volumes of 2 to 8 litres
      before and after thorough cleaning of the vaporizers. The measured halothane
      concentration was corrected to sea level. Of seven vaporizers one was delivering
      concentrations up to 240% higher than the setting. A second vaporizer delivered
      concentrations much lower than the setting; the maximum output was 1.5% at the 5%
      setting. After cleaning, all vaporizers delivered concentrations close to the
      dial setting. The maximum deviation from the setting was 0.5% at the 0.5%, 1% and
      2% setting and 0.9% at higher settings. Whether the replacement of damaged wicks
      and seals would improve the accuracy further could not be investigated because
      these spare parts were not available. It is concluded from this study that
      regular servicing of draw-over vaporizers is essential. Support for the training
      of technicians in developing countries and also support for the funding of spare
      parts and measuring instruments in these countries should be considered by
      donors.

PMID- 11205599
TI  - A clinico-epidemiological study of organophosphorus poisoning at a rural-based
      teaching hospital in eastern Nepal.
AB  - Thirty-seven patients with severe organophosphorus poisoning (OPP) presented to
      the emergency ward of BP Koirala Institute of Health Sciences between January
      1995 and December 1996. The mean age of patients was 26.9 years. There were 17
      (46%) males and 20 (54%) females, with male:female ratio being 1:1.2.Twenty-three
      (62%) patients were unmarried with 16 (46%) of them students. The most common
      reason for poisoning was suicide--32 patients (86.5%). The most commonly involved
      compound was Metacid (methyl-parathion)--23 (62%) patients. Ninety per cent of
      the patients presented within 2 h of ingestion. All patients were managed with
      intravenous atropine. Pralidoxime was given to patients with nicotinic symptoms
      and mechanical ventilation initiated in patients with respiratory distress. The
      mean dose of atropine used in the first 24 h and during the hospital stay was
      30.6 mg and 136.7 mg, respectively. The mean duration of treatment was 5.5 days
      (range 2-20 days). Two patients developed intermediate syndrome and the overall
      mortality among hospitalized patients was 8%.

PMID- 11205600
TI  - Drug Revolving Funds: a low-cost sustainable intervention?

PMID- 11205601
TI  - Train the trainers course on infection control and hospital hygiene in
      Bangladesh.

PMID- 11205602
TI  - Outcome of extracapsular cataract surgery plus posterior chamber intraocular lens
      insertion for age-related cataract in eastern Nepal.
AB  - As age-related cataract is the leading cause of blindness in Nepal, much more
      attention should be given to improving surgical outcomes. The aim of our study
      was to determine the effectiveness and risks of extracapsular cataract surgery
      (ECCE) for age-related cataract in a tertiary hospital of eastern Nepal. ECCE
      with posterior chamber intraocular lens (PC IOL) insertion on 797 eyes (754
      patients) revealed improved visual acuity in 97.9%. In 595 (74.6%) the best
      corrected visual acuity was 6/18 or better, and 167 (20.9%) had 6/24 to 6/60 with
      negligible operative/postoperative complications. Thus it is concluded that ECCE
      with PC IOL could be performed safely and effectively even in developing
      countries where people are unaware that surgery is available and of the good
      surgical outcome.

PMID- 11205603
TI  - Disengaging impacted head at caesarean section for obstructed labour--push or
      pull?

PMID- 11205605
TI  - Assessment of ability of Nigerian mothers to recognize anaemia in children with
      malaria.

PMID- 11205604
TI  - The management of nephroblastoma in a rural hospital.

PMID- 11205606
TI  - Influence of HIV infection on presentation of Kaposi's sarcoma.
AB  - We report a retrospective review of 57 patients with endemic Kaposi's sarcoma
      (EKS) seen between 1981 and 1990 and 40 prospectively diagnosed patients with and
      without human immunodeficiency virus (HIV) infection seen between 1991 and 1995.
      In the retrospective study 52 patients were males and five were females. Their
      ages ranged between 15 and 62 years with a mean of 39 years.Thirty-five (61%)
      patients had symptoms for more than 1 year. Nodular KS was seen in 75% of the
      patients. In the prospective study 26 patients had EKS while 14 had AIDS
      associated KS (AAKS). Among the patients with EKS 24 were males and two were
      females. The mean duration of symptoms was 20 months. The CD4 count done on nine
      patients ranged between 900 and 1300 cells/mm3 and there was no mortality within
      1 year of presentation. Eleven of the patients with AAKS were males and three
      were females. Their ages ranged between 22 months and 41 years with a mean of 26.
      Nine patients had symptoms for less than 6 months. Ten patients had peripheral
      lymphadenopathy. CD4 counts done on 11 patients ranged between 200 and 800
      cells/mm3. Five patients (35%) died within 6 months of presentation. Between 1991
      and 1995, 486 patients were seen with HIV infection. Patients with AAKS present
      with fulminant disease which seemed quickly fatal.

PMID- 11205607
TI  - Abdominal fasciocutaneous flap for upper extremity wound coverage in the
      developing world: indications and complications.

PMID- 11205608
TI  - Distribution of ABO and Rh-D blood groups among blood donors in a tertiary care
      centre in South India.
AB  - The distribution of ABO and Rh-D blood groups was studied among 150,536 blood
      donors screened at the Dr John Scudder Memorial Blood Bank, Christian Medical
      College Hospital, Vellore, over a period of 11 years (April 1988 to March 1999).
      The most common blood group was found to be group O [58,330 (38.75%)], followed
      by group B [49,202 (32.69%)], and group A [28,372 (18.85%)]. The least common
      blood group was AB group [7,930 (5.27%)]. A2 or A2B groups were found in 3.01%
      and 1.43% of donors, respectively. The prevalence of Rh-D negative group was
      found in 8,225 (5.47%) donors. Bombay group (H negative non-secretor, genotype hh
      phenotype Oh) was found in six donors (0.004%). Although the incidence of Rh-D
      negative group was identical to previously published data from North India, the
      most common blood group was O group in our study as opposed to B group.

PMID- 11205609
TI  - B-ultrasound and computed tomography scan diagnosis of 32 cases of intraorbital
      dermoid cysts.

PMID- 11205610
TI  - The management of club foot.

PMID- 11205611
TI  - Female genital mutilation and reproductive health: does publicity help to improve
      women's health?

PMID- 11205612
TI  - HIV and syphilis in pregnant women at a tertiary care hospital.

PMID- 11205613
TI  - Hypoglycaemia in Salmonella typhi.

PMID- 11205614
TI  - Factors militating against the effective implementation of the essential drug
      list.

PMID- 11205615
TI  - Palliative total gastrectomy in advanced gastric cancer.

PMID- 11205616
TI  - Indications and results of right hemicolectomy in Ilorin, Nigeria.

PMID- 11205617
TI  - Better oxygenation in newborns without extra oxygen.

PMID- 11205618
TI  - HIV/AIDS in Pakistan.

PMID- 11205619
TI  - Prisoners with HIV/AIDS: a participatory learning and action initiative in
      Malaysia.
AB  - Rapid participatory research and project development is possible within a tightly
      controlled social context such as a prison. Having gained access, based on trust
      and mutual respect, external agents may then facilitate significant change. Given
      adequate support, incarcerated people with HIV/AIDS and limited medical access
      may be able to develop mutual care, social support and income-generating
      activities. In the Malaysian context, we estimated in 1998 that up to one-quarter
      of prisoners with HIV had indicators of significant disease. We estimated that
      significant indicators remained unrevealed among between one-half and two-thirds
      of these. Given prevailing conditions, these would probably only be amenable to
      peer-based care.

PMID- 11205620
TI  - Post-stroke depression or fatigue.

PMID- 11205621
TI  - Current trends in the understanding and treatment of social phobia in youth.
AB  - Social phobia is a common psychiatric problem in children and adolescents that
      has recently gained serious attention in clinical practice and research. This
      article describes the clinical presentation of social phobia and reviews several
      emergent areas of related research to social phobia in children and adolescents.
      We begin with a summary of research regarding the developmental pathways of
      childhood social anxiety into social phobia, highlighting normative developmental
      factors, behavioral inhibition, pathophysiology, genetics, and
      parenting/environmental factors. This is followed by a critical review of
      findings from studies providing evidence for and against the existence of
      subtypes of social phobia. Common comorbid disorders and sequelae of social
      phobia in children and adolescents are discussed, bringing to attention the
      critical need for effective treatments, the current status of which is reviewed
      in the final section. In sum, this review demonstrates that through research in
      multiple disciplines, scientists are now developing a better understanding of the
      risk and protective factors of social phobia in children and adolescents,
      ultimately leading to improvements in primary prevention and intervention efforts
      for children at serious risk for long-term problems with education, employment,
      social relationships, and independent adult functioning.

PMID- 11205622
TI  - Multilevel modelling of hierarchical data in developmental studies.
AB  - This report attempts to give nontechnical readers some insight into how a
      multilevel modelling framework can be used in longitudinal studies to assess
      contextual influences on child development when study samples arise from
      naturally formed groupings. We hope to achieve this objective by: (1) discussing
      the types of variables and research designs used for collecting developmental
      data; (2) presenting the methods and data requirements associated with two
      statistical approaches to developmental data--growth curve modelling and discrete
      time survival analysis; (3) describing the multilevel extensions of these
      approaches, which can be used when the study of development includes intact
      clusters or naturally formed groupings; (4) demonstrating the flexibility of
      these two approaches for addressing a variety of research questions; and (5)
      placing the multilevel framework developed in this report in the context of some
      important issues, alternative approaches, and recent developments. We hope that
      readers new to these methods are able to visualize the possibility of using them
      to advance their work.

PMID- 11205623
TI  - Infant intersubjectivity: research, theory, and clinical applications.
AB  - We review research evidence on the emergence and development of active "self-and
      other" awareness in infancy, and examine the importance of its motives and
      emotions to mental health practice with children. This relates to how
      communication begins and develops in infancy, how it influences the individual
      subject's movement, perception, and learning, and how the infant's biologically
      grounded self-regulation of internal state and self-conscious purposefulness is
      sustained through active engagement with sympathetic others. Mutual self-other
      consciousness is found to play the lead role in developing a child's cooperative
      intelligence for cultural learning and language. A variety of preconceptions have
      animated rival research traditions investigating infant communication and
      cognition. We distinguish the concept of "intersubjectivity", and outline the
      history of its use in developmental research. The transforming body and brain of
      a human individual grows in active engagement with an environment of human
      factors--organic at first, then psychological or inter-mental. Adaptive, human
      responsive processes are generated first by interneuronal activity within the
      developing brain as formation of the human embryo is regulated in a support
      system of maternal tissues. Neural structures are further elaborated with the
      benefit of intra-uterine stimuli in the foetus, then supported in the rapidly
      growing forebrain and cerebellum of the young child by experience of the
      intuitive responses of parents and other human companions. We focus particularly
      on intrinsic patterns and processes in pre-natal and post-natal brain maturation
      that anticipate psychosocial support in infancy. The operation of an intrinsic
      motive formation (IMF) that developed in the core of the brain before birth is
      evident in the tightly integrated intermodal sensory-motor coordination of a
      newborn infant's orienting to stimuli and preferential learning of human signals,
      by the temporal coherence and intrinsic rhythms of infant behaviour, especially
      in communication, and neonates' extraordinary capacities for reactive and
      evocative imitation. The correct functioning of this integrated neural motivating
      system is found to be essential to the development of both the infant's
      purposeful consciousness and his or her ability to cooperate with other persons'
      actions and interests, and to learn from them. The relevance of infants' inherent
      intersubjectivity to major child mental health issues is highlighted by examining
      selected areas of clinical concern. We review recent findings on postnatal
      depression, prematurity, autism, ADHD, specific language impairments, and central
      auditory processing deficits, and comment on the efficacy of interventions that
      aim to support intrinsic motives for intersubjective communication when these are
      not developing normally.

PMID- 11205624
TI  - Research in mental retardation: toward an etiologic approach.
AB  - Over the past two decades, mental retardation research converges on three general
      themes: co-occurring mental retardation and psychopathology; families of
      offspring with mental retardation; and the developmental approach regarding
      behavioral sequences and profiles. Intertwined with each theme is a mounting body
      of research on genetic mental retardation syndromes. We first review recent
      progress in each of the three domains--psychopathology, families, and development
      -based on studies of groups with heterogenous or nonspecific mental retardation.
      We then show how new findings from specific genetic syndromes take this knowledge
      even further, as well as aid in the search for genetic, physiological, and
      environmental mechanisms associated with certain behaviors. We end the review by
      briefly summarizing our reasons for promoting an etiological approach to future
      mental retardation research, as well as by discussing methodological and other
      challenges.

PMID- 11205625
TI  - Pediatric psychopharmacology.
AB  - This paper reviews research in pediatric psychopharmacology over the past decade.
      The authors first discuss social, economic, and other influences on pediatric
      psychopharmacology research and prescribing patterns including changing models of
      childhood psychopathology, increased government funding, and changes in industry
      regulations. Definitions are offered for current research terminology including
      efficacy, effectiveness, and adverse events. Design trends and new approaches to
      outcome measurement are also presented. New data from the last 10 years of
      research is reviewed for each major class of psychotropic agents. Criteria for
      inclusion in the review are presented and include aspects of study design
      (placebo-controlled, large sample size), source of funding (government funded vs.
      industry), and vision (creative applications). Data for short-term efficacy, long
      term efficacy, effectiveness, and safety and adverse events are discussed for
      each class of medication, although for many, there remains little empirical data.
      Findings for stimulants, selective serotonin reuptake inhibitors, neuroleptics,
      alpha-adrenergic agonists, mood stabilizers, buproprion, secretin, naltrexone,
      immune therapies, and natural supplements are all presented. Finally, the authors
      offer some speculations regarding the future of pediatric psychopharmacology
      research.

PMID- 11205627
TI  - The exciting future of antifungal therapy.
AB  - Invasive fungal infections are becoming more common. Current therapy is generally
      limited to amphotericin B in its parent and lipid formulations, 5-fluctyosine,
      fluconazole, and itraconazole. Toxicity, drug-drug interactions, and increasing
      fungal resistance reduce the usefulness of these drugs, and the need for new
      therapies is pressing. This article briefly discusses the limitations of
      antifungal minimum inhibitory testing, and then summarizes new antifungal drugs
      in development that have been tested in humans. It also addresses novel treatment
      strategies such as drug combination therapy, pharmacological reformulations to
      improve the efficacy or reduce the toxicity of current antifungal drugs, immune
      function augmentation, and vaccine development. All of these strategies, although
      in their infancy, will enhance the clinician's ability to care for patients with
      invasive fungal infections.

PMID- 11205626
TI  - Developmental dyslexia: an update on genes, brains, and environments.
AB  - The science of reading and developmental dyslexia has experienced spectacular
      advances during the last few years. Five aspects of this research are discussed
      in the article. (1) The holistic phenomenon of reading is complex. Many lower
      level psychological processes (e.g., phonemic awareness, phonological decoding,
      ability to process stimuli rapidly and automatize this process, memory, ability
      to recognize words) contribute to a single act of reading. Conceptualizing the
      complex process of reading through its partly overlapping but partly independent
      components--which contribute to, but do not fully explain, the holistic process
      of reading--provides an excellent model for understanding complex hierarchies of
      higher mental functions. Those who master reading skills successfully and those
      who have difficulties doing so differ in a wide range of reading-related
      processes. The central deficit experienced by poor readers appears to be related
      to phonological processing (a complex hierarchy of functions related to
      processing phonemes), whereas characteristics of automatization processes seem to
      moderate the reading outcome for people whose phonological skills are weak. (2)
      There are new data addressing models of dyslexia in languages other than English.
      The most fascinating finding is that the model implicating phonological deficit
      as central to dyslexia, and the lack of ability to automatize as leading to
      troubled reading, appears to be universal, regardless of the specific language.
      However, there is an interaction effect between the characteristics of a
      particular language and the developmental model of dyslexia. In phonologically
      more difficult languages (e.g., English), the most pronounced weakness appears to
      occur in phonological processing, whereas in phonologically easier languages
      (e.g., German), the crucial role in the manifestation of dyslexia is played by
      the lack of the skills needed to achieve automatization. (3) There is abundant
      evidence that reading (i.e., any single act of reading as well as reading as a
      holistic process) is "cooked" by the brain. Although no unified brain map of
      reading has been developed, some specific areas of the brain have been implicated
      in different reading-related cognitive processes by different laboratories and on
      different samples. (4) Indisputable evidence has been accumulated suggesting the
      involvement of the genome in developmental dyslexia. As of now, specific regions
      of the genome have been identified as being intimately involved with a number of
      different reading-related processes. Today the field of developmental dyslexia is
      the only area of genetic studies of human abilities and disabilities in which
      linkages to the genome have been robustly replicated in independent laboratories.
      (5) Finally, evidence suggests that developmental dyslexia might be only one of
      the manifestations of a deep, underlying, anatomical syndrome. The comorbidity of
      developmental dyslexia with both internalizing and externalizing behavioral
      disturbances, as well as with other learning disabilities, underscores the need
      for wide-ranging cognitive and behavioral approaches in the remediation programs
      offered to dyslexic children.

PMID- 11205628
TI  - Review of the incidence and prognosis of Pseudomonas aeruginosa infections in
      cancer patients in the 1990s.
AB  - In an attempt to determine the actual relevance of Pseudomonas aeruginosa as a
      target of empiric antimicrobial first-line therapy in febrile cancer patients, 44
      reports of clinical trials on antimicrobial treatment regimens and 53 reports on
      the epidemiology of microbiologically documented infections in cancer patients
      were reviewed. The incidence of infections due to Pseudomonas aeruginosa was 1
      2.5% among all patients presenting with first fever during neutropenia, and 5-12%
      among patients with microbiologically documented infections. The proportion of
      Pseudomonas aeruginosa infections among cases of gram-negative bacteremia has not
      generally declined during the past 2 decades. There were marked local and
      regional differences regarding the incidence of documented Pseudomonas aeruginosa
      infections. No clear differences between neutropenic and non-neutropenic cancer
      patients, between patients with solid tumors and those with hematologic
      malignancies, or between inpatients and outpatients presenting with fever and
      neutropenia were detected with respect to the likelihood of Pseudomonas
      aeruginosa involvement. The mortality rate in patients with Pseudomonas
      aeruginosa bacteremia, particularly with polymicrobial bacteremia or bacteremic
      pneumonia with Pseudomonas aeruginosa involvement, is considerably high. The
      beneficial impact on mortality of an empiric antimicrobial treatment regimen with
      high antipseudomonal activity has not yet been demonstrated unequivocally.
      Additional factors such as the quality of intensive care management, effective
      second-line antimicrobial regimens, local resistance patterns, and patient
      related cofactors are very likely to influence the outcome of Pseudomonas
      aeruginosa infections in cancer patients.

PMID- 11205629
TI  - Seven-year study of bacteraemic pneumonia in a single institution.
AB  - In order to enhance current knowledge of nosocomial and community-acquired
      bacteraemic pneumonia in a single tertiary hospital in Israel, a 7-year study was
      conducted. Using a computerised database, all patients who had bacteraemic
      pneumonia from March 1988 to August 1995 were studied. During the study period,
      pneumonia was the source of bacteraemia in 319 of 4,548 (7%) episodes, occurring
      in 295 patients; 211 (66%) episodes were community-acquired and 108 (34%) were
      nosocomial. The microoroganisms isolated most frequently from patients with
      community-acquired bacteraemic pneumonia were Streptococcus pneumoniae (46%),
      Staphylococcus aureus (10%) and Haemophilus influenzae (8%); while Pseudomonas
      spp. (17%), Klebsiella spp. (11%) and Staphylococcus aureus (10%) were isolated
      most often from the patients with nosocomial bacteraemic pneumonia. The median
      age of patients was 68 years (range, 0.003-100). The overall mortality was 34%.
      No significant difference was found between the mortality rates of patients with
      community-acquired (31%) and nosocomial (40%) bacteraemic pneumonia (P=0.1).
      Multivariate analysis showed that hypothermia, respiratory failure, impaired
      consciousness, tracheal intubation, Staphylococcus aureus aetiology, septic
      shock, inappropriate empiric antibiotic treatment and age significantly increased
      mortality.

PMID- 11205630
TI  - Detection of seroconversion and persistence of Chlamydia trachomatis antibodies
      in five different serological tests.
AB  - Microimmunofluorescence (MIF), a Chlamydia trachomatis species-specific enzyme
      immunoassay incorporating lipopolysaccharide-extracted Chlamydia trachomatis L2
      elementary bodies, two different synthetic peptide-based species-specific tests,
      and a recombinant lipopolysaccharide genus-specific test were performed on
      multiple follow-up sera (n = 104 total) from 16 women with Chlamydia trachomatis
      positive cervical swabs. These women included five with IgG seroconversions, five
      with Chlamydia trachomatis reinfections after initial therapy, and six with
      serologic follow-up of more than 6 years after antibiotic therapy. Of all the
      tests employed in this study, MIF IgG reverted earliest to negative titers, while
      MIF IgA was the least sensitive. The lipopolysaccharide-extracted elementary body
      enzyme immunoassay exhibited the closest correlation with the MIF test. The
      highest test sensitivity was observed in one of the synthetic peptide-based
      tests, which detected earliest seroconversions and longest IgG persistence. The
      other synthetic peptide-based test gave false-negative results in 2 of 16 women
      and did not detect seroconversion earlier than the MIF test. Seroconversion and
      persistence of genus-specific IgG--cross-reactivity with Chlamydia pneumoniae-
      against lipopolysaccharide were similar to species-specific IgG. A significant
      serologic response to reinfection was observed only in women with signs of pelvic
      inflammatory disease. Species-specific tests of high sensitivity and
      reproducibility are best suited for gynecological diagnostic purposes.

PMID- 11205631
TI  - Mycobacterial growth indicator tube versus the proportion method on Lowenstein
      Jensen medium for antibiotic susceptibility testing of Mycobacterium
      tuberculosis.
AB  - The Mycobacterial Growth Indicator Tube, a reliable system for detection of
      mycobacterial growth, was compared with the reference proportion method on
      Lowenstein-Jensen medium for antibiotic susceptibility testing of Mycobacterium
      tuberculosis. A total of 62 clinical strains and four reference strains of
      Mycobacterium tuberculosis were tested for susceptibility to streptomycin,
      isoniazid, rifampicin and ethambutol. Of these, 36 were susceptible to all four
      antibiotics and 30 were resistant to at least one of them. Tests were repeated in
      cases of discrepant results. When each drug/strain combination was considered
      separately, the overall agreement between the two methods was 96.5% (98.4% for
      streptomycin, 95.3% for isoniazid, 96.9% for rifampicin and 95.3% for ethambutol)
      with regard to the initial testing and 98.8% (100, 98.5, 98.5 and 98.4%,
      respectively) after repeated testing. When the results were considered strain by
      strain, the agreement was 86% after the initial testing and 95% after repeated
      testing. The results were obtained after a mean time of 9.5 days. These results
      suggest that the Mycobacterial Growth Indicator Tube is a reliable method for
      testing susceptibility of mycobacterial strains to first-line antituberculous
      drugs.

PMID- 11205632
TI  - Streptococcus suis meningitis, a poacher's risk.
AB  - Streptococcus suis infection is a zoonosis that has been mainly reported in pig
      rearing and pork-consuming countries. The most common disease manifestation is
      meningitis, often associated with cochleovestibular signs. The causative agent is
      Streptococcus suis serotype 2, found as a commensal in the tonsils of its natural
      host, the pig. Persons at risk are mostly those with an occupational exposure to
      domestic pigs or their meat products. A case of meningitis caused by
      Streptococcus suis in a poacher who had killed and butchered a wild boar is
      reported. It appears that wild boar hunters are at additional risk of contracting
      the disease.

PMID- 11205633
TI  - A case of septicemia with Pediococcus acidilactici after long-term antibiotic
      treatment.
AB  - Presented here is a case of septicemia caused by an uncommon, multiresistant,
      gram-positive microorganism (Pediococcus acidilactici) after long-term antibiotic
      treatment. Pediococcus spp. are rarely cultivated from clinical specimens, and
      species differentiation is difficult due to the paucity of phenotypic traits. In
      this case, a polyphasic approach consisting of phenotypic and molecular genetic
      analyses was used, and the identification of Pediococcus acidilactici was
      conclusive. Precise identification and antimicrobial susceptibility testing of
      rarely isolated bacteria are required in order to provide adequate treatment to
      infected patients and to determine the pathogenic role of these organisms.

PMID- 11205634
TI  - Chronic cystitis caused by Corynebacterium urealyticum detected by polymerase
      chain reaction.
AB  - The case of a 73-year-old man with chronic cystitis due to Corynebacterium
      urealyticum was complicated by hematuria and urinary stone formation. The
      diagnosis was based on an amplification product obtained using polymerase chain
      reaction for mycobacterial species on urine and a bladder biopsy specimen. A
      specific 212 bp amplification fragment that did not hybridize with a
      Mycobacterium-specific probe was recognized. Sequence analysis of the fragment
      revealed Corynebacterium urealyticum. Routine urine cultures were negative, but
      prolonged culture on sheep blood agar led to the isolation and identification of
      Corynebacterium urealyticum. Identification was confirmed by polymerase chain
      reaction on the colonies. The patient was treated successfully with vancomycin.
      Integration of molecular laboratory diagnostics with conventional microbiology
      and pathology was synergistic for the diagnosis.

PMID- 11205635
TI  - Characterization of epidemic and nonepidemic methicillin-resistant Staphylococcus
      aureus strains in a university hospital in northeast Germany.
AB  - The aim of this study was to analyze methicillin-resistant Staphylococcus aureus
      strains isolated during a 1-year period by means of pulsed-field gel
      electrophoresis, resistance phenotyping and determination of biochemical
      features. Eight different resistance phenotypes with the predominant resistance
      type Pen Oxa Cip (penicillin, oxacillin, ciprofloxacin) were observed. None of
      the strains tested exhibited decreased susceptibility to vancomycin, but two
      strains were resistant to mupirocin. Genetic relatedness of methicillin-resistant
      Staphylococcus aureus isolates could be shown for two outbreaks, one of which was
      caused by a clone with an epidemic potential concerning duration of
      colonization/infection of patients and dissemination of the strains in the
      hospital.

PMID- 11205636
TI  - Screening for antimicrobial resistance in normal bacterial flora of the skin
      using the replica plating method.
AB  - The replica plating method was evaluated for detection of the antimicrobial
      resistance of normal bacterial flora of the skin and was compared with the
      results of a ten-colony method. If > or = 10% of the colonies from the master
      plate grew on a plate containing an antibiotic, the sensitivity of replica
      plating was comparable to that of a ten-colony method for samples containing
      resistant bacteria. However, this method classified significantly more samples as
      resistant to all eight antibiotics tested if the detection breakpoint was lowered
      to > or = 1% of the original colonies. Replica plating is an effective and
      practical tool for screening skin flora for resistance, also in samples with a
      low proportion of resistant strains.

PMID- 11205637
TI  - Validity of prior absorption of serum samples with Reiter's spirochetes in
      serological diagnosis of Borrelia burgdorferi infections.
AB  - Evidence of Borrelia burgdorferi sensu lato infection was sought in 230 patients
      with positive antibody titres in an indirect immunofluorescence test that became
      negative after serum samples were preabsorbed with treponemal antigen. Infection
      could be excluded in 82.2% (189/230) of patients, was questionable in 6.9%
      (16/230), and was judged to have occurred in 10.9% (25/230), including four
      (1.7%) cases of early, acute disease that required treatment. The preabsorption
      procedure clearly reduces the frequency of false-positive reactions; however,
      there is a definite risk of overlooking active infections with this technique.

PMID- 11205638
TI  - Detection of Bartonella henselae and Afipia felis DNA by polymerase chain
      reaction in specimens from patients with cat scratch disease.
AB  - Polymerase chain reaction (PCR) amplification and colorimetric identification of
      amplicons were performed to detect Bartonella henselae and Afipia felis DNA in
      specimens from patients who were clinically and histologically suspected of
      having cat scratch disease. PCR products were revealed using 2% ethidium bromide
      agarose-gel electrophoresis and identified with specific probes in a commercial
      colorimetric hybridization assay (DEIA) (GEN-ETI-K; DiaSorin, Italy). Six
      paraffin-embedded lymph node biopsies from 18 patients as well as 18 samples of
      peripheral whole blood and 18 sera were investigated. Bartonella henselae DNA was
      recovered from the whole blood of four patients, and Bartonella henselae and
      Afipia felis DNA were detected in one patient's lymph node biopsy. This study
      suggests that PCR-DEIA is sufficiently sensitive to be considered feasible for
      the molecular diagnosis of cat scratch disease.

PMID- 11205639
TI  - Puumala and Dobrava hantaviruses causing hemorrhagic fever with renal syndrome in
      Estonia.

PMID- 11205641
TI  - A case of disseminated infection with Pichia ohmeri.

PMID- 11205640
TI  - Successful treatment of multidrug-resistant Acinetobacter baumannii meningitis
      with intravenous colistin sulfomethate sodium.

PMID- 11205642
TI  - Rhabdomyolysis and Salmonella enteritidis infection.

PMID- 11205643
TI  - Hospital outbreak of methicillin-resistant Staphylococcus aureus followed by an
      in vivo change to a mecA-negative mutant with loss of epidemicity.

PMID- 11205644
TI  - Endoscopic management of bile duct stones.
AB  - The advantages of endoscopic retrograde cholangiopancreatography (ERCP) over open
      surgery make it the predominant method of treating choledocholithiasis. Today,
      technologic advances such as magnetic resonance cholangiopancreatography and
      laparoscopic surgery are challenging ERCP's primacy in the management of common
      bile duct (CBD) stones. This article reviews the current status of endoscopic
      treatment of biliary stones and examines this in relation to laparoscopic
      management. The techniques and safety of endoscopic sphincterotomy and balloon
      sphincteroplasty are reviewed. Balloon sphincteroplasty should be limited to
      study protocols because of safety questions and inherent limitations. After
      sphincterotomy, 85% to 90% of CBD stones can be removed with a Dormia basket or
      balloon catheter. These techniques are described as having both advantages and
      disadvantages. Methods for managing "difficult stones" include mechanical
      lithotripsy, intraductal shock wave lithotripsy, extracorporeal shock wave
      lithotripsy, chemical dissolution, and biliary stenting. These approaches are
      presented along with data supporting their use in specific situations.
      Laparoscopic cholecystectomy has emerged as the preferred alternative to open
      cholecystectomy. Parallel advances in the endoscopic and laparoscopic management
      of CBD stones have made the issue regarding the optimal treatment strategy
      complex. Three approaches to the management of choledocholithiasis in the
      laparoscopic era are presented as follows: strict therapeutic splitting, flexible
      therapeutic splitting, and strict laparoscopic management. The optimal approach
      needs to be defined in prospective comparative trials. For now, preoperative
      endoscopic stone extraction should still be recommended as the approach of choice
      in patients suspected to have CBD stones based on clinical, biochemical, and
      imaging parameters. Primary laparoscopic evaluation and management is reasonable
      in patients who have a low-to-moderate probability of having CBD stones.

PMID- 11205645
TI  - Efficacy of endoscopic isotonic saline-epinephrine injection for the management
      of active Mallory-Weiss tears.
AB  - Therapeutic endoscopy with isotonic saline-epinephrine (ISE) injection is a
      convenient and widely used procedure for hemostasis in upper gastrointestinal
      bleeding. We retrospectively evaluated 36 patients (from January 1996 to April
      1999) who had been diagnosed with recent or active bleeding due to Mallory-Weiss
      tears in emergency endoscopic examination. The endoscopic hemostatic method with
      ISE injection was performed in 15 of 36 patients. The other 21 patients received
      conservative treatment with hemodynamic support. Patient's clinical data,
      laboratory data, transfusion requirements, endoscopic findings, and length of
      hospital stays were evaluated. Initial hemoglobin was significantly lower in the
      ISE group than the conservative treatment group (9.74 +/- 2.86 g/dL vs. 12.57 +/-
      2.80 g/dL, respectively; p < 0.01). Mean transfusion requirements were
      significantly higher in the ISE group than the conservative treatment group (7.26
      +/- 8.78 units vs. 2.85 +/- 6.21 units, respectively; p < 0.1). Patients in the
      ISE group were supposed to be having a more severe bleeding episode. Most
      patients achieved initial hemostasis in the ISE group and the conservative
      treatment group (93% and 95%, respectively). The rebleeding rate was also similar
      in both groups (1 in 15 in the ISE group and I in 21 in the conservative
      treatment group). There was no significant difference in length of hospital stay
      and rebleeding between these two groups (3.47 +/- 1.92 days vs. 2.47 +/- 1.47
      days, respectively: p = 0.89). The endoscopic ISE injection is an inexpensive,
      simple, convenient therapeutic method and it can achieve initial hemostasis for
      active Mallory-Weiss tears.

PMID- 11205646
TI  - Autoantibody profile in progressive systemic sclerosis as markers for esophageal
      involvement.
AB  - We investigated the relationship between the severity and extent of esophageal
      involvement in patients with progressive systemic sclerosis (PSS) and the
      autoantibody profile. We studied 37 consecutive patients with PSS and compared
      their results to 25 healthy volunteers. Patients with PSS were separated into
      three subgroups: group 1 (antinuclear antibody [ANA] [+/-], anti-Sc170 antibody
      [Scl70] [-], and anticentromere antibody [ACA] [-]), group 2 (ANA [+], Scl70 [+],
      and ACA [-]), and group 3 (ANA [+], Scl70 [-], and ACA [+]). The lower esophageal
      sphincter pressure and the mean proximal esophageal amplitude were significantly
      lower in group 3 when compared with group 1, group 2, and the healthy controls.
      Distal esophageal aperistalsis was noted in 85% of group 3, 40% of group 2, and
      30% of group 1. An involvement of esophageal motility was found in 100% of the
      patients with ACA. Our results suggest that esophageal involvement is more
      pronounced in patients with PSS with ACA as compared with patients with only
      Sc170 or ANA.

PMID- 11205647
TI  - Can symptoms predict esophageal motor function or acid exposure in
      gastroesophageal reflux disease? A comparison of esophageal manometric and twenty
      four-hour pH parameters in typical and extraesophageal gastroesophageal reflux
      disease.
AB  - It has been suggested that patterns of esophageal motor function and acid
      exposure may differ between those patients with gastroesophageal reflux disease
      (GERD) with classic symptoms and those with extraesophageal manifestations. Our
      objective was to compare various parameters of esophageal motility and acid
      exposure between groups of patients who had presented with extraesophageal
      manifestations of GERD alone, a combination of classic and extraesophageal
      manifestations, or classic GERD symptoms alone. A retrospective review of
      consecutive patients undergoing esophageal manometry and 24-hour dual-channel
      esophageal pH testing was performed. Information on patient demographics,
      symptoms, and results of various manometric and pH testing parameters was
      examined. We evaluated 84 patients: 32 with extraesophageal symptoms alone, 24
      with both classic and extraesophageal symptoms, and 28 with classic symptoms
      alone. Apart from a trend toward less supine acid exposure in those with
      extraesophageal symptoms alone, no significant differences were evident among the
      three patient groups in any of the other parameters of proximal or distal
      esophageal acid reflux. With respect to motility parameters, lower esophageal
      sphincter pressure was lower in those with combined symptoms; otherwise,
      manometric findings were similar in the three patient groups. Our data do not
      support the hypothesis that the nature of the clinical presentation of GERD,
      whether in the form of classic or extraesophageal manifestations, is related to
      differing patterns of esophageal motor function or esophageal acid exposure.

PMID- 11205648
TI  - Prednisone withdrawal followed by interferon alpha for treatment of chronic
      hepatitis C infection: results of a randomized controlled trial.
AB  - Immunosuppressive therapy increases levels of hepatitis C virus (HCV) RNA, and
      when combined with interferon, corticosteroids have been reported to variably
      improve or have no effect on sustained response rates. We conducted a randomized
      double-blind placebo-controlled trial in 39 patients with biopsy-proven chronic
      HCV infection and elevated alanine aminotransferase levels. Patients received
      either 6 weeks of a tapering dose of prednisone (60 ng, 40 mg, and 20 mg in 2
      week intervals) or an identical placebo. All patients then received recombinant
      interferon alpha-2b, 3 million units three times a week for 24 weeks. Patients
      were then followed for a further 24 weeks. At the end of the study there was no
      significant difference in the sustained biochemical response rates between the
      two groups (4/20 vs. 3/19, p value was not significant). Prednisone-treated
      patients had a significant increase in HCV RNA from baseline during steroid
      treatment (400 +/- 60% increase vs. -280 +/- 140% decrease; p = 0.005). Two
      prednisone-treated patients were withdrawn from the study secondary to serious
      complications related to therapy. Prednisone priming before interferon alpha
      therapy in patients with chronic HCV infection does not improve the sustained
      response rate. This therapy was associated with an increase in viral burden and
      significant morbidity.

PMID- 11205650
TI  - A randomized, controlled trial of interactive, multimedia software for patient
      colonoscopy education.
AB  - The purpose of our study was to assess the effectiveness of computer-assisted
      instruction (CAI) in patients having colonoscopies. We conducted a randomized,
      controlled trial in large, multispecialty clinic. Eighty-six patients were
      referred for colonoscopies. The interventions were standard education versus
      standard education plus CAI, and the outcome measures were anxiety,
      comprehension, and satisfaction. Computer-assisted instruction had no effect on
      patients' anxiety. The group receiving CAI demonstrated better overall
      comprehension (p < 0.001). However, Comprehension of certain aspects of serious
      complications and appropriate postsedation behavior were unaffected by
      educational method. Patients in the CAI group were more likely to indicate
      satisfaction with the amount of information provided when compared with the
      standard education counterparts (p = 0.001). Overall satisfaction was unaffected
      by educational method. Computer-assisted instruction for colonoscopy provided
      better comprehension and greater satisfaction with the adequacy of education than
      standard education. Computer-assisted instruction helps physicians meet their
      educational responsibilities with no decrement to the interpersonal aspects of
      the patient-physician relationship.

PMID- 11205649
TI  - Lack of association between Helicobacter sp colonization and gallstone disease.
AB  - Recently, Helicobacter sp has been identified in resected gallbladder tissue and
      in collected bile from Chilean patients with chronic cholecystitis. Therefore, it
      an association between bile Helicobacter sp and gallbladder cancer has been
      proposed. Interestingly, both Helicobacter colonization and gallstone disease
      (GD) happen very frequently in Chile. However, whether there is an association
      between Helicobacter colonization and GD has not been completely studied. The aim
      of this study was to determine the incidence of Helicobacter in human gallbladder
      tissues with GD. The study included 95 Mexican patients undergoing
      cholecystectomy. Collected gallbladder specimens were assessed to identify
      Helicobacter sp using histology, immunohistochemistry, and polymerase chain
      reaction (PCR) analysis using Helicobacter-specific 16-S ribosomal RNA primers.
      Of the 95 specimens examined in detail, all had stones as follows: 56 (59%) had
      chronic cholecystitis; 7 (7.4%), acute cholecystitis: 15 (16%), both chronic and
      acute cholecystitis, 10 (9.5%), cholesterolosis, and 7 (7.4%), lymphoid
      hyperplasia. Specimens were considered positive for Helicobacter when histology
      was positive. Only 1 of the 95 specimens was positive for Helicobacter by
      immunohistochemistry analysis; 1 of 32 cases, by PCR. These results suggest a low
      incidence of Helicobacter in the gallbladder epithelium of Mexican patients with
      GD. However, we can not discard the existence of uncommon Helicobacter sp in
      gallbladder epithelium and its association with gallstone pathogenesis.
      Additionally, this study suggests no apparent association between GD and
      Helicobacter colonization in a Mexican population.

PMID- 11205651
TI  - Vaccination, screening for malignancy, and health maintenance of the liver
      transplant recipient.
AB  - Transplant recipients are highly motivated to maintain their recovered health
      status and are generally compliant with pharmacotherapy and medical follow-up. As
      well as routine blood tests and monitoring of immunosuppressant drug levels,
      recipients require immunization updates and regular screening for malignancy,
      diabetes, hypertension, hyperlipidemia, and ophthalmologic complications. Little
      information is available about the consistent implementation of these health
      maintenance strategies in this population. A telephone survey of liver transplant
      recipients was conducted using a 20-item questionnaire. It was designed to assess
      the frequency and adequacy of health maintenance screening, immunizations, and
      screening tests for malignancy, which are specific to the liver transplant
      population. We contacted 60 liver recipients transplanted at our institution
      between 1992 and 1996. The mean age of the patients (31 men and 29 women) was 48
      years (range, 42-56 years). Before transplantation, pneumococcal and hepatitis B
      vaccination occurred in 13% and 18%, respectively. After transplantation, 27% had
      received pneumococcal vaccination and none had received primary vaccination for
      hepatitis B. Forty-eight percent received yearly influenza vaccination. Of 60
      questioned recipients, 2 were aware of their varicella exposure status or a
      possible need for varicella immunoglobulin if a primary exposure to chickenpox
      were to occur. Two were aware of the need for the recipient's children or
      grandchildren who were undergoing polio vaccination to receive an inactivated
      intramuscular polio preparation. Yearly screening for dermatologic or oral
      malignancies was provided to only 40% of patients. Physician-performed breast
      examination or screening mammograms was done in 38% of the surveyed women. Eleven
      percent of the women had received a gynecologic examination with a cervical
      cytologic examination within the prior 2 years. Of the male recipients, 68%
      received either digital prostate examination or serum prostate specific antigen
      determinations or both. Of 60 recipients, 30 had had either flexible
      sigmoidoscopy or colonoscopy within the previous 2 years. Yearly dental
      examinations were performed on 75% of patients, and more than 90% had at least
      yearly blood pressure and weight determinations. Of 60 patients, 41 were aware of
      cholesterol and lipid profiles having been performed within the past 2 years.
      Ophthalmologic screening was performed in 83% of surveyed recipients. This survey
      suggests that routine health maintenance management is less than optimal in this
      population. Follow-up based on a standard protocol may improve the health care of
      these patients.

PMID- 11205652
TI  - Features of recurrent primary sclerosing cholangitis in two consecutive liver
      allografts after liver transplantation.
AB  - Recurrence of primary sclerosing cholangitis (PSC) after liver transplantation is
      very uncommon. The true incidence of recurrence is unknown, mainly because of the
      difficulty in differentiating ischemic strictures from that of recurrent disease.
      Primary sclerosing cholangitis and ischemic strictures have identical
      histopathologic and cholangiographic features. We report a young man who had
      recurrence of PSC in two allografts and report our experience in 32 patients who
      had liver transplantation for PSC. Six patients (18%) had evidence of non
      anastomotic strictures and, of these, only one patient (reported here) had
      unequivocal evidence of true recurrence. The strictures in other five patients
      happened because of ischemia. The recurrence of the disease in two allografts in
      an immunosuppressed patient, in the absence of ischemia, chronic rejection, or
      any known pathogen, raises the question of the role of an unidentified infectious
      agent in the etiopathogenesis of PSC.

PMID- 11205653
TI  - Bochdalek's hernia in adults.
AB  - Bochdalek's hernia is a congenital hernia of the diaphragm, which is manifested
      in the early years of life. Its diagnosis is difficult and is based on barium
      studies. We present an adult patient with Bochdalek's hernia who exhibited a
      gastric volvulus. The patient had a history of intermittent abdominal pains. In
      this article, we analyze the diagnostic and therapeutic procedures, laying
      special emphasis on the importance of early diagnosis in the prevention of
      complications.

PMID- 11205654
TI  - Fatal bleeding from a residual vein at the esophageal ulcer base after successful
      endoscopic variceal ligation.
AB  - Endoscopic variceal band ligation (EVL) is now one of the accepted treatment
      options for esophageal varices, and the safety of this procedure has been proved.
      However, we experienced a patient who had a fatal massive bleeding after
      successful EVL for ruptured esophageal varix. Postmortem study revealed a
      residual vein at the base of the esophageal ulceration associated with the
      ligation, which was believed to be the site of the fatal bleeding. His platelet
      counts and prothrombin time were not very impaired. Our case indicates that fatal
      massive bleeding can occur in patients after successful EVL without specific risk
      factors and indicates the importance of the awareness of the possibility of these
      complications.

PMID- 11205655
TI  - Amyloidosis-induced gastrointestinal bleeding in a patient with multiple myeloma.
AB  - We present a case of multiple myeloma (MM) complicated by recurrent amyloidosis
      induced gastrointestinal bleeding. The patient presented with episodes of coffee
      ground vomitus or massive hematochezia. No bleeding focus could be identified
      using endoscopy, a red blood cell scan, or angiography. Finally, a tissue biopsy
      taken at the irregular mucosa beside protruding vessels in the duodenum confirmed
      the diagnosis of gastrointestinal amyloidosis. As this case illustrates, the
      absence of systemic symptoms of amyloidosis and nonspecific endoscopic findings
      in gastrointestinal amyloidosis may make diagnosis difficult. Therefore, we
      recommend that a diagnosis of amyloidosis-induced gastrointestinal bleeding
      should be considered in patients with MM with an obscure hemorrhage.

PMID- 11205656
TI  - Intravascular stent implantation of the celiac artery in the treatment of chronic
      mesenteric ischemia.
AB  - We report a case of chronic mesenteric ischemia that caused abdominal angina and
      weight loss in an 80-year-old woman. A mesenteric angiogram revealed total
      occlusion of the superior mesenteric artery and 90% stenosis of the celiac and
      inferior mesenteric arteries. Balloon angioplasty of the celiac artery failed
      because of elastic recoil. A 15-mm Palmaz-Schatz stent was dilated to 6 mm in the
      proximal celiac artery with an excellent angiographic result and complete
      resolution of symptoms. A clinical, 1-year follow-up demonstrated success with no
      recurrence of pain. This case report illustrates the value of balloon dilatation
      and stent implantation in a patient with atherosclerotic narrowing of multiple
      abdominal visceral arteries.

PMID- 11205657
TI  - Anasarca and small bowel obstruction secondary to endometriosis.
AB  - Intestinal involvement by endometriotic tissue occurs in up to 37% of patients
      with endometriosis. The vast majority of patients do not experience symptoms
      related to the gastrointestinal tract. In particular, the complications of
      intestinal obstruction and malabsorption secondary to endometriosis are
      exceedingly uncommon. We present a 42-year-old woman with intestinal obstruction,
      protein-losing enteropathy, and anasarca secondary to endometriosis. She had a 1
      year history of watery diarrhea, bloating, and abdominal pain with a 30-lb weight
      loss over 3 months. She had no previous history of endometriosis, and laboratory
      investigations showed severe hypoalbuminemia, hypokalemia, and metabolic
      acidosis. Abdominal x-rays revealed air-fluid levels and dilated loops of small
      bowel. She underwent surgical resection with primary anastomosis. Pathologic
      evaluation showed extensive endometriosis of the small bowel and appendix, which
      resulted in complete obstruction. Segments of ileum also demonstrated moderate-to
      marked blunting of the villi. Postoperatively, the patient had a slow recovery
      with resolution of anasarca and a gradual increase in her weight. This report
      illuminates the rare, yet significant, complications of intestinal endometriosis,
      including small bowel obstruction, the development of a protein-losing
      enteropathy, and anasarca. One should consider the possibility of intestinal
      endometriosis in the differential diagnosis of bowel obstruction in women of
      childbearing age.

PMID- 11205658
TI  - Ulcerative duodenitis accompanying ulcerative colitis.
AB  - Ulcerative colitis (UC) is a chronic inflammatory disease of the colon of unknown
      etiology. There are varied manifestations in the natural course of UC. However,
      duodenum is not generally considered a target organ of UC. Here, we report two
      patients with steroid-responsive ulcerative duodenitis with colitis that was
      consistent with UC, but not with Crohn's disease. We also reviewed six cases of
      ulcerative duodenitis with UC. Duodenal lesion with UC may be a more common
      phenomenon, although infrequently clinically manifested under steroid therapy.
      Upper gastrointestinal tract inflammation in UC warrants further studies to
      ascertain whether the duodenum is a target organ in UC, especially in steroid
      free conditions.

PMID- 11205659
TI  - Interstitial nephritis in patients with inflammatory bowel disease treated with
      mesalamine.
AB  - Mesalamines are slow-release formulations of 5-aminosalicylic acid (5-ASA) and
      are effective as primary treatment and maintenance therapy in inflammatory bowel
      disease. Interstitial nephritis is a recognized side effect. We report two cases
      of biopsy-confirmed interstitial nephritis in patients being treated with 5-ASA.
      Both had a trial of steroid therapy. One patient had partial recovery of renal
      function but the other patient was in chronic renal failure and likely was
      approaching the need for dialysis. Interstitial nephritis is an under-recognized
      complication of 5-ASA therapy. Early identification and withdrawal of this drug
      can lead to a partial or complete reversal of renal dysfunction.

PMID- 11205660
TI  - A pregnant woman with hepatitis A and Guillain-Barre.
AB  - Guillain-Barre syndrome (GBS) is often preceded by an infectious disease. A case
      of GBS after hepatitis A in a pregnant woman is described. The patient was
      treated with intravenous immunoglobulin and had full recovery with no neurologic
      sequelae. She gave birth in term to a healthy baby. This is the first reported
      case in the English literature of a triple condition of hepatitis A, GBS, and
      pregnancy.

PMID- 11205661
TI  - Hepatic sarcoidosis with vanishing bile duct syndrome, cirrhosis, and portal
      phlebosclerosis. Report of an autopsy case.
AB  - A few cases of sarcoidosis are associated with progressive liver disease, with a
      wide variety of clinicopathologic features. Herein, we report an autopsy case (65
      year-old man). During an examination for liver dysfunction, cirrhosis with
      cholestatic dysfunction and splenomegaly were found. Needle liver biopsy revealed
      cirrhosis with lymphocytic piecemeal necrosis, dense septal fibrosis, and
      ductopenia. In addition, noncaseating epithelioid granuloma was also seen in the
      periportal region. Ductal enzymes and immunoglobulin M (IgM) levels were
      elevated, although antimitochondrial antibodies were negative. Instead,
      angiotensin-converting enzyme was elevated. He died of pulmonary failure and lung
      cancer. The autopsy liver (1,220 g) showed multinodular cirrhosis with broad and
      dense septa that divided the parenchyma. Mild lymphoid cell infiltration was seen
      in the periportal region. About a half of the interlobular bile ducts were lost,
      and the remaining bile ducts showed prominent periductal fibrosis, resembling
      sclerosing cholangitis. Interestingly, a few interlobular bile ducts showed
      chronic nonsuppurative cholangitis with epithelioid granulomas. Intrahepatic
      portal veins showed luminal narrowing with prominent phlebosclerosis.
      Hepatobiliary pathologies that resemble primary biliary cirrhosis and primary
      sclerosing cholangitis and that are followed by vanishing bile duct syndrome,
      chronic active hepatitis-related cirrhosis, and intrahepatic portal venous
      phlebosclerosis occur in a single case of sarcoidosis.

PMID- 11205662
TI  - Ulcerative duodenitis with ulcerative colitis: is it Crohn's disease or really
      ulcerative colitis?

PMID- 11205663
TI  - Look out for toxic effects of mesalamines!

PMID- 11205664
TI  - Surveillance issues in inflammatory bowel disease: ulcerative colitis.
AB  - This review article on the surveillance of patients with ulcerative colitis
      provides an overview of the criteria for evaluating screening and surveillance
      programs and applies the criteria to the available evidence to determine the
      effectiveness of the surveillance of patients with ulcerative colitis. We examine
      the clinical outcomes associated with surveillance, the additional clinical time
      required to confirm the diagnosis of dysplasia and cancer, compliance with
      surveillance and follow-up, and the effectiveness of the individual components of
      a surveillance program, including colonoscopy and pathologist's interpretation.
      The disability associated with colectomy is considered, as are the cost and
      acceptability of surveillance programs. Patients with long-standing ulcerative
      colitis are at risk for developing colorectal cancer. Recommended surveillance
      colonoscopy should be supported. New endoscopic and histopathologic techniques to
      improve the identification of high-risk patients may enhance the effectiveness
      and cost-effectiveness of surveillance practices.

PMID- 11205665
TI  - ERPET training course: establishment of reference levels in diagnostic radiology.
      European Radiation Protection, Education and Training.

PMID- 11205666
TI  - Endothelin: what does the radiologist need to know?
AB  - Endothelin (ET) is a potent endogenous vasoconstrictor peptide. It has been
      implicated in various pathological states since its discovery in 1988. The
      cardiovascular system and the kidneys are important sites for the action of this
      peptide. Two types of ET receptor, ETA and ETB, govern the biological effects of
      ET. Drugs that can prevent the endogenous synthesis of ET or block its binding to
      receptors may offer important therapeutic impact to patients with congestive
      heart failure, pulmonary hypertension and acute renal failure. Areas of
      particular interest to the radiologist include the role of ET in mediating some
      of the side effects of contrast media, particularly contrast medium nephropathy,
      and the involvement of ET in the pathogenesis of restenosis following
      angioplasty. This review outlines the basic biology of this important mediator
      and its role in health and disease.

PMID- 11205667
TI  - Growth rate of small lung cancers detected on mass CT screening.
AB  - CT has recently been used in mass screening for lung cancer. Small cancers have
      been identified but the growth characteristics of these lesions are not fully
      understood. We identified 82 primary cancers in our 3-year mass CT screening
      programme, of which 61 were examined in the present study. The volume doubling
      time (VDT) was calculated based on the exponential model using successive annual
      CT images or follow-up CT images. All cases were also examined in the hospital by
      high resolution CT (HRCT). Lesions were divided into three types based on HRCT
      characteristics: type G (n = 19), ground glass opacity (GGO); type GS (n = 19),
      focal GGO with a solid central component; and type S (n = 23), solid nodule. 18
      (95%) lesions of type G, 18 (95%) of type GS and 7 (30%) of type S were invisible
      on conventional chest radiographs. The mean size of the tumour was 10 mm, 11 mm
      and 16 mm for type G, type GS and type S, respectively. Most tumours (80%) were
      adenocarcinomas; 78% of these were GGO (type G and GS). Mean VDT values were 813
      days, 457 days and 149 days for type G, type GS and type S, respectively; these
      are significantly different from each other (p < 0.05). Our results show that
      annual mass screening CT for 3 successive years resulted in the identification of
      a large number of slowly growing adenocarcinomas that were not visible on chest
      radiographs.

PMID- 11205668
TI  - Upper retropharyngeal node involvement in differentiated thyroid carcinoma
      demonstrated by 131I scintigraphy.
AB  - We report four patients with papillary thyroid cancer who had upper
      retropharyngeal node involvement demonstrated by 131I scintigraphy. Three
      patients presented with a thyroid nodule and enlarged jugular nodes. Total
      thyroidectomy was performed with node dissection. Pathology demonstrated
      papillary carcinoma with several metastatic nodes. 131I scanning 4 weeks after
      surgery demonstrated increased uptake in an upper retropharyngeal node. In one
      patient, thyroidectomy had been performed 21 years previously. Increased
      thyroglobulin level led to 131I scanning, which showed focal retropharyngeal
      uptake. All four patients had asymmetrical uptake at mouth level with focal
      uptake close to the sagittal plane. A lateral projection showed focal uptake
      between the base of the skull and the mandibular angle, behind the region of the
      mouth and nose. CT in all cases and MRI in one case confirmed the presence of an
      enlarged node. The mass was removed surgically in two patients and pathology
      confirmed the papillary nature of the metastatic node. Two patients were treated
      by 131I. Focal uptake of 131I in the region of the mouth is ambiguous, since
      salivary uptake of 131I is a common finding on scintigraphy. In cases of
      asymmetrical uptake in the region of the mouth, a lateral projection of the head
      therefore allows the correct diagnosis.

PMID- 11205669
TI  - The usefulness of orbital lines in detecting blow-out fracture on plain
      radiography.
AB  - The purpose of this study was to assess the diagnostic value of orbital line
      changes on plain radiographs in detecting blow-out fracture. 92 cases of
      surgically confirmed blow-out fracture were retrospectively analysed in regard to
      plain radiographs and CT. Anterior and posterior lamina papyracea lines (ALPL and
      PLPL, respectively) of the orbital medial wall as well as the posteromedial floor
      line (PMFL) were assessed on orbital posteroanterior projections. The
      inferomedial orbital line (IMOL) and the inferior wall line were assessed on
      Waters projections. Orbital lines on plain radiographs were compared with CT
      findings. Of 53 cases of lamina papyracea fracture, 47 cases showed orbital line
      changes on plain radiographs (sensitivity 88.7%). Changes of PLPL (41/47), IMOL
      (29/47), ALPL (4/47) and PMFL (2/47) were demonstrated as depression, loss,
      discontinuity and irregularity. In four cases showing normal radiographs, the
      fractures measured less than 9 mm in size on CT. All 25 cases with orbital floor
      fracture accompanying medial wall fracture demonstrated orbital line changes of
      PMFL (16/25), PLPL (14/25), ALPL (3/25) and IMOL (2/25) (sensitivity 100%). 12 of
      14 cases with orbital floor fracture demonstrated changes of inferior wall line
      (7/12) and PMFL (6/12) (sensitivity 85.7%). Two cases demonstrated asymmetric
      focal soft tissue density without orbital line changes. Orbital line changes on
      plain radiographs corresponded well with CT findings, confirming the usefulness
      of plain radiographs in detecting blow-out fracture.

PMID- 11205670
TI  - The vascular manifestations of Behcet's disease: angiographic and CT findings.
AB  - The purpose was to evaluate angiographic and CT manifestations of vascular
      Behcet's disease. The medical records of 64 patients with Behcet's disease,
      treated in our hospital during the last 4 years, were reviewed. 37 patients
      underwent angiography or CT in the symptomatic regions because of symptoms or
      clinical signs of vascular involvement by Behcet's disease. 33 (male:female ratio
      28:5; mean age 35 years) of the 37 patients demonstrated vascular involvement,
      which was surgically proven (18 patients) or diagnosed on angiography (15
      patients). Angiograms and CT images of these 33 patients were retrospectively
      analysed for lesion type, location, extent and other characteristic findings of
      vascular involvement. 12 patients had only venous lesions, 11 had only arterial
      lesions and 10 had both arterial and venous lesions. The major angiographic
      findings of vascular Behcet's disease were acute or chronic thrombosis in deep
      veins of the lower extremities (19 patients), in the inferior vena cava (4
      patients) and in the superior vena cava (2 patients), pseudoaneurysms of large or
      medium sized arteries (11 patients), and occlusions/ stenoses of distal run-off
      arteries (13 patients). Common CT findings were obliterated deep veins (8
      patients) and non-calcified thickened aneurysmal walls (9 patients), with or
      without contrast enhancement. The combination of these angiographic and CT
      findings with clinical manifestations are helpful in distinguishing vascular
      Behcet's disease from other vasculitides.

PMID- 11205671
TI  - Non-tumorous enhancement caused by cholecystic venous inflow shown on biphasic CT
      hepatic arteriography: comparison with hepatocellular carcinoma.
AB  - The haemodynamics in non-tumorous abnormalities on CT arterial portography (CTAP)
      owing to cholecystic venous direct inflow to the liver were compared with the
      haemodynamics in hepatocellular carcinoma. 53 patients who simultaneously
      underwent CTAP and CT during hepatic arteriography (CTHA) to detect
      hepatocellular carcinoma had the late phase added to CTHA. Changes in size, shape
      and pattern of 47 non-tumorous enhancement abnormalities on the liver around the
      gall bladder or in the dorsum of segment IV between the early and late phases on
      biphasic CTHA as well as of 60 tumorous lesions were determined. Enhancement on
      biphasic CTHA was seen in all 47 lesions with a non-tumorous portal defect (early
      phase alone, n=8; late phase alone, n = 3; both, n = 36). In these 47 lesions,
      the size and the shape of enhancement changed in 63.8% and 51.1%, respectively,
      between the early and late phases on CTHA; the pattern of enhancement did not
      change in 72.3%. On the other hand, the size of enhancement on biphasic CTHA
      changed in only 16.7% of 60 tumours, and the shape in only 5%, although the
      enhancement pattern changed in a large proportion (80%). In conclusion, owing to
      the difference in haemodynamics, non-tumorous abnormalities caused by cholecystic
      venous inflow and tumours are clearly delineated on biphasic CTHA. Thus, adding
      the late phase to previous single phase CTHA (i.e. performing biphasic CTHA) is
      useful in differentiating the two entities.

PMID- 11205672
TI  - Evaluation of a technique for estimation of extraocular muscle volume using 2D
      MRI.
AB  - Measurements of extraocular muscle volume may be useful as an outcome indicator
      in the assessment of treatment options in thyroid-associated ophthalmopathy. In
      this study, a technique for estimating extraocular muscle volume from two
      dimensional T1 weighted MR images acquired in the coronal plane is described. For
      each image slice, the cross-sectional area of individual extraocular muscles was
      estimated using a combination of semi-automated outlining based on a local
      thresholding technique and manual outlining where thresholding was not possible.
      The technique was assessed using three sets of images: a computer-generated
      virtual image set with "extraocular muscles" of known volumes; a set of images
      from 19 biochemically and clinically euthyroid patients; and images from 7
      patients with thyroid-associated ophthalmopathy. From the computer-generated
      images, the accuracy was determined as 7.6%. Intraobserver agreement was
      investigated using repeated MRI scans on a single subject and repeat outlining of
      muscles on five sets of images from different subjects. The mean difference
      between repeat measurements was 2% (SD 5.9%). We conclude that two-dimensional MR
      images can be used to determine changes in muscle volume of greater than 12%
      during treatment of thyroid-associated ophthalmopathy.

PMID- 11205673
TI  - Effect of a full and empty bladder on radiation dose to the uterus, ovaries and
      bladder from lumbar spine CT and X-ray examinations.
AB  - This is a quantitative study of the effect of a full and empty bladder on the
      position of the uterus, ovaries and bladder relative to the lumbar spine. Data
      are used to estimate the difference in radiation dose to these organs from
      performing a lumbar spine CT investigation or a lateral lumbar spine radiograph
      with a full bladder compared with an empty bladder. 12 women of child-bearing age
      underwent pelvic magnetic resonance scans with full and empty bladders. The
      positions of the uterus, ovaries and bladder were matched with the radiation dose
      distribution that would have occurred either side of the inferior boundary of the
      CT scan volume and the lateral lumbar spine radiograph. These radiation dose
      profiles were measured on phantoms using a combination of ionization chambers and
      thermoluminescent dosemeters. When the bladder was emptied, the mean position of
      the endometrial cavity fundal tip moved from 4.1 cm to 6.1 cm inferior to the
      centre of the L5/S1 disc space, and from 0.87 cm to 1.12 cm anterior to the
      centre of the L5/S1 disc space. This movement on micturation would have reduced
      the mean dose to the uterine internal fundal tip during a pelvic CT scan from 6.8
      mGy to 3.9 mGy, which represents a mean reduction of 43% (range 12-67%). The mean
      dose from a lateral lumbar spine examination would have been reduced from 197
      microGy to 126 microGy. The change in ovary position results in the mean ovary
      dose being reduced by 48% for the lumbar spine CT scan and by 43%) for a lateral
      lumbar spine radiograph. When the bladder was emptied, the average position of
      the bladder wall moved from 7.2 cm to 10.3 cm inferior to the L5/S1 disc space.
      This change in bladder position reduces the mean dose to the wall of a full
      bladder from 5.7 mGy for a CT scan and 114 microGy for a lumbar spine radiograph
      to 2.2 mGy and 42 microGy, respectively, for an empty bladder.

PMID- 11205674
TI  - Evaluation of physical performance of a scintillation dosemeter for patient
      dosimetry in diagnostic radiology.
AB  - The physical performance of the patient scintillation dosemeter Skin Dose Monitor
      (SDM) was evaluated for use in diagnostic radiology. The SDM response was found
      to be linear, with output air kerma and output air kerma rate having a
      reproducibility in time lower than +/- 2.4%) (one standard deviation). A
      calibration protocol taking into account the more significant parameters, such as
      radiation quality dependence and the relative sensitivity of SDM detectors of the
      same batch, can be applied so that the maximum overall uncertainty is +/- 18% at
      the 95% confidence level. The SDM detectors did not show any loss of sensitivity
      during the 5-month period of evaluation. SDM performance was evaluated against
      thermoluminescent dosemeters (TLDs) (GR200A) by monitoring chest X-rays in 18
      adult patients. The difference in entrance surface dose (ESD) values between the
      SDM and TLDs was less than 10%, but a lack of accuracy in ESD values of less than
      0.3 mGy was observed. The main benefit of the SDM device compared with TLDs is
      the real-time read-out of dose combined with a better flexibility and rapidity of
      use for approximately the same cost per measurement. The SDM device is a good
      candidate for regular measurement of patient doses in diagnostic imaging
      departments as required under implementation of the European Council Medical
      Exposure Directive of 30 June 1997.

PMID- 11205675
TI  - Methods of measurement of image quality in teleultrasound.
AB  - In recent years, teleultrasound has emerged as a potentially effective method of
      provision of ultrasound services to remote areas of the community. Transmission
      of teleultrasound, however, requires a high degree of compression when utilizing
      the relatively low bandwidth ISDN connections available within the UK. The actual
      amount of compression occurring varies both with the connection and the image
      content, often on a frame to frame basis. For this reason, traditional
      measurements of image quality using test tools are ineffective. Most studies to
      date have assessed equipment performance by testing diagnostic performance.
      Although this is the most important method of assessing the results of image
      degradation, few studies have attempted to perform physical measurements of
      degradation. The aims of this study were to measure the amount of degradation
      within a teleultrasound system and, using a number of methods, to ascertain the
      most useful indicators of loss of image quality. Groups of successive abdominal
      ultrasound images were captured and digitized both before and after degradation
      via an ISDN6 teleultrasound system. Normalized mean squared error (NMSE), pixel
      histograms, line and surface plots, Fourier spectra and contrast measurements
      were carried out on regions of interest in both sets of images. The NMSE was most
      sensitive to degradation, with alterations in the NMSE value depending on image
      content and degree of degradation. Fourier analysis was also indicative, showing
      consistent changes in high frequency content again varying with image content.

PMID- 11205676
TI  - Breast radiotherapy phantom design for the START trial. START trial management
      group.
AB  - The design of phantoms for use in radiotherapy involves a number of complex
      issues. This paper describes breast and chest wall phantoms that have been
      designed and constructed for the START trial. Four phantoms have been
      manufactured, including two two-dimensional phantoms used on the first round of
      audit visits to assess the ability of departments to plan with the required
      accuracy. Two further phantoms have been constructed and will be used in the
      second round of audit visits; one is a water-filled three-dimensional phantom for
      investigating off-axis dosimetry, the other is to be used to assess dose in the
      junction region between the tangential fields and the supraclavicular fossa
      field. The manufacturing and design process for each of the phantoms is
      discussed.

PMID- 11205677
TI  - Treatment of a false aneurysm of an intercostal artery using a covered
      intracoronary stent-graft and a radial artery puncture.
AB  - This case report documents the successful treatment of a false aneurysm of the
      left internal mammary artery with a covered coronary artery stent. The advantages
      and disadvantages of this novel method of treatment are discussed, together with
      a review of alternative methods of treatment of false aneurysms.

PMID- 11205678
TI  - CT and DSA appearances of a ruptured congenital arteriovenous malformation of the
      posterior mediastinal aorta.
AB  - A case of symptomatic congenital arteriovenous malformation detected in an adult
      patient is presented. The diagnosis was not suspected clinically but was
      demonstrated by CT and digital subtraction angiography. Although very rare, a
      congenital arteriovenous malformation of the posterior mediastinal aorta could
      present as a catastrophic event if it ruptures. Serpiginous vascular channels in
      the retro-oesophageal posterior mediastinum on CT and angiography should raise
      the possibility of an arteriovenous malformation.

PMID- 11205679
TI  - Sacculation of the uterus and placenta accreta: MRI appearances.

PMID- 11205680
TI  - Metastasis to the male breast from carcinoma of the urinary bladder.
AB  - We report a case of male breast metastasis from a urothelial carcinoma. Only two
      cases of this type of metastasis have been previously reported, and these were in
      the female breast. Clinical examination showed a progressive swelling of the left
      mammary region, with periareolar skin infiltration. Both mammography and
      ultrasound showed a rounded mass. Only histological examination with
      immunohistochemical staining permitted the correct diagnosis to be made. A
      particular feature of the present case is the absence of contralateral
      gynaecomastia, normally seen in cases of metastatic tumour to the breast from
      prostatic carcinoma.

PMID- 11205681
TI  - Intracranial dural empyema.
AB  - Intracranial dural empyema is a neurosurgical emergency with potentially
      devastating complications. The prognosis is adversely affected by delay in
      diagnosis. Modern imaging techniques, especially contrast enhanced CT and MRI,
      have improved the speed and accuracy of radiological diagnosis of this condition,
      with an associated reduction in mortality. Despite this, there may still be a
      delay in diagnosis, partly owing to the subtlety of early radiological signs,
      especially on unenhanced CT. We present cases that illustrate some of the
      radiological manifestations, complications and potential pitfalls in diagnosis.

PMID- 11205682
TI  - A painful tibial lesion.

PMID- 11205683
TI  - Regarding X-ray leakage during radiotherapy.

PMID- 11205684
TI  - Limitations of randomized clinical trials. Proposed alternative designs.
AB  - BACKGROUND: The classical two-period crossover and two-parallel-groups designs
      for clinical drug trials are unable to answer many current scientific questions,
      and are sometimes ethically or financially difficult. For example, the classical
      designs do not allow the study of the effects of combined treatments and their
      interactions. Also, the generation of parallel data that are no more than a
      repetition of previous research is ethically debatable and in a sense a waste of
      money. Objectives are to identify what a classical clinical trial cannot manage,
      to summarize and discuss alternative trial designs that are helpful for such
      purposes. RESULTS: A classical clinical trial cannot: (i) assess combined
      therapies, (ii) take historical data into account, (iii) safeguard ethics and
      efficacy during the course of long-term trials, (iv) study drugs, before well
      established toxicity information is available, (v) account for the possibility of
      therapeutic equivalence between test and reference treatment, (vi) study multiple
      treatments in one trial, and (vii) adjust change scores for baseline levels.
      Alternative designs helpful for such purposes are respectively: (i) factorial
      designs, (ii) historical controls designs, (iii) group-sequential interim
      analysis designs, (iv) sequential designs for continuous monitoring, (v)
      therapeutic equivalence designs, (vi) multiple crossover-periods/multiple
      parallel-groups design, and (vii) increased precision designs through
      multivariate adjustment. Main problems include the increased risks of type I and
      type II errors and the loss of validity criteria. CONCLUSIONS: Non-classical
      trial designs are reviewed. They offer relevant scientific, ethical, and
      financial advantages. The increased risks of type I and type II errors should be
      accounted for in the design stage of the trial.

PMID- 11205685
TI  - Haemochromatosis: automated detection of the two point mutations in the HFE gene:
      Cys282Tyr and His63Asp.
AB  - Hereditary haemochromatosis (HH) is one of the most common inherited diseases
      among Caucasians. Two mutations in the HFE gene have been implicated in HH: 80 to
      90% of the patients with HH are homozygous for the point mutation CYS282Tyr,
      while the majority of the remaining patients displays either a compound
      heterozygosity for the mutation CYS282Tyr and the point mutation HIS63Asp, or are
      homozygous for HIS63Asp. Though the disease can be treated easily, symptoms are
      non-specific, and onset and severity are influenced by environmental factors, and
      therefore the disease can remain undetected until decades of iron overload lead
      to irreversible damage in a variety of organs, which may result in their failure.
      In order to detect patients with HH, simple and cost-effective tests are needed.
      We have developed a rapid, automated, PCR-based test which makes use of a
      diagnostic restriction site in each of two amplified fragments. The test employs
      off-the-shelf chemistry and uses the automated detection process of an
      immunoassay analyzer that is available in many clinical laboratories, thus
      avoiding an additional investment in a more specialized PCR analyzer. Because of
      its low costs and easy handling, the assay is particularly suited for the routine
      clinical laboratories.

PMID- 11205686
TI  - Presence of group IIa secretory phospholipase A2 in mast cells and macrophages in
      normal human ileal submucosa and in Crohn's disease.
AB  - Secretory group IIa phospholipase A2 (PLA2-II) is an important regulator of
      proinflammatory lipid mediator production and may play a role in ileal
      inflammation in Crohn's disease. The enzyme has previously only been detected in
      epithelial Paneth cells. However, one characteristic feature of Crohn's disease
      is the transmural inflammation. Full thickness ileal sections from nine patients
      with Crohn's disease, and histologically normal sections from patients with
      colonic cancer (n=7) and chronic severe constipation (n=1) as controls, were used
      in this study. PLA2-II-positive cells were detected by immunofluorescence and in
      situ hybridization. Metachromatic staining and esterase staining were used to
      identify mast cells and macrophages, respectively. It was shown that mast cells
      and macrophages in the ileal submucosa in both patients and controls showed
      positive PLA2-II staining. The number of PLA2-II-labeled cells that did not react
      with metachromasia, e.g. macrophages, was significantly greater in inflamed
      Crohn's disease compared to controls. This is, to our knowledge, the first study
      that has described the presence in healthy, while presence and upregulation of
      PLA2-II-positive cells in inflamed human ileal submucosa. Our findings suggest a
      proinflammatory potential for secretory PLA2-II in submucosa, while
      proinflammatory stimulation of mast cells and macrophages in vitro has shown that
      the enzyme is responsible for delayed prostaglandin formation.

PMID- 11205687
TI  - Relationship between plasma ammonia concentration and beta-N-acetylhexosaminidase
      isoenzyme activities in liver cirrhosis.
AB  - Ammonia is known to increase the secretion of beta-N-acetylhexosaminidase (Hex)
      to the extracellular medium in cultured human fibroblasts and Hep G2 cells. We
      examined 35 patients with liver cirrhosis and the results revealed a significant
      increase for the plasma activities of total Hex and its isoenzymes Hex A and Hex
      B (p < 0.001). The partial correlations, with other biochemical markers of liver
      injury constant, between plasma ammonia concentration and the activity (r =
      0.658) and the proportion in percentage of the Hex B isoenzyme (r = 0.692) were
      statistically significant (p < 0.001). The increased concentration of ammonia
      could explain, at least partially, an increased secretion of Hex B isoforms to
      the plasma in patients with liver disease.

PMID- 11205688
TI  - Thiol redox status influences extracellular concentration of homocysteine in HeLa
      cell cultures.
AB  - We have recently shown that low concentrations of copper ions increased the
      extracellular concentration of homocysteine in a HeLa cell culture system. This
      increase might be attributed to copper-induced oxidation of extracellular
      homocysteine, since earlier reports suggest that the oxidized fraction of
      homocysteine seems to be less available for cellular uptake than the reduced
      fraction. To investigate further this mechanism we have therefore, in the present
      study, determined intra- and extracellular concentrations of homocysteine and
      their relations to the extracellular thiol redox status. The results of this
      study show that the redox status of homocysteine is important for its
      extracellular concentration. Increased oxidation of thiols catalyzed by copper
      ions resulted in an increased extracellular concentration of homocysteine,
      whereas the addition of antioxidant agents (N-acetylcysteine or dithiothreitol)
      or a specific copper(I) ion chelator (bathocuproinedisulfonic acid) was
      accompanied by a decreased extracellular concentration of homocysteine. These
      effects are probably dependent on differences in cellular uptake between reduced
      and oxidized homocysteine.

PMID- 11205689
TI  - Serum total and lipid-bound sialic acid levels following acute myocardial
      infarction.
AB  - Although serum total sialic acid has been shown to be a cardiovascular risk
      factor, with elevated levels associated with increased cardiovascular mortality
      and also with cerebrovascular disease, the reason for the elevation in serum
      sialic acid content remains obscure. It has been shown that an increased output
      of serum proteins by the liver due to some type of acute phase reaction may be
      one of the possible sources of an increased serum sialic acid concentration in
      patients with myocardial infarction. An increase in the activity of sialidase,
      which cleaves the terminal sialic acid residues from oligosaccharides,
      glycoproteins and gangliosides, may also play an important role in the elevation
      of serum total sialic acid in myocardial infarction. Elevated serum total sialic
      acid in the blood might result either from the shedding or secreting of sialic
      acid from the cell membrane surface, or releasing of cellular sialic acid from
      the cell into the bloodstream due to cell damage after myocardial infarction. The
      purpose of the present study is to investigate serum total and lipid-bound sialic
      acid and the enzymes serum lactate dehydrogenase, creatine kinase and aspartate
      aminotransferase in patients with acute myocardial infarction, at 24 h post
      infarction (day 1), 48 h post-infarction (day 2) and 72 h post-infarction (day
      3). A possible role of cell damage in the elevation of serum total and lipid
      bound sialic acid levels in these patients was also evaluated. In this study, 40
      patients with myocardial infarction ranging in age from 42 to 68 years, and 26
      healthy volunteers ranging in age from 45 to 71 years were included. Serum total
      sialic acid determination was carried out by the thiobarbituric acid method of
      Warren and lipid-bound sialic acfd by the method of Katopodis. Our data shows
      that a) there is a gradual increase in the levels of serum total sialic acid and
      lipid-bound sialic acid during the first three days after the acute myocardial
      infarction and b) the elevation in serum total sialic acid levels correlates with
      the elevation in lactate dehydrogenase activity only on day 1 following
      infarction. Therefore, either the shedding or secreting of sialic acid from the
      cell or cell membrane surface may be partly responsible for an increased serum
      sialic acid concentration especially on day 1 following myocardial infarction.

PMID- 11205690
TI  - Concentration of leukocyte elastase in plasma and polymorphonuclear neutrophil
      extracts in type 2 diabetes.
AB  - The concentration of leukocyte elastase/alpha1-proteinase inhibitor complexes in
      plasma and polymorphonuclear neutrophil extracts, and plasma trypsin inhibitory
      capacity were determined in 88 patients with type 2 diabetes and 47 control
      subjects. Higher values of these variables were found in patients as compared to
      controls (p < 0.001). The concentration of elastase was higher in obese patients
      than in lean ones (p < 0.05 for plasma, p < 0.01 for polymorphonuclear
      leukocytes). Only leukocyte elastase levels were significantly higher in the
      group with both micro- and macroangiopathy in comparison to the group with
      microangiopathy (p < 0.01) or macroangiopathy (p < 0.05) alone. Poor short-term
      glycaemic control was associated with higher elastase concentration in plasma and
      neutrophils (p < 0.05). The present study demonstrates that measurements of
      plasma polymorphonuclear neutrophil elastase level can be considered as a marker
      of development of diabetic angiopathy.

PMID- 11205691
TI  - Hypertriglyceridemia characterized by low-density lipoprotein phenotype and
      lipoprotein lipase gene mutation.
AB  - A high serum triglyceride (TG) concentration is associated with an increased
      serum concentration of small, dense low-density lipoprotein (LDL). To further
      characterize the hypertriglyceridemic condition, we examined sera from 240
      subjects for small, dense LDL using non-denaturing polyacrylamide gradient gel
      electrophoresis. We focused on determining the frequency of the pattern B, which
      is characterized by a higher proportion of small, dense LDL, among
      hypertriglyceridemic individuals. The subjects were divided into four groups: a
      control group (TG < or = 1.65 mmol/l, high-density lipoprotein cholesterol (HDL
      C) > or =1.17 mmol/l; n = 71), a high TG group (TG > 1.65 mmol/l, HDL-C > or =
      1.17 mmol/l; n = 36), a group with high TG and low HDL-C (TG > 1.65 mmol/l, HDL-C
      < or = 0.91 mmol/l; n = 106), and a low HDL-C group (TG < or = 1.65 mmol/l, HDL-C
      < or = 0.91 mmol/l; n = 27). We found that pattern B occurs at a high frequency
      mainly in individuals with high TG and low HDL-C levels. We also observed an
      increased percentage of LDL within the 20.0 nm to 25.5 nm particle diameter range
      in this group. Analysis of the lipoprotein lipase gene in this group showed that
      some mutations seem to be associated with small, dense LDL, resulting in LDL
      pattern B.

PMID- 11205692
TI  - Different stability of free and complexed prostate-specific antigen in serum in
      relation to specimen handling and storage conditions.
AB  - The effect of sample collection, storage conditions (time and temperature), and
      freeze-thaw cycles on the stability of free prostate-specific antigen (fPSA), PSA
      complexed with alpha1-antichymotrypsin (ACT-PSA), and total PSA (tPSA) in serum
      was studied. The analytes were quantified using immunoassays for tPSA and fPSA on
      the Elecsys system 2010 and a research assay for ACT-PSA on the ES system (Roche
      Diagnostics). The stability of the analytes was calculated as percentages of the
      values measured in samples 1 h after blood collection. When the samples were
      stored at 37 degrees C, at room temperature or at 4 degrees C, the stability of
      ACT-PSA was less impaired than that of fPSA. To avoid erroneous results in the
      determination of PSA isoforms and their corresponding ratios, serum samples
      should be preserved at 4 degrees C when the analysis is performed within 8 h
      after blood collection, or they should be stored at -80 degrees C if the analysis
      is not feasible during that period.

PMID- 11205693
TI  - Erythrocyte superoxide dismutase and glutathione peroxidase activities, and
      malondialdehyde and reduced glutathione levels in schizophrenic patients.
AB  - There is abundant evidence that free radicals are involved in membrane pathology
      in the central nervous system and that they may play a role in neuropsychiatric
      disorders, including schizophrenia. In this study, we investigated erythrocyte
      superoxide dismutase and glutathione peroxidase activities as antioxidant
      enzymes, malondialdehydes as a sign of lipid peroxidation, and reduced
      glutathione levels in schizophrenic patients. Activities of superoxide dismutase
      and levels of malondialdehyde in erythrocytes were greater in all patients (n=48)
      and in patients with acute (n=16) and chronic schizophrenia (n=32) (p<0.001 for
      all patients and chronic patient group; p<0.05 for acute patient group). The
      activities of glutathione peroxidase were lower in patients (p<0.05 for all
      patients and acute patient group; p=0.051 for chronic patient group) compared
      with the control group. Mean erythrocyte reduced glutathione was lower in
      patients than in controls (p<0.05). In the patient group, erythrocyte superoxide
      dismutase activity was positively correlated with scales and duration of disease
      and erythrocyte malondialdehyde concentration. These data reveal that
      antioxidative defense mechanisms might be impaired in schizophrenic patients.

PMID- 11205694
TI  - Reference change value for HbA1c in patients with type 2 diabetes mellitus.
AB  - We estimated reference change value and steady state disease biological variation
      of glycohemoglobin (HbA1c) from serial measurements in 47 clinically stable type
      2 diabetes patients whose home-measured capillary glucose was stable throughout
      the study. Whole blood HbA1c assays were performed by turbidimetric inhibition
      immunoassay. The analytical imprecision (coefficient of variation) was 7.1% and
      5.0% for control materials with HbA1c of 5.1% and 10.7%, respectively (n=152).
      The sampling interval was 6 months. Patients were classified into three groups
      (good, acceptable and poor control) according to the American Diabetes
      Association (ADA) clinical practice recommendations of 1999 based on HbA1c
      reference interval. Steady state disease biological variation for each control
      group was 7.9%, 5.4% and 3.9%. HbA1c absolute reference change value was 1.42,
      1.50 and 1.37%, or as relative reference change value, 29.1%, 24.4% and 17.8%,
      respectively. The analytical goal, defined as one-half of the biological
      variation, was lower than 3.9% for well-controlled patients.

PMID- 11205695
TI  - Specific oxidase activity of cord serum ceruloplasmin in the newborn.
AB  - In a study of 50 full-term newborns, we found serum levels of ceruloplasmin, its
      oxidase activity and specific oxidase activity (activity per unit mass of enzyme
      protein) which were significantly lower than in adult subjects (p<0.001). A
      significant correlation was obtained between the specific oxidase activity of the
      neonatal ceruloplasmin and the transferrin/alpha-fetoprotein ratio (p<0.01),
      which reflects the maturity of the fetal hepatocyte through its ability to
      synthesise fetal- and non-fetal-associated proteins. The lower specific oxidase
      activity of the ceruloplasmin in newborns would be due to a higher relative
      proportion of apoprotein, and/or other molecular forms with a poor copper content
      in the oxidase sites. This could be due to an inability to transfer copper into a
      common intracellular pool for holoceruloplasmin synthesis and biliary copper
      excretion. A high interindividual variability was found for the specific oxidase
      activity of the neonatal ceruloplasmin, and in the newborns with higher levels of
      ceruloplasmin this, from a catalytic point of view, is more similar to the adult
      form.

PMID- 11205696
TI  - Sequential evaluation of serum urate concentrations in AIDS patients with
      infections of the central nervous system.
AB  - To evaluate the serum urate levels in AIDS patients with infections of the
      central nervous system (CNS), 46 patients who had at least two measurements of
      urate were included. A maximum of four measurements per patient were considered:
      prior to the CNS involvement (U-PRIOR), at the time of CNS involvement (U-CNS),
      after treatment for the CNS infection (U-AFTER), and the last measurement before
      death (U-LAST). Serum U-CNS levels were significantly lower than U-PRIOR values
      (p=0.038). U-AFTER levels were higher than U-CNS in the patients who improved
      (p=0.25), and lower in the patients who did not improve (p=0.026). There were no
      significant differences among the four diagnostic groups in U-CNS measurement
      (p=0.29) but they were found in U-AFTER determinations (p=0.018), probably as a
      result of the different response to treatment. Hypouricemia seemed to be
      associated with lower survival periods. We conclude that hypouricemia is common
      in AIDS patients with CNS infections, probably as a result of increased renal
      losses of urate, and that it may have prognostic significance. CNS infections are
      associated with significant decreases in serum urate levels in comparison with
      previous values. The urate concentrations seem to increase after successful
      treatment of the CNS infections, whereas they decrease further in patients who do
      not improve.

PMID- 11205697
TI  - Evaluation of iron status in anemic patients with rheumatoid arthritis using an
      automated immunoturbidimetric assay for transferrin receptor.
AB  - We have evaluated a newly introduced immunoturbidimetric transferrin receptor
      assay (IdeA TfR-IT, Orion Diagnostica, Finland) in healthy subjects and in a
      study population consisting of patients with rheumatoid arthritis and juvenile
      chronic arthritis. The IdeA TfR-IT assay was found to provide reproducible
      results which were in good agreement with the ELISA assays from Orion Diagnostica
      (IDeA-ELISA, correlation R2=0.8, n=102) and R&D systems (Quantikine TfR ELISA
      assay, correlation R2=0.95, n=39). The analysis of the patient samples suggested
      that, on the basis of serum transferrin receptor and ferritin concentrations, in
      approximately one third of patients with rheumatoid arthritis anemia is due to
      the depletion of iron stores. Apparently, in all patients with rheumatoid
      arthritis iron deficiency must be considered as a potential cause of the anemia.
      Now, that assays which are suitable for automated analyzers have become available
      for the measurement of serum transferrin receptor, this analyte has the potential
      to become a part of the routine evaluation of iron status.

PMID- 11205698
TI  - IFCC recommended reference method for the determination of the substance
      concentration of ionized calcium in undiluted serum, plasma or whole blood.
AB  - A reference method is described for the determination of the substance
      concentration of ionized calcium in plasma by which ionized calcium (free or
      unbound) may be reliably determined on the basis of calibration with aqueous
      solutions with known concentration of ionized calcium. The composition of the
      calibration solutions is chosen such that the activity coefficient of the calcium
      ion is assumed to be identical both in the calibration solutions and in "normal"
      plasma, i.e. by convention, the ionic strength (Im) is 0.160 mol/kg. The
      convention is adopted of reporting ionized calcium measurements as concentration
      expressed as mmol/l. The proposed reference method for ionized calcium
      measurement in plasma is based on the use of a cell consisting of an external
      reference electrode with a saturated potassium chloride liquid/liquid junction in
      combination with a calcium ion-selective membrane electrode of defined
      construction and performance. Procedures for using the reference cell and a
      protocol for sample measurement are described. The preparation of the calibration
      solutions to be used are described in detail in Appendix A, secondary calibration
      solutions and check standards in Appendix B, and reference cell vessel design in
      Appendix C.

PMID- 11205699
TI  - Current situation of clinical chemistry in mainland China.

PMID- 11205700
TI  - Caesarean section on demand--an ethical dilemma.

PMID- 11205701
TI  - For and against a European quality control of training.
AB  - In a world of medicine that evolves more and more rapidly, sufficient quality of
      education in the arts and crafts of our discipline and control of this quality
      are essential for the progress and vitality of Ob/Gyn. There are variations in
      training within European countries but with the aim of harmonization in training
      programmes and the flexibility of quality control mechanisms we will meet our
      objective that is the high standards in the care of woman throughout Europe.

PMID- 11205702
TI  - Clinical value of dilatation and curettage for abnormal uterine bleeding.
AB  - Dilatation and curettage was performed under anesthesia in outpatients in 1,837
      patients aged over 26 with a history of abnormal uterine bleeding not associated
      with pregnancy or ovulation. Fifty-one (2.8%) patients were found to have
      malignant disease. Of these, 47 patients had endometrial carcinoma. An additional
      111 (6.0%) patients were found to have endometrial hyperplasia. The incidence of
      either malignant disease or endometrial hyperplasia was 9.7% in patients over the
      age of 40. Complications of this method were noted in 12 (0.7%) patients; only
      three patients needed to stay in hospital.

PMID- 11205703
TI  - Evaluation of MUC1 and EGP40 in bone marrow and peripheral blood as a marker for
      occult breast cancer.
AB  - Mucin1 (MUCI) is a class of high molecular weight glycoproteins found in the cell
      membranes of human epithelial cells. Epithelial glycoprotein 40 (EGP40) is a
      homophilic cell-cell adhesion molecule and expressed on the surface of most
      simple epithelial cells and the majority of carcinomas. We analyzed the
      expression of MUC1 and EGP40 in human bone marrow (BM) and peripheral blood (PB)
      by reverse transcriptase polymerase chain reaction (RT-PCR) and
      immunocytochemistry (ICC). Eight BM and 95 PB samples from healthy donors, 39 BM
      and 17 PB samples from patients with haematological malignancies and 45 BM
      samples from patients with breast cancer were analyzed. MUC1 mRNA and EGP40 mRNA
      and protein were detected in BM samples and PB samples from healthy donors and
      from patients with multiple myeloma (MM), non-Hodgkin's lymphoma (NHL) and
      chronic myelogenous leukaemia (CML). The positive cells showed erythroblast-like
      and plasmacell-like morphology by immunocytochemistry. The MUC1 and EGP40 nested
      PCR were positive in 83.3% (10/12) and in 100% (33/33) respectively of BM from
      patiens with breast cancer who had no evidence of distant metastases. It is
      concluded that MUC1 and EGP40 is expressed in haematopoietic tissues and
      haematological malignancies. Therefore, MUC1 and EGP40 expression as a marker for
      detection of breast cancer cells and micrometastatic epithelial cells in BM and
      PB is not specific using RT-PCR technique and immunocytochemistry.

PMID- 11205704
TI  - The renin-aldosterone system during normal and hypertensive pregnancy.
AB  - Gestational hypertension complicates approximately 5%-7% of pregnancies and it
      may be deleterious to both maternal and fetal health. Gestational hypertension is
      a multisystem disorder which always resolves itself after delivery; its primary
      pathology still remains incompletely clarified. The renin-aldosterone system is a
      major determinant of sodium balance in pregnancy. To evaluate the changes in
      renin and aldosterone levels during normal and hypertensive pregnancy we
      undertook this study. Plasma renin activity and aldosterone levels were measured
      in 71 pregnant (43 normotensive, 28 hypertensive) and 24 non-pregnant (12
      normotensive, 12 hypertensive) women, aged 19-43 years (mean +/- SD 28 +/- 2.8).
      Women were allocated into the following five groups: Groups 1 and 2 consisted of
      12 normotensive and 12 hypertensive non-pregnant women, respectively; group 3
      consisted of 20 women (14 normotensive and 6 hypertensive) at 11-19 weeks of
      gestation; group 4 consisted of 24 women (14 normotensive and 10 hypertensive) at
      20-29 weeks of gestation, and group 5 consisted of 27 women (15 normotensive and
      12 hypertensive) at 30-37 weeks of gestation. Both plasma renin activity and
      aldosterone levels progressively increased during normotensive pregnancy and were
      higher compared to normotensive non-pregnant women. Among hypertensive pregnant
      women, plasma renin activity levels remained unchanged during the three
      trimesters of pregnancy and were higher compared to hypertensive non-pregnant
      women. Only during the third trimester did aldosterone levels significantly
      increase in hypertensive pregnant women, compared to hypertensive non-pregnant
      women. Despite stable renin levels, aldosterone levels increased significantly
      during the third trimester of hypertensive pregnancy. Thus, we conclude that
      aldosterone biology seems to be directly or indirectly involved in the etiology
      of gestational hypertension independently of renin levels.

PMID- 11205705
TI  - Cross-linked type I collagen C- and N-telopeptides in women with bone metastases
      from breast cancer.
AB  - This study documents values of biochemical markers of bone remodeling in 106
      patients with breast cancer. Based on scintigraphic and radiological findings,
      patients were divided into 3 groups: 19 patients with bone metastases, 65
      patients without bone metastases and normal bone scintigrams, and 22 patients
      with pathological, non-malignant findings on scintigraphy without proof of bone
      metastases. Urinary cross-linked type I collagen N-telopeptides (NTx) and serum
      cross-linked type I collagen C-telopeptides (ICTP) were assessed as markers of
      bone resorption. Bone alkaline phosphatase (BAP) was assessed as a marker of bone
      formation. All three markers were significantly higher in patients with bone
      metastases compared to both patients without skeletal recurrence and those with
      pathological, non-malignant scintigraphic findings (p < 0.01). There were no
      statistically significant differences between the latter two groups. The clinical
      sensitivity for diagnosing bone metastases was 44% for NTx, 65% for ICTP, and 26%
      for BAP, respectively. The clinical specificitiy for discriminating patients with
      bone disease from those without were 79%, 91%, and 92% for NTx, ICTP, and BAP,
      respectively. In conclusion, markers of bone remodeling are increased in patients
      with breast cancer metastatic to the skeleton. The sensitivity of the markers
      presented in this paper did not seem to be sufficient enough for early
      identification of patients with subclinical bone recurrence in a clinical
      practice setting.

PMID- 11205707
TI  - Obstetric outcome in grand multipara in the United Arab Emirates. A case control
      study.
AB  - OBJECTIVE: To compare the obstetric outcome in grand multiparous and low parous
      United Arab Emirates women. METHOD: The records of 418 grand multiparous women
      (study group), defined as having had given birth at least 5 times after completed
      22 weeks gestational age, and 418 women of parity 2-4 (control group) were
      reviewed. RESULTS: Mean parity in the study group was 7.9 +/- 2.4. The number of
      subjects who attended for antenatal care and the number of visits were equal in
      both groups. Diabetes mellitus (both overt and gestational) was significantly
      more common in the study group (p < 0.0001) but there was no significant increase
      in the incidence of other obstetric complications nor in perinatal mortality
      rate. Babies of grand multiparous mothers required significantly more admissions
      to special care unit because of maternal diabetes mellitus (p < 0.0002).
      CONCLUSION: Diabetes mellitus was more common in grand multiparous United Arab
      Emirates women but the incidence of other obstetric complications was similar to
      lower parity women.

PMID- 11205706
TI  - Relationship between the sonographic pattern of intrauterine growth restriction
      and acid-base status at the time of cordocentensis.
AB  - OBJECTIVE: To determine whether there is a difference in acid-base status at the
      time of cordocentesis between fetuses with symmetric and asymmetric intrauterine
      growth restriction (IUGR). STUDY DESIGN: Non-anomalous singleton fetuses with
      IUGR who underwent fetal blood sampling for rapid karyotype analysis from 1992
      1995 were retrospectively identified. Cases with gestational age <24 weeks,
      abnormal karyotype, or evidence of congenital infection were excluded. Fetuses
      were divided into two groups based on Head Circumference/ Abdominal Circumference
      Ratio (HC/AC). The asymmetric-IUGR group had HC/AC > or = 95% tile for GA, and
      the symmetric-IUGR group had HC/AC <95% tile. GA adjusted values of umbilical
      venous pH, pCO2, pO2, HCO3, hemoglobin and reticulocyte count were calculated by
      subtracting the mean values for GA from the observed and compared between groups.
      RESULTS: Both symmetric-IUGR (n = 7) and asymmetric-IUGR (n = 9) had umbilical
      venous pH and pO2, levels lower than GA normative values. However, there were no
      differences between groups for any of the parameters studied. CONCLUSIONS:
      Fetuses with symmetric and asymmetric IUGR due to UPI display a similar degree of
      acid-base impairment.

PMID- 11205708
TI  - Anxiety and depression before and after the menopause.
AB  - OBJECTIVE: Our purpose was to investigate the anxiety and depression at
      postmenopausal women. METHODS: We studied 32 postmenopausal and 32 premenopausal
      patients aged between 40-55 years in Kinrikkale University Medical Faculty
      Obstetric and Gynecology Department. We performed Beck depression scale and State
      Trait Anxiety Inventory (STAI) I and II on those patients. Blood samples were
      taken from each patient. We used student's t test, pearson correlation analysis.
      RESULTS: Beck depression test results were 21.3 +/- 6.7 and 15.1 +/- 5.6 in
      postmenopausal and premenopausal women respectively (p < 0.001). STAI-I were 50.4
      +/- 9.1 and 47.5 +/- 8.5 in this 2 groups (p = 0.19) and STAI-II values were 47.5
      +/- 9.1 and 45.4 +/- 7.5 (p = 0.33). We could not find a correlation between
      anxiety-depression and blood FSH, LH and E2 levels. We found a correlation
      between parity and depression (r = 0.423 p = 0.01). There were positive
      correlations between anxiety and depression tests (r = 0.489 p = 0.01 for STAI-I
      and r = 0.398 p) = 0.01 for STAI-II). CONCLUSION: Depression rate is
      significantly higher in menopausal women.

PMID- 11205709
TI  - Study of somatosensory evoked potentials (SSEPs) by stimulating vagina before and
      after hysterectomy.
AB  - OBJECTIVE: To assess the changing status of women after hysterectomy using the
      electrodiagnostic method. STUDY DESIGN: We compared pre- and postoperative
      somatosensory evoked potentials (SSEPs) through vaginal stimulation in twenty
      patients undergoing hysterectomy. RESULTS: 1) The latencies (Mean +/- SD) of the
      first positive peak (P1) and first negative peak (N1) in preoperative vaginal
      SSEP were 32.89 +/- 3.02 ms and 40.41 +/- 3.43 ms in the left side, 33.25 +/-
      4.28 ms and 41.39 +/- 5.46 ms in the right side respectively. 2) The
      postoperative P1 and N1 latencies were 33.68 +/- 4.50 ms and 42.00 +/- 4.30 ms in
      the left side, 33.78 +/- 3.10 ms and 42.00 +/- 3.62 in the right side
      respectively. CONCLUSION: There were no significant differences between the pre-
      and the postoperative vaginal SSEP by stimulating vagina in patients of
      hysterectomy.

PMID- 11205710
TI  - Sertoli-Leydig cell tumor.
AB  - Sertoli-Leydig cell tumors belong to the group of sex-cord stromal tumors of the
      ovary. They account for less than 0,5% of all ovarian neoplasms. The majority of
      these tumors are benign, and almost all are localised unilaterally. Herewith, we
      describe an ovarian Sertoli-Leydig cell tumor in an 11-year-old girl. Serum
      levels of estradiol and progesterone were mildly elevated. while testosterone and
      androstendion levels were raised to around three- and sevenfold upper normal
      limit respectively on presentation. A left salpingo-oophorectomy was performed.
      Microscopically, the tumor was intermediately differentiated. At 6 months follow
      up, there was neither clinical nor sonographical evidence of recurrence, and
      almost all sex hormone levels had returned to within normal range. Treatment of
      this pathological entity has to be individualized according to patient age, stage
      of tumor and degree of differentiation.

PMID- 11205711
TI  - Intracardiac leiomyomatosis. Case report and literature review.
AB  - We describe a case of intracardiac leiomyomatosis originating from the uterus,
      growing up in the inferior vena cava, and extending into the right ventricle. She
      also found to have lung metastasis. As she declined for further operative
      intervention, Tamoxifen was given for the control of disease. This case
      represented an unusual rapid recurrence of intravenous leiomyomatosis which was
      potentially preventable. To investigate for the appropriate management, a review
      of the literature concerning this rare condition was made.

PMID- 11205712
TI  - Percutaneous embolization in the management of intractable vaginal bleeding.
AB  - AIM: To assess the effectiveness of arterial embolization in gynecological
      malignancies by Polyvinyl Alcohol particles. MATERIAL AND METHODS: Six patients,
      four with cervix carcinoma, one endometrium carcinoma, and one vaginal metastasis
      of ovarian carcinoma underwent percutaneous embolization due to intractable
      vaginal bleeding. As an embolic agent PVA particles were used. RESULTS: Cessation
      of the bleeding was observed immediately after the embolization. Complete
      embolization has been achieved in all the patients Recurrent bleeding did not
      occur in any of the cases. There were no complications related to the
      embolization procedure. CONCLUSION: Transarterial embolization is a lifesaving
      procedure in treating intractable vaginal bleeding. PVA particles are effective
      and it is a simple way in ceasing the hemorrhage due to pelvic malignancies.

PMID- 11205713
TI  - Missed abortion complicated by Candida infection in a woman with rested IUD.
AB  - Although Candida species are frequent saprophytes of the female genital tract,
      chorioamnionitis or intrauterine fetal infections are rarely caused by these
      fungi. The present report describes a 34-year-old woman G2, P2, presenting with
      vaginal bleeding in the 11.6 weeks of gestation. Clinical and sonographic
      examination revealed a missed abortion and rested IUD. Histopathologically, a
      fungal chorioamnionitis due to Candida spp. was found at the curetting material,
      confirmed by detection of C. albicans infection on mycological culture. Foreign
      intrauterine bodies, like IUD's and cerclage sutures predispose to fungal
      chorioamnitis or fetal infections. This conditions urge repetetive search for
      Candida spp. to establish early anti-fungal therapy which may be therapeutic for
      this hithero rare intrauterine infection.

PMID- 11205714
TI  - Ritodrine-induced skin rash.
AB  - A 32-year-old nulligravida was hospitalized because of preterm labor and treated
      with intravenous ritodrine hydrochloride. After 33 days of therapy, the patient
      developed a fine maculopapular rash.

PMID- 11205715
TI  - Etiology of stroke in children.
AB  - Although the risk factors for stroke in children are numerous and differ greatly
      from the causes of stroke in adults, a thorough diagnostic evaluation can
      identify one or more risk factors in most patients. Cardiac disorders and
      hemoglobinopathy are the most common causes of ischemic infarction, whereas
      various congenital anomalies of the blood vessels or defects in coagulation or
      platelet function are often found in children with intraparenchymal hemorrhage.
      More than one risk factor is commonly identified, especially in children with
      dural venous thrombosis. Identification of the underlying risk factors for
      cerebrovascular disorders in children is important because many of the risk
      factors can be treated, reducing the risk of subsequent strokes.

PMID- 11205716
TI  - New radiographic techniques to evaluate cerebrovascular disorders in children.
AB  - The radiographic evaluation of the pediatric patient with cerebrovascular disease
      has dramatically improved during the past decade. Few new technologies have been
      introduced, but significant new developments in data acquisition and post
      processing have resulted from refinements in both software and, to a lesser
      extent, hardware. This review focuses on the advantages and limitations of the
      different imaging modalities and their recommended role in managing the pediatric
      patient who presents with signs or symptoms of cerebrovascular disease.

PMID- 11205717
TI  - Neonatal cerebral infarction.
AB  - Neonatal cerebral infarction in term infants has many possible causes, including
      bacterial meningitis, inherited or acquired coagulopathies, trauma, and hypoxia
      ischemia. However, a specific cause often cannot be identified. Neurologic
      symptoms in the neonatal period are often subtle and nonspecific, even in infants
      with large infarctions involving an entire cerebral artery distribution. The most
      common presenting symptom is focal motor seizures of the contralateral limbs.
      Cranial magnetic resonance imaging, especially with diffusion-weighting, is the
      most sensitive imaging modality, although ultrasonography with Doppler imaging of
      cerebral blood flow is useful in the neonate who is too ill to transport.
      Neurodevelopmental outcome is often surprisingly good, with many infants making a
      complete recovery of motor function. The effect of neonatal stroke on cognitive
      function, especially language acquisition and emotional and social development,
      has not been fully established.

PMID- 11205718
TI  - Cerebrovascular arterial dissection in children and young adults.
AB  - Dissection of the cervical and intracranial portions of the carotid and
      vertebrobasilar arteries may occur spontaneously or in association with trauma or
      other underlying risk factors. Astute recognition allows appropriate diagnostic
      and therapeutic protocols to be instituted. Dissection of extracranial carotid
      and vertebral arteries differ from their intracranial counterparts, both in terms
      of presentation and prognosis. Limited data are available regarding the most
      effective medical treatment of dissection in children and young adults.
      Interventional neuroradiology may offer a new approach in difficult cases. A
      multicenter controlled clinical trial is needed to assess the most effective
      treatment.

PMID- 11205719
TI  - Prothrombotic disorders and ischemic stroke in children.
AB  - Childhood ischemic stroke, including arterial ischemic stroke (AIS) and
      sinovenous thrombosis (SVT), is relatively rare in children but can result in
      devastating morbidity and mortality. An understanding of the etiology of
      childhood stroke is important because strategies for primary and secondary
      prevention can be devised. Prothrombotic disorders may contribute to the etiology
      of childhood stroke, and include deficiencies of antithrombin, protein C, protein
      S, plasminogen, and presence of Factor V Leiden, Prothrombin gene G20210A,
      dysfibrinogenemia, antiphospholipid antibodies, hyperhomocysteinemia, and
      elevated lipoprotein (a). The overall incidence of prothrombotic disorders in
      childhood AIS is estimated to be 20% to 50% in most studies and, in childhood
      SVT, to be 33% to 99%. In addition, hyperlipidemia, polycythemia, iron deficiency
      anemia, and platelet disorders may result in a prothrombotic state associated
      with ischemic stroke. The etiologic contribution of these prothrombotic disorders
      to initial and recurrent stroke has not been clearly defined; however, additional
      risk factors are usually present in affected children. Given the prevalence of
      prothrombotic disorders in childhood stroke, and their likely causative role,
      children with stroke should be screened for prothrombotic disorders. Future
      prospective and multicenter studies will elucidate the contribution of specific
      prothrombotic disorders to initial and recurrent stroke, and optimal therapy.

PMID- 11205720
TI  - Stroke in children: recognition, treatment, and future directions.
AB  - Childhood stoke is increasingly recognized, but studies remain largely
      descriptive. Important differences from adult stroke include the following: (1)
      frequently delayed or missed diagnosis, (2) heterogenous and overlapping risk
      factors, and (3) developmental differences in the cerebrovascular, neurologic,
      and coagulation systems. These aspects limit the extrapolation of the results of
      adult stroke research and present challenges in caring for children with stroke.
      The incidence of childhood ischemic stroke exceeds 3.3 in 100,000 children per
      year, more than double the estimates from past decades. The increased incidence
      reflects, in part, increased survival in previously fatal conditions predisposing
      to stroke, including congenital heart disease, sickle cell anemia, and leukemia.
      Risk factors for stroke are recognized in more than 75% of children. Common risk
      factors include congenital heart disease and sickle cell disease. Progressive
      arteriopathies, including vasculitis and moyamoya syndrome, are rare in children
      with stroke; however, transient arteriopathies including post-varicella
      angiopathy are increasingly recognized. Prothrombotic abnormalities are
      frequently present but of unclear significance. Adverse outcomes after childhood
      stroke, including death in 10%, recurrence in 20%, and neurologic deficits in two
      thirds of survivors could be reduced with available stroke treatments. Aggressive
      prehospital emergency care and transfer could improve access to hyperacute stroke
      therapies including tPA. Currently, the diagnosis is delayed by more than 24
      hours from onset in most children. As in adults, tPA will likely produce
      unacceptable rates of intracerebral hemmorrhage unless given within 3 hours of
      stroke symptom onset. The appropriate choices for in hospital treatment and
      secondary preventative strategies, including aspirin and anticoagulants, are
      controversial. Empiric recommendations are published; however, age-appropriate
      clinical trials are urgently needed. The large multinational networks of
      investigators necessary for designing and conducting these future trials are now
      being formed.

PMID- 11205721
TI  - Diastolic heart failure: diagnosis and treatment.
AB  - The most frequent hospital diagnosis-related group is congestive heart failure
      (CHF). CHF increases dramatically with age, making it an important problem in our
      aging population. CHF is caused by a primary abnormality in diastolic function
      (diastolic heart failure [DHF]) in 50% of patients with CHF who are > 70 years of
      age. Mortality rates in patients with DHF are comparable to those of patients
      with systolic heart failure, approaching 50% over 5 years. Successful therapy of
      DHF requires making a correct diagnosis, identifying the underlying cause, and
      applying specific and individualized treatment.

PMID- 11205722
TI  - Management of advanced heart failure.
AB  - Congestive heart failure (CHF) due to progressive systolic dysfunction has become
      a modern-day epidemic. Despite the increased incidence and prevalence,
      significant progress has been made in the past 10 to 15 years in the treatment of
      CHF at all stages. The current outlook for patients with newly diagnosed, mild
      heart failure is encouraging. It should be noted, however, that most of the
      morbidity and health care expenditure is incurred by a minority of patients
      diagnosed with CHF who are in the advanced stages of their disease. The thrust of
      this article will be to provide practical advice beyond current guidelines on the
      management of advanced CHF.

PMID- 11205723
TI  - Upcoming therapies for heart failure.
AB  - Treatment of maladaptive neurohormonal activation in congestive heart failure
      (CHF) has been successful because basic cardiovascular science findings have been
      confirmed or dismissed through the use of well-controlled, large-scale clinical
      trials. It should be no surprise that this exciting approach is evolving toward
      novel agents and devices directed toward other pathways involved in CHF
      neurohormonal/cytokine activation. Several of these are in advanced clinical
      development and are likely to play prominent roles in CHF therapy in the near
      future.

PMID- 11205724
TI  - Surgical options for the treatment of heart failure.
AB  - This article will examine the role of specific surgical interventions for
      congestive heart failure (CHF). The most definitive surgical option for severe
      end-stage heart failure is cardiac transplantation. In general, patients
      considered for heart transplant should have severe heart disease despite all
      other therapies with a high risk of death within 1 year. Noncardiac conditions
      that would by themselves shorten life expectancy or increase the risks of
      rejection, infection, or other fatal complication, should not be present.
      However, in light of the limited donor pool, complications associated with long
      term immunosuppressive therapy, and the ever-increasing number of CHF patients,
      the role of cardiac transplantation for CHF will continue to be limited. The
      conduct of and evaluation for cardiac transplantation has been well described
      previously and therefore will not be evaluated in this review (1); however, there
      has been recent progress in the genetic modification of animal organs for
      potential use in transplantation (xenografts) (2). If these developments come to
      fruition, then cardiac transplantation/organ replacement may become a surgical
      option for a much greater number of CHF patients. One alternative approach to
      complete cardiac transplantation is the surgical placement of transformed cells
      into the diseased myocardium, briefly discussed under "Future Directions." This
      article will examine surgical options that are currently being used for CHF
      patients, surgical modalities that are currently under clinical evaluation, and
      finally, potential future therapies with respect to surgical options for heart
      failure.

PMID- 11205725
TI  - Optimizing the science of drug development: opportunities for better candidate
      selection and accelerated evaluation in humans.

PMID- 11205727
TI  - Synergistic effect of enhancers for transdermal drug delivery.
AB  - Transdermal drug delivery offers a non-invasive route of drug administration,
      although its applications are limited by low skin permeability. Various enhancers
      including iontophoresis, chemicals, ultrasound, and electroporation have been
      shown to enhance transdermal drug transport. Although all these methods have been
      individually shown to enhance transdermal drug transport, their combinations have
      often been found to enhance transdermal transport more effectively than each of
      them alone. This paper summarizes literature studies on these combinations with
      respect to their efficacy and mechanisms.

PMID- 11205726
TI  - Protein kinases as therapeutic targets.
AB  - Protein kinases and phosphatases are likely targets for the development of
      therapeutic drugs since they are involved in specific signaling pathways which
      regulate cell functions such as metabolism, cell cycle progression, cell
      adhesion, vascular function and angiogenesis. Protein phosphorylation and
      dephosphorylation serve as molecular switches for modulating these processes and
      the level and duration of each is a highly regulated process in normal cells.
      Several compounds that inhibit the activity of tyrosine kinases are being
      evaluated as cancer therapeutic agents in clinical trials. Diabetes and
      complications of diabetes also involve deregulated levels of protein kinases. New
      approaches for regulating kinase gene expression include specific antisense
      oligonucleotides for inhibiting post-transcriptional processing of the messenger
      RNA, naturally occurring products and their chemical derivatives to inhibit
      kinase activity, and monoclonal antibodies to inhibit receptor linked kinases.
      Inhibition of phosphatases also serves to alter the duration of phosphorylation
      by kinases. Considerations for development of effective inhibitors include non
      specific actions of compounds, cellular uptake, multiple intracellular targets
      that can dilute the effective cellular concentration of an agent, and tissue
      specificity. Kinase inhibitors may allow other therapeutic agents additional time
      to become effective and they may act synergistically with current treatments.

PMID- 11205728
TI  - Generation of micro-particles of proteins for aerosol delivery using high
      pressure modified carbon dioxide.
AB  - PURPOSE: To investigate the feasibility of using the Aerosol Solvent Extraction
      System (ASES) to generate microparticles of proteins suitable for aerosol
      delivery from aqueous-based solutions. METHODS: The ASES technique using high
      pressure carbon dioxide modified with ethanol was utilised for the generation of
      microparticles of proteins (lysozyme, albumin, insulin and recombinant human
      deoxyribonuclease (rhDNase)) from aqueous solutions. Particle size, morphology,
      size distributions and powder aerosol performance were examined. The biochemical
      integrity of the processed proteins was assessed by testing the level of
      molecular aggregation using size exclusion chromatography and by bioassay
      technique for lysozyme. RESULTS: Proteins were precipitated as spherical
      particles ranging in size from 100 to 500 nm. The primary nano-sized particles
      agglomerated to form micron-sized particles during the precipitation process. The
      median size of the particles was a function of the operating conditions. In-vitro
      aerosol performance tests showed that the percent fine particle mass (< 5 microm)
      was approximately 65%, 40% and 20% for lysozyme, albumin and insulin,
      respectively. Negligible loss in the monomer content or biological activity was
      observed for lysozyme. Insulin exhibited slight aggregation and 93% of the
      monomer was retained after processing. Albumin was affected by processing and
      only 50-75% of the monomer was retained compared with 86% in the original
      material. However, rhDNase was substantially denatured during processing as shown
      by the significantly reduced monomer content. CONCLUSIONS: Micron-sized particles
      of lysozyme, albumin and insulin with satisfactory inhalation performance were
      successfully generated from aqueous solutions using the modified ASES technique.
      The biochemical integrity of the processed proteins was a function of the
      operating conditions and the nature of the individual protein.

PMID- 11205729
TI  - Formation and isolation of spherical fine protein microparticles through
      lyophilization of protein-poly(ethylene glycol) aqueous mixture.
AB  - PURPOSE: Preparation of spherical fine protein microparticles by the
      lyophilization of a protein-poly(ethylene glycol) (PEG) aqueous mixture was
      investigated. The main objective was to establish a method for preparing protein
      microparticles suitable for pharmaceutical production. METHODS: Aqueous solutions
      containing bovine serum albumin (BSA) and PEG at various mixing ratios were
      freeze-dried. The lyophilizates were dispersed in methylene chloride and
      subjected to particle size analysis. Analogous studies were performed using
      several model proteins. A phase diagram of the PEG-BSA aqueous system was
      obtained by the titration method. RESULTS: The particle size of BSA decreased as
      the PEG-BSA ratio increased. A bending point was observed in this relationship,
      at which the PEG-BSA ratio coincided with that of the critical point on the phase
      diagram of the PEG-BSA system. These results were explained by the freezing
      induced condensation, followed by phase separation in the PEG-BSA system.
      CONCLUSIONS: Spherical fine protein microparticles were successfully obtained at
      high yield and without any activity loss under optimum conditions. This new
      technology could be applicable to proteins with a wide range of molecular
      weights, and is expected to be developed for dry powder inhalations or long-term
      sustained release microsphere formulations.

PMID- 11205730
TI  - Protein spray-freeze drying. Effect of atomization conditions on particle size
      and stability.
AB  - PURPOSE: To investigate the effect of atomization conditions on particle size and
      stability of spray-freeze dried protein. METHODS: Atomization variables were
      explored for excipient-free (no zinc added) and zinc-complexed bovine serum
      albumin (BSA). Particle size was measured by laser diffraction light scattering
      following sonication in organic solvent containing poly(lactide-co-glycolide)
      (PLG). Powder surface area was determined from the N2 vapor sorption isotherm.
      Size-exclusion chromatography (SEC) was used to assess decrease in percent
      protein monomer. Fourier-transform infrared (FTIR) spectroscopy was employed to
      estimate protein secondary structure. PLG microspheres were made using a non
      aqueous, cryogenic process and release of spray-freeze dried BSA was assessed in
      vitro. RESULTS: The most significant atomization parameter affecting particle
      size was the mass flow ratio (mass of atomization N2 relative to that for liquid
      feed). Particle size was inversely related to specific surface area and the
      amount of protein aggregates formed. Zinc-complexation reduced the specific
      surface area and stabilized the protein against aggregation. FTIR data indicated
      perturbations in secondary structure upon spray-freeze drying for both excipient
      free and zinc-complexed protein. CONCLUSIONS: Upon sonication, spray-freeze dried
      protein powders exhibited friability, or susceptibility towards disintegration.
      For excipient-free protein, conditions where the mass flow ratio was > -0.3
      yielded sub-micron powders with relatively large specific surface areas. Reduced
      particle size was also linked to a decrease in the percentage of protein monomer
      upon drying. This effect was ameliorated by zinc-complexation, via a mechanism
      involving reduction in specific surface area of the powder rather than
      stabilization of secondary structure. Reduction of protein particle size was
      beneficial in reducing the initial release (burst) of the protein encapsulated in
      PLG microspheres.

PMID- 11205732
TI  - An increased throughput method for the determination of partition coefficients.
AB  - PURPOSE: To present an increased throughput automated shake-flask method for the
      direct determination of the partition coefficients of solutes between octan-1-ol
      and buffer. METHOD: The traditional shake-flask method has been transferred onto
      96-well plate technology and a robotic liquid handler has been used for sample
      preparation. A custom programmed Gilson autosampler samples the organic and
      aqueous phases directly from the plate, circumventing the need for any manual
      separation. Analyses are performed by reverse phase high performance liquid
      chromatography (RP-HPLC). Generic fast gradient RP-HPLC conditions are used to
      eliminate chromatographic method development time and reduce analysis time.
      RESULTS: A full validation of the automated method is presented for a range of
      compounds with log D values between -2 and 4. CONCLUSIONS: The advantages and
      limitations of this direct measurement method are discussed. The use of this
      methodology provides a means to rapidly assess log D values for large compound
      arrays.

PMID- 11205731
TI  - Use of artificial neural networks to predict drug dissolution profiles and
      evaluation of network performance using similarity factor.
AB  - PURPOSE: To use artificial neural networks for predicting dissolution profiles of
      matrix-controlled release theophylline pellet preparation, and to evaluate the
      network performance by comparing the predicted dissolution profiles with those
      obtained from physical experiments using similarity factor. METHODS: The Multi
      Layered Perceptron (MLP) neural network was used to predict the dissolution
      profiles of theophylline pellets containing different ratios of microcrystalline
      cellulose (MCC) and glyceryl monostearate (GMS). The concepts of leave-one-out as
      well as a time-point by time-point estimation basis were used to predict the rate
      of drug release for each matrix ratio. All the data were used for training,
      except for one set which was selected to compare with the predicted output. The
      closeness between the predicted and the reference dissolution profiles was
      investigated using similarity factor (f2). RESULTS: The f2 values were all above
      60, indicating that the predicted dissolution profiles were closely similar to
      the dissolution profiles obtained from physical experiments. CONCLUSION: The MLP
      network could be used as a model for predicting the dissolution profiles of
      matrix-controlled release theophylline pellet preparation in product development.

PMID- 11205733
TI  - Application of high performance liquid chromatography coupled with ultraviolet
      spectroscopy and electrospray mass spectrometry to the characterisation of
      ellagitannins from Terminalia macroptera roots.
AB  - PURPOSE: Terminalia macroptera roots are used in Guinea-Bissau and other West
      African countries to treat infectious diseases like gonorrhoea. Previous work
      showed an ethanol extract of T. macroptera roots (T) to have an in vitro
      antimicrobial profile against Neisseria gonorrhoae (including resistant strains)
      and enteropathogenic agents. The most active fractions of this extract were
      identified as the diethyl ether (T2) and water (T5) fractions. The aim of the
      present study was the identification of major compounds present in T and
      simultaneously in T2 or T5. METHODS: The T extract and T2 and T5 fractions were
      analysed by high performance liquid chromatography coupled with ultraviolet
      photodiode array (LC-UV) spectroscopy and electrospray ionization mass
      spectrometry (ES-MS). These analyses indicated the presence of ellagitannin
      derivatives. In order to confirm the identities of the detected compounds, they
      were isolated from T2 and T5 by preparative chromatographic techniques and
      identified by spectroscopic methods including tandem mass spectrometry. RESULTS:
      By using LC-UV-ES-MS, four major compounds (ellagic acid, gallic acid,
      punicalagin, terchebulin) could be identified in the T extract. Three other
      compounds (3,3'di-O-methylellagic acid, 3,4,3',4'-tetra-O-methylellagic acid,
      terflavin A) were also isolated and identified. CONCLUSIONS: LC-UV-ES-MS is a
      useful technique for the analysis of mixtures containing ellagitannins.

PMID- 11205735
TI  - In vivo study of the effect of valpromide and valnoctamide in the pilocarpine rat
      model of focal epilepsy.
AB  - PURPOSE: We evaluated the effectiveness of the commonly used antiepileptic drug
      sodium valproate (400 mg/kg) and two of its amide derivatives, valpromide and
      valnoctamide (both 100 mg/kg), in an in vivo rat model of focal epilepsy. Our
      main interest was to get insight into possible changes in extracellular amino
      acid neurotransmitter levels following administration of the drugs, both in
      control and in epileptic conditions. METHODS: Seizures were evoked in freely
      moving rats by intrahippocampal administration of pilocarpine via a microdialysis
      probe (10 mM for 40 min at 2 microl/min). Microdialysis was also used as in vivo
      sampling technique and alterations in extracellular hippocampal glutamate and
      GABA levels were monitored. Electrophysiological evidence for the presence or
      absence of seizures was simultaneously recorded with electrocorticography.
      RESULTS: The focally evoked pilocarpine-induced seizures were completely
      prevented by acute intraperitoneal pretreatment with each of the three drugs in
      the respective doses. Effective protection was reflected in the
      electrocorticographic recordings and in the lack of sustained elevations of the
      extracellular glutamate levels after pilocarpine perfusion. Little effects were
      seen on the basal extracellular amino acid levels after systemic administration
      of each of the compounds, nor after the intrahippocampal administration of sodium
      valproate. CONCLUSIONS: Valnoctamide and valpromide (100 mg/kg) proved to be at
      least as effective as their parent compound sodium valproate (400 mg/kg) against
      pilocarpine-induced seizures. All three compounds however failed to induce
      significant initial alterations in extracellular hippocampal GABA release. This
      questions the enhancement of GABA-mediated inhibition as being one of their
      mechanisms of action.

PMID- 11205734
TI  - Dextran-methylprednisolone succinate as a prodrug of methylprednisolone:
      immunosuppressive effects after in vivo administration to rats.
AB  - PURPOSE: To study the immunosuppressive activities of a macromolecular prodrug of
      methylprednisolone (MP), dextran-methylprednisolone succinate (DEX-MPS), in rats.
      METHODS: Single 5 mg/kg (MP equivalent) doses of MP or DEX-MPS were administered
      intravenously to rats, and blood and spleen samples were collected over 96 h. The
      immunosuppressive activity was determined by the effects of the free or dextran
      conjugated drug on the mitogen-stimulated spleen lymphocyte proliferation.
      Additionally, the number of lymphocytes in the spleen cell suspensions was
      estimated. Further, the plasma and spleen concentrations of the conjugated and
      free MP were determined using size-exclusion and reversed-phase chromatographic
      methods, respectively. RESULTS: Both MP and DEX-MPS injections resulted in the
      inhibition of the spleen lymphocyte proliferation. However, the maximal effect of
      DEX-MPS was significantly (P < 0.003) more intense (approximately 100%
      inhibition) and delayed (24 h) relative to that of MP (approximately 50%
      inhibition at 2 h). The DEX-MPS injection also resulted in a significantly (P <
      0.0001) higher decline in the estimated number of spleen lymphocytes
      (approximately 80% at 24 h), compared with the MP injection (approximately 30% at
      2 hr). Whereas the plasma and spleen concentrations of MP could not be measured
      at > or = 2 h after the drug injection, relatively high concentrations of DEX-MPS
      persisted in plasma and spleen for 24 h and 96 h, respectively. CONCLUSION:
      Dextran-methylprednisolone conjugate can effectively deliver the corticosteroid
      to its site of action for immunosuppression, resulting in more intense and
      sustained effects when compared with the free drug administration.

PMID- 11205736
TI  - Does epidermal turnover reduce percutaneous penetration?
AB  - PURPOSE: After its removal from the skin surface, chemical remaining within the
      skin can become systemically available. The fraction of chemical in the skin that
      eventually enters the body depends on the relative rates of percutaneous
      transport and epidermal turnover (i.e., stratum corneum desquamation). Indeed,
      some investigators have claimed that desquamation is an efficient mechanism for
      eliminating dermally absorbed chemical from the skin. METHODS: The fate of
      chemical within the skin following chemical contact was examined using a
      mathematical model representing turnover of and absorption into the stratum
      corneum and viable epidermis. The effects of turnover rate, exposure duration,
      penetrant lipophilicity, and lag time for chemical diffusion were explored.
      RESULTS: These calculations show that significant amounts of chemical can be
      removed from skin by desquamation if epidermal turnover is fast relative to
      chemical diffusion through the stratum corneum. However, except for highly
      lipophilic and/or high molecular weight (>350 Da) chemicals, the normal epidermal
      turnover rate is not fast enough and most of the chemical in the skin at the end
      of an exposure will enter the body. CONCLUSIONS: Epidermal turnover can
      significantly reduce subsequent chemical absorption into the systemic circulation
      only for highly lipophilic or high molecular weight chemicals.

PMID- 11205737
TI  - The in vitro cell association of invasin coated polylactide-co-glycolide
      nanoparticles.
AB  - PURPOSE: To determine the effect of particle size and ligand surface density on
      the cellular association of poly lactide-co-glycolide nanoparticles covalently
      coated with bacterial invasin. METHODS: Poly lactide-co-glycolide nanoparticles
      containing a flourescent probe were prepared at four diameters 155 nm, 200 nm,
      375 nm and 600 nm using standard techniques. Bacterial invasin was covalently
      coupled to the particles surface at varying surface concentrations using a water
      soluble carbodiimide. The modified particle's cellular association with HEp2 2B
      cells in tissue culture was determined using flow cytometry. RESULTS: Cellular
      association of modified nanoparticles was time dependent, abolished at low
      temperature, competitively inhibited by free invasin or the RGD peptide ligand
      and saturable. Increased cell association was produced by increasing the
      particle's surface invasin concentration however, this effect was size dependent.
      Small particles (155 nm and 200 nm) exhibiting a maximal association with
      increasing invasin concentration whilst the larger particles (375 nm and 600 nm)
      provide a minimum at low invasin concentrations. CONCLUSIONS: Modified particle
      cell association provided results commensurate with a receptor dependent uptake
      mechanism related to the presence of invasin. The size and surface concentration
      dependency however illustrate that application of these ligands to particulate
      drug delivery or targeting systems will be controlled by their natural cellular
      association properties.

PMID- 11205738
TI  - Absorption and disposition of a selective aldosterone receptor antagonist,
      eplerenone, in the dog.
AB  - PURPOSE: The present study was conducted to characterize the pharmacokinetics of
      eplerenone (EP), a selective aldosterone receptor antagonist, and its open
      lactone ring form in the dog. METHODS: Pharmacokinetic studies of EP were
      conducted in dogs following i.v., oral, and rectal dosing (15 mg/kg) and
      following intragastric, intraduodenal, intrajejunal, and intracolonic dosing (7.5
      mg/kg). RESULTS: After oral administration, the systemic availability of EP was
      79.2%. Systemic availabilities following administration via other routes were
      similar to that following oral administration. The half-life and plasma clearance
      of EP were 2.21 hr and 0.329 l/kg/hr, respectively. Plasma concentrations of the
      open lactone ring form were lower than EP concentrations regardless of the route
      of administration. The C-14 AUC in red blood cells was approximately 64% and 68%
      of the plasma AUC for i.v. and oral doses. Percentages of the dose excreted as
      total radioactivity in urine and feces were 54.2% and 40.6%, respectively, after
      i.v. administration, and 40.7% and 52.3%, respectively, after oral
      administration. The percentages of the dose excreted in urine and feces as EP
      were 13.7% and 2.5%, respectively, after i.v. administration, and 2.1% and 4.6%
      after oral administration, respectively. Approximately 11% and 15% of the doses
      were excreted as the open form following i.v. and oral doses. CONCLUSIONS: EP was
      rapidly and efficiently absorbed throughout the gastrointestinal tract, resulting
      in a good systemic availability. The drug did not preferentially accumulate in
      red blood cells. EP was extensively metabolized; however, first-pass metabolism
      after oral and rectal administration was minimal. EP and its metabolites appear
      to be highly excreted in the bile.

PMID- 11205740
TI  - Physical characterization of large porous particles for inhalation.

PMID- 11205739
TI  - The role of metabolites in bioequivalency assessment. III. Highly variable drugs
      with linear kinetics and first-pass effect.
AB  - PURPOSE: Simulated pharmacokinetic (PK) studies were done to determine the effect
      of intrinsic clearance (CL(INT)) on the probability of meeting bioequivalence
      criteria for extent (AUC) and rate (Cmax) of drug absorption when the absorption
      rate and fraction absorbed (F) were formulated either to be equivalent or to
      differ by 25%. METHODS: Simulated PK studies were done using a linear first-pass
      model with CL(INT) values ranging from 15 L/HR to 900 L/HR. Test/Reference
      absorption rate constants (Ka) and fraction absorbed (Fa) ratios of 1.0 or 1.25
      were used for all simulations. The impact of the value of CL(INT) and its
      intrasubject variation upon the probability of concluding bioequivalence at the
      two different Ka and F ratios was studied. Additionally, the effect of fraction
      metabolized i.v., (Fm) on the probabilities of concluding equivalence was studied
      at values of 0.25 and 0.75. RESULTS: When CL(INT) values were raised above those
      for liver blood flow, the frequency of trials in which bioequivalence was
      correctly declared decreased when parent AUC was used as a bioequivalence
      criterion. Only when CL(INT) exceeded liver blood flow did the metabolite become
      important in assessing extent of absorption. CONCLUSIONS: The Cmax for the parent
      drug provided the most accurate assessment of bioequivalence. The Cmax for the
      metabolite was insensitive to changes related to rate of input, and when CL(INT)
      exceeded liver blood flow, evaluation of the metabolite Cmax data may lead to a
      conclusion of bioequivalence for products that were not.

PMID- 11205741
TI  - Signal transducers and activators of transcription 5B potentiates v-Src-mediated
      transformation of NIH-3T3 cells.
AB  - Previously, we reported that whereas both signal transducers and activators of
      transcription (STAT) 5A and STAT5B can be activated with respect to tyrosine
      phosphorylation and DNA binding potential by Src kinase, only STAT5B was
      translocated to the nucleus, where it presumably activates unique downstream
      responses. To help elucidate the functional consequences of STAT5B activation by
      v-src, the properties of stably transfected NIH-3T3 cells containing both an
      intact and a dominant negative, COOH-terminal-truncated isoform of STAT5B were
      investigated. STAT5B enhanced the transforming potential of v-Src as reflected by
      both an increase in focus formation and growth in soft agar. STAT5B also enhanced
      v-Src-induced cell cycle progression and cell motility in NIH-3T3 cells.
      Furthermore, the dominant negative, COOH-terminal-truncated isoform of STAT5B was
      able to partially suppress v-Src-mediated cell transformation. These results
      support the hypothesis that STAT5B may enhance Src/Abl-induced tumorigenesis.
      Accordingly, the equilibrium between STAT5B and STAT5A and their naturally
      occurring truncated forms may therefore play a key role in the etiology of
      certain cancers.

PMID- 11205742
TI  - Morphologic conversion of a neuroblastoma-derived cell line by E6-mediated p53
      degradation.
AB  - Neuroblastoma-derived tumor cells, unlike cells from other tumor types,
      characteristically express a wildtype but cytoplasmically sequestered p53
      protein. To ascertain whether the p53 in these cells retained any physiological
      activity, we inactivated it in SK-N-SH cells, a neuroblastoma-derived cell line,
      by introducing the human papilloma virus type 16 E6 expression plasmid. Parent SK
      N-SH cell cultures are composed of two cell types exhibiting characteristic
      morphologies designated neuroblastic (N-type) or substrate-adherent fibroblastic
      (S-type) cells, both of which have been shown to spontaneously transdifferentiate
      or interconvert. We report here that down-regulation of p53 resulted in
      conversion of SK-N-SH cells to the substrate-adherent fibroblast-like S-type
      cells. The morphologic conversion was accompanied by a loss of neurofilament
      expression, a marker for the neuronal N-type cells, an increase in the expression
      of vimentin, and a lack of responsiveness to retinoic acid-induced neuronal
      differentiation. Importantly, we did not observe N-type cells in the E6
      transfected cell population, suggesting that they were incapable of
      transdifferentiating to the N-type morphology. We also tested the ability of
      these E6-transfected S-type cells to form colonies in soft agar and observed a
      markedly reduced capacity of these cells to do so when compared with the parent
      and mutant E6-transfected cells. These results suggest that p53 is required for
      the maintenance of the neuroblastic tumorigenic phenotype.

PMID- 11205743
TI  - Polo-like kinase interacts with proteasomes and regulates their activity.
AB  - The polo-like kinase (Plk) has been shown to be associated with the anaphase
      promoting complex at the transition from metaphase to anaphase and to regulate
      ubiquitination, the process that targets proteins for degradation by proteasomes.
      In this study, we have identified proteasomal proteins interacting with Plk by
      mass spectrometry and found that Plk and 20S proteasome subunits could be
      reversibly immunoprecipitated from both human CA46 cells and HEK 293 cells
      transfected with HA-Plk. Furthermore, both coprecipitated Plk and baculovirus
      expressed Plk were able to phosphorylate proteasome subunits, and metabolic
      labeling studies indicate that Plk is partially responsible for the
      phosphorylation of 20S proteasome subunits C9 and C8 in vivo. In addition,
      phosphorylation of proteasomes by Plk enhanced proteolytic activity toward an
      artificial substrate Suc-L-L-V-Y-AMC in vitro and in vivo. Finally, we were also
      able to detect Plk associated with 26S proteasomes under certain conditions.
      Together our results suggest that Plk is an important mitotic regulator of
      proteasome activity.

PMID- 11205744
TI  - Differences in early and late responses between neurotrophin-stimulated trkA- and
      trkC-transfected SH-SY5Y neuroblastoma cells.
AB  - Despite their sympathetic neuroblast origin, highly malignant neuroblastoma
      tumors and derived cell lines have no or low expression of the neurotrophin
      receptor genes, trkA and trkC. Expression of exogenous trkA in neuroblastoma
      cells restores their ability to differentiate in response to nerve growth factor
      (NGF). Here we show that stable expression of trkC in SH-SY5Y neuroblastoma cells
      resulted in morphological and biochemical differentiation upon treatment with
      neurotrophin-3 (NT-3). To some extent, trkA- and trkC-transfected SH-SY5Y (SH
      SY5Y/trkA and SH-SY5Y/trkC) cells resembled one another in terms of early
      signaling events and neuronal marker gene expression, but important differences
      were observed. Although induced Erk 1/2 and Akt/PKB phosphorylation was stronger
      in NT-3-stimulated SH-Y5Y/trkC cells, activation of the immediate-early genes
      tested was more prominent in NGF-treated SH-SY5Y/ trkA cells. In particular, c
      fos was not induced in the SH-SY5Y/trkC cells. There were also phenotypic
      differences. The concentrations of norepinephrine, the major sympathetic
      neurotransmitter, and growth cone-located synaptophysin, a neurosecretory granule
      protein, were increased in NGF-treated SH-SY5Y/trkA but not in NT-3-treated SH
      SY5Y/trkC cells. Our data suggest that NT-3/p145trkC and NGF/p140trkA signaling
      differ in some aspects in neuroblasoma cells, and that this may explain the
      phenotypic differences seen in the long-term neurotrophin-treated cells.

PMID- 11205745
TI  - Differentiation of Ly49s-positive or -negative natural killer cells is inhibited
      by anti-H-2b monoclonal antibodies acting at the level of bone marrow progenitors
      from B6 mice.
AB  - To investigate the role of MHC class I on in vitro differentiation of natural
      killer (NK) cells, a CD44low/-CD2-classlow population was isolated from mouse
      bone marrow. This population, which lacked expression of NK-1.1, Ly49A, Ly49C/I,
      and Ly49G, generated populations of NK-1.1+ NK cells expressing Ly49A, Ly49C/I,
      or Ly49G when cocultured for 13 days with syngeneic supportive stromal cells in
      the presence of interleukin 2. Ly49A and Ly49C/I were absent on the progeny of
      progenitors tested after 7 days of culture but were expressed as a late event
      together with low-level expression of NK-1.1, from day 8 of culture. The addition
      of anti-H-2b monoclonal antibody to cultures at day 0 inhibited proliferation of
      progenitors supported by either syngeneic, allogeneic, or H-2b-deficient stromal
      cells, thus suggesting that the effect was not exerted on stromal cells.
      Additional analyses demonstrated that class Ilow progenitors generated class I+
      cells on which the anti-H-2b monoclonal antibody exerted its inhibitory effect.

PMID- 11205747
TI  - [The diagnostic value of modelling the urinary bladder wall in women with pelvis
      minor tumors].
AB  - Basing on the authors' own observations and literature data diagnostic value of
      different imaging techniques was presented in differentiating pathologic changes
      deduced from deformations of urinary bladder walls. Modelling of the walls has
      proved to enable the localisation of the tumour without determining its
      character. The degree of modelling of urinary bladder wall, however, is
      proportionate to the size of tumour. In a considerable number of cases it was
      possible to exclude infiltration of the bladder wall or to show overgrowing it by
      neoplastic mass.

PMID- 11205746
TI  - Mechanism of induction of transforming growth factor-beta type II receptor gene
      expression by v-Src in murine myeloid cells.
AB  - Transforming growth factor (TGF)-beta1 plays an important role during
      hematopoiesis. Previously, we had shown that the growth of a v-Src-transformed
      myeloid cell line was markedly more inhibited by TGF-beta treatment when compared
      with the wild-type myeloid cell line. To investigate the increased growth
      sensitivity of the v-Src-transformed myeloid cell line, 32D-src, to TGF-beta, we
      examined expression of the TGF-beta type II receptor (TGF-beta RII) gene in
      myeloid cell lines. Northem blot analysis showed that expression of approximately
      8- and 6-kb species of TGF-beta RII transcripts was markedly increased in the 32D
      src cell line. The expression of the TGF-beta RII promoter linked to a reporter
      gene was increased 23-fold by v-Src. DNA transfection and electrophoretic
      mobility shift assay revealed that v-Src induces TGF-beta RII promoter activity
      through an AP1/ATF2-like sequence (-219 to -172), ETS binding sites (+1 to +36),
      and the inverted CCAAT box (-81 to -77). Novel DNA-protein complexes with ETS
      binding sites are significantly increased in v-src-transformed cell lines
      compared with the control cell line. These results suggest that v-Src induces
      activity of the TGF-beta RII promoter through multiple elements by inducing
      expression of nuclear proteins interacting with these elements.

PMID- 11205748
TI  - [Historical aspects of dental caries and its treatment].
AB  - The study presents the history of scientific research of caries incidence on the
      basis of the archaeological and excavated remains and other historical sources.
      The analysis of teeth curing was carried out on historical grounds covering early
      ancient and medieval methods as well as contemporary ways of caries prevention.

PMID- 11205749
TI  - Risk factors in patients after severe head injury.

PMID- 11205750
TI  - Caries intensity, salivary Streptococcus mutans and Lactobacillus counts in 12
      year-old children.

PMID- 11205751
TI  - Own observations on the use of Esputicon to eliminate gases from the pancreatic
      area during ultrasound examinations.

PMID- 11205752
TI  - Health education of multiple sclerosis patients and their families.

PMID- 11205753
TI  - Spinal epidural abscess conservatively treated--a case report.

PMID- 11205754
TI  - Promotion of nursing services.

PMID- 11205755
TI  - Realising nursing function in neurological ward.

PMID- 11205756
TI  - The use of virtual 3D CT in diagnosing some intracranial diseases.

PMID- 11205757
TI  - The influence of ethanol and different free radical scavengers on the lipid
      peroxidation process and antioxidant status in the rats' gastric mucosa.

PMID- 11205758
TI  - Ultrastructural examination of hippocampal cells after experimental
      administration of dexamethasone.

PMID- 11205759
TI  - Neurotoxic effects of glucocorticosteroids--morphological examinations of
      hippocampal cells after experimental administration of dexamethasone.

PMID- 11205760
TI  - Selected cytokines and acute phase proteins in psoriatic patients treated with
      cyclosporin A or Re-PUVA methods.

PMID- 11205761
TI  - Knowledge of prevention of cardiovascular diseases in fourth-year students of
      Pedagogical and Psychological Faculty, Maria Curie-Sklodowska University in
      Lublin.

PMID- 11205762
TI  - [Importance of dynamic computed tomography in detecting and evaluating liver
      cavernous hemangioma].
AB  - Dynamic sequential computed tomography (d-CT) was performed in 83 liver
      hemangiomas in 71 patients. In study group single lesions were present in 62
      patients, 9 patients had two or more. In early phase (30-150 s) (79%) hemangiomas
      were peripherally hyperdense. In the delayed phase (2-7 min) 27% were totally
      hyperdense, 48% were isodense and 18% were of mixed density. We conclude that the
      contrast enhancement pattern of hemangiomas seen in dynamic computed tomography
      is useful in detecting and in differential diagnosis of these tumors.

PMID- 11205763
TI  - The influence of natrium fluoride on serum protein and cholesterol levels in rats
      with adriblastin-induced nephrotic syndrome.

PMID- 11205764
TI  - Dynamic hepatic CT: uniphasic and biphasic contrast medium injection protocols.

PMID- 11205765
TI  - Realisation of patients' rights in the Internal Diseases Department of the
      Provincial Specialistic Hospital in Lublin.

PMID- 11205766
TI  - Influence of hypoxia-induced convulsions on morphological structure of
      hippocampal cells.

PMID- 11205767
TI  - Knowledge of health consequences of nicotinism among secondary school pupils.
      Young people's attitudes towards passive smoking and their opinions about anti
      nicotine act's regulations.
AB  - The aim of the paper was to examine the level of knowledge of health conquences
      of nicotinism among secondary school pupils. It was also intended to determine
      what attitudes towards passive smoking and towards anti-nicotine act that is
      presently in force, they have. The results of the survey were analysed according
      to sex, class that the subjects attended and the fact if they were active
      smokers.

PMID- 11205768
TI  - Stress and methods of dealing with it among the students of the Faculty of
      Medicine of Medical University in Lublin.
AB  - The aim of the paper was to determine the level of stress sensibility of   the
      students under examinations, to reconize its main causes as well as to determine
      what methods are used by students in order to overcome stress and how they
      evaluate the efficiency of these methods. The analysis of these kinds of
      behaviour according to such factors: sex, social background and temporary or
      permanent residence of the subject was carried out.

PMID- 11205769
TI  - Stress and methods of dealing with it among students of Arts Departments at the
      UMCS.
AB  - The aim of the paper was to determine the level of stress-perception for the
      students under examination, to recognise its main causes as well as to determine
      what methods are used by students in order to help them overcome stress. The
      analysis of these behaviours was carried out according to sex, social background
      and temporary or permanent residence of the subjects. The research results were
      confronted with similar survey carried out among students of the Faculty of
      Medicine at Medical University.

PMID- 11205770
TI  - Estimation of platelet activation and factor X activity in plasma of hypertensive
      patients.

PMID- 11205771
TI  - Morphological and clinical characteristics of renal cancers accidentally detected
      with ultrasound examination.

PMID- 11205772
TI  - tRNA of neoplastic tissues.

PMID- 11205773
TI  - Prevalence of various pathogens in patients treated in intensive care unit during
      the 7-year period.

PMID- 11205775
TI  - The correlation between activity and a circulating lymphocyte pattern in plasma
      of patients with psoriasis preceded by an infection.

PMID- 11205774
TI  - [Usefulness of current and retrospective markers of glycemia for early
      prognostication of ischemic stroke in diabetics and non-diabetics].
AB  - Diabetes mellitus is associated with an increased incidence of ischaemic stroke
      but it is not established whether it may exacerbate its clinical course and
      prognosis. In the study we have assessed relations of fasting (1st-2nd day of
      illness) and pre-stroke glycaemia (measured as HbA1 and FA) with recent clinical
      manifestation and outcome within one month in 22 diabetics and 37 non-diabetics
      with ischaemic brain infarction in the internal carotid territory. Merely
      enhanced HbA1 in the majority of non-diabetic stroke patients confirmed impaired
      pre-stroke glucose tolerance but did not influence severity of hemiparesis and
      further prognosis. Abnormally high both HbA1 and dFA in diabetics, reflecting non
      sufficient metabolic control of illness did not exacerbate acute manifestation of
      stroke and outcome. Fasting post-stroke glycaemia that expresses a stress
      response of brain origin was determinative for clinical state but not for one
      month prognosis in diabetics and non-diabetics with brain infarction.

PMID- 11205776
TI  - Congenital malformations in children up to 1 year of age in the autopsy material
      from the Department of Pathomorphology, Medical Academy in Lublin in the years
      1984-1998.

PMID- 11205777
TI  - Partial purification and characterization of enzymes degrading trehalose in
      mycobacteria.

PMID- 11205778
TI  - Proteolytic enzymes in the treatment of acute pancreatitis.

PMID- 11205779
TI  - Activity of cathepsins and morphological changes in the rat's liver after
      ranitidine and famotidine administration.

PMID- 11205780
TI  - Sudden deafness of vascular origin.

PMID- 11205782
TI  - Histo- and cytopathologic remote diagnosis (telepathology). Preliminary report.

PMID- 11205781
TI  - Evaluation of classes in medicine of catastrophe by students of Faculty of
      Medicine at the University School of Medicine in Lublin.

PMID- 11205783
TI  - CT imaging of the evolution of the post-traumatic intracerebral haematoma in
      children.

PMID- 11205784
TI  - Usefulness of CT in diagnosis of lung mycosis in children with acute leukemia.

PMID- 11205785
TI  - Analysis of mitochondrial tRNAs in hyperthyroidism.

PMID- 11205786
TI  - Serum sialic acid concentration and glycoprotein sialosylation in relation to
      temporary development of experimental alloxan induced diabetes in rabbits.

PMID- 11205787
TI  - Evaluation of occurrences of child maltreatment in teachers' opinions.
AB  - The fact of maltreatment is recorded in case of an intended or unintended action
      of the adult that has a negative influence on the child's health or
      psychophysical development. Apart from the term: mal-treatment a number of other
      terms are widely used: injuring, abuse, violence, harassment, ill-treatment.

PMID- 11205788
TI  - Social and medical factors of risk of premature births and prematurity.
AB  - The aim of the study is to estimate the influence of medical and social factors
      on the occurrence of    premature births.

PMID- 11205789
TI  - The evaluation of the first period of the health service reform.
AB  - The aim of the study was to give preliminary estimation of functioning of the
      health service after the introduction of the reform on the basis of the opinions
      of the patients who used the services of the public health institutions.

PMID- 11205790
TI  - Evaluation of physical health of 14-year-old students attending primary schools
      in Lublin.

PMID- 11205791
TI  - Pulp stones in chambers of permanent molar teeth.

PMID- 11205792
TI  - The evaluation of root canal width by means of digital radiography.

PMID- 11205793
TI  - Vesico-intestinal fistulas, vesico-sigmoid fistula in the course of sigmoid
      cancer.

PMID- 11205794
TI  - Epilepsy associated with neoplastic brain tumours. A clinical study.

PMID- 11205795
TI  - Otoacoustic emission in dialysed children.

PMID- 11205796
TI  - Fascicular structure of the mixed nerves of the brachial plexus.

PMID- 11205797
TI  - Experimental studies of Tetric Ceram composite material and Syntac Sprint bonding
      system applied to dental pulp and hard tissues in rats.

PMID- 11205798
TI  - Changes in the excretion of glycosaminoglycans with urine in patients with kidney
      stones.

PMID- 11205799
TI  - Serum lipid profile in psoriatic females.

PMID- 11205800
TI  - Susceptibility to selected antibiotics of Streptococcus pneumoniae and
      Streptococcus pyogenes strains isolated from patients with respiratory tract
      infections.

PMID- 11205801
TI  - Cutaneous carcinoma in own investigations.

PMID- 11205802
TI  - A presentation of immunity against diphtheria in various age groups of Lublin
      population.

PMID- 11205803
TI  - Microsurgery and balneotherapy in the treatment of hyperplastic laryngitis.

PMID- 11205804
TI  - The effect of working environment on mucous membrane of the upper respiratory
      tract and organ of hearing in miners of the Lublin Coal mines.

PMID- 11205805
TI  - Ultrasonographic estimation of the size of spleen in children with psoriasis.

PMID- 11205806
TI  - [An unusual case of intracranial osteoma in a CT image].
AB  - Osteomas are benign tumors that may cause life-threatening complications in
      intracranial localisation. A rare case of asymptomatic osteoma growing
      intracranially is reported. The review of literature on this subject is
      presented.

PMID- 11205807
TI  - Nucleolar organizer regions (NORs) as a prognostic factor in patients with
      squamous-cell oesophageal cancer.

PMID- 11205808
TI  - [Activity of malondialdehyde in rat plasma after H2 histamine receptor blockade].
AB  - The study evaluates the effect of cimetidine (C), ranitidine (R) and famotidine
      (F) on the level of the plasma malondialdehyde (MDA). The tested drugs were given
      intraperitoneally to the male Wistar rats twice a day, during 6 weeks' period, in
      two doses. CI--2.85 mg/kg body weight (b.w.), R1--0.71 mg/kg b.w., F1--0.28 mg/kg
      b.w. The second doses (C2, R2, F2) were 10 times higher than C1, R1, F1. At the
      end of the 6th week of the experiment half of the animals were terminated. The
      remaining rats were kept for the next 6 weeks without any medications and were
      killed at the end of 12th week of the experiment. Blood was taken from still
      beating heart and centrifuged. The level of the MDA was determined from the
      plasma and compared to the 1 mg of the blood protein. None of administered H2
      blockers changed the malondialdehyde level in serum of the experimental rats.

PMID- 11205809
TI  - Embryotoxic effect of low doses of caffeine.

PMID- 11205811
TI  - Development of nursing time standards as a problem of optimalisation of health
      care system management. I. Evaluation of the correctness of patients'
      classification.

PMID- 11205810
TI  - [Ultrasonographic diagnosis of Meckel's diverticulum--case report].
AB  - Meckel's diverticulum is the congenital anomaly of the gastrointestinal tract
      affecting about 2% of the population. It is a true diverticulum containing all
      layers of the ileum wall. Heterotopic tissue is frequently present (25%): gastric
      mucosa, duodenal mucosa, jejunal mucosa and pancreatic tissue. Meckel's
      diverticulum is localized about 50 cm from the ileo-colic valve on the external
      border of the ileum. Most of Meckel's diverticula are clinically silent; clinical
      symptoms (19%) are in cases of complications such as: strangulation of the bowel
      in a ring formed by the diverticulum, intussusception of the diverticulum into
      the ileum, volvulus, incarceration of the diverticulum in hernia, tumour
      originating in the diverticulum. The diagnosis of Meckel's diverticulum is very
      difficult. The most useful in the diagnosis are plain abdominal radiographs,
      barium studies, CT, sonography and scintigraphy Abdominal sonography shows a
      tubular fluid structure localized far from the coecum. The wall of the
      diverticulum is swollen and in the lumen are chyme or fat.

PMID- 11205812
TI  - Development of nursing time standards as a problem of optimalisation of health
      care system management. II. Comparative analysis of demand for nursing care.

PMID- 11205813
TI  - The exhumation of a World War II Jewish grave.
AB  - The results of the exhumation of a mass grave from the time of the World War II
      are presented. In the course of exhumation it was established that the subjects
      were 190 individuals (men, women and children) of Jewish origin. All had died a
      violent death due to gunshot or mechanical injury.

PMID- 11205814
TI  - Immunological monitoring of chronic pleural empyema patients.

PMID- 11205815
TI  - Acute pulmonary effects of ultrafine particles in rats and mice.
AB  - Ambient fine particles consist of ultrafine particles (< 100 nm) and accumulation
      mode particles (approximately 100 to 1,000 nm). Our hypothesis that ultrafine
      particles can have adverse effects in humans is based on results of our earlier
      studies with particles of both sizes and on the finding that urban ultrafine
      particles can reach mass concentrations of 40 to 50 micrograms/m3, equivalent to
      number concentrations of 3 to 4 x 10(5) particles/cm3. The objectives of the
      exploratory studies reported here were to (1) evaluate pulmonary effects induced
      in rats and mice by ultrafine particles of known high toxicity (although not
      occurring in the ambient atmosphere) in order to obtain information on principles
      of ultrafine particle toxicology; (2) characterize the generation and coagulation
      behavior of ultrafine particles that are relevant for urban air; (3) study the
      influence of animals' age and disease status; and (4) evaluate copollutants as
      modifying factors. We used ultrafine Teflon (polytetrafluoroethylene [PTFE]*)
      fumes (count median diameter [CMD] approximately 18 nm) generated by heating
      Teflon in a tube furnace to 486 degrees C to evaluate principles of ultrafine
      particle toxicity that might be helpful in understanding potential effects of
      ambient ultrafine particles. Teflon fumes at ultrafine particle concentrations of
      approximately 50 micrograms/m3 are extremely toxic to rats when inhaled for only
      15 minutes. We found that neither the ultrafine Teflon particles alone when
      generated in argon nor the Teflon fume gas-phase constituents when generated in
      air were toxic after 25 minutes of exposure. Only the combination of both phases
      when generated in air caused high toxicity, suggesting the existence of either
      radicals on the particle surface or a carrier mechanism of the ultrafine
      particles for adsorbed gas-phase compounds. We also found rapid translocation of
      the ultrafine Teflon particles across the epithelium after their deposition,
      which appears to be an important difference from the behavior of larger
      particles. Furthermore, the pulmonary toxicity of the ultrafine Teflon fumes
      could be prevented by adapting the animals with short 5-minute exposures on 3
      days prior to a 15-minute exposure. This shows the importance of preexposure
      history in susceptibility to acute effects of ultrafine particles. Aging of the
      fresh Teflon fumes for 3.5 minutes led to a predicted coagulation resulting in
      particles greater than 100 nm that no longer caused toxicity in exposed animals.
      This result is consistent with greater toxicity of ultrafine particles compared
      with accumulation-mode particles. When establishing dose-response relationships
      for intratracheally instilled titanium dioxide (TiO2) particles of the size of
      the urban ultrafine particles (20 nm) and of the urban accumulation-mode
      particles (250 nm), we observed significantly greater pulmonary inflammatory
      response to ultrafine TiO2 in rats and mice. The greater toxicity of the
      ultrafine TiO2 particles correlated well with their greater surface area per
      mass. Ultrafine particles of carbon, platinum, iron, iron oxide, vanadium, and
      vanadium oxide were generated by electric spark discharge and characterized to
      obtain particles of environmental relevance for study. The CMD of the ultrafine
      carbon particles was approximately 26 nm, and that of the metal particles was 15
      to 20 nm, with geometric standard deviations (GSDs) of 1.4 to 1.7. For ultrafine
      carbon particles, approximately 100 micrograms/m3 is equivalent to 12 x 10(6)
      particles/cm3. Homogeneous coagulation of these ultrafine particles in an animal
      exposure chamber occurred rapidly at 1 x 10(7) particles/cm3, so that particles
      quickly grew to sizes greater than 100 nm. Thus, controlled aging of ultrafine
      carbon particles allowed the generation of accumulation-mode carbon particles
      (due to coagulation growth) for use in comparative toxicity studies. We also
      developed a technique to generate ultrafine particles consisting of the stable
      isotope 13C by using 13C-graphite electrodes made in our laboratory from
      amorphous 13C powder. These particles are particularly useful tools for
      determining deposition efficiencies of ultrafine carbon particles in the
      respiratory tracts of laboratory animals and the translocation of particles to
      extrapulmonary sites. For compromised animals, we used acute and chronic
      pulmonary emphysema; a low-dose endotoxin inhalation aimed at priming target
      cells in the lung was also developed. Other modifying factors were age and
      copollutant (ozone) exposure. Exposure concentrations of the generated ultrafine
      particles for acute rodent inhalation studies were selected on the basis of lung
      doses predicted to occur in people inhaling approximately 50 micrograms/m3 urban
      ultrafine particles. Concentrations that achieved the same predicted lung burden
      per unit alveolar surface were used in rodents. (ABSTRACT TRUNCATED)

PMID- 11205816
TI  - Blood group phenotype distribution in Saudi Arabs.
AB  - The distribution of eight blood phenotypes (ABO, Rh, MNSs Lutheran, Kell, Duffy,
      Kidd and Lewis) was determined in Saudi Arabs and compared with corresponding
      published information for Caucasians and Negroes of United States of America,
      Saudi Arabs manifest ABO phenotype distribution similar to Negroes; rhesus
      phenotypes similar to Caucasians but an MNSs pattern largely distinct.
      Heterozygous Kell phenotype, Kk, was much more frequent in Saudi Arabs than in
      either Caucasians, or Negroes. The Kidd system null allete, JKa-b- was not seen
      in the studied group. However, increased frequencies of null alleles of the Duff
      (Fya-b-) and Lewis (Le(a-b-)) systems were observed in Saudi Arabs.

PMID- 11205817
TI  - Serum zinc, copper and magnesium in sickle cell disease at Ibadan, south western
      Nigeria.
AB  - Serum zinc, copper and magnesium were studied in patients with sickle cell
      disease in the steady state. There was significantly lower serum zinc
      concentration (P < 0.01) and significantly higher serum copper and magnesium in
      haemoglobin S patients compared with controls (HbA). In haemoglobin SC patients,
      there was a significant reduction in serum zinc (P < 0.01) but no significant
      difference in serum copper and magnesium concentrations compared with the
      controls. There was no significant difference in serum zinc concentration between
      the HbS and HbS + C patients. However there were significantly higher serum
      copper and magnesium in HbS than HbS + C patients (P < 0.01) The level of serum
      zinc has no correlation with the steady state Haematocrit or severity index score
      in HbS and HbS + C patients.

PMID- 11205818
TI  - Oral squamous cell carcinoma: a review of 246 Nigerian cases.
AB  - A review of 246 Nigerians with oral squamous cell carcinoma seen at the
      University College Hospital, Ibadan, over a 20-year (1976-1995) period was
      carried out. A prevalence rate of 1.2% was found with a male to female ratio of
      1.5:1. Their ages ranged from 20 to 88 years with mean and median ages of 53.7
      and 55.5 years respectively. The most common site was the palate while the least
      common was the buccal mucosa. Most patients presented later for treatment with
      advanced disease, but women tended to report earlier than men. Out of 125
      patients who had definitive treatment, only 33 (26%) had adequate follow-up
      records and recurrence was noted in 13 (39%). The prevalence of oral squamous
      cell carcinoma is significant in this environment but patient awareness is still
      low. There is a need to step up awareness campaign programmes, provide more
      centres for cancer treatment and introduce mass screening programmes.

PMID- 11205819
TI  - Electrophysiological effects of chilotoquine on tight junctions of immature rat
      Sertoli cells in vitro.
AB  - We investigated the effect of CQ, an antimalarial drug with antiprotease
      activity, and NH4Cl, a related amines on the development of intercellular tight
      junctions in cultured immature rat Sertoli cells. Sertoli cells were seeded in
      serum-free defined medium at a density of 3 x 10(6) cells/0.64 cm2/well on
      Matrigel-covered Millicell-HA filters. CQ (1 microM and 2 microM) or NH4Cl (6.25
      mM and 12 mM) was added to the outer (basal) compartment of the bicameral system
      either on day 1 or day 7 of the culture. Formation of tight junctions was
      monitored by measurement of the transepithelial resistance (TER) at 24 hr
      intervals using an impedance meter. TER in untreated controls was 50 omega/cm2 on
      day 1, increased progressively to 80 omega/cm2 by day 7 and plateaued until day
      12. The cells treated from day 1 with CQ showed dose-dependent progressive
      increase in TER until day 12, reaching 191 omega/cm2 in cells treated with 1
      microM concentration. In cells treated with CQ starting from day 7 of culture
      onwards, TER patterns were similar to those noted following exposure to
      chloroquine from day 1. Also in cultures containing NH4Cl, in comparison to the
      control, the increase in TER was significantly higher. These observations
      demonstrate that CQ and HN4Cl promote tight junction formation between immature
      rat Sertoli cells invitro suggesting that antiproteases may be involved in the
      formation of blood-testis barrier.

PMID- 11205820
TI  - Efficacy of pefloxacin in the treatment of postoperative sepsis in gynaecology.
AB  - Twenty four women with postoperative sepsis following gynaecological surgery were
      recruited into a study designed to determine the efficacy of Pefloxacin. With the
      standard oral dose of Pefloxacin, clinical cure or improvement occurred in 98% of
      the patients. In-vitro, 90% of bacterial isolates were sensitive to Pefloxacin.
      No adverse effect was encountered in any of the patients. We concluded that
      Pefloxacin is effective in the treatment of postoperative bacterial infections
      following gynaecological surgery.

PMID- 11205821
TI  - Estimation of plasma uric acid in pregnancy induced hypertension (PIH). Is the
      test still relevant?
AB  - Plasma uric acid and creatinine were estimated at each visit of 59 consenting
      women attending ante-natal clinic. Results in the third trimester of pregnancy
      confirmed that the plasma uric acid was able to differentiate between normal
      pregnancy and those with PIH at P < 0.002. The results of those with ordinary
      hypertension and the women who developed pre-eclampsia were similar. Plasma
      creatinine was found to be able to differentiate between women with ordinary
      hypertension (97.45 +/- 25.03 umol/L) and those with pre-eclampsia (288.75 +/-
      191.97 umol/L) at P < 0.01. For patients with pre-eclampsia who developed
      convulsions, there invariably was a further rise in the plasma uric acid levels.
      Monitoring of plasma creatinine level among patients with PH will help to predict
      those at risk of developing pre-eclampsia. In the same way, monitoring of plasma
      uric acid level in those with pre-eclampsia will help to predict those that will
      develop eclampsia. The tests are inexpensive but sensitive, which is in contrast
      to many more expensive electronic alternatives.

PMID- 11205822
TI  - Prevalence of gall stones in a group of antenatal women in Ibadan, Nigeria.
AB  - The prevalence of gall stones in Africa is low even though this varies from one
      part of the continent to another. The few studies were hospital based and
      excluded majority of silent stones. Abdominal ultrasounds were carried out
      prospectively on 4,214 consecutive patients referred to an ultrasound centre
      which cares primarily for pregnant women--a well known vulnerable group for gall
      stones. An overall prevalence rate of 2.1% was found. This represents a 300-fold
      increase over previous figures in Ibadan albeit from a different study group. A
      further study of the disease in the general population is necessary, though it is
      suggested that the figure in the general population may be less. When this figure
      is compared with the 10 to 20% in Europe and North America, it confirms the low
      incidence of the disease in our environment. Majority of the stones were
      asymptomatic (95%). This needs to be confirmed in the general population. The
      average stone former in our environment as in previous study does not conform to
      the classical caucassian description.

PMID- 11205823
TI  - Anaesthetic manpower development in West Africa.
AB  - Advances in surgery have been possible worldwide largely due to specialized
      manpower, innovations in modern anaesthetic techniques and drugs. Shortage of
      specialist manpower in anaesthesia has continued in West Africa despite various
      available local postgraduate training programmes. This paper examines the impact
      of the West African Postgraduate Medical College (WAPMC) training programme on
      anaesthetic manpower development in the West Africa subregion. Data collected
      from the records of the WAPMC revealed that from April 1992 to October 1996 a
      total number of 2,963 candidates attempted the primary examination of the various
      surgical faculties compared to 93 candidates for anaesthesia--a ratio of 32
      prospective surgeons to one anaesthetist. The end point of the training produced
      292 Fellows in the five-year period with only six in anaesthesia, i.e., 1
      anaesthetist to 49 surgeons. Although the diploma programme of the same College
      produced 56 graduates in the study period, 53.6% of them were pursuing the
      Fellowship programme in tertiary institutions. Suggestions are proposed to
      redress the ever-widening gap between the number of specialist surgeons and
      anaesthetists in the West Africa subregion.

PMID- 11205824
TI  - Antimicrobial screening of Bridelia, micrantha, Alchormea cordifolia and
      Boerhavia diffusa.
AB  - This report is on the antimicrobial potential of Bridelia micrantha, Alchornea
      cordifolia and Boerhavia diffusa sourced from traditional healers through an
      ethnobotanical survey of antiinfective plants in Egbado South in Ogun State,
      Nigeria. Extracts of B. micrantha and A. cordifolia exhibited significant
      inhibitory activity against the pathogenic organisms. In some cases, the
      antibacterial activity was comparable to those of ampicillin and gentamycin.
      However, only the leaf of A. cordifolia showed reasonable antifungal activity
      when compared with Trosyd. The study shows that there is justification for the
      use of these medicinal plants in traditional medicine.

PMID- 11205826
TI  - Levels of complement components, immunoglobulins and acute phase proteins in
      plasma during aging in Nigeria.
AB  - Plasma samples from Nigerians aged 6-95 years were examined for their content of
      complement components (C3, C4, factor B-Bf), immuloglobins (IgG, IgA, IgM IgD)
      and acute phase proteins (transferrin, albumin, C-reactive protein--CRP, alpha-2
      macroglobulin). Albumin, was estimated colorimetrically and the other components
      by the single radial immunodiffusion techniques. No significant age-related
      changes in mean values of the four immunobulins and the four acute phase proteins
      could be demonstrated. Also, the mean values for C3 and Bf did not change
      significantly with age but C4 values rose significantly with increasing age (r 
      0.232: P < 0.01).

PMID- 11205825
TI  - The antihyperglycamic effect of Telfaria occidentalis in mice.
AB  - The hypoglycemic effect of Telfaria occidentalis was studied in mice. The effect
      of the aqueous extract of the leaves on blood glucose level were assessed in
      normoglycaemic, glucose induced hyperglycaemic and streptozotocin (STZ) induced
      diabetic mice. The aqueous extract given orally in 1 g/kg did not alter the blood
      glucose level in normoglycaemic mice. In glucose-induced hyperglycemia,
      antidiabetic activity was seen when the extract and glucose were administered
      simultaneously and when the extract was giving to the mice 60 minutes before
      glucose. In STZ-induced diabetic mice, a reduction in the blood glucose level was
      seen from day two of the administration of the extract. The hypoglycemic effect
      of the aqueous extract was compared with that of an oral dose of chlorpropamide
      (200 mg/kg) under the same conditions. The results of this study indicate that
      the aqueous extract of the leaves of Telfaria occidentalis possess hypoglycaemic
      activity.

PMID- 11205827
TI  - Crystal deposition in normal and diseased articular cartilage: an extended
      report.
AB  - Particles observed on the surfaces of human articular cartilage following trauma
      and from chondromalacic, osteoarthritic and rheumatoid joints using the scanning
      electron microscope were analysed by x-ray diffraction technique. The particles
      contained calcium and phosphorus and they were identified only in structurally
      abnormal cartilage. These findings suggest that local abnormality of articular
      cartilage probably underlies crystal-deposition.

PMID- 11205828
TI  - Routine antenatal syphilis screening--a case against.
AB  - To highlight the deficiencies associated with the routine antenatal syphilis
      screening as it is done now in the University College Hospital, Ibadan, and
      determine the cost effectiveness or otherwise of syphilis screening using as
      parameters the specificity of the method of screening as well as the gravity of
      the disease. The results of VDRL tests performed on pregnant women attending the
      antenatal clinic of the University College Hospital, Ibadan, in a 10-year period,
      January 1988 to December 1997 were analysed for seropositivity as well as
      congenital syphilis. The case notes of 110 sero-reactive patients were retrieved
      and analysed for pregnancy outcome. The prevalence rate of seropositive patients
      was 1.1%. Only 3 of the seropositive had repeated tests and were treated
      empirically with high doses of penicillin. There was no case of congenital
      syphilis. This study has shown that the syphilis screening as it is done now is
      not cost-effective. If VDRL test is to be continued, efforts must be made to
      reintroduce TPHA-test, which is more specific-specificity; it wastes a lot of
      time and money of the patients. Hence it is not cost effective. If VDRL test is
      to be continued efforts must be made to reintroduce TPHA-test, which is more
      specific.

PMID- 11205829
TI  - Radiological ageing process in the cervical spine of Nigerian women.
AB  - The study was designed to determine the age of commencement of ageing process in
      Nigerian women Four hundred (400) consecutive women requesting for cervical spine
      radiographs where recruited for this study. A study chart was made showing
      different variables like osteoarthrosis, detached osteophytes, postural
      ulterations and disk degenerations in a four year period from 1st January, 1993
      to 31st December, 1996 the modified Kellgren and Lawrence grading system was used
      to assess radiographic changes. The highest rate of osteoarthrosis (31.13%) was
      found in the fifth decade. Incidence of postural alterations of the cervical
      spine rose sharply in the 5th and 6th decades of life. Grade 2 osteoarthrosis
      (Kellgren and Lawrence) was commonest (61.3%); Grades 3 and 4 had the lowest
      incidence (3.45%). Disc degeneration was commonest in the 5th; the most involved
      disc was C5/C6 and the least involved was C2/C3. It is concluded that the ageing
      process in the Nigerian women commences in the fourth decade of life, and
      apparently shows no difference with caucasian women.

PMID- 11205830
TI  - Intra-operative antibiotic bead maker--point of technique.
AB  - Chronic osteomyelitis is a disease of soft tissue and bone and it is common in
      the developing countries. The management of this debilitating disease requires
      the delivery of the appropriate chemotherapeutic agent at the site of the
      infection after adequate debridement. The search for a suitable carrier for these
      chemotherapeutic agents is the advent of the 'septopal' or gentamycin
      polymethylmethacrylate (gentamycin-PMMA) beads. Septopal beads are expensive and
      are not affordable by patients in the developing countries. Moreover, most of the
      micro-organisms (mixed flora) responsible for chronic osteomyelitis in our
      hospitals are sensitive to ceftriaxone and only in a few cases were gentamycin
      sensitive micro-organisms isolated. Therefore, it was imperative that patient
      specific and antibiotic-specific PMMA beads would be the way forward and this is
      the reasoning behind the production of the intra-operative antibiotic bead maker
      (IABM) and the point of technique is hereby presented.

PMID- 11205831
TI  - Effects of cold application on isometric strength and endurance of quadriceps
      femoris muscle.
AB  - This study was carried out to investigate the effect of cold therapy on isometric
      strength and endurance of the quadriceps femoris muscle group. Sixty volunteer
      healthy normal subjects participated in the study, 30 were males and 30 were
      females. They were aged between 20 and 27 years. The subjects were screened for
      previous knee injuries or abnormalities through history taking and physical
      examination. The baseline isometric strength and endurance of the quadriceps was
      tested before application of cold on the thigh. Immediate post and 10-minute post
      cold application isometric strength and endurance were measured using an adapted
      cable tensiometer. The result of the study showed that cold increased the
      isometric strength of the quadriceps in all the subjects immediate post and 10
      minute post cold application (P < 0.05) and the immediate post cooling endurance
      index of male and combined male and female subjects (P < 0.05). No significant
      increase was seen in the immediate post cooling endurance for female subjects (P
      > 0.05). Also no significant difference was seen in 10-minute post cooling
      endurance of all the subjects when compared with the pre-cooling endurance. This
      study therefore concluded that cold application increased isometric muscle
      strength and endurance post cold application. It was therefore recommended that
      application of cold on muscle should be employed while rehabilitating an
      individual with musculoskeletal pathology or deficit particularly while training
      for muscle endurance, strength and restoration of muscle function.

PMID- 11205832
TI  - Gastric outlet obstruction in Maiduguri.
AB  - In a review of sixty-four (64) cases of gastric outlet obstruction (G.O.O.) seen
      at the University of Maiduguri Teaching Hospital between 1991 and 1996,
      cicatrising chronic duodenal ulcer accounted for 65.7% of cases, followed by
      antral carcinoma of the stomach 15%, congenital hypertrophic pyloric stenosis
      9.4%, carcinoma of the head of pancreas 6% and congenital bands 3%. The usual
      presentations were forceful vomiting in a patient with background history of
      dyspepsia of varying duration depending on cause, visible persistalsis, weight
      loss, abdominal masses and electrolyte imbalances. Diagnoses was easy clinically
      and confirmed by barium studies and/or gastroduodenoscopy. Treatment offered
      depended on the cause of gastric outlet obstruction.

PMID- 11205833
TI  - Oral complications of cancer treatment.
AB  - This report describes the oral complications that may occur in patients who have
      undergone radiotherapy of the head and neck for the treatment of cancer. It
      highlights modalities available for reducing and managing these treatment-related
      consequences. It also discusses the difficulties encountered by the dental health
      professional providing care for these patients.

PMID- 11205834
TI  - Intravesical Lippes loop following insertion for the treatment of Asherman's
      syndrome: a case report.
AB  - A case report of a 36-year-old Para 6+0 (1 alive) civil servant who developed
      Asherman's syndrome following repair of ruptured uterus is presented. She had
      adhesiolysis and insertion of Lippes loop. She defaulted 3 months after
      presentation and was seen 1 year after with intravesical translocation of the
      IUCD. This was successfully removed using a forward biting bladder biopsy forceps
      under direct cystoscopic view.

PMID- 11205835
TI  - Potency status and efficacy of measles vaccine administered in Nigeria: a case
      study of three EPI centres in Lagos, Nigeria.
AB  - The potency status and efficacy of measles vaccines were studied in three
      immunization (EPI) centres in the suburban area of Lagos, Nigeria. A total of 14
      vials of measles vaccine were collected and subjected to potency testing while,
      203 measles-vaccinated children were recruited for this study. Only 85 (41.87%)
      of the vaccinees reported back for the post-vaccination follow-up screening. The
      seroconversion pattern showed that 51(60%) had potent antibody titres ranging
      from 1:40 to 1:1280, while the remaining 34 (40%) had a low antibody titres
      between < 1:20 and 1:20. The vaccine potency test showed that only 1 (7.14%) of
      the 14 vaccine vials collected at these centres had virus titre of 3.5 Log while
      the remaining 13 (92.86%) had virus titres lower than 3.0 Log: the recommended
      human dose by the World Health Organisation (WHO) for measles vaccine. The
      administration of these subpotent and/or impotent vaccines vis-a-vis the status
      of immune response elicited in the vaccinees may be one of the reasons for the
      occurrence of measles infection in vaccinated children in the recent time in
      Nigeria. We herein suggested the subjection of all vaccines to a thorough
      standard laboratory screening before use in Nigeria.

PMID- 11205836
TI  - Diagnostic value of alpha 1-fetoprotein and beta-human chorionic gonadotropin in
      infancy and childhood.
AB  - This article provides a comprehensive review of the current literature and
      summarizes the experience of the German cooperative protocols for nontesticular
      germ cell tumors (MAKEI) on the use of alpha 1-fetoprotein (AFP) and beta-human
      chorionic gonadotropin (beta-hCG) for diagnostic evaluation in pediatric
      oncology. Based on this evaluation, this review proposes guidelines for the
      initial diagnostic work-up for children with clinically suspected secreting
      tumors. AFP and beta-hCG represent the characteristic tumor markers of malignant
      epithelial liver tumors and malignant germ cell tumors (GCT). They play an
      important role in the initial diagnostic evaluation as well as in the follow-up
      examination during therapy. Current therapeutic strategies for both tumor types
      include preoperative chemotherapy followed by delayed tumor resection. Therefore,
      it is essential for the pediatrician in charge to be aware of the broad
      differential diagnosis of elevated AFP and beta-hCG. In a well-defined clinical
      setting, these tumor markers allow clinical diagnosis without histological
      confirmation, but the physiologically elevated AFP serum levels in infancy or
      unrecognized benign conditions, such as hepatic diseases or hereditary disorders,
      must also be considered as differential diagnoses. Therefore, the laboratory
      investigations should include liver parameters in all patients to exclude hepatic
      disease. In addition, pregnancy must be excluded in adolescents. Careful history
      taking and clinical examination will further help to rule out metabolic disorders
      or ataxia teleangiectasia that are associated with elevated AFP levels. Having
      excluded these conditions, elevated AFP levels above the age-related normal range
      (with or without high beta-hCG), indicate malignant epithelial liver tumors in
      primary liver lesions. At virtually all other sites, the diagnosis of a malignant
      GCT with a substantial yolk sac tumor and/or choriocarcinoma component can be
      established. Pancreaticoblastoma should be considered in the differential
      diagnosis of tumors of the upper abdomen, and biopsy must be performed. Other
      childhood tumors are rarely associated with AFP or beta-hCG production, usually
      at only moderately elevated serum levels, and in most patients these tumors can
      be excluded by clinical and radiological examination.

PMID- 11205837
TI  - Initial P-glycoprotein expression in childhood acute lymphoblastic leukemia: no
      evidence of prognostic impact in follow-up.
AB  - Treatment results in childhood acute lymphoblastic leukemia (ALL) have improved
      remarkably during the past 20 years, but still 25% of children cannot be
      permanently cured. Drug resistance is a major cause of poor outcome. One of the
      most investigated resistance mechanisms is the P-glycoprotein (P-gp)-mediated
      multiple-drug resistance (MDR). The authors prospectively analyzed P-gp using
      flow cytometry with monoclonal antibody JSB1 in a population-based series of 103
      children with ALL treated according to intensive Nordic ALL protocols. Increased
      P-gp expression was detected in 55 patients (53%). With a cutoff value of 1% P-gp
      positive blasts in bone marrow, no difference was found in event-free survival
      (EFS) or overall survival between children with low vs. increased P-gp
      expression. The 4-year EFS in the whole series was 77%. Patients with T-ALL had
      higher P-gp levels than the others, 3.6% vs. 1.0% (p = .002). P-gp expression did
      not correlate with the white blood cell count, age, sex, or cytogenetics. The
      authors conclude that the level of P-gp expression cannot be used as a tool for
      treatment stratification in childhood ALL.

PMID- 11205838
TI  - Tumor suppressor genes on the short arm of chromosome 1 in neuroblastoma.

PMID- 11205839
TI  - P73 expression in neuroblastoma: a role in the biology of advanced tumors?
AB  - p73, a recently identified gene showing high homology to p53 and mapping to
      1p36.33, was presented as a candidate gene for neuroblastoma. In this study the
      authors evaluate the levels and allelic nature of p73 expression in primary
      neuroblastomas using reverse transcription-polymerase chain reaction-restriction
      fragment length polymorphism strategies based on intragenic polymorphisms. From
      32 neuroblastoma patients, 11 were heterozygous for the p73 polymorphisms
      analyzed. p73 expression was found to be low in the correspondent tumors and
      while all 6 stages 1 and 2 tumors presented biallelic expression, 4 out of the 5
      stage 4 tumors showed only one active p73 allele. Analysis of blood samples from
      8 healthy donors and 4 neuroblastoma patients revealed much higher levels of p73
      expression, and exclusively of biallelic nature. These results are supportive of
      a role for p73 in the biology of neuroblastoma, particularly in some advanced
      tumors. Nevertheless, the G81A/C91T polymorphism, previously implicated in
      regulating the expression of p73, did not show any significant association with
      neuroblastoma development.

PMID- 11205840
TI  - Management of cutaneous hemangiomas: a retrospective analysis of 1109 cases and
      comparison of conventional dose prednisolone with high-dose methylprednisolone
      therapy.
AB  - The effectiveness of the different pharmacological agents and different doses of
      systemic corticosteroids was analyzed. A total of 1109 patients (median age 8
      months; F/M: 2.3) with hemangioma, followed up in our unit for 23 years, were
      evaluated retrospectively. Forty-five of them received systemic corticosteroids.
      Two different pharmacological agents, prednisolone (in 26 patients) and methyl
      prednisolone (in 19 patients), had been used in three different regimens. Groups
      were compared according to the final results and rebound regrowth. Response was
      considered good or excellent in 16 patients (36%). Then were no differences in
      response to therapy among the three regimens. No difference was found in response
      to therapy between prednisolone and methylprednisolone and the two different
      doses of the methylprednisolone. Rebound regrowth was significantly higher in
      methyl prednisolone than in the prednisolone group (p = .045). In multivariate
      analysis the dimension of the lesion (p = .0065) and age at initiation of
      treatment (p = .0041) were the most important factors affecting the response. In
      conclusion, the systemic corticosteroids are effective in 36% of patients,
      independent of dosage and pharmacological agents and duration of the therapy. The
      dimension of the lesion and age at initiation of treatment are the most important
      factors affecting the response to treatment.

PMID- 11205841
TI  - Effect of two-round Ficoll-Hypaque density gradient centrifugation on lymphocyte
      subsets and natural killer activity of umbilical cord blood mononuclear cells.
AB  - Umbilical cord blood (CB) mononuclear cells (MNCs) obtained from Ficoll-Hypaque
      density gradient centrifugation (FDGC) are frequently contaminated with
      erythrocytes and nucleated erythroid precursors. The authors investigated the
      effect of two-round (2-r) FDGC on lymphocyte subsets and natural killer activity
      of CB and adult peripheral blood (APB) MNCs, in comparison with those obtained
      from conventional one-round (1-r) separation. The percentage of CD45-expressing
      CB MNCs was greatly increased after the second density step (p < .01), indicating
      the efficacy in purification. The percentages of CD3/CD4, CD3/CD8, and CD16/56
      double-positive staining CB MNCs were significantly increased after 2-r FDGC, as
      compared to those after 1-r separation. However, the percentages of CD34+ stem
      cells and CD19+ B cells were not affected by 2-r FDGC. MNCs obtained from 2-r
      FDGC had higher natural killer (NK) activity than did MNCs obtained from 1-r
      separation (p < .01). In contrast, 2-r FDGC did not affect lymphocyte subsets and
      NK activity of APB MNCs as compared to 1-r FDGC. Thus, 2-r FDGC are recommended
      to obtain CB MNCs for flow cytometric analysis and NK cytotoxicity assays.

PMID- 11205842
TI  - Hemophagocytic lymphohistiocytosis associated with visceral leishmaniasis.
AB  - A 2-year-old child presented with fever and hepatosplenomegaly. Laboratory
      findings showed pancytopenia, hypertriglyceridemia, hyperferritinemia, and high
      levels of soluble-IL2 receptors. Initial bone marrow aspiration and biopsy
      revealed mild hemophagocytosis. A diagnosis of hemophagocytic lymphohistiocytosis
      was made and appropriate treatment was begun. Repeated marrow aspiration
      performed because of lack of clinical response revealed Leishmania amastigotes in
      macrophages in addition to active hemophagocytosis. Treatment with liposomal
      amphotericin resulted with rapid recovery. Visceral leishmaniasis should be
      considered in the differential diagnosis of hemophagocytic syndrome.

PMID- 11205843
TI  - University of Newcastle Upon Tyne: epidemiological studies of childhood cancer.

PMID- 11205844
TI  - Treatment of superior vena cava syndrome with recombinant tissue plasminogen
      activator in a sickle cell patient undergoing bone marrow transplantation.
AB  - Superior vena cava (SVC) syndrome is a well-recognized clinical entity seen with
      mediastinal malignancies and intraluminal venous thrombosis. The role of
      recombinant tissue plasminogen activator (rt-PA) in the resolution of SVC
      syndrome caused by thrombosis in the bone marrow transplant settings has not been
      described. The authors report a case of SVC syndrome with good clinical response
      in a 16-year-old female with sickle cell disease undergoing an allogeneic bone
      marrow transplant (BMT) from her HLA identical sibling. Shortly after her
      transplant, she was found to have significant facial edema and swelling above the
      neck. Concomitantly, her renal function deteriorated with progressive elevation
      of serum urea nitrogen and creatinine levels, requiring the use of continuous
      veno-venous hemofiltration. An upper extremity venogram showed complete SVC
      obstruction (type III) with apparent inferior reflux into the azygos system. rt
      PA was started at a dose of (0.5 mg/kg/day) for 2 days. There was a dramatic
      resolution of her symptoms, including significant improvement in renal function
      with increase in urine output. A repeat venogram showed free flow from the distal
      tip of the central line consistent with a patent superior vena cava. There was no
      evidence of any bleeding manifestations with rt-PA. This report highlights the
      usefulness of rt-PA as a treatment modality for SVC syndrome in the BMT settings.

PMID- 11205845
TI  - Hypertrophic osteoarthropathy and childhood Hodgkin disease.

PMID- 11205846
TI  - Intra-articular lipoma of the knee joint. A case report.

PMID- 11205847
TI  - Injuries of the posterolateral corner of the knee.
AB  - The complex anatomy of the posterolateral corner of the knee is due largely to
      the evolutionary changes in the anatomic relationships of the fibular head, the
      popliteus tendon, and the biceps femoris muscle. Recent research has improved our
      understanding of the popliteus complex, particularly the role of the
      popliteofibular ligament. Biomechanical studies provide a scientific basis for
      clinical examination of the knee with suspected injury of the posterolateral
      corner. All grade-I and most moderate grade-II injuries of the posterolateral
      structures can be treated nonoperatively, but residual laxity may remain,
      especially in knees with grade-II injury. Acute grade-III isolated or combined
      injury of the posterolateral corner is best treated early, by direct repair, if
      possible, or else by augmentation or reconstruction of all injured ligaments.
      Chronic injury of the posterolateral corner, whether isolated or combined, is
      probably best treated by reconstruction of the posterolateral corner along with
      reconstruction of any coexisting cruciate ligament injury. Failure to diagnose
      and treat an injury of the posterolateral corner in a patient who has a known
      tear of the anterior or posterior cruciate ligament can result in failure of the
      reconstructed cruciate ligament.

PMID- 11205848
TI  - The orthopaedic clinician-scientist.

PMID- 11205849
TI  - Repetitive stress injury.

PMID- 11205850
TI  - Repetitive stress injury.

PMID- 11205851
TI  - Inability to obtain formal informed consent in the face of a standard surgical
      indication.
AB  - A thirty-eight-year-old intoxicated man was admitted to the surgical trauma
      service following a single motor-vehicle accident. He had a severe closed head
      injury, bilateral pulmonary contusions, a fracture-dislocation of the right
      acetabulum, and an open injury of the right knee joint. The acetabular fracture
      pattern was an associated both-column fracture with the femoral head dislocated
      into a widely displaced posterior-column fracture line. The treating physicians
      agreed that it would be in the patient's best interest to take him to the
      operating room for emergent debridement and irrigation of his knee wound. At
      surgery, the patient also underwent attempted closed reduction of the acetabular
      fracture and placement of a skeletal traction pin. Radiographs obtained with the
      patient in traction showed reduction of the femoral head beneath a displaced
      superior dome fragment, but there remained a 12-mm gap in the posterior column,
      greater than 3 mm of step incongruity, and a large articular fragment entrapped
      in the anterior aspect of the hip joint. The patient remained intubated and
      sedated for several days. Upon weaning from the ventilator, it became evident
      that his head injury would prevent him from being able to give informed consent
      in the foreseeable future. The patient's family members refused to become
      involved with his care or medical decision-making, as he had become completely
      estranged from them as a result of his chronic alcohol abuse. Further delay in
      surgical treatment for the acetabular fracture would be associated with greater
      difficulty in obtaining an anatomic reduction, the potential for additional
      articular damage to the femoral head, and an increased risk of surgical
      complications. The question that arises is whether it is in the patient's best
      interest for the surgeon to proceed with open reduction and internal fixation of
      the acetabular fracture without having had the opportunity to fully inform him of
      the treatment options or the risks associated with an extensive surgical
      exposure.

PMID- 11205852
TI  - What's new in shoulder surgery.
AB  - The purpose of this update on shoulder surgery is to discuss, in summary fashion,
      topics presented at selected orthopaedic meetings during the time-period of
      August 1999 to July 2000. Sources for this article were presentations and
      symposia at meetings of the American Orthopaedic Society for Sports Medicine
      (Specialty Day, Orlando, Florida, March 2000, and the Twenty-sixth Annual
      Meeting, Sun Valley, Idaho, June 2000), the Arthroscopy Association of North
      America (Specialty Day, Orlando, Florida, March 2000, and the Nineteenth Annual
      Meeting, Miami, Florida, April 2000), the American Academy of Orthopaedic
      Surgeons (Sixty-seventh Annual Meeting, Orlando, Florida, March 2000), the
      American Shoulder and Elbow Surgeons (Specialty Day, Orlando, Florida, March
      2000, and the Sixteenth Annual Meeting, Philadelphia, Pennsylvania, October
      1999), and the American Orthopaedic Association (113th Annual Meeting, Hot
      Springs, Virginia, June 2000).

PMID- 11205853
TI  - Meta-analyses in orthopaedic surgery. A systematic review of their methodologies.
AB  - BACKGROUND: The number and quality of well-designed scientific studies in the
      orthopaedic literature are limited. The purpose of this review was to determine
      the methodological qualities of published meta-analyses on orthopaedic-surgery
      related topics. METHODS: A systematic review of meta-analyses was conducted. A
      search of the Medline database provided lists of meta-analyses in orthopaedics
      published from 1969 to 1999. Extensive manual searches of major orthopaedic
      journals, bibliographies of major orthopaedic texts, and personal files
      identified additional studies. Of 601 studies identified, forty met the criteria
      for eligibility. Two investigators each assessed the quality of the studies under
      blinded conditions, and they abstracted relevant data. RESULTS: More than 50% of
      the meta-analyses included in this review were published after 1994. We found
      that 88% had methodological flaws that could limit their validity. The main
      deficiency was a lack of information on the methods used to retrieve and assess
      the validity of the primary studies. Regression analysis revealed that meta
      analyses authored in affiliation with an epidemiology department and those
      published in nonsurgical journals were associated with higher scores for quality.
      Meta-analyses with lower scores for quality tended to report positive findings.
      The meta-analyses that focused upon fracture treatment and degenerative disease
      (hip, knee, or spine) had significantly lower mean quality scores than did meta
      analyses that examined thrombosis prevention and diagnostic tests (p < 0.05).
      CONCLUSIONS: The majority of meta-analyses on orthopaedic-surgery-related topics
      have methodological limitations. Limitation of bias and improvement in the
      validity of the meta-analyses can be achieved by adherence to strict scientific
      methodology. However, the ultimate quality of a meta-analysis depends on the
      quality of the primary studies on which it is based. A meta-analysis is most
      persuasive when data from high-quality randomized trials are pooled.

PMID- 11205854
TI  - Complications of elbow arthroscopy.
AB  - BACKGROUND: Although the potential complications of elbow arthroscopy, including
      nerve injuries, have been described, the prevalence of their occurrence has not
      been well defined. The purpose of this paper is to describe the serious and minor
      complications in a large series of patients treated with elbow arthroscopy.
      METHODS: A retrospective review of 473 consecutive elbow arthroscopies performed
      in 449 patients over an eighteen-year period was conducted. Of the 473 cases, 414
      were followed for more than six weeks. The most common final diagnoses were
      osteoarthritis (150 cases), loose bodies (112), and rheumatoid or inflammatory
      arthritis (seventy-five). The arthroscopic procedures included synovectomy (184),
      debridement of joint surfaces or adhesions (180), excision of osteophytes (164),
      diagnostic arthroscopy (154), loose-body removal (144), and capsular procedures
      such as capsular release, capsulotomy, and capsulectomy (seventy-three). RESULTS:
      A serious complication (a joint space infection) occurred after four (0.8%) of
      the arthroscopic procedures. Minor complications occurred after fifty (11%) of
      the arthroscopic procedures. These complications included prolonged drainage from
      or superficial infection at a portal site after thirty-three procedures,
      persistent minor contracture of 20 degrees or less after seven, and twelve
      transient nerve palsies (five ulnar palsies, four superficial radial palsies, one
      posterior interosseous palsy, one medial antebrachial cutaneous palsy, and one
      anterior interosseous palsy) in ten patients. The most significant risk factors
      for the development of a temporary nerve palsy were an underlying diagnosis of
      rheumatoid arthritis (p < 0.001) and a contracture (p < 0.05). There were no
      permanent neurovascular injuries, hematomas, or compartment syndromes in our
      series, and all of the minor complications, except for the minor contractures,
      resolved without sequelae. CONCLUSIONS: Our results indicate that the prevalence
      of temporary or minor complications following elbow arthroscopy may be greater
      than previously reported. However, serious or permanent complications were
      uncommon.

PMID- 11205855
TI  - A prospective evaluation of the clinical utility of the lower-extremity injury
      severity scores.
AB  - BACKGROUND: High-energy trauma to the lower extremity presents challenges with
      regard to reconstruction and rehabilitation. Failed efforts at limb salvage are
      associated with increased patient mortality and high hospital costs. Lower
      extremity injury-severity scoring systems were developed to assist the surgical
      team with the initial decision to amputate or salvage a limb. The purpose of the
      present study was to prospectively evaluate the clinical utility of five lower
      extremity injury-severity scoring systems. METHODS: Five hundred and fifty-six
      high-energy lower-extremity injuries were prospectively evaluated with use of
      five injury-severity scoring systems for lower-extremity trauma designed to
      assist in the decision-making process for the care of patients with such
      injuries. Four hundred and seven limbs remained in the salvage pathway six months
      after the injury. The sensitivity, specificity, and area under the receiver
      operating characteristic curve were calculated for the Mangled Extremity Severity
      Score (MESS); the Limb Salvage Index (LSI); the Predictive Salvage Index (PSI);
      the Nerve Injury, Ischemia, Soft-Tissue Injury, Skeletal Injury, Shock, and Age
      of Patient Score (NISSSA); and the Hannover Fracture Scale-97 (HFS-97) for
      ischemic and nonischemic limbs. The scores were analyzed in two ways: including
      and excluding limbs that required immediate amputation. RESULTS: The analysis did
      not validate the clinical utility of any of the lower-extremity injury-severity
      scores. The high specificity of the scores in all of the patient subgroups did
      confirm that low scores could be used to predict limb-salvage potential. The
      converse, however, was not true. The low sensitivity of the indices failed to
      support the validity of the scores as predictors of amputation. CONCLUSIONS:
      Lower-extremity injury-severity scores at or above the amputation threshold
      should be cautiously used by a surgeon who must decide the fate of a lower
      extremity with a high-energy injury.

PMID- 11205856
TI  - The effect of upper-limb motion on lower-limb muscle synchrony. Implications for
      anterior cruciate ligament injury.
AB  - BACKGROUND: A high prevalence of rupture of the anterior cruciate ligament is
      associated with activities that incorporate both abrupt deceleration and catching
      a ball. In the present study, we examined whether the upper-limb motion involved
      in catching a ball affected the synchrony of the lower-limb muscles during tasks
      known to stress the anterior cruciate ligament-namely, abrupt decelerative
      landings. METHODS: Seven male and eleven female subjects decelerated abruptly to
      land in single-limb stance after catching a chest-height pass and after no
      catching. Ground-reaction force and electromyographic data for six lower-limb
      muscles were sampled while the subjects' landing technique was filmed. The joint
      reaction forces and the sagittal planar net moments for the knee then were
      calculated to derive the tibiofemoral shear forces. The muscle onsets and peak
      muscle activities were temporally analyzed with respect to the time of initial
      foot-ground contact, the peak resultant ground-reaction force, and the peak
      tibiofemoral shear force. RESULTS: When catching a pass, the subjects
      demonstrated significantly (p < 0.05) earlier rectus femoris onset relative to
      the timing of the initial foot-ground contact and of the peak tibiofemoral shear
      force, and they showed delayed biceps femoris onset relative to the timing of the
      peak tibiofemoral shear force compared with the findings in the trials without
      catching. CONCLUSIONS: We concluded that catching a ball during an abrupt landing
      could increase the potential for an anterior cruciate ligament injury by limiting
      the time available for the hamstring muscles to generate posterior tibial-drawer
      force before the onset of the quadriceps-induced anterior tibial translation.
      CLINICAL RELEVANCE: The integrity of the anterior cruciate ligament during
      landing relies on the proper coordination of the lower-limb muscles, particularly
      the quadriceps and the hamstrings. The present study demonstrated that motion of
      the upper-limbs may interfere with recruitment of these muscles, thereby
      predisposing the anterior cruciate ligament to injury.

PMID- 11205857
TI  - Measurement accuracy in congenital scoliosis.
AB  - BACKGROUND: The accuracy of measurement of curves in idiopathic scoliosis has
      been extensively studied; however, we know of only one article in the literature
      concerning the accuracy of measurement of curves in congenital scoliosis. That
      article stated that intraobserver variability was +/- 9.6 degrees and
      interobserver variability was +/- 11.8 degrees. METHODS: Sixty-nine curves in
      fifty patients with congenital scoliosis were measured on two separate occasions
      by seven different observers with varying experience in curve measurement.
      RESULTS: Mean intraobserver variance ranged from 1.9 degrees to 5.0 degrees, with
      an average of 2.8 degrees (95% confidence limit, +/- 3 degrees) for the seven
      observers. The interobserver variance was 3.35 degrees (95% confidence limit,
      7.86 degrees). CONCLUSIONS: It is possible to measure curves in congenital
      scoliosis with much greater accuracy than previously reported. In the clinical
      situation in which a skilled observer can measure two radiographs at the same
      time, an accuracy of +/- 3 degrees can be expected 95% of the time.

PMID- 11205858
TI  - Damage to cobalt-chromium surfaces during arthroscopy of total knee replacements.
AB  - BACKGROUND: It has been stated that care must be taken not to scratch the metal
      components during total knee arthroscopy; however, this concern has not been
      studied. Clinical observation during arthroscopy of total knee replacements
      suggested the possibility of damage to the femoral component by the arthroscopic
      cannula; therefore, a bench test was performed to study this potential risk.
      METHODS: Cobalt-chromium femoral components were tested to determine the surface
      damage that resulted from moving a stainless-steel arthroscopic cannula and a
      plastic arthroscopic cannula across the components under a variety of applied
      loads. Scanning electron microscopy and surface-roughness measurements of the
      prosthetic surface were used to evaluate the damage. RESULTS: The stainless-steel
      cannula produced observable alterations to the surface of the femoral component
      at loads as small as 8 N. The majority of these alterations were deposits of
      stainless steel from the cannula onto the component. The plastic cannula did not
      appear to produce alterations on the component surface. Surface roughness
      increased with increasing loading of the stainless-steel cannula, but there was
      no noticeable change with increasing loading of the plastic cannula. These forces
      did, however, severely damage some parts of the plastic cannula. CONCLUSIONS:
      Alterations to the surface of cobalt-chromium femoral components can occur during
      arthroscopy with stainless-steel cannulae but not with plastic cannulae. The
      results of this study support a recommendation to use plastic cannulae during
      arthroscopy of total knee replacements. CLINICAL RELEVANCE: Arthroscopy of total
      knee replacements is increasing in the clinical setting, and damage to the
      prosthesis should be avoided whenever possible. This study provides evidence that
      damage to the femoral component is possible with a stainless-steel cannula and
      that use of a plastic cannula may reduce this risk.

PMID- 11205859
TI  - Spontaneous repair of full-thickness defects of articular cartilage in a goat
      model. A preliminary study.
AB  - BACKGROUND: Full-thickness defects measuring 3 mm in diameter have been commonly
      used in studies of rabbits to evaluate new procedures designed to improve the
      quality of articular cartilage repair. These defects initially heal
      spontaneously. However, little information is available on the characteristics of
      repair of larger defects. The objective of the present study was to define the
      characteristics of repair of 6-mm full-thickness osteochondral defects in the
      adult Spanish goat. METHODS: Full-thickness osteochondral defects measuring 6 x 6
      mm were created in the medial femoral condyle of the knee joint of adult female
      Spanish goats. The untreated defects were allowed to heal spontaneously. The knee
      joints were removed, and the defects were examined at ten time-intervals, ranging
      from time zero (immediately after creation of the defect) to one year
      postoperatively. The defects were examined grossly, microradiographically,
      histologically, and with magnetic resonance imaging and computed tomography.
      RESULTS: The 6-mm osteochondral defects did not heal. Moreover, heretofore
      undescribed progressive, deleterious changes occurred in the osseous walls of the
      defect and the articular cartilage surrounding the defect. These changes resulted
      in a progressive increase in the size of the defect, the formation of a large
      cavitary lesion, and the collapse of both the surrounding subchondral bone and
      the articular cartilage into the periphery of the defect. Resorption of the
      osseous walls of the defect was first noted by one week, and it was associated
      with extensive osteoclastic activity in the trabecular bone of the walls of the
      defect. Flattening and deformation of the articular cartilage at the edges of the
      defect was also observed at this time. By twelve weeks, bone resorption had
      transformed the surgically created defect into a larger cavitary lesion, and the
      articular cartilage and subchondral bone surrounding the defect had collapsed
      into the periphery of the defect. By twenty-six weeks, bone resorption had ceased
      and the osseous walls of the lesion had become sclerotic. The cavitary lesion did
      not become filled in with fibrocartilage. Instead, a cystic lesion was found in
      the center of most of the cavitary lesions. Only a thin layer of fibrocartilage
      was present on the sclerotic osseous walls of the defect. Specimens examined at
      one year postoperatively showed similar characteristics. CONCLUSIONS: Full
      thickness osteochondral defects, measuring 6 mm in both diameter and depth, that
      are created in the medial femoral condyle of the knee joint of adult Spanish
      goats do not heal spontaneously. Instead, they undergo progressive changes
      resulting in resorption of the osseous walls of the defect, the formation of a
      large cavitary lesion, and the collapse of the surrounding articular cartilage
      and subchondral bone. CLINICAL RELEVANCE: As surgeons apply new reparative
      procedures to larger areas of full-thickness articular cartilage loss, we believe
      that it is important to consider the potential deleterious effects of a "zone of
      influence" secondary to the creation of a large defect in the subchondral bone.
      When biologic and synthetic matrices with or without cells or bioactive factors
      are placed into surgically created osseous defects, the osseous walls serve as
      shoulders to protect and stabilize the preliminary repair process. It is
      important to protect the repair process until biologic incorporation occurs and
      the chondrogenic switch turns the cells on to synthesize an articular-cartilage
      like matrix. It takes a varying period of time to fill a large, surgically
      created bone defect underlying a chondral surface. The repair of such a defect
      requires bone synthesis and the reestablishment of a subchondral plate with a
      tidemark transition to the new overlying articular surface. The prevention of
      secondary changes in the surrounding bone and articular cartilage and the
      durability of the new reparative tissue making up the articulating surface are
      issues that must be addressed in future studies.

PMID- 11205860
TI  - Initial review of Electronic Residency Application Service charts by orthopaedic
      residency faculty members. Does applicant gender matter?
AB  - BACKGROUND: Orthopaedic surgery is a male-dominated field. As of 1998, women
      accounted for 42% of medical school graduates, yet only 6.9% of the total number
      of orthopaedic residents were female. The purpose of our study was to determine
      whether the Electronic Residency Application Service charts of female candidates
      for orthopaedic residencies are ranked lower by faculty reviewers than are those
      of male candidates with similar qualifications. METHODS: After we obtained
      permission from the applicants, the Electronic Residency Application Service
      applications submitted by ninety male and ten female candidates for admission to
      a university orthopaedic residency program for the 1998 National Residency
      Matching Program were randomly divided into ten groups, consisting of the charts
      of nine male candidates and one female candidate. Each chart from a female
      candidate was altered into a "male" version, in which all names and personal
      pronouns were changed but which was otherwise identical to the original female
      version. Therefore, each group of ten charts existed as a paired set: one
      containing the true female chart and one, the altered "male" chart. The paired
      sets acted as their own control. One hundred and twenty-one faculty reviewers
      from fourteen orthopaedic residency programs around the United States each
      reviewed either the "male" or the female version of one set, without knowledge of
      the goals of the study, and ranked the ten charts in the order in which they
      would like to have the candidates as residents in their own programs. Each
      version of the sets was reviewed by at least five separate reviewers. Reviewers
      at a given institution were randomized to review different sets, so that there
      was no overlap among them. The rankings of the female-"male" pairs were compared
      with use of a standard paired t test. RESULTS: No significant difference was
      detected in the rankings of the female and "male" charts (p = 0.5). The mean
      difference in rankings was -0.33, with a 95% confidence interval ranging from 
      1.41 (favoring females) to 0.74 (favoring "males"). CONCLUSIONS: The low
      percentage of female residents is not due to bias against female applicants in
      the initial chart-review phase of the orthopaedic residency selection process. It
      is possible that bias is introduced in other stages of the selection process,
      such as the interview.

PMID- 11205861
TI  - Surgical repair of chronic rotator cuff tears. A prospective long-term study.
AB  - BACKGROUND: Rotator cuff disease or injury is one of the most frequently seen
      orthopaedic conditions, and surgical repair of rotator cuff tears is a common
      procedure. A prospective analysis of the operation, with consistent assessment of
      patient characteristics, variables associated with the rotator cuff tear and
      repair techniques, and outcome factors, was performed. METHODS: One hundred and
      five shoulders with a chronic rotator cuff tear underwent open surgical repair
      and acromioplasty between 1975 and 1983. The patients were followed for an
      average of 13.4 years (range, two to twenty-two years). There were sixteen small
      tears, forty medium tears, thirty-eight large tears, and eleven massive tears.
      The tears were repaired directly (seventy-two tears), by V-Y plasty (twelve), by
      tendon transposition (twenty), or by reinforcement with a fascia lata graft
      (one). The long head of the biceps had been previously torn in eleven shoulders
      and was tenodesed in three other shoulders. In fifty-six shoulders, the distal
      part of the clavicle was excised for treatment of degenerative arthritic changes,
      often associated with osteophyte formation. RESULTS: Satisfactory pain relief was
      obtained in ninety-six shoulders (p < 0.0001). There was significant improvement
      in active abduction (p < 0.001) and external rotation (p < 0.007) as well as in
      strength in these directions of movement (p < 0.03 and p < 0.002, respectively).
      At the latest follow-up evaluation, the result was rated as excellent for sixty
      eight shoulders, satisfactory for sixteen, and unsatisfactory for twenty-one.
      Tear size was the most important determinant of outcome with regard to active
      motion, strength, rating of the result, patient satisfaction, and need for a
      reoperation. Older age, less preoperative active motion, preoperative weakness,
      distal clavicular excision, and a transposition repair technique were all
      associated with larger tear size. There were eight reoperations; five were for
      rerepair of a persistent or recurrent rotator cuff tear. CONCLUSIONS: Standard
      tendon repair techniques combined with anterior acromioplasty, postoperative limb
      protection, and monitored physiotherapy can produce consistent and lasting pain
      relief and improvement in range of motion. Improving the results of this
      procedure will depend upon the development of new techniques to address the
      active motion and strength deficiencies following repair of massive rotator cuff
      tears.

PMID- 11205862
TI  - Resection, rotationplasty, and femoropelvic arthrodesis in severe congenital
      femoral deficiency. A report of the surgical technique and three cases.
AB  - BACKGROUND: The major problems associated with severe congenital deficiency of
      the femur are an unstable hip joint and a femur that is more than 50% shorter
      than the contralateral, normal femur. The usual treatment of these extreme cases
      of congenital femoral deficiency is a Syme or Boyd amputation when the child
      begins to walk. A knee fusion is done when the child is older, and the patient
      functions as an above-the-knee amputee. Rotationplasty has been described as an
      alternative treatment that allows the patient to function as a below-the-knee
      amputee. None of the currently described types of rotationplasty address the
      problem of the unstable hip. METHODS: Three patients with severe congenital
      femoral deficiency underwent a unique single-stage reconstruction. In this
      procedure, the limb is completely detached except for the sciatic nerve and the
      femoral vessels. The proximal part of the dysplastic femur and some muscles are
      resected. The residual limb is externally rotated 180 degrees and the rotated
      distal part of the femur is fused to the pelvis. All of the muscles distal to the
      knee remain undisturbed. RESULTS: The anatomical knee in its rotated position
      functioned as a hip with flexion and extension, and the femoropelvic arthrodesis
      provided a more stable support. The rotated ankle acted as a knee, and the
      patients functioned as below-the-knee amputees. The duration of follow-up of
      these three patients was eight, six, and four years. Active hip flexion was 10
      degrees to 70 degrees , 10 degrees to 90 degrees , and 0 degrees to 80 degrees ,
      and active knee flexion was 900 and 95 . The patients' gait continued to improve
      as they matured. CONCLUSIONS: The femoropelvic arthrodesis provides a stable hip.
      Since the muscles distal to the knee are not disturbed, the problem of derotation
      of the limb, which is often seen following the Van Nes rotationplasty, is not
      seen after this operation.

PMID- 11205863
TI  - Primary repair of intraoperative disruption of the medical collateral ligament
      during total knee arthroplasty.
AB  - BACKGROUND: Intraoperative disruption of the medial collateral ligament during
      total knee arthroplasty is an uncommon complication that is frequently treated by
      implanting a prosthesis with varus-valgus constraint. To our knowledge, no data
      have been published on primary repair or reattachment of the medial collateral
      ligament and implantation of a minimally constrained posterior-stabilized or
      cruciate-retaining prosthesis. This retrospective study evaluates the hypothesis
      that satisfactory clinical results, at a minimum of two years, can be achieved
      with immediate repair or reattachment of the medial collateral ligament and
      without a constrained total knee prosthesis. METHODS: Of 600 knees treated with
      primary total knee arthroplasty, sixteen (in fourteen patients) sustained either
      a midsubstance disruption of the medial collateral ligament or an avulsion of the
      ligament from bone during the procedure. Preoperatively, all patients had either
      neutral or varus alignment and an intact medial collateral ligament. Midsubstance
      tears were treated with direct primary repair, and avulsions of the ligament off
      the tibia or femur were treated with suture-anchor reattachment to bone. All
      patients wore a hinged knee brace, with no limit to the range of motion, for six
      weeks postoperatively. Clinical and radiographic data were gathered prospectively
      as part of a database that was ongoing throughout the period of study; the cohort
      of patients was assembled retrospectively by searching that database. RESULTS: No
      patients were lost to follow-up. The mean duration of follow-up was forty-five
      months (range, twenty-four to ninety-five months). The Hospital for Special
      Surgery knee scores increased from a mean of 47 points (poor) preoperatively to a
      mean of 93 points (excellent) at the time of final follow-up. On physical
      examination, no patient had a Hospital for Special Surgery score in the fair or
      poor range and all patients had regained normal stability in the coronal plane
      both at full extension and at 30 degrees of flexion. No patient required knee
      bracing beyond the initial six-week postoperative period. The range of motion at
      the time of final follow-up averaged 108 degrees (range, 85 degrees to 125
      degrees ), although one knee required manipulation under anesthesia to obtain a
      satisfactory range of motion. No arthroplasties required revision. Radiographic
      examination demonstrated appropriate limb alignment in all patients at the time
      of final follow-up. CONCLUSIONS: Intraoperative disruption of the medial
      collateral ligament can be treated with primary repair or reattachment of the
      ligament to bone and postoperative bracing with good results; this avoids the
      potential disadvantages associated with the use of varus-valgus constrained
      implants.

PMID- 11205864
TI  - Effects of radial head excision and distal radial shortening on load-sharing in
      cadaver forearms.
AB  - BACKGROUND: The present study was performed to measure changes in radioulnar load
      sharing in the cadaveric forearm following two orthopaedic surgical procedures
      that often have varying results: radial head excision and distal radial
      shortening. A better understanding of the biomechanical consequences of those
      procedures could aid surgeons in obtaining a more satisfactory clinical outcome.
      METHODS: Miniature load-cells were inserted into the proximal part of the radius
      and the distal part of the ulna in twenty fresh-frozen cadaveric forearms. Load
      cell forces, radial head displacement relative to the capitellum, and local
      tension within the central band of the interosseous membrane were measured
      simultaneously as the wrist was loaded to 133.5 N in neutral pronation-supination
      and neutral radioulnar deviation. Testing was repeated after incremental distal
      radial shortening and after removal of the radial head. RESULTS: With the elbow
      flexed to 90 degrees and in valgus alignment (the radial head in contact with the
      capitellum), the mean force in the distal part of the ulna was 7.1% of the
      applied wrist force and the mean force in the interosseous membrane was 4.0%.
      With the elbow in varus alignment (a mean initial gap of 1.97 mm between the
      radial head and the capitellum), the respective mean values were 27.9% and 51.2%.
      After excision of the radial head, the mean force in the distal part of the ulna
      increased to 42.4% of the applied wrist force and the mean force in the
      interosseous membrane increased to 58.8%, in both varus and valgus elbow
      alignment. The mean distal ulnar force increased with progressive distal radial
      shortening in both varus and valgus elbow alignment; after 6 mm of radial
      shortening, the distal ulnar force averaged 92.4% (in varus alignment) and 60.9%
      (in valgus alignment). Equal distal load-sharing between the radius and ulna
      occurred after approximately 5 mm of radial shortening with the elbow in valgus
      alignment and after approximately 2 mm of radial shortening with the elbow in
      varus alignment. In valgus alignment, the force in the interosseous membrane was
      negligible after all degrees of radial shortening; in varus alignment, the mean
      force in the interosseous membrane decreased from 51.2% (0 mm of distal radial
      shortening) to 0% (6 mm of distal radial shortening) because of progressive
      slackening of the interosseous membrane. CONCLUSIONS: Radial head excision
      shifted the applied wrist force that normally would be transmitted to the elbow,
      through radial head-capitellar contact, to the interosseous membrane. The
      resulting proximal radial displacement created an ulnar-positive wrist and
      increased distal ulnar loading. Radial shortening and ulnar lengthening
      procedures have been designed to shift the applied wrist force from the distal
      part of the radius to the distal part of the ulna; it is commonly assumed that
      these procedures have equivalent biomechanical effects. We found that radial
      shortening resulted in slackening of the interosseous membrane, thereby negating
      its ability to transmit load through the forearm. Slackening of the interosseous
      membrane would not be expected with distal ulnar lengthening procedures. CLINICAL
      RELEVANCE: When the radial head has been fractured or excised, the mechanical
      status of the interosseous membrane is critical to the load-sharing process. If
      the interosseous membrane remains intact, distal ulnar loads will be limited to
      less than half of the applied wrist force; if the interosseous membrane has been
      damaged, nearly the entire applied wrist force will be shifted to the ulna. The
      amount of radial shortening or ulnar lengthening performed at the time of surgery
      during joint-leveling procedures has been largely empirical. We found that distal
      ulnar load increased by approximately 10% for each millimeter of radial
      shortening.

PMID- 11205865
TI  - Expression of intercellular adhesion molecule-1 induced by high glucose
      concentrations in human aortic endothelial cells.
AB  - We examined the effects of high glucose concentrations on the expression of
      adhesion molecules in human aortic endothelial cells. Expression levels of both
      mRNA and protein of intercellular adhesion molecule-1 (ICAM-1) were increased
      after incubation of endothelial cells with 30 mM glucose for 24 h. The effect of
      glucose on ICAM-1 was concentration dependent, partially attributable to
      osmolarity, and enhanced by glycated-collagen. Staurosporine (10 nM), epalrestat
      (10 microM) suppressed the expression of ICAM-1 mRNA and protein induced by high
      glucose to variable extents. Aminoguanidine (50 mM) suppressed the expression of
      ICAM-1 protein. It is thought that soluble ICAM-1 protein is produced by shedding
      in human aortic endothelial cells because RNA for the soluble form of ICAM-1
      formed by variant splicing has not been detected. These results show that glucose
      is an important determinant of ICAM-1 expression in endothelial cells, and
      suggest that ICAM-1 molecules induced by hyperglycemia may contribute to the
      development of atherosclerosis in diabetes mellitus.

PMID- 11205866
TI  - Panaxagin, a new protein from Chinese ginseng possesses anti-fungal, anti-viral,
      translation-inhibiting and ribonuclease activities.
AB  - From the roots of the Chinese ginseng Panax ginseng a protein designated
      panaxagin with ribonuclease activity, but possessing a sequence distinct from
      ribonucleases previously reported from ginseng calluses, was isolated. The
      purification protocol employed comprised extraction with cold saline, (NH4)2SO4
      precipitation, ion exchange chromatography on DEAE-cellulose, affinity
      chromatography on Affi-gel blue gel, ion exchange chromatography on SP-Sepharose,
      and gel filtration on Superdex 75 by fast protein liquid chromatography. The
      purified protein was composed of two identical subunits each with a molecular
      weight of 26 kDa. Its N-terminal amino acid sequence exhibits sites of similarity
      with the sequences of plant ribosome inactivating proteins and fungal
      ribonucleases. The spectrum of biological activities of panaxagin encompassed
      ribonuclease activity toward yeast transfer RNA, translation-inhibitory activity
      in a rabbit reticulocyte lysate system, and antifungal activity against fungi
      including Coprinus comatus and Fusarium oxysporum, but not against Rhizoctonia
      solani. In addition it displayed an inhibitory activity against human
      immunodeficiency virus reverse transcriptase and succinylation augmented this
      activity.

PMID- 11205867
TI  - Chalcones are potent inhibitors of aromatase and 17beta-hydroxysteroid
      dehydrogenase activities.
AB  - Chalcones were tested for estimating anti-aromatase, anti-3beta-hydroxysteroid
      dehydrogenase delta5/delta4 isomerase (3beta-HSD) and anti-17beta-hydroxysteroid
      dehydrogenase (17beta-HSD) activities in human placental microsomes. In the
      present study, we have demonstrated for the first time that chalcones are potent
      inhibitors of aromatase and 17beta-hydroxysteroid dehydrogenase activities: these
      enzymes being considered as important targets in the metabolic pathways of human
      mammary hormone-dependent cells. Our results showed that naringenin chalcone and
      4-hydroxychalcone were the most effective aromatase and 17beta-hydroxysteroid
      dehydrogenase inhibitors with IC50 values of 2.6 and 16 microM respectively. In
      addition, inhibitory effects of some flavones and flavanones were compared to
      those of the corresponding chalcones. A structure-activity relationship was
      established and regions or/and substituents essential for these inhibitory
      activities were determined.

PMID- 11205868
TI  - Optimization of the technique to isolate fetal hepatocytes, and assessment of
      their functionality by transplantation.
AB  - In contrast to adult hepatocytes, fetal hepatocytes (FH) are thought to be highly
      proliferative less immunogenic and more resistant to both cryopreservation and
      ischemic injury. In the present study, we describe the method for isolation of FH
      and the relationship between the transplantability of FH into the spleen of
      analbuminemic rats and expression of albumin mRNA. Rat FH were obtained using the
      nonperfusion collagenase/DNase digestion method. Nagase analbuminemic rats (NAR),
      a strain which bears a mutation that determines the impossibility of the normal
      splicing of the albumin mRNA were used as recipients. The transplanted FH
      immediately migrated to the liver via portal vein, and anchored there. To assess
      the functional state of the transplanted cells, one month after transplantation,
      the expression of the albumin gene was studied in the liver of the recipients.

PMID- 11205869
TI  - Isolation and characterization of a new ribosome inactivating protein,
      momorgrosvin, from seeds of the monk's fruit Momordica grosvenorii.
AB  - Momorgrosvin, a single-chained glycoprotein with a molecular weight of 27.7
      kilodaltons and an isoelectric point of about 9 was isolated from the seeds of
      Momordica grosvenorii (Family Cucurbitaceae). The isolation procedure entailed
      acetone precipitation, affinity chromatography on Hi Trap Blue, cation exchange
      chromatography on Resource S and size exclusion chromatography on Superose 12.
      The sequence of the first eighteen N-terminal amino acid residues of momorgrosvin
      exhibited homology to those of RIPs from other Momordica species. Momorgrosvin
      inhibited protein synthesis in the rabbit reticulocyte lysate system with an IC50
      of 0.3 nM and displayed RNA N-glycosidase activity giving rise to the diagnostic
      Endo's band at a concentration as low as 9 nM. The protein acted on tRNA to
      produce acid-soluble uv-absorbing species.

PMID- 11205870
TI  - Dipeptidyl peptidase IV is a target for covalent adduct formation with the acyl
      glucuronide metabolite of the anti-inflammatory drug zomepirac.
AB  - The nonsteroidal anti-inflammatory drug zomepirac (ZP) is metabolised to a
      chemically reactive acyl glucuronide conjugate (ZAG) which can form covalent
      adducts with proteins. In vivo, such adducts could initiate immune or toxic
      responses. In rats given ZP, the major band detected in liver homogenates by
      immunoblotting with a polyclonal ZP antiserum was at 110 kDa. This adduct was
      identified as ZP-modified dipeptidyl peptidase IV (DPP IV) by immunoblotting
      using the polyclonal ZP antiserum and monoclonal DPP IV antibodies OX-61 and
      236.3. In vitro, ZAG, but not ZP itself, covalently modified recombinant human
      and rat DPP IV. Both monoclonal antibodies recognized DPP IV in livers from ZP-
      and vehicle-dosed rats. Confirmation that the 110 kDa bands which were
      immunoreactive with the ZP and DPP IV antibodies represented the same molecule
      was obtained from a rat liver extract reciprocally immunodepleted of antigens
      reactive with these two antibodies. Furthermore, immunoprecipitations with OX-61
      antibody followed by immunolotting with ZP antiserum, and the reciprocal
      experiment, showed that both these antibodies recognised the same 110 kDa
      molecule in extracts of ZP-dosed rat liver. The results verify that DPP IV is one
      of the protein targets for covalent modification during hepatic transport and
      biliary excretion of ZAG in rats.

PMID- 11205871
TI  - Matrix metalloproteinase expression in cardiac myocytes following myocardial
      infarction in the rabbit.
AB  - Myocardial infarction (MI), leads to cardiac remodeling, thinning of the
      ventricle wall, ventricular dilation, and heart failure, and is a leading cause
      of death. Interactions between the contractile elements of the cardiac myocytes
      and the extracellular matrix (ECM) help maintain myocyte alignment required for
      the structural and functional integrity of the heart. Following MI,
      reorganization of the ECM and the myocytes occurs, contributing to loss of heart
      function. In certain pathological circumstances, the ECM is modulated such that
      the structure of the tissue becomes damaged. The matrix metalloproteinases (MMPs)
      are a family of enzymes that degrade molecules of the ECM. The present
      experiments were performed to define the time-course, isozyme subtypes, and
      cellular source of increased MMP expression that occurs following MI in an
      experimental rabbit model. Heart tissue samples from infarcted and sham animals
      were analyzed over a time-course of 1-14 days. By zymography, it was demonstrated
      that, unlike the sham controls, MMP-9 expression was induced within 24 hours
      following MI. MMP-3 expression, also absent in sham controls, was induced 2 days
      after MI. MMP-2 expression was detected in both the sham and infarcted samples
      and was modestly up-regulated following MI. Tissue inhibitor of metalloproteinase
      1 (TIMP-1) expression was evaluated and shown to be down-regulated following MI,
      inverse of MMP-9 and MMP-3 expression. Further, MMP-9 and MMP-3 expression was
      detected by immunohistochemistry in myocytes within the infarct. Additional
      studies were conducted in which cultured rat cardiac myocytes were exposed to a
      hypoxic environment (2% O2) for 24 hours and the media analyzed for MMP
      expression. MMP-9 and MMP-3 were induced following exposure to hypoxia. It is
      speculated that the net increase in proteolytic activity by myocytes is a
      contributing factor leading to myocyte misalignment and slippage. Additional
      studies with a MMP inhibitor would elucidate this hypothesis.

PMID- 11205872
TI  - Involvement of apoptosis during deciduomal regression in pseudopregnant hamsters
      effect of progesterone.
AB  - We determined whether fragmentation of genomic DNA, apoptosis, occurs during
      deciduomal regression in pseudopregnant hamsters and the effect of progesterone
      on the apoptotic processes. Artificially induced deciduoma were obtained on
      different days of pseudopregnancy and separated into mesometrial and
      antimesometrial tissues. The deciduomal cell cycle progression and population
      profiles of both sides were compared by flow cytometry. The proportion of sub-G1
      peak, which was correlated with the apoptotic cells, were about 10% on day 8 and
      reached to 40% in both tissues on day 10. Exogenous progesterone treatment by
      daily injection (2 mg; s.c.) on and after day 8 reduced the percentage of low
      molecular weight DNA in both tissues on day 10 and day 12 as compared to the
      nontreated control one, respectively. The appearance of DNA ladder was also
      delayed at least 24 h by progesterone administration. The intensity of DNA
      fragmentation was more pronounced in antimesometrial deciduoma. In situ 3'-end
      labeling of apoptotic cells further substantiated the apoptotic process. The
      apoptotic cells first appeared in the luminal region in antimesometrial deciduoma
      on day 8 and spreaded all over the entire deciduomal tissue on day 10.
      Progesterone treatment stimulated deciduomal proliferating cell nuclear antigen
      (PCNA) expression, maintained deciduoma until day 14 and retarded the
      differentiation and regeneration of the uterine epithelium.

PMID- 11205873
TI  - Changes in expression of ion channels and aquaporins mRNA during differentiation
      in normal human nasal epithelial cells.
AB  - Integrity of the airway epithelium is important for pulmonary defense mechanisms
      to infection. The lining of the airway contains a diverse population of cell
      types. Understanding about progenitor-progeny relationships during renewal of
      airway epithelium is important for elucidating mechanisms of injury repair or
      oncogenesis. Primary culture of airway epithelia is a good model for studying
      differentiation process of epithelial cells. Ion channels and aquaporins(AQPs)
      play a critical role on ion and fluid transport across airway epithelia. However,
      changes in their expression during differentiation of airway epithelial cells
      have not been reported yet. This study was undertaken to identify isoforms of
      aquaporins in cultured normal human nasal epithelial cells (NHNE) and effects of
      various culture conditions on expression of differentiation markers and channels.
      1. Degenerative RT-PCR revealed that AQP3 and AQP4 are expressed in cultured NHNE
      cells. 2. Culture of NHNE cells on permeable filters induced expression of mucin,
      aquaporins and CFTR. 3. Retinoic acid induced morphological changes in NHNE cells
      and inhibited their proliferation. The treatment of retinoic acid induced
      expression of mucin and CFTR, whereas it inhibited expression of cornifin. The
      effect of retinoic acid was enhanced by culture of cells on permeable filters. 4.
      Dexamethasone induced ENaC expression in NHNE cells grown on permeable supports
      only, but did not affect expression of mucin, aquaporins and CFTR. These results
      indicate that cultured NHNE cells express aquaporins (AQP3 and 4), CFTR and ENaC,
      and culture of NHNE cells on permeable filters induces differentiation in to
      mucosecretory and surface epithelial cells, and that effects of retinoic acid and
      dexamethasone on gene expression are affected by culture conditions.

PMID- 11205874
TI  - Tetrandrine inhibits Ca2+ release-activated Ca2+ channels in vascular endothelial
      cells.
AB  - The effects of tetrandrine (TET), a Ca2+ antagonist of bis-benzylisoquinoline
      alkaloid origin, on cultured single bovine pulmonary artery endothelial cells
      were examined using fluorescence ratio imaging and whole-cell attached patch
      clamp techniques. Thapsigargin (TSG, 100 nM), a selective endoplasmic reticulum
      Ca2+-ATPase pump inhibitor known to induce the release of nitric oxide (NO) from
      vascular endothelial cells via a Ca2+-dependent manner, caused a rapid elevation
      of cytosolic Ca2+ concentration, which was inhibited by 30 microM TET. In whole
      cell patch-clamp study using the same vascular endothelial cells, addition of 100
      nM TSG caused a significant enhancement of depolarization-evoked Ca2+-dependent,
      outward K+ currents, which could also be abolished by 30 microM TET. The present
      results demonstrate directly that TET, in addition to its known inhibitory
      effects on vascular smooth muscle by virtue of its Ca2+ antagonistic actions,
      also inhibits NO production by the endothelial cells through blockade of Ca2+
      release-activated Ca2+ channels.

PMID- 11205875
TI  - Roles of Se and NO in apoptosis of hepatoma cells.
AB  - Mice inoculated with hepatoma cell (H22) suspension subcutaneously at their right
      axilla were administered orally with kappa-selenocarrageenan (Se) solution, the
      inoculated hepatoma's growth was suppressed. Different concentrations of Se
      solution added in human hepatoma cell line culture could inhibit proliferation
      and induce apoptosis in hepatoma cells. Meanwhile Se solution could increase the
      activity of glutathione peroxidase (GSH-Px) in the mice's plasma and the content
      of NO in the mice's sera and the hepatoma cell culture supernatant as well.
      Therefore, apoptosis in hepatoma cell induced by Se solution may be associated
      with the increase in antioxidative activity, the suppression free radical's
      intervention, and the excessive release of NO by stress.

PMID- 11205876
TI  - Pavlovian conditioning of lung anaphylactic response in rats.
AB  - The present experiment was undertaken to verify if it is possible to impose
      Pavlovian conditioning on a lung anaphylactic response (LAR) in rats. Two
      experiments were done. In the 1st, egg albumin (OVA) aerosol inhalation, which
      induces signs and symptoms of LAR in OVA- sensitized rats, was paired with an
      audiovisual cue (conditional stimulus, CS). After reexposure to the CS, the signs
      and symptoms of LAR were quantitatively measured using a scoring system specially
      developed for this evaluation; the levels of stress response and anxiety were
      also quantified. Results showed that the rats reexposed to CS only, displayed LAR
      scores not significantly different from those reexposed to both CS and the
      antigen; animals of these groups showed significantly higher LAR scores than rats
      that received no OVA aerosol challenge. High levels of stress and anxiety were
      observed 30-40 min after the challenge with OVA aerosol. In the 2nd experiment,
      rats sensitized with OVA and submitted or not to Pavlovian conditioning were
      observed in the open-field and in the plus maze apparatus in the absence of OVA
      aerosol but in the presence of the CS; after behavioral observations the animals
      were sacrificed for serum corticosterone level determination. Both behavioral and
      biochemical data showed high levels of stress and anxiety in rats for which the
      antigen was previously paired with the CS; these changes were not observed in
      animals which received the antigen 24 h after the presentation of the CS
      (unpaired) or in those exposed to PBS aerosol (the OVA vehicle) only. The present
      data show not only that LAR can be submitted to Pavlovian conditioning, but also
      and importantly, that high levels of stress and anxiety are related to the course
      of LAR.

PMID- 11205877
TI  - Insulin restores neuronal nitric oxide synthase expression in streptozotocin
      induced diabetic rats.
AB  - Nitric oxide (NO) is known to play an important role in the pathophysiology of
      insulin-dependent diabetic mellitus (IDDM). In an attempt to investigate the
      relation between insulin and NO in IDDM, the present study employed male Wistar
      rats to induce IDDM by intravenous injection of streptozotocin (STZ). Four groups
      of rats were used; untreated normal control group, insulin treated STZ group,
      vehicle-treated STZ control, and one group of age-matched rats which were orally
      supplied with glucose to increase plasma glucose (glucose-challenged rats).
      Changes of the activity and gene expression of neuronal nitric oxide synthase
      (nNOS) were examined in cerebellum and kidney of these groups. The activity of
      nNOS in cerebellum, determined by conversion of [3H] L-arginine to [3H] L
      citrulline, in STZ-induced diabetic rats was markedly lower than normal rats.
      Insulin treatment reversed the nNOS activity. Similar reversion by insulin
      treatment was also obtained in the gene expression of nNOS. However, the activity
      and gene expression of nNOS in glucose-challenged rats were not different from
      those in normal rats. The role of hyperglycemia can thus be ruled out. These
      findings indicated that an impairment of nNOS in the brain of rats with IDDM is
      mainly due to the absence of insulin.

PMID- 11205878
TI  - Effect of endothelin-1(1-31) on p38 mitogen-activated protein kinase in cultured
      human mesangial cells.
AB  - It was reported that human chymase cleaves big endothelins (ETs) at the Tyr31
      Gly32 bond and produces 31-amino acid ETs(1-31). In this study, we investigated
      the effect of ET-1(1-31) on p38 mitogen-activated protein kinase (p38-MAPK)
      activity in human mesangial cells (HMCs). By measuring the kinase activity, we
      demonstrated that ET-1 (1-31) activated the p38-MAPK dose-dependently (10(-9) M
      to 10(-7) M), which was inhibited by SB203580. The p38-MAPK activation induced by
      ET-1(1-31) peaked at 10 minutes. BQ123 almost abolished ET-1(1-31)-induced p38
      MAPK activation, whereas BQ788 failed to inhibit it. These findings suggest that
      the stimulatory effect of ET-1(1-31) on p38-MAPK activation is mediated through
      ET(A) or ET(A)-like receptor. In conclusion, ET-1(1-31) induced increase in p38
      MAPK activation in cultured HMCs.

PMID- 11205879
TI  - Timing is everything the role of kinetics in G protein activation.
AB  - The binding of a drug to a G-protein coupled receptor initiates a complex series
      of dynamic events that ultimately leads to a cellular response. In addition to
      the concentrations of receptor, drug and G-protein, important determinants of the
      cellular response are the rates at which these species interact. However, most
      models for G-protein coupled receptor signaling are equilibrium models that
      neglect the role of reaction kinetics. A kinetic ternary-complex model of
      signaling through G-protein coupled receptors is presented. We demonstrate that
      this kinetic model can make significantly different predictions than an
      equilibrium ternary complex model, which provides a different perspective on
      multiple aspects of the signal transduction cascade, such as agonist efficacy,
      the effect of precoupled receptors, and the role of RGS proteins. Incorporation
      of the reaction kinetics is critical for a complete understanding of signal
      transduction and will ultimately impact the fields of drug discovery and drug
      design.

PMID- 11205881
TI  - Chronic pharmacological treatment with certain antidepressants alters the
      expression and DNA-binding activity of transcription factor AP-2.
AB  - Several of the genes in the serotonergic and the dopaminergic systems have
      consensus binding sites for the AP-2 transcription factor family in their
      regulatory regions. Imbalances in these systems have been implicated in many
      psychiatric disorders, including depression and bipolar affective disorder. We
      have made an effort to further elucidate the molecular mechanisms of drugs used
      for affective disorders. Recently, we analyzed the effects of chronic treatment
      with certain antidepressants on AP-2 in rat brain. The present study demonstrates
      that chronic administration of three different classes of antidepressants
      modulates the DNA-binding activity of AP-2 in the rat brain. Chronic
      administration of citalopram (10 mg/kg), imipramin (10 mg/kg) and lithium
      chloride (40 mg/kg) significantly decreased DNA-binding activity of AP-2.
      Furthermore, citalopram (10 mg/kg) and imipramin (10 mg/kg) significantly
      decreased the amount of AP-2alpha protein as determined by ELISA. In addition,
      citalopram (10 mg/kg) significantly decreased the amount of AP-2beta protein. In
      contrast, chronic administration of lithium-chloride (40 mg/kg) did not affect
      the amount of the two AP-2 isoforms. An increased understanding of the function
      of transcription factors and their involvement in human disease, such as
      depression, could make it possible in the future to selectively modulate relevant
      target genes directly.

PMID- 11205880
TI  - Hyperpolarization contributes to vascular hyporeactivity in rats with
      lipopolysaccharide-induced endotoxic shock.
AB  - We have examined the role of membrane hyperpolarization in mediating vascular
      hyporeactivity induced by bacterial lipopolysaccharide (LPS) in endothelial
      denuded strips of rat thoracic aorta ex vivo. The injection of rats with LPS
      caused a significant fall of blood pressure and a severe vascular hyporeactivity
      to norepinephrine. The membrane potential recording showed that endotoxemia
      caused a hyperpolarization when compared to the control. This hyperpolarization
      was fully restored by methylene blue (MB; 10 microM) and partially reversed by
      Nomega-nitro-L-arginine methyl ester (L-NAME; 0.3 mM), 1H-[1,2,4]oxadiazolo[4,3
      a]quinoxalin-1-one (ODQ; 1 microM), tetraethylammonium (TEA; 10 mM),
      charybdotoxin (CTX; 0.1 microM), or glibenclamide (GB; 10 microM), however, this
      hyperpolarization was not significantly affected by apamin (0.1 microM), 4
      aminopyridine (4-AP; 1 mM), or Ba2+ (50 microM). In addition, the basal tension
      of the tissues obtained from endotoxemic rats was enhanced by the following
      order: MB > or = ODQ > TEA > or = L-NAME > or = CTX > GB; whereas apamin, 4-AP or
      Ba2+ had no significant effects on these tissues. In contrast, none of these
      inhibitors had significant effects on the membrane potential or the basal tension
      in control tissues. Our electrophysiological results further confirmed previous
      studies showing that in addition to nitric oxide, the large conductance Ca2+
      activated K+-channels and ATP-sensitive K+-channels are, most likely, responsible
      for endotoxin-mediated hyporeactivity to vasoconstrictor agents in vascular
      smooth muscle.

PMID- 11205882
TI  - Hydrogen peroxide downregulates human organic anion transporters in the
      basolateral membrane of the proximal tubule.
AB  - Hydrogen peroxide (H2O2) is known to be involved in drug-induced and ischemic
      proximal tubular damage. The purpose of this study was to elucidate the effects
      of hydrogen peroxide on organic anion transport mediated by human organic anion
      transporters 1 and 3 (hOAT1 and hOAT3), which are localized at the basolateral
      side of the proximal tubule. For this purpose, we established and utilized the
      second segment of the proximal tubule cells from mice stably expressing hOAT1 or
      hOAT3 (S2 hOAT1 or S2hOAT3, respectively). H2O2 induced a dose- and a time
      dependent decrease in organic anion transport mediated by hOAT1 and hOAT3.
      Kinetic analysis revealed that H2O2 decreased the Vmax, but not Km of organic
      anion transport both in S2hOAT1 and S2hOAT3. The effects of gentamicin, known to
      induce proximal tubular damage via the production of H2O2, on the organic anion
      transporters were also examined. Gentamicin induced a significant decrease in
      organic anion transport in S2hOAT1 but not S2hOAT3. H2O2-induced decrease in
      organic anion transport was significantly inhibited by pretreatment with pyruvate
      as well as catalase, whereas the gentamicin-induced decrease was significantly
      inhibited by pretreatment with pyruvate but not with catalase. In conclusion,
      these results suggest that H2O2, which is produced during tubular injuries,
      downregulates organic anion transport mediated by both hOAT1 and hOAT3, leading
      to further modulation of pathophysiology.

PMID- 11205883
TI  - Protective effect of histidine on potassium chloride depolarization enhances 1
      methyl-4-phenylpyridinium ion-induced hydroxyl radical generation in the rat
      striatum.
AB  - The present study examined the antioxidant effect of histidine on extracellular
      potassium ion concentration, [K+]o-induced depolarization enhances 1-methyl-4
      phenylpyridinium ion (MPP+)-induced hydroxyl radical (*OH) generation in the rat
      striatum. Rats were anesthetized and sodium salicylate in Ringer's solution (0.5
      nmol/M microl/min) was infused through a microdialysis probe to detect the
      generation of *OH as reflected by the nonenzymatic formation of 2,3
      dihydroxybenzoic acid (DHBA) in the striatum. Induction of [K+]o (20, 70 and 140
      mM) significantly increased the level of 2,3-DHBA by the action of MPP+ (5 mM) in
      a concentration-dependent manner. However, histidine (25 mM) reduced the [K+]o
      induced *OH formation. Although the level of MPP+-induced dopamine (DA) and 2,3
      DHBA formation after [K+]o (70 mM) treatment increased, [K+]o failed to increase
      either the level of MPP+-induced DA and 2,3-DHBA in the reserpinized group. When
      iron (II) was administered to [K+]o (70 mM)-pretreated rats, iron (II) clearly
      produced a dose-dependent increase in the level of 2,3-DHBA, as compared with
      MPP+-only treated rats. However, in the presence of histidine (25 mM), the effect
      of [K+]o was abolished. These results indicated that histidine may reduce the
      [K+]o-induced depolarization enhanced *OH formation by the action of MPP+ in the
      rat striatum.

PMID- 11205884
TI  - Troglitazone stimulates acetyl-CoA carboxylase activity through a post
      translational mechanism.
AB  - Troglitazone, a thiazolidinedione, is known to act as an insulin sensitizer. The
      various effects of the drug include stimulation of glucose utilization and
      inhibition of gluconeogenesis and fatty acid oxidation. We studied the effect of
      troglitazone treatment on rat liver acetyl-CoA carboxylase (ACC), the key enzyme
      that catalyzes the formation of malonyl-CoA, the rate-limiting step in the
      synthesis of long chain fatty acids. Treatment of rats with troglitazone for 18
      days resulted in more than 200% increase in the activity of hepatic acetyl-CoA
      carboxylase (1.01+/-0.14 and 2.33+/-0.28 mU/mg supernatant protein for control
      and troglitazone-treated rats, respectively) (p<0.001). The expression of acetyl
      CoA carboxylase mRNA, as studied by RNAse protection assay, was not significantly
      different between the two groups of animals. The ACC from control and
      troglitazone-treated groups was purified by avidin-affinity chromatography. The
      purified enzyme migrated as a major protein band (Mr 262,000) on SDS
      polyacrylamide gels. Troglitazone treatment was associated with increased citrate
      sensitivity of ACC. The specific activity of the purified preparation in
      troglitazone-treated rats was increased by 67% (2.5 vs. 1.5 U/mg). Quantitation
      of alkali-labile phosphate content of the purified preparation revealed 5.66+/
      0.17 and 6.29+/-0.13 mol Pi/mol subunit of 262 Kda for control and troglitazone
      treated rats, respectively (P<0.01). The subtle increase in phosphate content
      does not explain the observed activation of the enzyme. It is possible that
      additional mechanisms such as troglitazone related rearrangement of the occupancy
      of select phosphate binding sites or altered binding of the biotin cofactor may
      also contribute to the observed activation of ACC.

PMID- 11205885
TI  - Pharmacological profile of nitrergic nerve-, nitric oxide-, nitrosoglutathione-
      and hydroxylamine-induced relaxations of the rat duodenum.
AB  - Activation of inhibitory nonadrenergic noncholinergic (NANC) nerves in the rat
      duodenum cause relaxations, which are reduced by nitric oxide synthase (NOS)
      inhibitors indicating that this response involves a nitrergic neurotransmission.
      The precise nature of the nitrergic neurotransmitter is still controversial since
      nitric oxide (NO) scavengers and superoxide generators, even in the presence of
      superoxide dismutase inhibitors, failed to inhibit nitrergic neurotransmission
      mediated relaxations. In order to understand the role of NOS in nitrergic
      neurotransmission and considering that N-OH-arginine (OH-L-Arg), L-citrulline,
      NO, S-nitrosoglutathione (GSNO) and hydroxylamine (NH2OH) can be formed in cells
      during the N(G)-oxidation of L-arginine catalyzed by NOS we explored whether any
      of these products could exhibit biological properties comparable to those of the
      nitrergic neurotransmitter. After establishing which of them was able to relax
      the rat duodenum, the pharmacological profile of such effect was determined
      employing oxyhemoglobin (OxyHb), pyrogallol (PYR), hydroquinone (HQ),
      hydroxocobalamin (HC) or carboxy-PTIO (C-PTIO) and compared with that of nerve
      mediated relaxations. NO, GSNO and NH2OH, but not OH-L-ARG and L-citrulline,
      caused concentration-dependent relaxations that were not affected by tetrodotoxin
      or L-NOARG. OxyHb almost abolished NO-induced relaxations but decreased only
      marginally the magnitude of nerve-, NH2OH- and SNG-induced relaxations. PYR, HQ
      and C-PTIO reduced significantly GSNO- and NO- induced relaxations but did not
      affect those induced by NH2OH or nerve activation. In contrast, HC abolished NO
      induced relaxations while it did not affect those induced by GSNO, NH2OH and
      nerve activation. The catalase inhibitor 1,2,4 aminotriazole failed to affect
      nerve and NH2OH induced relaxations. These findings indicate that among the
      products that can be formed during NOS catalyzed L-arginine N(G)-oxidation, only
      NH2OH caused relaxations that exhibited a pharmacological profile similar to
      those induced by the nitrergic neurotransmitter. Furthermore, if NH2OH is the
      actual neurotransmitter it appears to be acting either directly or by a catalase
      independent release of NO.

PMID- 11205886
TI  - Modulation of NMDA- and (+)TAN-67-induced nociception by GABA(B) receptors in the
      mouse spinal cord.
AB  - The present study was designed to investigate the effect of a selective GABA(B)
      receptor agonist baclofen on the pain-like nociceptive behavior (scratching,
      biting and licking) induced by intrathecal (i.t.) injection of N-methyl-D
      aspartate (NMDA) or (+)TAN-67, the enantiomorphs of 2-methyl-4aalpha-(3
      hydroxyphenyl)-1,2,3,4,4a,5,12,12aalpha-octahydro-quinolino[2,3,3g]isoquinoline
      (TAN-67), in the mouse. NMDA (0.05-0.2 microg/mouse) given i.t. immediately
      caused nociception in a dose-dependent manner. The nociception was significantly
      antagonized by i.t. co-injection with dizocilipine (0.1-1.0 microg/mouse), a non
      competitive NMDA receptor antagonist. I.t. co-injection with baclofen (37.5-150
      ng/mouse) significantly reduced the NMDA-induced nociceptive behavior in a dose
      dependent fashion. The inhibition produced by baclofen was completely reversed by
      a selective GABA(B) receptor antagonist 2-hydroxysaclofen (0.15 and 0.3
      microg/mouse). An i.t. injection of (+)TAN-67 at doses of 3.75-15 microg/mouse
      elicited a long-lasting and a dose-related nociception. The nociceptive behavior
      induced by (+)TAN-67 given i.t. was markedly suppressed by i.t. co-injection with
      baclofen (3-30 ng/mouse), and the inhibitory effect of baclofen was prevented by
      i.t. injection of 2-hydroxysaclofen (1 and 3 microg/ mouse). In addition, the
      (+)TAN-67-induced nociception was also attenuated by i.t. co-injection with
      dizocilipine (0.1-1.0 microg/mouse). These results suggest that spinal GABA(B)
      receptors may be implicated in the expression of nociception elicited by i.t.
      injection of either NMDA or (+)TAN-67 in the mouse.

PMID- 11205887
TI  - Tyrosine phosphorylation increases Ca2+ sensitivity of vascular smooth muscle
      contraction.
AB  - In order to elucidate the role of tyrosine phosphorylation in vasoconstriction,
      we investigated the effects of inhibitors of tyrosine kinase (genistein, 30
      microM) and phosphatase (sodium o-vanadate, 5 microM) on the contraction of aorta
      isolated from guinea pig. Genistein significantly inhibited norepinephrine
      induced contraction, but it did not affect that induced by KCI. Thus, tyrosine
      phosphorylation may not be involved in the contractile response to KCI alone. The
      aortic contraction elicited by KCl was significantly augmented by sodium o
      vanadate, which increased both the maximum force and pD2 values of KCl
      contraction. In the presence of verapamil, KCl-induced contraction was abolished
      even after pretreatment with sodium o-vanadate. Sodium o-vanadate also augmented
      Ca2+-induced contraction in the aortic strips depolarized with KCl, increasing
      both its maximum force and pD2 values. Neither basal 45Ca2+ uptake nor verapamil
      sensitive 45Ca2+ uptake induced by KCl were affected by pretreatment with sodium
      o-vanadate. These results suggest that tyrosine phosphorylation is involved in
      the contraction of guinea-pig aorta not through transplasmalemmal Ca2+ entry but
      through increased Ca2+ sensitivity of the intracellular contractile pathway.

PMID- 11205888
TI  - Effects of sulfhydryl modification on adrenal nicotinic acetylcholine receptors:
      disulfide integrity is not essential for activation.
AB  - The importance of disulfide bridges in muscle nicotinic receptors is well
      established; however, for neuronal nicotinic receptors, the effects of sulfhydryl
      modification are less definitive. In these studies the effects of treatment with
      the mild reducing agent, dithiothreitol, on adrenal nicotinic receptors are
      described. We have found that following dithiothreitol treatment, adrenal
      chromaffin cells retained the ability to be stimulated by a variety of nicotinic
      receptor agonists including nicotine, acetylcholine, cytisine, epibatidine, and
      bromoacetylcholine. However, with dithiothreitol treatment, changes in apparent
      affinities were seen with two agonists, epibatidine and bromoacetylcholine. These
      effects of dithiothreitol on apparent affinities were concentration-dependent and
      reversible upon treatment with an oxidizing agent. Dithiothreitol treatment also
      produced effects on secretion that were independent of nicotinic receptor
      activation. Our results are unlike those in other tissues containing nicotinic
      receptors and suggest that subunit composition of nicotinic receptors influences
      the functional outcome of sulfhydryl modification.

PMID- 11205889
TI  - Evidence of prooxidant and antioxidant action of melatonin on human liver cell
      line HepG2.
AB  - The aim of this study was to evaluate melatonin cytotoxicity by measuring its
      effects on various cellular targets. Cell viability, intracellular reduced
      glutathione (GSH) level, and reactive oxygen species (ROS) production were
      assessed in the human liver cell line (HepG2), after incubation with increasing
      melatonin concentrations (0.1-10,000 microM). The incubation times tested were
      24, 72, and 96 h for cell viability and intracellular GSH level, and 15 and 45
      minutes for ROS production. Cellular target evaluations were possible in living
      cells by means of a new microplate cytofluorimeter. This technology was suitable
      for the assessment of cell viability, GSH level, and ROS overproduction with,
      respectively, neutral red, monochlorobimane (mBCl), and 2',7'-dichlorofluorescin
      diacetate (DCFH-DA) fluorescent probes. At the lowest melatonin concentrations
      (0.1-10 microM) and for a relatively short incubation time (24 h), the
      antioxidant effect of melatonin was revealed by an increased intracellular GSH
      level, associated to cell viability improvement. In contrast, after longer
      incubation (96 h), cell viability significantly decreased with these lowest
      melatonin concentrations (0.1-10 microM). Moreover, high melatonin concentrations
      (1,000-10,000 microM) induced GSH depletion. This oxidative stress is associated
      with ROS overproduction from 10 microM after only 15 minutes of incubation. This
      dual effect is strong evidence that, in vitro, melatonin can be both antioxidant
      and prooxidant on the human liver cell line, depending on the concentration and
      incubation time.

PMID- 11205890
TI  - Catcholamine and nitric oxide systems as targets of chronic lead exposure in
      inducing selective functional impairment.
AB  - Rats were exposed for ten months to 60 ppm of lead (Pb, as acetate) in drinking
      water to further assess cardiovascular effects of chronic Pb exposure. At the end
      of the treatment, mean blood Pb was 3.1+/-0.3 microg/dL in the control rats and
      22.8+/-1.2 microg/dL in the Pb-exposed rats (means+/-SE, n=12 in each group);
      these values were not comparable to those of humans. Pb greatly increased plasma
      levels of noradrenaline (NA) and adrenaline (A), but not those of L-DOPA and
      dopamine; monoaminoxidase activity was augmented by Pb, mostly in the aorta and
      in the liver; the aorta, liver, heart and kidney showed discrete
      histopathological alterations in the Pb-exposed rats, in which plasma levels of
      nitric oxide (NO, determined as L-citrulline) were reduced. Pb was able to induce
      blood hypertension, resulting from increase of cardiac inotropism and, mostly,
      total peripheral resistance. These data were discussed also in relation to those
      obtained in our previous studies carried out in rats exposed to Pb in drinking
      water (15-60 ppm) for periods ranging from five to eighteen months. Pb appeared
      to increase both sympathetic nerve activity by central mechanisms (thus
      increasing plasma NA and A) and cyclic adenosine monophosphate (cAMP)-dependent
      availability of calcium ions (Ca++) for contractile mechanisms in the vascular
      and cardiac myocells (also through an increased vascular alpha2- and myocardial
      beta1-adrenoreceptor reactivity). The reduction of plasma NO, contributing to
      increase vascular resistance and cardiac inotropism, was explained as a result of
      actions of Pb on enzyme activities concerned with the kallikrein-kinin (KK) and
      renin-angiotensin-aldosterone (RAA) systems. It was concluded that chronic Pb
      exposure is able to affect selective neuroendocrine (i.e., catecholamine), au-
      tacoidal (i.e., KK and RAA) and transductional pathways (i.e., cAMP, NO, Ca++)
      involved in the cardiovascular function.

PMID- 11205891
TI  - Testosterone inhibits expression of inducible nitric oxide synthase in murine
      macrophages.
AB  - We investigated the effect of testosterone, the main sexual steroid hormone in
      men, upon inducible nitric oxide synthesis in murine macrophages. Incubation of
      murine macrophages (RAW 264.7 cells) stimulated by bacterial lipopolysaccharide
      (2 microg/ml) with increasing amounts of testosterone (0.1-40 microM) showed a
      dose dependent inhibition of inducible nitric oxide synthesis. Inducible nitric
      oxide synthase protein expression was reduced in a dose dependent manner as
      revealed by immunoblotting when cells were incubated with increasing amounts of
      testosterone. This was associated with a decline in iNOS mRNA-levels as
      determined by competitive semiquantitative PCR. As nitric oxide plays an
      important role in immune defense and atherosclerosis prevention, testosterone
      induced iNOS inhibition could lead to an elevated risk of infection as well as to
      the development of atherosclerotic lesions.

PMID- 11205892
TI  - Cocaine metabolism in human fetal and adult liver microsomes is related to
      cytochrome P450 3A expression.
AB  - Cocaine N-demethylation to norcocaine was studied in human liver microsomes of
      different ages. Norcocaine was formed at a considerable rate in fetal (45.4+/
      18.2 nmol/mg x hour, n = 8) and adult specimens (82.0+/-46.6 nmol/mg x hour, n =
      15), p = 0.04 (Mann-Whitney). Furthermore, the apparent Km values in fetal
      specimens (0.57 and 0.48 mM, n = 2) showed a higher affinity compared with those
      of adults (mean value 2.7 (1.8-4.25) mM, n = 4). Estimated enzyme metabolic
      clearance with respect to P450 total content was higher in fetal than in adult
      liver microsomes (2.22 ml/nmol P450 x hour, and 0.18 (0.14-0.23) ml/nmol P450 x
      hour, respectively). Several drugs, known to be CYP3A substrates, were used as
      potential inhibitors of cocaine metabolism. Midazolam, ergotamine and
      erythromycin showed strong inhibition (approx. 70 %) when used at concentrations
      of 500 microM (midazolam, erythromycin) or 200 microM (ergotamine). The
      metabolism of 1 mM cocaine correlated strongly with immunodetected CYP3A protein
      determined by Western blotting in both fetal (r = 0.89, p = 0.19) and adult
      specimens (r = 0.82, p < 0.01) . These findings further support CYP3A as a major
      catalyst of norcocaine formation in human liver microsomes. These results are
      important given the potential risk of toxicity to the foetus of maternal cocaine
      abuse during pregnancy. Although the high Km values found in adult livers reduce
      the importance of this enzyme pathway in cocaine detoxication, this pathway would
      emerge as significant in circumstances of CYP3A induction and/or drug
      interactions leading to potential liver toxicity in chronic cocaine abusers.

PMID- 11205893
TI  - Desipramine induced changes in salivary proteins, cultivable oral microbiota and
      gingival health in aging female NIA Fischer 344 rats.
AB  - Cyclic antidepressants are still a dominating group of psychotherapeutic drugs
      used in the treatment of depression. One of their major side effect is salivary
      gland dysfunction (oral dryness, xerostomia), leading in humans to increased oral
      disease and dysfunction of speech, chewing, swallowing and taste. The purpose of
      this study was to assess the effects of the long-term administration of the
      tricyclic antidepressant desipramine and the reversibility of this treatment
      following a 15 d washout period on specific salivary proteins, composition of
      oral microbiota, and oral health (gingivitis) of aging female F344 rats. Total
      salivary proteins showed decreased concentrations with age and desipramine.
      Similar SDS/PAGE protein profiles appeared in all phases but in different
      relative amounts with age and treatment. While certain proteins maintained steady
      levels (lactoferrin) or decreased with age and treatment (amylase), the synthesis
      of proline-rich proteins, high molecular weight mucin-type glycoproteins, and
      lysozyme was induced with desipramine and age. The oral microbiota was
      significantly changed with age and the administration of the antidepressant. The
      incidence of gingivitis with desipramine was highest in the oldest animals, For
      the different parameters measured, recovery was delayed with age. These data
      indicate, that desipramine has profound effects on salivary protein secretion.
      This may partially explain the changes in microbiota and the increased incidence
      of gingivitis.

PMID- 11205895
TI  - Quantitative and qualitative gender-related differences in jejunal glutathione S
      transferase in the rat effect of testosterone administration.
AB  - Gender-related differences and the regulation by testosterone of glutathione S
      transferase were studied in rat jejunum. We analyzed enzyme activity and the
      relative content of GST subunits. Four experimental groups of adult rats were
      studied: normal males, castrated males, castrated males injected with
      testosterone and normal females. Glutathione S-transferase activity was assayed
      using 1-chloro-2,4-dinitrobenzene and 1,2-dichloro-4-nitrobenzene as substrates.
      Differences in subunit composition among groups were evaluated by western blot
      analysis. The results demonstrated that 1-chloro-2,4-dinitrobenzene conjugation
      rate is higher in normal males than in normal females and castrated males.
      Testosterone administration to castrated males raised the activity up to the
      level observed in normal males. No significant difference in glutathione S
      transferase activity towards 1,2-dichloro-4-nitrobenzene was observed among
      groups. Western blot analysis revealed that males and females differ in all
      subunits tested that is, rGSTA2, rGSTM1, rGSTM2 and rGSTP1, and that testosterone
      regulates the content of rGSTM1, rGSTM2 and rGSTP1. In conclusion, jejunal GST
      shows a gender-dependent regulation affecting both enzyme activity and subunit
      composition, and testosterone appears to be one of the factors involved.

PMID- 11205894
TI  - The continuous administration of aspirin attenuates atherosclerosis in
      apolipoprotein E-deficient mice.
AB  - Aspirin reduces the incidence of thrombotic occlusive events. Classically this
      has been thought to be due to the platelet inhibitory action of aspirin but it
      has recently been shown that inflammation plays a predominant role in the
      initiation and progression of lesions in atherosclerosis. In humans, treatment
      with aspirin reduces cardiovascular risk and slows carotid plaque growth in a
      dose-dependent fashion. We have explored this issue in Apo E-deficient mice on a
      high-fat, high cholesterol diet which provided these animals with a continuous
      administration of 500 microg/day of acetylsalicylic acid in the drinking water.
      After 10 weeks of treatment, the size of the atherosclerotic lesion at the aortic
      sinus had reduced by 35%. At the end of the trial there were no significant
      changes in either plasma lipids or in the quantitative distribution among
      lipoproteins. Likewise, the total antioxidant status and the resistance of plasma
      to oxidation in vitro was similar and there was no change in the distribution of
      iron deposits and in the relative composition of plasma pro-oxidants and
      antioxidants, or in the concentration of plasma in ferritin. Therefore, it is our
      hypothesis that the antiinflammatory effect is responsible for the reduction in
      lesion size. We propose that antiinflammatory molecules which do not cause
      gastrointestinal complications should be tested in humans to determine long-term
      efficacy in the attenuation of atherosclerosis.

PMID- 11205896
TI  - Mechanisms of [Ca2+]i elevation by H2O2 in islets of rats.
AB  - Activity of reactive oxygen species is elevated in diabetes mellitus and has been
      implicated in the destruction of cellular components. The toxic effect of
      reactive oxygen species was investigated by testing the effect of H2O2 on [Ca2+]i
      in isolated islets of Langehans. H2O2 increased [Ca2+]i in a dose-dependent
      manner, which was irreversible at high concentrations. The maximum effect of H2O2
      on [Ca2+]i was larger than those of KCl, glucose, ATP, carbachol and endothelin
      1. The effect of H2O2 was only partially attenuated by removal of external Ca2+
      and by the in-organic Ca2+ channel blocker nickel, but was not blocked by voltage
      dependent or -independent Ca2+ channel blockers nimodipine, nicardipine, SK&F
      96365, econazole and lanthanum. H2O2, disrupted [Ca2+]i homeostasis in islets by
      affecting both release and influx of Ca2+ and causing dysfunction of Ca2+
      clearance systems and may contribute to the pathological process of diabetes.

PMID- 11205897
TI  - Nerve growth factor exerts differential effects on the growth of human pancreatic
      cancer cells.
AB  - Nerve growth factor (NGF) exerts both stimulatory and inhibitory effects on
      neuronal and certain nonneuronal tumors with the effect based on the type of
      tumor. We investigated NGF and its receptors (TrkA and p75) in pancreatic cancer
      cells (PANC-1, MIA-PaCa-2, CAPAN-1, ASPC-1, and T3M4) by reverse transcription
      PCR, Western blot analysis, NGF ELISA, and growth assays. NGF mRNA was present at
      comparable levels in all five pancreatic cancer cell lines. TrkA expression was
      relatively high in PANC-1 and MIA-PaCa-2 cells and low in CAPAN-1, ASPC-1, and
      T3M4 cells. p75 expression was high in PANC-1, MIA-PaCa-2, and T3M4 cells,
      moderate in CAPAN-1, and low in ASPC-1 cells. By ELISA assay, the intracellular
      NGF content in all cell lines was approximately 40 pg/10(6) cells. NGF content
      increased significantly in PANC-1 and MIA-PaCa-2 cells when these cells were
      cultured with serum-free media, whereas there was no change in the other cancer
      cell lines. PANC-1 and MIA-PaCa-2 cells but not the other cell lines released NGF
      in the culture media. Exogenous NGF stimulated the growth of PANC-1 and MIA-PaCa
      2 cells, inhibited the growth of T3M4 and CAPAN-1 cells in a dose- and time
      dependent manner, and did not affect the growth of ASPC-1 cells. NGF led to the
      phosphorylation of TrkA, mitogen-activated protein kinase (MAPK), and p38 MAPK
      but not stress-activated protein kinase/c-Jun NH2-terminal kinase in PANC-1 and
      MIA-PaCa-2 cells. In contrast, in the other pancreatic cancer cell lines none of
      these kinases were phosphorylated by NGF. In conclusion, the effects of NGF on
      pancreatic cancer cell growth are dependent on the expression levels and the
      balance of its TrkA and p75 receptors. NGF-induced pancreatic cancer cell growth
      seems to be mediated through the phosphorylation of TrkA and subsequently via
      MAPK. These results point to a previously unknown autocrine/paracrine pathway in
      pancreatic cancer, suggesting that NGF-TrkA interactions are important factors
      influencing cell growth and spread in this malignancy.

PMID- 11205898
TI  - Novel tankyrase-related gene detected with meningioma-specific sera.
AB  - In many meningiomas, alterations of chromosome 22 can be found, and the NF2
      (neurofibromatosis type 2) gene, in particular, is of great interest as a
      putative gene involved in meningioma. Because the NF2 gene is not mutated in all
      meningiomas, additional genes may be involved. Instead of looking for alterations
      directly at the DNA level, we used the immune response of meningioma patients to
      identify immunogenic antigens that may be associated with the disease. We
      screened a fetal brain cDNA expression library with sera pools from different
      patients bearing meningioma classified according to the three WHO grades, using
      the serological identification of antigens by recombinant expression cloning
      immunological screening method. Here, we report the finding of a new tankyrase
      related protein. We found 16 overlapping clones with homologies to tankyrase when
      we screened the library with the common-type meningioma sera pool and 2 such
      clones when we screened the library with the atypical meningioma sera. The
      anaplastic meningioma sera did not identify any tankyrase-related clones. We
      tested some of the newly identified clones with 13 single sera, 6 of which
      (37.5%) reacted positively with the tankyrase-related clones. In addition, we
      screened the tankyrase-related clone with six sera pools from individuals without
      obvious disease. Although 1 of 24 (4.2%) normal sera reacted with the tankyrase
      related clone, we found a striking difference in the frequency of reactivity to
      this clone by sera from patients bearing tumors corresponding to the three WHO
      meningioma grades; common-type sera was the most frequently reactive. Northern
      blot analysis demonstrates expression of the novel tankyrase gene in two common
      type meningiomas from patients with immune response.

PMID- 11205899
TI  - A conditionally replicative adenovirus with enhanced infectivity shows improved
      oncolytic potency.
AB  - The absence or the presence of low levels of the Coxsackievirus and adenovirus
      receptor (CAR) on several tumor types might limit the efficacy of recently
      proposed tumor-specific or conditionally replicative adenoviruses (CRAds). To
      address this issue, we used a genetic modification of the fiber knob in the
      context of an E1A-defective CRAd to allow CAR-independent target cell infection
      as a means to enhance oncolytic potency. Such infectivity-enhanced CRAd showed
      higher replication, more efficient infection, and lysis of tumor cells in vitro.
      Of note, the improved antitumor effect of the fiber-modified CRAd could be
      demonstrated in vivo. We conclude that the combination of genomic modification to
      achieve tumor-selective replication and capsid modification to enhance
      infectivity yields more potent oncolytic adenoviruses for use in cancer
      treatment.

PMID- 11205900
TI  - Dendritic cells transduced with full-length wild-type p53 generate antitumor
      cytotoxic T lymphocytes from peripheral blood of cancer patients.
AB  - Accumulation of wild-type or mutant p53 protein occurs in approximately 50% of
      human malignancies. This overexpression may generate antigenic epitopes
      recognized by CTLs. Because normal cells have undetectable levels of p53, these
      CTLs are likely to be tumor specific. Here, for the first time, we test the
      hypothesis that full-length wild-type p53 protein can be used for generation of
      an immune response against tumor cells with p53 overexpression. T cells obtained
      from nine HLA-A2-positive cancer patients and three HLA-A2-positive healthy
      individuals were stimulated twice with dendritic cells (DCs) transduced with an
      adenovirus wild-type p53 (Ad-p53) construct. Significant cytotoxicity was
      detected against HLA-A2-positive tumor cells with accumulation of mutant or wild
      type p53 but not against HLA-A2-positive tumor cells with normal (undetectable)
      levels of p53 or against HLA-A2-negative tumor cells. This response was specific
      and mediated by CD8+ CTLs. These CTLs recognized HLA-A2-positive tumor cells
      expressing normal levels of p53 protein after their transduction with Ad-p53 but
      not with control adenovirus. Stimulation of T cells with Ad-p53-transduced DCs
      resulted in generation of CTLs specific for p53-derived peptide. These data
      demonstrate that DCs transduced with the wild-type p53 gene were able to induce a
      specific antitumor immune response. This offers a new promising approach to
      immunotherapy of cancer.

PMID- 11205901
TI  - Neutron or photon irradiation for prostate tumors: enhancement of cytokine
      therapy in a metastatic tumor model.
AB  - We have shown that implantation of human prostate carcinoma PC-3 cells in the
      prostates of nude mice led to the formation of prostate tumors with metastases to
      para-aortic lymph nodes. We found that day 6 prostate tumors were responsive to
      systemic injections of interleukin 2 (IL-2) therapy. We have now investigated the
      combination of primary tumor irradiation and IL-2 for metastatic prostate cancer
      in this preclinical tumor model. The effect of neutron radiation was compared
      with that of photon radiation. Advanced prostate tumors (approximately 0.4 cm)
      were irradiated, and a day later, mice were treated with systemic IL-2 for three
      weekly cycles. In separate experiments, mice were either sacrificed on day 30 to
      assess prostate tumor size and tumor histology or followed for survival. A dose
      dependent inhibition of prostate tumor growth was caused either by photons or
      neutrons, but neutrons were more effective than photons with a relative
      biological effectiveness of 2. The tumor inhibition obtained with 250 cGy
      neutrons and 500 cGy photons was significant (>75%) and was further increased (>
      or = 90%) by addition of IL-2 therapy. In survival studies, the combination of
      radiation and IL-2 showed a significant survival advantage compared with
      untreated mice (P < or = 0.005) or radiation alone (P < or = 0.003) and an
      increase in median survival compared with IL-2 alone. Histologically, the
      combined regimen resulted in a greater degree of tumor destruction, inflammatory
      response, and vascular damage than that observed with each modality alone. After
      this combined treatment, no tumor was histologically detected in the para-aortic
      lymph nodes of these mice, and the lymph nodes were significantly smaller. These
      findings showed that primary tumor irradiation, either with neutrons or photons,
      enhanced IL-2 therapeutic effect for the treatment of advanced prostate cancer.
      This combined modality induced an antitumor response that controlled the growth
      of prostate tumors and their metastases.

PMID- 11205902
TI  - Overexpression of the ATP-binding cassette half-transporter, ABCG2
      (Mxr/BCrp/ABCP1), in flavopiridol-resistant human breast cancer cells.
AB  - We sought to characterize the interactions of flavopiridol with members of the
      ATP-binding cassette (ABC) transporter family. Cells overexpressing multidrug
      resistance-1 (MDR-1) and multidrug resistance-associated protein (MRP) did not
      exhibit appreciable flavopiridol resistance, whereas cell lines overexpressing
      the ABC half-transporter, ABCG2 (MXR/BCRP/ABCP1), were found to be resistant to
      flavopiridol. Flavopiridol at a concentration of 10 microM was able to prevent
      MRP-mediated calcein efflux, whereas Pgp-mediated transport of rhodamine 123 was
      unaffected at flavopiridol concentrations of up to 100 microM. To determine
      putative mechanisms of resistance to flavopiridol, we exposed the human breast
      cancer cell line MCF-7 to incrementally increasing concentrations of
      flavopiridol. The resulting resistant subline, MCF-7 FLV1000, is maintained in
      1,000 nM flavopiridol and was found to be 24-fold resistant to flavopiridol, as
      well as highly cross-resistant to mitoxantrone (675-fold), topotecan (423-fold),
      and SN-38 (950-fold), the active metabolite of irinotecan. Because this cross
      resistance pattern is consistent with that reported for ABCG2-overexpressing
      cells, cytotoxicity studies were repeated in the presence of 5 microM of the
      ABCG2 inhibitor fumitremorgin C (FTC), and sensitivity of MCF-7 FLV1000 cells to
      flavopiridol, mitoxantrone, SN-38, and topotecan was restored. Mitoxantrone
      efflux studies were performed, and high levels of FTC-reversible mitoxantrone
      efflux were found. Northern blot and PCR analysis revealed overexpression of the
      ABCG2 gene. Western blot confirmed overexpression of ABCG2; neither P
      glycoprotein nor MRP overexpression was detected. These results suggest that
      ABCG2 plays a role in resistance to flavopiridol.

PMID- 11205903
TI  - Increased fatty acid synthase is a therapeutic target in mesothelioma.
AB  - Many common human cancer tissues express high levels of fatty acid synthase
      (FAS), the primary enzyme for the synthesis of fatty acids, and the differential
      expression of FAS between normal and neoplastic tissues has led to the
      consideration of FAS as a target for anticancer therapy. To investigate the
      potential of targeting FAS for the treatment of pleural mesothelioma, we first
      determined whether FAS is overexpressed in human mesothelioma. By
      immunohistochemistry, we found 22 of 30 human mesothelioma tissue samples tested
      to express significantly increased levels of FAS compared with normal tissues,
      including mesothelium. To further explore FAS as a therapeutic target in
      mesothelioma, we established a nude mouse xenograft model for human mesothelioma
      using the H-Meso cell line. The i.p. xenografts of this cell line have high
      levels of FAS expression and fatty acid synthesis pathway activity and grow along
      mesothelial surfaces in a manner similar to the growth pattern of human
      mesothelioma. Growth of these tumor xenografts was essentially abolished in mice
      treated with weekly i.p. injections of C75, a synthetic, small molecule inhibitor
      of FAS, at levels that resulted in no significant systemic toxicity except for
      reversible weight loss. These results suggest that FAS may be an effective target
      for pharmacological therapy in a high proportion of human mesotheliomas.

PMID- 11205904
TI  - Differential sensitivity of various pediatric cancers and squamous cell
      carcinomas to lovastatin-induced apoptosis: therapeutic implications.
AB  - 3-Hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase is the rate-limiting enzyme of
      the mevalonate pathway, the diverse array of end products of which are vital for
      a variety of cellular functions, including cholesterol synthesis and cell cycle
      progression. We showed previously that this enzyme holds a critical role in
      regulating tumor cell fate, including cell death, as its expression is down
      regulated in response to retinoic acid, a potent anticancer therapeutic. Indeed,
      direct inhibition of HMG-CoA reductase with lovastatin, a competitive inhibitor
      of this enzyme, induced a pronounced apoptotic response in neuroblastoma and
      acute myeloid leukemic cells. We have now extended this work and evaluated a wide
      variety and large number of tumor-derived cell lines for their sensitivity to
      lovastatin-induced apoptosis. These cell lines were exposed to a wide range (0
      100 microM) of lovastatin for 2 days and assayed for cell viability using the
      3,4,5-dimethyl thiazlyl-2,2,5-diphenyltetrazolium bromide assay and the induction
      of apoptosis by flow cytometric and ultrastructural analyses. Lovastatin induced
      a pronounced apoptotic response in cells derived from juvenile monomyelocytic
      leukemia, pediatric solid malignancies (rhabdomyosarcoma and medulloblastoma),
      and squamous cell carcinoma of the cervix and of the head and neck.
      Interestingly, the subset of malignancies that are particularly sensitive to
      lovastatin-induced apoptosis correspond to those tumor subtypes that are
      sensitive to the biological and antiproliferative effects of retinoids in vitro.
      The nature of the biologically active form of lovastatin has been challenged
      recently as the growth-inhibitory effects of this drug were attributed to its
      prodrug lactone form that does not inhibit HMG-CoA reductase function. In this
      report, we demonstrate that the apoptotic properties of lovastatin are triggered
      by the open ring acid form that is a potent inhibitor of HMG-CoA reductase
      activity. Thus, we have identified a subset of tumors that are sensitive to
      lovastatin-induced apoptosis and show HMG-CoA reductase as a potential
      therapeutic target of these cancers.

PMID- 11205905
TI  - Pharmacological determinants of 9-aminocamptothecin cytotoxicity.
AB  - The camptothecins are a group of anticancer agents with a unique mechanism of
      action: poisoning of eukaryotic DNA topoisomerase I. 9-aminocamptothecin (9-AC),
      a potent water-insoluble derivative of camptothecin, is currently undergoing
      clinical testing. The kinetics of the active derivative 9-AC lactone in cell
      culture media was defined, and then 9-AC cytotoxicity against human breast (MCF
      7), bladder (MGH-U1), and colon (HT-29) cancer cell lines was studied. The
      relationship between cytotoxic effects, drug concentration, and exposure time was
      then explored. For all of the three cell lines, 9-AC cytotoxicity increased with
      both higher drug concentrations and longer exposure times. However, when the
      duration of exposure was less than 24 h, cytotoxicity was limited and less than 1
      log of cell killing occurred, even with very high drug concentrations. Minimal
      cell killing was also observed unless 9-AC concentrations exceeded a threshold of
      2.7 nM. No fixed relationship between the survival fraction and the area under
      the drug concentration-time curve could be modeled that would fit all of the
      three cell lines. However, data for the three cell lines from the multiple
      exposure time experiments were fitted very well to the pharmacodynamic model
      C(n)t = k (r2, 0.90-0.99), where C is the drug concentration, n is the drug
      concentration coefficient, and t is the exposure time. For the three cell lines,
      to kill 1 log of cells, 0.30 < n < 0.85, which indicated that duration of
      exposure was more important than concentration. Our data support the use of 9-AC
      by infusion for 24 h or longer in clinical studies providing target plasma
      concentrations can be achieved.

PMID- 11205906
TI  - Single-Dose versus fractionated radioimmunotherapy of human colon carcinoma
      xenografts using 131I-labeled multivalent CC49 single-chain fvs.
AB  - The prospects of radiolabeled antibodies in cancer detection and therapy remain
      promising. However, efforts to achieve cures, especially of solid tumors, with
      the systemic administration of radiolabeled monoclonal antibodies (MAbs) have met
      with limited success. Using genetic engineering techniques, MAbs have been
      tailored to improve the therapeutic index (tumor:normal tissue ratio) in clinical
      radioimmunotherapy. In the present study, we investigated the potential of
      tetravalent ([sc(Fv)2]2) and divalent [sc(Fv)2] single chain Fvs of MAb CC49 for
      therapy in athymic mice bearing s.c. LS-174T human colon carcinoma xenografts.
      Mice received 1,000 microCi of 131I-labeled [sc(Fv)2]2 or 131I-labeled sc(Fv)2,
      either as a single injection on day 6 or as four injections (250 microCi each) on
      days 6, 7, 8, and 9; the day of tumor implantation was taken as day 0. The median
      survival for the control group was 26 days. Comparisons of single and
      fractionated therapeutic regimens showed median survival as 32 (P < 0.001) and 53
      days (P < 0.0001), respectively for [sc(Fv)2]2 and 26 (P > 0.5) and 38 days (P <
      0.0001), respectively for sc(Fv)2 when compared with the control groups. The time
      for the quadrupling of tumor volume for single and fractionated therapeutic
      treatments were: 9.0 +/- 0.8 and 21.1 +/- 2.9 days respectively for sc(Fv)2; 16.6
      +/- 1.9 and 32.9 +/- 2.7 days respectively for [sc(Fv)2]2; and 8.3 +/- 0.7 and
      8.4 +/- 0.6 days respectively for the control group. No 131I-labeled systemic
      toxicity was observed in any treatment groups. The results show that
      radioimmunotherapy delivery for sc(Fv)2 and [sc(Fv)2]2 in a fractionated schedule
      clearly presented a therapeutic advantage over single administration. The
      treatment group receiving tetravalent scFv showed a statistically significant
      prolonged survival with both single and fractionated administrations suggesting a
      promising prospect of this reagent for cancer therapy and diagnosis in MAb-based
      radiopharmaceuticals.

PMID- 11205907
TI  - Ecteinascidin 743 induces protein-linked DNA breaks in human colon carcinoma
      HCT116 cells and is cytotoxic independently of topoisomerase I expression.
AB  - Ecteinascidin 743 (Et743; NSC 648766) is a potent antitumor agent presently in
      clinical trials. Et743 selectively alkylates guanine N2 from the minor groove of
      duplex DNA and bends the DNA toward the major groove. This differentiates Et743
      from other DNA-alkylating agents presently in the clinic. To date, the cellular
      effects of Et743 have not been elucidated. Recently, Et743 DNA adducts have been
      found to suppress gene expression selectively and to induce topoisomerase I
      (top1) cleavage complexes in vitro and top1-DNA complexes in cell culture. In the
      present study, we characterized the DNA damage and the cell cycle response
      induced by Et743 in human colon carcinoma HCT116 cells. Alkaline elution
      experiments demonstrated that micromolar concentrations of Et743 produced
      comparable frequencies of DNA-protein cross-links and DNA single-strand breaks.
      The single-strand breaks were protein-cross-linked and were not associated with
      detectable DNA double-strand breaks. By contrast with camptothecin, these lesions
      persisted for several hours after drug removal and were not formed at 4 degrees
      C. Et743 treatment induced transient p53 elevation, dose-dependent cell cycle
      accumulation in G2-M and in G1- and S-phase, and inhibition of DNA synthesis. The
      sensitivity of camptothecin-resistant mouse leukemia P388/ CPT45 cells, which
      fail to express detectable top1, was similar to the sensitivity of wild-type P388
      cells, suggesting that top1 is not a critical target for the antiproliferative
      activity of Et743.

PMID- 11205908
TI  - Single-cell cytotoxicity with radiolabeled antibodies.
AB  - Previous studies demonstrated the effective, antigen-specific killing of Raji B
      lymphoma cells in vitro by radiolabeled anti-CD74, attributable largely to the
      high level of uptake, of approximately 10(7) antibody (Ab) molecules/cell/ day.
      This Ab is rapidly delivered to lysosomes for catabolism, so the radionuclide
      delivered accumulates primarily in lysosomes. In this study, we have tested Abs
      that bind to the same target cells in similar amounts, but remain primarily on
      the cell surface, to compare the potency of radioactivity delivered to the cell
      surface versus the cytoplasm. The Abs tested were anti-major histocompatibility
      complex class II and anti-CD20. 111In-labeled conjugates made with these two Abs
      killed cells very effectively and specifically, with 100% kill of sample of 5 x
      10(5) cells. Because these Abs remain primarily on the cell surface, it would be
      predicted that residualizing radiolabels, which are trapped in lysosomes after Ab
      catabolism, would not be required, and this was observed, i.e., these two Abs
      were effective when labeled with either 125I or 131I, using conventional
      iodination, as well as with the residualizing label 111In-labeled DTPA. These
      results are in contrast to results obtained with anti-CD74, which required a
      residualizing radiolabel for effectiveness. The uptake of these radionuclides, in
      cpm/cell, was monitored, and this allowed estimation of the radiation dose
      delivered; the cytotoxicity observed was consistent with the estimated radiation
      dose delivered. To establish the generality of the results, we also demonstrated
      that 111In-labeled anti-CD74 effectively killed three other B-lymphoma cell
      lines, in addition to Raji and the adherent melanoma cell line SK-MEL-37. By
      using more potent radionuclides or conjugates of higher specific activity, this
      approach might be effective with other, lower density antigens.

PMID- 11205909
TI  - Use of dendritic cells to immunize against cancers overexpressing p53.

PMID- 11205910
TI  - In vitro synergistic interactions between the cisplatin analogue nedaplatin and
      the DNA topoisomerase I inhibitor irinotecan and the mechanism of this
      interaction.
AB  - Among the numerous clinical regimens used in combination chemotherapy, synergy is
      particularly marked in combinations containing cisplatin (CDDP). However, the
      clinical use of CDDP is sometimes limited due to its nephrotoxicity. Nedaplatin
      (NDP) is a second-generation platinum complex with reduced nephrotoxicity that
      may substitute for CDDP or even surpass it for use in combination with other
      drugs. We investigated the effects of combinations of NDP and other anticancer
      drugs on the growth of human small cell lung cancer cells (SBC-3) and non-small
      cell lung cancer cells (PC-14) using a three-dimensional analysis model. Among
      the combinations tested, the combination of NDP and irinotecan (CPT-11) showed
      the most marked synergistic interaction, and the synergism has also been observed
      against PC-14 cells. With regard to treatment schedule, a remarkable synergistic
      interaction was produced by concurrent exposure to NDP and CPT-11. On the other
      hand, sequential exposure to the two drugs led only to additivity. To analyze the
      interaction between the drugs, the effect of NDP on the 7-ethyl-1-hydroxy-CPT
      (the active form of CPT-11)-induced inhibitory effect on DNA topoisomerase I was
      examined. The topoisomerase I-inhibitory effect of 7-ethyl-1-hydroxy-CPT was
      enhanced 10-fold in the presence of NDP at microgram/milliliter concentrations.
      These biochemical interactions might be responsible for the synergistic
      interaction between NDP and CPT-11. These results suggest that the combination of
      NDP with CPT-11 may be clinically useful for the chemotherapy of lung cancer.

PMID- 11205911
TI  - Differential effects of adenovirus-p16 on bladder cancer cell lines can be
      overcome by the addition of butyrate.
AB  - High frequency of p16 alteration and high local recurrence rate of bladder cancer
      make this cancer an ideal target for p16 gene therapy. However, a low
      transduction rate of p16 via adenoviral vector causes an inconsistent result. In
      this study, we have tested adenovirus-p16 in several bladder cancer cell lines
      and investigated a way of improving the low transduction rate. Adenovirus-p16
      showed a strong antitumor effect on bladder cancer cell lines (253J and T24) with
      strong Coxackie-adenoviral receptor (CAR) expression but little antitumor effect
      on bladder cancer cell lines (J82 and HT1376) with little CAR expression. In this
      study, we suggest a simple way of overcoming the differential effects of the
      adenovirus. The addition of butyrate to media was found to increase the
      transduction rate of adenovirus remarkably and increase the antitumor effect of
      adenovirus-p16 in bladder cancer cell lines with little CAR expression. Butyrate
      effects were related with increased CAR expression on the cell surface as well as
      increased transgene expression from adenoviral vector. From these observations,
      application of adenovirus-p16 gene therapy with butyrate can overcome the
      obstacle of low gene transfer and enhance the antitumor effect of adenovirus-p16
      in bladder cancer.

PMID- 11205912
TI  - The effects of KNK437, a novel inhibitor of heat shock protein synthesis, on the
      acquisition of thermotolerance in a murine transplantable tumor in vivo.
AB  - A newly synthesized reagent, KNK437, has been found specifically to inhibit the
      synthesis of heat shock proteins in vitro. In this study, we investigated the
      effects of KNK437 on the synthesis of heat shock proteins and the induction of
      thermotolerance in transplantable tumors in vivo. SCC VII cells were grown in
      vivo and transplanted into C3H/He mice. The concentrations of KNK437 in the
      tumors and the sera of the mice were examined by high-performance liquid
      chromatography. Hsp72 synthesis was examined by Western immunoblot analysis. The
      response to hyperthermia was evaluated in terms of the delay in tumor growth.
      KNK437 had low toxicity in vivo. The concentration of KNK437 in the tumors
      gradually increased and reached a peak 6 h after i.p. injection. Hsp72 were
      synthesized 8 h after hyperthermia at 44 degrees C for 10 min, and their
      synthesis was inhibited by administration of KNK437 6 h before hyperthermia. At a
      concentration of 200 mg/kg, KNK437 alone showed no antitumor effects and did not
      increase the thermosensitivity of nontolerant tumors. The same dose of KNK437
      enhanced the antitumor effects of fractionated heat treatment at 44 degrees C in
      a synergistic manner. This study strongly suggests the inhibition of
      thermotolerance via the inhibition of HSP72 in vivo. The inhibition of
      thermotolerance by KNK437 may help to improve the efficacy of clinical
      fractionated hyperthermia.

PMID- 11205913
TI  - Immunotherapy of bladder cancer using autologous dendritic cells pulsed with
      human lymphocyte antigen-A24-specific MAGE-3 peptide.
AB  - Recent investigations have demonstrated the efficacy of autologous dendritic
      cells (DCs) pulsed with tumor antigens to generate tumor-specific CTLs against
      cancer cells. Melanoma antigens (MAGE) are a family of tumor-specific antigens
      shown to be expressed in various tumors, including bladder cancers and melanoma,
      but not in normal tissues except for the testis. Because invasive bladder cancers
      are frequently reported to express MAGE, we explored the possibility of
      establishing a new immunotherapeutic modality against advanced bladder cancer
      using autologous DCs pulsed with one of the MAGE-3 epitope peptides (IMPKAGLLI),
      which is synthesized to bind specifically to HLA-A24. A MAGE-3-expressing bladder
      cancer cell line, FY, was newly established from a lymph node metastasis of
      bladder cancer in a HLA-A24+ patient. The FY cell-specific CTL response was
      significantly higher when CTL was induced by autologous DCs pulsed with IMPKAGLLI
      than by FY cells alone or by nonpulsed DCs in vitro. A total of four HLA-A24+
      patients with advanced MAGE-3+ bladder cancers were treated with s.c. injections
      of autologous DCs pulsed with IMPKAGLLI every 2 weeks for a minimum of 6 and a
      maximum of 18 times. Three of four patients showed significant reductions in the
      size of lymph node metastases and/or liver metastasis. No significant untoward
      side effects were noted in these patients. This study indicated that, at sometime
      in the future, tumor-specific DC-based cancer immunotherapy may be useful as an
      additional treatment modality against advanced bladder cancer.

PMID- 11205914
TI  - A phase I study of irinotecan in pediatric patients: a pediatric oncology group
      study.
AB  - A Phase I trial of irinotecan was performed to determine the maximum tolerated
      dose (MTD), the dose-limiting toxicities (DLTs), and the incidence and severity
      of other toxicities in children with refractory solid tumors. Thirty-five
      children received 146 courses of irinotecan administered as a 60-min i.v.
      infusion, daily for 5 days, every 21 days, after premedication with dexamethasone
      and ondansetron. Doses ranged from 30 mg/m2 to 65 mg/m2. An MTD was defined in
      heavily pretreated and less-heavily pretreated (i.e., two prior chemotherapy
      regimens, no prior bone marrow transplantation, and no radiation to the spine,
      skull, ribs, or pelvic bones) patients. Myelosuppression was the primary DLT in
      heavily pretreated patients, and diarrhea was the DLT in less-heavily pretreated
      patients. The MTD in the heavily pretreated patient group was 39 mg/m2, and the
      MTD in the less-heavily pretreated patients was 50 mg/m2. Non-dose-limiting
      diarrhea that was well controlled and of brief duration was observed in
      approximately 75% of patients. A partial response was observed in one patient
      with neuroblastoma, and in one patient with hepatocellular carcinoma. Stable
      disease (4-20 cycles) was observed in seven patients with a variety of
      malignancies including neuroblastoma, pineoblastoma, glioblastoma, brainstem
      glioma, osteosarcoma, hepatoblastoma, and a central nervous system rhabdoid
      tumor. In conclusion, the recommended Phase II dose of irinotecan administered as
      a 60-min i.v. infusion daily for 5 days, every 21 days, is 39 mg/m2 in heavily
      treated and 50 mg/m2 in less-heavily treated children with solid tumors.

PMID- 11205915
TI  - A phase II trial of bryostatin 1 in the treatment of metastatic colorectal
      cancer.
AB  - Current chemotherapy for patients with advanced colorectal cancer is relatively
      ineffective and may be associated with significant toxicity. Bryostatin 1 (bryo
      1) influences cell proliferation, intracellular metabolism and signaling,
      differentiation, and apoptosis in human cancer cell lines via modulation of
      protein kinase C (PKC) activity. This trial investigates the efficacy and
      toxicity of bryo 1 as a novel therapeutic agent for patients with advanced
      colorectal cancer who have had previous 5-fluorouracil therapy. The primary end
      point was tumor response to bryo 1. Toxicity was also assessed. Twenty-eight
      patients with advanced colorectal cancer were enrolled. The mean age was 59 years
      (range, 38-76), with 16 men and 12 women, and good minority representation (11
      African-Americans). The first 10 patients initially received 25 microg/m2 of bryo
      1 weekly as a 24-h infusion for 3 weeks of every 4-week cycle, with dose
      escalation to 35 microg/m2 starting with the second cycle. The remaining patients
      were started at 35 microg/m2 and escalated to 40 microg/m2, if toxicity was
      minimal. Twenty-five patients were evaluable for objective tumor response, and
      complete data on toxicity were collected on 26 patients. No partial or complete
      tumor responses were observed. All 25 patients had disease progression within
      four cycles. Myalgia was the most common toxicity. Myelosuppression was not seen.
      bryo 1 as a weekly 24-h continuous infusion lacks single-agent antitumor activity
      in advanced colorectal cancer. Toxicity differs from that of traditional
      chemotherapeutic drugs.

PMID- 11205916
TI  - A phase I and pharmacokinetic study of the novel aza-anthracenedione compound BBR
      2778 in patients with advanced solid malignancies.
AB  - BBR 2778 is a novel aza-anthracenedione with no cardiotoxicity in preclinical
      models. This Phase I dose escalation trial of BBR 2778 was conducted to determine
      the maximum tolerated dose, the dose-limiting toxicity, and the pharmacokinetic
      profile of BBR 2778 in patients with advanced solid tumors. BBR 2778 was given in
      three consecutive weekly 30-min i.v. infusions over a 4-week cycle (cy). Thirty
      patients (pts) were treated with BBR 2778 at doses ranging from 5 to 150
      mg/m2/week. The dose levels 5, 10, 16.5, 25, 37.5, 75, 112.5, and 150 mg/m2/week
      were investigated in 4 pts (9 cy), 3 pts (3 cy), 3 pts (5 cy), 6 pts (9 cy), 1 pt
      (1 cy), 4 pts (9 cy), 6 pts (18 cy), and 3 pts (4 cy), respectively. The dose
      limiting toxicity was neutropenia, typically occurring at day 14. Other
      toxicities were mild to moderate and were principally thrombocytopenia,
      lymphopenia, alopecia, nausea, and vomiting and blue coloration of the skin and
      urine. No significant cardiac toxicity was observed. The plasma dose
      concentration curve fitted a biexponential profile, with a rapid distribution
      phase followed by a prolonged elimination phase (mean t1/2,z, 12 h). BBR 2778
      displayed a large volume of distribution (range, 9.7-29.7 l/kg) with a high
      plasma clearance rate (0.75-1.31 l/h/kg). Less than 10% of the dose was recovered
      in urine as unchanged drug. The maximum tolerated dose was 150 mg/m2/week for 3
      weeks, every 4 weeks. On the basis of this study, the recommended dose for Phase
      II studies is 112.5 mg/m2/week days 1 and 8 with individual optional
      administration at day 15, every 4 weeks. Antitumor activity was observed in
      patients with breast, small cell lung carcinoma, and facial cylindroma. This
      trial showed that BBR 2778 has a manageable toxicity profile on a weekly
      schedule. This lead compound of the aza-anthracenedione family shows promising
      antitumor activity and deserves Phase II investigation in patients with high risk
      of cumulative cardiotoxicity, such as anthracycline-pretreated breast cancer
      patients.

PMID- 11205917
TI  - Early detection of lung cancer: clinical perspectives of recent advances in
      biology and radiology.
AB  - Lung cancer is the most common cause of cancer death in developed countries. The
      prognosis is poor, with less than 15% of patients surviving 5 years after
      diagnosis. The poor prognosis is attributable to lack of efficient diagnostic
      methods for early detection and lack of successful treatment for metastatic
      disease. Most patients (>75%) present with stage III or IV disease and are rarely
      curable with current therapies. Within the last decade, rapid advances in
      molecular biology, pathology, bronchology, and radiology have provided a rational
      basis for improving outcome. These advancements have led to a better
      documentation of morphological changes in the bronchial epithelium before
      development of clinical evident invasive carcinomas. This has changed our concept
      of lung carcinogenesis and emphasized the multistep carcinogenesis approach on
      several levels. Combined with the technical developments in bronchoscopic
      techniques, e.g., laser-induced fluorescence endoscope (LIFE) bronchoscopy, we
      now have improved methods to localize preinvasive and early-invasive bronchial
      lesions. With the LIFE bronchoscope, a new morphological entity (angiogenic
      squamous dysplasia) has been recognized, which might be an important biomarker
      and target for antiangiogenic chemopreventive agents. To reduce the mortality of
      lung cancer, these new technologies have been taken into the clinic in different
      scientific settings. The use of low-dose spiral computed tomography in the
      screening of a high-risk population has demonstrated the possibility of
      diagnosing small peripheral tumors that are not seen on conventional X-ray. A
      shift in the therapeutic paradigm from targeting advanced clinically manifest
      lung cancer toward asymptomatic preinvasive and early-invasive cancer is
      occurring. The present article reviews the recent advances in the diagnosis of
      preinvasive and early-invasive cancer to identify biomarkers for early detection
      of lung cancer and for chemoprevention studies.

PMID- 11205918
TI  - Simultaneous immunomagnetic CD34+ cell selection and B-cell depletion in
      peripheral blood progenitor cell samples of patients suffering from B-cell non
      Hodgkin's lymphoma.
AB  - The reduction of residual tumor cells is one of the main targets of leukapheresis
      product (LP) processing. Immunomagnetic enrichment/selection of CD34+ progenitor
      cells (Baxter Isolex 300i) can achieve a reduction of contaminating B-cells of
      approximately 2-3 logs in B-cell non-Hodgkin's lymphoma patients. Specific
      release of the enriched CD34+ cells (stem cell releasing agent PR34+; Baxter) and
      the use of antibody-coated immunobeads targeted against B-cell markers (CD10,
      CD19, CD20, CD22, CD23, and CD37) during this procedure allows the GMP-like
      simultaneous capture of residual B cells within a closed system. This combination
      of two purging techniques enhances the B-cell depletion capacity up to 4.5 logs.
      By performing 10 clinical-scale purging procedures, we could show that the
      simultaneous immunomagnetic purging method is easy to perform and highly
      efficient. We evaluated B-cell log depletion by flow cytometry for cases with
      marker-positive cells detectable before and after the purging procedure. The mean
      reduction of B-cells in these cases was 3.5 logs; the mean CD34+ cell yield and
      purity were 47 and 92%. Using three LPs, we tested the procedure on a modified
      Baxter Isolex 300i device with software adaptations for this procedure (software
      version 2.0) in direct comparison with CD34+ cell selection only, using the
      former version (version 1.12). The CD34+ cell yield was 49% (40-54%) for the
      CD34+ cell selection and 51% (19-72%) for simultaneous double selection. The mean
      purity was 96% for CD34+ cell selection and 98% for simultaneous double
      selection. B-cell depletion was 1.9 logs for CD34+ cell selection, and after
      simultaneous double selection, the B-cell content was decreased by 3.7 log steps
      (P = 0.0495). Clinical application of double-purged cells has not prolonged the
      hematopoietic recovery times after high-dose therapy as compared with nonpurged
      peripheral blood progenitor cell autotransplants. In conclusion, we could show
      that the simultaneous double selection protocol developed leads to a highly
      increased B-cell purging efficacy when compared with CD34+ cell selection without
      any negative effects regarding CD34+ cell yield and engraftment times after high
      dose therapy.

PMID- 11205920
TI  - Weekly irinotecan and cisplatin in advanced non-small cell lung cancer: a
      multicenter phase II study.
AB  - The combination of weekly irinotecan (CPT-11) and monthly cisplatin has shown
      promising activity in advanced non-small cell lung cancer (NSCLC) in previous
      Phase I and II studies. However, same-day administration of these agents may
      better exploit their therapeutic synergy and minimize toxicities. This
      multicenter Phase II study was undertaken to evaluate the efficacy and safety of
      a combination of weekly CPT-11 and weekly cisplatin in patients with advanced
      NSCLC. Patients with chemotherapy-naive stage IIIB or IV NSCLC were treated with
      repeated cycles of therapy comprising weekly treatment with both cisplatin and
      CPT-11 for 4 weeks, followed by a 2-week rest. The starting doses of CPT-11 and
      cisplatin were 65 and 30 mg/m2, respectively. Treatment was continued until the
      occurrence of disease progression, unacceptable toxicity, or a maximum of six
      cycles. Fifty patients were enrolled. The median age was 59 years (range, 44-79
      years). Eastern Cooperative Oncology Group performance status was 0 in 22
      patients, 1 in 19 patients, and 2 in 9 patients. Seven and 43 patients had stages
      IIIB and IV disease, respectively. Five patients had brain metastasis. Patients
      received a median of three 6-week cycles (range, 1-6). The objective response
      rate was 36% (18 of 50; 95% confidence interval, 24-54%) and included 18 partial
      responses. Median time to tumor progression was 6.9 months (range, 0.6-15.2). The
      median survival was 11.6 months (range, 0.16-21.9 months), and the 1-year
      survival rate was 46%. Grade 3/4 nonhematological toxicities included vomiting
      (12%) and diarrhea (26%). Grade 3/4 hematological toxicities included anemia
      (14%), neutropenia (26%), and thrombocytopenia (14%). Relative dose intensities
      for CPT-11 and cisplatin were 89 and 62%, respectively. Weekly combined
      administration of CPT-11 and cisplatin achieved a promising overall response
      rate, median time to tumor progression, and median survival in patients with
      stage IIIB/IV NSCLC. The regimen was well tolerated, and the planned dose
      intensity was well maintained. Further evaluation of this combination in NSCLC is
      warranted.

PMID- 11205919
TI  - A phase I clinical, pharmacological, and biological trial of interleukin 6 plus
      granulocyte-colony stimulating factor after ifosfamide, carboplatin, and
      etoposide in children with recurrent/refractory solid tumors: enhanced
      hematological responses but a high incidence of grade III/IV constitutional
      toxicities.
AB  - A Phase I trial was conducted to determine the safety, biological activity, and
      hematopoietic recovery by the combination of interleukin 6 (IL-6) and granulocyte
      colony stimulating factor (G-CSF) after myelosuppressive chemotherapy in
      children. Patients <22 years of age at diagnosis with either recurrent or
      refractory solid tumors received ifosfamide 1,800 mg/m2/day x 5 days, carboplatin
      400 mg/m2/ day x 2 days, and etoposide 100 mg/m2/day x 5 days, followed by daily
      s.c. G-CSF (5 microg/kg/day) and IL-6 (2.5, 3.75, or 5.0 microg/kg/day).
      Pharmacokinetic, proinflammatory mediator levels, hematopoietic colony assays,
      and cytokine receptor expression studies were performed during course one.
      Nineteen patients were evaluable for toxicity and received IL-6 at doses of 2.5
      (n = 8), 3.75 (n = 5), or 5.0 (n = 6) microg/kg/day. Dose-limiting constitutional
      toxicity occurred in two of six patients at 5.0 microg/kg/day, two of five
      patients at 3.75 microg/kg/day, and two of eight patients at 2.5 microg/kg/day.
      The maximum tolerated dose (MTD) exceeded the lowest dose tested. Because of lack
      of drug availability, an MTD was not established. The maximum concentration of IL
      6 (2.5 microg/kg/day) was 0.799 +/- 1.055 ng/ml (mean +/- SD). During the first
      course, the median time to absolute neutrophil count > or = 1,000/mm3 and
      platelets > or = 100,000 mm3 was estimated at 19 and 23 days, respectively.
      Peripheral blood progenitor cells expressing receptors to IL-3, IL-6, and G-CSF
      increased significantly over baseline (P < 0.05). After the first dose of IL-6,
      IFN-gamma levels were abnormal in 13 patients, and IL-1beta levels were abnormal
      in 10 patients. IL-6 has a high incidence of constitutional toxicity and a lower
      MTD in children compared with adults. In vivo use of IL-6 in children after
      chemotherapy remains limited. However, IL-6 may be more optimally investigated in
      children under ex vivo conditions.

PMID- 11205921
TI  - Elevated caspase-3 activity in peripheral blood T cells coexists with increased
      degree of T-cell apoptosis and down-regulation of TCR zeta molecules in patients
      with gastric cancer.
AB  - To evaluate the mechanisms of T-cell dysfunction in patients with gastric cancer,
      we investigated the caspase activity of T cells, the induction of spontaneous T
      cell apoptosis, the expression of T-cell receptor (TCR) zeta molecules, and the
      ability of T cells to produce cytokines in peripheral blood lymphocytes from
      patients (n = 22) and healthy controls (n = 14). The caspase-3 activity of T
      cells was studied as the protease activity of caspase-3 using the cell-permeable
      substrate of PhiPhiLux G1D2. Flow cytometric analysis was performed with triple
      staining by annexin V-FITC, propidium iodide, and CD3-R-phycoerythrin-Cy5 for the
      detection of T-cell apoptosis and with intracellular staining using permeabilized
      cells for the expression of TCR-zeta molecules. IFN-gamma and tumor necrosis
      factor alpha production from T cells was evaluated in response to anti-CD3
      stimulation. Caspase-3 activity of peripheral blood T cells from patients with
      advanced disease was significantly increased compared with that from controls
      [15.5 +/- 3.6 mean fluorescence intensity (MFI) versus 11.5 +/- 3.3 MFI; P =
      0.0068]. Parallel to this, the apoptosis of peripheral blood T cells from
      patients with advanced disease was significantly higher than for those from
      controls (16.5 +/- 15.5% versus 4.8 +/- 2.7%; P = 0.010). Furthermore, the
      expression of TCR-zeta molecules in patients with advanced disease was
      significantly decreased in comparison with that of the controls (41.0 +/- 13.9
      MFI versus 56.7 +/- 16.3 MFI; P = 0.014), and this decreased expression coexisted
      with impaired IFN-gamma (42.4 +/- 43.2 pg/ml versus 1,757.4 +/- 2449.0 pg/ml; P =
      0.031) and tumor necrosis factor alpha (682.6 +/- 519.3 pg/ml versus 1,686.0 +/-
      1,533.7 pg/ml; P = 0.041) production of T cells. Thus, peripheral blood T cells
      from gastric cancer patients simultaneously exhibit an elevated caspase-3
      activity, an increased degree of T-cell apoptosis, a down-regulation of TCR-zeta
      molecules, and impaired cytokine production. These observations suggest that
      induction of T-cell apoptosis coexisting with a down-regulation of TCR-zeta
      molecules may be responsible for T-cell dysfunction in patients with gastric
      cancer.

PMID- 11205922
TI  - Independent association of angiogenesis index with outcome in prostate cancer.
AB  - New molecular factors have been characterized that are associated with the
      prognosis of prostate carcinoma patients, including p53 status and angiogenesis.
      We reported recently that mutant p53 (mp53) was associated with decreased
      expression of an endogenous inhibitor of angiogenesis, thrombospondin-1 (TSP-1),
      and increased microvessel density in melanoma and breast cancer. In this study,
      we performed a similar analysis on primary prostate carcinoma to determine
      whether these factors were associated with each other or patient outcomes.
      Paraffin-embedded specimens of 98 cases of primary prostate carcinoma were
      obtained and examined to confirm tissue diagnosis and Gleason scores. Carcinoma
      specific levels of p53, TSP-1, and tumor angiogenesis were determined using
      semiquantitative immunohistochemistry (IHC) methods. Acquisition of mp53 was
      significantly associated with decreased TSP-1 (P = 0.002) and increased
      angiogenesis (P < 0.0001). An angiogenesis index integrating mp53, TSP-1, and
      angiogenesis (CD31) scores was found to be an independent predictor of survival
      in univariate and multivariate analyses that included Gleason score, clinical
      stage, and patient age. Further validation of the angiogenesis index in prostate
      carcinoma may provide a new tool to stratify patient risk.

PMID- 11205923
TI  - The expression of G250/mn/CA9 antigen by flow cytometry: its possible implication
      for detection of micrometastatic renal cancer cells.
AB  - Monoclonal antibody (mAb) G250 is a well characterized and specific mAb to renal
      cell carcinoma (RCC). The gene G250 was recently cloned and was proved to be
      homologous to MN/CA9. The G250/MN/CA9 antigen was recently explored as a
      potential marker for RCC. Flow cytometry (FCM) allows quantitative analysis of
      cells. The present study describes a flow cytometric method to detect this
      antigen in human cell lines and in malignant and normal renal tissues. Twelve
      human carcinoma cell lines (HeLa, Colo205, HT29, BxPC3, OVCAR3, SKOV3, ACHN,
      A704, CAKI-2, SKRC-59, SKRC-10, and SKRC-52), 10 specimens of normal peripheral
      blood mononuclear cells, and 38 malignant and 36 adjacent normal renal tissues
      were studied. The malignant and normal renal tissues were disaggregated
      mechanically into a single-cell suspension, stained by mAb G250, and analyzed by
      FCM. All 22 of the clear cell carcinomas, 6 of 8 mixed cell carcinomas, and 3 of
      6 granular cell carcinomas were positive for G250/MN/CA9 antigen. SKRC-52 and
      SKRC-10 were strongly positive for G250/ MN/CA9. The G250/MN/CA9 antigen could
      also be detected in HeLa, SKOV3, HT29, and A704 cells. One chromophobic, one
      chromophilic cell carcinoma, the normal renal tissues, and normal peripheral
      blood mononuclear cells were considered as negative. Our results further
      confirmed that the G250/MN/CA9 antigen was an ideal marker for RCC, especially
      for clear cell carcinomas, and that this antigen was present in several types of
      malignant cells. FCM may serve as a fast tool of immunocytochemical detection of
      renal cancer cells. Flow cytometric detection of renal cancer cells by using mAb
      G250 should be further explored.

PMID- 11205924
TI  - Selective immunohistochemical staining of blood and lymphatic vessels reveals
      independent prognostic influence of blood and lymphatic vessel invasion in early
      stage cervical cancer.
AB  - Lymphovascular space invasion was shown to play a key role in the progression of
      cervical cancer. Because of the absence of a specific marker for lymphatic
      vessels, earlier studies could not reliably distinguish between blood and
      lymphatic vessel invasion. By immunostaining for podoplanin, a novel marker for
      lymphatic endothelium, and for factor VIII-related antigen, we determined
      lymphatic and blood vessel invasion in tissue samples of 98 patients with
      cervical cancer pT1b treated by radical hysterectomy. Eleven (11.2%) specimens
      showed invasion of blood vessels, 20 (20.4%) showed invasion of lymphatic
      vessels, and 15 (15.3%) showed invasion of blood and lymphatic vessels. There was
      a strong association of lymphatic vessel invasion and lymph node involvement (P <
      0.001). In univariate analysis, both blood and lymphatic vessel invasion failed
      to reach a statistically significant influence on overall survival, but a
      significant influence on disease-free survival was found (P = 0.0002 and P <
      0.0001, respectively). In multivariate analysis of disease-free survival, only
      blood vessel invasion remained statistically significant (P = 0.0457). Lymphatic
      vessel invasion reached significance when lymph node status was excluded from the
      model (P = 0.0025). Both lymphatic vessel and blood vessel invasion occur
      frequently in early-stage cervical cancer. Determination of the vessel status may
      be of clinical importance because it signifies the risk of recurrent disease.

PMID- 11205925
TI  - Novel expression and function of peroxisome proliferator-activated receptor gamma
      (PPARgamma) in human neuroblastoma cells.
AB  - Peroxisome proliferator-activated receptor gamma (PPAR-gamma) is a member of the
      nuclear receptor superfamily of ligand-dependent transcription factors that has
      been shown to play a major role in adipocyte and monocyte/macrophage
      differentiation. Recent work has also suggested a role for PPARgamma in cell
      cycle control and/or differentiation of other cell types including breast and
      lung cancer cells. Using reverse transcription-PCR, we now show for the first
      time that human neuroblastoma (nb) cells express PPARbeta and -gamma, but not 
      alpha. Using the LA-N-5 nb cell line, we have determined that the natural
      PPARgamma ligand 15-deoxy-delta prostaglandin J2, as well as the synthetic
      PPARgamma agonist GW1929, can stimulate the differentiation of nb cells, as
      evidenced by the inhibition of cell proliferation, neurite outgrowth, increased
      acetylcholinesterase activity, and the reduction of N-myc expression. We have
      also demonstrated that PPARgamma is expressed in primary nb and, furthermore,
      that the expression of this receptor correlates with the maturational stage of
      the nb cells. Taken together, these studies have implicated a role for PPARgamma
      in peripheral nerve cell biology and suggest that the PPARgamma signaling pathway
      is involved in the regulation of nb cell growth and differentiation.

PMID- 11205926
TI  - Cannabis arteritis revisited--ten new case reports.
AB  - The purpose of this paper was to revisit the old concept of cannabis arteritis
      first described in the 1960s and report 10 new cases. Ten male patients, with a
      median age of 23.7 years developed subacute distal ischemia of lower or upper
      limbs, leading to necrosis in the toes and/or fingers and sometimes to distal
      limb gangrene. Two of the patients also presented with venous thrombosis and
      three patients were suffering from a recent Raynaud's phenomenon. Biological test
      results did not show evidence of the classical vascular risk factors for
      thrombosis. Arteriographic evaluation in all cases revealed distal abnormalities
      in the arteries of feet, legs, forearms, and hands resembling those of Buerger's
      disease. A collateral circulation sometimes with opacification of the vasa
      nervorum was noted. In some cases, arterial proximal atherosclerotic lesions and
      venous thrombosis were observed. All patients were moderate tobacco smokers and
      regular cannabis users. Despite treatment with ilomedine and heparin in all
      cases, five amputations were necessary in four patients. The vasoconstrictor
      effect of cannabis on the vascular system has been known for a long time. It has
      been shown that delta-8- and delta-9-tetrahydrocanabinols may induce peripheral
      vasoconstrictor activity. Cannabis arteritis resembles Buerger's disease, but
      patients were moderate tobacco smokers and regular cannabis users. These cases
      show that prolonged use of cannabis could be an additive risk factor for juvenile
      and young adult arteritis. Cannabis arteritis is a forgotten and severe occlusive
      vascular disease occurring in young adults. Search for cannabis use may be an
      important tool for a better knowledge of arteritis in young smokers.

PMID- 11205927
TI  - Effects of estrogen therapy on arterial resistance and pulsatility in
      postmenopausal women.
AB  - The hypothesis of this study was that changes in arterial determinants of
      afterload due to static muscular contraction can be modified, in postmenopausal
      women, by estrogen replacement therapy. Two groups of 14 postmenopausal and 15
      premenopausal women were enrolled. Hemodynamic changes induced by right handgrip
      were recorded between days 7 and 10 of the menstrual cycle in premenopausal
      women. The same recordings were performed in postmenopausal women, before and
      after receiving transdermal estrogen replacement therapy for 8 days. Handgrip was
      performed at 50% of maximal voluntary contraction and maintained until
      exhaustion. Arterial pressure and blood velocity were recorded in the resting
      hand with photoplethysmographic and Doppler techniques. Indices of arterial
      elasticity and resistance were calculated. In postmenopausal women, these indices
      increased during effort only slightly less after therapy than before, if the mean
      values and statistical significance were considered, but the most evident effect
      of therapy was a decrease in interindividual differences in the effort induced
      changes. This means that, after therapy, increases in arterial resistance and
      elasticity indices were appreciably prevented mainly in those postmenopausal
      women who, before therapy, showed the greatest increases. Differences due to
      therapy were negligible in postmenopausal women in whom, before estrogen
      replacement, increases in elasticity and resistance indices during effort were
      similar to those obtained in premenopausal women. After therapy, no differences
      were found in resting conditions in any of the investigated cardiovascular
      parameters. Estrogen replacement did not appreciably affect changes in some
      arterial afterload-related indexes during handgrip, if the average values were
      considered in a group of postmenopausal women, but uneven and unpredictable peaks
      in individual responses were cut off, with a better predictability of the
      responses to sustained muscular contractions, as well as of the related risk
      factors.

PMID- 11205928
TI  - Clinical characteristics influence left and right ventricular diastolic function
      in healthy individuals.
AB  - The aim of this study was to determine whether clinical characteristics have an
      influence on left (LV) and right ventricular (RV) diastolic function indices
      measured by echocardiography in healthy individuals. Five hundred and three
      volunteers (253 women and 250 men) aged 18-66 years (mean 36.9 +/- 11.9) who were
      normotensive and free of clinically apparent heart disease were included in the
      study. Mitral and tricuspid peak E wave and A wave velocities, E/A ratio,
      deceleration time (DT) of the E wave, and left ventricular isovolumetric
      relaxation time (IVRT) were evaluated as left and right ventricular diastolic
      function indices. In order to determine the effects of age, gender, body surface
      area (BSA), waist/hip ratio (WHR), and heart rate (HR) on left and right
      ventricular diastolic function indices Student's t test and correlation and
      linear regression analysis were used. IVRT and deceleration time of the mitral E
      wave (DTm) were significantly longer in men. Mitral and tricuspid A wave
      velocities, tricuspid E/A ratio, and deceleration time of the tricuspid E wave
      (DTt) were similar in both genders. Mitral and tricuspid E wave velocities and
      mitral E/A ratio were greater in women. Mitral E wave velocity and IVRT mostly
      correlated with WHR. Age was found to be the most important factor affecting
      mitral A wave velocity, DTm, E/A ratio, and right ventricular diastolic function
      indices. This study shows that age, heart rate, body surface area, and waist/hip
      ratio have important correlations with Doppler echocardiographic diastolic
      indices in normal individuals and should be considered in the evaluation of LV
      and RV diastolic function.

PMID- 11205929
TI  - Primary pulmonary hypertension in HIV patients: a systematic review.
AB  - The relationship between grade of pulmonary hypertension and factors associated
      with human immunodeficiency virus among patients with HIV infection is poorly
      documented. This report documents the most extensive attempt made thus far to
      determine whether a relationship exists between degree of pulmonary hypertension
      and the following conditions: HIV risk factor, degree of immunosuppression,
      presence or absence of AIDS, and presence or absence of liver cirrhosis. A
      retrospective study involving a search of the published literature on primary
      pulmonary hypertension among HIV cases from 1987 to 1998, using the Medline and
      Aidsline databases was conducted. Patients for whom secondary causes of pulmonary
      hypertension could be excluded were selected, and the following information for
      each was recorded: age, gender, risk factors for HIV infection, HIV disease stage
      according to the Centers for Disease Control, previous opportunistic and
      neoplastic diseases, CD4+ cell count (cells/L), presence or absence of liver
      cirrhosis, pulmonary systolic artery pressure level, and lung pathology
      specimens. Information about the patient's survival time was also recorded.
      Seventy-six patients were judged to have primary pulmonary hypertension and were
      included in the study. While no correlation was found between pulmonary systolic
      artery pressure level and CD4+ cell counts, a statistically significant
      difference was found between HIV-positive patients with and without AIDS as
      determined by the Centers for Disease Control criteria with regard to the degree
      of pulmonary hypertension, expressed as pulmonary systolic artery pressure level
      (85.4 +/- 17 mm Hg vs 71.8 +/- 15 mm Hg, p < 0.013). Although a higher PAPS was
      present in HIV cirrhotic patients, a statistically significant difference was not
      found between degree of pulmonary hypertension and evidence of hepatic cirrhosis
      (85 +/- 21 mm Hg vs 73.1 +/- 15 mm Hg, p < 0.062). Patients with AIDS and primary
      pulmonary hypertension present a higher degree of pulmonary hypertension than non
      AIDS patients. Pulmonary hypertension associated with HIV seems to be related to
      a cytokine-related stimulation and proliferation of endothelium. High levels of
      cytokines present in AIDS patients can favor pulmonary hypertension, but the role
      of a host response to HIV--determined by one or more HLA subtypes--is suspected
      to enhance high cytokine production levels.

PMID- 11205930
TI  - QT dispersion in single coronary artery disease: is there a relation between QT
      dispersion and diseased coronary artery or lesion localization?
AB  - It has been shown that QT dispersion (QTD) increases during episodes of
      myocardial ischemia or infarction. However, no extensive data on the relation
      between the diseased coronary artery or the localization of stenosis and the QTD
      are available. The aim of the study was to examine the relation between QTD and
      diseased coronary artery and lesion localization during exercise stress test in
      patients with single coronary artery disease without prior myocardial infarction.
      One hundred nineteen patients with single coronary artery disease and 53 patients
      with normal coronary arteries were enrolled in study. All patients underwent
      exercise stress test with modified Bruce protocol, and QT interval parameters
      were measured at rest and at minute 2 of the recovery (rec-2) period. QT
      dispersion at rest was found higher in all single-vessel disease groups compared
      with that in the control group, and corrected QT dispersion at rec-2 period was
      also markedly higher in left anterior descending, circumflex, and right coronary
      artery groups compared with that in the control group. No relation was found
      between QT dispersion and diseased coronary artery or the lesion localization. In
      conclusion, no qualitative difference was found between QT dispersion and
      diseased coronary artery or proximal or distal lesion localization. However, it
      was observed that patients with single-vessel disease had wider baseline QT
      dispersion as compared with that in the control group, which further increased
      significantly with exercise. This finding supports the idea that severity of
      localized ischemia rather than extent of coronary artery disease would be
      expected to have a greater effect on inducible QT dispersion.

PMID- 11205932
TI  - Scleroderma pericardial disease presented with a large pericardial effusion--a
      case report.
AB  - Scleroderma pericardial disease is usually silent and benign. The incidence of
      pericardial involvement in scleroderma is about 50% according to autopsy results,
      but symptomatic pericarditis manifests in about 16% of patients with diffuse
      scleroderma and in about 30% of patients with limited scleroderma. The clinically
      evident pericardial effusion is rare in scleroderma, although it can be detected
      in about 41% of patients with echocardiography. In majority of the patients, the
      pericardial effusion is small and not associated with symptoms. The pericardial
      effusion manifests usually after the manifestation of the other clinical and
      serologic features of scleroderma. A case of scleroderma is reported that
      presented with a large pericardial effusion, which antedated the other clinical
      and serologic features of scleroderma. The pericardial involvement in scleroderma
      is reviewed.

PMID- 11205931
TI  - Improvement of left ventricular diastolic dynamics in prediabetic stage of a type
      II diabetic rat model after troglitazone treatment.
AB  - Troglitazone, an oral antidiabetic agent, has hypoglycemic effects in insulin
      resistant animal models and humans. This study was conducted to evaluate its
      effect on left ventricular diastolic dynamics of a spontaneous diabetic (DM) rat
      model. Twenty DM rats and 20 age-matched nonDM rats were used, and 10 of each
      group were treated with troglitazone as a 0.2% food admixture for 10 weeks. At 5
      and 15 weeks of age, Doppler echocardiography and M-mode echocardiography were
      performed. Troglitazone treatment significantly improved the left ventricular
      diastolic dynamics of DM rats: deceleration time (msec) of early diastolic inflow
      decreased significantly (treated 52 +/- 3 vs untreated 64 +/- 5, p = 0.0002), and
      peak velocity of early transmitral inflow (cm/sec) increased significantly
      (treated 96 +/- 7 vs untreated 86 +/- 8, p = 0.0216). The data suggest that
      troglitazone improves left ventricular diastolic dynamics of a DM rat model at
      prediabetic stage.

PMID- 11205933
TI  - Acral necrosis of the fingers as initial manifestation of cutaneous polyarteritis
      nodosa--a case report.
AB  - Cutaneous polyarteritis nodosa (CPN) is a well-known entity showing subcutaneous
      tender nodules, livedo reticularis, and ulcerations as predominant features;
      arthralgia, myalgia, peripheral neuropathy, and general symptoms such as fever
      and malaise may also be present. Although the localization of the disease is not
      specific, the characteristic primary lesions are painful subcutaneous nodules on
      the lower extremities. Here we report the case of a 33-year-old man with blue
      colored distal phalanges and necrosis of several fingertips on both hands as the
      initial manifestation of CPN.

PMID- 11205934
TI  - Idiopathic bilateral external jugular vein thrombosis--a case report.
AB  - The authors report a patient with the rare presentation of bilateral external
      jugular vein thrombosis. A 45-year-old man presented with swelling over both
      sides of the neck and puffiness of the face. Physical examination revealed
      cordlike thickening of both the external jugular veins. Two-dimensional
      echocardiographic and Doppler studies showed thrombosis of both the external
      jugular veins and digital subtraction angiography (DSA) revealed nonvisualization
      of external jugular veins of either side. No malignancy, coagulation disorder, or
      any infection was demonstrable. A regular follow-up for 1 year was done, but no
      other cause could be found and there was no progression of the disease.

PMID- 11205935
TI  - Lower extremity strength deficits in peripheral arterial occlusive disease
      patients with intermittent claudication.
AB  - The purposes of this study were to quantify the degree and distribution of lower
      extremity weakness in patients with peripheral arterial occlusive disease (PAOD)
      compared to apparently healthy older patients and to determine if performance of
      a simple functional measure correlates with lower extremity strength. Older
      patients (n = 46), 31 with PAOD (mean age = 69.9 years; mean ankle-brachial index
      = 0.67) and 15 without PAOD (mean age = 62.6 years; mean ankle-brachial index =
      1.20), underwent isometric strength testing of hip, knee, and ankle musculature.
      In patients with PAOD, dorsiflexion strength was 15% lower (p < 0.05) in the more
      affected limb (55 +/- 4 Newton-meters; mean +/- SE) versus the less affected limb
      (65 +/- 5 Newton-meters). Overall, the dorsiflexor muscles of the more affected
      extremity were 22% weaker (p < 0.05) in the PAOD group than in the non-PAOD group
      (73 +/- 6 Newton-meters). No other significant differences in strength were found
      between the PAOD and the healthy elderly groups or between the more affected and
      less affected limbs in the PAOD patients. The time to perform five sequential sit
      to-stand transfers using an armless chair was 23% greater (p < 0.01) in the PAOD
      group (13.0 +/- 0.5 s) than in the healthy elderly (10.7 +/- 0.9 s). In the PAOD
      patients, dorsiflexor strength was correlated with chair stand time (r = -0.37, p
      < 0.05). The authors conclude that PAOD patients with intermittent claudication
      are functionally limited by dorsiflexion weakness, impairing their ability to
      perform tasks requiring distal lower extremity strength.

PMID- 11205936
TI  - Left ventricular septal aneurysm in association with bicuspid aortic valve--a
      case report.
AB  - Diverticula of the left ventricle are rare cardiac anomalies. Most cases arise
      from the apex of the left ventricle and are usually found in children. Only a few
      cases have been documented in adults. The authors report a case of a 38-year-old
      woman who presented with dyspnea and chest pain. She was found to have a septal
      left ventricular diverticulum associated with bicuspid aortic valve, aortic
      stenosis, and aortic regurgitation. The aortic valve was replaced with the
      resection of the diverticulum. Pathologic examination confirmed the diagnosis of
      fibrous diverticulum.

PMID- 11205937
TI  - A huge mitral valve tumor and its vascularity--a case report.
AB  - Primary cardiac tumors of the mitral valve are extremely rare; however, they
      present a major risk of embolization. Therefore, prompt diagnosis and urgent
      treatment is obligatory. The authors report the case of a 60-year-old man with a
      huge mitral valve mass and its vascularity, which was diagnosed by transthoracic
      echocardiography and selective coronary arteriography. Our patient's mitral valve
      tumor had a size of 5.9 x 2.9 cm, which was the largest size reported up to this
      time in this location. The patient died from a major cerebrovascular event before
      surgical excision could be performed.

PMID- 11205939
TI  - Absence of left anterior descending artery associated with atherosclerotic heart
      disease.

PMID- 11205938
TI  - Myocardial infarction during sleep deprivation in a patient with dextrocardia--a
      case report.
AB  - A patient with dextrocardia who suffered his first myocardial infarction after
      approximately 26 hours of a diagnostic sleep deprivation protocol is described.
      The infarction started about 3 hours after a significant improvement in mood,
      which persisted during and after infarction. Total sleep deprivation may be an
      acute risk factor for myocardial infarction.

PMID- 11205940
TI  - The effects of processing methods on the levels of lysine, methionine and the
      general acceptability of ogi processed using starter cultures.
AB  - Batches of ogi were produced from maize flour slurry, dehulled maize grains and
      whole maize grains using Saccharomyces cerevisiae and Lactobacillus brevis as
      starter cultures. Fermentation over time showed that dehulled maize grains
      inoculated with the starter cultures and processed whole maize grains requiring
      steeping led to higher acid production than fermentation with dry-milled maize
      slurry. Ogi from dehulled maize grains inoculated with starter cultures showed
      the highest levels of lysine and methionine. Steeping grains encouraged a
      stronger ogi aroma than fermentation of maize flour slurry alone. Lactobacillus
      brevis contributed most to the taste of ogi. Fermentation with starter cultures
      showed good prospects for improving the lysine and methionine levels of ogi.

PMID- 11205941
TI  - Nisin-producing organisms during traditional 'Fior di latte' cheese-making
      monitored by multiplex-PCR and PFGE analyses.
AB  - In this work we studied using different molecular methods the population dynamics
      of nisin-producing organisms and the persistence of such organisms within a
      complex ecosystem, 'Fior di latte' cheese, a traditional high-moisture pasta
      filata cheese. Using the primers targeting the eubacterial 16S-23S rRNA spacer
      region, together with those amplifying the nisA or nisZ gene, we were able to
      provide a rapid species identification of the isolates. Inhibitors of Lactococcus
      lactis subsp. lactis DSM 20481T used as indicator occurred during the whole
      process of cheese manufacture as a significant part of lactic microflora;
      however, only 12 among 109 isolates of bacteriocin producers were nisin
      producers. Amplification of the nisA or nisZ gene, using DNA extracted directly
      from dairy samples as templates, showed that the nisin structural gene was
      detected during cheese-making from milk samples up to the end of curd ripening
      but not in the final cheese. In order to monitor nisin-producing strains during
      cheese manufacturing, the 12 Lactococcus lactis nis+ strains were analysed by low
      frequency restriction fragment and PFGE. Nine isolates among the 12 nisin
      producers exhibited an unique and distinct DNA banding pattern and are considered
      to be genetically diverse. The other three isolates from curd after ripening
      showed the same restriction pattern and could be the same strain. In fact, it was
      also isolated 2 months after the first analysis of cheese-making of 'Fior di
      latte'.

PMID- 11205942
TI  - Growth modelling of heat-resistant fungi: the effect of water activity.
AB  - Growth of three strains of heat-resistant fungi, Byssochlamys fulva, Neosartorya
      fischeri and Talaromyces avellaneus, was studied at 25 degrees C at eight or nine
      water activities (a(w)) adjusted with sucrose between 0.995 and 0.85. The
      flexible growth model of Baranyi describing the change in colony diameter (mm)
      with respect to time was first fitted to measured growth data and from the fitted
      curves the maximum colony growth rates were estimated. These values were fitted
      with respect to a(w) to predict colony growth rates at any a(w) within the range
      tested. Optimum a(w) values of 0.986, 0.985, and 0.990 for growth, and maximum
      colony growth rates of 12.6, 13.2 and 20.2 mm d(-1), respectively, were
      calculated. The time to reach a colony diameter of 3 mm and the optimum a(w) for
      each strain were also calculated. The results can be applied to the prevention of
      spoilage of canned fruit or juices and other heat processed fruit based products.

PMID- 11205943
TI  - The effect of calcium and sodium lactates on growth from spores of Bacillus
      cereus and Clostridium perfringens in a 'sous-vide' beef goulash under
      temperature abuse.
AB  - The effect of calcium and sodium lactates on growth from spores of Bacillus
      cereus and Clostridium perfringens at three different concentrations (0, 1.5 and
      3% w/w) and at different temperatures (10, 15 and 20 degrees C for B. cereus and
      15, 20 and 25 degrees C for C. perfringens) was investigated, using beef goulash
      as a model system for pasteurised vacuum-packaged convenience foods. Calcium
      lactate at a level of 3% reduced the pH values of the samples from 6.0 to 5.5. No
      B. cereus growth was observed at 10 degrees C, but after 7 days at an incubation
      temperature of 15 degrees C, cell number increased by 1 log cfu/g in the control
      samples. At this temperature, lactates were seen to be effective at inhibiting
      growth. Calcium lactate was more inhibitory than sodium lactate as the growth of
      B. cereus was inhibited at 1.5 and 3% concentrations at 20 degrees C,
      respectively. Growth of C. perfringens was arrested in the presence of 1.5%
      calcium lactate at all storage temperatures, whereas growth was inhibited by 3%
      sodium lactate only at 15 degrees C.

PMID- 11205944
TI  - Heat resistance of Bacillus cereus, Salmonella typhimurium and Lactobacillus
      delbrueckii in relation to pH and ethanol.
AB  - The aim of the present work was to investigate the effect of ethanol alone and in
      combination with low pH on the heat resistance of specific bacteria. The bacteria
      chosen are representative of heat resistant and heat sensitive pathogens
      (Bacillus cereus and Salmonella typhimurium) and of relatively heat resistant
      spoilage microorganisms (Lactobacillus delbrueckii). The chosen bacteria were
      treated at different temperatures ranging between 70 and 97 degrees C for B.
      cereus, 48 and 54 degrees C for S. typhimurium and 44 and 60 degrees C for L.
      delbrueckii, in media of different pH (3, 5 and 7) and ethanol content (0, 2.5,
      5, 7.5 and 10%). Both factors proved to be very effective in reducing the heat
      resistance of the bacteria examined in this work. At pH 7, an increase in ethanol
      content up to 10% caused D values to decrease by up to 100-fold (S. typhimurium).
      A drop from pH 7 to pH 3 also caused up to a 100-fold reduction in the D values
      (S. typhimurium). For B. cereus the regression analysis of the log10 of the D
      value in relation to temperature, pH and ethanol content was used to produce a
      second order polynomial equation. The z values increased at decreasing pH and
      cells were more sensitive to ethanol at lower pH. For S. typhimurium the
      polynomial equation produced to describe the relationship between log10 of the D
      values and temperature and ethanol content was also a second order equation
      indicating that the relationship between z values and ethanol was non-linear. For
      L. delbrueckii, z values were independent of the ethanol content of the heating
      medium. Acid tolerance at 25 and 37 degrees C (L. delbrueckii and S. typhimurium)
      and acid adaptation (S. typhimurium) were also tested. L. delbrueckii was more
      ethanol and pH tolerant than S. typhimurium at heat treatment temperatures whilst
      S. typhimurium was more acid tolerant than L. delbrueckii at incubation
      temperatures (25 and 37 degrees C). Acid adaptation increased the tolerance of S.
      typhimurium to low pH at 25 degrees C but failed to improve its thermal
      resistance at 48 degrees C. In all bacteria used, the effects of pH and ethanol
      were more evident at lower treatment temperatures and therefore their
      significance becomes greater in view of reduced thermal processing and/or changes
      in product formulation.

PMID- 11205945
TI  - Factors influencing resuscitation and growth of heat injured Listeria
      monocytogenes 13-249 in sous vide cooked beef.
AB  - The growth of Listeria monocytogenes 13-249 in vacuum-packed, minced beef was
      investigated as a function of degree of heat injury (including no injury i.e.
      uncooked beef), growth phase (logarithmic and late stationary phase), pH (5.6 and
      6.2), and storage temperature (3, 10 and 20 degrees C) during a storage period of
      30 days. Late logarithmic and late stationary phase cultures of L. monocytogenes
      13-249 showed similar growth in refrigerated, vacuum-packed, raw minced beef with
      a high pH (6.2). In normal pH (5.6) beef there was no growth at 3 degrees C while
      growth at 10 and 20 degrees C was only observed for logarithmic phase cultures.
      Heat injured late stationary phase cultures with 95-99.9% injured cells in the
      surviving population (as measured by differential plating on enriched vs.
      selective media after sous vide cooking) did not grow or repair sublethal
      injuries in sous vide cooked beef at 3 degrees C while repair and growth took
      place at 10 as well as at 20 degrees C. In logarithmic phase cultures heat injury
      occurred very rapidly and > or = 99.9% heat injury was observed in all trials in
      spite of much lower pasteurization values and fewer log10 reductions compared
      with late stationary phase cultures. Regardless of growth phase, all cultures
      where a high degree of heat injury (> or = 99.9%) was observed, did not
      subsequently grow in the beef product at 3 or 10 degrees C within 30 days. Growth
      of heat injured cultures preexposed to heat shock (46 degrees C, 30 min) or
      slowly rising temperatures (0.3 degrees C min(-1)) before heat injury was also
      investigated. Heat shocked or heat adapted cultures generally responded in the
      same manner as non-stressed cultures (no growth at 3 degrees C) except that a
      longer lag phase was observed in beef processed at slowly rising temperatures and
      in normal pH beef at 10 degrees C. Although processing at slowly rising
      temperatures may slightly increase the survival of L. monocytogenes 13-249 in
      cooked beef, there seem to be no indication of an increase in subsequent growth
      potential of the surviving cells.

PMID- 11205946
TI  - Identification of lactic acid bacteria constituting the predominating microflora
      in an acid-fermented condiment (tempoyak) popular in Malaysia.
AB  - Tempoyak is a traditional Malaysian fermented condiment made from the pulp of the
      durian fruit (Durio zibethinus). Salt is sometime added to proceed fermentation
      at ambient temperature. In various samples obtained from night markets, lactic
      acid bacteria (LAB) were the predominant microorganisms, ranging from log 8.4 to
      log 9.2 cfu g(-1). No other microorganisms were present to such a level. These
      samples contained reduced amount of saccharose, glucose and fructose but
      increased amount of D- and L-lactic acid and acetic acid compared with samples of
      non-fermented durian fruit. Sixty-four isolates of LAB were divided into five
      groups by use of a few phenotypic tests. A total of 38 strains of LAB were
      selected for comparison by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) of their whole cell protein patterns with a SDS-PAGE
      database of LAB. These strains were also examined for their carbohydrate
      fermentation patterns by use of API 50 CH. Isolates belonging to the
      Lactobacillus plantarum group were shown to be the predominant members of the LAB
      flora. In addition, isolates belonging to the Lactobacillus brevis group,
      Leuconostoc mesenteroides, Lactobacillus mali, Lactobacilus fermentum and an
      unidentified Lactobacillus sp. were also observed. A high degree of diversity
      among isolates belonging to the Lb. plantarum group was demonstrated by analysis
      of their plasmid profiles.

PMID- 11205947
TI  - Evaluation of lysine and methionine production in some Lactobacilli and yeasts
      from ogi.
AB  - Lysine and methionine producing cultures of Lactobacillus and yeasts in batch
      fermentation of ogi were selected by growth in the presence of the analogues, S-2
      aminoethyl]-L-cysteine (thialysine) and ethionine respectively. The study shows
      that 42.5% of the Lactobacillus and 83.3% of the yeast isolates tested were
      capable of lysine production while 25.0% of the Lactobacillus and 87.8% of the
      yeast isolates produced methionine. The lysine and methionine yields of
      Lactobacillus were significantly (P <0.01) higher than that of yeasts. The
      majority of the yeast isolates excreted most of the lysine and methionine
      produced. More lysine was produced than methionine in all tested isolates.

PMID- 11205948
TI  - Salmonella serotypes isolated from turkey meat in Albania.
AB  - Eleven (11) Salmonella strains were recovered from 11 (8.2%) out of 134 turkey
      meat samples in Albania, for the period of time 1996-1998. The percentage of
      Salmonella positive turkey meat samples varied with 5% in 1996 (3 out of 60),
      14.7% in 1997 (5 out of 34) and 7.5% in 1998 (3 out of 40). The isolated strains
      were found to belong to 3 different Salmonella serogroups; 6 isolates to
      serogroup B, 4 isolates to serogroup D and 1 isolate to serogroup C. Five (5)
      different serotypes were encountered; Salmonella enteritidis (4 isolates),
      Salmonella agona (3 isolates), S. saint-paul, S. reading and S. blockley with
      only one isolate each. One Salmonella strain, belonging to serogroup B, was not
      completely serotyped.

PMID- 11205949
TI  - The occurrence of Aeromonas spp. in natural mineral water and well water.
AB  - The presence of motile Aeromonas spp. in natural mineral water (NMW) and drinking
      well water in the area of Lecce (Italy) was investigated. Aeromonas spp. were not
      detected in any of the 60 NMW samples either by the direct and enrichment method.
      From a total of 20 wells, five were found to contain Aeromonas species with cell
      number ranging from 26 to 1609 250 ml(-1). In two wells the presence of Aeromonas
      spp. was not associated to the presence of faecal indicators, i.e. coliforms and
      faecal coliforms. Sixty-five Aeromonas spp. strains isolated in this survey were
      identified at species level and some were examined for haemolysis, Voges
      Proskauer reaction, lysine decarboxylase and sorbitol fermentation, tests which
      had been previously shown to correlate with production of enterotoxin/cytotoxin.
      Isolates identified as A. hydrophila and A. sobria showed potentially virulent
      properties.

PMID- 11205950
TI  - Membrane damage and enzyme inactivation of Lactobacillus plantarum by high
      pressure CO2 treatment.
AB  - Physiological changes of Lactobacillus plantarum (KFRI 815) by high pressure CO2
      treatment were investigated to examine the relevance to microbial inactivation.
      Characteristic properties of the cells measured in this study included salt
      tolerance, release of UV-absorbing substances, Mg and K ions, proton
      permeability, glycolysis, H+-ATPase and constitutive enzymes, and dye uptake. The
      cells treated with high pressure CO2 of 7 MPa at 30 degrees C for 10 min showed
      the irreversible cellular membrane damages including loss of salt tolerance,
      leakage of UV-absorbing substances, release of intracellular ions, collapse of
      proton permeability and uptake of Phloxine B dye. L. plantarum cells after CO2
      treatment also exhibited reduced glycolytic activity and inactivation of some
      constituent enzymes. However, H+-ATPase of the cell membrane maintained its
      initial specific activity of about 2.50 U/mg protein even though viability of the
      cells was reduced by several log cycles after high pressure CO2 treatment.

PMID- 11205951
TI  - Modelling the influence of pH and organic acid types on thermal inactivation of
      Bacillus cereus spores.
AB  - A model is proposed to describe the influence pH on the heat resistance of
      Bacillus cereus spores. In addition to the conventional z value, the effect of pH
      on the thermal resistance of spores is characterised by a z(pH) value (z(pH) is
      the distance of pH from a reference pH*, which leads to a 10-fold reduction of D
      value). The type of organic acid used for acidifying the heating medium,
      influences the z(pH) value. For nine organic acids, a linear relationship between
      the calculated z(pH) value and its lower acid pKa is observed. This relationship
      showed that the acid form (dissociated or undissociated) modifies the thermal
      spore resistance in addition to the H+ ion. The influence of acetic acid
      concentration on the D value at pH 7 shows the protective effect of the
      dissociated acid form on the heat resistance of spores. The acid concentration in
      the medium modified the heat resistance of spore and the z(pH) value.

PMID- 11205952
TI  - Investigation of bacterial spore structure by high resolution solid-state nuclear
      magnetic resonance spectroscopy and transmission electron microscopy.
AB  - High resolution solid-state nuclear magnetic resonance spectroscopy (NMR) in
      combination with transmission electron microscopy (TEM) of spores of Bacillus
      cereus, an outer coatless mutant B. subtilis 322, an inner coatless mutant B.
      subtilis 325 and of germinated spores of B. subtilis CMCC 604 were carried out.
      Structural differences in the coats, mainly protein of spores were reflected by
      NMR spectra which indicated also differences in molecular mobility of
      carbohydrates which was partially attributed to the cortex. Dipicolinic acid
      (DPA) of spores of B. cereus displayed a high degree of solid state order and may
      be crystalline. Heat activation was studied on spores of B. subtilis 357 lux +
      and revealed a structural change when analysed by TEM but this was not associated
      with increases in molecular mobility since no effects were measured by NMR.

PMID- 11205953
TI  - Effect of pH on the heat resistance of spores comparison of two models.
AB  - All published models describing the effect of pH on the heat resistance of spores
      can be regarded either as a linear first degree equation or a linear second
      degree equation. This work aimed to compare both models from three sets of
      published data for, Clostridium sporogenes and Bacillus stearothermophilus,
      respectively. The relative quality of fit of each model with respect to the other
      depends on the species, the strain and the heating temperature. Parameter
      estimation was more reliable for the second degree model than for of the simple
      first degree equation. However, in the case of acidic foodstuffs, predictions
      obtained from the second degree model are more sensitive toward errors of
      parameter values. The second degree model is better from the point of view of
      safety at most frequent ranges of pH of foods. Moreover, for Clostridium
      botulinum the goodness of fit of this model is clearly higher than that of the
      first degree equation. If this observation is confirmed by further work, the
      second degree model in application of standard calculations of heat processes of
      foods would be preferred.

PMID- 11205954
TI  - Development and validation of a combined temperature, water activity, pH model
      for bacterial growth rate of Lactobacillus curvatus.
AB  - A model was established to predict growth rate as a function of temperature, pH
      and water activity. The model is based on two, earlier developed models, one for
      growth rate as a function of temperature and water activity and the other for
      growth rate as a function of temperature and pH. Based on the assumption that
      combinatory effects between pH and water activity do not exist, the two models
      were multiplied to produce one overall model. The overall model was then fitted
      to data sets measured earlier, and the parameters of the model were determined. A
      new data set with values for controlling variables outside the range of the
      earlier developed model was then used to validate the overall model
      statistically. The model was well able to extrapolate outside the measured data
      range. Finally, the model was updated with all measured data. No significant
      changes in the parameters were found. The approach followed underpins the gamma
      concept, since in the gamma concept it is assumed that the effects of controlling
      variables can be multiplied, and cardinal parameters are not a function of other
      variables (temperature, pH, and water activity).

PMID- 11205955
TI  - A comparative study on the use of flow cytometry and colony forming units for
      assessment of the antibacterial effect of bacteriocins.
AB  - Flow cytometry was investigated as a rapid method to determine the antibacterial
      effect of the bacteriocins nisin, pediocin PA-1, and sakacin A on the indicator
      organisms Lactobacillus reuteri DSM 12246, Lactobacillus sakei NCFB 2714 and
      Lactobacillus sakei DSM 20017, respectively. Fluorescence intensities of the
      cells were measured by flow cytometry upon exposure to bacteriocins after
      staining with carboxyfluorescein diacetate (cFDA) and were compared to the number
      of colony forming units (CFU). The fluorescence index (FI) of the bacterial
      populations decreased when exposed to the bacteriocins. For the different
      bacteriocins the pattern of decreases in FI and colony forming units differed at
      equal bacteriostatic concentrations. FI was the most sensitive measure of
      bacteriocin activity, i.e. the decrease in FI was observed at lower bacteriocin
      concentrations than decrease in CFU. It was demonstrated that the decrease in FI
      was caused by rapid leakage of carboxyfluorescein from cells exposed to pediocin.
      Cells showing severe leakage after pediocin treatment could be detected as CFU
      when transferred to a rich medium. Such a repair was less pronounced for cells
      exposed to sakacin and very limited for cells exposed to nisin. The influence of
      temperature and NaCl in combination with pediocin on FI and CFU of Lactobacillus
      sakei NCFB 2714 was examined at conditions relevant to foods. At all temperatures
      (5, 10, 20 and 37 degrees C) and NaCl concentrations (0, 2 and 4% w/v)
      investigated the flow cytometric measurements were significantly more sensitive
      compared to CFU. Both methods showed that the inhibitory effect of pediocin
      increased with increasing temperatures and decreased with increasing NaCl
      concentrations.

PMID- 11205956
TI  - Interactions between Zygosaccharomyces mellis and Wallemia sebi in diluted
      molasses.
AB  - The yeast Zygosaccharomyces mellis and the mould Wallemia sebi were isolated from
      the same sample of crystalline sugar. Interactions between these fungi were
      investigated using a diluted molasses medium (water activity 0.89, pH 6.0) as a
      model system for the syrup film covering the surface of moist crystalline sugar.
      Single and mixed cultures of Z. mellis and W. sebi were incubated at 25 degrees C
      for 400 h. Our results show that the growth of Z. mellis in single culture was
      limited by available glucose and fructose, and that W sebi was able to invert
      sucrose to glucose and fructose in both single and mixed culture. Furthermore,
      the presence of W. sebi in the mixed culture increased the maximum specific
      growth rate of Z. mellis from 0.074 to 0.19 h(-1) and the growth yield of Z.
      mellis from 7.3 x 10(6) to 5.4 x 10(7) cfu/ml. These results indicate that the
      ability of W. sebi to invert sucrose may stimulate the growth of Z. mellis.
      Finally, the presence of Z. mellis inhibited the ability of W. sebi to invert
      sucrose: W. sebi was able to invert 1.0 g sucrose/l per h in single culture but
      only 0.6 g sucrose/l per h in mixed culture. As predicted by Raoults law, this
      corresponded to a reduction in the water activity of the growth medium from 0.890
      to 0.850 in single culture, and to 0.865 in mixed culture.

PMID- 11205957
TI  - Potential probiotic lactic acid bacteria Lactobacillus rhamnosus (HN001),
      Lactobacillus acidophilus (HN017) and Bifidobacterium lactis (HN019) do not
      degrade gastric mucin in vitro.
AB  - The mucus layer (mucin) coating the surface of the gastrointestinal tract (GIT)
      plays an important role in the mucosal barrier system. Any damage or disturbance
      of this mucin layer will compromise the host's mucosal defence function. In the
      present study, the ability of three potential probiotic lactic acid bacteria
      (LAB) strains (Lactobacillus rhamnosus HN001, Lactobacillus acidophilus HN017,
      Bifidobacterium lactis HN019) to degrade mucin in vitro was evaluated, in order
      to assess their potential pathogenicity and local toxicity. The LAB strains were
      incubated in medium containing hog gastric mucin (HGM, 0.3%) at 37 degrees C for
      48 h, following which any decrease in carbohydrate and protein concentration in
      the ethanol-precipitated portion of the culture medium was determined, using
      phenol-sulphuric acid and bicinchonic acid (BCA) protein assays, respectively.
      The change in molecular weight of mucin glycoproteins, following incubation with
      the test strains, was monitored by SDS-polyacrylamide gel electrophoresis (SDS
      PAGE). In order to expose any ability of the test strains to degrade mucin
      visually and more directly, the test strains were also cultured on agarose
      containing 0.3% HGM and incubated anaerobically for 72 h at 37 degrees C. No
      significant change in the carbohydrate or protein concentration in mucin
      substrates was found following incubation with the test strains. No mucin
      fragments were derived from the mucin suspension incubated with test strains, and
      no mucinolysis zone was identified on agarose. These results demonstrate that the
      potential probiotic LAB strains tested here were unable to degrade
      gastrointestinal mucin in vitro, which suggests that these novel probiotic
      candidates are likely to be non-invasive and non-toxic at the mucosal interface.

PMID- 11205958
TI  - High incidence of Listeria monocytogenes in European red smear cheese.
AB  - The incidence of Listeria and Listeria monocytogenes in European red smear cheese
      was determined in order to assess whether the lack of recent outbreaks of
      listeriosis associated with cheese is due to improved hygenic conditions in the
      dairies. Out of European red-smear cheese samples of various types, 15.8%
      contained organisms of the genus Listeria, 6.4% of the samples were contaminated
      with L. monocytogenes, 10.6% with L. innocua, and 1.2% with L. seeligeri. Six
      cheese samples contained two or more Listeria species, including at least one L.
      monocytogenes isolate. The incidences of L. monocytogenes in cheeses from various
      countries were: Italy 17.4%, Germany 9.2%, Austria 10%, and France 3.3%. Listeria
      were found most frequently in soft and semi-soft cheese. Eight samples contained
      more than 100 L. monocytogenes cfu/cm2 cheese surface, 2 samples had counts above
      10(4) cfu/cm2 cheese surface. Surprisingly, a higher incidence of L.
      monocytogenes was observed in cheeses made from pasteurized milk (8.0%) than in
      cheeses manufactured from raw milk (4.8%). Phage-typing of isolated Listeria
      strains clearly confirmed that (i) contaminations within dairy plants were
      persistent over a period of several weeks to months and (ii) that cross
      contamination within the dairy plant is and important factor. Comparison of our
      data with past surveys seems to indicate that contamination of red smear soft
      cheese with L. monocytogenes has not decreased sufficiently over the past 15
      years. It is therefore strongly recommended that these products are monitored
      carefully by cheese-making companies.

PMID- 11205959
TI  - Influence of holding temperature on the growth and survival of Salmonella spp.
      and Staphylococcus aureus and the production of staphylococcal enterotoxin in egg
      products.
AB  - In this study, growth and survival of Salmonella spp. and Staphylococcus aureus
      in steamed egg and scrambled egg held at 5, 18, 22, 37, 55 and 60 degrees C are
      investigated. The production of staphylococcal enterotoxin in steamed egg is also
      examined. Results reveal that Salmonella spp. and Staph. aureus in the egg
      products multiply best at 37 degrees C, followed closely by 22 and 18 degrees C.
      Neither pathogen showed growth in the egg products held at 5 degrees C. Initial
      inoculation dose, holding temperature and holding time affected the population of
      both organisms found in the egg products. Staphylococcal enterotoxin A (SEA) and
      B (SEB) are detected only in the egg products held at 37 or 22 degrees C. After
      holding at 37 degrees C for 36 h, scrambled egg inoculated with ca. 5.0 log cfu/g
      Staph. aureus contains the highest levels of SEA (> 64 ng/g) and SEB (> 64 ng/g).
      Although Salmonella spp. and Staph. aureus grow better in steamed eggs than in
      scrambled eggs, production of staphylococcal enterotoxin, in general, was higher
      in scrambled eggs than in steamed eggs. On the other hand, a repaid destruction
      of the test organisms in steamed eggs held at 60 degrees C was observed. Holding
      the steamed eggs at 60 degrees C, Salmonella spp. and Staph. aureus with an
      initial population of ca. 5.9 and 5.6 log cfu/g, respectively, reduced to a non
      detectable level in 1 h.

PMID- 11205960
TI  - Regular exercise enhances blood pressure lowering effect of acetylcholine by
      increased contribution of nitric oxide.
AB  - This study is aimed to test the hypothesis, that short-term daily bouts of
      exercise alter the endothelial regulation of peripheral vascular resistance by
      nitric oxide. Rats ran on a treadmill once a day, 5 days a week, for an average
      of three weeks with gradually increasing intensity (EX), while a control group
      remained sedentary (SED). Dose dependent reductions in mean arterial blood
      pressure (resting MABP; SED: 120.0 +/- 3.4 and EX: 127.8 +/- 4.0 mm Hg) of
      pentobarbital anesthetized rats to intravenous endothelium independent dilator
      sodium nitropmsside (SNP; 0.6-3.0 microg/kg) were not different in EX and SED
      animals. In contrast, dose dependent reductions in MABP to endothelium dependent
      dilator acetylcholine (ACh) were significantly enhanced in EX compared to those
      in SED rats (at 0.5 and 1.0 microg/kg ACh: 60.3 +/- 2.4 and 66.5 +/- 1.8 vs 52.8
      +/- 2.0 and 59.8 +/- 1.7 mmHg, respectively, p<0.01). There was no significant
      difference in the heart rate (HR) response to ACh and SNP in the two groups of
      rats. Intravenous administration of 20 mg/kg Nomega-nitro-L-arginine (L-NNA, a
      nitric oxide synthase inhibitor) elicited a similar increase (approximately 30%)
      in the MABP in the two groups and eliminated the difference between ACh-induced
      blood pressure lowering responses in EX and SED rats (at 0.5 and 1.0 microg/kg
      ACh: 44.6 +/- 4.7 and 56.3 +/- 4.4 vs 50.9 +/- 4.5 and 59.4 +/- 3.6 mm Hg,
      respectively). Thus, we suggest that the enhanced acetylcholine-induced decrease
      in systemic blood pressure following regular daily exercise is primarily due to
      the augmented synthesis of nitric oxide in the endothelium of peripheral
      vasculature. This change in the function of endothelium could be important in the
      adaptation of circulation to exercise training.

PMID- 11205961
TI  - A study of the liver glucocorticoid receptor binding capacity in newborn rat.
AB  - The binding capacity of newborn and adult rat liver glucocorticoid receptors was
      compared, using receptor kinetic analysis. Neonatal receptors have (non
      significantly) lower affinity and significantly less density to dexamethasone
      than adult ones. However, the neonatal binding is specific and there is no
      qualitative difference from the adult one.

PMID- 11205962
TI  - Effects of extracellular pH on the response of the isolated rat mesenteric artery
      to electrical field stimulation.
AB  - In experiments on isolated segments of the rat mesenteric artery, effects of
      changes in solution pH on the response of the segments to noradrenaline (10
      microM) or electrical field stimulation (EFS) were studied. The pH 7.8 solution
      slightly increased (from 0.48 +/- 0.07 mN at pH 7.4 to 0.67 +/- 0.12 mN or by
      41%). while the pH 7.0 and 6.6 solutions significantly decreased (to 0.16 +/-
      0.05 and 0.08 +/- 0.04 mN or by 66 and 83%, respectively) the EFS-evoked response
      of the vessel prestretched to the value corresponding to the intravascular
      pressure of about 100 mm Hg. A pH shift either to the alkaline or acidic range
      did not change the resting tension (15.65 +/- 0.74 mN at pH 7.4) of the vessel
      without precontraction. The pH 6.6 solution reduced the response to noradrenaline
      twofold. Dilation produced by EFS of noradrenaline-precontracted segment was
      inhibited and the constrictor responses appeared in the pH 6.6 solution. In the
      vessel pretreated with N(G)-nitro-L-arginine (100 microM), the acidification of
      the solution (pH 6.6) inhibited the response of the vascular segment to EFS to a
      lower extent and did not change its response to noradrenaline. The data obtained
      demonstrate an inhibitory effect of acidosis on reactivity of the rat mesenteric
      artery as well as a modification of this effect under a high initial tone of the
      vessel studied.

PMID- 11205963
TI  - Correlation between ACE activity and mean blood pressure in Iranian normotensive
      subjects after oral administration of a single dose of enalapril.
AB  - Relationship between serum ACE activity and mean blood pressure (MAP) after
      administration of a single oral dose of the ACE inhibitor enalapril 10 and 20 mg
      tablets was investigated in 19 Iranian normotensive male subjects. Enalapril at
      doses, which maximally inhibit ACE activity, reduced MAP dose dependently. The
      t(max) of ACE inhibition decreased significantly by increasing the enalapril
      doses, but t(max) of MAP reduction did not change by increasing the dose. The AUC
      (area under the curve) of ACE inhibition versus time was significantly larger in
      20 mg enalapril group compare to 10mg enalapril group (p<0.001). A significant
      correlation was found between log of residual ACE activity and MAP (r=0.4927;
      p<0.001). It is concluded that in Iranian normal subjects, after administration
      of a single oral dose of enalapril, MAP related to residual ACE activity.

PMID- 11205964
TI  - The effect of the glucocorticoid Oradexon on endotoxin-induced peritoneal cell
      response.
AB  - Glucocorticoids are important modulators of immune reactions. They are capable of
      antagonising several effects of the bacterial endotoxin by inhibiting endotoxin
      induced leukocyte activation, and the production of cytokines and inflammatory
      mediators. We earlier demonstrated that the antiglucocorticoid RU 38486 enhances
      the cytokine production induced by endotoxin and aggravates the course of
      experimental endotoxic and septic shock. In the present study we investigated the
      effect of the glucocorticoid Oradexon on the endotoxin-induced peritoneal cell
      response. For measurement of the peritoneal cell response, male CFLP mice (20-25
      g) were injected i.p. with 10 microg/10 g body weight endotoxin (E. coli 026:B6
      LPS, Difco Lab, Detroit, lot 110273JB). Dexamethasone (Oradexon, N.V, Organon
      Oss, The Netherlands) was administered i.p., i.v. or s.c. in a dose of 0.1 mg/10
      g body weight, alone or concomitantly with endotoxin. We found that bacterial
      endotoxin increased the total cell count due to neutrophilia at 24 hours and, due
      to increases in the number of macrophages and lymphocytes 48 and 72 hours after
      treatment, respectively. The i.p., i.v., and s.c. injection of Oradexon,
      increased the total cell count and the macrophage count at 24, 48 and 72 hours.
      The i.p., s.c. and i.v. injection of Oradexon, concomitantly with endotoxin,
      reduced the total cell count at 48 and 72 hours, due to decreases in the
      macrophage count. The i.p., i.v. or s.c. administration of Oradexon concomitantly
      with LPS decreased the lymphocyte count and the neutrophil count at 24 and 72
      hours. These results prove that glucocorticoids are capable of modifying the
      immune cell reactions induced by endotoxin.

PMID- 11205965
TI  - Strain differences in rabbit adrenocortical structure and morphological evidence
      of corticomedullary communication.
AB  - Interstrain differences in the structure of the mouse and rat adrenal cortex are
      well known, but related data on rabbits are not available. This study was planned
      to demonstrate possible strain differences in rabbit adrenal morphology and
      morphological evidence of a communication between cortex and medulla. For this
      purpose, the zonation of the adrenal cortex of intact mature male and female
      rabbits of different strains (New Zealand, Chinchilla and California) were
      compared using morphometry and the corticomedullary junction was evaluated for
      close relationship. Marked intersex and interstrain differences were found in the
      adrenocortical zonation. Female rabbits had larger adrenocortical zones than
      corresponding males. The rabbits of Chinchilla and California strains had the
      largest cortical sizes. This difference depended largely upon the higher
      thickness of the zona fasciculata. Whereas, there were no significant strain
      differences in the thickness of zona glomerulosa and zona reticularis.
      Furthermore, examination of corticomedullary junction showed that cortex and
      medulla were interwoven. Single and small accumulations of cortical cells were
      spread throughout the medulla. Our morphological data showed the presence of
      significant interstrain differences in the adrenocortical zonation in the rabbits
      and provide evidence for a possible paracrine interaction between medullary and
      cortical cells.

PMID- 11205966
TI  - Effect of glibenclamide and glimepiride treatment on the development of
      myocardial infarction in rats.
AB  - The effect of glibenclamide and glimepiride, two orally active antidiabetic
      sulphonylurea derivatives, on the development of myocardial infarction has been
      compared. Permanent coronary artery ligation was induced in rats and the
      development of infarction was evaluated by a computer-assisted method after
      nitroblue-terazolium staining. Seven-day coronary ligation produced enlargement
      of the left ventricular cavity, scar thinning and thickening of the non-infarcted
      myocardium. Glibenclamide treatment (5 mg/kg b.i.d. intraperitoneally) decreased
      the infarct volume (29.1 +/- 3.5% vs. 39.1 +/- 3.2% in controls), that occurred
      primarily as a result of more significant thinning of the scar tissue (1.6 +/-
      0.04 mm vs. 2.0 +/- 0.13 mm in controls). Glibenclamide also inhibited the
      thickening of the non-infarcted ventricular septum (2.1 +/- 0.10 mm vs. 2.9 +/-
      0.10 mm in controls). In contrast to the effects of glibenclamide, glimepiride
      treatment (5 mg/kg b.i.d. intraperitoneally) inhibited the enlargement of the
      left ventricular cavity (15.2 +/- 1.1% vs. 19.9 +/- 1.2% of the left ventricular
      volume in controls), it did not precipitate scar thinning and did not influence
      the development of hypertrophy of the non-infarcted myocardium. These results
      suggest that glimepiride treatment might inhibit the development of left
      ventricular dilatation after myocardial infarction. Glibenclamide treatment,
      however, producing a thinning of the scar tissue may further precipitate
      morphological changes that can contribute to the development of heart failure.

PMID- 11205967
TI  - Acute effects of zopiclone on blood glucose level and serum lipids in
      hyperlipidemic rats. Interactions with PK 11195 and flumazenil.
AB  - Intraperitoneal administration of 5 mg/kg zopiclone a cyclopyrolone acting on the
      central benzodiazepine receptors was found to produce significant reduction of
      total lipids, total cholesterol and triglyceride in rats randered hyperlipidemic
      by intraperitoneal injection of Triton W-1339. Blood glucose level was also
      reduced. Flumazenil (10 mg/kg) potentiated the hypoglicemic effect of zopiclone
      but had no additional effect on serum lipids. PK 11195 (25 mg/kg) antagonized the
      hypolipidemic effects of zopiclone. IN CONCLUSION: 1. The central benzodiazepine
      receptors are not involved in the hypolipidemic activity of zopiclone. 2. The
      peripheral type benzodiazepine receptors are partly responsible, for the
      hypolipidemic activity of this cyclopirrolone. 3. The changes of blood glucose
      level induced by these drugs does not seem to be related to benzodiazepine
      receptors.

PMID- 11205968
TI  - Acute effects of zopiclone on blood glucose level and serum lipids in
      hyperlipidemic rats.
AB  - In rats rendered hyperlipidemic by ip administration of Triton WR-1339, the ip
      administration of zopiclone at doses of 1.25, 2.5, 5.0, 7.5, 10.0 and 15.0 mg/kg,
      a cyclopyrrolone acting upon the central benzodiazepine receptors, induces very
      significant reductions of total lipids, total cholesterol, and triglycerides, at
      nearly all of the doses. The most active dose was 5.0 mg/kg. The blood glucose
      level was diminished by doses of 1.25, 2.5, 7.5 and 15.0 mg/kg and it was not
      changed by the rest of the other doses.

PMID- 11205969
TI  - Accuracy of velocity estimation by Reichardt correlators.
AB  - Although a great deal of experimental evidence supports the notion of a Reichardt
      correlator as a mechanism for biological motion detection, the correlator does
      not signal true image velocity. This study examines the accuracy with which
      realistic Reichardt correlators can provide velocity estimates in an organism's
      natural visual environment. The predictable statistics of natural images imply a
      consistent correspondence between mean correlator response and velocity, allowing
      the otherwise ambiguous Reichardt correlator to act as a practical velocity
      estimator. Analysis and simulations suggest that processes commonly found in
      visual systems, such as prefiltering, response compression, integration, and
      adaptation, improve the reliability of velocity estimation and expand the range
      of velocities coded. Experimental recordings confirm our predictions of
      correlator response to broadband images.

PMID- 11205970
TI  - Color constancy at a pixel.
AB  - In computational terms we can solve the color constancy problem if device red,
      green, and blue sensor responses, or RGB's, for surfaces seen under an unknown
      illuminant can be mapped to corresponding RGB's under a known reference light. In
      recent years almost all authors have argued that this three-dimensional problem
      is too hard. It is argued that because a bright light striking a dark surface
      results in the same physical spectra as those of a dim light incident on a light
      surface, the magnitude of RGB's cannot be recovered. Consequently, modern color
      constancy algorithms attempt only to recover image chromaticities under the
      reference light: They solve a two-dimensional problem. While significant progress
      has been made toward achieving chromaticity constancy, recent work has shown that
      the most advanced algorithms are unable to render chromaticity stable enough so
      that it can be used as a cue for object recognition [B. V. Funt, K. Bernard, and
      L. Martin, in Proceedings of the Fifth European Conference on Computer Vision
      (European Vision Society, Springer-Verlag, Berlin, 1998), Vol. II, p. 445.] We
      take this reductionist approach a little further and look at the one-dimensional
      color constancy problem. We ask, Is there a single color coordinate, a function
      of image chromaticities, for which the color constancy problem can be solved? Our
      answer is an emphatic yes. We show that there exists a single invariant color
      coordinate, a function of R, G, and B, that depends only on surface reflectance.
      Two corollaries follow. First, given an RGB image of a scene viewed under any
      illuminant, we can trivially synthesize the same gray-scale image (we simply code
      the invariant coordinate as a gray scale). Second, this result implies that we
      can solve the one-dimensional color constancy problem at a pixel (in scenes with
      no color diversity whatsoever). We present experiments that show that invariant
      gray-scale histograms are a stable feature for object recognition. Indexing on
      invariant distributions supports almost perfect recognition for a dataset of 11
      objects viewed under five colored lights. In contrast, object recognition based
      on chromaticity histograms (post-color constancy preprocessing) delivers much
      poorer recognition.

PMID- 11205971
TI  - Aging of the human lens: changes in lens shape at zero-diopter accommodation.
AB  - Scheimpflug photographs of the zero-diopter-accommodated anterior segments of 100
      human subjects, aged 18 to 70 yr and evenly spaced over this range, were
      digitized and analyzed to characterize lens and lens nucleus shape as a function
      of age by the Hough transform and other image analysis methods. Anterior and
      posterior lens surface curves exhibit a decrease in radius of curvature with
      increasing age, in qualitative but not quantitative agreement with the earlier
      observations of Brown [Exp. Eye Res. 19, 175 (1974)]. In contrast, the shape of
      the lens nuclear boundaries changes little with age. Overall lens volume at zero
      diopters increases with age, but the volume of the lens nucleus remains
      unchanged. The lens center of mass moves anteriorly with increasing age, as does
      the central clear region of the lens. Although these data sets were found to be
      more variable than those of Brown, the complementary variability of other
      factors, such as anterior chamber depth, for each subject leads to a very high
      statistical correlation between lens shape and lens location relative to the
      cornea. This supports the finding of previous work that image formation on the
      retina for a given individual results from the multifactorial balancing of
      related factors.

PMID- 11205972
TI  - Spatial summation of peripheral Gabor patches.
AB  - Previous studies have specified the foveal pattern that is seen most efficiently,
      with the assumption that the waveform of the best pattern matches the impulse
      response of the most sensitive visual filter. We measured the threshold contrast
      for circular, collinear, and orthogonal Gabor stimuli of 6 Hz temporal frequency
      presented 7 deg above the fixation point. We found that the threshold contrast
      energy is minimal for a class of stimuli whose Fourier-spectra bandwidth is less
      than approximately 1 octave. These findings suggest that an energy algorithm
      might underlie spatial summation of peripheral Gabor patches. The different
      behavior of spatial summation in fovea and periphery might reflect the
      differences in pattern detectability across space in the central and peripheral
      visual fields. It is also possible that a coherent (cross-correlation) algorithm
      is employed in detection of foveal stimuli and that an incoherent (energy)
      algorithm is employed in detection of peripheral stimuli.

PMID- 11205973
TI  - Contrast sensitivity function and image discrimination.
AB  - A previous study tested the validity of simulations of the appearance of a
      natural image (from different observation distances) generated by using a visual
      model and contrast sensitivity functions of the individual observers [J. Opt.
      Soc. Am. A 13, 1131 (1996)]. Deleting image spatial-frequency components that
      should be undetectable made the simulations indistinguishable from the original
      images at distances larger than the simulated distance. The simulated observation
      distance accurately predicted the distance at which the simulated image could be
      discriminated from the original image. Owing to the 1/f characteristic of natural
      images' spatial spectra, the individual contrast sensitivity functions (CSF's)
      used in the simulations of the previous study were actually tested only over a
      narrow range of retinal spatial frequencies. To test the CSF's over a wide range
      of frequencies, the same simulations and testing procedure were applied to five
      contrast versions of the images (10-300%). This provides a stronger test of the
      model, of the simulations, and specifically of the CSF's used. The relevant CSF
      for a discrimination task was found to be obtained by using 1-octave Gabor
      stimuli measured in a contrast detection task. The relevant CSF data had to be
      measured over a range of observation distances, owing to limitations of the
      displays.

PMID- 11205974
TI  - Discrimination of wide-field images as a test of a peripheral-vision model.
AB  - In order to test a model of peripheral vision, various contrast sensitivity
      functions (CSF's) and fundamental eccentricity constants (FEC's) [see J. Opt.
      Soc. Am. A 8, 1762 (1991)] were applied to real-world, wide-field (6.4 degrees-32
      degrees eccentricity) images. The FEC is used to model the change in contrast
      sensitivity as a function of retinal eccentricity. The processed test images were
      tested perceptually by determining the threshold FEC for which the observers
      could discriminate the test images from the original image. It was expected that
      higher CSF sensitivity would be associated with higher FEC's; and in fact, for
      images processed with low-pass (variable-window stimuli) CSF's, the threshold
      FEC's were larger for the higher-sensitivity (pattern-detection) CSF than for the
      lower-sensitivity (orientation detection) CSF. When two higher-sensitivity CSF's
      were compared, the bandpass (constant-window stimuli) CSF resulted in essentially
      the same FEC threshold as did the low-pass (variable-window stimuli) CSF. The
      fact that the FEC compensated for complex differences in the form of the CSF
      suggested that the discrimination task was mediated by a limited range of spatial
      frequencies over which the two CSF's were similar. Image contrast was then varied
      in order to extend the range of spatial frequencies tested. The FEC's estimated
      with the lower-contrast test images were unchanged for test images obtained with
      the high-sensitivity, bandpass CSF but increased for test images obtained with
      the high-sensitivity, low-pass CSF. These results suggest that peripheral
      contrast sensitivity as used in the present discrimination task is based on a
      high-sensitivity, bandpass CSF. The peripheral-vision model validated by the
      present analysis has practical applications in the evaluation of wide-field
      simulator images as well as area-of-interest or other foveating systems.

PMID- 11205975
TI  - Appearance of images through a multifocal intraocular lens.
AB  - The appearance of images through a multifocal intraocular lens (IOL) was
      simulated. The optical transfer function (OTF) of a model eye containing the
      multifocal lens was measured and divided by the OTF of the model eye with a
      monofocal IOL. This ratio was used to filter digital images, generating
      simulations that represent the retinal images seen through a multifocal
      intraocular lens when viewed through an eye with a monofocal lens. A dichoptic
      side-by-side display was used to present the original image to one eye, implanted
      with the multifocal lens, while the other eye, implanted with monofocal lens,
      viewed the simulations and variations on the simulations to derive a point of
      subjective equivalence. Four subjects with such bilateral lens implants were
      tested for near and distance vision. The results validate the test methodology
      and the simulations. Referenced to the nominal theoretical filter, the prediction
      was within a 0.25-diopter (D) blur for distance simulation and within a 0.50-D
      blur for the near-vision simulation.

PMID- 11205977
TI  - Spatiotemporal digital microholography.
AB  - We develop the theoretical background of a holographic method in which the
      hologram is sampled simultaneously in space and in time by a charge-coupled
      device (CCD) sensor. With the use of temporal heterodyning (rather than spatial
      heterodyning, which is employed in conventional holography), in-line, single
      sideband holograms of fields having an arbitrary degree of spatial coherence are
      recorded in an exposure time that can theoretically be as short as four frames of
      the CCD. The method is applied to microholography and is shown to avoid the main
      drawbacks of conventional holographic microscopy, namely, the need for high
      spatial-bandwidth detectors and for a high degree of spatial coherence, which
      unavoidably leads to speckle noise. The possibility of a posteriori aberration
      compensation is demonstrated, and experimental results are presented.

PMID- 11205976
TI  - Age-related changes in wavelength discrimination.
AB  - Wavelength discrimination functions (420 to 620-650 nm) were measured for four
      younger (mean 30.9 years) and four older (mean 72.5 years) observers. Stimuli
      consisted of individually determined isoluminant monochromatic lights (10 Td)
      presented in each half of a 2 degrees circular bipartite field with use of a
      Maxwellian-view optical system. A spatial two-alternative forced-choice method
      was used in combination with a staircase procedure to determine discrimination
      thresholds across the spectrum. Small but consistent elevations in discrimination
      thresholds were found for older compared with younger observers. Because the
      retinal illuminance of the stimuli was equated across all observers, these age
      related losses in discrimination are attributable to neural changes. Analyses of
      these data reveal a significant change in Weber fraction across adulthood for a
      chromatically opponent pathway receiving primarily antagonistic signals from
      middle-wavelength-sensitive and long-wavelength-sensitive cones but not for a
      short-wavelength-sensitive cone pathway.

PMID- 11205978
TI  - A posteriori processing of spatiotemporal digital microholograms.
AB  - In an accompanying paper [G. Indebetouw and P. Klysubun, J. Opt. Soc. Am. A 18,
      319 (2001)], the theoretical background of a spatiotemporal digital
      microholographic method was described, and some experimental results were
      presented. Here the usefulness of the method for microholographic imaging of
      biological specimens such as cells is demonstrated. The vast possibility of a
      posteriori processing of the microholograms is discussed. Dark-field, phase
      contrast, and interference-contrast images, as well as quantitative phase maps,
      all obtained a posteriori from the same microhologram, are illustrated as
      examples.

PMID- 11205979
TI  - Necessary conditions for spatially incoherent illumination of a three-dimensional
      object.
AB  - Spatially incoherent imaging systems are characterized by a linear-in-intensity
      relationship between the object and the image distributions. While strict spatial
      incoherence is theoretically not achievable, a particular imaging system may be
      made effectively linear in intensity by a choice of the appropriate illumination
      source location and size. The requirement for source size for effectively
      incoherent illumination of a two-dimensional object is well known. I extend the
      arguments for choosing the source size in a two-dimensional imaging system to
      develop necessary conditions for the source size for effectively spatially
      incoherent illumination of a three-dimensional object. While the conditions are
      necessary, they are not sufficient, since coherence in the direction of the
      optical axis is not addressed.

PMID- 11205980
TI  - Two-dimensional phase unwrapping with use of statistical models for cost
      functions in nonlinear optimization.
AB  - Interferometric radar techniques often necessitate two-dimensional (2-D) phase
      unwrapping, defined here as the estimation of unambiguous phase data from a 2-D
      array known only modulo 2pi rad. We develop a maximum a posteriori probability
      (MAP) estimation approach for this problem, and we derive an algorithm that
      approximately maximizes the conditional probability of its phase-unwrapped
      solution given observable quantities such as wrapped phase, image intensity, and
      interferogram coherence. Examining topographic and differential interferometry
      separately, we derive simple, working models for the joint statistics of the
      estimated and the observed signals. We use generalized, nonlinear cost functions
      to reflect these probability relationships, and we employ nonlinear network-flow
      techniques to approximate MAP solutions. We apply our algorithm both to a
      topographic interferogram exhibiting rough terrain and layover and to a
      differential interferogram measuring the deformation from a large earthquake. The
      MAP solutions are complete and are more accurate than those of other tested
      algorithms.

PMID- 11205982
TI  - Light scattering and ink penetration effects on tone reproduction.
AB  - Light scattering, or the so-called Yule-Nielsen effect, and ink penetration into
      the substrate paper play important roles in tone reproduction. We develop a
      framework in which the influences of both of these effects on the reflectance and
      tristimulus values of a halftone sample are investigated. The properties of the
      paper and the ink and their bilateral interaction can be parameterized by the
      reflectance Rp(o) of the substrate paper, the transmittance Ti of the ink layer,
      the parameter gamma describing the ink penetration, and p describing the Yule
      Nielsen effect. We derive explicit expressions that relate the reflectance of the
      ink dots (Ri), the paper (Rp) and the halftone image (R) as functions of these
      parameters. We also describe the optical dot gain as a function of these
      parameters. We further demonstrate that ink penetration leads to a decrease in
      optical dot gain and that scattering in the paper results in the printed image's
      being viewed as more saturated in color.

PMID- 11205981
TI  - In-depth resolution for a strip source in the Fresnel zone.
AB  - The problem of determining the achievable resolution limits in the reconstruction
      of a current distribution is considered. The analysis refers to the one
      dimensional, scalar case of a rectilinear, bounded electric current distribution
      when data are collected by measurement of the radiated field over a finite
      rectilinear observation domain located in the Fresnel zone, orthogonal and
      centered with respect to the source. The investigation is carried out by means of
      analytical singular-value decomposition of the radiation operator connecting data
      and unknown, which is made possible by the introduction of suitable scalar
      products in both the unknown and data spaces. This strategy permits the use of
      the results concerning prolate spheroidal wave functions described by B. R.
      Frieden [Progress in Optics Vol. IX, E. Wolf, ed. (North-Holland, Amsterdam
      1971), p. 311.] For values of the space-bandwidth product much larger than 1, the
      steplike behavior of the singular values reveals that the inverse problem is
      severely ill posed. This, in turn, makes it mandatory to use regularization to
      obtain a stable solution and suggests a regularization scheme based on a
      truncated singular-value decomposition. The task of determining the depth
      resolving power is accomplished with resort to Rayleigh's criterion, and the
      effect of the geometrical parameters of the measurement configuration is also
      discussed.

PMID- 11205983
TI  - Coherent broadband light effects in grating spectrometer studies of emission from
      alkali atoms at surfaces.
AB  - With ordinary grating spectrometers, strong bands that are due to broadband
      coherent light emission from samples containing various amounts of alkali atoms
      can be observed. The coherent light is proposed to be emitted by the alkali
      Rydberg states that are easily formed in these systems. The edges of the bands
      are observed at angles corresponding to low numbers of standing waves along the
      grating surface and perpendicular to it. This type of band is observed both with
      thermal sources and with broadband light sources created by pulsed laser light,
      and it is observed only with s-polarized (TE-mode) light. The band intensities
      are independent of the entrance slit width in the spectrometer, which shows that
      strong interference effects exist. The number of interference fringes observed on
      top of the most intense band is directly proportional to the width of the
      entrance slit. The time-resolved signal shows that large photon peaks from
      thermal sources are emitted in bursts within 2 mus, probably corresponding to the
      lifetime of the emitting Rydberg states and Rydberg clusters.

PMID- 11205984
TI  - Scattering by a slab containing randomly located cylinders: comparison between
      radiative transfer and electromagnetic simulation.
AB  - This study is devoted to the examination of scattering of waves by a slab
      containing randomly located cylinders. For the first time to our knowledge, the
      complete transmission problem has been solved numerically. We have compared the
      radiative transfer theory with a numerical solution of the wave equation. We
      discuss the coherent effects, such as forward-scattering dip and backscattering
      enhancement. It is seen that the radiative transfer equation can be used with
      great accuracy even for optically thin systems whose geometric thickness is
      comparable with the wavelength. We have also shown the presence of dependent
      scattering.

PMID- 11205985
TI  - Limits of the small-angle approximation to the radiative transport equation.
AB  - The small-angle approximation to the radiative transport equation is used
      extensively in imaging models in which the transport medium is optically thick.
      The small-angle approximation is generally considered valid when the particles
      are very large compared with the wavelength, when the refractive-index ratio of
      the particle to the medium is close to 1, and when the optical thickness is not
      too large. We report results showing the limits of the validity of the small
      angle approximation as a function of particle size and concentration for a
      particle-to-medium fixed refractive-index ratio of 1.196. This refractive-index
      ratio is comparable with that of minerals or diatoms suspended in water.

PMID- 11205986
TI  - Stable inversion method for a polarized-lidar: analysis and simulation.
AB  - A new inversion inhomogeneous atmosphere (IA) method that is more stable than
      Fernald's method for two-component (molecule and aerosol) scattering analysis of
      polarized Mie lidar signals is proposed and examined. The backscattering
      coefficient and the extinction-to-backscattering ratio (EBR) can be calculated
      for specified regions at which the depolarization ratio is less than that of
      molecule without further assumptions. The inversion procedure can be extended to
      both inward stepwise and outward stepwise integration algorithms. Simulation
      results indicate that a higher precision was achieved with the IA method than
      with Fernald's method in terms of error and random noise in estimating boundary
      value and EBR. Experimental results were also better with the IA method than with
      Fernald's method.

PMID- 11205987
TI  - Improved compensation of turbulence-induced amplitude and phase distortions by
      means of multiple near-field phase adjustments.
AB  - An approach for compensation of turbulence-induced amplitude and phase
      distortions is described. Two deformable mirrors are placed optically conjugate
      to the collecting aperture and to a finite range from this aperture. Two control
      algorithms are presented. The first is a sequential generalized projection
      algorithm (SGPA) that is similar to the Gerchberg-Saxton phase retrieval
      algorithm. The second is a parallel generalized projection algorithm (PGPA) that
      introduces constraints that minimize the number of branch points in the control
      commands for the deformable mirrors. These approaches are compared with the
      approach of placing the second deformable mirror conjugate to the far field of
      the collecting aperture and using the Gerchberg-Saxton algorithm to determine the
      optimal mirror commands. Simulation results show that placing the second
      deformable mirror at a finite range can achieve near-unity Strehl ratio
      regardless of the strength of the scintillation induced by propagation through
      extended paths, while the maximum Strehl ratio of the far-field approach drops
      off with increasing scintillation. The feasibility of the solutions is evaluated
      by counting the branch points contained in the deformable mirror commands. There
      are large numbers of branch points contained in the control commands that are
      generated by the Gerchberg-Saxton SGPA-based algorithms, irrespective of where
      the second deformable mirror is located. However, the control commands generated
      by the PGPA with branch point constraints achieves excellent Strehl ratio and
      minimizes the number of branch points.

PMID- 11205988
TI  - Colorimetric and spectroradiometric characteristics of narrow-field-of-view clear
      skylight in Granada, Spain.
AB  - As part of our ongoing research into the clear daytime sky's visible structure,
      we analyze over 1,500 skylight spectra measured during a seven-month period in
      Granada, Spain. We use spectral radiances measured within 3 degrees fields of
      view (FOV's) to define colorimetric characteristics along four sky meridians: the
      solar meridian and three meridians at azimuths of 45 degrees, 90 degrees, and 315
      degrees relative to it. The resulting clear-sky chromaticities in 44 different
      view directions (1) are close to but do not coincide with the CIE daylight locus,
      (2) form V-shaped meridional chromaticity curves along it (as expected from
      theory), and (3) have correlated color temperatures (CCT's) ranging from 3,800 K
      to infinity K. We also routinely observe that sky color and luminance are
      asymmetric about the solar meridian, usually perceptibly so. A principal
      components analysis shows that three vectors are required for accurate clear-sky
      colorimetry, whereas six are needed for spectral analyses.

PMID- 11205989
TI  - Tilted bilayer membranes as simple transmission quarter-wave retardation plates.
AB  - A tilted bilayer membrane, which consists of two thin films of transparent
      optically isotropic materials of different refractive indices, can function as a
      transmission quarter-wave retarder (QWR) at a high angle of incidence. A specific
      design using a cryolite-Si membrane in the infrared is presented, and its
      tolerances to small shifts of wavelength, incidence angle, and film thickness
      errors are discussed. Some designs provide a dual QWR in transmission and
      reflection. Such devices provide simple linear-to-circular (and circular-to
      linear) polarization transformers. Bilayer eighth-wave retarders without
      diattenuation are also introduced.

PMID- 11205990
TI  - Detection and analysis of depolarization artifacts in rotating-compensator
      polarimeters.
AB  - Absolute constraints, namely, the Schwarz inequality and a complementary
      expression derived by us, are used to obtain corresponding absolute constraints
      on the Fourier coefficients of the intensity transmitted through rotating
      compensator polarimeters and ellipsometers. These expressions allow the
      investigation of artifacts that result in mixed or apparently mixed polarization
      states over the cross section of the beam, the averaging time of the detector, or
      the frequency passband of the dispersing element. Examples include multiple
      internal reflections or inhomogeneous strain within an element, scattered light,
      and other types of system and component defects that cannot be accessed by means
      of polarization-state data alone. We apply these results to our polarizer-sample
      compensator-analyzer (PSCA) ellipsometer to illustrate capabilities. A simple
      analytic model is shown to give a quantitative description of depolarization in
      systems for which the resolution is finite and the retardation varies with
      wavelength.

PMID- 11205991
TI  - Photonic bandgap structures in planar waveguides.
AB  - If a one-dimensional (1D) or two-dimensional (2D) photonic bandgap (PBG)
      structure is incorporated into a planar optical waveguide, the refractive-index
      nonuniformity in the direction perpendicular to the waveguide plane responsible
      for waveguiding may affect its behavior detrimentally. Such influence is
      demonstrated in the paper by numerical modeling of a deeply etched first-order
      waveguide Bragg grating. On the basis of physical considerations, a simple
      condition for the design of 1D and 2D waveguide PBG structures free of this
      degradation is formulated; it is, in fact the separability condition for the wave
      equation. Its positive effect is verified by numerical modeling of a modified
      waveguide Bragg grating that fulfills the separability condition.

PMID- 11205992
TI  - Vertical-cavity surface-emitting resonances in photonic crystal films.
AB  - It is shown that thin films of dielectric, etched through with a suitably chosen
      lattice of holes, can support surface-emitting vertical resonances with very-high
      cavity Q factors (approximately 10(5) in the case of Al(x)GaAs(1-x) on oxidized
      AlyGaAs1-y). A Bloch-wave expansion is used to develop a complete vector-field
      analysis of these resonances and to reveal their underlying physics. Since they
      do not require multilayer mirrors, such resonators are a practical and simple
      replacement for conventional vertical-cavity surface-emitting laser structures.
      Other applications include wavelength-division-multiplexing components and highly
      sensitive gas detectors.

PMID- 11205993
TI  - Linear and nonlinear operation of a time-to-space processor.
AB  - The operational characteristics of a time-to-space processor based on three-wave
      mixing for instantaneous imaging of ultrafast waveforms are investigated. We
      assess the effects of various system parameters on the processor's important
      attributes: time window of operation and signal conversion efficiency. Both
      linear and nonlinear operation regimes are considered, with use of a Gaussian
      pulse profile and a Gaussian spatial mode model. This model enables us to define
      a resolution measure for the processor, which is found to be an important
      characteristic. When the processor is operated in the linear interaction regime,
      we find that the conversion efficiency of a temporal signal to a spatial image is
      inversely proportional to the resolution measure. In the nonlinear interaction
      regime, nonuniform signal conversion due to fundamental wave depletion gives rise
      to a phenomenon that can be used to enhanced the imaging operation. We
      experimentally verify this nonlinear operation.

PMID- 11205994
TI  - Veterinary epidemiology and decision making.

PMID- 11205995
TI  - Human health hazards associated with the administration of antimicrobials to
      slaughter animals. Part II. An assessment of the risks of resistant bacteria in
      pigs and pork.
AB  - Risks for the consumer regarding the acquisition of resistant bacteria and/or
      resistance genes via the consumption of pork are discussed. In general,
      Salmonella spp. and Escherichia coli that originate from animals do not easily
      transfer their resistance genes to the resident intestinal flora of humans. The
      prevalence of resistant E. coli in humans seems more associated with being a
      vegetarian (odds ratio (OR) 1.89) than with the consumption of meat and meat
      products. Other risk factors are treatment with antimicrobials (OR 2-5), becoming
      hospitalized (OR 5.93), or working in a health setting (OR 4.38). In the
      Netherlands, annually an estimated 45,000 people (0-150,000) become a carrier of
      resistant E. coli and/or resistance genes that ori ginate from pigs, while an
      estimated 345,000 persons (175,000-600,000) become a carrier of resistant E. coli
      and/or resistance genes that originate from hospitals, e.g. other patients. Any
      problems with resistant Salmonella spp. that stem from pigs are, in fact, an
      integral part of the total problem of food-borne salmonellosis. Sometimes there
      are outbreaks of a specific multi-resistant clone of S. typhimurium that causes
      problems in both farm animals and humans. The probability that in the next 30
      years there is no or maximally one outbreak of a specific clone that originates
      from pig herds is estimated at about 75%. Antimicrobials used as a growth
      promoter can have a measurable influence on the prevalence of resistant bacteria.
      The likely chain of events regarding avoparcin and the selection and
      dissemination of resistance against vancomycin in the enterococci gives the
      impression that the impact of the use of antimicrobials in animals on the
      prevalence of resistance in humans is largely determined by whether resistance
      genes are, or become, located on a self-transferable transposon. Furthermore,
      consumer health risks of antimicrobials used in slaughter pigs are mainly
      determined by the selection and dissemination of bacterial resistance and much
      less by the toxicological properties of any residues in pork. It is also
      concluded that most of the problems with resistant bacteria in humans are
      associated with the medical use of antimicrobials, and that the impact of
      particularly the veterinary use of antimicrobials is limited. However, the impact
      of antimicrobials used as a feed additive appears to be much greater than that of
      antimicrobials used for strictly veterinary purposes. The use of antimicrobials
      as a feed additive should therefore be seriously reconsidered.

PMID- 11205996
TI  - Human health hazards associated with the administration of antimicrobials to
      slaughter animals. Part I. An assessment of the risks of residues of
      tetracyclines in pork.
AB  - This article describes the assessment of consumer risks of residues of
      tetracyclines in slaughter pigs in the Netherlands. The assessed risks were toxic
      and allergic reactions, and the disturbance of the consumers' intestinal flora.
      Toxic and allergic reactions in humans and animals have only been observed at
      therapeutic doses, affecting between an estimated 1 in 5,000 and one 1 in 140,000
      individuals exposed. Residues of tetracyclines in pigs are closely associated
      with treatment with injectable formulations. Established Maximum Residue Levels
      (MRLs) do not reflect actual consumer risks in case a limit is violated
      incidentally. For example, when the established MRLs for tetracyclines in meat
      are exceeded with a factor 400, 40,000, and 200,000, respectively, the actual
      risk of an adverse drug reaction for the consumer following a single consumption
      of this meat is maximally 1 in 3 million, 1 in 300,000, and 1 in 8,000,
      respectively. At the current estimated low levels of incidental exposure via
      pork, the annual risk of negative health effects for a random consumer is
      estimated at maximally 1 in 33 million. The annual risk that a temporary
      disturbance of the intestinal flora may also result in a facilitated infection
      with certain enteropathogens, such as Salmonella spp., is estimated at 1 in 45
      million. It is concluded that the current microbiological risks of pork are
      greater than the risks of residues of tetracyclines as such, and that the control
      of the microbiological risks of pork should therefore be given first priority.

PMID- 11205997
TI  - Mathematical modelling of pseudorabies virus (syn. Aujeszky's disease virus)
      outbreaks aids eradication programmes: a review.
AB  - Pseudorabies virus will be eradicated from the Netherlands if a typical
      infectious pig (Rind) infects, on average, less than one other pig. In this
      review, we used a stochastic SIR model to estimate Rind using data from the field
      and from experiments. Rind in sow herds was estimated to be significantly less
      than 1 and in rearing and finishing pigs Rind was higher than 1. However, if Rind
      is higher than 1, PRV can still be eradicated if one infectious herd infects less
      than one other herd during the period that the herd is infectious(Rherd <1). Some
      future developments in Dutch pig husbandry (e.g. group-housing of sows) and
      possible risks after halting vaccination are also quantitatively evaluated.

PMID- 11205998
TI  - Review: reticuloruminal motility--a pharmacological target with a difference?
AB  - The vagal sensory inputs to and motor outputs from the hindbrain gastric centres
      required for reticuloruminal motility were sampled directly in anaesthetized
      sheep using electrophysiological 'single fibre' techniques and indirectly in
      conscious, surgically prepared sheep. Drugs were administered by close-arterial
      injection into a carotid artery to observe central effects and into the coeliac
      artery to observe peripheral effects on the reticulorumen. Escherichia coli
      lipopolysaccharide produced intermediates responsible for the smooth muscle
      relaxation in the first phase of reticuloruminal stasis and for gastric centre
      depression in the second phase. Adrenergic influences on reticuloruminal motility
      comprise (a) an alpha1 adrenoreceptor-induced contracture and raised tension
      receptor sensitivity, (b) an alpha2 adrenoreceptor-mediated depression of the
      gastric centres causing stasis, excitation of epithelial receptors evoking
      rumination, and interference with acetylcholine release in the parasympathetic
      pathway, (c) abeta1 adrenoreceptor-mediated inhibition of the gastric centres,
      and (d) abeta2 adrenoreceptor-mediated inhibition of intrinsic and extrinsic
      motility.

PMID- 11205999
TI  - Investigation of biochemical and haematological side-effects of cefquinome in
      healthy dogs.
AB  - In the present study, the effects of cefquinome, a 4th generation cephalosporin,
      on clinical, biochemical, haematological, and blood gas variables were
      investigated. Five healthy dogs were injected with cefquinome (1 mg/kg body
      weight, IM, daily) for 14 days. Negative effects of cefquinome on clinical,
      biochemical, and haematological variables were not observed, but it did change
      some blood gas variables.

PMID- 11206000
TI  - Macroanatomic investigations of the blood supply of thoracic limb of Kangal dogs.
AB  - In this study, the arterial supply of the thoracic limb was investigated in
      Kangal dogs. Twelve adult healthy Kangal dogs of either sex were used. Latex was
      injected into the common carotid artery, and then the axillary artery was
      dissected. The axillary artery is a continuation of the subclavian artery and
      supplies the thoracic limb in Kangal dogs. The axillary artery gave off a deltoid
      branch and external thoracic, lateral thoracic, and subscapular thoracic arteries
      in its course along the thoracic wall. The axillary artery continues distally as
      the brachial artery in the arm. The brachial artery gives rise to the cranial
      humeral circumflex, deep brachial, bicipital, ulnar collateral, superficial
      brachial, transverse cubital, and common interosseus arteries. It continues as
      the median artery after giving off the common interosseus artery. It was observed
      that the deep antebrachial artery arose from the median artery at the proximal
      third of the forearm. In the distal third of the forearm, the median artery
      divided into the palmar carpal and dorsal carpal branches. The deep palmar branch
      of the radial artery and deep branch of the palmar branch of the caudal
      interosseus artery form the deep palmar arch. The median artery joined the
      superficial branch of the palmar branch of the caudal interosseus artery to
      constitute the superficial palmar arch. The radial artery and cranial interosseus
      artery contributed to the dorsal carpal rete. The ulnar artery contributed to the
      formation of the deep and superficial palmar arches.

PMID- 11206001
TI  - Hyperaldosteronism in a cat with metastasised adrenocortical tumour.
AB  - In a 12-year-old male shorthaired cat with attacks of hypokalaemic muscular
      weakness in spite of oral potassium supplementation, highly elevated plasma
      aldosterone concentrations in combination with low plasma renin activity pointed
      to primary hyperaldosteronism. Ultrasonography and computed tomography revealed a
      large left-sided adrenal tumour growing into the phrenicoabdominal vein and the
      caudal vena cava. The tumour and its intravascular extension were surgically
      removed, but the subsequent stenosis of the caudal vena cava caused congestion
      and renal failure. At autopsy pulmonary micrometastases of the aldosteronoma were
      found.

PMID- 11206002
TI  - Population parameters to compare dog breeds: differences between five Dutch
      purebred populations.
AB  - Differences in five purebred dog populations born in 1994 in the Netherlands were
      evaluated using different parameters. Numerically, the Golden Retriever was the
      largest breed (840 litters of 234 sires) and the Kooiker Dog (101 litters of 41
      sires) the smallest. The litter per sire ratio was largest in the Bernese
      Mountain Dog (4.59) and lowest in the Kooiker Dog (2.46). The mean relatedness
      and the actual mean level of inbreeding in the studied generations were 0.102 and
      0.056 respectively for the Bernese Mountain Dog, 0.041 and 0.046 for the Bouvier
      des Flandres, 0.087 and 0.061 for the Boxer, 0.020 and 0.018 for the Golden
      Retriever, and 0.146 and 0.070 for the Kooiker Dog. Quantification and
      visualization of population parameters for purebred dogs will facilitate the
      comparison of breeds and the comparison of breeds in different periods or
      countries. It appears unlikely that the increase in inbreeding is a major
      determinant of the possible increase in the frequency of genetic diseases.

PMID- 11206003
TI  - Neurological signs in a horse due to metastases of an intestinal adenocarcinoma.
AB  - A 22-year-old Dutch Warmblood mare was referred to Utrecht University with
      progressive left hind limb paresis and hyporeflexia. The preliminary clinical
      diagnosis was the neurological form of equine herpes virus (EHV-1) infection.
      Within 1 day of admission, the mare became recumbent and deteriorated rapidly.
      Postmortem examination revealed an adenocarcinoma of the caecum, with metastases
      in all regional lymph nodes and extending from the lumbar nodes into the
      vertebral canal, causing spinal cord compression and destruction of the left 4th
      and 5th lumbar nerves.

PMID- 11206004
TI  - Cows, cats, and FSE: death penalty justified?
AB  - Transmissible spongiform encephalopathies affect a number of mammalian species.
      The most common spongiform encephalopathies are scrapie in sheep and Bovine
      Spongiform Encephalopathy (BSE) in cattle. Feline Spongiform Encephalopathy (FSE)
      is a related disorder in domestic cats. Because of the link between BSE and FSE,
      cats are put on a par with cattle, in terms of politics and regulations. In the
      Netherlands, when a case of BSE is found on a farm, not only the ruminants, but
      also the cats are taken away for post-mortem examination. So far, the cats
      examined have always been negative for FSE. There are no scientific reasons for
      destroying the cats on farms where BSE has been found.

PMID- 11206005
TI  - Oncological scintigraphy in dogs with 99mTechnetium MIBI and DMSA(V)--two case
      reports.
AB  - Oncological scintigraphy is described in two dogs with malignant lymphoma and
      malignant schwannoma, respectively. The distribution of the radiopharmaceuticals
      could be visualized for the purpose of detection of neoplasia and eventual
      metastases, and to evaluate the effectivity of therapy. It is concluded that
      99mTechnetium MIBI and 99mTc DMSA (V) scintigraphy is useful for the detection of
      soft tissue malignancy in dogs.

PMID- 11206006
TI  - Expression of multidrug resistance-associated protein (MRP) in human gliomas.
AB  - Drug resistance is a major clinical problem in the chemotherapy of human gliomas.
      The multidrug resistance-associated protein (MRP), a membrane transporter related
      to non-P-glycoprotein multidrug resistance, is overexpressed in some drug
      selected cancer cell lines. To investigate whether MRP is involved in the
      intrinsic drug resistance of human gliomas, surgical specimens of 20 gliomas (11
      glioblastomas, 6 anaplastic astrocytomas, and 3 astrocytomas), 3 normal brain
      specimens, and 4 glioma cell lines (U87MG, U251MG, U373MG, and T98G) were
      analyzed. The expression of MRP was studied by RT-PCR and immunohistochemistry in
      the surgical specimens. The MRP expression levels in the cell lines were assessed
      by the quantitative RT-PCR and Western blot analyses. Sensitivity to adriamycin
      (ADM), etoposide (VP-16), cisplatin (CDDP), and 1-(4-amino-2-methyl-5
      pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea (ACNU), were determined by
      MTT assay, and antisense treatment was evaluated in the cell lines. The
      expression of MRP was detected in 9 of 11 glioblastomas and 3 of 6 anaplastic
      astrocytomas. The quantitative analyses of the cell lines revealed that the MRP
      mRNA and protein levels were increased 4.5-fold in the T98G cells as compared to
      U87MG. T98G cells showed the highest resistance to all drugs. Western blot
      analysis revealed that treatment with the antisense oligonucleotide reduced the
      level of MRP expression to 25% of the sense oligonucleotide treatment in T98G
      cells. The sensitivity to ADM, VP-16 and CDDP was significantly increased in the
      antisense-treated cells as compared with the sense-treated cells. These results
      suggest that the MRP expression may be related to the intrinsic multidrug
      resistance in human gliomas.

PMID- 11206007
TI  - Altered nuclear localization of bax protein in BCNU-resistant glioma cells.
AB  - To investigate the role of apoptosis suppression in glioma chemotherapy
      resistance, protein levels and subcellular localization of bcl-2 family members
      were investigated in 2 pairs of sensitive cell lines and their in vitro generated
      resistant derivatives. The alkylating agent, 1,3-bis(2-chloroethyl)-1-nitrosourea
      (BCNU), induced apoptosis in both sensitive cell strains and apoptosis was
      suppressed in both resistant derivatives. Both resistant cell lines contained
      altered regulation of a bcl-2 related protein consistent with the suppression of
      apoptosis. Independent of which bcl-2 family member was dysregulated, resistance
      was associated with altered regulation in the subcellular localization of bax
      protein. Following BCNU treatment, bax accumulated in nucleoli and a nuclei
      containing fraction of sensitive cells but not their resistant derivatives.
      Nuclear accumulation was an early event in apoptosis induction. These data
      indicates altered subcellular localization of bax may play a role in resistance.
      In addition, the association between an early, nucleolar localization of bax and
      the induction of apoptosis suggests that localization of bax to nucleoli may play
      a role in apoptosis-induction of glioma cells.

PMID- 11206008
TI  - Craniotomy under local anesthesia and monitored conscious sedation for the
      resection of tumors involving eloquent cortex.
AB  - OBJECTIVE: Resection or even biopsy of an intra-axial mass lesion in close
      relationship to eloquent cortex carries a major risk of neurological deficit. We
      have assessed the safety and effectiveness of craniotomy under local anesthesia
      and monitored conscious sedation for the resection of tumors involving eloquent
      cortex. METHODS: We have performed a retrospective review of a consecutive series
      of 157 adult patients who underwent craniotomy under local anesthesia by one
      surgeon (P.M.B.) at Brigham and Women's Hospital in Boston. All patients had
      tumors in close proximity to eloquent cortex, including speech, motor, primary
      sensory, or visual cortex. In most cases the lesion was considered inoperable by
      the referring surgeon. All resection was verified by post-operative imaging
      approximately one month after surgery and all cases were reviewed by an
      independent neurosurgeon (A.D.). RESULTS: In 122 cases, brain mapping was
      performed to identify eloquent cortex and in the remainder neurological
      monitoring was maintained during the procedure. Radiological gross total
      resection was achieved in 57% of patients and greater than 80% resection was
      achieved in 23%. Thus 4 out of 5 of patients had major resection despite the
      close relationship of tumor to eloquent cortex. In 13%, less than 80% of tumor
      was removed because of danger of neurological deficit. In 7% of patients, only a
      biopsy could be done because of infiltration into eloquent cortex that could only
      be assessed at surgery. In 76 patients with pre-operative neurological deficits,
      there was complete resolution of these deficits in 33%, improvement in 32%, no
      change in 28%, and long-term worsening in 8%. Among 81 patients with no pre
      operative neurological deficit, 1 patient suffered a major permanent neurological
      deficit, and 2 developed minor deficits. There was a transient post-operative
      deficit in one-third of cases, but this had resolved at one month in all but
      three patients. Monitored conscious sedation was performed without anesthetic
      complications using midazolam, sufentanyl and fentanyl with or without propofol.
      Only one case needed to be converted to general anesthesia. Patient satisfaction
      with the procedure has been good. Operating time and hospital stay were lower
      than the mean for brain tumor craniotomy at this hospital. CONCLUSIONS: Tumor
      surgery with conscious sedation is a safe technique that allows maximal resection
      of lesions in close anatomical relationship to eloquent cortex, with a low risk
      of new neurological deficit. Only 7% of intrinsic cortical tumors were ineligible
      for partial or complete resection with this technique.

PMID- 11206009
TI  - Phase II trial of cystemustine, a new nitrosourea, as treatment of high-grade
      brain tumors in adults.
AB  - This study included 39 patients (37 evaluable, of whom 30 patients with recurrent
      gliomas and 7 patients with gliomas untreated by radiotherapy); they were
      enrolled into a phase II trial using a new nitrosourea, cystemustine,
      administrated every 2 weeks at 60 mg/m2 as a 15 min-infusion. Pathology at
      inclusion was (WHO classification): 14 glioblastomas, 20 grade 3-4 astrocytomas
      and 3 grade 3 oligodendrogliomas. Four partial responses have been obtained,
      giving an overall response rate of 10.8%. Four additional patients had a partial
      response, which for various reasons was not confirmed 4 weeks later; 12 patients
      had a stable disease for at least 8 weeks, 15 patients had progressive disease.
      Of the 4 responses, 2 were with a grade 3 oligodendroglioma and 2 glioblastoma.
      Toxicity (WHO grading) was mainly hematological: leukopenia (16.2% grade 3-4),
      neutropenia (29.7% grade 3-4), thrombopenia (27% grade 3-4). No other toxicity
      greater than grade 2 was observed. In conclusion, cystemustine at 60 mg/m2 has
      moderate clinical activity in relapsing glioma. Our results warrant further
      investigation of this agent with an increased dose or modified scheme.

PMID- 11206010
TI  - Surgery, tamoxifen, carboplatin, and radiotherapy in the treatment of newly
      diagnosed glioblastoma patients.
AB  - A historically controlled phase II study was undertaken to investigate the
      efficacy and toxicity of a postoperative treatment consisting of high-dose
      continuous tamoxifen, carboplatin and radiotherapy in patients with newly
      diagnosed glioblastoma. Between 1995 and 1998, 50 patients with newly diagnosed
      glioblastomas underwent surgery and were subsequently treated with 200 mg day(-1)
      tamoxifen continuously, 3 cycles of carboplatin (300 mg m(-2)), and radiotherapy.
      Survival data for a historical control group were calculated from respective
      prognostic indices and were obtained from studies with comparable patient
      populations treated with operation and radiotherapy only. In our study, the
      median time to tumor progression was 30 weeks and the median survival time (MST)
      55 weeks (95% confidence interval: 46-63 weeks). The MST of the control group (48
      weeks) showed to be within this interval. In addition to already known prognostic
      factors in malignant gliomas (age, Karnofsky performance score, extent of tumor
      resection), the gender (females lived longer than males, p = 0.0025) showed to
      influence survival. Serious side effects (thrombosis, pulmonary embolism)
      occurred in 6 patients. A high incidence of multifocal tumor recurrences (33%),
      which might be related to study-treatment, was observed. In conclusion, the
      combined therapy failed to demonstrate a higher efficacy than standard treatment
      for glioblastoma patients.

PMID- 11206011
TI  - FDG-PET as a prognostic factor in high-grade astrocytoma.
AB  - BACKGROUND: The prognostic value of the metabolic status of cerebral gliomas
      determined by positron emission tomography with [18F]-fluoro-deoxy-D-glucose (FDG
      PET) has been established in populations with a mixture of grades 2, 3 and 4
      gliomas, but remains uncertain when only malignant gliomas are considered (grade
      3 and 4). METHODS: FDG-PET performed in 30 patients with anaplastic astrocytoma
      (grade III) and 61 patients with glioblastoma (grade 4) were classified according
      to a metabolic grading. The uptake of FDG was lower in the tumor compared to
      white matter (WM) in grade 1 (4 glioblastoma, 4 anaplastic astrocytoma), it was
      intermediate between WM and cortex in grade 2 (20 glioblastoma, 22 anaplastic
      astrocytoma), and it was superior to cortex in grade 3 (38 glioblastoma, 4
      anaplastic astrocytoma). RESULTS: Kaplan-Meier survival curves were similar in
      patient with grades 1 and 2, but were significantly worse (p = 0.007) in grade 3.
      In multivariate analysis considering age, pathological grade (anaplastic
      astrocytoma versus glioblastoma), and metabolic grades, the metabolic grade did
      not appear to be an independent prognostic factor. When anaplastic astrocytomas
      and glioblastomas were considered separately, metabolic grade is of predictive
      value only in the group of glioblastomas. CONCLUSION: In malignant gliomas,
      metabolic grading determined by FDG-PET was not superior to the pathological
      grading for survival prediction. Still, it remains of predictive value when
      applied to malignant gliomas histologically classified as glioblastoma.

PMID- 11206012
TI  - Hydroxyurea chemotherapy for unresectable or residual meningioma.
AB  - Meningiomas represent 18-20% of all intracranial tumors and have a 10-year
      recurrence rate of 20-50%, despite aggressive surgery and irradiation. In
      addition, many tumors are not amenable to surgery due to their deep location or
      proximity to delicate structures. Chemotherapy is being explored as another
      potential treatment option for unresectable or refractory meningiomas.
      Hydroxyurea is an agent that inhibits ribonucleotide reductase and can induce
      apoptosis in meningioma cell cultures and animal models. We have placed 17
      patients with unresectable or residual meningioma on hydroxyurea chemotherapy (20
      mg/kg/d orally). The mean age of our cohort was 57.2 years; 13 patients were
      female. Eleven patients had actively growing tumors or neurological progression
      at the onset of chemotherapy. Sixteen patients were evaluable for response.
      Fourteen of the 16 patients (88%) responded with stable disease ranging from 20
      to 144+ weeks (median 80 weeks; 10 patients still accruing time). Three of the
      responders progressed after 20, 36, and 56 weeks, respectively. Two patients had
      progressive disease after 10 weeks. Toxicity was hematologic in most patients;
      leukopenia was most common. Nine patients (53%) required dosage reductions (250
      500 mg/d) secondary to hematologic toxicity. Hydroxyurea appears to have modest
      activity against meningiomas and should be considered in patients with
      unresectable tumors or large residual tumors following surgical resection.

PMID- 11206013
TI  - Therapeutic adjuncts for immediate transfer to the catheterization laboratory in
      patients with acute coronary syndromes.
AB  - Early coronary intervention in patients with non-ST-segment elevation myocardial
      infarction (MI) and unstable angina may be made safer and more efficacious with
      concomitant therapies, including glycoprotein IIb/IIIa inhibitors and low
      molecular-weight heparins. Stent placement has been shown to improve procedural
      success and reduce major in-hospital complications when compared with balloon
      angioplasty alone in patients with unstable angina. However, unstable angina
      remains a major hazard for adverse coronary events in long-term follow-up after
      elective stent placement. The currently available glycoprotein IIb/IIIa
      inhibitors-eptifibatide, tirofiban, and abciximab--have each been shown to reduce
      ischemic events before percutaneous coronary intervention when administered to
      patients presenting with non-ST-segment elevation acute coronary syndromes in
      large clinical trials. The adjunctive role of low-molecular-weight heparins in
      this scenario has been largely unexplored. Enoxaparin, when given before
      angiography or percutaneous coronary intervention, has been shown to be superior
      to unfractionated heparin in preventing major coronary events. In this review, an
      algorithm for treatment of non-ST-segment elevation acute coronary syndromes is
      presented and the current role of these newer adjunctive pharmacotherapies is
      explored. In the future, combinations of these agents may prove to be most
      beneficial in patients undergoing early percutaneous coronary intervention.

PMID- 11206015
TI  - Introduction: evidence to practice in acute coronary syndromes.

PMID- 11206014
TI  - Calming the plaque to delay intervention for 24 hours in acute coronary
      syndromes.
AB  - One approach to management of patients with acute coronary syndromes involves use
      of pharmacologic therapy to passivate plaque for at least 24 hours before
      interventional procedures are undertaken. This approach is supported by the view
      that whatever subsequent treatment the patient receives will less likely be
      complicated. An important factor in revolutionizing treatment for acute coronary
      syndromes in recent years has been the introduction of potent new antithrombotic
      and antiplatelet pharmacologic therapies such as low-molecular-weight heparins
      and glycoprotein IIb/IIIa inhibitors. Incorporation of these newer agents into
      clinical practice, along with a better understanding of the pathophysiology
      underlying acute coronary syndromes, has contributed greatly to improved outcomes
      in these patients. Although the optimal methods for integrating the newer
      therapies remains to be determined, thus far, they have been shown to lower the
      risk of acute complications, as well as improve long-term results.

PMID- 11206016
TI  - An ischemia-guided approach for risk stratification in patients with acute
      coronary syndromes.
AB  - The optimal management approach for patients with non-ST-segment elevation acute
      coronary syndromes continues to be an issue of debate. An ischemia-guided
      strategy appears to be effective as an alternative to either a very conservative
      "wait-and-see" approach or a very aggressive routine revascularization approach.
      The need for another approach is supported by the lack of conclusive evidence
      based results favoring an early routine invasive treatment strategy. In the
      Thrombolysis in Myocardial Infarction (TIMI) IIIB trial, there were no
      differences in the incidence of death or myocardial infarction (MI) between
      patients treated with an early invasive approach and those treated with a
      conservative approach to treatment. Significantly worse outcomes were shown in
      patients assigned to an early invasive strategy in the Veterans Affairs Non-Q
      Wave Infarction Strategies in Hospital (VANQWISH) trial at 1-year follow-up (111
      clinical events in the invasive group vs 85 in the conservative group; p = 0.05).
      Registry information, including that from the Organization to Assess Strategies
      for Ischemic Syndromes (OASIS), which included approximately 8,000 patients with
      unstable angina or suspected MI, has even suggested an excess hazard with a
      routine invasive approach. Patients with non-ST-segment elevation MI observed in
      the Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary
      Syndromes (GUSTO)-IIB and Platelet IIb/IIIa in Unstable Angina: Receptor
      Suppression Using Integrilin Therapy (PURSUIT) trials also fared better with an
      ischemia-guided strategy. Even the recent FRagmin and Fast Revascularization
      during InStability in Coronary artery disease (FRISC II) trial investigators had
      to be very selective relative to eliminating high-risk patients in the first week
      and treating with intense anti-ischemic therapy and 5-7 days of low-molecular
      weight heparin therapy to show an advantage for assigned revascularization. A
      careful clinical evaluation with attention to early risk stratification is
      essential in the ischemia-guided approach. The Braunwald classification for
      unstable angina helps identify independent clinical predictors of a poor outcome;
      high risk is clearly associated with Braunwald class III and type C.
      Electrocardiographic and biochemical markers for myocardial necrosis (cardiac
      troponin T or I) are important tools for assessing the presence and degree of
      ischemia and associated risk for adverse outcome. Noninvasive evaluation of left
      ventricular ejection fraction is essential for identifying those at high risk due
      to impaired contractile function. When these conventional markers do not provide
      conclusive information, noninvasive stress testing is most helpful to further
      identify those at highest risk for revascularization.

PMID- 11206017
TI  - Acute coronary syndromes: extending medical intervention for five days before
      proceeding to revascularization.
AB  - Intensive medical therapy before percutaneous coronary intervention appears to
      improve results in patients with unstable angina and non-ST-segment elevation
      myocardial infarction (MI). In this review of treatment strategies for patients
      with acute coronary syndromes, an "aggressive conservative" approach based on
      that used in the FRagmin and Fast Revascularisation during InStability in
      Coronary artery disease (FRISC II) trial is recommended. In FRISC II, an early
      (but not emergent) invasive therapeutic procedure undertaken within 7 days of
      starting open-label dalteparin lowered the risk of death and MI in moderate- and
      high-risk patients and resulted in better and more rapid symptom relief and fewer
      hospital readmissions than the noninvasive approach. The early treatment period
      represents a critical juncture in the spectrum of care for patients with unstable
      angina and affords physicians the best opportunity to educate them about the
      importance of risk factor modification. Informed consent is also an important
      issue, particularly in the event of ad hoc coronary intervention. The optimal
      treatment plan must include considerations of length of hospitalization,
      medication requirements, and the potential for symptom recurrence or need for
      hospital readmission. Finally, tailoring therapy for individual patients and
      establishing appropriate timing of procedures will help ensure the best possible
      outcome.

PMID- 11206018
TI  - Avoidance of routine revascularization in the management of patients with non-ST
      segment elevation acute coronary syndromes.
AB  - A debate continues over whether a routine invasive or a conservative strategy is
      the best treatment approach for patients with non-ST-segment elevation acute
      coronary syndrome. The fundamental question underlying this debate is whether
      risk stratification should be an anatomy-driven or an ischemia-driven process. An
      early routine invasive or "drive-through" strategy, which consists of cardiac
      catheterization followed by percutaneous coronary intervention within 24 hours of
      the onset of angina, has not been shown to result in improved outcomes. In fact,
      investigators in the Veterans Affairs Non-Q-Wave Infarction Strategies in
      Hospital (VANQWISH) trial found that aggressively treated patients had
      significantly worse outcomes during the first year of follow-up than did those
      treated with a conservative strategy. In this overview, a conservative (ischemia
      guided) strategy with aggressive medical therapy is recommended for patients with
      non-ST-segment elevation acute coronary syndrome. This conservative treatment
      includes intensive antiplatelet, antithrombotic, and anti-ischemic therapy
      combined with careful clinical assessment and provocative testing. Patients
      undergo catheterization and revascularization only if spontaneous angina occurs
      or there is objective evidence of stress-induced myocardial ischemia. In the
      future, it may be revealed that only patients at high risk have real benefit from
      early aggressive therapy, but the same approach may result in harm to patients at
      low risk. Tailoring therapy to the level of risk is essential to optimizing
      efficacy and clinical outcomes.

PMID- 11206019
TI  - Thrombosis prophylaxis in the acutely ill medical patient: insights from the
      prophylaxis in MEDical patients with ENOXaparin (MEDENOX) trial.
AB  - The clinical benefit and cost-effectiveness of routine thromboprophylaxis in
      surgical patients has been well documented, but use of this approach in general
      medical patients remains controversial. Following is an overview of major
      insights from the prophylaxis in Medical patients with Enoxaparin (MEDENOX)
      trial, which was undertaken to evaluate the efficacy of 2 dosage regimens of the
      low-molecular-weight heparin enoxaparin for prevention of venous thromboembolism
      in acutely ill medical patients. MEDENOX was a prospective, double-blind,
      randomized, placebo-controlled trial, which enrolled 1,102 hospitalized patients
      from 68 centers in 9 countries. Patients were randomly assigned to receive 40 mg
      of enoxaparin, 20 mg of enoxaparin, or placebo, given subcutaneously once a day
      for 6-14 days. The primary outcome was venous thromboembolism (deep-vein
      thrombosis or pulmonary embolism) between days 1 and 14. At the 40-mg dose, the
      risk of venous thromboembolism was significantly reduced in patients with heart
      failure, as well as in patients with other medical illnesses, including
      respiratory failure, infectious disease, or rheumatic disorders. The incidence of
      venous thromboembolism was 5.5% in the group that received 40 mg of enoxaparin as
      compared with 14.9% in the group that received placebo (p <0.001), a benefit that
      was maintained at 3-month follow-up. There was no significant difference in the
      incidence of venous thromboembolism between the group that received 20 mg of
      enoxaparin (15%) and the placebo group. Adverse effects did not significantly
      differ between the placebo group and either enoxaparin group. This study clearly
      establishes an effective strategy for lowering the risk of venous thromboembolism
      in the acutely ill population and provides a framework for future trials in this
      area.

PMID- 11206020
TI  - Strategies of patient care in acute coronary syndromes: rationale for the Global
      Registry of Acute Coronary Events (GRACE) registry.
AB  - An abundance of evidence is available from large, randomized clinical trials
      supporting the efficacy of therapies for the management of patients with acute
      coronary syndromes. For ST-segment elevation myocardial infarction (MI), a
      variety of databases can be used to assess how these therapies, both
      pharmacologic and invasive, are being integrated into real practice. Little
      information is available, however, with regard to how newer treatments are
      actually being implemented for patients with unstable angina and non-ST-segment
      elevation MI. There are several important issues to consider in evaluating
      current treatment practices for acute coronary syndromes, including limitations
      of clinical trial databases, a trend toward progressive shortening of length of
      hospital stay, and variations in the availability of resources among treatment
      centers. In response to the need for a broader database that would address the
      global impact of clinical management practices in acute coronary syndromes, the
      Global Registry of Acute Coronary Events (GRACE) Registry has been established.
      The GRACE Registry will initially collect data on patient care from a variety of
      treatment centers in 14 countries, the plan being to eventually enroll 10,000
      patients per year. This international observational database will obtain
      information on the complete spectrum of acute coronary syndromes, with the
      specific goals of describing diagnostic and treatment strategies, determining
      hospital outcomes, improving quality of care, and developing hypotheses for
      future clinical research.

PMID- 11206021
TI  - Health situation analysis in the Americas, 1999-2000.

PMID- 11206023
TI  - Outbreak of poliomyelitis in the Dominican Republic and Haiti.

PMID- 11206024
TI  - Case definitions. Syphilis.

PMID- 11206022
TI  - Interrupting measles transmission in the Americas.

PMID- 11206025
TI  - Dengue in Central America: the epidemics of 2000.

PMID- 11206026
TI  - West Nile virus in the Americas.

PMID- 11206027
TI  - European recommendations on surveillance of antituberculosis drug resistance.

PMID- 11206028
TI  - Malaria, Burundi.

PMID- 11206030
TI  - Social anxiety disorder: comorbidity and its implications.
AB  - Social anxiety disorder is an extremely common and potentially disabling
      psychiatric disorder. Generalized social anxiety disorder, a subtype of the
      disorder, is believed to be the most common and most severe form. It is also the
      form that is most often associated with other psychiatric disorders. Unless the
      clinician has a high index of suspicion, social anxiety disorder may remain
      undetected. The clinical and treatment implications of the most common
      psychiatric comorbidities associated with social anxiety disorder are discussed
      in this article, with a focus on major depression, panic disorder, posttraumatic
      stress disorder, and alcohol abuse/dependence. Other psychiatric disorders and
      some medical conditions commonly associated with social anxiety disorder are
      briefly mentioned. Finally, a differential diagnosis of social anxiety disorder
      is described. Individuals who present for treatment of other anxiety disorders,
      mood disorders, or alcohol/substance abuse disorders should be considered at risk
      for current but undetected social anxiety disorder.

PMID- 11206029
TI  - Social anxiety disorder: an unrecognized problem in primary care.
AB  - Social anxiety disorder, or social phobia, is one of the most common mental
      disorders, yet it remains underrecognized and undertreated. Individuals with
      social anxiety disorder frequently have psychiatric comorbidity, including mood,
      anxiety, and substance abuse disorders, that can further impair a person's
      ability to function. This article reviews the literature on social anxiety
      disorder and explores questions regarding its prevalence, rates of recognition
      and treatment, and natural history. The association between social anxiety
      disorder and psychiatric comorbidity and suicide is reviewed, as well as quality
      of-life issues, including the impact of social anxiety disorder on educational
      attainment, occupational functioning and financial dependency, marital status,
      and health care utilization. There is a need for further study and greater
      awareness among primary health care providers about the prevalence and treatment
      of social anxiety disorder.

PMID- 11206031
TI  - Social phobia: etiology, neurobiology, and treatment.
AB  - Social phobia is a common and often disabling condition, with an etiology that is
      not established. There is evidence at several levels for an interplay of
      biological and psychological processes in social phobia. Genetic studies show
      that both genetic and environmental factors are important, with evidence pointing
      to associations with 2 genetic conditions, autism and fragile X syndrome.
      Behavioral inhibition has emerged as an important precursor to social phobia and
      possibly to other anxiety disorders. Epidemiologic and clinical studies have
      suggested that factors within the family environment, such as overprotection,
      overcontrol, modeling of anxiety, criticism, and in some cases abuse, can play a
      role in the development of social phobia. During childhood, complex interactions
      between brain system disturbances that mediate responses to negative social cues
      and factors in the social setting may lead to the development of a distorted set
      of internal "blueprints" for social behavior. The impact of severe social anxiety
      on brain systems that mediate behavioral change may prevent patients from
      learning better "blueprints." These can be taught through cognitive-behavioral
      therapies. The effective control of social anxiety with medications enables
      patients to recover; whether recovery can last after discontinuation of
      medications may depend on whether a new "blueprint" has been developed and
      whether stable changes in affected brain systems have occurred. Neuroimaging
      techniques are at the early stage of identifying abnormalities at the
      neurotransmitter and systems levels.

PMID- 11206032
TI  - Current status of psychotherapeutic interventions for social phobia.
AB  - Psychotherapeutic interventions, especially the cognitive-behavioral
      psychotherapies, have been well studied as treatments for social phobia. The
      purposes of this article are to (1) enumerate and describe the varieties of
      cognitive-behavioral therapy (CBT) that have been applied to the treatment of
      social phobia, (2) provide a meta-analytic overview of the efficacy of these
      approaches, (3) examine the relative utility of CBT versus that of
      pharmacotherapy for social phobia, (4) examine the potential utility of
      multidisciplinary approaches to treatment, and (5) discuss possible future
      directions in the development of psychotherapeutic strategies for the treatment
      of social phobia, including the use of computers as adjunctive tools.

PMID- 11206034
TI  - Social phobia: prevalence and diagnostic threshold.
AB  - This article reviews the literature on the prevalence and demographic features of
      social phobia in both community and general medical settings. The age at onset of
      social phobia is examined, as are comorbid conditions. Important differences
      between social phobia as it appears in the community and in primary care settings
      are explored. We conclude that social phobia is common and associated with
      significant impairment in a number of life areas. We discuss the diagnostic
      threshold of social phobia and potential difficulties in differentiating this
      disorder from other mental disorders.

PMID- 11206033
TI  - Treatment of social phobia with antidepressants.
AB  - This article reviews evidence for the utility of antidepressant medications in
      the treatment of social phobia. Monoamine oxidase inhibitors (MAOIs) were the
      first antidepressants shown to be effective for social phobia, but dietary
      restrictions and a relatively high rate of adverse effects often relegate MAOIs
      to use after other treatments have been found ineffective. Reversible inhibitors
      of monoamine oxidase (RIMAs) hold promise as safer alternatives to MAOIs, but
      RIMAs may be less effective and are currently unavailable in the United States.
      Selective serotonin reuptake inhibitors (SSRIs), of which paroxetine has been the
      best studied in social phobia to date, have recently emerged as a first-line
      treatment for the generalized subtype of social phobia. The SSRIs are well
      tolerated and consistently have been shown to be efficacious in controlled
      trials.

PMID- 11206035
TI  - Benzodiazepines and anticonvulsants for social phobia (social anxiety disorder).
AB  - Both benzodiazepines and conventional anticonvulsants have been evaluated as
      treatments for social phobia (social anxiety disorder). Among the
      benzodiazepines, clonazepam is the best studied, although there is reason to
      expect that all benzodiazepine anxiolytics would be effective for this condition.
      Among the anticonvulsants, gabapentin and pregabalin, an analogue of gamma
      aminobutyric acid (GABA), have been shown to be more effective than placebo in
      double-blind studies. Other than a small negative open study of valproic acid for
      social phobia, there is a paucity of information on whether other anticonvulsants
      might be useful for this condition.

PMID- 11206036
TI  - Methadone maintenance treatment: is it possible to adapt the daily doses to the
      metabolic activity of the patient?
AB  - Controversy still exists concerning the proper daily dose of methadone to be used
      in opiate dependency treatment. Because it is admitted that serum methadone
      concentration may be significantly correlated with the amount of drug available
      at the receptor level, it could be interesting to predict the methadone daily
      doses necessary to reach such a serum concentration. The authors have attempted
      to correlate the serum methadone level with the daily intake, considering the
      metabolic activity of the patients. A poor correlation was found between
      methadone doses and methadone serum concentrations (r2 = 0.0409, p = 0.048). The
      test used to determine the metabolic activity of patients is the 6-OH cortisol/17
      OH corticosteroids ratio in urine. This urinary 6-OH cortisol/17-OH
      corticosteroids ratio was tested because cortisol is metabolized through the same
      P450 cytochromes as methadone, namely cytochrome P450 3A4. This determination
      could be of interest because it could be tested before methadone administration
      to predict optimal doses. But when the authors tried to correlate the methadone
      serum concentration with the steroid ratio, they failed to find a significant
      correlation (r2 = 0.0046, N.S.), even when they took into account the daily doses
      (r2 = 0.0015, N.S.), most probably because of some limitations of the cortisol
      ratio.

PMID- 11206037
TI  - Relation between dosage of carbamazepine and concentration in hair and plasma
      samples from a compliant inpatient epileptic population.
AB  - Compliance is a problem in all areas of therapeutic medicine. Methods for its
      assessment are classified as either indirect or direct. Indirect assessment is
      based on criteria such as pill counts, questionnaires, and self-reporting; direct
      methods involve the analytic measurement of the drugs in biologic fluids such as
      plasma or urine. Drugs taken either therapeutically or recreationally become
      incorporated into hair. This prospective study investigated the relation between
      the daily intake of the antiepileptic drug carbamazepine and both its trough
      plasma and hair concentrations in a highly supervised inpatient population of
      patients with epilepsy during a period of 6 months. Results showed that although
      there was a significant variation between patients resulting from the substantial
      range in the daily intake of carbamazepine (800-2400 mg/day), the intrapatient
      variation in both trough plasma and hair concentrations during the 6-month period
      were not significantly different. The mean intrapatient percentage coefficient of
      variation in total plasma and hair concentrations of carbamazepine was 11.5 +/-
      4.7 and 15.0 +/- 5.2, respectively, both of which were independent of the daily
      dosage. This relatively small intrapatient variation in hair concentration over
      time and its close relation to the plasma concentration suggests that hair
      analysis may be a complementary and useful technique in monitoring drug-taking
      behavior.

PMID- 11206038
TI  - Determination of sildenafil citrate in plasma by high-performance liquid
      chromatography and a case for the potential interaction of grapefruit juice with
      sildenafil citrate.
AB  - This study was designed to establish a simple and reliable assay method that
      could be routinely used in the clinical laboratory setting using liquid
      extraction and high-performance liquid chromatography (HPLC). In addition, a case
      of potential interaction of grapefruit juice with sildenafil citrate is
      presented. The peaks of sildenafil (measured as sildenafil salt) and internal
      standard were identified with an ultraviolet detector at 230 nm and detection
      limit at 10 ng/mL. In a single elderly male patient, grapefruit juice increased
      the Cmax of sildenafil by 42% (1067.7 ng/mL to 1517.0 ng/mL) although AUC was not
      significantly altered (4082.9 ng x h/mL to 4171.9 ng x h/mL) by grapefruit juice.
      Sildenafil could be determined in a simple and reliable method using HPLC with
      liquid extraction. This case indicated that grapefruit juice might increase the
      Cmax of sildenafil without significant change in AUC. A further study with an
      appropriate number of subjects is needed before determining the degree of
      interaction between grapefruit juice and sildenafil.

PMID- 11206039
TI  - Bioanalysis of racemic reboxetine and its desethylated metabolite in a
      therapeutic drug monitoring setting using solid phase extraction and HPLC.
AB  - Reboxetine is a new antidepressant drug acting as a potent and selective
      noradrenaline reuptake inhibitor on the noradrenergic neuronal system. Because of
      an expected interindividual variability in drug metabolism in the clinical
      practice the need for therapeutic drug monitoring routines in psychiatry is
      always a prominent feature. In this application, the preferred bioanalytic
      methodology was solid phase extraction combined with reversed-phase high
      performance liquid chromatography and ultraviolet detection at 210 nm. The
      technique proved reliable, with interday and intraday variation of less than 5%
      and a quantification limit for reboxetine and one of its main metabolites O
      desethylreboxetine (O-reboxetine) at 5 and 30 nmol/L, respectively. The method
      was applied on serum samples from 38 patients treated chronically with
      reboxetine. These samples were drawn as trough levels in steady state with a
      dosage range of 2-16 mg/day. They evidenced a mean reboxetine concentration that
      was fairly linear and dose proportional, although the variance in concentration
      was large between patients, even those taking the same dosage. O-reboxetine was
      detected in quantifiable amounts in only 1 of the 38 patients (<3%). In
      conclusion, these results suggest that a routine reboxetine therapeutic drug
      monitoring service that is robust enough to produce reliable and reproducible
      results may be introduced into everyday clinical practice.

PMID- 11206040
TI  - Mycophenolic acid plasma concentrations: influence of comedication.
AB  - Mycophenolate mofetil (MMF) in combination with cyclosporine (CsA) or Tacrolimus
      (TAC) has been show to be a potent immunosuppressive agent. The authors assessed
      the mycophenolic acid (MPA) plasma levels achieved in clinical practice and
      evaluated the effect of concomitant administration of CsA and TAC . One hundred
      forty transplant patients (kidney: 120 and lung: 20) received a triple
      immunosuppression regimen of CsA or TAC, prednisone and MMF. Twenty-two renal
      transplant patients received double therapy with MMF and prednisone. There was no
      correlation between MMF dose and MPA trough concentrations (r = -0.0657). The
      medians (range) of the MPA dose-to-concentration ratio (D/C) in the CsA and TAC
      groups were 0.90 (0.11-8.33) and 0.56 (0.11-14.3), respectively (p < 0.0001).
      According to the post transplant period (1-3, 4-6 and >6 months), D/C values were
      significantly lower in patients receiving MMF and TAC than those receiving MMF
      and CsA in all three periods. MPA levels in patients treated with MMF and CsA
      were significantly lower than those obtained in double therapy. The D/C ratio in
      CsA-treated patients, increased significantly (p = 0.0005) when CsA level
      increased. There was no relationship between D/C ratio and TAC blood
      concentrations. These results suggest that CsA exerts an influence on MPA trough
      levels, although further work is required to characterize the mechanism of
      interaction.

PMID- 11206041
TI  - Analytical validation for a series of marker compounds used to assess renal drug
      elimination processes.
AB  - Renal drug elimination is determined by glomerular filtration, tubular secretion,
      and tubular reabsorption. Changes in the integrity of these processes influence
      renal drug clearance, and these changes may not be detected by conventional
      measures of renal function such as creatinine clearance. The aim of the current
      study was to examine the analytic issues needed to develop a cocktail of marker
      drugs (fluconazole, rac-pindolol, para-aminohippuric acid, sinistrin) to measure
      simultaneously the mechanisms contributing to renal clearance. High-performance
      liquid chromatographic methods of analysis for fluconazole, pindolol, para
      aminohippuric acid, and creatinine and an enzymatic assay for sinistrin were
      developed or modified and then validated to allow determination of each of the
      compounds in both plasma and urine in the presence of all other marker drugs. A
      pilot clinical study in one volunteer was conducted to ensure that the assays
      were suitable for quantitating all the marker drugs to the sensitivity and
      specificity needed to allow accurate determination of individual renal
      clearances. The performance of all assays (plasma and urine) complied with
      published validation criteria. All standard curves displayed linearity over the
      concentration ranges required, with coefficients of correlation greater than
      0.99. The precision of the interday and intraday variabilities of quality
      controls for each marker in plasma and urine were all less than 11.9% for each
      marker. Recoveries of markers (and internal standards) in plasma and urine were
      all at least 90%. All markers investigated were shown to be stable when plasma or
      urine was frozen and thawed. For all the assays developed, there were no
      interferences from other markers or endogenous substances. In a pilot clinical
      study, concentrations of all markers could be accurately and reproducibly
      determined for a sufficient duration of time after administration to calculate
      accurate renal clearance for each marker. This article presents details of the
      analytic techniques developed for measuring concentrations of marker drugs for
      different renal elimination processes administered as a single dose to define the
      processes contributing to renal drug elimination.

PMID- 11206042
TI  - Effective fluconazole therapy for liver transplant recipients during continuous
      hemodiafiltration.
AB  - Fungal infections are still one of the main causes of death and complications
      after solid organ and bone marrow transplants. The authors evaluated the effect
      of continuous hemodiafiltration (CHDF) on the pharmacokinetics of fluconazole in
      liver transplant recipients. Six liver transplant patients (primary biliary
      cirrhosis, n = 2; fulminant hepatitis, n = 2; viral hepatitis, n = 2) were
      enrolled in this study. In one patient not receiving CHDF, the fluconazole levels
      increased with increasing dosages. In contrast, in patients undergoing CHDF, the
      dosage of fluconazole was increased from 100 mg/d to 200 mg/d, but fluconazole
      did not reach the targeted levels. It appears that the targeted trough level
      cannot be achieved by administration of fluconazole at a dosage of 100 to 200
      mg/d during CHDF. A higher dosage (600-1000 mg/d) of fluconazole may be required
      to achieve the therapeutic drug level in patients undergoing CHDF. In patients
      undergoing CHDF, fluconazole was given at a dosage of 800 mg/d and reached the
      targeted levels. In addition, after CHDF, the dosage of fluconazole was decreased
      to 100 mg/d, and fluconazole reached the near-targeted trough level. These
      results demonstrate that CHDF removes fluconazole from the blood at an
      efficiently high rate, resulting in its ineffective blood level. To guarantee
      safe and effective fluconazole therapy, the trough levels should be monitored
      routinely during CHDF.

PMID- 11206043
TI  - Urine drug screens in overdose patients do not contribute to immediate clinical
      management.
AB  - A prospective study assessed whether routine urine drug screens might alter the
      management of overdose patients. Urine was collected from 107 patients with a
      diagnosis of deliberate self-poisoning seen in the emergency department (ED) of a
      teaching hospital. The mean age of patients was 36 years (range 13-86 years) and
      64% were female. All patients recovered after standard investigations and
      management, which did not include knowledge of urinary drug screen results. Two
      hundred ninety-seven compounds were detected in the 107 urine samples. Twenty
      percent were drugs administered in the ED. Sixty-five percent of patients were
      found to have taken more than one drug. Benzodiazepines were detected in 18% of
      samples, paracetamol in 10%, and alcohol in 8%. Sixty-one drugs, in 35 people,
      were identified that the patients did not report taking. Of these, paracetamol
      (10), benzodiazepines (9), and tetrahydrocannabinol (8) were the most common. All
      patients in whom paracetamol was found had already had paracetamol detected in
      blood and appropriate management instituted. If the results of urine screening
      had been immediately available this would not have affected the management or
      outcome of any patient.

PMID- 11206044
TI  - Fully automated on-line determination of olanzapine in serum for routine
      therapeutic drug monitoring.
AB  - A method is presented for unattended fully automated extraction and on-line
      determination of the atypical antipsychotic drug olanzapine in serum. An ASPEC
      automatic sample-preparing apparatus with Isolute cyanopropyl-bonded silicagel
      cartridges was used for solid-phase extraction of the drugs from serum. The
      adsorbed drugs were eluted with methanol and an aliquot injected into a high
      performance liquid chromatograph (HPLC) apparatus. Trifluoperazine was used as
      internal standard, and the analytes were separated on an unmodified silicagel
      column using methanol-ammonium acetate buffer pH 9.9 (85:15) as mobile phase.
      Ultraviolet detection at 257 nm was used for quantitation. Within the therapeutic
      range for the serum concentration of olanzapine, the interday variations for the
      quantitative determinations were <8%. Comparisons between concentrations measured
      using liquid-liquid extraction and the present on-line extraction method showed
      good agreement. Other drugs often used in combination with olanzapine did not
      interfere with the quantitative determinations. The method has been in routine
      use for more than 1 year for therapeutic drug monitoring.

PMID- 11206045
TI  - Sensitive and rapid method for the simultaneous quantification of the HIV
      protease inhibitors indinavir, nelfinavir, ritonavir, and saquinavir in human
      plasma by reversed-phase liquid chromatography.
AB  - A rapid, sensitive, and specific liquid chromatography method for the
      simultaneous determination of four protease inhibitors (indinavir, nelfinavir,
      ritonavir, and saquinavir) in human plasma is described. After a liquid-liquid
      extraction with terbutyl methyl ether and a sequential washing of the
      reconstituted sample with hexane, protease inhibitors are separated on a phenyl
      column using a simple binary mobile phase of ammonium acetate buffer:acetonitrile
      (48:52) (pH = 7.5) with an ultraviolet detection at 260 nm. The standard curves
      are linear in the range 0.025-1 microg/mL for saquinavir, 0.1-4 microg/mL for
      indinavir and nelfinavir, and 0.25-10 microg/mL for ritonavir, with an average
      recovery ranging from 79% to 99%, and with both low interday and intraday
      coefficients of variation (<15%). This assay is simple, rapid (15-minute interval
      between runs) , and useful for therapeutic monitoring of the protease inhibitors
      on a routine basis.

PMID- 11206046
TI  - Screening for detection of new antidepressants, neuroleptics, hypnotics, and
      their metabolites in urine by GC-MS developed using rat liver microsomes.
AB  - A gas chromatography-mass spectrometry (GC-MS) procedure for the detection of new
      antidepressants, neuroleptics, hypnotics, and their metabolites in urine is
      presented. The metabolites were first identified in rat liver microsome
      preparations by GC-MS after isolation and derivatization. Using these GC-MS data,
      a GC-MS screening was developed for urine as part of the authors' modified
      systematic toxicologic analysis procedure. After acid hydrolysis of a 2.5-mL
      aliquot of urine, a further aliquot was added. The mixture was then liquid-liquid
      extracted at pH 8-9, acetylated, and GC separated. Using mass chromatography with
      the ions m/z 58, 100, 120, 182, 195, 235, 261, 276, 284. and 293, the presence of
      new antidepressants, neuroleptics, hypnotics, and their metabolites could be
      indicated. Positive peaks could be identified by library search using the
      reference mass spectra recorded during the microsome studies. The intake of
      therapeutic doses of the following drugs could be monitored in urine: dosulepin,
      mirtazapine, moclobemide, nefazodone, trazodone, venlafaxine, and zolpidem.
      Olanzapine and zotepine were detectable in human urine only under steady-state
      conditions, and low-dose zopiclone was detectable only in overdose. The detection
      limit was less than 100 ng/mL (signal-to-noise ratio = 3) for the parent drugs.

PMID- 11206047
TI  - Effect of coadministered drugs and ethanol on the binding of therapeutic drugs to
      human serum in vitro.
AB  - The effects of coadministered drugs and ethanol on the binding of therapeutic
      drugs to human serum in vitro was investigated. Acetaminophen, lidocaine,
      phenobarbital, quinidine, theophylline, and valproic acid were added to pooled
      human serum at therapeutic concentrations. To each preparation was added one
      additional drug at three concentrations ranging from therapeutic to toxic. The
      following eight target drug/added drug combinations were studied:
      acetaminophen/phenobarbital. acetaminophen/theophylline, lidocaine/quinidine,
      phenobarbital/acetaminophen, phenobarbital/valproic acid, quinidine/lidocaine,
      theophylline/acetaminophen, and valproic acid/phenobarbital. Each serum without
      the other added drug as well as the serum supplemented with the other drug at the
      three concentrations was dialyzed against phosphate buffer. Similarly dialyzed
      were phenobarbital, quinidine, and theophylline, both alone at therapeutic
      concentrations in serum and with ethanol at three different concentrations in
      serum. The percentage of drug binding in each preparation was calculated.
      Acetaminophen diminished the binding of theophylline to human serum by a net
      change of 5.7% (percentage increase in free drug fraction [FDF], 11.0%) at 662
      micromol/L and by a net change of 7.1% (percentage increase in FDF, 13.7%) at
      1324 micromol/L. Theophylline decreased the binding of acetaminophen by a net
      change of 6.8% (percentage increase in FDF, 8.8%) at 277.5 micromol/L;
      phenobarbital reduced it by a net change of 6.6% (percentage increase in FDF,
      8.5%) at 431 micromol/L. Valproic acid diminished binding of phenobarbital by a
      net change of 9.9% (percentage increase in FDF, 21.2%) at 1732 micromol/L. No
      significant effects were noted with other drug combinations or with the addition
      of ethanol. Coingestion of acetaminophen with theophylline, phenobarbital with
      acetaminophen, and valproic acid with phenobarbital at high to toxic
      concentrations decreases the binding of the target drug. The resulting increase
      in free drug concentration may lead to enhanced drug effect in vivo.

PMID- 11206048
TI  - Phenytoin intoxication induced by fluvoxamine.
AB  - A patient had phenytoin intoxication after administration of fluvoxamine, a
      selective serotonin reuptake inhibitor. The serum concentration of phenytoin
      increased dramatically from 16.6 to 49.1 microg/mL when fluvoxamine was
      coadministered, although the daily dosage of phenytoin and other drugs had not
      changed. During phenytoin and fluvoxamine treatment, ataxia, a typical side
      effect of phenytoin, was observed. The genotypes of CYP2C9 and 2C19, the enzymes
      responsible for phenytoin metabolism, were homozygous for the wild-type alleles
      (CYP2C9*1/*1 and 2C19*1/ *1). The interaction may be a result of inhibition of
      both CYP2C9 and 2C19 by fluvoxamine.

PMID- 11206049
TI  - Prediction of metabolic activity from genotype: the gene-dose effect of N
      acetyltransferase.
AB  - Metabolic activity of the polymorphic N-acetyltransferase (NAT2) is determined by
      the mutation pattern of the NAT2 gene. This results in interindividual
      differences in the metabolic capacity (the phenotype), with continuous
      distribution of the activities rather than qualitative distinction between rapid
      and slow acetylators. To determine whether the phenotype might be predicted
      solely from the mutation pattern of NAT2, quantitative relationships were
      calculated between mutation patterns of the NAT2 gene and the phenotype of NAT2
      assessed either in vitro or in vivo. Healthy volunteers were examined for the
      velocity at which they metabolized sulfamethazine, and human liver cytosols were
      measured for NAT2 enzymatic activity, obtaining in vivo and in vitro metabolic
      phenotype, respectively. Typing of the NAT2 gene was performed by polymerase
      chain reaction, restriction fragment length analysis, or allele-specific
      polymerase chain reaction. Multiple linear regression analysis provided
      quantitative relationships between allelic pattern and the NAT2 activities
      measured in vivo and in vitro. Estimates showed the influence of particular
      allelic configurations on enzyme activity in vitro and the extent of acetylation
      of the probe drug in vivo, resulting in a strict gene-dose effect. Comparison of
      in vitro results with in vivo phenotyping figures showed a high degree of
      correspondence, indicating that the one is the reflection of the other.

PMID- 11206050
TI  - Design of a minimal protein oligomerization domain by a structural approach.
AB  - Because of the simplicity and regularity of the alpha-helical coiled coil
      relative to other structural motifs, it can be conveniently used to clarify the
      molecular interactions responsible for protein folding and stability. Here we
      describe the de novo design and characterization of a two heptad-repeat peptide
      stabilized by a complex network of inter- and intrahelical salt bridges. Circular
      dichroism spectroscopy and analytical ultracentrifugation show that this peptide
      is highly alpha-helical and 100% dimeric tinder physiological buffer conditions.
      Interestingly, the peptide was shown to switch its oligomerization state from a
      dimer to a trimer upon increasing ionic strength. The correctness of the rational
      design principles used here is supported by details of the atomic structure of
      the peptide deduced from X-ray crystallography. The structure of the peptide
      shows that it is not a molten globule but assumes a unique, native-like
      conformation. This de novo peptide thus represents an attractive model system for
      the design of a molecular recognition system.

PMID- 11206051
TI  - Cysteine-independent polymerization of metallothioneins in solutions and in
      crystals.
AB  - Polymerization of metallothioneins is one of the usually encountered puzzles
      during the research process of metallothioneins' structure and function. Our work
      focuses on the cysteine independently occurred polymerization from
      metallothioneins monomers in different milieus, while it leaves out the
      aggregation caused by the oxidation of cysteine, because the latter circumstance
      is the result of purification lapsus. After the purification of metallothioneins
      monomers, a dynamic light-scattering technique is used to detect the polymerized
      states of rabbit liver metallothionein I and II in different buffers, which is
      the first systematical detection of polymerized states of metallothioneins in
      solutions. The effects of different compositions of each buffer are discussed in
      details. Steric complementarity, hydrophobic, and electrostatic interaction
      characteristics are studied, following the modeling of monomers and relevant
      polymers of rat metallothionein II, rabbit liver metallothionein I and II. These
      theoretical calculations are the first complete computer simulations on different
      factors affecting metallothioneins' polymerization. A molecular recognition
      mechanism of metallothioneins' polymerization in solutions is proposed on the
      bases of experimental results and theoretical calculations. Preliminary X-ray
      studies of two crystal forms of rabbit liver metallothionein II are compared with
      the crystal structure of rat metallothionein II, and the polymerized states in
      crystal packing are discussed with the knowledge of polymerization of
      metallothioneins in solutions. The hypothesis, which is consistent with
      theoretical calculations and experimental results, is expected to construct a
      connection between the biochemical characteristics and physiological functions of
      metallothioneins, and this research may give some enlightenment to the topics of
      protein polymerizations.

PMID- 11206052
TI  - Automated search of natively folded protein fragments for high-throughput
      structure determination in structural genomics.
AB  - Structural genomic projects envision almost routine protein structure
      determinations, which are currently imaginable only for small proteins with
      molecular weights below 25,000 Da. For larger proteins, structural insight can be
      obtained by breaking them into small segments of amino acid sequences that can
      fold into native structures, even when isolated from the rest of the protein.
      Such segments are autonomously folding units (AFU) and have sizes suitable for
      fast structural analyses. Here, we propose to expand an intuitive procedure often
      employed for identifying biologically important domains to an automatic method
      for detecting putative folded protein fragments. The procedure is based on the
      recognition that large proteins can be regarded as a combination of independent
      domains conserved among diverse organisms. We thus have developed a program that
      reorganizes the output of BLAST searches and detects regions with a large number
      of similar sequences. To automate the detection process, it is reduced to a
      simple geometrical problem of recognizing rectangular shaped elevations in a
      graph that plots the number of similar sequences at each residue of a query
      sequence. We used our program to quantitatively corroborate the premise that
      segments with conserved sequences correspond to domains that fold into native
      structures. We applied our program to a test data set composed of 99 amino acid
      sequences containing 150 segments with structures listed in the Protein Data
      Bank, and thus known to fold into native structures. Overall, the fragments
      identified by our program have an almost 50% probability of forming a native
      structure, and comparable results are observed with sequences containing domain
      linkers classified in SCOP. Furthermore, we verified that our program identifies
      AFU in libraries from various organisms, and we found a significant number of AFU
      candidates for structural analysis, covering an estimated 5 to 20% of the genomic
      databases. Altogether, these results argue that methods based on sequence
      similarity can be useful for dissecting large proteins into small autonomously
      folding domains, and such methods may provide an efficient support to structural
      genomics projects.

PMID- 11206053
TI  - Thermodynamic and structural characterization of Asn and Ala residues in the
      disallowed II' region of the Ramachandran plot.
AB  - Residue Asn47 at position L1 of a type II' beta-turn of the alpha-spectrin SH3
      domain is located in a disallowed region of the Ramachandran plot (phi = 56 +/-
      12, psi = -118 +/- 17). Therefore, it is expected that replacement of Asn47 by
      Gly should result in a considerable stabilization of the protein. Thermodynamic
      analysis of the N47G and N47A mutants shows that the change in free energy is
      small (approximately 0.7 kcal/mol; approximately 3 kJ/mol) and comparable to that
      found when mutating a Gly to Ala in a alpha-helix or beta-sheet. X-ray structural
      analysis of these mutants shows that the conformation of the beta-turn does not
      change upon mutation and, therefore, that there is no relaxation of the
      structure, nor is there any gain or loss of interactions that could explain the
      small energy change. Our results indicate that the energetic definition of II'
      region of the Ramachandran plot (phi = 60 +/- 30, psi = -115 +/- 15) should be
      revised for at least Ala and Asn in structure validation and protein design.

PMID- 11206054
TI  - Structural comparison of Ntn-hydrolases.
AB  - The Ntn-hydrolases (N-terminal nucleophile) are a superfamily of diverse enzymes
      that has recently been characterized. All of the proteins in this family are
      activated autocatalytically; they contain an N-terminally located catalytic
      nucleophile, and they cleave an amide bond. In the present study, the structures
      of four enzymes of this superfamily are compared in more detail. Although the
      amino acid sequence homology is almost completely absent, the enzymes share a
      similar alphabeta betaalpha-core structure. The central beta-sheets in the core
      were found to have different packing angles, ranging from 5 to 35 degrees. In the
      Ntn-hydrolases under study, eight totally conserved secondary structure units
      were found (region C). Five of them were observed to contain the greatest number
      of conserved and functionally important residues and are therefore crucial for
      the structure and function of Ntn-hydrolases. Two additional regions, consisting
      of secondary structure units (regions A and B), were found to be in structurally
      similar locations, but in different orders in the polypeptide chain. The
      catalytic machinery is located in the structures in a similar manner, and thus
      the catalytic mechanisms of all of the enzymes are probably similar. However, the
      substrate binding and the oxyanion hole differed partially.

PMID- 11206055
TI  - Beta-helix core packing within the triple-stranded oligomerization domain of the
      P22 tailspike.
AB  - A right-handed parallel beta-helix of 400 residues in 13 tightly packed coils is
      a major motif of the chains forming the trimeric P22 tailspike adhesin. The beta
      helix domains of three identical subunits are side-by-side in the trimer and make
      predominantly hydrophilic inter-subunit contacts (Steinbacher S et al., 1994,
      Science 265:383-386). After the 13th coil the three individual beta-helices
      terminate and the chains wrap around each other to form three interdigitated beta
      sheets organized into the walls of a triangular prism. The beta-strands then
      separate and form antiparallel beta-sheets, but still defining a triangular prism
      in which each side is a beta-sheet from a different subunit (Seckler R, 1998, J
      Struct Biol 122:216-222). The subunit interfaces are buried in the triangular
      core of the prism, which is densely packed with hydrophobic side chains from the
      three beta-sheets. Examination of this structure reveals that its packed core
      maintains the same pattern of interior packing found in the left-handed beta
      helix, a single-chain structure. This packing is maintained in both the
      interdigitated parallel region of the prism and the following antiparallel sheet
      section. This oligomerization motif for the tailspike beta-helices presumably
      contributes to the very high thermal and detergent stability that is a property
      of the native tailspike adhesin.

PMID- 11206056
TI  - Functional prediction: identification of protein orthologs and paralogs.
AB  - Orthologs typically retain the same function in the course of evolution. Using
      beta-decarboxylating dehydrogenase family as a model, we demonstrate that
      orthologs can be confidently identified. The strategy is based on our recent
      findings that substitutions of only a few amino acid residues in these enzymes
      are sufficient to exchange substrate and coenzyme specificities. Hence, the few
      major specificity determinants can serve as reliable markers for determining
      orthologous or paralogous relationships. The power of this approach has been
      demonstrated by correcting similarity-based functional misassignment and
      discovering new genes and related pathways, and should be broadly applicable to
      other enzyme families.

PMID- 11206057
TI  - Backbone dynamics of sequence specific recognition and binding by the yeast Pho4
      bHLH domain probed by NMR.
AB  - Backbone dynamics of the basic/helix-loop-helix domain of Pho4 from Saccharomyces
      cerevisae have been probed by NMR techniques, in the absence of DNA,
      nonspecifically bound to DNA and bound to cognate DNA. Alpha proton chemical
      shift indices and nuclear Overhauser effect patterns were used to elucidate the
      secondary structure in these states. These secondary structures are compared to
      the co-crystal complex of Pho4 bound to a cognate DNA sequence (Shimizu T.
      Toumoto A, Ihara K, Shimizu M, Kyogou Y, Ogawa N, Oshima Y, Hakoshima T, 1997,
      EMBO J 15: 4689-4697). The dynamic information provides insight into the nature
      of this DNA binding domain as it progresses from free in solution to a
      specifically bound DNA complex. Relative to the unbound form, we show that
      formation of either the nonspecific and cognate DNA bound complexes involves a
      large change in conformation and backbone dynamics of the basic region. The
      nonspecific and cognate complexes, however, have nearly identical secondary
      structure and backbone dynamics. We also present evidence for conformational
      flexibility at a highly conserved glutamate basic region residue. These results
      are discussed in relation to the mechanism of sequence specific recognition and
      binding.

PMID- 11206058
TI  - Evolution of binding affinity in a WW domain probed by phage display.
AB  - The WW domain is an approximately 38 residue peptide-binding motif that binds a
      variety of sequences, including the consensus sequence xPPxY. We have displayed
      hYAP65 WW on the surface of M13 phage and randomized one-third of its three
      stranded antiparallel beta-sheet. Improved binding to the hydrophobic peptide,
      GTPPPPYTVG (WW1), was selected in the presence of three different concentrations
      of proteinase K to simultaneously drive selection for improved stability as well
      as high-affinity binding. While some of the selected binders show cooperative
      unfolding transitions, others show noncooperative thermal unfolding curves. Two
      novel WW consensus sequences have been identified, which bind to the xPPxY motif
      with higher affinity than the wild-type hYAP65 WW domain. These WW domain
      sequences are not precedented in any natural WW domain sequence. Thus, there
      appear to be a large number of motifs capable of recognizing the target peptide
      sequence, only a subset of which appear to be used in natural proteins.

PMID- 11206059
TI  - Stability and peptide binding specificity of Btk SH2 domain: molecular basis for
      X-linked agammaglobulinemia.
AB  - X-linked agammaglobulinemia (XLA) is caused by mutations in the Bruton's tyrosine
      kinase (Btk). The absence of functional Btk leads to failure of B-cell
      development that incapacitates antibody production in XLA patients leading to
      recurrent bacterial infections. Btk SH2 domain is essential for phospholipase C
      gamma phosphorylation, and mutations in this domain were shown to cause XLA.
      Recently, the B-cell linker protein (BLNK) was found to interact with the SH2
      domain of Btk, and this association is required for the activation of
      phospholipase C-gamma. However, the molecular basis for the interaction between
      the Btk SH2 domain and BLNK and the cause of XLA remain unclear. To understand
      the role of Btk in B-cell development, we have determined the stability and
      peptide binding affinity of the Btk SH2 domain. Our results indicate that both
      the structure and stability of Btk SH2 domain closely resemble with other SH2
      domains, and it binds with phosphopeptides in the order pYEEI > pYDEP > pYMEM >
      pYLDL > pYIIP. We expressed the R288Q, R288W, L295P, R307G, R307T, Y334S, Y361C,
      L369F, and 1370M mutants of the Btk SH2 domain identified from XLA patients and
      measured their binding affinity with the phosphopeptides. Our studies revealed
      that mutation of R288 and R307 located in the phosphotyrosine binding site
      resulted in a more than 200-fold decrease in the peptide binding compared to
      L295, Y334, Y361, L369, and 1370 mutations in the pY + 3 hydrophobic binding
      pocket (approximately 3- to 17-folds). Furthermore, mutation of the Tyr residue
      at the betaD5 position reverses the binding order of Btk SH2 domain to pYIIP >
      pYLDL > pYDEP > pYMEM > pYEEI. This altered binding behavior of mutant Btk SH2
      domain likely leads to XLA.

PMID- 11206060
TI  - Delineation of the calcineurin-interacting region of cyclophilin B.
AB  - The immunosuppressant drug cyclosporin A (CsA) inhibits T-cell function by
      blocking the phosphatase activity of calcineurin. This effect is mediated by
      formation of a complex between the drug and cyclophilin (CyP), which creates a
      composite surface able to make high-affinity contacts with calcineurin. In vitro,
      the CyPB/CsA complex is more effective in inhibiting calcineurin than the
      CyPA/CsA and CyPC/CsA complexes, pointing to fine structural differences in the
      calcineurin-binding region. To delineate the calcineurin-binding region of CyPB,
      we mutated several amino acids, located in two loops corresponding to CyPA
      regions known to be involved, as follows: R76A, G77H, D155R, and D158R. Compared
      to wild-type CyPB, the G77H, D155R, and D158R mutants had intact isomerase and
      CsA-binding activities, indicating that no major conformational changes had taken
      place. When complexed to CsA, they all displayed only reduced affinity for
      calcineurin and much decreased inhibition of calcineurin phosphatase activity.
      These results strongly suggest that the three amino acids G77, D155, and D158 are
      directly involved in the interaction of CyPB/CsA with calcineurin, in agreement
      with their exposed position. The G77, D155, and D158 residues are not maintained
      in CyPA and might therefore account for the higher affinity of the CyPB/CsA
      complex for calcineurin.

PMID- 11206061
TI  - The effects of disulfide bonds on the denatured state of barnase.
AB  - The effects of engineered disulfide bonds on protein stability are poorly
      understood because they can influence the structure, dynamics, and energetics of
      both the native and denatured states. To explore the effects of two engineered
      disulfide bonds on the stability of barnase, we have conducted a combined
      molecular dynamics and NMR study of the denatured state of the two mutants. As
      expected, the disulfide bonds constrain the denatured state. However, specific
      extended beta-sheet structure can also be detected in one of the mutant proteins.
      This mutant is also more stable than would be predicted. Our study suggests a
      possible cause of the very high stability conferred by this disulfide bond: the
      wild-type denatured ensemble is stabilized by a nonnative hydrophobic cluster,
      which is constrained from occurring in the mutant due to the formation of
      secondary structure.

PMID- 11206062
TI  - Chaperonin-assisted folding of glutamine synthetase under nonpermissive
      conditions: off-pathway aggregation propensity does not determine the co
      chaperonin requirement.
AB  - One of the proposed roles of the GroEL-GroES cavity is to provide an "infinite
      dilution" folding chamber where protein substrate can fold avoiding deleterious
      off-pathway aggregation. Support for this hypothesis has been strengthened by a
      number of studies that demonstrated a mandatory GroES requirement under
      nonpermissive solution conditions, i.e., the conditions where proteins cannot
      spontaneously fold. We have found that the refolding of glutamine synthetase (GS)
      does not follow this pattern. In the presence of natural osmolytes trimethylamine
      N-oxide (TMAO) or potassium glutamate, refolding GS monomers readily aggregate
      into very large inactive complexes and fail to reactivate even at low protein
      concentration. Surprisingly, under these "nonpermissive" folding conditions, GS
      can reactivate with GroEL and ATP alone and does not require the encapsulation by
      GroES. In contrast, the chaperonin dependent reactivation of GS under another
      nonpermissive condition of low Mg2+ (<2 mM MgCl2) shows an absolute requirement
      of GroES. High-performance liquid chromatography gel filtration analysis and
      irreversible misfolding kinetics show that a major species of the GS folding
      intermediates, generated under these "low Mg2+" conditions exist as long-lived
      metastable monomers that can be reactivated after a significantly delayed
      addition of the GroEL. Our results indicate that the GroES requirement for
      refolding of GS is not simply dictated by the aggregation propensity of this
      protein substrate. Our data also suggest that the GroEL-GroES encapsulated
      environment is not required under all nonpermissive folding conditions.

PMID- 11206063
TI  - Thermal stability of Clostridium pasteurianum rubredoxin: deconvoluting the
      contributions of the metal site and the protein.
AB  - To provide a framework for understanding the hyperthermostability of some
      rubredoxins, a comprehensive analysis of the thermally induced denaturation of
      rubredoxin (Rd) from the mesophile, Clostridium pasteurianum was undertaken. Rds
      with three different metals in its M(SCys)4 site (M = Fe3+/2+, Zn2+, or Cd2+)
      were examined. Kinetics of metal ion release were monitored anaerobically at
      several fixed temperatures between 40 and 100 degrees C, and during progressive
      heating of the iron-containing protein. Both methods gave a thermal stability of
      metal binding in the order Fe2+ << Fe3+ < Zn2+ < Cd2+. The temperature at which
      half of the iron was released from the protein in temperature ramp experiments
      was 69 degrees C for Fe2+ Rd and 83 degrees C for Fe3+ Rd. Temperature-dependent
      changes in the protein structure were monitored by differential scanning
      calorimetry, tryptophan fluorescence, binding of a fluorescent hydrophobic probe,
      and 1H NMR. Major but reversible structural changes, consisting of swelling of
      the hydrophobic core and opening of a loop region, were found to occur at
      temperatures (50-70 degrees C) much lower than those required for loss of the
      metal ion. For the three divalent metal ions, the results suggest that the onset
      of the reversible, lower-temperature structural changes is dependent on the size
      of the MS4 site, whereas the final, irreversible loss of metal ion is dependent
      on the inherent M-SCys bond strength. In the case of Fe3+ Rd, stoichiometric
      Fe3+/cysteine-ligand redox chemistry also occurs during metal ion loss. The
      results indicate that thermally induced unfolding of the native Cp Rd must
      surmount a significant kinetic barrier caused by stabilizing interactions both
      within the protein and within the M(SCys)4 site.

PMID- 11206065
TI  - Presence of closely spaced protein thiols on the surface of mammalian cells.
AB  - It has been proposed that certain cell-surface proteins undergo redox reactions,
      that is, transfer of hydrogens and electrons between closely spaced cysteine
      thiols that can lead to reduction, formation, or interchange of disulfide bonds.
      This concept was tested using a membrane-impermeable trivalent arsenical to
      identify closely spaced thiols in cell-surface proteins. We attached the
      trivalent arsenical, phenylarsenoxide, to the thiol of reduced glutathione to
      produce 4-(N-(S-glutathionylacetyl)amino)phenylarsenoxide (GSAO). GSAO bound
      tightly to synthetic, peptide, and protein dithiols like thioredoxin, but not to
      monothiols. To identify cell-surface proteins that contain closely spaced thiols,
      we attached a biotin moiety through a spacer arm to the primary amino group of
      the gamma-glutamyl residue of GSAO (GSAO-B). Incorporation of GSAO-B into
      proteins was assessed by measuring the biotin using streptavidin-peroxidase. Up
      to 12 distinct proteins were labeled with GSAO-B on the surface of endothelial
      and fibrosarcoma cells. The pattern of labeled proteins differed between the
      different cell types. Protein disulfide isomerase was one of the proteins on the
      endothelial and fibrosarcoma cell surface that incorporated GSAO-B. These
      findings demonstrate that the cell-surface environment can support the existence
      of closely spaced protein thiols and suggest that at least some of these thiols
      are redox active.

PMID- 11206064
TI  - Fibers of tau fragments, but not full length tau, exhibit a cross beta-structure:
      implications for the formation of paired helical filaments.
AB  - We have used X-ray fiber diffraction to probe the structure of fibers of tau and
      tau fragments. Fibers of fragments from the microtubule binding domain had a
      cross beta-structure that closely resembles that reported both for
      neurofibrillary tangles found in Alzheimer's disease brain and for fibrous
      lesions from other protein folding diseases. In contrast, fibers of full-length
      tau had a different, more complex structure. Despite major differences at the
      molecular level, all fiber types exhibited very similar morphology by electron
      microscopy. These results have a number of implications for understanding the
      etiology of Alzheimer's and other tauopathic diseases. The morphology of the
      peptide fibers suggests that the region in tau corresponding to the peptides
      plays a critical role in the nucleation of fiber assembly. The dramatically
      different structure of the full length tau fibers suggests that some region in
      tau has enough inherent structure to interfere with the formation of cross beta
      fibers. Additionally, the similar appearance by electron microscopy of fibrils
      with varying molecular structure suggests that different molecular arrangements
      may exist in other samples of fibers formed from tau.

PMID- 11206066
TI  - Resonant mirror biosensor analysis of type Ialpha cAMP-dependent protein kinase B
      domain--cyclic nucleotide interactions.
AB  - A resonant mirror biosensor was used to study cyclic nucleotide-receptor
      interactions. In particular, a novel method was developed to determine inhibition
      constants (Ki) from initial rates of ligate association to immobilized ligand.
      This approach was applied to the comparison of cyclic nucleotide-binding
      properties of the wild-type isolated B domain of the cAMP-dependent protein
      kinase type Ialpha regulatory subunit and its Ala-334-Thr (A334T) variant that
      has altered cyclic nucleotide specificity. A cUMP-saturated form of the B domain
      was used for all measurements. Under the conditions used, cUMP did not affect the
      kinetics of B domain association to immobilized cAMP. Triton X-100 was required
      to stabilize the protein at nanomolar concentrations. The association and
      dissociation rate constants for wild-type and A334T B domains yielded equilibrium
      dissociation constants of 11 and 16 nM. Heterogeneity of ligate and immobilized
      ligand, mass transport effects, and other factors were evaluated for their
      influence on biosensor-determined kinetic constants. Biosensor-determined
      relative inhibition constants (Ki' = Ki(cAMP)/Ki(analog)) for 16 cyclic
      nucleotide analogs correlated well with those determined by a [3H]cAMP binding
      assay. Previously published Ki' values for the B domain in the intact regulatory
      subunit were similar to those of the isolated B domain. The Ki' values for the
      wild-type and A334T B domains were essentially unchanged except for dramatic
      enhancements in affinity of cGMP analogs for the A334T B domain. These
      observations validate the isolated B domain as a simple model system for studying
      cyclic nucleotide-receptor interactions.

PMID- 11206068
TI  - Thirty-plus functional families from a single motif.
AB  - It is now possible to identify over 30 functional subfamilies among the WD-repeat
      containing proteins found in the completed genomes. The majority of these
      subfamilies have at least one member for which experimental data allow assignment
      to a cellular pathway or process. Half of the 63 WD-repeat-containing proteins in
      Saccharomyces cerevisiae, half of the 70 in Caenorhabditis elegans, and a third
      of the 100 plus predicted in Drosophila can be assigned to 23 of these functional
      subfamilies. Perhaps indicative of the future, 33 WD-repeat-containing proteins
      from the partial genome of Arabidopsis thaliana can now be assigned to 18 of
      these subfamilies. These assignments have been made possible by combining
      traditional sequence similarity with an implied common beta propeller structural
      context to obtain measures of protein-protein surface similarity. The beta
      propeller structural context is represented in the form of a Hidden Markov Model.
      The procedure is completely automated.

PMID- 11206067
TI  - The design of a hyperstable mutant of the Abp1p SH3 domain by sequence alignment
      analysis.
AB  - We have characterized the thermodynamic stability of the SH3 domain from the
      Saccharomyces cerevisiae Abp1p protein and found it to be relatively low compared
      to most other SH3 domains, with a Tm of 60 degrees C and a deltaGu of 3.08
      kcal/mol. Analysis of a large alignment of SH3 domains led to the identification
      of atypical residues at eight positions in the wild-type Abp1p SH3 domain
      sequence that were subsequently replaced by the residue seen most frequently at
      that position in the alignment. Three of the eight mutants constructed in this
      way displayed increases in Tm ranging from 8 to 15 degrees C with concomitant
      increases in deltaGu of up to 1.4 kcal/mol. The effects of these substitutions on
      folding thermodynamics and kinetics were entirely additive, and a mutant
      containing all three was dramatically stabilized with a Tm greater than 90
      degrees C and a deltaGu more than double that of the wild-type domain. The
      folding rate of this hyperstable mutant was 10-fold faster than wild-type, while
      its unfolding rate was fivefold slower. All of the stabilized mutants were still
      able to bind a target peptide with wild-type affinity. We have analyzed the
      stabilizing amino acid substitutions isolated in this study and several other
      similar sequence alignment based studies. In approximately 25% of cases,
      increased stability can be explained by enhanced propensity of the substituted
      residue for the local backbone conformation at the mutagenized site.

PMID- 11206069
TI  - Enhancement by Mg2+ of domain specificity in Ca2+-dependent interactions of
      calmodulin with target sequences.
AB  - Mg2+ binds to calmodulin without inducing the changes in secondary structure that
      are characteristic of Ca2+ binding, or the exposure of hydrophobic surfaces that
      are involved in typical Ca2+-dependent target interactions. The binding of Mg2+
      does, however, produce significant spectroscopic changes in residues located in
      the Ca2+-binding loops, and the Mg-calmodulin complex is significantly different
      from apo-calmodulin in loop conformation. Direct measurement of Mg2+ binding
      constants, and the effects of Mg2+ on Ca2+ binding to calmodulin, are consistent
      with specific binding of Mg2+, in competition with Ca2+. Mg2+ increases the
      thermodynamic stability of calmodulin, and we conclude that under resting,
      nonstimulated conditions, cellular Mg2+ has a direct role in conferring stability
      on both domains of apo-calmodulin. Apo-calmodulin binds typical target sequences
      from skeletal muscle myosin light chain kinase and neuromodulin with Kd
      approximately 70-90 nM (at low ionic strength). These affinities are virtually
      unchanged by 5 mM Mg2+, in marked contrast to the strong enhancement of peptide
      affinity induced by Ca2+. Under conditions of stimulation and increased [Ca2+],
      Mg2+ has a role in directing the mode of initial target binding preferentially to
      the C-domain of calmodulin, due to the opposite relative affinities for binding
      of Ca2+ and Mg2+ to the two domains. Mg2+ thus amplifies the intrinsic
      differences of the domains, in a target specific manner. It also contributes to
      setting the Ca2+ threshold for enzyme activation and increases the importance of
      a partially Ca2+-saturated calmodulin-target complex that can act as a regulatory
      kinetic and equilibrium intermediate in Ca2+-dependent target interactions.

PMID- 11206071
TI  - Characterization of the interface structure of enzyme-inhibitor complex by using
      hydrogen-deuterium exchange and electrospray ionization Fourier transform ion
      cyclotron resonance mass spectrometry.
AB  - We investigated the interaction between a thiol protease inhibitor, cystatin, and
      its target enzyme, papain, by hydrogen-deuterium (H/D) exchange in conjunction
      with successive analysis by collision-induced dissociation (CID) in an rf-only
      hexapole ion guide with electrospray ionization-Fourier transform ion cyclotron
      resonance mass spectrometry (ESI-FTICR MS). The deuterium incorporation into
      backbone amide hydrogens of cystatin was analyzed at different time points in the
      presence or absence of papain, examining the mass of each fragment produced by
      hexapole-CID. In the absence of papain, amide hydrogens in short amino-terminal
      fragments, such as b10(2+) and b12(2+), were highly deuterated within 1 min.
      Although fewer fragments were observed for the cystatin-papain complex in the
      hexapole-CID spectra, significant reductions in initial deuterium content were
      recognized throughout the sequence of cystatin. This suggests that complex
      formation restricted the flexibility of the whole cystatin molecule. Detailed
      analyses revealed that a marked reduction in deuterium content in the region of
      residues 1-10 persisted for hours, suggesting that the flexible N-terminal region
      was tightly fixed in the binding pocket with hydrogen bonds. Our results are
      consistent with those of previous studies on the structure and inhibition
      mechanism of cystatin. We demonstrated here that enzyme-inhibitor interactions
      can be characterized by H/D exchange in combination with CID in a hexapole ion
      guide using ESI-FTICR MS rapidly and using only a small amount of sample.

PMID- 11206070
TI  - Structural changes in alpha-synuclein affect its chaperone-like activity in
      vitro.
AB  - Alpha-synuclein, a major constituent of Lewy bodies (LBs) in Parkinson's disease
      (PD), has been implicated to play a critical role in synaptic events, such as
      neuronal plasticity during development, learning, and degeneration under
      pathological conditions, although the physiological function of alpha-synuclein
      has not yet been established. We here present biochemical evidence that
      recombinant alpha-synuclein has a chaperone-like function against thermal and
      chemical stress in vitro. In our experiments, alpha-synuclein protected
      glutathione S-transferase (GST) and aldolase from heat-induced precipitation, and
      alpha-lactalbumin and bovine serum albumin from dithiothreitol (DTT)-induced
      precipitation like other molecular chaperones. Moreover, preheating of alpha
      synuclein, which is believed to reorganize the molecular surface of alpha
      synuclein, increased the chaperone-like activity. Interestingly, in organic
      solvents, which promotes the formation of secondary structure, alpha-synuclein
      aggregated more easily than in its native condition, which eventually might
      abrogate the chaperone-like function of the protein. In addition, alpha-synuclein
      was also rapidly and significantly precipitated by heat in the presence of Zn2+
      in vitro, whereas it was not affected by the presence of Ca2+ or Mg2+. Circular
      dichroism spectra confirmed that alpha-synuclein underwent conformational change
      in the presence of Zn2+. Taken together, our data suggest that alpha-synuclein
      could act as a molecular chaperone, and that the conformational change of the
      alpha-synuclein could explain the aggregation kinetics of alpha-synuclein, which
      may be related to the abolishment of the chaperonic-like activity.

PMID- 11206072
TI  - Methylene as a possible universal footprinting reagent that will include
      hydrophobic surface areas: overview and feasibility: properties of diazirine as a
      precursor.
AB  - Methylene is one of, if not the, most reactive organic chemical known. It has a
      very low specificity, which makes it essentially useless for synthesis, but
      suggests a possible role in protein footprinting with special importance in
      labeling solvent accessible nonpolar areas, identifying ligand binding sites, and
      outlining interaction areas on protomers that form homo or hetero oligomers in
      cellular assemblies. The singlet species is easily and conveniently formed by
      photolysis of diazirine. The reactions of interest are insertion into C-H bonds
      and addition to multiple bonds, both forming strong covalent bonds and stable
      compounds. Reaction with proteins and peptides is reported even in aqueous
      solutions where the vast majority of the reagent is used up in forming methanol.
      Species containing up to 5 to 10 extra :CH2 groups are easily detected by
      electrospray mass spectroscopy. In a mixture of a 14 Kd protein and a
      noninteracting 1.7 Kd peptide, the distribution of mass peaks in the electrospray
      spectra was close to that expected from random modification of the estimated
      solvent accessible area for the two molecules. For analysis at the single residue
      level, quantitation at labeling levels of one 13CH2 group per 10 to 20 kDa of
      protein appears to be possible with isotope ratio mass spectroscopy. In the
      absence of reactive solvents, photolysis of diazirine produces oily polymeric
      species that contain one or two nitrogen atoms, but not more, and are water
      soluble.

PMID- 11206073
TI  - An improved tripod amphiphile for membrane protein solubilization.
AB  - Intrinsic membrane proteins represent a large fraction of the proteins produced
      by living organisms and perform many crucial functions. Structural and functional
      characterization of membrane proteins generally requires that they be extracted
      from the native lipid bilayer and solubilized with a small synthetic amphiphile,
      for example, a detergent. We describe the development of a small molecule with a
      distinctive amphiphilic architecture, a "tripod amphiphile," that solubilizes
      both bacteriorhodopsin (BR) and bovine rhodopsin (Rho). The polar portion of this
      amphiphile contains an amide and an amine-oxide; small variations in this polar
      segment are found to have profound effects on protein solubilization properties.
      The optimal tripod amphiphile extracts both BR and Rho from the native membrane
      environments and maintains each protein in a monomeric native-like form for
      several weeks after delipidation. Tripod amphiphiles are designed to display
      greater conformational rigidity than conventional detergents, with the long-range
      goal of promoting membrane protein crystallization. The results reported here
      represent an important step toward that ultimate goal.

PMID- 11206074
TI  - Rationale for Bcl-xL/Bad peptide complex formation from structure, mutagenesis,
      and biophysical studies.
AB  - The three-dimensional structure of the anti-apoptotic protein Bcl-xL complexed to
      a 25-residue peptide from the death promoting region of Bad was determined using
      NMR spectroscopy. Although the overall structure is similar to Bcl-xL bound to a
      16-residue peptide from the Bak protein (Sattler et al., 1997), the Bad peptide
      forms additional interactions with Bcl-xL. However, based upon site-directed
      mutagenesis experiments, these additional contacts do not account for the
      increased affinity of the Bad 25-mer for Bcl-xL compared to the Bad 16-mer.
      Rather, the increased helix propensity of the Bad 25-mer is primarily responsible
      for its greater affinity for Bcl-xL. Based on this observation, a pair of 16
      residue peptides were designed and synthesized that were predicted to have a high
      helix propensity while maintaining the interactions important for complexation
      with Bcl-xL. Both peptides showed an increase in helix propensity compared to the
      wild-type and exhibited an enhanced affinity for Bcl-xL.

PMID- 11206076
TI  - N-terminal mutations in the anti-estradiol Fab 57-2 modify its hapten binding
      properties.
AB  - Recombinant antibodies often contain N-terminal mutations arising from the use of
      degenerate cloning primer sets and/or the introduction of restriction sites in
      the framework 1 regions. We studied the effects of such mutations in a
      recombinant anti-estradiol Fab fragment derived from the hybridoma cell line 57
      2. The 5' ends of the heavy and light chain genes were originally modified to
      introduce the restriction sites XhoI and SacI, respectively, for cloning
      purposes. However, the affinity and specificity of the recombinant Fab were
      lowered compared to the proteolytic Fab' fragment of the parental hybridoma IgG.
      Replacing the mutated sites with authentic amino acid coding sequences restored
      the binding properties as well as increased the bacterial production levels
      fivefold and 10-fold at 30 and 37 degrees C, respectively. Local changes in the
      antigen binding site were probed by determining the affinity constants (Kd) for
      estradiol and four related steroids. It was found that the mutated heavy chain
      amino terminus specifically increased the Kd for testosterone whereas the mutated
      light chain amino terminus decreased the Kd for all of the steroids to the same
      extent; the heavy and light chain effects were additive. Analysis of a newly
      determined crystal structure of the authentic Fab 57-2 in complex with estradiol
      suggests that mutations in the residue 2 in V(H), and 2 and 4 in the V(L) domain
      were those responsible for the observed effects. Their general roles as structure
      determining residues for the CDR3 loops imply that similar effects can occur with
      other recombinant antibodies as well.

PMID- 11206075
TI  - Ab initio molecular dynamics studies on HIV-1 reverse transcriptase triphosphate
      binding site: implications for nucleoside-analog drug resistance.
AB  - Quantum-chemical methods are used to shed light on the functional role of
      residues involved in the resistance of HIV-1 reverse transcriptase against
      nucleoside-analog drugs. Ab initio molecular dynamics simulations are carried out
      for models representing the adduct between the triphosphate substrate and the
      nucleoside binding site. The triphosphate is considered either deprotonated or
      protonated at the gamma-position. Although the protonated form already
      experiences large rearrangements in the ps time scale, the fully deprotonated
      state exhibits a previously unrecognized low-barrier hydrogen bond between Lys65
      and gamma-phosphate. Absence of this interaction in Lys65-->Arg HIV-1 RT might
      play a prominent role in the resistance of this mutant for nucleoside analogs (Gu
      Z et al., 1994b, Antimicrob Agents Chemother 38:275-281; Zhang D et al., 1994,
      Antimicrob Agents Chemother 38:282-287). Water molecules present in the active
      site, not detected in the X-ray structure, form a complex H-bond network. Among
      these waters, one may be crucial for substrate recognition as it bridges Gln151
      and Arg72 with the beta-phosphate. Absence of this stabilizing interaction in
      Gln151-->Met HIV-1 RT mutant may be a key factor for the known drug resistance of
      this mutant toward dideoxy-type drugs and AZT (Shirasaka T et al., 1995, Proc
      Natl Acad Sci USA 92:2398-2402: Iversen AK et al., 1996, J Virol 70:1086-1090).

PMID- 11206077
TI  - The structure of the yrdC gene product from Escherichia coli reveals a new fold
      and suggests a role in RNA binding.
AB  - The yrdC family of genes codes for proteins that occur both independently and as
      a domain in proteins that have been implicated in regulation. An example for the
      latter case is the sua5 gene from yeast. SuaS was identified as a suppressor of a
      translation initiation defect in cytochrome c and is required for normal growth
      in yeast (Na JG, Pinto I, Hampsey M, 1992, Genetics 11:791-801). However, the
      function of the Sua5 protein remains unknown; Sua5 could act either at the
      transcriptional or the posttranscriptional levels to compensate for an aberrant
      translation start codon in the cyc gene. To potentially learn more about the
      function of YrdC and proteins featuring this domain, the crystal structure of the
      YrdC protein from Escherichia coli was determined at a resolution of 2.0 A. YrdC
      adopts a new fold with no obvious similarity to those of other proteins with
      known three-dimensional (3D) structure. The protein features a large concave
      surface on one side that exhibits a positive electrostatic potential. The
      dimensions of this depression, its curvature, and the fact that conserved basic
      amino acids are located at its floor suggest that YrdC may be a nucleic acid
      binding protein. An investigation of YrdC's binding affinities for single- and
      double-stranded RNA and DNA fragments as well as tRNAs demonstrates that YrdC
      binds preferentially to double-stranded RNA. Our work provides evidence that 3D
      structures of functionally uncharacterized gene products with unique sequences
      can yield novel folds and functional insights.

PMID- 11206078
TI  - A single amino acid substitution affects substrate specificity in cysteine
      proteinases from Fasciola hepatica.
AB  - The trematode Fasciola hepatica secretes a number of cathepsin L-like proteases
      that are proposed to be involved in feeding, migration, and immune evasion by the
      parasite. To date, six full cDNA sequences encoding cathepsin L preproproteins
      have been identified. Previous studies have demonstrated that one of these
      cathepsins (L2) is unusual in that it is able to cleave substrates with a proline
      in the P2 position, translating into an unusual ability (for a cysteine
      proteinase) to clot fibrinogen. In this study, we report the sequence of a novel
      cathepsin (L5) and compare the substrate specificity of a recombinant enzyme with
      that of recombinant cathepsin L2. Despite sharing 80% sequence identity with
      cathepsin L2, cathepsin L5 does not exhibit substantial catalytic activity
      against substrates containing proline in the P2 position. Molecular modeling
      studies suggested that a single amino acid change (L69Y) in the mature
      proteinases may account for the difference in specificity at the S2 subsite.
      Recombinant cathepsin L5/L69Y was expressed in yeast and a substantial increase
      in the ability of this variant to accommodate substrates with a proline residue
      in the P2 position was observed. Thus, we have identified a single amino acid
      substitution that can substantially influence the architecture of the S2 subsite
      of F. hepatica cathepsin L proteases.

PMID- 11206079
TI  - Fluorescence and 19F NMR evidence that phenylalanine, 3-L-fluorophenylalanine and
      4-L-fluorophenylalanine bind to the L-leucine specific receptor of Escherichia
      coli.
AB  - The binding capacity of the L-leucine receptor from Escherichia coli was measured
      with L-phenylalanine and 4-fluoro-L-phenylalanine as substrates by fluorescence.
      The apparent dissociation constants (KD) for L-leucine, L-phenylalanine, and 4
      fluoro-L-phenylalanine are 0.40, 0.18, and 0.26 respectively. 19F NMR data show
      protein-induced shifts for the 4-fluoro-L-phenylalanine peak and 3-fluoro-L
      phenylalanine when receptor is present. Evidence points to the binding of only
      the L-isomers of these fluorine analogs.

PMID- 11206080
TI  - Effect of deamidation on folding of ribonuclease A.
AB  - The folding of ribonuclease A (RNase A) has been extensively studied by
      characterizing the disulfide containing intermediates using different
      experimental conditions and analytical techniques. So far, some aspects still
      remain unclear such as the role of the loop 65-72 in the folding pathway. We have
      studied the oxidative folding of a RNase A derivative containing at position 67
      the substitution Asn --> isoAsp where the local structure of the loop 65-72 has
      been modified keeping intact the C65-C72 disulfide bond. By comparing the folding
      behavior of this mutant to that of the wild-type protein, we found that the
      deamidation significantly decreases the folding rate and alters the folding
      pathway of RNase A. Results presented here shed light on the role of the 65-72
      region in the folding process of RNase A and also clarifies the effect of the
      deamidation on the folding/unfolding processes. On a more general ground, this
      study represents the first characterization of the intermediates produced along
      the folding of a deamidated protein.

PMID- 11206081
TI  - A newly uncovered phenotype associated with the fruitless gene of Drosophila
      melanogaster: aggression-like head interactions between mutant males.
AB  - Male sexual behavior is regulated by the sex-determination hierarchy (SDH) in
      Drosophila melanogaster. The fruitless (fru) gene, one of the regulatory factors
      functioning downstream of other SDH factors, plays a prominent role in male
      sexual behavior. Here we demonstrate that fru mutations cause a previously
      unappreciated behavioral anomaly: high levels of head-to-head interactions
      between mutant males. These apparent confrontations between males are exhibited
      by all of the homozygous-viable fru mutants (expressing the effects of a given
      allele, among the four tested). Mutant dissatisfaction (dsf) males also exhibit
      this behavior at higher-than-normal levels, but it was barely displayed by
      doublesex or intersex mutants. For fru, a social component is involved in the
      head-interaction phenotype, while increasing age is a modifying factor for the
      behavior of dsf males. We suggest that head-to-head interactions, especially
      those performed by fru males, are instances of putative aggression analogous to
      those exhibited by wild-type males and that head interactions are, to an extent,
      operationally separable from courtship behavior.

PMID- 11206082
TI  - Two mouse lines selected for differential sensitivities to beta-carboline-induced
      seizures are also differentially sensitive to various pharmacological effects of
      other GABA(A) receptor ligands.
AB  - Two mouse lines were selectively bred according to their sensitivity (BS line) or
      resistance (BR line) to seizures induced by a single i.p. injection of methyl
      beta-carboline-3-carboxylate (beta-CCM), an inverse agonist of the GABA(A)
      receptor benzodiazepine site. Our aim was to characterize both lines'
      sensitivities to various physiological effects of other ligands of the GABA(A)
      receptor. We measured diazepam-induced anxiolysis with the elevated plus-maze
      test, diazepam-induced sedation by recording the vigilance states, and picrotoxin
      and pentylenetetrazol-induced seizures after i.p. injections. Results presented
      here show that the differential sensitivities of BS and BR lines to beta-CCM can
      be extended to diazepam, picrotoxin, and pentylenetetrazol, suggesting a genetic
      selection of a general sensitivity and resistance to several ligands of the
      GABA(A) receptor.

PMID- 11206083
TI  - Habituation of activity in an open field: A survey of inbred strains and F1
      hybrids.
AB  - To determine if there is genetic variability in habituation of activity in an
      open field, we examined a number of inbred strains and F1 hybrids. Using 5-min
      exposures to a dark open field, we measured changes in exploratory behavior over
      3 consecutive days in 129S3/SvImJ, A/J, BALB/ cByJ, C3H/HeJ, C57BL/6J, CBA/J,
      DBA/2J, FVB/NJ, (B6 x 129)F1/J, and (B6 x C3H) F1/J male and female mice. Strain
      differences in open-field activity and in habituation were evident. Some of the
      strain differences were further modified by sex. The strains and F1's could be
      separated into groups that increased, decreased, or did not modify their
      activities across testing sessions. In a second study, the effects of altering
      the floor surface on habituation were examined in male 129S3/SvImJ, C57BL/6J,
      DBA/2J, and (B6 x 129)F1/J mice. When the floor was altered after 3 consecutive
      days of habituation, increased activity levels were evident. There were strain
      differences in the responsiveness to the changes in the floor. These results
      confirm a genetic role in intersession habituation to an open field.

PMID- 11206084
TI  - Natal dispersal in rhesus macaques is related to serotonin transporter gene
      promoter variation.
AB  - A VNTR polymorphism previously characterized in the promoter region of the human
      serotonin transporter (SLC6A4) gene was also found to segregate two major alleles
      (l and s) among the free-ranging rhesus macaques of Cayo Santiago, Puerto Rico.
      When VNTR genotypes were related to age at male natal dispersal on Cayo Santiago,
      ss homozygotes (43 of 532 males tested) were found to have left their natal
      groups significantly earlier (age 57.1 +/- 2.6 months) than carriers of the l
      allele (ll age, 71.5 +/- 2.1 months; ls age, 63.5 +/- 1.5 months; P = 0.0001).
      Since migration implies reproductive costs and benefits that change with age at
      dispersal, migration at an intermediate age might have conferred a heterozygote
      advantage serving to maintain the VNTR polymorphism via overdominant selection.

PMID- 11206085
TI  - Self-Reported zygosity and the equal-environments assumption for psychiatric
      disorders in the Vietnam Era Twin Registry.
AB  - The equal-environments assumption (EEA) in twin studies of psychiatric disorders
      assumes that the family environment which contributes to risk for a disorder is
      equally correlated between monozygotic (MZ) and dizygotic (DZ) twin pairs. In a
      study of psychiatric disorders in female twins, Kendler and colleagues (1993)
      have demonstrated the utility of a test of the EEA which includes a specified
      family environmental factor defined by using measures of perceived zygosity. We
      tested the EEA assumption among 3155 male-male twin pair members of the Vietnam
      Era Twin Registry for the following DSM-III-R lifetime disorders: alcohol
      dependence, marijuana dependence, any illicit drug dependence, nicotine
      dependence, major depression, and posttraumatic stress disorder. The majority of
      MZ (81.6%; n = 1593) and DZ (90.2%; n = 1086) twin pairs agreed with the
      investigator's assigned zygosity. The best-fitting model for each of these
      disorders did not allow for a specified family environmental influence. These
      results support the usefulness of perceived zygosity in tests of the EEA. In male
      twin pairs, perceived zygosity has little impact on twin similarity for common
      psychiatric disorders.

PMID- 11206086
TI  - Multivariate genetic analysis of brain structure in an extended twin design.
AB  - The hunt for genes influencing behavior may be aided by the study of intermediate
      phenotypes for several reasons. First, intermediate phenotypes may be influenced
      by only a few genes, which facilitates their detection. Second, many intermediate
      phenotypes can be measured on a continuous quantitative scale and thus can be
      assessed in affected and unaffected individuals. Continuous measures increase the
      statistical power to detect genetic effects (Neale et al., 1994), and allow
      studies to be designed to collect data from informative subjects such as extreme
      concordant or discordant pairs. Intermediate phenotypes for discrete traits, such
      as psychiatric disorders, can be neurotransmitter levels, brain function, or
      structure. In this paper we conduct a multivariate analysis of data from 111 twin
      pairs and 34 additional siblings on cerebellar volume, intracranial space, and
      body height. The analysis is carried out on the raw data and specifies a model
      for the mean and the covariance structure. Results suggest that cerebellar volume
      and intracranial space vary with age and sex. Brain volumes tend to decrease
      slightly with age, and males generally have a larger brain volume than females.
      The remaining phenotypic variance of cerebellar volume is largely genetic (88%).
      These genetic factors partly overlap with the genetic factors that explain
      variance in intracranial space and body height. The applied method is presented
      as a general approach for the analysis of intermediate phenotypes in which the
      effects of correlated variables on the observed scores are modeled through
      multivariate analysis.

PMID- 11206087
TI  - Genetic and environmental causes of covariation in interview assessments of
      disruptive behavior in child and adolescent twins.
AB  - Multirater, face-to-face, interview data relating to conduct disorder (CD),
      oppositional-defiant disorder (ODD), and inattentive, impulsive, and hyperactive
      components of attention-deficit hyperactivity disorder (ADHD) in a population
      based sample of 1376 pairs of 8- to 16-year-old MZ and DZ twins are analyzed to
      examine (1) the genetic and environmental causes of correlation among ratings of
      ODD and CD symptoms and (2) the pattern of genetic and environmental correlation
      among the three components of ADHD. Parental ratings of ADHD showed marked
      sibling contrast effects, specific within raters but partly common across
      components. After these effects were removed, there was a modest genetic
      correlation between maternal and paternal ratings, but genetic effects were
      virtually uncorrelated across boys and girls. Genetic correlations among
      inattention, impulsivity, and hyperactivity were all large but fell well short of
      unity. There was little evidence that counts of symptoms of CD and ODD were
      genetically independent but the genetic correlations among ratings of twins,
      mothers, and fathers were all relatively modest. ODD and CD showed much higher
      genetic correlations across sexes than did the measures of ADHD. There was no
      evidence of rater contrast effects or of shared family environment influences in
      the twin resemblance for ODD and CD.

PMID- 11206088
TI  - The use of mixture models to perform quantitative tests for linkage
      disequilibrium, maternal effects, and parent-of-origin effects with incomplete
      subject-parent triads.
AB  - The transmission disequilibrium test and related methods require complete triads
      of genotyped cases plus both parents to test for linkage disequilibrium in the
      presence of population stratification. Based on the work of Weinberg (1999ab) and
      Schaid and Li (1997) with dichotomous outcomes, we discuss how additional tests
      for maternal or parent-of-origin effects can be performed and incomplete subject
      parent triads can be used in situations where the outcome is a quantitative
      variable. This is achieved using a finite mixture model where class membership is
      known for complete triads and unknown for incomplete triads. Simulations were
      performed assuming different genetic models and various amounts of missing
      parental genotypes. Results showed that the tests resulted in accurate Type I
      errors, recovered much of the loss in information caused by missing genotypes,
      and yielded unbiased parameter estimates. Extensions of the model to nuclear
      families, multiple loci, and multiple outcome variables are briefly discussed.

PMID- 11206089
TI  - Measurement models for sexual orientation in a community twin sample.
AB  - Multivariate structural equation modeling techniques have been applied to examine
      the causes of individual differences in responses to several items concerning
      sexual orientation. To minimize potential ascertainment and response biases, the
      study sample involved a large (N = 4901) community-based cohort of Australian
      twins aged 18-52 who answered an anonymous questionnaire on sexual behavior and
      attitudes. The statistical power of the analysis was increased by the
      availability of multiple measures of sexual orientation (behaviors, attitudes and
      feelings), providing stronger evidence for the existence of additive genetic
      influences on this phenotype than in a previous analysis (Bailey et al., 2000).
      Estimates of the heritability of homosexuality in this sample ranged between 50
      and 60% in females but were significantly lower (heritability of approximately
      30%) in males.

PMID- 11206090
TI  - Quality assurance, quality control and accreditation.

PMID- 11206091
TI  - [Contributions to animal husbandry in southern Germany and Austria in the late
      Middle Ages].

PMID- 11206092
TI  - [Meat inspection in the second half of the 19th century, reflected in the
      progress of applied science].

PMID- 11206093
TI  - [Collected sources for the biography of Swiss veterinarians in the 19th and 20th
      centuries (until 1985)].

PMID- 11206094
TI  - [Veterinary occupations in the 16th through the 18th centuries].

PMID- 11206095
TI  - [Nonsurgical therapy methods in hepatocellular carcinoma].
AB  - The incidence of the hepatocellular carcinoma (HCC) is increasing in western
      countries mainly due to chronic hepatitis C. Therapy is dependent on the size and
      localization of the tumors as well as age and condition of the patient. If
      resection or transplantation are not possible, smaller tumors can be treated with
      local therapy either by percutaneous ethanol instillation, radiofrequency
      ablation or laser thermocoagulation. Larger tumors can be treated by
      transarterial chemoembolization which can also be combined with the methods named
      above. The results of systemic chemotherapy and medical treatment are
      disappointing. With early diagnosis and individualized therapeutic strategies
      prolongation of life or healing may be reached in many patients.

PMID- 11206096
TI  - [Clinical problem solving. Incidental finding during check-up examination for
      familial colorectal carcinoma susceptibility].

PMID- 11206097
TI  - [Liver cell carcinoma--pathomorphology and differential diagnosis].
AB  - Modern imaging techniques permit the detection of small and smaller nodular
      lesions of the liver. The classification and differential diagnosis of these
      lesions is still mainly based on pathomorphological analysis. With the exception
      of metastases from extra-hepatic malignant tumors, hepatocellular carcinoma is
      the most frequent malignant tumor of the liver. Whereas the classical variant of
      hepatocellular carcinoma preferentially arises in the cirrhotic liver, the
      fibrolamellar variant is found without association to cirrhosis and hepatitis B
      infection in the liver of young adults. Differential diagnosis of hepatocellular
      nodular lesions includes focal fatty change, focal nodular hyperplasia, liver
      cell adenoma, large regenerative nodules and dysplastic nodular lesions.

PMID- 11206098
TI  - [Liver resection and liver transplantation in liver cell adenoma, hepatocellular
      carcinoma and fibrolamellar liver carcinoma].
AB  - Hepatocellular adenomas are rare benign conditions but represent an indication
      for resection due to their risk of rupture and malignant mutation. Surgical
      resection should include a safety margin according to oncologic principles.
      Surgical resection does represent the optimal treatment modality for
      hepatocellular carcinoma without accompanied cirrhosis of the liver. The rare
      fibrolamellar carcinoma has the best prognosis. Liver transplantation is usually
      not performed in HCC without cirrhosis. In case of HCC with cirrhosis in stage I
      and II the relapse free 5-year-survival rate is more than 50% after liver
      transplantation. In the UICC-stages III and IV the results of liver
      transplantation are worse, which points to the impact of exact preoperative
      staging. Liver resection in HCC and cirrhosis is indicated in stage I and II in
      case of good liver function. In case of liver resection the survival rates are
      worse with significantly higher relapses compared to liver transplantation. For
      small, functionally irresectable hepatocellular carcinoma in cirrhosis liver
      transplantation is the treatment of choice today.

PMID- 11206099
TI  - Left ventricular dysfunction and cytoprotection.
AB  - With the projections of increasing aging of the population, heart failure is
      expected to become a major health problem for most Western societies. Therefore,
      the study of the pathophysiological mechanisms involved in heart failure should
      be one of the main priorities of cardiovascular research. A substantial amount of
      knowledge has been gathered in the recent years on the mechanisms involved in the
      development of heart failure. One such mechanism is the development of myocyte's
      apoptosis. This apoptotic mechanism is responsible for a substantial decrease in
      the number of cardiac myocytes, and therefore for the worsening of heart failure.
      This apoptotic mechanism can be triggered by a number of mechanisms such as the
      adrenergic stimulation, the angiotensin II production, changes in calcium
      homeostasis, and changes in cellular metabolism. At least in theory, the
      development of therapies (such as beta blockers, ACE inhibitors, calcium channel
      blockers and trimetazidine) that can inhibit these mechanisms can have a
      cytoprotective role and therefore reduce the development of heart failure.
      Because of its main role in the production of energy for the cell, the
      mitochondrion is one of the mainframes of cell viability. If the mitochondrial
      function is decreased the myocyte will be in jeopardy. Therefore, drugs that can
      prevent mitochondrial dysfunction will obviously have a cytoprotective role in
      heart failure.

PMID- 11206100
TI  - Clinical benefits of a metabolic approach in the management of coronary patients.
AB  - Patients with Angina Pectoris benefit from therapy with nitrates, beta-blockers,
      and calcium channel antagonists. All these drugs, through different action
      mechanisms, tend to reduce cardiac work and restore the balance between
      myocardial metabolic demand and blood supply. Failure of this conventional
      haemodynamic treatment in controlling symptoms and preventing ischemia is however
      frequent, and many such patients are then referred for myocardial
      revascularization. This scenario has been innovated by Trimetazidine, an anti
      ischemic agent that exerts its beneficial effects by increasing cell tolerance to
      ischemia and improving functional recovery at the time of reperfusion. Compared
      with classic "hemodynamic" agents, Trimetazidine demonstrated similar efficacy in
      reducing frequency and severity of ischemic attacks and in increasing exercise
      tolerance, with a lower incidence of side effects. The adjunct of Trimetazidine
      to propranolol was found superior to nitrates in reducing ischemic episodes. In
      angina patients not controlled by CA-antagonists, Trimetazidine lowered the
      frequency of ischemic attacks and prolonged the time to ischemia during exercise.
      More recently, Trimetazidine has been shown to improve left ventricular
      dysfunction in patients with congestive heart failure, and in ischemic patients
      undergoing PTCA. In chronic coronary artery disease, Trimetazidine improved
      regional dysfunction at rest and during dobutamine stress echocardiography. Given
      the metabolic mechanism of action of Trimetazidine, focused on improving energy
      metabolism and restoring membrane homeostasis, it is expected to especially
      benefit patients in whom metabolic alteration contribute to the pathogenesis of
      ischemia, namely diabetic patients. Preliminary data from a multicenter study do
      support this hypothesis. In conclusion, available data indicate that the
      cardioprotective effect of Trimetazidine results in improvement of symptoms and
      preservation of left ventricular function in patients with acute and chronic
      ischemic syndromes.

PMID- 11206101
TI  - Trimetazidine as adjunctive therapy to primary PTCA for acute myocardial
      infarction.
AB  - Acute myocardial infarction remains a complex medical problem despite major
      advances in its management, especially early myocardial reperfusion by
      percutaneous transluminal coronary angioplasty (PTCA). Situations such as absence
      of TIMI 3 flow grade and/or persistence of ST segment elevation despite
      successful PTCA, no-reflow phenomenon and absence of improvement of myocardial
      regional contractility despite angiographic TIMI 3 flow, probably involve
      microvascular injury due to neutrophil and platelet activation, free radical
      generation and myocardial metabolic disorders. Trimetazidine is a well tolerated
      and efficient antianginal agent, that experimentally reduces ischemia-reperfusion
      injuries, neutrophil infiltration, platelet aggregation and has antioxidant
      effects. The Limitation of Infarct Size by trimetazidine Trial (LIST) randomized
      94 patients with acute myocardial infarction undergoing primary PTCA into two
      groups: placebo versus trimetazidine i.v. infusion started before PTCA and
      continued for 48 hours. Continuous ST segment monitoring was performed during and
      after primary PTCA. The major results of the study were a significantly more
      important and faster reduction of ST segment elevation with a trend to less ST
      segment exacerbation, in the trimetazidine group after PTCA compared to the
      placebo group. These results suggest that trimetazidine may efficiently reduce
      ischemia-reperfusion lesions after primary PTCA for acute myocardial infarction.

PMID- 11206102
TI  - Trimetazidine and the contractile response of dysfunctional myocardium in
      ischaemic cardiomyopathy.
AB  - BACKGROUND: The therapeutic effect of anti-ischemic compounds is related to their
      ability to improve the oxygen supply-demand balance of the ischemic myocardium by
      increasing myocardial blood flow (calcium-antagonists), by reducing regional
      myocardial oxygen consumption (verapamil, betablockers) and increasing peripheral
      pooling of blood (nitrates, nifedipine). All these actions are also accompanied
      by hemodynamic changes, as evidenced by a lower double product, reduced wall
      stress, lower pulmonary wedge pressure, and lower systemic arterial pressure. In
      general, it was found that the combination of a betablocker with nifedipine
      improved the antianginal effect by further reducing the number and duration of
      ischemic events. The combination of a nitrate with a beta-blocker is particularly
      useful because it reduces the risk of heart failure by lowering left ventricular
      end-diastolic pressure and volume and by attenuating the negative inotropic
      effect of the betablocker. Although a combination therapy demonstrated benefits
      in comparison with drug treatment alone, it is associated with a higher incidence
      of untoward events. Trimetazidine (2, 3, 4 trimethoxybenzyl-piperazine
      dihydrochloride) is a novel anti-ischemic compound with a peculiar mechanism of
      action. Its anti-ischemic properties are unrelated to changes in myocardial
      oxygen supply-to-demand ratio, as shown by no significant effects on heart rate,
      blood pressure or rate-pressure product both at rest and during dynamic exercise.
      There are several possible mechanisms of action by which trimetazidine promotes
      preservation of membrane structures and cellular function: limitation of
      intracellular acidosis, correction of disturbances of transmembrane ion exchange
      leading to calcium overload, prevention of an excessive production of free
      radicals, inhibition of the inflammatory reaction and an antiplatelet effect.
      These documented actions cooperate to increase the rate of resynthesis of high
      energy phosphates within myocardial cells after episodes of ischemia. In several
      trials, trimetazidine has been tested as an antianginal agent, both as
      monotherapy and combined with "classical" anti-ischemic compounds. In comparison
      with nifedipine, trimetazidine had similar efficacy in reducing the number of
      weekly anginal attacks and in increasing the ischemic threshold in a group of 39
      patients with stable angina. However, the incidence of side effects was
      significantly higher with nifedipine (5 vs 20), and affected 5 patients with
      trimetazidine and 13 patients with nifedipine (p = 0.03). In a relatively large
      European study involving 149 patients (Trimetazidine European Multicenter Study,
      TEMS), trimetazidine (20 mg t.i.d.) was compared with propranolol (40 mg t.i.d.)
      in patients with stable angina pectoris and documented significant coronary
      artery stenoses. The number of anginal attacks was reduced equally by both drugs
      and exercise duration was increased by both treatments. However, in contrast with
      propranolol trimetazidine did not alter the rate pressure product. In patients
      already treated with nifedipine or beta-blockers, the addition of trimetazidine
      (20 mg t.i.d.) was able to reduce the number and the duration of anginal attacks
      and improved also the exercise capacity. Trimetazidine is generally well
      tolerated and only minor side effects have been reported (drowsiness, sedation,
      diarrhea). The improvement in cardiac energy metabolism should theoretically
      translate into enhancement in mechanical efficiency. This hypothesis has been
      object of recent investigations in patients with ischemic heart disease with and
      without left ventricular dysfunction. Brottier, et al. demonstrated that patients
      with ischemic cardiomyopathy treated with trimetazidine had a higher ejection
      fraction (measured by radionuclide angiography) than control patients who
      received a placebo after 6 months of therapy (p < 0.018). The group of Chierchia
      demonstrated that trimetazidine improved ischemic regional myocardial dysfunction
      at rest and during stress-induced ischemia in 15 patients with chronic coronary
      artery disease without affecting the hemodynamic determinants of myocardial
      oxygen consumption. There is recent demonstration that trimetazidine improves the
      contractile response of left ventricular hibernating myocardium in patients with
      ischemic heart disease. Belardinelli et al. showed that trimetazidine improved
      the contractile response of dysfunctional myocardial to low-dose dobutamine in
      patients with ischemic heart disease and left ventricular function. Twenty-two
      patients with prior anterior myocardial infarction and injection fraction < 35%
      (33 +/- 7%) were randomized into 2 groups. A group (= 11) received trimetazidine
      (20 mg tid) for 2 months, while another group (= 11) received a placebo. The
      usual medications were not altered during the study. (ABSTRACT TRUNCATED)

PMID- 11206103
TI  - Ischaemic heart disease: clinical improvement with metabolic approach--final
      remarks.

PMID- 11206104
TI  - Ischaemic heart disease: clinical improvement with metabolic approach.
AB  - The term myocardial ischemia describes a condition which exists when fractional
      uptake of oxygen in the heart is not sufficient to maintain the rate of cellular
      oxidation. This leads to extremely complex situations which have extensively in
      recent years. A large amount of experimental research has been directed to
      establish the precise sequence of biochemical events leading to myocyte necrosis
      as such knowledge could lead to rational treatments designed to delay myocardial
      cell death. At the present time there is no simple answer to the question of what
      determines cell death and no recovery on reperfusion. Problems arise because: 1)
      ischemic-damage is not homogeneous and many factors may combine to cause cell
      death; 2) severity of biochemical changes and development of necrosis are usually
      associated (both the processes being dependent on the duration of ischemia) and
      it is impossible to establish a causal relationship; 3) the inevitability of
      necrosis can only be assessed by reperfusion of the ischaemic myocardium.
      Restoration of flow, however, might result in numerous further negative
      consequences, thus directly influencing the degree of recovery. From the clinical
      point of view, we have recently learnt that there are several potential
      manifestations and outcomes associated with myocardial ischaemia and reperfusion.
      Without doubt ventricular dysfunction (either systolic or diastolic) of the
      ischaemic zone is the most reliable clinical sign of ischemia, since ECG changes
      and symptoms are often absent. The ischaemia-induced ventricular dysfunction, at
      least initially, is reversible, as early reperfusion of the myocardium results in
      restoration of normal metabolism and contraction. In the ischaemic zone, recovery
      of contraction might occur instantaneously or, more frequently, with a
      considerable delay, thus yielding the condition recently recognised as the
      stunned myocardium. On the other hand, when ischemia is severe and prolonged,
      cell death might occur. Reperfusion at this stage is associated with the released
      of intracellular enzymes, disruption of cell membranes, influx of calcium,
      persistent reduction of contractility, and eventual necrosis of at least a
      portion of the tissue. This entity has been called reperfusion damage by those
      who believe that much of the injury is the consequence of events occurring at the
      moment of reperfusion rather than a result of changes occurring during the period
      of ischaemia. The existence of reperfusion damage, however, it has been
      questioned, and has been argued that, with the exception of induction of
      arrhythmias, it is difficult to be certain that reperfusion causes further
      injury. The existence of such an entity has clinical relevance, as it would imply
      the possibility of improving recovery with specific interventions applied at the
      time of reperfusion. In 1985 Rahimtoola described another possible out-come of
      myocardial ischemia. He demonstrated that late reperfusion (after months or even
      years) of an ischaemic area showing ventricular wall-motion abnormalities might
      restore normal metabolism and function. He was the first to introduce the term
      hibernating myocardium, referring to ischemic myocardium in which the myocytes
      remain viable but in which contraction is chronically depressed. Our data on
      metabolic changes occurring during ischemia followed by reperfusion which were
      obtained either in the isolated and perfused rabbit hearts or in CAD patient
      undergoing intracoronary thrombolysis or aortocoronary bypass grafting will be
      reviewed.

PMID- 11206105
TI  - Pharmacokinetics of netobimin and microsomal metabolism of albendazole in
      infected gerbils with Echinococcus granulosus.
AB  - A comparison of the pharmacokinetic profiles of netobimin (NTB), albendazole
      sulfoxide (ABZSO) and albendazole sulfone (ABZSO2) was performed in gerbils
      (Meriones unguiculatus) with intra-abdominal hydatidosis and in healthy gerbils.
      The infection was developed after peritoneal inoculation of protoscolices of
      Echinooccus granulosus from sheep. Plasma concentrations of NTB, ABZSO and ABZSO2
      were measured by HPLC after oral administration of 50 mg NTB kg(-1). The results
      showed an incomplete biotransformation of NTB over the experimental time; and
      this increased in infected animals. ABZSO and ABZSO2 pharmacokinetic profiles
      were unaffected and were similar in both non-infected and infected animals. Both
      hepatic and intestinal microsomal sulfoxidase activities were measured. Since
      infected gerbils induced hepatic activity and decreased intestinal activity, the
      total activity was not different in infected and non-infected animals. In
      summary, intra-abdominal hydatid disease affected the pharmacokinetic profile of
      NTB, but ABZSO and ABZSO2 plasma concentrations were not different in infected
      and non-infected gerbils.

PMID- 11206106
TI  - Characterization of a proteasome alpha-chain from Giardia lamblia.
AB  - To begin to characterize the components of the 20S proteasome of Giardia lamblia,
      we have cloned a genomic sequence encoding an alpha-chain (type alpha3/C9,
      predicted size 244 amino acid residues). Southern analysis indicated that a
      single gene codes for this protein, and a Northern blot exhibited a single signal
      at 850 nt. An antiserum against a C-terminal fragment of the alpha-chain
      expressed in Escherichia coli reacted with a single protein band of Mr 27,000
      that was present at constant levels in trophozoites and encysting cells. On a 2D
      blot of the purified 20S proteasome, we identified the cross-reacting component
      as a single protein of IEP 6.0, in agreement with the IEP predicted by the coding
      sequence. Our data confirm that the G. lamblia 20S proteasome is typically
      eukaryotic in containing a set of diverged alpha-subunits.

PMID- 11206107
TI  - A comparison of sporozoite transport after homologous and heterologous challenge
      in chickens immunized with the Guelph strain or the Florida strain of Eimeria
      maxima.
AB  - The two strains of Eimeria maxima, Guelph and Florida, used in this study were
      previously shown to only partially cross-protect immunologically with respect to
      lesion scores, weight gains and feed conversions after heterologous challenge. In
      this paper, we provide evidence that this partial lack of cross-protection is
      manifested at the level of sporozoite transport. In birds immunized and
      challenged with the homologous strain, sporozoites accumulated in the lamina
      propria and were blocked from further movement into the crypts by 72 h post
      challenge, unlike the situation observed in naive birds. Fewer than 5% of
      sporozoites were found in the crypts by 72 h post-challenge. In immunized birds
      challenged with the heterologous strain, fewer sporozoites reached the crypts
      than in naive birds but at least four times as many sporozoites successfully
      migrated to the crypts, when compared with birds challenged with the homologous
      strain. The degree of cross-protection afforded by the heterologous strain as
      measured by sporozoite transport success was not equally reciprocal.

PMID- 11206108
TI  - Novel small strongyle (Cyathostominae) beta-tubulin sequences.
AB  - Several coding sequences of the benzimidazole (BZ) target beta-tubulin have been
      described for different parasitic nematodes. However, until recently no tubulin
      sequences from Cyathostome species were available, despite the importance of BZ
      resistance in horses in the field. Here, we describe several full-length beta
      tubulin coding sequences of two major small strongyle species, namely
      Cylicocyclus nassatus and Cyathostomum coronatum. In the latter sequence, the
      putative BZ resistant mutation in codon 200 leading to a Phe to Tyr exchange is
      present. High nucleotide sequence similarities (>95%) were found among the
      tubulin sequences of the two different genera. This will be of advantage for the
      development of an allele-specific BZ resistance polymerase chain reaction (PCR)
      for multiple small strongyle species.

PMID- 11206109
TI  - Protection of hamsters from amebic liver abscess formation by immunization with
      the 150- and 170-kDa surface antigens of Entamoeba histolytica.
AB  - A monoclonal antibody, EH3015, prevents in vitro adherence of Entamoeba
      histolytica trophozoites to mammalian cells and inhibits amebic liver abscess
      formation in hamsters. By immunoaffinity chromatography with the monoclonal
      antibody, purified E. histolytica antigens with molecular masses of 150 and 170
      kDa under non-reduced conditions were obtained. Hamsters were immunized with
      these antigens (group I) or with fractions further purified by polyacrylamide gel
      electrophoresis (group II). Pooled immune sera from the two groups inhibited in
      vitro amebic adherence to Chinese hamster ovary cells by 98% at 1:10 dilutions.
      The immunized hamsters were challenged by the intrahepatic injection of E.
      histolytica trophozoites. Complete protection from abscess formation was observed
      in 38% of hamsters in group I and 67% in group II, whereas all control hamsters
      inoculated only with adjuvant developed amebic liver abscesses. In the immunized
      hamsters, the abscesses in the two groups were significantly smaller than in the
      controls. These results demonstrate that the E. histolytica antigens are possible
      vaccine candidates for amebiasis.

PMID- 11206110
TI  - Parasite and vertebrate host genetic heterogeneity determine the outcome of
      infection by Schistosoma mansoni.
AB  - Intraspecific variation in Schistosoma mansoni infection and modulation of its
      expression by vertebrate host genetics was studied by evaluation of some
      biological parameters of the infection in BALB/c and C57BL/6 mice infected with
      one Brazilian (BH) and two Venezuelan (YT and SM) laboratory strains of the
      parasite. Mice infected with 60 cercariae of each parasite strain were euthanized
      at 5, 6, 8, and 12 weeks. Parameters recorded included the number of adult worms
      recovered by portal perfusion (infectivity); the number of eggs in the feces, the
      intestine, and the liver; and the ability of the eggs to cross the intestine,
      expressed as a quotient of the number of eggs in the intestine versus the feces.
      Results showed that the parasite appeared to determine the infectivity, the sex
      ratio, the onset and timing of oviposition, the number of eggs produced, initial
      egg laying toward the liver, and the ability to cross the intestinal wall. In
      this sense the BH strain appeared to be the most efficient and the SM strain, the
      most delayed; the YT strain was intermediate, although closer to the SM strain.
      On the other hand, the host appeared to influence the susceptibility to
      infection, the fecundity, and the percentage of eggs distributed in the liver and
      in the intestine during the chronic stage. In this sense, although they have been
      shown to be less susceptible to infection than BALB/c mice, C57BL/6 mice permit
      more eggs to be produced and exhibit similar numbers of eggs in the intestine and
      the liver at certain time points. It appears from these results that parasite
      genetics is essential for the outcome of infection with S. mansoni, but some
      characteristics may be quantitatively modulated by host genetics.

PMID- 11206111
TI  - Surface component characterization as taxonomic tools for Phytomonas spp
      identification.
AB  - The genus Phytomonas arbitrarily includes all protozoa of the family
      Trypanosomatidae isolated from plants, but its differentiation is a complex task.
      The phase separation technique using Triton X-114 was used to analyze hydrophobic
      and hydrophilic surface proteins in ten strains of Phytomonas isolated from
      various fruits. The iodination of surface proteins by the Iodo-Gen method was
      also used for Phytomonas isolates from tomatoes, corn and annatto, Herpetomonas
      samuelpessoai and Crithidia fasciculata. The distribution of protein-bound
      radioactivity in acrylamide gels was determined by autoradiograms and showed the
      presence of protein bands of 36-68 kDa in all strains of Phytomonas: there were
      two major bands at 88 kDa and 94 kDa, with minor bands at 36 kDa and 142 kDa in
      H. samuelpessoai; and there were three bands at 74, 86 and 94 kDa, with minor
      bands at 23 kDa and 105 kDa in C. fasciculata. The results demonstrated that
      samples of plant parasites can be clearly differentiated from H. samuelpessoai
      and C. fasciculata. These plant parasites were also submitted to polysaccharide
      analysis by gas-liquid chromatography of the corresponding alditol acetate.
      Arabinose, galactose, glucose and mannose, were the major monosaccharides found,
      while fucose, rhamnose and xylose were found in smaller amounts. The results of
      all these methods indicated that, after extension to a wider range of
      trypanosomatid strains, they may be useful in Phytomonas taxonomy.

PMID- 11206112
TI  - Assessment of Leishmania promastigote growth in vitro by means of nucleoside
      hydrolase activity determination.
AB  - Nucleoside hydrolases (NH) are involved in the purine salvage pathway of
      protozoan cells for the biosynthesis of nucleic acids. We developed a simple and
      reliable microassay based on N-ribohydrolase dosage using 4-nitrophenyl-beta-D
      ribofuranoside (NPR) substrate for the quantification of Leishmania infantum. The
      free promastigote stage of L. infantum contains high amounts of NH capable of
      cleaving NPR, but the parasitic amastigote does not. The method allows reliable
      quantification of viable parasites over a wide range of concentrations (5 x 10(4)
      2 x 10(8) parasites ml(-1)) in a single assay. No difference in NH activity was
      observed between various strains at equivalent concentrations and growth curves
      determined with NH dosage were similar to optical counts. Samples can be stored
      at -20 degrees C for weeks before use in this unique assay without significant
      loss of NH activity. The method is particularly simple and versatile and proves
      well adapted for the determination of growth characteristics and drug screening
      studies of L. infantum promastigotes in vitro.

PMID- 11206113
TI  - The effect of interleukin-4 on the induction of intestinal mast cells and
      chronological cytokine profiles during intestinal nematode Strongyloides ratti
      infection.
AB  - The effect of interleukin-4 (IL-4) on the induction of intestinal mast cells and
      cytokine profiles during Strongyloides ratti infection was studied using IL-4
      knockout (IL-4 KO) mice. The antigen-specific proliferative response of
      mesenteric lymph node cells was not impaired in IL-4 KO mice. The number of
      intestinal mast cells induced in IL-4 KO mice during S. ratti infection was 2- to
      3-fold lower than that observed in WT mice. Intestinal mastocytosis had
      disappeared in IL-4 KO mice by day 21 postinfection, when significant
      mastocytosis continued to be observed in WT mice. In mesenteric lymphnode of IL-4
      KO, IL-3 production decreased and mice IFN-gamma production significantly
      increased as compared with those of WT mice. The numbers of eggs excreted per
      gram of feces (EPG) by IL-4 KO mice were greater than those excreted by WT mice
      on day 6 postinfection, but no difference was observed in the subsequent period.
      In conclusion, intestinal mast cells are induced during S. ratti infection in the
      absence of IL-4, and IL-4 is not essential for protection against intestinal
      adult worms of S. ratti.

PMID- 11206114
TI  - The detection and occurrence of circulating antigens of Trichinella spiralis
      during worm development.
AB  - Four enzyme-based immunoassays were compared in detecting circulating antigens
      (CA) of Trichinella spiralis, i.e. microfluorescence, dissociated enhanced
      lanthanide fluoroimmunoassay (DELFIA), enhanced chemiluminescence and enzyme
      linked immunosorbent assay (ELISA). Parameters which could affect the sensitivity
      and specificity of the assays were evaluated. Different combinations of
      polyclonal antibody (PA) and five monoclonal antibodies (mAbs) against the
      excretory/secretory antigens of the nematode were tested to produce an optimal
      antigen-detecting system. DELFIA and a "sandwich" consisting of PA as capturing
      antibody and mAb 7C2C5 as detecting antibody, yielded the most stable and
      sensitive results; and 1 ng CA/ml could be detected. The assay did not cross
      react with heterologous antigens of Angiostrongylus cantonensis, Ascaris suum,
      Cysticercus cellulosae, Fasciolopsis buski, Gnathostoma hispidum and Trichuris
      suis. Fluctuating levels of CA were observed in the serum of experimentally
      infected mice at various periods post-infection. As early as days 4 and 6, a
      significant amount of CA was detected. The level reached a peak at day 10, then
      declined and another peak was observed at day 18. The monitoring of the
      corresponding antibody response by ELISA showed that IgM was first detected at
      day 10, reaching a peak at day 16. A marked increase in IgG1 was noted from day
      16 and its level was significantly higher than that of IgG2.

PMID- 11206116
TI  - Prevalence of infection by the protozoan Hemolivia mariae in ticks.
AB  - This paper considers the prevalence of natural infections of the protozoan
      Hemolivia mariae, in its hosts the Australian sleepy lizard, Tiliqua rugosa, and
      the ixodid tick species, Amblyomma limbatum. We investigate whether the protozoan
      may be influencing the tick population in the field, by comparing the observed
      prevalence of infection in ticks with the prevalence expected from known
      transmission dynamics. The prevalence of infection in nymphs was similar to the
      expected prevalence, but the observed prevalence in adults was higher than
      expected. These results provide no evidence for infection-induced mortality in
      ticks. We also found that tick loads on infected and uninfected lizards were not
      significantly different and, overall, infected lizards were as likely to be tick
      infested as uninfected lizards. However, infected lizards were less likely to be
      found carrying female ticks. On balance, the evidence did not strongly support
      the hypothesis that ticks avoid feeding on infected lizards. We use known
      parameters of H. mariae transmission to estimate the rate of tick ingestion that
      may be required to sustain the observed prevalences in the field.

PMID- 11206115
TI  - Analysis for Giardia cysts and Cryptosporidium oocysts in water samples from
      small water systems in Taiwan.
AB  - Giardia and Cryptosporidium have emerged as waterborne pathogens of concern.
      Twenty-six water samples were collected from small water systems in Taiwan and
      checked for the occurrence of both parasites. Water quality parameters and
      characteristics of the sampling sites were also recorded. The frequencies of
      occurrence for Giardia and Cryptosporidium were 46.2% for each; and their mean
      concentrations were 79.5 cysts/100 l and 22.1 oocysts/100 l, respectively. The
      concentrations of oocysts and heterotrophic bacteria exhibited the highest
      correlation and followed the concentrations of the two protozoa. The water
      samples from sites with filtration devices had a lower oocyst concentration than
      those from sites without filtration devices, while no significant difference was
      found for cysts. The level of each parasite had no direct relationship with
      altitude. The cyst concentrations increased proportionally with the consumer
      population using the water systems. Risk assessment of the parasitic infections
      suggests that setting up disinfection devices in the small water systems would be
      needed.

PMID- 11206117
TI  - Megasome biogenesis in Leishmania amazonensis: a morphometric and cytochemical
      study.
AB  - Megasomes are large lysosomes found in the amastigote stage of Leishmania species
      belonging to the mexicana complex. The biogenesis of megasomes was investigated
      by transmission electron microscopy during the transformation of promastigotes
      into the amastigote form of L. amazonensis maintained in axenic cultures. Mainly
      small vacuoles with low electron density were found in the promastigote and early
      intermediate forms. Morphometrical analysis showed an increase in the volume
      density of these structures during the transformation process. Cysteine
      proteinase was localized in this structure by immunocytochemical assay. Membrane
      bounded structures filled with electron-dense material were also found in
      significant amounts from the 2nd day on. These structures were relatively
      abundant, both in axenic and lesion-derived amastigotes, but not in stable long
      term axenic amastigote culture. A three-dimensional reconstruction of lesion
      derived amastigotes and axenic amastigotes of L. amazonensis demonstrated that
      megasomes comprise almost 5% of the total cell volume. In addition, the
      development of other organelles was examined during the transformation process.

PMID- 11206118
TI  - Tissues and cells involved in the invasion of the rabbit intestinal tract by
      sporozoites of Eimeria coecicola.
AB  - This study was designed to identify an extra-intestinal route of migration of
      Eimeria coecicola sporozoites and the types of cell harbouring the parasite
      during the invasion of the intestine. The presence of E. coecicola in blood,
      spleen and mesenteric lymph nodes of infected donor rabbits was demonstrated by
      immunohistology on donor organs and measurement of oocyst excretion by coccidia
      free recipient rabbits injected with whole-cell suspensions prepared from donor
      tissues. Two types of donor lymphocyte, B (IgM+) and T (CD5+), were labelled
      using a two-colour immunofluorescence-labelling technique and separated with a
      cell-sorter (FACStar(Plus)). The presence of parasites in the sorted cells was
      assessed by direct examination and by using the same in vivo test after
      intravenous injection of IgM+ B or CD5+ T lymphocytes collected from donors at
      different times after inoculation. This test provided evidence that the parasites
      were alive and still infectious within the sorted lymphocytes. It was
      demonstrated that both B and T lymphocytes were infected.

PMID- 11206119
TI  - [Two children with extrapulmonary symptoms due to tuberculosis].
AB  - Two patients came to their general practitioner for relatively minor problems: a
      4-year-old boy came with a red eye and a 10-year-old girl with red foot soles.
      They came from Pakistan and Vietnam respectively. Their symptoms were due to
      tuberculosis, which diagnosis was established by Mantoux test and culture of a
      stomach aspirate. They were treated accordingly with isoniazid, rifampicin and
      pyrazinamide and with isoniazid, rifampicin and ethambutol respectively. These
      cases stress the importance of knowledge of the extrapulmonary manifestations of
      tuberculosis. As treatment exists and adequate treatment can diminish the
      reservoir of tuberculosis bacteria, early diagnosis can prevent the morbidity,
      spread and mortality of tuberculosis.

PMID- 11206120
TI  - [CBO guideline 'Breast cancer: screening and diagnosis'].
AB  - New developments in the diagnostic procedures for women with an increased risk
      for, or symptoms related to breast cancer led to development of new guidelines by
      a working group under the auspices of the Dutch Institute for Health Care
      Improvement, the Organisation of Comprehensive Cancer Centres and the National
      Breast Group of the Netherlands. Based on the best available evidence this
      working group formulated recommendations on the following topics: indications for
      screening within the population screening programme, screening outside the
      population screening programme, the diagnostic procedures of symptomatic and
      asymptomatic lesions in the breast and the organisation of the diagnostic work-up
      of patients with breast symptoms. The most important recommendations in the
      guidelines are: individual screening is recommended to certain groups of women
      who do not participate in the population screening programme, based on their risk
      profiles; available evidence does not support the extension of the population
      screening programme to women 40-49 years of age; diagnosis and treatment have to
      take place in a structured context, the so-called breast team; to guarantee
      optimal diagnostic procedures a multidisciplinary clinic is mandatory; the
      diagnostic work-up of breast abnormalities is based on the triple assessment:
      physical examination, imaging by mammography and/or ultrasound and needle biopsy.
      For quality-controlled implementation of this guideline, uniform prospective
      registration of patients, diagnosis and treatment related data is an important
      condition.

PMID- 11206121
TI  - [Screening for breast cancer on basis of individual risk assessment for women
      ineligible for the national population screening program].
AB  - For healthy women, without malignancies in their personal histories, a positive
      family history for breast cancer is the single indication for individual breast
      surveillance outside the population screening. Management of women is based on
      individual risk assessment. A cumulative risk of 20% and more, as a result of a
      positive family history, will in practice be an indication for breast
      surveillance. This threshold is not evidence-based yet, nor are data available on
      the benefits of this surveillance efficacy. When a personal cumulative risk of
      more than 30% exists to develop breast cancer, a consultation with a clinical
      geneticist involved in a family cancer clinic should be offered. Surveillance of
      women with a high-risk cumulative risk should preferably be included in a
      prospective study design. Only in this way will data about compliance and the
      estimates of different ways of surveillance become available. There is no
      convincing evidence that population screening for women aged 40-49 years does
      lead to important mortality reduction in combination with a good balance between
      pros and cons for the women involved. Women in the age category 50-75 years, with
      breast cancer in their personal histories, who are not followed anymore, should
      be informed by their specialist about participating (again) in the population
      breast screening. There is no evidence of mortality reduction as a result of
      breast self-examination nor of palpation performed by a physician. However,
      awareness of the own body can be useful for early recognition of breast
      abnormalities; it may reduce the delay between the first recognizable symptom and
      the subsequently initiated therapy.

PMID- 11206122
TI  - [Quality control of DNA testing in hereditary diseases].
AB  - The laboratories performing diagnostic studies regarding hereditary diseases and
      the specialists providing hereditary counselling are housed in clinical genetic
      centres. The laboratories are subject to the Special Medical Performances Act and
      have had licenses from the Ministry. The DNA diagnostic laboratories united in
      the National Committee on DNA Diagnostics, engaged among other things in quality
      control. The large number of tests requested and the dramatic consequences for
      the patient and his relatives necessitate high quality standards. The
      laboratories made a division of labour for analysis of most disorders, in order
      to acquire and maintain expertise in spite of rarity of most hereditary diseases.
      For adequate handling of requests for DNA diagnostic tests, it is important that
      the patient material be sent directly to the laboratory specialized in the
      disorders in question, for the request form to be filled out completely and for
      the patient data to be stated on the blood tube. A regularly updated review of
      the DNA diagnostics in the Netherlands can be found on the website:
      http://www.unimaas.nl/ approximately LOD/lod.htm. This list indications per
      centre and information such as required material and maximal results deadlines.

PMID- 11206123
TI  - [Diagnostic image (21). Small intestine necrosis due to mesenteric venous
      thrombosis].
AB  - An 80-year-old woman was taken to the hospital because of acute abdominal pain.
      At laparotomy, necrosis of a segment of the small bowel was found, caused by
      mesenteric vein thrombosis.

PMID- 11206124
TI  - [High vaccination rates among children of Amsterdam].
AB  - OBJECTIVE: To examine if in Amsterdam there are social or cultural groups of
      children with a relatively low vaccination coverage for diphtheria, pertussis,
      tetanus and poliomyelitis (DPTP) and mumps, measles and rubella (MMR). DESIGN:
      Descriptive cross-sectional study. METHOD: In the Department of Child Health Care
      of the Municipal Health Service of Amsterdam all 83,217 children aged 2-12 years
      living in Amsterdam on the 1st of January 2000 were analysed for vaccination and
      sociodemographic data collected routinely by the Department of Child Health Care.
      The sociodemographic data concerned sex, year of birth, country of birth of the
      mother and child, name of the school and postal code of the home address. Schools
      were grouped by (religious) affiliation on the basis of the Amsterdam school
      guide 1999/2000. Based on postal codes children were classified by the
      neighbourhoods in which they were living. Neighbourhoods were grouped by socio
      economic status based on data from the Central Bureau for Statistics. RESULTS:
      The overall vaccination rates of DPTP and MMR were 92.4% and 93.5% respectively.
      No important variation in vaccination coverage was identified between more and
      less affluent neighbourhoods. The uptake rate among foreign children was
      sometimes slightly higher and sometimes slightly lower compared with native
      children. Especially foreign children born abroad (Surinam, Antilles, Morocco,
      Turkey) were not fully vaccinated: 70.9% were fully immunized for DPTP, 79.5% for
      MMR. Children who visited anthroposophical schools were considerably less
      frequently fully immunized compared with children visiting other schools: for
      DPTP and MMR 81.0 and 59.9% respectively versus 94.4 en 95.3% for children
      attending general municipal schools. CONCLUSION: The vaccination coverage was
      high in children in Amsterdam. Further improvement of the vaccination uptake
      might be achieved by a more outreaching attitude to children born abroad, and by
      more intensely informing sceptical parents about the benefits and (supposed)
      dangers of vaccinations.

PMID- 11206126
TI  - [Fever and vesiculopapular exanthema due to infection with Rickettsia africae
      after a sojourn in South Africa].
AB  - A 26-year-old woman, who had visited the Krugerpark in South Africa 5 days
      before, presented with fever, a skin lesion with a black crust (eschar),
      lymphadenopathy and a vesiculo papular rash. The clinical diagnosis 'Rickettsia
      africae infection' was confirmed by specific serological tests. A second patient
      aged 43 years, whose vesicular rash did not respond to flucloxacillin had been in
      the Krugerpark one week before and on examination was found with 2 eschars. Based
      on epidemiological and clinical grounds African tick fever can be distinguished
      from Mediterranean spotted fever (fievre boutonneuse). In the Netherlands
      specific diagnostic tests are not available. For treatment the distinction is not
      necessary; treatment is with tetracycline or doxycycline. Both patients recovered
      upon this treatment.

PMID- 11206127
TI  - [Definition of 'quack' in the public debate on alternative medicine].
AB  - In May 1999 the Amsterdam Court of Justice decided that a retired internist and
      propagandist of his own alternative cancer therapy, could rightfully be called a
      quack by his critics. Recently this judgment was reversed on appeal. The first
      court used the medical definition of quackery: a treatment of which the supposed
      benefits are unsubstantiated. The court of appeal, however, took into
      consideration that to the general public calling someone a quack is an indication
      that this person is a swindler and practises medicine unlawfully. This definition
      is supported by the most authoritative Dutch dictionary. Apparently a different
      semantic interpretation of the term quack has led to these strongly diverging
      verdicts. The terms quack and quackery are indispensable in the public debate on
      alternative medicine.

PMID- 11206128
TI  - [Value of the 'non-diagnostic' lung scan--further classification of pulmonary
      embolism not reliable].

PMID- 11206129
TI  - Identification and analysis of the myosin superfamily in Drosophila: a database
      approach.
AB  - The recent sequencing of the genome of Drosophila melanogaster has provided a
      valuable resource for mining the database for genes of interest. We took
      advantage of this opportunity in an attempt to identify novel myosins in
      Drosophila and confirm the presence of the previously identified myosins from
      classes I, II, III, V, VI, and VII. The Drosophila database annotators predicted
      the structure of three additional proteins which we identified as novel
      unconventional myosins, two of which fell into classes XV and XVIII,
      respectively. Our own efforts predicted the presence of four additional partial
      sequences that appear to be myosin proteins which did not fall into any specific
      class. In the future comparative genomics will hopefully lead to the placement of
      these myosins into new classes.

PMID- 11206130
TI  - Triad proteins and intracellular Ca2+ transients during development of human
      skeletal muscle cells in aneural and innervated cultures.
AB  - Dihydropyridine receptors (DHPRs), ryanodine receptors (RyRs), and triadin are
      major components of triads of mature skeletal muscle and play crucial roles in
      Ca2+ release in excitation-contraction (E-C) coupling. We investigated the
      expression and localization of these proteins as well as intracellular Ca2+
      transients during development of human muscle cells cultured aneurally and
      innervated with rat spinal cord. mRNAs encoding skeletal muscle isoforms of the
      DHPR alpha1 subunit (alpha1S-DHPR), the RyR, and triadin were scarce in myoblasts
      and increased remarkably after myotube formation. Immunocytochemically, alpha1S
      DHPR was expressed after myoblast fusion and localized mainly within the
      cytoplasmic area of aneural myotubes whereas the cardiac isoform (alpha1C-DHPR)
      was abundant along the plasma membrane. RyRs and triadin were both detected after
      myotube formation and colocalized in the cytoplasm of aneural myotubes and
      innervated muscle fibers. Along the plasma membrane of aneural myotubes,
      colocalization of alpha1C-DHPR with the RyR was more frequently observed than
      that of alpha1S-DHPR. In innervated muscle fibers, alpha1S-DHPR and RyR were
      colocalized first along the plasma membrane and later in the cytoplasmic area and
      formed regular double rows of cross-striation. The alpha1C-DHPR diminished after
      innervation. In Ca2+ imaging, spontaneous irregular slow Ca2+ oscillations were
      observed in aneurally cultured myotubes whereas nerve-driven regular fast
      oscillations were observed in innervated muscle fibers. Both caffeine and
      depolarization induced Ca2+ transients in aneurally cultured myotubes and
      innervated muscle fibers. In aneurally cultured myotubes, depolarization-induced
      Ca2+ transients were highly dependent on extracellular Ca2+, suggesting
      immaturity of the Ca2+ release system. This dependence remarkably decreased after
      innervation. Our present results show that these proteins are expressed
      differently in aneurally cultured myotubes than in adult skeletal muscle, that
      Ca2+ release in aneurally cultured myotubes is different from in adult skeletal
      muscle, and that innervation induces formation of a mature skeletal muscle-like
      excitation-contraction coupling system in cultured human muscle cells.

PMID- 11206131
TI  - Slow troponin T mRNA in striated muscles is expressed in both cell type and
      developmental stage specific manner.
AB  - We have cloned cDNA sequences of both rat and mouse slow troponin T gene. These
      sequences share a high level of homology with each other and with the human slow
      troponin T gene although we were unable to detect an alternatively spliced exon
      present at 3' end of human slow troponin T cDNA in either mouse or rat cDNAs.
      Northern blot analysis detected a high level expression of slow troponin T in
      adult mouse Soleus with a lower level expression in mixed postnatal skeletal
      muscles. Unlike late fetal and postnatal skeletal muscles in which slow troponin
      T expression is restricted to slow muscle fibre rich regions only, in situ
      hybridisation analysis detected this isoform to be highly expressed in somitic
      myotome and all muscle masses at 10-14 days of gestation after which its
      expression was rapidly downregulated. The unexpected expression of slow troponin
      T mRNA in fetal heart was apparent by both northern blotting and in situ
      hybridisation analyses. Slow troponin T mRNA in fetal heart was first detected at
      10 day in utero reaching maximum levels of expression at 12-15 days gestation.
      The slow troponin T in the heart was mainly expressed in the ventral ventricles
      until day 15 after which low level expression was also observed in both atria.
      Slow troponin T mRNA in both atrium and ventricle was mainly expressed in outer
      wall of the myocardium although it was also expressed in interventricular septum.
      This study therefore shows that in addition to being a cell type specific marker
      during later fetal and postnatal skeletal muscle development, slow troponin T
      represented one of the major developmental isoforms expressed in embryonic and
      fetal skeletal muscle as well as in the cardiac muscle.

PMID- 11206132
TI  - A novel Ca2+ binding protein associated with caldesmon in Ca2+-regulated smooth
      muscle thin filaments: evidence for a structurally altered form of calmodulin.
AB  - Smooth muscle thin filaments are made up of actin, tropomyosin, the inhibitory
      protein caldesmon and a Ca2+-binding protein. Thin filament activation of myosin
      MgATPase is Ca2+-regulated but thin filaments assembled from smooth muscle actin,
      tropomyosin and caldesmon plus brain or aorta calmodulin are not Ca2+-regulated
      at 25 degrees C/50 mM KCl. We isolated the Ca2+-binding protein (CaBP) from
      smooth muscle thin filaments by DEAE fast-flow chromatography in 6 M urea and
      phenyl sepharose chromatography using sheep aorta as our starting material. CaBP
      combines with smooth muscle actin, tropomyosin and caldesmon to reconstitute a
      normally regulated thin filament at 25 degrees C/50 mM KCl. It reverses caldesmon
      inhibition at pCa5 under conditions where CaM is largely inactive, it binds to
      caldesmon when complexed with actin and tropomyosin rather than displacing it and
      it binds to caldesmon independently of [Ca2+]. Amino acid sequencing, and
      electrospray mass spectrometry show the CaBP is identical to CaM. Structural
      probes indicate it is different: calmodulin increases caldesmon tryptophan
      fluorescence but CaBP does not. The distribution of charged species in
      electrospray mass spectrometry and nozzle skimmer fragmentation patterns are
      different indicating a less stable N-terminal lobe for CaBP. Brief heating
      abolishes these special properties of the CaBP. Mass spectrometry in aqueous
      buffer showed no evidence for the presence of any covalent or non-covalently
      bound adduct. The only remaining conclusion is that CaBP is calmodulin locked in
      a metastable altered state.

PMID- 11206133
TI  - Myostatin levels in regenerating rat muscles and in myogenic cell cultures.
AB  - Myostatin is a newly described member of the TGF-beta superfamily acting as a
      secreted negative regulator of skeletal muscle mass in several species, but whose
      mode of action remains largely unknown. In the present work, we followed the
      myostatin mRNA and protein levels in rat soleus and extensor digitorum longus
      (EDL) muscles regenerating in vivo from notexin-induced necrosis, and the
      myostatin transcript levels in two different in vitro myogenic differentiation
      models: i.e. in mouse BC3H1 and C2Cl2 cultured cells. The in vivo regenerating
      rat skeletal muscles showed a characteristic time-dependent expression of
      myostatin mRNA. After notexin injection, the transcript levels dropped below the
      detection limit on day 1 in soleus and close to the detection limit on day 3 in
      EDL, then increased to a maximum on day 7 in soleus and after 28 days finally
      reached the control values in both types of muscles. In contrast, the myostatin
      protein levels increased dramatically on the first days of regeneration in both
      muscles, i.e. at the time when its transcript level was low. Later on the
      myostatin protein level gradually declined to normal in soleus while in EDL it
      stayed high some days longer and decreased to normal on days 21-28. In vitro
      proliferating myoblasts produced low level of myostatin mRNA, which increased
      upon induction of differentiation suggesting that functional innervation is no
      prerequisite for myostatin expression. Myostatin production in vitro seems not to
      be dependent on myocyte fusion either, since it is observed in differentiated
      BC3H1 cells, which are defective in myofiber formation.

PMID- 11206134
TI  - Sarcomere length changes during end-held (isometric) contractions in intact
      mammalian (rat) fast and slow muscle fibres.
AB  - The sarcomere length change, within a 2 mm region, during end-held isometric
      contractions in intact rat fast and slow muscle fibre bundles was investigated at
      20 degrees C and an initial sarcomere length of 2.68 microm using He-Ne laser
      diffraction. In some experiments, the fibre segment displacement was monitored
      with markers (pieces of human hair) placed at regular intervals on the surface of
      the muscle fibre bundles. The sarcomere length changes, monitored near the
      proximal end of the bundle (transducer end), during tetanic contractions were
      similar to those previously reported in frog muscle fibres. Thus, throughout the
      tension plateau, sarcomere length remained constant (and shortened) but showed
      evidence of non-uniform sarcomere behaviour (further shortening) during the rapid
      tension relaxation phase. Such non-uniform behaviour was not seen during twitch
      contractions. During a twitch contraction, sarcomeres at the proximal end
      shortened rapidly at first and continued to shorten--or remained shortened--until
      the tension had relaxed to between 20-23% of its peak value before lengthening
      back to the original length. The maximum twitch sarcomere shortening (mean +/-
      SEM) was 5.9 +/- 0.2% (n = 16) in fast and 5.4 +/- 0.3% (n = 14) in slow fibre
      bundles at 20 degrees C; sarcomere shortening near body temperature
      (approximately 35 degrees C) was greater, 8.8 +/- 0.2% (n = 7) in fast and 8.1 +/
      0.2% (n = 5) in slow fibre bundles. Increasing the initial sarcomere length of a
      preparation decreased the extent of sarcomere shortening and reducing the amount
      of sarcomere shortening, by sarcomere length clamping, markedly increased the
      peak twitch tension without significantly altering the twitch time course. When
      examined at different positions along muscle fibres, a sarcomere shortening was
      observed along much of the fibre length in most preparations. However, in about a
      third of the preparations some sarcomere lengthening was recorded in the distal
      end, but its amplitude was too small to accommodate the fibre shortening
      elsewhere. Complementary data were obtained using the surface marker technique.
      The displacement was largest and in opposite--but fibre shortening--direction in
      the markers placed approximately 0.5-1.0 mm away from the two tendon attachments;
      the markers placed at or near the centre of the fibre bundle showed the least
      amount of displacement. The findings suggest that the compliant region, where
      lengthening occurs, is at fibre ends, i.e. near myotendinous junction.

PMID- 11206135
TI  - p0071, a member of the armadillo multigene family, is a constituent of sarcomeric
      I-bands in human skeletal muscle.
AB  - p0071 is a member of the armadillo gene family that is expressed in a wide
      variety of mammalian tissues and cell types with a prominent cell-cell contact
      association in epithelial cells. Here, we report the expression and localization
      patterns of p0071 in differentiating human skeletal muscle cells and in normal
      and diseased human skeletal muscle tissues. Northern blots revealed expression of
      p0071 mRNA in adult skeletal muscle tissue. RT-PCR analysis and Western blotting
      experiments identified two differentially spliced isoforms of p0071. The balance
      between these isoforms shifted during in vitro differentiation of isolated muscle
      cells from predominant expression of the short variant to a preponderance of the
      larger variant from day 6 onwards. Immunolocalization studies in mature skeletal
      muscle tissue revealed that p0071 is a constituent of myofibrils with a distinct
      localization at the level of sarcomeric N2-lines. During myofibrillogenesis,
      p0071 was not detected in non-striated nascent myofibrils, but became apparent
      shortly after the development of compact Z-discs in early myotubes. Furthermore,
      we studied the expression of p0071 in a wide variety of neuromuscular disorders
      by indirect immunofluorescence. Here, the myofibrillar staining of p0071 was
      preserved in all the disease entities included in our study. Our results provide
      the first evidence that a member of the armadillo multigene family is a
      constituent of the contractile apparatus in human skeletal muscle. The
      localization of p0071 at the level of I-bands and the timepoint of its
      integration into developing myofibrils suggest a possible role in the
      organization of thin filaments.

PMID- 11206136
TI  - Proximo-distal organization and fibre type regionalization in rat hindlimb
      muscles.
AB  - Five muscles of the rat's lower hindlimb were compared with regard to their
      histochemical fibre type distribution at seven different proximo-distal levels.
      The muscles were: extensor digitorum longus (ED), flexor digitorum and hallucis
      longus (FD), gastrocnemius medialis (GM), peroneus longus (PE) and tibialis
      anterior (TA). In all the five muscles, the relative density of the 'slow' type I
      fibres showed a striking and similar decrease from proximal toward more distal
      levels. In addition, the type I fibres were concentrated within smaller and more
      eccentrically placed regions at distal than at more proximal levels. As a
      background for the further analysis of these lengthwise aspects of type I fibre
      regionalization, architectural features of the muscles were determined. Pinnation
      angles and the position of major tendons and tendon sheets were assessed in fresh
      specimens. Muscle fibre lengths were measured for single fibres dissected from
      different regions of macerated muscles. In all cases, fibre length was much
      shorter than muscle length (mean fraction ranging from 21 to 55%), implying that
      the proximo-distal changes in histochemical fibre properties were indeed
      explainable as being due to gradual lengthwise changes in fibre type populations.
      The similarity of these lengthwise changes across the muscles was in contrast to
      their differences in other aspects of functional organization, such as the
      average density of type I fibres and architectural features determining their
      relative capacities for shortening and force generation. The possible functional
      role of the proximal accumulation of type I fibres was discussed in relation to
      circulation and thermal balance; besides, the proximo-distal regionalization of
      type I fibres might (partly) reflect processes that had been associated with
      early stages of muscle differentiation. Furthermore, the results underline that,
      when determining the fibre type composition of rat hindlimb muscles, identifying
      the proximo-distal level of sampling is a matter of great importance.

PMID- 11206137
TI  - Translation is regulated via the 3' untranslated region of alpha-myosin heavy
      chain mRNA by calcium but not by its localization.
AB  - Posttranscriptional regulation plays an important role in alpha-myosin heavy
      chain (alpha-MyHC) protein synthesis in cardiac muscle cells. In the present
      study, we test the effects of calcium and mRNA mislocalization on alpha-MyHC
      translation in order to determine the mechanism(s) contributing to translational
      block via the 3' untranslated region (3'UTR). Neonatal rat cardiac myocytes were
      treated for 6 h with L-isoproterenol (10 microM) to enhance beating, with 10
      microM verapamil to block beating and mislocalize mRNA, or with 3 microM
      colchicine to enhance beating but mislocalize mRNA by depolymerization of the
      microtubules. In order to determine whether translation is regulated by the
      3'UTR, either a control (SV40 3'UTR) or the experimental (alpha-MyHC 3'UTR) was
      placed after a luciferase reporter gene and transfected into the myocytes. The
      amount of luciferase protein only decreased significantly in verapamil arrested
      cells transfected with the alpha-MyHC 3'UTR construct (P < 0.01). To control for
      the possibility that pharmacological treatments might affect transcription or
      message stability, we analyzed neomycin and luciferase mRNA levels transcribed
      from the same transfected plasmid. No significant changes were found with an
      RNase protection assay. These results suggest that calcium but not mRNA
      localization regulates protein synthesis and further, this is mediated by the 3'
      untranslated region of alpha-MyHC.

PMID- 11206138
TI  - Perturbation theory applied to sound propagation in flowing media confined by a
      cylindrical waveguide.
AB  - First-order perturbation theory is employed to examine sound propagation in
      flowing media confined by a cylindrical waveguide. The use of perturbation theory
      allows examination of mode phase-speed changes due to any radially dependent flow
      w(r) as long as the flow magnitude is sufficiently small. The condition to be
      fulfilled is satisfied in the flow range: 0-0.3 m/s for the specific values of
      cylinder radius, ultrasound frequency, and sound speed analyzed in the present
      work [in the general case, however, the condition in Eq. (1) of the present work
      must be fulfilled]. This freedom of choice, i.e., the possibility to handle any
      radial flow profile, is used to analyze two flow profile cases: (1) where w(r) is
      a linear combination of a laminar flow profile and a flat profile corresponding
      to turbulent flow, and (2) where w(r) is a linear combination of a laminar flow
      profile and a more realistic logarithmic-dependent turbulent flow profile. In
      both cases, it is shown that large errors may result in ultrasound flow
      measurements if several modes are excited by the transmitting transducer, and
      that a logarithmic flow profile in the turbulent regime leads to somewhat larger
      measurement errors at high flow values as compared to assuming a simple flat
      profile in the turbulent regime.

PMID- 11206150
TI  - Isolating the auditory system from acoustic noise during functional magnetic
      resonance imaging: examination of noise conduction through the ear canal, head,
      and body.
AB  - Approaches were examined for reducing acoustic noise levels heard by subjects
      during functional magnetic resonance imaging (fMRI), a technique for localizing
      brain activation in humans. Specifically, it was examined whether a device for
      isolating the head and ear canal from sound (a "helmet") could add to the
      isolation provided by conventional hearing protection devices (i.e., earmuffs and
      earplugs). Both subjective attenuation (the difference in hearing threshold with
      versus without isolation devices in place) and objective attenuation (difference
      in ear-canal sound pressure) were measured. In the frequency range of the most
      intense fMRI noise (1-1.4 kHz), a helmet, earmuffs, and earplugs used together
      attenuated perceived sound by 55-63 dB, whereas the attenuation provided by the
      conventional devices alone was substantially less: 30-37 dB for earmuffs, 25-28
      dB for earplugs, and 39-41 dB for earmuffs and earplugs used together. The data
      enabled the clarification of the relative importance of ear canal, head, and body
      conduction routes to the cochlea under different conditions: At low frequencies
      (< or =500 Hz), the ear canal was the dominant route of sound conduction to the
      cochlea for all of the device combinations considered. At higher frequencies
      (>500 Hz), the ear canal was the dominant route when either earmuffs or earplugs
      were worn. However, the dominant route of sound conduction was through the head
      when both earmuffs and earplugs were worn, through both ear canal and body when a
      helmet and earmuffs were worn, and through the body when a helmet, earmuffs, and
      earplugs were worn. It is estimated that a helmet, earmuffs, and earplugs
      together will reduce the most intense fMRI noise levels experienced by a subject
      to 60-65 dB SPL. Even greater reductions in noise should be achievable by
      isolating the body from the surrounding noise field.

PMID- 11206151
TI  - Active noise control in a free field with virtual sensors.
AB  - The zone of local control around a "virtual energy density sensor" is compared
      with that offered by an actual energy density sensor, a single microphone, and a
      virtual microphone. Intended as an introduction to the concept of forward
      difference prediction and a precursor to evaluating the virtual sensor control
      algorithms in damped enclosures, this paper investigates an idealized scenario of
      a single primary sound source in a free-field environment. An analytical model is
      used to predict the performance of the virtual error sensors and compare their
      control performance with their physical counterparts. The model is then
      experimentally validated. The model shows that in general the virtual energy
      density sensor outperforms the actual energy density sensor, the actual
      microphone, and the virtual microphone in terms of centering a practically sized
      zone of local control around an observer who is remotely located from any
      physical sensors. However, in practice, the virtual sensor algorithms are shown
      to be sensitive (by varying degrees) to short wavelength spatial pressure
      variations of the primary and secondary sound fields.

PMID- 11206152
TI  - On the annoyance caused by impulse sounds produced by small, medium-large, and
      large firearms.
AB  - A laboratory study was designed in which the annoyance was investigated for 14
      different impulse sound types produced by various firearms ranging in caliber
      from 7.62 to 155 mm. Sixteen subjects rated the annoyance for the simulated
      conditions of (1) being outdoors, and (2) being indoors with the windows closed.
      In the latter case, a representative outdoor-to-indoor reduction in sound level
      was applied. It was anticipated that the presumed additional annoyance caused by
      the "heaviness" of the impulse sounds might be predicted from the difference
      between the C-weighted sound exposure level (CSEL; LCE) and the A-weighted sound
      exposure level (ASEL; LAE). In the outdoor rating conditions, the annoyance was
      almost entirely determined by ASEL. The explained variance, r2, in the mean
      ratings by ASEL was 0.95. In the indoor rating conditions, however, the explained
      variance in the annoyance ratings by (outdoor) ASEL was significantly increased
      from r2 = 0.87 to r2= 0.97 by adding the product (LCE-LAE)(LAE-alpha) as a second
      variable. In combination with a 12-dB adjustment for small firearms, the present
      results showed that for the entire set of impulse sounds rated indoors with
      windows closed, the rating sound level, Lr, is given by Lr=LAE +12dB+beta(LCE
      LAE)(LAE-alpha), with alpha=45dB and beta=0.015dB(-1). For the outdoor rating
      condition, the optimal parameter values were equal to alpha=57 dB and, again,
      beta=0.015 dB(-1). In validation studies, in which the effects of the present
      rating procedure will be compared to field data, it has to be determined to what
      extent the constants alpha and beta have to be adjusted.

PMID- 11206153
TI  - Enhancing maximum measurable sound reduction index using sound intensity method
      and strong receiving room absorption.
AB  - The sound intensity method is usually recommended instead of the pressure method
      in the presence of strong flanking transmission. Especially when small and/or
      heavy specimens are tested, the flanking often causes problems in laboratories
      practicing only the pressure method. The purpose of this study was to determine
      experimentally the difference between the maximum sound reduction indices
      obtained by the intensity method, RI,max, and by the pressure method, Rmax. In
      addition, the influence of adding room absorption to the receiving room was
      studied. The experiments were carried out in an ordinary two-room test
      laboratory. The exact value of RI,max was estimated by applying a fitting
      equation to the measured data points. The fitting equation involved the
      dependence of the pressure-intensity indicator on measured acoustical parameters.
      In an empty receiving room, the difference between RI,max and Rmax was 4-15 dB,
      depending on frequency. When the average reverberation time was reduced from 3.5
      to 0.6 s, the values of RI,max increased by 2-10 dB compared to the results in
      the empty room. Thus, it is possible to measure wall structures having 9-22 dB
      better sound reduction index using the intensity method than with the pressure
      method. This facilitates the measurements of small and/or heavy specimens in the
      presence of flanking. Moreover, when new laboratories are designed, the intensity
      method is an alternative to the pressure method which presupposes expensive
      isolation structures between the rooms.

PMID- 11206154
TI  - The prediction of speech intelligibility in underground stations of rectangular
      cross section.
AB  - Long enclosures are spaces with nondiffuse sound fields, for which the classical
      theory of acoustics is not appropriate. Thus, the modeling of the sound field in
      a long enclosure is very different from the prediction of the behavior of sound
      in a diffuse space. Ray-tracing computer models have been developed for the
      prediction of the sound field in long enclosures, with particular reference to
      spaces such as underground stations which are generally long spaces of
      rectangular or curved cross section. This paper describes the development of a
      model for use in underground stations of rectangular cross section. The model
      predicts the sound-pressure level, early decay time, clarity index, and
      definition at receiver points along the enclosure. The model also calculates the
      value of the speech transmission index at individual points. Measurements of all
      parameters have been made in a station of rectangular cross section, and compared
      with the predicted values. The predictions of all parameters show good agreement
      with measurements at all frequencies, particularly in the far field of the sound
      source, and the trends in the behavior of the parameters along the enclosure have
      been correctly predicted.

PMID- 11206157
TI  - The short-wave model and waves in two directions.
AB  - In the region where a sinusoidal wave in the cochlea reaches its maximum
      amplitude, the long-wave (or one-dimensional) model of the cochlea is deficient.
      In this region a short-wave model is more appropriate. However, in its current
      form, the short-wave model supports only waves in one direction. Therefore, it
      cannot cope with reflection effects associated with, e.g., inhomogeneities.
      Theoretical explorations of creation and internal reflection of otoacoustic
      emissions have almost exclusively been based on the long-wave model. In this
      article the road is paved for future explorations on a generalized form of the
      short-wave model, one that supports forward as well as backward waves, and thus
      can include internal reflections.

PMID- 11206156
TI  - Data processing options and response scoring for OAE-based newborn hearing
      screening.
AB  - Scoring of click-evoked otoacoustic emissions (CEOAEs) is typically achieved by
      the evaluation of the reproducibility of the whole emission and/or within narrow
      bands. Screening outcomes are influenced not only by the specific combination of
      the subdivision scheme (i.e., the number, position, and bandwidth of the narrow
      bands) and the threshold used to determine pass and refer, but also by the
      accuracy with which the reproducibility is estimated. This study was designed to
      examine what factors affect the accuracy of the reproducibility estimate and how
      the accuracy of the reproducibility estimate together with the choice of the
      subdivision scheme/thresholds affect CEOAE scoring. Simulations with real CEOAEs
      corrupted with synthesized noise indicated that the reproducibility estimate is
      influenced by time-windowing and band-pass filtering: the longer the time-window
      or the broader the bandwidth of the filter, the more accurate the estimate.
      Quantitative figures on numerical scoring were given in terms of the referral
      rate and were derived from CEOAEs recorded in a clinical environment from more
      than 3400 newborns. The narrow bands were extracted according to 12 different
      subdivision schemes covering the 1.5-4-kHz range. The referral rate was found to
      depend on the subdivision scheme being used: (i) the worst results were obtained
      considering four narrow bands at 1.6-2.4-3.2-4 kHz; (ii) the best results were
      obtained considering two narrow bands at 2.25 and 3.75 kHz; (iii) bandwidths
      greater than 1 kHz resulted in the lowest referral rates. Also, scoring based on
      the extraction of four narrow bands produced the most unstable results, i.e., a
      small change in the threshold might cause even a great change in the referral
      rate.

PMID- 11206158
TI  - Binaural coherence edge pitch.
AB  - The binaural coherence edge pitch (BICEP) is a dichotic broadband noise pitch
      effect similar to the binaural edge pitch (BEP). The BICEP stimulus is made by
      summing spectrally dense sine wave components with random phases. The interaural
      phase angle is a constant (0 or pi) for components with frequencies below (or
      above) a chosen edge frequency, and it is a random variable for the remaining
      components. The chosen edge frequency is a coherence edge because the noises to
      the two ears are mutually coherent within any band of frequencies on one side of
      the edge and they are mutually incoherent in any band on the other side. Pitch
      matching experiments show that the BICEP exists for coherence edge frequencies
      between about 300 and 1000 Hz. It is matched by a pure-tone frequency that
      differs from the edge frequency by 5% to 10%. The matching frequency lies on the
      incoherent side of the edge, an important result that is consistent with the way
      that the equalization-cancellation model has been applied to binaural pitch
      effects, especially the BEP. The results of BICEP experiments depend upon whether
      the coherent components are presented in 0 or pi interaural phase for some
      listeners but not for all. The BICEP persists if the noise to one of the ears is
      delayed, but it becomes weaker and less well matched as the delay increases
      beyond 2 ms. The BICEP does not depend on whether the component amplitudes are
      all created equal or are given a Rayleigh distribution. Some reliable pitch
      sensation exists even when the component amplitudes are entirely independent in
      the two ears, so long as the phase coherence conditions of the BICEP stimulus are
      maintained. The existence of the BICEP is a challenge for current models of
      dichotic pitch because none of them predicts all its features.

PMID- 11206159
TI  - A masking level difference due to harmonicity.
AB  - The role of harmonicity in masking was studied by comparing the effect of
      harmonic and inharmonic maskers on the masked thresholds of noise probes using a
      three-alternative, forced-choice method. Harmonic maskers were created by
      selecting sets of partials from a harmonic series with an 88-Hz fundamental and
      45 consecutive partials. Inharmonic maskers differed in that the partial
      frequencies were perturbed to nearby values that were not integer multiples of
      the fundamental frequency. Average simultaneous-masked thresholds were as much as
      10 dB lower with the harmonic masker than with the inharmonic masker, and this
      difference was unaffected by masker level. It was reduced or eliminated when the
      harmonic partials were separated by more than 176 Hz, suggesting that the effect
      is related to the extent to which the harmonics are resolved by auditory filters.
      The threshold difference was not observed in a forward-masking experiment.
      Finally, an across-channel mechanism was implicated when the threshold difference
      was found between a harmonic masker flanked by harmonic bands and a harmonic
      masker flanked by inharmonic bands. A model developed to explain the observed
      difference recognizes that an auditory filter output envelope is modulated when
      the filter passes two or more sinusoids, and that the modulation rate depends on
      the differences among the input frequencies. For a harmonic masker, the frequency
      differences of adjacent partials are identical, and all auditory filters have the
      same dominant modulation rate. For an inharmonic masker, however, the frequency
      differences are not constant and the envelope modulation rate varies across
      filters. The model proposes that a lower variability facilitates detection of a
      probe-induced change in the variability, thus accounting for the masked threshold
      difference. The model was supported by significantly improved predictions of
      observed thresholds when the predictor variables included envelope modulation
      rate variance measured using simulated auditory filters.

PMID- 11206160
TI  - Manipulating the "straightness" and "curvature" of patterns of interaural cross
      correlation affects listeners' sensitivity to changes in interaural delay.
AB  - The purpose of this study was to test the hypothesis that stimuli characterized
      by "straight" trajectories of their patterns of cross correlation foster greater
      sensitivity to changes in interaural temporal disparities (ITDs) than do stimuli
      characterized by more "curved" trajectories of their patterns of cross
      correlation. To do so, sensitivity to changes in ITD was measured, as a function
      of duration, using a set of "reference" stimuli that yielded differing relative
      amounts of straightness within their patterns of cross correlation while keeping
      the dominant trajectory at or near midline. The relative amounts of straightness
      were manipulated by employing specific combinations of bandwidth, ITD, and
      interaural phase disparity (IPD) of Gaussian noises centered at 500 Hz. The
      results were consistent with expectations in that the patterning of the threshold
      ITDs revealed increasingly poorer sensitivity as greater and greater curvature
      was imposed on the dominant, "midline," trajectory. The variations in threshold
      ITD across the stimulus conditions can be accounted for quite well quantitatively
      by assuming either that the listeners based their judgments on changes in the
      position of the most central peak of the cross-correlation function or that they
      based their judgments on changes in the centroid of a second-level cross
      correlation function. In a second experiment, binaural detection was measured
      using a subset of the reference stimuli as maskers. As expected, sensitivity was
      poorest with the maskers characterized by the greatest curvature, which were also
      those having the lowest interaural correlation.

PMID- 11206162
TI  - The influence of interaural stimulus uncertainty on binaural signal detection.
AB  - This paper investigated the influence of stimulus uncertainty in binaural
      detection experiments and the predictions of several binaural models for such
      conditions. Masked thresholds of a 500-Hz sinusoid were measured in an NrhoSpi
      condition for both running and frozen-noise maskers using a three interval,
      forced-choice (3IFC) procedure. The nominal masker correlation varied between
      0.64 and 1, and the bandwidth of the masker was either 10, 100, or 1,000 Hz. The
      running-noise thresholds were expected to be higher than the frozen-noise
      thresholds because of stimulus uncertainty in the running-noise conditions. For
      an interaural correlation close to +1, no difference between frozen-noise and
      running-noise thresholds was expected for all values of the masker bandwidth.
      These expectations were supported by the experimental data: for interaural
      correlations less than 1.0, substantial differences between frozen and running
      noise conditions were observed for bandwidths of 10 and 100 Hz. Two additional
      conditions were tested to further investigate the influence of stimulus
      uncertainty. In the first condition a different masker sample was chosen on each
      trial, but the correlation of the masker was forced to a fixed value. In the
      second condition one of two independent frozen-noise maskers was randomly chosen
      on each trial. Results from these experiments emphasized the influence of
      stimulus uncertainty in binaural detection tasks: if the degree of uncertainty in
      binaural cues was reduced, thresholds decreased towards thresholds in the
      conditions without any stimulus uncertainty. In the analysis of the data,
      stimulus uncertainty was expressed in terms of three theories of binaural
      processing: the interaural correlation, the EC theory, and a model based on the
      processing of interaural intensity differences (IIDs) and interaural time
      differences (ITDs). This analysis revealed that none of the theories tested could
      quantitatively account for the observed thresholds. In addition, it was found
      that, in conditions with stimulus uncertainty, predictions based on correlation
      differ from those based on the EC theory.

PMID- 11206163
TI  - Investigation of the relationship among three common measures of precedence:
      fusion, localization dominance, and discrimination suppression.
AB  - Listeners have a remarkable ability to localize and identify sound sources in
      reverberant environments. The term "precedence effect" (PE; also known as the
      "Haas effect," "law of the first wavefront," and "echo suppression") refers to a
      group of auditory phenomena that is thought to be related to this ability.
      Traditionally, three measures have been used to quantify the PE: (1) Fusion: at
      short delays (1-5 ms for clicks) the lead and lag perceptually fuse into one
      auditory event; (2) Localization dominance: the perceived location of the leading
      source dominates that of the lagging source; and (3) Discrimination suppression:
      at short delays, changes in the location or interaural parameters of the lag are
      difficult to discriminate compared with changes in characteristics of the lead.
      Little is known about the relation among these aspects of the PE, since they are
      rarely studied in the same listeners. In the present study, extensive
      measurements of these phenomena were made for six normal-hearing listeners using
      1-ms noise bursts. The results suggest that, for clicks, fusion lasts 1-5 ms; by
      5 ms most listeners hear two sounds on a majority of trials. However,
      localization dominance and discrimination suppression remain potent for delays of
      10 ms or longer. Results are consistent with a simple model in which information
      from the lead and lag interacts perceptually and in which the strength of this
      interaction decreases with spatiotemporal separation of the lead and lag. At
      short delays, lead and lag both contribute to spatial perception, but the lead
      dominates (to the extent that only one position is ever heard). At the longest
      delays tested, two distinct sounds are perceived (as measured in a fusion task),
      but they are not always heard at independent spatial locations (as measured in a
      localization dominance task). These results suggest that directional cues from
      the lag are not necessarily salient for all conditions in which the lag is
      subjectively heard as a separate event.

PMID- 11206164
TI  - Channel weights for speech recognition in cochlear implant users.
AB  - The purpose of this study was to develop and validate a method of estimating the
      relative "weight" that a multichannel cochlear implant user places on individual
      channels, indicating its contribution to overall speech recognition. The
      correlational method as applied to speech recognition was used both with normal
      hearing listeners and with cochlear implant users fitted with six-channel speech
      processors. Speech was divided into frequency bands corresponding to the bands of
      the processor and a randomly chosen level of corresponding filtered noise was
      added to each channel on each trial. Channels in which the signal-to-noise ratio
      was more highly correlated with performance have higher weights, and conversely,
      channels in which the correlations were smaller have lower weights. Normal
      hearing listeners showed approximately equal weights across frequency bands. In
      contrast, cochlear implant users showed unequal weighting across bands, and
      varied from individual to individual with some channels apparently not
      contributing significantly to speech recognition. To validate these channel
      weights, individual channels were removed and speech recognition in quiet was
      tested. A strong correlation was found between the relative weight of the channel
      removed and the decrease in speech recognition, thus providing support for use of
      the correlational method for cochlear implant users.

PMID- 11206165
TI  - Room reverberation effects in hearing aid feedback cancellation.
AB  - Room reverberation can affect feedback cancellation in hearing aids, with the
      strength of the effects depending on the acoustical conditions. These effects
      were studied using a behind the ear (BTE) hearing aid mounted on a dummy head and
      coupled to the ear canal via an open fitting. The hearing aid impulse response
      was measured for the dummy head placed at eight closely spaced locations in a
      typical office. The feedback cancellation in the hearing aid used a set of filter
      coefficients that were initialized for one location within the room, and then
      allowed to adapt to the feedback path measured at the same or to a different
      location. The maximum stable gain for the hearing aid was then estimated without
      feedback cancellation, for the initial set of feedback cancellation filter
      coefficients prior to adaptation, and for the feedback cancellation filter after
      adaptation. A low-order ARMA model combining a fixed set of poles with an
      adaptive FIR filter is shown to be effective in representing the feedback path
      exclusive of reverberation. Increasing the adaptive filter length has only a
      small benefit in improving the feedback cancellation performance due to the
      inability of the system to model the room reverberation. The mismatch between the
      modeled and actual feedback paths limits the headroom increase that can be
      achieved when using feedback cancellation, and varies with the location within
      the room.

PMID- 11206166
TI  - Recognition of time-distorted sentences by normal-hearing and cochlear-implant
      listeners.
AB  - This study evaluated the effects of time compression and expansion on sentence
      recognition by normal-hearing (NH) listeners and cochlear-implant (CI) recipients
      of the Nucleus-22 device. Sentence recognition was measured in five CI users
      using custom 4-channel continuous interleaved sampler (CIS) processors and five
      NH listeners using either 4-channel or 32-channel noise-band processors. For NH
      listeners, recognition was largely unaffected by time expansion, regardless of
      spectral resolution. However, recognition of time-compressed speech varied
      significantly with spectral resolution. When fine spectral resolution (32
      channels) was available, speech recognition was unaffected even when the duration
      of sentences was shortened to 40% of their original length (equivalent to a mean
      duration of 40 ms/phoneme). However, a mean duration of 60 ms/phoneme was
      required to achieve the same level of recognition when only coarse spectral
      resolution (4 channels) was available. Recognition patterns were highly variable
      across CI listeners. The best CI listener performed as well as NH subjects
      listening to corresponding spectral conditions; however, three out of five CI
      listeners performed significantly poorer in recognizing time-compressed speech.
      Further investigation revealed that these three poorer-performing CI users also
      had more difficulty with simple temporal gap-detection tasks. The results
      indicate that limited spectral resolution reduces the ability to recognize time
      compressed speech. Some CI listeners have more difficulty with time-compressed
      speech, as produced by rapid speakers, because of reduced spectral resolution and
      deficits in auditory temporal processing.

PMID- 11206167
TI  - Phonetically trained models for speaker recognition.
AB  - In this paper, a speaker recognition system that introduces acoustic information
      into a Gaussian mixture model (GMM)-based recognizer is presented. This is
      achieved by using a phonetic classifier during the training phase. The
      experimental results show that, while maintaining the recognition rate, the
      decrease in the computational load is between 65% and 80% depending on the number
      of mixtures of the models.

PMID- 11206168
TI  - A linear relation between the compressibility and density of blood.
AB  - By considering the blood as a mixture of ultrafiltrate and protein concentrate,
      the additive nature of compressibility and density from the components is
      utilized to deduce a linear relation between the compressibility and density for
      blood. This deduction also indicates that the intercept and slope of the linear
      relation are independent of the hematocrit, plasma protein concentration, and
      hemoglobin concentration of red blood cells. To verify experimentally this linear
      relation, saline and plasma dilutions on porcine or canine blood flowing in an
      extracorporeal circuit were carried out. The hematocrit of the experiments ranges
      from 0% to 55% and the plasma protein concentration ranges from 10 to 90 g/l. A
      resonance device in the circuit measured the density rhob of blood at 37 degrees
      C and an ultrasound system measured the sound velocity cb. The range of density
      is from 1,010 to 1,060 g/l and that of sound velocity is from 1,530 to 1,580 m/s.
      The linear relation that best fits the data of compressibility [computed as (rhob
      cb(2))-1] and density has a correlation coefficient of 0.9978. The linear
      relation is found to fit well the dependence of compressibility on density
      derived from the sound velocity data of human, horse, and porcine blood in the
      literature.

PMID- 11206170
TI  - Whistles of boto, Inia geoffrensis, and tucuxi, Sotalia fluviatilis.
AB  - Whistles were recorded and analyzed from free-ranging single or mixed species
      groups of boto and tucuxi in the Peruvian Amazon, with sonograms presented.
      Analysis revealed whistles recorded falling into two discrete groups: a low
      frequency group with maximum frequency below 5 kHz, and a high-frequency group
      with maximum frequencies above 8 kHz and usually above 10 kHz. Whistles in the
      two groups differed significantly in all five measured variables (beginning
      frequency, end frequency, minimum frequency, maximum frequency, and duration).
      Comparisons with published details of whistles by other platanistoid river
      dolphins and by oceanic dolphins suggest that the low-frequency whistles were
      produced by boto, the high-frequency whistles by tucuxi. Tape recordings obtained
      on three occasions when only one species was present tentatively support this
      conclusion, but it is emphasized that this is based on few data.

PMID- 11206174
TI  - Effects of flanking component spectral position and modulation pattern on
      thresholds for signals presented in the peaks of a modulated tonal masker.

PMID- 11206172
TI  - Sound localization in a new-world frugivorous bat, Artibeus jamaicensis: acuity,
      use of binaural cues, and relationship to vision.
AB  - Passive sound-localization acuity and its relationship to vision were determined
      for the echolocating Jamaican fruit bat (Artibeus jamaicensis). A conditioned
      avoidance procedure was used in which the animals drank fruit juice from a spout
      in the presence of sounds from their right, but suppressed their behavior,
      breaking contact with the spout, whenever a sound came from their left, thereby
      avoiding a mild shock. The mean minimum audible angle for three bats for a 100-ms
      noise burst was 10 degrees-marginally superior to the 11.6 degrees threshold for
      Egyptian fruit bats and the 14 degrees threshold for big brown bats. Jamaican
      fruit bats were also able to localize both low- and high-frequency pure tones,
      indicating that they can use both binaural phase- and intensity-difference cues
      to locus. Indeed, their ability to use the binaural phase cue extends up to 6.3
      kHz, the highest frequency so far for a mammal. The width of their field of best
      vision, defined anatomically as the width of the retinal area containing ganglion
      cell densities at least 75% of maximum, is 34 degrees. This value is consistent
      with the previously established relationship between vision and hearing
      indicating that, even in echolocating bats, the primary function of passive sound
      localization is to direct the eyes to sound sources.

PMID- 11206175
TI  - Sound source location by difference of phase, on a hydrophone array with small
      dimensions.

PMID- 11206176
TI  - A large-aperture array of nonlinked receivers for acoustic positioning of
      biological sound sources.

PMID- 11206182
TI  - Acoustic waveform inversion with application to seasonal snow covers.
AB  - The amplitude and waveform shape of atmospheric acoustic pulses propagating
      horizontally over a seasonal snow cover are profoundly changed by the air forced
      into the snow pores as the pulses move over the surface. This interaction greatly
      reduces the pulse amplitude and elongates the waveform compared to propagation
      above other ground surfaces. To investigate variations in snow-cover effects,
      acoustic pulses were recorded while propagating horizontally over 11 different
      naturally occurring snow covers during two winters. Two inversion procedures were
      developed to automatically match the observed waveforms by varying the snow-cover
      parameters in theoretical calculations. A simple frequency-domain technique to
      match the dominant frequency of the measured waveform suffered from multiple
      solutions and poor waveform matching, while a time-domain minimization method
      gave unique solutions and excellent waveform agreement. Results show that the
      effective flow resistivity and depth of the snow are the parameters controlling
      waveform shape, with the pore shape factor ratio of secondary importance.
      Inversion estimates gave flow resistivities ranging from 11 to 29 kN s m(-4),
      except for two late-season cases where values of 60 and 140 were determined
      (compared to 345 for the vegetation-covered site in the summer). Acoustically
      determined snow depths agreed with the measured values in all but one case, when
      the depth to a snow layer interface instead of the total snow depth was
      determined. Except for newly fallen snow, the pore shape factor ratio values
      clustered near two values that appear to correspond to wet (1.0) or dry (0.8)
      snow.

PMID- 11206183
TI  - Antagonistic effects of selective alpha1-adrenoceptor antagonists MDL73005EF and
      tamsulosin and partial agonists clonidine and tizanidine in rat thoracic aorta
      and rabbit iliac artery.
AB  - The antagonistic effects of MDL73005EF and tamsulosin and partial agonists
      clonidine and tizanidine at rat thoracic aorta and rabbit iliac artery alpha1
      adrenoceptors were investigated in this study. Selective alpha1-adrenoceptor
      antagonists MDL73005EF and tamsulosin dose-dependently shifted the concentration
      response curves for noradrenaline to the right. Schild plots of the results
      obtained from the inhibition by MDL73005EF (pA2 8.30 +/- 0.04) and tamsulosin
      (pA2 10.51 +/- 0.06) of noradrenaline yielded a straight line with a slope of
      unity in rat thoracic aorta. The slopes of Schild plots obtained from the
      inhibition by MDL73005EF and tamsulosin of noradrenaline were significantly
      different from unity in rabbit iliac artery. Schild plots of the results obtained
      from the inhibition by clonidine and tizanidine of noradrenaline yielded a
      straight line with a slope of unity in rat thoracic aorta (pA2 7.08 +/- 0.04 and
      7.32 +/- 0.04, respectively). These results suggest that alpha1D-adrenoceptors
      play a significant role in the alpha1-adrenoceptor-agonist-induced contraction of
      rat thoracic aorta and rabbit iliac artery, and that clonidine and tizanidine
      interact with the alpha1D-adrenoceptor subtype as competitive antagonists in rat
      thoracic aorta.

PMID- 11206184
TI  - Enhanced nasal retention of hydrophobically modified polyelectrolytes.
AB  - Hydrophobically modified polyelectrolytes (HMP) are polymers with a high content
      of ionizable groups bonded to hydrophobic groups. Copolymers of poly(acrylic
      acid) and Pluronic surfactants constitute a special class of HMP whereby
      poly(propylene oxide) segments act as hydrophobes. The poly(propylene oxide)
      segments possess temperature-dependent aqueous solubility and the solutions of
      the Pluronic-poly(acrylic acid) copolymers (MW > 3,000,000) undergo a sol-gel
      transition when kept at body temperature. Due to the presence of the poly(acrylic
      acid) segments, the Pluronic-poly(acrylic acid) copolymers are bioadhesive. We
      have examined the hypothesis that the in-situ gelling polymer formulations of
      Pluronic-poly(acrylic acid) copolymers may have an enhanced retention in the
      nasal cavity. The effects of putative bioadhesive (Carbomer 934P) and
      thermogelling (Pluronic F127) polymers on nasal clearance were compared with
      Pluronic-poly(acrylic acid) copolymers using a rat model. The enhancement of the
      residence time of fluorescent labels by the Pluronic-poly(acrylic acid)
      copolymers was shown to be 5-8-fold that of Carbomer, and 3-6-fold that of
      Pluronic F127. The results unequivocally demonstrate the superior retention of
      the HMP that combines bioadhesive and thermogelling capabilities over either a
      bioadhesive polyelectrolyte or a polymer of a low molecular weight that undergoes
      a sol-gel transition.

PMID- 11206185
TI  - Reduction of structural perturbations in bovine serum albumin by non-aqueous
      microencapsulation.
AB  - Protein stability is a factor limiting the use of sustained-release devices in
      medical applications. The aim of this study was to reduce structural
      perturbations occurring in the frequently used model protein, bovine serum
      albumin (BSA), upon microencapsulation in poly(D,L-lactide-co-glycolide) (PLG)
      microspheres. Spray freeze-dried BSA was encapsulated into PLG microspheres by a
      completely non-aqueous oil-in-oil encapsulation procedure. FTIR spectroscopy was
      used as a non-invasive method to quantify procedure-induced structural
      perturbations in BSA. Spray-freeze drying of BSA caused significant structural
      perturbations that were minimized by co-spray freeze-drying BSA with trehalose.
      BSA-containing microspheres were produced by suspension of the powder by
      homogenization in methylene chloride containing PLG, followed by formation of
      coacervate droplets by the addition of silicon oil and hardening using the
      solvent heptane. Resulting microspheres had dimensions of approximately 100
      microm and the encapsulation efficiency for BSA was > 90%. FTIR data showed that
      the structure of the BSA-trehalose formulation encapsulated into PLG microspheres
      was less perturbed than that of BSA obtained from buffer alone. The results
      demonstrate that the structure-guided encapsulation approach introduced for non
      aqueous casting encapsulation procedures can be extended to the non-aqueous
      production of pharmaceutically relevant PLG microspheres involving a complex
      encapsulation procedure.

PMID- 11206186
TI  - Biphasic effects of acetaldehyde-biogenic amine condensation products on membrane
      fluidity.
AB  - I have studied the effects of four acetaldehyde-biogenic amine condensation
      products on membrane fluidity of liposomes, consisting of 1-palmitoyl-2
      oleoylphosphatidylcholine and cholesterol, by measuring fluorescence polarization
      using different probes. The condensation products were 1-methyl-1,2,3,4
      tetrahydro-beta-carboline (MTBC), 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-beta
      carboline (6-OH-MTBC), 3-carboxy-1-methyl-1,2,3,4-tetrahydro-beta-carboline (3-C
      MTBC) and 6,7-dihydroxy-1-methyl-1,2,3,4-tetrahydroisoquinoline (salsolinol).
      They changed the fluidity of the hydrophobic and hydrophilic regions of liposomal
      membranes at micromolar levels almost corresponding to their antibacterial and
      antiplatelet concentrations, but their membrane effects varied by structure,
      concentration and membrane lipid composition. MTBC and salsolinol showed biphasic
      effects on the inner layers of membranes to enhance the fluidity at 250-1000
      microM and reduce the fluidity at 50-100 microM, whereas both of them fluidized
      the outer layers of the membranes. 3-C-MTBC concentration-dependently fluidized
      both layers of membranes. 6-OH-MTBC most weakly enhanced and reduced the fluidity
      of the outer and inner layers, respectively. The membrane effect of MTBC was the
      greatest of the four condensation products. MTBC (50-1000 nM) significantly
      reduced the fluidity by exclusively acting on the membrane core, but was less
      effective in fluidizing the membrane surface. However, the others were not active
      at low nanomolar levels. The membrane effects may be partly responsible for the
      antibacterial and antiplatelet actions of the acetaldehyde-biogenic amine
      condensation products, although they do not appear to be simple membrane
      fluidizers.

PMID- 11206187
TI  - Vancomycin resistance reversal in enterococci by flavonoids.
AB  - The development of clinical vancomycin-resistant strains of enterococci (VRE) is
      a major cause for concern. Here we show that a combination of galangin or 3,7
      dihydroxyflavone with vancomycin may be used to sensitize resistant strains of
      Enterococcus faecalis and Enterococcus faecium to the level of vancomycin
      sensitive strains. Minimum inhibitory concentrations (MICs) and viable counts
      were determined in Iso-sensitest broth using a microtitre method. MICs of
      vancomycin against 67% of resistant clinical isolates and a type strain of
      enterococci were lowered from > 250 microg mL(-1) to < 4 microg mL(-1) in the
      presence of galangin (12.5 microg mL(-1)) or 3,7-dihydroxyflavone (6.25 microg
      mL(-1)). Viable counts for type culture E. faecalis ATCC 51299 showed the
      flavonoids alone significantly lowered numbers of colony forming units (CFUs).
      CFUs were maintained at low levels (< 10(3) CFU mL(-1)) for 24 h by
      vancomycin/flavone combinations. This combinational action in reversing
      vancomycin resistance of enterococci highlights novel drug targets and has
      importance in the design of new therapeutic regimes against resistant pathogens.

PMID- 11206189
TI  - The biopharmaceutical aspects of nasal mucoadhesive drug delivery.
AB  - Nasal drug administration has frequently been proposed as the most feasible
      alternative to parenteral injections. This is due to the high permeability of the
      nasal epithelium, allowing a higher molecular mass cut-off at approximately 1000
      Da, and the rapid drug absorption rate with plasma drug profiles sometimes almost
      identical to those from intravenous injections. Despite the potential of nasal
      drug delivery, it has a number of limitations. In this review, the anatomy and
      physiology of the nasal cavity, as well as ciliary beating and mucociliary
      clearance as they relate to nasal drug absorption, are introduced. The rationale
      for nasal drug delivery and its limitations, some factors that influence nasal
      drug absorption, and the experimental models used in nasal drug delivery research
      are also reviewed. Nasal mucoadhesion as a promising method of nasal absorption
      enhancement is discussed, and factors that influence mucoadhesion, as well as
      safety of nasal mucoadhesive drug delivery systems are reviewed in detail. Nasal
      drug administration is presently mostly used for local therapies within the nasal
      cavity. Anti-allergic drugs and nasal decongestants are the most common examples.
      However, nasal drug administration for systemic effects has been practised since
      ancient times. Nasally-administered psychotropic drugs by native Americans, the
      use of tobacco snuffs, and nasal administration of illicit drugs such as cocaine
      are all well known (Illum & Davis 1992). Nowadays, the nasal cavity is being
      actively explored for systemic administration of other therapeutic agents,
      particularly peptides and proteins (Illum 1992; Edman & Bjork 1992), as well as
      for immunization purposes (Lemoine et al 1998). To better understand the basis
      for nasal drug absorption and factors that can influence it, a brief review of
      the anatomy and physiology of the nose is appropriate.

PMID- 11206188
TI  - Formulation and release characteristics of poly(lactic-co-glycolic acid)
      microspheres containing chemically modified protein.
AB  - Chemical modification of proteins may influence their formulation into and
      release from polymeric microspheres. Three chemical modifications of rat serum
      albumin (RSA) were effected on the amine groups of this protein: conjugation with
      a polyanion using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, intermolecular
      cross-linking using glutaraldehyde, and reductive alkylation using propyl
      aldehyde. The modified proteins had different physicochemical properties as well
      as improved encapsulation efficiencies compared with native RSA microspheres. The
      microspheres were incubated at 37 degrees C for over one month to investigate the
      influence of protein modification on the release profiles. Microsphere
      degradation accelerated from the ninth day of the release studies and this
      coincided with an increase in the release rates. The degradation rates of
      poly(lactic-co-glycolic acid) microspheres containing either native or cross
      linked RSA were more rapid than those containing either heparin conjugated or
      propylated RSA. This was in agreement with the release data, since the release of
      the native and cross-linked RSA were more rapid than those of the other modified
      proteins. The release profiles of the RSA-heparin conjugates and the propylated
      RSA were approximately zero rather than first order between the tenth and
      thirtieth day of study. Chemical modification of protein may be a useful method
      to increase encapsulation efficiency and to decrease release rates of proteins
      that are to be used in microsphere formulations of potent therapeutic proteins.

PMID- 11206190
TI  - Gastrointestinal transit of dosage forms in the pig.
AB  - The gastrointestinal transit of liquid, pellet and tablet formulations was
      measured under fasted conditions in the domestic pig (n = 4) using the technique
      of gamma scintigraphy. The mean times for 50% gastric emptying for liquid and
      pellet systems were 1.4 and 2.2 h, respectively; tablets emptied between 1.5 and
      6.0 h. Total transit times were in the order of 50 h. These data conform well to
      published values for the transit of liquid and solid food materials in the pig.
      The times are much shorter than those previously published for the transit of
      solid dosage forms in the pig. We conclude that the domestic pig would be a good
      model to study the gastrointestinal transit of pharmaceutical formulations and
      the absorption of drug compounds.

PMID- 11206191
TI  - An investigation into the thermal behaviour of an amorphous drug using low
      frequency dielectric spectroscopy and modulated temperature differential scanning
      calorimetry.
AB  - The objective of the study was to investigate the use of low frequency dielectric
      spectroscopy as a means of characterizing the thermal transitions of an amorphous
      drug substance, indometacin, with particular emphasis on modelling the response
      using the Dissado-Hill function. The low frequency dielectric behaviour of
      indometacin was measured over a temperature range of 10-160 degrees C and a
      frequency range of 10(-3)-10(6) Hz. Modulated temperature differential scanning
      calorimetry (MTDSC) studies were also performed on equivalent samples, showing a
      glass transition, recrystallization and melting. Isothermal low frequency
      dielectric spectra of the sample at temperatures below recrystallization showed
      the dynamic dielectric relaxation associated with the amorphous phase, while
      changes in the real and imaginary permittivities were observed that were
      associated with recrystallization and subsequent melting. A small discontinuity
      was observed immediately above the recrystallization process in the MTDSC and
      dielectric data, suggested to correspond to a solid state transformation. The use
      of the Dissado-Hill function as a means of modelling the dielectric behaviour has
      also been described. The study suggests that low frequency dielectric
      spectroscopy, used in conjunction with MTDSC and Dissado-Hill modelling, may be a
      useful tool for the characterization of amorphous and crystalline drugs.

PMID- 11206192
TI  - Effect of FITC-dextran molecular weight on its release from floating cetyl
      alcohol and HPMC tablets.
AB  - The release mechanism of high molecular weight fluorescein isothiocyanate
      dextrans (FITC-dextrans) from HPMC hydrogel matrices was studied. An anomaly was
      noted in the release behaviour of a series of high molecular weight FITC-dextrans
      from a tablet formulation designed to float in stomach contents. The tablets
      contained sodium bicarbonate and hydroxypropylmethyl cellulose (HPMC) in a cetyl
      alcohol matrix. When hydrated in an acid medium, this tablet consisted of a mixed
      solid with a viscous surface layer containing carbon dioxide bubbles through
      which the active ingredient (FITC-dextran) was released into the aqueous
      environment. However, it was observed that, above a critical molecular weight
      (approx. 65 kDa), the FITC-dextran was only released into the medium by an
      erosion-type mechanism, whereas, below this value, both diffusion and erosion
      processes took place. The key constraint appeared to be the apparent gel pore
      size of the hydrated HPMC that was approximately 12 nm in diameter, irrespective
      of the molecular weight of the HPMC samples evaluated. It was concluded that FITC
      dextran release was controlled by both FITC-dextran molecular weight and the HPMC
      hydrogel structure.

PMID- 11206193
TI  - Microparticulate uptake mechanisms of in-vitro cell culture models of the
      respiratory epithelium.
AB  - The objective of this study was to examine the uptake mechanisms of fluorescent
      polystyrene microspheres of various diameters and surface chemistry by two human
      cell lines derived from the respiratory epithelium, A549 and Calu-3. Briefly,
      A549 and Calu-3 cells were grown to confluence in 12-well cluster plates and the
      uptake of fluorescent microspheres by the cells was determined at various time
      points. The amount of microspheres internalized by the cells was determined by
      correcting for non-specific binding to the cell surface. The data showed that
      A549 cells appeared to have more phagocytic activity than Calu-3 cells. Albumin
      coated microspheres as large as 3 microm diameter can be internalized by A549
      cells. The amount of internalization by A549 cells observed for 0.5-microm
      diameter albumin-coated microspheres was approximately 10-times greater than that
      observed for 1-microm diameter spheres and approximately 100-times greater than
      values observed for 2- and 3-microm diameter beads. Transmission electron
      micrographs confirmed that the microspheres were internalized by the cells.
      Uptake experiments conducted with Calu-3 cells indicated that albumin-coated
      microspheres were neither bound nor internalized by the cells. The effect of
      microsphere surface chemistry on the uptake mechanism indicated that amidine
      microspheres were internalized more rapidly and to a greater extent by both A549
      and Calu-3 cells than carboxylate microspheres and non-coated microspheres. This
      phenomenon is thought to be attributed to masking of the negative polystyrene
      core by the positive amidine functional group; this effect was less marked for
      the carboxylate microspheres. These results suggest that A549 and Calu-3 cells
      can internalize microspheres and that size and effective charge played an
      important role in the uptake process.

PMID- 11206194
TI  - Pharmacokinetics and bioavailability of alpha-, gamma- and delta-tocotrienols
      under different food status.
AB  - We have investigated the pharmacokinetics and bioavailability of alpha-, gamma-
      and delta-tocotrienols under fed and fasted conditions in eight healthy
      volunteers. The volunteers were administered a single oral dose of mixed
      tocotrienols (300 mg) under fed or fasted conditions. The bioavailability of
      tocotrienols under the two conditions was compared using the parameters peak
      plasma concentration (Cmax), time to reach peak plasma concentration (Tmax) and
      total area under the plasma concentration-time curve (AUC(o-infinity)). A
      statistically significant difference was observed between the fed and fasted
      logarithmic transformed values of Cmax (P < 0.01) and AUC(0-infinity) (P < 0.01)
      for all three tocotrienols. In addition, the 90% confidence intervals for the
      ratio of the logarithmic transformed AUC(0-infinity) values of alpha-, gamma- and
      delta-tocotrienols under the fed state over those of the fasted state were found
      to lie between 2.24-3.40, 2.05-4.09 and 1.59-3.81, respectively, while those of
      the Cmax were between 2.28-4.39, 2.31-5.87 and 1.52-4.05, respectively. However,
      no statistically significant difference was observed between the fed and fasted
      Tmax values of the three homologues. The mean apparent elimination half-life
      (t(1/2)) of alpha-, gamma- and delta-tocotrienols was estimated to be 4.4, 4.3
      and 2.3 h, respectively, being between 4.5- to 8.7-fold shorter than that
      reported for alpha-tocopherol. No statistically significant difference was
      observed between the fed and fasted t(1/2) values. The mean apparent volume of
      distribution (Vd/f) values under the fed state were significantly smaller than
      those of the fasted state, which could be attributed to increased absorption of
      the tocotrienols in the fed state.

PMID- 11206195
TI  - Secretory transport of p-aminohippuric acid across intestinal epithelial cells in
      Caco-2 cells and isolated intestinal tissue.
AB  - The intestinal transport of an organic anion, p-aminohippuric acid (PAH), was
      studied in Caco-2 cell monolayers and rat intestinal tissue mounted in Ussing
      chambers. In both experimental methods, PAH exhibited vectorial transport with
      significantly greater permeability in the secretory direction than the absorptive
      direction, indicating net secretion. This secretory transport required metabolic
      energy, but protons or hydroxyl ions were not involved as the driving force. In
      Caco-2 monolayers, secretory transport of [3H]PAH was decreased, and the
      intracellular accumulation of PAH was increased with increasing concentration of
      unlabelled PAH at the basolateral side. Addition of probenecid and genistein at
      the basolateral side decreased the secretory transport of [3H]PAH; the
      accumulation was not changed by probenecid, but was increased by genistein. In
      addition, the initial uptake rate of [3H]PAH from the basolateral side was
      decreased by both PAH and probenecid, but not by genistein. Therefore, it is
      suggested that the transport of PAH in Caco-2 cells is regulated by several
      transporters: a genistein-sensitive transporter on the apical membrane and
      probenecid-sensitive transporters on both the basolateral and apical membranes.
      In rat intestinal tissues, the transport rate of PAH showed regional variation
      (ileum > jejunum > duodenum), suggesting that secretory transporters with high
      activity exist predominantly in the lower region of the small intestine. The
      results suggest that PAH transport in both Caco-2 cells and rat intestinal
      tissues is regulated by multiple transporters on the apical and basolateral
      membranes, and these transporters have different characteristics.

PMID- 11206196
TI  - Synthesis and in-vitro anticancer evaluation of bis-tacrine congeners.
AB  - In the search for potential new anticancer drugs, an efficient synthesis of bis
      tetrahydroaminoacridine (bis-tacrine) and its congeners was accomplished by bis
      amination of 9-chlorotetrahydroacridine and its congeners under heated
      conditions. The critical chlorides were efficiently prepared from o-aminoaromatic
      acids and cycloketones in-situ in the presence of phosphorus oxychloride. In
      vitro cytotoxic evaluation of the compounds was carried out against a panel of 60
      human cancer cell lines. Among them, butyl-linked bis-tacrine (5b) exhibited the
      strongest cytotoxic profile with GI50 (concentration causing 50% growth
      inhibition) values of approximately 0.04-0.08 microM against breast, colon,
      melanoma and non-small lung cancer cells. Congeners bearing a longer alkyl chain
      were on average 30- to 100-fold less cytotoxic against these cancer cells.
      Shorter connecting alkyl chains of bis-tacrine or its congeners dramatically
      decreased the cytotoxic effects. Compound 5b has been selected for further
      biological evaluation of its anticancer profile.

PMID- 11206197
TI  - Potential transition state phosphoramidate inhibitors of beta-tubulin as
      antifilarial agents.
AB  - Transition state phosphoramidate inhibitors of beta-tubulin were designed as
      potential antifilarial agents. The reaction of 2-aminobenzimidazole with
      diisopropyl phosphite and carbon tetrachloride at a low temperature gave the
      unexpected 1-diisopropoxyphosphoryl-2-aminobenzimidazole, which on heating gave
      the novel benzimidazole derivative, 2-(diisopropoxyphosphoryl)aminobenzimidazole.
      Both products were fully characterized and the synthetic procedure to both
      compounds was optimized. The procedure was used to prepare the related 5-benzoyl
      2-(diisopropoxyphosphoryl)aminobenzimidazole and 5-benzoyl-2
      (diethoxyphosphoryl)aminobenzimidazole (1d). In a preliminary trial against
      Brugia pahangi compound 1d was found to have no antifilarial activity. This lack
      of activity may be attributed to its extreme insolubility and thus low
      bioavailability. The synthesis of analogous, more soluble, phosphorothioate
      substituted benzimidazoles using the same methods may yield compounds with
      greater antifilarial activity.

PMID- 11206198
TI  - A near-infrared method for the assay of cineole in eucalyptus oil as an
      alternative to the official BP method.
AB  - Thirty different eucalyptus oil samples were scanned on the FOSS NIRSystems 6500
      Rapid Content Sampler using a reflectance vessel as sample presentation method.
      The cineole content of each sample was determined by the BP method and these
      reference data were used to construct two calibration equations for cineole
      content in the oils using Vision software. The mean accuracy for the NIR method
      differed by 1.01% or less, and the mean bias by +/-0.33% or less, compared with
      the BP method. Calculation of the 95% confidence intervals for the slope and
      intercept of plots of NIR predicted values against BP method reference values
      showed that there was no evidence of fixed or relative systematic errors. Tests
      for short-term and intermediate repeatability were conducted. The standard
      deviation was 0.83% w/w or less and the coefficient of variation was 1.11% or
      less. The confidence intervals for both short-term and intermediate repeatability
      overlapped with that for the BP method, suggesting that there was no evidence for
      a difference in values obtained by the BP and NIR methods. The range of cineole
      contents used in the calibrations was extended by incorporating five samples of
      eucalyptus oil spiked with cineole, and five samples of two essential oils known
      to have a lower cineole content than eucalyptus oil, to give a range of 52.5 to
      99.0% w/w. The mean accuracy decreased to an error of 1.26% or less and the bias
      to +/-0.50% or less. Again, confidence intervals suggested there was no evidence
      for fixed or systematic errors in the NIR calibrations. We propose that NIR
      spectroscopy could be used as an alternative method for the determination of
      cineole content in eucalyptus oils.

PMID- 11206199
TI  - Properties of inductive reasoning.
AB  - This paper reviews the main psychological phenomena of inductive reasoning,
      covering 25 years of experimental and model-based research, in particular
      addressing four questions. First, what makes a case or event generalizable to
      other cases? Second, what makes a set of cases generalizable? Third, what makes a
      property or predicate projectable? Fourth, how do psychological models of
      induction address these results? The key results in inductive reasoning are
      outlined, and several recent models, including a new Bayesian account, are
      evaluated with respect to these results. In addition, future directions for
      experimental and model-based work are proposed.

PMID- 11206200
TI  - Dual processes in recognition: does a focus on measurement operations provide a
      sufficient foundation?
AB  - Current theoretical thinking about dual processes in recognition relies heavily
      on the measurement operations embodied within the process dissociation procedure.
      We critically evaluate the ability of this procedure to support this theoretical
      enterprise. We show that there are alternative processes that would produce a
      rough invariance in familiarity (a key prediction of the dual-processing
      approach) and that the process dissociation procedure does not have the power to
      differentiate between these alternative possibilities. We also show that attempts
      to relate parameters estimated by the process dissociation procedure to
      subjective reports (remember-know judgments) cannot differentiate between
      alternative dual-processing models and that there are problems with some of the
      historical evidence and with obtaining converging evidence. Our conclusion is
      that more specific theories incorporating ideas about representation and process
      are required.

PMID- 11206201
TI  - The ties that bind what is known to the recall of what is new.
AB  - Cued recall success varies with what people know and with what they do during an
      episode. This paper focuses on prior knowledge and disentangles the relative
      effects of 10 features of words and their relationships on cued recall. Results
      are reported for correlational and multiple regression analyses of data obtained
      from free association norms and from 29 experiments. The 10 features were only
      weakly correlated with each other in the norms and, with notable exceptions, in
      the experiments. The regression analysis indicated that forward cue-to-target
      strength explained the most variance, followed by backward target-to-cue
      strength. Target connectivity and set size explained the next most variance,
      along with mediated cue-to-target strength. Finally, frequency, concreteness,
      shared associate strength, and cue set size also contributed significantly to
      recall. Taken together, indices of prior word knowledge explain 49% of the recall
      variance. Theoretically driven equations that use free association to predict
      cued recall were also evaluated. Each equation was designed to condense multiple
      indices of word interconnectivity into a single predictor.

PMID- 11206202
TI  - Semantic priming without association: a meta-analytic review.
AB  - A meta-analysis of 26 studies indicated that automatic semantic priming can occur
      without association. Priming did not vary substantially with differences in
      variables that affect automatic versus strategic processing, such as time spent
      processing the prime and target, relationship proportion, and task (except that
      average effects were smaller in the naming task). Although category coordinates
      were investigated in the majority of studies, synonyms, antonyms, and script
      relations also demonstrated priming; functional relations showed greater priming,
      and essential and perceptual relations showed less. The average effect size for
      semantic priming was smaller than that for associative priming, suggesting that
      there is an "associative boost" from adding an associative relationship to a
      semantic one. The implications of these findings for the modularity thesis and
      for models of semantic priming are discussed.

PMID- 11206203
TI  - Demonstration of a socially transmitted flavor aversion in rats? Kuan and Colwill
      (1997) revisited.
AB  - In each of three experiments that differed only in procedural detail, observer
      rats interacted with pairs of conspecific demonstrators, one fed a cocoa-flavored
      diet (Diet Coc) and the other a cinnamon-flavored diet (Diet Cin). Immediately
      after both members of a pair of demonstrators had been fed, and 5 min before they
      interacted with an observer or observers, one of the demonstrators was made ill
      by intraperitoneal injection with lithium chloride. After interacting with a pair
      of demonstrators for 15 min, each observer was allowed to choose between Diet Cin
      and Diet Coc for 22 h. In all three experiments, observer rats consumed as much
      Diet Cin after interacting simultaneously with both an ill demonstrator that had
      eaten Diet Cin and a healthy demonstrator that had eaten Diet Coc as after
      interacting simultaneously with both a healthy demonstrator that had eaten Diet
      Cin and an ill demonstrator that had eaten Diet Coc. These results raise
      questions about the generality of Kuan and Colwill's (1997) demonstration of
      socially transmitted flavor aversions in Norway rats.

PMID- 11206204
TI  - Blocking and backward blocking involve learned inattention.
AB  - Four experiments examine blocking of associative learning by human participants
      in a disease diagnosis procedure. The results indicate that after a cue is
      blocked, subsequent learning about the cue is attenuated. This attenuated
      learning after blocking is obtained for both standard blocking and for backward
      blocking. Attenuated learning after blocking cannot be accounted for by theories
      such as the Rescorla-Wagner model that rely on lack of learning about a redundant
      cue, nor can it be accounted for by extensions of the Rescorla-Wagner model
      designed to address backward blocking that encode absent cues with negative
      values. The results are predicted by the hypothesis that people learn not to
      attend to the blocked cue.

PMID- 11206205
TI  - Attentional requirements for object-location priming.
AB  - The purpose of the present experiments was to investigate whether a verbal and a
      spatial secondary task would disrupt priming for object-location associations.
      Symbols were placed one at a time in one of nine locations in a rectangle.
      Implicit memory was tested with a reaction time (RT) task. All symbols were
      placed in the same location of the rectangle across 10 trial blocks; then, all
      their locations were changed. Responses were made on the numeric keypad, which
      corresponded to the spatial locations used in the rectangle. A decrease in RTs
      across the first 10 trial blocks followed by an increase in RTs when the symbols
      changed locations would indicate priming for the associations. The results were
      that implicit memory for object-location associations was obtained under single-,
      but not under dual-task conditions. We have interpreted the results in terms of a
      working memory model that posits that implicit memory will suffer when cognitive
      resources are limited.

PMID- 11206207
TI  - Testing the counter model for perceptual identification: effects of repetition
      priming and word frequency.
AB  - The counter model for perceptual identification (Ratcliff & McKoon, 1997) differs
      from alternative views of word recognition in two important ways. First, it
      assumes that prior study of a word does not result in increased sensitivity but,
      rather, in bias. Second, the effects of word frequency and prior study are
      explained by different mechanisms. In the present experiment, study status and
      word frequency of target and foil were varied independently. Using a forced
      choice task, we replicated the bias effect. However, we also found several
      interactions between frequency and prior study that are in direct conflict with
      the counter model. Most important, prior study of both alternatives resulted in
      an attenuation of the frequency effect and an increase in performance for low
      frequency targets, but not for high-frequency targets. These findings suggest
      that the effects of frequency and prior study are not mediated by completely
      independent mechanisms.

PMID- 11206206
TI  - Mental rotation is suppressed during saccadic eye movements.
AB  - We examined whether mental rotation is suppressed during saccadic eye movements.
      Subjects judged whether a character was normal or mirror-reversed while making
      no, short, or long saccades. Reaction time was longer under saccade than under no
      saccade conditions and was longer when a long saccade rather than a short saccade
      was made, but only when the characters varied in orientation. These results
      indicate that mental rotation is suppressed during saccadic eye movements. The
      implications for theories of cognitive suppression during saccades are discussed.

PMID- 11206208
TI  - Repetition and form priming interact with neighborhood density at a brief
      stimulus onset asynchrony.
AB  - The relationships between repetition- and form-priming effects and neighborhood
      density were analyzed in two masked priming experiments with the lexical decision
      task. Given that form-priming effects appear to be influenced by a word's
      orthographic neighborhood, it is theoretically important to find out whether
      repetition priming also differs as a function of the word's orthographic
      neighborhood. Within an activation framework, repetition- and form-priming
      effects are just quantitatively different phenomena, whereas the two effects are
      qualitatively different in a serial-ordered model of lexical access (the entry
      opening model). The results show that repetition- and form-priming effects were
      stronger for hermit words than for words with many neighbors. These results pose
      some problems for both activation and serial-ordered models. The implications of
      these results for determining how neighbors affect the identification of a word
      are discussed.

PMID- 11206209
TI  - Stroop effect in words that differ from color words in one letter only.
AB  - In two experiments, participants named the color of a colored word, which was a
      Hebrew color word or a word in Hebrew that was different from a color word in one
      letter only. The magnitude of the Stroop effect increased with the location of
      the changed letter. It was smallest when the first letter of the color word was
      replaced, resulting in a noncolor word, and it was largest when the last letter
      was replaced. These results challenge the assumption that automatic reading, as
      indicated by the Stroop effect, can be explained exclusively by memory retrieval
      accounts of automaticity. The results also have implications for the sources of
      facilitation and inhibition in the Stroop effect.

PMID- 11206210
TI  - Estimating the frequency of nonevents: the role of recollection failure in false
      recognition.
AB  - Participants studied lists of multiply presented converging associates (e.g.,
      bed, dream, pillow, etc.) and were timed as they estimated how often they saw
      list items, related foils (e.g., blanket), and nonpresented critical items
      (SLEEP). Average number of repetitions (few [3] vs. many [6]) and repetition
      variability (fixed vs. variable) were manipulated between subjects. Participants
      responded more slowly to critical items (3.18 sec) than to list items (2.45 sec)
      or foils (2.22 sec). In addition, critical-item judgments of frequency (JOFs)
      were about as large as list-item JOFs, and false recognition (i.e., nonzero JOFs)
      of critical items was most likely in the few-fixed condition (96%) and least
      likely in the many-fixed condition (74%). These findings suggest that people can
      use recollection failure--the absence of an anticipated recollective experience,
      coupled with strong familiarity--to distinguish critical items from list items
      and that recollection failure is weighted most heavily when people expect
      familiar probes to access episodic information.

PMID- 11206211
TI  - Adults' strategy choices for simple addition: effects of retrieval interference.
AB  - Simple addition (e.g., 3 + 2, 7 + 9) may be performed by direct memory retrieval
      or by such procedures as counting or transformation. The distribution of
      associations (DOA) model of strategy choice (Siegler, 1988) predicts that
      procedure use should increase as retrieval interference increases. To test this,
      100 undergraduates performed simple addition problems, either after blocks of
      simple multiplication (high-interference context) or after blocks of simple
      division problems (low-interference context). Addition took longer and was more
      error prone after multiplication; in particular, there were more multiplication
      confusion errors on the relatively easy, small-number addition problems (e.g., 3
      + 2 = 6, 4 + 3 = 12), but not on the more difficult, large-number additions.
      Consistent with the DOA, participants reported greater use of procedures for
      addition after multiplication, but more so for small addition problems. The
      findings demonstrate that adults' use of procedural strategies for simple
      addition is substantially influenced by retrieval interference.

PMID- 11206212
TI  - Depictions of motion devised by a blind person.
AB  - A blind man (E.A.) was asked to draw pictures suggesting wheels in various kinds
      of motion. Six pictures were drawn by E.A. The pictures were shown to sighted
      subjects, who were asked to assign labels to the pictures, in a multiple-choice
      format. The labels were assigned at a rate above chance. We argue that the
      pictures are metaphoric and that pictorial metaphor relies on common properties
      of the static picture and the kinetic referent.

PMID- 11206213
TI  - Immunity to functional fixedness in young children.
AB  - In the candle problem (Duncker, 1945), subjects must attach a candle to a
      vertical surface, using only a box of tacks and a book of matches. Subjects
      exhibit functional fixedness by failing, or being slow, to make use of one object
      (the tack box) as a support, rather than as a container, in their solutions. This
      failure to produce alternate functions is measured against improved performance
      when the tack box is presented empty rather than full of tacks (i.e., not
      preutilized as a container). Using an analogous task, we show that functional
      fixedness can be demonstrated in older children (6- and 7-year-olds); they are
      significantly slower to use a box as a support when its containment function has
      been demonstrated than when it has not. However, younger children (5-year-olds)
      are immune to this effect, showing no advantage when the standard function is not
      demonstrated. Moreover, their performance under conditions of preutilization is
      better than that of both older groups. These results are interpreted in terms of
      children's developing intuitions about function and the effects of past
      experience on problem solving.

PMID- 11206214
TI  - Modeling the effects of repetition and word frequency in perceptual
      identification.
AB  - The counter model for word identification (Ratcliff & McKoon, 1997) has been
      challenged by recent empirical findings that performance on low-frequency words
      improves as the result of repetition of the words. We show that the model can
      accommodate this learning effect, and that it can do so without jeopardizing its
      explanations of the effects on word identification of a large number of other
      variables.

PMID- 11206215
TI  - A criterion-shift model for enhanced discriminability in perceptual
      identification: a note on the counter model.
AB  - The original version of the counter model for perceptual identification (Ratcliff
      & McKoon, 1997) assumed that word frequency and prior study act solely to bias
      the identification process (i.e., subjects have a tendency to prefer high
      frequency and studied low-frequency words, irrespective of the presented word).
      In a recent study, using a two-alternative forced-choice paradigm, we showed an
      enhanced discriminability effect for high-frequency and studied low-frequency
      words (Wagenmakers, Zeelenberg, & Raaijmakers, 2000). These results have led to a
      fundamental modification of the counter model: Prior study and high frequency not
      only result in bias, but presumably also result in a higher rate of feature
      extraction (i.e., better perception). We demonstrate that a criterion-shift
      model, assuming limited perceptual information extracted from the flash as well
      as a reduced distance to an identification threshold for high-frequency and
      studied low-frequency words, can also account for enhanced discriminability.

PMID- 11206216
TI  - Working memory and interference: a comment on Jenkins, Myerson, Hale, and Fry
      (1999).
AB  - Jenkins, Myerson, Hale, and Fry (1999) showed that slopes relating complex spans
      to simple spans were considerably smaller than one, indicating that persons with
      higher simple spans suffered more interference when the span task was combined
      with a processing demand. They argued that this finding ruled out accounts of
      working memory based on interference and/or inhibition of interfering
      information. We demonstrate that the effect is mainly an artifact from regression
      to the mean, owing to the low reliability of span scores as used by Jenkins et
      al. Data from 133 young adults for two verbal and two spatial span tasks show
      that the slopes relating complex to simple performance are considerably higher
      for sum scores than for span scores. Furthermore, an adequate test for an
      interference or an inhibition account of working memory is to predict
      interference from complex span tasks, not from simple span tasks. Interference
      effects in the verbal span tasks were negatively correlated with an independent
      measure of working memory capacity, consistent with the interference/inhibition
      account.

PMID- 11206217
TI  - The training of surgeons in America.

PMID- 11206218
TI  - Complementarity of blue dye and isotope in sentinel node localization for breast
      cancer: univariate and multivariate analysis of 966 procedures.
AB  - BACKGROUND: The hypothesis that sentinel lymph node (SLN) mapping in breast
      cancer patients is optimized by combining blue dye and isotope is reasonable and
      intuitive. Despite this, few studies examine in detail the factors contributing
      to the success of these techniques, either individually or in combination.
      METHODS: During a time period of 21/2 years, 1000 consecutive patients at
      Memorial Sloan-Kettering Cancer Center had SLN mapping performed by using both
      blue dye and isotope, with preoperative lymphoscintigraphy (LSG). Among the 966
      patients with invasive cancer, 12 variables were examined for their correlation
      with the success of SLN localization by blue dye, by isotope, and by the combined
      method, using univariate and multivariate models. RESULTS: By univariate
      analysis, blue dye success was more frequent in association with: a positive LSG
      (P = .02), age < or = 60 (P < .0005), a previous surgical biopsy (P = .03), and
      an outer quadrant tumor (P < .0005). Isotope success was more frequent with a
      positive LSG (P < .0005), age < or = 60 (P = .004), and intradermal isotope
      injection (P < .0005). Combined (dye and/or isotope) success was more frequent
      when there was a positive LSG (P < .0005), age < or = 60 (P = .006) and
      intradermal isotope injection (P < .0005). In multivariate analysis, blue dye
      success remained uniquely associated with outer quadrant tumor location (P <
      .0005), and isotope success was uniquely associated with intradermal isotope
      injection (P = .012). Combined success was more frequent with a positive LSG (P <
      .0005), age < or = 60 (P = .033), and intradermal isotope injection (P = .003).
      CONCLUSIONS: The five variables associated with successful SLN localization by
      blue dye or by isotope overlap but are not identical. Only three of these,
      intradermal isotope injection, a positive LSG, and age < 60, predicted success by
      the dye-isotope combination in the multivariate model. Dye and isotope complement
      each other, and SLN biopsy for breast cancer should use both.

PMID- 11206219
TI  - Intradermal isotope injection: a highly accurate method of lymphatic mapping in
      breast carcinoma.
AB  - BACKGROUND: The combined approach of radioactive tracer and blue-dye mapping of
      sentinel lymph nodes (SLN) has evolved into a safe and effective alternative to
      routine axillary node dissection in specific patient populations with breast
      carcinoma. The optimal route of injection for the isotope has not been clearly
      defined. To assess the intradermal route of isotope injection, we prospectively
      evaluated 100 patients with biopsy-proven invasive breast carcinoma with SLN
      biopsy followed by planned axillary node dissection. METHODS: All patients were
      given an intradermal injection of Tc-99m sulfur colloid and an intraparenchymal
      injection of blue dye. All patients underwent a complete axillary node
      dissection. Each sentinel node was serially sectioned and examined by
      immunohistochemistry. RESULTS: Sentinel nodes were successfully identified in 99%
      of cases. Forty-six patients had axillary metastases; of these, four had falsely
      negative sentinel nodes (false-negative rate, 9%). The false-negative rate was 0
      of 24 (0%) for T1 tumors, 2 of 18 (11%) for T2 tumors, and 2 of 4 (50%) for T3
      tumors. Three of four patients with false negatives had palpable, clinically
      suspicious axillary nodes found intraoperatively. If these cases are excluded,
      the accuracy of the procedure was 100% for T1 and T2 tumors. Of the 42 positive
      axillae identified by SLNB (true positives), 40 were localized using the
      intradermal injection of radioisotope; in 13 of these cases, this was the only
      method that identified the true-positive node. CONCLUSION: These data demonstrate
      that intradermal injection of radioactive tracer is an effective method of
      localizing the SLN in cases involving small breast cancers. Further investigation
      is warranted before this technique is adopted for use in larger breast cancers.
      Intraoperative examination and biopsy of any suspicious nonsentinel nodes are
      critical.

PMID- 11206220
TI  - Effect of breast surgery on serum levels of insulin-like growth factors (IGF-I,
      IGF-II, and IGF binding protein-3) in women with benign and malignant breast
      lesions.
AB  - BACKGROUND: There is evidence that insulin-like growth factors play a role in the
      development of breast cancer. Antiestrogens reduce circulating levels of IGF-I,
      but the influence of other breast cancer treatments, including surgery, is
      unknown and is investigated in this study. METHODS: Circulating serum
      concentrations of IGF-I, IGF-II, and IGF binding protein-3 (IGFBP-3) were
      measured before and after breast surgery in 31 patients with breast cancer and 12
      controls with benign breast lesions. Serum albumin was measured as a marker of
      the nonspecific metabolic effect of surgery. RESULTS: Serum IGF-I, IGF-II, IGFBP
      3, and albumin fell 24 hours after surgery for breast cancer but largely
      normalized again over the next 7 days. The fall in IGF-I and IGFBP-3 was not
      significant when the change in serum albumin was used as a covariate, suggesting
      a nonspecific effect of surgery. However, the reduction in IGF-II remained
      significant when adjusted for albumin and was greater after lumpectomy of
      malignant tumors (-8 +/- 2%) compared with benign disease (2 +/- 2%, P = .001).
      The fall in IGF-II was significantly related to the size of the removed tumor.
      CONCLUSIONS: Breast cancer may directly influence the serum concentration of IGF
      II, possibly by direct tumor production.

PMID- 11206221
TI  - Modification of the sentinel node technique: it was a hit in New York, but will
      it play in Poughkeepsie?

PMID- 11206222
TI  - Antisense TGF-beta2 immunotherapy for hepatocellular carcinoma: treatment in a
      rat tumor model.
AB  - BACKGROUND: The overexpression of transforming growth factor-beta (TGF-beta) in
      hepatocellular carcinoma (HCC) appears to induce immunosuppression toward the
      tumor cells. METHODS: A rat HCC cell line, Morris hepatoma rat cell line (MRH)
      7777 (MRH), was transfected with antisense TGF-beta2 in pCEP-4 vector and used as
      immunotherapy against the development of wild-type tumors. An enzyme-linked
      immunosorbent assay (ELISA) confirmed that TGF-beta2 production was markedly
      lower for antisense modified cells as compared to wild-type tumor cells. Tumors
      were initiated by injecting MRH cells into the flanks of Buffalo rats. This was
      followed by biweekly vaccinations with irradiated MRH cells (unmodified, pCEP-4
      alone, or antisense TGF-beta2 modified). RESULTS: In the group that received
      irradiated MRH unmodified cells, 55% of rats died from tumor burden, and 36%
      developed tumor regression. In the group that received irradiated MRH cells
      modified with pCEP-4 vector alone, 50% died from tumors and 33% had spontaneous
      regression. In animals treated with pCEP-4/TGF-beta antisense modified cells,
      none developed tumors. Cell-mediated cytotoxicity assays demonstrated a twofold
      increase in lytic activity in the effector cells of the animals treated with
      antisense modified cells. CONCLUSIONS: These results demonstrate the successful
      treatment of HCC tumors in rats by a HCC vaccine genetically altered with
      antisense TGF-beta2. Decreased production of TGF-beta in HCC vaccine enhances
      immunogenicity against wild-type HCC tumor cells.

PMID- 11206223
TI  - Role for surgical cytoreduction in multimodality treatments for cancer.

PMID- 11206224
TI  - The effect of treatment for colorectal cancer on long-term health-related quality
      of life.
AB  - BACKGROUND: Little information is available on the impact that therapies used in
      the treatment of colorectal cancer (CRC) have on long-term, health-related
      quality of life (HRQL). Knowledge of how HRQL is affected by these therapies is
      essential in properly selecting patients for treatment. The purpose of this study
      was to determine the long-term impact that surgical and adjuvant therapy for
      resectable CRC has on patient-reported HRQL in a male veteran population through
      a case-control design. METHODS: All participating patients had completed therapy
      at least 6 months before enrollment. One hundred fifty-eight patients were
      accrued over a 3-year period (January 1, 1997 to December 31, 1999) at a single
      institution. The impact of CRC surgery on HRQL was measured by comparing a cohort
      of 61 patients undergoing surgery alone for the treatment of CRC (CRC-S group)
      with 44 patients undergoing surgery for benign colonic disease (BCD group). To
      study the effect of adjuvant therapy for CRC on HRQL, a third cohort of 53
      patients undergoing both surgical and adjuvant treatment (CRC-S/A group) was
      compared with the CRC-S group. For each group, health status was measured by a
      health survey questionnaire, SHORT FORM 36 (SF36). For patients treated for CRC,
      an additional disease-specific supplemental questionnaire also was used. RESULTS:
      Self-reported health status, as measured by mean SF36 score, was significantly
      reduced for the BCD group compared with CRC-S patients on general health
      perception (41.9 +/- 3.9 vs. 52.2 +/- 3.0, P = .04) and the standardized physical
      component score (31.2 +/- 1.7 vs. 37.5 +/- 1.5, P < .005). Despite an increased
      number of distally located tumors, later stage cancers, and an increased number
      of recurrences in the CRC-S/A group compared with the CRC-S cohort, no
      significant differences were identified between these groups on any of the
      subscales or standardized scores of SF36. Using the supplemental questions, no
      differences were identified between the CRC groups with respect to appetite,
      weight, or gastrointestinal or urinary functioning. CONCLUSIONS: Surgical therapy
      for CRC probably has minimal impact on long-term HRQL when compared with surgery
      for benign colonic processes. Similarly, there does not appear to be a
      measurable, lasting impact of CRC adjuvant therapy on HRQL when compared with
      surgery alone. Although overall impact of therapies for CRC on HRQL appears to be
      limited, measurement of therapeutic influence on an individual level and
      identification of selection criteria based on estimated impact on HRQL for these
      therapies requires prospective validation.

PMID- 11206225
TI  - Malignant gastrointestinal stromal tumors of the small intestine: a review of 50
      cases from a prospective database.
AB  - BACKGROUND: Malignant gastrointestinal stromal tumors (M-GIST) are rare
      mesenchymal tumors originating in the wall of the gastrointestinal (GI) tract.
      Previous studies have included limited numbers of patients, and most included
      malignant and benign cases from throughout the GI tract. We reviewed the
      experience of a single tertiary cancer care center with M-GIST of the small
      intestine only. METHODS: A prospective database identified all patients seen from
      1989 to 1998. Clinical and pathological data, treatment, and outcome were
      analyzed. Overall median follow-up time was 24 months (range, 1-176 months).
      RESULTS: Fifty patients (31 male, 19 female) were identified. Mean age at
      diagnosis was 55 years. Disease was localized in 11 patients, locally advanced
      (invasion into adjacent organs/peritoneum) in 24 patients, perforated in 4
      patients, multiple primary lesions in 2 patients, and distant metastases in 9
      patients. All patients underwent resection, which was complete in 70%.
      Locoregional recurrence (LR) developed in 43% (median, 25 months), and distant
      metastases in 59% (median, 21 months) of patients at risk. At last follow-up, 14
      patients were alive (6 disease-free), 2 had died disease-free, and 34 died with
      recurrent disease. Overall survival (OS) was similar for localized and locally
      advanced disease; OS also was similar for patients with multiple primaries and
      distant metastases at diagnosis. Patients were grouped into three stages: (I)
      patients with localized and locally advanced disease; (II) patients with
      perforated; and (III) patients with multiple primaries and distant metastases.
      Actuarial OS at 5 years was 41% (n = 50)--42% for those with complete resection
      and 8% for incomplete resection. Univariable analysis showed that earlier stage
      at diagnosis (P = .001) and completeness of resection (P = .004) predicted for
      longer OS. CONCLUSIONS: Most patients with M-GIST of the small intestine relapse
      following resection, but survival may be prolonged. In univariable analysis,
      stage at presentation and complete resection were significant prognostic
      variables for OS; grade was not significant. Localized and locally advanced M
      GIST of the small intestine have a mean OS > 5 years. Complete resection should
      be the goal of initial surgical treatment.

PMID- 11206226
TI  - Treatment of malignancy arising in pilonidal disease.
AB  - BACKGROUND: Malignant degeneration is a rare complication of pilonidal disease
      and is associated with a high recurrence rate and poor prognosis compared with
      regular nonmelanoma skin cancer. Treatment in our departments and in the
      international literature was evaluated. METHODS: We analyzed the data from three
      patients with malignant degeneration who were treated in our departments and an
      additional 56 patients who were found after an extensive literature search.
      RESULTS: A total of 47 males and 12 females, with a mean age of 52 years, were
      most frequently primarily treated with surgery. After a mean follow-up time of 28
      months, 20% of all patients died with evidence of disease and an additional 10%
      died of unrelated causes. The overall recurrence rate was 39%, with a median time
      to recurrence of only 9 months. The local recurrence rate was lower when
      radiotherapy was added to surgical treatment alone (30% vs. 44%). Re-excision of
      local recurrence resulted in some long-term survivals. CONCLUSIONS: Early
      diagnosis and treatment may lead to improvement of the relative poor prognosis.
      Surgical treatment should be tailored according to the locoregional extent. The
      high recurrence rate after surgical treatment can be reduced by the addition of
      radiotherapy. Although repeat surgery for recurrent disease may involve extensive
      resection and morbidity, this may result in prolonged survival.

PMID- 11206227
TI  - Phase II trial of debulking surgery and photodynamic therapy for disseminated
      intraperitoneal tumors.
AB  - BACKGROUND: Photodynamic therapy (PDT) combines photosensitizer drug, oxygen, and
      laser light to kill tumor cells on surfaces. This is the initial report of our
      phase II trial, designed to evaluate the effectiveness of surgical debulking and
      PDT in carcinomatosis and sarcomatosis. METHODS: Fifty-six patients were enrolled
      between April 1997 and January 2000. Patients were given Photofrin (2.5 mg/kg)
      intravenously 2 days before tumor-debulking surgery. Laser light was delivered to
      all peritoneal surfaces. Patients were followed with CT scans and laparoscopy to
      evaluate responses to treatment. RESULTS: Forty-two patients were adequately
      debulked at surgery; these comprise the treatment group. There were 14 GI
      malignancies, 12 ovarian cancers and 15 sarcomas. Actuarial median survival was
      21 months. Median time to recurrence was 3 months (range, 1-21 months). The most
      common serious toxicities were anemia (38%), liver function test (LFT)
      abnormalities (26%), and gastrointestinal toxicities (19%), and one patient died.
      CONCLUSIONS: Photofrin PDT for carcinomatosis has been successfully administered
      to 42 patients, with acceptable toxicity. The median survival of 21 months
      exceeds our expectations; however, the relative contribution of surgical
      resection versus PDT is unknown. Deficiencies in photosensitizer delivery, tissue
      oxygenation, or laser light distribution leading to recurrences may be addressed
      through the future use of new photosensitizers.

PMID- 11206228
TI  - Localizing the sentinel node outside of the specialty center: success of a
      lymphatic mapping course in disseminating new technology.
AB  - BACKGROUND: Sentinel node biopsy (SNB) is an evolving technology in the
      management of breast cancer. The purpose of this study was to determine the
      success of an SNB course in emphasizing principles for participants to
      successfully initiate an SNB program at their institution. METHODS: Participants
      in a university-sponsored course were queried 6 to 18 months after the course
      regarding their success in initiating SNB in their practice. Univariate analysis
      was used to determine the likelihood of implementing a SNB program. RESULTS:
      Ninety-one participants responded. Of these respondents, 56 had initiated an SNB
      program at their hospital, and 20 had completed a "validation" phase.
      "Validation" consisted of less than 10 cases for 11 respondents, 11 to 20 cases
      for 5 respondents, and 20 to 30 cases for 3 respondents and >30 cases for 1
      respondent. Twenty-eight percent initiated the learning curve without an
      Institutional Review Board (IRB) protocol, and a further 20% went on to utilize
      SNB without axillary dissection in sentinel node-negative patients without IRB
      approval. Univariate analysis revealed that surgeons practicing in a group whose
      caseload consisted of more than 25% breast surgery cases were most likely (P <
      0.05) to implement SNB in their practice. CONCLUSIONS: Success in applying SNB
      after a course is high among surgeons in groups with a significant breast
      caseload, although recommendations for obtaining institutional approval and
      completing a 30-case validation series are often disregarded.

PMID- 11206229
TI  - Vascular endothelial growth factor expression in stage I non-small cell lung
      cancer correlates with neoangiogenesis and a poor prognosis.
AB  - BACKGROUND: Vascular endothelial growth factor (VEGF) plays an important role in
      tumor growth and metastasis. We investigated the prognostic significance of VEGF
      overexpression, intratumoral microvessel density (MVD), and angiolymphatic
      invasion in stage Ia-b non-small cell lung cancer (NSCLC). METHODS: Eighty-five
      patients undergoing complete surgical resection of pathologic stage Ia-b NSCLC
      were evaluated. The mean and median clinical follow-up were 37.1 and 39.0 months
      (range, 30-44 months), respectively. Paraffin-embedded tumor specimens were
      stained with VEGF and CD31 (a specific endothelial marker) using
      immunohistochemical methods. VEGF staining was evaluated, by combining both
      percentage of positive tumor cells and staining intensity, as low (negative and <
      20% of tumor cells showing weak positivity), or high (> 20% of tumor cells
      showing strong positivity). CD31 staining was expressed as MVD per high power
      field at 400x magnification. Angiolymphatic invasion was expressed as either
      presence or absence. RESULTS: Low VEGF expression was seen in 25 (29%) patients,
      and high VEGF expression was seen in 60 (71%) patients. The survival rate in
      patients with low VEGF expression was significantly higher (80%) than that in
      those with high VEGF expression (48%, P = .018). The mean MVD in the low VEGF
      group was 23.7 +/- 5.7 vs. 34.4 +/- 9.3 in the high VEGF group (P = .001).
      Patients with high MVD also had a significantly lower survival rate than did
      those with low MVD count (46% vs. 73%, P = .0053). Age, sex, tumor type, and
      tumor differentiation were not found to be associated with overall survival. The
      presence of angiolymphatic invasion and T2 stage (i.e., tumor size > 3 cm) were
      associated with decreased survival. High VEGF expression, tumor size, and
      angiolymphatic invasion emerged as three independent factors predicting worsening
      prognosis using multivariate analysis. CONCLUSION: High VEGF expression within
      stage I NSCLC is closely associated with high intratumoral angiogenesis and poor
      prognosis. Immunohistochemical evaluation of T stage and VEGF expression along
      with examination of angiolymphatic invasion perioperatively may aid in predicting
      prognosis. Adjuvant therapies aimed at retarding tumor angiogenesis may be
      considered for stage I NSCLC patients with high VEGF levels.

PMID- 11206230
TI  - Accuracy of biopsy techniques for limb and limb girdle soft tissue tumors.
AB  - BACKGROUND: The biopsy method of choice for soft tissue sarcomas (STS) of the
      limb and limb girdle is controversial. There have been no randomized controlled
      trials that compare incision biopsy with Tru-cut biopsy. We present a large
      series, which includes an analysis of the effectiveness of Tru-cut core biopsy
      both in a tertiary referral center as well as from many referring hospitals. This
      is compared with the other methods of biopsy of all soft tissue tumors (STT)
      referred to this institution. METHODS: A retrospective review of all patients who
      were referred to Royal Marsden Hospital NHS Trust (RMH) from 1989 to 1998.
      RESULTS: There were 570 patients (576 lesions) identified. Overall Tru-cut biopsy
      differentiated benign from malignant tumors with a sensitivity of 99.4%,
      specificity 98.7%, positive predictive value 99.4%, and negative predictive value
      98.7% with similar results for RMH and referral hospitals. Tru-cut identified
      both tumor subtype and grade in approximately 80% of STS. Incision biopsy had
      similar sensitivity and specificity for differentiating benign from malignant STT
      as well as subtype of STS but was less accurate for grade assessment. Tumors from
      patients who were referred after enucleation had a median maximum tumor diameter
      (MTD) of 4.9 cm, whereas median MTD of tumors diagnosed at referring hospitals by
      Tru-cut biopsy was 10.6 cm. (P < 0.001). CONCLUSION: Tru-cut biopsy is highly
      sensitive and specific in the diagnosis of STT as well as subtyping and grading
      of STS. It is equally effective as incision biopsy in all these parameters and
      has a lesser morbidity. The failure to use Tru-cut biopsy is most likely because
      of the possibility that STS is not suspected in patients with small tumors even
      when they are deep to the investing fascia.

PMID- 11206231
TI  - Rib pain in a 23-year-old woman with severe asthma.
AB  - This case illustrates the importance of considering a wide range of diagnoses in
      patients complaining of rib, flank, and pleuritic pain. Further, additional
      evaluation is warranted when "pneumonia" does not respond to conventional
      treatment.

PMID- 11206232
TI  - A randomized, 12-week, double-blind, placebo-controlled study comparing
      formoterol dry powder inhaler with albuterol metered-dose inhaler.
AB  - BACKGROUND: Formoterol is a beta2-adrenergic agent which, when inhaled, produces
      rapid and long-lasting bronchodilatation. OBJECTIVE: The aim of this study was to
      compare the efficacy, safety, and tolerability of formoterol powder for
      inhalation delivered via the Aerolizer device with placebo and with albuterol
      delivered via metered-dose inhaler in patients with mild to moderate persistent
      asthma. METHODS: In a multicenter, double-blind, parallel-group study, 541
      patients were randomized at 26 trial sites to receive either formoterol, 12
      microg twice daily; formoterol, 24 microg twice daily; albuterol, 180 microg four
      times daily; or a placebo for 12 weeks. The effects of each treatment on lung
      function, asthma symptoms, and frequency of rescue albuterol use were evaluated.
      Adverse effects and clinical laboratory parameters were also evaluated. RESULTS:
      The bronchodilatory effects of formoterol were rapid in onset and persisted for
      12 hours. Both formoterol doses were more effective than placebo and albuterol
      for objective measures of lung function. Morning and evening peak expiratory flow
      rates were more improved with formoterol, and formoterol provided significantly
      greater improvements in asthma symptom scores compared with both albuterol and
      placebo. Overall, patients taking formoterol used significantly less rescue
      medication than did those taking albuterol or placebo. Nocturnal awakenings
      occurred less often with formoterol than with placebo or albuterol. The
      therapeutic effects of formoterol were maintained over the entire 12 weeks of
      treatment. Adverse events were similar for all treatment groups, and clinical
      laboratory data were unremarkable. CONCLUSIONS: Rapid-onset, long-acting
      formoterol, administered via the Aerolizer inhaler, is an effective and safe
      treatment for patients with mild to moderate persistent asthma.

PMID- 11206233
TI  - Lane markers and guardrails.

PMID- 11206234
TI  - Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial
      nonallergic) rhinitis.
AB  - BACKGROUND: Azelastine hydrochloride is an antihistamine with anti-inflammatory
      properties that is available in the United States in a nasal spray formulation
      for the treatment of seasonal allergic rhinitis. Vasomotor (perennial
      nonallergic) rhinitis (VMR) is a noninfectious, chronic rhinitis usually not
      associated with inflammatory cell infiltration. OBJECTIVE: Two multicenter,
      randomized, double-blind, placebo-controlled, parallel-group clinical trials were
      conducted to determine whether patients with symptoms of VMR (rhinorrhea,
      sneezing, postnasal drip, and nasal congestion) could be effectively treated with
      azelastine nasal spray. METHODS: All of the patients who participated in the
      trials had a diagnosis of VMR, symptoms for at least 1 year, negative skin tests
      for a mixed panel of seasonal and perennial allergens, and a nasal cytology
      examination negative for eosinophils. After a 1-week, single-blind, placebo lead
      in period, patients who met the symptom severity qualification criteria were
      randomized to receive either azelastine nasal spray (two sprays per nostril twice
      daily, 1.1 mg/day) or placebo nasal spray for 21 days. Patients recorded the
      severity of their VMR symptoms on diary cards each morning and evening of the
      trial using a four-point symptom rating scale (0 = none to 3 = severe). The
      primary efficacy variable was the overall reduction from baseline in the total
      vasomotor rhinitis symptom score (TVRSS) over the 21-day, double-blind treatment
      period. RESULTS: In both studies, azelastine nasal spray significantly (study 1,
      P = .002; study 2, P = .005) reduced the TVRSS from baseline when compared with
      placebo. Significant improvement was observed within the first week and
      improvement in all symptoms favored treatment with azelastine nasal spray. No
      serious or unexpected adverse events were reported in either study. Bitter taste
      (19% vs 2%) was the only adverse experience that occurred with a statistically
      significantly greater incidence in the azelastine group than in the placebo
      group. CONCLUSIONS: This is the first demonstration of the efficacy of an
      antihistamine in the therapy of VMR in two double-blind, placebo-controlled
      clinical trials.

PMID- 11206235
TI  - Long-acting bronchodilators for the control of asthma symptoms.

PMID- 11206236
TI  - Comparison of once-daily to twice-daily treatment with mometasone furoate dry
      powder inhaler.
AB  - BACKGROUND: Once-daily dosing with an effective inhaled corticosteroid (ICS)
      would likely enhance compliance and, therefore, aid in the management of asthma.
      OBJECTIVE: Several once-daily dosing regimens of mometasone furoate (MF)
      administered by dry powder inhaler (DPI) were compared with a twice-daily dosing
      regimen in 286 patients with mild to moderate persistent asthma who were
      previously being treated with ICS. METHODS: During a 2-week open-label phase,
      patients received MF-DPI, 200 microg twice daily. They were then randomized to
      continue MF-DPI, 200 microg twice-daily treatment or to receive MF-DPI, 200
      microg once daily in the morning (AM), 200 microg once daily in the evening (PM),
      400 microg once daily AM, or placebo as part of the 12-week, double-blind phase.
      The primary efficacy variable was the mean change from the baseline to endpoint
      (last evaluable observation) for FEV1. RESULTS: Once-daily MF-DPI, 400 microg, AM
      maintained FEV1, and morning peak expiratory flow rate, FVC, FEF25%-75%, and
      asthma symptom scores, at levels similar to those for MF-DPI, 200 microg twice
      daily and significantly better than placebo. Once-daily MF-DPI, 200 microg, PM
      was effective in maintaining pulmonary function, but was less effective on other
      efficacy measures. In comparison to the other MF-DPI groups, once-daily MF-DPI,
      200 microg, AM was not as effective overall. The incidence of local adverse
      events, including oral candidiasis, was low with all dosages. CONCLUSIONS: Once
      daily MF-DPI, 400 microg, AM was as effective as MF-DPI, 200 microg twice daily,
      whereas once-daily MF-DPI, 200 microg, was more effective when administered in
      the evening compared with morning, for patients receiving ICS therapy. Once-daily
      dosing offers an effective and convenient treatment that could aid compliance in
      the treatment of asthma.

PMID- 11206237
TI  - Suppression of the early and late cutaneous allergic responses using fexofenadine
      and montelukast.
AB  - BACKGROUND: The relative contribution of histamine and the cysteinyl leukotrienes
      to the early and late cutaneous allergic responses (ECAR and LCAR) can be studied
      using antagonists of these mediators. OBJECTIVE: To determine the relative
      suppression of the ECARs and LCARs using standard doses of an H1-receptor
      antagonist, a cysteinyl leukotriene1-receptor antagonist, and the two antagonists
      administered concurrently. METHODS: We carried out a prospective, randomized,
      double-blind, placebo-controlled, four-way crossover study in 12 highly allergic
      participants. Intradermal tests with standardized allergen, and with histamine
      phosphate, LTD4, and saline controls were performed on 5 different test days as
      follows: pretreatment baseline and at steady state immediately after the seventh
      and last dose of a 1-week course of treatment with once-daily fexofenadine, 120
      mg; montelukast, 10 mg; fexofenadine and montelukast administered concurrently;
      or placebo. On each test day, the skin test results were read at intervals from
      0.25 to 24 hours after the intradermal injections were performed. RESULTS: After
      allergen injection, compared with baseline, all treatment regimens significantly
      decreased the ECAR and LCAR. After allergen injection, compared with placebo,
      fexofenadine significantly decreased the ECAR and the LCAR from 0.25 to 2 hours
      and at 8 hours. Montelukast did not significantly decrease the ECAR or LCAR.
      Fexofenadine and montelukast administered concurrently were not more effective
      than fexofenadine alone at any time. In the control skin tests, compared with
      placebo, fexofenadine, but not montelukast, significantly decreased the histamine
      induced response, and montelukast, but not fexofenadine, significantly decreased
      the LTD4-induced response. CONCLUSIONS: Fexofenadine and montelukast administered
      concurrently were not significantly more effective than fexofenadine alone in
      decreasing the ECAR and LCAR. Montelukast does not need to be discontinued before
      allergen skin testing. Further studies of the effect of concurrent treatment with
      higher doses of a histamine antagonist and a leukotriene modifier on the allergic
      response in the skin are needed.

PMID- 11206238
TI  - Practice parameters: background and usefulness.
AB  - BACKGROUND/OBJECTIVE: The number of clinical practice parameters has been
      increasing in recent years. A more complete understanding of the development of
      parameters will help the clinician understand the purpose of practice parameters
      and how to use them in their clinical practice. DATA SOURCE: The MEDLINE database
      was used to review the recent English language literature about practice
      parameters. CONCLUSIONS: The overall goal of practice parameters is to improve
      patient care. Practice parameters may be considered a major tool that can aid the
      clinician in decision-making, and improve overall health care for patients. They
      can help reduce unwanted variation in clinical practice and help physicians make
      more efficient use of resources. Practice parameters can also be used as teaching
      tools, reference documents, and aids to help defend patient care decisions,
      particularly in managed health care situations.

PMID- 11206239
TI  - Cockroach allergy appears early in life in inner-city children with recurrent
      wheezing.
AB  - BACKGROUND: Cockroach allergy and exposure to high levels of this allergen are
      important in the increasing asthma-related health problems among young inner-city
      children. However, there are very little data regarding the prevalence of
      cockroach allergy in infants and young children with asthma. OBJECTIVE: This
      retrospective study was designed to test the hypothesis that cockroach allergy
      appears early in life in young children with recurrent wheezing. METHODS: We
      reviewed the medical records of all 196 children (ages 5 months to 16 years)
      evaluated between January 1995 and September 1997 at the Cook County Hospital
      Pediatric Allergy Clinic for recurrent wheezing. The patients were assigned into
      two age groups, less than 4 years old and 4 to 16 years old. The percentages of
      IgE skin tests positive for common aeroallergens were compared within and between
      the two age groups. All children in the younger age group were tested for
      cockroach and dust mites, cat, and dog when indicated by positive environmental
      history. All children in the older age group were tested for indoor and outdoor
      allergens. RESULTS: Sixty-three children were younger than 4 years of age, and of
      these, 15 (23.8%) had cockroach allergen sensitivity, compared with only eight
      patients (12.7%) who were skin test positive to dust mite allergen (P = .01). The
      youngest patient with a positive reaction to cockroach allergen was 6 months old.
      Patients with a single allergen skin reactivity were considered as
      monosensitized. Nine children younger than 4 years of age (14.3%) were
      monosensitized only to cockroach allergen in contrast to three children (4.8%)
      who were monosensitized to house-dust mites (P < .05). CONCLUSIONS: Our data
      suggest that cockroach allergen sensitivity starts early in life and may be the
      only sensitizing allergen in many young inner-city children.

PMID- 11206240
TI  - Immunoglobulin deficiency in children with a sudden overwhelming infection.
AB  - BACKGROUND: A small percentage of previously healthy children develop a sudden
      overwhelming infection (SOI) that rapidly progresses and results in shock and,
      occasionally, death. Some of these children may have an undetected Ig deficiency.
      OBJECTIVE: The aim of this study was to evaluate the incidence of Ig deficiency
      in children with a SOI. METHODS: A case series study was conducted in a
      university hospital and included 18 children who either died in the emergency
      room or required admission to the pediatric intensive care unit secondary to a
      SOI. Two age-matched control groups included children hospitalized to regular
      floor beds with an infectious process (infected control group) or a noninfectious
      process (noninfected control group). Serum left from the initial blood draw,
      before fluid resuscitation, was collected and stored at -70 degrees C. Total IgG,
      IgG subclasses, IgM, and IgA were assayed by rate nephelometry in a blinded
      fashion. RESULTS: In the study group, one of six children under 1 year of age had
      low Ig levels in comparison with two of nine control patients. In those children
      over the age of 1 year, 8 of 12 patients (67%) had low Ig levels as compared with
      2 of 19 controls (11%) by Fisher's exact test, P = .002. Of those patients with
      Ig deficiencies, three of eight had isolated IgG deficiency, two of eight had
      combined IgG and IgA deficiency, three of eight had combined IgG and IgM
      deficiency. CONCLUSIONS: Children over the age of 1 year who present with a SOI
      have a significantly higher incidence of Ig deficiencies compared with age
      matched controls.

PMID- 11206241
TI  - Tobacco hypersensitivity and environmental tobacco smoke exposure in a pediatric
      population.
AB  - BACKGROUND: Skin testing and RAST have verified the existence of tobacco-specific
      IgE. However, published studies report conflicting results concerning the
      clinical significance of tobacco IgE. Previous studies have not focused on the
      role of environmental tobacco smoke (ETS) as it relates to tobacco
      hypersensitivity (TH) in nonsmoking children. OBJECTIVE: We used nonsmoking
      pediatric patients to investigate the relationship between ETS and TH. METHODS:
      Children, ages 4 to 10 years, were prospectively enrolled. ETS exposure and smoke
      triggered symptoms were recorded by questionnaire and physician history. Patients
      were given a skin test (ST) with a panel of aeroallergens plus tobacco extract. A
      ST reaction to at least one aeroallergen classified a patient as atopic; a ST
      reaction to tobacco classified a patient as TH. RESULTS: We enrolled 170
      patients, mean age 7.2 years. We found 58 (34%) patients reported routine
      exposure to ETS and 78 (46%) patients reported ETS-induced symptoms. We found 121
      (71%) atopic patients and 61 (36%) TH patients. TH was more common in atopic
      patients (P < .0001) and those routinely exposed to ETS (P < .05). However, TH
      failed to predict ETS-induced symptoms in either atopic or non-atopic patients
      (PPV = 0.40, NPV = 0.69). CONCLUSIONS: We evaluated the clinical significance of
      TH in a nonsmoking patient population related to ETS exposure. We concluded that
      although TH is statistically related to atopy and ETS exposure, the low
      predictive values of skin testing for TH limit its clinical usefulness.

PMID- 11206242
TI  - Repeated exposure to low levels of sulfur dioxide (SO2) enhances the development
      of ovalbumin-induced asthmatic reactions in guinea pigs.
AB  - BACKGROUND: Sulfur dioxide (SO2) is one of the major air pollutants. It is known
      to aggravate asthma symptoms in human beings, but few studies have focused on the
      effects of SO2 upon the development of bronchial asthma in animal models.
      OBJECTIVE: This study was undertaken to evaluate the role of SO2 upon the
      development of ovalbumin (OA)-induced asthmatic reactions in guinea pigs.
      METHODS: Guinea pigs were divided into four groups: (1) OA- and SO2-exposed group
      (n = 12), (2) SO2-exposed group (n = 12), (3) OA-exposed group (n = 11), and (4)
      saline-exposed group (n = 7). Guinea pigs of the first and second groups were
      exposed to 0.1 ppm SO2 for 5 hours a day on 5 consecutive days. Guinea pigs in
      the first and third groups inhaled 0.1% OA aerosols for 45 minutes a day on days
      3, 4, and 5. One week after the sensitization procedure, all the guinea pigs
      underwent bronchial challenge with 1.0% OA aerosols, using unrestricted whole
      body plethysmography. Bronchoalveolar lavage and histopathologic examination were
      performed 24 hours after the bronchial challenge. RESULTS: Increases in enhanced
      pause (Penh), as an index of airway obstruction, after the bronchial challenge
      was significantly higher in OA- and SO2-exposed group (group 1) than the other
      groups (P < .05, respectively). Eosinophil counts in bronchoalveolar lavage
      fluids were also significantly higher in group 1 than in the other groups (P <
      .05, respectively). Histopathologic findings of bronchial and lung tissue in the
      group 1 showed an infiltration of inflammatory cells, bronchiolar epithelial
      damage, and mucus and cell plug in the lumen, but no significant abnormalities
      were observed in the other groups. CONCLUSIONS: These results indicate that
      repeated exposure to low levels of sulfur dioxide may enhance the development of
      ovalbumin-induced asthmatic reactions in guinea pigs.

PMID- 11206244
TI  - Mountain cedar.

PMID- 11206243
TI  - Anaphylaxis to raw potato.
AB  - BACKGROUND: Potato allergy has been described rarely, generally in relation to
      the Oral Allergy Syndrome (OAS). Adults with seasonal allergic rhinitis have been
      reported in whom peeling of raw potatoes causes oculonasal symptoms, wheezing,
      and contact urticaria. Skin testing with fresh fruits and vegetables has been
      recommended in cases of OAS, although the sensitivity of commercial potato
      extract is reportedly equal to that of fresh potato. CASE REPORT: This report
      describes a 4-year-old with raw potato-induced anaphylaxis. He rapidly developed
      urticaria, angioedema, respiratory distress, vomiting and diarrhea after biting
      into a raw potato that was being used for painting in preschool. Review of
      systems is significant for viral-induced wheezing, but no symptoms suggestive of
      seasonal allergic rhinitis were evident. His mother has a history of seasonal
      allergic rhinitis and contact urticaria with raw potato. Skin testing to
      commercial potato extract was negative and skin testing to fresh potato by the
      prick + prick method was markedly positive. Skin testing to birch tree was
      negative. An open challenge to a small amount of cooked potato was negative. Food
      challenge to raw potato was not considered indicated in this case of immediate
      anaphylaxis to a single food. CONCLUSIONS: This patient had clinical and skin
      test reactivity to raw and uncooked potato in the absence of OAS. The patient
      will be followed for the development of seasonal allergic rhinitis.

PMID- 11206245
TI  - American Dental Education Association 78th Annual Session. Chicago, Illinois,
      USA. March 3-7, 2001. Abstracts.

PMID- 11206246
TI  - Honesty--a fundamental trait.

PMID- 11206247
TI  - Low-risk stress fractures.
AB  - Stress fractures can occur in almost any bone in the body, with the lower
      extremity weightbearing bones, especially the tibia, tarsals, and metatarsals,
      being affected most frequently. Although the cause of these fractures is
      multifactoral, repetitive physical forces without adequate rest are the primary
      culprits. Stress fractures may be broadly classified as low-risk or high-risk
      injuries. Low-risk stress fractures, the topic of this review article, can be
      diagnosed through a thorough history, physical examination, and radiographs.
      Nuclear scintigraphy is occasionally necessary for confirmation, especially for
      fractures of the spine and pelvis. When diagnosed early and treated with
      restriction of activity, low-risk stress fractures have a favorable prognosis.

PMID- 11206248
TI  - Osteochondritis dissecans of the patellofemoral joint.

PMID- 11206249
TI  - Nonoperative treatment of ulnar collateral ligament injuries in throwing
      athletes.
AB  - Ulnar collateral ligament injury of the elbow in throwing athletes is a common
      occurrence, and either operative or nonoperative treatment is an option. The
      results of operative repairs and reconstructions have been well documented in the
      literature; however, little information has been reported on the outcome of
      nonoperative treatment. From 1994 to 1997, we evaluated 31 throwing athletes with
      ulnar collateral ligament injuries. The purpose of this study was to determine
      what percentage of athletes could return to their sport without surgical
      intervention and to identify factors that would predict return to full
      competition by an athlete treated nonoperatively. The factors studied included
      acute versus insidious onset of symptoms, the duration of symptoms before
      treatment, and age. Nonoperative treatment, which included a minimum of 3 months'
      rest with rehabilitation exercises, allowed 42% of the athletes in our study (N =
      13) to return to their previous level of competition. Those who did return did so
      at an average of 24.5 weeks after diagnosis. No predictive findings obtained
      either through the patient's history or physical examination were found that
      would assist the clinician or athlete in predicting the success of nonoperative
      treatment.

PMID- 11206250
TI  - The incidence of patellofemoral osteoarthritis and associated findings 7 years
      after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone
      autograft.
AB  - To evaluate the development of postoperative patellofemoral osteoarthritis, we
      performed a retrospective clinical and radiographic study of 100 patients who had
      undergone anterior cruciate ligament reconstruction with a bone-patellar tendon
      bone autograft an average of 7 years before the follow-up. Radiographic
      evaluation showed no patellofemoral osteoarthritis in 53 patients (group I), mild
      osteoarthritis in 34 patients (group II), moderate osteoarthritis in 12 patients,
      and severe osteoarthritis in 1 patient (group III, moderate and severe changes).
      The average shortening of the patellar tendon was 2.4 mm in group I, 3.9 mm in
      group II, and 6.8 mm in group III. The placement of the femoral or tibial tunnel
      of the graft, as measured from lateral radiographs, did not correlate
      significantly with the degree of patellofemoral osteoarthritis. Patients who
      developed patellofemoral osteoarthritis experienced worse final outcomes, were
      more often dissatisfied with the condition of the operated knee, experienced more
      frequent pain and swelling in the knee joint, and had poorer range of motion and
      poorer quadriceps muscle strength than did patients without patellofemoral
      osteoarthritis. Only three patients had an unstable knee, and degenerative
      changes in the tibiofemoral joint were uncommon.

PMID- 11206251
TI  - Lower-limb function among former elite male athletes.
AB  - To determine the relationship between previous lower-limb loading and current
      self-reported hip and knee disability, we sent a questionnaire to 1321 former
      elite male athletes who had represented Finland between 1920 and 1965 in
      international competitions and to 814 control subjects who had been classified as
      healthy at the age of 20. After adjustment for age, body mass index, and
      occupational group, the odds ratios of hip disability in the athletes compared
      with control subjects were 0.35 in endurance athletes (95% confidence interval,
      0.14 to 0.85, P = 0.02), 0.56 in team sport athletes (0.28 to 1.10, P = 0.09),
      0.30 in track and field athletes (0.12 to 0.73, P < 0.01), 0.84 in power sport
      athletes (0.51 to 1.39, P = 0.49), 0.30 in shooters (0.07 to 1.32, P = 0.11), and
      0.54 (0.36 to 0.82, P < 0.01) in all athletes combined. Compared with control
      subjects, only team sport athletes had a higher risk of knee disability (odds
      ratio, 1.76; 95% confidence interval, 1.03 to 3.02; P = 0.04). Even though
      athletes have been reported to be at an increased risk for lower-limb
      osteoarthritis, our data show that former elite male endurance and track and
      field athletes and all athletes combined reported less hip disability than the
      control subjects. The effect of vigorous athletic activity on the function of
      knee joints is more controversial, because sports that involve a high risk of
      knee injury are likely to lead to pain, disability, and osteoarthritis.

PMID- 11206253
TI  - Prospective evaluation of syndesmotic ankle sprains without diastasis.
AB  - Sixty consecutive collegiate athletes with "high" ankle symptoms were
      prospectively evaluated over a 3-year period in an effort to better define this
      debilitating ankle injury. All athletes included in this study had tenderness
      over the distal anterior tibiofibular ligament, tenderness proximally along the
      interosseous membrane, and functional disability. No study subject had a fracture
      or frank tibia-fibula diastasis. The severity of the sprain was quantified using
      the interosseous "tenderness length." A standard rehabilitation protocol was
      followed by all patients. Athletes returned to competition when they could
      perform all functional testing without difficulty. Time to return to full
      competitive activity averaged 13.4 days. The number of days missed from
      competition was statistically related to the interosseous tenderness length (P =
      0.0001) and to positive results on the squeeze test (P = 0.03). Fifty-three of
      the 60 injured athletes were evaluated at least 6 months after injury. Patients
      rated their outcomes as good or excellent. Six of the patients experienced
      occasional ankle pain and stiffness, four patients reported recurrent ankle
      sprains, and one patient had heterotopic ossification formation.

PMID- 11206252
TI  - Effect of ankle disk training combined with tactile stimulation to the leg and
      foot on functional instability of the ankle.
AB  - Twenty-two university students with unilateral functional instability of the
      ankle participated in this study. They were randomly assigned to one of two
      experimental groups. Subjects in both groups were trained to stand on the
      affected limb on an ankle disk. In group 1, two pieces of 1-cm wide nonelastic
      adhesive tape were applied to the skin around the lateral malleolus from the
      distal third of the lower leg to the sole of the foot before the training
      sessions. Subjects in group 2 participated in the training sessions without the
      application of the adhesive tape. Training was performed for 10 minutes a day,
      five times per week, for a period of 10 weeks. Subjects were tested for postural
      sway while standing on the affected limb before, during, and after the training
      period. In group 1, postural sway values decreased significantly after 4 weeks
      compared with the pretraining performance, and they were within the normal range
      after not more than 6 weeks of training. In group 2, the values did not improve
      significantly compared with the pretraining performance until after 6 weeks of
      training, and they were not within the normal range until after 8 weeks of
      training. The findings suggest that the 2-week earlier correction of postural
      sway in group 1 was due to an increased afferent input from skin receptors that
      were stimulated by the traction of the adhesive tape.

PMID- 11206254
TI  - Dynamic function after anterior cruciate ligament reconstruction with autologous
      patellar tendon.
AB  - The purpose of this study was to dynamically assess the functional outcome of
      patients who had undergone successful anterior cruciate ligament reconstruction
      using an autologous patellar tendon technique and to determine whether their
      dynamic knee function was related to quadriceps and hamstring muscle strength.
      The knee kinematics and kinetics of 22 subjects who had undergone anterior
      cruciate ligament reconstruction (mean age, 27 +/- 11 years) and of 22 age- and
      sex-matched healthy control subjects were determined during various dynamic
      activities using a computerized motion analysis and force plate system. The
      differences in the sagittal plane angles and external moments between the two
      groups during light (walking), moderate (climbing and descending stairs), and
      higher-demand (jogging, jog and cut, jog and stop) activities were related to
      isokinetic strength measurements. Although patients who are asymptomatic and
      functioning well after anterior cruciate ligament reconstruction can perform
      normally in light activities, higher-demand activities reveal persistent
      functional adaptations that require further study.

PMID- 11206255
TI  - Thermal chondroplasty with radiofrequency energy. An in vitro comparison of
      bipolar and monopolar radiofrequency devices.
AB  - The purpose of this study was to examine the in vitro effects of three
      radiofrequency energy devices (two bipolar devices and one monopolar device) for
      the performance of thermal chondroplasty. Thirty-two fresh bovine femoral
      osteochondral sections (approximately 3 x 4 x 5 cm) from eight cows were divided
      into four groups (three treatment patterns and one sham-operated group with eight
      specimens per group). The three treatment patterns consisted of 1) radiofrequency
      energy delivered by a mechanical jig at 1 mm/sec in a contact mode (50 g of
      pressure), 2) radiofrequency energy delivered by a mechanical jig at 1 mm/sec in
      a noncontact mode (1 mm between probe tip and articular cartilage surface), and
      3) radiofrequency energy smoothing of abraded cartilage during arthroscopic
      visualization. Thermal smoothing of the abraded cartilage surface was
      accomplished with all three devices. Significant chondrocyte death, as determined
      by confocal laser microscopy and cell viability staining, was observed with each
      device. The bipolar radiofrequency systems penetrated 78% to 92% deeper than the
      monopolar system. The bipolar systems penetrated to the level of the subchondral
      bone in all osteochondral sections during arthroscopically guided paintbrush
      pattern treatment. Radiofrequency energy should not be used for thermal
      chondroplasty until further work can establish consistent methods for limiting
      the depth of chondrocyte death while still achieving a smooth articular for
      thermal chondroplasty until further work can establish consistent methods for
      limiting the depth of chondrocyte death while still achieving a smooth articular
      surface.

PMID- 11206256
TI  - Catastrophic injuries in pole-vaulters.
AB  - Pole vaulting is a unique sport in that athletes often land from heights ranging
      from 10 to 20 feet. We retrospectively reviewed 32 catastrophic pole-vault
      injuries that were reported to the National Center for Catastrophic Sports Injury
      Research between 1982 and 1998. The purpose of this study was to determine the
      mechanisms of injury so that preventive strategies can be implemented.
      Information was obtained by means of a telephone interview with someone familiar
      with the accident. All injuries occurred in male athletes at an average age of
      17.5 years; 31 were catastrophic head injuries and 1 was a thoracic spine
      fracture that resulted in paraplegia. Three common mechanisms were identified: 17
      (53%) athletes landed with their body on the landing pad and their head on the
      surrounding hard ground, 8 (25%) landed in the vault box after being stranded at
      the height of the jump, and 5 (16%) completely missed the landing pad. The
      mechanism of injury in the remaining two athletes was unknown. The accident
      resulted in death in 16 (50%) athletes and in permanent disability in 6 (19%).
      Increasing the minimum landing pad size and enforcing the rule requiring soft
      surfaces adjacent to the landing pads are the primary recommendations for
      preventing injuries. The authors discuss other rule and equipment changes that
      may help reduce the occurrence of future injuries.

PMID- 11206257
TI  - Fractures about the orbit in professional American football players.
AB  - A retrospective review was performed of records for players who suffered
      fractures about the orbit during participation in officially sponsored activities
      of the National Football League from 1980 to 1997. Clinical information was
      obtained on 19 of 29 players who sustained orbital fractures. The most common
      signs and symptoms included decreased visual acuity (74%, 14), decreased eye
      movement (42%, 8), hyphema (37%, 7), and infraorbital numbness (21%, 4). The
      mechanisms of injury were a digital poke (74%, 14) and blunt facial trauma (26%,
      5). There were significantly more orbital fractures than zygomatic fractures
      suffered by offensive linemen as compared with all other positions. Fifteen of 19
      players were managed with surgical reconstruction; 4 players were treated
      nonoperatively. The mean time from injury to surgical procedure was 7.7 days
      (range, 0 to 42). The mean interval to follow-up was 45.6 months (range, 3 to
      146). At follow-up examination, eight (53%) of the patients treated surgically
      still reported diplopia with upper field gaze. Three of the four patients treated
      nonoperatively were asymptomatic. The mean time lost from games or practice was
      25 days (range, 5 to 56). Ultimately, 17 (89%) players with orbital fractures
      were able to return to full football activities. Two patients were unable to
      resume their careers because of residual visual impairment.

PMID- 11206258
TI  - Correlation of anthropometric measurements, strength, anterior cruciate ligament
      size, and intercondylar notch characteristics to sex differences in anterior
      cruciate ligament tear rates.
AB  - We performed a prospective study based on the hypothesis that physiologic
      differences exist between men and women in strength after adjustments for body
      weight; that the size of the anterior cruciate ligament is proportionate to the
      strength of its antagonists, the quadriceps muscles; and that women have a
      relatively small anterior cruciate ligament, thus predisposing them to a
      disproportionate number of anterior cruciate ligament injuries. One hundred
      matched high school basketball players, 50 male and 50 female, were evaluated
      with anthropometric measurements, body fat analysis, muscle strength evaluation,
      and magnetic resonance imaging measurements of the intercondylar notch and cross
      sectional area of the anterior cruciate ligament at the outlet. The male players
      were taller and heavier than their female counterparts, although they had 11%
      less body fat. Male players had statistically greater quadriceps and hamstring
      muscle strength than female players, even when adjustments were made for body
      weight. With adjustments for body weight, the size of the anterior cruciate
      ligament in girls was found to be statistically smaller than in boys. There was
      no statistically significant difference in the notch width index between the
      sexes. The study data support our hypothesis that sex differences in anterior
      cruciate ligament tear rates are caused primarily by several interrelated
      intrinsic factors. Most importantly, stiffness and muscular strength increase
      stress on the anterior cruciate ligament in female athletes. The anterior
      cruciate ligament, when adjustments have been made for body weight, is smaller in
      female athletes, and therefore, probably does not compensate for the lack of
      stiffness and strength.

PMID- 11206259
TI  - Mechanical evaluation of a soft tissue interference screw in free tendon anterior
      cruciate ligament graft fixation.
AB  - In this study of bioabsorbable screw fixation of free tendon grafts used in
      anterior cruciate ligament reconstruction, we performed load-to-failure and
      cyclic loading of tendon fixation in porcine bone. Bone density measurements from
      dual photon absorptometry scans were obtained to correlate bone density with
      fixation failure. The average density of porcine bone (1.42 g/cm2) was similar to
      that of young human bone (1.30 g/cm2) and significantly higher than that of
      elderly human cadaveric bone specimens (0.30 g/cm2). Cyclic loading was performed
      on free tendon grafts fixed with a bioabsorbable screw alone and on grafts fixed
      with a bioabsorbable screw and an anchor (polylactic acid ball or cortical bone
      disk). Stiffness of fixation increased substantially with the addition of a
      cortical bone disk anchor or polylactic acid ball compared with the interference
      screw alone. Tensile fixation strength of central quadriceps free tendon and
      hamstring tendon grafts were significantly superior in porcine bone of density
      similar to young human bone than in elderly human cadaveric bone. The
      bioabsorbable interference screw yielded loads at failure comparable with
      traditional bone-tendon-bone and hamstring tendon fixation when controlled for
      bone density. The addition of a cortical bone disk anchor provided the most
      optimal fixation of free tendon with the bioabsorbable screw and reduced slippage
      with cyclic loading to a very low level.

PMID- 11206260
TI  - Sagittal plane knee translation and electromyographic activity during closed and
      open kinetic chain exercises in anterior cruciate ligament-deficient patients and
      control subjects.
AB  - Using electrogoniometry and electromyography, we measured tibial translation and
      muscle activation in 12 patients with unilateral anterior cruciate ligament
      injury and in 12 control subjects. Measurements were made during an active
      extension exercise with 0-, 4-, and 8-kg weights and during squats on two legs
      and on one leg where the projection of the center of gravity was placed over,
      behind, and in front the feet. In the uninjured subjects, tibial translation
      increased with increasing load except during the squat with the center of gravity
      behind the feet, which produced the smallest translation. For the active
      extension exercises, translation was greater during eccentric activity. In the
      anterior cruciate ligament-injured knees, all squats resulted in similar
      translation, which was smaller than that during the active extension exercise.
      The highest muscle activation was seen during squats. Hamstring muscle activity
      was low. Increased static laxity in the anterior cruciate ligament-deficient knee
      can be controlled during closed but not during open kinetic chain exercises.
      Coactivation of the quadriceps and gastrocnemius muscles seems to be important
      for knee stability, whereas hamstring muscle coactivation was insignificant. To
      minimize sagittal translation during nonoperative management of anterior cruciate
      ligament-deficient knees, closed kinetic chain exercises are preferable to open
      kinetic chain exercises, and importance should be attached to the spontaneous
      coactivation of the quadriceps and gastrocnemius muscles.

PMID- 11206261
TI  - Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans.
AB  - It has been emphasized that the anterior cruciate ligament plays an important
      role in the proprioceptive feedback system. The anterior cruciate ligament
      hamstring reflex has been revealed in animal experiments, but it has not been
      established in humans. The purpose of this study was to demonstrate direct
      evidence of the anterior cruciate ligament-hamstring reflex arc. Nine knees in
      nine healthy subjects were investigated. The anterior cruciate ligament was
      stimulated by the use of wire electrodes inserted using an arthroscopic
      technique. Electromyographic signals from the biceps femoris and the
      semitendinosus muscles were recorded with surface electrodes. The change in
      electromyographic activity was analyzed after electrical stimulation in the
      normal knee condition, and again after intraarticular sensation had been
      interrupted with a local anesthetic. After electrical stimulation, subjects
      demonstrated increased electromyographic activity of the hamstring muscles in the
      normal knee condition. This response indicates the existence of an anterior
      cruciate ligament-hamstring reflex arc. Conversely, there was no change in
      activity for the hamstring muscle in the anesthetized knee because the afferent
      impulse from the neural elements of the anterior cruciate ligament had been
      removed.

PMID- 11206262
TI  - The effects of patellar taping on patellofemoral incongruence. A computed
      tomography study.
AB  - Patellar taping for the purpose of patellar medialization is a nonoperative
      rehabilitation technique used in the treatment of patellofemoral pain. Despite
      early reports of excellent success rates, the indications for this treatment and
      its efficacy on patellofemoral pain are unclear. The present computed tomography
      study was undertaken to evaluate the effect of patellar taping on patellofemoral
      incongruence. Sixteen female patients (age range, 16 to 25 years) with anterior
      knee pain related to patellofemoral incongruence underwent computed tomography
      examination with their quadriceps muscles relaxed and contracted both before and
      after patellar taping. Patellar lateralization was measured as lateral patellar
      displacement, and patellar tilt was measured as lateral patellar angle. Patellar
      taping did not significantly affect patellofemoral lateralization or tilt. The
      results of this study do not support the use of this method for passive
      correction of patellofemoral incongruence. Although patellar taping may well be
      effective in controlling anterior knee pain during physical therapy, it does not
      do so by medializing the patella.

PMID- 11206263
TI  - The effects of time course after anterior cruciate ligament injury in correlation
      with meniscal and cartilage loss.
AB  - In this study, 130 consecutive patients with anterior cruciate ligament
      insufficiency who were undergoing ligament reconstruction underwent arthroscopic
      examination at the time of reconstruction, and any loss of meniscal or chondral
      integrity was documented in a systematic fashion. In these patients, a greater
      proportion of the medial meniscus was lost compared with the lateral meniscus
      (16% versus 5%). On average, 6 cm2 of the articular cartilage was damaged (5.2
      cm2) or lost (0.8 cm2), with the area of damage and loss greatest on the medial
      femoral condyle. Patients whose injuries had occurred more than 2 years before
      the examination had more than sixfold greater cartilage loss and damage compared
      with those whose injuries had occurred within the past 2 months. Meniscal loss
      was associated with a threefold increase in cartilage damage or loss. The group
      of patients with meniscal loss whose initial anterior cruciate ligament injury
      occurred more than 2 years before examination exhibited 18 times the amount of
      cartilage loss or damage as did the group that had no meniscal loss and whose
      injury occurred less than 1 month before examination.

PMID- 11206264
TI  - Subluxating biceps femoris tendon: an unusual case of lateral knee pain in a
      soccer athlete. A case report.

PMID- 11206265
TI  - Complications associated with the use of meniscal arrows.

PMID- 11206266
TI  - PET in neuro-oncology.
AB  - This article reviews possible clinical applications of positron emission
      tomography (PET) in brain tumor patients. PET allows quantitative assessment of
      brain tumor pathophysiology and biochemistry. It therefore provides different
      information about tumors when compared to histological or neuroradiological
      methods. Common clinical indications for PET comprise tumor delineation and
      identification of the metabolically most active tumor regions (target for biopsy,
      differentiation of viable tumor from necrosis). Further, the spatial relation
      between brain activated e.g., by speech, and the tumor bulk can be explored by
      activation studies. PET could also aid in the prediction of treatment response by
      measurement of tumor perfusion or hypoxia. Moreover, PET tracers could identify
      treatment targets e.g., gene products. The latter topic has not been
      systematically evaluated in human patients.

PMID- 11206267
TI  - Fas receptor counterattack against tumor-infiltrating lymphocytes in vivo as a
      mechanism of immune escape in gastric carcinoma.
AB  - We investigated the presence and functional status of surface expression of the
      Fas receptor (FasR) and its ligand (FasL) in tumor and tumor-infiltrating
      lymphocytes (TIL) in gastric carcinoma (n = 36) from the primary locus,
      metastatic gastric carcinoma (n = 30) from malignant ascites, and benign gastric
      mucosa (n = 30) for the control. The quantitative analysis was based on the
      percentage of positive cells by a flow cytometry. The results showed that the
      membrane-bound FasL molecule was constitutively expressed in primary and
      metastatic gastric carcinomas as well as normal gastric epithelium in nearly all
      the patients. In particular, metastatic carcinoma proved to aberrantly express
      the FasL molecule. On the other hand, FasR expression ranged from minimal or
      absent in primary and metastatic gastric carcinomas, suggesting that the
      carcinoma might be rendered less sensitive toward FasR-induced killing. Apoptotic
      tumor cells detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP
      nick and labeling (TUNEL) were barely identified in primary and metastatic
      carcinomas. In the analysis of TIL, the expression of FasR and FasL, and
      apoptotic TIL could not usually be observed in primary gastric carcinoma. In
      metastatic carcinoma, however, there was significant overexpression of FasR and
      FasL in immune TIL associated with a higher frequency of apoptotic cell death
      detected by TUNEL. The results suggest that metastatic carcinoma expressing FasL,
      but not FasL+ primary carcinoma, might evade the immune attack by apoptotic
      depletion of activated TIL through the FasR/FasL systems. These results provide
      the direct and quantitative evidence of FasR counterattacks and/or paracrine
      fratricides as a mechanism of tumor-immune escape in vivo in human cancer.

PMID- 11206268
TI  - Efficient tumor regression induced by genetically engineered tumor cells
      secreting interleukin-2 and membrane-expressing allogeneic MHC class I antigen.
AB  - PURPOSE: To analyze the immunotherapeutic potentials of genetically engineered
      tumor cells secreting IL-2 and a membrane-expressing allogeneic MHC class I
      molecule Kb in a murine hepatoma model. METHODS: In order to express both genes
      in coordination in the target cells, we constructed a polycistronic retroviral
      vector containing Kb, IL-2, and NeoR genes using two internal ribosome entry
      sites (IRES). Tumor growth was carried out by implantation of transduced tumor
      cells into mouse, while anti-tumor effects were demonstrated by the treatment of
      established tumors. The infiltrated cells were analyzed by immunohistochemistry.
      RESULTS: The combined effect of IL-2 secretion and alloantigen expression on
      immunostimulation was demonstrated by the rejection of transduced tumor cells. In
      the treatment of established tumors, the Kb/IL-2 co-expressing tumor cells
      induced strong anti-tumor immunity, superior to that induced by the single gene
      transduced cells. The increased diversity of infiltrated cell types in tumor
      sites indicated that both a specific and non-specific immune response had been
      activated. CONCLUSION: Our study provides evidence that tumor cells with IL-2
      secretion and membrane-expression of allogeneic MHC class I antigen are capable
      of inducing both strong tumor rejection and immunity.

PMID- 11206269
TI  - Dietary cancer risk from conditional cancerogens (tumor promoters) in produce of
      livestock fed on species of spurge (Euphorbiaceae). IV. Toxicologic and
      pathophysiologic observations in lactating goats and their suckling kids fed on
      the irritant herbs Euphorbia nubica and Euphorbia helioscopia: an etiologic model
      for investigations on the putative risk of cancer by consumption of food p.
AB  - The feeding of lactating goats on usual green fodder, contaminated with Euphorbia
      helioscopia or E. nubica, results in poisoning of the dams as well as their
      suckling kids. General signs of toxicity were emaciation, depression, shedding of
      body hair, arching of back, and possible death. Post-mortem changes of dams and
      dead suckling kids included congestion and hemorrhage in cardiac muscle, lung,
      liver, and kidneys. Blood analyses of goats exposed to these contaminants showed
      an increased level of serum alanine amino transferase compared to control
      samples, indicating cellular destruction in the liver. The latter was confirmed
      by histopathological changes in the organ which include severe congestion,
      necrosis, and degenerative changes. The goats also suffered from deterioration of
      renal function as indicated by increased blood urea nitrogen and creatinine
      levels. In histopathologic inspections of kidney, severe congestion, hemorrhage
      in the cortex and medulla, as well as necrosis of epithelial cells of kidney
      tubules were noticed. Considerable degenerative changes were also observed in
      heart and lung. The pathophysiological appearances indicate that by feeding on
      the Euphorbia species mentioned above, the goats are poisoned in a way similar to
      the case of E. peplus reported previously. Such intoxication most likely is due
      to irritant and hyperplasiogenic diterpene ester (DTE) toxins, usually present in
      the aerial parts of Euphorbia species and well known as tumor promoters in mouse
      skin. After ingestion of the toxic plant parts by the goats, the DTE toxins might
      be metabolized and thereby partially detoxified. Yet, at least in part, they may
      show up in the milk of the goats, as indicated by severe poisoning of their
      suckling kids. As discussed previously in lactating goats fed on fodder
      contaminated with E. peplus, tumor promoters of the DTE type may enter the human
      food chain via this source of milk. Such milk may be considered a valuable
      etiologic model for the investigation of economic, ecologic, and public health
      problems raised by human diet polluted with tumor promoters, i.e., conditional
      (non-genotoxic) cancerogens.

PMID- 11206270
TI  - Dietary cancer risk from conditional cancerogens (tumor promoters) in produce of
      livestock fed on species of spurge (Euphorbiaceae). V. Skin irriitant and tumor
      promoting diterpene ester toxins of the tigliane and ingenane type in the herbs
      Euphorbia nubica and Euphorbia helioscopia contaminating fodder of livestock.
AB  - Irritant diterpene ester toxins were isolated from Euphorbia nubica and E.
      helioscopia, which are contaminants of the green fodder of livestock in Egypt.
      Fractionations of methanol extracts of aerial parts of both plants were monitored
      by the irritation unit on the mouse ear. Plant extracts were subjected to
      multiplicative distribution methods, yielding irritant hydrophilic fractions that
      were further purified by column chromatography. Final purification of the
      materials was achieved by TLC (silica gel) followed by HPLC, or by TLC alone. In
      this way, from E. nubica, five Euphorbia factors (Nu1-Nu5) were isolated and
      characterized as short-chain polyfunctional diterpene esters of tigliane-type
      parent alcohols. The two weak irritants Nul and Nu3 were triesters of 4
      deoxy(4alpha)phorbol. Nu2 was shown to be a triester of the stereoisomeric
      tigliane-type parent alcohol 4-deoxyphorbol. Weak irritant Nu4 probably is a
      positional isomer of Nu2. Nu5 was characterized as a short-chain triester of 4,20
      dideoxy-5xi-hydroxyphorbol. From E. helioscopia, six short- to medium-chain
      polyfunctional diterpene esters of the ingenane type, generally containing
      unsaturated acids were obtained, i.e., four irritant esters of ingenol (Euphorbia
      factors H1, H2, H5, and H6) and two esters of 20-deoxyingenol (non-irritant
      Euphorbia substance HS4, and irritant Euphorbia factor H8). All irritant
      Euphorbia factors of the tigliane and ingenane diterpene ester type described in
      this investigation are considered to be more or less active tumor promoters,
      i.e., conditional (non-genotoxic) cancerogens. The Euphorbia factors assayed
      exhibited moderate (H1) to low (H8) relative tumor-promoting potency in
      comparison to the ingenane prototype DTE tumor promoter 3-TI.

PMID- 11206271
TI  - Bendamustine monotherapy in advanced and refractory chronic lymphocytic leukemia.
AB  - Bendamustine, an alkylating agent without cross-resistance to cyclophosphamide is
      active in a variety of lymphoproliferative and other malignancies. In an open
      phase-II study we treated 23 patients with a median age of 62 years at study
      entry (43-86 years) with advanced, refractory or relapsed (Rai stage III n = 9,
      Rai stage IV n = 14) chronic lymphocytic leukemia (CLL) with bendamustine. At
      study entry, only 13 patients were chemotherapy-naive. The treatment schedule
      with bendamustine was as follows: for patients up to 70 years 60 mg/m2 for 5
      days, for patients over 70 years 50 mg/m2 for 5 days, repetition at day 29.
      Remission criteria were used according to Cheson et al. (1996). All patients were
      evaluable for toxicity and 20 for response. An objective remission was achieved
      in 15/20 patients (75%), including six patients with complete remission (CR).
      Three of the complete responders had no chemotherapy prior to bendamustine. No
      change (NC) occurred in 5/20 patients (25%). Median overall survival after
      bendamustine treatment is 13.6 months (1-46 months) and 16.6 months (1-46 months)
      in patients responding to bendamustine. In total, 74 courses of bendamustine were
      applied. Therapy-related anemia and thrombocytopenia were rare. However, WHO
      grade III/IV leukocytopenia occurred in 38/74 cycles (51%), resulting in
      treatment-related mortality in 3/23 patients (13%). These patients were severely
      immunocompromised due to pretreatment or the underlying disease. As a corollary
      of the study, a general prophylactic antibiotic treatment (trimethoprim/
      sulfamerazine) was instituted. A general feature was the decline of the CD4/CD8
      ratio: mean before therapy: 1.36; after two courses: 0.98; after four courses:
      0.6, as documented in all patients who received at least two courses of
      bendamustine (n = 12). All evaluable patients showed a decline in the CD4/8
      ratio. However, this decline was not clearly related to an increased risk of
      infectious episodes. We observed mainly cutaneous allergic reactions (three WHO
      grade I; one WHO grade II) leading to a cessation of bendamustine treatment in
      4/23 patients (18%). Bendamustine is highly effective in advanced or refractory
      CLL. In multiple pretreated or otherwise severely immunocompromised patients
      bendamustine might lead to additional immunosuppression with subsequent
      infectious complications.

PMID- 11206272
TI  - Neurotoxicity associated with a regimen of carboplatin (AUC 5-6) and paclitaxel
      (175 mg/m2 over 3 h) employed in the treatment of gynecologic malignancies.
AB  - While the combination chemotherapy regimen of carboplatin (AUC 5-6) and
      paclitaxel (175 mg/m2 over 3 h) is widely employed in the treatment of ovarian
      cancer, there are limited data available in the oncologic literature regarding
      the neurotoxic potential of the program. We retrospectively reviewed the clinical
      course of 87 patients treated in the Gynecologic Cancer Program of the Cleveland
      Clinic Taussig Cancer Center to address this important clinical issue. The
      overall incidence of peripheral neuropathy in this population was 25%, with 13%
      of women experiencing symptoms > or = grade 2 in severity. We conclude that while
      neurotoxicity is common following the use of this regimen, significant
      neurological dysfunction (> or = grade 2) is relatively infrequent.

PMID- 11206273
TI  - A comparative study of the clinicopathological significance of E-cadherin and
      catenins (alpha, beta, gamma) expression in the surgical management of oral
      tongue carcinoma.
AB  - PURPOSE: E-cadherin and catenins are important epithelial adhesion molecules in
      normal epithelium. Loss of E-cadherin-catenin adhesion is an important step in
      the progression of many epithelial cancers. E-cadherin and catenins expression in
      carcinoma of the tongue were evaluated in relation to their clinicopathological
      features and prognostic values. METHOD: Immunohistochemical staining was carried
      out with E-cadherin and (alpha, beta, gamma)-catenin monoclonal antibodies for 85
      surgical specimens of oral tongue carcinoma, nine matched metastatic lymph nodes,
      and seven locally recurrent tumours. RESULTS: There was under-expression in 85%
      of E-cadherin, 94% of alpha-catenin, 89% of beta-catenin, and 83% of gamma
      catenin in the primary tumours. There was no correlation of E-cadherin/catenin
      expression with sex, age, cancer stage, and differentiation. Nodal metastasis was
      found in 68% of patients with weak expression of gamma-catenin compared with 9%
      with strong expression in primary tumours (chi-square, P = 0.02). E-cadherin was
      a significant prognostic factor for survival and recurrence; patients with weak E
      cadherin expression had 53% 5-year survival compared with 85% with strong
      expression (Wilcoxon, P = 0.0159). CONCLUSIONS: Both E-cadherin and catenins were
      highly under-expressed in oral tongue carcinoma, metastatic lymph node, and
      recurrent tumour. gamma-catenin had predictive value for nodal metastasis. E
      cadherin was, however, a more important prognostic factor for recurrence and
      survival.

PMID- 11206274
TI  - Carboplatin pharmacokinetics in patients receiving carboplatin and
      paclitaxel/docetaxel for advanced lung cancers: impact of age and renal function
      on area under the curve.
AB  - PURPOSE: To further define the most appropriate way of choosing the dose of
      carboplatin. PATIENTS AND METHODS: The pharmacokinetics of carboplatin were
      analyzed in 30 patients with advanced lung cancer receiving a total of 48 cycles
      of carboplatin plus paclitaxel/ docetaxel combination chemotherapy. Platin
      concentrations of ultrafiltrated plasma and urine samples were determined by
      flameless atomic absorption spectrometry. A multiple regression analysis was
      performed for interactions between pharmacokinetic parameters and pretreatment
      characteristics. RESULTS: Using a twocompartment-model, the following parameters
      were obtained (mean, coefficient of variation): initial half-life, 0.903 h (48%);
      terminal half-life, 13.6 h (116%); maximum plasma concentration (Cmax), 38.5
      microM (86%); AUC, 111.9 microM/h (86%); volume of distribution, 411 l (130%);
      total clearance (Ct), 579 ml/min (75%); renal clearance (Cr), 453 ml/min (80%);
      renal elimination, 76% of dose (17%). In the univariate analysis, age was
      significantly related to Cmax (P = 0.0303), AUC (P = 0.0050), Ct (P = 0.0020), Cr
      (P = 0.0092). Plasma creatinine (Crp) was related to Cmax (P = 0.0228), and
      1/[Crp] was related to Cmax (P = 0.0015) and AUC (P = 0.0054), while body weight
      was related to Cmax (P = 0.0365). No interaction with the schedule of application
      of the two drugs was observed. In the multivariate analysis, factors
      significantly related to AUC were 1/[Crp] (P < 0.01) and age (P < 0.01). Crp (P <
      0.05) and 1/[Crp] (P < 0.01) were significantly associated with Cmax.
      CONCLUSIONS: These data stress the importance of dosing carboplatin according to
      renal function and age and warrant further analyses to validate this concept
      prospectively.

PMID- 11206275
TI  - Combination cancer chemoprevention with green tea extract and sulindac shown in
      intestinal tumor formation in Min mice.
AB  - Green tea is the most effective beverage for cancer prevention in humans. Looking
      at the concept of combination cancer chemoprevention, we previously reported the
      synergistic effects of (-)-epigallocatechin gallate (EGCG) with sulindac, and the
      additive effects of EGCG with tamoxifen, on cancer-preventive activity in human
      lung cancer cell line PC-9. This paper reports confirmation of the synergistic
      effects of EGCG with sulindac on the inhibition of intestinal tumors in multiple
      intestinal neoplasia (Min) mice. Treatment with both green tea extract and
      sulindac significantly reduced the number of tumors from 72.3 +/- 28.3 to 32.0 +/
      18.7 tumors per mouse, a decrease of 44.3%, whereas treatment with green tea
      extract alone or with sulindac alone reduced it to 56.7 +/- 3.5 and 49.0 +/-
      12.7, respectively. The results also indicated that green tea extract inhibited
      tumor growth in Min mice almost as potently as sulindac itself did. The three
      treated groups did not show any adenocarcinomas, whereas 10.8% of the control
      group did. Since cancer-preventive agents like sulindac and tamoxifen are
      associated with adverse effects, we discuss the possibility of non-toxic,
      combination cancer chemoprevention with green tea, looking at the goal of truly
      effective cancer prevention.

PMID- 11206276
TI  - Epidemiologic aspects of cancer prevention in Germany.
AB  - In Germany, as in other highly industrialized countries, cancer is the second
      most common cause of death. With approximately 210,000 individuals dying each
      year from malignant tumours, roughly one in four deaths in Germany can currently
      be attributed to cancer. Only in the past few years has there been a slow decline
      in the age-standardized mortality rates for cancer, even among men. This follows
      a long period of some decades, during which the mortality steadily increased and
      then persisted at a high level. The reversal, however, does not mean that the
      situation is no longer a cause for concern. In fact, for the most common cause of
      death, namely the cardiovascular diseases, a much greater decrease in mortality
      has been observed for many years now. If this trend continues, cancer could
      become the largest killer in another 15 to 20 years. On the other hand, we have
      been aware since the end of the 1960s that the majority of cancers are caused by
      environmental influences and are thus, in principle, avoidable. In the present
      contribution we present: (a) the fundamental arguments to support the thesis that
      a large proportion of cancers, and of cancer deaths, could be avoided; and (b) an
      estimate for Germany of both the theoretical potential of primary cancer
      prevention and also the practically attainable potential. The estimates are based
      on very conservative assumptions. They yield, for the theoretical potential,
      values in the range 43-65% and for the reduction actually obtainable in the
      medium term due to primary prevention, values of 18-31%.

PMID- 11206277
TI  - Short-term plasticity of extrinsic excitatory inputs to neocortical layer 1.
AB  - Previous studies have shown that different pyramidal cell inputs vary in the
      short-term plasticity expressed when they are subjected to repetition of use.
      Here, we describe short-term plasticity at synapses that mediate long-range input
      to neocortical layer 1 and compare it with that which normally occurs in the
      hippocampal Schaffer collateral pathway, which also involves projection by remote
      inputs onto apical dendrites. We isolated tangential inputs to layer 1 in
      neocortical slices, stimulated these with brief 40-Hz trains, and examined
      postsynaptic responses by recording extracellularly from layer 1 in
      somatosensory, prefrontal, and visual neocortex, and intracellularly from
      visually identified pyramidal cell somata in layer 2/3 in somatosensory and
      prefrontal neocortex. Train response amplitudes were characterized by calculating
      paired-pulse ratios, fifth-versus-first amplitude ratios (5th/1st ratios), and a
      center-of-mass index "M". As expected, the hippocampal train responses
      facilitated strongly. In contrast, layer-1 responses displayed strong synaptic
      depression in all regions examined. This depression was reflected in 5th/lst
      ratios and M scores, but not paired-pulse ratios because it did not consistently
      begin until the third responses in trains. It persisted unchanged in the presence
      of partially blocking levels of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), but
      was converted to strong facilitation when slices were bathed in low-Ca++ media.
      Intracellularly, we observed response-train depression very similar to that
      recorded extracellularly. These findings show that long-range inputs to
      neocortical layer 1 display short-term plasticity markedly different from that
      which normally occurs at hippocampal Schaffer collateral synapses, but similar to
      that which has been described previously for excitatory inputs to pyramidal cells
      in deeper neocortical layers.

PMID- 11206278
TI  - Thalamocortical arbors extend beyond single cortical barrels: an in vivo
      intracellular tracing study in rat.
AB  - Neurons in layer IV of rat somatosensory (SI) barrel cortex receive punctate
      somatic input from well-defined regions of the periphery. Following peripheral
      deafferentation, SI neurons in deafferented cortex respond to new input from
      neighboring regions of the skin surface. The precise mechanism(s) through which
      this occurs is unknown, although corticocortical and barreloid to barrel
      connections have been suggested as possible substrates. Because layer-IV barrels
      receive a strong afferent input from ventroposterior (VP) thalamic projection
      neurons, any divergence in the thalamocortical (TC) projection to multiple
      cortical barrels could also provide an anatomical substrate for rapid cortical
      reorganization. We used in-vivo intracellular recording methods to record and
      physiologically identify neurons in rat VP and to label those neurons with an
      intracellular tracer. Thalamic neurons (n=117) were impaled with sharp
      intracellular electrodes, and the receptive field(s) and firing pattern were
      measured. Cells were then injected with biocytin or biotinylated dextran amine
      (BDA). A total of 38 labeled TC neurons were quantitatively analyzed for soma
      size and dendritic arborization size; quantitative analysis of TC-axon
      arborizations in layer IV of barrel cortex was carried out in a total of 13 TC
      neurons. Two different axon-arborization patterns were identified in SI cortex:
      direct-projecting axons (n=6) were observed to project to and arborize within a
      single cortical barrel as well as extend their fibers into adjacent barrels;
      bifurcating-type axons (n=7) were seen to bifurcate in the subcortical white
      matter or in layer VI and then project to multiple barrel columns, where they
      arborized in layer IV. Axon fibers were always observed in three or more cortical
      barrels (mean=5, range=3-7). The mean mediolateral extent of arborizations in
      layer IV for the direct-projecting and bifurcating type axons were 458 microm and
      1,302 microm, respectively, and these were significantly different (t=3.78,
      P<0.01). Axon-fiber length within cortical laminae was measured for each
      arborization pattern in relationship to the total fiber length within a cortical
      column. Direct-projecting axons always had greater than 50% of their fiber length
      within layer IV. Bifurcating-type axons were differentially distributed within
      multiple columns and always had less than 50% of their total column fiber length
      in layer IV. Morphological analysis of TC somata and dendrites revealed no
      correlation between local neuron morphology and axonal-arborization patterns. All
      intracellularly recorded TC neurons had similar adapting firing patterns when
      injected with a long-duration pulse. Our results showed that TC neurons project
      to multiple cortical barrels with one barrel receiving the principal input. This
      divergent TC projection pattern in SI cortex may provide an anatomical substrate
      for cortical plasticity and must be considered in any mechanism of rapid cortical
      reorganization.

PMID- 11206279
TI  - Canal-otolith interaction in the fastigial nucleus of the alert monkey.
AB  - To determine the contribution of the otoliths as well as the horizontal and
      vertical semicircular canals to the response of "vestibular only" neurons in the
      rostral fastigial nucleus of the alert monkey, we applied natural sinusoidal
      vestibular stimuli (0.6 Hz; +/-15 deg) around different axes. During the
      experiment the monkey sat erect in a primate chair with the head immobile.
      Semicircular canal responses were investigated during tilted yaw stimulation
      around an earth vertical axis. The tilt angle was varied by 30 deg and included
      the optimal plane for horizontal canal stimulation (15 deg nose down from the
      stereotactic plane). The otoliths and mainly the vertical canals made
      contributions during stimulation around an earth-fixed horizontal axis (vertical
      stimulation). Head orientation was also slowly altered (2-3 deg/s) over a range
      of 180 deg under both stimulus conditions (tilted yaw and vertical stimulation).
      Neuronal data for each paradigm were fitted by a least squares best-sine
      function. Computation of the hypothetical contributions made by all three pairs
      of semicircular canals and the otoliths to these responses showed that 74% of the
      46 neurons investigated received an otolith input; in most instances it was
      combined with a canal input. Neurons most often received input from the
      horizontal and vertical canals as well as the otoliths. Only a minority of
      neurons received a purely otolith (13%), vertical canal (13%), or horizontal
      canal (4%) input. Conventional criteria (head position-related activity,
      spatiotemporal convergence, STC) failed to detect an otolith contribution in
      several such instances. Thus, canal-otolith convergence is the general rule at
      this central stage of vestibular information processing in the fastigial nucleus.
      The large variety of response types allows these neurons to participate in
      multiple tasks of vestibulospinal movement control.

PMID- 11206280
TI  - Postnatal development of biotinylated dextran amine-labeled corpus callosum axons
      projecting from the visual and auditory cortices to the visual cortex of the rat.
AB  - The distribution and morphology of developing corpus callosum (CC) axons in rat
      visual cortex was studied by unilateral application of the in vivo anterograde
      tracer biotinylated dextran amine (BDA) to the visual or auditory cortex of
      newborns through adults. Changes in the distribution and morphology of CC axons
      during development were observed. Following BDA placement only in visual cortex,
      nearly all CC projections were to visual cortex (homotopic CC projections). At
      postnatal day (PND) 5-8, labeled CC axons were found throughout the contralateral
      visual cortex, including area 17; these CC axons could be followed from the white
      matter to layer I. By PND 13, few CC axons were found in medial area 17,
      indicating the existence of transitory CC axons in area 17 at younger ages.
      Morphological changes were investigated at the area 17/18a border and showed that
      CC axon collaterals were not formed until PND 8, and terminal arbors were not
      visible until PND 13; by PND 17, the adult CC-axon terminal pattern was present.
      At all ages, only a few heterotopic CC projections from visual to auditory cortex
      were found in the gray matter, although many labeled CC axons extended laterally
      into the white matter underlying the auditory cortex. Following BDA placement
      only in auditory cortex, CC projections to both auditory (homotopic CC
      projections) and visual (heterotopic CC projections) cortex were observed. At all
      ages, the homotopic CC projections were present throughout the auditory cortex,
      but were not distributed homogeneously; densely labeled CC axons showed a
      distinct columnar organization. The heterotopic CC projections were present in
      all visual cortical areas, including medial area 17, in significant numbers until
      PND 24, but were mostly eliminated by PND 28, at which time a labeling pattern
      similar to the adult was found. Thus, most of the heterotopic CC projections were
      transitory. The present study confirms the existence of transitory CC axons
      projecting through all layers of the visual cortex, as revealed by DiI, and
      extends the DiI results by showing that these transitory CC axons arise from both
      homotopic and heterotopic origins. Furthermore, different sources of transitory
      CC axons have different timetables for elimination.

PMID- 11206281
TI  - Passive finger movement evoked fields in magnetoencephalography.
AB  - We studied neuromagnetic fields during passive finger movements in 11 normal
      subjects. Activation started 27 ms after the onset of movement and remained for
      about 100 ms. Four activation maxima occurred within this time range, PM1 at 27
      ms, PM2 at 46 ms, PM3 at 85 ms, and PM4 at 125 ms. Not all components were
      distinguishable in every subject partly due to overlapping effects, but PM3 was
      present in all subjects. Magnetic source imaging (MSI) revealed dipolar sources
      within 1 cm of the central sulcus for all four components. The results suggest
      that studying the integrity of the sensorimotor system in patients regardless of
      their degree of motor impairment is feasible.

PMID- 11206282
TI  - Eye-head coordination and the variation of eye-movement accuracy with orbital
      eccentricity.
AB  - Different humans vary widely in the tendency to move the head during saccadic
      shifts in gaze. The reasons for this variation are unknown. Because combined eye
      head movements are associated with a recentering of the eyes in the orbits,
      humans who are "head movers" tend to maintain the eyes within a narrower range
      than do non-head movers. We explored the possibility that variations in the
      ability to control eye movements at eccentric positions lead to variations in
      customary ocular motor range and, by extension, explain the variations in head
      movement tendencies. We studied ten normal adults. In each, we measured the full
      scale ocular motor range and customary ocular motor range (the eccentricity range
      within which the eye was found at the conclusion of eye- or eye-head saccades).
      We also determined the eye-only range, the orbital range within which the
      probability of a head movement accompanying a gaze shift was low. Customary, eye
      only, and full-scale ranges spanned (mean +/-SD) 41.1+/-16.9 degrees, 30.2+/-18.8
      degrees, and 92.8+/- 9.1 degrees, respectively. We then assessed variations in
      kinematics of several ocular motor behaviors as functions of eye eccentricity.
      The stable fixation range, defined by the range over which drift velocities were
      below 1 degree/s, spanned 81.1+/-11.2 degrees in the light and 69.5+/-21.5
      degrees in the dark. The range over which the gains of the vestibulo-ocular
      reflex in the light and smooth pursuit approached their values at zero
      eccentricity spanned 66.3+/-7.1 degrees and 69.0+/-10.0 degrees, respectively.
      Small centrifugal saccades (5-10 degrees) tended to become either slowed or
      hypometric with increasing eccentricity. Sensitive to both slowing and
      hypometria, the ratio of peak gaze velocity to target shift amplitude was flat
      over a range spanning 65.7+/-14.9 degrees. Finally, the ranges over which the
      initial saccade placed the fovea upon the target averaged 35.5+/-10.7 degrees for
      eye-only saccades and 36.6+/-15.0 degrees for eye-head saccades. With the
      exception of the range of stable fixation in the light, the kinematic ranges were
      either unrelated or inconsistently related to full-scale range, indicating that
      the deterioration of eye movements with increasing ocular eccentricity is not a
      simple consequence of the eyes encountering the limits of their excursion. None
      of the kinematic ranges correlated positively with customary or eye-only range.
      Thus, while head movements may be orchestrated so as to maintain the eyes within
      a desired range, that range (and thus head movement tendencies) is not predicated
      upon the range of ocular eccentricity over which eye movements are accurately
      controlled.

PMID- 11206283
TI  - Abnormal vestibular control of gaze and posture in a strain of a waltzing rat.
AB  - The waltzing behavior is usually attributed to vestibular dysfunction. However,
      the vestibular control of gaze and posture has not yet been measured
      quantitatively in any waltzing mutant. Therefore, this study was aimed at
      investigating the relationship between inner-ear morphology, the circling
      behavior, and the vestibular control of gaze and posture in a new strain of
      waltzing rats. Light- and electron-microscopy studies of these mutants did not
      reveal any structural abnormalities of the vestibular neural epithelia. In
      addition, the expression of Calretinin and 200-kD phosphorylated and non
      phosphorylated neurofilaments was also found to be normal in the vestibular
      neural epithelia and ganglion cells. In contrast, the mutants showed severe
      dysfunctions of the vestibular control of gaze and posture. The skeletal geometry
      of the alert unrestrained animals was studied using cineradiography. At rest,
      waltzing rats held their heads tilted down: the horizontal semicircular-canal's
      plane was near the earth-horizontal's plane, instead of being tilted up as in
      Long Evans control rats. In addition, their cervical column was pitched more
      forward (33.6 degrees) than in the control group (6.9 degrees). The circling
      behavior was observed frequently, and the rats had episodes of circling in both
      directions. The episodes of circling amounted to an average of 17 turns, and the
      average angular velocity of the circling was 645 degrees/s. Unilateral
      labyrinthectomy induced the same postural and oculomotor syndromes in the
      waltzing and control groups. This indicates that the mutant vestibular nerve had
      a significant resting discharge before the lesion. Eye movements were recorded
      using acutely implanted search coils. Although waltzing rats were able to perform
      normal spontaneous eye movements, they showed a complete deficit of the
      horizontal vestibulo-ocular reflex (HVOR) and an impairment of the maculo-ocular
      reflex (MOR) during constant velocity, off-vertical axis rotation (OVAR). These
      results show, for the first time, that deficient transduction and/or processing
      of the horizontal-canal- and macular-related information can be causally related
      to the circling behavior and abnormal posture, respectively.

PMID- 11206284
TI  - How sensitive is hand transport to illusory context effects?
AB  - A recent report that hand transport was sensitive to a size-contrast illusion
      (SCI) implied that the distinction between visual processing for perception
      versus action might only affect visual information obtained late during reaching.
      In this study, the presence of a perceptual SCI did not affect reaction time,
      movement time, or movement amplitude. However, both perception and action became
      sensitive to the SCI with memory-based responses. It is concluded that the
      distinction between visual processing for perception versus action does extend to
      hand transport. Immediate action is entirely based on veridical visuo-motor
      representations, whereas even slightly delayed actions begin to reflect distorted
      perceptual representations.

PMID- 11206285
TI  - Spatial and temporal control of trunk-assisted prehensile actions.
AB  - The present study utilized a trunk-assisted prehension task to examine the
      hypothesis that there is spatial regularity between the grasp and transport
      components. To test this hypothesis, we varied movement amplitude, reach speed,
      and object size. When examining the opening and closure phases of aperture
      formation, it was found that the distance to peak aperture increased
      systematically with hand-path trajectory length, while the distance from peak
      aperture to the object remained constant, which supports the notion of state
      space control. Regarding the relationship among the body segments involved,
      temporal measures such as relative time to peak aperture, and peak velocity of
      the arm and trunk were altered by the changes in both object size and reach
      speed. It was also found that the time to peak trunk velocity was coupled with
      the time to peak arm velocity as well as with the time to peak aperture. Based on
      these results, it appears that the trunk is closely linked not only to the arm
      motion, but also to the aperture formation. Collectively, these findings suggest
      that, during trunk-assisted prehension, the arm and the trunk are coordinated by
      neuromotor synergies that appear to position grip aperture for a stable closure
      to grasp the object.

PMID- 11206286
TI  - Reaching affects saccade trajectories.
AB  - The pre-motor theory suggests that, when attention is oriented to a location, the
      motor systems that are involved in achieving current behavioural goals are
      activated. For example, when a task requires accurate reaching, attention to a
      location activates the motor circuits controlling saccades and manual reaches.
      These actions involve separate neural systems for the control of eye and hand,
      but we believe that the selection processes acting on neural population codes
      within these systems are similar and can affect each other. The attentional
      effect can be revealed in the subsequent movement. The present study shows that
      the path the eye takes as it saccades to a target is affected by whether a reach
      to the target is also produced. This effect is interpreted as the influence of a
      hand-centred frame used in reaching on the spatial frame of reference required
      for the saccade.

PMID- 11206287
TI  - Initial evidence for the mixing and soft assembly of the ankle, suspensory, and
      hip muscle patterns.
AB  - The onset latencies of automatic muscle responses to backward translations of the
      support surface in standing subjects were assessed to test two longstanding
      hypotheses: that (1) the ankle, hip, and suspensory muscle patterns represent
      discrete synergies; and (2) the suspensory pattern cannot be mixed with the ankle
      and the hip patterns (based on theoretical modeling). Muscle responses were
      recorded at the leg (medial gastrocnemius and tibialis anterior), thigh
      (hamstring and quadriceps), lower trunk (paraspinals and abdominals), and the
      upper trapezius muscles. A principal factor analysis with orthogonal varimax
      rotation was conducted to describe the variation among the muscle onset latencies
      by means of the smallest possible set of newly defined variables, or factors.
      Muscles that were correlated with each other were grouped into a factor. The
      analysis produced three factors with eigenvalues > or =1, which accounted for 81%
      of the total variance. Based on the first muscle response in each factor, the
      muscle patterns resembled the hip, ankle, and suspensory synergies. Muscle
      responses within a synergy were activated before the completion of the muscle
      responses in the other synergies, indicating that the synergies, though mixed,
      are triggered separately. This is consistent with the hypothesis that the ankle,
      hip, and suspensory patterns represent discrete synergies. On the other hand, the
      results do not support the hypothesis that the three patterns cannot be combined.

PMID- 11206288
TI  - Pupillary response to chromatic flicker.
AB  - There is significant evidence for higher-level cortical control of pupillary
      responses to visual stimuli, suggesting that factors other than luminance changes
      may induce a pupillary response. In the present study, the pupillary responses to
      equiluminant flickering stimuli in a range of 3-13 Hz were examined. Flicker
      stimuli included color-black (luminance-modulated) and color-color (hue
      modulated) flicker. Equiluminance was determined both by objective luminance
      measures as well as by subjective, perceptual equiluminance for each subject. For
      both objectively and subjectively equiluminant flicker, significant, sustained
      pupillary constrictions were recorded. The magnitude of these responses was
      sensitive to both color and frequency parameters; red-blue color-paired flicker
      consistently produced the strongest constrictions. These responses occurred even
      when the flicker was of a lower luminance, both physically and perceptually, than
      a preceding nonflickering color, indicating that chromatic rather than luminance
      sensitive mechanisms are involved in this response. Interestingly, the color- and
      frequency-sensitivity of constriction parallels those of flickers which maximally
      stimulate photosensitive epileptic patients, raising the possibility that
      chromatic response may be a factor in photosensitivity.

PMID- 11206289
TI  - Neuronal pathways from group-I and -II muscle afferents innervating hindlimb
      muscles to motoneurons innervating trunk muscles in low-spinal cats.
AB  - Synaptic inputs to motoneurons innervating the back and abdominal muscles in the
      lumbar part of the body from low-threshold hindlimb muscle afferents were studied
      in unanesthetized low-spinal cats. At a stimulus intensity of 1.2-1.5x threshold
      (T), which was sufficient to activate only group-I afferents, the incidence of
      post-synaptic potentials (PSPs) was higher when stimulating proximal muscle
      nerves than when stimulating distal muscle nerves (e.g., 52% versus 22% for
      motoneurons innervating m. iliocostalis lumborum: Ilio MNs; 38% versus 18% for
      motoneurons innervating m. obliquus externus: OEA MNs). At 2-5 T, at which group
      II as well as group-I muscle afferents were presumably stimulated, the PSP
      incidence increased irrespective of nerves stimulated (e.g., 76% for Ilio MNs;
      60% for OEA MNs). The minimal central latencies of EPSPs evoked at 1.2-1.5 T
      ranged 0.8-16.7 ms for Ilio motoneurons and 1.4 -14.2 ms for OEA motoneurons,
      indicating that the connection between back and abdominal motoneurons and low
      threshold afferents from the hindlimb muscle include a monosynaptic one. The
      latencies of IPSPs were longer and ranged 1.9-18.8 ms for Ilio motoneurons and
      2.4-15.8 ms for OEA motoneurons. Input patterns from various hindlimb muscles
      varied among individual motoneurons, even though they were within the same
      motoneuron pool. Such synaptic organization seems to differ from that for the leg
      motoneuron pool. The overall projection pattern of low-threshold afferents from
      leg muscles to lumbar back and abdominal motoneurons nevertheless suggests that
      group-I afferent inputs are related to lateral and vertical movements, and that
      group-II afferent inputs control the stiffness of the trunk.

PMID- 11206290
TI  - Operant conditioning of rat H-reflex affects motoneuron axonal conduction
      velocity.
AB  - This study assessed the effects of operant conditioning of the H-reflex on
      motoneuron axonal conduction velocity in the rat. After measurement of the
      control H-reflex size, rats were either exposed for at least 40 days to the HRup
      or HRdown conditioning mode, in which reward occurred only if the soleus H-reflex
      was greater than (HRup mode) or less than (HRdown mode) a criterion or continued
      under the control condition (HRcon mode) in which the H-reflex was simply
      measured. We then measured axonal conduction velocity of triceps surae motor
      units of HRup, HRdown, and HRcon rats by stimulating the axon in the ventral root
      and recording from the tibial nerve. Conduction velocity was 8% less in
      successful HRdown rats than in HRcon rats (P=0.02). Conduction velocity in HRup
      rats and unsuccessful HRdown rats was not significantly different from that in
      HRcon rats. Since recording bypassed the intra-spinal portion of the motoneuron,
      the change was clearly in the axon. This decrease was similar to the 6% decrease
      previously found in successful HRdown monkeys. Unsuccessful HRdown rats and
      monkeys did not show this decrease. This result suggests that the mechanism of
      HRdown conditioning is similar in rats and monkeys and provides further support
      for the hypothesis that HRdown conditioning decreases motoneuron excitability by
      producing a positive shift in firing threshold. While traditional theories of
      learning emphasize synaptic plasticity, neuronal plasticity may also contribute
      to operantly conditioned behavioral changes.

PMID- 11206291
TI  - Operant conditioning of rat H-reflex: effects on mean latency and duration.
AB  - We are currently studying the mechanisms of operantly conditioned changes in the
      H-reflex in the rat. Primate data suggest that H-reflex decrease is due to a
      positive shift in motoneuron firing threshold and a small decrease in the
      monosynaptic excitatory postsynaptic potential (EPSP), and that increase might be
      due to change in group-I oligosynaptic (especially disynaptic) input. To further
      evaluate the possibility of conditioned change in oligosynaptic input, we
      compared the mean latency (i.e., the average latency of the entire H-reflex) and
      the duration of control (i.e., pre-conditioning) H-reflexes with those of H
      reflexes after up-conditioning or down-conditioning. Up-conditioning was
      associated with small, statistically significant increases in H-reflex mean
      latency [+0.11+/-0.05 (+/-SE) ms] and duration (+0.32+/-0.16 ms). The mean
      latency of the H-reflex increase (i.e., the part added to the H-reflex by up
      conditioning) was 0.28+/-0.14 (+/-SE) ms greater than that of the control H
      reflex. Down-conditioning had no significant effect on mean latency or duration.
      While these results indicate that operant conditioning does not greatly change H
      reflex mean latency or duration, the effects detected with up-conditioning are
      consistent with the hypothesis that decreased inhibition, or increased
      excitation, by homonymous and heteronymous group-I oligosynaptic input
      contributes to the H-reflex increase produced by up-conditioning. Several other
      mechanisms might also account for these small effects.

PMID- 11206292
TI  - What do the MMPI scales fundamentally measure? Some hypotheses.
AB  - I consider the question of whether all psychopathological behaviors can, on an
      evolutionary foundation, be considered as positive adaptations. I proposed that
      higher functions can be differentiated from their associated emotional
      modulations at simultaneous subjective, behavioral, and neural levels and that
      organizing analyses in this way will enable us to fill in our understanding of
      both the effects and relief of traumatic experiences. I then present each of the
      8 clinical scales of the MMPI (Hathaway & McKinley, 1943) as a dimension of
      positive adaptation with simultaneous cognitive-emotional, operant-classical, and
      neocortical-limbic elements. A variety of life-experience paradigms are then
      offered to explain the factors that operate to increase MMPI scale elevations as
      well as countermeasures that can operate to reduce such elevations. Understanding
      all such behaviors as adaptive leads to a notable enhancement of empathy.

PMID- 11206293
TI  - An openness scale for the California Psychological Inventory.
AB  - We developed a 36-item scale to measure Openness, using items on the California
      Psychological Inventory (CPI; Gough, 1957, 1987, 1996), Form 434. Items were
      initially chosen on the basis of content validity. Five samples (N = 2,375) were
      used to establish reliability, validity, and norms; 4 samples consisted of
      university undergraduate students, and 1 comprised applicants for nonmanagement
      call centerjobs. Internal consistency estimates obtained in each sample averaged
      approximately .75, and test-retest stability, assessed in 1 sample, was estimated
      at .84. Cross-correlations with related scales, for example, the NEO Personality
      Inventory-Revised Openness scale (Costa & McCrae, 1992) and other CPI-based
      scales, provided evidence of construct validity. Statistically significant
      predictive validities were obtained in 2 call centerjob-incumbent samples, with
      range-corrected true validities of .20 to .36 for a number of job performance
      criteria. Construct and predictive validity were found to be higher than for
      other scales consisting of CPI items designed to measure Openness or a related
      construct. Finally, norms were prepared for university undergraduate students (n
      = 1,847) and nonmanagement service-sector job applicants (n = 528).

PMID- 11206294
TI  - Should human figure drawings be admitted into court?
AB  - In recent years, there has been debate about the validity of figure drawings,
      although surveys of clinicians in both general and forensic practice still find
      them to be one of the most widely used tests of personality functioning. Using
      both Heilbrun's (1992) guidelines for the use of psychological tests in a
      forensic evaluation and the U.S. Supreme Court's Daubert v. Merrell Dow
      Pharmaceuticals, Inc. (1993) criteria for the admission of scientific evidence, I
      examine the admissibility of human figure drawings in court. The results suggest
      that the most commonly used methods for interpreting human figure drawings fall
      short of meeting the standards for admissibility. The use of overall rating
      scales, although weak in validity, appear to minimally meet these standards.

PMID- 11206295
TI  - Predicting DMS-IV cluster B personality disorder criteria from MMPI-2 and
      Rorschach data: a test of incremental validity.
AB  - Despite their frequent conjoint clinical use, the incremental validity of
      Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has
      not been adequately established, nor has any study to date explored the
      incremental validity of these tests for predicting Diagnostic and Statistical
      Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association,
      1994) personality disorders (PDs). In a reanalysis of existing data, we used
      select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial,
      borderline, histrionic, and narcissistic PD criteria in a sample of treatment
      seeking outpatients. The correlational findings revealed alimited relation
      between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer,
      1989) variables, with only 5 of 30 correlations reaching significance (p <.05).
      Hierarchical regression analyses showed that both the MMPI and Rorschach data add
      incrementally in the prediction of DSM-IV borderline and narcissistic PD total
      criteria scores. The findings were less clear for the incremental value of
      Rorschach and MMPI-2 data in predicting the total number of DSM-IV histrionic PD
      criteria, which were best predicted by Rorschach data, and antisocial PD
      criteria, which were best predicted by MMPI-2 data. In addition to providing
      evidence of the incremental validity of Rorschach data, these findings also shed
      light on the psychological characteristics of the DSM-IV Cluster B PDs.

PMID- 11206296
TI  - Dimensions of self-serving misrepresentation in forensic assessment.
AB  - I conducted an exploratory principal components analysis of 15 scales that
      evaluate a variety of possible self-serving biases using assessment data from 101
      general forensic clients. Three distinct factors emerged, representing
      exaggeration of psychiatric symptoms versus exaggeration of personal adjustment,
      exaggeration of virtue, and exaggeration of physical health difficulties.
      Confirmatory factor analysis supported the findings. The surprising fact that
      none of the scales contained a significant number of items representing the
      affirmation or exaggeration of positive mental health adjustment precluded the
      possibility of finding a specific factor in that area. The factor structure was
      similar to previous results based on personal injury evaluations alone,
      suggesting that this 3-factor categorization of self-serving misrepresentation
      has some degree of generality, at least in forensic settings.

PMID- 11206297
TI  - Psychological assessment on internship: a survey of training directors and their
      expectations for students.
AB  - We used a survey of internship training directors to examine the nature of
      assessment use and assessment skills training at 382 internship settings in
      professional psychology across the United States and Canada. For the purposes of
      this study, we created a questionnaire that inquired about the types of
      assessment instruments used at each internship setting, the amount and type of
      training offered at internship sites, and the type of assessment experience
      desired of interns before beginning their rotations. The results revealed several
      differences across type of internship facility surveyed as well as several trends
      in the current use of assessment in applied settings. The findings further
      demonstrate the important role of projective assessment in the training of
      graduate students and lead to the conclusion that major discrepancies may exist
      between what is being taught in graduate school and what students are expected to
      know on entering their internship positions.

PMID- 11206298
TI  - Agency and communion in the structure of parental representations.
AB  - We administered the revised Assessment of Qualitative and Structural Dimensions
      of Object Representations (Blatt, Chevron, Quinlan, Schaffer, & Wein, 1992) to
      279 male and female undergraduate students and carried out independent principal
      components analyses of maternal and paternal ratings. Three stable factors,
      Agency, Communion, and Structure, were found in both sets of ratings. This factor
      structure differed from that reported by Quinlan, Blatt, Chevron, and Wein
      (1992). Results found here are consistent with contemporary interpersonal
      personality theory.

PMID- 11206299
TI  - Levels of interpersonal concerns and social functioning in early adolescent boys
      and girls.
AB  - Previous research has shown that the Interpersonal Concerns factor of the
      Depressive Experiences Questionnaire (DEQ; Blatt, D'Affliti, & Quinlan, 1976,
      1979; Depressive Experiences Questionnaire for Adolescent [DEQ-A]; Blatt,
      Schaffer, Bers, & Quinlan, 1992) assesses 2 levels of interpersonal relatedness
      in young adults and older adolescents: neediness and relatedness. However,
      studies investigating the relation of the DEQ and DEQ-A with social functioning
      have not used the Neediness and Relatedness subscales of the Interpersonal
      Concerns factor. This study investigated (a) whether the Neediness and
      Relatedness subscales can be differentiated in a sample of early adolescents and
      (b) how the 2 subscales are differentially associated with indexes of social
      functioning. Results indicate that this differentiation of Neediness and
      Relatedness, and their associations with social functioning, emerges in early
      adolescence, especially for girls.

PMID- 11206300
TI  - Superiority of form% over Lambda for research on the Rorschach Comprehensive
      System.
AB  - Lambda is an important variable in the Rorschach Comprehensive System. However,
      because of the way it is calculated it has properties that can produce problems
      for parametric statistical analyses. We illustrate these difficulties and
      encourage the use of Form% (i.e., pure form responses/total responses) instead of
      Lambda in research. Form% is easy to calculate, and it is conceptually and
      mathematically comparable to Lambda. Because it is much more normally
      distributed, Form% is suitable to use in parametric analyses (e.g., t tests,
      analyses of variance, correlations, factor analyses, multiple regressions).

PMID- 11206301
TI  - Evaluation of an MMPI--a short form: implications for adaptive testing.
AB  - Efforts to develop a viable short form of the MMPI (Hathaway & McKinley, 1943)
      span more than 50 years, with more recent attempts to significantly shorten the
      item pool focused on the use of adaptive computerized test administration. In
      this article, we report some psychometric properties of an MMPI-Adolescent
      version (MMPI-A; Butcher et al., 1992) short form based on administration of the
      first 150 items of this test instrument. We report results for both the MMPI-A
      normative sample of 1,620 adolescents and a clinical sample of 565 adolescents in
      a variety of treatment settings. We summarize results for the MMPI-A basic scales
      in terms of Pearson product-moment correlations generated between full
      administration and short-form administration formats and mean Tscore elevations
      for the basic scales generated by each approach. In this investigation, we also
      examined single-scale and 2-point congruences found for the MMPI-A basic clinical
      scales as derived from standard and short-form administrations. We present the
      relative strengths and weaknesses of the MMPI-A short form and discuss the
      findings in terms of implications for attempts to shorten the item pool through
      the use of computerized adaptive assessment approaches.

PMID- 11206302
TI  - Body-esteem scale for adolescents and adults.
AB  - Body esteem (BE) refers to self-evaluations of one's body or appearance. This
      article outlines a BE questionnaire for adolescents and adults that has 3
      subscales: BE-Appearance (general feelings about appearance), BE-Weight (weight
      satisfaction), and BE-Attribution (evaluations attributed to others about one's
      body and appearance). The subscales have high internal consistency and 3-month
      test-retest reliability. Females scored lower than males on BE-Weight and BE
      Appearance. BE-Weight was the only subscale uniquely related to weight,
      especially in females, with heavy individuals tending to be dissatisfied with
      their weight. BE-Appearance was the only subscale that consistently predicted
      self-esteem. BE-Appearance and BE-Weight covaried more with Neeman and Harter's
      (1986) Appearance subscale than with other self-esteem subscales; BE-Attribution
      covaried more with social self-esteem subscales than did BE-Appearance and BE
      Weight.

PMID- 11206303
TI  - Working towards a real cure for patients with small hepatocellular carcinoma.

PMID- 11206304
TI  - Comparison of intraductal ultrasonography with percutaneous transhepatic
      cholangioscopy for the identification of residual bile duct stones during
      lithotripsy.
AB  - BACKGROUND: An imaging modality that can be used to identity small stones after a
      biliary lithotripsy is required. Intraductal ultrasonography was evaluated by
      using percutaneous transhepatic cholangioscopy as the gold standard. METHODS:
      Lithotripsy, under percutaneous transhepatic cholangioscopy guidance, was
      performed in 20 patients. A thin-caliber ultrasonic probe (2.0 mm in diameter and
      20 MHz frequency) was inserted into the bile duct through the percutaneous tract
      after lithotripsy, and residual stones were identified. This was followed by
      percutaneous transhepatic cholangioscopy. RESULTS: In the extrahepatic bile
      ducts, intraductal ultrasonography provided images of all the stones demonstrated
      on cholangioscopy (n = 11). The sensitivity was superior to that of
      cholangiography (P < 0.005). However, in the intrahepatic bile ducts, intraductal
      ultrasonography only visualized the stones located in the cannulated lobe.
      Extrahepatic stones smaller than 5.0 mm in diameter or in a common hepatic duct
      larger than 15.0 mm in diameter were missed by cholangiography, but were
      visualized by the use of intraductal ultrasonography (P < 0.05). CONCLUSIONS:
      Intraductal ultrasonography is equivalent to cholangioscopy in the extrahepatic
      bile ducts. Cholangiography and intraductal ultrasonography should be used in
      combination to image intrahepatic and extrahepatic stones.

PMID- 11206305
TI  - Images of interest. Gastrointestinal: gallstone ileus.

PMID- 11206306
TI  - Images of interest. Hepatobiliary and pancreatic: a woman with abdominal pain and
      fever.

PMID- 11206307
TI  - Acinar cell carcinoma with hypervascularity.
AB  - Acinar cell carcinoma is an uncommon malignancy with a reported incidence of 1%
      among exocrine tumors of the pancreas. The case of a 60-year-old Taiwanese man
      who presented with obstructive jaundice, abdominal pain, and body weight loss is
      described here. A mixed clinical picture of islet cell tumor and ductal carcinoma
      of the pancreas was shown to be a hypervascular tumor at the pancreatic head
      region with an irregular stricture at the common channel of the common bile and
      pancreatic ducts. The patient had normal levels of plasma carcinoembryonic
      antigen, carbohydrate antigen 19-9, alpha-fetoprotein, but an increase in plasma
      levels of insulin and C-peptide. Immunohistochemical stains and electron
      microscopic examination of the tumor was consistent with acinar cell carcinoma.

PMID- 11206308
TI  - Lupus-like syndrome with submassive hepatic necrosis associated with hepatitis A.
AB  - Hepatitis A is a common self-limited liver disease. However, 15% of patients may
      have some complications. Autoimmune hepatitis that is triggered by viral
      hepatitis has been reported. We hereby describe an unrecognized association of
      hepatitis A with a full blown lupus-like syndrome manifested by the appearance of
      arthralgia, exudative pleural effusion with the presence of lupus erythematosus
      cells and autoantibodies. All these findings disappeared after a short course of
      steroid treatment. The case is presented and the literature is reviewed.

PMID- 11206309
TI  - Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum
      multiflorum.
AB  - Herbal preparations are widely available and generally regarded by the public as
      harmless remedies for a variety of medical ailments. We report the first case in
      Australia of acute hepatitis associated with the Chinese herbal medicine Shou-Wu
      Pian, prepared from Polygonum multiflorum. Cholestatic hepatitis developed in a
      Chinese woman taking this preparation for the greying of her hair, and liver
      biopsy was consistent with a toxic reaction. Clinical and biochemical resolution
      occurred following cessation of the drug.

PMID- 11206310
TI  - Aging increases, and duodenal ulcer reduces the risk for intestinal metaplasia of
      the gastric corpus in Japanese patients with dyspepsia.
AB  - BACKGROUND AND AIMS: The classification of gastritis by using the revised Sydney
      system suggests that there are two types of Helicobacter pylori-related
      gastritis. The aim of the present study was to examine the risk factors that
      might be involved in the presence of either atrophic gastritis or intestinal
      metaplasia of the gastric corpus of Japanese patients. METHODS: Biopsy samples
      were obtained from the gastric corpus in 154 patients with dyspepsia, and the
      degree of atrophy or intestinal metaplasia was determined histologically. The
      correlation between several variables and presence of atrophy or intestinal
      metaplasia was evaluated by using multivariate analysis. RESULTS: Among the 11
      variables, which included age, peptic ulcer diseases and H. pylori infection, H.
      pylori infection was the major risk factor associated with the presence of
      atrophic gastritis or intestinal metaplasia of the gastric corpus. In contrast,
      duodenal ulcer (DU) disease reduced the risk of contracting both conditions. Age
      was an independent risk factor only for intestinal metaplasia of the gastric
      corpus. When 128 H. pylori-positive subjects were analyzed, DU and age were
      similarly associated with the presence of both conditions. CONCLUSIONS: These
      results suggest that DU reduces the risk for contracting atrophic gastritis and
      intestinal metaplasia, and age is an independent risk factor for intestinal
      metaplasia of the gastric corpus in dyspeptic Japanese patients.

PMID- 11206311
TI  - Molecular therapy with recombinant antisense c-myc adenovirus for human gastric
      carcinoma cells in vitro and in vivo.
AB  - BACKGROUND AND AIMS: This study used a recombinant antisense c-myc adenovirus (Ad
      ASc-myc) to evaluate how alterations of c-myc expression in the SGC7901 human
      gastric carcinoma cells could influence the proliferation, apoptosis and the
      growth of human gastric tumors in nude mice. METHODS: The human gastric carcinoma
      cell line, SGC7901, treated with Ad-ASc-myc or adenovirus recombinants carrying
      LacZ gene (Ad-LacZ) were analyzed by using X-gal stain, MTT, DNA ladder, TUNEL
      assay, flow cytometric analysis, polymerase chain reaction and western blot in
      vitro. The tumorigenicity and experimental therapy in nude mice models were
      assessed in vivo. RESULTS: The Ad-ASc-myc could strongly inhibit cell growth and
      induce apoptosis in SGC7901 cells. The proliferation of the Ad-ASc-myc-infected
      SGC7901 cells was reduced by 44.1%. The mechanism of killing gastric carcinoma
      cells by Ad-ASc-myc was found to be apoptosis, which was detected by the use of a
      DNA ladder, TUNEL and flow cytometric analysis. Infection of Ad-ASc-myc in nude
      mice showed that all three mice failed to form tumors from the 7 to 30 day
      period, compared with injection of Ad-LacZ and parent SGC7901 cells. Experimental
      therapy on the nude mice bearing subcutaneous tumors of SGC7901 cells showed that
      intratumor instillation of Ad-ASc-myc inhibited the growth of the tumors.
      Recombinant antisense c-myc adenovirus-treated tumors were inhibited by 68.9%,
      compared with tumors injected with Ad-LacZ and control (LacZ and phosphate
      buffered saline). CONCLUSION: The expression of Ad-ASc-myc can inhibit growth and
      induce apoptosis of gastric cancer cells in vitro and in vivo and thus is a
      potential clinical utility in gene therapy for the treatment of gastric
      carcinoma.

PMID- 11206312
TI  - Kinetics of the hepatitis C virus during interferon therapy as a marker of
      therapeutic response.
AB  - BACKGROUND: The viral load and subtype of hepatitis C virus (HCV) are predictors
      of the efficacy of interferon (IFN) therapy. The kinetics of HCV during IFN
      therapy have been described recently, suggesting that HCV infection is highly
      dynamic. These observations have raised the issue as to whether early monitoring
      of the viral load can help guide IFN therapy. METHODS: We measured HCV-RNA levels
      at 0, 24 and 48 h after the start of IFN-alpha treatment (10 MU daily for 2 weeks
      and then three times weekly for 22 weeks) or IFN-beta treatment (6 MU daily for 6
      weeks). Then we analyzed the relationship between HCV kinetics and therapeutic
      response using stepwise multivariate logistic regression analysis. RESULTS: The
      exponential decay slope of the viral load during the first 24 h, not the first 48
      h or the next 24 h, was a predictor of viral eradication at 6 months after
      completion of the treatment (sustained response; P = 0.0023). This decay slope
      was not affected by the HCV serotype or the type of IFN used. Initial viral load
      and HCV serotype were also predictors, as reported previously (P < 0.0001 and P =
      0.0347, respectively). We also proposed a model using a prognostic index that
      predicted a sustained response with more than 80% sensitivity, specificity and
      efficacy in an independent and external group of patients. CONCLUSION: This study
      demonstrated that the exponential decay slope of the viral load during the first
      24 h was an important predictor of the response to IFN therapy as well as the
      initial viral load and HCV serotype. The model may also be useful for the
      clinical management of IFN therapy.

PMID- 11206313
TI  - Use of ursodeoxycholic acid in liver diseases.
AB  - Ursodeoxycholic acid is currently the only established drug for the treatment of
      chronic cholestatic liver diseases. It has cytoprotective, anti-apoptotic,
      membrane stabilizing, anti-oxidative and immunomodulatory effects. Prolonged
      administration of ursodeoxycholic acid in patients with primary biliary cirrhosis
      (PBC) is associated with survival benefit and a delaying of liver
      transplantation. There is evidence that it might even prevent progression of the
      histologic stage of PBC. It also has a beneficial effect on primary sclerosing
      cholangitis, intrahepatic cholestasis of pregnancy, liver disease associated with
      cystic fibrosis, chronic graft versus host disease, total parenteral nutrition
      associated cholestasis and various pediatric cholestatic liver diseases. In the
      present review the current knowledge about the mechanisms of the action and role
      of ursodeoxycholic acid in the treatment of various liver diseases has been
      discussed.

PMID- 11206314
TI  - Subcellular redistribution of protein kinase C isozymes is associated with rat
      liver cirrhotic changes induced by carbon tetrachloride or thioacetamide.
AB  - BACKGROUND AND AIMS: Protein kinase C (PKC) plays a key role in the alteration of
      signal transduction in the liver, which may contribute to the development of
      liver cirrhosis. The aim of the present study was to examine the subcellular
      redistribution of PKC isozymes in rat liver cirrhosis, which is induced by two
      different cirrhotic chemical agents, carbon tetrachloride (CCl4) and
      thioacetamide (TAA). METHODS AND RESULTS: Thioacetamide and CCl4 were
      administered to rats for 8 and 30 weeks, respectively before rats were killed and
      autopsies performed at 9, 20 and 30 weeks later. The TAA induced a fibrotic
      pattern in the liver that differed from that produced by CCl4, notably in the
      formation of fibrous connective tissue and the proliferation of bile ductule
      cells. Cholangiofibrosis and clear-cell foci were also observed in TAA-treated
      rats at 30 weeks. Histological examination revealed that severe cirrhotic changes
      were present 9 weeks after the commencement of CCl4 treatment and 30 weeks after
      TAA treatment. DISCUSSION: When the subcellular redistribution of PKC isozymes
      (PKCalpha, -beta1, -delta, and -epsilon) was examined, all the PKC isozymes in
      CCl4-treated rats were found to be translocated to the membrane fraction, which
      may mean PKC activation, and then downregulated by proteolytic degradation after
      9 weeks of treatment, which coincided with peak cirrhotic changes. All rats
      treated with CCl4 recovered to the control level after 20 weeks of treatment. In
      the case of TAA-treated rats, PKC isozymes were translocated to the particulate
      fraction of the liver after 9 weeks of treatment and this persisted in most of
      the rats for the duration of the experiment. CONCLUSIONS: From these results, it
      would appear that PKC translocation preceded morphologic changes, and that an
      altered subcellular distribution of the PKC isozyme may be associated with the
      response to liver damage and carcinogenesis.

PMID- 11206315
TI  - Portal hypertensive response to bradykinin in inflamed or cirrhotic rat livers is
      mediated by B2-type receptors.
AB  - BACKGROUND: We have shown that the portal hypertensive response to bradykinin in
      normal rats is mediated by B2 receptors. METHODS: By using isolated and
      exsanguinated rat liver perfusion, we studied the portal hypertensive response to
      bradykinin or des-Arg9-bradykinin (B1 agonist) in inflamed or cirrhotic rat
      livers. Livers were perfused with bovine serum albumin Krebs-Henseleit buffer (pH
      7.4; 37 degrees C) at a constant flow rate, in the absence or presence of des
      Arg9[Leu8]-bradykinin or HOE 140 (B1 and B2 receptor antagonists, respectively).
      Bradykinin (140 nmol) or des-Arg9-bradykinin was injected as a bolus via the
      afferent route to the liver. RESULTS: Basal perfusion pressure in liver-cirrhotic
      rats was higher than in normal rats. In normal, inflamed, or liver-cirrhotic
      rats, the presence of the B1 antagonist did not change the portal hypertensive
      response to bradykinin, while the B2 antagonist abolished this response. A 140
      nmol dose of des-Arg9-bradykinin did not change the perfusion pressure; 700 nmol
      of this B1 agonist produced an insignificant perfusion pressure increase. The
      perfusion pressure increase induced by bradykinin in cirrhotic livers was lower
      than in normal livers. CONCLUSIONS: The portal hypertensive response to
      bradykinin in inflamed or cirrhotic rat livers is mediated by B2 receptors, but
      not B1 receptors, and there is a contracting hyporeactivity to bradykinin in
      cirrhotic rat livers.

PMID- 11206316
TI  - Importance of achieving complete necrosis during the first treatment for
      hepatocellular carcinoma to prevent bone metastasis: a prospective study.
AB  - BACKGROUND AND AIMS: Recent advances in the treatment of hepatocellular carcinoma
      (HCC) have changed the importance of bone metastasis during the follow up of such
      patients. In the present study, we investigated risk factors for bone metastasis
      after treatment for HCC. METHODS: Two hundred and two patients with HCC were
      diagnosed as free of bone metastasis by technecium 99m-methylene diphosphonate
      bone scintigraphy and were followed prospectively after treatment of the primary
      lesions (follow-up period 2-146 months; median 20 months). We statistically
      analyzed the risk factors for bone metastasis using the clinical characteristics
      at the time of first treatment. RESULTS: Multiple tumors (P < 0.005), main tumor
      size > 5 cm in diameter (P < 0.005), the presence of distant metastasis (P <
      0.005), elevation of serum alpha-fetoprotein (> 100 ng/mL; P < 0.05),
      chemotherapy (P < 0.05) and insufficient therapeutic response (P < 0.0005) were
      identified as risk factors for bone metastasis by univariate analyses.
      Insufficient therapeutic response and main tumor size > 5 cm in diameter (both P
      < 0.05) were identified as independent predisposing factors for bone metastasis.
      CONCLUSIONS: Complete necrosis of primary HCC during the first treatment is
      important to prevent subsequent bone metastasis.

PMID- 11206317
TI  - Survival of conditionally immortalized hepatocytes in the spleen of syngeneic
      rats.
AB  - BACKGROUND: Hepatocyte transplantation has been shown to be effective in the
      treatment of liver failure; however, the shortage of donor organs limits its
      clinical application. Several reports have suggested that conditionally
      immortalized hepatocytes (CIH) could be an alternative to primary hepatocytes.
      However, CIH are known to undergo apoptosis in vitro at a non-permissive
      temperature, which is similar to body temperature. METHODS: To investigate the
      duration of survival and in vivo apoptosis of CIH in the syngeneic host, the L2A2
      cells (a kind of CIH) that were established from hepatocytes of a Lewis rat with
      a gene for a temperature-sensitive Simian Virus 40 (SV40) large T antigen were
      transplanted into the spleen. Cells were isolated from the spleen that was
      removed periodically up to 6 months, and used to detect the presence of the L2A2
      cells among them with the selective culture for CIH and T-antigen PCR. In situ
      apoptosis of L2A2 cells was also examined. In order to improve the survival of
      transplanted L2A2 cells in the host, a group of rats were partially
      hepatectomized 1 day before transplantation was performed. RESULTS: The L2A2
      cells secreted albumin at a rate of 1.17 +/- 0.18 microg/24 h per 10(6) cells in
      vitro. After transplantation, L2A2 cell colonies and PCR amplification bands
      appeared up to 14 and 7 days, respectively, but this duration was not prolonged
      by a partial hepatectomy. The spleen showed a large number of hepatocytes that
      were in the process of dying on the 5th day, and only a number of ghost
      hepatocytes were present on the 7th day of transplantation. No tumors were found
      during the 6-month observation period. CONCLUSIONS: Conditionally immortalized
      hepatocytes can survive in the spleen for a limited period, in spite of the
      growth stimulation, most likely because they undergo apoptosis in vivo as well as
      in vitro at a non-permissive temperature. These data suggest that the use of
      these cells in hepatocyte transplantation be limited to temporary hepatic
      support.

PMID- 11206318
TI  - Endotoxin treatment causes an upregulation of the endothelin system in the liver:
      amelioration of increased portal resistance by endothelin receptor antagonism.
AB  - BACKGROUND: Mechanisms underlying hepatic microcirculatory failure during
      endotoxemia are incompletely understood. Because endothelin-1 (ET-1) has been
      implicated in endotoxin-induced liver injury, we investigated the hepatic ET-1
      system in endotoxin-treated rats. METHODS: Rats were treated with endotoxin
      (Escherichia coli lipopolysaccharide; 3 mg/kg, i.p.), and various determinations
      were made 24 h later. RESULTS: Endotoxin treatment caused 11.2 +/- 1.6% weight
      loss, a decrease in mean arterial pressure (MAP; 96 +/- 5 mmHg vs 108 +/- 3 mmHg;
      P < 0.05) and an increase in portal pressure (11.6 +/- 1.3 mmHg vs 7.4 +/- 1
      mmHg; P < 0.02). No significant changes in the serum levels of liver enzymes or
      hepatocellular necrosis were observed. Endotoxin caused increases in hepatic ET-1
      (from 345 +/- 31 to 565 +/- 38 pg/g; P < 0.01), ET-1 receptor density (from 179
      +/- 16 to 340 +/- 26 fmol/mg; P < 0.02), and mRNA expression of preproendothelin
      1, and ET(A) and ET(B) receptors. While the serum nitric oxide (nitrite +/-
      nitrate) concentration was increased in endotoxin-treated rats, that of ET-1
      remained unchanged. A mixed ET(A)/ET(B) receptor antagonist, TAK-044 (10 mg/kg,
      i.v.), reduced the weight loss from 11.2 +/- 1.6% to 5.9 +/- 2.9% (P < 0.05) and
      the portal pressure from 11.6 +/- 1.3 mmHg to 8.6 +/- 0.7 mmHg (P < 0.05) in
      endotoxin-treated rats. The mixed ET(A)/ET(B) receptor antagonist also caused an
      increase in serum ET-1 concentration, but did not affect serum nitric oxide and
      MAP in endotoxin-treated rats. CONCLUSIONS: These results suggest that the
      upregulated hepatic ET-1 system is an important mechanism of increased portal
      resistance and related complications of endotoxemia.

PMID- 11206319
TI  - Aortic hyporeactivity to norepinephrine induced by lipopolysaccharide in
      cirrhotic rats: beneficial effects of a non-steroidal anti-inflammatory drug
      coupled with a nitric oxide donor.
AB  - BACKGROUND AND AIMS: Cirrhosis is associated with a hyperdynamic syndrome and
      arterial vasodilation that is related to nitric oxide (NO) synthase 3
      overactivity. Septic shock is frequently associated with cirrhosis and with a
      vascular induction of NO synthase 2. The aims of this study were to compare the
      effects of lipopolysaccharide (LPS) in normal and cirrhotic rats, and to test the
      effects of a nonsteroidal anti-inflammatory drug (NSAID) coupled with a (NO)
      donor. METHODS: Cirrhotic rats received NO-flurbiprofen, flurbiprofen or vehicle
      followed by LPS or placebo 15 min later. The heart rate and mean arterial
      pressure of rats were monitered for 5 h. Thoracic aortic rings were removed and
      contracted with the use of norepinephrine. Nitric oxide synthase activity was
      measured in the aorta and stomach of cirrhotic rats. RESULTS: Arterial pressure
      decreased in cirrhotic rats in the vehicle/LPS and flurbiprofen/LPS groups. After
      LPS administration, the heart rate of rats increased in all groups. In the aortic
      rings, LPS induced hyporeactivity to norepinephrine in all groups except the NO
      flurbiprofen group. This hyporeactivity was abolished after preincubation with Nw
      nitro-L-arginine (L-NNA). Nw-nitro-L-arginine had no effect on norepinephrine
      induced vasoconstriction in the NO-flurbiprofen/LPS group. Nitric oxide synthase
      2 activity in the stomach and aorta of cirrhotic rats was increased in each group
      except in the NO-flurbiprofen group after LPS administration. Pretreatment with
      NO NSAID prevented aortic hyporeactivity to norepinephrine in cirrhotic rats
      treated with LPS as it probably inhibited the NO synthase 2 induction.
      CONCLUSIONS: These findings suggest that NO-flurbiprofen has a beneficial
      hemodynamic effect in cirrhotic rats and may help to prevent LPS aortic
      hyporeactivity.

PMID- 11206320
TI  - Pancreatitis-associated protein-I mRNA expression in mouse pancreas is
      upregulated by lipopolysaccharide independent of cerulein-pancreatitis.
AB  - BACKGROUND AND AIMS: It is well known that endotoxemia, which is caused by a
      bacterial infection, can exacerbate acute pancreatitis, whereas pancreatitis
      associated protein (PAP) has the ability to induce bacterial aggregation.
      Pancreatitis-associated protein is supposed to protect the tissue from infection
      during inflammation. In order to clarify the relationship between PAP mRNA
      expression and endotoxemia during acute pancreatitis, the kinetic patterns of PAP
      I mRNA in mouse pancreas treated with either cerulein or lipopolysaccharide (LPS)
      or both were investigated in this study. METHODS AND RESULTS: The administration
      of LPS (5 mg/kg) intraperitoneally resulted in a dramatic upregulation of PAP-I
      mRNA expression, increasing 18.61-fold to a maximum at 12 h, then decreasing, but
      still sustaining at a high level and reaching baseline on day five. These changes
      were accompanied by the upregulation of tumor necrosis factor (TNF)-alpha,
      interleukin-1beta (IL-1beta), interleukin 6 (IL-6) and interferon gamma
      (IFNgamma) mRNA expressions in the pancreas, but not by marked alterations of
      serum amylase, lactic dehydrogenase (LDH) and histology. Cerulein also increased
      PAP-I mRNA expression. However, the combination of cerulein and LPS was not able
      to enhance PAP-I mRNA expression further, although more prominent pancreatitis
      based on significant changes of serum amylase, LDH and histology were observed.
      CONCLUSION: These results suggest that PAP-I mRNA might be modulated by
      endotoxemia, independent of cerulein-pancreatitis. There were no strong
      correlations between PAP-I mRNA expression and the severity of pancreatitis.

PMID- 11206321
TI  - Evaluation of pancreatic secretion after administration of secretin: application
      of magnetic resonance imaging.
AB  - BACKGROUND: To evaluate pancreatic exocrine function, we measured the changes in
      T2 enhanced hydrograhic intensity on magnetic resonance (MR) images of the
      pancreas following an injection of secretin, which is representative of the
      changes in duodenal fluid volume. METHODS: The subjects were 10 patients with
      normal pancreatic function (N > 70% detected by using a pancreatic function
      diagnostant test) and 12 patients with hypo-function, including those with mild
      hypo-function (MH, 50-70%, six patients) and severe hypo-function (SH < 50%, six
      patients). RESULTS: In the N group, T2 enhanced intensity of the pancreas
      increased to a maximum value (more than 10% compared with baseline) within 5 min
      of stimulation, then gradually decreased. No significant difference in the
      response was observed between the head and body of the pancreas. Changes in the
      MH group were similar to those of the N group. In contrast, significantly lower
      changes in T2 enhanced intensity were observed in SH group, relative to both the
      N and MH group (P < 0.05). The amount of secretin-induced increase in duodenal
      fluid after 16 min was not significantly different among the three groups.
      Furthermore, an evaluation of the residual pancreatic tissue after a
      pancreatoduodenectomy was also feasible. CONCLUSIONS: Our results indicate that
      the MR-secretin test is useful for the evaluation of severe pancreatic exocrine
      dysfunction. The diagnostic test is simple, direct and non-invasive.

PMID- 11206323
TI  - Dictyostelium discoideum: a model system for differentiation and patterning.
AB  - In Dictyostelium, development begins with the aggregation of free living amoebae,
      which soon become organized into a relatively simple organism with a few
      different cell types. Coordinated cell type differentiation and morphogenesis
      lead to a final fruiting body that allows the dispersal of spores. The study of
      these processes is having increasing impact on our understanding of general
      developmental mechanisms. The availability of biochemical and molecular genetics
      techniques has allowed the discovery of complex signaling networks which are
      essential for Dictyostelium development and are also conserved in other
      organisms. The levels of cAMP (both intracellular and extracellular) play
      essential roles in every stage of Dictyostelium development, regulating many
      different signal transduction pathways. Two-component systems, involving
      histidine kinases and response regulators, have been found to regulate
      intracellular cAMP levels and PKA during terminal differentiation. The sequence
      of the Dictyostelium genome is expected to be completed in less than two years.
      Nevertheless, the available sequences that are already being released, together
      with the results of expressed sequence tags (ESTs), are providing invaluable
      tools to identify new and interesting genes for further functional analysis.
      Global expression studies, using DNA microarrays in synchronous development to
      study temporal changes in gene expression, are presently being developed. In the
      near future, the application of this type of technology to the complete set of
      Dictyostelium genes (approximately 10,000) will facilitate the discovery of the
      effects of mutation of components of the signaling networks that regulate
      Dictyostelium development on changes in gene expression.

PMID- 11206322
TI  - Long-term evaluation of extracorporeal shock-wave lithotripsy for cholesterol
      gallstones.
AB  - BACKGROUND: Extracorporeal shock-wave lithotripsy (ESWL) is a treatment that
      preserves the gallbladder. Problems after ESWL treatment include stone recurrence
      and the development of biliary symptoms. METHODS: Two hundred and sixty-two
      patients with cholesterol-type gallstones, the best indication for ESWL
      treatment, and 42 control patients with cholesterol-type gallstones who received
      no treatment entered this study. We evaluated the factors associated with
      recurrence of gallstones after stone clearance and the development of biliary
      symptoms after ESWL treatment. RESULTS: The 3-, 5- and 7-year cumulative
      probabilities of gallstone recurrence were 20.6, 27.1 and 33.1%, respectively,
      with the recurrence probability significantly lower in patients with good
      gallbladder contractility. In patients with recurrence, ursodeoxycholic acid
      (UDCA) treatment was effective. In 69 patients with residual gallstones, the 3-,
      5- and 7-year cumulative risks of biliary symptoms were 17.3, 24.9 and 30.5%,
      respectively. With residual gallstones, the risk of biliary symptoms developing
      was significantly lower in patients with a < or = 3 mm fragment size at the end
      of ESWL treatment and in those treated consistently with UDCA for 6 months or
      more after treatment with ESWL. The risk of biliary symptoms was significantly
      lower in ESWL-treated patients with residual stones who had a < or = 3 mm
      fragment size after treatment compared to those of control patients. CONCLUSIONS:
      Ursodeoxycholic acid was effective in clearing stones in patients with gallstone
      recurrence. In patients with residual stones, the fragmentation of stones to < or
      = 3 mm and UDCA administration effectively reduced the risk of subsequent biliary
      symptoms.

PMID- 11206324
TI  - Fertilization triggers activation of Fyn kinase in the zebrafish egg.
AB  - Fertilization results in the tyrosine phosphorylation of several egg proteins and
      studies have shown that tyrosine protein kinase activity is required for
      successful fertilization. The Fyn protein kinase has been detected in eggs of the
      sea urchin, frog and rat, although measurement of fertilization-induced changes
      in Fyn kinase activity have only been successful in the sea urchin system. The
      present study demonstrates the presence of Fyn kinase in the zebrafish egg and
      the stimulation of this enzyme at fertilization. Activation of Fyn was detected
      as early as 30 seconds post-fertilization and increased approximately six-fold by
      2 minutes post-insemination. The activation of Fyn in the zebrafish egg required
      sperm and was not observed in spontaneously activated eggs.

PMID- 11206325
TI  - Controlled translation initiation on insulin-like growth factor 2-leader 1 during
      Xenopus laevis embryogenesis.
AB  - A number of growth factors, whose spatio-temporal expression is essential for
      embryonic development, are encoded by mRNAs with a complex 5'UTR. Human insulin
      like growth factor 2 mRNA contains a long (592 nucleotides) 5'UTR (IGFl1) with
      one upstream open reading frame and stable stem-loop structures, elements which
      might be important for controlled translation. To investigate whether these
      unusual features of IGFl1 can control translation initiation during
      embryogenesis, we examined the initiation efficiency on this 5'UTR during
      development of Xenopus laevis. The results demonstrate that IGFl1 strongly
      represses translation of a reporter in early embryos, compared with the Xenopus
      beta-globin 5'UTR. The inhibition is alleviated soon after the midblastula
      transition, suggesting a stimulatory effect of the transcription start. However,
      a similar stimulation of IGFl1-driven translation is seen in embryos in which de
      novo transcription was inhibited by actinomycin D. Furthermore, it is shown that
      up-regulation of IGFl1 activity is independent of eIF4E levels, and activity of
      IGFl1 is observed in all tissues of transgenic Xenopus embryos. These results
      indicate that post-translational modulation of a trans-acting factor enables
      efficient initiation on this complex 5'UTR after the midblastula transition.

PMID- 11206326
TI  - Sequence and translation initiation properties of the xenopus TGFbeta5, PDGF-A,
      and PDGF-alpha receptor 5' untranslated regions.
AB  - The properties of the architecturally complex Xenopus laevis TGFbeta5, PDGF-A and
      PDGF-alpha receptor 5'UTRs were investigated. 5' extended cDNAs were obtained by
      5'RACE, resulting in long 5'UTRs (478-710 nt) with multiple upstream AUGs (3-13),
      andthe potential to fold into stable structures. Injection studies suggested that
      the cloned PDGF-alphaR 5'UTR contains an intron. Splicing at potential 5' and 3'
      splice sites would result in a non-complex 5'UTR of 142 nt. The above mentioned
      5'UTR characteristics are inhibitory for ribosomal scanning. Indeed, relative to
      the beta-globin 5'UTR, the complex 5'UTRs strongly repressed initiation of
      protein synthesis in pre-MBT Xenopus embryos. However, later in embryogenesis,
      the inhibition was partly relieved. The results show temporal translational
      control by these 5'UTRs. Transgenic embryos showed that the 5'UTRs allowed
      translation throughout the embryo; spatial control could not be observed.
      Interestingly, a fragment in the PDGF-A 5'UTR highly similar to an element in the
      human PDGF-A 5'UTR is complementary to Xenopus 18S ribosomal RNA. None of these
      Xenopus 5'UTRs contains an IRES, as determined by injecting bicistronic
      constructs.

PMID- 11206327
TI  - Morphological chimeras of larvae and adults in a hydrozoan--insights into the
      control of pattern formation and morphogenesis.
AB  - In the marine hydroid Hydractinia echinata, metamorphosis transforms the spindle
      shaped larva into a primary polyp. It bears a hypostome with a ring of tentacles
      at its apical end, a gastric region in the middle and stolons at the base. In
      nature, metamorphosis is induced in response to external stimuli provided by
      bacteria. These stimuli can be replaced by artificial inducers, one of which is
      heat shock. Among heat shock treated stages are those undergoing complete
      metamorphosis but also specimens forming chimeras of different developmental
      stages. In the chimeric larvae, the posterior is transformed into the apical
      hypostome of the adult polyp while the anterior part of the larva persists as
      larval tissue. After transverse sectioning, these stage chimeras regenerate the
      missing body parts with respect to the nature of the tissue at the wound surface.
      This shows that the decision to make larva or polyp morphology depends not on the
      majority of the tissue in the original body section, but on stage specificity
      within the regenerating animal part. Single cells can escape from this general
      rule, since RFamide nerve cells which usually differentiate in polyp tissue
      appear in regenerated larval tails of sectioned stage chimeras. The results
      indicate that the pattern-forming system of the larva and of the adult have
      features in common. The primary signals controlling patterning along the anterior
      posterior axis in larvae and the apical-basal axis in polyps arethus likelyto be
      the same while the interpretation of these primary signals by the individual
      cells changes during metamorphosis.

PMID- 11206328
TI  - Patterns of migration and regulation of trunk neural crest cells in zebrafish
      (Danio rerio).
AB  - Regulation is the replacement of lost, undifferentiated embryonic cells by
      neighboring cells in response to environmental signals. Neural crest cells,
      embryonic cells unique to craniates, are good candidates for studies of
      regulation because they are pluripotent, and thus might be able to alter their
      behavior in response to environmental signals. This study investigated regulation
      for the loss of trunk neural crest (TNC) cells, specifically pigment derivatives,
      in the zebrafish, Danio rerio. The first part of the study clarifies and extends
      what has previously been described on normal patterns of TNC migration and
      differentiation. These data were then used to address the hypothesis that there
      is regulation for loss of TNC, and that regulation would vary with the amount
      removed, the position or stage of removal. Zebrafish TNC cells are large and
      numerous. SEM and Dil labeling revealed that TNC cells undergo several successive
      waves of 'sheet' and 'segmental' migration, beginning as early as the 12 somite
      stage. Dil-labeled TNC cells often migrated several somite lengths anteriorly and
      posteriorly along the trunk axis to form glial cells, ganglia, pigment,
      ectomesenchyme and tail reticular cells. Regulation occurred on a sliding scale,
      ranging from complete to incomplete. Defects in development and/or pigmentation
      occurred if large regions of TNC cells were removed, or if cells were removed
      from anterior (cardiac) and posterior (tail) extremities of the trunk.
      Melanophores were the cell type most visibly affected by TNC extirpations.
      Otherwise, pigmentation was remarkably normal. We propose that the completeness
      of regulation largely depends upon healing of the overlying epidermis.

PMID- 11206329
TI  - Tissue-specific distribution and variation of the channel-forming protein ductin
      during development of Drosophila melanogaster.
AB  - Ductins represent membrane channel proteins which are supposed to form both
      proton channels in V-ATPases and connexon channels in gap junctions. In order to
      localize and characterize these proteins in different tissues of Drosophila, we
      applied indirect immunofluorescence microscopy and immunoblots, using antisera
      prepared against Drosophila ductin and against Nephrops ductin. Previously, these
      antisera have been shown to recognize, in ovarian follicles and young embryos of
      Drosophila, the ductin monomer of 16 kDa and a putative dimer of 29 kDa.
      Moreover, both anti-ductin sera label antigens in plasma membranes and in the
      cytoplasm and block, when microinjected, cell-cell communication via gap
      junctions. In the present study, comparing several embryonic, larval and adult
      tissues, the anti-ductin sera were found to recognize antigens with various
      locations in cells of the midgut, the salivary gland, the nervous system, the
      muscles and the epidermis. For example, in midgut cells, antigens were labeled
      mainly in apical plasma membranes and in the apical part of the cytoplasm, while
      in salivary-gland cells, labeling was found throughout the plasma membranes and
      the cytoplasm. We conclude that putative gap junctions were revealed in the
      salivary gland, the nervous system and the epidermis, while plasma membrane
      associated putative V-ATPases were detected in the midgut, the salivary gland and
      the muscles. Moreover, V-ATPases associated with cytoplasmic vesicles were found
      in almost every tissue. On immunoblots of homogenates from various tissues, the
      anti-ductin sera specifically labeled bands of 16, 21 and 29 kDa. When comparing
      these bands using peptide mapping with V8 protease, we found that they represent
      closely related proteins. Therefore, either different ductins or modifications of
      a single ductin appear to be present in different cellular regions, cell types
      and developmental stages of Drosophila.

PMID- 11206330
TI  - Time-lapse observation of branching morphogenesis of the lung bud epithelium in
      mesenchyme-free culture and its relationship with the localization of actin
      filaments.
AB  - It has been shown that branching morphogenesis of the lung bud is mediated by
      epithelial-mesenchymal interaction via such molecules as FGF10, BMP4 and Shh.
      However, a recent study showed that the isolated lung epithelium still undergoes
      branching morphogenesis in vitro even in the absence of mesenchyme (Nogawa and
      Ito, 1995). In the present study, we observed in vitro the dynamic movement of
      the isolated lung epithelium of the fetal mouse using time-lapse recording, and
      investigatedthe roles of actinfilaments in branching of the lung bud. First, time
      lapse observation of the initial phase of lung branching morphogenesis revealed
      that at the sites of cleft formation, the epithelial surface was retracted inward
      from its original position. From this observation we assumed that there should be
      some structures which exert a physical force on the epithelium, and the
      localization and arrangement of actin fibers in the cultured lung epithelium were
      examined at various stages of branching morphogenesis. At the prebudding (6 h)
      and onset-budding (24 h) stages, no specific localization of actin filaments was
      observed in the lung bud epithelium, but at the postbudding stage (48 h) they
      were localized densely in the cells at the tip of the branched lung epithelium.
      The cell density was not different between the tip and cleft regions of the lung
      bud epithelium. When cultured with FGF-soaked beads, an actin-rich region was
      induced at the tip of the lung bud which was growing toward an FGF-soaked bead.
      These results indicate that actin fibers do not play a significant part in cleft
      formation but can be secondarily induced by FGF in the surrounding matrix and
      play some roles at later shaping of the branch in lung morphogenesis.

PMID- 11206331
TI  - Cell morphology in amphioxus nerve cord may reflect the time course of cell
      differentiation.
AB  - Amphioxus embryos elongate following neurulation, and this lengthens the
      developing nerve cord. Most neurons and support cells remain attached at their
      apices to the neuroepithelium, and the apices themselves become correspondingly
      longer. In consequence, apex length can be used in some instances as a measure of
      whether a given cell last divided before elongation or after, and approximately
      when. The data indicate that most floorplate, ependymoglial and infundibular
      cells are generated comparatively early, before most neurons. Among the neurons,
      the segmentally arranged DC (dorsal compartment) motoneurons appear to be among
      the first to develop, which accords with molecular data on the time course of
      neural development, using neurogenin and islet as markers.

PMID- 11206332
TI  - Ambient atmospheric particles in the airways of human lungs.
AB  - Epidemiologic studies linking particulate matter (PM) air pollution and adverse
      respiratory and cardiovascular effects have focused attention on the interactions
      of PM and lung cells. Information on the types, numbers, composition, sizes, and
      distribution of ambient particles in the airways is potentially useful for
      correlations with pathological and/or physiological changes, but relatively
      little is known about the extent to which ambient particles actually enter airway
      epithelial cells and are retained in airway walls and even less information is
      available about correlations with pathologic changes. Since many ambient
      particles are colorless and/or well below the level of resolution of light
      microscopy, definitive evaluation of particle burden in the airway wall requires
      analytical electron microscopy. Studies from the authors' laboratory suggest that
      in Vancouver, a city with relatively low PM levels, particle loads in the airway
      mucosa are nonetheless numerically substantial, typically in the range of 10(7)
      particles/g dry tissue. In most individuals particle concentrations in the larger
      airways show a clear increase in concentration with increasing airway generation
      (smaller airway diameter) as expected from deposition models; however, smoking
      disrupts this pattern in some subjects. Respiratory bronchioles accumulate
      particularly high particle loads, typically 25-100 times the concentrations seen
      in the mainstem bronchus. Similarly high concentrations are found in the large
      airway carinas, suggesting that these locations are likely sites for particle
      toxicity. The majority of particles in the airways in Vancouver lungs appear to
      be crustal in origin, with particular accumulation of silica in the airways
      compared to the parenchyma. Ultrafine particles, which have been postulated to be
      important in PM toxicity, are present in small numbers as singlet particles and
      are largely metals, perhaps representing combustion products, but carbonaceous
      chain aggregates are rarely found. Mean particle aerodynamic diameters vary from
      about 0.3 to 0.6 microm in different parts of the airways and, overall, the
      airways retain PM2.5 rather than PM10, a finding supporting the observation that,
      in some studies, adverse health effects appear to correlate better with PM2.5
      than with PM10 concentrations. Preliminary examination of lungs of subjects from
      Mexico City, a location with relatively high ambient particle concentrations,
      indicates that the airway mucosa retains relatively large numbers of carbonaceous
      chain aggregates of ultrafine particles that appear to be combustion products and
      that presumably produce the numerous adverse effects documented for such
      products. Limited published data correlating visible particle load and airway
      mucus secretion, inflammation, and mural fibrosis suggest that high levels of air
      pollutant particles can induce chronic fibrotic responses in the airways, a
      phenomenon that might be linked to chronic airflow obstruction; this observation
      needs confirmation as well as correlation with specific types of particles.

PMID- 11206333
TI  - Chronic inflammatory demyelinating polyneuropathy: immunopathological and
      ultrastructural study of peripheral nerve biopsy in 42 cases.
AB  - The authors recently reexamined the peripheral nerve biopsies from 42 patients
      with chronic inflammatory demyelinating polyneuropathy (CIDP). There were 27
      males and 15 females, aged from 9 to 84 years, and 13 had relapses. No patient
      had vasculitis, monoclonal gammopathy, tumor, diabetes mellitus, Lyme disease,
      familial neuropathy, HIV, or any other immune deficiency. In the endoneurium,
      perivascular inflammatory cell infiltrates were present in only one case, but
      scattered histiocytes marked by KP1 on paraffin-embedded fragments were present
      in every case and there were no T-lymphocytes. At ultrastructural examination
      macrophage-associated demyelination was observed in 17 cases, of which 6 had
      relapses separated by intervals of several months or years. Axonal lesions
      without associated primary demyelination were observed in 4 cases and 3 of these
      had relapses. Thirty-two patients had mixed lesions of demyelination and axonal
      involvement. This study confirms other recent data indicating that in all cases
      of CIDP, macrophages are present in the endoneurium. Macrophage-associated
      demyelination is the characteristic feature of demyelinating forms. On the other
      hand, isolated primary axonal forms, which have been known since 1989, are
      relatively frequent and prone to relapses.

PMID- 11206334
TI  - Phyllodes tumor of the breast: EGFR family expression and relation to
      clinicopathological features.
AB  - The expression of EGFR family members was examined by immunohistochemistry in 22
      phyllodes tumors, and the results were evaluated together with
      immunohistochemical findings for proliferation markers Ki67 and BM28, and the
      tumor suppressor gene product p53. Light and electron microscopy were performed
      in all cases. Clinical information was obtained from the medial records. We did
      find that expression of EG FR, c-erbB-3 and c-erbB-4 proteins could be detected
      in the neoplastic mesenchymal cells, and that the expression increased with
      increasing malignancy. Increased expressions of Ki67, BM28, p53 and EGFR family
      members in neoplastic cells were associated with malignancy and unfavorable
      clinical course. Furthermore, the expression of ER-alpha and PR in the epithelial
      cells of phyllodes tumors was increased compared to that in normal breast
      epithelium. Finally, the application of electron microscopy helped to identify a
      group of malignant tumors, revealing neoplastic cells with characteristic nuclear
      indentations, as well as an increasing number of myofibroblasts.

PMID- 11206335
TI  - The continuing value of electron microscopy in surgical pathology.
AB  - For decades, transmission electron microscopy has played a valuable diagnostic
      role in surgical pathology. The continuing importance of electron microscopy,
      however, can be debated, given the major advances that have occurred in
      immunohistochemistry and other techniques. Electron microscopy retains excellent
      educational potential and broad research applicability, and it continues to be a
      necessity for the evaluation of a small subset of surgical pathology cases, such
      as renal biopsies and cilia specimens. The real controversy, then, centers on the
      contribution of electron microscopy in the evaluation of neoplasms. The opinion
      of many experts indicates that electron microscopy is still vital in the
      diagnostic assessment of some neoplasms, and that both electron microscopy and
      immunohistochemistry are more powerful when viewed as complementary rather than
      competitive techniques. For electron microscopy to be used to its potential,
      however, electron microscopists must function effectively as consultants. When
      optimally applied, electron microscopy remains an essential diagnostic tool.

PMID- 11206336
TI  - Composite keratohyaline granules in striate keratoderma.
AB  - The gross, light microscopic, and ultrastructural findings in a 55 year old man
      was striate keratoderma are presented. There was no family history of the
      disease. The lesions developed in his late teens and early adult years, and
      consisted of progressively worsening, raised, hyperkeratotic, linear plaques on
      the palm and volar surface of the third and fifth fingers bilaterally. There were
      also painful callosities on both heels, and thick, raised plaques on the heels
      and lateral plantar surfaces. The epidermis was papillomatous and acanthotic,
      with marked orthokeratosis, minimal parakeratosis, and a very thickened granular
      layer. No epidermolysis was seen. Electron microscopy showed increased
      tonofibrils in the stratum spinosum arranged in wavy, parallel bundles and a
      granular layer in which normal Odland bodies were present. However, the
      keratohyaline granules were large, with rounded borders and a striped,
      alternating, dark and light content characteristic of composite granules. There
      was diminished contact of the granules with tonofibrils. The transition to the
      stratum corneum was abrupt. The ultrastructural and genetic features of
      keratodermas, with special emphasis on the striate type, are reviewed.

PMID- 11206337
TI  - Ultrastructural identification of protein bodies, cellular markers of human
      catecholamine neurons, in a temporal lobe ganglioglioma.
AB  - A temporal lobe ganglioglioma, surgically removed from an 8-year-old body, and a
      human brainstem at the level of locus coeruleus (LC) were processed for light
      microscopy (LM), with formalin fixation and paraffin embedding, and for electron
      microscopy (EM) with glutaraldehyde fixation, potassium permanganate
      postfixation, phosphotungstic acid-hematoxylin block-staining, and epoxy resin
      embedding. The paraffin sections were stained with toluidine blue O/rhodamine B
      and observed under epi-fluorescence. The thin sections for EM were viewed
      directly without further staining. The neuronal neoplastic cells of ganglioglioma
      and the neurons of LC are known to produce catecholamines. Both also contain
      spherical protein bodies (pb), cellular markers that identify catecholamine
      neurons in humans. The ultrastructural characteristics of the pb in LC were
      compared with those of the pb in neoplastic ganglion cells. These bodies had an
      identical ultrastructure, in both tissues, consisting of electron-lucent core
      surrounded by an electron-dense thin rim. The rhodamine B-stained sections also
      emphasized the identical morphology of the pb in ganglioglioma and LC. Based on
      the EM comparison, these brightly fluorescing spherical bodies are ideal markers
      for identifying in LM, the clusters of large neoplastic cells, representing
      neurons, which are the most important clue to the correct diagnosis of
      gangliogliomas.

PMID- 11206338
TI  - Nemaline cardiomyopathy in a young adult: an ultraimmunohistochemical study and
      review of the literature.
AB  - Heart transplantation was performed in a 26-year-old man who suffered from severe
      dilatative cardiomyopathy. A nemaline myopathy characterized by the accumulation
      of Z-line material and the formation of rod-like structures had been diagnosed in
      the skeletal muscle. Routine light microscopy of the heart disclosed only
      nonspecific findings. On electron microscopy scattered cardiomyocytes showed
      formations of rod-like structures and a structural desintegration of contractile
      filaments near the intercalated disks. Immunocytochemistry at the light and
      electron microscopical level exhibited an accumulation of alpha-actinin, desmin,
      and occasionally vinculin in abnormal cardiomyocytes. The rods were specifically
      stained with alpha-actinin and were less immunoreactive for desmin. No mutations
      were revealed in the skeletal muscle alpha-actin gene. The results illustrate a
      complex derangement of the cytoskeletal apparatus in nemaline cardiomyopathy.
      Nemaline cardiomyopathy may be difficult to diagnose in routine diagnostic
      procedures. A close correlation between the severity of cardiac dysfunction and
      the morphological expression of the disease in the heart may not be found.
      Nemaline cardiomyopathy should be included in the differential diagnosis of
      dilatative cardiomyopathy and may be diagnosed with certainty by ultrastructural
      immunhistochemical investigations.

PMID- 11206339
TI  - Focal parietal cell differentiation in a well-differentiated (intestinal-type)
      early gastric cancer.
AB  - A well-differentiated (intestinal-type) early gastric cancer characterized by
      multifocal areas containing adenocarcinoma cells with eosinophilic cytoplasm is
      presented. The electron microscopy revealed that cytoplasmic eosinophilia was
      mainly due to the presence of numerous mitochondria. In addition, individual
      cells showed features of preparietal cell differentiation such as numerous
      mitochondria, tubulovesicles, intracellular canaliculi and rare mucin granules.
      There were also adenocarcinoma cells with a pyloric gland (mucopeptic)
      differentiation as revealed by the presence of granules with a dense protein core
      eccentrically located in the mucus matrix. These ultrastructural data suggested a
      gastric epithelial cell differentiation. The implications with regard to the
      classification and histogenesis of this tumor are discussed.

PMID- 11206340
TI  - Case for the panel. Crystalline cytoplasmic inclusions in an anaplastic
      oligodendroglioma.

PMID- 11206341
TI  - Early contributions to the study of bone and joint disease in Glasgow, Scotland.
AB  - Despite the fact that the University of Glasgow had a well-developed medical
      school founded in the eighteenth century, a modern rheumatology unit was only
      opened in 1965. However, Glasgow physicians, surgeons, and pathologists
      contributed to the study of bone and joint disease before this date. This paper
      is a summary of their contributions.

PMID- 11206342
TI  - Proteus IgG antibodies and C-reactive protein in English, Norwegian and Spanish
      patients with rheumatoid arthritis.
AB  - The distribution of Proteus antibody levels was compared in English, Norwegian
      and Spanish patients with rheumatoid arthritis (RA). Using an indirect
      immunofluorescence method, the IgG antibody titre against Proteus mirabilis was
      measured in the sera of 27 English, 53 Norwegian and 34 Spanish patients with RA
      and divided into active and inactive disease groups according to the serum C
      reactive protein (CRP) level (> or = 10 mg/l). Serum samples were also collected
      from 25 English, 30 Norwegian and 14 Spanish healthy individuals who served as
      controls. The levels of Proteus IgG antibodies were significantly higher in the
      sera of active RA patients (p<0.001) when compared with the corresponding healthy
      controls, whether these groups belonged to the English, Norwegian or Spanish
      populations. Furthermore, active RA patients from each country showed
      significantly higher levels of Proteus antibodies when compared with inactive
      English (p<0.01), Norwegian (p<0.001) or Spanish (p<0.001) RA patients. Finally,
      a significant correlation was observed between Proteus IgG antibody levels and
      the CRP concentrations in RA patients whether each population was tested
      individually or all together (p<0.001). The increased levels of Proteus
      antibodies in RA patients from three different European countries support the
      concept of a possible aetiopathogenetic role for Proteus microorganisms in the
      development of RA.

PMID- 11206343
TI  - Polyarteritis nodosa in Arab children in Saudi Arabia.
AB  - At both King Khalid University Hospital and King Faisal Specialist Hospital in
      Riyadh, Saudi Arabia, between 1990 and 1997, we identified 11 children with
      polyarteritis nodosa (PAN). Nine of them satisfied the American College of
      Rheumatology 1990 criteria for the classification of PAN. All patients were
      followed for at least 12 months. The male-to-female ratio was 1.8:1. Their mean
      age at disease onset was 5.8 years (range 2-11.5 years) and the mean duration of
      the disease was 2.5 years (range 1-7 years). The clinical presentations in the
      children were musculoskeletal symptoms in all patients, mucocutaneous findings in
      10 (91%), fever in eight (73%), gastrointestinal manifestations in six (55%) and
      hypertension in five (45%). The most frequent laboratory findings were
      leucocytosis, anaemia, thrombocytosis and a high erythrocyte sedimentation rate.
      Both histopathological and angiographic findings were an effective means of
      diagnosis. Nine children responded to glucocorticoids (GC) with cytotoxic drugs
      while the rest improved on GC alone. None of the children died from the disease.
      A high index of suspicion with early combination therapy will help in decreasing
      the morality in these cases.

PMID- 11206344
TI  - Cervical and trochanteric hip fractures: bone mass and other parameters.
AB  - We examined 310 hip fracture patients (55 men, 255 women) to identify differences
      in those patients who had suffered a cervical fracture compared with those with a
      trochanteric fracture of the hip. Patients underwent a dual-energy X-ray
      absorptiometry (DXA) scan of their hip and total body and quantitative ultrasound
      (QUS) scans of their heel. Other measurements included medical/drug history.
      Significant differences were found for broadband ultrasound attenuation (BUA) and
      DXA total-body measurements, with those with a cervical fracture having a higher
      bone mass. Those with a trochanteric fracture showed a significantly higher
      incidence of stroke (12.8% vs. 6.3%, p = 0.05), while high blood
      pressure/antihypertensive therapy was significantly more common in the cervical
      fracture group (11.6% vs. 4.3%, p < 0.03). Therefore, it is not only bone
      parameters that differ in these patients. In the presence of certain medical
      conditions, preventative therapy may be directed to managing co-existing
      conditions as well as improving bone density.

PMID- 11206345
TI  - PFAPA syndrome (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitis).
AB  - This paper aims to remind paediatric clinicians to suspect and confirm 'PFAPA'
      syndrome (Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis
      syndrome). We report two cases of PFAPA syndrome: a 3-year-old healthy boy with
      atopic rhinitis and a boy aged 8 years 5 months who simultaneously had
      lymphocytic vasculitis syndrome treated with immunosuppressive drugs. Both met
      Marshall's criteria. The literature regarding PFAPA syndrome was complied using a
      Medline search for articles published between 1963 and 1998 and we then reviewed
      the reference lists of the articles. The Medline search revealed 28 cases with
      available clinical manifestations, management and prognosis. Our study describes
      two additional cases. We divided the cases into typical (28 cases) and atypical
      (two cases) PFAPA syndrome. In typical PFAPA, the age of onset was less than 5
      years in most cases and the patients presented 4.9 +/- 1.4 days of fever (100%),
      pharyngitis (89.3%), cervical adenitis (72.1%), stomatitis (71.4%), malaise
      (64.3%), headache (60.7%), abdominal pain (53.6%) and nausea/vomiting (17.9%).
      Afebrile intervals were 3.2 +/- 2.4 months and increased with age. The time from
      initial onset to final episode was 3 years 7 months +/- 3 years 6 months. The
      total number of episodes was 8.3 +/- 2.5 (range 6-14). Effective treatment
      included steroids, tonsillectomy/adenoidectomy and cimetidine. The general
      outcome was good. In atypical PFAPF, the clinical manifestations were similar to
      those of typical PFAPA except that the age of onset was more than 5 years, and
      life-threatening intestinal perforation happened once in a patient with
      underlying Fanconi's anaemia. It was concluded that typical PFAPA syndrome is
      benign and can be diagnosed by detailed history-taking and from physical findings
      during repeated febrile episodes with tests to rule out other periodic fever
      syndromes. A review of the literatures since the first report in 1987 has shown
      that typical PFAPA syndrome is not associated with significant long-term sequelae
      and has a good response to steroids. One patient with atypical PFAPA, who
      received low-dose steroids for over 1 year, developed intestinal perforation
      after an increment of the 7-day steroid dose. If an underlying problem requires
      long-term immunosuppressive medication, it is wiser to choose cimetidine rather
      than increasing the steroid dosage to resolve atypical PFAPA.

PMID- 11206346
TI  - Osteoarthricular involvement of brucellosis in Turkey.
AB  - The aim of this study was to determine the rates, types, clinical features and
      treatment of osteoarthricular involvement of brucellosis in Turkey. In a
      restrospective study in adults, we investigated 238 patients diagnosed with
      brucellosis over a period of 6 years. A diagnosis of brucellosis was established
      by isolation of Brucella species in blood or by a compatible clinical picture
      together with a standard tube agglutination titre of > or = 1/160 of antibodies
      for brucellosis and/or demonstration of an at least four-fold rise in antibody
      titre in serum specimens taken over 2 or 3 weeks. Osteoarthricular involvement
      was defined by inflammatory signs in peripheral joints or by unrelieved pain at
      rest together with radiological alterations and/or radionuclide uptake in any
      deep joint. Eighty-seven patients (36.5%) had osteoarthricular involvement (58.6%
      female, 41.4% male), 47 (54.1%) of whom were reported to consume unpasteurised
      dairy products. The mean age was 32.3 +/- 16 years. Sacroiliitis was the most
      common involvement (n = 53, 60.9%) followed by peripheral arthritis (n = 17,
      19.5%), spondylitis (n = 12, 13.8%) and bursitis (n = 5, 5.7%). During the
      observation period, 60 (69%) patients with osteoarthricular involvement and
      radiographic abnormalities. A bone scan was positive in 15 patients with no
      radiographic abnormalities. All patients received merely medical treatment and
      relapse occurred in five (5.7%) patients. Sacroiliitis has been determined as the
      most frequently observed type of osteoarthricular involvement in brucellosis in
      Turkey.

PMID- 11206347
TI  - Juvenile chronic arthritis in adult life: a study of long-term outcome in
      patients with juvenile chronic arthritis or adult rheumatoid arthritis.
AB  - We compared the prognostic factors and outcome of 30 patients with juvenile
      chronic arthritis (JCA) extending into adult life with those of 30 patients with
      adult rheumatoid arthritis (RA) at a university adult rheumatology clinic; pairs
      were matched for sex and duration of disease (mean 8 years). One-third of JCA
      patients had seronegative polyarticular disease and another third had
      oligoarticular disease. In a third of the JCA patients, the clinical presentation
      changed during the follow-up. Over half of the RA patients had seropositive
      polyarticular and a one-third had seronegative polyarticular disease. Fewer
      seropositive patients were recorded in the JCA group than in the RA group both at
      the beginning (16.7% versus 56.7%; p=0.003) and at the end of the follow-up
      (14.3% versus 59.3%; p=0.001). JCA patients developed less radiographic changes
      than RA patients (46.7% versus 76.7%; p=0.034); oligoarthritis in the JCA group
      had the best prognosis whereas seropositive polyarthritis in the RA group had the
      worst prognosis. Significantly more patients with JCA than RA (60% versus 23%;
      p=0.009) were in remission at the end of the follow-up. In conclusion, when
      studied in adult life, the long-term prognosis is better in patients with JCA
      than in those with RA.

PMID- 11206348
TI  - Distribution of double-negative (CD4- CD8-, DN) T subsets in blood and synovial
      fluid from patients with rheumatoid arthritis.
AB  - Double-negative (CD4- CD8-) T (DNT) cells have been postulated to be potentially
      autoreactive. However, the role of DNT cells in rheumatoid arthritis (RA) has
      received limited attention. We investigated the distribution of DNT subsets in
      peripheral blood (PB) and synovial fluid (SF) from patients with active RA to
      determine whether these cells have relevance to RA. Two-colour flow cytometric
      analysis was performed to detect DNT cells in PB from 35 RA patients, 26 healthy
      controls and in SF aspirated from 19 inflamed rheumatoid joints. The subsets of
      DNT cells, i.e those expressing T cell receptor alphabeta (alphabeta DNT) or
      gammadelta (gammadelta DNT) were simultaneously examined. Our results showed that
      DNT cells constituted a very minor subset of PB lymphocytes. When expressed as a
      percentage of total lymphocytes, alphabeta DNT levels in normal individuals
      ranged from 0.27 to 2.08% (average 0.76%), while those of gammadelta DNT ranged
      from 1.02 to 11.42% (average 3.23%). Compared with normal individuals, RA
      patients had a similar distribution of alphabeta DNT cells in both PB and SF.
      However, RA patients had significantly lower levels of gammadelta DNT cells in PB
      than control subjects (1.38 +/- 1.08% vs 3.23 +/- 2.12%, p<0.05), while the
      levels of gammadelta DNT cells in SF of RA patients were higher than those in PB
      from RA patients and normal controls. The difference between PB and SF in RA was
      statistically significant (3.90 +/- 1.88% vs 1.38 +/- 1.08%, p<0.05). A higher
      level of gammadelta DNT in SF than their paired PB was consistently noted from
      nine available paired samples. Our findings suggest that gammadelta NT cells, but
      not alphabeta DNT cells, are probably relevant to RA. The lower percentage of
      circulating gammadelta DNT cells might have resulted from migration from the
      circulation into the synovium, suggesting a role for gammadelta DNT cells in the
      pathogenesis of rheumatoid synovitis.

PMID- 11206349
TI  - Degeneration of the scaphoid-trapezium joint: a useful finding to differentiate
      calcium pyrophosphate deposition disease from osteoarthritis.
AB  - This study aimed to determine whether osteoarthritis of the scaphoid-trapezium
      joint (ST osteoarthritis) is associated with calcium pyrophosphate deposition
      disease (CPDD) in an elderly population with or without concomitant polyarthritis
      of the finger joints (FIPO). An age- and gender matched case-control study was
      performed at a university hospital outpatient clinic. Cases and controls were
      identified from a clinical registry. The case ascertainment process included: (1)
      chart review for evidence of pyrophosphate crystals from arthrocentesis and/or
      cartilage calcifications and (2) blinded reading of hand X-rays by three
      observers for calcification of the triangular fibrocartilage and/or cartilage
      calcification around the spatium triangulare. Osteoarthritis was graded from 0 to
      4 according to the Standard Atlas of Radiographs. The association of ST
      osteoarthritis with the diagnosis was examined using chi2 tests or the Wilcoxon
      rank sum test as appropriate. From 65 potential cases, 30 fulfilled the
      inclusion/exclusion criteria whereas from 185 potential controls, 81 fulfilled
      the inclusion/exclusion criteria. Thirty controls were matched to cases for
      gender and age. ST osteoarthritis was much more severe in CPDD (median: 3.0) than
      in patients with FIPO (median: 0.3) and was strongly associated with the
      diagnosis (odds ratio 13.8; CI 3.4-59.8). Definite ST osteoarthritis identified
      CPDD with a sensitivity of 83% and a specificity of 73% with regard to FIPO. It
      was concluded that the presence of ST osteoarthritis is a helpful diagnostic
      finding for the diagnosis of CPDD in an elderly, predominantly female population
      with a high prevalence of FIPO. Especially in cases without radiographic
      cartilage or fibrocartilage calcification of the wrist, ST osteoarthritis may
      point to the correct diagnosis.

PMID- 11206350
TI  - Marked improvement of severe cardiac dysfunction after one course of intravenous
      immunoglobulin in a patient with systemic lupus erythematosus.
AB  - Intravenous immunoglobulin (IVIg) is currently used with much enthusiasm for the
      treatment of many autoimmune diseases, including systemic lupus erythematosus
      (SLE). Among its various indications, IVIg has also been found to be beneficial
      in myocarditis, whether or not it is associated with an autoimmune disease (e.g.
      Kawasaki's disease). We report a 59-year-old SLE patient who, while being treated
      with steroids, developed severe cardiac dysfunction with a left ventricular
      ejection fraction of 20%. Coronary angiography demonstrating normal coronary
      arteries supported the diagnosis of myocarditis. High-dose IVIg treatment was
      started, followed by improved cardiac function a few days later and normalisation
      of the ejection fraction (50%) 1 month later. This is the second report of a
      beneficial effect of IVIg in myocarditis secondary to SLE.

PMID- 11206351
TI  - Thrombocytopenia in systemic-onset juvenile chronic arthritis: report of two
      cases with unusual bone marrow features.
AB  - Two children with systemic-onset juvenile chronic arthritis (S-JCA) suffering
      from severe, symptomatic thrombocytopenia are reported. Case 1 is a 10-year-old
      girl who had fever, chronic polyarthritis and hepatosplenomegaly for 6 months and
      severe gum bleeding and generalised petechiae for 1 week. Immune thrombocytopenic
      purpura (ITP) was indicated by bone marrow findings of megakaryocytic
      hyperplasia, and her thrombocytopenia responded well to steroid therapy without
      recurrence, but progressive, deforming polyarthritis with anaemia and
      thrombocytosis persisted. Case 2 is a 7-year-old girl who presented with spiking
      fever, arthritis and skin rashes and was suspected of having S-JCA. She developed
      a severe nosebleed with impending shock while receiving full-dose aspirin.
      Pancytopenia and elevated liver enzymes were also noted. Bone marrow aspiration
      revealed erythroid hyperplasia, maturation arrest of myeloid series with
      increased blasts, and adequate megakaryocytes. Her thrombocytopenia resolved in 1
      week without specific treatment. Her subsequent clinical course confirmed the
      diagnosis of S-JCA, while thrombocytopenia did not recur during follow-up.

PMID- 11206352
TI  - Pure red cell aplasia in Felty's syndrome: a case report of successful reversal
      after cyclosporin A treatment.
AB  - We describe the first report of a patient with Felty's syndrome who developed
      pure red cell aplasia, likely not attributable to medication, that was
      successfully treated with cyclosporin A.

PMID- 11206353
TI  - Two siblings with juvenile hyaline fibromatosis: case reports and review of the
      literature.
AB  - In this paper, we describe two siblings with Juvenile Hyaline Fibromatosis (JHF)
      who were diagnosed at the age of 34 and 29 years respectively. JHF is a very
      congenital disease, mainly diagnosed in the first few years of life, with less
      than 40 published cases in literature. All the main clinical features of this
      syndrome, which may be summarised as multiple subcutaneous tumours, marked
      gingival hypertrophy, flexion contractures and osteolytic lesions were present in
      both of these cases. Clinical, radiological and histological differential
      diagnosis of JHF were made. Recent information about histopathology, treatment
      and prognosis of JHF was also reviewed.

PMID- 11206354
TI  - Burkitt's lymphoma presenting as ileocaecal intussusception in systemic lupus
      erythematosus.
AB  - Patients with systemic lupus erythematosus (SLE) are reported to have an
      increased risk of malignancy, especially lymphoproliferative disorders. We
      decribe the occurrence of ileocaecal intussusception secondary to Burkitt's
      lymphoma in a patient with SLE. A 23-year-old woman, who had been diagnosed with
      SLE 2 years ago, developed intermittent abdominal pain with a palpable mass.
      Computed tomography and a double-contrast barium enema showed a lobulated mass
      with intussusception at the ileocaecal junction. Right hemicolectomy and
      splenectomy was performed after histopathological examinations on colonoscopic
      biopsy revealed Burkitt's lymphoma. Fourteen months after chemotherapy, there is
      no evidence of recurrence of the Burkitt's lymphoma. When a patient with SLE has
      abdominal complaints, besides serositis, lupus enteritis such as peptic ulcer
      disease, mesenteric vasculitis with or without complications and pancreatitis, we
      have to consider intussusception secondary to gastrointestinal lymphoma as one of
      the differential diagnoses. Therefore, we should thoroughly investigate patients
      with SLE presenting with abdominal pain and not simply consider it afeature of
      lupus enteritis until other causes have been ruled out.

PMID- 11206355
TI  - Polyarteritis nodosa mimicking polymyalgia rheumatica.
AB  - We report a case of polyarteritis nodosa with a clinical presentation mimicking
      polymyalgia rheumatica, as well as pathological findings of non-giant-cell
      arteritis on temporal artery biopsy with symptoms of jaw claudication. Although
      certain clinical syndromes have been attributed to specific types of systemic
      vasculitis, considerable overlap occurs. Obtaining tissue biopsy in cases of
      vasculitis is mandatory for diagnosis and classification.

PMID- 11206356
TI  - Inflammatory bowel disease and myositis.
AB  - A patient with Crohn's disease developed proximal muscle weakness, increased
      serum creatine phosphokinase activity and electromyographic abnormalities. A
      muscle biopsy was non-diagnostic. Although rare, myositis should be included in
      the differential diagnosis of muscle weakness in patients with inflammatory bowel
      disease.

PMID- 11206357
TI  - Perceived risks of joint infection following intra-articular corticosteroid
      injections: a survey of rheumatologists.
AB  - There are no clear published data on the risks of bacterial arthritis following
      intra-articular corticosteroid injections. Forty rheumatologists were given a
      detailed questionnaire; 32 (response 80%) completed questionnaires were analysed.
      On the basis of recalled cases of post-injection joint infection we estimate this
      risk to be low, at 4.6/100,000 injections.

PMID- 11206358
TI  - Analgesic effect of intravenous pamidronate on chronic back pain due to
      osteoporotic vertebral fractures.
AB  - Pamidronate, a bisphosphonate analogue has been evaluated in a retrospective
      study for its analgesic effect on chronic back pain due to vertebral fractures in
      26 patients suffering from senile osteoporosis or glucocorticoid-induced
      osteoporosis. Sixty milligrams of pamidronate was administered intravenously
      every 3 months for one year. After three months of treatment, the pain score fell
      from 3.2 +/- 0.1 to 1.2 +/- 0.2 in both groups. In conclusion, intravenous
      pamidronate seems to be a valuable treatment for chronic back pain due to
      osteoporotic vertebral fractures.

PMID- 11206359
TI  - Antineutrophil cytoplasmic antibody in patients with primary Sjogren's syndrome.
AB  - The incidence, specificity and clinical significance of positivity for serum
      antineutrophil cytoplasmic antibody (ANCA) was investigated in 60 patients with
      primary Sjogren's syndrome (SjS). The indirect immunofluorescence (IIF) technique
      and an enzyme-linked immunosorbent assay (ELISA) were used to measure ANCA.
      Purified myeloperoxidase (MPO), lactoferrin (LF), cathepsin-G (CTG) and elastase
      (HLE) served as ANCA antigens for the ELISA. Ten (16.7%) of the 60 SjS patients
      showed positivity by IIF for perinuclear, but not cytoplasmic, ANCA. Four of the
      60 sera were shown to be positive for LF, four for MPO, 0 for CTG and 0 for HLE
      by ELISA. There was no correlation between ANCA positivity and clinical features.
      ANCA in patients with SjS might be an epiphenomenon of polyclonal B-cell
      activation.

PMID- 11206360
TI  - Benchmarking of model core potentials: application to the halogen complexes of
      group 4 metals.
AB  - The reliability of the model core potential (MCP) method was probed in a
      systematic RHF and MP2 study of the geometries of the group 4 metal halogen
      complexes (MX4; M = Ti, Zr, Hf and X = F, Cl, Br, I). The computed bond lengths
      were compared with experimental values, as well as those predicted using
      effective core potentials. Provided that electrons from the outermost core shell
      of the metal atom are treated explicitly in the calculation, both the MCP and ECP
      methods predict M-X bond lengths within 0.02-0.03 A of experiment. The reaction
      energies for a simple set of halogen substitution reactions of the MX4 complexes
      leading to the mixed halogen complex, MX2Y2, were also studied. Although no
      experimental values are available for these reactions, comparison was made with
      the values computed using effective core potentials. The predictability of the
      different pseudopotential techniques and the importance of the metal atom valence
      basis set contraction scheme and polarization space are discussed.

PMID- 11206361
TI  - CheD: chemical database compilation tool, Internet server, and client for SQL
      servers.
AB  - An efficient program, which runs on a personal computer, for the storage,
      retrieval, and processing of chemical information, is presented, The program can
      work both as a stand-alone application or in conjunction with a specifically
      written Web server application or with some standard SQL servers, e.g., Oracle,
      Interbase, and MS SQL. New types of data fields are introduced, e.g., arrays for
      spectral information storage, HTML and database links, and user-defined
      functions. CheD has an open architecture; thus, custom data types, controls, and
      services may be added. A WWW server application for chemical data retrieval
      features an easy and user-friendly installation on Windows NT or 95 platforms.

PMID- 11206362
TI  - Spiral codes and Goldberg representations of icosahedral fullerenes and
      octahedral analogues.
AB  - An icosahedral fullerene may be considered as a tessellation of the sphere
      specified by an ordered pair of integers, or as a tightly wound spiral of faces.
      Explicit analytical relations for interconverting the two representations are
      given, enabling the canonical spiral code to be constructed for an icosahedral
      fullerene of any size. Analogous relations hold for the octahedral square +
      hexagon polyhedra that have been mentioned as possible candidates for boron
      nitride "fullerenes".

PMID- 11206363
TI  - Spectral moments of phenylenes.
AB  - In a series of publications Estrada (Estrada, E. J. Chem. Inf. Comput. Sci. 1996,
      36, 844-849; 1997 37, 320-328; 1998, 38, 23-27) employed spectral moments of line
      graphs in QSPR and QSAR relationship studies of various classes of compounds. A
      recent paper (Markovic, S.; Gutman, I. J. Chem. Inf Comput. Sci. 1999, 39, 289
      293) reported that in QSPR and QSAR investigations of benzenoid hydrocarbons
      based on linear combination of spectral moments, it made no difference whether
      one used spectral moments of the molecular graph or those of the line graph. In
      the present work spectral moments of molecular graphs (Mk) and line graphs (muk)
      of phenylenes are considered. The first few Mk's and muk'S of phenylenes are
      dependent on identical structural parameters. It is proved that the two sets of
      moments of phenylenes are linearly dependent. It is also shown that in the case
      of the heat of formation of phenylenes there is no advantage in using lower
      spectral moments of line graphs instead of lower spectral moments of molecular
      graphs. In this way the redundancy observed in the case of benzenoid hydrocarbons
      is also shown to exist in the class of phenylenes.

PMID- 11206364
TI  - High-throughput prediction of blood-brain partitioning: a thermodynamic approach.
AB  - A high-throughput in silico screening tool for potentially CNS active compounds
      was developed on the basis of the correlation of solvation free energies and
      blood-brain partitioning (log(cbrain/cblood) = log BB) data available from
      experimental sources. Utilizing a thermodynamic approach, solvation free energies
      were calculated by the fast and efficient generalized Born/surface area continuum
      solvation model, which enabled us to evaluate more than 10 compounds/min. Our
      training set involved a structurally diverse set of 55 compounds and yielded a
      function of log BB = 0.035Gsolv + 0.2592 (r = 0.85, standard error 0.37).
      Calculation of solvation free energies for 8700 CNS active compounds (CIPSLINE
      database) revealed that Gsolv is higher than -50 kJ/mol for the 96% of these
      compounds which can be used as suitable criteria for the identification of
      compounds preferable for CNS penetration.

PMID- 11206365
TI  - Determining the number of resonance structures in concealed non-Kekulean
      benzenoid hydrocarbons.
AB  - The number of resonance structures (SC) for previously published concealed non
      Kekulean benzenoid hydrocarbons is determined. Using a simple computer program,
      analytical expressions for determining SC for various classes of non-Kekulean
      (free-radical) benzenoid hydrocarbons are derived, and some properties of
      concealed non-Kekulean benzenoid hydrocarbons are studied.

PMID- 11206366
TI  - Ties in proximity and clustering compounds.
AB  - Hierarchical clustering algorithms such as Wards or complete-link are commonly
      used in compound selection and diversity analysis. Many such applications utilize
      binary representations of chemical structures, such as MACCS keys or Daylight
      fingerprints, and dissimilarity measures, such as the Euclidean or the Soergel
      measure. However, hierarchical clustering algorithms can generate ambiguous
      results owing to what is known in the cluster analysis literature as the ties in
      proximity problem, i.e., compounds or clusters of compounds that are equidistant
      from a compound or cluster in a given collection. Ambiguous ties can occur when
      clustering only a few hundred compounds, and the larger the number of compounds
      to be clustered, the greater the chance for significant ambiguity. Namely, as the
      number of "ties in proximity" increases relative to the total number of
      proximities, the possibility of ambiguity also increases. To ensure that there
      are no ambiguous ties, we show by a probabilistic argument that the number of
      compounds needs to be less than 2(n 1/4), where n is the total number of
      proximities, and the measure used to generate the proximities creates a uniform
      distribution without statistically preferred values. The common measures do not
      produce uniformly distributed proximities, but rather statistically preferred
      values that tend to increase the number of ties in proximity. Hence, the number
      of possible proximities and the distribution of statistically preferred values of
      a similarity measure, given a bit vector representation of a specific length, are
      directly related to the number of ties in proximities for a given data set. We
      explore the ties in proximity problem, using a number of chemical collections
      with varying degrees of diversity, given several common similarity measures and
      clustering algorithms. Our results are consistent with our probabilistic argument
      and show that this problem is significant for relatively small compound sets.

PMID- 11206367
TI  - Novel chirality descriptors derived from molecular topology.
AB  - Several series of novel chirality descriptors of chemical organic molecules have
      been introduced. The descriptors have been developed on the basis of conventional
      topological descriptors of molecular graphs. They include modified molecular
      connectivity indices, Zagreb group indices, extended connectivity, overall
      connectivity, and topological charge indices. These modified descriptors make use
      of an additional term called chirality correction, which is added to the vertex
      degrees of asymmetric atoms in a molecular graph. Chirality descriptors can be
      real or complex numbers. Advantages and drawbacks of different series of
      chirality descriptors are discussed. These descriptors circumvent the inability
      of conventional topological indices to distinguish chiral or enantiomeric
      isomers, which so far has been the major drawback of 2D descriptors as compared
      to true 3D descriptors (e.g., shape, molecular fields) of molecular structure.
      These novel chirality descriptors have been implemented in a quantitative
      structure-activity releationship (QSAR) study of a set of ecdysteroids with a
      high content of chiral and enantiomeric compounds using the k nearest neighbor
      QSAR method (kNN) recently developed in this laboratory. We show that the results
      of this study compare favorably with those obtained with the comparative
      molecular field analysis (CoMFA) applied to the same dataset. The novel chirality
      descriptors of molecular structure should find their applications in QSAR studies
      and related investigations of molecular sdatasets.

PMID- 11206368
TI  - A constant time algorithm for estimating the diversity of large chemical
      libraries.
AB  - We describe a novel diversity metric for use in the design of combinatorial
      chemistry and high-throughput screening experiments. The method estimates the
      cumulative probability distribution of intermolecular dissimilarities in the
      collection of interest and then measures the deviation of that distribution from
      the respective distribution of a uniform sample using the Kolmogorov-Smirnov
      statistic. The distinct advantage of this approach is that the cumulative
      distribution can be easily estimated using probability sampling and does not
      require exhaustive enumeration of all pairwise distances in the data set. The
      function is intuitive, very fast to compute, does not depend on the size of the
      collection, and can be used to perform diversity estimates on both global and
      local scale. More importantly, it allows meaningful comparison of data sets of
      different cardinality and is not affected by the curse of dimensionality, which
      plagues many other diversity indices. The advantages of this approach are
      demonstrated using examples from the combinatorial chemistry literature.

PMID- 11206369
TI  - Results of a new classification algorithm combining K nearest neighbors and
      recursive partitioning.
AB  - We present results of a new computational learning algorithm combining favorable
      elements of two well-known techniques: K nearest neighbors and recursive
      partitioning. Like K nearest neighbors, the method provides an independent
      prediction for each test sample under consideration, while like recursive
      partitioning, it incorporates an automatic selection of important input variables
      for model construction. The new method is applied to the problem of correctly
      classifying a set of chemical data samples designated as being either active or
      inactive in a biological screen. Training is performed at varying levels of
      intrinsic model complexity, and classification performance is compared to that of
      both K nearest neighbor and recursive partitioning models trained using the
      identical protocol. We find that the cross-validated performance of the new
      method outperforms both of these standard techniques over a considerable range of
      user parameters. We discuss advantages and drawbacks of the new method, with
      particular emphasis on its parameter robustness, required training time, and
      performance with respect to chemical structural class.

PMID- 11206370
TI  - A novel method for building regression tree models for QSAR based on artificial
      ant colony systems.
AB  - Among the multitude of learning algorithms that can be employed for deriving
      quantitative structure-activity relationships, regression trees have the
      advantage of being able to handle large data sets, dynamically perform the key
      feature selection, and yield readily interpretable models. A conventional method
      of building a regression tree model is recursive partitioning, a fast greedy
      algorithm that works well in many, but not all, cases. This work introduces a
      novel method of data partitioning based on artificial ants. This method is shown
      to perform better than recursive partitioning on three well-studied data sets.

PMID- 11206371
TI  - Combined pseudopotential and density functional study of Bis-eta6-benzene d and f
      element complexes.
AB  - The electronic and molecular structures of selected zerovalent d and f metal bis
      eta6-benzene sandwich complexes M(C6H6)2 (M = Sc, Ti, V, Cr, Y, Zr, Nb, Mo, La,
      Ce, Gd, Lu, Hf, Ta, Nb, Th) were investigated at the scalar-relativistic level
      using a combination of energy-consistent ab initio pseudopotentials and gradient
      corrected density functionals. The results are compared to previous
      pseudopotential coupled-cluster and all-electron density functional results based
      on the zero-order regular approximate Hamiltonian of Chang, Pelissier, and Durand
      as well as to experimental data.

PMID- 11206372
TI  - Algorithm for naming molecular equivalence classes represented by labeled
      pseudographs.
AB  - The emergence of large chemical databases imposes a need for organizing the
      compounds in these databases. Mapping the chemical graph in particular, and a
      molecular equivalence class represented by a labeled pseudograph in general, to a
      unique number or string facilitates high-throughput browsing, grouping, and
      searching of the chemical database. Computing this number using a naming
      adaptation of the Morgan algorithm, we observed a large classification noise in
      which nonisomorphic graphs were mapped to the same number. Our extensions to that
      algorithm greatly reduced the classification noise.

PMID- 11206373
TI  - QSAR models using a large diverse set of estrogens.
AB  - Endocrine disruptors (EDs) have a variety of adverse effects in humans and
      animals. About 58,000 chemicals, most having little safety data, must be tested
      in a group of tiered assays. As assays will take years, it is important to
      develop rapid methods to help in priority setting. For application to large data
      sets, we have developed an integrated system that contains sequential four phases
      to predict the ability of chemicals to bind to the estrogen receptor (ER), a
      prevalent mechanism for estrogenic EDs. Here we report the results of evaluating
      two types of QSAR models for inclusion in phase III to quantitatively predict
      chemical binding to the ER. Our data set for the relative binding affinities
      (RBAs) to the ER consists of 130 chemicals covering a wide range of structural
      diversity and a 6 orders of magnitude spread of RBAs. CoMFA and HQSAR models were
      constructed and compared for performance. The CoMFA model had a r2 = 0.91 and a
      q2LOO = 0.66. HQSAR showed reduced performance compared to CoMFA with r2 = 0.76
      and q2LOO = 0.59. A number of parameters were examined to improve the CoMFA
      model. Of these, a phenol indicator increased the q2LOO to 0.71. When up to 50%
      of the chemicals were left out in the leave-N-out cross-validation, the q2
      remained significant. Finally, the models were tested by using two test sets; the
      q2pred for these were 0.71 and 0.62, a significant result which demonstrates the
      utility of the CoMFA model for predicting the RBAs of chemicals not included in
      the training set. If used in conjunction with phases I and II, which reduced the
      size of the data set dramatically by eliminating most inactive chemicals, the
      current CoMFA model (phase III) can be used to predict the RBA of chemicals with
      sufficient accuracy and to provide quantitative information for priority setting.

PMID- 11206374
TI  - Computational modeling of a binding conformation of the intermediate L-histidinal
      to histidinol dehydrogenase.
AB  - Histidinol dehydrogenase (HDH) is one of the enzymes involved in the L-histidine
      biosynthesis pathway. HDH is a dimer that contains one Zn2+ ion in each identical
      subunit. In this study, we predicted a possible binding conformation of the
      intermediate L-histidinal, which is experimentally not known, using a
      computational modeling method and three potent HDH inhibitors whose structures
      are similar to that of L-histidinal. At first, a set of the most probable active
      conformations of the potent inhibitors was determined using two different
      pharmacophore mapping techniques, the active analogue approach and the distance
      comparison method. From the most probable active conformations of the three
      potent inhibitors, the common parts of the L-histidinal structure were extracted
      and refined by energy minimization to obtain the binding conformation of L
      histidinal. This predicted conformation of L-histidinal agrees with an
      experimentally determined conformation of L-histidine in a single crystal,
      suggesting that it is an experimentally acceptable conformation. The capability
      in this conformation to coordinate a Zn2+ ion was examined by comparing the
      spatial relative geometry of its functional groups with those of ligands that
      coordinate with a Zn2+ ion in Zn proteins of the Protein Data Bank. This
      comparison supported our predicted conformation.

PMID- 11206375
TI  - Analysis of the internal representations developed by neural networks for
      structures applied to quantitative structure--activity relationship studies of
      benzodiazepines.
AB  - An application of recursive cascade correlation (CC) neural networks to
      quantitative structure-activity relationship (QSAR) studies is presented, with
      emphasis on the study of the internal representations developed by the neural
      networks. Recursive CC is a neural network model recently proposed for the
      processing of structured data. It allows the direct handling of chemical
      compounds as labeled ordered directed graphs, and constitutes a novel approach to
      QSAR. The adopted representation of molecular structure captures, in a quite
      general and flexible way, significant topological aspects and chemical
      functionalities for each specific class of molecules showing a particular
      chemical reactivity or biological activity. A class of 1,4-benzodiazepin-2-ones
      is analyzed by the proposed approach. It compares favorably versus the
      traditional QSAR treatment based on equations. To show the ability of the model
      in capturing most of the structural features that account for the biological
      activity, the internal representations developed by the networks are analyzed by
      principal component analysis. This analysis shows that the networks are able to
      discover relevant structural features just on the basis of the association
      between the molecular morphology and the target property (affinity).

PMID- 11206376
TI  - Use of 13C NMR spectrometric data to produce a predictive model of estrogen
      receptor binding activity.
AB  - We have developed a spectroscopic data-activity relationship (SDAR) model based
      on 13C NMR spectral data for 30 estrogenic chemicals whose relative binding
      affinities (RBA) are available for the alpha (ERalpha) and beta (ERbeta) estrogen
      receptors. The SDAR models segregated the 30 compounds into strong and medium
      binding affinities. The SDAR model gave a leave-one-out (LOO) cross-validation of
      90%. Two compounds that were classified incorrectly in the SDAR model were in the
      transition zone between classifications. Real and predicted 13C NMR chemical
      shifts were used with test compounds to evaluate the predictive behavior of the
      SDAR model. The 13C NMR SDAR model using predicted 13C NMR data for the test
      compounds provides a rapid, reliable, and simple way to screen whether a compound
      binds to the estrogen receptors.

PMID- 11206377
TI  - Applications of effective core potentials and density functional theory to the
      spin states of iron porphyrin.
AB  - We investigated the performance of the B3LYP density functional in combination
      with ab initio effective core potentials (ECPs) that are derived from either
      Hartree-Fock or Dirac-Fock calculations. The transferability of ab initio ECPs is
      assessed on the basis of comparison with all-electron density functional
      calculations. For iron(II) porphyrin in particular, our assessment focused on the
      relative energetic ordering of five low-lying spin states, 1A1G, 3A1G, 3B2G,
      5A2G, and 5B1G, and their properties, including optimized structures, charge
      distribution, spin density, and vibrational frequencies. Our results show that
      core electron correlation and core-valence electron correlation do not have
      significant effects on the relative energetics of the spin states of iron
      porphyrin. Our calculations suggest that effects of replacing the core electrons
      with ECPs are less significant than the choice of basis functions. We conclude
      that ab initio ECPs such as LANL2, RCEP, and MEFIT-R may be combined with the
      B3LYP density functional theory to provide consistent and accurate results.

PMID- 11206378
TI  - A QSPR study of the 31P NMR chemical shifts of phosphines.
AB  - Quantitative structure-property relationships (QSPR) on a large set of
      descriptors are developed for the 31P NMR chemical shifts of a large set of
      phosphines. The data set was composed of 291 primary, secondary, and tertiary
      phosphines, PH3-nRn, including substituents with different steric and electronic
      characteristics. Multiple linear regression and computational neural networks
      (CNN) were employed to create the models best suited for the prediction of 31P
      NMR chemical shifts. A correlation equation including seven descriptors (R2 =
      0.8619) is reported. A 7-5-1 CNN was developed that produced a root-mean-error of
      9.6 ppm (R2 = 0.9513) for the training set, of 11.7 ppm (R2 = 0.8986) for the
      cross-validation set, and of 11.3 ppm (R2 = 0.9527) for an external prediction
      set. The CNN methods give significantly better predictions of 31P NMR chemical
      shifts for phosphines than the multiple linear regression approach.

PMID- 11206379
TI  - Formal analysis of effective core potential methods.
AB  - Effective core potentials are analyzed from the standpoint of the underlying
      frozen core approximation. The content of the pseudoorbital, the content of the
      potential, and the properties of both are elaborated, showing the points at which
      they differ from the frozen core approximation and where possible deficiencies
      might lie.

PMID- 11206380
TI  - Modeling intermolecular effects on nonlinear optical properties of transition
      metal complexes. An effective core potential study.
AB  - An initial effort to study the nonlinear optical (NLO) properties of interacting
      transition-metal-oxo complexes is presented and studied by effective core
      potential approaches. Osmium tetroxide is used for this study. Favorable
      intermolecular interaction effects, even within this weak interaction regime,
      that yield enhancements in NLO properties have been found. Interaction effects
      increase alpha (polarizability) up to 6% and gamma (second hyperpolarizability)
      up to 100% relative to the isolated monomer result for OsO4. The magnitude of the
      interaction (hyper)polarizabilities, and indeed even the sign, is found to be
      quite sensitive to the relative orientation of the osmium tetroxide monomers.

PMID- 11206381
TI  - Recent progress in atomic and chemical group effective potentials.
AB  - Recent progress on atomic and chemical group effective potentials is presented.
      The reviewed effective potentials follow a shape-consistent extraction technique
      from ab initio data, within a scalar relativistic approximation. Two types of
      averaged relativistic effective core potentials are considered: the correlated
      ones where a part of the correlation energy is included in the effective
      potential, and the polarized ones for which only the core polarization effects
      are taken into account. In addition spin-orbit polarized pseudopotentials have
      been extracted, and the effects of the core polarization are tested on the atomic
      spectroscopy of iodine. Finally a very recent chemical group effective
      methodology is presented, reducing the number of both electrons and nuclei
      explicitly treated. Chemical transferability is investigated, and test
      calculations on a cyclopentadienyl effective group potential are presented.

PMID- 11206382
TI  - A computational study of the effectiveness of the frontier molecular orbital
      formalism in predicting conformational isomerism in (p-RC6H4NC)2W(dppe)2.
AB  - Ab initio electronic structure calculations on a series of ligands, p-RC6H4NC:,
      indicate, that the energy of the LUMO correlates with the electron
      withdrawing/donating capabilities of the substituent group, which determines the
      relative pi-acidity of the ligand. Depending on the nature of the para
      substituent group on the aryl isocyanide ligand, bis(aryl isocyanide) complexes
      of tungsten-containing bulky bidentate arylphosphine ligands adopt either cis or
      trans conformations. The frontier molecular orbital formalism predicts that
      strong pi-acids, which contain electron-withdrawing groups, tend to polarize
      sufficient charge density away from the metal center to effect the formation of
      the sterically less favorable but electronically stabilized cis conformer.
      Density functional theory calculations on similar complexes containing phosphines
      which do not impose severe steric contraints indicate that the balance between
      steric and electronic stabilization can be effectively predicted by comparing the
      relative energies of the ligand LUMOs.

PMID- 11206383
TI  - DFT/ECP study of C-H activation by (PCP)Ir and (PCP)Ir(H)2(PCP=eta3-1,3
      C6H3(CH2PR2)2). Enthalpies and free energies of associative and dissociative
      pathways.
AB  - (PCP)Ir(H)2 (PCP = eta3-1,3-C6H3(CH2PR2)2) complexes are highly effective
      catalysts for the dehydrogenation of alkanes; in particular, they are the first
      efficient molecular catalysts for alkane dehydrogenation that do not require a
      sacrificial hydrogen acceptor. Using density functional theory/effective core
      potential methods, we have examined C-H bond cleavage in alkanes and arenes by
      both (PCP)Ir and (PCP)Ir(H)2. C-H addition to the dihydride is accompanied by
      loss of H2; both associative and dissociative pathways for this exchange reaction
      have been examined. The energetic barrier (deltaE(is not equal)) for associative
      displacement of H2 by benzene is much lower than the barrier for a dissociative
      pathway involving initial loss of H2; however, the pathways have very comparable
      free energy barriers (deltaG(is not equal)). Extrapolation to the higher
      temperatures, bulkier phosphine ligands, and the alkane substrates used
      experimentally leads to the conclusion that the pathway for the "acceptorless"
      dehydrogenation of alkanes is dissociative. For hydrocarbon/hydrocarbon
      exchanges, which are required for transfer-dehydrogenation, dissociative pathways
      are calculated to be much more favorable than associative pathways. We emphasize
      that it is the free energy, not just the internal energy or enthalpy, that must
      be considered for elementary steps that show changes in molecularity.

PMID- 11206384
TI  - Nodeless valence (pseudo)spinors.
AB  - Atomic calculations using small-core relativistic effective core potentials
      (RECPs) explicitly treating outer core electrons are used to define two-component
      nodeless valence spinors (NVSs) and nodeless valence pseudospinors (NVPSs).
      Errors attributable to nonlocal electron repulsion interactions that arise from
      large-core RECPs are shown to result from the inherent arbitrariness in the
      choice of match points and number of derivatives that define shape-consistent
      pseudospinors, as well as the positions of radial nodes that reside in the outer
      core regions of atoms. Self-consistent field calculations in omegaomega-coupling
      for InH and InCl using RECPs derived from NVSs and NVPSs are reported. Increased
      bond distances relative to those calculated using very-large-core RECPs for In
      agree with those due to frozen 4d(3/2) and 4d(5/2) spinors and a small-core RECP.
      Results for AmCl+2 also reveal that the shortening in the bond length is
      recovered when the very-large-core RECP is derived using nodeless valence
      (pseudo)spinors.

PMID- 11206385
TI  - Ab initio structure of the active site of phosphotriesterase.
AB  - This research exploits two recent developments to obtain a fundamental
      understanding of the metalloenzyme active site using the bimetallic enzyme
      phosphotriesterase as an example of this class. First is the theoretical
      prediction that the structure and spectroscopy of a native metalloenzyme active
      site is qualitatively determined by the supermolecule complex of the metal(s) and
      the first shell of ligands with proper charge states including waters directly
      bonded to ionic ligands. The second is the development of an effective potential
      for representing the molecular environment interacting with an all-electron
      active site in the quantum Hamiltonian. The GAMESS suite of electronic structure
      codes has implemented this new methodology, effective fragment potentials (EFP),
      to make theoretical calculations on structure, spectroscopy, and reactivity
      tractable for systems involving hundreds of atoms. Since there are transition
      metal cations at the active site of these enzymes, the all-electron part of the
      complex is calculated with relativistic compact effective potentials (CEP) and
      their concomitant basis sets. A realistic representation of the active site with
      its protein environment can be obtained using a combination of the CEP and EFP.
      This presentation will determine the inherent electronic and structural
      characteristics of phosphotriesterase using ab initio quantum mechanical methods.
      A single X-ray structure for the Zn-Zn enzyme is leveraged to obtain the
      structure of the Cd-Cd enzyme and to examine the consequences of protonating the
      active site.

PMID- 11206386
TI  - Solving incomplete inorganic chemical systems through a fuzzy knowledge frame.
AB  - A model for the completion and balancing of inconsistent inorganic reactions is
      presented. A series of fuzzy parameters is proposed. These parameters are
      considered within a knowledge frame representing inorganic reactions via a
      semantic/functional network and, through the calculation of possibility measures,
      allow the completion and solution of such reactions by considering new inorganic
      species to be added to the reaction. Species to be added are formulated on the
      basis of atoms present and/or absent in the reaction, along with valence, system
      features, and a series of flags that determines the cardinality of the possible
      solution set. Incorporation of the proposed model into an inorganic chemistry
      formulation system would contribute to the development of powerful computer
      assisted learning systems, given the extent of information extracted from a
      reaction.

PMID- 11206387
TI  - Relativistic pseudopotentional incorporating core/valence polarization and
      nonlocal effects.
AB  - A relativistic pseudopotentional (RPP) for use in ab initio molecular electronic
      structure calculations is derived in the context of the relativistic effective
      core potential (REP) method of Lee et al. The resulting atom-specific RPP has
      salient features of the REP imbedded within it while retaining the form of a
      functional that is dynamically defined at runtime when used in calculations on
      molecules. The RPP is determined from Dirac-Fock wave functions for the isolated
      atom. Outer core two-electron interactions are incorporated into the RPP by means
      of variable coefficients that are defined in the context of the final molecular
      wave function. This form permits polarization of the outer core shells analogous
      to that occurring in all-electron molecular Hartree-Fock calculations while
      retaining these shells as part of the atomic pseudopotentional. Use of the RPP in
      post-Hartree-Fock molecular calculations permits the incorporation of
      core/valence correlation effects.

PMID- 11206388
TI  - Capsular serogroups of Pasteurella multocida isolated from animals in Zimbabwe.
AB  - Pasteurella multocida is isolated from a variety of disease conditions from
      different animal species in our diagnostic laboratory. In order to determine
      serogroup distribution among the isolates, an indirect haemagglutination test
      using glutaraldehyde-fixed sheep red blood cells was employed. A serological
      examination of 79 isolates revealed that 47/79 were of capsular serogroup A,
      11/79 capsular serogroup D, 4/79 capsular serogroup B and 17/79 were untypable
      strains. None of the isolates belonged to either serogroup E or F. All those from
      cases of classical pasteurellosis could be grouped, but a significantly high
      proportion of those which originated from companion animals were untypable. The
      significance of these results is discussed. This report appears to be the first
      detailed information on the prevalence of various serogroups of P. multocida in
      animals in southern Africa.

PMID- 11206390
TI  - Efficacy of flumethrin 1% pour-on against ticks on cattle under field conditions
      in Ethiopia.
AB  - The efficacy of a flumethrin 1% pour-on (Bayticol, Bayer AH) was evaluated
      against natural infestations of ticks on cattle on a dairy farm in Ethiopia
      during 1997/98. The cattle, (n = 92), which were Friesian/ Zebu crosses, were
      heavily infested with Boophilus decoloratus. Dry cows (n = 8) were randomly
      selected and allocated either into a treatment or a control group. Flumethrin 1 %
      pour-on was applied to the treatment group according to the manufacturer's
      recommendation, i.e. along the dorsal mid-line from the head to the base of the
      tail. Ticks were counted and identified in situ on treated and control animals.
      When the total tick counts of the treated group were similar to those on the
      control, the trial was discontinued. Excellent results were achieved with
      flumethrin against heavy tick infestations. There was a rapid kill after 24 h
      post-treatment, and from day 4 onwards 100% control was achieved and maintained
      for a further 29 days. The results obtained indicate that there was a significant
      difference between the mean tick counts of the control group compared with those
      of the treatment group (P < 0,05). The evidence presented here suggests that the
      flumethrin 1 % pour-on may be applied at 45 day intervals and should provide
      effective protection against the economically important ticks if it is used at
      the recommended dosage rate and applied correctly.

PMID- 11206389
TI  - Studies on the genus Setaria Viborg, 1795 in South Africa. I. Setaria africana
      (Yeh, 1959).
AB  - Setaria africana (Yeh, 1959) is represented by two subspecies, Setaria africana
      africana Troncy, Graber & Thal, 1976 from giant eland (Taurotragus derbianus)
      from the Central African Republic and Cameroon and Setaria africana farchai
      Troncy, Graber & Thal, 1976 from bushbuck (Tragelaphus scriptus), also from the
      Central African Republic. Material collected from nyala (Tragelaphus angasii),
      bushbuck and kudu (Tragelaphus strepsiceros) from several localities in the
      eastern region of South Africa was re-examined. Measurements of adult worms
      confirmed the differences between the two subspecies and scanning electron
      microscopy showed that the deirids of S. africana africana are single whereas
      those of S. africana farchaiare double. Setaria africana farchaiis recorded for
      the first time in South Africa.

PMID- 11206391
TI  - Parasites of domestic and wild animals in South Africa. XXXVIII. Ixodid ticks
      collected from 23 wild carnivore species.
AB  - Ixodid ticks were collected from 104 wild carnivores belonging to 23 species in
      various nature reserves and on several farms in all nine provinces of South
      Africa. Seven feral cats in a nature reserve were also examined. Twenty-four tick
      species belonging to seven genera were recovered and identified. Amongst these
      ticks we consider the adults of Haemaphysalis leachi, Haemaphysalis spinulosa,
      Haemaphysalis zumpti, Ixodes rubicundus, Rhipicentor nuttalli, Rhipicephalus
      simus and Rhipicephalus turanicus to be true parasites of wild carnivores.
      Although numerous adult Rhipicephalus appendiculatus and Rhipicephalus
      zambeziensis were collected from some lions these were either sick or old
      animals. The immature stages of seven species regularly utilized wild carnivores
      as hosts on an opportunistic basis.

PMID- 11206392
TI  - Application of ultrasonography in prevalence studies of hydatid cysts in goats in
      north-western Turkana, Kenya and Toposaland, southern Sudan.
AB  - A study was done to determine the prevalence of hydatid cysts in goats using
      ultrasonography. A total of 1,390 goats were examined, 43,6 % (606/1,390) of them
      from north-western Turkana, Kenya, and 56,4% (784/1,390) from Toposaland,
      southern Sudan. Hydatid cysts were visualized in 1,82 % (11/ 606) of the goats
      from north-western Turkana and 4,34% (34/784) of those from Toposaland. Unlike
      abattoir surveys, the prevalence data obtained in this study were unbiased
      because entire flocks were examined. The lower prevalence rate of the disease in
      goats from Turkana was attributed to the hydatid disease control programme in
      that area, which is absent in Toposaland.

PMID- 11206393
TI  - Fertility in rats immunized with steroid-free bovine follicular fluid.
AB  - Inhibin is a gonadal hormone that inhibits the release of follicle stimulating
      hormone (FSH) from the anterior pituitary gland. The objective of this study was
      to determine whether active immunization of male and female rats against inhibin
      rich, steroid-free bovine follicular fluid would increase inhibin antibody titre,
      onset of female puberty, pregnancy rate, litter size, testis weights,
      testosterone concentration and serum FSH. Immunization of rats with steroid free
      bovine follicular fluid stimulated production of anti-inhibin antibodies that
      immunoneutralized endogenous inhibins and increased levels of circulating FSH in
      immunized males. Inhibin immunoneutralization resulted in early vaginal opening
      in immunized females compared with controls and pregnancy rates were increased
      when immunized female rats were mated with immunized males. However, serum
      testosterone, testis weights and potential litter size remained unchanged. We
      conclude that methods to immunoneutralize inhibin may have merit as therapeutic
      procedures to enhance reproductive performance in domestic animals.

PMID- 11206394
TI  - Parameters for the determination and evaluation of heat stress in dairy cattle in
      South Africa.
AB  - Not all parameters are trustworthy and practical to use as parameters to
      determine heat stress in dairy cattle. The temperature-humidity index (THI) is
      still the best, simplest and most practical index (parameter) for measurement of
      environmental warmth which cause heat stress in dairy cattle. It is practical,
      easy to determine and relatively trustworthy to use body temperature and
      respiratory rate as parameters to determine heat stress in dairy cattle. These
      physiological parameters must always be used together with THI values to
      determine and evaluate heat stress in dairy cattle. For practical purposes,
      plasma cortisol concentration and milk composition cannot be used as parameters
      to determine heat stress in dairy cattle although good indications of acute or
      chronic heat stress can be obtained. Vanillic acid is a break-down product of
      adrenalin found in milk, but before its concentration in milk can be used as an
      indicator/parameter of heat stress in dairy cows, more about the pharmacodynamics
      of adrenaline in the milk has to be known. Selection and breeding of dairy cows
      on the basis of their adaptibility to heat stress using the most practical heat
      stress parameters will ensure that their offspring will have superior performance
      in the prevailing environmental conditions.

PMID- 11206395
TI  - In vitro erythrophagocytosis by cultured macrophages stimulated with extraneous
      substances and those isolated from the blood, spleen and bone marrow of Boran and
      N'Dama cattle infected with Trypanosoma congolense and Trypanosoma vivax.
AB  - A standard radioactive chromium (51Cr) release assay was used to assess the in
      vitro phagocytosis and lysis of bovine erythrocytes by cultured splenic, bone
      marrow and peripheral blood monocyte-derived (PBM) macrophages isolated from
      healthy and Trypanosoma congolense and T. vivax-infected cattle of the Boran and
      N'Dama breeds. Recombinant cytokines (rHuTNF-alpha and rBolFN-gamma) and non-acid
      dialysed peripheral blood mononuclear cell (PBMNC) culture supernatants
      stimulated these PBM for enhanced activities. The stimulants caused increases in
      the rate of erythrocyte phagocytosis and lysis by cultured PBM in a concentration
      dependent manner. But very high stimulant concentrations caused deceased in vitro
      erythrophagocytosis. However, bacterial lipopolysaccharide (LPS) and acid
      dialysed PBMNC culture supernatants did not cause any increase in cultured PBM
      erythrophagocytosis. In vitro erythrocyte phagocytosis and lysis by splenic, bone
      marrow and peripheral blood monocyte (PBM)-derived macrophages of Boran breed of
      cattle infected with Trypanosoma congolense increased from 14 days post-infection
      (DPI) onwards and thereafter maintained at various levels above pre-infection.
      Cultured splenic macrophages showed the greatest erythrocyte destruction
      capability while PBM-derived macrophages was the least. The rates of in vitro
      erythrocyte phagocytosis and lysis were higher with the cultured PBM of the Boran
      than those of the N'Dama cattle during T. congolense infection. The rate of in
      vitro erythrocyte destruction was however, similar in both groups of cattle
      during T. vivax infection. These results correlated positively with the dynamics
      and degree of anaemia developed by these groups of animals during both T.
      congolense and T. vivax infections. Cattle infected with T. congolense and T.
      vivax developed varying degrees of normocytic normochromic anaemia during
      infection. Boran cattle developed a more severe anaemia, and had to be treated
      with diminazine aceturate, than N'Dama cattle during T. congolense infection.
      Both breeds of cattle developed a milder but similar degree of anaemia during T.
      vivax infection. None of the animals were treated. The results of this study
      indicated a role of in vivo macrophage stimulatory factors, notably cytokines
      such as TNF-alpha and IFN-gamma in host's serum, as well as parasite antigens,
      which may act singly or in concert, in the process of enhanced erythrocyte
      destruction, hence anaemia by the mononuclear phagocytic system (MPS) during
      bovine trypanosomosis.

PMID- 11206396
TI  - Differential expression of surface membrane antigens on bovine monocytes
      activated with recombinant cytokines and during Trypanosoma congolense infection.
AB  - The expression of surface membrane antigens on peripheral blood monocytes (PBM)
      of cattle of the Boran and N'Dama breeds activated with recombinant cytokines
      (TNF-alpha and IFN-gamma) and during experimental infection with Trypanosoma
      congolense was investigated using monoclonal antibodies (MoAbs) and fluorescein
      activated cell sorter (FACS). The surface antigens investigated were C3bi
      receptor, major histocompartibility (MHC) II complex (Ia antigen) and two
      monocyte/macrophage (Mphi) differentiation antigens. The study revealed that both
      cytokines caused the enhancement of the expression of all the PBM surface
      antigens studied. rBolFN-gammaat low concentrations was more efficient in causing
      the activation of PBM. While the PBM of Boran cattle were more significantly
      activated to express the C3bi receptor vis-a-vis the Ia antigen than N'Dama
      cattle, the reverse was the case with the PBM of N'Dama cattle which expressed
      more Ia antigens than Boran PBM. Similar results were observed during T.
      congolense infection in the two breeds of cattle. The significantly higher
      expression of C3bi receptor and correspondingly lower Ia antigen expression by
      the PBM of Boran cattle, both during trypanosomosis and in vitro may be
      responsible for the higher rate of erythrocyte phagocytosis, hence the
      development of more severe anaemia by Boran cattle during trypanosomosis than
      N'Dama. In addition, the expression of significantly higher numbers of Ia antigen
      by N'Dama Mphi, hence are more able to process, present and initiate better
      trypanosome antigen-specific immune response than Boran cattle during infection.
      These two attributes are known genetic characteristics of trypanotolerance in
      cattle.

PMID- 11206397
TI  - Bacterial colonization and endotoxin activity during experimental acute fowl
      typhoid in chickens.
AB  - Bacterial colonization and endotoxin production were investigated before and
      after experimental Salmonella gallinarum infection in 8-week-old female broiler
      chickens. These parameters were assayed by means of colony forming units test
      (CFU) and the Limulus Amebocyte Lysate test (LAL), respectively. Birds were
      infected per os with 1,5 x 10(9) CFU/ml of wild strain of S. gallinarum isolated
      from a dead hen. Approximately 1,5 x 10(2); 1,3 x 10(2) and 1,2 x 10(2) CFU of S.
      gallinarum were recorded from 1 g of liver, 1 g of spleen and 1 ml of blood from
      the chickens on day 1 post infection. By day 4 corresponding data were 3,7 x
      10(4); 4,8 x 10(3) and 1,1 x 10(3) respectively and on day 7 10(5) CFU were
      present in all three specimen types. The liver and spleen of dead birds were
      contaminated with more than 10(7) CFU per g. The endotoxin from S. gallinarum was
      found to have an activity of 1,5; 12,0 and 15,0 endotoxin units (EU)/ml on day 1,
      4 and 7 after infection, respectively. No endotoxin activity was established in
      the blood of the control group (before infection) by the LAL test. This is the
      first time the connection between the amount of live S. gallinarum in the blood,
      liver and the circulating level of endotoxin in the blood during the infectious
      stage of experimental acute fowl typhoid, has been demonstrated.

PMID- 11206398
TI  - Pasteurella gallinarum: Zimbabwean experience of a versatile pathogen.
AB  - Pasteurella gallinarum-related outbreaks in chickens and African guinea fowls are
      described. Four outbreaks were recorded in chickens and one in guinea fowls.
      Periorbital swelling and keratoconjunctivitis were the consistently present
      clinical signs in all the diseased birds. In several, swollen hocks and wattles
      were also discerened. Birds which succumbed to the infection showed petechiation
      in the internal organs and evidence of airsacculitis. Pasteurella gallinarum was
      isolated from the lesions and also from conjunctival swabs of the apparently
      healthy in-contact birds. There was no evidence of concurrent infection with
      Haemophilus, Mycoplasma or Chlamydia. Quinolone therapy when resorted to on one
      of the farms resolved the clinical signs. Phenotypes of 28 isolates were studied.
      The results compared well with the Pasteurella gallinarum isolates reported
      earlier from elsewhere. It was also found that results of xylose fermentation and
      ONPG test appear to be a variable character. There is no earlier report of P.
      gallinarum infection in guinea fowls.

PMID- 11206399
TI  - Finally we have arrived in a new millennium.

PMID- 11206400
TI  - Paraoxonase2 polymorphisms are associated with nephropathy in Type II diabetes.
AB  - AIMS/HYPOTHESIS: Paraoxonase is a member of a multigene family of three genes.
      Paraoxonase2 gene polymorphisms have been associated with coronary heart disease
      in non-diabetic patients and with an increased fasting glycaemia in patients with
      Type II (non-insulin-dependent) diabetes mellitus. We tested the hypothesis of
      whether paraoxonase1 and paraoxonase2 polymorphisms were associated with diabetic
      nephropathy. METHODS: Our case-control study of 299 Swiss patients with Type II
      diabetes included 147 patients with confirmed diabetic nephropathy. RESULTS: In
      univariate analyses the two paraoxonase2 polymorphisms were associated with
      diabetic nephropathy. When subjected to multivariate analyses, both paraoxonase2
      polymorphisms remained statistically associated with diabetic nephropathy
      independent of traditional risk factors (paraoxonase2-148: OR = 2.53, p = 0.003;
      paraoxonase2-311: OR = 2.67, p = 0.002). In addition, BMI interacted with
      paraoxonase2 polymorphisms as a risk factor of nephropathy.
      CONCLUSIONS/INTERPRETATION: The paraoxonase2 gene polymorphisms were
      significantly associated with diabetic nephropathy independent of traditional
      risk factors in Type II diabetic patients. The susceptibility to diabetic
      nephropathy was intensified by the degree of obesity. Pathophysiological pathways
      should be investigated and could be involved in insulin resistance or lipids
      metabolism or both.

PMID- 11206401
TI  - Renoprotective effects of a novel inhibitor of advanced glycation.
AB  - AIMS/HYPOTHESIS: ALT-946, an inhibitor of advanced glycation with a minimal
      inhibitory effect on nitric oxide synthase, was compared with aminoguanidine in
      experimental diabetic nephropathy. METHODS: In vitro and in vivo assays were used
      to assess the ability of ALT-946 to inhibit AGE-protein cross-link formation.
      Diabetic animals were randomly allocated into groups receiving aminoguanidine for
      32 weeks, ALT-946 or vehicle (untreated). As a delayed intervention protocol, an
      additional diabetic group was treated with ALT-946 from week 16 to week 32 of the
      study. Non-diabetic rats were studied concurrently. Systolic blood pressure, body
      weight, plasma glucose, glycated haemoglobin and urinary albumin excretion were
      measured serially. Accumulation of advanced-glycation end products in the kidney
      was assessed by immunohistochemistry. RESULTS: The ALT-946 inhibitor was more
      potent than aminoguanidine in inhibiting AGE-protein cross-linking both in vitro
      and in vivo. Increased albuminuria observed in diabetic rats was attenuated in
      all three treatment groups. We found no difference in body weight, blood pressure
      or glycaemic control with any of the treatments. The untreated diabetic group had
      a twofold increase in glomerular staining for advanced-glycation end products
      compared with the diabetic groups which received treatment.
      CONCLUSION/INTERPRETATION: ALT-946 is a potent inhibitor of advanced renal
      glycation end-product accumulation and reproduces the renoprotective effects of
      aminoguanidine. Therefore, ALT-946 should be considered as a treatment for
      preventing or retarding diabetic nephropathy.

PMID- 11206402
TI  - Genetic and environmental nature of the insulin resistance syndrome in Indo
      Mauritian subjects with premature coronary heart disease: contribution of beta3
      adrenoreceptor gene polymorphism and beta blockers on triglyceride and HDL
      concentrations.
AB  - AIMS/HYPOTHESIS: Insulin resistance syndrome is an important risk factor for
      developing premature coronary heart disease. It is a complex syndrome which could
      arise from the interaction of several genes modulated by environmental factors.
      The Trp64Arg polymorphism in the beta3-adrenoreceptor gene has been found to be
      associated with insulin resistance, obesity or with earlier onset of Type II (non
      insulin-dependent) diabetes mellitus in different populations. We aimed to study
      whether features of the insulin resistance syndrome are associated with this
      polymorphism in Indo-Mauritian patients with premature coronary heart disease.
      METHODS: We carried out a case control study using PCR-RFLP techniques, of
      consecutive Indo-Mauritian patients (n = 338) with premature coronary heart
      disease (onset below age of 60 years) and unrelated control subjects (n = 148) of
      the same ethnicity. RESULTS: In Indo-Mauritian patients with premature coronary
      heart disease who were not treated by beta blockers, triglyceride concentrations
      were lower (median: 1.44 vs 1.93 mmol/l, p < 0.008) and HDL cholesterol
      concentrations higher (mean: 0.98 vs 0.85 mmol/l, p < 0.015) in those carrying
      the wild type of the beta3-adrenoreceptor gene than in those carrying the
      Trp64Arg variant. The latter genotype specific effect on HDL was inverse in
      patients treated with beta blockers. CONCLUSION/INTERPRETATION: The beta3
      adrenoreceptor gene variant seems to modulate the effects of beta blockers on
      triglyceride and HDL cholesterol concentrations in this group of Indo-Mauritian
      population. Dyslipidaemia, a key component of the metabolic syndrome has a
      heterogeneous nature in Indo-Mauritian subjects. This potent risk factor for
      early-onset coronary heart disease is influenced by the interaction between
      genetic and environmental effects.

PMID- 11206403
TI  - Polymorphisms in the neurogenin 3 gene (NEUROG) and their relation to altered
      insulin secretion and diabetes in the Danish Caucasian population.
AB  - AIM/HYPOTHESIS. Neurogenin 3 (NEUROG3) is a member of the subfamily of basic
      helix-loop-helix (bHLH) transcription factors involved in differentiation of the
      endocrine pancreas and therefore a possible candidate gene for maturity-onset
      diabetes of the young (MODY) and Type II (non-insulin-dependent) diabetes
      mellitus. METHODS: Using Polymerase-chain-reaction single-stranded-conformation
      polymorphism, we examined the coding region including the 5'-untranslated and 3'-
      untranslated regions of the NEUROG3 in a group of 133 diabetic patients
      comprising 19 MODY patients, 19 patients with dominant Type I diabetes, and 31
      early-onset and 64 late-onset Type II diabetic patients. RESULTS: We found two
      missense mutations, Glyl67Arg and Serl99Phe, as well as two non-coding variants
      in the 5' UTR, a c --> t nucleotide variant at position -10 upstream of the start
      codon in one MODY patient and a 2 base pair (CA) deletion polymorphism at
      position -44/-45. Allele frequencies measured in 377 diabetic patients and in 217
      glucose-tolerant control subjects were: Gly167Arg, 0.04 (95 % CI: 0.02-0.06) and
      0.04 (0.02-0.06); Ser199Phe, 0.31 (0.26-0.36) and 0.30 (0.24-0.36); -44-45delCA,
      0.33 (0.31-0.35) and 0.35 (0.32-0.38), respectively. Both Ser199Phe and the -44
      45delCA were in linkage disequilibrium (chi2 > 60) but the Ser199Phe and the -44
      45delCA polymorphism were not associated with consistent changes in fasting- or
      glucose-induced insulin secretion in 249 glucose-tolerant offspring (first-degree
      relatives) of Type II diabetic parents or in 217 unrelated middle-aged glucose
      tolerant subjects. CONCLUSION/INTERPRETATION: Genetic variability in NEUROG3 is
      not associated with dominant Type I diabetes, MODY, Type II diabetes or changes
      in insulin secretion in the Danish Caucasians examined subjects.

PMID- 11206404
TI  - Mutations in the hepatocyte nuclear factor-1beta (MODY5) gene are not a major
      factor contributing to end-stage renal disease in Japanese people with diabetes
      mellitus.

PMID- 11206405
TI  - A comparison of the prevalence of islet autoantibodies in children from two
      countries with differing incidence of diabetes.
AB  - AIMS/HYPOTHESIS: To examine the prevalence of sub-: clinical islet autoimmunity
      in children from two countries with a twofold to threefold difference in
      incidence of childhood Type I (insulin-dependent) diabetes mellitus. METHODS:
      Sera were collected from 2,860 English and 3,053 Lithuanian non-diabetic
      schoolchildren according to the same protocol. Occult diabetes was excluded by
      blood glucose measurement. Antibodies to GAD and the protein tyrosine phosphatase
      IA-2 were measured with standardised radiobinding assays in a single laboratory.
      Islet cell antibodies and insulin autoantibodies were additionally measured in
      all samples with GAD and/or IA-2 antibody levels above the 97.5th centile of the
      English schoolchildren. RESULTS: Of Lithuanian schoolchildren 2.7 % had GAD
      antibodies above the 97.5th centile of the English schoolchildren but only 0.2 %
      had antibodies to IA-2 above this threshold (p < 0.001). Islet cell and/ or
      insulin autoantibodies above the 97.5th centile were found in 22 Lithuanian and
      16 English schoolchildren and the overall prevalence of two or more antibodies on
      or above the 97.5th centile was similar [0.7 % (0.5-1.1) vs 0.6 % (0.4-1.0)] in
      the two cohorts. CONCLUSION/INTERPRETATION: The prevalence of multiple antibody
      markers was similar in the cohorts from the two populations, despite the two to
      three-fold difference in incidence of diabetes. The unexpectedly high prevalence
      of subclinical islet autoimmunity suggests that the incidence of diabetes in
      Lithuania is likely to increase in the near future.

PMID- 11206406
TI  - Increasing trend of type I diabetes in children and young adults in the province
      of Turin (Italy). Analysis of age, period and birth cohort effects from 1984 to
      1996.
AB  - AIMS/HYPOTHESIS: This study aimed to determine if the incidence of Type I
      (insulin-dependent) diabetes mellitus increased over time and if the time trend
      is attributable to linear trend, calendar period or birth cohort effects.
      METHODS: This study was based on a cohort of subjects aged 0-29 years from 1984
      to 1996, who resided in the province of Turin, Italy. Poisson regression models
      were used to estimate the effect of sex, age, calendar time and cohorts on
      incidence rates. RESULTS: The mean incidence rate in the age group of 0 to 29
      years was 7.78 of 100,000 person-years (95% confidence interval: 7.26-8.32), with
      a lower risk in women than in men [rate ratio (RR): 0.76 (0.67-0.88)]. We found a
      trend of incidence increasing over time (annual increase of risk 2.25 % a year,
      95 % CI 0.44-4.10). In Poisson regression analysis we found that the best model
      was the one with sex, age and a linear term attributable to either calendar
      period or cohort effects. The linear term corresponds to a RR of 1.12 (1.02
      1.22,p = 0.015) for each 5-year age span. CONCLUSION/INTERPRETATION: We found
      that the time trend in this Mediterranean area was similar in magnitude to that
      reported in northern European countries. The increase was linear in pattern, each
      birth cohort and each calendar period showing a higher risk than the preceeding
      one with some evidence of two steep increases in the incidence of Type I diabetes
      centered on the years 1964 and 1984. We found that the incidence of diabetes
      increased in the 0 to 14 age group and also in the older age group of 15 to 29
      years and that the age-period models were not statistically significantly better
      than the age-cohort models.

PMID- 11206407
TI  - Diabetic groups as defined by ADA and NDDG criteria have a similar aerobic
      capacity, blood pressure and body composition. American Diabetes Association and
      National Diabetes Data Group.
AB  - AIMS/HYPOTHESIS: In 1997 the American Diabetes Association (ADA) published new
      categories for diabetes based on fasting plasma glucose that classified diabetes
      as a plasma glucose of 7.0 mmol/l, or more, rather than one of 7.8 mmol/l or
      more, as published previously by the National Diabetes Data Group (NDDG) in 1979.
      We compared the cardiovascular disease risk factors of subjects classified as
      having Type II (non-insulin-dependent) diabetes mellitus under the NDDG and ADA
      criteria. METHODS: We examined a database of approximately 3,700 men (40.4 +/-
      11.5 years old) and distributed them into four categories: normal fasting plasma
      glucose (NFG) of less than 6.1 mmol/l, impaired (IFG) 6.1 to 7.0 mmol/l, ADA
      diabetic 7.0 to 7.8 mmol/l and NDDG diabetic of 7.8 mmol/l or more. RESULTS:
      Fasting glucose was 5.2 +/- 0.5, 6.4 +/- 0.2, 7.3 +/- 0.2 and 11.2 +/- 2.9 mmol/l
      for the subjects of the NFG, IFG, ADA and NDDG groups, respectively. Estimated
      treadmill VO2max was 41.4 +/- 8.0, 36.0 +/- 7.8, 32.2 +/- 7.6, 30.6 +/- 7.0 ml x
      kg(-1) x min(-1) in the NFG, IFG, ADA, and NDDG groups, respectively (NFG and IFG
      > ADA and NDDG: p < 0.05). The ADA and NDDG groups were also similar for resting
      and exercise blood pressure and body composition. Triglycerides and total: HDL
      cholesterol ratios were higher and LDL cholesterol concentration was lower, in
      the NDDG group than in all other groups (p < 0.05). Total and LDL cholesterol in
      the ADA and NDDG groups were similar. CONCLUSION/INTERPRETATION: The similarities
      in the aerobic capacities, blood pressure and body composition of the ADA and
      NDDG groups indicate that the decision to lower the cut-off from 7.8 mmol/l to
      7.0 mmol/l blood glucose for the clinical classification of diabetes was
      appropriate. The ADA and NDDG groups, however, might not have identical risks for
      cardiovascular disease because of differences between total:HDL cholesterol
      ratios, circulating HDL cholesterol and triglyceride concentrations.

PMID- 11206408
TI  - Diabetes and gender.
AB  - It is often assumed that there is little or no sex bias within either Type I
      (insulin-dependent) or Type II (non-insulin-dependent) diabetes mellitus. This
      review considers evidence that sex effects of interest and importance are present
      in both forms of the disease. Type I diabetes is the only major organ-specific
      autoimmune disorder not to show a strong female bias. The overall sex ratio is
      roughly equal in children diagnosed under the age of 15 but while populations
      with the highest incidence all show male excess, the lowest risk populations
      studied, mostly of non-European origin, characteristically show a female bias. In
      contrast, male excess is a consistent finding in populations of European origin
      aged 15-40 years, with an approximate 3:2 male:female ratio. This ratio has
      remained constant in young adults over two or three generations in some
      populations. Further, fathers with Type I diabetes are more likely than affected
      mothers to transmit the condition to their offspring. Women of childbearing age
      are therefore less likely to develop Type I diabetes, and--should this occur--are
      less likely to transmit it to their offspring. Type II diabetes showed a
      pronounced female excess in the first half of the last century but is now equally
      prevalent among men and women in most populations, with some evidence of male
      preponderance in early middle age. Men seem more susceptible than women to the
      consequences of indolence and obesity, possibly due to differences in insulin
      sensitivity and regional fat deposition. Women are, however, more likely to
      transmit Type II diabetes to their offspring. Understanding these experiments of
      nature might suggest ways of influencing the early course of both forms of the
      disease.

PMID- 11206409
TI  - Testing the fetal origins hypothesis in twins: the Birmingham twin study.
AB  - AIMS/HYPOTHESIS: To test whether the link between birthsize and raised blood
      pressure or glucose tolerance is due to genetic or intrauterine factors, we
      studied whether differences in birthweight between pairs of monozygous and
      dizygous twins are associated with adult differences in blood pressure and
      glucose tolerance. METHODS: A sample of 58 monozygous and 140 dizygous twins were
      identified from a register of births in Birmingham, United Kingdom, between 1950
      and 1954. The twins had their blood pressure measured and underwent an oral
      glucose tolerance test. RESULTS: There were no statistically significant
      associations between birthweight, length or ponderal index, and either blood
      pressure or glucose tolerance in the twins. Although there were substantial
      within-pair differences in birthweight between monozygous and dizygous twin
      pairs, these differences did not correlate with the adult outcomes. Monozygous
      correlations, however, for both blood pressure and glucose tolerance were
      statistically significantly higher than dizygous correlations and a quantitative
      genetic model suggested statistically significant heritability for these traits.
      In contrast correlations of birthsize were similar in monozygous and dizygous
      pairs suggesting only a small genetic component in determining fetal size.
      CONCLUSION/INTERPRETATION: Our results show that birthsize in twins does not
      predict adult blood pressure or glucose tolerance. We also suggest that shared
      genetic determinants for fetal growth and adult outcomes are not likely to be
      prevalent or powerful.

PMID- 11206410
TI  - Male-to-female excess in diabetes diagnosed in early adulthood is not specific
      for the immune-mediated form nor is it HLA-DQ restricted: possible relation to
      increased body mass index.
AB  - AIMS/HYPOTHESIS. We investigated whether the reported HLA-DQ/DR restricted male
      to-female (M:F) excess in Type I (insulin-dependent) diabetes mellitus also
      exists in Belgian patients, is specific for immune-mediated diabetes, remains
      genotype-restricted after adjustment for age at diagnosis, and is associated with
      sex-dependent environmental factors. METHODS: Autoantibodies, HLA-DQ and 5'INS
      (5'insulin gene) polymorphisms were assessed in 2,532 diabetic patients (all
      phenotypes) diagnosed under 40 years of age. Autoantibodies and body mass index
      (expressed as a standard deviation score by comparison to age-matched and sex
      matched control subjects; SDS-BMI) were measured in 1986 siblings or offspring of
      Type I diabetes patients (0-39 years). RESULTS: In patients aged 15-39 years at
      diagnosis, the male-to-female ratio was 1.5 or more regardless of their antibody
      status and significantly higher (p < 0.001) than that in the age-matched Belgian
      general population. There was no sex bias in patients under 15 years of age.
      Overall, the male-to-female ratio was significantly higher in patients without
      HLADQA1*0301-DQB1*0302 (p < or = 0.003) but stratification in age groups and
      multivariate analysis identified age as the major determinant of male-to-female
      ratio. The SDS-BMI increased (p < 0.01) in male antibodypositive relatives (n =
      103) but not in female antibody-positive (n = 92) or in antibody-negative
      relatives (n = 1,791). This phenomenon tended to be restricted to male relatives
      who were positive only for glutamate decarboxylase antibodies (n = 44).
      CONCLUSIONS/INTERPRETATION: The male-to-female excess in Belgian diabetic
      patients diagnosed in early adulthood is not specific for immune-mediated Type I
      diabetes and not HLA-DQ or 5'INS restricted. Our data suggest that, similar to
      Type II (non-insulin-dependent) diabetes mellitus, the metabolic burden of
      obesity and insulin resistance could preferentially precipitate postpubertal
      clinical onset in male subjects with slowly progressive subclinical (immune
      mediated) diabetes.

PMID- 11206411
TI  - Lipid-dependent control of hepatic glycogen stores in healthy humans.
AB  - AIMS/HYPOTHESIS: Non-esterified fatty acids and glycerol could stimulate
      gluconeogenesis and also contribute to regulating hepatic glycogen stores. We
      examined their effect on liver glycogen breakdown in humans. METHODS: After an
      overnight fast healthy subjects participated in three protocols with
      lipid/heparin (plasma non-esterified fatty acids: 2.2 +/- 0.1 mol/l; plasma
      glycerol: 0.5 +/- 0.03 mol/l; n = 7), glycerol (0.4 +/- 0.1 mol/l; 1.5 +/- 0.2
      mol/l; n = 5) and saline infusion (control; 0.5 +/- 0.1 mol/l; 0.2 +/- 0.02
      mol/l; n = 7). Net rates of glycogen breakdown were calculated from the decrease
      of liver glycogen within 9 h using 13C nuclear magnetic resonance spectroscopy.
      Endogenous glucose production was measured with infusion of D-[6,6-2H2]glucose.
      RESULTS: Endogenous glucose production decreased by about 25 % during lipid and
      saline infusion (p < 0.005) but not during glycerol infusion (p < 0.001 vs lipid,
      saline). An increase of plasma non-esterified fatty acids or glycerol reduced the
      net glycogen breakdown by about 84 % to 0.6 +/- 0.3 micromol x kg(-1) x min(-1)
      (p < 0.001 vs saline: 3.7 +/- 0.5 micromol x kg(-1) x min(-1)) and by about 46 %
      to 2.0 +/- 0.4 micromol x kg(-1) x min(-1) (p < 0.01 vs saline and lipid),
      respectively. Rates of gluconeogenesis increased to 11.5 +/- 0.8 micromol x kg(
      1) x min(-1) (p < 0.01) and 12.8 +/- 1.0 micromol x kg(-1) min(-1) (p < 0.01 vs
      saline: 8.2 +/- 0.7 micromol x l(-1) x min(-1)), respectively.
      CONCLUSION/INTERPRETATION: An increase of non-esterifled fatty acid leads to a
      pronounced inhibition of net hepatic glycogen breakdown and increases
      gluconeogenesis whereas glucose production does not differ from the control
      condition. We suggest that this effect is not due to increased availability of
      glycerol alone but rather to lipid-dependent control of hepatic glycogen stores.

PMID- 11206412
TI  - Distinct long-term regulation of glycerol and non-esterified fatty acid release
      by insulin and TNF-alpha in 3T3-L1 adipocytes.
AB  - AIMS/HYPOTHESIS: Adipose tissue lipolysis plays a central part in total body fuel
      metabolism. Our study was to assess the long-term regulation of glycerol and non
      esterified fatty acid (NEFA) release by insulin or TNF-alpha. METHODS: Fully
      differentiated 3T3-L1 adipocytes were exposed for up to 22 h to insulin or TNF
      alpha. RESULTS: Long-term insulin treatment resulted in increased basal glycerol
      release, reaching sixfold at 22 h with 1 nmol/l insulin. Partial inhibition was
      observed by pharmacologically inhibiting phosphatidylinositol 3-kinase or the
      mitogen-activated kinase kinase--extracellular signal-regulated kinase cascades.
      This represented 50-60% of the response induced by 1 nmol/l TNF-alpha and
      approximately 40 % of the glycerol release maximally stimulated by isoproterenol
      (1 micromol/l, 30 min). The cellular mechanism seemed to be distinct from that of
      TNF-alpha: First, glycerol release in response to long-term insulin was
      progressive with time and did not display a lag-time characteristic of the effect
      of TNF-alpha. Second, pretreatment and co-treatment of the cells with
      troglitazone greatly inhibited TNF-alpha-induced glycerol release (128.5 +/- 10.2
      to 35.4 +/- 2.1 nmol/mg protein per h) but not the effect of insulin, which was
      exaggerated. Third, hormone-sensitive lipase protein content was decreased (45 %)
      by TNF-alpha but not following long-term insulin. Finally, TNF-alpha was
      associated with NEFA release to the medium, whereas long-term insulin treatment
      was not. Moreover, glycerol release during isoproterenol-stimulated lipolysis was
      additive to the effect of long-term insulin, whereas NEFA release was inhibited
      by nearly 90 %. CONCLUSIONS INTERPRETATION: Contradictory to its short-term
      inhibitory effect, long-term insulin stimulates glycerol release with concomitant
      stimulation of NEFA re-esterification.

PMID- 11206413
TI  - Short-term exclusive breastfeeding predisposes young children with increased
      genetic risk of Type I diabetes to progressive beta-cell autoimmunity.
AB  - AIMS/HYPOTHESIS: This study aimed to establish the relation between early infant
      nutrition and signs of beta-cell autoimmunity in young children. METHODS: We
      identified and observed from birth 2949 infants with increased genetic risk of
      Type I (insulin-dependent) diabetes mellitus (HLA DQB1*02/ *0302 or DQB1*0302/x,
      x = other than *02, *0301 or *0602) and monitored them for islet cell antibodies
      at 3 to 6 month intervals. If an infant seroconverted to islet cell antibody
      positivity, all of his or her samples were also analysed for autoantibodies to
      insulin, GAD65 (GADA) and to the protein tyrosine phosphatase related IA-2
      molecule (IA-2A). Our case-control study comprises the first 65 children who
      seroconverted to islet cell antibody positivity before the age of 4 years and 390
      control children who were islet cell antibody-negative (six control children/
      case). We monitored the duration of exclusive and total breastfeeding and the age
      at which cows' milk was introduced. RESULTS: Infants who had been breastfed
      exclusively for at least 4 months had lower risk of seroconversion to positivity
      for IA-2A or all four autoantibodies [odds ratio (OR) 0.24; 95 % CI 0.06-0.94 and
      OR 0.17; 95 % CI 0.03-0.86, respectively] than those infants who had been
      breastfed exclusively for less than 2 months. The risk of seroconversion to
      positivity for IA-2A or all four autoantibodies was higher in those younger than
      2 months (OR 4.37; 95 % CI 1.33-14.42 and OR 5.02; 95 % CI 1.27-19.89) or aged 2
      to 3.9 months (OR 5.50; 95 % CI 1.21-25.04 and 6.19; 95% CI 1.10-34.84) when they
      first received cows' milk than in those aged 4 months or older.
      CONCLUSIONS/INTERPRETATION: These observations suggest that short-term
      breastfeeding and the early introduction of cows' milk-based infant formula
      predispose young children who are genetically susceptible to Type I diabetes to
      progressive signs of beta-cell autoimmunity.

PMID- 11206414
TI  - HLA-DR53 molecules restrict glutamic acid decarboxylase peptide presentation to T
      cells of a Type I diabetes patient: specification of the trimolecular HLA
      peptide/T-cell receptor complex.
AB  - AIMS/HYPOTHESIS: Our aim was to define the molecular specificity of glutamic acid
      decarboxylase-specific T-cells isolated from a patient (patient 40) with recent
      onset Type I (insulin-depent) diabetes mellitus. METHODS: The peptide epitope was
      defined using synthetic peptides to identify the minimal sequence required for T
      cell activation and to determine the amino acids that contribute either to MHC
      binding or T-cell receptor signaling. The MHC class II-restricted peptide
      presentation was determined using a panel of allogeneic antigen-presenting cells
      and murine fibroblast-cell lines transfected to express individual human class II
      alleles and by blocking studies with monoclonal antibodies. The T-cell receptor
      was also molecularly characterized. RESULTS: Despite that patient 40 carries high
      risk alleles of the DRB1 and DQB1 loci, his T-cells recognize a glutamic acid
      decarboxylase-derived peptide in association with class II, DR53, molecules.
      Although anchor residues for DR53 molecules have not yet been determined, it was
      possible to model epitope binding based on sequence comparisons with other class
      II molecules associated with susceptibility or protection for Type I diabetes.
      CONCLUSION/INTERPRETATION: The complete molecular specification of the MHC
      peptide ligand and the T-cell receptor complex of glutamic acid decarboxylase
      specific T-cells will enable analysis of strategies designed to alter T-cell
      function. For example, the role of altered peptide ligands or T-cell receptor
      specific peptides can be studied using a model whose components reflect the
      natural affinities of MHC-peptide and T-cell receptor-ligand interactions
      selected in response to this important autoantigen.

PMID- 11206415
TI  - The IA-2 gene family: homologs in Caenorhabditis elegans, Drosophila and
      zebrafish.
AB  - AIMS/HYPOTHESIS: IA-2 and IA-2beta are major autoantigens in Type I (insulin
      dependent) diabetes mellitus and are expressed in neuroendocrine tissues
      including the brain and pancreatic islets of Langerhans. Based on sequence
      analysis, IA-2 and IA-2beta are transmembrane protein tyrosine phosphatases but
      lack phosphatase activity because of critical amino acid substitutions in the
      catalytic domain. We studied the evolutionary conservation of IA-2 and IA-2beta
      genes and searched for homologs in non-mammalian vertebrates and invertebrates.
      METHODS: IA-2 from various species was identified from EST sequences or cloned
      from cDNA libraries or both. Expression in tissues was determined by transfection
      and in situ hybridization. RESULTS: We identified homologs of IA-2 in C. elegans,
      Drosophila, and zebrafish which showed 46, 58 and 82 % identity and 60, 65 and 87
      % similarity, respectively, to the amino acids of the intracellular domain of
      human IA-2. Further studies showed that IA-2 was expressed in the neural tissues
      of the three species. Comparison of the genomic structure of the intracellular
      domain of human IA-2 with that of human IA-2beta showed that they were nearly
      identical and comparison of the intron-exon boundaries of Drosophila IA-2 with
      human IA-2 and IA-2beta showed a high degree of relatedness.
      CONCLUSION/INTERPRETATION: Based on these findings and sequence analysis of IA-2
      homologs in mammals, we conclude that there is an IA-2 gene family which is a
      part of the larger protein tyrosine phosphatase superfamily. The IA-2 and IA
      2beta genes represent two distinct subgroups within the IA-2 family which
      originated over 500 million years ago, long before the development of the
      pancreatic islets of Langerhans.

PMID- 11206416
TI  - Adenine and guanine nucleotide-specific succinyl-CoA synthetases in the clonal
      beta-cell mitochondria: implications in the beta-cell high-energy phosphate
      metabolism in relation to physiological insulin secretion.
AB  - AIMS/HYPOTHESIS: Succinyl-CoA synthetase catalyses the substrate level
      phosphorylation of ADP or GDP. It also supplies succinyl-CoA for heme synthesis.
      Recently, two distinct mitochondrial succinyl-CoA synthetase activities, one
      specific for ATP and the other for GTP, have been characterized in various
      tissues of pigeon. Because of the relative importance of mitochondrial high
      energy phosphate metabolism in physiological insulin secretion and the few data
      available on mitochondrial succinyl-CoA synthetase in the beta cell, this study
      examined whether ATP-specific and GTP-specific succinyl-CoA synthetase activities
      are localized in the clonal beta-cell mitochondria. METHODS: Using the
      mitochondrial extracts from clonal beta [INS-1 and HIT-T15] cells, we measured
      the formation of succinyl-CoA from succinate, CoA and ATP or GTP. To confirm the
      identity of these two enzymes, individual subunits of ATP-specific and GTP
      specific to succinyl-CoA synthetase were identified by Western blot analysis.
      RESULTS: Both ATP-and GTP activities of succinylCoA synthetase were observed in
      the mitochondrial fractions from these cells. The ratios of GTP to ATP activities
      of succinyl-CoA synthetase were near unity in both of the cell types studied.
      Using affinity-purified antisera directed specifically against individual (alpha
      and beta) subunits of succinyl-CoA synthetase, we also identified both ATP
      specific and GTP-specific forms of succinyl-CoA synthetase in HIT and INS cell
      mitochondria. Furthermore, using [gamma-32P]ATP as a phosphoryl donor, we
      observed that the alpha subunit of succinyl-CoA synthetase undergoes
      autophosphorylation at a histidine residue; co-provision of exogenous succinate
      and CoA resulted in pronounced dephosphorylation of the phosphorylated alpha
      subunit of succinyl-CoA synthetase. CONCLUSION/INTERPRETATION: We provide
      evidence for the localization of two distinct activities of succinyl-CoA
      synthetase in the beta cell mitochondria. Whereas it is well established that ATP
      is critical for the beta cell mitochondrial metabolism, we propose that GTP
      generated by the activation of succinylCoA synthetase could promote key
      functional roles in the mitochondrial metabolism leading to insulin secretion.

PMID- 11206417
TI  - Glucose and insulin exert additive ocular and renal vasodilator effects on
      healthy humans.
AB  - AIMS/HYPOTHESIS: There is evidence that insulin and glucose cause renal and
      ocular vasodilation. There is, however, currently no data on the effect of
      combined hyperglycaemia and hyperinsulinaemia on the renal and ocular blood flow
      seen in diabetic patients on insulin therapy. METHODS: We carried out two
      different 3-way crossover studies in healthy subjects (each, n = 9). In study
      one, hyperglycaemic clamps (5.6 mmol/l, 11.1 mmol/ 1, 16.7 mmol/l) were carried
      out during placebo or insulin (dose 1: 1 mU/kg/min; dose 2: 2 mU/kg/min)
      infusion. The second study was identical but endogenous insulin secretion was
      blocked with somatostatin. The renal plasma flow, glomerular filtration rate and
      pulsatile choroidal blood flow were measured using the paraaminohippurate method,
      the inulin method and a laser interferometric measurement of fundus pulsation
      amplitude, respectively. RESULTS: Insulin increased renal plasma flow and fundus
      pulsation amplitude but not the glomerular filtration rate. Hyperglycaemia
      increased all the renal and ocular parameters studied. Haemodynamic effects of
      glucose and insulin were additive when somatostatin was co-administered but not
      under basal conditions. CONCLUSIONS/INTERPRETATION: Glucose and insulin can exert
      additive vasodilator properties on renal and ocular circulation. To find out
      whether this observation is related to the increased regional perfusion in
      diabetes longitudinal studies on patients with Type I (insulin-dependent)
      diabetes mellitus are needed.

PMID- 11206418
TI  - Heterosexuals' use of "fag" and "queer" to deride one another: a contributor to
      heterosexism and stigma.
AB  - This paper is on heterosexuals' use of words such as "fag" and "queer" to refer
      to one another in an insulting manner. This behavior perpetuates heterosexism and
      the stigmatization of gays. Two hundred and fifty-seven university students (73%
      Euro-American) served as participants. Males exhibited more anti-gay prejudice
      and anti-gay behavior than females. Heterosexual males frequently used words such
      as "fag" and "queer" to put one another down. Anti-homosexual prejudice was
      predictive of anti-gay behavior. However, approximately half of those who engaged
      in the behavior were not strongly anti-homosexual. For these individuals, the
      behavior may win approval from their social group. Awareness campaigns and peer
      reminders that the derisive use of "fag" and "queer" harms homosexuals may be
      effective in changing this group. It is more difficult to reduce this behavior in
      individuals with strong anti-homosexual attitudes. The role of individuals and
      educational and work organizations in bringing about change is discussed.

PMID- 11206419
TI  - Gay male adult development: some stage issues of an older cohort.
AB  - This paper is a qualitative investigation into developmental stage issues, using
      a sample of older gay males. Twenty Ohio informants were obtained through
      convenience sampling for unstructured oral interviews. Erik Erikson's
      developmental stage model serves as representing traditional stage theory. The
      traditional view portrays life course in heterosexual terms. While the
      developmental issues addressed across the life course are likely the same or
      similar, the traditional schedules of these issues are not apt for gays. Gay life
      paths start at different ages, based on when identity-acceptance begins. Only
      then can a gay person undertake successful adult development. Findings indicate
      that as closeted homosexuals, gay men may experience a false development,
      resulting from living a double-life. With the acceptance of one's homosexuality,
      developmental regression occurs in an effort to address gay identity issues
      previously denied or ignored. Many of the developmental issues arise not from
      being gay, per se, but from discovering how to assimilate being gay into one's
      life pattern. This paper thus shows an imperfection in traditional stage models.

PMID- 11206420
TI  - Heterosexual masculinity and homophobia: a reaction to the self?
AB  - Heterosexual masculinity is the cultural pressure exerted on males to be
      masculine in traits and heterosexual in orientation or else be viewed as feminine
      and socially unacceptable. The current study investigated the link between
      heterosexual masculinity and homophobia in 74 college males. Specifically, gender
      self-discrepancy (how well males think they fit cultural expectations of how they
      should act as a man), attribute importance (perceived importance of possessing
      masculine attributes), and self-esteem were examined as predictors of homophobia.
      Attribute importance, self-discrepancy along masculine traits, and their
      interaction significantly predicted degree of homophobia in this sample.

PMID- 11206421
TI  - The influence of race, ethnicity, class, and sexual politics on lesbians' body
      image.
AB  - Based on interviews conducted with eight lesbians, this paper explores how the
      intersection of gender, sexual identity, race, ethnicity, and class affect
      lesbians' feelings about their bodies. Their responses suggest that, while being
      female has a strong effect on lesbians' feelings about their bodies, issues of
      race, acculturation, and class also affect body image. Lesbian feminism and S/M
      politics also appear to play a significant role in lesbians' body image. These
      findings highlight the limitations of existing theories about body image and call
      for a more complex theory incorporating a more diverse range of experiences.

PMID- 11206422
TI  - The Toronto Lesbian Family Study.
AB  - Twenty-seven lesbian mothers completed standardized tools chosen to assess
      current functioning, followed by a video-taped interview. Verbal children were
      also interviewed. Questions involved perceptions of the mothers' and children's
      experiences of being homosexual or being raised by homosexual parents, knowledge
      and fantasies about the donor/father, feelings regarding the role of fathers,
      parents' experiences of being fathered, legal issues, and development. All
      mothers were strongly lesbian identified and most were completely "out." All but
      one mother planned to or had told their children. All mothers planned to reveal
      donor information at an appropriate age. Many, especially parents of boys, had
      concerns about lack of a male role model, but none felt this would negatively
      affect the child's development. Mothers were open to having their child ask
      questions and even seek out the donor when older. Thirty-one percent of mothers
      reported a positive relationship with their own father, 42% a father who was
      present but unavailable or punitive and 27% a completely absent father for large
      parts of their childhood. Couples divided parenting work based on individual
      strengths and interests, work schedules and demands. Only two of the couples felt
      that one of them played a role typical of a father. An aggregate score was
      compiled for each mother based on the number of negative outcomes in the
      standardized tools. The mean number of negative outcomes for the mothers was 3.15
      (SD = 1.85). Of the six women with 5 or more negative outcomes on the scales,
      three were single parents and one had lost her partner when her child was two
      months old. On the CESD, three mothers showed depression levels that were high.
      The Internal External scale showed 42% of mothers to have an external locus of
      control. Three mothers scored negatively on the Family Assessment Device. Ninety
      two percent of women showed moderate to high self-esteem on the Rosenberg Self
      Esteem scale, and the Parenting Stress Index found only 4 women showing enough
      stress to warrant follow-up. Mothers who reported very negative early experiences
      of coming out were more likely to report current depressive symptoms (p = .03).
      All but one child living in two-mother homes identified both mothers as part of
      their family. Our initial impression is that these are primarily strong families
      with a variety of parenting skills, stressors and philosophies.

PMID- 11206423
TI  - Considerations of family structure and gender composition: the lesbian and gay
      stepfamily.
AB  - Lesbian and gay stepfamilies are unique family forms which must be investigated
      as such. This paper explores the similarities and dissimilarities between
      heterosexual stepfamilies and lesbian/gay stepfamilies, arguing that similarity
      of structure is impacted by gender composition. Utilizing face-to-face and
      telephone interviews with biological and stepparents in 23 lesbian and gay
      stepfamilies, the results show that while lesbian and gay stepfamilies share some
      challenges and strengths with heterosexual stepfamilies, they also evidence a
      unique and flexible adaptation to becoming a family. The paper is aimed at
      delineating future areas for lesbian and gay stepfamily research.

PMID- 11206424
TI  - Popular cinema and lesbian interpretive strategies.
AB  - In its examination of the relationship between popular film and lesbian viewing
      practices, this study attempts to more fully elucidate current ideas around
      audience engagement and forms of cultural reception. Drawing on 15 in-depth
      interviews conducted in Western Canada in 1996, the results clearly demonstrate
      the existence of active lesbian viewers, whose interpretations of popular film
      are intimately informed by lesbian-specific life experiences and cultural
      competencies. Although the social conditions which create the need for resistant
      viewing are themselves oppressive, subversion of mainstream film holds out some
      possibility of empowerment for lesbian viewers.

PMID- 11206425
TI  - Development of differentiation between writing and drawing systems.
AB  - When does a writing system emerge out of children's drawing to separate (a)
      script processing and production from (b) picture processing and production? And
      does one system's activation help or hinder the other system's operation?
      Children 4-12 years of age wrote repeated Os and Vs and drew matching shapes, in
      the contexts of script and of pictures. The technique elicits matching products
      in order to identify differences between production kinematics in different
      contexts. A transition occurred around age 6 in which (a) production was more
      fluent for writing than drawing and (b) activation of one system interfered with
      the other. Modeling the consolidation of both phenomena generated testable
      parameters for the slow approach to the adult steady state, involving increasing
      specialization and the waning of the need for suppression of the two systems'
      interference.

PMID- 11206426
TI  - Sibling influences on gender development in middle childhood and early
      adolescence: a longitudinal study.
AB  - The development of gender role qualities (attitudes, personality, leisure
      activities) from middle childhood to early adolescence was studied to determine
      whether siblings' gender role qualities predicted those of their sisters and
      brothers. Participants were 198 firstborn and second-born siblings (Ms = 10 years
      9 months and 8 years 3 months, respectively, in Year 1) and their parents.
      Families were interviewed annually for 3 years. Firstborn siblings' qualities in
      Year 1 predicted second-born children's qualities in Year 3 when both parent and
      child qualities in Year 1 were controlled, a pattern consistent with a social
      learning model of sibling influence. Parental influence was more evident and
      sibling influence less evident in predicting firstborns' qualities; for
      firstborns, sibling influences suggested a de-identification process.

PMID- 11206427
TI  - Self-representations and socioemotional competence in young children: a 3-year
      longitudinal study.
AB  - In a longitudinal study, the connections between children's self-representations
      at age 5 and their self-perceptions, socioemotional competence according to the
      teacher, and peer acceptance at age 8 were examined. The sample consisted of 60
      children (33 boys, 27 girls). Self-representations at age 5 were assessed by the
      Puppet Interview (J. Cassidy, 1988). Results generally revealed the expected
      connections between the positiveness of self at age 5 and self-perceptions and
      socioemotional functioning 3 years later. These findings support the predictive
      validity of the Puppet Interview. Moreover, they suggest that young children do
      possess at least a rudimentary sense of being generally worthy and lovable, which
      can be assessed by using adequate, age-appropriate interviews.

PMID- 11206428
TI  - Attention and recognition memory in the 1st year of life: a longitudinal study of
      preterm and full-term infants.
AB  - Several aspects of visual attention and their implications for recognition memory
      were examined in a longitudinal sample of full-term and preterm (birth weight <
      1,750 g) infants seen at 5, 7, and 12 months of age. At all 3 ages, full-terms
      had shorter look durations, faster shift rates, less off-task behavior, and
      higher novelty scores than preterms. Both groups followed similar developmental
      trajectories, with older infants having shorter looks and more shifts. Infants
      were consistent in attentional style across problems of the same type, across
      problems that used different types of stimuli (faces and patterns), and across
      the familiarization and test phases of this paired-comparison design; there was
      also modest cross-age stability. Shorter looks and higher shift rates during
      familiarization were related to better recognition memory, with shift rate adding
      to prediction independently of either peak or mean look. These findings
      underscore the importance of attention to infant information processing.

PMID- 11206429
TI  - Young children's evaluations of exclusion in gender-stereotypic peer contexts.
AB  - This study investigated how 50 preschool children (25 girls, 25 boys) evaluated
      the appropriateness of excluding boys and girls from two types of activities
      (doll play, truck play) and two types of future roles (playing a teacher, playing
      a firefighter) across different exclusion contexts. Children judged straight
      forward exclusion from activities on the basis of gender as wrong, even if the
      child's gender was stereotypical of the activity. Furthermore, they justified
      these decisions on the basis of moral reasons, such as equality and unfairness.
      Children used a mixture of moral and social conventional reasoning (including
      stereotypes), however, to evaluate multifaceted situations that called for
      judgments about both inclusion and exclusion and that included information about
      the children's past experience with the activity.

PMID- 11206430
TI  - Early adolescent peer orientation and adjustment during high school.
AB  - The long-term consequences of early adolescents' orientation toward peers for
      their adjustment during high school were assessed. Approximately 1,200
      adolescents completed questionnaires in the 7th grade and in the 10th or 12th
      grades; course grades were also obtained from the students' school records. Early
      adolescents who were willing to sacrifice their talents, school performance, and
      parents' rules engaged in greater problem behavior and evidenced lower academic
      achievement than did other adolescents during high school. The poorer adjustment
      of adolescents with this extreme orientation toward peers was mediated by their
      reported involvement in deviant peer groups. In contrast, a tendency to seek
      advice from peers more than from parents during early adolescence had little
      implication for later adjustment. Discussion focuses on the need to consider the
      role of peer dependence along with the effects of supportive friendships during
      adolescence.

PMID- 11206431
TI  - Maltreatment, competency deficits, and risk for academic and behavioral
      maladjustment.
AB  - Maltreatment was predicted to negatively affect children's academic and
      behavioral adjustment through the creation of deficits in academic engagement,
      social competencies, ego resiliency, and ego control. Teachers' comprehensive
      evaluations, school records, and camp counselors' ratings were obtained for 229
      socioeconomically disadvantaged children (ages 5-12 years), 146 of whom had been
      maltreated. Maltreated children showed less academic engagement, more social
      skills deficits, and lower ego resiliency than nonmaltreated comparison children.
      Maltreated children manifested multiple forms of academic risk and showed more
      externalizing and internalizing behavior problems. The effects of maltreatment on
      academic maladjustment were partially mediated by academic engagement, whereas
      maltreatment's effects on behavior problems were mediated fully by social
      competencies and ego resiliency.

PMID- 11206432
TI  - In vitro fertilization and the family: quality of parenting, family functioning,
      and child psychosocial adjustment.
AB  - This study examined associations between homologous in vitro fertilization (IVF)
      and quality of parenting, family functioning, and emotional and behavioral
      adjustment of 3-7-year-old children. A cross-sectional survey was conducted in
      Taiwan with 54 IVF mother-child pairs and 59 mother-child pairs with children
      conceived naturally. IVF mothers reported a greater level of protectiveness
      toward their children than control mothers. Teachers, blind to condition, rated
      IVF mothers as displaying greater warmth but not overprotective or intrusive
      parenting behaviors toward their children. Teachers scored children of IVF as
      having fewer behavioral problems than control children. In contrast, IVF mothers
      reported less satisfaction with aspects of family functioning. Family composition
      moderated parenting stress: IVF mothers with only 1 child perceived less
      parenting stress than did those in the control group.

PMID- 11206433
TI  - Essentialism in Brazilian children's extensions of animal names.
AB  - The present study investigates whether Brazilian children have essentialist
      beliefs about animal categories. Two groups of Brazilian 4-year-olds (middle
      class and from shantytowns) were told that 2 animals share either internal or
      superficial properties. They were then taught labels for the animals. Across
      conditions, children from both groups were equally likely to interpret the labels
      as referring to mutually exclusive categories of animals, but they differed on
      how likely they were to maintain an inclusion relation between the labels. More
      important, children from both groups were more likely to accept a common label
      for animals sharing internal than superficial properties, indicating that
      internal property information convinced children that the animals were of the
      same kind. These findings were comparable to the results of a recent study by G.
      Diesendruck, S. A. Gelman, and K. Lebowitz (1998) with North American 4-year
      olds.

PMID- 11206434
TI  - Aggression toward female partners by at-risk young men: the contribution of male
      adolescent friendships.
AB  - Deviancy training was examined as a risk factor for physical and psychological
      aggression toward a female partner among boys and young men in the Oregon Youth
      Study. Hostile talk about women during videotaped male friendship interactions
      was hypothesized to indicate a process by which aggression toward women is
      reinforced within male peer networks. Both antisocial behavior and hostile talk
      were predicted to be associated with later aggression toward a female partner.
      Prospective developmental models were tested from 9-10 years of age through young
      adulthood. Findings indicated that the relation of deviant peer association in
      adolescence and later aggression toward a partner was mediated by antisocial
      behavior; observed hostile talk about women with male peers explained additional
      variance in aggression toward a partner.

PMID- 11206435
TI  - Absolute pitch in infant auditory learning: evidence for developmental
      reorganization.
AB  - To what extent do infants represent the absolute pitches of complex auditory
      stimuli? Two experiments with 8-month-old infants examined the use of absolute
      and relative pitch cues in a tone-sequence statistical learning task. The results
      suggest that, given unsegmented stimuli that do not conform to the rules of
      musical composition, infants are more likely to track patterns of absolute
      pitches than of relative pitches. A 3rd experiment tested adults with or without
      musical training on the same statistical learning tasks used in the infant
      experiments. Unlike the infants, adult listeners relied primarily on relative
      pitch cues. These results suggest a shift from an initial focus on absolute pitch
      to the eventual dominance of relative pitch, which, it is argued, is more useful
      for both music and speech processing.

PMID- 11206436
TI  - Child-parent attachment and children's peer relations: a quantitative review.
AB  - The central premise of attachment theory is that the security of the early child
      parent bond is reflected in the child's interpersonal relationships across the
      life span. This meta-analysis was based on 63 studies that reported correlations
      between child-parent attachment and children's peer relations. The overall effect
      size (ES) for child-mother attachment was in the small-to-moderate range and was
      quite homogeneous. ESs were similar in studies that featured the Strange
      Situation and Q-sort methods. The effects were larger for peer relations in
      middle childhood and adolescence than for peer relations in early childhood. ESs
      were also higher for studies that focused on children's close friendships rather
      than on relations with other peers. Gender and cultural differences in ESs were
      minimal. The results for the few studies on father-child attachment were
      inconclusive.

PMID- 11206437
TI  - Design and synthesis of new potent human cytomegalovirus (HCMV) inhibitors based
      on internally hydrogen-bonded 1,6-naphthyridines.
AB  - 1,6-Naphthyridine-2-carboxylic acid benzylamides are potent anti-HCMV compounds.
      Replacement of the amide moiety by other groups containing internal hydrogen
      bonds was undertaken to extend the SAR. Our results indicated that the urca
      derivatives showed very good activity.

PMID- 11206438
TI  - Broad spectrum antiprotozoal agents that inhibit histone deacetylase: structure
      activity relationships of apicidin. Part 1.
AB  - Apicidin, a natural product recently isolated at Merck, inhibits both mammalian
      and protozoan histone deacetylases (HDACs). The conversion of apicidin, a
      nanomolar inhibitor of HDACs, into a series of side-chain analogues that display
      picomolar enzyme affinity is described within this structure-activity study.

PMID- 11206439
TI  - Broad spectrum antiprotozoal agents that inhibit histone deacetylase: structure
      activity relationships of apicidin. Part 2.
AB  - Recently isolated at Merck, apicidin inhibits both mammalian and protozoan
      histone deacetylases (HDACs). The conversion of apicidin, a nonselective
      nanomolar inhibitor of HDACs, into a series of picomolar indole-modified and
      parasite-selective tryptophan-replacement analogues is described within this
      structure-activity study.

PMID- 11206440
TI  - Which aminoglycoside ring is most important for binding? A hydropathic analysis
      of gentamicin, paromomycin, and analogues.
AB  - The NMR structures of gentamicin and paromomycin in complex with the A-site of
      Escherichia coli 16S ribosomal RNA were modified with molecular modeling to 12
      analogues. The intermolecular interactions between these molecules and RNA were
      examined using the HINT (Hydropathic INTeractions) computational model to obtain
      interaction scores that have been shown previously to be related to free energy.
      The calculations correlated well with experimental binding data, and the
      interaction scores were used to analyze the specific structural features of each
      aminoglycoside that contribute to the overall binding with the 16S rRNA. Our
      calculations indicate that, while ring I binds to the main binding pocket of the
      rRNA A-site, ring IV of paromomycin-based aminoglycosides contributes
      significantly to the overall binding.

PMID- 11206441
TI  - 8-Amido-Bearing pseudomycin B (PSB) analogue: novel antifungal agents.
AB  - During the course of a structure-activity relationship (SAR) study on novel
      depsinonapeptide pseudomycin B, we synthesized a total of 12 8-amidopseudomycin
      analogues via standard two-step sequence from either ZPSB 2 or AllocPSB 3. A
      number of these amides exhibited good in vitro antifungal activities.

PMID- 11206442
TI  - Bioisosteres of 9-carboxymethyl-4-oxo-imidazo[1,2-a]indeno-[1,2-e]pyrazin-2
      carboxylic acid derivatives. Progress towards selective, potent in vivo AMPA
      antagonists with longer durations of action.
AB  - A novel series of 2- and 9-disubstituted heterocyclic-fused 4-oxo-indeno[1,2
      e]pyrazin derivatives was synthesized. One of them, the 9-(1H-tetrazol-5
      ylmethyl)-4-oxo-5,10-dihydroimidazo[1,2-a]indeno[1,2-e]pyrazin-2-yl phosphonic
      acid 4i exhibited a strong and a selective binding affinity for the AMPA receptor
      (IC50 = 13 nM) and demonstrated potent antagonist activity (IC50 = 6nM) at the
      ionotropic AMPA receptor. This compound also displayed good anticonvulsant
      properties against electrically-induced convulsions after ip and iv
      administration with ED50 values between 0.8 and 1 mg/kg. Furthermore, a strong
      increase in potency was observed when given iv 3 h before test (ED50 = 3.5
      instead of 25.6 mg/kg for the corresponding 9-carboxymethyl-2-carboxylic acid
      analogue). These data confirmed that there is an advantage in replacing the
      classical carboxy substituents by their bioisosteres such as tetrazole or
      phosphonic acid groups.

PMID- 11206443
TI  - S-adenosylmethionine reverses ilimaquinone's vesiculation of the Golgi apparatus:
      a fluorescence study on the cellular interactions of ilimaquinone.
AB  - The marine sponge metabolite ilimaquinone has a wide range of biological
      activities, including vesiculation of the Golgi apparatus and interference with
      intracellular protein trafficking. Some of these activities may arise from
      ilimaquinone's influence on the activated methyl cycle. To visualize the
      morphological effects of ilimaquinone on the Golgi apparatus, NRK (normal rat
      kidney) cells were labeled with fluorescent wheat germ agglutinin and treated
      with ilimaquinone in the presence and absence of the methylating agent S
      adenosylmethionine (SAMe). While ilimaquinone alone fragments the Golgi
      apparatus, the organelle remains intact when SAMe is included in the incubation
      mixture. This observation supports ilimaquinone's interaction with methylation
      enzymes as the cause of Golgi vesiculation. The examination of a fluorescently
      labeled ilimaquinone analogue in NRK cells suggests that the cellular
      interactions of ilimaquinone are not localized to the Golgi apparatus.

PMID- 11206444
TI  - New anti-MRSA cephalosporins with a basic aminopyridine at the C-7 position.
AB  - Incorporation of a basic aminopyridine into the C-7 position of 3-(amine
      substituted arylthio)-3-norcephalosporins, as in 3, afforded high potency against
      MRSA and acceptable solubility for intravenous administration.

PMID- 11206445
TI  - Hydrolase and sialyltransferase activities of trypanosoma cruzi trans-sialidase
      towards NeuAc-alpha-2,3-gal-Gal-beta-O-PNP.
AB  - NeuAc-alpha-2,3-Gal-beta-O-PNP has been synthesised and its ability to act as a
      substrate for the hydrolase and transferase activities of Trypanosoma cruzi trans
      sialidase have been investigated. The turn-over of this compound shows marked
      differences from the behaviour of NeuAc-MU. In addition, distinct differences in
      the action of T. cruzi trans-sialidase and Clostridium perfringens neuraminidase
      on NeuAc-alpha-2,3-Gal-beta-O-PNP were apparent.

PMID- 11206446
TI  - Chemical synthesis of UDP-beta-L-arabinofuranose and its turnover to UDP-beta-L
      arabinopyranose by UDP-galactopyranose mutase.
AB  - Uridine-5'-diphospho-beta-L-arabinofuranose, a possible donor of L
      arabinofuranose residues in plants, was synthesized. This compound, in the
      presence of UDP-galactopyranose mutase, underwent interconversion with UDP-beta-L
      arabinopyranose that is a likely precursor of L-arabinofuranose in vivo. This
      result provided a working model for the biogenesis of arabinofuranose in plants.

PMID- 11206447
TI  - Design and synthesis of sialyl Lewis x mimics as E-selectin inhibitors.
AB  - The design and synthesis of novel beta-C-mannosides that inhibit the binding of
      sialyl Lewis x to E-selectin are described. Compounds that contained a phenyl
      substituent at the C-6 position were found to have increased potency.

PMID- 11206448
TI  - Synthesis and P2Y receptor activity of a series of uridine dinucleoside 5'
      polyphosphates.
AB  - A series of dinucleoside 5-polyphosphates UpnU (n = 2-7) was synthesized. Their
      relative potencies as agonists at the G-protein-coupled receptors P2Y1, P2Y2,
      P2Y4, and P2Y6 were determined by intracellular calcium measurements using
      fluorescent imaging techniques. The correlation of phosphate chain length to
      activities at these receptors is discussed.

PMID- 11206449
TI  - The synthesis of pseudomycin C' via a novel acid promoted side-chain deacylation
      of pseudomycin A.
AB  - The gamma hydroxyl present in the aliphatic side chain of the natural products
      pseudomycin A and C' provided a unique handle for the pH dependent side-chain
      deacylation. Low pH reaction conditions were used to cleave the side chain with
      minimal degradation of the peptide core. The pseudomycin nucleus intermediate
      obtained from the deacylation of pseudomycin A was pivotal in the synthesis of
      novel side-chain analogues. A practical synthesis of a minor fermentation factor
      pseudomycin C' and related analogues is reported.

PMID- 11206450
TI  - 2,2-Dimethyl-4,5-diaryl-3(2H)furanone derivatives as selective cyclo-oxygenase-2
      inhibitors.
AB  - A series of 2,2-dimethyl-5-[4-(methylsulfonyl)phenyl]-4-phenyl-3(2H)furanones was
      prepared and evaluated for their ability to inhibit cyclo-oxygenase-2 (COX-2).

PMID- 11206451
TI  - Studies directed towards the refinement of the pancratistatin cytotoxic
      pharmacophore.
AB  - Two deoxy-analogues of the anticancer/antiviral agent pancratistatin containing
      functionality complementary to the minimum structural pharmacophore were
      synthesized and subjected to anticancer screening. One of the analogues exhibited
      selective inhibition of certain tumor cell lines but was significantly less
      potent than the natural products. The minimum structural pharmacophore has now
      been refined from eight to three possible structures.

PMID- 11206452
TI  - 3-Deoxy-3-substituted-D-myo-inositol imidazolyl ether lipid phosphates and
      carbonate as inhibitors of the phosphatidylinositol 3-kinase pathway and cancer
      cell growth.
AB  - 3-Modified D-myo-inositol imidazolyl ether lipid phosphates and a carbonate were
      synthesized and evaluated as inhibitors of P13-K and Akt. These data are
      presented along with IC50 values for the inhibition of the growth of three cancer
      cell lines.

PMID- 11206453
TI  - Atropisomeric quinazolin-4-one derivatives are potent noncompetitive alpha-amino
      3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonists.
AB  - Piriqualone (1) was found to be an antagonist of AMPA receptors. Structure
      activity optimization was conducted on each of the three rings in 1 to afford a
      series of potent and selective antagonists. The sterically crowded environment
      surrounding the N-3 aryl group provided sufficient thermal stability for
      atropisomers to be isolated. Separation of these atropisomers resulted in the
      identification of (+)-38 (CP-465,022), a compound that binds to the AMPA receptor
      with high affinity (IC50 = 36 nM) and displays potent anticonvulsant activity.

PMID- 11206454
TI  - 3,28-Di-O-(dimethylsuccinyl)-betulin isomers as anti-HIV agents.
AB  - Four isomers of 3,28-di-O-(dimethylsuccinyl)-betulin were prepared and evaluated
      for anti-HIV activity against HIV-1 replication in H9 lymphocyte cells. 3-O
      (3',3'-Dimethylsuccinyl)-28-O-(2", 2"-dimethvlsuccinyl)-betulin (11) was the most
      potent anti-HIV compound with an EC5, value of 0.00087 microM and a TI value of
      42,400.

PMID- 11206455
TI  - Synthesis and antiparasitic activity of 2-(trifluoromethyl)-benzimidazole
      derivatives.
AB  - 2-(Trifluoromethyl)benzimidazole derivatives substituted at the 1-, 5-, and 6
      positions have been synthesized and in vitro tested against the protozoa Giardia
      lamblia, Entamnoeha histolytica. and the helminth Trichinella spiralis. Results
      indicate that all the compounds tested are more active as antiprotozoal agents
      than Albendazole and Metronidazole. One compound (20) was as active as
      Albendazole against T. spiralis. These compounds were also tested for their
      effect on tubulin polymerization and none inhibited tubulin polymerization.

PMID- 11206456
TI  - High-pressure synthesis of enantiomerically pure C-6 substituted pyrazol.
AB  - The synthesis of enantiomerically pure C-6 substituted pyrazolo[3,4-d]pyrimidines
      has been performed by aromatic nucleophilic substitution of 4-amino-6-chloro-1
      phenylpyrazolo[3,4-rd]pyrimidine under conditions of high pressure at ambient
      temperature. Conventional synthetic conditions (reflux at atmospheric pressure)
      were unsuccessful. The S enantiomer 11 displayed higher affinity and selectivity
      for the adenosine A1 receptor than the R enantiomer 12.

PMID- 11206458
TI  - Diastereoselective synthesis, activity and chiral stability of cyclic
      alkoxyketone inhibitors of cathepsin K.
AB  - The diastereoselective synthesis of a novel class of cathepsin K inhibitors
      together with their cathepsin K affinity and stability towards aqueous buffer is
      reported.

PMID- 11206457
TI  - Solid-phase synthesis of cyclic alkoxyketones, inhibitors of the cysteine
      protease cathepsin K.
AB  - Using solid-phase synthesis, a library of novel cyclic alkoxyketones has been
      constructed which show strong inhibitory activity against the cysteine protease,
      cathepsin K (EC 3.4.22.38).

PMID- 11206459
TI  - Inhibition of hepatitis C virus NS3 protease activity by product-based peptides
      is dependent on helicase domain.
AB  - Structure activity relationships (SARs) of product-based inhibitors of hepatitis
      C virus NS3 protease were evaluated using an in vitro assay system comprising the
      native bifunctional full-length NS3 (protease-helicase/NTPase). The results were
      compared to previously reported data derived from the corresponding NS3 protease
      domain assay. Shortening the length of the protease inhibitors from hexapeptides
      to tripeptides revealed that the decrease in potency was much less when
      determined in the assay system with the full-length NS3 protein. Disagreements in
      SARs at different positions (P5 P2) were also discovered. Taken together, the
      results suggest that the impact of the helicase domain upon protease inhibitor
      binding is substantial.

PMID- 11206460
TI  - Dimeric beta-turn peptidomimetics as ligands for the neurotrophin receptor TrkC.
AB  - Twelve dimeric peptidomimetics 1 were prepared via a divergent-convergent
      strategy. These peptidomimetics incorporated the same amino acids as i +1 and i +
      2 residues in key beta-turns of the neurotrophin NT-3. Cytosensor
      microphysiometry was used to gauge the effects of the dimers 1 on cells that
      overexpress the NT-3 receptor, TrkC. Increases in extracellular acidification
      rates were observed for some monomers 3, but the active dimers gave greater
      effects.

PMID- 11206461
TI  - 3,3a-Dihydropyrano[4,3,2-de]quinazolin-2(1H)-ones are potent non-nucleoside
      reverse transcriptase inhibitors.
AB  - A series of unique 3,3a-dihydropyrano[4,3,2-de]quinazolin-2(1H)-ones and a 2a,5
      dihydro-2H-thieno[4,3,2-de]quinazo-line-4(3H)-thione were found to be HIV-1 non
      nucleoside reverse transcriptase inhibitors. One of these compounds, as the
      racemate, possessed an IC90 = 4.6 nM against wild-type virus in a whole cell
      antiviral assay and had an IC90 = 76 and 897 nM against the clinically
      significant K103N and K103N/L100I mutant viruses, respectively.

PMID- 11206462
TI  - Synthesis and evaluation of caffeic acid amides as antioxidants.
AB  - A series of amides of caffeic acid has been synthesised and their antioxidant
      properties evaluated as lipid peroxidation inhibitors. Anilides of caffeic acid
      were found to be very efficient antioxidants with IC50's of 0.3 microM.

PMID- 11206463
TI  - Design, synthesis, and biological evaluation of HIV/FIV protease inhibitors
      incorporating a conformationally constrained macrocycle with a small P3' residue.
AB  - A series of norstatine-based HIV/FIV protease inhibitors incorporating a 15
      membered macrocycle as a mimic of the tripeptide (Ala-Val-Phe), a motif with a
      small P3' residue elective against the FIV protease and the drug-resistant HIV
      proteases, has been synthesized. It was found that the macrocycle is important to
      the overall activity of the inhibitors. Certain inhibitors were developed
      expressing low nanomolar inhibitory activity against the HIV/FIV proteases and
      they are also effective against some drug-resistant as well as TL3-resistant HIV
      proteases.

PMID- 11206464
TI  - Synthesis and dopaminergic properties of the two enantiomers of 3-(3,4
      dimethylphenyl)-1-propylpiperidine, a potent and selective dopamine D4 receptor
      ligand.
AB  - The synthesis of the two enantiomers of 3-(3,4-dimethylphenyl)-1-propylpiperidine
      1, a potent and selective D4 dopaminergic ligand, was performed. The 3-(3,4
      dimethylphenyl)- 1-propylpiperidine with the R configuration showed an affinity
      for the D4 receptors 6-fold higher than the corresponding enantiomer with the S
      configuration. Furthermore, the (R)-1 enantiomer proved to be highly selective
      for D4 receptors with respect to D2-D3 receptors, with a Ki ratio higher than
      25,000, while the (S)-1 enantiomer was about 100-fold less selective than the (R)
      1 one.

PMID- 11206465
TI  - Solid-phase optimisation of achiral amidinobenzyl indoles as potent and selective
      factor Xa inhibitors.
AB  - Starting from the achiral and potent factor Xa inhibitor 1, a new and flexible
      solid-phase optimisation strategy is described to reduce its cationic character.
      By replacing one positively charged side chain by a lipophilic substituent, a
      novel series of highly potent and selective achiral factor Xa inhibitors was
      discovered. The identified lipophilic replacements in the S4 pocket might be
      valuable for other approaches towards fXa inhibitors.

PMID- 11206466
TI  - Structure--activity relationships of side-chain modified didemnins.
AB  - The synthesis and antitumor activity of a novel didemnin B analogue containing a
      psi[CH2NH] amide bond surrogate between N-Me-D-Leu7 and Pro8 are reported. The
      analogue shows activity (GI50 = 4 nM) comparable to that of didemnin B (GI50 = 13
      nM) in the NCI-60 tumor cell screen. This result, along with new data from
      previously reported synthetic didemnin analogues, is discussed within the context
      of the side-chain SAR for didemnins.

PMID- 11206467
TI  - The discovery of anthranilic acid-based MMP inhibitors. Part 1: SAR of the 3
      position.
AB  - A novel series of anthranilic acid-based inhibitors of MMP-1, MMP-9, and MMP-13
      was prepared and evaluated both in vitro and in vivo. The most potent compound,
      6e, has in vivo activity in a rat sponge-wrapped cartilage model.

PMID- 11206468
TI  - Heteroaryl and cycloalkyl sulfonamide hydroxamic acid inhibitors of matrix
      metalloproteinases.
AB  - Heteroaryl and cycloalkyl sulfonamide-hydroxamic acid MMP inhibitors were
      investigated. Of these, the pyridyl analogue 2 is the most potent and selective
      inhibitor of MMP-9 and MMP-13 in vitro.

PMID- 11206469
TI  - Intracellular inhibition of human neutrophil elastase by orally active
      pyrrolidine-trans-lactams.
AB  - Described are the acylation binding of trans-lactam 1 to porcine pancreatic
      elastase, the selection of the SO2Me activating group for the lactam N which also
      confers metabolic stability in hamster liver microsomes, the introduction of
      aqueous solubility through the piperidine salt 9, the in vivo oral activity of 9
      and its bioavailability, and the introduction of 9 as an intracellular neutrophil
      elastase inhibitor.

PMID- 11206470
TI  - Synthesis, absolute configuration and antimuscarinic activity of the enantiomers
      of [1-(2,2-diphenyl-[1,3]dioxolan-4-yl)-ethyl]-dimethyl-amine.
AB  - Methylation of the carbon atom C of compound 1, a potent and not selective
      muscarinic antagonist, was carried out. The resulting diastereomers were
      separated and the corresponding racemate further resolved to give four
      enantiomers, which were tested both as hydrogen oxalate and methiodide salts. The
      pharmacological results obtained at M1, M2 and M3 muscarinic receptor subtypes,
      show that methylation at C1, depending on the stereochemistry, increases
      antagonist potency, having thus the same effect of nitrogen quaternization. These
      results may well lead to the development of new potent antimuscarinic drugs
      lacking a cationic head.

PMID- 11206471
TI  - Polyamines with N-(3-phenylpropyl) substituents are effective competitive
      inhibitors of trypanothione reductase and trypanocidal agents.
AB  - Several N-(3-phenylpropyl)-substituted spermidine and spermine derivatives were
      prepared and found to be potent competitive inhibitors of Trypanosoma cruzi
      trypanothione reductase (seven compounds with Ki values < 5 microM are
      described). The most effective inhibitor studied was compound 12 with a Ki value
      of 0.151 microM. Six of the compounds described are also effective trypanocides
      with IC50 values < 1 microM.

PMID- 11206472
TI  - 3-p-Toluoyl-2-[4'-(3-diethylaminopropoxy)-phenyl]-benzofuran and 2-[4'-(3
      diethylaminopropoxy)-phenyl]-benzofuran do not act as surfactants or micelles
      when inhibiting the aggregation of beta-amyloid peptide.
AB  - The cmc and IC50 values of the beta-amyloid (Abeta) aggregation inhibitors, 3-p
      toluoyl-2-[4'-(3-diethylaminopropoxy)-phenyl]-benzofuran 1, and 2-[4'-(3
      diethylaminopropoxy)-phenyl]-benzofuran 2 have been determined. After comparison
      of the cmc data and biological data (IC50 values), we conclude that these active
      benzofurans do not act as surfactants or micelles at the concentration required
      to inhibit beta-amyloid-peptide aggregation.

PMID- 11206473
TI  - Antagonists of the human CCR5 receptor as anti-HIV-1 agents. part 1: discovery
      and initial structure-activity relationships for 1 -amino-2-phenyl-4-(piperidin-1
      yl)butanes.
AB  - Screening of the Merck sample collection for compounds with CCR5 receptor binding
      afforded (2S)-2-(3,4-dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4
      [spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (4) as a
      potent lead structure having an IC50 binding affinity of 35 nM. Herein, we
      describe the discovery of this lead structure and our initial structure activity
      relationship studies directed toward the requirement for and optimization of the
      1-amino fragment.

PMID- 11206474
TI  - Antagonists of the human CCR5 receptor as anti-HIV-1 agents. Part 2: structure
      activity relationships for substituted 2-Aryl-1-[N-(methyl)-N
      (phenylsulfonyl)amino]-4-(piperidin-1-yl)butanes.
AB  - (2S)-2-(3,4-Dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3
      dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (3) has been identified
      as a potent CCR5 antagonist lead structure having an IC50 = 35 nM. Herein, we
      describe the structure-activity relationship studies directed toward the
      requirement for and optimization of the C-2 phenyl fragment. The phenyl was found
      to be important for CCR5 antagonism and substitution was limited to small
      moieties at the 3-position (13 and 16: X= H, 3-F, 3-Cl, 3-Me).

PMID- 11206475
TI  - Liquid-phase parallel synthesis of ureas.
AB  - An efficient and general liquid-phase method has been developed for the synthesis
      of a piperazine containing urea library. Reactions of the polymer bound carbamoyl
      chloride with primary or secondary amines afford ureas at ambient temperature.
      Desired compounds are liberated from the polymer support under mild conditions in
      high yields and high purity by simple precipitation and washings.

PMID- 11206476
TI  - Synthesis and structure--activity analysis of novel dihydropyridine derivatives
      to overcome multidrug resistance.
AB  - The structure activity relationships were studied on newly synthesized 1,4
      dihydropyridine derivatives possessing a 1-pentyl group at the 4-position, and 3
      pyridylpropylester was found to be one of the effective fragments for overcoming
      P-glycoprotein mediated multidrug-resistance (MDR) in cultured human cancer
      cells, in vitro. 3-Pyridylpropylester was also found to be one of the effective
      fragments for increasing the life span of P-glycoprotein overexpressing MDR P388
      leukemia-bearing mice, in vivo. All compounds had weak calcium antagonistic
      activities, but there appeared no relationship between MDR reversing effect and
      calcium antagonistic activity.

PMID- 11206477
TI  - Cocaine catalytic antibodies: the primary importance of linker effects.
AB  - Current treatments for cocaine addiction are not effective. The development of a
      catalytic monoclonal antibody (mAb) provides a strategy for not only binding, but
      also degrading cocaine, which offers a broad-based therapy. Hapten design is the
      central element for programming antibody catalysis. The characteristics of the
      linker used in classic transition-state analogue phosphonate haptens were shown
      to be important for obtaining mAbs that hydrolyze the benzoate ester of cocaine.

PMID- 11206479
TI  - A disubstituted NAD+ analogue is a nanomolar inhibitor of trypanosomal
      glyceraldehyde-3-phosphate dehydrogenase.
AB  - N6-Naphthalenemethyl-2'-methoxybenzamido-beta-NAD+, a derivative of a low
      micromolar first-generation inhibitor of trypanosomal glyceraldehyde phosphate
      dehydrogenase (GAPDH), was synthesized, taking advantage of methodology for the
      selective phosphitylation of nucleosides. The compound was found to be a poor
      alternate cosubstrate for GAPDH, but an extremely potent inhibitor. Although
      intended for use in crystallization trials, the analogue presents possibilities
      for further drug design.

PMID- 11206478
TI  - Arylalkylidene rhodanine with bulky and hydrophobic functional group as selective
      HCV NS3 protease inhibitor.
AB  - Arylalkylidene rhodanines 2(a-d) inhibit HCV NS3 protease at moderate
      concentrations. They are better inhibitors of other serine proteases such as
      chymotrypsin and plasmin. However, the selectivity of arylmethyliden e rhodanines
      (8a, 9a) with bulkier and more hydrophobic functional groups increases by 13- and
      25-fold towards HCV NS3 protease respectively.

PMID- 11206481
TI  - Human HOX gene mutations.
AB  - HOX genes play a fundamental role in the development of the vertebrate central
      nervous system, axial skeleton, limbs, gut, urogenital tract and external
      genitalia, but it is only in the last 4 years that mutations in two of the 39
      human HOX genes have been shown to cause congenital malformations; HOXD13, which
      is mutated in synpolydactyly, and HOXA13, which is mutated in Hand-Foot-Genital
      syndrome. Here we review the mutations already identified in these two genes,
      consider how these mutations may act, and discuss the possibility that further
      mutations remain to be discovered both in developmental disorders and in cancer.

PMID- 11206505
TI  - Lessons from Huntingdon.

PMID- 11206480
TI  - Synthesis of 7,8-disubstituted benzolactam-V8 and its binding to protein kinase
      C.
AB  - 7-Methoxy-8-decynyl-benzolactam-V8 4 is synthesized using a catalytic asymmetric
      alkylation reaction as a key step. This compound shows potent activity to three
      PKC isozymes tested (Ki =45.6, 91.1, and 121.3 nM to PKCalpha, delta, and
      epsilon, respectively), indicating that introduction of a suitable substituent at
      the 7-position of 8-decynyl-benzolactam-V8 only slightly reduces the PKC binding
      affinity.

PMID- 11206506
TI  - Italians drop beef as first cow tests positive.

PMID- 11206507
TI  - Agencies face uphill battle to keep United States free of BSE.

PMID- 11206509
TI  - Students fuzzy about the future.

PMID- 11206508
TI  - Public have right to see data from all gene trials, says FDA.

PMID- 11206511
TI  - Max Planck Society broke pledge to ask Jews back after war.

PMID- 11206510
TI  - Animal-rights protests raise calls for UK government move.

PMID- 11206513
TI  - Canadian minister keeps researchers guessing.

PMID- 11206514
TI  - Assessment ups the ante on climate change.

PMID- 11206512
TI  - Health and energy chiefs sail through Senate.

PMID- 11206515
TI  - Demand for physicists on the rise.

PMID- 11206517
TI  - Nuclear physics. Bringing supernovae down to Earth.

PMID- 11206516
TI  - Stem-cell research to start in Britain.

PMID- 11206518
TI  - Santiago Ramon y Cajal. The brain in Spain.

PMID- 11206519
TI  - European researchers encourage improvement in lab animal welfare.

PMID- 11206520
TI  - Users must help to keep public databases correct.

PMID- 11206521
TI  - The long-term answer: fight fire with research.

PMID- 11206522
TI  - The suspense of strangeness.

PMID- 11206524
TI  - Quantum optics. Stopping light in its tracks.

PMID- 11206523
TI  - Natural progression.

PMID- 11206525
TI  - Extrasolar planets. Giant giants or dwarf dwarfs?

PMID- 11206526
TI  - Gastrogenomics.

PMID- 11206527
TI  - The age of river carbon.

PMID- 11206528
TI  - Walking on other planets.

PMID- 11206529
TI  - Plant biology. Floral quartets.

PMID- 11206530
TI  - Watching an atom tunnel.

PMID- 11206531
TI  - A new code for axons.

PMID- 11206532
TI  - Sperm and mammalian polarity.

PMID- 11206533
TI  - Watching fights raises fish hormone levels.

PMID- 11206534
TI  - Light-emitting diodes as chemical sensors.

PMID- 11206535
TI  - Screening slaughtered cattle for BSE.

PMID- 11206536
TI  - Gene capture in archaeal chromosomes.

PMID- 11206537
TI  - The architecture of active zone material at the frog's neuromuscular junction.
AB  - Active zone material at the nervous system's synapses is situated next to
      synaptic vesicles that are docked at the presynaptic plasma membrane, and calcium
      channels that are anchored in the membrane. Here we use electron microscope
      tomography to show the arrangement and associations of structural components of
      this compact organelle at a model synapse, the frog's neuromuscular junction. Our
      findings indicate that the active zone material helps to dock the vesicles and
      anchor the channels, and that its architecture provides both a particular spatial
      relationship and a structural linkage between them. The structural linkage may
      include proteins that mediate the calcium-triggered exocytosis of
      neurotransmitter by the synaptic vesicles during synaptic transmission.

PMID- 11206538
TI  - Dynamos in asymptotic-giant-branch stars as the origin of magnetic fields shaping
      planetary nebulae.
AB  - Planetary nebulae are thought to be formed when a slow wind from the progenitor
      giant star is overtaken by a subsequent fast wind generated as the star enters
      its white dwarf stage. A shock forms near the boundary between the winds,
      creating the relatively dense shell characteristic of a planetary nebula. A
      spherically symmetric wind will produce a spherically symmetric shell, yet over
      half of known planetary nebulae are not spherical; rather, they are elliptical or
      bipolar in shape. A magnetic field could launch and collimate a bipolar outflow,
      but the origin of such a field has hitherto been unclear, and some previous work
      has even suggested that a field could not be generated. Here we show that an
      asymptotic-giant-branch (AGB) star can indeed generate a strong magnetic field,
      having as its origin a dynamo at the interface between the rapidly rotating core
      and the more slowly rotating envelope of the star. The fields are strong enough
      to shape the bipolar outflows that produce the observed bipolar planetary
      nebulae. Magnetic braking of the stellar core during this process may also
      explain the puzzlingly slow rotation of most white dwarf stars.

PMID- 11206539
TI  - Geochemical evidence for magmatic water within Mars from pyroxenes in the
      Shergotty meteorite.
AB  - Observations of martian surface morphology have been used to argue that an
      ancient ocean once existed on Mars. It has been thought that significant
      quantities of such water could have been supplied to the martian surface through
      volcanic outgassing, but this suggestion is contradicted by the low magmatic
      water content that is generally inferred from chemical analyses of igneous
      martian meteorites. Here, however, we report the distributions of trace elements
      within pyroxenes of the Shergotty meteorite--a basalt body ejected 175 million
      years ago from Mars--as well as hydrous and anhydrous crystallization experiments
      that, together, imply that water contents of pre-eruptive magma on Mars could
      have been up to 1.8%. We found that in the Shergotty meteorite, the inner cores
      of pyroxene minerals (which formed at depth in the martian crust) are enriched in
      soluble trace elements when compared to the outer rims (which crystallized on or
      near to the martian surface). This implies that water was present in pyroxenes at
      depth but was largely lost as pyroxenes were carried to the surface during magma
      ascent. We conclude that ascending magmas possibly delivered significant
      quantities of water to the martian surface in recent times, reconciling geologic
      and petrologic constraints on the outgassing history of Mars.

PMID- 11206540
TI  - Observation of coherent optical information storage in an atomic medium using
      halted light pulses.
AB  - Electromagnetically induced transparency is a quantum interference effect that
      permits the propagation of light through an otherwise opaque atomic medium; a
      'coupling' laser is used to create the interference necessary to allow the
      transmission of resonant pulses from a 'probe' laser. This technique has been
      used to slow and spatially compress light pulses by seven orders of magnitude,
      resulting in their complete localization and containment within an atomic cloud.
      Here we use electromagnetically induced transparency to bring laser pulses to a
      complete stop in a magnetically trapped, cold cloud of sodium atoms. Within the
      spatially localized pulse region, the atoms are in a superposition state
      determined by the amplitudes and phases of the coupling and probe laser fields.
      Upon sudden turn-off of the coupling laser, the compressed probe pulse is
      effectively stopped; coherent information initially contained in the laser fields
      is 'frozen' in the atomic medium for up to 1 ms. The coupling laser is turned
      back on at a later time and the probe pulse is regenerated: the stored coherence
      is read out and transferred back into the radiation field. We present a
      theoretical model that reveals that the system is self-adjusting to minimize
      dissipative loss during the 'read' and 'write' operations. We anticipate
      applications of this phenomenon for quantum information processing.

PMID- 11206541
TI  - Formation cross-sections of singlet and triplet excitons in pi-conjugated
      polymers.
AB  - Electroluminescence in organic light-emitting diodes arises from a charge
      transfer reaction between the injected positive and negative charges by which
      they combine to form singlet excitons that subsequently decay radiatively. The
      quantum yield of this process (the number of photons generated per electron or
      hole injected) is often thought to have a statistical upper limit of 25 per cent.
      This is based on the assumption that the formation cross-section of singlet
      excitons, sigmaS, is approximately the same as that of any one of the three
      equivalent non-radiative triplet exciton states, sigmaT; that is, sigmaS/sigmaT
      approximately 1. However, recent experimental and theoretical work suggests that
      sigmaS/sigmaT may be greater than 1. Here we report direct measurements of
      sigmaS/sigmaT for a large number of pi-conjugated polymers and oligomers. We have
      found that there exists a strong systematic, but not monotonic, dependence of
      sigmaS/sigmaT on the optical gap of the organic materials. We present a detailed
      physical picture of the charge-transfer reaction for correlated pi-electrons, and
      quantify this process using exact valence bond calculations. The calculated
      sigmaS/sigmaT reproduces the experimentally observed trend. The calculations also
      show that the strong dependence of sigmaS/sigmaT on the optical gap is a
      signature of the discrete excitonic energy spectrum, in which higher energy
      excitonic levels participate in the charge recombination process.

PMID- 11206543
TI  - Geochemical evidence for the melting of subducting oceanic lithosphere at plate
      edges.
AB  - Most island-arc magmatism appears to result from the lowering of the melting
      point of peridotite within the wedge of mantle above subducting slabs owing to
      the introduction of fluids from the dehydration of subducting oceanic crust.
      Volcanic rocks interpreted to contain a component of melt (not just a fluid) from
      the subducting slab itself are uncommon, but possible examples have been
      recognized in the Aleutian islands, Baja California, Patagonia and elsewhere. The
      geochemically distinctive rocks from these areas, termed 'adakites, are often
      associated with subducting plates that are young and warm, and therefore thought
      to be more prone to melting. But the subducting lithosphere in some adakite
      locations (such as the Aleutian islands) appears to be too old and hence too cold
      to melt. This implies either that our interpretation of adakite geochemistry is
      incorrect, or that our understanding of the tectonic context of adakites is
      incomplete. Here we present geochemical data from the Kamchatka peninsula and the
      Aleutian islands that reaffirms the slab-melt interpretation of adakites, but in
      the tectonic context of the exposure to mantle flow around the edge of a torn
      subducting plate. We conclude that adakites are likely to form whenever the edge
      of a subducting plate is warmed or ablated by mantle flow. The use of adakites as
      tracers for such plate geometry may improve our understanding of magma genesis
      and thermal structure in a variety of subduction-zone environments.

PMID- 11206542
TI  - Riverine export of aged terrestrial organic matter to the North Atlantic Ocean.
AB  - Global riverine discharge of organic matter represents a substantial source of
      terrestrial dissolved and particulate organic carbon to the oceans. This input
      from rivers is, by itself, more than large enough to account for the apparent
      steady-state replacement times of 4,00-6,000 yr for oceanic dissolved organic
      carbon. But paradoxically, terrestrial organic matter, derived from land plants,
      is not detected in seawater and sediments in quantities that correspond to its
      inputs. Here we present natural 14C and 13C data from four rivers that discharge
      to the western North Atlantic Ocean and find that these rivers are sources of old
      (14C-depleted) and young (14C-enriched) terrestrial dissolved organic carbon, and
      of predominantly old terrestrial particulate organic carbon. These findings
      contrast with limited earlier data that suggested terrestrial organic matter
      transported by rivers might be generally enriched in 14C from nuclear testing,
      and hence newly produced. We also find that much of the young dissolved organic
      carbon can be selectively degraded over the residence times of river and coastal
      waters, leaving an even older and more refractory component for oceanic export.
      Thus, pre-ageing and degradation may alter significantly the structure,
      distributions and quantities of terrestrial organic matter before its delivery to
      the oceans.

PMID- 11206544
TI  - A bizarre predatory dinosaur from the Late Cretaceous of Madagascar.
AB  - Here we report the discovery of a small-bodied (approximately 1.8 m) predatory
      dinosaur from the Late Cretaceous (Maastrichtian) of Madagascar. Masiakasaurus
      knopfleri, gen. et sp. nov., represented by several skull elements and much of
      the postcranial skeleton, is unique in being the only known theropod with a
      highly procumbent and distinctly heterodont lower dentition. Such a derived
      dental morphology is otherwise unknown among dinosaurs. Numerous skeletal
      characteristics indicate that Masiakasaurus is a member of Abelisauroidea, an
      enigmatic clade of Gondwanan theropods. Previously, small-bodied abelisauroids
      were known only from Argentina. The occurrence of Masiakasaurus on Madagascar
      suggests that small-bodied abelisauroids, like their larger-bodied counterparts,
      were more cosmopolitan, radiating throughout much of Gondwana and paralleling the
      diversification of small coelurosaur theropods in Laurasia.

PMID- 11206545
TI  - Archaeal dominance in the mesopelagic zone of the Pacific Ocean.
AB  - The ocean's interior is Earth's largest biome. Recently, cultivation-independent
      ribosomal RNA gene surveys have indicated a potential importance for archaea in
      the subsurface ocean. But quantitative data on the abundance of specific
      microbial groups in the deep sea are lacking. Here we report a year-long study of
      the abundance of two specific archaeal groups (pelagic euryarchaeota and pelagic
      crenarchaeota) in one of the ocean's largest habitats. Monthly sampling was
      conducted throughout the water column (surface to 4,750 m) at the Hawai'i Ocean
      Time-series station. Below the euphotic zone (> 150 m), pelagic crenarchaeota
      comprised a large fraction of total marine picoplankton, equivalent in cell
      numbers to bacteria at depths greater than 1,000 m. The fraction of crenarchaeota
      increased with depth, reaching 39% of total DNA-containing picoplankton detected.
      The average sum of archaea plus bacteria detected by rRNA-targeted fluorescent
      probes ranged from 63 to 90% of total cell numbers at all depths throughout our
      survey. The high proportion of cells containing significant amounts of rRNA
      suggests that most pelagic deep-sea microorganisms are metabolically active.
      Furthermore, our results suggest that the global oceans harbour approximately 1.3
      x 10(28) archaeal cells, and 3.1 x 10(28) bacterial cells. Our data suggest that
      pelagic crenarchaeota represent one of the ocean's single most abundant cell
      types.

PMID- 11206546
TI  - Testing Hamilton's rule with competition between relatives.
AB  - Hamilton's theory of kin selection suggests that individuals should show less
      aggression, and more altruism, towards closer kin. Recent theoretical work has,
      however, suggested that competition between relatives can counteract kin
      selection for altruism. Unfortunately, factors that tend to increase the average
      relatedness of interacting individuals--such as limited dispersal--also tend to
      increase the amount of competition between relatives. Therefore, in most natural
      systems, the conflicting influences of increased competition and increased
      relatedness are confounded, limiting attempts to test theory. Fig wasp taxa
      exhibit varying levels of aggression among non-dispersing males that show a range
      of average relatedness levels. Thus, across species, the effects of relatedness
      and competition between relatives can be separated. Here we report that--contrary
      to Hamilton's original prediction but in agreement with recent theory--the level
      of fighting between males shows no correlation with the estimated relatedness of
      interacting males, but is negatively correlated with future mating opportunities.

PMID- 11206547
TI  - Reduced antinociception and plasma extravasation in mice lacking a neuropeptide Y
      receptor.
AB  - Neuropeptide Y (NPY) is believed to exert antinociceptive actions by inhibiting
      the release of substance P and other 'pain neurotransmitters' in the spinal cord
      dorsal horn. However, the physiological significance and potential therapeutic
      value of NPY remain obscure. It is also unclear which receptor subtype(s) are
      involved. To identify a possible physiological role for the NPY Y1 receptor in
      pain transmission, we generated NPY Y1 receptor null mutant (Y1-/-) mice by
      homologous recombination techniques. Here we show that Y1-/- mice develop
      hyperalgesia to acute thermal, cutaneous and visceral chemical pain, and exhibit
      mechanical hypersensitivity. Neuropathic pain is increased, and the mice show a
      complete absence of the pharmacological analgesic effects of NPY. In the
      periphery, Y1 receptor activation is sufficient and required for substance P
      release and the subsequent development of neurogenic inflammation and plasma
      leakage. We conclude that the Y1 receptor is required for central physiological
      and pharmacological NPY-induced analgesia and that its activation is both
      sufficient and required for the release of substance P and initiation of
      neurogenic inflammation.

PMID- 11206548
TI  - Role for sperm in spatial patterning of the early mouse embryo.
AB  - Despite an apparent lack of determinants that specify cell fate, spatial
      patterning of the mouse embryo is evident early in development. The axis of the
      post-implantation egg cylinder can be traced back to organization of the pre
      implantation blastocyst. This in turn reflects the organization of the cleavage
      stage embryo and the animal-vegetal axis of the zygote. These findings suggest
      that the cleavage pattern of normal development may be involved in specifying the
      future embryonic axis; however, how and when this pattern becomes established is
      unclear. In many animal eggs, the sperm entry position provides a cue for
      embryonic patterning, but until now no such role has been found in mammals. Here
      we show that the sperm entry position predicts the plane of initial cleavage of
      the mouse egg and can define embryonic and abembryonic halves of the future
      blastocyst. In addition, the cell inheriting the sperm entry position acquires a
      division advantage and tends to cleave ahead of its sister. As cell identity
      reflects the timing of the early cleavages, these events together shape the
      blastocyst whose organization will become translated into axial patterning after
      implantation. We present a model for axial development that accommodates these
      findings with the regulative nature of mouse embryos.

PMID- 11206549
TI  - Adherens junctions inhibit asymmetric division in the Drosophila epithelium.
AB  - Asymmetric division is a fundamental mechanism for generating cellular diversity.
      In the central nervous system of Drosophila, neural progenitor cells called
      neuroblasts undergo asymmetric division along the apical-basal cellular axis.
      Neuroblasts originate from neuroepithelial cells, which are polarized along the
      apical-basal axis and divide symmetrically along the planar axis. The asymmetry
      of neuroblasts might arise from neuroblast-specific expression of the proteins
      required for asymmetric division. Alternatively, both neuroblasts and
      neuroepithelial cells could be capable of dividing asymmetrically, but in
      neuroepithelial cells other polarity cues might prevent asymmetric division. Here
      we show that by disrupting adherens junctions we can convert the symmetric
      epithelial division into asymmetric division. We further confirm that the
      adenomatous polyposis coli (APC) tumour suppressor protein is recruited to
      adherens junctions, and demonstrate that both APC and microtubule-associated EB1
      homologues are required for the symmetric epithelial division along the planar
      axis. Our results indicate that neuroepithelial cells have all the necessary
      components to execute asymmetric division, but that this pathway is normally
      overridden by the planar polarity cue provided by adherens junctions.

PMID- 11206550
TI  - Complexes of MADS-box proteins are sufficient to convert leaves into floral
      organs.
AB  - Genetic studies, using floral homeotic mutants, have led to the ABC model of
      flower development. This model proposes that the combinatorial action of three
      sets of genes, the A, B and C function genes, specify the four floral organs
      (sepals, petals, stamens and carpels) in the concentric floral whorls. However,
      attempts to convert vegetative organs into floral organs by altering the
      expression of ABC genes have been unsuccessful. Here we show that the class B
      proteins of Arabidopsis, PISTILLATA (PI) and APETALA3 (AP3), interact with
      APETALA1 (AP1, a class A protein) and SEPALLATA3 (SEP3, previously AGL9), and
      with AGAMOUS (AG, a class C protein) through SEP3. We also show that vegetative
      leaves of triply transgenic plants, 35S::PI;35S::AP3;35S::AP1 or
      35S::PI;35S::AP3;35S::SEP3, are transformed into petaloid organs and that those
      of 35S::PI;35S::AP3;35S::SEP3;35S::AG are transformed into staminoid organs. Our
      findings indicate that the formation of ternary and quaternary complexes of ABC
      proteins may be the molecular basis of the ABC model, and that the flower
      specific expression of SEP3 restricts the action of the ABC genes to the flower.

PMID- 11206551
TI  - Genome sequence of enterohaemorrhagic Escherichia coli O157:H7.
AB  - The bacterium Escherichia coli O157:H7 is a worldwide threat to public health and
      has been implicated in many outbreaks of haemorrhagic colitis, some of which
      included fatalities caused by haemolytic uraemic syndrome. Close to 75,000 cases
      of O157:H7 infection are now estimated to occur annually in the United States.
      The severity of disease, the lack of effective treatment and the potential for
      large-scale outbreaks from contaminated food supplies have propelled intensive
      research on the pathogenesis and detection of E. coli O157:H7 (ref. 4). Here we
      have sequenced the genome of E. coli O157:H7 to identify candidate genes
      responsible for pathogenesis, to develop better methods of strain detection and
      to advance our understanding of the evolution of E. coli, through comparison with
      the genome of the non-pathogenic laboratory strain E. coli K-12 (ref. 5). We find
      that lateral gene transfer is far more extensive than previously anticipated. In
      fact, 1,387 new genes encoded in strain-specific clusters of diverse sizes were
      found in O157:H7. These include candidate virulence factors, alternative
      metabolic capacities, several prophages and other new functions--all of which
      could be targets for surveillance.

PMID- 11206552
TI  - Genomic binding sites of the yeast cell-cycle transcription factors SBF and MBF.
AB  - Proteins interact with genomic DNA to bring the genome to life; and these
      interactions also define many functional features of the genome. SBF and MBF are
      sequence-specific transcription factors that activate gene expression during the
      G1/S transition of the cell cycle in yeast. SBF is a heterodimer of Swi4 and
      Swi6, and MBF is a heterodimer of Mbpl and Swi6 (refs 1, 3). The related Swi4 and
      Mbp1 proteins are the DNA-binding components of the respective factors, and Swi6
      mayhave a regulatory function. A small number of SBF and MBF target genes have
      been identified. Here we define the genomic binding sites of the SBF and MBF
      transcription factors in vivo, by using DNA microarrays. In addition to the
      previously characterized targets, we have identified about 200 new putative
      targets. Our results support the hypothesis that SBF activated genes are
      predominantly involved in budding, and in membrane and cell-wall biosynthesis,
      whereas DNA replication and repair are the dominant functions among MBF activated
      genes. The functional specialization of these factors may provide a mechanism for
      independent regulation of distinct molecular processes that normally occur in
      synchrony during the mitotic cell cycle.

PMID- 11206553
TI  - Arrangement of RNA and proteins in the spliceosomal U1 small nuclear
      ribonucleoprotein particle.
AB  - In eukaryotic cells, freshly synthesized messenger RNA (pre-mRNA) contains
      stretches of non-coding RNA that must be excised before the RNA can be translated
      into protein. Their removal is catalysed by the spliceosome, a large complex
      formed when a number of small nuclear ribonucleoprotein particles (snRNPs) bind
      sequentially to the pre-mRNA. The first snRNP to bind is called U1; other snRNPs
      (U2, U4/U6 and U5) follow. Here we describe the three-dimensional structure of
      human U1 snRNP, determined by single-particle electron cryomicroscopy at 10 A
      resolution. The reconstruction reveals a doughnut-shaped central element that
      accommodates the seven Sm proteins common to all snRNPs, supporting a proposed
      model of circular Sm protein arrangement. By taking earlier biochemical results
      into account, we were able to assign the remaining density of the map to the
      other known components of U1 snRNP, deriving a structural model that describes
      the three-dimensional arrangement of proteins and RNA in U1 snRNP.

PMID- 11206554
TI  - Laser Raman and IR spectra and force fields for 2,4-dichlorobenzonitrile.
AB  - Raman spectrum of 2,4-dichlorobenzonitrile (2,4-DCBN) in powder form has been
      recorded in the region 50-4000 cm(-1) on a Jasco K-500 Raman spectrophotometer
      using the 488.0 nm radiation from an argon laser. FTIR spectra in the region 200
      4000 cm(-1) have been recorded in KBr pellet and nujol mull on a Nicolet DX
      spectrometer. Using the observed Raman and IR frequencies, normal co-ordinate
      analysis has been carried out to support the vibrational analysis and to
      determine the planar and non-planar force fields.

PMID- 11206555
TI  - Study on fluorescent property of degrading products of piperacillin and its
      analytical application.
AB  - The fluorimetric property of the degrading products of piperacillin has been
      studied in detail. The studies on degrading pH, degrading time, detection
      alkalinity and other corresponding analytical parameters of acid degradation have
      been made. Then fluorometry of piperacillin was established by producing its
      stable fluorescent products. The detection limit for acid degradation analytical
      method is 2.34 ng/ml, the linear range is 7.80-4.0 x 10(2) ppb. The analytical
      sensitivity, precision and stability of degrading products of acid degradation
      are satisfactory, which has been used for the determination of the trace
      piperacillin in human serum and urine with satisfactory results.

PMID- 11206556
TI  - Charge-transfer complex formation between o-chloranil and a series of polynuclear
      aromatic hydrocarbons.
AB  - The equilibrium constants, enthalpies and entropies of formation of molecular
      electron donor-acceptor (EDA) complexes of o-chloranil with a series of aromatic
      hydrocarbons have been determined spectrophotometrically. Spectroscopic and
      thermodynamic aspects of these complexes have been analysed.

PMID- 11206557
TI  - The effect of pressure and temperature on the vibrational spectra of different
      hydrogen bonded systems.
AB  - The effect of pressure and temperature on the vibrational spectra of hydrogen
      bonded systems has been studied on amides, thioamides, carboxylic acids and urea.
      The compounds under investigation are indicative for the kind of hydrogen bonding
      changing from pure intermolecular to intramolecular and dimeric forms. The
      discussion of the temperature dependence on the fundamentals involved in the
      hydrogen bonding is straightforward but the pressure data are much more
      complicated and only if the changes in the crystalline state at different
      pressures are known, we will have a better understanding of the dependence of
      some fundamentals in the hydrogen bonded systems. A clear example of this
      approach is given for urea.

PMID- 11206558
TI  - Vibrational spectroscopic study of DL-methionine dihydrogen phosphate.
AB  - The two methionine cations in the asymmetric part of the unit cell of bis(DL
      methionine dihydrogen phosphate) have different conformations. This, together
      with the different environments seen by the two -CH2- groups in each skeleton
      cause several of the group wavenumbers to occur as doublets or as broad bands.
      The anion contains two dissimilar P-O bonds, which distorts the phosphate
      tetrahedron. Due to this, the stretching wavenumbers appear as doublets. There is
      extensive hydrogen bonding in the system in all three crystallographic directions
      and this is responsible for the changes in the position and intensity of several
      bands. Fermi resonance has also been observed.

PMID- 11206559
TI  - The infrared intensities and polar tensors of the fluorochloromethanes.
AB  - The polar tensors of CF3Cl, CF2Cl2 and CFCl3 have been calculated using recent
      measurements of their gas phase infrared fundamental intensities. The polar
      tensors obtained for CF2Cl2 and CFCl3 are in very good agreement with those
      obtained previously since the more recent experimental intensity results are in
      good agreement with those reported earlier. For CF2Cl2 rhoC = +1.626, rhoF = 
      0.577 and rhoCl = -0.26e whereas rhoC = +1.369, 0.478 and rhoCl = 0.297e for
      CFCl3. However, two sets of significantly different mean dipole moment
      derivatives are obtained from the experimentally measured intensities of CF3Cl
      reported by two different laboratories. On the other hand, the differences in the
      mean derivatives of these two sets are not large enough so that results from
      electronegativity models, potential models for core ionization energies and
      quantum chemical calculations at the Moller-Plesset 2 and B3LYP density
      functional levels are sufficient to indicate which set is the correct one. As
      such average values of rhoC = +1.907+/-0.178e, rhoF = -0.590+/-0.056e and rhoCl =
      -0.139+/-0.013e obtained from both sets of polar tensor elements are recommended
      for the CF33Cl mean dipole moment derivatives.

PMID- 11206560
TI  - Molecular structure and vibrational spectra of phenolphthalein and its dianion.
AB  - Infrared (IR) and Raman spectra of phenolphthalein (PP) and its dianion form
      (sodium and potassium salts) were studied both in the solid state and in aqueous
      solution. Band assignments were carried out on the basis of the isotope shifts of
      the ring deuterated and 13C-substituted derivatives. Spectral analyses reveal
      that the PP dianion exists as mixtures of the benzenoid form (colorless) and the
      quinonoid form (colored) in the solid state and in aqueous solution, while the
      neutral PP solely takes the gamma-lactone form. This work provides the first
      vibrational spectroscopic evidence for the coexistence of the two species in the
      PP dianions.

PMID- 11206561
TI  - Thermal and optical properties of Tm3+ doped tellurite glasses.
AB  - Ultraviolet, visible (UV/VIS) and differential thermal analysis (DTA)
      measurements were carried out in order to investigate the optical and thermal
      properties of various 0.5 mol.% Tm2O3 containing (1 - x)TeO2 + xLiCl glasses in
      molar ratio. The samples were prepared by fusing the mixture of their respective
      reagent grade powders in a platinum cricuble at 750 degrees C for 30 min. DTA
      curves taken in the 23-600 degrees C temperature range with a heating rate of 10
      degrees C/min reveal a change in the value of the glass transition temperature,
      Tg, while melting was not observed for the glasses containing LiCl content less
      than 50 mol.%. These glasses were found to be moisture-resistant. However, the
      glasses with LiCl content higher than 50 mol.%, in which a melting peak was
      observed at Tc = 401 degrees C, were moisture-sensitive. Absorption measurements
      in the UV/VIS region of the glasses without Tm2O3 content show that the Urbach
      cutoff occurs at about 320 nm and, is relatively independent of the LiCl content.
      Six absorption bands were observed in the Tm2O3 doped glasses corresponding to
      the absorption of the 1G4, 3F2, 3F3 and 3F4, 3H5 and 3H4 levels from the 3H6
      ground level of Tm3+ ions. The spectra also show that the integrated absorption
      cross-section of each band depends on the glass composition. Judd-Ofelt theory
      was used to determine the Judd-Ofelt parameters as well as the radiative
      transition probabilities for the metastable levels of Tm3+ ions in (0.3)LiCl +
      (0.7) TeO2: 0.01 Tm2O3 glass which is moisture-resistant.

PMID- 11206562
TI  - Surface enhanced fluorescence and Raman imaging of Langmuir-Blodgett azopolymer
      films.
AB  - The spectroscopic properties and surface-enhanced spectra of Langmuir-Blodgett
      (LB) films of methacrylic homopolymer (HPDR13) are presented. It is shown that LB
      film displays strong fluorescence attributed to the spatial restrictions imposed
      by its structure. The emission is observed in conjunction with
      photoisomerization, a process clearly demonstrated by the formation of surface
      relief gratings in the LB film [C.R. Mendonca et al., Macromolecules 32 (1999)
      1493]. Surface-enhanced Raman scattering (SERS), Surface-enhanced resonance Raman
      scattering (SERRS) and surface-enhanced fluorescence (SEF) were observed for LB
      films of HPDR13 deposited onto silver island films. SERS measurements were also
      carried out on a sample fabricated with one monolayer LB film deposited onto
      silver islands followed by one overlayer of silver (LB sandwiched between two
      layers of silver islands). The polymer interacts very weakly with the metal
      surface (physisorption), and the enhancement effect is determined by the local
      electric field enhancement. The strong SERS and SERRS signals were suitable for
      micro-Raman imaging. Line, area mapping and global images of the LB monolayer on
      silver island are reported. The transfer ratio in the fabrication of the LB
      suggests a homogeneous coating of the silver islands, thereby the chemical images
      show the variation of the SERS intensity due to surface enhancement.

PMID- 11206563
TI  - An experimental and theoretical study of excited-state dipole moments of some
      flavones using an efficient solvatochromic method based on the solvent polarity
      parameter, E(N)(T).
AB  - The electronic absorption and fluorescence spectra of some biologically active
      natural flavones have been recorded at room temperature (298 K) in solvents of
      different polarities. The effects of the solvents upon the spectral properties
      are discussed. Difference in fluorescence intensity of flavones has been
      explained on the basis of intersystem crossing and degree of non-planarity
      calculated theoretically using Austin Model 1 (AM1) method. Excited-state dipole
      moments have been determined using the solvatochromic method based on the
      microscopic solvent polarity parameter, E(N)(T). A reasonable agreement has been
      observed between experimental and AM1 calculated dipole moment changes. Our
      results are found to be quite reliable in view of the fact that the correlation
      of the solvatochromic Stokes shifts with microscopic solvent polarity parameter,
      E(N)(T) is superior to that obtained using bulk solvent polarity functions for
      all the systems studied here.

PMID- 11206564
TI  - Intramolecular excited-state proton-transfer studies on flavones in different
      environments.
AB  - The absorption and fluorescence spectra of some biologically active flavones have
      been studied as a function of the acidity (pH/H0) of the solution. Dissociation
      constants have been determined for the ground and first excited singlet states.
      The results are compared with those obtained from Forster-Weller calculations.
      The acidity constants obtained by fluorimetric titration method are in complete
      agreement (in most of the systems) with ground state data indicating a excited
      state deactivation prior to prototropic equilibration. Compared to
      umbelliferones, flavones are only weakly fluorescent in alkaline solution. This
      behaviour is explained by the small energy difference between the singlet excited
      state and triplet excited state giving rise to more efficient intersystem
      crossing. Most of the flavones studied here undergo adiabatic photodissociation
      in the singlet excited state indicating the formation of an exciplex or a
      phototautomer.

PMID- 11206565
TI  - Absorption spectroscopic study of EDA complexes of.
AB  - [70]Fullerene has been shown to form 1:1 molecular complexes with toluene, p
      xylene, m-xylene, 1,2,4,5-tetramethyl benzene (durene) and pentamethyl benzene
      (PMB) in CCl4 medium by absorption spectroscopic method. Isosbestic points have
      been detected in case of complexes with PMB and durene. Charge transfer
      absorption band could not be detected but the intensity of the broad absorption
      band of C70 in CCl4 decreases systematically with increase in the concentration
      of the added methylbenzenes. From this trend the formation constants (Kc) of the
      complexes have been determined at three different wavelengths. The constancy of
      Kc with respect to change in the wavelength of measurement supports the view that
      complex of a single stoichiometry (1:1) is formed in each case.

PMID- 11206566
TI  - Study of the adsorptive behavior of water-soluble dye molecules (rhodamine 6G) at
      the air-water interface using confocal fluorescence microscope.
AB  - A confocal fluorescence microscope was applied to directly study the
      characteristic behaviors of adsorbed molecules at the air-water interface for a
      water-soluble chromophore, rhodamine 6G (R6G), in its extremely low-concentration
      region (below 10(-10) M). Significant photon bursts were observed only from the
      surface, and their width, height, and frequency were found to depend on the bulk
      concentration, suggesting the inhomogeneous distribution of R6G molecules at the
      air-water interface. This property of the adsorbed molecules is different from
      that of the bulk one. The influence of the ionic strength on photon bursts from
      the interface was investigated. It was found that the addition of NaCl to the R6G
      solution caused a decrease of the fluorescence signal. A change in the size of
      the aggregate and in the fluorescence quantum yield of the adsorbed molecules was
      suggested to be responsible for this experimental result.

PMID- 11206567
TI  - Eigenvalues and principal component loadings of heavily overlapped vibrational
      spectra.
AB  - In order to illustrate the possibilities of principal component analysis in
      determining the number of components in a system of heavily overlapped spectra,
      several numerical spectral models were formed of bands with very close
      parameters. The models consisted of three bands, whose peak positions were
      locally shifted and noise added. For all the cases the relations between
      eigenvalues and principal component loadings were considered. It was shown that
      for those complex spectra for which peak positions and band halfwidths can be
      determined with high accuracy, eigenvalues criteria could easily indicate the
      number of components. For all analyzed models, the consideration of the shape of
      loadings was proven to have a high importance. In limited number of cases the
      shape of a loading can make the results of eigenvalue analysis more
      understandable. It has been shown that the noise can be treated as a main
      limitation in the application of the method to this type of the spectra.

PMID- 11206568
TI  - Vibrational overtone spectra of chloroanilines--evidence for intramolecular
      hydrogen bonding in o-chloroaniline.
AB  - The near infrared vibrational overtone absorption spectra of liquid phase aniline
      and chloroanilines are reported. The analysis of the observed CH and NH local
      mode mechanical frequency values shows that intramolecular hydrogen bonding
      occurs between NH2 group and chlorine atom in o-chloroaniline. This observation
      supports the conclusion drawn from microwave spectroscopic studies reported
      earlier.

PMID- 11206569
TI  - Spectrofluorimetric determination of Er (III) with diantipyrylmethane.
AB  - The optimum fluorescence conditions for erbium (III) are obtained by irradiating
      this lanthanide at 435 nm in 0.04 microg ml(-1) diantipyrylmethane solution at pH
      = 8 (lambdaem = 510 nm). The method proposed is satisfactory for the
      determination of erbium (III) in the range of 0.001 to 1 microg ml(-1). The
      relative standard deviation 0.02 microg ml(-1) Er (III) in 0.04 microg ml(-1)
      diantipyrylmethane solution is 1.1%. The effect of other rare earths upon the
      intensity of the fluorescence emitted by erbium (III) is discussed.

PMID- 11206570
TI  - Vibration and vibronic spectra of lanthanide compounds with different types of
      coordination polyhedra of tungsten and molybdenum.
AB  - Luminescence excitation vibronic spectra as well as IR and Raman spectra of about
      50 primary, binary and ternary lanthanide tungstates and molybdates and compounds
      with mixed anions (doped by Eu3+ ions) relating to about 15 structural types were
      analysed. Correlation of the types of isolated and joint coordination polyhedra
      of tungsten or molybdenum with details of the vibration and Eu3+ vibronic spectra
      was investigated.

PMID- 11206571
TI  - Emission spectra studies on the hydrogen-bonding complexes between p-methoxy-2
      styrylquinoline and acids.
AB  - The ground and excited state interactions between p-methoxy-2-styrylquinoline (2
      StQ-OMe) and different protic acids with various acid concentrations were studied
      in different media. Emission bands due to the hydrogen bonding complex,
      protonation complex and aggregation or solid complex were observed for the first
      time, in n-hexane. The different reaction pathways were controlled by the solvent
      polarity and the concentrations of the protic acid. The acidity of acid was also
      important to the acid-base complex.

PMID- 11206572
TI  - Infrared evidence of NO linkage photoisomerization in Na2[Fe(CN)5NO].2H2O at low
      temperature: experimental and theoretical (DFT) isotopic shifts from 15n(O), 18O
      and 54Fe species.
AB  - Infrared spectra of the metastable state I (MSI) of normal and 15NO, N18O and
      54Fe isotopically substituted sodium nitroprusside dihydrate
      (Na2[Fe(CN)5NO].2H2O) have been obtained at 77 K. A comparison of the isotopic
      shifts measured for the vibrational modes of the FeXY (XY = NO or ON) moiety with
      those calculated by means of quantum chemistry (DFT) procedures supports the
      linear Fe-O = N arrangement for the MSI state.

PMID- 11206573
TI  - Tautomerism and infrared spectra of 2-thiopurine: an experimental matrix
      isolation and theoretical ab initio and density functional theory study.
AB  - Infrared spectra of 2-thiopurine (2-mercaptopurine, 2-purinethiol ) isolated in
      low-temperature Ar and N2 matrixes are reported. These spectra indicate that the
      compound adopts exclusively the thiol N9H tautomeric form. The theoretical
      calculations of relative energies of 2-thiopurine tautomers have been carried out
      at the MP4(SDTQ)//HF level using the 6-31G(d,p) basis set. The thiol N9H tautomer
      was predicted to be the most stable of all isomers of 2-thiopurine. The infrared
      spectra of the tautomers of 2-thiopurine have been calculated at the DFT(B3LYP)/6
      31G(d,p) level. Good agreement between the experimental spectra and the spectra
      calculated for thiol N9H tautomer supported the identification of the dominant
      tautomer. It has also allowed for the reliable assignment of the bands observed
      in the experimental IR spectrum.

PMID- 11206574
TI  - Study of properties on non-protected room temperature phosphorescence and delayed
      excimer fluorescence of pyrene solution.
AB  - A strong and stable room temperature phosphorescence (RTP) and delayed excimer
      fluorescence signal located at 596 and 475 nm, respectively, can be induced for
      pyrene solution in the absence of any protective medium only use KI or TlNO3 as a
      heavy atom perturber (HAP) and Na2SO3 as a deoxygenator. Both lifetimes of RTP
      and the delayed fluorescence are in the order of X-ms and the intensities are
      changed with kind and amount of HAP, but the peak positions are same and there is
      a iso-luminescent point in the emission spectra corresponding to emission at 475
      nm and at 596 nm. The optimum conditions and the effects of kind and amount of
      HAP and organic solvents on luminescence properties of pyrene solution were
      studies in detail, and the photophysical process in the presence of KI or TlNO3
      for phosphorescence and delayed excimer fluorescence emission of pyrene solution
      was discussed.

PMID- 11206575
TI  - An engineered lox sequence containing part of a long terminal repeat of HIV-1
      permits Cre recombinase-mediated DNA excision.
AB  - In our previous report, one 34-bp sequence from a long terminal repeat (LTR) of
      human immunodeficiency virus type 1 (HIV-1) clone, loxLTR-1, was proposed as a
      target site for site-specific excision by modified Cre recombinase. To support
      this suggestion, an engineered lox sequence, designated loxIL1, was made. This
      variant lox has the corresponding sequence of loxLTR-1 at the spacer region and
      the last two bases of inverted repeat sequence. Through in vitro recombination
      assay, loxIL1 also allowed the wild-type Cre to specifically recombine the
      sequence. An in vitro DNA binding experiment with mutants CreK244R and CreK244L
      revealed that lysine 244 of Cre plays an important role in interaction with the
      engineered lox. This result suggests that loxLTR-1 would be a candidate for
      antiviral strategy using site-specific recombinase.

PMID- 11206576
TI  - Changes in lung-specific molecular expression during differentiation of hamster
      embryonic M3E3/C3 cell line.
AB  - To clarify the differentiation mechanisms of bronchiolar epithelial cells,
      changes at the transcription level of epithelial cell-specific proteins were
      examined using M3E3/C3, a cell line derived from hamster fetal lung. During a 9
      day incubation period with 24 microg/mL of retinol, the cells became attached to
      each other and formed large bud-like structures which could be detected with
      periodic acid-Schiff staining. During the incubation period, the mRNA level of
      surfactant-associated protein-B significantly increased 2.6- and 5.4-fold higher
      than cells incubated without retinol on days 3 and 9, respectively. The Clara
      cell-specific secretory protein mRNA level also increased and peaked at 5.1-fold
      (P < 0.05) on day 5 compared with control cells. In contrast, mRNA for surfactant
      associated protein-C, an alveolar type II cell-specific protein, decreased.
      Moreover, the expression of the gene for hepatocyte nuclear factor 3alpha, a
      putative transactivating factor for lung-related genes, was up-regulated
      resulting in consistently higher levels (2.4- to 5.6-fold) compared with
      controls, while those for transmembrane-type mucin-1 and glyceraldehyde-3
      phosphate dehydrogenase were constantly expressed during the incubation. The
      present study confirms that at the gene transcription level M3E3/C3 cells
      differentiate into Clara-like cells with mucus granules in the presence of
      retinol.

PMID- 11206577
TI  - Effect of oxidative stress on stability and structure of neurofilament proteins.
AB  - Neurofilament proteins are highly phosphorylated molecules in the axonal
      compartment of the adult nervous system. We report the structural analysis of
      neurofilament proteins after oxidative damage. SDS-PAGE, immunoblotting, circular
      dichroism, and Fourier transform infrared spectroscopy were used to investigate
      the relative sensitivity of neurofilaments to oxidative stress and to identify
      changes in their molecular organization. An ascorbate-Fe+3-O2 buffer system as
      well as catechols were used to generate free radicals on a substrate of
      phosphorylated and dephosphorylated neurofilaments. By Fourier Transform Infrared
      spectroscopy and circular dichroism, we established that the neurofilament
      secondary structure is mainly composed of alpha-helices and that after free
      radical damage of the peptide backbone of neurofilaments, those helices are
      partly modified into beta-sheet and random coil structures. These characteristic
      reorganizations of the neurofilament structure after oxidative exposure suggest
      that free radical activity might play an important role in the biogenesis of the
      cytoplasmic inclusions found in several neurodegenerative diseases.

PMID- 11206578
TI  - The interaction of ferrocytochrome c with long-chain fatty acids and their CoA
      and carnitine esters.
AB  - Non-covalent modification of cytochrome c may have implications for electron
      transport and energy metabolism. We examined the interaction of various fatty
      acids (FAs), their coenzyme A and carnitine esters, and fatty alcohols with horse
      heart ferrocytochrome c. A comparison of FAs indicated a minimum chain length of
      14 carbons was required for significant effect on the ferroheme chromophore and
      major changes in electronic spectra. Coenzyme A and carnitine esters interacted
      less strongly than FAs whereas long-chain alcohols did not interact with the
      protein. We found a single, saturable FA binding site with Kd (oleate) of 23.1
      microM (by stopped-flow kinetics), 30 microM (by radiochemical binding assay),
      and 29 microM (by spectrophotometric assay). The binding stoichiometry was 1:1.
      We present evidence from electronic spectra, and proton NMR (nuclear magnetic
      resonance) that the S-Fe coordination (methionine 80) was disrupted by ligand
      binding. From molecular modeling we identify a putative binding channel flanked
      by lysines 72 and 73.

PMID- 11206579
TI  - A comparative hybridization analysis of yeast DNA with Paramecium parafusin- and
      different phosphoglucomutase-specific probes.
AB  - Molecular probes designed for the parafusin (PFUS), the Paramecium exocytic
      sensitive phosphoglycoprotein, gave distinct hybridization patterns in
      Saccharomyces cerevisiae genomic DNA when compared with different
      phosphoglucomutase specific probes. These include two probes identical to
      segments of yeast phosphoglucomutase (PGM) genes 1 and 2. Neither of the PGM
      probes revealed the 7.4 and 5.9 kb fragments in Bgl II-cut yeast DNA digest
      detected with the 1.6 kb cloned PFUS cDNA and oligonucleotide constructed to the
      PFUS region (insertion 3--I-3) not found in other species. PCR amplification with
      PFUS-specific primers generated yeast DNA-species of the predicted molecular size
      which hybridized to the I-3 probe. A search of the yeast genome database produced
      an unassigned nucleotide sequence that showed 55% identity to parafusin gene and
      37% identity to PGM2 (the major isoform of yeast phosphoglucomutase) within the
      amplified region.

PMID- 11206580
TI  - Antioxidant activity levels and oxidative stress as blood markers of allergic
      response to drugs.
AB  - Antioxidant enzymes work together in human blood cells against toxic reactive
      oxygen species. Although their relationship with several pathophysiologic
      processes has been stated, not much is known about the connection between
      antioxidant defence and allergy. This study was designed to determine the
      enzymatic activities and the oxidative indices in the blood and serum proteins in
      patients suffering from allergy to drugs. We hypothesize that serum and blood
      reactions may serve as useful clinical marker for the allergic state. We used
      enzymatic antioxidant activities, thiobarbituric acid reactive substances, and
      carbonyl contents of proteins as suitable markers. We determined superoxide
      dismutases, glutathione peroxidase and catalase activities in each cell type.
      After antihistaminics plus steroids were given as part of a protocol treatment,
      enzymatic antioxidant activities, thiobarbituric acid reactive substance levels,
      and carbonyl contents were used as recovering markers for the disease. We found a
      relationship between antioxidant enzymatic activities, thiobarbituric acid
      reactive substance levels, and carbonyl contents for allergic reactions belonging
      to several type I and type IV allergies, as well as cross-reactive intolerance to
      nonsteroidal anti-inflammatory drugs and an anaphylactoid reaction to a
      radiocontrast media. A similar pattern also exists for analogous allergic
      manifestations and disease-like status.

PMID- 11206581
TI  - Flammulin: a novel ribosome-inactivating protein from fruiting bodies of the
      winter mushroom Flammulina velutipes.
AB  - A protein with a molecular weight of 40 kDa, capable of inhibiting cell-free
      translation in a rabbit reticulocyte lysate system with an IC50 of 0.25 nM, was
      isolated from fruiting bodies of the mushroom Flammulina velutipes. The protein,
      designated flammulin, was devoid of ribonuclease activity. Flammulin was
      unadsorbed on DEAE-cellulose at neutral pH and low ionic strength and adsorbed on
      CM-Sepharose and Affi-gel blue gel under similar conditions. Its N-terminal
      sequence demonstrates sites of similarity to those of plant ribosome-inactivating
      proteins (RIPs).

PMID- 11206582
TI  - The chicken stathmin gene and its expression in the embryo.
AB  - Stathmin, which functions as an intracellular relay in signal transduction
      pathways, has been suggested as a potential indicator of pluripotent cells in the
      early mouse embryo. In this study, chicken stathmin cDNA and genomic DNA were
      analyzed. In mammals stathmin consists of five exons and four introns; exons 3,
      4, and 5 in the mammalian stathmin gene are equivalent to one relatively large
      exon in the chicken stathmin gene. Introns equivalent to introns 3 and 4 in the
      mammalian stathmin gene are not present in the counterpart gene in chickens and,
      although intron 2 was shown to be present in both mammals and birds, it is
      smaller in the chicken stathmin gene. Despite differences in the genomic
      organization of the gene and its smaller size in chickens compared with that in
      humans and mice, similarities in the coding sequences and in the expression of
      the chicken and mouse stathmin genes at certain stages of embryo development, as
      determined by whole-mount in situ hybridization experiments, suggest that their
      products are functional homologues. The argument is thus substantiated for
      further investigations into the use of regulatory regions of the stathmin gene in
      a system for the establishment of long-term cultures of germline competent
      chicken embryonic stem (ES) cells by the selective ablation of differentiated
      cells in culture using drug selection.

PMID- 11206583
TI  - Tamoxifen inhibits phorbol ester stimulated osteoclastic bone resorption: an
      effect mediated by calmodulin.
AB  - Tamoxifen inhibits bone resorption by disrupting calmodulin-dependent processes.
      Since tamoxifen inhibits protein kinase C in other cells, we compared the effects
      of tamoxifen and the phorbol ester, phorbol myristate acetate, on osteoclast
      activity. Phorbol esters stimulate bone resorption and calmodulin levels four
      fold (k0.5 = 0.1-0.3 microM). In contrast, tamoxifen inhibited osteoclast
      activity approximately 60% with an IC50 of 1.5 microM, had no apparent effect on
      protein kinase C activity in whole-cell lysates, and reduced protein kinase C
      alpha recovered by immunoprecipitation 75%. Phorbol esters stimulated resorption
      in a time-dependent manner that was closely correlated with a similar-fold
      increase in calmodulin. Protein kinase C alpha, beta, delta, epsilon, and zeta
      were all down-regulated in response to phorbol ester treatment. Tamoxifen and
      trifluoperazine inhibited PMA-dependent increases in bone resorption and
      calmodulin by 85 +/- 10%. Down-regulation of protein kinase C isoforms by phorbol
      esters suggests that the observed increases in bone resorption and calmodulin
      levels are most likely due to a mechanism independent of protein kinase C and
      dependent on calmodulin. In conclusion, the data suggest that protein kinase C
      negatively regulates calmodulin expression and support the hypothesis that the
      effects of both phorbol esters and tamoxifen on osteoclast activity is mediated
      by calmodulin.

PMID- 11206584
TI  - Glycine cleavage enzyme complex: rabbit H-protein cDNA sequence analysis and
      comparison to human, cow, and chicken.
AB  - The H-protein is one of the four essential components (H-, L-, P-, and T
      proteins) of the mammalian glycine cleavage enzyme complex, the major degradative
      pathway of glycine. We have isolated the full-length cDNA of the H-protein gene
      from the rabbit (Oryctolagus caniculus) by reverse transcription of liver poly-A
      mRNA and determined its nucleotide sequence (GenBank Acc. No. BankIt 31828

PMID- 11206585
TI  - Diagnostic yield of the lactate stress test in 160 patients with suspected
      respiratory chain disorder.
AB  - Aim of the present study was to investigate the diagnostic yield of the lactate
      stress-test in unselected patients with suspected respiratory-chain disorder
      (RCD). Serum lactate was determined before, during and after a 15-minute,
      constant 30W workload on a bicycle in 48 controls and 160 patients with suspected
      RCD. 122 had definite RCD, 38 neurological disorders other than RCD. The
      sensitivity, specificity, positive predictive value, negative predictive value
      and pre-test likelihood of the test was 69, 74, 89, 42 and 76% respectively. In
      conclusion, the lactate-stress-test proved a powerful tool to assess impaired
      oxidative metabolism in RCDs.

PMID- 11206586
TI  - Altered striatal dopamine D2 receptor density and dopamine transport in a patient
      with hepatic encephalopathy.
AB  - A patient suffering from liver cirrhosis presented with a bradykinetic-rigid
      syndrome suspected as Parkinson's disease. A detailed work-up of the case
      revealed hepatic encephalopathy as the cause of the neurological symptomatology.
      An alteration of striatal dopamine D2 receptor binding and dopamine re-uptake
      sites was demonstrated by 123I-iodobenzamide (IBZM) and 123I-beta-CIT single
      photon emission computed tomography (SPECT), respectively. It is suggested that
      the alteration of the dopamine re-uptake in cirrhotics may be the cause of an
      increased catabolism of dopamine in HE.

PMID- 11206587
TI  - Visual event-related potentials in cirrhotic patients without overt
      encephalopathy.
AB  - Ambulant patients with cirrhosis and no clinical evidence of encephalopathy were
      screened for impaired brain function by neuroelectrophysiological testing
      dependent on cognitive function. Infrequent large checkerboard visual stimuli
      were randomly interleaved with frequent small ones to elicit P300 event-related
      potentials (ERPs). Three ERP components, N200, P3a and P3b, were derived from the
      electroencephalogram (EEG) by computer averaging. The use of 10% contrast and a
      minimum of four precisely placed scalp electrodes were found to be necessary for
      optimal separation of ERPs from sensory evoked potentials. Visual ERPs,
      onset/offset and pattern-reversal visual evoked potentials (VEPs), the
      spontaneous EEG and the time taken to complete a standard number connection test
      (NCT) were obtained from 20 normal adult subjects and 19 age-matched patients
      with histologically-confirmed cirrhosis and no clinical evidence encephalopathy.
      The latencies and amplitudes of evoked potentials and the alpha rhythm of the EEG
      were determined. In 6 of the 19 patients the latencies of P3a and/or P3b exceeded
      the corresponding mean for controls + 2 standard deviations of that mean. In 4
      other patients the NCT was prolonged. In all of the patients the N200, VEPs and
      alpha rhythm of the EEG were normal. IN CONCLUSION: (i) Optimal isolation of ERPs
      is critically dependent on stimulus contrast and electrode placement; (ii) ERPs
      appear to be more sensitive than primary sensory evoked potentials or the EEG in
      detecting impaired brain neuroelectrophysiological function; and (iii) Cirrhotic
      patients without overt encephalopathy in whom P3a and/or P3b latencies are
      prolonged may have subclinical hepatic encephalopathy.

PMID- 11206588
TI  - Protective effect of riluzole on MPTP-induced depletion of dopamine and its
      metabolite content in mice.
AB  - The neuroprotective effects of riluzole (2-amino-6-trifluoromethoxy
      benzothiazole), a Na+ channel blocker with antiglutamatergic activity, MK-801, a
      blocker of N-methyl-D-aspartate (NMDA) receptors and monoamine oxidase (MAO)
      inhibitor pargyline were compared in the model of 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP)-induced depletion of dopamine and its metabolite 3,4
      dihydroxyphenylacetic acid (DOPAC) levels in mice. The mice received four
      intraperitoneal injections of MPTP (10 mg/kg) at 1-hr intervals and then the
      brains were analyzed at 1, 3 and 7 days after the treatments. Dopamine and DOPAC
      levels were significantly decreased in the striatum from 1 day after MPTP
      treatments. A severe depletion in dopamine and DOPAC levels was found in the
      striatum 3 and 7 days after MPTP treatments. Riluzole dose-dependently
      antagonized the MPTP-induced decrease in dopamine and DOPAC levels in the
      striatum. Pargyline also protected against MPTP-induced decrease in dopamine
      levels in the striatum. However, this drug showed no significant change in the
      striatal DOPAC levels. On the other hand, MK-801 failed to protect against MPTP
      induced decrease in dopamine levels in the striatum. However, MK-801 reversed the
      MPTP-induced decrease in DOPAC levels. These results suggest that riluzole can
      protect against MPTP-induced striatal dopamine and DOPAC depletion in mice. This
      protective effect may be caused by inactivation of voltage-dependent Na+ channels
      by riluzole. Furthermore, the present study suggests that the activation of NMDA
      receptors does not mainly contribute to MPTP-induced neurodegeneration, whereas
      MAO, especially MAO type B(MAO-B) plays a crucial role in MPTP-induced
      degeneration of the nigrostriatal dopaminergic neuronal pathway.

PMID- 11206589
TI  - Cyanide-induced free radical production and lipid peroxidation in rat brain
      homogenate is reduced by aspirin.
AB  - The neuroprotective properties of aspirin were investigated using cyanide-induced
      neurotoxicity as model. Cyanide, a known neurotoxic agent significantly increased
      lipid peroxidation and superoxide anion levels in rat brain homogenate in a
      concentration-dependent manner (0.25-1.0 mM). When homogenate, containing 1.0 mM
      KCN was co-treated with aspirin (1.0 mM) there was a significant decrease in
      lipid peroxidation. Aspirin (0.5 mM and 1.0 mM) also significantly reduced KCN
      induced superoxide anion generation. The results of the present report therefore
      indicate a neuroprotective role for aspirin.

PMID- 11206591
TI  - Intracellular pH measurements of the whole head and the basal ganglia in chronic
      liver disease: a phosphorus-31 MR spectroscopy study.
AB  - The purpose of this study was to determine the intracellular pH of the whole head
      and in voxels localized to the basal ganglia in patients with chronic liver
      disease using phosphorus-31 magnetic resonance spectroscopy (31P MRS). The study
      group compromised 82 patients with biopsy-proven cirrhosis (43 Child's grade A,
      25 Child's grade B and 14 Child's grade C). Eleven subjects showed no evidence of
      neuropsychiatric impairment on clinical, psychometric and electrophysiological
      testing, 37 showed evidence of minimal hepatic encephalopathy and 34 had overt
      hepatic encephalopathy. Unlocalized 31P MRS of the whole head was performed in 48
      patients and 10 healthy volunteers. Localized 31P MRS of the basal ganglia was
      performed in the 34 patients and in 20 healthy volunteers. The intracellular pH
      values were calculated from the chemical shift difference between the inorganic
      phosphate (P) and phosphocreatine (PCr) resonances. The percentage inorganic
      phosphate (%Pi), phosphocreatine (%PCr) and betaNTP signals, relative to the
      total 31P signal, and peak area ratios of inorganic phosphate and
      phosphocreatine, relative to betaNTP were also measured. There were no
      differences between patients and volunteers in intracellular pH in 31P MR spectra
      measured from the whole head or the basal ganglia. There was no correlation
      between the severity of encephalopathy (West Haven criteria) or liver dysfunction
      (Child score) and intracellular pH values. There was also no significant change
      in the inorganic phosphate, phosphocreatine or betaNTP resonances in spectra
      acquired from the whole head. However, in spectra localized to the basal ganglia,
      there was a significant increase in mean P/NTP (p=0.02) and PCr/NTP (p=0.009).
      The mean %Pi and mean %PCr were also increased (p=0.06; p=0.05, respectively),
      but there was no significant change in mean %betaNTP. When the patient population
      was classified according to the severity of encephalopathy, those with overt
      disease had a higher mean P/NTP and %Pi (p=0.03; p=0.01), compared to the
      reference population. Our results suggest that there are detectable bioenergetic
      abnormalities in patients with minimal hepatic encephalopathy or stable, overt
      chronic hepatic encephalopathy, but any associated intracellular pH change is
      probably a secondary, rather than a primary phenomenon.

PMID- 11206590
TI  - Glucose transporters and glucose utilization in rat brain after acute ethanol
      administration.
AB  - In the normal adult brain, glucose provides 90% of the energy requirements as
      well as substrate for nucleic acid and lipid synthesis. In the present study,
      effects of ethanol on glucose transporters (GLUT) and glucose utilization were
      examined in rat brain. Male Sprague-Dawley rats weighing 250-300 gms were given
      either ethanol 3 gm/kg BW or saline i.p. 4 hrs prior to the animal sacrifice and
      removal of the cerebral cortical tissue. The cortical plasma membranes analyzed
      by cytochalasin B binding assay showed a decrease in GLUT number but not in GLUT
      affinity in the ethanol treated rats as compared to the control rats. The
      estimated Ro values were 70 +/- 8.9 Vs 91 +/- 8.9 pmoles/mg protein (p < 0.05
      N=4) and the estimated Kd values were 0.37 +/- 0.03 and 0.28 +/- 0.05 microM (p:
      NS) in ethanol and control experiments respectively. Immunoblots of purified
      cerebral plasma membranes and low density microsomal fraction showed 17% and 71%
      decrease for GLUTI and 54% and 21% (p<0.05 or less; n=6) for GLUT3 respectively
      in ethanol treated rats than in control animals. Immunofluoresence studies also
      showed reduction of GLUT1 immunoreactively in choroid plexus and cortical
      microvessels of ethanol treated rats as compared to control rats. The effect of
      ethanol on regional cerebral metabolic rates for glucose (CMR(Glc)) was studied
      using [6-(14)C] glucose and showed statistically insignificant decrease in brain
      glucose utilization. These data suggest that ethanol in-vivo decrease GLUT number
      and protein content in rat cerebral cortex.

PMID- 11206592
TI  - New drug discovery in the postgenomic era: from genomics to proteomics.
AB  - We have entered an exciting new era in which the nearly completed mapping of the
      human genome is now leading to the ability to characterize the human proteome,
      thereby expanding the horizon for new drug development by 3 orders of magnitude.
      Figuring out which proteins are involved in which disorders and in which
      individuals with any given disorder holds the promise of highly individualized
      therapeutics in the not so distant future.

PMID- 11206593
TI  - Citalopram therapy for depression: a review of 10 years of European experience
      and data from U.S. clinical trials.
AB  - BACKGROUND: This review summarizes and evaluates clinical experience with
      citalopram, the latest selective serotonin reuptake inhibitor (SSRI) to be
      approved for the treatment of depression in the United States. DATA SOURCES:
      Published reports of randomized, double-blind, controlled clinical studies of
      citalopram were retrieved using a MEDLINE literature search. Search terms
      included citalopram, SSRI, TCA (tricylic antidepressant), depression, and
      clinical. For each study, data on antidepressant efficacy and adverse events were
      evaluated. Pharmacokinetic studies and case reports were reviewed to supplement
      the evaluation of citalopram's safety and tolerability. Data presented at major
      medical conferences and published in abstract form also were reviewed. STUDY
      FINDINGS: Thirty randomized, double-blind, controlled studies of the
      antidepressant efficacy of citalopram were located and reviewed. In 11 studies,
      citalopram was compared with placebo (1 of these studies also included comparison
      with another SSRI). In 4 additional studies, the efficacy of citalopram in
      preventing depression relapse or recurrence was investigated. In another 11
      studies (including 1 meta-analysis of published and unpublished trials),
      citalopram was compared with tricyclic and tetracyclic antidepressants. Finally,
      results are available from 4 studies in which citalopram was compared with other
      SSRIs. A placebo-controlled study of citalopram for the treatment of panic
      disorder was reviewed for data on long-term adverse events. CONCLUSION: Data
      published over the last decade suggest that citalopram is (1) superior to placebo
      in the treatment of depression, (2) has efficacy similar to that of the tricyclic
      and tetracyclic antidepressants and to other SSRIs, and (3) is safe and well
      tolerated in the therapeutic dose range of 20 to 60 mg/day. Distinct from some
      other agents in its class, citalopram exhibits linear pharmacokinetics and
      minimal drug interaction potential. These features make citalopram an attractive
      agent for the treatment of depression, especially among the elderly and patients
      with comorbid illness.

PMID- 11206594
TI  - Safety and tolerability of a rapidly escalating dose-loading regimen for
      risperidone.
AB  - BACKGROUND: Risperidone is an "atypical" antipsychotic with strong binding
      affinity for dopamine-2 and serotonin-2 receptors. Risperidone is often used to
      treat hospitalized patients who have acute psychotic decompensation, and the
      therapeutic target dose commonly used is 2 to 6 mg/day. The most common clinical
      practice is to titrate the dose of risperidone to the target therapeutic dose
      over several days. This study investigated the safety and tolerability of a rapid
      oral-loading regimen for risperidone developed to achieve therapeutic doses of
      this antipsychotic within 24 hours. METHOD: Rapid-loaded risperidone was
      initiated with 1 mg. Subsequent doses were increased by 1 mg every 6 to 8 hours
      up to 3 mg. Dose increases were contingent on tolerance of last administered
      dose. RESULTS: Of a sample of 11 consecutive inpatients admitted to an acute
      psychiatric facility who were treated with this protocol, 7 tolerated the most
      rapid titration, achieving a standing dose of 3 mg b.i.d. in 16 hours. Three
      required a slightly slower titration and achieved this target dose in 24 hours.
      One patient could not tolerate the 3-mg dose but tolerated a standing regimen of
      2 mg t.i.d. No patient experienced serious extrapyramidal side effects, sedation,
      or any other adverse event during the rapid titration, and in no case did
      risperidone have to be discontinued. CONCLUSION: These results suggest that
      aggressive dosing of risperidone is well tolerated in most psychiatric
      inpatients.

PMID- 11206595
TI  - Switching clozapine responders to olanzapine.
AB  - BACKGROUND: Clozapine is an atypical antipsychotic indicated for the management
      of severely ill patients with schizophrenia who have failed to respond adequately
      to standard drug treatment. The significant risk of agranulocytosis and seizure
      associated with clozapine has led to the restrictions in its use. Additionally,
      drug-induced sedation, sialorrhea, enuresis, and weight gain are often cited as
      problematic consequences of clozapine treatment. Our primary objective was to
      determine the effectiveness and safety of a method of slow cross-titration from
      clozapine to olanzapine among patients responsive to clozapine treatment but
      experiencing medication-induced adverse events. METHOD: Changes in
      symptomatology, mood, subjective response, and safety were examined in 20
      outpatients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder
      who converted from clozapine to olanzapine. Patients were considered clozapine
      responsive as evidenced by improved social function and decreased symptoms with
      clozapine therapy; however, they were interested in alternative pharmacologic
      treatment because of clozapine-related side effects. RESULTS: Equivalent efficacy
      of olanzapine to clozapine was found in 90% of the patients (18/20) in the study
      group, without rehospitalization or suicidal behavior in any of the patients.
      Also notable was a reduction in drug-induced side effects and improved subjective
      response to pharmacotherapy. CONCLUSION: The successful conversion from clozapine
      to olanzapine has the potential to provide great benefits for the patient,
      including reducing drug-induced side effects while maintaining symptom control.
      These preliminary results suggest that further research on converting clozapine
      responders to olanzapine is warranted.

PMID- 11206596
TI  - Divalproex sodium in substance abusers with mood disorder.
AB  - BACKGROUND: Substance abuse is a common comorbid illness in patients with mood
      disorders. Little has been written about the pharmacologic treatment of patients
      with affective lability and co-occurring substance abuse, however. The following
      report will describe clinical experience using divalproex sodium in substance
      abusing patients with mood disorder. METHOD: Twenty patients admitted to an
      intermediate-care inpatient substance abuse program were diagnosed with comorbid
      mood disorder (according to DSM-IV criteria) and treated with divalproex sodium
      in an open-label, naturalistic trial with no blind. All patients were followed
      clinically and were assessed using the Clinical Global Impressions scale (CGI)
      and laboratory studies. RESULTS: Seven patients referred while on divalproex
      treatment continued to exhibit improved mood. Eleven others had at least 1 week
      of follow-up, and 10 of these also showed improvement. In 13 cases, divalproex
      was used safely with other psychiatric medications. Two patients complained of
      slight tremor, 1 of whom was also taking fluoxetine. Fifteen of 17 patients in
      whom biochemistry and hematology laboratory studies were completed had
      unremarkable results; 2 other patients had pretreatment abnormalities, which
      worsened over the course of treatment. Mean plasma valproate level was 58.53
      microg/mL. Mean length of follow-up was 38 days. Mean period of abstinence prior
      to starting medication was 48 days. Some patients reported decreased cravings,
      and, by self-report, all patients remained abstinent. CONCLUSION: This report
      suggests that divalproex sodium is efficacious and safe, both alone and in
      combination with other psychiatric medications, in treating substance-abusing
      patients with mood disorder.

PMID- 11206597
TI  - Sertraline treatment of panic disorder: response in patients at risk for poor
      outcome.
AB  - BACKGROUND: More than one third of panic disorder patients have a chronic and/or
      recurrent form of the disorder, accounting for much of the individual and
      societal cost associated with the illness. Six clinical variables have been most
      consistently identified as high-risk predictors of poor outcome: (1) panic
      severity, (2) presence of agoraphobia, (3) comorbid depression, (4) comorbid
      personality disorder, (5) duration of illness, and (6) female sex. No published
      research has systematically examined the differential antipanic efficacy of
      selective serotonin reuptake inhibitors in patients at high risk for poor
      outcome. METHOD: Data were pooled (N = 664) from 4 double-blind, placebo
      controlled studies of the efficacy of sertraline for the treatment of DSM-III-R
      panic disorder. Two of the studies were 12-week fixed-dose studies with starting
      daily doses of sertraline, 50 mg, and 2 were 10-week flexible-dose studies with
      starting daily doses of sertraline, 25 mg. All other study design features were
      the same, except for the exclusion of women of childbearing potential in the 2
      fixed-dose studies. Exclusion of patients with marked personality disorders and
      depression meant that only 4 of the poor-outcome variables could be evaluated.
      RESULTS: Clinical improvement was similar for patients treated with sertraline
      whether or not they carried an agoraphobia diagnosis, had a duration of illness >
      2 years, or were female. Patients with high baseline panic severity had
      significantly (p = .01) less improvement on the endpoint Clinical Global
      Impressions-Improvement (CGI-I) scale than patients with moderate severity,
      although the Clinical Global Impressions-Severity of Illness scale change score
      was higher in the patients with high severity (-2.00 vs. -1.31). For patients
      with 3 or more high-risk variables, there was a modest, but statistically
      significant, tendency for reduced global improvement (endpoint CGI-I score of 2.7
      for the high-risk vs. 2.4 for the non-high-risk group; p = .017), although the
      high-risk group actually had a similar endpoint reduction in frequency of panic
      attacks (82%) compared with the non-high-risk group (78%). CONCLUSION: Treatment
      of panic disorder with sertraline was generally effective, even in the presence
      of baseline clinical variables that have been associated with poor treatment
      response. The main limitations of the analysis were the reliance on pooled data
      from 4 studies (even if the designs were similar) and our inability to examine
      the impact of depression and personality disorders on response to treatment
      because of the exclusion criteria of the clinical trials.

PMID- 11206598
TI  - Patient compliance to a new enteric-coated weekly formulation of fluoxetine
      during continuation treatment of major depressive disorder.
AB  - BACKGROUND: A new formulation of enteric-coated fluoxetine given once weekly
      could be a useful option for the long-term treatment of depression, but
      compliance to once-weekly fluoxetine treatment has not been assessed. METHOD:
      Patients were adults from the United Kingdom who had responded to fluoxetine
      treatment for a current episode of depression (DSM-IV criteria). In the baseline
      assessment phase, all patients (N = 117) were continued on 20 mg of open-label
      fluoxetine once daily for 4 weeks. In the follow-up phase, patients (N = 109)
      were randomly assigned to once-weekly or once-daily fluoxetine for 3 months.
      Patient compliance was monitored by electronic devices during both phases of the
      study. RESULTS: Compliance to once-weekly fluoxetine treatment was higher than
      compliance to once-daily fluoxetine (85.9% vs. 79.4%, respectively). CONCLUSION:
      Once-weekly fluoxetine treatment allows for new flexibility for both the
      clinician and the patient, and this study alleviates the concern that patients
      will forget weekly doses.

PMID- 11206601
TI  - Divalproex sodium for alcohol withdrawal and relapse prevention: a case report.

PMID- 11206599
TI  - Intramuscular ziprasidone compared with intramuscular haloperidol in the
      treatment of acute psychosis. Ziprasidone I.M. Study Group.
AB  - BACKGROUND: This 7-day, randomized, open-label, multicenter, international study
      compared the efficacy and tolerability of intramuscular (i.m.) ziprasidone with
      haloperidol i.m. and the transition from i.m. to oral treatment in hospitalized
      patients with acute psychotic agitation (related to DSM-III-R diagnoses). METHOD:
      Patients received up to 3 days of flexible-dose ziprasidone i.m. (N = 90) or
      haloperidol i.m. (N = 42) followed by oral treatment to day 7. After an initial
      ziprasidone i.m. dose of 10 mg, subsequent i.m. doses of 5 to 20 mg could be
      given every 4 to 6 hours (maximum daily dose = 80 mg) if needed, followed by oral
      ziprasidone, 80-200 mg/day. Haloperidol i.m. doses of 2.5 to 10 mg were given on
      entry, followed by 2.5 to 10 mg i.m. every 4 to 6 hours (maximum daily dose = 40
      mg) if needed, then by oral haloperidol, 10-80 mg/day. RESULTS: The mean
      reductions in Brief Psychiatric Rating Scale (BPRS) total, BPRS agitation items,
      and Clinical Global Impressions-Severity scale scores were statistically
      significantly greater (p < .05, p < .01, and p < .01, respectively) after
      ziprasidone i.m. treatment compared with haloperidol i.m. treatment. Further
      reductions in these scores also occurred in both groups following transition to
      oral treatment. Ziprasidone was associated with a lower incidence of movement
      disorders and a reduced requirement for anticholinergic medication during both
      i.m. and oral treatment compared with haloperidol. Movement disorder scale scores
      improved with ziprasidone i.m. and oral treatment, but deteriorated with
      haloperidol. Other adverse events were rare with both treatments. CONCLUSION:
      Ziprasidone i.m. was significantly more effective in reducing the symptoms of
      acute psychosis and was better tolerated than haloperidol i.m., particularly in
      movement disorders. The transition from ziprasidone i.m. to oral ziprasidone was
      effective and well tolerated.

PMID- 11206600
TI  - Efficacy and response time to sertraline versus fluoxetine in the treatment of
      unipolar major depressive disorder.
AB  - BACKGROUND: Few studies have compared the treatment efficacy of the 2 selective
      serotonin reuptake inhibitors sertraline and fluoxetine. METHOD: A randomized,
      single-blind, parallel-group study of 10 weeks' duration comparing the efficacy
      of sertraline, 50 mg/day; sertraline, 100 mg/day; and fluoxetine, 20 mg/day, was
      conducted in 44 psychiatric outpatients with DSM-IV unipolar major depressive
      disorder. Antidepressant dosages were doubled at 6 weeks for subjects who had not
      achieved remission. Primary outcome measurements included the 21-item Hamilton
      Rating Scale for Depression (HAM-D) and the Clinical Global Impressions
      Improvement scale (CGI-I), with scores of < or = 7 on the HAM-D and < or = 2 on
      the CGI-I representing a positive treatment response, i.e., remission. RESULTS:
      At 4 weeks, significant differences in rate of positive treatment response were
      noted, with 0% for sertraline, 50 mg; 46% for sertraline, 100 mg; and 31% for
      fluoxetine, 20 mg (p = .023). At 6 weeks, positive treatment response rates were
      21%, 43%, and 31% for subjects taking 50 mg of sertraline, those taking 100 mg of
      sertraline, and those taking 20 mg of fluoxetine, respectively, with treatment
      groups no longer differing significantly from each other. In subjects for whom
      antidepressant dose was doubled at week 6, response rates at week 10 (4 weeks on
      increased dose) were 40% for sertraline, 100 mg; 43% for sertraline, 200 mg; and
      55% for fluoxetine, 40 mg. CONCLUSION: Subjects taking sertraline, 100 mg, and
      fluoxetine, 20 mg, demonstrated an earlier treatment response compared with
      subjects taking sertraline, 50 mg. For patients without a positive response at 6
      weeks, an increased antidepressant dose resulted in remission for a substantial
      proportion of patients when assessed 4 weeks later.

PMID- 11206602
TI  - The effectiveness of combining lithium with olanzapine in the treatment of
      resistant schizophrenia.

PMID- 11206603
TI  - Treatment of primary cranial dystonia (Meige's syndrome) with clozapine.

PMID- 11206605
TI  - Colon perforation and peritonitis associated with clozapine.

PMID- 11206604
TI  - Severe lithium toxicity induced by combined levofloxacin administration.

PMID- 11206606
TI  - Treatment of of koro with citalopram.

PMID- 11206607
TI  - The scourge of EPS: have atypical antipsychotics solved the problem?

PMID- 11206608
TI  - Heterogeneity of response to antipsychotics from multiple disorders in the
      schizophrenia spectrum.
AB  - BACKGROUND: Antipsychotic response after the initiation of neuroleptic treatment
      shows wide variation in schizophrenic patient populations. In this overview, the
      authors suggest that the variance in antipsychotic drug response within
      schizophrenia can be reduced by resolving the schizophrenias into several
      discrete "endophenotypes," each with different etiologic underpinnings. METHOD:
      Studies relating differences in the relative speed or completeness of
      antipsychotic response to differences in distribution of 2 biological markers
      with possible etiologic significance are reviewed. Such studies had assessed
      recently hospitalized, neuroleptic-free patients undergoing exacerbation of
      nonaffective psychotic disorders. Prior to initiation of neuroleptic, the cohort
      of patients had been assessed for the quantity of the dopamine metabolite
      homovanillic acid in plasma (pHVA) and had undergone the first of 2 magnetic
      resonance imaging (MRI) studies for analyses of ventricle volumes. A second MRI
      was subsequently performed during a period of (partial) remission to determine
      within-patient stability of ventricular volumes. These selected studies assessed
      the distribution of pHVA and distribution of rates of ventricular change, with
      non-normal distributions resolved by K-means clustering. The speed and
      completeness of neuroleptic-induced antipsychotic response were related to 3
      clusters of patients delineated by modal distributions of pHVA and of apparent
      rates of ventricular change. RESULTS: At least 3 unique "endophenotypes" of the
      "group of the schizophrenias" can be defined with respect to speed and
      completeness of antipsychotic response. Each endophenotype appears to show at
      least one unique biological feature that differentiates it from a normal
      comparison group. A rapidly responsive psychosis was associated with excessive
      production of dopamine, as identifiable by elevation of pHVA and a "good
      prognosis" course. A delayed-response psychosis had low-to-normal pHVA,
      clinically demonstrated persistent negative symptoms, and was associated with an
      excessive rate of change in ventricle volume between exacerbations of psychosis
      and (partial) remissions. Finally, a nonresponsive psychosis could be
      characterized as having both low-to-normal pHVA and rate of change of ventricle
      volumes similar to that of controls. Additional studies revealed that each of the
      endophenotypes had high rates of the psychoses in family members. The good
      prognosis course of the rapidly responsive group of studied patients was also
      found in their family members who had psychotic disorders. Similarly, the
      prominent negative symptoms of the delayed-response probands were reflected as a
      prominent trait in their family members also afflicted with psychosis. The
      endophenotypes tended to "breed true" in terms of prognosis and negative
      symptoms. CONCLUSION: Major differences in antipsychotic response patterns appear
      to be associated with patient and family characteristics that may be related to
      differences in the etiology and consequent pathophysiology of illness.

PMID- 11206609
TI  - Simple nephrectomy: transperitoneal approach.
AB  - Transperitoneal laparoscopic nephrectomy is performed much as originally
      described by Clayman and associates, although preoperative embolization of the
      kidney is no longer routine. Some surgeons use a hand-assisted technique,
      especially in difficult cases or when the organ is being removed intact, as in
      live-donor nephrectomy.

PMID- 11206610
TI  - Simple nephrectomy: retroperitoneal approach.
AB  - Direct extraperitoneal surgery has become the preferred approach to laparoscopic
      nephrectomy since the introduction of the balloon dilation method. The lateral
      decubitus position provides good exposure, but the prone position is used at some
      centers to gain better exposure with the aid of gravity. The open conversion rate
      ranges from 0 to 16% and the complication rate from 5% to 45%, with most
      complications being minor. Retroperitoneal laparoscopic simple nephrectomy is
      definitely superior to open nephrectomy as judged by analgesic use and recovery
      time. The higher complication rate and lower efficiency can be taken care of by
      experience and proper case selection.

PMID- 11206611
TI  - Simple nephrectomy: hand-assisted technique.
AB  - Chronic inflammation or prior surgical procedures may complicate the laparoscopic
      performance of simple nephrectomy. In these difficult cases, hand-assisted
      laparoscopy may be useful. The position of the hand port depends on the
      particular situation, but the port must allow flexion of the wrist and access to
      the entire surgical field. The hand-assisted procedure is similar to standard
      laparoscopy in analgesic use, time to oral intake, length of stay, and time to
      full recovery. Hand-assisted laparoscopy allows the inexperienced surgeon to
      perform laparoscopy with the aid of tactile sensation and three-dimensional
      spatial orientation. For the experienced surgeon, the technique offers an
      alternative to open conversion when the laparoscopic procedure fails to progress.

PMID- 11206612
TI  - Simple nephrectomy: managing the difficult case: xanthogranulomatous
      pyelonephritis and autosomal dominant polycystic kidney disease.
AB  - Laparoscopic surgery for kidneys with xanthogranulomatous pyelonephritis or
      autosomal dominant polycystic disease has proved to be technically difficult but
      is possible. The Harmonic Scalpel facilitates the dissection of inflammatory
      tissues and does not inflict burns. Hand-assisted laparoscopy may be useful. Pain
      relief is obtained by most patients undergoing cyst drainage, although recurrence
      after a year or two is common. A specific and detailed preoperative diagnosis and
      treatment plan are essential to a successful outcome.

PMID- 11206613
TI  - Simultaneous bilateral simple nephrectomy.
AB  - Bilateral simultaneous nephrectomy is a rare procedure usually performed for end
      stage renal disease, most often because of persistent hypertension after renal
      transplantation. Four trocars generally are inserted, with a lower abdominal and
      a subcostal port being used by the surgeon. An intra-abdominal pressure of 8 to
      10 mm Hg is used during the procedure. The first kidney is left in situ while the
      other one is being dissected. Unless there is infection or malignancy, a
      retrieval sac is not used. In our series of 13 cases, the operating times ranged
      from 240 to 390 minutes (mean 320 minutes), and the mean 125 mL. Surgical
      discharges criteria usually were met on postoperative day 1 or 2. Laparoscopic
      bilateral nephrectomy in a single session is feasible in nearly all properly
      selected cases, even in patients with previous abdominal surgery or peritoneal
      dialysis. The operation takes longer than open surgery and may have a higher
      complication rate, but recovery is faster.

PMID- 11206614
TI  - Laparoscopic live donor nephrectomy: outcomes equivalent to open surgery.
AB  - A shortage of kidney donors has contributed to the interest in laparoscopic live
      donor nephrectomy. Three transperitoneal ports are used, as is an AESOP robot. To
      maintain urine flow, the donor is kept volume expanded during the procedure, and
      the pneumoperitoneum pressure is minimized. The most critical and hazardous part
      of the surgery is dissection of the renal artery and vein. Abundant periureteral
      tissue should be left to protect the blood supply. Harvest of the right kidney is
      more difficult. Placing the extraction incision in the right upper quadrant and
      using a Satinsky clamp instead of a stapling device at the origin of the renal
      vein will provide maximum venous length and help prevent postoperative thrombosis
      of the allograft. In the first 175 laparoscopic renal harvest procedures at Johns
      Hopkins, the complication rate was 14%, the rate of open conversion was 2%, and
      3% of the patients required transfusions. These rates improved with experience.
      There was no significant difference in the performance of the allografts or the
      recovery of the recipients from what is seen after open kidney harvest. Wider
      acceptance of laparoscopic renal harvest will increase the number of donors and
      will be helped by development of methods and devices that shorten the learning
      curve.

PMID- 11206615
TI  - Approach to decortication of simple cysts and polycystic kidneys.
AB  - Laparoscopic excision and marsupialization of symptomatic of recurrent simple
      renal cysts is an alternative to open or percutaneous surgery. Such surgery may
      also be useful for pain relief in patients with autosomal dominant polycystic
      kidney disease (ADPKD). An occlusion balloon catheter is placed in the renal
      pelvis at the start of the procedure. Cysts are punctured, and the outer wall of
      the larger cysts is excised with care not to incise the renal parenchyma. In
      patients with ADPKD, it is important to mobilize the kidney completely,
      particularly the upper pole, to treat every visible cyst. A laparoscopic
      ultrasound probe is used to guide the unroofing of any large cysts within 5 to 10
      mm of the renal surface. At the end of the procedure, the integrity of the
      collecting system is confirmed. Strict criteria must be used in selecting
      patients with simple cysts for laparoscopic marsupialization to minimize the
      incidence of unsuspected malignancy, and the cyst wall should be examined by
      frozen and permanent section. Long-term follow-up is needed to evaluate the
      effect of laparoscopic decompression in ADPKD.

PMID- 11206616
TI  - Laparoscopic surgery for renal  urolithiasis: pyelolithotomy, caliceal
      diverticulectomy, and treatment of stones in a pelvic kidney.
AB  - Laparoscopic techniques may be considered for the uncommon patient in whom open
      stone surgery is considered. Stones in caliceal diverticula not accessible
      percutaneously may be approached transperitoneally. Pelvic stones in ectopic
      kidneys can be retrieved laparoscopically through a pyelotomy created with
      scissors or a knife. Percutaneous nephrolithotomy under laparoscopic guidance can
      be used if the stone extends beyond the renal pelvis. In the patient with
      difficult stone disease, laparoscopy does not replace other minimally invasive
      techniques but rather complements them. It should be the rare patient in the
      future who needs open surgery for stone removal regardless of its location or the
      presence of anatomic variants.

PMID- 11206617
TI  - Laparoscopic retroperitoneal renal biopsy.
AB  - Histologic information can be pivotal in making treatment decisions. Ultrasound
      guided percutaneous biopsy is the current standard, but if this procedure fails
      or is considered to be high risk, laparoscopic biopsy may be appropriate. A CT or
      ultrasound scan is obtained to determine whether there is any condition that
      would mandate biopsy of a particular kidney. The retroperitoneal space is entered
      with a visual obturator, and, after CO2 insufflation to 15 to 20 mm Hg, the space
      is enlarged initially by blunt dissection with the laparoscope. Two-tooth biopsy
      forceps are used to obtain tissue, and hemostasis is achieved with the argon beam
      coagulator with care to vent the increased pressure created by the flow of gas.
      Postoperatively, specific attention is given to blood pressure control.
      Hemorrhage is the most common serious complication, so any anticoagulation
      regimen must be reinstituted cautiously.

PMID- 11206618
TI  - Laparoendoscopic renal surgery in children.
AB  - Laparoscopic renal surgery in children has been slow to evolve, but further
      development is warranted. Dysplasia, obstruction, or reflux leading to
      nonfunction are the most common indications for nephrectomy. Partial nephrectomy
      and reconstructive surgery can also be performed laparoscopically. Both
      transperitoneal and retroperitoneal approaches can be used, with each having
      advantages and disadvantages. The future of pediatric laparoscopic renal surgery
      will be determined by technical and methodologic advances.

PMID- 11206619
TI  - Laparoscopic radical nephrectomy.
AB  - Although open nephrectomy is the standard of care for localized renal-cell
      carcinoma, the significant postoperative pain and lengthy convalescence have
      encouraged the use of laparoscopy, which can yield similar 2- to 5-year survival
      rates. Either a transperitoneal or a retroperitoneal approach may be used, and
      sometimes, they are combined. Generally, the technique is limited to tumors <10
      cm, but larger tumors can be removed. Nitrous oxide is avoided as an anesthetic
      agent. The dissection follows accepted oncologic principles: in situ renal
      dissection within Gerota's fascia, early ligation of the renal vessels, and
      careful removal of the specimen to prevent tumor spillage. Dissection of the
      hilum is facilitated by a PEER retractor and an Endoholder. On average, patients
      having laparoscopic radical nephrectomy return to normal activities approximately
      4.5 weeks sooner than those having open surgery, a fact not taken into account in
      cost analyses. Laparoscopic nephrectomy may offer a special benefit in patients
      with known metastatic disease, as interleukin-2 administration can be started a
      month earlier than after open surgery. There may also be immunologic benefits of
      minimally invasive v open surgery. The technique and instruments continue to
      evolve, and cost-effectiveness should continue to improve.

PMID- 11206620
TI  - Laparoscopic radical nephroureterectomy.
AB  - Because of the high rate of ipsilateral multifocal disease and the low incidence
      of contralateral disease, upper tract transitional-cell carcinoma has
      historically been treated with radical nephroureterectomy. This operation has
      been performed laparoscopically in many medical centers, with various techniques.
      The difficult concept has always been handling of the distal ureter and bladder
      cuff. A technique involving transvesical laparoscopy-assisted transurethral
      dissection with low pressure that mimics the open procedure is used at the
      Cleveland Clinic. The reported mean operative times range from 2.6 to 8.3 hours,
      with the longest time being reported from one of the earliest series. Although
      the cost of laparoscopic nephroureterctomy is higher than that of the open
      procedure by about 24%, this figure does not include the societal costs of the
      longer convalescence after the latter operation. Longer follow-up will be
      required to learn whether the laparoscopic method is as effective from an
      oncologic standpoint as open surgery.

PMID- 11206621
TI  - Laparoscopic partial nephrectomy and wedge resection.
AB  - Partial nephrectomy is a more challenging operation than radical or simple
      nephrectomy, primarily because of the risk of complications such as bleeding.
      This problem is even more troublesome with minimally invasive approaches because
      of the dearth of effective hemostatic instruments and supplies. The location of
      the lesion determines whether a transperitoneal or a retroperitoneal route will
      be employed. Centrally located or anterior renal lesions generally are approached
      transperitoneally whereas peripheral lateral or posterior lesions are accessed by
      retroperitoneoscopy. The Harmonic Scalpel with slow cutting and high coagulation
      settings is useful for incising the renal capsule and parenchyma. The argon beam
      coagulator is helpful to stop any persistent bleeding. The few reported series of
      laparoscopic partial nephrectomy indicate considerably longer operative times
      than are needed for open surgery and hospitalization of upwards of 5 days,
      largely to monitor drainage and urine leakage. It is hoped that this advanced
      laparoscopic technique will become more user friendly with further developments
      in techniques and instrumentation to provide patients with the expected benefits
      of minimally invasive surgery.

PMID- 11206622
TI  - Laparoscopic cryoablation for renal-cell cancer.

PMID- 11206623
TI  - Laparoscopic nephropexy.
AB  - Although there has long been debate about the existence of nephroptosis,
      contemporary radiologic and biochemical studies confirm its existence. Both
      percutaneous and laparoscopic operations are available for fixing the kidney,
      with high early success rates. Objective documentation of the diagnosis is
      mandatory. Further studies with validated quality-of-life and pain questionnaires
      are needed to determine the long-term success of nephropexy.

PMID- 11206624
TI  - Laparoscopic Fenger plasty.
AB  - BACKGROUND: At our department, adults presenting with hydronephrosis secondary to
      short intrinsic stenoses of the ureteropelvic junction (UPJ) or ventrally
      crossing vessels are treated with laparoscopic nondismembered pyeloplasty. We
      herein present our long-term results. PATIENTS AND METHODS: From August 1994 to
      September 1999, 34 female and 31 male patients presenting with 67 obstructed UPJs
      underwent laparoscopic nondismembered pyeloplasty. The patients' ages ranged from
      11 to 77 (mean 35.6) years. Preoperatively, all patients were evaluated with
      intravenous urography and isotope scans. In addition, color Doppler
      ultrasonography was performed to identify crossing vessels at the UPJ. Prior to
      surgery, a stent was placed, which was left indwelling until 6 weeks after
      surgery. On the right side, the transperitoneal and on the left, the
      retroperitoneal approach was used. Following dissection of the UPJ, the
      obstructing vessels were displaced. The stenosis of the UPJ was corrected by
      either Fenger plasty (63 UPJs) or Y-V plasty (4 UPJs). Postoperative evaluation
      included color Doppler ultrasonography, intravenous urography, and isotope
      studies. RESULTS: The mean operative time was 123 minutes. No intraoperative
      complications were seen. In 79% of the patients, ventrally crossing vessels were
      found and displaced from the UPJ. Forty-eight patients have been available for
      follow-up, which currently ranges from 4 to 60 (mean 25) months. In the most
      recent nine patients, the position of the crossing vessels relative to the UPJ
      was also assessed postoperatively by means of color Dopper ultrasonography. The
      mean distance of the vessels from the UPJ was 1.5 cm. There was a single failure,
      in a 19-year-old woman who presented with infected hydronephrosis. Laparoscopic
      nondismembered pyeloplasty failed because the stenosis, which was aggravated by
      the infection, was too long. The success rate thus was 98%. CONCLUSIONS: At our
      department, laparoscopic nondismembered pyeloplasty is the preferred method for
      the management of UPJ obstruction, while dismembered pyeloplasty is performed in
      rare cases only.

PMID- 11206625
TI  - Laparoscopic pyeloplasty.
AB  - Open pyeloplasty has long been considered the gold standard for the relief of
      ureteropelvic junction (UPJ) obstruction, but the incisional morbidity led
      urologists to explore less invasive alternatives such as endopyelotomy and the
      Acucise cutting balloon. Laparoscopic pyeloplasty was introduced in 1993 and has
      since been performed in patients as young as 2.5 years. The operation should be
      considered in patients with UPJ obstruction caused by a crossing vessel, high
      ureteral insertion, failed prior procedures, high-grade hydronephrosis, or
      marginal differential renal function. Hynes-Anderson, Foley Y-V, and Fenger
      procedures can all be performed laparoscopically, generally with excellent
      results. The procedure requires advanced laparoscopic skills and so is available
      in only a few medical centers at present.

PMID- 11206626
TI  - Retroperitoneoscopic and laparoscopic suturing: tips and strategies for improving
      efficiency.
AB  - BACKGROUND: The difficulties of minimally invasive reconstructive surgery,
      laparoscopically or retroperitoneoscopically, are caused by spatial limitation
      and fixed trocar positions and, therefore, restricted movement and handling of
      the instruments. In addition to a standardization of the technique, continual
      training, and improved instrument technologies, optimization of the geometry of
      reconstructive surgery, such as angles and distances between the working ports or
      the camera and needle position, are imperative to providing an optimal clinical
      performance. MATERIALS AND METHODS: After designing a standardized suturing
      technique and conducting an experimental analysis of the geometric factors
      important in reconstructive surgery, we transferred these results to our clinical
      setting. A series of 116 reconstructive laparoscopic and retroperitoneoscopic
      procedures (nephropexy, pyeloplasty, bladder neck suspension, and radical
      prostatectomy) were analyzed according to the technical realization and quality
      of reconstruction. Trocar and table positions were adjusted according to our
      preliminary results, as were the position of the instruments and camera. RESULTS:
      The trocar and instrument positions are critical for the clinical outcome of
      reconstructive surgery. Continual training in a standardized suturing technique,
      together with the clinical application of the important geometric rules, can
      reduce surgery time by 50%. The time required for suturing single knots could be
      decreased even more: as much as 75%, thus ensuring efficient and safe
      reconstructive surgery. CONCLUSION: Reconstructive procedures such as pyeloplasty
      or radical prostatectomy can be standardized and performed in an acceptable
      amount of time with adequate quality when adhering to a standardized technique
      and the important geometric rules. Improved performance in terms of time and
      quality will increase the acceptance of these procedures, which can help to solve
      the problem associated with a low total number of indications for laparoscopy and
      retroperitoneoscopy.

PMID- 11206627
TI  - Management of hemorrhage during laparoscopy.
AB  - Bleeding can be a complication of laparoscopic procedures commonly performed by
      urologists, such as pelvic node dissection and nephrectomy, and is often
      difficult to manage. Hemorrhage also can occur as a result of Veress needle or
      trocar placement, and there are specific strategies for the management of these
      injuries. Laparoscopic clip appliers, laparoscopic staplers, laparoscopic
      suturing, various energy sources (monopolar and bipolar electrocautery, laser,
      ultrasonic dissectors, and argon beam coagulators), and topical agents (gelatin
      foam, cellulose, collagen, and fibrin sealant) can be used to obtain hemostasis.
      Converting to laparotomy to obtain hemostasis may be necessary in some cases.
      Proper patient selection is important for lowering the risk of hemorrhage.

PMID- 11206628
TI  - Technical advances in laparoscopy: hand assistance, retractors, and the
      pneumodissector.
AB  - Technology is crucial to the laparoscopic surgeon. Reducing the technical
      difficulty of laparoscopic procedures is beneficial on many fronts: training is
      facilitated, operative time is reduced, and the practice of minimally invasive
      surgery can be further disseminated. Many advances in urologic laparoscopic
      surgery are attributable to the development of new operative instruments that
      reduce the technical difficulty. In this article, we highlight three technical
      advances in laparoscopy. Hand assistance can simplify many laparoscopic
      procedures. Because the surgeon retains tactile sensation, operative times are
      reduced compared with standard laparoscopic surgery, with minimal, if any,
      increase in patient morbidity. Other advances in instrumentation include various
      laparoscopic retractors and the Pneumodissector, a unique dissecting device. The
      breadth of retractors extends from reusable metal "fans" to disposable inflated
      "paddles," with many in between. The metal retractors may be more traumatic to
      delicate tissues than the inflatable ones but also are more versatile. The
      Pneumodissector facilitates tissue dissection by releasing short burst of carbon
      dioxide. It is a safe and effective instrument for blunt tissue dissection. These
      technical advances have contributed to the progression of laparoscopic urologic
      procedures. Technology will continue to have a significant impact on the
      advancement of laparoscopic urology and its potential widespread dissemination.

PMID- 11206629
TI  - Significance of the expression of p27Kip1 in esophageal squamous cell carcinomas.
AB  - Recent observations have demonstrated that the reduced expression of p27Kip1
      (p27) is correlated with progression and poor prognosis of breast, colon, and
      gastric carcinomas. These observations led us to examine the expression of p27
      and cyclin D1 and E protein in six esophageal carcinoma cell lines and 81
      esophageal carcinoma tissues by Western blot analysis and immunohistochemistry.
      The expression levels of cyclin D1 and p27 were correlated clearly in esophageal
      carcinoma cell lines by Western blot analysis. Immunohistochemical analysis
      revealed that the high-grade expression of p27 protein was detected in 61% of
      esophageal carcinomas, and it was correlated with tumor invasion, lymph node
      metastasis, and poor patient prognosis. This observation was different from the
      results reported in other organs. Cell cycle regulation is a very complicated
      process. Homeostatic feedback mechanisms against the overexpression of cyclin D1
      may exist in esophageal carcinomas, and there can be organ-specific regulations
      in the progression of carcinomas.

PMID- 11206630
TI  - Expression of p53, bcl-2, and bax as predictors of response to radiotherapy in
      esophageal cancer.
AB  - The sensitivity of cancers to radiotherapy or chemotherapy may be influenced by
      susceptibility to apoptosis. We evaluated whether expression of three proteins
      regulating apoptosis, p53, bcl-2, and bax, could predict the effect of
      radiotherapy in esophageal cancers. We used immunohistochemical staining for
      these protein regulators of apoptosis to study biopsy specimens obtained from 25
      patients with esophageal squamous cell carcinoma before they underwent
      preoperative radiotherapy. Effectiveness of radiotherapy was assessed by barium
      esophagography, esophagoscopy, and computed tomography. Radiotherapy was
      effective in 12 patients and ineffective in 13 patients. Biopsy specimens from
      the 25 patients showed expression of p53, bcl-2, and bax to be 48.0%, 32.0%, and
      76.0% respectively. Effectiveness of radiotherapy was correlated with p53
      expression (p = 0.047), but bcl-2 and bax expression showed no relationship to
      effectiveness of radiotherapy. Expression of p53 protein in biopsy specimens may
      predict effectiveness of preoperative radiotherapy in esophageal cancers.

PMID- 11206631
TI  - Assessment of the predictive value of clinical and histopathological factors as
      well as the immunoexpression of p53 and bcl-2 proteins in response to
      preoperative chemotherapy for esophageal squamous cell carcinoma.
AB  - The aim of the study was to determine the predictive value of selected clinical
      and histopathological factors as well as the immunohistochemical expression of
      p53 and bcl-2 proteins in the prediction of the pathological response to
      preoperative chemotherapy in esophageal squamous cell carcinoma. Thirty-four
      patients with advanced squamous cell carcinoma of the thoracic esophagus (T2-4 N0
      1 M0), who underwent one cycle of cisplatin and 5-fluorouracil therapy followed
      by subtotal esophagectomy, were studied. All clinical factors (tumor longitudinal
      diameter in a computed tomographic scan, invasion depth, the presence of lymph
      node metastasis and clinical tumor staging) were evaluated before the onset of
      the therapy. The histopathological features (grade of differentiation, degree of
      keratinization, nuclear polymorphism, mitotic index, pattern of cancer invasion
      and inflammatory response), and the expression of p53 and bcl-2 proteins were
      also estimated in prechemotherapy endoscopic biopsy specimens. Pathological
      response to chemotherapy was assessed in surgically resected specimens. Of 34
      patients, two (5.9%) showed complete response (CR), six patients (17.6%)
      exhibited major histological changes (partial response 1; PR1), 24 (70.6%) showed
      minor histological changes (partial response 2; PR2), and two patients (5.9%)
      exhibited no response to chemotherapy (stable disease; SD). There were no
      significant relationships between the response to preoperative chemotherapy (CR +
      PR1 vs. PR2 + SD) and the majority of the clinical and all the histopathological
      features. Deeper cancer invasion before chemotherapy was the only factor that
      tended to worsen the therapy effect (p < 0.01). The pathological response to
      treatment had no significant associations with the expression of p53 and bcl-2
      proteins in esophageal squamous cell carcinoma. It should be noted, however, that
      both patients in CR were p53 and bcl-2 protein-negative.

PMID- 11206632
TI  - Significance of lymph node dissection of the superior mediastinal region in
      esophageal cancer patients.
AB  - The effect of the superior mediastinal lymph node dissection was compared
      retrospectively with that of standard dissection in 108 esophageal cancer
      patients. Five-year survival rates were 46.3% in patients who underwent standard
      surgery (group A) and 39.3% in patients who underwent superior mediastinal lymph
      node dissection (group B). The survival curves were basically the same. Nineteen
      out of 42 (45.2%) tumors in group A and 24 out of 66 (36.4%) tumors in group B
      recurred. The distribution of the first sites of recurrence did not differ
      significantly between groups. However, 14 tumors (67%) in group A recurred in the
      lymph nodes, but only seven tumors recurred (28%) in the lymph nodes in group B.
      Eleven tumors (52%) in group A recurred to superior mediastinal nodes, but only
      one tumor (4%) recurred to a superior mediastinal node in group B. Fourteen of
      the group B patients showed metastasis to superior mediastinal lymph nodes and
      none of these patients survived for more than 5 years. Eleven of these 14
      patients showed metastasis to only one or two nodes. Based on our data and other
      reported findings, we conclude that extended lymphadenectomy of the superior
      mediastinal region alone does not contribute to improved survival of esophageal
      cancer patients, but it does contribute to the prevention of lymph node
      recurrence in this region.

PMID- 11206633
TI  - Pyloroplasty in gastric replacement of the esophagus after esophagectomy: one
      layer or two-layer technique?
AB  - Pyloroplasty is our routine drainage procedure performed when the stomach is used
      as the esophageal substitute after esophageal resection for cancer. The technique
      of pyloroplasty varies among surgeons and effectiveness has not been studied.
      Thirty-four patients with a gastric conduit whose pyloroplasty was constructed
      with a one-layer technique (group 1) were compared with a historical cohort of 31
      patients treated with a two-layer method (group 2). Patients who had an abnormal
      pyloroduodenal region were excluded from the study. Perioperative morbidity and
      post-operative gastrointestinal symptoms within the first 6 months were
      evaluated. Patient demographics and the types of surgical procedures did not
      differ between the two groups. The median daily output from the nasogastric tube
      was 119 mL in group 1 and 115 mL in group 2 (p = 0.49). In 40 out of 65 patients
      (62%), the nasogastric tube was removed at a median of 3 days after the operation
      in both groups. There was no leakage from the pylorus or the esophagogastric
      anastomosis in this study. In both groups, the patients could resume a semisolid
      diet at a median of 8 days after surgery. One patient in group 1 and two patients
      in group 2 developed gastroparesis clinically. No patient, however, required
      reoperation. There was no significant difference in cardiopulmonary complications
      attributable to the technique of pyloroplasty. The incidence of gastrointestinal
      symptoms within the first 6 months after surgery did not differ. Regurgitation
      was the most common symptom, affecting 10 patients in each group, 29% and 32% in
      group 1 and group 2 respectively (p = 1.0). Pyloroplasty was an effective gastric
      drainage procedure after esophagectomy whether the one or two-layer method was
      used. The authors prefer the one-layer method, which is safe and simple.

PMID- 11206634
TI  - Composite reconstruction of hypopharynx and esophagus.
AB  - Extended surgical resection of the whole esophagus and associated hypopharynx may
      require composite reconstructions using a combination of pediculated and free
      tissue units. Twelve patients were assigned to composite reconstructions of the
      hypopharynx and esophagus for either metachronous carcinoma of the esophagus and
      head and neck (group I, n = 4), cervical anastomotic recurrence of esophageal
      carcinoma (group II, n = 3), or secondary reconstruction after the failure of a
      previous reconstruction of hypopharynx or esophagus (group III, n = 5).
      Pediculated tissues were the stomach (n = 10), colon (n = 1), or jejunum (n = 1).
      A free jejunal graft was constantly interposed between the pharynx and the
      mobilized organ. There were no hospital deaths. Swallowing function was restored
      in all patients except one who had cervical leakage as a result of partial
      necrosis of the free jejunal graft. Composite reconstruction permitted, even in
      groups I and II in which prognosis was extremely poor, prolonged survival and
      oral feeding, which proved beneficial in terms of the patients' quality of life.

PMID- 11206635
TI  - Larynx preservation in surgical treatment of cervical esophageal cancer--combined
      procedure of laryngeal suspension and cricopharyngeal myotomy.
AB  - From July 1994 to July 1998, a larynx-preserving procedure was performed on 10
      out of 22 (45%) patients in the surgical treatment of hypopharyngeal and cervical
      esophageal cancer. At first, all 10 patients were treated with concurrent
      radiochemotherapy with cisplatin (10 mg/m2/day), 5-fluorouracil (500 mg/m2/day)
      and radiation (2 Gy/day) five times per week for 4 weeks. After preoperative
      radiochemotherapy, the larynx-preserving procedure, combining laryngeal
      suspension and cricopharyngeal myotomy, was performed. The operative and hospital
      mortality rate was 0%. The incidence of post-operative morbidity with minor
      complications was 70% in the present study. Laryngeal speech and oral food intake
      were preserved in all patients after this procedure. The new larynx-preserving
      procedure combining laryngeal suspension and cricopharyngeal myotomy for cervical
      esophageal cancer is a favorable operative method for retaining intelligible
      laryngeal speech and good food intake.

PMID- 11206636
TI  - Late esophageal toxicity using a combination of external beam radiation,
      intraluminal brachytherapy and 5-fluorouracil infusion in carcinoma of the
      esophagus.
AB  - One hundred patients with potentially curable squamous cell carcinoma of the
      esophagus were treated using a combination of external beam radiation, medium
      dose intraluminal brachytherapy (ILBT), and 5-fluorouracil infusion (as a
      radiosensitizer) from January 1990 to December 1993. The main objective was to
      determine late toxicity and optimization of the dose of intraluminal radiation.
      All patients had external radiation of 50 Gy over 5 1/2 weeks, followed by ILBT
      of 20 Gy for 50 patients (group 1) and 15 Gy for a subsequent 50 patients (group
      2), using a dose rate of 315-330 cGy/h with the prescription at 1 cm off axis.
      The 5-fluorouracil infusion was 500 mg/m2 administered 12 h prior to ILBT. The
      treatment-related complications among groups 1 and 2 were strictures 24% vs. 8%
      (p = 0.029), ulceration 30% vs. 28% (p = 0.8), and tracheoesophageal fistulae 12%
      for both groups. The overall survival for groups 1 and 2 was 8% and 23% at 5
      years. The development of life-threatening complications is a major concern and
      extreme caution is urged before selecting patients for a combination of ILBT and
      5-fluorouracil treatment.

PMID- 11206637
TI  - Multiple primary malignant neoplasms in patients with esophageal cancer.
AB  - This study aims to elucidate the incidence and the therapeutic and prognostic
      implications of co-existent non-esophageal primary malignant neoplasms in
      patients with esophageal cancer. Between 1974 and 1997, 33 patients with
      esophageal cancer treated at the Nippon Medical School Hospital were documented
      as having multiple primary malignant neoplasms (MPN). The therapeutic strategies
      and post-therapeutic survival of these patients were retrospectively
      investigated. Among 291 patients with esophageal cancer, 33 patients (11.3%) were
      also found to have non-esophageal primary malignant neoplasms. Twenty patients
      (60.6%) had synchronous MPN and 13 (39.4%) had metachronous MPN. Among the MPN,
      apart from esophageal cancer, gastric (32.6%) and head and neck cancer (32.6%)
      were the most common. The incidence of esophageal cancer occuring in association
      with cancers of the head and neck or gastric cancer was high. Frequent
      examination in these cancer patients, using fiberoptic esophagogastric endoscopy
      for example, may be helpful in the early diagnosis of esophageal cancer.

PMID- 11206638
TI  - Effect of clarithromycin on esophageal motility.
AB  - As clarithromycin (CLA), an antibiotic commonly used for Helicobacter pylori
      eradication, stimulates gastroduodenal motility, we investigated whether it also
      stimulates esophageal motility. In 15 normal subjects, esophageal motility was
      recorded using a low-compliance manometric system with two ports in the
      esophageal body, one port in the lower esophageal sphincter (LES), and five ports
      in the antroduodenal tract to monitor the occurrence of phases I-III of the
      migrating motor complex. Thirty minutes after the occurrence of a duodenal phase
      III, we infused intravenously, randomly, and in a double-blind manner, CLA 100 mg
      in five subjects (group A), CLA 250 mg in five subjects (group B), and normal
      saline in the remaining five subjects (group C). LES tone and post-deglutitive
      residual pressure, as well as the amplitude and duration of the esophageal
      contractions, were measured each minute and averaged over a post-infusion period
      of 30 min. Both group A and B showed a LES tone significantly higher than that of
      group C after CLA infusion, whereas the post-deglutitive residual pressure was
      not significantly different from that of group C. The LES tone of group B was
      significantly higher than that of group A. Group B, but not group A, showed a
      wave amplitude and duration significantly higher than that of group C. In
      conclusion, CLA is able to stimulate LES tone and esophageal contractions with a
      dose-related effect.

PMID- 11206639
TI  - Experimental evaluation of the safety and biocompatibility of a new antireflux
      prosthesis.
AB  - Previous studies have shown that encircling of the esophagogastric junction by a
      semiabsorbable scarf effectively prevents gastroesophageal reflux. The present
      study was performed to assess the long-term safety and biocompatibility of this
      type of scarf. The semiabsorbable scarf was implanted into 20 dogs either
      laparoscopically or via laparotomy. Pre- and post-operatively, contrast
      radiography, esophageal manometry, and upper gastrointestinal endoscopy were
      performed. No cases of perforation, stricture formation or other adverse effects
      were found after 1 and 2 years. It is concluded that the new type of scarf is
      without any adverse side-effects. Functional evaluation in reflux patients
      appears to be warranted.

PMID- 11206640
TI  - Long-segment substernal jejunal esophageal replacement with internal mammary
      vascular augmentation.
AB  - We describe a technique that uses the internal mammary vessels to enhance long
      segment jejunal graft blood supply in addition to an intact distal mesenteric
      vascular arcade. We believe that this technique, called vascular augmentation,
      improves jejunal graft perfusion and decreases ischemic complications.

PMID- 11206641
TI  - Gastric tube gastrectomy.
AB  - The incidence of esophageal adenocarcinoma has increased significantly in recent
      years. Early detection of a small mucosal tumor by endoscopy is occurring more
      frequently. This, together with improved results of surgical treatment, has
      created a new population of patients with prolonged post-esophagectomy survival.
      Adenocarcinoma in the reconstructed gastric tube is no longer a rare finding and
      is expected to be even more common in the future. We report a case of a patient
      treated for metachronous gastric tube carcinoma and discuss the steps of the
      surgical procedure.

PMID- 11206642
TI  - Squamous cell carcinoma in esophageal remnant after 24 years: lessons learnt from
      esophageal bypass surgery.
AB  - Cervical esophageal carcinoma has been a vexing problem because of the
      multicentric nature of the disease, the common advanced stage at presentation
      (with invasion of important adjacent structures, especially the trachea or
      larynx), and difficulty in satisfactorily reconstructing pharyngogastric
      continuity after extensive resection. In this case report, we highlight the
      complexity of managing squamous cell carcinoma of the cervical esophagus, which
      can reappear either as a new primary or recurrence, in a retained esophageal
      segment 24 years after esophageal bypass surgery. We strongly recommend total
      esophagectomy at the time of initial surgery and not 24 years later.

PMID- 11206643
TI  - Massive distension of the esophageal stump after cervical esophagogastrostomy in
      psychiatric patients.
AB  - We present two similar cases of huge distension of the esophageal stump after
      cervical esophagogastrostomy in two psychotic patients. Chronic use of anti
      psychotic drugs, in combination with prolonged mild anastomotic stricture, may
      have contributed to this situation.

PMID- 11206645
TI  - Radiation-induced esophageal squamous cell carcinoma in situ.
AB  - A report of radiation-induced squamous cell carcinoma in situ of the esophagus is
      presented. This report indicates that the patient developed the carcinoma in situ
      many years after chest wall irradiation for breast cancer treatment. A review of
      the literature with respect to carcinogenesis after radiotherapy is included and
      recommendations for the follow-up of patients having mediastinal radiation are
      suggested.

PMID- 11206644
TI  - Skin tube esophagus: present indications and late malignization.
AB  - If there is no other possibility for the replacement of the whole esophagus, skin
      tube esophageal reconstruction gives a good result. Three successful cases
      treated with the antethoracal neoesophagus formed from musculocutaneous flaps are
      discussed. All patients recovered successfully. However, there exists the
      possibility of late malignization in the skin tube esophagus. Two such cases are
      also presented.

PMID- 11206646
TI  - Long-term survivors after the resection of limited esophageal small cell
      carcinoma.
AB  - Patients with small cell carcinoma of the esophagus have a poor prognosis and
      have generally been treated by chemotherapy. However, all reported cases were at
      advanced stages. We need to establish an adequate treatment for patients with
      small cell carcinoma of the esophagus with invasion limited to the submucosal
      layer. In this paper, five cases of small cell carcinomas, which accounted for
      2.8% of 180 surgically treated esophageal carcinomas, were reviewed for
      pathological findings, treatment, and outcome. Among three patients who had a
      small cell carcinoma of the esophagus with invasion limited to the submucosal
      layer, two patients survived for 7 and 9 years after surgery with no evidence of
      the disease. One of them was treated using surgery alone. Consequently, surgery
      may be considered as a possible choice of treatment for small cell carcinoma of
      the esophagus with invasion limited to the submucosa.

PMID- 11206647
TI  - Gastropericardial fistula after failure of laparoscopic hiatal repair.
AB  - We describe a 77-year-old patient with gastropericardial fistula occurring 5
      years after laparoscopic surgery for hiatal hernia and gastroesophageal reflux.
      The patient presented with isolated intermittent substernal pain without fever.
      Chest radiographs disclosed extensive pneumopericardium and thoracic computed
      tomography suggested gastropericardial fistula between the pericardium and the
      surgical wrap, slipped into the thorax. Emergency surgery allowed successful
      repair through laparotomy via the trans-hiatal approach.

PMID- 11206649
TI  - AIDS and cultural practices in Africa: the case of the Tonga (Zambia).
AB  - The fight against AIDS in Africa is often presented as a fight against "cultural
      barriers" that are seen as promoting the spread of the HIV virus. This attitude
      is based on a long history of Western prejudices about sexuality in Africa, which
      focus on its exotic aspects only (polygamy, adultery, wife-exchange,
      circumcision, dry sex, levirate, sexual pollution, sexual cleansing, various
      beliefs and taboos, etc.). The article argues that those cultural aspects are a
      wrong target of AIDS prevention programs because they are not incompatible with a
      safer behavior, and because their eradication would not ensure the protection of
      people. To fight against them might alienate the people whose cooperation is
      necessary if one wants to prevent the spread of AIDS. The major problems of AIDS
      prevention in Africa are not specifically African, but are similar to the
      problems existing in Europe or America. Therefore, anti-AIDS projects should not
      fight against one local African culture in order to impose another (Western), but
      should rather try to make behavior and practises safer in a way that is
      culturally acceptable to people.

PMID- 11206648
TI  - Mental health and stress in the workplace: the case of general practice in the
      UK.
AB  - This study adopted a 'workforce' perspective in a study of job strain in primary
      care (general practice) in the UK. It explored the level of stress amongst
      workers in general practice and between practices and examined the relationship
      between level of stress and work characteristics. Postal questionnaires were sent
      to a random sample of general practices (n = 81) in southern England. The study
      showed that 23% of all responders could be classified, according to the GHQ-12,
      as suffering from mental distress with practice managers having the highest level
      of stress and clerical and administrative staff the lowest. Work characteristics
      as measured by Karasek's Job Content Instrument were shown to be significant
      predictors of job stress as were marital status and health status. The
      implications of these findings are discussed, particularly focusing on the value
      of the job strain model for explaining job stress in general practice.

PMID- 11206650
TI  - Understanding the dynamics of illness and help-seeking: event-structure analysis
      and a Cambodian-American narrative of "spirit invasion".
AB  - Event structure analysis (ESA) and its computer analog, ETHNO, represent a class
      of relatively new methodological approaches that make it possible to capture the
      complexity of help-seeking interactions. Using narrative data from a study of
      Cambodian-American help-seeking interactions within a circumscribed illness
      episode, this paper demonstrates the feasibility of using ESA/ETHNO to illuminate
      how event sequence, operant illness beliefs, structural conditions, and human
      agency interpenetrate and shape the occurrence and timing of pivotal actions and
      the denouement of a help-seeking episode.

PMID- 11206651
TI  - Gender trends in occupancy rates in mental health beds in Northern Ireland.
AB  - Based on census material from 1926 to 1991, this study focuses on gender
      differences in occupancy rates in mental health beds in Northern Ireland. More
      specifically, using two sets of research literature--the relationships between
      war and mental health and gender and mental health respectively--it explores
      changing patterns in bed occupancy in terms of both gender and age differences
      within this society. The results suggest that, although men and women no longer
      vary in terms of their overall occupancy rates within mental health facilities in
      Northern Ireland, within their respective male and female sub-populations,
      however, some notable age-specific differences have now emerged. Since 1981,
      whereas increases in mental health bed occupancy among women have been
      exclusively confined to the old (65 years or older), among males, it is the very
      young, specifically men aged 15-24 years, who have demonstrated the most dramatic
      rise in bed usage. It is important to note, however, that these age-specific
      gender increases cannot be accounted for by demographic changes in the general
      population. The authors suggest that, at least as far as men are concerned, the
      increasing pattern of vulnerability among the young may be attributed to the
      impact of changing definitions of mental disorder rather than to the effect of
      political violence on mental health. It is to this group of individuals--the
      cohort of men born since the outbreak of civil unrest in Northern Ireland in 1969
      -that future research should be directed.

PMID- 11206652
TI  - Gender and health: reassessing patterns and explanations.
AB  - Recent research on gender and health challenges the prevailing notion of women's
      generalized health disadvantage by revealing a more variable pattern of gender
      differences in health. As such differences come to be comprehended as more
      complex than previously thought, there is a need to reassess the pathways linking
      gender and health. Using data from a Canadian national probability sample, we
      examine: (1) gender differences in distress, self-rated health, chronic
      conditions, restricted activity and heavy drinking; and (2) the role of gender
      based differential exposure and vulnerability to chronic stress and life events
      in explaining observed differences. We find that women report more distress and
      chronic conditions than men, but gender differences are reversed for heavy
      drinking, and negligible for self-rated health and restricted activity. Although
      women reported more chronic stress and life events, their greater exposure
      accounted for only some of the gender disparity in health, and only for distress.
      Differential vulnerability to stressors played no role in explaining gender
      differences in health. These findings raise questions about a gendered,
      generalized health response to the vicissitudes of life and suggest the need for
      further theoretical and empirical exploration of "gendered" experiences and their
      pathways to health.

PMID- 11206653
TI  - Knowledge, action and resistance: the selective use of pre-natal screening among
      Bedouin women of the Negev, Israel.
AB  - The selective use of prenatal screening by Bedouin women attending Ministry of
      Health, maternal and child health clinics in Israel is examined. The data consist
      of a review of 537 prenatal care records, 16 in depth interviews with mothers,
      and four interviews with health personnel. These data are part of a larger study
      that took place between 1994-99 amongst Negev Bedouin women, part of the
      Palestinian Arab minority within Israel. The record review shows that the
      majority of women who attend prenatal care do not take up referrals for Maternal
      Serum Alpha Feto Protein (MSAFP) testing or for amniocentesis tests. Although
      many women interviewed talked about the value of prenatal screening, they also
      spoke of 'false alarms' that may result from testing. Similarly, women were aware
      that the socially preferred pattern of consanguinity in marriage amongst the
      Bedouin may cause medical problems, however test uptake was unrelated to
      consanguinity. There was a variety of views concerning the permissibility of
      terminating a pregnancy. This study shows that women use prenatal screening
      selectively in a way that helps them to balance social and medical risk.

PMID- 11206654
TI  - Substance use during pregnancy in the state of California, USA.
AB  - Most analyses of prenatal substance use focus on individual level correlates and
      ignore community level variables and the effect of the dependency of respondents
      within communities. This analysis uses multilevel logistic regression models to
      more accurately assess the correlates of perinatal substance use in California.
      Statistical results indicate that a significant portion of substance use can be
      attributed to neighborhood heterogeneity, and that traditional models of
      substance use may inaccurately attribute this variation to individual level
      regression coefficients. Substantive results indicate that levels of neighborhood
      public assistance had an independent, significant effect on the prevalence of all
      substances tested for except alcohol. Black women had higher predicted prevalence
      risks for alcohol and cocaine while White women had higher predicted risks for
      tobacco, marijuana and amphetamines. Racial contrasts were non-significant for
      the overall illicit drug category and opiates, after controlling for neighborhood
      public assistance. Finally, individual level variables, with the exception of
      age, were not moderated by levels of neighborhood public assistance.

PMID- 11206655
TI  - Female control of sexuality: illusion or reality? Use of vaginal products in
      south west Uganda.
AB  - This paper reports on a trial of vaginal products that were distributed and used
      by 131 women and 21 men in south west Uganda. It focuses specifically upon the
      issue of female control in heterosexual relationships and examines whether
      methods which are ostensibly under women's control, will in practice give women
      greater control of their sexual health. Participants were invited to select two
      from a range of vaginal products that included the female condom, contraceptive
      sponge, film, tablets, foam and gel, and use each for five weeks and their
      favourite product for a further three months. They were interviewed up to seven
      times over a five-month period. Although the women perceived that a major
      advantage of the products (with the exception of the female condom) was that they
      could be used secretly, less than 40% were using the products without their
      partner's knowledge after one week and this proportion declined over time with
      only 22% using the products secretly after ten weeks. In the main male partners
      were told as women felt it their duty to inform them. In general the women were
      very much more positive about the products than they were about the male condom,
      as were the men. A contributory factor to their popularity among women was the
      greater control they gave them. Even though, use of these products in practice
      often involved negotiation with male partners, the fact that use was contingent
      on women's action was empowering and increased somewhat their ability to control
      their sexual health.

PMID- 11206656
TI  - High-risk behaviors and the prevalence of sexually transmitted diseases among
      women prisoners at the women state penitentiary in Metro Manila.
AB  - Women prisoners in the Philippines are particularly vulnerable to HIV infection.
      The economic and social disadvantages that women endure in mainstream society are
      magnified once they are committed to penitentiaries where control over one's own
      life is even more restricted and limited. Outside prison, impoverished and
      uninformed about the ways of protecting their health, women have engaged in
      unprotected sex with their male partners, many of whom have had casual sex or
      extra-marital affairs. Within prison, it is therefore not surprising that over
      25% of women were already infected with sexually transmitted diseases (STDs).
      None were infected with HIV. The presence of STDs among female inmates highlights
      the importance of addressing health needs while at the correctional facility. It
      also raises the need for educational and prevention programs and health services
      that will help reduce women's vulnerability to HIV, AIDS and STDs.

PMID- 11206657
TI  - Predictors of patient satisfaction.
AB  - Correlates of patient satisfaction at varying points in time were assessed using
      a survey with 2-week and 3-month follow-up in a general medicine walk-in clinic,
      in USA. Five hundred adults presenting with a physical symptom, seen by one of 38
      participating clinicians were surveyed and the following measurements were taken
      into account: patient symptom characteristics, symptom-related expectations,
      functional status (Medical Outcomes Study Short-Form Health Survey [SF-6]),
      mental disorders (PRIME-MD), symptom resolution, unmet expectations, satisfaction
      (RAND 9-item survey), visit costs and health utilization. Physician perception of
      difficulty (Difficult Doctor Patient Relationship Questionnaire), and Physician
      Belief Scale. Immediately after the visit, 260 (52%) patients were fully
      satisfied with their care, increasing to 59% at 2 weeks and 63% by 3 months.
      Patients older than 65 and those with better functional status were more likely
      to be satisfied. At all time points, the presence of unmet expectations markedly
      decreased satisfaction: immediately post-visit (OR: 0.14, 95% CI: 0.07-0.30), 2
      week (OR: 0.07, 95% CI: 0.04-0.13) and 3-month (OR: 0.05, 95% CI: 0.03-0.09).
      Other independent variables predicting immediate after visit satisfaction
      included receiving an explanation of the likely cause as well as expected
      duration of the presenting symptom. At 2 weeks and 3 months, experiencing
      symptomatic improvement increased satisfaction while additional visits (actual or
      anticipated) for the same symptom decreased satisfaction. A lack of unmet
      expectations was a powerful predictor of satisfaction at all time-points.
      Immediately post-visit, other predictors of satisfaction reflected aspects of
      patient doctor communication (receiving an explanation of the symptom cause,
      likely duration, lack of unmet expectations), while 2-week and 3-month
      satisfaction reflected aspects of symptom outcome (symptom resolution, need for
      repeat visits, functional status). Patient satisfaction surveys need to carefully
      consider the sampling time frame as well as adjust for pertinent patient
      characteristics.

PMID- 11206658
TI  - Why do women use dietary supplements? The use of the theory of planned behaviour
      to explore beliefs about their use.
AB  - Dietary supplements use is increasing, despite the lack of evidence to suggest
      they are needed to meet dietary deficiency in the majority of people. Reasons for
      consuming dietary supplements are likely to be complex, combining social,
      psychological, knowledge and economic factors. The Theory of Planned Behaviour
      (TPB) is a widely used model of social cognition, which has recently been applied
      to the nutrition field. It was used in a questionnaire, along with a number of
      additional measures, to explore dietary supplement use in a cohort of women. Data
      from 303 questionnaires were included in the analysis. The results showed that
      intentions were the major predictor of dietary supplement use. Health value and
      susceptibility to illness were also significant predictors of dietary supplement
      use (total of 82.9% of respondents correctly classified as users or non-users).
      Intentions themselves were most strongly predicted by attitude, with 70% of
      variance explained by attitude, subjective norms and perceived behavioural
      control. Other significant predictors of intentions were control beliefs,
      normative beliefs and health value. Beliefs underlying dietary supplement use
      revealed differences between supplement users and non-users in relation to the
      notion that taking dietary supplements acts as an insurance against possible ill
      health, with supplement users believing more strongly than non-users that taking
      dietary supplements would stop them getting ill and help them to be healthy. Both
      users and non-users of supplements also perceived the media, in the form of books
      and magazines, to be a powerful influence on a person's decision to use
      supplements. The findings of this study highlight the potential of the TPB in
      exploring supplement-taking behaviour, while throwing light on the factors
      influencing an individual's motivations to use dietary supplements.

PMID- 11206659
TI  - Managing and treating risk and uncertainty for health: a case study of diabetes
      among First Nation's people in Ontario, Canada.
AB  - 'Risk' has become a key concept for understanding health care policies that are
      focused on prevention. Intervention no longer depends on the presence of an
      illness but rather an individual's risk of developing an illness. Through 'risk
      factors' individuals are subject to medical examination and surveillance to
      determine the real presence of danger, based on this abstract notion of risk.
      This paper explores 'risk' and its consequences for medical intervention by
      focusing on biomedical practices surrounding diabetes care among First Nations on
      Manitoulin Island, Ontario. The first section explores the process of diagnosing
      diabetes. The second section outlines the treatment regimens resulting from
      membership in this category. The theme linking these two processes is that both
      diagnosis and management of diabetes depend on inclusion into categories of
      'risk'. Practices surrounding diagnosis focus on a population described 'at risk'
      for diabetes. First Nation's people. Similarly, practices surrounding management
      of diabetes focus on a population 'at risk' for secondary complications,
      referring to individuals with diabetes. As the following discussion outlines, it
      is through the quantitative assessment of risk that scientific uncertainty is
      translated into definitive therapy and the need for constant surveillance.

PMID- 11206660
TI  - The impact of health status on work, symptoms, and functional outcomes in severe
      mental illness.
AB  - This study evaluated the relationships between self-ratings of physical role
      functioning and general health, two components of the MOS SF-36, and a variety of
      demographic, quality of life, clinical, functional, and attitudinal variables in
      a cohort of adults living with severe and persistent mental illness (SPMI). We
      hypothesized that poorer self-perceptions of physical functioning and general
      health would be significantly related to more severe symptoms and poorer
      functioning and quality of life. Study subjects were 218 adults with SPMI
      enrolled in a randomized controlled trial comparing two vocational interventions
      for persons who were unemployed. Hierarchical regression analysis was used to
      determine whether psychiatric symptoms, poorer self-perceptions of role
      limitations due to physical health problems and overall general health
      independently contributed to more severe symptoms and poorer functioning and
      quality of life. Psychiatric symptoms were inversely related to size of social
      network and satisfaction with safety. Increased role limitations were associated
      with reduced medication compliance, general life satisfaction, and satisfaction
      with health, daily activities, and safety. Reduced general health was
      significantly associated with reduced work motivation, self-esteem, current
      inability to work, self-report of functioning, and almost all subjective life
      satisfaction domains. Within this group of people with severe mental illness,
      psychiatric symptoms were minimally associated with outcomes. Physical role
      limitations contributed more, and an integrated global measure of overall health
      perception was most important. If we are to help persons with severe mental
      illness maximize their quality of life and functioning, our clinical
      interventions should employ an approach that appreciates and recognizes the
      importance of the patients' experience of a holistic and integrated experience of
      health.

PMID- 11206661
TI  - Insight changes in acute psychotic episodes: a prospective study of Hong Kong
      Chinese patients.
AB  - Insight impairment occurs commonly in psychotic disorders (including mood
      episodes with psychotic symptoms). The aim of the present study is to measure
      changes of insight over the course of a psychotic episode and to investigate its
      relationships with symptoms and neurocognitive functions, as well as psychosocial
      factors. Insight was assessed at weekly intervals in 80 consecutive inpatients
      presenting with a psychotic episode by using a Chinese translation of the Scale
      to Assess Unawareness of Mental Disorder (SUMD). The relationships between
      insight change and other variables were explored. Modest but significant changes
      in insight were found in both directions with clinical resolution of psychotic
      symptoms. In particular, insight "declined" as symptoms improved in a number of
      patients. In addition, changes in insight score correlated with changes in
      Wisconsin Card Sorting Test (WCST) performance. More changes in insight (in
      either direction) tended to occur in younger patients. These results indicated
      that adequate control of psychotic symptoms and improvement in neuropsychological
      functioning might be associated with better insight recovery.

PMID- 11206662
TI  - Impact of family burden and patient symptom status on clinical outcome in bipolar
      affective disorder.
AB  - Studies have suggested that family burden adversely affects clinical outcome in
      the major mental disorders. Logistic regression analysis was used to evaluate the
      effect of family burden reported at baseline (acute model), or 7 months
      (stabilization model), on the risk of having a subsequent affective episode, in a
      sample of 264 patients with Research Diagnostic Criteria-diagnosed bipolar
      illness. Higher levels of baseline burden and a depressive index episode
      significantly increased the risk for a major episode at 7 months. Higher 7-month
      burden significantly increased the risk for a major episode at 15 months among
      patients with relatively low 7-month BPRS symptom levels. Caregiver burden
      reported at times of symptom relapse and during stabilization predicts subsequent
      adverse clinical outcomes among patients with bipolar disorder and suggests a
      need for family support.

PMID- 11206664
TI  - Effects of exposure to death in a war mortuary on posttraumatic stress disorder
      symptoms of intrusion and avoidance.
AB  - Exposure to the dead has been an important subject for traumatic stress research,
      considering that such exposure is a risk factor for posttraumatic stress disorder
      (PTSD). Individuals required to handle the dead from war are exposed to multiple
      stressors. No previous studies, however, have examined pre- and post-responses to
      traumatic death. We studied the pre-post responses of 352 military men and women
      who worked in the mortuary that received the dead from the Persian Gulf War
      (Operation Desert Storm) in 1990 to 1991. The respondents were volunteers and
      nonvolunteers for assignment to the mortuary; some had prior experience in
      handling the dead and some did not. Symptoms of intrusion and avoidance were
      measured before and after exposure. Four groups were examined based on the degree
      of exposure to remains. Age, sex, volunteer status, and prior experience handling
      remains were statistically controlled. Post-exposure intrusion symptoms increased
      significantly for all groups exposed to the dead. Increased post-exposure
      avoidance symptoms were present in the two groups with the greatest exposure to
      remains. There were no significant increases in intrusion or avoidance in the
      unexposed group.

PMID- 11206663
TI  - Family functioning in subjects with pseudoseizures and epilepsy.
AB  - The purpose of this study was to identify differences in family functioning
      between subjects with pseudoseizures and their families, and control subjects
      with epilepsy. Thirty-one adult subjects with pseudoseizures and 31 controls with
      intractable epilepsy, whose diagnoses were confirmed using video-EEG, were
      recruited from the epilepsy unit of a tertiary care hospital over a 4-year
      period. Each study participant and their first-degree adult family members
      completed two standardized questionnaires designed to measure family functioning:
      the McMaster Family Assessment Device (FAD) and the Beavers Self-Report Family
      Inventory (SFI). Individuals with pseudoseizures, when compared with epileptic
      subjects, exhibited significantly elevated scores in three scales of the FAD and
      in one scale of the SFI, indicating greater psychopathology within the family, as
      perceived by the individual. Statistically significant differences with the FAD
      were on measures of affective involvement (p = .044), communication (p = .004),
      and general functioning (p = .013). The SFI revealed significantly greater
      difficulty with conflict (p = .050). No differences were noted between subjects
      with both pseudoseizures and epilepsy and subjects with pseudoseizures alone. In
      comparison with the families of the epileptic group, the families of subjects
      with pseudoseizures displayed statistically significant elevations in their
      responses on the roles scale (p = .003) of the FAD. The responses of the family
      members did not differ in regard to the role they assumed within the family unit
      (i.e., spouse, parent). In summary, individuals with pseudoseizures view their
      families as being more dysfunctional, particularly in the area of communication,
      whereas their family members perceived difficulties in defining roles. This
      suggests that family education and interventions focusing on these areas, may be
      an important aspect of the treatment of patients with pseudoseizures.

PMID- 11206665
TI  - Characteristics of people lost to attrition in psychiatric follow-up studies.
AB  - In a large (N = 1,744) study of previously hospitalized psychiatric patients,
      multiple follow-up attempts were made to contact the ex-patients over a 1-year
      period after their discharges. When contacted they were asked to provide
      information about their posthospital adjustment; 59.5% of the sample was reached
      at least once and usable data obtained either in a telephone interview or from a
      mailed survey form. The contacted and noncontacted people represented very
      different subpopulations, both demographically and in terms of typical
      psychiatric descriptors. Those who were of lower socioeconomic status, male,
      unmarried, racial minorities, and those with records of substance abuse or
      assaultiveness, and who were generally more severely impaired during the baseline
      hospitalization were underrepresented in the contacted group. Possible reasons
      for these sample biases, the implications for hospitals conducting outcome
      assessments (i.e., for research and program evaluation purposes), and strategies
      for dealing with this kind of methodological problem are discussed.

PMID- 11206666
TI  - Literacy in the psychiatric emergency service.

PMID- 11206667
TI  - Mixed handedness and trauma symptoms in disaster-exposed adolescents.

PMID- 11206668
TI  - Evaluating the tolerability of the newer mood stabilizers.

PMID- 11206669
TI  - Benefit of long-term stimulants on driving in adults with ADHD.

PMID- 11206670
TI  - The association between antisaccade task and working memory task performance in
      schizophrenia and bipolar disorder.
AB  - To date, the research literature has yielded conflicting reports regarding the
      specificity of antisaccade deficits to schizophrenia. We sought to examine
      antisaccade and working memory task performance in schizophrenia patients and
      bipolar patients, as well as to examine the relationship between the two tasks in
      both patient populations. Thirty-four schizophrenia patients, 20 bipolar
      patients, and 30 nonpatient controls were administered saccadic inhibition
      (antisaccade), working memory, and sensorimotor tasks. Compared with the
      controls, the schizophrenia patients displayed both antisaccade deficits and
      working memory deficits. In contrast, the bipolar patients produced significantly
      more errors on the antisaccade task than the controls, though the bipolar group
      performed similarly to the control group on the working memory task. Mediational
      analyses demonstrated that working memory partially mediates the relationship
      between patients' diagnostic group status and antisaccade task performance;
      working memory performance contributed uniquely to the prediction of antisaccade
      task performance in the two patient groups. Antisaccade deficits do not appear
      specific to schizophrenia. The results suggest that in schizophrenia, working
      memory and antisaccade tasks are tapping similar cognitive processes, whereas in
      bipolar patients the processes underlying antisaccade and working memory
      performance are disparate.

PMID- 11206671
TI  - A glance back: one year into the millennium.

PMID- 11206672
TI  - A new chronotherapeutic oral drug absorption system for verapamil optimizes blood
      pressure control in the morning.
AB  - A novel verapamil chronotherapeutic oral drug absorption system (CODAS-Verapamil)
      designed for bedtime dosing and with controlled onset and extended-release
      properties was evaluated in 257 patients with mild-to-moderate essential
      hypertension in an 8-week, double-blind, placebo-controlled trial. After bedtime
      dosing (9 PM to 11 PM, this delivery system delays drug release for 4 to 5 h, and
      provides the highest concentrations of verapamil between 6 AM and noon. The study
      results showed that CODAS-verapamil produced its greatest antihypertensive effect
      during this morning period (6 AM to 12 noon) and also provided effective trough
      diastolic blood pressure reductions at 200, 300, and 400 mg. Significant trough
      systolic blood pressure reductions were achieved only with the 300- and 400-mg
      doses. The nighttime dosing regimen was not associated with excessive blood
      pressure (BP) reductions during the sleeping hours, when the antihypertensive
      effect was generally slightly less than that of the 24-h mean reduction. The
      CODAS-verapamil provides enhanced BP reduction during the morning period when
      compared with other time intervals of the 24-h dosing period.

PMID- 11206673
TI  - Inverse association of Chlamydia pneumoniae infection with high blood pressure in
      Japanese adults.
AB  - To determine whether Chlamydia pneumoniae (C. pneumoniae) infection is associated
      with hypertension in Japanese adults, we measured serum levels of IgA (a marker
      of reinfection) and of IgG (a marker of previous infection) antibodies to C.
      pneumoniae by enzyme-linked immunosorbent assay in 112 adults including
      normotensive and untreated hypertensive subjects and in 117 hypertensive subjects
      who had been receiving treatment for more than 3 years. In 112 adults, positivity
      rate for IgA was lower (P < .01) in hypertensive than in normotensive or
      borderline hypertensive subjects. Positivity rates for IgA and IgG together,
      which indicate persistent infection of C. pneumoniae, were lower (P < .01) in
      hypertensive than in normotensive subjects. IgA levels were inversely correlated
      with systolic blood pressure (SBP) (r = 0.530, P = .0001) and with diastolic
      blood pressure (DBP) (r = 0.398, P = .0001). In the 117 hypertensive subjects
      treated with medication, positivity rate for IgA was lower (P < .01) in subjects
      with poor control than in those with good control. Positivity rates for IgA and
      IgG together were lower (P < 0.01) in the poor control group than in the good or
      fair control groups. IgA levels were correlated inversely with SBP and DBP. In
      both 112 adults and 117 hypertensive patients, levels of SBP or DBP were
      inversely associated with positivity rates for IgA and IgG together in multiple
      logistic regression analysis. The results suggest an inverse relationship between
      high blood pressure and C. pneumoniae infection in Japanese adults.

PMID- 11206675
TI  - Nitric oxide does not participate in the metabolic effects of exogenous
      bradykinin in fructose-fed rats.
AB  - The study was carried out to demonstrate the effects of bradykinin (BK) on
      hypertension, hyperinsulinemia, and hypertriglyceridemia in fructose-fed rats,
      and to determine whether these actions are mediated through nitric-oxide (NO)
      formation. Eighteen rats, rendered hypertensive, hyperinsulinemic, and
      hypertriglyceridemic by a fructose-enriched diet, were studied. BK (0.2 mg/day)
      was infused intravenously using osmotic pumps attached by a catheter to the
      jugular vein of 12 rats for 12 days. BK was administered either alone (n = 6) or
      with concomitant inhibition of NO synthase (n = 6). Six untreated rats served as
      control. Measurements of systolic blood pressure (indirect method) and levels of
      insulin and triglyceride in serum were taken every second day. BK infused
      chronically, induced a marked fall in all parameters as early as the second day
      of infusion: in blood pressure from 152+/-7 to 126+/-12 mmHg, in insulin from
      8.7+/-2.9 to 4.6+/-5.4 pg/mL, and in triglyceride from 308+/-94 to 76+/-19 mg/dL.
      No such reduction was seen in untreated animals. When BK was administered
      concurrently with NO synthase inhibitor, blood pressure rose significantly,
      reaching very high values at the end of treatment. However, the reduction in
      insulin and triglyceride levels induced by BK was not affected. The capacity of
      BK to enhance reduction in hyperinsulinemia and hypertriglyceridemia in the
      fructose-fed rats is not mediated by NO formation. Whether this action of BK is
      related to a direct effect of this peptide remains to be determined.

PMID- 11206674
TI  - Sexual activity in hypertensive men treated with valsartan or carvedilol: a
      crossover study.
AB  - The aim of this study was to compare the effect of antihypertensive treatment
      with valsartan or cavedilol on sexual activity in hypertensive men who were never
      treated for hypertension. A total of 160 newly diagnosed hypertensive men
      (diastolic blood pressure [DBP] > or = 95 mm Hg and < 110 mm Hg), aged 40 to 49
      years, all married and without any previous sexual disfunction, were enrolled.
      After a 4-week placebo period, the patients were divided into two groups: a) 120
      patients were randomized to receive carvedilol 50 mg once daily or valsartan 80
      mg once daily for 16 weeks according to a double-blind, cross-over design; after
      another 4-week placebo period, patients were crossed over to the alternative
      regimen for a further 16 weeks; b) 40 patients were treated with placebo
      according to a single-blind design for 16 weeks. At the screening visit and every
      4 weeks thereafter, blood pressure (BP) was evaluated and patients were
      interviewed by a questionnaire about their sexual activity. Blood pressure was
      significantly lowered by both treatments, with a 48% of normalization with
      valsartan and 45% with carvedilol. During the first month of therapy, sexual
      activity (assessed as number of sexual intercourse episodes per month) declined
      with both drugs as compared with baseline, although the decrease was
      statistically significant in the carvedilol (from 8.2 to 4.4 sexual intercourse
      episodes, P < .01) but not in the valsartan-treated patients (from 8.3 to 6.6
      sexual intercourse episodes, not significant). Ongoing with the treatment the
      sexual activity further worsened with carvedilol (3.7 sexual intercourse episodes
      per month) while fully recovered and also improved with valsartan (10.2 sexual
      intercourse episodes per month). The results were confirmed by the cross-over.
      Erectile dysfunction was a complaint of 15 patients with carvedilol (13.5%), one
      patient with valsartan (0.9%), and one patient in the placebo group. These
      findings suggest that carvedilol induces a chronic worsening of sexual activity,
      whereas valsartan not only does not significantly worsen sexual activity but may
      even improve it.

PMID- 11206676
TI  - Relation between sodium-lithium countertransport and hypertriglyceridemia in type
      V hyperlipidemia.
AB  - Sodium-lithium countertransport (SLC) kinetics were measured in 30 patients with
      type V hyperlipidemia, 30 patients with type IIB hyperlipidemia on similar
      treatment, and 30 age- and sex-matched healthy controls. Clinical and laboratory
      data including basic anthropometry and blood pressure were obtained and blood was
      taken for detailed lipid biochemistry, glucose, insulin, and leptin measurements.
      Patients with type V hyperlipidemia were normotensive but more obese than
      controls, had elevated triglycerides, very low-density lipoprotein, glucose, and
      insulin; and reduced HDL cholesterol compared with type IIb controls. The median
      SLC activity (0.23 v 0.21 mmol Li+/L RBC/h) and median maximal velocity (0.33 v
      0.31 mmol Li+/L RBC/h) were increased, but not significantly, compared to
      controls. In patients with type V hyperlipidemia SLC maximal velocity correlated
      with log triglycerides (r2 = 0.853; P < .001) and log very low-density
      lipoprotein (VLDL) triglycerides (r2 = 0.947; P < .001). Sodium-lithium
      countertransport maximal velocity correlated weakly with the homeostasis model
      assessment index of insulin resistance (r2 = 0.224; P = .06). The sodium affinity
      of the transporter did not differ between the groups and was independent of any
      of clinical or biochemical parameter studied. We conclude that VLDL triglyceride
      is strongly correlated with SLC maximal velocity and activity in patients with
      type V hyperlipidemia.

PMID- 11206677
TI  - Sleep effects on ambulatory blood pressure measurements in pregnant women.
AB  - The aim of this study was to investigate the effect of the definition of daytime
      and nighttime on ambulatory blood pressure (ABP) in pregnancy. To determine the
      prevalence of a <10% decrease in mean arterial pressure with sleep (nondipper) in
      pregnancy and the consistency of nondipper status throughout pregnancy. In a
      prospective, longitudinal study, 102 pregnant woman underwent 24-h ABP monitoring
      and recorded sleep patterns at < or = 14, 19 to 22, 27 to 30, 35 to 37 weeks'
      gestation and 5 to 9 weeks' postpartum. Nighttime was defined by arbitrary hours
      or actual periods of sleep. Ambulatory blood pressure measurements using the
      different definitions of nighttime were compared in the total cohort and
      individual women. Nondipper status of each woman was determined throughout
      pregnancy and postpartum. At 35 to 37 weeks' gestation, 19% of women napped
      during the day and 20% were awake during the night. Throughout pregnancy, mean
      day and night systolic and diastolic ABP measurements were similar whether
      daytime and nighttime were defined by arbitrary hours or by sleep periods. In
      individuals, the use of arbitrary hours (day 07:00 to 21:59, night 22:00 to
      06:59) compared to sleep periods to define day and night resulted in differences
      in daytime systolic (SBP) and diastolic blood pressure (DBP) of up to 4 and 5 mm
      Hg, respectively. Similarly there were individual differences in nighttime SBP up
      to 10 mm Hg and DBP up to 11 mm Hg. A third of women were nondippers at least
      once during pregnancy, but only two women were consistent nondippers. The
      different definitions of day and night did not change group ABP measurements, but
      resulted in significant variation in ABP measurements in individual pregnant
      women. Nondippers were common and nondipper status frequently changed during
      pregnancy.

PMID- 11206678
TI  - Endogenous ouabain and hemodynamic and left ventricular geometric patterns in
      essential hypertension.
AB  - We sought to evaluate the relationships among circulating levels of an endogenous
      ouabain-like factor (EO) and systemic hemodynamics and left ventricular (LV)
      geometry in patients with recently diagnosed essential hypertension. We selected
      92 never-treated patients with essential hypertension. Blood samples were drawn
      for estimation of plasma EO (radioimmunoassay) and subjects underwent
      echocardiographic examination to evaluate LV end-systolic and end-diastolic wall
      thickness and internal dimensions. LV volumes, stroke volume, cardiac output,
      total peripheral resistance, LV mass, and relative wall thickness were
      calculated, and all except the last parameter were indexed by body surface area.
      LV mass also was indexed by height. On the basis of the values of LV mass index
      (body surface area or height) and relative wall thickness, subjects were divided
      into groups with either normal geometry, concentric remodeling, concentric
      hypertrophy, or eccentric nondilated hypertrophy. In the study population as a
      whole, circulating EO levels were significantly and directly correlated with mean
      blood pressure (r = 0.21, P = .048), relative wall thickness (r = 0.34, P =
      .001), and total peripheral resistance index (r = 0.37, P = .0003). Plasma EO
      also was significantly and inversely correlated with LV end-diastolic volume
      index (r = -0.32, P = .002), stroke index (r = -0.34, P = .0009), and cardiac
      index (r = -0.35, P = .0007). In multiple regression analysis, plasma EO was an
      independent correlate of total peripheral resistance index, cardiac index, and
      relative wall thickness. Regardless of the indexation method used for LV mass,
      plasma EO was higher in patients with concentric remodeling than in those with
      either normal geometry or concentric hypertrophy. Plasma EO tended to be higher
      (indexation by body surface area) or was significantly higher (indexation by
      height) in subjects with concentric remodeling than in those with eccentric
      nondilated hypertrophy. Patients with concentric remodeling showed the highest
      total peripheral resistance index and the lowest cardiac index. Our data suggest
      that EO plays a role in regulating systemic hemodynamics and LV geometry in
      patients with essential hypertension.

PMID- 11206679
TI  - Correlation between the glucose clamp technique and the homeostasis model
      assessment in hypertension.
AB  - The homeostasis model assessment (HOMA) has been extensively used as a reliable
      surrogate marker for measuring insulin resistance in patients with diabetes
      mellitus and in normal subjects. Comparative data in another insulin resistance
      state, hypertension, is lacking. The goal of the present study was to obtain that
      information by testing the correlation of HOMA with the euglycemic
      hyperinsulinemic clamp in 36 hypertensive and 27 normotensive subjects. Clamp
      derived insulin sensitivity was calculated as the glucose disposal rate over
      steady-state plasma insulin concentration. Homeostasis model assessment was
      computed using the formula (fasting glucose x fasting insulin)/22.5. There was
      significant correlation between the clamp and HOMA for both the hypertensive (r =
      -0.64, P < .0001) and normotensive subjects (r = -0.58, P = .002). The HOMA can
      be used reliably as a less expensive and less cumbersome alternative for
      measuring insulin resistance in hypertension.

PMID- 11206680
TI  - Losartan versus enalapril on cerebral edema and proteinuria in stroke-prone
      hypertensive rats.
AB  - Stroke-prone spontaneously hypertensive rats (SHRSP), subjected to high NaCl,
      show severe hypertension, organ damage, and early death. Preventive treatment
      with angiotensin II type 1 (AT1) receptor antagonists is known to be effective.
      Previously, we found that angiotensin converting enzyme (ACE) inhibition could
      reduce cerebral edema when treatment was started after manifestation of either
      proteinuria or cerebral edema. In this study AT1 receptor blockade was started at
      the same time points to evaluate whether this had an effect superior to ACE
      inhibition. SHRSP drank 1% NaCl. Group 1 served as controls. Group 2 and 3 rats
      were started on losartan and enalapril after proteinuria exceeded 40 mg/day.
      Group 4 and 5 rats were started on losartan and enalapril after the first
      observation of cerebral edema with T2-weighted magnetic resonance imaging scans.
      In controls, median survival was 54 days (range, 35 to 80 days) after the start
      of salt loading. With early-onset losartan and enalapril, survival increased to
      305 days (range, 184 to 422 days) and 320 days (range, 134 to 368 days) (both P <
      .01 v group 1). Cerebral edema formation was prevented in all but two rats, one
      from each treatment modality. Development of proteinuria was markedly reduced.
      With late-onset treatment with losartan and enalapril, survival was 290 days
      (range, 120 to 367 days) and 264 days (range, 154 to 319 days) (both P < .01).
      Both losartan and enalapril decreased cerebral edema to baseline levels.
      Ultimately cerebral edema reoccurred, despite continued treatment, in 75% of the
      rats. Systolic blood pressure did not decrease after losartan treatment, but,
      similarly to early-onset treatment, decreased transiently after enalapril
      treatment. Cerebral edema and proteinuria were prevented and reduced in SHRSP
      treated with either an AT1 receptor antagonist or an ACE inhibitor. Survival was
      markedly and similarly prolonged by both treatments, whether initiated directly
      before or after development of cerebral edema. In rats where treatment was
      initiated after manifestation of cerebral edema, both cerebral edema and
      proteinuria reappeared despite continued treatment. Apparently, when hypertension
      is sustained, reappearance of target organ damage may not be entirely dependent
      on angiotensin.

PMID- 11206681
TI  - Hypertension due to renal artery occlusion in a patient with antiphospholipid
      syndrome.
AB  - We report an unusual case of renovascular hypertension in a 16-year-old boy with
      primary antiphospholipid syndrome (PAPS), admitted to our clinic for severe drug
      resistant hypertension and hypokalemia. Hormonal investigation revealed secondary
      aldosteronism and positive captopril test for renovascular disease. Aortography
      confirmed the occlusion of the left renal artery. After nephrectomy,
      normalization of blood pressure and secondary aldosteronism occurred. Presently
      the patient remains in good health, receiving warfarin anticoagulant therapy.
      PAPS is defined by the presence of antiphospholipid antibodies and recurrent
      thrombosis. Arterial thrombosis (29%) appears to be less prevalent than venous
      thrombosis. Thrombotic microangiopathy of the kidney is frequently observed but
      renal artery occlusion, as seen in our patient, is unusual.

PMID- 11206682
TI  - Effects of short- and long-acting calcium channel blockers on the relationship
      between blood pressure and physical activity.
AB  - Calcium channel blockers are widely used as antihypertensive drugs. However,
      there is some controversy as to how they should be used. Our first aim was to
      clarify how the dihydropyridine calcium channel blocker, benidipine, affects the
      quantitative relationship between blood pressure (BP) and physical activity. The
      second aim was to determine whether there is a relationship between systolic
      blood pressure (SBP) and physical activity in patients with hypertension when
      treating with a short-acting (nifedipine) or long-acting (benidipine) calcium
      channel blocker. In Study 1, ambulatory BP and physical activity were measured
      simultaneously in 27 patients with hypertension before and after 6 months with
      benidipine. In Study 2, ambulatory BP and physical activity were measured
      simultaneously in 16 patients with hypertension before (placebo) and after 6
      weeks of crossover treatment with nifedipine and benidipine. In Study 1, there
      was no difference in the SBP change caused by physical activity between the pre-
      and posttreatment periods. In Study 2, SBP was significantly related to physical
      activity in the placebo (16/16) and benidipine (16/16) groups but not in the
      nifedipine (12/16) group. The lowest BP during day-time and nighttime in the
      nifedipine group were significantly lower than those in the benidipine group.
      Plasma renin activity (ng/mL/h) was significantly higher in the nifedipine group
      (1.20+/-1.05) than in the placebo (0.57+/-0.59) and benidipine (0.75+/-0.78)
      groups. These findings indicate that nifedipine might interfere with the
      adaptation mechanism of BP changed by physical activity and that the activated
      renin-angiotensin system might cause cardiac events.

PMID- 11206683
TI  - Coronary microvasculature alteration in hypertensive rats. Effect of treatment
      with a diuretic and an ACE inhibitor.
AB  - The development of hypertension is accompanied by rarefaction of arterioles and
      capillaries in both animal models and humans. Although many studies have examined
      the effects of antihypertensive therapies on hemodynamics, cardiac hypertrophy,
      and large vessel structure, the question of whether changes in microvascular
      density induced by hypertension can be restored by pharmacologic treatment has
      yet to be answered. We report a series of experiments performed in rats with
      renovascular hypertension induced by unilateral nephrectomy and renal artery
      stenosis (Goldblatt one-kidney, one-clip model). Animals were treated for 4
      weeks, after renal artery clipping, either with an angiotensin converting enzyme
      inhibitor (perindopril [PER], 0.76 mg/kg/day), or with an indol derivative
      diuretic with specific vascular properties (indapamide [IDP], 0.24 mg/kg/day) or
      with the combination of both drugs at the same doses as during monotherapy.
      Coronary microvessel densities (arterioles and capillaries) were evaluated by
      double immunolabeling in nonserial cryostat sections of the left ventricular
      inner myocardium. After 4 weeks of hypertension (mean arterial pressure, 174+/-11
      v 124+/-5 mm Hg in normotensive (NT) controls, P < .01), cardiac hypertrophy
      (+59%, P < .001) was associated with a significant increase in myocardial
      arteriolar density (+27%, P < .01), and a decrease in capillary density (-12%, P
      < .05). Treatment with PER prevented the increase in arterial pressure, heart
      weight, and arteriolar density, but did not significantly affect the low coronary
      capillary density in comparison with that measured in untreated hypertensive (HT)
      rats. Treatment with IDP preserved normal capillary myocardial density but did
      not significantly lower the blood pressure (BP) (169+/-9 mm Hg) and only slightly
      reduced the cardiac ventricular hypertrophy: - 14% v untreated HT (P < .05) and
      +37% v NT (P < .01). In the same way, IDP normalized the left ventricular
      capillary density in spontaneously HT rats (+18% v untreated rats, P < .01). The
      combination of both drugs, PER and IDP, at the same low doses as during
      monotherapy, resulted in normal levels of arterial pressure and complete
      normalization of cardiac hypertrophy and arteriolar and capillary myocardial
      densities. In conclusion, the results observed after PER suggest that blockade of
      the renin-angiotensin system could inhibit large coronary vessel growth but
      minimally affects the capillary density despite complete normalization of BP.
      Indapamide could have beneficial effect on myocardial capillary density. The
      combination of IDP and PER has additional effects and prevents the increase in BP
      and cardiac weight, and reverses microvascular rarefaction, specifically
      arteriolar and capillary densities.

PMID- 11206684
TI  - Effect of sildenafil in patients with erectile dysfunction taking
      antihypertensive therapy. Sildenafil Study Group.
AB  - Oral sildenafil is an effective treatment for erectile dysfunction (ED), which is
      a common complaint for patients with hypertension and those taking
      antihypertensive agents. This post hoc subanalysis assessed the efficacy and
      safety of sildenafil in men with ED who were receiving concomitant
      antihypertensive medication. Efficacy was assessed in 3414 men (1218 of whom were
      taking antihypertensive medication) who received sildenafil (5 to 200 mg) or
      placebo for 6 weeks to 6 months in 10 double-blind, placebo-controlled studies.
      The significant improvements in erectile function demonstrated by sildenafil
      treated patients were comparable in patients taking and those not taking
      antihypertensive medication. Safety was assessed in 3975 men (1094 of whom were
      taking one or more antihypertensive agent, classified as a diuretic, beta
      blocker, alpha1-blocker, angiotensin converting enzyme inhibitor, or calcium
      channel blocker), who received sildenafil or placebo in 18 double-blind, placebo
      controlled studies. For patients taking sildenafil and antihypertensive
      medication, the incidence of treatment-related adverse events (34%) was similar
      to that for sildenafil-treated patients not taking any antihypertensive agent
      (38%). The incidences of the most common adverse events and of adverse events
      potentially related to blood pressure decreases (eg, hypotension, dizziness, and
      syncope) were similar in both sildenafil groups. The number of antihypertensive
      medications taken from among the five classes had no effect on the adverse event
      profile of sildenafil. Sildenafil is an effective and well-tolerated treatment
      for ED in patients taking concomitant antihypertensive medication, including
      those on multidrug regimens.

PMID- 11206685
TI  - Device-guided breathing exercises reduce blood pressure: ambulatory and home
      measurements.
AB  - Slow breathing practiced routinely using an interactive device has demonstrated a
      sustained reduction in high blood pressure (BP). We reevaluated the BP response
      of hypertensives (n = 13) to this daily treatment for 8 weeks using 24-h
      ambulatory, home, and office BP measurements. A clinically significant BP
      reduction of similar magnitude was observed in all BP monitoring modalities
      during the daytime. Greater BP reductions were found for older patients and
      higher baseline BP. The results provide additional support for the efficacy of
      the device as an adjunctive lifestyle modification for treating hypertension.

PMID- 11206686
TI  - Preeclamptic serum enhances endothelin-converting enzyme expression in cultured
      endothelial cells.
AB  - Increased vascular sensitivity to vasoconstrictors, such as angiotensin II and
      epinephrine, is observed in preeclampsia (PE). Recently, it was suggested that
      abnormal endothelial function might contribute to the pathophysiologic changes in
      PE. We investigated vasoconstrictor (angiotensin II and epinephrine)-induced
      endothelin-1 (ET-1) release from human umbilical vein endothelial cells incubated
      with sera from women with PE compared with normotensive pregnant and nonpregnant
      women. Moreover, inositol 1,4,5-trisphosphate production and endothelin
      converting enzyme (ECE) expression in human umbilical vein endothelial cells were
      also evaluated. There were no significant differences in ET-1 release without
      vasoconstrictors among the three groups (nonpregnant, normotensive pregnant, and
      PE). No significant differences in basal inositol 1,4,5-trisphosphate production
      and ECE expression without vasoconstrictors were detected among the three groups.
      Vasoconstrictor-induced ET-1 release was significantly increased by PE sera. No
      significant difference was detected in vasoconstrictor-induced inositol 1,4,5
      trisphosphate production among the three groups. However, ECE expression after
      incubation with vasoconstrictor was significantly increased by PE sera. Our
      results suggest that ET-1 release from endothelial cells may contribute to the
      increased vascular sensitivity to vasoconstrictors observed in PE, and that
      vasoconstrictor-induced ET-1 release may be related to enhanced ECE expression.

PMID- 11206687
TI  - Laragh's lessons in pathophysiology and clinical pearls for treating
      hypertension.

PMID- 11206688
TI  - Teenage women's use of contraceptives in two populations.
AB  - BACKGROUND: Adolescent patterns of contraceptive use might be different in
      various populations and might have changed in the last 30 years. More appropriate
      use of contraception could prevent unplanned pregnancy. METHODS: We interviewed
      378 women in rural East Tennessee and 396 women in suburban-urban Baltimore, all
      of whom were aged 18 to 50 years, in a convenience sampling about their memories
      of sexual experiences and early contraceptive use. RESULTS: First sexual
      experiences began at a younger age in women from Tennessee than in women from
      Baltimore. Sexual experiences occurred at an earlier age during the last 15 years
      in Baltimore women. Contraceptive use at first sexual experience has
      approximately doubled in both locations, from 7% to 15% in Tennessee and from 42%
      to 75% in Baltimore during the last 15 years. The primary reason in Baltimore is
      increased use of condoms. Condom use in Tennessee is very low. CONCLUSIONS: These
      two populations are using contraception and condoms differently. Although the two
      populations are diverse, it could help physicians to learn about the particular
      contraceptive practices of their patient population to help their patients more
      appropriately with their contraceptive needs.

PMID- 11206689
TI  - Comparison of anticoagulation clinic patient outcomes with outcomes from
      traditional care in a family medicine clinic.
AB  - BACKGROUND: Giving patients oral anticoagulation therapy in an ambulatory clinic
      setting is associated with substantial risk of adverse outcomes leading to
      emergency department visits and unplanned inpatient admissions. This article
      describes an effectiveness study conducted in a well-characterized family
      practice setting that compares anticoagulation outcomes in patients managed by a
      traditional care model with outcomes obtained with an anticoagulation clinic
      model. METHODS: All study patients received continuous anticoagulation care at
      the Family Medicine of Southwest Washington (FMSW) clinic during the 1-year study
      period. The method was retrospective and used linked record review, including
      outpatient, inpatient, and emergency department records. Patients were divided
      into two groups as naturally observed: those treated in the clinic by traditional
      care compared with those treated in an anticoagulation clinic model. Data
      analyses compared the two groups in terms of patient demographics,
      anticoagulation control, and inpatient admissions and emergency department visits
      that were related to clotting or bleeding events. RESULTS: There were no
      differences in demographic variables between the anticoagulation clinic and
      traditional care groups. There was a statistically significant difference in
      anticoagulation control as measured by international normalized ratio (INR)
      values. The anticoagulation clinic group had fewer INR values outside the target
      range, +/- 0.1, than the traditional care group (40.4% vs 47.3% P = .022). The
      anticoagulation clinic group also had significantly fewer INR tests drawn more
      than 6 weeks apart than the traditional care group (3.7% vs 8.1% P = .01). There
      was no statistically significant difference in emergency department visit rates
      caused by adverse events. Inpatient admission rates for the anticoagulation
      clinic and traditional care groups were not statistically different; however,
      they were clinically different (4.7 vs 19.7 admissions per 100 patient years of
      therapy P = .15). CONCLUSIONS: More anticoagulation patients treated by the
      anticoagulation clinic model at FMSW received an INR test at least every 6 weeks
      than those treated by the traditional care model, and more of their INR results
      were within target range +/- 0.1 when compared with the traditional care model.

PMID- 11206690
TI  - Compounded percutaneous testosterone gel: use and effects in hypogonadal men.
AB  - BACKGROUND: Current methods of testosterone replacement therapy are limited to
      fixed-dosage patches and depot injections. Neither of these methods provides
      ideal therapy because of the inflexibility of dosing and other nuisance problems
      associated with the patches and nonphysiologic hormone levels when depot
      injections are used. Testosterone gels offer the potential for convenience and
      ease of administration, as well as flexible dosing regimens, by means of a simple
      topical application. METHODS: Ten hypogonadal men were selected from the author's
      general practice, ranging in age from 44 to 77 years. Four of these men had newly
      diagnosed and 6 had preexisting hypogonadism. Patients were withdrawn from their
      previous hormone therapy (where applicable), and baseline laboratory studies were
      obtained for total testosterone, free testosterone, dihydrotestosterone,
      estradiol, luteinizing hormone, follicle-stimulating hormone, complete blood
      counts, lipid panels, and chemistry panels. The patients then started taking
      increasing dosages of the testosterone gel until physiologic levels of
      testosterone were realized or until the study period (6 weeks) was concluded.
      There was no blinding, and each patient served as his own control. Testosterone
      and free testosterone levels were monitored weekly, and estradiol and
      dihydrotestosterone less frequently. At the conclusion of the study, all the
      baseline laboratory tests were repeated. A questionnaire evaluating the
      psychosexual well-being of the patients was administered before and after the
      treatment period. RESULTS: The average total testosterone level rose from 136
      ng/dL to 442.9 ng/dL (P < .001). Average free testosterone levels rose from 34.2
      pg/mL to 120.3 pg/mL (P < .001). Average dihydrotestosterone levels rose from
      20.5 to 199.2 ng/dL (P = .006). Average estradiol levels rose only slightly from
      34.1 pg/mL to 40.0 pg/mL P = .191). Average total androgens (testosterone plus
      dihydrotestosterone) rose in all patients to therapeutic levels, from 149.3 ng/dL
      to 642.1 ng/dL (P = .001). The ratio of total androgen to estradiol rose from 5.1
      to 17.1 (P < .002). Luteinizing hormone was suppressed in the 6 patients for whom
      meaningful data were available, and decreased on average from 5.66 to 1.10 mIU/mL
      (P = .005) Lipid effects were measured, and a 15% drop in all cholesterol
      fractions was noted (P < .005). Evaluation of the questionnaire showed
      considerable improvements in sexual function and overall well-being in all but 1
      patient. No adverse effects or nuisance-problems were detected during the
      duration of the study. CONCLUSION: Topically applied testosterone gels are an
      effective and convenient means of hormone replacement in hypogonadal men.

PMID- 11206691
TI  - A primary care approach to the infertile couple.
AB  - BACKGROUND: Approximately 20% of reproductive age couples have difficulty
      conceiving or maintaining an established pregnancy. The family physician is in a
      unique position to provide patient education, begin initial evaluation, make
      appropriate referrals, and offer ongoing counseling and support to couples who
      experience problems with fertility. METHODS: And extensive clinical review was
      conducted based on a MEDLINE search, the Cochrane database of systematic reviews,
      and other supporting evidence. RESULTS: Major physiologic influences affecting
      live birth rates include age, coital frequency, and duration of infertility. Male
      factor is associated with approximately 40% of these cases and should be
      addressed early in the evaluation. CONCLUSION: Many conditions once considered
      untreatable can now be routinely corrected. As managed care programs expand
      coverage to include infertility services, primary care providers will be asked to
      participate in the initial phase of this care. This article offers a practical
      approach.

PMID- 11206692
TI  - Crossing diagnostic borders: herpes encephalitis complicated by cultural and
      language barriers.
AB  - BACKGROUND: The patient who complains of vague mental status changes requires
      extra vigilance in that the underlying condition might itself affect the
      patient's ability to communicate well and relate a medical history. The
      differential diagnosis of delirium is broad, ranging from the benign to the
      potentially fatal. The diagnostic uncertainty inherent in primary care is
      compounded when language and cultural differences interfere with physician
      patient communication. METHODS: We undertook a MEDLINE-assisted review of the
      medical literature concerning herpes simplex encephalitis. Additionally, we
      performed an Internet search of several government Web sites to find current
      legal and federal guidelines concerning the use of medical interpreters. RESULTS
      AND CONCLUSIONS: We recount the case of a young Eastern European immigrant who
      complained initially of vague mental status changes and was found to have herpes
      simplex encephalitis. Diagnosis could have been made sooner had the physician
      been familiar with the patient's baseline mental status or had cultural and
      language barriers not stood between the physician and the patient and his mother.
      Herpes simplex encephalitis is a rare, but specific, cause of delirium for which
      prompt diagnosis and treatment with intravenous acyclovir can prevent death or
      serious sequelae.

PMID- 11206693
TI  - Screening for Strongyloides infection among the institutionalized mentally
      disabled.
AB  - BACKGROUND: Strongyloidiasis is an intestinal helminthic infection common among
      the mentally disabled population and can cause persistent occult infection before
      resulting in disseminated, possibly fatal disease. METHODS: Two cases of
      strongyloidiasis are described. The literature was searched using the key words
      "Strongyloides" and "mass screening." RESULTS AND CONCLUSION: Strongyloidiasis is
      clinically important and well documented in the mentally disabled populations
      both in endemic and nonendemic regions of North America. It has a substantial
      latent phase during which screening can be conducted, and its treatment with
      thiabendazole is convenient, effective, and reasonably well tolerated. Although
      strongyloidiasis is usually incidentally detected by findings of eosinophilia
      during routine blood screening, peripheral eosinophilia occurs only in 50% to 80%
      of infected persons and is extremely nonspecific for Strongyloides infection.
      Given the high cost of critical care for a patient with disseminated disease,
      screening mentally disabled populations in institutional settings for
      strongyloidiasis by administering the Strongyloides stercoralis antibody ELISA
      appears justifiable, particularly if risk factors for hyperinfection syndrome are
      used to select a subpopulation to be screened.

PMID- 11206694
TI  - Community-oriented primary care: historical perspective.
AB  - BACKGROUND: Community-oriented primary care (COPC) is a systematic approach to
      health care based upon principles derived from epidemiology, primary care,
      preventive medicine, and health promotion. We describe the development of COPC
      from an historical perspective. A critical assessment of current trends and
      implication for physician education and practice of COPC will be discussed in a
      companion article in the next issue of The Journal. METHODS: MEDLINE was searched
      using the key phrase "community-oriented primary care" Other sources of
      information included books and other documents. RESULTS AND CONCLUSIONS: In the
      1950s, Sydney Kark showed dramatic positive changes in the health status of the
      population of Pholela, South Africa, using this approach. Similar approaches
      showed positive change in the health status of poor and underserved populations
      in the United States. The results were so impressive that the Institute of
      Medicine recommended widespread application of COPC in the United States.
      Successful COPC practices, however, have historically required considerable
      external funding from private and government sources. Thus, controversy about the
      feasibility of implementation of COPC in mainstream primary care practices
      developed. Schools of medicine and the discipline of family medicine have
      struggled to implement effective training in COPC within traditional medical
      school and residency structures. Yet, the societal need for recognition of and
      intervention in community health problems and coordination of community health
      resources continues.

PMID- 11206695
TI  - Mid-third femoral stress fracture with hip pain.

PMID- 11206696
TI  - Neonatal lupus erythematosus.

PMID- 11206697
TI  - Feasibility of using an alcohol-screening and health education system with older
      primary care patients.
AB  - BACKGROUND: This study evaluated the feasibility of a combined alcohol-screening
      and health education system for elderly patients METHODS: The Computerized
      Alcohol-Related Problems Survey (CARPS) was evaluated in primary care practices
      among 106 current drinkers, 60 years and older. The CARPS contains (1) a self
      administered screening survey; (2) software to scan or hand-enter survey
      responses; (3) software to process data and electronically generate reports of
      patients' drinking risks; (4) health education; and (5) a database useful for
      clinical and quality improvement purposes. RESULTS: Nearly all study participants
      were able to complete the CARPS while waiting for a prescheduled appointment with
      their physician. There were 44% of patients who were hazardous and 9% who were
      harmful drinkers. About 20% of men and 26% of women were binge drinkers. Most
      (85%) patients agreed that alcohol is an important topic, 67% reported learning
      new information, 78% had never discussed drinking with a physician, and 31%
      intended to do so. After reviewing CARPS data, physicians concluded that alcohol
      use in the elderly is an important quality improvement topic. CONCLUSIONS:
      Combined screening and health education systems appear feasible for use in
      practice if they deal with pertinent health problems such as alcohol use. Their
      data can encourage discussions between physicians and patients and might be used
      for quality improvement activities.

PMID- 11206698
TI  - Benzene-induced myelodysplastic syndrome.

PMID- 11206699
TI  - While you're waiting, let me introduce you to our computer.

PMID- 11206700
TI  - Family practice and emergency medicine.

PMID- 11206701
TI  - Pica and developmental disability.

PMID- 11206702
TI  - Dopamine D4 receptors and development of newer antipsychotic drugs.
AB  - The last ten years have witnessed the generation of a large amount of information
      on the neurobiology of dopamine receptors. Molecular biology and pharmacology
      studies have revealed existence of at least five dopamine receptor subtypes,
      namely D1, D2, D3, D4 and D5. The discovery of D4 receptors and the putative
      affinity of clozapine for D4 receptors have kindled development of selective D4
      receptor antagonists for the treatment of schizophrenia. Studies on expression of
      D4 receptor proteins have shown selective localisation of D4 receptors in
      mesolimbic/mesocortical areas which could probably explain the lack of motor side
      effects with atypical antipsychotics like clozapine and olanzapine. However,
      neuropathological and genetic studies on the role of D4 receptors in the
      pathophysiology of schizophrenia and preliminary clinical studies with selective
      D4 receptor antagonists have been disappointing. There have been, however,
      complimentary findings between selective D4 receptor antagonism and genetic
      approaches such as antisense treatment or gene targeting. The therapeutic
      potential of D4 receptors as a target for developing antipsychotics will be known
      only when selective D4 receptor-antagonists with varying D2/D4 and D4/5-HT2A
      ratios are developed and tested in psychiatric patients.

PMID- 11206703
TI  - Angiotensin II type 1 receptor antagonist versus angiotensin I-converting enzyme
      inhibitor in experimental renal diseases.
AB  - Angiotensin II has an important role in the structural and functional regulation
      of the cardiovascular and renal systems. Blockade of the renin-angiotensin system
      can be achieved with angiotensin-converting enzyme (ACE) inhibitors and non
      peptidic, orally active, angiotensin II type I receptor (AT1) antagonists.
      However, the question that has yet to be answered is whether ACE inhibitors and
      AT1 receptor antagonists have similar renoprotective effects in various
      experimental diseases. Although many studies have assessed the role of either ACE
      inhibitors or AT1 receptor antagonists, we have reviewed the literature comparing
      both types of blocker in the same experiment. In most models of hypertension or
      renal failure, both classes of blocker appear to have similar antihypertensive
      and renal profiles. In a few models, the influence of the ACE inhibitor on
      arterial pressure and/or renal function is more marked than that of the AT1
      receptor antagonist. Even though the maximum dose-effect curve for each compound
      was not often carried out for the systemic haemodynamics and renal alterations,
      the difference between both classes of blocker, when observed, appeared to favour
      the participation of non-angiotensin II or non-AT1-mediated mechanisms. Among
      them are the stimulation of prostaglandin production, kinin accumulation, nitric
      oxide generation and modulation of endothelin or TGFbeta1 expression via direct
      or indirect pathways. Future experimental and probably human studies aimed at
      comparing angiotensin II receptor antagonists and ACE inhibitors, with respect to
      blood pressure and renal damage, should be designed with all these concerns in
      mind.

PMID- 11206704
TI  - Pathophysiology of aldosterone and its antagonists.

PMID- 11206705
TI  - The protective effect of melatonin on cisplatin nephrotoxicity.
AB  - Regarding the mechanisms of cisplatin (CP) nephrotoxicity, several hypotheses
      have been put forward, among which oxidative stress (including depletion of
      glutathione and production of lipid peroxide) is noticeable. This investigation
      elucidates the role of the antioxidant system in CP-induced nephrotoxicity and
      the nephroprotection by melatonin. Balb/c mice were injected i.p. with: 1)
      vehicle control; 2) a single dose of 6.5 mg/kg cisplatin, CP group; 3) melatonin
      in a dose of 10 mg/kg for 5 days after CP injection, CP-M group; 4) melatonin (10
      mg/kg) for 5 days before and after CP injection, M-CP-M group; 5) melatonin in a
      dose of 10 mg/kg for 5 days, M group. Mice were sacrificed 5 days after CP
      injection to determine blood urea nitrogen (BUN) and serum creatinine. Renal
      lipid peroxidation (LP) and glutathione (GSH) levels were evaluated in kidney
      homogenates. Cisplatin administration resulted in increased LP, BUN and serum
      creatinine levels and decreased GSH levels, whereas melatonin reversed these
      effects. Morphological kidney damage was apparent in the CP group. Mentioned
      degeneration was moderate in the CP-M group, whereas morphological findings of
      the M-CP-M group implied a well preserved kidney tissue. When M was administered
      alone, it didn't cause any significant change in biochemical parameters. Both C
      and M groups exhibited similar biochemical and morphological findings in light
      and transmission electron microscope observation. In conclusion, the present
      study suggests that melatonin may be of therapeutic benefit when used with CP.

PMID- 11206706
TI  - Protective effect of aminoguanidine in a murine model of pulmonary fibrosis
      induced by bleomycin.
AB  - Aminoguanidine is a drug known for more than a century, which has been attracting
      increasing interest in recent years due to the discovery of new pharmacological
      properties. This study investigated the effects of aminoguanidine on the fibrotic
      response induced by intratracheal administration of bleomycin to rats. Three
      groups of animals were studied: Group A (n = 19) corresponded to the control
      group. Group B (n = 20) received 10 IU/kg bleomycin intratracheal, and Group C (n
      = 12) received the same amount of bleomycin as Group B followed by 50 mg/kg/day
      aminoguanidine bicarbonate for 4 weeks. Aminoguanidine led to significant
      reductions in total hydroxyproline content of the lungs in Group C compared to
      Group B (Group A: 1.83+/-0.14 mg x Group B: 3.46+/-0.36 mg x Group C: 2.09+/-0.22
      mg). Morphometric collagen studies carried out on histological sections stained
      with Sirius red F3BA showed that aminoguanidine promoted a significant reduction
      of the area occupied by collagen in the axial and septal zones of the lungs
      (Axial region = Group A: 4.29+/-1.31% x Group B: 19.30+/-4.86% x Group C: 8.52+/
      1.96%; Septal region = Group A: 0.15+/-0.06% x Group B: 0.61+/-0.21% x Group C:
      0.15+/-0.06%). These results suggest that aminoguanidine is a potential
      therapeutic agent for the treatment and prevention of pulmonary fibrosis which is
      associated with different clinical conditions.

PMID- 11206707
TI  - Effects of zinc ions on Ca2+ uptake during histamine-induced contraction in
      guinea-pig taenia coli.
AB  - The present study was undertaken to clarify the effects of zinc ions (Zn2+) on
      Ca2+ uptake during histamine-induced contraction in guinea-pig taenia coli. Zn2+
      (0.3 mM) had smaller effect on the initial phasic response to 10(-5) M histamine
      accompanied with decreased Ca uptake at the high affinity sites, while it
      inhibited the tonic response by inhibiting Ca2+ uptake at the low affinity sites.
      After the first stimulation with histamine in the presence of Zn2+, the Ca2+
      binding at high affinity sites was not significantly recovered in the presence of
      Zn2+. A second stimulation with histamine in the presence of Zn2+ did not elicit
      any phasic response. Furthermore, after beta-escin treatment of the fibres, which
      leaves receptor-coupled signal transduction including the Ca2+ storage sites
      intact, the contraction due to 10(-5) M histamine was not so affected by 0.3 mM
      Zn2+, but, after resuspension in a solution of pCa 5, 10(-5) M histamine of
      second application did not elicit the contraction in the presence of Zn2+. These
      results suggested that Zn2+ does not affect the histamine-induced Ca2+ release
      from the intracellular storage sites in taenia coli. However, when Zn2+ is
      present, Ca2+ is not supplied to the storage sites for the phasic response due to
      second stimulation with histamine. In addition, Zn2+ reduced the tonic response
      to histamine mainly by inhibiting Ca2+ influx through receptor-operated and/or
      voltage-dependent Ca2+ channels.

PMID- 11206708
TI  - Interaction between the partially insurmountable antagonist valsartan and human
      recombinant angiotensin II type 1 receptors.
AB  - The interaction between the AT1 receptor-selective antagonist valsartan, and its
      human receptor, was investigated by direct radioligand binding as well as by its
      inhibition of angiotensin II induced inositol phosphate accumulation in CHO cells
      expressing human recombinant AT1 receptors. Specific binding of [3H]-valsartan
      rapidly reached equilibrium at 37 degrees C. It was saturable and occurred to a
      homogeneous class of sites with a K(D) of 0.88+/-0.076. It was inhibited by other
      AT1 receptor antagonists with the same potency order as previously described for
      the binding of [3H]-angiotensin II and [3H]-candesartan to human AT1 receptors
      (i.e. candesartan > or = EXP3174 > valsartan = irbesartan = angiotensin II >
      losartan). When valsartan and angiotensin II were applied simultaneously to the
      CHO-AT1 cells. the antagonist caused a rightward shift of the angiotensin II
      concentration response curve. Hence, valsartan interacts with the AT1 receptor in
      a manner that is competitive with angiotensin II. Pre-incubation of the cells
      with 0.5, 5 and 50 nM valsartan caused an additional, concentration-dependent, up
      to 55% decline of the maximal response. The partial nature of this insurmountable
      inhibition by valsartan was confirmed by biphasic antagonist concentration
      inhibition curves. These data reflect the co-existence of a fast
      reversible/surmountable as well as a tight binding/insurmountable valsartan
      receptor complex. In agreement, pre-incubation of the CHO-AT1 cells with 5 and 50
      nM valsartan produced a partial inhibition of the angiotensin II induced increase
      of the free intracellular calcium concentration. [3H]-Valsartan dissociated from
      its receptors with a half-life of 17 min. In functional recovery experiments with
      valsartan-pre-treated cells, the angiotensin II-mediated response was half
      maximally restored within approximately 30 min. These kinetic data suggest that
      the insurmountable inhibition by valsartan is related to its relatively slow
      dissociation from the human AT1 receptors.

PMID- 11206709
TI  - Cardiovascular effects of chronic ifenprodil in a model of central sympathetic
      stimulation.
AB  - In the present study we investigated the effects of a long-term treatment (14
      days) with ifenprodil on the excitatory haemodynamic responses induced by central
      pharmacological stimulation in anaesthetised rabbits. The intracerebroventricular
      injection of L-glutamate (3 mg/kg) induced important rises in dP/dtmax (32.9%),
      mean arterial pressure (42.6%) and in the myocardial oxygen consumption index:
      the triple product (84.2%). Ifenprodil (1.5, 3 and 6 mg/kg/day, i.p.) reduced the
      increases in myocardial oxygen demand induced by intracerebral L-glutamate in a
      dose-related manner. Interestingly, ifenprodil also reduced in a dose-dependent
      manner the maximum values of the oxygen demand indices reached during the central
      nervous system stimulation. These results indicate that the long-term treatment
      with ifenprodil can reduce the myocardial oxygen consumption induced by central
      nervous system stimulation without significant depression of the resting cardiac
      function. This favourable effect of ifenprodil is in fact a consequence of the
      association of mild inhibitory effects on the three parameters taken into account
      in the triple product index of myocardial oxygen consumption.

PMID- 11206711
TI  - Ursodeoxycholic acid modulates cyclosporin A oral absorption in liver transplant
      recipients.
AB  - The aim was to study the ursodeoxycholic acid (UDC) effect on the cyclosporin A
      (CsA) pharmacokinetics after oral administration of the microemulsion formulation
      Neoral (CsA-ME) in liver transplant recipients, and test the potential protective
      effect of this bile acid on liver and renal CsA-ME-induced toxicity. At entry
      into the study, 12 patients who underwent orthotopic liver transplantation
      received CsA-ME, for at least 6 months. They then received a cotreatment CsA-ME
      plus UDC (13.8 mg x kg(-1) x day(-1)) for three months. Blood concentrations of
      CsA were measured using a monoclonal antibody specific for the parent compound.
      The kinetic data were analysed by a mathematical model incorporating a time
      dependent rate coefficient for CsA intestinal absorption, before and after UDC
      treatment. Changes in serum markers of hepatic and renal injury were assessed.
      Individual serum bile acids were determined by chromatography. Serum levels of
      UDC increased from 3 to about 45% of total serum bile acids after UDC treatment.
      The estimated model parameters indicate that UDC administration modulates CsA
      intestinal absorption. In the nine non-cholestatic patients, UDC reduced the
      absorption rate and the bioavailability of CsA without modifying the elimination
      rate constant of CsA and the CsA pre-drug levels. In contrast, in the three
      cholestatic patients, the bioavailability tended to be higher and the absorption
      rate faster when CsA was combined with UDC. UDC significantly decreased elevated
      gamma-glutamyl transferase and creatinine serum levels and induced some clinical
      improvements such as disappearance of headaches in four patients. In conclusion,
      a 3-month UDC treatment modifies CsA intestinal absorption without affecting CsA
      elimination rate constant. On the other hand, UDC supplementation appears to
      improve CsA tolerability.

PMID- 11206710
TI  - Effect of lipopolysaccharide treatment on neurogenic contraction and
      noradrenaline release in rat arteries.
AB  - In the present study, contractile responses and [3H]-noradrenaline overflow
      evoked by electrical field stimulation were assessed, respectively, in the small
      mesenteric artery and in tail artery removed from rats pre-treated with either
      saline or lipopolysaccharide (LPS). In small mesenteric arteries, LPS treatment
      did not significantly modify the contractile responses elicited by electrical
      stimulation, in the absence or in the presence of L-arginine. However, in
      arteries removed from rats treated with LPS, L-arginine addition produced
      relaxation of vessels pre-contracted with noradrenaline. The amplification of
      neurogenic contraction by the nitric oxide (NO) synthase inhibitor Nomega-nitro-L
      arginine methyl ester (L-NAME) was similar in arteries removed from saline and
      LPS-infused rats. In mesenteric arteries, LPS treatment suppressed the
      potentiation of the neurogenic responses by the alpha2-adrenoceptor antagonist,
      yohimbine and by the inhibitor of neuronal uptake of noradrenaline, cocaine. In
      rat tail artery exposed to L-arginine, LPS treatment produced an increase in [3H]
      noradrenaline overflow evoked by electrical stimulation. Altogether, these data
      suggest that an enhanced noradrenaline release from sympathetic nerves, probably
      resulting from inhibition of the modulatory effect of both prejunctional alpha2
      adrenoceptors and neuronal uptake mechanism, may play a role in the preservation
      of neurogenic response after LPS treatment despite evidence of the induction of
      NO synthase.

PMID- 11206712
TI  - Calcium and bicarbonate ions mediate the inhibition of mast cell histamine
      release by Avene spa water.
AB  - Avene spa water (ASW) inhibits the histamine release induced in mast cells by
      substance P; the inhibition is reversed by EDTA and by EGTA. Calcium and
      magnesium ions, the major cations present in ASW, were experimented in simple
      saline solutions in the presence of various counter-ions. Only calcium salts
      inhibited the peptidergic stimulation, with different potencies ruled by the
      nature of the counter-anion (HCO3- > Cl- > SO4(2)). On a Ca2+ concentration
      basis, ASW was, however, more inhibitory, suggesting that other compounds present
      in ASW potentiate the effect of calcium.

PMID- 11206713
TI  - Pharmacogenomics and therapeutic target validation in cerebral vasospasm.
AB  - One of the most important pharmacogenomic technologies is transcriptome analysis.
      We used this method to study the change of gene expression profiles in animal
      models of cerebral vasospasm. We found novel drug target candidates in cerebral
      vasospasm through pharmacogenomics. By using differential display and
      quantitative reverse transcriptase-polymerase chain reaction, we found that heme
      oxygenase-1 (HO-1) mRNA was prominently induced in the basilar artery and
      modestly in brain tissue in a murine vasospasm model. There was a significant
      correlation between the degree of vasospasm and HO-1 mRNA levels in the basilar
      arteries exhibiting vasospasm. Antisense HO-1 oligodeoxynucleotides (ODN)
      inhibited HO-1 induction in the basilar arteries, but not in the whole brain
      tissue. This phenomenon was not observed in the nontreatment, sense HO-1 ODN and
      scrambled ODN treatment arteries. We report, for the first time, the protective
      effects of HO-1 gene induction by endogenous or clinical compounds in cerebral
      vasospasm after subarachnoid hemorrhage, a finding that should provide a novel
      therapeutic target for cerebral vasospasm.

PMID- 11206714
TI  - Long-term regulation of catecholamine formation by ouabain in cultured bovine
      adrenal chromaffin cells.
AB  - The long-term effects of ouabain, an inhibitor of Na+/K+ -ATPase, on
      catecholamine formation in cultured bovine adrenal chromaffin cells were
      examined. The increase in [14C]catecholamine formation from [14C]tyrosine induced
      by ouabain was dependent on incubation time, and its maximal effect was observed
      after incubation for 8 h. The stimulatory effect of ouabain was concentration
      dependent (10-300 nM), causing maximal stimulation at 300 nM. The formation of
      [14C]catecholamines induced by ouabain was not increased by incubation with
      [14C]DOPA instead of [14C]tyrosine. Ouabain-induced [14C]catecholamine formation
      was influenced by decreases in extracellular Ca2+ concentration, but not by the
      presence of cycloheximide or actinomycin D. These results suggested that ouabain
      stimulates continuous activation of hydroxylation of tyrosine through a Ca2+ 
      dependent mechanism in cultured bovine adrenal chromaffin cells.

PMID- 11206716
TI  - Dystrophin disruption might be related to myocardial cell apoptosis caused by
      isoproterenol.
AB  - Sarcolemma integrity is stabilized by the dystrophin-associated glycoprotein
      complex that connects actin and laminin-2 in contractile machinery and the
      extracellular matrix, respectively. Interruption of the connection by the primary
      gene defect or acquired pathological burden can cause cardiac failure. The
      purposes of the present study were to verify whether dystrophin is disrupted in
      acute myocardial injury after the isoproterenol overload (10 mg/kg) and to
      examine its relation to myocardial cell apoptosis in rats. This injury from 4-16
      h at the subendocardium was accompanied by dystrophin disruption and dislocation
      from subsarcolemma to cytoplasm, which were confirmed by immunohistology and
      Western blotting. However, delta-sarcoglycan was thoroughly preserved in
      sarcolemma. The dystrophin degradation preceded the appearance of apoptotic cells
      and exactly coincided with the transferase-mediated dUTP-biotin nick end labeling
      positive cardiomyocytes (TUNEL), as was verified by double-staining. These data
      suggest that beta-adrenergic stimulation induces dystrophin breakdown followed by
      apoptosis.

PMID- 11206715
TI  - Carvedilol enhances atrial and brain natriuretic peptide mRNA expression and
      release in rat heart.
AB  - To clarify the role of the natriuretic peptide (NP) system in the myocardial
      protective effects of carvedilol, a beta-blocking agent, we investigated the
      effects of carvedilol on the NP system in the rat heart. After oral
      administration of carvedilol (low-dose group: 2 mg/kg/day, group C2; high-dose
      group: 20 mg/kg/day, group C20) for 1 week, plasma rat atrial NP (r-ANP), atrial
      mRNA levels of ANP, left ventricular mRNA of brain NP (BNP), NP receptor-A and NP
      receptor-C (NPR-C) (as a clearance receptor) were measured. Values were compared
      with those in vehicle-treatment rats (group V). The concentration of r-ANP was
      significantly higher in group C2 (135 +/- 9 pg/ml) and group C20 (161 +/- 11
      pg/ml) than group V (75 +/- 6 pg/ml; both p < 0.01). ANP and BNP mRNA levels were
      significantly increased and NPR-C was significantly down regulated in group C2
      (151 +/- 7, 120 +/- 8 and 78 +/- 7%, respectively, vs. group V) and group C20
      (164 +/- 8. 133 +/- 7 and 72 +/- 8%, respectively, vs. group V) compared with
      group V (all p < 0.01). These results suggest that not only a high dose, but a
      low dose of carvedilol has the effect of increasing plasma ANP and BNP levels.
      This effect was closely related to the upregulation of ANP and BNP mRNA
      expression, and the down regulation of NPR-C mRNA expression in the heart. These
      mechanisms seem to account for a sizable portion of the protective effect of
      carvedilol for heart diseases.

PMID- 11206717
TI  - Chronic adriamycin treatment impairs myocardial interstitial neuronal release of
      norepinephrine and epinephrine.
AB  - Although chronic adriamycin (doxorubicin) treatment is known to induce
      cardiomyopathic heart failure with sympathetic neurohumoral activation in a dose
      dependent manner, its effect on local neuronal catecholamine release at the
      cardiac sympathetic nerve terminals remains to be clearly determined. Using a
      cardiac microdialysis technique, we measured dialysate norepinephrine (NE) and
      epinephrine (Epi) concentrations as indices of myocardial interstitial NE and Epi
      levels. respectively, in rabbits with chronic adriamycin treatment (ADR) (4
      mg/kg/week, 6 weeks, n = 8) and in control rabbits (CNT) (n = 6). Exocytotic
      release was evoked by the local administration of KCl (100 mM) through the
      dialysis probe. Basal levels of NE and Epi did not differ between the ADR and CNT
      groups (NE, 11.6 +/- 6.6 vs. 20.4 +/- 17.2 pg/ml; Epi, 4.0 +/- 0.1 vs. 4.6 +/-
      1.7 pg/ml: mean +/- SD). The exocytotic release was suppressed in the ADR
      compared with the CNT group (NE, 191.4 +/- 144.7 vs. 760.5 +/- 337.8 pg/ml; p <
      0.05: Epi, 4.2 +/- 0.4 vs. 20.8 +/- 9.9 pg/ml; p < 0.05). We conclude that
      chronic adriamycin treatment impairs the neuronal exocytotic release of
      catecholamine at the cardiac sympathetic nerve terminals.

PMID- 11206718
TI  - Norepinephrine release is increased in the hibernating heart, studied in a
      chronic canine model of myocardial hibernation.
AB  - We examined the change in cardiac sympathetic function in the hibernating heart.
      To induce hibernating hearts in dogs, we placed a nylon tube via the carotid
      artery in the left circumflex artery (LCx) and obstructed the LCx flow. The
      plasma norepinephrine (NE) and epinephrine (E) concentrations in the coronary
      sinus and the aorta were measured before and 1 week after the tube placement to
      evaluate the catecholamine release from the heart. The wall motion was followed
      by echocardiography and. 1 week after the tube placement, regional myocardial
      blood flow (RBF) was measured using colored microspheres. Also. the restorability
      of myocardial dysfunction was examined in other dogs by extracting the LCx tube 1
      week after the placement. Finally, the heart was removed for pathological
      observation and dogs showing myocardial infarction were excluded. One week after
      placing the tube, wall thickening was reduced in the LCx area, but was not in the
      left anterior descending (LAD) area. Compared with the LAD area, RBF in the LCx
      area was decreased in the endocardium (p < 0.05), but was not in the epicardium.
      In other dogs, the reduced wall thickening in the LCx area was restored to normal
      levels 1 or 2 weeks after the tube extraction. Thereby, our dogs with the tube
      placed were considered to be models of myocardial hibernation. The plasma NE and
      E concentrations were not significantly changed by placing the tube, but NE
      release from the heart was increased after the tube placement (p < 0.05). E
      uptake from the heart did not differ. Therefore, it is suggested that NE release
      is increased in the hibernating heart and may contribute to its mechanism.

PMID- 11206719
TI  - Beneficial effect of angiotensin-converting enzyme inhibitor on dilated
      cardiomyopathy induced by autoimmune mechanism against beta1-adrenoceptor.
AB  - We have shown that a peptide corresponding to the sequence of the second
      extracellular loop of the human beta1-adrenoceptor (beta1-peptide) was able to
      induce an autoimmune cardiomyopathy in rabbits. In this study, we examined the
      effect of angiotensin-converting enzyme inhibitor (ACEI) on beta1-peptide-induced
      cardiomyopathy. Rabbits were divided into four groups: (1) control group (n= 6)
      receiving saline injection; (2) beta1-peptide group (n = 8) immunized with beta1
      peptide; (3) ACEI group (n = 6), lisinopril (3 mg/day) given orally and receiving
      saline injection; and (4) ACEI + beta1-peptide group (n = 7), lisinopril (3
      mg/day) given orally and immunized with beta1-peptide. Our results showed that,
      after 1 year, all rabbits in the beta1-peptide group had an increase in heart
      weight, wall thinning and dilatations of both ventricles as compared with rabbits
      in the ACEI + beta1-peptide group that had normal heart weight and shape. All
      rabbits in the beta1-peptide group exhibited multifocal degeneration and necrosis
      of myocardial cells with moderate infiltration of inflammatory cells. In the ACEI
      + beta1-peptide group, three rabbits showed focal degeneration and necrosis of
      myocardial cells accompanied by mononuclear cells. The lesions in this group were
      apparently less marked than those in the beta1-peptide group. In conclusion, ACEI
      protects the myocardium from injury induced by an autoimmune mechanism against
      beta1-adrenoceptor.

PMID- 11206720
TI  - Acute effects of endothelin-1 and TAK-044 (ET(A) and ET(B) receptor antagonist)
      in rats with dilated cardiomyopathy.
AB  - The hemodynamic effects of endothelin (ET)-1 and TAK-044 (ET(A) and ET(B)
      receptor antagonist) were studied in a rat model of dilated cardiomyopathy after
      autoimmune myocarditis. Six weeks after immunization, survived Lewis rats (30/43
      = 70%) were randomly allocated into five groups to be given 0, 0.3, 3, 30 and 60
      mg/kg/day (groups F0, F0.3, F3, F30 and F60; each group, n = 4) of TAK-044 using
      an osmotic pump subcutaneously. Age-matched normal Lewis rats (n = 26) were also
      randomly divided into four groups to be given 0, 0.3, 3 and 30 mg/kg/day (groups
      N0, N0.3, N3 and N30; each group, n = 4). ET-1 concentrations in plasma and
      myocardium were measured, and immunohistochemical detection of ET-1 in the left
      ventricle from the remaining rats (groups F and N) was performed. After
      administration of TAK-044 for 7 days, 2, 4, 11, 21 and 42 ng/min ET-1 every 20
      min was infused using a pump, and the change in mean arterial pressure of each
      group during the infusion was examined. The plasma and myocardial ET-1
      concentrations were significantly higher in group F than group N (12.3 +/- 1.5
      vs. 5.4 +/- 0.2 pg/ml and 426 +/- 31 vs. 98 +/- 6 pg/g tissue; both p < 0.01).
      Strong positive signals for ET-1 were found to be widely distributed in the left
      ventricular myocardium of both groups of rats. Although the ET-1-induced increase
      in the mean arterial pressure was abolished in group N30, the maximal dose of ET
      1 produced a 34% increase in the mean arterial pressure in group F30. Even in
      group F60, ET-1-induced hypertension was blocked incompletely. These results
      indicate that the heart may be a major ET-1-producing organ, and a higher dose of
      ET-1 antagonist is needed to block the effect of ET-1 in rats with dilated
      cardiomyopathy.

PMID- 11206721
TI  - Differential effects of omega-conotoxin GVIA, tetrodotoxin and prolonged cold
      storage on purinergic and adrenergic transmission in isolated canine splenic
      artery.
AB  - Double-peaked vasoconstrictions (biphases of vasoconstrictions) were readily
      induced in the conditions of 30 s trains of pulses at 1 Hz in the isolated,
      perfused canine splenic artery. P2X purinoceptors have previously been shown to
      be involved mainfy in the first-peaked response and alpha1-adrenoceptors mostly
      in the second. The treatment with 10 nM omega-conotoxin GVIA (omega-CTX) produced
      a parallel inhibitory effect on the first- and second-peaked vasoconstrictor
      responses to nerve stimulation. A submaximal concentration of tetrodotoxin (TTX)
      (3 nM) did not affect the first peak of constriction, but strongly inhibited the
      second peak, although a larger dose of TTX (30 nM) abolished either the first- or
      second-peaked response. On the other hand, after cold storage at 4 degrees C for
      7 days, the first-peaked vasoconstriction markedly decreased, whereas the second
      peaked response was not significantly modified. IN CONCLUSION: (1) omega-CTX
      sensitive calcium channels may produce a parallel modulation of purinergic and
      adrenergic components of sympathetic cotransmission; (2) TTX-sensitive sodium
      channels may have a more important role in controlling the adrenergic rather than
      purinergic transmission; and (3) the function of purinergic transmission of
      sympathetic nerve might be affected more strongly than that of adrenergic
      transmission in the cold-stored canine splenic artery.

PMID- 11206722
TI  - Effect of inhaled nitric oxide on cardiovascular response to catecholamine in
      heart failure.
AB  - We examined the dose responses to continuous infusion of isoproterenol (ISO) and
      norepinephrine (NE) in normal (control) and procainamide-induced heart failure
      dogs with or without inhalation of 70 ppm nitric oxide (NO). Inhaled NO affected
      neither left ventricular (LV) function nor hemodynamics at baseline in both
      control and heart failure dogs. There were no significant differences in the
      responses to ISO and NE with or without inhaled NO in the control. The responses
      of LV dP/dt to ISO and NE were significantly enhanced in heart failure; however,
      they were not affected by inhaled NO. In contrast, LV pressure and dimension at
      end diastole were significantly increased, and pulmonary vascular resistance
      (PVR) was significantly decreased by inhaled NO during infusion of both ISO and
      NE in heart failure. In conclusion, the positive inotropic response to
      cathecholamine is not affected by inhaled NO even in heart failure. Inhaled NO
      decreases PVR, but potentially increases LV preload in the presence of additional
      stress of cathecholamine in heart failure.

PMID- 11206723
TI  - Role of the parasympathetic nervous system and interaction with the sympathetic
      nervous system in the early phase of hypertension.
AB  - The role of the peripheral parasympathetic nervous system in the development of
      hypertension was investigated in spontaneously hypertensive rats (SHR) and Wistar
      Kyoto (WKY) rats. Animals were 5-7 weeks old, anesthetized, and in the open-chest
      condition. The decrement in heart rate evoked by parasympathetic nerve
      stimulation (62 +/- 8 beats/min) in SHR was greater (p < 0.01) than that in WKY
      rats (23 +/- 4 beats/min). Furthermore, the decrease in heart rate (73 +/- 9
      beats/min) in response to combined stimulation of sympathetic and parasympathetic
      nerves in SHR was greater (p < 0.05) than that in response to vagal stimulation
      alone. The extent of the interaction of sympathetic and parasympathetic nerves
      was calculated as the difference between the decrease in heart rate during
      combined stimulation and that during vagal nerve stimulation alone. The extent of
      the interaction in SHR (-11 +/- 5) was not significantly different from that in
      WKY rats (-8 +/- 3 beats/min). Therefore, the influence of the peripheral
      parasympathetic nervous system in the early phase of hypertension may be greater
      than that in the normotensive state. Interaction between the two branches of the
      autonomic nervous system may occur as accentuated antagonism originating in the
      early phase of hypertension. The interaction during the early phase of
      hypertension may not be different in extent from that of the normotensive state.

PMID- 11206724
TI  - Effects of beta-endorphin on norepinephrine release in hypertension.
AB  - Recent studies have suggested an involvement of the endogenous opioid system in
      blood pressure control. The purpose of the present study was to determine the
      role of beta-endorphin in the regulation of sympathetic nervous activity in the
      central nervous system of hypertension. The effects of beta-endorphin on the
      electrically evoked release of [3H]norepinephrine (NE) were investigated in
      superfused slices of rat medulla oblongata. Beta-endorphin inhibited the
      stimulation-evoked NE release in a dose-dependent manner in rat medulla
      oblongata. In the medulla oblongata of spontaneously hypertensive rats (SHR), the
      inhibitory effect of beta-endorphin on the stimulation-evoked NE release was
      significantly smaller than in the medulla oblongata of Wistar-Kyoto rats. These
      results showed that beta-endorphin might reduce NE release in rat medulla
      oblongata. Furthermore, the lesser inhibitory effect of beta-endorphin on NE
      release in SHR might suggest that the opioid peptide could be involved in the
      regulation of central sympathetic nervous activity in hypertension.

PMID- 11206725
TI  - Conserved smooth muscle contractility and blood pressure increase in response to
      high-salt diet in mice lacking the beta3 subunit of the voltage-dependent calcium
      channel.
AB  - Voltage-dependent calcium channels are crucially important for calcium influx and
      the following smooth muscle contraction. Beta subunits of these channels are
      known to modify calcium currents through pore-forming alpha subunits. Among the
      four reported independent beta subunits, the beta3 subunit is expressed in smooth
      muscle cells and thought to compose L-type calcium channels in the tissue. To
      determine the role of the beta3 subunit in the cardiovascular system, we have
      analyzed beta3-null mice. Electrophysiological examinations proved the existence
      of dihydropyridine (DHP)-sensitive. L-type calcium channels in the smooth muscle
      cells. Beta3-null mice show no apparent changes in smooth muscle contraction and
      sensitivity to DHP, and normal blood pressure when they are raised on a normal
      diet, but the 13 subunit deficient mice show elevated blood pressure in response
      to a high-salt diet, with significant reductions in plasma catecholamine
      concentrations. Our finding strongly suggests a close relationship between
      voltage-dependent channels and high blood pressure.

PMID- 11206726
TI  - A dopamine-secreting pheochromocytoma.
AB  - We describe a patient with pheochromocytoma, which secretes dopamine. He was
      admitted to hospital because of chronic diarrhea. After surgical resection of the
      tumor, dramatic cessation of the diarrhea and blood pressure elevation were
      observed. Decreased expression of dopamine beta-hydroxylase in the tumor was
      considered a possible mechanism of producing a pathophysiological concentration
      of dopamine. This case shows that excessive excretion of dopamine, a vasodilative
      hormone, may affect blood pressure.

PMID- 11206727
TI  - Heart rate and plasma cyclic AMP responses to isoproterenol infusion and effect
      of beta-adrenergic blockade in patients with postural orthostatic tachycardia
      syndrome.
AB  - To clarify the pathophysiological mechanism of postural orthostatic tachycardia
      syndrome (POTS). the responses of heart rate and the plasma cyclic AMP (cAMP)
      level to isoproterenol infusion in the supine position were evaluated in 10 POTS
      patients and 10 age-matched controls. Also, the effect of beta-adrenergic
      blockade on POTS was assessed using the headup tilt test. The POTS patients
      consisted of two men and eight women, with a mean age of 19.7 years (range. 15-28
      years). An exaggerated increase of both heart rate and the plasma cAMP
      concentration after isoproterenol infusion at a low dose (1 microg/min) was
      observed in the POTS patients, but not in control subjects. Seven POTS patients
      received oral beta-blocker therapy. In five of these, symptoms were abolished and
      there was a smaller heart rate increase during the head-up tilt test. These data
      suggest that POTS may be more prevalent in young women and that beta-adrenergic
      hypersensitivity may play a role in the mechanisms of this syndrome. However, a
      larger series of patients need to be studied in the future.

PMID- 11206728
TI  - Effect of a hypocaloric diet on adrenomedullin and natriuretic peptides in obese
      patients with essential hypertension.
AB  - We examined the effect of a hypocaloric diet on adrenomedullin (AM), atrial
      natriuretic peptide (ANP), and brain natriuretic peptide (BNP) in 12 obese
      patients with essential hypertension (age, 48-81 years; body mass index, 26-34
      kg/m2). For the initial week, a standard diet of 2000 kcal/day was given,
      followed by 3 weeks of a hypocaloric diet of 850 kcal/day, with a constant intake
      of sodium. The patients lost 3.7 +/- 0.2 kg body weight during the hypocaloric
      diet period (p < 0.0001). The decrease in blood pressure during the study period
      was 10.3 +/- 3.6 mmHg systole (p = 0.017) and 4.2 +/- 3.2 mmHg diastole (NS).
      Plasma AM concentration was decreased significantly from 4.88 +/- 0.46 to 3.97 +/
      0.38 pmol/l by the hypocaloric diet (p = 0.004). Plasma ANP and BNP
      concentrations were also decreased significantly by the hypocaloric diet (p =
      0.042 for each). These results demonstrate, for the first time, that plasma AM
      concentration as well as plasma ANP and BNP concentrations are decreased by a
      hypocaloric diet in obese patients with essential hypertension. These vasodilator
      peptides may act against further elevation in blood pressure in obese patients
      with essential hypertension.

PMID- 11206729
TI  - Therapeutic use of dopamine and beta-blockers modulates plasma interleukin-6
      levels in patients with congestive heart failure.
AB  - We previously reported that the spillover of interleukin-6 (IL-6) into the
      peripheral circulation increases with the severity of congestive heart failure
      (CHF), and that the increase is mainly associated with activation of the
      endogenous sympathetic nervous system. However, the role of the sympathetic
      nervous system in the increase of IL-6 in CHF patients is not yet fully
      understood. To address this question, we measured plasma IL-6 levels before and
      after therapeutic administration of dopamine and betablockers in patients with
      CHF. After more than 24 h (mean, 34 h) of treatment with a low dose of
      intravenous dopamine (mean, 2.4 microg/kg/min) in 1 patients with dilated
      cardiomyopathy and deterioration of CHF, the plasma IL-6 level was increased
      significantly (30.8 vs. 16.6 pg/ml; p = 0.003) despite the improved hemodynamics.
      After 377 days of beta-blocker therapy in 24 patients with dilated
      cardiomyopathy, the plasma IL-6 level was decreased significantly (2.04 vs. 3.11
      pg/ml; p = 0.01) along with the improvement of symptoms, left ventricular
      ejection fraction, and neurohumoral factors. Dopamine increases and beta-blockers
      decrease the plasma IL-6 level in patients with CHF, suggesting that drugs
      modulating the sympathetic nervous system may alter IL-6 in these patients.

PMID- 11206730
TI  - Biphasic inotropic response to endothelin-1 in the presence of various
      concentrations of norepinephrine in dog ventricular myocardium.
AB  - The present study was undertaken to investigate the interaction between
      endothelin-1 (ET-1) and norepinephrine (NE) on contractile regulation in dog
      ventricular myocardium. ET-1 alone did not elicit any inotropic response in
      isolated dog ventricular trabeculae (37 degrees C, 0.5 Hz). In the presence of NE
      at a high concentration (10(-7) M), ET-1 (10(-8) M) elicited a long-lasting
      negative inotropic effect, while in the presence of NE at a moderate
      concentration (3 x 10(-8) M) it produced a biphasic inotropic effect: a sustained
      positive inotropic effect subsequent to a short-lasting negative inotropic
      effect. In the presence of a lower concentration (10(-9) M) that affected
      scarcely the basal force of contraction, ET-1 produced a pronounced positive
      inotropic effect in association with negative lusitropic and negative clinotropic
      effects in a concentration-dependent manner subsequent to a small transient
      negative inotropic effect. The presented results indicate that not only the
      extent, but also the quality of the inotropic response to ET-1 is determined by
      the level of NE in the biophase. The crosstalk of ET-1 with NE may play a crucial
      role in pathophysiological regulation of cardiac contractility in intact dog
      ventricular myocardium.

PMID- 11206731
TI  - Diseases of the eye of farmed shrimp Penaeus monodon.
AB  - Lesions were found in the eyes of cultured shrimp Penaeus monodon that displayed
      non-specific signs of disease, including lethargy, dark pigmentation, brown
      gills, empty midgut, anorexia, white tail muscle, necrosis of uropods and fouled
      cuticle. Eye lesions were associated with sexual development in moribund shrimp
      in at least 1 disease event. Suppurative inflammation, granuloma and malacia were
      observed in histological examination of the eye and the causative agents of
      lesions appear to be Vibrio spp. and a rod-shaped virus (similar to Lymphoid
      Organ Virus, Gill-Associated Virus [GAV] and Yellow-Head Virus). Suppurative
      inflammation was characterised by edema, infiltration of haemocytes and local
      sites of abscesses. Eyes with granuloma usually appeared white in pond-side
      examinations, and histology showed that fibrous tissue replaced ommatidia,
      ganglia and internal structures of the eye. Malacia of the eye was characterised
      by necrosis of nervous tissue, vacuolation and vascular proliferation in the
      medulla ganglia. Levels of presumptive Vibrionaceace were high in moribund
      specimens and Gram-negative rods were observed in some specimens as free
      particles in the interstitial fluid and haemolymph in the eye. Transmission
      electron microscopy showed that nerve cells in the fasciculated zone (near the
      basement membrane) contained cytoplasmic vesicles (1 to 3 microm in diameter)
      with particles (15 to 26 nm in diameter) and rod-shaped nucleocapsids. The rods
      were similar to those of GAV and were 130 to 260 nm long, 10 to 16 nm in diameter
      and had helical symmetry with a screw-like thread (2.4 to 3.5 nm pitch). Also,
      unidentified enveloped virions, averaging 74 nm in diameter, were observed in
      cytoplasmic vesicles in the fasciculated zone. In conclusion, it is suggested
      that bacterial and viral infections of the eye could result in impaired
      neuroendocrine functions, which may cause a range of clinical signs of disease.

PMID- 11206732
TI  - Identification of genomic variations among geographic isolates of white spot
      syndrome virus using restriction analysis and Southern blot hybridization.
AB  - White spot syndrome virus (WSSV) is widely distributed in most of the Asian
      countries where penaeid shrimp are cultured, as well as in some regions of the
      USA. Six geographic isolates of WSSV-1 each from penaeid shrimp from China,
      India, Thailand, and the US states of Texas and South Carolina, and 1 isolated
      from crayfish at the National Zoological Park in Washington, DC-were compared by
      combining the methods of restriction analysis and Southern blot hybridization.
      DNA was extracted from purified viruses and then digested with selected
      endonucleases: AccI, BglII, ClaI, BamHI, EcoRI, HindII, HaeI, SacI and XhoI. The
      blots were detected with digoxigenin-11-dUTP-labeled WSSV genomic probes: LN4,
      C42 and A6. No distinctive differences among the 5 WSSV isolates from penaeid
      shrimp were detected; however, differences in the WSSV isolate from crayfish were
      observed. A 2.8 kb DNA fragment originating from the crayfish isolate and
      encompassing the LN4 region was subcloned into pBluescript and sequenced for
      comparison with the LN4 fragment from the Thailand WSSV isolate. The results
      indicate that some genomic components of WSSV from different geographic regions
      share a high degree of homology. This method can be used to distinguish between
      the WSSV isolate from crayfish and the WSSV isolates from penaeid shrimp.

PMID- 11206733
TI  - Isolation in cell culture of nodavirus from farmed Atlantic halibut Hippoglossus
      hippoglossus in Norway.
AB  - Isolation in cell culture of nodavirus from Atlantic halibut Hippoglossus
      hippoglossus suffering from viral encephalopathy and retinopathy (VER) is
      described. The cell line SSN-1 was inoculated with tissue material from affected
      juveniles (60 d after first feeding). Extensive cytopathic effects (CPE)
      developed approximately 5 d after inoculation, and were also observed after
      several passages in the same cell line. Cells from infected cultures showed
      reactivity with an antiserum against sea bass Dicentrarchus labrax nodavirus in
      an indirect immunofluorescence test. Analysis of infected cells with reverse
      transcriptase-polymerase chain reaction (RT-PCR) resulted in a product of the
      predicted size using primers specific for striped jack Pseudocaranx dentex
      nodavirus. Electron micrographs of infected SSN-1 cells demonstrated virus
      particles that were approximately less than 30 nm. Challenge of Atlantic halibut
      larvae (4 d post-hatching) with supernatants from infected SSN-1 cells resulted
      in development of VER as verified by immunohistochemistry performed on larvae
      sampled from Day 9 after challenge. The present results show that a nodavirus
      from Atlantic halibut has been isolated using the SSN-1 cell line and that virus
      propagated in cell culture retained virulence.

PMID- 11206734
TI  - Characterization of a virus obtained from snakeheads Ophicephalus striatus with
      epizootic ulcerative syndrome (EUS) in the Philippines.
AB  - This is the first report of the isolation and characterization of a fish virus
      from the Philippines. The virus was isolated using snakehead spleen cells (SHS)
      from severely lesioned epizootic ulcerative syndrome (EUS)-affected snakehead
      Ophicephalus striatus from Laguna de Bay, in January 1991. The virus induced
      cytopathic effects (CPE) in SHS cells yielding a titer of 3.02 x 10(6) TCID50 ml(
      1) at 25 degrees C within 2 to 3 d. Other susceptible cell lines included
      bluegill fry (BF-2), catfish spleen (CFS) and channel catfish ovary (CCO) cells.
      Replication in chinook salmon embryo cells (CHSE-214) was minimal while
      Epithelioma papulosum cyprini cells (EPC) and rainbow trout gonad cells (RTG-2)
      were refractory. Temperatures of 15 to 25 degrees C were optimum for virus
      replication but the virus did not replicate at 37 degrees C. The virus can be
      stored at -10 and 8 degrees C for 30 and 10 d, respectively, without significant
      loss of infectivity. Viral replication was logarithmic with a 2 h lag phase;
      viral assembly in the host cells occurred in 4 h and release of virus occurred 8
      h after viral infection. A 1-log difference in TCID50 titer between the cell-free
      virus and the total virus was noted. Freezing and thawing the virus caused a half
      log drop in titer. Viral exposure to chloroform or heating to 56 degrees C for 30
      min inactivated the virus. Exposure to pH 3 medium for 30 min resulted in a more
      than 100-fold loss of viral infectivity. The 5-iododeoxyuridine (IUdR) did not
      affect virus replication, indicating a RNA genome. Neutralization tests using the
      Philippine virus, the ulcerative disease rhabdovirus (UDRV) and the infectious
      hematopoietic necrosis virus (IHNV) polyvalent antisera showed slight cross
      reaction between the Philippine virus antiserum and UDRV but established no
      serological relationship with SHRV and IHN virus. Transmission electron
      microscopy (TEM) of SHS cells infected with the virus showed virus particles with
      typical bullet morphology and an estimated size of 65 x 175 nm. The Philippine
      virus was therefore a rhabdovirus, but the present study did not establish its
      role in the epizootiology of EUS.

PMID- 11206735
TI  - Mortality and kidney histopathology of chinook salmon Oncorhynchus tshawytscha
      exposed to virulent and attenuated Renibacterium salmoninarum strains.
AB  - An isolate of Renibacterium salmoninarum (strain MT 239) exhibiting reduced
      virulence in rainbow trout Oncorhynchus mykiss was tested for its ability to
      cause bacterial kidney disease (BKD) in chinook salmon Oncorhynchus tshawytscha,
      a salmonid species more susceptible to BKD. Juvenile chinook salmon were exposed
      to either 33209, the American Type Culture Collection type strain of R.
      salmoninarum, or to MT 239, by an intraperitoneal injection of 1 x 10(3) or 1 x
      10(6) bacteria fish(-1), or by a 24 h immersion in 1 x 10(5) or 1 x 10(7)
      bacteria ml(-1). For 22 wk fish were held in 12 degrees C water and monitored for
      mortality. Fish were sampled periodically for histological examination of kidney
      tissues. In contrast to fish exposed to the high dose of strain 33209 by either
      injection or immersion, none of the fish exposed to strain MT 239 by either route
      exhibited gross clinical signs or histopathological changes indicative of BKD.
      However, the MT 239 strain was detected by the direct fluorescent antibody
      technique in 4 fish that died up to 11 wk after the injection challenge and in 5
      fish that died up to 20 wk after the immersion challenge. Viable MT 239 was
      isolated in culture from 3 fish that died up to 13 wk after the immersion
      challenge. Total mortality in groups injected with the high dose of strain MT 239
      (12%) was also significantly lower (p < 0.05) than mortality in groups injected
      with strain 33209 (73 %). These data indicate that the attenuated virulence
      observed with MT 239 in rainbow trout also occurs in a salmonid species highly
      susceptible to BKD. The reasons for the attenuated virulence of MT 239 were not
      determined but may be related to the reduced levels of the putative virulence
      protein p57 associated with this strain.

PMID- 11206736
TI  - A new strain of Cryptocaryon irritans from the cultured olive flounder
      Paralichthys olivaceus.
AB  - An obligate parasite, Cryptocaryon irritans, which is responsible for the white
      spot disease of marine fish is known to develop in the temperature regime over 19
      degrees C. Recently, however, we found white spot disease of olive flounder
      Paralichthys olivaceus during winter at water temperatures ranging between 12 and
      16 degrees C in Korea. In the present study we isolated a C. irritans-like
      ciliate from the affected fish and investigated its reproductive characters to
      compare the newly found ciliate with typical C. irritans. The newly found ciliate
      had an additional process in the reproductive stage, characterized by a budding
      before palintomic division, and it showed a higher ability to carry out
      tomitogenesis at a low temperature (16 degrees C) than at a high temperature (24
      degrees C). Nevertheless, the present ciliates still had much in common with
      typical C. irritans with respect to clinical, histopathological, and
      morphological characters, suggesting that it is a new strain of C. irritans,
      adapted to lower water temperature.

PMID- 11206737
TI  - Neoparamoeba Page, 1987: light and electron microscopic observations on six
      strains of different origin.
AB  - Although amoebic gill disease (AGD) has emerged as one of the most severe health
      problems in the fish industry, proof of the identity of AGD agents from various
      localities is still missing. Six strains of amoebae designated until recently as
      Paramoeba species (the agents of AGD) were studied in cultures by light and
      electron microscopy. Although they were isolated from gills of different hosts
      (Dicentrarchus labrax and Scophthalmus maximus) and from distant localities,
      their morphology was identical. The strains differed from Paramoeba eilhardi, the
      type species of the genus, in that they lacked the boat-shaped microscales on the
      cell surface but could be safely identified as belonging to the genus
      Neoparamoeba Page, 1987. Transmission electron microscopy revealed the presence
      of a symbiotic organism, Perkinsiella amoebae Hollande, 1980, in all strains
      under study. The only difference among the strains examined was found in the size
      of trophozoites, which could be attributed to the different origins of the
      strains, but until more refined diagnostic methods are available, in addition to
      N. pemaquidensis, the closely related species N. aestuarina also has to be taken
      into consideration as the agent of AGD.

PMID- 11206738
TI  - Ultrastructural justification for the transfer of Pleistophora anguillarum
      Hoshina, 1959 to the genus Heterosporis Schubert, 1969.
AB  - This study presents the ultrastructure of the microsporidian infecting the trunk
      musculature of Anguilla japonica and originally described as Pleistophora
      anguillarum Hoshina, 1959. All stages develop within a special structure, the
      sporophorocyst (SPC), which is equipped with a thick dense wall. This wall grows
      along with the growth of the parasites within it. Meronts are uni- to binucleate,
      which divide and steadily give rise to sporonts. During transition to sporonts
      the cell coat of the meronts increases its thickness, temporarily featuring thick
      irregular projections. Eventually a uniformly thick sporont wall is formed, then
      the sporont cells detach themselves from the wall (= future wall of the
      sporophorous vesicle, SPV) and start a series of divisions to produce
      sporoblasts. The SPV wall is compact, has no pores and consists of 2 layers. The
      presence of the SPC justifies the transfer of the species into the genus
      Heterosporis. Spores from disrupted SPCs are ingested by macrophages and within
      them are spread into various body tissues including the outermost layers of the
      epidermis. From here, they can easily be released to the outside and can
      contaminate the environment while the host is still alive.

PMID- 11206739
TI  - A new shell disease in the mud crab Scylla serrata from Port Curtis, Queensland
      (Australia).
AB  - In 1994 a previously unreported rust spot shell disease was seen in mud crabs
      Scylla serrata - Forskal from Port Curtis, central Queensland, Australia. Of 673
      crabs surveyed, 21.7% had shell lesions. Of these, 82.9% had rust spot lesions on
      the carapace. The majority of rust spot-affected crabs (78.8%) were female. Rust
      spot lesions were predominantly non-perforated (89.4%) and 54.8% were bilaterally
      symmetrical. There was also a gender difference in the areas of the carapace most
      commonly affected. The main histological features of the rust spot lesion
      included: a cavity in the upper endocuticle; indentation of the endocuticle below
      the cavity; remains of muscle attachment adhesive epithelium within the cavity;
      fibrous connective tissue between the damaged carapace and the attached muscle;
      and islands of endocuticle in this fibrous connective tissue. Histopathology of
      the internal organs failed to find evidence of an infectious or parasitic cause
      of the rust spot lesions. The cause(s) of the syndrome appear(s) to be non
      infectious.

PMID- 11206740
TI  - Transcaruncular approach to medial canthal tendon plication for lower eyelid
      laxity.
AB  - PURPOSE: A new operation to correct lower eyelid laxity was evaluated. METHODS: A
      new transcaruncular, orbital approach to posterior medial canthal tendon
      plication was performed on eight orbits of four cadavers, which were then
      analyzed with computed tomography or histologic techniques. The procedure was
      also performed on 23 eyelids of 15 patients with lower eyelid medial canthal
      tendon laxity, alone or in conjunction with other procedures. These patients were
      followed up for a mean of 12 months. RESULTS: Improved postoperative eyelid
      position, epiphora, and superficial punctate keratopathy were found. Radiographic
      and histologic analysis demonstrated consistency of suture placement without
      involvement of contiguous anatomical structures. CONCLUSIONS: This procedure
      appears to be a safe, reproducible, and effective corrective procedure for medial
      canthal tendon laxity and lagophthalmos. When combined with lateral lower eyelid
      tightening, it is also an effective treatment for lower eyelid retraction and
      superficial punctate keratopathy. Other potential advantages and complications of
      this procedure are described in comparison to other reported surgical methods
      used to address medial canthal tendon laxity and malpositions of the medial lower
      eyelid.

PMID- 11206741
TI  - Stabilization of the posterior limb of the medial canthal tendon using
      biodegradable tag anchors: a cadaveric model.
AB  - PURPOSE: This study describes and tests in a cadaveric model a new method of
      fixation designed for potential stabilization of the posterior limb of the medial
      canthal tendon, using biodegradable Tag anchors. METHODS: Study of the
      possibility of performing surgery to repair medial ectropion using biodegradable
      polyglyconate Tag anchors was commenced in the sheep cadaveric head model, and in
      the whole dry human skull model. This was then performed using five preserved
      human cadaveric whole heads, and pullout tensions were estimated in four of
      these. Computed tomography and magnetic resonance imaging were obtained for this
      model in the fifth head, and computed tomography was performed on the whole dry
      human skull. Dissections were carried out to establish the site of the bony
      defect in each of the heads. RESULTS: It was possible to obtain good Tag anchor
      fixation in bone overlying the maxillary and ethmoidal sinuses of the sheep, and
      in a young human skull. It was also possible to place adequately the anchor in
      the medial wall of the orbit close to the posterior lacrimal crest in all cases
      in the human cadaveric model. Pullout strengths were evaluated and found to range
      from 3.5 N to 12.4 N (mean, 7.5 N). Computed tomography and magnetic resonance
      imaging failed to demonstrate the biodegradable anchors in both the dry human
      whole skull and in the fifth cadaveric head, but did demonstrate the bony defects
      in the medial orbital walls through which the anchor passed. CONCLUSIONS: We have
      shown, for the first time, the stability of biodegradable Tag anchor fixation in
      a human cadaveric head model using pullout tensions and dissection studies. This
      method would allow adequate strength and stability to provide for control of
      fixation of the medial end of the lower eyelid in patients with medial ectropion
      and medial canthal tendon laxity.

PMID- 11206742
TI  - Flap minimization via peripheral recruitment.
AB  - PURPOSE: To describe tissue-conserving modifications to traditional flap design
      such as the use of beveled incisions and the pattern of the incisions. These
      techniques should maintain flap viability and enhance cosmesis. METHODS: We
      describe the techniques of peripheral flap recruitment. RESULTS: Flaps conformed
      to reduced geometry, beveled incisions and bases, and tapered ends maximize
      vascularity. Peripheral tissues are recruited to fill primary defects; smaller
      flaps thus can be used to fill larger defects. Additionally, this flap design
      enhances cosmetic results and maintains a high probability for flap survival.
      CONCLUSION: The described novel flap design has many potential advantages over
      traditional designs. Correctly applied, these flap techniques spare tissue,
      decrease scarification, trauma and bleeding, and reduce the need for secondary
      procedures. Potential drawbacks of this flap design include temporary anatomic
      distortion especially over rounded structures such as the nose. Complications are
      minimal.

PMID- 11206743
TI  - Aesthetic surgery: diagnosing and healing the miscues of human facial expression.

PMID- 11206744
TI  - Evisceration with scleral modification.
AB  - PURPOSE: To describe an evisceration technique that combines scleral modification
      with optic nerve release for coverage of any sized orbital implant. METHODS: The
      medical records of 70 patients who underwent the described evisceration procedure
      were reviewed. RESULTS: The average implant was 20 mm in diameter, with 50
      patients (71%) receiving a solid polymethylmethacrylate sphere. Fifty-eight
      patients (83%) had a history of at least one previous ocular surgery, and 12
      patients (17%) had phthisical eyes preoperatively with moderate to severe scleral
      cicatrization. Postoperatively, there were two cases of new or worsened ptosis,
      no cases of worsened motility, and no cases of implant extrusion. CONCLUSION:
      Evisceration with scleral modification is a simple and effective procedure that
      allows placement of any size orbital implant. Surgical results are excellent with
      few complications.

PMID- 11206745
TI  - Chronic dacryocystitis in American mucocutaneous leishmaniasis.
AB  - PURPOSE: This study describes lacrimal tract involvement and surgical outcome in
      patients with mucocutaneous leishmaniasis. METHODS: Four patients, ages 20 to 75
      years, had nasal lesions resulting from mucocutaneous leishmaniasis and sought
      treatment for chronic dacryocystitis. Each patient had had lacrimal symptoms
      since childhood or early adulthood, concomitantly with the development of upper
      airway lesions. Dacryocystography showed nasolacrimal duct stenosis in all cases
      on the affected side. Three patients underwent dacryocystorhinostomy (one
      bilaterally), and one patient had bilateral dacryocystectomy. RESULTS: Two
      patients had surgical fistula closure soon after surgery. A sequential endoscopic
      operation for remotion of a synechia between the fistula and the middle turbinate
      was successful in one of these patients. Histopathologic analysis of lacrimal
      sacs and nasal mucous membranes close to the anastomotic site revealed chronic
      nonspecific inflammatory process and negative immunohistochemistry for
      Leishmania. CONCLUSIONS: Dacryocystitis may result from nasal mucocutaneous
      leishmaniasis. The surgical outcome was unsatisfactory in one of the four
      patients.

PMID- 11206746
TI  - A case of bilateral cryptophthalmia and euryblepharon with two-stage
      reconstruction.
AB  - PURPOSE: A two-stage reconstruction of cryptophthalmia and euryblepharon
      occurring in the same patient is described. METHODS: Case report. RESULTS: The 7
      month-old patient underwent forniceal reconstruction and upper eyelid reformation
      in a two-stage procedure that used the excess lower eyelid tissue present in
      euryblepharon to augment the cryptophthalmia-related upper eyelid deficiency.
      CONCLUSIONS: To reconstruct the eyelids of this patient with both cryptophthalmia
      and euryblepharon, we were able to use the manifestations of one disorder to
      address the deficiencies of the other.

PMID- 11206747
TI  - Congenitally anomalous tented eyebrows.
AB  - PURPOSE: An uncommon congenital anomaly of the eyebrows is described. METHODS:
      Case report and review of the literature. RESULTS: Two articles in the English
      literature were found describing patients similar to ours. CONCLUSIONS:
      Congenital upward tenting of the midportion of the eyebrows, resembling the
      eyebrow line of an owl, is uncommon. This anomaly is thought to be transmitted in
      an autosomal dominant fashion and may be accompanied by myopia and strabismus,
      but has not been associated with systemic disease.

PMID- 11206748
TI  - Orbital malignant fibrous histiocytoma following irradiation for retinoblastoma.
AB  - PURPOSE: An unusual case is reported of orbital malignant fibrous histiocytoma
      that developed after irradiation for retinoblastoma. METHODS: Case report.
      RESULTS: A 5-month-old girl underwent enucleation of the left eye, external beam
      irradiation of the right eye, and systemic chemotherapy for bilateral sporadic
      retinoblastoma. At age 17 years, a malignant fibrous histiocytoma developed in
      the medial aspect of the orbit and nasal cavity. After attempted excisional
      biopsy, she underwent craniofacial resection, orbital exenteration, maxillectomy,
      and tracheostomy. The patient was alive 12 months postoperatively without local
      or metastatic disease. CONCLUSIONS: Although orbital fibrous histiocytoma occurs
      usually as a primary tumor of adulthood, it can also develop as a secondary tumor
      after irradiation for retinoblastoma.

PMID- 11206749
TI  - Successful treatment of rhino-orbital mucormycosis without exenteration: the use
      of multiple treatment modalities.
AB  - PURPOSE: To describe the successful management of rhino-orbital mucormycosis
      without the use of orbital exenteration. METHOD: Case report. RESULTS: The
      patient had successful eradication of the fungal infection with retention of
      normal vision and ocular function. CONCLUSIONS: The use of multiple treatment
      modalities including aggressive surgical debridement guided by intraoperative
      frozen section monitoring, intravenous liposomal amphotericin B, intraorbital
      regular amphotericin B and hyperbaric oxygen may allow complete resolution of
      orbital phycomycosis and spare the patient from the blindness and disfigurement
      associated with exenteration.

PMID- 11206750
TI  - Intraorbital rupture of a cavernous internal carotid artery aneurysm: therapeutic
      options.
AB  - PURPOSE: To describe the use of an endovascular therapeutic technique in the
      management of a giant carotid cavernous aneurysm. METHODS: We reviewed the
      clinical and neuroradiologic findings of a patient with an unusual case of
      carotid cavernous aneurysm and intraorbital rupture. The medical literature was
      searched for similar cases and to review the use of endovascular techniques.
      RESULTS: The patient was treated by balloon occlusion of the left internal
      carotid artery. CONCLUSIONS: Endovascular techniques can be used to treat complex
      giant cranioorbital cavernous aneurysms.

PMID- 11206751
TI  - Five things oculoplastic surgeons should know about medical genetics.

PMID- 11206752
TI  - Sudoriferous cyst of the orbit.
AB  - PURPOSE: A case of sudoriferous cyst of the orbit in an adult patient is
      reported. This unusual cyst in the orbit has heretofore been reported only in
      congenital cases. METHODS: Case report. RESULTS: A 45-year-old woman sought
      treatment for an asymptomatic mass of the left lower eyelid. Computed tomography
      of the orbits showed a cystic lesion in the inferior orbit with bony remodeling.
      Histopathologic examination showed the lesion to be a solitary cyst lined by two
      to three layers of cuboidal epithelial cells with eosinophilic cytoplasm. Some of
      the epithelial cells contained periodic acid-Schiff-positive, diastase-resistant
      granules. The pathologic diagnosis was a sudoriferous cyst. CONCLUSION:
      Sudoriferous cysts, although uncommon, should be included in the differential
      diagnosis of orbital cystic tumors.

PMID- 11206753
TI  - Suggested precautions when using a monocanalicular stent.

PMID- 11206754
TI  - Stress analysis of the aortic valve with and without the sinuses of valsalva.
AB  - BACKGROUND AND AIM OF THE STUDY: In some patients with dilated aortic root,
      attempts have been made to replace the aorta and preserve the anatomically normal
      leaflets. The tubular Dacron graft used in the valve-sparing procedure does not
      have the sinuses of Valsalva, and therefore might adversely affect the valve. The
      effect of the presence or absence of the sinuses was investigated on stresses in
      the leaflets. METHODS: Finite element models of the tubular aortic root and the
      root with the sinuses were constructed. The model dimensions were: aorta radius
      13 mm; valve height 18 mm; leaflet thickness 0.5 mm; aorta and sinus wall
      thickness 1.3 mm. In the root with the sinuses, each leaflet-sinus unit formed a
      cylindrical geometry. The model was loaded with an internal pressure of 80 mmHg
      (0.01 N/mm2) and the stress determined. RESULTS: The stress in the leaflet belly
      was 0.26 N/mm2, and not affected by the geometry and stiffness of the root. In
      the tubular root there was a stress concentration along the leaflet attachment,
      and the stress reached 0.65 N/mm2; in contrast, in the sinus root there was no
      stress concentration and maximum stress was only 0.3 N/mm2. Under pressure, the
      leaflet-sinus assembly expanded in a uniform manner, whereas in a tubular root
      large deformations occurred along the leaflet attachment. CONCLUSION: The sinuses
      of Valsalva play a very important role in minimizing stress in the leaflets;
      thus, use of the sinus graft is expected to enhance the longevity of the spared
      valve.

PMID- 11206755
TI  - Hemodynamic assessment of the Medtronic Mosaic bioprosthesis in the aortic
      position.
AB  - BACKGROUND AND AIM OF THE STUDY: The Medtronic Mosaic bioprosthesis (MMB) is a
      newly developed tissue valve which incorporates several features such as a low
      profile semi-flexible stent, zero-pressure tissue fixation, and anti
      mineralization pretreatment with alpha-amino oleic acid aimed to improve
      hemodynamics and prevent structural deterioration. METHODS: Between November 1995
      to June 1999, 62 patients underwent aortic valve replacement (AVR) with the MMB;
      41 of these who reached the one-year follow up interval and who had isolated AVR
      without any concomitant procedure with size 23 mm and 25 mm MMB were evaluated by
      serial echocardiography after three, six and 12 months. RESULTS: For size 23 mm
      valves, mean and peak gradients were 12+/-3 and 21+/-6 mmHg at 3 months, 12+/-3
      and 20+/-5 mmHg at 6 months, and 12+/-4 and 20+/-6 mmHg at 12 months. For size 25
      mm valves, mean and peak gradients were 13+/-2 and 22+/-4 mmHg at 3 months, 12+/
      3 and 21+/-5 mmHg at 6 months, and 12+/-4 and 22+/-6 mmHg at 12 months. In
      patients with 23 mm MMB, left ventricular mass index (LVMi) was reduced from
      181+/-34 g/m2 before surgery to 158+/-32, 150+/-28 and 140+/-25 g/m2 at 3, 6 and
      12 months after AVR (p <0.001); in patients with 25 mm MMB, LVMi was reduced from
      182+/-28 g/m2 before surgery to 165+/-25, 156+/-24 and 146+/-19 g/m2 at 3, 6 and
      12 months after AVR (p <0.001). CONCLUSION: Our results indicate that MMB is
      associated with low mean and peak gradients and significant reduction in LVMi
      throughout the postoperative period. Thus, the MMB appears to be an excellent
      cardiac valve substitute in elderly subjects who require AVR.

PMID- 11206756
TI  - A new design for polyurethane heart valves.
AB  - BACKGROUND AND AIM OF THE STUDY: The synthetic flexible tri-leaflet heart valve
      offers considerable potential for improvement in both hydrodynamic and
      biomechanical performance of replacement heart valves. To date, success with the
      synthetic leaflet heart valve has been limited, partly due to limitations in the
      biostability of the polyurethanes used. With the synthesis of new biostable
      polyurethanes, the integration of advancing technology, and better knowledge of
      the functional and biomechanical design requirements necessary to increase the
      long-term durability of the polyurethane heart valve, novel clinical solutions
      are now in sight. METHODS: This study describes the design characteristics,
      hydrodynamic and biomechanical performance of a new design of polyurethane heart
      valve. The function and durability characteristics of this novel design of heart
      valve, manufactured using a proven durable non-biostable polyurethane, was
      compared with that of a single AorTech porcine bioprosthetic heart valve and a
      single tilting disc mechanical heart valve, the Bjork-Shiley Monostrut valve
      (BSM), of similar size. RESULTS: For equivalent sizes of valve, the new
      polyurethane heart valve design had significantly lower pressure gradients
      compared with the porcine valve at all flow rates and to the BSM valve at the
      higher flow rates. The effective orifice area of the polyurethane valve was
      greater than the other two valves studied; regurgitation and total energy loss
      were less. The new polyurethane valve design reached over 360 million cycles in
      an accelerated durability tester, without failure. CONCLUSION: This new design of
      polyurethane heart valve showed improved hydrodynamic function in comparison with
      either the porcine bioprosthetic or the BSM mechanical heart valve. The pulsatile
      flow results showed a lower total energy loss associated with this valve,
      indicating improved potential patient benefit. The durability of this new design
      of polyurethane heart valve was demonstrated when manufactured using a medical
      grade polyurethane.

PMID- 11206758
TI  - Aortic insufficiency after surgical repair of acute type a aortic dissection:
      incidence, indications for reoperation and medical management.
AB  - Recurrent aortic insufficiency presents in as many as 20% of patients late after
      repair of acute type A aortic dissection. This underscores the need for life-long
      follow up and appropriate management of patients after such surgery. The
      prevalence of, and risk factors for, recurrent aortic regurgitation, and the
      indications for and results of medical and surgical treatment are discussed.

PMID- 11206757
TI  - Harvested porcine mitral xenograft fixation: impact on fluid dynamic performance.
AB  - BACKGROUND AND AIM OF THE STUDY: Recent developments suggest that stentless
      bioprosthetic mitral valve heterografts should be considered in order to optimize
      valve hydrodynamics. The fixation process alters the mechanical properties of
      tissue. This study investigates the changes in mitral valve morphology and
      hemodynamic performance following fixation. METHODS: Porcine mitral valves were
      excised and attached to a physiological annular ring. Mitral valve function was
      studied in vitro with a rigid transparent left heart model, allowing transverse
      and sagittal views. Initial experiments were performed with fresh valves under
      physiological conditions. Three different papillary muscle positions were used,
      and each was recorded. After glutaraldehyde fixation, genipin fixation, and
      cryopreservation, the valves were re-studied while maintaining cardiac output.
      Performance characteristics before and after fixation were obtained from
      hydrodynamic pressure and flow data, high-speed video camera, digital video,
      Doppler ultrasound, and three-dimensional papillary muscle force measurements.
      Morphology changes were detected by detailed anatomic measurements of the valves
      before and after fixation. RESULTS: Valve length was reduced by 18.5% after
      fixation with genipin (p <0.001), but not with glutaraldehyde. Cryopreserved
      valves showed no statistically significant changes in morphology or hydrodynamic
      performance after preservation. The forward flow opening area was reduced by
      12.2% (p <0.001) after glutaraldehyde fixation, and by 32.3% (p = 0.004) after
      genipin fixation. Thus, maximal forward flow velocity was increased by 33.3% (p =
      0.008) after glutaraldehyde fixation and by 52.8% (p = 0.001) after genipin
      fixation. The flow acceleration was consistent with a funnel shape of the fixed
      valves causing important flow contraction beyond the orifice (vena contracta).
      The papillary muscle force increased with apically posterior papillary muscle
      displacement by 20.4% (p = 0.001) and 101.5% (p <0.001) after glutaraldehyde and
      genipin fixation, respectively, and total regurgitant volume was increased by
      91.6% (p <0.001) and 117.3% (p <0.001), respectively. The work required by the
      heart simulator to maintain a constant cardiac output at constant vascular
      resistance increased by 24.2% (p = 0.003) and 34.2% (p = 0.004) after
      glutaraldehyde and genipin fixation, respectively. CONCLUSION: The present study
      shows that chemical fixation of porcine mitral valves adversely affects the
      hemodynamics of the valves, increasing overall workload. The effects were more
      severe after fixation with genipin than with glutaraldehyde. This suggests the
      need to explore other fixation agents to optimize valvular cardiac function.
      Cryopreservation had no detrimental effects on valvular hemodynamic performance.

PMID- 11206759
TI  - Structural modification and cryopreservation of porcine heart valves for
      xenotransplantation with reduced immunity.
AB  - BACKGROUND AND AIM OF THE STUDY: In order to provide valved xenografts with
      reduced immunity, yet durability comparable with that of homografts, a method for
      endothelial cell removal was developed. METHODS: Adult porcine valved pulmonary
      conduits were isolated, washed and incubated in trypsin-EDTA solution. The
      endothelial cells were flushed free with a stream of culture medium, and the
      xenografts cryopreserved. Grafts were thawed after three months, and evaluated
      structurally. RESULTS: Macroscopic inspection of the grafts revealed no cracks or
      other morphological damage. Light microscopy revealed mildly edematous changes,
      and the elastic layers appeared to be preserved. Incubation with trypsin-EDTA
      solution consistently removed the entire endothelial layer, without obvious
      damage to the underlying tissues. CONCLUSION: With care and appropriate timing,
      the xenograft endothelium can be selectively removed, leaving the underlying
      tissue intact. This process may allow further structural manipulations to improve
      the durability of these grafts.

PMID- 11206760
TI  - Diagnostic value of intraoperative swabs of heart valves in infective
      endocarditis.
AB  - BACKGROUND AND AIM OF THE STUDY: Intraoperative swabs of heart valves are
      obtained regularly from patients undergoing heart valve surgery for infective
      endocarditis (IE) in order to confirm the preoperative diagnosis and to adjust
      the antibiotic regimen. The study aim was to assess the diagnostic value of
      intraoperative swabs of heart valves in IE. METHODS: A total of 83 patients was
      referred for surgical treatment of active IE between October 1994 and May 1999.
      Preoperatively, microorganisms were isolated using a minimum of two positive
      blood cultures; results were compared with those obtained from intraoperative
      heart valve swab cultures. RESULTS: Preoperatively, 73 patients (88%) had a
      positive blood culture, and 10 (12%) had culture-negative endocarditis. The
      intraoperative swab confirmed the preoperative diagnosis in 31 cases (37%).
      Bacteria were isolated in three of the ten patients with preoperative culture
      negative IE. Despite positive histopathological findings in seven patients, no
      microorganisms were cultured either pre- or intraoperatively. Among the remaining
      42 patients (51%) with active IE, 25 valve cultures were sterile and 17 valve
      swabs were presumed to be contaminated. CONCLUSION: In patients with active IE in
      whom the causative agent could be isolated and identified before surgery,
      intraoperative valve swabs did not contribute further to patient management. In
      isolating contaminants, the risk of inappropriate modification of the antibiotic
      regimen is imminent. The diagnostic validity in culture-negative IE appears
      negligible.

PMID- 11206761
TI  - Fractured occluder disc: a previously unrecognized complication of the Starr
      Edwards disc prosthesis.
AB  - Fracture of the occluder disc of a low-profile Starr-Edwards prosthesis is a
      hitherto unrecognized complication. We describe a patient who presented with
      right heart failure and severe pulmonary hypertension 27 years after mitral valve
      replacement with a model 6520 caged-disc prosthesis. At surgery, there was a
      longitudinal split in the occluder disc, and organized thrombus was lodged
      between the split segments. This case offers a unique opportunity to study the
      long-term effects of wear on the polyethylene poppet and Stellite cage.

PMID- 11206762
TI  - Long-term pathological changes of expanded polytetrafluoroethylene (ePTFE) suture
      in the human heart.
AB  - Expanded PTFE (ePTFE) sutures have been used widely as a mitral chordal
      substitute. We present a structural analysis of ePTFE sutures implanted as
      artificial chordae for 7.5 years and 8.6 years in patients with mitral
      regurgitation. No calcification was found either macroscopically or
      microscopically, and the ePTFE suture retained its normal flexibility. The suture
      was totally encapsulated with host tissues composed of dense fibrous tissue
      covered with endothelial cells.

PMID- 11206763
TI  - Comparison of cardiovascular risk and lipid profiles in patients undergoing
      aortic valve surgery versus those undergoing coronary artery bypass grafting.
AB  - BACKGROUND AND AIM OF THE STUDY: Hyperlipidemia is a risk factor for the
      progression of coronary artery disease, and possibly also valvular aortic
      stenosis. Thus, patients with aortic stenosis, coronary disease (or both) might
      be expected to have more abnormal lipid profiles than those without these two
      conditions. METHODS: The lipid profiles of patient subsets undergoing aortic
      valve replacement (AVR) with or without concomitant coronary artery bypass
      grafting (CABG), as well as those undergoing isolated CABG, between 1987 and 1997
      were analyzed retrospectively. Four surgical groups were identified: AVR for
      aortic regurgitation (n = 370); AVR for predominant aortic stenosis (n = 1,072);
      AVR for aortic stenosis (AS) with CABG (n = 914); and isolated CABG (n = 11,156).
      The complete fasting lipid profiles of patients were collected, analyzed by
      group, and compared. RESULTS: Analysis by Spearman's correlation showed that
      total cholesterol levels, triglycerides and low-density lipoproteins (LDL-C) were
      modestly, yet significantly, increased in each successive group, while high
      density lipoproteins were decreased. AS patients undergoing isolated AVR had
      significantly higher total cholesterol (215 versus 201 mg/dl; p <0.0001),
      triglycerides (125 versus 104 mg/dl; p <0.0001) and LDL-C (139 versus 132 mg/dl;
      p = 0.003) than those undergoing AVR for aortic regurgitation. Total cholesterol
      >200 mg/dl was significantly associated with AS, even after adjusting for
      differences in age, sex, diabetes mellitus and hypertension, with an odds ratio
      of 1.5 (95% confidence interval, 1.2-2.0; p = 0.001). CONCLUSION: Progressively
      abnormal lipid profiles are associated with AS and coronary disease in patients
      undergoing AVR. This evidence helps to extend the link between dyslipidemia and
      AS in a large consecutive series of patients.

PMID- 11206764
TI  - Aortic surgery in patients with marfan syndrome: long-term survival, morbidity
      and function.
AB  - BACKGROUND AND AIM OF THE STUDY: The natural history of patients with Marfan
      syndrome is depressing, but surgical intervention on the aorta can improve the
      prognosis. Study results were analyzed with reference to long-term survival,
      morbidity and function. METHODS: Seventy-four Marfan patients (51 males, 23
      females; mean age 41+/-14 years), underwent first-time aortic surgery between
      1977 and 1998. Follow up information regarding mortality, morbidity and
      functional status was obtained from patient records and by questionnaire. The
      mean follow up was 5 years (range: 0-19 years). Forty-seven patients (64%) had a
      dissection, 27 (36%) an aneurysm, and 45 (61%) patients underwent emergency
      operations (<4 h from arrival at hospital). In 72 patients (97%) the disease
      affected the ascending aorta, and implantation of a composite graft was the most
      frequent operation. RESULTS: Overall 30-day mortality was 12% (3% in elective
      cases, 18% in emergency cases, p <0.05). Emergency operations and surgery
      extended to the aortic arch were risk factors for early mortality. Overall
      actuarial survival was 63.4+/-8% at 10 years. Age was the only risk factor for
      late mortality. Seventeen patients were reoperated on due to pathologies of the
      remaining aorta (n = 12), pseudoaneurysms (n = 4) and aortic valve endocarditis
      (n = 1). A total of five patients had endocarditis; one patient with a homograft
      required surgery, and medical treatment was successful in the other four
      patients. Five patients had neurological thromboembolic episodes without
      permanent damage, and six had minor bleeding complications. Freedom from early
      and late mortality, reoperation on the aorta and major cardiovascular events
      (endocarditis episodes, thromboembolic/hemorrhagic strokes and other major
      bleeding/embolic episodes) was 33.3 +/- 8.1% at 10 years. At follow up, 98% of
      patients were in NYHA functional class I or II, and 80% were working. CONCLUSION:
      Elective aortic surgery in Marfan patients can be performed with good results.
      Close follow up of patients undergoing surgery is important. The long-term
      functional status of surviving patients is satisfactory.

PMID- 11206765
TI  - Influence of transesophageal echocardiography on intraoperative decision making
      for toronto stentless prosthetic valve implantation.
AB  - BACKGROUND AND AIM OF THE STUDY: Intraoperative transesophageal echocardiography
      (TEE) is commonly used during aortic valve surgery. In aortic valve replacement
      (AVR), this permits measurement of the aortic annulus, study of the anatomy of
      aortic valve components, and prediction of prosthesis valve size. After
      cardiopulmonary bypass (CPB), echocardiography is valuable in checking prosthesis
      function. In this study, we evaluated the impact of intraoperative TEE on the
      decision-making process of aortic Toronto stentless prosthetic valve (TSPV)
      implantation. METHODS: Fifty-two consecutive patients undergoing elective AVR
      were collected prospectively. Multiplane TEE was performed before CPB to
      determine diameters of the aortic valve annulus and sinotubular junction. This
      was to evaluate the feasibility of TSPV implantation in the aortic position and
      to predict prosthesis size. Further TEE evaluation was carried out after CPB to
      assess prosthetic valve function. RESULTS: TEE allowed measurement of the aortic
      annulus and sinotubular junction, and enabled correct prediction of prosthesis
      size. Ultrasonic evaluation also revealed contraindications to TSPV implantation
      in five patients. In one case, color-Doppler examination led to immediate
      successful surgical correction of prosthetic incompetence. CONCLUSION:
      Intraoperative multiplane TEE examination is useful in the decision-making
      process in AVR with the TSPV by selecting patients suitable for the stentless
      valve, predicting prosthesis size, and checking prosthesis function.

PMID- 11206766
TI  - Medium-term follow up of pulmonary autograft aortic valve replacement: technical
      advances and echocardiographic follow up.
AB  - BACKGROUND AND AIM OF THE STUDY: The Ross procedure (aortic valve replacement
      (AVR) with pulmonary autograft and pulmonary homograft replacement of pulmonary
      valve) was developed as a durable aortic valve substitute that avoids the need
      for anticoagulation and provides young patients with a long-lasting aortic valve
      substitute. Our seven-year follow up echocardiography data are reviewed. METHODS:
      Between May 1993 and March 2000, 40 adult patients (28 males, 12 females; mean
      age 33.3 years) underwent the Ross procedure at the Brigham and Women's Hospital
      for congenital aortic stenosis (n = 6), aortic insufficiency (n = 17) and mixed
      disease (n = 17). All patients had aortic root replacement with the pulmonary
      autograft and had no regurgitation after operation. Postoperative evaluation was
      conducted by transthoracic echocardiography, office visit and/or telephone
      interview. NYHA functional class, aortic and pulmonary valve function and aortic
      root dimensions were evaluated. RESULTS: One patient died postoperatively as a
      result of a low output state related to global left ventricular dysfunction. Four
      patients (10%) developed pulmonary homograft stenosis with a peak gradient
      >40mmHg; and six developed mild pulmonary stenosis. One patient had aortic
      insufficiency seven years postoperatively that required valve replacement. Eight
      patients developed mild dilatation (>37 mm) of the neoaortic root, and five of
      these had aortic insufficiency. One patient required transplantation at 40 months
      for restrictive cardiomyopathy. CONCLUSION: The Ross procedure is an effective
      means of AVR that can be accomplished with low perioperative morbidity and
      mortality if certain technical modifications are carried out. In this series of
      40 patients with mid-term follow up, a significant number developed moderate
      pulmonary trunk stenosis, though echo characterization demonstrated good valve
      function.

PMID- 11206767
TI  - Left ventricular remodeling after pulmonary autograft replacement of the aortic
      valve (Ross operation).
AB  - BACKGROUND AND AIM OF THE STUDY: Aortic valve replacement (AVR) with a pulmonary
      autograft is an alternative treatment for young patients with aortic valve
      disease. Superior hemodynamic performance of the pulmonary autograft, and impact
      on parameters of left ventricular function were analyzed. METHODS: Thirty
      patients (21 males, nine females; mean age 29.97+/-12.29 years; range: 6-54
      years) underwent a Ross procedure between November 1997 and November 1999. Seven
      patients (23%) were children (aged <15 years). In total, 22 patients were
      analyzed; each had at least three months follow up. Eleven patients had
      predominant aortic stenosis (AS), and 11 had aortic insufficiency (AI). RESULTS:
      There were no operative deaths. Two patients developed severe insufficiency, and
      the autograft was replaced with a mechanical valve. Pre- and postoperative
      echocardiograms were reviewed. The mean neoaortic maximal gradient was 7.85+/
      5.59 mmHg (range: 3-29 mmHg). AS patients showed reduced interventricular septal
      (IVS) thickness at one month (from 13.27+/-3.69 to 11.60+/-2.44 mm; p = 0.0165)
      and 18 months after surgery (p = 0.0104). Left ventricular posterior wall (LVPW)
      thickness was reduced from 12.04+/-3.75 to 9.48+/-2.47 mm (p = 0.0338) at one
      month and 18 months (p= 0.0128) after surgery. The left ventricular end-diastolic
      internal dimension (LVIDd) decreased from 50.71+/-10.20 to 44.98+/-7.29 mm (p =
      0.0491) at one month after surgery. In AI patients, LVPW and IVS thicknesses
      showed no significant variation, and LVIDd was decreased at one month (from
      68.50+/-8.39 to 59.04+/-9.21 mm; p = 0.0017) and 18 months (p = 0.0229) after
      surgery. Left ventricular end-systolic internal dimension (LVIDs) decreased from
      44.06+/-6.39 to 39.03+/-7.99 mm (p = 0.0081) at three months after surgery. Left
      ventricular mass index (LVMI) in the AS group decreased from 179.01+/-62.26 to
      115.74+/-37.62 g/m2 (p = 0.0021) at one month after surgery, and at 18 months was
      normal, with a decrease from 208.77+/-32.89 to 95.89+/-28.82 g/m2 (p= 0.0003) (n
      = 5). In the AI group, LVMI decreased from 186.25+/-85.21 to 140.58+/-62.02 g/m2
      (p = 0.0011) at one month after surgery, and at 18 months from 217.70+/-98.02 to
      146.73+/-84.55 g/m2 (p= 0.0131) (n = 5). CONCLUSION: The pulmonary autograft
      procedure can be used safely to replace the aortic valve, and allows optimal
      hemodynamic performance, with no significant aortic regurgitation. The Ross
      procedure results in normalization of left ventricular dimensions and improvement
      of left ventricular function early in the postoperative period.

PMID- 11206769
TI  - Relationship between papillary muscle size and benefit to cardiac function in
      mitral valve replacement with chordal preservation.
AB  - BACKGROUND AND AIM OF THE STUDY: Mitral valve replacement (MVR) with chordal
      preservation in patients with chronic mitral regurgitation (MR) has been reported
      to maintain systolic function of the left ventricle. However, the benefits of MVR
      with chordal preservation are not always predictable. The study aim was to
      ascertain the influence that papillary muscle (PM) size has on cardiac function
      after MVR with chordal preservation. METHODS: Postoperative regional shortening
      and its relationship with PM size were investigated by two-dimensional
      echocardiography in 18 patients who underwent MVR with chordal preservation, and
      nine patients without chordal preservation between 1986 and 1998 at Tenri
      Hospital. The PM cross-sectional area was measured in each patient, as well as
      postoperative fractional shortening (FS) of the septolateral, anteroposterior and
      vertical dimensions of the left ventricle. The technique of preserving all
      chordae tendineae involved reattaching the anterior leaflet chordae to the mitral
      annulus near each commissure. RESULTS: Postoperative FS of the septolateral and
      anteroposterior dimensions was better in patients with chordal preservation than
      in those without. In the former subgroup, a larger PM was associated with better
      FS of the left ventricle in the septolateral dimension (anterior PM, p <0.001, r
      = 0.78; posterior PM, p = 0.0010, r = 0.69), but not in the anteroposterior or
      vertical dimensions. This discrepancy in the relationship between PM size and
      functional benefits among the three dimensions may be related to the direction in
      which the PMs are suspended in our technique, or its effect on regional left
      ventricular function. CONCLUSION: The present study indicated that PM size may be
      used as a factor to better predict the outcome of MVR with chordal preservation.

PMID- 11206768
TI  - Effect of cardiac output on mitral valve area in patients with mitral stenosis:
      validation and pitfalls of the pressure half-time method.
AB  - BACKGROUND AND AIM OF THE STUDY: The non-invasive evaluation of mitral valve area
      is often used in the assessment of patients with mitral stenosis. The pressure
      half-time method is commonly used to calculate valve area, but is inaccurate in
      many clinical scenarios. We sought to quantify the effects of changing cardiac
      output on the accuracy of mitral valve area determination. METHODS: Thirteen
      patients with mitral stenosis underwent routine stress echocardiography with
      resting and peak exercise results compared. A previously described and clinically
      validated mathematical model of the cardiovascular system was used to validate
      the clinical results. Seven different loading conditions for each of four
      different stenotic valve areas were modeled. RESULTS: In patients, with
      increasing cardiac output, pressure half-time decreased (-30.6+/-35.3 ms/l/min)
      and calculated valve area increased by 0.25+/-0.30 cm2/l/min. By continuity, it
      appeared that approximately half of this increase was due to actual valve orifice
      stretching, the remainder reflecting fundamental changes in the relationship
      between half-time and valve area. Mathematical modeling resulted in similar
      changes in pressure half-time and calculated valve area (0.06 to 0.12 cm2/l/min,
      p = 0.20 versus clinical results). CONCLUSION: Changes in cardiac output result
      in predictable changes in pressure half-time, and should be considered when
      performing serial examinations in patients with mitral stenosis.

PMID- 11206770
TI  - Transesophageal echocardiography as predictor of mitral valve repair.
AB  - BACKGROUND AND AIM OF THE STUDY: Mitral valve repair has recently emerged as the
      treatment of choice in patients presenting with insufficiency due to valve
      prolapse. The study aims were to evaluate: (i) the clinical presentation in a
      consecutive series of patients with mitral valve prolapse undergoing surgical
      repair; (ii) the correlation between pre- and intraoperative echocardiographic
      features and surgical findings in these patients; and (iii) whether clinical and
      echocardiographic data may predict surgical outcome. METHODS: Between March 1997
      and May 2000, 152 patients (110 men, 42 women; mean age 59+/-13 years) were
      recruited into the study. All patients had myxomatous mitral valve disease
      causing severe regurgitation and underwent systematic examination by
      transesophageal echocardiography (TEE) for clear delineation of the three
      scallops of the posterior leaflet and juxtaposed segments of the anterior
      leaflet. RESULTS: In 119 patients (78%) a flail valve was documented by TEE and
      confirmed on surgical inspection; an anterior leaflet chordal rupture was not
      visualized by TEE in one case. In 15 cases (10%) there was flail of the anterior
      leaflet, and in 105 cases (69%) flail of the posterior leaflet. A bileaflet
      complex prolapse without chordal rupture was found in 32 cases. On the basis of
      TEE evaluation, mitral valve replacement was performed electively in 10 patients
      (7%); the other 142 (93%) underwent mitral valve repair. Adequate repair was
      obtained in 93% of cases; residual mitral regurgitation (eight cases; grade 3+)
      and mitral stenosis (one case) were documented by intraoperative TEE, and nine
      patients (6%) underwent valve replacement. CONCLUSION: The majority of patients
      with myxomatous mitral valve prolapse and severe regurgitation undergoing valve
      repair have chordal rupture of the posterior mitral leaflet, a condition in which
      results of valve repair are excellent. TEE provides a powerful means to define
      the mechanisms of mitral regurgitation and to identify the suitability of
      patients for valvuloplasty.

PMID- 11206771
TI  - Mitral valve repair and transesophageal echocardiographic findings in a high-risk
      subgroup of patients with active, acute infective endocarditis.
AB  - BACKGROUND AND AIM OF THE STUDY: Limited data are available regarding the
      efficacy of mitral valve repair in patients affected by active, acute infective
      endocarditis. In addition, the predictivity of transesophageal echocardiography
      (TEE) for guiding the surgical decision-making process in these patients has not
      yet been reported. The study aim was to evaluate the long-term results of mitral
      valve repair and role of TEE in active, acute infective endocarditis. METHODS:
      The study population consisted of patients affected by infective endocarditis of
      the mitral valve who underwent surgery. TEE was performed intraoperatively to
      guide the best surgical approach. All patients were followed up (mean 73+/-8
      months) after surgery. RESULTS: Twenty-eight patients underwent surgery for
      infective endocarditis; of these, 13 had mitral valve repair for active, acute
      infective endocarditis and formed the basis of the study. Sensitivity,
      specificity, positive predictive value, negative predictive value of TEE in
      detecting the mechanism of mitral regurgitation were 87%, 100%, 100% and 92%,
      respectively. The predictivity test of TEE in guiding surgical strategy was 94%.
      All patients were alive at the time of follow up; 10 (77%) were in NYHA class I
      and three in class II (23%). Mitral regurgitation was severe in one patient (8%),
      moderate in three (23%), mild in four (31%), and absent in five (38%). No
      relapses of active infective endocarditis were observed during the follow up
      period. CONCLUSION: Mitral valve repair appears to be an effective treatment for
      active, acute infective endocarditis with mitral regurgitation and should be
      considered as a therapeutic strategy when surgery is contemplated. TEE has a
      fundamental role in the surgical decision-making process in these patients.

PMID- 11206772
TI  - Mechanical versus biological valve prosthesis in the mitral position: a 10-year
      follow up of St. Jude Medical and Biocor valves.
AB  - BACKGROUND AND AIM OF THE STUDY: During the past 30 years, the development of
      mechanical and biological valves has led to major improvements in patient
      survival. Here, we present long-term results obtained with both types of
      prosthesis. METHODS: At our institution, between 1985 and 1989, 158 patients
      received a Biocor porcine bioprosthesis, and 100 patients a St. Jude Medical
      (SJM) mechanical valve. Preoperatively, mean age, male:female ratio, NYHA
      functional class and pathology of mitral valve disease were similar in both
      groups. RESULTS: The 30-day mortality was 4.4% in the Biocor group and 4% in the
      SJM group, the major cause being congestive heart failure. Late mortality was
      17.9% and 15.6% respectively in the two groups, but valve-related mortality was
      very low in both (1.3% versus 4.2%). Ten-year survival was similar in each group
      (77.8+/-3.4% versus 81.0+/-3.9%; p = 0.538). Ten-year freedom from anticoagulant
      related hemorrhage was higher with Biocor prostheses (99.3+/-0.7% versus 90.9+/
      3.1%; p = 0.007). Valve thrombosis was seen only in the SJM group, and structural
      valve degeneration (SVD) only in the Biocor group. Ten-year freedom from
      reoperation was lower in the Biocor group (84.9+/-3.2% versus 92.2+/-2.8%; p =
      0.206). The significant causes of reoperation were SVD in the Biocor group and
      valve thrombosis in the SJM group. Freedom from prosthetic valve endocarditis was
      similar in both groups (96.3+/-1.6% versus 95.5+/-2.2%). CONCLUSION: As no
      difference was seen in survival and reoperation rates between patients receiving
      either bioprostheses or mechanical valves, the valve used will depend on the
      surgeon's choice and the type of patient, notably elderly patients who are
      intolerant of anticoagulation, and young women wishing to have children.

PMID- 11206773
TI  - Mitral valve replacement with chordal preservation in a rheumatic population.
AB  - BACKGROUND AND AIM OF THE STUDY: Mitral valve replacement (MVR) with preservation
      of the subvalvular apparatus may maintain postoperative left ventricular (LV)
      function better than conventional MVR. A prospective study was undertaken to
      assess the advantages of chordal preservation in rheumatic patients undergoing
      isolated MVR. METHODS: Between January 1996 and January 1999, 240 patients with
      rheumatic etiology and normal LV ejection fraction (>50%) underwent isolated MVR
      using a St. Jude Medical prosthesis. Patients were allocated to two groups: in
      group I (n = 168), both the anterior and posterior chordae were preserved; in
      group II (n = 72), the entire native mitral valve apparatus was excised. Patients
      from both groups were evaluated postoperatively (mean 12.5 months) by
      echocardiography and treadmill testing. RESULTS: Demographic and clinical
      profiles were comparable in both groups. There were three early deaths in group
      I, and one in group II. There were no late deaths. One patient in group I
      required reoperation for a stuck mitral prosthesis. LV function (ejection
      fraction >50%) was better in group I (94%) than in group II (82%) (p <0.05). No
      patient in either group had LV outflow tract obstruction on echocardiography.
      Patients in group I showed better exercise performance on treadmill (Bruce
      protocol): 92% of group I patients versus 88% of group II patients (p >0.05)
      completed stage I; 16% of group I patients, but no group II patients, were able
      to complete stage IV (p <0.05). CONCLUSION: Mitral valve replacement with
      preservation of the subvalvular apparatus maintains LV function, and does not
      cause LV outflow tract obstruction.

PMID- 11206774
TI  - Case report: outer sheath rupture may precede complete chordal rupture in
      fibrotic mitral valve disease.
AB  - Rupture mechanics of mitral valve chordae have been difficult to elucidate
      because most surgical repairs and pathological examinations are performed after
      the rupture. In an excised anterior leaflet from a fibrotic mitral valve, chordae
      were observed in an initial phase of rupture. Microscopic sections showed that
      thinned, nearly ruptured chordal segments were actually chordal cores, containing
      highly aligned collagen fibers. The outer sheath of elastic fibers, disorganized
      circumferentially oriented collagen fibers, and endothelial cells that normally
      surrounds the collagen core apparently had retracted to the extreme ends of the
      thinned segment, resulting in a bulbous shape, as noted in the chordal rupture
      literature. In conclusion, these new observations lead us to propose that the
      rupture of mitral valve chordae is not spontaneous, but may occur over time. The
      failure of the outer sheath may represent the first phase in a slow, two-part
      process leading to eventual chordal rupture.

PMID- 11206775
TI  - Early clinical experience with the On-X prosthetic heart valve.
AB  - BACKGROUND AND AIM OF THE STUDY: The study was designed to investigate the
      clinical performance of the On-X prosthetic heart valve in a multicenter
      experience. METHODS: Between September 1996 and September 1999, 301 patients (56%
      males) underwent isolated On-X valve replacement (184 isolated aortic (AVR), 117
      isolated mitral (MVR)) at 11 European centers under a standardized protocol.
      Average age at implant was 60.2 years. Office or hospital follow up was required
      by the protocol; average follow up on all patients was 11 months. RESULTS: Thirty
      day mortality in the study was 2.2% for AVR and 6.0% for MVR, with valve-related
      mortality of 0.5% for AVR. There were eight late deaths (0.7%/pt-yr AVR and
      2.3%/pt-yr MVR). Two of these deaths were sudden, and thus possibly valve-related
      (one AVR, one MVR). Early total valve-related morbidity was 3.5% for AVR and 2.6%
      for MVR. In total, 13 thromboembolic events occurred; one early event in AVR
      resulted in death (0.5%), and one transient early event occurred in MVR (0.9%).
      There were 11 late events (seven AVR (1.7%/pt-yr) and four MVR (1.8%/pt-yr)), for
      a two-year freedom from thromboembolism of 96.6% after AVR and 97.1% after MVR.
      Three late bleeding events occurred, all after AVR (0.7%/pt-yr and 98.9% free at
      two years). Major paravalvular leaks requiring reoperation occurred on two
      occasions early (one AVR (0.5%), one MVR (0.8%)) and once late in MVR (0.5%/pt
      yr). Late minor, untreated paravalvular leaks occurred in three AVR patients
      (0.7%/pt-yr) and in one MVR patient (0.5%/pt-yr). Prosthetic endocarditis
      occurred four times (two AVR (0.5%/pt-yr), two MVR (0.9%/pt-yr)), all within the
      first 12 months of surgery. Actuarial freedom from all valve-related events at
      two years was 88.7% for AVR and 88.1% for MVR. NYHA class was improved in 75.8%
      of AVR patients and 70.6% of MVR patients at two years after surgery. CONCLUSION:
      These early results indicate that the On-X valve provides satisfactory clinical
      outcome in the immediate postoperative period, and that the valve is both safe
      and effective.

PMID- 11206776
TI  - High-performance liquid chromatographic enantiomeric separation of an enzyme
      inhibitor which possesses both a chiral center and tautomeric moieties.
AB  - The enantiomeric separation using high-performance liquid chromatography (HPLC)
      on chiral stationary phases (CSPs) of a chiral compound which exists in solution
      in several tautomeric forms is described. 2,4-Dioxo-5-acetamido-6-phenylhexanoic
      acid is the most potent inhibitor known for peptidylamidoglycolate lyase (PGL, EC
      4.3.2.5), an enzyme which plays an essential role in carboxyl-terminal amidation
      of many biological peptides. Synthesis of this inhibitor entails an alkaline
      hydrolysis step, under which condition the compound is racemized; thus, HPLC with
      a CSP was employed to obtain the individual enantiomers of this inhibitor. Since
      2,4-dioxo-5-acetamido-6-phenylhexanoic acid exists in solution in several
      tautomeric forms, the strategy of first converting this compound from its
      multiple enol forms into a single diketo tautomer, which was then applied to
      various CSPs, was employed. Successful preparative scale enantiomeric separation
      of this compound was achieved using a Chiralpak AD CSP. Enantiomeric separation
      was also accomplished on a D-penicillamine column, but this CSP was found to be
      less satisfactory for preparative purposes.

PMID- 11206777
TI  - Optical resolution of asymmetric triacylglycerols by chiral-phase high
      performance liquid chromatography.
AB  - A simple method for direct optical resolution of some asymmetric triacylglycerols
      (TGs) has been established. The method employs chiral-phase high-performance
      liquid chromatography (HPLC). An enantiomeric pair of TGs comprising 1
      eicosapentaenoyl-2,3-dicapryroyl-sn-glycerol (ECC) and 1,2-dicapryroyl-3
      eicosapentaenoyl-sn-glycerol (CCE) was resolved on a CHIRALCEL OF or on a
      CHIRALCEL OD column. The separation of another pair of asymmetric TGs, 1
      docosahexaenoyl-2,3-dicapryroyl-sn-glycerol (DCC) and 1,2-dicapryroyl-3
      docosahexaenoyl-sn-glycerol (CCD), was achieved with the CHIRALCEL OD column. The
      chiral-phase HPLC method in combination with silver-ion HPLC and high-temperature
      gas chromatography was used for monitoring two interesterification reactions,
      whose products were chiral TGs. Interesterification of tricapryloylglycerol with
      ethyleicosapentaenoate or with ethyldocosahexaenoate was performed using
      Rhizomucor miehei lipase as the catalyst. The products targeted were the
      asymmetric pair of TGs, ECC and CCE or DCC and CCD. The amounts of sn-1
      substituted products (ECC or DCC) were greater than their sn-3-substituted
      counterparts (CCE or CCD) throughout the reaction period, suggesting that R.
      miehei lipase had a stereopreference towards the sn-1 position over the sn-3
      position.

PMID- 11206778
TI  - Reversed-phase high-performance liquid chromatographic separation of tert.-butyl
      hydroperoxide oxidation products of unsaturated triacylglycerols.
AB  - Triacylglycerols containing monounsaturated fatty acids are known to be
      relatively resistant to autoxidation and require long periods of exposure to
      dilute oxidants. Use of concentrated solutions of synthetic hydroperoxides,
      however, yields in addition to the hydroperoxides also unidentified oxidation by
      products. In the present study we have employed synthetic triacylglycerols
      containing one (18:0/18:1/18:0 and 18:1/16:0/16:0) and two (18:0/18:0/18:2 and
      18:1/18:1/18:0) double bonds per molecule to reinvestigate the formation of
      oxotriacylglycerols using tert.-butyl hydroperoxide as an oxidant. Reversed-phase
      HPLC was used to separate and tentatively identify the oxidation products based
      on relative retention times of standards and the estimated elution factors for
      functional groups and their positional distribution. Hydroperoxides, diepoxides
      and hydroxides were the major components of the oxidation mixtures (50-95% of
      total). Previously unidentified peroxide-bridged tert.-butyl adducts were present
      in significant amounts (5-50% of total oxidation products) in all preparations.
      In several instances more than one functional group was present on a single fatty
      chain. The tentative reversed-phase chromatographic identification of the adducts
      was confirmed by determination of the molecular mass of each component by on-line
      LC with electrospray MS. The oxidation products were quantified by HPLC with
      light scattering detection.

PMID- 11206779
TI  - Bi-column method for purification of transcription factors.
AB  - A novel bi-column method for purifying transcription factors, using two different
      columns and two different elution strategies is described. Lac repressor elutes
      at lower heparin concentrations from a lower affinity lactose operatorl (Op1)
      Sepharose column than from a higher affinity column containing the same sequence
      with a T18:A18 tail (Op1T18). A bi-column method was developed in which lac
      repressor fusion protein is eluted from the Op1-Sepharose with a low heparin
      concentration and trapped on a Op1T18-Sepharose column because of its higher
      affinity for the lac repressor protein. Elution of the latter column with buffer
      containing a high salt concentration gives significantly purer transcription
      factor than the conventionally used single column methods and removes residual
      heparin. Highly pure CAAT enhancer binding protein and the B3 transcription
      factor are also obtained by using variants of this bi-column method.

PMID- 11206780
TI  - Determination of porphyrins and metalloporphyrins using liquid chromatography
      diode array detection and mass spectrometry.
AB  - A HPLC procedure has been optimized and successfully applied to porphyrins of
      environmental interest, such as etio and octaethylporphyrins and their VO and Ni
      compounds. The use of UV-Vis diode array allowed the detection of the analytes
      within the 5-15 ng/ml range. In order to achieve greater specificity and some
      structural information, the coupling of liquid chromatography with mass
      spectrometry was investigated, and the particle beam interface conditions were
      optimized. Electron impact (EI) spectra, comparable to those reported in the
      literature were obtained. The entire procedure has been applied to a real marine
      sediment, previously spiked with porphyrins to resemble oil-contaminated samples.
      The results pointed out that the method is suitable for such levels of analytes
      (5-10 microg/ml), allowing their identification and quantification with no need
      for purification steps.

PMID- 11206781
TI  - Preparative isolation and purification of lutein from the microalga chlorella
      vulgaris by high-speed counter-current chromatography.
AB  - High-speed counter-current chromatography (HSCCC) was applied to the isolation
      and purification of lutein from microalgae. Analytical HSCCC was used for the
      preliminary selection of a suitable solvent system composed of n-hexane-ethanol
      water (4:3:1, v/v). Using the above solvent system, preparative HSCCC was
      successfully performed yielding lutein at 98% purity from 200 mg of the crude
      extract in a one-step separation.

PMID- 11206782
TI  - Determination of metal complexes of ethylenediaminetetraacetate in the presence
      of organic matter by high-performance liquid chromatography.
AB  - A high-performance liquid chromatography method is described here for the
      determination of the Cd(II), Co(II), Cu(II), Pb(II), and Zn(II) complexes of
      ethylenediaminetetraacetate (EDTA) in municipal wastewaters and surface waters.
      The method involves separation by ion-exchange chromatography on a reversed-phase
      C18 column coated with ion-pair reagent, followed by post-column conversion to
      FeEDTA and subsequent detection by UV absorbance. Although Co(II) and Cu(II)
      coelute, they can be quantified by analyzing absorbance by CuEDTA2- prior to post
      column conversion. The method detection limit of 6-8 x 10(-8) M (5-7 ng) is an
      order of magnitude improvement over previous UV absorbance post-column reaction
      methods. The technique can be used in the presence of organic matter encountered
      in matrices such as untreated wastewater without pre-concentration or sample
      cleanup.

PMID- 11206783
TI  - TiO2 colloidal suspension polydispersity analysed with sedimentation field flow
      fractionation and electron microscopy.
AB  - Sedimentation field flow fractionation (SdFFF) operated at multi gravitational
      field is used to analyse a highly polydisperse TiO2 colloidal suspension. From
      the initial sample, time dependent eluted fractions are collected and submitted
      to electron microscopy (EM) shape and size analysis. To assess the accuracy of
      FFF in determining the average size of the different fractions, these are re
      introduced into the channel by means of two different procedures, the on-channel
      concentration of the fractions and the direct re-injection of pre-concentrated
      fractions (DRI). Both methods appear accurate to determine the average size of
      every fraction, associated to a lower recovery in the case of DRI. The fractogram
      band spreading characteristics of the re-introduced fractions are correlated to
      the particle size distribution measured by EM. After density determination of
      fractionated particles, the fractogram is calibrated in terms of size and size
      distribution using data obtained from EM for each fraction. Quantitative
      analyses, based on particle counting showed high recovery (80-90%) of the eluted
      species. However, this loss limited the possibility to extend signal information
      to a quantitative one.

PMID- 11206784
TI  - Semi-preparative gas chromatographic separation of all-trans-perhydrotriphenylene
      enantiomers on a chiral cyclodextrin stationary phase.
AB  - Enantiomers of all-trans-perhydrotriphenylene (PHTP) were separated by gas
      chromatography using heptakis(6-O-tert.-butyldimethylsilyl-2,3-di-O-methyl)-beta
      cyclodextrin (TBDMS-beta-CD) as the chiral selector. Conditions for semi
      preparative separations were established using a 2 m x 2 mm I.D. packed column
      and subsequently extended to a 1.8 m x 4 mm I.D. column which enabled separations
      on a mg scale. The column packing was TBDMS-beta-CD dissolved in SE-54 coated on
      Chromosorb P AW-DMCS 80-100 mesh. Optimization of the chromatographic conditions
      (oven temperature, carrier gas flow, and column load) with respect to better
      efficiency and peak retention resulted in a system capable of separating up to 10
      mg of the racemate per day. Purities of separated enantiomers were determined by
      capillary gas chromatography. Yields and purities of the fractions obtained by
      single- and double-step separations are compared. Highly enriched enantiomers
      with purities of up to 99.6% (99.2% ee) were obtained by a single separation
      step.

PMID- 11206785
TI  - Comparison of direct and indirect methods of measuring the precursors of beta
      methyl-gamma-octalactone and their application to the analysis of Sessile oak
      wood.
AB  - A new indirect method for measuring the level of beta-methyl-gamma-octalactone
      precursors in oak wood by GC-MS is described. This level is calculated from the
      difference between the amount of free beta-methyl-gamma-octalactone and the
      amount formed after hydrolysis and lactonization. It is compared to the level of
      a precursor of cis-beta-methyl-gamma-octalactone, a 6'-O-gallate derivative of
      (3S,4S)-4-[3-beta-glucopyranosyloxy-3-methyloctanoic acid, determined directly by
      HPLC. These two methods are applied to 12 powdered samples of Sessile oak wood
      and the results show that the 6'-O-gallate derivative of (3S,4S)-4-beta-D
      glucopyranosyloxy-3-methyloctanoic acid is by far the most abundant precursor of
      beta-methyl-gamma-octalactone in this wood.

PMID- 11206786
TI  - Nuclear magnetic resonance studies of solvent flow through chromatographic
      columns: effect of packing density on flow patterns.
AB  - NMR (nuclear magnetic resonance) techniques have been used to measure and
      characterise solvent flow through chromatographic columns. NMR imaging was used
      to track an injection of D2O. PGSE (pulsed gradient spin echo) NMR was used to
      measure the flow-rate dependence of axial and transverse apparent diffusion. A
      combination of these two techniques (dynamic NMR imaging) gave the spatial
      distribution of the local velocity and apparent diffusion through a cross-section
      of the column. Significant column wall effects were observed and these effects
      were found to be highly dependent upon the column packing density. The column
      performance was assessed in terms of the HETP (height equivalent to a theoretical
      plate) determined by the NMR techniques employed.

PMID- 11206787
TI  - Gas chromatography-mass spectrometry and chemometric resolution applied to the
      determination of essential oils in Cortex cinnamomi.
AB  - In this paper, a novel procedure for qualitative and quantitative analysis of the
      two-dimensional data obtained from GC-MS is investigated to determine chemical
      components of essential oils in Cortex Cinnamomi from four different producing
      areas. A new method named iterative optimization procedure (IOP) specially used
      to resolve embedded peaks is also developed. With the help of IOP and other
      chemometric techniques, such as heuristic evolving latent projections, evolving
      factor analysis, sub-window factor analysis and orthogonal projection resolution,
      and etc., the detection of the purity of chromatographic peaks can be first
      addressed, and then the overlapping peaks are resolved into the pure chromatogram
      and mass spectrum of each component. The similarity searches in the MS database
      are finally conducted to qualitatively determine the chemical components. The
      results obtained showed that the accuracy of qualitative and quantitative
      analysis could be greatly enhanced by chemometric resolution methods. The
      chemometric resolution techniques upon the two-dimensional data can be quite
      promising tools for the analysis of the complex samples like traditional Chinese
      medicine.

PMID- 11206788
TI  - Structural determination of zinc dithiophosphates in lubricating oils by gas
      chromatography-mass spectrometry with electron impact and electron-capture
      negative ion chemical ionization.
AB  - Pentafluorobenzyl ester derivatives were used to identify zinc
      dialkyldithiophosphates and diaryldithiophosphates antiwear engine oil additives
      by GC-electron impact ionization (EI) MS and GC-electron-capture negative ion
      chemical ionization (ECNCI) MS analysis. GC-EI-MS of the dialkyldithiophosphate
      pentafluorobenzyl derivatives afforded characteristic fragment ions corresponding
      to the cleavage of one and two alkyl radicals. In most cases, information was
      only obtained on one alkyl chain. Additional and complete information was
      obtained with retention time indices using synthetic derivatives and with GC
      ECNCI-MS analysis. ECNCI afforded characteristic dithiophosphate anions which
      allowed the determination of the total number of carbon atoms in the alkyl
      radicals. The diastereoisomer mixtures of 2-hydroxy-sec.-alkyl radicals were
      completely separated on GC analysis.

PMID- 11206789
TI  - Multiresidual method for the gas chromatographic analysis of pesticides in
      honeybees cleaned by gel permeation chromatography.
AB  - The analysis of several organophosphorus and carbamate pesticide residues in the
      bodies of honeybees using gas chromatography (GC) and gel permeation
      chromatography (GPC) clean-up is described. Freeze-dried or lyophilized insect
      samples were blended with diatomaceous earth (Extrelut) then underwent elution
      with methylene chloride. This extraction method has shown good recovery on
      various spike standard levels. Samples are cleaned up by GPC with a Bio Beads SX
      3 column and a cyclohexane-ethylacetate (1:1) eluant. Organophosphorus and
      carbamate compounds are quantified using capillary gas chromatography. Good
      linearity ranges were observed for all compounds. The extraction process was
      rapid and results were good, despite the complexity of the matrix on which it was
      applied. It allowed a reduction both in cost and the consumption of solvents,
      thereby safeguarding the health of the analyst and the environment. Environmental
      monitoring using bees was confirmed to be a valid procedure.

PMID- 11206790
TI  - Two-fibre solid-phase microextraction combined with gas chromatography-mass
      spectrometry for the analysis of volatile aroma compounds in cooked pork.
AB  - The volatile aroma compounds in cooked pork were examined using solid-phase
      microextraction (SPME). Two SPME fibres coated with different stationary phases
      were used simultaneously to collect aroma compounds from the headspace above the
      pork. One fibre was coated with 75 microm. Carboxen-polydimethylsiloxane and the
      other was coated with 50/30 microm divinylbenzene-Carboxen on
      polydimethylsiloxane. After extraction, the two fibres were desorbed in the
      injection port of a gas chromatograph sequentially, so that the aroma compounds
      from both of the fibres could be analysed in one gas chromatogram. This procedure
      resulted in a chromatogram containing a more complete aroma profile for cooked
      pork than the chromatograms from either of the fibres on their own. Thirty-six
      compounds were identified in cooked pork for the first

PMID- 11206791
TI  - High-throughput reactor for simulating the flame photometric detector.
AB  - Quenching of luminescing species by co-eluting hydrocarbons has been widely
      reported in the flame photometric detector (FPD). This paper describes a novel
      method of investigating the chemical behavior of both analyte and quencher
      molecules in the FPD. The method is designed to reproduce the FPD's behaviour on
      a large scale by using a custom-built reactor. The high-throughput reactor's
      multi-capillary burner, situated inside a glass housing, is well suited to
      approximate the low-temperature, fuel-rich conditions of the conventional FPD,
      and also allows the study of various other flame phenomena. Wide regions of gas
      composition can be accessed by both diffusion- and premixed-type flames, and
      products can be easily sampled. Effluent collection demonstrates that 2 to 82% of
      various organic compounds may survive passage through the diffusion flame and be
      recovered intact. The recovery of several (unchanged) model hydrocarbons was
      found to decrease with increasing carbon number. Hetero-atoms such as sulfur,
      nitrogen, or oxygen greatly decrease the recovery of molecules relative to their
      pure hydrocarbon analogues. Compared to a diffusion flame, the recoveries of n
      alkanes from a premixed flame are much lower and largely independent of carbon
      number or volatility.

PMID- 11206792
TI  - Chain separation of monounsaturated fatty acid methyl esters by argentation thin
      layer chromatography.
AB  - A technique for separating methyl esters of monounsaturated fatty acids by
      argentation chromatography using silver nitrate-impregnated TLC plates is
      described. Monounsaturated fatty acid methyl esters are separated from
      polyunsaturated and saturated fatty acid methyl esters and the monounsaturated
      fatty methyl esters are resolved according to chain length. cis isomers are well
      resolved from the corresponding trans isomers. R(F) values for individual
      monounsaturated fatty acids are very reproducible. The potential of the technique
      in metabolic studies is demonstrated in the chain elongation of [14C]-18:1(n-9)
      and delta-9 desaturation of [14C]-18:0 by human skin fibroblasts. Recoveries of
      individual [14C]-fatty acids for scintillation counting exceed 94%.

PMID- 11206793
TI  - Capillary zone electrophoresis of basic analytes in methanol as non-aqueous
      solvent mobility and ionisation constant.
AB  - The electrophoretically relevant properties of monoacidic 21 bases (including
      common drugs) containing aliphatic or aromatic amino groups were determined in
      methanol as solvent. These properties are the actual mobilities (that of the
      fully ionised weak bases), and their pKa values. Actual mobilities were measured
      in acidic methanolic solutions containing perchloric acid. The ionisation
      constants of the amines were derived from the dependence of the ionic mobilities
      on the pH of the background electrolyte solution. The pH scale in methanol was
      established from acids with known conventional pK*a values in this solvent used
      as buffers, avoiding thus further adjustment with a pH sensitive electrode that
      might bias the scale. Actual mobilities in methanol were found larger than in
      water, and do not correlate well with the solvent's viscosity. The pK*a values of
      the cation acids, HB-, the corresponding form of the base, B, are higher in
      methanol, whereas a less pronounced shift was found than for neutral acids of
      type HA. The mean increase (compared to pure aqueous solution) for aliphatic
      ammonium type analytes is 1.8, for substituted anilinium 1.1, and for aromatic
      ammonium from pyridinium type 0.5 units. The interpretation of this shift was
      undertaken with the concept of the medium effect on the particles involved in the
      acid-base equilibrium: the proton, the molecular base, B, and the cation HB+.

PMID- 11206794
TI  - Optimization of background electrolytes for capillary electrophoresis I.
      Mathematical and computational model.
AB  - A mathematical and computational model is introduced for optimization of
      background electrolyte systems for capillary zone electrophoresis of anions. The
      model takes into account mono- or di- or trivalent ions and allows also for
      modeling of highly acidic or alkaline electrolytes, where a presence of hydrogen
      and hydroxide ions is significant. At maximum, the electrolyte can contain two co
      anions and two counter-cations. The mathematical relations of the model are
      formulated to enable an easy algorithmization and programming in a computer
      language. The model assesses the composition of the background electrolyte in the
      analyte zone, which enables prediction of the parameters of the system that are
      experimentally available, like the transfer ratio, which is a measure of the
      sensitivity in the indirect photometric detection or the molar conductivity
      detection response, which expresses the sensitivity of the conductivity
      detection. Furthermore, the model also enables the evaluation of a tendency of
      the analyte to undergo electromigration dispersion and allows the optimization of
      the composition of the background electrolyte to reach a good sensitivity of
      detection while still having the dispersion properties in the acceptable range.
      Although the model presented is aimed towards the separation of anions, it can be
      straightforwardly rearranged to serve for simulation of electromigration of
      cationic analytes. The suitability of the model is checked by inspecting the
      behavior of a phosphate buffer for analysis of anions. It is shown that
      parameters of the phosphate buffer when used at neutral and alkaline pH values
      possess singularities that indicate a possible occurrence of system peaks.
      Moreover, if the mobility of any analyte of the sample is close to the mobilities
      of the system peaks, the indirect detector signals following the background
      electrolyte properties will be heavily amplified and distorted. When a specific
      detector sensitive on presence of the analyte were used, the signal would be
      almost lost due to the excessive dispersion of the peak.

PMID- 11206795
TI  - Sulfonated acrylamide copolymers as pseudo-stationary phases in electrokinetic
      chromatography.
AB  - Sulfonated copolymers were synthesized, characterized and used as separation
      media in electrokinetic chromatography. The polymers used were synthesized from
      AMPS (2-acrylamido-2-methyl-1-propanesulfonic acid) and LMAm (lauryl
      methacrylamide) in different mole ratios (from 100:0 to 60:40). Electrophoretic
      mobilities and methylene selectivities were calculated, which showed the expected
      correlation with the monomer ratios. The chemical selectivities for the
      separation of nine solutes by the copolymers were compared with that of sodium
      lauryl sulfate micelles, showing significant differences. No significant
      difference in chemical selectivities was observed for copolymers with different
      monomer ratios. No significant change of hydrophobic microdomain of copolymers
      was found in background buffers with different ionic strength values, based on
      the investigation of the retention factors, methylene selectivities and polymer
      effective mobilities. No change of hydrophobic microdomain of the copolymer
      solutions was found at copolymer concentrations from 0.17 to 3% (w/v), however,
      plots of k' versus polymer concentration suggested a different copolymer phase at
      lower concentrations (from 0 to 0.1%, w/v) from that at higher concentrations
      (from 0.17 to 3%, w/v). The copolymer with AMPS-LMAm (80:20) could be chosen as
      optimum copolymer as far as the methylene selectivity, peak symmetry and polymer
      mobility were concerned.

PMID- 11206796
TI  - Polyacrylamides as hydrophilic selectors in non-aqueous capillary
      electrophoresis.
AB  - Polyacrylamides (PAAms) were investigated as hydrophilic selectors in non-aqueous
      capillary electrophoresis (CE). Separation of 10 substituted benzoates and
      unsubstituted benzoate as model samples was greatly improved by the addition of
      PAAms in acetonitrile-CE. The migration behavior indicates that the carbonyl
      moiety of PAAms works as a good hydrogen-accepting site toward hydrogen-donating
      analytes such as 4-hydroxybenzoate anion (4OH-BA) in acetonitrile. PAAms also
      serve as electron-accepting agents with its amide proton interacting with the
      dissociated carboxyl groups of the benzoates. The ion-dipole interaction is
      useful to control the migration behavior of benzoates without hydrogen-donating
      substituents. The overall mode of the interaction is similar to that of
      polyethylene glycol (PEG) 20000 reported previously, but the complex formation
      constant of poly(N-tert.-butyl)acrylamide (PBAAm) with 40H-BA estimated here was
      130-fold larger than that of PEG 20000. This would be ascribed to the strong
      basicity of the carbonyl oxygen atoms of PBAAm as compared with the ether oxygen
      atoms of PEG. Furthermore, a copolymer of (N-tert.-butyl)acrylamide-acrylamide
      [70:30 (in feed)] exhibited a complex formation constant of about fourfold larger
      toward 4OH-BA than PBAAm, most probably due to decrease in steric hindrance from
      the tert.-butyl groups. Adrenaline and its six precursors have been separated
      successfully using the PAAms.

PMID- 11206797
TI  - Characterization of polyethylene glycol-modified proteins by semi-aqueous
      capillary electrophoresis.
AB  - A new program to characterize polyethylene glycol-modified (PEGylated) proteins
      is outlined using capillary zone electrophoresis (CZE). PEGylated ribonuclease A
      and lysozyme were selected as examples. Five separation procedures were compared
      to select out the mixed buffer of acetonitrile-water (1:1, v/v) at pH 2.5 as the
      best to characterize the PEGylated proteins without sample pretreatment.
      Polyethylene oxide (PEO) with a high molecular mass of 8 x 10(6) was applied to
      rinse the capillary to form a dynamic coating which would decrease the
      undesirable proteins adsorbed to the inner wall of the silica. The electroosmotic
      flow (EOF) mobility of the five procedures was determined, respectively. It is
      found that acetonitrile is mainly responsible for the good resolution of
      PEGylated proteins with the help of PEO coating in the semi-aqueous system. The
      low EOF mobility and current in the semi-aqueous system might also have some
      responsibility for the high resolution. The semi-aqueous procedure described in
      this paper also demonstrates higher resolution of natural proteins than aqueous
      ones.

PMID- 11206798
TI  - Influence of the solute hydrophobicity on the enantioselective adsorption of beta
      blockers on a cellulase protein used as the chiral selector.
AB  - Adsorption isotherm data were acquired at different eluent pH values for the
      enantiomers of several beta-blockers on cellobiohydrolase I on silica gel. They
      fit well to the biLangmuir model, allowing the determination of the equilibrium
      constants and the monolayer capacities for chiral and nonselective adsorption.
      The adsorption of the S-enantiomers (eluted second) is exothermic at low pH,
      endothermic at high pH, and athermal in a narrow pH range depending on the beta
      blocker. This transition pH range is lower for S-alprenolol than for the more
      hydrophobic S-propranolol, although their endothermic adsorption originates from
      hydrophobic interactions. This surprising observation is explained by the
      relative values of the isotherm coefficients. S-Alprenolol seems to have a more
      pronounced endothermic behavior than S-propranolol because the nonselective
      interactions of both compounds with the stationary phase are exothermic but their
      contribution to retention, relative to that of the endothermic chiral
      interactions, is less important for alprenolol. The order of increasing energy of
      the chiral interactions is the same as that of hydrophobicity,
      propranolol>alprenolol>metoprolol.

PMID- 11206800
TI  - Separation of the insecticidal pyrethrin esters by capillary
      electrochromatography.
AB  - A simple, rapid technique for the direct separation and quantification of the six
      insecticidally active pyrethrin esters in typical extracts and commercial
      formulations by capillary electrochromatography (CEC) has been described. The
      separation of the pyrethrin esters was achieved by optimizing several parameters
      including the length of stationary phase, the mobile phase composition and column
      temperature. The mobile phase composition had the most pronounced effect toward
      resolving these structurally similar compounds. A ternary mobile phase composed
      of acetonitrile-aqueous buffer-tetrahydrofuran (55:35:10) provided the elutropic
      solvent strength needed to resolve the six esters from an extract mixture in
      under 16 min. A 25 cm packed bed of Hypersil 3 microm C18 stationary phase was
      used with the ternary mobile phase at 25 degrees C and 30 kV voltage. These
      conditions also yielded excellent separation of the pyrethrin esters in two
      different commercially available insecticidal formulations. In addition, the
      developed CEC method was shown to be a fast and easy way of quantifying the
      amount of these esters in typical pyrethrin formulations.

PMID- 11206799
TI  - Applications of a copper microparticle-modified carbon fiber microdisk array
      electrode for the simultaneous determination of aminoglycoside antibiotics by
      capillary electrophoresis.
AB  - A copper microparticle-modified carbon fiber microdisk array electrode was
      fabricated and employed in capillary electrophoresis for the simultaneous
      determination of the five aminoglycoside antibiotics (AGs) including netilmicin,
      tobramycin, lincomycin, kanamycin and amikacin. The array electrode exhibited
      high catalytic activity for AGs, good reproducibility and stability. Under the
      optimum separation conditions (separation voltage of 6.2 kV, electrophoretic
      medium of 125 mM NaOH), the five AGs above were baseline separated within 20 min.
      At a working electrode potential of 0.7 V (versus saturated calomel electrode),
      the calibration curves were linear over two orders of magnitude of concentration,
      and the detection limits (SIN=3) were below 2 microM except for lincomycin (6.7
      microM). The developed method was successfully employed for the simultaneous
      determination of the five AGs studied in pharmaceutical injections. The
      feasibility of this method for the simultaneous determination of lincomycin,
      kanamycin and amikacin in urine sample was also demonstrated.

PMID- 11206801
TI  - Chiral ion-pair chromatography on porous graphitized carbon using N-blocked
      dipeptides as counter ions.
AB  - Two newly synthesized chiral di-anionic counter ions were tested for enantiomeric
      resolution of a set of amino alcohols on porous graphitized carbon, Hypercarb. Z
      L-Aspartyl-L-proline dissolved in methanol baseline resolved nine of 12 tested
      racemates. One of its diastereoisomers, Z-L-aspartyl-D-proline was also tested
      but resulted in low separation factors, <1.1. Sodium hydroxide was added to the
      mobile phase in order to titrate the counter ion to its mono- or di-anionic form.
      Results show that the di-anionic form was found to be superior to the mono
      anionic form regarding enantioselectivity. Increased content of the counter ion
      in the mobile phase, with constant ratio between counter ion and sodium hydroxide
      concentration, decreased retention but only slightly affected enantioselectivity.
      Increased retention and enantioselectivity were observed with decreased column
      temperature. Resolution factors >3 were obtained between the enantiomers in
      atenolol and metoprolol with a total retention time of less than 15 min. Further,
      all four stereoisomers of an analogue to metoprolol were separated using
      Hypercarb and a mobile phase of 5 mM Z-L-aspartyl-L-proline and 9 mM sodium
      hydroxide in methanol.

PMID- 11206802
TI  - Application of reinforced frontal affinity chromatography and advanced processing
      procedure to the study of the binding property of a Caenorhabditis elegans
      galectin.
AB  - Frontal affinity chromatography is a very useful and simple method to analyze
      molecular interactions between an analyte and an immobilized ligand by
      calculating the extent of "retardation" of the elution front. We developed a very
      simple and efficient data-processing procedure that enables the measurement of
      very small differences in retardation with precision. This procedure was
      successfully applied to comparison of the binding properties of recombinant C.
      elegans galectins for their ligand.

PMID- 11206803
TI  - Determination of retinoids in galenicals by column liquid chromatography with
      fluorescence and diode-array detection.
AB  - Simple and rapid reversed-phase gradient column liquid chromatography (LC) with
      fluorescence detection at different wavelengths was developed for the
      simultaneous analysis of all-trans, 13-cis, 9-cis retinoic acids, vitamin A
      palmitate and beta-carotene in galenicals. The assay results agreed with those
      obtained by an LC method with diode-array UV detection. A post-column on-line
      photochemical reactor (irradiation at 254 and 366 nm) was inserted between the LC
      column and the fluorescence detector to enhance the performance of the method.
      Two fluorescence spectra (photoreactor on and off) were obtained for each analyte
      which proved useful for the unambiguous identification of the various analytes.

PMID- 11206804
TI  - Evaluation of the retention dependence on the physicochemical properties of
      solutes in reversed-phase liquid chromatographic linear gradient elution based on
      linear solvation energy relationships.
AB  - This paper describes the results of the evaluation of retention dependence on the
      physicochemical properties of solutes in linear gradient elution by reversed
      phase liquid chromatography (RPLC) based on linear solvation energy relationships
      (LSERs). Retention time data on Inertsil ODS(3) column by linear gradient elution
      were collected for both acetonitrile-water and methanol-water binary mobile
      phases under various gradient steepness. Based on the LSERs, the retention times
      were linearly correlated with the physicochemical properties (size, dipolarity,
      and hydrogen bond donor-acceptor acidity and basicity) of solutes. As predicted
      by LSERs, very acceptable linear relationships are observed for both mobile
      phases. While the magnitudes of the coefficients are modified by the gradient
      steepness, their signs are consistent with those obtained by isocratic elution.
      As obtained for isocratic elution, the dominant factors to retention in linear
      gradient elution of RPLC are the solutes' size and hydrogen bond acceptor
      basicity. The conclusions of the study allow us to predict retention in
      chromatographic method development by gradient elution.

PMID- 11206805
TI  - Effect of pH on the oxidation of paralytic shellfish poisoning toxins for
      analysis by liquid chromatography.
AB  - The effect of pH on the oxidation of individual PSP toxins using both periodate
      and peroxide oxidations was studied. It was found that the optimum pH for
      individual toxins varied considerably. For periodate oxidations, pH 8.2 produced
      the maximum yield of fluorescent products for neosaxitoxin and GTX1/GTX4 while
      the non-hydroxylated toxins (saxitoxin, GTX2/GTX3, decarbamoyl saxitoxin, GTX5)
      showed optimum pHs from about pH 10-11.5. Neosaxitoxin and GTX1/GTX4 did not
      produce significant fluorescent oxidation products with peroxide oxidation at any
      of the pHs studied (pH 8.2-12.8). The non-hydroxylated toxins all showed optimum
      pHs above pH 12 with peroxide oxidation. Yields of fluorescent products of these
      toxins decreased substantially at pHs below pH 12. Neosaxitoxin and GTX1/GTX4
      each produced three product peaks at pH 8.2 with periodate oxidation. There was
      no pH where these toxins produced predominantly a single oxidation product.
      Decarbamoyl saxitoxin always produced two oxidation products with both oxidation
      reactions at the pHs studied. However, the relative yields of the products
      changed with pH. At low pH the second eluting product predominated, while at
      higher pH values the first eluting product predominated. This pattern was
      observed for both oxidation reactions. The other non-hydroxylated toxins produced
      mainly single unique products with both oxidation reactions over the pH range
      studied. No single pH was found optimum for the oxidation of both hydroxylated
      and non-hydroxylated toxins without a significant compromise in yield of
      oxidation products. This has implications for the post column oxidation liquid
      chromatographic methods, since small changes in pH of the post column oxidant can
      both positively and negatively affect the yields of oxidation products of toxin
      mixtures leading to increased error in the subsequent quantitation of these
      compounds.

PMID- 11206806
TI  - Characterisation of sorbate geometrical isomers.
AB  - trans,trans Isomers of sorbic acid, its potassium salt and ethyl sorbate
      isomerise under UV irradiation. All four geometrical isomers of the acid, salt
      and ester were separated using high-performance liquid chromatography on a
      nonpolar reversed-phase column (C18) and the ester also by gas chromatography on
      a VOCOL capillary column. The limit of detection and the interval of linearity
      were determined for all chromatographic methods. Individual isomers were
      identified with NMR analysis. Resolved chemical shifts of protons adjacent to the
      double bonds enabled qualitative and quantitative determination of isomers in the
      mixture. Antimicrobial activity of potassium sorbate isomers was tested on yeast
      Saccharomyces cerevisiae. Results show that the pure trans,trans isomer has a
      higher antimicrobial activity than the mixture of isomers.

PMID- 11206807
TI  - Spatial and temporal progressions of spatial statistical moments in linear
      chromatography.
AB  - Generalizations of existing models of chromatography allow the spatial and
      temporal progressions of all spatial statistical moments in linear chromatography
      to be given as the solution to a set of ordinary differential equations. Basic
      strategies of simplifying these equations are described.

PMID- 11206808
TI  - Consequences of variable purity of heptakis(2,3,6-tri-O-methyl)-beta-cyclodextrin
      determined by liquid chromatography-mass spectrometry on the enantioselective
      separation of polychlorinated compounds.
AB  - The composition of 10 batches of heptakis(2,3,6-tri-O-methyl)-beta-cyclodextrin
      (PM-CD) from different suppliers was determined by high-performance liquid
      chromatography combined with atmospheric pressure chemical ionisation mass
      spectrometry (MS). Considerable differences were found. Some batches consisted of
      more than 95% pure PM-CD, whereas others were not completely derivatised or
      contained a significant amount of by-products. Some suggestions about the
      structures of these impurities are given though neither nuclear magnetic
      resonance spectroscopy nor MS-MS investigations could completely reveal their
      nature. Capillaries for high-resolution gas chromatography were coated with the
      batches of most differing composition. They demonstrated widely varying column
      performance and separation properties for selected chiral polychlorinated
      substances such as chlordane compounds, o,p'-DDT, o,p'-DDD, alpha
      hexachlorocyclohexane and atropisomeric polychlorinated biphenyls. The best
      enantioselectivity was obtained with the purest PM-CD. Compared to separations
      reported in the literature, a broader enantioselectivity was observed and also
      trans-heptachlor epoxide and oxychlordane could be resolved into enantiomers.

PMID- 11206810
TI  - Autoxidation products of normal and genetically modified canola oil varieties
      determined using liquid chromatography with mass spectrometric detection.
AB  - Normal, high stearic acid and high lauric acid canola oil varieties were heated
      in the presence of air to allow autoxidation to occur. After the reaction, the
      oils were analyzed using a non-aqueous reversed-phase high-performance liquid
      chromatographic separation followed by detection using atmospheric pressure
      chemical ionization mass spectrometry. Oxidized products were separated and
      identified. The major autoxidation products which remained intact were epoxides
      and hydroperoxides. Two classes of epoxy triacylglycerols (TAGs) were formed. One
      class with the epoxy group replacing a site of unsaturation and one class
      adjacent to a site of unsaturation, as was previously reported for model TAGs.
      Intact oxidation products resulted mostly from oxidation of oleic acid, while
      oxidation products of linoleic and linolenic acid chains decomposed to yield
      chain-shortened species. Both neutral and polar chain-shortened products were
      observed. Polar chain-shortened decomposition products eluted at very short
      retention times and required a different chromatographic gradient to separate the
      molecules. This class of molecules was tentatively identified as core aldehydes.
      The high stearic acid canola oil yielded more intact oxidation products
      containing stearic acid, as expected. The high lauric acid oil produced intact
      oxidation products which contained lauric acid.

PMID- 11206811
TI  - Computer-assisted discrimination among malignant lymphomas and leukemia using
      immunophenotyping, intelligent image repositories, and telemicroscopy.
AB  - The process of discriminating among pathologies involving peripheral blood, bone
      marrow, and lymph node has traditionally begun with subjective morphological
      assessment of cellular materials viewed using light microscopy. The subtle
      visible differences exhibited by some malignant lymphomas and leukemia, however,
      give rise to a significant number of false negatives during microscopic
      evaluation by medical technologists. We have developed a distributed, clinical
      decision support prototype for distinguishing among hematologic malignancies. The
      system consists of two major components, a distributed telemicroscopy system and
      an intelligent image repository. The hybrid system enables individuals located at
      disparate clinical and research sites to engage in interactive consultation and
      to obtain computer-assisted decision support. Software, written in JAVA, allows
      primary users to control the specimen stage, objective lens, light levels, and
      focus of a robotic microscope remotely while a digital representation of the
      specimen is continuously broadcast to all session participants. Primary user
      status can be passed as a token. The system features shared graphical pointers,
      text messaging capability, and automated database management. Search engines for
      the database allow one to automatically identify and retrieve images, diagnoses,
      and correlated clinical data of cases from a "gold standard" database which
      exhibit spectral and spatial profiles which are most similar to a given query
      image. The system suggests the most likely diagnosis based on majority logic of
      the retrieved cases. The system was used to discriminate among three
      lymphoproliferative disorders and healthy cells. The system provided the correct
      classification in more than 83% of the cases studied. System performance was
      evaluated using rigorous statistical assessment and by comparison with human
      observers.

PMID- 11206809
TI  - Effects of acid treatment on the trace metal content of chromatographic silica:
      bulk analysis, surface analysis and chromatographic performance of bonded phases.
AB  - A series of studies has been carried out on the effect of refluxing silica
      chromatography particles for 0.5 h and 18 h in water, dilute hydrochloric acid
      and dilute hydrofluoric acid. The bulk and surface trace metal concentrations
      were measured by inductively-coupled plasma atomic emission spectroscopy, static
      secondary ion mass spectrometry (SSIMS) and X-ray photoelectron spectroscopy.
      Diffuse reflectance Fourier transform infrared spectroscopy was used to determine
      changes in 'isolated" and "bonded" silanol groups. The chromatographic behaviour
      of a series of weakly basic analytes was investigated on C8 and C18 bonded phases
      manufactured from the acid-treated silicas. The different reflux treatments all
      resulted in a reduction in the numbers of isolated silanols compared with the
      untreated silica and SSIMS analysis suggested that the HF-treated silicas had
      undergone a more efficient surface rehydroxylation. Bulk trace metals were
      removed most effectively by the HF treatment, with the multivalent elements (Ti
      and Al) being the most difficult to remove. Surface specific analysis suggested
      that trace metals were removed more rapidly from the surface of the silica
      compared to the bulk matrix and that the acid treatments resulted in halide
      contamination of the silica surface. Evidence is presented to suggest that the
      bulk metal content of the silica is not representative of the concentration of
      metals at the chromatographic surface. The chromatographic investigations showed
      that the HF-treated silica gave substantially better performance towards weak
      bases than the HCl-treated silicas.

PMID- 11206812
TI  - Autonomous decision-making: a data mining approach.
AB  - The researchers and practitioners of today create models, algorithms, functions,
      and other constructs defined in abstract spaces. The research of the future will
      likely be data driven. Symbolic and numeric data that are becoming available in
      large volumes will define the need for new data analysis techniques and tools.
      Data mining is an emerging area of computational intelligence that offers new
      theories, techniques, and tools for analysis of large data sets. In this paper, a
      novel approach for autonomous decision-making is developed based on the rough set
      theory of data mining. The approach has been tested on a medical data set for
      patients with lung abnormalities referred to as solitary pulmonary nodules
      (SPNs). The two independent algorithms developed in this paper either generate an
      accurate diagnosis or make no decision. The methodolgy discussed in the paper
      depart from the developments in data mining as well as current medical
      literature, thus creating a variable approach for autonomous decision-making.

PMID- 11206813
TI  - The design and performance of a 2.5-GHz telecommand link for wireless biomedical
      monitoring.
AB  - This paper details the implementation and operational performance of a minimum
      power 2.45-GHz pulse receiver and a companion on-off keyed transmitter for use in
      a semi-active, duplex RF biomedical transponder. A 50-ohm microstrip stub-matched
      zero-bias diode detector forms the heart of a body-worn receiver that has a (CMOS
      baseband amplifier consuming 20 microA from +3 V and achieves a tangential
      sensitivity of -53 dBm. The base transmitter generates 0.5 W of peak RF output
      power into 50 ohms. Both linear and right-hand circularly polarized Tx-Rx antenna
      sets were employed in system reliability trials carried out in a hospital
      Coronary Care Unit. For transmitting antenna heights between 0.3 and 2.2 m above
      floor level, transponder interrogations were 95% reliable within the 67-m2 area
      of the ward, falling to an average of 46% in the surrounding rooms and corridors.
      Overall, the circular antenna set gave the higher reliability and lower
      propagation power decay index.

PMID- 11206814
TI  - Skeletal growth estimation using radiographic image processing and analysis.
AB  - An automated knowledge-based vision system for skeletal growth estimation in
      children is reported in this paper. Images were obtained from hand radiographs of
      32 male and 25 female children of age 1-16 yr. Phalanx bones were automatically
      localized and segmented using hierarchical inferences and active shape models,
      respectively. A number of shape descriptors were obtained from the segmented bone
      contour to quantify skeletal growth. From these descriptors, a feature vector was
      selected for a regression model and a Bayesian estimator. The estimation accuracy
      was 84% for females and 82% for males. This level of accuracy is comparable to
      that of expert pediatric radiologists, which suggests that the proposed approach
      has a potential application in pediatric medicine.

PMID- 11206815
TI  - An adaptive nonlinear diffusion algorithm for filtering medical images.
AB  - The nonlinear anisotropic diffusive process has shown the good property of
      eliminating noise while preserving the accuracy of edges and has been widely used
      in image processing. However, filtering depends on the threshold of the diffusion
      process, i.e., the cut-off contrast of edges. The threshold varies from image to
      image and even from region to region within an image. The problem compounds with
      intensity distortion and contrast variation. We have developed an adaptive
      diffusion scheme by applying the Central Limit Theorem to selecting the
      threshold. Gaussian distribution and Rayleigh distribution are used to estimate
      the distributions of visual objects in images. Regression under such
      distributions separates the distribution of the major object from other visual
      objects in a single-peak histogram. The separation helps to automatically
      determine the threshold. A fast algorithm is derived for the regression process.
      The method has been successfully used in filtering various medical images.

PMID- 11206816
TI  - Hadamard-based image decomposition and compression.
AB  - In this paper, we develop a general algorithm for decomposition and compression
      of grayscale images. The decomposition can be expressed as a functional relation
      between the original image and the Hadamard waveforms. The dynamic adaptive
      clustering procedure incorporates potential functions as a similarity measure for
      clustering as well as a reclustering phase. The latter is a multi-iteration,
      convergent procedure which divides the inputs into nonoverlapping clusters. These
      two techniques allow us to efficiently store and transmit a class of half-tone
      medical images such as magnetic resonance imaging (MRI) of the human brain. Due
      to the redundant image structure of MRI, obtained after the decomposition and
      clustering, almost half of the image can be omitted all together. Naturally, the
      compression rates for this specific type of grayscale image are increased
      greatly. A run-length coding is performed in order to compress further the
      retained information from the first two steps. Although all the techniques
      applied are simple, they represent an efficient way to compress grayscale images.
      The algorithm exhibits a performance which is competitive and often outperforming
      some of the methods reported in the literature.

PMID- 11206817
TI  - A screening gate to prevent entry of mobile telephone handsets in the
      speaking/stand-by mode into prohibited and restricted areas.
AB  - Electromagnetic interference to electronic equipment by mobile telephone handsets
      is well known. We present an automatic screening gate that detects concealed
      mobile telephone handsets and classifies them by type. The screening method used
      in the gate does not require any additions to or reconstruction of mobile
      telephone systems.

PMID- 11206818
TI  - Delayed reduction and stabilization of the tibiofibular syndesmosis.
AB  - Six patients with chronic widening and instability of the tibiofibular
      syndesmosis subsequent to pronation--external rotation ankle fractures were
      reviewed as regards diagnosis and treatment. An evaluation of the syndesmotic
      interval was best done by CT scans using axial cuts. Delayed reduction and
      stabilization using primarily large screw fixation resulted in maintenance of the
      reduction and satisfactory results in 5 of 6 cases. In one case, an arthrodesis
      of the tibiofibular interval was done because of significant incongruity.

PMID- 11206819
TI  - Cavovarus foot treated with combined calcaneus and metatarsal osteotomies.
AB  - Twenty-one feet in fifteen patients underwent osteotomies of the calcaneus and
      one or more metatarsals for symptomatic cavovarus foot deformity. Seven (nine
      feet) were male, and eight (twelve feet) were female. The etiology included
      hereditary motor sensory neuropathy (HMSN) (fifteen feet), post-polio syndrome
      (two feet), sacral cord lipomeningocele (two feet), parietal lobe porencephalic
      cyst (one foot), and idiopathic peripheral neuropathy (one foot). Presenting
      complaints were metatarsalgia (fifteen feet), ankle instablility (five), and
      ulceration beneath the second metatarsal head (one foot). Eleven feet were
      assessed using the Maryland Foot Rating Score. Maryland Foot Rating Score
      (University of Maryland, Baltimore, MD) improved from 72.1 (avg.) preoperatively
      to 89.9 (avg.) post-operatively (follow-up 70.9 months avg.). Eight feet were
      assessed using the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle
      Hindfoot and Midfoot Scores. The AOFAS Ankle-Hindfoot Score improved from 46.3
      (avg.) pre-operatively to 89.1 (avg.) post-operatively, and the AOFAS Midfoot
      Score improved from 40.9 (avg.) pre-operatively to 88.8 (avg.) post-operatively
      (follow-up 20.8 months avg.). The postoperative AOFAS Ankle-Hindfoot Score for
      all nineteen feet was 90.8 (avg.) and the post-operative AOFAS Midfoot Score for
      all nineteen feet was 90.2 (avg.). Two patients were lost to follow-up and were
      not included in the study. Ankle, hindfoot, and midfoot motion was maintained or
      improved in sixteen feet. Complications included delayed union in two and
      nonunion in three of 66 metatarsal osteotomies. While three patients required an
      AFO (ankle-foot orthosis) for ambulation preoperatively, all patients were brace
      free postoperatively. All patients expressed willingness to undergo the same
      procedure again if it were necessary. Weight-bearing radiographs were available
      for 17 feet. Radiographic analysis revealed a decrease in forefoot adduction (9.6
      degrees avg.) and a reduction in both hindfoot (9.1 degrees avg.) and forefoot
      cavus (10.6 degrees) leading to an overall 13 percent reduction in the height of
      the longitudinal arch. Lateral sliding elevating calcaneal osteotomy combined
      with dorsolateral closing wedge osteotomies of one or more metatarsal bases in
      the severe symptomatic cavovarus foot can provide a pain-free, plantigrade foot
      with a lowered longitudinal arch and a stable ankle without sacrificing motion.

PMID- 11206820
TI  - Extrinsic muscle activity, foot motion and ankle joint moments during the stance
      phase of walking.
AB  - This study examined stance phase foot kinematics, kinetics and electromyographic
      (EMG) activity of extrinsic muscles of 18 healthy males. Three-dimensional
      kinematic and kinetic data were obtained via video analysis of surface markers
      and a force plate. Ankle joint moments are described about orthogonal axes in a
      segmental coordinate system. Kinematic data comprise rearfoot and forefoot
      motion, described about axes of a joint coordinate system, and medial
      longitudinal arch height. Surface EMG was obtained for tibialis anterior, soleus,
      gastocnemius medialis and lateralis, peroneus longus and peroneus brevis and
      extensor digitorum longus. It was concluded that the demands on the controlling
      muscles are greatest prior to foot flat and after heel rise. Tibialis anterior
      restrained rearfoot plantarflexion from heel contact to 10% stance, and eversion
      between 10% stance and footflat. Activity in peroneus longus was consistent with
      its role in causing eversion after heel contact, then as a stabiliser of the
      forefoot after heel rise. Activity in peroneus brevis suggested a role in
      restraining lateral rotation of the leg over the foot, late in stance.

PMID- 11206821
TI  - Sonographic measurement of instability of the subtalar joint.
AB  - A sonographic method of measuring instability of the subtalar joint was
      developed. After defining reference points, we determined a sonographic fibulo
      trochlear angle. This angle was measured in a neutral position and under an
      inversion stress position. A ratio q representing the relationship between the
      fibulo-trochlear angle measured in the neutral position and under stress, was
      determined. The method was tested on volunteers with clinically and
      radiologically stable subtalar joints and a control group with unstable subtalar
      joints. The stress radiograph using the Zwipp method was utilized for radiologic
      correlation. A sonographic ratio q>1.6 correlated with a radiological unstable
      subtalar joint. The borderline zone in which there was an overlap of stable and
      unstable subtalar joints was characterized by a q value of 1.2-1.6. A ratio q<1.2
      correlated with a stable subtalar joint.

PMID- 11206822
TI  - Dorsiflexion contracture after the Weil osteotomy: results of cadaver study and
      three-dimensional analysis.
AB  - For metatarsalgia caused by a dislocated lesser metatarsophalangeal (MTP) joint
      and isolated over-long lesser metatarsals, surgical treatment options without
      sacrificing the joint are limited. Recently, the Weil osteotomy has been
      advocated for the treatment of this deformity. In our experience, preliminary
      results with this technique have revealed a high rate of dorsiflexion contracture
      of the MTP joints at follow-up. We performed a cadaver study and a three
      dimensional analysis on sawbones to investigate this phenomenon. In the cadaveric
      portion of this study, the second MTP joints of two fresh-frozen cadavers were
      dissected; the entire ray, with the metatarsal shaft, MTP joint, toe, and plantar
      fascia, was removed en bloc. After gross anatomic structures were photographed, a
      Weil osteotomy was performed at 25 degrees relative to the long axis of the
      metatarsal shaft. The positions of muscles, ligaments, and tendons were noted and
      photographed before and after the osteotomy. In the sawbones portion of this
      study, a Weil osteotomy was performed at four different angles (25 degrees, 30
      degrees, 35 degrees, and 40 degrees) relative to the long axis of the metatarsal.
      To ensure reproducibility, the sawbone models were fixed proximally to a vertical
      milling machine with the second metatarsals inclined 15 degrees to simulate the
      anatomic position. After making the cut, the plantar fragment was translated
      along the dorsal fragment proximally for a distance of 5 mm. Before and after the
      osteotomy, selected x, y, and z coordinates were obtained using a Microscribe 3D
      digitizer. Data analysis was performed with Microsoft Excel, and ANOVA was used
      to determine significant differences (p < 0.05) between the various osteotomies.
      Analysis of the cadaver dissection revealed that after the Weil osteotomy, the
      tendons of the interosseous muscles move dorsally with respect to the axis of the
      MTP joint due to the depression of the plantar fragment of the metatarsal. The
      loss of their flexion effect on the joint permits the pull of the extensor to
      dorsiflex the toe. The size of the depression for the various osteotomies
      averaged: 25 degrees osteotomy, 3.03 mm (range, 1.8 to 3.8 mm); 30 degrees
      osteotomy, 3.2 mm (range, 1.9 to 4.0 mm); 35 degrees osteotomy, 3.5 mm (range,
      1.7 to 5.7 mm); and 40 degrees osteotomy, 4.2 mm (range, 2.8 to 6.4 mm). Amounts
      of shortening relative to the long axis of the metatarsal for the various
      osteotomies averaged: 25 degrees osteotomy, 5.03 mm (range, 4.77 to 5.30 mm); 30
      degrees osteotomy, 4.59 mm (range, 3.47 to 5.19 mm); 35 degrees osteotomy, 4.27
      mm (range, 2.87 to 5.00 mm); and 40 degrees osteotomy, 3.65 mm (range, 3.20 to
      4.31 mm). According to our analysis, depression of the plantar fragment always
      occurs after a Weil osteotomy. This depression changes the center of rotation of
      the MTP joint, and the interosseous muscles then act more as dorsiflexors than as
      plantarfexors.

PMID- 11206823
TI  - Tibialis posterior tendon dysfunction: a primary or secondary problem?
AB  - Seventeen patients with a mean follow-up of 64.4 months following a tibialis
      posterior tendon transfer to regain active foot dorsiflexion were clinically
      examined specifically for signs of tibialis posterior tendon dysfunction. The
      results show that 8 patients (47%) had Grade 4 or better power of eversion but
      none had a clinical flatfoot on the Harris-Beath footprints. Only 6% had forefoot
      abduction; 17% exhibited hindfoot valgus and 82% were able to perform the single
      heel rise. Tibialis posterior tendon dysfunction therefore does not appear to be
      an inevitable sequel of tibialis posterior tendon transfer even in the presence
      of a functioning peroneal muscle. Other studies have noted that a pre-existent
      flatfoot was often present in patients with tibialis posterior tendon
      dysfunction. None of the patients in this study had pre-existent flatfoot. We
      suggest that a predisposition, in the form of a pre-existent tendency to flatfoot
      may also be a factor in the pathogenesis of tibialis posterior tendon
      dysfunction. This may explain the long-term failure of flexor digitorum longus
      and flexor hallucis longus tendon transfers in the treatment for tibialis
      posterior tendon dysfunction when the biomechanics of the foot has not been
      altered.

PMID- 11206824
TI  - Stress fracture of the talus following resection of a talocalcaneal coalition: a
      case report.
AB  - We report the case of a 15-year-old male with bilateral talocalcaneal coalition.
      Following resection of the symptomatic coalition, the patient developed a painful
      ankle. MR imaging revealed a stress fracture of the talar body. In this report we
      discuss presentation and treatment of a symptomatic talocalcaneal coalition
      complicated by a later stress fracture as well as a review of the literature.

PMID- 11206825
TI  - Fibroma of a tendon-sheath presenting as toe deformity.
AB  - We describe a rare manifestation fibroma in a tendon-sheath in an 83-year-old
      man. The patient complained initially of a slowly progressive spreading, apart of
      the right second and third toes. A mass was found in the plantar aspect of the
      foot. It was completely excised at surgery. Histological examination revealed
      sparse spindle or stellate cells with slit-like vessels in the dense collagenous
      matrix. There had been no recurrence at follow-up 17 months after surgery.

PMID- 11206826
TI  - Flexor to extensor tendon transfer: a new method of tensioning and securing the
      tendon.

PMID- 11206827
TI  - Lateral premalleolar bursitis as a result of sitting on the foot.
AB  - Lateral premalleolar bursitis develops on the dorsolateral aspect of the foot in
      people who sit on their feet for prolonged periods. Twenty-nine premalleolar
      bursae in 21 patients were diagnosed. The patients presented with one or more of
      the complaints of swelling, pain and difficulty in wearing shoes. One bursa was
      infected. Initial treatment was non-surgical. With avoidance of the sitting
      position, the problem resolved in eight of the sixteen patients who were
      followed. Four bursae were injected with cortisone, three without success. Six
      bursae were surgically excised, and four of them, with a minimum of one year
      follow-up were doing well.

PMID- 11206828
TI  - Digital photography in orthopaedic surgery.
AB  - Digital photography has become a practical alternative to film photography for
      documentation, communication, and education about orthopaedic problems and
      treatment. Digital cameras may be used to document preoperative and postoperative
      condition, intraoperative findings, and imaging studies. Digital photographs are
      captured on the charged coupler device (CCD) of the camera, and processed as
      digital data. Images may be immediately viewed on the liquid crystal display
      (LCD) screen of the camera and reshot if necessary. Photographic image files may
      be stored in the camera in a floppy diskette, CompactFlash card, or SmartMedia
      card, and transferred to a computer. The images may be manipulated using photo
      editing software programs, stored on media such as Zip disks or CD-R discs,
      printed, and incorporated into digital presentations. The digital photographs may
      be transmitted to others using electronic mail (e-mail) and Internet web sites.
      Transparency film slides may be converted to digital format and used in digital
      presentations. Despite the initial expense to obtain the required hardware, major
      cost savings in film and processing charges may be realized over time compared
      with film photography.

PMID- 11206829
TI  - Dragons and the VAT.

PMID- 11206830
TI  - Primary subtalar arthrodesis of calcaneal fractures.
AB  - We evaluated retrospectively the long-term results of isolated calcaneal
      fractures treated with open reduction and internal fixation and a primary
      subtalar arthrodesis. From 1990 to 1997 258 patients were treated with a
      calcaneal fracture, for the current study six patients were included. Six
      different surgeons operated on the patients. The indication for the fusion was
      based on the comminution of the posterior facet according to the preoperative CT
      as well as the intraoperative evaluation of destruction of the cartilage. The
      restoration of length, axes and angles of the calcaneus was almost anatomical in
      all cases. Follow-up was done at a mean of 4.9 (2.5 - 7.5 years). Using the AOFAS
      score, the results were good or excellent in five patients. In one patient with a
      painful arthritis in the talonavicular joint and hyperesthesia of the sural
      nerve, the results were fair. All returned to their profession within 9 months
      and had no or only minor daily restrictions. The results are comparable with
      single surgeon series. We found open reconstruction of the calcaneus with primary
      fusion of the subtalar joint may be indicated in selected patients and, in these
      6 patients led to good results.

PMID- 11206831
TI  - Social isolation stress augments angiogenesis induced by colon 26-L5 carcinoma
      cells in mice.
AB  - We have previously shown that tumor necrosis factor-alpha (TNF-alpha), which is
      an important angiogenesis-related factor, was over-secreted in male BALB/c mice
      under social isolation stress as compared with the control, and closely
      associated with a remarkable elevation of tumor invasion and metastasis of colon
      26-L5 carcinoma cells. In the present study, we explored the effect of isolation
      stress on the angiogenesis caused by colon 26-L5 carcinoma cells in vivo and in
      vitro. Social isolation lead to the enhancement of tumor growth after
      intrahepatic implantation with a fragment of colon 26-L5 tumor. Angiogenic
      response (number of vessels oriented towards tumor mass) and tumor growth (size)
      were significantly increased in the socially isolated mouse relative to that in
      the group-housed mice. Furthermore, higher protein level of hepatic TNF-alpha was
      found in the stressed mice than that in the control. Expression of mRNA for
      vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were
      also elevated in the tumor regions and liver tissues of the stressed mice in
      comparison with that in group-housed mice. On the other hand, hepatic sinusoidal
      endothelial (HSE) cells treated with TNF-alpha exhibited a marked promotion of
      the migration, invasion, expression of mRNA for matrix metalloproteinase (MMP)-9,
      and tube-like formation, but no cytotoxicity against the cells in vitro. The
      above data suggest that the social isolation stress augmented the tumor-induced
      angiogenesis probably by up-regulating the angiogenesis-related factors,
      including TNF-alpha, VEGF and HGF, and consequently mediating the functions of
      endothelial cells such as migration, invasion, and tube-like formation.

PMID- 11206833
TI  - Behaviour of metastasis in relation to vascular index in patients with node
      positive breast cancer treated with adjuvant tamoxifen.
AB  - Some experimental studies suggested that one possible oestrogen-receptor
      unrelated mechanism of action of tamoxifen involves inhibition of angiogenesis.
      We evaluated the correlation of the degree of vascularisation of the primary
      tumour and we assessed it by using the panendothelial marker anti-CD31 and
      immunohistochemistry with microvessels count, performed at the vascular 'hot
      spot' of each single cancer, with the risk of recurrence in time. A cohort of 176
      consecutive patients with node-positive invasive breast cancer treated with
      adjuvant tamoxifen (30 mg/daily for 3 years) and a median follow-up of 72 months
      was studied. Sixty-two patients developed metastasis (30 visceral, 18 skeletal
      and 14 in soft tissues) during the time of observation. The study of the hazard
      function for metastasis was performed by a generalized linear modelling approach
      with a binomial error according to Efron. The risk of first recurrence was
      strictly associated with vascular index, having the patients with the highest
      microvessel counts the highest risk of metastasis during all the period of
      observation. We did not find an interaction of vascularity with oestrogen
      receptor (ER) status. However, in the subgroup of patients with ER-positive
      tumours the hazard of metastasis was almost constant in time, while in that with
      ER-negative tumours it increased rapidly up to 20 months and, thereafter,
      decreased sharply. The results of our study are an indirect evidence that the
      patients with highly vascularized breast cancers may gain poor benefit of
      adjuvant tamoxifen and, therefore. that this antioestrogen is unlikely to retain
      a clinically relevant antiangiogenic activity in human breast cancer. Our data
      need confirmation by a prospective randomized clinical trial.

PMID- 11206832
TI  - The impact of laparoscopic biopsy of pancreatic lymph nodes with helium and
      carbon dioxide on port site and liver metastasis in BOP-induced pancreatic cancer
      in hamster.
AB  - The influence of pancreatic biopsy during laparoscopy with carbon dioxide (CO2)
      and helium on the incidence of port site and liver metastasis in pancreatic
      carcinoma is still unknown. Ductal adenocarcinoma of the pancreas was induced in
      Syrian hamsters (n = 30) by injection of N-nitrosobis-2-oxopropylamin (BOP, 10
      mg/kg body weight/week) for 12 weeks. In week 13, hamsters were randomized in 3
      groups (n = 10): While in group 1 (gr. 1) a laparotomy and biopsy of pancreatic
      lymph nodes was performed, gr. 2 and gr. 3 underwent a laparoscopic biopsy either
      with CO2 or helium. Therefore, one trocar was located in the left (biopsy) and
      the right abdominal wall (camera). In the 18th week all animals were sacrificed
      and the incidence of abdominal wall, port site and liver metastases was
      histologically determined. While there were abdominal wall metastases after
      laparotomy in 10% (n = 1), we observed trocar metastases in the CO2 group in 20%
      (n = 2). However, there were no trocar metastases in the helium group. The
      incidence of liver metastasis did not differ between the laparotomy and the
      helium group (20% vs 30%), but was increased in the CO2 group (60%). Laparoscopic
      biopsy of pancreatic lymph nodes with CO2 increased the incidence of port site
      and liver metastases in pancreatic cancer. The helium group was equal to the
      laparotomy group in this respect. Thus, staging laparoscopy with helium might
      become an alternative to explorative laparotomy in pancreatic cancer.

PMID- 11206834
TI  - Cyclooxygenase-2 expression in colorectal cancer liver metastases.
AB  - Cyclooxygenase-2 (COX-2) is up-regulated in 85-90% of primary human colorectal
      cancers and is a putative target for the chemopreventative activity of non
      steroidal anti-inflammatory drugs. However, COX-2 expression by human colorectal
      cancer liver metastases has been poorly characterized. We studied a consecutive
      series of 38 patients who underwent liver resection for metastatic disease, for
      whom long-term (up to 57 months), prospective follow-up data were available. Semi
      quantitative immunohistochemistry for COX-2 was performed on 54 metastases from
      35 patients, for whom adequate histological material was available. Diffuse
      cytoplasmic staining for COX-2 protein was detected in cancer cells in 100% of
      metastases (COX-2 score 1, n = 25; score 2, n = 29). There was no relationship
      between metastasis size or differentiation grade and the level of COX-2 protein
      expression. There was no difference in colorectal cancer-free or overall survival
      between patients with high (score 2) and low (score 1) COX-2 scores (Kaplan-Meier
      survival analysis and log rank test, both P = 0.97). Multivariate Cox regression
      analysis identified age, incomplete resection and presence of extra-hepatic
      disease as independent predictors of disease-free and overall survival following
      surgery. COX-2 protein was also localized to a subset of stromal fibroblasts and
      mononuclear cells within metastases as well as hepatocytes from resection
      specimens. COX-2 protein was expressed by cancer cells in all human colorectal
      cancer liver metastases which were studied. Investigation of the effect of
      selective COX-2 inhibition on metastasis growth and metastasis cancer cell
      proliferation/apoptosis in vivo are warranted.

PMID- 11206835
TI  - Isolation and characterization of cell lines with reduced urokinase binding.
AB  - Six cell lines have been generated from the human fibrosarcoma HT-1080 by
      mutagenesis. They were selected on the basis of reduced urokinase (uPA) binding
      on replicate polyester filters. Single cell clones were then isolated by limited
      dilution cloning. All cloned cells showed less uPA binding on filters, and as
      cell monolayers. These cell lines were able to bind only 10 to 65% as much uPA as
      the wild-type HT-1080 cells. Surface-bound uPA proteolytic activity and surface
      activation of plasminogen from these cells were also reduced relative to the wild
      type. uPA could activate MAP kinases in the wild-type and two of the cell lines
      with the least uPA-binding, but the amount of the activated forms of the
      signalling molecules were reduced. Immunoblotting using two different anti-uPA
      receptor antibodies showed two cross-reacting protein species of approximately 53
      kDa and approximately 38 kDa. The proportion of the lower Mr band to the higher
      Mr band was found to be reduced in all the cell lines relative to the wild-type.
      Chemical cross-linking with single-chain urokinase (scuPA) showed only one high
      molecular-weight adduct, with Mr approximately 90 kDa, in all the cell lines
      tested. Similarly, cross-linking with the amino terminal fragment of uPA yielded
      a single approximately 70 kDa adduct. These would indicate that only the
      approximately 53 kDa band was responsible for cross-linking reactions.
      Equilibrium binding experiments showed that only one set of high-affinity binding
      sites for the wild-type cells. However, the binding of scuPA to two of these cell
      lines was best fitted to a two-site model, one of which was similar to the high
      affinity binding sites of the wild-type, although the number of sites was
      reduced, while the other was of much lower affinity but was large in number.
      These results are discussed in relation to changes in the structure of ligand
      binding machinery in these cells, which affect other cellular functions.

PMID- 11206836
TI  - A new method for assaying adhesion of cancer cells to the greater omentum and its
      application for evaluating anti-adhesion activities of chemically synthesized
      oligosaccharides.
AB  - A new ex vivo method for assaying adhesion of cancer cells to the greater omentum
      has been developed using mouse greater omentum and [3H]labelled human gastric and
      mouse colorectal cancer cells. Since the adhesion rates were found to increase up
      to 18 h and labelled cells seemed to be stable during the period, the present
      method could be useful for investigating adhesion of cancer cells to the greater
      omentum, which must occur at the first step of the peritoneal dissemination. The
      adhesion of cancer cells to the greater omentum was inhibited by a series of
      chemically synthesized oligosaccharides and Gal beta1,3[3OMeGal beta1,4GlcNAc
      beta1,6]alphaBn was found to be the best inhibitor. The anti-tumor effect of this
      novel tetrasaccharide in vivo was shown in preliminary experiments using Balb/c
      mice and colon26 cells.

PMID- 11206837
TI  - Activated leukocyte cell adhesion molecule (ALCAM) and annexin II are involved in
      the metastatic progression of tumor cells after chemotherapy with Adriamycin.
AB  - Metastasis frequently occurs during and/or after chemotherapy resulting in
      failure. This suggests that inadequate chemotherapy promotes the emergence of
      more malignant tumor cells with metastatic potential. However, it is not
      determined how chemotherapy could promote the metastatic progression of tumor
      cells. In this study, we isolated highly metastatic clones from the tumors
      treated with ADR using an in vivo experimental model, in which non-metastatic
      tumor cells were inoculated s.c. in mice, treated with or without Adriamycin and
      then culture lines were re-established from the tumors. Then we isolated cDNAs
      for activated leukocyte cell adhesion molecule (ALCAM), osteopontin, and annexin
      II as candidates for metastasis-promoting genes with the use of a PCR-based
      subtraction method. Further we examined the metastatic potential of transfectants
      over-expressing ALCAM, osteopontin, or annexin II and combinations of them.
      Metastasis to the lung was observed in the mice where transfectants over
      expressing ALCAM plus annexin II had been inoculated via tail vein. These results
      suggest that the over-expression of ALCAM and annexin II play a role in the
      metastatic progression after chemotherapy with ADR.

PMID- 11206838
TI  - Expression of metastasis-associated mts1 gene is co-induced with membrane type-1
      matrix metalloproteinase (MT1-MMP) during oncogenic transformation and tubular
      formation of Madin Darby canine kidney (MDCK) epithelial cells.
AB  - Madin-Darby canine kidney (MDCK) epithelial cells form branching tubules in three
      dimensional collagen gel in the presence of hepatocyte growth factor (HGF).
      Membrane type-1 matrix metalloproteinase (MT1-MMP), expression of which was
      induced by collagen-gel culture, was demonstrated to play an essential role in
      tubular formation (Y. Kadono et al. Biochem Biophys Res Commun 1988; 251: 681-7
      [13]). Oncogenic transformation of MDCK cells by erbB2 and v-src induced
      expression of MT1-MMP, loss of cell-cell adhesion and scattered invasion into
      collagen gel, mRNA differential display and Northern hybridization identified
      metastasis-associated mts1 as one of the genes co-induced with MT1-MMP by
      oncogenic transformation or collagen-gel culture of MDCK cells. Expression of
      antisense RNA to mts1 in MDCK cells interfered with the extension of tubules into
      the collagen gel, however, it did not affect the morphological changes induced by
      HGF in culture on plastic dishes. ErbB2-transformant transfected with mts1
      antisense construct, which showed unaltered morphology in culture on plastic
      dishes, did not scatter into collagen gel but formed aggregates. These results
      suggested that Mts1 contributes not only to tumor invasion but also to kidney
      tubulogenesis in cooperation with MT1-MMP. The coordinated action of MT1-MMP and
      Mts1, which is responsible for the highly invasive properties of mesenchymal
      cells, may be involved in epithelial tubulogenesis and invasion of malignant
      carcinoma cells.

PMID- 11206839
TI  - A highly metastatic Lewis lung carcinoma orthotopic green fluorescent protein
      model.
AB  - The Lewis lung carcinoma has been widely used for many important studies.
      However, the subcutaneous transplant or orthotopic cell-suspension injection
      models have not allowed the expression of its full metastatic potential. A
      powerful new highly metastatic model of the widely-used Lewis lung carcinoma is
      reported here using surgical orthotopic implantation (SOI) of tumor fragments and
      enhanced green fluorescent protein (GFP) transduction of the tumor cells. To
      achieve this goal, we first developed in vitro a stable high-expression GFP
      transductant of the Lewis lung carcinoma with the pLEIN retroviral expression
      vector containing the enhanced Aequorea victoria GFP gene. Stable high-level
      expression of GFP was found maintained in vivo in subcutaneously-growing Lewis
      lung tumors. The in vivo GFP-expressing tumors were harvested and implanted as
      tissue fragments by SOI in the right lung of additional nude mice. This model
      resulted in rapid orthotopic growth and extensive metastasis visualized by GFP
      expression. 100% of the animals had metastases on the ipsilateral diaphragmatic
      surface, contralateral diaphragmatic surface, contralateral lung parenchima, and
      in mediastinal lymph nodes. Heart metastases were visualized in 40%, and brain
      metastases were visualized in 30% of the SOI animals. Mice developed signs of
      respiratory distress between 10-15 days post-tumor implantation and were
      sacrificed. The use of GFP-transduced Lewis lung carcinoma transplanted by SOI
      reveals for the first time the high malignancy of this tumor and provides an
      important useful model for metastasis, angiogenesis and therapeutic studies.

PMID- 11206840
TI  - Anti-metastatic efficacy and safety of MMI-166, a selective matrix
      metalloproteinase inhibitor.
AB  - The anti-metastatic efficacy and safety of a newly-developed matrix
      metalloproteinase (MMP) inhibitor were examined. MMI-166, a N-sulfonylamino acid
      derivative, inhibited the enzyme activity of MMP-2, 9, and 14 but not MMP-1, 3 or
      7. Daily oral administration of MMI-166 resulted in potent inhibition of
      metastatic lung colonization of Lewis lung carcinoma injected via the tail vein
      and liver metastasis of C-1H human colon cancer implanted into the spleen at
      inhibition levels of 43% and 63%, respectively. Daily administration of MMI-166
      also resulted in prolonged survival of mice given intraperitoneal implantation of
      Ma44 human lung cancer cells. The anti-metastatic activity of MMI-166 was as
      effective as that of other MMP inhibitors with broad inhibitory spectrum. MMI-166
      did not affect in vitro tumor cell growth. Neither body weight losses nor
      hematotoxicity was observed during long-term treatment, indicating the safety of
      MMI-166 in mice. These results indicate that the selective MMP inhibitor MMI-166
      has therapeutic potential as an anti-metastasis agent.

PMID- 11206841
TI  - CD44 and beta1 integrins mediate ovarian carcinoma cell migration toward
      extracellular matrix proteins.
AB  - Epithelial cancer of the ovary spreads by implantation of tumor cells onto the
      mesothelial cells that line the peritoneal cavity. The aim of this study was to
      identify the cell-matrix interactions that mediate ovarian carcinoma cell
      migration toward components of the mesothelial cell-associated extracellular
      matrix. The human ovarian carcinoma cell lines NIH:OVCAR5 and SKOV3 were analyzed
      by flow cytometry for the expression of cell surface receptors. The ability of
      those receptors to mediate ovarian carcinoma cell migration toward fibronectin,
      type IV collagen, and laminin was determined. A monoclonal antibody against the
      beta1 integrin subunit abrogated the migration of both cell lines toward the
      extracellular matrix proteins. Blocking antibodies against alpha integrin
      subunits suggest that ovarian carcinoma cell migration toward fibronectin is
      primarily mediated by the alpha5beta1 integrin, type IV collagen by the
      alpha2beta1 integrin, and laminin by the alpha6beta1 integrin. These results
      suggest that ovarian carcinoma cell migration is regulated by multiple beta1
      integrin-matrix interactions. Significant reduction of cell migration was
      observed with a monoclonal antibody against CD44 that blocks the hyaluronan
      binding site of CD44, but not with an antibody that binds at an alternate site on
      CD44. Intact hyaluronan and/or hyaluronan oligomers also inhibited cell
      migration, suggesting that the CD44-hyaluronan interaction provides an integrin
      independent mechanism of control for ovarian carcinoma cell migration. These
      results suggest that ovarian carcinoma cell migration is regulated by both
      integrin-dependent mechanisms, involving the interaction of beta1 integrins with
      extracellular matrix proteins, and an integrin-independent mechanism that
      involves the interaction of CD44 and hyaluronan.

PMID- 11206842
TI  - Absence of correlation of MUC1 expression to malignant behavior of renal cell
      carcinoma in experimental systems.
AB  - A correlation between MUC1 expression in renal cell carcinomas (RCCs) and the
      clinical stages was previously demonstrated. To assess whether MUC1 expression is
      causally related to malignant tumor behavior, MUC1 cDNA was stably transfected
      into a renal carcinoma cell line SN12C that expresses trace levels of MUC1. MUC1
      with sialylated carbohydrate chains was detected on the surface of transfected
      cells in two independent experiments. There was no correlation between MUC1
      expression and in vitro growth and motility. In vivo growth of the transfectants
      at the site of orthotopic transplantation in nude mice was slower than mock
      transfected cells. Therefore, MUC1 alone did not seem to confer a malignant
      phenotype to RCCs.

PMID- 11206843
TI  - Increased expression of fascin, motility associated protein, in cell cultures
      derived from ovarian cancer and in borderline and carcinomatous ovarian tumors.
AB  - Fascin bundles actin microfilaments within dynamic cellular structures such as
      microspikes, stress fibers and membrane ruffles. Fascin overexpression induces
      membrane protrusions and increased cell motility, and is highly expressed in
      various transformed cells, and in specialized normal cells including neuronal,
      endothelial and dendritic cells. In breast cancer, fascin expression correlates
      with high-grade tumors. To investigate whether fascin might be a predictor factor
      for ovarian cancer progression, eighteen cell cultures derived from ovarian
      cancer, and thirty four archival paraffin-embedded material of normal versus
      borderline and carcinomatous ovaries were stained by immunocytochemistry and
      immunohistochemistry with fascin Mab 55K-2. Overall expression of the fascin
      protein was found in 50% (9/18) of cell cultures derived from original samples of
      ovarian tumors. Expression of fascin protein was found in 67% (6/9) of cell
      cultures derived from patients diagnosed with stage IV disease, and 33% (3/9) of
      cell cultures from patients diagnosed with stage II/III. There was no clear
      relationship between fascin expression and histologic types, tumor grade, or DNA
      ploidy. However, 75% of cell cultures, which developed into a xenograft after
      intraperitoneal inoculation, showed fascin expression, while 86% of non
      tumorigenic cell cultures did not show fascin expression. Expression of fascin in
      these established ovarian tumor cell cultures was significantly associated with
      the ability for these cells to grow intraperitoneally (P < 0.05). Furthermore,
      fascin was never expressed in normal epithelial ovarian tissues, but was present
      in all pathologic ovaries. Both diffuse and focal patterns were observed in
      borderline ovarian tumors (67% and 33%), advanced primary ovarian cancer (67% and
      33%) and metastatic ovarian cancer (89% and 11%). Therefore, our data suggest
      that fascin could serve as a prognostic factor for abnormal ovarian epithelial
      pathology and could be a novel target for the treatment of ovarian cancer.

PMID- 11206844
TI  - Interaction of tumor cells with vascular endothelia: role of platelet-activating
      factor.
AB  - We investigated whether tumor cell/endothelia interaction can be influenced by
      platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine),
      a lipid mediator that promotes adhesiveness and extravasation of leukocytes in
      the inflammatory reaction. We found that the PAF receptor antagonist WEB 2086
      prevents adhesion of melanoma Hs294T and colon carcinoma LS180 lines to IL-1
      stimulated endothelial cells. Moreover, PAF stimulated the adhesiveness of Hs294T
      and LS180 cells to VCAM-1 and E- selectin, respectively, in an artificial model
      consisting of recombinant adhesive proteins bound to protein A-coated substrata.
      Thus, tumoral and not endothelial cell surface seems to be involved in the PAF
      mediated enhancement of tumor cell adhesiveness to IL-1-activated endothelia.
      This observation is supported by the finding that Hs294T and LS180 cells express
      high affinity and functionally active receptors for PAF. By using specific
      inhibitors, we found that PAF-induced enhancement of cell adhesiveness was
      mediated by G-protein activation and protein tyrosine phosphorylation. In
      addition, protein tyrosine phosphorylation was observed in Hs294T and LS180 cells
      stimulated by PAF. In conclusion, we demonstrated that PAF-mediated activation of
      tumor cells enhances their adhesiveness to IL-1-stimulated vascular endothelia.

PMID- 11206845
TI  - New approaches to assess selenium status and requirement.
AB  - Selenium is one of the essential nutrients that may have beneficial effects on
      health at dietary intakes higher than the established Recommended Dietary
      Allowances in the United States. Dietary recommendations for this element have
      been the subject of much controversy, illustrating the difficulties involved in
      the definition of requirements based on the interpretation of biochemical
      markers. This review will show how concepts may differ and even change as a
      consequence of the evolution of the knowledge concerning classical parameters
      (e.g., identification of isoforms of the classical selenium-dependent enzyme
      glutathione peroxidase) or following the discovery of new biologic markers for
      selenium such as iodothyronine desiodinase, thioredoxin reductase, or the
      selenoproteins P and W.

PMID- 11206846
TI  - Current international approaches to food claims.
AB  - The market for functional foods is rapidly increasing. It is necessary to
      establish a legal framework for these foods. This has proved difficult in a
      number of countries. The control through health claims is generally accepted as
      the most appropriate measure. Activity in this area has been developing both at
      the national and international levels. However, the regulations and proposals
      from a number of national authorities and other nongovernmental sectors are
      varied and difficult to reconcile. This paper examines the range of health claim
      controls being used in the food area. They are considered in detail so as to
      establish a better understanding of the claims. In this paper, the claims have
      been classified into six categories: nutrient content claims, comparative claims,
      nutrient function claims, claims related to dietary guidelines or healthy diets,
      enhanced function claims, and reduction of disease risk claims. Of these, the
      latter four claims are considered to have significant implications for functional
      foods.

PMID- 11206847
TI  - Holiday weight gain: fact or fiction?
AB  - The prevalence of obesity continues to rise and controversy remains regarding the
      underlying specific causes of this trend. Recently, the magnitude of holiday
      weight gain and its contribution to annual weight gain were examined in a
      convenience sample of 195 adults. On average, weight gain during the 6-week
      winter period from Thanksgiving through New Year averaged only 0.37 kg. However,
      weight gain was greater among individuals who were overweight or obese, and 14%
      gained >2.3 kg (5 lb). In addition, among the entire population, weight gain
      during the 6-week holiday season explained 51% of annual weight gain. These
      results suggest that holiday weight gain may be an important contributor to the
      rising prevalence of obesity, even though absolute values for weight gain in this
      study were less than anticipated. Further studies using representative
      populations are needed to confirm these findings.

PMID- 11206849
TI  - A Robertsonian translocation, rob(2;28), found in Vietnamese cattle.
AB  - A new Robertsonian translocation, rob(2;28), was discovered in a local population
      of the Vietnamese Cattle. The animal (2n = 59, XY) was found by Q- and R-banding
      to be a heterozygous carrier of a centric fusion translocation involving
      chromosomes 2 and 28. FISH analysis using a bovine satellite I DNA probe
      demonstrated that the centromeric heterochromatin block of the rob(2;28)
      chromosome become much smaller than its ancestors suggesting a monocentric nature
      of this centric fusion. This is the first report identifying a Robertsonian
      translocation in Southeast Asian cattle by karyotyping of banded chromosomes.

PMID- 11206848
TI  - Evolution of parental ITS regions of nuclear rDNA in allopolyploid Aegilops
      (Poaceae) species.
AB  - The genus Aegilops comprises approximately 25 diploid, tetraploid and hexaploid
      species, in which the genome types of all allopolyploids involve either U or D
      genome, or both of them. The internal transcribed spacer (ITS) region of 18S-26S
      nuclear ribosomal DNA (rDNA) from 11 allopolyploid species and 7 related diploid
      species in the genus were directly sequenced by pooled PCR products. Phylogenetic
      analyses for tracing evolutionary patterns of parental rDNA in allopolyploid
      species were performed using the neighbor-joining method. The D genome involved
      tree included three clades (CC-DDCC, DDMM-DDMMSS-DDMMUU, and MM-MhMh-DDNN), but
      did not include Ae. squarrosa (DD). It indicated that the rDNA of ancestral D
      genome had been somewhat differentiated in allopolyploids. The U genome involved
      tree showed that the allopolyploids and their common ancestor, Ae. umbellulata,
      formed a clade, suggesting that rDNA in UUMM and UUSS genomes has been
      homogenizing toward that of ancestral U genome. The phylogenetic pattern of U
      genome based on ITS sequences also supported the "pivotal-differential"
      hypothesis.

PMID- 11206850
TI  - Computer simulation analysis suggests weak balancing selection operative at the
      MICA locus.
AB  - A high degree of polymorphism has been reported at the major histocompatibility
      class I chain-related gene A (MICA) locus, which is located 46 kb away from HLA
      Bin the human major histocompatibility complex (MHC) class I region. Although it
      is known that the polymorphisms at the conventional MHC class I loci have been
      maintained by balancing selection, it is unclear whether positive natural
      selection is also operative in maintaining the polymorphism at the MICA locus. In
      order to explain the degree of polymorphism at the MICA locus, a computer
      simulation study was carried out. The high degree of polymorphism at the MICA
      locus (heterozygosity and number of polymorphic residues) could not be explained
      solely by balancing selection at the HLA-B locus even if no recombination was
      assumed between MICA and HLA-B. Although there is no definite evidence indicating
      that balancing selection is operative at the MICA locus, our results suggest that
      the MICA gene is subject to weak balancing selection.

PMID- 11206851
TI  - Trait diversity, heritability and genetic advance in selected germplasm lines of
      tef.
AB  - The genetic improvement of the Ethiopian cereal, tef, Eragrostis tef (Zucc.)
      Trotter, depends upon the variability in the indigenous germplasm. A bi
      replicated randomized complete block field experiment was, therefore, carried out
      at Debre Zeit and Alem Tena in Ethiopia during the 1996 main season to study the
      pheno-morphic and agronomic trait diversity in 320 tef germplasm lines. All of
      the 17 traits assessed showed substantial (p < or = 0.001) variation among the
      lines. Genotypes and locations interacted significantly (p < or = 0.05) on 11 of
      the traits. At about 50% similarity level, the tef lines grouped into six major
      clusters of nine to 243 lines. Five principal components (PCs) extracted about
      71% of the entire variation of the lines. About 28% of the total variance
      explained by the first PC was due chiefly to variation in main shoot culm length,
      diameters of the two basal culm internodes, panicle length and grain
      yield/panicle. About 16% of the whole variance explained by the second PC
      originated mainly from variation in the length of the first and second basal culm
      internodes, grain yield/plant, and peduncle length. The third PC accounting for
      about 12% of the entire variance resulted largely from variation in harvest index
      and shoot phytomass yield/plant. Across traits, the phenotypic and genotypic
      coefficients of variation varied in that order from about 2% for grain
      yield/panicle to 58% for number of fertile tillers/plant, and from less than 1%
      for diameters of the two basal culm internodes and grain yield/panicle to 35% for
      panicle length. Estimates of broad sense heritability and genetic advance (as
      ratio of the mean) were highest for panicle length (71%) and number of fertile
      tillers/plant (21%), respectively. But both of these were lowest for the second
      basal culm internode diameter (< 1%). Overall, the study confirmed that tef is a
      highly versatile crop with broad trait diversity in the germplasm, and this
      offers ample opportunities for improvement through breeding.

PMID- 11206852
TI  - Nucleotide sequence of 5S rDNA and localization of the ribosomal RNA genes to
      metaphase chromosomes of the Tilapiine cichlid fish, Oreochromis niloticus.
AB  - In this study, we report the cloning and nucleotide sequence of PCR-generated 5S
      rDNA from the Tilapiine cichlid fish, Oreochromis niloticus. Two types of 5S rDNA
      were detected that differed by insertions and/or deletions and base substitutions
      within the non-transcribed spacer (NTS). Two 5S rDNA loci were observed by
      fluorescent in situ hybridization (FISH) in metaphase spreads of tilapia
      chromosomes. FISH using an 18S rDNA probe and silver nitrate sequential staining
      of 5S-FISH slides showed three 18S rDNA loci that are not syntenic to the 5S rDNA
      loci.

PMID- 11206853
TI  - Genetic erosion in northern marginal population of the common wild rice Oryza
      rufipogon Griff. and its conservation, revealed by the change of population
      genetic structure.
AB  - In order to monitor genetic erosion within the northern marginal population of
      common wild rice Oryza rufipogon Griff. from Dongxiang, Jiangxi Province, China,
      allozyme diversity encoded by 22 loci was analyzed electrophoretically from all
      the existing subpopulations in 1980, 1985 and 1994. The sample collected from the
      nine large subpopulations in 1980 showed the highest levels of genetic diversity
      (A = 1.27, P = 18.20%, Ho = 0.042 and He = 0.049) and a slight deviation from
      Hardy-Weinberg expectation (F = 0.143), the sample from five moderate ones in
      1985 displayed medium levels of genetic diversity (A = 1.14, P = 13.60%, Ho =
      0.008 and He = 0.049) and a great deviation from Hardy-Weinberg expectation (F =
      0.837), and the sample from two small ones in 1994 demonstrated the lowest levels
      of genetic diversity (A = 1.09, P = 9.10%, Ho = 0.000 and He = 0.043) and the
      largest deviation from Hardy-Weinberg expectation (F = 1.000). The results not
      only documented the genetic erosion stemmed from the extinction of the
      subpopulations, but also revealed the drastic change of the population genetic
      structure due to the reduction of the population. Finally, some conservation
      strategies for the population are proposed.

PMID- 11206854
TI  - A new karyotype in Callicebus torquatus (Cebidae, Primates).
AB  - We describe a new karyotype of Callicebus torquatus using conventional staining,
      G-banding with Wright Stain, CBG, Ag-NOR staining and fluorescence in situ
      hybridization (FISH) with human telomere probes and comparative analysis with the
      previously reported karyotype of C. torquatus torquatus (2n = 20). We studied a
      female specimen maintained in captivity at the Centro Nacional de Primatas (Para,
      Brazil). This titi monkey presented 2n = 22, with four large biarmed and six
      acrocentric autosome pairs; the X chromosome is a medium submetacentric. C-bands
      were revealed at the centromeric region of all acrocentrics and X chromosome;
      punctual C-bands also are visualized at the centromeric region in the large
      biarmed pairs. The NOR site was located at the long arm of pair 4, at the
      position of a conspicuous secondary constriction. Hybridization signals were
      detected exclusively at the terminal region of all chromosomes. The karyotype
      described here has one acrocentric pair more than that found in the literature
      and also differs by amount and distribution of constitutive heterochromatin. Our
      data support the notion that the torquatus group may be composed of distinct
      species, each with its own karyotype.

PMID- 11206855
TI  - Half-sib analysis of three morphological traits in Drosophila melanogaster under
      poor nutrition.
AB  - Variation in thorax length, wing length and sternopleural bristle number was
      examined in Drosophila melanogaster reared in stressful and nonstressful
      environments using paternal half-sib design. Low concentration of yeast in the
      medium was used as a stress factor. Phenotypic variation of thorax length and
      wing length was higher under poor nutrition than in the control; in bristle
      number, phenotypic variation was relatively stable regardless of the environment.
      Heritability of all the traits analyzed was generally lower under nutritional
      stress. Heritability changes in thorax length and wing length were mainly due to
      an increase in the environmental variance under stress, whereas in bristle
      number, stress resulted in a decrease in genetic variation. Genetic variance in
      thorax length was higher under poor nutrition; in wing length, no difference in
      genetic variance between environments was found.

PMID- 11206856
TI  - Colonization of America by Drosophila subobscura: spatial and temporal lethal
      gene allelism.
AB  - About twenty years ago Drosophila subobscura, a western Palearctic species,
      colonized both North and South America. Lethal genes in the O chromosome has been
      subject to much research. Lethal gene allelisms between American populations far
      away have been studied. These allelisms were not negligible, but all cases were
      due to the lethal gene completely associated to the O5 chromosomal inversion.
      Here we analyze the lethal genes in a new American population of D. subobscura
      (Centralia, Washington), located fairly close to a previously studied population
      (Bellingham, Washington) and separated in space and time with other American
      populations (Gilroy I and II in California and Santiago de Chile). The
      frequencies of lethal and semilethal genes of Centralia were 16.9+/-4.6 and 6.2+/
      3.0, respectively. The intrapopulational allelism of Centralia was 0.122+/-0.036.
      Interpopulational allelisms were studied using the lethal genes from the
      populations separated in space and time from Centralia. The interpopulational
      allelisms between Centralia and Gilroy I (California) and between Centralia and
      Bellingham (Washington) were higher than the intrapopulational allelism (0.155+/
      0.032 and 0.153+/-0.024, respectively). In all these cases allelism was due to a
      complete association between a lethal gene and the O5 chromosomal inversion.
      Accordingly, no other lethal genes are shared in these populations.

PMID- 11206857
TI  - Synaptomenal complex analysis of four breeds of Bos taurus taurus x B. taurus
      indicus hybrids.
AB  - The synaptonemal complex (SC) was analyzed in four F1 hybrids of Bos taurus
      taurus and B. taurus indicus including Gyr-Simmental (G-S), Nelore Simmental (N
      S), Gyr-Holstein-Friesian (G-H) and Nelore-Piemontese (N-P). We analysed the
      frequency of various types of SC abnormalities and the frequency of cells with SC
      abnormalities. The results were compared with similar observations made on
      purebred animals. All the animals studied possessed 29 autosomal and one sex
      bivalent. The frequency of cells with abnormalities in the hybrids were 28.0% in
      the N-P, 29.1% in the G-S, 33.3% in the N-S and 40.0% in the G-H. The frequency
      of cells with abnormalities in the four hybrids was 31.5%; 57.9% of these
      abnormalities occurred in zygotene and 42.0% occurred in pachytene. The
      comparisons among the hybrids and among the hybrids and their parental breeds
      showed that the only significant difference was between Gyr and Gyr-Holstein
      Friesian animals. Some aspects of the relationship between the frequency of cells
      with anomalies and the fertility of hybrids are discussed.

PMID- 11206858
TI  - A phylogeny of the Drosophilidae using the sex-behaviour gene fruitless.

PMID- 11206860
TI  - The challenge of evidence-based migraine therapy.
AB  - It is important that physicians practise evidence-based medicine. Clinical
      experience is important, but there are a number of reasons why clinical
      experience can lead to the impression that ineffective treatments are effective.
      There are major educational and research challenges which must be met before
      clinicians can practice evidence-based migraine therapy more extensively than at
      present. Treating physicians will need to learn more about the principles of
      evidence-based medicine. Researchers will need to produce more and better
      clinical trials that address important clinical questions. The results of these
      trials will need to be reported clearly, and we need to improve the efficiency
      with which these results can be accessed. It is important that the pharmaceutical
      industry, clinicians, and academic health centres work together to meet these
      challenges.

PMID- 11206859
TI  - Nuclear DNA restriction site polymorphisms and the phylogeny and population
      structure of an intertidal snail species complex (Littorina).
AB  - Primers for amplification of four novel, unlinked nuclear DNA loci, the first
      reported for the rough periwinkles of the genus Littorina, are described.
      Patterns of restriction site polymorphism for these loci are detailed within the
      rough periwinkles. RFLPs are not found to be diagnostic for any of the currently
      accepted species within this group, nor for any of the contentious subspecies, or
      forms, whose taxonomic status is uncertain. However, there are important
      differences in allele frequencies between these taxa and certain of these mirror
      differences detected in a previous study of the mitochondrial DNA. These allele
      frequency data are used to construct a phylogeny in which groupings of the three
      recognised species are obvious when either Nei's genetic distances or Reynold's
      distances are clustered. Contentious forms (L. neglecta, L. saxatilis 'b' and L.
      tenebrosa) do not cluster as distinct taxa, although populations of L. neglecta
      have important allele frequency differences from L. saxatilis. These four loci
      have confirmed the consensus view of Littorina phylogeny and provided important
      information on population structure-however four loci is insufficient for
      reaching definitive conclusions. Since analysis of nuclear DNA polymorphisms such
      as these is invaluable for analysis of phylogeny, population structure and
      phylogeography, identification of additional loci is considered imperative.

PMID- 11206861
TI  - The principles of evidence-based medicine.
AB  - Evidence-based medicine (EBM) integrates individual clinical expertise with the
      best available external evidence in the care of individual patients. By enabling
      clinicians to directly appraise and apply current clinical research, EBM deals
      with the problems of deterioration in clinical performance, information overload,
      and lag in application of research findings to clinical practice. Thus, EBM is a
      useful tool to address the problems faced by clinicians attempting to provide
      optimum, current care for their patients. The rationale for EBM, its principles
      and application, as well as some limitations, are described here.

PMID- 11206862
TI  - Acute migraine treatment outcome measures: a clinician's view.
AB  - The efficacy of acute therapies for migraine can be measured in many ways.
      Traditional endpoints (such as reduction in pain from moderate or severe to mild
      or absent) are used for regulatory purposes, but do not reflect all components of
      the migraine syndrome, nor, necessarily, what is most valued by patients and
      clinicians. There is also a pharmacokinetic-pharmacodynamic disconnection for
      these traditional types of endpoint, suggesting that they teach us little about
      how these drugs work. More rigorous, but nonetheless pain-score based, endpoints
      are reviewed. The biases that can attach to measures such as therapeutic gain and
      number needed to treat, in the context of migraine therapy, and the limitations
      of these measures for use in meta-analysis, are discussed. The clinical
      subtleties of these endpoints are numerous: understanding patients' ability to
      distinguish between multiple headache types, the best timing of treatment
      relative to the start of an attack, and measuring clinical outcome may be
      statistically difficult, but yet may also provide more clinical utility than pain
      score analyses. The three therapeutic strategies (Step, Stepped-within-attack,
      and Stratified care) are reviewed and the place of 5HT(1B/1D) agonists within
      them, based on the currently best available evidence, is identified.
      Consideration should be given to more real-life studies, to measuring drug
      efficacy after early administration during onset of headache, and to greater
      sophistication in our approach to the necessarily gestalt measures of patient
      satisfaction and treatment preference.

PMID- 11206863
TI  - Drug comparisons: why are they so difficult?
AB  - Comparing therapeutic agents in a drug class can be difficult. This article
      examines the ways in which the triptans can be and have been compared and
      evaluates the advantages and disadvantages of the approaches. Direct comparative
      trials are clearly the best method for evaluating the triptans, however, there is
      a scarcity of this type of data on the currently available compounds. Indirect
      comparison such as meta-analysis is a second method of comparing these agents but
      only serves as an estimate of relative efficacy or safety based on a comparison
      of pooled data derived from a number of different trials for each agent.
      Comparison of the data found in the regulatory documents represents another type
      of indirect comparison that can be done so long as the data is presented in a
      consistent format across products.

PMID- 11206864
TI  - Evidence-based analysis of a migraine treatment drug comparison trial.
AB  - Patients present with specific problems against a background of their particular
      situation. The applicability of a treatment to a specific case may be difficult
      to assess in the light of the information available on that treatment. Evidence
      based medicine is a discipline developed to achieve the best informed treatment
      decisions in clinical situations. In this paper, we illustrate a logical approach
      to reaching a decision regarding which of two migraine treatments should be used
      in a clearly defined patient. The information evaluated is a comparative trial
      between sumatriptan (100 mg), rizatriptan (5 and 10 mg) and placebo. The use of
      the analytical tools of evidence-based medicine is demonstrated in this exercise.
      The example was chosen because this is an area of great current interest in the
      field of neurology.

PMID- 11206865
TI  - Evidence-based migraine therapy: learning needs and knowledge assessment.
AB  - One of the primary goals of continuing medical education (CME) is to enhance the
      learners' performance, and a major goal of evidence-based medicine (EBM) is to
      improve knowledge of current best care. This paper overviews the use of a
      Learning Needs and Knowledge Assessment tool to highlight the potential learning
      needs and knowledge of neurologists and to focus the issues, interest and
      interactions of neurologists in a workshop on EBM migraine therapy. Virtually all
      neurologists felt they used evidence-based medicine in their daily practice.
      Surprisingly, 50% of neurologists agreed that they were uncertain which triptan
      to use. The great majority of neurologists felt that the triptans were not all
      equally efficacious. Our survey identified significant knowledge gaps among
      neurologists regarding how to appraise the validity of evidence from a randomized
      clinical trial, and with regard to what are the most clinically useful measures
      of benefit in clinical trials.

PMID- 11206866
TI  - Hepatitis G virus infection in India: prevalence and phylogenetic analysis based
      on 5' non-coding region.
AB  - OBJECTIVES: To determine the prevalence of hepatitis G virus (HGV) infection in
      western India and to carry out phylogenetic analysis of HGV isolates. METHODS:
      Reverse transcription-polymerase chain reaction (RT-PCR) assay was used to detect
      HGV RNA in serum samples obtained from paid plasma donors, patients with
      hemophilia and voluntary blood donors. Nine Indian and one Kenyan HGV RNA
      positive samples were sequenced in the 5' non-coding region (5'-NCR).
      Phylogenetic analysis based on the comparison of a 101 nucleotide fragment from a
      large number of HGV isolates from 22 countries (including Indian and Kenyan
      sequences obtained during the present study) was carried out. RESULTS: HGV RNA
      positivity rates among paid plasma donors from a commercial plasmapheresis unit
      (7/43, 16.3%) and patients with hemophilia (5/44, 11.4%) were significantly
      higher than that in voluntary blood donors (0/51; p=0.003 and 0.019,
      respectively). Among patients with acute non-A to E hepatitis and fulminant
      hepatic failure, 1 of 50 and 1 of 28 were HGV RNA-positive, whereas 6 of 49 (12%)
      patients with chronic liver disease had circulating HGV RNA. All Indian isolates
      belonged to genotype 2, whereas the Kenyan isolate formed a distinct branch
      within genotype 1 consisting of African isolates. CONCLUSION: Our results suggest
      existence of parenteral transmission of HGV in the Indian population. HGV was not
      an important cause of acute non-A to E hepatitis or fulminant hepatic failure
      among the patients investigated. Genotype 2 seems to be the most prevalent
      genotype in western India.

PMID- 11206867
TI  - Effect of rotavirus infection on lipid composition and glucose uptake in infant
      mouse intestine.
AB  - OBJECTIVE: To study the effect of rotavirus infection on lipid composition and
      glucose uptake in small intestine of infant mice. METHODS: Thirty six 7-day old
      balb/c mice were given 50 mL (100 ID50) rotavirus suspension orally; 36 control
      animals received only normal saline. Body weight of animals was recorded. Six
      animals in each group were sacrificed on days 0, 1, 3, 5, 7 and 10 post
      inoculation (pi). Intestines were removed, everted and homogenized in ice-cold
      saline. Cholesterol and phospholipid content, glucose uptake and alkaline
      phosphatase in the jejunum and ileum were determined. RESULTS: Rotavirus
      infection led to a significant decrease in body weight with on days 3 and 5 pi as
      compared to controls, and to an increase in cholesterol and phospholipid content
      of the intestine. Uptake of glucose also increased significantly. Alkaline
      phosphatase activity was significantly reduced on days 3 and 5 pi as compared to
      controls. CONCLUSION: This study provides characterization of the lipid
      composition and uptake of glucose in infant mice small intestinal segments during
      rotavirus infection.

PMID- 11206868
TI  - Gastroenterology on the internet--V.

PMID- 11206869
TI  - Intrapulmonary vascular dilatation in portal hypertension due to cirrhosis of
      liver.
AB  - BACKGROUND: Intrapulmonary vascular dilatation in patients with portal
      hypertension due to chronic liver disease has been reported mainly from Western
      countries. METHODS: Fifty in-patients with portal hypertension due to cirrhosis
      of the liver were subjected to contrast-enhanced two-dimensional echocardiography
      in order to detect the presence of intrapulmonary vascular dilatation. Their
      arterial blood oxygen saturation was measured. The patients, including 37 men,
      were aged mean 43.5 years; 30 had alcoholic cirrhosis and 20 postnecrotic
      cirrhosis. Twelve patients were in Child-Pugh, class B and 38 in class C.
      RESULTS: None of the 50 patients was cyanosed or had clubbing. Their mean pO2 was
      83.2 mmHg. None had evidence of intrapulmonary vascular dilatations. CONCLUSION:
      Intrapulmonary vascular dilatation was not observed in our patients with liver
      cirrhosis. However, the sensitivity of contrast-enhanced echocardiography for
      this purpose needs to be reviewed.

PMID- 11206870
TI  - Hepatopulmonary syndrome: prevalence and clinical profile.
AB  - BACKGROUND: The hepatopulmonary syndrome (HPS) is defined as a triad of liver
      dysfunction, intrapulmonary vascular dilatations (IPVD) and arterial hypoxemia.
      There is paucity of Indian studies regarding the prevalence of IPVD and arterial
      hypoxemia particularly amongst patients with non-cirrhotic portal fibrosis (NCPF)
      and extrahepatic portal vein obstruction (EHPVO), where liver dysfunction is not
      a feature. METHODS: All patients with portal hypertension and esophageal varices
      seen at a tertiary care hospital during 1995-98 were studied. Ultrasonography of
      abdomen, contrast-enhanced echocardiography (CEE), arterial blood gas analysis
      and assessment of alveolar-arterial oxygen gradient were done. RESULTS: Of 138
      patients with portal hypertension seen during the study period, 88 fulfilled the
      inclusion and exclusion criteria. These included 63 with cirrhosis, 15 with NCPF
      and 10 with EHPVO. CEE showed IPVD in 17 (27%) patients with cirrhosis, of which
      11 (17.5%) fulfilled the criteria for HPS. IPVD were also noted in 4 (26.6%)
      cases of NCPF and 3 (30%) of EHPVO, though only 2 (13.3%) and 1 (10%)
      respectively had elevated alveolar-arterial gradient and liver dysfunction in
      addition. Age and sex distribution and duration of symptoms were not different in
      patients with HPS. Patients with HPS had higher incidence of dyspnea, platypnea,
      clubbing and spider nevi. CONCLUSIONS: Hepatopulmonary syndrome is present in
      17.5% of cirrhotics, 13.3% of patients with NCPF and 10% with EHPVO. Patients
      with HPS had significantly higher incidence of dyspnea, platypnea, clubbing and
      spider nevi.

PMID- 11206871
TI  - Primary biliary cirrhosis: an Indian experience.
AB  - Primary biliary cirrhosis (PBC) is believed to be rare in India. We analyzed our
      data pertaining to patients with PBC seen in a tertiary referral center over a 5
      year period. The diagnosis of PBC was based on liver biochemistry, histology and
      antimitochondrial antibodies, in the absence of biliary obstruction. Five
      patients, all women, were diagnosed to have PBC. Pruritus, jaundice and fatigue
      were the most common initial symptoms. Hepatomegaly was seen in 4 of 5 patients.
      Associated autoimmune diseases were present in 2 patients. All patients presented
      with mild hyperbilirubinemia (< or = 6 mg/dL) with disproportionately raised
      serum alkaline phosphatase level. AMA was positive in 4 patients. Liver biopsy
      showed stage III-IV disease in 3 of 4 patients. The clinical presentation and
      course of PBC in India are similar to the experience in the West.

PMID- 11206872
TI  - Hepatopulmonary or portopulmonary syndrome?

PMID- 11206873
TI  - Dermatofibrosarcoma protuberans of the jejunum.
AB  - We report a 55-year-old man with recurrent bleeding from the small intestine.
      Preoperative investigations suggested it to be a small intestine tumor. The
      resected specimen was diagnosed at histology as dermatofibrosarcoma protuberans
      of the small bowel.

PMID- 11206874
TI  - Leiomyosarcoma of third part of duodenum with perforation.
AB  - Malignant stromal cell tumors of the duodenum present with pain or bleed. We
      report a patient with leiomyosarcoma of the third part of the duodenum that
      presented with perforation.

PMID- 11206875
TI  - Ganglioneuroma of small intestine presenting with perforation peritonitis.
AB  - We report a 42-year-old man with benign solitary small intestinal ganglioneuroma
      presenting with perforation peritonitis. The patient had no evidence of MEN IIB
      syndrome. Simple segmental resection was done; the patient is well on follow up
      one year later.

PMID- 11206876
TI  - Laparoscopic cholecystectomy in patient with portal cavernoma and portal
      hypertension.
AB  - Successful laparoscopic cholecystectomy has been reported in patients with
      cirrhosis of liver with portal hypertension; the procedure has, however, not been
      reported in patients with portal vein thrombosis, portal cavernoma and portal
      hypertension. We report an 18-year-old man with portal hypertension due to portal
      vein thrombosis and portal cavernoma who had symptomatic gallstone disease and
      was successfully treated with laparoscopic cholecystectomy.

PMID- 11206877
TI  - Leiomyosarcoma of inferior vein cava presenting as acute Budd-Chiari syndrome.
AB  - We report a 49-year-old lady who presented with acute Budd-Chiari syndrome.
      Spiral CT scan showed inferior vein cava (IVC) tumor and ischemia of the right
      liver secondary to hepatic vein blockage. These were confirmed by MRI scan and
      IVC gram, at which time tissue diagnosis was obtained. At surgery, the tumor was
      seen to originate from the infrahepatic IVC and extended to the level of the
      diaphragm, blocking the hepatic vein outflow. The tumor was excised completely.
      Histology confirmed it to be leiomyosarcoma of the IVC. The patient is well,
      without recurrence of symptoms or tumor, 10 months later.

PMID- 11206878
TI  - Mesothelial cyst at porta hepatis.
AB  - Mesothelial cysts are fluid-filled sacs lined by mesothelial cells. They are rare
      lesions that have been known to occur at various sites, but have not been
      reported at the porta hepatis. We report a 45-year-old woman with mesothelial
      cyst at the porta hepatis that was detected incidentally during open
      cholecystectomy.

PMID- 11206879
TI  - Implantation malignancy after laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy may result in spillage of gall bladder contents
      during dissection or delivery of gall bladder through the umbilical port. We
      report a 50-year-old man who underwent laparoscopic cholecystectomy for suspected
      calculous cholecystitis. Histology showed a single focus of adenocarcinoma in the
      gall bladder. There was spillage of gall bladder contents at the umbilical port
      during delivery. Six months later, he developed adenocarcinoma at the port site.
      This was treated by wide excision.

PMID- 11206880
TI  - Eradication of Helicobacter pylori with a metronidazole-containing regimen in a
      metronidazole-abusing population.

PMID- 11206881
TI  - Ulcerative colitis in a married couple.

PMID- 11206882
TI  - Neonatal ectopic pancreatic cyst.

PMID- 11206883
TI  - Self-reported disease awareness--a questionnaire survey of ulcerative colitis
      patients.
AB  - OBJECTIVE: To evaluate patient knowledge about ulcerative colitis and relate this
      to their socio-demographic characteristics. METHODS: 145 patients with ulcerative
      colitis were given a two-sectioned awareness questionnaire in a language they
      understood. The first section, which tested disease awareness, consisted of 16
      items. Awareness was classified as very low (< or = 4 correct answers), low (5
      8), medium (9-12) and high (13-16). The second section contained 11 questions
      pertaining to general opinions and views about the disease. RESULTS: Nine (6.2%)
      participants had very low level of awareness, 107 (73.8%) low level, 29 (20%)
      medium, and none high disease awareness. Only disease duration influenced disease
      awareness significantly. Age, sex, marital status, occupation and education level
      had no relation to the level of awareness. A majority of patients resorted to use
      of alternative medicines during their disease course; however, with increasing
      awareness the use of other types of therapy was reduced. Drug compliance had
      significant association with disease awareness. CONCLUSIONS: Our patients with
      ulcerative colitis had poor disease awareness. Since awareness affected treatment
      compliance, the study emphasizes the need for better education of the patients
      and their family about the disease.

PMID- 11206884
TI  - Symptomatic, endoscopic and histological assessment of upper gastrointestinal
      tract in renal transplant recipients.
AB  - AIM: To assess the prevalence of gastrointestinal symptoms, endoscopic findings,
      and histological abnormalities in renal transplant recipients. SETTING: Teaching
      hospital in northern Jordan. METHODS: Seventy-six renal transplant recipients
      with stable renal function were interviewed for gastrointestinal symptoms, and
      underwent upper gastrointestinal endoscopy; gastric antral biopsies were
      evaluated for inflammatory changes and the presence of Helicobacter pylori. One
      hundred consecutive patients attending the general medical outpatient for various
      medical problems served as controls; 41 of them consented to undergo endoscopy
      and biopsy examination. RESULTS: Upper gastrointestinal symptoms were present in
      50% of patients compared to 47% of controls (p=0.80). Endoscopic abnormalities
      were found in 71% versus 63.4%. One patient in each group had duodenal ulcer. H.
      pylori were found in 60.5% versus 46.3% (p=0.20), and histological gastritis in
      40 (52.6%) with acute inflammatory changes in 22 (28.9%), compared to 21 (51.2%)
      and 15 (36.6%) controls, respectively. Monilial and cytomegalovirus esophagitis
      were found in 2 (2.6%) and one patient, respectively. CONCLUSIONS: Prevalence of
      gastrointestinal symptoms and endoscopic and histological findings in stable
      renal transplant recipients are similar to those in controls. Also, there was no
      increase in opportunistic infections of the gastrointestinal tract or of gastric
      H. pylori in these patients.

PMID- 11206885
TI  - Carotid endarterectomy based on duplex ultrasound in patients with and without
      hemispheric symptoms.
AB  - Carotid endarterectomy is the most commonly performed vascular procedure. This
      retrospective study was conducted to determine the efficacy of duplex imaging as
      the sole diagnostic study for preoperative evaluation of symptomatic and
      asymptomatic patients who underwent carotid endarterectomy. We conducted a
      retrospective case series analysis in a community teaching hospital. From January
      1994 to September 1998, 316 patients underwent carotid endarterectomy for carotid
      stenosis. A total of 177 patients were symptomatic and 139 patients were
      asymptomatic. Angiography was performed routinely in the beginning of the study
      but later was performed only in selected patients. Preoperative duplex ultrasound
      of carotid artery was performed by a laboratory accredited by the Intersocietal
      Commission for the Accreditation of Vascular Laboratories. Data were reviewed to
      obtain morbidity and mortality rates, and duplex imaging results were compared
      with operative findings. Cost and risk analysis of carotid angiography reviewed.
      This study reviewed variables of age, sex, race, diabetes, smoking, hypertension,
      hypercholesterolemia, coronary artery disease, and renal failure. Five patients
      had a lesion in the proximal portion of the carotid artery by duplex imaging
      criteria. Duplex ultrasound results were grossly confirmed intraoperatively in
      all patients except in one patient who was found to have complete occlusion of
      carotid artery whose duplex was read as high-grade stenosis. The duration of stay
      ranged from two to 30 days. This duration was influenced by patients' comorbid
      conditions, postoperative complications or simultaneous coronary artery bypass
      graft. Four patients had a stroke within 30 days of surgery making the stroke
      rate of 1.26 per cent. There has been considerable debate on the use of duplex
      ultrasound as the only method of preoperative evaluation of carotid stenosis
      before carotid endarterectomy. Our study demonstrates that it is safe to perform
      carotid endarterectomy based on neurologic history and duplex ultrasound with
      good technical quality performed in an accredited vascular laboratory. This
      approach eliminates the cost and risk associated with angiography. Proximal
      carotid and intrathoracic lesions are rare and can be predicted by the duplex
      study. We think that carotid angiography is required only when duplex imaging is
      suboptimal or equivocal in the presence of atypical symptoms or uncommon vascular
      abnormalities.

PMID- 11206886
TI  - Leonardo da Vinci: anatomist and physiologist.

PMID- 11206887
TI  - Surgery by the lowest bidder?

PMID- 11206888
TI  - Mirizzi's syndrome: experience from a multi-institutional review.
AB  - P.L. Mirizzi described in 1948 a partial or spastic obstruction of the common
      hepatic duct secondary to an impacted gallstone in the cystic duct or
      infundibulum of the gallbladder. The modern definition of Mirizzi's syndrome is
      thought to include four components: anatomic arrangement of the cystic duct at
      the gallbladder neck such that it runs parallel to the common hepatic duct;
      impaction of a stone in the cystic duct or neck of the gallbladder; mechanical
      obstruction of the common hepatic duct by the stone itself or by secondary
      inflammation; and intermittent or constant jaundice causing possible recurrent
      cholangitis and, if longstanding, secondary biliary cirrhosis. Intermittent
      symptomatology may make Mirizzi's syndrome difficult to diagnose preoperatively
      or intraoperatively. Bilio-biliary fistulas may or may not be present. Diagnosis
      and choice of operative repair may be best accomplished by open operative
      technique. Over a 24-year period two faculty members from Louisiana State
      University (LSU) Medical Center-Shreveport at Monroe and LSU Baton Rouge treated
      4180 cases of cholelithiasis at six Louisiana university and private hospitals.
      Eleven cases of Mirizzi's syndrome were diagnosed on the basis of operative and
      preoperative notes with detailed description of size and extent of biliobiliary
      fistulas when they were present. These 11 cases were reviewed and followed from
      one to 20 years. Presentation, workup, operative findings, choice of operative
      repair, choice of operative approach, and complications were evaluated by
      retrospective chart review. Review of the pertinent literature for informative
      and comparative purposes was also completed. These 11 cases ranged from Csendes
      Type I to III. There were no Type IV cases. They were ultimately diagnosed and
      managed by classical open technique. Four laparoscopic procedures were converted
      to open technique following initial inspection. All four were converted to open
      as a result of inability to delineate structures in and adjacent to the triangle
      of Calot due to marked scarring in the subhepatic space. No iatrogenic injuries
      or major complications occurred. Mirizzi's syndrome occurs in fewer than 0.5 per
      cent of patients with cholelithiasis. Removal of stones with partial
      cholecystectomy and use of gallbladder or cystic duct remnant to oversew or
      repair Mirizzi fistulas should be considered. Roux-en-y hepaticojejunostomy
      becomes the procedure of choice when the vascularity or viability of the hepatic
      duct or tissues available for duct repair is questionable. Review of the
      literature reveals the increase in complications with laparoscopic versus open
      technique in Mirizzi's syndrome. Although very little direct evidence exists we
      believe that when this syndrome is diagnosed or strongly suspected open biliary
      operation is the procedure of choice because the increased potential for major
      complications with the use of laparoscopic technique far outweighs the potential
      slight increase in morbidity of an open procedure.

PMID- 11206889
TI  - Effect of a composite membrane of chitosan and poloxamer gel on postoperative
      adhesive interactions.
AB  - Excessive postoperative adhesion formation is a major result of surgery. The
      adhesion reduction effects of a chitosan membrane and poloxamer gel barrier were
      measured in a rat peritoneal model. Forty-four male Sprague-Dawley rats were
      divided into four groups (control, poloxamer, chitosan, and poloxamer+chitosan
      sandwich). Two cm2 of cecal serosa and the adjacent abdominal wall were abraded.
      The denuded cecum was covered with either a chitosan membrane, a poloxamer gel,
      chitosan in a sandwich configuration with poloxamer on both sides, or neither
      (control group) and apposed to the abdominal wall. Fourteen days after surgery
      adhesions were graded using a whole-number scoring system of zero to five.
      Adhesion strength was determined using a whole-number system of one to four.
      Adhesion area was measured on a continuous scale of adhesion severity. Adhesion
      grades were highest in the control group (5.00 +/- 0.00) and were significantly
      (P < 0.05) lower in the poloxamer group (3.50 +/- 1.35), the chitosan group (1.64
      +/- 1.63), and the poloxamer+chitosan group (1.18 +/- 1.25). The two chitosan
      containing groups also had significantly (P < 0.05) reduced adhesion grades in
      comparison with the poloxamer group. Adhesion area in both chitosan-containing
      groups was reduced in comparison with control and adhesion strength was reduced
      significantly (P < 0.05) in all groups compared with control. The
      poloxamer+chitosan group had significantly (P < 0.05) reduced adhesion strength
      versus poloxamer only. There was a significant (P < 0.05) linear correlation (r =
      0.931, P < 0.001) between adhesion grade and adhesion strength. We conclude that
      chitosan and the combination of poloxamer+chitosan were shown to effectively
      reduce adhesion area, grade, and strength.

PMID- 11206890
TI  - The role of follow-up radiographic studies in nonoperative management of spleen
      trauma.
AB  - The management of splenic injuries has evolved significantly in recent years from
      an operative to a nonoperative approach in stable patients with blunt abdominal
      trauma. The management of these patients with serial radiographic studies before
      hospital discharge remains controversial. We reviewed the management of 90
      patients retrospectively who were admitted to our Level II trauma center with
      splenic injuries secondary to blunt trauma to determine the value of serial
      radiographic studies. Forty-seven (52%) patients underwent immediate laparotomy.
      Forty-three (48%) patients were managed conservatively without surgery. All
      nonoperative patients had an initial CT of the abdomen to evaluate their
      abdominal injuries. Among the 43 patients managed without surgery 31 had no
      follow-up radiographic studies. Twelve patients had follow-up studies before
      discharge. Two of these 12 patients subsequently underwent splenectomy. Both had
      developed hypotension, tachycardia, and a decreasing hematocrit, which prompted
      their repeat radiographic studies. Ten patients had no change in their clinical
      status and showed no significant change in the radiographic injury pattern to the
      spleen. One patient who was initially managed nonoperatively became
      hemodynamically unstable with increasing abdominal pain and subsequently
      underwent splenectomy without follow-up radiographic studies. The remaining 30
      patients who had no follow-up studies had no significant change in their clinical
      abdominal examinations and had no further complications from their splenic
      injuries. Routine follow-up radiographic evaluations are not necessary in the
      nonoperative management of stable patients with splenic injuries.

PMID- 11206891
TI  - Routine chest X-rays after insertion of implantable long-term venous catheters:
      necessary or not?
AB  - Can long-term subcutaneous venous (Mediport) catheters be safely inserted without
      routine chest X-ray (CXR) verification? An estimated 500,000 Mediport catheters
      are inserted yearly in the United States, and elimination of unnecessary
      radiographs would result in substantial savings of increasingly limited health
      care resources. A total of 513 consecutive Mediport catheters were inserted by a
      single surgeon over a 5-year period using a standardized protocol and selective
      indications for follow-up CXR that included unilateral chest pain, aspiration of
      air, decreased breath sounds, and difficult catheter insertion. The 513 catheters
      were inserted in 498 patients with 271 patients (53%) undergoing postprocedure
      CXR. Of the 513 catheters 461 (90%) were placed by percutaneous approach to the
      subclavian vein. Six pneumothoraces (1.2% incidence) occurred, all in patients
      who met criteria for immediate CXR. The overall complication rate was 3.1 per
      cent and included eight instances of catheter-tip malposition (seven of the eight
      were successfully repositioned by vascular radiology), one mediastinal hematoma,
      and one chest-wall hematoma. This largest single-surgeon-reported series
      demonstrates that Mediport insertion can be safely accomplished with minimal
      complications following a standardized protocol using selective radiologic
      evaluation.

PMID- 11206892
TI  - Diaphragmatic hernia after Ivor-Lewis esophagectomy manifested as lower
      gastrointestinal bleeding.
AB  - Diaphragmatic hernia after esophageal resection is a recognized but rare
      complication. Parahiatal hernias may result from manipulation and extension of
      the crura during surgery. This can lead to a wide array of symptoms depending on
      the extent and organ that is herniated. A high index of suspicion is required
      because there is no one symptom that is specific for herniation. This report
      represents the first case of a patient presenting with lower gastrointestinal
      bleed from a parahiatal hernia after esophageal resection.

PMID- 11206893
TI  - Gingko biloba: a case report of herbal medicine and bleeding postoperatively from
      a laparoscopic cholecystectomy.
AB  - An increasing variety of alternative health care products (defined as "over-the
      counter," nonprescribed herbal medicines) are taken by patients for a plethora of
      reasons. Unfortunately these self-prescribed remedies are seldom considered by
      the patient to be medications and as a result it has been noted that 70 per cent
      of patients do not reveal herbal use to their allopathic practitioners or
      hospital personnel. The rapid growth of this herbal self-therapy has important
      implications for the practice of surgery. A case of post-laparoscopic
      cholecystectomy bleeding in a patient taking Gingko biloba is reported. This
      preparation has been reported to cause spontaneous bleeding and may interact with
      anticoagulants and antiplatelet agents. Other herbal medicines have also been
      associated with potential increased bleeding including garlic, feverfew, ginger,
      and ginseng. It is vital for surgeons to be apprised of all substances ingested
      by patients, to be cognizant of their potential adverse effects and drug
      interactions, and to be familiar with their therapeutic modality, all of which
      will help to optimize therapeutic approaches and improve patient outcome.

PMID- 11206894
TI  - Surgical treatment of severe colonic inertia with restorative proctocolectomy.
AB  - Patients with severe constipation due to colonic inertia who remain symptomatic
      after extensive medical therapy or partial colonic resection have occasionally
      been treated with ileostomy as a last resort. The hospital records of five
      patients with persistent symptomatic idiopathic colonic inertia were reviewed.
      Each of the patients had undergone extensive medical management, and eventually
      four underwent one or more colonic resections to relieve the recurrent abdominal
      distention and pain. Three of the patients eventually received a distal
      ileostomy, which functioned well. Anorectal manometric studies were within normal
      range for each of the five patients. Restorative proctocolectomy (J pouch) was
      therefore performed for each. With a mean follow-up of 42 months after
      restorative proctocolectomy each of the five patients was relieved of
      constipation and small bowel distention. The average number of bowel movements
      per 24 hours at 6 months was 4.8. All patients were able to discriminate flatus
      from stool, could hold back for up to 1.5 hours after the initial urge to
      defecate, and had total daytime continence. Each returned to work or school
      within 3 months, and each reported greater satisfaction with bowel function than
      with the ileostomy. Restorative proctocolectomy with a J pouch provides a
      satisfactory option for the management of patients with persistent abdominal
      distention and pain due to idiopathic colonic inertia.

PMID- 11206896
TI  - Does cell-saver blood administration and free hemoglobin load cause renal
      dysfunction?
AB  - Our aim was to evaluate the impact of cell-saver volume and free hemoglobin load
      on renal dysfunction. Intraoperative blood salvage was conducted in standard
      fashion, and in each case a sample of the blood was removed for testing. Outcome
      data on individual patients were collected during a 6-year period (1992-1998).
      The total amount of free hemoglobin each patient received was calculated. Renal
      dysfunction was defined as a rise in creatinine level of 1.0 mg/dL above
      baseline. There were a total of 125 patients who received salvaged blood. The
      free hemoglobin concentration ranged from 19 to 304 mg/dL (mean, 87.5 mg/dL).
      Patients were stratified into groups on the basis of the total free hemoglobin
      received, and the Kruskal-Wallis test demonstrated a difference between groups in
      the prevalence of renal dysfunction (P < 0.001). A total of 15 patients (12%) had
      significant postoperative renal dysfunction. There was an association between the
      amount of free hemoglobin load and subsequent renal dysfunction. This may warrant
      further study toward establishing policies and limits regarding maximal free
      hemoglobin blood.

PMID- 11206895
TI  - Meckel's diverticulum causing cecal volvulus.
AB  - Meckel's diverticulum is present in 2 per cent of the population with bowel
      obstruction as its most common complication. This case report describes an
      extremely rare complication of a Meckel's diverticulum, a cecal volvulus. The
      diagnosis of cecal volvulus was made preoperatively on abdominal X-rays; the
      diagnosis of a Meckel's diverticulum was made intraoperatively. The cecum was
      found to be twisted around a vitelline band on a broad-based Meckel's
      diverticulum extending to the umbilicus. The diverticulum was resected. The
      patient did well postoperatively and was discharged without any difficulty.

PMID- 11206897
TI  - The ascendance of laparoscopic splenectomy.
AB  - The application of laparoscopic techniques for abdominal procedures has been
      achieved with varying success. The general acceptance of laparoscopic splenectomy
      (LS) may be hindered by its infrequent performance and difficulty in manipulating
      the spleen. A retrospective review of splenectomies performed for primary splenic
      pathology was done to assess the role and outcome of LS. One hundred fifty LSs
      were performed from July 1995 through September 1999. Over that time period the
      proportion of LS performed increased steadily from 17 to 75 per cent of all
      splenectomies. The primary indications for splenectomy included immune
      thrombocytopenic purpura in 75 (50%), lymphoma/leukemia 36 (24%), and
      splenomegaly 19 (13%). There were 86 females and 64 males. Immediately before
      operation 36 patients (4%) had a platelet count <50,000/ mL, and 24 patients
      (16%) a hemoglobin <10 mg per cent. The mean operative time was 161 minutes with
      an average blood loss of 138 cm3 (<50-800). The mean morcellated weight of the
      entire group was 411 g (33-3300) indicating generally large splenic size. In the
      37 patients with splenomegaly the mean weight was 735 g (293-3300). There were
      two conversions to open splenectomy. Two patients with hematologic malignancy,
      splenomegaly, and cytopenias died from overwhelming post-splenectomy sepsis
      (1.3%). Morbidity occurred in 14 (9%) with the most common complication being
      pancreatitis in seven (5%). The median length of postoperative stay was 2.4 days
      (range 1-5). In summary LS has rapidly replaced the open approach for nearly all
      elective splenectomies in adults and children. When performed with the patient in
      the lateral position it can be accomplished with minimal morbidity, even in
      complex patients, including those with splenomegaly.

PMID- 11206898
TI  - Comparison of safety and cost of percutaneous versus surgical tracheostomy.
AB  - Tracheostomy continues to be a standard procedure for the management of long-term
      ventilator-dependent patients. Traditionally the procedure has been performed by
      surgeons in the operating theater using an open technique. This routine practice
      has recently been challenged by the introduction of bedside percutaneous
      dilatational tracheostomy (PDT), which has been reported to be a cost-effective
      alternative. The purpose of this study is to evaluate and compare the safety,
      procedure time, cost, and utilization of percutaneous and surgical tracheostomies
      at a university hospital. A retrospective medical chart review was performed on
      all ventilator-dependent intensive care unit patients at the University of
      Virginia Medical Center undergoing tracheostomy during a 23-month period
      beginning December 26, 1996. Of the 213 patients identified for review, 74 and
      139 patients received percutaneous and surgical tracheostomies, respectively. Of
      74 percutaneous tracheostomies, 73 reviewed were performed by general surgeons,
      pulmonary physicians, or anesthesiologists in the intensive care unit; all open
      tracheostomies were performed by surgeons in the operating room, and one
      percutaneous procedure was performed in the operating room. Perioperative
      complications occurred in five of 74 patients (6.76%) during PDT; of these, three
      patients (4.1%) experienced major complications requiring emergent operative
      exploration of the neck. Three patients (2.2%) experienced perioperative
      complications during surgical tracheostomy. The mean procedure time was
      significantly shorter for the percutaneous procedure. Average charges per patient
      in an uncomplicated case including professional fees, inventory, bronchoscopy (if
      performed), and operating room charges were $1753.01 and $2604.00 for
      percutaneous and standard tracheostomies, respectively. These charges do not
      include the charges associated with surgical intervention after PDT
      complications. In contrast to previously published reports showing complications
      clustered during a physician's first 30 percutaneous cases, our study
      demonstrated no relationship between complication occurrence and physician
      experience. That is, no learning curve associated with performing PDT was
      evident. In addition there was no association seen between physician specialty
      and complication rate. PDT in the intensive care unit costs less than surgical
      tracheostomy performed in the operating room and can be performed in less time.
      Several other studies have recommended that bronchoscopy during PDT provides
      additional safety; however, in our series all three major complications took
      place during bronchoscopy-assisted percutaneous procedures. Our series suggests
      that PDT carries an appreciable risk of major complications. Careful patient
      selection and additional experience with the procedure may decrease complication
      rates to an acceptable level.

PMID- 11206899
TI  - Impact of presenting physiology and associated injuries on outcome following
      traumatic rupture of the thoracic aorta.
AB  - We hypothesized that the predominant factor influencing outcome of traumatic
      rupture of the thoracic aorta (TRA) was the degree of shock on presentation and
      associated injuries. We reviewed our experience with TRA over a 15-year period.
      Patients were classified as "unstable" if presenting systolic blood pressure was
      <90 mm Hg or if it decreased to <90 mm Hg after admission. We determined the
      presence of closed head injury, cardiac risk factors, a preoperative acute lung
      injury (ALI). The influence of these factors on mortality, postoperative adult
      respiratory distress syndrome (ARDS), and paralysis was analyzed. One hundred
      thirty-six patients were admitted with TRA. One hundred twenty underwent
      operative repair with a mortality of 31 per cent. Operative mortality was
      significantly higher in unstable patients (62%) versus stable patients (17%, P =
      0.001), in patients with cardiac risk factors (71%) versus those without (24%, P
      = 0.001), and in patients with preoperative free rupture (83%) with versus those
      without (19%, P = 0.001). Free rupture was the cause of hypotension in only 10 of
      42 unstable patients, with the remainder being due to other causes. Preoperative
      ALI was associated with a marked increase in postoperative ARDS (47% with vs 9%
      without, P = 0.001) but not operative mortality. Mechanical circulatory support
      (MCS) was used in 59 cases, none of whom experienced paralysis, whereas eight of
      61 operated on without MCS developed paralysis (P = 0.001). When logistic
      regression was applied the use of MCS was not determined to be statistically
      significant. However, preoperative instability was found to be a significant
      predictor of postoperative paralysis with the risk being increased 5.5 times
      (confidence interval 3.3-10). The predominant factor influencing mortality,
      postoperative ARDS, and paralysis was preoperative instability and associated
      injuries. In patients who are hypotensive, other injuries should take precedence
      over repair of TRA. Patients who are stable but who have cardiac or pulmonary
      risk factors may be better managed by a period of nonoperative management until
      their condition improves.

PMID- 11206900
TI  - Evolving techniques in the treatment of carotid artery kinking: the use of
      resected redundant arterial segment.
AB  - Internal carotid artery kinking is frequently accompanied by atheromatous disease
      at the carotid bifurcation, and in this case both lesions may be treated
      simultaneously. Various surgical techniques have been used to correct carotid
      kinking but no particular one has been widely established. We conducted a
      retrospective review of 18 patients operated upon for internal carotid kinking
      during the last 5 years, which represents 4.1 per cent of the total carotid
      procedures performed during the same period. In 13 of the 18 patients carotid
      endarterectomy was performed before the repair of the kink. In four patients
      resection of the kinked segment with end-to-end anastomosis was performed
      combined with longitudinal arteriotomy at the carotid bifurcation. Two patients
      developed restenosis at the site of anastomosis requiring reoperation with patch
      angioplasty. Three patients were treated with eversion endarterectomy and end-to
      side anastomosis, whereas in six patients we performed resection of the redundant
      internal carotid artery combined with longitudinal arteriotomy at the
      bifurcation. The posterior wall was reconstructed with interrupted sutures and
      the procedure was completed with patch angioplasty of the anterior wall. In four
      of these cases we used the autogenous resected arterial segment as patch
      material. None of these patients developed restenosis or symptoms in a follow-up
      period of 3 to 32 months. In cases in which significant carotid artery stenosis
      and internal carotid kinking coexist resection of the involved segment with end
      to-end anastomosis of the posterior wall and patch angioplasty using the resected
      autogenous arterial segment constitute a convenient and satisfactory method of
      reconstruction.

PMID- 11206901
TI  - Porcelain gallbladder is not associated with gallbladder carcinoma.
AB  - The surgical management of porcelain gallbladder is based on studies performed in
      1931 and 1962, which indicated a correlation between porcelain gallbladder and
      carcinoma. We sought to evaluate the characteristics of patients with porcelain
      gallbladder and the risk for gallbladder carcinoma. The medical records of 10,741
      cholecystectomies performed between 1955 and 1998 were reviewed and recorded. The
      pathology slides were evaluated for evidence of calcification and gallbladder
      carcinoma. Fifteen (0.14%) of 10,741 specimens were porcelain gallbladders. Ten
      patients (67%) had symptoms suggestive of biliary colic or cholecystitis. Five
      (33%) were asymptomatic and diagnosed incidentally. All specimens demonstrated
      chronic cholecystitis and partial calcification of the gallbladder wall. Nine
      (60%) had cholelithiasis. None had gallbladder carcinoma by recent review of
      pathologic material. During this same period 88 (0.82%) patients had gallbladder
      carcinoma, none of which showed calcification of the wall. This report represents
      the largest modern review of porcelain gallbladders. No carcinoma was identified
      among patients with porcelain gallbladder. In addition no patient with
      gallbladder carcinoma had calcified gallbladder. With a better understanding of
      the natural history of the porcelain gallbladder the current management of these
      patients may change.

PMID- 11206902
TI  - Axillary lymph node status of T1 primary breast cancer in a diverse population.
AB  - The utility of level I and II axillary lymph node dissection in women with
      primary tumors less than 1 cm in diameter has recently received extensive
      evaluation. Numerous patients undergo axillary lymph node dissection ultimately
      to discover no pathological involvement. This study investigates the lymph node
      status in T1 primary breast adenocarcinoma in our diverse patient population. A
      retrospective evaluation of patients treated at the Medical Center of Louisiana
      at New Orleans and the Tulane University Medical Center with breast
      adenocarcinoma less than or equal to 2 cm was performed. Demographic data and
      pathological reports were reviewed to obtain breast lesion size and lymph node
      status. One hundred sixteen patients were found to have T1 lesions. Ethnic
      distribution was African American 66 per cent; Caucasians 30 per cent; Hispanic 2
      per cent; and Asian 3 per cent. Whereas no patients with T1a lesions had positive
      lymph nodes, 11 per cent of patients with T1b lesions and 36 per cent of patients
      with T1c lesions had positive lymph nodes. However, in our patient population no
      patients with tumors less than 1.0 cm. in diameter had positive lymph nodes.
      Although this may be due to our relatively small sample size axillary lymph node
      dissection may be unnecessary in this select patient population. For patients
      with lesions 1.0 cm and greater an axillary lymph node dissection seems to add
      necessary information for correct treatment in a small percentage of patients.
      The use of lymphatic mapping with sentinel axillary lymph node biopsy may reduce
      the number of unnecessary axillary dissections in early breast cancer.

PMID- 11206903
TI  - Aerodigestive injuries of the neck.
AB  - Cervical aerodigestive trauma is rare and most centers have a limited experience
      with its management. The purpose of this review was to study the epidemiology,
      diagnosis, and problems related to the early evaluation and management of these
      injuries. This was a retrospective study based on trauma registry and on chart,
      operative, radiological, and endoscopic reports. There were 1560 admissions with
      blunt or penetrating trauma to the neck. The overall incidence of aerodigestive
      trauma was 4.9 per cent (10.2% for gunshot wounds, 4.6% for stab wounds, and 1.2%
      for blunt trauma). All patients with aerodigestive trauma had suspicious signs or
      symptoms on admission. The most common life-threatening problem in the emergency
      room and directly related to the aerodigestive trauma was airway compromise.
      Twenty-nine per cent of patients with laryngotracheal trauma required an
      emergency room airway establishment because of threatened airway loss. Although
      rapid sequence induction was successful in the majority of cases, in 11.9 per
      cent there was loss of airway and a cricothyroidotomy was necessary. Overall, 9
      per cent of cases with aerodigestive injuries were successfully treated
      nonoperatively. Thirty-six per cent of patients with laryngotracheal trauma and
      surgical repair were successfully treated without a protective tracheostomy.
      There was no mortality due to the aerodigestive injuries. Cervical aerodigestive
      trauma is rare. In conclusion, all patients with significant aerodigestive
      injuries requiring treatment had suspicious signs and symptoms. Airway compromise
      was a common problem in the emergency room. Loss of airway after rapid sequence
      induction is a potentially lethal complication and the trauma team should be
      ready for a surgical airway. Repair of laryngotracheal injuries without a
      protective tracheostomy is safe in selected cases.

PMID- 11206904
TI  - Splenic abscess: report of six cases and review of the literature.
AB  - Splenic abscesses are rare but appear to be increasing in frequency. Recent
      advances in radiologic techniques have affected the diagnosis and management. The
      purpose of this study was to evaluate these effects. The medical records of one
      institution were retrospectively reviewed and six cases of splenic abscesses seen
      between 1989 and 1999 were identified. All patients had predisposing conditions
      with metastatic hematogenous infection in three and one each with trauma,
      immunodeficiency, and a contiguous site of infection. Fever was present in all
      patients with chills and vomiting in five and three patients, respectively. Left
      upper quadrant tenderness appeared in four patients and leukocytosis was found in
      every patient except one with the acquired immunodeficiency syndrome. Chest
      roentgenograms were abnormal in five patients with a left pleural effusion most
      common. Ultrasound revealed the defect in both patients it was utilized in and
      computed tomography was diagnostic in all cases. The causative organisms were
      anaerobes in two cases and Candida albicans, Streptococcus viridans, Escherichia
      coli, and Citrobacter freundii each present in one case. Radiology guided
      percutaneous drainage was attempted in four patients but was only successful in
      one. Splenectomy with antibiotics was curative in the remainder with a 100 per
      cent survival. These data suggest that percutaneous drainage may be appropriate
      for certain patients initially, but the high failure rate demonstrates that
      splenectomy remains the standard treatment.

PMID- 11206905
TI  - The potential value of intraoperative imprint cytology of axillary sentinel lymph
      nodes in breast cancer patients.
AB  - Axillary sentinel nodes predict the node status and may allow dissection of the
      axilla on a selective basis. Seventy-two sentinel nodes from 60 patients
      identified with Patent blue and/or the high radioactivity due to the uptake of
      99m-Tc-labeled colloidal albumin were bisected for hematoxylin and eosin-stained
      touch preparations. The sentinel nodes were submitted in toto for permanent step
      sections and immunostained for cytokeratins. The imprints had a sensitivity of 83
      per cent, a negative predictive value of 86 per cent, and a false negative rate
      of 17 per cent when the cut surface histology was considered. These corresponding
      values were 59, 68, and 41 per cent on a patient basis when the whole sentinel
      node histology was considered as many micrometastases did not appear in the cut
      surface sampled by the imprints. Although up to two-fifths of patients with tumor
      cells in the sentinel lymph nodes may be undetected by the method imprint
      cytology is valuable in the intraoperative assessment of sentinel nodes. This
      series suggests that 78 per cent of the patients can be adequately selected for a
      one-step axillary operation on the basis of intraoperative imprints. Results may
      be improved if the surface sampled is appropriately large and well selected.

PMID- 11206906
TI  - Game theory in the operating room environment.
AB  - To optimize the functioning of an operating room the interactions of the staff
      (physicians and nurses) and other stakeholders (administrators) must be
      understood. Game theory provides a representation of the interactions that
      typically take place in the operating room environment. By understanding the
      types of games/interactions that occur the participants can better predict
      outcome and adapt their own behavior to optimize that outcome. Types of games
      seen in the operating room include fixed-sum, zero-sum, and non-zero-sum games.
      The Prisoner's Dilemma game and some of its variations are used to illustrate
      common interactions in the operating room. Examples of strategies for typical
      scenarios are discussed as well as ways to improve the outcome of the games. A
      better understanding of human behavior can improve the functioning of complex
      systems such as that found in the operating room.

PMID- 11206907
TI  - Acute cholecystitis in the immediate postoperative period following
      esophagogastrectomy.
AB  - Postoperative acute cholecystitis (PAC) occurs after 0.06 per cent of all
      operations. However, PAC may occur in up to 3.1 per cent of patients after
      gastrectomy. This increased incidence of PAC is due to bile stasis and gall
      bladder ischemia promoted by vagotomy and gastrohepatic ligament dissection
      during gastrectomy. Despite similar factors during esophagogastrectomy PAC is
      rarely reported in large American series of patients undergoing
      esophagogastrectomy. We report two cases of PAC occurring after
      esophagogastrectomy.

PMID- 11206908
TI  - Comparison of the column performance of narrow-bore and standard-bore columns for
      the chromatographic determination of alpha-, beta-, gamma-, and delta-tocopherol.
AB  - A comparison of the performance of narrow-bore (2.1-mm i.d.) and standard-bore
      (4.6-mm i.d.) analytical silica columns having the same length is completed for
      the resolution of alpha-, beta-, gamma-, and delta-tocopherol. The studies are
      performed on high-performance liquid chromatographic equipment with minimum
      extracolumn contribution. Column permeabilities are 1.16 x 10(-9) and 2.48 x 10(
      9) cm2 for narrow and standard bore, respectively. The narrow-bore column gives
      up to a 7 times increase in sensitivity compared with a standard-bore column at
      equivalent running times for the analytes. Approximately one-third solvent
      savings can be achieved with the narrow-bore column. Theoretical plates of the
      standard-bore column are higher than that of the narrow-bore column.

PMID- 11206909
TI  - Method development and validation for the determination of various sulfur
      containing anions and other anions in the corrosion process by capillary ion
      electrophoresis with indirect detection.
AB  - A method of capillary ion electrophoresis with indirect detection is developed
      for the simultaneous determination of the sulfur-containing anions S2O4(2-),
      S2O3(2-), SO4(2-), SO3(2-), and S2- and other anions (Cl-, Br-, NO2-, NO3-,
      (COO)2(2-), F-, and PO4(3-)) in the corrosion process. The effects of pH,
      tetradecyltrimethylammonium hydroxide, chromate, 2-[n-cyclohexylamino]-ethane
      sulfonate, calcium gluconate, and acetonitrile on the migration and resolution of
      the anions and the stability of sulfur-containing anions are systematically
      investigated. The detection limits, repeatability, and linearity for the anions
      are comparatively studied at 374, 274, and 254 nm, and the results show that 374
      nm is the optimal length. The simultaneous multiwavelength detection at 374, 254,
      214, and 195 nm can assist in confirming the identification of UV-absorbing
      anions.

PMID- 11206910
TI  - Industrial scale-up of countercurrent chromatography: predictive scale-up.
AB  - This study describes how scale-up in countercurrent chromatography (CCC) can be
      simply predicted on a process scale CCC device by running a preliminary
      analytical-sized sample and having knowledge of the stationary-phase retention at
      scale-up conditions. Results have shown that simple experimentation can lead
      within a day to a process with the capability of several kilograms per day (tons
      per year) compound yield, and that this is feasible with benchtop CCC units.

PMID- 11206911
TI  - Quantitative structure-retention relationships with model analytes as a means of
      an objective evaluation of chromatographic columns.
AB  - The performance of several previously designed model series of test analytes has
      been tested to characterize in an objective, quantitative manner modern
      stationary phases for reversed-phase high-performance liquid chromatography (RP
      HPLC) using quantitative structure-retention relationships (QSRRs). Three QSRR
      approaches and three respective series of test analytes recommended for studies
      of the molecular mechanism of chromatographic retention are employed: the reduced
      linear solvation energy relationship (LSER)-based model of Abraham, a model
      employing structural descriptors from molecular modeling, and a model relating
      retention to the n-octanol-water partition coefficient log P. All of the models
      and test analytes proposed provide reliable QSRR equations. Those equations
      discriminate in quantitative terms individual columns and chromatographic systems
      and can be interpreted in straightforward rational chemical categories. In view
      of QSRRs, the differences in the intermolecular interactions between a given
      stationary phase and a structurally defined analyte rationalize the observed
      differences in retention. The QSRR models (previously derived retrospectively)
      are demonstrated to work well on new sets of RP-HPLC data. At the same time, it
      has been confirmed that the three test series of analytes have properly been
      designed and can be recommended for comparative studies of analytical columns.
      QSRRs once derived on a given column for model analytes can be used to predict
      the retention of other analytes of a defined structure. That in turn can
      facilitate the procedure of the rational optimization of chromatographic
      separations.

PMID- 11206912
TI  - Liquid chromatographic determination of the total available free and intrachain
      lysine in various foods.
AB  - A method for the quantitative determination of the total available lysine in
      various foods is developed. The method is based on the reaction of the amino
      groups on the lysine molecule with fluorodinitrobenzene and is capable of
      furnishing simultaneous determination of the available intrachain lysine (known
      as N-epsilon-[2,4-dinitrophenyl]-L-lysine) or the available free and/or N
      terminal lysine (known as N,N'-di-[2,4-dinitrophenyl]-L-lysine). Optimum
      conditions for separation and quantitation are studied. The results show the
      proposed method to be both accurate and precise and suitable for food samples
      containing hydrolyzed proteins.

PMID- 11206913
TI  - Rejuvenate columns that have experienced peak-shape deterioration.

PMID- 11206914
TI  - Stability-indicating high-performance liquid chromatographic assay method and
      photostability of carprofen.
AB  - A rapid, sensitive, and accurate stability-indicating high-performance liquid
      chromatographic assay method for determining the degradation of carprofen (CPF)
      is developed and validated under acidic, basic, or photo-irradiated conditions.
      The analysis is monitored with a Cosmosil 5C18-AR column using a mobile phase of
      CH3CN-H2O-AcOH (50:49:1, v/v/v) at 260 nm. The developed method satisfies the
      system suitability criteria, peak integrity, and resolution among the parent drug
      and its degradation products. The results indicate that the established assay
      method shows good selectivity and specificity suitable for stability measurements
      of CPF. CPF is found to be more sensitive to exposure to light and in acidic
      conditions, but it is stable in a basic medium. The kinetic study of the
      photodegradation of CPF follows an apparent first-order reaction in a variety of
      solvents. The solvent effects on the rates of degradation are in the decreasing
      order of chloroform > dichloromethane > methanol > ethanol > 2-propanol, which is
      irrelevant to the dielectric constant epsilon. However, the hydrogen-donating
      ability of the solvents is essential to the photochemical decomposition of CPF. A
      plot of log k versus the Kirkwood function exhibits a linear relationship in
      aqueous ethanolic solutions, which implies that degradation proceeds via an ionic
      mechanism.

PMID- 11206915
TI  - Therapeutic perspectives of in vivo cell electropermeabilization.
AB  - Cell electropermeabilization (also termed cell electroporation) is nowadays a
      routine technique used in biochemical and pharmacological studies for the in
      vitro introduction of nonpermeant molecules into living cells. But electric
      pulses can be used as well in vivo for the delivery of drugs or DNA into cells of
      tissues. This review then gives an updated overview of the therapeutic
      perspectives of cell electropermeabilization in vivo, in particular of the
      antitumour electrochemotherapy (i.e., the combination of a cytotoxic nonpermeant
      drug with permeabilizing electric pulses delivered to the tumours) and of in vivo
      DNA electrotransfer for gene therapy. After a short summary of the present
      knowledge on cell electropermeabilization (particularly in vivo), the basis, the
      present achievements, and the challenges of electrochemotherapy are described and
      discussed, which includes an overview of still open questions and an update on
      recent clinical trials. DNA electrotransfer for gene therapy is an emerging field
      in which results are rapidly accumulating. Present knowledge on DNA
      electrotransfer mechanisms, as wel as the potentialities of DNA electrotransfer
      to become an efficient non-viral approach for gene therapy, are reviewed.

PMID- 11206916
TI  - An electrochemical evidence of free radicals formation from flutamide and its
      reactivity with endo/xenobiotics of pharmacological relevance.
AB  - This paper reports the feasibility of free radicals formation from flutamide by
      using cyclic voltammetry. The electrochemical characteristics and the reactivity
      of the one-electron reduction product from flutamide in mixed media with thiol
      compounds and the nuclei acid bases are characterized. Results from this paper
      show the thermodynamic feasibility of free radical formation expressed for both
      the cathodic peak potential and the second-order rate constant values. The
      reactivity of the radical towards thiol compounds (glutathione, cysteamine, N
      acetylcysteine) and the nuclei acid base, adenine, thymine and uracil were
      quantitatively assessed through the calculation of the respective interaction
      rate constants. Based on these results, the following tentative order of
      reactivity towards the xeno/endobiotics is as follows: cysteamine > uracil >
      glutathione > adenine > N-acetylcysteine > thymine. The stability of the nitro
      radical anion electrochemically generated from flutamide showed a linear
      dependence with pH.

PMID- 11206917
TI  - Electrooxidation of phenol by catalase immobilized on graphite electrodes.
AB  - Electrocatalytic properties of catalase (CAT) immobilized on graphite and soot to
      mediate electrooxidation of phenol have been investigated. The kinetic parameters
      -Km, k(s), deltaG*Ar and Z0 of the process studied were calculated. Conclusions
      on a probable mechanism of the biocatalytic and electrochemical process observed
      were drawn from the calculated values of activation and kinetic parameters. A
      quantitative UV-spectrophotometrical approach was used as an analytical tool. The
      electrochemical oxidation of phenol was examined with potentiodynamic and
      polarization curves' method.

PMID- 11206918
TI  - The proton uptake channel of bacteriorhodopsin as studied by a
      photoelectrochemical method.
AB  - A series of the mutant proteins (D96N, D96N/D85N, D115N, L93T, T46V, V49A) where
      the residues are located at the cytoplasmic domain of bacteriorhodopsin (bR) were
      studied photoelectrochemically and their photocurrent response characteristics at
      the electrode/electrolyte interface were compared with those of the wild-type bR.
      While the wild-type bR of normal proton pumping activity yields symmetrical
      cathodic (positive) and anodic (negative) responses, corresponding to proton
      release and proton uptake, respectively, these mutants, with the exception of
      D115N, showed diminished amplitudes in the negative response. This indicates
      retardation of proton translocation from the cytoplasmic surface to the retinal
      Schiff base. The mutation that gave the strongest influence on the negative
      response was D96N while moderate influence was obtained with L93T, T46V, and
      V49A. These results suggest that residues other than D96 also participate in the
      cytoplasmic proton uptake channel, either by interacting with D96 directly or by
      forming a hydrogen-bonded network with water molecules. The D96N/D85N double
      mutant yielded little response at neutral pH, but the response was partially
      recovered by addition of azide, while it was fully recovered in the single mutant
      D96N. The D115N mutant showed the response profile that closely resembles the
      wild-type, indicating that D115 is not crucially involved in the event of proton
      transfer relay at the cytoplasmic region. It was also found that every mutant in
      this study releases protons prior to uptake at the other membrane surface, as
      does the wild-type.

PMID- 11206919
TI  - Influence of the hydrodynamics on the biofilm formation by mass transport
      analysis.
AB  - Biofilm are formed wherever there is some water in our environment: pipes,
      pipelines, tap water systems, air conditioning systems... Furthermore, the
      ecological and economical consequences are very important: energy losses,
      bacterial contamination, material deterioration. The aim of this work is to
      develop a new method to detect and monitor the biofilm formation. This method can
      also determine some mechanical properties of the biofilm. An application of this
      method is a realization of a biofilm sensor. Biofilm is considered as an inert
      porous layer with respect to mass transport. In our experiment, the biofilm is
      grown on a gold electrode in natural seawater. Its thickness is determined by
      considering the oxygen diffusion limiting current measured for different rotation
      speeds on this electrode. Two different incubators are used during the biofilm
      development: one, with a laminar flow, permits the rotation of the electrode
      during the biofilm formation, and for the second, a tube is used under turbulent
      conditions during the biofilm formation. This experiment allows us to
      characterize the mechanical behavior (thickness, elasticity, rigidity) of the
      biofilm in function of different conditions of development.

PMID- 11206920
TI  - Acute effects of whole-body exposure to static magnetic fields and 50-Hz
      electromagnetic fields on muscle microcirculation in anesthetized mice.
AB  - Acute microhemodynamic effects of static and alternating magnetic fields at a
      threshold level were investigated on modulating the muscle capillary
      mirocirculation in pentobarbital-anesthetized mice. The skin in a tibialis
      anterior was circularly removed with 1.5 mm diameter for intravital-microscopic
      recording of the capillary blood velocity in the tibialis anterior muscle.
      Fluorescein isothiocyanate (FITC)-labeled dextran (MW 150 kDa) was used for an in
      vivo fluorescent plasma marker of the muscle capillaries. Following a bolus
      injection of FITC-dextran solution into the caudal vein, the peak blood velocity
      in the muscle capillaries was measured prior to, during, and following exposure
      to static magnetic fields (SMF) or 50-Hz electromagnetic fields (EMF) using a
      fluorescence epi-illumination system. The whole body of experimental animals,
      placed on the observing stage of a fluorescence microscope, was exposed to SMF
      (0.3, 1 and 10 mT) or 50-Hz EMF (0.3 and 1 mT) for 10 min using a specially
      devised electromagnet. For sham exposure, the electromagnet was not energized.
      During exposure and post-exposure to SMF of 10 mT, the peak blood velocity
      significantly increased as compared to sham exposure. After the withdrawal of SMF
      and 50-Hz EMF of 1 mT, significant similar effects on the blood velocity were
      present or enhanced. These findings suggest that field intensity of 1 mT might be
      considered as a threshold level for enhancing muscle microcirculation under
      pentobarbital-induced hypnosis.

PMID- 11206921
TI  - 25 Hz electromagnetic field exposure has no effect on cell cycle distribution and
      apoptosis in U-937 and HCA-2/1cch cells.
AB  - It is reported that exposure to 50 Hz extremely low-frequency electromagnetic
      field (ELF-EMF) can produce apoptosis and small variations in cell cycle
      distribution on different cell lines. In order to study the effect of ELF-EMF on
      tumoral cells in vitro, two cell lines (U-937, from a histiocytic lymphoma, and
      HCA-2/1cch, from a human colon adenocarcinoma) were exposed to 25 Hz, 1.5 mT, for
      2 h and 45 min. Cell cycle distribution, apoptosis (spontaneous and dexamethasone
      induced) and cell growth were evaluated. Neither significant alteration in cell
      cycle phases nor induction of apoptosis was observed. Nevertheless, the relative
      cell number was found to decrease to 55.84+/-7.35% (p <0.05, Student's t-test)
      for HCA-2/1cch cells after exposure to EMF in the presence of dexamethasone. The
      presence of dexamethasone during the EMF exposure could probably produce a
      decrease in the cell growth of this cell line.

PMID- 11206922
TI  - Direct electrochemistry of heme proteins: effect of electrode surface
      modification by neutral surfactants.
AB  - Direct electrochemical studies on horse heart myoglobin and horseradish
      peroxidase (HRP) have been carried out using tin-doped indium oxide (ITO) and
      surfactant modified glassy carbon working electrodes. These proteins show very
      slow electron transfer kinetics at metal or untreated electrodes. Moreover, small
      amounts of surface-active impurity were drastically affects the electrode
      reaction of these proteins. The results showed that modification of the electrode
      surface with neutral surfactants significantly improves the electrochemical
      response of myoglobin as well as of HRP. The electrode response was found to
      depend on the structure of the surfactants. The amount of surfactant required per
      unit area of the electrode surface to promote the maximum electron transfer rate
      constants was found to be constant. This indicated that the surfactant molecules
      interacted with the electrode surface in a specific manner and anchored the
      protein molecules to align in the suitable orientation. The hydrophobicity of the
      surfactants rather than their charge was found to be crucial in promoting the
      electrode response of these proteins at the glassy carbon electrode.

PMID- 11206923
TI  - Control by membrane order of voltage-induced permeabilization, loading and gene
      transfer in mammalian cells.
AB  - Cells can be transiently permeabilized by application of electric pulses. A
      direct consequence of this treatment is to create a new state in the membrane
      leading to DNA and protein transfers. A key step, in the interaction between
      macromolecules and the electropermeabilized membrane, is involved. We previously
      reported that membrane and DNA associated hydration and undulation forces
      appeared to be involved in this process by studying the effects of osmotic
      pressure. Effects of ethanol (EtOH) and L-alpha-lysophosphatidylcholine (lyso
      PC), molecules known to affect membrane order and therefore undulation forces,
      were investigated on Chinese hamster ovary (CHO) cells. We used millisecond
      square wave pulses, conditions giving high efficiency for gene transfer. No
      effect was observed on cell permeabilization for small sized molecules. Only
      little change on electroloading of proteins such as R-phycoerythrin was obtained
      in presence of EtOH. But, a decrease (increase) in electrotransfection was
      observed for cells treated with EtOH (lyso-PC). Under our conditions, no
      additional effects of the chemical treatment were observed on cell viability and
      on membrane resealing. These results tentatively explained in terms of the effect
      of membrane order on membrane organization and interaction between molecules and
      membrane supports the existence of the plasmid-membrane interaction in the
      mechanism of electrically mediated gene transfer.

PMID- 11206924
TI  - Kinetic modeling of the photosynthetic electron transport chain.
AB  - A simulation model of the photosynthetic electron transport chain operating under
      steady state conditions is presented. The model enables the calculation of (1)
      the rates of electron transport and transmembrane proton translocation, (2) the
      proton/electron stoichiometry, (3) the number of electrons stored in the
      different redox centers and (4) the stationary transmembrane pH difference. Light
      intensity and proton permeability of the thylakoid membrane are varied in order
      to compare the predictions of the model with experimental data. The routes of
      electron transport and proton translocation are simulated by two coupled
      arithmetic loops. The first one represents the sequence of reaction steps making
      up the linear electron transport chain and the Q-cycle. This loop yields the
      electron flow rate and the proton/electron ratio. The second loop balances the H+
      fluxes and yields the internal H+ concentration. The bifurcation of the electron
      transport pathways at the stage of plastoquinol oxidation is obligatory. The
      first electron enters always the linear branch and is transferred to photosystem
      I. The electron of the remaining semiquinone can enter the Q-cycle or,
      alternatively, the semiquinone can be lost from the cytochrome b6f complex. The
      competition between these two reactions explains the experimentally observed
      variability of the proton/electron ratio. We also investigated additional model
      variants, where the variation of the proton/electron stoichiometry is attributed
      to other loss reactions within the cytochrome b6f complex. However, the
      semiquinone detachment seems to be the best candidate for a satisfactory
      description of the experimental data. Additional calculations were done in order
      to assess the effects of the movement of the Rieske protein on linear electron
      transport; it was found that this conformational change does not limit the
      electron transport rate, if it occurs with a time constant of at least 1000 s(
      1).

PMID- 11206925
TI  - Dissociation and electrooxidation of primaquine diphosphate as an approach to the
      study of anti-chagas prodrugs mechanism of action.
AB  - This paper describes the voltammetric behavior of primaquine as a previous
      support to the further understanding of the delivery and action mechanisms of its
      respective synthesized prodrugs. There are few papers describing the drug
      behavior and most of the time no correlation between oxidation process and pH is
      done. Our results showed that primaquine oxidation is a one-step reaction
      involving two electrons with the charge transfer process being strongly pH
      dependent in acid medium and pH-independent in a weak basic medium, with the
      neutral form being easily oxidized. This leads to the conclusion that quinoline
      nitrogen ring neutralization is a determinant step to the formation of the
      oxidized primaquine form. The existence of a relationship between the primaquine
      dissociation equilibrium and its electrooxidation process is shown. This work
      points the importance of voltammetric methodology as a tool for further studies
      on quantitative relationship studies between chemical structure and biological
      activity (QSAR) for electroactive drugs.

PMID- 11206926
TI  - Enzymatic oxidation of cadmium and lead metals photodeposited on cadmium sulfide.
AB  - Cadmium and lead metals deposited on CdS particles are shown to act as substrates
      -electron donors for enzymes, hydrogenase from Thiocapsa roseopersicina (HG), NAD
      dependent hydrogenase from Alcaligenes eutrophus (NLH), and ferredoxin:NADP
      oxidoreductase (FNR) from Chlorella in the formation of hydrogen, NADH and NADPH,
      respectively. Adsorption of the enzyme on the surface of the metallized CdS
      particle is required for enzymatic oxidation of metal. The maximum rates for the
      formation of hydrogen and NADH catalyzed by hydrogenase and NAD-dependent
      hydrogenase with metals as electron donors are comparable with the rates obtained
      for these enzymes using soluble substrates. Kinetic analysis of the enzymatic
      oxidation of cadmium metal has revealed that the rate decreases mainly due to the
      formation of a solid product, which is supposed to be Cd(OH)2. The deceleration
      of lead oxidation catalyzed by hydrogenase proceeds at the expense of the
      inhibitory effect of the formed Pb2+. The enzymatic oxidation of
      electrochemically prepared cadmium metal is also shown. Based on these results, a
      new mechanism of action of the enzymes involved in anaerobic biocorrosion is
      proposed. By this mechanism, the enzyme accelerates the process of metal
      dissolution through a mediatorless catalysis of the reduction of the enzyme
      substrate.

PMID- 11206927
TI  - ELF magnetic fields initiate protein tyrosine phosphorylation of the T cell
      receptor complex.
AB  - The human T cell line Jurkat registers a sinusoidal extremely low frequency
      (ELF), 0.10 mT magnetic fields (MFs) at the level of the plasma membrane. In this
      study, the protein tyrosine phosphorylation (PY) of two membrane-associated
      proteins in Jurkat cells were examined following a short-term MFs exposure, the
      zeta chains and the Src kinases p56lck. These proteins are interesting to study
      since the earliest biochemical event upon T cell receptor (TcR) activation is PY
      of the zeta chains. These signalling chains in the TcR complex was assessed using
      Western blotting and the activation of the p56lck kinase was analysed by in vitro
      kinase assay. The MFs exposure of Jurkat for 5 min activated p56lck and resulted
      in PY of zeta. These findings are in line with earlier reports on how MFs
      exposure affects signal transduction in Jurkat.

PMID- 11206929
TI  - Mechanical and electromagnetic induction of protection against oxidative stress.
AB  - Cells and tissues can be protected against a potentially lethal stress by first
      exposing them to a brief dose of the same or different stress. This "pre
      conditioning" phenomenon has been documented in many models of protection against
      oxidative stress, including ischemia/reperfusion and ultraviolet (UV) light
      exposure. Stimuli which induce this protective response include heat, chemicals,
      brief ischemia, and electromagnetic (EM) field exposures. We report here that
      constant mechanical vibration pre-conditions chick embryos, protecting them
      during subsequent stress from hypoxia or UV light exposure. Continuously
      mechanically vibrated embryos (60 Hz, 1 g (32 ft/s2), 20 min) exhibited nearly
      double the survival (67.5%, P < 0.001) after subsequent hypoxia as compared to
      non-vibrated controls (37.6%). As a second set of experiments, embryos were
      vibrated and then exposed to UV light stress. Those embryos that were vibrated
      prior to UV had nearly double the survival 3 h after UV exposure (66%, P < 0.001)
      as compared to controls (35%). The degree of protection, however, was dependent
      on the constancy of the vibration amplitude. When vibration was turned on and off
      at 1-s intervals throughout exposure, no increase in hypoxia protection was
      noted. For 50 s on/off vibration intervals, however, hypoxia protection
      comparable to continuous vibration was obtained. In contrast, random, inconstant
      mechanical vibration did not induce protection against subsequent UV exposure.
      These data suggest that to be an effective pre-conditioning agent, mechanical
      vibration must have a degree of temporally constancy (on/off intervals of greater
      than 1 s). Further experiments in both models (hypoxia and UV) indicated an
      interaction between vibration and EM field-induced protection. Vibration-induced
      hypoxia protection was inhibited by superposition of a random EM noise field
      (previously shown to inhibit EM field-induced protection). In addition, EM field
      induced UV protection was inhibited by the superposition of random mechanical
      vibration. Thus, the superposition of either vibrational or EM noise during pre
      conditioning virtually eliminated protection against hypoxia and UV. This link
      between EM field exposures and mechanical vibration is consistent with the
      hypothesis that cells sense these stimuli via a similar mechanism involving
      counter ion displacement.

PMID- 11206928
TI  - Charge displacement by adhesion and spreading of a cell.
AB  - The potentiostatic control of surface charge density and interfacial tension of
      an electrode immersed in an aqueous electrolyte solution offers a possibility for
      direct studies of non-specific interactions in cell adhesion. Unicellular marine
      alga, Dunaliella tertiolecta (Chlorophyceae) of micrometer size and flexible cell
      envelope was used as a model cell and 0.1 M NaCl as supporting electrolyte. The
      dropping mercury electrode acted as in situ adhesion sensor and the
      electrochemical technique of chronoamperometry allowed measurement of the spread
      cell-electrode interface area and the distance of the closest approach of a cell.
      The adhesion and spreading of a single cell at the mercury electrode causes a
      displacement of counter-ions from the electrical double layer over a broad range
      of the positive and negative surface charge densities (from +16.0 to -8.2
      microC/cm2). The flow of compensating current reflects the dynamics of adhesive
      contact formation and subsequent spreading of a cell. The adhesion and spreading
      rates are enhanced by the hydrodynamic regime of electrode's growing fluid
      interface. The distance of the closest approach of an adherent cell is smaller or
      equal to the distance of the outer Helmholz plane within the electrical double
      layer, i.e. 0.3-0.5 nm. There is a clear evidence of cell rupture for the
      potentials of maximum attraction as the area of the contact interface exceeded up
      to 100 times the cross-section area of a free cell.

PMID- 11206930
TI  - The direct electrochemistry of myoglobin at a DL-homocysteine self-assembled gold
      electrode.
AB  - A pair of well-defined redox waves of myoglobin at a DL-homocysteine self
      assembled gold electrode was achieved. Myoglobin can strongly bind to the
      homocysteine self-assembled gold electrode, so the Mb-Hcy self-assembled gold
      electrode was prepared and the standard rate constant (ks) of Mb was calculated
      as 9.3 x 10(-1) s(-1). X-ray photoelectron spectroscopy (XPS) measurements
      demonstrated that Hcy monolayer was formed and Mb was bound to Hcy monolayer.

PMID- 11206931
TI  - Choriocarcinoma-induced suppression of lymphocyte activity.
AB  - The aim of the investigation was to study the influence of human choriocarcinoma
      cell culture supernatants (HCS) on the expression of lymphocyte surface
      molecules. Lymphocytes were stimulated with phytohemagglutinin in culture medium
      supplemented with 50% HCS. After 12 h and 60 h, fluorescence-activated cell
      sorter analysis was performed with specific monoclonal antibodies. After 12 h of
      incubation, the cell surface expression of the classical activation markers CD25,
      CD69, CD71, CD134 and CD3/HLA-DR, as well as of the apoptosis marker CD95 were
      significantly suppressed by HCS. Qualitatively similar results were obtained
      after 60 h. It was concluded that choriocarcinoma-induced suppression might be
      related to a nearly complete block in the cell cycle at early activation steps.
      The clinical and biological relevance of this phenomenon for the maternal-fetal
      tolerance are briefly discussed.

PMID- 11206932
TI  - Tolerance of immunotherapy with a standardized extract of Alternaria tenuis in
      patients with rhinitis and bronchial asthma.
AB  - We studied the safety of immunotherapy with an Alternaria extract in patients
      with rhinitis and bronchial asthma. The few studies that have investigated
      immunotherapy with mold allergens suggest that they cause adverse reactions more
      frequently than do other extracts. All treatments prescribed by our allergology
      service with Alternaria immunotherapy between 1988 and 1996 were recorded and
      analyzed. In all cases a biologically standardized depot extract of Alternaria
      tenuis containing 5 BU/ml was used according to a conventional immunotherapy
      schedule. During the study period 129 patients received immunotherapy with
      Alternaria extract. Of the 3,892 doses given, 1.95% led to adverse reactions,
      which occurred in 39.5% of the patients. Most of the adverse reactions were
      systemic and mild, and reproduced the underlying disease. The risk of adverse
      reactions was significantly higher in children, patients with asthma, and during
      the initial phase of treatment. Patients who suffered from adverse reactions had
      a significantly higher level of total and specific IgE. It was concluded that
      tolerance of Alternaria mold extract was worse than for other allergenic
      extracts, although most reactions recorded were mild. The risk of adverse
      reactions was greater in children and patients with asthma, and during the
      initial phase of immunotherapy.

PMID- 11206933
TI  - Bronchial asthma healthcare costs in Mexico: analysis of trends from 1991-1996
      with information from the Mexican Institute of Social Security.
AB  - Cost trends for bronchial asthma have not been previously estimated in Mexico.
      The increasing prevalence of bronchial asthma as well as its elevated costs make
      it necessary to expand the availability of information for health planners. This
      is a growing problem which has been given little attention in national health
      reports. We did a descriptive, retrospective analysis using national data from
      the Mexican Institute for Social Security. We estimated the number of medical
      consultations provided by the state family medicine and specialty areas. A total
      of 756,843 consultations due to bronchial asthma were provided between 1991 and
      1996 in the service areas under study. The healthcare expenditure for bronchial
      asthma showed an ascending and sustained trend during the study period. When
      analyzing the trends by type of service, a significant increase in in-hospital
      care was observed, ranging from US $14.5 (1991) to $19.8 (1996) million and a
      maximum of $28.4 (1994) million. A similar increase was found in specialty
      consultation, from $3.96 (1991) to $8.5 (1996) million; in emergencies, from $1.
      1 (1991) to $2.9 (1996) million; and family medicine, from $0.66 (1991) to $0.79
      (1996) million. Bronchial asthma follows the same pattern as other
      noncommunicable chronic diseases, increasing in highly urbanized areas and
      nationwide. In order to improve healthcare and maximize results with scarce
      resources, a set of strategies is presented to reduce bronchial asthma
      recurrence, decrease healthcare costs, and improve quality of life.

PMID- 11206934
TI  - Successful treatment of chronic idiopathic urticaria associated with thyroid
      autoimmunity.
AB  - The prevalence of thyroid autoimmunity is high in patients with chronic
      idiopathic urticaria (CIU), but in few selected patients the possible clinical
      benefit of levothyroxine sodium or antithyroid drugs has been studied. The
      objective of the present study was to confirm the prevalence of antithyroid
      antibodies in patients with CIU and to investigate the clinical response to
      levothyroxine sodium or methimazole. Antithyroglobulin and antiperoxidase
      antibodies were measured in 170 consecutive patients with CIU. Twenty-five
      (14.7%) had an antithyroglobulin or antiperoxidase antibody levels > 180 lU/ml
      and all but three were women. Twenty patients with CIU and thyroid autoimmunity
      were treated with levothyroxine sodium if hypothyroidism or normal thyroid
      function were present (18 patients) and with methimazole if hyperthyroidism was
      detected (two patients). Clinical response was evaluated by a clinical score.
      Autologous serum skin test before treatment was performed in 18 patients with
      thyroid autoantibodies. Urticaria resolved rapidly in two patients with Graves'
      disease. The clinical response of urticaria to levothyroxine sodium treatment was
      good in 15 patients and partial in two, whereas only one patient showed no
      improvement in clinical score (p < 0.0005). No changes in the antithyroglobulin
      or antiperoxidase levels were detected. Five patients reported adverse effects.
      The autologous serum skin test was positive in 10 patients and negative in eight.
      After successful treatment the test was repeated in six patients, proving
      negative in four and significantly diminished in two. We concluded that patients
      with CIU and thyroid autoimmunity benefit from treatment with levothyroxine
      sodium or antithyroid drugs. Antithyroid antibodies and positive autologous serum
      skin test in these patients could be markers of autoimmune disease with several
      target organs.

PMID- 11206935
TI  - Sensitization to different mite species in German farmers: clinical aspects.
AB  - Various mite species referred to collectively as house dust and storage mites are
      recognized worldwide as a cause of allergic airway disease. Our study aimed to
      investigate the frequency of sensitization and potential importance of mite
      species in farmers using a broad mite spectrum. A total of 86 German farmers with
      rhinitis and/or asthma were studied by skin prick testing and/or enzyme
      allergosorbent test (EAST) with the following mites: Blomia tjibodas, Blomia
      tropicalis, Blomia kulagini, Glycyphagus domesticus, Thyreophagus entomophagus,
      Euroglyphus maynei, Chortoglyphus arcuatus, Dermatophagoides pteronyssinus,
      Dermatophagoides farinae, Acarus siro, Lepidoglyphus destructor, Tyrophagus
      putrescentiae, Acarus farris and Cheyletus eruditus. Sensitization to at least
      one mite species was detected in 51 patients (59%) by skin prick testing, and in
      31 patients (36%) by EAST. The most frequent sensitizations determined by skin
      tests were found for the three Blomia species, E. maynei and G. domesticus.
      Twelve patients (14%) gave a positive EAST with the predator mite C. eruditus. A
      total of 22 patients gave positive EAST results with the Dermatophagoides
      species. We were able to document sensitization to C. arcuatus, E. maynei and T.
      entomophagus for the first time in Germany. A considerable proportion of the
      German farmers tested were sensitized to storage mites. The allergological
      potential of various mite species has been recognized, some for the first time.
      It was concluded that B. tjibodas, G. domesticus, C. arcuatus and C. eruditus in
      particular should be included in an allergy diagnosis. Further investigations
      into the clinical relevance of the sensitizations and possible cross-reactivity
      between the mite species are necessary.

PMID- 11206936
TI  - Clinical and immunological spectrum of partial DiGeorge syndrome.
AB  - We present four cases of DiGeorge syndrome diagnosed at our center. Onset
      occurred during the neonatal period and was associated with severe congenital
      heart disease. In case 1, the patient had heart disease and absence of thymus.
      Total T-lymphocytes were 34%; total T4-lymphocytes were 27%. Stimulation test
      with phytohemagglutinin (PHA), concanavalin A (conA) and pokeweed mitogen were
      negative. Microdeletion was found in the chromosome 22q11 region. The second case
      involved heart disease, microstomia, round and rotated ears and branchial cyst.
      Total T-lymphocytes were 38% and total T4-lymphocytes 27%. Thymus was absent.
      Microdeletion in the chromosome 22q11 region. Case 3 showed heart disease, renal
      malformation, absence of thymus and parathyroid gland. The patient died 5 days
      postsurgery. Microdeletion was seen at chromosome 22q11. In the fourth case there
      was heart disease, microretrognathia, hypertelorism, short neck, absence of
      thymus and parathyroid glands. Total T-lymphocytes were 22%, total T4-lymphocytes
      15%, and total T lymphocytes for pokeweed mitogen were negative. Microdeletion
      was found at chromosome 22q11. At the age of 13 days the patient died. The cases
      were recorded during a 2-year period, between 1997 and 1998. The prevalence of
      DiGeorge syndrome in the number of admissions for congenital heart disease among
      the neonates at our hospital was 3.14%. Presentation in the form of repeated
      infections is rare, since most cases of DiGeorge syndrome are partial, and
      functional cellular immunity is preserved.

PMID- 11206937
TI  - Isolation and partial characterization of Fes p 4 allergen.
AB  - More than 75% of grass pollen-allergic patients produce specific IgE antibodies
      against group-4 allergens. Purification and characterization of different grass
      group-4 allergens should help to further understand their allergenicity. In this
      study, an attempt was made to isolate and characterize Fes p 4 allergen by
      several biochemical and immunochemical methods. Fes p 4 was purified by a
      combination of chromatographic techniques (gel permeation and ion exchange
      chromatography). Isolated protein revealed four main spots at a molecular weight
      of 60 kDa and a pI ranging from 8.7 to 9.1. Eight sera were selected from
      patients with positive result of skin prick test to the mixture of grass pollen
      extracts. ELISA inhibition technique was used to study Fes p 4-specific IgE in
      the patients' sera. ELISA to Festuca pratensis was inhibited up to 80% by F.
      pratensis pollen extract and up to 48% by Fes p 4. 2D-PAGE-immunoblot was used to
      identify allergenic and antigenic components of Fes p 4 with patients' IgE and
      monoclonal antibodies (MABs). Three components of purified protein expressed IgE
      binding ability. Two MABs which recognized unrelated regions on Phl p 4, bound
      three components of Fes p 4. The role of the carbohydrate moiety in allergenicity
      was examined with individual patient sera by using periodate-treated Fes p 4. Six
      out of eight patients reduced IgE binding to periodate-treated allergen. Isolated
      Fes R 4 glycoprotein consisted of four components, three of which were
      allergenic, and share common epitopes specific for grass group-4 homologs. The
      results of periodate oxidation of Fes p 4 suggest that the carbohydrate moiety is
      involved in IgE binding.

PMID- 11206938
TI  - Dermographism and atopy in patients with Behcet's disease.
AB  - Dermographism is the appearance of whealing and erythema within minutes in a site
      where skin has been exposed to pressure or mechanical irritation. In our clinical
      observations, dermographism seems to be frequent in patients with Behcet's
      disease. Since the prevalence of allergic responses is reportedly increased in
      vasculitic syndromes, we aimed to assess dermographism and atopy in a group of
      Behcet's patients. The study group comprised 30 consecutive patients with
      Behcet's disease. The study was carried out in two parts: elicited dermographism
      and atopy tests. In the first part, dermographism was investigated in the study
      group (Behcet's patients) and 230 healthy controls. In the second part, the study
      group, 30 healthy controls and 17 patients with allergic bronchial asthma were
      evaluated for specific and nonspecific atopy. Dermographism was found to be
      increased in patients with Behcet's disease. Peripheral blood eosinophil count,
      serum total IgE and nasal eosinophil scores were similar in patients with
      Behcet's disease and healthy controls. Although blood eosinophil count and serum
      total IgE levels were higher in allergic bronchial asthma patients than in
      Behcet's patients, the difference was significant only in the former. Skin prick
      test was positive in three of the patients with Behcet's disease and in six
      healthy controls. The difference was statistically insignificant (p > 0.05). None
      of the Behcet's disease patients had pathergy or a pathergy-like reaction at the
      site of the skin prick test after 48 h. In conclusion, our results confirm the
      general impression that dermographism is common in patients suffering from
      Behcet's disease.

PMID- 11206939
TI  - Allergy to ethylenediamine and steroid.
AB  - Intravenous preparations combining aminophylline and a steroid are used
      frequently in the treatment of bronchial asthma attacks. However, anaphylactoid
      reactions to such preparations have been rarely observed. We report the case of a
      31-year-old man with aminophylline and steroid allergy. Aminophylline is the
      ethylenediamine salt of theophylline. In our patient, aminophylline,
      ethylenediamine and various steroids were found to be positive in the intradermal
      test. The challenge test with intravenous aminophylline was positive, while that
      with oral theophylline was negative. Ethylenediamine is used in everyday products
      such as shellacs and rubber products. In the case of our patient, his asthma
      worsened following the remodelling of his restaurant. Occupational asthma due to
      exposure to ethylenediamine is also discussed.

PMID- 11206940
TI  - Non-X-linked hyperimmunoglobulin M syndrome with chronic interstitial
      pneumonitis.
AB  - Hyperimmunoglobulin M (IgM) syndrome is a rare primary immunodeficiency disorder,
      and the non-X-linked form of this syndrome is even more infrequent. We report the
      clinical case of a 6-year-old girl. Her disease began at the age of 1 year when
      she experienced bronchial obstruction. When she was 3 years old she developed
      severe recurrent respiratory infections of unusual clinical course. Serum IgM was
      elevated and the other serum immunoglobulins were absent. Cellular immune
      response was impaired, with severe depression of delayed hypersensitive cutaneous
      response and of proliferative response to mitogens. The CD40 ligand expression
      decreased. Chest CT scan showed areas of lung condensation, bronchial dilatation
      and signs suggesting interstitial pneumonitis. The latter was confirmed by a
      biopsy showing a high number of Langerhans' cells and an early-stage fibrosis.
      She was treated with antibiotics, inhaled bronchodilators and corticosteroids,
      intravenous immunoglobulin, chloroquine and prednisone. Despite the substitution
      therapy, her clinical course was slow, with respiratory infections and oxygen
      dependance. The follow-up thoracoscopic biopsy performed after 18 months of
      immunosuppressant therapy showed a progression of fibrosis and a decrease in the
      inflammatory infiltrate.

PMID- 11206941
TI  - Chronic urticaria associated with chronic myelomonocytic leukemia.
AB  - Although chronic urticaria is usually idiopathic, in rare cases it may be a sign
      of underlying malignancy. We describe the first case of chronic urticaria
      associated with chronic myelomonocytic leukemia. The urticarial lesions healed
      successfully with etoposide, an antineoplastic agent. This case demonstrates that
      cases of chronic urticaria should not to be labeled as idiopathic until diligent
      evaluation has failed to reveal a cause.

PMID- 11206942
TI  - Randomized trial of a patient decision aid for choice of surgical treatment for
      breast cancer.
AB  - A decision aid for the surgical treatment of early breast cancer was evaluated in
      a randomized controlled trial. The decision aid, a tape and workbook, includes
      explicit presentation of probabilities, photographs and graphics, and a values
      clarification exercise. Community surgeons were randomized to use the decision
      aid or a control pamphlet. Patients completed a questionnaire prior to using the
      decision aid, after reviewing it but prior to surgery, and 6 months after
      enrollment. There was no difference in anxiety, knowledge, or decisional regret
      across the 2 groups. There was a nonsignificant trend toward lower decisional
      conflict in the decision aid group. A subgroup of women who were initially
      leaning toward mastectomy or were unsure had lower decisional conflict. Although
      the decision aid had minimal impact on the main study outcomes, a subgroup may
      have benefited. Such subgroups should be identified, and appropriate decision
      support interventions should be developed and evaluated.

PMID- 11206943
TI  - Visual analog scales, standard gambles, and relative risk aversion.
AB  - BACKGROUND: It has been argued that visual analog scales (VASs) elicit an
      individual's measurable value function. The theoretical link between an
      individual's measurable value function v(.) and his or her von Neumann-Morgenstem
      utility function u(.) appears to provide a justification for transforming VAS
      scores into standard gamble (SG) utilities. However, VAS scores have been found
      to be subject to the effects of context, which casts doubt that the procedure is
      properly revealing v(.). METHODS: The authors tested for the effects of context
      on VAS and SG scores. They also explored whether the range-frequency (R-F) model
      of Parducci offers a means of correcting VAS scores for the effects of context.
      RESULTS AND CONCLUSIONS: The R-F model may provide a means of correcting VAS
      scores for the effects of context, but no stable relationship exists between
      these corrected scores and SG utilities. Hence, there remain no grounds for
      transforming VAS scores into SG utilities.

PMID- 11206944
TI  - Factors influencing physicians' judgments of adherence and treatment decisions
      for patients with HIV disease.
AB  - New medications for HIV reduce mortality and morbidity but require strict
      adherence. Thus, physicians treating HIV-positive patients must weigh both
      disease severity and likelihood of adherence when deciding whether to start
      patients on treatment. A national sample of 495 physicians surveyed via mail
      responded to clinical scenarios depicting HIV-positive patients and indicated
      whether they would start patients on medication (response rate = 53%). Scenarios
      varied on the patient characteristics of gender, disease severity, ethnicity, and
      risk group. Physicians predicted that patients with less severe disease, former
      injection drug users, and African American men would be less likely to adhere.
      Perceived adherence and disease severity influenced treatment decisions. Results
      are discussed in the context of attitudes about minority groups and injection
      drug users, which may influence adherence judgments in practice settings.
      Psychological research to identify better methods of predicting medication
      adherence may serve to inform medical decision making.

PMID- 11206945
TI  - General performance on a numeracy scale among highly educated samples.
AB  - BACKGROUND: Numeracy, how facile people are with basic probability and
      mathematical concepts, is associated with how people perceive health risks.
      Performance on simple numeracy problems has been poor among populations with
      little as well as more formal education. Here, we examine how highly educated
      participants performed on a general and an expanded numeracy scale. The latter
      was designed within the context of health risks. METHOD: A total of 463 men and
      women aged 40 and older completed a 3-item general and an expanded 7-item
      numeracy scale. The expanded scale assessed how well people 1) differentiate and
      perform simple mathematical operations on risk magnitudes using percentages and
      proportions, 2) convert percentages to proportions, 3) convert proportions to
      percentages, and 4) convert probabilities to proportions. RESULTS: On average,
      18% and 32% of participants correctly answered all of the general and expanded
      numeracy scale items, respectively. Approximately 16% to 20% incorrectly answered
      the most straightforward questions pertaining to risk magnitudes (e.g., Which
      represents the larger risk: 1%, 5%, or 10%?). A factor analysis revealed that the
      general and expanded risk numeracy items tapped the construct of global numeracy.
      CONCLUSIONS: These results suggest that even highly educated participants have
      difficulty with relatively simple numeracy questions, thus replicating in part
      earlier studies. The implication is that usual strategies for communicating
      numerical risk may be flawed. Methods and consequences of communicating health
      risk information tailored to a person's level of numeracy should be explored
      further.

PMID- 11206946
TI  - Prognostic modeling with logistic regression analysis: in search of a sensible
      strategy in small data sets.
AB  - Clinical decision making often requires estimates of the likelihood of a
      dichotomous outcome in individual patients. When empirical data are available,
      these estimates may well be obtained from a logistic regression model. Several
      strategies may be followed in the development of such a model. In this study, the
      authors compare alternative strategies in 23 small subsamples from a large data
      set of patients with an acute myocardial infarction, where they developed
      predictive models for 30-day mortality. Evaluations were performed in an
      independent part of the data set. Specifically, the authors studied the effect of
      coding of covariables and stepwise selection on discriminative ability of the
      resulting model, and the effect of statistical "shrinkage" techniques on
      calibration. As expected, dichotomization of continuous covariables implied a
      loss of information. Remarkably, stepwise selection resulted in less
      discriminating models compared to full models including all available
      covariables, even when more than half of these were randomly associated with the
      outcome. Using qualitative information on the sign of the effect of predictors
      slightly improved the predictive ability. Calibration improved when shrinkage was
      applied on the standard maximum likelihood estimates of the regression
      coefficients. In conclusion, a sensible strategy in small data sets is to apply
      shrinkage methods in full models that include well-coded predictors that are
      selected based on external information.

PMID- 11206947
TI  - Health values and prospect theory: a comment.
AB  - In a recent volume of Medical Decision Making, Treadwell and Lenert stated that
      under prospect theory, community members compared with patients underestimate the
      utility of health improvements. In this comment, the authors show that this
      statement holds only for a subset of possible preference functions. Furthermore,
      the authors provide arguments that, in general, the rater's current health state
      is not the appropriate reference level if applying prospect theory to health
      valuations.

PMID- 11206948
TI  - The inclusion of patient testimonials in decision aids: effects on treatment
      choices.
AB  - BACKGROUND: Decision aids often provide statistical information and patient
      testimonials to guide treatment choices. This raises the possibility that the
      testimonials will overwhelm the statistical information. METHODS: Prospective
      jurors in Philadelphia County were presented with hypothetical statistical
      information about the percentage of angina patients who benefit from angioplasty
      and bypass surgery (50% and 75%, respectively). They were also given written
      testimonials from hypothetical patients who had benefited or not benefited from
      each of the two treatments. The numbers of patients benefiting and not benefiting
      were varied to be either proportionate to the statistical information or
      disproportionate. In study 1, all participants received 1 testimonial from a
      patient who had benefited from angioplasty and 1 from a patient who had not.
      Participants receiving the proportionate questionnaire version were also given 3
      testimonials from patients who benefited from bypass surgery and 1 from a patient
      who did not, coinciding with the hypothetical statistical information. In
      contrast, participants receiving the disproportionate questionnaire version
      received only 1 testimonial from a patient who benefited from surgery and 1 from
      a patient who did not. In study 2, all participants received 2 examples of
      patients who benefited from angioplasty and 2 who did not. Participants with the
      proportionate questionnaire version received the same testimonials regarding
      surgery as in study 1. Those receiving the disproportionate questionnaire version
      received 2 testimonials from patients who benefited from bypass and 2 from
      patients who did not. Finally, a separate set of participants in study 2 received
      a questionnaire with no testimonials. RESULTS: In study 1, 30% of participants
      receiving the disproportionate questionnaire version chose bypass surgery versus
      44% of those receiving the proportionate questionnaire (P = 0.002 by chi2). In
      study 2, 34% of participants receiving the disproportionate questionnaire version
      chose bypass surgery versus 37% of those receiving the proportionate
      questionnaire (P = 0.59 by chi2). Of those receiving no patient testimonials, 58%
      chose bypass surgery. CONCLUSIONS: The inclusion of written patient testimonials
      significantly influenced hypothetical treatment choices. Efforts to make the mix
      of positive versus negative testimonials proportionate to statistical information
      may, under some circumstances, affect choices in ways that cannot automatically
      be assumed to be optimal.

PMID- 11206949
TI  - A comparison of United Kingdom and Spanish general population time trade-off
      values for EQ-5D health states.
AB  - Few studies have compared preference values for health states obtained in
      different countries. The present study compared Spanish and United Kingdom (UK)
      time trade-off values for EuroQol-5D health states. The same preference
      elicitation protocol was followed in both countries. Differences in values for 43
      health states rated directly were analyzed using t tests, and regression
      coefficients generated by random effects modeling were compared by aggregating
      the 2 value sets and using dummy variables to analyze country effect by dimension
      and level of severity. For the milder health states, Spanish and UK value
      assignation was similar; for intermediate health states, Spanish values were both
      higher and lower than UK values, whereas for health states worse than death, UK
      values were generally higher than Spanish values. There were statistically
      significant differences (P < 0.01) in values for 34.9% of health states rated
      directly, and some preference reversals between countries. UK raters ascribed
      greater importance to dimensions of pain/discomfort and anxiety/depression,
      whereas Spanish raters placed more importance on functional dimensions of
      mobility and self-care. Further analysis is required to determine how these
      differences affect cost-effectiveness and cost-utility analyses.

PMID- 11206950
TI  - Reflections on the beginnings and future of Medical Decision Making.

PMID- 11206951
TI  - Medical Decision Making: 20 years of advancing the field.

PMID- 11206952
TI  - The Society for Medical Decision Making at 21.

PMID- 11206953
TI  - A Society for Medical Decision Making.

PMID- 11206954
TI  - Law and ethics.

PMID- 11206955
TI  - On using the standard gamble to determine utilities for uncertain health states.

PMID- 11206956
TI  - Current issues with blood transfusions in sickle cell disease.
AB  - With increased recognition of the profound morbidity of sickle cell disease and
      with growing evidence of the efficacy of transfusion therapy in prevention and
      treatment of sickle cell complications, most patients now receive intermittent
      transfusion therapy. The purpose of this report is to review blood component
      therapy and Its risks for sickle cell patients. Packed red cells are the
      preferred blood component. Leukocyte-reduced units should be standard because of
      their beneficial effects in reducing alloimmunization, transfusion reactions,
      platelet refractoriness, and infection transmission. The use of washed, frozen,
      or Irradiated units is limited to specific problems. Sickle trait-positive units
      function normally, but because of difficulties with calculating hemoglobin S
      percentages and leukocyte filters, they are not routinely used. Transfusion
      acquired infections have shown a marked decrease but still present a major risk.
      Viral hepatitis transmission is currently low, but at least 10% of adult sickle
      cell patients are hepatitis C positive, and they often have liver damage.
      Although bacterial infections are rare, they account for 16% of transfusion
      related fatalities. Patients who are iron overloaded are particularly vulnerable
      to Yersina enterocolitica. Red cell alloimmunization is a serious problem that
      could potentially affect 50% of transfused patients. However, preventive
      phenotypic matching for common antigens can minimize alloimmunization; limited
      matching for at least E, C, and K has become the standard of care. Recently, more
      patients are being identified who have developed red cell autoantibodies, which
      can mask alloantibodies and occasionally are hemolytic. Careful laboratory
      evaluation of all cases is essential. Transfusions also may trigger sickle cell
      events, including pain crises, stroke, and acute pulmonary deterioration. In
      part, these are induced by blood viscosity and increased blood pressure. Diuretic
      therapy and close monitoring of transfusion volume and vital signs can minimize
      these events. In summary, transfusion therapy carries risks, but the routine use
      of leukocyte-reduced, phenotypically matched units in conjunction with close
      monitoring of patients can make transfusion therapy safer.

PMID- 11206957
TI  - Consensus document for transfusion-related iron overload.

PMID- 11206958
TI  - Techniques for blood administration in sickle cell patients.
AB  - Transfusion therapy provides many benefits to Individuals with sickle cell
      disease but may lead to cardiovascular complications, alloimmunization, exposure
      to infection, and iron overload. Simple transfusion is used to increase oxygen
      carrying capacity. Chronic simple transfusion is useful in preventing a number of
      complications in sickle cell disease. Acute erthrocyte exchange transfusion can
      reduce the percentage of cells containing sickle hemoglobin while decreasing
      volume overload and minimizing hyperviscosity. Chronic erythrocyte exchange
      transfusion reduces iron loading but Increases donor exposure. Directed odnation
      may reduce alloimmunization and exposure to infection.

PMID- 11206959
TI  - Iron overload is a determinant of morbidity and mortality in adult patients with
      sickle cell disease.
AB  - Patients with sickle cell disease (SCD) often require blood transfusion starting
      in early childhood. Multiple blood transfusions on a chronic basis lead to
      excessive accumulation of iron, especially in adults with sickle cell anemia (SS)
      that is progressively increasing in size. Blood exchange transfusion and the use
      of iron chelation therapy may prevent or delay the onset of iron overload. The
      majority of adults with SS, however, require episodic blood transfusions on a
      chronic basis and, hence, are at risk to develop iron overload. Recent reports
      suggest an association between iron overload and organ failure in chronically
      transfused patients. Patients with SCD and iron overload may thus be at increased
      risk to develop organ failure compared to those with normal iron stores. In order
      to clarify this issue we have prospectively collected the following data on our
      adult patients with SCD between 1978 and 1998: (1) the amount of blood
      transfused; and (2) the status of iron stores determined with serum ferritin,
      serum iron, total iron binding capacity (TIBC), and percent transferrin
      saturation (% Sat). Between 1987 and 1998, 247 adult patients with SS were
      regularly followed in our sickle cell center. Of these, 152 (62%) were transfused
      with 4,875 units of red blood cells (RBCs). Transfused patients received an
      average of 10 units of RBCs per year, which is equivalent to about 2.0 g of iron
      per year. This does not include transfusions at other institutions or before
      1987. About one third of the adult patients with SS had % Sat greater than 50 in
      the steady state, suggesting iron overload. During painful episodes serum
      ferritin increased significantly in paired observations. Serum iron and TIBC
      decreased during painful episode disproportionately so that there was a
      significant net decrease in % Sat in paired observations. Patients with low
      values of serum ferritin and % Sat had lower incidence of acute painful episodes
      (38% v 64%) and organ failure (19% v 71%) than those who had iron overload,
      respectively. Mortality was significantly higher in the iron overload group: 64%
      versus 5%, respectively. Taken together, the data indicate that (1) the status of
      iron stores in adults with SS is best determined by keeping accurate records of
      the amount of blood transfused and serial determinations of ferritin levels in
      the steady state; (2) a significant number of adults with SS have iron overload;
      and (3) iron overload seems to be a predisposing factor of disease severity.

PMID- 11206960
TI  - Noninvasive methods for quantitative assessment of transfusional iron overload in
      sickle cell disease.
AB  - Because optimal management of iron chelation therapy in patients with sickle cell
      disease and transfusional iron overload requires accurate determination of the
      magnitude of iron excess, a variety of techniques for evaluating iron overload
      are under development, including measurement of serum ferritin iron levels, x-ray
      fluorescence of iron, magnetic resonance imaging, computed tomography, and
      measurement of magnetic susceptibility. The most promising methods for
      noninvasive assessment of body iron stores in patients with sickle cell anemia
      and transfusional iron overload are based on measurement of hepatic magnetic
      susceptibility, either using superconducting quantum interference device (SQUID)
      susceptometry or, potentially, magnetic resonance susceptometry.

PMID- 11206961
TI  - Indications for red cell transfusion in sickle cell disease.
AB  - Transfusion of red blood cells is an important therapeutic method employed in the
      care of people with sickle cell disease (SCD). There are several clinical
      situations in which patients with SCD clearly need red cell transfusion (RCT). In
      other situations, the indication for RCT is doubtful, controversial, or III
      advised. RCT is used on either an episodic or chronic basis in the management of
      SCD. Episodic transfusions are usually applied in a patient who has already
      developed a serious complication of SCD or are used to reduce the chances for the
      development of a complication. Chronic transfusion therapy is often used to
      prevent the recurrence of a major complication such as a stroke. Recently,
      chronic transfusion has been applied to patients with evidence of cerebrovascular
      disease to prevent the first occurrence of stroke.

PMID- 11206962
TI  - Progression of iron overload in sickle cell disease.
AB  - The expanding indications for transfusions in patients with sickle cell disease
      raise the issues of appropriate measurement of body iron burden and optimal
      timing of iron chelation therapy. In this study, we obtained 42 biopsy specimens
      from 20 patients with sickle cell disease (mean age, 15.7 years) who received
      transfusions. In 12 patients whose mean age was 11.3 years at the time of liver
      biopsy, hepatic iron concentration was measured to provide information about the
      rate of iron accumulation in sickle cell disease, as well as to guide the
      initiation of chelating therapy. Mean hepatic iron concentration after an average
      of 15.4 transfusions administered over 21 months was 9.4 +/- 1.2 mg/g liver, dry
      weight, which did not correlate significantly with determinations of serum
      transferrin or ferritin levels. On Initial liver biopsy, hepatic portal fibrosis
      was noted in 4 of 12 patients. Twenty-nine biopsies in 16 patients were performed
      after variable periods of treatment with deferoxamine. These 16 patients had
      received a mean of 38.5 transfusions over 4 years. Hepatic iron was 14.1 +/- 1.9
      mg/g of liver, dry weight, Indicating poor control of body iron in many patients.
      Cirrhosis was reported in one of 29 and portal fibrosis in 10 biopsy specimens.
      Hepatic iron concentration in patients in whom fibrosis was observed varied from
      8.9 to 37.7 mg/g of liver, dry weight. These data show that after 1 to 2 years of
      conventional transfusions, variable tissue iron concentrations and tissue damage
      are observed in patients with sickle cell disease. In some patients, iron
      chelation therapy may not be appropriate after 1 year of transfusions; in others,
      therapy is clearly indicated by this time to prevent tissue injury. The data also
      suggest that patients with sickle cell disease develop increased portal fibrosis
      at the thresholds previously described in young patients with thalassemia
      (approximately 7 mg/g of liver, dry weight).

PMID- 11206963
TI  - Deferoxamine pharmacokinetics.
AB  - Despite the clinical use of deferoxamine for more than a quarter of a century,
      pharmacokinetic studies are few and have not been performed explicitly in
      patients with sickle cell disorders. Early studies with Intravenous
      administration to healthy volunteers and patients with transfusional overload
      showed that although peak concentrations of deferoxamine were similar in both
      groups, concentrations of ferrioxamine were higher in the latter. In iron
      overloaded patients with hereditary hemochromatosis, an intramuscular 10 mg/kg
      bolus of deferoxamine gave maximal plasma ferrioxamine concentrations exceeding
      those of deferoxamine, whereas in normal controls the reverse was the case. In
      more recent studies with homozygous beta-thalassemia, using continuous
      Intravenous deferoxamine infusion at 50 mg/kg/d, and initial elimination half
      life of 0.28/h and steady-state concentration of 7 micromol/L were observed. In
      these studies, steady-state plasma levels of the predominant deferoxamine
      metabolite B were usually lower than those of unmetabolized deferoxamine. In a
      further intravenous infusion study, the proportion of plasma metabolites was
      higher in those thalassaemia patients with low serum ferritin levels relative to
      their current mean daily deferoxamine dose, suggesting that high metabolite
      levels may predict excessive desferrioxamine dosing. This hypothesis is supported
      by subcutaneous studies in which low doses of slow-release depot deferoxamine
      resulted in significantly lower proportions of plasma metabolites than with
      conventional 8-hour infusions at 40 mg/kg. Because serum ferritin is particularly
      unreliable as a marker of iron overload in sickle cell disorders, measurement of
      metabolites or the relative proportions of deferoxamine and ferrloxamine may help
      identify patients at risk of excessive dosing. Because iron overload is likely to
      become an increasing issue in patients with sickle cell disorders, studies of the
      pharmacokinetics and metabolism of deferoxamine in this patient group are needed.

PMID- 11206964
TI  - Iron chelation therapy in sickle cell disease.
AB  - Iron chelation therapy with deferoxamine enhances iron excretion and removes
      excessive tissue iron in regularly transfused patients with sickle cell disease.
      Long-term studies of deferoxamine in other hemoglobinopathies demonstrate that
      regular chelation therapy also reduces iron-related organ damage and mortality.
      Careful design of chelation regimens and attention to compliance are critical
      elements of successful therapy. The role of new chelators in sickle cell disease
      is currently under Investigation.

PMID- 11206965
TI  - Iron chelation: new therapies.
AB  - Iron chelators are used in clinical practice to protect patients from the
      complications of iron overload and iron toxicity because there is no physiologic
      way for excess iron to be actively excreted. Deferoxamine, the only iron
      chelating agent available for clinical use in the United States, is administered
      as a prolonged (8 to 24 hours) infusion, leading to poor compliance in many
      patients. Although many compounds have been screened in tissue cultures and
      animals as iron chelators, few have reached the stage of phase I and II clinical
      trials. The search for new chelating agents, which includes the "slow-release"
      depot formulation of deferoxamine and the "long-acting" hydroxyethyl starch
      deferoxamine, has been disappointing because clinical trials have not
      demonstrated the intended efficacy. A more promising compound, ICL 670A--an
      orally active representative of a new class of iron chelators designed by
      computer modeling-is a potent and selective iron chelator. Its ability to
      mobilize tissue iron and promote its excretion has been shown in several animal
      models. In phase I dose-finding trials, ICL 670A was well tolerated and had a
      good safety profile. This compound is currently undergoing further clinical
      evaluation.

PMID- 11206966
TI  - Improving adherence with deferoxamine regimens for patients receiving chronic
      transfusion therapy.
AB  - We designed a study to obtain follow-up on behavioral aspects of compliance with
      home deferoxamine administration, explore social factors that might influence
      compliance, and evaluate the effectiveness of a pilot intervention program for
      patients with thalassemia or sickle cell disease who were receiving chronic
      transfusion therapy. Thirty-one patients between the ages of 6 and 21 years and
      their primary caregivers were administered a 24-hour recall Interview about home
      care. Fifteen went on to participate in a Desferal Day Camp, which combined
      educational strategies with peer support. Behavioral measures of treatment
      adherence were similar for most patients with sickle cell disease and
      thalassemia. Patient compliance with days of deferoxamine administration at
      follow-up was associated with initial compliance, perceived support, and patient
      and caregiver knowledge. Increased sharing of responsibilities for home care by
      patients and caregivers and caregiver knowledge were associated with lower
      ferritin and liver iron levels. A subsample of 3 patients who were extremely
      noncompliant with days of deferoxamine administration was examined separately;
      these patients were found to be moderately compliant with the number of hours and
      amount of deferoxamine administered and to share fewer home care tasks with
      primary caregivers. Participation in Desferal Day Camp did not result in
      increases in knowledge or peer support, suggesting that future interventions
      should focus on family support and on improving self-regulatory skills. The
      crucial role of collaboration among patients, families, and health care providers
      in developing interventions to enhance adherence was emphasized.

PMID- 11206967
TI  - Plant tubulins: a melting pot for basic questions and promising applications.

PMID- 11206968
TI  - A new gene trap construct enriching for insertion events near the 5' end of
      genes.
AB  - The gene trap approach is based on the integration of a gene trap vector into the
      genome. This can be done either by electroporation of a plasmid construct or by
      infection with a viral vector. Commonly used viral gene trap vectors have been
      shown to select for integrations near the 5' end of genes. To date, no plasmid
      vector with a similar tendency has been reported. In this paper we describe a new
      plasmid vector, pKC199beta geo. This vector contained a short splice acceptor
      fragment from the Hoxc9 gene, a full length lacZ gene, including an ATG, and a
      reduced activity, mutant neomycin phosphotransferase gene as a selectable marker.
      This vector enriched the population of trapped genes in our gene trap screen for
      insertion events in the 5' end of genes. In the two cases examined the beta
      galactosidase activity pattern accurately reflected the endogenous promotor
      activity.

PMID- 11206969
TI  - Efficient production of transgenic cassava using negative and positive selection.
AB  - In order to improve the efficiency of cassava (Manihot esculenta Crantz)
      transformation, two different selection systems were assessed, a positive one
      based on the use of mannose as the selective agent, and a negative one based on
      hygromycin resistance encoded by an intron-containing hph gene. Transgenic plants
      selected on mannose or hygromycin were regenerated for the first time from
      embryogenic suspensions cocultivated with Agrobacterium. After the initial
      selection using mannose and hygromycin, 82.6% and 100% of the respective
      developing embryogenic callus lines were transgenic. A system allowing plant
      regeneration from only transgenic lines was designed by combining chemical
      selection with histochemical GUS assays. In total, 12 morphologically normal
      transgenic plant lines were produced, five using mannose and seven using
      hygromycin. The stable integration of the transgenes into the nuclear genome was
      verified using PCR and Southern analysis. RT-PCR and northern analyses confirmed
      the transgene expression in the regenerated plants. A rooting test on mannose
      containing medium was developed as an alternative to GUS assays in order to
      eliminate escapes from the positive selection system. Our results show that
      transgenic cassava plants can be obtained by using either antibiotic resistance
      genes that are not expressed in the micro-organisms or an antibiotic-free
      positive selection system.

PMID- 11206970
TI  - Copy number related transgene expression and mosaic somatic expression in
      hemizygous and homozygous transgenic tilapia (Oreochromis niloticus).
AB  - Three lines of transgenic tilapia (Oreochromis niloticus) fish were generated
      with a construct containing a lacZ reporter gene spliced to a 4.7 kb 5'
      regulatory region of a carp beta actin gene. All these three lines contain
      different copy numbers of transgenes and the levels of lacZ expression were found
      to be related to transgene copy number. Mosaic patterns of somatic lacZ
      expression were observed in these three lines which differed between lines but
      were consistent within a line. We also observed that expression of the reporter
      gene in homozygous transgenic fish was approximately two-fold greater than in the
      hemizygous transgenics. Analysis of expression of the reporter gene on a tissue
      to-tissue basis demonstrated that lacZ expression of the reporter gene in stably
      transformed fish occured with variable intensity in different organs and tissues
      and was also sometimes variable in different cells of the same tissue in Gland G2
      generations of the transgenic lines.

PMID- 11206971
TI  - Constitutive expression of interferon-induced human MxA protein in transgenic
      tobacco plants does not confer resistance to a variety of RNA viruses.
AB  - MxA is a key component in the interferon-induced antiviral defense in humans.
      After viral infections, MxA is rapidly induced and accumulates in the cytoplasm.
      The multiplication of many RNA viruses, including all bunyaviruses tested so far,
      is inhibited by MxA. These findings prompted us to express MxA in plants in an
      attempt to create resistance to tospoviruses. Here, we report the generation of
      transgenic tobacco plants that constitutively express MxA under the control of
      the 35 S cauliflower mosaic virus promotor. Northern and western blot analysis
      confirmed the expression of MxA in several transgenic plant lines. MxA expression
      had no obvious detrimental effects on plant growth and fertility. However,
      challenge experiments with tomato spotted wilt virus, tomato chlorotic spot
      virus, and groundnut ringspot virus revealed no increased resistance of MxA
      transgenic tobacco plants to tospovirus infections. Neither was the
      multiplication of tobacco mosaic virus, cucumber mosaic virus and potato virus Y
      inhibited in MxA-transgenic plants. The results indicate that the expression of
      human MxA alone does not enhance virus resistance in planta.

PMID- 11206972
TI  - Deletion of the gene encoding H-FABP/MDGI has no overt effects in the mammary
      gland.
AB  - Heart fatty acid binding protein (H-FABP) is expressed abundantly in the mammary
      gland. A number of in vitro studies have shown that H-FABP is functionally
      indistinguishable from a factor isolated from this organ, termed mammary derived
      growth inhibitor (MDGI), which specifically inhibits the proliferation of mammary
      tissue. We have previously shown that over-expression of H-FABP/MDGI in the
      mammary gland of transgenic mice has no discernable effects on cell proliferation
      or differentiation. In this report we describe knockout mouse in which the H
      FABP/MDGI gene has been specifically disrupted. The mice exhibit no overt
      phenotype in the mammary gland, and we conclude that this gene does not play a
      specific role in regulating the normal development or function of this tissue.

PMID- 11206973
TI  - Constitutive expression of soybean ferritin cDNA in transgenic wheat and rice
      results in increased iron levels in vegetative tissues but not in seeds.
AB  - We used particle bombardment to produce transgenic wheat and rice plants
      expressing recombinant soybean ferritin, a protein that can store large amounts
      of iron. The cDNA sequence was isolated from soybean by RT-PCR and expressed
      using the constitutive maize ubiquitin-1 promoter. The presence of ferritin mRNA
      and protein was confirmed in the vegetative tissues and seeds of transgenic wheat
      and rice plants by northern and western blot analysis, respectively. The levels
      of ferritin mRNA were similar in the vegetative tissues of both species, but
      ferritin protein levels were higher in rice. Both ferritin mRNA and protein
      levels were lower in wheat and rice seeds. ICAP spectrometry showed that iron
      levels increased only in vegetative tissues of transgenic plants, and not in the
      seeds. These data indicate that recombinant ferritin expression under the control
      of the maize ubiquitin promoter significantly increases iron levels in vegetative
      tissues, but that the levels of recombinant ferritin in seeds are not sufficient
      to increase iron levels significantly over those in the seeds of non-transgenic
      plants.

PMID- 11206975
TI  - Isogenic transgenic homozygous fish induced by artificial parthenogenesis.
AB  - As a model system for vertebrate transgenesis, fish have many attractive
      advantages, especially with respect to the characteristics of eggs, allowing us
      to produce isogenic, transgenic, homozygous vertebrates by combining with
      chromosome-set manipulation. Here, we describe the large-scale production of
      isogenic transgenic homozygous animals using our experimental organism, the mud
      loach Misgurnus mizolepis, by the simple process of artificial parthenogenesis in
      a single generation. These isogenic fish have retained transgenic homozygous
      status in a stable manner during the subsequent 5 years, and exhibited increased
      levels of transgene expression. Furthermore, their isogenic nature was confirmed
      by cloned transgenic homozygous offspring produced via another step of
      parthenogenic reproduction of the isogenic homozygous transgenic fish. These
      results demonstrate that a combination of transgenesis and artificial
      parthenogenesis will make the rapid utilization of genetically pure homozygous
      transgenic system in vertebrate transgenesis possible.

PMID- 11206974
TI  - Overexpression of the calcium-dependent protein kinase OsCDPK2 in transgenic rice
      is repressed by light in leaves and disrupts seed development.
AB  - Independent transgenic rice lines overexpressing the rice CDPK isoform OsCDPK2
      were generated by particle bombardment. High levels of OsCDPK2 were detected in
      leaves removed from etiolated plants, as well as in stems and flowers. However,
      there was no overexpression in green leaves that had been exposed to light,
      confirming that OsCDPK2 protein stability was subject to light regulation. The
      morphological phenotype of transgenic plants producing high levels of recombinant
      OsCDPK2 was normal until the onset of seed development. Flowers developed
      normally, producing well-shaped ovaries and stigmas, and mature anthers filled
      with pollen grains. However, seed formation in these plants was strongly
      inhibited, with only 3-7% of the flowers producing seeds. Seed development was
      arrested at an early stage. We discuss these data with respect to the possible
      requirement for specific CDPK isoforms during rice seed development.

PMID- 11206976
TI  - Floral spray transformation can efficiently generate Arabidopsis transgenic
      plants.
AB  - In this study, floral spray and floral dip were used to replace the vacuum step
      in the Agrobacterium-mediated transformation of a superoxide dismutase (SOD) gene
      into Arabidopsis. The transgene was constructed by using a CaMV 35S promoter to
      drive a rice cytosolic CuZnSOD coding sequence in Arabidopsis. The transgene
      construct was developed in binary vectors and mobilized into Agrobacterium. When
      Arabidopsis plants started to initiate flower buds, the primary inflorescence
      shoots were removed and then transformed by floral spray or floral dip. More than
      300 transgenic plants were generated to assess the feasibility of floral spray
      used in the in planta transformation. The result indicates that the floral spray
      method of Agrobacterium can achieve rates of in planta transformation comparable
      to the vacuum-infiltration and floral dip methods. The floral spray method opens
      up the possibility of in planta transformation of plant species which are too
      large for dipping or vacuum infiltration.

PMID- 11206977
TI  - Active expression of the ubiA gene from E. coli in tobacco: influence of plant ER
      specific signal peptides on the expression of a membrane-bound prenyltransferase
      in plant cells.
AB  - The ubiA gene from E. coli codes for 4-hydroxybenzoate: polyprenyldiphosphate 3
      polyprenyltransferase, an integral membrane protein involved in ubiquinone
      biosynthesis. This prokaryotic membrane protein was stably expressed in tobacco
      using Agrobacterium tumefaciens-mediated transformation. Transgenic lines
      containing a direct fusion of the ubiA structural gene to a 35S-derived promoter
      gave very low enzyme activity levels (average 0.16 pkat/mg). Inclusion of an N
      terminal ER-specific signal peptide from a lectin gene from Phaseolus vulgaris
      resulted in an average activity of 1.08 pkat/mg in the transgenic tobacco lines.
      The additional inclusion of a C-terminal HDEL tetrapeptide, responsible for the
      retention of proteins in the endoplasmic reticulum of eukaryotic cells, increased
      the activity to 18.6 pkat/mg. When the promotor of this construct was changed
      from the 35S derivative to the recently described very strong plant promoter
      (ocs)3mas, the activity increased further to 128.6 pkat/mg. The most active
      tobacco line showed activities of the introduced enzyme which exceeded those of
      wild-type E. coli (the source of ubiA) by a factor of 1100. These results
      demonstrate the efficacy of plant ER-specific signal peptides for the active
      expression of a prokaryotic membrane protein in plants.

PMID- 11206978
TI  - Molecular farming-OECD workshop. Organisation for Economic Cooperation and
      Development.

PMID- 11206979
TI  - Effects of hyaluronic acid on the morphology and proliferation of human
      chondrocytes in primary cell culture.
AB  - Hyaline articular cartilage is a specialised connective tissue with weight
      bearing and adsorbing functions. Injury or loss of which often leads to impaired
      joint function and severe pain. Since the self-renewing abilities of hyaline
      articular cartilage are limited, there is major interest in the development of
      bioengineered cartilaginous implants. A cell-matrix-biocomposite composed of a
      collagen I/III scaffold seeded with autologous chondrocytes is currently being
      used in clinical trials; however, in order to optimise culture conditions, we
      cultured human condrocytes and seeded them on type I/III collagen membranes and
      on Thermanox plastic coverslips with media containing 0 to 500 microg/ml
      Hyaluronic Acid. After 4 days, the cells were either fixed or BrdU incorporation
      procedures begun. HE staining clearly demonstrated that cells grown in HA form
      three dimensional clusters and produce secretory vesicles as opposed to the
      monolayer control cells with noticeably fewer secretory vesicles. BrdU
      incorporation revealed a noticeable increase in cell proliferation in cells grown
      in 100 microg/ml; however, no comparable increase in 500 micorg/ml but rather a
      slight depression in proliferation. Immunohistochemistry for collagen II and
      aggrecan revealed an obvious increase in deposition of these two substances with
      increased HA administration as compared to the control; however, again, the
      higher concentration of HA, 500 microg/ml, did not result in a further increase
      in production. These results suggest that HA at 100 microg/ml not only influences
      chondrocytes to differentiate and produce more Collagen II and aggrecan, but also
      increases proliferation. We, therefore, propose that the addition of HA at low to
      middle dosages in condrocyte culturing might help improve condrocyte
      redifferentation and thus, the bioengineered cartilage.

PMID- 11206980
TI  - Functional and angioarchitectural structure and classification of lingual
      papillae on the postero-dorsal surface of the beagle dog tongue.
AB  - A scanning electron microscopic study was done of the three-dimensional,
      morphological structure and classification by means of microvascular cast
      specimens (MVCS) of the filiform (FiP), fungiform (FuP) and circumvallate
      papillae (CvP) on the postero-centro-peripheral, and conical papillae (CoP) on
      the posteroperipheral-dorsal surface of the caudal portion of the beagle dog
      tongue. The characteristics and functional arrangement of each lingual papilla
      were as follows: the FiP densely and geometrically covered the entire postero
      centro-peripheral dorsal surface. The outer structure of the FiP, consisting of
      both the ascending and descending branches from their tributaries, was a spoon
      like capillary micro-network structure with a sharp arrowhead-like top inclined
      posteriorly. On the other hand, the outer structure of the FuP, appearing
      sporadically on the oblique lines of the FiP, was of round form consisting of a
      capillary microvascular network structure. The FuP, consisting of ascending and
      descending branches similar to the FiP, were distributed sporadically and
      geometrically on oblique lines in a V-form running from both peripheral sides to
      postero-central direction on the FiP A group of three CvPs were arranged on
      oblique lines in a V form from the peripheral to the postero-central region on
      the postero-dorsal surface. The outer shape of the microvascular network
      structure of the CvP was a round fence-like structure surrounding the papillary
      body and the papillary body consisted of an inner semi-spherical microvascular
      network structure. The CoP densely covered the entire postero-peripheral-dorsal
      surface. The exterior figure of the conical micro-network structure, consisting
      of both the ascending and descending branches of the CoP, was a cone-like
      capillary network structure, and the sharp tops were inclined posteriorly. They
      were classified into three types: large (L-CoP), medium (M-CoP) and small (S-CoP)
      according to the morphological characteristics in shape, size and the
      distributive position. It was conjectured that the FiP play a concentric
      functionally important role in transporting food and liquid from both sides in a
      postero-central direction towards the pharynx. And, on the other hand, the FuPs
      play an assistant role in receiving gustatory sensations from the masticated food
      and liquid on the central dorsal surface. The CoP play a functionally important
      role on the postero-peripheral-dorsal surface, in transporting food and liquid
      towards the pharynx and a complementary role of the CvP is to receive gustatory
      sensations from masticated food and liquid on the postero-peripheral-dorsal
      surface of the caudal portion of the beagle dog tongue.

PMID- 11206981
TI  - The secondary tongue of Salamandra salamandra: histochemical and ultrastructural
      aspects of the developing lingual epithelium.
AB  - The development of the lingual epithelium of Salamandra salamandra was
      investigated with emphasis on histochemical and ultrastructural aspects. The
      temporal and spatial occurrence and the typical appearance of various cell types;
      i.e. pavement cells, replacement pavement cells, basal cells, mitochondria rich
      cells, goblet cells and glandular cells have been analysed and documented in
      detail from the young larval stage up to the metamorphosed animal (2 months after
      metamorphosis). It is shown that anatomical re- and de novo-constructions related
      to the formation of the secretory tongue led to distinct changes in the cellular
      equipment of the epithelium of the tongue, including various histochemical
      properties. Finally, functional aspects of the morphological characteristics are
      discussed in detail and compared with respective findings in other species.

PMID- 11206982
TI  - The development of the tooth pattern and dentigerous bones in Polypterus
      senegalus (Cladistia, Actinopterygii).
AB  - The formation sequence of the tooth-bearing bones and the tooth pattern in early
      ontogeny of Polypterus senegalus is investigated using transparent preparation,
      histological sections, and SEM. During the attachment step of the yolk-sac larva
      the first dermal bones and teeth are formed. Teeth appear simultaneously in the
      areas of the maxillary, dentary, dermopalatine, prearticular, and coronoid 1
      along with the first separate anlagen of these bones. A monostichous arrangement
      of primary teeth is established on the maxillary, dentary, and dermopalatine.
      Polystichous tooth arrangements do not occur before the early pterolarval phase,
      and then only in connection with bones of the palate and inner dental arcades.
      Especially pronounced is the influence of tooth formation on the structure of the
      parasphenoid that becomes much thickened by accretion of denticulate platelets,
      but we found neither evidence for a distinct vomeral contribution to the
      parasphenoid, nor a composite origin of the ectopterygoid in ontogeny. First
      replacement teeth are found in association with the maxillary and dentary as
      early as the late apterolarval phase. Primary teeth are of a single general type,
      whereas from the pterolarval phase onward three tooth types can be distinguished
      that are restricted to certain tooth bearing bones. Relatively late in ontogeny,
      dermo-metapterygoid and entopterygoid become formed and colonised by teeth,
      whereas first branchial teeth and tooth plates appear earlier during the first
      phase of extrinsic larval feeding. Characteristics of development of the
      dentition are discussed in comparison with character states of other better known
      fossil and recent taxa among Actinopterygii and Sarcopterygii. Compared to the
      assumed basic pattern of actinopterygian fishes, Polypteriformes show a derived
      condition with respect to structure, arrangement, replacement, and
      differentiation of teeth, which arises in sequence during larval development.
      This also corresponds to observed changes of feeding behaviour and functional
      demands during larval life.

PMID- 11206983
TI  - Anatomical composition of the anterior shoulder joint capsule. A cadaver study on
      12 glenohumeral joints.
AB  - Twelve right cadaver shoulder joints were investigated after alcohol-formalin
      glycerol fixation. The tendons of the "rotator cuff" were separated from the
      joint capsule. The capsulo-ligamentous structures: Lig. coracohumerale, Lig.
      coracoglenoidale and Ligg. glenohumeralia were dissected. In addition to the
      Ligg. glenohumerale superius, medium et inferius, an "unknown glenohumeral
      ligament" coursed in the midline of the superficial layer of the anterior
      shoulder joint capsule. It arose from the axillary part of the Lig. glenohumerale
      inferius and the insertion tendon of the Caput longum m. tricipitis brachii,
      coursed upwards laterally and fused with the Lig. glenohumerale medium. Between
      the Ligg. glenohumerale medium et inferius it was connected with the shoulder
      joint capsule by loose connective tissue. Craniolaterally it melted into the
      superior portion of the M. subscapularis and inserted together with its tendon to
      the Tuberculum minus of the Humerus. The ascending fibres of the "unknown
      glenohumeral ligament" and the oblique, descending fibres of the Ligg.
      glenohumeralia medium et inferius crossed twice and formed X-shape connections
      between the ligaments. In external rotation and abduction or anteversion the
      course of fibres of the "unknown glenohumeral ligament" was spiral. According to
      the shape and anatomical position of the "unknown glenohumeral ligament" we
      propose to name it "Lig. glenohumerale spirale".

PMID- 11206984
TI  - Development of the membranous labyrinth of human embryos and fetuses using
      computer aided 3D-reconstruction.
AB  - The last detailed description of the development of the inner ear membranous
      labyrinth goes back to Streeter in 1918. This investigation can be regarded to be
      of outstanding scientific value. However, at that time no staging system of human
      embryos existed. In this respect, Streeter's work is outdated. It was the aim of
      this study to reinvestigate the development of the membranous labyrinth in human
      embryos and fetuses of which the developmental stages have been determined
      according to the Carnegie staging system and to compare the results with the
      literature. Serial histologic sections in the coronal or frontal plane of the
      heads of human embryos and fetuses of different developmental stages were used
      for computer aided 3D-reconstruction of the membranous labyrinth. From the
      obtained results, it is concluded that the endolymphatic duct develops earlier
      than previously described in the literature. The induction of the differentiation
      of the endolymphatic duct does not correspond with the superficial ectoderm
      because the endolymphatic duct develops medial of the otic vesicle. The
      membranous labyrinth determines the form of the petrosal bone as early as in
      stage 19 (47-48 days post conception).

PMID- 11206985
TI  - 3D-reconstruction of craniofacial structures of a human anencephalic fetus. Case
      report.
AB  - It was the purpose of this study to investigate the craniofacial bones,
      cartilages and major blood vessels of a human anencephalic fetus and to describe
      the malformations of these structures accompanying this developmental disruption.
      The head of a 16 week old human fetus with anencephaly was serially sectioned and
      the craniofacial bones, cartilages and major blood vessels were traced and
      reconstructed by 3D-computer technology. The sphenoidal, temporal and occipital
      bones showed severe malformations, whereas the bones of the facial cranium were
      normally developed. Both internal carotid arteries ended within the cerebro
      vascular area with no further branches. The vertebral arteries also ended within
      the cerebro-vascular area. No arterial circle of Willis was developed. The
      notochord terminated normally in the sphenoid body. The observations indicate
      that the possible reason for this malformation was non-closure of the anterior
      neuropore of the neural tube. The normal termination of the notochord suggests
      that it had no influence on the pathogenesis of this malformation. The
      malformations of the temporal and occipital bones are contradictory to the
      hypothesis of Marin-Padilla (1991) that anencephaly is caused by a maldevelopment
      of the sphenoidal bone.

PMID- 11206986
TI  - Osteological investigations of the incidence of cranial alterations in domestic
      ducks (Anas platyrhynchos f. dom.) with feather crests.
AB  - The feather crest of the domestic duck (Anas platyrhynchos f. dom.) represents a
      peculiar mutation of the integument of the head, which has been known since the
      17th century. In literature this is described as a variety with malformations in
      skull and brain anatomy in which various central nervous deficiencies in affected
      birds are possible. Our examinations demonstrated several conspicuous anatomical
      alterations in the skulls of domestic ducks with feather crests. Osteophytes of
      different size in the hypodermis of the crest integument were found as well as
      cranial perforations located in the parieto-occipital region. In morphometric
      studies, a significant increase in the capacity of the cranium was found in
      Crested ducks compared to other examined breeds (Abacot Ranger, German Pekin
      ducks). This increase in cranial capacity in Crested ducks results from the
      occurrence and enlargement of a tentorial fatty depot during craniogenesis. The
      formation and enlargement of the fat body can influence cranium growth as long as
      the cranial bones are not entirely fused. Thus, in comparison to other
      phenotypically similar domesticated birds like the crested chicken, the
      expression of feather crests in domestic ducks demonstrates symptomatologic
      differences. In conclusion, our examinations demonstrate that the skulls of
      Crested ducks show various peculiar morphological alterations whose genesis is up
      to now not known with satisfactory accuracy. Further investigations are
      continuing to assertain whether there are linkages between cranial alterations
      (malformations of the calvaria, osteophytes, increased capacity of the cranium)
      and the extremely high prenatal and postnatal mortalities and numerous
      abnormalities described in crested breeds of the domestic duck.

PMID- 11206987
TI  - Musculoskeletal system of the neck of the polar bear (Ursus maritimus) and the
      Malayan bear (Helarctos malayanus).
AB  - The gross anatomical study was undertaken in the musculoskeletal system of the
      neck of the polar bear, and the findings were compared with those of the Malayan
      bear. The Musculus splenius and the M. trapezius were well-developed in the polar
      bear. The long neck of the polar bear consisted mainly of the M. splenius with
      the M. biventer cervicis and the M. complexus lying tightly underneath. The
      cervical vertebrae possessed huge ventral tubercle in the ventral part of the
      transverse process in the polar bear. These morphological characteristics suggest
      that the polar bear may rotate and bend the skull and the long cervical
      vertebrae. We postulate that the polar bear has evolved the high-mobility long
      neck to adapt for swimming. Unlike the polar bear, the Malayan bear has not
      specialized in the neck structure.

PMID- 11206988
TI  - Lack of inferior thyroid artery.
AB  - In the present study, a case of a cadaver is reported in which variations of some
      branches of both subclavian arteries occur. Among the most impressive findings is
      the lack of the right inferior thyroid artery combined with an abnormal
      ramification of the right superior thyroid artery, the terrace-like course of the
      left inferior thyroid artery and variations in the course of the prevertebral
      segment of both vertebral arteries with a high entry into the transverse cervical
      foramen of one of them. A morphometric description of the arterial variations has
      been carried out and their possible significance for the surgical and diagnostic
      practice is outlined.

PMID- 11206989
TI  - A modified Spalteholz technique with preservation of the histology.
AB  - The Spalteholz technique for producing clear macroscopic specimens was introduced
      100 years ago, and is still in use today because it immediately provides
      transparent three-dimensional specimens. The classical clearing procedure with
      peroxide severely damages formalin-fixed tissue and inhibits further
      investigation on a histological level. We, therefore, wanted to make a
      transparent specimen by a modified Spalteholz method and chose the human larynx
      as an example of a large specimen. Its blood vessels were injected with gelatin,
      the specimen treated with acetone and peracetic acid and subjected to freeze
      substitution. After complete dehydration, benzyl benzoate and dimethylphthalate
      were used for impregnation. The cleared specimen satisfactorily revealed the
      laryngeal blood vessels and such structures as muscles, cartilage and the thyroid
      gland. The histology of the laryngeal glands, thyroid tissue, and infrahyoid
      muscle fibres was preserved. Tissue shrinkage became apparent with subsequent
      steps of the clearing procedure. We conclude that our modifications maintain the
      transparency of the specimen and allow histological investigation. The herein
      described technique thus constitutes an improvement of the classical Spalteholz
      technique.

PMID- 11206990
TI  - Re: "Cancer incidence near radio and television transmitters in Great Britain. I.
      Sutton Coldfield transmitter; II. All high power transmitters".

PMID- 11206991
TI  - Severe syndrome of inappropriate antidiuretic hormone secretion with docetaxel
      treatment in metastatic breast cancer.

PMID- 11206992
TI  - Lise Meitner and Niels Bohr--a historical note.

PMID- 11206993
TI  - Palliative medicine--a research challenge.

PMID- 11206994
TI  - Palliative care--past and future--questioning great expectations.
AB  - This paper argues that the future of palliative care cannot be divined reliably
      without considering how a set of basic questions might be answered by health-care
      professionals, administrators of health care systems, and citizens in countries
      throughout the world. Seven of the many questions centering on the mission of
      palliative care are explored here as pathways into the future of how we care for
      gravely ill and dying people. That future cannot be predicted from the vantage
      point of some super observatory. It will rather emerge from the responses we give
      now to a range of questions such as the seven considered in this paper. These
      questions identify fundamental dimensions of the mission of palliative care, and
      our responses will determine when, and where that mission will become reality.

PMID- 11206995
TI  - Psychosocial aspects in palliative care--communicating with the patient and
      family.
AB  - The dynamics surrounding the patient and family facing a death as the 'unit of
      care' is discussed. Aspects of communication, openness within the family,
      especially concerning children and teenagers, and factors that enable a family to
      function under the stress of a loved one's terminal illness are explored. The use
      of a genogram in palliative care to help to piece together the family dynamics
      and available support is fundamental to the care for the whole family.

PMID- 11206996
TI  - Qualitative research methods in palliative medicine and palliative oncology--an
      introduction.
AB  - Qualitative research methods can be used as a complement to quantitative methods
      in palliative research. Possible applications are 1) for the induction of
      hypotheses, 2) for the development of quality-of-life instruments, 3) for the
      exploration of complex phenomena and personal experiences, 4) for studying
      attitudes, 5) for the observation of interactions and 6) for validation of
      quantitative results. Depending on the context and the research question,
      different qualitative methods such as hermeneutics, phenomenology, grounded
      theory or phenomenography might be used. The assumptions, the main steps and the
      methods are briefly described, with some examples from palliative situations.

PMID- 11206997
TI  - Cancer patients' perceptions of their participation and own resources after
      receiving information about discontinuation of active tumour treatment.
AB  - The focus of most studies on informational needs has been on primary cancer
      diagnosis. The aim of this study was to explore how cancer patients in a
      palliative care setting perceived their own participation and resources after
      receiving information about the discontinuation of active tumour treatment.
      Thirty cancer patients admitted to a hospital-based home-care unit participated
      in the study. Semi-structured interviews were conducted and analysed using a
      phenomenographic method. The patients described their own participation as being
      either verbally passive or active, in order to receive more information or to
      avoid information. Furthermore, previous knowledge, at different levels, was
      described as important: 1) Unsuspecting naive, 2) apprehensive suspicious, 3)
      well prepared. Patients' own resources included a sense of wellbeing, a sense of
      security and individual strength. In conclusion, patients' previous knowledge and
      own resources are important components for their capacity to take part in the
      dialogue when receiving information.

PMID- 11206998
TI  - Are mobile phones harmful?
AB  - There is increasing public interest in health risks of mobile phone use. Although
      there is a vast body of material on the biological effects of radiofrequency
      fields, current risk assessment is still limited. The article describes several
      hypotheses and results of biological effects such as thermal effect, genetic and
      carcinogenic effects and cancer related investigations. Mobile phones transmit
      and receive waves of frequencies mainly at 800-1800 MHz. Findings on the thermal
      effect of acute exposure to radiofrequency fields were consistent, resulting in
      an increase of cellular, tissue or body temperature by 1 degree C or more.
      Guidelines for risk limits are based on this thermal effect. Experimental
      investigation suggests that radiofrequency fields are not tumor initiators and
      that if they are related to carcinogenicity, this would be by tumor promotion or
      by increasing the uptake of carcinogens in cells. Implications of these
      experimental results on public health concerns are yet unclear. Few
      epidemiological studies are available on the use of mobile phones or on the
      radiofrequency exposure and the development of cancer. Most of these studies have
      no or little quantitative exposure data and they are limited by the small number
      of observations. Large epidemiological studies are necessary in order to
      investigate the use of mobile phones on the development of cancer. It should be
      emphasized that even a small elevated risk may have a large implication for
      public health, as the use of mobile phones and the exposure is rapidly
      increasing.

PMID- 11206999
TI  - Maspin--a novel protease inhibitor with tumor-suppressing activity in breast
      cancer.
AB  - Maspin (mammary serpin) is a novel serine protease inhibitor related to the
      serpin family with a tumor-suppressing function in breast cancer. Maspin was
      originally identified from normal mammary epithelium by subtractive hybridization
      and might function as a class II tumor-suppressor gene. Maspin's decreased
      expression with increased level of malignancy and its loss in metastatic cells is
      regulated at the transcriptional level. Cytosin methylation and
      heterochromatinization in the promoter region might account for this down
      regulation of maspin. Transfection of tumor cells with maspin cDNA inhibits
      invasion and motility and decreases tumor growth and metastatic ability in nude
      mice. Maspin interacts with the p53 tumor-suppressor pathway and function as an
      inhibitor of angiogenesis in vitro and in vivo. The progressive loss of
      expression of maspin during tumor progression makes this new protein an
      interesting diagnostic and prognostic marker. The re-expression of maspin by
      pharmacological intervention potentially offers a promising approach as a
      therapeutic option in breast cancer therapy.

PMID- 11207000
TI  - Follow-up after primary treatment for breast cancer.
AB  - Follow-up after primary treatment for breast cancer is a routine practice aiming
      at early detection and management of local recurrences and/or distant metastases
      of the disease or of new primaries. Breast self-examination and periodic physical
      examination, mammography, and pelvic examination are the most important methods
      in following-up these patients. The, at one time, more popular intensive routine
      diagnostic evaluation (including head, chest, abdominal, and pelvic computerized
      tomography and/or magnetic resonance imaging, liver ultrasonography, bone scans,
      tumor markers, etc.) is not currently considered appropriate and cost-effective.
      However, flexibility, based on clinical judgement, is required on the part of
      medical staff involved in the follow-up in order appropriately to adapt the
      general guidelines and meet the specific needs of the individual patients. Non
      specialist or non-physician models of follow-up care have been proposed as
      interesting and cost-effective alternatives in the follow-up of breast cancer
      patients.

PMID- 11207001
TI  - Morphine or oxycodone in cancer pain?
AB  - Oxycodone is an opioid analgesic that closely resembles morphine. Oxymorphone,
      the active metabolite of oxycodone, is formed in a reaction catalyzed by CYP2D6,
      which is under polymorphic genetic control. The role of oxymorphone in the
      analgesic effect of oxycodone is not yet clear. In this study, controlled-release
      (CR) oxycodone and morphine were examined in cancer pain. CR oxycodone and
      morphine were administered to 45 adult patients with stable pain for 3-6 days
      after open-label titration in a randomized, double-blind, cross-over trial.
      Twenty patients were evaluable. Both opioids provided adequate analgesia. The
      variation in plasma morphine concentrations was higher than that of oxycodone,
      consistent with the lower bioavailability of morphine. Liver dysfunction affected
      selectively either oxycodone or morphine metabolism. Three patients with markedly
      aberrant plasma opioid concentrations are presented. Significant individual
      variation in morphine and oxycodone metabolism may account for abnormal responses
      during treatment of chronic cancer pain.

PMID- 11207002
TI  - Pretreatment quality of life of inoperable non-small cell lung cancer patients
      referred for primary radiotherapy.
AB  - This study examined the association between the most important prognostic factors
      in non-small cell lung carcinoma (NSCLC) and self-reported pretreatment quality
      of life (QoL) and the impact of the presence, severity and changes in respiratory
      symptoms on general symptoms and QoL. The study included 262 patients. The
      European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and
      EORTC QLQ-LC13 were used to assess symptoms and QoL before radiotherapy. Patients
      with inoperable NSCLC showed major differences in self-reported QoL as a function
      of clinical prognostic factors. A significant association was found between World
      Health Organization (WHO) performance status and QoL but not other prognostic
      factors. Dyspnoea was the only respiratory symptom associated significantly with
      general symptoms, physical and psychosocial functioning and QoL. Furthermore,
      changes in dyspnoea were associated significantly with changes in physical and
      role functioning, global QoL and fatigue as assessed 6 weeks after radiotherapy.
      These results indicate that palliation of dyspnoea may have a significant
      beneficial effect on QoL and that palliation of other respiratory symptoms is not
      necessarily associated with improvement of general symptoms, physical and
      psychological functioning or global QoL.

PMID- 11207003
TI  - Randomized trial of adjuvant tamoxifen and/or goserelin in premenopausal breast
      cancer--self-rated physiological effects and symptoms.
AB  - After primary surgery, 149 premenopausal breast cancer patients, with node
      negative disease, were randomized to one of four treatment groups: goserelin,
      tamoxifen, goserelin plus tamoxifen or to a systematically untreated control
      group. The aim was to assess the effects of adjuvant endocrine therapy in terms
      of physical symptoms and perception of anxiety and depressive symptoms.
      Assessments were made before randomization, at 3-4 months and at 12 months.
      Treatment with goserelin resulted in early and more intense menopausal symptoms,
      while the effects of tamoxifen were slower and milder. The side effects with
      goserelin appeared to be alleviated by concurrent tamoxifen except for vasomotor
      symptoms (hot flashes, sweating, feeling warm). No significant group differences
      were found for anxiety and depressive symptoms. In conclusion, chemical
      castration with goserelin was associated with the highest level of physical
      symptoms. The group treated with tamoxifen alone showed the lowest levels of
      symptoms among the treatment groups, except for vaginal discharge and irregular
      bleedings.

PMID- 11207004
TI  - Is a dense mammographic parenchymal pattern a contraindication to hormonal
      replacement therapy?
AB  - The aim of the study was to find out whether the effect of hormonal replacement
      therapy (HRT) is modified by the mammographic parenchymal patterns on the risk of
      breast cancer. Subjects were 4163 Finnish women aged 40-47 years at entry who
      were invited to breast cancer screening every second year from 1982 to 1990.
      Mammographic parenchymal patterns (Wolfe's classification) were recorded at each
      screening round. The information, on use of HRT, was recorded from 1984. The
      follow-up ended in 1993 and up until that time 68 new breast cancers were
      diagnosed. A Poisson regression model was used in the analysis of the data. Use
      of HRT was not related to the risk of breast cancer (RR = 0.7, 95% CI 0.4-1.4),
      whereas mammographic parenchymal pattern was statistically significantly
      associated with risk of breast cancer. The age-adjusted relative risk of breast
      cancer among women with P2 versus N1 pattern was 2.5 (95% CI 1.3-4.8) and with DY
      versus N1 pattern 4.9 (951% CI 1.6-15.1). Women using HRT and with DY pattern
      were at substantially increased risk of breast cancer (RR = 11.6, 95% CI 2.5
      53.6) compared with women not using HRT and with N1 pattern. There was an
      increased risk of breast cancer among women with DY mammographic parenchymal
      pattern who used HRT, which was consistent with a synergistic joint effect.

PMID- 11207006
TI  - Parental cigarette smoking, hard liquor consumption and the risk of childhood
      brain tumors--a case-control study in northeast China.
AB  - In this study we examine the effect of parents' lifestyles on the risk of
      childhood brain tumors. Parents of 82 children newly diagnosed with primary
      malignant brain tumors and 246 individually matched hospital controls were
      interviewed in the hospital wards between September 1991 and December 1996. Data
      were collected on socioeconomic status, parental lifestyle prior to and during
      the pregnancy, and family history. Odds ratios and 95% confidence intervals were
      derived through conditional logistic regression. The risk of childhood brain
      tumors was associated with paternal use of hard liquor prior to the pregnancy:
      the odds ratios were 3.72 (95% CI = 1.91-7.26) for < or = 15 years of hard liquor
      consumption and 4.06 (95% CI = 1.09-15.21) for > or = 16 years of hard liquor
      consumption compared with never consuming hard liquor (test for trend p =
      0.0001); the odds ratios increased with increasing lifetime hard liquor
      consumption. There is little evidence to support an association between childhood
      brain tumors and parents' smoking prior to or during pregnancy.

PMID- 11207007
TI  - Squamous cell carcinoma of the oropharynx--an analysis of treatment results in
      289 consecutive patients.
AB  - In this retrospective study the results of primary and salvage treatment of
      oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103
      females and 186 males) were included in the study. Most tumours originated in the
      tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The
      primary treatment was delivered with curative intent in 276 cases (96%). Of
      these, 266 received primary radiotherapy. The median radiation dose was 62 Gy,
      given as laterally opposed fields to the primary tumour and bilateral neck. Eight
      patients were treated with primary surgery and two with chemotherapy as part of a
      curatively intended treatment programme including radiotherapy. Six patients
      received palliative treatment, and seven were not treated at all. Out of 276
      tumours treated with curative intent, 173 reappeared; 72% recurred in T position,
      38% in N position, and 12% at distant metastatic sites, some in combination.
      Salvage surgery was possible in 52 patients, and 24 treatments were successful.
      Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were
      controlled. For the entire group, the 5-year locoregional tumour control, disease
      specific survival and overall survival rates were 38%, 44% and 31%, respectively.
      For patients treated with curative intent, clinical T- and N-stage, stage, tumour
      size, gender, age, and pretreatment haemoglobin were significant prognostic
      parameters in a univariate analysis. The Cox multivariate analysis showed that T
      stage, N-stage and gender were independent prognostic factors. It is concluded
      that T-stage, N-stage and gender are significant independent prognostic factors.
      The primary control of the carcinoma in the T-position is crucial for overall
      success, but salvage surgery is found to have a favourable success rate in
      patients suitable for relapse treatment.

PMID- 11207005
TI  - Serum thyroglobulin as a risk factor for thyroid carcinoma.
AB  - Samples from a biological serum bank taken up to 23 years prior to diagnosis of
      thyroid carcinoma were analysed for human thyroglobulin, thyroid-stimulating
      hormone and thyroxin. After exclusions, the final study material consisted of 59
      cases of papillary and follicular carcinomas. These cases were compared with 164
      controls, matched for sex, age and time of sample taking. The most interesting
      finding was that concentrations of thyroglobulin in serum were abnormally
      elevated in cases compared with controls, equal to or above 30 microg/L, with
      odds ratio 7.0 (CI 3.1-15.7). This elevation of serum thyroglobulin occurred in
      44% of the carcinoma cases. Sensitivity was around 50 for measurements taken up
      to 15 years prior to diagnosis, but 21 when the interval was over 15 years.
      Specificity was 89. No differences were found between cases and controls in
      values for thyroid-stimulating hormone and thyroxin.

PMID- 11207008
TI  - Comparison between young and old patients with bronchogenic carcinoma.
AB  - The aim of this study was to compare the clinical characteristics, histological
      type, stage at diagnosis, treatment and survival of young (< or = 45 years) and
      older patients with bronchogenic carcinoma. The study was designed as a
      retrospective review of all lung cancer patients referred to the Kuwait Cancer
      Control Center over a 10-year period from 1985 to 1994. The study comprised 590
      patients with primary bronchogenic carcinoma, of whom 72 (12%) were < or = 45
      years of age at the time of diagnosis. Median (range) duration of symptoms,
      percentage of smokers and male to female ratios for the younger and older
      patients were 8 (2-48) weeks vs. 8 (1-52) weeks (p = 0.9), 74% vs. 83% (p = 0.06)
      and 5.5 vs. 5.3, respectively. The majority of patients had advanced stage
      disease at presentation; 91% of the younger patients had stage III or IV compared
      with 88% of the older patients (p = 0.1). The histological types for the younger
      and older patients were 32% vs. 20% for adenocarcinoma (p = 0.01) and 33% vs. 45%
      for squamous cell carcinoma (p = 0.1). There were more patients in the younger
      group who had surgery (21% vs. 7.5%) than in the older group (p = 0.001). Follow
      up data were available for 177 patients out of 190 Kuwaiti national patients
      (93%). The median (range) survival rates for young and old patients were 8 (3-62)
      months and 7 (1-174) months, respectively (p = 0.09). Only 6 patients survived
      for more than 5 years, one (7.6%) from the younger group and 5 (3%) from the
      older group. Our study shows a relatively high percentage of young patients in
      our population of lung cancer patients. Apart from the higher incidence of
      adenocarcinoma in the young group and the fact that these patients had more
      surgery than the older group, there were no other significant differences between
      the two groups.

PMID- 11207009
TI  - Preventing and controlling tuberculosis along the U.S.-Mexico border.
AB  - Converging factors contribute to elevated tuberculosis (TB) incidence and
      complicate case management in the U.S. states bordering Mexico. These factors
      include a) Mexico's higher TB rate; b) low socioeconomic status and limited
      access to health care in the border area; c) frequent border crossings and travel
      in the United States for employment, commerce, health services, and leisure; d)
      language and sociocultural differences; and e) lack of coordinated care across
      health jurisdictions on both sides of the U.S.-Mexico border. Prevention and
      control efforts that address the challenges created by border-crossing
      populations require collaboration among local, state, and national TB control
      programs in both countries. In June 1999, to facilitate future discussions with
      Mexican counterparts, CDC convened a meeting of TB control officials from the
      four U.S. states bordering Mexico (i.e., California, Arizona, New Mexico, and
      Texas) to address TB prevention and control in the border area. Focus areas
      included a) surveillance needs, b) case management and therapy completion, c)
      performance indicators and program evaluation, and d) research needs. Meeting
      participants' deliberations and resulting proposals for action by CDC and state
      and local TB control programs are detailed in this report.

PMID- 11207010
TI  - Elevated level of circulating matrix metalloproteinase-9 in patients with lung
      cancer.
AB  - The 72 kDa matrix metalloproteinase (MMP-2) and the 92 kDa matrix
      metalloproteinase (MMP-9), are type IV collagenases that have been implicated as
      important factors in cancer invasion and metastasis formation. We have used
      quantitative zymography and computer-assisted image analysis to measure the
      levels of MMP-9 and MMP-2 in 19 samples of serum of lung cancer patients and in
      23 samples of normal serum. Mean levels of MMP-9 were significantly elevated in
      cancer samples compared with normal sera (1.33 +/- 0.61 microU microl(-1) vs.
      0.37 +/- 0.10 microU microl(-1), P<0.0001). MMP-2 levels did not differ
      significantly in these two groups. However, there was no significant correlation
      between serum MMP-9 activity and the disease stage. We found that circulation
      levels of MMP-9 in lung cancer patients is 3.6-fold higher than in healthy
      volunteers, however, we do not consider this elevation to be a direct reflection
      of MMP-9 over-production by tumour cells.

PMID- 11207011
TI  - Leisure-time energy expenditure in asthmatics and non-asthmatics.
AB  - An association between obesity and asthma has been documented previously, but the
      nature of this relationship remains unknown. This study aimed to determine if
      asthma is associated with a sedentary lifestyle which may explain this
      association. The energy expenditure (EE) on leisure activities was examined in
      16,813 subjects, of at least 12 years of age, who participated in the Canadian
      National Population Health Survey 1994-95. Energy expenditure was calculated by
      multiplying the duration of leisure-time physical activity by its estimated
      metabolic energy cost. Asthma was considered to be present if an affirmative
      response was given to the question, 'Do you have asthma diagnosed by a health
      professional?' The average EE (+/- standard error) in males was 2.47 (+/- 0.11)
      kcal kg(-1) day(-1) for asthmatics and 1.98 (+/- 0.03) kcal kg(-1) day(-1) for
      non-asthmatics. The corresponding average EEs in females were 1.77 (+/- 0.08) and
      1.54 (+/- 0.02) kcal kg(-1) day(-1) for asthmatics and non-asthmatics,
      respectively. The mean EE values decreased with increasing age. A significant
      interaction between asthma and age was noted with respect to EE; asthmatics
      tended to have higher mean EE values than non-asthmatics among younger subjects,
      and lower mean EE values in older subjects. This effect was more pronounced in
      females than in males. It was concluded that asthmatics were not consistently
      inactive compared with non-asthmatics. Leisure-time physical activity cannot
      explain the positive association between obesity and asthma.

PMID- 11207012
TI  - Capsaicin cough sensitivity is decreased in smokers.
AB  - Although capsaicin provocation has been used to evaluate treatment against cough,
      which is one of the most common respiratory symptoms, there are still
      methodological considerations that are not fully known. Capsaicin stimulates the
      unmyelinated slow C-fibres of the sensory nervous system, which leads to
      coughing. Smoking often leads to respiratory symptoms with cough and phlegm. The
      aim of this study was to examine the effect of smoking on capsaicin provocation.
      Subjectively healthy smokers and non-smokers were challenged with capsaicin in
      increasing doses. The coughs were counted and irritation of the lower airways was
      graded on a symptom score. Smokers reacted to provocation with significantly
      fewer coughs, but there was no difference regarding other symptoms. These results
      are in agreement with the hypothesis that nicotine inhibits or blocks C-fibres of
      the sensory nervous system of the lower respiratory tract. Clinically, this may
      serve to explain increasing airway symptoms that are often seen after cessation
      of smoking.

PMID- 11207013
TI  - Quality of life in primary care asthma.
AB  - In primary care, asthma is usually assessed by means of the patients' history
      regarding symptoms and simple lung-function testing. These outcomes may, however,
      not be related to other estimates of asthma control such as quality of life. In
      the present study quality of life was studied in relation to symptoms (visual
      analogue scale, VAS) and lung function in adult patients with asthma in a primary
      care setting. In a healthcare centre in Stockholm, 405 individuals diagnosed as
      having asthma were identified. Out of this number, 120 patients completed the
      study. Patients were categorized into four groups according to lung function and
      their response to a question regarding asthma symptoms on the VAS. Quality of
      life was evaluated with the Asthma Quality of Life Questionnaire (AQLQ) and
      current treatment was recorded. Quality of life differed significantly between
      the groups with regard to all domains and overall score; overall score was 6.0
      (0.12)--(mean SEM) in group A (VAS < or = 2, normal FEV1), 5.4 (0.24) in group B
      (VAS < or = 2, low FEV1), 4.8 (0.25) in group C (VAS > 2, normal FEV1) and 4.6
      (0.24) in group D (VAS > 2, low FEV1) (P < 0.0001). In general a gradient, with
      group A having the highest and group D the lowest score, was detected. Experience
      of symptoms (VAS > 2) was highly related to lower scores in the environmental
      domain (P < 0.0001). The correlation between FEV1 and quality of life was
      generally low whereas there was a fairly good correlation between VAS and quality
      of life (P < 0.0001 for all domains). Patients without steroid treatment had
      higher quality of life scores than patients treated with steroids. The majority
      of asthma patients in primary care have high quality of life scores, indicating a
      low prevalence of symptoms and only slight activity limitations. Evaluation of
      quality of life enables a more careful grading of asthma status. Furthermore,
      this measure provides information concerning asthma control that is not revealed
      by spirometry and simple questions regarding symptoms.

PMID- 11207014
TI  - Inspiratory muscle training in patients with cystic fibrosis.
AB  - Little information is available about the effects of inspiratory muscle training
      in patients with cystic fibrosis (CF). In this study the effects of inspiratory
      threshold loading in patients with CF on strength and endurance of the
      inspiratory muscles, pulmonary function, exercise capacity, dyspnoea and fatigue
      were evaluated. Sixteen patients were assigned to one of two groups using the
      minimization method: eight patients in the training group and eight patients in
      the control group. The training was performed using an inspiratory-threshold
      loading device. Patients were instructed to use the threshold trainer 20 min a
      day, 5 days a week for 6 weeks. Patients in the training group trained at
      inspiratory threshold loads up to 40% of maximal static inspiratory pressure
      (Pimax) and patients in the control group got 'sham' training at a load of 10% of
      Pimax. No significant differences were found among the two groups in gender, age,
      weight, height, pulmonary function, exercise capacity, inspiratory-muscle
      strength and inspiratory-muscle endurance before starting the training programme.
      Mean (SD) age in the control group was 19 (5.5) years, mean (SD) age in the
      training group was 17 (5.2) years. Mean FEV1 in both groups was 70% predicted,
      mean inspiratory-muscle strength in both groups was above 100% predicted. All
      patients except one, assigned to the training group, completed the programme.
      After 6 weeks of training, mean inspiratory-muscle endurance (% Pimax) in the
      control group increased from 50% to 54% (P = 0.197); in the training group mean
      inspiratory muscle endurance (% Pimax) increased from 49% to 66% (P = 0.003).
      Statistical analysis showed that the change in inspiratory-muscle endurance (%
      Pimax) in the training group was significantly higher than in the control group
      (P = 0.012). After training, in the training group there was a tendency of
      improvement in Pimax with an increase from 105 to 123% predicted, which just fell
      short of statistical significance (P = 0.064). After training no significant
      differences were found in changes from baseline in pulmonary function, exercise
      capacity, dyspnoea and fatigue. It is concluded that low-intensity inspiratory
      threshold loading at 40% of Pimax was sufficient to elicit an increased
      inspiratory-muscle endurance in patients with CF.

PMID- 11207015
TI  - Psychological disorder in asthma is associated with poor control and poor
      adherence to inhaled steroids.
AB  - Previous studies have linked psychological morbidity to poor control of asthma,
      but have not objectively measured adherence to treatment, and have linked poor
      adherence to depression, but have not measured asthma severity. This study
      assessed asthma and psychological morbidity and objectively measured adherence to
      medication and showed that psychological morbidity in those with asthma is
      significantly increased when control of asthma is poor, especially when control
      is poor and adherence to inhaled steroid regimen is low.

PMID- 11207016
TI  - Respiratory symptoms relate to physiological changes and inflammatory markers
      reflecting central but not peripheral airways. A study in 60-year-old 'healthy'
      smokers and never-smokers.
AB  - The aim of this study was to evaluate the relationship between respiratory
      symptoms, lung function and inflammatory markers in 'healthy' smokers. The study
      population was recruited from an epidemiological study with subjects of the same
      age, 60 years. Only smokers who considered themselves healthy (n=58) and a random
      sample of never-smokers (n=34) were investigated. All subjects underwent lung
      function tests--spirometry, carbon monoxide transfer (DLco) and the single-breath
      N2 method (N2 test)--together with high-resolution computed tomography (HRCT). A
      flexible bronchoscopy with a bronchoalveolar lavage (BAL) was performed in 30
      smokers and 18 never-smokers. Bronchial biopsies were also taken. Smokers who
      reported non-specific respiratory problems, chronic bronchitis and wheezing in a
      symptom questionnaire had a lower forced expiratory volume in 1 sec (FEV1), FEV%
      and specific airway conductance (sGaw), lung function tests supposed to reflect
      the more central airways, than smokers without respiratory symptoms. A limited
      number of smokers with occasional non-specific respiratory problems also had more
      cytotoxic T cells (CD8) in bronchial biopsies. No differences were found in DLCO
      and the N2 test, lung function tests supposed to reflect the more peripheral
      airways including the alveoli, HRCT-diagnosed emphysema or inflammatory markers
      in blood and BAL between smokers with and without respiratory symptoms. It is
      concluded that even when smokers consider themselves 'healthy' they have mild
      symptoms that are related more to physiological changes and inflammatory markers
      that may reflect events in the central airways than to changes that may reflect
      events in the peripheral airways.

PMID- 11207017
TI  - Granulocyte markers in induced sputum in patients with respiratory disorders and
      healthy persons obtained by two sputum-processing methods.
AB  - Induced sputum is increasingly used to detect and monitor airway inflammation in
      respiratory diseases. However, the processing of sputum has been rather laborious
      for clinical practice. The aim of this study was to improve the practicality of
      induced-sputum studies by simplifying sample processing. Eosinophil cationic
      protein (ECP), eosinophil peroxidase (EPO), neutrophil lipocalin (HNL) and
      myeloperoxidase (MPO) were used as biochemical markers of airway inflammation and
      the results of the study method were compared with a previously validated
      (reference) method. Induced sputum was obtained from 42 healthy controls, 10
      subjects with acute respiratory infection, eight patients with chronic
      obstructive pulmonary disease (COPD) and 17 asthmatics. The sputum sample was
      divided into two parts and treated either: (i) by the reference method (released
      markers), where sputum was homogenized with dithiotreitol and centrifuged to
      yield cell-free supernatant and a cell pellet, or (ii) by the study method (total
      markers), where the cells were lysed after homogenization so that cell-associated
      markers were released and solubilized. For comparison, the four biochemical
      markers were measured in sputum supernatant and in sputum lysate. The
      differential cell count was performed from the cell pellet in the reference
      method. Repeatability was assessed in a group of 16 subjects. The effect of
      reagents and the recovery of assays were also evaluated. Released and total
      markers correlated well (ECP r(s)=0.80, P<0.0001; EPO r(s)=0.49, P<0.0001; HNL
      r(s)=0.87, P<0.0001; MPO r(s)=0.71, P<0.0001). Incubation with dithiotreitol and
      lysis reagent had no negative influence on marker assays. The within-subject
      variability of total ECP, MPO and HNL in both methods was small in two
      measurements taken I week apart. The study method, measuring total inflammatory
      markers, gave comparable results to the reference method, measuring released
      markers. In the study method the sputum processing was simplified, which may
      improve its applicability.

PMID- 11207018
TI  - Influence of patient posture on oxygen saturation during fibre-optic
      bronchoscopy.
AB  - This study was designed to investigate the effect of posture on oxygen saturation
      during fibre-optic bronchoscopy (FOB). Thirty-eight consecutive patients
      requiring diagnostic FOB were randomized into two groups according to the initial
      posture in which the FOB was performed. In group 1 (20 patients), FOB was
      commenced supine, and in group 2 (18 patients) in a semi-recumbent position (45
      degrees from horizontal). Sedation with midazolam was titrated according to
      clinical response. All patients received atropine 0.6 mg intravenously and
      topical lignocaine. Observations of peak, trough and plateau oxygen saturation
      and pulse rate were recorded during six study periods, each lasting 3 min.
      Periods 1 and 2 were pre- and post-sedation without supplemental oxygen,
      respectively. The bronchoscope was then inserted into the distal end of the
      trachea and observations taken during periods 3 and 4 (no supplemental oxygen)
      and periods 5 and 6 (2 l oxygen by nasal cannulae). In group 1, posture was
      changed from supine to semi-recumbent from periods 3-4 and reversed in periods 5
      and 6. In group 2, posture changes were in reverse sequence. Patients with
      initial oxygen saturation of less than 90% or showing a fall below 85% during FOB
      were excluded. Five patients from each group were withdrawn because of hypoxia.
      In both groups, oxygen saturation fell significantly (P<0.001) following
      sedation. There was no significant change in saturation (peak, trough or plateau)
      with change in posture from supine to semi-recumbency (group 1) or the reverse
      (group 2). These correspond to periods 3-4 and 5 6 in both groups. Supplemental
      oxygen was associated with a significant rise in oxygen saturation in both
      postures, attaining levels close to presedation levels.

PMID- 11207019
TI  - Long-term economic evaluation of intensive patient education during the first
      treatment year in newly diagnosed adult asthma.
AB  - The cost-effectiveness of intensive patient education of guided asthma self
      management given during the first treatment year was evaluated after 5 years of
      follow-up. Consecutive, newly-diagnosed asthmatics (n = 162, age 18-76 years)
      were randomized for intensive (80 patients) vs. conventional patient education.
      Effectiveness was evaluated in terms of lung functions, airway
      hyperresponsiveness (PD15), and quality of life as measured by the generic 15D
      and disease-specific St. George's Respiratory Questionnaire (SGRQ). Total
      treatment costs were also estimated. All patients had anti-inflammatory treatment
      from the beginning. Sixty-four intervention group (IG) patients and 70 control
      group (CG) patients were evaluated after 5 years. Forced expiratory volume in 1
      sec (FEV1) improved only in the IG, and only during the first treatment year.
      However, PD15 improved throughout the follow-up. The unscheduled healthcare costs
      were significantly higher in the CG than in the IG (P = 0.04) and the relative
      risk for sickness days due to asthma was lower in the IG than in the CG, odds
      ratio 0.33 (95% CI 0.28; 0.40). However, because there was no significant
      difference between the groups in any outcome variable or in total costs at 5
      years, the incremental cost-effectiveness ratio could not be calculated. The
      first year intervention had only a short-term beneficial treatment effect, which
      the CG could catch up during the two last follow-up years, except in FEV1. The
      peak expiratory flow (PEF)-based self-management had no advantage over the
      symptom-based self-management. However, the intervention had a consistent
      tendency of being less costly in the long-run. It is possible to conclude
      tentatively that regular effective medical treatment and control visits during
      the first treatment year is at least as important for the long-term treatment
      result as intensive patient education.

PMID- 11207020
TI  - Comparison between formoterol 12 microg b.i.d. and on-demand salbutamol in
      moderate persistent asthma.
AB  - Inhalation of on-demand salbutamol (ODS) several times daily is sometimes the
      only beta2-agonist prescribed in moderate persistent asthma, whereas a long
      acting beta2-agonist should be added. This trial aimed to compare the efficacy of
      formoterol dry-powder capsule 12 microg b.i.d. (Foradil) and ODS in patients with
      moderate persistent asthma treated with inhaled corticosteroids, in the
      conditions of real practice. Two hundred and fifty-nine patients were randomized
      (formoterol; 130; ODS: 129) in this open, parallel-group trial. The mean
      increases in morning peak expiratory flow (PEF primary variable) and evening PEF
      over the 3-month treatment period were statistically significantly higher with
      formoterol: +25.7 and +24.1 l min(-1), respectively vs. +4.5 and +0.5 l min(-1)
      respectively with ODS. The increase in FEV1 was statistically significantly
      higher with formoterol at months 1 and 3. Formoterol reduced the use of
      salbutamol as rescue medication by two-thirds. The percentages of symptom-free
      days and nights statistically significantly increased with formoterol (+20% and
      +33% respectively), but did not significantly change with ODS. Clinically
      relevant and statistically significant improvement in the mean total score of the
      St George's Hospital Respiratory Questionnaire was observed in the formoterol
      group. Adverse events were similar in the two groups. The results show that
      treatment with formoterol has significant advantages over ODS in patients with
      moderate persistent asthma.

PMID- 11207021
TI  - A comparison of three disease-specific and two generic health-status measures to
      evaluate the outcome of pulmonary rehabilitation in COPD.
AB  - The use of health status as an outcome measure is becoming more widespread in
      pulmonary rehabilitation. There are a number of health status measures but the
      choice remains uncertain. Three disease specific measures and two generic
      measures of health status were employed to observe their relative sensitivity to
      a 7-week course of pulmonary rehabilitation. Patients with stable chronic
      obstructive pulmonary disease (COPD) were recruited into a rehabilitation
      programme. They completed a shuttle-walking test and three disease-specific
      questionnaires: the Chronic Respiratory Questionnaire (CRQ), the St. George's
      Hospital Respiratory Questionnaire (SGRQ) and the Breathing Problems
      Questionnaire (BPQ). Patients also completed two generic questionnaires: a global
      quality-of-life scale and an activity checklist. Ninety-seven patients [58 male
      mean (SD) age 67 (8.7) years] completed the course over a 12-month period. The
      mean pre-rehabilitation (SD) FEV1 was 1.06 (0.59) l. The shuttle-walking test and
      the treadmill-endurance test increased significantly after rehabilitation
      (P<0.001). All three disease-specific questionnaires improved significantly (the
      CRQ and SGRQ improved beyond minimum clinically important difference). The global
      score improved significantly whilst the 'things people do' decreased. All three
      disease-specific measures were responsive to pulmonary rehabilitation. However
      the operator-led CRQ appears to be the most sensitive short-term outcome measure.

PMID- 11207022
TI  - The influence of the severity of community-acquired pneumonia on the usefulness
      of blood cultures.
AB  - The value of blood cultures in community-acquired pneumonia (CAP) has been
      questioned. At issue is the potential for blood cultures to change management. We
      prospectively studied the yield and impact of blood cultures in patients admitted
      with CAP. Two hundred and nine subjects had at least two blood cultures prior to
      receiving antibiotics. The severity of CAP was graded using the Pneumonia
      Severity Index (PSI). Twenty-nine patients (13.9%) had a pathogen identified by
      blood culture. The yield of blood cultures increased with PSI grade (I--5.3%, II-
      10.2%, III--10.3%, IV--16.1%, V--26.7%), as did the likelihood of blood cultures
      changing antibiotic therapy (I to III--0%, IV--9.7%, V--20.0%). One hundred and
      seventy-nine (85.6%) patients received a quinolone, limiting the impact of
      pathogens resistant to beta-lactams. Four of 16 patients (25.0%) with a culture
      (blood or sputum)-guided change in antibiotic therapy died, compared to five of
      31 patients (16.1%) who had an empiric change. Blood cultures are of minimal
      value in mild to moderate CAP, and should be limited to patients with PSI grade
      IV or V CAP unless a specific risk factor for pathogens resistant to the empiric
      therapy is present.

PMID- 11207023
TI  - Changes in asthma drug therapy costs for patients receiving chronic montelukast
      therapy in the U.K.
AB  - The aim of this study was to assess changes in the costs of asthma drug therapy
      before and during the use of chronic montelukast treatment in the U.K. A
      retrospective cohort analysis of a primary care database in the U.K. was carried
      out. Patients with chronic montelukast use (> or = 140 once-daily doses) were
      selected for analysis. Benchmarking data were obtained for matched patients with
      chronic inhaled corticosteroid (ICS) use and patients with chronic salmeterol
      therapy with concomitant ICS use. The main outcome measures were changes in
      utilization and monthly cost of asthma therapies costs. Asthma patients
      experienced significant (P<0.05) reductions in the monthly costs of ICS, short
      acting beta-agonists and antibiotics following chronic montelukast therapy.
      Monthly concomitant drug costs were reduced by Pound Sterling 7.49 per month,
      which offset 27.5% of the additional cost of montelukast, yielding an increase in
      total drug costs of Pound Sterling 19.78 per month. Meanwhile, increased total
      drug costs for matched patients with chronic ICS use, and matched patients with
      chronic salmeterol therapy and concomitant ICS use, increased by Pound Sterling
      5.37 per month and Pound Sterling 44.55 per month respectively. Additionally,
      patients using chronic montelukast therapy experienced a statistically
      significant (P<0.05) reduction in the use of short acting beta-agonists, and
      antibiotics, suggesting improvement in asthma control. Chronic use of montelukast
      therapy is associated with a reduction of concomitant drug therapy costs.

PMID- 11207024
TI  - The natural history of respiratory allergy: a follow-up study of 99 patients up
      to 10 years.
AB  - A strict relationship between allergic rhinitis and allergic asthma has been seen
      recently, and in many ways respiratory allergy could be seen as a single disorder
      of the airways. The link between rhinitis and asthma can be elucidated only by
      studying the natural history of the disease over long periods. We describe the
      follow-up of 99 allergic patients up to 10 years and the evolution of their
      disease. Ninety-nine patients (50 male, 49 female, mean age 31 years) out of 142,
      suffering from allergic rhinitis or allergic asthma, could be monitored up to 10
      years after the initial diagnosis. Demographics, sensitizations and smoke habit
      were assumed as evaluation parameters. At baseline, 44 patients suffered from AR
      alone, 12 from AA alone and 43 from AR+AA. After 10 years, 31.8% of the AR
      patients developed developed AA and 50% of the patients with AA developed AR.
      Only the familial history for atopy significantly influenced the disease's
      evolution, whereas gender, age, smoking habit and skin sensitization did not.
      Sixty-five percent of patients with a single sensitization at the beginning
      developed new sensitizations. In conclusion, this long-term survey confirms that
      a relevant percentage of patients with AR alone or AA alone have a progression of
      the disease.

PMID- 11207025
TI  - What time of day do patients take steroid tablets?

PMID- 11207026
TI  - Organization of the CYP1A cluster on human chromosome 15: implications for gene
      regulation.
AB  - The sequence and organization of the CYP1A cluster on human chromosome 15 was
      determined. A human genomic clone from a BAC library, containing both CYP1A1 and
      CYP1A2 genes, was isolated and sequenced. The results of Southern blot analysis
      using human genomic DNA were compatible with the structure of the BAC clone. The
      CYP1A1 and CYP1A2 genes are separated by a 23 kb segment that contains no other
      open reading frames. The CYP1A1 and CYP1A2 genes are in opposite orientation,
      revealing that the 5' flanking region is in common between the two genes.
      Analysis of the sequence obtained revealed the presence of xenobiotic response
      elements (XREs) previously reported for CYP1A1 and CYP1A2 and several additional
      consensus sequences for putative XREs. The presence of all the XREs upstream of
      both genes suggest that some of the regulatory elements known to control CYP1A1
      gene expression, could also control CYP1A2 gene expression.

PMID- 11207027
TI  - Serotonin receptor gene HTR3A variants in schizophrenic and bipolar affective
      patients.
AB  - Serotonin receptor genes have always been considered excellent candidate genes in
      the aetiology of neurogenetic diseases. In this study, we assessed sequence
      variations of the HTR3A gene. For this purpose, we established exon-specific
      primers and analysed DNA samples from 165 unrelated individuals including 70
      schizophrenic patients, 48 patients with bipolar affective disorder and 47
      healthy control persons using polymerase chain reaction/single-strand
      conformational polymorphism analysis. We discovered six sequence variants, five
      of which represent polymorphisms. These polymorphisms could not be associated
      with schizophrenia and bipolar affective disorder (P = 0.055-1). We also detected
      a missense mutation in exon 9 in a schizophrenic patient at a conserved position
      (Pro391Arg). To determine the incidence of this substitution an extended set of
      358 schizophrenic patients and 155 control individuals was investigated. The
      Pro391Arg mutation was not detected in these schizophrenic patients and controls
      screened. However, a second missense mutation (Arg344His) was detected in one
      schizophrenic patient, but not in any of the controls. These results suggest that
      the observed mutations in HTR3A are rare and therefore do not play a major role
      in the aetiology of the disorder. Further studies are needed to support the
      hypothesis that HTR3A may contribute to the schizophrenia in these patients.

PMID- 11207028
TI  - Inhibition of cytochrome P450 2C9 activity in vitro by 5-hydroxytryptamine and
      adrenaline.
AB  - In the present study, the occurrence of a modulatory effect of 14
      neurotransmitters, precursors and metabolites on the cytochrome P450 2C9 (CYP2C9)
      enzyme activity, as determined by diclofenac 4-hydroxylation, was studied in
      human liver microsomes. Two indoleamines, 5-hydroxytryptamine (5-HT) and
      adrenaline, showed a non-competitive-type inhibitory effect of approximately 90%
      of the diclofenac 4-hydroxylase activity, with Ki values of 63.5 (0.7 and 156
      (89.3 microM, respectively. The rest of substances analysed were weak inhibitors
      or had no inhibitory effect. CYP2C subfamily is present in human brain, although
      CYP2C9 isozyme has not yet been identified in this tissue, and CYP2C9 is involved
      in the metabolism of psychoactive drugs. Therefore, the fact that endogenous
      compounds could modulate the CYP2C9 activity, suggests that an hypothetical local
      activity of brain CYP2C9 might be susceptible to regulatory mechanisms. The
      possible clinical implications of this modulation are discussed.

PMID- 11207029
TI  - Genetic polymorphisms of cytochrome P450 2A6 in a case-control study on lung
      cancer in a French population.
AB  - Cytochrome P450 2A6 (CYP2A6) is involved in the C-oxidation of nicotine and in
      the metabolic activation of tobacco nitrosamines. Recent data have suggested that
      CYP2A6 genetic polymorphisms might play a role in tobacco dependence and
      consumption as well as in lung cancer risk. However, the previously published
      studies were based on a genotyping method that overestimated the frequencies of
      deficient alleles, leading to misclassification for the CYP2A6 genotype. In this
      study, we genotyped DNA from 244 lung cancer patients and from 250 control
      subjects for CYP2A6 (wild-type allele CYP2A6*1, and two deficient alleles:
      CYP2A6*2, and CYP2A6*4, the latter corresponding to a deletion of the gene) using
      a more specific procedure. In this Caucasian population, we found neither a
      relation between genetically impaired nicotine metabolism and cigarette
      consumption, nor any modification of lung cancer risk related to the presence of
      defective CYP2A6 alleles (odds ratio = 1.1, 95% confidence interval = 0.7-1.9).

PMID- 11207030
TI  - Polymorphisms in CYP2D6 duplication-negative individuals with the ultrarapid
      metabolizer phenotype: a role for the CYP2D6*35 allele in ultrarapid metabolism?
AB  - Ultrarapid drug metabolism mediated by CYP2D6 is associated with inheritance of
      alleles with duplicated or amplified functional CYP2D6 genes. However, genotyping
      for duplicated CYP2D6 alleles only explains a fraction (10-30%) of the ultrarapid
      metabolizer phenotypes observed in Caucasian populations. Using a sample of
      CYP2D6 duplication-negative ultrarapid metabolizer subjects and selected control
      subjects with extensive metabolism, we examined parts of the CYP2D7 pseudogene,
      and the promoter region and 5'-coding sequence of CYP2D6 for polymorphisms
      possibly associated with the ultrarapid metabolizer phenotype. In an initial
      screening of 17 subjects (13 ultrarapid metabolizers and four extensive
      metabolizers), we identified three DNA variants in the 5'-end of the CYP2D7
      pseudogene and 29 variants in the 5'-end of the CYP2D6 gene. Five variants were
      then selected for examination in a larger sample of subjects having the
      ultrarapid metabolizer (n = 27) or extensive metabolizer phenotype (n = 77).
      Subsequent statistical analyses of allele, genotype and estimated haplotype
      distributions showed that the 31A allele of the 31G > A (Val(II)Met) polymorphism
      was significantly more frequent in ultrarapid metabolizer subjects than in
      extensive metabolizer subjects (P = 0.04). Also, estimation of haplotype
      frequencies suggested that one of the haplotypes with the 31A variant was
      significantly more frequent among the ultrarapid metabolizers compared with the
      extensive metabolizers (P = 0.03). The average metabolic ratio was significantly
      lower in subjects possessing the 31A allele compared with subjects homozygous for
      the 31G allele (P = 0.02). We also observed a nonsignificant over-representation
      of the G-allele of a - 1584 C > G promoter polymorphism in the ultrarapid
      metabolizer group. Since our results are based on a relatively low number of
      subjects, further studies on larger samples and functional analyses of the
      polymorphisms detected are necessary to determine the role of the 31G > A and -
      1584C > 6 variants in CYP2D6 duplication-negative ultrarapid metabolizer
      subjects.

PMID- 11207031
TI  - Sulfation pharmacogenetics: SULT1A1 and SULT1A2 allele frequencies in Caucasian,
      Chinese and African-American subjects.
AB  - Sulfotransferase (SULT) enzymes catalyze the sulfate conjugation of drugs, other
      xenobiotics, neurotransmitters and hormones. The genes for SULT1A1 and SULT1A2
      contain common genetic polymorphisms that are associated with individual
      variations in levels of enzyme activity as well as variations in biochemical and
      physical properties. We set out to compare the frequencies of common SULT1A1 and
      SULT1A2 alleles in Caucasian, Chinese and African-American subjects. Allele
      frequencies for SULT1A1*1, *2 and *3 in 242 Caucasian subjects were 0.656, 0.332
      and 0.012, respectively. Frequencies of those same alleles were significantly
      different in 290 Chinese subjects: 0.914, 0.080 and 0.006, respectively, as were
      frequencies in 70 African-American subjects: 0.477, 0.294 and 0.229,
      respectively. Ethnic variation in allele frequencies was also observed for
      SULT1A2, with frequencies in Caucasian subjects for SULT1A2*1, *2 and *3 of
      0.507, 0.389 and 0.104; frequencies in Chinese of 0.924 and 0.076 with no *3
      alleles observed; and, finally, in African-Americans frequencies of 0.637, 0.249
      and 0.114, respectively. We also found that SULT1A1*2 and SULT1A2*2, the most
      common variant alleles for these two genes, were in positive linkage
      disequilibrium in all three populations studied, with D' values of 0.776 in
      Caucasian (P < 0.001), 0.915 in Chinese (P < 0.001) and 0.864 in African-American
      subjects (P < 0.001). These observations represent a step towards determining the
      possible functional implications for individual variations in sulfate conjugation
      of common genetic polymorphisms for SULT1A1 and SULT1A2.

PMID- 11207032
TI  - Allele and genotype frequencies of polymorphic cytochromes P4502D6, 2C19 and 2E1
      in aborigines from western Australia.
AB  - The polymorphisms of the important xenobiotic metabolizing enzymes CYP2D6,
      CYP2C19 and CYP2E1 have been studied extensively in a large number of populations
      and show significant heterogeneity in the frequency of different
      alleles/genotypes and in the prevalence of the extensive and poor metabolizer
      phenotypes. Understanding of inter-ethnic differences in genotypes is important
      in prediction of either beneficial or adverse effects from therapeutic agents and
      other xenobiotics. Since no data were available for Australian Aborigines, we
      investigated the frequencies of alleles and genotypes for CYP2D6, CYP2C19 and
      CYP2E1 in a population living in the far north of Western Australia. Because of
      its geographical isolation, this population can serve as a model to study the
      impact of evolutionary forces on the distribution of different alleles for
      xenobiotic metabolizing enzymes. Twelve CYP2D6 alleles were analysed. The wild
      type allele *1 was the most frequent (85.81%) and the non-functional alleles (*4,
      * 5, * 16) had an overall frequency of less than 10%. Only one subject (0.4%) was
      a poor metabolizer for CYP2D6 because of the genotype *5/*5. For CYP2C19, the
      frequencies of the *1 (wild-type) and the non-functional (*2 and *3) alleles were
      50.2%, 35.5% and 14.3%, respectively. The combined CYP2C19 genotypes (*2/*2,
      *2/*3 or *3/*3) correspond to a predicted frequency of 25.6% for the CYP2C19 poor
      metabolizer phenotype. For CYP2EI, only one subject had the rare c2 allele giving
      an overall allele frequency of 0.2%. For CYP2D6 and CYP2C19, allele frequencies
      and predicted phenotypes differed significantly from those for Caucasians but
      were similar to those for Orientals indicating a close relationship to East Asian
      populations. Differences between Aborigines and Orientals in allele frequencies
      for CYP2D6* 10 and CYP2E1 c2 may have arisen through natural selection, or
      genetic drift, respectively.

PMID- 11207033
TI  - Variation in enzymes of arylamine procarcinogen biotransformation among bladder
      cancer patients and control subjects.
AB  - Arylamines such as 2-naphthylamine and 4-aminobiphenyl are suspected human
      bladder procarcinogens that require bioactivation to DNA-reactive species to
      exert their carcinogenic potential. The goals of the present study were (i) to
      assay for the presence of the arylamine acetyltransferases NAT1 and NAT2, and of
      the cytochrome P450 isoform CYP1A2, in human bladder epithelium; and (ii) to
      determine whether the activities of these arylamine biotransforming enzymes
      differ between bladder cancer patients and control subjects. We measured in-vitro
      enzyme activities in biopsies of normal, undiseased bladder epithelium obtained
      from 103 bladder cancer patients. NAT1 activity was detectable in all samples,
      with mean levels higher than those found in human liver. Kinetic evidence also
      suggested low levels of NAT2 expression in this tissue, but there was no
      detectable CYP1A2 by either enzymatic or immunochemical measurements. We also
      compared several probe drug indices of in-vivo NAT1, NAT2 and CYP1A2 activity
      between 53 bladder cancer patients and 96 cancer-free control subjects who were
      carefully matched for age, gender and smoking status. NAT1 and NAT2 genotypes
      were also determined. No significant differences were found between bladder
      cancer patients and control subjects for a number of individual phenotypic or
      genotypic predictors of enzyme function. Our results suggest that although
      expression of particular arylamine biotransforming enzymes within the bladder
      tissue could play a significant role in locally bioactivating arylamine
      procarcinogens in theory, interindividual variations in CYP1A2, NAT1 and NAT2
      activities do not significantly differ between bladder cancer patients and
      control subjects when potential arylamine exposures are controlled for

PMID- 11207034
TI  - Polymorphisms in the human paraoxonase (PON1) promoter.
AB  - Paraoxonase (PON1) is a protein component of high-density lipoprotein (HDL)
      particles that protects against oxidative damage to both low-density lipoprotein
      and HDL and detoxifies organophosphorus pesticides and nerve agents. A wide range
      of expression levels of PON1 among individuals has been observed. We examined the
      promoter region of PON1 for genetic factors that might affect PON1 activity
      levels. We conducted a deletion analysis of the PON1 promoter region in transient
      transfection assays and found that cell-type specific promoter elements for liver
      and kidney are present in the first 200bp upstream of the coding sequence.
      Sequence analysis of DNA from a BAC clone and a YAC clone identified five
      polymorphisms in the first 1000 bases upstream of the coding region at positions 
      108, -126, -162, -832 and -909. Additionally, the promoter sequences of two
      individuals expressing high levels of PON1 and two individuals expressing low
      levels of PON1 were analysed. The two polymorphisms at -126 and -832 had no
      apparent effect on expression level in the reporter gene assay. The polymorphisms
      at position -909, -162 (a potential NF-I transcription factor binding site) and 
      108 (a potential SP1 binding site) each have approximately a two-fold effect on
      expression level. The expression level effects of the three polymorphisms appear
      not to be strictly additive and may depend on context effects.

PMID- 11207035
TI  - Ethnic variability in the allelic distribution of human aryl hydrocarbon receptor
      codon 554 and assessment of variant receptor function in vitro.
AB  - The aryl hydrocarbon receptor (AHR) is a ligand-dependent transcriptional
      regulator of several genes including the cytochrome P4501 (CYP1) family as well
      as genes encoding factors involved in cell growth and differentiation. In mice,
      several polymorphic forms of the AHR are known, some of which have altered
      affinity for toxic and carcinogenic ligands. Remarkably little genetic variation
      has been detected in the human AHR gene. In studies on human AHR, Kawajiri et al.
      (Pharmacogenetics 1995; 5:151-158) reported a variation at codon 554 that results
      in an amino acid change from arginine to lysine; the frequency of the variant
      allele in a Japanese population (n = 277) was 0.43. We investigated the Lys554
      allele in 386 individuals of various ethnic origins and found the frequency to
      be: 0.58 in Ivory Coast Africans (n = 58); 0.53 in a mixed African group (n =
      20); 0.39 in Caribbean-Africans (n = 55); 0.32 in Canadian Chinese (n = 41); 0.14
      in North American Indians (n = 47); 0.12 in French Canadian Caucasians (n = 20);
      0.11 in a mixed ethnicity North American group (n = 45); 0.09 in Canadian Inuits
      (n = 22); and 0.07 in German Caucasians (n = 78). We expressed the human Lys554
      allele in an in-vitro transcription-translation system and found that the
      receptor bearing the R554L substitution had an equivalent ability to that of the
      wild-type receptor to bind to a dioxin-responsive element following treatment
      with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The Lys554 allele also was
      equivalent to the wild-type receptor at stimulating CYP1A1 mRNA expression when
      transfected into TCDD-treated receptor-deficient mouse Hepa-1 cells. It is not
      yet known if any of the wide variations in allele frequency at codon 554 are
      related to ethnic differences in susceptibility to adverse effects of
      environmental chemicals.

PMID- 11207036
TI  - The prognostic advantage of preoperative intratumoral injection of OK-432 for
      gastric cancer patients.
AB  - To investigate, by a multi-institutional randomized trial, the prognostic
      significance of the augmentation of tumour-infiltrating lymphocytes (TILs) by
      preoperative intratumoral injection of OK-432 (OK-432 it), a bacterial biological
      response modifier, in patients with gastric cancer. The 10-year survival and
      disease-free survival were examined and analysis of the factors showing survival
      benefit was performed. 370 patients who had undergone curative resection of
      gastric cancer were enrolled in this study and followed up for 10 years
      postoperatively. Patients were randomized into either an OK-432 it group or a
      control group. Ten Klinishe Einheit (KE) of OK-432 was endoscopically injected at
      1 to 2 weeks before the operation in the OK-432 it group. Both groups received
      the same adjuvant chemoimmunotherapy consisting of a bolus injection of mitomycin
      C (0.4 mg kg(-1) i.v.) and administration of tegafur and OK-432 from
      postoperative day 14 up to 1 year later. Tegafur (600 mg day(-1)) was given
      orally and OK-432 (5 KE/2 weeks) was injected intradermally for a maintenance
      therapy. The TILs grades in resected tumour specimens and presence of metastasis
      and metastatic pattern in dissected lymph nodes were examined. Multivariate
      analysis was performed to determine the efficacy of OK-432 it on prognostic
      factors. All patients were followed up for 10 years. The overall 5- and 10-year
      survival rates and disease-free survival rates of the OK-432 it group were not
      significantly higher than those of the control group. However, OK-432 it
      significantly increased the 5- and 10-year survival rates of patients with stage
      IIIA + IIIB, moderate lymph node metastasis (pN2), and positive TILs. OK-432 it
      was most effective at prolonging the survival of patients who had both positive
      TILs and lymph node metastasis. The OK-432 it group with positive TILs showed a
      significant decrease in metastatic lymph node frequency and in the number of
      lymph node micro- metastatic foci when compared to the control group. This study
      showed that only one time preoperative OK-432 it, particularly when it triggers
      TILs, is effective for reduction of regional lymph node metastasis. OK-432 it
      probably acts partly by eliminating micro-metastatic foci in lymph nodes.
      Preoperative intratumoral injection of OK-432 is technically very easy and has no
      serious adverse effects, so it is a promising form of neoadjuvant immunotherapy
      for advanced gastric cancer.

PMID- 11207037
TI  - Estimation of glomerular filtration rate in cancer patients.
AB  - The frequent need to obtain an estimate of renal function in cancer patients, not
      least for targeting carboplatin dose, has led to a number of approaches to
      estimate glomerular filtration rate (GFR). This study aimed to develop a simple
      and reliable method to estimate GFR using readily-available patient
      characteristics. Data from 62 patients with estimates of 51Cr-EDTA clearance were
      analysed to determine the most appropriate formula relating this method of
      measuring GFR to patient characteristics. The population pharmacokinetics of 51Cr
      EDTA were analysed using NONMEM to evaluate the influence of each covariate. The
      formulae derived were then validated using a further 38 patients and compared
      with those obtained using existing formulae. 51Cr-EDTA clearance (GFR) was
      positively related to Dubois surface area, negatively related to age, and
      inversely related to serum creatinine (SCr). Females had lower 51Cr-EDTA
      clearance than males. The enzymatic method of SCr assay gave more reliable
      results than the Jaffe colorimetric method. A measure of creatine kinase
      significantly improved the estimation of GFR. The new formula produced estimates
      of GFR which were less biased (Mean Prediction Error = -3%) and more precise
      (Mean Absolute Prediction Error = 12%) than Cockcroft and Gault (-8% and 16%) or
      Jelliffe (-15% and 19%) estimates. The formulae developed here can be used to
      provide reliable estimates of GFR, particularly in regard to targeted dosing of
      carboplatin.

PMID- 11207038
TI  - Treatment of advanced neuroblastoma: feasibility and therapeutic potential of a
      novel approach combining 131-I-MIBG and multiple drug chemotherapy.
AB  - Biological and clinical observations suggest that initial marked reduction of
      resistant clones may be critical in any attempt to improve long-term results in
      advanced neuroblastoma (NB). The aim of this pilot study is to determine short
      term toxicity and efficacy of a new therapeutic model based on the simultaneous
      use of multiple drug chemotherapy and specific irradiation using 131-I-MIBG. The
      study population consisted of 21 patients, from 1 to 8 years of age with good 131
      I-MIBG uptake. 16 extensively pre-treated patients with refractory or relapsed
      disease were divided into 2 groups. In Group 1 (9 patients) the basic
      chemotherapy regimen consisted in cisplatin at the dose of 20 mg/m(2) i.v. per
      day infused over 2 h, for 4 consecutive days; on day 4 Cy 2 g/m(2) i.v. was
      administered over 2 h followed by Mesna. Group 2 (7 patients) was treated with
      basic chemotherapeutic regimen plus VP16 and Vincristine. VP16 at the dose of 50
      mg/m(2) i.v. per day was administered as a 24 h infusion on days 1-3; Vincristine
      1.5 mg/m(2) i.v. was administered on days 1 and 6. On day 10 a single dose of 131
      I-MIBG (200 mCi) with a high specific activity (>1.1 GBq/mg) was administered to
      both Groups by i.v. infusion over 4-6 hours. A further 5 patients were treated at
      diagnosis: 2 with the same regimen as Group 1 and 3 with the same as Group 2. The
      severity of toxicity was graded according to World Health Organization (WHO)
      criteria. Assessment of tumour response was monitored 4-6 weeks after the
      beginning of combined therapy (CO-TH). Response was defined according to INSS
      (International Neuroblastoma Staging System) criteria. No extra-medullary
      toxicity was observed in any patient. Haematological toxicity was the only
      toxicity observed and seemed mainly related to chemotherapy. Myelosuppression was
      mild in the 5 patients treated at diagnosis. No serious infections or significant
      bleeding problems were observed. In the 16 resistant patients, 12 PR, 1 mixed
      response and 3 SD were obtained. In the 5 patients treated at diagnosis 2 PR, 1
      CR and 2 VGPR were observed. No alteration in 131-I-MIBG uptake was observed
      after the chemotherapy preceding radio-metabolic treatment. The therapeutic
      results of this pilot regimen of CO-TH resulted in a high percentage of major
      response after only a single course in both resistant patients and patients
      treated at diagnosis. Because of the minimal toxicity observed in patients
      studied at diagnosis so far, there is room for gradual intensification of the
      treatment. It is to be hoped that this suggested novel approach may represent an
      important route of investigation to improve final outcome in patients with
      advanced NB.

PMID- 11207039
TI  - A phase II study of sequential chemotherapy with docetaxel after the weekly PELF
      regimen in advanced gastric cancer. A report from the Italian group for the study
      of digestive tract cancer.
AB  - In advanced gastric cancer, we investigated feasibility and activity of
      sequential chemotherapy with docetaxel after an intensive weekly regimen
      consisting of cisplatin, epidoxorubicin, fluorouracil, leucovorin (PELF) plus
      filgrastim. Chemotherapy-naive patients with relapsed or metastatic gastric
      cancer received 8 weekly administrations of chemotherapy with cisplatin 40
      mg/m(2), fluorouracil 500 mg/m(2), epidoxorubicin 35 mg/m(2), 6S-stereoisomer of
      leucovorin 250 mg/m(2) and glutathione 1.5 g/m(2). On the other days filgrastim 5
      microg kg(-1) was administered by subcutaneous injection. Subsequently, patients
      with partial response or stable disease received 3 cycles of docetaxel 100
      mg/m(2) every 3 weeks. 40 patients have been enrolled and they are evaluable for
      response and toxicity. After the PELF regimen, 3 patients achieved complete
      response, 13 patients showed partial response, 21 patients had stable disease and
      3 patients progressed (40% response rate; 95% CI 25% to 55%). After docetaxel, 9
      out 34 patients improved the outcome (26.5%); 7 patients with stable disease
      achieved partial response and 2 patients with partial response achieved complete
      response. The overall response rate in the 40 patients was 57.5% (95% CI, 42.5%
      to 72.5%). The PELF regimen did not cause any grade IV toxicity, the most
      frequent grade III acute side-effects were thrombocytopenia and vomiting which
      occurred in the 10% of 320 PELF cycles. Docetaxel caused grade III-IV neutropenia
      and thrombocytopenia in the 10% and the 19% of cycles respectively. Fatigue was a
      frequent side-effect during both PELF and docetaxel chemotherapy. The sequential
      application of docetaxel after PELF chemotherapy gained major objective responses
      with manageable toxicity. This strategy is worth of further investigation in the
      setting of palliative or neoadjuvant chemotherapy.

PMID- 11207040
TI  - The frequency of the predominant Jewish mutations in BRCA1 and BRCA2 in
      unselected Ashkenazi colorectal cancer patients.
AB  - It is presently unclear whether carriers of BRCA1 mutations have an increased
      risk for colorectal cancer (CRC). To gain insight into this issue, 225 unselected
      Ashkenazi Jewish CRC patients were tested for the presence of the three common
      Jewish BRCA1/2 germline mutations: 185delAG and 5382insC (BRCA1) and 6174delT
      (BRCA2). A total of four carriers was found (4/225, 1.78%). This frequency is
      similar to the estimated normal Ashkenazi population frequency, thus suggesting
      that these specific mutations do not contribute to CRC predisposition.

PMID- 11207041
TI  - The rate of the 6174delT founder Jewish mutation in BRCA2 in patients with non
      colonic gastrointestinal tract tumours in Israel.
AB  - Inherited predisposition occurs in 5-10% of all gastrointestinal (GI) cancer
      patients, but with the exception of colorectal cancer (CRC), the genes involved
      in conferring genetic susceptibility remain largely unknown. Indirect evidence
      indicates that germline mutations in BRCA2 might be associated with an increased
      risk for various GI malignancies. A single mutation (6174delT) occurs in the
      BRCA2 gene in high-risk breast ovarian cancer families of Jewish Ashkenazi
      origin, in about 1% of the general Ashkenazi population, and rarely in non
      Ashkenazi Jews. In order to assess the contribution of this germline mutation to
      non-CRC GI cancer in Jewish Israeli patients, we tested 70 unselected,
      consecutive Jewish Ashkenazi patients with gastrointestinal malignancies for this
      mutation by PCR amplification and modified restriction enzyme digests. Patients'
      age range was 38-90 years (mean 65.8+/-11.8 years). The most common malignancies
      were gastric cancer (n = 35) and exocrine pancreatic cancer (n = 23). Overall, 6
      mutation carriers were detected: 3/23 (13%) of the patients with pancreatic
      cancer, 2/35 (5.7%) of patients with gastric cancer and 1/4 (25%) of patients
      with bile duct cancer. The 8.6% mutation carrier rate among patients is a rate
      significantly higher than that of the general Ashkenazi population (1.16%, P =
      0.0002). We conclude that the rate of the predominant Jewish BRCA2 mutation in
      patients with gastric and pancreatic cancer significantly differ from that of the
      general population of the same ethnic origin. Thus, BRCA2 mutations probably
      contribute to gastrointestinal tumorigenesis other then colon cancer, and the
      surveillance scheme for mutation carriers should incorporate this information.

PMID- 11207042
TI  - Screening of male breast cancer and of breast-ovarian cancer families for BRCA2
      mutations using large bifluorescent amplicons.
AB  - 41 breast cancer or breast-ovarian cancer families, including 12 families with at
      least one affected first-degree male relative, were screened for mutations in the
      BRCA2 gene. Mutations had not been found in the BRCA1 gene of these families.
      Chemical cleavage of mismatch was used to identify nucleotide changes within
      large PCR products (average size 1.2 kb) that carried strand-specific fluorescent
      end-labels. 15 amplicons were sufficient to scan 18 exons, including the large
      exon 11. The remaining 9 small exons were examined by Denaturing Gradient Gel
      Electrophoresis. The high sensitivity of this approach was documented by the
      detection, in these 41 patients, of all 9 exonic single nucleotide polymorphisms
      reported with heterozygosity >0.1. Truncating BRCA2 mutations were found in 7 of
      the 41 families. 3 of them were in the group of 12 families comprising cases of
      male breast cancer. Since the methods used here have no bias for particular types
      of mutations, these data confirm the high proportion of frameshifts among
      mutations in BRCA2. However, relevant single nucleotide substitutions were also
      found: one resulting in a stop codon and another one, present in a male patient,
      was the previously reported change Asp2723His, that affects a highly conserved
      region of the BRCA2 protein. This study indicates a BRCA2 contribution of 10%
      (95% CI 2.5-17.5) to our original cohort of 59 breast-ovarian cancer families,
      whereas the contribution of BRCA1 had been estimated at 46% (95% CI 33-59).

PMID- 11207043
TI  - A role for chromosomal instability in the development of and selection for
      radioresistant cell variants.
AB  - Chromosome instability is a common occurrence in tumour cells. We examined the
      hypothesis that the elevated rate of mutation formation in unstable cells can
      lead to the development of clones of cells that are resistant to the cancer
      therapy. To test this hypothesis, we compared chromosome instability to radiation
      sensitivity in 30 independently isolated clones of GM10115 human-hamster hybrid
      cells. There was a broader distribution of radiosensitivity and a higher mean
      SF(2)in chromosomally unstable clones. Cytogenetic and DNA double-strand break
      rejoining assays suggest that sensitivity was a function of DNA repair
      efficiency. In the unstable population, the more radioresistant clones also had
      significantly lower plating efficiencies. These observations suggest that
      chromosome instability in GM10115 cells can lead to the development of cell
      variants that are more resistant to radiation. In addition, these results suggest
      that the process of chromosome breakage and recombination that accompanies
      chromosome instability might provide some selective pressure for more
      radioresistant variants.

PMID- 11207044
TI  - High rates of loss of heterozygosity on chromosome 19p13 in human breast cancer.
AB  - We have recently discovered that the nuclear matrix protein SAFB is an oestrogen
      receptor corepressor. Since it has become clear that many steroid receptor
      cofactors play important roles in breast tumorigenesis, we investigated whether
      SAFB could also be involved in breast cancer. To address this question, the gene
      locus was examined for structural alterations in breast cancer tissue. Laser
      capture microdissection was used for isolating DNA from paired primary breast
      tumour and normal tissue specimens, and the loss of heterozygosity (LOH) at
      chromosome 19p13.2-3 was determined by use of microsatellite markers. LOH was
      detected at the marker D19S216, which colocalizes with the SAFB locus, in
      specimens from 29 (78.4%) of 37 informative patients. The peak LOH rate occurred
      at D19S216 near the SAFB locus, with LOH frequencies ranging from 21.6% to 47.2%
      at other markers. The finding of a very high LOH rate at the marker D19S216
      strongly indicates the presence of a breast tumour-suppressor gene locus. While
      preliminary findings of mutations in SAFB suggest that this indeed may be a
      promising candidate, other potential candidate genes are located at this locus.

PMID- 11207045
TI  - Copy number gain at 12q12-14 may be important in the transformation from
      follicular lymphoma to diffuse large B cell lymphoma.
AB  - The purpose of this study was to identify novel areas of genomic copy number
      change associated with transformation from follicular lymphoma (FL) to diffuse
      large B cell lymphoma (DLBL). DNA was extracted from tumour cells micro-dissected
      from paraffin- embedded tissue sections in 24 patients with FL and subsequent
      transformation to DLBL and 18 patients with de novo DLBL. Tumour DNA was compared
      to reference DNA using comparative genomic hybridization. Abnormalities common to
      all 3 groups were gains on chromosomes 4q, 5q, 7q, 11q and X and losses on 3p, 8p
      and 10q. Copy number changes seen in both transformed and de novo DLBL and not
      seen in FL were gains on 2p and losses on 1q, 15q and Xq. Gains on 2q, 6p, 7p and
      17q and losses on 5p and 8q were specific to transformed DLBL cases. Gain on
      12q12-14 was found in 52% of the transformed DLBL cases and was never seen in its
      follicular counterpart. Patterns of genomic copy number change associated with
      specific clinical events in NHL have been demonstrated and suggest that gains on
      2q, 6p, 7p, 12q and 17q and losses on 5p and 8q may be important in the
      transformation from low to high-grade disease.

PMID- 11207047
TI  - Expression of individual lamins in basal cell carcinomas of the skin.
AB  - In this study we used a unique collection of type specific anti-lamin antibodies
      to study lamin expression patterns in normal human skin and in skin derived from
      patients with basal cell carcinomas (BCCs). Lamin expression in serial sections
      from frozen tissue samples was investigated by single and double indirect
      immunofluorescence. In normal skin, lamin A was expressed in dermal fibroblasts
      and in suprabasal epithelial cells but was absent from all basal epithelial
      cells. Lamin C was expressed in dermal fibroblasts, suprabasal epithelial cells
      and a majority of basal epithelial cells. However, lamin C was not expressed in
      quiescent basal epithelial cells. Lamin B1 was expressed in all epithelial cells
      but was not expressed in dermal fibroblasts. Finally, lamin B2 was expressed in
      all epithelial cells but was not expressed in dermal fibroblasts. Finally, lamin
      B2 was expressed in all cell types in normal skin. Lamin expression was also
      investigated in a collection of 16 BCCs taken from a variety of body sites. Based
      upon patterns of lamin expression the BCCs were classified into four groups: A
      negative (10/16 tumours), C-negative (5/16 tumours), A/C-negative (1/16 tumours)
      and A/B2-negative (1/16 tumours). Lamin expression was also compared to cell
      proliferation index by staining serial sections with the proliferation marker
      Ki67. 9/10 of the lamin A negative tumours were highly proliferative, whereas 4/5
      of the lamin C negative tumours were slow growing. Thus as a general rule absence
      of lamin A was correlated with rapid growth within the tumour, while absence of
      lamin C was correlated with slow growth within the tumour. Our data supports the
      hypothesis that lamin A has a negative influence on cell proliferation and its
      down regulation may be a requisite of tumour progression.

PMID- 11207046
TI  - Telomerase activation cooperates with inactivation of p16 in early head and neck
      tumorigenesis.
AB  - Alteration of the p16/pRb pathway may cooperate with telomerase activation during
      cellular immortalization and tumour progression. We studied p16 expression status
      by immunohistochemistry and telomerase activity using the TRAP assay in 21
      premalignant lesions of the head and neck epithelium as well as 27 squamous-cell
      carcinomas. We also examined expression of other components of the pathway
      (cyclin D1 and pRb) as well as presence of human papillomavirus genomes which can
      target these molecules. 4 of 9 mild dysplastic lesions (44%), 8 of 12
      moderate/severe dysplastic lesions (67%), and 25 of 27 squamous-cell carcinomas
      (92%) demonstrated high telomerase activity (P = 0.009). There was a parallel
      increase with severity of lesions for the trend in proportions of cases
      demonstrating p16 inactivation or cyclin D1 overexpression (P = 0.02 and P =
      0.01, respectively). For Ki67, a marker of cell proliferation, this trend was not
      significant (P = 0.08). Human papillomavirus infection was only found in 4 cases
      among the 48 samples tested (8.3%). In conclusion, progression of disease is
      accompanied by a parallel and continuous increase in telomerase activity and
      alterations in cell cycle regulators (p16, cyclin D1), as proposed by in vitro
      models.

PMID- 11207048
TI  - Transcriptional down-regulation of the retinoblastoma protein is associated with
      differentiation and apoptosis in human colorectal epithelial cells.
AB  - The aim of this study was to investigate the regulation of Rb protein expression
      in relation to increased differentiation and induction of apoptosis in colonic
      epithelial cells. In vivo, Rb protein expression was found to be down-regulated
      towards the top of the normal colonic crypt, coincident with the region of
      differentiation and apoptosis, but highly expressed in colonic carcinoma tissue.
      Using in vitro models to study the regulation of Rb expression in pre-malignant
      colonic epithelial cells, we have been able to show for the first time that Rb
      protein expression is transcriptionally down-regulated in differentiated pre
      malignant cells (in post-confluent cultures) but not in malignant colorectal
      epithelial cells. Furthermore, suppression of rb protein function by the HPV-E7
      viral oncoprotein increased both spontaneous and DNA damage-induced apoptosis.
      These results suggest that Rb is able to act as a survival factor in colonic
      epithelial cells by suppressing apoptosis, and that over-expression of pRb in
      colorectal tumour cells can cause a loss of sensitivity to apoptotic signalling,
      resulting in aberrant cell survival and resistance to therapy.

PMID- 11207049
TI  - The level of manganese superoxide dismutase content is an independent prognostic
      factor for glioblastoma. Biological mechanisms and clinical implications.
AB  - We address the issue of the role of manganese superoxide dismutase in
      tumorigenesis by studying a relatively homogeneous group of tumours for the
      correlation between amount of this anti-oxidant enzyme and prognosis. The
      clinical outcome of 30 patients affected by glioblastomas whose manganese
      superoxide dismutase content had been established at the time of first diagnosis
      is compared. When the survival of patients is stratified according to manganese
      superoxide dismutase level in the tumour, a link of these levels and prognosis
      can be observed. Patients with high levels of manganese superoxide dismutase show
      a median survival time of 6.11 months, while patients whose tumours display a low
      amount of MnSOD have a median survival time of 12.17 months. To assess the
      upstream mechanisms that sustain the increase in manganese superoxide dismutase
      content in brain neuroepithelial tumours, we also studied the expression of p53
      in a series of 17 astrocytomas of various grading. In all tested astrocytomas,
      high manganese superoxide dismutase content is associated with cytoplasmic
      accumulation of p53. Thus glioblastomas can be divided into two distinct groups
      on the basis of their content of manganese superoxide dismutase, having 'better'
      or 'worse' prognosis, respectively. The use of this protein as a marker may help
      to define therapeutic strategies in the clinical management of glioblastoma.

PMID- 11207050
TI  - Malignant melanoma is genetically distinct from clear cell sarcoma of tendons and
      aponeurosis (malignant melanoma of soft parts).
AB  - Clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts)
      and conventional malignant melanoma may demonstrate significant morphologic
      overlap at the light microscopic and ultrastructural level. Consequently, the
      clinically relevant distinction between primary clear cell sarcoma and metastatic
      melanoma in the absence of a known primary cutaneous, mucosal or ocular tumour
      may occasionally cause diagnostic problems. A balanced translocation,
      t(12;22)(q13;q13), which can be detected, amongst others, using the reverse
      transcriptase polymerase chain reaction (RT-PCR) or fluorescent in situ
      hybridization (FISH), has been identified in a high percentage (50-75%) of clear
      cell sarcomas and is presumed to be tumour specific. Whether this chromosomal
      rearrangement is present in malignant melanoma has, to date, not as yet been
      studied by molecular genetic or molecular cytogenetic techniques. Using RT-PCR
      and FISH, a series of metastases from 25 known cutaneous melanomas and 8 melanoma
      cell lines (5 uveal and 3 cutaneous) were screened for the t(12;22)(q13;q13)
      translocation. Primers for RT-PCR were chosen based upon published breakpoint
      sequences. The Cosmids G9 and CCS2.2, corresponding to the 5' region of EWS and
      3' region of ATF-1 respectively, were used as probes. The translocation was not
      identified in any of the melanomas or melanoma cell lines analysed in this study;
      in contrast this translocation was identified in 3 out of 5 clear cell sarcomas
      using these techniques. This allows distinction between translocation positive
      cases of clear cell sarcoma and malignant melanoma at a molecular genetic level.
      Consequently, in diagnostically challenging cases, this represents a valuable
      tool for the clinicopathologic differentiation between these two entities, with
      an important impact on patient management and prognosis.

PMID- 11207051
TI  - Histological type and marker expression of the primary tumour compared with its
      local recurrence after breast-conserving therapy for ductal carcinoma in situ.
AB  - We have investigated primary ductal carcinomas in situ (DCIS) of the breast and
      their local recurrences after breast-conserving therapy (BCT) for histological
      characteristics and marker expression. Patients who were randomized in the EORTC
      trial 10853 (wide local excision versus excision plus radiotherapy) and who
      developed a local recurrence were identified. Histology was reviewed for 116
      cases; oestrogen and progesterone receptor status, and HER2/ neu and p53
      overexpression were assessed for 71 cases. Comparing the primary DCIS and the
      invasive or non-invasive recurrence, concordant histology was found in 62%, and
      identical marker expression in 63%. Although 11% of the recurrences developed at
      a distance from the primary DCIS, nearly all these showed the same histological
      and immunohistochemical profile. 5 patients developed well-differentiated DCIS or
      grade I invasive carcinoma after poorly differentiated DCIS. Although these
      recurrences occurred in the same quadrant as the primary DCIS, they may be
      considered as second primary tumours. Only 4 patients developed poorly
      differentiated DCIS or grade III invasive carcinoma after well differentiated
      DCIS. We conclude that in most cases the primary DCIS and its local recurrence
      are related histologically or by marker expression, suggesting that local
      recurrence usually reflects outgrowth of residual DCIS; progression of well
      differentiated DCIS towards poorly differentiated DCIS or grade III invasive
      carcinoma is a non-frequent event.

PMID- 11207052
TI  - Oestrogen receptor beta expression and depth of myometrial invasion in human
      endometrial cancer.
AB  - We assessed the relative expression of oestrogen receptor (ER)alpha and oestrogen
      receptor (ER)beta mRNAs in 36 human endometrial cancers using a multiplex
      polymerase chain reaction (PCR). To determine whether or not the expression of ER
      subtypes in endometrial cancers is associated with clinicopathological
      parameters, we examined correlations between ER subtypes and age, tumour grade
      and depth of myometrial invasion. Using multiple regression analysis, myometrial
      invasion showed a significant correlation with ER-beta: ER-alpha ratio (r = 0.54,
      P = 0.0007). The ER-beta:ER-alpha ratio was high in advanced invasive carcinoma.
      Western blotting analysis showed that ER-beta proteins were highly expressed in
      comparison with ER-alpha proteins in endometrial cancer with severe myometrial
      invasion. Our results suggest that ER-beta is important in the progression of
      myometrial invasion.

PMID- 11207053
TI  - A novel doxorubicin-glucuronide prodrug DOX-GA3 for tumour-selective
      chemotherapy: distribution and efficacy in experimental human ovarian cancer.
AB  - The doxorubicin (DOX) prodrug N-[4-doxorubicin-N-carbonyl (oxymethyl) phenyl] O
      beta-glucuronyl carbamate (DOX-GA3) was synthesised for specific activation by
      human beta-glucuronidase, which is released in necrotic areas of tumour lesions.
      This novel prodrug was completely activated to the parent drug by human beta
      glucuronidase with V(max)= 25.0 micromol x min(-1) x mg(-1) and K(m) = 1100
      microM. The pharmacokinetics and distribution of DOX-GA3 in nude mice bearing
      human ovarian cancer xenografts (OVCAR-3) were determined and compared with DOX.
      Administration of DOX at 8 mg x kg(-1) i.v. (maximum tolerated dose, MTD) to
      OVCAR-3-bearing mice resulted in a peak plasma concentration of the drug of 16.4
      microM (t = 1 min). A 7.6-times lower peak plasma concentration of DOX was
      measured after injection of DOX-GA3 at 250 mg x kg(-1) i.v. (50% of MTD). In
      normal tissues the prodrug showed peak DOX concentrations that were up to 5-fold
      (heart) lower than those found after DOX administration. DOX-GA3 activation by
      beta-glucuronidase in the tumour yielded an almost 5-fold higher DOX peak
      concentration of 9.57 nmol x g(-1) (P< 0.05) than the peak concentration of only
      2.14 nmol x g(-1) observed after DOX. As a consequence, the area under the curve
      of DOX calculated in tumour tissue after DOX-GA3 (13.1 micromol x min(-1) x g(
      1)) was 10-fold higher than after DOX (1.31 micromol x min(-1) x g(-1)). The anti
      tumour effects of DOX-GA3 and DOX were compared at equitoxic doses in OVCAR-3
      xenografts at a mean tumour size of 125 mm(3). The prodrug given i.v. at 500 mg x
      kg(-1) weekly x 2 resulted in a maximum tumour growth inhibition of 87%, while
      the standard treatment with DOX at a dose of 8 mg x kg(-1) i.v. weekly x 2
      resulted in a maximum tumour growth inhibition of only 56%. Treatment with DOX
      GA3 was also given to mice with larger tumours containing more necrosis. For
      tumours with a mean size of 400 mm(3) the specific growth delay by DOX-GA3
      increased from 2.7 to 3.9. Our data indicate that DOX-GA3 is more effective than
      DOX and suggest that the prodrug will be specifically advantageous for treatment
      of advanced disease.

PMID- 11207054
TI  - Human bladder cancer invasion model using rat bladder in vitro and its use to
      test mechanisms and therapeutic inhibitors of invasion.
AB  - As well as being a passive support, the extracellular matrix also regulates key
      biological processes such as invasion, differentiation and angiogenesis. We have
      therefore developed an in vitro model of bladder cancer invasion using de
      epithelialized rat bladder to allow for tumour cell-extracellular matrix
      interactions. Onto this we have seeded a panel of human bladder cancer cell lines
      (RT4, RT112, 253J and EJ28 (T24)) representing progression from well to poorly
      differentiated phenotypes and used as models of superficial to invasive bladder
      cancer. The better differentiated cell lines RT4 and RT112 reproducibly grew as
      stratified epithelium, whereas poorly differentiated EJ28 cells invaded across a
      broad front. Invasion was not simply related to proliferation rate, measured
      either as doubling time on plastic (non-invasive 253J and invasive EJ28 having
      the same doubling time) or by Ki-67 proliferation index within the model. We used
      the model to test the ability of 4 compounds that interfere with tumour cell
      extracellular matrix interactions (suramin, N-acetylcysteine and the urokinase
      plasminogen activator pathway antagonists A5 compound and monoclonal antibody Mab
      3936) to inhibit invasion. At non-toxic concentrations, all significantly
      inhibited invasion (P< 0.05), although to varying degrees, suramin and A5 almost
      completely and N-acetylcysteine the least. In conclusion, this model shows the
      urokinase system is important for bladder invasion and can be used to investigate
      other mechanisms of bladder cancer invasion and also for the testing of
      intravesical drugs.

PMID- 11207055
TI  - Electroporation of human microvascular endothelial cells: evidence for an anti
      vascular mechanism of electrochemotherapy.
AB  - Recent studies have indicated that the antitumour effectiveness of
      electrochemotherapy, a combination of chemotherapeutic drugs with application of
      high voltage electric pulses applied to the tumour nodule (electroporation),
      result in a significant reduction in tumour blood flow and may therefore be
      mediated by an anti-vascular mechanism. The aim of this study was to evaluate the
      cytotoxicity of electroporation with bleomycin or cisplatin on cultured human
      microvascular endothelial cells (HMEC-1). The sensitivity of HMEC-1 cells to a 5
      min treatment by electroporation with bleomycin or cisplatin (8 electric pulses,
      pulse duration 100 micros, frequency 1 Hz, electric field intensity 1400 V x cm(
      1)) was compared to the sensitivity of cells treated continuously for 3 days with
      drugs alone. HMEC-1 cells were moderately sensitive to continuous exposure to
      cisplatin, but showed greater sensitivity to bleomycin. Combination of a 5 min
      drug exposure with electric pulses increased cytotoxicity approximately 10-fold
      for cisplatin and approximately 5000-fold for bleomycin. The electroporation of
      HMEC-1 cells with bleomycin for a 5 min exposure was approximately 250-fold
      better than a continuous exposure to the drug alone. The results of this study
      indicate that the anti-tumour action of electrochemotherapy is likely to be due,
      in part, to the highly sensitive response of vascular endothelial cells. Further
      studies are necessary to identify the determinants of endothelial response and
      its relationship to the anti-vascular action of electrochemotherapy in vivo.

PMID- 11207056
TI  - Therapy of human T-cell acute lymphoblastic leukaemia with a combination of anti
      CD7 and anti-CD38-SAPORIN immunotoxins is significantly better than therapy with
      each individual immunotoxin.
AB  - Severe combined immunodeficient (SCID) mice injected i.v. with the human T-ALL
      cell line CCRF CEM (SCID-CEM mice) develop within 50 days life-threatening multi
      organ growth of leukaemia cells. The development of leukaemia in SCID-CEM mice
      treated with three 10 microg i.v. doses of the anti-CD7 immunotoxin (IT) HB2
      SAPORIN or the anti-CD38 IT OKT10-SAPORIN was significantly delayed compared with
      PBS sham-treated animals but 90% of animals treated with either IT eventually
      developed disseminated leukaemia cell growth. In contrast treatment of SCID-CEM
      mice with a combination of both ITs led not only to a significantly greater delay
      in time to leukaemia development but also in the numbers of animals remaining
      leukaemia free (60%). The native HB2 and OKT10 antibodies (both murine
      IgG1antibodies) exerted significant, though relatively weak therapeutic effects,
      probably mediated through an antibody-dependent cellular cytotoxicity (ADCC)
      mechanism. Moreover, there was no in vivo additivity of therapeutic effect when
      both antibodies were used in combination. Apparent, however, was that the
      combination of HB2-SAPORIN IT with OKT10 antibody led to an intermediate
      therapeutic effect that was significantly greater than that obtained when either
      was used alone but significantly less than that obtained when the two IT
      combination was utilized. This was similarly the case for the combination of
      OKT10-SAPORIN IT with HB2 antibody though the effect was less pronounced in this
      instance. This result suggests that the therapeutic effect of IT + antibody
      treatment results from an additivity between antibody-mediated delivery of
      saporin combined with a SCID mouse NK cell-mediated ADCC attack on the target
      cell directed through target cell bound antibody Fc engagement with FcgammaRIII
      on the NK cell surface. The combination of both ITs however gave the best
      therapeutic outcome in SCID-CEM mice probably as the result of (i) delivery of
      greater amounts of saporin to target CEM cells positive for both CD7 and CD38,
      (ii) delivery of an effective dose of saporin to CEM cells downregulated or
      negative for one of the target antigens and (iii) through ADCC mechanisms that
      interact additively with IT action. We have previously proposed that combination
      IT therapy would be one means of overcoming the problem of heterogeneity of
      antigen expression within a global tumour cell population and these additional
      findings support this and provide a further strengthening of the rationale for
      employing cocktails of ITs for the treatment of human malignancies.

PMID- 11207059
TI  - The pharmacology of phosducin.
AB  - The discovery of phosducin (Phd) in photoreceptor cells of the retina and the
      further identification of phosducin-like proteins (PhdLP) emphasizes the
      existence of a family of proteins characterized as cytosolic regulators of G
      protein functions. The individual members represent phosphoproteins with distinct
      tissue distributions whose highest concentrations were in the retina and the
      pineal gland, while lower levels were reported for tissues such as liver, spleen,
      striated muscle, and the brain. Several functions of Phd and PhdLP have been
      suggested, but their most important ability appears to be their high affinity
      sequestration with G betagamma subunits of heterotrimeric G proteins. This
      finding suggests that neutralization of G betagamma by Phd effectively impedes G
      protein-mediated signal transmission, since G alpha cannot reassemble with G
      betagamma to provide a functional G protein trimer (G alphabetagamma). Thus, it
      is the scavenger quality of Phd that is hypothesized to diminish intracellular
      communication simply by reducing the number of G proteins. An additional
      important function of Phd relates to the inhibition of G alpha subunits' inherent
      GTPase. The ability of Phd to directly bind G alpha subunits is probably of minor
      significance as the affinity between both proteins is low. In general, similar
      mechanisms have been reported for PhdLPs. In the majority of investigations
      concerning the interference of Phd with physiological mechanisms, the dark/light
      adaptation of retinal photoreceptor cells has been the most frequently studied
      aspect of Phd. More recently, Phd was associated with the adenylyl cyclase of
      olfactory cilia, as in the presence of the phosphoprotein an increased
      concentration of cAMP is observed. This finding is in line with the experimental
      outcome of permanent cell lines transfected to overexpress Phd, which exhibit
      sensitization to excitatory acting PGE(1), and isoproterenol, respectively.
      Furthermore, Phd was found to effectively slow down the mechanism of
      internalization of G protein-coupled opioid receptors. Pathophysiological
      processes associated with Phd were found for certain eye diseases. Experimental
      evidence suggests the development of retinal inflammation as a consequence of an
      autoimmunization process triggered by Phd or shorter fragments thereof. Thus, our
      present knowledge regarding the functions of members of the Phd family is limited
      currently to their control of G protein-mediated intracellular signal
      transmission, the process of endocytosis, and certain autoimmune diseases of the
      uvea and the pineal gland. However, recent information regarding the presence of
      certain members of the Phd family in the cell nucleus may bear new insights into
      the function of these compounds.

PMID- 11207057
TI  - Ternary combination of irinotecan, fluorouracil-folinic acid and oxaliplatin:
      results on human colon cancer cell lines.
AB  - A marked antitumour efficacy is currently obtained by oxaliplatin (LOHP)
      fluorouracil (FU)-folinic acid (FA) combination and by CPT11-FU-FA combination.
      Logically, the triple association LOHP, CPT11 and FUFA will be soon tested in
      cancer patients. The aim of the present study was to compare two schedules
      combining SN38 (the active metabolite of CPT11, irinotecan) with FU-FA and LOHP.
      The two schedules differed by the SN38 position. The relative contribution of
      each drug in the resulting global cytotoxicity was evaluated. Two human colon
      cancer cell lines were used (WIDR and SW620 both p53 mutated). LOHP plus FA were
      applied for 2 h, just before a 48 h FU exposure. The SN38 sequence was applied
      for 24 h, starting either 48 h before LOHP-FA (schedule A), or just after LOHP-FA
      exposure (schedule B). Cytotoxicity was assessed by the 3-(4,5-demethylthiazol-2
      yl)-2,5 diphenyltetrazolium bromide (MTT) test and drug interactions were
      analysed according to the Chou and Talalay method, based on the computation of a
      combination index (CI). The SN38 position significantly induces a shift from
      additivity-antagonism when SN38 was applied after LOHP, towards additivity
      synergism when SN38 was applied first (P = 0.03). The relative contribution (RC)
      of each drug in the overall cytotoxicity of the triple combination was defined as
      the drug concentration giving 50% cell lethality (IC(50)) of the double
      association without that drug divided by the IC(50)of the triple association.
      Whatever the SN38 position, the larger contribution was made by LOHP (median RC =
      2.4) and the smaller by SN38 (median RC = 1.1). In addition, the contribution of
      FUFA was improved when SN38 was applied first (median RC = 2.2) as compared to
      the opposite schedule (median RC = 1.2). Results were in agreement between the
      two explored cell lines. The present data should be taken into account when
      establishing the rationale of future trials combining CPT11, LOHP and FU-FA.

PMID- 11207060
TI  - Bombycis corpus extract prevents amyloid-beta-induced cytotoxicity and protects
      superoxide dismutase activity in cultured rat astrocytes.
AB  - Bombycis corpus(BC) or Bombyx Batryticatus, a batryticated silkworm and white
      stiff silkworm, is a drug consisting of the dried larva of silkworm, Mobyz mori
      L., dead and stiffened due to the infection of Beauveria (Bals.) Vuill. In the
      present study, we have examined the protective effect of the water extracts
      against Amyloid- beta(A beta) 25-35 peptide-induced cytotoxicity by microscopic
      observation and LDH assay, and its action on antioxidative enzymes using cultured
      astrocyte cells. A beta 25-35-induced cell death was protected by the application
      of water extract of BC in a dose-dependent manner, and concentrations of 10(-6)to
      10(-7)g ml(-1)showed a significant effect compared to exposure of A beta 25-35
      alone. When antioxidative enzyme activities such as catalase, superoxide
      dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione-S transferase
      (GST) were assayed after A beta 25-35 treatment, most enzyme activities were
      decreased in a similar fashion. BC treatment of A beta 25-35-treated astrocytes
      did not affect the enzyme activities of catalase, GSH-Px and GST. However, only
      SOD activity was enhanced by BC treatment and this may result from the
      potentiation of the antioxidative ability of BC. The protective effect of BC
      against cytotoxicity induced by Abeta 25-35 strongly indicates that BC could be a
      protective agent for free radical generating compounds, and that Abeta 25-35 is
      not only a potent lipid peroxide inducer, but can also cause changes in
      antioxidative enzymes. From the results, it was concluded that BC has a
      protective effect against Abeta -induced cytotoxicity in cultured astrocyte cells
      through the inhibition of lipid peroxidation and protection of antioxidative
      enzymes.

PMID- 11207061
TI  - The ameliorating effect of the water layer of Fructus Schisandrae on
      cycloheximide-induced amnesia in rats: interaction with drugs acting at
      neurotransmitter receptors.
AB  - Our previous study indicated that the water layer present in Fructus
      Schisandra(FS(w)) at 10 and 25 mg kg(-1)significantly counteracted cycloheximide
      (CXM)-induced amnesia. Therefore, the mechanism of action of the ameliorating
      effect of FS(w)on CXM-induced amnesia in the passive avoidance task was
      investigated in rats. The ameliorating effect of FS(w)on CXM-induced amnesia was
      depressed by scopolamine. The serotonin releaser, p -chloroamphetamine
      significantly antagonized the ameliorating effect of FS(w)on CXM-induced amnesia.
      Furthermore, the ameliorating effect was also inhibited by the 5-HT(1A)receptor
      agonist 8-OH-DPAT, but potentiated by the 5-HT(2)receptor antagonist ritanserin.
      Finally, the GABA(A)receptor antagonist bicuculline blocked the ameliorating
      effect of FS(w). These results suggest that the beneficial effect of FS(w)on CXM
      induced amnesia is amplified by treatment with serotonergic 5-HT(2)receptor
      antagonists, but reduced by serotonergic 5-HT(1A)receptor agonists as well as
      GABA(A)and cholinergic receptor antagonists.

PMID- 11207062
TI  - Teprenone promotes the healing of acetic acid-induced chronic gastric ulcers in
      rats by inhibiting neutrophil infiltration and lipid peroxidation in ulcerated
      gastric tissues.
AB  - Teprenone, an anti-ulcer drug, has been reported to promote the healing of acetic
      acid-induced chronic gastric ulcers in rats by stimulating gastric mucus
      synthesis and secretion. Recently, it has been implicated that neutrophil
      infiltration and lipid peroxidation in ulcerated gastric tissues have an
      inhibitory effect on the healing of acetic acid-induced chronic gastric ulcers in
      rats. Therefore, we attempted to clarify whether teprenone exerts a healing
      promoting effect on acetic acid-induced chronic gastric ulcers through its
      inhibitory effect on neutrophil infiltration and lipid peroxidation in ulcerated
      gastric tissues. In rats with chronic gastric ulcers made by applying acetic acid
      to the stomach, gastric ulcer healing started later than 3 days after the acetic
      acid application. Gastric mucosal myeloperoxidase (MPO) activity, an index of
      tissue neutrophil infiltration, and lipid peroxide content were higher in the
      ulcerated region than in the intact region on the 8th, 15th, and 22nd day after
      the acetic acid application. Gastric mucosal non-protein SH content was lower in
      the ulcerated region than in the intact region on the 8th, 15th, and 22nd day
      after the acetic acid application, and gastric mucosal adherent mucus content was
      lower in the ulcerated region than in the intact region on the 8th and 15th day.
      Daily oral administration of teprenone (100 mg kg(-1)x 2) for 7 or 14 days,
      starting on the 8th day after the application of acetic acid to the stomach,
      enhanced the reduction of the ulcer area with attenuation of all these
      biochemical changes found in the ulcerated region. The teprenone administration
      caused a decrease in MPO activity and an increase in adherent mucus content in
      the gastric mucosa of the intact region. These results suggest that the healing
      promoting effect of teprenone on acetic acid-induced chronic gastric ulcers in
      rats could be due not only to stimulation of gastric mucus secretion but also to
      inhibition of neutrophil infiltration and enhanced lipid peroxidation in the
      ulcerated gastric tissue.

PMID- 11207063
TI  - A comparative study of policosanol vs lovastatin on intimal thickening in rabbit
      cuffed carotid artery.
AB  - Policosanol is a cholesterol-lowering drug isolated from sugar cane wax, which
      acts by inhibiting cholesterol biosynthesis. Previous studies have demonstrated
      that policosanol inhibited smooth muscle cell (SMC) proliferation in the cuffed
      carotid artery of the rabbit and in arterial wall damage induced by forceps in
      the central artery of the ear of rabbits. The present study was undertaken to
      compare the effects of policosanol and lovastatin on SMC proliferation in the
      cuffed carotid artery of rabbits. Collars were placed around the left carotid for
      7 and 15 days. The contralateral artery was sham operated. We studied eight
      experimental groups: two controls groups receiving vehicle for 7 and 15 days,
      respectively, a satellite sham operated control group, four groups treated with
      policosanol at 5 and 25 mg kg(-1)for 7 and 15 days and a reference group
      receiving lovastatin at 20 mg kg(-1)for 15 days. Samples of arteries were
      examined by light and electron microscopy. To evaluate intimal thickening the
      cross-sectional areas of intima and media were measured. Neointima was
      significantly reduced in treated animals compared with controls, but the
      reduction in lovastatin animals was significantly lower than in policosanol
      treated groups. The SMC proliferation was studied by the immunohistochemical
      detection of proliferating cell nuclear antigen and the reduction observed in
      policosanol-treated rabbits was significantly larger than in lovastatin-treated
      animals. It is concluded that the protective effect of policosanol against
      neointima formation in this experimental model was slightly better than that of
      lovastatin.

PMID- 11207064
TI  - Possible role of nitric oxide and mast cells in endotoxin-induced
      cardioprotection.
AB  - The present study is designed to investigate the role of nitric oxide (NO) and
      cardiac mast cells in the cardioprotective effect of endotoxin in isolated rat
      heart subjected to 30 min of global ischaemia and 30 min of reperfusion.
      Endotoxin (2.5 mg kg(-1); i.p.) was administered 8 h before subjecting the heart
      to global ischaemia. Endotoxin pretreatment markedly reduced the release of
      lactate dehydrogenase (LDH) and creatine kinase (CK), markers of cardiac injury,
      in coronary effluent and the percentage incidence of ventricular premature beats
      (VPBs) and ventricular tachycardia/fibrillation (VT/VF) during the reperfusion
      phase. Endotoxin pretreatment significantly increased the release of nitrite
      prior to and after global ischaemia. On the other hand, endotoxin pretreatment
      decreased the release of mast cell peroxidase (MPO) during the reperfusion phase.
      The cardioprotective and antiarrhythmic effect of endotoxin pretreatment was
      abolished by dexamethasone (3 mg kg(-1); i.p.) or l -canavanine (20 mg kg(-1);
      i.p.) given 1 h before the administration of endotoxin. It is proposed that the
      cardioprotective and antiarrhythmic effect of the endotoxin may be ascribed to
      the induction of nitric oxide synthase (NOS) and subsequent increase in the
      release of NO. NO may stabilize cardiac mast cells and consequently decrease the
      release of cytotoxic mediators from these cells. Prevention of degranulation of
      cardiac mast cells may be responsible for the cardioprotective and antiarrhythmic
      effects of the endotoxin.

PMID- 11207065
TI  - AMPA-receptor blockade within the RVLM modulates cardiovascular responses via
      glutamate during peripheral stimuli.
AB  - We investigated the effects of AMPA-receptor blockade in the rostral
      ventrolateral medulla (RVLM) on cardiovascular responses and extracellular
      concentrations of glutamate during two different types of stimuli that activate
      peripheral Adelta - and C-fiber polymodal nociceptors using anesthetized rats.
      First, mechanical stimulation was achieved by applying a bilateral hindpaw pinch
      for 5 s, and second, thermal stimulation was evoked by immersing bilaterally the
      hindpaw metatarsi in a 52 degrees C hot water bath for 4 s. Mechanical
      stimulation increased mean arterial pressure (MAP) by 23 +/- 1 mmHg and heart
      rate (HR) by 25 +/- 3 bpm (n= 8). Thermal stimuli increased MAP by 32 +/- 3 mmHg
      and HR by 27 +/- 4 bpm (n= 8). After controlled generation of mechanical or
      thermal stimulation, 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX; 1.0 microM) was
      microdialysed bilaterally into the RVLM for 30 min. Administration of CNQX
      attenuated MAP and HR responses during a subsequent mechanical but not during
      thermal stimulation. Analyses of extracellular concentrations of glutamate within
      the RVLM bilaterally revealed an increase of this neurotransmitter within the
      RVLM during mechanical noxious stimulation. Concomitant with attenuation of the
      cardiovascular responses, glutamate concentrations were also decreased during the
      mechanical stimulation after administration of CNQX. These results demonstrate
      that the AMPA-receptor blockade within the RVLM that attenuates cardiovascular
      responses during mechanical stimulation is associated with a reduction in
      extracellular levels of glutamate. In addition, it appears that AMPA receptors in
      the RVLM do not play a role in mediating cardiovascular responses during thermal
      stimulation.

PMID- 11207066
TI  - Lazaroid compounds prevent early but not late stages of oxidant-induced cell
      injury: potential explanation for the lack of efficacy of lazaroids in clinical
      trials.
AB  - Earlier in vitro studies demonstrated the remarkable potency of the lazaroid
      compounds to prevent oxidant-induced early cell injury. However, the ability of
      lazaroid compounds to limit oxidative injury in vivo(including renal ischemia
      reperfusion) has been less certain, and the early clinical trials using lazaroids
      to limit CNS injury or organ injury in the setting of transplantation have not
      been promising. Lazaroid compounds are potent inhibitors of lipid peroxidation,
      and their inability to influence other key injury processes, particularly during
      the late stages of cell injury, might partly explain the limited clinical
      efficacy. To test this, renal tubular (LLC-PK1) cells were incubated with 250
      micromH(2)O(2)for 135 min, in the presence or absence of 2-methyl aminochroman (2
      MAC, U-83836E), a lazaroid with potent ability to inhibit lipid peroxidation, or
      desferrioxamine, (DFO) an iron chelator with broader antioxidant efficacy. Cell
      injury, lipid peroxidation, DNA damage and ATP depletion were measured in the
      early (immediately after H(2)O(2)incubation) and late (24 h after
      H(2)O(2)incubation) stages of cell injury. In the early stage, 2-MAC suppressed
      H(2)O(2)-induced lipid peroxidation and LDH release, but not the DNA damage, ATP
      depletion or loss of cell replication. In contrast, DFO suppressed all of the
      measurements. In the late stages, despite continued suppression of lipid
      peroxidation, only DFO maintained significant cytoprotection against H(2)O(2),
      and this was accompanied by reduced DNA damage, higher ATP levels and
      preservation of cell proliferation. Thus, the inability of the lazaroid compound
      2-MAC to sustain cytoprotection in the later stages of cell injury might provide
      at least a partial explanation for the inefficiency of lazaroids to limit tissue
      injury in clinical and certain in vivo settings.

PMID- 11207067
TI  - Induction of heme oxygenase-1 by Ginkgo biloba extract but not its terpenoids
      partially mediated its protective effect against lysophosphatidylcholine-induced
      damage.
AB  - In this study, we examined whether Ginkgo Biloba Extract and its terpenoid
      constituents protect against oxidative stress through actions on heme oxygenase
      (HO) gene expression and activity. HO-1 and glutathione peroxidase (GPx) gene
      expressions were examined by reverse transcription polymerase chain reaction (RT
      PCR) analysis, HO activity and GPx enzyme activity were analysed by
      spectrophotometric assay. Pretreatment of H9c2 myocytes with 100-500 microgml(
      1)Ginkgo Biloba Extract caused induction of HO-1 gene expression and a
      significant increase in HO activity; 30 microgml(-1)ginkgolide B and 30 microgml(
      1)bilobalide had little effect. Treatment with Ginkgo Biloba Extract for 24 h
      also significantly increased GPx gene expression and GPx enzyme activity.
      Pretreatment with Ginkgo Biloba Extract, ginkgolide B and bilobalide protected
      myocytes against lysophosphatidylcholine (LPC)-induced damage. The protective
      effect of Ginkgo Biloba Extract against LPC-induced damage was partially
      suppressed by a HO inhibitor, Zinc protoporphyrin-IX (ZnPP-IX), while ZnPP-IX did
      not suppress the protective effect of ginkgolide B or bilobalide. Furthermore,
      pretreatment with hemin, biliverdin or bilirubin reduced cytotoxicity induced by
      LPC. These results suggest that induction of HO-1 by Ginkgo Biloba Extract but
      not its terpenoid constituents may play a beneficial role in oxidative stress.
      The mechanism of Ginkgo Biloba Extract-induced HO-1 gene expression and the
      increase in HO activity may be related to alteration of intracellular glutathione
      levels.

PMID- 11207068
TI  - Immunotoxicity of cupravit and previcur fungicides in mice.
AB  - Female mice received either cupravit or previcur at dose levels of 300 ppm and
      1000 ppm, respectively, for 8 weeks. Humoral immune response was evaluated by
      measuring the plaque-forming cell (PFC) response and hemolysing antibody titers
      against sheep red blood cells (SRBCs), a T lymphocyte-dependent antigen. In
      addition, the hemagglutinating antibody titers against Escherichia coli
      lipopolysaccharide (LPS), a T cell-independent antigen, were determined. Both
      cupravit and previcur suppressed the PFC response by 74% and 78% of control
      values, respectively. The primary hemolysin antibody titers were reduced to 62%
      and 76% of control values, respectively. The hemagglutinating antibody titers
      were decreased to 66% and 77% of control values, respectively. Memory function
      was reduced as evidenced by inhibition of secondary hemolysin titers to SRBCs.
      Cell-mediated immunity was inhibited by both cupravit and previcur as evidenced
      by reduced delayed-type hypersensitivity (DTH) reaction to tuberculin to 77% and
      76% of control values, respectively. Decreases in total leukocytic and
      lymphocytic counts were recorded together with histopathological changes in
      spleen and thymus gland of intoxicated animals.

PMID- 11207069
TI  - Effect of oral selenium administration on cisplatin-induced nephrotoxicity in
      rats.
AB  - Cis -diamminedichloroplatinum(II) (CP), an important antineoplasic drug, shows
      remarkable toxicity to the kidney. Methods to reduce CP nephrotoxicity include
      the use of sodium selenite. The aim of the present study was to investigate the
      interaction between orally administered selenium and CP in the rat. After
      observing the effects of CP on body growth rate, urinary volume, serum
      creatinine, serum selenium levels, creatinine clearance, renal malondialdehyde,
      and glutathione levels, as well as on renal light microscopically visible
      lesions, the effects of the sodium selenite administration by gavage of 2 mg per
      kg of body wt. 24 h and 1 h prior to a single CP intraperitoneal injection of 5
      mg per kg of body wt. followed by its daily administration for the 7 subsequent
      days on these parameters, were examined. CP increased renal malondialdehyde,
      renal glutathione, and serum creatinine and decreased creatinine clearance. Lipid
      peroxidation is one of the mechanisms by which CP induces renal damage. Selenium
      treatment decreased the effect of CP on serum creatinine, and renal
      malondialdehyde levels, but did not affect the other parameters with the
      exception of kidney necrosis which was also diminished by this treatment.

PMID- 11207070
TI  - Inhibition of the NANC relaxation of the guinea-pig proximal colon longitudinal
      muscle by the purinoceptor antagonist PPADS, inhibition of nitric oxide synthase,
      but not by a PACAP/VIP antagonist.
AB  - The effects of the P(2)-purinoceptor antagonist pyridoxal-phosphate-6-azophenyl-
      2('),4(')- disulphonic acid (PPADS), the nitric oxide (NO) synthase inhibitor
      N(G)-nitro- l -arginine (l -NOARG), the K(+)-channel blocker apamin, the
      pituitary adenylate cyclase activating peptide (PACAP) antagonist PACAP(6-38) and
      the sensory neuron-blocking drug capsaicin were examined on the non-adrenergic,
      non-cholinergic (NANC) relaxation evoked by electrical field stimulation in the
      longitudinal muscle of the guinea-pig proximal colon. Both PPADS (50 microm) and
      l -NOARG (100 microm) significantly inhibited the NANC relaxation. In the
      presence of l -NOARG, PPADS inhibited and apamin (100 nm) practically abolished
      the response. Capsaicin slightly but significantly enhanced the NANC relaxation
      at 10, but not at 1 Hz stimulation frequency. PACAP(6-38) (3 microm) had no
      effect on the NANC relaxation, although it abolished the relaxant effect of
      exogenous PACAP(1-27) (10 nm) and reduced that of exogenous vasoactive intestinal
      polypeptide (VIP, 30-100 nm) by about 60 %. PPADS (50 microm) inhibited the
      relaxant action of exogenous adenosine 5(')-triphosphate (ATP; 1 and 10 microm),
      the inhibition being stronger at 1 microm ATP. These data indicate that an
      exogenous P(2)-purinoceptor stimulant (possibly ATP) and NO are involved in the
      NANC relaxation of the guinea-pig colon. The 'non-nitrergic' apamin-sensitive
      component of the response might also include an unidentified transmitter. No
      evidence has been found for a mediating role of PACAP/VIP-like peptides.

PMID- 11207071
TI  - Effect of A. lanata leaf extract and Vediuppu chunnam on the urinary risk factors
      of calcium oxalate urolithiasis during experimental hyperoxaluria.
AB  - Urolithiasis is one of the third most common afflictions found in humans. The
      efficacy of the two Siddha drugs, Aerva lanata and Vediuppu chunnam as antilithic
      agents using a urolithic rat model were tested in this study. Hyperoxaluria was
      induced in rats using 0.75% ethylene glycol in drinking water. Aerva lanata(3.0
      mg kg(-1)body weight) and Vediuppu chunnam (3.5 mg kg(-1)body weight) were given
      orally for 28 days. Urinary risk factors of urolithiasis were monitored at the
      end of 7th, 14th, 21st and 28th days. Urinary volume was increased in
      hyperoxaluric as well as drug-treated rats. Increased urinary excretion of
      calcium, oxalate, uric acid, phosphorus and protein in hyperoxaluric rats was
      brought down significantly by the administration of A. lanata or Vediuppu
      chunnam. Decreased magnesium excretion in hyperoxaluric rats was normalized by
      drug treatment. The drug increases the urine volume, thereby reducing the
      solubility product with respect to calcium oxalate and other crystallizing salts
      such as uric acid, which may induce epitaxial deposition of calcium oxalate. Drug
      alone treated rats did not show any adverse effects. Combination therapy was
      found to be more effective and this indigenous medicine can be used successfully
      as an antilithic agent.

PMID- 11207072
TI  - Differential inhibitory mechanism of Fe2+ and Fe3+ on contraction of ileal
      longitudinal smooth muscle.
AB  - The mechanism of the inhibition of K(+)-induced contraction caused by ferrous
      (Fe(2+)) and ferric (Fe(3+)) ions were analysed in guinea-pig ileal longitudinal
      muscle and taenia coli. Fe(2+)increased the threshold for Ca(2+)-induced
      contraction in Ca(2+)-free, K(+)-depolarized taenia coli. However, Fe(3+)reduced
      the size of the maximal response to Ca(2+)without shifting the dose-response
      curves in taenia coli. Both 10 mM Fe(2+)and 2 mM Fe(3+)caused significant
      decreases in Ca uptake, as determined by the La method, during K(+)-induced ileal
      contraction. After treatment with 10 mM Fe(2+)in a state of cell membrane
      depolarization with K(+)for 30 min, the ileal K(+)-induced tonic contraction was
      completely restored by washing with medium containing EDTA, a chelator of
      divalent cations, and Fe(2+)remaining in muscle was almost eliminated by washing.
      In contrast, after treatment with 2 mM Fe(3+)in K(+)medium, K(+)-induced
      contraction was reversed only to a slight degree by washing with medium
      containing deferoxamine, a chelator of trivalent cations, and Fe(3+)in muscle
      largely remained despite the washing. These results suggest that Fe(2+)binds to
      the ileal surface membrane and reduces the contraction in response to K(+)mainly
      by inhibiting Ca(2+)influx. Fe(3+)may exert an inhibitory action on intracellular
      sites, in addition to the interference of Ca(2+)influx at the cell membrane.

PMID- 11207073
TI  - High sensitivity C-reactive protein for predicting cardiovascular disease: an
      inflammatory hypothesis.

PMID- 11207074
TI  - Ionic or non-ionic contrast media during coronary intervention: does it make a
      difference?

PMID- 11207075
TI  - What should be the focus in the management of patients with heart failure? The
      importance of peripheral vision.

PMID- 11207076
TI  - The Brugada syndrome: diagnostic criteria and cellular mechanisms.

PMID- 11207077
TI  - Screening for drug-induced (acquired) long QT syndrome: is it time to apply new
      methods?

PMID- 11207078
TI  - The role of tilt table testing in neurocardiocascular instability in older
      adults.

PMID- 11207079
TI  - Risk of infection by reprocessed and resterilized virus-contaminated catheters;
      an in-vitro study.
AB  - AIMS: In spite of increasing reuse of disposable catheters, there are few
      scientific data on potential viral transmission and infection after reuse. To
      determine the theoretical risk of virus transmission during reuse of catheters an
      in vitro study was performed using an RNA virus (echovirus-11) and a DNA virus
      (adenovirus-2). METHODS AND RESULTS: After deliberate contamination of the
      catheters, reprocessing and reuse of the cleaned and glutaraldehyde sterilized
      catheters was simulated. The presence of residual virus was determined by cell
      culture and by polymerase chain reaction (PCR). After the sterilization step,
      infectious enterovirus was detectable in one (10%) of the samples, whereas two
      (20%) contained detectable enterovirus RNA. After simulated reuse, enterovirus
      was cultured from one (10%) of the catheters, but no less than six (60%) of the
      samples were enterovirus PCR positive and one (10%) contained detectable
      adenovirus DNA. After sonification of the catheter tips no infectious virus could
      be detected, but enterovirus RNA was detected in two (20%) and adenovirus DNA in
      three (30%) of the samples. CONCLUSIONS: It has been clearly demonstrated in this
      in vitro study that, even after rigorous cleaning and sterilization, virus was
      still present in the catheter. Reuse of catheters, labelled for single-use only,
      is dangerous and should be prevented.

PMID- 11207080
TI  - Acute and subacute stent occlusion; risk-reduction by ionic contrast media.
AB  - AIMS: Current data concerning the influence of X-ray contrast media on the
      incidence of thrombotic complications in interventional cardiology are
      controversial. The effect of ionic contrast media on acute (< or =72 h) and
      subacute (< or =30 days) stent thrombosis has not been investigated. METHODS:
      Three thousand, nine hundred and ninety consecutive patients underwent coronary
      stent placement. Group I (n=1808) received non-ionic contrast media while group
      II (n=2182) was given the ionic Ioxaglate. All patients were treated with a
      standard regimen of aspirin and ticlopidine for 4 weeks post intervention.
      RESULTS: Both acute and subacute stent occlusion occurred more frequently in
      patients receiving non-ionic contrast media compared to ionic contrast media
      (acute stent occlusion: 1.3% in group I vs 0.3% in group II, P=0.001; subacute
      stent occlusion: 2.4% in group I vs 0.7% in group II, P=0.001). The incidence of
      the combined clinical end-point of coronary artery bypass grafting, target lesion
      revascularization, and overall mortality within 12 months was significantly
      reduced by the use of Ioxaglate (22.9% vs 16.3%, P=0.001). CONCLUSIONS: Based
      upon these data, we recommend the use of Ioxaglate in coronary interventions when
      stent placement is anticipated.

PMID- 11207081
TI  - Preservation of exercise capacity and lack of peripheral changes in asymptomatic
      patients with severely impaired left ventricular function.
AB  - AIMS: To establish the extent, if any, of peripheral changes in asymptomatic
      patients with severe left ventricular dysfunction. METHODS ANS RESULTS: Nine
      asymptomatic and nine symptomatic patients with left ventricular ejection
      fraction, <25%, matched for age and left ventricular ejection fraction
      (asymptomatic vs symptomatic, age: 52+/-1.5 vs 55.9+/-2.5 years [Mean+/-SEM],
      left ventricular ejection fraction: 16+/-2 vs 19+/-2%P=0.23 and 0.48,
      respectively) were studied and compared with 26 age-matched normal controls. We
      assessed exercise capacity, leg blood flow (occlusion plethysmography),
      respiratory muscle strength, quadriceps maximal isometric strength, fatigue and
      CT cross-sectional muscle area at mid thigh. Fatigue was expressed as the
      percentage reduction in maximal strength following a 20 min fatiguing protocol.
      There was a graded increase in peak oxygen consumption comparing symptomatic,
      asymptomatic and control groups (16.6+/-1.3 vs 27.1+/-1.6 vs 32.8+/-1.3 ml x min(
      1) x kg(-1)respectively, ANOVA P<0.0001). Between the three groups there was
      significant variation in muscle strength (P<0.0001), endurance (P=0.0002) and
      cross-sectional area (P=0.0003) and in peak blood flow (P=0.027) and respiratory
      muscle strength (P<0.05). When asymptomatic patients and controls were compared
      no significant differences existed. CONCLUSIONS: Patients with severe left
      ventricular dysfunction may have near normal exercise capacity and no peripheral
      changes. Exercise capacity may depend less upon left ventricular function than on
      the presence or absence of peripheral factors.

PMID- 11207082
TI  - Diagnosis and long-term follow-up of the Brugada syndrome in patients with
      idiopathic ventricular fibrillation.
AB  - AIMS: Some patients with idiopathic ventricular fibrillation may suffer from the
      Brugada syndrome. The diagnostic criteria for the Brugada syndrome are uncertain
      and arbitrarily set. Therefore, we studied the prevalence of the Brugada syndrome
      using various diagnostic criteria and long-term follow-up in 37 idiopathic
      ventricular fibrillation patients. METHODS AND RESULTS: Idiopathic ventricular
      fibrillation was diagnosed after thorough clinical evaluation in 37 survivors of
      an out-of-hospital cardiac arrest referred to our institute (UMC Utrecht).
      Retrospectively, nine patients (24%, group I) were classified as potentially
      having the Brugada syndrome based on the presence of (in)complete right bundle
      branch block and ST-segment elevation in leads V(1)-V(3)of > or =1 mm. Only three
      patients (8%, group II) showed (in)complete right bundle branch block and > or =2
      mm ST-segment elevation. With the intermittent presence of these ECG features
      and/or their (re)appearance with class I antiarrhythmic drugs included as
      criteria, the percentage of the Brugada syndrome was attenuated in group I (2/37;
      5%) and group II (1/37; 3%). Sixteen (43%) of all idiopathic ventricular
      fibrillation patients (mean follow-up 77+/-41 months) had a recurrent episode of
      syncope, ventricular tachyarrhythmias or sudden death. Recurrence rate was 3/9
      (33%) in Brugada patients group I, 2/3 (66%) in group II and 13/28 (46%) in
      patients without the Brugada syndrome (P=ns). CONCLUSIONS: Depending on the
      diagnostic criteria used, the Brugada syndrome was observed in 3% to 24% of
      patients with idiopathic ventricular fibrillation, underlining the importance of
      defining the precise diagnostic criteria in these patients. For all idiopathic
      ventricular fibrillation patients, the ventricular tachyarrhythmia recurrence
      rate was substantial during an average follow-up of more than 6 years.

PMID- 11207083
TI  - Dynamic analysis of the QT interval in long QT1 syndrome patients with a normal
      phenotype.
AB  - AIMS: In families with the long QT syndrome penetrance may be low: up to 70% of
      gene carriers may have a normal QTc interval. These patients require therapy,
      similar to that in those with longer QTc intervals, but identifying them, using
      molecular analysis, is difficult to apply on a large scale. A large French family
      affected by the long QT1 syndrome was followed-up over a 25-year period. In adult
      males but not in females, the QTc interval normalized after puberty. We aimed to
      find clinical criteria, based on ambulatory ECG recordings so that we could
      improve diagnosis in affected members with a normal QTc. METHODS AND RESULTS:
      Linkage analysis and direct sequencing were an indicator of the long QT1 gene in
      our family. Reverse transcription-polymerase chain reaction analysis demonstrated
      abnormal transcripts in lymphocytes from silent gene carriers. The functional
      profile of mutated protein isoforms was investigated using the patch-clamp
      technique. Dynamic analysis of ventricular depolarization was conducted using
      Holter recordings in patients, and in sex- and age-matched controls. Circadian
      variations of the QTc interval and the QT/RR relationship were assessed.
      Sensitivity, specificity, and predictive values were evaluated for proposed
      clinical criteria. We found that dynamic analysis of the QT interval permitted
      individual diagnosis in mutation carriers even when the QTc interval was normal
      (adult males). CONCLUSION: Dynamic analysis of the QT interval is of diagnostic
      value in the long QT1 syndrome in patients with a normal phenotype. Clinical
      implications include improvement in screening and patient management.

PMID- 11207084
TI  - Impact of radiofrequency catheter ablation of accessory pathways on the frequency
      of atrial fibrillation during long-term follow-up; high recurrence rate of atrial
      fibrillation in patients older than 50 years of age.
AB  - AIMS: Atrial fibrillation represents a frequent and potentially life-threatening
      arrhythmia in patients with accessory atrioventricular pathways. Radiofrequency
      ablation has become the curative treatment of first choice for these patients.
      Investigations after successful surgical pathway dissection reported an almost
      complete elimination of paroxysmal atrial fibrillation. However, there are only a
      few reports which include a small number of patients undergoing radiofrequency
      ablation. The purpose of this study was to examine whether successful
      radiofrequency ablation of accessory pathways prevents the occurrence of
      paroxysmal atrial fibrillation, and to identify possible predictors of atrial
      fibrillation recurrence. METHODS AND RESULTS: A total of 116 consecutive patients
      (mean age 42+/-15 years) with manifest or concealed accessory pathways and
      documented paroxysmal atrial fibrillation underwent radiofrequency catheter
      ablation. The patients were reexamined at 6 and 12 months. Long-term follow-up
      information was obtained by questionnaire and/or by consulting the referring
      physician. Pathway conduction was abolished in 101 cases (87%). Late follow-up
      information was obtained from 91 of these 101 patients (90%) with successful
      ablation with a mean follow-up duration of 23.9+/-12.3 months. During follow-up,
      25 of 91 patients (27%) experienced arrhythmias. Recurrent episodes of atrial
      fibrillation were observed in 18 of these 25 cases (i.e. 20% of the 91 patients).
      Differences between patients with and without recurrences of atrial fibrillation
      were examined for age, sex, associated cardiac disease, presence of multiple
      pathways, pathway location, atrial fibrillation inducibility during the procedure
      and cycle length of the atrioventricular reentrant tachycardia. Only older age
      was a significant independent predictor of atrial fibrillation recurrence
      (P=0.02). Eleven of 31 patients (35%) older than 50 years of age had atrial
      fibrillation recurrences during follow-up compared to seven of 60 patients (12%)
      under age 50. The recurrence rate of atrial fibrillation was even higher in
      patients older than 60 years (6 of 11 patients, i.e. 55%). In comparison, the
      occurrence rate of atrial fibrillation during follow-up in a control group of 100
      consecutive patients with successful accessory pathway ablation, who did not have
      evidence of paroxysmal atrial fibrillation prior to ablation, was 4% and, thus,
      significantly lower than in the study group of the 91 patients (P=0.001).
      CONCLUSIONS: The recurrence rate of paroxysmal atrial fibrillation after
      successful radiofrequency ablation of accessory pathways shows an age-related
      increase, being low in patients younger than 50 years of age (12%) and high in
      the older patients: 35% in patients older than 50 years and 55% in patients older
      than 60. These results have significant therapeutic implications concerning the
      decisions on pharmacological therapy after successful ablation in patients older
      than 50 years. Furthermore, these data will help physicians advise older patients
      properly about their risk of recurrence of atrial fibrillation after ablation.

PMID- 11207085
TI  - Omega-3 fatty acids improve blood pressure control and preserve renal function in
      hypertensive heart transplant recipients.
AB  - BACKGROUND: Hypertension and cyclosporine-induced nephrotoxicity are common
      complications in heart transplant recipients. Omega-3 fatty acids may prevent
      blood pressure rise early, but have not been studied long-term after heart
      transplantation. METHODS AND RESULTS: Forty-five clinically stable hypertensive
      heart transplant recipients were studied 1-12 years after transplantation and
      randomized in a double-blind fashion to receive either 3.4 g of omega-3 fatty
      acids daily or placebo for 1 year. Ambulatory 24 h blood pressure monitoring and
      haemodynamic studies were performed before randomization and at the end of the
      study. Systolic blood pressure increased by 8+/-3 mmHg (P<0.01) in the placebo
      group, with a non-significant increase in diastolic blood pressure of 3+/-2 mmHg
      (P=0.10), accompanied by a 14% increase in systemic vascular resistance (P<0.05).
      In contrast, no change in blood pressure or systemic vascular resistance was
      recorded in the omega-3 group. Plasma creatinine increased (P<0.01) and
      glomerular filtration rate decreased (P<0.05) in the placebo group, while no
      changes were observed in the omega-3 group. The antihypertensive effect was
      related to an increase in serum eicosapentaenoic and docosahexaenoic acid.
      CONCLUSION: Treatment with omega-3 fatty acids may reduce the long-term
      continuous rise in blood pressure after heart transplantation and may offer a
      direct or indirect renoprotective effect, making these fatty acids a potentially
      attractive treatment for post-transplant hypertension.

PMID- 11207087
TI  - The risk of alcohol leakage into the left anterior descending coronary artery
      during non-surgical myocardial reduction in patients with obstructive
      hypertrophic cardiomyopathy.

PMID- 11207089
TI  - Kinetic analysis of a model of the sarcoplasmic reticulum Ca-ATPase, with
      variable stoichiometry, which enhances the amount and the rate of Ca transport.
AB  - The sarcoplasmic reticulum (SR) Ca-dependent adenosinetriphosphatase (Ca-ATPase)
      actively transports Ca2+ from the myoplasm to the SR lumen. Under optimal
      conditions a 2:1 stoichiometry of Ca transport/ATP hydrolysis has been observed,
      but lower stoichiometries have been reported under several circumstances. A lower
      stoichiometry under conditions of high Ca2+ load, although thermodynamically less
      efficient, could in theory increase the rate and the maximal amount of Ca uptake.
      We analysed, by computing simulation, the transient kinetics of a model of the SR
      Ca-ATPase with variable stoichiometry. The model is based on current experimental
      reports and includes the most relevant properties of the system. The results show
      an acceleration in the rate of Ca uptake, an increase in the net Ca transport,
      and an increase in the rate of [Ca2+] reduction in the medium, which might be
      physiologically useful to increase the rate of Ca pumping at high Ca load of the
      sarcoplasmic reticulum.

PMID- 11207090
TI  - Building the cellular puzzle: control in multi-level reaction networks.
AB  - Quantitative conceptual tools dealing with control and regulation of cellular
      processes have been mostly developed for and applied to the pathways of
      intermediary metabolism. Yet, cellular processes are organized in different
      levels, metabolism forming the lowest level in a cascade of processes. Well-known
      examples are the DNA-mRNA-enzyme-metabolism cascade and the signal transduction
      cascades consisting of covalent modification cycles. The reaction network that
      constitutes each level can be viewed as a "module" in which reactions are linked
      by mass transfer. Although in principle all of these cellular modules are
      ultimately linked by mass transfer, in practice they can often be regarded as
      "isolated" from each other in terms of mass transfer. Here modules can interact
      with each other only by means of regulatory or catalytic effects-a chemical
      species in one module may affect the rate of a reaction in another module by
      binding to an enzyme or transport system or by acting as a catalyst. This paper
      seeks to answer two questions about the control and regulation of such multi
      level reaction networks: (i) How can the control properties of the system as a
      whole be expressed in terms of the control properties of individual modules and
      the effects between modules? (ii) How do the control properties of a module in
      its isolated state change when it is embedded in the whole system through its
      connections with the other modules? In order to answer these questions a
      quantitative theoretical framework is developed and applied to systems containing
      two, three or four fully interacting modules; it is shown how it can be extended
      in principle to n modules. This newly developed theory therefore makes it
      possible to quantitatively dissect intermodular, internal and external regulation
      in multi-level systems.

PMID- 11207091
TI  - Heat and water rate transfer processes in the human respiratory tract at various
      altitudes.
AB  - The process of the respiratory air conditioning as a process of heat and mass
      exchange at the interface inspired air-airways surface was studied. Using a model
      of airways (Olson et al., 1970) where the segments of the respiratory tract are
      like cylinders with a fixed length and diameter, the corresponding heat transfer
      equations, in the paper are founded basic rate exchange parameters-convective
      heat transfer coefficient h(c)(W m(-2) degrees C(-1)) and evaporative heat
      transfer coefficient h(e)(W m(-2)hPa(-1)). The rate transfer parameters assumed
      as sources with known heat power are connected to airflow rate in different
      airways segments. Relationships expressing warming rate of inspired air due to
      convection, warming rate of inspired air due to evaporation, water diffused in
      the inspired air from the airways wall, i.e. a system of air conditioning
      parameters, was composed. The altitude dynamics of the relations is studied.
      Every rate conditioning parameter is an increasing function of altitude. The
      process of diffusion in the peripheral bronchial generations as a basic transfer
      process is analysed. The following phenomenon is in effect: the diffusion
      coefficient increases with altitude and causes a compensation of simultaneous
      decreasing of O(2)and CO(2)densities in atmospheric air. Due to this
      compensation, the diffusion in the peripheral generations with altitude is
      approximately constant. The elements of the human anatomy optimality as well as
      the established dynamics are discussed and assumed. The square form of the
      airways after the trachea expressed in terms of transfer supposes (in view of
      maximum contact surface), that a maximum heat and water exchange is achieved,
      i.e. high degree of air condition at fixed environmental parameters and
      respiration regime.

PMID- 11207092
TI  - Model of the carbon concentrating mechanism in chloroplasts of eukaryotic algae.
AB  - A generic chloroplast-based model for the carbon concentrating mechanism (CCM) in
      eukaryotic algae is presented. The fine structure of chloroplasts is represented
      by separate compartments: marginal and bulk stroma, pyrenoid, girdle lamella,
      bulk thylakoids, and central lamella traversing the pyrenoid. The roles of the
      individual structural elements of the chloroplast with respect to the CCM and the
      effect of carbonic anhydrase activity in various compartments are analysed.
      Hypothetical HCO(-)(3)transport into the acidic thylakoid lumen is adjusted by
      imposing an optimization principle: a given [CO(2)] at the site of RuBisCO is
      achieved with minimum energy costs for the CCM. Our model is highly efficient in
      terms of saturation of RuBisCO carboxylase activity and the affinity of the
      chloroplast for CO(2), if either a girdle lamella or a pyrenoid is present. The
      highest efficiency is achieved with a pyrenoid. A eukaryotic CCM is not
      necessarily associated with accumulation of dissolved inorganic carbon (DIC) as
      in cyanobacteria. Chloroplasts are categorized into four types corresponding to
      morphological characteristics of all major algal classes with regard to the
      presence of pyrenoids, girdle lamellae, and the distribution of CA activity.

PMID- 11207093
TI  - The response of a selfish herd to an attack from outside the group perimeter.
AB  - According to the selfish herd hypothesis, animals can decrease predation risk by
      moving toward one another if the predator can appear anywhere and will attack the
      nearest target. Previous studies have shown that aggregations can form using
      simple movement rules designed to decrease each animal's Domain of Danger.
      However, if the predator attacks from outside the group's perimeter, these simple
      movement rules might not lead to aggregation. To test whether simple selfish
      movement rules would decrease predation risk for those situations when the
      predator attacks from outside the flock perimeter, we constructed a computer
      model that allowed flocks of 75 simulated fiddler crabs to react to one another,
      and to a predator attacking from 7 m away. We attacked simulated crab flocks with
      predators of different sizes and attack speeds, and computed relative predation
      risk after 120 time steps. Final trajectories showed flight toward the center of
      the flock, but curving away from the predator. Path curvature depended on the
      predator's size and approach speed. The average crab experienced a greater
      decrease in predation risk when the predator was small or slow moving. Regardless
      of the predator's size and speed, however, predation risk always decreased as
      long as crabs took their flock-mates into account. We conclude that, even when
      flight away from an external predator occurs, the selfish avoidance of danger can
      lead to aggregation.

PMID- 11207094
TI  - Variability of excitatory currents due to single-channel noise, receptor number
      and morphological heterogeneity.
AB  - Patch clamp recordings of excitatory postsynaptic currents (EPSCs) in central
      neurons reveal large fluctuations in amplitudes and decay times of AMPA-receptor
      mediated EPSCs. By using Monte Carlo simulations of synaptic transmission in
      brainstem interneurons, we tested several hypothesis that could account for the
      observed variability. The coefficient of variation (CV) of 0.5 for miniature
      amplitudes cannot be explained by fluctuations in vesicle content or receptor
      distribution, but is traced to variations in receptor number, which is estimated
      as 77+/-39 receptors per bouton. As the variability of rise times reflects
      fluctuations in size of the post-synaptic density and heterogeneity of the
      receptor distribution, the relatively small CV=0.37 of experimentally determined
      values points to a homogeneous arrangement of receptors. Within our model the
      large variability of decay times (CV=0.49) can only be explained by fluctuations
      in the transmitter time course (mean residence times of 0.4+/-0.13 ms),
      presumably resulting from heterogeneities in synaptic morphology. Hence, our
      simulations indicate that different noise sources control the variability of
      amplitudes, rise and decay times. In particular, the distribution of decay times
      yields information about the synaptic transmission process, which cannot be
      obtained from other observables.

PMID- 11207095
TI  - Performance of basic strategies for following gradients in two dimensions.
AB  - Computer models for following stimulus gradients in two-dimensional space were
      evaluated to determine the relative advantages of different strategies and to
      identify the issues that must be addressed in making such a comparison. The
      simulations were implemented with emphasis on making them as general and free of
      specific assumptions as possible. Performance was defined as progress along the
      gradient divided by the cost of the movements and time taken. Plausible values of
      costs were taken from data on animal energetics. The models also included various
      kinds of noise that limit performance. These included unintended variations and
      biases in motor outputs as well as sensory inputs. An initial guess at
      appropriate noise levels led to performance worse than that observed in
      experiments with leukocytes. Reduced noise levels gave good agreement. Under
      these, more appropriate, conditions, peak performance for the various models
      varied from 24 to 99% of the maximum possible. The threshold gradient required to
      provide performance equal to 1% of the maximum possible varied from 800 to 5000
      searcher diameters per gradient decay length. Some models performed well only
      over a narrow range of gradients. There was no indication of a tradeoff between
      sensitivity to shallow gradients and high performance in steep gradients. The
      model of tropotaxis (simultaneous, spatial comparison) with movement in any
      direction was superior in having the lowest threshold, the highest maximum
      performance, requiring the fewest parameters to fit, and performed well over the
      widest range of gradients. This result suggests that amoeboid cells and
      echinoderms might be particularly well suited to following gradients. The
      modeling demonstrates the need to obtain quantitative estimates for a number of
      parameters (relating costs and noise levels) for a more rigorous understanding of
      the relative advantages of these different strategies.

PMID- 11207096
TI  - A new method for assembling metabolic networks, with application to the Krebs
      citric acid cycle.
AB  - To understand why a molecular network has a particular connectivity one can
      generate an ensemble of alternative networks, all of which meet the same
      performance criteria as the real network. We have generated alternatives to the
      Krebs cycle, allowing group transfers and B(12)-mediated shifts that were
      excluded in previous work. Our algorithm does not use a reaction list, but
      determines the reactants and products in generic reactions. It generates networks
      in order of increasing number of reaction steps. We find that alternatives to the
      Krebs cycle are very likely to be cycles. Many of the alternatives produce toxic
      or unstable compounds and use group transfer reactions, which have unfavorable
      consequences. Although alternatives are better than the Krebs cycle in some
      respects, the Krebs cycle has the most favorable combination of traits.

PMID- 11207097
TI  - The role of H+ concentration on the capacitance of a membrane channel protein.

PMID- 11207098
TI  - Programmed cell death or cell death programme? That is the question.

PMID- 11207099
TI  - Political decision adversely affects women's health.

PMID- 11207100
TI  - Women's attitudes to being asked about exposure to violence.
AB  - OBJECTIVE: to examine women's attitudes to being questioned by their midwife,
      during and after pregnancy, about exposure to violence. DESIGN: an explorative
      study using content analysis of one open-ended question. SETTING: all antenatal
      clinics in Uppsala, a medium-sized Swedish university town. PARTICIPANTS: all
      women registered for antenatal care before 32 weeks of pregnancy, during a period
      of 6 months. MEASUREMENTS: all women were assessed regarding abuse, using the
      Abuse Assessment Screen (McFarlane 1993) twice during pregnancy and once again
      more than four weeks after the birth. On the last occasion the women were asked
      to respond to an open-ended written question worded: 'Please describe how you
      felt about being questioned by your midwife at the antenatal clinic concerning
      violence' Those women who reported violence and those who did not were compared
      regarding their attitude to being asked about violence. FINDINGS: 879 women were
      presented with the open-ended question. Eighty per cent found the questioning
      acceptable, 12% neither acceptable nor unacceptable, 5% both acceptable and
      unacceptable, and only 3% found it unacceptable. There was no difference between
      those who reported abuse and those who did not, as to whether the questioning was
      unacceptable. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the findings suggest
      that most pregnant women are not averse to being asked, by their midwife, about
      exposure to violence. As part of the identification of risk factors that is
      carried out in every pregnancy, the midwife should ask about exposure to violence
      at the antenatal clinic. To feel confident when raising the subject of abuse,
      midwives must be taught about the nature of intimate-partner violence, and
      appropriate referral and intervention strategies.

PMID- 11207101
TI  - Breast-feeding practices among Thai women in Australia.
AB  - OBJECTIVE: to examine the perceptions and experience of breast-feeding practices
      among Thai women who are now living in Australia. DESIGN: ethnographic interviews
      and participant observation among Thai women in Australia. SETTING: Melbourne
      Metropolitan Area,Victoria, Australia. FINDINGS: Thai women see breast milk as
      the most valuable food for newborn babies and young children. Breast milk is seen
      as 'human milk', while infant formula is referred to as 'animal milk'. Breast
      feeding is seen as beneficial not only to babies' health, but also to the
      mother's health. Women consume certain foods such as drinking hot water and
      consuming hot soup during the confinement period as a way to ensure breast milk
      production. Women appear to know that 'breast is best', but some lack accurate
      knowledge about breast feeding. They also receive inaccurate information
      regarding feeding practices from health professionals. IMPLICATIONS FOR PRACTICE:
      there is no doubt that Thai women see that 'breast is best', therefore, the main
      message for those involved in giving breast-feeding advice is to 'make it easy
      for women to do it'. Only then can health services and care be made more
      meaningful to the many women who have decided to breast feed their babies in
      their new country.

PMID- 11207102
TI  - 'Giving midwifery care: student midwives' views of their working role.
AB  - OBJECTIVE: to explore the opinions, feelings and views of student midwives of
      their education as they progressed through their two-year programme in Ireland,
      with the intention of interpreting and understanding the working and learning
      world of the participants so that future students might be assisted to improve
      their educational experiences. DESIGN: using quantitative and qualitative
      methods. A phenomenological approach was used to guide the qualitative section of
      the study reported here. SETTING: all seven midwifery schools in Southern
      Ireland. PARTICIPANTS: all students in the first intake of 1995 in every
      midwifery school in Ireland (n = 125). DATA COLLECTION: individual and group
      interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: the findings
      presented here illustrate the students' views of their working role. The
      environment appeared to be one of work, rather than learning, and the students'
      status that of junior employee rather than 'learner' They perceived themselves as
      'thrown in the deep end' without much support or guidance from qualified staff.
      They were frightened, unsure of themselves and suffered from role conflict and
      loss of status. There appeared to be an acute shortage of staff and the care
      given was seen to be the basic minimum, fulfilling women's physical needs but
      ignoring their emotional ones. The care given appeared to be planned according to
      routine and economic necessity rather than for sound midwifery, medical or social
      reasons. IMPLICATIONS FOR PRACTICE: the education of students needs to focus on
      the development of autonomous practice and the use of routines and non-research
      based care should be phased out. Students need to be assisted, with support from
      educated mentors, to plan care in a holistic way that will enable them to develop
      their midwifery skills in the future.

PMID- 11207103
TI  - An investigation into the feasibility of comparing three management options
      (augmentation, conservative and water) for nulliparae with dystocia in the first
      stage of labour.
AB  - OBJECTIVE: to evaluate the feasibility of a randomised controlled trial (RCT)
      examining the effect of three options (augmentation, conservative and water) for
      the management of dystocia in nulliparae. The main objectives were to explore the
      feasibility of trial procedures in the clinical environment, consent rates and
      acceptability of the management options to women, local incidence of dystocia in
      nulliparae and the size of the subsequent study. DESIGN: a two part study: a
      pilot, RCT with follow-up through to delivery with postnatal maternal surveys,
      and a case review of nulliparae with dystocia. SETTING: a large maternity unit in
      the South of England in May-July 1997 inclusive. PARTICIPANTS: nulliparae with
      dystocia in the first stage of labour who had an otherwise uncomplicated
      obstetric background. INTERVENTIONS: women in the pilot RCT received one of three
      management options: labouring in a waterbirth pool, conservative management or
      augmentation of labour, which is the standard management of women with dystocia
      condition in the Unit. FINDINGS: it is feasible to conduct an RCT of management
      of dystocia in the Unit. Seventy per cent (95% confidence interval 47% to 87%) of
      women approached agreed to participate. Conservative management was the least
      acceptable option to women and has been dropped from the subsequent trial. The
      audit provided some idea of possible differences in operative delivery and
      epidural rates depending on augmentation or not. A sample of 220 women should be
      large enough to detect moderate changes and will require a 2-year recruitment
      period. CONCLUSIONS: a subsequent trial is feasible and is now underway. It has
      the potential to provide information enabling women and practitioners to have a
      greater choice of care options in the presence of dystocia, or provide a good
      basis for an even larger trial.

PMID- 11207104
TI  - Contemporary breast-feeding policy and practice: implications for midwives.
AB  - In this paper, the authors draw upon recent Australian research to provide a
      critical commentary on the current policies and professional practices
      surrounding breast feeding. These studies, conducted by the first and second
      authors, explored aspects of the breast-feeding experience, with the findings
      highlighting areas for concern in relation to the promotion and support of breast
      feeding in western societies. Of particular concern to the authors was the number
      of women in these studies who equated breastfeeding with being a 'good' mother.
      This perception meant that some women maintained a strong commitment to breast
      feeding despite enormous difficulties. In this paper we firstly, overview the
      findings of these studies and use women's stories to illustrate their
      perseverance and their intense commitment to breast feeding. In the second part
      of the paper, we consider the consequences of the strong public rhetoric
      surrounding breast feeding in Australia and challenge some of the assumptions
      underlying policies and professional practices related to breast feeding. We
      examine the consequences of 'professionalising' breast feeding, and make
      suggestions for a way forward in the promotion of breast feeding that encompasses
      the range of perspectives held by women. In conclusion, the authors highlight the
      complexity of establishing appropriate breast-feeding policies that guide
      professional practices in a flexible manner, allowing for diversity in individual
      breast-feeding experiences.

PMID- 11207105
TI  - The instruction in pelvic floor exercises provided to women during pregnancy or
      following delivery.
AB  - OBJECTIVES: to examine the instruction in pelvic floor exercises given to women
      during pregnancy or following delivery, to assess the quality of any instruction
      provided, and to consider these in light of the women's views about the service.
      DESIGN: a postal questionnaire was sent to a sample of women when they reached 34
      weeks of pregnancy and a second at 8 weeks postpartum. A sub-sample of women who
      reported symptoms of stress incontinence at 8 weeks postpartum were interviewed
      about the instruction in pelvic floor exercises that they received during their
      pregnancy, or in the puerperium. PARTICIPANTS: of the 918 women who were sent the
      first questionnaire, 717 returned it completed (78%). Five-hundred-and-seventy
      two of 894 women (64%) completed the second questionnaire. Forty-two of 179
      symptomatic women (23%) took part in an interview. FINDINGS: 55% of women
      received some form of instruction in pelvic floor exercises by 34 weeks of
      pregnancy. Eighty-six percent received instruction following birth. The way the
      information was given varied, ranging from a brief reminder, to exercising in a
      class with an instructor. The information was provided by a range of health
      professionals, and no single profession appeared to undertake responsibility for
      the service. As a result, the views of the service varied. A few women reported
      that they had received good quality instruction, others were critical of it, and
      a small number reported that they had received no instruction at all. The
      widespread practice of leaving a leaflet by the women's beds during their stay in
      hospital, was criticised by a large proportion of the women. KEY CONCLUSION: the
      instruction in pelvic floor exercises by health service professionals was
      provided on an ad hoc basis. In many instances, the programme of instruction did
      not meet recommendations made in the literature. It is likely that the success of
      randomised controlled trials reported in the literature would not be repeated in
      the 'real world' Implications for practice: there is a need for the service to be
      reorganised so that all women receive high-quality instruction during pregnancy,
      with a reminder to exercise following birth. This could help to prevent, or
      relieve, the symptoms of stress incontinence that frequently occur at these
      times.

PMID- 11207106
TI  - The process of implementing a community-based peer breast-feeding support
      programme: the Glasgow experience.
AB  - AIM: to document the process of implementing and maintaining a community-based
      peer-support programme. DESIGN AND SETTING: a community-based study located in a
      socio-economically disadvantaged housing estate on the outskirts of Glasgow.
      PARTICIPANTS: pregnant women residing in a target postcode area. INTERVENTION: a
      programme of peer counselling and support for breast feeding, comprising
      antenatal and postnatal home visits over a period of three years. IMPLICATIONS
      FOR PRACTICE: peer support may provide an acceptable and appropriate role model
      for breast-feeding mothers. However, further research is required on other
      influential factors such as the social network and the impact of this programme
      on the peer supporter. CONCLUSIONS: despite a low prevalence of breast feeding,
      initiating and maintaining peer breast-feeding support was possible. Peer support
      appeared to be acceptable to mothers and health professionals. Study mothers
      spoke enthusiastically of the intervention and mentioned increased confidence and
      self-esteem.

PMID- 11207107
TI  - The 'Term Breech Trial': findings of this major international study leave a
      question mark over midwives' role in breech delivery.

PMID- 11207108
TI  - Crithidia guilhermei: purification and partial characterization of a 62-kDa
      extracellular metalloproteinase.
AB  - An extracellular metalloproteinase from Crithidia guilhermei, a monoxenic
      trypanosomatid of insects, was purified 11-fold by ammonium sulfate
      precipitation, gel filtration on a Shinpack Diol-150 column, and anion-exchange
      chromatography in a MONO Q column, both using the HPLC system. The proteinase
      appeared as a single band with an apparent molecular mass of 62 kDa in SDS-PAGE,
      under reducing conditions, and was optimally active at 37 degrees C and pH 6.0.
      The enzyme showed 62% residual activity at 50 degrees C for 30 min. The
      proteinase was completely inhibited by 1, 10-phenanthroline, indicating that the
      enzyme belongs to the metalloproteinase class. This is the first report of the
      purification of an extracellular metalloproteinase from the Crithidia species.
      The possible role of this enzyme in the digestive tract of the insect host is
      discussed.

PMID- 11207109
TI  - Electron and video-light microscopy analysis of the in vitro effects of pyrantel
      pamoate on Giardia lamblia.
AB  - Electron and video-light microscopy analysis of the in vitro effects of pyrantel
      pamoate on Giardia lamblia. Experimental Parasitology 97, 9-14. Giardia infection
      is predominant in the small intestine of vertebrates, where the trophozoites
      attach to epithelial cells and adversely affect the microvilli and other
      epithelial cell structures. Giardiasis, the disease caused by this protozoan, is
      very common in developing countries and mainly affects children. Drugs currently
      used to treat Giardia infection, such as some benzimidazole derivatives, were
      originally designed to treat helminthic infections. Many of the drugs are known
      to cause severe side effects and disturbances to the patient. Using transmission
      electron microscopy and video-light microscopy, we studied the effects of
      pyrantel pamoate, a drug commonly used in the treatment of helminthic infections
      in horses and ruminants, on Giardia lamblia trophozoites. Pyrantel pamoate was
      administered to Giardia cells in four different concentrations. Using video-light
      microscopy, we observed the decrease in flagella beating frequency and severe
      changes in the lateral flange and in the general aspect of the cell. Using
      transmission electron microscopy, we observed changes in the cytoplasm and
      peripheral vesicles. The flagella and adhesive disk structure were not affected.
      Apparently, the effects of pyrantel pamoate are irreversible.

PMID- 11207110
TI  - Trypanosoma cruzi: peripheral blood monocytes and heart macrophages in the
      resistance to acute experimental infection in rats.
AB  - The contribution of mononuclear phagocytes to host resistance against acute
      Chagas disease has been studied in vivo in a rat model inoculated with
      Trypanosoma cruzi, Y strain. Acute T. cruzi infection triggered a dramatic
      increase (937%) in peripheral blood monocyte number at day 12 of infection. At
      this point, histological analysis of the heart showed high parasitism and diffuse
      and a moderate to intense mononuclear inflammatory process. Ultrastructural study
      revealed a large number of macrophages, in addition to lymphocytes and undiffer
      entiated cells. Clusters of macrophages exhibited different morphologi cal
      phenotypes, with evident signs of activation (increase in size, surface
      rufflings, and amount of cytoplasmic organelles). Cell-to-cell contacts involving
      macrophages and lymphocytes or macrophages and mono cytes were observed.
      Depletion of macrophages by treatment with silica, a selective cytotoxic agent
      for these cells, caused a significant increase in the number of amastigote nests
      in cardiomyocytes. The present findings indicate that the early phase of
      infection with T. cruzi induces rapid production, maturation, and activation of
      the monocyte/macrophage system so as to control T. cruzi replication, emphasizing
      the crucial role for macrophages in the rat resistance to Chagas disease.

PMID- 11207111
TI  - Onchocerca volvulus: genetic diversity of parasite isolates from Sudan.
AB  - Onchocerciasis in Sudan exists in three distinct foci which exhibit differing
      clinical presentations. Previous studies have demonstrated that a tandemly
      repeated Onchocerca sequence family with a unit repeat length of 150 bp (the O
      150 family) is a useful marker for deducing relationships among different O.
      volvulus populations. In the current study, the O-150 repeat families of O.
      volvulus from Sudan were analyzed and compared to each other and to those of
      parasites from West Africa. Similar to West African and American O. volvulus, the
      O-150 families of the Sudanese parasites could be divided into clusters within
      which little or no intracluster variation was evident, suggesting that the O-150
      family in these parasites was subject to the forces of concerted evolution.
      Statistical analysis of the O-150 families from the different Sudanese parasite
      isolates, employing a nested algorithm based on an analysis of variance, revealed
      that O. volvulus endemic to the northern focus at Abu Hamed were significantly
      different from all other O. volvulus populations examined to date. In contrast,
      parasites from the southern and eastern foci of Sudan were indistinguishable from
      those endemic to the West African savanna. The significance of these data are
      discussed in light of knowledge of the biogeography and biology of transmission
      of O. volvulus in Africa.

PMID- 11207112
TI  - Leishmania donovani: intraspecific polymorphisms of Sudanese isolates revealed by
      PCR-based analyses and DNA sequencing.
AB  - Four polymerase chain reaction (PCR)-based approaches were used to analyze
      diversity within 23 Sudanese isolates of Leishmania donovani. Methods compared
      were fingerprinting with single nonspecific primers, restriction analysis of the
      amplified ribosomal internal transcribed spacer (ITS) locus, single-stranded
      conformation polymorphism (SSCP), and sequencing of the ITS region. When PCR
      fingerprinting and restriction analysis of ITS were applied, highly similar
      fragment patterns were observed for all strains of L. donovani studied. The ITS1
      locus gave five different SSCP profiles among the 23 Sudanese isolates, whereas
      the ITS2 locus was highly conserved with the exception of 1 isolate. Strains of
      L. donovani derived from other geographical areas were found to have different
      ITS2 patterns. SSCP analysis correlated well with results of DNA sequencing and
      confirmed that SSCP was able to detect genetic diversity at the level of a single
      nucleotide. SSCP had advantages over the other methods employed for investigation
      of sequence variation within the species L. donovani. There was no correlation
      between the form of clinical manifestation of the disease and the PCR
      fingerprinting, ITS-RFLP, or ITS-SSCP characteristics.

PMID- 11207113
TI  - Plasmodium falciparum: production and characterization of rat monoclonal
      antibodies specific for the sexual-stage Pfs48/45 antigen.

PMID- 11207114
TI  - Long PCR amplification of Plasmodium falciparum DNA extracted from filter paper
      blots.

PMID- 11207115
TI  - Isolation and characterization of a cold-sensitive attachment/invasion mutant of
      Toxoplasma gondii.

PMID- 11207116
TI  - A new technique for the repair and reconstruction of frontoethmoidal
      encephalomeningoceles by medial orbital composite-unit translocation.
AB  - A frontoethmoidal encephalomeningocele is a herniation of brain and meninges
      through a congenital bone defect in the skull at the junction of the frontal and
      ethmoidal bones. Between 1992 and 1999, we treated 145 cases of frontoethmoidal
      encephalomeningocele. Before 1993, the operation was performed in two stages. An
      intracranial repair by neurosurgeons preceded the external extirpation of the
      mass. In 70 cases that were operated on after 1993, a one-stage closure of the
      skull defect with a medial orbital composite-unit translocation technique was
      used. The medial orbital rim on each side, with intact periosteum, medial canthal
      ligament and lacrimal apparatus, was translocated as a unit to the midline. The
      advantages of this technique are that it allows convenient access to resect the
      herniation mass and close the defect, it restores normal interorbital and
      intercanthal distances and it eliminates the need for a transnasal medial
      canthopexy. Augmentation rhinoplasty can be avoided in most cases by tilting the
      composite unit with its preserved blood supply.

PMID- 11207117
TI  - The panda naevus: management of synchronous upper- and lower-eyelid pigmented
      naevi.
AB  - We report four patients presenting with rare synchronous upper- and lower-eyelid
      naevi. The distributions and appearances of these naevi resemble the distinctive
      periorbital pigmentation of the panda. The possible embryological origin of this
      naevus and an approach to management are discussed.

PMID- 11207118
TI  - Eyelid reconstruction using a hard palate mucoperiosteal graft combined with a V
      Y subcutaneously pedicled flap.
AB  - Full-thickness eyelid defects after tumour ablation require the reconstruction of
      two layers, the anterior and posterior lamellae. Eyelids were successfully
      reconstructed after removal of malignant tumours in four patients using a hard
      palate mucoperiosteal graft combined with a curved V-Y subcutaneously pedicled
      flap. Although there have been some reports of hard palate mucosal grafts for
      reconstruction of the posterior lamella, the graft is not sufficiently rigid to
      support the reconstructed eyelid without the aid of supporting materials such as
      cartilage grafts. The hard palate mucoperiosteal graft seems to be rigid enough
      to support the reconstructed eyelid without the use of cartilage or other
      supporting materials. The subcutaneously pedicled V-Y advancement flap is useful
      for reconstruction of the anterior lamella in partial eyelid defects. We used it
      with a modified curved design to allow easy advancement and to make postoperative
      scars inconspicuous.

PMID- 11207119
TI  - Pre-arterialisation of an arterialised venous flap: clinical cases.
AB  - Many factors affecting the survival of arterialised venous flaps have been
      elucidated, both experimentally and clinically. The survival of large
      arterialised venous flaps has been reported, with varying results. Large
      arterialised venous flaps with preformed arteriovenous fistulae at the donor
      sites have been successfully performed in experimental animals. We report the
      results of repair of skin defects in the extremities with arterialised venous
      flaps in eight patients. The arteriovenous shunts were created at the donor sites
      at least 2 weeks before the flaps were harvested. The flap sizes ranged between 4
      x 4cm and 9 x 10 cm. Flap survival was between 93% and 100% of the surface area,
      as shown by digitalised scanning. In addition to the known advantages of venous
      flaps, such as less bulk, preservation of the main arteries and ease of
      harvesting, pre-arterialisation makes designing the flap easier due to the
      noticeable superficial veins. Pre-arterialisation, when used in carefully
      selected cases, did not prolong the hospital course of the patients.

PMID- 11207120
TI  - Correction of pectus excavatum using a sternal elevator: preliminary report.
AB  - Operative procedures to correct the deformity caused by pectus excavatum are
      generally based on either sternal elevation or turnover. In either case, the
      operation is highly invasive. By considering the softness of the costal
      cartilages in early childhood, we have developed an endoscopically assisted
      procedure that applies external traction continuously in order to elevate the
      depressed sternum and costal cartilages. Since August 1993, we have performed
      this operation in 11 patients with pectus excavatum who ranged in age from 3
      years 1 month to 28 years. The traction screws came loose spontaneously in two
      early cases. Augmentation transfer of a latissimus dorsi muscle flap and dermal
      fat grafting were subsequently performed in these two patients, respectively. We
      achieved an excellent cosmetic outcome in the other nine patients, with results
      similar to those achieved with the conventional operation. Our technique is a two
      stage procedure and the patient is limited in performing daily activities while
      wearing the traction device. Despite this drawback it can achieve permanent
      correction of the deformity. Accordingly, this method should be considered when
      pectus excavatum is corrected surgically, particularly in infants and young
      children.

PMID- 11207121
TI  - Trilucent breast implants: a 3 year series.
AB  - The use of Trilucent breast implants in the UK dates back to 1995 and their
      introduction coincided with the medium-term effects of the silicone-implant
      controversy. We present a review of 3 years' experience of the Trilucent implant
      (1996-1998) during which 29 patients with a mean age of 39.4 years had a total of
      50 implants. The aim of the study was to analyse the results in these patients in
      terms of complications, reoperation rate and patient satisfaction. Using a
      combination of retrospective chart analysis and postal survey, we found an
      incidence of implant deflation of 10% (5/50). The overall reoperation rate was
      20% (10/50). The postal survey yielded a mean satisfaction score of 7.1 (on a
      scale of 0-10) from the 20 respondents out of the 29 patients (68.9%). In view of
      the high complication rate, we discontinued the use of Trilucent implants in
      advance of their withdrawal by the Medical Devices Agency (MDA) in March 1999.
      However, these findings may now be considered of added interest, particularly
      with regard to patients who are opting to keep their Trilucent implants despite
      the recommendation of the MDA in June 2000 that such implants should be removed.

PMID- 11207122
TI  - Single axillary incision for quadrantectomy, axillary clearance and immediate
      reconstruction with latissimus dorsi.
AB  - This paper describes a method of immediate breast reconstruction following
      conservative breast surgery. The technique is innovative in that axillary
      clearance, quadrantectomy and the harvest of the latissimus dorsi muscle are
      carried out through a small transverse axillary incision with no incision in the
      breast.

PMID- 11207123
TI  - Classification of hand anomalies in Poland's syndrome.
AB  - Poland's syndrome classically consists of the combination of unilateral aplasia
      of the sternocostal head of the pectoralis major muscle and an ipsilateral
      hypoplastic hand with simple syndactyly and short fingers. However, patients with
      Poland's syndrome may have a broad range of hand anomalies. In this paper, the
      author reviews 20 cases of Poland's syndrome and offers a classification of the
      hand anomalies. The hand anomalies are divided into seven types according to the
      severity of the deformity. Clinical cases are presented along with similar cases
      from the literature. The aetiology of Poland's syndrome is discussed and the
      various malformations that may co-exist with this syndrome are reviewed.

PMID- 11207124
TI  - The effect of elevation on digital blood pressure.
AB  - Elevation of the hand is recommended for all patients undergoing hand surgery to
      decrease the swelling in the hand. This study was designed to look at the effects
      of elevation of the hand on digital blood pressure at different elevation
      positions. Digital blood pressure was recorded using a digital plethysmograph in
      30 subjects for increasing levels of elevation above the heart. Friedman's test
      was applied to the blood-pressure changes recorded in the four positions of the
      upper limb and showed a significant sustained fall in mean blood pressure with
      increasing elevation, bringing into question the use of elevation in certain
      clinical situations.

PMID- 11207125
TI  - An evaluation of Polaroid photographic imaging for cutaneous-lesion referrals to
      an outpatient clinic: a pilot study.
AB  - A pilot study consisted of 65 patient referrals to a Regional Plastic Surgery
      Department in which the referral letter, accompanied by a high-quality Polaroid
      photograph, was assessed by four consultants. The diagnosis, degree of urgency of
      treatment, grade of surgeon (to undertake the operation) and anticipated time for
      the procedure were recorded. The results were statistically analysed. Our aim was
      to evaluate the diagnostic accuracy and consistency of the four observers. The
      majority of malignant skin lesions were detected accurately; those that were
      missed received urgent attention due to a high degree of suspicion. This study
      supports the view that 'triage' of referrals using high-quality photographic
      images in association with an accurate referral letter can offer a significant
      reduction in pressure on waiting time and inconvenience for patients by avoiding
      an additional outpatient visit. Advantages to purchasers in terms of cost savings
      on outpatient visits and travelling reimbursement can result from this
      initiative.

PMID- 11207126
TI  - Successful reduction in skin damage resulting from exposure to the normal-mode
      ruby laser in an animal model.
AB  - Normal-mode ruby laser (NMRL) irradiation of skin has now become an acceptable
      method of producing depilation. However, side effects, which include superficial
      burning and changes in skin pigmentation, still occur and, although temporary,
      can be distressing to the patient. This paper reports a method by which the skin
      can be protected (or preconditioned) from damage during NMRL treatment by pre
      heating to a lower, non-damaging level prior to irradiation. Using the black
      haired mouse (C57B1/10) as an animal model, an appropriate 'preconditioning'
      temperature was established by exposing the mouse skin to a range of
      temperatures, taking biopsies and staining the skin immunohistochemically for
      heat shock protein 70 (HSP 70) expression within the keratinocyte cells.
      Increased HSP 70 expression is stimulated by exposure to environmental stressors
      such as heat, so it was hypothesised that its increased expression conveyed
      increased cellular protection. The appropriate temperature (45 degrees C for 15
      min) allowed for the superficial skin cells to be protected (as assessed by
      maximal HSP 70 staining) but undamaged (as assessed by haematoxylin and eosin
      staining), leaving the target hair-producing cells unprotected. Eight mice (16
      flanks) were then exposed to this preconditioning temperature (eight of the
      flanks being growing-hair sites and eight resting-hair sites) and 5 h later
      exposed to a laser fluence known to cause mild skin damage and depilation
      (6J/cm2). This exposure was to both the preconditioned and the adjacent non
      preconditioned sites. A statistically significant reduction in skin damage (P
      <0.001), as measured by the time taken to heal and noted both clinically and
      histologically, was seen in the preconditioned sites in resting-hair regions but
      not in growing-hair regions. Depilation, established over an 8 week period, was
      successful in growing-hair regions within both preconditioned and non
      preconditioned sites, but complete hair regrowth had occurred in preconditioned
      and non-preconditioned sites within resting-hair regions by 5 weeks. The latter
      finding was consistent with work already reported suggesting that NMRL-assisted
      depilation in this animal model is not successful for hairs in the telogen phase.
      Successful preconditioning of mouse skin prior to laser exposure appears to
      reduce NMRL-induced skin side effects. In addition, the technique does not appear
      to adversely affect successful depilation.

PMID- 11207127
TI  - Do superficial epigastric veins of rats have valves?
AB  - The rat is a good model for experimental studies on the haemodynamic patterns of
      free-flap transfer but models involving the superficial epigastric vein have not
      been supported by the demonstration of the anatomical presence or absence of
      valves inside it. We performed a morphological study to assess whether or not
      valves are present inside the superficial epigastric vein of the rat. Segments of
      superficial epigastric veins were explanted from fifteen Sprague-Dawley rats. The
      lumen was studied with scanning electron microscopy after longitudinal or
      transverse incision of the venous walls. No valves were detected and we saw no
      evidence of their accidental removal. As most human veins do have valves, the
      clinical implications of haemodynamic data on reverse-flow island flaps obtained
      in rats must be considered very carefully.

PMID- 11207128
TI  - Basal cell carcinomata in port wine stains.
AB  - The development of basal cell carcinoma (BCC) in a port wine stain is rare and
      the aetiology of these malignancies in this situation is the subject of some
      debate. Early treatment of port wine stains with ionising radiation has been
      implicated in the development of BCC. The use of the argon laser has not been
      implicated. We present four cases of BCC in port wine stains, one previously
      treated with an argon laser, and discuss the possible aetiological factors.

PMID- 11207129
TI  - Moustache reconstruction using an extended midline forehead flap.
AB  - A new method for reconstruction of the upper lip and moustache is presented. An
      extended midline forehead flap is described, which is a modification of the
      classical midline forehead flap in which the flap is extended into the hair
      bearing scalp. Simultaneously, a nasal alar defect was reconstructed using the
      non-hair-bearing forehead skin in a patient with cancrum oris. The flap is
      reliable, technically easy to raise, does not require any special expertise and
      causes minimal donor site deformity. However, it is a multistage procedure and
      hence causes prolonged morbidity.

PMID- 11207130
TI  - Isolated bilateral orbital neurofibromatosis in a twelve-year-old.
AB  - A patient with bilateral orbital neurofibromatosis is described. This patient had
      no other dysmorphic features and no systemic stigmata indicative of Von
      Recklinghausen's disease or endocrine syndromes. To our knowledge, this is the
      first report in the literature of isolated bilateral orbital neurofibromatosis in
      an otherwise normal patient.

PMID- 11207131
TI  - External venous shunt as a solution to venous thrombosis in microvascular
      surgery.
AB  - We report a case in which venous occlusion occurred after fibular osteocutaneous
      flap transfer for open tibial fracture. The flap was salvaged using an external
      venous shunt. The shunt consisted of a Teflon catheter for intravenous infusion,
      a three-way stopcock, a urokinase-immobilised catheter and a pressurising bag for
      arterial-pressure monitoring. This method can be used to establish venous
      drainage when there is no accessible recipient vein. It may improve the success
      rate of microvascular surgery and extend the indications for surgery.

PMID- 11207132
TI  - Avulsion of vascular anastomosis in free-flap breast reconstruction.
AB  - We report a case of anastomotic avulsion following a free deep inferior
      epigastric perforator (DIEP) flap reconstruction immediately after mastectomy for
      carcinoma of the breast. This occurred on the 5th postoperative day when the
      patient was allowed a shower and abducted her shoulders to wash her hair. The aim
      of this report is to make readers aware of such a possibility, and we suggest
      exercising caution in early mobilisation of the upper limb after free-flap breast
      reconstruction.

PMID- 11207133
TI  - Cutaneous verrucous carcinoma.
AB  - Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell
      carcinoma most commonly seen on mucosa. It has been infrequently reported to
      occur on the skin, where it is a slow-growing and locally aggressive tumour. It
      is not uncommon for cutaneous verrucous carcinomas to be mistaken for the more
      frequent verruca vulgaris and treated accordingly. Three cases of cutaneous
      verrucous carcinoma are presented with the medical history and follow-up data.
      Surgery is the treatment of choice; these lesions may sustain a potentially
      anaplastic transformation after radiation therapy.

PMID- 11207134
TI  - Distal plantar area reconstruction using a flexor digitorum brevis muscle flap
      with reverse-flow lateral plantar artery.
AB  - It is difficult to resurface skin defects of the sole because of its unique
      anatomy, which is resistant to mechanical stimuli. Though various methods have
      been reported, few are functionally satisfactory, and it is especially difficult
      to repair the distal plantar area. We report a reconstruction of the distal
      plantar area using a flexor digitorum brevis muscle flap based on a reverse-flow
      lateral plantar artery pedicle in a patient with a malignant melanoma on the
      right lateral metatarsal head of the fifth toe. The muscle flap was sufficient to
      cover the exposed fifth metatarsal and was covered with a full-thickness skin
      graft. The result was favourable and the patient has a normal gait and no
      pressure sores.

PMID- 11207135
TI  - Pedicled scrotal island skin flap in the treatment of anal basal cell carcinoma.
AB  - Basal cell carcinoma of the anus is extremely rare, accounting for only 0.1% of
      anorectal malignancies. We report the reconstruction of the anus with a biaxial
      pedicled scrotal island myofasciocutaneous flap following excision of an anal
      basal cell carcinoma, and conclude that this technique may be valuable in the
      reconstruction of the anal region.

PMID- 11207136
TI  - Subungual pilonidal sinus of the hand in a dog groomer.
AB  - Interdigital pilonidal sinus of the hand is an occupational hazard in barbers,
      sheep shearers and cow milkers. We present a case of a subungual pilonidal sinus
      of the thumb of a dog groomer, complicated by the development of osteomyelitis in
      the distal phalanx.

PMID- 11207137
TI  - Paraffinoma--a complication of Jelonet packs following rhinoplasty.

PMID- 11207138
TI  - Best use of anomaly of radial artery.

PMID- 11207139
TI  - A dermoid cyst presenting as an epidermoid cyst in the malar region.

PMID- 11207140
TI  - Ametop gel and suture removal.

PMID- 11207142
TI  - New use for a prep sponge.

PMID- 11207141
TI  - Mycobacterium marinum hand infection.

PMID- 11207143
TI  - A novel method of ring removal from a swollen finger.

PMID- 11207144
TI  - Free TRAM flap breast reconstruction: V-flap to improve vessel access.

PMID- 11207145
TI  - Incidence of incomplete excision in surgically treated basal cell carcinoma: a
      retrospective clinical audit.

PMID- 11207147
TI  - Invited commentary: studies of workers exposed to low doses of radiation.

PMID- 11207146
TI  - First analysis of cancer incidence and occupational radiation exposure based on
      the National Dose Registry of Canada.
AB  - A cohort study was conducted to investigate the relation between cancer incidence
      and occupational exposure to ionizing radiation. Records containing dose
      information from 1951 to 1988 for 191,333 persons were extracted from the
      National Dose Registry of Canada. The records were linked to the Canadian Cancer
      Data Base, with incidence data from 1969 to 1988. Standardized incidence ratios
      were calculated using Canadian cancer incidence rates stratified by age, sex, and
      calendar year. Excess relative risks were obtained from internally based dose
      response analyses. The following significant results were found for males and
      females combined: a deficit in the standardized incidence ratio for all cancers
      combined; elevated standardized incidence ratios for thyroid cancer and melanoma;
      and elevated excess relative risks for rectum, leukemia, lung, all cancers
      combined, all except lung, and all except leukemia. For males, cancers of the
      colon, pancreas, and testis also showed significantly elevated excess relative
      risks. The specific cancer types listed above have been implicated in previous
      studies on occupational exposure to ionizing radiation, except for testis, colon,
      and melanoma, while the findings on thyroid cancer from previous studies are
      inconclusive. The thyroid standardized incidence ratios in this study are highly
      significant, but further investigation is needed to assess the possibility of
      association with occupational radiation exposure.

PMID- 11207148
TI  - Sont et al. Respond to "Studies of Workers Exposed to Low Doses of Radiation"

PMID- 11207149
TI  - Maternal exposure to nitrate from drinking water and diet and risk for neural
      tube defects.
AB  - In this population-based case-control study conducted in California between June
      1989 and May 1991, the authors investigated the association between maternal
      periconceptional exposure to nitrate from drinking water and diet and risk for
      neural tube defects. The mothers of 538 cases and 539 nonmalformed controls were
      interviewed regarding residential history, consumption of tap water at home, and
      dietary intake during the periconceptional period. Dietary nitrate exposure was
      not associated with increased risk for neural tube defects. Exposure to nitrate
      in drinking water at concentrations above the 45 mg/liter maximum contaminant
      level was associated with increased risk for anencephaly (odds ratio (OR) = 4.0,
      95% confidence interval (CI): 1.0, 15.4), but not for spina bifida. Increased
      risks for anencephaly were observed at nitrate levels below the maximum
      contaminant level among groundwater drinkers only (OR = 2.1, 95% CI: 1.1,4.1 for
      5-15 mg/liter; OR = 2.3, 95% CI: 1.1, 4.5 for 16-35 mg/liter; and OR = 6.9, 95%
      CI: 1.9, 24.9 for 36-67 mg/liter compared with <5 mg/liter). Adjustment for
      identified risk factors for anencephaly did not substantially alter these
      associations, nor did control for maternal dietary nitrate, total vitamin C
      intake, and quantity of tap water consumed. The lack of an observed elevation in
      risk for anencephaly in association with exposure to mixed water containing
      nitrate at levels comparable with the concentration in groundwater may indicate
      that something other than nitrate accounts for these findings.

PMID- 11207150
TI  - Placental abruption and perinatal mortality in the United States.
AB  - Placental abruption is an uncommon obstetric complication associated with high
      perinatal mortality rates. The authors explored the associations of abruption
      with fetal growth restriction, preterm delivery, and perinatal survival. The
      study was based on 7,508,655 singleton births delivered in 1995 and 1996 in the
      United States. Abruption was recorded in 6.5 per 1,000 births. Perinatal
      mortality was 119 per 1,000 births with abruption compared with 8.2 per 1,000
      among all other births. The high mortality with abruption was due, in part, to
      its strong association with preterm delivery; 55% of the excess perinatal deaths
      with abruption were due to early delivery. Furthermore, babies in the lowest
      centile of weight (<1% adjusted for gestational age) were almost nine times as
      likely to be born with abruption than those in the heaviest (> or =90%) birth
      weight centiles. This relative risk progressively declined with higher birth
      weight centiles. After controlling for fetal growth restriction and early
      delivery, the high risk of perinatal death associated with abruption persisted.
      Even babies born at 40 weeks of gestation and birth weight of 3,500-3,999 g
      (where mortality was lowest) had a 25-fold higher mortality with abruption. The
      link between fetal growth restriction and abruption suggests that the origins of
      abruption lie at least in midpregnancy and perhaps even earlier.

PMID- 11207151
TI  - Fingerprint ridge-count difference between adjacent fingertips (dR45) predicts
      upper-body tissue distribution: evidence for early gestational programming.
AB  - Fingerprint ridge counts, which remain constant from the 19th week of pregnancy,
      are related to fingertip growth during early gestation. Each finger corresponds
      neurologically to a spinal-cord segment ranging from C6 (thumb, relatively
      cephalad) to C8 (fifth finger, relatively caudad). The authors hypothesized that
      large ridge-count differences between fingertips (cephalad > caudad) might
      reflect fetal inhibition of caudal growth. Among 69 male Atlanta, Georgia,
      military recruits (1994-1997; aged 17-22 years), they tested associations of the
      anthropometric waist-to-thigh ratio with 20 ridge-count differences. Waist-to
      thigh ratio was associated with the ridge-count difference between the right
      fourth and fifth fingertips only (dR45; r = 0.36, p = 0.003). The race-adjusted
      standardized regression coefficient was 0.22 (95% confidence interval: 0.03,
      0.41). Since upper-body tissue distribution indicates disease risk, the authors
      then tested the association of age (an indicator of survivorship) with dR45 in a
      sample of 135 male patients from Bangalore, India (1989-1990; aged 38-82 years).
      Age was inversely associated with dR45 (r = -0.17, p = 0.04), notably among the
      75 men with diabetes (r = -0.22, p = 0.06). An increased dR45 predicts an upper
      body tissue distribution originating before the midpoint of pregnancy. The cause
      of this developmental pattern is unknown, but it may lead to reduced
      survivorship.

PMID- 11207152
TI  - Predictive 5-year survivorship model of cystic fibrosis.
AB  - The objective of this study was to create a 5-year survivorship model to identify
      key clinical features of cystic fibrosis. Such a model could help researchers and
      clinicians to evaluate therapies, improve the design of prospective studies,
      monitor practice patterns, counsel individual patients, and determine the best
      candidates for lung transplantation. The authors used information from the Cystic
      Fibrosis Foundation Patient Registry (CFFPR), which has collected longitudinal
      data on approximately 90% of cystic fibrosis patients diagnosed in the United
      States since 1986. They developed multivariate logistic regression models by
      using data on 5,820 patients randomly selected from 11,630 in the CFFPR in 1993.
      Models were tested for goodness of fit and were validated for the remaining 5,810
      patients for 1993. The validated 5-year survivorship model included age, forced
      expiratory volume in 1 second as a percentage of predicted normal, gender, weight
      for-age z score, pancreatic sufficiency, diabetes mellitus, Staphylococcus aureus
      infection, Burkerholderia cepacia infection, and annual number of acute pulmonary
      exacerbations. The model provides insights into the complex nature of cystic
      fibrosis and supplies a rigorous tool for clinical practice and research.

PMID- 11207153
TI  - Coffee consumption and serum lipids: a meta-analysis of randomized controlled
      clinical trials.
AB  - Coffee drinking has been associated with increased serum cholesterol levels in
      some, but not all, studies. A Medline search of the English-language literature
      published prior to December 1998, a bibliography review, and consultations with
      experts were performed to identify 14 published trials of coffee consumption.
      Information was abstracted independently by two reviewers using a standardized
      protocol. With a random-effects model, treatment effects were estimated by
      pooling results from individual trials after weighting the results by the inverse
      of total variance. A dose-response relation between coffee consumption and both
      total cholesterol and LDL cholesterol was identified (p < 0.01). Increases in
      serum lipids were greater in studies of patients with hyperlipidemia and in
      trials of caffeinated or boiled coffee. Trials using filtered coffee demonstrated
      very little increase in serum cholesterol. Consumption of unfiltered, but not
      filtered, coffee increases serum levels of total and LDL cholesterol.

PMID- 11207154
TI  - Neighborhood socioeconomic status and all-cause mortality.
AB  - This study sought to determine the contribution of neighborhood socioeconomic
      status to all-cause mortality and to explore its correlates. As part of the
      longitudinal "Gezondheid en LevensOmstandigheden Bevolking en omstreken" (GLOBE)
      study in the Netherlands, 8,506 randomly selected men and women aged 15-74 years
      from 86 neighborhoods in the city of Eindhoven reported on their socioeconomic
      status in the 1991 baseline survey. During the 6-year follow-up, 487 persons
      died. Neighborhood socioeconomic status was derived from individual reports on
      socioeconomic status. Its effect on mortality was stringently controlled for four
      individual-level socioeconomic indicators. Persons living in a neighborhood with
      a high percentage of unemployed/disabled or poor persons had a higher mortality
      risk than did those living in a neighborhood with a low percentage of
      unemployed/disabled or poor persons. This was independent of individual
      socioeconomic characteristics, including individual unemployment/disability or
      reports of severe financial problems. Educational and occupational neighborhood
      indicators were similarly, but less strongly, related to mortality. The
      prevalence of poor housing conditions, social disintegration, and unhealthy
      psychologic profiles and behaviors was higher in neighborhoods with a low
      socioeconomic status. Contextual effects of socioeconomic status may thus be due
      to one or more of these specific circumstances. The findings indicate potential
      public health benefits of modifying socioeconomic characteristics of areas.

PMID- 11207155
TI  - Immigration and the health of Asian and Pacific Islander adults in the United
      States.
AB  - The authors used the 1992-1995 National Health Interview Survey to examine the
      effect of immigrant status (both nativity and duration of residence in the United
      States) on the health of Asian and Pacific Islander adults by constructing models
      in which national origin was also specified. In logistic regression models
      adjusted for age, marital status, living arrangement, family size, and several
      socioeconomic indicators, immigrants were found to be in better health than their
      US-born counterparts, but their health advantages consistently decreased with
      duration of residence. For example, for Asian and Pacific Islander immigrants
      whose duration of residence was less than 5 years, 5-9 years, and 10 years or
      more, the odds ratios for activity limitations were 0.45 (95% confidence interval
      (CI): 0.33, 0.62), 0.65 (95% CI: 0.46, 0.93), and 0.73 (95% CI: 0.60, 0.90),
      respectively. Similar findings emerged for respondent-reported health and bed
      days due to illness. These results support the validity and complementarity of
      the migration selectivity and acculturation hypotheses. However, the picture was
      not uniformly positive. The health of certain Asian and Pacific Islander groups,
      notably Pacific Islanders and Vietnamese, was found to be less favorable than
      average. Finally, after adjustment for health status, immigrants seemed to have
      less adequate access to formal medical care.

PMID- 11207156
TI  - Early therapy for latent tuberculosis infection.
AB  - The risk of developing active tuberculosis is highest within the first 2 years of
      infection. Therefore, an intervention that targets persons with recent infection,
      such as identifying contacts of active cases, could be particularly effective as
      an epidemic control measure. A mathematical model of a tuberculosis epidemic is
      formulated and used to evaluate the strategy of targeting therapy to persons with
      recently acquired latent tuberculosis infection. The model is used to quantify
      the effectiveness of therapy for early latent tuberculosis infection in reducing
      the prevalence of active tuberculosis. The model is also used to demonstrate how
      effective therapy for early latent tuberculosis infection has to be to eliminate
      tuberculosis, when used in conjunction with therapy for active tuberculosis.
      Analysis of the model suggests that programs such as contact investigations,
      which identify and treat persons recently infected with Mycobacterium
      tuberculosis, may have a substantial effect on controlling tuberculosis
      epidemics.

PMID- 11207157
TI  - Modeling changes in CD4-positive T-lymphocyte counts after the start of highly
      active antiretroviral therapy and the relation with risk of opportunistic
      infections: the Aquitaine Cohort, 1996-1997.
AB  - After initiation of a treatment for human immunodeficiency virus type 1 infection
      containing a protease inhibitor, immune restoration associated with increases in
      CD4-positive (CD4+) T lymphocyte count may be delayed. In a sample of patients
      who had been prescribed protease inhibitors for the first time, the authors
      tested to see whether there was a minimal duration of CD4+ cell count increase
      before the increase had an impact on the occurrence of opportunistic infections.
      The evolution (difference between time t and baseline) of CD4+ cell count was
      modeled using a mixed effects linear model. Changes in CD4+ count estimated by
      this model were then included as time-dependent covariates in a proportional
      hazards model. Finally, the authors tested for the existence of a CD4+ change x
      time interaction. The authors used a sample of 553 French patients first
      prescribed protease inhibitors in 1996 and followed for a median of 16 months.
      During the first 120 days, there was no association between CD4+ change and the
      rate of opportunistic infections. After 120 days, each 50-cell/mm3 increase in
      CD4+ count was associated with a 60% (95% confidence interval: 45, 72) reduction
      in the incidence of opportunistic infections. These results, based on modeling of
      CD4+ cell response, at least indirectly reinforce the concept of a delayed but
      possible immune recovery with the use of protease inhibitors. The findings
      support the potential for interruption of certain types of prophylaxis against
      opportunistic infections under reasonable conditions of duration of
      antiretroviral therapy and sustained CD4+ cell response.

PMID- 11207158
TI  - Empirical evidence of correlated biases in dietary assessment instruments and its
      implications.
AB  - Multiple-day food records or 24-hour recalls are currently used as "reference"
      instruments to calibrate food frequency questionnaires (FFQs) and to adjust
      findings from nutritional epidemiologic studies for measurement error. The common
      adjustment is based on the critical requirements that errors in the reference
      instrument be independent of those in the FFQ and of true intake. When data on
      urinary nitrogen level, a valid reference biomarker for nitrogen intake, are
      used, evidence suggests that a dietary report reference instrument does not meet
      these requirements. In this paper, the authors introduce a new model that
      includes, for both the FFQ and the dietary report reference instrument, group
      specific biases related to true intake and correlated person-specific biases.
      Data were obtained from a dietary assessment validation study carried out among
      160 women at the Dunn Clinical Nutrition Center, Cambridge, United Kingdom, in
      1988-1990. Using the biomarker measurements and dietary report measurements from
      this study, the authors compare the new model with alternative measurement error
      models proposed in the literature and demonstrate that it provides the best fit
      to the data. The new model suggests that, for these data, measurement error in
      the FFQ could lead to a 51% greater attenuation of true nutrient effect and the
      need for a 2.3 times larger study than would be estimated by the standard
      approach. The implications of the results for the ability of FFQ-based
      epidemiologic studies to detect important diet-disease associations are
      discussed.

PMID- 11207159
TI  - Is shorter always better? Relative importance of questionnaire length and
      cognitive ease on response rates and data quality for two dietary questionnaires.
AB  - In this study, the authors sought to determine the effects of length and clarity
      on response rates and data quality for two food frequency questionnaires (FFQs):
      the newly developed 36-page Diet History Questionnaire (DHQ), designed to be
      cognitively easier for respondents, and a 16-page FFQ developed earlier for the
      Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The PLCO
      Trial is a 23-year randomized controlled clinical trial begun in 1992. The sample
      for this substudy, which was conducted from January to April of 1998, consisted
      of 900 control and 450 screened PLCO participants aged 55-74 years. Controls
      received either the DHQ or the PLCO FFQ by mail. Screenees, who had previously
      completed the PLCO FFQ at baseline, were administered the DHQ. Among controls,
      the response rate for both FFQs was 82%. Average amounts of time needed by
      controls to complete the DHQ and the PLCO FFQ were 68 minutes and 39 minutes,
      respectively. Percentages of missing or uninterpretable responses were similar
      between instruments for questions on frequency of intake but were approximately 3
      and 9 percentage points lower (p < or = 0.001) in the DHQ for questions on
      portion size and use of vitamin/mineral supplements, respectively. Among
      screenees, response rates for the DHQ and the PLCO FFQ were 84% and 89%,
      respectively, and analyses of questions on portion size and supplement use showed
      few differences. These data indicated that the shorter FFQ was not better from
      the perspective of response rate and data quality, and that clarity and ease of
      administration may compensate for questionnaire length.

PMID- 11207160
TI  - Chronic musculoskeletal and other idiopathic pain syndromes.

PMID- 11207162
TI  - Stamps in paediatrics: Oral rehydration therapy.

PMID- 11207161
TI  - Incidence, aetiology, and outcome of non-traumatic coma: a population based
      study.
AB  - AIM: To determine the incidence, presentation, aetiology, and outcome of non
      traumatic coma in children aged between 1 month and 16 years. METHODS: In this
      prospective, population based, epidemiological study in the former Northern NHS
      region of the UK, cases were notified following any hospital admission or
      community death associated with non-traumatic coma. Coma was defined as a Glasgow
      Coma Score below 12 for more than six hours. RESULTS: The incidence of non
      traumatic coma was 30.8 per 100 000 children under 16 per year (6.0 per 100 000
      general population per year). The age specific incidence was notably higher in
      the first year of life (160 per 100 000 children per year). CNS specific
      presentations became commoner with increasing age. In infants, nearly two thirds
      of presentations were with non-specific, systemic signs. Infection was the
      commonest overall aetiology. Aetiology remained unknown in 14% despite extensive
      investigation and/or autopsy. Mortality was highly dependent on aetiology, with
      aetiology specific mortality rates varying from 3% to 84%. With follow up to
      approximately 12 months, overall series mortality was 46%.

PMID- 11207163
TI  - Cognitive and adaptive outcomes and age at insult effects after non-traumatic
      coma.
AB  - Cognitive and adaptive behavioural outcome were studied in the identified
      survivors of a population based study of non-traumatic coma (NTC) in childhood.
      Children were assessed early (six weeks) and late (12 months) after NTC. At least
      7% of those children in whom no suspicions of prior neurodevelopmental morbidity
      existed showed moderate or severe disability following NTC. Children over 2 years
      of age at insult showed some improvement between early and late assessments;
      however, children below 2 years showed no improvement. Differing age at insult
      effects were observed between aetiological groups. A relation between early age
      at first insult and poor outcome was particularly evident among children
      experiencing NTC caused by epilepsy.

PMID- 11207164
TI  - A review of measures of quality of life for children with chronic illness.
AB  - AIMS: To identify currently available generic and disease specific measures of
      quality of life (QoL) for work with children; and make recommendations about the
      future development and application of QoL measures. METHODS: Systematic searches
      were conducted to identify measures of QoL. Primary research papers were coded by
      the authors on the basis of predefined inclusion and exclusion criteria. RESULTS:
      Of the 137 papers included in the review, 43 involved the development of a new
      measure. These included 19 generic and 24 disease specific measures. Almost half
      the measures were developed in the USA. Measures were identified which were
      appropriate for children across a broad age range, and included provision for
      completion by different respondents (child only, parent only, or both). There
      were no clear distinctions between measures of QoL, health, or functional status.
      CONCLUSIONS: We have identified a small number of measures which fulfil basic
      requirements and could be used to assess QoL in clinical trials or following
      interventions. However, there remain a number of problems in measuring QoL in
      children. These include limited availability of disease specific measures;
      discrepancies between child and parent ratings; limited availability of measures
      for self completion by children; lack of precision regarding the content of
      domains of QoL; and the cultural appropriateness of measures developed elsewhere
      for children in the UK.

PMID- 11207167
TI  - Social class difference in catch up growth in a national British cohort.
AB  - AIM: To examine the influence of socioeconomic status on growth pattern in height
      from age 7 to 23 years. METHODS: Prospective cohort study. A total of 10 200
      white singleton born children from the 1958 British birth cohort (National Child
      Development Study) were analysed. RESULTS: Differences in height by birth weight
      persisted throughout the follow up period. However, the mean differences in
      height between low birth weight infants (<2500 g) and adequate birth weight
      infants (>/=2500 g) were less notable in social classes I and II than in the
      lower social classes. The catching up of growth in height of low birth weight
      infants was also more pronounced in social classes I and II than in other social
      classes. That is, the mean height deficits of low birth weight infants were
      decreased from 2.9 cm at age 7, to 1.6 cm at age 16, and 2.5 cm at age 23; the
      significant difference disappeared after age 16 in social classes I and II.
      Although such improving tendency was more pronounced among the preterm born
      infants, a similar growth pattern was observed among the term infants. Such
      improvement was not observed in the other social classes. CONCLUSION: The growth
      retardation in height by birth weight can be overcome by improved social
      conditions and proper health care from childhood to adulthood.

PMID- 11207165
TI  - Birth weight, subsequent growth, and cholesterol metabolism in children 8-12
      years old born preterm.
AB  - AIMS: To test the hypothesis that plasma lipids, lipoproteins, and markers of
      cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in
      children aged 8-12 years are related to birth size and subsequent growth.
      METHODS: A total of 412 girls and boys weighing less than 1850 g at birth were
      studied. Birth weight, gestation, and weight at 18 months were recorded and
      followed up at 8-12 years. Plasma total cholesterol, low density lipoprotein
      cholesterol, high density lipoprotein cholesterol, apolipoprotein A1,
      apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured.
      RESULTS: Birth weight for gestational age was positively related to plasma
      campesterol, and remained so after adjusting for current body size or fatness.
      Birth weight was negatively related to current plasma lathosterol but only after
      adjusting for current body size or fatness. For both lathosterol and campesterol
      the significant relation with birth size adjusted for current size indicates that
      the change in size between these points (postnatal upward centile crossing) was
      influential. These relations were absent for total cholesterol, lipoproteins,
      apolipoproteins, and triacylglycerol. CONCLUSION: Preterm children who were
      smaller for gestational age at birth had lower predicted cholesterol absorption
      efficiency 8-12 years later. Among children of the same current size, predicted
      endogenous cholesterol synthesis was higher and cholesterol absorption efficiency
      lower in those who showed the greatest increase in weight centile between birth
      and follow up. This finding was not confined to children with the smallest birth
      weights for gestational age. We suggest that both fetal and childhood growth
      relate to programming of cholesterol metabolism in children born preterm.

PMID- 11207169
TI  - Influences of ethnicity on perinatal and child mortality in the Netherlands.
AB  - AIMS: To investigate the differences in perinatal death and child mortality
      between different ethnic groups in the Netherlands. METHODS: Retrospective
      analysis of data collected between 1990 and 1993 in the national obstetric
      registry comprising 569 743 births. Retrospective analysis of all death
      certificates of 0 to 15 year old children routinely collected between 1979 and
      1993, comprising 20 211 deaths. RESULTS: Black mothers had the highest perinatal
      death rate compared with indigenous Dutch mothers (odds ratio 2.2). Hindustanis
      (West Indian Asians) had an odds ratio of 1.4 and Mediterraneans 1.3. The
      increased rate for black and Hindustani women could be fully explained by preterm
      birth. In the Mediterranean group the differences were explained by teenage
      pregnancy, grand multiparity, and socioeconomic status rather than prematurity.
      The death rate of Turkish and Moroccan children was twice as high as that of
      native Dutch children. For the different diagnostic categories this was:
      infectious diseases, relative risk (RR) 2.2; hereditary (metabolic) disorders, RR
      2.0; accidents and drowning, RR 1.9. One quarter of the Turkish and Moroccan
      children died while on holiday in their country of origin. Sudden infant death
      syndrome was twice as high for Turkish infants as for Dutch children and four
      times higher than for Moroccan infants. CONCLUSION: Ethnic minorities in the
      Netherlands have a higher perinatal and child mortality rate than the indigenous
      Dutch. Apart from socioeconomic differences, sociocultural and lifestyle factors
      play an important role.

PMID- 11207170
TI  - Idiopathic thrombocytopenic purpura and MMR vaccine.
AB  - A CAUSAL ASSOCIATION BETWEEN MEASLES: mumps-rubella (MMR) vaccine and idiopathic
      thrombocytopenic purpura (ITP) was confirmed using immunisation/hospital
      admission record linkage. The absolute risk within six weeks of immunisation was
      1 in 22 300 doses, with two of every three cases occurring in the six week post
      immunisation period being caused by MMR. Children with ITP before MMR had no
      vaccine associated recurrences.

PMID- 11207172
TI  - Five year follow up of vertically HIV infected children in a randomised double
      blind controlled trial of immediate versus deferred zidovudine: the PENTA 1
      trial.
AB  - A total of 195 children were randomised to zidovudine (immediate) or matching
      placebo (deferred) in a multicentre double blind trial in vertically HIV infected
      children with early disease (the PENTA 1 trial). Median follow up in the blinded
      phase was 1.9 years. Thereafter, individual children were unblinded following the
      results of adult trials showing a benefit of combination antiretroviral therapy
      (ART) over monotherapy, but follow up continued and is reported here until
      December 1998 (total follow up 4.6 years). Median time to starting ART in the
      deferred group was 2.7 years; 19% of deferred children had not started ART by
      1999. Throughout follow up, the percentage of time spent on no ART, monotherapy,
      dual, and triple ART was 21%, 44%, 29%, and 6% respectively for immediate and
      62%, 12%, 18%, and 8% for deferred groups. During the blinded phase eight (7.8%)
      immediate and 12 (13.3%) deferred children developed AIDS or died (log rank p =
      0.24); overall 21 immediate and 20 deferred children progressed. In an analysis
      including all children regardless of original allocation, the risk of progression
      to AIDS or death, adjusting for age and time since trial entry was significantly
      lower during 1997-98 (2.4 per 100 child years) than during 1992-96 (6.6 per 100
      child years), most likely a result of increased use of combination ART.

PMID- 11207173
TI  - Double blind, randomised controlled clinical trial of hypo-osmolar oral
      rehydration salt solution in dehydrating acute diarrhoea in severely malnourished
      (marasmic) children.
AB  - AIMS: To compare the clinical efficacy of hypo-osmolar oral rehydration salt
      (ORS) solution (224 mmol/l) and standard ORS solution (311 mmol/l) in severely
      malnourished (marasmic) children having less than 60% Harvard standard weight for
      age with dehydrating acute watery diarrhoea. METHODS: In a double blind,
      randomised, controlled trial, 64 children aged 6-48 months were randomly assigned
      standard (n = 32) or hypo-osmolar ORS (n = 32). RESULTS: Stool output (52.3 v
      96.6 g/kg/day), duration of diarrhoea (41.5 v 66.4 hours), intake of ORS (111.5 v
      168.9 ml/kg/day), and fluid intake (214.6 v 278.3 ml/kg/day) were significantly
      less in the hypo-osmolar group than in the standard ORS group. Percentage of
      weight gain on recovery in the hypo-osmolar group was also significantly less
      (4.3 v 5.4% of admission weight) than in the standard ORS group. A total of 29
      (91%) children in the standard ORS group and 32 (100%) children in the hypo
      osmolar group recovered within five days of initiation of therapy. Mean serum
      sodium and potassium concentrations on recovery were within the normal range in
      both groups. CONCLUSION: Our findings suggest that hypo-osmolar ORS has
      beneficial effects on the clinical course of dehydrating acute watery diarrhoea
      in severely malnourished (marasmic) children. Furthermore, children did not
      become hyponatraemic after receiving hypo-osmolar ORS.

PMID- 11207175
TI  - Shared decision making in pediatrics.

PMID- 11207174
TI  - Randomised controlled trial of three day versus 10 day intravenous antibiotics in
      acute pyelonephritis: effect on renal scarring.
AB  - BACKGROUND: Acute pyelonephritis often leaves children with permanent renal
      scarring. AIMS: To compare the prevalence of scarring following initial treatment
      with antibiotics administered intravenously for 10 or three days. METHODS: In a
      prospective two centre trial, 220 patients aged 3 months to 16 years with
      positive urine culture and acute renal lesions on initial DMSA scintigraphy, were
      randomly assigned to receive intravenous ceftriaxone (50 mg/kg once daily) for 10
      or three days, followed by oral cefixime (4 mg/kg twice daily) to complete a 15
      day course. After three months, scintigraphy was repeated in order to diagnose
      renal scars. RESULTS: Renal scarring developed in 33% of the 110 children in the
      10 day intravenous group and 36% of the 110 children in the three day group.
      Children older than 1 year had more renal scarring than infants (42% (54/129) and
      24% (22/91), respectively). After adjustment for age, sex, duration of fever
      before treatment, degree of inflammation, presence of vesicoureteric reflux, and
      the patients' recruitment centres, there was no significant difference between
      the two treatments on renal scarring. During follow up, 15 children had
      recurrence of urinary infection with no significant difference between the two
      treatment groups. CONCLUSION: In children with acute pyelonephritis, initial
      intravenous treatment for 10 days, compared with three days, does not
      significantly reduce the development of renal scarring.

PMID- 11207176
TI  - Electroencephalographic and clinical features of cerebral malaria.
AB  - BACKGROUND: Seizures are a prominent feature of childhood cerebral malaria, and
      are associated with an increased risk of death and neurological sequelae. We
      present the electroencephalographic (EEG) findings from a detailed clinical and
      electrophysiological study. METHODS: Children with cerebral malaria had EEGs
      recorded within six hours of admission, and at 12 hourly intervals until recovery
      of consciousness. Ten deeply comatose children underwent intracranial pressure
      monitoring. Children were not mechanically ventilated, which made it possible to
      directly correlate the clinical and EEG findings. RESULTS: Of 65 children aged 9
      months and above, 40 had one or more seizures, and 18 had an episode of status
      epilepticus. Most seizures were partial motor, and spike wave activity
      consistently arose from the posterior temporo-parietal region, a border zone area
      lying between territories supplied by the carotid and vertebrobasilar
      circulations. Fifteen children had seizures that were clinically subtle or
      electrographic. Clinical seizures were associated with an abrupt rise in
      intracranial pressure. Fifty children recovered fully, seven died, and eight had
      persistent neurological sequelae. Initial EEG recordings of very slow frequency,
      or with background asymmetry, burst suppression, or interictal discharges, were
      associated with an adverse outcome. CONCLUSIONS: Serial EEG recording has
      uncovered a range of clinical, subtle, and electrographic seizures complicating
      childhood cerebral malaria, and has emphasised their importance in the
      pathogenesis of coma. Further work is required to determine the most appropriate
      regimen for the prophylaxis and treatment of seizures in cerebral malaria, in
      order to improve outcome.

PMID- 11207177
TI  - Exercise induced hypoglycaemic hyperinsulinism.
AB  - BACKGROUND: Hyperinsulinism in childhood is often caused by genetic defects
      involving the regulation of insulin secretion leading to recurrent episodes of
      hypoglycaemia. We report two patients with exercise induced hypoglycaemia.
      METHODS: Standardised short exercise tests with frequent blood glucose and plasma
      insulin measurements were performed in the patients and young healthy controls.
      RESULTS: Short term exercise resulted in insulin induced hypoglycaemia 15 to 50
      minutes after the end of exercise. A massive burst of insulin secretion was
      observed within a few minutes of the start of exercise in both patients. By
      contrast glucose and insulin concentrations remained unchanged in healthy
      controls. CONCLUSIONS: Hyperinsulinaemic hypoglycaemia after moderate physical
      exercise represents a rarely described phenotype of hyperinsulinism with an as
      yet unknown defect in the regulation of insulin secretion. It should be suspected
      in individuals with recurrent exercise related syncope or disturbance of
      consciousness.

PMID- 11207178
TI  - Prognosis of patients with acute renal failure without cardiopathy.
AB  - BACKGROUND: The outcome for children with acute renal failure (ARF) may be poor.
      However, relatively few published studies have considered prognosis of these
      patients. METHODS: We prospectively studied, from 1978 to 1998, 92 such children
      without heart disease to try to identify risk factors for mortality. RESULTS:
      Forty five per cent of children with tumours, shock, and other causes died
      compared with none of those with a primary urinary tract related problem. ARF did
      not seem to be the cause of death in any case. Univariate analysis showed that in
      the non-primary urinary problem group (55 cases), patients with hypotension, high
      values of BUN or creatinine, or who needed mechanical ventilation or dialysis,
      had a poor outcome. Multivariate analysis showed that probability of death can be
      estimated using the following score: -0.02 + 0.28 (hypotension) + 0.19
      (ventilation) + 0.27 (dialysis) + 0.01 (BUN). CONCLUSIONS: Mortality of patients
      with ARF was related to aetiology, the need for dialysis and/or ventilator use,
      hypotension, and BUN values.

PMID- 11207179
TI  - Pancreatic dysfunction in severe obesity.
AB  - AIMS: To investigate pancreatic function in children attending an obesity clinic.
      METHODS: Thirty six children (of which 34 were white) with severe obesity of
      prepubertal onset (body mass index more than +2 SDS) were reviewed clinically and
      dysmorphologically, with assessment of pancreatic function. RESULTS: Eight had
      dysmorphic features and 13 had learning difficulties. Four of 17 prepubertal
      children had hyperinsulinaemia and seven had hyperproinsulinaemia. All 19
      pubertal children had hyperinsulinaemia, 14 had hyperproinsulinaemia, and one had
      type II diabetes. CONCLUSIONS: Metabolic abnormalities predictive of type II
      diabetes occur in severely obese white children.

PMID- 11207180
TI  - Retinal haemorrhage and fatal stroke in an infant with fibromuscular dysplasia.
AB  - Non-accidental injury should be suspected and excluded in any infant found to
      have intracranial and retinal haemorrhage of unknown aetiology. This can be a
      sensitive issue for both medical staff and parents. We present a case in which
      the underlying cause of intracranial and retinal haemorrhage was fibromuscular
      dysplasia. It was a diagnosis made only at postmortem examination and it
      illustrates the diagnostic difficulty such cases may present.

PMID- 11207182
TI  - Acute urinary retention: an unusual presentation of acute appendicitis in a 3
      year old boy.

PMID- 11207181
TI  - Identifying futility in a paediatric critical care setting: a prospective
      observational study.
AB  - AIMS: To determine the extent of futile care provided to critically ill children
      admitted to a paediatric intensive care setting. METHODS: Prospective evaluation
      of consecutive admissions to a 20 bedded multidisciplinary paediatric intensive
      care unit of a North London teaching hospital over a nine month period. Three
      previously defined criteria for futility were used: (1) imminent demise futility
      (those with a mortality risk greater than 90% using the Paediatric Risk of
      Mortality (PRISM II) score); (2) lethal condition futility (those with conditions
      incompatible with long term survival); and (3) qualitative futility (those with
      unacceptable quality of life and high morbidity). RESULTS: A total of 662
      children accounting for 3409 patient bed days were studied. Thirty four patients
      fulfilled at least one of the criteria for futility, and used a total of 104 bed
      days (3%). Only 33 (0.9%) bed days were used by patients with mortality risk
      greater than 90%, 60 (1.8%) by patients with poor long term prognosis, and 16
      (0.5%) by those with poor quality of life. Nineteen of 34 patients died;
      withdrawal of treatment was the mode of death in 15 (79%). CONCLUSIONS: Cost
      containment initiatives focusing on futility in the paediatric intensive care
      unit setting are unlikely to be successful as only relatively small amounts of
      resources were used in providing futile care. Paediatricians are recognising
      futility early and may have taken ethically appropriate measures to limit care
      that is futile.

PMID- 11207183
TI  - Parental compliance with home cardiorespiratory monitoring.
AB  - AIMS: To evaluate parental compliance with home cardiorespiratory monitoring of
      premature infants with apnoea, siblings of infants who died of sudden infant
      death syndrome (SIDS), and infants with an apparent life threatening event
      (ALTE), during the first month of use. METHODS: A retrospective review of the
      first month's recordings was conducted on 39 premature infants with apnoea, 13
      siblings of SIDS, and 16 infants with ALTE. All infants were singletons.
      Recommendations during the study period (1992-1994) were for daily use for 23
      hours per day. Measurements were average daily hours of use and consistency of
      use (daily or variable). Gestational age, maternal age, and socioeconomic status
      as measured by receipt of public assistance were also recorded. RESULTS: Siblings
      of SIDS were monitored for fewer hours than were premature or ALTE infants. Only
      54% of sibings of SIDS were monitored daily, compared to 87% of premature infants
      and 93% of ALTEs. Within each diagnostic category socioeconomic status did not
      affect average hours of monitoring. Consistency of use was more evident in those
      with private insurance, although the trend did not reach significance.
      CONCLUSIONS: Parents of infants with apnoea of prematurity or ALTE are highly
      compliant with cardiorespiratory monitoring recommendations in the first month of
      monitor usage. Siblings of SIDS are monitored for fewer hours and are less likely
      to be monitored on a daily basis.

PMID- 11207184
TI  - Simultaneous monitoring of gastric and oesophageal pH reveals limitations of
      conventional oesophageal pH monitoring in milk fed infants.
AB  - BACKGROUND: Monitoring oesophageal pH conventionally detects "acid reflux" (pH
      less than 4). The pH of the gastric contents determines whether or not reflux can
      be detected. AIM: To monitor gastric and oesophageal pH simultaneously in order
      to determine the effect of milk feeds on gastric pH and how this would influence
      interpretation of the oesophageal pH record. METHODS: Milk fed infants for whom
      oesophageal pH monitoring was requested underwent simultaneous gastric and
      oesophageal pH monitoring using a dual channel pH probe. RESULTS: Twenty of 24
      records were technically satisfactory. Mean reflux index was 1.0%, range 0.0
      4.0%. Gastric pH was less than 4 for 24.5% (range 0.6-69.1%) of the total time.
      The average time the gastric pH was greater than 4 after feeds was 130 minutes
      (range 29-212 minutes). The corrected reflux index (limited to the time the
      gastric pH was less than 4) was 2.6% (range 0.0-11.0%). CONCLUSION: The pH of the
      gastric contents may be greater than 4 for prolonged intervals, during which
      oesophageal pH monitoring using current criteria cannot detect reflux nor
      correlate it with clinical events. A low reflux index may reflect prolonged
      buffering of gastric acidity rather than the absence of reflux.

PMID- 11207185
TI  - Ion channels and neurology.

PMID- 11207186
TI  - Negative feedback regulation of the secretion and actions of gonadotropin
      releasing hormone in males.
AB  - This minireview considers the state of knowledge regarding the interactions of
      testicular hormones to regulate the secretion and actions of GnRH in males, with
      special focus on research conducted in rams and male rhesus monkeys. In these two
      species, LH secretion is under the negative feedback regulation of testicular
      steroids that act predominantly within the central nervous system to suppress
      GnRH secretion. The extent to which these actions of testicular steroids result
      from the direct actions of testosterone or its primary metabolites, estradiol or
      dihydrotestosterone, is unclear. Because GnRH neurons do not contain steroid
      receptors, the testicular steroids must influence GnRH neurons via afferent
      neurons, which are largely undefined. The feedback regulation of FSH is
      controlled by inhibin acting directly at the pituitary gland. In male rhesus
      monkeys, the feedback regulation of FSH secretion is accounted for totally by the
      physiologically relevant form of inhibin, which appears to be inhibin B. In rams,
      the feedback regulation of FSH secretion involves the actions of inhibin and
      testosterone and interactions between these hormones, but the physiologically
      relevant form of inhibin has not been determined. The mechanisms of action for
      inhibin are not known.

PMID- 11207187
TI  - Plasma inhibin A in heifers: relationship with follicle dynamics, gonadotropins,
      and steroids during the estrous cycle and after treatment with bovine follicular
      fluid.
AB  - The relationship between follicle growth and plasma inhibin A, FSH, LH, estradiol
      (E), and progesterone was investigated during the normal bovine estrous cycle and
      after treatment with steroid-free bovine follicular fluid (bFF) to arrest
      follicle development. In the first study, four heifers were monitored over three
      prostaglandin (PG)-synchronized cycles. Blood was collected every 2-8 h, and
      ovaries were examined daily by ultrasonography. Inhibin A was measured using a
      modified enzyme-linked immunosorbent assay that employed a new monoclonal
      antibody against the alpha subunit of bovine inhibin. Plasma inhibin A (
      approximately 50 pg/ml before luteolysis) rose steadily during the induced
      follicular phase (P < 0.05) to a peak ( approximately 125 pg/ml) coincident with
      the preovulatory E/LH/FSH surge. After ovulation, inhibin A fell sharply (P <
      0.05) to a nadir ( approximately 55 pg/ml) coincident with the secondary FSH
      rise. During the next 3 days, inhibin A increased to approximately 90 pg/ml in
      association with growth of the new dominant follicle (DF). Plasma E also rose
      twofold during this period, whereas FSH fell by approximately 50%. Inhibin A was
      negatively correlated with FSH (r = -0.37, P < 0.001) and positively correlated
      with E (r = 0.49, P < 0.0001). Observations on eight cycles (two cycles/heifer),
      in which growth of the ovulatory DF was monitored from emergence to ovulation,
      showed that the first-wave DF (DF1) ovulated in three cycles and the second-wave
      DF (DF2) in five cycles. After PG, plasma inhibin A and E increased similarly in
      both groups, with concomitant falls in FSH. In the former group, the restricted
      ability of DF1 to secrete both inhibin A and E was restored after luteolysis.
      Results indicate that dynamic changes in the secretion of both E and inhibin A
      from the DF contribute to the fall in FSH during the follicular phase and to the
      generation and termination of the secondary FSH surge, both of which play a key
      role in follicle selection. In the second study, bFF (two dose levels) was
      administered to heifers (n = 3-4) for 60 h starting from the time of DF1
      emergence. Both doses suppressed FSH (P < 0.05) and blocked DF1 growth to the
      same extent (P < 0.01), although inhibin A levels were only marginally raised by
      the lower dose (not significant compared to controls). The high bFF dose raised
      (P < 0.001) inhibin A to supraphysiological levels ( approximately 1 ng/ml). A
      large "rebound" rise in FSH occurred within 1 day of stopping both treatments,
      even though the inhibin A level in the high-dose bFF group was still
      approximately threefold higher than that in controls. This indicates that
      desensitization of gonadotropes to inhibin negative feedback is a contributory
      factor, together with reduced ovarian output of E, in generation of the post-bFF
      rebound in FSH.

PMID- 11207188
TI  - Ectopic transplantation of equine invasive trophoblast.
AB  - A system for transplanting invasive equine trophoblast (i.e., chorionic girdle)
      to ectopic sites has been developed as a means to study the differentiation of
      this tissue and to assess maternal immune responses to the conceptus tissue in a
      site outside the uterus. Chorionic girdle was isolated from Day 33 to 34
      conceptuses and surgically placed into the vulvar mucosa or subdermal skin of
      recipient mares. Biopsy specimens of the graft sites for immunohistochemical
      staining were taken at weekly or biweekly intervals after grafting. Serum samples
      were collected from each recipient and tested for antibody to donor major
      histocompatibility complex (MHC) class I antigens using the lymphocyte
      microcytotoxicity assay. Transplanted trophoblast cells expressed differentiation
      markers associated with invading chorionic girdle and endometrial cup cells. The
      transplanted trophoblast cells were also labeled by an antibody to eCG. Strong
      cellular and humoral immune responses to the transplanted tissue were mounted by
      the recipients, similar to those occurring during normal equine pregnancy.
      Despite these responses, the invasive trophoblast transplants survived for at
      least 28 days after grafting and downregulated MHC class I antigens, as do the
      mature endometrial cup cells in equine pregnancy. These findings suggest that
      invasive equine trophoblast has the capacity to differentiate fully in equine
      nonuterine tissues, and that it can evade maternal immune responses independent
      of the physiological state of pregnancy and in sites other than the uterus.

PMID- 11207190
TI  - Telomerase activity in early bovine embryos derived from parthenogenetic
      activation and nuclear transfer.
AB  - This study examined the telomerase activity in preimplantation bovine embryos
      derived from either parthenogenetic activation or nuclear transfer. Telomeres are
      the DNA-protein structures located at the ends of eukaryotic chromosomes.
      Telomerase is the ribonuclear enzyme that helps to restore telomere length by
      synthesizing telomeric DNA repeat (5'-TTAGGG-3') from its own RNA template.
      Without telomerase activity, telomeres shorten with each cell division through
      conventional DNA replication. In most mammalian species, telomerase activity is
      present in germ cells but not in somatic cells. Previously, we reported the
      dynamics of telomerase activity in bovine in vitro fertilized (IVF) embryos. In
      the present study, we examined the telomerase activity in bovine embryos derived
      either from parthenogenetic activation or somatic cell nuclear transfer (i.e.,
      cloning). Embryos from both sources were harvested at different stages, from
      zygote to blastocyst. Telomerase activity in embryos derived from parthenogenetic
      activation and nuclear transfer showed a dynamic profile similar to that of those
      derived from IVF. Telomerase activity was detected in embryos at all stages
      examined, with the highest level in the blastocyst stage, regardless of the
      method of embryo production.

PMID- 11207189
TI  - Na+ reabsorption in cultured rat epididymal epithelium via the Na+/nucleoside
      cotransporter.
AB  - The effect of nucleoside on Na+ reabsorption via Na+/nucleoside cotransporter in
      cultured rat epididymal epithelia was studied by short-circuit current (Isc)
      technique. Guanosine added apically stimulated Isc in a dose-dependent manner,
      with a median effective concentration (EC50) of 7 +/- 2 microM (mean +/- SEM).
      Removal of Na+ from the apical bathing solution or pretreatment with a
      nonspecific Na+/nucleoside cotransporter inhibitor, phloridzin, completely
      blocked the Isc response to guanosine. Moreover, the guanosine response was
      abolished by pretreatment of the tissue with ouabain, a Na+/K+-ATPase inhibitor,
      suggesting the involvement of Na+/nucleoside cotransporter on the apical side and
      Na+/K+-ATPase on the basolateral side in Na+ reabsorption. In contrast, the Isc
      response to guanosine was not affected after desensitization of purinoceptors by
      ATP. Addition of the Na+/K+/2Cl- symport inhibitor bumetanide to the basolateral
      side or the nonspecific Cl- channel blocker diphenylamine-2-carboxylate to the
      apical side showed no effect on the Isc response to guanosine, excluding
      stimulation of Cl- secretion by guanosine as the cause of the guanosine-induced
      Isc. The Isc response to purine nucleoside (guanosine and inosine) was much
      higher than that to pyrimidine nucleoside (thymidine and cytidine). Consistent
      with substrate specificity, results of reverse transcription-polymerase chain
      reaction revealed mRNA for concentrative nucleoside transporter (CNT2), which is
      a purine nucleoside-selective Na+/nucleoside cotransporter in the epididymis, but
      not for CNT1. It is suggested that the Na+/nucleoside cotransporter (i.e., CNT2)
      may be one of the elements involved in Na+ and fluid reabsorption in the
      epididymis, thereby providing an optimal microenvironment for the maturation and
      storage of spermatozoa.

PMID- 11207191
TI  - Steroidogenic factor-1 contributes to the cyclic-adenosine monophosphate down
      regulation of human SRY gene expression.
AB  - In mammals, male sex determination is initiated by SRY (sex-determining region of
      the Y chromosome) gene expression and followed by testicular development. This
      study describes specific down-regulation of the human SRY gene transcription by
      cAMP stimulation using reverse transcription-polymerase chain reaction
      experiments. Using transfection experiments, conserved nuclear hormone receptor
      (NHR1) and Sp1 consensus binding sites were identified as essential for this cAMP
      transcriptional response. Steroidogenic factor-1 (SF-1), a component of the sex
      determination cascade, binds specifically to the NHR1 site and activates the SRY
      promoter. Activation of SF-1 was abolished by cAMP pretreatment of the cells,
      suggesting a possible effect of cAMP on the SF-1 protein itself. Indeed, human SF
      1 protein contains at least two in vitro cAMP-dependent protein kinase (PKA)
      phosphorylation sites, leading after phosphorylation to a modification of both
      DNA-binding activity and interaction with general transcription factors such as
      Sp1. Taken together, these data suggest that cAMP responsiveness of human SRY
      promoter involves both SF-1 and Sp1 sites and could act via PKA phosphorylation
      of the SF-1 protein itself.

PMID- 11207192
TI  - Expression of Fas/Fas ligand by decidual leukocytes in hydatidiform mole.
AB  - Complete hydatidiform moles are entirely paternally derived and, therefore,
      represent a complete intrauterine allograft that might be expected to provoke an
      altered maternal immune response compared with that of normal pregnancy. Uterine
      decidua contains a large leukocyte population, of which 10%-20% are T
      lymphocytes. Fas ligand (FasL) expression by placental trophoblast may induce
      apoptosis of Fas+ lymphocytes, thereby facilitating immune tolerance and survival
      of the molar trophoblast. Our previous studies have shown an increase in
      activated CD4+ decidual T cells in molar pregnancy compared with normal
      pregnancy. This study was designed to characterize and quantitate Fas/FasL
      expression by decidual leukocytes in complete and partial hydatidiform mole
      compared with that in normal early pregnancy using single and double
      immunohistochemical labeling (i.e., avidin-biotin-peroxidase and avidin-biotin
      alkaline phosphatase). A significant increase was found in Fas and FasL
      expression by decidual CD4+ T cells in complete (Fas+, P = 0.0106; FasL+, P =
      0.0081) and partial (Fas+, P = 0.0131; FasL+, P = 0.0051) hydatidiform moles, as
      was a significant decrease in Fas expression by decidual CD8+ T cells in complete
      (P = 0.0137) and partial (P = 0.0202) hydatidiform mole compared with normal
      early pregnancy. The implications of altered Fas/FasL status of decidual T-cell
      subsets in hydatidiform mole are also discussed.

PMID- 11207193
TI  - Production of 25-hydroxycholesterol by testicular macrophages and its effects on
      Leydig cells.
AB  - Testicular macrophages secrete 25-hydroxycholesterol, which can be converted to
      testosterone by neighboring Leydig cells. The purposes of the present studies
      were to determine the mode of production of this oxysterol and its long-term
      effects on Leydig cells. Because oxysterols are produced both enzymatically and
      by auto-oxidation, we first determined if testicular macrophages possess
      cholesterol 25-hydroxylase mRNA and/or if macrophage-secreted products oxidize
      cholesterol extracellularly. Rat testicular macrophages had 25-hydroxylase mRNA
      and converted 14C-cholesterol to 14C-25-hydroxycholesterol; however, radiolabeled
      cholesterol was not converted to 25-hydroxycholesterol when incubated with medium
      previously exposed to testicular macrophages. Exposure of Leydig cells to 10
      microg/ml of 25-hydroxycholesterol, a dose within the range known to result in
      high basal production of testosterone when tested from 1 to 6 h, completely
      abolished LH responsiveness after 2 days of treatment. Because 25
      hydroxycholesterol is toxic to many cell types at 1-5 microg/ml, we also studied
      its influence on Leydig cells during 4 days in culture using a wide range of
      doses. Leydig cells were highly resistant to the cytotoxic effects of 25
      hydroxycholesterol, with no cells dying at 10 microg/ml and only 50% of cells
      affected at 100 microg/ml after 2 days of treatment. Similar conditions resulted
      in 100% death of a control lymphocyte cell line. These results demonstrate that
      1) testicular macrophages have mRNA for cholesterol 25-hydroxylase and can
      convert cholesterol into 25-hydroxycholesterol, 2) macrophage-conditioned medium
      is not capable of auto-oxidation of cholesterol, 3) Leydig cells are highly
      resistant to the cytotoxic influences of 25-hydroxycholesterol, and 4) long-term
      treatment with high doses of 25-hydroxycholesterol results in loss of LH
      responsiveness. These results support the concept that testicular macrophages
      enzymatically produce 25-hydroxycholesterol that not only is metabolized to
      testosterone by Leydig cells when present at putative physiological levels but
      also may exert inhibitory influences on Leydig cells when present for extended
      periods at very high concentrations that may occur under pathological conditions.

PMID- 11207194
TI  - Effects of neonatal progestin exposure on female reproductive tract structure and
      function in the adult ewe.
AB  - Endometrial glands are present in all mammalian uteri and produce secretions that
      are hypothesized to support conceptus (i.e., embryo/fetus and placental
      membranes) survival and development. In sheep, endometrial gland morphogenesis
      occurs postnatally and can be epigenetically ablated by chronic neonatal exposure
      to a progestin from birth, thereby producing an adult uterine gland knock-out
      (UGKO) phenotype. This study determined the long-term effects of neonatal
      progestin exposure on adult ovine reproductive tract structure and function.
      Neonatal ewes were exposed to norgestomet (Nor) from birth to 32 wk of age.
      Unexposed ewes served as controls. After puberty, adult Nor-treated (n = 6) and
      control (n = 6) ewes were repeatedly bred at estrus (Day 0) to intact rams of
      proven fertility. In contrast to a pregnancy rate of 80% for control ewes,
      pregnancy was never detected on Day 25 after mating (or thereafter) in bred UGKO
      ewes. Control and Nor-treated ewes were then bred and necropsied on Day 9.
      Similar numbers of hatched blastocysts were present in uterine flushings from
      control and Nor-treated ewes. Weights of the ovaries and cervices were not
      affected by treatment. No histoarchitectural differences between control and Nor
      treated ewes were detected for ovaries, oviducts, cervices, or vaginae. However,
      uterocervical and uterine weight as well as uterine horn length were less for Nor
      treated ewes. The uteri of Nor-treated ewes were devoid of endometrial glands and
      lacked the stromal delineation characteristic of intercaruncular endometrium in
      control ewes. Endometrial width, area, and lumenal epithelial length were
      decreased in uteri from Nor-treated ewes, but myometrial width and morphology
      were not affected. Expression of a number of mRNAs that are expressed
      predominantly in the endometrial epithelia was not different between uteri from
      control and from Nor-treated ewes. Collectively, these results indicate that
      neonatal exposure of ewes to a progestin from birth appears to only affect
      development of the uterus and not any extrauterine reproductive tract tissues.
      The infertility of the UGKO ewes appears to result from a lack of endometrial
      glands and, by extension, of their secretions that are required to support growth
      and development of peri-implantation conceptuses.

PMID- 11207195
TI  - Cloning of rainbow trout egg envelope proteins: members of a unique group of
      structural proteins.
AB  - All vertebrate eggs are surrounded by an extracellular envelope that protects the
      egg and is vital for a successful fertilization. The terminology and functions of
      the egg envelope vary in different vertebrate groups, but the envelope itself is
      consistently composed of a few major proteins that are deposited around the
      oocyte during oocyte growth. Here, we describe the deduced amino acid sequences
      and tissue expression patterns of the three major egg envelope proteins for
      rainbow trout (Oncorhynchus mykiss). All three vitelline envelope proteins (VEPs)
      are expressed in the livers of both male and female fish, with higher expression
      in females. In addition, VEPgamma mRNA is also detected in the female gonads. To
      our knowledge, this is the first time that expression of a VEP protein gene has
      been demonstrated to occur in more than one organ. Sequence comparison reveals
      that all three VEP proteins share distinct homology with their amphibian, avian,
      and mammalian counterparts. Whereas mammalian zona pellucida protein 3 isoforms
      contain two conserved serines needed for sperm binding, these are not conserved
      in teleost species, in which sperm entry is restricted to the micropyle. Besides
      the difference in VEPgamma sperm-binding function, the high sequence homology
      suggests that the egg envelope proteins from these distinct vertebrate groups
      share a common ancestry and form a unique group of structural proteins.

PMID- 11207196
TI  - Corticosteroid-binding globulin status at the fetomaternal interface during human
      term pregnancy.
AB  - The status of the corticosteroid-binding globulin (CBG) at the fetomaternal
      interface, especially in the maternal intervillous blood space (I), was
      investigated and compared to that of CBG in the maternal (M) and fetal (umbilical
      arteries [A] and vein [V]) peripheral circulations at term. Immunoquantitation of
      plasma CBG showed that the CBG concentration in I was 30% less than that in M (P
      < 0.001) and threefold higher than that in umbilical cord blood (P < 0.001). The
      microheterogeneity of CBG studied by immunoaffinoelectrophoresis in the presence
      of concanavalin A and Western blotting indicated that the CBG in I was mainly of
      maternal origin and different from fetal CBG. A CBG mRNA, but no classic 50- to
      59-kDa CBG, was found in isolated term trophoblastic cells. The steroid
      environment of the CBG in I differed greatly from that in the peripheral maternal
      and fetal circulations, because the progesterone:cortisol molar ratio in I was 75
      fold higher than that in M and 7- to 10-fold higher than that in the fetal
      circulation. Binding studies revealed that the affinity constants of CBG for
      cortisol in I, A, and V were significantly lower than that in M plasma (P < 0.02)
      in their respective hormonal contexts. The binding parameters for I-CBG stripped
      of endogenous steroids and lipids were close to those for M-CBG but different
      from those of fetal CBG (P < 0.001). These data reflect the physiological
      relevance of the CBG-steroid interaction, especially with very CBG-loaded
      progesterone at the fetomaternal interface during late pregnancy.

PMID- 11207197
TI  - Morphological and biochemical changes of isolated chicken egg-envelope during
      sperm penetration: degradation of the 97-kilodalton glycoprotein is involved in
      sperm-driven hole formation on the egg-envelope.
AB  - The chicken egg-envelope is made of two major glycoprotein components, which are
      designated as gp97 and gp42 (after their molecular masses). To elucidate how
      these two components are involved in macromolecular organization of the chicken
      egg-envelope, the isolated egg-envelope was characterized by immunochemical and
      biochemical methods. The gp97 was suggested to be a homologue of mouse ZPB based
      on the similarities of N-terminal and internal sequences. Immunoblotting using
      anti-gp97 monoclonal antibodies and two-dimensional gel electrophoresis with or
      without mercaptoethanol treatment revealed that gp97 formed a homodimer through
      disulfide bonds, whereas gp42 did not. Under indirect immunofluorescence
      microscopy, the anti-gp97 antibody visualized indistinct, small spots on the egg
      envelope, whereas the anti-gp42 antibody showed a meshwork of blurry, fibrous
      structures. The hole formation on the egg-envelope by in vitro sperm penetration
      was completely inhibited by two anti-gp97 monoclonal antibodies. Interestingly,
      the anti-gp97 monoclonal antibodies blocked the proteolysis not only of gp97 but
      also of gp42 during incubation of the egg-envelope with either sperm or the crude
      chicken acrosin. Taken together, these results indicate that gp97 may play
      pivotal roles not only in constitution of the macromolecular organization of the
      egg-envelope but also in triggering hydrolysis of the egg-envelope during sperm
      penetration.

PMID- 11207198
TI  - Stromal-epithelial interactions modulate estrogen responsiveness in normal human
      endometrium.
AB  - The coculture of endometrial epithelial cells (EEC) with stromal cells (ESC)
      allows achievement of an improved in vitro system for studying interactions
      between cells via soluble signals. The purpose of this study was to investigate
      whether 17beta-estradiol and insulin can induce proliferation of EEC through ESC
      secreted factors. No evidence of estrogen-induced EEC proliferation has been
      reported so far in the conventional culture methods. To this end, we used an in
      vitro bicameral coculture model where human EEC were grown on extracellular
      matrix-coated inserts applied in dishes containing ESC. Proliferation was
      assessed by tritiated thymidine incorporation. Homogeneity of endometrial cell
      populations was ascertained immunocytochemically. 17beta-estradiol did not induce
      any proliferative effect on EEC cultured alone. Endometrial epithelial cell
      proliferation was significantly enhanced in EEC/ESC cocultures; moreover, it was
      further increased by 17beta-estradiol addition. Insulin increased proliferation
      in EEC cultured alone, but again the effect was more pronounced in EEC/ESC
      cocultures. Coincubation of 17beta-estradiol and an antibody against insulin-like
      growth factor I (IGF I) led to neutralization of ESC-mediated EEC proliferation.
      This work provides evidence that the effect of 17beta-estradiol on human EEC
      proliferation may be mediated at least in part through ESC-secreted IGF I. We
      also showed that insulin effect is also partially due to ESC activation.

PMID- 11207199
TI  - Alterations in intrafollicular regulatory factors and apoptosis during selection
      of follicles in the first follicular wave of the bovine estrous cycle.
AB  - Changes in follicular fluid (FF) concentrations of estradiol, inhibin forms, and
      insulin-like growth factor binding proteins (IGFBPs), percentage of apoptotic
      granulosa cells (%A), and follicular size for individual follicles in a growing
      cohort were determined throughout the first wave of follicular development during
      the bovine estrous cycle and related to FSH decline. Four groups of heifers (n =
      31) were ovariectomized between Days 1.5 and 4.5 of the estrous cycle at 5 +/- 1,
      33 +/- 2, 53 +/- 1, and 84 +/- 2 h after the periovulatory peak in FSH
      concentrations. Follicles > or = 2.5 mm were dissected, measured, and FF
      aspirated. The five largest follicles were ranked based on their diameter (F1 to
      F5). Diameters of F1 to F5 were positively correlated with interval from FSH peak
      (r > or = 0.6, P < 0.05). Five hours after the FSH peak, follicular diameter and
      FF concentrations of estradiol, inhibins, and IGFBPs were similar for F1 to F5.
      From 5 to 33 h, amounts of the six precursor inhibin forms (> or = 48 kDa)
      increased (P < 0.05) in F1 follicles. The IGFBPs in F1 follicles remained low at
      all time periods. At 33 h, amounts of IGFBP-4 and -5 were higher (P < 0.05) in F4
      and F5 compared with F1 follicles. At 84 h, IGFBP-2, -4, and -5 were increased (P
      < 0.05) in F3, F4, and F5 compared with F1. At 5, 33, or 53 h, %A was not
      different between follicles in any size class. At 84 h %A was increased (P <
      0.05) in follicles <6 mm in diameter. However, at that time, %A did not differ
      between the selected DF and the largest subordinate follicle. For individual
      heifers, the selected DF at 84 h was largest in size, highest in estradiol, and
      lowest in IGFBP-2 and -4. The F1 follicle had highest estradiol in 23 of 27
      heifers irrespective of stage of the wave and lowest IGFBP-4 in 19 of 21 heifers
      from 33 h. We concluded that the earliest intrafollicular changes that
      differentiate a dominant-like follicle from the growing cohort are enhanced
      capacity to produce estradiol and maintenance of low levels of IGFBPs.

PMID- 11207200
TI  - Generation of dwarf goat (Capra hircus) clones following nuclear transfer with
      transfected and nontransfected fetal fibroblasts and in vitro-matured oocytes.
AB  - The developmental potential of caprine fetal fibroblast nuclei after in vitro
      transfection and nuclear transfer (NT) into enucleated, in vitro-matured oocytes
      was evaluated. Fetal fibroblasts were isolated from Day 27 to Day 30 fetuses from
      a dwarf breed of goat (BELE: breed early lactate early). Cells were transfected
      with constructs containing the enhanced green fluorescent protein (eGFP) and
      neomycin resistance genes and were selected with G418. Three eGFP lines and one
      nontransfected line were used as donor cells in NT. Donor cells were cultured in
      Dulbecco minimum Eagle medium plus 0.5% fetal calf serum for 4-8 days prior to
      use in NT. Immature oocytes were recovered by laparoscopic ovum pick-up and
      matured for 24 h prior to enucleation and NT. Reconstructed embryos were
      transferred as cleaved embryos into synchronized recipients. A total of 27
      embryos derived from transgenic cells and 70 embryos derived from nontransgenic
      cells were transferred into 13 recipients. Five recipients (38%) were confirmed
      pregnant at Day 35 by ultrasound. Of these, four recipients delivered five male
      kids (7.1% of embryos transferred) derived from the nontransfected line. One
      recipient delivered a female kid derived from an eGFP line (7.7% of embryos
      transferred for that cell line). Presence of the eGFP transgene was confirmed by
      polymerase chain reaction, Southern blotting, and fluorescent in situ
      hybridization analyses. Nuclear transfer derivation from the donor cells was
      confirmed by single-strand confirmation polymorphism analysis. These results
      demonstrate that both in vitro-transfected and nontransfected caprine fetal
      fibroblasts can direct full-term development following NT.

PMID- 11207201
TI  - Regulation of cyclic guanosine monophosphate-dependent protein kinase in human
      uterine tissues during the menstrual cycle.
AB  - Contractility of uterine smooth muscle is essential for the cyclic shedding of
      the endometrial lining and also for expulsion of the fetus during parturition.
      The nitric oxide (NO)-cGMP signaling pathway is involved in smooth muscle
      relaxation. The downstream target of this pathway essential for decreasing
      cytoplasmic calcium and muscle tone is the cGMP-dependent protein kinase (PKG).
      The present study was undertaken to localize expression of PKG in tissues of the
      female reproductive tract and to test the hypothesis that uterine smooth muscle
      PKG levels vary with the human menstrual cycle. Immunohistochemistry was used to
      localize PKG in myometrium, cervix, and endometrium obtained during proliferative
      and secretory phases. The PKG was localized to uterine and vascular smooth muscle
      cells in myometrium, stromal cells in endometrium, and a small percentage of
      cervical stromal cells. Using Western blot analysis and protein kinase activity
      assays, the expression of PKG was reduced significantly in progesterone-dominated
      uteri compared with myometrium from postmenopausal women or women in the
      proliferative phase. These findings support a role for PKG in the control of
      uterine and vascular smooth muscle contractility during the menstrual cycle.

PMID- 11207202
TI  - Formyl-methionyl-leucyl-phenylalanine induces prostaglandin E2 release from human
      amnion-derived WISH cells by phospholipase C-mediated [Ca+]i rise.
AB  - The presence of binding sites for formyl-methionyl-leucyl-phenylalanine (fMLP),
      its effect on prostaglandin E (PGE) release, and the signal transduction pathway
      activated by the peptide were investigated in human amnion-derived WISH cells.
      Our results demonstrate that specific binding sites for fMLP are present on WISH
      cells and that the peptide induces a significant increase of prostaglandin (PG)E2
      release. The kinetic properties of binding are similar to those previously found
      in amnion tissue prior to the onset of labor, i.e., only one population of
      binding sites with low affinity for the peptide is present. Binding of 3H-fMLP in
      WISH cells is inhibited by N-t-butoxycarbonyl-methionyl-leucyl-phenylalanine, an
      fMLP receptor antagonist, with an IC50 value very close to that shown by
      nonlaboring amnion. The fMLP-induced PGE2 output is inhibited by indomethacin,
      quinacrine, and U-73122, inhibitors of cyclooxygenase, phospholipase A2, and
      phospholipase C, respectively. As regards the transduction pathway activated by
      fMLP, we demonstrate that phospholipase C activation, followed by an increase of
      intracellular calcium concentration ([Ca2+]i), is involved in response to the
      peptide. Our results add further evidence to the role of proinflammatory agents
      in the determination of labor. Furthermore, because WISH cells appear to behave
      like nonlaboring amnion tissue, they represent the ideal candidate for in vitro
      investigation of the events triggering the mechanism of delivery.

PMID- 11207203
TI  - Inactivation of M-phase promoting factor at exit from first embryonic mitosis in
      the rat is independent of cyclin B1 degradation.
AB  - Exit from M-phase and completion of cell division requires inactivation of M
      phase promoting factor (MPF), a heterodimer composed of the regulatory cyclin B1
      and the catalytic p34cdc2 kinase. Inactivation of MPF is associated with cyclin
      B1 degradation that is brought about by the ubiquitin-proteasome pathway. Our
      study examined the role of the proteasome in the first mitosis of rat embryos and
      its participation in the regulation of cyclin B1 degradation and MPF
      inactivation. We show that in the early zygote the proteasome is evenly
      distributed in the ooplasm and the nucleus, whereas during mitosis it accumulates
      on the spindle apparatus. We further demonstrate that inhibition of proteasomal
      catalytic activity prevents 1-cell embryos from undergoing mitosis. This mitotic
      arrest is associated with the presence of relatively high amounts of cyclin B1,
      which unexpectedly does not result in elevated MPF activity. Our findings
      strongly imply that completion of the first embryonic division depends on
      proteasomal degradation and that cyclin B1 is included among its target proteins.
      They also provide the first evidence that MPF inactivation at this stage of
      development is not solely dependent upon cyclin B1 degradation and is
      insufficient to allow the formation of the 2-cell embryo.

PMID- 11207204
TI  - Dynamic events are differently mediated by microfilaments, microtubules, and
      mitogen-activated protein kinase during porcine oocyte maturation and
      fertilization in vitro.
AB  - The role of microfilaments, microtubules, and mitogen-activated protein (MAP)
      kinase in regulation of several important dynamic events of porcine oocyte
      maturation and fertilization is described. Fluorescently labeled microfilaments,
      microtubules, and cortical granules were visualized using either epifluorescence
      microscopy or laser scanning confocal microscopy. Mitogen-activated protein
      kinase phosphorylation was revealed by Western immunoblotting. We showed that 1)
      microfilament disruption did not affect meiosis resumption and metaphase I
      meiotic apparatus formation but inhibited further cell cycle progression
      (chromosome separation) even though MAP kinase was phosphorylated; 2) cortical
      granule (CG) migration was driven by microfilaments (but not microtubules), and
      once the chromosomes and CGs were localized beneath the oolemma their anchorage
      to the cortex was independent of either microfilaments or microtubules; 3)
      neither microfilaments nor microtubules were involved in CG exocytosis during
      oocyte activation; 4) sperm incorporation was mediated by microfilaments, while
      pronuclear (PN) syngamy was controlled by microtubules rather than
      microfilaments; 5) spindle microtubule organization was temporally correlated
      with MAP kinase phosphorylation, while the extensive microtubule organization in
      the sperm aster that is required for PN apposition and syngamy occurred in the
      absence of MAP kinase activation; and 6) MAP kinase phosphorylation did not
      change either when microtubules were disrupted by nocodazole or when cytoplasmic
      microtubule asters were induced by taxol. The present study suggests that the
      role of the cytoskeleton during porcine oocyte maturation is similar to that of
      rodents, while the mechanisms of fertilization in pig resemble those of lower
      vertebrates.

PMID- 11207205
TI  - Actions of prostaglandin F2alpha and prolactin on intercellular adhesion molecule
      1 expression and monocyte/macrophage accumulation in the rat corpus luteum.
AB  - Expression of intercellular adhesion molecule-1 (ICAM-1) and the accumulation of
      monocytes/macrophages are inflammatory events that occur during PRL (PRL)-induced
      regression of the rat corpus luteum. Here we have compared the ability of
      prostaglandin F2alpha (PGF) and PRL to induce, in rat corpora lutea, inflammatory
      events thought to perpetuate luteal regression. Immature rats were ovulated with
      eCG-hCG and then hypophysectomized (Day 0), which resulted in a single cohort of
      persistent, functional corpora lutea. On Days 9-11, the rats received twice daily
      injections of saline, PGF (Lutalyse, 250 microg/injection), or PRL (312
      microg/injection) to induce luteal regression. Surprisingly, luteal weight and
      plasma progestin concentrations (progesterone and 20alpha-dihydroprogesterone)
      did not differ between PGF-treated rats and controls; whereas both luteal weight
      and plasma progestins declined significantly in PRL-treated rats. Furthermore,
      corpora lutea of PGF-treated rats and controls contained relatively minimal ICAM
      1 staining and few monocytes/macrophages. In contrast, but as expected, corpora
      lutea of PRL-treated rats stained intensely for ICAM-1 and contained numerous
      monocytes/macrophages. In an additional experiment, there was no indication that
      luteal prostaglandin F2alpha receptor mRNA diminished as a result of
      hypophysectomy. These findings suggest that prolactin, not PGF, induces the
      inflammatory events that accompany regression of the rat corpus luteum.

PMID- 11207206
TI  - Internalization rates of murine and ovine gonadotropin-releasing hormone
      receptors.
AB  - Rates of internalization of the murine GnRH receptor fused via its C-terminus to
      green fluorescent protein (GnRH-R-GFP) were examined in Chinese hamster ovary
      cells (CHO cells) and compared to those of native murine GnRH-R in a clonal
      murine gonadotroph cell line (LbetaT2 cells). The resulting rates of
      internalization of murine receptors were then compared with those of sheep GnRH-R
      in ovine gonadotrophs. Cells were incubated with radioiodinated [D-Ala6]GnRH on
      ice for 4 h to allow binding of the ligand to GnRH-R, then cells were warmed to
      37 degrees C to permit internalization. Surface-bound radioligand began to
      decrease as soon as the cells were warmed and had decreased significantly within
      20 min. A steady-state level of surface-bound radioligand was achieved after 60
      min in both CHO cells and LbetaT2 cells (38% and 41%, respectively, of initial
      value; P < 0.05). Internalization of radioligand began immediately after warming
      the cells to 37 degrees C, and a significant proportion of surface ligand had
      been internalized by 20 min. A steady-state maximum of internalization was
      reached after 60 min in both CHO cells and LbetaT2 cells (29% and 28%,
      respectively, of total cell-associated ligand; P < 0.05). Changes in surface
      bound radioligand and internalized radioligand in sheep pituitary cells were
      similar to those in CHO cells and LbetaT2 cells, but the amount of radioligand
      internalized after 60 min (40% of total cell-associated ligand) was 1.4 times
      higher than in CHO cells and LbetaT2 cells (P < 0.05). In a separate experiment,
      the effect of estradiol on the rate of internalization of GnRH-R in ovine
      pituitary cells was examined. Although treatment of ovine pituitary cells with
      estradiol approximately doubled the number of GnRH receptors, it did not alter
      either the rate or extent of receptor internalization. These results show that
      rates of internalization of recombinant murine GnRH-R-GFP in CHO cells and native
      murine and ovine GnRH-R in LbetaT2 cells and in sheep pituitary cells,
      respectively, are similar, but amounts of ovine GnRH-R internalized are greater
      than those for murine GnRH-R. Further, the rate of internalization of occupied
      receptor is similar in gonadotroph and nongonadotroph cells, and the addition of
      GFP to the C-terminus of the murine GnRH-R does not alter the rate of
      internalization.

PMID- 11207207
TI  - Mitochondrial distribution and adenosine triphosphate content of bovine oocytes
      before and after in vitro maturation: correlation with morphological criteria and
      developmental capacity after in vitro fertilization and culture.
AB  - In this study, we evaluated mitochondrial distribution and ATP content of
      individual bovine oocytes before and after in vitro maturation (IVM). Cumulus
      oocyte complexes were classified according to morphological criteria: category 1,
      homogeneous oocyte cytoplasm, compact multilayered cumulus oophorus; category 2,
      cytoplasm with small inhomogeneous areas, more than five layers of compact
      cumulus; category 3, heterogeneous/vacuolated cytoplasm, three to five layers of
      cumulus including small areas of denuded zona pellucida; category 4,
      heterogeneous cytoplasm, completely or in great part denuded. In immature
      oocytes, staining with MitoTracker green revealed mitochondrial clumps in the
      periphery of the cytoplasm, with a strong homogenous signal in category 1
      oocytes, a weaker staining in category 2 oocytes, allocation of mitochondria
      around vacuoles in category 3 oocytes, and poor staining of mitochondria in
      category 4 oocytes. After IVM, mitochondrial clumps were allocated more toward
      the center, became larger, and stained more intensive in category 1 and 2
      oocytes. This was also true for category 3 oocytes; however, mitochondria
      maintained their perivacuolar distribution. No mitochondrial reorganization was
      seen for category 4 oocytes. Before IVM, the average ATP content of category 1
      oocytes (1.8 pmol) tended to be higher than that of category 2 oocytes (1.6 pmol)
      and was significantly (P < 0.01) higher than in category 3 (1.4 pmol) and 4
      oocytes (0.9 pmol). The IVM resulted in a significant (P < 0.01) increase in the
      average ATP content of all oocyte categories, with no difference between oocytes
      extruding versus nonextruding a polar body. After in vitro fertilization (IVF)
      and culture, significantly (P < 0.05) more category 1 and 2 than category 3 and 4
      oocytes developed to the morula or blastocyst stage (determined 168 h after IVF).
      Total cell numbers of expanded blastocysts derived from category 1 and 2 oocytes
      were significantly (P < 0.05) higher than of those originating from category 3
      and 4 oocytes. These data indicate that mitochondrial reorganization and ATP
      levels are different between morphologically good and poor oocytes and may be
      responsible for their different developmental capacity after IVF.

PMID- 11207208
TI  - A comparative study of gene expression in murine embryos developed in vivo,
      cultured in vitro, and cocultured with human oviductal cells using messenger
      ribonucleic acid differential display.
AB  - The objectives of this study were to compare the mRNA expression patterns in
      early mouse embryos in different culture conditions by differential display
      reverse transcription-polymerase chain reaction (DDRT-PCR). Embryos developed in
      vivo, cultured in vitro, and cocultured with human oviductal epithelial cells
      were studied at the 2-cell, 4-cell, 8-cell/morula, and blastocyst stages.
      Messenger RNA profiles were displayed by DDRT-PCR using downstream T11VV (V = A,
      C, or G) and upstream decamer primers. Total cDNA banding patterns were highly
      conserved in the three groups studied. Some fragments are unique in different
      culture conditions. Thirteen out of the 40 selected differentially expressed
      clones were characterized. The DNA sequence analyses of these clones displayed
      high sequence homology with cDNA sequences in the mouse expressed sequence tag
      database. Using semiquantitative RT-PCR, we confirmed differential expression of
      these DD amplicons in the three groups of embryos. The temporal expression of
      some of the selected DD amplicons during preimplantation development were studied
      in the three groups of embryos. In conclusion, DDRT-PCR is an effective tool for
      contrasting gene expression patterns and characterizing mRNA transcripts in mouse
      embryo.

PMID- 11207210
TI  - Diethylstilbestrol-treated adult rats with altered epididymal sperm numbers and
      sperm motility parameters, but without alterations in sperm production and sperm
      morphology.
AB  - In this study, we characterized estrogenic effects of diethylstilbestrol (DES) on
      reproductive parameters in male rats to identify a minimal dose level that alters
      epididymal and sperm functions but has little or no effect on sperm production
      and/or spermatogenesis. Adult rats (five animals/group) received s.c. injections
      of 0.2 ml of corn oil containing DES at a rate of 1.0 mg, 200 microg, 40 microg,
      8 microg, 1.6 microg, or 320 ng x rat(-1) x day(-1) for 12 days. The control
      group received corn oil only. DES effects were similar in the 8-microg group and
      higher dose groups and included significant (P < or = 0.05) reductions in 1)
      absolute and relative weights of the head and body of the epididymis (EP), tail
      of the EP, and seminal vesicle, 2) numbers of sperm in both regions of the EP,
      and 3) motility characteristics in sperm collected from the tail of the EP.
      Conversely, no significant changes were observed in relative testis weight, daily
      sperm production, spermatogenesis, seminiferous epithelial height in stage VII,
      and sperm morphology. All of the above parameters in the 1.6-microg group (except
      seminal vesicle weight) and 320-ng group were comparable to those of controls.
      Plasma testosterone (T) level was reduced to an almost undetectable level in the
      > or = 8-microg groups and to a very low level in the 1.6-microg group (0.35 vs.
      2.36 ng/ml in controls or 320-ng group), but LH level was unaltered. In a
      parallel fertility study, males received DES at a rate of 40, 8, or 1.6 microg x
      rat(-1) x day(-1) for 12 days prior to and 12 days during cohabitation (1:1) with
      untreated females. Of the 15 females cohabited with treated males (5
      females/dose), none in the 40-microg and 8-microg groups and 1 in the 1.6-microg
      group formed a copulatory plug and delivered 8 pups, in contrast to 5/5
      copulatory plugs and 13-15 pups/litter in the controls. DES at a rate of 8 microg
      x rat(-1) x day(-1) for 12 days reduced EP weights, sperm numbers in the EP, and
      sperm motility patterns but caused minimal to no alterations in daily sperm
      production, spermatogenesis, or sperm morphology. Factors other than T, or in
      addition to lower T, may be responsible for DES-induced reproductive disorders
      (despite lower T, sperm contents and sperm motility patterns in the EP were
      normal in the 1.6-microg group). Deficits in EP sperm functions and/or sexual
      behavior (as evident from absence of copulatory plugs) probably accounted for
      reduced fertility in treated males.

PMID- 11207209
TI  - Culture of preimplantation mouse embryos affects fetal development and the
      expression of imprinted genes.
AB  - Culture of preimplantation mammalian embryos and cells can influence their
      subsequent growth and differentiation. Previously, we reported that culture of
      mouse embryonic stem cells is associated with deregulation of genomic imprinting
      and affects the potential for these cells to develop into normal fetuses. The
      purpose of our current study was to determine whether culture of preimplantation
      mouse embryos in a chemically defined medium (M16) with or without fetal calf
      serum (FCS) can affect their subsequent development and imprinted gene
      expression. Only one third of the blastocysts that had been cultured from two
      cell embryos in M16 medium complemented with FCS developed into viable Day 14
      fetuses after transfer into recipients. These M16 + FCS fetuses were reduced in
      weight as compared with controls and M16 fetuses and had decreased expression of
      the imprinted H19 and insulin-like growth factor 2 genes associated with a gain
      of DNA methylation at an imprinting control region upstream of H19. They also
      displayed increased expression of the imprinted gene Grb10. The growth factor
      receptor binding gene Grb7, in contrast, was strongly reduced in its expression
      in most of the M16 + FCS fetuses. No alterations were detected for the imprinted
      gene MEST: Preimplantation culture in the presence of serum can influence the
      regulation of multiple growth-related imprinted genes, thus leading to aberrant
      fetal growth and development.

PMID- 11207211
TI  - Identification, cloning, and initial characterization of a novel mouse testicular
      germ cell-specific antigen.
AB  - A monoclonal antibody, designated TES101, was raised by immunizing BALB/c mice
      with an allogenic mouse testicular homogenate followed by immunohistochemical
      selection as the initial screening method. By searching the expressed sequence
      tag (EST) database with the N-terminal amino acid sequence of TES101 reactive
      protein, we found that the predicted amino acid sequence encoded by a mouse
      testicular EST clone matched the TES101 protein sequence. Sequence analysis of
      the clone revealed no homologous molecule in the DNA/protein database. Based on
      data obtained from N-terminal amino acid analysis of the TES101 protein, the
      derived amino acid sequence contained a signal peptide region of 25 amino acids
      and a mature protein region of 225 amino acids, which translated into a protein
      with a molecular weight of 24 093. Northern blot analysis showed that mRNA of the
      TES101 protein was found in testis but not in any other mouse tissues examined.
      Western blot analysis revealed that TES101 reacted with a 38-kDa band on SDS-PAGE
      under nonreducing conditions, and this reactivity was abrogated under reducing
      conditions. Immunoelectron microscopic studies demonstrated that the molecule was
      predominantly located on the plasma membrane of spermatocytes and spermatids but
      not in Sertoli cells or interstitial cells, including Leydig cells. Thus, the
      TES101 protein is a novel molecule present primarily on the surface of developing
      male germ cells. TES101 protein may play a role in the processes underlying male
      germ cell formation.

PMID- 11207212
TI  - Expression of Fas and Fas ligand in normal and ischemia-reperfusion testes:
      involvement of the Fas system in the induction of germ cell apoptosis in the
      damaged mouse testis.
AB  - Apoptosis of germ cells is very common in normal and injured mammalian testes.
      The aim of this study was to examine the possible involvement of the Fas and Fas
      ligand (FasL) system in the induction of germ cell apoptosis in normal and
      ischemia-reperfusion testes of adult mice. Apoptosis was assessed by the TUNEL
      method and by DNA gel electrophoresis. Fas and FasL mRNAs were detected by
      Northern blotting and reverse transcription polymerase chain reaction techniques,
      and proteins were analyzed by Western blotting and immunohistochemistry.
      Apoptosis of germ cells was identified in the normal testis especially around
      stages XI and XII, whereas the expression of Fas and FasL was largely confined to
      Leydig cells and Sertoli cells, respectively. However, in the testes reperfused
      after 1 h of ischemia, a high number of TUNEL-positive cells were identified in
      parallel with increased Fas-positive germ cells, whereas FasL expression in
      Sertoli cells was almost constant irrespective of the duration of reperfusion.
      Moreover, i.p. injection of anti-Fas antibody, which blocks the interaction
      between Fas and FasL, inhibited apoptosis, as indicated by the reduced number of
      TUNEL-positive cells, except for apoptosis at stages XI and XII. Our results
      indicate that the Fas/FasL system mediates apoptosis of spermatogenic cells in
      the injured testis but not spontaneous apoptosis in the normal testis.

PMID- 11207213
TI  - Disruption of neuroendocrine control of luteinizing hormone secretion by aroclor
      1254 involves inhibition of hypothalamic tryptophan hydroxylase activity.
AB  - Mechanisms governing the effect of polychlorinated biphenyl (PCB) toxicity on
      hypothalamic serotonergic function and the neuroendocrine system controlling LH
      secretion were investigated in Atlantic croaker (Micropogonias unulatus) exposed
      to the PCB mixture Aroclor 1254 (1 microg x g body weight(-1) x day(-1)) in the
      diet for 30 days. PCB treatment caused a decrease in hypothalamic 5
      hydroxytryptamine (5-HT) concentrations and significant inhibition of
      hypothalamic tryptophan hydroxylase (TPH), the rate-limiting enzyme in 5-HT
      synthesis, but did not alter the activity of monoamine oxidase, the catabolic
      enzyme. Further, PCB treatment caused significant decreases in GnRH content in
      the preoptic-anterior hypothalamic area. Significant decreases in pituitary GnRH
      receptor concentrations and the LH response to the GnRH analogue (GnRHa) were
      also observed in PCB-exposed fish, possibly as a consequence of a decline in GnRH
      release. The possible association between impaired serotonergic and
      neuroendocrine functions after PCB treatment was explored using serotonergic
      drugs. Treatment of croaker with p-chlorophenylalanine, an irreversible TPH
      inhibitor, mimicked the effects of PCB on the GnRH system and the LH response to
      GnRHa. Bypassing the TPH-dependent hydroxylation step with the administration of
      5-hydroxytryptophan restored 5-HT to control levels and prevented the deleterious
      effects of PCB on the neuroendocrine parameters. Moreover, slow-release GnRH
      implants prevented the PCB-induced decline in GnRH receptors and restored the LH
      response to GnRHa, suggesting that GnRH therapy can reverse PCB-induced
      disruption of LH secretion. These results demonstrate that TPH is one of the
      targets of PCB neurotoxicity and indicate that a decrease in 5-HT availability in
      PCB-exposed croaker results in disruption of the stimulatory 5-HT/GnRH pathway
      controlling LH secretion.

PMID- 11207214
TI  - Interferon-tau suppresses prostaglandin F2alpha secretion independently of the
      mitogen-activated protein kinase and nuclear factor kappa B pathways.
AB  - Pregnancy is established in ruminants through inhibitory actions of interferon
      (IFN)-tau on the release of prostaglandin F2alpha (PGF), which allows the corpus
      luteum to survive and continue to produce progesterone. Experiments were designed
      to 1) delineate the signal transduction pathway coordinating the synthesis of
      PGF, 2) determine how rapidly recombinant bovine (rb) IFN-tau attenuated phorbol
      ester (PDBu)-induced secretion of PGF, and 3) establish the site at which rbIFN
      tau attenuates the secretion of PGF in cultured bovine endometrial (BEND) cells.
      BEND cells were untreated (control) or treated for 5, 10, 60, 180, or 300 min
      with PDBu (100 ng/ml), rbIFN-tau (50 or 500 ng/ml), PDBu + rbIFN-tau, or PDBu +
      PD98059 (MEK-1 inhibitor; 50 microM). Secretion of PGF was induced (P < 0.0001)
      by PDBu within 180 min, but induction was inhibited 74% by the addition of rbIFN
      tau (P < 0.0001) and was ablated completely by PD98059. Parallel results were
      obtained for cyclooxygenase (COX)-2 protein expression. PDBu induced (P < 0.05)
      activation of the Raf-1/MEK-1/ERK-1/2 pathway, which was obligatory for the
      expression of COX-2 and secretion of PGF but was not altered by cotreatment with
      rbIFN-tau. PDBu induced (P < 0.05) transcription of c-jun and c-fos mRNAs within
      30 min; induction was inhibited (P < 0.05) by cotreatment with PD98059 but not by
      cotreatment with rbIFN-tau. Treatment of BEND cells with rbIFN-tau also did not
      attenuate PDBu-induced degradation of IkappaBalpha, suggesting that the
      IkappaBalpha/NFkappaB pathway is not a site of IFN-tau inhibition of PGF.
      However, rbIFN-tau did block transcription of the COX-2 gene induced by PDBu
      within 30 min. In conclusion, COX-2 expression and PGF secretion induced by PDBu
      is mediated through the Raf-1/MEK-1/ERK-1/2 pathway, but this pathway is not
      disrupted by rbIFN-tau. Because rbIFN-tau inhibits COX-2 mRNA within 30 min, we
      hypothesized that transcription factors activated by rbIFN-tau rapidly and
      directly attenuate COX-2 gene expression, thereby suppressing secretion of PGF.

PMID- 11207215
TI  - Aging-related expression of inducible nitric oxide synthase and markers of tissue
      damage in the rat penis.
AB  - Erectile dysfunction in the aging male results in part from the loss of
      compliance of the corpora cavernosal smooth muscle due to the progressive
      replacement of smooth muscle cells by collagen fibers. We have examined the
      hypothesis that a spontaneous local induction of inducible nitric oxide synthase
      (iNOS) expression and the subsequent peroxynitrite formation occurs in the penis
      during aging and that this process is accompanied by a stimulation of smooth
      muscle apoptosis and collagen deposition. The penile shaft and crura were excised
      from young (3-5 mo old) and old (24-30 mo old) rats, with or without perfusion
      with 4% formalin. Fresh tissue was used for iNOS and proteasome 2C mRNA
      determinations by reverse transcription polymerase chain reaction assay,
      ubiquitin mRNA by Northern blot, and iNOS protein by Western blot. Penile
      sections from perfused animals were embedded in paraffin and immunostained with
      antibodies against iNOS and nitrotyrosine, submitted to the TUNEL assay for
      apoptosis, or stained for collagen, followed by image analysis quantitation. A
      4.1-fold increase in iNOS mRNA was observed in the old versus young tissues,
      paralleled by a 4.9-fold increase in iNOS protein. The proteolysis marker,
      ubiquitin, was increased 1.9-fold, whereas a related gene, proteasome 2c, was not
      significantly affected. iNOS immunostaining was increased 3.6-fold in the penile
      smooth muscle of the old rats as compared with the young rats. The peroxynitrite
      indicator nitrotyrosine was increased by 1.6-fold, accompanied by a 3.6-fold
      increase in apoptotic cells and a 2.0-fold increase in collagen fibers in the old
      penis. In conclusion, aging in the penis is accompanied by an induction of iNOS
      and peroxynitrite formation that may lead to the observed increase in apoptosis
      and proteolysis and may counteract a higher rate of collagen deposition in the
      old penis.

PMID- 11207216
TI  - Molecular characterization of bovine prostaglandin G/H synthase-2 and regulation
      in uterine stromal cells.
AB  - Prostaglandin G/H synthase (PGHS) is a key rate-limiting enzyme in the
      prostaglandin biosynthetic pathway, and prostaglandins play a central role in the
      control of the reproductive cycle. The objectives of this study were to clone and
      characterize the primary structure of bovine PGHS-2 and to study its regulation
      in uterine stromal cells in vitro. The bovine PGHS-2 cDNA was cloned by a
      combination of reverse transcription-polymerase chain reaction and cDNA library
      screening. Results showed that the complete bovine PGHS-2 cDNA is composed of a
      5'-untranslated region of 128 bp, an open reading frame of 1815 bp, and a 3'
      untranslated region of 1565 bp containing multiple repeats (n = 11) of the Shaw
      Kamen sequence 5'-ATTTA-3'. The open reading frame encodes a 604-amino acid
      protein that is 86-97% identical to other mammalian PGHS-2 homologs. The
      regulation of PGHS-2 mRNA and protein was studied in primary cultures of bovine
      uterine stromal cells stimulated with phorbol 12-myristate 13-acetate (PMA; 100
      nM). Northern and Western blot analyses reveal a marked induction in PGHS-2
      transcript (4.0 kilobases) and protein (M(r) = 72 000) after 3-12 h of PMA
      stimulation (P < 0.05). However, this induction was transient in nature as levels
      of PGHS-2 mRNA and protein returned to basal levels after 24 h of PMA
      stimulation. In contrast, PMA had no effect on levels of PGHS-1 (P > 0.05). The
      PMA-dependent induction of PGHS-2 was associated with a significant increase in
      prostaglandin E2 secretion in the culture media (P < 0.05). To study promoter
      activity of the 5'-flanking DNA region of the bovine PGHS-2 gene, the genomic
      fragment -1574/-2 (+1 = transcription start site), as well as a series of 5'
      deletion mutants, were fused upstream of the firefly luciferase gene and
      transiently transfected into primary cultures of bovine uterine stromal cells.
      Results showed that a first promoter region located between -1574 and -492 and a
      second region between -88 and -39 appear to play important roles in PMA-dependent
      regulation of PGHS-2 promoter activity in bovine uterine cells. Thus, this study
      characterizes for the first time the structure of the bovine PGHS-2 transcript
      and the deduced amino acid sequence of its encoded protein and establishes an in
      vitro model to study the regulation of PGHS-2 gene expression in bovine uterine
      tissue.

PMID- 11207217
TI  - Monocyte chemotactic protein-1 and -2 messenger ribonucleic acids in the ovine
      uterus: regulation by pregnancy, progesterone, and interferon-tau.
AB  - Endometrial leukocytes may play important roles during pregnancy. Because
      chemokines are regulators of immune cell activity and trafficking, this study
      determined if mRNAs for monocyte chemotactic proteins (MCP) were present in the
      ovine uterus and regulated by progesterone (P) and/or recombinant ovine
      interferon tau (roIFN-tau). Uteri of normal cycling and pregnant ewes (experiment
      1) and uteri of ovariectomized ewes receiving intrauterine infusions of IFN-tau
      and/or i.m. injections of P (experiment 2) were used to detect MCP-1 and MCP-2
      mRNA. In experiment 1, slot-blot hybridization analysis of endometrial total RNA
      revealed that MCP-1 and MCP-2 mRNA levels did not change during the estrous cycle
      but increased between Days 13 and 19 of pregnancy. Using in situ hybridization,
      MCP-1 and MCP-2 mRNA were localized to immune cells in the subepithelial compact
      stroma. Histomorphological studies and in situ hybridization for major basic
      protein (MBP) indicated that MCP-positive immune cells were eosinophils. In
      experiment 2, treatment with P and roIFN-tau increased (P < 0.05) the number of
      MCP-1- and MCP-2-expressing eosinophils in the endometrium compared to ewes
      treated with P alone. Injection of the P receptor antagonist (ZK 137,316)
      inhibited effects of P and/or roIFN-tau to recruit eosinophils expressing MCP-1
      and MCP-2 mRNAs. Endometrial production of MCPs by eosinophils during early
      pregnancy may play a role(s) in central implantation and/or placentation in ewes
      that is crucial for successful establishment of pregnancy.

PMID- 11207218
TI  - Differential expression of the coxsackievirus and adenovirus receptor regulates
      adenovirus infection of the placenta.
AB  - The molecular mechanisms and pathologic significance of placental viral
      infections are poorly understood. We investigated factors that regulate placental
      infection by adenovirus, which is the most common viral pathogen identified in
      fetal samples from abnormal pregnancies (i.e., fetal growth restriction,
      oligohydramnios, and nonimmune fetal hydrops). We also determined the pathologic
      significance of placental adenovirus infection. Northern hybridization, flow
      cytometry, and immunostaining revealed that placental expression of the
      coxsackievirus and adenovirus receptor (CAR) varied with gestational age and
      trophoblast phenotype. The CAR was continuously expressed in invasive or
      extravillous trophoblast cells but not in villous trophoblast cells. We postulate
      that the villous syncytiotrophoblast, which does not express CAR and is resistant
      to adenovirus infection, limits the transplacental transmission of viral
      pathogens, including adenovirus. Conversely, extravillous trophoblast cells
      underwent apoptosis when infected by adenovirus in the presence of decidual
      lymphocytes (which simulated the maternal immune response to viral infection).
      Thus, adenovirus infection and/or the maternal immune response to adenovirus
      infection induced the death of placental cell types that expressed CAR.
      Consequently, we speculate that adenovirus infection of extra-villous trophoblast
      cells may negatively impact the process of placental invasion and predispose the
      mother and fetus to adverse reproductive outcomes that result from placental
      dysfunction.

PMID- 11207219
TI  - Molecular biology of channel catfish gonadotropin receptors: 1. Cloning of a
      functional luteinizing hormone receptor and preovulatory induction of gene
      expression.
AB  - There is little known about the molecular biology of piscine gonadotropin
      receptors, and information about gene expression during reproductive development
      is particularly lacking. We have cloned the LH receptor (LHR) in the channel
      catfish (cc), and examined its gene expression throughout a reproductive cycle. A
      cDNA encoding the receptor was isolated from the testis using reverse
      transcription-polymerase chain reaction (RT-PCR) and rapid amplification of cDNA
      ends procedures. It encoded a 696-amino acid protein that showed the greatest
      homology (46-50% identity) with the known LHRs and lesser similarity with FSH
      receptors and thyroid-stimulating hormone receptors (44-47% and 42-44% identity,
      respectively). In addition, two characteristics unique to the LHRs were conserved
      in the cloned receptor and the encoding gene: presence of an intron corresponding
      to intron 10 in mammals and turkey and occurrence of a double cysteine residue in
      the cytoplasmic tail for potential palmitoylation. The ccLHR gene was well
      expressed in the gonads and kidney and merely detectable in the gills, muscle,
      and spleen. The isolated cDNA encoded an active ccLHR protein, as the recombinant
      receptor expressed in COS7 cells activated a cAMP response element-driven
      reporter gene (luciferase) upon exposure to hCG in a dose-dependent manner.
      Seasonal changes in the ovarian expression of the ccLHR gene, as examined by
      measuring the transcript abundance by quantitative real-time RT-PCR, remained
      rather low during most of the reproductive cycle but was acutely induced around
      the time of spawning. This pattern of expression correlates well with the
      reported expression of its ligand (LH) in fishes and concurs with the notion that
      LH is a key regulator of the periovulatory maturational events.

PMID- 11207220
TI  - Evidence of selection bias in preterm survival studies: a systematic review.
AB  - OBJECTIVE: To determine by how much selection bias in preterm infant cohort
      studies results in an overestimate of survival. DESIGN: Systematic review of
      studies reporting survival in infants less than 28 weeks of gestation published
      1978-1998. Studies were graded according to cohort definition: A, stillbirths and
      live births; B, live births; C, neonatal unit admissions. Proportions of infants
      surviving to discharge were calculated for each week of gestation. RESULTS: Sixty
      seven studies report data on 55 cohorts (16 grade A, 23 grade B, 16 grade C).
      Studies that are more selective report significantly higher survival between 23
      and 26 weeks of gestation (grade C > grade B > grade A, p < 0.01), exaggerating
      survival by 100% and 56% at 23 and 24 weeks respectively. CONCLUSION: To minimise
      the potential for overestimating survival around the limits of viability, future
      studies should endeavour to report the outcome of all pregnancies for each week
      of gestation (terminations, miscarriages, stillbirths, and all live births).

PMID- 11207221
TI  - Neonatal meningitis in England and Wales: 10 years on.
AB  - OBJECTIVES: To determine the incidence of neonatal meningitis in England and
      Wales. DESIGN: A national postal survey using the British Paediatric Surveillance
      Unit (BPSU) card scheme supplemented by information from other sources. SETTING:
      England and Wales 1996-1997. SUBJECTS: A total of 274 babies less than 28 days of
      age who were treated for meningitis. RESULTS: The incidence of neonatal
      meningitis in England and Wales has not changed since our previous study in 1985
      1987. However, the acute phase mortality has fallen from 19.8% in 1985-1987 to
      6.6% in this study. Group B streptococci (42%) and Escherichia coli (16%) remain
      the most common infecting microorganisms. Eight of 69 (12%) babies with group B
      streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on the
      third generation cephalosporins, notably cefotaxime, were most commonly used
      (84%). The BPSU scheme identified 72% of cases during the study period. Most
      cases of viral meningitis were not reported through the BPSU. Less than a third
      of samples from aseptic meningitis were examined for viruses; 56% of these were
      positive. CONCLUSIONS: Although the incidence of neonatal meningitis remains
      unchanged, mortality from this infection has fallen significantly. If this
      improvement is maintained as reflected in the level of sequelae at 5 years of
      age, then the fear surrounding meningitis during the neonatal period will have
      been dramatically reduced.

PMID- 11207222
TI  - Brain specific proteins in posthaemorrhagic ventricular dilatation.
AB  - Median neurofilament and glial fibrillary acidic protein concentrations in the
      cerebrospinal fluid of 18 infants with posthaemorrhagic ventricular dilatation
      were 20-200 times higher than control values. S-100 protein in cerebrospinal
      fluid was four times higher than control values. Glial fibrillary acidic protein
      concentrations correlated with death or disability and with parenchymal lesions
      but not with shunt dependence.

PMID- 11207223
TI  - Neonatal cranial ultrasound interpretation: a clinical audit.
AB  - OBJECTIVE: To assess the abilities of doctors to interpret neonatal cranial
      ultrasound scans. DESIGN AND SETTING: High resolution scanned images of six
      important neonatal cranial ultrasound abnormalities were posted as a
      questionnaire to the 59 neonatal units in the North and South Thames regions.
      RESULTS: Forty two questionnaires were returned (71%). Currently 56% of those
      interpreting cranial ultrasound scans are neonatal registrars, 27% are consultant
      paediatricians or neonatologists, and 17% are radiologists. The response rate
      from registrars was excellent (97%), but it was poor from consultant paediatric
      (38%) and radiological (40%) staff. The mean accurate identification of cerebral
      abnormalities was only 59% (range 45-71%). Only 44% of the neonatal registrars,
      compared with nearly all the consultant staff, have had any formal training in
      cranial ultrasonography. CONCLUSIONS: The data highlight the current accuracy of
      neonatal cranial ultrasound scan reporting in the Greater London region and have
      important implications for clinical services and research studies. Doctors who
      are responsible for interpreting neonatal cranial ultrasound scans should have
      formal training and supervision, and more formal reporting would improve and
      maintain standards. The findings raise significant doubts about the accuracy of
      local interpretation of cranial ultrasound scans in multicentre research studies.

PMID- 11207224
TI  - Red blood cell transfusions in very and extremely low birthweight infants under
      restrictive transfusion guidelines: is exogenous erythropoietin necessary?
AB  - OBJECTIVE: To examine the number and volume of red blood cell transfusions
      (RBCTs) in very and extremely low birthweight infants under restrictive red blood
      cell transfusion guidelines without erythropoietin administration, and to compare
      the results with those reported in similar infants receiving erythropoietin.
      METHODS: From April 1996 to June 1999, all RBCTs given to infants with a birth
      weight of less than 1500 g were prospectively recorded. Data on RBCT combined
      with erythropoietin treatment and RBCT guidelines were extracted from four
      prospective randomised trials of erythropoietin for anaemia of prematurity.
      RESULTS: When the restrictive RBCT guidelines were followed, the number of RBCTs
      and volume transfused were similar to those reported during erythropoietin
      administration. CONCLUSIONS: RBCT guidelines may have a similar impact on RBCT in
      very low birthweight infants to the administration of erythropoietin. The effect
      of RBCT guidelines on RBCT frequency should be considered when evaluating the
      efficacy of erythropoietin administration to preterm infants.

PMID- 11207225
TI  - Hepatic iron storage in very low birthweight infants after multiple blood
      transfusions.
AB  - OBJECTIVE: To investigate the effect of multiple blood transfusions on hepatic
      iron storage in preterm, very low birthweight (VLBW) infants. METHODS: Seventeen
      VLBW infants who died within the first six months of life and underwent
      postmortem examination were studied. Serum ferritin, iron, and total iron binding
      capacity were measured within the week before the infants' death. Liver iron
      concentration was quantitatively determined by atomic absorption
      spectrophotometry and semiquantitatively assessed by histochemical liver iron
      grading. The clinical characteristics and the iron results were compared between
      infants receiving < 100 ml of blood (group A) and those receiving >/= 100 ml
      (group B). Spearman's correlation coefficient was used to evaluate the relation
      between the volume of blood transfused and serum/liver iron concentrations.
      Statistically significant variables associated with liver iron concentration were
      further subjected to multivariate stepwise regression analysis. RESULTS: Infants
      in group B had significantly higher serum iron (p < 0.01), serum ferritin (p <
      0.01), and liver iron concentration (p < 0.01) than those in group A. The total
      and net volume of blood transfused were significantly associated with liver iron
      concentration (p < 0.001, r = 0.86; p < 0.001, r = 0.71 respectively),
      semiquantitative histochemical liver iron grading (p < 0.001, r = 0.80; p <
      0.005, r = 0.71 respectively), and serum ferritin (p < 0.001, r = 0.84; p < 0.01,
      r = 0.69 respectively). In addition, both liver iron concentration and liver iron
      grading were found to be significantly associated with serum ferritin (p < 0.001,
      r = 0.76; p < 0.005, r = 0.68 respectively). Multivariate stepwise regression
      analysis indicated that the (log) liver iron concentration was significantly
      associated with the (log) volume of blood transfusion (p < 0.001; regression
      coefficient 0.39, SE 0.09), after adjustment for gestational age (R(2) = 0.84).
      CONCLUSIONS: This study showed a significant positive relation between the volume
      of blood transfused and the liver iron concentration in preterm VLBW infants.
      Although the transfusional blood volume correlated closely with the amount of
      iron deposited in hepatic tissues, clinical manifestations of iron overload were
      not observed. Carers should be aware of this potential harmful effect before
      prescribing blood or routine iron supplement to vulnerable preterm infants.

PMID- 11207226
TI  - Pulse oximetry, severe retinopathy, and outcome at one year in babies of less
      than 28 weeks gestation.
AB  - AIM: To determine whether differing policies with regard to the control of oxygen
      saturation have any impact on the number of babies who develop retinopathy of
      prematurity and the number surviving with or without signs of cerebral palsy at
      one year. METHODS: An examination of the case notes of all the 295 babies who
      survived infancy after delivery before 28 weeks gestation in the north of England
      in 1990-1994. RESULTS: Babies given enough supplemental oxygen to maintain an
      oxygen saturation of 88-98%, as measured by pulse oximetry, for at least the
      first 8 weeks of life developed retinopathy of prematurity severe enough to be
      treated with cryotherapy four times as often as babies only given enough oxygen
      to maintain an oxygen saturation of 70-90% (27.2% v 6.2%). Surviving babies were
      also ventilated longer (31.4 v 13.9 days), more likely to be in oxygen at a
      postmenstrual age of 36 weeks (46% v 18 %), and more likely to have a weight
      below the third centile at discharge (45% v 17%). There was no difference in the
      proportion who survived infancy (53% v 52%) or who later developed cerebral palsy
      (17% v 15%). The lowest incidence of retinopathy in the study was associated with
      a policy that made little use of arterial lines. CONCLUSIONS: Attempts to keep
      oxygen saturation at a normal "physiological" level may do more harm than good in
      babies of less than 28 weeks gestation.

PMID- 11207227
TI  - Cerebral palsy in the surviving twin associated with infant death of the co-twin.
AB  - BACKGROUND: Monozygotic twins are at greater risk of dying and of serious
      morbidity than dizygotic twins, and both are at greater risk than singletons.
      This is only partly explained by the higher proportion of low birthweight infants
      among twins. AIM: To compare, in same sex and different sex twins, birth weight
      specific neonatal death rates and cerebral palsy prevalence rates in the
      surviving twin when the co-twin has died in infancy. METHODS: Analysis of birth
      and death registration data for same sex and different sex twins for England and
      Wales 1993-1995 where both were live births. Death certificates of all liveborn
      twins who died were obtained from the Office for National Statistics. A
      questionnaire was sent to the general practitioners of all surviving co-twins to
      determine if the child had any disability. RESULTS: The neonatal death rate in
      same sex twins was 25.4 and in different sex twins 18.0 per 1000 live births
      (death rate difference 7.4; 95% confidence interval 4.7 to 10.1; p < 0.001). The
      higher neonatal death rate in same sex compared with different sex twins is
      attributable to the higher proportion of same sex twins with low birth weight.
      Prevalence of cerebral palsy in the low birthweight group (< 1000 g) was
      marginally higher in same sex (224 per 1000) than different sex (200 per 1000)
      twin survivors. In the birth weight group 1000-1999 g, same sex twin survivors
      were at a significantly higher risk of cerebral palsy than those of different
      sex: 167 v 21 per 1000; difference 145 (95% confidence interval 44 to 231; p <
      0.01) per 1000 infant survivors. CONCLUSION: There are two components to the
      cause of cerebral palsy in twins. Immaturity per se predisposes to cerebral
      damage. Also, same sex twins may sustain cerebral damage that is in excess of
      that due to immaturity.

PMID- 11207228
TI  - Respiratory distress syndrome and birth order in premature twins.
AB  - OBJECTIVE: To determine the effect of birth order on respiratory distress
      syndrome (RDS) in the outcome of twins in a large premature population managed in
      a modern neonatal intensive care unit. METHODS: An historical cohort study design
      was used to analyse the neonatal outcomes of 301 premature liveborn twin sibling
      pairs of between 23 and 31 weeks gestation from the Australia and New Zealand
      Neonatal Network 1995 database. RESULTS: Among the 56 twin sibling pairs who were
      discordant for RDS, the second twin was affected in 41 cases (odds ratio (OR)
      2.7, 95% confidence interval (CI) 1.5 to 5.3). The excess risk of RDS in the
      second twin increased with gestation and was statistically significant for twins
      above 29 weeks gestation (OR 4.4, 95% CI 1.6 to 15). CONCLUSIONS: There is a
      significant increased risk of RDS associated with being the second born of
      premature twins, which appears to depend on gestation.

PMID- 11207229
TI  - Refractory hypotension in preterm infants with adrenocortical insufficiency.
AB  - Five preterm, very low birthweight infants with severe hypotension and
      adrenocortical insufficiency are described. The profound hypotension was
      resistant to volume expansion and inotrope treatment, but responded promptly to
      corticosteroid treatment. A human corticotrophin releasing hormone (hCRH) test
      performed before corticosteroid treatment showed adequate pituitary response, and
      the endocrine dysfunction was identified at the adrenal level. Corticosteroid
      treatment should be considered and could be life saving in severely hypotensive
      preterm infants who do not respond to conventional treatment with volume
      expanders and inotropes.

PMID- 11207231
TI  - Positioning long lines: contrast versus plain radiography.
AB  - AIM: To assess the value of contrast versus plain radiography in determining
      radio-opaque long line tip position in neonates. METHODS: In a prospective study,
      plain radiography was performed after insertion of radio-opaque long lines. If
      the line tip was not visible on the plain film, a second film with contrast was
      obtained in an attempt to visualise the tip. RESULTS: Sixty eight lines were
      inserted during the study period, 62 of which were included in the study. In 31,
      a second radiographic examination with contrast was necessary to determine
      position of the tip. In 29 of these, the line tip was clearly visualised with
      contrast. On two occasions, the line tip could not be seen because the contrast
      had filled the vein and obscured the tip from view. Eight of the lines that
      required a second radiograph with contrast were repositioned. CONCLUSION:
      Intravenous contrast should be routinely used in the assessment of long line
      position in the neonate.

PMID- 11207230
TI  - Follow up care of bereaved parents after treatment withdrawal from newborns.
AB  - OBJECTIVE: To explore parents' experiences of bereavement care after withdrawal
      of newborn intensive care. DESIGN: Face to face interviews with 108 parents of 62
      babies born over two calendar years in the East of Scotland. RESULTS: Only 22%
      were seen by six weeks after the death, 10% were not recalled before 6-11 months,
      and 8% were not seen at all in the first year. All except one couple saw the
      neonatologist who had cared for their baby. Only 33% remembered a neonatal nurse
      being present. Most (88%) were seen in the study hospital. Parents highlighted a
      number of specific needs. Appointments should be: (a) scheduled soon after the
      death of the baby and certainly within two months of the death irrespective of
      whether or not autopsy results are available; (b) with the named neonatologist;
      (c) in a setting away from the hospital if possible. Parents value: (a) efforts
      to find out how they are coping; (b) full frank information given sensitively to
      enable them to build up a cohesive picture of what happened and assess their
      future risks; (c) reassurance where possible, but half truths, false
      reassurances, and broken promises are unacceptable. CONCLUSIONS: Follow up care
      is a crucial part of the management of families from whose babies treatment has
      been withdrawn. Resources devoted to it should be re-examined to provide a
      service more in tune with parental need. In choosing the place, timing, and
      conduct of the meeting, staff should be sensitive to the expressed wishes of the
      parents themselves.

PMID- 11207232
TI  - Amphotericin B lipid complex for neonatal invasive candidiasis.
AB  - This study describes the safety and efficacy of amphotericin B lipid complex
      (ABLC) in 11 neonates with systemic Candida infections. Nine of the 11 improved
      clinically, and eight of nine evaluable patients had a mycological cure with
      ABLC. Creatinine levels improved or did not significantly change in eight of the
      11 patients.

PMID- 11207233
TI  - Neonatal paroxetine withdrawal syndrome.
AB  - Four term neonates presented with symptoms such as jitteriness and necrotising
      enterocolitis after paroxetine exposure in utero.

PMID- 11207234
TI  - Preterm infants with athetoid cerebral palsy: kernicterus?

PMID- 11207235
TI  - Wilhelm Conrad Roentgen (1845-1923), the discovery of x rays and perinatal
      diagnosis.

PMID- 11207236
TI  - Dexamethasone treatment and cerebral palsy.

PMID- 11207237
TI  - Cutting edge: is vasoactive intestinal peptide a type 2 cytokine?
AB  - A component of the chemical language shared by the immune and nervous system is
      the expression of neuropeptides by immune cells. Vasoactive intestinal peptide
      (VIP) was shown to be produced by T lymphocytes. Here we investigate whether T
      cell subsets differentially express VIP. Our studies indicate that, upon specific
      Ag stimulation, Th2 and T2 cells, but not Th1 and T1 cells derived from TCR
      transgenic (Tg) mice, express VIP mRNA and protein, and secrete VIP. Following
      immunization with the specific Ag, significant levels of VIP are present in the
      serum of syngeneic, non-Tg hosts that receive Th2, but not Th1 Tg cells. Th2 Tg
      cells recovered from the non-Tg hosts immunized with the specific Ag, but not
      with an irrelevant Ag, express intracellular VIP. Because VIP is produced by Ag
      stimulated type 2 T cells, and differentially affects Th1 and Th2 cells, could
      VIP be viewed as a type 2 cytokine?

PMID- 11207238
TI  - Cutting edge: reversal of murine lupus nephritis with CTLA4Ig and
      cyclophosphamide.
AB  - Cyclophosphamide (CTX) prevents progression of nephritis and prolongs survival in
      (NZB x NZW)F(1) (B/W) mice and is used to treat humans with lupus nephritis. To
      compare the efficacy of CTLA4Ig with CTX and determine whether there is an
      incremental benefit to combining CTLA4Ig with CTX, we treated B/W mice with CTX,
      CTLA4Ig, or both agents. In mice with mild renal disease, treatment delayed the
      onset of proteinuria and prolonged survival in all groups. In mice with advanced
      renal disease, treatment with both agents reduced proteinuria in 71% of mice,
      whereas mice treated with either agent alone had no such improvement. Survival
      was also markedly improved among mice treated with both agents. Thus, combination
      treatment with CTX and CTLA4Ig is more effective than either agent alone in
      reducing renal disease and prolonging survival of B/W mice with advanced
      nephritis. This striking reversal of proteinuria is unprecedented in animal
      models of SLE.

PMID- 11207239
TI  - Cutting edge: the class II transactivator prevents activation-induced cell death
      by inhibiting Fas ligand gene expression.
AB  - The Fas:Fas ligand pathway is critical in regulating immune homeostasis by
      eliminating activated T cells that proliferated in response to an infection.
      Here, we show that the MHC class II transactivator (CIITA) can suppress this
      pathway by inhibiting transcription of the Fas ligand gene. CIITA can effectively
      repress transcription from the Fas ligand promoter in both T cell lines as well
      as primary cells. The repression appears to be at least partly due to
      interference of NFAT-mediated induction of Fas ligand gene transcription. T cells
      that express CIITA constitutively do not up-regulate Fas ligand on the cell
      surface after activation via the TCR. Consequently, these cells lack the ability
      to undergo activation-induced cell death, and to kill Fas-bearing target cells.

PMID- 11207240
TI  - Gastrointestinal cells of IL-7 receptor null mice exhibit increased sensitivity
      to irradiation.
AB  - IL-7 is a critical cytokine in the development of T and B cells but little is
      known about its activity on nonhematopoietic cells. An unexpected finding was
      noted in allogeneic bone marrow transplant studies using IL-7 receptor null (IL
      7R alpha(-/-)) mice as recipients. These mice exhibited a significantly greater
      weight loss after total body irradiation compared with wild type, IL-7R
      alpha(+/+), mice. Pathological assessment indicated greater intestinal crypt
      damage in IL-7R alpha(-/-) recipients, suggesting these mice may be predisposed
      to gut destruction. Therefore, we determined the effect of the conditioning
      itself on the intestinal tract of these mice. IL-7R alpha(-/-) mice and IL-7R
      alpha(+/+) mice were irradiated and examined for lesions and apoptosis within the
      small intestine. In moribund animals, IL-7R alpha(-/-) mice had extensive damage
      in the small intestine, including marked ablation of the crypts and extreme
      shortening of villi following 1500 cGy total body irradiation. In contrast, by 8
      days after irradiation, the small intestines of IL-7R alpha(+/+) mice had
      regenerated as distinguished by normal villus length and hyperplastic crypts.
      Following 750 cGy irradiation, IL-7R alpha(-/-) mice had a higher proportion of
      apoptotic cells in the crypts and an accompanying increase in the pro-apoptotic
      protein Bak was expressed in intestinal epithelial cells. These results
      demonstrate the increased radiosensitivity of intestinal stem cells within the
      crypts in IL-7R alpha(-/-) mice and a role for IL-7 in the protection of
      radiation-induced apoptosis in these same cells. This study describes a novel
      role of IL-7 in nonhematopoietic tissues.

PMID- 11207241
TI  - Human B cell growth and differentiation in the spleen of immunodeficient mice.
AB  - Human mAbs (HumAbs) have therapeutic potential against infectious diseases and
      cancer. Heretofore, their production has been hampered by ethical constraints
      preventing the isolation of Ag-specific activated B cells by in vivo
      immunization. Alternatively, severe combined immune deficient (SCID) mice,
      transplanted i.p. with human (Hu)-PBLs, allow the in vivo stimulation of human Ab
      responses without the usual constraints. Unfortunately, human B cells only
      represent a minor fraction of the surviving graft, they are scattered all over
      the animal body, and thus are hard to isolate for subsequent immortalization
      procedures. To prevent this dispersion and to provide the human B cells with a
      niche for expansion and maturation, SCID mice were engrafted with Hu-PBL directly
      into the spleen. Simultaneously endogenous murine NK cell activity was depleted
      by treatment with an anti-mouse IL-2 receptor beta-chain Ab. During engraftment,
      human B lymphocytes became activated, divided intensely, and differentiated into
      plasmacytoid cells. In vivo exposure to a recall Ag after cell transfer induced
      expansion of Ag-specific B cell clones. One week after inoculation, human B cells
      were abundant in the spleen and could easily be recovered for fusion with a
      heteromyeloma line. This resulted in the formation of stable hybridoma cell lines
      that secreted Ag-specific HumAbs. Thus transplantation of human lymphoid cells in
      the spleens of immune deficient mice represents a model for the study of human T
      cell-dependent B cell activation and proves to be an excellent tool for the
      successful production of HumAbs.

PMID- 11207242
TI  - Thioredoxin acts as a B cell growth factor in channel catfish.
AB  - To identify differentially expressed genes from channel catfish macrophages, a
      cDNA library from LPS-stimulated catfish macrophages was screened by subtractive
      hybridization. This screening yielded a 552-bp cDNA coding for catfish
      thioredoxin (CF-TRX). The deduced amino acid sequence revealed that CF-TRX
      contains 107 amino acids and is 59% homologous to human adult T cell leukemia
      derived factor/TRX, originally described as an IL-2R alpha-inducing factor.
      Northern blot analyses showed that CF-TRX is expressed in catfish T and
      macrophage cell lines, but weakly in B cell lines. Similar results were also
      observed in Western blot analyses using a mAb specific for recombinant CF-TRX
      (rTRX). The use of rTRX in functional studies demonstrated that rTRX induces in
      vitro proliferative responses of catfish PBL that were synergistically enhanced
      by the addition of culture supernatants from catfish T cell lines. In addition,
      cell separation studies and flow cytometric analyses revealed that the cells
      proliferating in rTRX-stimulated cultures were mostly B cells. These results
      suggest that CF-TRX may have an important role in the activation and
      proliferation of channel catfish B cells.

PMID- 11207243
TI  - The balance between CD45RChigh and CD45RClow CD4 T cells in rats is intrinsic to
      bone marrow-derived cells and is genetically controlled.
AB  - The level of CD45RC expression differentiates rat CD4 T cells in two
      subpopulations, CD45RC(high) and CD45RC(low), that have different cytokine
      profiles and functions. Interestingly, Lewis (LEW) and Brown Norway (BN) rats,
      two strains that differ in their ability to mount type 1 and type 2 immune
      responses and in their susceptibility to autoimmune diseases, exhibit distinct
      CD45RC(high)/CD45RC(low) CD4 T cell ratios. The CD45RC(high) subpopulation
      predominates in LEW rats, and the CD45RC(low) subpopulation in BN rats. In this
      study, we found that the antiinflammatory cytokines, IL-4, IL-10, and IL-13, are
      exclusively produced by the CD45RC(low) CD4 T cells. Using bone marrow chimeras,
      we showed that the difference in the CD45RC(high)/CD45RC(low) CD4 T cell ratio
      between naive LEW and BN rats is intrinsic to hemopoietic cells. Furthermore, a
      genome-wide search for loci controlling the balance between T cell subpopulations
      was conducted in a (LEW x BN) F(2) intercross. Genome scanning identified one
      quantitative trait locus on chromosome 9 (approximately 17 centiMorgan (cM); log
      of the odds ratio (LOD) score 3.9). In addition, two regions on chromosomes 10
      (approximately 28 cM; LOD score 3.1) and 20 (approximately 40 cM; LOD ratio score
      3) that contain, respectively, a cytokine gene cluster and the MHC region were
      suggestive for linkage. Interestingly, overlapping regions on these chromosomes
      have been implicated in the susceptibility to various immune-mediated disorders.
      The identification and functional characterization of genes in these regions
      controlling the CD45RC(high)/CD45RC(low) Th cell subpopulations may shed light on
      key regulatory mechanisms of pathogenic immune responses.

PMID- 11207244
TI  - Induction of polyclonal prostate cancer-specific CTL using dendritic cells
      transfected with amplified tumor RNA.
AB  - Polyvalent cancer vaccines targeting the entire antigenic spectrum on tumor cells
      may represent a superior therapeutic strategy for cancer patients than vaccines
      solely directed against single Ags. In this study, we show that autologous
      dendritic cells (DC) transfected with RNA amplified from microdissected tumor
      cells are capable of stimulating CTL against a broad set of unidentified and
      critical prostate-specific Ags. Although the polyclonal CTL responses generated
      with amplified tumor RNA-transfected DC encompassed as a subcomponent a response
      against prostate-specific Ag (PSA) as well as against telomerase reverse
      transcriptase, the tumor-specific CTL were consistently more effective than PSA
      or telomerase reverse transcriptase CTL to lyse tumor targets, suggesting the
      superiority of the polyclonal response. Although tumor RNA-transfected DC
      stimulated CTL, which recognized not only tumor but also self-Ags expressed by
      benign prostate tissue, these cross-reactive CTL were exclusively specific for
      the PSA, indicating an immunodominant role of PSA in the prostate cancer-specific
      immune response. Our data suggest that tumor RNA-transfected DC may represent a
      broadly applicable, potentially clinically effective vaccine strategy for
      prostate cancer patients, which is not limited by tumor tissue availability for
      Ag preparation and may minimize the risk of clonal tumor escape.

PMID- 11207245
TI  - Differential regulation of human blood dendritic cell subsets by IFNs.
AB  - Based on the relative expression of CD11c and CD1a, we previously identified
      subsets of dendritic cells (DCs) or DC precursors in human peripheral blood. A
      CD1a(+)/CD11c(+) population (CD11c(+) DCs), also called myeloid DCs, is an
      immediate precursor of Langerhans cells, whereas a CD1a(-)/CD11c(-) population
      (CD11c(-) DCs), sometimes called lymphoid DCs but better known as plasmacytoid
      DCs, is composed of type I IFN (IFN-alpha beta)-producing cells. Here, we
      investigate the effects of IFN-alpha beta and IFN-gamma as well as other
      cytokines on CD11c(+) and CD11c(-) DC subsets, directly isolated from the
      peripheral blood, instead of in vitro-generated DCs. IFN-gamma and IFN-alpha,
      rather than GM-CSF, were the most potent cytokines for enhancing the maturation
      of CD11c(+) DCs. Incubation of CD11c(+) DCs with IFN-gamma also resulted in
      increased IL-12 production, and this IL-12 allowed DCs to increase Th1 responses
      by alloreactive T cells. In contrast, IFN-alpha did not induce IL-12 but, rather,
      augmented IL-10 production. IFN-alpha-primed matured CD11c(+) DCs induced IL-10
      producing regulatory T cells; however, this process was independent of the DC
      derived IL-10. On the other hand, IFN-alpha by itself neither matured CD11c(-)
      DCs nor altered the polarization of responding T cells, although this cytokine
      was a potent survival factor for CD11c(-) DCs. Unlike IFN-alpha, IL-3 was a
      potent survival factor and induced the maturation of CD11c(-) DCs. The IL-3
      primed CD11c(-) DCs activated T cells to produce IL-10, IFN-gamma, and IL-4.
      Thus, CD11c(+) and CD11c(-) DC subsets play distinct roles in the cytokine
      network, especially their responses to IFNs.

PMID- 11207246
TI  - CD4 T cell-mediated alloresistance to fully MHC-mismatched allogeneic bone marrow
      engraftment is dependent on CD40-CD40 ligand interactions, and lasting T cell
      tolerance is induced by bone marrow transplantation with initial blockade of this
      pathway.
AB  - Costimulatory blockade can be used to promote allogeneic marrow engraftment and
      tolerance induction, but on its own is not 100% reliable. We sought to determine
      whether one or the other of the CD4 or CD8 T cell subsets of the recipient was
      primarily responsible for resistance to allogeneic marrow engraftment in mice
      receiving costimulatory blockade, and to use this information to develop a more
      reliable, minimal conditioning regimen for induction of mixed chimerism and
      transplantation tolerance. We demonstrate that a single anti-CD40 ligand mAb
      treatment is sufficient to completely overcome CD4 cell-mediated resistance to
      allogeneic marrow engraftment and rapidly induce CD4 cell tolerance, but does not
      reliably overcome CD8 CTL-mediated alloresistance. The data suggest that
      costimulation, which activates alloreactive CTL, is insufficient to activate
      alloreactive CD4 cells when the CD40 pathway is blocked. The addition of host CD8
      T cell depletion to anti-CD40 ligand treatment reliably allows the induction of
      mixed chimerism and donor-specific skin graft tolerance in 3 Gy-irradiated mice
      receiving fully MHC-mismatched bone marrow grafts. Thus, despite the existence of
      multiple costimulatory pathways and pathways of APC activation, our studies
      demonstrate an absolute dependence on CD40-mediated events for CD4 cell-mediated
      rejection of allogeneic marrow. Exposure to donor bone marrow allows rapid
      tolerization of alloreactive CD4 cells when the CD40 pathway is blocked, leading
      to permanent marrow engraftment and intrathymic tolerization of T cells that
      develop subsequently.

PMID- 11207247
TI  - Regulatory and effector CD4 T cells in nonobese diabetic mice recognize
      overlapping determinants on glutamic acid decarboxylase and use distinct V beta
      genes.
AB  - The 524--543 region of glutamic acid decarboxylase (GAD65), GAD65(524--543), is
      one of the first fragments of this islet Ag to induce proliferative T cell
      responses in the nonobese diabetic (NOD) mouse model of spontaneous autoimmune
      diabetes. Furthermore, NOD mice given tolerogenic doses of GAD65(524--543) are
      protected from spontaneous and cyclophosphamide-induced diabetes. In this study,
      we report that there are at least two I-A(g7)-restricted determinants present in
      the GAD65(524--543) sequence, each capable of recruiting unique T cell
      repertoires characterized by distinct TCR V beta gene use. CD4(+) T cells arise
      spontaneously in young NOD mice to an apparently dominant determinant found
      within the GAD65 peptide 530--543 (p530); however, T cells to the overlapping
      determinant 524-538 (p524) dominate the response only after immunization with
      GAD65(524--543). All p530-responsive T cells used the V beta 4 gene, whereas the
      V beta 12 gene is preferentially used to encode the TCR of p524-responsive T cell
      populations. T cell clones and hybridomas from both of these T cell groups were
      responsive to APC pulsed with GAD65(524--543) or whole rGAD65. p524-reactive
      cells appeared to be regulatory upon adoptive transfer into young NOD mice and
      could inhibit insulin-dependent diabetes mellitus development, although they were
      unable to produce IL-4, IL-10, or TGF beta upon antigenic challenge. Furthermore,
      we found that i.p. injection with p524/IFA was very effective in providing
      protection from cyclophosphamide-induced insulin-dependent diabetes mellitus.
      These data demonstrate that the regulatory T cells elicited by immunizing with
      GAD65(524--543) are unique and distinct from those that arise from spontaneous
      endogenous priming, and that T cells to this limited region of GAD65 may be
      either regulatory or pathogenic.

PMID- 11207248
TI  - Different NK cell surface phenotypes defined by the DX9 antibody are due to
      KIR3DL1 gene polymorphism.
AB  - KIR3DL1 and KIR3DL2 are NK cell receptors for polymorphic HLA-B and -A
      determinants. The proportion of NK cells that bind anti-KIR3DL1-specific Ab DX9
      and their level of binding vary between individuals. To determine whether these
      differences are due to KIR polymorphism, we assessed KIR3D gene diversity in
      unrelated individuals and families. Both KIR3DL1 and KIR3DL2 are highly
      polymorphic genes, with KIR3DS1 segregating like an allele of KIR3DL1. A KIR
      haplotype lacking KIR3DL1 and KIR3DS1 was defined. The two KIR3DL1 alleles of a
      heterozygous donor were expressed by different, but overlapping, subsets of NK
      cell clones. Sequence variation in KIR3DL1 and KIR3DL2 appear distinct;
      recombination is more evident in KIR3DL1, and point mutation is more evident in
      KIR3DL2. The KIR3DL1 genotype correlates well with levels of DX9 binding by NK
      cells, but not with the frequency of DX9-binding cells. Different KIR3DL1 alleles
      determine high, low, and no binding of DX9 Ab. Consequently, heterozygotes for
      high and low binding KIR3DL1 alleles have distinct subpopulations of NK cells
      that bind DX9 at high and low levels, giving characteristic bimodal distributions
      in flow cytometry. The Z27 Ab gave binding patterns similar to those of DX9. Four
      KIR3DL1 alleles producing high DX9 binding phenotypes were distinguished from
      four alleles producing low or no binding phenotypes by substitution at one or
      more of four positions in the encoded protein: 182 and 283 in the extracellular
      Ig-like domains, 320 in the transmembrane region, and 373 in the cytoplasmic
      tail.

PMID- 11207249
TI  - Cumulative inhibition of NK cells and T cells resulting from engagement of
      multiple inhibitory Ly49 receptors.
AB  - Inhibitory receptors specific for MHC class I molecules are expressed on
      partially overlapping subpopulations of NK cells and memory T cells. A central
      question pertinent to NK cell development and function is how the combinatorial
      expression of different receptors with distinct class I specificities affects
      functional recognition. We therefore studied the quantitative effects resulting
      from class I engagement of multiple inhibitory Ly49 receptors. We used a
      transgenic mouse model in which all NK cells and T cells express two different
      Ly49 receptors with shared class I specificity. Comparisons of cells from these
      mice with cells from single transgenic mice and wild-type mice revealed that Ly49
      receptors cumulatively inhibit lymphocyte effector functions. Multiple Ly49
      interactions also had a cumulative impact on NK cell development. The findings
      suggest that the interactions of inhibitory receptors with class I are
      interpreted quantitatively rather than as on/off switches. They have intriguing
      implications concerning NK cell tolerance and reactivity toward cells with
      extinguished expression of a limited number of class I molecules.

PMID- 11207250
TI  - CD25+ CD4+ T cells regulate the expansion of peripheral CD4 T cells through the
      production of IL-10.
AB  - The mechanisms by which the immune system achieves constant T cell numbers
      throughout life, thereby controlling autoaggressive cell expansions, are to date
      not completely understood. Here, we show that the CD25(+) subpopulation of
      naturally activated (CD45RB(low)) CD4 T cells, but not CD25(-) CD45RB(low) CD4 T
      cells, inhibits the accumulation of cotransferred CD45RB(high) CD4 T cells in
      lymphocyte-deficient mice. However, both CD25(+) and CD25(-) CD45RB(low) CD4 T
      cell subpopulations contain regulatory cells, since they can prevent naive CD4 T
      cell-induced wasting disease. In the absence of a correlation between disease and
      the number of recovered CD4(+) cells, we conclude that expansion control and
      disease prevention are largely independent processes. CD25(+) CD45RB(low) CD4 T
      cells from IL-10-deficient mice do not protect from disease. They accumulate to a
      higher cell number and cannot prevent the expansion of CD45RB(high) CD4 T cells
      upon transfer compared with their wild-type counterparts. Although CD25(+)
      CD45RB(low) CD4 T cells are capable of expanding when transferred in vivo, they
      reach a homeostatic equilibrium at lower cell numbers than CD25(-) CD45RB(low) or
      CD45RB(high) CD4 T cells. We conclude that CD25(+) CD45RB(low) CD4 T cells from
      nonmanipulated mice control the number of peripheral CD4 T cells through a
      mechanism involving the production of IL-10 by regulatory T cells.

PMID- 11207251
TI  - IL-7 administration alters the CD4:CD8 ratio, increases T cell numbers, and
      increases T cell function in the absence of activation.
AB  - IL-7 is vital for the development of the immune system and profoundly enhances
      the function of mature T cells. Chronic administration of IL-7 to mice markedly
      increases T cell numbers, especially CD8(+) T cells, and enhances T cell
      functional potential. However, the mechanism by which these effects occur remains
      unclear. This report demonstrates that only 2 days of IL-7 treatment is needed
      for maximal enhancement of T cell function, as measured by proliferation, with a
      6- to 12-fold increase in the proportion of CD4(+) and CD8(+) T cells in cell
      cycle by 18 h of ex vivo stimulation. Moreover, a 2-day administration of IL-7 in
      vivo increases basal proliferation by 4- and 14-fold in CD4(+) and CD8(+) T
      cells, respectively. These effects occur in the absence of cytokine production,
      increases in most activation markers, and changes in memory markers. This
      enhanced basal proliferation is the basis for the increase in T cell numbers in
      that IL-7 induces an additional 60% and 85% of resting CD4(+) and CD8(+) T cells,
      respectively, to enter cell cycle in mice given IL-7 for 7 days. These results
      demonstrate that in vivo administration of IL-7 increases T cell numbers and
      functional potential via a homeostatic, nonactivating process. These findings may
      suggest a unique clinical niche for IL-7 in that IL-7 therapy may increase T cell
      numbers and enhance responses to specific antigenic targets while avoiding a
      general, nonspecific activation of the T cell population.

PMID- 11207252
TI  - Potent cytolytic response by a CD8+ CTL clone to multiple peptides from the same
      protein in association with an allogeneic class I MHC molecule.
AB  - CTL clone 2C recognizes the allogeneic class I MHC molecule L(d) in association
      with peptides derived from alpha-ketoglutarate dehydrogenase (oxoglutarate
      dehydrogenase (OGDH)), a ubiquitous intracellular protein. One of these peptides,
      QLSPFPFDL (QL9), elicits more vigorous cytolytic responses than two previously
      identified naturally processed peptides with overlapping sequences, LSPFPFDL
      (p2Ca) and VAITRIEQLSPFPFDL (p2Cb), from OGDH. In this study, we show that QL9
      forms a more stable complex with cell surface L(d) than does p2Ca or p2Cb and is
      processed from the longer, naturally occurring peptide p2Cb by 20S proteosomes in
      vitro. The N-terminal cyclized pyroglutaminyl QL9 (pyroQL9), a form of QL9 to
      which it is converted at the low pH used for peptide isolation from tissue
      extracts, is even more active than QL9 in cytotoxicity assays with 2C CTL.
      Overall, the results indicate that along with the abundant natural peptides p2Ca
      and p2Cb, the QL9 and other OGDH peptides of various lengths, sharing a conserved
      C-terminal sequence, are also processed and presented with L(d) as allogeneic
      ligands for T cells expressing 2C TCR. All these peptides, each available in a
      low amount, could act in concert at the cell surface, resulting in a high density
      of cognate ligands that accounts for the exceptionally potent cytolytic response
      by 2C CTL.

PMID- 11207253
TI  - Fas-mediated apoptosis causes elimination of virus-specific cytotoxic T cells in
      the virus-infected liver.
AB  - Immunity to allogeneic MHC Ags is weak in rodent livers, raising questions as to
      the mechanisms that might control responses in this organ. Infection with an
      adenovirus vector reveals that T cell-mediated immunity to nonself-Ags in the
      liver is self-limiting. Virus-induced liver injury decreases and coincides with
      disappearance of virus-specific CTL, concomitant to an increase of apoptotic T
      cells early after infection. But whereas death in CD4 cells is independent of
      Fas, perforin, and TNF-alpha, that of CD8 cells requires Fas and not perforin or
      TNF-alpha pathways. Fas ligand is expressed on liver-infiltrating cells, pointing
      to death by fratricide that causes almost complete disappearance of virus
      specific CTL 4 wk after infection. CTL elimination is virus dose dependent, and
      high doses induced high alanine aminotransferase values, elevated expression of
      Fas ligand on CD8 cells, and increased CD8 cell migration into the infected
      liver.

PMID- 11207254
TI  - Phenotypic distinction and functional characterization of pro-B cells in adult
      mouse bone marrow.
AB  - A lymphoid-committed progenitor population was isolated from mouse bone marrow
      based on the cell surface phenotype Thy-1.1(neg)Sca-1(pos)c-Kit(low)Lin(neg).
      These cells were CD43(pos)CD24(pos) on isolation and proliferated in response to
      the cytokine combination of steel factor, IL-7, and Flt3 ligand. Lymphoid
      committed progenitors could be segregated into more primitive and more
      differentiated subsets based on expression of AA4.1. The more differentiated
      subset generated only B lymphoid cells in 92% of total colonies assayed, lacked T
      lineage potential, and expressed Pax5. These studies have therefore defined and
      isolated a B lymphoid-committed progenitor population at a developmental stage
      corresponding to the initial expression of CD45R.

PMID- 11207255
TI  - Cell surface-expressed moesin-like receptor regulates T cell interactions with
      tissue components and binds an adhesion-modulating IL-2 peptide generated by
      elastase.
AB  - The adhesion of leukocytes to the extracellular matrix (ECM) depends on their
      responses to variations in the chemotactic signals in their milieu, as well as on
      the functioning of cytoskeletal and context-specific receptors. Ezrin, radixin,
      and moesin constitute a family of proteins that link the plasma membrane to the
      actin cytoskeleton. The surface expression of moesin on T cells and its role in
      cell adhesion has not been fully elucidated. Recently, we found that IL-2
      peptides generated by elastase modified the adhesion of activated T cells to ECM
      ligands. Here, we further examined the adhesion regulatory effects of EFLNRWIT,
      one of the IL-2 peptides, as well as the existence and putative function of its
      receptor on T cells. We found that when presented to T cells in the absence of
      another activator, the EFLNRWIT peptide induced cell adhesion to vessel wall and
      ECM components. Binding of a radiolabeled peptide to T cells, precipitation with
      the immobilized peptide, and amino acid sequencing of the precipitated protein
      revealed that EFLNRWIT exerts its function via a cell surface-expressed moesin
      like moiety, whose constitutive expression on T cells was increased after
      activation. This notion was further supported by our findings that: 1) anti
      moesin mAb inhibited the binding of T cells to the immobilized EFLNRWIT peptide,
      2) immobilized recombinant moesin bound the IL-2 peptide, and 3) soluble moesin
      inhibited the EFLNRWIT-induced T cell adhesion to fibronectin. Interestingly,
      moesin appears to be generally involved in T cell responses to adhesion
      regulating signals. Thus, the IL-2 peptide EFLNRWIT appears to exert its
      modulating capacities via an adhesion-regulating moesin-like receptor.

PMID- 11207256
TI  - The roles of MHC class II, CD40, and B7 costimulation in CTL induction by plasmid
      DNA.
AB  - DNA-based vaccines generate potent CTL responses. The mechanism of T cell
      stimulation has been attributed to plasmid-transfected dendritic cells. These
      cells have also been shown to express plasmid-encoded proteins and to become
      activated by surface marker up-regulation. However, the increased surface
      expression of CD40 and B7 on these dendritic cells is insufficient to overcome
      the need for MHC class II-restricted CD4(+) T cell help in the priming of a CTL
      response. In this study, MHC class II(-/-) mice were unable to generate a CTL
      response following DNA immunization. This deficit in CTL stimulation by MHC class
      II-deficient mice was only modestly restored with CD40-activating Ab, suggesting
      that there were other elements provided by MHC class II-restricted T cell help
      for CTL induction. CTL activity was also augmented by coinjection with a vector
      encoding the costimulatory ligand B7.1, but not B7.2. These data indicate that
      dendritic cells in plasmid DNA-injected mice require conditioning signals from
      MHC class II-restricted T cells that are both CD40 dependent and independent and
      that there are different roles for costimulatory molecules that may be involved
      in inducing optimal CTL activity.

PMID- 11207257
TI  - Stromal cell-derived factor 1 alpha-induced chemotaxis in T cells is mediated by
      nitric oxide signaling pathways.
AB  - Stromal cell-derived factor 1 alpha (SDF1 alpha) and its cognate chemokine
      receptor CXCR4 act as potent chemoattractants and regulate trafficking and homing
      of hematopoietic progenitor cells and lymphocytes. However, the molecular
      mechanisms regulating SDF1 alpha-driven cell migration are not well defined. In
      this study, we have explored the roles of the second messenger NO and the
      transcription factor NF-kappa B in SDF1 alpha-induced T cell migration. SDF1
      alpha treatment of Jurkat T cells increased the activity of NO synthase, which
      catalyzes the generation of NO. We observed that pretreatment of Jurkat cells or
      activated PBLs with several NO donors significantly enhanced the SDF1 alpha
      induced migration, whereas various inhibitors of NO synthase markedly abrogated
      the chemotactic response in a concentration-dependent manner. Furthermore, we
      observed that inhibitors of the transcription factor NF-kappa B, which is linked
      to NO signaling pathways, also significantly blocked the SDF1 alpha-induced
      chemotactic response. However, these compounds did not have a significant effect
      on SDF1 alpha-induced mitogen-activated protein kinase activity. In addition, the
      MAP/Erk kinase kinase inhibitor PD98059 did not abrogate SDF1 alpha-induced
      chemotaxis. AKT, which has been shown to mediate NO production, was also
      phosphorylated upon SDF1 alpha stimulation. These studies suggest that NO-related
      signaling pathways may mediate SDF1 alpha-induced chemotaxis, but not mitogen
      activated protein kinase activation.

PMID- 11207258
TI  - The production of IFN-gamma by IL-12/IL-18-activated macrophages requires STAT4
      signaling and is inhibited by IL-4.
AB  - Macrophages release IFN-gamma on combined stimulation with IL-12 and IL-18, but
      the signaling requirements of this process and its regulation by other cytokines
      are unknown. Here, we demonstrate that STAT4 is indispensable for IL-12/IL-18
      induced production of IFN-gamma by mouse peritoneal macrophages. Type 2 NO
      synthase (NOS2), which we previously found to be a prerequisite for IL-12-induced
      IFN-gamma production in NK cells, was not required for IFN-gamma production by
      these macrophages. IL-12 alone already induced the expression of IFN-gamma mRNA,
      but nuclear translocation of STAT4, the release of IFN-gamma protein, and the
      subsequent production of NO was strictly dependent on the simultaneous presence
      of IL-18. NF-kappa B, which mediates IL-18 effects in T cells, was only weakly
      activated by IL-12 and/or IL-18 in macrophages. Known inhibitors of macrophage
      functions (e.g., IL-4 and TGF-beta) also suppressed macrophage IFN-gamma
      production and the subsequent production of NOS2-derived NO. The inhibitory
      effect of IL-4 was paralleled by nuclear translocation of STAT6, which in EMSAs
      was able to bind to the same DNA oligonucleotide as STAT4. These results further
      define the production of IFN-gamma by macrophages and point to a diversity in the
      signals required for IFN-gamma production by various cell types.

PMID- 11207259
TI  - Expression of a V region-less B cell receptor confers a tolerance-like phenotype
      on transgenic B cells.
AB  - Neoplastic B cells from H chain disease patients express a truncated B cell
      receptor (BCR), comprising a membrane Ig that lacks part of its extracellular
      domain. It has been speculated that deletion of the Ag binding domain would
      confer a constitutive activity on the BCR, as it has been shown for oncogenic
      growth factor receptors. A V region-less BCR has constitutive activity, because
      in transgenic mice it causes inhibition of endogenous H chain gene rearrangements
      and relieves the requirement for surrogate L chain in pre-B cell development.
      However, it has been speculated that normal Ag receptors also display
      constitutive activity. Here we show that transgenic B cells expressing a membrane
      H chain disease protein on their surface are phenotypically and functionally
      similar to B cells developing in the presence of their cognate Ag and that cells
      with normal levels of mutant BCR are eliminated in spleen via a bcl-2 sensitive
      pathway while progressing toward the mature stage. In contrast, cells with lower
      levels of mutant receptors develop as mature B cells. These findings support the
      view that the truncated BCR has a constitutive activity that mimics ligand
      binding, in analogy to what has been shown for oncogenic growth factor receptors.

PMID- 11207260
TI  - Involvement of CD1 in peripheral deletion of T lymphocytes is independent of NK T
      cells.
AB  - During peripheral T cell deletion, lymphocytes accumulate in nonlymphoid organs
      including the liver, a tissue that expresses the nonclassical, MHC-like molecule,
      CD1. Injection of anti-CD3 Ab results in T cell activation, which in normal mice
      is followed by peripheral T cell deletion. However, in CD1-deficient mice, the
      deletion of the activated T cells from the lymph nodes was impaired. This defect
      in peripheral T cell deletion was accompanied by attenuated accumulation of
      CD8(+) T cells in the liver. In tetra-parental bone marrow chimeras, expression
      of CD1 on the T cells themselves was not required for T cell deletion, suggesting
      a role for CD1 on other cells with which the T cells interact. We tested whether
      this role was dependent on the Ag receptor-invariant, CD1-reactive subset of NK T
      cells using two other mutant mouse lines that lack most NK T cells, due to
      deletion of the genes encoding either beta(2)-microglobulin or the TCR element J
      alpha 281. However, these mice had no abnormality of peripheral T cell deletion.
      These findings indicate a novel role for CD1 in T cell deletion, and show that
      CD1 functions in this process through mechanisms that does not involve the major,
      TCR-invariant set of NK T cells.

PMID- 11207261
TI  - Src homology 2 domain-containing protein-tyrosine phosphatases, SHP-1 and SHP-2,
      are required for platelet endothelial cell adhesion molecule-1/CD31-mediated
      inhibitory signaling.
AB  - Platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) is a newly assigned
      member of the Ig immunoreceptor tyrosine-based inhibitory motif superfamily, and
      its functional role is suggested to be an inhibitory receptor that modulates
      immunoreceptor tyrosine-based activation motif-dependent signaling cascades. To
      test whether PECAM-1 is capable of delivering inhibitory signals in B cells and
      the functional requirement of protein-tyrosine phosphatases (PTPs) for this
      inhibitory signaling, we generated chimeric Fc gamma RIIB1-PECAM-1 receptors
      containing the extracellular and transmembrane portions of murine Fc gamma RIIB1
      and the cytoplasmic domain of human PECAM-1. These chimeric receptors were stably
      expressed in chicken DT40 B cells either as wild-type or mutant cells deficient
      in SHP-1(-/-), SHP-2(-/-), SHIP(-/-), or SHP-1/2(-/-) and then assessed for their
      ability to inhibit B cell Ag receptor (BCR) signaling. Coligation of wild-type Fc
      gamma RIIB1-PECAM-1 with BCR resulted in inhibition of intracellular calcium
      release, suggesting that the cytoplasmic domain of PECAM-1 is capable of
      delivering an inhibitory signal that blocks BCR-mediated activation. This PECAM-1
      mediated inhibitory signaling correlated with tyrosine phosphorylation of the Fc
      gamma RIIB1-PECAM-1 chimera, recruitment of SHP-1 and SHP-2 PTPs by the
      phosphorylated chimera, and attenuation of calcium mobilization responses.
      Mutational analysis of the two tyrosine residues, 663 and 686, constituting the
      immunoreceptor tyrosine-based inhibitory motifs in PECAM-1 revealed that both
      tyrosine residues play a crucial role in the inhibitory signal. Functional
      analysis of various PTP-deficient DT40 B cell lines stably expressing wild-type
      chimeric Fc gamma RIIB1-PECAM-1 receptor indicated that cytoplasmic Src homology
      2-domain-containing phosphatases, SHP-1 and SHP-2, were both necessary and
      sufficient to deliver inhibitory negative regulation upon coligation of BCR
      complex with inhibitory receptor.

PMID- 11207262
TI  - Functional expression of a costimulatory B7.2 (CD86) protein on human salivary
      gland epithelial cells that interacts with the CD28 receptor, but has reduced
      binding to CTLA4.
AB  - B7 molecules expressed on classic APC play a critical role in the regulation of
      immune responses by providing activation or inhibitory signals to T cells,
      through the ligation with CD28 or CTLA4 receptors, respectively. We have recently
      described the expression of B7 molecules by the salivary gland epithelial cells
      (SGEC) of patients with Sjogren's syndrome (also termed autoimmune epithelitis).
      The role of such expression needs to be clarified. Thus, in the present study, we
      sought to address the existence and function of B7.2 proteins on cultured
      nonneoplastic SGEC lines derived from Sjogren's syndrome patients. The occurrence
      of B7.2 proteins on SGEC was verified by flow cytometry, immunocytochemistry,
      immunoprecipitation, and immunoblotting. The assessment of several cell lines in
      costimulation assays had revealed that the constitutive expression of B7.2
      molecules is sufficient to provide costimulatory signals to anti-CD3-stimulated T
      cells. SGEC-derived costimulation induced IL-2-dependent proliferation of CD4(+)
      T cells, which was associated with low production of IL-2, but probably also with
      the secretion of yet undefined autocrine T cell growth factor(s). B7.2 proteins
      expressed by SGEC were found to display distinctive binding properties denoted by
      the functional interaction with CD28 receptor and reduced binding to CTLA4.
      Finally, the detection of a functional soluble form of B7.2 protein in cell-free
      culture supernatants of both SGEC and EBV-transformed B cell lines is
      demonstrated. These findings imply a critical role for epithelial cells in the
      regulation of local immune responses in the salivary glands.

PMID- 11207263
TI  - Oral tolerance revisited: prior oral tolerization abrogates cholera toxin-induced
      mucosal IgA responses.
AB  - Oral delivery of a large dose or prolonged feeding of protein Ags induce systemic
      unresponsiveness most often characterized as reduced IgG and IgE Ab- and Ag
      specific CD4(+) T cell responses. It remains controversial whether oral tolerance
      extends to diminished mucosal IgA responses in the gastrointestinal tract. To
      address this issue, mice were given a high oral dose of OVA or PBS and then
      orally immunized with OVA and cholera toxin as mucosal adjuvant, and both
      systemic and mucosal immune responses were assessed. OVA-specific serum IgG and
      IgA and mucosal IgA Ab levels were markedly reduced in mice given OVA orally
      compared with mice fed PBS. Furthermore, when OVA-specific Ab-forming cells
      (AFCs) in both systemic and mucosa-associated tissues were examined, IgG AFCs in
      the spleen and IgA AFCs in the gastrointestinal tract lamina propria of mice
      given OVA orally were dramatically decreased. Furthermore, marked reductions in
      OVA-specific CD4(+) T cell proliferative and cytokine responses in spleen and
      Peyer's patches were seen in mice given oral OVA but were unaffected in PBS-fed
      mice. We conclude that high oral doses of protein induce both mucosal and
      systemic unresponsiveness and that use of mucosal adjuvants that induce both
      parenteral and mucosal immunity may be a better way to assess oral tolerance.

PMID- 11207264
TI  - Antigen receptor proximal signaling in splenic B-2 cell subsets.
AB  - Splenic marginal zone (MZ) and follicular mantle (FO) B cells differ in their
      responses to stimuli in vitro and in vivo. We have previously shown that MZ cells
      exhibit greater calcium responses after ligation of membrane IgM (mIgM). We have
      now investigated the molecular mechanism underlying the difference in calcium
      responses following ligation of mIgM and studied the response to total B cell
      receptor ligation in these two subsets. We compared key cellular proteins
      involved in calcium signaling in MZ and FO cells. Tyrosine phosphorylation and
      activity of phospholipase C-gamma 2 and Syk protein tyrosine kinase were
      significantly higher in MZ cells than in FO cells after mIgM engagement,
      providing a likely explanation for our previous findings. Tyrosine
      phosphorylation of CD22 and expression of Src homology 2-containing inositol
      phosphatase and Src homology 2-containing protein tyrosine phosphatase-1 were
      also higher in the MZ cells. Expression and tyrosine phosphorylation of Btk,
      BLNK, Vav, or phosphatidylinositol 3-kinase were equivalent. In contrast,
      stimulation with anti-kappa induced equivalent increases in calcium and
      activation of Syk in the two subsets. These signals were also equivalent in cells
      from IgM transgenic, J(H) knockout mice, which have equivalent levels of IgM in
      both subsets. With total spleen B cells, Btk was maximally phosphorylated at a
      lower concentration of anti-kappa than Syk. Thus, calcium signaling in the
      subsets of mature B cells reflects the amount of Ig ligated more than the isotype
      or the subset and this correlates with the relative tyrosine phosphorylation of
      Syk.

PMID- 11207265
TI  - Proteasomes modulate balance among proapoptotic and antiapoptotic Bcl-2 family
      members and compromise functioning of the electron transport chain in leukemic
      cells.
AB  - The mechanism underlying apoptosis induced by proteasome inhibition in leukemic
      Jurkat and Namalwa cells was investigated in this study. The proteasome inhibitor
      lactacystin differentially regulated the protein levels of proapoptotic Bcl-2
      family members and Bik was accumulated at the mitochondria. Bik overexpression
      sufficed to induce apoptosis in these cells. Detailed examination along the
      respiration chain showed that lactacystin compromised a step after complex III,
      and exogenous cytochrome c could overcome this compromise. Probably as a result,
      the succinate-stimulated generation of mitochondrial membrane potential was
      significantly diminished. Bcl-x(L) interacted with Bik in the cells, and Bcl-x(L)
      overexpression prevented cytochrome c leakage out of the mitochondria, corrected
      the mitochondrial membrane potential defect, and protected the cells from
      apoptosis. These results show that proteasomes can modulate apoptosis of
      lymphocytes by affecting the half-life of Bcl-2 family members, Bik being one of
      them.

PMID- 11207266
TI  - Regulation and function of T1/ST2 expression on CD4+ T cells: induction of type 2
      cytokine production by T1/ST2 cross-linking.
AB  - The orphan receptor T1/ST2, a member of the IL-1R family, is preferentially
      expressed on the surface of murine Th2 cells. In this study, we analyzed the
      kinetics and function of T1/ST2 expression on Th2 cells in vitro. Whereas naive
      CD4(+) cells did not express T1/ST2, most CD4(+) cells became T1/ST2(+) upon
      repeated antigenic stimulation under Th2-polarizing conditions. Flow cytometric
      analyses revealed that the kinetics of T1/ST2 expression on Th2 cells was delayed
      compared with the kinetics of type 2 cytokine production. Exogenous IL-6, IL-5,
      IL-1, and TNF-alpha enhanced the expression of T1/ST2 on Th2 cells, and IL-6 was
      by far most effective in this regard. However, the expression of T1/ST2 did not
      depend on the presence of IL-6 and was also detected in IL-6-deficient mice. Most
      important, cross-linking of T1/ST2 provided a costimulatory signal for Th2 but
      not Th1 cells and directly induced proliferation and type 2 cytokine production.
      Thus, T1/ST2 is not only a Th2 cell marker but also plays an important role in
      the activation of Th2 cells.

PMID- 11207267
TI  - Single-cell analyses reveal two defects in peptide-specific activation of naive T
      cells from aged mice.
AB  - Confocal fluorescent microscopy was used to study redistribution of membrane
      associated proteins in naive T cells from young and old mice from a transgenic
      stock whose T cells express a TCR specific for a peptide derived from pigeon
      cytochrome C. About 50% of the T cells from young mice that formed conjugates
      with peptide-pulsed APC were found to form complexes, at the site of binding to
      the APC, containing CD3epsilon, linker for activation of T cells (LAT), and Zap
      70 in a central area and c-Cbl, p95(vav), Grb-2, PLC gamma, Fyn, and Lck
      distributed more uniformly across the interface area. Two-color staining showed
      that those cells that were able to relocalize c-Cbl, LAT, CD3epsilon, or PLC
      gamma typically relocalized all four of these components of the activation
      complex. About 75% of conjugates that rearranged LAT, c-Cbl, or PLC gamma also
      exhibited cytoplasmic NF-AT migration to the T cell nucleus. Aging had two
      effects. First, it led to a diminution of approximately 2-fold in the proportion
      of T cell/APC conjugates that could relocalize any of the nine tested proteins to
      the immune synapse. Second, aging diminished by approximately 2-fold the
      frequency of cytoplasmic NF-AT migration among cells that could generate immune
      synapses containing LAT, c-Cbl, or PLC gamma. Thus naive CD4 T cells from old
      mice exhibit at least two separable defects in the earliest stages of activation
      induced by peptide/MHC complexes.

PMID- 11207268
TI  - The identification and characterization of a ligand for bovine CD5.
AB  - CD5, a type I glycoprotein expressed by T cells and a subset of B cells, is
      thought to play a significant role in modulating Ag receptor signaling.
      Previously, our laboratory has shown that bovine B cells are induced to express
      this key regulatory molecule upon Ag receptor cross-linking. To date, a ligand
      has not been described for bovine CD5. Given the importance ligand binding
      presumably plays in the functioning of CD5 on this B cell subset and on T cells,
      we sought to characterize the ligand for this protein using a bovine CD5-human
      IgG1 (CD5Ig) fusion protein produced by both mammalian and yeast cells. As
      determined by CD5Ig binding, expression of this ligand is negative to low on
      freshly isolated lymphocytes, with low-density expression being limited to
      activated B cells. Activation with LPS, PMA, and calcium ionophore, or ligation
      of CD40 alone or in combination with anti-IgM, resulted in B cell-specific
      expression of this ligand. Interestingly, activation through B cell Ag receptor
      cross-linking alone, although able to induce CD5 expression, did not result in
      expression of CD5 ligand (CD5L). In addition, we demonstrate a functional role
      for CD5L as a costimulatory molecule that augments CD40L-stimulated B cell
      proliferation. Finally, immunoprecipitation with CD5Ig suggests that the ligand
      characterized in this study has a molecular mass of approximately 200 kDa. The
      data reported herein, as well as future studies aimed at further characterizing
      this newly identified bovine CD5L, will undoubtedly aid in understanding the role
      that the CD5-CD5L interaction plays in immune responses.

PMID- 11207269
TI  - Activation of the EBV/C3d receptor (CR2, CD21) on human B lymphocyte surface
      triggers tyrosine phosphorylation of the 95-kDa nucleolin and its interaction
      with phosphatidylinositol 3 kinase.
AB  - We previously demonstrated that CR2 activation on human B lymphocyte surface
      triggered tyrosine phosphorylation of a p95 component and its interaction with
      p85 subunit of phosphatidylinositol 3' (PI 3) kinase. Despite identical molecular
      mass of 95 kDa, this tyrosine phosphorylated p95 molecule was not CD19, the proto
      oncogene Vav, or the adaptator Gab1. To identify this tyrosine phosphorylated p95
      component, we first purified it by affinity chromatography on anti
      phosphotyrosine mAb covalently linked to Sepharose 4B, followed by polyacrylamide
      gel electrophoresis. Then, the isolated 95-kDa tyrosine phosphorylated band was
      submitted to amino acid analysis by mass spectrometry; the two different isolated
      peptides were characterized by amino acid sequences 100% identical with two
      different domains of nucleolin, localized between aa 411--420 and 611--624. Anti
      nucleolin mAb was used to confirm the antigenic properties of this p95 component.
      Functional studies demonstrated that CR2 activation induced, within a brief span
      of 2 min, tyrosine phosphorylation of nucleolin and its interaction with Src
      homology 2 domains of the p85 subunit of PI 3 kinase and of 3BP2 and Grb2, but
      not with Src homology 2 domains of Fyn and Gap. These properties of nucleolin
      were identical with those of the p95 previously described and induced by CR2
      activation. Furthermore, tyrosine phosphorylation of nucleolin was also induced
      in normal B lymphocytes by CR2 activation but neither by CD19 nor BCR activation.
      These data support that tyrosine phosphorylation of nucleolin and its interaction
      with PI 3 kinase p85 subunit constitute one of the earlier steps in the specific
      intracellular signaling pathway of CR2.

PMID- 11207270
TI  - Ligation of 4-1BB (CDw137) regulates graft-versus-host disease, graft-versus
      leukemia, and graft rejection in allogeneic bone marrow transplant recipients.
AB  - 4-1BB is expressed on activated CD4(+) and CD8(+) T cells; its ligand, 4-1BB
      ligand is expressed on APCs. Despite expression on both T cell subpopulations, 4
      1BB has been reported to predominantly affect CD8(+) T cell responses. By
      quantifying graft-vs-host disease alloresponses in vivo, we demonstrate that both
      CD4(+) and CD8(+) T cell-mediated alloresponses are regulated by 4-1BB/4-1BB
      ligand interactions to approximately the same extent. 4-1BB receptor-facilitated
      CD4(+) T cell-mediated alloresponses were partly CD28 independent. In two
      distinct marrow graft rejection systems, host CD8(+) and CD4(+) T cells each
      separately contributed to host anti-donor T cell-mediated allograft rejection.
      alpha 4-1BB mAb increased the graft-vs-leukemia effect of a suboptimal number of
      donor splenocytes given later post bone marrow transplantation by bolstering
      allogeneic responses resulting in leukemia elimination. In summary, 4-1BB
      ligation is a potent regulator of CD4(+) and CD8(+) T cell-mediated allogeneic
      responses in vivo. Modifying the ligation of 4-1BB represents a new approach to
      altering the graft-vs-host disease and graft-vs-leukemia effects of allogeneic T
      cells post bone marrow transplantation.

PMID- 11207272
TI  - Anergy and not clonal ignorance determines the fate of B cells that recognize a
      physiological autoantigen.
AB  - Autoantibodies to insulin arise spontaneously in the insulin autoimmune syndrome
      and in type I diabetes. In addition, administration of insulin to individuals
      without autoimmune disease routinely results in Abs that bind autologous hormone.
      These observations and findings in transgenic models of tolerance led to an
      inference that physiological levels of hormones and growth factors, such as
      insulin, are not sufficient to induce tolerance in B cells, a state termed clonal
      ignorance. In contrast, we have discovered that virtually all conventional B
      cells expressing a low affinity anti-insulin transgene interact with endogenous
      insulin and are effectively silenced for Ig production and for T cell-dependent
      immune responses. A fraction of transgenic B cells escapes silencing and
      functions autonomously to produce insulin Abs that may lower fasting blood sugars
      similar to an insulin autoimmune syndrome. These B cells have characteristics of
      a B1-like subset and are depleted by hypotonic peritoneal lysis. These findings
      question the concept of clonal ignorance and show that physiological
      concentrations of Ag may effectively silence conventional B cells even when the
      affinity for autoantigen is low. Self-reactivity may arise in the repertoire
      because of compartmental differences that govern the fate of B cells and not as a
      result of true clonal ignorance.

PMID- 11207271
TI  - Premature TCR alpha beta expression and signaling in early thymocytes impair
      thymocyte expansion and partially block their development.
AB  - In thymocyte ontogeny, Tcr-a genes rearrange after Tcr-b genes. TCR alpha beta
      transgenic (Tg) mice have no such delay, consequently expressing rearranged TCR
      alpha beta proteins early in the ontogeny. Such mice exhibit reduced thymic
      cellularity and accumulate mature, nonprecursor TCR(+)CD8(-)4(-) thymocytes,
      believed to be caused by premature Tg TCR alpha beta expression via unknown
      mechanism(s). Here, we show that premature expression of TCR alpha beta on early
      thymocytes curtails thymocyte expansion and impairs the CD8(-)4(-) --> CD8(+)4(+)
      transition. This effect is accomplished by two distinct mechanisms. First, the
      early formation of TCR alpha beta appears to impair the formation and function of
      pre-TCR, consistent with recently published results. Second, the premature TCR
      alpha beta contact with intrathymic MHC molecules further pronounces the block in
      proliferation and differentiation. These results suggest that the benefit of
      asynchronous Tcr-a and Tcr-b rearrangement is not only to minimize waste during
      thymopoiesis, but also to simultaneously allow proper expression/function of the
      pre-TCR and to shield CD8(-)4(-) thymocytes from TCR alpha beta signals that
      impair thymocyte proliferation and CD8(-)4(-) --> CD8(+)4(+) transition.

PMID- 11207273
TI  - Uncoupling p70(s6) kinase activation and proliferation: rapamycin-resistant
      proliferation of human CD8(+) T lymphocytes.
AB  - Rapamycin is a fungal macrolide that inhibits the proliferation of T cells.
      Studies in both animals and humans have found that rapamycin significantly
      reduces graft rejection. However, though CD8(+) T cells are involved in graft
      infiltration and rejection, little is known regarding the effects of rapamycin on
      CD8(+) human T cell responses. In this study, we examined the mechanism of
      rapamycin-induced inhibition of Ag-driven activation of CD8(+) T cells.
      Surprisingly, a heterogeneous proliferative response in the presence of rapamycin
      was observed among different Ag-specific CD8(+) T cell clones; this was also
      observed in CD8(+) peripheral blood T cells activated with TCR cross-linking ex
      vivo. Inhibition of T cell proliferation by rapamycin was controlled by both the
      strength of signal delivered through the Ag receptor as well as the specific
      costimulatory signals received by the T cell. Rapamycin-resistant proliferation
      occurred despite inhibition of p70(s6) kinase activity. Moreover, rapamycin
      resistant proliferation of the CD8(+) T cell clones was blocked by anti-IL-2 Abs,
      suggesting that while some of the parallel pathways triggered by IL-2R signaling
      are sensitive to the effects of rapamycin, others account for the Ag-driven
      rapamycin resistance. These data provide a new framework for examining the
      specific mechanism of action of rapamycin in human disease.

PMID- 11207274
TI  - In vivo CD40-CD154 (CD40 ligand) interaction induces integrated HIV expression by
      APC in an HIV-1-transgenic mouse model.
AB  - Because of their relative resistance to viral cytopathic effects, APC can provide
      an alternative reservoir for latently integrated HIV. We used an HIV-transgenic
      mouse model in which APC serve as the major source of inducible HIV expression to
      study mechanisms by which integrated virus can be activated in these cells. When
      admixed with transgenic APC, activated T lymphocytes provided a major contact
      dependent stimulus for viral protein expression in vitro. Using blocking anti
      CD154 mAb as well as CD154-deficient T cells, the HIV response induced by
      activated T lymphocytes was demonstrated to require CD40-CD154 interaction. The
      role of this pathway in the induction of HIV expression from APC in vivo was
      further studied in an experimental model involving infection of the HIV
      transgenic mice with PLASMODIUM: chabaudi parasites. Enhanced viral production by
      dendritic cells and macrophages in infected mice was associated with up-regulated
      CD40 expression. More importantly, in vivo treatment with blocking anti-CD154 mAb
      markedly reduced viral expression in P. chabaudi-infected animals. Together,
      these findings indicate that immune activation of integrated HIV can be driven by
      the costimulatory interaction of activated T cells with APC. Because chronic T
      cell activation driven by coinfections as well as HIV-1 itself is a
      characteristic of HIV disease, this pathway may be important in sustaining viral
      expression from APC reservoirs.

PMID- 11207275
TI  - The granzyme B inhibitor, protease inhibitor 9, is mainly expressed by dendritic
      cells and at immune-privileged sites.
AB  - Granzyme B is released from CTLs and NK cells and an important mediator of CTL/NK
      induced apoptosis in target cells. The human intracellular serpin proteinase
      inhibitor (PI)9 is the only human protein able to inhibit the activity of
      granzyme B. As a first step to elucidate the physiological role of PI9, PI9
      protein expression in various human tissues was studied. A mAb directed against
      human PI9 was developed, which specifically stained PI9-transfected COS-7 cells,
      and was used for immunohistochemistry. Both in primary lymphoid organs and in
      inflammatory infiltrates, PI9 was present in different subsets of dendritic
      cells. Also T-lymphocytes in primary and organ-associated lymphoid tissues were
      PI9 positive. Endothelial cells of small vessels in most organs tested as well as
      the endothelial layer of large veins and arteries showed strong PI9 staining.
      Surprisingly, high PI9 protein expression was also found at immune-privileged
      sites like the placenta, the testis, the ovary, and the eye. These data fit with
      the hypothesis that PI9 is expressed at sites where degranulation of CTL or NK
      cells is potentially deleterious.

PMID- 11207276
TI  - The T cell-dependent B cell immune response and germinal center reaction are
      intact in A-myb-deficient mice.
AB  - Expression of the protooncogene A-myb is restricted to the developing CNS, adult
      testes, breasts in late pregnancy, and germinal centers of secondary B cell
      follicles. The functional relevance of A-myb expression at three of these sites
      has been demonstrated previously via the generation and analysis of A-myb
      deficient mice, which display behavioral abnormalities, male sterility, and
      perturbed breast development during pregnancy. In contrast, here we show that the
      germinal center response driven by T cell-dependent Ag immunization and the
      associated processes of Ab V gene somatic hypermutation, affinity maturation, and
      heavy chain class switching are overtly normal in A-myb-deficient mice.
      Nonetheless, these mice display mild splenic white pulp hypoplasia and blunted
      primary serum Ab responses, suggesting that although A-myb is not directly
      involved in the regulation of the memory B cell response, it may play a role in
      enhancing peripheral B cell survival or proliferative capacity.

PMID- 11207277
TI  - The globular heads of C1q specifically recognize surface blebs of apoptotic
      vascular endothelial cells.
AB  - Complement protein C1q is required to maintain immune tolerance. The molecular
      mechanism responsible for this link has not been determined. We have previously
      demonstrated that C1q binds directly and specifically to surface blebs of
      apoptotic human keratinocytes, suggesting that it may participate in clearance of
      self Ags generated during programmed cell death. Here, we demonstrate that C1q
      also binds directly to apoptotic blebs of vascular endothelial cells and PBMC.
      These apoptotic cells are recognized by the globular heads of C1q, which bind
      specifically to the surface blebs, and deposition increases as the blebs mature
      on the cell surface. These observations suggest that C1q may participate in the
      clearance of apoptotic cells from the circulation and from the walls of the
      vascular lumen. The interaction of surface blebs with the globular heads of C1q
      suggests that surface blebs may be capable of directly activating the classical
      pathway of complement under certain circumstances, generating C4- and C3-derived
      ligands for receptors such as CR1, CR2, CR3, and CR4. Appropriate recognition of
      apoptotic cells by C1q and targeted clearance of the molecular contents of
      surface blebs to complement receptors may be critical for the maintenance of
      immune tolerance.

PMID- 11207278
TI  - CD95 ligand-expressing tumors are rejected in anti-tumor TCR transgenic perforin
      knockout mice.
AB  - CD95 (APO-/Fas) ligand (CD95L) is a member of the TNF family predominantly
      expressed by activated T and NK cells but also by tumors of diverse cellular
      origin. CD95L trimerizes surface CD95 expressed by target cells that subsequently
      undergo apoptosis. The role of the CD95/CD95L system in the down-regulation of an
      immune response (activation-induced cell death) is established. However, it is so
      far unclear why tumors express CD95L. To investigate whether tumors use the CD95L
      to down-regulate an anti-tumor immune response, we established a transgenic (tg)
      mouse model consisting of 1) apoptosis-resistant tumor cells, designated LKC
      CD95L, which express functional CD95L and the model tumor Ag K(b); and 2)
      perforin knockout (PKO) anti-K(b) TCR tg mice. L1210-Fas antisense expressing
      K(b), crmA, and CD95L (LKC-CD95L) killed CD95(+) unrelated tumor targets and Con
      A-activated splenocytes from anti-K(b) TCR tg PKO mice by a CD95L-dependent
      mechanism in vitro. However, we could not detect any cytotoxic activity against
      anti-tumor (anti-K(b)) T cells in vivo. We also observed reduced growth of LKC
      CD95L in nude mice and rapid rejection in anti-K(b) TCR tg PKO mice. Because the
      tumor cells are resistant to CD95L-, TNF-alpha-, and TNF-related apoptosis
      inducing ligand-induced apoptosis and the mice used are perforin-deficient, the
      involvement of these four cytotoxicity mechanisms in tumor rejection can be
      excluded. The histological examination of tumors grown in nude mice showed
      infiltration of LKC-CD95L tumors by neutrophils, whereas L1210-Fas antisense
      expressing K(b) and crmA (LKC) tumor tissue was neutrophil-free. Chemotaxis
      experiments revealed that CD95L has no direct neutrophil-attractive activity.
      Therefore, we conclude that LKC-CD95L cells used an indirect mechanism to attract
      neutrophils that may cause tumor rejection.

PMID- 11207279
TI  - Immunobiology of allograft rejection in the absence of IFN-gamma: CD8+ effector
      cells develop independently of CD4+ cells and CD40-CD40 ligand interactions.
AB  - Both wild-type (WT) and IFN-gamma-deficient (IFN-gamma(-/-)) C57BL/6 mice can
      rapidly reject BALB/c cardiac allografts. When depleted of CD8(+) cells, both WT
      and IFN-gamma(-/-) mice rejected their allografts, indicating that these mice
      share a common CD4-mediated, CD8-independent mechanism of rejection. However,
      when depleted of CD4(+) cells, WT mice accepted their allografts, while IFN
      gamma(-/-) recipients rapidly rejected them. Hence, IFN-gamma(-/-), but not WT
      mice developed an unusual CD8-mediated, CD4-independent, mechanism of allograft
      rejection. Allograft rejection in IFN-gamma(-/-) mice was associated with
      intragraft accumulation of IL-4-producing cells, polymorphonuclear leukocytes,
      and eosinophils. Furthermore, this form of rejection was resistant to treatment
      with anti-CD40 ligand (CD40L) mAb, which markedly prolonged graft survival in WT
      mice. T cell depletion studies verified that anti-CD40L treatment failed to
      prevent CD8-mediated allograft rejection in IFN-gamma(-/-) mice. However, anti
      CD40L treatment did prevent CD4-mediated rejection in IFN-gamma(-/-) mice,
      although grafts were eventually rejected when CD8(+) T cells repopulated the
      periphery. The IL-4 production and eosinophil influx into the graft that occurred
      during CD8-mediated rejection were apparently epiphenomenal, since treatment with
      anti-IL-4 mAb blocked intragraft accumulation of eosinophils, but did not
      interfere with allograft rejection. These studies demonstrate that a novel, CD8
      mediated mechanism of allograft rejection, which is resistant to experimental
      immunosuppression, can develop when IFN-gamma is limiting. An understanding of
      this mechanism is confounded by its association with Th2-like immune events,
      which contribute unique histopathologic features to the graft but are apparently
      unnecessary for the process of allograft rejection.

PMID- 11207280
TI  - Functional association of CD9 with the Fc gamma receptors in macrophages.
AB  - CD9, a member of the tetraspan family of proteins, is highly expressed on
      macrophages. Although a clear function for the molecule has yet to be described,
      we have found that the anti-CD9 mAb activates mouse macrophages. The rat anti-CD9
      mAb, KMC8.8, but not the F(ab')(2), induced tyrosine phosphorylation of proteins
      including syk and cbl and induced cell aggregation in the mouse macrophage cell
      line, J774, suggesting that co-cross-linking of CD9 and Fc gamma R was required
      for the signal. Co-cross-linking of CD9-Fc gamma R with KMC8.8 on macrophages
      from three different FcR-deficient mice, FcR gamma-chain(-/-), Fc gamma RIIB(-/
      ), and Fc gamma RIII(-/-), revealed that Fc gamma RIII is specific and crucial
      for syk phosphorylation. Although both KMC8.8 and the anti-Fc gamma RIIB/III mAb,
      2.4G2, evoked similar phosphorylation patterns, only KMC8.8 induced cell
      aggregation. Additionally, KMC8.8 treatment led to reduce levels of TNF-alpha
      production and p42/44 extracellular signal-related kinase phosphorylation
      relative to 2.4G2 stimulation. Immunofluorescence staining showed that co-cross
      linking of CD9-Fc gamma R with KMC8.8 induced filopodium extension before cell
      aggregation, which was followed by simultaneous colocalization of CD9, Fc gamma
      RIIB/III, Mac-1, ICAM-1, and F-actin at the cell-cell adhesion site. Moreover,
      KMC8.8 treatment of Fc gamma R-deficient macrophages revealed that the
      colocalization of CD9, Fc gamma RIII, Mac-1, and F-actin requires co-cross
      linking of CD9-Fc gamma RIII, whereas co-cross-linking of CD9-Fc gamma RIIB
      induced the colocalization of only CD9 and Fc gamma RIIB. Our results demonstrate
      that co-cross-linking of CD9 and Fc gamma Rs activates macrophages; therefore,
      CD9 may collaborate with FcRs functioning in infection and inflammation on
      macrophages.

PMID- 11207282
TI  - Notch signaling suppresses IgH gene expression in chicken B cells: implication in
      spatially restricted expression of Serrate2/Notch1 in the bursa of Fabricius.
AB  - The bursa of Fabricius is a central organ for chicken B cell development and
      provides an essential microenvironment for expansion of the B cell pool and for
      generation of a diversified B cell repertoire. We report here that genes encoding
      the Notch family of transmembrane proteins, key regulators of cell fate
      determination in development, are differentially expressed in the bursa of
      Fabricius: Notch1 is expressed in medullary B cells located close to the basement
      membrane-associated epithelium (BMAE). In contrast, a Notch ligand, Serrate2, is
      expressed exclusively in the BMAE, which surrounds bursal medulla. A basic helix
      loop-helix-type transcription factor, Hairy1, a downstream target of Notch
      signaling, is expressed in the bursa coordinately with Notch1 and Serrate2 and an
      immature B cell line, TLT1, which expresses both Notch1 and Serrate2.
      Furthermore, stable expression of a constitutively active form of chicken Notch1
      or Notch2 in a B cell line results in a down-regulation of surface IgM
      expression, which is accompanied by the reduction of IgH gene transcripts.
      Transient reporter assay with the human IgH gene intronic enhancer reveals that
      an active form of Notch1 inhibits the IgH enhancer activity in chicken B cells,
      suggesting that Notch-mediated signals suppress the IgH gene expression via
      influencing the IgH intronic enhancer. These findings raise the possibility that
      the local activation of Notch1 in a subset of B cells by Serrate2 expressed in
      BMAE may influence the cell fate decision that is involved in B cell
      differentiation and selection inside the bursa.

PMID- 11207283
TI  - The dendritic cell-specific CC-chemokine DC-CK1 is expressed by germinal center
      dendritic cells and attracts CD38-negative mantle zone B lymphocytes.
AB  - DC-CK1 (CCL18) is a dendritic cell (DC)-specific chemokine expressed in both T
      and B cell areas of secondary lymphoid organs that preferentially attracts
      CD45RA(+) T cells. In this study, we further explored the nature of DC-CK1
      expressing cells in germinal centers (GCs) of secondary lymphoid organs using a
      newly developed anti-DC-CK1 mAb. Immunohistochemical analysis demonstrated a
      remarkable difference in the number of DC-CK1 expressing cells in adjacent GCs
      within one tonsil, implicating that the expression of DC-CK1 in GCs depends on
      the activation and/or progression stage of the GC reaction. Using immunohistology
      and RNA analysis, we demonstrated that GCDC are the source of DC-CK1 production
      in the GCs. Considering the recently described function of GCDC in (naive) B cell
      proliferation, isotype switching and Ab production, we investigated the ability
      of DC-CK1 to attract B lymphocytes. Here we demonstrate that DC-CK1 is a
      pertussis toxin-dependent chemoattractant for B lymphocytes with a preference in
      attracting mantle zone (CD38(-)) B cells. The findings that GCDC produce DC-CK1
      and attract mantle zone B cells support a key role for GCDC in the development of
      GCs and memory B cell formation.

PMID- 11207281
TI  - MHC class I-related neonatal Fc receptor for IgG is functionally expressed in
      monocytes, intestinal macrophages, and dendritic cells.
AB  - The neonatal Fc receptor (FcRn) for IgG, an MHC class I-related molecule,
      functions to transport IgG across polarized epithelial cells and protect IgG from
      degradation. However, little is known about whether FcRn is functionally
      expressed in immune cells. We show here that FcRn mRNA was identifiable in human
      monocytes, macrophages, and dendritic cells. FcRn heavy chain was detectable as a
      45-kDa protein in monocytic U937 and THP-1 cells and in purified human intestinal
      macrophages, peripheral blood monocytes, and dendritic cells by Western blot
      analysis. FcRn colocalized in vivo with macrosialin (CD68) and Ncl-Macro, two
      macrophage markers, in the lamina propria of human small intestine. The heavy
      chain of FcRn was associated with the beta(2)-microglobulin (beta(2)m) light
      chain in U937 and THP-1 cells. FcRn bound human IgG at pH 6.0, but not at pH 7.5.
      This binding could be inhibited by human IgG Fc, but not Fab. FcRn could be
      detected on the cell surface of activated, but not resting, THP-1 cells.
      Furthermore, FcRn was uniformly present intracellularly in all blood monocytes
      and intestinal macrophages. FcRn was detectable on the cell surface of a
      significant fraction of monocytes at lower levels and on a small subset of tissue
      macrophages that expressed high levels of FcRn on the cell surface. These data
      show that FcRn is functionally expressed and its cellular distribution is
      regulated in monocytes, macrophages, and dendritic cells, suggesting that it may
      confer novel IgG binding functions upon these cell types relative to typical Fc
      gamma Rs: Fc gamma RI, Fc gamma RII, and Fc gamma RIII.

PMID- 11207284
TI  - Immature multipotent hemopoietic progenitors lacking long-term bone marrow
      reconstituting activity in the aorta-gonad-mesonephros region of murine day 10
      fetuses.
AB  - Previous studies indicated that multipotent progenitors exist in early fetuses
      that do not contain long-term reconstituting (LTR) activity. However, it remained
      unclear whether these multipotent progenitors are committed to the hemopoietic
      lineage or are immature mesodermal cells or hemangioblasts. In this study, we
      have succeeded in enriching the multipotent progenitors that are capable of
      generating myeloid, T, and B cells in the LFA-1(-) subpopulation of TER-119(-)c
      kit(+)CD45(+) cells from the aorta-gonad-mesonephros (AGM) region of day 10
      fetuses. We found that these day 10 AGM LFA-1(-) cells do not show the LTR
      activity, whereas day 11 AGM LFA-1(-) cells do have such an activity. These
      results strongly suggest that multipotent progenitors lacking LTR activity emerge
      as CD45(+) hemopoietic progenitor cells in the AGM region on the 10th day of
      gestation, and such p-Multi mature into hemopoietic stem cells by acquiring LTR
      activity.

PMID- 11207285
TI  - Modes of salmonid MHC class I and II evolution differ from the primate paradigm.
AB  - Rainbow trout (Oncorhynchus mykiss) and brown trout (Salmo trutta) represent two
      salmonid genera separated for 15--20 million years. cDNA sequences were
      determined for the classical MHC class I heavy chain gene UBA and the MHC class
      II beta-chain gene DAB from 15 rainbow and 10 brown trout. Both genes are highly
      polymorphic in both species and diploid in expression. The MHC class I alleles
      comprise several highly divergent lineages that are represented in both species
      and predate genera separation. The class II alleles are less divergent, highly
      species specific, and probably arose after genera separation. The striking
      difference in salmonid MHC class I and class II evolution contrasts with the
      situation in primates, where lineages of class II alleles have been sustained
      over longer periods of time relative to class I lineages. The difference may
      arise because salmonid MHC class I and II genes are not linked, whereas in
      mammals they are closely linked. A prevalent mechanism for evolving new MHC class
      I alleles in salmonids is recombination in intron II that shuffles alpha 1 and
      alpha 2 domains into different combinations.

PMID- 11207286
TI  - Association of mouse mammary tumor virus superantigen with MHC class II during
      biosynthesis.
AB  - Mouse mammary tumor viruses encode superantigens that interact with MHC class II
      proteins and stimulate T cells. We show here that presentation of mouse mammary
      tumor virus superantigen does not require DM. Furthermore, we have identified a
      strong class II peptide binding motif in the Mtv-7 superantigen, and we show that
      this motif is necessary for association with class II molecules in in vitro
      translation and in vivo functional assays. Our results suggest that endogenously
      synthesized viral superantigen can bind to MHC class II heterodimers during
      biosynthesis in the endoplasmic reticulum in a manner analogous to that used by
      the class II-associated invariant chain.

PMID- 11207287
TI  - Novel control motif cluster in the IgH delta-gamma 3 interval exhibits B cell
      specific enhancer function in early development.
AB  - The majority of the human Ig heavy chain (IgH) constant (C) region locus has been
      cloned and mapped. An exception is the region between C delta and C gamma 3,
      which is unstable and may be a recombination hot spot. We isolated a pBAC clone
      (pHuIgH3'delta-gamma 3) that established a 52-kb distance between C delta and C
      gamma 3. Sequence analysis identified a high number of repeat elements,
      explaining the instability of the region, and an unusually large accumulation of
      transcription factor-binding motifs, for both lymphocyte-specific and ubiquitous
      transcription activators (IKAROS, E47, Oct-1, USF, Myc/Max), and for factors that
      may repress transcription (Delta EF1, Gfi-1, E4BP4, C/EBP beta). Functional
      analysis in reporter gene assays revealed the importance of the C delta-C gamma 3
      interval in lymphocyte differentiation and identified independent regions capable
      of either enhancement or silencing of reporter gene expression and interaction
      with the IgH intron enhancer E mu. In transgenic mice, carrying a construct that
      links the beta-globin reporter to the novel delta-gamma 3 intron enhancer (E
      delta-gamma 3), transgene transcription is exclusively found in bone marrow B
      cells from the early stage when IgH rearrangement is initiated up to the
      successful completion of H and L locus recombination, resulting in Ab expression.
      These findings suggest that the C delta-C gamma 3 interval exerts regulatory
      control on Ig gene activation and expression during early lymphoid development.

PMID- 11207288
TI  - At least one class I gene in restriction fragment pattern-Y (Rfp-Y), the second
      MHC gene cluster in the chicken, is transcribed, polymorphic, and shows divergent
      specialization in antigen binding region.
AB  - MHC genes in the chicken are arranged into two genetically independent clusters
      located on the same chromosome. These are the classical B: system and restriction
      fragment pattern-Y (Rfp-Y), a second cluster of MHC genes identified recently
      through DNA hybridization. Because small numbers of MHC class I and class II
      genes are present in both B: and Rfp-Y, the two clusters might be the result of
      duplication of an entire chromosomal segment. We subcloned, sequenced, and
      analyzed the expression of two class I loci mapping to Rfp-Y to determine whether
      Rfp-Y should be considered either as a second, classical MHC or as a region
      containing specialized MHC-like genes, such as class Ib genes. The Rfp-Y genes
      are highly similar to each other (93%) and to classical class Ia genes (73% with
      chicken B: class I; 49% with HLA-A). One locus is disrupted and unexpressed. The
      other, YFV, is widely transcribed and polymorphic. Mature YFV protein associated
      with beta(2)m arrives on the surface of chicken B (RP9) lymphoma cells expressing
      YFV as an epitope-tagged transgene. Substitutions in the YFV Ag-binding region
      (ABR) occur at four of the eight highly conserved residues that are essential for
      binding of peptide-Ag in the class Ia molecules. Therefore, it is unlikely that
      Ag is bound in the YFV ABR in the manner typical of class Ia molecules. This ABR
      specialization indicates that even though YFV is polymorphic and widely
      transcribed, it is, in fact, a class Ib gene, and Rfp-Y is a region containing
      MHC genes of specialized function.

PMID- 11207289
TI  - Gorillas with spondyloarthropathies express an MHC class I molecule with only
      limited sequence similarity to HLA-B27 that binds peptides with arginine at P2.
AB  - The human MHC class I gene, HLA-B27, is a strong risk factor for susceptibility
      to a group of disorders termed spondyloarthropathies (SpAs). HLA-B27-transgenic
      rodents develop SpAs, implicating HLA-B27 in the etiology of these disorders.
      Several nonhuman primates, including gorillas, develop signs of SpAs
      indistinguishable from clinical signs of humans with SpAs. To determine whether
      SpAs in gorillas have a similar HLA-B27-related etiology, we analyzed the MHC
      class I molecules expressed in four affected gorillas. Gogo-B01, isolated from
      three of the animals, has only limited similarity to HLA-B27 at the end of the
      alpha1 domain. It differs by several residues in the B pocket, including
      differences at positions 45 and 67. However, the molecular model of Gogo-B*0101
      is consistent with a requirement for positively charged residues at the second
      amino acid of peptides bound by the MHC class I molecule. Indeed, the peptide
      binding motif and sequence of individual ligands eluted from Gogo-B*0101
      demonstrate that, like HLA-B27, this gorilla MHC class I molecule binds peptides
      with arginine at the second amino acid position of peptides bound by the MHC
      class I molecule. Furthermore, live cell binding assays show that Gogo-B*0101 can
      bind HLA-B27 ligands. Therefore, although most gorillas that develop SpAs express
      an MHC class I molecule with striking differences to HLA-B27, this molecule binds
      peptides similar to those bound by HLA-B27.

PMID- 11207290
TI  - Structural and functional consequences of altering a peptide MHC anchor residue.
AB  - To better understand TCR discrimination of multiple ligands, we have analyzed the
      crystal structures of two Hb peptide/I-E(k) complexes that differ by only a
      single amino acid substitution at the P6 anchor position within the peptide
      (E73D). Detailed comparison of multiple independently determined structures at
      1.9 A resolution reveals that removal of a single buried methylene group can
      alter a critical portion of the TCR recognition surface. Significant variance was
      observed in the peptide P5-P8 main chain as well as a rotamer difference at
      LeuP8, approximately 10 A distal from the substitution. No significant variations
      were observed in the conformation of the two MHC class II molecules. The ligand
      alteration results in two peptide/MHC complexes that generate bulk T cell
      responses that are distinct and essentially nonoverlapping. For the Hb-specific T
      cell 3.L2, substitution reduces the potency of the ligand 1000-fold. Soluble 3.L2
      TCR binds the two peptide/MHC complexes with similar affinity, although with
      faster kinetics. These results highlight the role of subtle variations in MHC Ag
      presentation on T cell activation and signaling.

PMID- 11207291
TI  - Early recruitment of neutrophils determines subsequent T1/T2 host responses in a
      murine model of Legionella pneumophila pneumonia.
AB  - The contribution of neutrophils to lethal sensitivity and cytokine balance
      governing T1 and T2 host responses was assessed in a murine model of Legionella
      pneumophila pneumonia. Neutrophil depletion by administration of granulocyte
      specific mAb RB6-8C5 at 1 day before infection rendered mice approximately 100
      fold more susceptible to lethal pneumonia induced by L. pneumophila. However,
      this treatment did not alter early bacterial clearance, despite a substantial
      decrease in neutrophil influx at this time point. Cytokine profiles in the lungs
      of control mice demonstrated strong T1 responses, characterized by an increase of
      IFN-gamma and IL-12. In contrast, neutrophil-depleted mice exhibited
      significantly lower levels of IFN-gamma and IL-12, and elevation of T2 cytokines,
      IL-4 and IL-10. Immunohistochemistry of bronchoalveolar lavage cells demonstrated
      the presence of IL-12 in neutrophils, but not alveolar macrophages. Moreover, IL
      12 was detected in lavage cell lysates by ELISA, which was paralleled to
      neutrophil number. However, intratracheal administration of recombinant murine IL
      12 did not restore resistance, whereas reconstitution of IFN-gamma drastically
      improved bacterial clearance and survival in neutrophil-depleted mice. Taken
      together, these data demonstrated that neutrophils play crucial roles in primary
      L. pneumophila infection, not via direct killing but more immunomodulatory
      effects. Our results suggest that the early recruitment of neutrophils may
      contribute to T1 polarization in a murine model of L. pneumophila pneumonia.

PMID- 11207292
TI  - Impaired pulmonary host defense in mice lacking expression of the CXC chemokine
      lungkine.
AB  - Lungkine (CXCL15) is a novel CXC chemokine that is highly expressed in the adult
      mouse lung. To determine the biologic function of Lungkine, we generated Lungkine
      null mice by targeted gene disruption. These mice did not differ from wild-type
      mice in their hematocrits or in the relative number of cells in leukocyte
      populations of peripheral blood or other tissues, including lung and bone marrow.
      However, Lungkine null mice were more susceptible to Klebsiella pneumonia
      infection, with a decreased survival and increased lung bacterial burden compared
      with infected wild-type mice. Histologic analysis of the lung and assessment of
      leukocytes in the bronchioalveolar lavage revealed that neutrophil numbers were
      normal in the lung parenchyma, but reduced in the airspace. The production of
      other neutrophil chemoattractants in the Lungkine null mice did not differ from
      that in wild-type mice, and neutrophil migration into other tissues was normal.
      Taken together, these findings demonstrate that Lungkine is an important mediator
      of neutrophil migration from the lung parenchyma into the airspace.

PMID- 11207293
TI  - Hypercholesterolemia exacerbates virus-induced immunopathologic liver disease via
      suppression of antiviral cytotoxic T cell responses.
AB  - The immune system has to be optimally balanced to be highly effective against
      infections with cytopathic microbial pathogens and must guarantee efficient
      destruction of cells infected with noncytopathic agents while leaving the
      integrity of noninfected cells largely unaltered. We describe here the effects of
      genetically induced hypercholesterolemia on cellular immunity in apolipoprotein E
      (ApoE(-/-)) and low density lipoprotein receptor-deficient (LDLR(-/-)) mice
      during infection with the hepatotropic lymphocytic choriomeningitis virus WE
      strain. In both ApoE(-/-) and LDLR(-/-) mice hypercholesterolemia aggravated
      virus-induced immunopathologic liver disease. ApoE(-/-) mice exhibited a higher
      susceptibility to virus-induced immunopathology than LDLR(-/-) mice and usually
      succumbed to immunopathologic disease when infected with high doses of virus.
      Initial virus spread was not influenced by the hypercholesterolemia, whereas
      clearance of the virus from spleen and nonlymphoid organs, including liver, was
      delayed. Activation of antiviral CTL, measured by ex vivo cytotoxicity and IFN
      gamma production, and recruitment of specific CTL into blood and liver were
      impaired in hypercholesterolemic mice, indicating that hypercholesterolemia had a
      significant suppressive effect on cellular immunity. Taken together, these data
      provide evidence that hypercholesterolemia suppresses antiviral immune responses,
      thereby changing the host-virus balance, and can increase susceptibility to acute
      or chronic and potentially lethal virus-induced immunopathologic disease. These
      findings impinge on our understanding of hypercholesterolemia as a disease
      parameter and may explain aspects of the frequent association of persistent
      pathogens with hypercholesterolemia-induced diseases, such as atherosclerosis.

PMID- 11207294
TI  - Soluble CD16 inhibits CR3 (CD11b/CD18)-mediated infection of
      monocytes/macrophages by opsonized primary R5 HIV-1.
AB  - We demonstrate that soluble CD16 (sCD16; soluble Fc gamma RIII), a natural ligand
      of CR3, inhibits the infection of monocytes by primary R5 HIV-1 strain opsonized
      with serum of seronegative individuals. Inhibition of monocyte infection by sCD16
      was similar to that observed with anti-CR3 mAbs, indicating that opsonized HIV
      may use a CR3-dependent pathway for entry in monocytic cells. Cultured human
      monocytes express both CR3 (CD11b/CD18) and CCR5 receptors. RANTES, the natural
      ligand of CCR5, inhibited infection of monocytes with unopsonized HIV particles
      and partially that of monocytes infected with HIV particles opsonized with
      complement-derived fragments. Although HIV-infected monocytes from homozygous
      CCR5 Delta 32/Delta 32 (CCR5(-/-)) individuals produce low levels of p24, cells
      infected with opsonized particles produced higher levels of p24 than cells
      infected with unopsonized particles. Our results thus suggest that CR3 may
      represent an alternative coreceptor to CCR5 of opsonized primary R5 virus entry
      into monocytes/macrophages. We also observed that the concentration of sCD16 is
      greatly decreased in sera of HIV-infected patients with low lymphocyte CD4(+)
      counts. Taken together, our findings suggest that sCD16, present in plasma, may
      play an important role in controlling HIV-1 spread.

PMID- 11207295
TI  - Depletion of CD4+ T cells precipitates immunopathology in immunodeficient mice
      infected with a noncytocidal virus.
AB  - IFN-gamma-deficient (IFN-gamma(-/-)) mice inoculated with intermediate doses of a
      slowly replicating strain of lymphocytic choriomeningitis virus become
      chronically infected. In such mice a hypercompensated CTL response is observed
      that partially controls virus replication. Here we have investigated whether
      CD4(+) Th cells are required to establish and maintain this new equilibrium. The
      absence of IFN-gamma does not impair the generation of IL-2-producing CD4(+)
      cells, and depletion of these cells precipitates severe CD8(+) T cell-mediated
      immunopathology in IFN-gamma(-/-) mice, indicating an important role of CD4(+) T
      cells in preventing this syndrome. Analysis of organ virus levels revealed a
      further impairment of virus control in IFN-gamma(-/-) mice following CD4(+) cell
      depletion. Initially the antiviral CTL response did not require CD4(+) cells, but
      with time an impaired reactivity toward especially the glycoprotein 33--41
      epitope was noted. Enumeration of epitope-specific (glycoprotein 33--41 and
      nucleoprotein 396--404) CD8(+) T cells by use of tetramers gave similar results.
      Finally, limiting dilution analysis of CTL precursors reveal an impaired capacity
      to sustain this population in CD4(+)-depleted mice, especially in mice also
      deficient in IFN-gamma. Thus, our findings disclose that T cell help is required
      to sustain the expanded CTL precursor pool required in IFN-gamma(-/-) mice. This
      interpretation is supported by mathematical modeling that predicts an increased
      requirement for help in IFN-gamma(-/-) hosts similar to what is found with fast
      replicating virus strains in normal hosts. Thus, the functional integrity of
      CD8(+) effector T cells is one important factor influencing the requirement for T
      cell help during viral infection.

PMID- 11207296
TI  - Mycobacterium tuberculosis phagosomes exhibit altered calmodulin-dependent signal
      transduction: contribution to inhibition of phagosome-lysosome fusion and
      intracellular survival in human macrophages.
AB  - Mycobacterium tuberculosis successfully parasitizes macrophages by disrupting the
      maturation of its phagosome, creating an intracellular compartment with endosomal
      rather than lysosomal characteristics. We have recently demonstrated that live M.
      tuberculosis infect human macrophages in the absence of an increase in cytosolic
      Ca(2+) ([Ca(2+)](c)), which correlates with inhibition of phagosome-lysosome
      fusion and intracellular viability. In contrast, killed M. tuberculosis induces
      an elevation in [Ca(2+)](c) that is coupled to phagosome-lysosome fusion. We
      tested the hypothesis that defective activation of the Ca(2+)-dependent effector
      proteins calmodulin (CaM) and CaM-dependent protein kinase II (CaMKII)
      contributes to the intracellular pathogenesis of tuberculosis. Phagosomes
      containing live M. tuberculosis exhibited decreased levels of CaM and the
      activated form of CaMKII compared with phagosomes encompassing killed tubercle
      bacilli. Furthermore, ionophore-induced elevations in [Ca(2+)](c) resulted in
      recruitment of CaM and activation of CaMKII on phagosomes containing live M.
      tuberculosis. Specific inhibitors of CaM or CaMKII blocked Ca(2+) ionophore
      induced phagosomal maturation and enhanced the bacilli's intracellular viability.
      These results demonstrate a novel role for CaM and CaMKII in the regulation of
      phagosome-lysosome fusion and suggest that defective activation of these Ca(2+)
      activated signaling components contributes to the successful parasitism of human
      macrophages by M. tuberculosis.

PMID- 11207297
TI  - Organ-specific regulation of the CD8 T cell response to Listeria monocytogenes
      infection.
AB  - The intestinal mucosal CD8 T cell response to infection with Listeria
      monocytogenes was measured using MHC class I tetramers and was compared with the
      response in peripheral blood, secondary lymphoid tissue, and liver. To assess the
      vaccination potential of Listeria and to analyze responses in C57BL/6 mouse
      strains, a recombinant Listeria expressing OVA (rLM-ova) was generated. The
      response peaked at 9 days postinfection with a much larger fraction of the
      intestinal mucosa and liver CD8 T cell pool OVA specific, as compared with the
      spleen. However, these differences were not linked to bacterial titers in each
      site. The higher responses in lamina propria and liver resulted in a larger CD8
      memory population in these tissues. Furthermore, the level of memory induced was
      dependent on infectious dose and inversely correlated with the magnitude of the
      recall response after oral challenge. Recall responses in the tissues were most
      robust in the lamina propria and liver, and reactivated Ag-specific T cells
      produced IFN-gamma. Infection of CD40- or MHC class II-deficient mice induced
      poor CD8 T cell responses in the intestinal mucosa, but only partially reduced
      responses in the spleen and liver. Overall, the results point to novel pathways
      of tissue-specific regulation of primary and memory antimicrobial CD8 T cell
      responses.

PMID- 11207298
TI  - C5a and C5a(desArg) enhance the susceptibility of monocyte-derived macrophages to
      HIV infection.
AB  - Mononuclear phagocytes, which include circulating blood monocytes and
      differentiated tissue macrophages, are believed to play a central role in the
      sexual transmission of HIV infection. The ability of HIV to productively infect
      these cells may be influenced by action of exogenous or host-derived substances
      at the site of viral entry. Given the potent capacities of inflammatory mediators
      to stimulate anaphylatoxic and immunomodulatory functions in mucosa, the effects
      of complement-derived anaphylatoxins on the susceptibility of monocytes and
      monocyte-derived macrophages (MDM) to HIV-1 infection were examined. In our in
      vitro system, the susceptibility to infection was up to 40 times increased in MDM
      that had been exposed to C5a or C5a(desArg), but not to C3a or C3a(desArg), for 2
      days before adding of virus. By contrast, the treatment with complement
      anaphylatoxins did not affect HIV replication in fresh monocytes. Stimulatory
      effect of C5a and its desArg derivative on HIV infection correlated with the
      increase of TNF-alpha and IL-6 secretion from MDM. All these functional effects
      of C5a and C5a(desArg) were reversible by treatment of cells with the mAb that
      functionally blocks C5aR. Taken together, these results indicate that C5a and
      C5a(desArg) may increase the susceptibility of MDM to HIV infection through
      stimulation of TNF-alpha and IL-6 secretion from these cells.

PMID- 11207299
TI  - General suppression of macrophage gene expression during Leishmania donovani
      infection.
AB  - Within the mammalian host, Leishmania donovani is an obligatory intracellular
      protozoan that resides and multiplies exclusively in the phagolysosomes of
      macrophages. The outcome of this infection is governed by the interaction between
      Leishmania and macrophage molecules that ultimately effect the expression of
      genes within both cells. To explore the effect of this intracellular infection on
      macrophage gene expression, a cDNA expression array analysis was performed to
      compare gene expression profiles in noninfected and L. donovani-infected
      macrophages. In this manner, it was possible to examine the effect of infection
      on the expression of several hundred well-characterized host cell genes in an
      unbiased manner. Interestingly, approximately 40% of the genes whose expression
      was detected in macrophages were down-regulated during infection with L.
      donovani. However, several genes were also induced during the infection process,
      some of which could play a role in recruitment of additional macrophages to the
      site of infection. Taken together, the general suppression of gene expression in
      addition to the selective induction of key genes is likely to play an important
      role in allowing the parasite to survive and proliferate within its host
      macrophage cell.

PMID- 11207300
TI  - Requirement of mitogen-activated protein kinases and I kappa B phosphorylation
      for induction of proinflammatory cytokines synthesis by macrophages indicates
      functional similarity of receptors triggered by glycosylphosphatidylinositol
      anchors from parasitic protozoa and bacterial lipopolysaccharide.
AB  - In the present study, we evaluated the ability of GPI-anchored mucin-like
      glycoproteins purified from Trypanosoma cruzi trypomastigotes (tGPI-mucin) to
      trigger phosphorylation of different mitogen-activated protein kinases (MAPKs)
      and related transcription factors in inflammatory macrophages. Kinetic
      experiments show that the peak of extracellular signal-related kinase (ERK)-1/ERK
      2, stress-activated protein kinase (SAPK) kinase-1/mitogen-activated protein
      kinase (MAPK) kinase-4, and p38/SAPK-2, phosphorylation occurs between 15 and 30
      min after macrophage stimulation with tGPI-mucin or GPI anchors highly purified
      from tGPI-mucins (tGPI). The use of the specific inhibitors of ERK-1/ERK-2 (PD
      98059) and p38/SAPK-2 (SB 203580) phosphorylation also indicates the role of
      MAPKs, with possible involvement of cAMP response element binding protein, in
      triggering TNF-alpha and IL-12 synthesis by IFN-gamma-primed-macrophages exposed
      to tGPI or tGPI-mucin. In addition, tGPI-mucin and tGPI were able to induce
      phosphorylation of I kappa B, and the use of SN50 peptide, an inhibitor of NF
      kappa B translocation, resulted in 70% of TNF-alpha synthesis by macrophages
      exposed to tGPI-mucin. Finally, the similarity of patterns of MAPK and I kappa B
      phosphorylation, the concentration of drugs required to inhibit cytokine
      synthesis, as well as cross-tolerization exhibited by macrophages exposed to
      tGPI, tGPI-mucin, or bacterial LPS, suggest that receptors with the same
      functional properties are triggered by these different microbial glycoconjugates.

PMID- 11207301
TI  - Contribution of Th1 and Th2 cells to protection and pathology in experimental
      models of granulomatous lung disease.
AB  - Mice that had received adoptive transfer of DO11.10 TCR transgenic T cells
      polarized toward a Th1 or a Th2 phenotype were challenged with Ag-coated beads or
      with recombinant Mycobacterium tuberculosis expressing the OVA determinant. The
      resulting bead-induced pulmonary granulomas reflected the phenotype of the
      adoptively transferred T cells, with the Th2 cells promoting a fibrotic reaction.
      Mice receiving Th1 cells mounted an epitope-specific protective response to
      challenge with recombinant M. tuberculosis. Th2 recipients were characterized by
      enhanced weight loss and lung fibrosis during acute high-dose infection. The
      combination of TCR transgenic T cells and epitope-tagged mycobacteria provides a
      novel experimental model for investigation of the pathogenesis of tuberculosis.

PMID- 11207302
TI  - Prophylactic tumor vaccination: comparison of effector mechanisms initiated by
      protein versus DNA vaccination.
AB  - Clinical success in tumor vaccination frequently does not reach expectation.
      Since vaccination protocols are quite variable, we used the murine renal cell
      carcinoma line RENCA transfected with the lacZ gene (RENCA-beta-gal) to compare
      the efficacy of two different vaccination strategies or their combination and to
      elaborate on the underlying mechanisms. BALB/c mice were vaccinated either with
      naked lacZ DNA or with attenuated Salmonella typhimurium transformed with lacZ
      DNA or with dendritic cells (DC) loaded with the beta-galactosidase protein or
      mice were vaccinated with both DNA and protein. Although all regimens led to a
      prolongation of survival time, oral vaccination with transfected S. typhimurium
      followed by i.v. transfer of protein-loaded DC provided the optimal schedule. In
      this setting, >50% of mice remained tumor free after challenge with 10 times the
      lethal tumor dose of RENCA-beta-gal. As explored in transfer experiments, the
      superior efficacy of combining DNA and protein vaccination is due to the facts
      that 1) optimal protection depends on both activated CD4(+) and CD8(+) cells and
      2) CD8(+) CTL are most strongly activated by vaccination with transformed
      Salmonella, whereas vaccination with protein-loaded DC is superior for the
      activation of Th. The latter induced sustained activation of CTL and recruitment
      of nonadaptive defense mechanisms. The data demonstrate the strength of DNA
      vaccination, particularly by the oral route, and provide evidence that a combined
      treatment with protein-loaded DC can significantly increase the therapeutic
      efficacy.

PMID- 11207303
TI  - Intranasal immunization with CpG oligodeoxynucleotides as an adjuvant
      dramatically increases IgA and protection against herpes simplex virus-2 in the
      genital tract.
AB  - Development of vaccines capable of preventing the transmission or limiting the
      severity of sexually transmitted viruses, such as HSV and HIV, will likely be
      dependent on the induction of potent long-lasting mucosal immune responses in the
      genital tract. Recently, synthetic oligodeoxynucleotides (ODN) containing
      immunostimulatory CpG motifs were shown to serve as potent adjuvants for the
      induction of mucosal immune responses. Here, we show that intranasal immunization
      with CpG ODN, plus recombinant glycoprotein B (rgB) of HSV-1, results in
      significantly elevated levels of specific anti-gB IgA Abs in vaginal washes that
      remained high throughout the estrous cycle. Additionally, dramatically elevated
      numbers of specific IgA Ab-secreting cells were present and persisted in the
      genital tract in response to intravaginal (IVAG) HSV-2 challenge. HSV-2-specific
      CTL were observed at moderate levels in the spleens of CpG or non-CpG ODN
      immunized mice. In contrast, strong CTL responses were observed locally in the
      genital tissues of both groups following IVAG HSV-2 challenge. Interestingly,
      mice immunized intranasally with rgB plus CpG ODN, but not non-CpG ODN, were
      significantly protected following IVAG HSV-2 challenge. Measurement of virus in
      protected CpG-immunized mice revealed a log lower level of replication within the
      first few days after infection. In conclusion, these results indicate that
      intranasal immunization with CpG ODN plus protein mediates immunity in the female
      genital tract capable of protecting against a sexually transmitted pathogen.

PMID- 11207305
TI  - Maturation versus death of developing double-positive thymocytes reflects
      competing effects on Bcl-2 expression and can be regulated by the intensity of
      CD28 costimulation.
AB  - Immature double-positive (DP) thymocytes mature into CD4(+)CD8(-) cells in
      response to coengagement of TCR with any of a variety of cell surface "coinducer"
      receptors, including CD2. In contrast, DP thymocytes are signaled to undergo
      apoptosis by coengagement of TCR with CD28 costimulatory receptors, but the
      molecular basis for DP thymocyte apoptosis by TCR plus CD28 coengagement is not
      known. In the present study, we report that TCR plus CD28 coengagement does not
      invariably induce DP thymocyte apoptosis but, depending on the intensity of CD28
      costimulation, can induce DP thymocyte maturation. We demonstrate that distinct
      but interacting signal transduction pathways mediate DP thymocyte maturation
      signals and DP thymocyte apoptotic signals. Specifically, DP maturation signals
      are transduced by the extracellular signal-related kinase (ERK)/mitogen-activated
      protein kinase (MAPK) pathway and up-regulate expression of the antiapoptotic
      protein Bcl-2. In contrast, the apoptotic response stimulated by CD28
      costimulatory signals is mediated by ERK/MAPK-independent pathways. Importantly,
      when TCR-activated thymocytes are simultaneously coengaged by both CD28 and CD2
      receptors, CD28 signals can inhibit ERK/MAPK-dependent Bcl-2 protein up
      regulation. Thus, there is cross-talk between the signal transduction pathways
      that transduce apoptotic and maturation responses, enabling CD28-initiated signal
      transduction pathways to both stimulate DP thymocyte apoptosis and also
      negatively regulate maturation responses initiated by TCR plus CD2 coengagement.

PMID- 11207304
TI  - Fas/Fas ligand pathway, apoptosis, and clonal anergy involved in systemic
      acetylcholine receptor T cell epitope tolerance.
AB  - The cellular mechanisms of high dose systemic acetylcholine receptor (AChR) T
      cell epitope, alpha 146--162 peptide-induced tolerance in experimental myasthenia
      gravis were examined. CD4 cells are the prime target for alpha 146--162 peptide
      induced tolerance. The expression of CD69, Fas, and B7.2 molecules on AChR-immune
      lymphocytes was enhanced within 4--12 h after tolerance induction. A high dose of
      alpha 146--162 peptide in IFA failed to suppress T cell proliferation and/or
      clinical myasthenia gravis in lpr and gld mice deficient in Fas and Fas ligand,
      respectively. A high dose of alpha 146--162 peptide in IFA in AChR-immunized mice
      induced apoptosis of BV6 cells. Further, reconstitution of IL-2 in vitro
      recovered alpha 146--162 peptide tolerized T cell proliferation, IFN-gamma, and
      IL-10 production. The findings implicate the possible role of Fas-/Fas ligand
      mediated apoptosis and the resulting clonal anergy as the mechanisms of high dose
      AChR alpha 146--162 peptide-induced tolerance on CD4 cells.

PMID- 11207306
TI  - Promotion of neutrophil apoptosis by TNF-alpha.
AB  - We examined the ability of TNF-alpha to modulate human neutrophil apoptosis.
      Neutrophils cultured with TNF-alpha alone undergo a low but significant increase
      in the number of apoptotic cells. More interestingly, when neutrophils were
      pretreated with TNF-alpha for 1-2 min at 37 degrees C and then were exposed to a
      variety of agents such as immobilized IgG, IgG-coated erythrocytes, complement
      treated erythrocytes, zymosan, PMA, zymosan-activated serum, fMLP, Escherichia
      coli, and GM-CSF for 3 h at 37 degrees C, a marked stimulation of apoptosis was
      observed. Similar results were obtained in neutrophils pretreated with TNF-alpha
      for 30 min, 1 h, 3 h, and 18 h. Dose-dependent studies showed that TNF-alpha
      enhances neutrophil apoptosis at concentrations ranging from 1 to 100 ng/ml. In
      contrast to the observations made in neutrophils pretreated with TNF-alpha, there
      was no stimulation of apoptosis when TNF-alpha was added to neutrophils
      previously activated by conventional agonists. Experiments performed to establish
      the mechanism through which TNF-alpha promotes neutrophil apoptosis showed that
      neither reactive oxygen intermediates nor the Fas/Fas ligand system appear to be
      involved. Our results suggest that TNF-alpha plays a critical role in the control
      of neutrophil survival by virtue of its ability to induce an apoptotic death
      program which could be triggered by a variety of conventional agonists.

PMID- 11207307
TI  - Differential effects of CD18, CD29, and CD49 integrin subunit inhibition on
      neutrophil migration in pulmonary inflammation.
AB  - Neutrophil migration to lung alveoli is a characteristic of lung diseases and is
      thought to occur primarily via capillaries rather than postcapillary venules. The
      role of adhesion molecules CD18 and CD29 on this migration in a mouse model of
      lung inflammation has been investigated. The number of neutrophils present in
      bronchoalveolar lavage fluid was determined 4 h after intratracheal instillation
      of LPS (0.1-1 microg) or murine recombinant KC (CXC chemokine, 0.03-0.3 microg).
      Both stimuli produced a dose-related increase in neutrophil accumulation.
      Intravenous anti-mouse CD18 mAb, 2E6 (0.5 mg/mouse), significantly (p < 0.001)
      attenuated LPS (0.3 microg)- but not KC (0.3 microg)-induced neutrophil
      accumulation. The anti-mouse CD29 mAb, HM beta 1-1 (0.02 mg/mouse), significantly
      (p < 0.05) inhibited both LPS (0.3 microg)- and KC (0.3 microg)-induced
      neutrophil migration. A second mAb to CD18 (GAME-46) and both F(ab')(2) and Fab
      of HM beta 1-1 produced similar results to those above, while coadministration of
      mAbs did not result in greater inhibition. Electron microscopy studies showed
      that CD29 was involved in the movement of neutrophils from the interstitium into
      alveoli. The effect of mAbs to CD49 (alpha integrin) subunits of CD29 was also
      examined. mAbs to CD49e and CD49f inhibited both responses, while anti-CD49b and
      CD49d significantly inhibited responses to KC only. These data suggest that CD29
      plays a critical role in neutrophil migration in pulmonary inflammation and that
      CD49b and CD49d mediate CD18-independent neutrophil accumulation.

PMID- 11207309
TI  - Effective treatment of established murine collagen-induced arthritis by systemic
      administration of dendritic cells genetically modified to express IL-4.
AB  - Dendritic cells (DC) are APCs that are able to stimulate or inhibit immune
      responses, depending on levels of expression of MHC class I and II costimulatory
      molecules and cytokines. Our previous studies have suggested that the observed
      contralateral effect, where injection of a vector carrying certain
      immunomodulatory genes into one joint resulted in inhibition of arthritis in
      untreated joints, is mediated by in vivo modification of DC. Therefore, we have
      examined the ability of genetically modified DC to suppress established murine
      collagen-induced arthritis (CIA) after i.v. delivery. IL-4 has been shown to
      partially reduce the severity of CIA after repeated injection of recombinant
      protein or by injection of an adenoviral vector expressing IL-4. Here we
      demonstrate that i.v. injection of immature DC, infected with an adenoviral
      vector expressing IL-4, into mice with established CIA resulted in almost
      complete suppression of disease, with no recurrence for up to 4 wk posttreatment.
      Injection i.v. of fluorescently labeled DC demonstrated that the cells rapidly
      migrated to the liver and spleen after 6 h and to the lymph nodes by 24 h. In
      culture, spleen cells from DC/IL-4-treated mice produced less IFN-gamma after
      stimulation by collagen than did control groups. In addition, DC/IL-4
      administration decreased the level of specific Abs against type II collagen, in
      particular the IgG2 Th1 isotype 14 days posttreatment. These results demonstrate
      the ability to treat effectively established murine arthritis by systemic
      administration of DC expressing IL-4.

PMID- 11207308
TI  - Oncostatin M-induced matrix metalloproteinase and tissue inhibitor of
      metalloproteinase-3 genes expression in chondrocytes requires Janus kinase/STAT
      signaling pathway.
AB  - Oncostatin M (OSM), a member of the IL-6 superfamily of cytokines, is elevated in
      patients with rheumatoid arthritis and, in synergy with IL-1, promotes cartilage
      degeneration by matrix metalloproteinases (MMPs). We have previously shown that
      OSM induces MMP and tissue inhibitor of metalloproteinase-3 (TIMP-3) gene
      expression in chondrocytes by protein tyrosine kinase-dependent mechanisms. In
      the present study, we investigated signaling pathways regulating the induction of
      MMP and TIMP-3 genes by OSM. We demonstrate that OSM rapidly stimulated
      phosphorylation of Janus kinase (JAK) 1, JAK2, JAK3, and STAT1 as well as
      extracellular signal-regulated kinase (ERK) 1/2, p38, and c-Jun N-terminal kinase
      1/2 mitogen-activated protein kinases in primary bovine and human chondrocytes. A
      JAK3-specific inhibitor blocked OSM-stimulated STAT1 tyrosine phosphorylation,
      DNA-binding activity of STAT1 as well as collagenase-1 (MMP-1), stromelysin-1
      (MMP-3), collagenase-3 (MMP-13), and TIMP-3 RNA expression. In contrast, a JAK2
      specific inhibitor, AG490, had no impact on these events. OSM-induced ERK1/2
      activation was also not affected by these inhibitors. Similarly, curcumin
      (diferuloylmethane), an anti-inflammatory agent, suppressed OSM-stimulated STAT1
      phosphorylation, DNA-binding activity of STAT1, and c-Jun N-terminal kinase
      activation without affecting JAK1, JAK2, JAK3, ERK1/2, and p38 phosphorylation.
      Curcumin also inhibited OSM-induced MMP-1, MMP-3, MMP-13, and TIMP-3 gene
      expression. Thus, OSM induces MMP and TIMP-3 genes in chondrocytes by activating
      JAK/STAT and mitogen-activated protein kinase signaling cascades, and
      interference with these pathways may be a useful approach to block the catabolic
      actions of OSM.

PMID- 11207310
TI  - Integrin alpha E(CD103)beta 7 mediates adhesion to intestinal microvascular
      endothelial cell lines via an E-cadherin-independent interaction.
AB  - Integrins are important for T cell interactions with endothelial cells. Because
      the integrin alpha(E)beta(7) is expressed on some circulating gut-homing T cells
      and as T cell numbers are reduced in the intestinal lamina propria of alpha(E)
      deficient mice, we evaluated whether alpha(E)beta(7) mediates binding to
      intestinal endothelial cells. We found that anti-alpha(E)beta(7) mAbs partially
      blocked the binding of cultured intraepithelial T cells to human intestinal
      microvascular endothelial cells (HIMEC). Furthermore, alpha(E)beta(7)-transfected
      K562 cells bound more efficiently than vector-transfected K562 cells to HIMEC.
      Finally, HIMEC bound directly to an alpha(E)beta(7)-Fc fusion protein. These
      interactions were partially blocked by anti-alpha(E)beta(7) mAbs, and endothelial
      cell binding to the alpha(E)beta(7)-Fc was dependent upon the metal ion-dependent
      adhesion site within the alpha(E) A domain. Of note, the HIMEC lacked expression
      of E-cadherin, the only known alpha(E)beta(7) counterreceptor as assessed by
      functional studies, flow cytometry, and RT-PCR. Thus, HIMEC/alpha(E)beta(7)
      binding was independent of E-cadherin. In addition, this interaction appeared to
      be tissue selective, as HIMEC bound to the alpha(E)beta(7)-Fc, whereas
      microvascular endothelial cells from the skin did not. Finally, there was
      evidence for an alpha(E)beta(7) ligand on intestinal endothelial cells in vivo,
      as alpha(E)beta(7) expression enhanced lymphocyte binding around vessels in the
      lamina propria in tissue sections. Thus, we have defined a novel interaction for
      alpha(E)beta(7) at a nonepithelial location. These studies suggest a role for
      alpha(E)beta(7) in interactions with the intestinal endothelium that may have
      implications for intestinal T cell homing or functional responses.

PMID- 11207311
TI  - Extracellular signal-regulated kinase 1/2-mediated phosphorylation of cytosolic
      phospholipase A2 is essential for human eosinophil adhesion to fibronectin.
AB  - We examined the role of p38, p42, and p44 mitogen-activated protein kinase (MAPK)
      isoforms and cytosolic phospholipase A(2) (cPLA(2)) activation in human
      eosinophil adhesion to plate-coated fibronectin (FN). In the control state,
      eosinophil adhesion was maximal, with 10 microg/ml FN at 30 min, and decreased
      after 60-90 min. Western blot analysis demonstrated that p44/42 MAPK
      (extracellular signal-regulated kinase (ERK)1/2) and cPLA(2) were phosphorylated
      during adhesion to FN, whereas p38 MAPK phosphorylation was unchanged.
      Preincubation of eosinophils with U0126 or PD98059, two structurally unrelated
      MAPK kinase inhibitors, or arachidonic trifluoromethyl ketone, a cPLA(2)
      inhibitor, blocked eosinophil adhesion to FN. By contrast, eosinophil adhesion
      was unaffected by SB203580, a p38 MAPK inhibitor. Pretreatment of eosinophils
      with okadaic acid, a serine/threonine phosphatase inhibitor, at the
      concentrations that induced ERK1/2 and cPLA(2) phosphorylation caused an increase
      in maximal eosinophil adhesion to FN for >60 min. MAPK kinase inhibition but not
      p38 inhibition also blocked FN-mediated F-actin redistribution in eosinophils and
      prevented cPLA(2) phosphorylation caused by adhesion to FN. These results
      demonstrate that ERK1/2 mediating cPLA(2) activation is essential for eosinophil
      adhesion to FN.

PMID- 11207312
TI  - Oral administration of recombinant cholera toxin subunit B inhibits IL-12
      mediated murine experimental (trinitrobenzene sulfonic acid) colitis.
AB  - Trinitrobenzene sulfonic acid (TNBS)-induced colitis is an IL-12-driven, Th1 T
      cell-mediated colitis that resembles human Crohn's disease. In the present study,
      we showed initially that the oral administration of recombinant subunit B of
      cholera toxin (rCT-B) at the time of TNBS-induced colitis by intrarectal TNBS
      instillation inhibits the development of colitis or, at later time when TNBS
      induced colitis is well established, brings about resolution of the colitis. Dose
      response studies showed that a majority of mice (68%) treated with rCT-B at a
      dose of 100 microg (times four daily doses) exhibited complete inhibition of the
      development of colitis, whereas a minority (30%) treated with rCT-B at a dose of
      10 microg (times four daily doses) exhibited complete inhibition; in both cases,
      however, the remaining mice exhibited some reduction in the severity of
      inflammation. In further studies, we showed that rCT-B administration is
      accompanied by prevention/reversal of increased IFN-gamma secretion (the hallmark
      of a Th1 response) without at the same time causing an increase in IL-4
      secretion. This decreased IFN-gamma secretion was not associated with the up
      regulation of the secretion of counterregulatory cytokines (IL-10 or TGF-beta),
      but was associated with a marked inhibition of IL-12 secretion, i.e., the
      secretion of the cytokine driving the Th1 response. Finally, we showed that rCT-B
      administration results in increased apoptosis of lamina propria cells, an effect
      previously shown to be indicative of IL-12 deprivation. From these studies, rCT-B
      emerges as a powerful inhibitor of Th1 T cell-driven inflammation that can
      conceivably be applied to the treatment of Crohn's disease.

PMID- 11207313
TI  - Role of nitric oxide synthase type 2 in acute infection with murine
      cytomegalovirus.
AB  - Whether or not NO plays a critical role in murine CMV (MCMV) infection has yet to
      be elucidated. In this study, we examined the role of NO in acute infection with
      MCMV using NO synthase type 2 (NOS2)-deficient mice. NOS2(-/-) mice were more
      susceptible to lethal infection with MCMV than NOS2(+/+) mice and generated a
      much higher peak virus titer in the salivary gland after acute infection. A
      moderate increase in the MCMV titer was also observed in other organs of NOS2(-/
      ) mice such as the spleen, lung, and liver. The immune responses to MCMV
      infection including NK cell cytotoxicity and CTL response in NOS2(-/-) mice were
      comparable with those of NOS2(+/+) mice. Moreover, the ability to produce IFN
      gamma is not impaired in NOS2(-/-) mice after MCMV infection. The peritoneal
      macrophages from NOS2(-/-) mice, however, exhibited a lower antiviral activity
      than those from NOS2(+/+) mice, resulting in an enhanced viral replication in
      macrophages themselves. Treatment of these cells from NOS2(+/+) mice with a
      selective NOS2 inhibitor decreased the antiviral activity to a level below that
      obtained with NOS2(-/-) mice. In addition, the absence of NOS2 and NOS2-mediated
      antiviral activity of macrophages resulted in not only an enhanced MCMV
      replication and a high mortality but also a consequent risk of the latency. It
      was thus concluded that the NOS2-mediated antiviral activity of macrophages via
      NO plays a protective role against MCMV infection at an early and late stage of
      the infection.

PMID- 11207314
TI  - IL-13-induced airway hyperreactivity during respiratory syncytial virus infection
      is STAT6 dependent.
AB  - Airway damage and hyperreactivity induced during respiratory syncytial virus
      (RSV) infection can have a prolonged effect in infants and young children. These
      infections can alter the long-term function of the lung and may lead to severe
      asthma-like responses. In these studies, the role of IL-13 in inducing and
      maintaining a prolonged airway hyperreactivity response was examined using a
      mouse model of primary RSV infection. Using this model, there was evidence of
      significant airway epithelial cell damage and sloughing, along with mucus
      production. The airway hyperreactivity response was significantly increased by 8
      days postinfection, peaked during days 10-12, and began to resolve by day 14.
      When the local production of Th1- and Th2-associated cytokines was examined,
      there was a significant increase, primarily in IL-13, as the viral response
      progressed. Treatment of RSV-infected mice with anti-IL-13 substantially
      inhibited airway hyperreactivity. Anti-IL-4 treatment had no effect on the RSV
      induced responses. Interestingly, when IL-13 was neutralized, an early increase
      in IL-12 production was observed within the lungs, as was a significantly lower
      level of viral Ags, suggesting that IL-13 may be regulating an important
      antiviral pathway. The examination of RSV-induced airway hyperreactivity in
      STAT6(-/-) mice demonstrated a significant attenuation of the response, similar
      to the anti-IL-13 treatment. In addition, STAT6(-/-) mice had a significant
      alteration of mucus-producing cells in the airway. Altogether, these studies
      suggest that a primary factor leading to chronic RSV-induced airway dysfunction
      may be the inappropriate production of IL-13.

PMID- 11207315
TI  - HLA-DP allele-specific T cell responses to beryllium account for DP-associated
      susceptibility to chronic beryllium disease.
AB  - Occupational exposure to small molecules, such as metals, is frequently
      associated with hypersensitivity reactions. Chronic beryllium (Be) disease (CBD)
      is a multisystem granulomatous disease that primarily affects the lung, and
      occurs in approximately 3% of individuals exposed to this element. Immunogenetic
      studies have demonstrated a strong association between CBD and possession of
      alleles of HLA-DP containing glutamic acid (Glu) at position 69 in the HLA-DP
      beta-chain. T cell clones were raised from three patients with CBD in whom
      exposure occurred 10 and 30 years previously. Of 25 Be-specific clones that were
      obtained, all were restricted by HLA-DP alleles with Glu at DP beta69.
      Furthermore, the proliferative responses of the clones were absolutely dependent
      upon DP beta Glu(69) in that a single amino acid substitution at this position
      abolished the response. As befits a disease whose pathogenesis involves a delayed
      type hypersensitivity response, the large majority of Be-specific clones secreted
      IFN-gamma (Th1) and little or no IL-4 (Th2) cytokines. This study provides
      insights into the molecular basis of DP2-associated susceptibility to CBD.

PMID- 11207316
TI  - CD40/CD40 ligand interactions are critical for elicitation of autoimmune-mediated
      fibrosis in the lung.
AB  - Pulmonary interstitial fibrosis (PIF), associated with persistent inflammation
      and increased collagen deposition in the interstitium, is often considered an
      autoimmune disease. Hapten immune PIF (HIPIF), a model for PIF, is elicited in
      the lung by a single intratracheal (i.t.) challenge in mice sensitized with
      hapten (2,4,6-trinitrobenzene sulfonic acid, TNBS). In this study, we
      characterized the role of CD40/CD40 ligand (CD40L) interactions in the
      elicitation of secondary cell-mediated immune responses that lead to development
      of fibrosis in the lung using an adoptive transfer model of HIPIF. The expression
      of CD40 was detected on bronchoalveolar lavage (BAL) cells 1-3 days after i.t.
      challenge with hapten in the HIPIF lung, but not lungs from the control mice. The
      CD40(bright) BAL cells morphologically resembled infiltrating monocytes.
      Furthermore, blocking CD40/CD40L interactions with blocking Ab decreased BAL
      production of Th1-mediators (IL-12 and TNF-alpha). Moreover, either blocking
      CD40/CD40L interactions with the Ab or using IL-12 knockout recipient mice
      prevented the increased collagen deposition (accumulation of hydroxyproline) in
      the lungs during HIPIF induction. We conclude that second signals (CD40/CD40L
      interactions) are required for elicitation of secondary immune responses that
      lead to PIF in vivo. The results support the notion that CD40/CD40L interactions
      are involved in the pathogenesis of an ongoing autoimmune disease.

PMID- 11207317
TI  - Immunosensitization of melanoma tumor cells to non-MHC Fas-mediated killing by
      MART-1-specific CTL cultures.
AB  - The discovery of human melanoma rejection Ags has allowed the rational design of
      immunotherapeutic strategies. One such Ag, MART-1, is expressed on >90% of human
      melanomas, and CTL generated against MART-1(27-35) kill most HLA A2.1(+) melanoma
      cells. However, variant tumor cells, which do not express MART-1, down-regulate
      MHC, or become resistant to apoptosis, will escape killing. Cytotoxic lymphocytes
      kill by two main mechanisms, the perforin/granzyme degranulation pathway and the
      TNF/Fas/TNF-related apoptosis-inducing ligand superfamily of apoptosis-inducing
      ligands. In this study, we examined whether cis-diaminedichloroplatinum (II)
      cisplatin (CDDP) sensitizes MART-1/HLA A2.1(+) melanoma and melanoma variant
      tumor cells to non-MHC-restricted, Fas ligand (FasL)-mediated killing by CTL.
      MART-1(27-35)-specific bulk CTL cultures were generated by pulsing normal PBL
      with MART-1(27-35) peptide. These CTL cultures specifically kill M202 melanoma
      cells (MART-1(+), HLA A2.1(+), FasR(-)), and MART-1(27-35) peptide-pulsed T2
      cells (FasR(+)), but not M207 melanoma cells (MART-1(+), HLA A2.1(-), FasR(-)),
      FLU(58-66) peptide-pulsed T2 cells, or DU145 and PC-3 prostate cells (MART-1(-),
      HLA A2.1(-), FasR(+)). CDDP (0.1-10 microg/ml) sensitized non-MART-1(27-35)
      peptide-pulsed T2 to the CD8(+) subset of bulk MART-1-specific CTL, and killing
      was abolished by neutralizing anti-Fas Ab. Furthermore, CDDP up-regulated FasR
      expression and FasL-mediated killing of M202, and sensitized PC-3 and DU145 to
      killing by bulk MART-1-specific CTL cultures. These findings demonstrate that
      drug-mediated sensitization can potentiate FasL-mediated killing by MHC
      restricted CTL cell lines, independent of MHC and MART-1 expression on tumor
      cells. This represents a novel approach for potentially controlling tumor cell
      variants found in primary heterogeneous melanoma tumor cell populations that
      would normally escape killing by MART-1-specific immunotherapy.

PMID- 11207318
TI  - Gene expression of osteoclast differentiation factor is induced by
      lipopolysaccharide in mouse osteoblasts via Toll-like receptors.
AB  - Osteoclast differentiation factor (ODF), a recently identified cytokine of the
      TNF family, is expressed as a membrane-associated protein in osteoblasts and
      stromal cells. ODF stimulates the differentiation of osteoclast precursors into
      osteoclasts in the presence of M-CSF. Here we investigated the effects of LPS on
      the gene expression of ODF in mouse osteoblasts and an osteoblast cell line and
      found that LPS increased the ODF mRNA level. A specific inhibitor of
      extracellular signal-regulated kinase or protein kinase C inhibited this up
      regulation, indicating that extracellular signal-regulated kinase and protein
      kinase C activation was involved. A protein synthesis inhibitor, cycloheximide,
      rather enhanced the LPS-mediated increase of ODF mRNA, and both a neutralizing Ab
      of TNF-alpha and a specific inhibitor of PGE synthesis failed to block the ODF
      mRNA increase by native LPS. Thus, LPS directly induced ODF mRNA. Mouse
      osteoblasts and an osteoblast cell line constitutively expressed Toll-like
      receptor (TLR) 2 and 4, which are known as putative LPS receptors. ODF mRNA
      increases in response to synthetic lipid A were defective in primary osteoblasts
      from C3H/HeJ mice that contain a nonfunctional mutation in the TLR4 gene,
      suggesting that TLR4 plays an essential role in the process. Altogether, our
      results indicate that ODF gene expression is directly increased in osteoblasts by
      LPS treatment via TLR, and this pathway may play an important role in the
      pathogenesis of LPS-mediated bone disorders, such as periodontitis.

PMID- 11207319
TI  - Recombinant HIV-1 glycoprotein 120 induces distinct types of delayed
      hypersensitivity in persons with or without pre-existing immunologic memory.
AB  - Induction of T cell help is critical in HIV-1 control and potentially in
      prevention by immunization. A practical approach is needed to identify HIV-1
      specific helper activities in vivo. We explored the feasibility of measuring
      delayed-type hypersensitivity (DTH) following intradermal injection of
      recombinant soluble HIV-1(MN) glycoprotein 120 in HIV-1-infected, vaccinated, and
      exposed individuals. DTH reactions were elicited within 48 h in 16 of 29
      untreated, infected patients and in 24 of 30 uninfected vaccinees. Concomitant
      envelope-specific lymphoproliferation in vitro was undetectable among 9 infected
      patients tested with positive envelope-specific DTH. By contrast, no 48-h DTH
      reactions occurred among 25 high risk and 32 low risk, uninfected volunteers.
      However, 7--12 days after injection, 10 (40%) high risk and 11 (34%) low risk
      individuals developed induration resembling DTH, and the cellular infiltrates
      contained monocytes and T cells. Five of 18 examined also developed anti-gp120
      Abs. The very delayed time course and lack of correlation with previous Ag
      exposure clearly distinguish this reaction from DTH. Thus, HIV-1 skin testing can
      identify persons with HIV-specific recall responses resulting from infection, in
      the absence of in vitro lymphoproliferation, and from vaccination. In contrast,
      very late reactivities may signify chemotactic properties of the envelope protein
      and/or herald the induction of primary HIV-specific Th1-type immunity.

PMID- 11207320
TI  - Characterization of hepatitis C virus core-specific immune responses primed in
      rhesus macaques by a nonclassical ISCOM vaccine.
AB  - Current therapies for the treatment of hepatitis C virus (HCV) infection are only
      effective in a restricted number of patients. Cellular immune responses,
      particularly those mediated by CD8(+) CTLs, are thought to play a role in the
      control of infection and the response to antiviral therapies. Because the Core
      protein is the most conserved HCV protein among genotypes, we evaluated the
      ability of a Core prototype vaccine to prime cellular immune responses in rhesus
      macaques. Since there are serious concerns about using a genetic vaccine encoding
      for Core, this vaccine was a nonclassical ISCOM formulation in which the Core
      protein was adsorbed onto (not entrapped within) the ISCOMATRIX, resulting in
      approximately 1-microm particulates (as opposed to 40 nm for classical ISCOM
      formulations). We report that this Core-ISCOM prototype vaccine primed strong
      CD4(+) and CD8(+) T cell responses. Using intracellular staining for cytokines,
      we show that in immunized animals 0.30-0.71 and 0.32-2.21% of the circulating
      CD8(+) and CD4(+) T cells, respectively, were specific for naturally processed
      HCV Core peptides. Furthermore, this vaccine elicited a Th0-type response and
      induced a high titer of Abs against Core and long-lived cellular immune
      responses. Finally, we provide evidence that Core-ISCOM could serve as an
      adjuvant for the HCV envelope protein E1E2. Thus, these data provide evidence
      that Core-ISCOM is effective at inducing cellular and humoral immune responses in
      nonhuman primates.

PMID- 11207322
TI  - Eukaryotic translation initiation factor-6 enhances histamine and IL-2 production
      in mast cells.
AB  - Eukaryotic translation initiation factor (eIF)-6 is known to be important in
      ribosome biogenesis. Previously, we have discovered that eIF-6 mRNA is induced in
      lung in a murine model of asthma. We also found that there was enhanced eIF-6
      expression in mast cells stimulated with PMA plus calcium ionophore. Therefore,
      we hypothesized that the induction of eIF-6 enhances the production of bioactive
      mediators by mast cells upon allergic stimulation. In the current study, we found
      that eIF-6 mRNA was rapidly induced in murine mast cells stimulated by Fc epsilon
      RI cross-linking, which is a major physiologic stimulant for mast cells. eIF-6
      was also induced in human mast cells upon stimulation. The increase in eIF-6 gene
      expression in murine mast cells was blocked by therapeutic agents such as
      dexamethasone and cyclosporin A. To determine the location and function of eIF-6,
      murine mast cells were transfected with a construct that overexpressed enhanced
      green fluorescent protein-tagged eIF-6. These experiments demonstrated that eIF-6
      was localized predominantly in the nucleolus of the mast cells. Also,
      overexpression of enhanced green fluorescent protein/eIF-6 enhanced the
      production of histamine and IL-2, but not IL-4 by stimulated murine mast cells.
      These results suggest that eIF-6 regulates the production of selected bioactive
      mediators in allergic diseases. This is the first demonstration of a biologic
      function of eIF-6 in mammalian cells.

PMID- 11207321
TI  - IC14, an anti-CD14 antibody, inhibits endotoxin-mediated symptoms and
      inflammatory responses in humans.
AB  - CD14 is a receptor for cell wall components of Gram-negative and Gram-positive
      bacteria that has been implicated in the initiation of the inflammatory response
      to sepsis. To determine the role of CD14 in LPS-induced effects in humans, 16
      healthy subjects received an i.v. injection of LPS (4 ng/kg) preceded (-2 h) by
      i.v. IC14, a recombinant chimeric mAb against human CD14, at a dose of 1 mg/kg
      over 1 h, or placebo. In subjects receiving IC14, saturation of CD14 on
      circulating monocytes and granulocytes was >90% at the time of LPS injection.
      IC14 attenuated LPS-induced clinical symptoms and strongly inhibited LPS-induced
      proinflammatory cytokine release, while only delaying the release of the anti
      inflammatory cytokines soluble TNF receptor type I and IL-1 receptor antagonist.
      IC14 also inhibited leukocyte activation, but more modestly reduced endothelial
      cell activation and the acute phase protein response. The capacity of circulating
      monocytes and granulocytes to phagocytose Escherichia coli was only marginally
      reduced after infusion of IC14. These data provide the first proof of principle
      that blockade of CD14 is associated with reduced LPS responsiveness in humans in
      vivo.

PMID- 11207324
TI  - Schizophrenia: what's under the microscope?

PMID- 11207323
TI  - Antigen-independent suppression of the allergic immune response to bee venom
      phospholipase A(2) by DNA vaccination in CBA/J mice.
AB  - Phospholipase A(2) (PLA(2)) is one of the major honey bee venom allergens for
      humans. To assess the long-term prevention of allergic reactions by DNA
      vaccination, a PLA(2)-CBA/J mouse model was employed using empty or PLA(2)
      sequence-carrying DNA plasmids. Early skin application of either DNA construct
      before (prophylactic approach) or after (therapeutic approach) sensitization with
      PLA(2)/alum led to reduced PLA(2)-specific IgE and IgG1 titers at 7 mo, with
      concomitant rise in IgG2a and IgG3. Splenocytes recovered at 5-6 mo after the
      last DNA administration exhibited a sustained IFN-gamma and IL-10 secretion and
      reduced IL-4 production. Recall challenge with PLA(2) boosted IFN-gamma and IL-10
      secretion, suggesting the reactivation of quiescent memory Th1 lymphocytes. Mice
      from the prophylactic groups were fully protected against anaphylaxis, whereas
      65% of the animals recovered in the therapeutic groups. Th1-polarized immune
      responses were also active in mice vaccinated with an empty plasmid 32 wk before
      sensitization with another Ag (OVA). This is the first demonstration that the Ag
      coding sequence in DNA vaccine is not necessary to promote immune modulation in
      naive and sensitized animals for a prolonged period, and has relevance for the
      understanding of the innate and induced mechanisms underlying gene immunotherapy
      in long-term treatment of allergy.

PMID- 11207325
TI  - Role of serotonin in the behavioral and psychological symptoms of dementia.
AB  - The behavioral and psychological symptoms of dementia (BPSD) can have serious
      debilitating effects on the patient and increase caregiver burden. Investigations
      into the underlying neuropathology indicate that the serotonergic system may
      contribute to BPSD. In addition, serotonergic pathways are known to interact
      extensively with the cholinergic, noradrenergic, GABAergic, and dopaminergic
      systems. Hence, serotonergic therapies may be used to manipulate other
      neurotransmitters systems to alleviate BPSD or in combination with agents
      specific for the other neurotransmitter receptor sites. Neurotransmitter
      modulated behaviors and evidence provided by pharmacological interventions are
      reviewed, focusing primarily on the serotonergic system.

PMID- 11207326
TI  - The lactic acid response to alkalosis in panic disorder : an integrative review.
AB  - Panic patients consistently show exaggerated lactic acid response to alkalosis,
      whether produced by hyperventilation or by sodium lactate infusion. Understanding
      why this occurs may provide important clues to the pathogenesis of panic
      disorder. Although brain hypoxia from excessive hypocapnia-induced cerebral
      vasoconstriction is often cited as the mechanism of elevated brain lactic acid in
      panic disorder, studies of brain metabolism show that hypocapnia rarely leads to
      brain hypoxia. Increased lactic acid production is a normal response to
      intracellular alkalosis and to intracellular cyclic AMP. Thus, other possible
      mechanisms of the exaggerated lactic acid response in panic disorder include a
      disturbance of mechanisms regulating intracellular pH and factors increasing
      intracellular cyclic AMP. Both mechanisms are consistent with the suffocation
      false alarm theory of panic disorder. This review suggests a theoretical
      framework for future magnetic resonance spectroscopy studies that can test some
      of the predictions of these competing models.

PMID- 11207327
TI  - Relationship between mood and motor fluctuations in Parkinson's disease.
AB  - Mood fluctuations have been reported in up to two-thirds of patients with
      Parkinson's disease who experience motor fluctuations. Most researchers indicate
      that mood fluctuations tend to be associated with motor fluctuations in that
      patients experience decreased mood when "off" (immobile) and elevated mood when
      "on" (mobile). Sixteen patients with Parkinson's disease and motor fluctuations
      completed hourly diaries for 7 consecutive days documenting their mood, anxiety,
      and motor states using visual analogue scales. Mood and anxiety fluctuations were
      frequently documented. Motor and emotional states were not, however, consistently
      correlated. When they were correlated, the most frequent pattern was the common
      occurrence of decreased mood, increased anxiety, and reduced motor function.

PMID- 11207328
TI  - Neuropsychiatric symptoms of patients with progressive supranuclear palsy and
      Parkinson's disease.
AB  - Neuropsychiatric symptoms are common in basal ganglia disorders and may have
      severe clinical consequences. The authors compared the neuropsychiatric
      manifestations of patients with Parkinson's disease (PD) and progressive
      supranuclear palsy (PSP). All 103 PD patients and 27 of the 61 PSP patients were
      taking dopaminergic agents. PSP patients showed significantly more apathy and
      disinhibition. Patients with PD had higher frequency of hallucinations,
      delusions, and depression. These results suggest that PSP patients show symptoms
      compatible with lesioned orbitofrontal and medial frontal circuits, such as
      disinhibition and apathy, whereas PD patients show symptoms associated with
      monoaminergic disturbances, such as psychosis and depression.

PMID- 11207329
TI  - The psychotic phenomenon in probable Alzheimer's disease: a positron emission
      tomography study.
AB  - Positron emission tomography was used to examine the mechanisms of the psychotic
      phenomenon in Alzheimer's disease (AD). Data from 2 patients with delusions and 2
      with hallucinations were compared with those of 5 AD patients without psychosis.
      The patients with paranoid delusions had diminished relative regional cerebral
      blood flow (rel-CBF) in the left dorsolateral prefrontal and left medial temporal
      cortices. The patients with visual hallucinations showed diminished rel-CBF in
      the right parietal, left medial temporal, and left dorsolateral prefrontal
      cortices. These findings support the hypothesis that a frontal-temporal
      abnormality is associated with paranoid delusions in AD. By contrast, visual
      hallucinations are associated with parietal as well as frontal and temporal lobe
      dysfunction. In these patients, a left prefrontal-temporal cortex dysfunction
      appears to be a common denominator for the development of the psychotic
      phenomenon in AD.

PMID- 11207330
TI  - Psychiatric symptoms associated with cortical-subcortical dysfunction in
      Alzheimer's disease.
AB  - Positron emission tomography was used to evaluate 3 Alzheimer's disease (AD)
      patients: 1 with major depression, 1 with emotional lability, and 1 with apathy.
      Compared with 5 non-mood-disordered AD patients, the patient with depression had
      diminished relative regional cerebral blood flow (rel-CBF) in the anterior
      cingulate and superior temporal cortices, bilaterally. This patient also showed
      diminished rel-CBF in the left dorsolateral prefrontal and right medial temporal
      and parietal cortices. The patient with emotional lability had diminished rel-CBF
      in the anterior cingulate and dorsolateral prefrontal cortices, bilaterally, and
      left basal ganglia. The patient with apathy had diminished rel-CBF in the basal
      ganglia and dorsolateral prefrontal cortex, bilaterally. Results are consistent
      with the hypothesis of a common frontal-temporal-subcortical substrate (e.g.,
      involving aminergic nuclei) in the etiology of depression in AD. Frontal
      subcortical dysfunction may also be associated with emotional lability and apathy
      in AD, although these may be related to a greater involvement of frontal-basal
      ganglia circuits.

PMID- 11207331
TI  - Risk factors in psychosis secondary to traumatic brain injury.
AB  - Psychosis is a rare but devastating sequela of traumatic brain injury (TBI). This
      study examined risk factors for developing a psychosis secondary to TBI (PSTBI).
      Demographics of 25 inpatients with PSTBI were statistically analyzed for risk
      factors. Data from the PSTBI group were also compared with data from a control
      group of TBI patients without psychosis. Results indicate the PSTBI group was
      more likely to have had a previous congenital neurological disorder or to have
      sustained a head injury prior to adolescence. The PSTBI also had a higher
      proportion of males. Discussion focuses on potential models for developing PSTBI.

PMID- 11207332
TI  - Personality disorder in multiple sclerosis correlates with cognitive impairment.
AB  - Previous studies of personality change in multiple sclerosis (MS) relied on
      brief, nonstandardized assessments or tests that are confounded with symptoms of
      acute psychiatric disorder. Objectives of the present study were to evaluate
      character change in MS by using comprehensive trait measures of personality and
      to determine if there is an association between personality change and cognitive
      dysfunction. Thirty-four MS patients and 14 healthy volunteers were studied. All
      underwent comprehensive neurologic and neuropsychologic evaluation. Personality
      assessments included both self and informant reports on the Hogan Empathy Scale
      and the NEO Personality Inventory. Abnormalities were found among MS patients
      indicating elevated neuroticism and reduction in empathy, agreeableness, and
      conscientiousness. Large patient/informant discrepancies were observed in the MS
      but not the control group. Three neuropsychological tests emphasizing executive
      control predicted the presence of these abnormalities; this association suggests
      a neurogenic, frontal lobe syndrome.

PMID- 11207333
TI  - An EEG severity index of traumatic brain injury.
AB  - EEG spectral analyses were conducted from 19 scalp locations for patients with
      mild (n=40), moderate (n=25), and severe (n=43) traumatic brain injury (TBI), 15
      days to 4 years after injury. Severity of TBI was judged by emergency hospital
      admission records (Glasgow Coma Score and duration of coma and amnesia). Highest
      loading EEG variables on each factor that differed significantly between severe
      and mild TBI by univariate t-test were entered into a multivariate discriminant
      analysis, yielding 16 variables. Discriminant analysis between mild and severe
      TBI groups showed classification accuracy of 96.39%, sensitivity 95.45%, and
      specificity 97.44%. The EEG discriminant score also measured intermediate
      severity in moderate TBI patients. Results were cross-validated in 503 VA
      patients. Significant correlations between EEG discriminant scores, emergency
      admission measures, and post-trauma neuropsychological test scores validated the
      discriminant function as an index of severity of injury and a classifier of the
      extremes of severity.

PMID- 11207334
TI  - Depression does not influence basal ganglia-mediated psychomotor speed in HIV-1
      infection.
AB  - The authors examined the effects of depressive mood (Hamilton Rating Scale for
      Depression [Ham-D]) on basal ganglia-mediated psychomotor speed (motor test
      battery) in 202 HIV-1 seropositive homosexual males with no prior history of
      antiretroviral treatment. HIV-1 seropositive patients showed a significant
      slowing of most rapid alternating movements (MRAM) and significantly prolonged
      contraction times (CT) compared with 66 HIV-1 seronegative male control subjects.
      Factor analysis of Ham-D scores isolated a factor containing the items depressed
      mood, suicide, and psychic and somatic anxiety. This factor did not correlate
      with MRAM or CT. Depression and psychomotor speed are independent in HIV
      1infection.

PMID- 11207335
TI  - Ventricular enlargement in adults with profound mental retardation who
      demonstrate violent/destructive behaviors.
AB  - The authors determined brain ventricular size (ventricular brain ratio [VBR]) in
      39 ambulatory adult mentally retarded individuals who did or did not require
      psychotropic medication for violent/destructive behavior. The mean VBR of
      mentally retarded patients who required psychotropic medication was significantly
      greater than the VBR of those who did not require such medication.

PMID- 11207336
TI  - Dissociative flashbacks after right frontal injury in a vietnam veteran with
      combat-related posttraumatic stress disorder.
AB  - A Vietnam veteran with a combat-related posttraumatic stress disorder developed
      recurrent dissociative flashbacks (related to the atrocities of a specific war
      incident) several months after suffering a traumatic brain injury. CT disclosed a
      small lesion in the right dorsolateral prefrontal cortex. SPECT demonstrated more
      extensive functional changes in prefrontal and anterior paralimbic brain regions,
      mainly in the right hemisphere. This case further implicates the provocative
      effect of physical stimuli (brain damage) in reawakening old dormant memories and
      the preferential role of the right hemisphere for the storage of traumatic
      memories.

PMID- 11207337
TI  - A "cure" for chronic combat-related posttraumatic stress disorder secondary to a
      right frontal lobe infarct: a case report.
AB  - A 48-year-old combat veteran sustained a right frontal cerebral infarct at the
      age of 45 years. The patient's family reports that prior to the infarct he had a
      preoccupation with memories of combat, as well as nightmares, avoidance of
      reminders, and multiple arousal symptoms. Since his recovery from the infarct,
      the patient and his family continue to relate significant arousal symptoms but
      deny any continued history of preoccupation with traumatic memories, reminder
      avoidance, or nightmares. The resolution of a limited number of symptoms in this
      patient following damage to the right frontal cortex suggests that some of the
      symptoms of posttraumatic stress disorder may be amenable to current biological
      interventions.

PMID- 11207338
TI  - Cerebellar-subcortical circuits and mania in cerebellar disease.

PMID- 11207339
TI  - Critical use of venlafaxine serology to uncover genetic rapid metabolism.

PMID- 11207340
TI  - Full remission of panic attacks in a schizophrenic patient after switching from
      haloperidol to risperidone.

PMID- 11207341
TI  - Risperidone addition and psychotic exacerbation.

PMID- 11207342
TI  - Obsessive-compulsive schizophrenia: a new diagnostic entity?

PMID- 11207344
TI  - A case of myasthenia gravis preceded by major depression.

PMID- 11207349
TI  - Gene-expression profiles in hereditary breast cancer.
AB  - BACKGROUND: Many cases of hereditary breast cancer are due to mutations in either
      the BRCA1 or the BRCA2 gene. The histopathological changes in these cancers are
      often characteristic of the mutant gene. We hypothesized that the genes expressed
      by these two types of tumors are also distinctive, perhaps allowing us to
      identify cases of hereditary breast cancer on the basis of gene-expression
      profiles. METHODS: RNA from samples of primary tumor from seven carriers of the
      BRCA1 mutation, seven carriers of the BRCA2 mutation, and seven patients with
      sporadic cases of breast cancer was compared with a microarray of 6512
      complementary DNA clones of 5361 genes. Statistical analyses were used to
      identify a set of genes that could distinguish the BRCA1 genotype from the BRCA2
      genotype. RESULTS: Permutation analysis of multivariate classification functions
      established that the gene-expression profiles of tumors with BRCA1 mutations,
      tumors with BRCA2 mutations, and sporadic tumors differed significantly from each
      other. An analysis of variance between the levels of gene expression and the
      genotype of the samples identified 176 genes that were differentially expressed
      in tumors with BRCA1 mutations and tumors with BRCA2 mutations. Given the known
      properties of some of the genes in this panel, our findings indicate that there
      are functional differences between breast tumors with BRCA1 mutations and those
      with BRCA2 mutations. CONCLUSIONS: Significantly different groups of genes are
      expressed by breast cancers with BRCA1 mutations and breast cancers with BRCA2
      mutations. Our results suggest that a heritable mutation influences the gene
      expression profile of the cancer.

PMID- 11207350
TI  - Genetic variation in alcohol dehydrogenase and the beneficial effect of moderate
      alcohol consumption on myocardial infarction.
AB  - BACKGROUND: A polymorphism in the gene for alcohol dehydrogenase type 3 (ADH3)
      alters the rate of alcohol metabolism. We investigated the relation among the
      ADH3 polymorphism, the level of alcohol consumption, and the risk of myocardial
      infarction in a nested case-control study based on data from the prospective
      Physicians' Health Study. METHODS: We identified 396 patients with eligible newly
      diagnosed cases of myocardial infarction among men in the Physicians' Health
      Study. Of these patients, 374 were matched with 2 randomly selected control
      subjects each and the remaining 22 with 1 control each (total, 770 controls). The
      ADH3 genotype (gamma1gamma1, gamma1gamma2, or gamma2gamma2) was determined in all
      subjects. We examined the relations among the level of alcohol intake, the ADH3
      genotype, and plasma high-density lipoprotein (HDL) levels in this study
      population and in a similar cohort of women. RESULTS: As compared with
      homozygosity for the allele associated with a fast rate of ethanol oxidation
      (gamma1), homozygosity for the allele associated with a slow rate of ethanol
      oxidation (gamma2) was associated with a reduced risk of myocardial infarction
      (relative risk, 0.65; 95 percent confidence interval, 0.43 to 0.99). Moderate
      alcohol consumption was associated with a decreased risk of myocardial infarction
      in all three genotype groups (gamma1gamma1, gamma1gamma2, and gamma2gamma2);
      however, the ADH3 genotype significantly modified this association (P=0.01 for
      the interaction). Among men who were homozygous for the gamma1 allele, those who
      consumed at least one drink per day had a relative risk of myocardial infarction
      of 0.62 (95 percent confidence interval, 0.34 to 1.13), as compared with the risk
      among men who consumed less than one drink per week. Men who consumed at least
      one drink per day and were homozygous for the gamma2 allele had the greatest
      reduction in risk (relative risk, 0.14; 95 percent confidence interval, 0.04 to
      0.45). Such men also had the highest plasma HDL levels (P for interaction =
      0.05). We confirmed the interaction among the ADH3 genotype, the level of alcohol
      consumption, and the HDL level in an independent study of postmenopausal women
      (P=0.02). CONCLUSIONS: Moderate drinkers who are homozygous for the slow
      oxidizing ADH3 allele have higher HDL levels and a substantially decreased risk
      of myocardial infarction.

PMID- 11207351
TI  - Lack of effect of induction of hypothermia after acute brain injury.
AB  - BACKGROUND: Induction of hypothermia in patients with brain injury was shown to
      improve outcomes in small clinical studies, but the results were not definitive.
      To study this issue, we conducted a multicenter trial comparing the effects of
      hypothermia with those of normothermia in patients with acute brain injury.
      METHODS: The study subjects were 392 patients 16 to 65 years of age with coma
      after sustaining closed head injuries who were randomly assigned to be treated
      with hypothermia (body temperature, 33 degrees C), which was initiated within 6
      hours after injury and maintained for 48 hours by means of surface cooling, or
      normothermia. All patients otherwise received standard treatment. The primary
      outcome measure was functional status six months after the injury. RESULTS: The
      mean age of the patients and the type and severity of injury in the two treatment
      groups were similar. The mean (+/-SD) time from injury to randomization was 4.3+/
      1.1 hours in the hypothermia group and 4.1+/-1.2 hours in the normothermia group,
      and the mean time from injury to the achievement of the target temperature of 33
      degrees C in the hypothermia group was 8.4+/-3.0 hours. The outcome was poor
      (defined as severe disability, a vegetative state, or death) in 57 percent of the
      patients in both groups. Mortality was 28 percent in the hypothermia group and 27
      percent in the normothermia group (P=0.79). The patients in the hypothermia group
      had more hospital days with complications than the patients in the normothermia
      group. Fewer patients in the hypothermia group had high intracranial pressure
      than in the normothermia group. CONCLUSIONS: Treatment with hypothermia, with the
      body temperature reaching 33 degrees C within eight hours after injury, is not
      effective in improving outcomes in patients with severe brain injury.

PMID- 11207352
TI  - Intussusception among infants given an oral rotavirus vaccine.
AB  - BACKGROUND: Intussusception is a form of intestinal obstruction in which a
      segment of the bowel prolapses into a more distal segment. Our investigation
      began on May 27, 1999, after nine cases of infants who had intussusception after
      receiving the tetravalent rhesus-human reassortant rotavirus vaccine (RRV-TV)
      were reported to the Vaccine Adverse Event Reporting System. METHODS: In 19
      states, we assessed the potential association between RRV-TV and intussusception
      among infants at least 1 but less than 12 months old. Infants hospitalized
      between November 1, 1998, and June 30, 1999, were identified by systematic
      reviews of medical and radiologic records. Each infant with intussusception was
      matched according to age with four healthy control infants who had been born at
      the same hospital as the infant with intussusception. Information on vaccinations
      was verified by the provider. RESULTS: Data were analyzed for 429 infants with
      intussusception and 1763 matched controls in a case-control analysis as well as
      for 432 infants with intussusception in a case-series analysis. Seventy-four of
      the 429 infants with intussusception (17.2 percent) and 226 of the 1763 controls
      (12.8 percent) had received RRV-TV (P=0.02). An increased risk of intussusception
      3 to 14 days after the first dose of RRV-TV was found in the case-control
      analysis (adjusted odds ratio, 21.7; 95 percent confidence interval, 9.6 to
      48.9). In the case-series analysis, the incidence-rate ratio was 29.4 (95 percent
      confidence interval, 16.1 to 53.6) for days 3 through 14 after a first dose.
      There was also an increase in the risk of intussusception after the second dose
      of the vaccine, but it was smaller than the increase in risk after the first
      dose. Assuming full implementation of a national program of vaccination with RRV
      TV, we estimated that 1 case of intussusception attributable to the vaccine would
      occur for every 4670 to 9474 infants vaccinated. CONCLUSIONS: The strong
      association between vaccination with RRV-TV and intussusception among otherwise
      healthy infants supports the existence of a causal relation. Rotavirus vaccines
      with an improved safety profile are urgently needed.

PMID- 11207353
TI  - A mutation in the surfactant protein C gene associated with familial interstitial
      lung disease.

PMID- 11207354
TI  - Images in clinical medicine. Four types of acute post-traumatic intracranial
      hemorrhage.

PMID- 11207355
TI  - Neonatal hyperbilirubinemia.

PMID- 11207356
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 6-2001. A 17-year-old girl with marked jaundice and weight loss.

PMID- 11207357
TI  - Genome-wide views of cancer.

PMID- 11207358
TI  - Hypothermia for traumatic brain injury--a good idea proved ineffective.

PMID- 11207359
TI  - Quality control of mRNA function.

PMID- 11207360
TI  - A general model for nucleic acid helicases and their "coupling" within
      macromolecular machines.

PMID- 11207361
TI  - Mutations in the RNA component of RNase MRP cause a pleiotropic human disease,
      cartilage-hair hypoplasia.
AB  - The recessively inherited developmental disorder, cartilage-hair hypoplasia (CHH)
      is highly pleiotropic with manifestations including short stature, defective
      cellular immunity, and predisposition to several cancers. The endoribonuclease
      RNase MRP consists of an RNA molecule bound to several proteins. It has at least
      two functions, namely, cleavage of RNA in mitochondrial DNA synthesis and
      nucleolar cleaving of pre-rRNA. We describe numerous mutations in the
      untranslated RMRP gene that cosegregate with the CHH phenotype. Insertion
      mutations immediately upstream of the coding sequence silence transcription while
      mutations in the transcribed region do not. The association of protein subunits
      with RNA appears unaltered. We conclude that mutations in RMRP cause CHH by
      disrupting a function of RNase MRP RNA that affects multiple organ systems.

PMID- 11207362
TI  - Loss of the ClC-7 chloride channel leads to osteopetrosis in mice and man.
AB  - Chloride channels play important roles in the plasma membrane and in
      intracellular organelles. Mice deficient for the ubiquitously expressed ClC-7 Cl(
      ) channel show severe osteopetrosis and retinal degeneration. Although
      osteoclasts are present in normal numbers, they fail to resorb bone because they
      cannot acidify the extracellular resorption lacuna. ClC-7 resides in late
      endosomal and lysosomal compartments. In osteoclasts, it is highly expressed in
      the ruffled membrane, formed by the fusion of H(+)-ATPase-containing vesicles,
      that secretes protons into the lacuna. We also identified CLCN7 mutations in a
      patient with human infantile malignant osteopetrosis. We conclude that ClC-7
      provides the chloride conductance required for an efficient proton pumping by the
      H(+)-ATPase of the osteoclast ruffled membrane.

PMID- 11207363
TI  - MiRP2 forms potassium channels in skeletal muscle with Kv3.4 and is associated
      with periodic paralysis.
AB  - The subthreshold, voltage-gated potassium channel of skeletal muscle is shown to
      contain MinK-related peptide 2 (MiRP2) and the pore-forming subunit Kv3.4. MiRP2
      Kv3.4 channels differ from Kv3.4 channels in unitary conductance, voltage
      dependent activation, recovery from inactivation, steady-state open probability,
      and block by a peptide toxin. Thus, MiRP2-Kv3.4 channels set resting membrane
      potential (RMP) and do not produce afterhyperpolarization or cumulative
      inactivation to limit action potential frequency. A missense mutation is
      identified in the gene for MiRP2 (KCNE3) in two families with periodic paralysis
      and found to segregate with the disease. Mutant MiRP2-Kv3.4 complexes exhibit
      reduced current density and diminished capacity to set RMP. Thus, MiRP2 operates
      with a classical potassium channel subunit to govern skeletal muscle function and
      pathophysiology.

PMID- 11207364
TI  - Morphogenesis and renewal of hair follicles from adult multipotent stem cells.
AB  - The upper region of the outer root sheath of vibrissal follicles of adult mice
      contains multipotent stem cells that respond to morphogenetic signals to generate
      multiple hair follicles, sebaceous glands, and epidermis, i.e., all the lineages
      of the hairy skin. At the time when hair production ceases and when the lower
      region of the follicle undergoes major structural changes, the lower region
      contains a significant number of clonogenic keratinocytes, and can then respond
      to morphogenetic signals. This demonstrates that multipotent stem cells migrate
      to the root of the follicle to produce whisker growth. Moreover, our results
      indicate that the clonogenic keratinocytes are closely related, if not identical,
      to the multipotent stem cells, and that the regulation of whisker growth
      necessitates a precise control of stem cell trafficking.

PMID- 11207365
TI  - A human BRCA2 complex containing a structural DNA binding component influences
      cell cycle progression.
AB  - Germline mutations of the human BRCA2 gene confer susceptibility to breast
      cancer. Although the function of the BRCA2 protein remains to be determined,
      murine cells homozygous for BRCA2 inactivation display chromosomal aberrations.
      We have isolated a 2 MDa BRCA2-containing complex and identified a structural DNA
      binding component, designated as BRCA2-Associated Factor 35 (BRAF35). BRAF35
      contains a nonspecific DNA binding HMG domain and a kinesin-like coiled coil
      domain. Similar to BRCA2, BRAF35 mRNA expression levels in mouse embryos are
      highest in proliferating tissues with high mitotic index. Strikingly, nuclear
      staining revealed a close association of BRAF35/BRCA2 complex with condensed
      chromatin coincident with histone H3 phosphorylation. Importantly, antibody
      microinjection experiments suggest a role for BRCA2/BRAF35 complex in modulation
      of cell cycle progression.

PMID- 11207366
TI  - Branch migration and Holliday junction resolution catalyzed by activities from
      mammalian cells.
AB  - During homologous recombination, DNA strand exchange leads to Holliday junction
      formation. The movement, or branch migration, of this junction along DNA extends
      the length of the heteroduplex joint. In prokaryotes, branch migration and
      Holliday junction resolution are catalyzed by the RuvA and RuvB proteins, which
      form a complex with RuvC resolvase to form a "resolvasome". Mammalian cell-free
      extracts have now been fractionated to reveal analogous activities. An ATP
      dependent branch migration activity, which migrates junctions through >2700 bp,
      cofractionates with the Holliday junction resolvase during several
      chromatographic steps. Together, the two activities promote concerted branch
      migration/resolution reactions similar to those catalyzed by E. coli RuvABC,
      highlighting the preservation of this essential pathway in recombination and DNA
      repair from prokaryotes to mammals.

PMID- 11207367
TI  - Replication initiation proteins regulate a developmental checkpoint in Bacillus
      subtilis.
AB  - We identified a signaling pathway that prevents initiation of sporulation in
      Bacillus subtilis when replication initiation is impaired. We isolated mutations
      that allow a replication initiation mutant (dnaA) to sporulate. These mutations
      affect a small open reading frame, sda, that was overexpressed in replication
      initiation mutants and appears to be directly regulated by DnaA. Mutations in
      replication initiation genes inhibit the onset of sporulation by preventing
      activation of a transcription factor required for sporulation, Spo0A. Deletion of
      sda restored activation of Spo0A in replication initiation mutants.
      Overexpression of sda in otherwise wild-type cells inhibited activation of Spo0A
      and sporulation. Purified Sda inhibited a histidine kinase needed for activation
      of Spo0A. Our results indicate that control of sda by DnaA establishes a
      checkpoint that inhibits activation of Spo0A and prevents futile attempts to
      initiate sporulation.

PMID- 11207368
TI  - Lipoxygenase mRNA silencing in erythroid differentiation: The 3'UTR regulatory
      complex controls 60S ribosomal subunit joining.
AB  - 15-lipoxygenase (LOX) expression is translationally silenced in early erythroid
      precursor cells by a specific mRNA-protein complex formed between the
      differentiation control element in the 3' untranslated region (UTR) and hnRNPs K
      and E1. The 3'UTR regulatory complex prevents translation initiation by an
      unknown mechanism. We demonstrate that the 40S ribosomal subunit can be recruited
      and scan to the translation initiation codon even when the silencing complex is
      bound to the 3'UTR. However, the joining of the 60S ribosomal subunit at the AUG
      codon to form a translation competent 80S ribosome is inhibited, unless
      initiation is mediated by the IGR-IRES of the cricket paralysis virus. These
      findings identify the critical step at which LOX mRNA translation is controlled
      and reveal that 60S subunit joining can be specifically regulated.

PMID- 11207369
TI  - Structure of the complete extracellular domain of the common beta subunit of the
      human GM-CSF, IL-3, and IL-5 receptors reveals a novel dimer configuration.
AB  - The receptor systems for the hemopoietic cytokines GM-CSF, IL-3, and IL-5 consist
      of ligand-specific alpha receptor subunits that play an essential role in the
      activation of the shared betac subunit, the major signaling entity. Here, we
      report the structure of the complete betac extracellular domain. It has a
      structure unlike any class I cytokine receptor described thus far, forming a
      stable interlocking dimer in the absence of ligand in which the G strand of
      domain 1 hydrogen bonds into the corresponding beta sheet of domain 3 of the
      dimer-related molecule. The G strand of domain 3 similarly partners with the
      dimer-related domain 1. The structure provides new insights into receptor
      activation by the respective alpha receptor:ligand complexes.

PMID- 11207370
TI  - Crystal structure of a complement control protein that regulates both pathways of
      complement activation and binds heparan sulfate proteoglycans.
AB  - Vaccinia virus complement control protein (VCP) inhibits both pathways of
      complement activation through binding the third and fourth components. A homolog
      of mammalian regulators of complement activation, its ability to bind heparin
      endows VCP with additional activities of significance to viral infectivity. The
      structure of VCP reveals a highly extended molecule with a putative heparin
      recognition site at its C-terminal end. A second cluster of positive charges
      provides a possibly overlapping binding site for both heparin and complement
      components. Experiments suggested by the structure indicate that VCP can bind
      heparin and control complement simultaneously. This, the structure of any intact
      regulator of complement activation, along with attendant functional insights,
      will stimulate the design of new therapeutic inhibitors of complement.

PMID- 11207371
TI  - Protein sorting upon exit from the endoplasmic reticulum.
AB  - It is currently thought that all secretory proteins travel together to the Golgi
      apparatus where they are sorted to different destinations. However, the specific
      requirements for transport of GPI-anchored proteins from the endoplasmic
      reticulum to the Golgi apparatus in yeast could be explained if protein sorting
      occurs earlier in the pathway. Using an in vitro assay that reconstitutes a
      single round of budding from the endoplasmic reticulum, we found that GPI
      anchored proteins and other secretory proteins exit the endoplasmic reticulum in
      distinct vesicles. Therefore, GPI-anchored proteins are sorted from other
      proteins, in particular other plasma membrane proteins, at an early stage of the
      secretory pathway. These results have wide implications for the mechanism of
      protein exit from the endoplasmic reticulum.

PMID- 11207374
TI  - The roles of iron in health and disease.
AB  - Iron is vital for almost all living organisms by participating in a wide variety
      of metabolic processes, including oxygen transport, DNA synthesis, and electron
      transport. However, iron concentrations in body tissues must be tightly regulated
      because excessive iron leads to tissue damage, as a result of formation of free
      radicals. Disorders of iron metabolism are among the most common diseases of
      humans and encompass a broad spectrum of diseases with diverse clinical
      manifestations, ranging from anemia to iron overload and, possibly, to
      neurodegenerative diseases. The molecular understanding of iron regulation in the
      body is critical in identifying the underlying causes for each disease and in
      providing proper diagnosis and treatments. Recent advances in genetics, molecular
      biology and biochemistry of iron metabolism have assisted in elucidating the
      molecular mechanisms of iron homeostasis. The coordinate control of iron uptake
      and storage is tightly regulated by the feedback system of iron responsive
      element-containing gene products and iron regulatory proteins that modulate the
      expression levels of the genes involved in iron metabolism. Recent identification
      and characterization of the hemochromatosis protein HFE, the iron importer
      Nramp2, the iron exporter ferroportin1, and the second transferrin-binding and 
      transport protein transferrin receptor 2, have demonstrated their important roles
      in maintaining body's iron homeostasis. Functional studies of these gene products
      have expanded our knowledge at the molecular level about the pathways of iron
      metabolism and have provided valuable insight into the defects of iron metabolism
      disorders. In addition, a variety of animal models have implemented the
      identification of many genetic defects that lead to abnormal iron homeostasis and
      have provided crucial clinical information about the pathophysiology of iron
      disorders. In this review, we discuss the latest progress in studies of iron
      metabolism and our current understanding of the molecular mechanisms of iron
      absorption, transport, utilization, and storage. Finally, we will discuss the
      clinical presentations of iron metabolism disorders, including secondary iron
      disorders that are either associated with or the result of abnormal iron
      accumulation.

PMID- 11207375
TI  - Effects of chronic alcohol ingestion on the mesostriatal dopamine system in the
      rat.
AB  - The effects of chronic alcohol use on the mesostriatal dopamine (DA) system
      remain relatively unknown. The aim of the present study was to assess multiple
      measures of the status of the mesostriatal DA system in rats chronically fed an
      alcohol diet for approximately 1 year. Tissue levels of DA and its metabolite,
      3,4-dihydroxyphenylacetic acid, were significantly decreased in both the dorsal
      striatum (34 and 33%, respectively) and ventral striatum (33 and 36%,
      respectively) in alcohol-fed rats compared to pair-fed matched controls. Western
      blotting revealed a mean 20% decrease in tyrosine hydroxylase protein levels in
      the dorsal and ventral striatum of alcohol-fed animals while dopamine transporter
      protein levels from the same animals were significantly increased compared to
      controls (mean 60% increase for the dorsal and ventral striatum). The present
      results demonstrate significant alterations in the mesostriatal DA system after 1
      year of chronic alcohol use. It is possible that the observed changes in DA
      synthesis and re-uptake measures result in altered intracellular and
      extracellular DA levels, perhaps contributing to the addictive properties of
      alcohol.

PMID- 11207376
TI  - Beta-amyloid peptide induces the expression of voltage dependent outward
      rectifying K+ channels in rat microglia.
AB  - Upregulation of voltage-dependent outward rectifying K+ (Kv) channels has been
      reported in activated microglia. Since beta-amyloid peptide (A beta) is known to
      activate microglia, we tested whether the exposure of cultured rat microglia to A
      beta fragment 25-35 (A beta 25-35) induced the Kv current. A beta 25-35 in 5-200
      nM concentration range significantly increased Kv current density, while there
      was small change in inward rectifying K+ current density. The full length A beta
      peptide (A beta 1-42) also increased Kv current. However, the control peptide, A
      beta 35-25, did not induce Kv current. Most of the Kv current induced by A beta
      was specifically blocked by the presence of antisense deoxyoligonucleotides
      against Kv1.3, and Kv1.5. Thus, it is concluded that we have identified Kv1.3 and
      Kv1.5 as the channel types expressed in A beta-treated microglia.

PMID- 11207377
TI  - Calcitonin gene-related peptide modifies the ectopic discharge from damaged nerve
      fibres in the ferret.
AB  - Previous studies in our laboratory have shown that the neuropeptide, calcitonin
      gene-related peptide (CGRP) accumulates at a site of inferior alveolar nerve
      injury at the time when high levels of spontaneous activity and mechanical
      sensitivity are recorded electrophysiologically. The present study was undertaken
      to determine whether or not the CGRP could be playing a role in initiating or
      modulating the neuronal activity. In 18 anaesthetised adult ferrets the left
      inferior alveolar nerve was sectioned and ligated and recovery permitted for 3
      days. Under a second anaesthetic recordings were made from a fine nerve filament,
      containing up to four active or silent units, dissected from the nerve proximal
      to the injury. After recording activity for a 30 min control period, CGRP and
      then the CGRP antagonist (CGRP 8-37) were applied either by close-arterial
      injection or topically (10(-4) M, 0.2 ml). After each application activity was
      recorded for a 30 min period. Recordings were made from 52 units, of which 26
      (50%) were spontaneously active and 30 (58%) were mechanically sensitive. The
      spontaneous activity in five units was increased by the application of CGRP, and
      the CGRP antagonist subsequently reduced the activity in two of these units.
      Activity was induced by CGRP in three previously silent units. Overall, activity
      was affected in 19% of the units studied. We conclude that CGRP present within a
      neuroma may initiate or modulate the level of ectopic discharge from some damaged
      nerve fibres and therefore may contribute to the sensory disturbances which
      follow nerve injury.

PMID- 11207378
TI  - Induction of polysialic acid-neural cell adhesion molecule in surviving
      motoneurons of transgenic amyotrophic lateral sclerosis mice.
AB  - The highly polysialylated neural cell adhesion molecule (PSA-NCAM) is recognized
      as a marker of neurogenesis or neural plasticity in adult nervous system. PSA
      NCAM expression was examined in the spinal cord of transgenic mice harboring a
      mutant Cu/Zn superoxide dismutase (SOD1) gene. Immunohistochemistry showed a
      progressive expression of PSA-NCAM in surviving motoneurons of spinal ventral
      horns from an early and presymptomatic stage (25 weeks) before significant loss
      of ventral horn neurons, while no detectable PSA-NCAM in the ventral horn of non
      transgenic littermates during the ageing process. The present data suggest that a
      specific expression of PSA-NCAM may be involved in the survival of spinal
      motoneurons under pathological conditions such as amyotrophic lateral sclerosis.

PMID- 11207379
TI  - Intrapallidal D2 dopamine receptors control globus pallidus neuron activity in
      the rat.
AB  - Because activation of D2 dopamine receptors inhibits gamma-aminobutyric acid
      (GABA) release from intrapallidal nerve terminals, we measured the effects of
      modifiers of dopamine D2 receptors on the firing rate of single neurons in the
      globus pallidus (GP) of the anesthetized rat. The predominant effect of
      intrapallidal administration of the selective D2 agonist quinpirole was an
      increase in the rate of spontaneous firing while the D2 blocker sulpiride caused
      a decrease. The spontaneous firing of GP neurons is inhibited by stimulation of
      the GABAergic striatopallidal projection. We therefore measured the effects of
      modifiers of D2 receptors on striatal inhibition of GP neurons and found that
      intrapallidal quinpirole blocked the inhibitory effects of striatal stimulation
      while sulpiride enhanced them. These experiments show that both the spontaneous
      rate of firing of pallidal neurons and its modification by striatopallidal inputs
      is controlled by intrapallidal dopamine D2 receptors. In addition, taken together
      with other findings in the literature, our results suggest that activation of
      dopamine D2 receptors within the globus pallidus leads to inhibition of GABA
      release from presynaptic terminals.

PMID- 11207380
TI  - Transient receptor potential protein mRNA expression in rat substantia nigra.
AB  - Receptor gated Ca2+ entry has been associated with transient receptor potential
      (TRP) proteins encoded by several different genes. Here, we compare expression of
      mRNA for TRP isoforms encoded by genes TRP1-6 in the rat substantia nigra and
      whole brain. The substantia nigra and the whole brain expressed mRNA
      predominantly for TRP3 and TRP6. The levels of TRP1, 2, 4 and 5 were very low in
      both. The TRP6 mRNA levels in substantia nigra and the whole brain were
      comparable while those for TRP3 were significantly lower in substantia nigra than
      in the whole brain. Thus substantia nigra differs from the whole brain in its TRP
      expression.

PMID- 11207381
TI  - Hyperpolarizing shift by quinine in the steady-state inactivation curve of
      delayed rectifier-type potassium current in bullfrog sympathetic neurons.
AB  - Whole-cell recordings were made from dissociated bullfrog sympathetic neurons to
      examine the actions of quinine (1-100 microM) on the steady-state activation and
      inactivation curves of a delayed rectifier-type potassium current (I(K)). Quinine
      (EC50 approximately 8 microM) caused a hyperpolarizing shift (approximately 31 mV
      with 30 microM) in the inactivation curve of I(K) without significantly affecting
      its activation curve. Quinine (20 microM) was without effects on the voltage
      dependence of a rapidly-inactivating A-type potassium current (I(A)). It is
      concluded that quinine can selectively modulate the voltage-dependence of I(K) in
      amphibian autonomic neurons.

PMID- 11207383
TI  - Tau protein in cerebrospinal fluid (CSF): a blood-CSF barrier related evaluation
      in patients with various neurological diseases.
AB  - Tau protein (tau) is primarily localised in neurons, and after brain parenchymal
      damage its release into cerebrospinal fluid (CSF) is increased. The particular
      influences of blood-CSF barrier function and of disease topography on CSF tau
      levels have not been studied yet. CSF tau concentrations determined by enzyme
      immunoassay in various neurological diseases (n = 61) were not dependent upon
      blood-CSF barrier dysfunction. Significant elevation of tau levels in patients
      with meningoencephalitis and cerebral hemorrhage indicates brain parenchymal
      damage. In contrast, tau levels remained normal in patients with bacterial
      meningitis if encephalitic complications did not occur. In patients with Guillain
      Barre syndrome tau levels were low. Increased tau levels in active multiple
      sclerosis compared to clinically nonactive states indicate axonal pathology in
      active disease.

PMID- 11207382
TI  - Functional expression of cholecystokinin-A receptor on ventromedial hypothalamic
      neurons in the immature rat brain.
AB  - Cholecystokinin-8 (CCK-8) dose-dependently increased the cytosolic Ca2+
      concentration ([Ca]i) in ventromedial hypothalamic neurons acutely dissociated
      from the immature rat brain. The CCK-8 response was mimicked by caerulein, but
      not by CCK(B) agonists, and was often inhibited by CCK(A) receptor antagonists,
      but rarely by CCK(B) receptor antagonists. The response was dependent on external
      Ca2+ and Na+, and was inhibited by voltage-dependent Ca2+ channel blockers. The
      results suggest that CCK-8-induced depolarization via CCK(A) receptors increased
      Ca2+ influx through a voltage-dependent Ca2+ channel, which in turn increased
      [Ca]i.

PMID- 11207384
TI  - A monoclonal antibody that enables specific immunohistological detection of prion
      protein in bovine spongiform encephalopathy cases.
AB  - The specificity of a monoclonal antibody (mAB) raised against recombinant bovine
      prion protein (PrP) for the immunohistological detection of PrP accumulation in
      the medulla oblongata of bovine spongiform encephalopathy (BSE) and ovine scrapie
      cases was investigated. mAB KG9 showed a diffuse low intensity reaction with the
      cytoplasm of neurones in normal cattle and sheep sections. In BSE sections the
      mAB detected widespread granular deposits of PrP associated with neurones and the
      neuropil. Although scrapie sections showed similar levels of granular deposits
      with another antibody to PrP these were not detected by KG9 which did however
      detect diffuse staining in neuronal cytoplasm. Possible explanations for the
      specificity of binding of KG9 are discussed.

PMID- 11207385
TI  - Caspase activation as an apoptotic evidence in the gerbil hippocampal CA1
      pyramidal cells following transient forebrain ischemia.
AB  - To determine whether apoptotic process is involved in the delayed neuronal death
      in hippocampal CA1 region following forebrain ischemia in gerbils, time dependent
      activation of caspase and DNA fragmentation were evaluated by immuno-staining and
      terminal dUTP nick-end-labeling staining, respectively. After transient forebrain
      ischemia in gerbils, activation of apoptosis related caspase, including caspase
      3, was apparent, and it preceded DNA fragmentation in CA1 region. These
      observations suggest that apoptotic process is involved in hippocampal delayed
      neuronal death.

PMID- 11207386
TI  - The role of the chorda tympani nerve in the activation of the rat hypothalamic
      histaminergic system by leptin.
AB  - A possible pathway through which leptin activates the histaminergic system was
      studied using in vivo microdialysis in rats. Intraperitoneal injection of leptin
      (1.3 mg/kg) caused a significant increase in hypothalamic histamine release,
      however, its intracerebroventricular injection (10 microg/rat) did not cause any
      significant changes in the release. Furthermore, leptin (1.3 mg/kg) had no effect
      on histamine release in rats whose chorda tympani nerves, a branch of the facial
      nerve which mediates taste information, were transected bilaterally. These
      findings indicate that leptin activates the histaminergic system by the
      peripheral signal inputs via the chorda tympani resulting in the suppression of
      food intake.

PMID- 11207388
TI  - Collaboration of fibronectin matrix and neurotrophin in regulating spontaneous
      transmitter release at developing neuromuscular synapses in Xenopus cell
      cultures.
AB  - Integrins mediate cell-extracellular matrix connection and are particularly
      important during neuronal development. We here investigated the regulation of
      fibronectin (FN) matrix and neurotrophins on the embryonic synaptic transmission.
      Spontaneous synaptic currents (SSCs) were recorded from innervated myocytes of 1
      day-old Xenopus cultures by whole-cell recordings. The SSC increasing action of
      alpha,beta-methylene adenosine triphosphate was enhanced in neurons grown on FN
      substratum, which was further potentiated by chronic treatment with brain-derived
      neurotrophic factor (BDNF). The SSC increasing action of thapsigargin, carbonyl
      cyanide m-chlorophenylhydrazone and N-methyl-D-aspartate was also markedly
      potentiated in neurons grown on FN-coated glass coverslips and chronically
      treated with BDNF. FN matrix or BDNF alone only exerts slight potentiation on the
      SSC increasing action of these three drugs. Our results suggest that FN matrix
      can collaborate with neurotrophin in regulating synaptic transmission at
      developing motoneurons, which may play an important role in the maturation of
      embryonic neuromuscular junction.

PMID- 11207387
TI  - Cloning of mouse BMAL2 and its daily expression profile in the suprachiasmatic
      nucleus: a remarkable acceleration of Bmal2 sequence divergence after Bmal gene
      duplication.
AB  - Brain-Muscle-Arnt-Like-protein 2 (BMAL2; Arnt4) (aryl hydrocarbon receptor
      nuclear translocator) is a recently identified basic Helix-Loop-Helix-Per-Arnt
      Sim (bHLH-PAS) transcription factor, which contributes to a positive regulation
      of autoregulatory feedback loop in vertebrate circadian clock systems. In this
      study, we cloned cDNAs encoding mouse and rat BMAL2 (mBMAL2 and rBMAL2) from
      mouse midbrain and rat-1 fibroblast cells, respectively. A phylogenetic analysis
      strongly suggested that vertebrate Bmal1 and Bmal2 genes were generated by a
      single gene duplication of an ancestral Bmal gene, a vertebrate ortholog of dCyc
      gene, and that 'BMAL2's putatively termed so far are orthologous. Interestingly,
      BMAL2 proteins have diverged about 20-fold more rapidly than BMAL1 proteins after
      the duplication, suggesting an as-yet-unidentified function conserved in BMAL1
      but not in BMAL2. mBmal2 mRNA was constitutively expressed throughout the day
      under light-dark cycle in the mouse hypothalamus containing suprachiasmatic
      nucleus, the site of the central circadian oscillator in mammals.

PMID- 11207389
TI  - Expression of dystrophin in the mouse myenteric neurones.
AB  - Dystrophin, a membrane-associated protein, plays relevant roles in cell
      functions. Its lack or trunkated expression results in Duchenne muscular
      dystrophy (DMD), a pathology associated with alterations in gastrointestinal
      motility considered to be neural in origin. No data are available on the presence
      of dystrophin in myenteric neurones. We labelled mouse myenteric neurones with
      DYS1-, DYS2-, DYS3-antibodies; staining was located on the perikarya and
      processes, with no differences in distribution or intensity among the antibodies;
      the western immunoblot analysis indicated that myenteric neurones express several
      dystrophin isoforms; anti-dystrophins/anti-neuronal specific enolase double
      labeling confirmed that all neurones express dystrophin. Dystrophin in myenteric
      neurones might play a role in cytoskeletal organization, axonal transport and
      signal pathways; its lack might cause the intestinal motor abnormalities reported
      in DMD patients.

PMID- 11207390
TI  - Genetic studies in Parkinson's disease with an alpha-synuclein/NACP gene
      polymorphism in Japan.
AB  - Dinucleotide repeat polymorphism has been observed in the promoter of the alpha
      synuclein (alpha-SYN)/NAC precursor protein (NACP) gene. Alpha-SYN/NACP allele 3
      (described by Xia et al. (Ann. Neurol., 40 (1996) 207), equivalent to allele 1
      described by Kruger et al. (Ann. Neurol. 45 (1999) 611) is reported to be
      significantly more frequent among patients with sporadic Parkinson's disease
      (sPD) than controls. In this study, we genotyped the same alpha-SYN/NACP
      polymorphism in Japanese sPD patients and healthy controls, but found that any
      aliele showed no significant difference between the two groups.

PMID- 11207391
TI  - Assessing placebo effects without placebo groups: an untapped possibility?

PMID- 11207392
TI  - Response variability to analgesics: a role for non-specific activation of
      endogenous opioids.
AB  - Individual differences in pharmacokinetics and pharmacodynamics, the type of pain
      and the method of drug administration can account for the response variability to
      analgesics. By integrating a clinical and an experimental approach, we report
      here that another important source of variability is represented by individual
      differences in non-specific (placebo) activation of endogenous opioid systems. In
      the first part of this study, we analyzed the effectiveness of buprenorphine,
      tramadol, ketorolac and metamizol in the clinical setting, where the placebo
      effect was completely eliminated by means of hidden infusions. We found that the
      hidden injections were significantly less effective and less variable compared
      with open injections (in full view of the subject), suggesting that part of the
      response variability was due to non-specific factors (placebo). Since we could
      not administer the opioid antagonist, naloxone, to these patients, in the second
      part of this study, we induced experimental ischemic arm pain in healthy
      volunteers and found that, as occurred in clinical pain, the analgesic response
      to a hidden injection of the non-opioid ketorolac was less effective and less
      variable than an open injection. Most importantly, we obtained the same effects
      by adding naloxone to an open injection of ketorolac, thus blocking the opioid
      mediated placebo component of analgesia. These findings indicate that both the
      psychological (hidden injection) and pharmacological (naloxone) blockade of the
      placebo response reduce the effectiveness of, and the response variability to,
      analgesic drugs. Therefore, an important source of response variability to
      analgesics appears to be due to differences in non-specific activation of
      endogenous opioid systems.

PMID- 11207393
TI  - The effects of GABA(B) agonists and gabapentin on mechanical hyperalgesia in
      models of neuropathic and inflammatory pain in the rat.
AB  - We have examined the effects of a novel GABA(B) agonist, CGP35024, in models of
      chronic neuropathic (partial sciatic ligation) and inflammatory (Freund's
      complete adjuvant) pain in the rat, and its inhibitory action on spinal
      transmission in vitro. The effects of CGP35024 were compared with L-baclofen and
      gabapentin. CGP35024 and L-baclofen reversed neuropathic mechanical hyperalgesia
      following single subcutaneous or intrathecal administration, but did not affect
      inflammatory mechanical hyperalgesia. Gabapentin only moderately affected
      neuropathic hyperalgesia following a single administration by either route, but
      produced significant reversal following daily administration for 5 days. It was
      only weakly active against inflammatory hyperalgesia following single or repeated
      administration. The antihyperalgesic effects of L-baclofen and CGP35024, but not
      gabapentin, were blocked by the selective GABA(B) receptor antagonist CGP56433A.
      CGP35024 was seven times more potent against neuropathic hyperalgesia than in the
      rotarod test for motor co-ordination, whilst L-baclofen was approximately
      equipotent in the two tests. In the isolated hemisected spinal cord from the rat,
      CGP35024, L-baclofen and gabapentin all inhibited capsaicin-evoked ventral root
      potentials (VRPs). CGP35024 and L-baclofen, but not gabapentin, also inhibited
      the polysynaptic and monosynaptic phases of electrically-evoked VRPs, as well as
      the 'wind-up' response to repetitive stimulation. These data indicate that
      CGP35024 and L-baclofen modulate nociceptive transmission in the spinal cord to
      inhibit neuropathic hyperalgesia, and that CGP35024 has a therapeutic window for
      antihyperalgesia over spasmolysis.

PMID- 11207394
TI  - Modulation of neuronal activity in the nucleus raphe magnus by the 5-HT(1)
      receptor agonist naratriptan in rat.
AB  - Modulatory effects of the new antimigraine drug naratriptan, a 5-HT(1)-receptor
      agonist, on neurons of the nucleus raphe magnus were examined in rat by
      extracellular recordings. In the nucleus raphe magnus neuronal activity decreased
      in on-cells and increased in off-cells after intravenous administration of
      naratriptan. The modulatory effects of naratriptan were similar to the well-known
      effects of morphine on neurons in the nucleus raphe magnus. The results of this
      study suggest central actions of naratriptan and may point to an involvement of
      the endogenous pain control system in the antinociceptive effects of the 5-HT(1)
      receptor-agonist.

PMID- 11207395
TI  - Somatostatin receptors on peripheral primary afferent terminals: inhibition of
      sensitized nociceptors.
AB  - Somatostatin (SST) is in primary afferent neurons and reduces vascular and
      nociceptive components of inflammation. SST receptor (SSTR) agonists provide
      analgesia following intrathecal or epidural administration in humans, but
      neurotoxicity in the central nervous system (CNS) has been reported in
      experimental animals. With the rationale that targeting peripheral SSTRs would
      provide effective analgesia while avoiding CNS side effects, the goals of the
      present study are to investigate the presence of SSTRs on peripheral primary
      afferent fibers and determine the behavioral and physiological effects of the SST
      agonist octreotide (OCT) on formalin-induced nociception and bradykinin-induced
      primary afferent excitation and sensitization in the rat. The results demonstrate
      that: (1) SSTR2as are present on 11% of peripheral primary afferent sensory
      fibers in rat glabrous skin; (2) intraplantar injection of OCT reduces formalin
      induced nociceptive behaviors; (3) OCT reduces, in a dose-dependent fashion,
      responses to thermal stimulation in C-mechanoheat sensitive fibers; and (4) OCT
      reduces the responses of C-mechanoheat fibers to bradykinin-induced excitation
      and sensitization to heat. Each of these actions can be reversed following co
      injection of OCT with the SSTR antagonist cyclo-somatostatin (c-SOM). Thus,
      activation of peripheral SSTRs reduces both inflammatory pain and the activity of
      sensitized nociceptors, avoids deleterious CNS side effects and may be clinically
      useful in the treatment of pain of peripheral origin.

PMID- 11207396
TI  - Orofacial pain symptoms: an interaction between age and sex.
AB  - This study investigated sex and age cohort differences in the subjective report
      of orofacial pain symptoms in a stratified sample of community dwelling adults.
      The subjects were 724 participants in the Florida Dental Care Study, a
      longitudinal study of oral health among dentate adults, age 45 and older at
      baseline. Pain prevalence and subjective ratings were assessed for a range of
      orofacial pain sites using a standardized telephone interview. The results
      suggest that the 6-month prevalence of jaw joint pain (8.3%), face pain (3.1%),
      toothache pain (12.0%), painful oral sores (15.6%), and burning mouth (1.6%)
      found in the FDCS sample are similar to United States population estimates. In
      addition, prevalence for pain when chewing and temperature sensitivity were also
      reported as 23% and 24% respectively, suggesting that these two seldom documented
      painful experiences are common. Female respondents reported higher 6-month
      prevalence for multiple symptoms and painful oral sores, with trends also
      observed for female sex as a risk factor for jaw joint pain and face pain,
      whereas males were more likely to report temperature sensitivity. A higher
      percentage of females rated their pain as severe enough to impact behavior for
      jaw joint pain, toothache pain, and painful oral sores. Few overall age effects
      were found, with the exception of higher prevalence of temperature sensitivity
      and pain when chewing in the 45--64-year-old group, compared to respondents in
      the 65+ age cohort. However, the most interesting finding was that when sex by
      age cohort comparisons were made, with the exception of painful oral sores, all
      significant differences in pain ratings were found within the 45--64-year-old
      cohort and not the 65+ group. This finding clarified inconsistencies found in
      earlier studies in the orofacial pain literature where sex differences in pain
      ratings were found in several adult samples of a wide range of ages but not in a
      sample of older adults.

PMID- 11207397
TI  - Role of the dopaminergic system in chronic pain -- a fluorodopa-PET study.
AB  - Recent data from animal experiments suggest an important role for the basal
      ganglia in the processing and sensorimotor gating of nociceptive information.
      However, very little is known about their possible participation in human pain.
      Because of our previous finding of increased excitability of the blink reflex (a
      brainstem reflex under dopaminergic inhibitory control) in some burning mouth
      syndrome (BMS) patients, we have studied the dopaminergic function of the
      striatum (putamen and caudatus) of BMS patients with positron emission tomography
      (PET). 6-[(18)F]fluorodopa (FDOPA) PET scans were done on ten BMS patients and 14
      healthy control subjects. The presynaptic dopaminergic function was significantly
      decreased in the right putamen (20%, P=0.04) of the BMS patients compared to
      control subjects. On the left side, the FDOPA uptake was decreased by 17%
      (P=0.08). The mean FDOPA uptake was not significantly changed in the caudate
      nucleus of the patients. The finding of decreased striatal FDOPA uptake in the
      putamen supports our previous neurophysiological observations indicating
      decreased dopaminergic inhibition in BMS patients. The present result provides
      direct evidence of the involvement of the nigrostriatal dopaminergic system in
      pain for the first time in a clinical pain condition.

PMID- 11207398
TI  - Characteristics and prediction of early pain after laparoscopic cholecystectomy.
AB  - Small-scale studies have suggested a large inter-individual variation in early
      postoperative pain after laparoscopic cholecystectomy, emphasizing the need for
      improved analgesic treatment and valid predictors. We investigated prospectively
      the association between a preoperative nociceptive stimulus by ice water (cold
      pressor test), neuroticism, dyspepsia, patient history of biliary symptoms,
      intraoperative factors, and demographic information in 150 consecutive patients
      undergoing uncomplicated laparoscopic cholecystectomy for their influence on
      early postoperative pain. During the first postoperative week patients registered
      overall pain, incisional, visceral, and shoulder pain on a visual analogue scale
      and verbal rating scale, and daily analgesic requirements were noted. Throughout
      the first postoperative week overall pain showed a pronounced inter-individual
      variability. Incisional pain dominated in incidence and intensity compared with
      visceral pain, which in turn dominated over shoulder pain. In a multivariate
      analysis model, preoperative neuroticism, sensitivity to cold pressor-induced
      pain, and age were identified as independent risk factors for early postoperative
      pain. Our results suggest that future analgesic studies after laparoscopic
      cholecystectomy should focus on reduction of incisional pain.

PMID- 11207400
TI  - Oral mucosal blood flow in patients with burning mouth syndrome.
AB  - The pathophysiology of burning mouth syndrome (BMS) is largely unknown. Thus, the
      aim was to study oral mucosal blood flow in BMS-patients using laser Doppler
      flowmetry (LDF). Thirteen BMS patients (11 female, two male; mean age+/-SD 64.3+/
      7.9 years, mean disease duration 18.9+/-6.2 months) and 13 healthy non-smoking
      controls matched for age and gender (11 female, two male; mean age 64.7+/-8.1
      years) were investigated. Using the LDF technique mucosal blood flow (mBF) was
      measured at the hard palate, the tip of the tongue, on the midline of the oral
      vestibule, and on the lip. Measurements were made at rest and over 2 min
      following dry ice application of 10 s duration using a pencil shaped apparatus.
      In addition, blood pressure (BP), heart rate (HR), peripheral cutaneous blood
      flow, and transcutaneous pCO(2) were continuously recorded. Mucosal blood flow
      (mBF) increased at all measurement sites in response to dry ice application
      (P<0.001) with peak flow at 0.5--1.5 min after stimulation onset. During the
      following 1.5--2 min, blood flow decreased at all sites with a tendency to return
      to baseline towards the end of the observation period. Except for BP and
      peripheral blood flow, all of the cardiovascular changes exhibited significant
      changes during the observation period; no differences between groups were
      detected. When compared to healthy controls BMS patients generally exhibited
      larger changes in mBF. These changes were significant for recordings made on the
      hard palate (F[1,24]=13.9, P<0.001). Dry ice stimulation appears to be an
      effective, non-invasive and reasonably tolerable means to investigate mucosal
      blood flow at different mucosal sites. In general, vasoreactivity in BMS patients
      was higher than in healthy controls. BMS patients exhibited a higher response on
      the hard palate compared to controls. These changes in oral blood flow appear to
      be specifically related to BMS symptoms indicating a disturbed vasoreactivity.

PMID- 11207399
TI  - Bee venom injection into an acupuncture point reduces arthritis associated edema
      and nociceptive responses.
AB  - Bee venom (BV) has traditionally been used in Oriental medicine to relieve pain
      and to treat inflammatory diseases such as rheumatoid arthritis (RA). While
      several investigators have evaluated the anti-inflammatory effect of BV
      treatment, the anti-nociceptive effect of BV treatment on inflammatory pain has
      not been examined. Previous studies in experimental animals suggest that the
      therapeutic effect of BV on arthritis is dependent on the site of administration.
      Because of this potential site specificity, the present study was designed to
      evaluate the anti-nociceptive effect of BV injections into a specific acupoint
      (Zusanli) compared to a non-acupoint in an animal model of chronic arthritis.
      Subcutaneous BV treatment (1 mg/kg per day) was found to dramatically inhibit paw
      edema caused by Freund's adjuvant injection. Furthermore, BV therapy
      significantly reduced arthritis-induced nociceptive behaviors (i.e. the
      nociceptive scores for mechanical hyperalgesia and thermal hyperalgesia). These
      anti-nociceptive/anti-inflammatory effects of BV were observed from 12 days
      through 21 days post-BV treatment. In addition, BV treatment significantly
      suppressed adjuvant-induced Fos expression in the lumbar spinal cord at 3 weeks
      post-adjuvant injection. Finally, injection of BV into the Zusanli acupoint
      resulted in a significantly greater analgesic effect on arthritic pain as
      compared to BV injection in to a more distant non-acupoint. The present study
      demonstrates that BV injection into the Zusanli acupoint has both anti
      inflammatory and anti-nociceptive effects on Freund's adjuvant-induced arthritis
      in rats. These findings raise the possibility that BV acupuncture may be a
      promising alternative medicine therapy for the long-term treatment of rheumatoid
      arthritis.

PMID- 11207401
TI  - A selective increase in Fos expression in spinal dorsal horn neurons following
      graded thermal stimulation in rats with experimental mononeuropathy.
AB  - In order to clarify the central mechanisms of thermal hyperalgesia produced by
      peripheral nerve injury, Fos protein-like immunoreactive (Fos-LI) cells in spinal
      dorsal horn neurons were studied in rats with chronic constriction nerve injury
      (CCI) following graded thermal stimulation of the hind paw. The graded thermal
      stimuli (cold: 5, 10 and 15 degrees C, heat: 42, 46 and 54 degrees C) were
      applied to the plantar surface of the operated hind paw 14 days after CCI or sham
      operation, and the number of Fos-LI cells in the spinal dorsal horn was
      quantified. Many Fos-LI cells were expressed in the superficial laminae of the
      spinal dorsal horn both in sham-operated and CCI rats following thermal
      stimulation. Fos-LI cells were mainly restricted to the medial half of the
      superficial laminae of the spinal dorsal horn, and were sparsely distributed in
      the deeper laminae. The number of Fos-LI cells in the superficial laminae
      (laminae I--II) of the dorsal horn was significantly higher in CCI rats after
      stimulation at 10 and 46 degrees C, but not at the other stimulating temperatures
      (5, 15, 42, and 54 degrees C) as compared to that in sham-operated rats. In
      laminae III-IV, the number of Fos-LI cells was significantly higher at all
      stimulus temperatures in CCI rats when compared to the sham-operated rats. No
      distribution difference of Fos-LI cells was observed between CCI and sham
      operated rats in laminae V--VI. Thus, in the spinal dorsal horn of the CCI rats,
      there was a selective increase in thermal stimulus-induced Fos-LI cells in the
      superficial dorsal horn after stimulating at near noxious threshold intensities
      and a non-selective increase in Fos-LI cells in laminae III--IV after both
      noxious and innocuous thermal stimuli. The increase of Fos-LI cells in the
      superficial laminae may be related to hypersensitivity to noxious stimuli while
      the increase of Fos-LI cells in laminae III--IV may be related to an increased
      sensitivity to both noxious and innocuous stimuli that leads to increased reflex
      activity following nerve injury.

PMID- 11207402
TI  - Emergency Department compression ultrasound to diagnose proximal deep vein
      thrombosis.
AB  - Emergency Department (ED) patients with suspected deep vein thrombosis (DVT)
      require an objective vascular study such as ultrasound (US) to confirm the
      diagnosis prior to treatment or disposition. A simple compression US test of the
      common femoral vein and popliteal vein reliably detects proximal DVT in
      symptomatic patients. Application of compression US in the ED by Emergency
      Physicians (EPs) has been tested in a single previous study. We evaluated the
      ability of ED compression US, performed by EPs, to diagnose proximal DVT as
      compared to duplex US performed in a vascular laboratory. A prospective,
      observational study was conducted on a convenience sample of patients presenting
      to an ED with lower extremity symptoms and signs suggestive of DVT. Patients with
      a history of DVT in the symptomatic extremity were excluded. Final diagnosis of
      DVT was made by color-flow duplex US performed in a vascular laboratory. ED
      compression US was performed by one of six EP sonographers. In compression US,
      DVT was diagnosed by the inability to compress the common femoral vein or
      popliteal vein. The examination was considered indeterminate if the veins could
      not be clearly identified or compressibility was equivocal. For statistical
      analysis, an indeterminate examination was considered positive. In those cases
      where ED compression US was discordant with duplex US, and not indeterminate, we
      retrospectively reviewed the US findings. There were 76 patients who completed
      the study, and 18 patients (24%) were diagnosed with DVT by duplex US, among whom
      ED compression US was positive in 14, negative in 2, and indeterminate in 2.
      Among 58 patients diagnosed without DVT by duplex US, there were 4 false-positive
      ED compression US examinations and 10 indeterminate examinations. In all, ED
      compression US was indeterminate in 12 patients (15.8%). Compared to duplex US,
      ED compression US had a sensitivity of 88.9% (95% C.I. 65.3-98.6%) and
      specificity of 75.9% (62.8-86.1). Negative predictive value was 95.7% (85.2
      99.5). Among ED patients with the clinical diagnosis of possible DVT, negative ED
      compression US greatly reduces the likelihood of DVT, such that discharge and
      outpatient follow-up can be considered. Because of limited specificity, positive
      results require confirmation, but may justify immediate treatment pending follow
      up testing. Indeterminate results can be expected in a significant number of
      patients and mandate further testing prior to disposition.

PMID- 11207403
TI  - Slow infusion for the prevention of akathisia induced by prochlorperazine: a
      randomized controlled trial.
AB  - The utility of intravenous prochlorperazine (PCZ) in the treatment of nausea,
      vomiting, and headache may be limited by the akathisia that occurs frequently
      with the recommended 2-min infusion rate. We tested the hypothesis that
      decreasing the rate of PCZ infusion to 15 min reduces the incidence of akathisia
      at 1 hour. This double-blinded, randomized, controlled trial was conducted in the
      Emergency Department of an academic tertiary-care medical center with an annual
      census of 95,000 emergency patient visits. We enrolled a convenience sample of
      adult patients who received 10 mg i.v. PCZ for the treatment of nausea, vomiting,
      or headache. Subjects were randomized to receive either a 2-min infusion of PCZ
      (10 mg) followed by a 15-min infusion of saline, or a 2-min infusion of saline
      followed by a 15-min infusion of prochlorperazine. The incidence of akathisia at
      1 hour was measured by using explicit diagnostic criteria. One hundred sixty
      patients were randomly enrolled into two groups, which were comparable with
      respect to age, gender, weight, and complaint. Akathisia developed in 31 of 84
      patients (36.9%) who received the 2-min infusion of PCZ and in 18 of 76 patients
      (23.7%) who received the 15-min infusion of PCZ (p = 0.07), a 36% (95% CI, -5% to
      61%) relative reduction. The delta from pre-infusion to postinfusion scores
      between the two groups was not significant (p = 0.19). We conclude that slowing
      the rate of PCZ infusion does not decrease akathisia.

PMID- 11207404
TI  - A prospective study comparing i.m. ketorolac with i.m. meperidine in the
      treatment of acute biliary colic.
AB  - Ketorolac is a nonsteroidal anti-inflammatory medication that is used widely for
      pain management. Its effects are mediated through the inhibition of
      prostaglandins, which makes it uniquely different from opioids in relieving pain.
      We conducted a randomized, prospective, double blind study of patients presenting
      to our Emergency Department (ED) with a diagnosis of acute biliary colic. Study
      patients were randomized into one of two treatment groups, meperidine 1.5 mg/kg
      with a maximum dose of 100 mg or ketorolac 60 mg given intramuscularly (i.m.).
      The patients rated their pain before and 30 min after medication on a scale of 1
      to 10 using a Visual Analog Pain Scale. Overall pain relief was compared between
      the two groups using a two-sample t test. Thirty patients were enrolled in the
      study, 16 in the ketorolac group and 14 in the meperidine group. Patients ranged
      in age from 18 to 71 years and 6 (20%) were male. The average pain score at time
      0 was 7.6 for the ketorolac group and 7.3 for the meperidine group. Pain relief
      at time 30 min was 3.8 in the ketorolac group and 3.9 in the meperidine group,
      which was not statistically different. The mean global pain score and need for an
      emergency cholecystectomy were similar in the two groups. Rescue medication for
      additional analgesia at 30 min was needed in 4 patients in the meperidine group
      and in 2 patients in the ketorolac group (28.6% versus 12.5%, respectively; NS).
      In this study of patients with acute biliary colic there was no significant
      difference in the pain relief achieved by using either ketorolac or meperidine.

PMID- 11207405
TI  - Corneal bee sting with retained stinger.
AB  - Bee stings of the cornea are rarely reported, but have the potential for causing
      serious ophthalmologic injuries. We present a case of corneal bee sting with
      retained stinger apparatus and associated iritis and discuss the pathologic
      mechanisms of injury, evaluation, and treatment of these uncommon presentations.

PMID- 11207406
TI  - Airbags and bilateral eye injury: five case reports and a review of the
      literature.
AB  - We report five cases of bilateral eye injuries from airbag deployment in motor
      vehicle crashes and review the world's literature on ocular injuries associated
      with airbags. The cases in the literature were identified by cross-referencing
      Medline searches from airbags and ocular injuries. Additional cases were
      identified after review of references from each article in the search. An
      additional 89 cases from the literature were identified and are included for
      discussion. Patients were treated individually in a noncontrolled, nonrandomized
      fashion according to the nature of each injury with regular follow-up
      examinations in clinic. Of the 94 cases studied, 24 (27%) were bilateral eye
      injuries, and 15 (16%) patients were wearing spectacles at the time of the
      accident. The most common injuries included corneal abrasions, eyelid trauma, and
      hyphemas. Outcomes ranged from complete resolution of symptoms and return of
      normal visual acuity to primary enucleation. This report describes the wide
      spectrum of eye injuries that may occur after airbag deployment. We suggest a
      management plan for the evaluation and treatment of the ocular complications of
      airbag-related trauma.

PMID- 11207407
TI  - Three common presentations of ascariasis infection in an urban Emergency
      Department.
AB  - In the United States, approximately 4 million people per year are infected with
      Ascaris lumbricoides. We reviewed the common presentations of complications of
      Ascariasis infection in the Emergency Department (ED) and the diagnostic tools
      and treatment available. This was a retrospective case review conducted on all
      patients diagnosed with Ascariasis (using ICD-9 codes) over a 6-year period at
      Los Angeles County and University of Southern California Medical Center. Three
      patients with distinct complications secondary to Ascariasis were chosen, and all
      ED and inpatient records were reviewed. The patient's age, sex, race, presenting
      symptoms, data, outcome, and ED course and diagnosis were recorded. The three
      cases included a periappendiceal abscess, Loeffler's syndrome, and biliary
      colic/choledocholithiasis. The first patient underwent a computed tomography
      guided drainage of the abscess. The second patient received supportive care and
      antibiotic therapy secondary to a superimposed bacterial pneumonia. The third
      patient underwent endoscopic retrograde cholangiopancreatography with
      sphincterotomy. All three patients had a stool ova and parasites positive for A.
      lumbricoides, and all received a 3-day course of mebendazole. Symptomatic cases
      of Ascariasis may present to EDs in the United States. Important diagnostic tools
      for the ED include chest X-ray, X-ray of the kidney-ureter-bladder and
      ultrasonography. Single-dose medications given in the ED are very effective in
      eradicating A. lumbricoides infection, thus avoiding hospitalization.

PMID- 11207408
TI  - Twenty-foot fall averts fatality from massive hydrogen sulfide exposure.
AB  - Hydrogen sulfide is a colorless irritant and asphyxiant gas with a noxious odor
      of "rotten eggs." Acute hydrogen sulfide exposure may cause, depending on the
      level and duration of toxicity, symptoms ranging from mild mucous membrane
      irritation to permanent neurologic impairment and cardiopulmonary arrest. We
      present a case of an oil refinery worker exposed to a typically fatal
      concentration of hydrogen sulfide gas (>1000 ppm) while working on top of a 20
      foot ladder. The "knockdown" effect of exposure to high concentrations of
      hydrogen sulfide caused him to lose consciousness and fall from the top of the
      ladder. He was transported to the Emergency Department as a major trauma victim.
      Ironically, this 20-foot fall saved his life and possibly those of the rescuers
      by immediately removing him from the source of the hydrogen sulfide. Treatment of
      hazardous materials incidents and the pathophysiology and treatment options for
      hydrogen sulfide poisoning are discussed.

PMID- 11207409
TI  - Electrocardiographic manifestations: digitalis toxicity.
AB  - Toxicity from the digitalis family of cardiac glycoside medications remains
      common. Successful treatment depends on early recognition; however, the diagnosis
      of potentially life-threatening toxicity remains difficult because the clinical
      presentation is often nonspecific and subtle. The hallmark of cardiac toxicity is
      increased automaticity coupled with concomitant conduction delay. Though no
      single dysrhythmia is always present, certain aberrations such as frequent
      premature ventricular beats, bradydysrhythmias, paroxysmal atrial tachycardia
      with block, junctional tachycardia, and bidirectional ventricular tachycardia are
      common. Treatment depends on the clinical condition rather than serum drug level.
      Management varies from temporary withdrawal of the medication to administration
      of digoxin-specific Fab fragments for life-threatening cardiovascular compromise.

PMID- 11207410
TI  - A rare cause of congestive heart failure.

PMID- 11207411
TI  - Penile incarceration: a wrapping technique.

PMID- 11207412
TI  - Sinus arrest or sinoventricular conduction in mild hyperkalemia.

PMID- 11207413
TI  - Lung abscess.

PMID- 11207414
TI  - 5th Annual David R. Boyd, MD Lecture: Revolutionary advances in wound repair in
      emergency medicine during the last three decades. A view toward the new
      millennium.
AB  - This lecture provides an overview of advances in wound repair devised by our
      multidisciplinary team of physicians, scientists, and students. Our collective
      efforts have devised products, drugs, and concepts that are facilitating wound
      repair without infection and with the least possible scar. Some of the beneficial
      products and drugs developed or identified by our laboratory include nitrile
      examination and surgical gloves, magnification loupes, high pressure syringe
      irrigation, Shur Clens, as well as a wide variety of different wound closure
      techniques. In addition, our studies of the mechanism of wound injury, soil
      infection-potentiating fractions, dynamic and static skin tensions, and
      microflora of the skin have become important predictors of the outcomes of wound
      repair. During the new millennium, the computerized clinical information system
      as well as studies of tissue regeneration should dramatically change our
      approaches to wound repair.

PMID- 11207416
TI  - The diagnosis.

PMID- 11207415
TI  - Using Q methodology to assess the needs of emergency medicine support staff
      employees.
AB  - The support staff members of any Department of Emergency Medicine perform a
      plethora of tasks that are crucial to the productivity of both individual
      physicians and the department as a whole. It is important to ensure that the
      personal and professional needs of the support staff are being met. This report
      describes the use of a relatively new statistical technique, Q methodology, to
      elucidate the needs of the support staff. This method allowed the investigators
      to quantitatively reveal the presence of two distinct viewpoints on employee
      needs among the support staff. Additionally, opinions that were held by the
      employees concerning their needs were identified. These results allowed for
      strategies to be tailored to both the individual and the group. The results
      indicate that Q methodology can have widespread application in the relatively new
      area of health care quality research.

PMID- 11207417
TI  - Pearls of wisdom for your emergency medicine rotation.

PMID- 11207419
TI  - Dopaminergic innervation of human basal ganglia.
AB  - This paper summarises the results of some of our recent tyrosine hydroxylase (TH)
      immunohistochemical studies of the dopaminergic innervation of the human basal
      ganglia. It also reports new findings on the presence of TH-immunoreactive (ir)
      neurons in the striatum. Our data show the existence of nigrostriatal TH-ir axons
      that provide collaterals arborizing in the globus pallidus and subthalamic
      nucleus. These thin and varicose collaterals emerge from thick and smooth axons
      that course along the main output pathways of the basal ganglia, including the
      ansa lenticularis, the lenticular fasciculus and Wilson's pencils. We postulate
      that this extrastriatal innervation, which allows nigral dopaminergic neurons to
      directly affect the pallidum and subthalamic nucleus, plays a critical role in
      the functional organisation of human basal ganglia. The TH-ir fibres that reach
      the striatum arborize according to a highly heterogeneous pattern. At rostral
      striatal levels, numerous small TH-poor zones embedded in a TH-rich matrix
      correspond to calbindin-poor striosomes and calbindin-rich extrastriosomal
      matrix, respectively. At caudal striatal levels, in contrast, striosomes display
      a TH immunostaining that is more intense than that of the matrix. A significant
      number of small, oval, aspiny TH-ir neurons scattered throughout the rostrocaudal
      extent of the caudate nucleus and putamen, together with a few larger,
      multipolar, spiny TH-ir neurons lying principally within the ventral portion of
      the putamen, were disclosed in human. This potential source of intrinsic striatal
      dopamine might play an important role in the functional organisation of the human
      striatum, particularly in case of Parkinson's disease.

PMID- 11207420
TI  - The use of cerebral blood flow as an index of neuronal activity in functional
      neuroimaging: experimental and pathophysiological considerations.
AB  - Over recent years, activation studies that have been undertaken using brain
      imaging techniques, such as functional magnetic resonance imaging, positron
      emission tomography or near infrared spectroscopy, have greatly improved our
      knowledge of the functional anatomy of the brain. Nevertheless, activation
      studies do not directly quantify the variations of synaptic transmission
      (neuronal activity) but detect it indirectly either through the visualisation of
      changes in cerebral blood flow, oxidative or glycolytic metabolism (for positron
      emission tomography), or through the measurement of a global index that is
      dependent on both cerebral blood flow and oxidative metabolism (for functional
      magnetic resonance imaging and near infrared spectroscopy). Such approaches are
      based on the concept of a tight parallelism--termed coupling--between variations
      in neuronal activity, metabolism and cerebral blood flow. However, several
      "uncoupled" situations between these parameters have been reported over the last
      decade through experimental, pharmacological and pathophysiological studies. The
      aim of this review is to focus on these data that have to be taken into account
      for the interpretation of the results obtained in activation paradigms.

PMID- 11207421
TI  - New insights into genetic and molecular mechanisms of brain degeneration in
      tauopathies.
AB  - Abundant neurofibrillary lesions consisting of the microtubule associated protein
      tau and amyloid beta peptide deposits are the defining lesions of Alzheimer's
      disease. Prominent filamentous tau pathology and brain degeneration in the
      absence of extracellular amyloid deposition characterize a number of other
      neurodegenerative disorders (i.e. progressive supranuclear palsy, corticobasal
      degeneration, Pick's disease) collectively referred to as tauopathies. The
      discovery of multiple tau gene mutations that are pathogenic for hereditary
      frontotemporal dementia and parkinsonism linked to chromosome 17 in many
      kindreds, as well as the demonstration that tau polymorphisms are genetic risk
      factors for sporadic tauopathies, directly implicate tau abnormalities in the
      onset/progression of neurodegenerative disease. Different tau gene mutations may
      be pathogenic by impairing the functions of tau or by perturbing the splicing of
      the tau gene, thereby resulting in biochemically and structurally distinct tau
      aggregates. However, since specific polymorphisms and mutations in the tau gene
      lead to diverse phenotypes, it is plausible that additional genetic or epigenetic
      factors influence the clinical and pathological manifestations of both familial
      and sporadic tauopathies. Thus, efforts to develop animal models of tau-mediated
      neurodegeneration should provide further insights into the onset and progression
      of tauopathies as well as Alzheimer's disease, and they could accelerate research
      to discover more effective therapies for these disorders.

PMID- 11207422
TI  - Alpha-synuclein is not a requisite component of synaptic boutons in the adult
      human central nervous system.
AB  - It is increasingly clear that the normal protein alpha-synuclein is in some
      manner closely associated with presynaptic components of select neuronal types
      within the adult human central nervous system (CNS) and, in addition, that in its
      pathologically altered state alpha-synuclein aggregates selectively in the form
      of filamentous inclusion bodies during certain progressive neurodegenerative
      disorders, such as familial and sporadic Parkinson's disease. By having the
      antibody AFshp raised specifically to alpha-synuclein to label Parkinson disease
      specific Lewy bodies and Lewy neurites as well as synaptic boutons containing the
      unaltered protein, an initial attempt is made to map the overall distribution
      pattern and describe the staining behavior of the immunoreactive punctae in
      select regions of the prosencephalon. Neocortical immunolabeling is most
      prominent in the prodigious, but incompletely myelinated, association fields and
      faintest in the heavily myelinated primary motor and primary sensory fields, with
      the premotor and first order sensory association areas occupying an intermediate
      position. Of the thalamic grays evaluated, those containing powerfully myelinated
      fiber tracts (e.g. centrum medianum, habenular complex) show the weakest
      immunolabeling, whereas, less sturdily myelinated structures are highly
      immunoreactive. The fact that the immunostaining spectrum for normal alpha
      synuclein is so broad, together with the fact that some thalamic sites actually
      are immunonegative leads to the following conclusions (1) alpha-synuclein,
      although present in the synaptic boutons of many nerve cells in the adult human
      CNS, is by no means ubiquitous there, and (2) neuronal types lacking the normal
      protein cannot generate the Parkinson's disease-specific filamentous pathology.

PMID- 11207424
TI  - Glutamate decarboxylase(65)-immunoreactive terminals in cingulate and prefrontal
      cortices of schizophrenic and bipolar brain.
AB  - Recent postmortem studies have been suggesting that a defect of GABAergic
      neurotransmission might occur in the corticolimbic system of subjects with
      schizophrenia and bipolar disorder. To explore this possibility, a method for
      immunolocalizing the 65 kdalton isoform of glutamate decarboxylase (GAD(65)) has
      been developed and applied to the anterior cingulate (ACCx) and prefrontal (PFCx)
      cortices of 12 normal controls (CONs), 12 schizophrenics (SZs) and 5 manic
      depressive (MDs) subjects. A computer-assisted technique was employed under
      strictly blind conditions to determine the density of GAD(65)-IR terminals in
      apposition with pyramidal (PNs) and nonpyramidal (NPs) neurons and in neuropil
      (NPL) of layers II, III, V and VI of each cortical region. For SZs, no difference
      in the numerical density of GAD(65)-IR terminals in contact with either PNs or
      NPs or in NPL of layers II-VI in ACCx or PFCx was detected. There were also no
      differences in the size of either PNs and NPs that could have influenced the
      nature of these findings. Using a pixel count analysis, the size of IR terminals
      was, however, found to be increased in layers II (10.3%) and III (15.8%) of SZs,
      but only in subjects treated with neuroleptic drugs. For MDs, the density of
      GAD(65)-IR terminals was significantly reduced in all four layers of ACCx, but
      these differences were most significant in layers II (27.8%) and III (37.2%),
      whether or not the subjected were treated with neuroleptics. In PFCx, the MDs
      showed similar differences in terminal density for PNs and NPs but not neuropil
      in the four laminae examined. The MD group showed no differences in either the
      size of cell bodies or IR terminals. Age and PMI did not account for any of the
      differences between the CONs vs SZs and MDs. Overall, the results of this study,
      though preliminary, suggest that there may be complex changes in GABAergic
      terminals in SZ and MD, ones that may vary with respect to primary diagnosis and
      neuroleptic exposure.

PMID- 11207423
TI  - Crosslinking of alpha-synuclein by advanced glycation endproducts--an early
      pathophysiological step in Lewy body formation?
AB  - An excess of reactive carbonyl compounds (carbonyl stress) and their reaction
      products, advanced glycation endproducts (AGEs), are thought to play a decisive
      role in the pathogenesis of neurodegenerative disorders and Parkinson's disease
      (PD) in particular. Accumulation of AGEs in various intracellular pathological
      hallmarks of PD, such as Lewy bodies, densely crosslinked intracellular protein
      deposits formed from neurofilament components and alpha-synuclein, have already
      been described in patients in advanced stages of the disease. There is, however,
      no indication of the involvement of AGE-induced crosslinking of alpha-synuclein
      in very early stages of the disease. In this study, we observed that AGEs and
      alpha-synuclein are similarly distributed in very early Lewy bodies in the human
      brain in cases with incidental Lewy body disease. These cases might be viewed as
      pre-Parkinson patients, i.e. patients who came for autopsy before the possible
      development of clinical signs of PD. AGEs are both markers of transition metal
      induced oxidative stress as well as, inducers of protein crosslinking and free
      radical formation by chemical and cellular processes. Thus, it is likely that AGE
      promoted formation of Lewy bodies reflects very early causative changes rather
      than late epiphenomenons of PD.

PMID- 11207425
TI  - Serotonin transporters upregulate with chronic cocaine use.
AB  - Cocaine potently inhibits serotonin (5-HT) reuptake in cell bodies and at nerve
      terminals and 5-HT has been implicated as a modulator of dopaminergic
      neurotransmission. Chronic use of cocaine may lead to a "serotonin-deficit" form
      of 5-HT dysregulation. We have examined the status of the 5-HT transporter (SERT)
      using ligand binding and autoradiographic methods in subgroups of cocaine
      overdose deaths. Quantitative autoradiography of [125I]RTI-55 was used to map and
      measure the effect of chronic cocaine use on SERT densities in the striatum,
      substantia nigra, amygdala, and adjacent paralimbic cortical areas of cocaine
      overdose (CO) victims with and without preterminal evidence of excited delirium
      (ED). SERT densities were elevated in the nucleus accumbens and throughout the
      anterior and posterior sectors of striatum in CO victims compared with age
      matched and drug-free control subjects. In contrast, SERT densities were
      increased significantly in the anterior striatum, but not the posterior sectors
      in ED victims. Significant elevations in SERT were measured in the orbitofrontal
      gyrus (Brodmann area 11), the anterior portion of the insular cortex and the
      cingulate gyrus (Brodmann area 24) in CO and ED victims. Saturation binding site
      analysis demonstrated an increase in the density of RTI-55 binding sites with no
      change in the affinity of the radioligand for the SERT. Chronic cocaine exposure
      upregulated SERT densities in the substantia nigra of the CO, but not ED victims.
      The lack of SERT upregulation in the substania nigra and posterior striatum
      suggests the possibility of a distinct phenotype for fatal ED victims that
      exhibited an acute onset of bizarre and violent behavior prior to death. Adaptive
      changes in the SERT densities may contribute to depressed mood and drug craving
      associated with acute cocaine abstinence.

PMID- 11207426
TI  - Nicotinic receptors in human brain: topography and pathology.
AB  - Brain nicotinic acetylcholine receptors (nAChR) are a class of ligand-gated
      channels composed of alpha and beta subunits with specific structural, functional
      and pharmacological properties. They participate in the physiological and
      behavioural effects of acetylcholine and mediate responses to nicotine. They are
      associated with numerous transmitter systems and their expression is altered
      during development and ageing as well as in diseases such as autism,
      schizophrenia, Alzheimer's disease, Parkinson's disease and Lewy body dementia.
      Nicotinic receptors containing a number of different subunits are highly
      expressed during early human development. Disorders believed to be associated
      with abnormal brain maturation involve deficits in both alpha4beta2, in the case
      of autism, and alpha7 possibly in addition to alpha4beta2 nAChRs in the case of
      schizophrenia. In ageing and age-related neurodegenerative disorders nAChR
      deficits are predominantly associated with alpha4-containing receptors, although
      some studies also indicate the involvement of alpha3 and alpha7 subunits. Whilst
      ageing appears to be associated with reductions in subunit mRNA as well as
      protein expression, in Alzheimer's disease only protein loss is apparent.
      Nicotinic therapy may be of benefit in a number of neurological conditions,
      however studies evaluating further both the distribution of specific subunit
      involvement and the correlation of nAChR deficits with clinical symptoms are
      required to inform therapeutic strategy.

PMID- 11207427
TI  - The alpha7-nicotinic acetylcholine receptor and the pathology of hippocampal
      interneurons in schizophrenia.
AB  - This paper is a review of a recent findings on the pathology of hippocampal
      interneurons in schizophrenia, with specific emphasis on a protein expressed by
      these cells, the alpha7-nicotinic acetylcholine receptor subunit. Convergent
      information indicates that interneurons in the hippocampus and other forebrain
      structures are decreased in number and function in subjects with schizophrenia.
      Among the neurochemical markers that are decreased in the hippocampus are
      synapsin I, cholecystokinin, somatostatin, glutamic acid decarboxylase, and
      nitric oxide synthase. GABA uptake sites and the GABA synthetic enzyme glutamic
      acid decarboxylase are also diminished. Included among these findings is
      decreased binding of alpha-bungarotoxin, which binds to low-affinity nicotinic
      acetylcholine receptors, such as the alpha7-nicotinic receptor. Co-labeling
      experiments in rodents indicate that these markers are expressed on overlapping
      populations of hippocampal interneurons. Thus, the finding of decreased
      neurochemical function of hippocampal interneurons is a widely replicated
      finding, with different groups reporting markedly similar findings using
      independent post mortem samples and different neurochemical strategies. Decreased
      alpha-bungarotoxin binding or decreased alpha7-nicotinic receptor
      immunoreactivity has also been found in the frontal cortex and in the nucleus
      reticularis thalami of schizophrenic subjects. The alpha7-nicotinic receptor
      subunit gene on chromosome 15q14 is a site of heritability for schizophrenia and
      bipolar affective disorder, and in, particular, for a deficit in inhibitory
      neuronal function associated with these illnesses. Thus, the post mortem data are
      further supported by psychophysiologic and genetic investigations that indicate a
      deficit in inhibitory interneuronal function, involving the alpha7-nicotinic
      receptor. The alpha7-receptor is a ligand-gated ion channel that admits calcium
      ions into cells, and it has been proposed to have various developmental roles.
      Its malfunction may be part of the developmental pathogenesis of schizophrenia.

PMID- 11207428
TI  - Ontogeny of the dopamine D2 receptor mRNA expressing cells in the human
      hippocampal formation and temporal neocortex.
AB  - The study details the cellular expression of the dopamine D2 receptor mRNA in the
      human temporal lobe during prenatal development. At 13 embryonic weeks (E13) D2
      mRNA was widely expressed in the temporal lobe. At this time point in the dentate
      gyrus D2 mRNA positive cells first appeared at the outer border of the granular
      layer and their number increased with development. The CA1 exhibited the highest
      level of D2 mRNA expression. By E19-25 the hippocampal formation underwent rapid
      morphological maturation. D2 mRNA expression became more uniform and dense in the
      ammonic subfield. At all ages the subiculum appeared more mature morphologically
      but less intensely stained for D2 mRNA than the ammonic fields. In the entorhinal
      cortex D2 mRNA expression was most conspicuous in the future layer II at all
      ages. In the temporal neocortex D2 mRNA-positive cells were detected in the
      subplate and cortical plate. Differentiation of the cortical plate was
      accompanied by concentration of D2 mRNA-positive cells in layer V. The most
      conspicuous cells expressing D2 mRNA were found in the marginal zone of all
      regions and resembled Cajal-Retzius cells in morphology and location. Density of
      putative Cajal-Retzius cells expressing D2 mRNA decreased with development. They
      all but disappeared from the hippocampal areas by mid gestation, but in the
      temporal neocortex occasional cells were seen even at term. Early and widespread
      but region and cell type specific expression of D2 receptor mRNA suggests an
      important role of this DA receptor subtype in prenatal development of the human
      temporal lobe.

PMID- 11207429
TI  - Characterization of NPY mRNA-expressing cells in the human brain: co-localization
      with Y2 but not Y1 mRNA in the cerebral cortex, hippocampus, amygdala, and
      striatum.
AB  - Neuropeptide Y (NPY) is one of the most abundant peptides in the central nervous
      system. Its effects on, for example, cognition, memory and motor functions are
      thought to be mediated mainly via its interactions with the NPY Y1 and Y2
      receptor subtypes. We had previously described the neuroanatomical organization
      of the Y1 and Y2 mRNA expression in humans. However, in view of the lack of
      information regarding the overall detailed distribution of NPY mRNA expression in
      the human brain, a complete picture of the anatomical organization of the NPY
      related genes was still missing. Thus, in the present study, the regional
      distribution of NPY mRNA-expressing cells was analyzed in the post-mortem human
      brain. In addition, double labeling in situ hybridization was performed to
      characterize the NPY neuronal populations in relation to the Y1 and/or Y2
      receptor mRNA localization in the human cerebral cortex, striatum, and amygdala.
      NPY mRNA was found to be abundant in layers II and VI of the neocortex,
      polymorphic layer of the dentate gyrus, basal ganglia, and amygdala. Double
      labeling in situ hybridization showed the co-expression of NPY mRNA with the Y2,
      but not with the Y1, mRNA in the human cerebral cortex, hippocampus, amygdala,
      striatum, and nucleus accumbens, and the existence of co-expression of the Y1 and
      Y2 mRNAs in the cerebral cortex and amygdala. Overall, these results suggest a
      role for the Y2, but not Y1, as an autoreceptor in the NPY neuronal populations
      of the human brain.

PMID- 11207430
TI  - Distribution of angiotensin IV binding sites (AT4 receptor) in the human
      forebrain, midbrain and pons as visualised by in vitro receptor autoradiography.
AB  - Angiotensin IV and other AT4 receptor agonists, improve memory retention and
      retrieval in the passive avoidance and swim maze learning paradigms. Angiotensin
      IV binding sites (also known as the AT4 receptors) are widely distributed in
      guinea pig and monkey (Macaca fascicularis) brains where high densities of the
      binding sites have been detected in the hippocampus, neocortex and motor nuclei.
      However, the distribution of the binding sites in the human brain is not known.
      We have recently localised the angiotensin IV binding sites (AT4 receptors) in
      post-mortem human brain using iodinated Nle-angiotensin IV, a higher affinity and
      more stable analogue of angiotensin IV. This radioligand bound with relatively
      high affinity and specificity to angiotensin IV binding sites. In competition
      studies on consecutive sections through the prefrontal cortex and claustrum,
      angiotensin IV, Nle-angiotensin IV and LVV-hemorphin 7 competed for the binding
      of 125I[Nle]-angiotensin IV with nanomolar affinities. Angiotensin II and the AT1
      and AT2 receptor antagonists were ineffective in competing for the binding at
      concentrations of up to 10 microM. We found high densities of 125I[Nle]
      angiotensin IV binding sites throughout the cerebral cortex including the
      insular, entorhinal, prefrontal and cingulate cortices. Very high densities of
      the binding sites were observed in the claustrum, choroid plexus, hippocampus and
      pontine nucleus. Some thalamic nuclei displayed high densities of binding
      including the anteroprincipal, ventroanterior, anteromedial, medial dorsal and
      ventrolateral nuclei. The caudate nucleus, putamen, many amygdaloid nuclei and
      the red nucleus all displayed moderate densities of binding with a higher level
      detected in the substantia nigra pars compacta. In the hypothalamus, high
      densities binding sites were found in the ventromedial nucleus with lower levels
      in the dorsomedial and paraventricular nuclei. The distribution of 125I[Nle]
      angiotensin IV binding sites in the human brain is similar to that found in other
      species and supports multiple roles for the binding sites in the central nervous
      system, including facilitation of memory retention and retrieval.

PMID- 11207431
TI  - Phosphodiesterase type 4 isozymes expression in human brain examined by in situ
      hybridization histochemistry and[3H]rolipram binding autoradiography. Comparison
      with monkey and rat brain.
AB  - We have examined the distribution of four different cyclic AMP-specific
      phosphodiesterase isozyme (PDE4A, PDE4B, PDE4C and PDE4D) mRNAs in the brain of
      different species by in situ hybridization histochemistry and by autoradiography
      with [3H]rolipram. We have compared the localization of each isozyme in human
      brain with that in rat and monkey brain. We have found that the four PDE4
      isoforms display a differential expression pattern at both regional and cellular
      level in the three species. PDE4A, PDE4B and PDE4D are widely distributed in
      human brain, with the two latter appearing more abundant. In contrast, PDE4C in
      human brain, presents a more restricted distribution, limited to cortex, some
      thalamic nuclei and cerebellum. This is at variance with the distribution of
      PDE4C in rat brain, where it is found exclusively in olfactory bulb. In monkey
      brain, the highest expression for this isoform is found in the claustrum, and at
      lower levels in cortical areas and cerebellum. PDE4B presented a broad
      distribution, being expressed in both neuronal and non neuronal cell populations.
      In general, the distribution of binding sites visualized with [3H]rolipram
      correlated well with the expression of each PDE4 isozyme.

PMID- 11207432
TI  - Expression of the purported sigma(1) (sigma(1)) receptor in the mammalian brain
      and its possible relevance in deficits induced by antagonism of the NMDA receptor
      complex as revealed using an antisense strategy.
AB  - Sigma (sigma) receptors have generated a great deal of interest on the basis of
      their possible role in psychosis, neuroprotection and various other behaviors
      including learning processes. The existence of at least two classes of sigma
      receptor binding sites (sigma(1) and sigma(2)) is now well established. The
      recent cloning of the mouse, guinea pig and human sigma(1) receptors has allowed
      the study of the discrete distribution of the sigma(1) receptor mRNA in rodent
      and human brain tissues using in situ hybridization. Overall, the sites of
      expression of specific sigma(1) receptor mRNA signals were in accordance to the
      anatomical distribution of sigma(1) receptor protein first established by
      quantitative receptor autoradiography. Specific sigma(1) receptor hybridization
      signals were found to be widely, but discretely distributed, in mouse and guinea
      pig brain tissues. The highest levels of transcripts were seen in various cranial
      nerve nuclei. Lower, but still high hybridization signals were observed in
      mesencephalic structures such as the red nucleus, periaqueductal gray matter and
      substantia nigra, as well as in some diencephalic structures including such as
      the habenula and the arcuate, paraventricular and ventromedial hypothalamic
      nuclei. Superficial (I-II) and deeper (IV-VI) cortical laminae were moderately
      labeled in the mouse brain. Moderate levels of sigma(1) receptor mRNA were also
      found in the pyramidal cell layer and the dentate gyrus of the hippocampal
      formation. Other structures such as the thalamus and amygdaloid body also
      expressed the sigma(1) receptor mRNA although to a lesser extent. In murine
      peripheral tissues, strong hybridization signals were observed in the liver,
      white pulp of the spleen and the adrenal gland. In the postmortem human brain,
      moderate levels of sigma(1) receptor mRNA, distributed in a laminar fashion, were
      detected in the temporal cortex with the deeper laminae (IV-VI) being
      particularly enriched. In the hippocampal formation, the strongest hybridization
      signals were observed in the dentate gyrus while all other subfields of the human
      hippocampal formation expressed lower levels of the sigma(1) receptor mRNA.
      Antisense oligodeoxynucleotides against the purported sigma(1) receptor were used
      next to investigate the possible role of this receptor in dizocilpine (MK
      801)/NMDA receptor blockade-induced amnesia. Following a continuous
      intracerebroventricular infusion of a specific sigma(1) receptor antisense into
      the third ventricle (0.4 nmol/h for 5 days), sigma(1)/[3H](+)pentazocine binding
      was significantly reduced in mouse brain membrane homogenates while a scrambled
      antisense control was without effect. Moreover, the sigma(1) receptor antisense
      treatments (5 nmol/injection, every 12 hx3 or 0.4 nmol/h for 5 days) attenuated
      (+)MK-801/NMDA receptor blockade-induced cognitive deficits in the treated mice
      while a scrambled antisense control had no effect. Taken together, these results
      demonstrate the widespread, but discrete, distribution of the sigma(1) receptor
      mRNA in the mammalian central nervous system. Moreover, antisense treatments
      against the purported sigma(1) receptor gene reduced specific
      sigma(1)/[3H](+)pentazocine binding and modulated cognitive behaviors associated
      with NMDA receptor blockade providing further evidence for the functional
      relevance of the cloned gene.

PMID- 11207433
TI  - The molecular basis of O2-sensing and hypoxia tolerance in pheochromocytoma
      cells.
AB  - Hypoxia is a common environmental stimulus. However, very little is known about
      the mechanisms by which cells sense and respond to changes in oxygen. Our
      laboratory has utilized the PC12 cell line in order to study the biophysical and
      molecular response to hypoxia. The current review summarizes our results. We
      demonstrate that the O2-sensitive K(+) channel, Kv1.2, is present in PC12 cells
      and plays a critical role in the hypoxia-induced depolarization of PC12 cells.
      Previous studies have shown that PC12 cells secrete a variety of
      autocrine/paracrine factors, including dopamine, norepinephrine, and adenosine
      during hypoxia. We investigated the mechanisms by which adenosine modulates cell
      function and the effect of chronic hypoxia on this modulation. Finally, we
      present results identifying the mitogen- and stress-activated protein kinases
      (MAPKs and SAPKs) as hypoxia-regulated protein kinases. Specifically, we show
      that p38 and an isoform, p38gamma, are activated by hypoxia. In addition, our
      results demonstrate that the p42/p44 MAPK protein kinases are activated by
      hypoxia. We further show that p42/p44 MAPK is critical for the hypoxia-induced
      transactivation of endothelial PAS-domain protein 1 (EPAS1), a hypoxia-inducible
      transcription factor. Together, these results provide greater insight into the
      mechanisms by which cells sense and adapt to hypoxia.

PMID- 11207434
TI  - Purification and characterization of superoxide dismutase from chicken liver.
AB  - Superoxide dismutase (SOD; EC 1.15.1.1) is an enzyme that protects against
      oxidative stress from superoxide radicals in living cells. This enzyme has been
      isolated, purified and partially characterized from chicken liver. The following
      steps were carried out in order to purify chicken liver SOD. Initially, the liver
      was homogenized and hemoglobin was removed. Subsequently protein precipitation
      was effected with (NH(4))(2)SO(4), methanol, (NH(4))(2)SO(4)-methanol and
      polyethylene glycol methods. The product from polyethylene glycol-3350
      precipitation was found to have the highest SOD activity. Polyethylene glycol was
      removed by chromatography using a PD-10 column. After passing through an
      ultrafilter, the superoxide dismutase was fractionated by DEAE-ion chromatography
      and then Sephadex G-75 gel filtration chromatography. During this purification
      procedure, a specific activity of 4818.2 IU/mg was reached, corresponding to
      285.8-fold purification. The purified enzyme, which was characterized as cyanide
      sensitive SOD, contained two subunits having Cu and Zn elements with a molecular
      weight of 16000+/-500 for each. The optimum pH of purified CuZnSOD was determined
      to be 8.9. The enzyme was found to have good pH stability in the pH range 6.0-7.5
      at 25 degrees C over a 2-h incubation period and displayed good thermal stability
      up to 45 degrees C at pH 7.4 over a 1-h incubation period. The SOD enzyme was not
      inhibited by DTT and beta-mercaptoethanol, but inhibited by CN(-) and H(2)O(2).
      In the presence of 2 mM iodoacetamide, the enzyme showed an approximately 40%
      activity loss. Finally, the inhibitory effect of ionic strength on SOD was also
      investigated.

PMID- 11207435
TI  - Morphological and biochemical characterization of mitochondria in Torpedo red
      blood cells.
AB  - A study is presented on the morphology and respiratory functions of mitochondria
      from Torpedo marmorata red blood cells. In vivo staining of red blood cells and
      transmission electron microscopy showed the existence of a considerable number of
      vital and orthodox mitochondria which decreased from young erythroblasts to
      mature erythrocytes from 60-50 to 30-20 per cell. In erythrocytes mitochondria
      exhibited a canonical, functional respiratory chain. The content and activity of
      cytochromes in erythrocytes were, however, significantly lower as compared to
      mammalian tissues.

PMID- 11207436
TI  - Dermatan sulfates of normal and scarred fascia.
AB  - We evaluated the composition of dermatan sulfates (DS) derived from 23 samples of
      normal and 23 samples of scarred fascia lata. We analyzed the molecular weight of
      intact DS chains and the length of chain regions comprising: (1) clusters of L
      iduronate-containing disaccharides ("iduronic sections"); (2) clusters of D
      glucuronate-containing disaccharides ("glucuronic sections"); and (3) copolymeric
      sections with both types of disaccharides. A portion of scarred fascia DS chains
      demonstrated higher molecular weight compared with those from normal tissue. Most
      disaccharides of DS chains derived from both fascia types form copolymeric
      segments - heterogeneous in size - with alternatively distributed single
      disaccharides with glucuronic residues and mainly single ones with iduronate.
      Only a small number of disaccharides form "glucuronic sections" of heterogeneous
      size or short "iduronic sections". However, the scarred fascia DS chains
      demonstrate an increased content of shorter "glucuronic sections" and shorter,
      often oversulfated, copolymeric segments. It seems that in normal fascia, the DS
      chain type with a single, long copolymeric region and a single, shorter
      "glucuronic section" is predominant, while in scarred tissue an increase in
      multidomain DS chain content may occur.

PMID- 11207437
TI  - Lactate dehydrogenase from the northern krill Meganyctiphanes norvegica:
      comparison with LDH from the Antarctic krill Euphausia superba.
AB  - Electrophoretic polymorphism of lactate dehydrogenase (LDH, EC 1.1.1.27) from
      abdominal muscle is reported in the northern krill Meganyctiphanes norvegica. In
      the population, from the Gullmarsfjord (west coast of Sweden), LDH was encoded
      for by two different Ldh-A* and -B* loci. The isoenzymes were named according to
      their electrophoretic mobilities. Ldh-A* locus was polymorphic. The allelic
      frequencies were a=0.99, a'=0.002, a"=0.004, a"'=0.004. The level of LDH
      polymorphism is low. Most individuals possess the same amount of two LDH
      homopolymers (LDH-A*(4) and LDH-B*(4)). The Meganyctiphanes norvegica LDH-A*(4)
      and LDH-B*(4) isoenzymes and the predominant LDH-A*(4) isoenzyme from Euphausia
      superba were purified to specific activities of 294, 306 and 464 micromol NADH
      min(-1) mg(-1), respectively. In both species the LDH isoenzymes were separated
      by chromatofocusing. All three isoenzymes are L-specific tetramers with molecular
      weight of approximately 160 kDa. Northern krill LDH-A*(4) has higher affinity for
      pyruvate and lactate and is more thermostable than LDH-B*(4). Both isoenzymes are
      inhibited significantly by high concentration of pyruvate but not lactate.
      Antarctic krill isoenzyme exhibits high substrate affinities, high NAD
      inhibition, high inhibition at 10 mM pyruvate, lack of lactate inhibition, and
      high heat stability and resembles northern krill LDH-A*(4) isoenzyme.

PMID- 11207438
TI  - Nitric oxide induces apoptosis in the fat body cell line IPLB-LdFB from the
      insect Lymantria dispar.
AB  - The presence of immunoreactive inducible nitric oxide synthase molecules (ir
      iNOS) is demonstrated in the Lymantria dispar IPLB-LdFB cell line. The maximum ir
      iNOS inducibility is observed 18 h after incubation with sodium nitroprusside
      (SNP). The increase in NO provoked by SNP in turn induces apoptosis. However,
      this phenomenon is observed only after 48 h. The NOS-inhibitors N(omega)-nitro-L
      arginine methyl ester (L-NAME) and N-[3-(aminomethyl)-benzyl]acetamide (1400W)
      were both unable to block the SNP-induced apoptosis at all the concentrations
      used. Incubation with SNP plus N-acetyl-L-cysteine (NAC) further augmented the
      percentage of cell death with respect to SNP used alone, and this process is seen
      earlier, i.e. after 24 h. Moreover, the induction of apoptosis in the presence of
      NAC is time- and concentration-dependent. The high percentage of cell death with
      SNP+NAC suggests that NAC forms S-nitrosothiols with NO, resulting in an increase
      in the bioavailability of NO. In conclusion, these findings show the existence of
      a close relationship between mammalian and invertebrate cells with regards to SNP
      and NAC induction and the related NO response.

PMID- 11207439
TI  - Effects of ration on somatotropic hormones and growth in coho salmon.
AB  - We examined the response of growth hormone (GH), total plasma insulin-like growth
      factor I (IGF-I), and growth rate to a change in ration in coho salmon. Tanks of
      individually tagged fish were placed on high, medium, or low ration, and sampled
      every 2 weeks for 8 weeks to create a range of growth rates. Some fish received
      non-lethal blood draws, while others were sampled terminally. Plasma IGF-I levels
      were higher in high ration fish than in low ration fish from 4 weeks after the
      beginning of experimental diets to the end of the experiment. GH levels were low
      and similar in all fish after changing rations, except for the fish in the low
      ration group at week 2. IGF-I was strongly correlated with specific growth rate
      in weight in terminally sampled fish after 4 weeks. GH did not correlate with
      growth rate or IGF-I levels. Growth parameters (length, weight, specific growth
      rates in weight and length, and condition factor) responded to ration. Serial
      sampling reduced growth rates and hematocrit, but did not change hormone levels.
      This study shows that IGF-I responds to changed rations within 2-4 weeks in
      salmonids.

PMID- 11207440
TI  - Antifreeze glycoproteins: relationship between molecular weight, thermal
      hysteresis and the inhibition of leakage from liposomes during thermotropic phase
      transition.
AB  - Antifreeze glycoproteins (AFGP) were isolated and purified from the blood plasma
      of rock cod (Gadus ogac), using DEAE-Bio-gel ion exchange chromatography,
      followed by high performance liquid chromatography (HPLC). The purified proteins
      were analyzed using polyacrylamide gel electrophoresis (PAGE), and electrospray
      mass spectrometry. The results indicated that rock cod synthesize seven size
      classes of glycoproteins, ranging from 2.6 to 24 kDa, with each size class
      containing multiple isoforms. Antifreeze activity, as determined by thermal
      hysteresis, indicated that the AFGP could be separated into two groups, with the
      larger size classes (molecular mass>13 kDa) having approximately 3-4 times the
      activity of the smaller, proline containing, size classes (molecular mass<10
      kDa). All of the AFGP size classes prevented leakage from
      dielaidoylphosphatidylcholine (DEPC) liposomes as they were cooled through their
      phase transition temperature, with the larger size classes being approximately 4
      times as effective as the smaller ones. It is hypothesized that AFGP prevent
      liposomes from leaking as they pass through the phase transition temperature by
      binding to the phospholipid membrane.

PMID- 11207441
TI  - Glucokinase is highly induced and glucose-6-phosphatase poorly repressed in liver
      of rainbow trout (Oncorhynchus mykiss) by a single meal with glucose.
AB  - The low dietary starch utilisation by rainbow trout (Oncorhynchus mykiss) may be
      attributed to a dysfunction of the nutritional regulation of the hepatic
      glucose/glucose-6-phosphate cycle. The present study was initiated to analyse the
      regulation of activity and gene expression of hepatic glucokinase (GK) and
      glucose-6-phosphatase (G6Pase) by dietary carbohydrates in this species. We found
      that even a single meal containing 24% of glucose is sufficient to induce the GK
      expression (mRNA and activity) as in mammals. In contrast, although the
      inhibitory effect of dietary glucose on G6Pase expression is observed at the
      molecular level, the G6Pase activity is not significantly inhibited by dietary
      glucose. Thus, in contrast to the gluconeogenic G6Pase enzyme, a rapid adaptation
      of the hepatic glycolytic GK enzyme to dietary glucose seems effective in rainbow
      trout. These results suggest that in carnivorous rainbow trout, the liver is
      capable to strongly regulate the utilisation of glucose but not the synthesis of
      glucose.

PMID- 11207442
TI  - Hyperlipidemia and reproductive failure in captive-reared alligators: vitamin E,
      vitamin A, plasma lipids, fatty acids, and steroid hormones.
AB  - Blood samples were collected from 26 captive-reared alligators (25 females; one
      male) and 12 (seven females and five males) wild "nuisance" alligators collected
      by wildlife personnel in south Louisiana in May 1995. The captive alligators,
      hatched from artificially incubated eggs in 1972-1973, had received vitamin E
      supplements during the 3 weeks before the blood sample was collected. Each sample
      was analyzed for vitamin E (alpha-tocopherol), vitamin A (retinol), total lipid,
      triacylglycerol, phospholipid, cholesterol, cholesteryl ester, free fatty acids,
      steroid hormones and a standard clinical blood panel. The fatty acid composition
      of the plasma lipid fraction was also analyzed. Results indicated that 18 of the
      captive females and three of the seven wild females were undergoing
      vitellogenesis, i.e. had elevated plasma estradiol and elevated plasma calcium.
      Vitellogenic females had higher vitamin E than non-vitellogenic females (77.4
      microg/ml vs. 28.6 microg/ml in captive females; 24.0 microg/ml vs. 21 microg/ml
      in wild females). Plasma retinol was similar in all groups, ranging from 0.5 to
      1.4 microg/ml and close to values reported in birds. All lipid fractions, with
      the exception of cholesteryl ester, were higher in captive alligators than in
      wild alligators. There were also significant differences in the fatty acid
      composition of wild and captive alligators. Plasma eicosapentaenoic and
      docasahexaenoic acid were higher in wild than in captive alligators, whereas
      linoleic was higher in captive than in wild.

PMID- 11207443
TI  - Seasonal changes in thermotropic behavior of phosphatidylcholine and
      phosphatidylethanolamine in different organs of the ascidian Halocynthia
      aurantium.
AB  - Differential scanning calorimetry and polarising microscopy were used to
      investigate the crystal-liquid crystal-isotropic melt phase transitions of
      phosphatidylcholine (PC), and phosphatidylethanolamine (PE), isolated from
      muscles, gill pouches, gonads and digestive glands of Halocynthia aurantium,
      collected in summer and winter. We also analyzed the fatty chain composition of
      these phospholipids. In summer, the crystalline to liquid crystalline phase
      transitions of PC and PE from different organs were more co-operative than in
      winter. Their peak maximum temperatures were close and temperature ranges
      overlapped for summer samples. Peak maximum temperatures of winter samples
      decreased sharply, by 18-27 degrees C for PC and by 10-44 degrees C for PE,
      respectively, depending on the organ. Total heat changes of transitions also
      decreased. Thermograms were completely located at temperatures below -1.7 degrees
      C (minimal temperature of seawater in winter). In contrast to summer samples,
      peak maximum temperatures for PC and PE in winter differed significantly, (by 14
      30 degrees C depending on organ), while the temperature ranges of their
      transitions still showed considerable overlap. Simultaneously, the temperature
      ranges of the liquid crystalline to isotropic phase transitions decreased. The
      main reason for changes in thermotropic behavior of phospholipids seems to be the
      decrease of saturated/unsaturated ratios. The existence of stable and
      thermoadaptative labile phospholipid pools in the membrane structure is proposed.
      The relationship of these transitions to low- and high-temperature adaptation is
      discussed.

PMID- 11207444
TI  - Chemical characterisation of the oligosaccharides in hooded seal (Cystophora
      cristata) and Australian fur seal (Arctocephalus pusillus doriferus) milk.
AB  - Carbohydrates were extracted from hooded seal milk, Crystophora cristata (family
      Phocidae). Free oligosaccharides were separated by gel filtration and then
      purified by ion exchange chromatography, gel filtration and preparative thin
      layer or paper chromatography and their structures determined by 1H-NMR. The
      hooded seal milk was found to contain inositol and at least nine
      oligosaccharides, most of which had lacto-N-neotetraose or lacto-N-neohexaose as
      core units, similar to those in milk of other species of Carnivora such as bears
      (Ursidae). Their structures were as follows: Gal(beta1-4)Glc (lactose);
      Fuc(alpha1-2)Gal(beta1-4)Glc (2'-fucosyllactose); Gal(beta1-4)GlcNAc(beta1
      3)Gal(beta1-4)Glc (lacto-N-neotetraose); Fuc(alpha1-2)Gal(beta1-4)GlcNAc(beta1
      3)Gal(beta1-4)Glc (lacto-N-fucopentaose IV); Gal(beta1-4)GlcNAc(beta1
      3)[Gal(beta1-4)GlcNAc(beta1-6)]Gal(1-4)Glc (lacto-N-neohexaose); Fuc(alpha1
      2)Gal(beta1-4)GlcNAc(beta1-3)[Gal(beta1-4)GlcNAc(beta1-6)]Gal(beta1-4)Glc
      (monofucosyl lacto-N-neohexaose a); Gal(beta1-4)GlcNAc(beta1-3)[Fuc(alpha1
      2)Gal(beta1-4)GlcNAc(beta1-6)]Gal(beta1-4)Glc (monofucosyl lacto-N-neohexaose b);
      Fuc(alpha1-2)Gal(beta1-4)GlcNAc(beta1-3)[Fuc(alpha1-2)Gal(beta1-4)GlcNAc(beta1
      6)]Gal(beta1-4)Glc (difucosyl lacto-N-neohexaose); Gal(beta1-4)GlcNAc(beta1
      3)Gal(beta1-4)GlcNAc(beta1-3)Gal(beta1-4)Glc (para lacto-N-neohexaose);
      Fuc(alpha1-2)Gal(beta1-4)GlcNAc(beta1-3)Gal(beta1-4)GlcNAc(beta1-3)Gal(beta1
      4)Glc (monofucosyl para lacto-N-neohexaose). Milk of the Australian fur seal,
      Arctophalus pusillus doriferus (family Otariidae) contained inositol but no
      lactose or free oligosaccharides. These results, therefore, support the
      hypothesis that the milk of otariids, unlike that of phocids, contains no free
      reducing saccharides.

PMID- 11207445
TI  - Isolation and characterization of mitochondrial F(1)-ATPase from crayfish
      (Orconectes virilis) gills.
AB  - A soluble F(1)-ATPase was isolated from the mitochondria of crayfish (Orconectes
      virilis) gill tissue. The maximal mitochondrial disruption rate (95%) was
      obtained by sonicating for 4 min at pH 8.6. A 15-fold purification was estimated.
      The properties for both soluble and membrane-bound enzyme were studied. Both
      enzyme forms were stable at 4 to -70 degrees C when kept in 20% glycerol. Soluble
      F(1)-ATPase was more stable at room temperature than membrane-bound enzyme. It
      displayed a narrower pH profile (pK(1) =6.58, pK(2)=7.68) and more acid pH
      optimum (7.13) than membrane-bound enzyme (pK(1)=6.42, pK(2)=8.55, optimum pH
      7.49). The anion-stimulated activities were in the order HCO(3)(-)>SO(4)(2-)>Cl(
      ). The apparent K(a) values for soluble enzyme were 11.4, 11.2, and 10.9 mM,
      respectively, but the K(a) of HCO(3)(-) for membrane-bound enzyme (14.9 mM) was
      higher than for soluble enzyme. Oligomycin and DCCD inhibited membrane-bound F(1)
      ATPase with I(50) of 18.6 ng/ml and 2.2 microM, respectively, but were
      ineffective in inhibiting soluble enzyme. Both enzyme forms shared identical
      sensitivity to DIDS (I(50)=12.5 microM) and vanadate (I(50)=9.0 mM). Soluble
      ATPase was significantly more sensitive to pCMB (I(50)=0.15 microM) and NO(3)(-)
      (I(50)=28.6 mM) than membrane-bound enzyme (I(50)=1.04 microM pCMB and 81.5 mM
      NO(3)(-)). In addition, soluble F(1)-ATPase was slightly more sensitive to azide
      (I(50)=91.8 microM) and NBD-Cl (I(50)=9.18 microM) than membrane-bound enzyme
      (I(50)=111.6 microM azide and 12.88 microM NBD-Cl). These data suggest a
      conformational change transmission between F(0) and F(1) sectors and slight
      conformational differences between soluble F(1) and membrane-bound F(1). In
      addition, an unmodified F(0) stabilizes F(1) and decreases F(1) sensitivities to
      inhibitors and modulators.

PMID- 11207446
TI  - Kinetic studies on mitochondrial F(1)-ATPase from crayfish (Orconectes virilis)
      gills.
AB  - The substrate kinetics and the role of free Mg(2+) and free ATP were studied in
      membrane-bound F(1)-ATPase from crayfish (Orconectes virilis) gills. It was shown
      that the MgATP complex was the true substrate for the ATPase activity with a K(m)
      value of 0.327 mM. In the absence of bicarbonate, the maximum azide-sensitive
      activities in the presence and absence (<18 microM) of free ATP were 0.878 and
      0.520 micromol P(i)/mg protein/min, respectively, while the maximum bicarbonate
      stimulated activity in absence of free ATP was 1.486 micromol P(i)/mg
      protein/min. Free ATP was a competitive inhibitor (K(i)=0.77 mM) and free Mg(2+)
      was a mixed inhibitor (K(i)=0.81 mM, K(i)'=5.89 mM). However, free ATP also acted
      as an activator. Lineweaver-Burk plots for MgATP hydrolysis at high free Mg(2+)
      concentrations exhibited an apparent negative cooperativity, which was not the
      case for high free ATP levels. These results suggest that, although free ATP
      inhibited the enzyme by binding to catalytic sites, it stimulated ATPase activity
      by binding to non-catalytic sites and promoted the dissociation of inhibitory
      MgADP from the catalytic site.

PMID- 11207447
TI  - Purification and characterization of cathepsin D from herring muscle (Clupea
      harengus).
AB  - Cathepsin D was purified and concentrated 469-fold from a homogenate of Clupea
      harengus muscle. The purified enzyme is a monomer with a molecular weight of
      38000-39000. It is inhibited by pepstatin and has optimal activity at pH 2.5 with
      hemoglobin as the substrate. The isoelectric point is at pH 6.8. Glycosidase
      treatment and binding to Concanavalin A indicated that the enzyme contains one N
      linked carbohydrate moiety of the high-mannose type per molecule. The first 21
      amino acid residues of the N-terminal showed high similarity to cathepsin D from
      antarctic icefish liver (Chionodraco hamatus) and trout ovary (Oncorhynchus
      mykiss). Digestion of the beta-chain of oxidized insulin resulted in preferential
      cleavage at Leu(15)-Tyr(16), (47%), Tyr(16)-Leu(17) (34%) and Ala(14)-Leu(15)
      (18%). Incubation with myofibrils from herring muscle at pH 4.23 showed that the
      enzyme mainly degraded myosin, actin and tropomyosin.

PMID- 11207448
TI  - Adaptation of tobacco budworm Heliothis virescens to proteinase inhibitors may be
      mediated by the synthesis of new proteinases.
AB  - The tobacco budworm Heliothis virescens is adapted to feed on tobacco leaves that
      have proteinase protein inhibitors (PIs). To study this adaptation, the midgut
      proteinases of Heliothis virescens larvae reared on artificial PI-free diet and
      on tobacco leaves were compared using ion exchange chromatography, hydrophobic
      chromatography, gel filtration and polyacrylamide gel electrophoresis at
      different conditions. SDS polyacrylamide-gradient gel electrophoresis (SDS-PAGE)
      and kinetic studies shown that leaf-fed larvae have a chymotrypsin (M(r) 26000)
      and four trypsins (T1-T4) with the following properties: T1, K(m) 0.3 microM,
      M(r) 70000; T2, K(m) 0.4 microM, M(r) 67000; T3, K(m) 2.4 microM, M(r) 29000; T4,
      K(m) 15 microM, M(r) 17000. Diet-fed larvae have a chymotrypsin (M(r) 26000) and
      a major trypsin (K(m) 2.9 microM, M(r) 29000). Native PAGE at different gel
      concentrations showed that in these conditions, only T1 and T2 occur in leaf-fed
      larvae, whereas gel filtration in the absence and presence of SDS revealed that
      T1 and T2 might arise by polymerization of T3 and T4, respectively. The data
      suggest that, in the presence of PI-containing food, H. virescens larvae express
      new trypsin molecules that form oligomers and are apparently less affected by PIs
      because of tighter binding to the substrate (lower K(m) values) and a putative
      decreased affinity for PIs.

PMID- 11207450
TI  - A systematic review of treatments for severe psoriasis.

PMID- 11207451
TI  - Equity and the economic evaluation of healthcare.

PMID- 11207452
TI  - A millstone in the uphill battle for credibility.

PMID- 11207453
TI  - Nutritional strategies for treating chronic fatigue syndrome.

PMID- 11207454
TI  - Natural agents in the prevention of cancer. Part 1: human chemoprevention trials.
AB  - Data exist in the scientific literature showing reduction in the risk of tumor
      occurrence achieved by the use of nutritional and other natural materials.
      However, many trials that have attempted to prevent cancer occurrence with
      nutritional supplementation have found no effect or even increased tumor
      incidence. Several factors appear to be responsible for these disparate data,
      including the forms of nutrients used and the types of cancer being studied. In
      addition, combinations of nutrients have often been found to be more effective
      than single nutrient interventions. Appropriate use of supplemental nutrition,
      along with attention to pertinent dietary and lifestyle risk factors, comprise
      for the average person perhaps the best presently available strategy for
      prevention of the common types of malignancy.

PMID- 11207455
TI  - The etiologies, pathophysiology, and alternative/complementary treatment of
      asthma.
AB  - A chronic inflammatory disorder of the respiratory airways, asthma is
      characterized by bronchial airway inflammation resulting in increased mucus
      production and airway hyper-responsiveness. The resultant symptomatology includes
      episodes of wheezing, coughing, and shortness of breath. Asthma is a
      multifactorial disease process with genetic, allergic, environmental, infectious,
      emotional, and nutritional components. The underlying pathophysiology of asthma
      is airway inflammation. The underlying process driving and maintaining the
      asthmatic inflammatory process appears to be an abnormal or inadequately
      regulated CD4+ T-cell immune response. The T-helper 2 (Th2) subset produces
      cytokines including interleukin-4 (IL-4), IL-5, IL-6, IL-9, IL-10, and IL-13,
      which stimulate the growth, differentiation, and recruitment of mast cells,
      basophils, eosinophils, and B-cells, all of which are involved in humoral
      immunity, inflammation, and the allergic response. In asthma, this arm of the
      immune response is overactive, while Th1 activity, generally corresponding more
      to cell-mediated immunity, is dampened. It is not yet known why asthmatics have
      this out-of-balance immune activity, but genetics, viruses, fungi, heavy metals,
      nutrition, and pollution all can be contributors. A plant lipid preparation
      containing sterols and sterolins has been shown to dampen Th2 activity.
      Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to
      be necessary in asthma treatment. Vitamins B6 and B12 also may be helpful. Omega
      3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora
      asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory
      component. Physical modalities, including yoga, massage, biofeedback,
      acupuncture, and chiropractic can also be of help.

PMID- 11207456
TI  - Maitake extracts and their therapeutic potential.
AB  - Maitake (Grifola frondosa) is the Japanese name for an edible fungus with a large
      fruiting body characterized by overlapping caps. It is a premier culinary as well
      as medicinal mushroom. Maitake is increasingly being recognized as a potent
      source of polysaccharide compounds with dramatic health-promoting potential. The
      most recent development is the MD-fraction, a proprietary maitake extract its
      Japanese inventors consider to be a notable advance upon the preceding D
      fraction. The D-fraction, the MD-fraction, and other extracts, often in
      combination with whole maitake powder, have shown particular promise as
      immunomodulating agents, and as an adjunct to cancer and HIV therapy. They may
      also provide some benefit in the treatment of hyperlipidemia, hypertension, and
      hepatitis.

PMID- 11207457
TI  - Can manipulation of the ratios of essential fatty acids slow the rapid rate of
      postmenopausal bone loss?
AB  - The rapid rate of postmenopausal bone loss is mediated by the inflammatory
      cytokines interleukin-1, interleukin-6, and tumor necrosis factor alpha. Dietary
      supplementation with fish oil, flaxseeds, and flaxseed oil in animals and healthy
      humans significantly reduces cytokine production while concomitantly increasing
      calcium absorption, bone calcium, and bone density. Possibilities may exist for
      the therapeutic use of the omega-3 fatty acids, as supplements or in the diet, to
      blunt the increase of the inflammatory bone resorbing cytokines produced in the
      early postmenopausal years, in order to slow the rapid rate of postmenopausal
      bone loss. Evidence also points to the possible benefit of gamma-linolenic acid
      in preserving bone density.

PMID- 11207458
TI  - Taurine - monograph.

PMID- 11207459
TI  - Idebenone - monograph.

PMID- 11207460
TI  - Vitamin B6 (pyridoxine and pyridoxal 5'-phosphate) - monograph.

PMID- 11207461
TI  - How to use evidence-based medicine in anaesthesiology.

PMID- 11207462
TI  - The assessment of postoperative cognitive function.
AB  - Postoperative cognitive function (POCD) has been subject to extensive research.
      In the literature, large differences are apparent in methodology such as the test
      batteries, the interval between sessions, the endpoints to be analysed,
      statistical methods, and how neuropsychological deficits are defined.
      Traditionally, intelligence tests or tests developed for clinical neuropsychology
      have been used. The tests for detecting POCD should be based on well-described
      sensitivity and suitability in relation to surgical patients. In tests using
      scores, floor/ceiling effects may compromise the evaluation if the tests are
      either too easy or to difficult. Uncontrolled testing facilities and change of
      test personnel may affect the test performance. Practice effects are pronounced
      in neuropsychological tests but have generally been ignored. The use of a
      suitable normative population is essential to allow correction for practice
      effects and variability between sessions. Missing follow-up may severely
      compromise valid conclusions since subjects unable or unwilling to be examined
      are particularly prone to suffer from POCD. In the statistical analysis of the
      test results, the evaluation should be based on differences between pre- and
      postoperative performance. Parametric statistical tests are not relevant unless
      the appropriate Gaussian distributions are present, perhaps after transformation
      of data. The definition of cognitive dysfunction should be restrictive and the
      criteria should be fulfilled in only a small proportion of volunteers. In the
      literature, these requirements often have not been fulfilled. This precludes a
      reasonable estimation of the incidence of POCD and the conclusions of comparative
      studies should be interpreted with great caution. In this review article, we
      present a number of recommendations for the design and execution of studies
      within this area. In addition, the critical reader may use these recommendations
      in the evaluation of the literature.

PMID- 11207463
TI  - Is transient lumbar pain after spinal anaesthesia with lidocaine influenced by
      early mobilisation?
AB  - BACKGROUND: The aetiology of transient lumbar pain (TLP) after spinal anaesthesia
      has generated much interest. Many theories have been discussed. Early ambulation
      has been suggested as one plausible theory for developing TLP. METHODS: A total
      of 107 patients scheduled for inguinal hernial repair under spinal anaesthesia
      (20 mg/ml hyperbaric lidocaine) were randomised to either early or late
      ambulation: the early ambulation (group A), as early as possible after total
      regression of spinal block or the late mobilisation (group B) bedridden for more
      than 12 h. The clinical course and duration of operation were monitored.
      Assessments 4, 8 and 12 h after spinal anaesthesia were performed with respect to
      wound pain, nausea, tiredness and eventual symptoms of TLP were recorded. The
      patients also kept a diary about any symptoms once daily day 1-3 at home. A
      telephone follow-up was performed at day 5-7. RESULTS: Our results showed an
      incidence of TLP of 23% in all patients. No difference was recorded between early
      and late mobilisation patients, 12 and 13 patients, respectively. CONCLUSION:
      Early ambulation does not seem to increase the risk of developing TLP.

PMID- 11207465
TI  - Risk factors for preoperative anxiety in adults.
AB  - BACKGROUND: Patients who undergo surgery experience acute psychological distress
      in the preoperative period. The objective of this study was to identify and
      quantify the effect of risk factors for preoperative anxiety in adults. METHODS:
      A cross-sectional study was performed with 592 inpatients scheduled for elective
      surgery. Age ranged from 18 to 60 years (ASA physical status I-III). Demographic
      information was collected using a structured questionnaire. The measuring
      instruments were a visual analog scale, the State-Trait Anxiety Inventory; the
      Montgomery-Asberg Depression Rating Scale, the WHO Self-Reporting Questionnaire
      20, and the future self-perception questionnaire. Multivariate conditional
      regression modeling was used to control confounding factors and to determine
      independent predictors of preoperative anxiety, taking into account the
      hierarchical relationship between risk factors. RESULTS: High preoperative
      anxiety was associated with history of cancer (odds ratio (OR)=2.26) and smoking
      (OR=7.47), psychiatric disorders (OR=5.93), negative future perception (OR=
      2.30), moderate to intense depressive symptoms (3.22), high trait-anxiety (3.83),
      moderate to intense pain (2.12), medium surgery (OR=1.52), female gender
      (OR=2.0), ASA category III (OR=3.41), up to 12 years of education (OR=1.36), and
      more than 12 years of education (OR=1.68). Previous surgery (OR= 0.61) was
      associated with lower risk for preoperative state-anxiety. CONCLUSIONS: History
      of cancer and smoking, psychiatric disorders, negative future perception,
      moderate to intense depressive symptoms, high trait-anxiety, moderate to intense
      pain, medium surgery, female gender, ASA category III, up to 12 years of
      education and more than 12 years of education constituted independent risk
      factors for preoperative state-anxiety. Previous surgery reduced the risk for
      preoperative anxiety.

PMID- 11207464
TI  - Unintentional hypotension from lidocaine infiltration during orthognathic surgery
      and general anaesthesia.
AB  - BACKGROUND: A probable causal relationship between submucosal infiltration of
      lidocaine, with adrenaline 12.5 microg x mL(-1), and untoward arterial
      hypotension during general anaesthesia for orthognathic surgery was investigated
      in two parts. METHODS: The first part of the study was open and non-randomised.
      The patients served as their own controls, receiving 5.4 mL saline/adrenaline
      before mandibular or maxillary surgery on the first side of the jaw and 5.4 mL
      lidocaine (2%)/adrenaline on the other side a minimum of 40 min later. Nine
      patients received in total 11 pairs of injections of the study drugs. In Part
      Two, 50 mg or 100 mg of lidocaine with adrenaline was infiltrated in an observer
      blinded and randomised order in either side of the jaw in another 13 patients.
      RESULTS: A significant and dose-dependent blood pressure decrease was observed
      after infiltration of lidocaine/adrenaline, but not after saline/adrenaline. The
      heart rate increased significantly after both types of injections, most
      pronounced after saline/adrenaline. Mean arterial blood pressure decreased on
      average 11% and 23% with lidocaine 50 mg and 100 mg, respectively (P<0.05,
      ANOVA). CONCLUSION: Lidocaine induced dose-dependent arterial hypotension when
      combined with a defined level of general anaesthesia. The causative mechanism is
      unclear.

PMID- 11207466
TI  - Reduced isoflurane consumption with bispectral index monitoring.
AB  - BACKGROUND: Bispectral index (BIS) monitoring has been found to decrease the
      requirements for propofol, sevoflurane and desflurane and to improve recovery. We
      wanted to assess the effect of BIS monitoring on intraoperative isoflurane
      utilisation, and the early recovery profile. METHODS: Eighty patients undergoing
      various surgical procedures were studied. In the first phase of the study,
      patients were anaesthetised without the use of BIS, the anaesthetists being
      blinded to the BIS readings, and isoflurane being administered according to
      standard clinical practice (control group). In a second phase, isoflurane was
      titrated to maintain a BIS value between 40 and 60 during surgery, and then 60-70
      during 15 min prior to the end of surgery (BIS group). Isoflurane consumption was
      measured. Recovery times and the time to achieve a modified Aldrete score of 9
      were recorded. RESULTS: Despite similar mean BIS levels during maintenance of
      anaesthesia, the cumulative time spent with BIS values between 40 and 60 during
      maintenance of anaesthesia was significantly longer in the BIS group as compared
      with the control group (P<0.001). The isoflurane usage in the BIS group was 12
      25% lower than in the control group (P<0.05). The time to awakening and
      extubation were comparable in the two groups. Although the patients were less
      sedated (P<0.01) during the three postoperative hours in the BIS (vs. control)
      group, no significant differences were observed in the time to obtain an Aldrete
      score of 9. CONCLUSION: The addition of BIS to standard monitoring decreases
      isoflurane consumption. However, we found only a small advantage in using BIS
      with respect to recovery from isoflurane anaesthesia.

PMID- 11207467
TI  - Management of anaphylactic shock evaluated using a full-scale anaesthesia
      simulator.
AB  - BACKGROUND: The diagnosis of an anaphylactic reaction during anaesthesia is not
      the first consideration for the anaesthetist and might be missed. The aim of this
      study was to describe anaesthetists' management of an anaphylactic reaction
      concerning diagnosing, treatment and application of anaesthesia crisis resource
      management (ACRM) in a full-scale anaesthesia simulator. METHODS: Forty-two
      anaesthetists in teams of two attended training sessions with a critical incident
      of anaphylactic shock in a full-scale simulator. Trained observers from the study
      group evaluated the medical treatment according to a treatment sequence developed
      from the literature and graded the ACRM performance on a five-point scale where 1
      is bad and 5 is best. RESULTS: None of the teams made the correct diagnosis
      within 10 min and treatment according to the treatment sequence was not
      initiated. Only 6/21 teams considered the right diagnosis but first after hints
      from the instructor 15 min after the start of the incident. Evaluation of the use
      of the total ACRM concept (that is the use of all of the ACRM expressions seen in
      a total connection: called general impression) gave a median value of 2.0 with a
      range of (1-3). CONCLUSION: Anaphylactic shock was difficult to diagnose and no
      structured plans were used for the treatment in the simulated incident in this
      study.

PMID- 11207468
TI  - Recovery profile and side effects of remifentanil-based anaesthesia with
      desflurane or propofol for laparoscopic cholecystectomy.
AB  - BACKGROUND: Nitrous oxide (N2O) has been suggested to contribute to bowel
      distension, resulting in worsened operating conditions for laparoscopic surgery,
      and to increase incidence of postoperative nausea and vomiting. Therefore, our
      objective was to assess the feasibility of two remifentanil-based anaesthetic
      regimens free from N2O with special regard to recovery profile, postoperative
      analgesic demand and side effects in patients undergoing laparoscopic
      cholecystectomy. METHODS: Fifty patients (ASA I-II, 23-65 yr) were randomly
      assigned to receive remifentanil-based anaesthesia in conjunction with propofol
      (group R/P) or desflurane (group R/D). After standardised induction of
      anaesthesia, analgesia was continued with remifentanil in all patients. For
      maintenance of hypnosis, propofol or desflurane were used in concentrations to
      ensure loss of consciousness, lack of awareness, and maintenance of heart rate
      and blood pressure within +/- 25% of initial values. At the end of surgery all
      anaesthetics were discontinued without tapering and early emergence and recovery
      were recorded. Pain scores were assessed by using a visual analogue scale.
      Patient-controlled analgesia with i.v. piritramide was used for treatment of
      postoperative pain and recorded for 90 min in the postanaesthesia care unit
      (PACU). In addition, side effects were noted. RESULTS: Early emergence from
      anaesthesia did not differ between the groups. In group R/P, time to eye opening,
      spontaneous respiration and extubation was 4.4 +/- 2.9 min, 5.2 +/- 3.4 min and
      5.5 +/- 3.3 min respectively, compared with 4.7 +/- 2.7 min, 5.3 +/- 2.4 min and
      5.7 +/- 2.5 min in group R/D. While pain scores did not differ between both
      groups on admission to the PACU, patients receiving desflurane required more i.v.
      piritramide as compared to those receiving propofol, 22.0 +/- 6.5 mg and 17.9 +/-
      7.0 mg, respectively (P<0.05). Nausea was less frequent after propofol (16% vs.
      48%, P<0.05). CONCLUSION: In patients undergoing laparoscopic cholecystectomy,
      remifentanil-based anaesthetic regimens in conjunction with propofol or
      desflurane are suitable and allow for rapid recovery from anaesthesia. However,
      the use of propofol results in less postoperative analgesic consumption and
      nausea as compared to desflurane.

PMID- 11207469
TI  - A survey of tracheal intubation difficulty in the operating room: a prospective
      observational study.
AB  - BACKGROUND: The purpose of this study is to describe all degrees of endotracheal
      intubation difficulty among patients attended by eight anesthesiologists during
      routine surgery over a six-month period. Airway characteristics were routinely
      assessed preoperatively, according to the anesthesiologists' usual practice.
      METHODS: Difficult tracheal intubation was evaluated by the Intubation Difficulty
      Scale (IDS), a quantitative score based on seven variables. An IDS value of 0 is
      consistent with a procedure without difficulty, and an IDS > 5 with a procedure
      involving moderate to major difficulty. RESULTS: For 1171 patients undergoing
      tracheal intubation, IDS was 0 in 55%, and greater than 5 in 8% of cases.
      External laryngeal pressure, repositioning the patient and added use of a stylet
      were the most frequent methods chosen to facilitate tracheal intubation.
      CONCLUSION: There was a high incidence (37%) of minor difficulties encountered
      during routine surgery.

PMID- 11207470
TI  - Postoperative tracheal extubation after orthotopic liver transplantation.
AB  - BACKGROUND: The duration of postoperative mechanical ventilation and its
      influence on pulmonary function in liver transplant recipients is still debated
      controversially. METHODS: We retrospectively analyzed the incidence of immediate
      tracheal extubation, prolonged mechanical ventilation (>24 h following surgery),
      and episodes of reintubation in 546 patients who underwent orthotopic liver
      transplantation (OLT) at our institution. RESULTS: Immediate tracheal extubation
      in the operating theater was achieved in 18.7% of patients, and prolonged
      mechanical ventilation was required by 11.2% of patients. In these, median time
      of extubation was 49.5 h, whereas the remaining 70.1% of patients required
      ventilation support for a median 5 h after OLT. As risk factors for prolonged
      mechanical ventilation we identified the indications of acute liver failure and
      retransplantation, as well as factors such as mechanical ventilation prior to
      OLT, massive intraoperative bleeding, and severe reperfusion injury of the liver
      graft. The incidence of reintubation was 8.8% in patients who were immediately
      extubated following surgery, and 13.1% in patients who underwent extubation
      within 24 h. The incidence was significantly increased in patients requiring
      prolonged mechanical ventilation (36.1%). CONCLUSIONS: Immediate tracheal
      extubation was safe and well tolerated. The incidence of reintubation was not
      increased when compared to patients in whom extubation succeeded later. However,
      special attention should be given to transplant recipients presenting in reduced
      clinical condition at the time of OLT, undergoing complicated surgery, or
      receiving liver allografts with severe reperfusion injury because of an increased
      risk for prolonged mechanical ventilation.

PMID- 11207471
TI  - Airway pressure release ventilation and prone positioning in severe acute
      respiratory distress syndrome.
AB  - BACKGROUND: Implementation of lung protective strategy in the treatment of severe
      Acute Respiratory Distress Syndrome (ARDS) has been reported to be associated
      with improved outcome. To fulfil this approach, sedation, neuromuscular blocking
      agents and full mechanical ventilatory support are often used in critical failure
      of gas exchange. CASE REPORT: We present a patient who developed multiple organ
      failure, including severe ARDS, after severe skin injuries and septic shock.
      Ventilatory strategy consisted of lung protective approach, permissive
      hypercapnia and prone positioning. Airway pressure release ventilation (APRV)
      with the patient's superimposed spontaneous breathing was implemented and
      maintained, also during prone episodes. Improvement of gas exhange occurred after
      application of combined use of APRV and prone positioning. CONCLUSION: APRV and
      maintenance of patients' spontaneous ventilation is feasible during prone
      positioning, and this approach may have beneficial synergistic effects on gas
      exhange in patients with severe acute lung injury.

PMID- 11207472
TI  - Postoperative intensive care admittance: the role of tobacco smoking.
AB  - BACKGROUND: Smokers have been shown to have increased risk of intraoperative
      pulmonary complications and of a wide range of postoperative complications, but
      an increased risk of postoperative intensive care admittance has not yet been
      described. The aim of this study was to estimate the risk of pulmonary
      complications and postoperative intensive care admittance in smokers and non
      smokers in a general and orthopaedic surgical population. METHODS: A total of
      4725 surgical patients were assessed. The following information was noted: age,
      sex and smoking status, history of heart and lung disease, ASA classification,
      type of anaesthesia, intensive care admittance and postoperative pulmonary or
      cardiovascular complications. A logistic regression model was used to determine
      the probability of intensive care admittance and pulmonary complications as a
      function of smoking status, age, and chronic heart and lung disease. RESULTS: Of
      the patients, 39.9% were smokers, 45.5% were non-smokers and in 14.6% of the
      cases smoking status was unspecified. Postoperative intensive care admittance and
      pulmonary complications were found in 2.0% and 4.3% of the patients,
      respectively. Non-smokers were more often female (P<0.01), and smokers had a
      higher incidence of emergency surgical procedures (P<0.05). When applying
      multiple regression analysis, we found that smoking, age >65 years, and a history
      of chronic lung disease increased the risk of unplanned intensive care admittance
      (odds ratio 1.55, 12.52 and 2.73). CONCLUSION: Our results indicate a
      relationship between a history of tobacco smoking and postoperative intensive
      care admittance.

PMID- 11207473
TI  - Modelling of hypoxaemia after gynaecological laparotomy.
AB  - BACKGROUND: Late postoperative arterial hypoxaemia is common after major surgery,
      and may contribute to cardiovascular, cerebral or wound complications. This study
      investigates the time course of hypoxaemia following gynaecological laparotomy,
      and estimates parameters of mathematical models of pulmonary gas exchange to
      describe hypoxaemia. METHODS: Twelve patients were studied on four occasions;
      preoperatively, 2, 8 and 48 h after surgery. On each occasion inspired oxygen
      fraction (FIO2) was varied, changing end-expired oxygen fraction (FEO2) to
      achieve arterial oxygen saturations (SaO2) ranging from 90% to 100%. Measurements
      of ventilation and blood gases were taken. Oxygenation was characterized plotting
      FEO2 against SaO2. The shape and position of the FEO2/SaO2 curve was described
      using two mathematical models including parameters describing gas exchange:
      either shunt and resistance to oxygen diffusion (Rdiff); or shunt and asymmetry
      of ventilation-perfusion (fA2). RESULTS: Two hours after surgery SaO2 was reduced
      from 97.5%+/-1.2% (mean+/-SD) to 93.8%+/-2.7% (mean+/-SD) (P<0.001). Values of
      shunt, Rdiff and fA2 were significantly changed at 2 and 8 h postoperatively.
      Forty-eight hours postoperatively Rdiff and fA2 were still significantly changed.
      CONCLUSION: Oxygenation in 12 patients preoperatively, 2, 8 and 48 h after
      gynaecological laparotomy is described. Two patients were hypoxaemic (SaO2 <92%)
      48 h postoperatively. When two different models of oxygen transport are fitted to
      patient data, high values of Rdiff or low values of fA2 describe the right shift
      in the FEO2/SaO2 curve seen in patients with oxygenation problems. These models
      fit patient data identically, and may be useful in quantifying postoperative
      hypoxaemia.

PMID- 11207474
TI  - End-tidal to arterial oxygen tension difference as an oxygenation index.
AB  - BACKGROUND: "Ideal" alveolar oxygen tension (PAO2) is a calculated entity and the
      alveolar-arterial oxygen tension difference (PA-aO2) is used to evaluate gas
      exchange function of the lungs. Accurate calculations of PAO2 necessitate
      measurements of the respiratory exchange ratio (RER), which is less frequently
      done, and most often approximations are made. The measured end-tidal oxygen
      tension (PETO2) is a reflection of the alveolar oxygen tension. The aim was to
      study the relationship between PAO2 and PETO2, and to see whether the end-tidal
      to arterial oxygen tension difference (PET-aO2) could give the same information
      about lung function as PA-aO2. METHODS: Twenty patients admitted for cardio
      pulmonary exercise tests were studied. They bicycled for 4 min at each work load
      until maximum work load was reached. Arterial blood gases were analysed before,
      after 4 min at each work load, at maximum work load and after 2 min of recovery.
      A metabolic computer measured mixed expired gas concentrations. End-tidal gas
      concentrations were measured with a side stream gas analyser. RESULTS: We
      measured major increases in oxygen uptake, carbon dioxide elimination and RER.
      PAO2 and PETO2 increased at maximum exercise and during recovery. PAO2 and PETO2
      were closely correlated during the study, through great changes in oxygen uptake
      and RER (r=0.88). When correction was made for wet gas the median difference was
      0.12 kPa. CONCLUSIONS: At ambient air (FIO2=0.21), PET-aO2 as a respiratory index
      may give equivalent information to PA-aO2, without the need for measurements of
      mixed expired gas tensions or the hazard of an assumed RER.

PMID- 11207475
TI  - Early detection of increased tumour necrosis factor alpha (TNFalpha) and soluble
      TNF receptor protein plasma levels after trauma reveals associations with the
      clinical course.
AB  - BACKGROUND: The inflammatory response after trauma includes tumour necrosis
      factor alpha (TNFalpha) as pro-inflammatory cytokine. Furthermore, both soluble
      TNF receptor proteins (sTNF-R1 and sTNF-R2) were described to influence the post
      traumatic inflammatory response and organ dysfunction. METHOD: From 47 trauma
      patients, blood samples were obtained at the scene of accident, at hospital
      admission, after 4 h, 12 h, and 24 h, and daily until day 6. Plasma levels of
      TNFalpha, sTNFR1 and sTNF-R2 were measured by enzyme immunoassay (EIA) and
      analysed comparing clinical parameters such as injury scores (ISS, AIS),
      development of multiple organ dysfunction syndrome (MODS) and/or systemic
      inflammatory response syndrome (SIRS), and outcome. RESULTS: Significant changes
      were observed in a time-dependent manner: TNFalpha and soluble TNF receptor
      levels were elevated compared to values of healthy persons. At 4 h after trauma,
      TNFalpha and sTNF-R2 showed an increase from initial values, which continued
      during the entire observation period. Severe trauma led to enhanced sTNF-R1
      levels on scene and on hospital admission. Development of SIRS along with
      elevated sTNF-R1 began on scene and was present on admission, with increased sTNF
      R2 from day 1 to day 4. MODS (until day 6) was preceded by increased sTNF-R2
      levels on admission and up to 4 h after trauma. Outcome was associated neither
      with TNFalpha nor with soluble TNF receptor levels. CONCLUSION: Thus, in trauma
      patients, early post-traumatic MODS and SIRS coincide with increased levels of
      TNFalpha and TNF receptor proteins, revealing different, time-dependent changes.
      Hence, detection of TNFalpha and soluble TNF receptor proteins after trauma
      should pay regard to the time point of sampling.

PMID- 11207476
TI  - Blood viscosity, hemodynamics and vascular hindrance in a rat model of acute
      controlled bleeding and volume restitution with blood or Haemaccel.
AB  - BACKGROUND: Hemorrhage and volume restitution with commercially available
      solutions is followed by reduced blood viscosity. Consequent hemodynamic changes
      may arise not only from the reduced viscosity itself but also from changes in
      vascular geometry induced by autoregulation processes. Vascular hindrance
      reflects the contribution of vascular geometry to flow. Our aim was to explore
      the possible effects of blood volume restitution with Haemaccel or blood, on
      regional blood flow and vascular geometry. METHODS: Under ketamine anesthesia,
      blood was withdrawn at a rate of 0.3 ml/min for 15 min followed by 15 min of
      stabilization. The shed blood or Haemaccel was infused at the same rate and
      volume as used for withdrawal. Hemodynamic measurements were performed using
      radioactive microspheres. Blood viscosity was measured with an Ostwald
      viscometer. Vascular hindrance was calculated as the resistance/viscosity ratio.
      RESULTS: Volume replacement with Haemaccel (n=10), compared to blood (n=10), was
      followed by increased cardiac output and portal venous inflow (37.1 +/- 9.0 and
      3.1 +/- 0.5 vs 25.9 +/- 6.8 and 2.2 +/- 0.9 ml x min(-1) x 100 g bw(-1),
      respectively; P<0.05), decreased viscosity (2.8 +/- 1.3 vs 3.7 +/- 1.3,
      respectively; P<0.01) and decreased peripheral and splanchnic arteriolar
      resistance (3.8 +/- 1.1 and 40.9 +/- 7.6 vs 5.2 +/- 1.7 and 61.1 +/- 29.5 mmHg x
      ml(-1) x min x 100 g bw, respectively; P<0.05). No significant differences
      between the groups were observed in vascular hindrance and cardiac output
      distribution. CONCLUSION: Volume replacement with Haemaccel, compared to blood,
      induced increase in systemic and splanchnic blood flows, reflecting mainly
      changes in viscosity and not in blood vessel geometry. These results suggest no
      significant difference in overall activation of autoregulation process between
      volume restitution with blood or Haemaccel.

PMID- 11207477
TI  - The effect of chronic cocaine administration on hemodynamic stability and
      neurohumoral mediators during isoflurane anesthesia and shock in rats.
AB  - BACKGROUND: The aim of this investigation was to determine whether chronic
      cocaine administration altered endogenous vasoconstrictor secretion in response
      to hypotension from isoflurane anesthesia and blood loss in rats. METHODS: Rats
      received continuous intravenous infusions of saline (n=11), or cocaine 6 mg kg(
      1) d(-1) (n=13) or 18 mg kg(-1) d(-1) (n=12) for 13 days. On day 14, rats were
      anesthetized with intraperitoneal ketamine and xylazine and a femoral artery
      catheter and a tracheotomy performed to allow lung ventilation (PaCO2, 30-40
      mmHg). After baseline parameters were noted, isoflurane was introduced to end
      tidal concentrations of 0.7% for 10 min (1/2 MAC), 1.4% for 10 min (MAC) and
      again 0.7% for 10 min (1/2 MAC-2) when 5 ml of blood was withdrawn (SHOCK). Blood
      samples were drawn to assess arterial blood gas indices at various time points as
      well as plasma epinephrine, angiotensin II and vasopressin at MAC, 1/2 MAC-2 and
      SHOCK. RESULTS: Rats administered cocaine had higher oxygen extraction, required
      higher minute ventilation and had lower PaO2 values than rats administered saline
      despite similar body temperatures and hematocrits. Isoflurane administration
      resulted in significant dose dependent but similar blood pressure decreases in
      all study groups. Plasma epinephrine, angiotensin II and vasopressin
      concentrations were not different in saline or cocaine treated animals at any
      time point. CONCLUSION: These data suggest that chronic cocaine treatment in rats
      does not impair endogenous vasoconstrictor secretion nor alter the heart rate and
      blood pressure response to isoflurane and blood loss.

PMID- 11207478
TI  - Influence of colloid fluids on polymorphonuclear granulocyte function in vivo.
AB  - BACKGROUND: Granulocytes have a role in the immediate immune response. In a
      previous investigation we could demonstrate in vitro a moderate increase of the
      complement receptors CR1 (CD35) and CR3 (CD11b/CD18) on the surface of
      polymorphonuclear neutrophils (PMN) after incubation of whole blood with
      colloids. To elucidate the clinical significance, we investigated if these
      changes were also present in vivo. METHODS: The study was performed prior to
      anaesthesia for orthopaedic surgery. A total of 60 ASA-I patients was evaluated.
      Patients received in a randomised manner 7 mL/kg of the following solutions:
      human albumin 5% (HA), gelatine 4% (GEL), hydroxyethylstarch solution 6% with MW
      200,000 Da, degree of substitution 0.5 (HES), or Ringer's solution. Prior to the
      infusion, at the end (30 min) and again 30 min later, blood samples were taken.
      Blood was incubated with fluorescein-conjugated monoclonal antibodies (CD11b,
      CD16, CD35, CD62L) and analysed with flow cytometry. RESULTS: HA, GEL, HES, and
      Ringer's solution failed to induce significant differences in the expression of
      complement receptors CR1 (CD35) and CR3 (CD11b/CD18), Fc gamma receptor IIIb
      (CD16), and of L-selectin (CD62L) receptor on the surface of PMN. CONCLUSIONS:
      Application of colloids like HA, GEL, or HES in moderate amounts shows no short
      term effect on adhesion or activation molecules on granulocytes. However, in high
      doses, infused in situations such as multiple trauma and sepsis, the consequences
      on the function of PMN may be speculative and require further investigations.

PMID- 11207479
TI  - Increased blood-brain barrier permeability of morphine in a patient with severe
      brain lesions as determined by microdialysis.
AB  - Intracerebral microdialysis was utilised to obtain information regarding how
      morphine is transported across the blood-brain barrier (BBB). In a patient with a
      severe brain injury, we measured simultaneously unbound extracellular fluid (ECF)
      concentrations of morphine in human brain and in subcutaneous fat tissue, which
      were compared to morphine levels in arterial blood. This report shows an increase
      in morphine levels near the trauma site in the brain compared to uninjured brain
      tissue. The half-life of morphine in uninjured and injured brain tissue of 178
      min and 169 min, respectively, were comparable but were longer than in blood (64
      min) and adipose tissue (63 min). This indicates that morphine is retained in
      brain tissue for a longer time than what could be expected from the blood
      concentration-time profile. These results show the potential of the microdialysis
      technique in providing new information regarding the pharmacokinetics of drug in
      the human brain close to the trauma site and in macroscopically intact tissue.

PMID- 11207480
TI  - Life-threatening upper airway obstruction in a child caused by retropharyngeal
      emphysema.
AB  - A 2 1/2-year-old boy with acute obstructive lung disease from adenovirus
      infection developed cough-induced paroxysms of intense dyspnoea leading to
      respiratory failure. Chest x-ray and fluoroscopy demonstrated retropharyngeal air
      occluding the airway. The clinical management of this and similar air-leak
      problems is discussed.

PMID- 11207481
TI  - Reversible increase in QT dispersion during carbon monoxide poisoning.
AB  - Increased QT dispersion is a marker for cardiac morbidity and mortality. Carbon
      monoxide (CO) is a potent myocardial toxin and this report describes the change
      in QT dispersion during intensive care therapy for severe CO poisoning.

PMID- 11207482
TI  - Vaginal term breech delivery--a time for reappraisal?

PMID- 11207483
TI  - Oocyte donation in infertility treatment--a review.

PMID- 11207484
TI  - Induction of endometriosis in the mouse inhibits spleen leukocyte function.
AB  - BACKGROUND: It is still unclear whether the immunologic perturbation observed in
      women with endometriosis represents an intrinsic defect of the immune system or
      it is consequent to the presence of endometrium in ectopic sites. The present
      study was aimed to evaluate the immunoregulatory properties of ectopic
      endometrial implants in a model of experimental endometriosis in mice. METHODS:
      Endometriosis was induced in n=10 mice by inoculating endometrial fragments
      obtained from syngenic donor mice into the peritoneal space. Twelve mice were
      similarly treated but were not inoculated with endometrium and were used as
      control mice. At an explorative laparotomy performed in all the animals after
      three weeks, the extent of peritoneal lesions, when present, was evaluated by
      weight assessment and surface area measurement. In both mice that were inoculated
      with endometrium and control animals, spleens were removed. The effect of
      endometriosis induction on concanavalin A-induced spleenocyte proliferation was
      investigated. RESULTS: A significant inhibition of spleenocyte growth was
      demonstrated in mice in which endometriosis was induced (36156+/-3061 cpm)
      compared to control animals (47172+/-3210 cpm; p<0.05). Moreover, a significant
      inverse correlation was found between spleenocyte proliferation and weight and
      surface area of the peritoneal endometriotic lesions (r=0.76; p<0.02 and r=0.75;
      p<0.02, respectively). CONCLUSION: These findings suggest that the presence of
      ectopic endometrial implants within the peritoneal cavity leads to substantial
      changes of the immune response in vivo. These changes may have significant
      implications for the understanding of the etiopathogenesis of endometriosis.

PMID- 11207485
TI  - Child births in a modified midwife managed unit: selection and transfer according
      to intended place of delivery.
AB  - BACKGROUND: As small obstetrical departments may not be able to give second-level
      perinatal care, the delivery unit at Lofoten hospital was for the years 1997-98
      reorganized to a modified midwife managed unit. Women at low obstetrical risk
      were delivered at this unit and women at high risk were referred to the central
      hospital. We assessed the effectiveness of the risk selection. MATERIAL AND
      METHODS: The study was a prospective, pragmatic, population-based trial. Desired
      outcome was defined as a non-operative delivery at 35-42 weeks gestational age
      giving an infant not needing resuscitation. Intermediate outcomes: Operative
      deliveries, infants transferred to neonatal intensive care unit and infants
      diverging from normal. The intended place of delivery was ultimately decided at
      admittance to the midwife managed unit. RESULTS: Of the 628 women in study 435
      (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be
      delivered at the central hospital and 41 (6.5%) were transferred to the central
      hospital after admittance to the midwife managed unit. Desired outcome was
      recorded in 94% of the deliveries at the midwife managed unit as compared to
      50.3% at the central hospital. Women who intended to be delivered at the midwife
      managed unit, needed fewer operative deliveries and relatively few infants were
      transferred to the neonatal intensive care unit or diverged from normal.
      CONCLUSIONS: As nearly 70% of the births occurred at the midwife managed unit and
      94% of these deliveries had a desired outcome, this indicates an effective
      selection process. This model might be an alternative to centralization of births
      in sparsely population areas.

PMID- 11207486
TI  - Symptoms across pregnancy in relation to psychosocial and biomedical factors.
AB  - BACKGROUND: There is current interest in symptoms during pregnancy, but yet
      little is known about their prevalence and how often they are experienced across
      pregnancy. The reasons why some women experience more symptoms or experience them
      more often than others has received limited research attention. OBJECTIVE: To
      document the prevalence and frequency of 27 pregnancy symptoms and to
      systematically investigate, cross-sectionally and prospectively, the effect of
      psychosocial factors on the prevalence and frequency of these symptoms, while
      controlling for biomedical factors. METHODS: Four hundred and seventy-six
      nulliparous Scandinavian women who attended routine prenatal care in Uppsala
      county, Sweden, were studied six times during pregnancy (gestational weeks 10,
      12, 20, 28, 32, and 36). RESULTS: The prevalence of symptoms was high, but only a
      smaller portion of these symptoms were experienced frequently. Psychological
      stress particularly contributed to the prevalence and frequency of concurrent
      symptoms and predicted symptoms up to 16 weeks later, independent of medical
      risk, smoking, and weight gain. CONCLUSIONS: Prevalence rates may be inflated,
      because many symptoms were experienced only 'occasionally' during each of the 4
      week periods we sampled. By examining how frequently symptoms were experienced,
      we gained an indication of which symptoms are more likely to be bothersome or
      intrude upon daily activities. Psychosocial variables accounted for individual
      differences in symptom reports after taking biomedical factors into account.
      Attention to psychosocial variables in future studies will aid in our
      understanding of the etiology of pregnancy symptoms.

PMID- 11207487
TI  - Prenatal diagnosis of six major cardiac malformations in Europe--a population
      based study.
AB  - AIM: To present data on prenatal diagnosis of six major cardiac malformations in
      low-risk European populations. METHODS: Data from 12 Eurocat registries on
      congenital malformations. All registries have multiple sources of information and
      use the same methods of data collection and coding. The six cardiac malformations
      included were hypoplastic left heart, tricuspid atresia, single ventricle,
      Tetralogy of Fallot, transposition of great arteries and common A-V-canal.
      RESULTS: There were significant differences in the proportion of cases diagnosed
      prenatally, with the highest detection rate in France (91% for single ventricle
      in Paris) and the lowest detection rate in countries without prenatal ultrasound
      screening (no cases diagnosed prenatally in the Danish registry area). Prenatal
      detection rate was significantly higher for the three malformations affecting the
      size of the ventricles (hypoplastic left heart, tricuspid atresia, single
      ventricle) compared to the other three malformations (46% versus 24%, p<0.001).
      Time of diagnosis was late, with only one third diagnosed before 24 weeks of
      gestation. The risk of fetal death seems to be low. CONCLUSION: There are
      significant regional differences in prenatal detection rate of major cardiac
      malformations in Europe.

PMID- 11207488
TI  - Third and fourth degree perineal tears. Predictor factors in a referral hospital.
AB  - BACKGROUND: Tears of the anal sphincter are a feared complication of vaginal
      delivery, as many as 50% of these patients experience incontinence as an after
      effect. Identifying significant predictor factors leading to third or fourth
      degree perineal tears during vaginal delivery was the objective of this study.
      METHODS: During a two-year period (1995-1996), a third or fourth degree perineal
      rupture occurred in 214 women (3.7%) after vaginal delivery. Data from these
      deliveries were collected and compared to data from deliveries without anal
      sphincter tears in order to identify risk factors. A stepwise logistic regression
      model was used for the analysis. RESULTS: Independent risk factors of
      significance were vaginal nulliparity, a squatting position on a delivery chair,
      maternal age exceeding 35 years, baby's birth weight over 4000 g, vacuum
      extraction (both outlet and mid release), median episiotomy, oxytocin
      augmentation and birthing between 3 a.m. and 6 a.m. CONCLUSIONS: This study
      identified several factors associated with anal sphincter tears. Median
      episiotomy should be avoided. Delivery, while squatting on a low chair, should be
      used with caution. A woman with one or more risk factors requires caution by
      birth attendants during delivery. Gynecologists should consider the option of
      cesarean section instead of vacuum extraction, especially when mid release is
      needed in the presence of macrosomia. A continuous audit regarding instrumental
      delivery technique is necessary.

PMID- 11207489
TI  - Maternal risk factors for cause-specific stillbirth and neonatal death.
AB  - BACKGROUND: To study specific effects of four maternal risk factors: age, parity,
      educational level, smoking, for specific causes of stillbirth and neonatal death
      according to a previously described hierarchic classification. METHODS: The study
      is based on 9,785 stillbirths or neonatal deaths among infants born in Sweden,
      1983-1995 (n=1,412,754) and identified with various Swedish health registers.
      Statistical analysis is performed using Mantel-Haenszel analysis. RESULTS: Some
      risk factors, known from the literature, were confirmed and could be quantified.
      In addition, high parity was shown to increase the risk for death associated with
      multiple births (OR=2.49, 95% CI 2.07-3.01) and low educational level seems to be
      protective for such death (OR=0.75, 95% CI 0.60-0.93). If the infant is SGA, the
      risk for death is higher at high than at low parity (1.70, 95% CI 1.19-2.43, and
      1.0, 95% CI 1.06-1.15, respectively). Maternal smoking seems to aggravate the
      placental abruption because the death risk in the presence of abruption increases
      when the mother smoked (OR = 1.74, 95% CI 45-2.08). CONCLUSIONS: The study shows
      that the groups of the classification system used (NICE) differ in their
      association with known risk factors for stillbirth and neonatal deaths and an
      analysis based on specific causes of death can therefore unravel risk factors
      hidden when total mortality is used. The computerized method of classification
      and the cause-of-death classification developed by us is clearly useful for such
      analyses which requires large materials.

PMID- 11207490
TI  - A randomized, controlled trial comparing effect of oral misoprostol and
      intravenous syntocinon on intra-operative blood loss during cesarean section.
AB  - BACKGROUND: Oxytocics are routinely used in an attempt to prevent excessive blood
      loss during cesarean section. Misoprostol, a potent uterotonic agent, has been
      reported to be useful in the prevention and treatment of postpartum hemorrhage by
      several investigators but its use during cesarean section has not been described.
      The objective of this study was to randomly compare the effectiveness of oral
      misoprostol with intravenous syntocinon on blood loss during elective cesarean
      sections under regional anesthesia. METHODS: Sixty pregnant women were randomized
      either to receive misoprostol 400 micrograms orally or syntocinon 10 IU
      intravenously during cesarean section. The primary outcome measure was intra
      operative blood loss as estimated by physicians, and by values of preoperative
      and postoperative hemoglobin concentration and hematocrit. Demographic
      characteristics of the subjects and outcomes were compared using chi-square test
      for categorical and two-sample t-test for continuous data. RESULTS: Baseline
      characteristics in terms of age, body weight, parity, gestational age and
      indications for cesarean section were similar in both groups. The estimated blood
      loss was 545 ml (CI 476-614) in misoprostol group and 533 ml (CI 427-639) in
      syntocinon group (p = 0.85). Differences in preoperative and postoperative
      hemoglobin and hematocrit values were also similar in both groups. Two women in
      the misoprostol group and three in the syntocinon group (p=0.64) required
      additional oxytocics. One patient in each group required blood transfusion. No
      serious side effects were noted in either group. CONCLUSION: Oral misoprostol
      appears to be safe and as effective as intravenous syntocinon in reduction of
      intra-operative blood loss during elective cesarean section under regional
      anesthesia and merits further investigation.

PMID- 11207491
TI  - Prevalence of depressive symptoms in late pregnancy and postpartum.
AB  - BACKGROUND: Postnatal depression refers to a non-psychotic depressive episode
      that begins in or extends into the postpartum period. The aims of this study were
      to examine the prevalence of depressive symptoms in a pregnant and later
      postnatal population, to determine the natural course of these symptoms and
      whether there is an association between antenatal and postnatal depressive
      symptomatology. METHODS: A longitudinal study with a total population of 1,558
      consecutively registered pregnant women in the southeast region of Sweden.
      Presence of depressive symptoms was measured with the Edinburgh Postnatal
      Depression Scale on four occasions namely in gestational week 35-36, in the
      maternity ward, 6-8 weeks and 6 months postpartum. RESULTS: The prevalence of
      depressive symptoms during late pregnancy was 17%; in the maternity ward 18%; 6-8
      weeks postnatally 13%; and 6 months postnatally, 13%. A correlation between
      antenatal and postnatal depressive symptoms was found (r=0.50, p<0.0001).
      CONCLUSION: Detection of women at risk for developing postnatal depressive
      symptoms can be done during late pregnancy. Antenatal care clinics constitute a
      natural and useful environment for recognition of women with depressive symptoms.

PMID- 11207492
TI  - Conduct of labor and rupture of the sphincter ani.
AB  - OBJECTIVE: To determine whether the conduct of the second stage of labor and
      delivery technique influences the incidence of rupture of the anal sphincter.
      MATERIAL AND METHOD: A total of 1072 primipara delivered vaginally at term at
      Rigshospitalet in 1998. A questionnaire on prenatal risk factors, conduct of the
      second stage of labor, and delivery technique was completed by the attending
      midwife immediately after delivery in 90 cases with rupture of the sphincter and
      in two subsequent controls (n = 164), matched by use of vacuum extractor and
      episiotomy. RESULTS: Partial or total sphincter rupture was found in 8.4% of
      primipara who delivered vaginally, in 20.9% of those delivered by vacuum
      extraction, and in 6.4% of those with episiotomy only. The prenatal risk factors-
      maternal age, birth weight, shoulder dystocia, and edema of the perineum were
      found to have a statistically significant effect on the incidence of rupture of
      the sphincter ani. In non-instrumental vaginal deliveries easing of the perineum
      over the caput as it advanced helped prevent a rupture of the anal sphincter.
      Vacuum extraction performed with the woman in a semi-recumbant position was
      associated with an increased risk of rupture of the anal sphincter, whereas
      attention to the perineum during extraction decreased the risk. CONCLUSIONS: The
      significant effect of prenatal risk factors did not explain a correlation between
      delivery technique and rupture of the sphincter ani. The present study indicates
      that a reduction in the incidence of sphincter rupture may be accomplished by
      improved obstetric care: fewer vacuum extractions and improved delivery
      technique.

PMID- 11207493
TI  - Comparison of cervical smears secured with different instruments.
AB  - BACKGROUND: In this presentation we have compared the results from cytologic
      samples obtained with the cervical brush and Ayre's wooden spatula, against
      samples obtained with Acellon Combi. METHODS: One thousand cervical smears were
      collected. This was a cross-sectional study, where it was decided randomly to use
      cervical brush for sampling of the endocervix and Ayre's wooden spatula for
      exocervix or Acellon Combi for both. RESULTS: The combination of the cervical
      brush and the wooden spatula yielded an acceptable quantity of columnar cells in
      71.6% of the cases, during both endocervical and exocervical sampling, while the
      Acellon Combi yielded an acceptable quantity in 61.7% of the cases (p<0.01). The
      combination of brush/spatula yielded an acceptable quantity of squamous cells
      from samples of endocervix and exocervix in 87.5% cases, while with the Acellon
      device amounted to 77.4% (p<0.001). Highly significant differences in the state
      of cellular preservation of samples from endocervix obtained with cervical brush
      technique were found upon comparison to Acellon group. CONCLUSIONS: Henceforth,
      we believe that the use of the cervical brush and the Ayre wooden spatula
      increases the quantity and preservation of the cells retrieved during cervical
      smears compared to Acellon Combi.

PMID- 11207495
TI  - Fetal position associated with an increased risk of cesarean delivery in
      nulliparous twin gestations.

PMID- 11207494
TI  - Hysterectomy on benign indication in Denmark 1988-1998. A register based trend
      analysis.
AB  - BACKGROUND: The aims of the study were to describe the trends in Danish
      hysterectomy rates from 1988 to 1998 for operations done on benign indication.
      METHODS: Data from all women (n=67,096) undergoing hysterectomy from 1988 to 1998
      were obtained from the Danish National Patient Register. Data on the female
      population distribution were obtained from the Danish National Population
      Register. RESULTS: During the last 11 years the incidence rate of hysterectomy
      performed for benign diseases has been stable. However, the rate of women treated
      surgically for benign diseases of the uterus has increased by 14%. During the
      study period the number of total abdominal hysterectomies has decreased by 38%,
      the number of subtotal abdominal hysterectomies has increased by 458%, the number
      of vaginal hysterectomies has increased by 107% and two new methods of surgical
      treatment for benign diseases of the uterus have been introduced. Abdominal
      hysterectomy still accounts for 80% of the total number of hysterectomies
      performed in Denmark in 1998. The age distribution for all hysterectomies has
      changed, from a maximum of 36-45 years in 1988 to 46-55 years in 1998. The age
      maximum for abdominal hysterectomy corresponds to that of all hysterectomies. For
      vaginal hysterectomy the age maximum is 56 years or older, while it is 36-45
      years for laparoscopic hysterectomy. CONCLUSIONS: The incidence rate of
      hysterectomy was stable during the study period and the age distribution for all
      hysterectomies has changed. The study showed a change in the choice of surgical
      methods, although no evidence supports this practice.

PMID- 11207497
TI  - Naturally conceived twin pregnancy with hyperreactio luteinalis, causing
      hyperandrogenism and maternal virilization.

PMID- 11207496
TI  - A case of locked twins successfully treated with nitroglycerin sublingually
      before manual reposition and vaginal delivery.

PMID- 11207498
TI  - Adenocarcinoma of the Bartholin's gland in a 34 years old multipara.

PMID- 11207499
TI  - Pelvic tuberculosis: a case of delayed diagnosis.

PMID- 11207500
TI  - Pregnancy and labor after TVT-plasty.

PMID- 11207501
TI  - Reply to P. Vargas letter to the editor: Comparative evaluation of the Misgav
      Ladach cesarean section with two traditional techniques. The first four years'
      experience (published in volume 80, 1).

PMID- 11207502
TI  - Non-closure of peritoneum and adhesions: the repeat cesarean section.

PMID- 11207503
TI  - Review article: Barrett's oesophagus, dysplasia and pharmacologic acid
      suppression.
AB  - Barrett's oesophagus, a significant complication of gastro-oesophageal reflux
      disease (GERD), is the single most important risk factor for oesophageal
      adenocarcinoma. The strong association between Barrett's oesophagus and chronic
      GERD suggests that abnormal oesophageal acid exposure plays an important role in
      this condition. The progression of Barrett's oesophagus from specialized
      intestinal metaplasia to dysplasia and finally invasive carcinoma is incompletely
      understood, but increased and disordered proliferation is a key cellular event.
      In ex vivo organ culture experiments, cell proliferation is increased after
      exposure to short pulses of acid, whilst proliferation is reduced in Barrett's
      oesophagus specimens taken from patients with oesophageal acid exposure
      normalized by antisecretory therapy. In long-term clinical studies, consistent
      and profound intra-oesophageal acid suppression with proton pump inhibitors
      decreases cell proliferation and increases differentiation in Barrett's
      oesophagus, but the clinical importance of such favourable effects on these
      surrogate markers is not clear. In clinical practice, proton pump inhibitors
      relieve symptoms and induce partial regression to squamous epithelium, but
      abnormal oesophageal acid exposure and the risk for dysplasia or adenocarcinoma
      persist in many patients. The ability of proton pump inhibitors to suppress acid
      profoundly and consistently may be critical in the long-term management of
      Barrett's oesophagus.

PMID- 11207504
TI  - Review article: tegaserod.
AB  - Tegaserod (Zelmac), an aminoguanidine indole derivative of serotonin, is a
      selective partial agonist highly selective for 5-HT(4) receptor with an affinity
      constant in the nanomolar range. Tegaserod does not cause adverse pharmacodynamic
      effects, is absorbed rapidly after oral administration and distributes widely
      into tissues. Pharmacokinetics of oral tegaserod are linear in the 2--12 mg dose
      range. After oral administration tegaserod is metabolized mainly pre
      systemically; when absorbed, intact tegaserod is excreted as N-glucuronides
      mainly via the bile. No clinically relevant drug--drug interactions were
      identified. Tegaserod has proven safe in toxicity studies. In pharmacodynamic
      studies, tegaserod stimulated the peristaltic reflex in vitro, increased canine
      intestinal and colonic motility and transit, reduced visceral afferent firing or
      sensation in response to distension in animals, and accelerated gastric, small
      bowel and colonic transit in healthy patients, and small bowel transit in
      patients with constipation-predominant irritable bowel syndrome. Three large
      phase III randomized, double-blinded, and placebo-controlled trials were
      performed predominantly in females (approximately 85%) with constipation
      predominant irritable bowel syndrome. Overall, phase III results support efficacy
      as assessed by the subject's global assessment of relief with significant
      improvement in secondary endpoints such as abdominal pain, bowel frequency and
      consistency. Tegaserod was well-tolerated; the most frequent adverse event was
      transient diarrhoea.

PMID- 11207505
TI  - Review article: a drug therapy for the prevention of variceal haemorrhage.
AB  - The development of varices is a major complication of cirrhosis, and variceal
      haemorrhage has a high mortality. There have been major advances in the primary
      and secondary prevention of variceal haemorrhage over the last 20 years involving
      endoscopic, radiological and pharmacological approaches. This review concentrates
      principally on drug therapy, particularly on the numerous haemodynamic studies.
      Many of these drugs have not been studied in clinical trials, but provide data
      about the underlying pathogenesis of portal hypertension. Also covered in this
      review are the randomized controlled trials and meta-analyses that involve a
      large number of patients. These trials involve relatively few drugs such as non
      selective beta-blockers and nitrates. Correlations between haemodynamic and
      clinical parameters are discussed. Despite the recent increase in the use of
      alternative endoscopic therapies, an effective and well tolerated drug remains a
      clinically important research goal.

PMID- 11207506
TI  - Review article: the potential role for photodynamic therapy in the management of
      upper gastrointestinal disease.
AB  - Photodynamic therapy involves the activation of an exogenously administered, or
      an endogenously generated, photosensitizer with light to produce localized tissue
      destruction. It is an attractive, predominantly endoscopic technique for the
      palliation of advanced upper gastrointestinal cancer and the eradication of early
      neoplastic and pre-neoplastic lesions. The nature of the biological response
      allowing safe healing and the exploitation of tissue threshold effects mean that
      adjacent tissue damage can be minimized. This review used a database of 368
      papers. The nature of the photosensitizer is critical to the depth of tissue
      damage and the risk of adjacent tissue damage and stricture formation. The
      generation of protoporphyrin IX following administration of 5-aminolaevulinic
      acid has proved useful for the treatment of high-grade dysplasia in Barrett's
      oesophagus. A double-blind randomized placebo controlled trial has confirmed that
      it is a safe and effective method for the ablation of low-grade dysplasia. The
      treatment of more advanced lesions requires exogenously administered photo
      sensitizers. However, recent data indicate that the neoplastic potential remains
      in some patients and continued follow-up is necessary. Photodynamic therapy can
      be used to eradicate early neoplasia and palliate advanced cancer, but caution is
      required before a definitive cure can be claimed.

PMID- 11207507
TI  - Review article: the prevention of colorectal cancer.
AB  - Colorectal cancer is a leading cause of cancer mortality in the industrialized
      world. Survival remains poor because most cases are diagnosed at an advanced
      stage. It is a preventable disease as colorectal cancers usually develop slowly
      from an identifiable precursor lesion, the adenoma. The existing strategies for
      colorectal cancer prevention include dietary prevention, chemoprevention and
      endoscopic intervention. The exact relationship between diet, particularly fibre,
      and colorectal cancer remains unclear, with the most recent studies suggesting
      that dietary fibre may not decrease colorectal cancer risk as previously thought.
      Non-steroidal anti-inflammatory drugs have been shown to have a protective effect
      against colorectal cancer, but the adverse effect profile of the non COX-2
      selective drugs, particularly the risk of gastrointestinal haemorrhage, precludes
      their widespread use. There is increasing evidence that colorectal cancer
      incidence and mortality can be decreased from endoscopic polypectomy and early
      detection of cancer. Faecal occult blood testing in the general population
      ('average-risk') has been shown in randomized trials to decrease mortality from
      colorectal cancer by 15--33%. Long-term results of randomized trials of the
      effectiveness of flexible sigmoidoscopy and colonoscopy screening in the general
      population are awaited. Targeting high risk individuals may also be an effective
      and efficient way to decrease the colorectal cancer burden. As many as 15--30% of
      colorectal cases may be due to hereditary factors. Individuals with one or two
      direct relatives affected are at moderate risk for colorectal cancer (empirical
      lifetime mortality from colorectal cancer approximately 10%) and approximately 2-
      3% of cases arise in individuals harbouring highly penetrant autosomal dominant
      mutations, which puts them at high-risk for colorectal cancer. Surveillance
      colonoscopy is offered to individuals at moderate and high risk for colorectal
      cancer.

PMID- 11207508
TI  - Review article: Mycobacterium avium subsp. paratuberculosis as one cause of
      Crohn's disease.
AB  - A number of theories regarding the aetiology of Crohn's disease have been
      proposed. Diet, infections, other unidentified environmental factors and immune
      disregulation, all working under the influence of a genetic predisposition, have
      been viewed with suspicion. Many now believe that Crohn's disease is a syndrome
      caused by several aetiologies. The two leading theories are the infectious and
      autoimmune theories. The leading infectious candidate is Mycobacterium avium
      subspecies paratuberculosis (Mycobacterium paratuberculosis), the causative agent
      of Johne's disease, an inflammatory bowel disease in a variety of mammals
      including cattle, sheep, deer, bison, monkeys and chimpanzees. The evidence to
      support M. paratuberculosis infection as a cause of Crohn's disease is mounting
      rapidly. Technical advances have allowed the identification and/or isolation of
      M. paratuberculosis from a significantly higher proportion of Crohn's disease
      tissues than from controls. These methodologies include: (i) improved culture
      techniques; (ii) development of M. paratuberculosis-specific polymerase chain
      reaction assays; (iii) development of a novel in situ hybridization method; (iv)
      efficacy of macrolide and anti-mycobacterial drug therapies; and (v) discovery of
      Crohn's disease-specific seroreactivity against two specific M. paratuberculosis
      recombinant antigens. The causal role for M. paratuberculosis in Crohn's disease
      and correlation of infection with specific stratification(s) of the disorder need
      to be investigated. The data implicating Crohn's as an autoimmune disorder may be
      viewed in a manner that supports the mycobacterial theory. The mycobacterial
      theory and the autoimmune theory are complementary; the first deals with the
      aetiology of the disorder, the second deals with its pathogenesis. Combined
      therapies directed against a mycobacterial aetiology and inflammation may be the
      optimal treatment of the disease.

PMID- 11207510
TI  - Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel
      syndrome.
AB  - AIM: To update previous overviews of placebo-controlled double-blind trials
      assessing the efficacy and tolerance of smooth muscle relaxants in irritable
      bowel syndrome. METHODS AND TRIALS: A total of 23 randomized clinical trials were
      selected for meta-analyses of their efficacy and tolerance. Six drugs were
      analysed: cimetropium bromide (five trials), hyoscine butyl bromide (three
      trials), mebeverine (five trials), otilium bromide (four trials), pinaverium
      bromide (two trials) and trimebutine (four trials). The total number of patients
      included was 1888, of which 945 received an active drug and 943 a placebo.
      RESULTS: The mean percentage of patients with global improvement was 38% in the
      placebo group (n=925) and 56% in the myorelaxant group (n=927), in favour of
      myorelaxants with a mean odds ratio of 2.13, P < 0.001 (95% CI: 1.77--2.58) and a
      mean risk difference of 22% P < 0.001 (95% CI: 13--32%). The percentage of
      patients with pain improvement was 41% in the placebo group (n=568) and 53% in
      the myorelaxant group (n=567): odds ratio 1.65, P < 0.001 (95% CI: 1.30--2.10)
      and risk difference 18%, P < 0.001 (95% CI: 7--28%). There was no significant
      difference for adverse events. CONCLUSION: Myorelaxants are superior to placebo
      in the management of irritable bowel syndrome.

PMID- 11207509
TI  - Esomeprazole 20 mg maintains symptom control in endoscopy-negative gastro
      oesophageal reflux disease: a controlled trial of 'on-demand' therapy for 6
      months.
AB  - BACKGROUND: Most patients with gastro-oesophageal reflux disease (GERD),
      regardless of endoscopic status, suffer symptomatic relapse within 6 months of
      stopping acid suppressant therapy. AIM: To assess the efficacy of 'on-demand'
      treatment of GERD with esomeprazole, the first proton pump inhibitor developed as
      an optical isomer. METHODS: In this multicentre, double-blind study, 342
      endoscopy-negative GERD patients demonstrating complete resolution of heartburn
      during the final week of a 4-week treatment period with esomeprazole 20 mg or
      omeprazole 20 mg once daily were randomized to receive esomeprazole 20 mg or
      placebo on demand (maximum of one dose per day) for a further 6 months. Use of
      rescue antacids was permitted. RESULTS: All 342 patients (191 males), aged 19-79
      (mean 49) years, were evaluable in the intention-to-treat analysis. The
      proportion of patients who discontinued treatment due to insufficient control of
      heartburn was significantly higher among placebo compared to esomeprazole
      recipients (51% vs. 14%; P < 0.0001). Patients randomized to esomeprazole on
      demand therapy remained in the study longer than those in the placebo group (mean
      165 vs. 119 days). Over 50% took the study medication for periods of 1--3
      consecutive days (esomeprazole) or 4--13 consecutive days (placebo). Use of
      antacids was > 2-fold higher among placebo recipients. The frequency of adverse
      events was similar in the two groups, when adjusted for time spent in the study,
      as were the clinical laboratory profiles. CONCLUSIONS: On-demand therapy with
      esomeprazole 20 mg is effective and well tolerated in maintaining symptom control
      in endoscopy-negative GERD.

PMID- 11207511
TI  - Minimal renal dysfunction in inflammatory bowel disease is related to disease
      activity but not to 5-ASA use.
AB  - BACKGROUND: Conflicting data exist about proteinuria in inflammatory bowel
      diseases. It is still unclear whether the occurrence of proteinuria in
      inflammatory bowel disease patients is an extra-intestinal manifestation of
      disease or the result of adverse effects to medication, especially to
      aminosalicylates (ASA). METHODS: A total of 95 patients (51 with Crohn's disease
      and 44 with ulcerative colitis) were enrolled in the study. Disease activity was
      assessed by Crohn's Disease Activity Index (CDAI) or the Truelove index,
      respectively. Urine was collected over 24 h and protein excretion of specific
      marker proteins for tubular (alpha 1-microglobulin-alpha 1-MG) and glomerular
      (albumin-Alb, Immunoglobulin G-IgG) dysfunction was measured using a highly
      sensitive immunoluminometric assay. RESULTS: Out of 51 Crohn's disease patients,
      20 showed elevated urinary alpha 1-MG. The amount of alpha 1-MGuria was strongly
      correlated to the CDAI (r=0.6, P < 0.001). Only four Crohn's disease patients
      showed slightly elevated values for glomerular proteins in urine. Similar results
      were obtained for ulcerative colitis: whereas only two ulcerative colitis
      patients showed albuminuria, tubular proteinuria was detected in 28 out of 44
      ulcerative colitis patients. Proteinuria was strongly dependent on disease
      activity (P < 0.01) but was not related to ASA treatment. CONCLUSIONS:
      Proteinuria of tubular marker proteins occurs in the majority of inflammatory
      bowel disease patients and is related to disease activity rather than to ASA
      treatment. Tubular proteinuria seems to reflect a renal extra-intestinal
      manifestation of inflammatory bowel disease and may serve as a new relevant
      marker of disease activity.

PMID- 11207512
TI  - Oral tacrolimus long-term therapy in patients with Crohn's disease and steroid
      resistance.
AB  - AIM: To report the results of a prospective, open-label, uncontrolled study in 13
      patients affected by Crohn's disease with resistance to steroids. METHODS: The
      patients were treated long-term with oral tacrolimus, aiming to both resolve
      acute attacks and maintain remission. Tacrolimus was administered at the dose of
      0.1--0.2 mg.day/kg and adjusted in order to achieve levels of 5--10 ng/mL; only
      mesalazine was continued concomitantly. Steroids and total parenteral nutrition
      were tapered when appropriate. RESULTS: Median treatment was 27.3 months. Only
      one patient dropped out due to adverse events. Crohn's disease activity index
      score significantly decreased after 6 months in 11 patients; for 1 year in nine
      of them, and 7 years in two of them. The inflammatory bowel disease life-quality
      questionnaire score significantly increased over the same periods. A marked drop
      in hospitalizations was recorded. In three out of six patients complete closure
      of fistulas occurred. Tacrolimus allowed total parenteral nutrition to be
      withdrawn in three out of five patients. Supplementation with low-dose steroids
      was required in five patients. Two patients underwent surgery. CONCLUSIONS:
      Tacrolimus therapy appears to be associated with both short- and long-term
      benefits, and may represent a therapeutic option in Crohn's disease when
      conventional therapies fail. This study encourages its use in controlled trials.

PMID- 11207513
TI  - Non-Helicobacter pylori bacterial flora during acid-suppressive therapy:
      differential findings in gastric juice and gastric mucosa.
AB  - BACKGROUND: Intragastric growth of non-Helicobacter pylori bacteria commonly
      occurs during acid-suppressive therapy. The long-term clinical consequences are
      still unclear. AIM: To investigate the luminal and mucosal bacterial growth
      during gastric acid inhibition, in relation to the type and duration of acid
      inhibitory treatment, as well as to concomitant H. pylori infection. METHODS: A
      total of 145 patients on continuous acid inhibition with either proton pump
      inhibitors (n=109) or histamine2-receptor antagonists (H(2)RAs, n=36) for gastro
      oesophageal reflux disease, and 75 dyspeptic patients without acid inhibition
      (control group) were included. At endoscopy, fasting gastric juice was obtained
      for pH measurement and bacteriological culture. Gastric biopsy specimens were
      examined for detection of H. pylori (immunohistochemistry) and of non-H. pylori
      bacteria (modified Giemsa stain-positive and immunohistochemistry-negative at the
      same location). RESULTS: Non-H. pylori flora was detected in the gastric juice of
      92 (41.8%) patients and in the gastric mucosa of 109 (49.6%) patients. In gastric
      juice, prevalence rate for non-H. pylori bacteria was higher in patients taking
      proton pump inhibitors than controls and those taking H(2)RAs (58.7% vs. 22.6%
      and vs. 30.6%, P < 0.0001 and P < 0.003, respectively), but did not differ
      statistically between H(2)RAs and controls. In gastric mucosa, prevalence rates
      for non-H. pylori bacteria were higher in patients taking proton pump inhibitors
      and H(2)RAs than in the controls (antrum: 46.9% and 48.6% vs. 25%, P < 0.05 for
      both; corpus: 52.2% and 56.8% vs. 23.7%, P < 0.001 for both), but did not differ
      between proton pump inhibitors and H(2)RAs. Both luminal and mucosal growth of
      non-H. pylori bacteria were significantly greater in H. pylori-positive than 
      negative patients taking proton pump inhibitors (P < 0.05 for both). Luminal
      growth of non-H. pylori flora increased with the intragastric pH level, whilst
      mucosal bacterial growth increased with the duration of acid inhibition.
      CONCLUSIONS: Non-H. pylori flora not only contaminates the gastric juice but also
      colonizes the gastric mucosa of a large proportion of patients treated long-term
      with acid inhibition. The relationship between H. pylori and non-H. pylori
      bacteria in the pathogenesis of atrophic gastritis and gastric cancer needs
      further elucidation.

PMID- 11207514
TI  - Evaluation of a novel continuous real time (13)C urea breath analyser for
      Helicobacter pylori.
AB  - AIM: To evaluate the sensitivity and specificity of a new (13)C urea breath test,
      Oridion BreathID, for the diagnosis of Helicobacter pylori. METHODS: A total of
      97 consecutive symptomatic patients referred for upper endoscopy were included in
      the 'pre-therapy' part of the study. After endoscopy the patients were analysed
      for H. pylori by Oridion BreathID. BreathID continuously sampled the subject's
      breath for 20 min, and displayed the results on the BreathID screen in real time.
      Results of the BreathID were compared with the 'gold standard' (rapid urease test
      and histology). We also prospectively tested the validity of BreathID in
      comparison to isotope ratio mass spectrometry, in 40 patients referred to monitor
      the efficacy of H. pylori eradication treatment. RESULTS: Complete agreement was
      observed between the 'gold standard' and the Breath ID test in 96.9% (94 out of
      97) of the patients. The sensitivity and specificity of BreathID were 97.8% and
      96.1%, respectively. The correlation between BreathID and isotope ratio mass
      spectrometry breath test was 100%. CONCLUSIONS: The Oridion BreathID has
      comparable sensitivity and specificity to the claims of the currently available
      urea breath tests. Furthermore, BreathID has the potential advantages of ease of
      use with minimal medical staff requirement, and real time rapid results (20 min
      maximum) which may make the BreathID preferable to other urea breath test assays.

PMID- 11207515
TI  - Post-treatment diagnostic accuracy of a new enzyme immunoassay to detect
      Helicobacter pylori in stools.
AB  - BACKGROUND: Helicobacter pylori has attracted increasing attention among
      gastroenterologists because of its pathogenic potential, stimulating the search
      for non-invasive diagnostic tests. AIMS: In this study the efficacy of a new
      enzyme immunoassay designed to detect H. pylori antigens in stools (HpSA) was
      evaluated before and after eradication therapy. METHODS: HpSA was performed on
      stool samples collected from 268 patients whose H. pylori status was defined on
      the basis of concordant results for the (13)C-urea breath test, rapid urease test
      and histology. The H. pylori-positive patients were treated with a 1-week triple
      therapy to eradicate the infection. One (T30) and 3 months (T90) after the end of
      therapy, (13)C-urea breath test and HpSA were repeated in the treated patients.
      RESULTS: The overall diagnostic accuracy of HpSA at T30 (83%, 95% confidence
      interval (CI) 77--89%) was significantly lower in comparison to the values
      obtained at baseline (94%, 95% CI: 91--97%) and at T90 (97%, 95% CI: 94--99%). No
      significant difference was found between the diagnostic accuracy of HpSA at
      baseline and at T90 (P=0.253). CONCLUSIONS: The present data suggest that HpSA
      provides a low diagnostic accuracy when used shortly after treatment. It needs a
      longer period of follow-up (8--12 weeks) to reach a reliability comparable to the
      (13)C-urea breath test.

PMID- 11207516
TI  - One-week ranitidine bismuth citrate-based triple therapy for the eradication of
      Helicobacter pylori in Hong Kong with high prevalence of metronidazole
      resistance.
AB  - AIM: To compare 1-week ranitidine bismuth citrate-based (RBC) triple therapy vs.
      omeprazole-based (O) triple therapy for the eradication of Helicobacter pylori
      infection in Hong Kong with high prevalence of metronidazole resistance. METHODS:
      Patients with non-ulcer dyspepsia and H. pylori infection were randomized to
      receive either: (i) RBCCM: ranitidine bismuth citrate (pylorid) 400 mg,
      clarithromycin 250 mg and metronidazole 400 mg; or (ii) OCM: omeprazole 20 mg,
      clarithromycin 250 mg and metronidazole 400 mg, each given twice daily for 1
      week. Endoscopy (CLO test, histology and culture) and 13C-urea breath test were
      performed before randomization and 6 weeks after drug treatment. RESULTS: A total
      of 180 patients were randomized. H. pylori eradication rates (intention-to-treat,
      n=180/per protocol, n=166) were 83%/92% for RBCCM and 66%/70% for OCM (P=0.01,
      intention-to-treat and P=0.001, per protocol, respectively). RBCCM treatment was
      unaffected by metronidazole susceptibility and achieved a significantly higher
      eradication rate in metronidazole-resistant cases (89%) than the OCM group (45%,
      P=0.0064). CONCLUSION: One-week ranitidine bismuth citrate-based triple therapy
      is significantly better than omeprazole-based triple therapy for the eradication
      of H. pylori infection, especially in metronidazole-resistant cases. It is an
      effective regimen for the eradication of H. pylori infection in regions with a
      high prevalence of metronidazole resistance.

PMID- 11207517
TI  - Clarithromycin vs. furazolidone in quadruple therapy regimens for the treatment
      of Helicobacter pylori in a population with a high metronidazole resistance rate.
AB  - BACKGROUND: The eradication of Helicobacter pylori plays a pivotal role in the
      treatment of peptic ulcer disease. Metronidazole resistance, common in Iran, is
      claimed to be a major reason for the failure of metronidazole-containing
      regimens. Both clarithromycin and furazolidone are potential alternatives for
      metronidazole. AIM: To assess and compare the effectiveness of clarithromycin-
      and furazolidone-based regimens in eradicating H. pylori in a population with a
      high metronidazole resistance rate. METHODS: Patients with proven duodenal ulcer
      and H. pylori infection were randomly assigned to one of two groups. The patients
      received 2 weeks of omeprazole 20 mg b.d., amoxicillin 1000 mg b.d, bismuth
      subcitrate 240 mg b.d. and either clarithromycin 500 mg b.d. (the OABC group) or
      furazolidone 200 mg b.d. (the OABF group). RESULTS: A total of 118 patients were
      randomized, 55 in the OABC group and 63 in the OABF group. The intention-to-treat
      eradication rate was 84% and 85% for the OABF and OABC groups, respectively. The
      per protocol eradication rates were 90% for both groups. CONCLUSIONS: OABC and
      OABF are both effective in eradicating H. pylori in areas where metronidazole
      resistance is a problem. OABF is a good alternative in the face of growing
      resistance to clarithromycin in developed countries, and is attractive for
      developing countries where clarithromycin is not readily available.

PMID- 11207518
TI  - Five-day proton pump inhibitor-based quadruple therapy regimen is more effective
      than 7-day triple therapy regimen for Helicobacter pylori infection.
AB  - BACKGROUND: There have been no reports that describe whether 5-day quadruple
      therapy (rabeprazole + amoxicillin + clarithromycin + metronidazole; RACM) could
      substitute for standard 7-day triple therapy as a first-line therapy for
      Helicobacter pylori. PATIENTS AND METHODS: This study was designed as a
      randomized prospective single centre study. A total of 160 H. pylori-positive
      patients who had not received therapy were given either a 5-day RACM regimen
      (n=80, rabeprazole 20 mg b.d., amoxicillin 750 mg b.d., clarithromycin 200 mg
      b.d. and metronidazole 250 mg b.d.) or a 7-day RAC regimen (n=80, rabeprazole 20
      mg b.d., amoxicillin 750 mg b.d. and clarithromycin 200 mg b.d.). Cure of the
      infection was assessed by a (13)C urea breath test 1 month after the completion
      of therapy. RESULTS: The eradication rates of the 5-day RACM regimen and the 7
      day RAC regimen were 93% (95% CI: 84--97%) and 81% (95% CI: 71--89%) by intention
      to-treat analysis, 94% (95% CI: 86--98%) and 83% (95% CI: 73--91%) by all
      patients-treated analysis analysis and 95% (95% CI: 87--98%; P < 0.05) and 82%
      (95% CI: 72--90%) by per protocol analysis, respectively. No serious adverse
      effect was observed, and 99% of the patients reported complete compliance.
      CONCLUSIONS: The cure rate of the 5-day RACM regimen was more effective than the
      7-day RAC regimen, suggesting that this regimen could be preferable as a first
      line therapy for H. pylori infection.

PMID- 11207535
TI  - Cellular microbiology - a research agenda and an emerging discipline.

PMID- 11207519
TI  - Validation of a new immunoblot assay for the diagnosis of Helicobacter pylori in
      the Asian population.
AB  - BACKGROUND: Performance of commercial serological tests for Helicobacter pylori
      varies in different populations, largely due to strain heterogeneity and
      variations in antigenic preparations. Currently available serology tests often
      show sub-optimal accuracy when used for Asian patients. AIM: This study evaluated
      a recombinant antigen-based immunoblot for the diagnosis of H. pylori infection
      in Chinese patients, and compared it with a conventional ELISA test. METHODS:
      Dyspeptic patients referred for diagnostic endoscopy were recruited. The gold
      standard for H. pylori infection was based on two or more positive results among
      rapid urease test, histology and (13)C-urea breath test. Serological diagnosis of
      H. pylori infection was conducted by an ELISA test (pylori DTect; Diagnostic
      Technology) and an immunoblotting against a novel recombinant antigen (C1S;
      Genelab), which was constructed by immunological screening of the genomic DNA
      library of H. pylori. RESULTS: A total of 87 patients were evaluated and H.
      pylori infection was diagnosed in 40 (46%) by the reference tests. The
      sensitivities of the ELISA and immunoblot were 80% (95% CI: 64--91%) and 90% (95%
      CI: 76--97%), whilst the specificities were 96% (95% CI: 86--96%) and 87% (95%
      CI: 74--95%), respectively. The respective likelihood ratios of the two tests
      were 18.6 and 7.0. CONCLUSIONS: Satisfactory performance is obtained by the use
      of the new recombinant antigen-based immunoblot for diagnosing H. pylori
      infection in Chinese patients.

PMID- 11207536
TI  - Cellular Microbiology is launched.

PMID- 11207537
TI  - Identification of the intimin-binding domain of Tir of enteropathogenic
      Escherichia coli.
AB  - Enteropathogenic Escherichia coli (EPEC) attaches intimately to mammalian cells
      via a bacterial outer membrane adhesion molecule, intimin, and its receptor in
      the host cell membrane, Tir. Tir is a bacterial protein translocated into the
      host cell membrane and tyrosine phosphorylated after insertion. Tir-intimin
      binding induces organized actin polymerization beneath the adherent bacteria,
      resulting in the formation of pedestal-like structures. A series of Tir deletion
      derivatives were constructed to analyse which Tir domains are involved in intimin
      binding. We have localized the intimin-binding domain (IBD) of Tir using a yeast
      two-hybrid system and a gel-overlay approach to a region of 109 amino acids that
      is predicted to be exposed on the surface of the plasma membrane. A truncated Tir
      protein lacking this domain was translocated to the host cell membrane and
      tyrosine phosphorylated, but failed to bind intimin or to induce either actin
      polymerization or Tir accumulation beneath the bacteria. These results indicate
      that only a small region of Tir is needed to bind intimin and support the
      predicted topology for Tir, with both N- and C-terminal regions in the mammalian
      cell cytosol. They also confirm that Tir-intimin interactions are needed for
      cytoskeletal organization. We have also identified N-terminal regions involved in
      Tir stability and Tir secretion to the media.

PMID- 11207538
TI  - Impaired recruitment of the small GTPase rab7 correlates with the inhibition of
      phagosome maturation by Leishmania donovani promastigotes.
AB  - We have shown recently that one of the survival strategies used by Leishmania
      donovani promastigotes during the establishment of infection in macrophages
      consists in inhibiting phagosome-endosome fusion. This inhibition requires the
      expression of lipophosphoglycan (LPG), the predominant surface glycoconjugate of
      promastigotes, as parasites expressing truncated forms of LPG reside in
      phagosomes that fuse extensively with endocytic organelles. In the present study,
      we developed a single-organelle fluorescence analysis approach to study and
      analyse the intracellular trafficking of 'fusogenic' and 'low-fusogenic'
      phagosomes induced by an LPG repeating unit-defective mutant (Ipg2 KO) or by wild
      type L. donovani promastigotes respectively. The results obtained indicate that
      phagosomes containing mutant parasites fuse extensively with endocytic organelles
      and transform into phagolysosomes by losing the early endosome markers EEA1 and
      transferrin receptor, and acquiring the late endocytic and lysosomal markers rab7
      and LAMP1. In contrast, a majority of 'low-fusogenic' phagosomes containing wild
      type L. donovani promastigotes do not acquire rab7, wheres they acquire LAMP1
      with slower kinetics. These results suggest that L. donovani parasites use LPG to
      restrict phagosome-endosome fusion at the onset of infection in order to prevent
      phagosome maturation. This is likely to permit the transformation of hydrolase
      sensitive promastigotes into hydrolase-resistant amastigotes within a hospitable
      vacuole not displaying the harsh environment of phagolysosomes.

PMID- 11207539
TI  - Biogenesis of Salmonella typhimurium-containing vacuoles in epithelial cells
      involves interactions with the early endocytic pathway.
AB  - In epithelial cells, the intracellular pathogen Salmonella typhimurium resides
      and replicates within a unique cytoplasmic organelle, the Salmonella-containing
      vacuole (SCV). In vitro studies have shown that the SCV is a dynamic organelle
      that selectively acquires lysosomal glycoproteins (Igps) without fusing directly
      with lyosomes. Here, we have investigated early events in SCV biogenesis using
      immunofluorescence microscopy and epitope-specific flow cytometry. We show that
      proteins specific to the early endocytic pathway, EEA1 and transferrin receptor
      (TR), are present on early SCVs. The association of these proteins with SCVs is
      transient, and both proteins are undetectable at later time points when Igp and
      vATPase are acquired. Analysis of the fraction of SCVs containing both TR and
      lamp-1 showed that TR is lost from SCVs as the Igp is acquired, and that these
      processes occur progressively and not as the result of a single fusion/fission
      event. These experiments reveal a novel mechanism of SCV biogenesis, involving
      previously undetected initial interactions with the early endocytic pathway
      followed by the sequential delivery of Igp. The pathway does not involve
      interactions with the late endosome/prelysosome and is distinct from traditional
      phagocytic and endocytic pathways. Our study indicates that intracellular S.
      typhimurium occupies a unique niche, branching away from the traditional
      endocytic pathway between the early and late endosomal compartments.

PMID- 11207540
TI  - Signalling and cellular specificity of airway nitric oxide production in
      pertussis.
AB  - Bordetella pertussis, the aetiological agent of whooping cough (pertussis),
      causes selective destruction of ciliated cells of the human airway mucosa. In a
      hamster tracheal organ culture model, B. pertussis causes identical cytopathology
      as does tracheal cytotoxin (TCT), a glycopeptide released by the bacterium. The
      damage caused by B. pertussis or TCT has been shown to be mediated via nitric
      oxide (NO*). Using immunofluorescence detection of the cytokine-inducible NO
      synthase (iNOS; NOS type II), we determined that B. pertussis induced epithelial
      NO* production exclusively within non-ciliated cells. This epithelial iNOS
      activation could be reproduced by the combination of TCT and endotoxin. However,
      neither TCT alone nor endotoxin alone was capable of inducing epithelial iNOS.
      This result mirrors the synergistic activity of TCT and endotoxin exhibited in
      monolayer cultures of tracheal epithelial cells. Therefore, TCT and endotoxin are
      both important virulence factors of B. pertussis, combining synergistically to
      cause the specific epithelial pathology of pertussis.

PMID- 11207541
TI  - CpG-DNA upregulates the major acute-phase proteins SAA and SAP.
AB  - The acute-phase response is an immediate reaction of the host against invading
      microorganisms. We show here that oligodeoxynucleotides (ODNs) containing a CpG
      motif rapidly induce the major murine acute-phase proteins in vivo, i.e. serum
      amyloid A (SAA) and serum amyloid P (SAP). Serum levels of these proteins are
      elevated within 12 h and peak at 24 h after the injection of CpG-ODN or
      endotoxin. Liver cells produce the proteins with the same kinetics. Injection of
      interleukin 6 (IL-6), IL-1beta and tumour necrosis factor alpha (TNF-alpha)
      induces SAA and SAP in vivo, but the CpG-ODN-mediated induction does not depend
      on the presence of the TNF receptor p55, as the acute-phase response in TNF
      receptor p55-deficient mice does not differ from that of wild-type mice. Aside
      from CpG-ODN, bacterial genomic DNA also induces the acute-phase response in LPS
      resistant C3H/Hej mice. The induction of the major acute-phase proteins SAA and
      SAP is blocked by the simultaneous injection of CpG-ODN together with D
      galactosamine (D-GalN). As D-GalN sensitizes the host for the toxic effects of
      TNF-alpha, a possible mechanism could be the prevention of synthesis of the major
      acute-phase proteins SAA and SAP.

PMID- 11207542
TI  - Channels formed by subnanomolar concentrations of the toxin aerolysin trigger
      apoptosis of T lymphomas.
AB  - Aerolysin is a channel-forming toxin that binds to glycosylphosphatidylinositol
      (GPI)-anchored proteins, such as Thy-1, on target cells. Here, we show that
      subnanomolar concentrations of aerolysin trigger apoptosis of T lymphomas. Using
      inactive aerolysin variants, we determined that apoptosis was not directly
      triggered by binding to GPI-anchored receptors, nor was it caused by receptor
      clustering induced by toxin oligomerization. Apoptosis was caused by the
      production of a small number of channels in the cell membrane. Channel formation
      resulted in a rapid increase in intracellular calcium, which may have been the
      signal for apoptosis. Overexpression of the antiapoptotic protein bcl-2 blocked
      aerolysin-induced apoptosis, although this effect was overcome at higher toxin
      concentrations.

PMID- 11207543
TI  - Toxin entry: how bacterial proteins get into mammalian cells.
AB  - Certain bacteria secrete protein toxins that catalytically modify and disrupt
      essential processes in mammalian cells, often leading to cell death. As the
      substrates modified by these toxins are located in the mammalian cell cytosol, a
      catalytically active toxin polypeptide must reach this compartment in order to
      act. The toxins bind to receptors on the surface of susceptible cells and enter
      them by endocytic uptake. Endocytosed toxins initially accumulate in endosomes,
      where some of these proteins take advantage of the acidic environment within
      these organelles to form, or contribute to the formation of, protein-conducting
      channels through which the catalytic polypeptide is able to translocate into the
      cytosol. Other toxins are unable to respond to low pH in this way and must
      undergo intracellular vesicular transport to reach a compartment where pre
      existing protein-conducting channels occur and can be exploited for membrane
      translocation--the endoplasmic reticulum. In this way, cell entry by this second
      group of toxins demonstrates that the secretory pathway of mammalian cells is
      completely reversible.

PMID- 11207544
TI  - Molecular response of gastric epithelial cells to Helicobacter pylori-induced
      cell damage.
AB  - Infection with the Gram-negative bacterium Helicobacter pylori leads to different
      clinical and pathological outcomes in humans, including chronic gastritis, peptic
      ulcer disease and adenocarcinoma of the stomach. H. pylori-induced damage to
      gastric mucosal cells is controlled by bacterial virulence factors encoded by
      genes of the cag pathogenicity island, which trigger the inflammatory response of
      the host through the activation of nuclear factor kappaB-dependent gene
      transcription. Also, H. pylori infection impairs the processes of gastric mucosal
      healing through inhibition of epidermal growth factor receptor-dependent signal
      transduction pathways and induction of apoptosis. H. pylori infection may
      influence the progression from chronic gastritis to gastric adenocarcinoma by
      stimulating cell proliferation and growth factor expression, inhibiting apoptosis
      and increasing the DNA mutation rate of infected gastric mucosa.

PMID- 11207545
TI  - Fibronectin-binding protein acts as Staphylococcus aureus invasin via fibronectin
      bridging to integrin alpha5beta1.
AB  - The ability of Staphylococcus aureus to invade mammalian cells may explain its
      capacity to colonize mucosa and to persist in tissues after bacteraemia. To date,
      the underlying molecular mechanisms of cellular invasion by S. aureus are
      unknown, despite its high prevalence and difficulties in treatment. Here, we show
      cellular invasion as a novel function for an S. aureus adhesin, previously
      implicated solely in attachment. S. aureus, but not S. epidermidis, invaded
      epithelial 293 cells in a temperature- and F-actin-dependent manner. Formaldehyde
      fixed and live bacteria were equally invasive, suggesting that no active
      bacterial process was involved. All clinical S. aureus isolates analysed, but
      only a subset of laboratory strains, were invasive. Fibronectin-binding proteins
      (FnBPs) acted as S. aureus invasins, because: (i) FnBP deletion mutants of
      invasive laboratory strains lost invasiveness; (ii) expression of FnBPs in
      noninvasive strains conferred invasiveness; and (iii) the soluble isolated
      fibronectin-binding domain of FnBP (D1-D4) completely blocked invasion. Integrin
      alpha5beta1 served as host cell receptor, which interacted with staphylococcal
      FnBPs through cellular or soluble fibronectin. FnBP-deficient mutants lost
      invasiveness for epithelial cells, endothelial cells and fibroblasts. Thus,
      fibronectin-dependent bridging between S. aureus FnBPs and host cell integrin
      alpha5beta1 is a conserved mechanism for S. aureus invasion of human cells. This
      may prove useful in developing new therapeutic and vaccine strategies for S.
      aureus infections.

PMID- 11207546
TI  - The Chlamydia trachomatis IncA protein is required for homotypic vesicle fusion.
AB  - Chlamydiae replicate within an intracellular vacuole, termed an inclusion, that
      is non-fusogenic with vesicles of the endosomal or lysosomal compartments.
      Instead, the inclusion appears to intersect an exocytic pathway from which
      chlamydiae intercept sphingomyelin en route from the Golgi apparatus to the
      plasma membrane. Chlamydial protein synthesis is required to establish this
      interaction. In an effort to identify those chlamydial proteins controlling
      vesicle fusion, we have prepared polyclonal antibodies against several Chlamydia
      trachomatis inclusion membrane proteins. Microinjection of polyclonal antibodies
      against three C. trachomatis inclusion membrane proteins, IncA, F and G, into the
      cytosol of cells infected with C. trachomatis demonstrates reactivity with
      antigens on the cytoplasmic face of the inclusion membrane, without apparent
      inhibition of chlamydial multiplication. Microinjection of antibodies against the
      C. trachomatis IncA protein, however, results in the development of an aberrant
      multilobed inclusion structure remarkably similar to that of C. psittaci GPIC.
      These results suggest that the C. trachomatis IncA protein is involved in
      homotypic vesicle fusion and/or septation of the inclusion membrane that is
      believed to accompany bacterial cell division in C. psittaci. This proposal is
      corroborated by the expression of C. trachomatis and C. psittaci IncA in a yeast
      two-hybrid system to demonstrate C. trachomatis, but not C. psittaci, IncA
      interactions. Despite the inhibition of homotypic fusion of C. trachomatis
      inclusions, fusion of sphingomyelin-containing vesicles with the inclusion was
      not suppressed.

PMID- 11207547
TI  - Visualization of harpin secretion in planta during infection of apple seedlings
      by Erwinia amylovora.
AB  - Erwinia amylovora is a Gram-negative pathogenic bacterium that infects pear and
      apple trees as well as other plants from the Rosaceae family. E. amylovora
      pathogenicity is dependent on a functional Hrp type III secretion system. Harpin,
      a protein playing a major role in virulence, has been shown to be exported in
      vitro via the type III secretion apparatus. The data presented here focus on
      harpin detection in planta after infection of apple seedlings with the wild-type
      strain CFPB 1430. Using a specific harpin antiserum, harpin was not detected
      inside the host plant cells, but was found associated with the bacteria and
      secreted. The extracellular localization of harpin is in agreement with the
      physiological effects induced by purified harpin when applied as an exogenous
      elicitor. Harpin was not found associated with the host plant cell wall, a result
      that weakens its postulated role in cell wall loosening. A differential labelling
      was observed at the bacterial level: for some bacteria, harpin was exclusively
      cytoplasmic, whereas in others, it appeared as small patches over the bacterial
      outer membrane or associated with extracellular linear structures. All the
      bacteria present within the same area were similarly labelled, suggesting co
      ordination in the secretion process. All observations suggest that harpin is
      synthesized in the bacterial cytoplasm and that secretion occurs from this
      cytoplasmic pool upon sensing of a plant or bacterial signal.

PMID- 11207548
TI  - Inhibition of Shigella flexneri-induced transepithelial migration of
      polymorphonuclear leucocytes by cadaverine.
AB  - Dysentery caused by Shigella species is characterized by infiltration of
      polymorphonuclear leucocytes (PMNs) into the colonic mucosa. Shigella spp.
      evolved into pathogens by the acquisition of virulence genes and by the deletion
      of 'antivirulence' genes detrimental to its pathogenic lifestyle. An example is
      cadA (encoding lysine decarboxylase), which is uniformly absent in Shigella spp.,
      whereas it is present in nearly all isolates of the closely related non-pathogen
      Escherichia coli. Here, using monolayers of T84 cells to model the human
      intestinal epithelium, we determined that the introduction of cadA into S.
      flexneri and the expression of lysine decarboxylase attenuated the bacteria's
      ability to induce PMN influx across model intestinal epithelium. Such inhibition
      was caused by cadaverine generated from the decarboxylation of lysine. Cadaverine
      treatment of model intestinal epithelia specifically inhibited S. flexneri
      induction of PMN transepithelial migration, while having no effect on the ability
      of Salmonella or enteropathogenic E. coli (EPEC) to induce PMN migration. These
      observations not only provide insight into mechanisms of S. flexneri pathogen
      evolution and pathogenesis, but also suggest a potential for the use of
      cadaverine in the treatment of dysentery.

PMID- 11207550
TI  - Molecular analysis of neisserial Opa protein interactions with the CEA family of
      receptors: identification of determinants contributing to the differential
      specificities of binding.
AB  - The carcinoembryonic antigen (CEA) gene family members, CEACAM1, CEACAM3, CEACAM5
      and CEACAM6, are bound by the Opa outer membrane proteins of pathogenic Neisseria
      spp., whereas CEACAM8 is not. In this study, we demonstrate that the closely
      related CEACAM4 and CEACAM7, which are also members of the CEA family, are not
      Opa receptors. We exploited the high conservation between CEACAM6 and CEACAM8 to
      generate an extensive set of chimeric receptors in order to delineate the
      sequences necessary for Opa binding. Using a transfection-based infection system,
      we showed that binding of Opa52 involves residues 27-42, which are predicted to
      form beta-strand C and short loops adjacent to it, and residues lying between
      amino acids 60 and 108 in the amino-terminal domain. The replacement of residues
      27-29 in CEACAM6 with the CEACAM1 or CEACAM5 sequences generated recombinant
      CEACAM6 receptors that are bound by CEACAM1/CEACAM5-specific Opa variants.
      Together, our data demonstrate that Opa proteins bind to residues exposed on the
      GFCC' face of the N-terminal domain of CEACAM receptors, and identify an amino
      acid triplet sequence that is responsible for the differential binding of Opa
      proteins to CEACAM1, CEACAM5 and CEACAM6.

PMID- 11207551
TI  - The secreted IpaB and IpaC invasins and their cytoplasmic chaperone IpgC are
      required for intercellular dissemination of Shigella flexneri.
AB  - Invasion of epithelial cells by Shigella flexneri involves entry and
      dissemination. The main effectors of entry, IpaB and IpaC, are also required for
      contact haemolytic activity and escape from the phagosome in infected
      macrophages. These proteins are stored in the cytoplasm in association with the
      chaperone IpgC, before their secretion by a type III secretion apparatus is
      activated by host cells. We used a His-tagged IpgC protein to purify IpgC
      containing complexes and showed that only IpaB and IpaC are associated with IpgC.
      Plasmids expressing His6-IpgC either alone or together with IpaB or IpaC under
      the control of an IPTG-inducible lac promoter were introduced into ipgC, ipaB or
      ipaC mutants. Induction of expression of the recombinant plasmid-encoded proteins
      by IPTG allowed bacteria to enter epithelial cells, and the role of these
      proteins in dissemination was investigated by incubating infected cells in either
      the absence or the presence of IPTG. The size of plaques produced by recombinant
      strains on cell monolayers was regulated by IPTG, indicating that IpgC, IpaB and
      IpaC were each required for efficient dissemination. Electron microscopy analysis
      of infected cells indicated that these proteins were necessary for lysis of the
      membrane of the protrusions during cell-to-cell spread.

PMID- 11207549
TI  - Involvement of alpha5beta1 integrins in interleukin 8 production induced by oral
      viridans streptococcal protein I/IIf in cultured endothelial cells.
AB  - Using human endothelial cells, we define a mechanism that accounts for the
      induction of interleukin 8 (IL-8) by protein I/IIf, an adhesin from Streptococcus
      mutans serotype f. We report that protein I/IIf interactions with endothelial
      cells increased the tyrosine phosphorylation of three cellular components with
      relative mass of 145,000, 125,000 and 70,000 in endothelial cells. These proteins
      were identified as phospholipase Cgamma (PLCy), focal adhesion kinase (FAK) and
      paxillin after immunoprecipitation with monoclonal antibodies (mAbs) and
      immunoblotting with antiphosphotyrosine mAbs. These results suggested that beta1
      integrins could be one of the components implicated in the modulin activity of
      protein I/IIf. By incubating protein I/IIf with either purified alpha5beta1
      integrins or with alpha5beta1 integrins overexpressing CHO cells, we demonstrated
      that alpha5beta1 integrins act as cell receptors for protein I/IIf. We also
      showed that protein I/IIf interactions with alpha5beta1 integrins lead to IL-8
      secretion. Using specific inhibitors, we demonstrated that protein I/IIf-induced
      IL-8 release involves mitogen-activated protein kinases (MAPKs), and that
      PLCgamma and PKC also seem to contribute to protein I/IIf stimulation. However,
      PI-3K activation is not involved in IL-8 release. Altogether, these results
      indicate that, after binding to alpha5beta1 integrins, protein I/IIf induces IL-8
      release by activating the MAPKs signalling pathways.

PMID- 11207552
TI  - New insights into the role of the cytoskeleton in phagocytosis of Entamoeba
      histolytica.
AB  - Entamoeba histolytica, a human parasite, crosses the natural barriers of the
      intestine and, in turn, spreads into the deeper organs, resulting in amoebiasis.
      The motility of the parasite and its ability to lyse or phagocytose human cells
      facilitates passage of the amoeba through the intestinal epithelium. Little is
      known about the uptake of material by this parasite; nevertheless, the
      cytoskeleton is believed to play a role in phagocytosis. Myosin IB, an actin
      binding protein, localizes to the phagocytic cup and, with time, surrounds the
      internalized phagosome itself. The role of unconventional myosins in phagocytosis
      has also been demonstrated in other cell types, suggesting that this molecular
      mechanism is a common denominator in phagocytic events. Here, we summarize the
      emerging view of the role of unconventional myosins as well as other cytoskeleton
      associated proteins in pseudopod formation at early stages of phagocytosis and
      during the late step of this process in E. histolytica.

PMID- 11207553
TI  - Phagocytic processing of antigens for presentation by class II major
      histocompatibility complex molecules.
AB  - Microbes and other particulate antigens (Ags) are internalized by phagocytosis
      and then reside in plasma membrane-derived phagosomes. The contribution of
      phagosomes to the degradation of Ags has long been appreciated. It has been
      unclear, however, whether peptides derived from these degraded antigens bind
      class II major histocompatibility complex (MHC-II) molecules within phagosomes or
      within endocytic compartments that receive Ag fragments from phagosomes. Recent
      experiments have demonstrated that phagosomes containing Ag-conjugated latex
      beads express a full complement of Ag-processing molecules, e.g. MHC-II
      molecules, invariant chain, H2-DM and proteases sufficient to degrade bead-
      associated Ag. These phagosomes mediate the formation of peptide-MHC-II
      complexes, which are transported to the cell surface and presented to T cells.
      Phagosomes acquire both newly synthesized and plasma membrane-derived MHC-II
      molecules, but the formation of peptide-MHC-II complexes in phagosomes primarily
      involves newly synthesized MHC-II molecules. The content and traffic of
      phagosomal proteins vary considerably with the type of Ag ingested. Pathogenic
      microbes can alter phagosome composition and function to reduce Ag processing.
      For example, Mycobacterium tuberculosis blocks the maturation of phagosomes and
      reduces the ability of infected cells to present exogenous soluble protein Ags.

PMID- 11207554
TI  - Fluorescence image analysis of the association between Porphyromonas gingivalis
      and gingival epithelial cells.
AB  - We have developed a fluorescence imaging technique using a DNA-binding dye to
      visualize, over time, the physical interactions between Porphyromonas gingivalis
      and human gingival epithelial cells in vitro. The results extend previous
      observations of P. gingivalis invasion of gingival epithelial cells based on
      indirect measurements. An intracellular location for P. gingivalis was
      established by optical sectioning of images in the z-plane. Kinetic analysis
      showed that P. gingivalis invasion of epithelial cells is a rapid and efficient
      process, reaching completion after 12 min. Imaging of infected monolayers
      revealed that over 90% of a population of gingival epithelial cells contained
      bacteria. Furthermore, only vital bacteria were capable of invasion, and
      intracellular bacteria congregated in the perinuclear region of the epithelial
      cells. P. gingivalis remained inside the epithelial cells over a 24 h period and
      induced rearrangement of the actin cytoskeleton along with alteration of the size
      and shape of the epithelial cells. These findings provide direct evidence that
      entry rates of P. gingivalis into gingival epithelial cells are high and rapid,
      and that internalized bacteria initially localize in a specific region of the
      epithelial cells.

PMID- 11207555
TI  - Secretion of micronemal proteins is associated with toxoplasma invasion of host
      cells.
AB  - Toxoplasma gondii is an obligate intracellular parasite that actively invades a
      wide variety of vertebrate cells, although the basis of its pervasive cell
      invasion is not completely understood. Here, we demonstrate, using several
      independent assays, that Toxoplasma invasion of host cells is tightly coupled to
      the release of proteins stored within apical secretory granules called
      micronemes. Both microneme secretion and cell invasion were highly temperature
      dependent, and partial depletion of microneme resulted in a transient loss of
      infectivity. Chelation of parasite intracellular calcium strongly inhibited both
      microneme release and invasion of host cells, and this effect was partially
      reversed by raising intracellular calcium using the ionophore A23187. We also
      provide evidence that a staurosporine-sensitive kinase activity regulates
      microneme discharge and is required for parasite invasion of host cells.
      Additionally, we demonstrate that, during apical attachment to the host cell, the
      micronemal protein MIC2 is released at the junction between the parasite and the
      host cell. During invasion, MIC2 is successively translocated towards the
      posterior end of the parasite and is shed before entry of the parasite into the
      vacuole. Furthermore, we show that the full-length cellular form of MIC2, but not
      the proteolytically modified secreted form of MIC2, binds specifically to host
      cells. Collectively, these observations strongly imply that micronemal proteins
      play a role in Toxoplasma invasion of host cells.

PMID- 11207556
TI  - Characterization and intracellular trafficking pattern of vacuoles containing
      Chlamydia pneumoniae in human epithelial cells.
AB  - Chlamydiae are obligate intracellular pathogens that reside within a membrane
      bound vacuole throughout their developmental cycle. In this study, the
      intraphagosomal pH of Chlamydia pneumoniae (Cpn) was qualitatively assessed, and
      the intracellular fate of the pathogen-containing vacuole and its interaction
      with endocytic organelles in human epithelial cells were analysed using
      conventional immunofluorescence and confocal microscopy. The pH-sensitive probes
      acridine orange (AO), LysoTracker (LyT) and DAMP did not accumulate in the
      bacterial inclusion. In addition, exposure of cells to bafilomycin A1(BafA1), a
      potent acidification inhibitor, did not inhibit or delay chlamydial growth. The
      chlamydial compartment was not accessible to the fluid-phase tracer Texas Red
      (TR)-dextran and did not exhibit any level of staining for the late endosomal
      marker cation-independent mannose-6-phosphate receptor (Ci-M6PR) or for the
      lysosomal-associated membrane proteins (LAMP-1 and -2) and CD63. In addition,
      transferrin receptor (TfR)-enriched vesicles were observed close to Cpn vacuoles,
      potentially indicating a specific translocation of these organelles through the
      cytoplasm to the vicinity of the vacuole. We conclude that Cpn, like other
      chlamydial spp., circumvents the host endocytic pathway and inhabits a non-acidic
      vacuole, which is dissociated from late endosomes and lysosomes, but selectively
      accumulates early endosomes.

PMID- 11207557
TI  - Stability of the Listeria monocytogenes ActA protein in mammalian cells is
      regulated by the N-end rule pathway.
AB  - Upon infection of mammalian cells, Listeria monocytogenes lyses the phagosome and
      enters the cytosol, where it secretes proteins necessary for its intracellular
      growth cycle. Consequently, bacterial proteins exposed to the cytosol are
      potential targets for degradation by host cytosolic proteases. One pathway for
      degradation of host cytosolic proteins, the N-end rule pathway, involves
      recognition of the N-terminal amino acid and is mediated by the proteasome.
      However, very few natural N-end rule substrates have been identified. We have
      examined the L. monocytogenes ActA protein as a potential target for this
      pathway. ActA is an essential determinant of L. monocytogenes pathogenesis that
      is required to induce actin-based motility and cell-to-cell spread. We show that
      the half-life of a secreted form of ActA can be altered in the mammalian cytosol
      by changing the N-terminal amino acid. Moreover, the introduction of a
      destabilizing N-terminus into the functional, surface-bound form of ActA results
      in a small-plaque phenotype in L2 cells, which is partially reversible by an
      inhibitor of the proteasome. These results indicate that the L. monocytogenes
      ActA protein is a natural N-end rule substrate, and that optimal function of ActA
      in mediating cell-to-cell spread is dependent upon its intracellular turnover
      rate.

PMID- 11207558
TI  - Enteropathogenic Escherichia coli (EPEC) attachment to epithelial cells:
      exploiting the host cell cytoskeleton from the outside.
AB  - Enteropathogenic Escherichia coli (EPEC), a leading cause of human infantile
      diarrhoea, is the prototype for a family of intestinal bacterial pathogens that
      induce attaching and effacing (A/E) lesions on host cells. A/E lesions are
      characterized by localized effacement of the brush border of enterocytes,
      intimate bacterial attachment and pedestal formation beneath the adherent
      bacteria. As a result of some recent breakthrough discoveries, EPEC has now
      emerged as a fascinating paradigm for the study of host-pathogen interactions and
      cytoskeletal rearrangements that occur at the host cell membrane. EPEC uses a
      type III secretion machinery to attach to epithelial cells, translocating its own
      receptor for intimate attachment, Tir, into the host cell, which then binds to
      intimin on the bacterial surface. Studies of EPEC-induced cytoskeletal
      rearrangements have begun to provide clues as to the mechanisms used by this
      pathogen to subvert the host cell cytoskeleton and signalling pathways. These
      findings have unravelled new ways by which pathogenic bacteria exploit host
      processes from the cell surface and have shed new light on how EPEC might cause
      diarrhoea.

PMID- 11207559
TI  - Distinct effects of Vibrio cholerae haemagglutinin/protease on the structure and
      localization of the tight junction-associated proteins occludin and ZO-1.
AB  - Vibrio cholerae produces a little-studied cytotoxin, haemagglutinin/protease
      (HA/P), in addition to several better-characterized enterotoxins, i.e. cholera
      toxin (CT), zonula occludens toxin (ZOT) and accessory cholera enterotoxin (Ace).
      We have found recently that HA/P perturbs the barrier function of Mardin-Darby
      canine kidney epithelial cell line I (MDCK-I) by affecting the intercellular
      tight junctions (TJs) and the F-actin cytoskeleton. In the present study we have
      assessed more specifically how TJs are affected by HA/P by investigating the
      cellular localization and biochemical integrity of two well-characterized TJ
      associated proteins, occludin and ZO-1. Western blot analysis showed that
      occludin bands of 66-85 kDa were digested by HA/P to two predominant bands of
      around 50 kDa and 35 kDa, and that this degradation was greatly attenuated when
      the specific bacterial metalloproteinase inhibitor Zincov was co-administered.
      Trypsin, on the other hand, did not degrade occludin when it was applied in the
      same way, suggesting that the degradation of occludin by HA/P is an early and
      specific event. The other TJ-associated protein ZO-1 was not degraded by HA/P in
      parallel experiments, suggesting the selectivity of HA/P-associated protein
      degradation. Moreover, immunofluorescence labelling and confocal microscopy
      showed that ZO-1, but not occludin, around cell-cell boundaries was rearranged by
      HA/P treatment. Since ZO-1 is located on the inside of the plasma membrane and is
      directly associated with occludin, the results indicate that breakdown of
      occludin may send signals to ZO-1 that affect its organization and the structure
      of the F-actin cytoskeleton. Our finding that the zinc-containing metalloprotease
      of V. cholerae specifically degraded occludin suggests that specific degradation
      of important host proteins by bacterial zinc-containing metalloproteases may be
      an important mechanism in microbial pathogenesis.

PMID- 11207560
TI  - CD44 binds to the Shigella IpaB protein and participates in bacterial invasion of
      epithelial cells.
AB  - Shigella entry into epithelial cells is characterized by a transient
      reorganization of the host cell cytoskeleton at the site of bacterial interaction
      with the cell membrane, which leads to bacterial engulfment in a macropinocytic
      process. Using affinity chromatography on HeLa cell extracts, we show here that
      the hyaluronan receptor CD44 associates with IpaB, a Shigella protein that is
      secreted upon cell contact. Overlay and solid-phase assays indicated that IpaB
      binds directly to the extracellular domain of CD44; binding is saturable and
      inhibitable, with a half-maximal inhibitory concentration of 175 nM.
      Immunoprecipitation experiments showed that IpaB associates with CD44 during
      Shigella entry. CD44 is recruited at bacterial entry sites and localizes at the
      plasma membrane of cellular extensions induced by Shigella. Pretreatment of cells
      with an anti-CD44 monoclonal antibody resulted in inhibition of Shigella-induced
      cytoskeletal reorganization, as well as inhibition of bacterial entry, whereas
      transfection of CD44 in cells that are deficient for CD44 results in increased
      bacterial binding to cells and internalization. The IpaB-CD44 interaction appears
      to be required for Shigella invasion by initiating the early steps of the entry
      process.

PMID- 11207561
TI  - A secondary structure motif predictive of protein localization to the chlamydial
      inclusion membrane.
AB  - Chlamydiae are obligate intracellular pathogens that spend their entire growth
      phase sequestered in a membrane-bound vacuole called an inclusion. A set of
      chlamydial proteins, labelled Inc proteins, has been identified in the inclusion
      membrane (IM). The predicted IncA, IncB and IncC amino acid sequences share very
      limited similarity, but a common hydrophobicity motif is present within each Inc
      protein. In an effort to identify a relatively complete catalogue of Chlamydia
      trachomatis proteins present in the IM of infected cells, we have screened the
      genome for open reading frames encoding this structural motif. Hydropathy plot
      analysis was used to screen each translated open reading frame in the C.
      trachomatis genome database. Forty-six candidate IM proteins (C-lncs) that
      satisfied the criteria of containing a bilobed hydrophobic domain of at least 50
      amino acids were identified. The genome of Chlamydia pneumoniae encodes a larger
      collection of C-lnc proteins, and only approximately half of the C-lncs are
      encoded within both genomes. In order to confirm the hydropathy plot screening
      method as a valid predictor of C-lncs, antisera and/or monoclonal antibodies were
      prepared against six of the C. trachomatis C-lncs. Immunofluorescence microscopy
      of C. trachomatis-infected cells probed with these antibodies showed that five
      out of six C-lncs are present in the chlamydial IM. Antisera were also produced
      against C. pneumoniae p186, a protein sharing identity with Chlamydia psittaci
      lncA and carrying a similar bilobed hydrophobic domain. These antisera labelled
      the inclusion membrane in C. pneumoniae infected cells, confirming that proteins
      sharing the unique secondary structural characteristic also localize to the
      inclusion membrane of C. pneumoniae. Sera from patients with high-titre
      antibodies to C. trachomatis were examined for reactivity with each tested C-lnc
      protein. Three out of six tested C-lncs were recognized by a majority of these
      patient sera. Collectively, these studies identify and characterize novel
      proteins localized to the chlamydial IM and demonstrate the existence of a
      potential secondary structural targeting motif for localization of chlamydial
      proteins to this unique intracellular environment.

PMID- 11207562
TI  - The Salmonella virulence plasmid spv genes are required for cytopathology in
      human monocyte-derived macrophages.
AB  - The pathogenesis of serious systemic Salmonella infections is characterized by
      survival and proliferation of bacteria inside macrophages. Infection of human
      monocyte-derived macrophages in vitro with S. typhimurium or S. dublin produces
      cytopathology characterized by detachment of cells that contain large numbers of
      proliferating bacteria. This cytopathology is dependent on the expression of the
      bacterial spv genes, a virulence locus previously shown to markedly enhance the
      ability of Salmonella to produce systemic disease. After 24 h of infection,
      macrophage cultures contain two populations of bacteria: (i) proliferating
      organisms present in a detached cell fraction; and (ii) a static bacterial
      population in macrophages remaining attached to the culture well. Mutations in
      either the essential transcriptional activator SpvR or the key SpvB protein
      markedly reduce the cytopathic effect of Salmonella infection. The spv-dependent
      cytopathology in macrophages exhibits characteristics of apoptosis, with release
      of nucleosomes into the cytoplasm, nuclear condensation and DNA fragmentation.
      The current findings suggest that the mechanism of the spv effect is through
      induction of increased cytopathology in host macrophages.

PMID- 11207563
TI  - A recombinant Salmonella typhimurium vaccine strain is taken up and survives
      within murine Peyer's patch dendritic cells.
AB  - The attenuated Salmonella typhimurium PhoPc strain is avirulent but immunogenic
      via the oral route in mice and is attenuated in survival in macrophage cell
      lines. In this study, the fate of PhoPc bacteria expressing green fluorescent
      protein was investigated in murine Peyer's patches. The survival of PhoPc was
      monitored after orogastric inoculation of BALB/c mice. Bacteria persisted for
      several weeks in the Peyer's patches and were also recovered from the mesenteric
      lymph nodes and spleen. Confocal microscopy analysis identified dendritic cells
      as the Peyer's patch cell type that internalized PhoPc expressing green
      fluorescent protein at early time points. In addition, live PhoPc were found in
      Peyer's patch dendritic cells and not in B cells 3 days after orogastric
      inoculation. Taken together, these results provide strong evidence that PhoPc is
      internalized and survives within Peyer's patch dendritic cells. As these cells
      are potent antigen-presenting cells, these data could explain the immunogenicity
      of S. typhimurium vaccine strains in vivo.

PMID- 11207564
TI  - Syndecan-1 and syndecan-4 can mediate the invasion of OpaHSPG-expressing
      Neisseria gonorrhoeae into epithelial cells.
AB  - Neisseria gonorrhoeae (Ngo) expressing the outer membrane protein OpaHSPG can
      adhere to and invade epithelial cells via binding to heparan sulphate
      proteoglycan (HSPG) receptors. In this study, we have investigated the role of
      syndecan-1 and syndecan-4, two members of the HSPG family, in the uptake of Ngo
      by epithelial cells. When overexpressed in HeLa cells, both syndecans co-localize
      with adherent Ngo on the host cell surface. This overexpression of syndecan-1 and
      syndecan-4 leads to a three- and sevenfold increase in Ngo invasion respectively.
      In contrast, transfection with the syndecan-1 and syndecan-4 mutant constructs
      lacking the intracellular domain results in an abrogation of the invasion
      process, characteristic of a dominant-negative mode of action. A concomitant loss
      of the capacity to mediate Ngo uptake was also observed with syndecan-4 mutant
      constructs carrying lesions in the dimerization motif necessary for the binding
      of protein kinase C (PKC) and phosphatidylinositol 4,5-bisphosphate (PIP2), and
      mutants that are deficient in a C-terminal EFYA amino acid motif responsible for
      binding to syntenin or CASK. We conclude that syndecan-1 and syndecan-4 can both
      mediate Ngo uptake into epithelial cells, and that their intracellular domains
      play a crucial role in this process, perhaps by mediating signal transduction or
      anchorage to the cytoskeleton.

PMID- 11207565
TI  - Cross-talk between enteric pathogens and the intestine.
AB  - Enteric pathogens finely regulate the expression of virulence genes in reply to
      stimuli generated by the intestinal environment. This minireview focuses on
      recently discovered strategies developed by enteric bacteria to cause intestinal
      secretion through the elaboration of factors that share structure and function
      with specific host counterparts. Such bacterial antigens appear to interfere
      largely with the epithelial cell signalling that physiologically regulates the
      numerous and, as yet not fully elucidated, mechanisms controlling both the
      transcellular and the paracellular secretion pathways. Heat-stable enterotoxins
      (STs) elaborated by enterotoxigenic Escherichia coli and the enteroaggregative E.
      coli enterotoxin (EAST1) are both typical examples of enteric toxins that
      activate the transcellular secretion pathway by mimicking guanylin, the
      endogenous modulator of cGMP signalling. Alternative strategies have been
      developed by Salmonella to induce intestinal secretion through the elaboration of
      a factor (SopB) that resembles at least two of the host cell 4-phosphatases,
      enzymes that activate the Ca-dependent transcellular secretion pathway. Finally,
      Vibrio cholerae has developed innovative tactics to activate the paracellular
      secretion pathway through the elaboration of Zonula occludens toxin (Zot), a
      factor that mimics a recently described physiological modulator of intercellular
      tight junctions.

PMID- 11207566
TI  - Theileria parva: taking control of host cell proliferation and survival
      mechanisms.
AB  - The intracellular parasite Theileria parva infects and transforms bovine T-cells,
      inducing their uncontrolled proliferation and spread in non-lymphoid as well as
      lymphoid tissues. This parasite-induced transformation is the predominant factor
      contributing to the pathogenesis of a lymphoproliferative disease, called East
      Coast fever. T. parva-transformed cells become independent of antigenic
      stimulation or exogenous growth factors. A dissection of the signalling pathways
      that are activated in T. parva-infected cells shows that the parasite bypasses
      signalling pathways that normally emanate from the T-cell antigen receptor to
      induce continuous proliferation. This review concentrates on the influence of the
      parasite on the state of activation of the mitogen-activated protein kinase
      (MAPK), NF-kappaB and phosphoinositide-3-kinase (PI3-K) pathways in the host
      cell. Of the MAPKs, JNK, but not ERK or p38, is active, inducing constitutive
      activation of the transcription factors AP-1 and ATF-2. A crucial step in the
      transformation process is the persistent activation of the transcription factor
      NF-kappaB, which protects T. parva-transformed cells from spontaneous apoptosis
      accompanying the transformation process. Inhibitor studies also suggest an
      important role for the lipid kinase, PI-3K, in the continuous proliferation of T.
      parva-transformed lymphocytes.

PMID- 11207567
TI  - LaXp180, a mammalian ActA-binding protein, identified with the yeast two-hybrid
      system, co-localizes with intracellular Listeria monocytogenes.
AB  - The Listeria monocytogenes surface protein ActA is an important virulence factor
      required for listerial intracellular movement by inducing actin polymerization.
      The only host cell protein known that directly interacts with ActA is the
      phosphoprotein VASP, which binds to the central proline-rich repeat region of
      ActA. To identify additional ActA-binding proteins, we applied the yeast two
      hybrid system to search for mouse proteins that interact with ActA. A mouse cDNA
      library was screened for ActA-interacting proteins (AIPs) using ActA from strain
      L. monocytogenes EGD as bait. Three different AIPs were identified, one of which
      was identical to the human protein LaXp180 (also called CC1). Binding of LaXp180
      to ActA was also demonstrated in vitro using recombinant histidine-tagged LaXp180
      and recombinant ActA. Using an anti-LaXp180 antibody and fluorescence microscopy,
      we showed that LaXp180 co-localizes with a subset of intracellular, ActA
      expressing L. monocytogenes but was never detected on intracellularly growing but
      ActA-deficient mutants. Furthermore, LaXp180 binding to intracellular L.
      monocytogenes was asymmetrical and mutually exclusive with F-actin polymerization
      on the bacterial surface. LaXp180 is a putative binding partner of stathmin, a
      protein involved in signal transduction pathways and in the regulation of
      microtubule dynamics. Using immunofluorescence, we showed that stathmin co
      localizes with intracellular ActA-expressing L. monocytogenes.

PMID- 11207568
TI  - Leishmania promastigotes require lipophosphoglycan to actively modulate the
      fusion properties of phagosomes at an early step of phagocytosis.
AB  - The lipophosphoglycan (LPG) of Leishmania promastigotes plays key roles in
      parasite survival in both insect and mammalian hosts. Evidence suggests that LPG
      decreases phagosome fusion properties at the onset of infection in macrophages.
      The mechanisms of action of this molecule are, however, poorly understood. In the
      present study, we used a panoply of Leishmania mutants displaying modified LPG
      structures to determine more precisely how LPG modulates phagosome-endosome
      fusion. Using an in vivo fusion assay measuring, at the electron microscope, the
      transfer of solute materials from endosomes to phagosomes, we provided further
      evidence that the repeating Gal(beta1,4)Man(alpha1-PO4) units of LPG are
      responsible for the alteration in phagosome fusion. The inhibitory effect of LPG
      on phagosome fusion was shown to be more potent towards late endocytic organelles
      and lysosomes than early endosomes, explaining how Leishmania promastigotes can
      avoid degradation in hydrolase-enriched compartments. The involvement of other
      repeating unit-containing molecules, including the secreted acid phosphatase, in
      the inhibition process was ruled out, as an LPG-defective mutant (Ipg1-) which
      secretes repeating unit-containing glycoconjugates was present in highly
      fusogenic phagosomes. In L. major, oligosaccharide side-chains of LPG did not
      contribute to the inhibition process, as Spock, an L. major mutant lacking LPG
      side-chains, blocked fusion to the same extent as wild-type parasites. Finally,
      dead parasites internalized from the culture medium were not as efficient as live
      parasites in altering phagosome-endosome fusion, despite the presence of LPG.
      However, the killing of parasites with vital dyes after their sequestration in
      phagosomes had no effect on the fusion properties of this organelle.
      Collectively, these results suggest that living promastigotes displaying full
      length cell surface LPG can actively influence macrophages at an early stage of
      phagocytosis to generate phagosomes with poor fusogenic properties.

PMID- 11207569
TI  - A novel function of InIB from Listeria monocytogenes: activation of NF-kappaB in
      J774 macrophages.
AB  - Listeria monocytogenes causes a pro-inflammatory response on adhesion to
      macrophages. Upregulation of inflammation genes involves the transcription factor
      NF-kappaB. Several components of L. monocytogenes, including lipoteichoic acid
      (LTA), phospholipases and listeriolysin O (LLO), have since been shown to mediate
      NF-kappaB activation. Here, we report that purified recombinant InlB, but not
      internalin (InlA), is a potent activator of NF-kappaB in the mouse macrophage
      like cell line J774. Expression of InlB in Listeria innocua enhances its ability
      to activate NF-kappaB, while deletion of InlB from L. monocytogenes marginally
      decreases its effect on NF-kappaB, possibly because of the presence of NF-kappaB
      activators such as LTA and LLO. The effect correlates with the rapid degradation
      of IkappaBalpha, a sustained degradation of IkappaBbeta and increases in tumour
      necrosis factor alpha (TNF-alpha) and interleukin (IL) 6 production, two
      cytokines controlled by NF-kappaB. Using a series of anti-InlB monoclonal
      antibodies and domains of InlB, NF-kappaB activation was shown to be dependent
      upon the N-terminal 213-amino-acid leucine-rich repeat (LRR) domain of InlB,
      recently demonstrated to be responsible for InlB-mediated L. monocytogenes
      invasion and phosphoinositide-3 (PI-3) kinase activation. The effect of InlB was
      blocked by PI-3 kinase inhibitors, indicating the involvement of PI-3 kinase in
      this response. This report thus illustrates that InlB not only promotes invasion,
      but also contributes to the macrophage pro-inflammatory response.

PMID- 11207570
TI  - Chlamydia-dependent biosynthesis of a heparan sulphate-like compound in
      eukaryotic cells.
AB  - One hypothesis for the mechanism of chlamydial interaction with its eukaryotic
      host cell invokes a trimolecular mechanism, whereby a Chlamydia-derived
      glycosaminoglycan bridges a chlamydial acceptor molecule and a host receptor
      enabling attachment and invasion. We show that a heparan sulphate-specific
      monoclonal antibody specifically binds a glycosa-minoglycan localized to the
      surface of the chlamydial organism and effectively neutralizes infectivity of
      both C. trachomatis and C. pneumoniae. In addition to the ability of this
      antibody to neutralize infectivity, direct visualization using immunofluorescence
      demonstrated staining of chlamydial organisms localized to the intracellular
      vacuole. The chlamydial-associated glycosaminoglycan was specifically labelled
      with [14C]-glucosamine, and the labelled compound was immunoprecipitated and
      resolved by gel electrophoresis. The chlamydial-associated glycosaminoglycan is a
      high-molecular-weight compound similar in size to heparin or heparan sulphate and
      was sensitive to cleavage by heparan sulphate lyase. These data demonstrate that
      a glucosamine-containing sulphated polysaccharide is produced within the
      intracellular vacuole containing chlamydiae and is a target for antibody-mediated
      neutralization of infectivity.

PMID- 11207571
TI  - Two distinct pathways for the invasion of Streptococcus pyogenes in non
      phagocytic cells.
AB  - Adherence to and invasion of epithelial cells represent important pathogenic
      mechanisms of Streptococcus pyogenes. A fibronectin-binding surface protein of S.
      pyogenes, Sfbl protein, has been implicated in both adherence and invasion
      processes. Invasion of Sfbl-containing strains has been suspected to be
      responsible for the failure of antibiotics treatment to eradicate S. pyogenes. In
      this study, we tested the adherence and invasion properties of two well
      characterized clinical isolates: A40, which expresses Sfbl; and A8, which is Sfbl
      negative and is unable to bind fibronectin. In strain A40, Sfbl was the main
      factor required for attachment and invasion by using fibronectin as a bridging
      molecule and the alpha5beta1 integrin as cellular receptor. The uptake process
      was characterized by the generation of large membrane invaginations at the
      bacteria-cell interface without evidence of actin recruitment or cellular injury.
      A40 cells were located in phagosomes and, only 24 h after infection, a consistent
      part of the bacterial population reached the cytoplasm. In contrast, uptake of
      strain A8 required major rearrangements of cytoskeletal proteins underneath
      attached bacteria. In A8, a proteinaceous moiety was involved, which does not
      interact with alpha5beta1 or need any known bridging molecule. Bacterial
      attachment stimulated elongation and massive recruitment of neighbouring
      microvilli, which fused to surround streptococcal chains. They led to the
      generation of large pseudopod-like structures, which engulfed bacteria that were
      rapidly released and replicated in the cytoplasm. The identification of two
      completely different uptake pathways reported here provided further evidence
      regarding the diversity of S. pyogenes isolates and might contribute towards
      understanding the pathogenesis and persistence of S. pyogenes.

PMID- 11207573
TI  - Dictyostelium discoideum: a new host model system for intracellular pathogens of
      the genus Legionella.
AB  - The soil amoeba Dictyostelium discoideum is a haploid eukaryote that, upon
      starvation, aggregates and enters a developmental cycle to produce fruiting
      bodies. In this study, we infected single-cell stages of D. discoideum with
      different Legionella species. Intracellular growth of Legionella in this new host
      system was compared with their growth in the natural host Acanthamoeba
      castellanii. Transmission electron microscopy of infected D. discoideum cells
      revealed that legionellae reside within the phagosome. Using confocal microscopy,
      it was observed that replicating, intracellular, green fluorescent protein (GFP)
      tagged legionellae rarely co-localized with fluorescent antibodies directed
      against the lysosomal protein DdLIMP of D. discoideum. This indicates that the
      bacteria inhibit the fusion of phagosomes and lysosomes in this particular host
      system. In addition, Legionella infection of D. discoideum inhibited the
      differentiation of the host into the multicellular fruiting stage. Co-culture
      studies with profilin-minus D. discoideum mutants and Legionella resulted in
      higher rates of infection when compared with infections of wild-type amoebae.
      Because the amoebae are amenable to genetic manipulation as a result of their
      haploid genome and because a number of cellular markers are available, we show
      for the first time that D. discoideum is a valuable model system for studying
      intracellular pathogenesis of microbial pathogens.

PMID- 11207572
TI  - Translocation of the Helicobacter pylori CagA protein in gastric epithelial cells
      by a type IV secretion apparatus.
AB  - Helicobacter pylori is one of the most common bacterial pathogens, infecting
      about 50% of the world population. The presence of a pathogenicity island (PAI)
      in H. pylori has been associated with gastric disease. We present evidence that
      the H. pylori protein encoded by the cytotoxin-associated gene A (cagA) is
      translocated and phosphorylated in infected epithelial cells. Two-dimensional gel
      electrophoresis (2-DE) of proteins isolated from infected AGS cells revealed H.
      pylori strain-specific and time-dependent tyrosine phosphorylation and
      dephosphorylation of several 125-135 kDa and 75-80 kDa proteins. Immunoblotting
      studies, matrix-assisted laser desorption/ionization mass spectrometry (MALDI
      MS), cell fractionation and confocal microscopy demonstrated that one of the 125
      135 kDa proteins represents the H. pylori CagA protein, which is translocated
      into the host cell membrane and the cytoplasm. Translocation of CagA was
      dependent on functional cagA gene and virulence (vir) genes of a type IV
      secretion apparatus composed of virB4, virB7, virB10, virB11 and virD4 encoded in
      the cag PAI of H. pylori. Our findings support the view that H. pylori actively
      translocates virulence determinants, including CagA, which could be involved in
      the development of a variety of gastric disease.

PMID- 11207574
TI  - Translocation of Yersinia entrocolitica across reconstituted intestinal
      epithelial monolayers is triggered by Yersinia invasin binding to beta1 integrins
      apically expressed on M-like cells.
AB  - Yersinia enterocolitica cross the intestinal epithelium via translocation through
      M cells, which are located in the follicle-associated epithelium (FAE) of Peyer's
      patches (PP). To investigate the molecular basis of this process, studies were
      performed using a recently developed in vitro model, in which the enterocyte-like
      cell line Caco-2 and PP lymphocytes are co-cultured in order to establish FAE
      like structures including M cells. Here, we demonstrate that Y. enterocolitica
      does not adhere significantly to the apical membrane of differentiated enterocyte
      like Caco-2 cells that express binding sites for Ulex europaeus agglutinin (UEA)
      1. In contrast, Y. enterocolitica adhered to, and was internalized by, cells that
      lacked UEA-1 binding sites and displayed a disorganized brush border. These cells
      were considered to be converted to M-like cells. Further analysis revealed that
      part of these cells expressed beta1 integrins at their apical surface and, as
      revealed by comparison of wild-type and mutant strains, interacted with invasin
      of Y. enterocolitica. Consistently, anti-beta1 integrin antibodies significantly
      inhibited internalization of inv-expressing yersiniae. Experiments with Yersinia
      mutant strains deficient in YadA or Yop secretion revealed that these virulence
      factors play a minor role in this process. After internalization, yersiniae were
      transported within LAMP-1-negative vacuoles to, and released at, the basal
      surface. Internalization and transport of yersiniae was inhibited by cytochalasin
      D, suggesting that F-actin assembly is required for this process. These results
      provide direct evidence that expression of beta1 integrins at the apical surface
      of M cells enables interaction with the invasin of Y. enterocolitica, and thereby
      initiates internalization and translocation of bacteria.

PMID- 11207575
TI  - Bacterial signals and cell responses during Shigella entry into epithelial cells.
AB  - Shigella invades epithelial cells by inducing cytoskeletal reorganization
      localized at the site of bacterial-host cell interaction. During entry, the
      Shigella type III secretion apparatus allows the insertion of a pore that
      contains the IpaB and IpaC proteins into cell membranes. Insertion of this
      complex is thought to allow translocation of the carboxy-terminus moiety of IpaC,
      but also of other Shigella effectors, such as IpaA, into the cell cytosol. IpaC
      triggers actin polymerization and the formation of filopodial and lamellipodial
      extensions dependent on the Cdc42 and Rac GTPases. IpaA, on the other hand, binds
      to the focal adhesion protein vinculin and induces depolymerization of actin
      filaments. IpaA and the GTPase Rho are not required for actin polymerization at
      the site of bacterial contact with the cell membrane, but allow the
      transformation of the IpaC-induced extensions into a structure that is productive
      for bacterial entry. Rho is required for the recruitment at entry foci of ezrin,
      a cytoskeletal linker required for Shigella entry, and also of the Src tyrosine
      kinase. The Src tyrosine kinase activity, which is required for Shigella-induced
      actin polymerization, also appears to be involved in a negative regulatory loop
      that downregulates Rho at the site of entry.

PMID- 11207576
TI  - Actin-based motility of pathogens: the Arp2/3 complex is a central player.
AB  - Bacterial actin-based motility has provided cell biologists with tools that led
      to the recent discovery that, in many forms of actin-based motilities, a key
      player is a protein complex named the Arp2/3 complex. The Arp2/3 complex is
      evolutionally conserved and made up of seven polypeptides involved in both actin
      filament nucleation and organization. Interestingly, this complex is inactive by
      itself and recent work has highlighted the fact that its activation is achieved
      differently in the different types of actin-based motilities, including the well
      known examples of Listeria and Shigella motilities. Proteins of the WASP family
      and small G-proteins are involved in most cases. It is interesting that bacteria
      bypass or mimic some of the events occurring in eukaryotic systems. The Shigella
      protein IcsA recruits N-WASP and activates it in a Cdc42-like fashion. This
      activation leads to Arp2/3 complex recruitment, activation of the complex and
      ultimately actin polymerization and movement. The Listeria ActA protein activates
      Arp2/3 directly and, thus, seems to mimic proteins of the WASP family. A
      breakthrough in the field is the recent reconstitution of the actin-based
      motilities of Listeria and N-WASP-coated E. coli (IcsA) using a restricted number
      of purified cellular proteins including F-actin, the Arp2/3 complex, actin
      depolymerizing factor (ADF or cofilin) and capping protein. The movement was more
      effective upon addition of profilin, alpha-actinin and VASP (for Listeria).
      Bacterial actin-based motility is now one of the best-documented examples of the
      exploitation of mammalian cell machineries by bacterial pathogens.

PMID- 11207577
TI  - Alteration of epithelial cell transferrin-iron homeostasis by Neisseria
      meningitidis and Neisseria gonorrhoeae.
AB  - Iron is an essential element for nearly all organisms. In mammals, iron is
      transported to body tissues by the serum glycoprotein transferrin. Transferrin
      iron is internalized by binding to specific receptors followed by endocytosis. In
      vitro, Neisseria meningitidis and Neisseria gonorrhoeae can use iron from a
      variety of iron-containing compounds, including human transferrin. In vivo,
      transferrin is an important source of iron for N. gonorrhoeae: a mutant that is
      unable to bind and use transferrin-iron is unable to colonize the urethra of men
      or initiate disease at this site. As pathogenic Neisseria and its human host
      derive much of their iron from transferrin, we reasoned that a competition may
      exist between microbe and host epithelial cells for transferrin-iron at certain
      stages of infection. We therefore tested the hypothesis that N. meningitidis and
      N. gonorrhoeae may actively interfere with host transferrin-iron metabolism. We
      report that Neisseria-infected human epithelial cells have reduced levels of
      transferrin receptor messenger RNA and cycling transferrin receptors. The ability
      of infected cells to internalize transferrin receptor is also reduced. Finally,
      the relative distribution of surface and cycling transferrin receptors is altered
      in an infected cell. We conclude that Neisseria infection alters epithelial cell
      transferrin-iron homeostasis at multiple levels.

PMID- 11207578
TI  - Integrin beta1-chain residues involved in substrate recognition and specificity
      of binding to invasin.
AB  - A highly conserved 14-amino-acid region of the chicken beta1 integrin chain
      (beta1chk residues 151-168) hypothesized to be involved in divalent cation
      coordination was analysed to determine whether invasin uses the same structural
      determinants as fibronectin (Fn) to recognize receptors. For the most part, both
      proteins required similar beta1 chain residues for integrin recognition, although
      the relative preference of the integrin for the two substrates could be inverted
      mutationally. Substitution mutations in the amino terminal residues of this
      region resulted in defective binding to both substrates by the receptor, while
      substitutions at the carboxyl-terminal end of this region were better tolerated.
      A derivative carrying the double substitution (KDD160RDV) had the unique
      phenotype of maintaining Fn binding while abolishing invasin binding, indicating
      that this region of the receptor may determine substrate specificity. These data
      indicate that the integrin beta1 chain possesses a ligand binding site shared by
      invasin and Fn that can be altered by mutation to allow greater preference for
      the normally lower affinity substrate Fn than for invasin. It was also
      established that the region analysed has the ability to bind divalent cations.

PMID- 11207579
TI  - The bacterial protein YopJ abrogates multiple signal transduction pathways that
      converge on the transcription factor CREB.
AB  - Bacterially encoded proteins are known to affect eukaryotic signalling pathways
      and thus cell growth and differentiation. The enteric pathogen Yersinia
      pseudotuberculosis (YP) can translocate Yersinia outer proteins (Yops) into
      eukaryotic cells. Recently, MKK proteins have been identified as tentative
      targets of YopJ-mediated inhibition of ligand receptor-dependent signal
      transduction in mammalian cells. These results prompted us to assess whether
      multiple signal transduction pathways and their downstream target genes would
      also be subject to regulation by YopJ. Here, we show that YopJ effectively blocks
      the lipopolysaccharide (LPS) receptor, the interleukin (IL)-1beta receptor and
      the UVC-induced activation of the transcription receptor cAMP response element
      binding protein (CREB). In addition, by abrogating the phosphorylation of CREB
      and thus activating protein (AP)-1-dependent transcription, YopJ can block LPS
      induced clonal expansion that is associated with an adaptive immune response.
      Thus, YopJ interferes with multiple pathways converging on the transcription
      factor CREB. Our data are discussed in the context of YopJ acting as an
      antagonist to circumvent innate and adaptive immune responses at multiple levels.

PMID- 11207580
TI  - Salmonella typhimurium mutants that downregulate phagocyte nitric oxide
      production.
AB  - To examine the potential and strategies of the facultative intracellular pathogen
      Salmonella typhimurium to increase its fitness in host cells, we applied a
      selection that enriches for mutants with increased bacterial growth yields in
      murine J774-A.1 macrophage-like cells. The selection, which was based on
      intracellular growth competition, rapidly yielded isolates that out-competed the
      wild-type strain during intracellular growth. J774-A.1 cells responded to
      challenge with S. typhimurium by mounting an inducible nitric oxide synthase
      (iNOS) mRNA and protein expression and a concomitant nitric oxide (NO)
      production. Inhibition of NO production with the use of the competitive inhibitor
      N-monomethyl-L-arginine (NMMA) resulted in a 20-fold increase in bacterial growth
      yield, suggesting that the NO response prevented bacterial intracellular growth.
      In accordance with this observation, five out of the nine growth advantage
      mutants isolated inhibited production of NO from J774-A.1 cells, despite an
      induction of iNOS mRNA and iNOS protein. Accompanying bacterial phenotypes
      included alterations in lipopolysaccharide structure and in the profiles of
      proteins secreted by invasion-competent bacteria. The results indicate that S.
      typhimurium has the ability to mutate in several different ways to increase its
      host fitness and that inhibition of iNOS activity may be a major adaptation.

PMID- 11207581
TI  - Proteolytic activation of receptor-bound anthrax protective antigen on
      macrophages promotes its internalization.
AB  - Immunofluorescence and other methods have been used to probe the self-assembly
      and internalization of the binary toxin, anthrax lethal toxin (LeTx), in primary
      murine macrophages. Proteolytic activation of protective antigen (PA; 83 kDa, the
      B moiety of the toxin) by furin was the rate-limiting step in internalization of
      LeTx and promoted clearance of PA from the cell surface. A furin-resistant form
      of PA remained at the cell surface for at least 90 min. Oligomerization of
      receptor-bound PA63, the 63 kDa active fragment of PA, was manifested by its
      conversion to a pronase-resistant state, characteristic of the heptameric prepore
      form in solution. That oligomerization of PA63 triggers toxin internalization is
      supported by the observation that PA20, the complementary 20 kDa fragment of PA,
      inhibited clearance of nicked PA. The PA63 prepore, with or without lethal factor
      (LF), cleared slowly from the cell surface. These studies show that proteolytic
      cleavage of PA, in addition to permitting oligomerization and LF binding, also
      promotes internalization of the protein. The relatively long period of activation
      and internalization of PA at the cell surface may reflect adaptation of this
      binary toxin that maximizes self-assembly.

PMID- 11207582
TI  - Translocation of Bacillus anthracis lethal and oedema factors across endosome
      membranes.
AB  - The two exotoxins of Bacillus anthracis, the causative agent of anthrax, are the
      oedema toxin (PA-EF) and the lethal toxin (PA-LF). They exert their catalytic
      activities within the cytosol. The internalization process requires receptor
      mediated endocytosis and passage through acidic vesicles. We investigated the
      translocation of EF and LF enzymatic moieties across the target cell membrane. By
      selective permeabilization of the plasma membrane with Clostridium perfringens
      delta-toxin, we observed free full-size lethal factor (LF) within the cytosol,
      resulting from specific translocation from early endosomes. In contrast, oedema
      factor (EF) remained associated with the membranes of vesicles.

PMID- 11207583
TI  - Pathogen-induced apoptosis of macrophages: a common end for different pathogenic
      strategies.
AB  - Microbe-macrophage interactions play a central role in the pathogenesis of many
      infections. Several bacterial pathogens induce apoptosis specifically in
      macrophages, but the mechanisms by which it occurs differ, and the resulting
      pathology can take different courses. Macrophage death caused by Shigella
      flexneri and Salmonella spp. has been shown to result in the release of pro
      inflammatory cytokines. Conversely, Yersinia spp. induce apoptosis by suppressing
      the signalling pathways that lead to the production of tumour necrosis factor
      (TNF)-alpha, a cytokine essential for the control of this infection. It is likely
      that there are a variety of reasons why macrophages are particularly susceptible
      to pathogen-induced apoptosis. One reason may be the expression of surface
      receptors that recognize highly conserved bacterial components, such as
      lipopolysaccharide (LPS) and bacterial lipoproteins (BLPs). These receptors have
      recently been shown to activate pro-apoptotic signalling pathways. The roles of
      macrophage apoptosis in different disease processes are discussed.

PMID- 11207584
TI  - Intracellular survival by Chlamydia.
AB  - Chlamydiae are obligate intracellular bacterial pathogens whose entry into
      mucosal epithelial cells is required for intracellular survival and subsequent
      growth. After a seemingly stealthy entry, chlamydiae quickly modify their vacuole
      (i) for exit from the endosomal pathway to the exocytic pathway and (ii) to
      permit fusion with intercepted endoplasmic reticulum- and Golgi-derived vesicles
      carrying glycerophospholipids and sphingolipids for chlamydiae-containing vacuole
      membrane expansion. Chlamydiae possess novel hollow proteinaceous structures,
      termed projections, which they use to pierce the inclusion membrane, possibly to
      acquire from the epithelial cytoplasm nutrients they cannot synthesize; whether
      or not these truncated flagellar-like structures serve a dual exchange function
      for secretion of molecules to programme host cell signalling is unknown. Despite
      the accumulation of some 500-1000 progeny in the enormously enlarged inclusion,
      host cell function is surprisingly little disrupted, and progeny escape can be
      unobtrusive. This elegant adaptive pathogen strategy, which leads to silent,
      chronic human infection, is fascinating from a cellular microbiology perspective.

PMID- 11207585
TI  - Bacterial determinants of persistent throat colonization and the associated
      immune response in a primate model of human group A streptococcal pharyngeal
      infection.
AB  - Group A streptococcal (GAS) pharyngitis and the subsequent bacterial colonization
      of the human throat elicit an immune response that may precipitate acute
      rheumatic fever in a susceptible host. To study the bacterial determinants that
      influence throat colonization and induction of humoral immunity, we characterized
      the behavior of GAS strains in a baboon model. An M-type 3 clinical isolate of
      GAS typical of strains that cause pharyngitis and invasive infection was
      recovered from the pharynx of six out of six baboons for at least 6 weeks after
      oral inoculation. By contrast, an isogenic mutant deficient in M protein failed
      to colonize most animals or was rapidly cleared. An isogenic mutant deficient in
      hyaluronic acid capsule colonized five out of six animals, but only persisted in
      the pharynx for 14-21 days. Colonized animals developed serum antistreptolysin O
      (SLO) and anti-M protein immunoglobulin (Ig)G. The kinetics of the antibody
      responses were similar to those seen after human infection. Peak titres increased
      with the duration of throat carriage. Colonization with GAS prevented recurrent
      colonization after challenge with the homologous wild-type strain, but not after
      challenge with a strain of different M protein type. Early clearance of the M
      protein-deficient strain was associated with increased susceptibility of this
      strain to phagocytic killing in non-immune serum, whereas clearance of the
      acapsular strain was associated with increased susceptibility to phagocytic
      killing in the presence of specific antibody. These studies support critical and
      distinct effects of the GAS M protein and capsule on throat colonization and
      induction of humoral immunity in a model that reproduces important features of
      pharyngeal colonization and immune response following human infection.

PMID- 11207586
TI  - The secreted effector protein of Salmonella dublin, SopA, is translocated into
      eukaryotic cells and influences the induction of enteritis.
AB  - Salmonella-induced enteritis is associated with the induction of an acute
      intestinal inflammatory response and net fluid secretion into the lumen of
      infected mucosa. Proteins secreted by the Inv/Spa type III secretion system of
      Salmonella play a key role in the induction of these responses. We have
      demonstrated recently that the Inv/Spa-secreted SopB and SopD effector proteins
      are translocated into eukaryotic cells via a Sip-dependent pathway and act in
      concert to mediate inflammation and fluid secretion in infected ileal mucosa.
      Mutations of both sopB and sopD significantly reduced, but did not abrogate, the
      enteropathogenic phenotype. This indicated that other virulence factors are
      involved in the induction of enteritis. In this work, we characterize SopA, a
      secreted protein belonging to the family of Sop effectors of Salmonella dublin.
      We demonstrate that SopA is translocated into eukaryotic cells and provide
      evidence suggesting that SopA has a role in the induction of enteritis.

PMID- 11207587
TI  - Enteropathogenic Escherichia coli dephosphorylates and dissociates occludin from
      intestinal epithelial tight junctions.
AB  - Enteropathogenic Escherichia coli (EPEC) increases tight junction permeability in
      part by phosphorylating the 20 kDa myosin light chain (MLC20) that induces
      cytoskeletal contraction. The impact of this enteric pathogen on specific tight
      junction (TJ) proteins has not been investigated. We examined the effect of EPEC
      infection on occludin localization and phosphorylation in intestinal epithelial
      cells. After infection by EPEC, a progressive shift of occludin from a primarily
      TJ-associated domain to an intracellular compartment occurred, as demonstrated by
      immunofluorescent staining. A reverse in the ratio of phosphorylated to
      dephosphorylated occludin accompanied this morphological change. Eradication of
      EPEC with gentamicin resulted in the normalization of occludin localization and
      phosphorylation. The serine/threonine phosphatase inhibitor, calyculin A,
      prevented these events. The EPEC-associated decrease in transepithelial
      electrical resistance, a measure of TJ barrier function, returned to baseline
      after gentamicin treatment. Non-pathogenic E. coli, K-12, did not induce these
      changes. Transformation of K-12 with the pathogenicity island of EPEC, however,
      conferred the phenotype of wild-type EPEC. Deletion of specific EPEC genes
      encoding proteins involved in EPEC type III secretion markedly attenuated these
      effects. These findings suggest that EPEC-induced alterations in occludin
      contribute to the pathophysiology associated with this infection.

PMID- 11207588
TI  - Chlamydial infection of polarized HeLa cells induces PMN chemotaxis but the
      cytokine profile varies between disseminating and non-disseminating strains.
AB  - While genital infections caused by Chlamydia trachomatis are generally
      asymptomatic, the density and pattern of inflammation varies considerably. The
      purpose of this study was to try to dissect the signalling in chlamydiae-infected
      epithelial cells that triggers innate responses and regulates polymorphonuclear
      neutrophil (PMN) chemotaxis. Polarized endocervical epithelial HeLa cells, grown
      in commercial inserts, were inoculated either with the non-disseminating
      (luminal) serovar E or the disseminating serovar L2. At 12-48 h after infection,
      the chambers were used in a quantitative chemotaxis assay, and cytokine
      production by infected cells was examined using cDNA microarray technology and
      confirmed by enzyme-linked immunosorbent assay (ELISA). Infection of HeLa cells
      with C. trachomatis E or L2 induced a strong and similar PMN chemotactic
      response, but larger amounts of interleukin (IL)-8 and IL-11 were released after
      infection with serovar L2. IL-6 was also produced in modest amounts after
      infection with either strain, but no IL-1alpha or tumour necrosis factor (TNF)
      alpha was detected in any of the culture supernatants tested. IL-11 did not
      appear to influence the PMN response to chlamydial infection, but secretion of
      large amounts of this anti-inflammatory cytokine, mainly active on macrophages,
      in the very early stages of the infection may allow C. trachomatis to escape some
      innate defences to establish infection.

PMID- 11207589
TI  - Constitutive PI3-K activity is essential for proliferation, but not survival, of
      Theileria parva-transformed B cells.
AB  - Theileria is an intracellular parasite that causes lymphoproliferative disorders
      in cattle, and infection of leucocytes induces a transformed phenotype similar to
      tumour cells, but the mechanisms by which the parasite induces this phenotype are
      not understood. Here, we show that infected B lymphocytes display constitutive
      phosphoinositide 3-kinase (PI3-K) activity, which appears to be necessary for
      proliferation, but not survival. Importantly, we demonstrate that one mechanism
      by which PI3-K mediates the proliferation of infected B lymphocytes is through
      the induction of a granulocyte-monocyte colony-stimulating factor (GM-CSF)
      dependent autocrine loop. PI3-K induction of GM-CSF appears to be at the
      transcriptional level and, consistently, we demonstrate that PI3-K is also
      involved in the constitutive induction of AP-1 and NF-kappaB, which characterizes
      Theileria-infected leucocytes. Taken together, our results highlight a novel
      strategy exploited by the intracellular parasite Theileria to induce continued
      proliferation of its host leucocyte.

PMID- 11207590
TI  - Cholera toxin and extracellular Ca2+ induce adherence of non-piliated Neisseria:
      evidence for an important role of G-proteins and Rho in the bacteria-cell
      interaction.
AB  - In this study, we characterize the interaction between non-piliated (P-)
      Neisseria gonorrhoeae and human epithelial cells. P- mutants lacking the pilus
      subunit protein PilE attach at low levels to cells. Although the binding may not
      lead to heavy inflammatory responses, the interaction between P- Neisseria and
      host cells most probably play a role in colonization and asymptomatic carriage of
      the pathogen. Here we show that the adherence of P N. gonorrhoeae is blocked by
      GDP-beta-S [guanosine 5'-O(thio)diphosphate], a non-hydrolyzable GTP analogue,
      and by C3 exotoxin, an inhibitor of the small G-protein Rho. G-protein activators
      such as cholera toxin, that activates Gs, and fluoroaluminate, a general G
      protein activator, induced bacterial adherence. Furthermore, increase of the
      extracellular free [Ca2+] dramatically enhanced adherence of non-piliated
      Neisseria. The pharynx and the urogenital tract are natural entry sites of the
      pathogenic Neisseria species, and at both sites the epithelial cells can be
      exposed to wide variations in Ca2+ concentration. Taken together, these data show
      the importance of extracellular Ca2+ in the pathogenic Neisseria-host
      interaction, and reveal a novel function of cholera toxin, namely induction of
      bacterial adherence.

PMID- 11207591
TI  - The microneme protein MIC3 of Toxoplasma gondii is a secretory adhesin that binds
      to both the surface of the host cells and the surface of the parasite.
AB  - Assay of the adhesion of cultured cells on Toxoplasma gondii tachyzoite protein
      Western blots identified a major adhesive protein, that migrated at 90 kDa in non
      reducing gels. This band comigrated with the previously described microneme
      protein MIC3. Cellular binding on Western blots was abolished by MIC3-specific
      monoclonal and polyclonal antibodies. The MIC3 protein affinity purified from
      tachyzoite lysates bound to the surface of putative host cells. In addition, T.
      gondii tachyzoites also bound to immobilized MIC3. Immunofluorescence analysis of
      T. gondii tachyzoite invasion showed that MIC3 was exocytosed and relocalized to
      the surface of the parasite during invasion. The cDNA encoding MIC3 and the
      corresponding gene have been cloned, allowing the determination of the complete
      coding sequence. The MIC3 sequence has been confirmed by affinity purification of
      the native protein and N-terminal sequencing. The deduced protein sequence
      contains five partially overlapping EGF-like domains and a chitin binding-like
      domain, which can be involved in protein-protein or protein-carbohydrate
      interactions. Taken together, these results suggest that MIC3 is a new microneme
      adhesin of T. gondii.

PMID- 11207592
TI  - Subversion of a young phagosome: the survival strategies of intracellular
      pathogens.

PMID- 11207593
TI  - Bacterial inhibition of phagocytosis.
AB  - The concerted study of molecular mechanisms of phagocytosis and the inhibition of
      phagocytosis by specific products of extracellular bacterial pathogens has borne
      considerable fruit. The importance of tyrosine phosphorylation and of the Rho
      family of GTPases has become clear to cell biologists, but pathogenic bacteria
      recognized the importance of these signalling pathways in phagocytic cells long
      ago. The discoveries described in this review are only the beginning. The
      simultaneous pursuit of the mechanisms and molecules involved in the initiation
      and regulation of phagocytosis and that pathogenic bacteria use to inhibit
      phagocytosis will surely identify more interesting pathways on each side of the
      contest. Are there any obvious possibilities? There are several bacterial factors
      that have the potential to inhibit known mechanisms of phagocytosis. Clostridium
      species, for example, make a number of exotoxins of interest. Clostridium
      botulinum and Clostridium tetani neurotoxins inactivate the regulated secretory
      machinery by proteolytic cleavage of SNARE proteins, and targets of tetanus toxin
      and botulinum b toxin inhibit the exocytotic delivery of membrane vesicles needed
      for phagocytosis of large particles (Hackam et al., 1998). Moreover, the C3
      exotoxin of C. botulinum catalyses ADP ribosylation and inactivation of rho
      family GTPases (Wiegers et al., 1991), and toxins A and B of C. difficile UDP
      glucosylate and inactivate rho GTPases and thereby disrupt the actin cytoskeleton
      (Just et al., 1995a,b). However, as Clostridia lack the machinery for type III
      secretion, these proteins are not rapidly targeted to the phagocyte cytoplasm.
      More searching may reveal a pathogen that has combined the type III secretory
      machinery with clostridia toxin-like substrates. A potentially unique strategy
      for remaining outside phagocytes is exhibited by Helicobacter pylori, which
      contain a type IV secretion system. Unopsonized virulent strains of H. pylori
      bind readily to macrophages but are only internalized after a delay of several
      minutes. Such a delay appears to be sufficient for the bacteria to remain
      extracellular (Allen et al., 2000). Elucidation of the mechanism used by H.
      pylori to delay phagocytosis may reveal one or more novel virulence factors as
      well as one or more novel targets in the phagocyte that will add to the
      understanding of a fundamental process in host defence. Another field ripe for
      further mechanistic investigation is complement receptor-mediated phagocytosis.
      Dedicated study of the molecular events and molecular mediators of phagocytosis
      downstream of CR3 is likely to reveal interesting differences from FcgammaR
      phagocytosis and is just as likely to reveal that microbes have discovered unique
      mechanisms for circumventing them. Study of extracellular pathogens and the
      mechanisms that they use to remain outside phagocytic cells has revealed a great
      deal about the initial encounter between pathogen and phagocyte. We can look
      forward to additional discoveries about the host-pathogen interactions and the
      mechanisms and factors that each side uses to battle against the other.

PMID- 11207594
TI  - Type III secretion systems: what is the translocator and what is translocated?

PMID- 11207595
TI  - Actin induction during PMA and cAMP-dependent signal pathway activation in
      Entamoeba histolytica trophozoites.
AB  - Activation of PKC or cAMP-dependent signalling pathways in Entamoeba histolytica
      triggers the phosphorylation of proteins involved in actin rearrangements
      necessary for adhesion and locomotion. Analogous motifs to SRE and CRE sequences-
      known to respond to PMA and cAMP--were identified within the 5' regulatory region
      (5'RR) of one of the parasite actin genes. These sequences could be involved in
      the actin transcriptional upregulation reported during signalling. To test this
      hypothesis, a plasmid containing the 5'RR of the actin gene fused to the
      bacterial neomycin gene (neo) was used for stable transfection. Expression of neo
      and endogenous actin was measured after stimulation of transfected amoebae by PMA
      and dcAMP. It was found that both compounds induced neo and actin expression and
      showed a co-operative effect in the induction of neo. Induction by PMA or dcAMP
      failed if the directing amoebic 5'RR lacked SRE and CRE motifs. Transfection of
      amoebae with plasmid constructs, containing either progressive deletions of the
      actin 5'RR or site-directed mutations of the SRE and CRE-like motifs,
      corroborated that these sequences and a co-ordinated participation of PKC- and
      PKA-activated transcription factors are responsible for the increments in neo and
      actin mRNAs. In vivo, these PMA and cAMP-response elements could play an
      important role in regulating actin expression and organization in signalling
      processes activated during tissue invasion.

PMID- 11207596
TI  - The Yersinia tyrosine phosphatase YopH targets a novel adhesion-regulated
      signalling complex in macrophages.
AB  - The Yersinia protein tyrosine phosphatase (PTP) YopH is translocated into
      eukaryotic cells by a type III secretion system that requires bacterial-host cell
      contact. YopH is composed of two modular effector domains: a substrate-binding
      domain located in the N-terminal region (residues 1-130) and a PTP catalytic
      domain located in the C-terminal region (residues 206-468). Previous studies have
      shown that YopH selectively targets tyrosine-phosphorylated proteins of
      approximate molecular weight 120 kDa (p120) and 55 kDa (p55) in murine
      macrophages. It has been demonstrated that p120 actually represents two tyrosine
      phosphorylated target proteins, Cas and Fyb. We used the substrate-binding domain
      of YopH to affinity purify tyrosine-phosphorylated target proteins from lysates
      of J774A.1 macrophages. Protein microsequencing identified p55 as murine SKAP
      HOM. Direct interaction between SKAP-HOM and a catalytically inactive form of
      YopH was demonstrated in vitro and in macrophages. In addition, we obtained
      evidence that SKAP-HOM is tyrosine phosphorylated in response to macrophage cell
      adhesion and that it forms a signalling complex with Fyb. We suggest that
      dephosphorylation of SKAP-HOM and Fyb by YopH allows yersiniae to interfere with
      a novel adhesion-regulated signal transduction pathway in macrophages.

PMID- 11207598
TI  - Interaction of Bartonella henselae with endothelial cells results in rapid
      bacterial rRNA synthesis and replication.
AB  - Bartonella henselae is a slow-growing microorganism and the causative pathogen of
      bacillary angiomatosis in man. Here, we analysed how interaction of B. henselae
      with endothelial cells might affect bacterial growth. For this purpose, bacterial
      rRNA production and ribosome content was determined by fluorescence in situ
      hybridization (FISH) using rRNA-targeted fluorescence-labelled oligonucleotide
      probes. B. henselae grown on agar plates showed no detectable rRNA content by
      means of FISH, whereas B. henselae co-cultured with endothelial cells showed a
      rapid increase of rRNA production within the first 18 h after inoculation. The
      increased rRNA synthesis was paralleled by a approximately 1000-fold
      intracellular bacterial replication, whereas bacteria grown on agar base showed
      only a approximately 10-fold replication within the first 48 h of culture.
      Pretreatment of host cells with paraformaldehyde prevented adhesion, invasion,
      intracellular replication and bacterial rRNA synthesis of B. henselae. In
      contrast, inhibition of host cell protein synthesis by cycloheximide did not
      affect bacterial adhesion and invasion, but prevented intracellular replication
      although bacterial rRNA content was increased. Inhibition of actin polymerization
      by cytochalasin D did not affect adhesion, invasion, increased rRNA content or
      intracellular replication of B. henselae. These results demonstrate that rRNA
      synthesis and replication of B. henselae is promoted by viable host cells with
      intact de novo protein synthesis.

PMID- 11207597
TI  - Macrophage subsets harbouring Leishmania donovani in spleens of infected BALB/c
      mice: localization and characterization.
AB  - The purpose of the current study was to characterize parasite-containing cells
      located in spleens of BALB/c mice infected with Leishmania donovani. In
      particular, expression of MHC class II molecules by these cells was examined to
      determine whether they could potentially act as cells capable of
      immunostimulating Leishmania-reactive CD4+ T lymphocytes. To this end, an
      immunohistological analysis of spleens taken at various time points after
      infection was undertaken. Using this approach, we observed, in the red pulp, the
      formation of small cellular infliltrates containing heavily infected macrophages
      that could be stained with the monoclonal antibodies MOMA-2 and FA/11. All of
      them expressed high levels of MHC class II molecules. Parasites were also
      detected in the white pulp, especially in MOMA-2+, FA/11+ and MHC class II+
      macrophages of the periarteriolar lymphocyte sheath and in MOMA-2+ marginal zone
      macrophages. Infected cells were further characterized by fluorescence microscopy
      after their enrichment by adherence. All infected mononuclear cells recovered by
      this procedure could be stained with MOMA-2 and FA/11 and thus very probably
      belonged to the mononuclear phagocyte lineage. Furthermore, all of them strongly
      expressed both MHC class II as well as H-2M molecules, regardless of the time
      points after infection. Analysis of the parasitophorous vacuoles (PV) by confocal
      microscopy showed that these compartments were surrounded by a membrane enriched
      in lysosomal glycoproteins lamp-1 and lamp-2, in macrosialin (a membrane protein
      of prelysosomes recognized by FA/11) and in MOMA-2 antigen. About 80% of the PV
      also had MHC class II and H-2M molecules on their membrane. Altogether, these
      data indicate that in the spleens of L. donovani-infected mice, a high percentage
      of amastigotes are located in macrophages expressing MHC class II molecules and
      that they live in PV exhibiting properties similar to those of PV detected in
      mouse bone marrow-derived macrophages exposed to a low dose of interferon gamma
      (IFN-gamma) and infected in vitro.

PMID- 11207599
TI  - The regulatory protein PhoP controls susceptibility to the host inflammatory
      response in Shigella flexneri.
AB  - The PhoP/PhoQ two-component regulatory system controls transcription of several
      key virulence genes essential for Salmonella survival in the host cell phagosome.
      Here, we determine that the PhoP/PhoQ system also regulates virulence in the
      aetiological agent of bacillary dysentery, Shigella flexneri, even though this
      pathogen escapes from the phagosome into the cytoplasm of the host cell. A phoP
      mutant of Shigella established infections and induced an acute inflammatory
      response in two different animal models. However, infections with phoP mutant
      bacteria were resolved more rapidly than infections with wild-type Shigella.
      Moreover, the Shigella phoP mutant was more sensitive than the wild-type strain
      to killing by polymorphonuclear leucocytes (PMNs), cationic polypeptides
      extracted from PMNs and other animal-derived antimicrobial peptides. The phoP
      mutant, however, invaded epithelial cells, spread intercellularly, induced
      apoptosis in macrophages and tolerated extreme acid pH as efficiently as the wild
      type strain. PhoP appears to regulate Shigella susceptibility to PMNs and
      antimicrobial molecules that are important for the late stages of infection with
      this enteric bacterium.

PMID- 11207600
TI  - Early Bacillus anthracis-macrophage interactions: intracellular survival survival
      and escape.
AB  - This study describes early intracellular events occurring during the
      establishment phase of Bacillus anthracis infections. Anthrax infections are
      initiated by dormant endospores gaining access to the mammalian host and becoming
      engulfed by regional macrophages (Mphi). During systemic anthrax, late stage
      events include vegetative growth in the blood to very high titres and the
      synthesis of the anthrax exotoxin complex, which causes disease symptoms and
      death. Experiments focus on the early events occurring during the first few hours
      of the B. anthracis infectious cycle, from endospore germination up to and
      including release of the vegetative cell from phagocytes. We found that newly
      vegetative bacilli escape from the phagocytic vesicles of cultured Mphi and
      replicate within the cytoplasm of these cells. Release from the Mphi occurs 4-6 h
      after endospore phagocytosis, timing that correlates with anthrax infection of
      test animals. Genetic analysis from this study indicates that the toxin plasmid
      pXO1 is required for release from the Mphi, whereas the capsule plasmid pXO2 is
      not. The transactivator atxA, located on pXO1, is also found to be essential for
      release, but the toxin genes themselves are not required. This suggests that Mphi
      release of anthrax bacilli is atxA regulated. The putative 'escape' genes may be
      located on the chromosome and/or on pXO1.

PMID- 11207601
TI  - The invasion protein InIB from Listeria monocytogenes activates PLC-gamma1
      downstream from PI 3-kinase.
AB  - Entry of the bacterial pathogen Listeria monocytogenes into non-phagocytic
      mammalian cells is mainly mediated by the InlB protein. Here we show that in the
      human epithelial cell line HEp-2, the invasion protein InlB activates
      sequentially a p85beta-p110 class I(A) PI 3-kinase and the phospholipase C-gamma1
      (PLC-gamma1) without detectable tyrosine phosphorylation of PLC-gamma1. Purified
      InlB stimulates association of PLC-gamma1 with one or more tyrosine
      phosphorylated proteins, followed by a transient increase in intracellular
      inositol 1,4,5-trisphosphate (IP3) levels and a release of intracellular Ca2+ in
      a PI 3-kinase-dependent manner. Infection of HEp-2 cells with wild-type L.
      monocytogenes bacteria also induces association of PLC-gamma1 with phosphotyrosyl
      proteins. This interaction is undetectable upon infection with a deltainlB mutant
      revealing an InlB specific signal. Interestingly, pharmacological or genetic
      inactivation of PLC-gamma1 does not significantly affect InlB-mediated bacterial
      uptake, suggesting that InlB-mediated PLC-gamma1 activation and calcium
      mobilization are involved in post-internalization steps.

PMID- 11207602
TI  - Surface-targeted lysosomal membrane glycoprotein-1 (Lamp-1) enhances lysosome
      exocytosis and cell invasion by Trypanosoma cruzi.
AB  - To gain entry into non-phagocytic cells, Trypanosoma cruzi trypomastigotes
      recruit lysosomes to the host cell surface. Lysosome fusion at the site of
      parasite entry leads to the formation of a parasitophorous vacuole with lysosomal
      properties. Here, we show that increased expression of the lysosomal membrane
      glycoprotein Lamp-1 at the cell surface renders CHO cells more susceptible to
      trypomastigote invasion in a microtubule-dependent fashion. Mutation of critical
      residues in the lysosome-targeting motif of Lamp-1 abolished the enhancement of
      T. cruzi invasion. This suggests that interactions dependent on Lamp-1
      cytoplasmic tail motifs, and not the surface-exposed luminal domain, modulate T.
      cruzi entry. Measurements of Ca2+-triggered exocytosis of lysosomes in these cell
      lines revealed an enhancement of beta-hexosaminidase release in cells expressing
      wild-type Lamp-1 on the plasma membrane; this effect was not observed in cell
      lines transfected with Lamp-1 cytoplasmic tail mutants. These results also
      implicate Ca2+-regulated lysosome exocytosis in cell invasion by T. cruzi and
      indicate a role for the Lamp-1 cytosolic domain in promoting more efficient
      fusion of lysosomes with the plasma membrane.

PMID- 11207603
TI  - Listeriolysin O-induced stimulation of mucin exocytosis in polarized intestinal
      mucin-secreting cells: evidence for toxin recognition of membrane-associated
      lipids and subsequent toxin internalization through caveolae.
AB  - Lysteriolysin O (LLO) induces a microtubule-dependent activation of mucin
      exocytosis in the human mucin-secreting HT29-MTX. Cholesterol inhibits the LLO
      induced mucin exocytosis, whereas the oxidized form of cholesterol had no
      inhibitory effect. LLO-induced mucin exocytosis inhibited by cholesterol can be
      restored by enzymatic treatment with cholesterol oxidase. Inhibition of
      cholesterol synthesis in HT29-MTX cells results in a decrease in the LLO-induced
      mucin exocytosis. Other lipids such as gangliosides are able to inhibit the LLO
      induced mucin exocytosis, suggesting that the binding of the toxin occurs at a
      multiplicity of membrane-associated lipids acting as receptors. Incubation of the
      toxin with lipids such as cholesterol or gangliosides does not decrease binding
      of LLO to target membranes. The present work also provides evidence that the LLO
      induced mucin exocytosis develops independently of the pore-forming activity of
      the toxin. Finally, we demonstrated that the toxin associates with detergent
      insoluble glycolipid microdomains (DIGs) containing VIP/21 caveolin, allowing
      internalization of the toxin and subsequent activation of the mucin exocytosis.

PMID- 11207604
TI  - The anaerobic pathogen Clostridium perfringens can escape the phagosome of
      macrophages under aerobic conditions.
AB  - Clostridium perfringens is the most common cause of gas gangrene (clostridial
      myonecrosis), a disease that begins when ischaemic tissues become contaminated
      with C. perfringens vegetative cells or spores. An aerotolerant anaerobe, C.
      perfringens quickly multiplies in ischaemic tissues and spreads to healthy areas,
      leading to a high level of morbidity and mortality. As a species, the bacterium
      can synthesize 13 different toxins, and these are thought to be the major
      virulence factors of the disease. However, we present evidence here that C.
      perfringens can also persist inside macrophages, under aerobic conditions, by
      escaping the phagosome into the cytoplasm. C. perfringens was not killed by the
      cells of a clone (J774-33) of the macrophage-like murine cell line J774A.1 under
      aerobic or anaerobic conditions, whereas the non-pathogenic bacterium Bacillus
      subtilis was killed by J774-33 cells under both conditions. Electron microscopy
      images showed that C. perfringens cells were intact and resided mostly in the
      cytoplasm of J774-33 cells, whereas B. subtilis was in the phagosome.
      Immunofluorescence microscopy showed that intracellular C. perfringens bacteria
      failed to co-localize with the late endosome-lysosomal marker glycoprotein LAMP
      1, whereas B. subtilis did co-localize with LAMP-1. C. perfringens also appeared
      to escape the phagosome of both activated and unactivated mouse peritoneal
      macrophages, but not as efficiently as was seen with the J774-33 cell line. In
      addition, cytochalasin D was used to show that phagocytosis of C. perfringens was
      dependent on actin polymerization and that the bacteria attach to J774-33 cells
      at distinct areas of the cell membrane. We propose that the ability to escape the
      phagosome and persist inside macrophages is an important factor in the early
      stages of a gangrene infection, when bacterial numbers are low and phagocytic
      cells are present.

PMID- 11207605
TI  - Co-operative binding of human fibronectin to Sfbl protein triggers streptococcal
      invasion into respiratory epithelial cells.
AB  - Streptococcal fibronectin binding protein I (SfbI) mediates adherence to and
      invasion of Streptococcus pyogenes into human epithelial cells. In this study, we
      analysed the binding activity of distinct domains of SfbI protein towards its
      ligand, the extracellular matrix component fibronectin, as well as the biological
      implication of the binding events during the infection process. By using purified
      recombinant SfbI derivatives as well as in vivo expressed SfbI domains on the
      surface of heterologous organism Streptococcus gordonii, we were able to
      dissociate the two major streptococcal target domains on the human fibronectin
      molecule. The SfbI repeat region exclusively bound to the 30 kDa N-terminal
      fragment of fibronectin, whereas the SfbI spacer region exclusively bound to the
      45 kDa collagen-binding fragment of fibronectin. In the case of native surface
      expressed SfbI protein, an induced fit mode of bacteria-fibronectin interaction
      was identified. We demonstrate that binding of the 30 kDa fibronectin fragment to
      the repeat region of SfbI protein co-operatively activates the adjacent SfbI
      spacer domain to bind the 45 kDa fibronectin fragment. The biological consequence
      arising from this novel mode of fibronectin targeting was analysed in eukaryotic
      cell invasion assays. The repeat region of SfbI protein is mediating adherence
      and constitutes a prerequisite for subsequent invasion, whereas the SfbI spacer
      domain efficiently triggers the invasion process of streptococci into the
      eukaryotic cell. Thus, we were able to dissect bacterial adhesion from invasion
      by manipulating one protein. SfbI protein therefore represents a highly evolved
      prokaryotic molecule that exploits the host factor fibronectin not only for
      extracellular targeting but also for its subsequent activation that leads to
      efficient cellular invasion.

PMID- 11207606
TI  - Monitoring phase-specific gene expression in Histoplasma capsulatum with
      telomeric GFP fusion plasmids.
AB  - Dimorphism is an essential feature of Histoplasma capsulatum pathogenesis, and
      much attention has been focused on characteristics that are unique to the
      saprophytic mycelial phase or the parasitic yeast phase. Recently, we identified
      a secreted calcium-binding protein, CBP, that is produced in large amounts by
      yeast cells but is undetectable in mycelial cultures. In this study, the green
      fluorescent protein (GFP) was established as a reporter in H. capsulatum to study
      regulation of CBP1 expression in cultures and in single cells grown under
      different conditions and inside macrophages. One GFP version that was optimized
      for human codon usage yielded highly fluorescent Histoplasma yeast cells. By
      monitoring GFP fluorescence during the transition from mycelia to yeast, we
      demonstrated that the CBP1 promoter is only fully active after complete
      morphological conversion to the yeast form, indicating for the first time that
      CBP1 is developmentally regulated rather than simply temperature regulated.
      Continuous activity of the CBP1 promoter during infection of macrophages supports
      the hypothesis that CBP secretion plays an important role for Histoplasma
      survival within the phagolysosome. Broth cultures of Histoplasma yeasts carrying
      a CBP-GFP protein fusion construct were able to secrete a full-length fluorescent
      fusion protein that remained localized within the phagolysosomes of infected
      macrophages. Additionally, a comparison of two Histoplasma strains carrying the
      CBP1 promoter fusion construct either epichromosomally or integrated into the
      chromosome revealed cell-to-cell variation in plasmid copy number due to uneven
      plasmid partitioning into daughter cells.

PMID- 11207607
TI  - CAS/Crk signalling mediates uptake of Yersinia into human epithelial cells.
AB  - Uptake of Yersinia pseudotuberculosis into mammalian cells involves engagement of
      beta1 integrin receptors by the bacterial protein invasin. This triggers a host
      response that involves tyrosine phosphorylation of proteins and the induction of
      actin rearrangements that lead to cellular uptake of bacteria. In this report, we
      show that the focal adhesion protein CAS plays an important role in Yersinia
      uptake, and that its function is linked to the phosphorylation-dependent
      interaction between CAS and Crk. These studies demonstrate that Yersinia binding
      to host cell receptors initiates a cascade of events involving tyrosine
      phosphorylation of CAS, subsequent formation of functional CAS-Crk complexes and
      the activity of the small GTP-binding protein Rac1. The delineation of this
      pathway lends support for a model in which Yersinia uptake into human epithelial
      cells is dependent upon aspects of host signalling pathways that govern actin
      cytoskeleton remodelling and cell migration.

PMID- 11207608
TI  - Mycobacterium avium enters intestinal epithelial cells through the apical
      membrane, but not by the basolateral surface, activates small GTPase Rho and,
      once within epithelial cells, expresses an invasive phenotype.
AB  - Mycobacterium avium is a common pathogen in AIDS patients that is primarily (but
      not exclusively) acquired through the gastrointestinal tract, leading to the
      development of bacteraemia and disseminated disease. To cause infection through
      the gut, binding and invasion of the intestinal epithelial barrier are required.
      To characterize this process further, we determined the cell surface(s)
      (basolateral vs. apical membrane) that M. avium interacts with in intestinal
      mucosal cells in vitro. The level of binding and invasion of both HT-29 and Caco
      2 intestinal cell monolayers by M. avium were similar when the assay was
      performed with control medium in the presence of Ca2+ (when only the apical
      surface was exposed), with Ca2+-depleted medium or with Ca2+-depleted medium + 1
      mM EGTA (exposure of both apical and basolateral membranes), suggesting that the
      bacterium enters the apical surface of the epithelial lining. These observations
      were confirmed by assays in a transwell system and by using fluorescent
      microscopy. Real-time video microscopy showed that M. avium entry was not
      associated with membrane ruffling and the use of pharmacological inhibitors of
      the small GTPases demonstrated that M. avium invasion is dependent on the
      activation of the small GTPases Rho, but not on Rac or Cdc42. Passage of M. avium
      through HT-29 cells led to a phenotypic change (intracellular growth; IG) that
      was associated with a significantly greater (between five- and ninefold) ability
      to bind to and invade new monolayers of epithelial cells or macrophages when
      compared with the invasion by M. avium grown on agar (extracellular growth; EG).
      IG phenotype invasion of HT-29 cells also takes place only by the apical surface.
      M. avium enters intestinal epithelial cells by the apical surface and, once
      within the cells, changes phenotype, becoming more invasive towards both
      macrophages and other epithelial cells.

PMID- 11207610
TI  - Targeting of an enteropathogenic Escherichia coli (EPEC) effector protein to host
      mitochondria.
AB  - Many Gram-negative pathogens use a type III secretion apparatus to deliver
      effector molecules into host cells to subvert cellular processes in favour of the
      pathogen. Enteropathogenic Escherichia coli (EPEC) uses such a system to deliver
      the Tir effector molecule into host cells. In this paper, we show that the gene
      upstream of tir, orf19, encodes an additional type III secreted effector protein.
      Orf19 is delivered into host cells by a mechanism independent of endocytosis, but
      dependent on EspB. Orf19 is targeted to host mitochondria, where it appears to
      interfere with the ability to maintain membrane potential. Although the precise
      role of Orf19 remains to be elucidated, its interaction with mitochondria
      suggests a possible role in the subversion of key functions of these organelles,
      such as energy production or control of cell death. This is the first example of
      a type III secreted protein targeted to mitochondria; it is probable that
      homologues (present in EPEC and Shigella species) and other bacterial effectors
      will also target this organelle.

PMID- 11207609
TI  - Cytoplasmic tail motifs mediate endoplasmic reticulum localization and export of
      transmembrane reporters in the protozoan parasite Toxoplasma gondii.
AB  - In mammalian cells and yeasts, amino acid motifs in the cytoplasmic tails of
      transmembrane proteins play a prominent role in protein targeting in the early
      secretory pathway by mediating localization to or rapid export from the
      endoplasmic reticulum (ER). However, early sorting events are poorly
      characterized in protozoan parasites. Here, we show that a C-terminal QKTT
      sequence mediates the ER localization of chimeric reporter constructs consisting
      of bacterial alkaline phosphatase (BAP) fused to the transmembrane domain (TMD)
      and truncated cytoplasmic tail of the human low-density lipoprotein receptor
      (LDL) receptor or of murine lysosome-associated membrane protein (lamp-1) in
      Toxoplasma gondii. The cytoplasmic tail of human TGN46 also determines ER
      localization of BAP chimeras in the parasite, but this can be overcome by the
      addition at the C-terminus of the tail of an acidic patch, which functions as an
      ER export signal in conjunction with an upstream tyrosine motif. These results
      suggest that COPI-dependent ER retrieval and COPII-dependent export mechanisms
      mediated by KKXX and DXE motifs of mammalian cells are generally conserved in T.
      gondii. In contrast, the failure of the QKTT motif and TGN46 cytoplasmic tail to
      induce steady-state ER localization of vesicular stomatitis virus glycoprotein
      (VSVG) chimeras in HeLa and NRK cells indicates that significant differences in
      early secretory trafficking also exist.

PMID- 11207611
TI  - The relapsing fever spirochaete, Borrelia crocidurae, activates human endothelial
      cells and promotes the transendothelial migration of neutrophils.
AB  - The blood-borne, erythrocyte-aggregating Borrelia crocidurae, the causative agent
      of African relapsing fever, have been shown to induce severe cellular lesions in
      mice. In this paper, we present the first report of how the endothelium is
      stimulated during an African relapsing fever B. crocidurae infection. B.
      crocidurae co-incubated with cultured human umbilical vein endothelial cells
      (HUVECs) activated endothelium in such way that E-selectin and intercellular
      adhesion molecule 1 (ICAM-1) became upregulated in a dose- and time-dependent
      fashion, as determined by a whole-cell enzyme-linked immunosorbent assay (ELISA).
      The upregulation was reduced by treatment that killed the bacteria, suggesting
      that viability is important for the stimulation of HUVECs by B. crocidurae.
      Furthermore, conditioned medium from HUVECs stimulated with B. crocidurae
      contained interleukin (IL)-8, which is a chemotactic agent for neutrophils.
      Activation of HUVECs by B. crocidurae resulted in migration of subsequently added
      neutrophils across the endothelial monolayers, and this migration was inhibited
      by antibodies to IL-8. The activation of endothelium by B. crocidurae may
      constitute a key pathophysiological mechanism in B. crocidurae-induced vascular
      damage.

PMID- 11207612
TI  - Functional role for the class IX myosin myr5 in epithelial cell infection by
      Shigella flexneri.
AB  - Efficient control of Shigella-induced, rho-dependent cytoskeletal rearrangements
      seems to be required to shape the delicate cellular structures associated with
      bacterial invasion of epithelial cells. We therefore studied a class IX myosin
      and rho antagonist, the GTPase-activating protein (GAP) myr5, for a potential
      role in the bacterial entry process. We show that myr5 is recruited into
      bacterial entry spots. The recruitment pattern resembled that of rhoC or ezrin,
      but not rhoA, rac or CDC42, while in vitro GAP activity of myr5 was similar for
      rhoA, B or C. Analysis of myr5 mutants suggested that GTPase- or ATP-binding
      activites are not required for Shigella-induced recruitment of this atypical
      myosin to the bacterial entry site. Functional studies revealed a potential dual
      role of the myosin functions and the GAP module of myr5 for bacterial
      internalization.

PMID- 11207613
TI  - Caspase 3-dependent killing of host cells by the parasite Entamoeba histolytica.
AB  - The parasite Entamoeba histolytica is named for its ability to lyse host tissues.
      To determine the factors responsible, we have initiated an examination of the
      contribution of parasite virulence factors and host caspases to cellular
      destruction by the parasite. Amoebic colitis in C3H/HeJ mice was associated with
      extensive host apoptosis at sites of E. histolytica invasion. In vitro studies of
      E. histolytica-Jurkat T-cell interactions demonstrated that apoptosis required
      contact via the amoebic Gal/GalNAc lectin, but was unaffected by 75% inhibition
      of the amoebic cysteine proteinases. Parasite-induced DNA fragmentation was
      unaffected in caspase 8-deficient Jurkat cells treated with the caspase 9
      inhibitor Ac-LEHD-fmk. In contrast, caspase 3-like activity was observed within
      minutes of E. histolytica contact and the caspase 3 inhibitor Ac-DEVD-CHO blocked
      Jurkat T cell death, as measured by both DNA fragmentation and 51Cr release.
      These data demonstrate rapid parasite-induced activation of caspase 3-like
      caspases, independent of the upstream caspases 8 and 9, which is required for
      host cell death.

PMID- 11207614
TI  - Host cell-derived sphingolipids are required for the intracellular growth of
      Chlamydia trachomatis.
AB  - Chlamydia trachomatis, an important cause of human disease, is an obligate
      intracellular bacterial pathogen that relies on the eukaryotic host cell for its
      replication. Recent reports have revealed that the C. trachomatis vacuole
      receives host-derived sphingolipids by fusing with trans-Golgi network
      (TGN)derived secretory vesicles. Here, it is shown that these lipids are required
      for the growth of the bacteria. C. trachomatis was unable to replicate at 39
      degrees C in the Chinese hamster ovary (CHO)-derived cell line SPB-1, a cell line
      incapable of synthesizing sphingolipids at this temperature because of a
      temperature-sensitive mutation in the serine palmitoyltransferase (SPT) gene.
      Complementation with the wild-type SPT gene or addition of exogenous cell
      permeable sphingolipid precursors to the mutant cells restored their ability to
      support chlamydial replication. L-cycloserine (L-CS) and fumonisin B1 (FB1),
      inhibitors of sphingolipid biosynthesis, decreased the proliferation of the
      bacteria in eukaryotic cells at concentrations that also decreased host cell
      sphingolipid synthesis. In the case of FB1, the vacuoles appeared aberrant; the
      addition of sphingolipid precursors was able to reverse the altered morphology of
      the FB1-treated vacuoles. Collectively, these data strongly suggest that the
      growth and replication of chlamydiae is dependent on synthesis of sphingolipids
      by the eukaryotic host cell and may contribute to this organism's obligate
      intracellular parasitism.

PMID- 11207615
TI  - The gastrointestinal ecosystem: a precarious alliance among epithelium, immunity
      and microbiota.
AB  - The gastrointestinal (GI) tract is a complex ecosystem generated by the alliance
      of GI epithelium, immune cells and resident microbiota. The three components of
      the GI ecosystem have co-evolved such that each relies on the presence of the
      other two components to achieve its normal function and activity. Experimental
      systems such as cell culture, germ-free animal models and intestinal isografts
      have demonstrated that each member of the GI ecosystem can follow a predetermined
      developmental pathway, even if isolated from the other components of the
      ecosystem. However, the presence of all three components is required for full
      physiological function. Genetic or functional alterations of any one component of
      this ecosystem can result in a broken alliance and subsequent GI pathology. A
      more detailed understanding of the interactions among microbiota, GI epithelium
      and the immune system should provide insight into multiple human disease states.

PMID- 11207616
TI  - Overexpression of cysteine proteinase 2 in Entamoeba histolytica or Entamoeba
      dispar increases amoeba-induced monolayer destruction in vitro but does not
      augment amoebic liver abscess formation in gerbils.
AB  - To study the role of cysteine proteinases in the pathogenicity of Entamoeba
      histolytica, we have attempted to overexpress the three main cysteine proteinases
      (EhCP1, EhCP2, EhCP5) of this parasite in trophozoites of E. histolytica as well
      as in non-pathogenic Entamoeba dispar by episomal transfection. Although each of
      the corresponding coding sequences were cloned in identical expression plasmids,
      we were unable to overexpress EhCP1 and EhCP5, respectively, but could
      substantially induce expression of EhCP2 in both amoeba species by sevenfold,
      leading to a threefold increase in total cysteine proteinase activity.
      Overexpression of EhCP2 did not influence expression of other cysteine
      proteinases and could be attributed to an increase of a single 35 kDa activity
      band in substrate gel electrophoresis. In contrast to previous findings, which
      indicated that amoeba cysteine proteinases are involved in erythrophagocytosis
      and liver abscess formation, cells overexpressing EhCP2 showed no difference in
      erythrophagocytosis or liver abscess formation compared with respective controls.
      However, overexpression of EhCP2 in both amoeba species resulted in a marked
      increase of in vitro monolayer destruction.

PMID- 11207617
TI  - Interaction of Helicobacter pylori with professional phagocytes: role of the cag
      pathogenicity island and translocation, phosphorylation and processing of CagA.
AB  - Chronic infection of the human gastric mucosa with Helicobacter pylori is a major
      cause of gastroduodenal pathologies, including peptic ulcerations, mucosa
      associated lymphoid tissue (MALT) lymphoma and adenocarcinoma. Helicobacter
      pylori strains carrying the cag pathogenicity island, which encodes an active
      type IV protein secretion system (cag+ or type I strains), are preferentially
      associated with strong gastric inflammation and severe disease. We show here that
      cag+ H. pylori strains use the type IV secretion system to inject the bacterial
      protein CagA into various types of professional phagocytes, including human
      polymorphonuclear leucocytes (PMNs) and the human and murine macrophage cell
      lines THP-1 and J774A.1 CagA is rapidly tyrosine phosphorylated and
      proteolytically processed to generate a stable 35-45 kDa C-terminally tyrosine
      phosphorylated protein fragment. H. pylori was efficiently ingested by the
      different types of phagocytic cells. A chromosomal deletion of the complete
      pathogenicity island had no significant effect on the rate of ingestion.
      Furthermore, the survival rate of H. pylori in the phagosome was unchanged
      between the wild type and a deletion mutant lacking the type IV secretion system.
      Thus, the type IV secretion system seems to be involved neither in active
      phagocytosis resistance nor in prolonged survival of the bacteria in phagocytic
      cells.

PMID- 11207618
TI  - Expression of pathogen-like Opa adhesins in commensal Neisseria: genetic and
      functional analysis.
AB  - Several species of commensal Neisseriae (Cn) may colonize the human nasopharynx,
      but little is known about their adhesion mechanisms. We have investigated
      structural and functional similarities between adhesins of Cn and of Neisseria
      meningitidis (Nm), also a frequent colonizer of the nasopharynx. In this study,
      we demonstrate the expression of Opa-like proteins in nine strains of Cn.
      Phylogenetic analysis segregated the majority of the Cn Opa in a cluster
      separated from the pathogenic cluster with a few exceptions. One Opa, which
      located within the pathogenic cluster, was strikingly similar (74%) to an Opa of
      a Neisseria gonorrhoeae (Ng) strain and, like Ng, it lacked the extra Y11 or the
      136DKF138 triplet insert, which are conserved among many N. meningitidis Opa
      proteins. Most importantly, the majority of the Cn Opa proteins were able to
      interact with human CEACAM1 (CD66a) molecules, previously identified as receptors
      for pathogenic Opa proteins. By the use of CEACAM1 N-domain mutants, we
      demonstrate that Cn Opa target the same region of the N-domain of the receptor as
      that used by Nm. Furthermore, Cn strains bound to cell-expressed human CEACAM1.
      In competition assays, adherent Cn strain C450, exhibiting high affinity for
      CEACAM1, was not displaced by a Nm isolate and vice versa. But in simultaneous
      incubation, Nm out-competed the Cn strain. This is the first study to demonstrate
      the expression of adhesins in Cn that are structurally and functionally closely
      related to pathogenic adhesins. The studies imply that some Cn have the potential
      to occupy and thus compete with the pathogens for receptors on human mucosa,
      their common and exclusive niche.

PMID- 11207619
TI  - Expression, activity and cytotoxicity of pertussis toxin S1 subunit in
      transfected mammalian cells.
AB  - Pertussis toxin (PT) comprises an active subunit (S1), which ADP-ribosylates the
      alpha subunit of several mammalian G proteins, and the B oligomer (S2-S5), which
      binds glycoconjugate receptors on cells. In a previous report, expression of S1
      in Cos cells resulted in no observable cytotoxicity, and it was hypothesized that
      either S1 failed to locate its target proteins or the B oligomer was also
      necessary for cytotoxicity. To address this, we stably transfected S1 with and
      without a signal peptide into mammalian cells. Immunofluorescence analysis
      confirmed the function of the signal peptide. Surprisingly, we found that S1 was
      active in both transfectants, as determined by clustering of transfected Chinese
      hamster ovary (CHO) cells and ADP-ribosylation of G proteins. Constructs with a
      cysteine-to-serine change at residue 201 or a truncated S1 (residues 1-181) were
      also active when transfected into cells. Constructs with an inactive mutant S1
      had no activity, confirming that the observed results were due to the activity of
      the toxin subunit. We conclude that S1 is active when expressed in mammalian
      cells without the B oligomer, that secretion into the endoplasmic reticulum does
      not prevent this activity and that the C-terminal portion of S1 is not required
      for its activity in cells.

PMID- 11207620
TI  - Genome ploidy in different stages of the Giardia lamblia life cycle.
AB  - The early diverging eukaryotic parasite Giardia lamblia is unusual in that it
      contains two apparently identical nuclei in the vegetative trophozoite stage. We
      have determined the nuclear and cellular genome ploidy of G. lamblia cells during
      all stages of the life cycle. During vegetative growth, the nuclei cycle between
      a diploid (2N) and tetraploid (4N) genome content and the cell, consequently,
      cycles between 4N and 8N. Stationary phase trophozoites arrest in the G2 phase
      with a ploidy of 8N (two nuclei, each with a 4N ploidy). On its way to cyst
      formation, a G1 trophozoite goes through two successive rounds of chromosome
      replication without an intervening cell division event. Fully differentiated
      cysts contain four nuclei, each with a ploidy of 4N, resulting in a cyst ploidy
      of 16N. The newly excysted cell, for which we suggest the term 'excyzoite',
      contains four nuclei (cellular ploidy 16N). In a reversal of the events occurring
      during encystation, the excyzoite divides twice to form four trophozoites
      containing two diploid nuclei each. The formation of multiple cells from a single
      cyst is likely to be one of the main reasons for the low infectious doses of G.
      lamblia.

PMID- 11207621
TI  - Gliding motility and cell invasion by Apicomplexa: insights from the Plasmodium
      sporozoite.
AB  - Apicomplexa constitute one of the largest phyla of protozoa. Most Apicomplexa,
      including those pathogenic to humans, are obligate intracellular parasites. Their
      extracellular forms, which are highly polarized and elongated cells, share two
      unique abilities: they glide on solid substrates without changing their shape and
      reach an intracellular compartment without active participation from the host
      cell. There is now ample ultrastructural evidence that these processes result
      from the backward movement of extracellular interactions along the
      anteroposterior axis of the parasite. Recent work in several Apicomplexa,
      including genetic studies in the Plasmodium sporozoite, has provided molecular
      support for this 'capping' model. It appears that the same machinery drives both
      gliding motility and host cell invasion. The cytoplasmic motor, a transmembrane
      bridge and surface ligands essential for cell invasion are conserved among the
      main apicomplexan pathogens.

PMID- 11207622
TI  - SifA permits survival and replication of Salmonella typhimurium in murine
      macrophages.
AB  - SifA was originally identified as a virulence factor required for formation of
      Salmonella-induced filaments (Sifs), elongated tubules rich in lysosomal
      glycoproteins that extend from the Salmonella-containing vacuole in infected
      epithelial cells. Here, we demonstrate that deletion mutants of ssaR, a component
      of the SPI-2 type III secretion system, do not form Sifs in HeLa epithelial
      cells. This suggests that SifA is a translocated effector of this system, acting
      within host cells to form Sifs. In support of this hypothesis, transfection of
      HeLa cells with a vector encoding SifA fused to the green fluorescent protein
      caused extensive vacuolation of LAMP-1-positive compartments. Filamentous tubules
      that closely resembled Sifs were also observed in transfected cells,
      demonstrating that SifA is sufficient to initiate alteration of host cell
      endosomal structures. deltasifA mutants were impaired in their ability to
      survive/replicate in RAW 264.7 murine macrophages, a phenotype similar to ssaR
      mutants. Our findings suggest that SifA is an effector of the SPI-2 type III
      secretion system and allows colonization of murine macrophages, the host niche
      exploited during systemic phases of disease in these animals. A family of SifA
      related proteins and their importance to Salmonella pathogenesis is also
      discussed.

PMID- 11207623
TI  - Rho GTPase activity modulates Pseudomonas aeruginosa internalization by
      epithelial cells.
AB  - The Gram-negative pathogen Pseudomonas aeruginosa invades epithelial cells in
      vivo and in vitro. We have examined the pathway(s) by which epithelial cells
      internalize P. aeruginosa strain PA103 using Madin-Darby canine kidney (MDCK)
      cells. We have recently demonstrated that P. aeruginosa internalization occurs by
      an actin-dependent Toxin B-inhibited pathway which becomes downregulated as
      epithelial cells become polarized, suggesting that one or more of the Rho family
      GTPases is involved in bacterial internalization. Here, we demonstrate that
      activation of the Rho family GTPases by cytotoxic necrotizing factor 1 (CNF-1)
      stimulates P. aeruginosa internalization. Examination of the roles of the
      individual Rho family GTPases in internalization shows that expression of a
      constitutively active allele of RhoA (RhoAV14), but not of constitutively active
      Rac1 (Rac1V12) or Cdc42 (Cdc42V12), is sufficient to increase uptake of
      PA103pscJ. This relative increase persists when bacterial infection is
      established at the basolateral surface of polarized cells, suggesting that the
      effect of RhoAV14 is not simply due to its known ability to disrupt tight
      junction integrity in polarized cells. RhoAV14-mediated stimulation of bacterial
      uptake is actin dependent as it is abrogated by exposure to latrunculin A. We
      also find that endogenous Rho GTP levels in epithelial cells are increased by
      infection with an internalized strain of P. aeruginosa; conversely, a poorly
      internalized isogenic strain expressing the bacterial anti-internalization
      protein ExoT causes decreased Rho GTP levels. Experimental inhibition of Rho,
      either by expressing dominant negative RhoAN19 or by inhibiting native Rho using
      a membrane permeable fusion construct of a Rho-specific inhibitor, C3 ADP
      ribosyltransferase, does not inhibit PA103pscJ internalization in MDCK or HeLa
      cells. Models consistent with these data are presented.

PMID- 11207624
TI  - Evidence that Dot-dependent and -independent factors isolate the Legionella
      pneumophila phagosome from the endocytic network in mouse macrophages.
AB  - Legionella pneumophila survives within macrophages by evading phagosome-lysosome
      fusion. To determine whether L. pneumophila resides in an intermediate endosomal
      compartment or is isolated from the endosomal pathway and to investigate what
      bacterial factors contribute to establishment of its vacuole, we applied a series
      of fluorescence microscopy assays. The majority of vacuoles, aged 2.5 min to 4 h
      containing post-exponential phase (PE) L. pneumophila, appeared to be separate
      from the endosomal pathway, as judged by the absence of transferrin receptor,
      LAMP-1, cathepsin D and each of four fluorescent probes used to label the
      endocytic pathway either before or after infection. In contrast, more than 70% of
      phagosomes that contained Escherichia coli, polystyrene beads, or exponential
      phase (E) L. pneumophila matured to phagolysosomes, as judged by co-localization
      with LAMP-1, cathepsin D and fluorescent endosomal probes. Surprisingly, neither
      bacterial viability nor the putative Dot/Icm transport complex was absolutely
      required for vacuole isolation; although phagosomes containing either formalin
      killed PE wild-type or live PE dotA or dotB mutant L. pneumophila rapidly
      accumulated LAMP-1, less than 20% acquired lysosomal cathepsin D or fluorescent
      endosomal probes. Therefore, a Dot-dependent factor(s) isolates the L.
      pneumophila phagosome from a LAMP-1-containing compartment, and a formalin
      resistant Dot-independent activity inhibits vacuolar accumulation of endocytosed
      material and delivery to the degradative lysosomes.

PMID- 11207625
TI  - Helicobacter pylori-mediated transcriptional regulation of the human beta
      defensin 2 gene requires NF-kappaB.
AB  - Human beta-defensin 2 (hBD-2) is an antimicrobial peptide involved in host
      defence against bacterial infection in epithelial tissues. Its levels are
      dramatically increased after bacterial infection. The involvement of NF-kappaB in
      Helicobacter pylori-mediated induction of hBD-2 promoter activity was examined. A
      luciferase reporter plasmid containing the hBD-2 promoter extending from -2110
      base pairs to -1 was transiently expressed in MKN45 cells, and promoter activity
      was determined after incubation with H. pylori for 6 h. Deletion or mutation of
      the NF-kappaB site at -208 abolished activation of the hBD-2 promoter. Only H.
      pylori strains carrying a cag pathogenicity island (PAI) induced activation of
      the NF-kappaB site of the hBD-2 promoter gene. By gel retardation analyses, H.
      pylori increased NF-kappaB binding to hBD-2 promoter gene sequences. Supershift
      analysis demonstrated that whereas H. pylori activated NF-kappaB p65-p65 and p50
      p50 homodimers, and the p65-p50 heterodimer of NF-kappaB, only the p65-p65
      homodimer bound to the NF-kappaB site of the hBD-2 promoter. Thus, specific NF
      kappaB proteins are important cis-elements for induction of hBD-2 gene
      transcription by H. pylori.

PMID- 11207626
TI  - Growth hormone and the heart.
AB  - Impaired cardiovascular function has recently been demonstrated to potentially
      reduce life expectancy both in GH deficiency and excess. Experimental and
      clinical studies have supported the evidence that GH and IGF-I are implicated in
      cardiac development. In most patients with acromegaly a specific cardiomyopathy,
      characterized by myocardial hypertrophy with interstitial fibrosis, lympho
      mononuclear infiltration and areas of monocyte necrosis, results in biventricular
      concentric hypertrophy. In contrast, patients with childhood or adulthood-onset
      GH deficiency (GHD) may suffer both from structural cardiac abnormalities, such
      as narrowing of cardiac walls, and functional impairment, that combine to reduce
      diastolic filling and impair left ventricular response to peak exercise. In
      addition, GHD patients may have an increase in vascular intima-media thickness
      and a higher occurrence of atheromatous plaques, that can further aggravate the
      haemodynamic conditions and contribute to increased cardiovascular and
      cerebrovascular risk. However, several lines of evidence have suggested that the
      cardiovascular abnormalities can be partially reversed by suppressing GH and IGF
      I levels in acromegaly or after GH replacement therapy in GHD patients. Recently,
      much attention has been focussed on the ability of GH to increase cardiac mass
      suggesting its possible use in the treatment of chronic nonendocrine heart
      failure. In fact, GH administration can induce an improvement in haemodynamic and
      clinical status in some patients. Although these data need to be confirmed in
      more extensive studies, such promising results seem to open new perspectives for
      GH treatment in humans.

PMID- 11207627
TI  - Hypertension, aortic dilatation and aortic dissection in Turner syndrome: a
      potentially lethal triad.

PMID- 11207628
TI  - Oestrogen replacement in young women with Turner's syndrome.

PMID- 11207629
TI  - Choosing an oestrogen replacement therapy in young adult women with Turner
      syndrome.
AB  - OBJECTIVE: Hormone replacement therapy (HRT) is prescribed to most patients with
      Turner syndrome (TS) although its use in adult TS patients has not been
      scientifically evaluated. The present study was performed to compare the short
      term effects in adult women with Turner syndrome of low-dose oral conjugated
      oestrogen (0.625 mg, CE) with relatively high dose ethinyl oestradiol (30 microg,
      EE2); both combined with an oral progestin. DESIGN AND PATIENTS: After 4 months
      off HRT, 17 young, otherwise healthy women with TS were enrolled in a random,
      unblinded, crossover study of the two oestrogenic preparations, each given for 6
      months. MEASUREMENTS: We compared parameters of oestrogenic activity that would
      cover immediate changes in hormone levels, biochemistry, bone turnover, uterine
      and cardiac variables, which constitute risk factors for later development of
      diabetes, atherosclerosis, osteoporosis and aortic dissection. RESULTS: Serum FSH
      returned to normal follicular phase levels only on the EE2 regimen. The
      hypotrophic endometria normalized with either of the two oestrogen regimens with
      no excessive hypertrophy. Hyperinsulinaemia was suppressed to normal by both EE2
      and CE. PTH and 1,25-dihydroxyvitamin D levels increased on HRT (EE2 > CE), and
      phosphorus decreased. Alkaline phosphatase, osteocalcin and urinary
      deoxypyridinoline cross-links (DPD) were high off therapy; the former two
      suppressed to high-normal levels on the EE2 regimen, but not on CE, and DPD did
      not normalize with either HRT. Lipid profiles in these young TS patients were
      normal. Liver enzymes were mildly elevated off therapy and suppressed to normal
      levels on both regimens, but more so with EE2. CONCLUSIONS: The risk factors
      embodied in hyperinsulinaemia and enhanced bone turnover which, ultimately, have
      consequences for TS morbidity, are minimized by HRT. In the short term, neither
      regimen is effective for bone turnover in adult women with Turner syndrome.

PMID- 11207630
TI  - Effects of peroral and transdermal oestrogen replacement therapy on glucose and
      insulin metabolism.
AB  - OBJECTIVE: Conflicting data have been reported previously on the effects of
      oestrogen replacement therapy on glucose tolerance, and the effects on
      glycosylated haemoglobin GHbA(1c) have been studied only among diabetics. The
      objective of this study was to evaluate the effects on glucose and insulin
      metabolism among nondiabetic women and to compare the outcomes of peroral and
      transdermal modes of administration. DESIGN: The effects of peroral oestradiol
      valerate 2 mg/day with placebo gel were compared to those of transdermal 17 beta
      oestradiol gel (1 mg oestradiol/day) and placebo tablets in a randomised, double
      blind, double-dummy study for six months. PATIENTS: Seventy-nine hysterectomised,
      nondiabetic postmenopausal women, 39 women in the peroral oestrogen group and 40
      in the gel group. MEASUREMENTS: Oral glucose tolerance tests (OGTT) with blood
      glucose, serum C-peptide and insulin determinations were performed. GHbA(1c), IGF
      I and IGFBP-1 were measured at baseline and after six months of therapy. In
      addition, insulin sensitivity and insulin secretion indices were obtained from
      OGTT. RESULTS: A small significant reduction in the GHbA(1c) concentration was
      observed during both peroral (P < 0.05) and transdermal oestrogen therapy (P <
      0.05). However, no effect on insulin sensitivity was observed. The response to a
      standard 75 g oral glucose load was similar in the study groups. Compared with
      the baseline values, the area under the curve for C-peptide decreased by 8% both
      in the peroral group (P < 0.05) and in the gel group (P < 0.01). The fasting and
      postchallenge glucose and insulin levels or insulin release indices were not
      significantly altered. Peroral oestrogen decreased IGF-I and increased IGFBP-1,
      but these findings were not associated with the changes in glucose metabolism.
      CONCLUSIONS: Neither peroral nor transdermal oestradiol replacement therapy
      seemed to induce any negative effects on glucose metabolism over a time period of
      6 months.

PMID- 11207631
TI  - Oestradiol improves arterial endothelial function in healthy men receiving
      testosterone.
AB  - OBJECTIVE: To assess prospectively the effects of low dose oestradiol on arterial
      endothelial and smooth muscle function in healthy men. Oestrogen use is
      associated with reduced cardiovascular disease in oestrogen-deficient women,
      however, the vascular effects of low-dose oestradiol in healthy men have not been
      investigated previously. PATIENTS AND DESIGN: Twenty-three men (aged 32 +/- 8
      years) were randomized to receive depot implants of testosterone (T) alone (group
      1, n = 10), or T with either 10 mg (group 2, n = 7) or 20 mg (group 3, n = 6) of
      oestradiol (E). MEASUREMENTS: Hormone levels, lipids and vascular reactivity were
      measured before, 1 month and 6 months after hormone implantation. Using high
      resolution ultrasound, brachial artery diameter was measured at rest, during
      reactive hyperaemia (leading to flow-mediated dilatation, FMD, which is
      endothelium-dependent) and after sublingual nitroglycerin (GTN, an endothelium
      independent dilator). RESULTS: Oestradiol produced a dose-dependent increase in
      plasma oestradiol (at 1 month 96 +/- 7, 149 +/- 6, 192 +/- 23 pmol/l in the 3
      groups, respectively, P < 0.001 by ANOVA for trend). Minor side-effects
      (gynaecomastia, nipple tenderness) indicated that 20 mg oestradiol was the
      maximum tolerated dose. There was also a dose-dependent increase in FMD with
      oestradiol dose: at 1 month, - 0.2, + 0.2 and + 1.8% for groups 1-3, respectively
      (P = 0.31 by ANOVA for trend); and at 6 months, - 0.8, + 0.4 and + 2.2% (P =
      0.02). The rise in oestradiol levels following treatment correlated with the
      improvement in FMD (P = 0.01). GTN responses were similar in the 3 groups
      throughout the study. CONCLUSION: In healthy young men, oestradiol
      supplementation is associated with enhanced arterial endothelial function, a key
      marker of vascular health.

PMID- 11207632
TI  - Hypogonadism in patients with acromegaly: data from the multi-centre acromegaly
      registry pilot study.
AB  - OBJECTIVE: Because acromegaly is an uncommon disorder, epidemiological data
      regarding the demographics of the disease such as the prevalence of hypogonadism
      have been limited. In order to derive clinical and epidemiological information,
      including underlying hormonal factors, regarding hypogonadism in patients with
      acromegaly, we performed a pilot study designed to develop a multi-centre
      acromegaly patient registry. DESIGN AND MEASUREMENTS: Medical records of patients
      with acromegaly seen between 1976 and 1996 at three Institutions were reviewed,
      and data were entered into a database using a secure internet website.
      Hypogonadism was defined as amenorrhoea in women and testosterone deficiency in
      men. Subanalysis was performed in patients with microadenomas and women less than
      50 years of age, to include women of reproductive age. RESULTS: Information was
      available on 363 patients, of whom 54% were women. The mean age at diagnosis was
      41 +/- 13 years. In subjects less than 50 years of age, hypogonadism was present
      in 59%. Hyperprolactinaemia was present in 45% and 21% of hypogonadal and
      eugonadal patients of reproductive age, respectively (P = 0.0003). GH levels were
      higher in patients with hypogonadism (P = 0.03). In patients < 50 years of age
      with microadenomas, hypogonadism was present in nine of the 22 (41%) patients,
      including 55% of the women and 27% of the men (P = ns). Hyperprolactinaemia was
      present in three of the 10 and four of the 14 of microadenoma patients with
      hypogonadism and eugonadism, respectively. CONCLUSION: We developed a web-based
      acromegaly patient registry and used it to show that hypogonadism is a frequent
      consequence of acromegaly, even in patients with microadenomas, who are not at
      risk from hypopituitarism due to local mass effects. We also demonstrated that
      prolactin and GH hypersecretion contribute to the pathogenesis of hypogonadism in
      acromegaly, and that hypogonadism may occur in microadenoma patients even in the
      absence of hyperprolactinaemia.

PMID- 11207633
TI  - Relationship between blood pressure and glucose tolerance in acromegaly.
AB  - BACKGROUND: Hypertension represents a well-known risk factor for cardiovascular
      diseases. The pathogenesis of hypertension in acromegaly is commonly viewed as
      multifactorial, but the possible influence of metabolic disorders on blood
      pressure (BP) in affected patients is largely unknown. OBJECTIVE: The aim of the
      present study was to evaluate the impact of glucose metabolism abnormalities on
      BP values in a series of patients with active acromegaly. DESIGN: An open
      multicentre prospective study. PATIENTS: Sixty-eight patients with active
      disease, aged 47.5 +/- 11.7 years, have been studied. Thirty-nine had normal
      glucose tolerance (NGT), 16 impaired glucose tolerance (IGT) and 13 suffered from
      diabetes mellitus (DM). MEASUREMENTS: Mean clinical BP values were calculated as
      the mean of BP values obtained by sphygmomanometric measurement in three separate
      occasions and mean 24-h, diurnal and nocturnal systolic (SBP) and diastolic (DBP)
      values were obtained by 24-h ambulatory blood pressure monitoring (ABPM).
      RESULTS: Patient's age and the degree of glucose tolerance abnormalities were
      found to significantly and independently influence BP values. All clinical and
      ABPM SBP and DBP values significantly increased with age by linear regression (P
      < 0.02 for all BP values, 0.30 < or = R < or = 0.43), and the independent
      influence of this parameter on BP values was confirmed by mutivariate analysis.
      Similarly, the independent influence of glucose tolerance abnormalities on BP
      values was confirmed when introducing age as a covariable in a multivariate
      analysis, and patients with DM presented significantly higher clinical SBP and 24
      h, diurnal and nocturnal SBP and DBP than patients with NGT (P < 0.02 for
      clinical SBP, P < 0.015 for all ABPM values, respectively). In addition, patients
      with DM showed significantly higher 24-h, diurnal and nocturnal DBP than those
      with IGT (P < 0.05 in all cases). In contrast, no significant difference was
      found between NGT and IGT patients. No significant influence of disease duration,
      BMI, GH, IGF-I, or fasting and 2-h post glucose load insulinaemia on BP values
      was observed. CONCLUSIONS: Abnormalities of glucose metabolism significantly
      contribute to increase systolic blood pressure and especially diastolic blood
      pressure in acromegalic patients. Careful control of blood pressure and of risk
      factors for developing systemic hypertension, with special reference to glucose
      tolerance, is mandatory to decrease cardiovascular morbidity and mortality in
      such patients.

PMID- 11207634
TI  - Determinants of changes in plasma homocysteine in hyperthyroidism and
      hypothyroidism.
AB  - OBJECTIVE: Hyperhomocysteinaemia is a risk factor for premature atherosclerotic
      vascular disease and venous thrombosis. The aim of the present study was to
      assess plasma total homocysteine (tHCys) concentrations in hypo- as well as
      hyperthyroid patients before and after treatment, and to evaluate the role of
      potential determinants of plasma tHCys levels in these patients. DESIGN:
      Prospective follow up study. PATIENTS: Fifty hypothyroid and 46 hyperthyroid
      patients were studied in the untreated state and again after restoration of
      euthyroidism. MEASUREMENTS: Fasting plasma levels of tHCys and its putative
      determinants (plasma levels of free thyroxine (fT4), folate, vitamin B(12), renal
      function, sex, age, smoking status and the C677T polymorphism in the
      methylenetetrahydrofolate reductase (MTHFR) gene were measured before and after
      treatment. RESULTS: Restoration of the euthyroid state decreased both tHCys (17.6
      +/- 10.2-13.0 +/- 4.7 micromol/l; P < 0.005) and creatinine (83.9 +/- 22.0-69.8
      +/- 14.2 micromol/l; P < 0.005) in hypothyroid patients and increased both tHCys
      (10.7 +/- 2.5-13.4 +/- 3.3 micromol/l; P < 0.005) and creatinine (49.0 +/- 15.4
      66.5 +/- 15.0 micromol/l; P < 0.005) in hyperthyroid patients (values as mean +/-
      SD). Folate levels were lower in the hypothyroid group compared to the
      hyperthyroid group (11.7 +/- 6.4 and 15.1 +/- 7.6 nmol/l; P < 0.05). Pretreatment
      tHCys levels correlated with log fT(4) (r = - 0.47), folate (r = - 0.21), plasma
      creatinine (r = 0.45) and age (r = 0.35) but not with C677T genotype.
      Multivariate analysis indicated that pretreatment log(fT(4)) levels and age
      accounted for 28% the variability of pre-treatment tHCys (tHCys = 14.2-5.50
      log(fT(4)) + 0.14 age). After treatment the logarithm of the change (Delta) in
      fT(4) (expressed as the post-treatment fT(4)/pre-treatment fT(4) ratio) accounted
      for 45% of the variability in change of tHCys ( tHCys = - 0.07-4.94 log (
      fT(4))); there was no independent contribution of changes in creatinine which
      was, however, strongly related to changes in tHCys (r = 0.61). CONCLUSIONS:
      Plasma tHCys concentrations increased in hypothyroidism and decreased in
      hyperthyroidism. Plasma fT(4) is an independent determinant of tHCys
      concentrations. Lower folate levels and a lower creatinine clearance in hypo
      thyroidism, and a higher creatinine clearance in hyperthyroidism only partially
      explain the changes in tHCys.

PMID- 11207635
TI  - The usefulness of quantitative orbital magnetic resonance imaging in Graves'
      ophthalmopathy.
AB  - BACKGROUND: Two-thirds of patients with Graves' ophthalmopathy (GO) respond to
      immunosuppressive treatment (prednisone or orbital irradiation), but one-third do
      not respond. Responders are likely to be in the active, oedematous stage of the
      eye disease, nonresponders in the inactive fibrotic stage. Clinical distinction
      between the two stages can be difficult. Quantitative magnetic resonance imaging
      (MRI) might be helpful in this respect, as T2 relaxation times are longer in
      oedematous than in fibrotic tissues. STUDY DESIGN: Prospective study on
      quantitative orbital MRI in healthy subjects and patients with moderately severe
      GO, evaluating T2 relaxation time of extraocular muscles (EOM): (a) in patients
      vs. controls, and (b) in patients, as a predictor of outcome to orbital
      irradiation. SUBJECTS AND MEASUREMENTS: Nine healthy volunteers and 64
      consecutive patients with moderately severe untreated GO, who were euthyroid for
      > or = 2 months and qualified for orbital irradiation. T2 relaxation times were
      measured at the site of the largest diameter in all eight EOM of each subject.
      Baseline T2 values in patients were related to outcome of radiotherapy, as
      assessed by an independent observer 6 months later according to predefined
      criteria. RESULTS: T2 relaxation times of the eight EOM were longer in GO
      patients than in controls: median [range] 126 [52--250] vs. 88 [50--126] msec; P
      = 0.003. Per subject the single eye muscle with the longest T2 time was selected
      to represent active inflammation (excluding the lateral muscles for technical
      reasons). Again patients were different from controls: 160 [68--250] vs. 103 [86-
      115] msec, P < 0.001. In the group of 34 responders to subsequent radiotherapy,
      these T2 times tended to be longer than in the 30 nonresponding patients: 168
      [108--250] vs. 138 [68--216] msec, P = 0.07. Using a cut-off value of 130 msec
      (derived from a receiver-operator-characteristics curve) a positive predictive
      value of 64% and a negative predictive value of 92% for the outcome of
      radiotherapy was calculated. CONCLUSION: Quantitative orbital magnetic resonance
      imaging was found to be less accurate in predicting successful outcome of
      radiotherapy than expected. It seems more useful in detecting the fibrotic end
      stage than the active stage of Graves' ophthalmopathy. It is therefore of limited
      use in the decision whether or not to apply immunosuppression in patients with
      moderately severe Graves' ophthalmopathy.

PMID- 11207636
TI  - Autoimmune polyendocrine syndrome type 1 (APS I) in Norway.
AB  - OBJECTIVE: The aim of the present study was to investigate Norwegian patients
      with autoimmune polyendocrine syndrome type I (APS I), with respect to occurrence
      and clinical presentation, reactivity towards different autoantigenes and
      mutations in the autoimmune regulator (AIRE) gene. PATIENTS: Twenty Norwegian
      patients from 15 families with APS I (11 males, nine females; mean age 26 years,
      range 4--54) were included by contacting all major hospitals in Norway. METHODS:
      Clinical data was collected from both patients and their physicians by the use of
      questionnaires and patient records. Autoantibodies were analysed using
      radioimmunoassays based on antigen synthesized by in vitro transcription and
      translation. AIRE mutations were determined by DNA sequence analysis. RESULTS:
      The prevalence of APS I in Norway was estimated to be about 1 : 80,000
      individuals. We found about the same distribution of disease characteristics as
      has been reported in Finnish patients. The diagnosis was delayed in many
      individuals. In two thirds of the cases, the patients were admitted in Hospital
      with acute adrenal insufficiency or hypocalcaemic crisis. Forty percent of these
      patients already had one of the main disease manifestations. Four different
      mutations in the AIRE gene were found in the Norwegian cohort. A 13-bp deletion
      in exon 8 (1085--1097(del)) was the most frequent mutation, present in 22/40
      (55%) of the alleles. Eighty-five percent of the patients had either
      autoantibodies against 21 hydroxylase or aromatic L-amino acid decarboxylase.
      Five of eight women (age > 13 years) had ovarian failure, and all of these had
      antibodies against side-chain cleavage enzyme (P = 0.0002). CONCLUSION: Norwegian
      patients with APS I clinically resemble patients from Finland and other European
      countries. The diagnosis APS I must be considered in children and adolescents
      with chronic mucocutaneous candidiasis, autoimmune adrenocortical failure or
      hypoparathyroidism in order to avoid fatal complications. Analysis of
      autoantibodies and mutational analysis of the AIRE gene are valuable diagnostic
      tools, especially in the early stages of the disease.

PMID- 11207637
TI  - Effect of vitamin K and/or D on undercarboxylated and intact osteocalcin in
      osteoporotic patients with vertebral or hip fractures.
AB  - OBJECTIVE: To examine serum undercarboxylated osteocalcin (OC) with application
      of an ELISA in normal women and in osteoporotic patients with vertebral fractures
      or hip fractures, and to investigate the effects of vitamin K and/or D treatment
      on undercarboxylated OC and intact OC in vertebral fractures. PATIENTS: They were
      43 premenopausal (PRE) and 48 postmenopausal healthy females (POST), 89
      osteoporotic patients with vertebral fractures (VX) and, 24 patients with hip
      fracture (HX). MEASUREMENTS: Intact OC was measured by an IRMA and
      undercarboxylated OC was measured by an ELISA. RESULTS: Intact osteocalcin was
      significantly higher in POST and VX than in PRE, and was significantly lower in
      HX than in POST and VX. Undercarboxylated OC tended to be higher in POST, VX and
      HX than in PRE, but not significantly. The ratio of undercarboxylated OC to
      intact OC was significantly higher in HX than in POST and in VX. After 4 weeks
      treatment with K, D, and K + D to 56 VX, undercarboxylated OC decreased
      significantly in the groups with K and K + D. Intact OC tended to increase
      slightly in the groups given K, D, K + D, but not significantly so. Vitamin K and
      vitamin K + D markedly decreased the ratio of undercarboxylated/intact OC to
      approximately 80%. On the other hand, vitamin D did not decrease that ratio.
      CONCLUSIONS: There was a disproportion of undercarboxylated osteocalcin to intact
      osteocalcin between postmenopausal women and osteoporotic patients with vertebral
      fractures or hip fractures. Vitamin K did decrease undercarboxylated osteocalcin,
      vitamin D did not change undercarboxylated osteocalcin, and vitamin D did not
      enhance the effect of vitamin K on undercarboxylated osteocalcin.

PMID- 11207638
TI  - Serum leptin levels are higher but are not independently associated with severity
      or mortality in the multiple organ dysfunction/systemic inflammatory response
      syndrome: a matched case control and a longitudinal study.
AB  - OBJECTIVE: Hypercatabolism and immune dysfunction are closely associated with the
      development of systemic inflammatory response--multiple organ dysfunction
      (SIRS/MODS) in critical illness. It remains unclear however, whether leptin, an
      adipocyte-derived hormone whose levels are influenced by several cytokines and
      which regulates immune function, food-intake and energy expenditure is
      independently related to the development of and/or severity and mortality from
      SIRS/MODS. DESIGN AND PATIENTS: To assess the role of leptin in SIRS/MODS we
      performed a matched case control and a longitudinal study (14 days) in 35
      critically ill patients with SIRS/MODS and 35 matched controls. RESULTS: Baseline
      leptin levels were positively associated with body mass index (BMI) and TNF-alpha
      (P < 0.01) in patients and with IGF-1 and IL-6 levels (P < 0.05) in controls.
      Furthermore, leptin levels exhibited a progressive increase from the first to the
      last day of the study and although baseline levels were not different, peak
      leptin levels as well as leptin levels on the last day of the study were
      significantly higher in cases than in controls (P < 0.05). TNF-alpha levels, IL-6
      and cortisol levels were also higher, whereas IGF-1 levels were lower in cases (P
      < 0.05). To assess whether leptin levels are independently associated with
      SIRS/MODS we performed multivariate logistic regression analysis which revealed
      that leptin up-regulation in cases is mediated by elevated TNF-alpha and cortisol
      levels. Finally, there was no independent association between leptin and survival
      in this group of critically ill patients. CONCLUSION: We conclude that cytokines
      and cortisol upregulate leptin levels, which may contribute to the development of
      the hypercatabolism, wasting and immune dysfunction but leptin levels are not
      independently associated with severity or mortality of patients with systemic
      inflammatory response-multiple organ dysfunction.

PMID- 11207639
TI  - Growth restriction in dexamethasone-treated preterm infants may be mediated by
      reduced IGF-I and IGFBP-3 plasma concentrations.
AB  - OBJECTIVE: Preterm infants receiving dexamethasone for respiratory morbidity
      frequently suffer restricted growth. The aim of this study was to investigate the
      interactions between dexamethasone treatment regimen and circulating IGFBP-3 and
      IGF-I levels, and the associations between these variables and linear growth rate
      in preterm babies receiving dexamethasone for chronic lung disease of
      prematurity. DESIGN: A randomised, unblinded, clinical trial of two different
      courses of dexamethasone: a 42-day tapering course (the long course) and a
      repeatable 3 day pulse course. PATIENTS: Forty preterm infants (19 in the pulse
      group, 21 in the long group) with a birthweight < or = 1250 g who were ventilated
      at 7 days of age. MEASUREMENTS: Lower leg length was measured thrice weekly by
      knemometry, and IGFBP-3 and IGF-I levels were measured prior to commencing
      treatment, at 14 and 42 days of treatment and at 36 weeks postmenstrual age
      (PMA). Interactions between variables were analysed by stepwise regression
      analysis and analysis of covariance (ANCOVA). Associations between variables were
      assessed by correlation coefficients. RESULTS: In an ANCOVA, mean daily dose of
      dexamethasone/kg (MDDD) and treatment group both significantly influenced IGFBP-3
      levels (P = 0.0009 and P = 0.017, respectively), and tended to influence IGF-I
      levels similarly (P = 0.098 and P = 0.07). MDDD also significantly influenced
      mean daily increase in lower leg length (MDILL; P < 0.01). IGFBP-3 and IGF-I
      levels were significantly related to MDILL (ANCOVA: P < 0.01). The correlation
      coefficients for IGFBP-3 and IGF-I levels and MDILL were 0.2 and 0.3 (both P <
      0.0001), respectively. IGFBP-3 and IGF-I levels were highly correlated (r(2) =
      0.52, P < 0.0001) and both increased significantly with increasing PMA (P <
      0.0001). IGF-I levels were higher in females (P = 0.036). CONCLUSION: This study
      provides evidence that the growth-restricting effects of dexamethasone may be
      mediated, at least in part, via suppression of the IGF axis. Both dexamethasone
      dose and treatment regimen influence circulating IGF-I and IGFBP-3 levels, and
      both are important in inducing growth restriction.

PMID- 11207640
TI  - Carbohydrate metabolism during long-term growth hormone treatment in children
      with short stature born small for gestational age.
AB  - OBJECTIVE: To assess possible side-effects of long-term continuous growth hormone
      (GH) treatment on carbohydrate (CH) metabolism in children with short stature
      born small for gestational age. DESIGN: In a prospective, randomised double
      blind, dose-response multicentre trial, the effect of GH treatment on CH
      metabolism was evaluated, comparing two GH dosages [3 vs. 6 IU/(m(2) body
      surface.day)]. PATIENTS: Seventy-eight children with short stature (height SD
      score < - 1.88) born small for gestational age (birth length SD-score < - 1.88)
      being all prepubertal with a mean (SD) chronological age of 7.3 (2.2) years
      before start of treatment. MEASUREMENTS: Glucose and insulin concentrations
      during oral glucose tolerance tests (OGTTs) and glycosylated haemoglobin
      (HbA(1c)) were measured before and during 6 years of GH treatment. RESULTS:
      Before treatment, the glucose response to oral glucose after 120 min was in six
      of the 78 children (8%) above 7.8 mmol/l but below 11.1 mmol/l, indicating
      impaired glucose tolerance (IGT), whereas after 6 years of GH treatment, IGT was
      found in 4% of the children. None of the children developed diabetes mellitus.
      Mean fasting glucose levels had increased significantly by 0.5 mmol/l after 1
      year of GH treatment, without a further increase thereafter. The 2-h area under
      the curve adjusted for fasting levels (AUCab) for glucose and the HbA(1c) levels
      were lower after 6 years of GH treatment compared to baseline. During GH
      treatment, all HbA(1c) levels were in the normal range. In contrast to the
      effects on glucose levels, GH treatment induced considerably higher fasting
      insulin levels and glucose-stimulated insulin levels. The increase in AUCab for
      insulin occurred particularly during the first year of treatment, whereas the
      fasting insulin levels showed a further increase from one to six years. As a
      result, the 30- and 120-min ratios of insulin to glucose were higher during GH
      treatment compared to the start of treatment. The children who remained
      prepubertal during the entire study period showed similar patterns in glucose and
      insulin levels compared to the children who entered puberty. None of the observed
      changes were different between the GH dosage groups. CONCLUSIONS: Continuous GH
      treatment during 6 years in children with short stature born small for
      gestational age has no adverse effects on glucose levels, even with dosages up to
      6 IU/(m(2) d). However, as has been reported in other patient groups, GH
      treatment induces higher fasting insulin levels and glucose-stimulated insulin
      levels, indicating relative insulin resistance. Since the consequences of long
      term hyperinsulinism during childhood are unknown, careful follow-up of these GH
      treated children born small for gestational age is required.

PMID- 11207641
TI  - Novel application of IGF-I and IGFBP-3 generation tests in the diagnosis of
      growth hormone axis disturbances in children with beta-thalassaemia.
AB  - OBJECTIVE: Children with beta-thalassaemia major (beta-thal) frequently have
      growth retardation in the presence of low serum IGF-I and a normal GH response to
      pharmacological stimulation suggesting that they have GH insensitivity (GHIS).
      This study was carried out to study the cause of their growth retardation.
      DESIGN: We studied IGF-I and IGFBP-3 generation after exogenous GH administration
      for four days, in 15 prepubertal controls (C) and 41 prepubertal beta-thal
      patients divided into three groups according to their growth status: (Group 1) 15
      with normal growth (N-thal) (Group 2) 16 with decelerated growth (D-thal) and
      (Group 3) 10 with short stature (S-thal), in order to determine whether GHIS is
      the cause of their growth retardation. MEASUREMENTS: IGF-I and IGFBP-3 were
      measured daily, before and for 4 days after daily administration of 0.1 IU/kg
      hGH, in 3 groups of prepubertal beta-thal patients and normal controls. RESULTS:
      N-thal and C had similar basal serum IGF-I (142 +/- 52 and 196 +/- 56 ng/ml,
      respectively) and IGFBP-3 concentrations (2.07 +/- 0.49 and 2.66 +/- 0.41 mg/l,
      respectively) as well as a similar percent increase of IGF-I (101 +/- 23% and 104
      +/- 37%, respectively) and IGFBP-3 (52 +/- 36%, and 38 +/- 14%, respectively)
      during the generation tests. S-thal and D-thal had significantly lower basal IGF
      I and IGFBP-3 concentrations (85 +/- 42 and 101 +/- 36 ng/ml; and 1.60 +/- 0.49
      and 1.79 +/- 0.52 mg/l, respectively) as compared to N-thal and C (P < 0.001 and
      P < 0.005, respectively), and a significantly higher percent increase of IGF-I
      and IGFBP-3 during the generation tests (249 +/- 43 and 161 +/- 76%; and 121 +/-
      99 and 73 +/- 35%, respectively) as compared to N-thal and C (P < 0.0001 and P <
      0.01, respectively). Twenty-five percent of the growth retarded patients had
      classic GH deficiency (GHD) and percent increases of IGF-I and IGFBP-3 in the
      generation tests (164 +/- 86% and 80 +/- 49%, respectively) which were similar to
      those of the remaining growth-retarded children. CONCLUSION: The greater percent
      increases of IGF-I and IGFBP-3 in the generation tests of the growth retarded
      beta-thal patients, both with and without GHD, strongly suggest impaired GH
      secretion rather than GHIS as the cause of their growth retardation. We conclude
      that the IGF-I and IGFBP-3 generation tests are useful tools for the study not
      only of GHIS but also of GH secretory disorders in patients with beta-thal and
      short stature that can easily be performed in an outpatient setting as an initial
      test to identify the patients that may benefit from GH therapy.

PMID- 11207642
TI  - Effect of exogenous melatonin on vascular reactivity and nitric oxide in
      postmenopausal women: role of hormone replacement therapy.
AB  - OBJECTIVE: Several effects of melatonin are modulated by gonadal steroids and are
      reduced in ageing women. Administration of melatonin reduces internal carotid
      artery pulsatility index (PI), and blood pressure in young individuals. Whether
      these effects are conserved in postmenopausal women and are influenced by hormone
      replacement therapy (HRT), was herein investigated. DESIGN: Randomised, double
      blind placebo controlled study. PATIENTS: Twenty-three postmenopausal women of
      which 11 were unreplaced with HRT and 12 on the oestrogenic phase of continuous
      transdermal estradiol (50 microg/day) plus cyclic medroxyprogesterone acetate (5
      mg/day x 12 days every 28 days). MEASUREMENTS: Internal carotid PI, by colour
      Doppler, and supine blood pressure were evaluated 90, 180 and 240 minutes
      following the oral administration of melatonin (1 mg) or placebo. Levels of
      nitrites/nitrates (NOx), the stable derivatives of nitric oxide, were also
      evaluated in samples collected 90 minutes following the administration of placebo
      or melatonin. RESULTS: In women not on replacement therapy melatonin was
      ineffective. In HRT-treated women, melatonin reduced internal carotid artery PI
      (P = 0.005). The effect was maximal within 90 minutes, and maintained for at
      least 240 minutes, with melatonin levels in the nocturnal physiological range.
      Systolic and diastolic blood pressures were reduced of 8 mmHg (P = 0.038) and 4
      mmHg (P = 0.045), respectively, while NOx levels were significantly increased (P
      = 0.024). CONCLUSIONS: The circulatory response to melatonin is conserved in
      postmenopausal women with but not without hormone replacement therapy.
      Maintenance of the cardiovascular response to melatonin, may be implicated in the
      reduced cardiovascular risk of postmenopausal women with hormone replacement
      therapy.

PMID- 11207643
TI  - Hydrocortisone replacement dosage influences intraocular pressure in patients
      with primary and secondary hypocortisolism.
AB  - BACKGROUND: It has been suggested that the variation of intraocular pressure
      (IOP) during the day follows the diurnal variation of serum cortisol. There is
      also a higher risk of ocular hypertension and glaucoma in patients taking
      excessive oral steroid treatment. We assessed whether different replacement doses
      of hydrocortisone (HC) influenced IOP. METHODS: Seventeen patients (six Addison's
      disease, 11 hypopituitarism; seven males) aged 24-58 years mean 42.7 years and 20
      control subjects (nine males) aged 20--59 years mean 38.7 years were studied. On
      the first visit, the 17 patients had been taking HC replacement doses, 20 mg
      morning and 10 mg afternoon. Serum cortisol and IOP in both eyes (Goldmann
      applanation tonometer) were measured at 0900, 1100, 1300, 1500, 1700 hours with
      HC 20 mg taken after the 0900 h assessment. The dose of HC was then reduced to 10
      mg morning and 10 mg afternoon for 1 week and the measurements were repeated in
      16 patients, with HC 10 mg taken at 0900 h. RESULTS: In the patients the peak
      serum cortisol occurred at 1100 h after the 0900 h HC dose. Cortisol levels were
      significantly higher at 1100, 1300, 1500 and 1700 h after taking 20 mg compared
      to 10 mg HC. The mean (SEM) IOP (mmHg) was significantly higher after 20 mg HC
      compared with 10 mg HC at 1300 h: 14.7(0.6) v 13.1(0.6) (P = 0.004) and at 1500
      h: 14.4(0.6) v 13.1(0.5) (P = 0.04). The total mean (SEM) daily IOP score was
      significantly higher after 20 mg HC compared with 10 mg HC: 14.5(0.3) v 13.5(0.3)
      (P = 0.0002). The total mean (SEM) daily IOP score after the 20 mg HC dose
      compared with the control subjects was: 14.5(0.3) v 13.7(0.3) (P = 0.08).
      CONCLUSION: Intraocular pressures during the day are influenced by the morning
      hydrocortisone replacement dosage with significantly higher intraocular pressure
      levels in the early afternoon following 20 mg compared with 10 mg. A morning
      hydrocortisone dose of 10 mg leads to a more physiological intraocular pressure
      profile during the day. These data support the view that a daily replacement dose
      of 30 mg hydrocortisone may be excessive.

PMID- 11207644
TI  - Panhypopituitarism associated with severe retroperitoneal fibrosis.
AB  - A 43-year-old man, with a history of central diabetes insipidus diagnosed 3 years
      previously, complained about reduced libido. An MRI scan showed a suprasellar
      lesion just below the supraoptic recess of the third ventricle. A
      stereotactically guided biopsy revealed fibrous glia, but no other specific
      tissue and no inflammatory cells. Two months later the patient presented with
      fatigue and muscular weakness. Tertiary adrenal failure and hypothyroidism were
      diagnosed by endocrine function tests and therapy with levothyroxine and
      hydrocortisone was started. Another 2 months later the patient was admitted with
      giddiness, nausea, peripheral oedema and oliguria. Radiological imaging and an
      open transperitoneal kidney exploration showed severe fibrosis around both
      ureters. Histological examination confirmed the diagnosis of idiopathic
      retroperitoneal fibrosis. Presumably the suprasellar tumour was the first
      manifestation of retroperitoneal fibrosis. Once the diagnosis 'idiopathic
      retroperitoneal fibrosis' is confirmed, fibrotic manifestations and complications
      involving extra-retroperitoneal tissues including the endocrine system, should be
      sought.

PMID- 11207645
TI  - Recurrent ACTH-independent Cushing's syndrome in multiple pregnancies and its
      treatment with metyrapone.
AB  - A 17-year-old primigravid woman presented with Cushing's syndrome. Typical
      clinical symptoms and signs developed at the beginning of pregnancy. By week 17
      of gestation, plasma cortisol diurnal rhythm was absent and there was a
      paradoxical increase in plasma cortisol after a 1-mg dexamethasone overnight
      suppression test. Basal urinary free cortisol was 10 times above the upper limit
      (in pregnancy) and ACTH levels were suppressed. The diagnosis of ACTH-
      independent Cushing's syndrome was established. MRI scans revealed normal adrenal
      and pituitary glands. To control hypercortisolism, the patient was treated with
      metyrapone. At 34 weeks of gestation, the patient developed preeclampsia and
      underwent caesarean section. A female infant weighing 1070 g was delivered. No
      apparent metyrapone-induced teratogenic effects were observed. Cushing's syndrome
      in the patient resolved within three weeks of delivery. No corticosteroid
      replacement therapy either for child or mother was needed. Eight months after
      delivery the patient became pregnant again and rapidly developed Cushing's
      syndrome with typical clinical symptoms and signs and laboratory results (urinary
      free cortisol 6464 nmol/24 h). This second pregnancy was unwanted and terminated
      by artificial abortion that was followed by rapid resolution of hypercortisolism.
      A third pregnancy, 12 months after delivery was also accompanied by the rapid
      development of hypercortisolism which recovered after artificial termination. The
      mechanisms by which pregnancy-induced Cushing's syndrome occurred in this patient
      are unclear. Aberrant responsiveness or hyperresponsiveness of adrenocortical
      cells to a non-ACTH and non-CRH substance produced in excess in pregnancy should
      be considered. Metyrapone suppression of hypercortisolism currently represents
      the best treatment for these rare cases.

PMID- 11207646
TI  - Apoptosis signals in atopy and asthma measured with cDNA arrays.
AB  - A variety of studies have stressed the importance of the control of inflammatory
      cell longevity and the balance of pro-survival and pro-apoptotic signalling.
      Recently, asthma was found to be associated with reduced apoptosis of
      inflammatory cells in lung tissue. The aim of the study was to investigate the
      systemic activation of apoptosis pathways using cDNA array technology in atopy
      and asthma. Eighteen atopic asthmatics (AA), eight atopic non-asthmatic (AN) and
      14 healthy control subjects (C) were included in the study. Peripheral blood
      mononuclear cells were separated with gradient centrifugation, mRNA purified and
      the reverse-transcribed probes hybridized to cDNA arrays. The signals were
      compared by standardizing to the 100 most expressed genes and group differences
      assessed with the Mann-Whitney U-test. We found a concerted up-regulation of
      several pro-survival cytokines and growth factors in AN and AA. FAS and FASL were
      not differentially expressed, but FAST kinase was over-expressed in AN and AA.
      The tumour necrosis factor pathway was activated in AN and AA with increased
      cytokine and receptor levels and increased TRAF2, an intracellular signalling
      product. There were indications of a down-regulated p53 system. In contrast, the
      Bcl-2 family of genes showed a net pro-apoptotic profile in AN and AA. The group
      of caspases showed a constant gene expression pattern in all groups. In
      conclusion, significant differences in the expression of apoptosis-related genes
      were found in peripheral blood of atopic individuals with and without asthma.
      cDNA array technology proved to be useful and may be complementary to DNA-based
      studies in order to analyse interactive and multidimensional pathways as shown
      here for apoptosis.

PMID- 11207647
TI  - Tears contain the complement regulator CD59 as well as decay-accelerating factor
      (DAF).
AB  - Previous studies have shown that DAF (or CD55), a cell surface inhibitor of
      autologous C3 activation, is present in tears and that > 90% of the C3 convertase
      regulatory activity in tear fluid resides in this protein (Lass JH et al., Invest
      Ophth Vis Sci 1990; 31:1136-48). This study investigated whether (i) the membrane
      cofactor protein (MCP or CD46), an additional factor that regulates C3
      activation, and (ii) the membrane inhibitor of reactive lysis (MIRL or CD59), a
      cell surface regulator that acts to prevent formation of the membrane attack
      complex, are also present in tears, and if so, are functional. Two-site
      immunoradiometric assays showed that MCP is present in tears at low levels (42 +
      8 ng/ml, n = 8) while CD59 is present at levels (222 + 78 ng/ml, n = 14)
      comparable to those of DAF (325 + 289 ng/ml, n = 12). The concentrations of CD59
      (i) were increased two-fold or more in closed eye tears, and (ii) were decreased
      in reflex tears. Western blotting showed that CD59 protein in tears migrates with
      an apparent mol. wt similar to membrane CD59 protein. Phenyl-Sepharose adsorption
      and Triton X-114 partitioning of tear CD59 as well as of tear DAF however, showed
      that both proteins are devoid of GPI anchors. Assays using cobra venom factor
      activated human serum and guinea pig erythrocytes showed that CD59 is
      functionally active in inhibiting autologous C5b-9-mediated lysis and, under
      constitutive conditions, accounts for > 85% of the C9 inhibitory activity in tear
      fluid.

PMID- 11207648
TI  - Immune complex processing in C1q-deficient mice.
AB  - Complement and Fcgamma receptors are known to mediate the processing of immune
      complexes (IC), and abnormalities in these mechanisms may predispose to the
      development of lupus. We explored the processing of IC in mice deficient in
      complement component C1q. 125I-labelled IC comprising Hepatitis B surface antigen
      (HBsAg)/human anti-HBsAg (HBsAg/Ab) were injected intravenously and the sites of
      IC clearance determined by direct counting of organ uptake at various time
      points. The liver and spleen were the main sites of IC uptake in all mice. The
      splenic uptake of IC was significantly reduced in the C1q-deficient mice compared
      with the control mice. C1q-deficient mice also exhibited an initial accelerated
      hepatic uptake of IC similar to that seen in human subjects with
      hypocomplementaemia. The hepatic localization of IC at later time points was
      similar in both groups of mice. These data in mice are consistent with previous
      observations in humans that confirm that the classical pathway of complement
      plays an important role in the appropriate processing of IC in vivo.

PMID- 11207649
TI  - Expression of IL-18 by Mycobacterium avium-infected human monocytes; association
      with M. avium virulence.
AB  - Disseminated Mycobacterium avium infection is the most frequent bacterial
      infection in patients with advanced AIDS and also associated with interferon
      gamma (IFN-gamma) or IL-12 receptor deficiency. IFN-gamma is a key cytokine in
      host defence against M. avium infection. Expression of IL-18, a potent IFN-gamma
      inducer, and IFN-gamma by human monocytes after infection with M. avium was
      examined. Monocytes were co-cultured with isogenic smooth-transparent (SmT:
      virulent) or smooth-domed (SmD: avirulent) M. avium strains (10 organisms per
      monocyte). Infection with the SmD strain induced significantly higher
      concentration of IL-18 and IFN-gamma in culture supernatants than did the SmT
      strain. IFN-gamma production in response to M. avium was partially inhibited by
      anti-human IL-18 MoAb. Both recombinant human IL-12 (77 +/- 42 pg/ml, control
      versus 1492 +/- 141 pg/ml, cultures with IL-12 1 ng/ml) and IL-18 (126 +/- 37
      pg/ml, control versus 2683 +/- 864 pg/ml, cultures with IL-18 10 ng/ml) augmented
      M. avium-induced IFN-gamma production. Freshly isolated uninfected monocytes
      expressed constitutive levels of IL-18. Following infection with M. avium,
      enhancement of IL-18 mRNA expression peaked at 3-6 h. IL-18 protein was detected
      in monocyte lysates as early as 1 h after infection with both SmT and SmD M.
      avium strains by Western blotting. Higher IL-18 expression by monocytes infected
      with the avirulent strain may result in more IFN-gamma production, thus
      modulating its pathogenicity. Local induction of IL-18 may be important both for
      M. avium pathogenicity and host defence and become a potential candidate for
      immunotherapy.

PMID- 11207650
TI  - Opsonizing antibodies (IgG1) up-regulate monocyte proinflammatory cytokines
      tumour necrosis factor-alpha (TNF-alpha) and IL-6 but not anti-inflammatory
      cytokine IL-10 in mycobacterial antigen-stimulated monocytes-implications for
      pathogenesis.
AB  - Cachexia is one of the prominent features of advanced tuberculosis (TB) seen in
      association with increased expression of the monokine TNF-alpha. Several
      mycobacterial proteins, including PPD, stimulate TNF-alpha secretion from
      monocytes. Host factors that may play a role in cytokine expression from
      monocytes remain largely unknown. One such factor is the opsonizing antibodies.
      Monocytes have high-affinity receptors (FcgammaI and FcgammaIII) for IgG1 and
      IgG3 antibodies that mediate antigen uptake. We have reported selective up
      regulation of IgG1 (which bind to Fcgamma receptors) in advanced TB and have
      recently shown the ability of PPD-specific IgG1 antibodies to augment TNF-alpha
      expression in PPD-stimulated monocytes. These observations have now been extended
      to other cytokines with semipurified fractions from secreted antigens of
      Mycobacterium tuberculosis (containing 30 kD and 58 kD) that were devoid of
      lipids, glycolipids and carbohydrates. In the presence of heat-inactivated TB
      plasma containing known amounts of antigen-specific IgG1 antibodies, these
      fractions induced significantly increased TNF-alpha, IL-6 and IL-10 secretion.
      Absorption of IgG1 with Protein 'A' removed the augmenting activity for TNF-alpha
      and IL-6 secretion from the TB plasma samples. In the case of IL-10, removal of
      IgG1 resulted in increased rather than decreased IL-10 secretion. These results
      suggest a possible pathogenic role for antibodies in TB by enhancing
      proinflammatory and blocking down-regulatory cytokines such as IL-10 cytokines
      during the chronic phase of TB.

PMID- 11207651
TI  - Effect of deworming on human T cell responses to mycobacterial antigens in
      helminth-exposed individuals before and after bacille Calmette-Guerin (BCG)
      vaccination.
AB  - The protective efficacy of BCG vaccination against pulmonary tuberculosis (TB) is
      highly variable in different populations. The reason remains to be elucidated.
      This study aims to investigate the possible effect of intestinal helminths on the
      immune response to PPD in naturally immunized or BCG-vaccinated humans. The study
      population was assessed for helminthic infection and those found to be positive
      were randomly assigned to either an albendazole treatment group or a control
      group who received a placebo. The immune response to PPD was compared between the
      two groups. In addition, subjects who were tuberculin skin test-negative in both
      groups were BCG vaccinated and later on tested for PPD-specific responses.
      Albendazole induced elimination/or reduction in intestinal worms resulting in a
      significant improvement in T cell proliferation and in interferon-gamma
      production by peripheral blood mononuclear cells (PBMC) stimulated with PPD.
      Moreover, BCG vaccination significantly improved PPD-specific immune responses in
      the treated group but not in the placebo group. The differences in the in vivo
      skin test responses were not significant. The data show that cellular immune
      responses to PPD are reduced in persons with concurrent helminthic infections,
      perhaps reflecting a lowered resistance to mycobacterial infections. This could
      explain, at least in part, the reduced efficacy of BCG against TB in helminth
      endemic areas of the world.

PMID- 11207652
TI  - Epitope focus, clonal composition and Th1 phenotype of the human CD4 response to
      the secretory mycobacterial antigen Ag85.
AB  - Lymphoproliferation of healthy donors was tested against mycobacterial antigens
      (PPD, Ag85, Ag85 peptides). All PPD responders recognized the secretory antigen
      Ag85 and the peptide specificity for Ag85B was defined. Peptide 91-108 was
      recognized by 85% of donors. In addition, all CD4 T cell lines generated from 12
      donors against PPD or Ag85 responded to 91-108. When this peptide was used to
      generate T cell lines, the cells responded also to tuberculins from atypical
      mycobacterial species. Thus the cross-reactive peptide behaved as quasi
      universal. The analysis of TCR-BV gene usage by cell lines showed that most Ag85
      specific T cells correspond to 91-108-specific clonotypes. Intracytoplasmic
      staining of cell lines after phorbol myristate acetate stimulation resulted in
      dominance of interferon-gamma (IFN-gamma)-IL-4 double-positive cells, whereas
      antigen stimulation resulted in production of IFN-gamma only. The data show that
      peptide 91-108 is the major focus of the CD4 response to mycobacterial antigens
      in peripheral blood mononuclear cells and in T cell lines from PPD responders.

PMID- 11207654
TI  - The impact of CMV on the respiratory burst of macrophages in response to
      Pneumocystis carinii.
AB  - Infection of human monocyte-derived macrophages with CMV decreased the
      respiratory burst when cells were stimulated with opsonized zymosan or
      Pneumocystis carinii (P. carinii). Such an effect, though smaller, was also seen
      with heat-inactivated CMV, but only when triggered by zymosan. The effect was
      most pronounced in cells obtained from CMV antibody-negative donors.
      Dexamethasone further reduced the respiratory burst, both in uninfected and CMV
      infected cells. Interferon-gamma increased the response in uninfected cells and,
      to a lesser extend, in cells treated with heat-inactivated CMV, whereas no effect
      was seen with infective CMV. No overt productive infection or cytopathology could
      be detected, however, the monocytes incubated with infective but also heat
      inactivated CMV formed clusters, a phenomenon that was equally pronounced in
      cultures from CMV antibody positive and negative-donors. These results might help
      explain the worse prognosis of P. carinii pneumonia in patients coinfected with
      CMV and receiving dexamethasone.

PMID- 11207653
TI  - Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients.
AB  - Active TB in HIV-1-infected subjects is associated with increased HIV-1-related
      immunodeficiency and mortality. We assessed plasma viral load in HIV-1-infected
      patients with pulmonary TB (HIV/TB) and non-TB symptomatic HIV-1-infected
      patients (HIV). HIV-1 load was higher in HIV/TB compared with HIV at higher CD4
      counts (> 500/microl) (P < 0.01), but not at lower CD4 counts (< 500/microl). We
      also evaluated the status of HIV-1 gene expression in peripheral blood
      mononuclear cells (PBMC) and serum from HIV/TB and CD4-matched healthy HIV
      infected patients (HIV/C) by reverse transcriptase-polymerase chain reaction over
      a range of CD4 (> 900/microl to < 200/microl). HIV-1 RNA in serum and PBMC
      correlated to one another, and both were markedly higher in HIV/TB compared with
      HIV/C with higher CD4 counts. Also, during a longitudinal study of anti
      tuberculous chemoprophylaxis in HIV-1-infected patients, 10 subjects who
      developed TB had serologies before, at the time, and after the diagnosis of TB.
      These HIV/TB patients had an increase in viral load (average 2.5-fold) at the
      time of diagnosis of TB (P < 0.05). Overall, these data indicate that the
      transcriptional activity of HIV-1 is enhanced in HIV-1-infected patients with
      active TB, especially during early HIV-1 disease. As TB often is an early HIV-1
      opportunistic infection, it may particularly favour early viral replication and
      dissemination, and therefore contribute to progression of HIV-1 disease.

PMID- 11207655
TI  - Characterization of the cellular immune function of patients with chronic
      mucocutaneous candidiasis.
AB  - Chronic mucocutaneous candidiasis (CMC) is a rare syndrome characterized by
      persistent and refractory infections of the skin, nails and mucosal tissues by
      yeasts of the genus Candida. Defects in the cellular limb of the immune system
      are well documented in CMC patients, but non-specific immune defects, such as
      myeloperoxidase deficiency or phagocyte chemotaxis disorders, have also been
      described. Nonetheless, the underlying defect(s) remains poorly understood, and
      further studies are required. We studied eight CMC patients without
      endocrinopathies, who showed (i) low normal proliferative response to
      phytohaemagglutinin (PHA), (ii) partially defective response to pokeweed mitogen
      (PWM), and (iii) impaired response to Candida and PPD antigens. Furthermore,
      peripheral blood mononuclear cells (PBMC) from CMC patients produced lower levels
      of type-1 cytokines (IL-2 and interferon-gamma) in response to Candida antigens,
      compared with control individuals. Conversely, we did not observe an enhancement
      of IL-4 and IL-10 in the patients, suggesting that, even though Th1 cytokines are
      decreased, the Th2 response is not increased in CMC. Nevertheless, the synthesis
      of these cytokines was normal when induced by PHA. We also observed an increased
      antigen-induced apoptosis in lymphocytes from the patients compared with
      controls, and this applied both to Candida and PPD antigens. Lastly, innate
      immunity defects were investigated. We observed an impairment of natural killer
      activity against K-562 target cells in half of the studied patients. These
      findings corroborate the extensive clinical and laboratory variability of CMC,
      which requires further studies on a larger number of patients to be better
      understood.

PMID- 11207656
TI  - Accelerated calcium influx and hyperactivation of neutrophils in chronic
      granulomatous disease.
AB  - The relationship between activation of NADPH-oxidase, alterations in membrane
      potential and triggering of Ca2+ fluxes in human phagocytes has been investigated
      using neutrophils from four subjects with chronic granulomatous disease (CGD).
      Cytosolic Ca2+ and membrane potential were measured by spectrofluorimetry, and
      net efflux and influx of Ca2+ by radiometric procedures. Exposure of normal
      neutrophils to the chemotactic tripeptide, N-formyl-L-methionyl-L-leucyl-L
      phenylalanine (FMLP; 1 microM) was accompanied by an abrupt increase in cytosolic
      Ca2+ coincident with membrane depolarization and efflux of the cation. These
      events terminated at around 30 s after the addition of FMLP and were followed by
      membrane repolarization and store-operated influx of Ca2+, both of which were
      superimposable and complete after about 5 min. Activation of CGD neutrophils was
      also accompanied by an increase in cytosolic Ca2+, which, in spite of an
      efficient efflux response, was prolonged in relation to that observed in normal
      cells. This prolonged increase in cytosolic Ca2+ in activated CGD neutrophils
      occurred in the setting of trivial membrane depolarization and accelerated influx
      of Ca2+, and was associated with hyperactivity of the cells according to
      excessive release of elastase and increased activity of phospholipase A2.
      Treatment of CGD neutrophils with the type 4 phosphodiesterase inhibitor,
      rolipram (1 microM) restored Ca2+ homeostasis and attenuated the increase in
      elastase release. These findings support the involvement of NADPH-oxidase in
      regulating membrane potential and Ca2+ influx in activated neutrophils, and may
      explain the disordered inflammatory responses and granuloma formation which are
      characteristic of CGD.

PMID- 11207657
TI  - Recombinant bacille Calmette-Guerin (BCG) expressing human interferon-alpha 2B
      demonstrates enhanced immunogenicity.
AB  - To increase its immunostimulatory properties, BCG was genetically engineered to
      secrete recombinant human interferon-alpha 2B (rhIFN-alpha) under control of the
      mycobacterial heat shock protein (hsp)60 promoter and the alpha antigen signal
      sequence. Expression of rhIFN-alpha was readily detectable by ELISA and on
      Western blotting. When compared with control BCG, rhIFN-alpha BCG was
      substantially more active in inducing the production of IFN-gamma and IFN
      inducible protein 10 (IP-10) from human peripheral blood mononuclear cells, while
      IL-10 production was correspondingly decreased. These effects were reversible
      upon antibody neutralization of rhIFN-alpha. Among 10 patients tested, rhIFN
      alpha BCG enhanced IFN-gamma production in all patients ranging from 1.4- to 23.7
      fold with a general trend toward greatest enhancement among those with weakest
      baseline responses to control BCG. Correspondingly, rhIFN-alpha BCG decreased IL
      10 production in all patients by 1.2-4.8-fold. The onset of IFN-gamma production
      induced by rhIFN-alpha BCG was also more rapid, occurring within 4 h after
      stimulation versus > 24 h with wild-type BCG. The observation that the maximum
      IFN-gamma induction depends on the simultaneous presence of both IFN-alpha and
      BCG highlights the advantages of rhIFN-alpha BCG. Taken together, these
      immunostimulatory properties of rhIFN-alpha BCG suggest that it may be a superior
      agent for immunotherapeutic protocols involving live BCG in humans.

PMID- 11207658
TI  - Increase of chemokine interferon-inducible protein-10 (IP-10) in the serum of
      patients with autoimmune liver diseases and increase of its mRNA expression in
      hepatocytes.
AB  - To clarify the role of IP-10 in autoimmune liver diseases, we studied the serum
      levels of IP-10 in 14 patients with autoimmune hepatitis (AIH), 23 patients with
      primary biliary cirrhosis (PBC), and 65 patients with chronic viral hepatitis (20
      type B and 45 type C). The hepatic expression of IP-10 mRNA and the correlation
      between the serum levels of IP-10 and clinical parameters were also evaluated. In
      addition to 20 healthy controls, 16 rheumatoid arthritis (RA) patients were
      included as an extrahepatic inflammatory disease. The serum level of IP-10 was
      significantly (P < 0.02) higher in patients with AIH, PBC, and chronic hepatitis
      B and C than in healthy controls, and it was significantly correlated (P < 0.05)
      with the serum levels of aspartate aminotransferase and alanine aminotransferase
      in patients with AIH, PBC, and chronic hepatitis B and C. The serum level of IP
      10 was not elevated in RA patients. After successful treatment of AIH and chronic
      hepatitis C, the serum level of IP-10 decreased to the same level as in healthy
      volunteers. As we previously showed in cases with chronic hepatitis B or C, in
      situ hybridization in both AIH and PBC cases demonstrated the expression of IP-10
      mRNA in hepatocytes around focal or lobular necrosis surrounded by infiltrating
      mononuclear cells, whereas IP-10 mRNA was not expressed in areas around the
      damaged bile ducts in PBC cases. The present results suggest that IP-10 is
      specifically produced by hepatocytes in inflammatory areas irrespective of the
      aetiology of hepatitis, and that IP-10 may help to recruit T cells to the hepatic
      lesions in autoimmune liver diseases as well as in chronic viral hepatitis.

PMID- 11207659
TI  - Monocyte-derived dendritic cells: a potential target for therapy in multiple
      sclerosis (MS).
AB  - Monocytes can differentiate into dendritic cells (DC), cells with a pivotal role
      in both protective immunity and tolerance. Defects in the maturation or function
      of DC may be important in the development of autoimmune disease. We sought to
      establish if there were differences in the cytokine (granulocyte-macrophage
      colony-stimulating factor and IL-4)-driven maturation of monocytes to DC in
      patients with MS and whether drugs used to treat MS affected this process in
      vitro. We have demonstrated that there is no defect in the ability of magnetic
      activated cell sorting (MACS)-purified monocytes from patients with MS to
      differentiate to DC, but equally they show no tendency to acquire a DC phenotype
      without exogenous cytokines. Interferon-beta1a prevents the acquisition of a full
      DC phenotype as determined by light and electron microscopy and by flow
      cytometry. Methylprednisolone not only prevents the development of monocyte
      derived DC but totally redirects monocyte differentiation towards a macrophage
      phenotype. Evidence is evolving for a role for DC in central nervous system
      immunity, either within the brain or in cervical lymph nodes. The demonstrated
      effect of both drugs on monocyte differentiation may represent an important site
      for immune therapy in MS.

PMID- 11207660
TI  - The fine specificity of human T cell lines towards myelin basic protein peptides
      in southern Italian multiple sclerosis patients.
AB  - We studied the relationship between the HLA specificities associated with
      multiple sclerosis (MS) susceptibility in southern Italy and the reactivity of
      the human myelin basic protein (hMBP) immunogenic peptides 84-98 and 143-168,
      using short-term T-cell lines established from 9 MS patients and from 8 healthy
      individuals. In our population, DR15 was significantly associated with MS (34.9%
      in MS versus 13.7% in healthy controls, P < 0.05). This result is in agreement
      with the association found in northern Europe, but not with data obtained in a
      population from the island of Sardinia (Italy). In MS patients the frequency of
      reactive T-cell lines (TCL), tested for fine specificity against the
      immunodominant hMBP peptides 84-98 and 143-168, was increased for the hMBP 143
      168 peptide (P < 0.05) but not for the 84-98 peptide. Although this reactivity
      was higher in DR15+ MS patients than in DR 15- MS patients, it seemed not to be
      associated with DR15 specificity in the MS population. Furthermore, there were no
      significant differences in frequency of reactive TCL to hMBP peptide 84-98 in
      DR15-positive or DR15-negative MS patients. Consequently, it appears that peptide
      84-98, considered as a relevant autoantigen, is not implicated in the
      pathogenesis of MS in our population from southern Italy.

PMID- 11207661
TI  - Anti-inflammatory cytokine IL-10 and T cell cytokine profile in periodontitis
      granulation tissue.
AB  - Th2 cells are more abundant than Th1 cells in periodontitis lesions, but the
      relative importance of the Th1 and Th2 subsets in periodontal disease is not
      understood. In addition, the role of proinflammatory and anti-inflammatory
      cytokines in this disease process is unclear. Biopsies were obtained from 10
      patients with early onset periodontitis (EOP) and 10 patients with adult
      periodontitis (AP). From all of the patients in the AP group we were able to
      obtain and section the gingival tissue to serve as controls. We used polyclonal
      monospecific antibodies to detect cells expressing IL-2, IL-4, IL-6, IL-10 and IL
      15, tumour necrosis factor (TNF-alpha) and interferon-gamma (IFN-gamma) in
      formalin-fixed, paraffin-embedded sections of granulation tissue from
      periodontitis lesions. We also employed a series of oligonucleotide probes to
      detect cells expressing the cytokine transcripts in the same tissue biopsies.
      Cells that expressed IL-4 or IL-6 were more numerous than cells expressing either
      IL-2 or IFN-gamma. Th2 cells were more numerous in EOP and AP tissues. IL-15
      substitutes for IL-2 in a number of biological activities related to the Th1
      immune response, and interestingly, in periodontal lesions the IL-15-expressing
      cells outnumbered IL-2-expressing cells, suggesting that this is the pattern of
      immune regulation by T cells in the periodontium. The functional balance in the T
      cell subsets detected by their cytokine profiles underlies the importance of the
      anti-inflammatory mechanisms taking place in the diseased tissue. The numbers of
      inflammatory leucocytes that express the anti-inflammatory cytokine IL-10 are
      much more widely distributed than those that express the proinflammatory
      cytokines IL-6 and TNF-alpha. This study suggests that large numbers of
      infiltrating inflammatory cells as well as accessory cells are involved in the
      down-regulation of the inflammatory and immune response in periodontitis.

PMID- 11207662
TI  - Increase in tonsillar germinal centre B-1 cell numbers in IgA nephropathy (IgAN)
      patients and reduced susceptibility to Fas-mediated apoptosis.
AB  - IgAN is a common form of primary glomerulonephritis and also a disease of
      tonsillar focal infection. The comprehensive mechanism underlying this disease
      remains to be defined. To better understand its pathogenesis, we investigated
      tonsillar CD5+ B cells (B-1 cells) with respect to IgA synthesis. Germinal centre
      (GC) B cells were isolated from the tonsils of IgAN patients and the number of B
      1 cells in the GC determined by flow cytometry. GC B-1 and B-2 (CD5- B) cells
      were purified by cell sorter, the cells were incubated with agonist anti-CD40
      MoAb and the ability for antibody production by B-1 and B-2 cells determined by
      ELISPOT assay. GC B-1 cells and B-2 cells were incubated with agonist anti-Fas
      MoAb, and apoptosis in GC B-1 cells and B-2 cells was analysed by flow cytometry.
      Although B-1 cells do not usually take part in the GC reaction, an increase in B
      1 cell numbers was observed in the GC of tonsils from IgAN patients. These B-1
      cells were likely IgA1 antibody-producing cells, since the prominent IgA subclass
      in IgAN is generally considered to be IgA1. Although Fas-dependent apoptosis is
      essential for the elimination of activated B cells, these B-1 cells showed a
      reduced susceptibility to Fas-mediated apoptosis. It is conceivable that
      activated B-1 cells may survive in the GC due to impaired apoptosis and thus
      produce abnormal antibodies. These findings suggest that the immune responses of
      B-1 cells in the tonsillar GC could thus have an impact on the pathogenesis of
      IgAN.

PMID- 11207663
TI  - Role of macrophage migration inhibitory factor (MIF) in murine antigen-induced
      arthritis: interaction with glucocorticoids.
AB  - (MIF) is a broad-spectrum proinflammatory cytokine implicated in human rheumatoid
      arthritis. The synthesis of MIF by synovial cells is stimulated by
      glucocorticoids, and previous studies suggest that MIF antagonizes the anti
      inflammatory effects of glucocorticoids. This has not been established in a model
      of arthritis. We wished to test the hypothesis that MIF can act to reverse the
      anti-inflammatory effects of glucocorticoids in murine antigen-induced arthritis
      (AIA). Cutaneous DTH reactions and AIA were induced by intradermal injection and
      intra-articular injection, respectively, of methylated bovine serum albumin in
      presensitized mice. Animals were treated with anti-MIF MoAbs, recombinant MIF,
      and/or dexamethasone (DEX). Skin thickness of DTH reactions was measured with
      callipers and arthritis severity was measured by blinded quantitative
      histological assessment of synovial cellularity. Cutaneous DTH to the disease
      initiating antigen was significantly inhibited by anti-MIF MoAb treatment (P <
      0.001). AIA was also significantly inhibited by anti-MIF MoAb (P < 0.02). DEX
      treatment induced a dose-dependent inhibition of AIA, which was significant at
      0.2 mg/kg (P < 0.05). MIF treatment reversed the effect of therapeutic DEX on AIA
      (P < 0.001). DEX also significantly inhibited DTH reactions (P < 0.05) but rMIF
      had no effect on this effect of DEX. DTH and AIA are MIF-dependent models of
      inflammation and arthritis. The reversal of glucocorticoid suppression of AIA by
      MIF supports the concept that MIF is a counter-regulator of glucocorticoid
      control of synovial inflammation. Although DTH was observed to be MIF-dependent
      and glucocorticoid-sensitive, rMIF had no reversing effect on the suppression of
      DTH by glucocorticoids. This suggests that inflammatory processes in specific
      tissues may respond differently to MIF in the presence of glucocorticoids.

PMID- 11207664
TI  - CD4+ and CD8+ clonal T cell expansions indicate a role of antigens in ankylosing
      spondylitis; a study in HLA-B27+ monozygotic twins.
AB  - Ankylosing spondylitis (AS) is a complex genetic disease in which both MHC and
      non-MHC genes determine disease susceptibility. To determine whether the T cell
      repertoires of individuals with AS show signs of increased stimulation by
      exogenous antigens, CD4+ and CD8+ T cell subsets of five monozygotic HLA-B27+
      twins (two concordant and three discordant for AS) and CD8+ T cell repertoires of
      three healthy HLA-B27+ individuals were characterized by TCR beta-chain (TCRB)
      CDR3 size spectratyping. Selected TCRB-CDR3 spectra were further analysed by BJ
      segment analysis and TCRB-CDR3 from expanded T cell clones were sequenced. In an
      analysis of all data (519/598 possible TCRB-CDR3 spectra), AS was associated with
      increased T cell oligoclonality in both CD8+ (P = 0.0001) and CD4+ (P = 0.033) T
      cell subsets. This was also evident when data were compared between individual
      twins. Nucleotide sequence analysis of expanded CD8+ or CD4+ T cell clones did
      not show selection for particular TCRB-CDR3 amino acid sequence motifs but
      displayed sequence homologies with published sequences from intra-epithelial
      lymphocytes or synovial T cells from rheumatoid arthritis patients. Together,
      these results provide support for the hypothesis that responses to T cell
      stimulating exogenous or endogenous antigens are involved in the induction and/or
      maintenance of AS.

PMID- 11207665
TI  - Up-regulation of prostaglandin E receptor EP2 and EP4 subtypes in rat synovial
      tissues with adjuvant arthritis.
AB  - To evaluate the role of the prostaglandin E receptor (EP) subtypes in the
      development of inflammatory synovitis, we examined EP subtype mRNA distribution
      in the synovial tissue of rats with adjuvant arthritis and the effect of
      selective EP agonists on cytokine production by cultured rat synovial cells. We
      used reverse transcriptase-polymerase chain reaction (RT-PCR) and in situ
      hybridization to measure the level of EP subtype (EP1, EP2, EP3, and EP4) mRNA
      expression in synovial tissues and cultured synovial cells from the arthritic
      joints of rats. RT-PCR and ELISA were used to analyse the effects of two
      selective EP agonists on IL-6 production by cultured rat synovial cells. EP2 and
      EP4 mRNA expression in inflamed synovial tissues was up-regulated. EP2 and EP4
      mRNA were co-expressed in synovial macrophages and fibroblasts in inflamed
      tissues. EP4 and EP2 agonists both inhibited IL-1-induced IL-6 production. Our
      results suggest that prostaglandin E2 regulates the functions of synovial
      macrophages and fibroblasts through EP2 and EP4, which are induced by
      inflammatory stimuli in rats with adjuvant arthritis.

PMID- 11207666
TI  - Induction of lymphocyte apoptosis in rat liver allograft with ongoing rejection
      by FTY720.
AB  - The action mechanism of FTY720, a novel immunosuppressant, is completely
      different from conventional immunosuppressants. The drug, which triggers
      apoptosis in murine and human lymphocytes, has a potent immunosuppressive
      activity to prevent allograft rejection without any severe side-effect. The
      present study was designed to determine whether FTY720 induces apoptotic cell
      death in activated lymphocytes infiltrated into liver grafts with ongoing
      rejection. FTY720 was orally administered at 5 mg/kg to the recipients on day 3
      and day 4 after grafting, when the graft rejection was histologically confirmed.
      The intragraft patterns of IL-2, interferon-gamma (IFN-gamma), perforin, and
      granzyme B gene expression were detected by reverse transcriptase-polymerase
      chain reaction. The treatment reversed ongoing rejection and significantly
      prolonged recipient survival time compared with the control group. Light
      microscopic observation of the graft sections stained with the DNA nick-end
      labelling method showed that the apoptosis in the control allografts was mainly
      induced in hepatocytes, while that in the FTY720-treated allografts was in
      infiltrated lymphocytes. The rejection therapy with FTY720 did not alter the
      expression of IL-2, IFN-gamma, and perforin mRNAs, but slightly decreased
      granzyme B expression. Our results suggest that FTY720 does not alter the
      intrinsic lymphocyte function to produce the rejection-related cytokines, but
      strongly induces apoptotic cell death in the activated lymphocytes. Thus, FTY720
      affords new insight into the mechanisms underlying improvements in
      immunosuppressive treatments.

PMID- 11207667
TI  - Paired cloning of the T cell receptor alpha and beta genes from a single T cell
      without the establishment of a T cell clone.
AB  - T cell receptors, which recognize antigen peptides on MHC molecules, are
      essential probes for the analysis of T cell antigen specificity. The
      identification of paired T cell receptor (TCR) chains, alpha/beta or gamma/delta,
      usually requires the establishment of T cell clones, which is not always
      available. In this study, we tried, as an alternative method, the paired cloning
      of TCR alpha/beta genes directly from a single T cell. T cells were sorted as a
      single cell from which RNA was extracted. Then, TCR alpha/beta CDR3 regions were
      amplified from the single cell-derived cDNA by reverse transcriptase-polymerase
      chain reaction to determine their sequences. We successfully identified pairs of
      TCR alpha/beta genes, and reconstructed the TCR molecule by a bacterial
      expression system. This strategy makes it possible to obtain recombinant TCR
      molecules from a single T cell without cellular cloning and promotes the
      investigation of T cell antigen specificity.

PMID- 11207668
TI  - Acute opioid receptor desensitization and tolerance: is there a link?
AB  - 1. Morphine, used long-term for the treatment of pain, results in drug tolerance.
      The therapeutic benefits, as well as side effects, of morphine are mediated
      predominantly via activation of mu-opioid receptors. Although the underlying
      mechanisms for opioid tolerance remains unclear, early adaptive processes, such
      as acute receptor desensitization and receptor downregulation, have been
      suggested to be crucial to the development of opioid tolerance. 2. Other
      neuroadaptations resulting from chronic opioid use include upregulation of the
      cAMP pathway, an increase in the cAMP response element-binding protein and Fos
      related antigens. However, the connection between upregulation of these cellular
      elements and the mechanism behind the behavioural phenomenon remains unclear. 3.
      Acute receptor desensitization is thought to occur via uncoupling of the receptor
      and G-protein, which is followed by internalization of the receptor from the cell
      membrane. This process occurs after a few minutes of agonist exposure. Receptor-G
      protein uncoupling is mediated via phosphorylation of putative sites on the
      intracellular loops of activated receptors. 4. Acute desensitization and
      downregulation of receptors both result in a reduction of agonist efficacy. These
      events occur early in the cascade of cellular adaptation; however, it is
      uncertain whether these processes contribute to the long-term changes in receptor
      sensitivity that occur after repeated exposure to opioids. 5. Acute
      desensitization may, in fact, be a protective mechanism whereby cells adapt to
      avoid the development of physiological drug tolerance by rapidly attenuating
      receptor-mediated signalling. Those drugs that do not cause receptor
      internalization, such as morphine, may have higher propensities to develop
      tolerance.

PMID- 11207669
TI  - Role of nitric oxide on pressor mechanisms within the dorsomedial and rostral
      ventrolateral medulla in anaesthetized cats.
AB  - 1. The role of nitric oxide (NO) in central cardiovascular regulation and the
      correlation between NO and glutamate-induced mechanisms is not clear.
      Microinjection of glutamate (3 nmol/30 nL) into dorsomedial medulla (DM) and
      rostral ventrolateral medulla (RVLM) increased arterial blood pressure (BP) and
      sympathetic vertebral nerve activity (VNA). Thus, in the present study, we
      examined the modulation by NO of glutamate-induced pressor responses in the DM
      and RVLM of cats. 2. Histochemical methods using nicotinamide adenine
      dinucleotide phosphate diaphorase (NADPHd) as a marker to stain neurons
      containing NO synthase (NOS), showed positive findings of NOS in both the DM and
      RVLM. 3. Microinjection of N(G)-nitro-L-arginine methyl ester (L-NAME), a NOS
      inhibitor, into the DM or RVLM did not alter resting BP and VNA, but it did cause
      a dose-dependent attenuation of glutamate-induced pressor responses.
      Interestingly, the increase in NO levels that resulted from pretreatment with L
      arginine (L-Arg) or sodium nitroprusside (SNP) did not alter resting BP and VNA,
      but still inhibited glutamate-induced pressor responses in the DM and RVLM in a
      dose-dependent manner. 4. We also examined whether NO modulated the pressor
      responses induced by activation of different excitatory amino acid receptors. N
      Methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazole
      proprionic acid (AMPA) were used. Consistent with the results from the initial
      glutamate studies, we observed that not only L-NAME, but also L-Arg and SNP
      attenuated pressor responses induced by NMDA and AMPA. No difference was found
      between the effects of NO on NMDA- and AMPA-induced pressor responses. 5. To
      investigate the possibility of a loss of agonist selectivity, the effects of D-2
      amino-5-phosphonovalerate (D-AP5) and 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX)
      on AMPA and NMDA responses in the DM were examined. The results showed that CNQX
      did not alter NMDA-induced pressor responses, while D-AP5 failed to alter AMPA
      induced responses. 6. Our results suggest that activation of the glutamate
      induced pressor mechanism is regulated by changes in NO levels in the DM and
      RVLM. This implies that NO may play a permissive role to allow operation of the
      glutamate-activation mechanism.

PMID- 11207670
TI  - Increase in gastric intramucosal hydrogen ion concentration following endotoxin
      challenge in the rat and the actions of nitric oxide synthase inhibitors.
AB  - 1. Cardiovascular events and outcome in septic shock may be predicted by
      monitoring the fall in intramural pH (pHi), as an index of splanchnic perfusion
      and mucosal ischaemia. In the present study, a small animal model for monitoring
      the changes of gastric pHi or intramucosal [H+] following challenge with the
      endotoxin lipopolysaccharide (LPS) was developed in the rat. The role of nitric
      oxide (NO) in these events in this model was evaluated using the non-selective NO
      synthase (NOS) inhibitors N(G)-nitro-L-arginine methyl ester (L-NAME) and N(G)
      monomethyl-L-arginine (L-NMMA). 2. The pHi and intramucosal [H+] were evaluated
      in omeprazole-pretreated rats (30 mg/kg, i.p.) using the Henderson equation after
      estimating the PCO2 and the bicarbonate concentration in gastric wall. To measure
      gastric wall PCO2, the oesophagus was intubated and the pylorus ligated. The PCO2
      was measured by a blood gas analyser in 2 mL saline instilled for 30 min in the
      gastric lumen to equilibrate with the gastric wall. The pHi was measured under
      basal conditions and 3 and 5 h after LPS (3 mg/kg) administration. Separate
      groups received treatment with L-NMMA (25-50 mg/kg) or L-NAME concomitantly or
      2.5 h after administration of LPS. 3. Intravenous administration of Escherichia
      coli LPS provoked a significant fall in gastric pHi from 7.37 to 7.18 (median
      values; n =10-19) determined after 5 h. In groups treated concurrently with LPS
      and L-NAME (5 mg/kg; n = 19), there was a similar increase in intramucosal [H+]
      as that induced by LPS alone (n = 15) in those animals that survived. In
      contrast, L-NAME (5 mg/kg; n = 12), given 2.5 h after LPS challenge, at a time at
      which inducible NOS is known to be significantly expressed, prevented the
      increase in intramucosal [H+] at 3 and 5 h after LPS challenge. Similarly, L-NMMA
      (25-50 mg/kg; n = 23), given 2.5 h after LPS challenge, dose-dependently
      inhibited the increase in intramucosal [H+] at 3 and 5 h. 4. In conclusion, these
      findings indicate that this rat model could be useful in exploring the
      pathophysiology of acute endotoxin shock. Delayed administration of L-NAME and L
      NMMA abolished the increase in gastric intramucosal [H+], supporting the
      involvement of excess NO in the tissue dysfunction associated with endotoxin
      shock. This suggests the potential value of this small animal model in evaluating
      the therapeutic activity of novel agents for use in septic shock.

PMID- 11207671
TI  - Suppressive effects of oxcarbazepine on tooth pulp-evoked potentials recorded at
      the trigeminal spinal tract nucleus in cats.
AB  - 1. The purpose of the present study was to evaluate the antinociceptive effect of
      oxcarbazepine, a keto derivitive of carbamazepine (an anticonvulsant), in an
      animal model. To evoke a nociceptive response, we electrically stimulated the
      maxillary canine tooth pulp (MCTP) in anaesthetized (allobarbital-urethane),
      spontaneously breathing cats. 2. The evoked potentials were recorded from the
      superficial layers of the caudal part of the trigeminal spinal tract nucleus
      (5ST). We examined a slow component with a large amplitude (the P3 component) in
      evoked compound potentials; its mean conduction velocity was 1.7 m/s, suggesting
      a response mediated by C-fibres. 3. To confirm that the P3 component was related
      to pain sensation, we used morphine, a most efficacious antinociceptive agent, in
      the present study. The P3 component was significantly suppressed by intravenous
      administration of morphine (3 mg/kg) and was also suppressed by microinjection of
      morphine (2 microg) into the recording site of the 5ST. These results suggest
      that the P3 component is involved in the transmission of nociceptive information.
      4. We compared the effect of oxcarbazepine with mexiletine; both are known to
      block neuronal Na+ channels. Intravenous administration of mexiletine suppressed
      the P3 component at a dose of 5 mg/kg. Microinjection of mexiletine (10 microg)
      into the recording site of the 5ST tended to suppress the P3 component, but this
      effect was not significant. 5. Intravenous administration of oxcarbazepine (1-10
      mg/kg) caused a dose-dependent inhibition of the P3 component, which was
      significantly suppressed at 10 mg/kg oxcarbazepine. Intravenous administration of
      10,11-dihydro-10-hydroxy-5H-dibenz[b,f]azepine-5-carboxamide (MHD), a metabolite
      of oxcarbazepine, at doses of 3-30 mg/kg caused a dose-dependent inhibition of
      the P3 component. Oxcarbazepine was not available for the microinjection study
      because it is not water soluble. We used MHD for the microinjection study instead
      of oxcarbazepine, because MHD can be dissolved in water up to 3 mg/mL.
      Microinjections of MHD (6 microg) into the recording site of the 5ST suppressed
      the P3 component. These results indicate that oxcarbazepine has an
      antinociceptive action.

PMID- 11207672
TI  - Effects of ageing on the activation metabolism of rat papillary muscles.
AB  - 1. A myothermic technique has been used to investigate the mechanics and
      energetics of left ventricular papillary muscles from 6-, 15-, 22- and 27-32
      month-old Sprague-Dawley rats. 2. There was a significant increase in the left
      ventricular mass to body mass (LVM:BM) ratio in the senescent. 27-32-month-old
      group of animals compared with the younger animals (P<0.05). 3. The maximum
      stress developed in the senescent groups was reduced by almost 40% in comparison
      with the stress developed by the 6-, 15- and 22-month-old groups (P<0.001). The
      mean rise time, half relaxation time and half width were increased significantly
      (P<0.05) in the 22-month-old group but, unexpectedly, this effect was not seen in
      the senescent group. 4. Heat production per beat versus total stress
      relationships were obtained in two different ways to determine the magnitude of
      the activation heat and the isometric economy (given by the slope of the
      relationship). The activation heat was not significantly different between groups
      with either method, but there was a significant increase (P<0.001) in the economy
      with which stress was developed in the senescent group in comparison with the 6-
      and 15-month-old groups. 5. A combination of forskolin (2.5-6.5 micromol/L) and
      high Ca2+ (7.5 mmol/L) was used to increase the energy usage per beat. In the 6-
      and 15-month-old groups, these agents caused a four-fold increase in the
      activation heat magnitude compared with a less than two-fold increase in the 22
      month-old and senescent groups (P<0.001). There was no effect of forskolin/high
      calcium on the slope of the heat:total stress relationship. 6. The data suggest
      that, under conditions known to increase cardiac contractility, there is a
      reduced ability to cycle calcium in the 22-month-old and senescent groups
      relative to the young adult 6-month-old and adult 15-month-old groups.

PMID- 11207673
TI  - Contractile and electrical properties of sternohyoid muscle in streptozotocin
      diabetic rats.
AB  - 1. The effects of diabetes on the electrical and contractile function of skeletal
      muscle are variable, depending on muscle fibre type distribution. The muscles of
      the upper airway have a characteristic fibre distribution that differs from
      previously studied muscles, but the effects of diabetes on upper airway muscle
      function are unknown. Normally, contraction of upper airway muscles, such as the
      sternohyoids, dilates and/or stabilizes the upper airway, thereby preventing its
      collapse. Diabetes is associated with obstructive sleep apnoea in which there is
      collapse of the upper airway due to failure of the upper airway musculature to
      maintain airway patency. Therefore, the purpose of the present study was to
      determine the effects of diabetes on the electrical and contractile
      characteristics of upper airway muscle. 2. Rats were treated with vehicle (sodium
      citrate buffer; pH 4.5) or with streptozotocin to induce diabetes, confirmed by
      the presence of hyperglycaemia, and the contractile and electrical properties of
      the sternohyoid were compared in these two groups. Isometric contractile
      properties and membrane potentials were determined in isolated sternohyoid
      muscles in physiological saline solution at 25 degrees C. 3. Streptozotocin had
      no effect on sternohyoid muscle fatigue, the tension-frequency relationship or
      membrane potentials, but did increase contraction time, half-relaxation time,
      twitch tension and tetanic tension. 4. Streptozotocin-induced diabetes has no
      effect on sternohyoid muscle fatigue or the tension-frequency relationship, but
      does reduce contractile kinetics and increases force generation. These effects
      are not due to changes in resting membrane potential. These data are evidence
      that the association of sleep apnoea and diabetes is not due to effects on upper
      airway muscle contractile properties.

PMID- 11207674
TI  - Association of serum tumour necrosis factor-alpha with serum low-density
      lipoprotein-cholesterol and blood pressure in apparently healthy Japanese women.
AB  - 1. The pro-inflammatory cytokine tumour necrosis factor (TNF)-alpha is considered
      to be involved in the development of atherosclerosis by inducing local
      inflammatory responses in the vascular wall. Because TNF-alpha is also known to
      affect lipid and glucose metabolism, the association between the circulating
      concentration of TNF-alpha and atherogenic risk factors was examined in 82
      apparently healthy Japanese women (aged 19-69 years; mean age 48.5 years). 2. The
      mean (+/-SD) serum TNF-alpha concentration was 2.7+/-0.9 pg/mL (range 1.4-5.9
      pg/mL). The TNF-alpha concentration showed significant correlations with age (r =
      0.28; P = 0.01), body mass index (r = 0.27; P = 0.01), the waist-hip ratio (r =
      0.41; P = 0.0002), percentage body fat (r = 0.30; P = 0.006), systolic (r = 0.32;
      P = 0.004) and diastolic (r = 0.24; P = 0.03) blood pressure, total cholesterol
      (r = 0.27; P = 0.02) and low-density lipoprotein-cholesterol (LDL-C; r = 0.36; P
      = 0.001), while the correlations with high-density lipoprotein-cholesterol (r = 
      0.20; P = 0.08) and insulin resistance estimated by the homeostasis model
      assessment (HOMA(IR); r = 0.16; P = 0.15) were not statistically significant. 3.
      When adjusted for age and menopause, TNF-alpha was significantly associated with
      systolic blood pressure (r = 0.25; P = 0.02) and LDL-C (r = 0.27; P = 0.02). The
      association between TNF-alpha and LDL-C remained significant when adjustment was
      made for age, menopause and the waist-hip ratio (r = 0.24; P = 0.03). 4. Our
      results indicate that TNF-alpha may play a role in modulating blood pressure and
      LDL-C.

PMID- 11207675
TI  - Role of protein kinase C, K(ATP) channels and DNA fragmentation in the infarct
      size-reducing effects of the free radical scavenger T-0970.
AB  - 1. In the present study, we investigated the effect of 1-(3-tert-butyl-2-hydroxy
      5-methoxyphenyl)-3-(3-pyridylmethyl) urea hydrocloride (T-0970), a novel water
      soluble low-molecular weight free radical scavenger, on the generation of
      hydroxyl radicals in vivo and on myocardial infarct size in an in vivo model of
      myocardial infarction in rabbits. 2. T-0970 scavenged hydroxyl radicals generated
      in the myocardium during reperfusion, as assessed by using a microdialysis
      technique and HPLC in an in vivo model with 30 min coronary occlusion and 30 min
      reperfusion in rabbits. 3. Another group of rabbits was subjected to 30 min
      coronary occlusion and 48 h reperfusion. The control group (n = 10) was infused
      with saline for 190 min from 10 min before occlusion to 180 min after
      reperfusion. The treatment group (T-0970 group; n = 10) was injected with a bolus
      2.5 mg/kg T-0970 and then infused with T-0970 for 190 min from 10 min before
      reperfusion to 180 min after reperfusion at a rate of 100 microg/kg per min. The
      T-0970 + CHE group (n = 5) was given chelerythrine (CHE; a selective inhibitor of
      protein kinase C (PKC); 5 mg/kg, i.v.) 10 min before the administration of T
      0970. The T-0970 + 5-HD group (n = 5) was given 5-hydroxydecanoate (5-HD; an
      inhibitor of mitochondrial K(ATP) channels; 5 mg/kg, i.v.) 10 min before the
      administration of T-0970. The CHE and 5-HD groups were given CHE (5 mg/kg, i.v.)
      and 5-HD (5 mg/kg, i.v.) 20 min before reperfusion, respectively. After 48 h
      reperfusion, infarct size was measured histologically and expressed as a
      percentage of the area at risk (AAR). In another series of experiments, the
      control (n = 5) and T-0970 (n = 5) groups were killed 4 h after reperfusion
      following 30 min coronary occlusion and DNA fragmentation in myocytes was
      assessed using in situ dUTP nick end-labelling (TUNEL) at the light microscopic
      level. 4. Infarct size, as a percentage of AAR, in the T-0970 group was
      significantly reduced compared with the control group (21+/-4 vs 41+/-4%,
      respectively; P<0.05). This reduction of infarct size by T-0970 was abolished by
      pretreatment with CHE and 5-HD. Neither CHE nor 5-HD alone had any effect on
      infarct size. The percentage of infarcted myocytes with DNA fragmentation by
      TUNEL in the T-0970 group was significantly reduced compared with the number in
      the control group (4.0+/-1.5 vs 10.7+/-1.9%, respectively; P<0.05). 5. T-0970, a
      free radical scavenger, improved reperfusion injury. This effect seemed to be
      mediated by activation of PKC, the opening of mitochondrial K(ATP) channels and
      inhibition of DNA fragmentation.

PMID- 11207676
TI  - Subarachnoid haemorrhage-induced sympathoexcitation in rats is reversed by
      bosentan or sodium nitroprusside.
AB  - 1. The roles played by nitric oxide (NO) and endothelin (ET) in the genesis of
      sympathetic nervous activation following experimental subarachnoid haemorrhage
      was investigated using spectral analysis of blood pressure rhythms. 2.
      Subarachnoid haemorrhage was induced in conscious rats by injecting 0.3 mL
      homologous blood via a catheter placed along the surface of the brain and
      directed towards the circle of Willis. Three hours after the insult and after
      sympathetic activation was evident, animals received either an acute injection of
      the ET antagonist bosentan (5 mg/kg, i.v.; n = 7), an infusion of the NO donor
      sodium nitroprusside (SNP; 18 microg/h; n = 7) or no treatment (n = 7). 3. Three
      hours following the induction of subarachnoid haemorrhage, the mid-frequency
      components of systolic blood pressure were markedly elevated, indicating a
      pronounced sympathoexcitation. However, blood pressure and heart rate levels
      remained unchanged at this time. In the absence of treatment, the mid-frequency
      components of blood pressure remained elevated for a subsequent 2 h. Treatment
      with a non-hypotensive dose of SNP reversed the sympathoexcitation within 1 h.
      Treatment with bosentan was also effective in reducing the mid-frequency
      oscillations in blood pressure associated with subarachnoid haemorrhage. 4. Our
      results indicate that subarachnoid haemorrhage is associated with an acute
      activation of the sympathetic nervous system. The degree of sympathoexcitation
      can be reversed by the use of either bosentan or SNP.

PMID- 11207677
TI  - KRH-594, a new angiotensin AT1 receptor antagonist, prevents end-organ damage in
      stroke-prone spontaneously hypertensive/Izm rats.
AB  - 1. In the present study, we examined whether KRH-594, a new angiotensin AT1
      receptor antagonist, would stop the progression of renal failure and end-organ
      damage and improve the survival rate in salt-loaded stroke-prone spontaneously
      hypertensive rats (SHRSP/Izm). 2. Oral administration of KRH-594 (3 and 10 mg/kg
      per day) for 11 weeks significantly reduced systolic blood pressure, urinary
      total protein, blood urea nitrogen, serum creatinine and urinary N-acetyl
      glucosaminidase and increased creatinine clearance in SHRSP/Izm. 3. In a
      histological study, KRH-594 (3 and 10 mg/kg per day) significantly improved the
      glomerulosclerosis, basophilic change and hyalin cast of tubules, proliferation
      of afferent arterioles and interlobular artery wall scores of the kidney and the
      cardiac fibrosis scores of the heart in SHRSP/Izm. KRH-594 (3 and 10 mg/kg per
      day) also significantly inhibited cardiac hypertrophy. 4. KRH-594 (3 and 10 mg/kg
      per day) prevented death in SHRSP/Izm during the examination period. 5. These
      results suggest that KRH-594 improves hypertensive complications, such as renal
      failure, cardiac hypertrophy and thickening of the artery wall, and prevents
      death in salt-loaded SHRSP/Izm.

PMID- 11207678
TI  - Inhibitory effect of reactive oxygen species on angiotensin I-converting enzyme
      (kininase II).
AB  - 1. Somatic angiotensin I-converting enzyme (ACE) is a protein that contains two
      similar domains (N- and C-terminal), each possessing an active site. We have
      examined the effects of a generator of hydroxyl radicals (g*OH: 2,2'-azo-bis(2
      amidinopropane)) and hydrogen peroxide (H2O2) on ACE using an in vitro approach.
      2. The generator of hydroxyl radicals inactivated ACE in a time (2-6 h)- and
      concentration (0.3-3 mmol/L)-dependent manner at 37 degrees C. When ACE was
      coincubated for 4 h with g*OH (3 mmol/L), its activity decreased by 70%. Addition
      of dimethylthiourea or mannitol + methionine, two *OH scavengers, resulted in a
      significant protection of ACE activity. Mercaptoethanol and dithiotreitol, two
      thiol-reducing agents, also efficiently protected ACE activity. 3. The hydrolysis
      of two natural and domain-specific substrates was explored. The hydrolysis of
      angiotensin I, preferentially cleaved by the C-domain, was significantly
      inhibited (57-58%) after 4 h exposure to g*OH (0.3-1 mmol/L). Under the same
      conditions of exposure, the hydrolysis of N-acetyl-Ser-Asp-Lys-Pro, a specific
      substrate for the N-domain, was only slightly inhibited by 1 mmol/L g*OH. 4.
      Hydrogen peroxide, another source of *OH, was used. After exposure to H2O2 (3
      mmol/L; 4 h), an 89% decrease in ACE activity was observed. Pretreatment with the
      iron chelator deferoxamine (1 mmol/L) attenuated H2O2-mediated ACE inactivation,
      demonstrating that the effect of H2O2 was partly due to its conversion into *OH
      (Fenton reaction). 5. In summary, our findings demonstrate that g*OH and H2O2
      inhibit ACE activity and suggest a preferential action of g*OH on the C-domain of
      the enzyme.

PMID- 11207679
TI  - Effective treatment of leg vein telangiectasia with a new 940 nm diode laser.
AB  - BACKGROUND: A variety of lasers have been used in an attempt to treat leg vein
      telangiectasia OBJECTIVE: To evaluate the feasibility of a new 940 nm diode laser
      for the treatment of leg vein telangiectasia. METHODS: Thirty-one patients with
      leg vein telangiectasia were treated with a diode laser; 26 of these with 940 nm,
      300-350 J/cm2, 40-70 msec, 1.0 mm handpiece, one pass, and 5 of these with 940
      nm, 815 J/cm2, 50 msec, 0.5 mm handpiece, one pass. Each subject had three
      treatments of the same site at 4-week intervals. Photographs taken before and 4
      weeks after the last treatment were evaluated by two independent observers for
      vessel clearance. RESULTS: In those 26 patients treated with a fluence of 300-350
      J/cm2, a vessel clearance of greater than 50% was achieved in 20 patients (76%),
      12 of these patients had clearance rates greater than 75%. A clearance rate of
      less than 50% was obtained in six patients, with three of these patients showing
      responses of less than 25%. In five patients treated with a fluence of 815 J/cm2
      a clearance rate of more than 75% was observed. CONCLUSIONS: In this preliminary
      study a 940 nm diode laser was shown to be safe and effective for the treatment
      of leg vein telangiectasia.

PMID- 11207680
TI  - Resurfacing of pitted facial acne scars with a long-pulsed Er:YAG laser.
AB  - BACKGROUND: Conventional short-pulsed Er:YAG lasers show less effective
      hemostasis and weak photothermal damage on papillary dermis. Recently, newer long
      pulsed Er:YAG laser systems has been developed. OBJECTIVE: To evaluate the
      clinical and histologic effects of long-pulsed Er:YAG laser resurfacing for
      pitted facial acne scars. METHODS: Thirty-five patients with pitted facial acne
      scars were treated with a long-pulsed Er:YAG laser. All patients had Fitzpatrick
      skin phototypes III-V. A pulsed Er:YAG laser with a 5 mm handpiece at a setting
      of 7.0-7.5 J/cm2 with a 10-msec pulse duration was used. The laser was fired at 5
      Hz, with four to five passes. In 28 patients, the results of laser treatment were
      evaluated for the degree of clinical improvement, duration of erythema,
      pigmentary change, and any adverse events at 2 weeks, 1 month, and 3 months. In
      seven patients, skin biopsy specimens were obtained at the following intervals:
      immediately, 1 week, 2 weeks, 4 weeks, and 8 weeks postoperatively for histologic
      examination. RESULTS: The results of long-pulsed Er:YAG laser resurfacing for
      pitted facial acne scars were excellent in 10 patients (36%), good in 16 patients
      (57%), and fair in 2 patients (7%). Erythema occurred in all patients after laser
      treatment and lasted longer than 3 months in 15 patients (54%). Postinflammatory
      hyperpigmentation occurred in 8 patients (29%). But the pigmentation faded or
      disappeared within 3 months. One patient (4%) experienced mild hypopigmentation.
      Pruritic symptoms that required medical intervention occurred in 16 patients
      (57%). Mild to moderate postoperative acne flare-up occurred in 8 patients (29%).
      No other adverse effects such as scarring, bacterial infection, or contact
      dermatitis were observed. CONCLUSION: In conclusion, resurfacing with a long
      pulsed Er:YAG laser is a safe and very effective treatment modality for pitted
      facial acne scars.

PMID- 11207681
TI  - Facial rejuvenation with a nonablative 1320 nm Nd:YAG laser: a preliminary
      clinical and histologic evaluation.
AB  - BACKGROUND: Rejuvenation of photoaged skin involves removal of the epidermis and
      superficial dermis, encouraging the production of new epidermis with collagenesis
      and remodeling. The facial appearance during healing is unpleasant, and the
      complication rate is high. OBJECTIVE: We evaluate a Q-switched Nd:YAG laser
      operating at 1320 nm, with a cryogen delivery system and a skin temperature
      sensor. The system cools the target skin, followed by the laser impulse which
      passes through the cooled epidermis into the dermis. METHODS: Ten patients are
      presented. Two treatments a week were given over 4 weeks, and the patients were
      seen at 2 and 6 weeks after the final treatment. RESULTS: The histology showed
      improvement in the condition of the dermis in all 10 patients, but only 2 of the
      10 patients expressed satisfaction with the results, despite similar histologic
      findings. CONCLUSIONS: Careful patient selection is required. Better patient
      education is necessary to ensure that the patients' expectations are realistic.
      We should add treatments that will improve the youthful aspect of the epidermis.
      The system may well help in maintaining the effects of collagen remodeling
      following traditional ablative resurfacing procedures, but studies are necessary
      to show this.

PMID- 11207682
TI  - Endovenous laser: a new minimally invasive method of treatment for varicose veins
      -preliminary observations using an 810 nm diode laser.
AB  - BACKGROUND: Long-term success in the treatment of truncal and significant branch
      leg varicosities, when the saphenofemoral junction (SFJ) and the greater
      saphenous vein (GSV) are involved, depends on the elimination of the highest
      point of reflux and the incompetent venous segment, and is best achieved by
      surgical ligation and stripping. Minimally invasive alternatives in the treatment
      of varicose veins with SFJ and GSV incompetence have been tried over the years to
      increase patient comfort, reduce cost and risk, and allow implementation by a
      wide variety of practitioners resulting in varying degrees of success depending
      on the fulfillment of the above two premises and the effectiveness of the method
      used. OBJECTIVE: To demonstrate a novel way to use laser energy through an
      endoluminal laser fiber for the minimally invasive treatment of truncal
      varicosities that eliminates the highest point of reflux and the incompetent
      segment. METHODS: Patients were treated with 810 nm diode laser energy
      administered endovenously through a bare-tipped laser fiber (400-750 microm).
      Vein access for endoluminal placement of the fiber through a catheter was
      achieved by means of percutaneous or stab wound incision under ultrasound
      guidance and local anesthesia. Exact placement of the fiber was determined by
      direct observation of the aiming beam through the skin and by ultrasound
      confirmation. RESULTS: Preliminary short-term postprocedure results (up to 1
      year, 2 months after treatment) in the endovenous laser treatment of 40 greater
      saphenous veins in 33 patients indicate a 100% rate of closure with no
      significant complications. In addition, a 2-year experience of 80 cases of
      isolated branch varicosities (Giacomini, anterolateral branch, etc.) also shows a
      100% rate of closure. CONCLUSION: Early results of our endoluminal laser
      methodology indicate a very effective and safe way to eliminate SFJ incompetence
      and close the GSV. With proper patient selection, the ease of methodology and the
      reduced risk and cost associated with endovenous laser treatment may make it a
      successful minimally invasive alternative for a wide group of patients that
      previously would have required ligation and stripping.

PMID- 11207683
TI  - Micropigmentation as an adjuvant in cosmetic surgery of the scalp.
AB  - BACKGROUND: Unsightly scalp scars, refractory to surgical revision, can pose a
      difficult therapeutic problem. Application of cosmetics for camouflage is time
      consuming, repetitive, expensive, and seldom satisfactory. Treatment of scalp
      scars with micropigmentation has never been reported. OBJECTIVE: To show that
      iron oxide micropigmentation of scalp scars is simple, safe, and effective.
      METHODS: A commercially available micropigmentation system, sterile needle
      assemblies, and appropriately colored iron oxide pigments were used in all
      procedures. Due to the varying textures of scalp scars, greater force was
      required in some areas to achieve proper needle penetration. Once the scar area
      was pigmented, the surrounding scalp was also pigmented to obtain a "feathering"
      effect. RESULTS: The cosmetic improvement after micropigmentation was always
      dramatic and all patients were pleased with the results. About 22% of the
      patients requested a touch-up of the micropigmentation to reinforce the residual
      pigment. Frontal edema was the only complication and was seen in one patient.
      CONCLUSION: Micropigmentation of the scalp is a safe and effective technique for
      camouflaging scalp scars.

PMID- 11207684
TI  - Presurgical ultrasound-guided anchor-wire marking of soft tissue metastases in
      stage III melanoma patients.
AB  - BACKGROUND: Due to increased sensitivity of diagnostic procedures, soft tissue
      metastases in melanoma patients are frequently detected very early. However,
      small sizes, deep location, or position close to vulnerable structures could
      render subsequent surgery quite difficult. OBJECTIVE: To test the feasibility and
      effectiveness of presurgical ultrasound-guided anchor-wire marking of melanoma
      metastases. METHODS: We selected melanoma patients with cytologically proven
      metastases in clinical stage III which were either unfavorably located or which
      have failed removal by previous surgery. Anchor-wire marking was performed
      ultrasound guided and free-hand style without the use of local anesthesia.
      RESULTS: Twelve procedures in nine patients were well tolerated without any
      complications. In 11 cases the wire tip proved to be located within the tumor
      lesion; in one case the wire tip missed the target by less than 5 mm and thus was
      close enough to support appropriate surgery. Earlier, 3 of the 12 study lesions
      had undergone unsuccessful surgery. The median diameter of the removed metastases
      was 18.5 mm (range 7-30 mm). CONCLUSION: Ultrasound-guided anchor-wire marking of
      unfavorably located melanoma metastases is feasible and might facilitate
      subsequent surgery.

PMID- 11207685
TI  - Reasons for ulceration after injection treatment of telangiectasia.
AB  - BACKGROUND: Sclerotherapy of telangiectasias is widely used for their treatment,
      but causes skin ulceration in 0.2-1.2% of patients. The cause of this
      complication is still unclear. OBJECTIVE: We hypothesized that an arteriole is
      occluded because the sclerosant gets into an arteriovenous (AV) shunt. We have
      looked for these communications underneath the telangiectasias. METHODS: Doppler
      examination was performed in 155 cases above the telangiectasias to reveal the
      presence of an AV shunt. Twenty-two positive sites were excised and
      histologically screened for AV shunts. RESULTS: Pulsatile sound could be detected
      by Doppler transducer above spider veins in 112 cases (72.2%). Of the 22 Doppler
      positive telangiectasias, 19 AV microshunts could be found histologically.
      CONCLUSIONS: Understanding the mechanism of this complication can lead to its
      prevention. No more than 0.2 ml of sclerosant should be administered to a single
      site. The warning sign of backwash of sclerosant into arterials is the temporary
      blanching of the skin from the arterial spasm.

PMID- 11207686
TI  - Topical L-ascorbic acid: percutaneous absorption studies.
AB  - BACKGROUND: Reactive oxygen species generated by ultraviolet light result in
      photocarcinogenic and photoaging changes in the skin. Antioxidants protect skin
      from these insults. OBJECTIVE: This study defines formulation characteristics for
      delivering L-ascorbic acid into the skin to supplement the skin's natural
      antioxidant reservoir. METHODS: L-ascorbic acid or its derivatives were applied
      to pig skin. Skin levels of L-ascorbic acid were measured to determine
      percutaneous delivery. RESULTS: L-ascorbic acid must be formulated at pH levels
      less than 3.5 to enter the skin. Maximal concentration for optimal percutaneous
      absorption was 20%. Tissue levels were saturated after three daily applications;
      the half-life of tissue disappearance was about 4 days. Derivatives of ascorbic
      acid including magnesium ascorbyl phosphate, ascorbyl-6-palmitate, and
      dehydroascorbic acid did not increase skin levels of L-ascorbic acid.
      CONCLUSIONS: Delivery of topical L-ascorbic acid into the skin is critically
      dependent on formulation characteristics.

PMID- 11207687
TI  - Bowen's disease (squamous cell carcinoma in situ) in immunosuppressed patients
      treated with imiquimod 5% cream and a cox inhibitor, sulindac: potential
      applications for this combination of immunotherapy.
AB  - BACKGROUND: Patients with chronic lymphocytic leukemia (CLL) often have a
      protracted course. However, all these patients are immunosuppressed and may have
      a high incidence of cutaneous malignancies. OBJECTIVE: To determine if
      combination therapy using topical imiquimod cream 5% and the oral cyclooxygenase
      (COX) inhibitor are useful in the therapy of squamous cell carcinoma in situ (SCC
      in situ)/Bowen's disease in patients with long-standing CLL. METHODS: Five CLL
      patients with head and neck cutaneous SCC in situ, which met criteria for Bowen's
      disease, were treated with topical 5% topical imiquimod cream and an oral COX
      inhibitor, sulindac 200 mg twice a day. RESULTS: All patients showed clinical
      resolution and histologic clearing of the tumors after 16 weeks of therapy.
      CONCLUSION: The local immune modulator, 5% imiquimod, in combination with a COX
      inhibitor, with its many potential antitumor effects may stimulate the innate and
      possibly the adaptive immune responses to clear these malignancies.

PMID- 11207688
TI  - Immediate postoperative laser resurfacing improves second intention healing on
      the nose: 5-year experience.
AB  - BACKGROUND: Mohs surgery defects on convex nasal surfaces do not reliably heal
      well by second intention. Prior to the availability of laser resurfacing we found
      that immediate postoperative dermabrasion improved the predicted outcome from
      second intention healing for these defects. OBJECTIVE: To determine the ability
      of immediate postoperative CO2 and Er:YAG laser resurfacing to improve predicted
      healing by second intention. METHODS: Seventy-four patients with Mohs surgical
      defects on the nose underwent immediate postoperative resurfacing with either a
      scanned CO2 or long-pulsed Er:YAG laser. Thirty patients had photographs of
      appropriate quality and follow-up for evaluation by a panel of nine objective
      physicians. RESULTS: All 74 patients were satisfied with their result and none
      have requested scar revision. Of the 30 patients evaluated by the panel, all were
      scored acceptable to excellent. CONCLUSION: Immediate laser resurfacing can
      improve the predicted outcome from second intention healing on the nose and
      should be considered for select patients.

PMID- 11207689
TI  - Ocular damage due to chlorhexidine versus eyeshield thermal injury.
AB  - BACKGROUND: Ocular damage may occur from a number of mechanisms during laser use.
      OBJECTIVE: To review issues relevant to ocular protection during laser
      resurfacing. METHODS: The authors were consulted to evaluate the thermal energy
      transferred from the outer to the inner (ie, corneal contact) surface of
      stainless steel eyeshields following direct exposure to the carbon dioxide (CO2)
      resurfacing laser beam. Measurements were obtained using thermocouples (attached
      to the inner surface of the eyeshields) and analyzed with a computer-based
      acquisition system. RESULTS: A maximum eyeshield temperature increase of 13
      degrees C above the ambient temperature was noted following one pass with a CO2
      resurfacing laser (Sharplan continuous CO2 laser with Clinicon SureScan scanner,
      15 W, 950 microsec pulse duration, square spot of 9 mm). CONCLUSION: The
      eyeshields analyzed in this study minimized thermal transfer following a single
      direct hit with a CO2 resurfacing laser. An understanding of the potential
      mechanisms of ocular injury is essential in preventing its occurrence.

PMID- 11207690
TI  - Minimizing postoperative drainage with 20% ferric chloride after chemical
      matricectomy with phenol.
AB  - BACKGROUND: Phenol used in partial matricectomy shows its effects by denaturing
      matrix proteins. This highly successful method has the major problem of oozing
      which can continue for 5-6 weeks. OBJECTIVE: The goal of this study was to
      determine the effect of 20% ferric chloride (FC) (FeCl3) on minimizing the oozing
      after chemical matricectomy with phenol. METHODS: Sixty-seven patients with stage
      III onychocryptosis were treated by chemical matricectomy with 90% aqueous
      phenol. In 32 of these patients FC was applied to the nail bed after the
      phenolization procedure. RESULTS: We found a statistically significant (P <.001)
      reduction of oozing in the FC-applied group of patients. CONCLUSION: We think
      that using FC after phenol chemical matricectomy results in a significant
      reduction in oozing from the operation site.

PMID- 11207691
TI  - The versatility of the nasolabial flap enhanced by the delay procedure.
AB  - BACKGROUND: The nasolabial flap is a versatile and effective option for the
      closure of nasal defects of the cheek and nasal sidewall following Mohs surgery.
      However, both extirpation of a tumor in the region of the base of the flap or
      previous use of the flap often destroy the proximal axial blood supply to the
      flap, excluding its immediate utilization. We describe a different use of the
      nasolabial flap and a technique for preserving its capacity in the case of
      reutilization OBJECTIVE: To describe the versatility of the nasolabial flap and a
      delay procedure that enables its exploitation despite prior disruption of the
      proximal blood supply. METHODS: Three different uses of the same nasolabial flap
      are demonstrated in one patient. The surgical techniques are discussed in detail.
      RESULTS: The reconstructive results were excellent. There were no postoperative
      complications. CONCLUSION: The nasolabial flap is a versatile and effective
      option for the closure of nasal defects of the cheek and nasal sidewall. When the
      nasolabial flap has been used before, or its blood supply compromised, the delay
      procedure can reestablish its applicability.

PMID- 11207692
TI  - Merkel cell carcinoma of the skin and mucosa: report of 12 cutaneous cases with 2
      cases arising from the nasal mucosa.
AB  - BACKGROUND: Merkel cell carcinoma (MCC) is an uncommon skin tumor that most
      frequently arises on sun-exposed facial sites. It rarely occurs on mucous
      membranes of the head region. The primary MCC is usually treated by wide excision
      followed by radiation to the primary site and regional lymph nodes. Using
      traditional surgery the local recurrence rate ranges from 20 to 50%. In our
      clinic, Mohs surgery is used to excise the primary MCC completely, followed by
      radiation. Here we present our treatment experiences and outcomes. OBJECTIVE: To
      document our experience of MCC treated by Mohs surgery. We present our series of
      12 cases of MCC, 2 cases of which arose from mucosal sites of the nasal cavity.
      METHODS: We reviewed 12 cases of MCC from the Mohs clinic database. We also
      reviewed the literature for cutaneous and mucosal MCC. RESULTS: There were 12
      cases of MCC: 10 cutaneous and 2 mucous. The site distribution of cutaneous MCC
      was eight on the head, one on the neck, and one on the groin. Of these, nine were
      treated by Mohs excision. Two patients developed local recurrence following Mohs
      treatment. The local recurrence rate was 22% (2 of 9). The sites of mucosal MCC
      were the nasal septum and nasopharynx. One case had a history of previous
      radiation and developed an MCC 40 years later. This case also demonstrated
      epidermotropic spread of Merkel cells to the overlying mucous epithelium. This
      patient required extensive intranasal and cranial surgery to remove the tumor.
      Both patients with mucosal MCCs died of their disease. The overall mucocutaneous
      survival of MCC at 1 year was 80% and at 2 years was 50%. CONCLUSION: In our
      series, local control of the primary MCC was achieved in 70% of patients (7 of
      10) using combined Mohs excision and radiation. Two recurrences had primary
      tumors larger than 3.5 cm in diameter, while the other case was nonresectable by
      Mohs surgery. Tumor size appeared to determine the degree of local control. When
      the postoperative Mohs defect was less than 3.0 cm in diameter, local and
      regional control appeared to be more favorable. When the primary facial MCC is
      relatively small, removal by Mohs surgery followed by radiation was effective,
      therapeutic, and less disfiguring. Mucosal MCC is rare and may occur as a long
      term sequelae after radiation therapy to the skin.

PMID- 11207693
TI  - Effect of the 585 nm flashlamp-pumped pulsed dye laser for the treatment of
      keloids.
AB  - BACKGROUND: Due to its potential effects on skin microcirculation and collagen
      metabolism, the 585 nm flashlamp-pumped pulsed dye laser has been proposed for
      treating abnormal scars. Indeed, one of the main problems with keloidal scars is
      their disfiguring erythematous color. OBJECTIVE: To assess the efficacy of the
      585 nm pulsed dye laser on the appearance of keloids. METHODS: Eleven patients
      with skin phototypes II-IV and keloids were treated with the 585 nm pulsed dye
      laser. After one to three treatment sessions, clinical assessments of the scars
      were performed in combination with remittance spectroscopy measurements of the
      redness and melanin pigmentation. A group of nine keloids covered by silicone gel
      sheeting served as controls. Data were compared statistically. RESULTS: During
      laser treatments, a discrete decrease in redness of the scars was clinically
      reported. However, this improvement was not confirmed by the objective
      spectrophotometric data. No side effects, especially hyperpigmentation, were
      disclosed. The keloids redness was not improved in the control group. CONCLUSION:
      The 585 nm pulsed dye laser yields only minimal effects, if any, on the erythema
      of keloids. Similarly silicone gel sheeting does not modify the keloids redness.

PMID- 11207694
TI  - Moist wound healing with occlusive dressings: a clinical focus.
AB  - The concept of moist wound healing, which is facilitated by the application of
      occlusive dressings, dates back to 1615 BC, and the technique is currently
      supported by a relatively large volume of data. It is clear that occlusive
      dressings are in many cases associated with more rapid reepithelialization, a
      reduced risk of infection, and more rapid wound healing than the alternatives.
      Nevertheless, many clinicians have been slow to accept this therapeutic
      technique. This article traces the history of moist wound healing from its
      earliest inception, examines the theoretical mechanisms of its effect, and
      explores its advantages and disadvantages. It also reviews the literature
      supporting the use of occlusive dressings in a variety of wound settings and
      examines the possible reasons behind the apparent reluctance on the part of the
      medical community to accept a potentially valuable therapy.

PMID- 11207695
TI  - Forceps and cotton applicator method of freezing benign lesions.
AB  - BACKGROUND: Cryosurgery is one of the most common treatment methods in the
      dermatologists armamentarium. We describe a method combining forceps and a cotton
      applicator to freeze benign lesions for practitioners who prefer to use cotton
      tipped applicators instead of a cryosurgery spray device. METHODS: We describe
      the technique using common in-office instruments. CONCLUSION: Lesions around
      delicate areas can be treated with forceps and a cotton-tipped applicator dipped
      in liquid nitrogen resulting in less pain and decreased collateral damage vs.
      traditional methods. For the most delicate areas, the forceps dipped directly in
      liquid nitrogen method is preferred.

PMID- 11207696
TI  - Human anti-hyaluronic acid antibodies: is it possible?
AB  - BACKGROUND: Although hyaluronan has been acknowledged as being free of species
      and organ specificity, for 4 years I have encountered a variety of adverse
      reactions to injectable hyaluronic acid as used in aesthetic medicine. OBJECTIVE:
      I have tried to prove that some of those side effects may be allergic reactions
      to the commercial preparations of injectable hyaluronic acid. METHODS: I began
      with intradermal tests to the reactive patients and to 2 witnesses; then
      lymphocyte transforming tests were performed at the University of Geneva
      (Switzerland). Histology was performed on the skin tests and on reactive treated
      areas of the face of different patients. A serum analysis was then done by Pr.
      Sainte Laudy of Laboratoire Pasteur--Cerba (France). RESULTS: The skin tests were
      positive for one or the other or both of the injectable hyaluronic acid
      preparations used in aesthetic medicine. The different biopsies have shown for
      some a chronic inflammatory reaction, even 11 months after the treatment or a
      severe granulamatous reaction to foreign bodies. Serum analysis revealed positive
      antibodies against Restylane and/or Hylaform and even IgG and E anti-hyaluronic
      acid. CONCLUSION: Since 1995, I have 8 patients with adverse reactions to
      injectable hyaluronic acid, which after several tests, may be allergic to those
      products. Isn't it time to introduce intradermal tests before any injection of
      this type, as done with injectable bovine collagen?

PMID- 11207697
TI  - Renal cell carcinoma metastatic to the scalp: case report and review of the
      literature.
AB  - BACKGROUND: Renal cell carcinoma metastatic to the skin is rare. OBJECTIVE: To
      illustrate by a case report the clinical presentation and management of the
      disease. METHODS: We present a case of renal carcinoma metastatic to the skin of
      the scalp that occurred 6 years after removal of her kidney. The tumor was
      diagnosed using frozen tissue and paraffin sections. RESULTS: Cutaneous
      metastasis treated by excision. CONCLUSION: Renal cell carcinoma may metastasize
      to the skin of the scalp. Our case illustrated an interesting ipsilateral
      metastasis that occurred 6 years after treatment of her primary tumor.
      Physicians, dermatologists, pathologists, and Mohs surgeons should be aware of
      this entity.

PMID- 11207698
TI  - Basal cell carcinoma arising in a cleft lip repair scar.
AB  - BACKGROUND: A case of basal cell carcinoma (BCC) developing in the repair scar of
      a cleft lip is presented. OBJECTIVE: Primary BCCs arising in surgical scars are
      very rare and no known reported cases exist of a BCC developing in a surgically
      repaired cleft lip scar. METHODS: A 69-year-old white man presented with a 5 mm
      primary BCC on his upper lip at the site of his cleft lip repair scar. The
      diagnosis was made by a tangential biopsy that showed an ulcerated BCC. RESULTS:
      Review of the medical literature indicates that a scar may be an independent risk
      factor for developing BCC. CONCLUSION: BCC may rarely arise in a cleft lip repair
      scar.

PMID- 11207699
TI  - Adverse granulomatous reaction after cosmetic dermal silicone injection.
AB  - BACKGROUND: Various alloplastic injectable implants have been developed for soft
      tissue augmentation without surgery, but different local or systemic adverse
      reactions have limited their use for cosmetic purposes. OBJECTIVE: To examine the
      problems associated with silicone injection. METHODS: Case report and literature
      review. RESULTS: We describe an adverse granulomatous reaction after the
      injection of liquid silicone for lip augmentation, causing facial disfigurement.
      Although the initial response to steroids was poor, after 3 years of follow-up
      the nodules have almost disappeared spontaneously. CONCLUSION: We advise that
      silicone injection be performed solely by trained physicians using medical-grade
      silicone or consider other injectable materials.

PMID- 11207700
TI  - Rhinophyma and coexisting occult skin cancers.
AB  - BACKGROUND: Although coexistent tumors have been reported in patients with
      rhinophyma, few reports have described the coexistence of rhinophyma and an
      occult infiltrating squamous cell carcinoma (SCC). OBJECTIVE: Preoperatively and
      during rhinophymaplasty, recognition of subtle changes can suggest an underlying
      malignancy. METHODS: A large infiltrating SCC was noted during electrosurgical
      rhinophymaplasty. Mohs micrographic surgery was performed to clear the tumor.
      RESULTS: The patient was tumor-free with no evidence of recurrence at 1-year
      follow-up. CONCLUSION: In the evaluation of changing rhinophyma or subtle changes
      in tissue noted during rhinophymaplasty, physicians must consider the possibility
      of an underlying malignancy.

PMID- 11207701
TI  - Bilateral auricular squamous cell carcinomas with perineural invasion.
AB  - BACKGROUND: Bilateral squamous cell carcinoma (SCC) of the external ears is a
      rare phenomenon, and we are unaware of instances of bilateral perineural
      involvement. OBJECTIVE: To describe bilateral auricular SCCs, each with
      perineural invasion. METHODS: Case report and literature review. RESULTS:
      Histopathologic examination revealed perineural invasion in both tumors.
      CONCLUSION: This appears to be an unusual presentation of bilateral auricular
      SCCs with perineural invasion in an elderly immunocompromised patient.

PMID- 11207702
TI  - Liposuction Council Bulletin.

PMID- 11207703
TI  - Facial skin rejuvenation: laser resurfacing or chemical peel: choose your weapon.

PMID- 11207704
TI  - Chemical peeling vs. laser resurfacing.

PMID- 11207705
TI  - The use of combined nasolabial V-Y advancement and glabellar flaps for large
      medial canthal defects.
AB  - BACKGROUND: Reconstruction of the medial canthal area presents many challenges
      for surgeons. It has many functional and cosmetic peculiarities. The combined use
      of glabellar and nasolabial V-Y advancement flaps is an effective method for
      repairing large medial canthal defects. OBJECTIVE: To describe and illustrate a
      technique to repair medial canthal defects. METHODS: Our experience with combined
      usage of nasolabial V-Y flap and glabellar flaps for medial canthal closure after
      tumor resection in 23 patients is reported. RESULTS: All resections and
      reconstructive procedures were performed under local anesthesia. All patients
      were treated without any complications such as flap loss, wound dehiscence,
      lymphedema, or ectropion. Fine results were achieved from both the functional and
      aesthetic point of view. CONCLUSION: This combination has many advantages over
      skin grafts and other local flaps. It is easy to design, reliable, and offers
      good cosmetic results. This combination is recommended to plastic surgeons as a
      safe and effective procedure for reconstruction of medial the canthal area.

PMID- 11207706
TI  - Using suture removal kit for punch biopsy.

PMID- 11207707
TI  - Punch techniques, acne scarring, and resurfacing.

PMID- 11207709
TI  - Regarding surgical recontouring of the neck.

PMID- 11207711
TI  - The birth of Environmental Microbiology.

PMID- 11207712
TI  - Microbial diversity--the past and future of microbiology. In recognition of the
      centennial of the American Society for Microbiology.

PMID- 11207713
TI  - What makes Pseudomonas bacteria rhizosphere competent?

PMID- 11207714
TI  - The ecology of the myxobacteria.

PMID- 11207715
TI  - Inhibition of Escherichia coli precursor-16S rRNA processing by mouse intestinal
      contents.
AB  - The correlation between ribosome content and growth rate found in many bacterial
      species has proved useful for estimating the growth activity of individual cells
      by quantitative in situ rRNA hybridization. However, in dynamic environments, the
      stability of mature ribosomal RNA causes problems in using cellular rRNA contents
      for direct monitoring of bacterial growth activity in situ. In a recent paper,
      Cangelosi and Brabant suggested monitoring the content of precursors in rRNA
      synthesis (pre-rRNAs) as an alternative approach. These are rapidly broken down
      after the cessation of bacterial growth. We have applied fluorescence in situ
      hybridization of pre-16S rRNA to Escherichia coil cells growing in vitro in
      extracts from two different compartments of the mouse intestine: the caecal mucus
      layer, where E. coli grew rapidly, and the contents of the caecum, which
      supported much slower bacterial growth. The amounts of 23S rRNA and pre-16S rRNA
      measured for E. coil growing in intestinal mucus corresponded to that expected
      for bacteria with the observed growth rate. In contrast, the slow-growing E. coli
      cells present in intestinal contents turned out to have an approximately ninefold
      higher content of pre-16S rRNA than cultures of the same strain growing rapidly
      in rich media. We present results suggesting that the mouse intestinal contents
      contain an agent that inhibits the growth of E. coli by disturbing its ability to
      process pre-16S rRNA.

PMID- 11207716
TI  - Adaptive mgl-regulatory mutations and genetic diversity evolving in glucose
      limited Escherichia coli populations.
AB  - The mutational adaptation of E. coli to low glucose concentrations was studied in
      chemostats over 280 generations of growth. All members of six independent
      populations acquired increased fitness through the acquisition of mutations at
      the mgl locus, increasing the binding protein-dependent transport of glucose.
      These mutations provided a strong fitness advantage (up to 10-fold increase in
      glucose affinity) and were present in most isolates after 140 generations. mgl
      constitutivity in some isolates was caused by base substitution, short
      duplication, small deletion and IS1 insertion in the 1041 bp gene encoding the
      repressor of the mgl system, mglD (galS). But an unexpectedly large proportion of
      mutations were located in the short mgl operator sequence (mglO), and the
      majority of mutations were in mglO after 280 generations of selection. The
      adaptive mglO substitutions in several independent populations were at exactly
      the positions conserved in the two 8 bp half-sites of the mgl operator, with the
      nature of the base changes also completely symmetrical. Either mutations were
      directed to the operator or the particular operator mutations had a selective
      advantage under glucose limitation. Indeed, isolates carrying mglO mutations
      showed greater rates of transport for glucose and galactose at low concentrations
      than those carrying mglD null mutations. mglO mutations avoid cross-talk by
      members of the GalR-Lacl repressor family, reducing transporter expression and
      providing a competitive advantage in a glucose-limited environment. Another
      interesting aspect of these results was that each adapted population acquired
      multiple mgl alleles, with several populations containing at least six different
      mgl-regulatory mutations co-existing after 200 generations. The diversity of
      mutations in the mglO/mglD region, generally in combination with mutations at
      other loci regulating glucose uptake (malT, mlc, ptsG), provided evidence for
      multiple clones in each population. Increased fitness was accompanied by the
      generation of genetic diversity and not the evolution of a single winner clone,
      as predicted by the periodic selection model of bacterial populations.

PMID- 11207717
TI  - The generation of multiple co-existing mal-regulatory mutations through polygenic
      evolution in glucose-limited populations of Escherichia coli.
AB  - The multicomponent glucose transport system of Escherichia coli was used to study
      the polygenic basis of increased fitness in prolonged nutrient-limited,
      continuous cultures. After 280 generations of glucose-limited growth, nearly all
      bacteria in four independent chemostat populations exhibited increased glucose
      transport and contained multiple, stable mutations. Fitter bacteria increased
      outer membrane permeability for glucose through overexpression of the LamB
      glycoporin. Three classes of mutation influenced LamB levels as well as
      regulation of other mal genes. Low-level mal/lamB constitutivity resulted from
      mlc mutations acquired in all populations as well as changes at another
      uncharacterized locus. Larger increases in transporter content resulted from
      widespread acquisition of a regulatory malT-con mutation in fit isolates. The
      malT mutations sequenced from 67 adapted isolates were all single base
      substitutions resulting in amino acid replacements in the N-terminal third of the
      MalT activator protein. Analysis of malT-con sequences revealed a mutational
      spectrum distinct from that found in plate-selected malT mutants, suggesting that
      mutational pathways were affected by environmental factors. A second major
      finding was the remarkable allele diversity in malT within a population derived
      from a single clone, with at least 11 different alleles co-existing in a
      population. The multiplicity of alleles (as well as those found in adaptive mgl
      changes in the accompanying study) suggest that the periodic selection events
      observed previously in such populations are not a major factor in reducing
      genetic diversity. A simple model is presented for the generation of genetic
      heterogeneity in bacterial populations undergoing polygenic selection.

PMID- 11207718
TI  - Evidence for recent intergeneric transfer of a new tetracycline resistance gene,
      tet(W), isolated from Butyrivibrio fibrisolvens, and the occurrence of tet(O) in
      ruminal bacteria.
AB  - We have previously reported high-frequency transfer of tetracycline resistance
      between strains of the rumen anaerobic bacterium Butyrivibrio fibrisolvens. Donor
      strains were postulated to carry two TcR genes, one of which is transferred on a
      novel chromosomal element. It is shown here that coding sequences within the non
      transmissible gene in B. fibrisolvens 1.230 are identical to those of the
      Streptococcus pneumoniae tet(O) gene. This provides the first evidence for
      genetic exchange between facultatively anaerobic bacteria and rumen obligate
      anaerobes. In contrast, the product of the transmissible TcR gene shares only 68%
      amino acid sequence identity with the TetO and TetM proteins and represents a new
      class of ribosome protection tetracycline resistance determinant, designated Tet
      W. The tet(W) coding region shows a higher DNA G + C content (53%) than other B.
      fibrisolvens genes or other ribosome protection-type tet genes, suggesting recent
      acquisition from a high G + C content genome. Tet(W) genes with almost identical
      sequences are also shown to be present in TcR strains of B. fibrisolvens from
      Australian sheep and in TcR strains of two other genera of rumen obligate
      anaerobes, Selenomonas ruminantium and Mitsuokella multiacidus. This provides
      compelling evidence for recent intergeneric transfer of resistance genes between
      ruminal bacteria. Tet(W) is not restricted to ruminal bacteria, as it was also
      present in a porcine strain of M. multiacidus.

PMID- 11207719
TI  - Sulphate reduction and vertical distribution of sulphate-reducing bacteria
      quantified by rRNA slot-blot hybridization in a coastal marine sediment.
AB  - In the past, enumeration of sulphate-reducing bacteria (SRB) by cultivation-based
      methods generally contradicted measurements of sulphate reduction, suggesting
      unrealistically high respiration rates per cell. Here, we report evidence that
      quantification of SRB rRNA by slot-blot hybridization is a valuable tool for a
      more realistic assessment of SRB abundance in the natural environment. The
      distribution of SRB was investigated in a coastal marine sediment by
      hybridization of membrane-immobilized rRNA with oligonucleotide probes. As
      represented by general probe-target groups, SRB rRNA contributed between 18% and
      25% to the prokaryotic rRNA pool. The dominant SRB were related to complete
      oxidizing genera (Desulphococcus, Desulphosarcina and Desulphobacterium), while
      Desulphobacter could not be detected. The vertical profile and quantity of rRNA
      from SRB was compared with sulphate reduction rates (SRR) measured with 35SO4(2-)
      tracer in whole-core incubations. While SRB abundance was highest near the
      surface, peaking at around 1.5 cm, measured sulphate reduction rates were lowest
      in this region. A second peak of SRB rRNA was observed at the transition zone
      from oxidized to reduced sediment, directly above the sulphate reduction maximum.
      Cell numbers calculated by converting the relative contribution of SRB rRNA to
      the percentage of DAPI-stained cells indicated a population size for SRB of 2.4
      6.1 x 10(8) cells cm(-3) wet sediment. Cellular sulphate reduction rates
      calculated on the basis of these estimated cell numbers were between 0.01 and
      0.09 fmol SO4(2-) cell(-1) day(-1), which is below the rates that have been
      determined for pure cultures (0.2-50 fmol SO4(2-) cell(-1) day(-1)) growing
      exponentially at nearoptimal temperature with a surplus of substrates.

PMID- 11207720
TI  - Functional analysis of the Pseudomonas syringae rulAB determinant in tolerance to
      ultraviolet B (290-320 nm) radiation and distribution of rulAB among P. syringae
      pathovars.
AB  - The effect of the plasmid-encoded rulAB (resistance to ultraviolet radiation)
      determinant on responses of Pseudomonas syringae to ultraviolet-B (UV-B)
      radiation and the distribution of rulAB among pathovars of P. syringae were
      determined. The cloned rulAB determinant and the native rulAB+ plasmid pPSR1 both
      conferred approximately a 10-fold increase in survival on P. syringae pv.
      syringae FF5 following increasing doses of UV-B radiation. rulAB+ P. syringae
      strains also maintained significantly larger epiphytic populations on leaf
      surfaces irradiated with UV-B. rulAB-insertional mutants, constructed in two
      native rulAB+ strains, were from 10- to 100-fold more sensitive to UV-B
      radiation. The UV tolerance phenotype and the rulAB genes were widely distributed
      among P. syringae pathovars isolated from varied plant hosts throughout the world
      and within a broad range of genotypic backgrounds of P. syringae pv. syringae.
      With one exception, the rulAB determinant was harboured on pPT23A-like plasmids;
      these replicons are indigenous residents of the species P. syringae and also tend
      to encode determinants of importance in host-pathogen interactions.

PMID- 11207721
TI  - Humics as an electron donor for anaerobic respiration.
AB  - The possibility that microorganisms might use reduced humic substances (humics)
      as an electron donor for the reduction of electron acceptors with a more positive
      redox potential was investigated. All of the Fe(III)- and humics-reducing
      microorganisms evaluated were capable of oxidizing reduced humics and/or the
      reduced humics analogue anthrahydroquinone-2,6,-disulphonate (AHODS), with
      nitrate and/or fumarate as the electron acceptor. These included Geobacter
      metallireducens, Geobacter sulphurreducens, Geothrix fermentans, Shewanella alga,
      Wolinella succinogenes and 'S. barnesii'. Several of the humics-oxidizing
      microorganisms grew in medium with AHQDS as the sole electron donor and fumarate
      as the electron acceptor. Even though it does not reduce Fe(III) or humics,
      Paracoccus denitrificans could use AHQDS and reduced humics as electron donors
      for denitrification. However, another denitrifier, Pseudomonas denitrificans,
      could not. AHODS could also serve as an electron donor for selenate and arsenate
      reduction by W. succinogenes. Electron spin resonance studies demonstrated that
      humics oxidation was associated with the oxidation of hydroquinone moieties in
      the humics. Studies with G. metallireducens and W. succinogenes demonstrated that
      the anthraquinone-2,6-disulphonate (AQDS)/AHQDS redox couple mediated an
      interspecies electron transfer between the two organisms. These results suggest
      that, as microbially reduced humics enter less reduced zones of soils and
      sediments, the reduced humics may serve as electron donors for microbial
      reduction of several environmentally significant electron acceptors.

PMID- 11207722
TI  - Electrokinetic movement of Escherichia coli in capillaries.
AB  - The movement of Escherichia coli K-12 has been studied in capillaries with an 8
      microm inside diameter under a DC electric field. At low applied voltages (< 0.2
      V cm(-1)), bacterial motility is the predominant mode of motion, with bacteria
      swimming, tumbling and moving unidirectionally towards the anode and the cathode,
      although a significant difference between the mean moving speeds towards the two
      electrodes was observed. When the electric field was removed, the mean swimming
      speeds were the same for both directions. At higher voltages, all the cells were
      swept by electro-osmotic flow exclusively towards the cathode.

PMID- 11207723
TI  - Biodegradation, plasmid-encoded catabolic pathways, host factors and cell
      metabolism.

PMID- 11207724
TI  - Biodegradation.

PMID- 11207725
TI  - Environmental microbiology--the second wave.

PMID- 11207726
TI  - Interactions between Clavibacter michiganensis and its host plants.

PMID- 11207727
TI  - Predicting biodegradation.
AB  - Biodegradation is important for natural and industrial cycling of environmental
      chemicals. Industries and government regulators increasingly seek to know the
      fate of chemicals in the environment and thus prevent potential negative impacts
      on human or ecosystem health. However, millions of organic compounds are known,
      and most will remain unstudied with respect to biodegradation. This necessitates
      the development of organized biodegradation information coupled with predictive
      methods. Biodegradation prediction methods are being developed using the
      information contained in the University of Minnesota Biocatalysis/ Biodegradation
      database. Heuristic rules are derived from compiled biodegradation information.
      Additional rules are generated by deconstructing compounds into a set of the 40
      most common organic functional groups. The rules consist of deriving
      biochemically plausible catabolic reactions for each of the functional groups.
      More complex compounds, containing multiple functional groups, are analysed using
      higher order rules requiring prioritizing enzymatic attack and reactions cleaving
      functional groups. While biodegradation prediction, like weather prediction, will
      never be perfect, it can be an important tool for guiding industry, regulators
      and experimentalists.

PMID- 11207728
TI  - Phylogeny and in situ identification of a morphologically conspicuous bacterium,
      Candidatus Magnospira bakii, present at very low frequency in activated sludge.
AB  - A morphologically conspicuous bacterium that constituted a very small fraction (<
      0.01%) of the total microbial community of activated sludge was enriched and
      analysed phylogenetically by a combination of cultivation-independent molecular
      and physical methods. The large, corkscrew-shaped, filamentous bacteria were
      first detected in municipal activated sludge by light microscopy owing to their
      unusual rotating gliding motility. Various attempts at microbiological enrichment
      and pure culture isolation with traditional techniques failed, as did attempts to
      retrieve the morphotype of interest by micromanipulation. In situ hybridization
      with the group-specific, rRNA-targeted oligonucleotide probe CF319a indicated a
      phylogenetic affiliation to the Cytophaga-Flexibacter group of the Cytophaga
      Flavobacterium-Bacteroides phylum. Based on strong morphological resemblance to
      members of the genus Saprospira, additional 16S rRNA-targeted oligonucleotides
      with more narrow specificity were designed and evaluated for in situ
      hybridization to the morphotype of interest. Flow cytometric cell sorting based
      on the fluorescence conferred by probe SGR1425 and forward scatter enabled a
      physical enrichment of the helical coiled cells. Subsequent polymerase chain
      reaction (PCR) amplification of 16S rDNA fragments from whole fixed sorted cells
      with a primer pair based on probes CF319a and SGR1425 resulted in the retrieval
      of 12 almost identical partial 16S rDNA fragments with sequence similarities
      among each other of more than 99.2%. In situ hybridizations proved that the
      sequences that showed the highest similarity (88.4%) to the 16S rRNA of
      Saprospira grandis were indeed retrieved from the corkscrew-shaped filaments. The
      bacterium is likely to be a member of a genus of which no species has been
      cultured hitherto. It was consequently tentatively named 'Magnospira bakii' and
      has the taxonomic rank of Candidatus Magnospira bakii, as the ultimate taxonomic
      placement has to await its cultivation. In this study, it was demonstrated that
      even bacteria occurring at very low frequencies in highly complex environmental
      samples can be retrieved selectively without cultivation for further molecular
      analysis.

PMID- 11207729
TI  - Application of nested polymerase chain reaction for the detection of as yet
      uncultured organisms of the class Actinobacteria in environmental samples.
AB  - Different groups of as yet uncultured, phylogenetically deeply rooting organisms
      of the class Actinobacteria have been shown previously by analysis of 16S rDNA
      clone libraries to be present in different soil and marine environments of
      worldwide distribution. In order to monitor specifically the occurrence of two of
      the actinobacterial groups among bacterial DNA extracted from different
      environments, a nested polymerase chain reaction (PCR) method, aiming at the
      sensitive detection of 16S rDNA, was used. Analysis of a clone library generated
      from one of these 16S rDNA-derived, group-specific PCR products of DNA from a
      forest soil broadened the spectrum of putative taxa within the two phylogenetic
      groups. Application of this PCR system demonstrated the presence of these
      organisms in natural environments and in a sample of dried and moistened peat.
      Fluctuations in the detectability of the target groups in different samples from
      the same site strongly suggest that the taxon diversity of a 16S rDNA clone
      library must be regarded as a temporal genomic snapshot taken from this
      environmental community.

PMID- 11207730
TI  - Anaerobic utilization of alkylbenzenes and n-alkanes from crude oil in an
      enrichment culture of denitrifying bacteria affiliating with the beta-subclass of
      Proteobacteria.
AB  - Denitrifying bacteria were enriched from freshwater sediment with added nitrate
      as electron acceptor and crude oil as the only source of organic substrates. The
      enrichment cultures were used as laboratory model systems for studying the
      degradative potential of denitrifying bacteria with respect to crude oil
      constituents, and the phylogenetic affiliation of denitrifiers that are
      selectively enriched with crude oil. The enrichment culture exhibited two
      distinct growth phases. During the first phase, bacteria grew homogeneously in
      the aqueous phase, while various C1-C3 alkylbenzenes, but no alkanes, were
      utilized from the crude oil. During the second phase, bacteria also grew that
      formed aggregates, adhered to the crude oil layer and emulsified the oil, while
      utilization of n-alkanes (C5 to C12) from the crude oil was observed. During
      growth, several alkylbenzoates accumulated in the aqueous phase, which were
      presumably formed from alkylbenzenes. Application of a newly designed,
      fluorescently labelled 16S rRNA-targeted oligonucleotide probe specific for the
      Azoarcus/Thauera group within the beta-subclass of Proteobacteria revealed that
      the majority of the enriched denitrifiers affiliated with this phylogenetic
      group.

PMID- 11207731
TI  - Methanogenic archaea and CO2-dependent methanogenesis on washed rice roots.
AB  - Washed excised roots of rice (Oryza sativa) immediately started to produce CH4
      when they were incubated in phosphate buffer under anoxic conditions (N2
      atmosphere), with initial rates varying between 2 and 70nmolh(-1)g(-1) dry weight
      of root material (mean +/- SE: 20.3 +/- 5.9 nmol h(-1) g(-1) dry weight; n = 18).
      Production of CH4 continued for at least 500 h, with rates usually decreasing
      slowly. CH4 production was not significantly affected by methyl fluoride, an
      inhibitor of acetoclastic methanogenesis. Less than 0.5% of added [2-14C]-acetate
      was converted to 14CH4, and conversion of 14CO2 to 14CH4 indicated that CH4 was
      almost exclusively produced from CO2. Occasionally, however, especially when the
      roots were incubated without additional buffer, CH4 production started to
      accelerate after about 200h reaching rates of > 100 nmol h(-1) g(-1) dry weight.
      Methyl fluoride inhibited methanogenesis by more than 20% only in these cases,
      and the conversion of 14CO2 to 14CH4 decreased. These results indicate that CO2
      dependent rather than acetoclastic methanogenesis was primarily responsible for
      CH4 production in anoxically incubated rice roots. Determination of most probable
      numbers of methanogens on washed roots showed highest numbers (10(6)g(-1) dry
      roots) on H2 and ethanol, i.e. substrates that support CH4 production from CO2.
      Numbers on acetate (10(5) g(-1) dry roots) and methanol (10(4)g(-1) dry roots)
      were lower. Methanogenic consortia enriched on H2 and ethanol were characterized
      phylogenetically by comparative sequence analysis of archaeal small-subunit (SSU)
      ribosomal RNA-encoding genes (rDNA). These sequences showed a high similarity to
      SSU rDNA clones that had been obtained previously by direct extraction of total
      DNA from washed rice roots. The SSU rDNA sequences recovered from the H2/CO2
      using consortium either belonged to a novel lineage of methanogens that grouped
      within the phylogenetic radiation of the Methanosarcinales and Methanomicrobiales
      or were affiliated with Methanobacterium bryantii. SSU rDNA sequences retrieved
      from the ethanol-using consortium either grouped within the genus Methanosarcina
      or belonged to another novel lineage within the phylogenetic radiation of the
      Methanosarcinales and Methanomicrobiales. Cultured organisms belonging to either
      of the two novel lineages have not been reported yet.

PMID- 11207734
TI  - Web alert. Mycology. An annotated selection of World Wide Web sites revelant to
      the topics environmental microbiology.

PMID- 11207732
TI  - Towards elucidation of microbial community metabolic pathways: unravelling the
      network of carbon sharing in a pollutant-degrading bacterial consortium by
      immunocapture and isotopic ratio mass spectrometry.
AB  - Although much information on metabolic pathways within individual organisms is
      available, little is known about the pathways operating in natural communities in
      which extensive sharing of nutritional resources is the rule. In order to analyse
      such a consortium pathway, we have investigated the flow of 4-chlorosalicylate as
      carbon substrate within a simple chemostat microbial community using 13C-labelled
      metabolites and isotopic ratio mass spectrometric analysis of label enrichment in
      immunocaptured member populations of the community. A complex pathway network of
      carbon sharing was thereby revealed, involving two different metabolic routes,
      one of which is completely novel and involves the toxic metabolite protoanemonin.
      The high stability of the community results, at least in part, from
      interdependencies based on carbon sharing and the rapid removal of toxic
      metabolites.

PMID- 11207733
TI  - A novel system for efficient gene expression and monitoring of bacteria in
      aquatic environments.
AB  - In a previous study, we reported the identification of Escherichia coli genes
      with increased expression in an aquatic environment. Here, we describe the use of
      one of these genes, gapC, as an expression system in freshwater habitats. We have
      identified the transcriptional start site of gapC and analysed the synthesis of
      the GapC protein during incubation in aquatic medium. The promoter of gapC was
      used to construct fusions to the reporter genes lacZ and gfp. Analysis of these
      fusions indicates the potential of gapC as a valuable tool for the detection of
      E. coli in freshwater habitats, as well as for expressing other genes in aquatic
      environments.

PMID- 11207735
TI  - Report on 1st Euroconference on Bacterial-Metal/Radionuclide Interactions: Basic
      Research and Bioremediation.

PMID- 11207736
TI  - An urgent need to reassess the balance between fundamental and applied
      environmental research.

PMID- 11207737
TI  - Improving human health means eliminating microbial pathogens.

PMID- 11207738
TI  - Multiple responses of gram-negative bacteria to organic solvents.

PMID- 11207739
TI  - Identification of the metabolically active members of a bacterial community in a
      polychlorinated biphenyl-polluted moorland soil.
AB  - The presumptive metabolically active members of a bacterial community in a
      moorland soil in Germany, highly polluted with polychlorinated biphenyls (PCBs),
      were identified by sequencing of cloned reverse transcription-polymerase chain
      reaction (RT-PCR) amplification products of 16S rRNA generated from total RNA
      extracts. Analysis of the 16S rRNA clone library revealed a considerable
      diversity of metabolically active bacteria in the soil, despite the acidic pH and
      high concentrations of PCBs. Cloned sequence types clustered within the
      Proteobacteria (34% alpha-, 33% beta- and 7% gamma-subclasses), the Holophaga
      Acidobacterium phylum (14%), the Actinobacteria (6.5%) and the Planctomycetales
      (2%). Three cloned sequence types were not affiliated to any described
      phylogenetic group. An unusual feature of this soil was the abundance of sequence
      types within the beta-subclass of the Proteobacteria, most of which were similar
      to the 16S rRNA gene sequences of species from only two genera, Burkholderia and
      Variovorax. Three other numerous 16S rRNA sequence types were similar to the
      sequences of Sphingomonas species, members of the Rhodopila globiformis group and
      Acidobacterium capsulatum. Some of the sequence types retrieved were similar to
      the 16S rRNA sequences of bacterial isolates able to degrade a variety of organic
      pollutants, including PCBs. As the PCB contamination is the major source of
      measurable carbon in this soil, some of the 16S rRNA sequence types detected and
      presumed to represent the metabolically active members of the community indicate
      the organisms likely to be involved, directly or indirectly, in the utilization
      of the PCBs as carbon and energy sources.

PMID- 11207740
TI  - Grazing of the copepod Diaptomus connexus on purple sulphur bacteria in a
      meromictic salt lake.
AB  - A meromictic lake ecosystem (Mahoney Lake, BC, Canada) was investigated to
      elucidate the significance of chemocline bacteria in the total carbon cycle under
      natural conditions. In this lake, primary production by oxygenic phototrophs was
      insufficient to support the observed net secondary production of the calanoid
      copepod Diaptomus connexus and the rotifer Brachionus plicatilis, indicating the
      presence of additional food sources for consumers. Mahoney Lake harbours the
      densest population of phototrophic sulphur bacteria ever reported in a natural
      body of water. This layer is located at the interface between oxic and anoxic
      water layers and is dominated by the purple sulphur bacterium Amoebobacter
      purpureus. The transfer rates of A. purpureus carbon to D. connexus determined in
      stratified mesocosms were very low (0.71 ngC copepod(-1) day(-1)) and accounted
      for only 0.6% of the observed net biomass increase in the zooplankter. Stable
      stratification within the mesocosms prevented an upwelling of A. purpureus into
      the oxic part. However, measurements of carbon fluxes, infrared fluorescence
      microscopy and stable carbon analysis provided cumulative evidence that, under in
      situ conditions, the cell carbon of purple sulphur bacteria indeed enters the
      aerobic food chain via the grazing activity of D. connexus. Based on a two-source
      isotopic mixing model, A. purpureus represents at least 75-85% of the diet of D.
      connexus. Autumnal upwelling into oxic water layers and aggregation of A.
      purpureus cells appear to be the main factors determining the high carbon flux
      from purple sulphur bacteria to zooplankton under natural conditions, and most
      probably also play a key role in other aquatic ecosystems. Through this pathway,
      over 53% of the reduced organic matter of purple sulphur bacteria trapped in
      anoxic bottom waters is returned to the oxic realm.

PMID- 11207741
TI  - Inhibition of photosynthesis and bleaching of zooxanthellae by the coral pathogen
      Vibrio shiloi.
AB  - Vibrio shiloi is the causative agent of bleaching (loss of endosymbiotic
      zooxanthellae) of the coral Oculina patagonica in the Mediterranean Sea. To
      obtain information on the mechanism of bleaching, we examined the effect of
      secreted material (AK1-S) produced by V. shiloi on zooxanthellae isolated from
      corals. AK1-S caused a rapid inhibition of photosynthesis of the algae, as
      measured with a Mini-PAM fluorometer. The inhibition of photosynthesis was caused
      by (i) ammonia produced during the growth of V. shiloi on protein-containing
      media and (ii) a non-dialysable heat-resistant factor. This latter material did
      not inhibit photosynthesis of the algae by itself but, when added to different
      concentrations of NH4Cl, enhanced the inhibition approximately two- to threefold.
      Ammonia and the enhancer were effective to different degrees on zooxanthellae
      isolated from four species of coral examined. In addition to the rapid inhibition
      of photosynthesis, AK1-S caused bleaching (loss of pigmentation) and lysis of
      zooxanthellae. Bleaching was more rapid than lysis, reaching a peak (25% bleached
      algae) after 6 h. The factors in AK1-S responsible for bleaching and lysis were
      different from those responsible for the inhibition of photosynthesis, because
      they were heat sensitive, non-dialysable and active in the dark. Thus, the coral
      pathogen V. shiloi produces an array of extracellular materials that can inhibit
      photosynthesis, bleach and lyse zooxanthellae.

PMID- 11207742
TI  - Microbial characterization of a JP-4 fuel-contaminated site using a combined
      lipid biomarker/polymerase chain reaction--denaturing gradient gel
      electrophoresis (PCR-DGGE)-based approach.
AB  - The impact of pollution on soil microbial communities and subsequent
      bioremediation can be measured quantitatively in situ using direct, non-culture
      dependent techniques. Such techniques have advantages over culture-based methods,
      which often account for less than 1% of the extant microbial community. In 1988,
      a JP-4 fuel spill contaminated the glacio-fluvial aquifer at Wurtsmith Air Force
      Base, Michigan, USA. In this study, lipid biomarker characterization of the
      bacterial and eukaryotic communities was combined with polymerase chain reaction
      denaturing gradient gel electrophoresis (PCR-DGGE) analysis of the eubacterial
      community to evaluate correlation between contaminant (JP-4 fuel) concentration
      and community structure shifts. Vadose, capillary fringe and saturated zone
      samples were taken from cores within and up- and down-gradient from the
      contaminant plume. Lipid biomarker analysis indicated that samples from within
      the plume contained increased biomass, with large proportions of typically gram
      negative bacteria. Outside the plume, lipid profiles indicated low-biomass
      microbial communities compared with those within the initial spill site. 16S rDNA
      sequences derived from DGGE profiles from within the initial spill site suggested
      dominance of the eubacterial community by a limited number of phylogenetically
      diverse organisms. Used in tandem with pollutant quantification, these molecular
      techniques should facilitate significant improvements over current assessment
      procedures for the determination of remediation end-points.

PMID- 11207743
TI  - Adaptation of Pseudomonas fluorescens to the plant rhizosphere.
AB  - Saprophytic Pseudomonas are common root-colonizing bacteria that can improve
      plant health. Efficient exploitation of these bacteria in agriculture requires
      knowledge of traits that enhance ecological performance in the rhizosphere. Here,
      I describe the development and application of a promoter-trapping technology
      (IVET) that enables the isolation of Pseudomonas fluorescens genes that show
      elevated levels of expression in the rhizosphere. Using IVET, 20 P. fluorescens
      genes were identified that are induced during rhizosphere colonization, and their
      patterns of expression were analysed in laboratory media and in the rhizosphere.
      Fourteen genes showed significant homology to sequences in GenBank that are
      involved in nutrient acquisition, stress response, or secretion; six showed no
      homology. Seven of the rhizosphere-induced (rhi) genes have homology to known non
      Pseudomonas genes. One of the rhi genes (hrcC) is a component of a type III
      secretion pathway, not previously known in non-parasitic bacteria. Together,
      these genes provide a view of the rhizosphere environment as perceived by a
      rhizosphere colonist, and suggest that the nature of the association between P.
      fluorescens and the plant root may be more complex and intimate than previously
      thought.

PMID- 11207744
TI  - rRNA probe-based cell fishing of bacteria.
AB  - We have developed a new, cultivation-independent, fast and flexible method for
      the rRNA-targeted probe-based enrichment of bacteria. The target cells were
      labelled by in situ hybridization with biotinylated polyribonucleotide probes.
      These probes were generated by in vitro transcription of amplified rDNA of a
      variable region in domain III of the 23S rRNA molecules. The probes were about
      300 nucleotides in length and were labelled by incorporation of biotin-UTP during
      the transcription. Probes were hybridized with bacterial cells and incubated with
      paramagnetic streptavidin-coated particles. The labelled target cells can be
      separated in a column filled with steel wool inserted into the field of a
      permanent magnet. Unlabelled, non-target cells pass through the column, whereas
      labelled cells are retained. They were eluted from the column after removal of
      the magnetic field. Up to now, the method has been tested with mixtures of
      different pure cultures. For the first time, transcript probes have been used for
      the labelling of the target cells and for their specific separation. The
      enrichment of the target cells can be monitored by a streptavidin-fluorescein
      staining of the biotinylated target cells and/or by a subsequent in situ
      hybridization with fluorescently labelled oligonucleotide probes. Enrichment
      rates of up to 90-fold, depending on the original abundance of the cells of
      interest, could be determined. To demonstrate that the sorted cells were amenable
      to molecular analysis, we amplified and sequenced a part of the tuf gene of
      enriched Acinetobacter calcoaceticus cells.

PMID- 11207746
TI  - Post-modern ecology--is the environment the organism?

PMID- 11207745
TI  - Scientific basis for the bioremediation of the toxic spill of the Aznalcollar
      mine: combining bacteria and plants to address and intractable kind of pollution.

PMID- 11207747
TI  - Legionella: from environmental habitats to disease pathology, detection and
      control.
AB  - Studies on Legionella show a continuum from environment to human disease.
      Legionellosis is caused by Legionella species acquired from environmental
      sources, principally water sources such as cooling towers, where Legionella grows
      intracellularly in protozoa within biofilms. Aquatic biofilms, which are
      widespread not only in nature, but also in medical and dental devices, are
      ecological niches in which Legionella survives and proliferates and the ultimate
      sources to which outbreaks of legionellosis can be traced. Invasion and
      intracellular replication of L. pneumophila within protozoa in the environment
      play a major role in the transmission of Legionnaires' disease. Protozoa provide
      the habitats for the environmental survival and reproduction of Legionella
      species. L. pneumophila proliferates intracellularly in various species of
      protozoa within vacuoles studded with ribosomes, as it also does within
      macrophages. Growth within protozoa enhances the environmental survival
      capability and the pathogenicity (virulence) of Legionella. The growth
      requirements of Legionella, the ability of Legionella to enter a viable non
      culturable state, the association of Legionella with protozoa and the occurrence
      of Legionella within biofilms complicates the detection of Legionella and
      epidemiological investigations of legionellosis. Polymerase chain reaction (PCR)
      methods have been developed for the molecular detection of Legionella and used in
      environmental and epidemiological studies. Various physical and chemical
      disinfection methods have been developed to eliminate Legionella from
      environmental sources, but gaining control of Legionella in environmental waters,
      where they are protected from disinfection by growing within protozoa and
      biofilms, remains a challenge, and one that must be overcome in order to
      eliminate sporadic outbreaks of legionellosis.

PMID- 11207748
TI  - Dynamics of anoxygenic photosynthesis in an experimental green sulphur bacteria
      biofilm.
AB  - The dynamics of sulphide oxidation in an experimental biofilm of the green
      sulphur bacterium, Prosthecochloris aestuarii, were studied using a newly
      developed light-dark cycling procedure. The biofilm was grown for 6 weeks in a
      benthic gradient chamber, in which gradients of light, sulphide and oxygen were
      imposed experimentally. The H2S concentrations and pH were measured with
      microsensors as a function of depth in the biofilm and of time after a change in
      illumination status. The sulphide oxidation rates were calculated as a function
      of time and depth in the biofilm using a numerical procedure to solve the non
      stationary general diffusion equation. A close agreement was found between the
      areal rates of anoxygenic photosynthesis during the cycling procedure and the
      steady state before the cycling experiment. For the different layers of the
      biofilm, the maximum activity was observed after 10-12min of light exposure.
      After this maximum, sulphide oxidation decreased concomitantly with sulphide
      concentration, indicating sulphide limitation of anoxygenic photosynthesis. This
      lag time limits the application of the standard dark-light shift method with a
      brief light exposure of a few seconds and, therefore, the numerical procedure
      described in this study enables the depth distribution of anoxygenic
      photosynthesis rates in microbial mats to be determined more accurately.

PMID- 11207749
TI  - Molecular screening for alkane hydroxylase genes in Gram-negative and Gram
      positive strains.
AB  - We have developed highly degenerate oligonucleotides for polymerase chain
      reaction (PCR) amplification of genes related to the Pseudomonas oleovorans GPo1
      and Acinetobacter sp. ADP1 alkane hydroxylases, based on a number of highly
      conserved sequence motifs. In all Gram-negative and in two out of three Gram
      positive strains able to grow on medium- (C6-C11) or long-chain n-alkanes (C12
      C16), PCR products of the expected size were obtained. The PCR fragments were
      cloned and sequenced and found to encode peptides with 43.2-93.8% sequence
      identity to the corresponding fragment of the P. oleovorans GPo1 alkane
      hydroxylase. Strains that were unable to grow on n-alkanes did not yield PCR
      products with homology to alkane hydroxylase genes. The alkane hydroxylase genes
      of Acinetobacter calcoaceticus EB104 and Pseudomonas putida P1 were cloned using
      the PCR products as probes. The two genes allow an alkane hydroxylase-negative
      mutant of Acinetobacter sp. ADP1 and an Escherichia coli recombinant containing
      all P. oleovorans alk genes except alkB, respectively, to grow on n-alkanes,
      showing that the cloned genes do indeed encode alkane hydroxylases.

PMID- 11207751
TI  - Phylogenetic diversity of termite gut spirochaetes.
AB  - A molecular phylogenetic analysis was done of not-yet-cultured spirochaetes
      inhabiting the gut of the termite, Reticulitermes flavipes (Kollar). Ninety-eight
      clones of near-full-length spirochaetal 16S rDNA genes were classified by ARDRA
      pattern and by partial sequencing. All clones grouped within the genus Treponema,
      and at least 21 new species of Treponema were recognized within R. flavipes
      alone. Analysis of 190 additional clones from guts of Coptotermes formosanus
      Shiraki and Zootermopsis angusticollis (Hagen), as well as published data on
      clones from Cryptotermes domesticus (Haviland), Mastotermes darwiniensis
      Froggatt, Nasutitermes lujae (Wasmann) and Reticulitermes speratus(Kolbe),
      revealed a similar level of novel treponemal phylogenetic diversity in these
      representatives of five of the seven termite families. None of the clones was
      closely related (i.e. all bore < or = 91% sequence similarity) to any previously
      recognized treponeme. The data also revealed the existence of two major
      phylogenetic groups of treponemes: one containing all of the currently known
      isolates of Treponema and a large number of phylotypes from the human gingival
      crevice, but only a minority of the termite gut spirochaete clones; another
      containing the majority of termite spirochaete clones and two Spirochaeta (S.
      caldaria and S. stenostrepta), which, although free living, group within the
      genus Treponema on the basis of 16S rRNA sequence. Signature nucleotides that
      almost perfectly distinguished the latter group, herein referred to as the
      'termite cluster', occurred at the following (E. coli numbering) positions: 289-G
      x C-311; A at 812; and an inserted nucleotide at 1273. The emerging picture is
      that the long-recognized and striking morphological diversity of termite gut
      spirochaetes is paralleled by their phylogenetic diversity and may reflect
      substantial physiological diversity as well.

PMID- 11207750
TI  - Reduction of (per)chlorate by a novel organism isolated from paper mill waste.
AB  - As part of a study on the microbiology of chlorate reduction, several new
      dissimilatory chlorate-reducing bacteria were isolated from a broad diversity of
      environments. One of these, strain CKB, was selected for a more complete
      characterization. Strain CKB was enriched and isolated from paper mill waste with
      acetate as the sole electron donor and chlorate as the sole electron acceptor.
      Strain CKB is a completely oxidizing, non-fermentative, Gram-negative,
      facultative anaerobe. Cells of strain CKB are 0.5 x 2 microm and are highly
      motile, with a single polar flagellum. In addition to acetate, strain CKB can use
      propionate, butyrate, lactate, succinate, fumarate, malate or yeast extract as
      electron donors, with chlorate as the sole electron acceptor. Strain CKB can also
      couple chlorate reduction to the oxidation of ferrous iron, sulphide, or the
      reduced form of the humic substances analogue 2,6-anthrahydroquinone
      disulphonate. Fe(II) is oxidized to insoluble amorphous Fe(II) oxide, whereas
      sulphide is oxidized to elemental sulphur. Growth is not associated with this
      metabolism, even when small quantities of acetate are added as a potential carbon
      source. In addition to chlorate, strain CKB can also couple acetate oxidation to
      the reduction of oxygen or perchlorate. Chlorate is completely reduced to
      chloride. Strain CKB has an optimum temperature of 35 degrees C, a pH optimum of
      7.5 and a salinity optimum of 1% NaCl. Strain CKB can grow in chlorate and
      perchlorate concentrations of 80 or 20 mM respectively. Under anaerobic
      conditions, strain CKB can dismutate chlorite into chloride and O2, and is only
      the second organism shown to be capable of this metabolism. Oxidized minus
      reduced spectra of whole-cell suspensions of strain CKB showed absorbance maxima
      at 423, 523 and 552nm, which are indicative of the presence of c-type
      cytochrome(s). Analysis of the complete sequence of the 16S rDNA indicates that
      strain CKB is a member of the beta subclass of the Proteobacteria. The phototroph
      Rhodocyclus tenuis is the closest known relative. When tested, strain CKB could
      not grow by phototrophy and did not contain bacteriochlorophyll. Phenotypically
      and phylogenetically, strain CKB differs from all other described bacteria and
      represents the type strain of a new genus and species.

PMID- 11207752
TI  - Interaction between bacteriophage PBS1 and clay minerals and transduction of
      Bacillus subtilis by clay-phage complexes.
AB  - Bacteriophage PBS1 of Bacillus subtilis was rapidly adsorbed on montmorillonite
      (M) and kaolinite (K), and adsorption was maximal after 30min on both clays.
      There was no correlation between adsorption and the cation exchange capacity of
      the clays. Studies with sodium metaphosphate (a polyanion that interacts with
      positively charged sites on clay) indicated that positively charged sites on K
      were primarily responsible for the adsorption of the phage, whereas other
      mechanisms appeared to be involved in adsorption of the phage on M. X-ray
      diffraction and electron microscopic analyses showed that the phage partially
      intercalated M. Survival of the phage was increased by adsorption on the clays,
      and adsorbed phage maintained its ability to transduce bacterial cells for at
      least 30 days (the longest time studied) after the preparation of the clay-phage
      complexes. Electron microscopic observations indicated that transduction by the
      clay-phage complexes was primarily the result of the phage detaching from the
      clays in the presence of host cells.

PMID- 11207753
TI  - Novel bacterial endosymbionts of Acanthamoeba spp. related to the Paramecium
      caudatum symbiont Caedibacter caryophilus.
AB  - Acanthamoebae are increasingly being recognized as hosts for obligate bacterial
      endosymbionts, most of which are presently uncharacterized. In this study, the
      phylogeny of three Gram-negative, rod-shaped endosymbionts and their Acanthamoeba
      host cells was analysed by the rRNA approach. Comparative analyses of 16S rDNA
      sequences retrieved from amoebic cell lysates revealed that the endosymbionts of
      Acanthamoeba polyphaga HN-3, Acanthamoeba sp. UWC9 and Acanthamoeba sp. UWE39 are
      related to the Paramecium caudatum endosymbionts Caedibacter caryophilus,
      Holospora elegans and Holospora obtusa. With overall 16S rRNA sequence
      similarities to their closest relative, C. caryophilus, of between 87% and 93%,
      these endosymbionts represent three distinct new species. In situ hybridization
      with fluorescently labelled endosymbiont-specific 16S rRNA-targeted probes
      demonstrated that the retrieved 16S rDNA sequences originated from the
      endosymbionts and confirmed their intracellular localization. We propose to
      classify provisionally the endosymbiont of Acanthamoeba polyphaga HN-3 as
      'Candidatus Caedibacter acanthamoebae', the endosymbiont of Acanthamoeba sp.
      strain UWC9 as 'Candidatus Paracaedibacter acanthamoebae' and the endosymbiont of
      Acanthamoeba sp. strain UWE39 as 'Candidatus Paracaedibacter symbiosus'. The
      phylogeny of the Acanthamoeba host cells was analysed by comparative sequence
      analyses of their 18S rRNA. Although Acanthamoeba polyphaga HN-3 clearly groups
      together with most of the known Acanthamoeba isolates (18S rRNA sequence type 4),
      Acanthamoeba sp. UWC9 and UWE39 exhibit <92% 18S rRNA sequence similarity to each
      other and to other Acanthamoeba isolates. Therefore, we propose two new sequence
      types (T13 and T14) within the genus Acanthamoeba containing, respectively,
      Acanthamoeba sp. UWC9 and Acanthamoeba sp. UWE39.

PMID- 11207754
TI  - Web alert. Microbial taxonomy.

PMID- 11207755
TI  - Probiotics and benefits to human health--the evidence in favour.

PMID- 11207756
TI  - Probiotics--snake oil for the new millennium?

PMID- 11207757
TI  - Application of molecular tools for in situ monitoring of bacterial growth
      activity.

PMID- 11207758
TI  - Development and characterization of a lux-modified 2,4-dichlorophenol-degrading
      Burkholderia sp. RASC.
AB  - lux-marked biosensors for assessing the toxicity and bioremediation potential of
      polluted environments may complement traditional chemical techniques. luxCDABE
      genes were introduced into the chromosome of the 2,4-dichlorophenol (2,4-DCP)
      mineralizing bacterium, Burkholderia sp. RASC c2, by biparental mating using the
      Tn4431 system. Experiments revealed that light output was constitutive and
      related to cell biomass concentration during exponential growth. The transposon
      insertion was stable and did not interrupt 2,4-DCP-degradative genes, and
      expression of luxCDABE did not constitute a metabolic burden to the cell. A
      bioluminescence response was detectable at sublethal 2,4-DCP concentrations: at <
      10.26 microg ml(-1), bioluminescence was stimulated (e.g. 218% of control), but
      at concentrations >60 microg ml(-1) it declined to < 1%. Investigating the effect
      of [14C]-2,4-DCP concentration on the evolution of 14CO2 revealed that, for
      initial concentrations of 2.5-25 microg ml(-1), approximately equals 55% of the
      added 14C was mineralized after 24 h compared with <1% at 50 and 100 microg ml(
      1). Inhibition of 2,4-DCP mineralization between 25 and 50 microg ml(-1)
      corresponded well to the EC50 value (33.83 microg ml(-1)) obtained from
      bioluminescence inhibition studies. lux-marked RASC c2 may therefore be used as a
      functionally (i.e. 2,4-DCP degrader) and environmentally relevant biosensor of
      toxicity and biodegradation inhibition.

PMID- 11207759
TI  - Molecular evidence for shifts in polysaccharide composition associated with
      adaptation of soybean Bradyrhizobium strains to the Brazilian Cerrado soils.
AB  - Pyrolysis mass spectrometry (PyMS) and DNA fingerprinting (RAPD and RSalpha
      hybridization) were used to characterize soybean inoculant strains and root
      nodule isolates of bradyrhizobia from the Brazilian Cerrado soils. Most isolates
      were shown to be derived from the inoculant strains on the basis of genotype
      comparisons by DNA fingerprinting. Phenotypic analysis (using PyMS) of the
      strains and separately of the polysaccharides derived from them showed that the
      nodule isolates differed from the parental strains, suggesting adaptation to the
      Cerrado soil environment. The extent of the differences between the derivatives
      and inoculant strains was similar for comparisons made on the basis of whole-cell
      preparations or from the isolated polysaccharides, indicating that the adaptation
      was caused by changes in the composition of the polysaccharides produced.

PMID- 11207760
TI  - 13C/12C isotope fractionation of aromatic hydrocarbons during microbial
      degradation.
AB  - The influence of microbial degradation on the 13C/12C isotope composition of
      aromatic hydrocarbons is presented using toluene as a model compound. Four
      different toluene-degrading bacterial strains grown in batch culture with oxygen,
      nitrate, ferric iron or sulphate as electron acceptors were studied as
      representatives of different environmental redox conditions potentially
      prevailing in contaminated aquifers. The biological degradation induced isotope
      shifts in the residual, non-degraded toluene fraction and the kinetic isotope
      fractionation factors alphaC for toluene degradation by Pseudomonas putida
      (1.0026 +/- 0.00017), Thauera aromatica (1.0017 +/- 0.00015), Geobacter
      metallireducens (1.0018 +/- 0.00029) and the sulphate-reducing strain TRM1
      (1.0017 +/- 0.00016) were in the same range for all four species, although they
      use at least two different degradation pathways. A similar 13C/12C isotope
      fractionation factor (alphaC = 1.0015 +/- 0.00015) was observed in situ in a non
      sterile soil column in which toluene was degraded under sulphate-reducing
      conditions. No carbon isotope shifts resulting from soil-hydrocarbon interactions
      were observed in a non-degrading soil column control with aquifer material under
      the same conditions. The results imply that microbial degradation of toluene can
      produce a 13C/12C isotope fractionation in the residual hydrocarbon fraction
      under different environmental conditions.

PMID- 11207761
TI  - Anaerobic degradation of naphthalene by a pure culture of a novel type of marine
      sulphate-reducing bacterium.
AB  - Incubation of marine sediment in anoxic, sulphate-rich medium in the presence of
      naphthalene resulted in the enrichment of sulphate-reducing bacteria. Pure
      cultures with short, oval cells (1.3 by 1.3-1.9 microm) were isolated that grew
      with naphthalene as the only organic carbon source and electron donor for
      sulphate reduction to sulphide. One strain, NaphS2, was characterized. It
      affiliated with completely oxidizing sulphate-reducing bacteria of the delta
      subclass of the Proteobacteria, as revealed by 16S rRNA sequence analysis. 2
      Naphthoate, benzoate, pyruvate and acetate were used in addition to naphthalene.
      Quantification of substrate consumption, sulphide formation and formed cell mass
      revealed that naphthalene was completely oxidized with sulphate as the electron
      acceptor.

PMID- 11207762
TI  - Environmental and clinical isolates of Pseudomonas aeruginosa show pathogenic and
      biodegradative properties irrespective of their origin.
AB  - Virulence properties of pathogenic bacteria, as well as resistance to
      antibiotics, are thought to arise through a specialization process favoured by
      the strong selection pressure imposed in clinical treatments. Nevertheless, in
      the case of opportunistic pathogens, it is unclear whether strains can be
      classified into virulent and non-virulent isolates. Clones of the opportunistic
      pathogen Pseudomonas aeruginosa do not seem to be associated to a particular
      biovar or pathovar, which suggests that virulence characteristics in
      opportunistic pathogens may already be present in environmental (non-clinical)
      isolates. We have explored this possibility, studying environmental isolates
      (mainly from oil-contaminated soils) and clinical isolates (from bacteraemia and
      cystic fibrosis patients) of P. aeruginosa. All environmental strains were found
      to actively efflux quinolones, which are synthetic antibiotics not expected to be
      present in the environment. These strains contained multidrug resistance
      determinants, were capable of invading epithelial cells and presented genes from
      the quorum-sensing and type III secretion systems. Some of them expressed either
      haemolytic or proteolytic activities or both, characteristics considered to be
      typical of virulent strains. All the strains tested, of clinical or environmental
      origin, could use alkanes (oil hydrocarbons) as a carbon source. Our results
      suggest that clinical and non-clinical P. aeruginosa strains might be
      functionally equivalent in several traits relevant for their virulence or
      environmental properties. Selection of clinically relevant traits, such as
      antibiotic resistance or cellular invasiveness, in opportunistic pathogens
      present in soil ecosystems is discussed.

PMID- 11207763
TI  - Host specificity in the Richelia-diatom symbiosis revealed by hetR gene sequence
      analysis.
AB  - The filamentous heterocyst-forming cyanobacterium Richelia intracellularis forms
      associations with diatoms and is very abundant in tropical and subtropical seas.
      The genus Richelia contains only one species, R. intracellularis Schmidt,
      although it forms associations with several diatom genera and has considerable
      variation in size and morphology. The genetic diversity, and possible host
      specificity, within the genus Richelia is unknown. Using primers against hetR, a
      gene unique for filamentous cyanobacteria, specific polymerase chain reaction
      (PCR) products were obtained from natural populations of R. intracellularis
      filaments associated with three diatom genera. Phylogenetic analyses of these
      sequences showed that they were all in the same clade. This clade contained only
      the R. intracellularis sequences. The genetic affiliation of hetR sequences of R.
      intracellularis to those of other heterocystous cyanobacteria strongly suggests
      that it was not closely related to endosymbiotic Nostoc spp. hetR sequences.
      Sequences from R. intracellularis-Hemiaulus membranaceus sampled in the Atlantic
      and Pacific Oceans were almost identical, demonstrating that the genetic
      relatedness was not dependent on geographical location. All sequences displayed a
      deep divergence between symbionts from different genera and a high degree of host
      specificity.

PMID- 11207764
TI  - Tomato seed and root exudate sugars: composition, utilization by Pseudomonas
      biocontrol strains and role in rhizosphere colonization.
AB  - The role of tomato seed and root exudate sugars as nutrients for Pseudomonas
      biocontrol bacteria was studied. To this end, the major exudate sugars of tomato
      seeds, seedlings and roots were identified and quantified using high-performance
      liquid chromatographic (HPLC) analysis. Glucose, fructose and maltose were
      present in all studied growth stages of the plant, but the ratios of these sugars
      were strongly dependent on the developmental stage. In order to study the
      putative role of exudate sugar utilization in rhizosphere colonization, two
      approaches were adopted. First, after co-inoculation on germinated tomato seeds,
      the root-colonizing ability of the efficient root-colonizing P. fluorescens
      strain WCS365 in a gnotobiotic quartz sand-plant nutrient solution system was
      compared with that of other Pseudomonas biocontrol strains. No correlation was
      observed between the colonizing ability of a strain and its ability to use the
      major exudate sugars as the only carbon and energy source. Secondly, a Tn5lacZ
      mutant of P. fluorescens strain WCS365, strain PCL1083, was isolated, which is
      impaired in its ability to grow on simple sugars, including those found in
      exudate. The mutation appeared to reside in zwf, which encodes glucose-6
      phosphate dehydrogenase. The mutant grows as well as the parental strain on other
      media, including tomato root exudate. After inoculation of germinated sterile
      tomato seeds, the mutant cells reached the same population levels at the root tip
      as the wild-type strain, both alone and in competition, indicating that the
      ability to use exudate sugars does not play a major role in tomato root
      colonization, despite the fact that sugars have often been reported to represent
      the major exudate carbon source. This conclusion is supported by the observation
      that the growth of mutant PCL1083 in vitro is inhibited by glucose, a major
      exudate sugar, at a concentration of 0.001%, which indicates that the glucose
      concentration in the tomato rhizosphere is very low.

PMID- 11207765
TI  - The formation of migratory ripples in a mixed species bacterial biofilm growing
      in turbulent flow.
AB  - Mixed-species biofilms, consisting of Klebsiella pneumoniae, Pseudomonas
      aeruginosa, Pseudomonas fluorescens and Stenotrophomonas maltophilia, were grown
      in glass flow cells under either laminar or turbulent flow. The biofilms grown in
      laminar flow consisted of roughly circular-shaped microcolonies separated by
      water channels. In contrast, biofilm microcolonies grown in turbulent flow were
      elongated in the downstream direction, forming filamentous 'streamers'. Moreover,
      biofilms growing in turbulent flow developed extensive patches of ripple-like
      structures between 9 and 13 days of growth. Using time-lapse microscopic imaging,
      we discovered that the biofilm ripples migrated downstream. The morphology and
      the migration velocity of the ripples varied with short-term changes in the bulk
      liquid flow velocity. The ripples had a maximum migration velocity of 800
      micromh(-1) (2.2 x 10(-7) m s(-1)) when the liquid flow velocity was 0.5 ms(-1)
      (Reynolds number=1,800). This work challenges the commonly held assumption that
      biofilm structures remain at the same location on a surface until they eventually
      detach.

PMID- 11207766
TI  - Effect of temperature on sulphate reduction, growth rate and growth yield in five
      psychrophilic sulphate-reducing bacteria from Arctic sediments.
AB  - Five psychrophilic sulphate-reducing bacteria (strains ASv26, LSv21, PSv29, LSv54
      and LSv514) isolated from Arctic sediments were examined for their adaptation to
      permanently low temperatures. All strains grew at -1.8 degrees C, the freezing
      point of sea water, but their optimum temperature for growth (T(opt)) were 7
      degrees C (PSv29), 10 degrees C (ASv26, LSv54) and 18 degrees C (LSv21, LSv514).
      Although T(opt) was considerably above the in situ temperatures of their habitats
      (-1.7 degrees C and 2.6 degrees C), relative growth rates were still high at 0
      degrees C, accounting for 25-41% of those at T(opt). Short-term incubations of
      exponentially growing cultures showed that the highest sulphate reduction rates
      occurred 2-9 degrees C above T(opt). In contrast to growth and sulphate reduction
      rates, growth yields of strains ASv26, LSv54 and PSv29 were almost constant
      between -1.8 degrees C and T(opt). For strains LSv21 and LSv514, however, growth
      yields were highest at the lowest temperatures, around 0 degrees C. The results
      indicate that psychrophilic sulphate-reducing bacteria are specially adapted to
      permanently low temperatures by high relative growth rates and high growth yields
      at in situ conditions.

PMID- 11207767
TI  - Web alert. Microscopy of microorganisms.

PMID- 11207768
TI  - Bacillus subtilis macrofibres, colonies and bioconvection patterns use different
      strategies to achieve multicellular organization.

PMID- 11207769
TI  - Cell envelope mutants of Pseudomonas putida: physiological characterization and
      analysis of their ability to survive in soil.
AB  - To generate mutants with altered lipopolysaccharides (LPS) of the wild-type
      Pseudomonas putida KT2442, we used the mini-Tn5luxAB-Km transposon. A mutant was
      found among luminescent colonies and selected as a negative clone in enzyme
      linked immunosorbent assay (ELISA) with monoclonal antibody (mAb) 7.3B, which
      recognizes the O-antigen of P. putida LPS. The DNA region of the LPS mutant
      interrupted by the minitransposon insertion was cloned and sequenced. Comparison
      of the deduced amino acid sequence with protein sequence databases showed
      similarity to the O-antigen polymerase (Wzy) of Salmonella enterica (muenchen).
      The wild-type gene was rescued by polymerase chain reaction (PCR), cloned into a
      broad-host-range plasmid and used to carry out complementation assays. The cloned
      gene was able to restore the wild-type phenotype of the P. putida wzy mutant. We
      constructed an isogenic mutant of the luminescent wzy mutant to which an oprL
      mutation was transferred by homologous recombination with an oprL::xylE cassette.
      The wzy mutants of P. putida were more sensitive to SDS, deoxycholate and EDTA
      than the corresponding parental strains. We analysed the ability of wzy, oprL and
      wzy oprL mutants of P. putida to colonize soil. In comparison with the wild-type
      strain, the ability of single mutants to colonize soil decreased; this
      characteristic was more evident for the double mutant, especially at high
      temperatures.

PMID- 11207770
TI  - Aerotaxis in Desulfovibrio.
AB  - Aerotaxis of two sulphate-reducing bacteria, the freshwater strain Desulfovibrio
      desulfuricans CSN (DSM 9104) and the marine strain Desulfovibrio oxyclinae N13
      (DSM 11498), was studied using capillary microslides, microscopy and oxygen
      microsensors. The bacteria formed ring-shaped bands in oxygen diffusion gradients
      surrounding O2 bubbles, which were placed into anoxic sulphate-free cell
      suspensions in capillary microslides. The radial expansion of the oxic volume by
      diffusion was stopped by aerobic respiration. Bands were formed by cells avoiding
      high O2 levels near the O2 bubble, as well as by cells entering from the
      surrounding anoxic zone. At the inner edge of the bands, O2 levels of up to 20%
      air saturation (50 microM O2) were found, while the outer edge always coincided
      with the oxic-anoxic interface. Ring diameters and O2 concentrations at the inner
      edge of the band depended on the cell density and the strain used in the
      suspension. Band formation did not occur in the absence of an electron donor (5mM
      lactate) or when N2 gas bubbles were used. Both strains were highly motile with
      velocities of approximately equals 32 microm s(-1) during forward runs, and 7
      microm s(-1) during backward runs respectively. Within the bands, cells moved in
      circles of about 20 microm diameter, while cells outside the band exhibited
      straighter or only slightly bent traces. It is concluded that the capacity of
      respiration at high rates and the positive and negative aerotactical responses of
      Desulfovibrio provide an efficient strategy for removing O2 from the habitat in
      situations where sufficient electron donors and high cell densities are present.

PMID- 11207771
TI  - Signalling by the fungus Pythium ultimum represses expression of two ribosomal
      RNA operons with key roles in the rhizosphere ecology of Pseudomonas fluorescens
      F113.
AB  - Pseudomonas fluorescens F113 produces antifungal metabolites that protect the
      roots of sugarbeet from the fungus Pythium ultimum. The phytopathogen, in turn,
      has the ability to downregulate the expression of genes fundamental to the
      rhizosphere competence of the bacterial strain. This paper describes the
      characterization of two of these genes, which were isolated by screening a mini
      Tn5::lacZ mutant bank for differential expression of beta-galactosidase in the
      presence of P. ultimum. In order to identify the genes affected in reporter
      mutants SF3 and SF5, the transposons and flanking regions were cloned. Sequence
      analysis of the regions flanking the transposons in SF3 revealed that mini
      Tn5::lacZ had inserted into a tRNA(Ile) gene, which maps within a ribosomal RNA
      (rrn) operon. In SF5, the transposon inserted between the promoter of a second
      rrn operon and a gene encoding a 16S rRNA. Southern blot analysis demonstrated
      that there are five rrn operons in P. fluorescens F113 and that the transposons
      in SF3 and SF5 had inserted into two different operons. Further characterization
      of these mutants suggests that their reduced rhizosphere competence is not the
      result of reduced viability in the short term but may be accounted for partly by
      reduced growth rates under conditions that support rapid growth. Analysis of lacZ
      expression in the reporter mutants indicate that the marked rrn operons are
      regulated differently, suggesting different physiological roles.

PMID- 11207772
TI  - Climatic influence on mesophilic Bacillus cereus and psychrotolerant Bacillus
      weihenstephanensis populations in tropical, temperate and alpine soil.
AB  - Bacillus weihenstephanensis strains are psychrotolerant and grow from below 7
      degrees C to 38 degrees C. Closely related mesophilic Bacillus cereus strains can
      grow from above 7 degrees C to 46 degrees C. We classified 1060 B. cereus group
      isolates from different soil samples with respect to their psychrotolerant and
      mesophilic genotypes by polymerase chain reaction (PCR) targeting of specific 16S
      rDNA and cold shock protein A gene signatures. In parallel, growth tests at 7
      degrees C were carried out to determine the thermal phenotype. The geographic
      distribution of psychrotolerant and mesophilic isolates was found to depend
      significantly on the prevalent annual average temperature. In one tropical, one
      temperate and two alpine habitats, the proportion of psychrotolerant cspA
      genotypes was found to be 0%, 45% and 86% and 98%, respectively, with the
      corresponding annual average temperatures being 28 degrees C, 7 degrees C, 4
      degrees C and 1 degrees C. In the tropical habitat, only the mesophilic B. cereus
      was found, characterized by correspondence of thermal genotype and phenotype. In
      the alpine habitat, almost only the psychrotolerant B. weihenstephanensis was
      isolated. In the temperate habitat, mesophilic B. cereus and psychrotolerant B.
      weihenstephanensis as well as 'intermediate thermal types' occurred, the latter
      having opposite thermal genotypes and phenotypes or opposing sets of thermal DNA
      signatures, characterized by the coexistence of mesophilic and psychrotolerant
      16S rDNA operon copies within a single isolate. Both sugar utilization and DNA
      fingerprinting patterns revealed a high, probably non-clonal microsite diversity
      within the population of the temperate habitat. We interpret our observations in
      terms of a temperature-dependent selection regime, acting on recombining B.
      cereus/ B. weihenstephanensis populations in soil.

PMID- 11207773
TI  - Fluorescence in situ hybridization analysis of the prokaryotic community
      inhabiting crystallizer ponds.
AB  - A fluorescence in situ hybridization (FISH) protocol suitable for the
      identification of prokaryotes inhabiting hypersaline environments was developed
      and applied to several crystallizer ponds with salinities above 36% from a
      multipond solar saltern in Alicante, Spain. Two morphotypes were abundant in
      these environments: rods and square or square-like prokaryotes that could be
      affiliated to Bacteria and Archaea, respectively, by FISH with domain-specific
      probes. FISH with a newly designed probe proved that the archaeal 16S rDNA
      sequence most frequently recovered from the crystallizers, SPhT, originated from
      the dominant square-like prokaryotes. These uncultured prokaryotes have the
      morphology of Walsby's square bacteria. Additionally, FISH with a probe targeted
      to the genus Haloarcula, members of which are frequently isolated from this
      environment, indicated that this genus accounts for less than 0.1% of the total
      prokaryotic community.

PMID- 11207775
TI  - The hexY genes of Erwinia carotovora ssp. carotovora and ssp. atroseptica encode
      novel proteins that regulate virulence and motility co-ordinately.
AB  - Mutations located in a new gene, hexY, in Erwinia carotovora ssp. carotovora
      (Ecc) and ssp. atroseptica (Eca) cause strong upregulation of production of
      exoenzyme virulence factors and motility. The hexY gene encodes a novel 14.4 kDa
      protein with no known homologues. The hexY mRNA transcript has an unusually long
      (525bp) 5' untranslated region, which may be important for post-transcriptional
      regulation. An elevated level of transcription of two exoenzyme genes, pelCand
      celV, was observed in the HexY mutant background. The levels of cellulase and
      protease in a HexY mutant were independent of the presence of PGA, suggesting a
      role for HexY in the induction of these enzymes seen upon PGA addition. Electron
      microscopy revealed that HexY cells were hyperflagellated, perhaps contributing
      to the hypermotility phenotype of this mutant. The HexY mutant M5 exhibited
      enhanced maceration capacity on potato tubers. Therefore, the hexY gene and its
      gene product may define another level of regulation of virulence determinants in
      Ecc and Eca.

PMID- 11207776
TI  - Web alert. Microbial ecology.

PMID- 11207774
TI  - Co-evolution between Frankia populations and host plants in the family
      Casuarinaceae and consequent patterns of global dispersal.
AB  - Symbioses between the root nodule-forming, nitrogen-fixing actinomycete Frankia
      and its angiospermous host plants are important in the nitrogen economies of
      numerous terrestrial ecosystems. Molecular characterization of Frankia strains
      using polymerase chain reaction/restriction fragment length polymorphism
      (PCR/RFLP) analyses of the 16S rRNA-ITS gene and of the nifD-nifK spacer was
      conducted directly on root nodules collected worldwide from Casuarina and
      Allocasuarina trees. In their native habitats in Australia, host species
      contained seven distinctive sets of Frankia in seven different molecular
      phylogenetic groups. Where Casuarina and Allocasuarina trees are newly planted
      outside Australia, they do not normally nodulate unless Frankia is introduced
      with the host seedling. Nodules from Casuarina trees introduced outside Australia
      over the last two centuries were found to contain Frankia from only one of the
      seven phylogenetic groups associated with the host genus Casuarina in Australia.
      The phylogenetic group of Frankia found in Casuarina and Allocasuarina trees
      introduced outside Australia is the only group that has yielded isolates in pure
      culture, suggesting a greater ability to survive independently of a host.
      Furthermore, the Frankia species in this group are able to nodulate a wider range
      of host species than those in the other six groups. In baiting studies, Casuarina
      spp. are compatible with more Frankia microsymbiont groups than Allocasuarina
      host spp. adapted to drier soil conditions, and C. equisetifolia has broader
      microsymbiont compatibility than other Casuarina spp. Some Frankia associated
      with the nodular rhizosphere and rhizoplan, but not with the nodular tissue, of
      Australian hosts were able to nodulate cosmopolitan Myrica plants that have broad
      microsymbiont compatibility and, hence, are a potential host of Casuarinaceae
      infective Frankia outside the hosts' native range. The results are consistent
      with the idea that Frankia symbiotic promiscuity and ease of isolation on organic
      substrates, suggesting saprophytic potential, are associated with increased
      microsymbiont ability to disperse and adapt to diverse new environments, and that
      both genetics and environment determine a host's nodular microsymbiont.

PMID- 11207779
TI  - Advances in neuroimaging: surgical localization.

PMID- 11207780
TI  - Changes in nitric oxide synthesis and epileptic activity in the contralateral
      hippocampus of rats following intrahippocampal kainate injection.
AB  - PURPOSE: To investigate the effects of nitric oxide (NO) on seizure activity
      observed in brain areas that are remote from a primary epileptic focus. METHODS:
      Following an injection of kainate (concentration 1 mg/ml, volume 1 microl) in the
      rat hippocampus, we measured NO synthesis in the contralateral hippocampus and
      epileptic activity by electroencephalogram (EEG). The NO end products, nitrite
      and nitrate, were measured by in vivo microdialysis combined with an automated NO
      end-product analyzer and then used as indices of NO synthesis. We also assessed
      the effect of a specific inhibitor of neuronal NO synthase (NOS) on both the
      epileptic activity and NO synthesis in the contralateral hippocampus. For this
      assessment, we administered 7-nitroindazole (7-NI) (50 mg/kg) intraperitoneally
      30 min before the kainate injection. RESULTS: Epileptic discharges in the
      contralateral hippocampus were frequently observed 90 min after unilateral
      hippocampus kainate injection. The duration of these discharges gradually
      increased until 240 min after the kainate injection. The NO end-product levels
      increased immediately after kainate injection and continued to increase gradually
      throughout the experiments, to a maximum of 213% of the base level. This
      elevation of NO end products was followed by epileptic discharges. Both the
      seizure activity and the elevation of contralateral hippocampus NO end-product
      levels were markedly attenuated in the animals that received 7-NI. CONCLUSIONS:
      The results suggest that remote seizure activity caused by the transneuronal
      spread of kainate-induced discharges may be related to NO derived from neuronal
      NOS.

PMID- 11207781
TI  - Postictal diffusion-weighted imaging for the localization of focal epileptic
      areas in temporal lobe epilepsy.
AB  - PURPOSE: Diffusion-weighted MR imaging (DWI) is a novel technique to delineate
      focal areas of cytotoxic edema of various etiologies. We hypothesized that DWI
      may also detect the epileptogenic region and adjacent areas during the ictal and
      early postictal periods in patients with temporal lobe epilepsy (TLE). METHODS:
      We studied patients with intractable TLE (n = 9), due to hippocampal sclerosis
      (HS, n = 7), left mesial temporal lobe tumor (n = 1), and of unknown etiology (n
      = 1). Informed consent was obtained before inclusion in the study. All patients
      with single short seizures were scanned immediately after EEG-documented seizures
      (between 45 and 150 min); one of two patients in status was scanned 14 h after
      cessation of seizures. DWI results were analyzed visually and by calculating
      apparent diffusion coefficient (ADC) maps. RESULTS: We found significant
      decreases in ADC postictally in one of six patients with TLE due to HS and single
      short seizures. One patient with an incompletely resected temporal lobe tumor
      also exhibited ADC abnormalities. One patient in focal status epilepticus
      revealed a decrease in ADC, and one patient with a continuous aura had no DWI
      abnormality. CONCLUSIONS: Postictal DWI technique may occasionally help delineate
      epileptic areas in some patients with TLE. Yield is low in patients with HS and
      single short seizures: it may be higher in patients with tumor or status
      epilepticus.

PMID- 11207782
TI  - Effects of vigabatrin on brain GABA+/CR signals in patients with epilepsy
      monitored by 1H-NMR-spectroscopy: responder characteristics.
AB  - PURPOSE: Vigabatrin (VGB) is a new antiepileptic drug that increases the human
      brain gamma-aminobutyric acid (GABA) level by irreversibly inhibiting GABA
      transaminase. Although some patients respond to VGB with a significant seizure
      reduction, others do not. The aim of this study was to identify possible
      responders before or in an early phase of VGB treatment by measuring the GABA and
      homocarnosine contaminated with macromolecules/creatine and phosphocreatine ratio
      (GABA+/Cr) signal by means of proton-nuclear magnetic resonance (1H NMR)
      spectroscopy. METHODS: Measurements were performed immediately before and after a
      titration period of 1 month (2 g/day during the past 2 weeks). A third
      measurement followed a maintenance period of 3 months (2 or 3 g/day). In 14
      patients with drug-resistant temporal lobe epilepsy and 3 patients with occipital
      lobe epilepsy, GABA+/Cr was measured in the ipsilateral (i.e., epileptogenic)
      hemisphere and contralateral (i.e., nonepileptogenic) hemisphere in a volume of 8
      cm3. RESULTS: Depending on the therapeutic efficacy of VGB, we defined three
      groups: (a) full responders (n = 7), (b) nonresponders (n = 7), and (c) partial
      responders (n = 3). The nonresponders had no significant change in the GABA+/Cr
      signal during the treatment compared with baseline. The full responders had a
      significant increase of the GABA+/Cr signal during the whole treatment phase and
      a lower ipsilateral level at baseline. The partial responders had also a lowered
      ipsilateral GABA+/Cr signal at baseline and an increase during treatment but a
      decrease when the seizures started again. CONCLUSIONS: Responders to VGB could be
      identified by a lower ipsilateral baseline GABA+/Cr signal and a steeper increase
      during VGB treatment. However, it was not possible to predict the duration of the
      response (full versus partial responder) with these criteria.

PMID- 11207783
TI  - Magnetic resonance spectroscopy and histopathological findings in temporal lobe
      epilepsy.
AB  - PURPOSE: In some patients with temporal lobe epilepsy, histopathological
      evaluation of resected brain tissue after surgical treatment may reveal several
      features indicative of discrete cortical malformations. We sought to determine
      whether these histopathological features were accompanied by hippocampal changes
      detectable preoperatively by proton magnetic resonance (MR) spectroscopy and to
      evaluate their relationship with postoperative outcome. METHODS: In 25
      consecutive temporal lobe epilepsy patients who were scheduled for surgical
      treatment, MR spectroscopy was performed, and resected brain tissue was analyzed
      histopathologically for the presence of discrete cortical malformations (e.g.,
      microdysgenesis). Outcome was assessed in all patients with an average
      postoperative period of 26 months. RESULTS: In 13 patients, we found subtle,
      histopathologically detectable signs of cortical malformation: 6 of them with
      concomitant hippocampal sclerosis (dual pathology) and 7 without. The latter
      subgroup had a worse surgical outcome and showed enhanced bilateral and/or
      contralateral pathological changes in the hippocampal formation when investigated
      by MR spectroscopy. CONCLUSIONS: These data suggest that by showing
      contralaterally or bilaterally abnormal spectra, MR spectroscopy might be able to
      indicate pathological changes in subtle developmental disorders that are possibly
      more widespread over the brain. This observation may improve noninvasive
      diagnosis in presurgical evaluation and the neurobiological understanding of
      cortical malformations in pharmacoresistant temporal lobe epilepsy.

PMID- 11207784
TI  - Short-term outcomes of children with febrile status epilepticus.
AB  - Febrile status epilepticus (SE) represents the extreme end of the complex febrile
      seizure spectrum. If there are significant sequelae to febrile seizures, they
      should be more common in this group. We have prospectively identified 180
      children aged 1 month to 10 years who presented with febrile SE over a 10-year
      period in Bronx, New York, and Richmond, Virginia. They were compared with 244
      children who presented with their first febrile seizure (not SE) in a prospective
      study done in the Bronx. The mean age of the children with febrile SE was 1.92
      years, and of the comparison group, 1.85 years. Duration of SE was 30-59 min in
      103 (58%), 60-119 min in 43 (24%), and > or =120 min in 34 (18%). Focal features
      were present in 64 (35%) of cases. There were no deaths and no cases of new
      cognitive or motor handicap. Children with febrile SE were more likely to be
      neurologically abnormal (20% vs. 5%; p < 0.001), to have a history of neonatal
      seizures (3% vs. 0; p = 0.006) and a family history of epilepsy (11% vs. 5%; p =
      0.05) and less likely to have a family history of febrile seizures (15% vs. 27%;
      p = 0.01) than were children in the comparison group. The short-term morbidity
      and mortality of febrile SE are low. There are differences in the types of
      children who have febrile SE compared with those who experience briefer febrile
      seizures. Long-term follow-up of this cohort may provide insight into the
      relationship of prolonged febrile seizures and subsequent mesial temporal
      sclerosis.

PMID- 11207786
TI  - Visual symptoms in epilepsy and migraine: localization and patterns.
AB  - PURPOSE: To clarify differences in the localization of visual symptom patterns in
      epilepsy and migraine, we analyzed patient-generated illustrations of visual
      symptoms. METHODS: Patients were asked to draw their visual symptoms from memory
      using marker pens of 12 colors. All patients illustrated their symptoms on a
      template sheet representing the binocular visual field. We analyzed a total of 67
      illustrations from 54 patients aged 6-40 years: 28 with epilepsy, 23 with
      migraine, and 3 with migraine-epilepsy syndrome. RESULTS: With respect to
      positive visual manifestations, those of epileptic patients were predominantly
      centrally localized (20 of 24, 83%), whereas those of migraine patients were
      predominantly peripherally localized (10 of 13, 77%) (p < 0.0001). With respect
      to negative visual symptoms, those in epilepsy were commonly diffuse (10 of 14,
      71%) compared with those in migraine, which were peripheral (9 of 12, 75%) (p <
      0.05). CONCLUSIONS: Results of this study suggest that the localization of visual
      symptoms differs between epilepsy and migraine.

PMID- 11207785
TI  - The role of vigabatrin in childhood seizure disorders: results from a clinical
      audit.
AB  - PURPOSE: The emergence of visual field defects attributed to vigabatrin (VGB)
      treatment and intramyelinic edema in animal experiments has raised concerns about
      its future role in the treatment of childhood seizures. METHODS: We evaluated our
      experience with this antiepileptic agent with retrospective analysis of database
      and chart audit. RESULTS: Of 73 patients, 43 girls and 33 boys were treated with
      VGB over a 7-year period. The mean age of patients at the introduction of VGB was
      87 months (range, 5-257 months). In 12 of 73 cases, VGB was used as monotherapy;
      in 61 of 73 cases, it was used as an add-on drug. Seizure types included
      secondarily generalized seizures (21), mixed seizures (21), partial seizures
      (18), and generalized seizures (13). Seizure etiology was idiopathic/cryptogenic
      in 22 patients, symptomatic in 50, and undetermined in a single patient. The mean
      duration of therapy was 16 months (median, 10 months; range, 1-144 months). VGB
      was effective in 30 (seven seizure free, 23 with >90% reduction in seizures),
      partially effective in four (50-90% reduction in seizures), and ineffective in 38
      (<50% reduction in seizures). Nearly 50% of patients with infantile spasms
      responded to VGB. All patients underwent ophthalmic evaluation; two (16%) of 12
      patients who could undergo static threshold perimetry were demonstrated to have
      the characteristic visual field constriction. CONCLUSIONS: VGB is effective in
      producing a significant reduction in seizure frequency in nearly half the
      patients with childhood seizures, including refractory epilepsy. Despite emerging
      concerns regarding visual side effects, this drug retains an important role in
      the medical management of childhood epilepsy.

PMID- 11207787
TI  - Surgical outcome of corpus callosotomy in patients with drop attacks.
AB  - PURPOSE: We examined presurgical factors that independently influence surgical
      outcome after corpus callosotomy. For adequate measurement of the surgical
      outcome, we analyzed seizure outcome of drop attacks, postoperative overall daily
      function, and family satisfaction. METHODS: At least 2 years after callosotomy
      (mean, 40.0 months), we retrospectively investigated 52 patients with drop
      attacks. As presurgical factors, we analyzed the age at surgery, age at seizure
      onset, age at drop attack onset, sex, hemiparesis, severe mental retardation, EEG
      abnormality, MRI abnormality, and extent of callosal section (total or partial
      callosotomy). Stepwise logistic regression was used for analysis. RESULTS:
      Satisfactory outcome (seizure cessation or >90% seizure reduction) was achieved
      in 85% of patients with drop attacks, 32% of those with generalized tonic
      seizures, and 31% of those with generalized tonic-clonic seizures. The families
      assessed the overall daily function as improved in 62% of patients, unchanged in
      23%, and impaired in 15%. Family satisfaction with callosotomy was achieved in
      83% of patients (definitely satisfied, 39%, somewhat satisfied, 44%). Total
      callosotomy is independently predictive of satisfactory reduction of drop attacks
      (p = 0.013). A younger age is independently predictive of improvement of overall
      daily function (impaired and improved: p = 0.004) and family satisfaction
      (unsatisfied and somewhat satisfied, p = 0.018; unsatisfied and definitely
      satisfied, p = 0.0006). CONCLUSIONS: In the present study, we found that total
      callosotomy is more effective for treatment of drop attacks than partial
      callosotomy and that children receive more benefit than adults after callosotomy.

PMID- 11207788
TI  - Seizures in multiple sclerosis.
AB  - PURPOSE: In patients with multiple sclerosis (MS), epileptic seizures occur more
      frequently than in the general population. The aim of this study was to analyze
      clinical characteristics of epilepsy in patients with MS, potential correlation
      between the semiology of seizures, EEG and magnetic resonance imaging (MRI)
      findings in these patients, as well as to examine the response to anticonvulsant
      therapy. METHODS: In a series of 268 consecutive patients with definite MS
      hospitalized at the Institute of Neurology, Belgrade, we identified 20 (7.5%)
      patients with seizures or epilepsy. All patients with seizures or epilepsy were
      submitted to standard EEG and brain MRI with gadopentetate dimeglumine. RESULTS:
      In four patients, epilepsy occurred 1-5 years before other clinical
      manifestations of MS. Eight patients had seizures only during MS relapses
      (provoked seizures). In two of them, seizures were the only manifestations of
      relapse. In 12 patients, seizures occurred regardless of the phase of MS (chronic
      epilepsy). In the majority of patients, seizures were partial with secondary
      generalization. Five patients experienced episodes of status epilepticus, and
      they all had dementia. Abnormal EEG pattern was found in 11 patients. Brain MRI
      disclosed cortical-subcortical lesions in nine patients and focal cortical
      atrophy in one, whereas in the remaining patients, findings were inconclusive.
      Probable EEG-MRI-seizure type correlation existed in 10 patients. CONCLUSIONS:
      Our data suggest that epilepsy may represent an initial symptom of MS and a
      single clinical manifestation of a relapse, and further support the assumption of
      the existing correlation between the presence of cortical-subcortical lesions and
      epileptic seizures or epilepsy in patients with MS.

PMID- 11207789
TI  - A detailed analysis of frontal lobe seizure semiology in children younger than 7
      years.
AB  - PURPOSE: We sought to analyze semiology of seizure onset and evolution in young
      children with frontal lobe epilepsy (FLE), compare this with adult reports, and
      assess age-related differences. METHODS: We analyzed 111 videotaped seizures from
      14 patients with FLE based on focal cortical dysplasia aged 3-81 months (mean, 30
      months). Ictal events were categorized into behavioral, consciousness, autonomic,
      and sensory features, as well as motor patterns, which included tonic, clonic,
      epileptic spasm, and myoclonic seizure components. We developed a time-scaled
      datasheet to record each epileptic event as onset, very early, early, or late
      manifestation. RESULTS: Patients had a high seizure frequency with up to 40
      attacks/day; half of them showed a cluster tendency. Forty-seven percent of the
      seizures started in sleep. Mean duration of seizures was short (29 s). Most
      common seizure components were motor manifestations, mostly tonic-clonic
      seizures, and epileptic spasms. Behavioral change was frequent, and hypermotor
      seizures were not seen. In five patients, the motor features were contralateral
      to the epileptic focus, including two children with asymmetric epileptic spasms.
      Secondarily generalized tonic-clonic seizures (SGTCSs) were not recorded, but had
      been reported in the history of two patients. Complex motor automatisms were not
      seen, whereas oral automatism appeared in three children. CONCLUSIONS: Motor
      features are common in young children with FLE, as reported in adults. The
      characteristics, however, differ. Epileptic spasms and subtle behavioral change
      were frequent. Hypermotor seizures and complex motor automatisms were not seen,
      and SGTCSs were unusual. Our results suggest that FLE in young children shows age
      related features differing from those of adults.

PMID- 11207791
TI  - Recurrence after a first untreated seizure in the Hong Kong Chinese population.
AB  - PURPOSE: There is wide variation in the reported prognosis after a first
      unprovoked generalized tonic-clonic convulsion and in the risk factors that are
      associated with recurrence. Estimates for the risk of recurrence range from 26 to
      71%. We investigated the likelihood of a second attack in Hong Kong Chinese
      patients. METHODS: One hundred thirty-two patients with a first convulsion that
      was unexplained by acute neurological or medical causes were retrospectively
      ascertained. Patients' demographic details, potential risk factors for
      recurrence, and current seizure status were recorded. Survival analysis was
      performed using the Kaplan-Meier procedure. RESULTS: The cumulative probability
      of a second attack at 1, 2, 3, and 4 years was 30, 37, 42, and 47%, respectively.
      Seizures in patients with abnormal computer tomography scans of the brain were
      associated with an increased risk of recurrence on multivariate analysis.
      CONCLUSIONS: Thirty percent of the sample population experienced a second seizure
      after 1 year. An additional 17% continue to be at risk of a second convulsion
      during the next 3 years.

PMID- 11207790
TI  - Changes in public attitudes toward epilepsy in Hungary: results of surveys
      conducted in 1994 and 2000.
AB  - Our study investigated public attitudes toward epilepsy, and knowledge and
      understanding of epilepsy in Hungary. We compared changes of public attitudes in
      the last six years, hypothesizing a trend of positive changes because of recent
      national initiatives for acceptance and integration of people with epilepsy
      (e.g., participation of Hungary in the "Out of the Shadows" world campaign). We
      also studied how the demographic background of the respondents affects awareness,
      understanding, and attitudes toward epilepsy. Using a questionnaire design, we
      conducted a public opinion poll with a representative sample of 1,000 people in
      1994 and 6 years later, in 2000. Hungarian respondents were most prejudiced
      regarding employment of people with epilepsy. In recent years, significant
      decreases in prejudice rates were found regarding all attitude aspects (marriage,
      children associating, work). Significant background effects of demographic
      variables were also apparent: differences by age, education, residence, and
      family status were found. Some culture-specific characteristics of understanding
      epilepsy could be observed. Significant positive attitude changes from 1994 to
      2000 confirm the need for and potentialities of education of the public and
      informational initiatives. Demographic influences and culture-specific
      characteristics could be of relevance in designing public education for different
      target groups.

PMID- 11207792
TI  - Reexamination of interictal psychoses based on DSM IV psychosis classification
      and international epilepsy classification.
AB  - We sought to examine interictal psychoses based on the international epilepsy
      classification and DSM IV criteria, with special attention paid to epilepsy types
      as well as to subcategories of psychoses. One hundred thirty-two outpatients were
      studied, each with definite evidence of both epilepsy and interictal psychosis
      clearly demarcated from postictal psychosis. We compared them with 2,773 other
      epilepsy outpatients as a control. Risk factors for psychosis were examined
      within the temporal lobe epilepsy (TLE) group and the more extended group of
      symptomatic localization-related epilepsy. Further, nuclear schizophrenia and
      other nonschizophrenic psychotic disorders were compared. We confirmed a close
      correlation between TLE and interictal psychoses. Within the TLE group, only
      early epilepsy onset and a history of prolonged febrile convulsions were revealed
      to be significantly associated with interictal psychosis. Within the symptomatic
      localization-related epilepsy group, such parameters as complex partial seizures,
      autonomic aura, and temporal EEG foci were closely associated with psychoses.
      There was also a significant difference between groups as to ictal fear and
      secondary generalization. Whereas patients with early psychosis onset and a low
      intelligence quotient were overrepresented in the nuclear schizophrenia group,
      drug-induced psychosis and alternative psychosis were underrepresented. TLE
      proved to be preferentially associated with interictal psychoses. Within the TLE
      group, medial TLE in particular was found to be more closely associated with
      psychosis. Our data support the original postulation of Landolt, stating that
      alternative or drug-induced psychoses constitute a definite subgroup of
      interictal psychoses, which are different from chronic epileptic psychoses that
      simulate schizophrenia.

PMID- 11207793
TI  - Impact of pediatric epilepsy on the family: a new scale for clinical and research
      use.
AB  - PURPOSE: There is no brief, global instrument available that specifically
      measures the psychosocial impact of pediatric epilepsy on the family. An 11-item
      scale was created for parents' use to evaluate the influence of epilepsy on the
      major aspects of their family and child's life. This will be a helpful tool both
      in the clinical setting and as an outcome measure for research studies. METHODS:
      Mothers rated their child's quality of life on a visual analogue scale (1-6) and
      completed the Impact of Pediatric Epilepsy Scale (IPES), which assesses the
      impact on academic achievement, participation in activities, health,
      relationships with family and with peers and siblings, social activities, self
      esteem, and the caregiver's hopes for their child's future adapted from the scale
      developed by Jacoby. External validation was determined by comparison of the IPES
      with physicians' reports of the characteristics of the child's epilepsy and
      neurological limitations and parents' ratings on the Family Environment Scale or
      Parenting Stress Index. In addition, each school-aged child completed the Piers
      Harris Children's Self-Concept Scale, Brother-Sister Questionnaire, and
      Loneliness Scale. Teachers of children completed the Academic Performance Rating
      Scale. Seven days later, retest reliability of the IPES was evaluated. RESULTS:
      Ninety-seven mothers of children aged 2-16 years completed the IPES and the
      appropriate family and age-related questionnaires. Internal validation on the
      IPES yielded a Cronbach's a for the scale of 0.92. A significant Pearson's
      correlation indicated that total scores were consistent over time (r = 0.81).
      Spearman's correlations for the individual items were also significant, ranging
      from 0.48 to 0.78. Significant Spearman's correlations also indicated that
      quality of life was negatively related to impact on each of the 11 items of
      psychosocial function. Children with IPES scores above the median differed in
      some psychosocial aspects from those who scored below. Their parents were more
      stressed, their siblings were more respectful, they had lower self-esteem, and
      they experienced more emotional problems. Total impact was also significantly
      related to seizure frequency, total number of medications taken, number of visits
      to a physician in the previous year, and number of nights spent in hospital for
      neurological reasons. CONCLUSIONS: The IPES is an accurate, acceptable, and quick
      measurement tool that reflects the way in which childhood epilepsy has an impact
      on the child and on family life. It may be helpful in routine clinical care and
      may be useful in the research setting to find ways to improve the lives of
      children with epilepsy.

PMID- 11207794
TI  - Changes in quality of life in epilepsy: how large must they be to be real?
AB  - PURPOSE: The study goal was to assess the magnitude of change in generic and
      epilepsy-specific health-related quality-of-life (HRQOL) instruments needed to
      exclude chance or error at various levels of certainty in patients with medically
      refractory epilepsy. METHODS: Forty patients with temporal lobe epilepsy and
      clearly defined criteria of clinical stability received HRQOL measurements twice,
      3 months apart, using the Quality of Life in Epilepsy Inventory-89 and -31 (QOLIE
      89 and QOLIE-31), Liverpool Impact of Epilepsy, adverse drug events, seizure
      severity scales, and the Generic Health Utilities Index (HUI-III). Standard error
      of measurement and test-retest reliability were obtained for all scales and for
      QOLIE-89 subscales. Using the Reliable Change Index described by Jacobson and
      Truax, we assessed the magnitude of change required by HRQOL instruments to be 90
      and 95% certain that real change has occurred, as opposed to change due to chance
      or measurement error. RESULTS: Clinical features, point estimates and
      distribution of HRQOL measures, and test-retest reliability (all > 0.70) were
      similar to those previously reported. Score changes of +/-13 points in QOLIE-89,
      +/-15 in QOLIE-31, +/-6.3 in Liverpool seizure severity-ictal, +/-11 in Liverpool
      adverse drug events, +/-0.25 in HUI-III, and +/-9.5 in impact of epilepsy exclude
      chance or measurement error with 90% certainty. These correspond, respectively,
      to 13, 15, 17, 18, 25, and 32% of the potential range of change of each
      instrument. CONCLUSIONS: Threshold values for real change varied considerably
      among HRQOL tools but were relatively small for QOLIE-89, QOLIE-31, Liverpool
      Seizure Severity, and adverse drug events. In some instruments, even relatively
      large changes cannot rule out chance or measurement error. The relation between
      the Reliable Change Index and other measures of change and its distinction from
      measures of minimum clinically important change are discussed.

PMID- 11207795
TI  - Quantitative assessment of seizure severity for clinical trials: a review of
      approaches to seizure components.
AB  - Quantitative assessment of seizure severity has been approached using a variety
      of systems. This review describes currently available methods and possible new
      approaches to seizure assessment for clinical trials. A review of the literature
      on methods of seizure assessments resulted in tabulation of the seizure rating
      scales known as VA, Chalfont-National Hospital, Liverpool, Hague, and the
      Occupational Hazard Scale. Seizures have been evaluated by simply counting all
      events, counting events by type, by clinician ratings, patient ratings, and
      combinations. Each of the scales has advantages and disadvantages. Most scales
      share core components: seizure frequency, seizure type, seizure duration,
      postictal events, postictal duration, automatisms, seizure clusters, known
      patterns, warnings, tongue biting, incontinence, injuries, and functional
      impairment. This review revealed a partial consensus about aspects of seizures
      that are important markers for severity. However, usefulness of the existing
      scales is limited by lack of data on responsiveness. New approaches are needed to
      assess changes in seizure severity as a result of an intervention in a clinical
      trial.

PMID- 11207796
TI  - Hippocampal volume and glucose metabolism in temporal lobe epileptic foci.
AB  - PURPOSE: Reports conflict on the relation of glucose metabolism to hippocampal
      volume in temporal lobe foci. Previous studies usually have used side-side ratios
      rather than regional metabolic rates. METHODS: We measured hippocampal volume and
      glucose metabolism in 37 patients with temporal epileptogenic zones identified by
      ictal video-EEG telemetry. Metabolic rates were normalized to global brain mean.
      RESULTS: Both 18-fluoro-2-deoxyglucose-PET and volumetric MRI lateralized the
      epileptic focus determined by ictal video-EEG. There were significant
      correlations between left-right metabolic asymmetry and hippocampal formation
      volume left-right ratios. Comparisons between normalized metabolism and
      hippocampal formation volume, ignoring the side of the epileptic focus, showed
      significant relations between left hippocampal volume and left inferior lateral
      temporal metabolism, right hippocampus and right inferior mesial temporal, and
      left hippocampus and left inferior mesial temporal metabolism. In contrast, when
      normalized metabolism was compared with hippocampal volume in the epileptic
      focus, no relation was found. CONCLUSIONS: Our study suggests that the relation
      between hippocampal volume and glucose metabolism breaks down in epileptic foci
      and that hypometabolism is not dependent on neuronal loss. It is consistent with
      data suggesting that hypometabolism is an independent predictor of surgical
      outcome.

PMID- 11207797
TI  - Deep wound infection after vagus nerve stimulator implantation: treatment without
      removal of the device.
AB  - Effective treatment of deep wound infection without removal of a previously
      implanted foreign body is difficult. The Neurocybernetic Prosthesis (NCP) System
      (Cyberonics Inc., Webster, TX, U.S.A.), implanted for vagus nerve stimulation in
      patients with medically refractory epilepsy, uses coil-like electrodes placed
      around the left vagus nerve after exposure of the nerve in the carotid sheath.
      Infection within this compartment endangers the contained structures and makes
      removal of the system hazardous. We report the case of one patient implanted with
      the NCP who underwent successful open wound treatment without removal of the
      system. A 35-year-old man had local signs of wound infection 5 weeks after
      implantation of a vagus nerve stimulator. Systemic signs of infection were
      absent. C-reactive protein was slightly elevated, but all other laboratory values
      were normal. After open wound debridement and thorough rinsing with bacitracin
      containing solution, the wound was packed with 3% iodoformized gauze. The NCP was
      left in place. Systemic antibiotic therapy with fosfomycin and cefmenoxim was
      started. Cultures confirmed an infection with Staphylococcus aureus. The wound
      was rinsed daily with 3% hydrogen peroxide solution and 5% saline until cultures
      were sterile and granulation tissue started to fill the wound. Delayed primary
      closure was performed 2 weeks later. Wound healing was accomplished without
      removal of the device. No signs of recurrent infection were observed during a
      follow-up of 1 year. Open wound treatment without removal of the implanted vagus
      nerve stimulator is feasible in cases of deep cervical wound infection and can be
      an alternative if removal of the device appears hazardous.

PMID- 11207798
TI  - The treatment gap in epilepsy: the current situation and ways forward.
AB  - This article is a summary of a workshop held by the ILAE concerning the issue of
      the epilepsy treatment gap in developing countries. The gap is defined in terms
      of those people with epilepsy who are not being appropriately treated and is the
      result of an array of medical, political, social, economic, and cultural factors.
      The situation regarding the treatment gap for various countries is reviewed,
      along with some of its causes. Although the overall gap is estimated to be large,
      a number of recent projects and interventions have been effective in delivering
      appropriate treatment to people with epilepsy in underresourced countries of the
      developing world. It is hoped that these may be transferable elsewhere and that,
      combined with the ILAE/IBE/WHO Global Campaign against Epilepsy and increased
      support from the worldwide epilepsy community, the treatment gap will begin to be
      bridged.

PMID- 11207799
TI  - Developmental and cellular expression pattern of epithelial sodium channel alpha,
      beta and gamma subunits in the inner ear of the rat.
AB  - Endolymphatic ion composition in the adult inner ear is characterized by high
      K(+) and low Na(+) concentration. This unique ion composition is essential for
      proper functioning of sensory processing. Although a lot has been learned in
      recent years about molecules involved in K(+) transport in inner ear, the
      molecules involved in Na(+) transport are only beginning to emerge. The
      epithelial Na(+) channel (ENaC) is a highly selective Na(+) channel that is
      expressed in many Na(+)-reabsorbing tissues. The aim of our study was to
      investigate whether ENaC is expressed in inner ear of rats and could account for
      Na(+) reabsorption from endolymph. We detected mRNA for the three channel-forming
      subunits (alpha, beta and gamma ENaC) in cochlea, vestibular system and
      endolymphatic sac. mRNA abundance increased during the first 12 days of life in
      cochlea and vestibular system, coinciding with decreasing Na(+) concentration in
      endolymph. Expression was strongest in epithelial cells lining scala media, most
      notably Claudius' cells. As these cells are characterized by a very negative
      resting potential they would be ideally suited for reabsorption of Na(+). mRNA
      abundance in endolymphatic sac decreased during the first 6 days of life,
      suggesting that ENaC might be implicated in reabsorption of endolymph in the
      endolymphatic sac of neonatal animals. Together, our results suggest that the
      epithelial Na+ channel is a good candidate for a molecule involved in Na(+)
      homeostasis in inner ear.

PMID- 11207800
TI  - The highly sialylated isoform of the neural cell adhesion molecule is required
      for estradiol-induced morphological synaptic plasticity in the adult arcuate
      nucleus.
AB  - The large quantities of polysialic acid (PSA) characterizing highly sialylated
      isoform of the neural cell adhesion molecule (PSA-NCAM), greatly reduce cell
      adhesion and render this particular cell surface adhesion molecule a likely
      candidate to intervene in dynamic neuronal phenomena, such as synaptic
      plasticity. The hypothalamic arcuate nucleus expresses high levels of PSA-NCAM
      and maintains a high capacity for neuroplastic changes in the adult. Thus, in the
      arcuate nucleus of female rats, varying circulating levels of estrogen give rise
      to a reversible reduction in the number of axo-somatic GABA synapses, together
      with a changing ensheathing of neuronal somata by astrocytes. To examine the role
      of PSA in such changes, we perturbed its expression, either by blockade with
      antibodies raised against this carbohydrate moiety (delivered
      intracerebroventricularly), or by its enzymatic cleavage after microinjection of
      endoneuraminidase N over the arcuate nucleus. Either procedure was performed in
      ovariectomized adult rats that received concurrent treatment with 17 beta
      estradiol. Morphological synaptic plasticity was analysed using the unbiased
      disector method to assess synaptic densities in ultrathin sections of the arcuate
      nucleus immunogold-labelled for GABA. As expected, 17 beta-estradiol induced a
      significant reduction in the number of GABAergic axo-somatic synapses, a
      reduction which did not occur after infusion of anti-PSA antibodies or in vivo
      enzymatic removal of PSA from NCAM. Taken together, our results provide strong
      evidence that the presence of large quantities of the PSA moiety on NCAM is a
      necessary prerequisite for estrogen-induced phasic remodelling of synapses in the
      adult female arcuate nucleus.

PMID- 11207801
TI  - Progression of spontaneous seizures after status epilepticus is associated with
      mossy fibre sprouting and extensive bilateral loss of hilar parvalbumin and
      somatostatin-immunoreactive neurons.
AB  - The development of spontaneous limbic seizures was investigated in a rat model in
      which electrical tetanic stimulation of the angular bundle was applied for up to
      90 min. This stimulation produced behavioural and electrographic seizures that
      led to a status epilepticus (SE) in most rats (71%). Long-term EEG monitoring
      showed that the majority of the rats (67%) that underwent SE, displayed a
      progressive increase of seizure activity once the first seizure was recorded
      after a latent period of about 1 week. The other SE rats (33%) did not show this
      progression of seizure activity. We investigated whether these different patterns
      of evolution of spontaneous seizures could be related to differences in cellular
      or structural changes in the hippocampus. This was the case regarding the
      following changes. (i) Cell loss in the hilar region: in progressive SE rats this
      was extensive and bilateral whereas in nonprogressive SE rats it was mainly
      unilateral. (ii) Parvalbumin and somatostatin-immunoreactive neurons: in the
      hilar region these were almost completely eliminated in progressive SE rats but
      were still largely present unilaterally in nonprogressive SE rats. (iii) Mossy
      fibre sprouting: in progressive SE rats, extensive mossy fibre sprouting was
      prominent in the inner molecular layer. In nonprogressive SE rats, mossy fibre
      sprouting was also present but less prominent than in progressive SE rats.
      Although mossy fibre sprouting has been proposed to be a prerequisite for chronic
      seizure activity in experimental temporal lobe epilepsy, the extent of hilar cell
      death also appears to be an important factor that differentiates between whether
      or not seizure progression will occur.

PMID- 11207802
TI  - Real-time, two-dimensional visualization of ischaemia-induced glutamate release
      from hippocampal slices.
AB  - The involvement of excitatory amino acid (EAA) toxicity in ischaemia-induced
      neuronal cell death has long been suggested. However, in the hippocampus, the
      brain site most vulnerable to ischaemia, the detailed spatial and temporal
      patterns of EAA release are not yet known. To address this issue, we have
      developed a novel strategy for the continuous, real-time, two-dimensional
      monitoring of EAA release from brain slices. As EAA detector, we used a cell line
      transformed with the N-methyl-D-aspartate (NMDA) receptor, which is exclusively
      activated by EAAs, leading to an increase in the intracellular Ca(2+) level.
      Combined with a calcium imaging technique, the use of this cell line allowed the
      temporal and regional analysis of EAA release from a brain slice placed directly
      on top of the clonal cells in a culture dish. Using this strategy, we
      demonstrated ischaemia-induced EAA release in rat hippocampal slices. Increased
      EAA release was seen initially in the CA1 region, about 3 min after the beginning
      of ischaemia, then in the CA3 region and dentate gyrus, and, finally, throughout
      the hippocampal slice. Regional differences in extracellular EAA levels were also
      seen, with more EAA being released from the CA1 region than from the middle
      dentate gyrus. The present results are especially interesting as neurons in the
      CA1 region are more vulnerable to ischaemia than those in the CA3 region and
      dentate gyrus.

PMID- 11207803
TI  - Enhanced CREB phosphorylation in immature dentate gyrus granule cells precedes
      neurotrophin expression and indicates a specific role of CREB in granule cell
      differentiation.
AB  - Differentiation and maturation of dentate gyrus granule cells requires
      coordinated interactions of numerous processes. These must be regulated by
      protein factors capable of integrating signals mediated through diverse
      signalling pathways. Such integrators of inter and intracellular physiological
      stimuli include the cAMP-response element binding protein (CREB), a leucine
      zipper class transcription factor that is activated through phosphorylation.
      Neuronal activity and neurotrophic factors, known to be involved in granule cell
      differentiation, are major physiologic regulators of CREB function. To examine
      whether CREB may play a role in governing coordinated gene transcription during
      granule cell differentiation, we determined the spatial and temporal profiles of
      phosphorylated (activated) CREB throughout postnatal development in immature rat
      hippocampus. We demonstrate that CREB activation is confined to discrete, early
      stages of granule cell differentiation. In addition, CREB phosphorylation occurs
      prior to expression of the neurotrophins BDNF and NT-3. These data indicate that
      in a signal transduction cascade connecting CREB and neurotrophins in the process
      of granule cell maturation, CREB is located upstream of neurotrophins.
      Importantly, CREB may be a critical component of the machinery regulating the
      coordinated transcription of genes contributing to the differentiation of granule
      cells and their integration into the dentate gyrus network.

PMID- 11207804
TI  - Differential daily expression of Per1 and Per2 mRNA in the suprachiasmatic
      nucleus of fetal and early postnatal mice.
AB  - It is well known that there are circadian rhythms of 2-deoxyglucose uptake and
      neuronal firing in the rat suprachiasmatic nucleus (SCN) during fetal and early
      postnatal periods. A core clock mechanism in the mouse SCN appears to involve a
      transcriptional feedback loop in which CLOCK and BMAL1 function as positive
      regulators and three mPeriod (mPer) genes play a role in negative feedback. Per
      genes expression occurs not only in the adult SCN but also in the fetal SCN.
      However, the developmental change in these genes remains unclear. In this
      experiment, we examined the day--night pattern of expression of Per1 and Per2
      mRNA in the mouse SCN and cerebral cortex on embryonic day 17, postnatal day 3,
      and in young adult mice under a light-dark cycle. Daily rhythms of mRNA content
      were observed in mPer1 but not mPer2 in the fetal SCN. Interestingly, the
      expression of mPer2 in the SCN was high throughout the entire day, and a
      significant daily rhythm of this gene was observed on postnatal day 6. The
      expression pattern of SCN mPer1 in constant darkness was similar to that seen in
      the light-dark cycle. The present results suggest that the daily oscillation of
      mPer1 but not of mPer2 in the SCN in fetal and early postnatal mice may be
      associated with the daily rhythms of 2-deoxyglucose uptake and neuronal firing.

PMID- 11207805
TI  - Corticonuclear projections of the cerebellum preserve both anteroposterior and
      mediolateral pairing patterns.
AB  - The aim of the present study was to establish whether a diverging arrangement of
      the corticonuclear cerebellar projections exists and, if so, what relation it has
      with the inferior olivary complex. Iontophoretic injections of a 1 : 1 mixture of
      tetramethylrhodamine dextran amine and biotinylated dextran amine into the
      cerebellar cortex orthogradely labelled fibre terminals in the cerebellar nuclei
      and retrogradely labelled cell bodies in the inferior olivary complex. The
      injections were into A, B, C2, C3, D1 and D2 bands. These injections showed
      diverging projections to the cerebellar nuclei, with 'primary projections'
      directed to the nuclear region previously reported to be specifically connected
      with the injected band and 'secondary projections' directed to other nuclear
      regions. Secondary projections from the A, C2 and C3 bands diverged to nuclear
      regions primarily controlled by cortical bands lateral to those injected.
      Secondary projections from the D1, and D2 bands diverged to nuclear regions
      primarily controlled by cortical bands medial to those injected. Moreover,
      injections distributed along the D1 and D2 bands showed similar sets of nuclear
      targets, while those distributed along the A, C2 and C3 bands showed two sets of
      nuclear targets in relation to the anteroposterior location of the injected area
      within these bands. The cortical areas that projected to the same set of nuclear
      targets were innervated from single olivary regions, while those that projected
      to different sets of nuclear targets were innervated from different subsets of
      single regions of the inferior olive. The results suggest that the olivary bands
      of the cerebellar cortex project to the cerebellar nuclei with a diverging
      pattern that is organized in both the mediolateral and the anteroposterior axes.

PMID- 11207806
TI  - Mismatch between BDNF mRNA and protein expression in the developing visual
      cortex: the role of visual experience.
AB  - Brain-derived neurotrophic factor (BDNF) messenger RNA (mRNA) expression in the
      rat visual cortex of young and postnatal day 90 (P90) animals is developmentally
      regulated and influenced by visual experience. In the present paper we compared
      the expression of BDNF mRNA to the actual changes of BDNF protein occurring
      during postnatal development and verified whether BDNF protein distribution is
      controlled by visual activity. To achieve this aim we analysed BDNF mRNA and/or
      BDNF protein cellular distribution in the rat visual cortex at different
      postnatal ages by using immunohistochemistry and highly sensitive in situ
      hybridization. We found that before eye opening (P13), in all cortical layers a
      large number of visual cortical neurons contain BDNF mRNA with no detectable
      amount of BDNF protein. At later ages (P23 and P90), the number of BDNF
      immunostained cells increases; most neurons are double labelled for BDNF mRNA and
      protein, and a small group of neurons is labelled only for BDNF protein. The
      cellular increase of BDNF immunolabelling is blocked in animals deprived of
      visual experience from birth (dark rearing), with a large population of neurons
      containing BDNF mRNA but not BDNF protein. This is similar to what is observed
      before eye opening. Exposure of dark-reared rats to a brief period (2 h) of light
      restores a good match between BDNF mRNA and BDNF protein cellular expression. We
      propose that visual experience controls the neuronal content of BDNF mRNA and
      BDNF protein in developing visual cortex.

PMID- 11207807
TI  - Swelling-activated calcium signalling in cultured mouse primary sensory neurons.
AB  - The effects of hypo-osmotic membrane stretch on intracellular calcium
      concentration ([Ca(2+)](i)), cell volume and cellular excitability were
      investigated in cultured mouse primary sensory trigeminal neurons. Hypotonic
      solutions (15--45%) led to rapid cell swelling in all neurons. Swelling was
      accompanied by dose-dependent elevations in [Ca(2+)](i) in a large fraction of
      neurons. Responses could be classified into three categories. (i) In 57% of the
      neurons [Ca(2+)](i) responses had a slow rise time and were generally of small
      amplitude. (ii) In 21% of the neurons, responses had a faster rise and were
      larger in amplitude. (iii) The remaining cells (22%) did not show [Ca(2+)](i)
      responses to hypo-osmotic stretch. Slow and fast [Ca(2+)](i) changes were
      observed in trigeminal neurons of different sizes with variable responses to
      capsaicin (0.5 microM). The swelling-induced [Ca(2+)](i) responses were not
      abolished after depletion of intracellular Ca2+ stores with cyclopiazonic acid or
      preincubation in thapsigargin, but were suppressed in the absence of external
      Ca(2+). They were strongly attenuated by extracellular nickel and gadolinium.
      Hypotonic stimulation led to a decrease in input resistance and to membrane
      potential depolarization. Under voltage-clamp, the [Ca(2+)](i) elevation produced
      by hypotonic stimulation was accompanied by the development of an inward current
      and a conductance increase. The time course and amplitude of the [Ca(2+)](i)
      response to hypo-osmotic stimulation showed a close correlation with
      electrophysiological properties of the neurons. Fast [Ca(2+)](i) responses were
      characteristic of trigeminal neurons with short duration action potentials and
      marked inward rectification. These findings suggest that hypo-osmotic stimulation
      activates several Ca(2+)-influx pathways, including Gd(3+)-sensitive stretch
      activated ion channels, in a large fraction of trigeminal ganglion neurons.
      Opening of voltage-gated Ca(2+) channels also contributes to the response. The
      pattern and rate of Ca(2+) influx may be correlated with functional subtypes of
      sensory neurons.

PMID- 11207808
TI  - In vitro effects of acetyl-DL-leucine (tanganil) on central vestibular neurons
      and vestibulo-ocular networks of the guinea-pig.
AB  - For 40 years, the amino acid acetyl-DL-leucine (or isoleucine/Tanganil) has been
      used in clinical practice to reduce the imbalance and autonomic signs associated
      with acute vertigo crises. In animal models, acetyl-DL-leucine was shown to
      accelerate vestibular compensation following unilateral labyrinthectomy, while
      having only minor effects on normal vestibular function. However, the underlying
      mechanisms are unknown. In this study, the effect of acetyl-DL-leucine on the
      activity of central vestibular neurons of the medial vestibular nucleus (MVN)
      and/or the overall activity of vestibular-related networks was
      electrophysiologically measured in brainstem slices and in the isolated, in vitro
      whole brain (IWB) of guinea-pig. Only moderate effects were obtained in normal
      animals, where both excitatory and inhibitory actions of acetyl-DL-leucine were
      obtained. However, intracellular recordings from MVN neurons revealed that the
      nature of the response depended on the resting membrane potential. The neurons
      excited by acetyl-DL-leucine were significantly hyperpolarized compared to
      nonsensitive cells, whereas the neurons inhibited by this compound tended to
      display higher than normal membrane potentials. In accordance with these data,
      acetyl-DL-leucine reduced the prominent asymmetry characterizing the vestibular
      related networks of IWBs taken from previously labyrinthectomized animals, by
      decreasing the activity of the abnormally depolarized neurons on the hyperactive
      side. Altogether, our results suggest that acetyl-DL-leucine might act mainly on
      abnormally hyperpolarized and/or depolarized MVN neurons, by bringing back their
      membrane potential towards a mean value of -65 to -60 mV. Since in animal models,
      acute vestibular disorders are associated with asymmetrical spontaneous
      activities of MVN neurons, this study suggests how acetyl-DL-leucine may reduce
      acute, vestibular-related imbalances in humans.

PMID- 11207809
TI  - Neural cell adhesion molecule is endocytosed via a clathrin-dependent pathway.
AB  - Neural cell adhesion molecule (NCAM) constitutes a group of cell surface
      glycoproteins that regulate cell-cell interactions in the developing and adult
      brain. Endocytosis is a mechanism which dynamically controls the amount of cell
      surface NCAM expression and may involve the rapid changes occurring in NCAM
      expression under certain physiological or pathological conditions. However, the
      endocytic pathway of NCAM is presently unknown. Using astrocytes in culture and
      immunofluorescence we show that NCAM is internalized and that the immunolabelling
      presents a high degree of colocalization with clathrin, alpha-adaptin and
      transferrin, suggesting that NCAM is endocytosed by a clathrin-dependent pathway.
      Potassium depletion which disrupts clathrin-mediated endocytosis, inhibited
      internalization of NCAM. Electron microscopy and immunogold studies also
      demonstrate that the surface of clathrin-coated vesicles are also immunolabelled
      for both alpha-adaptin and PSA-NCAM, the highly sialylated isoform of NCAM.
      Furthermore, immunoprecipation studies demonstrate that NCAM is associated with
      both clathrin and alpha-adaptin, a component of adaptor complex AP-2, in brain,
      neurons and astrocytes. These findings indicate that NCAM is mainly endocytosed
      via clathrin-coated vesicles, suggesting a possible mechanism that may contribute
      to the rapid changes in NCAM expression at the cell surface.

PMID- 11207810
TI  - Immunohistochemical localization of voltage-gated calcium channels in substantia
      nigra dopamine neurons.
AB  - The rhythmic firing of dopaminergic (DA) neurons in the substantia nigra pars
      compacta (SNc) is thought to be mediated by nifedipine-sensitive Ca(2+) channels,
      although an involvement of omega-conotoxin-sensitive Ca(2+) channels is also
      suggested. In an attempt to localize such Ca(2+) channels at both the regional
      and cellular levels, their expression and distribution patterns were
      immunohistochemically investigated in the rat SNc. The three distinct subtypes of
      voltage-gated Ca(2+) channels were tested: the class B N-type alpha 1 subunit
      (CNB1), the class C L-type alpha 1 subunit (CNC1) and the class D L-type alpha 1
      subunit (CND1). A large number of SNc neurons showed intense immunoreactivity
      against CND1 and they were distributed throughout the entire extent. By contrast,
      many fewer neurons displayed less intense CNC1 immunoreactivity and many of them
      were located in the lateral aspect of the SNc. No immunoreactivity against CNB1
      was detected in the SNc. Moreover, double immunofluorescence analysis in
      combination with tyrosine hydroxylase staining revealed that virtually all DA
      neurons were CND1-immunoreactive whereas many DA neurons especially in the medial
      SNc exhibited only faint or no immunoreactivity against CNC1. Both CNC1 and CND1
      were expressed in cell bodies and proximal dendrites of SNc DA neurons, whilst
      their distal dendrites that penetrated into the substantia nigra pars reticulata
      expressed CND1 alone. Thus, the ubiquitously and intensely expressed class D
      alpha 1 subunit of L-type Ca(2+) channels that is sensitive to both nifedipine
      and omega-conotoxin may be responsible for the pacemaker activity of SNc DA
      neurons.

PMID- 11207811
TI  - Characteristics of fast Na(+) current of hypoglossal motoneurons in a rat
      brainstem slice preparation.
AB  - Whole-cell patch clamp recordings were performed on hypoglossal motoneurons in a
      brainstem slice preparation from the neonatal rat brain to study the
      characteristics of the fast Na(+) current (I(Na)) which has not been hitherto
      investigated in these cells. To aid voltage clamping of I(Na), cells were bathed
      in low Na(+) solution, loaded intracellularly with Na(+) (to reverse the Na(+)
      gradient) or treated with a small dose (20 nM) of tetrodotoxin. In low
      extracellular Na(+) solution (Na(+) was replaced by choline or N-methyl-D
      glucamine) I(Na) activated at membrane potentials positive to -45 mV and was half
      maximally activated at -30 mV. Similar data were obtained when the Na(+) gradient
      was reversed or tetrodotoxin was applied. I(Na) rapidly activated (1--3.5 ms time
      constant) and inactivated (1.6 ms time constant at 0 mV) during membrane
      depolarization. Inactivation was strongly voltage-dependent (half inactivation at
      -44 mV) and developed mono-exponentially. Recovery from inactivation was bi
      exponential with fast and slow time constants of 14 and 160 ms, respectively, at 
      58 mV. The rapid turning on of I(Na) was presumably responsible for the upstroke
      of the fast action potential generated by these cells while the slow phase of
      recovery from inactivation might modulate the ability to fire repetitively at
      high rate.

PMID- 11207812
TI  - Dopamine D(2) receptors regulate tyrosine hydroxylase activity and
      phosphorylation at Ser40 in rat striatum.
AB  - In the striatum, dopamine release is inhibited by activation of dopamine D(2)
      autoreceptors. Changes in dopamine release have been attributed to changes in the
      synthesis of dopamine, which is regulated via phosphorylation of tyrosine
      hydroxylase (TH), the rate-limiting enzyme in the synthesis of catecholamines.
      Here, we have studied the involvement of dopamine D(2) receptors in the
      regulation of TH phosphorylation at distinct seryl residues, using
      phosphorylation site-specific antibodies and a preparation of rat striatal
      slices. The D(2) receptor agonist, quinpirole, reduced basal TH phosphorylation
      at Ser40 but not at Ser19 or Ser31. Quinpirole was also able to reduce the
      increase in Ser40 phosphorylation caused by forskolin, an activator of adenylyl
      cyclase, without affecting the increase in Ser19 phosphorylation produced by the
      glutamate receptor agonist, N-methyl-D-aspartate (NMDA). In addition, the
      dopamine D(2) receptor agonist reduced both basal and forskolin-stimulated
      activity of TH, measured as 3,4-dihydroxyphenylalanine (DOPA) accumulation.
      Quinpirole decreased phosphorylation of Ser40 induced by okadaic acid, an
      inhibitor of protein phosphatase 1 and 2A and Ro-20-1724, a phosphodiesterase
      inhibitor. In contrast, quinpirole did not affect the increase in Ser40
      phosphorylation caused by the cAMP analogue, 8-Br-cAMP. These data indicate that,
      in the striatum, activation of dopamine D(2) receptors results in selective
      inhibition of TH phosphorylation at Ser40 via reduction of the activity of
      adenylyl cyclase. They also provide a molecular mechanism accounting for the
      ability of dopamine D(2) autoreceptors to inhibit dopamine synthesis and release
      from nigrostriatal nerve terminals.

PMID- 11207813
TI  - Gating of vagal inputs by sciatic afferents in nonspinally projecting neurons in
      the rat rostral ventrolateral medulla oblongata.
AB  - Integration and coordination of somato-visceral sensory information is crucial to
      achieve adaptive behavioural responses. We have recently shown that sensory vagal
      and somato-sensory (sciatic nerve) inputs converge in neurons of the rostral
      ventrolateral medulla oblongata, which was implicated in adjusting visceral
      activities to changing somatic performances. In the present study, the neuronal
      mechanism of interaction between sciatic and vagal sensory inputs was examined in
      the rostral ventrolateral medulla oblongata using in vivo intracellular recording
      and labelling. Conditioning stimulation of the contralateral sciatic nerve (2 V)
      led to a time-dependent inhibition of responses to vagal stimulation (100 microA)
      in each RVLM neuron that received convergent sciatic and vagal sensory inputs (n
      = 50). None of these neurons had direct spinal projections, and only 8% of them
      exhibited a visible response to stimulation of the aortic depressor nerve. A
      significant attenuation of the amplitude of vagal test responses was present for
      up to 800 ms of conditioning delay, although the duration of this sciatico-vagal
      inhibition was greatly dependent on the intensity of both stimuli. The
      electrophysiological data indicated that sciatico-vagal inhibition is mediated
      presynaptically, via activation of GABAB receptors. Morphological evidence of axo
      axonic interactions that may underlie sciatico-vagal inhibition was subsequently
      found in the electron microscope. It is suggested that during movements of the
      hindleg, activation of sciatic sensory fibres leads to re-patterning of neuronal
      activity in RVLM neurons via inhibition of visceral sensory inputs. Sciatico
      vagal inhibition is likely to affect the activity of those RVLM neurons that
      modulate higher neuronal activities via ascending projections.

PMID- 11207814
TI  - The supramammillary nucleus contributes to associative EPSP-spike potentiation in
      the rat dentate gyrus in vivo.
AB  - The supramammillary nucleus (SUM) of the hypothalamus sends neural projections to
      the hippocampus and is supposed to be involved in learning and memory. To test
      the possibility that SUM afferents modulate hippocampal functions, we
      investigated the effect of electrical stimulation of the SUM on the induction of
      long-term potentiation (LTP) at medial perforant path (PP)--granule cell synapses
      in the dentate gyrus (DG) of anaesthetized rats. High-frequency stimulation of
      the SUM (100 pulses at 100 Hz) alone did not change PP--DG field potentials.
      However, when the SUM stimulation was applied simultaneously with weak tetanic
      stimulation of the PP (20 pulses at 20 Hz) which alone did not induce any
      potentiation, it produced a long-lasting potentiation of the population spike,
      without an accompanying increase in the population excitatory postsynaptic
      potential (EPSP). The EPSP-spike (E-S) potentiation induced by pairing SUM and PP
      stimulation was abolished by lesions of the fimbria--fornix, a major pathway of
      SUM afferents. SUM stimulation applied 1 s before or after PP stimulation failed
      to produce E-S potentiation, and SUM stimulation augmented PP--DG field
      potentials during tetanic stimulation. Furthermore, the E-S potentiation was
      abolished by blocking GABAergic neurotransmission with picrotoxin. These results
      suggest that coactivation of SUM and PP inputs produces a long-lasting increase
      of granule cell excitability by modulating GABAergic inhibition. SUM afferents
      may contribute to associative memory processing by modulating hippocampal
      excitability.

PMID- 11207815
TI  - RGS9 proteins facilitate acute tolerance to mu-opioid effects.
AB  - This paper reports that regulators of G-protein signalling (RGS) proteins
      modulate the timing and amplitude of opioid signals by a push-pull mechanism.
      This is achieved without noticeable changes in the binding properties of opioids,
      e.g. beta-endorphin to mu-opioid receptors. The expression of RGS proteins was
      reduced by blocking their mRNA with antisense oligodeoxynucleotides (ODN). Knock
      down of RGS2 or RGS3 diminished morphine and beta-endorphin analgesia, whereas
      that of RGS9 or RGS12 enhanced this activity. In mice with impaired RGS9, but not
      impaired RGS2, the potency and, in particular, the duration of opioid
      antinociception increased. Further, the animals did not exhibit acute tolerance
      generated by a single and efficacious dose of morphine, nor did they develop
      tolerance after a daily i.c.v. injection of the opioid for 4 days. In a model of
      sustained morphine treatment, the impairment of RGS9 proteins facilitated
      increases in the response to the delivered opioid. This was only effective for 2-
      3 h after the subcutaneous implantation of an oily morphine pellet; later,
      tolerance developed. To reduce the impact of the chronic morphine acting on
      opioid receptors, other RGS proteins presumably substitute the GTPase-activating
      function of RGS9 on morphine-activated G-alpha-GTP subunits. The desensitization
      of mu-opioid receptors appears to be a cell membrane-limited process facilitated
      by RGS9's sequestering of agonist-segregated G alpha subunits.

PMID- 11207816
TI  - Influence of glucocorticoids on dopaminergic transmission in the rat dorsolateral
      striatum.
AB  - Glucocorticoid hormones exert strong influences on central neurotransmitter
      systems. In the present work, we examined the functional consequences of
      corticosterone suppression on the dopaminergic transmission in the dorsolateral
      striatum by studying the expression of Fos-like proteins and extracellular
      dopamine levels. Glucocorticoid hormones were suppressed by adrenalectomy, and
      the specificity of the effects assessed by restoring physiological plasmatic
      corticosterone concentrations. We show that, in the dorsolateral striatum,
      glucocorticoids modify postsynaptic dopaminergic transmission. Suppression of
      glucocorticoids decreased the induction of Fos proteins in response to a direct
      agonist of dopamine D(1) receptors (SKF 82958, 1.5 mg/kg, i.p.), but not the
      release of dopamine induced by morphine (2 mg/kg, s.c.) or the density of the
      limiting enzyme of dopamine synthesis, tyrosine hydroxylase. In contrast to the
      dopaminergic response to morphine, the response to cocaine (15 mg/kg, i.p.) was
      modified by the suppression of corticosterone. In this case, adrenalectomy
      increased cocaine-induced changes in extracellular dopamine but did not modify
      the expression of Fos-like proteins. This absence of changes in cocaine-induced
      Fos-like proteins might result from a compensatory mechanism between the increase
      in the dopaminergic response and the decrease in the functional activity of
      dopamine D(1) receptors. The increased dopaminergic response to cocaine also
      contrasts with the decreased response previously observed in the shell of the
      nucleus accumbens [Barrot et al. (2000) Eur. J. Neurosci., 12, 973-979]. The
      present data highlight the profound heterogeneous influence of glucocorticoids
      within dopaminergic projections.

PMID- 11207817
TI  - Novelty-evoked elevations of nucleus accumbens dopamine: dependence on impulse
      flow from the ventral subiculum and glutamatergic neurotransmission in the
      ventral tegmental area.
AB  - In vivo microdialysis in freely moving rats was used to monitor novelty-evoked
      elevations in extracellular dopamine in the nucleus accumbens septi (NAS) and to
      examine the role of the ventral subiculum of the hippocampus and glutamatergic
      transmission in the ventral tegmental area (VTA) on these elevations. Exposure to
      novel stimuli evoked investigatory activity and increased nucleus accumbens
      dopamine. Unilateral injections of the sodium channel blocker tetrodotoxin (0.16
      ng/0.5 microL) into the ventral subiculum ipsilateral to the dialysed NAS
      abolished novelty-evoked elevations in dopamine. Injections of tetrodotoxin into
      the contralateral VS did not prevent novelty-evoked elevations in nucleus
      accumbens dopamine. Unilateral perfusion (via microdialysis) of the ionotropic
      glutamate receptor antagonists kynurenic acid (1 mM) into the ipsilateral but not
      the contralateral VTA blocked novelty-evoked elevations in nucleus accumbens
      dopamine. Neither unilateral injections of tetrodotoxin nor unilateral perfusion
      of kynurenic acid disrupted investigatory behaviour. These data indicate that
      phasic elevations in nucleus accumbens dopamine evoked by exposure to
      unconditioned novel stimuli are dependent on impulse flow from the hippocampus
      and glutamatergic transmission in the VTA.

PMID- 11207818
TI  - Immunocytochemical identification and analysis of the diffuse bipolar cell type
      DB6 in macaque monkey retina.
AB  - The distribution and morphology of CD15-immunoreactive bipolar cells were studied
      in the retina of macaque monkey. Labelled cells have a large dendritic tree
      contacting several cones and a narrowly stratified axon terminal that ends deep
      in the inner plexiform layer, close to the ganglion cell layer. The morphology of
      the labelled cells corresponds to that of the diffuse bipolar cell type named DB6
      by Boycott & Wassle (1991; Eur. J. Neurosci., 3,1069). We conclude that CD15 is a
      marker for DB6 bipolar cells, enabling the quantitative analysis of the
      distribution and connectivity of this diffuse bipolar cell type.

PMID- 11207819
TI  - Bcl-2 overexpression per se does not promote regeneration of neonatal crushed
      optic fibers.
AB  - We have explored whether overexpression of the bcl-2 gene 'per se' can promote
      regeneration of retinal ganglion cells (RGCs) after optic nerve axotomy in
      developing transgenic mice. We have used newborn mice (postnatal day 5) because
      at this age the central nervous system environment is more permissive for
      regeneration than in adults, thus, maximizing the probability to detect a
      regeneration-promoting role of bcl-2. Thirty days postsurgery we found that in
      mice overexpressing bcl-2, a high proportion of retinal ganglion cells survived
      and also that some fibers in the proximal stump of the optic nerve were
      preserved. However, the optic nerve of transgenic mice does not show signs of
      regeneration. On the contrary, in the presence of Schwann cell transplants, there
      are signs of fiber regrowth. Indeed, many axonal terminals cross the crush site
      and reach the chiasm in both wild type and transgenic mice nerves. These results
      suggest that bcl-2 overexpression is not sufficient 'per se' to increase the
      regenerative potentiality of axotomized RGCs.

PMID- 11207821
TI  - Precursor lesions of ovarian epithelial malignancy.
AB  - Most ovarian carcinomas arise from the mesothelial surface lining of the ovaries,
      or from invaginations of this lining into the superficial ovarian cortex to form
      cortical inclusion cysts. The native ovarian surface mesothelium is of an
      'uncommitted' phenotype, and has potential to modulate to epithelial or
      mesenchymal phenotypes in response to signals such as those associated with
      ovulation. The exposure of the mesothelial lining of an inclusion cyst to the
      ovarian stromal microenvironment may be responsible for the phenotypic change to
      Mullerian epithelium so commonly seen in these cysts. Mullerian metaplasia is
      usually to a serous phenotype, and it is possible that undefined molecular events
      occurring in an inclusion cyst that has undergone Mullerian metaplasia may
      initiate neoplastic change in these cysts. This may be the developmental pathway
      of most invasive serous carcinomas. Occasional rare cases of ovarian
      intraepithelial neoplasia, manifested by epithelial atypia in an inclusion cyst
      or on the surface epithelium without invasive carcinoma, are identified
      histologically. Serous borderline tumours represent a separate category and in
      most cases probably do not progress to frank carcinoma. Mucinous carcinomas may
      in some cases have arisen from pre-existing benign and borderline mucinous
      tumours. Endometriosis of the ovary is associated with genetic abnormalities and
      is frequently found in association with clear cell and endometrioid carcinomas,
      suggesting that in many cases these latter two types of carcinoma may have arisen
      directly from endometriotic deposits. Ovaries removed prophylactically from women
      with a family history of ovarian carcinoma or with a mutation in one of the genes
      predisposing to ovarian carcinoma should be processed in their entirety, and
      examined closely not just for obviously neoplastic lesions, but also for more
      subtle morphological abnormalities of the surface epithelium or the epithelium
      lining cortical inclusion cysts.

PMID- 11207820
TI  - Vasoactive intestinal polypeptide (VIP) phase-shifts the rat suprachiasmatic
      nucleus clock in vitro.
AB  - In mammals, the principal circadian pacemaker is housed in the hypothalamic
      suprachiasmatic nuclei (SCN). The SCN exhibit high levels of vasoactive
      intestinal polypeptide (VIP) immunoreactivity and two of the three VIP receptors,
      VPAC(2) and PAC(1), are found in the rat SCN. However, the role of VIP in the SCN
      remains unclear. In this study, we examined the phase-resetting actions of VIP
      and selective VIP receptor agonists on the electrical activity rhythm of rat SCN
      neurons in vitro. Application of VIP during the subjective day did not shift the
      peak in the firing rate rhythm. However, VIP treatment during the early or late
      subjective night evoked a small phase delay or a large phase advance,
      respectively. The phase-advancing effect of VIP was reproduced by the novel
      VPAC(2) receptor agonist RO 25-1553, but not by pituitary adenylate cyclase
      activating peptide (a potent PAC(1) receptor agonist), or by [K15,R16,L27]VIP(1
      7)/GRF(8-27), a novel, selective VPAC(1) receptor agonist. These data show that
      VIP phase-dependently phase-resets the rodent SCN pacemaker in vitro, presumably
      via the VPAC(2) receptor. As the pattern of phase-shifting evoked by VIP and RO
      25-1553 resembles the phase-resetting actions of light on rodent behavioural
      rhythms, these data support a role for VIP and the VPAC(2) receptor in photic
      entrainment of the rodent circadian pacemaker.

PMID- 11207822
TI  - Overexpression of HER2/neu in solid tumours: an immunohistochemical survey.
AB  - AIMS: Using a standardized immunohistochemical assay we have evaluated 575
      primary neoplasms of different histogenesis to determine the incidence of HER2
      overexpression in some of the most common categories of human solid neoplasms.
      This study addresses the variable incidence of HER2 overexpression previously
      published for some tumour types. METHODS AND RESULTS: The immunohistochemical
      staining was performed on paraffin sections of surgical specimens and a well
      defined scoring system based upon numbers of HER2 receptors expressed on the cell
      surface was applied. Overexpression of HER2 as defined as a HER2 score of equal
      or greater than 2 was seen in breast cancer (22%), pulmonary adenocarcinoma
      (28%), colorectal adenocarcinomas (17%), pulmonary squamous (11%) and gastric
      adenocarcinomas (11%). As expected, the proportion of cases with a HER2 score of
      3 was highest in breast cancer. Contrary to published results prostate and
      pancreas adenocarcinomas showed a very low incidence of HER2 overexpression.
      CONCLUSIONS: Overexpression of HER2 is detected immunohistochemically in a
      proportion of epithelial neoplasms of diverse histogenesis in addition to ductal
      breast cancer. The standardized format of the assay will allow comparative
      analyses of studies performed at different institutions.

PMID- 11207823
TI  - Inflammatory pseudotumour (inflammatory myofibroblastic tumour) of the pancreas:
      a report of six cases associated with obliterative phlebitis.
AB  - AIMS: To describe in detail an uncommon pancreatic condition, which generally
      presents with cholestasis and a mass lesion suspicious of malignancy, and which
      is characterized histologically by proliferation of fibrous tissue with
      associated moderate or marked inflammation, as well as obliterative phlebitis.
      METHODS AND RESULTS: Out of a consecutive series of 23 pancreaticoduodenectomy
      specimens which on histological evaluation were found to contain no malignant
      tumour, six cases characterized by the features mentioned above were identified
      and investigated further. Poor circumscription, firm consistence, histology of
      dense sclerosis with scattered round cell infiltrates and associated obliterative
      phlebitis and often perineural accentuation of inflammation were the
      distinguishing features. On the basis of available histological evidence, the
      term inflammatory pseudotumour perhaps remains the term best suited to designate
      this entity, since it sums up its two most distinctive features. However, the
      possibility that this lesion is in fact a neoplastic process with reactive
      inflammation (inflammatory myofibroblastic tumour) cannot be ruled out on the
      basis of the histology, and remains a serious consideration in view of the proven
      neoplastic nature of lesions with very similar histology arising elsewhere in the
      body. Importantly, none of the pancreatic lesions reported here recurred or
      progressed (five informative cases, median follow-up time 70 months).
      CONCLUSIONS: Inflammatory pseudotumour (inflammatory myofibroblastic tumour) of
      the pancreas may closely mimic pancreatic adenocarcinoma clinically and
      radiologically.

PMID- 11207824
TI  - Interrelationship between Epstein-Barr virus infection in gastric carcinomas and
      the expression of apoptosis-associated proteins.
AB  - AIMS: Epstein-Barr virus (EBV) and its associated proteins may be protective
      against the occurrence of apoptosis that would normally inhibit cancer
      development and progression. Alternatively, the viral infection may cause altered
      or mutated expression of oncogenes or tumour suppressor genes that are necessary
      for tumour development, an action that may also involve apoptosis. In this study,
      a relationship was sought between occurrence of EBV infection, expression of
      apoptosis-associated proteins (tumour suppressor gene p53 and oncogenes c-myc and
      bcl-2) and levels of cell death (apoptosis or necrosis) in 119 cases of gastric
      carcinoma. METHODS AND RESULTS: The EBV status of the gastric carcinomas (using
      the EBV-encoded small RNA I (EBER-1) and in-situ hybridization), stage and grade
      of tumour and sex of patients were compared for bcl-2, p53 and c-myc expression
      patterns. EBER-1 was detected in approximately 20% of cases studied. There was no
      significant correlation between levels of cell death in the tumour tissue and EBV
      status. In the protein analyses, development and progression of gastric
      carcinoma, with or without EBV infection, was independent of bcl-2 expression.
      However, in gastric cancers with EBV infection, p53 overexpression was inhibited
      and c-myc expression was increased in early stage cancers, in comparison with
      decreased c-myc expression in late stage cancers. CONCLUSIONS: The p53 and c-myc
      expression patterns indicate that EBV-infected gastric carcinomas are less likely
      to have a natural regression via apoptosis at an early stage and explain, in
      part, the resistance to treatment of late stage of gastric cancers.

PMID- 11207826
TI  - S100 expression in cutaneous scars: a potential diagnostic pitfall in the
      diagnosis of desmoplastic melanoma.
AB  - AIMS: The histological distinction of desmoplastic melanoma from cutaneous scar
      tissue, particularly in the context of re-excision specimens or possible
      recurrence, may be very difficult. Immunostaining for S100 protein is often used
      to discriminate although there are little data on S100 expression in scar tissue.
      The aim of this study was to assess whether S100-positive cells are present in
      dermal scars and, if so, their extent, distribution and nature. METHODS AND
      RESULTS: Twenty-two re-excision specimens of previously biopsied nonmelanocytic
      skin lesions were reviewed. Formalin-fixed paraffin-embedded sections containing
      dermal scars were stained by a standard ABC immunoperoxidase technique for S100
      protein, CD1a and neurofilaments. The distribution and morphology of positive
      cells within the dermal scar tissue were documented. Cells expressing S100
      protein were identified within the scars of 21 of the 22 cases. The number of
      S100-positive cells varied between cases but in four specimens was substantial.
      They displayed a variety of morphological appearances but the majority were
      spindle-shaped. A few showed mild cytological atypia. It is suggested that the
      majority represent Schwann cells with a minority of Langerhans cells and cells of
      uncertain lineage. CONCLUSION: S100-positive cells, including spindle cells
      showing mild atypia, are found in cutaneous scars. S100 staining of re-excision
      specimens or putative recurrences of desmoplastic melanoma should be interpreted
      with caution.

PMID- 11207825
TI  - Evidence that neurones accumulating amyloid can undergo lysis to form amyloid
      plaques in Alzheimer's disease.
AB  - AIMS: Amyloid has recently been shown to accumulate intracellularly in the brains
      of patients with Alzheimer's disease (AD), yet amyloid plaques are generally
      thought to arise from gradual extracellular amyloid deposition. We have
      investigated the possibility of a link between these two apparently conflicting
      observations. METHODS AND RESULTS: Immunohistochemistry and digital image
      analysis was used to examine the detailed localization of beta-amyloid(42) (A
      beta 42), a major component of amyloid plaques, in the entorhinal cortex and
      hippocampus of AD brains. A beta 42 first selectively accumulates in the
      perikaryon of pyramidal cells as discrete, granules that appear to be cathepsin D
      positive, suggesting that they may represent lysosomes or lysosome-derived
      structures. AD brain regions abundantly populated with pyramidal neurones
      exhibiting excessive A beta 42 accumulations also contained evidence of neuronal
      lysis. Lysis of these A beta 42-burdened neurones apparently resulted in a local,
      radial dispersion of their cytoplasmic contents, including A beta 42 and
      lysosomal enzymes, into the surrounding extracellular space. A nuclear remnant
      was found at the dense core of many amyloid plaques, strengthening the idea that
      each amyloid plaque represents the end product of a single neuronal cell lysis.
      The inverse relationship between the amyloid plaque density and pyramidal cell
      density in the AD brain regions also supports this possibility, as does the close
      correlation between plaque size and the size of local pyramidal cells.
      CONCLUSIONS: Our findings suggest that excessive intracellular accumulation of A
      beta 42-positive material in pyramidal cells can result in cell lysis, and that
      cell lysis is an important source of amyloid plaques and neuronal loss in AD
      brains.

PMID- 11207827
TI  - Calcifying/ossifying synovial sarcoma shows t(X;18) with SSX2 involvement and
      mitochondrial calcifications.
AB  - AIMS: Synovial sarcoma with extensive calcification and ossification is a rare
      variant, the ultrastructural, cytogenetic and molecular analysis of which has not
      been reported previously. METHODS AND RESULTS: A large mass in the shoulder of a
      20-year-old male patient led to a deformity of the chest wall, thus supporting
      the hypothesis that this is a slowly growing variant of synovial sarcoma.
      Nevertheless, the patient developed metastatic lung disease 7 months after
      resection. On histology, the monophasic spindle cell proliferation was in several
      areas obscured by the massive calcification and ossification.
      Immunohistochemistry showed keratin, epithelial membrane antigen, vimentin and
      CD99 expression. The cytogenetic analysis revealed a single t(X;18)(p11.2;
      q11.2), typical for synovial sarcoma. Additional fluorescence in-situ
      hybridization revealed SSX2 involvement. At the ultrastructural level, prominent
      needle-shaped intramitochondrial crystals were present, both in the cytoplasm and
      in the extracellular matrix. CONCLUSION: The presence of the t(X;18) with SSX2
      involvement definitively characterizes this tumour as a variant of synovial
      sarcoma. In addition, the needle-like mitochondrial calcifications give a
      possible clue to the pathogenesis of the extensive metaplastic ossification and
      calcification.

PMID- 11207828
TI  - Lymphoproliferative disorders in children with primary immunodeficiencies:
      immunological status may be more predictive of the outcome than other criteria.
AB  - AIMS: Lymphoproliferative disorders (LPDs) are a severe complication in primary
      immunodeficiency and post-transplant patients. In primary immunodeficiency
      patients, LPDs are not well-known and, thus, we tried to evaluate their
      distinctive features and to determine prognostic factors predictive of clinical
      outcome by comparison with LPDs in post-transplant children. METHODS AND RESULTS:
      Clinical records and histopathology of 18 LPDs occurring in primary
      immunodeficieny children were compared with those of 10 LPDs in post-transplant
      children, together with results of in-situ hybridization for the detection of
      Epstein-Barr virus (EBV)-RNA and molecular biological techniques. LPDs were
      frequently extranodal, EBV-associated, and were more commonly pleomorphic in
      primary immunodeficiency than in post-transplant patients. A low T-cell count and
      abnormal T-cell function indicated bad prognosis in both groups. Polymorphic LPDs
      (PLPDs) were most frequent (n = 19), whereas lymphomas were rare (n = 7), and
      pseudo-tumoral lymphoid hyperplasias (n = 2) were observed only in primary
      immunodeficiency. Comparative p53/bcl-2 staining revealed a p53 overexpression in
      lymphomas compared with PLPDs; CD20/CD79a showed a similar staining in lymphomas,
      whereas PLPD expressed mainly CD20. TCR and IgH rearrangements did not help in
      distinguishing PLPDs from lymphomas, but detection of IgH clonality by Southern
      blot indicated poor prognosis, whereas oligoclonality by Southern blot regardless
      of PCR clonality and especially a polyclonal profile by Southern blot and PCR
      indicated a relatively good prognosis. CONCLUSIONS: This study documents the
      pleomorphism of LPDs in primary immunodeficiency compared to post-transplant
      children, even if some LPDs are similar in both groups (PLPDs). No criteria are
      useful enough to ascertain the diagnosis of malignancy in this series. Some
      molecular biological criteria help to predict the clinical outcome which,
      nevertheless, seems to depend more on the degree of immunosuppression and on T
      lymphocyte presence and function.

PMID- 11207829
TI  - Increased proliferation activities of vascular endothelial cells and tumour cells
      in residual hepatocellular carcinoma following transcatheter arterial
      embolization.
AB  - AIMS: Transcatheter arterial embolization induces extensive ischaemic necrosis or
      hypoxia via the obstruction of the hepatic artery in hepatocellular carcinoma
      (HCC). Ischaemia is strongly correlated with an increased expression of
      angiogenic factor and stimulates an increase in angiogenesis, including
      endothelial cell proliferation. The aim of this study was to evaluate whether
      ischaemic necrosis induced by transcatheter arterial embolization could increase
      the proliferative activities of intratumoral endothelial cells or tumour cells in
      the residual HCC. METHODS AND RESULTS: Using a double immunohistochemical
      technique (Ki67 antibody to determine the proliferative activity and CD34
      antibody to highlight the intratumoral endothelial cells), we performed
      immunohistochemical staining for 24 HCCs treated by transcatheter arterial
      embolization. Seven HCCs without any preoperative transcatheter arterial
      embolization and nine cirrhosis cases were also studied as the control cases. The
      residual tumour was then divided into five areas at 0.5 mm intervals, according
      to the distance from the necrotic margin induced by embolization. The Ki67
      labelling indices of the intratumoral endothelial cells and tumour cells were
      counted in each area. The correlation between the indices and the corresponding
      distance from the ischaemic necrosis was analysed. The Ki67 labelling index of
      intratumoral vascular endothelial cells in the area less than 0.5 mm from the
      necrotic margin (area 1) was 10.60 +/- 3.64% (mean +/- SD), which was twofold
      greater than those of the other areas more than 0.5 mm from the margin (areas 2-
      5) and those of the control HCCs without preoperative transcatheter arterial
      embolization. In addition, the proliferation labelling index of the tumour cells
      was 35.77 +/- 11.45% (mean +/- SD) in area 1. This was higher than those of areas
      2--5 and control HCCs without preoperative transcatheter arterial embolization.
      There was a positive correlation between the proliferation of both endothelial
      and tumour cells and ischaemic necrosis (P < 0.05). CONCLUSIONS: Our study
      suggests that the proliferative activity of intratumoral endothelial cells and
      tumour cells is increased by ischaemic necrosis induced by transcatheter arterial
      embolization, and its effect is maximal in the area adjacent to the necrosis
      (less than 0.5 mm from the necrotic margin).

PMID- 11207830
TI  - Limitations of the histopathological diagnosis and prognostic assessment of
      hepatocellular carcinoma.

PMID- 11207832
TI  - Endometrial cancer, vasculitis of the genital tract and occult temporal
      arteritis.

PMID- 11207835
TI  - JAGS Enters the New Millennium: Direction, Decision, Determination, Dedication,
      and Distinction.

PMID- 11207834
TI  - Highlights of Papers in Clinical Investigation Section.

PMID- 11207836
TI  - The effect of aging on circulating levels of proinflammatory cytokines during
      septic shock. Norasept II Study Investigators.
AB  - BACKGROUND: As the proportion of the population that is older continues to rise,
      infection in older people has become an important healthcare problem. Although
      aging is associated with multiple abnormalities in immune function, the effect of
      aging on the production of proinflammatory cytokines has not been well studied
      under conditions of clinical stress. OBJECTIVES: The aim of this study was to
      examine the effect of aging on circulating levels of the proinflammatory
      cytokines in a large cohort of septic shock patients. We hypothesized that aging
      would be associated with a diminished proinflammatory cytokine response to
      sepsis. DESIGN: Patients with septic shock who were enrolled in the placebo limb
      of the North American Sepsis Trial (NORASEPT II) study were analyzed. SETTING:
      The intensive care units of 105 hospitals in the United States and Canada.
      PARTICIPANTS: Nine hundred and thirty patients presenting to hospital within 12
      hours of the onset of septic shock. MEASUREMENTS: Interleukin-6 (IL-6), tumor
      necrosis factor-alpha (TNF-alpha), soluble tumor necrosis factor-receptor-55
      (sTNF-R55), and soluble tumor necrosis factor-receptor-75 (sTNF-R75)
      concentrations were measured at enrollment. The study population was broken down
      into five age groups as follows: less than 50 years (group one), 50 to 64 years
      (group two), 65 to 74 years (group three), 75 to 84 years (group four), and 85 or
      older (group five). Clinical, demographic, and cytokine data were extracted to
      describe each age group. RESULTS: Data were available for 930 patients. The
      patients' mean age (+/- SD) was 59 +/- 17 years (range, 18 to 102). There were
      280 patients in group one, 242 in group two, 210 in group three, 150 in group
      four, and 48 in group five. The primary diagnoses; clinical characteristics; and
      IL-6, sTNF-R55, and sTNF-R75 levels were similar among the five age groups. The
      TNF-alpha levels were significantly higher, however, in the oldest group of
      patients (group five). The 28-day survival was 49% in patients over the age of 75
      and 58% in those under 75 years (P = .03). There was no gender difference in
      survival or cytokine levels. CONCLUSIONS: Contrary to our expectations, we found
      that aging was not associated with a decline in the circulating levels of
      proinflammatory cytokines.

PMID- 11207837
TI  - Exercise training for rehabilitation and secondary prevention of falls in
      geriatric patients with a history of injurious falls.
AB  - OBJECTIVE: To determine the safety and efficacy of an exercise protocol designed
      to improve strength, mobility, and balance and to reduce subsequent falls in
      geriatric patients with a history of injurious falls. DESIGN: A randomized
      controlled 3-month intervention trial, with an additional 3-month follow-up.
      SETTING: Out-patient geriatric rehabilitation unit. PARTICIPANTS: Fifty-seven
      female geriatric patients (mean age 82 +/- 4.8 years; range 75-90) admitted to
      acute care or inpatient rehabilitation with a history of recurrent or injurious
      falls including patients with acute fall-related fracture. INTERVENTION:
      Ambulatory training of strength, functional performance, and balance 3 times per
      week for 3 months. Patients of the control group attended a placebo group 3 times
      a week for 3 months. Both groups received an identical physiotherapeutic
      treatment 2 times a week, in which strengthening and balance training were
      excluded. MEASUREMENTS: Strength, functional ability, motor function,
      psychological parameters, and fall rates were assessed by standardized protocols
      at the beginning (T1) and the end (T2) of intervention. Patients were followed up
      for 3 months after the intervention (T3). RESULTS: No training-related medical
      problems occurred in the study group. Forty-five patients (79%) completed all
      assessments after the intervention and follow-up period. Adherence was excellent
      in both groups (intervention 85.4 +/- 27.8% vs control 84.2 +/- 29.3%). The
      patients in the intervention group increased strength, functional motor
      performance, and balance significantly. Fall-related behavioral and emotional
      restrictions were reduced significantly. Improvements persisted during the 3
      month follow-up with only moderate losses. For patients of the control group, no
      change in strength, functional performance, or emotional status could be
      documented during intervention and follow-up. Fall incidence was reduced
      nonsignificantly by 25% in the intervention group compared with the control group
      (RR:0.753 CI:0.455-1.245). CONCLUSIONS: Progressive resistance training and
      progressive functional training are safe and effective methods of increasing
      strength and functional performance and reducing fall-related behavioral and
      emotional restrictions during ambulant rehabilitation in frail, high-risk
      geriatric patients with a history of injurious falls.

PMID- 11207838
TI  - Coimpairments as predictors of severe walking disability in older women.
AB  - OBJECTIVE: Severe disabilities are common among older people who have impairments
      in a range of physiologic systems. It is not known, however, whether the presence
      of multiple impairments, or coimpairments, is associated with increased risk of
      developing new disability. The aim of this study was to determine the combined
      effects of two impairments, decreased knee-extension strength and poor standing
      balance, on the risk of developing severe walking disability among older,
      moderately-to-severely disabled women who did not have severe walking disability
      at baseline. DESIGN: The Women's Health and Aging Study is a 3-year prospective
      study with 6 semi-annual follow-up data-collection rounds following the baseline.
      SETTING: At baseline, knee-extension strength and standing balance tests took
      place in the participants' homes. PARTICIPANTS: 758 women who were not severely
      walking disabled at baseline. MEASUREMENTS: Severe walking disability was defined
      as customary walking speed of < 0.4 meters/second and inability to walk one
      quarter of a mile, or being unable to walk. RESULTS: Over the course of the
      study, 173 women became severely disabled in walking. The cumulative incidence of
      severe walking disability from the first to the sixth follow-up was: 7.8%, 12.0%,
      15.1% 19.5% 21.2%, and 22.8%. In Cox proportional hazards models, both strength
      and balance were significant predictors of new walking disability. In the best
      balance category, the rates of developing severe walking disability expressed per
      100 person years were 3.1, 6.1, and 5.3 in the highest- to lowest-strength
      tertiles. In the middle balance category, the rates were 9.6, 13.2, and 14.7, and
      in the poorest balance category 21.6, 12.7, and 37.1, correspondingly. The
      relative risk (RR) of onset of severe walking disability adjusted for age,
      height, weight, and race was more than five times greater in the group with
      poorest balance and strength (RR 5.12, 95% confidence limit [95% CI] 2.68-9.80)
      compared with the group with best balance and strength (the reference group).
      Among those who had poorest balance and best strength, the RR of severe walking
      disability was 3.08 (95% CI 1.33-7.14). Among those with best balance and poorest
      strength, the RR was 0.97 (95% CI 0.49-1.93), as compared with the reference
      group. CONCLUSION: The presence of coimpairments is a powerful predictor of new,
      severe walking disability, an underlying cause of dependence in older people.
      Substantial reduction in the risk of walking disability could be achieved even if
      interventions were successful in correcting only one of the impairments because a
      deficit in only one physiologic system may be compensated for by good capacity in
      another system.

PMID- 11207839
TI  - Simultaneous validation of ten physical activity questionnaires in older men: a
      doubly labeled water study.
AB  - OBJECTIVE: The purpose of this study was to simultaneously validate 10 physical
      activity (PA) questionnaires in a homogenous population of healthy elderly men
      against the reference method: doubly labeled water (DLW). DESIGN: Cross-sectional
      study. SETTING: Community-based sample from Lyon, France. PARTICIPANTS: Nineteen
      healthy old men (age 73.4 +/- 4.1 years), recruited from various associations for
      elderly people in Lyon, agreed to participate in the study. MEASUREMENTS: The
      questionnaire-derived measures (scores) were compared with two validation
      measures: DLW and maximal oxygen uptake (VO2max). With the DLW method three
      parameters were calculated: (1) total energy expenditure (TEE), (2) physical
      activity level (PAL), i.e., the ratio of TEE to resting metabolic rate, (3)
      energy expenditure of PA. RESULTS: Relative validity. Correlation between the
      questionnaires and TEE ranged from 0.11 for the Yale Physical Activity Survey
      (YPAS) total index to 0.63 for the Stanford usual activity questionnaire. This
      questionnaire also gave the best correlation coefficients with PAL (0.75), and
      with VO2max (0.62). Significant results with TEE measured by the DLW method were
      also obtained for college alumni sports score, Seven Day Recall moderate
      activity, and Questionnaire d'Activite Physique Saint-Etienne sports activity (r
      = 0.54, r = 0.52, and r = 0.54, respectively). Absolute validity. No difference
      was found between PA measured by the Seven Day Recall or by the YPAS and DLW, on
      a group basis. The limits of agreement were wide for all the questionnaires.
      CONCLUSIONS: Only a few questionnaires demonstrated a reasonable degree of
      reliability and could be used to rank healthy older men according to PA.
      Correlation coefficients were best when the Stanford Usual Activity Questionnaire
      was compared with all the validation measures. The two questionnaires reporting
      recent PA, the Seven Day Recall, and YPAS accurately assessed energy expenditure
      for the group. The individual variability was high for all the questionnaires,
      suggesting that their use as a proxy measure of individual energy expenditure may
      be limited.

PMID- 11207840
TI  - Patterns of self-rated health in older adults before and after sentinel health
      events.
AB  - OBJECTIVES: To describe and compare patterns of change in self-rated health for
      older adults before death and before and after stroke, myocardial infarction,
      congestive heart failure, cardiac procedure, hospital admission for cancer, and
      hip fracture. DESIGN: "Event cohort," measuring time in months before and after
      the event. SETTING: Four U.S. communities. PARTICIPANTS: 5888 participants in the
      Cardiovascular Health Study (CHS), sampled from Medicare rolls and followed up to
      8 years. Mean age at baseline was 73. MEASUREMENTS: Self-rated health, including
      a category for death, assessed at 6-month intervals, and ascertainment of events.
      METHODS: We examined the percentage that was healthy each month in the 5 years
      before death and in the 2 years before and after the other events, and compared
      the patterns to a "no event" group and to one another, using graphs and linear
      regression. RESULTS: For people who died, health status declined slowly until
      about 9 months before death, when it dropped steeply. Comparing persons equally
      far from death, health was unrelated to age, but men and whites were healthier
      than women and blacks. Health for other events declined before the event, dropped
      steeply at the event, showed some recovery, and then declined further after the
      event. About 65% to 80% of the subjects were healthy 2 years before their event,
      but only 35% to 65% were healthy two years afterwards. Patterns were similar
      although less extreme for the "no event" group. CONCLUSION: Visualizing
      trajectories of health helps us understand how serious health events changes
      health. Conclusions about change must be drawn with care because of a variety of
      possible biases. We have described the trajectories in detail. Work is now needed
      to explain, predict, and possibly prevent such changes in health.

PMID- 11207841
TI  - Quantifying the problem of abuse and neglect in adults--analysis of a statewide
      database.
AB  - BACKGROUND: Mistreatment of adults, including abuse, neglect, and exploitation,
      affects more than 1.8 million older Americans. Presently, there is a lack of
      precise estimates of the magnitude of the problem and the variability in risk for
      different types of mistreatment depending on such factors as age and gender.
      OBJECTIVES: To describe the universe of case reports received during one year in
      a centralized computer database maintained by the Texas Department of Protective
      and Regulatory Services--Adult Protective Services Division (TDPRS-APS). DESIGN:
      Descriptive. SETTING: Texas. PARTICIPANTS: Mistreated or neglected older people.
      MEASUREMENTS: The distribution of abuse types reported and population prevalence
      estimates of each abuse type by age and sex. RESULTS: There were over 62,000
      allegations of adult mistreatment and neglect filed in Texas in 1997. Neglect
      accounted for 80% of the allegations. The incidence of being reported to the
      TDPRS-APS increased sharply after age 65. The prevalence was 1,310
      individuals/100,000 > or = 65 years of age for all abuse types. CONCLUSIONS: The
      TDPRS database is an excellent tool for characterizing and tracking cases of
      reported elder mistreatment. Achieving a clearer understanding of this ever
      increasing public health problem can aid in the development of better
      interventions and prevention strategies.

PMID- 11207842
TI  - Weight outcomes among antidepressant users in nursing facilities.
AB  - OBJECTIVES: Depression is a common and treatable condition among nursing facility
      residents, with low body weight being a frequent concomitant concern. A common
      prescribing dictum is that older tricyclic antidepressants (TCAs) enhance
      appetite and may facilitate weight gain, while newer selective serotonin reuptake
      inhibitors (SSRIs) cause anorexia and resultant weight loss in older adults.
      Evidence is lacking on whether the small weight changes noted during short-term
      antidepressant efficacy trials translate into larger weight changes during
      prolonged treatment periods. Our main objective was to compare weight outcomes at
      6 months among users of three different antidepressant groups with a control
      group of non-antidepressant users. A secondary objective was to determine whether
      antidepressant selection was associated with weight pattern before drug
      initiation, to capture possible prescribing bias that would affect study
      inferences. DESIGN: Retrospective cohort design using the Minimum Data Set--Plus
      (MDS+). SETTING: Kansas nursing facilities. PARTICIPANTS: 1,157 antidepressant
      users age 65 and older who started an antidepressant after admission and remained
      on the same single agent for at least 6 months, and 4,852 persons meeting the
      same inclusion/exclusion criteria but not receiving an antidepressant.
      MEASUREMENTS: Antidepressant use was identified by drug code data and divided
      into four groups for analysis: TCAs, SSRIs, others, and none. (Amitriptyline and
      trazodone were excluded because of frequent use for nondepression purposes.)
      Rates of clinically important loss and gain (assigned for a 10% change from
      baseline weight or presence of the significant loss or gain markers on the 6
      month MDS assessment) and mean weight changes were compared across the four
      groups. Regression models were used to control for age, gender, baseline weight,
      confounding comorbidity, and functional variables related to eating. Previous
      weight patterns (loss, gain, neither, or unknown) before antidepressant
      initiation were compared across drug groups. RESULTS: Clinically important weight
      loss and gain occurred at 6 months in 14.8% and 14.4% of the sample,
      respectively. In unadjusted analyses, an increased likelihood of loss was found
      for users of SSRIs (Odds Ratio 1.57; CI 1.30, 1.90) and others (OR 1.89; CI 1.18,
      3.03), compared with none. In logistic models accounting for potential
      confounding factors, however, SSRI use showed a modest association with gain (OR
      1.31, CI 1.01, 1.70) and a trend toward a similarly modest association with loss
      (OR 1.28; CI 0.995, 1.64). TCA use was not associated with weight gain. When
      weight was examined as a continuous variable, all groups demonstrated a broad
      range of both loss and gain with mean-unadjusted weight changes < 3 pounds.
      Pairwise comparisons of adjusted differences in weight change at 6 months for
      SSRIs (mean loss of 1.6 pounds) and TCAs (mean gain of 0.4 pounds) were of
      marginal importance (P = .046) given the large sample size. No evidence was found
      for prescribing bias based on prior weight pattern. CONCLUSIONS: TCAs do not
      facilitate weight gain more than other antidepressant groups and SSRIs are not
      associated disproportionately with weight loss when other important clinical
      variables are accounted for. Small but statistically significant differences in
      mean weight changes between groups are largely a reflection of large sample size
      rather than clinically important differences. Clinicians may wish to reconsider
      the widely held notions that TCAs facilitate weight gain and that SSRIs place
      depressed older nursing facility residents at disproportionate risk for weight
      loss.

PMID- 11207843
TI  - The reform of the Israeli health care system: a comparison between older and
      younger consumers, one year and three years after its implementation.
AB  - OBJECTIVE: One of the main objectives of the National Health Insurance Law, which
      was implemented in Israel in January 1995, was to increase equity among different
      population groups and improve services for weaker populations, such as older
      people. It is not clear, however, whether the law's goals are being achieved.
      This study aimed to examine changes in the satisfaction and perceived quality of
      healthcare services among older people one year and three years after enactment
      of the law, and to compare the satisfaction and perceptions of older people with
      those of young adults. DESIGN: Two cross-sectional telephone surveys conducted by
      the JDC-Brookdale Institute. SETTING: Israel. PARTICIPANTS: Two random samples of
      the adult residents of Israel at the end of 1995 and at the end of 1997. Two
      hundred and eighteen older people (of 1,116 respondents) were included in the
      first survey, and 198 older people (of 1,205 respondents) were included in the
      second survey. Sixty-seven percent of older respondents in both surveys were 65
      to 74 years old and the remaining 33% were 75 years old and over. Forty-three
      percent were men. Sixty-four percent reported having had at least one chronic
      illness. There were no differences between the two samples, with the exception of
      a higher percentage of new immigrants in the second survey. MEASUREMENTS:
      Perception of changes in the level of services, satisfaction with services, and
      perceived quality of care (availability, accessibility, early detection
      procedures). RESULTS: Older people felt there had been an improvement in the
      level of sick fund (who operate as health maintenance organizations [HMOs] in the
      United States) services since implementation of the law. The proportion reporting
      improvement increased from 13% in 1995 to 28% in 1997. At the same time, the
      proportion of older people who sensed a decline in the level of services also
      increased, albeit at a much lower rate (4% in 1995 and 8% in 1997). The
      percentage of younger adults reporting an improvement in services and the
      percentage reporting a decline were greater than the percentages of older people,
      in both surveys. Regarding access to services, 69% waited up to 15 minutes to see
      their physician and 56% received an appointment to see a specialist within one
      week; this was an improvement. While a higher proportion of younger adults
      received an appointment within a shorter time span in 1995, the gap had
      diminished by 1997. Most of the older people felt that the office hours of their
      family physicians, specialists, administrative services, and laboratories were
      convenient. The proportion of elderly reporting so increased between 1995 and
      1997, and in both surveys was higher than among younger adults. CONCLUSION: The
      study's findings show that older people perceived an improvement in a number of
      areas during the first three years of the law's implementation. Their experience
      was similar to that of younger adults and was even better in some areas. It is
      necessary to continue monitoring the impact of the law on the need for health
      services of vulnerable groups such as the chronically ill and disabled older
      people.

PMID- 11207844
TI  - The medical interview: differences between adult and geriatric outpatients.
AB  - BACKGROUND: There is a perception that primary care physicians spend less time
      with older patients and little is known about physician and older patient
      satisfaction during clinical encounters. OBJECTIVE: To determine how primary care
      interviews of geriatric patients differ from those of other adults. DESIGN:
      Descriptive, analytic study. SETTING: Ten primary care sites in the United States
      and one in Canada, including public, voluntary, and private clinics and
      practices. PARTICIPANTS: Of the 544 patients, 45.6% were 65 and older and 17.8%
      were 75 or older. There were 127 participating physicians. MEASUREMENTS:
      Encounters were audiotaped and analyzed. Patients and physicians also completed
      exit questionnaires. RESULTS: Interview length increased significantly with age
      for men but not for women. Physician satisfaction did not change as patient age
      increased. Patient satisfaction, on the other hand decreased with age among women
      but not for men. Although physicians' and younger patients' perceptions of health
      were moderately associated, there was no association for men ages 75 and over.
      CONCLUSIONS: There is no evidence that physicians spend less time or are more
      uncomfortable with older patients. Both physician and male patient satisfaction
      remain stable with increasing patient age, despite greater disparity in patient
      and physician perceptions of health. Older female patients are less satisfied
      with physician visits than their younger counterparts, in the absence of changes
      in interview length or disparities between older female patients and their
      physicians in health perception.

PMID- 11207845
TI  - Validation of dizziness as a possible geriatric syndrome.
AB  - OBJECTIVE: While dizziness has traditionally been considered solely as a symptom
      of discrete diseases, recent findings from population-based studies of older
      persons suggest that it may often be a geriatric syndrome with multiple
      predisposing risk factors, representing impairments in diverse systems. To
      validate these findings, we identified predisposing risk factors for dizziness in
      a clinic-based population. DESIGN: Cross-sectional study. SETTING: Geriatric
      assessment center. PARTICIPANTS: 262 consecutive, eligible patients.
      MEASUREMENTS: Medical history and physical examination data were ascertained and
      characteristics of patients with and without a report of dizziness were compared.
      RESULTS: Seven factors were independently associated with a report of dizziness,
      namely depressive symptoms, cataracts, abnormal balance or gait, postural
      hypotension, diabetes, past myocardial infarction, and the use of three or more
      medications. Of patients with none of these risk factors, none reported
      dizziness. This proportion rose from 6% among patients with one factor, to 12%,
      26%, and 51% among patients with two, three, and four or more factors,
      respectively. CONCLUSIONS: The finding of similar factors associated with
      dizziness in previous community-based cohorts and the present clinic-based cohort
      supports the possibility of a multifactorial etiology of dizziness in many older
      persons. A multifactorial intervention targeting the factors identified in these
      studies may be effective at reducing the frequency or severity of dizziness in
      older patients.

PMID- 11207846
TI  - Offspring of centenarians have a favorable lipid profile.
AB  - OBJECTIVES: It is well recognized that a favorable lipid profile provides
      protection from atherosclerotic cardiovascular disease. Because the major cause
      of nontraumatic death in the western world is considered to be due to
      cardiovascular disease, centenarians (defined here as subjects over 95 years of
      age) are believed to possess "atherosclerotic protective" factors. However, it is
      impossible to study comparatively the lipid profile in centenarians because of
      lack of controls. Assuming that certain genes responsible for encoding the lipid
      phenotype may be inherited, we studied the lipid profile characteristics of
      offspring of centenarians and compared them with control groups. DESIGN:
      Prospective cohort study. SETTING: The study was part of the Longevity Genes
      Project at Albert Einstein College of Medicine. PARTICIPANTS: Ashkenazi Jewish
      centenarians (n = 27, 98.4 +/- 10.4 years) and their offspring (n = 33, 67.4 +/-
      1.4 years). The Ashkenazi Jewish offsprings' spouses, who were not related by
      blood to the centenarians or their offspring, were used as a control group (n =
      26, 68.4 +/- 1.2 years). MEASUREMENTS: The lipoprotein profile of the offspring
      was compared with the above control group and to a larger control group (age and
      gender matched) from the National Health and Nutrition Examination Survey
      (NHANES) III study (without the sample weights, n = 394, 60 to 69 years).
      RESULTS: Female offspring of centenarians had significantly higher plasma levels
      of high density lipoprotein-cholesterol (HDL-C) levels compared with controls
      (70.2 +/- 3.1 vs 59.0 +/- 4.1 mg/dl, P = .029). Male offspring of centenarians
      had higher plasma levels of HDL-C levels (56.2 +/- 7.1 vs 44.3 +/- 3.4 mg/dl, P =
      0.130) and significantly lower LDL-cholesterol (LDL-C) levels (95.0 +/- 6.0 vs
      127.0 +/- 8.0 mg/dl, P = .009) compared with controls. CONCLUSION: Offspring of
      centenarians have a favorable lipid profile compared with controls. These data
      support the notion that a certain phenotypic lipid profile may be transmitted in
      families and suggest that a favorable lipid profile may play a role in longevity.

PMID- 11207847
TI  - Internal low energy atrial cardioversion: efficacy and safety in older patients
      with chronic persistent atrial fibrillation.
AB  - BACKGROUND: Low-energy internal atrial cardioversion is a relatively new
      technique based on delivery of intracardiac shocks through transvenous catheters
      placed into the atria or the vessels. OBJECTIVE: The aim of this study was to
      assess in older and younger patients with chronic persistent atrial fibrillation
      (AF) the efficacy and safety of transvenous low-energy internal atrial
      cardioversion performed without routine administration of sedatives or
      anesthetics. DESIGN: A prospective longitudinal study. SETTING: A cardiological
      university hospital. PARTICIPANTS: 82 patients, divided into older (> or = 60
      years) (n = 49) and younger (n = 33) subjects. MEASUREMENTS: Atrial
      defibrillation threshold for internal cardioversion, measured as leading edge
      voltage (V) and delivered energy (J) of effective shocks, percentage of patients
      maintaining sinus rhythm at short-term (within 3 days) and at long-term follow
      up. METHODS: Patients with chronic persistent AF, treated with oral
      anticoagulants for at least 3 to 4 weeks, were admitted to hospital. Following a
      clinical work-up, patients were subjected to low-energy internal atrial
      cardioversion with shock delivery according to a step-up protocol. RESULTS:
      Internal cardioversion was effective in restoring sinus rhythm in 90% (44/49) of
      the older patients and in 94% (31/33) of the younger patients. Shocks were
      effective at a mean energy between 6 and 8 joules (range 0.9-23) and
      administration of sedatives or anesthetics was required during the procedure in
      22% (11/49) of older and in 48% (16/33) of younger patients (P = .026 at chi
      square). No major complications occurred during the procedure. Pharmacological
      prophylaxis of AF recurrences was instituted immediately following the procedure.
      During inhospital stay and during the follow-up (mean 12 +/- 9 months for older
      patients and 15 +/- 10 months for younger patients), AF recurred in 39% (17/44)
      of older patients and in 16% (5/31) of younger subjects (P = .064 at chi-square).
      CONCLUSIONS: Internal low energy cardioversion is a very effective procedure for
      restoring sinus rhythm in patients with AF; it can be performed in older
      patients, and administration of sedatives or anesthetics can be avoided or
      minimized in a substantial proportion of subjects. Recurrences of AF in the long
      term tend to be higher in older subjects and intensive prophylaxis with
      antiarrhythmic drugs is required.

PMID- 11207848
TI  - Interventions to prevent pneumonia among older adults.
AB  - Pneumonia is a common cause of death in older people. Antimicrobial drugs do not
      prevent pneumonia and, because of increasingly resistant organisms, their value
      in curing infection will become more limited. Establishing new strategies to
      prevent pneumonia through consideration of the mechanisms of this devastating
      illness is essential. The purpose of this review is to discuss how pneumonia
      develops in older people and to suggest preventive strategies that may reduce the
      incidence of pneumonia among older adults. Aspiration of oropharyngeal bacterial
      pathogens to the lower respiratory tract is one of the most important risk
      factors for pneumonia; impairments in swallowing and cough reflexes among older
      adults, e.g., related to cerebrovascular disease, increase the risk for the
      development of pneumonia. Thus, strategies to reduce the volumes and
      pathogenicity of aspirated material should be pursued. For example, since both
      swallowing and cough reflexes are mediated by endogenous substance P,
      pharmacologic therapy using angiotensin-converting enzyme inhibitors, which
      decrease substance P catabolism, may improve both reflexes and result in the
      lowering of the risk of pneumonia. Similarly, since the production of substance P
      is regulated by dopaminergic neurons in the cerebral basal ganglia, treatment
      with dopamine analogs or potentiating drugs such as amantadine (and, of course,
      prevention of cerebral vascular disease, which can result in basal ganglia
      strokes) should affect the incidence of pneumonia. The purpose of this review is
      to consider promising pharmacologic treatments as methods of preventing pneumonia
      in older adults and to review other proven strategies, e.g., infection control
      and cerebrovascular disease prevention that will lessen the incidence of
      pneumonia.

PMID- 11207849
TI  - The sin of omission: a systematic review of antithrombotic therapy to prevent
      stroke in atrial fibrillation.

PMID- 11207850
TI  - Spontaneously perforated pyometra presenting as diffuse peritonitis in older
      females at nursing homes.

PMID- 11207851
TI  - Regarding clinical practice guidelines on the use of warfarin.

PMID- 11207852
TI  - In reply.

PMID- 11207854
TI  - In reply:

PMID- 11207853
TI  - In re colon cancer screening.

PMID- 11207855
TI  - Regarding atrial fibrillation and cognitive function in older people.

PMID- 11207856
TI  - In reply to Cheng.

PMID- 11207857
TI  - In re atrial fibrillation and cognitive impairment.

PMID- 11207858
TI  - In re atrial fibrillation.

PMID- 11207859
TI  - In reply to Belmin et al:

PMID- 11207860
TI  - In reply to Park et al:

PMID- 11207861
TI  - An old nun with diabetes who should not have been moved from her nunnery.

PMID- 11207862
TI  - Highlights of Papers in Clinical Investigations Section.

PMID- 11207863
TI  - Cardiovascular disease risk factors among older black, Mexican-American, and
      white women and men: an analysis of NHANES III, 1988-1994. Third National Health
      and Nutrition Examination Survey.
AB  - CONTEXT: There are few studies of ethnic differences in cardiovascular disease
      (CVD) risk factors in older populations. OBJECTIVES: To examine the association
      of ethnicity on CVD risk factors, after accounting for socioeconomic status
      (SES), and to examine health behaviors among those with CVD risk factors. DESIGN:
      Third National Health and Nutrition Examination Survey, 1988-1994. SETTING:
      Eighty-nine mobile examination centers. PARTICIPANTS: 700 black, 628 Mexican
      American, and 2192 white women and men age 65 to 84 years. MEASUREMENTS:
      Ethnicity in relation to type II diabetes mellitus, physical inactivity,
      abdominal obesity, hypertension, cigarette smoking and non-high-density
      lipoprotein cholesterol (non-HDL-C). RESULTS: After accounting for age and SES,
      both black and Mexican-American women had significantly higher prevalences of
      type II diabetes than white women. In addition, black women were significantly
      more likely to have abdominal obesity and hypertension and to be physically
      inactive than white women. Black men had significantly higher prevalences of
      hypertension and physical inactivity than white men. However, black men had lower
      prevalences of abdominal obesity than white men, and black women had lower
      prevalences of high non-HDL-C than white women. Among those with CVD risk
      factors, health behaviors were in need of improvement, especially among Mexican
      American women whose primary language was Spanish. CONCLUSIONS: In this national
      sample of older women and men, black and Mexican American women and black men
      were at the greatest risk for CVD. These findings parallel the heightened risk of
      CVD among younger ethnic minority populations and argue for appropriate primary
      and secondary prevention programs, modified for the language, cultural, and
      medical needs of older ethnic minorities.

PMID- 11207864
TI  - Lipoprotein(a) serum levels and vascular diseases in an older Caucasian
      population cohort. Italian Longitudinal Study on Aging (ILSA).
AB  - OBJECTIVE: To investigate elevated lipoprotein(a) [Lp(a)] levels as a risk factor
      for stroke, myocardial infarction, angina, intermittent claudication, and
      combination of the above in a cohort of unselected older individuals. DESIGN:
      Population cohort from one of the eight centers participating in the Italian
      Longitudinal Study on Aging (ILSA). SETTING: General community. PARTICIPANTS: A
      subsample of 446 subjects (M/F: 231/ 215, mean age: 74.5 +/- 5.7 years) of the
      original, randomly selected, population cohort of 704 individuals, 65 to 84 years
      of age, free-living or institutionalized in the Impruneta Municipality, area of
      Florence, Italy. MEASUREMENTS: Conventional vascular risk factors and vascular
      diseases defined following a two-step procedure (screening phase and confirmation
      on positives) using standard and validated criteria. Lp(a) levels determined by
      an ELISA method. RESULTS: No association was observed between elevated Lp(a)
      levels alone and any of the examined vascular diseases (stroke, myocardial
      infarction, angina, and intermittent claudication). In contrast, examining the
      interactions between elevated Lp(a) and conventional vascular risk factors, when
      elevated Lp(a) was combined with a history of smoking, a marked increase in the
      risk of vascular diseases combined (odds ratio [OR]: 4.12; 95% confidence
      interval [CI]: 1.27-13.40) was observed, much higher than that expected based on
      the additive effect of smoking and elevated Lp(a) alone. CONCLUSIONS: With the
      cautions due to the cross-sectional design of the study and the limited
      statistical power, these results suggest a possible synergistic effect between
      elevated Lp(a) levels and other pro-atherogenic factors such as smoking on the
      risk of vascular diseases in older individuals.

PMID- 11207865
TI  - Risk factors for hospitalized gastrointestinal bleeding among older persons.
      Cardiovascular Health Study Investigators.
AB  - OBJECTIVES: We sought to estimate the incidence of hospitalization for upper and
      lower gastrointestinal bleeding among older persons and to identify independent
      risk factors. DESIGN: Prospective cohort study. SETTING: The Cardiovascular
      Health Study (CHS). PARTICIPANTS: 5,888 noninstitutionalized men and women age 65
      years or older in four U.S. communities enrolled in the CHS. MEASUREMENTS:
      Gastrointestinal bleeding events during the period 1989 through 1998 were
      identified using hospital discharge diagnosis codes and confirmed by medical
      records review. Risk-factor information was collected in a standardized fashion
      at study baseline and annually during follow-up. RESULTS: Among CHS participants
      (mean baseline age 73.3 years, 42% male), the incidence of hospitalized
      gastrointestinal bleeding was 6.8/1,000 person-years. In multivariate analyses,
      advanced age, male sex, unmarried status, cardiovascular disease, difficulty with
      daily activities, use of multiple medications, and use of oral anticoagulants
      were independent risk factors. Compared with nonsmokers, subjects who smoked more
      than half a pack per day had a multivariate-adjusted hazard ratio (HR) of 2.14
      (95% confidence interval [CI] = 1.22-3.75) for upper gastrointestinal bleeding
      and a multivariate-adjusted HR of 0.21 (95% CI = 0.03-1.54) for lower
      gastrointestinal bleeding. Aspirin users did not have an elevated risk of upper
      gastrointestinal bleeding (HR = 0.76, 95% CI = 0.52-1.11), and users of other
      nonsteroidal anti-inflammatory drugs had a HR of 1.54 (95 % CI = 0.99-2.36). Low
      ankle-arm systolic blood pressure index was associated with higher risk of
      gastrointestinal bleeding among subjects with clinical cardiovascular disease but
      not among those without clinical cardiovascular disease. CONCLUSION: This study
      identifies risk factors for gastrointestinal bleeding, such as disability, that
      may be amenable to modification. The findings will help clinicians to identify
      older persons who are at high risk for gastrointestinal bleeding.

PMID- 11207866
TI  - Correlates of attributing new disability to old age. Study of Osteoporotic
      Fractures Research Group.
AB  - OBJECTIVES: To describe women who attribute new disability to old age and to
      identify demographic, medical, behavioral, and psychosocial characteristics that
      correlate with attributing new disability to old age. DESIGN: Prospective cohort
      study with 4-year follow-up. SETTING: Four geographic regions of the United
      States. PARTICIPANTS: 9704 women aged > or = 67 years participating in the Study
      of Osteoporotic Fractures. Of these, 657 who reported no disability at baseline
      but at follow-up reported difficulty carrying out 1 or more of 13 functional
      activities were eligible for our analysis. MEASUREMENTS: All women reporting
      difficulty in any functional activity at follow-up were asked "What is the main
      condition that causes you to have difficulty or prevents you from (doing the
      activity)?" and were shown a card listing 14 medical conditions as well as the
      option "old age," from which they could choose only one response. Women
      attributing difficulty or inability in 1 or more functional activities to old age
      were classified as attributing new disability to old age. We examined the
      relationship between attributing new disability to old age and the following
      characteristics measured at baseline: age, level of education, medical
      comorbidity, cognitive function, body mass index (BMI), gait speed, grip
      strength, visual acuity, physical activity level, smoking status, social network
      level, and depressed mood. RESULTS: Overall, 13.5% of women attributed new
      disability to old age. Age was a strong independent correlate of attributing new
      disability to old age: compared with women age 67 to 69, the odds of attributing
      new disability to old age for women age 70 to 79 was 3.6 times as large (95%
      confidence interval [CI] = 1.6-8.3), and for women age 80 or over was 5.5 times
      as large (95% CI = 2.1-14.7). The only other characteristic that remained an
      independent correlate of attributing new disability to old age was grip strength;
      for each decile decrease in grip strength, a woman's odds of attributing new
      disability to old age increased by 9% (odds ratio [OR] = 1.09, 95% CI = 1.01
      1.19). CONCLUSIONS: Despite great advances in geriatric medicine, old age is
      still perceived as a causal agent in functional decline, especially among our
      oldest patients. Further study is needed to determine whether, how often, and
      under what circumstances older adults who attribute new disability to old age
      have medical conditions amenable to interventions that could preserve their
      functioning and improve their quality of life.

PMID- 11207867
TI  - Medical care for nursing home residents: differences by dementia status.
      Epidemiology of Dementia in Nursing Homes Research Group.
AB  - OBJECTIVE: To understand the use of medical services by nursing home residents.
      DESIGN: Descriptive, longitudinal study comparing medical service use of
      residents by dementia status and describing the use of medical services following
      detection of fever or infection. SETTING: Fifty-nine randomly selected nursing
      homes in Maryland from 1992 to 1995. PARTICIPANTS: 2,153 residents admitted to
      one of 59 randomly selected nursing homes. MEASUREMENT: A panel of psychiatrists
      and neurologists ascertained dementia based on review of medical records,
      interview data with significant others and nursing staff, and results of a
      cognitive exam. Medical service use was abstracted from medical records.
      BACKGROUND: Understanding the use of medical services by nursing home residents
      as distinct from services provided by the nursing home is important, particularly
      as new medical care models are tested. This study compares the medical service
      use of residents by dementia status and describes the use of medical services
      following detection of fever or infection. RESULTS: Residents with dementia
      compared with those without dementia had lower annual rates of physician visits
      (10.2 vs 12.7, P < .001) and hospitalizations (0.9 vs 1.2, P < .001), virtually
      the same rate of emergency department visits, and similar lengths of stay in the
      hospital. Subsequent to infection, a lower proportion of residents with dementia
      had either a physician visit, an emergency department visit, or a hospital
      admission compared with residents without dementia (27.2% vs 32.2%, P < .001). In
      87% of infections, an antibiotic was used, implying meaningful contact with a
      physician. Residents with dementia compared with those without dementia had fewer
      physician visits subsequent to fevers (20.6% vs 29.9%, P < .001) and infections
      (21.8% vs 27.5%, P < .001). CONCLUSIONS: The association of less medical service
      use by individuals with dementia compared with those without dementia may reflect
      differences in health status or implicit end-of-life decision-making and a
      proclivity toward less-aggressive treatment for these individuals.

PMID- 11207868
TI  - State practice variations in the use of tube feeding for nursing home residents
      with severe cognitive impairment.
AB  - OBJECTIVE: To describe the differences in prevalence of tube feeding among states
      and to examine possible factors that could explain practice patterns. DESIGN:
      Analysis of random samples from an interstate data bank comprised of the Minimum
      Data Set (MDS), a standardized, federally mandated assessment instrument for
      nursing home residents. SETTING: Nursing homes in four states participating in a
      federal demonstration project of case mix payment plus five others with existing
      MDS data systems. PARTICIPANTS: Individuals 65 years of age and older (N =
      57,029), who had very severe cognitive impairment, including total dependence in
      eating, and who resided in nursing homes during 1994, the most recent year for
      which uniform data were available. MEASUREMENTS: State-by-state differences in
      prevalence of tube feeding, controlling for demographic and clinical variables.
      RESULTS: The prevalence of tube feeding ranged from 7.5% in Maine to 40.1% in
      Mississippi. Each state had a significantly elevated prevalence of tube feeding
      compared with Maine, with odds ratios (ORs) ranging from 1.50 to 5.83, P < .001.
      Specific directives not to provide tube feeding (OR 0.41, P < .001), and white
      race (OR 0.45, P < .001) were strongly and negatively associated with tube
      feeding. CONCLUSIONS: Wide regional variations exist in the use of tube feeding
      of nursing home residents with equivalent impairments. Sociodemographic factors
      could be important, but more study is needed to determine whether physician
      characteristics, such as race, attitudes, or knowledge, have an impact and to
      clarify medical standards for the use of tube feeding in this population.

PMID- 11207869
TI  - Life-sustaining treatment and assisted death choices in depressed older patients.
AB  - OBJECTIVES: The major purpose of this study was to examine the effect of
      depressed mood in older, medically ill, hospitalized patients on their
      preferences regarding life-sustaining treatments, physician-assisted suicide
      (PAS), and euthanasia and to determine the degree to which financial constraints
      affected their choices. DESIGN: Cross-sectional study. SETTING: General medical
      hospital. PARTICIPANTS: One hundred fifty-eight medically hospitalized,
      nondemented patients age 60 or older, mean age 74.1 (range 60-94). The sample was
      divided, based on Center for Epidemiologic Studies-Depression (CES-D) scores,
      into a depressed group (n = 71) and a nondepressed control group. MEASUREMENTS:
      Subjects underwent a structured interview evaluating their life-sustaining
      treatment choices and whether they would accept or refuse PAS or euthanasia under
      a variety of hypothetical conditions. These choices were reevaluated with the
      introduction of financial impact. In addition, assessment included measures of
      depression, suicide, cognition, social support, functioning, and religiosity.
      RESULTS: Depression was found to be highly associated with acceptance of PAS and
      euthanasia in most hypothetical clinical scenarios in addition to patients'
      current condition. Compared with nondepressed people, depressed respondents were
      13 times as likely to accept PAS when considering their current condition (95%
      confidence interval [CI] 1.68-110.98), and over twice as likely to accept PAS
      when facing a hypothetical terminal illness or coma. Depression alone was weakly
      associated with life-sustaining treatment choices but, when financial impact was
      introduced, significantly more depressed subjects refused treatment options they
      had previously desired than did nondepressed subjects. The presence of suicidal
      ideation, even passive ideation, was strongly predictive of life-sustaining
      treatment refusals and increased interest in PAS and euthanasia. Depression's
      effect on acceptance of PAS was confirmed by logistic regression, which also
      showed that religious coping was significantly correlated with less interest in
      PAS in two hypothetical scenarios. CONCLUSION. Depressed subjects and even
      subjects with subtle, passive suicidal ideation were markedly more interested in
      PAS and euthanasia than nondepressed subjects in hypothetical situations.
      Depressed subjects were also particularly vulnerable to rejecting treatments if
      financial consequences might have resulted.

PMID- 11207871
TI  - Late-onset multiple sclerosis.
AB  - OBJECTIVE: The onset of multiple sclerosis (MS) after age 50 is infrequent and
      presents a diagnostic challenge. The purpose of the present study was to review
      the prevalence, presentation, and clinical characteristics of late-onset MS.
      DESIGN: A retrospective chart review. SETTING: The Multiple Sclerosis Center at
      Sheba Medical Center, Israel. PARTICIPANTS: 640 patients with a definite
      diagnosis of MS. MEASUREMENTS: Diagnosis of MS was established according to Poser
      criteria and confirmed by brain magnetic resonance imaging (MRI) using our unit's
      computerized database. Late-onset MS was defined as the first presentation of
      clinical symptoms after the age of 50 years. For each patient, age, gender,
      clinical presentation, disease course, neurological involvement, disease
      duration, neurological disability assessed, and Progression Index (PI) were
      analyzed. All patients were interviewed using the structured clinical interview
      for DSM-IV, SCID-lifetime Hebrew version. RESULTS: Of 640 MS patients, 30 (4.6%)
      were diagnosed as suffering from late-onset MS. Mean age at onset was 53.5 +/-
      3.1, range 50 to 62 years. Female to male ratio was 1.73:1. Mean disease duration
      was 7.6 years, range 2 to 11 years. In 50% of patients the disease course was
      relapsing-remitting. Motor symptoms were the most common neurological
      presentation at onset (63.3%). Major depressive episode was diagnosed in 6 out of
      30 patients (20%) in the two years prior to the diagnosis of MS. After a mean
      disease duration of 7.6 years there was a marked increase in sphincteric and
      cerebellar involvement. In addition 7 out of 30 patients had suffered a major
      depressive episode within 4 years of diagnosis. Mean PI was 0.81, suggesting
      rapid neurological deterioration. CONCLUSIONS: Late-onset MS is not rare and may
      present as major depression and, although neurological presentation at onset is
      similar to that of young adults, progression to disability is more rapid and a
      primary progressive course is more prevalent.

PMID- 11207870
TI  - Guar gum reduces postprandial hypotension in older people.
AB  - OBJECTIVE: To determine whether slowing of gastric emptying and glucose
      absorption with guar gum would reduce the fall in blood pressure after an oral
      glucose load in older subjects. DESIGN: A randomized, experimental, cross-over
      study. SETTING: Department of Nuclear Medicine, Royal Adelaide Hospital,
      Adelaide, SA, Australia. PARTICIPANTS: Ten healthy subjects, age 67 to 78.
      MEASUREMENTS: Simultaneous measurements of gastric emptying, blood pressure,
      blood glucose, serum insulin, and oral glucose absorption (3-O-methyl-D-glucose
      [3-OMG]) on two occasions after ingestion of 300 mL water containing 50 g glucose
      and 30 mL lemon juice, 3 g 3-OMG labeled with 99mTc-sulphur colloid; with or
      without 9 g guar gum. Blood pressure and gastric emptying were monitored for 180
      minutes. RESULTS: The magnitude of the falls in systolic (P = .02), diastolic (P
      < .05), and mean arterial (P = .05) blood pressure were less, and gastric
      emptying slower (P < .05), after guar. Blood glucose, insulin, and 3-OMG
      concentrations were reduced (P < .001 for all) by guar. 3-OMG concentrations were
      inversely related to the intragastric retention of glucose (r = -0.72, P = .02)
      and blood pressure was inversely related to 3-OMG (r = -0.64, P < .05) after the
      drink without guar. The blood glucose concentration was related to 3-OMG (r >
      0.64, P < .05). CONCLUSION: Guar gum reduces the magnitude of the fall in blood
      pressure after oral glucose. Slowing of gastric emptying and glucose absorption
      may represent a novel approach to the treatment of postprandial hypotension.

PMID- 11207872
TI  - Methodologic issues in conducting research on hospitalized older people.
AB  - OBJECTIVE: To describe challenges in conducting research with hospitalized
      geriatric patients. DESIGN: Quasi-experimental longitudinal study with inperson
      interviews at baseline and discharge and a three-month postdischarge telephone
      interview. Study protocol required baseline interviews within 48 hours of
      admission for patients or 72 hours for proxies. SETTING: 813-bed urban teaching
      hospital. PARTICIPANTS: 240 patients, mean age 83.8 years, at moderate to high
      risk for functional decline during hospitalization, admitted from the emergency
      room to a general medical unit. MEASUREMENTS: Delays starting or interruptions
      continuing interviews; patient and environmental conditions potentially affecting
      data quality; and information on proxy use. RESULTS: Timely access to patients or
      proxies was a major difficulty, resulting in the screening of only 53.1% of 867
      potentially eligible patients. Multiple patient contacts and visits were required
      to complete interviews. Only 61.3% of baseline and 28.1% of follow-up interviews
      were completed on the initial day of contact. Despite having on-site interviewers
      7 days a week, 29% of discharge interviews were conducted by telephone.
      Interviews were >90% complete in 487 of 503 of encounters (97%). Baseline delays
      and interruptions were usually due to the presence of medical staff, off-unit
      tests, patient illness, nurse unavailability for interview, and need for a proxy.
      Most in-hospital interviews were conducted with others present. Proxies were
      required for approximately one-third of patients at all three interviews.
      CONCLUSION: Conducting clinical research with older adults in the current
      inpatient setting, where patients are more severely ill yet have shorter lengths
      of stay now than in the past, proves a challenging yet achievable goal. Effective
      procedures for negotiating the acute care environment are critical to successful
      studies.

PMID- 11207873
TI  - Hormone replacement therapy and fractures in older adults.
AB  - Estrogen deficiency in women is associated with accelerated bone loss, and
      estrogen replacement therapy has been proven to be effective in preventing
      osteoporosis and fractures in postmenopausal women. The introduction of selective
      estrogen receptor modulators that have an estrogen-like effect on the skeleton
      but have a different pattern of effects on other tissues may have an important
      role in the management of osteoporosis in women in the near future. In men,
      androgen deficiency has been shown to be associated with osteoporosis. Although
      androgen replacement in hypogonadal men may decrease bone resorption and increase
      bone mass, long-term placebo-controlled trials are needed to better define the
      benefits and risks of such therapy before it can be recommended. Sex hormone
      deficiency is linked to the development of osteoporosis in both women and men. In
      women, hormonal replacement by estrogen or the newly developed selective estrogen
      receptor modulators may prevent the development of osteoporosis and its related
      fractures. In men, there is early evidence that testosterone replacement therapy
      may enhance bone mass in hypogonadal men.

PMID- 11207874
TI  - Pain management in older adults: prevention and treatment.
AB  - The release of guidelines in 1998 by the American Geriatrics Society on "The
      Management of Chronic Pain in Older Persons" was a breakthrough in helping to
      manage pain in this population. Already advances have fostered a need to update
      recommendations. This article focuses on the treatment strategies available for
      seniors that are likely to help to fulfill the obligation to relieve pain and
      suffering in patients. A review was done of the literature using Medline and
      other search techniques. New pain scales have been developed with seniors in mind
      and greater testing of older scales in elderly populations have helped to
      identify measures of pain more suited to frail seniors. Advances in
      cyclooxygenase inhibition selectivity, alternative medicine, and progress in the
      identification of nonopioid pain receptors and the development of products to
      target them are just a few of changes that have altered the way clinicians think
      about treating pain. The use of hospice in end-of-life palliative care is a
      valuable resource for clinicians managing pain at that phase in care as well.
      Tools are available to prevent and treat pain successfully in seniors. Educating
      clinicians about available assessment tools, techniques and interventions may be
      the biggest challenge to comforting the older adult in pain.

PMID- 11207875
TI  - Suboptimal prescribing in older inpatients and outpatients.
AB  - Investigators searched Medline and HealthSTAR databases from January 1, 1985
      through June 30, 1999 to identify articles on suboptimal prescribing in those age
      65 years and older. A manual search of the reference lists from identified
      articles and the authors' article files, book chapters, and recent reviews was
      conducted to identify additional articles. The definitions for various types of
      suboptimal prescribing (polypharmacy, inappropriate, and underutilization) are
      numerous, and measurement varies from study to study. The literature suggests
      that suboptimal prescribing is common in older outpatients and inpatients.
      Moreover, there is significant morbidity and mortality associated with suboptimal
      prescribing for these older patients. Evidence from well-controlled studies
      suggests that multidisciplinary teams and clinical pharmacy interventions can
      modify suboptimal drug use in older people. Future research is necessary to
      measure and test other methods for tackling this major public health problem
      facing older people.

PMID- 11207876
TI  - Practice guideline for evaluation of fever and infection in long-term care
      facilities.
AB  - The elderly population (i.e., persons aged > or = 65 years) in the United States
      is rapidly expanding and will nearly double in number over the next 30 years. It
      is estimated that >40% of persons aged > or = 65 years will require care in a
      long-term care facility (LTCF), such as a skilled nursing facility (SNF), at some
      point during their lifetime. For the most part, residents of LTCFs are very old
      and have age-related immunologic changes, chronic cognitive and/or physical
      impairments, and diseases that alter host resistance; therefore, they are highly
      susceptible to infections and their complications. The diagnosis of infections in
      residents of LTCFs is often difficult because LTCFs differ from acute-care
      facilities in their goals of care, staffing ratios, types of primary care
      providers, availability of laboratory tests, and criteria for infections.
      Consequently, guidelines and standards of practice used for diagnosis of
      infections in patients in acute-care facilities may not be applicable nor
      appropriate for residents in LTCFs. Moreover, the clinical manifestations of
      diseases and infections are often subtle, atypical, or nonexistent in the very
      old. Fever may be low or absent in LTCF residents with infection. The initial
      evaluation of an LTCF resident suspected of an infection may not be done by a
      physician. Although nurses commonly perform initial assessments for infection in
      residents of LTCFs, further studies are needed to determine the appropriateness
      and validity of this practice. Provided there are no directives (advance or
      current by resident or caregiver) limiting diagnostic or therapeutic
      interventions, all residents of LTCFs with suspected symptomatic infection should
      have appropriate diagnostic laboratory studies done promptly, and the findings
      should be discussed with the primary care clinician (see Recommendations). The
      most common infections among LTCF residents are urinary tract infections,
      respiratory infections, skin or soft tissue infections, and gastroenteritis.
      Decisions concerning possible transfer of an LTCF resident to an acute-care
      facility are best expressed through an advance directive or, when not available,
      through transfer policies developed by the LTCF. In general, LTCF residents have
      been transferred to an acute-care facility when any of the following conditions
      exist: (1) the resident is clinically unstable and the resident or family goals
      indicate aggressive interventions should be initiated, (2) critical diagnostic
      tests are not available in the LTCF, (3) necessary therapy or the mode of
      administration of therapy (frequency or monitoring) are beyond the capacity of
      the LTCF, (4) comfort measures cannot be assured in the LTCF, and (5) specific
      infection-control measures are not available in the LTCF.

PMID- 11207877
TI  - Education in geriatric Medicine. AGS Education Committee and Public Policy
      Advisory Group (PPAG).

PMID- 11207878
TI  - Genetic testing for late-onset Alzheimer's disease. AGS Ethics Committee.

PMID- 11207879
TI  - New drugs for old folks: the evidence-based argument for newer antidepressants.

PMID- 11207880
TI  - Oral health and the role of the geriatrician.

PMID- 11207881
TI  - In re Daytime sleepiness and mortality.

PMID- 11207882
TI  - In reply.

PMID- 11207883
TI  - Patients with late-onset depression have poor cognitive function at old age.

PMID- 11207884
TI  - Giant incidental cardiac mass compatible with myxoma in a 92-year-old woman.

PMID- 11207885
TI  - Association between oxybutynin and neuropsychiatric adverse effects not confirmed
      in daily practice.

PMID- 11207886
TI  - Charles Bonnet syndrome and opioids.

PMID- 11207887
TI  - The Newcastle protocol for carotid sinus massage.

PMID- 11207888
TI  - Implementing a program in the surgical specialties--what is out there and how to
      begin.

PMID- 11207889
TI  - Are primary biliary cirrhosis and autoimmune cholangitis reflective of the
      pendulum of a clock and therefore represent a 'phase' of the same disease?

PMID- 11207890
TI  - New hepatitis viruses: contenders and pretenders.
AB  - Following the development of tests for hepatitis C virus and hepatitis E virus
      infection, it became clear that there remained cases of hepatitis that were non-A
      E. Such cases provided impetus for the search for additional hepatitis viruses
      and, by using molecular techniques, several candidates were identified. An
      enteric agent responsible for sporadic non-A and non-E hepatitis was tentatively
      called hepatitis F virus. However, the lack of any corroborating reports has cast
      doubt on its status as a true hepatitis virus. Two groups independently reported
      the isolation of a blood-borne virus, designated as hepatitis G virus (HGV) and
      GB virus C (GBV-C) by their respective discoverers. They were later shown to be
      isolates of the same virus. While the virus has a high prevalence in cases of non
      A-E hepatitis, it also has a high prevalence in the appropriate control groups
      and convincing evidence for its replication in the liver is lacking. Another
      possible hepatitis virus, TT virus, was discovered in the blood of a patient with
      post-transfusion non-A-E hepatitis. By using PCR primers designed to overcome the
      high nucleotide sequence divergence, TT virus was found to be ubiquitous with a
      worldwide distribution. A disease association is thus unlikely. Most recently, a
      DNA virus designated as SEN-V has been announced as a major cause of non-A-E
      hepatitis. Based on limited data available to researchers, SEN-V is the most
      convincing contender for the new hepatitis virus title. However, the lessons
      learnt from the hepatitis virus pretenders will need to be applied to SEN-V and
      any future contenders.

PMID- 11207891
TI  - Role of hiatus hernia and gastric mucosal atrophy in the development of reflux
      esophagitis in the elderly.
AB  - BACKGROUND AND AIMS: The pathogenetic mechanism responsible for the increased
      prevalence of reflux esophagitis in the elderly remains controversial. The aim of
      this study was to determine if an increased occurrence of hiatus hernia (HH)
      and/or a lower rate of gastric mucosal atrophy (GMA) are the main causes of the
      increased prevalence of reflux esophagitis in elderly patients. METHODS: The
      prevalence of HH, GMA, and reflux esophagitis was investigated by reviewing the
      endoscopic films of 2788 consecutive patients examined during a 3-year period.
      RESULTS: The prevalence of esophagitis in males was higher than in females (11.6%
      vs 7.6%, P< 0.0005). The prevalence of reflux esophagitis and HH was found to
      increase with age in females, but not in male patients. The prevalence of reflux
      esophagitis in hernia-positive patients also increased with age in women, but not
      in men. Age, male gender, presence of HH, and closed-type of GMA were significant
      risk factors for the prevalence of esophagitis (P=0.0001, 0.0229, <0.0001,
      <0.0001, respectively). In addition, the risk ratios of HH and low-grade GMA for
      reflux esophagitis increased with age, and this tendency was higher in female
      patients than in males. CONCLUSIONS: Aging, male gender, HH and closed-type GMA
      are most likely the risk factors of endoscopically proven reflux esophagitis in
      Japanese patients.

PMID- 11207892
TI  - Ulcer in the gastric tube for esophageal replacement: a comparison of 12
      esophageal cancer patients with or without postoperative radiotherapy.
AB  - BACKGROUND AND AIMS: Ulcer in the gastric tube for esophageal replacement, which
      was caused by peptic factors or postoperative radiotherapy (Rx), are occasionally
      reported. The aim of this study was to clarify the clinicopathologic features of
      the ulcers in the gastric tube. METHODS: In 62 patients with a reconstructed
      gastric tube, after esophagectomy for esophageal cancer,
      esophagogastroduodenoscopy was performed. Ulcers of the gastric tube were
      detected in 12 patients: six with postoperative Rx and six without Rx. The 12
      patients with gastric tube ulcers (GU-group) were reviewed and compared to the
      remaining 50 patients without ulcers of the gastric tube (Control-group).
      Clinicopathologic features of gastric tube ulcers were compared between the
      patients with and without Rx. RESULTS: There was no difference in any parameter
      between the patients of the GU- and Control-groups. Comparing the patients of the
      GU-group with and without Rx, the ulcers of the gastric tube in the patients
      without Rx were frequently located in the lower part of the gastric tube (P =
      0.067), detected in a later period after surgery (P = 0.055), associated with
      cervical esophagitis (P = 0.03), and less associated with gastritis (P = 0.03).
      In three patients of the GU-group without Rx, Helicobacter pylori was detected in
      the gastric tube. Two of the three patients had a history of peptic ulcers before
      surgery, and had recurrence of the gastric tube ulcers. CONCLUSIONS: Gastric tube
      ulcers without postoperative Rx may have different characteristics compared to
      those induced by Rx.

PMID- 11207894
TI  - Vascularity of advanced gastric carcinoma: evaluation by using power Doppler
      imaging.
AB  - BACKGROUND: We investigated the vascularity of advanced gastric adenocarcinomas
      by using percutaneous power Doppler imaging. METHODS: Seventeen patients with
      gastric cancer and 10 without a gastric tumor, but with a slightly thick gastric
      wall in the B-mode ultrasound, were investigated with the use of power Doppler
      imaging. The color signals of the gastric lesion were graded as follows: 1, no
      color signals or the same as the surroundings; 2, color signals were slightly
      increasing; and 3, color signals were obviously increasing. RESULTS: The color
      signals of three patients were graded 1, those of eight patients were graded 2
      and those of six patients were graded 3 in the gastric cancer group. The color
      signals of all 10 patients without a gastric tumor were grade 1. This difference
      was statistically significant (P = 0.0002). CONCLUSIONS: Power Doppler imaging
      showed vascularity of gastric cancer increasing in the majority of patients (14
      of 17: 82%). Thus, power Doppler imaging might be a good screening examination
      method for gastric cancer.

PMID- 11207893
TI  - Shift of the gastric T-cell response in gastric carcinoma.
AB  - BACKGROUND AND AIMS: The etiology and pathophysiology of stomach carcinoma is
      complex, and the mechanism whereby H. pylori directly or indirectly induces
      carcinoma remains unclear. In this study, interleukin (IL)-8, IL-4 and interferon
      (IFN)-gamma were measured in the tissue culture supernatant of gastric organ
      cultures from subjects with chronic gastritis with or without H. pylori
      infection, and with or without gastric cancer and gastric dysplasia. RESULTS:
      Interleukin-8 levels were higher in cancer- and H. pylori-infected gastritis
      subjects than in H. pylori-negative subjects (12.95 +/- 3.16, 10.48 +/- 1.55 and
      4.49 +/- 1.28 ng/mL, respectively). Elevated levels of IFN-gamma were detected in
      both H. pylori-infected and non-infected subjects with uncomplicated gastritis
      (72.23 +/- 19.0 and 34.61 +/- 5.30 pg/mL) and in non-infected dysplasia subjects
      (88 +/- 20.5 pg/mL). Background levels of IL-4 (< or = 9.4 pg/mL) in
      uncomplicated gastritis subjects and relatively high levels of IL-4 in dysplasia
      subjects (25.8 +/- 7.3 pg/mL) were detected. In contrast, trace amounts of IFN
      gamma (16.01 +/- 0.35 pg/mL) and high levels of IL-4 (42.81 +/- 8.49 pg/mL) in
      gastric biopsy culture supernatants were found in cancer subjects. Mucosal IL-4
      levels (but not IL-8 levels) correlated with infection and mucosal anti-H. pylori
      immunoglobulin G antibody. CONCLUSIONS: The significant differences between
      gastritis with and without cancer and dysplasia indicated a shift from a Th1 to a
      Th2 helper cell pattern of cytokine secretion. This study has identified a local
      mucosal defect in gastric cancer. The near absence of IFN-gamma production from
      the mucosa at the margins of the tumor may be a critical factor in promoting
      growth of neoplastic cells.

PMID- 11207895
TI  - Predictors of health-care consultation for recurrent abdominal pain among urban
      schoolchildren in Malaysia.
AB  - AIM: To look at the predictors of health-care consultation for recurrent
      abdominal pain among urban schoolchildren in Malaysia. METHODS: Recurrent
      abdominal pain was defined as at least three episodes of abdominal pain, severe
      enough to affect a child's activities over a period longer than 3 months. A
      health-care consulter was defined as a child who had been brought to see a doctor
      regarding recurrent abdominal pain at least once in the past year. Children aged
      between 9 and 15 years were randomly chosen from schools in the city of Petaling
      Jaya, given questionnaires to fill in and interviewed to determine whether they
      fulfilled the above criteria for having symptoms of recurrent abdominal pain and
      for being a consulter. Bivariate analysis and multiple logistic regression
      analysis were performed on the data obtained. RESULTS: One hundred and forty
      three (9.61%) children fulfilled the criteria for recurrent abdominal pain out of
      a total of 1488 schoolchildren interviewed. There were 65 (45.5%) consulters and
      78 (54.5%) non-consulters. Among the consulters, the male to female ratio was
      1:1.4, while among the non-consulters, the ratio was 1:1.1. On bivariate
      analysis, the Chinese had a significantly lower likelihood to consult a doctor (P
      = 0.02), while the other two races did not show any increase in consultation
      (Malays, P = 0.08; Indians, P = 0.21). Among those with severe pain, there was a
      significantly higher prevalence of consulters (P < 0.01). Furthermore, those
      whose sleep was interrupted by abdominal pain were more likely to consult (P <
      0.01). Children who had consulted a doctor were more likely to be missing school
      because of abdominal pain (P < 0.01). Following multiple logistic regression
      analysis, ethnicity was no longer a significant predictor. CONCLUSIONS:
      Approximately 45.5% of schoolchildren with recurrent abdominal pain in an urban
      setting were brought to see a doctor. Predictors of recent health-care
      consultation were school absence, pain severity and interruption of sleep caused
      by abdominal pain.

PMID- 11207896
TI  - Dietary fiber fraction of germinated barley foodstuff attenuated mucosal damage
      and diarrhea, and accelerated the repair of the colonic mucosa in an experimental
      colitis.
AB  - BACKGROUND AND AIMS: Germinated barley foodstuff (GBF) contains protein and
      insoluble dietary fiber. We have previously shown in ulcerative colitis patients
      and a colitis model that GBF feeding attenuates mucosal damage by increasing
      luminal butyrate levels. However, the detailed mechanism remains unclear because
      of its heterogeneous nature. The present study was carried out to: (i) evaluate
      the active ingredient in GBF; and (ii) examine its effect on the repair process
      in colonic inflammation by using a dextran sulfate sodium (DSS) colitis model.
      METHODS: Colitis was induced by feeding a diet containing 0.5-3.5% DSS to male
      Sprague-Dawley rats. (i) Active ingredient: GBF was fractionated enzymatically
      into fiber- and protein-rich fractions. Each fraction was administered to DSS
      colitis rats. Clinical signs, cecal short chain fatty acid concentrations and
      serum alpha1-acid glycoprotein (AAG) levels were determined. (ii) Effect on
      mucosal repair: GBF with or without salazosulfapyridine (SASP), or SASP alone was
      administered to rats after the onset of colitis. Seven days after initial
      treatment, the number of epithelial cells in HE sections was evaluated
      morphologically in a blind fashion and serum AAG was determined. RESULTS: (i)
      Germinate barley foodstuff and GBF-fiber significantly attenuated the clinical
      signs of colitis and decreased serum AAG levels, with a significant increase in
      cecal butyrate production, while GBF-protein did not. (ii) Treatment with GBF
      alone and GBF plus SASP significantly accelerated colonic epithelial repair and
      improved clinical signs. CONCLUSIONS: These findings suggest that the fiber
      fraction of GBF may effectively enhance luminal butyrate production, and thereby
      accelerate colonic epithelial repair in colitis.

PMID- 11207897
TI  - Binding sites for progastrin-derived peptides in colonic crypts.
AB  - BACKGROUND AND AIMS: Gastrin17gly acts as a growth factor for the colonic mucosa.
      Studies on the binding properties of the receptor involved in transducing the
      proliferative effects have generally been confined to colorectal carcinoma cell
      lines, and no investigation of gastrin17gly receptors on normal colonocytes has
      yet been reported. The aim of this study was to investigate the binding of 125I
      [Met15]-gastrin17gly to normal colonic crypts. METHODS: Crypts were released from
      normal rat and rabbit colonic mucosa by treatment with EDTA and isolated by
      centrifugation. The binding of 125I-[Met15]-gastrin17gly was measured in
      displacement experiments with increasing concentrations of either gastrin17gly,
      gastrin17 or gastrin receptor antagonists. The concentrations required for 50%
      inhibition were determined by the use of curve fitting. RESULTS: 125I-[Met15]
      Gastrin17gly bound to both rat and rabbit crypts, and displacement experiments
      with unlabeled gastrin17gly revealed that the IC50 values were 1.0 +/- 0.6 and
      0.6 +/- 0.2 micromol/L, respectively. Binding was also competed by gastrin17,
      with IC50 values of 2.4 +/- 1.7 and 2.4 +/- 0.7 micromol/L, respectively. Binding
      was inhibited by the non-selective gastrin/CCK receptor antagonists proglumide
      and benzotript, but not by the cholecystokinin (CCK)-A receptor antagonist L364
      718, or the gastrin/CCK-B receptor antagonist L365 260. CONCLUSION: We conclude
      that the gastrin17gly binding site on normal colonic crypts has properties
      consistent with the gastrin/CCK-C receptor.

PMID- 11207898
TI  - Comparison of the expression of ABH/Lewis-related antigens in polypoid and non
      polypoid growth types of colorectal carcinoma.
AB  - BACKGROUND AND AIMS: Colorectal tumors can be classified based on their growth
      pattern into the polypoid growth-type (PG-type) and non-polypoid growth-type (NPG
      type). To ascertain whether there is any relationship between the expression of
      particular blood group-related antigens (A, B, H, Lewis (Le)a, sialyl Le(a),
      Le(x), sialyl Le(x)) in a colorectal tumor, and a tumor having polypoid or non
      polypoid growth, we examined 78 PG-type and NPG-type colorectal cancers. METHODS:
      Fourteen PG-type and 64 NPG-type colorectal carcinomas were subjected to
      immunohistochemical analyses by using monoclonal antibodies against A, B, H,
      Le(a), sialyl Le(a), Le(x) and sialyl Le(x). RESULTS: The patients with NPG-type
      carcinomas had a significantly younger age of onset, significantly smaller
      maximal tumor diameter, significantly higher rate of lymph node metastasis and
      significantly worse prognosis than those with PG-type carcinomas. Among the 32
      tumors of patients with blood type A or AB, isoantigen A was expressed in a
      significantly larger percentage of NPG-type carcinomas than PG-type carcinomas
      (95.8 vs 62.5%, respectively; P=0.014). Among all 78 tumors, sialyl Le(x) antigen
      was expressed in a significantly larger percentage of NPG-type than PG-type
      carcinomas (90.6 vs 64.3%, respectively; P=0.010). Multivariate analysis using
      the logistic regression model revealed that isoantigen A and sialyl Le(x)
      expression were independent predictive risk factors for the development of NPG
      type colorectal carcinoma. CONCLUSIONS: These data suggest that the expression of
      isoantigen A and sialyl Le(x) in a colorectal carcinoma partially determines
      whether the tumor will have polypoid or non-polypoid growth.

PMID- 11207899
TI  - Polymorphic expression of decay-accelerating factor in human colorectal cancer.
AB  - BACKGROUND: We have previously shown that expression of decay-accelerating factor
      (DAF), a complement regulatory protein, is enhanced immunohistochemically on the
      luminal surface of cancer glands in human colorectal cancer and is detected in
      stool specimens of patients with colorectal cancer. The amount of DAF present in
      the stools might be influenced by the stability of DAF on the cell surface which
      is regulated by biochemical properties such as glycosylation of the protein. In
      the present study, to help elucidate the mechanism for the release of DAF from
      human colorectal cancers, we biochemically analyzed DAF expression by western and
      northern blotting by using surgically resected specimens of colorectal cancers.
      METHODS: Surgically resected colorectal cancer tissues were obtained from 10
      patients. Expression of DAF was determined by western and northern blotting, and
      glycosylation of DAF protein was analyzed with glycosidase digestion. RESULTS:
      Northern blot analysis demonstrated that the expression of DAF mRNA in colorectal
      cancer was enhanced two- to threefold compared with normal tissues. In western
      blotting, expression of DAF protein in the cancer tissue was increased, and
      heterogeneity in the apparent molecular weight of DAF was observed among
      patients. When o-linked sugars were removed, this heterogeneity of DAF size
      diminished. CONCLUSIONS: The polymorphic expression of DAF in colorectal cancer
      is likely to reflect variability in the o-glycosylation of the protein. We
      speculate that this variability could affect the stability of DAF on the surfaces
      of cancer cells and, in turn, the amount of DAF shed into the stools of
      colorectal cancer patients.

PMID- 11207900
TI  - Hepatic steatosis in chronic hepatitis C virus infection: prevalence and clinical
      correlation.
AB  - BACKGROUND AND AIMS: Hepatic steatosis is a histological characteristic in
      patients with chronic hepatitis C virus (HCV) infection. The aim of this study
      was to evaluate the prevalence of hepatic steatosis in Chinese patients with
      chronic hepatitis C, and to look for possible correlation with various
      histopathological changes and to look for possible correlation with various
      clinical and pathologic variables. METHODS: One hundred and six patients were
      enrolled, and patients with alcoholism or diabetes mellitus were excluded.
      Clinical, biochemical and virologic data, including HCV genotype and serum HCV
      RNA titer and histological findings, were compared between patients with and
      without hepatic steatosis. RESULTS: Fifty-five (52%) of the 106 patients with
      chronic hepatitis C had hepatic steatosis. Patients with hepatic steatosis had
      significantly higher mean serum levels of triglyceride and gamma-glutamyl
      transpeptidase, higher body mass index, and a higher incidence of obesity
      compared with patients without hepatic steatosis. No significant differences in
      serum HCV-RNA titer and HCV genotype or the response to interferon therapy were
      noted between the two groups. Histological analysis showed patients with hepatic
      steatosis had a significantly higher mean fibrotic score than patients without
      hepatic steatosis (1.9 +/- 1.2 vs 1.3 +/- 1.0; P = 0.016). There were no
      significant differences in the severity of necroinflammation, the presence of
      lymphoid aggregation/follicle or bile duct damage between the two groups.
      Multivariate logistic regression analysis showed that independent predictors
      associated with hepatic steatosis were obesity or a histology fibrotic score of >
      or = 2. CONCLUSION: It was found that 52% of Chinese patients with chronic
      hepatitis C had hepatic steatosis. Patients with hepatic steatosis were more
      frequently obese and had more severe hepatic fibrosis.

PMID- 11207901
TI  - Serum amino-terminal propeptide of type III procollagen and 7S domain of type IV
      collagen correlate with hepatic iron concentration in patients with chronic
      hepatitis C following alpha-interferon therapy.
AB  - BACKGROUND: It has been reported that chronic infection with hepatitis C virus is
      associated with excess iron deposits in the liver of subjects who are neither
      alcoholics nor recipients of blood transfusions. However, little is known about
      the relationship between hepatic iron concentration (HIC) and the serum levels of
      hepatic fibrogenesis markers, which were caused by interferon therapy for chronic
      hepatitis C. Therefore, changes in the serum amino-terminal propeptide of type
      III procollagen (P-III-P) and the 7S domain of type IV collagen (7S-IV) in 16
      patients treated with alpha-interferon (IFN-alpha) were studied, and their HIC
      and histological assessment evaluated. Hepatic iron concentrations were measured
      by using liver biopsy specimens obtained before and 6 months after the cessation
      of treatment. METHODS AND RESULTS: Eight subjects (50%) who had normal alanine
      transaminase levels at 6 months after therapy showed significantly lowered HIC,
      and attenuated hepatic iron staining with decreased serum levels of P-III-P and
      7S-IV compared to the remaining subjects. The HIC was significantly correlated
      with the serum levels of P-III-P and 7S-IV in all subjects. CONCLUSIONS: These
      findings suggest that IFN-alpha treatment may decrease stimuli for fibrogenesis,
      at least in part, by reducing the hepatic iron deposition in patients with
      chronic hepatitis C.

PMID- 11207902
TI  - Clinical significance of TT virus in chronic hepatitis C.
AB  - BACKGROUND AND AIMS: Much is still unknown about the clinical significance of TT
      virus (TTV), which has been reported as a candidate for non A-G hepatitis virus.
      The aim of this study was to clarify the clinical significance of TTV in patients
      coinfected with TTV and hepatitis C virus (HCV). METHODS: The 95 subjects studied
      had chronic hepatitis C (CHC), and underwent interferon (IFN) therapy. TT Virus
      DNA was detected by using polymerase chain reaction. The nucleotide sequences
      were determined by using a dideoxy chain termination method. A phylogenetic tree
      was drawn up by using the neighbor-joining method. RESULTS: TT Virus DNA was
      detected in 37.9% of patients with the use of an open reading frame 1 (ORF1)
      primer, and in 88.4% of patients by using a 5' untranslated region (5' UTR)
      primer. Using both sets of primers, no differences were found between TTV-DNA
      positive and -negative subjects with CHC in the clinical findings. Serum TTV DNA
      was eradicated in 30.6% of patients with the ORF1 primer, and in 19.1% of
      patients with the 5' UTR primer at 6 months after the cessation of IFN therapy.
      The levels of TTV DNA before IFN therapy were significantly lower in the viral
      eradication group than in non-eradication group. The changes in alanine
      aminotransferase (ALT) concentrations were significantly correlated with changes
      in HCV-RNA in CHC patients with TTV. Moreover, there was no correlation between
      the changes in TTV DNA and the course of ALT. CONCLUSION: Hepatocellular injury
      in patients with chronic hepatitis who are coinfected with HCV and TTV appears to
      primarily be caused by HCV and is less attributable to TTV.

PMID- 11207903
TI  - Comparison of clinical, virologic and pathologic features in patients with acute
      hepatitis B and C.
AB  - BACKGROUND AND AIMS: The clinical outcomes of adult-acquired acute infection of
      hepatitis C virus (HCV) and hepatitis B virus (HBV) are quite different. In order
      to compare the clinical, biochemical, virologic and pathologic pictures in these
      two groups of patients, we enrolled 22 adult patients with acute hepatitis C and
      16 adult patients with acute hepatitis B, on whom liver biopsies were performed
      within 3 months of acute onset of the illness. RESULTS: The results showed that a
      significantly younger age, a higher ratio of the clinical symptoms of jaundice,
      nausea, vomiting, and poor appetite, a higher mean serum level of alanine
      transaminase, aspartate transaminase, and total bilirubin were present in
      patients with acute hepatitis B patients than in those with acute hepatitis C (P
      < 0.05). There was a significantly higher degree of periportal inflammation and
      total necro-inflammatory activity in the acute hepatitis B patients (P = 0.002
      and 0.049, respectively). Fifteen (68.2%) of the 22 patients with acute hepatitis
      C had detectable serum HCV-RNA, but only two (14.3%) of the 14 tested patients
      with acute hepatitis B had detectable serum HBV-DNA, detected by using the
      branched DNA signal amplification assay. Eighteen (82%) of the 22 acute hepatitis
      C patients and none of the 16 acute hepatitis B patients progressed into a
      chronic hepatitis stage (P < 0.001). CONCLUSION: The manifestations of mild
      clinical symptoms, lower mean serum transaminases and bilirubin levels, a lesser
      degree of histological periportal necroinflammation, and more patients with a
      high circulatory viral load among the acute hepatitis C patients, may lead to
      more of that group developing chronicity than patients with acute hepatitis B.

PMID- 11207904
TI  - Prevalence of hepatitis B or C virus infections in patients with non-Hodgkin's
      lymphoma.
AB  - BACKGROUND: Hepatitis C virus (HCV) and hepatitis B virus (HBV) are not only
      hepatotropic, but also lymphotropic viruses. Recently, some reports suggested
      that these viruses may participate in the development of malignant
      lymphoproliferative disorders. METHODS: We investigated the prevalence of HCV or
      HBV infection in 348 patients with non-Hodgkin's lymphoma (NHL). We also compared
      these prevalences with those in blood donors as a control group representing the
      general population in our area (n= 1,513,358). Next, we evaluated the clinical
      and pathologic characteristics of HCV- or HBV-infected NHL cases. Non-Hodgkin's
      lymphoma was classified according to the Working Formulation classification.
      RESULTS: Thirty-seven cases (14.9%) were found to be infected with HCV or HBV; of
      these, 20 (8.1%) were infected with HCV, and 17 (6.9%) with HBV. In male NHL
      patients, the rate of HCV infection was significantly higher than in an age- and
      sex-matched population in the same area (P < 0.001, Mantel-Haenszel test). The
      rate of HBV infection also tended to be higher in the population (P = 0.0551). In
      contrast, in female NHL patients, the rate of HCV or HBV infection was not higher
      than in the general population. In HCV-infected cases, 15 cases (75%) had B-cell
      NHL and 16 cases (80%) were classified as being in the intermediate grade; B-cell
      NHL comprised 83% of all NHL cases. In HBV-infected NHL cases, 11 (65%) were of B
      cell type and 10 (58%) were classified as being in the intermediate grade.
      CONCLUSIONS: The high prevalence of HCV or HBV infections in our study population
      provides epidemiologic evidence suggesting that HCV and HBV infections may be
      involved in the development of a subgroup of NHL in males. Our investigation also
      revealed that both HCV- and HBV-infected NHL patients showed certain similarities
      in clinical and pathologic manifestations.

PMID- 11207905
TI  - Imaging and clinical characteristics of focal atrophy of segments 2 and 3 in
      primary sclerosing cholangitis.
AB  - BACKGROUND AND AIMS: Focal atrophy in primary sclerosing cholangitis (PSC) is
      usually thought to result from severe biliary stricture and focal biliary
      cirrhosis. Atrophy of the left lateral segments (segments 2 and 3) are striking
      when observed grossly. This type of atrophy may be subtle on cross-sectional
      imaging and by endoscopic retrograde cholangiopancreatography (ERCP) because of
      the peripheral location and compensatory hypertrophy of other parts of the liver.
      We examined 44 consecutive PSC patients to determine the incidence and clinical
      characteristics of this abnormality, and to correlate imaging studies with the
      gross appearance. METHODS: We reviewed all cases of PSC encountered over a 3 year
      period ascertained from the liver disease registry. Magnetic resonance imaging or
      CT images were re-examined for evidence of segment 2 and 3 atrophy. RESULTS: Four
      of 44 patients had focal segment 2 and 3 atrophy. These four had been confirmed
      laparoscopically or by inspection of the liver explant. The remaining segments of
      the liver were relatively spared of injury in two of the patients, and three of
      the four patients had preserved synthetic function without evidence of portal
      hypertension. While the abnormality is clearly visible on cross-sectional
      imaging, its peripheral location caused it to be an unobtrusive. Likewise, ERCP
      did not clearly reveal the abnormality on initial inspection. CONCLUSIONS: We
      conclude that focal atrophy of segments 2 and 3 is a sometimes early and subtle
      finding in PSC that may be overlooked in cross-sectional imaging or ERCP unless
      specifically sought.

PMID- 11207906
TI  - Images of interest. Hepatobiliary and pancreatic: an old woman with gallstones.

PMID- 11207907
TI  - Images of interest. Gastrointestinal: gastric volvulus.

PMID- 11207908
TI  - Hepatobiliary and pancreatic: Commentary.

PMID- 11207909
TI  - Sphincter of Oddi dysfunction associated with choledochal cyst.
AB  - The pathophysiology of choledochal cysts remains unclear, although an association
      with anomalous pancreato-biliary junction and the reflux of pancreatic enzymes
      into the biliary tree is known. Sphincter of Oddi (SO) manometry was performed in
      three patients with choledochal cysts. All patients exhibited an elevated basal
      pressure diagnostic of sphincter of Oddi dysfunction. Two patients exhibited
      anomalous pancreato-biliary junction. This report suggests an association between
      the choledochal cyst and sphincter of Oddi dysfunction, and may suggest that SO
      dysfunction plays a role in choledochal cyst formation.

PMID- 11207910
TI  - Duodenal tuberculosis with a choledocho-duodenal fistula.
AB  - A 22-year-old man visited our hospital (National Cancer Center Hospital East)
      complaining of fatigue and anorexia. A laboratory investigation demonstrated a
      biochemical 'picture' of obstructive jaundice. An abdominal CT showed a low
      density mass in the retropancreatic area with multiple enlarged periportal lymph
      nodes. Upper gastrointestinal endoscopy revealed active ulceration on the dorsal
      wall of the descending part of the duodenum, and histopathology of the biopsy
      specimen revealed an ulcer with reactive inflammatory cell infiltration; no tumor
      cells were detected. The possibility of neoplasm had been ruled out by the use of
      CT and angiography. The jaundice recovered spontaneously and the abdominal mass
      gradually decreased in size. Endoscopic retrograde pancreatography showed no
      evidence of pancreatic disease; however, endoscopic retrograde cholangiography
      showed a choledocho-duodenal fistula. This patient showed hypersensitivity
      against the tuberculin skin test and Mycobacterium tuberculosis was successfully
      detected in gastric juice by using a polymerase chain reaction method and
      culture. Biopsy samples obtained from the duodenal ulcer at the second upper
      gastrointestinal endoscopy showed chronic inflammation with an epithelioid
      granuloma, suggesting tuberculosis. We thus diagnosed this case as a duodenal
      tuberculosis with a choledocho-duodenal fistula. To the best of our knowledge,
      there has been no report available of duodenal tuberculosis being the cause of a
      choledocho-duodenal fistula.

PMID- 11207912
TI  - Editorial.

PMID- 11207911
TI  - Changes in titers of antimitochondrial and antinuclear antibodies during the
      course of primary biliary cirrhosis.
AB  - A case of primary biliary cirrhosis (PBC) in whom a complete biochemical (serum
      bilirubin, transaminases and alkaline phosphatase) remission was noted after
      combination treatment with ursodeoxycholic acid (UDCA) and corticosteroid is
      reported. The antimitochondrial antibody (AMA) detected by indirect
      immunofluorescence was initially positive, and the antinuclear antibody (ANA) was
      negative, but these two antibodies subsequently fluctuated independently (AMA
      positive/ANA-negative, AMA-negative/ANA-negative, AMA-negative/ANA-positive, AMA
      positive/ANA-positive, and again AMA-negative/ANA-positive) in spite of a lack of
      histopathological improvement in the liver after treatment. The clinical
      presentation in our case suggests that in some cases the diagnosis of PBC or so
      called autoimmune cholangitis (AIC) might depend on the 'phase' of the same
      disease. Our results also suggest that detailed immunoreactive profiles against 2
      oxo-acid dehydrogenase complex (2-OADC) enzymes by using immunoblotting, together
      with a serial histological examination, should provide more precise information
      for a diagnosis of PBC.

PMID- 11207913
TI  - Polymer composites in 2000: structure, performance, cost and compromise.
AB  - Polymer matrix composites are based on the combination of stiff, strong
      reinforcing fibres with either thermosetting or thermoplastic polymer matrices.
      Since their introduction in the early 1940s, the world market has increased to
      some 5 million tonnes per annum, and some composites may now be considered
      commodity materials. The spectrum of fibre-reinforced plastics ranges from very
      high-performance speciality materials costing more than $1000/kg to these
      commodity composites, with more modest properties, at less than $10/kg. The
      performance of composites is determined by the properties of the fibre, the
      fraction of fibre in the composite and the structure, or fibre architecture.
      Processing technologies have been developed which maximise fibre content and
      precisely control the fibre architecture allowing for the manufacture of
      components with mechanical properties tailored to service requirements. Many
      composites offer significant advantages in specific stiffness and/or specific
      strength over metals. This makes them attractive for applications where high
      mechanical performance and minimum weight are important. However, the wider
      acceptance of composites is based on their ability to offer a more cost-effective
      alternative. In particular, composites also allow a dramatic reduction in the
      parts count in many applications, which leads to significant manufacturing
      advantages and greater economy.

PMID- 11207914
TI  - Active coatings for SiC particles to reduce the degradation by liquid aluminium
      during processing of aluminium matrix composites: study of interfacial reactions.
AB  - The application of a surface coating on SiC particles is studied as an
      alternative means of solving problems of reactivity between SiC reinforcements
      and molten aluminium and problems of low wetting which limit the application of
      casting routes for fabrication of Al-SiCp composites. The selected active barrier
      was a ceramic composed of SiO2, which was generated by controlled oxidation of
      the SiC particles. The coating behaves as an active barrier, preventing a direct
      reaction between molten aluminium and SiC to form Al4C3 as the main degradation
      product. At the same time, the SiO2 provokes other interfacial reactions, which
      are responsible for an improvement in wetting behaviour. Composites were prepared
      by mixing and compacting SiC particles with Al powders followed by melting in a
      vacuum furnace, and varying the residence time. Transmission electron microscopy
      (TEM), high resolution electron microscopy (HREM) and field emission TEM were
      employed as the main characterization techniques to study the interfacial
      reactions occurring between the barrier and the molten aluminium. These studies
      showed that the SiO2 coating behaves as an active barrier which reacts with the
      molten Al to form a glassy phase Al-Si-O. This compound underwent partial
      crystallization during the composite manufacture to form mullite. The formation
      of an outer crystalline layer, composed mainly of Al2O3, was also detected.
      Participation of other secondary interface reactions inside the active barrier
      was also identified by HREM techniques.

PMID- 11207915
TI  - Epitaxial nucleation of crystallization at polymer-filler interfaces.
AB  - In polymer composites the interaction between polymer matrix and filler particles
      often results in nucleation of spherulites. The principles of polymer crystal
      nucleation and spherulite growth are investigated using scanning transmission
      electron microscopy (STEM) and microdiffraction techniques in combination with
      polarized light microscopy. Simultaneous diffraction patterns from the interface
      of the filler and the polymer were obtained. Special precautions for successful
      recording of the diffraction patterns were used to overcome the rapid loss of
      polymer crystallinity, resulting from electron beam damage. Analysis of the
      diffraction patterns has shown that partial epitaxial correlation between the
      atomic periodicity of the particle surface and the molecular periodicity of
      polymer chains is always present when spherulites are nucleated. STEM images show
      that only large particles, with well developed facets (cleavage planes), are
      nucleating. The nucleating efficiency of the filler is therefore dependent on the
      size as well as on the crystallographic orientation of the facet. Small
      particles, or those with no suitable facets, do not affect the crystalline
      structure of the polymer. It is also shown that anisotropic polymer structures
      can be formed by inhomogeneous dispersion of nucleating filler particles.

PMID- 11207916
TI  - High-resolution electron microscope observation of interface microstructure of a
      cast Al-Mg-Si-Bi-Pb(6262)/Al2O3p composite.
AB  - High-resolution electron microscopy was employed to characterize the interface
      structure of a cast Al-Mg-Si-Bi-Pb aluminium(6262)-based composite reinforced by
      alpha alumina particles with a trace of beta alumina in order to investigate the
      behaviour of alloying elements in cast composites. Except for a few primary Mg2Si
      particles, few reaction products were detected at the interface of Al/alpha-Al2O3
      due to the unfavourable reaction kinetics during the squeeze-casting process. The
      Mg2Si particle has an orientation relationship with alpha-Al2O3 of
      [011]Mg2Si//[1210]alpha-Al2O3 (111)Mg2Si//(0006)alpha-Al2O3. A significant amount
      of MgAl2O4 was found on the surface of the beta-Al2O3 particles, which is in
      contrast to the small degree of reaction found on alpha-Al2O3 particles. MgAl2O4
      and beta-Al2O3 particles have the following orientation relationship:
      [011]MgAl2O4//[1210]beta-Al2O3 (111) MgAl2O4//(0006)beta-Al2O3. The similar
      crystal structure of beta-Al2O3 to MgAl2O4 favours MgAl2O4 nucleation and growth
      on the surface of beta-Al2O3. Interfacial energy minimization dominates the
      atomic structure of the interface with the result that close packed planes and
      directions in the Al2O3 reinforcement and reaction products are parallel to the
      interfaces. Bi and Pb were found in the form of metallic nanometre particles
      between Al2O3 particles, or between the MgAl2O4 and Al2O3 particles, or in the
      open channels of beta-Al2O3 filled by the Al matrix.

PMID- 11207917
TI  - Voronoi cells, fractal dimensions and fibre composites.
AB  - The use of fibre-reinforced polymer matrix composite materials is growing at a
      faster rate than the gross domestic product (GDP) in many countries. An improved
      understanding of their processing and mechanical behaviour would extend the
      potential applications of these materials. For unidirectional composites, it is
      predicted that localized absence of fibres is related to longitudinal compression
      failure. The use of woven reinforcements permits more effective manufacture than
      for unidirectional fibres. It has been demonstrated experimentally that
      compression strengths of woven composites are reduced when fibres are clustered.
      Summerscales predicted that clustering of fibres would increase the permeability
      of the reinforcement and hence expedite the processing of these materials.
      Commercial fabrics are available which employ this concept using flow-enhancing
      bound tows. The net effect of clustering fibres is to enhance processability
      whilst reducing the mechanical properties. The effects reported above were
      qualitative correlations. To improve the design tools for reinforcement fabrics
      we have sought to quantify the changes in the micro/meso-structure of woven
      reinforcement fabrics. Gross differences in the appearance of laminate sections
      are apparent for different weave styles. The use of automated image analysis is
      essential for the quantification of subtle changes in fabric architecture. This
      paper considers Voronoi tessellation and fractal dimensions for the
      quantification of the microstructures of woven fibre-reinforced composites. It
      reviews our studies in the last decade of the process-property-structure
      relationships for commercial and experimental fabric reinforcements in an attempt
      to resolve the processing vs. properties dilemma. A new flow-enhancement concept
      has been developed which has a reduced impact on laminate mechanical properties.

PMID- 11207918
TI  - Thermal imaging of composites.
AB  - Active thermal imaging techniques and their applications to composite materials
      are reviewed. The techniques included are transient thermography, scanning
      thermal microscopy and scanning thermal probe microscopy. The factors that affect
      the images produced by both pulsed and periodic forms of active heating are
      considered. For pulsed heating, experimental and numerical modelling results for
      carbon fibre-reinforced plastic are used to show how the resolution of subsurface
      features depends on their size and depth and on the anisotropy in thermal
      materials properties common in such composites. For periodic heating, thermal
      wave characteristics are introduced to show how the resolution of subsurface
      features also depends on modulation frequency and focal spot radius. Examples are
      given of the applications of scanning thermal microscopy and scanning thermal
      probe microscopy that illustrate the potential of these techniques for the
      imaging of composite materials.

PMID- 11207919
TI  - Localization of strain in metal matrix composites studied by a scanning electron
      microscope-based grating method.
AB  - The deformation characteristics of the metal matrix composites Ag/Ni and Al/Al2O3
      are studied at microstructural level by a scanning electron microscopebased
      grating method and finite element (FE) simulation. The measured strain was found
      to localize in narrow bands in the ductile matrix of both composites. In the case
      of the Al/Al2O3 composite, the bands are preferentially initiated in Al regions
      adjacent to the interface of large Al2O3 particles, leading to local strain
      maxima. The band positions found in the Ag/Ni composite are also affected by the
      less deformable Ni phase, but strain localization first occurs by sliding of
      single Ag grains sometimes located away from the Ni phase. Using a FE model of
      real phase geometry and measured border displacements as boundary conditions, the
      simulation agrees reasonably with the experiment. The differences in the case of
      the Al/Al2O3 composite are due to particle cracks and voids at the
      particle/matrix interface. This effect was found in the experiment but not
      considered in modelling. For the Ag/Ni composite the band positions agree fairly
      well. However, the level and gradient of strain is clearly different as the
      crystallographic orientation of the Ag grains was not accounted for in modelling.

PMID- 11207920
TI  - Microstructural analysis of silicon carbide monofilaments.
AB  - In the development of monofilaments, a good understanding of the process/property
      relationships is essential. Transmission electron microscopy (TEM) is a powerful
      tool but too slow and expensive to be used routinely. Alternative, cheaper
      techniques have therefore been investigated. The microstructures of three SiC
      monofilaments (DERA Sigma SM1140+, Textron SCS-6 and Ultra-SCS) and some
      experimental samples were studied using a combination of TEM, electron microprobe
      analysis, Raman microprobe analysis, thermo-gravimetric analysis (TGA) and
      differential scanning calorimetry (DSC). It was found that the Raman technique
      was complementary to TEM and easily identified the presence of amorphous C and
      Si. These could not be seen by electron or X-ray diffraction techniques. DSC
      indicated the presence of free Si in the DERA Sigma SM1140+ monofilament by a
      distinctive peak at approximately 1400 degrees C. TGA showed the reaction of
      monofilament components with gaseous species. The Textron SCS-6 and Ultra species
      lost weight as C was oxidized to gaseous CO. By contrast, the Sigma monofilament
      gained weight from formation of SiO2 from the free Si. The separations of the
      transverse optical phonon peaks in the Raman spectra were correlated with the
      density of stacking faults in the SiC crystallites. This was similar in all
      monofilaments. Analysis of the polarization of the Raman scattering gave
      information on the orientation of crystallites. The crystallites in SM1140+ and
      SCS-6 were orientated predominantly with the <111> parallel to the radius.
      Preliminary interpretation of the polarized Raman scattering from Ultra-SCS
      indicated more than one orientation of crystallite. One possibility was a mixture
      of <111> and <110> directions parallel to the radius.

PMID- 11207921
TI  - Simulation and quantitative assessment of homogeneous and inhomogeneous particle
      distributions in particulate metal matrix composites.
AB  - Reinforcement distributions play an important role in various aspects of the
      processing and final mechanical behaviour of particulate metal matrix composites
      (PMMCs). Methods for quantifying spatial distribution in such materials are,
      however, poorly developed, particularly in relation to the range of particle
      size, shape and orientation that may be present in any one system. The present
      work investigates via computer simulations the influences of particle morphology,
      homogeneity and inhomogeneity on spatial distribution measurements obtained by
      finite-body tessellation. Distribution inhomogeneity was simulated both by the
      segregation of particles away from specified regions within a microstructure and
      by generating point density peaks at random locations within a microstructure.
      Both isotropic and anisotropic inhomogeneous distributions were considered to
      simulate distribution patterns in PMMCs before and after mechanical working. It
      was found that the coefficient of variation of the mean near-neighbour distance
      (COV(dmean)), derived from particle interfaces using finite-body tessellation,
      was essentially independent of particle shape, size distribution, orientation and
      area fraction in homogeneous (random) distributions, but showed great sensitivity
      to inhomogeneity. Increased values of COV(dmean) were seen for both forms of
      inhomogeneous distributions considered here, with little influence of particle
      morphology. The COV(dmean) was also seen to be sensitive to anisotropic
      clustering, the presence of which was identified via nearest-neighbour angles and
      cell orientations. Although generally formulated for PMMCs, the present results
      may be generalized to other systems containing low aspect ratio finite bodies of
      low to moderate area fraction.

PMID- 11207922
TI  - Microstructural analysis of a FeAl/quasicrystal-based composite prepared using a
      focused ion beam miller.
AB  - A composite consisting of a brittle multiphase matrix containing both an Al-based
      quasicrystalline phase (psi) and an ordered body centred cubic phase (beta) and a
      relatively ductile ordered body centred cubic intermetallic FeAl phase has been
      developed as an abrasive wear-resistant coating material. It is applied as a 500
      um thick layer onto stainless steel substrates through plasma spray processing.
      The microstructure of such materials can be readily examined by optical and
      scanning electron microscopy, but the inherent difficulty of preparing
      transmission electron microscope (TEM) samples has inhibited higher resolution
      studies. However, the relatively recent development of the focused ion beam (FIB)
      miller as a tool in materials science provides a method ideal for the preparation
      of TEM specimens of these materials. In this study a coating consisting of a
      mixture of an Al-Cu-Fe based quasicrystal and FeAl+Cr was deposited on to a 304
      stainless steel substrate. TEM specimens were prepared using a FIB and subjected
      to detailed microstructural characterization. The structure consisted of
      elongated bands of a FeAl phase about 100 nm in width and several micrometres in
      length, which enclosed more equiaxed regions about 1 um in diameter that
      consisted of fine mixtures of quasicrystal and two Al-Fe-Cu phases
      isostructurally related to FeAl.

PMID- 11207923
TI  - Subsurface deformation of machined Al2O3 and Al2O3/5vol%SiC nanocomposite.
AB  - Under machine grinding, material removal in monolithic Al2O3 is by intergranular
      fracture and grain pull-out. In comparison, under the same grinding conditions,
      an Al2O3/5%SiC nanocomposite undergoes significant surface grooving and
      intragranular fracture. The subsurface deformation mechanisms were investigated
      by cross-sectional transmission electron microscopy. For Al2O3, the residual
      deformation zone was localized very close to the surface in the first layer of
      grains, with dislocations occurring only within 1.5 um of the top surface and a
      high density of basal twins penetrating to a depth of one single grain. Cracks
      were present along grain boundaries or basal twin interfaces. For Al2O3/SiC
      nanocomposites, the main residual plastic deformation is observed to be
      dislocations activated to a depth of about 10 um (approx. 3-4 grains), with
      twinning rarely observed. Possible mechanisms by which the SiC particles
      influence the subsurface deformation and material removal modes are discussed.

PMID- 11207924
TI  - Applications of microscopy to the deformation and fracture of rubber-toughened
      polymers.
AB  - The principal mechanisms of inelastic deformation in rubber-toughened plastics,
      and in other similar multiphase polymers, are shear yielding and multiple crazing
      in the rigid matrix phase, and cavitation in the soft disperse phase. Microscopy
      has played a very important part in the identification and study of these
      mechanisms. However, no one technique has been predominant. Polarized-light
      microscopy is useful for observing crazing, and has proved to be the most
      effective method for studying shear yielding, whereas transmission electron
      microscopy has provided valuable insights into the cavitation behaviour of
      complex rubber particles. Scanning electron microscopy has made significant
      contributions in the study of all three micromechanisms. In some microscopy
      investigations, thin sections have been strained in situ on the microscope stage.
      In others, specimens have been deformed in the bulk state before being polished
      and etched, or stained and microtomed, or coated with a thin layer of metal, in
      preparation for examination in the microscope. The importance of combining
      microscopy with other, complementary methods for studying deformation
      micromechanics is emphasized, and two novel methods for detecting cavitation in
      multiphase polymers are discussed briefly.

PMID- 11207925
TI  - Microcracking mechanism in a SiCf-SiBC composite creep-tested in argon.
AB  - This paper addresses the creep behaviour of a woven SiCf-SiBC composite, tested
      in tension under a partial pressure of argon, between 1273 K and 1473 K. It
      appears that the creep strain begins from 1273 K and becomes larger at higher
      temperatures. Moreover, the shapes of the creep curves led to the assumption of
      the existence of two competing deformation mechanisms depending on the
      temperature domain. The creep mechanism involved is microcrack damage-creep. From
      higher resolution studies at higher scales (scanning electron microscopy,
      transmission electron microscopy (TEM) and high resolution electron microscopy
      (HREM)), many types of damage were observed, for example matrix microcracking,
      fibre/matrix debonding and fibre/matrix sliding. The observations via TEM and
      HREM enabled us to specify the existence or not of the classical creep mechanism
      of the constituents of the composite, and also to characterize the behaviour and
      the role of the different interfaces and especially of the pyrocarbon interphase.
      These multiscale observations will be discussed in order to highlight the creep
      damage mechanism as a function of temperature of the SiCf-SiBC composites.

PMID- 11207926
TI  - Microstructure, toughness and flexural strength of self-reinforced silicon
      nitride ceramics doped with yttrium oxide and ytterbium oxide.
AB  - Self-reinforced silicon nitride ceramics with additions of either yttrium oxide
      or ytterbium oxide have been investigated at room temperature after various
      processing heat treatments. Devitrification of the intergranular phase in these
      materials is very sensitive to the heat treatment used during processing and does
      not necessarily improve their strength and toughness. Hot-pressed ceramics
      without a subsequent devitrification heat treatment were the strongest. The
      ytterbium oxide-doped silicon nitride ceramics were consistently tougher, but
      less strong, than the yttrium oxide-doped silicon nitride ceramics. In all the
      ceramics examined, the fracture toughness showed evidence for R-curve behaviour.
      This was most significant in pressureless sintered ytterbium oxide-doped silicon
      nitride ceramics. A number of toughening mechanisms, including crack deflection,
      bridging, and fibre-like grain pull-out, were observed during microstructural
      analysis of the ceramics. In common with other silicon nitride-based ceramics,
      thin amorphous films were found at the grain boundaries in each of the ceramics
      examined. Arrays of dislocations left in the elongated silicon nitride grains
      after processing were found to belong to the {101;0}<0001> primary slip system.

PMID- 11207927
TI  - Structural studies of pulsed-laser deposited nanocomposite metal-oxide films.
AB  - Pulsed laser deposition in vacuum has been used to develop metal-oxide
      nanocomposite films with well controlled structural quality. Results for the
      copper-aluminium oxide (Cu:Al2O3) system are used to illustrate the main
      morphological and structural features of these films. High resolution
      transmission electron microscopy (TEM) analysis shows that the films consist of
      Cu nanocrystals with average dimensions that can be controlled between 2 nm and
      10 nm embedded in an amorphous Al2O3 matrix. It is observed that the in-plane
      shape of the nanocrystals evolves from circular to elongated, and the number of
      nanocrystals per unit area decreases as their size increases. This evolution is
      explained in terms of nucleation at the substrate surface and coalescence during
      the later stages of growth. The thermal stability of the films has been studied
      by in situ TEM annealing and no transformation could be observed up to about 800
      degrees C when partial crystallization of the Al2O3 starts.

PMID- 11207928
TI  - Subsurface nanoindentation deformation of Cu-Al multilayers mapped in 3D by
      focused ion beam microscopy.
AB  - A new technique for the three-dimensional analysis of subsurface damage of
      nanocomposites is presented. Cu-Al multilayers, grown epitaxially on (0001)Al2O3
      single crystals by ultra high vacuum molecular beam epitaxy, have been deformed
      by nanoindentation. Systematic slicing and imaging of the deformed region by
      focused ion beam microscopy enables a 3D data set of the damaged region to be
      collected. From this 3D data set, profiles of the deformed sub-surface interfaces
      can be extracted. This enables the deformation of the individual layers,
      substrate and overall film thickness to be determined around the damage site.
      These 3D deformation maps have exciting implications for the analysis of
      mechanical deformation of nanocomposites on a sub-micrometre scale.

PMID- 11207929
TI  - Accumulation of in-vivo fatigue microdamage and its relation to biomechanical
      properties in ageing human cortical bone.
AB  - Bone matrix accumulates microdamage in the form of microcracks as a result of
      everyday cyclic loading activities. In two very recent studies, which used
      conventional histological stains and light microscopy techniques, the amount of
      this in-vivo microdamage in the cortices of long bones has been shown to increase
      with age. These articles have suggested that in-vivo microcracks may have an
      effect on the material properties of the tissue. However, a precise quantitative
      relationship between the number of microcracks and the mechanical properties of
      these same bones has not been produced before, and in particular the way the
      microcracks may affect the stiffness, the strength or possibly the toughness of
      the tissue. This article presents an examination of the in-vivo microdamage in
      human bones by the use of laser scanning confocal microscopy, which offers better
      discrimination and allows examination of the cracks in-situ. Quantification of in
      vivo fatigue microcracks was performed by counting the microcrack numerical
      density and surface density in specimens for which we have previously derived a
      full set of mechanical properties as a function of age. It is shown that bone
      microdamage relates more to the toughness (measured by three different measures)
      of ageing bone tissue than to its stiffness and strength. The result allows us
      (i) to re-evaluate the fragility of ageing human bone and put more emphasis on
      its energy-related resistance to fracture than perhaps on its stiffness or
      strength and also (ii) to understand more fully the causal relationship and
      interactions between microcracks and tissue toughness.

PMID- 11207930
TI  - Dynamic experimentation on the confocal laser scanning microscope: application to
      soft-solid, composite food materials.
AB  - Confocal laser scanning microscopy (CLSM) is used to follow the dynamic
      structural evolution of several phase-separated mixed biopolymer gel composites.
      Two protein/polysaccharide mixed gel systems were examined: gelatin/maltodextrin
      and gelatin/agarose. These materials exhibit 'emulsion-like' structures, with
      included spherical particles of one phase (i.e. polymer A) within a continuous
      matrix of the second (i.e. polymer B). Compositional control of these materials
      allows the phase order to be inverted (i.e. polymer B included and polymer A
      continuous), giving four basic variants for the present composites. Tension and
      compression mechanical tests were conducted dynamically on the CLSM, with
      crack/microstructure interactions investigated using a notched compact tension
      geometry. Gelatin/maltodextrin composites exhibit a 'pseudo-yielding'
      stress/strain response in both tension and compression, when the gelatin-rich
      phase is continuous, which was attributed to debonding of the particle/matrix
      interface. This behaviour is significantly less apparent for both the
      gelatin/agarose composites, and the maltodextrin continuous gelatin/maltodextrin
      composites, with these materials responding in a nominally linear elastic manner.
      Values of the interfacial fracture energy for selected compositions of the two
      biopolymer systems were determined by 90 degrees peel testing, where a gelatin
      layer was peeled from either a maltodextrin or agarose substrate. For biopolymer
      layers 'cast' together, a value of 0.2 +/- 0.2 J m-2 was obtained for the
      fracture energy of a gelatin/maltodextrin interface, while a significantly higher
      value of 6.5 +/- 0.2 J m-2 was determined for a gelatin/agarose interface. The
      interfacial fracture energy of the two mixed systems was also determined
      following an indirect elastomer composite debonding model. An interfacial
      fracture energy of approximately 0.25 J m-2 was determined using this approach
      for the gelatin continuous gelatin/maltodextrin composite, which compares
      favourably with the value calculated directly by peel testing (i.e. approximately
      0.2 J m-2). A somewhat higher value was estimated for the gelatin continuous
      gelatin/agarose system (1.0-2.0 J m-2), using this model, although there are
      severe limitations to this approach for this mixed gel system. In the present
      case, it is believed that the differing mechanical response of the two mixed
      biopolymer systems, when the gelatin phase is continuous, arises from the order
      of magnitude difference in interfacial fracture energy. It is postulated that
      polymer interdiffusion may occur across the interface for the gelatin/agarose
      system, to a significantly greater extent than for interfaces between gelatin and
      maltodextrin, resulting in a higher interfacial fracture energy.

PMID- 11207931
TI  - Interfacial reaction and its influence on the mechanical properties of the ASZ
      short fibre-reinforced Al alloy composite.
AB  - The effect of interfacial reaction on the mechanical properties of the AC8A Al
      alloy reinforced with ASZ short fibres (ASZ/AC8A composite) was studied. In the
      ASZ/AC8A composite, the interfacial reaction was observed to proceed between the
      SiO2 binder layer and Mg of the matrix to form MgAl2O4 at the interface.
      Formation of MgAl2O4 was believed to enhance the interfacial bonding strength,
      resulting in the improved composite strength. However, the interfacial reaction
      in the ASZ/AC8A composite always took place at the expense of Mg in the matrix,
      resulting in the composite devoid of the Mg bearing precipitates such as Al2CuMg
      and Mg2Si. Interfacial reaction mechanisms were investigated for composites
      containing various Mg contents. The resultant mechanical properties of the
      composite were measured to determine the adequate amount of Mg within the
      composite. Microstructural changes of the composite were observed using
      transmission electron microscopy and differential scanning calorimetry to provide
      qualitative analyses on the experimental observations.

PMID- 11207932
TI  - Transmission electron microscopy studies of squeeze cast Al-AlN composites.
AB  - Aluminium-matrix composites containing approximately 45 vol.% AlN particles were
      fabricated by melt infiltration of aluminium into an AlN preform under a pressure
      up to 130 MPa. Three types of aluminium alloy (2024, 6060 and 5754) were used.
      The as-prepared composites were studied by light microscopy, scanning and
      transmission electron microscopies, and energy-dispersive X-ray spectroscopy. As
      a result of the melt infiltration process, the composites are very dense and the
      microstructure shows a homogeneous distribution of the reinforcement. The
      interfaces are clean with very little porosity. Composites with 2024 and 6060
      matrices were carefully studied by transmission electron microscopy (TEM) and
      high resolution electron microscopy (HREM) after heat treatments. Dislocation
      density in the matrix of the reinforced material increases due to the difference
      in thermal expansion coefficients of aluminium alloys and AlN. This can induce an
      accelerated ageing response of the coherent and semicoherent precipitations of
      age-hardened matrices. This behaviour has been studied in the 2024 and 6060
      composites by using microhardness measurements and TEM. Reactions between the AlN
      reinforcement and aluminium matrices (6060 and 5754) were observed and analysed
      by TEM. Matrices containing some of magnesium display a MgAl2O4 spinel formation
      at the AlN/matrix interface. The spinel formation is probably due to the reaction
      between magnesium of the matrix and the thin Al2O3 layer on the AlN surfaces.
      This reaction can affect the mechanical behaviour of the composite infiltrated
      with the 5754 matrix. This has been confirmed by overageing some samples at high
      temperatures (300 degrees C and 550 degrees C) for 10 days in order to emphasize
      the interfacial reactions.

PMID- 11207933
TI  - Reducing chemical vapour infiltration time for ceramic matrix composites.
AB  - Conventional routes to producing ceramic matrix composites (CMCs) require the use
      of high temperatures to sinter the individual ceramic particles of the matrix
      together. Sintering temperatures are typically much higher than the upper
      temperature limits of the fibres. This paper details preliminary work carried out
      on producing a CMC via chemical vapour infiltration (CVI), a process that
      involves lower processing temperatures, thus avoiding fibre degradation. The CVI
      process has been modified and supplemented in an attempt to reduce the CVI
      process time and to lower the cost of this typically expensive process. To this
      end microwave-enhanced CVI (MECVI) has been chosen, along with two alternative
      pre-infiltration steps: electrophoretic infiltration and vacuum bagging. The
      system under investigation is based on silicon carbide fibres within a silicon
      carbide matrix (SiCf/SiC). The results demonstrate that both approaches result in
      an enhanced initial density and a consequent significant reduction in the time
      required for the MECVI processing step. Dual energy X-ray absorptiometry was used
      as a non-destructive, density evaluation technique. Initial results indicate that
      the presence of the SiC powder in the pre-form changes the deposition profile
      during the MECVI process.

PMID- 11207934
TI  - Monitoring unidirectional carbon/carbon composite processing by light microscopy.
AB  - Unidirectional carbon/carbon composites were prepared using polyacrylonitrile
      based carbon fibres and a commercial coal-tar pitch. The preparation includes a
      three-sequential-step process: (i) prepreging, (ii) moulding/pressing, and (iii)
      carbonization to 1000 degrees C. The effect of the process parameters including
      pressure, mould characteristics, and temperature and duration of pressure
      application on the microstructure of composites was monitored by light
      microscopy. Results show that the application of a pressure of 1 MPa close to the
      temperature of pitch solidification produces lower porosity composites. This
      porosity is significantly reduced when the solidification of the pitch is
      tempered by the introduction of a soak time of 10 h at the temperature at which
      pressure is applied.

PMID- 11207935
TI  - Novel MMC microstructure with tailored distribution of the reinforcing phase.
AB  - Saffil short fibre agglomerates with diameters of 0.4 mm to 1 mm have been
      prepared using a tumbling technique. These were packed and infiltrated with
      molten 6061 Al alloy to make a metal matrix composite (MMC) with a novel
      microstructure in which the composite spheres are randomly distributed in the
      fibre-free aluminium matrix. In parallel, a commercial preform made of identical
      Saffil alumina short fibres and having the same fibre volume faction was used to
      prepare a conventional MMC by the same technique. Microstructural observation
      indicates that, within the composite spheres, the local volume fraction of fibre
      decreases from the outer layer to the centre region. The energy absorption during
      fracture was estimated by using a three point loading test on notched samples and
      was compared with that for conventional MMCs. Preliminary results suggest that
      this novel MMC possesses higher energy absorption capability and hence better
      damage tolerance. The fracture surfaces were examined by scanning electron
      microscopy in order to inform these experimental results.

PMID- 11207936
TI  - Photoresponsive Fischer 344 Rats are reproductively inhibited by melatonin and
      differ in 2-[125I] lodomelatonin binding from nonphotoresponsive Sprague-Dawley
      rats.
AB  - Many temperate-zone species use photoperiod as an environmental cue to regulate
      reproductive timing. Strains of laboratory rats differ in their responsiveness to
      photoperiod, with the Fischer 344 (F344) strain being the most responsive known.
      F344 rats and closely related strains that differ in photoresponsiveness may be
      useful models to study the mechanisms and genetic basis for photoresponsiveness.
      We tested two hypotheses: (i) that melatonin mediates photoresponsiveness in F344
      rats, as is the case in all other mammals tested, and (ii) that the location,
      abundance, or affinity of melatonin receptors, as estimated by the amount and
      location of binding of the radioligand 2-[125I]-iodomelatonin (IMEL) in the
      brain, might cause variation in photoresponsiveness among rat strains. Melatonin
      injections 1 h before lights off in a stimulatory photoperiod (L14 : D10) induced
      reproductive inhibition and reduced weight gain in a manner similar to short days
      of L8 : D16, while injections of ethanolic saline vehicle did not. Interestingly,
      melatonin injections administered during an inhibitory photoperiod (L10 : D14)
      caused greater inhibition of both reproduction and weight gain than short
      photoperiod alone. Pinealectomized F344 rats implanted subcutaneously with
      melatonin in a silastic capsule did not differ in testis size or body weight from
      controls with blank implants. The brains and pars tuberalis of the pituitary from
      photoresponsive F344 rats and nonphotoresponsive Harlan Sprague-Dawley (HSD) rats
      were processed for autoradiography using IMEL. We found significantly higher
      specific IMEL binding in the anterior and posterior regions of the
      paraventricular nucleus of the thalamus (PVNt) and reuniens nucleus of the
      thalamus of F344 rats than in the same areas in HSD rats. There were no
      differences between strains in specific IMEL binding in the medial PVNt,
      anteroventral and anterodorsal nucleus of the thalamus, suprachiasmatic nucleus,
      or the pars tuberalis. These results indicate that melatonin mediates
      photoresponsiveness in F344 rats. In addition, they provide support for the
      hypothesis that F344 rats may be photoresponsive due to differences from other
      strains in the location, density, or affinity of melatonin receptors.

PMID- 11207937
TI  - Corticosteroid effects on serotonin responses in granule cells of the rat dentate
      gyrus.
AB  - Granule cells in the rat dentate gyrus contain mineralocorticoid and
      glucocorticoid receptors to which the adrenal hormone corticosterone binds with
      differential affinity. These cells also express various receptor-subtypes for
      serotonin (5-HT), including the 5-HT1A receptor which mediates a membrane
      hyperpolarization accompanied by a decrease in membrane resistance. Earlier
      studies have shown that removal of corticosterone by adrenalectomy, particularly
      in the dentate gyrus, results in enhanced expression of the 5-HT1A receptor mRNA
      and increased 5-HT1A receptor binding capacity. This was normalized by activation
      of mineralocorticoid receptors or concurrent activation of both receptor types.
      In the present, intracellular recording study in vitro, we examined if the
      altered levels of 5-HT1A receptor mRNA and protein are associated with changes in
      the response to 5-HT. We found that the hyperpolarization and resistance decrease
      induced in granule cells by a submaximal (10 microM) dose of 5-HT were unaltered
      2-4 days after adrenalectomy, indicating a dissociation between corticosteroid
      actions on 5-HT1A receptor mRNA/protein levels and functional responses to 5-HT.
      Subsequent occupation of mineralocorticoid receptors in vitro significantly
      suppressed the 5-HT induced change in resistance, 1-4 h after steroid
      application. Compared to this, concurrent activation of glucocorticoid receptors
      led to large responses to 5-HT. This modulation by steroids was not observed with
      a higher dose of 5-HT (30 microM). The data suggest that with moderate amounts of
      5-HT, corticosteroids affect the information flow through the dentate gyrus such
      that excitatory transmission is promoted with predominant mineralocorticoid
      receptor activation and attenuated with additional glucocorticoid receptor
      occupation.

PMID- 11207938
TI  - Neural circuits regulating pulsatile luteinizing hormone release in the female
      guinea-pig: opioid, adrenergic and serotonergic interactions.
AB  - We studied three neurotransmitters involved in the regulation of pulsatile
      luteinizing hormone (LH) release: opioid peptides, serotonin and norepinephrine,
      using the ovariectomized guinea-pig. This is an attractive animal model due to
      the regularity of its LH pulses, enabling any disruptions to be clearly
      ascertained. In all experiments, a specific agonist or antagonist was
      administered, either alone or serially to enable detection of interactions, and
      effects on mean LH concentrations, pulse amplitude and interpulse interval were
      determined by PULSAR analysis. In the ovariectomized guinea-pig, catecholamines
      are stimulatory (acting through the alpha1 and alpha2 but not beta receptors,
      unlike other species), opioids inhibitory and serotonin permissively stimulatory
      to pulsatile LH release. Stimulatory effects of the opiate antagonist were not
      blocked by pretreatment with an alpha1- or alpha2-adrenergic antagonist.
      Similarly, pretreatment with the opiate antagonist did not prevent the
      suppression of LH release by alpha1 and alpha2 antagonists. This suggests that,
      in the guinea-pig, effects of opiates and catecholamines on LH release are
      exerted by independent pathways to luteinizing hormone releasing hormone (LHRH)
      neurones. For the opiate-serotonin interactions, pretreatment with the
      serotonergic antagonist did not block the stimulatory effect of the opiate
      antagonist on LH release. However, pretreatment with the opiate agonist could not
      be overcome by the serotonergic agonist. This suggests that the effects of the
      serotonin system on LHRH release may be indirectly mediated by opioid neurones.
      Taken together, these studies demonstrate that the three neurotransmitter systems
      studied are critically involved in normal pulsatile LH release in the female
      guinea-pig, and demonstrate novel functional relationships between the opioid and
      the adrenergic and serotonergic systems.

PMID- 11207939
TI  - Evidence for direct involvement of beta-catenin in phorbol ester-induced neurite
      outgrowth in GT1-1 hypothalamic neurones.
AB  - Gonadotropin-releasing hormone (GnRH) is a pivotal neuroendocrine regulator
      controlling reproductive functions. However, the scattered distribution of GnRH
      neurones in the mammalian brain has hindered studies on the development and
      differentiation of GnRH neurones. In the present study, we used the immortalized
      GnRH-producing GT1-1 cells to examine whether activation of protein kinase C
      (PKC) pathway with 12-O-tetradecanoyl-13-acetate (TPA) induces morphological and
      functional differentiation of GnRH neurones. TPA induced neurite outgrowth and
      inhibited proliferation of GT1-1 cells that were specifically antagonized by
      cotreatment of PKC inhibitor, calphostin C. The functional significance of TPA
      induced differentiation of GT1-1 cells was manifested in part by the changes in
      the effects of gamma-aminobutyric acid (GABA) on intracellular Ca2+ levels. In
      untreated GT1-1 cells, activation of GABA-A receptor with 10 microM muscimol
      increased intracellular Ca2+ levels, whereas such stimulatory effects disappeared
      in GT1-1 cells bearing neurites. Accordingly, muscimol could not stimulate GnRH
      release in TPA-treated GT1-1 cells. To elucidate the molecular mechanism
      underlying TPA-induced neurite outgrowth, we performed differential display
      reverse transcription-polymerase chain reaction. Among several genes that are
      affected by TPA treatment, we found a significant induction of beta-catenin mRNA
      expression. Along with the rapid induction of beta-catenin protein levels, we
      observed that beta-catenin was reallocated from cell-cell adhesion sites to the
      growth cones within 3 h of TPA treatment. Transient transfection studies with
      green fluorescent protein as a reporter gene demonstrated that beta-catenin
      overexpression alone can promote neurite outgrowth in GT1-1 cells. Moreover, TPA
      was found to increase the transcription-activational roles of beta-catenin.
      Together, these data provide evidence that beta-catenin is involved in the TPA
      induced functional differentiation of immortalized GnRH neurones.

PMID- 11207940
TI  - Effects of chronic bromocriptine treatment on tyrosine hydroxylase (TH) mRNA
      expression, TH activity and median eminence dopamine concentrations in ageing
      rats.
AB  - The purpose of this study was to investigate the age-related changes in the
      responsiveness of tuberoinfundibular dopamine (TIDA) neurones to chronic
      hypoprolactinemia induced by treatment with bromocriptine, a dopamine receptor
      agonist. In one experiment, TIDA neuronal activity after acute hypoprolactinemia
      or exogenous prolactin was monitored by measuring tyrosine hydroxylase (TH)
      activity in the stalk median eminence of middle-aged cycling female rats (10-12
      months), old constant oestrous rats (18-20 months) and old pseudopregnant rats
      (22-24 months). In another experiment, middle-aged cycling (10-12 months) rats
      were treated with bromocriptine for 6 or 12 months. TH activity was measured in
      the stalk median eminence, TH mRNA levels were measured in the arcuate nucleus
      and dopamine concentrations were measured in the arcuate nucleus and median
      eminence. Responsiveness of TIDA neurones to exogenous prolactin and to the
      withdrawal of bromocriptine in these rats was also tested. While the TIDA
      neurones in all three age groups responded to acute hypoprolactinemia by showing
      a reduction in TH activity, older rats failed to respond to exogenous prolactin
      administration. In contrast, chronic hypoprolactinemia for 12 months enabled the
      rats to retain TIDA neuronal responsiveness to exogenous prolactin. It also
      decreased TIDA neuronal function as measured by dopamine concentrations in the
      median eminence, TH activity in the stalk median eminence and TH mRNA in the
      arcuate nucleus of ageing rats. The restoration of the responsiveness of these
      neurones to prolactin stimulation in older rats demonstrates for the first time
      that hypoprolactinemia produced by chronic bromocriptine treatment indeed
      provides a neuroprotective effect on TIDA neurones. These results indicate that
      maintaining a low level of neuronal activity by lowering prolactin levels may be
      a contributing factor in retaining the plasticity of TIDA neurones.

PMID- 11207941
TI  - Increased synaptic input to gonadotropin releasing hormone cells in preoptic area
      grafts that support reproductive development in female hypogonadal mice.
AB  - Ultrastructural studies have established that gonadotropin releasing hormone
      (GnRH) neuronal cell bodies receive sparse synaptic input compared to other
      neuronal cell types. In the present studies, immunocytochemistry for the
      presynaptic marker synaptophysin, coupled with confocal microscopy, was employed
      to evaluate whether there was a difference in synaptic input to GnRH cells within
      preoptic area grafts (hypogonadal, HPG; preoptic area, POA) in hypogonadal female
      mice that did or did not show ovarian development. GnRH cells in HPG/POA mice
      with ovarian development exhibited significantly higher numbers of synaptophysin
      immunoreactive (syn-IR) appositions as compared with HPG/POA mice without ovarian
      development. This suggests that synaptic input to the grafted GnRH cells is
      important for the correction of reproductive functions in HPG/POA mice. Following
      mating, Fos immunoreactivity was present in several GnRH cells in HPG mice with
      successful POA grafts, indicating the establishment of neuronal projections
      conveying somatosensory information to the GnRH cells in these mice. The presence
      of a higher number of syn-IR appositions to GnRH cells in the successful grafts
      supports this hypothesis.

PMID- 11207942
TI  - Thyroid hormones regulate pituitary growth hormone secretagogue receptor gene
      expression.
AB  - Thyroid hormones regulate growth hormone (GH) secretion by actions both at the
      hypothalamus and at the pituitary gland. At the level of the pituitary, thyroid
      hormones increase GH and GH-releasing hormone receptor (GHRH-R) mRNA expression.
      To test if thyroid hormones might also regulate the pituitary expression of mRNA
      for the recently identified GH secretagogue (GHS) receptor, GHS-R, primary
      pituitary cell cultures from adult male rats were treated with triiodothyronine
      (T3) and GHS-R mRNA levels were assessed by reverse transcriptase-polymerase
      chain reaction. T3 increased pituitary GHS-R mRNA levels in a dose- and time
      dependent manner. The stimulatory action of T3 on GHS-R mRNA levels was also
      observed in the presence of the RNA synthesis inhibitor, actinomycin D,
      indicating that gene transcription is not required. Closer examination of the
      decay rates of GHS-R mRNA in the presence of actinomycin D revealed T3 extended
      the half-life of the GHS-R mRNA from 8 h (basal) to15 h, demonstrating that T3
      increases GHS-R mRNA levels in vitro by increasing message stability.

PMID- 11207943
TI  - Agonist-mediated endocytosis of rat somatostatin receptor subtype 3 involves beta
      arrestin and clathrin coated vesicles.
AB  - Agonist-induced endocytosis of somatostatin receptors determines subsequent
      cellular responsiveness to peptide agonist and influences somatostatin receptor
      scintigraphy, a technique to image various tumours. We examined the
      internalization of sst3HSV, an epitope-tagged type 3 somatostatin receptor, in
      transfected rat neuroendocrine insulinoma cells. Stimulation of these cells with
      somatostatin induced trafficking of coexpressed enhanced green fluorescence
      protein/beta-arrestin1 fusion protein and sst3HSV to colocalize in the same
      endocytic vesicles. Coexpression of a dominant negative mutant of the arrestin
      fusion protein with the receptor blocked the internalization of sst3HSV.
      Stimulation with somatostatin also induced the transient translocation of alpha
      adaptin, a component of the adaptor protein complex 2, to the plasma membrane.
      alpha-adaptin and clathrin colocalized with the receptor. By electron microscopy,
      we observed internalized sst3 in clathrin coated pits, endosomes and at the
      limiting membrane of multivesicular bodies, a location typical for receptors
      being recycled. Concordantly, we observed sst3HSV colocalized with Rab11 in a
      perinuclear compartment which is likely to correspond to the pericentriolar
      recycling endosome. Thus, agonist-induced endocytosis of sst3 depends on its
      interaction with beta-arrestin, involves the adaptor protein complex 2 and
      proceeds via clathrin coated vesicles to the recycling compartment.

PMID- 11207944
TI  - Effect of superior cervical ganglionectomy on 24-h variations in hormone
      secretion from the anterior hypophysis and in hypothalamic monoamine turnover
      during the preclinical phase of Freund's adjuvant arthritis in rats.
AB  - The effect of superior cervical ganglionectomy (SCGx) on 24-h rhythms of
      circulating adrenocorticotropic hormone (ACTH), growth hormone (GH), prolactin
      and luteinizing hormone (LH) and of hypothalamic noradrenaline content and
      dopamine and serotonin turnover, was assessed in rats 3 days after administering
      Freund's complete adjuvant. In sham-operated rats, Freund's adjuvant injection
      increased serum ACTH without affecting its diurnal rhythmicity. SCGx, performed
      10 days earlier, suppressed 24-h rhythmicity and augmented mean values of
      circulating ACTH. A depressive effect of immunization on GH release was found in
      both sham-operated and SCGx rats. GH concentrations did not exhibit diurnal
      rhythmicity and decreased after immunization. Time-of-day-related changes in
      serum prolactin were significant for all examined groups, except for SCGx
      immunized rats. Freund's adjuvant administration augmented prolactin secretion.
      Daily changes in serum LH concentration and a decrease after immunization were
      found in both sham-operated and SCGx rats. SCGx: (i) counteracted inhibition of
      daily variations of noradrenaline content in medial hypothalamus of Freund's
      adjuvant-injected rats; (ii) decreased anterior hypothalamic dopamine turnover
      and augmented it in the medial hypothalamus; (iii) lowered amplitude of serotonin
      turnover rhythm in medial hypothalamus. The data indicate that several early
      changes in levels and 24-h rhythms of circulating ACTH and prolactin, and in
      hypothalamic noradrenaline content and dopamine and serotonin turnover, were
      modified by a previous SCGx in Freund's adjuvant-injected rats.

PMID- 11207945
TI  - The in vitro role of tumour necrosis factor-alpha and interleukin-6 in the
      hypothalamic-pituitary gonadal axis.
AB  - The adipocyte derived hormone leptin has been implicated as an important
      nutritional signal to the reproductive system, but the role of other adipocyte
      related cytokines is not clear. Tumour necrosis factor-alpha (TNF-alpha) and
      interleukin (IL)-6 are present in adipose tissue and released into the
      circulation where plasma levels correlate positively with body mass index and
      body fat mass. These cytokines could play a role in signalling nutritional status
      to the hypothalamic-pituitary-gonadal axis. We investigated the effects of TNF
      alpha and IL-6 on basal and luteinizing hormone releasing hormone (LHRH)
      stimulated luteineizing hormone (LH) release from cultured anterior pituitary
      cells, harvested from either proestrus female or male Wistar rats. We examined
      the effects of TNF-alpha and IL-6 on LHRH release from hypothalamic explants
      harvested from proestrus female and male rats in vitro. IL-6 significantly
      suppressed LHRH stimulated LH release from male dispersed pituitaries throughout
      the dose range, but did not influence basal LH release. IL-6 had no effect on
      basal or LHRH stimulated LH release in dispersed pituitaries from proestrus
      females. By contrast, TNF-alpha significantly suppressed LHRH stimulated LH
      release in dispersed pituitaries from proestrus female rats in a dose responsive
      manner, but did not influence basal LH release. TNF-alpha had no effect on basal
      or LHRH stimulated LH release in dispersed pituitaries from male rats. TNF-alpha
      and IL-6 had no effect on LHRH release from male hypothalamic explants in vitro.
      TNF-alpha and IL-6 had no effect on LHRH release from proestrus female
      hypothalamic explants in vitro. TNF-alpha and IL-6 have differential effects in
      dispersed pituitaries harvested from males and proestrus female rats. TNF-alpha
      and IL-6 may be important in mediating some of the nutritional effects on the
      reproductive axis by acting at the level of the anterior pituitary rather than
      the hypothalamus.

PMID- 11207947
TI  - Editorial.

PMID- 11207946
TI  - Progestin regulation of galanin and prolactin gene expression in oestrogen
      induced pituitary tumours.
AB  - Galanin is a peptide widely distributed in the hypothalamic-pituitary axis. In
      the female rat pituitary, galanin is mainly present in lactotrophs, where it
      regulates their secretion and proliferation. Galanin expression is increased in
      oestrogen-induced prolactinomas, and it has been proposed that oestrogen effects
      on lactotroph function and proliferation could be mediated by galanin. Previous
      studies from our laboratory demonstrated that the synthetic progestin
      levonorgestrel antagonizes pituitary tumorigenesis of rats given oestrogen,
      reducing the number of proliferating cells and increasing cell death by
      nonapoptotic mechanism(s). To elucidate the role of galanin in levonorgestrel
      effects on the tumours, we examined galanin and prolactin mRNA and peptide
      expression in prolactinomas of rats receiving the progestin. Levonorgestrel
      reduced the pituitary weight and serum prolactin concentrations in oestrogen
      treated rats. Galanin mRNA expression (determined by in situ hybridization), and
      the number of galanin expressing cells (determined by immunocytochemistry) were
      also reduced by the progestin in tumour-bearing rats. However, neither prolactin
      mRNA content, nor the number of prolactin-expressing cells, were modified by
      levonorgestrel treatment of oestrogen-receiving rats. The present study suggests
      that levonorgestrel controls pituitary growth by diminishing galanin expression.
      In contrast, changes in serum prolactin concentration seem to be more related to
      the reduction in tumour size, since the reduction in galanin expression was not
      large enough to regulate prolactin mRNA expression or the percentage of
      lactotrophs.

PMID- 11207949
TI  - The quality manager.
AB  - In the entire quality management jigsaw, no one piece is more important than an
      adequately trained and qualified quality manager. The terms quality co-ordinator
      and quality improvement officer do nothing to assist the understanding of this
      vital member of a hospital's staff. This paper describes the qualifications and
      role of a quality manager and emphasises that few such qualified quality managers
      exist in Australian hospitals.

PMID- 11207948
TI  - The effects of a seamless model of management on the quality of care for
      emergency department patients.
AB  - The aim of this study was to examine the effectiveness of the seamless model of
      management on the quality of care for emergency department (ED) patients. This
      was a pre- and postintervention study of comparing post intervention data with
      the baseline on several variables of interest. The intervention was the seamless
      model of ED management, designed and implemented as a response to the challenge
      of increasing work load at the ED. Information on patients' waiting times,
      critical care performance, patients' satisfaction and staff morale was collected
      at baseline and postintervention for comparison. The results indicated
      significant improvements on all outcome measures were found postintervention. The
      average waiting time reduced by 40%, from 92.1 to 55.3 min, as well as the time
      to craniotomy from 120 to 45 min for more severe patients. Complaints from
      patients were reduced by 80% and staff morale had improved with a 48% reduction
      in sick days and a 80% reduction in staff resignations. Ambulatory patients
      presenting to the department saw a 20% improvement in their waiting time. We
      report a successful restructuring process that used routinely collected clinical
      and administrative data to highlight problems. Using these data and through a
      systematic planning process, appropriate strategies for restructuring were
      developed by emergency staff in partnership with the hospital executive.
      Significant improvements in waiting time and patient care were clearly
      demonstrated.

PMID- 11207950
TI  - 'Quality is everyone's business' why this approach will not work in hospitals.
AB  - Implementing effective quality management in hospitals requires quite complex
      micromanagement systems. Health professionals, doctors and nurses do not have the
      time, skills and in many cases the interest to be responsible for these systems.
      To state the 'quality is everyone's business' is to use a platitude that
      seriously understates the difficulty of the exercise.

PMID- 11207951
TI  - Using clinical indicators to identify areas for quality improvement.
AB  - Clinical indicators (CI) are increasingly being used to assess the quality of
      health care being provided by physicians and hospitals. However, a standardised
      reporting format and a methodology to assess the utility of the CI data has not
      been developed. This paper provides the reporting format that has been developed
      for the clinical colleges. The results for four surgical indicators are used to
      illustrate how the CI data can determine the potential to improve the quality of
      care. Numerical estimates of the potential gains that could be made are
      calculated by: (i) determining the outcome if the current mean rate was shifted
      to the rate for the best 20% of hospitals and (ii) identifying units with unusual
      variation in rates and shifting their rate to the average. All four indicators
      reveal gains that could impact on health policy and clinical practice.

PMID- 11207952
TI  - Variance analysis in clinical pathways for total hip and knee joint arthroplasty.
AB  - Clinical pathways are being increasingly used for daily patient care. The
      pathways consist of a sequence of critical treatment events matched to the
      patient's recovery. Variance analysis identifies deviations from the pathway and
      can be used for quality improvement and clinical audit. The aim of this study is
      to analyse the variances from clinical pathways in two common elective
      orthopaedic operations. A prospective variance analysis was performed from the
      clinical pathways of all patients undergoing total hip and total knee
      arthroplasty over a 12 month period. Variances were categorised according to
      their source and then further divided into serious and non-serious variances. A
      total of 65 patients underwent total knee replacement during the study. Eleven
      serious variances were recorded in eight of these patients (12.3%) with a
      surprisingly high number of cardiac events. A total of 52 patients underwent
      total hip replacement with nine serious variances recorded in seven of these
      patients (13.5%). Clinical pathways can be used as a means of incorporating
      evidence-based medicine into clinical practice. Variance analysis of the pathways
      can be utilised as a process of quality control and to improve patient outcomes.
      Serious variances within this study were higher than anticipated.

PMID- 11207953
TI  - Pressure ulcer prevention and care: a survey of current practice.
AB  - The incidence and management of pressure ulcers in hospitalised patients is an
      ongoing concern for nurses. Efforts to prevent pressure ulcer development are
      plagued with inconsistencies and a general lack of best practice guidelines.
      Establishing current practice approaches to the assessment, prevention and
      management of pressure ulcers is a necessary first step in the implementation of
      evidence-based/best practice guidelines. Anecdotal evidence suggested a range of
      different approaches were being used in a Sydney metropolitan area health service
      (AHS) to assess patients to identify those at risk, to prevent pressure ulcers
      and to treat existing ulcers. A collaborative research project was undertaken to
      examine current practice and to explore the apparent clinical variance. It
      involved the distribution of a questionnaire to registered nurses working within
      the AHS (n = 2113) and a review of nursing policy documents in the various
      hospitals in the health service area. While the overall response rate was
      satisfactory (40%) many of the returned questionnaires were incomplete. Only 21%
      (n = 444) of the questionnaires were deemed suitable for analysis. The findings
      highlight a range of inconsistencies within and across nursing practice domains.
      Nurses generally do not use a tool to assess pressure ulcer risk potential, but
      rely on a range of practice procedures and risk indicators to determine risk
      potential of developing pressure ulcers. Repositioning patients is the most
      common approach used in an attempt to prevent the development of pressure ulcers,
      but additional measures are diverse. Most nurses seem to be familiar with modern
      wound dressings such as hydrocolloids, foams and alginates in the treatment of
      second and third stage ulceration. However, the care provided by some nurses
      reflects an adherence to outdated practices, including the use of water filled
      gloves, povidone iodine and gauze packing.

PMID- 11207954
TI  - Adjusting the balance in health-care quality.
AB  - In an increasingly informed society there has been a growing interest by
      consumers in evaluating the quality-of-care provided by their practitioners. This
      task is complicated by an asymmetry in the technical knowledge required to assess
      health-care quality between consumers and health providers. Recently attempts
      have been made to incorporate patient views into the assessment of quality to try
      and address this asymmetry. A number of quality initiatives have been developed
      to help provide consumers with markers of practitioner competency including
      professional training programmes and examinations, quality standards and quality
      assurance activities. International trends include federal funding for quality
      improvement activities within practices, and greater use of information
      technology to provide error warning systems for practitioners, to monitor
      practice patterns, and to promote better communication of information between
      health services. It is important in developing these new initiatives that
      'symmetrical' approaches which capture consumers' views on quality are employed.

PMID- 11207955
TI  - Clinicians' perceptions of placing a fetal oximetry sensor.
AB  - The aim of this study was to determine clinicians' perceptions of placing a fetal
      oximetry sensor. A survey was developed seeking details of staff category, birth
      suite experience, previous sensor placement, ease of application and use of
      epidural analgesia. Following staff feedback, the survey was revised from asking
      clinicians to rate women's comfort during sensor placement, to a visual analogue
      scale (VAS) of the clinician's assessment of the women's pain during sensor
      placement. Survey validity was sought from experts during development and for
      specific questions using item-total correlation in this analysis. Ease of sensor
      placement (n = 131) was rated as good or excellent 71% of the time. Clinicians
      rated women's comfort during sensor placement as good or excellent in 90% of
      cases. Median pain VAS was 0 (range 0-7.5). Item-total correlations of survey
      questions were all significant. Fetal oximetry sensor placement was rated well by
      clinicians in this purpose-designed survey.

PMID- 11207956
TI  - Evidence-based surgery at ASERNIP-S. Can this improve quality in surgical
      practice? Australian Safety and Efficacy Register of New Interventional
      Procedures-Surgical.
AB  - The Australian Safety and Efficacy Register of New Interventional Procedures
      Surgical (ASERNIP-S) project has been established to form a register of new
      surgical procedures which have been assessed for their safety and efficacy. The
      ASERNIP-S project systematically reviews the evidence and produces
      recommendations on the future use of surgical procedures in clinical practice.
      Further data may be collected to provide information on the outcomes of
      procedures in use in Australia. Horizon Scanning of new and emerging techniques
      and technologies complements the ASERNIP-S process. This research identifies
      procedures that will impact on clinical practice in the near future.
      Dissemination of information from ASERNIP-S assessments, both locally and
      internationally, is important for quality improvement. The ultimate aim is for
      appropriate changes in practice to ensure the highest quality of Australian
      healthcare.

PMID- 11207957
TI  - Hip fracture treatments--what happens to patients from residential care?
AB  - Hip fractures are a growing problem and new models of care have been called for.
      However, patients from residential care are rarely considered in these
      discussions. Hip fracture is a common serious problem for older people in
      residential care with profound effects on subsequent mobility and quality-of
      life. There are no Australian data documenting differences in hospital treatments
      offered to patients from the community and residential care to inform
      discussions. In a prospective audit we describe the treatment and 4 month
      outcomes of patients with fractured hips who were admitted to Flinders Medical
      Centre in South Australia from the community and residential care between August
      1998 and June 1999. Information was collected on prefracture health, types of
      surgical and rehabilitation treatments and dependency. Of the 215 older adults
      who were admitted during this time, 183 agreed to participate (119 from community
      and 64 from residential care). Surgical management of the fracture was not
      affected by admission accommodation. Those from residential care had short
      hospital stays, less rehabilitation and access to physiotherapy. Although 61% of
      those from residential care were classified as independently mobile prefracture,
      by 4 months this had declined to 32% of survivors. Strategies to improve outcomes
      in those from residential care include: early identification of those walking
      independently prefracture with assessment by rehabilitation teams. Inclusion of
      liaison with community therapists in the clinical pathway and in selected cases
      use of 'rehabilitation at home' services to provide physiotherapy services should
      be considered.

PMID- 11207958
TI  - A system for systems is required for quality health systems.
AB  - Improving quality of health-care requires a systematic approach at many different
      levels within a health system. The levels range from the interactions between
      individual patient-health provider to the international stage. The provision of
      care within and between each level needs to be systematically organised if the
      quality of our health-care is to improve. There is a need to develop a systematic
      approach to the multiple systems within health care. An organisational structure
      similar to the Cochrane Collaboration may provide the mechanism to better
      coordinate all our efforts to improve health-care quality.

PMID- 11207959
TI  - From health information to health action.

PMID- 11207960
TI  - Childhood lichen planus: a report of 23 cases.
AB  - Lichen planus (LP) in children is a rare entity. We report 23 cases of childhood
      LP seen over a period of 7 years. Ninety-six percent of the children were of Arab
      ancestry. There were 52% boys and 48% girls. Classic LP was the most common
      clinical variant (70%), followed by eruptive generalized LP (13%). A majority of
      the patients had mild, localized disease. Oral involvement was seen in 39% of
      patients. Topical steroids were the mainstay of treatment in most of the cases.
      Children with chronic and recurrent disease responded to dapsone therapy, whereas
      in those with eruptive and widespread disease, UVB phototherapy was found to be
      safe and effective. The present report highlights the salient clinical features,
      treatment, and course of LP in children in Kuwait compared to those reported in
      children of other countries as well as those of adults.

PMID- 11207961
TI  - Dysplastic nevi of the scalp and forehead in children.
AB  - To determine if there is a significant difference in the relative frequency and
      degree of atypia of sporadic dysplastic nevi from the scalp, face, and neck area
      in children as compared with nevi from the rest of the body, we reviewed 99
      consecutive biopsy specimens of melanocytic nevi from the scalp, face, and neck
      areas in children less than 18 years of age and compared them with 95 consecutive
      cases of nevi from other areas of the body in children of the same age. Large
      numbers of the nevi biopsied from the scalp (13 of 31; 41.93%) and forehead (2 of
      10; 20%) were dysplastic. The number of dysplastic nevi from the neck (1 of 58;
      1.72%) was not assessed as very different from the incidence found in other
      regions of the body, where 7 dysplastic nevi (7.36%) from a total of 95 nevi were
      found. Of the 13 dysplastic nevi from the scalp, 9 showed minimal atypia and 4
      showed moderate atypia. No nevi with severe atypia were found. Many pigmented
      nevi from the scalp and forehead in children in this study were dysplastic. This
      finding points out the importance of examining the scalp of children for the
      presence of dysplastic nevi. The majority of nevi from the neck were common nevi.

PMID- 11207962
TI  - Louse comb versus direct visual examination for the diagnosis of head louse
      infestations.
AB  - The techniques used for diagnosis of head louse (Pediculosis capitis) infestation
      are a source of controversy. Most epidemiologic and diagnostic studies have been
      done using direct visual examination. The main objective of this study is to
      compare the efficacy of direct visual examination versus the louse comb method.
      The hair of each child was examined twice; one team used a screening stick and
      another team used a louse comb. Seventy-nine boys and 201 girls, 7-10 years old
      were examined. Examination with a louse comb found that 25.4% of the children
      were infested with both lice and nits, while another 31.3% had nits only. Boys
      were significantly less infested with lice and nits than girls (lice: 15.2 and
      29.6%; nits: 21.5 and 35.4%, respectively). The infestation rate with lice and
      nits was significantly higher in children with long (68.9%) and medium-length
      (63.9%) hair than in children with short hair (44.0%) (p < 0.01). Direct visual
      examination found that 5.7% of the children were infested with both lice and
      nits, and another 49.0% with nits only. The average time until detection of the
      first louse was 57.0 seconds with the comb as compared to 116.4 seconds by direct
      visual examination. Diagnosis of louse infestation using a louse comb is four
      times more efficient than direct visual examination and twice as fast. The direct
      visual examination technique underestimates active infestation and detects past,
      nonactive infestations.

PMID- 11207963
TI  - An ultrastructural study of lipodystrophia centrifugalis abdominalis infantilis,
      with special reference to fibrous long-spacing collagen.
AB  - Lipodystrophia centrifugalis abdominalis infantilis (LCAI) in a 2.5-year-old
      Japanese girl is reported. Clinically she had a curved cutaneous depression with
      a slightly elevated erythematous border on the left abdomen beyond the left
      groin. The regional lymph node was palpable. Histologic examination showed a
      decrease of the fat, an inflammatory infiltrate mainly composed of lymphocytes,
      and septal fibrosis in the subcutaneous tissue. Immunohistochemical analysis
      found that infiltrating lymphocytes were mainly positive against CD4.
      Ultrastructurally nuclei in the adipocytes were crescent shaped and located
      toward the periphery of the cell. Some banded structures with a periodicity of
      150 nm, and with intraperiodic bands, referred to as fibrous long-spacing
      collagen (FLSC), were observed in the septal area of the fatty tissue. These
      results indicated that FLSC was correlated with the breakdown of fibrillar
      collagens in LCAI.

PMID- 11207964
TI  - Multiple familial smooth muscle hamartomas.
AB  - Smooth muscle hamartoma is a cutaneous abnormality characterized by a
      disorganized proliferation of normal muscle fibers of arrector pili. Usually a
      single congenital hypertrichotic plaque involves the trunk and the extremities.
      Multiple lesions have rarely been reported in the literature. We describe three
      members of the same family with multiple skin-colored patches on the back and
      legs, histologically confirmed as smooth muscle hamartomas. To our knowledge this
      is the first report of multiple smooth muscle hamartomas in different members of
      the same family and quite interestingly involving the same skin site.

PMID- 11207965
TI  - Lipoid proteinosis: report of four siblings and brief review of the literature.
AB  - Lipoid proteinosis (Urbach-Wiethe disease) is a rare autosomal recessive disorder
      associated with deposition of periodic acid-Schiff (PAS)-positive hyaline
      material in various tissues including skin, mucous membranes, and internal
      organs. A family is reported in which four siblings (two boys and two girls) born
      to nonconsanguineous parents had lipoid proteinosis. All had the characteristic
      hoarseness of voice and three had skin lesions. The diagnosis was confirmed by
      the presence of typical features on light and electron microscopy.

PMID- 11207966
TI  - Pseudopili annulati in a dark-haired individual: a light and electron microscopic
      study.
AB  - We report pseudopili annulati for the first time in a dark-haired Chinese girl.
      The hair was elliptical in shape and twisted along its long axis. The banded or
      ringed appearance was due to incident light being reflected by the flattened
      segments. Banding was also noted under polarized light but was not present under
      transmitted light. Under transmitted light the whole length of the hair appeared
      dark and the thickness varied at regular intervals, giving rise to fusiform
      segments due to the twisted nature of the hair shaft. Scanning and transmission
      electron microscopic examinations revealed no abnormalities in the cuticle and
      cortex.

PMID- 11207967
TI  - Periorbital congenital melanocytic nevus associated with ankyloblepharon.
AB  - We report periorbital congenital melanocytic nevus associated with
      ankyloblepharon in a 2-month-old boy. This unusual presentation may be explained
      by the assumption that the development of the congenital melanocytic nevus (CMN)
      in utero was related to the failure of normal eyelid separation, which occurs
      around the 20th week of gestation.

PMID- 11207968
TI  - Rubinstein-Taybi syndrome with epidermal nevus: a case report.
AB  - We describe an 8-year-old boy with Rubinstein-Taybi syndrome, a multiple
      congenital anomaly/mental retardation syndrome characterized by broad thumbs and
      great toes, peculiar facies, and mental retardation caused by mutations in the
      transcriptional coactivator CREB binding protein (CBP). He had on his right side
      yellowish papular lesions organized in narrow bands according to Blaschko lines,
      later confirmed by histology as an epidermal nevus. Epidermal nevus syndrome has
      been ruled out because the patient failed to meet the criteria for inclusion
      under this designation. This association may be coincidental.

PMID- 11207969
TI  - Toxic epidermal necrolysis after the use of high-dose cytosine arabinoside.
AB  - We report a fatal case of toxic epidermal necrolysis (TEN) resulting from a high
      dose of cytosine arabinoside (ARA-C). A 13-year-old girl with acute lymphocytic
      leukemia was treated according to the protocol of the BFM Group (BFM-95, HRG). On
      the fifth day after administration of a high dose of ARA-C (2 g/m2 intravenously
      every 12 hours), she developed bullous lesions on the hands and soles that
      disseminated, evolving to necrosis, sepsis, and death on the 22nd day. ARA-C is
      frequently associated with dermatologic toxicity, but this is only the second
      case of toxic epidermal necrolysis described in connection with this drug.

PMID- 11207970
TI  - Urticating Hashimoto-Pritzker Langerhans cell histiocytosis.
AB  - Red-brown papules developing during the neonatal period may present a diagnostic
      dilemma. The Darier sign has been a reliable feature in the diagnosis of
      mastocytosis. However, the cutaneous infiltrate of Hashimoto-Pritzker Langerhans
      cell histiocytosis (LCH) may contain a large number of mast cells, leading to
      confusion both clinically and histologically. We report an infant who developed
      red-brown papules of Hashimoto-Pritzker LCH during the neonatal period and
      presented with a positive Darier sign and acute urticaria.

PMID- 11207971
TI  - Papillon-Lefevre syndrome with pyogenic hepatic abscess: a rare association.
AB  - Papillon-Lefevre syndrome in a 14-year-old boy presenting with palmoplantar
      keratoderma, periodontosis, recurrent pyogenic infections of the skin, and
      hepatic abscesses is reported for its rarity and unusual manifestations. The
      patient showed a dramatic response to acitretin therapy.

PMID- 11207972
TI  - An unusual presentation of immunodeficiency with hyper-IgM.
AB  - Hyper-IgM syndrome is a rare immunodeficiency disease characterized by markedly
      decreased serum IgG, IgA, and IgE levels but normal or elevated IgM levels. The
      most common clinical signs are infections, cirrhosis, arthritis, malignancies,
      and mucosal ulcers. Approximately two-thirds of patients have chronic neutropenia
      associated with oral and perirectal ulcers. We report a 14-month-old girl with
      hyper-IgM syndrome who has recurrent cutaneous ulcers restricted to the diaper
      area.

PMID- 11207974
TI  - Incontinentia pigmenti: a case associated with cardiovascular anomalies.
AB  - Various cutaneous and developmental defects of the eyes, teeth, skeleton, and
      central nervous system have been detected in infants with incontinentia pigmenti.
      We report an isolated case of incontinentia pigmenti in a 6-month-old girl in
      association with tricuspid insufficiency, an abnormal shunt of the right
      pulmonary vein into the superior vena cava, and pulmonary hypertension. We
      believe that our findings will help to confirm the association of cardiovascular
      anomalies in IP.

PMID- 11207973
TI  - Complete recovery from juvenile pemphigus vulgaris.
AB  - A 10-year-old boy with vesicles and eroded lesions on his labia, oral mucosa, and
      trunk was diagnosed as having pemphigus vulgaris. The diagnosis was confirmed by
      histopathologic and immunofluorescence studies. The patient was successfully
      treated systemically with methylprednisolone and azathioprine. After 4.5 years
      the therapy was discontinued and the patient has had no relapse over the last 4
      years.

PMID- 11207975
TI  - Localized acquired hypertrichosis following cast application.
AB  - A 11-year-old boy with transient hypertrichosis following calcaneal osteotomy and
      cast application for 2 months is described. We postulate that hyperemia may be
      responsible for his hypertrichosis, which lasted 3 months and created a cosmetic
      problem.

PMID- 11207976
TI  - Microsporum canis tinea capitis in an 8-month-old infant successfully treated
      with 2 weekly pulses of oral itraconazole.
AB  - We report an 8-month-old girl with tinea capitis caused by Microsporum canis
      which was successfully treated with two pulses of oral itraconazole 50 mg/day,
      each of 1 week duration with an interval of 2 weeks. M. canis tinea capitis can
      be a difficult therapeutic problem in an infant, as the treatment is usually
      long, lasting up to 4-6 weeks with griseofulvin and 6-12 weeks with terbinafine,
      and the desire to provide a safe systemic therapy is particularly important. With
      an intermittent regimen the duration of treatment with active drug can be much
      shorter compared to continuous therapy. We found that itraconazole pulse therapy
      for M. canis tinea capitis was a safe and effective treatment in an infant.

PMID- 11207977
TI  - Topical ivermectin: a new successful treatment for scabies.
AB  - Ivermectin is the only one of the avermectins that has been widely used in
      humans, since it is recommended as the treatment of choice for onchocerciasis, a
      filariasis that produces "river blindness," a parasitic endemic infestation in
      countries of West Equatorial Africa and in some areas of Central and South
      America. Also, ivermectin has been used for treating human endo- and
      ectoparasites with effective results and with almost no side effects. To study
      the efficacy of ivermectin for scabies, which is very common in Colombia, a trial
      with this drug that could be easily administered, with fast application and high
      efficacy, was undertaken. For this purpose, six complete families with active
      scabies, consisting of 12 adults and 20 children ranging in age from 1 to 10
      years, were treated with 1% ivermectin in a solution of propylene glycol applied
      topically to the affected skin. The dose employed was 400 microg/kg, repeated
      once the following week. All patients were cured, tolerated the medication well,
      and there were no side effects or signs of recurrence 2, 4, or 6 weeks after
      therapy. In addition to its efficacy, easy administration, and lack of side
      effects, ivermectin is a low-cost medication.

PMID- 11207979
TI  - What syndrome is this? Chondroectodermal dysplasia--the Ellis-van Creveld
      syndrome.

PMID- 11207978
TI  - Allergic reactions due to ibuprofen in children.
AB  - Ibuprofen is 2-(4-isobutyl-fenyl)-propionic acid, which belongs to the same group
      of nonsteroidal antiinflammatory drugs (NSAIDs) as naproxen and ketoprofen. We
      present two instances of adverse reaction to pediatric ibuprofen, an acute
      urticaria and a fixed drug eruption, with tolerance to acetylsalicylic acid (ASA)
      and acetaminophen, in what seems to be hypersensitivity to the propionic acid
      group. Although these reactions are very rare and ibuprofen is still very safe,
      we think it is important to know about the possible side effects in order to
      recognize and treat them when they occur.

PMID- 11207980
TI  - Extensive hemorrhagic vesicles in a child.

PMID- 11207981
TI  - Scalp excisions: getting "ahead" of pain.

PMID- 11207982
TI  - Updated guide to information for families with inherited skin disorders.

PMID- 11207983
TI  - Inexpensive head lice comb.

PMID- 11207984
TI  - Myxoid liposarcoma in a 12-year-old girl: response.

PMID- 11207986
TI  - Neonatal herpes simplex and incontinentia pigmenti.

PMID- 11207987
TI  - Psoriasis in a 5-month-old girl with HIV infection.

PMID- 11207988
TI  - Eosinophilic cellulitis in a newborn.

PMID- 11207989
TI  - Mutation analysis of phenylketonuria in Yamagata prefecture, Japan.
AB  - BACKGROUND: We have screened 309,914 newborns in Yamagata prefecture, Japan,
      since 1977 and have detected four patients with phenylketonuria (PKU). We
      analyzed the phenylalanine hydroxylase (PAH) gene of the four patients to study
      the genetic background in this area and the genotype-phenotype relationship in
      these patients. METHODS: Mutations of the PAH gene were screened by denaturing
      gradient gel electrophoresis analysis and the sequences were determined. RESULTS:
      Three cases were compound heterozygotes of six different mutations of the PAH
      gene and the remaining case was a homozygote. Of the six detected mutations,
      K115fs is novel, whereas the others have been previously detected among Chinese
      and/or Japanese patients. CONCLUSIONS: The incidence and genetic basis in
      Yamagata prefecture was similar to that of other parts of Japan. Analysis of the
      genotype is useful to understand the clinical variation in some families.

PMID- 11207990
TI  - Epidemiology of Helicobacter pylori infection in children: a serologic study of
      the Kyushu region in Japan.
AB  - BACKGROUND: The prevalence of Helicobacter pylori infection in children varies as
      a function of socioeconomic development, with low rates in developed countries
      and high rates in developing countries. The prevalence of H. pylori infection in
      Japanese children is unknown. METHODS: The present study examined the effect of
      living conditions on the prevalence of H. pylori infection in children. We
      determined the prevalence of H. pylori infection in healthy children of the
      Kyushu region in Japan and compared it with the prevalence in institutionalized
      children with severe neurologic illness. Serum concentrations of anti-H. pylori
      IgG antibody were measured by an enzyme-linked immunosorbent assay in 336 healthy
      children and 56 patients with severe neurologic impairment. An antibody
      concentration > 50 units/mL was taken as evidence of infection. RESULTS: The
      prevalence of H. pylori seropositivity in healthy children increased with age (P
      < 0.0001) and was 29% in children 15-19 years of age. This value is slightly
      higher than prevalences reported in developed countries (5-15%), but is lower
      than in developing countries (30-60%). Seropositivity did not vary with respect
      to gender, water supply or location of housing. Helicobacter pylori
      seropositivity was more prevalent among institutionalized children aged 5-19
      years than their healthy counterparts (P < 0.005). CONCLUSIONS: The intermediate
      prevalence of H. pylori seropositivity in healthy children between that measured
      in developed and developing countries is consistent with the socioeconomic
      'westernization' of Japan.

PMID- 11207991
TI  - Effects of albumin infusion therapy on total and unbound bilirubin values in term
      infants with intensive phototherapy.
AB  - BACKGROUND: The purpose of the present study was to evaluate the effect of
      intravenous albumin administration on the serum total and unbound bilirubin
      values in term non-hemolytic hyperbilirubinemic neonates during intensive
      phototherapy. METHODS: Fifty-eight infants (gestational age 39.4 +/- 1.4 weeks;
      birth weight 3,245 +/- 435 g) were given phototherapy with similar light energy.
      Twenty infants (control group) received only phototherapy, while 38 others
      (albumin-treated group) were also given human albumin at 1 g/kg bodyweight, i.v.,
      during the first 2 h of phototherapy. RESULTS: When comparing changes in total
      and unbound bilirubin values 0, 2, 6 and 24 h after entering the study between
      the albumin-treated group and the control group, there was a significant
      reduction in the serum unbound bilirubin values at the end of albumin treatment
      and at 6 and 24 h. However, there was no significant reduction in total serum
      bilirubin values during the study period. In the albumin-treated group, the mean
      serum unbound bilirubin reduction from the baseline level at the end of albumin
      treatment and at 6 and 24 h was 0.40 +/- 0.19, 0.41 +/- 0.20 and 0.43 +/- 0.20
      microg/dL, respectively. CONCLUSIONS: The results suggest that albumin priming
      may be effective for an immediate reduction in serum unbound bilirubin values,
      the fraction that is potentially neurotoxic.

PMID- 11207992
TI  - Differences in transcutaneous bilirubin readings in Japanese term infants
      according to feeding method.
AB  - BACKGROUND: Controversy has existed for many years over whether infant feeding
      methods are related to serum bilirubin concentrations during the first few days
      of life. Differences in initial jaundice patterns according to the feeding method
      until 72 h after birth have not been elucidated hitherto. The difference may
      become clear in Japanese neonates because jaundice shows a much higher peak
      bilirubin concentration and a later peak in Japanese neonates than in Caucasian
      neonates. METHODS: In the present study, we investigated variations in the
      transcutaneous bilirubin reading (TcB) obtained within 72 h after birth among 177
      breast-fed and 494 formula-fed healthy Japanese term neonates. RESULTS: There was
      no difference between TcB in formula-fed and breast-fed infants until the first
      30 h, after which time the rate of increase in TcB was lower in formula-fed
      infants. Among breast-fed neonates, a good linear regression between time after
      birth and TcB was maintained. Similarly, weight losses in breast-fed infants at
      24-48 h and 48-72 h after birth were greater than those in formula-fed infants.
      CONCLUSIONS: The jaundice pattern in Japanese neonates from 30 to 72 h after
      birth according to the feeding method was different from that in Caucasian
      neonates.

PMID- 11207993
TI  - Effect of vibration on auditory organ systems in low-birth weight infants treated
      with high-frequency oscillatory ventilation: 5 year outcome.
AB  - BACKGROUND: To determine the effects of vibration exposure caused by high
      frequency oscillatory ventilation (HFOV) on the auditory organ systems in low
      birth weight (LBW) infants. METHODS: Between 1989 and 1990, 30 LBW infants who
      received assisted ventilation with HFOV (n = 14) or conventional mechanical
      ventilation (CMV; n = 16) in the level III neonatal intensive care unit at Tokyo
      Metropolitan Ohtsuka Hospital were enrolled in this study. The effects of
      vibration exposure on the auditory system structures were investigated with
      auditory brainstem responses (ABR) at 37-41 weeks of postconceptional age and at
      6, 12, 18 and 24 months of age until they passed and follow-up studies were
      performed at least until 5 years of age. RESULTS: All infants enrolled in the
      study survived at discharge and one (7.1%) infant in the HFOV group and two
      (12.5%) in the CMV group failed the initial ABR test, but there were no
      significant differences between the two groups. Auditory brainstem response
      abnormalities were still observed in one infant in the HFOV group at 6 months of
      age, but this child died at 9 months of age because of meningitis. In contrast,
      in the CMV group, one patient passed the ABR test at 6 months of age, but another
      remained abnormal at 5 years of age. One of three infants with ABR abnormalities
      at 6 months of age had neurologic sequelae at 5 years of age and one of 28
      infants who passed the initial ABR test was detected with cerebral palsy. No
      patients with hearing loss were clinically detected at 5 years of age.
      CONCLUSIONS: The results of the serial ABR examinations and the 5 year follow-up
      studies suggest that vibration exposure caused by HFOV may not increase the
      adverse effects on the auditory system in LBW infants.

PMID- 11207994
TI  - A prospective clinical study on inhaled nitric oxide therapy for neonates in
      Japan.
AB  - BACKGROUND: This is the first report about a prospective clinical investigation
      to study the efficacy and safety of nitric oxide (NO) inhalation in infants with
      persistent pulmonary hypertension of the newborn (PPHN) in Japan. METHODS:
      Patients in the present study had to meet the following entry criteria: (i) they
      had to be younger than 7 days of age; (ii) they had to have evidence of PPHN as
      defined by echocardiograph; (iii) they had to have severe systemic hypoxemia
      under mechanical ventilation at 100% oxygen supplementation; and (iv) they had to
      have a failure to respond to conventional therapies. Patients were excluded from
      this trial if they had any of the following: hypoplastic lung, structural cardiac
      lesions or severe multiple anomalies. RESULTS: Nitric oxide inhalation therapy
      was performed in 68 infants who had severe PPHN at 18 hospitals between May 1995
      and May 1997. At birth, 21 of 68 infants (31%) weighed less than 1,500 g and 39
      infants weighed more than 2,500 g. The diagnoses associated with PPHN were as
      follows: 27 infants had meconium aspiration syndrome, 15 infants had dry lung
      syndrome, nine infants had congenital diaphragmatic hernia, six infants had
      respiratory distress syndrome, three infants had pneumonia and eight infants had
      other diagnoses. The mean oxygenation index (OI) before NO inhalation therapy in
      68 infants was 43.2; 55 infants (81%) had good responses. CONCLUSIONS: These
      results may be valuable for further randomized controlled and double-blind trials
      in Japan to evaluate whether NO inhalation therapy is more effective than
      conventional therapy in infants with severe PPHN.

PMID- 11207995
TI  - Effect of gestational age on plasma fibronectin concentrations in the neonate.
AB  - BACKGROUND: Fibronectin (FN) is known to have important roles in host defense
      against infection. The risk for neonatal sepsis increases with the degree of
      immaturity of the host. Conflicting results have been reported on the
      relationship between plasma FN levels and gestational age (GA) in the preterm
      neonate. METHODS: In the present study, we determined plasma FN concentrations
      with an immunodiffusion method in 40 newborns of various gestational ages,
      ranging from 30 to 42 weeks. RESULTS: We found a strong direct correlation
      between plasma FN levels and GA (r = 0.86; P < 0.001). CONCLUSIONS: We speculate
      that the increased risk for neonatal sepsis with degree of prematurity may, in
      part, be explained by impaired defense with decreasing plasma FN levels seen with
      lessening GA.

PMID- 11207996
TI  - Contact pressure distribution in the supine position in low-birth weight infants
      analyzed by a photoelastic method.
AB  - BACKGROUND: Contact pressure distribution patterns in the supine position in low
      birth weight (LBW) neonates were analyzed by the use of a photoelastic method.
      METHODS: A total of 61 subjects (LBW neonates, mature (bodyweight > 2,500 g at
      birth) neonates, normal infants and Down syndrome (DS) infants) were selected for
      the study. Infants were placed on a photoelastic measuring table. Photoelastic
      images generated in the contact regions of the body were photographed with a
      camera and printed on monochrome paper. The coefficient of variation in the
      pressure distribution value (PcV) and the top and bottom ratio (mu) of the trunk
      at the center of pressure were calculated. RESULTS: The Pcv value was
      significantly lower in DS than LBW (P < 0.001), mature (P < 0.002) and normal
      infants (P < 0.01). The mu value in LBW and mature neonates was 48.9 and 50.2%,
      respectively. Normal infants had a mu value of 44.0%, which was significantly
      lower than that in LBW neonates. However, there was no significant difference
      between LBW and DS infants. CONCLUSIONS: Neurological impairment specifically
      affects the data obtained by photoelastic analysis.

PMID- 11207997
TI  - Risk factors for persistence of pulmonary arterial branch stenosis in neonates
      and young infants.
AB  - BACKGROUND: Pulmonary arterial branch stenosis (PBS) in neonates is considered to
      be transient. However, PBS has been found not only in neonates, but also in young
      infants. Among these patients, we encountered several patients whose PBS was
      still present after the age of 1 year. METHODS: To clarify the natural history of
      PBS in neonates and young infants, we retrospectively reviewed the records of 103
      patients diagnosed with PBS in the neonatal period and early infancy. RESULTS:
      The PBS findings were improved in all patients. Pulmonary arterial branch
      stenosis disappeared in 94 patients by the age of 1 year (group A), but persisted
      after I year of age in nine patients (group B). Group B patients had a
      significantly lower mean birth weight and greater deltavelocity (the difference
      in the peak flow velocity between the main pulmonary artery and stenotic branch)
      at diagnosis than group A patients. Incidences of low birth weight (< 2,500 g)
      and deltavelocity above 1.2 m/s were significantly higher in group B than group A
      patients. There was no significant difference in the frequency of premature
      infants (gestational age < 36 weeks) between the groups, suggesting that
      intrauterine growth retardation may be related to developmental abnormalities of
      the pulmonary arterial branch. CONCLUSIONS: All cases of PBS in neonates and
      young infants were improved. However, PBS persisted in some patients after the
      age of 1 year. Low birth weight and deltavelocity above 1.2 m/s are risk factors
      for persistent PBS. Pulmonary arterial branch stenosis was not present after the
      age of 1 year in 62 of 63 patients without either of these risk factors.

PMID- 11207998
TI  - Idiopathic sustained left ventricular tachycardia in pediatric patients.
AB  - BACKGROUND: Idiopathic sustained ventricular tachycardia originating from the
      left ventricle (ILVT) has been an indication for catheter ablation. The present
      study evaluated the clinical features, long-term prognosis and indications for
      treatment in pediatric patients with ILVT. METHODS: The subjects of the present
      study were eight patients (four males and four females) with a mean age at onset
      of 11.0 years (range 3-15 years). The mean follow-up period was 7.7 years (range
      2.1-11.3 years). RESULTS: In electrophysiologic studies, intravenously
      administered verapamil was effective for the termination of tachycardia in all
      six patients who received this treatment and for the prevention of tachycardia in
      four of five patients. Oral administration of verapamil was effective in five of
      seven patients. Propranolol or flecainide was added to the treatment protocol for
      two patients who did not respond to verapamil alone. Tachycardia disappeared
      without drugs in four patients during the follow-up period and became non
      sustained in another patient. Two of three patients with persistent tachycardia
      underwent catheter ablation. Pharmacologic treatment was very effective for ILVT
      among these patients. CONCLUSIONS: Pharmacologic therapy, such as with verapamil,
      is still the treatment of choice for ILVT because of a good long-term prognosis
      and potential risks and complications by manipulation of catheter ablation.

PMID- 11207999
TI  - Anti-interleukin-8 autoantibody in the tracheobronchial aspirate of infants with
      chronic lung disease.
AB  - BACKGROUND: A high concentration of interleukin (IL)-8 has been observed in the
      tracheobronchial aspirate of infants with chronic lung disease (CLD), although
      the pattern varies depending on the type of CLD. Alveolar fluid from patients
      with adult respiratory distress syndrome (ARDS) also contains an elevated level
      of IL-8. Recently, the presence of anti-IL-8 autoantibody was demonstrated in the
      alveolar fluid from patients with ARDS. METHODS AND RESULTS: The concentration of
      anti-IL-8 autoantibody in the tracheobronchial aspirate of infants with CLD was
      measured in order to discover whether there was any correlation with the
      concentration of IL-8. Similar to IL-8 concentration, the anti-IL-8 IgM antibody
      concentration in all infants with CLD following intrauterine infection was
      already high during the first 48 h. However, the concentration in infants with
      CLD following respiratory distress syndrome began to increase after 11 days of
      life, in contrast with the rise in IL-8 between 48 h after birth and day 5.
      CONCLUSIONS: The presence of anti-IL-8 autoantibody may provide a mechanism that
      limits the bioavailability of free IL-8 in the lungs. In addition, the time lag
      between the increase in IL-8 and anti-IL-8 IgM autoantibody demonstrated in the
      present study could be used to estimate the time when the inflammation begins,
      even if the IL-8 concentration is already high.

PMID- 11208000
TI  - Severe upper airway obstruction in the tropics requiring intensive care.
AB  - BACKGROUND: The clinical profile of severe upper airway obstruction, a
      challenging acute pediatric emergency, has not been extensively documented in the
      developing nations of the tropics. METHODS: The diagnostic categories, severity
      of illness and outcome from 63 episodes of severe upper airway obstruction in 56
      children admitted to the Pediatric Intensive Care Unit between January 1994 and
      December 1999 were reviewed. Outcome variables studied included requirement for
      ventilation, mortality and complications. Severity of illness was determined with
      the Pediatric Risk of Mortality (PRISM) II score. RESULTS: Viral croup (29%) was
      the most common diagnosis, followed by mediastinal malignancy (13%), bacterial
      tracheitis (11%) and Pierre Robin syndrome (11%). There were no admissions for
      acute epiglottitis. Thirty episodes (48%) required ventilation for a median
      duration of 4.0 days. Bacterial tracheitis (100%) and subglottic stenosis (100%)
      were the most likely diagnoses requiring ventilation. Difficulty in intubation
      was encountered in 13 episodes (43%) involving, in particular, patients with
      bacterial tracheitis (83%; P = 0.006). Only two patients required a tracheostomy.
      The overall mortality was 11%. The PRISM score for all categories was generally
      low (mean 10.3 +/- 1.0; median 9.0). Non-survivors had a significantly higher
      PRISM II score than survivors (27.4 +/- 9.7 vs 8.1 +/- 4.9, respectively; P =
      0.002) and were more likely to include children with bacterial tracheitis and
      mediastinal malignancy. CONCLUSIONS: There is marked heterogeneity in the causes
      of upper airway obstruction in the tropics with viral croup remaining the most
      common. A significant proportion required ventilation, but outcome is generally
      favorable, except in those with bacterial tracheitis and mediastinal malignancy.

PMID- 11208001
TI  - Immunoglobulin subgroups in children with febrile seizures.
AB  - BACKGROUND: The aim of the present study was to determine whether or not there
      was a role for immunoglobulin (Ig) or IgG subgroups in the pathogenesis of
      febrile seizures (FS). METHODS: Serum levels of IgA, total IgG, IgM, IgE, IgGI,
      IgG2, IgG3 and IgG4 were measured in 34 children with FS and in 37 healthy
      children used as a control group. Both patients and controls were divided into
      two groups according to age (group I, 6-24 months; group II, 25-72 months).
      RESULTS: Compared with controls, mean IgG4 levels in patients were found to be
      decreased in both groups I and II (group I: 95 +/- 14 vs 57 +/- 5, respectively,
      P = 0.01; group II: 178.5 +/- 38.5 vs 65.1 +/- 24.5, respectively, P < 0.01),
      while mean IgG2 levels were found to be decreased only in group II patients (170
      +/- 16 vs 103 +/- 22; P < 0.05). CONCLUSIONS: The results of the present study
      suggest that Ig subclass deficiencies may be responsible for the infections
      connected with FS or that they may be related to the pathogenesis of FS in some
      children.

PMID- 11208002
TI  - Vagus nerve stimulation for children and adolescents with intractable epilepsies.
AB  - BACKGROUND: Vagus nerve stimulation (VNS) has been shown to be efficacious in the
      treatment of patients > 12 years of age with refractory partial epilepsies and it
      is suggested that VNS should be considered as one of the treatment options for
      these patients. METHODS: Four patients had partial epilepsies and one had
      symptomatic generalized epilepsy. After observation of the baseline seizure
      frequency and the average seizure frequency for 3 months, the VNS system was
      implanted. Thereafter, seizure frequency, average seizure frequency of each
      seizure type during the month just before the evaluation, seizure severity, side
      effects and quality of life were recorded. RESULTS: In four of five patients,
      overall seizure frequency was reduced > 50% after VNS treatment. The seizure
      types that showed a > 50% reduction in frequency were auras, focal clonic,
      generalized tonic clonic seizures, astatic, versive, hypomotor, generalized tonic
      and generalized clonic seizures according to Luders' classification. In two
      patients, as major convulsive seizures were reduced in number after VNS
      treatment, dialeptic seizures (non-convulsive seizure with lapse of
      consciousness) gradually appeared. In one patient without significant seizure
      reduction, quick recovery from postictal periods after generalized tonic seizure
      was seen after treatment. In one patient with generalized epilepsy, improvement
      of cognitive function was reported by his guardians. After VNS, the number of
      antiepileptic drugs was reduced from three to one in one patient. No significant
      adverse effects were noted in any patients. CONCLUSIONS: Our results suggest that
      VNS is well tolerated in young patients with intractable epilepsies and it may be
      an important non-pharmacologic treatment option for children with severe
      epilepsies who cannot tolerate medical therapy and/or are not candidates for
      epilepsy surgery.

PMID- 11208003
TI  - Cerebral blood flow abnormalities in symptomatic West syndrome: a single photon
      emission computed tomography study.
AB  - BACKGROUND: Infantile spasm (IS) is an age-dependent epileptic encephalopathy of
      variable etiology. Although IS is well studied, its pathogenesis is unclear.
      Infantile spasm is usually considered a generalized epilepsy, but recent studies
      point to focal cerebral blood flow (CBF) abnormalities. METHODS: In six
      symptomatic IS patients, single photon emission computed tomography (SPECT) with
      [99Tc]-HMPAO, electroencephalography (EEG), magnetic resonance imaging
      (MRI)/computed tomography (CT) and their correlation were evaluated. RESULTS:
      Single photon emission computed tomography showed unifocal (regional) cerebral
      hypoperfusion in two infants, multifocal (diffuse) cerebral hypoperfusion in
      three infants and normal perfusion in the other infant. Electroencephalograms
      obtained in near-time of the SPECT studies showed diffuse abnormalities in five
      infants with hypoperfusion on SPECT. Cranial MRI/CT showed diffuse and/or
      localized cerebral lesions in all infants, all of whom had corresponding areas of
      hypoperfusion on SPECT. In one patient whose spasms were stopped with
      anticonvulsants, SPECT was normal, in two patients SPECT showed unifocal lesions,
      while in another three patients whose spasms were decreased but not stopped,
      SPECT showed multifocal hypoperfusion. CONCLUSIONS: This pilot study may indicate
      that there are CBF anomalies in symptomatic IS. The degree of CBF may be a
      predictor of prognosis and multifocal hypoperfusion may be a poor prognostic
      criteria in IS.

PMID- 11208005
TI  - Possible effects of antioxidant status on increased platelet aggregation in
      childhood iron-deficiency anemia.
AB  - BACKGROUND: Alterations in platelet function and antioxidant status in children
      with iron-deficiency anemia (IDA) have been reported previously. The present
      study was performed to better understand possible interactions between these two
      systems. METHODS: Erythrocyte superoxide dismutase (SOD), catalase (CAT) and
      glutathione peroxidase (GSH-Px) activity and platelet function were evaluated in
      15 children (aged 1 1/2-15 years) with IDA. The antioxidant enzyme activity was
      determined spectrophotometrically. Platelet aggregation and secretion studies
      were performed using impedance and bioluminescence methods, respectively. Ten age
      matched healthy children were included as a control group. RESULTS: There were no
      differences in SOD and CAT activities between patients and controls. However, GSH
      Px activity was significantly lower in the iron-deficient children. Platelet
      aggregation responses to collagen and ADP were also significantly higher in iron
      deficient children than in controls. CONCLUSIONS: Decreased antioxidant defense
      in IDA may cause increased oxidant stress, which, in turn, may result in a
      tendency towards platelet aggregation.

PMID- 11208004
TI  - Endomysium antibodies in the diagnosis of celiac disease in short-statured
      children with no gastrointestinal symptoms.
AB  - BACKGROUND: Endomysium antibodies (EmAb) are strongly associated with untreated
      celiac disease and are suggested to be diagnostic. The aim of the present study
      was to assess the value of anti-EmAb for celiac disease screening in children
      with short stature. METHODS: In 84 children with height less than the third
      percentile for age, preliminary work-ups were made to find a cause for their
      short stature and then their serum was assayed for anti-EmAb by indirect
      immunofluorescence tests using monkey esophagus. RESULTS: Seven children were
      strongly positive for EmAb and all had positive histologic findings for celiac
      disease. CONCLUSIONS: Our results show that there is an association with occult
      celiac disease and idiopathic short stature and that the serum anti-EmAb test is
      useful in identifying such cases.

PMID- 11208006
TI  - A newborn infant with lipoprotein glomerulopathy associated with congenital
      nephrotic syndrome.

PMID- 11208007
TI  - Vertebral osteomyelitis and paravertebral abscess due to Salmonella oranienburg
      in a child.

PMID- 11208008
TI  - Tumor cell lysis syndrome resulting from transient abnormal myelopoiesis in a
      neonate with Down's syndrome.

PMID- 11208009
TI  - Precocious puberty in a girl with congenital hypothyroidism receiving continuous
      L-thyroxine-replacement therapy.

PMID- 11208010
TI  - A 4-month-old infant showing anemia, granulocytopenia and thrombocytopenia
      probably due to autoreactive IgG.

PMID- 11208011
TI  - Transient remission of intractable systemic-type of juvenile rheumatoid arthritis
      after chickenpox in a 2-year-old boy.

PMID- 11208012
TI  - An injection needle as a foreign body in the trachea resulting from asthma
      inhalation therapy.

PMID- 11208013
TI  - Oromandibular-limb hypogenesis with pulmonary hypoplasia.

PMID- 11208014
TI  - Highly suspected case of FAPA (periodic fever, aphthous stomatitis, pharyngitis
      and adenitis) syndrome.

PMID- 11208015
TI  - Free carnitine concentrations in cord blood in preterm and full-term infants with
      intrauterine growth retardation.

PMID- 11208016
TI  - Elevated serum levels of soluble interleukin-2 receptor in juvenile
      dermatomyositis.

PMID- 11208017
TI  - A novel cold-inducible zinc finger protein from soybean, SCOF-1, enhances cold
      tolerance in transgenic plants.
AB  - Cold stress on plants induces changes in the transcription of cold response
      genes. A cDNA clone encoding C2H2-type zinc finger protein, SCOF-1, was isolated
      from soybean. The transcription of SCOF-1 is specifically induced by low
      temperature and abscisic acid (ABA) but not by dehydration or high salinity.
      Constitutive overexpression of SCOF-1 induced cold-regulated (COR) gene
      expression and enhanced cold tolerance of non-acclimated transgenic Arabidopsis
      and tobacco plants. SCOF-1 localized to the nucleus but did not bind directly to
      either C-repeat/dehydration (CRT/DRE) or ABA responsive element (ABRE), cis
      acting DNA regulatory elements present in COR gene promoters. However, SCOF-1
      greatly enhanced the DNA binding activity of SGBF-1, a soybean G-box binding bZIP
      transcription factor, to ABRE in vitro. SCOF-1 also interacted with SGBF-1 in a
      yeast two-hybrid system. The SGBF-1 transactivated the beta-glucuronidase
      reporter gene driven by the ABRE element in Arabidopsis leaf protoplasts.
      Furthermore, the SCOF-1 enhanced ABRE-dependent gene expression mediated by SGBF
      1. These results suggest that SCOF-1 may function as a positive regulator of COR
      gene expression mediated by ABRE via protein-protein interaction, which in turn
      enhances cold tolerance of plants.

PMID- 11208018
TI  - Plastid-expressed 5-enolpyruvylshikimate-3-phosphate synthase genes provide high
      level glyphosate tolerance in tobacco.
AB  - Plastid transformation (transplastomic) technology has several potential
      advantages for biotechnological applications including the use of unmodified
      prokaryotic genes for engineering, potential high-level gene expression and gene
      containment due to maternal inheritance in most crop plants. However, the
      efficacy of a plastid-encoded trait may change depending on plastid number and
      tissue type. We report a feasibility study in tobacco plastids to achieve high
      level herbicide resistance in both vegetative tissues and reproductive organs. We
      chose to test glyphosate resistance via over-expression in plastids of tolerant
      forms of 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS). Immunological,
      enzymatic and whole-plant assays were used to prove the efficacy of three
      different prokaryotic (Achromobacter, Agrobacterium and Bacillus) EPSPS genes.
      Using the Agrobacterium strain CP4 EPSPS as a model we identified translational
      control sequences that direct a 10,000-fold range of protein accumulation (to
      >10% total soluble protein in leaves). Plastid-expressed EPSPS could provide very
      high levels of glyphosate resistance, although levels of resistance in vegetative
      and reproductive tissues differed depending on EPSPS accumulation levels, and
      correlated to the plastid abundance in these tissues. Paradoxically, higher
      levels of plastid-expressed EPSPS protein accumulation were apparently required
      for efficacy than from a similar nuclear-encoded gene. Nevertheless, the
      demonstration of high-level glyphosate tolerance in vegetative and reproductive
      organs using transplastomic technology provides a necessary step for transfer of
      this technology to other crop species.

PMID- 11208019
TI  - Resistance to the plant PR-5 protein osmotin in the model fungus Saccharomyces
      cerevisiae is mediated by the regulatory effects of SSD1 on cell wall
      composition.
AB  - The capacity of plants to counter the challenge of pathogenic fungal attack
      depends in part on the ability of plant defense proteins to overcome fungal
      resistance by being able to recognize and eradicate the invading fungi. Fungal
      genes that control resistance to plant defense proteins are therefore important
      determinants that define the range of fungi from which an induced defense protein
      can protect the plant. Resistance of the model fungus Saccharomyces cerevisiae to
      osmotin, a plant defense PR-5 protein, is strongly dependent on the natural
      polymorphism of the SSD1 gene. Expression of the SSD1-v allele afforded
      resistance to the antifungal protein. Conversely, yeast strains carrying the SSD1
      d allele or a null ssd1Delta mutation displayed high sensitivity to osmotin. The
      SSD1-v protein mediates osmotin resistance in a cell wall-dependent manner.
      Deletion of SSD1-v or SSD1-d impeded sorting of the PIR proteins (osmotin
      resistance factors) to the cell wall without affecting mRNA levels, indicating
      that SSD1 functions in post-transcriptional regulation of gene expression. The
      sensitivity of ssd1Delta cells to osmotin was only partially suppressed by over
      accumulation of PIR proteins in the cell wall, suggesting an additional function
      for SSD1 in cell wall-mediated resistance. Accordingly, cells carrying a null
      ssd1 mutation also displayed aberrant cell-wall morphology and lower levels of
      alkali-insoluble cell-wall glucans. Therefore SSD1 is an important regulator of
      fungal cell-wall biogenesis and composition, including the deposition of PIR
      proteins which block the action of plant antifungal PR-5 proteins.

PMID- 11208020
TI  - The spatial expression patterns of a phosphate transporter (MtPT1) from Medicago
      truncatula indicate a role in phosphate transport at the root/soil interface.
AB  - The movement of phosphate from the soil into plant root cells is the first of
      many crucial transport events required to supply phosphorous (P) to cells
      throughout the plant. In addition to the ability to acquire phosphate from the
      soil, the majority of the vascular plants are able to form arbuscular mycorrhizal
      associations in which phosphate may be delivered to the cortex via a fungus.
      Previously, we cloned two phosphate transporter genes, MtPT1 and MtPT2 from
      Medicago truncatula roots. Complementation of a yeast phosphate transport mutant
      revealed that MtPT1 is a functional phosphate transporter and Northern analyses
      revealed that MtPT1 is expressed exclusively in roots (Liu et al., 1998, Mol.
      Plant-Microbe Interact. 11, 14--22). Utilising an antibody specific for MtPT1, we
      have analysed the accumulation and spatial expression patterns of the MtPT1
      transporter. MtPT1 transcript and protein levels show close correlation and
      increase dramatically in the roots in response to phosphate starvation. MtPT1
      protein levels decrease in roots during development of a symbiosis with
      arbuscular mycorrhizal (AM) fungi, indicating that this transporter is not
      involved in symbiotic phosphate transport. Membrane fractionation and analysis of
      a MtPT1/GFP fusion protein revealed that MtPT1 is located in the plasma membrane,
      while in situ hybridisation and immunolocalisation demonstrate the presence of
      MtPT1 transcripts and protein in the epidermal cells and root hairs of M.
      truncatula roots. MtPT1 shows expression patterns consistent with a role
      specifically in the acquisition of phosphate from the soil and is distinct from
      the other phosphate transporter of this class described to date.

PMID- 11208021
TI  - The ABI1 and ABI2 protein phosphatases 2C act in a negative feedback regulatory
      loop of the abscisic acid signalling pathway.
AB  - The Arabidopsis ABI1 and ABI2 genes encode two protein serine/threonine
      phosphatases 2C (PP2C). These genes have been originally identified by the
      dominant mutations abi1--1 and abi2--1, which reduce the plant's responsiveness
      to the hormone abscisic acid (ABA). However, recessive mutants of ABI1 were
      recently shown to be supersensitive to ABA, which demonstrated that the ABI1
      phosphatase is a negative regulator of ABA signalling. We report here the
      isolation and characterisation of the first reduction-of-function allele of ABI2,
      abi2--1R1. The in vitro phosphatase activity of the abi2--1R1 protein is
      approximately 100-fold lower than that of the wild-type ABI2 protein. Abi2--1R1
      plants displayed a wild-type ABA sensitivity. However, doubly mutant plants
      combining the abi2--1R1 allele and a loss-of-function allele at the ABI1 locus
      were more responsive to ABA than each of the parental single mutants. These data
      indicate that the wild-type ABI2 phosphatase is a negative regulator of ABA
      signalling, and that the ABI1 and ABI2 phosphatases have overlapping roles in
      controlling ABA action. Measurements of PP2C activity in plant extracts showed
      that the phosphatase activity of ABI1 and ABI2 increases in response to ABA.
      These results suggest that ABI1 and ABI2 act in a negative feedback regulatory
      loop of the ABA signalling pathway.

PMID- 11208022
TI  - Genes determining pathogenicity to pea are clustered on a supernumerary
      chromosome in the fungal plant pathogen Nectria haematococca.
AB  - Three genes that contribute to the ability of the fungus Nectria haematococca to
      cause disease on pea plants have been identified. These pea pathogenicity (PEP)
      genes are within 25 kb of each other and are located on a supernumerary
      chromosome. Altogether, the PEP gene cluster contains six transcriptional units
      that are expressed during infection of pea tissue. The biochemical function of
      only one of the genes is known with certainty. This gene, PDA1, encodes a
      specific cytochrome P450 that confers resistance to pisatin, an antibiotic
      produced by pea plants. The three new PEP genes, in addition to PDA1, can
      independently increase the ability of the fungus to cause lesions on pea when
      added to an isolate lacking the supernumerary chromosome. Based on predicted
      amino acid sequences, functions for two of these three genes are hypothesized.
      The deduced amino acid sequence of another transcribed portion of the PEP
      cluster, as well as four other open reading frames in the cluster, have a high
      degree of similarity to known fungal transposases. Several of the features of the
      PEP cluster -- a cluster of pathogenicity genes, the presence of transposable
      elements, and differences in codon usage and GC content from other portions of
      the genome -- are shared by pathogenicity islands in pathogenic bacteria of
      plants and animals.

PMID- 11208023
TI  - Ethylene-dependent salicylic acid regulates an expanded cell death response to a
      plant pathogen.
AB  - The molecular events associated with susceptible plant responses to disease
      causing organisms are not well understood. We have previously shown that ethylene
      insensitive tomato plants infected with Xanthomonas campestris pv. vesicatoria
      have greatly reduced disease symptoms relative to wild-type cultivars. Here we
      show that salicylic acid (SA) is also an important component of the susceptible
      disease response. SA accumulates in infected wild-type tissues and is correlated
      with necrosis but does not accumulate in ethylene-insensitive plants. Exogenous
      feeding of SA to ethylene-deficient plants restores necrosis, indicating that
      reduced disease symptoms are associated with failure to accumulate SA. These
      results indicate a mechanism for co-ordination of phytohormone signals that
      together constitute a susceptible response to pathogens.

PMID- 11208024
TI  - Alteration of a single amino acid changes the substrate specificity of
      dihydroflavonol 4-reductase.
AB  - Many plant species exhibit a reduced range of flower colors due to the lack of an
      essential gene or to the substrate specificity of a biosynthetic enzyme. Petunia
      does not produce orange flowers because dihydroflavonol 4-reductase (DFR) from
      this species, an enzyme involved in anthocyanin biosynthesis, inefficiently
      reduces dihydrokaempferol, the precursor to orange pelargonidin-type
      anthocyanins. The substrate specificity of DFR, however, has not been
      investigated at the molecular level. By analyzing chimeric DFRs of Petunia and
      Gerbera, we identified a region that determines the substrate specificity of DFR.
      Furthermore, by changing a single amino acid in this presumed substrate-binding
      region, we developed a DFR enzyme that preferentially reduces dihydrokaempferol.
      Our results imply that the substrate specificity of DFR can be altered by minor
      changes in DFR.

PMID- 11208025
TI  - The MLA6 coiled-coil, NBS-LRR protein confers AvrMla6-dependent resistance
      specificity to Blumeria graminis f. sp. hordei in barley and wheat.
AB  - The barley Mla locus confers multiple resistance specificities to the obligate
      fungal biotroph, Blumeria (= Erysiphe) graminis f. sp. hordei. Interspersed
      within the 240 kb Mla complex are three families of resistance gene homologs
      (RGHs). Probes from the Mla-RGH1 family were used to identify three classes of
      cDNAs. The first class is predicted to encode a full-length CC-NBS-LRR protein
      and the other two classes contain alternatively spliced, truncated variants.
      Utilizing a cosmid that contains a gene corresponding to the full-length
      candidate cDNA, two single-cell expression assays were used to demonstrate
      complementation of AvrMla6-dependent, resistance specificity to B. graminis in
      barley and wheat. The first of these assays was also used to substantiate
      previous genetic data that the Mla6 allele requires the signaling pathway
      component, Rar1, for function. Computational analysis of MLA6 and the Rar1
      independent, MLA1 protein reveals 91.2% identity and shows that the LRR domain is
      subject to diversifying selection. Our findings demonstrate that highly related
      CC-NBS-LRR proteins encoded by alleles of the Mla locus can dictate similar
      powdery mildew resistance phenotypes yet still require distinct downstream
      signaling components.

PMID- 11208026
TI  - Cytometric analysis of an epitope-tagged transit peptide bound to the chloroplast
      translocation apparatus.
AB  - Chloroplast transit peptides are necessary and sufficient for the targeting and
      translocation of precursor proteins across the chloroplast envelope. However, the
      mechanism by which transit peptides engage the translocation apparatus has not
      been investigated. To analyse this interaction, we have developed a novel epitope
      tagged transit peptide derived from the precursor of the small subunit of pea
      Rubisco. The recombinant transit peptide, His-S-SStp, contains a removable dual
      epitope tag, His-S, at its N-terminus that permits both rapid purification via
      immobilized metal affinity chromatography and detection by blotting, flow
      cytometry and laser-scanning confocal microscopy. Unlike other chimeric
      precursors, which place the passenger protein C-terminal to the transit peptide,
      His-S-SStp bound to the translocation apparatus yet did not translocate across
      the chloroplast envelope. This early translocation intermediate allowed non
      radioactive detection using fluorescent and chemiluminescent reporters. The
      physiological relevance of this interaction was confirmed by protein import
      competitions, sensitivity to pre- and post-import thermolysin treatment,
      photochemical cross-linking and organelle fractionation. The interaction was
      specific for the transit peptide since His-S alone did not engage the chloroplast
      translocation apparatus. Quantitation of the bound transit peptide was determined
      by flow cytometry, showing saturation of binding yet only slight ATP-dependence.
      The addition of GTP showed inhibition of the binding of His-S-SStp to the
      chloroplasts indicating an involvement of GTP in the formation of this early
      translocation intermediate. In addition, direct visualization of His-S-SStp and
      Toc75 by confocal microscopy revealed a patch-like labeling, suggesting a co
      ordinate localization to discrete regions on the chloroplast envelope. These
      findings represent the first direct visualization of a transit peptide
      interacting with the chloroplast translocation apparatus. Furthermore,
      identification of a chloroplast-binding intermediate may provide a novel tool to
      dissect interactions between a transit peptide and the chloroplast translocation
      apparatus.

PMID- 11208027
TI  - Increasing the proportion of diabetics with AV fistulas.
AB  - Worldwide, older diabetic patients represent the most rapidly growing group of
      patients treated for end-stage renal disease (ESRD). Preexisting arterial as well
      as venous problems have led to a pessimistic view on the creation of vascular
      access in this population. During 1993-98 I created all primary arteriovenous
      (AV) accesses for a total of 181 patients with diabetes mellitus (DM) ESRD and
      567 patients with ESRD due to all other causes (non-DM). The following approach
      led to good outcomes for both groups whether assessed by time to first
      intervention or time to failure: careful preoperative investigations for
      selection of adequate location for initial AV fistula through ultrasonographic
      techniques; timely surgical AV fistula creation; preference of large-diameter,
      "healthy" arteries and veins, frequently requiring use of the elbow region;
      absolute priority for use of native vessels (i.e., avoidance of initial
      polytetrafluoroethylene [PTFE]); meticulous surgical technique and creativity;
      and continuous surveillance by the nephrologist and staff allowing elective
      revisions and avoidance of thrombosis. With this approach AV fistulas rather than
      PTFE grafts can be created in most diabetic and nondiabetic patients.

PMID- 11208028
TI  - Reconsidering the importance of long-term low-level aluminum exposure in renal
      failure patients.
AB  - Aluminum toxicity is widely considered a problem of the past. However, low-level
      aluminum exposure and low but abnormal body burdens of aluminum are common.
      Aluminon, the routinely used histochemical stain for aluminum in bone, has a low
      sensitivity. The role of aluminum in renal osteodystrophy needs to be reassessed
      using more sensitive techniques. Low-level aluminum exposure also may resu in
      subtle neurological dysfunction, another area that needs further investigation.

PMID- 11208030
TI  - Is Kt/V Urea a Satisfactory Measure for Dosing the Newer Dialysis Regimens?

PMID- 11208029
TI  - Is Kt/V urea a satisfactory measure for dosing the newer dialysis regimens?

PMID- 11208031
TI  - Is Kt/V Urea a Satisfactory Measure for Dosing the Newer Dialysis Regimens?

PMID- 11208032
TI  - Is Kt/V Urea a Satisfactory Measure for Dosing the Newer Dialysis Regimens?

PMID- 11208033
TI  - Is Kt/V Urea a Satisfactory Measure for Dosing the Newer Dialysis Regimens?

PMID- 11208034
TI  - Ethical issues in dialysis. Managing noncompliant dialysis patients.

PMID- 11208035
TI  - Must we treat noncompliant ESRD patients?
AB  - Coping with the stress induced by ESRD patient noncompliance is a time consuming,
      nonproductive, demoralizing undertaking that is unavoidable. An orderly, non
      confrontational approach encompassing measures to protect mentally incompetent
      and unaware patients as well as those too sick to comprehend and consent to
      therapy (dialysis) is provided. Individual practitioners should utilize all
      available resources including patient relatives and friends, collaborating
      psychiatrists, and institutional risk-management officers to assist in devising
      the best resolution to what may escalate into an onslaught against the renal care
      team. No single solution is applicable to the myriad variables that may impinge
      on a specific patient's seemingly apathetic or hateful behavior underlying
      noncompliance.

PMID- 11208036
TI  - There is a duty to treat noncompliant patients.

PMID- 11208037
TI  - Quantitative characterization of hemodialyzer solute and water transport.
AB  - Clinicians are frequently faced with the task of selecting a hemodialyzer for a
      dialysis-dependent patient. Several quantitative dialyzer parameters, such as
      clearance, sieving coefficients, and ultrafiltration coefficient, are routinely
      used in this selection process. However, the quantitative basis and exact meaning
      of these indices are often unclear or misinterpreted. The purpose of this article
      is to provide a detailed description of several of these parameters with the hope
      that this information will enable clinicians to make dialyzer selection from a
      more quantitative perspective.

PMID- 11208038
TI  - Noninfectious causes of cloudy peritoneal dialysate.
AB  - The appearance of cloudy dialysate fluid in combination with the clinical
      manifestations of peritonitis usually heralds infectious peritonitis. Diagnosis
      is readily established in most cases by routine culture of the turbid dialysate.
      However, an occasional patient presents with culture-negative, cloudy dialysate.
      After ruling out atypical infectious etiologies, a diverse set of aseptic causes
      remains in the differential diagnosis. Herein we review these causes and suggest
      an organizational scheme, based on identifying the cellular or noncellular
      constituent producing the dialysate turbidity, to facilitate appropriate
      diagnostic and therapeutic interventions.

PMID- 11208039
TI  - Individualizing the dialysate in the hemodialysis patient.
AB  - In most outpatient centers the dialysate is prepared centrally such that the
      composition of the dialysate is the same for all patients. When delivered in this
      manner most patients tolerate the procedure well. However, there are patients who
      tolerate the procedure poorly, which has prompted a great deal of research
      focused on individualizing the composition of the dialysate in order to improve
      patient tolerability. Prescribing a patient-specific dialysate will become
      increasingly important as the age of and number of comorbid conditions increase
      in the dialysis population. Patients with end-stage renal disease (ESRD) depend
      on dialysis to maintain fluid and electrolyte balance. Hemodialysis allows for
      solutes to diffuse between blood and dialysate such that, over the course of the
      procedure, plasma composition is restored toward normal values. The makeup of the
      dialysate is of paramount importance in accomplishing this goal. In most out
      patient settings patients receive hemodialysis using dialysate prepared in bulk
      and delivered via a central delivery system so that the composition of the
      dialysate is the same for all patients. While most patients tolerate the
      procedure when administered in this fashion, many patients suffer from
      hemodynamic instability or symptoms of dialysis disequilibrium. One strategy to
      improve the clinical tolerance to dialysis is to adjust the dialysate composition
      according to the individual characteristics of the patient. This article reviews
      recent developments on how the dialysate can be manipulated in order to improve
      patient tolerance. Individualizing the dialysate composition is likely to gain
      increasing importance given the advancing age and increasing number of comorbid
      conditions found in ESRD patients.

PMID- 11208040
TI  - Dialysate leaks in peritoneal dialysis.
AB  - Dialysate leakage represents a major noninfectious complication of peritoneal
      dialysis (PD). An exit-site leak refers to the appearance of any moisture around
      the PD catheter identified as dialysate; however, the spectrum of dialysate leaks
      also includes any dialysate loss from the peritoneal cavity other than via the
      lumen of the catheter. The incidence of dialysate leakage is somewhat more than
      5% in continuous ambulatory peritoneal dialysis (CAPD) patients, but this
      percentage probably underestimates the number of early leaks. The incidence of
      hydrothorax or pleural leak as a complication of PD remains unclear. Factors
      identified as potentially related to dialysate leakage are those related to the
      technique of PD catheter insertion, the way PD is initiated, and weakness of the
      abdominal wall. The pediatric literature tends to favor Tenckhoff catheters over
      other catheters as being superior with respect to dialysate leakage, but no
      consensus on catheter choice exists for adults in this regard. An association has
      been found between early leaks (< or =30 days) and immediate CAPD initiation and
      perhaps median catheter insertion. Risk factors contributing to abdominal
      weakness appear to predispose mostly to late leaks; one or more of them can
      generally be identified in the majority of patients. Early leakage most often
      manifests as a pericatheter leak. Late leaks may present more subtly with
      subcutaneous swelling and edema, weight gain, peripheral or genital edema, and
      apparent ultrafiltration failure. Dyspnea is the first clinical clue to the
      diagnosis of a pleural leak. Late leaks tend to develop during the first year of
      CAPD. The most widely used approach to determine the exact site of the leakage is
      with computed tomography after infusion of 2 L of dialysis fluid containing
      radiocontrast material. Treatments for dialysate leaks include surgical repair,
      temporary transfer to hemodialysis, lower dialysate volumes, and PD with a
      cycler. Recent recommendation propose a standard approach to the treatment of
      early and late dialysate leaks: 1-2 weeks of rest from CAPD, and surgery if
      recurrence. Surgical repair has been strongly suggested for leakage causing
      genital swelling. Delaying CAPD for 14 days after catheter insertion may prevent
      early leakage. Initiating CAPD with low dialysate volume has also been
      recommended as a good practice measure. Although peritonitis and exit-site
      infections are the most frequent causes of technical failure in peritoneal
      dialysis (PD), dialysate leaks represent one of the major noninfectious
      complications of PD. In some instances, dialysate leakage may lead to
      discontinuation of the technique (1). Despite its importance, the incidence, risk
      factors, management, and outcome of dialysate leakage are poorly characterized in
      the literature. We will review the limited available information on this topic in
      the next few sections.

PMID- 11208041
TI  - Regulation of bone remodeling: impact of novel therapies.
AB  - The kidneys serve as both an endocrine organ and as a target of endocrine action,
      with the aim of controlling mineral and water balance. Hormones and other key
      metabolites regulate mineral homeostasis by altering gene function directly or by
      initiating a sequence of events, leading ultimately to a change in enzyme
      function. Two of these hormones, parathyroid hormone (PTH) and calcitriol (the
      active form of vitamin D), interact in multiple tissues in the body to regulate
      the flux of calcium and phosphorus between extra- and intracellular compartments.
      Changes in the concentration of PTH and vitamin D, or the interaction of these
      with other factors, lead to the aberrant regulation of calcium and phosphorus.
      Among other effects, this aberrant regulation leads to pathologic changes in bone
      metabolism. The pathology of renal bone disease varies along a spectrum from
      disorders of low turnover to those of high turnover. This spectrum reflects the
      results of therapeutic intervention, hormone balances, and other causes.
      Effective management of renal bone disease therefore requires thorough evaluation
      of relevant risk factors, measurement of biochemical markers of bone remodeling,
      and determination of the physical status of bone tissue either by bone mineral
      density or bone biopsy. Subsequent therapeutic intervention with newer vitamin D
      compounds, novel phosphate binders, calcimimetics, and the use of alternative
      dialysis modalities offer hope in normalizing bone remodeling and mineral
      balance. The human skeleton functions in two capacities: the storage of minerals
      and structural support of the body. It is the only tissue that behaves as both a
      major source and a sink of calcium (Ca) and phosphorus (P). Healthy bone is a
      composite of a collagenous matrix embedded with crystals of hydroxyapatite. On
      the surface of bone and within the calcified matrix are specialized cells that
      build and maintain the tissue, and facilitate the movement of Ca and P into and
      out of serum. Bone undergoes remodeling in response to either damage from
      mechanical strain or as part of the normal cycle of bone renewal. The process
      involves distinct steps of cellular activation, bone resorption, and subsequent
      bone formation. It is a relatively slow process that takes several months, and at
      any one time occurs at many different sites along the bone surface. Systemic
      factors, such as PTH and vitamin D, regulate the resorption and formation of
      bone, and thus the systemic movement of Ca and P. However, during conditions of
      stress and disease, other factors may also play a role. In patients with chronic
      renal disease, the balance of Ca and P is profoundly disturbed. This disruption
      and the compensatory changes that occur in response alter the normal processes of
      bone metabolism.

PMID- 11208042
TI  - Pericarditis associated with renal failure: evolution and management.

PMID- 11208043
TI  - Wide complex tachycardia in a dialysis patient.

PMID- 11208044
TI  - Sip, sip, sippy.

PMID- 11208045
TI  - Vitamin E for dialysis patients.

PMID- 11208046
TI  - Use of aspirin in hemodialysis patients.

PMID- 11208047
TI  - Beta-blocker use in peritoneal dialysis patients.

PMID- 11208048
TI  - The "pinch off" syndrome.

PMID- 11208049
TI  - The seventh day: a day of unrest.

PMID- 11208050
TI  - The hem of the garment.

PMID- 11208053
TI  - Motors, clutches and brakes for membrane traffic: a commemorative review in honor
      of Thomas Kreis.
AB  - Membranous organelles interact with a wide variety of cytoskeletal proteins that
      allow them to be organized into dynamic, yet stable, structures with distinct
      subcellular addresses. This review provides an up-to-date summary of the motor
      enzymes and membrane-microtubule crosslinking proteins that have been implicated
      in this process, and discusses the potential impact membrane anchoring may have
      on cellular architecture.

PMID- 11208054
TI  - Unconventional myosins: anchors in the membrane traffic relay.
AB  - The family of unconventional myosins is ever growing and the functions attributed
      to them seem to expand in parallel. These actin-based motor proteins have been
      implicated in processes as seemingly diverse as endocytosis and exocytosis, the
      transport of organelles, in spermatogenesis and in neurosensory functions such as
      hearing and sight. A common myosin function may underlie them all--the regulation
      of intracellular membrane traffic.

PMID- 11208055
TI  - The polymerization motor.
AB  - Polymerization and depolymerization of actin filaments and microtubules are
      thought to generate force for movement in various kinds of cell motility, ranging
      from lamellipodial protrusion to chromosome segregation. This article reviews the
      thermodynamic and physical theories of how a nonequilibrium polymerization
      reaction can be used to transduce chemical energy into mechanical energy, and
      summarizes the evidence suggesting that actin polymerization produces motile
      force in several biological systems.

PMID- 11208056
TI  - Stirring up development with the heterotrimeric kinesin KIF3.
AB  - KIF3 is a heterotrimeric member of the kinesin superfamily of microtubule
      associated motors. This functionally diverse family of motor is involved in
      anterograde transport of membrane bound organelles in neurons and melanosomes,
      mediates transport between the endoplasmic reticulum and the Golgi, and
      transports protein complexes within cilia and flagella required for their
      morphogenesis. Interestingly, a mutation of KIF3, which impairs ciliogenesis in
      nodal cells, prevents the unidirectional leftward flow (nodal flow) of putative
      morphogens during embryogenesis, thereby altering the development of left-right
      asymmetry in mammals.

PMID- 11208057
TI  - Membrane traffic in anaglyph stereo.

PMID- 11208058
TI  - Mitotic phosphorylation of the dynein light intermediate chain is mediated by
      cdc2 kinase.
AB  - Cytoplasmic dynein, a large minus-end-directed microtubule motor, performs
      multiple functions during the cell cycle. In interphase, dynein moves membrane
      organelles, while in mitosis it moves chromosomes and helps to form the mitotic
      spindle. The cell-cycle regulation of dynein activity may be controlled, at least
      in part, by the phosphorylation of its light intermediate chains (DLIC), since a
      10-fold increase in light intermediate chain phosphorylation correlates with a
      decrease in dynein-based membrane transport of similar magnitude in mitosis. In
      this study, we sought to identify the kinase responsible for this potentially
      important phosphorylation event. We show that bacterially-expressed chicken light
      intermediate chain (chDLIC) will undergo mitosis-specific phosphorylation when
      added to Xenopus egg extracts. Mutation of a conserved cdc2 kinase consensus site
      (Ser197) abolishes this phosphorylation event, and mass spectroscopy analysis
      confirms that the wild-type DLIC is stoichiometrically phosphorylated at this
      site when incubated with metaphase but not interphase extracts. We also show that
      purified cdc2 kinase phosphorylates purified DLICs at Ser197 in vitro and that
      Ser197 phosphorylation is dramatically reduced in metaphase extracts depleted of
      cdc2 kinase. These results indicate that cdc2 kinase directly phosphorylates
      dynein and thus may be an important regulator of dynein activity in the cell
      cycle.

PMID- 11208059
TI  - The yeast endosomal t-SNARE, Pep12p, functions in the absence of its
      transmembrane domain.
AB  - Delivery of proteins to the vacuole of the yeast Saccharomyces cerevisiae
      requires the function of two distinct SNARE complexes. Pep12p and Vam3p are both
      t-SNAREs of the syntaxin family that are components of these SNARE complexes. We
      have used a genetic approach to address the role of Pep12p in vacuolar protein
      transport. Our screen for temperature-sensitive pep12 mutants yielded six alleles
      that were rapidly inactivated upon exposure to the non-permissive temperature.
      Surprisingly, the proteins encoded by these alleles were all truncated
      immediately prior to the transmembrane domain. Here we demonstrate that Pep12p
      requires its transmembrane domain for proper localization, but not for its role
      in vesicle fusion. In addition, we show that although Pep12p can replace Vam3p in
      the vacuolar SNARE complex, its transmembrane domain is required to function at
      this step. Therefore, the transmembrane domain of Pep12p performs different roles
      in the prevacuolar and vacuolar SNARE complexes.

PMID- 11208060
TI  - Morphogenesis and dynamics of the yeast Golgi apparatus.
AB  - A kinetic and morphometric study was conducted with the electron microscope to
      clarify the biogenesis and structural diversity of the Golgi apparatus in the
      yeast Saccharomyces cerevisiae. Secretion was synchronized by inhibiting protein
      synthesis and/or by subjecting thermosensitive secretory mutants to double
      temperature shifts. Five membrane-bounded structures disappeared or reappeared in
      an orderly manner at approximately the rate of secretory protein flow. 1) The
      first detectable post-ER intermediates were very short-lived clusters of small
      vesicles that appeared next to the endoplasmic reticulum (ER). 2) Their
      constituent small vesicles were rapidly bridged by membrane tubules in a SEC18
      dependent manner, giving short-lived tubular clusters of small vesicles,
      analogous to mammalian vesicular-tubular clusters. 3) Fine and 4) large nodular
      networks (coated with the Golgi protein Sec7), and 5) secretory granules. Upon
      relieving a secretory block, each structure successively reappeared, seemingly by
      transformation of the previous one. When no secretory cargo was to be
      transported, these structures were not renewed. They disappeared more than five
      times faster than some Golgi enzymes such as Och1p, implying that the latter are
      recycled and perhaps partially retained. Retention could arise from intra
      compartmental flow of cargo/carrier, hinted at by the varying calibers within a
      single nodular network.

PMID- 11208061
TI  - Complete reconstitution of clathrin basket formation with recombinant protein
      fragments: adaptor control of clathrin self-assembly.
AB  - Clathrin polymerization into a polyhedral basket, surrounding budding membrane
      vesicles, mediates protein sorting during endocytosis and organelle biogenesis.
      Adaptor proteins target clathrin assembly to specific membrane sites and
      sequester receptors into the clathrin coat. We have reconstituted complete
      clathrin basket formation from recombinantly expressed fragments of clathrin and
      adaptors. This reconstitution reveals a hierarchy of clathrin self-assembly
      interactions and demonstrates that adaptors control basket formation by alignment
      of the distal domains of the clathrin triskelion leg through their binding to the
      terminal domain.

PMID- 11208063
TI  - Membrane dynamics in endocytosis: structure--function relationship.
AB  - A number of years ago a small group of investigators was torn apart by a debate
      over the existence or fate of somewhat obscure endosomal vesicles not even
      represented in text books. During the last decade, however, interest has shifted
      with the fireworks of newly discovered molecules involved in the regulation of
      protein transport. We are now entering the post-genomic era, where individual
      components can be re-assembled into functional, multiprotein cellular machines.
      Borders between disciplines in Life Sciences are fading away as our molecular
      understanding approaches atomic resolution. It is these exciting developments
      that were captured by the latest edition of the ESF conference series on
      endocytosis.

PMID- 11208062
TI  - Microvillus inclusion disease: a genetic defect affecting apical membrane protein
      traffic in intestinal epithelium.
AB  - The striking similarities between microvillus inclusions (MIs) in enterocytes in
      microvillus inclusion disease (MID) and vacuolar apical compartment in tissue
      culture epithelial cells, led us to analyze endoscopic biopsies of duodenal
      mucosa of a patient after the samples were used for diagnostic procedures.
      Samples from another patient with an unrelated disease were used as controls. The
      MID enterocytes showed a decrease in the thickness of the apical F-actin layer,
      and normal microtubules. The immunofluorescence analysis of the distribution of
      five apical membrane markers (sucrase isomaltase, alkaline phosphatase, NHE-3
      Na+/H+ exchanger, cGMP-dependent protein kinase, and cystic fibrosis trans
      membrane conductance regulator), showed low levels of these proteins in their
      standard localization at the apical membrane as compared with normal duodenal
      epithelium processed in parallel. Instead, four of these markers were found in a
      diffuse distribution in the apical cytoplasm, below the terminal web (as
      indicated by co-localization with F-actin and cytokeratin 19), and in MIs as
      well. The basolateral protein Na(+)-K+ATPase, in contrast, was normally
      localized. These results support the hypothesis that MID may represent the first
      genetic defect affecting apical membrane traffic, possibly in a late step of
      apical exocytosis.

PMID- 11208064
TI  - Proteomic tools for cell biology.
AB  - Acquisition of large bodies of genomic sequence is facilitating the use of global
      techniques to assay cellular function. DNA microarrays have enabled the
      measurement of global mRNA levels and are able to detect changes in gene
      expression between different cellular states. Since much of the regulation of
      physiological processes happens post-translationally, measuring only the mRNA
      levels gives an incomplete picture. Strategies to assay global expression,
      localization, or interaction of proteins fall into the emerging field of
      proteomics, with various combinations of techniques being utilized to separate
      and identify proteins. In this review, we will present a general overview of the
      currently available proteomic tools and then give examples of how these tools are
      being utilized to answer questions in cell biology.

PMID- 11208065
TI  - Watching proteins in the wild: fluorescence methods to study protein dynamics in
      living cells.
AB  - The advent of GFP imaging has led to a revolution in the study of live cell
      protein dynamics. Ease of access to fluorescently tagged proteins has led to
      their widespread application and demonstrated the power of studying protein
      dynamics in living cells. This has spurred development of next generation
      approaches enabling not only the visualization of protein movements, but
      correlation of a protein's dynamics with its changing structural state or ligand
      binding. Such methods make use of fluorescence resonance energy transfer and dyes
      that report changes in their environment, and take advantage of new chemistries
      for site-specific protein labeling.

PMID- 11208066
TI  - The use of yeast two-hybrid screens in studies of protein:protein interactions
      involved in trafficking.
AB  - The yeast two-hybrid system has provided a convenient means to both screen for
      proteins that interact with a protein of interest and to characterise the known
      interaction between two proteins. Several groups with an interest in the
      molecular mechanisms that underlie discrete steps along trafficking pathways have
      exploited the yeast two-hybrid system. Here, we provide a brief background to the
      technology, attempt to point out some of the pitfalls and benefits of the
      different systems that can be employed, and mention some of the areas (within the
      trafficking field) where yeast two-hybrid interaction assays have been
      particularly informative.

PMID- 11208067
TI  - Proteomic analysis of two functional states of the Golgi complex in mammary
      epithelial cells.
AB  - Organellar compartments involved in secretion are expanded during the transition
      from late pregnancy (basal secretory state) to lactation (maximal secretory
      state) to accommodate for the increased secretory function required for copious
      milk production in mammary epithelial cells. The Golgi complex is a major
      organelle of the secretory pathway and functions to sort, package, distribute,
      and post-translationally modify newly synthesized proteins and membrane lipids.
      These complex functions of the Golgi are reflected in the protein complement of
      the organelle. Therefore, using proteomics, the protein complements of Golgi
      fractions isolated at two functional states (basal and maximal) were compared to
      identify some of the molecular changes that occur during this transition. This
      global analysis has revealed that only a subset of the total proteins is
      upregulated from steady state during the transition. Identification of these
      proteins by tandem mass spectrometry has revealed several classes of proteins
      involved in the regulation of membrane fusion and secretion. This first
      installment of the functional proteomic analysis of the Golgi complex begins to
      define the molecular basis for the transition from basal to maximal secretion.

PMID- 11208068
TI  - Weibel-Palade body membrane proteins exhibit differential trafficking after
      exocytosis in endothelial cells.
AB  - Weibel-Palade bodies, the secretory granules of endothelial cells, possess two
      different membrane proteins. However, P-selectin is seen only in Weibel-Palade
      bodies in HUVECs, whereas CD63 is also seen in late endosomes/lysosomes. Since P
      selectin is targeted to lysosomes in heterologous expression studies, we have
      determined whether a lysosomal targeting signal also operates within HUVECs. We
      have also examined the trafficking of CD63 to its two different intracellular
      locations. By following antibodies bound at the plasma membrane during
      stimulation, we have discovered that while half of the P-selectin recycles to the
      WPBs, 50% is rapidly delivered to a lamp-1-positive compartment. Thus, the
      lysosomal targeting signal of this protein also operates in HUVECs. CD63 is found
      constitutively at the cell surface of HUVECs and most of it is delivered to the
      late endosomes/lysosomes after internalisation. However, stimulation causes both
      a rise in the CD63 plasma membrane level and in the amount that recycles to the
      WPBs. Our data strongly suggest that the CD63 that originates in the WPB
      preferentially recycles to the granule rather than being delivered to the late
      endosome/lysosome, and that there are, therefore, two separate pools of this
      protein within HUVECs. Our findings indicate that although P-selectin and CD63
      are both targeted to the same compartments from the PM, the kinetics and the
      ratio of their targeting to Weibel-Palade bodies versus lysosomes are very
      different.

PMID- 11208069
TI  - Detergent insoluble microdomains are not involved in transcytosis of polymeric Ig
      receptor in FRT and MDCK cells.
AB  - In polarized epithelial cells, sorting of proteins and lipids to the apical or
      basolateral domain of the plasma membrane can occur via direct or indirect
      (transcytotic) pathways from the trans Golgi network (TGN). The 'rafts'
      hypothesis postulates that the key event for direct apical sorting of some
      transmembrane proteins and the majority of GPI-anchored proteins depends on their
      association with glycosphingolipid and cholesterol enriched microdomains (rafts).
      However, the mechanism of indirect sorting to the apical membrane is not clear.
      The polyimmunoglobulin receptor (pIgR) is one of the best studied proteins that
      follow the transcytotic pathway. It is normally delivered from the TGN to the
      basolateral surface of polarized Madin-Darby Canine Kidney (MDCK) cells from
      where it transports dIgA or dIgM to the apical surface. We have studied the
      intracellular trafficking of pIgR in Fischer rat thyroid cells (FRT), and have
      investigated the sorting machinery involved in transcytosis of this receptor in
      both FRT and MDCK cells. We found that, in contrast with MDCK cells, a
      significant amount (approximately 30%) of pIgR reaches the apical surface by a
      direct pathway. Furthermore, in both cell lines it does not associate with Triton
      X-100 insoluble microdomains, suggesting that at least in these cells 'rafts' are
      not involved in basolateral to apical transcytosis.

PMID- 11208070
TI  - Biomolecule function: no reliable prediction from cell culture.

PMID- 11208072
TI  - Analysis of the lysosomal storage disease Chediak-Higashi syndrome.
AB  - Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disorder of human,
      mouse (beige) and other mammalian species. The same genetic defect was found to
      result in the disease in all species identified, permitting a positional cloning
      approach using the mouse model beige to identify the responsible gene. The CHS
      gene was cloned and mutations identified in affected species. This review
      discusses the clinical features of CHS contrasting features seen in similar
      syndromes. The possible functions of the protein encoded by the CHS/beige gene
      are discussed, along with the alterations in cellular physiology seen in mutant
      cells.

PMID- 11208071
TI  - Membrane traffic in sphingolipid storage diseases.
AB  - In this review, we summarize our studies of membrane lipid transport in
      sphingolipid storage disease (SLSD) fibroblasts. We recently showed that several
      fluorescent SL analogs were internalized from the plasma membrane predominantly
      to the Golgi complex of normal cells, while in ten different SLSD cell types,
      these lipids accumulated in endosomes and lysosomes (The Lancet 1999;354: 901
      905). Additional studies showed that cholesterol homeostasis is perturbed in
      multiple SLSDs secondary to SL accumulation and that mistargeting of SL analogs
      was regulated by cholesterol (Nature Cell Biol 1999;1: 386-388). Based on these
      findings, we hypothesize that endogenous sphingolipids, which accumulate in SLSD
      cells due to primary defects in lipid catabolism, result in an altered
      intracellular distribution of cholesterol, and that this alteration in membrane
      composition then results in defective sorting and transport of SLs. The
      importance of SL/cholesterol interactions and potential mechanisms underlying the
      regulation of lipid transport and targeting are also discussed. These studies
      suggest a new paradigm for regulation of membrane lipid traffic along the
      endocytic pathway and could have important implications for future studies of
      protein trafficking as well as lipid transport. This work may also lead to
      important future clinical developments (e.g. screening tests for SLSD, new
      methodology for screening drugs which abrogate lipid storage, and possible
      therapeutic approaches to SLSD).

PMID- 11208073
TI  - Hermansky-Pudlak syndrome and related disorders of organelle formation.
AB  - Hermansky-Pudlak syndrome (HPS) consists of a group of genetically heterogeneous
      disorders which share the clinical findings of oculocutaneous albinism, a
      platelet storage pool deficiency, and some degree of ceroid lipofuscinosis.
      Related diseases share some of these findings and may exhibit other symptoms and
      signs but the underlying defect in the entire group of disorders involves
      defective intracellular vesicle formation, transport or fusion. Two HPS-causing
      genes, HPS1 and ADTB3A, have been isolated but the function of only the latter
      has been determined. ADTB3A codes for the beta 3A subunit of adaptor complex-3,
      responsible for vesicle formation from the trans-Golgi network (TGN). The many
      HPS patients who do not have HPS1 or ADTB3A mutations have their disease because
      of mutations in other genes. Candidates for these HPS-causing genes include those
      responsible for mouse models of HPS or for the 'granule' group of eye color genes
      in Drosophila. Each gene responsible for a subset of HPS or a related disorder
      codes for a protein which almost certainly plays a pivotal role in vesicular
      trafficking, inextricably linking clinical and cell biological interests in this
      group of diseases.

PMID- 11208074
TI  - Traffic jam: a compendium of human diseases that affect intracellular transport
      processes.
AB  - As sequencing of the human genome nears completion, the genes that cause many
      human diseases are being identified and functionally described. This has revealed
      that many human diseases are due to defects of intracellular trafficking. This
      'Toolbox' catalogs and briefly describes these diseases.

PMID- 11208075
TI  - Traffic pattern of cystic fibrosis transmembrane regulator through the early
      exocytic pathway.
AB  - The pathway of transport of the cystic fibrosis transmembrane regulator (CFTR)
      through the early exocytic pathway has not been examined. In contrast to most
      membrane proteins that are concentrated during export from the ER and therefore
      readily detectable at elevated levels in pre-Golgi intermediates and Golgi
      compartments, wild-type CFTR could not be detected in these compartments using
      deconvolution immunofluorescence microscopy. To determine the basis for this
      unusual feature, we analyzed CFTR localization using quantitative immunoelectron
      microscopy (IEM). We found that wild-type CFTR is present in pre-Golgi
      compartments and peripheral tubular elements associated with the cis and trans
      faces of the Golgi stack, albeit at a concentration 2-fold lower than that found
      in the endoplasmic reticulum (ER). delta F508 CFTR, a mutant form that is not
      efficiently delivered to the cell surface and the most common mutation in cystic
      fibrosis, could also be detected at a reduced concentration in pre-Golgi
      intermediates and peripheral cis Golgi elements, but not in post-Golgi
      compartments. Our results suggest that the low level of wild-type CFTR in the
      Golgi region reflects a limiting step in selective recruitment by the ER export
      machinery, an event that is largely deficient in delta F508. We raise the
      possibility that novel modes of selective anterograde and retrograde traffic
      between the ER and the Golgi may serve to regulate CFTR function in the early
      secretory compartments.

PMID- 11208076
TI  - Two independent regions of HIV-1 Nef are required for connection with the
      endocytic pathway through binding to the mu 1 chain of AP1 complex.
AB  - The Nef protein from the human immunodeficiency virus (HIV) induces down
      regulation of the CD4 and major histocompatibility complex class I molecules from
      the cell surface by interfering with the endocytic machinery. This work focuses
      on the interaction of HIV-1 Nef with the mu 1 chain of adaptor protein type 1
      (AP1) complex and its contribution to the Nef-induced alterations of membrane
      trafficking. Two independent regions surrounding a disordered loop located in the
      C-terminal part of Nef are involved in mu 1 binding. Each region can separately
      interact with mu 1, and simultaneous point mutations within both regions are
      needed to abolish binding. We used CD8 chimeras in which the cytoplasmic tail was
      replaced by Nef mutants to show that these mu 1-binding sites contain
      determinants required to induce CD4 down-regulation and to target the chimera to
      the endocytic pathway by promoting AP1 complex recruitment. Ultrastructural
      analysis revealed that the CD8-Nef chimera provokes morphological alterations of
      the endosomal compartments and co-localizes with AP1 complexes. These data
      indicate that the recruitment by Nef of AP1 via binding to mu 1 participates in
      the connection of Nef with the endocytic pathway.

PMID- 11208077
TI  - Targeting of HIV-1 Nef to the centrosome: implications for antigen processing.
AB  - To gain a better understanding of the intracellular sites of antigen processing
      we have looked at the localization of human immunodeficiency virus (HIV)-1 Nef
      protein by confocal microscopic and biochemical means. We found that ubiquitin
      (Ub)-Nef fusion proteins were localized to the centrosome in transfected COS-7
      cells, and that the colocalization was inhibited by the microtubule-disrupting
      agent, nocodazole. Interestingly, we found that Ub-Nef trafficking to the
      centrosome was not dependent upon the metabolic stability of Ub-Nef nor on the
      inhibition of proteasome activity. We also analyzed the MHC class I antigen
      processing of a reporter epitope linked to the Ub-Nef fusion proteins and found
      that Ub-Nef was processed in COS-7 cells. In addition, we show that this
      processing was inhibited by nocodazole. We suggest that the centrosome may serve
      as a site of antigen processing in vivo.

PMID- 11208079
TI  - Overexpression of a novel sorting nexin, SNX15, affects endosome morphology and
      protein trafficking.
AB  - Sorting nexin (SNX) 15 is a novel member of the SNX family of proteins. Although
      the functions of most SNXs have not yet been determined, several family members
      (e.g., SNX1, SNX2, SNX3, and SNX8) are orthologs of yeast proteins involved in
      protein trafficking. Overexpression of myc-tagged SNX15 in COS-7 cells altered
      the morphology of several endosomal compartments. In transient transfection
      experiments, myc-SNX15 was first seen in small punctate spots and small ring
      structures. Later, myc-SNX15 was found in larger rings. Finally, myc-SNX15 was
      observed in large, amorphous membrane-limited structures. These structures
      contained proteins from lysosomes, late endosomes, early endosomes, and the trans
      Golgi network. However, the morphology of the endoplasmic reticulum and Golgi was
      not affected by overexpression of myc-SNX15. In myc-SNX15-overexpressing cells,
      the endocytosis of transferrin was severely inhibited and endocytosis of tac
      trans-Golgi network (TGN) 38 and tac-furin was slowed. In addition, the recycling
      of internalized tac-TGN38 and tac-furin was also inhibited. Both the
      morphological and biochemical data indicate that SNX15 plays a crucial role in
      trafficking through the endocytic pathway. This is the first demonstration that a
      mammalian SNX protein is involved in protein trafficking.

PMID- 11208080
TI  - Advocacy for biomedical research: looking back, looking forward.

PMID- 11208081
TI  - Membrane traffic and cytokinesis.
AB  - Cytokinesis, the last step in cell division, is a process common to all
      eukaryotic life forms. The many mechanisms cells use to divide one parent cell
      into two progeny reflect the diversity of eukaryotic life. Despite the varied
      mechanisms cells use, increasing evidence demonstrates that many different cells
      use 'classical' membrane trafficking proteins for cytokinesis. This review
      highlights recent evidence for roles for membrane trafficking proteins in
      cytokinesis.

PMID- 11208082
TI  - Construction of centrosomes and spindle poles by molecular motor-driven assembly
      of protein particles.
AB  - Centrosomes and other microtubule organizing centers are the largest non
      membranous organelles in most cells. This morphologically diverse class of
      organelles shares a common ability to nucleate and organize microtubules in
      interphase and participates in the formation of mitotic spindles during cell
      division. This review summarizes recent evidence suggesting that assembly of
      centrosomes and mitotic spindle poles require transport of large protein
      particles along microtubules by the molecular motor cytoplasmic dynein.

PMID- 11208083
TI  - Raising the speed limits for 4D fluorescence microscopy.
AB  - Three-dimensional time-lapse (4D) fluorescence microscopy is becoming a routine
      experimental tool. This article summarizes current technologies, and describes a
      new method for speeding image acquisition during 4D confocal microscopy.

PMID- 11208084
TI  - Purification of the vertebrate nuclear pore complex by biochemical criteria.
AB  - The nuclear pore is a large and complex biological machine, mediating all signal
      directed transport between the nucleus and the cytoplasm. The vertebrate pore has
      a mass of approximately 120 million daltons or 30 times the size of a ribosome.
      The large size of the pore, coupled to its tight integration in the nuclear
      lamina, has hampered the isolation of pore complexes from vertebrate sources. We
      have now developed a strategy for the purification of nuclear pores from in vitro
      assembled annulate lamellae (AL), a cytoplasmic mimic of the nuclear envelope
      that lacks a lamina, nuclear matrix, and chromatin-associated proteins. We find
      that purified pore complexes from annulate lamellae contain every nuclear pore
      protein tested. In addition, immunoblotting reveals the presence of soluble
      transport receptors and factors known to play important roles in the transport of
      macromolecules through the pore. While transport factors such as Ran and NTF2
      show only transient interaction with the pores, a number of soluble transport
      receptors, including importin beta, show a tight association with the purified
      pores. In summary, we report that we have purified the vertebrate pore by
      biochemical criteria; silver staining reveals approximately 40-50 distinct
      protein bands.

PMID- 11208085
TI  - Cholesterol is required for the formation of regulated and constitutive secretory
      vesicles from the trans-Golgi network.
AB  - We studied the role of cholesterol in regulated protein secretion in
      neuroendocrine cells by manipulating the cholesterol content of AtT-20 cells.
      Depletion of cellular cholesterol levels caused a reversible block of immature
      secretory granule biogenesis at the level of the trans-Golgi-network, whereas
      increased cholesterol levels promoted immature secretory granule formation.
      Cholesterol depletion also blocked the formation of constitutive secretory
      vesicles, but did not inhibit the transport between the endoplasmic reticulum and
      the Golgi complex. Our results indicate that the assembly of cholesterol-based
      lipid microdomains is required for the biogenesis of both regulated and
      constitutive secretory vesicles from the trans-Golgi-network in neuroendocrine
      cells.

PMID- 11208086
TI  - GMx33: a novel family of trans-Golgi proteins identified by proteomics.
AB  - The known functions of the Golgi complex include the sorting, packaging, post
      translational modification, and transport of secretory proteins, membrane
      proteins, and lipids. Other functions still remain elusive to cell biologists.
      With the goal of identifying novel Golgi proteins, a proteomics project was
      undertaken to map the major proteins of the organelle using two-dimensional gels,
      to identify the unknowns using tandem mass spectrometry, and to screen for Golgi
      residents using GFP-fusion constructs. Multiple unknowns were identified, and the
      initial characterization of one of these proteins is reported here. GMx33 alpha
      is a member of a conserved family of cytosolic Golgi-associated proteins with no
      known homology to any known functional domain or protein. Biochemical analyses
      show that GMx33 alpha differentially partitions into all phases of multiple
      detergent extractions, and two-dimensional immunoblots reveal that there are
      multiple differentially modified forms of GMx33 alpha associated with the Golgi,
      several of which are phosphorylated. Evidence suggests that these post
      translational modifications regulate its association with the Golgi. GMx33 alpha
      was not found on Golgi budded vesicles, and immuno-electron microscopy co
      localizes GMx33 alpha to the trans-face on the same three cisternae as TGN38 in
      normal rat kidney cells. This work represents the preliminary characterization of
      a novel family of trans-Golgi-associated proteins.

PMID- 11208087
TI  - Rab3A and Rab3D control the total granule number and the fraction of granules
      docked at the plasma membrane in PC12 cells.
AB  - Rab proteins are Ras-like GTPases that regulate traffic along the secretory or
      endocytic pathways. Within the Rab family, Rab3 proteins are expressed at high
      levels in neurons and endocrine cells where they regulate release of dense core
      granules and synaptic vesicles. Immunoelectron microscopy shows that Rab3A and
      Rab3D can coexist on the same granule before and after docking. Using electron
      microscopy of transfected PC12 cells, we report that expression of wild-type
      Rab3A (or Rab3D) increases the total number of granules and the percentage that
      is docked at the plasma membrane. Mutated Rab3A N135I (or Rab3D N135I) decreases
      the total granule number and the fraction of granules docked to the plasma
      membrane. These data show that at least one of the functions of Rab3A and Rab3D
      proteins is to control the number of granules docked at the plasma membrane.

PMID- 11208089
TI  - Redirection of host vesicle trafficking pathways by intracellular parasites.
AB  - Bacterial and protozoon intracellular parasites have evolved diverse mechanisms
      for evasion of host cellular defenses associated with adaptations for survival in
      distinct intracellular compartments. As the reagents identifying discrete steps
      in vesicle maturation and trafficking have become increasingly available, it has
      become clear that the vacuoles occupied by intracellular parasites are much more
      diverse than had been previously appreciated. Many parasites induce selective
      fusion competence with the vacuoles they occupy, without affecting vesicular
      trafficking elsewhere in the cell. A likely means of controlling vesicular
      interactions is modification of the parasitophorous vacuole membrane by the
      insertion of parasite-specific proteins. A rapidly expanding class of bacterial
      proteins that modify the vacuolar membrane are the chlamydial inclusion membrane
      proteins. Although the functions of most of these proteins remain to be defined,
      the majority are expressed early in the infectious process, suggesting that
      modification of the vacuole is critical to the outcome of the host-parasite
      interaction.

PMID- 11208088
TI  - Trafficking and folding defects in hereditary spherocytosis mutants of the human
      red cell anion exchanger.
AB  - Hereditary spherocytosis (HS) is a common inherited hemolytic anemia caused by
      mutations in erythrocyte proteins including the anion exchanger, AE1 (band 3).
      This study examined seven missense mutations (L707P, R760Q, R760W, R808C, H834P,
      T837M, and R870W) located in the membrane domain of the human AE1 that are
      associated with this disease. The HS mutants, constructed in full-length AE1
      cDNA, could be transiently expressed to similar levels in HEK 293 cells.
      Immunofluorescence, cell surface biotinylation, and pulse chase labeling showed
      that the HS mutants all exhibited defective cellular trafficking from the
      endoplasmic reticulum to the plasma membrane. Impaired binding to an inhibitor
      affinity matrix indicated that the mutant proteins had non-native structures and
      may be misfolded. Further characterization of the HS R760Q mutant showed no
      change in its oligomeric structure or turnover (half-life = 15 h) compared to
      wild-type AE1, suggesting the mutant was not aggregated or targeted for rapid
      degradation via the proteasome. Intracellular retention of HS mutant AE1 would
      lead to destruction of the protein during erythroid development and would account
      for the lack of HS mutant AE1 in the plasma membrane of the mature red cell.

PMID- 11208090
TI  - Cell invasion by un-palatable parasites.
AB  - While some intracellular pathogens invade and replicate exclusively in phagocytic
      host cells, others have evolved mechanisms to stimulate their uptake by cells not
      equipped with a well-developed phagocytic machinery. A common mechanism utilized
      by bacteria involves the induction of macropinocytosis, or of other F-actin
      driven processes which result in engulfment of the pathogen through formation of
      a plasma membrane-derived vacuole. Interestingly, this type of "induced
      phagocytosis" mechanism does not appear to be utilized by protozoan parasites,
      which are significantly larger than bacteria in size (about 5-10 microns in
      average length). Intracellular protozoa either restrict themselves to infecting
      "professional" phagocytes (one example is the trypanosomatid Leishmania), or
      utilize highly unusual mechanisms for gaining access to the intracellular
      environment. Here we discuss what has been revealed in recent years about the
      remarkable cell invasion strategies of two highly successful intracellular
      parasites: Toxoplasma gondii and Trypanosoma cruzi. Toxoplasma utilizes a
      distinct form of actin/myosin-dependent gliding motility to propel itself into
      mammalian cells, while T. cruzi invades by subverting a Ca(2+)-regulated
      lysosomal exocytic pathway.

PMID- 11208091
TI  - Poisons, ruffles and rockets: bacterial pathogens and the host cell cytoskeleton.
AB  - The cytoskeleton of eukaryotic cells is affected by a number of bacterial and
      viral pathogens. In this review we consider three recurring themes of
      cytoskeletal involvement in bacterial pathogenesis: 1) the effect of bacterial
      toxins on actin-regulating small GTP-binding proteins; 2) the invasion of non
      phagocytic cells by the bacterial induction of ruffles at the plasma membrane; 3)
      the formation of actin tails and pedestals by intracellular and extracellular
      bacteria, respectively. Considerable progress has been made recently in the
      characterization of these processes. It is becoming clear that bacterial
      pathogens have developed a variety of sophisticated mechanisms for utilizing the
      complex cytoskeletal system of host cells. These bacterially-induced processes
      are now providing unique insights into the regulation of fundamental eukaryotic
      mechanisms.

PMID- 11208092
TI  - Facing inward from compartment shores: how many pathways were we looking for?
AB  - Protein toxins of the Shiga family have become potent tools in studying a number
      of intracellular transport events such as endocytosis, the communication between
      endosomes and the biosynthetic/secretory pathway, and retrograde transport from
      the Golgi apparatus to the endoplasmic reticulum. It seems clear today that most
      of these transport events can be explained from the toxins' interactions with
      cellular factors. This review will primarily focus on the discussion of recent
      data obtained on Shiga toxin and related toxins. We will point out to what extent
      the study of these proteins has opened new avenues for the development of
      intracellular targeting tools.

PMID- 11208093
TI  - Definition of distinct compartments in polarized Madin-Darby canine kidney (MDCK)
      cells for membrane-volume sorting, polarized sorting and apical recycling.
AB  - Previous studies of fibroblasts have demonstrated that recycling of endocytic
      receptors occurs through a default mechanism of membrane-volume sorting.
      Epithelial cells require an additional level of polar membrane sorting, but there
      are conflicting models of polar sorting, some suggesting that it occurs in early
      endosomes, others suggesting it occurs in a specialized apical recycling endosome
      (ARE). The relationship between endocytic sorting to the lysosomal, recycling and
      transcytotic pathways in polarized cells was addressed by characterizing the
      endocytic itineraries of LDL, transferrin (Tf) and IgA, respectively, in
      polarized Madin-Darby canine kidney (MDCK) cells. Quantitative analyses of 3
      dimensional images of living and fixed polarized cells demonstrate that endocytic
      sorting occurs sequentially. Initially internalized into lateral sorting
      endosomes, Tf and IgA are jointly sorted from LDL into apical and medical
      recycling endosomes, in a manner consistent with default sorting of membrane from
      volume. While Tf is recycled to the basolateral membrane from recycling
      endosomes, IgA is sorted to the ARE prior to apical delivery. Quantifications of
      the efficiency of sorting of IgA from Tf between the recycling endosomes and the
      ARE match biochemical measurements of transepithelial protein transport,
      indicating that all polar sorting occurs in this step. Unlike fibroblasts, rab11
      is not associated with Tf recycling compartments in either polarized or glass
      grown MDCK cells, rather it is associated with the compartments to which IgA is
      directed after sorting from Tf. These results complicate a suggested homology
      between the ARE and the fibroblast perinuclear recycling compartment and provide
      a framework that justifies previous conflicting models of polarized sorting.

PMID- 11208094
TI  - Adipsin and the glucose transporter GLUT4 traffic to the cell surface via
      independent pathways in adipocytes.
AB  - Insulin increases the exocytosis of many soluble and membrane proteins in
      adipocytes. This may reflect a general effect of insulin on protein export from
      the trans Golgi network. To test this hypothesis, we have compared the
      trafficking of the secreted serine protease adipsin and the integral membrane
      proteins GLUT4 and transferrin receptors in 3T3-L1 adipocytes. We show that
      adipsin is secreted from the trans Golgi network to the endosomal system, as
      ablation of endosomes using transferrin-HRP conjugates strongly inhibited adipsin
      secretion. Phospholipase D has been implicated in export from the trans Golgi
      network, and we show that insulin stimulates phospholipase D activity in these
      cells. Inhibition of phospholipase D action with butan-1-ol blocked adipsin
      secretion and resulted in accumulation of adipsin in trans Golgi network-derived
      vesicles. In contrast, butan-1-ol did not affect the insulin-stimulated movement
      of transferrin receptors to the plasma membrane, whereas this was abrogated
      following endosome ablation. GLUT4 trafficking to the cell surface does not
      utilise this pathway, as insulin-stimulated GLUT4 translocation is still observed
      after endosome ablation or inhibition of phospholipase D activity.
      Immunolabelling revealed that adipsin and GLUT4 are predominantly localised to
      distinct intracellular compartments. These data suggest that insulin stimulates
      the activity of the constitutive secretory pathway in adipocytes possibly by
      increasing the budding step at the TGN by a phospholipase D-dependent mechanism.
      This may have relevance for the secretion of other soluble molecules from these
      cells. This is not the pathway employed to deliver GLUT4 to the plasma membrane,
      arguing that insulin stimulates multiple pathways to the cell surface in
      adipocytes.

PMID- 11208095
TI  - MHC class II presentation of endogenous tumor antigen by cellular vaccines
      depends on the endocytic pathway but not H2-M.
AB  - We have developed cell-based cancer vaccines that activate anti-tumor immunity by
      directly presenting endogenously synthesized tumor antigens to CD4+ T helper
      lymphocytes via MHC class II molecules. The vaccines are non-conventional antigen
      presenting cells because they express MHC class II, do not express invariant
      chain or H-2M, and preferentially present endogenous antigen. To further improve
      therapeutic efficacy we have studied the intracellular trafficking pathway of MHC
      class II molecules in the vaccines using endoplasmic reticulumlocalized lysozyme
      as a model antigen. Experiments using endocytic and cytosolic pathway inhibitors
      (chloroquine, primaquine, and brefeldin A) and protease inhibitors (lactacystin,
      LLnL, E64, and leupeptin) indicate antigen presentation depends on the endocytic
      pathway, although antigen degradation is not mediated by endosomal or proteasomal
      proteases. Because H2-M facilitates presentation of exogenous antigen via the
      endocytic pathway, we investigated whether transfection of vaccine cells with H
      2M could potentiate endogenous antigen presentation. In contrast to its role in
      conventional antigen presentation, H-2M had no effect on endogenous antigen
      presentation by vaccine cells or on vaccine efficacy. These results suggest that
      antigen/MHC class II complexes in the vaccines may follow a novel route for
      processing and presentation and may produce a repertoire of class II-restricted
      peptides different from those presented by professional APC. The therapeutic
      efficacy of the vaccines, therefore, may reside in their ability to present novel
      tumor peptides, consequently activating tumor-specific CD4+ T cells that would
      not otherwise be activated.

PMID- 11208096
TI  - Actin assembly plays a variable, but not obligatory role in receptor-mediated
      endocytosis in mammalian cells.
AB  - Three cell-permeant compounds, cytochalasin D, latrunculin A and jasplakinolide,
      which perturb intracellular actin dynamics by distinct mechanisms, were used to
      probe the role of filamentous actin and actin assembly in clathrin-mediated
      endocytosis in mammalian cells. These compounds had variable effects on receptor
      mediated endocytosis of transferrin that depended on both the cell line and the
      experimental protocol employed. Endocytosis in A431 cells assayed in suspension
      was inhibited by latrunculin A and jaspiakinolide, but resistant to cytochalasin
      D, whereas neither compound inhibited endocytosis in adherent A431 cells. In
      contrast, endocytosis in adherent CHO cells was more sensitive to disruption of
      the actin cytoskeleton than endocytosis in CHO cells grown or assayed in
      suspension. Endocytosis in other cell types, including nonadherent K562 human
      erythroleukemic cells or adherent Cos-7 cells was unaffected by disruption of the
      actin cytoskeleton. While it remains possible that actin filaments can play an
      accessory role in receptor-mediated endocytosis, these discordant results
      indicate that actin assembly does not play an obligatory role in endocytic coated
      vesicle formation in cultured mammalian cells.

PMID- 11208098
TI  - The endoplasmic reticulum--structure and function (Bristol, September 20-22,
      1999).

PMID- 11208097
TI  - Sec7p directs the transitions required for yeast Golgi biogenesis.
AB  - Endoplasmic reticulum (ER)-to-Golgi traffic in yeast proceeds by the maturation
      of membrane compartments from post-ER vesicles to intermediate small vesicle
      tubular clusters (VTCs) to Golgi nodular membrane networks (Morin-Ganet et al.,
      Traffic 2000; 1: 56-68). The balance between ER and Golgi compartments is
      maintained by COPII- and COPI-mediated anterograde and retrograde traffic, which
      are dependent on Sec7p and ARF function. The sec7-4 temperature-sensitive allele
      is a mutation in the highly conserved Sec7 domain (Sec7d) found in all ARF
      guanine nucleotide exchange factor proteins. Post-ER trafficking is rapidly
      inactivated in sec7-4 mutant yeast at the restrictive temperature. This
      conditional defect prevented the normal production of VTCs and instead generated
      Golgi-like tubes emanating from the ER exit sites. These tubes progressively
      developed into stacked cisternae defining the landmark sec7 mutant phenotype.
      Consistent with the in vivo results, a Sec7d peptide inhibited ER-to-Golgi
      transport and displaced Sec7p from its membrane anchor in vitro. The similarities
      in the consequences of inactivating Sec7p or ARFs in vivo was revealed by genetic
      disruption of yeast ARFs or by addition of brefeldin A (BFA) to whole cells.
      These treatments, as in sec7-4 yeast, affected the morphology of membrane
      compartments in the ER-Golgi transition. Further evidence for Sec7p involvement
      in the transition for Golgi biogenesis was revealed by in vitro binding between
      distinct domains of Sec7p with ARFs, COPI and COPII coat proteins. These results
      suggest that Sec7p coordinates membrane transitions in Golgi biogenesis by
      directing and scaffolding the binding and disassembly of coat protein complexes
      to membranes, both at the VTC transition from ER exit sites to form Golgi
      elements and for later events in Golgi maturation.

PMID- 11208099
TI  - Transport of proteins and membrane in eukaryotic cells (Gottingen, September 29
      October 1, 1999).

PMID- 11208100
TI  - Second international workshop on antigen processing and presentation (Bar Harbor,
      October 16-18, 1999).

PMID- 11208101
TI  - Getting stuck in the Golgi.

PMID- 11208102
TI  - Lipid metabolism and regulation of membrane trafficking.
AB  - The past 20 years have witnessed tremendous progress in our understanding of the
      molecular machinery that controls protein and membrane transport between
      organelles (Scheckman R, Orci L. Coat proteins and vesicle budding. Science
      1996;271: 1526-1533 and Rothman JE. Mechanisms of intracellular protein
      transport. Nature 1994;372: 55-63.) The research efforts responsible for these
      impressive advances have largely focused on the identification and
      characterization of protein factors that participate in membrane trafficking
      events. The role of membranes and their lipid constituents has received
      considerably less attention. Indeed, until rather recently, popular models for
      mechanisms of membrane trafficking had relegated membrane lipids to the status of
      a passive platform, subject to deformation by the action of coat proteins whose
      polymerization and depolymerization govern vesicle budding and fusion reactions.
      The 1990s, and particularly its last half, has brought fundamental reappraisals
      of the interface of lipids and lipid metabolism in regulating intracellular
      membrane trafficking events. Some of the emerging themes are reviewed here.

PMID- 11208103
TI  - Role of membrane organization and membrane domains in endocytic lipid
      trafficking.
AB  - Lipid compositions vary greatly among organelles, and specific sorting mechanisms
      are required to establish and maintain these distinct compositions. In this
      review, we discuss how the biophysical properties of the membrane bilayer and the
      chemistry of individual lipid molecules play a role in the intracellular
      trafficking of the lipids themselves, as well as influencing the trafficking of
      transmembrane proteins. The large diversity of lipid head groups and acyl chains
      lead to a variety of weak interactions, such as ionic and hydrogen bonding at the
      lipid/water interfacial region, hydrophobic interactions, and van-der-Waals
      interactions based on packing density. In simple model bilayers, these weak
      interactions can lead to large-scale phase separations, but in more complex
      mixtures, which mimic cell membranes, such phase separations are not observed.
      Nevertheless, there is growing evidence that domains (i.e., localized regions
      with non-random lipid compositions) exist in biological membranes, and it is
      likely that the formation of these domains are based on interactions similar to
      those that lead to phase separations in model systems. Sorting of lipids appears
      to be based in part on the inclusion or exclusion of certain types of lipids in
      vesicles or tubules as they bud from membrane organelles.

PMID- 11208104
TI  - Caveolins and cellular cholesterol balance.
AB  - Caveolins are major integral membrane components of caveolae. Over the last few
      years, evidence has accumulated for a close link between caveolin, caveolae, and
      the regulation of cellular cholesterol levels. However, the exact role of
      caveolin in this process, the intracellular trafficking routes followed by
      caveolin/cholesterol complexes, and the relationship of caveolin-cholesterol to
      other caveolin-mediated processes such as signal transduction have remained
      unclear. Recent findings from a number of systems suggest that specific signaling
      pathways require precise regulation of cellular cholesterol. Here we review
      evidence for caveolin regulation of cholesterol transport and consider how this
      may relate to signal transduction.

PMID- 11208105
TI  - Niemann-Pick type C mutations cause lipid traffic jam.
AB  - The Niemann-Pick C protein (NPC1) is required for cholesterol transport from late
      endosomes and lysosomes to other cellular membranes. Mutations in NPC1 cause
      lysosomal lipid storage and progressive neurological degeneration. Cloning of the
      NPC1 gene has given us tools with which to investigate the function of this
      putative cholesterol transporter. Here, we discuss recent studies indicating that
      NPC1 is not a cholesterol-specific transport molecule. Instead, NPC1 appears to
      be required for the vesicular shuttling of both lipids and fluid-phase
      constituents from multivesicular late endosomes to destinations such as the trans
      Golgi network.

PMID- 11208106
TI  - Lipid traffic: the ABC of transbilayer movement.
AB  - Membrane lipids do not spontaneously exchange between the two leaflets of lipid
      bilayers because the polar headgroups cannot cross the hydrophobic membrane
      interior. Cellular membranes, notably eukaryotic plasma membranes, are equipped
      with special proteins that actively translocate lipids from one leaflet to the
      other. In addition, cellular membranes contain proteins that facilitate a passive
      equilibration of lipids between the two membrane halves. In recent years, a
      growing number of proteins have been put forward as lipid translocators or
      facilitators. Unexpectedly, some of these appear to be required for efficient
      translocation of lipids lacking bulky headgroups, like cholesterol and fatty
      acids. The candidate lipid translocators identified so far belong to large
      protein families whose other members include pumps for amphiphilic molecules like
      bile salts and drugs.

PMID- 11208107
TI  - Trafficking and release of mycobacterial lipids from infected macrophages.
AB  - Analysis of infected macrophages revealed that lipid-containing moieties of the
      mycobacterial cell wall are actively trafficked out of the mycobacterial vacuole.
      To facilitate the analysis of vesicular trafficking from mycobacteria-containing
      phagosomes, surface-exposed carbohydrates were labeled with hydrazide-tagged
      markers. The distribution of labeled carbohydrate/lipid moieties and subsequent
      interaction with cellular compartments were analyzed by immunoelectron microscopy
      and by fluorescence microscopy of live cells. The released mycobacterial
      constituents were associated with several intracellular organelles and were
      enriched strikingly in tubular endocytic compartments. Subcellular fractionation
      of infected macrophages by density gradient electrophoresis showed temporal
      movement of labeled bacterial constituents through early and late endosomes. Thin
      layer chromatography analysis of these subcellular fractions confirmed their
      lipid nature and revealed five dominant bacteria-derived species. These
      mycobacterial lipids were also found in extracellular vesicles isolated from the
      medium and could be observed in un-infected 'bystander' cells. Their transfer to
      bystander cells could expand the bacteria's sphere of influence beyond the
      immediate confines of the host cell.

PMID- 11208109
TI  - Pep12p is a multifunctional yeast syntaxin that controls entry of biosynthetic,
      endocytic and retrograde traffic into the prevacuolar compartment.
AB  - Delivery of proteins to the vacuole of the yeast Saccharomyces cerevisiae
      requires the function of the endosomal syntaxin, Pep12p. Many vacuolar proteins,
      such as the soluble vacuolar hydrolase, carboxypeptidase Y (CPY), traverse the
      prevacuolar compartment (PVC) en route to the vacuole. Here we show that deletion
      of the carboxy-terminal transmembrane domain of Pep12p results in a temperature
      conditional block in transport of CPY to the PVC. The PVC also receives traffic
      from the early endosome and the vacuole, and mutation in PEP12 also blocks these
      other trafficking pathways into the PVC. Therefore, Pep12p is a multifunctional
      syntaxin that is required for all known trafficking pathways into the yeast PVC.
      Finally, we found that the internalized pheromone receptor, Ste3p, can cycle out
      of the PVC in a VPS27-independent fashion.

PMID- 11208108
TI  - Mammalian tumor susceptibility gene 101 (TSG101) and the yeast homologue, Vps23p,
      both function in late endosomal trafficking.
AB  - The mammalian tumor susceptibility gene tsg101 encodes the homologue of Vps23p, a
      class E Vps protein essential for normal membrane trafficking in the late
      endosome/multivesicular body of yeast. Both proteins assemble into large
      (approximately 350 kDa) cytosolic protein complexes and we show that the yeast
      complex contains another class E Vps protein, Vps28p. tsg101 mutant cells exhibit
      defects in sorting and proteolytic maturation of the lysosomal hydrolase
      cathepsin D, as well as in the steady-state distribution of the mannose-6
      phosphate receptor. Additionally, endocytosed EGF receptors that are normally
      sorted to the lysosome are instead rapidly recycled back to the cell surface in
      tsg101 mutant cells. We propose that tsg101 mutant cells are defective in the
      delivery of cargo proteins to late endosomal compartments. One consequence of
      this endosomal trafficking defect is the delayed down-regulation/degradation of
      activated cell surface receptors, resulting in prolonged signaling. This may
      contribute to the tumorigenic phenotype exhibited by the tsg101 mutant
      fibroblasts.

PMID- 11208110
TI  - A new functional domain of guanine nucleotide dissociation inhibitor (alpha-GDI)
      involved in Rab recycling.
AB  - Guanine nucleotide dissociation inhibitor (GDI) is a 55-kDa protein that
      functions in vesicular membrane transport to recycle Rab GTPases. We have now
      determined the crystal structure of bovine alpha-GDI at ultra-high resolution
      (1.04 A). Refinement at this resolution highlighted a region with high mobility
      of its main-chain residues. This corresponded to a surface loop in the primarily
      alpha-helical domain II at the base of alpha-GDI containing the previously
      uncharacterized sequence-conserved region (SCR) 3A. Site-directed mutagenesis
      showed that this mobile loop plays a crucial role in binding of GDI to membranes
      and extraction of membrane-bound Rab. This domain, referred to as the mobile
      effector loop, in combination with Rab-binding residues found in the multi-sheet
      domain I at the apex of alpha-GDI may provide flexibility for recycling of
      diverse Rab GTPases. We propose that conserved residues in domains I and II
      synergize to form the functional face of GDI, and that domain II mediates a
      critical step in Rab recycling during vesicle fusion.

PMID- 11208111
TI  - A screen of random sequences for those that alter the trafficking of the
      influenza virus hemagglutinin in vivo.
AB  - In order to determine if the sequence patterns known to specify internalization
      represent the majority of possible internalization signals, we identified random
      sequences capable of causing a reporter protein to be internalized at least
      several-fold faster than the rate of non-selective internalization of membrane by
      clathrin-coated pits. A library of influenza hemagglutinin (HA) proteins, bearing
      short random sequences in place of the wild-type cytoplasmic domain, was prepared
      in recombinant SV40 virus. The library was expressed and screened for HAs that
      could internalize anti-HA antibody from the medium. The cytoplasmic sequences of
      the selected proteins were determined. From a small sample of sequences we
      detected several that did not resemble those previously identified. The known
      internalization signals must represent only a subset of the sequences that can
      serve as internalization signals.

PMID- 11208112
TI  - When cell biology grew up.

PMID- 11208113
TI  - Pathways for lipid antigen presentation by CD1 molecules: nowhere for
      intracellular pathogens to hide.
AB  - A crucial feature of peptide antigen presentation by major histocompatibility
      complex (MHC) class I and II molecules is their differential ability to sample
      cytosolic and extracellular antigens. Intracellular viral infections and bacteria
      that are taken up in phagosomes, but then escape from the endocytic compartment
      efficiently, enter the class I pathway via the cytosol. In contrast, phagosome
      resident bacteria yield protein antigens that are sampled deep in the endocytic
      compartment and presented in a vacuolar acidification-dependent pathway mediated
      by MHC class II molecules. Despite this potential for antigen sampling, microbes
      have evolved a variety of evasive mechanisms that affect peptide transport in the
      MHC class I pathway or blockade of endosomal acidification and inhibition of
      phagosome-lysosome fusion that may compromise the MHC class II pathway of antigen
      presentation. Thus, besides MHC class I and II, a third lineage of antigen
      presenting molecules that bind lipid and glycolipid antigens rather than peptides
      exists and is mediated by the family of CD1 proteins. CD1 isoforms (CD1a, b, c,
      and d) differentially sample both recycling endosomes of the early endocytic
      system and late endosomes and lysosomes to which lipid antigens are
      differentially delivered. These CD1 pathways include vacuolar acidification
      independent pathways for lipid antigen presentation. These features of presenting
      lipid antigens, independently monitoring various antigen-containing intracellular
      compartments and avoiding certain evasive techniques employed by microbes, enable
      CD1 molecules to provide distinct opportunities to function in host defense
      against the microbial world.

PMID- 11208114
TI  - Intracellular surveillance: controlling the assembly of MHC class I-peptide
      complexes.
AB  - MHC class I molecules bind with high affinity to peptides in the endoplasmic
      reticulum and display them on the cell surface. Here they are screened by CD8
      positive T-lymphocytes for the presence of foreign, pathogen-derived peptides
      within the mass of self-peptides expressed. MHC class I assembly is a complicated
      process involving a number of accessory molecules, including specialized
      components as well as common chaperones. Our understanding of the mechanisms
      involved, while quite advanced, is far from complete.

PMID- 11208115
TI  - Control of MHC class I traffic from the endoplasmic reticulum by cellular
      chaperones and viral anti-chaperones.
AB  - MHC class I molecules assemble with peptides in the endoplasmic reticulum (ER).
      To ensure that only peptide-loaded MHC molecules leave the ER, empty molecules
      are retained by ER-resident chaperones, most notably the MHC-specific tapasin. ER
      exit of class I MHC is also controlled by viruses, but for the opposite purpose
      of preventing peptide presentation to T cells. Interestingly, some viral proteins
      are able to retain MHC class I molecules in the ER despite being transported. By
      contrast, other viral proteins exit the ER only upon binding to class I MHC,
      thereby rerouting newly synthesized class I molecules to intracellular sites of
      proteolysis. Thus, immune escape can be achieved by reversing, inhibiting or
      redirecting the chaperone-assisted MHC class I folding, assembly and
      intracellular transport.

PMID- 11208116
TI  - Antigen traffic pathways in dendritic cells.
AB  - Dendritic cells (DC) are now believed to be the principal initiators of T cell
      mediated immune responses. Their location in body tissues, migratory behaviour in
      response to inflammatory stimuli, endocytic properties, expression of MHC
      molecules and key T cell stimulatory molecules and many other attributes place
      these remarkable cells in a unique and influential position in the immune system.
      Progress in DC culture methods has recently allowed in-depth studies on the cell
      biological features that enable them to fulfill their crucial role in the immune
      response.

PMID- 11208118
TI  - Role of cholesterol in developing T-tubules: analogous mechanisms for T-tubule
      and caveolae biogenesis.
AB  - Recent work has suggested that caveolae biogenesis and transverse-tubule (T
      tubule) formation in muscle cells share similar underlying features. We compared
      the properties of caveolin-1 (cav-1)-positive caveolae, in epithelial cells, with
      caveolin-3 (cav-3)-positive precursor T-tubules, in differentiating C2C12 muscle
      cells, using the cholesterol-binding drug, Amphotericin B (AmphB). Treatment of
      MDCK epithelial cells with acute high doses or chronic low doses of AmphB caused
      a loss of surface caveolae and the rapid redistribution of cav-1, and exogenously
      expressed cav-3, from the cell surface into modified endosomes. This effect was
      reversible and specific, as the GPI-anchored protein, alkaline phosphatase, was
      largely unaffected by the treatment unless it had been previously partitioned
      into caveolar domains. In differentiating C2C12 mouse myotubes, AmphB also caused
      a complete redistribution of cav-3 from precursor T-tubule elements into enlarged
      endosomes, morphologically very similar to those seen in MDCK cells. This was
      accompanied by redistribution of a T-tubule marker and a dramatic reduction in
      the extent of surface-connected tubular elements. We propose that cholesterol
      enriched glycolipid 'raft' domains are involved in the formation and maintenance
      of diverse membrane systems including caveolae and the T-tubule system of muscle.

PMID- 11208117
TI  - Human cytomegalovirus immediate early glycoprotein US3 retains MHC class I
      molecules by transient association.
AB  - Human cytomegalovirus (HCMV) interferes with major histocompatibility complex
      (MHC) class I antigen presentation by a sequential multistep process to escape T
      cell surveillance. During the immediate early phase of infection, the
      glycoprotein US3 prevents intracellular transport of MHC class I molecules.
      Interestingly, US3 displays a significantly shorter half-life than US3-retained
      MHC class I molecules. Here we show that US3 associates only transiently with MHC
      class I molecules, exits the ER, and is inefficiently retrieved from the Golgi.
      US3 was degraded in a post-Golgi compartment, most likely lysosomes, because: i)
      Brefeldin A treatment prolonged the half-life of US3; and ii) US3 co-localized
      with the lysosomal marker protein LAMP in chloroquine-treated cells. In contrast,
      MHC class I molecules remained stable in the ER. Upon inhibition of protein
      synthesis MHC class I molecules were released suggesting that a continuous supply
      of newly synthesized US3 molecules is required for inhibition of transport. Thus,
      US3 does not seem to retain MHC class I molecules by a retrieval mechanism.
      Instead, our observations are consistent with US3 preventing MHC class I
      trafficking by blocking forward transport.

PMID- 11208119
TI  - Coatomer vesicles are not required for inhibition of Golgi transport by G-protein
      activators.
AB  - The G-protein activators guanosine 5'-O-(3-thiodiphosphate) (GTP gamma S) and
      aluminum fluoride (AIF) are thought to inhibit transport between Golgi cisternae
      by causing the accumulation of nonfunctional coatomer-coated transport vesicles
      on the Golgi. Although GTP gamma S and AIF inhibit transport in cell-free intra
      Golgi transport systems, blocking coatomer vesicle formation does not. We
      therefore determined whether inhibition of in vitro Golgi transport by these
      agents requires coatomer vesicle formation. Depletion of coatomer was found to
      completely block coated vesicle formation on Golgi cisternae without affecting
      inhibition of in vitro transport by either GTP gamma S or AIF. Depletion of ADP
      ribosylation factor (ARF) prevented inhibition of transport by GTP gamma S, but
      not by AIF, suggesting that the AIF-sensitive component in transport may not be a
      GTP-binding protein. Surprisingly, depletion of cytosolic ARF did not prevent the
      GTP gamma S-induced formation of Golgi-coated vesicles, whereas ARF was required
      for AIF-induced vesicle formation. Although ARF or coatomer depletion caused an
      increase in the fenestration of cisternae, no other ultrastructural changes were
      observed that might explain the inhibition of transport by GTP gamma S or AIF.
      These findings suggest that ARF-GTP gamma S and AIF act by distinct and coatomer
      independent mechanisms to inhibit membrane fusion in cell-free intra-Golgi
      transport.

PMID- 11208120
TI  - Targeting of an apical endosomal protein to endosomes in Madin-Darby canine
      kidney cells requires two sorting motifs.
AB  - The efficient sorting and targeting of endocytosed macromolecules is critical for
      epithelial function. However, the distribution of endosomal compartments in these
      cells remains controversial. In this study, we show that polarized Madin-Darby
      canine kidney (MDCK) cells target the apical endosomal protein endotubin into an
      apical early endosomal compartment that is distinct from the apical recycling
      endosomes. Furthermore, through a panel of site-directed mutations we show that
      signals required for apical endosomal targeting of endotubin are composed of two
      distinct motifs on the cytoplasmic domain, a hydrophobic motif and a consensus
      casein kinase II site. Endotubin-positive endosomes in MDCK cells do not label
      with basolaterally internalized transferrin or ricin, do not contain the small
      guanosine triphosphate-binding protein rab11, and do not tubulate in response to
      low concentrations of brefeldin-A (BFA). Nevertheless, high concentrations of BFA
      reversibly inhibits the sorting of endotubin from transferrin and cause
      colocalization in tubular endosomes. These results indicate that, in polarized
      cells, endotubin targets into a distinct subset of apical endosomes, and the
      targeting information required both for polarity and endosomal targeting is
      provided by the cytoplasmic portion of the molecule.

PMID- 11208121
TI  - Are the curves in all the right places?

PMID- 11208122
TI  - Traffic COPs of the early secretory pathway.
AB  - Intracellular transport between the endoplasmic reticulum and Golgi compartments
      is mediated by coat protein complexes (COPI and COPII) that form transport
      vesicles and collect the desired set of cargo. Although the COPI and COPII coats
      are molecularly distinct, a number of mechanistic parallels appear to be
      emerging, most notably a general role for small guanine triphosphatases in co
      ordinating coat assembly with cargo selection. A combination of morphological,
      biochemical, and genetic methods is revealing a very dynamic relationship between
      these compartments, and highlights a central role for COPs in directing traffic
      through the early secretory pathway. This review focuses on recent advances in
      molecular mechanisms underlying coated-vesicle assembly and connections with
      cellular structures.

PMID- 11208123
TI  - Selective inhibition of adaptor complex-mediated vesiculation.
AB  - A short while ago, we could only inhibit post-Golgi membrane traffic with crude,
      unselective tools, such as low temperature or high extracellular sucrose.
      Molecular dissection of vesiculation steps has revealed unexpected complexity in
      the coating machinery that has initiated a search for more specific inhibitors.
      We have learned that membrane vesiculation is driven by a tightly regulated
      multicomponent, membrane-associated protein machine held together by carefully
      specified interaction domains. An experimental advantage of such complex
      interacting machinery is that it is very susceptible to disruption by dominant
      negative inhibitors or by overexpression. As a result, we now have much more
      specific inhibitors of post-Golgi membrane traffic. Some, such as dynamin K44A,
      may be general inhibitors, whereas others can distinguish classes of endocytotic
      events (10), binding events that require clathrin from those that do not (42), or
      specific steps of endocytosis (62). Ligand-mediated uptake of EGF and numerous,
      but not all, GPCRs can be inhibited by overexpression of an ARF GTPase-activating
      protein that has no effect on transferrin uptake (67). We can look forward to
      increasingly powerful and selective inhibitors that should help us to navigate
      successfully the complex routes of post-Golgi membrane traffic.

PMID- 11208124
TI  - Garrotes, springs, ratchets, and whips: putting dynamin models to the test.
AB  - The GTPase dynamin is essential for clathrin-mediated endocytosis. Numerous new
      and exciting discoveries regarding dynamin function in vivo and in vitro have led
      to various models in which dynamin functions directly in membrane fission and the
      release of clathrin-coated vesicles from the plasma membrane. This would make
      dynamin unique among GTPases in its ability to act as a mechanochemical enzyme.
      Here we review the various models and their supporting data. We then discuss new
      findings that raise doubts as to whether dynamin breaks the paradigm that governs
      regulatory GTPases.

PMID- 11208125
TI  - Molecular structures of proteins involved in vesicle coat formation.
AB  - This review includes 16 structures of vesicle coat components and accessory
      proteins and a description of their roles in vesicle budding or coat disassembly.

PMID- 11208126
TI  - The tail domain of myosin M catalyses nucleotide exchange on Rac1 GTPases and can
      induce actin-driven surface protrusions.
AB  - Members of the myosin superfamily play crucial roles in cellular processes
      including management of the cortical cytoskeleton, organelle transport and signal
      transduction. GTPases of the Rho family act as key control elements in the
      reorganization of the actin cytoskeleton in response to growth factors, and other
      functions such as membrane trafficking, transcriptional regulation, growth
      control and development. Here, we describe a novel unconventional myosin from
      Dictyostelium discoideum, MyoM. Primary sequence analysis revealed that it has
      the appearance of a natural chimera between a myosin motor domain and a guanine
      nucleotide exchange factor (GEF) domain for Rho GTPases. The functionality of
      both domains was established. Binding of the motor domain to F-actin was ATP
      dependent and potentially regulated by phosphorylation. The GEF domain displayed
      selective activity on Rac1-related GTPases. Overexpression, rather than absence
      of MyoM, affected the cell morphology and viability. Particularly in response to
      hypo-osmotic stress, cells overexpressing the MyoM tail domain extended massive
      actin-driven protrusions. The GEF was enriched at the tip of growing
      protuberances, probably through its pleckstrin homology domain. MyoM is the first
      unconventional myosin containing an active Rac-GEF domain, suggesting a role at
      the interface of Rac-mediated signal transduction and remodeling of the actin
      cytoskeleton.

PMID- 11208127
TI  - Truncated brush border myosin I affects membrane traffic in polarized epithelial
      cells.
AB  - We investigate, in this study, the potential involvement of an acto-myosin-driven
      mechanism in endocytosis of polarized cells. We observed that depolymerization of
      actin filaments using latrunculin A decreases the rate of transferrin recycling
      to the basolateral plasma membrane of Caco-2 cells, and increases its delivery to
      the apical plasma membrane. To analyze whether a myosin was involved in
      endocytosis, we produced, in this polarized cell line, truncated, non-functional,
      brush border, myosin I proteins (BBMI) that we have previously demonstrated to
      have a dominant negative effect on endocytosis of unpolarized cells. These non
      functional proteins affect the rate of transferrin recycling and the rate of
      transepithelial transport of dipeptidyl-peptidase IV from the basolateral plasma
      membrane to the apical plasma membrane. They modify the distribution of
      internalized endocytic tracers in apical multivesicular endosomes that are
      accessible to fluid phase tracers internalized from apical and basolateral plasma
      membrane domains. Altogether, these observations suggest that an acto-myosin
      driven mechanism is involved in the trafficking of basolaterally internalized
      molecules to the apical plasma membrane.

PMID- 11208128
TI  - A novel pathway for transport and metabolism of a fluorescent phosphatidic acid
      analog in yeast.
AB  - Phosphatidic acid is a central intermediate of biosynthetic lipid metabolism as
      well as an important signaling molecule in the cell. These studies assess the
      internalization, or retrograde transport, and metabolism of phosphatidic acid in
      yeast using a fluorescent analog. An analog of phosphatidic acid fluorescently
      labeled at the sn-2 position with N-4-nitrobenz-2-oxa-1, 3-diazole-aminocaproic
      acid (NBD-phosphatidic acid) was introduced to yeast cells by spontaneous
      transfer from phospholipid vesicles. Transport and metabolism of the NBD
      phosphatidic acid were then monitored by fluorescence spectrophotometry,
      fluorescence microscopy and routine biochemical methods. Primary metabolites of
      the NBD-phosphatidic acid in yeast were found to be NBD-diacylgycerol and NBD
      phosphatidylinositol. Experiments in cells possessing different levels of
      phosphatidate phosphatase activity suggest that conversion of the NBD
      phosphatidic acid to NBD-diacylglycerol is not a pre-requisite for
      internalization in yeast. Internalization is sensitive to decreased temperature,
      but neither ATP depletion nor a sec6-4 mutation, which interrupts endocytosis,
      has an affect. Thus, internalization of NBD-phosphatidic acid apparently occurs
      via a non-endocytic route. These characteristics of retrograde transport of NBD
      phosphatidic acid in yeast differ significantly from transport of other NBD
      phospholipids in yeast as well as NBD-phosphatidic acid transport in mammalian
      fibroblasts.

PMID- 11208129
TI  - Secretory lysosome biogenesis in cytotoxic T lymphocytes from normal and Chediak
      Higashi syndrome patients.
AB  - The lytic proteins mediating target cell killing are stored in the lysosomes of
      activated cytotoxic T lymphocytes (CTL) and are secreted upon recognition of a
      target cell. These secretory lysosomes cannot be detected in resting T
      lymphocytes. Interaction of a resting cell with a target cell activates de novo
      formation of secretory lysosomes. CTL clones in culture mimic this behaviour, and
      so provide an ideal system for studying secretory lysosome biogenesis and
      maturation. In the genetic disease, Chediak Higashi syndrome (CHS), all lysosomes
      in the cells are enlarged and reduced in number compared with wild-type (WT)
      cells. We have used CTL from this disease to study secretory lysosome biogenesis
      and maturation. We show that at early stages after activation the secretory
      lysosomes are identical in WT and mutant cells, and that delivery of proteins to
      the secretory lysosome along the biosynthetic and endocytic pathways is normal in
      the mutant cells. With time, the lysosomes in the mutant cells aggregate, become
      larger and fewer in number and eventually form giant structures. Our results show
      that the initial steps of secretory lysosome formation are normal in CHS, but
      that the organelles subsequently fuse together during cell maturation to form the
      giant secretory lysosomes.

PMID- 11208131
TI  - The protein import machinery of the mitochondrial membranes.
AB  - Mitochondria are surrounded by two membranes that contain independent and non
      related protein transport machineries. Remarkable progress was recently achieved
      in elucidating the structure of the outer membrane import channel and in the
      identification of new components involved in protein traffic across the
      intermembrane space and the inner membrane. Traditional concepts of protein
      targeting and sorting had to be revised. Here we briefly summarize the data on
      the mitochondrial protein import system with particular emphasis on new
      developments and perspectives.

PMID- 11208130
TI  - The molecular mechanism of transport of macromolecules through nuclear pore
      complexes.
AB  - Trafficking of macromolecules between nuclear and cytoplasmic compartments takes
      place through the nuclear pore complexes (NPCs) of the nuclear envelope. Nuclear
      trafficking involves a complex series of interactions between cargo, soluble
      transport factors (carriers) and nuclear pore proteins (nucleoporins) that are
      orchestrated by the Ras-family GTPase Ran. The primary role of Ran is probably to
      establish directionality and to sort molecules to be transported by controlling
      the interaction between carriers and cargoes, so that they bind in one
      compartment but dissociate in the other. Translocation of carriers and cargo
      carrier complexes through NPCs requires interactions between the carriers and
      nucleoporins that contain distinctive tandem sequence repeats based on cores rich
      in glycine and phenylalanine residues that are separated by hydrophilic linkers.
      Much recent work has focused on these interactions and, in particular, their
      specificity, regulation and function. Evidence is accumulating that carriers move
      through the NPC by distinct but overlapping routes using specific subsets of
      nucleoporins.

PMID- 11208132
TI  - How peroxisomes arise.
AB  - Peroxisomes are formed by the synthesis and assembly of membrane proteins and
      lipids, the selective import of proteins from the cytosol, and the growth and
      division of resultant organelles. To date, 23 proteins, called peroxins, are
      known to participate in these processes. This review summarizes recent progress
      in peroxin characterization and examines the underlying molecular mechanisms of
      peroxisome biosynthesis.

PMID- 11208133
TI  - Molecular structures of proteins involved in vesicle fusion.
AB  - We present a summary of the structures of 13 proteins involved in the docking and
      fusion of intracellular transport vesicles to their target membranes.

PMID- 11208134
TI  - Apical and basolateral endocytic pathways of MDCK cells meet in acidic common
      endosomes distinct from a nearly-neutral apical recycling endosome.
AB  - Quantitative confocal microscopic analyses of living, polarized MDCK cells
      demonstrate different pH profiles for apical and basolateral endocytic pathways,
      despite a rapid and extensive intersection between the two. Three-dimensional
      characterizations of ligand trafficking demonstrate that the apical and
      basolateral endocytic pathways share early, acidic compartments distributed
      throughout the medial regions of the cell. Polar sorting for both pathways occurs
      in these common endosomes as IgA is sorted from transferrin to alkaline
      transcytotic vesicles. While transferrin is directly recycled from the common
      endosomes, IgA is transported to a downstream apical compartment that is nearly
      neutral in pH. By several criteria this compartment appears to be equivalent to
      the previously described apical recycling endosome. The functional significance
      of the abrupt increase in lumenal pH that accompanies IgA sorting is not clear,
      as disrupting endosome acidification has no effect on polar sorting. These
      studies provide the first detailed characterizations of endosome acidification in
      intact polarized cells and clarify the relationship between the apical and
      basolateral endocytic itineraries of polarized MDCK cells. The extensive mixing
      of apical and basolateral pathways underscores the importance of endocytic
      sorting in maintaining the polarity of the plasma membrane of MDCK cells.

PMID- 11208135
TI  - Both calmodulin and the unconventional myosin Myr4 regulate membrane trafficking
      along the recycling pathway of MDCK cells.
AB  - In epithelial cells, endocytosed transferrin and its receptor, which cycle
      basolaterally, have been shown to transit through recycling endosomes which can
      also be accessed by markers internalized from the apical surface. In this work,
      we have used an in vitro assay to follow transfer of an endocytosed marker from
      apical or basolateral early endosomes to recycling endosomes labeled with
      transferrin. We show that calmodulin (CaM) function is necessary for transfer and
      identified myr4, a member of the unconventional myosin superfamily known to use
      CaM as a light chain, as a possible target protein for CaM. Since myr4 is
      believed to act as an actin-based mechanoenzyme, we tested the role of
      polymerized actin in the assay. Our data show that conditions which either
      prevent actin polymerization or induce the breakdown of existing filaments
      strongly inhibit interactions between recycling endosomes and either set of early
      endosomes. Altogether, our data indicate that trafficking at early steps of the
      endocytic pathway in Madin-Darby Canine Kidney cells depends on the actin-based
      mechanoenzyme myr4, its light chain CaM, and polymerized actin.

PMID- 11208136
TI  - Phospholipase A2 antagonists inhibit constitutive retrograde membrane traffic to
      the endoplasmic reticulum.
AB  - Eukaryotic cells contain a variety of cytoplasmic Ca(2+)-dependent and Ca(2+)
      independent phospholipase A2s (PLA2s; EC 2.3.1.2.3). However, the physiological
      roles for many of these ubiquitously-expressed enzymes is unclear or not known.
      Recently, pharmacological studies have suggested a role for Ca(2+)-independent
      PLA2 (iPLA2) enzymes in governing intracellular membrane trafficking events in
      general and regulating brefeldin A (BFA)-stimulated membrane tubulation and Golgi
      to-endoplasmic reticulum (ER) retrograde membrane trafficking, in particular.
      Here, we extend these studies to show that membrane-permeant iPLA2 antagonists
      potently inhibit the normal, constitutive retrograde membrane trafficking from
      the trans-Golgi network (TGN), Golgi complex, and the ERGIC-53-positive ER-Golgi
      intermediate compartment (ERGIC), which occurs in the absence of BFA. Taken
      together, these results suggest that iPLA2 enzymes play a general role in
      regulating, or directly mediating, multiple mammalian membrane trafficking
      events.

PMID- 11208137
TI  - A functional role for VAP-33 in insulin-stimulated GLUT4 traffic.
AB  - Soluble N-ethylmaleimide sensitive factor attachment protein receptors (SNAREs)
      are critical proteins in membrane fusion, in both regulated and constitutive
      vesicular traffic. In addition, proteins that interact with the SNAREs are
      thought to regulate fusion. Vesicle-associated membrane protein-2 (VAMP-2) is a
      SNARE protein involved in insulin-dependent glucose transporter 4 (GLUT4)
      traffic. VAMP-2 is required for productive GLUT4 incorporation into the plasma
      membrane. VAMP-associated protein of 33 kDa (VAP-33) is an integral membrane
      protein that binds VAMPs in vitro, and is hypothesized to be a regulator of
      VAMPs. In L6 skeletal myoblasts, which display insulin-dependent traffic of
      GLUT4, we show that VAP-33 colocalized significantly with VAMP-2 using indirect
      confocal immunofluorescence and biochemical cosegregation. Overexpression of wild
      type VAP-33 in L6 myoblasts attenuated the insulin-dependent incorporation of myc
      tagged GLUT4 into the plasma membrane, and this response was restored by co
      overexpression of VAMP-2 linked to green fluorescent protein. Antibodies to VAP
      33 microinjected into 3T3-L1 adipocytes abrogated the insulin-stimulated
      translocation of GLUT4 to the plasma membrane, as measured in adhered plasma
      membrane lawns. Immunopurified VAMP-2-containing compartments from L6 myotubes
      and 3T3-L1 adipocytes showed significant levels of VAP-33. We propose that VAP-33
      may be a regulator of VAMP-2 availability for GLUT4 traffic and other vesicle
      fusion events.

PMID- 11208138
TI  - Occam's Razor slices through the mysteries of neurofilament axonal transport: can
      it really be so simple?

PMID- 11208139
TI  - Endocytosis in viral replication.
AB  - Although initially recognised as essential for the entry of certain viruses,
      endocytosis is now known to also play important roles in the replication of, and
      adaptation to, the host cell of a number of viruses. Here we consider several
      aspects of this association and recent results that have emerged to support this
      view.

PMID- 11208140
TI  - Folding of viral envelope glycoproteins in the endoplasmic reticulum.
AB  - Viral glycoproteins fold and oligomerize in the endoplasmic reticulum of the host
      cell. They employ the cellular machinery and receive assistance from cellular
      folding factors. During the folding process, they are retained in the compartment
      and their structural quality is checked by the quality control system of the
      endoplasmic reticulum. A special characteristic that distinguishes viral fusion
      proteins from most cellular proteins is the extensive conformational change they
      undergo during fusion of the viral and cellular membrane. Many viral proteins
      fold in conjunction with and dependent on a viral partner protein, sometimes even
      synthesized from the same mRNA. Relevant for folding is that viral glycoproteins
      from the same or related virus families may consist of overlapping sets of domain
      modules. The consequences of these features for viral protein folding are at the
      heart of this review.

PMID- 11208141
TI  - Role of P30 in replication and spread of TMV.
AB  - The P30 movement protein (MP) of tobacco mosaic virus is essential for
      distribution of sites of replication within infected cells and for cell-cell
      spread of infection. MP is an integral membrane protein and in early and mid
      stages of infection causes severe disruption of the cortical endoplasmic
      reticulum (ER). MP also associates with microtubules, and in late stages is
      targeted for degradation by the 26S proteosome. During these stages, the ER
      regains its normal pre-infection configuration. Viral RNA is associated with ER
      and microtubules in the presence of MP. The MP is phosphorylated and mutation of
      the phosphorylated amino acid reduced association of MP with the ER,
      plasmodesmata, and microtubules, and altered the stability of the MP. The nature
      of the association of MP with vRNA and ER and microtubules, and the role of
      phosphorylation of MP in each of these functions, if any, remains to be
      determined.

PMID- 11208142
TI  - The production of 'cell cortices' for light and electron microscopy.

PMID- 11208143
TI  - SNARE protein trafficking in polarized MDCK cells.
AB  - A key feature of polarized epithelial cells is the ability to maintain the
      specific biochemical composition of the apical and basolateral plasma membrane
      domains. This polarity is generated and maintained by the continuous sorting of
      apical and basolateral components in the secretory and endocytic pathways.
      Soluble N-ethyl maleimide-sensitive factor attachment protein receptors (SNARE)
      proteins of vesicle-associated membrane protein (VAMP) and syntaxin families have
      been suggested to play a role in the biosynthetic transport to the apical and
      basolateral plasma membranes of polarized cells, where they likely mediate
      membrane fusion. To investigate the involvement of SNARE proteins in membrane
      trafficking to the apical and basolateral plasma membrane in the endocytic
      pathway we have monitored the recycling of various VAMP and syntaxin molecules
      between intracellular compartments and the two plasma membrane domains in Madin
      Darby canine kidney (MDCK) cells. Here we show that VAMP8/endobrevin cycles
      through the apical but not through the basolateral plasma membrane. Furthermore,
      we found that VAMP8 localizes to apical endosomal membranes in nephric tubule
      epithelium and in MDCK cells. This asymmetry in localization and cycling behavior
      suggests that VAMP8/endobrevin may play a role in apical endosomal trafficking in
      polarized epithelium cells.

PMID- 11208144
TI  - Endocytic recycling is required for the presentation of an exogenous peptide via
      MHC class II molecules.
AB  - Exogenous antigenic peptides captured and presented in the context of major
      histocompatibility (MHC) class II molecules on APC, have been employed as potent
      vaccine reagents capable of activating cellular immune responses. Binding and
      presentation of select peptide via surface class II molecules has been reported.
      Here, a role for endocytosis and early endosomes in the presentation of exogenous
      peptides via MHC class II molecules is described. T cell recognition of a 14
      amino acid human serum albumin-derived peptide in the context of HLA-DR4 was
      observed only with metabolically active APC. The delayed kinetics and temperature
      dependence of functional peptide presentation via APC, were consistent with a
      requirement for peptide internalization to early endosomal compartments prior to
      T cell recognition. Ablating endocytosis by exposing cells to inhibitors of ATP
      production completely blocked the display of functional peptide:class II
      complexes on the surface of the APC. Presentation of the peptide was also found
      to be sensitive to primaquine, a drug that perturbs the recycling of transport
      vesicles containing endocytic receptors and mature class II complexes. Functional
      presentation of the endocytosed peptide was dependent upon these mature class II
      complexes, as inhibitor studies ruled out a requirement for newly synthesized
      class II molecules. N-terminal processing of the endocytosed peptide was observed
      upon trafficking through endosomal compartments and linked to the formation of
      functional peptide:class II complexes. These findings establish a novel mechanism
      for regulating class II-restricted peptide presentation via the endocytic
      pathway.

PMID- 11208146
TI  - Membrane tethering and fusion in the secretory and endocytic pathways.
AB  - Studies of intracellular trafficking over the past decade or so have led to
      striking advances in our understanding of the molecular processes by which
      transport intermediates dock and fuse. SNARE proteins play a central role,
      assembling into complexes that bridge membranes and may catalyze membrane fusion
      directly. In general, different SNARE proteins operate in different intracellular
      trafficking pathways, so recent reports that SNARE assembly in vitro is
      promiscuous have come as something of a surprise. We propose a model in which
      proper SNARE assembly is under kinetic control, orchestrated by members of the
      Sec1 protein family, small GTP-binding Rab proteins, and a diverse assortment of
      tethering proteins.

PMID- 11208145
TI  - Regulation of lamp2a levels in the lysosomal membrane.
AB  - The selective degradation of cytosolic proteins in lysosomes by chaperone
      mediated autophagy depends, at least in part, on the levels of a substrate
      receptor at the lysosomal membrane. We have previously identified this receptor
      as the lysosome-associated membrane protein type 2a (lamp2a) and showed that
      levels of lamp2a at the lysosomal membrane directly correlate with the activity
      of the proteolytic pathway. Here we show that levels of lamp2a at the lysosomal
      membrane are mainly controlled by changes in its half-life and its distribution
      between the lysosomal membrane and the matrix. The lysosomal degradation of
      lamp2a requires the combined action of at least two different proteolytic
      activities at the lysosomal membrane. Lamp2a is released from the membrane by the
      action of these proteases, and then the truncated lamp2a is rapidly degraded
      within the lysosomal matrix. Membrane degradation of lamp2a is a regulated
      process that is inhibited in the presence of substrates for chaperone-mediated
      autophagy and under conditions that activate that type of autophagy. Uptake of
      substrate proteins also results in transport of some intact lamp2a from the
      lysosomal membrane into the matrix. This fraction of lamp2a can be reinserted
      back into the lysosomal membrane. The traffic of lamp2a through the lysosomal
      matrix is not mediated by vesicles, and lamp2a reinsertion requires the lysosomal
      membrane potential and protein components of the lysosomal membrane. The
      distribution of lamp2a between the lysosomal membrane and matrix is a dynamic
      process that contributes to the regulation of lysosomal membrane levels of lamp2a
      and consequently to the activity of the chaperone-mediated autophagic pathway.

PMID- 11208147
TI  - Membrane fusion mechanisms: the influenza hemagglutinin paradigm and its
      implications for intracellular fusion.
AB  - The mechanism of membrane fusion induced by the influenza virus hemagglutinin
      (HA) has been extensively characterized. Fusion is triggered by low pH, which
      induces conformational changes in the protein, leading to insertion of a
      hydrophobic 'fusion peptide' into the viral membrane and the target membrane for
      fusion. Insertion perturbs the target membrane, and hour glass-shaped lipidic
      fusion intermediates, called stalks, fusing the outer monolayers of the two
      membranes, are formed. Stalk formation is followed by complete fusion of the two
      membranes. Structures similar to those formed by HA at the pH of fusion are found
      not only in many other viral fusion proteins, but are also formed by SNAREs,
      proteins involved in intracellular fusion. Substances that inhibit or promote HA
      induced fusion because they affect stalk formation, also inhibit or promote
      intracellular fusion, cell-cell fusion and even intracellular fission similarly.
      Therefore, the mechanism of influenza HA-induced fusion may be a paradigm for
      many intracellular fusion events.

PMID- 11208148
TI  - Greasing membrane fusion and fission machineries.
AB  - Biological membrane fusion is a local-point event, extremely fast, and under
      strict control. Proteins are responsible for the mutual recognition of the fusion
      partners and for the initiation of biomembrane fusion, and thus determine where
      and when fusion occurs. However, the central event during membrane fusion is the
      merger of two membranes, which requires a transient reorganization of membrane
      lipids into highly curved fusion intermediates. This review focuses on the
      potential role of lipids in the generation of membrane curvature, and thus in the
      regulation of membrane fusion and fission.

PMID- 11208149
TI  - How to convert a traditional electron microscopy laboratory to digital imaging:
      follow the 'middle road'.
AB  - Today, electron microscopy (EM) is increasingly confronted by the revolution in
      image-processing technology provoked by modern computers. Digital cameras are
      fast replacing film-based cameras in EM, as elsewhere, and the procedures for
      digital image-archiving, image-analysis, and image publication are rapidly
      evolving. To take advantage of these advances, we have chosen for the moment a
      'middle road', in which film remains our basic recording medium in the electron
      microscope, but immediately thereafter, all film-based images are converted to
      digital files for further analysis and processing. The rationale behind this
      approach is that film still offers far greater sensitivity and resolution
      (providing an image equivalent to > 10,000 pixels per inch in a 1-s exposure),
      and film is still far easier to organize and archive than digital images of
      comparable resolution. However, digital manipulation of EM images has become
      mandatory. Hence, we explain here, in some detail, how we convert from film to
      digital.

PMID- 11208150
TI  - Multiple local contact sites are induced by GPI-linked influenza hemagglutinin
      during hemifusion and flickering pore formation.
AB  - Membrane fusion intermediates induced by the glycosylphosphatidylinositol-linked
      ectodomain of influenza hemagglutinin (GPI-HA) were investigated by rapid freeze,
      freeze-substitution, thin section electron microscopy, and with simultaneous
      recordings of whole-cell admittance and fluorescence. Upon triggering, the
      previously separated membranes developed numerous hourglass shaped points of
      membrane contact (approximately 10-130 nm waist) when viewed by electron
      microscopy. Stereo pairs showed close membrane contact at peaks of complementary
      protrusions, arising from each membrane. With HA, there were fewer contacts, but
      wide fusion pores. Physiological measurements showed fast lipid dye mixing
      between cells after acidification, and either fusion pore formation or the lack
      thereof (true hemifusion). For the earliest pores, a similar conductance
      distribution and frequency of flickering pores were detected for both HA and GPI
      HA. For GPI-HA, lipid mixing was detected prior to, during, or after pore
      opening, whereas for HA, lipid mixing is seen only after pore opening. Our
      findings are consistent with a pathway wherein conformational changes in the
      ectodomain of HA pull membranes towards each other to form a contact site, then
      hemifusion and pore formation initiate in a small percentage of these contact
      sites. Finally, the transmembrane domain of HA is needed to complete membrane
      fusion for macromolecular content mixing.

PMID- 11208151
TI  - The dileucine motif within the tail of MPR46 is required for sorting of the
      receptor in endosomes.
AB  - The cytoplasmic tail of MPR46 carries a leucine-based motif that is required for
      the sorting of lysosomal enzymes by the receptor. In addition, it is one of three
      independent, but functionally redundant, internalization signals present in the
      cytoplasmic tail of MPR46. We have analyzed a mutant of MPR46, in which the
      dileucine pair was replaced by alanines (MPR46 LL/AA) with respect to its
      intracellular distribution and trafficking. Ultrastructural analysis of cells
      expressing the MPR46 LL/AA mutant revealed that the substitution of the dileucine
      pair causes a shift of the receptor distribution from the TGN, where it is
      packaged into AP1-containing vesicles, to vesicular structures distributed
      throughout the cytoplasm. The vesicles could be identified as early endosomes
      with internalized BSA-gold and rab5 as markers. By analyzing the receptor
      trafficking biochemically, we found that return of the LL/AA mutant receptor from
      the plasma membrane/endosome pool back to the TGN was impaired, while recycling
      from endosomes to the plasma membrane was enhanced. In conclusion, our data
      indicate that the dileucine motif in the MPR46 tail is required for a sorting
      event in endosomes.

PMID- 11208152
TI  - Generation of MHC class I peptide antigens by protein processing in the secretory
      route by furin.
AB  - Cytosolic degradation of endogenously synthesized proteins by the proteasome and
      translocation of processed peptides to the endoplasmic reticulum by the
      transporters associated with antigen presentation constitutes the classical route
      for antigen presentation by MHC class I proteins. We have previously defined an
      alternative pathway in the secretory route involving proteolytic maturation of
      precursor proproteins for chimeric hepatitis B virus secretory core protein HBe
      containing a class I epitope at its carboxy-terminus. We extend those results by
      demonstrating that intracellular delivery of the trans-Golgi network protease
      furin increases both proteolytic maturation and antigen presentation of the
      chimeric HBe proteins. An additional class I epitope from the HIV envelope gp160
      protein was inserted into this COOH-terminal region of two different chimeric HBe
      proteins. This epitope was also presented to CTL in a transporter-independent
      manner involving furin, and protein maturation and antigen presentation were also
      enhanced by furin over-expression. Presentation of this second epitope was
      restricted by a different class I allele, thus suggesting that antigen
      presentation by this new pathway may apply to any antigenic epitope and class I
      molecule. These results define the furin proteolytic maturation pathway of HBe in
      the secretory route as a general antigen processing route for MHC class I
      presentation.

PMID- 11208153
TI  - Biogenesis of insulin-responsive GLUT4 vesicles is independent of brefeldin A
      sensitive trafficking.
AB  - Insulin stimulates translocation of GLUT4 from an intracellular compartment to
      the plasma membrane in adipocytes. As a significant amount of GLUT4 is localised
      to the TGN, independently of the biosynthetic pathway, one possibility is that
      trafficking via the TGN is important in either intracellular sequestration or
      insulin-dependent movement to the cell surface. In this study we have used immuno
      electron microscopy to show that GLUT4 is localised to AP-1 vesicles in the TGN
      region in 3T3-L1 adipocytes. To dissect the role of this trafficking pathway we
      used brefeldin A (BFA) to disrupt AP-1 association with membranes. Despite a
      reorganisation of GLUT4 compartments following BFA treatment, the intracellular
      sequestration of GLUT4, and its insulin-dependent movement to the cell surface,
      was unaffected. BFA increased the half time of reversal of insulin-stimulated
      glucose transport from 17 to 30 min but did not prevent complete reversal.
      Furthermore, following reversal restimulation of glucose transport activity by
      insulin was not compromised. We conclude that under basal conditions GLUT4 cycles
      between the TGN and endosomes via the AP-1 pathway. However, neither this
      pathway, nor any other BFA-sensitive pathway, appears to play a major role in
      insulin-dependent recruitment of GLUT4 to the cell surface.

PMID- 11208154
TI  - The simian immunodeficiency virus envelope glycoprotein contains multiple signals
      that regulate its cell surface expression and endocytosis.
AB  - The cell surface expression of the envelope glycoproteins (Envs) of primate
      immunodeficiency viruses is, at least in part, regulated by endocytosis signal(s)
      located in the Env cytoplasmic domain. Here, we show that a membrane proximal
      signal that directs the simian immunodeficiency virus (SIV) Env to clathrin
      coated pits, and is conserved in all SIV and human immunodeficiency virus Envs,
      conforms to a YxxO motif (where x can be any amino acid and O represents a large
      hydrophobic residue). This motif is similar to that described for a number of
      cellular membrane proteins. By surface plasmon resonance we detected a high
      affinity interaction between peptides containing this membrane proximal signal
      and both AP1 and AP2 clathrin adaptor complexes. Mutation of the tyrosine in this
      membrane proximal motif in a SIV Env with a prematurely truncated cytoplasmic
      domain leads to a > or = 25-fold increase in Env expression on infected cells. By
      contrast, the same mutation in an Env with a full-length cytoplasmic domain
      increases cell surface expression only 4-fold. We show that this effect results
      from the presence of additional endocytosis signals in the full-length
      cytoplasmic domain. Chimeras containing CD4 ecto- and membrane spanning domains
      and a full-length SIV Env cytoplasmic domain showed rapid endocytosis even when
      the membrane proximal tyrosine-based signal was disrupted. Mapping experiments
      indicated that at least some of the additional endocytosis information is located
      between residues 743 and 812 of Env from the SIVmac239 molecular clone. Together,
      our findings indicate that the cytoplasmic domain of SIV Env contains multiple
      endocytosis and/or trafficking signals that modulate its surface expression on
      infected cells, and suggest an important role for this function in pathogenesis.

PMID- 11208156
TI  - The making and breaking of the endoplasmic reticulum.
AB  - The endoplasmic reticulum (ER) is a dynamic organelle central to many essential
      cellular functions. It is an important calcium store, which functions in cellular
      signal transduction cascades. It is also the site of entry for secreted proteins
      into the secretory pathway. Lumenal enzymes will fold and glycosylate these
      proteins, and if a protein is destined to be secreted, it will be packaged into
      membrane vesicles that bud off from the ER. The ER is also the site where most
      cellular lipids are synthesized. It is contiguous with the nuclear envelope,
      which serves as a diffusion barrier to control entry into and out of the nucleus.
      In the life cycle of a cell, the ER is in a constant flux of membrane traffic.
      What maintains the ER in the shape of an intact reticulum among this constant
      flux of material? We discuss the mechanisms that contribute to the biogenesis of
      the ER, the maintenance of the organelle, as well as processes that give the ER
      its characteristic shape and pattern of inheritance.

PMID- 11208155
TI  - ADPKD: a human disease altering Golgi function and basolateral exocytosis in
      renal epithelia.
AB  - Epithelial cells explanted from autosomal dominant polycystic kidney disease
      (ADPKD) tissue exhibit impaired exocytosis, specifically between the Golgi and
      basolateral membrane (Charron A, Nakamura B, Bacallo R, Wandinger-Ness A.
      Compromised cytoarchitecture and polarized trafficking in autosomal dominant
      polycystic kidney disease cells. J Cell Biol 2000; 148: 111-124.). Here the
      defect is shown to result in the accumulation of the basolateral transport marker
      vesicular stomatitis virus (VSV) G protein in the Golgi complex. Golgi complex
      morphology is consequently altered in the disease cells, evident in the
      noticeable fenestration and dilation of the cisternae. Further detailed
      microscopic evaluation of normal kidney and ADPKD cells revealed that ineffective
      basolateral exocytosis correlated with modulations in the localization of select
      post-Golgi transport effectors. The cytosolic coat proteins p200/myosin II and
      caveolin exhibited enhanced association with the cytoskeleton or the Golgi of the
      disease cells, respectively. Most cytoskeletal components with known roles in
      vesicle translocation or formation were normally arrayed with the exception of
      Golgi beta-spectrin, which was less prevalent on vesicles. The rab8 GTPase,
      important for basolateral vesicle targeting, was redistributed from the
      perinuclear Golgi region to disperse vesicles in ADPKD cells. At the basolateral
      membrane of ADPKD cells, there was a notable loss of the exocyst components
      sec6/sec8 and an unidentified syntaxin. It is postulated that dysregulated
      basolateral transport effector function precipitates the disruption of
      basolateral exocytosis and dilation of the ADPKD cell Golgi as basolateral cargo
      accumulates within the cisternae.

PMID- 11208157
TI  - Biogenesis of the sorting endosome: the role of Rab5.
AB  - Rab5 is a regulatory guanosine triphosphatase that is associated with the sorting
      endosome and participates in endosomal membrane fusion reactions. Recent
      experiments have provided insights into Rab5 function by demonstrating direct
      links between Rab5-interacting proteins and components of the membrane fusion
      apparatus. In addition, a realisation that Rab5 has additional functions in
      endosome biogenesis is emerging. These advances may be profoundly important in
      changing the way that we view the sorting endosome and in developing models that
      properly reflect the dynamic qualities of the endocytic pathway.

PMID- 11208158
TI  - Rab2 requires PKC iota/lambda to recruit beta-COP for vesicle formation.
AB  - The small GTPase Rab2 initiates the recruitment of soluble components necessary
      for protein sorting and recycling from pre-Golgi intermediates. Our previous
      studies showed that Rab2 required protein kinase C (PKC) or a PKC-like protein to
      recruit beta-COP to membrane (Tisdale EJ, Jackson M. Rab2 protein enhances
      coatomer recruitment to pre-Golgi intermediates. J Biol Chem 1998;273: 17269
      17277). We investigated the role of PKC in Rab2 function by first determining the
      active isoform that associates with membranes used in our assay. Western blot
      analysis detected three isoforms: PKC alpha, gamma and iota/lambda. A
      quantitative binding assay was used to measure recruitment of these kinases when
      incubated with Rab2. Only PKC iota/lambda translocated to membrane in a dose
      dependent manner. Microsomes treated with anti-PKC iota/lambda lost the ability
      to bind beta-COP, suggesting that Rab2 requires PKC iota/lambda for beta-COP
      recruitment. The recruitment of beta-COP to membranes is not regulated by PKC
      iota/lambda kinase activity. However, PKC iota/lambda activity was necessary for
      Rab2-mediated vesicle budding. We found that the addition of either a kinase
      deficient PKC iota/lambda mutant or atypical PKC pseudosubstrate peptide to the
      binding assay drastically reduced vesicle formation. These data suggest that Rab2
      causes translocation of PKC iota/lambda to vesicular tubular clusters (VTCs),
      which promotes the recruitment of COPI to generate retrograde-transport vesicles.

PMID- 11208159
TI  - The luminal domain of TGN38 interacts with integrin beta 1 and is involved in its
      trafficking.
AB  - TGN38 luminal domain (TGN38LD) was expressed in Cos-7 cells to identify potential
      binding partners. The luminal domain was secreted but, surprisingly, a
      significant portion bound to the plasma membrane. Cells overexpressing TGN38LD or
      the full-length molecule detached from the substratum and left footprints
      positive for TGN38. Unexpectedly, in these cells, TGN38 colocalizes with integrin
      alpha 5 beta 1 at the Golgi, the cell surface or in the footprints and an
      increased amount of both integrin subunits on the plasma membrane was observed.
      Under physiological conditions when TGN38 is not overexpressed, it interacts with
      integrin beta 1. This was demonstrated by reciprocal co-immunoprecipitation of
      integrin beta 1 and TGN38. Functional analysis reveals that modification of the
      trafficking of TGN38 results in a parallel change in the distribution of integrin
      alpha 5 beta 1, leading to the conclusion that TGN38 is involved in the
      trafficking of integrin beta 1.

PMID- 11208160
TI  - Procathepsin L self-association as a mechanism for selective secretion.
AB  - The lysosomal cysteine pro-protease procathepsin L was enriched in dense vesicles
      detectable when microsomes prepared from wild-type or transformed mouse
      fibroblasts were resolved on sucrose gradients. These dense vesicles did not
      comigrate with proteins characteristic of the endoplasmic reticulum, Golgi,
      endosomes or lysosomes. When gradient fraction vesicles were lysed at acidic pH
      in the presence of excess mannose 6-phosphate to prevent binding to mannose
      phosphate receptors, the majority of the procathepsin L was associated with the
      membrane, not the soluble, fraction. Immunogold labeling of procathepsin L in
      thin sections of cells or gradient fractions, using antibodies directed against
      the propeptide to avoid detection of the mature enzyme in dense lysosomes,
      revealed that the proenzyme was concentrated in dense cores localized in small
      vesicles near the plasma membrane and in multivesicular bodies. Consistent with
      the density of the gradient fraction and the electron density of the cores, yeast
      two-hybrid assays indicated the proenzyme could bind itself but could not
      interact with the aspartic proprotease procathepsin D. The data suggest that in
      mouse fibroblasts procathepsin L may self-associate into aggregates, initiating
      the formation of dense vesicles that could mediate the selective secretion of
      procathepsin L independent of mannose phosphate receptors.

PMID- 11208161
TI  - Gut thoughts on the Golgi complex.
AB  - The new millennium coincides within 1 year of Camillo Golgi's centennial
      celebrations. It is quite remarkable that the structure and formation of this
      organelle is as controversial today as was its mere existence from Golgi's time
      to the 1950s, when EM approaches were introduced. Since the late 1950s, two
      opposing models of Golgi structure and function have split the Golgi scientific
      community, namely vesicular transport versus organelle maturation. Although a few
      years ago Golgi maturation seemed to be 'out for the count', it has recently seen
      an almost messianic revival. In this review, I argue that this large-scale
      desertion from the vesicle transport model to the maturation camp is premature. I
      propose an alternative, dynamic steady-state model, in which transient tubular
      connections function in parallel to vesicular transport and that the biosynthetic
      pathway is made up of three major distinct compartments: the ER, the Golgi and
      the TGN.

PMID- 11208163
TI  - GLUT4--at the cross roads between membrane trafficking and signal transduction.
AB  - GLUT4 is a mammalian facilitative glucose transporter that is highly expressed in
      adipose tissue and striated muscle. In response to insulin, GLUT4 moves from
      intracellular storage areas to the plasma membrane, thus increasing cellular
      glucose uptake. While the verification of this 'translocation hypothesis'
      (Cushman SW, Wardzala LJ. J Biol Chem 1980;255: 4758-4762 and Suzuki K, Kono T.
      Proc Natl Acad Sci 1980;77: 2542-2545) has increased our understanding of insulin
      regulated glucose transport, a number of fundamental questions remain unanswered.
      Where is GLUT4 stored within the basal cell? How does GLUT4 move to the cell
      surface and what mechanism does insulin employ to accelerate this process?
      Ultimately we require a convergence of trafficking studies with research in
      signal transduction. However, despite more than 30 years of intensive research we
      have still not reached this point. The problem is complex, involving at least two
      separate signal transduction pathways which feed into what appears to be a very
      dynamic sorting process. Below we discuss some of these complexities and
      highlight new data that are bringing us closer to the resolution of these
      questions.

PMID- 11208164
TI  - Regulation of receptor tyrosine kinase signaling by endocytic trafficking.
AB  - Activated receptor tyrosine kinase (RTK) receptors are rapidly internalized and
      eventually delivered to the lysosomes. Although ligand-induced endocytosis was
      originally thought to be a mechanism of receptor inactivation, many studies
      suggest that receptors remain active within endosomes. This review discusses the
      role that internalized signaling complexes may play in different RTK systems
      including recent data on how ubiquitination may regulate this process. In
      general, it appears that some receptor systems have evolved to enhance endosomal
      signaling, as is the case for TrkA and NGF. In contrast, the insulin receptor
      system appears to limit the extent of endosomal signaling. The EGFR system is the
      intermediate example. In this case, some signals are specifically generated from
      the cell surface while others appear to be generated from within endosomes. This
      may act as a mechanism to produce ligand-specific signals. Thus, trafficking
      could play diverse roles in receptor signaling, depending on the specific cell
      and tissue type.

PMID- 11208165
TI  - In vitro assays of vesicular transport.
AB  - Movement of proteins and lipids between the various compartments of eukaryotic
      cells is fundamental to the maintenance of cellular homeostasis, and an
      understanding of the molecular mechanisms that govern these processes remains a
      key goal of cell biological research. This aim has been greatly facilitated by
      the development of assays that recapitulate specific events in vitro. In the
      following article we provide an overview of some of the currently used assays
      that measure the movement of proteins within the exocytic and endocytic pathways,
      and provide a starting point for those wishing to establish their own systems to
      study other vesicular transport steps.

PMID- 11208166
TI  - Reconstitution of clathrin-independent endocytosis at the apical domain of
      permeabilized MDCK II cells: requirement for a Rho-family GTPase.
AB  - This paper studies the endocytosis of ricin at the apical pole of polarized MDCK
      II cells after permeabilization of the cells basolaterally with streptolysin O.
      Ricin endocytosis after the addition of cytosol with an ATP-regenerating system
      was 2-3-fold higher than after the addition of a transport medium. A similar
      increase in ricin endocytosis was obtained by reconstitution of dialyzed cytosol
      with the nonhydrolyzable GTP analog, GTP gamma S, in the presence of an ATP
      regenerating system. The nonhydrolyzable GDP analog, GDP beta S, did not increase
      ricin uptake. In contrast to the data obtained with ricin, GTP gamma S was found
      to inhibit apical transferrin uptake in MDCK II cells transfected with the human
      transferrin receptor, and the data thus imply that GTP gamma S supports clathrin
      independent endocytosis. Electron microscopy (EM) demonstrated that free
      endocytic vesicles were formed from the apical pole of permeabilized MDCK II
      cells in the presence of GTP gamma S and that both a ricin-HRP conjugate, HRP,
      and cationized gold were endocytosed. Ricin endocytosis in the presence of intact
      cytosol, as well as GTP gamma S-stimulated ricin uptake, was inhibited by
      Clostridium botulinum C3 transferase, an enzyme found to inactivate Rho proteins.
      The data demonstrate that apical clathrin-independent endocytosis functions in
      the presence of GTP gamma S, and suggest that one or more of the small GTP
      binding proteins of the Rho family is involved in regulation of the apical
      clathrin-independent endocytosis in MDCK II cells.

PMID- 11208167
TI  - NBD-labeled phosphatidylcholine and phosphatidylethanolamine are internalized by
      transbilayer transport across the yeast plasma membrane.
AB  - The internalization and distribution of fluorescent analogs of
      phosphatidylcholine (M-C6-NBD-PC) and phosphatidylethanolamine (M-C6-NBD-PE) were
      studied in Saccharomyces cerevisiae. At normal growth temperatures, M-C6-NBD-PC
      was internalized predominantly to the vacuole and degraded. M-C6-NBD-PE was
      internalized to the nuclear envelope/ER and mitochondria, was not transported to
      the vacuole, and was not degraded. At 2 degrees C, both were internalized to the
      nuclear envelope/ER and mitochondria by an energy-dependent, N-ethylmaleimide
      sensitive process, and transport of M-C6-NBD-PC to and degradation in the vacuole
      was blocked. Internalization of neither phospholipid was reduced in the
      endocytosis-defective mutant, end4-1. However, following pre-incubation at 37
      degrees C, internalization of both phospholipids was inhibited at 2 degrees C and
      37 degrees C in sec mutants defective in vesicular traffic. The sec18/NSF
      mutation was unique among the sec mutations in further blocking M-C6-NBD-PC
      translocation to the vacuole suggesting a dependence on membrane fusion. Based on
      these and previous observations, we propose that M-C6-NBD-PC and M-C6-NBD-PE are
      transported across the plasma membrane to the cytosolic leaflet by a protein
      mediated, energy-dependent mechanism. From the cytosolic leaflet, both
      phospholipids are spontaneously distributed to the nuclear envelope/ER and
      mitochondria. Subsequently, M-C6-NBD-PC, but not M-C6-NBD-PE, is sorted by
      vesicular transport to the vacuole where it is degraded by lumenal hydrolases.

PMID- 11208168
TI  - Fission of biological membranes: interplay between dynamin and lipids.
AB  - Membrane budding and fission are the key stages of ubiquitous processes of
      formation of intracellular transport vesicles. We present a theoretical
      consideration of one of the most important types of fission machinery, which is
      mediated by GTPase dynamin and controlled by lipid composition of the membrane.
      We suggest a mechanism for collapse of a membrane neck driven by interplay
      between the dynamin collar and the bending elastic energy of the neck membrane.
      The collar plays a role of a rigid external skeleton, which imposes mechanical
      constraints on the neck. We show that in certain conditions the membrane of the
      neck loses its stability and collapses. Collapse can result from: (i) shifting of
      the spontaneous curvature of the neck membrane towards negative values, (ii)
      stretching of the dynamin collar, (iii) tightening of the dynamin collar. The
      three factors can act separately or concertedly. The suggested model accounts for
      the major experimental knowledge on membrane fission mediated by dynamin. It
      includes the elements of all previous models of dynamin action based on different
      sets of experimental results [Sever et al., Traffic 2000; 1: 385-392]. It
      reconciles, at least partially, the apparent contradictions between the existing
      alternative views on biomembrane fission machinery.

PMID- 11208169
TI  - Targeting of C-terminal (tail)-anchored proteins: understanding how cytoplasmic
      activities are anchored to intracellular membranes.
AB  - A class of integral membrane proteins, referred to as 'tail-anchored proteins',
      are inserted into phospholipid bilayers via a single segment of hydrophobic amino
      acids at the C-terminus, thereby displaying a large functional domain in the
      cytosol. This membrane attachment strategy allows eukaryotic cells to position a
      wide range of cytoplasmic activities close to the surface of an intracellular
      membrane. Tail-anchored proteins often, but not always, demonstrate a selective
      distribution to specific intracellular organelles. This membrane-specific
      distribution is required for the large number of targeting proteins that are tail
      anchored, but may or may not be critical for the numerous tail-anchored pro
      apoptotic and anti-apoptotic proteins of the Bcl-2 family. Recent work has begun
      to address the mechanism for targeting tail-anchored proteins to their resident
      membranes, but questions remain. What targeting signals determine each protein's
      intracellular location? Are there receptors for these signals and, if so, how do
      they function? What steps are required to integrate tail-anchored proteins into
      the phospholipid bilayers? In this Traffic interchange, we summarise what is
      known about tail-anchored proteins, and outline the areas that are currently
      under study.

PMID- 11208170
TI  - Gene therapy in wound healing--2000: a promising future.

PMID- 11208171
TI  - Gene therapy in wound repair and regeneration.
AB  - The potential use of gene therapy to treat human disease increases with the
      development of various physical, chemical, and biological methods to deliver
      genes to mammalian cells, and with our rapidly expanding knowledge of the human
      genome. One area of therapeutic interest for gene therapy is the treatment of
      wound healing disorders. Most recently, recombinant human growth factor therapy
      has been examined as a means to treat problem wounds. However, this approach
      suffers from the difficulty in providing an accurate dose of growth factor and
      the expense of the recombinant proteins. Delivery of a gene that could be
      expressed within the wound is an attractive alternative to application of the
      protein. This review discusses several methods that have been used to deliver
      genes encoding growth factor proteins into wounds and the
      advantages/disadvantages of each approach. Novel methods to regulate the
      expression of the transgene are also presented, highlighting the ability of these
      unique vector systems to adjust gene dose as the wound heals. We expect that gene
      therapy will become a significant treatment modality for those wound healing
      pathologies refractory to other wound management approaches in the years ahead.

PMID- 11208172
TI  - Particle-mediated gene therapy of wounds.
AB  - Gene therapy is becoming a reality, and it is a particularly attractive approach
      for wound healing, because the wound site is often exposed, the treatment and
      condition should be transient, and gene products such as growth factors and
      cytokines suffer from problems with bioavailability and stability. Among the
      techniques for gene delivery to the wound site, particle-mediated bombardment
      with a device called the gene gun has become an important developmental tool.
      This instrument has been used in numerous examples of wound gene therapy with
      growth factors or their receptors in the last decade. Among the advantages of
      particle-mediated bombardment are ease and speed of preparation of the delivery
      vehicle, the stability of the DNA preparation, the absence of (viral) antigens,
      the ability to target the projectiles to different tissue depths and areas, and
      the rapid shedding of both particles and DNA if they are targeted to the
      epidermis. Clinical application of the technology remains limited by the
      relatively low efficiency of the method, the potential tissue damage created by
      impact of the particles, and the coverage area. The gene gun can also be used to
      facilitate the discovery and validation of gene products as wound healing agents.

PMID- 11208173
TI  - Adenoviral-mediated gene transfer in wound healing.
AB  - The application of gene transfer strategies to wound healing is not an obvious
      use of this technology until one considers the important role of cytokines and
      growth factors in the normal wound healing response. Several gene transfer
      strategies have been proposed, from in vitro retroviral-mediated gene transfer
      with autologous transplantation, to in vivo plasmid based gene transfer as
      retroviral gene transfer. The limitations of these approaches have been
      efficiency of gene transfer, transgene expression and biologic response.
      Adenoviral-mediated gene transfer in wound healing is a relatively new
      application of this vector. The advantage of the adenovirus as a gene transfer
      vector lies in its ability to transduce nondividing cells of all types at very
      high efficiency without integration into the host cell's genome. The disadvantage
      of adenovirus as a vector is the relatively short duration of transgene
      expression and the inflammatory response it elicits. In the setting of wound
      healing brief duration of high levels of transgene may be all that is necessary
      to favorably influence wound healing. Secondly, as wound healing is fundamentally
      an inflammatory response, the inflammation elicited by the adenovirus may not be
      detrimental as long as the transgene is a growth factor with significant
      vulnerary effects such as platelet-derived growth factor-B. This review
      summarizes the current state of adenoviral-mediated gene transfer in experimental
      models of impaired wound healing which have laid the groundwork for proposed
      phase I clinical trials of adenoviral-mediated gene transfer of platelet-derived
      growth factor-B in chronic venous leg ulcers and chronic nonhealing diabetic foot
      ulcers. Adenoviral-mediated gene transfer is a useful tool in the study of the
      role of specific cytokines and growth factors in normal and impaired wound
      healing. Adenoviral-mediated gene transfer may hold significant promise for
      clinical application as a means of efficient growth factor delivery in correcting
      impaired wound healing.

PMID- 11208174
TI  - Matrix-enabled gene transfer for cutaneous wound repair.
AB  - Several growth factor proteins have been evaluated as therapeutic agents for the
      treatment of chronic dermal wounds. Unfortunately, most have failed to produce
      significant improvements in wound healing, in part due to ineffective delivery
      and poor retention in the wound defect. It has been proposed that gene therapy
      might overcome the limitations of protein therapy via ongoing transcription and
      translation, thus prolonging the availability of the therapeutic protein.
      Reasoning that it would be of further benefit to ensure retention of the DNA
      vector as well as the therapeutic protein within the wound defect, we have
      evaluated matrix-enabled gene transfer for cutaneous wound repair (Gene Activated
      Matrix). Formulations consisting of bovine type I collagen mixed with adenoviral
      or plasmid gene vectors have been evaluated in 3 in vivo models. The therapeutic
      transgenes employed encode human platelet-derived growth factor-A or -B, proteins
      key to each phase of normal wound repair. Increased granulation tissue formation,
      vascularization, and reepithelialization have been shown compared to controls
      treated with collagen alone or collagen containing a reporter gene vector.
      Further enhancements of the tissue repair response have been achieved by
      combining matrix-enabled gene transfer with molecular targeting, in which the DNA
      vector is conjugated to a growth factor ligand (basic fibroblast growth factor).
      These promising results support the clinical evaluation of gene activated
      matrices for the treatment of chronic dermal wounds.

PMID- 11208175
TI  - Clinical protocol: Phase I trial to evaluate the safety of H5.020CMV.PDGF-B for
      the treatment of a diabetic insensate foot ulcer.
AB  - Most patients with chronic wounds fail to heal in a reasonable period of time.
      Despite considerable advances in elucidating the molecular basis of wound repair,
      attempts at developing new therapies have been disappointing. In fact, in the few
      studies where cytokine growth factors have been efficacious, their effect has
      been dramatically less than would have been predicted from animal studies. We
      hypothesize that platelet-derived growth factor-BB, a growth factor associated
      with wound healing, when produced in large quantities within the wound bed due to
      adenovirus mediated gene overexpression by the cells of the wound bed will
      dramatically enhance wound healing. Simply stated, we plan to insure the delivery
      of the growth factor by using gene therapy techniques so that cells locally
      involved in the wound healing process will temporarily increase their production
      of platelet-derived growth factor-BB. We present the first step in the series of
      human investigations to test this hypothesis which is a phase I clinical trial.
      Our proposed study is designed to assess local and systemic toxicity, and the
      feasibility of using the maximum tolerated dose of H5.020CMV.PDGF-b associated
      with in vivo platelet-derived growth factor-BB gene transduction via an
      intraulcer injection of H5.020CMV.PDGF-b in patients with a diabetic insensate
      foot ulcer.

PMID- 11208177
TI  - Transplantation of virally transduced cells into the dermis of immunocompetent
      and immunodeficient (SCID) mice to determine gene expression profile and
      differential donor cell survival.
AB  - Cell therapy and bioengineering hold great promise as therapeutic approaches
      using cells and cell-derived factors to treat various pathologic or trauma
      induced states. One possible application is the transplantation of cells into
      wounded tissue to help regulate tissue repair. Cells engineered for optimal wound
      healing may help to minimize scarring following surgery or to enhance the rate of
      healing of chronic wounds. The purpose of the current study was to determine the
      effect of a viral insert, the LacZ-bearing, first generation adenovirus AdRGD, on
      the survival of dermally transplanted murine skin allogenic fibroblasts. The LacZ
      insert facilitated quantitation of both cell survival and gene expression and was
      used here to measure viable cell number. In addition to bearing the LacZ marker,
      the AdRGD vector is capable of carrying therapeutic gene inserts, so this study
      tested the feasibility of gene therapy for wound healing. Murine skeletal muscle
      PP6 (i.e., Pre-Plate 6) myogenic stem cells served as an alternate donor cell
      type. Cells were labeled with the LacZ-bearing AdRGD adenovirus vector and
      injected (50,000 cells/site) into the dorsal skin of adult normal,
      immunocompetent mice as well as in immunodeficient SCID mice. Skin biopsies were
      taken on days 0, 1, 2, 3, and 7 post-transplant, and assayed for LacZ expression.
      Soon after transplant (day 1), cell numbers underwent a transient decrease, but
      by day 2 post-transplant they were present in appreciable numbers. Between days 2
      7 post-transplant, both allogenic fibroblasts and PP6 myogenic stem cells
      maintained survivability in similar numbers. Further, survival of transplanted
      cell types was similar in both normal, immunocompetent as well as SCID mice
      during this time period. There were no signs of acute inflammation or rejection
      in any of the samples. This study shows that AdRGD-transduced cells are not
      immunogenic in the mouse skin model and the cells show similar survival for the
      first 7 days post-transplantation independent of the cell type or
      immunocompetence of the host.

PMID- 11208176
TI  - Comparison and evaluation of gene therapy and epigenetic approaches for wound
      healing.
AB  - During the past decade considerable evidence has mounted concerning the
      importance of growth factors in the wound healing process both for cell
      replication and for stimulating reparative cells to synthesize and secrete
      extracellular matrix components. During normal wound healing the growth factor
      concentration has to be maintained at a certain level. If the growth factor
      concentration is too low, normal healing fails to occur. Whereas if the growth
      factor concentration is too high due to either over-expression of the growth
      factor or too much growth factor being applied to the wound, aberrant wound
      healing will occur. One approach for controlling the amount of growth factor at
      the wound site during normal healing is through gene therapy and the titration of
      gene dosage. However if a narrow window exists between the beneficial therapeutic
      effect and toxic effects with increasing gene dosage, an agent may be necessary
      to give in combination with gene therapy to regulate the over-expression of
      growth factor. In addition to genetic approaches to regulate wound healing,
      epigenetic approaches also exist. Antisense oligodeoxynucleotides have been shown
      to regulate wound repair in certain model systems and to determine the protein(s)
      necessary for normal wound healing. A novel approach to regulate the activity of
      collagen genes, thereby affecting fibrosis, is to use a sense
      oligodeoxynucleotide having the same sequence of the cis element which regulates
      the promoter activity of a particular collagen gene. This exogenous
      oligodeoxynucleotide will compete with the cis element in the collagen gene for
      the trans-acting factor which regulates promoter activity. These epigenetic
      approaches afford the opportunity to regulate over-expression of growth factor
      and therefore preclude the potential toxic effects of gene therapy. Both genetic
      and epigenetic approaches for regulating the wound healing process, either normal
      or aberrant wound healing, have certain advantages and disadvantages which are
      discussed in the present article.

PMID- 11208178
TI  - Use of the wound healing trajectory as an outcome determinant for acute wound
      healing.
AB  - Accurate and clinically practical methods for measuring the progress of acute
      wound healing is necessary before interventions designed to optimize and even
      accelerate acute wound healing can be applied. Complete wound closure rates and
      operative wound closure severity are irrelevant to most acute wounds since most
      are closed at the time of primary tissue repair and remain closed throughout
      healing. Analogous to chronic wound closure, the rate of increase of incision
      tensile strength progressively decreases as time passes and 100% unwounded tissue
      strength is never achieved making the endpoint definition of "healed" vague.
      Conceptualizing acute wound healing in terms of its design elements with
      reintegration into a final outcome lends itself to the description of acute wound
      healing as a mathematical trajectory. Frequently such an equation is a rate
      expressing the change in an acute healing parameter, most often tensile strength,
      over time. Such an approach also normalizes misinterpretations in analysis or
      errors in theory developed by measuring healing parameters at fixed points in
      time. Distributions of fractional strength gain times (e.g., 85% normal strength)
      can be determined using statistical methodology similar that used for failure
      time of survival analysis. Preclinical studies show that acute wound healing
      trajectories can be shifted to the left from a "normal" or "impaired" curve to an
      accelerated or more "ideal" curve. A useful method for measuring acute wound
      healing outcomes is therefore required before the basic science of acute wound
      healing is inevitably applied to the problem of acute surgical wounds.

PMID- 11208179
TI  - Thrombin peptide TP508 accelerates closure of dermal excisions in animal tissue
      with surgically induced ischemia.
AB  - TP508 is a synthetic peptide corresponding to amino acids 508 through 530 of
      human prothrombin. We previously demonstrated that a single topical application
      of TP508 stimulates revascularization and healing of acute incisional and
      excisional wounds in normal, healthy rat skin. To determine if TP508 would
      enhance wound healing in ischemic skin, we used bipedicle flaps, cranially based
      flaps, and free grafts to surgically create ischemic regions on the backs of
      rats. Full-thickness, circular excisions were made within the flaps or grafts and
      immediately treated with a single application of saline +/- TP508 (0.1
      microg/wound). Compared to wound closure in normal skin, ischemic skin wounds
      exhibited delayed closure, and the length of delay correlated with the degree of
      surgically induced ischemia. TP508 significantly accelerated closure in both
      normal and ischemic skin, resulting in closure rates that were increased within
      the first 7 days of wounding by 30% in normal tissue and bipedicle flaps, 50% in
      cranially based flaps, and 225% in free grafts. Moreover, in both flap models,
      TP508 restored the rate of closure to a rate approximating the control rate
      observed in normal skin. Histological comparisons of wound tissue from normal
      skin and cranially based flaps showed that ischemia reduced early recruitment of
      inflammatory cells at day 1 but increased inflammatory cell numbers in wound beds
      at day 14. TP508 treatment of ischemic flap wounds significantly increased early
      inflammatory cell recruitment and restored the normal rapid resolution of the
      inflammatory phase. In addition, at day 7, TP508-treated wounds appeared to have
      an increased number of large functional blood vessels compared to saline
      controls. These studies support the potential efficacy of TP508 in treating
      ischemic wounds in humans.

PMID- 11208180
TI  - Lysophosphatidic acid enhances healing of acute cutaneous wounds in the mouse.
AB  - Lysophosphatidic acid is a phospholipid growth factor and intercellular signaling
      molecule released by activated platelets and injured fibroblasts that affects
      keratinocytes, fibroblasts, neutrophils,and monocytes. We therefore hypothesized
      that lysophosphatidic acid could influence the inflammation and
      reepithelialization phases of wound healing. Lysophosphatidic acid (100 microM)
      was applied daily for 5 days to 2 mm-diameter excisional mouse ear skin wounds
      and re-epithelialization was measured. We also evaluated whether the bioactivity
      of lysophosphatidic acid could be increased by zinc (Zn2+, 1 mM). Inflammatory
      cells were counted in wound sections after 1, 3, or 5 days of healing.
      Reepithelialization was accelerated significantly by either lysophosphatidic acid
      or lysophosphatidic acid + Zn2+ (p < 0.01 and p < 0.0001, respectively). Both
      lysophosphatidic acid solutions significantly increased the amount of new
      epithelium in the wounds on days 1, 2, and 3 (p < 0.05). Little wound area
      remained on day 4, and all wounds were fully reepithelialized by day 5.
      Lysophosphatidic acid did not affect the number of neutrophils or macrophages
      present in the wound area. Our findings show that lysophosphatidic acid increased
      the amount of reepithelialization in the early stages of cutaneous wound healing
      in excisional ear wounds, without affecting inflammatory function.

PMID- 11208181
TI  - Activation of latent transforming growth factor-beta1 is induced by mannose 6
      phosphate/insulin-like growth factor-II receptor.
AB  - This study was conducted to further explore the mechanism of transforming growth
      factor beta1 (TGF-beta1) activation, which plays a critical role in many
      physiological and pathological conditions. We have previously shown that the
      large (270 kDa), but not small (40 kDa), mannose 6-phosphate receptors facilitate
      the cellular response to latent TGF-beta1 released from genetically modified
      cells. In this study, we explored the role of cell membrane associated
      transglutaminase and plasmin in mannose 6-phosphate receptor induced latent TGF
      beta activation using MS and MS-9 cells bearing either no receptors or the 270
      kDa mannose 6-phosphate/insulin-like growth factor II receptors, respectively. As
      a source of latent TGF-beta1, PA317 cells were transfected with either pLin-TGF
      beta1 vector or pLin retroviral vector with no TGF-beta1 insert using calcium
      phosphate precipitation. The latency and bioactivity of TGF-beta1 in conditioned
      medium derived from transfected PA317 cells were evaluated by enzyme-linked
      immunosorbent assay and mink lung epithelial cell growth inhibition assay,
      respectively. The level of latent TGF-beta1 was 13-fold higher (20.1 +/- 0.4 vs.
      1.5 +/- 0.03 ng/ml) in conditioned medium from pLin-TGF-beta1 transfected cells
      than that of control. The latency and bioactivity of TGF-beta1 released from pLin
      TGF-beta1 transfected cells were confirmed by evaluation of 3H-thymidine
      incorporation in Mv1Lu epithelial cells treated with non- and heat-activated 10%
      conditioned medium. The results showed a significantly lower 3H-thymidine
      incorporation in Mv1Lu epithelial cells treated with heat-activated PA317
      conditioned medium (4% of control) relative to those treated with either control
      or nonheated conditioned medium. This inhibition was abrogated by addition of 40
      microg/ml of TGF-beta1 neutralizing antibody. The level of 3H-thymidine
      incorporation was then evaluated in MS-9 cells receiving Dulbecco's modified
      Eagle medium containing either 0% 10%, 30% or 50% volumes of nonactivated PA317
      conditioned medium for 24 hours. The results showed a markedly lower
      proliferation in response to 30% and 50% conditioned medium used in MS-9 cells.
      Under similar experimental conditions, addition of only mannose 6-phosphate, but
      not fructose 6-phosphate or mannose 1-phosphate, at 1 mM concentration restored
      the MS-9 cell proliferative response to latent TGF-beta1. The inhibitory effects
      of latent TGF-beta1 on MS-9 cell proliferation were restored by addition of
      either TGF-beta1 neutralizing antibody or cystamine, a transglutaminase
      inhibitor. In contrast, addition of aprotinin, a plasmin inhibitor, had a
      marginal influence on inhibitory effects of latent TGF-beta1 on MS-9 cell
      proliferation. Interestingly, a mixture of latent TGF-beta1 + MS-9 cell
      membranes, but not MS cell membranes, also inhibited the mink lung epithelial
      cell proliferation (34% of control). These findings indicate that mannose 6
      phosphate/insulin-like growth factor II receptors are involved in latent TGF-beta
      activation and that is at least partly dependent on cell membrane associated
      transglutaminase, but not on plasmin.

PMID- 11208182
TI  - Inhibition of tumor necrosis factor-alpha attenuates wound breaking strength in
      rats.
AB  - Exogenous administration of tumor necrosis factor-alpha has been shown to both
      enhance and attenuate cutaneous healing in a dose-dependent manner. We examined
      the effects of tumor necrosis factor inhibition in the healing wound by both
      systemic and local administration of tumor necrosis factor-binding protein. Male
      Balb/C mice underwent dorsal skin incision with subcutaneous implantation of 20
      mg polyvinyl alcohol sponges (4 per animal). In Experiment I, one group (n = 20)
      received intraperitoneal injections of tumor necrosis factor-binding protein (3
      mg/kg) at the time of wounding, while another group (n = 20) received saline.
      Four animals from each group were euthanized on days 1, 3, 5, 7, and 14
      postwounding. In Experiment II, one group (n = 10) received an intraperitoneal
      injection of tumor necrosis factor-binding protein (3 mg/kg) at the time of
      wounding and every third day thereafter. Another group (n = 10) received an
      intraperitoneal injection of saline at the time of wounding and every third day
      thereafter. In Experiment III, one group received a single intraperitoneal
      injection of tumor necrosis factor-binding protein (3 mg/kg) at the time of
      wounding (n = 7), or on postwounding day 4 (n = 7), or day 7 (n = 7). Another
      group received saline injections at the time of wounding (n = 7), or on
      postwounding days 4 or 7 (n = 7, respectively). All animals in Experiments II and
      III were killed at postwounding day 14. Wound breaking strengths were assessed
      using a tensiometer. Wound fluid collected from the implanted sponges was assayed
      for tumor necrosis factor-alpha and tumor necrosis factor-binding protein levels
      using a biological assay and enzyme-linked immunosorbent assay, respectively.
      Collagen gene expression in sponge granulomata was assessed by Northern analysis.
      Collagen deposition in sponges was quantified by measuring hydroxyproline
      content. Wounds were significantly weaker in the animals that received repeated
      injections of tumor necrosis factor-binding protein with a mean wound breaking
      strength of 93.1 g vs. 186.6 g in controls (p < 0.05). Wound breaking strength in
      groups that received a single injection of tumor necrosis factor-binding protein
      on either day 0, 4, or 7 postwounding were no different than their respective
      controls. There was no difference in the mean hydroxyproline content of sponges
      between any of the tumor necrosis factor-binding protein groups and their
      respective controls. Northern analysis for collagen I and III expression also
      revealed no differences. These data indicate that continued systemic
      administration of tumor necrosis factor-binding protein resulted in significantly
      weaker wounds with no corresponding differences in wound collagen content, and
      collagen gene expression. This suggests that tumor necrosis factor-alpha
      inhibition throughout healing leads to a qualitatively impaired wound without a
      quantitative alteration in collagen deposition.

PMID- 11208183
TI  - Cell, matrix changes and alpha-smooth muscle actin expression in repair of the
      canine meniscus.
AB  - Processes in the repair of a crevice in the knee joint meniscus were investigated
      in 10 dogs. Two 2-mm cylindrical plugs from each medial meniscus were removed,
      rendered acellular by freezing and thawing, and then reinserted into the
      meniscus. Dogs were euthanized at intervals of 3-52 weeks after surgery. The
      crevice between the plug and meniscus at 3 weeks after surgery was filled with a
      tissue containing alpha-smooth muscle actin-positive cells. One year after
      surgery, the plug had remodeled and was populated with spindle-shaped and
      fibrochondrocyte-like cells. The plug had an appearance intermediate between that
      of hyaline and fibrocartilage at this time, with a seamless integration in sites
      between the remodeled plug and the surrounding meniscus. alpha-smooth muscle
      actin-positive cells were concentrated at the interface of the remodeled plug and
      adjacent meniscus and at the surface of the plug. Therefore, remodeling of both
      the plug and meniscal tissue and the participation of alpha-smooth muscle actin
      positive cells appear essential for integration of the plug into the adjacent
      meniscal tissue. Cells in the superficial zone of the meniscus seem to be active
      in the repair process. A change in both the phenotype of the cells and the
      quality of the matrix toward a more hyaline state appears to be an integral part
      of the remodeling process in the meniscus.

PMID- 11208185
TI  - Editorial.

PMID- 11208184
TI  - Use of a noncontact radiant heat bandage and Staphylococcus aureus dermal
      infections in an ovine model.
AB  - Diabetic foot wounds are difficult to manage due to relative tissue ischemia and
      high rates of soft tissue infection. One potential treatment modality is the
      application of local radiant heat to promote wound healing and control infection.
      However, there are concerns that local heat will spread rather than control
      infection. We determined in this study the effect of a noncontact radiant heat
      bandage in controlling an ischemic soft tissue infection. Bilateral 10 x 15 cm
      dermal flaps were created in 15 adult range sheep. The flaps were inoculated
      intradermally with 107 Staphylococcus aureus in 3 separate areas. The control
      flap was left open to air, while the treatment flap was covered with a noncontact
      radiant heat bandage and heated to 38 degrees C for three 1-hour periods
      separated by two 1-hour nonheating periods daily. After 10 days, both dermal
      flaps were harvested and sent for quantitative bacteriology. Due to operative
      complications, 12 of 15 sheep completed the study. The heated flap temperature
      was significantly higher 39.2 +/- 0.5 degrees C (+/- SE) vs. the control flap
      36.1 +/- 0.1 degrees C (p < 0.00001) and bacterial counts were significantly
      smaller in the heated flap (median 1.0 x 107 colony-forming units per gm tissue)
      when compared to the control flap (median 7.5 x 107) (p = 0.001). This study
      shows the use of a noncontact radiant heat bandage controls ischemic soft tissue
      infections in an ovine model.

PMID- 11208186
TI  - Both IgG and IgM anti-pig antibodies induce complement activation and
      cytotoxicity.
AB  - Hyperacute rejection of pig xenografts transplanted in humans is caused by
      endothelial cell binding of pre-formed xenoreactive antibodies (XAb) and
      activation of the classical pathway of complement. Human XAb mainly consist of
      anti-Galalpha1 3Gal antibodies, which occur in IgM, IgG and IgA classes. Whereas
      IgM anti-Galalpha1 3Gal antibodies have an established role in hyperacute
      rejection, the potential role of IgG XAb in this process is still controversial.
      The aim of the present study was to assess the specificity and functional
      properties of IgG and IgM XAb. Both classes were present in all human plasma
      samples tested, with a high inter-individual variability. Levels of IgG XAb did
      not correlate with levels of IgM XAb. Binding to Galalpha1 3Gal is strongly
      correlated with binding to the pig cell line PK15, both for IgG and for IgM,
      pointing to Galalpha1 3Gal as the major antigen recognized. Both purified IgM and
      IgG induced C3 deposition on PK15 cells and complement-dependent cytotoxicity in
      a dose-dependent way. The combination of IgG and IgM XAb resulted in an additive
      effect on cytotoxicity. Affinity-purified IgG anti-Galalpha1 3Gal antibodies were
      22 times less potent than IgM in induction of cytotoxicity. These results
      indicate a quantitative, but not a qualitative, difference between IgM and IgG
      anti-pig antibodies concerning their complement-activating properties. Therefore,
      both classes of XAb are of importance in the pathogenesis of hyperacute
      rejection, and the relative importance of each class may differ considerably
      between individual patients, depending on the ratio of IgG and IgM XAb present in
      serum.

PMID- 11208187
TI  - Removal of bowel aerobic gram-negative bacteria is more effective than
      immunosuppression with cyclophosphamide and steroids to decrease natural alpha
      galactosyl IgG antibodies.
AB  - Natural alpha-Galactosyl (Gal) antibodies play an important role in the rejection
      of pig xenografts by humans and Old World monkeys. In this study we investigate
      the efficacy of two different strategies to reduce the serum level of natural
      anti-Gal antibodies. On the one hand, removal of aerobic gram-negative bacteria
      from the intestinal flora, because anti-Gal antibodies appear to be produced as a
      result of the continuous sensitization by these microorganisms. On the other
      hand, we studied the effect on these antibodies of an immunosuppressive regimen
      of cyclophosphamide and steroids. Ten baboons were treated for three months with
      norfloxacin (Nor Group; n=6) or cyclophosphamide and steroids (CyP Group; n=4). A
      further four baboons did not receive any treatment (Control Group). Aerobic gram
      negative bacteria became negative in stools of the Nor Group after two weeks of
      treatment, and remained undetectable until week 7. Thereafter, a gradual increase
      on the fecal concentration of aerobic gram-negative bacteria was observed despite
      the norfloxacin treatment. The mean anti-Gal IgG in the Nor Group gradually
      declined from week 4 to 9 to a mean of 62.7 +/- 18% of the baseline level, and
      during this period were significantly lower than in the CyP (P<0.02) and the
      Control (P<0.05) groups. No differences were observed between the three groups
      during the 16 weeks of follow-up in serum levels of anti-Gal IgM, hemolytic anti
      pig antibodies, total IgG, IgM and IgA. In conclusion, removal of normal aerobic
      gram-negative bacteria from the intestinal flora is more effective than
      immunosuppression with CyP and steroids in reducing the level of natural anti-Gal
      antibodies, although there is no discernible effect on IgM antibodies.

PMID- 11208188
TI  - Low molecular weight dextran sulfate prevents complement activation and delays
      hyperacute rejection in pig-to-human xenotransplantation models.
AB  - Dextran sulfate of 5000 molecular weight (DXS 5000) is known to block complement
      activation as well as the intrinsic coagulation cascade by potentiation of C
      inhibitor. The effect of DXS 5000 on hyperacute rejection (HAR) was tested in pig
      to-human xenotransplantation models. For in vitro testing, a cytotoxicity assay
      was used with the pig kidney cell line PK15 as target cells and fresh, undiluted
      human serum as antibody and complement source. Ex vivo pig lung perfusion was
      chosen to assess DXS 5000 in a physiologic model. Pig lungs were perfused with
      fresh, citrate-anticoagulated whole human blood to which 1 or 2 mg/ml DXS 5000
      were added; the lungs were ventilated and the blood de-oxygenated. Pulmonary
      vascular resistance (PVR) and blood oxygenation (deltapO2) were monitored
      throughout the experiment. Autologous pig blood and human blood without DXS 5000
      served as controls. In the PK 15 assay DXS 5000 led to a complete, dose-dependent
      inhibition of human serum cytotoxicity with an average IC50 of 43 +/- 18
      microg/ml (n=8). Pig lungs perfused with untreated human blood (n=2) underwent
      HAR within 105 +/- 64 min, characterized by increased PVR, decrease of deltapO2,
      and generalized edema. Microscopically, capillary bleeding as well as deposition
      of human antibodies, complement and fibrin could be observed. Addition of DXS
      5000 (n=4) prolonged lung survival to 170 +/- 14 min for 1 mg/ml and 250 +/- 42
      min for 2 mg/ml. and PVR values as well as edema formation were comparable to
      control lungs that were perfused with autologous pig blood (n=2). Activation of
      complement (activation products in serum, deposition on lung tissue) and the
      coagulation system (fibrin monomers) were significantly diminished as compared to
      human blood without DXS 5000. Binding of anti-Gal antibodies was not influenced,
      and in vitro experiments showed no evidence of complement depletion by DXS 5000.
      In conclusion, DXS 5000 is an efficient complement inhibitor in pig-to-human
      xenotransplantation models and therefore a candidate for complement
      inhibitory/anti-inflammatory therapy either alone or in combination with other
      substances and warrants further investigation.

PMID- 11208189
TI  - Human membrane cofactor protein (MCP, CD 46) protects transgenic pig hearts from
      hyperacute rejection in primates.
AB  - Recently, we and others have shown the prolongation of xenograft survival with
      the use of transgenic pigs bearing human CD 59 and DAF complement regulatory
      proteins (CRP). We now report heart transplantation using a new line of
      transgenic pigs bearing a different human CRP, membrane cofactor protein (MCP, CD
      46). We transplanted three MCP transgenic and three wild-type porcine hearts into
      baboons suppressed with cyclosporine, methylprednisone, and rapamycin or
      cyclophosphamide. In addition, recipients were treated with extracorporeal plasma
      perfusion to remove alpha-Gal reactivity. The wild-type grafts were rapidly
      rejected at 60 to 80 min. Two functioning MCP hearts were removed after 5 and 46
      h for histological examination. One MCP heart showed vigorous function until
      postoperative day 16. Immunohistochemistry of both wild-type and MCP-transgenic
      hearts showed strong deposition of IgM. In contrast, there was less MAC
      deposition in the transgenic graft as compared to the wild-type control. MCP is
      another CRP capable of decreasing the features of hyperacute rejection of cardiac
      xenografts in baboon recipients.

PMID- 11208190
TI  - Preconditioning with the prostacyclin analog epoprostenol and cobra venom factor
      prevents reperfusion injury and hyperacute rejection in discordant liver
      xenotransplantation.
AB  - Liver xenografts transplanted from guinea pig to rat suffer from inadequate organ
      reperfusion and initial dysfunction, despite sufficient complement depletion
      using cobra venom factor (CVF). Reperfusion injury is prevented when complement
      depleted donors are treated with the prostacyclin analog epoprostenol.
      Histological analysis suggests that epoprostenol preconditioning prevents post
      reperfusion spasms of the intrahepatic branches of the portal vein and strongly
      reduces appearance of hepatocyte apoptosis shortly after transplantation. Cobra
      venom-treated rats show breakdown of glucose metabolism and die in acute
      hypoglycaemia, whereas the additional application of epoprostenol restores
      gluconeogenesis. Consequently, recipient survival after epoprostenol and CVF
      treatment is significantly improved compared with animals receiving CVF only (5.1
      +/- 2.6 h vs. 17.9 +/- 5.1 h). These data demonstrate that initial dysfunction of
      discordant liver grafts in the guinea-pig-to-rat species combination, can be
      overcome by the application of epoprostenol combined with CVF. Using this
      pharmacologic regimen, the discordant guinea-pig-to-rat model appears useful to
      study further questions concerning functional and immunological compatibility of
      a discordant liver xenograft.

PMID- 11208191
TI  - Immortalized bone-marrow derived pig endothelial cells.
AB  - Primary cultures of porcine endothelial cells (EC) can only be maintained for a
      limited number of passages. To facilitate studies of xenogeneic human anti-pig
      immune responses in vitro, pig microvascular bone-marrow (BM) and macrovascular
      aortic EC were obtained from our herd of partially inbred miniature swine,
      homozygous for the major histocompatibility locus, and immortalized with a
      modified SV40 large T vector. The resulting BM-derived (2A2) and aortic
      (PEDSV.15) immortalized EC lines showed unlimited growth and EC phenotype as
      indicated by expression of von Willebrand Factor (vWF) and low density
      lipoprotein (LDL) receptors as well as by formation of typical cobblestone
      monolayers. Ultrastructural studies revealed morphological similarities in
      primary and immortalized EC. Flow cytometry analysis demonstrated constitutive
      SLA class I expression by all lines whereas SLA class II was only expressed after
      stimulation with porcine IFNgamma. Furthermore, pig CD34 mRNA was detected by
      Northern blot analysis in primary and immortalized aortic EC but not in 2A2. Both
      EC lines expressed a number of myeloid markers, adhesion molecules and
      xenoantigens, the latter being determined by binding of human natural antibodies.
      Gene transfer into the porcine EC lines was successfully performed by
      electroporation or calcium-phosphate transfection, as well as by adenoviral
      infection. Finally, the functional similarity between primary and immortalized EC
      was demonstrated in adhesion and cytotoxicity assays. Together, these results
      suggest that 2A2 and PEDSV. 15 represent valuable tools to study both human
      cellular and humoral immune responses in vitro against pig EC derived from
      microvascular and large vessels.

PMID- 11208192
TI  - Characterization of human killer cell reactivity against porcine target cells:
      differential modulation by cytokines.
AB  - The cytotoxic cell response to porcine cells by human lymphocytes, and the
      modulation of cytolytic cellular activity by human cytokines were investigated.
      Human peripheral blood mononuclear cells (PBMC) and purified lymphocyte subsets
      were co-cultured with fresh irradiated porcine stimulator cells and examined for
      the development of lytic activity and for their proliferative response. Porcine
      target cells included a new cell line, MS-PBMC-J2 (designated J2; SLA-DR+MHC
      class I+CD2+CD3 CD8+CDI6+CD45+), aortic and microvascular endothelial cells.
      Initial results showed that natural killer (NK) cells were fivefold more
      efficient in killing porcine target cells compared with T cells. IL-12 augmented
      the killing of porcine target cells by human NK cells beyond that induced by
      stimulation with cells alone. In contrast, IL-2 and IL-15 often induced
      substantial human NK cell mediated killing of porcine target cells, including
      endothelial cells in the case of IL-2 where such targets were examined, even in
      the absence of stimulator cells. Finally, neither IL-18 nor IL-8 had any effect
      beyond background on NK cell mediated killing of porcine target cells. These
      findings show that cytokines that would be produced in a xenograft setting
      clearly modulate the ability of human cytolytic cells to kill porcine targets. In
      addition, fresh unstimulated human NK cells lysed J2 and porcine aortic
      endothelial cells, but not porcine microvascular endothelial cells, suggesting
      the possibility of rapid attack of xenografts by NK cells, and differential
      susceptibility of endothelial cells from different vascular structures to this
      attack.

PMID- 11208193
TI  - Oral delivery of xeno-antigen combined with non-depleting anti-CD4 monoclonal
      antibody induces significantly prolonged survival of concordant skin xenograft.
AB  - Oral administration can induce unresponsiveness to protein antigens. Therefore,
      we examined whether oral administration of xeno-antigen could induce the
      prolonged survival of xenogeneic skin grafts. CBA mice were given 1 x 10(7) SD
      rat splenocytes orally, 7 days before transplantation of a SD rat skin in the
      presence or absence of a non-depleting anti-CD4 monoclonal antibody (mAb)
      (YTS177, 200 microg/dose, 8 and 7 days relative to transplantation). All skin
      grafts survived with a median survival time (MST) of 62 days when xeno-antigens
      were administered orally in combination with anti-CD4 mAb. Mice treated with anti
      CD4 mAb alone or oral administration of xeno-antigen alone induced modest
      prolonged survival of rat skin grafts (MST = 18 and 19 days, respectively) while
      naive mice rejected rat skin acutely (MST= 12 days). Oral administration alone or
      combined with anti-CD4 mAb reduced the level of xeno-antibody production compared
      with that in untreated mice after transplantation. Xenogeneic mixed leukocyte
      response was reduced when splenocytes from mice pre-treated with oral
      administration of xenogeneic cells were used as the responder compared with that
      in untreated mice. Oral delivery of xeno-antigen plus non-depleting anti-CD4 mAb
      can induce prolongation of concordant xenogeneic skin grafts.

PMID- 11208194
TI  - "Literature update 1999, part 3".

PMID- 11208195
TI  - A tribute to leadership, dedication, and performance in publishing.

PMID- 11208196
TI  - Periapical abscess formation and resolution adjacent to dental implants: a
      clinical report.
AB  - The vitality of teeth adjacent to dental implants should be considered in the
      treatment planning of dental implants. Both the restorability of an
      endodontically treated tooth and the risk of infection of the adjacent implant
      are important factors in planning for success. Given the illustrated difficulties
      and difficulties associated with resolving periapical infections of teeth and
      implants, it is essential to define the vitality of teeth by careful pulp testing
      and to consider the integrity of existing questionable, endodontically treated
      teeth before implant treatment. The risk of periapical infection at teeth
      adjacent to implants must be minimized.

PMID- 11208197
TI  - Fabrication of a digitally scanned, custom-shaped abutment: a clinical report.
AB  - A procedure for the creation of a custom, anatomic implant abutment copy milled
      with digitally scanned information has been described. The definitive restoration
      was a custom-machined abutment with a ceramic crown that had an aluminous oxide
      core.

PMID- 11208198
TI  - An endosseous, implant-retained obturator for the rehabilitation of a recurrent
      central giant cell granuloma: a clinical report.
AB  - The prosthodontic rehabilitation of a patient with a recurrent maxillary CGCG has
      been described. The patient's immense defect originally was rehabilitated with a
      scapular microvascular free flap, endosseous dental implants, and an ISP that
      became obsolete by virtue of the resection of recurrent disease and the
      subsequent need for velopharyngeal obturation. The patient was provided with a
      surgical obturator at the time of the resection of the recurrent CGCG. The
      surgical obturator thereafter was modified into an interim obturator to provide
      velopharyngeal competence while the soft tissues around the palatal defect
      healed. Finally, the construction of a bar-retained definitive obturator markedly
      improved the patient's speech, mastication, and deglutition.

PMID- 11208199
TI  - Teaching an abbreviated impression technique for complete dentures in an
      undergraduate dental curriculum.
AB  - STATEMENT OF PROBLEM: Traditional methods for teaching complete denture
      fabrication are time-consuming, difficult to master, and not used by many general
      practitioners. PURPOSE: This study compared the efficacy of traditional denture
      fabrication techniques with a more abbreviated method in a dental school setting.
      MATERIAL AND METHODS: A retrospective record review of 80 completely edentulous
      patients treated by predoctoral dental students was completed. Forty patients
      were treated with traditional denture techniques; the other 40 patients were
      treated with an abbreviated method. The data abstracted included the number of
      visits to completion and the number of postinsertion visits and relines required
      within the first 3 months after delivery. A Wilcoxon rank sum test was performed
      to determine statistical significance between the groups with regard to number of
      visits for fabrication and postinsertion adjustments. A test for a difference in
      proportions by using the normal approximation to the binomial distribution was
      performed for statistical analysis of the incidence of relines. RESULTS: The
      abbreviated denture technique resulted in a statistically significant difference
      in the number of visits for fabrication (P<.01) and postinsertion adjustments
      (P<.05.) There was no difference (P=.39) in the number of relines between the 2
      groups. CONCLUSION: Teaching the abbreviated complete denture technique in an
      undergraduate dental clinic decreased the number of appointments necessary to
      complete denture therapy without increasing the number of adjustments or reline
      procedures.

PMID- 11208200
TI  - The pontic-splinted procedure for tooth and denture base additions in denture
      repair.
AB  - Various methods for adding teeth to existing dentures have been used clinically.
      Although a direct, single-tooth addition method saves time, it often is difficult
      to achieve an esthetic appearance when adding several missing anterior teeth with
      this technique. Indirectly adding teeth may achieve a better esthetic result, but
      this method is time-consuming. This article describes the pontic-splinted
      procedure, an indirect method for replacing several anterior teeth and part of
      the denture base that can save time and, at the same time, help the clinician
      achieve acceptable esthetics.

PMID- 11208201
TI  - Comparative in vitro evaluation of two provisional restorative materials.
AB  - STATEMENT OF PROBLEM: Provisional crowns traditionally have been associated with
      problems such as poor occlusion, contour, fit, and finish. Fabrication procedures
      should be uncomplicated and predictable within a realistic time frame. PURPOSE:
      The purpose of this study was to compare the quality of provisional restorations
      fabricated by dental students from 2 different materials (bis-acryl composite
      resin and PMMA) and identify the advantages and disadvantages associated with
      each material. MATERIAL AND METHODS: This study evaluated the occlusion, contour,
      marginal adaptation, and finish of 222 provisional crowns fabricated by 2 groups
      (A and B) of dental students. One bis-acryl composite resin material (Integrity)
      and 2 PMMA resins (C&B Resin and Snap) were evaluated. RESULTS: For group A,
      Integrity was statistically superior (P<.05) to C&B Resin in all 4 categories for
      anterior provisional crowns. For posterior provisional crowns, Integrity proved
      superior in the categories of contour and marginal adaptation, but no significant
      differences were established for occlusion and finish. For group B, Integrity was
      statistically superior to Snap in the categories of occlusion, contour, and
      marginal adaptation, whereas there was no statistical difference in finish. When
      all 4 categories were analyzed, Integrity was found to be statistically superior.
      CONCLUSION: Bis-acryl composite resin (Integrity) was significantly superior to
      PMMA (C&B Resin and Snap) as a provisional restorative material.

PMID- 11208202
TI  - Evaluation of high-temperature distortion of high-palladium metal-ceramic crowns.
AB  - STATEMENT OF PROBLEM: Crown fit is a prerequisite for long-term clinical success;
      however, crown distortion may occur during porcelain firing. The dimensional
      stability of some high-palladium alloys at high temperatures has been questioned.
      PURPOSE: The purpose of this study was to use a new method to measure the
      distortion of copings for metal-ceramic single units of selected high-palladium
      alloys with compositions representative of commercial alloys. MATERIAL AND
      METHODS: Four high-palladium alloys containing copper and 3 containing no copper
      were tested. A palladium-silver alloy was included for comparison, and a gold
      palladium alloy served as the control. By using reference points scribed on the
      margin, the mesiodistal and buccolingual margin diameters of identical copings
      were measured with a traveling microscope at 4 stages: as-cast, oxidized, after 2
      simulated opaque porcelain firings, and after 2 simulated dentin porcelain
      firings. The margin distortions for the various specimen groups representing
      combinations of alloys, stages, and measurement diameters were compared with the
      use of 1-way analysis of variance and a multiple range test. RESULTS: Most of the
      high-palladium alloys had high-temperature distortions that were not
      significantly different from those of the control alloy. The distortions occurred
      principally during the oxidation cycle. The effect of mesiodistal groove
      reinforcement on preventing distortion was not the same for all alloys.
      CONCLUSION: The results suggest that small observed distortions of these alloys
      will not produce clinical problems. Several laboratory techniques are available
      to counteract the distortions.

PMID- 11208203
TI  - A patient-based assessment of implant-stabilized and conventional complete
      dentures.
AB  - STATEMENT OF PROBLEM: Outcomes of oral implant therapy have been described
      primarily in terms of implant survival rates and the durability of implant
      superstructures. Reports of patient-based outcomes of implant therapy have been
      sparse, and none of these studies have used oral-specific health status measures.
      PURPOSE: This study assessed the impact of implant-stabilized prostheses on the
      health status of complete denture wearers using patient-based, oral-specific
      health status measures. It also assessed the influence of preoperative
      expectations on outcome. MATERIAL AND METHODS: Three experimental groups
      requesting replacement of their conventional complete dentures completed an Oral
      Health Impact Profile (OHIP) and a validated denture satisfaction scale before
      treatment. One group received an implant-stabilized prosthesis (IG), and 2 groups
      received new conventional complete dentures (CDG1 and CDG2). After treatment, all
      subjects completed the health status measures again; preoperative data were
      compared with postoperative data. RESULTS: Before treatment, satisfaction with
      complete dentures was low in all 3 groups. Subjects requesting implants (IG and
      CDG1) had high expectations for implant-stabilized prostheses. Improvement in
      denture satisfaction and OHIP scores was reported by all 3 groups after
      treatment. Subjects who received their preferred treatment (IG and CDG2 subjects)
      reported a much greater improvement than CDG1 subjects. Preoperative expectation
      levels did not appear to influence satisfaction with the outcomes of implant
      therapy in IG subjects. CONCLUSION: Subjects who received implants (IG) that
      replaced conventional complete dentures reported significant improvement after
      treatment, as did subjects who requested conventional replacement dentures
      (CDG2). The OHIP appears useful in identifying patients likely to benefit from
      implant-stabilized prostheses.

PMID- 11208204
TI  - Freestanding and multiunit immediate loading of the expandable implant: an up-to
      40-month prospective survival study.
AB  - STATEMENT OF PROBLEM: The subject of immediate loading of dental implants has
      received substantial attention, although it appears to conflict with the basic
      principles of dental implant therapies developed and established over the past 20
      years. Clinicians would welcome the use of a reliable, immediate-loading implant
      system. PURPOSE: The purpose of this study was to evaluate the effectiveness of
      an expandable implant design for immediate and delayed loading and for
      freestanding and multiunit situations. MATERIAL AND METHODS: Two hundred eighty
      six immediate-load Sargon implants were placed in 75 patients during a 40-month
      period. Of the 273 implants that survived, 81 were placed into fresh extraction
      sockets and immediately loaded, 162 were placed into healed sites and immediately
      loaded, and 30 were delay loaded. Some implants that had failed to remain stable
      after immediate loading became stable and osseointegrated after the load was
      removed and their expansion mechanisms were reactivated. RESULTS: The overall
      survival rate during the 40-month period was 96.0% in the maxilla and 94.8% in
      the mandible. Implants placed in fresh extraction sockets showed a 98.9% survival
      rate. Healed sites showed a 93.9% survival rate. Immediate loading of 52 fresh
      extraction socket implants in the maxilla showed a 100% survival rate during the
      evaluation period. CONCLUSION: Within the limitations of this study, it was shown
      that the feature of mechanical expandability may provide operators some control
      over implant stability during the vulnerable period after immediate loading of
      single, freestanding implants.

PMID- 11208205
TI  - Three-dimensional quantification of color-marked occlusal paths on anatomically
      oriented casts.
AB  - STATEMENT OF PROBLEM: The analysis of occlusal contacts on mounted diagnostic
      casts is an important task in prosthetic diagnostics. However, it is still
      restricted mainly to qualitative aspects because existing measuring techniques
      fail to provide 3-dimensional data for more than a few single points in
      acceptable time. PURPOSE: The aim of this study was to develop a method for
      quantifying occlusal contacts and paths by using anatomically oriented diagnostic
      casts and to design the method to allow fast acquisition of digital 3-dimensional
      coordinates. MATERIAL AND METHODS: Plaster casts with color-marked contacts were
      digitized optically with a profilometric system based on the fringe projection
      technique. Digital camera images taken simultaneously were used to define the
      contact areas by marking them either manually or automatically with the help of
      image-processing routines. Three-dimensional coordinates were determined by
      finding the corresponding points within the profilometric data set. RESULTS:
      Color-marked contact areas on diagnostic casts were successfully digitized with a
      computer-controlled, automatic setup in approximately 30 seconds. The accuracy of
      the acquired 3-dimensional data was estimated to be better than 60 microm in
      lateral and 30 microm in height resolution. The data set was visualized and
      evaluated in a skull related coordinate system. SUMMARY: This study verified the
      use of a new tool to quantify color-marked occlusal contacts on diagnostic casts
      in terms of spatial coordinates. The resulting digital data may be stored easily
      and analyzed numerically as well as visualized 3-dimensionally with computer
      graphic equipment. Because the anatomic orientation of the casts is maintained
      throughout the measurement process, it is possible to compare the data with
      electronically registered condyle paths and therefore to investigate, for
      example, their relation to the corresponding guidance paths of the frontal teeth
      and the canines in dynamic occlusion.

PMID- 11208206
TI  - A review of saliva: normal composition, flow, and function.
AB  - An adequate supply of saliva is critical to the preservation and maintenance of
      oral tissue. Clinicians often do not value the many benefits of saliva until
      quantities are decreased. Much is written on the subject of salivary
      hypofunction, but little attention is paid to normal salivary flow and function.
      This article is a brief, up-to-date overview of the literature on the basics of
      normal salivary composition, flow, and function. A review of the literature was
      conducted using MEDLINE and Healthstar (1944 through 1999); articles were
      selected for inclusion on the basis of relevance and significance to the
      clinician.

PMID- 11208207
TI  - Setting characteristics of five autopolymerizing resins measured by an
      oscillating rheometer.
AB  - STATEMENT OF PROBLEM: Ease of handling and the working time of autopolymerizing
      resins are directly associated with the setting characteristics during
      polymerization. PURPOSE: This study assessed the setting characteristics of
      autopolymerizing resins by measuring viscosity changes and tested the hypotheses
      that: (1) different products have different viscosity increase patterns during
      polymerization, and (2) the increased rate of viscosity is not proportional to
      the length of the setting time. MATERIAL AND METHODS: Viscosity change during
      polymerization was measured in 5 test materials (Unifast II, ADFA, META FAST,
      Miky, and Trim) with an oscillating rheometer. The working time was defined as
      the time required for a 5% reduction in the amplitude of the rheometer trace. The
      setting time was measured as the time required to reach zero amplitude on the
      rheometer trace. RESULTS: The order of working times from longest to shortest was
      Trim, Unifast II and META FAST, ADFA, Miky (ANOVA, P<.0001). The order of setting
      times from longest to shortest was Trim, META FAST, Miky, ADFA, Unifast II.
      Materials that had rapid setting times did not necessarily have short working
      times. Unifast II showed well-balanced setting properties that satisfied both
      longer working time and faster setting time. CONCLUSION: Autopolymerizing resins
      have setting characteristics specific to the brand. Knowledge of these
      characteristics is essential for selection of the appropriate resin product
      depending on the purpose of clinical usage and the individual dentist's
      technique.

PMID- 11208208
TI  - Effects of flowable composite lining and operator experience on microleakage and
      internal voids in class II composite restorations.
AB  - STATEMENT OF PROBLEM: When inexperienced clinicians perform class II composite
      restorations, improper placement techniques can lead to problems, including
      marginal adaptation and void formation. PURPOSE: The aim of this study was to
      determine the influence of flowable composite linings on marginal microleakage
      and internal voids in class II composite restorations performed by practitioners
      with different levels of experience. MATERIAL AND METHODS: Eighty extracted
      molars were prepared with mesial and distal class II cavity preparations and
      divided into 4 groups. Each group was restored separately with the following
      materials: Prodigy/Revolution lining (group I), Prodigy (group II), Tetric
      Ceram/Tetric Flow lining (group III), and Tetric Ceram (group IV). Each group was
      equally divided and restored by 2 practitioners, one experienced and another
      untrained in composite restorations. After restoration, all teeth were stored for
      24 hours, thermocycled (at 5 degrees C to 60 degrees C) 1500 times, and soaked in
      2% basic Fuchsin dye for 24 hours. After soaking, the teeth were sectioned, and
      gingival marginal microleakage and internal voids (at the gingival wall interface
      and in the cervical and the occlusal parts) were recorded. Data were analyzed
      with the Kruskal-Wallis test. RESULTS: There was no significant reduction in
      microleakage for either practitioner. There were fewer interface voids within
      pairs with or without flowable composite linings made by the experienced
      practitioner (P<.05). CONCLUSION: When flowable composite lining was placed at
      the gingival floor of a class II composite restoration by an experienced
      practitioner, voids in the restored interface were reduced. Gingival marginal
      sealing was not improved by the same technique.

PMID- 11208209
TI  - Effects of two silane coupling agents, a bonding agent, and thermal cycling on
      the bond strength of a CAD/CAM composite material cemented with two resin luting
      agents.
AB  - STATEMENT OF PROBLEM: Surface treatment of CAD/CAM-generated composite material
      is important for a strong bond of resin luting agents to composite material.
      Purpose. This study evaluated the shear bond strengths of 2 dual-cured resin
      luting agents to a CAD/CAM composite material and the effect of silane coupling
      agent and bonding resin on the bond strength. MATERIAL AND METHODS: Rectangular-
      and disk-shaped CAD/CAM composite materials were untreated or treated with 1 of
      the 2 silane coupling agents or bonding resin and then cemented together with 1
      of the 2 dual-cured resin luting agents. Half of the specimens were stored in
      water at 37 degrees C for 24 hours, the other half thermocycled 50,000 times
      before shear bond strength testing. Shear bond strengths were measured with a
      servohydraulic mechanical testing machine, and results were analyzed with 2-way
      analysis of variance. RESULTS: Surface treatment by silane coupling agent
      improved the shear bond strength when compared with nontreatment. Specimens
      treated with bonding resin showed significantly greater shear bond strength than
      the untreated groups. However, all specimens had the same adhesive failures at
      the composite-luting agent interface as untreated groups. When the CAD/CAM
      composite material was treated with 1 of the 2 silane coupling agents, no
      significant differences in bond strength were noted between water storage alone
      and after 50,000 thermocycles. For the 2 groups treated with bonding resin or
      silane coupling agent and cemented with 1 of the 2 dual-cured resin luting
      agents, there were significant increases in bond strength after 50,000
      thermocycles, compared with specimens that were not subjected to thermal cycling.
      On the other hand, for the 2 untreated groups, there were significant decreases
      in bond strength after thermocycling. After 50,000 thermocycles, all specimens
      treated with silane coupling agent and then cemented with 1 of the 2 resin luting
      agents showed cohesive failures within the composite material. CONCLUSION: The
      application of a silane coupling agent to the CAD/CAM composite surface provided
      the highest bond strength between the resin luting agent and composite after long
      term thermal cycling.

PMID- 11208210
TI  - Pilot study of the relationship between the hardness and abrasion resistance of
      two base metal alloys used for metal-ceramic restorations.
AB  - STATEMENT OF PROBLEM: Base metal alloys present high values of strength and
      hardness, which have been associated with the greater abrasion resistance and
      polishing of metal-ceramic restorations. However, surface hardness has been shown
      to be a poor indicator of abrasion resistance. PURPOSE: The study aimed to
      compare the hardness and abrasion resistance of Ni-Cr alloys and determine
      whether there is a correlation between these 2 properties. MATERIAL AND METHODS:
      Two Ni-Cr alloys for metal-ceramic restorations with different hardness values
      were subjected to the following procedures: (1) initial measurement of Vickers
      hardness, (2) a series of abrasion cycles, (3) measurement of mass loss after
      each cycle, and (4) Vickers hardness measurements after each cycle. RESULTS: For
      each alloy, linear regression revealed a negative correlation between hardness
      and reduction in mass. The higher hardness of alloy A was associated with higher
      mass loss during abrasion when compared with alloy B. CONCLUSION: There was no
      significant correlation between hardness and mass loss for either alloy.

PMID- 11208212
TI  - Methods for recycling discarded mouth guard sheets.

PMID- 11208211
TI  - Electrochemical corrosion of titanium and titanium-based alloys.
AB  - STATEMENT OF PROBLEM: Two varieties of unalloyed titanium, Ti-6Al-4V and NiTi,
      commonly are used in medical and dental fields. Several other types of alloys for
      potential use in these fields have been developed, including Ti-4.5Al-3V-2Mo-2Fe
      and vanadium-free alloys (Ti-5Al-2.5Fe and Ti-5Al-3Mo-4Zr). The corrosion of
      these alloys under simulated physiologic conditions is not known. Purpose. This
      study compared the corrosion behaviors of 6 titanium materials through
      electrochemical polarization tests in 37 degrees C Ringer's solution. MATERIAL
      AND METHODS: The applied voltage was potentiostatically scanned from -0.6 to 1.0
      V. From polarization curves, the corrosion rate (averaged over 3 samples) for
      each alloy was calculated and compared with that of other alloys. Analysis of
      variance (ANOVA) and the Student-Newman-Keuls multiple range test were performed
      at a 95% overall confidence level to identify statistically significance
      differences in corrosion rates. Surface oxide films were identified by electron
      diffraction, and the electrolyte medium was analyzed by atomic absorption
      spectrophotometry after each alloy was tested. RESULTS: Commercially pure
      titanium and Ti-5Al-2.5Fe were the most resistant to corrosion; Ti-5Al-3Mo-4Zr,
      Ti-6Al-4V, and NiTi were the least resistant to corrosion. NiTi exhibited pitting
      corrosion along with transpassivation. CONCLUSION: Electron diffraction patterns
      indicated that all titanium alloys were covered mainly with rutile-type oxide
      (TiO(2)) after corrosion tests. The oxides that formed on Ti-5Al-2.5Fe were
      identified as a mixture of TiO(2) and Ti(9)O(17), and those that formed on NiTi
      were identified as a mixture of TiO(2) and Ni(2)Ti(4)O.

PMID- 11208213
TI  - How to achieve a path of insertion for a provisional fixed partial denture
      retained by stainless steel posts.

PMID- 11208214
TI  - Implant superstructure hygienic modification.

PMID- 11208215
TI  - Organized method for ultrasonically cleaning and sterilizing small prosthetic
      components used in implant therapy.

PMID- 11208216
TI  - Re: Fabrication of a two-piece superstructure for a fixed detachable implant
      supported mandibular complete denture. Golden et al. J Prosthet Dent 2000;84:205
      9.

PMID- 11208218
TI  - Effect of direction of applied mobilization force on the posteroanterior response
      in the lumbar spine.
AB  - OBJECTIVE: The purpose of this study was to investigate whether changing the
      direction of applied force affects measured posteroanterior stiffness and
      associated pelvic (sacral) and lower thoracic rotations. DESIGN: A repeated
      measures design was used. SETTING: University biomechanical laboratory.
      PARTICIPANTS: Twenty-four subjects (14 male, 10 female) with no history of recent
      low back pain or contraindications to mobilization volunteered for testing. MAIN
      OUTCOME MEASURE: Posteroanterior stiffness was assessed at vertebral levels L3
      and L5 through use of 3 sagittal plane directions of applied force; the
      directions differed by 10 degrees. The amount of sacral and lower thoracic
      rotation that occurred during loading between 30 and 100 N was also recorded.
      RESULTS: A small but significant variation of stiffness with direction of applied
      force was found. At L3, mean stiffness was greatest when the posteroanterior
      force was applied in a base direction; it was 11% less when the force was applied
      10 degrees more caudad than the base direction and 14% less when the force was
      applied 10 degrees more cephalad than the base direction. There was no
      significant effect of direction when the force was applied at L5. Both sacral and
      thoracic rotations displayed significant variation with direction of force when
      load was applied at L5, with decreasing rotation as the force was applied in a
      more caudal direction. CONCLUSION: Posteroanterior stiffness in individuals
      without back pain is affected by the sagittal plane direction in which the
      posteroanterior force is applied to the lumbar spine. Remote (thoracic and
      sacral) movements are also affected by the direction of posteroanterior force.
      Direction of applied force should therefore be controlled, particularly in the
      research setting.

PMID- 11208219
TI  - Recruitment and accrual of women in a randomized controlled trial of spinal
      manipulation.
AB  - OBJECTIVE: To report on recruitment efforts and accrual rates for a
      nonmusculoskeletal chiropractic clinical trial. DESIGN: Information regarding the
      method of recruitment was collected for each individual who responded to an
      advertisement and completed an interviewer-administered telephone screening.
      SETTING: A suburban chiropractic teaching clinic with recruitment efforts
      extending throughout the larger metropolitan area. PATIENTS: A total of 2312
      women were screened for participation and the advertisement source was noted for
      each. Of these, 138 women were recruited and fulfilled all study requirements.
      MAIN OUTCOME MEASURES: The numbers of responses and accrual rates were determined
      for 8 different recruitment methods: newspaper advertisements, community
      referrals, radio advertisements, community colleges, press releases, a community
      electronic sign, public television, and local posters. RESULTS: The most
      effective recruitment methods were newspaper advertisements, community referrals,
      and radio advertisements; the least effective methods were public television and
      local posters. CONCLUSIONS: The effort required for the recruitment of subjects
      was underestimated in this study. Based on the information gained, future
      recruitment methods for study participants will primarily focus on low-effort,
      high-yield methods such as newspaper and radio advertising, followed by press
      releases, campus electronic signs, and public television.

PMID- 11208220
TI  - Sources of variation in spinal indentation testing: indentation site relocation,
      intraabdominal pressure, subject movement, muscular response, and stiffness
      estimation.
AB  - BACKGROUND: Force-displacement properties of spinal tissues assessed by blunt
      indentation are thought to have clinical relevance; however, numerous variables
      with respect to spinal indentation have yet to be identified or characterized
      completely. OBJECTIVE: To identify and quantify, where possible, previously
      unidentified or incompletely characterized variables with respect to spinal
      indentation. DESIGN: Multiprotocol design. METHODS: Four experiments were
      performed: (1) Twelve asymptomatic subjects were indented with concurrent
      electromyography during conditions of rest, held inspiration, increased
      intraabdominal pressure and lumbar extension. (2) Changes in the recumbent
      position of 12 subjects were measured while a series of movements was performed
      in restrained and unrestrained conditions. (3) Ten clinicians attempted to
      locate, and to relocate, a subcutaneous anatomical landmark through
      visualization/palpation and ultrasonic imaging. (4) Performances of 3 methods of
      force-displacement curve modeling were compared with respect to stiffness
      estimation. RESULTS: (1) Spinal stiffness increased significantly in a minority
      of subjects awaiting indentation and in a majority of subjects during increases
      in intraabdominal pressure. (2) Changes in subject position were significantly
      reduced by a restraint system. (3) With respect to interclinician error in
      locating and relocating an indentation site, there was significant improvement
      with the use of ultrasonic visualization. (4) The error associated with linear
      techniques used to model curvilinear force-displacement data plots increased with
      increasing linear intervals. CONCLUSION: Several sources of variation in spinal
      indentation were identified: indentation site relocation, intraabdominal
      pressure, subject movement, muscular response, and stiffness estimation. These
      variables, which have been unaccounted for in previous indentation studies, might
      be responsible for the change or lack of change in force-displacement properties
      between preintervention and postintervention indentation trials.

PMID- 11208221
TI  - Patient characteristics and physicians' practice activities for patients with
      chronic low back pain: a practice-based study of primary care and chiropractic
      physicians.
AB  - BACKGROUND: Chronic low back pain sufferers are among those who account for the
      greatest usage of health care resources. Primary care medical (MD) physicians and
      chiropractic (DC) physicians treat most of these patients. OBJECTIVES: To study
      patient characteristics and physician practice activities for patients with
      chronic low back pain treated by DC physicians and MD physicians. METHODS: A
      longitudinal, practice-based observational study was undertaken in 14 general
      practice and 51 DC community-based clinics. A total of 2945 consecutive patients
      with ambulatory low back pain of mechanical origin were enrolled; 835 patients
      were in the chronic subgroup. Patients were followed for 12 months. Data were
      obtained on all of the following: patient demographics, health status, and
      psychosocial characteristics; history, duration, and severity of low back pain
      and disability; physicians' practice activities; and low back complaint status at
      1 year. RESULTS: Patients treated by MD physicians were younger and had lower
      incomes; their care was more often paid for by a third party; their baseline pain
      and disability were slightly greater. In addition, patients treated by MD
      physicians had one fourth as many visits as patients treated by DC physicians.
      Utilization of imaging procedures by enrolling physicians was equivalent for the
      two provider groups. Medications were prescribed for 80% of the patients enrolled
      by MD physicians; spinal manipulation was administered to 84% of patients
      enrolled by DC physicians. Physical modalities, self-care education, exercise,
      and postural advice characterized low back pain management in both provider
      groups. Patients' care-seeking was not exclusive to one provider type. Most
      patients experienced recurrences (patients treated by MD physicians, 59.3%;
      patients treated by DC physicians, 76.4%); 34.1% of patients treated by MD
      physicians and 12.7% of patients treated by DC physicians reported 12 months of
      continuous pain. Only 6.7% of patients treated by MD physicians and 10.9% of
      patients treated by DC physicians reported 1 resolved episode during the year.
      CONCLUSIONS: Differences in sociodemographics, present pain intensity, and
      functional disability may distinguish patients with chronic low back pain seeking
      care from primary care medical physicians from those seeking care from DC
      physicians. Although the primary treatment modality differs, the practice
      activities of MD physicians and DC physicians have much in common. Long-term
      evaluation suggests that chronic back pain is persistent and difficult to treat
      for both provider types.

PMID- 11208222
TI  - Significant changes in systolic blood pressure post vectored upper cervical
      adjustment vs resting control groups: a possible effect of the cervicosympathetic
      and/or pressor reflex.
AB  - OBJECTIVE: To determine whether a vectored adjustment of the atlas in patients
      identified as demonstrating signs of upper cervical joint dysfunction would cause
      lowering of blood pressure in comparison with resting controls. DESIGN: Test 1:
      controlled clinical trial with a treatment (adjustment) group and a control
      (resting) group. Test 2: controlled clinical trial with subjects serving as their
      own controls. SETTING: Private chiropractic practice. PARTICIPANTS: Test 1: Forty
      established patients demonstrating signs of upper cervical subluxation/joint
      dysfunction and 40 established patients without such signs. Test 2: Thirty
      established patients demonstrating signs of upper cervical subluxation/joint
      dysfunction. INTERVENTION: Specific, vectored upper cervical (atlas) adjustment
      or similarly positioned resting. MAIN OUTCOME MEASURES: Prerest, postrest, and
      postadjustment systolic, diastolic, and pulse rates as recorded through use of a
      digital oscillometric sphygmomanometer. RESULTS: In test 1, subjects receiving
      adjustment had a significant (P <.001) decrease in systolic blood pressure
      whereas resting subjects did not. Intergroup comparison of the treatment
      (adjustment) and control (resting) groups demonstrated a significant difference
      (P <.001). A greater pre/post drop in systolic pressure was associated with
      greater age and higher initial systolic pressure. In test 2, the pre/postrest
      change in systolic blood pressure was not significant. The systolic blood
      pressure changed significantly (P <.001) from postrest readings to postadjustment
      readings. CONCLUSION: The results indicate that palpation and vectored atlas
      adjustment causes a significant decrease in systolic blood pressure in patients
      with putative upper cervical subluxation/joint dysfunction in comparison with
      resting controls. Similar results were also demonstrated when subjects acted as
      their own controls. The lack of randomization, blinding, and a manipulated
      control group are factors that weaken these findings. The sudden drop in systolic
      pressure is proposed to be due to stimulation of the cervicosympathetic reflex or
      moderation of muscle tone and elimination of the effects of the pressor reflex.

PMID- 11208223
TI  - Isometric back extension endurance tests: a review of the literature.
AB  - OBJECTIVE: To review the literature that describes and evaluates the use of
      isometric back extension endurance tests. DATA COLLECTION: Relevant articles in
      English were retrieved through a search of MEDLINE and the Index to Chiropractic
      Literature. Key search terms were back muscle endurance, isometric back
      endurance, trunk extensors, back muscle performance, and Sorensen test. DATA
      SYNTHESIS: The principal criterion for inclusion was as follows: any study that
      discussed or tested an isometric type of back endurance extension test. Studies
      that were excluded did not use an isometric testing protocol. Thirty-seven of the
      initial studies are included in this review. RESULTS: Six different types of
      isometric back extension endurance testing methods were found. Three of these
      procedures require special testing devices. Much of the research on this topic
      has centered on a procedure known as the Sorensen test. Normative databases have
      been established for the Sorensen test and 2 other test types. Validity and
      reliability have been assessed for some of the procedures. CONCLUSIONS: The
      influence of motivation and effort exerted by the subject are limiting factors in
      all of the tests reviewed. These psychologic factors warrant further research. On
      the basis of the literature reviewed, we determined that the Sorensen is probably
      the most clinically useful of these tests; it is easy to perform, requires no
      special equipment, and enjoys the most support from the literature.

PMID- 11208224
TI  - Missed lumbar transverse process fractures in a high school football player.
AB  - OBJECTIVE: To discuss the case of a football player who had suffered a transverse
      process fracture of the lumbar spine that was overlooked on initial chiropractic
      and medical examination. CLINICAL FEATURES: A 17-year-old male football player
      had been speared in the back by another player. He reported severe initial pain
      that caused him to fall to the ground, and there was a moderate degree of pain at
      the time of his chiropractic examination 1 week after injury. INTERVENTION AND
      OUTCOME: Initial chiropractic treatment consisted of spinal manipulation to the
      lumbar spine. Follow-up care consisted of lumbar spine radiographs that showed
      evidence of a lumbar transverse process fracture at 2 levels. The boy was
      referred to his medical doctor, who was not convinced of the presence of a
      fracture and returned him to play. A computed tomography scan was subsequently
      performed; this confirmed fractures of the transverse processes of L2 and L3. The
      patient was precluded from contact sports for 4 weeks. Chiropractic care 3 weeks
      after injury included physiotherapy and drop table mobilization to the sacroiliac
      joints. The patient returned to play 4 weeks after the injury. CONCLUSION:
      Transverse process fractures commonly occur secondary to blunt trauma in contact
      sports such as football. With high-force direct trauma, radiographs should be
      performed to rule out fracture before returning the athlete to play or commencing
      spinal manipulation.

PMID- 11208225
TI  - Dialysis-related spondyloarthropathy.
AB  - OBJECTIVE: To discuss a case of dialysis-related spondyloarthropathy due to beta
      2 microglobulin amyloid deposition. An emphasis is placed on the imaging
      findings. CLINICAL FEATURES: A 67-year-old man sought treatment for low back
      pain. His history revealed coronary artery bypass surgery, diabetes with
      bilateral foot neuropathy, gout, and bilateral renal failure that had been
      treated with dialysis for 2 years before left renal transplantation; the renal
      transplant had been performed 6 years earlier. Radiography, computed tomography,
      and magnetic resonance imaging revealed changes characteristic of dialysis
      related spondyloarthropathy. INTERVETION AND OUTCOME: The patient was initially
      treated with physiotherapy. He was then admitted to the hospital and treated for
      renal infection and medicated for low back pain. Two weeks later he returned to
      the chiropractor, who began a treatment plan that included spinal manipulation,
      physiotherapy, manual distractive traction, and a gradual increase in activities
      of daily living. The patient was released from care after 2 months with
      significantly decreased pain. CONCLUSIONS: Dialysis-related spondyloarthropathy
      is a relatively uncommon complication of renal dialysis. It should be suspected
      in those patients who present with a correlative medical history and
      characteristic radiographic appearance. Chiropractic treatment can be effective
      as an adjunct to medical care in cases of chronic renal failure and associated
      complications.

PMID- 11208226
TI  - Evidence-based clinical guidelines submitted to the Australian National Health
      and Medical Research Council for the management of acute low back pain: a
      critical review.

PMID- 11208227
TI  - Sitting biomechanics, Part II: optimal car driver's seat and optimal driver's
      spinal model.

PMID- 11208230
TI  - A randomized controlled trial of chiropractic spinal manipulative therapy for
      migraines.

PMID- 11208229
TI  - A randomized controlled trial of chiropractic spinal manipulative therapy for
      migraines.

PMID- 11208231
TI  - Effects of orthotic intervention and 9 holes of simulated golf on club head
      velocity in experienced golfers.

PMID- 11208233
TI  - Reliability of chiropractic methods commonly used to detect manipulable lesions
      in patients with chronic low-back pain.

PMID- 11208234
TI  - The ten most commonly asked questions about infection as a cause of
      atherosclerotic heart disease.

PMID- 11208235
TI  - Mechanisms and management of paroxysmal supraventricular tachycardia.
AB  - Paroxysmal supraventricular tachycardia (PSVT) is defined as a regular rapid
      heart beat, which initiates and terminates suddenly. PSVT may have a variety of
      electrophysiologic mechanisms, including atrial tachycardia, atrioventricular
      (AV) nodal reentry, and tachycardia involving an accessory AV connection. Atrial
      tachycardia may be reentrant or may be caused by abnormal automaticity or
      triggered activity. AV nodal reentry, in which the reentrant circuit is confined
      to the AV node or the region around the AV node, is the most common type of PSVT
      in adults. Orthodromic supraventricular tachycardia is the most frequently found
      tachycardia in patients with accessory AV connections. During orthodromic
      supraventricular tachycardia, antegrade conduction occurs via the AV node, and
      retrograde conduction occurs via an accessory AV connection. Other types of PSVT,
      including junctional tachycardia, are less common. A definitive diagnosis of the
      PSVT mechanism usually requires electrophysiologic testing, but clinical and
      electrocardiographic clues may be present. Understanding the mechanism of PSVT
      can alter therapy because the response to antiarrhythmic drugs may be somewhat
      different depending on the PSVT type. In addition, the risks and efficacy of
      catheter ablation for curing PSVT may differ depending on the PSVT type. A better
      understanding of PSVT mechanisms, which has developed over the past 20 years, has
      led to dramatic improvements in therapy.

PMID- 11208236
TI  - What is commotio cordis?
AB  - Although thought to be rare, sudden deaths caused by nonpenetrating chest wall
      impact in the absence of structural injury to the ribs, sternum, and heart
      (commotio cordis) are reported with increasing frequency. This phenomenon is
      described in individuals when they are struck by relatively innocent blows to the
      chest wall. Young male athletes aged 5 to 18 years are particularly at risk for
      this catastrophe. It has been described after blows to the chest from baseballs,
      softballs, hockey pucks, and other objects. Death is usually instantaneous, and
      successful resuscitation is uncommon. A recently reported experimental model
      provides clues to the mechanisms and inferences for the prevention and treatment
      of this devastating condition. This swine model shows that a) ventricular
      fibrillation results from low-energy chest wall impacts during a vulnerable
      period of repolarization, b) the risk of this event can be decreased with softer
      than-standard baseballs, and c) prompt defibrillation is crucial for
      resuscitation to be successful.

PMID- 11208237
TI  - Intraoperative transesophageal echocardiography: correlation of echocardiographic
      findings and surgical pathology.
AB  - Before the introduction of transesophageal echocardiography (TEE) in the
      operating room, intraoperative echocardiography relied on epicardial imaging. The
      disadvantages of this approach included interference with the surgical procedure,
      limited windows, and potential distortion of cardiac structures. Consequently,
      multiplane TEE has now emerged as the intraoperative imaging method of choice. It
      provides high-resolution images of cardiac structures and excellent portraits of
      flow abnormalities. Intraoperative TEE does not interfere with the surgical field
      and procedure. TEE provides better imaging of the valves, atria, aorta, pulmonic
      vasculature, and pericardium, which are sometimes difficult to visualize by
      transthoracic echocardiography. TEE is especially beneficial in surgeries for
      valve replacement, valve repair, cardiac mass, aortic disease, congenital heart
      disease, and pericardial disease. Presurgical TEE provides information for
      surgical planning. TEE is helpful for the assessment of the immediate result of
      surgery and detection of complications that may need a prompt response. Thus,
      intraoperative TEE has a vital impact on management of cardiac surgery.

PMID- 11208238
TI  - Outpatient management of heart failure.
AB  - The outpatient treatment of heart failure can be divided into 2 broad categories:
      older therapies, which improve hemodynamics, and newer therapies, which increase
      survival and improve function. Hemodynamic "triple" therapy includes digoxin to
      increase cardiac inotropy, antihypertensives to lower systolic pressure, and
      diuretics to remove fluid and decrease filling pressures. Disease-modifying
      therapy requires the use of specific agents to lower blood pressure (angiotensin
      converting enzyme inhibitors, angiotensin II blockers, spironolactone, or
      hydralazine and nitrates) and beta-adrenergic blockade with carvedilol. The
      success of these newer therapies suggests that the standard triple therapy for
      heart failure should be expanded to "quadruple" therapy that includes carvedilol.

PMID- 11208239
TI  - The dietary approaches to stop hypertension (DASH) clinical trial: implications
      for lifestyle modifications in the treatment of hypertensive patients.
AB  - Lifestyle modifications, such as weight loss, sodium restriction, and limiting
      alcohol consumption, are important components of the initial treatment of
      hypertensive patients. The Dietary Approaches to Stop Hypertension (DASH) study
      investigated the effects of dietary patterns on blood pressure in individuals
      with diastolic blood pressure between 80-95 mmHg. Two different dietary patterns
      were tested in this feeding study. A diet enriched in fruits and vegetables and a
      diet enriched in fruits, vegetables, and low-fat dairy products and low in total
      and saturated fat (combination diet) were compared with a control diet. Dietary
      intake was adjusted so that participants did not lose weight, and all study diets
      had comparable sodium intake (approximately 3 grams/day). All meals were provided
      for 459 participants for an 11-week period. Those randomized to the combination
      diet (n = 151) had a significant change in systolic (-5.5 mmHg; p < 0.001) and
      diastolic blood pressure (-3.0 mmHg; p < 0.001) after subtracting the response to
      the control diet (n = 154). The fruits-and-vegetables diet (n = 154) produced a
      significant but lesser decrease in blood pressure (systolic, -2.8 mmHg; p < 0.001
      and diastolic, -1.1 mmHg; p = 0.07). Hypertensive individuals and African
      Americans had particularly favorable responses with blood pressure reductions,
      which were significantly greater than other subgroups. The combination diet was
      well-accepted and adherence to the diet was high (>90%) for all participants. The
      DASH combination diet is an effective lifestyle modification for lowering blood
      pressure in patients with high-normal or Stage 1 hypertension.

PMID- 11208240
TI  - Application of intravascular ultrasound imaging in understanding and guiding
      percutaneous therapy for atherosclerotic coronary disease.
AB  - Intravascular ultrasound imaging is a relatively new imaging modality that uses
      miniaturized ultrasound transducers, which are mounted on catheter tips and
      introduced into the vessel lumen to provide cross-sectional images of the
      vascular structure in real time. It has gained popularity rapidly among
      interventional cardiologists because of its ability to overcome many limitations
      of angiography, especially when dealing with complex anatomy and new devices for
      coronary revascularization. The tomographic perspective and the ability to elicit
      the detailed structure of the arterial wall have allowed the use of intravascular
      ultrasound to better understand the coronary atherosclerotic and allograft
      vasculopathy disease processes. The response of lesions to various interventional
      procedures also has been studied in detail. This review discusses the rationale,
      technique, methods of interpretation, and the current knowledge in the field of
      intravascular ultrasound imaging.

PMID- 11208241
TI  - Exercise and heart disease in women: why, how, and how much?
AB  - Despite a traditional view that cardiovascular disease primarily affects men, a
      growing body of information now recognizes that it is a disease that equally
      affects women and is the leading cause of morbidity and mortality in women in the
      United States. Both physical activity and physical fitness have been shown to
      have an inverse association with coronary heart disease and cardiovascular risk
      factors. Furthermore, physical inactivity is now recognized by the American Heart
      Association as an independent risk factor for coronary heart disease. However,
      national surveillance programs have reported that 1/4 of adults are currently
      sedentary, and 1/3 of women do not engage in any leisure-time physical activity.
      Regular exercise may significantly impact coronary heart disease in women, as
      some coronary risk factors have a stronger predictive value for coronary heart
      disease in women as compared with men. Recent studies have shown that women who
      exercise regularly are less likely to develop diabetes mellitus; exercise may
      reduce blood pressure and produce improvements in lipid profiles. Conflicting
      data exist regarding the dose and intensity of exercise necessary to achieve
      significant health benefits; however, many reports demonstrate a reduced risk of
      mortality from cardiovascular diseases and from all causes with only moderate
      intensity physical activity. The Centers for Disease Control, American Heart
      Association, and American College of Sports Medicine recommend a regular pattern
      of physical activity of moderate intensity, which can be accumulated throughout
      the day and should be performed at least 3 to 5 days per week. In addition, the
      benefit of weight-bearing exercise should be underscored in women, because it
      plays an important role in the prevention and treatment of osteoporosis.
      Continued efforts are necessary to encourage the many American women who are
      currently inactive to make even modest increases in levels of physical activity
      to achieve substantial cardiovascular, as well as other, health benefits.

PMID- 11208242
TI  - The ten most commonly asked questions about pericardial disease.

PMID- 11208243
TI  - Alcohol septal ablation for hypertrophic obstructive cardiomyopathy.
AB  - Until the early 1990s, surgical myectomy was the standard treatment for patients
      with hypertrophic obstructive cardiomyopathy and drug refractory symptoms. In the
      past few years, the potential therapeutic options have dramatically changed with
      the introduction of DDD-pacemaker implantation and percutaneous transluminal
      septal myocardial ablation by alcohol-induced septal branch occlusion. The
      circumscribed therapeutic myocardial infarction results in widening of the left
      ventricular outflow tract with consecutive gradient reduction. Follow-up studies
      show impressive clinical improvement, as well as further gradient reduction as a
      result of left ventricular remodeling. In this article, we provide an updated
      review of the latest results of percutaneous transluminal septal myocardial
      ablation.

PMID- 11208244
TI  - Gene therapy for restenosis after balloon angioplasty and stenting.
AB  - Percutaneous coronary revascularization is an increasingly attractive alternative
      to medical therapy and surgical revascularization for coronary artery disease.
      The leading drawback of this procedure continues to be restenosis-the process of
      late arterial renarrowing at the site of initially successful intervention.
      Restenosis after balloon angioplasty seems to be determined primarily by the
      direction and magnitude of vessel wall remodeling. In contrast, the major
      limitation of stent implantation is the initiation of neointimal tissue
      proliferation within and adjacent to the stent. The goal of this review is to
      summarize recent laboratory and clinical investigations of the transmission of
      mitogenic signals from the membrane to the nucleus in smooth muscle cells. The
      mechanisms responsible for restenosis after balloon angioplasty and stenting and
      the possibility of transferring specific genes into somatic vascular cells with
      molecular tools to inhibit smooth muscle cell proliferation also will be
      reviewed.

PMID- 11208246
TI  - Hypertriglyceridemia and coronaryheart disease risk.
AB  - Several angiographic-based trials have established that triglyceride remnant
      particles are associated with progression of coronary stenosis, and a recent
      prospective study has shown that triglycerides are associated with coronary heart
      disease (CHD), even after adjustment for high-density lipoprotein cholesterol.
      The importance of plasma triglycerides in CHD risk must be interpreted within the
      context of other plasma lipoproteins, as well as the fasting and postprandial
      triglyceride levels. Recommendations for triglyceride lowering are empiric
      because of the lack of randomized clinical trial data that evaluate triglyceride
      lowering therapies and CHD prevention. This article presents a clinical approach
      to the management of hypertriglyceridemia.

PMID- 11208245
TI  - Therapeutic management of patients with Marfan syndrome: focus on cardiovascular
      involvement.
AB  - Marfan syndrome is an autosomal dominant disorder of the connective tissues, with
      mutation on the fibrillin-1 gene encoding for fibrillin, a major component of the
      extracellular microfibrils. The prevalence of the syndrome is 7 to 17 in 100,000.
      The mean life expectancy for untreated patients with Marfan syndrome is 32 years,
      with aortic dissection, aortic rupture, or cardiac failure from mitral or aortic
      valve regurgitation as the predominant cause of death in >90% of patients.
      However, with optimal clinical management of patients with Marfan syndrome, life
      expectancy may be improved substantially to a nearly normal life span.
      Cornerstones of clinical management include modern noninvasive imaging
      modalities, molecular analysis at the complementary deoxyribonucleic
      acid/deoxyribonucleic acid level of the fibrillin-1 gene, genetic counseling,
      lifestyle changes, and cardiovascular surveillance, the latter including regular
      imaging of the aorta and endocarditis prophylaxis. Prophylactic use of beta
      blocking agents, the timing of elective surgery, and the optimal surgical
      technique are difficult issues that need to be evaluated individually. Juvenile,
      postoperative, and pregnant patients with Marfan syndrome pose particular
      problems. The goal of this review is to facilitate differential decision-making
      based on referenced evidence and to provide guidelines for medical and surgical
      therapeutic strategies.

PMID- 11208247
TI  - Cardiac transplantation for end-stage heart disease.
AB  - In the nearly 30 years since the first successful human heart transplant, a
      variety of developments have allowed this form of cardiac replacement therapy to
      flourish. These have included improvements in surgical and critical care
      technology, as well as breakthroughs in immunosuppressive pharmacology, the most
      notable of which was the introduction of cyclosporine in 1980. Subsequently,
      indications and exclusion criteria for heart transplantation have evolved, guided
      by the constraints of a limited donor supply and facilitated by an improved
      understanding of prognostic risk factors. Current 1- and 5-year survival
      estimates are encouraging, and despite the frequency of acute rejection, current
      management strategies have, for the most part, limited the fatal consequences of
      this complication. Graft atherosclerosis, however, has continued to complicate
      the posttransplant course of many patients, and despite therapeutic strategies
      aimed at a variety of potential pathogenic mechanisms, this entity remains the
      most common cause of late death after transplantation. In these patients and
      other victims of allograft failure, retransplantation remains a viable option.
      Finally, the recent trend of selecting increasingly critically ill transplant
      recipients, although not associated with inferior survival, has driven the costs
      of this form of cardiac replacement therapy to unprecedented levels. These
      issues, as well as current developments in the fields of mechanical cardiac
      assistance, xenotransplantation, and cardiac gene therapy, will certainly result
      in a continually evolving role for cardiac transplantation in the treatment of
      end-stage heart disease.

PMID- 11208248
TI  - Appetite-suppressing drugs and valvular heart disease.
AB  - The popular diet drugs, fenfluramine and dexfenfluramine, were withdrawn from the
      market in the United States after the publication of an association of these
      drugs with valvulopathy in a small series of patients, spontaneous reports to the
      Food and Drug Administration, and echocardiographic surveys that suggested a
      valvulopathy prevalence of 32.8% among diet drug users. Subsequent publications
      suggested that there is an association of these agents with valvulopathy, but
      that the prevalence seems lower than initially suspected. This review examines
      the available prevalence data and attempts to account for some of the variability
      in these data. Potential pathophysiologic mechanisms are discussed and management
      guidelines for these patients are provided. This is an area of ongoing study and
      more information about the natural history of these lesions will certainly be
      forthcoming. A review of the data reveals that the withdrawal of these agents was
      prudent and likely prevented further harm.

PMID- 11208249
TI  - Gender differences in manifestation of cardiac arrhythmias.
AB  - It is now appreciated that a patient's sex has a significant impact on
      presentation of cardiac diseases. This has been well described in patients with
      coronary artery disease but is less well appreciated in the setting of arrhythmia
      management. In Cardiology in Review in 1998, Tracy outlined some of the major
      differences between the sexes with regard to the electrocardiogram and the
      presentation of arrhythmias. Arrhythmia management also can be considerably
      different, and in this review, we address some additional aspects of differences
      between the sexes in this area.

PMID- 11208250
TI  - The ten most commonly asked questions about echocardiography: part 2.

PMID- 11208251
TI  - Mitral valve surgery with concomitant treatment of atrial fibrillation.
AB  - Recovery of sinus rhythm after mitral valve surgery in patients with chronic
      atrial fibrillation lowers thromboembolic risk and improves survival and quality
      of life. This article reviews the principal surgical procedures devised in the
      1980s and 1990s to treat atrial fibrillation during mitral valve operations.
      Advantages and drawbacks of the different techniques are discussed. Traditional
      atrial fibrillation surgery is technically demanding and increases operative
      morbidity. Simplified techniques, mostly limited to the left atrium, have been
      developed to reduce operation time and procedure-related complications.
      Intraoperative radiofrequency ablation has recently proven extremely effective in
      atrial fibrillation surgery, allowing a further simplification of the procedures.
      We report the results of an original technique for atrial fibrillation treatment
      during mitral valve surgery through epicardial radiofrequency ablation. Based on
      recently reported results of atrial fibrillation surgery and on prognostic
      considerations, specific treatment of both chronic and paroxysmal atrial
      fibrillation is indicated in virtually all affected patients undergoing mitral
      valve surgery.

PMID- 11208252
TI  - Carotid and cerebrovascular disease.
AB  - Stroke remains a major public health problem, and carotid artery atherosclerotic
      disease causes a significant proportion of all strokes. Because the U.S.
      population is aging, the incidence of cerebrovascular disease is increasing, and
      cardiologists often are involved in the care of these patients because many of
      them have either occult or symptomatic coronary artery disease. We review the
      current status of carotid and cerebrovascular diseases and therapeutic options.

PMID- 11208253
TI  - Aortic valve surgery in the elderly.
AB  - As the population ages, aortic valve replacement, particularly for aortic
      stenosis, has become more common. Although many patients have considerable
      coexisting morbidity, almost all symptomatic patients are candidates for surgery.
      Once symptoms develop, surgery should not be unduly delayed, because the
      operative mortality clearly increases in the presence of poor left ventricular
      function, heart failure, and New York Heart Association Class III or IV symptoms.
      Operative difficulties often are related to fragile tissues, a small aortic
      annulus, and extensive calcification of the aortic annulus and root. In the
      author's experience, approximately 10% of these patients undergo aortic annulus
      and root enlargement using pericardium. A tissue valve is the preferred
      prosthesis. Operative mortality for elective surgery in patients older than 80
      years of age is 4-10%, depending on whether associated procedures are required
      (eg, coronary artery bypass grafting) or whether the patient has had previous
      surgery. Postoperative neurologic events are important complications that are
      more common in the elderly. Outcome after successful surgery is excellent, with a
      5-year survival of approximately 60%. The vast majority of patients have an
      improved symptomatic status.

PMID- 11208254
TI  - Overview of recent clinical trials in heart failure: what is the current standard
      of care?
AB  - Heart failure develops as a consequence of cardiac injury. As the heart begins to
      fail to meet the body's metabolic demands, the renin angiotensin aldosterone
      system (RAAS) and the sympathetic nervous system are activated. These
      interrelated systems act in concert to facilitate cardiac output and tissue
      perfusion. Though these neurohormonal systems are initially compensatory,
      evidence suggests that they promote deleterious cardiac remodeling and myocyte
      destruction. Recent studies in patients with heart failure have targeted the RAAS
      and sympathetic nervous system for therapeutic intervention. This article reviews
      major recent multicenter, randomized, double-blind, and placebo-controlled trials
      in heart failure that have resulted in a new standard of care for patients with
      this devastating disease.

PMID- 11208255
TI  - Role of glycoprotein IIb/IIIa inhibitors in unstable angina: current
      perspectives.

PMID- 11208256
TI  - Noninvasive diagnostic testing of coronary artery disease in women.
AB  - Noninvasive diagnostic testing of coronary artery disease (CAD) is widely
      recognized as an area that is less studied and less accurate with regard to women
      than to men. Accurate and safe diagnostic testing constitutes the crucial link
      between early detection and optimal management of CAD. Many noninvasive
      diagnostic modalities are available to the clinician, including traditional
      electrocardiography, the relatively novel imaging of echocardiography, the
      emerging nuclear perfusion technology of electron beam computed tomography,
      exercise testing, and pharmacologic testing. The most accurate and cost-effective
      diagnostic method for patients depends on the patients' pretest likelihood of the
      disease as determined by factors such as sex, age, and cardiovascular risk
      factors. Noninvasive tests are most useful in the diagnosis of CAD in patients
      with intermediate pretest likelihood of CAD. Patients with low pretest likelihood
      of CAD with normal electrocardiograms may benefit from noninvasive tests or a
      watchful waiting strategy. Patients with a high pretest likelihood of CAD may
      benefit greatly from direct referral to coronary angiography. Among the
      noninvasive diagnostic methods, exercise electrocardiography is the most studied
      and least accurate with regard to women patients. Electrocardiography improves in
      accuracy when combined with imaging techniques such as echocardiography or
      nuclear single photon emission computed tomography. Combining data from all
      studies has shown that exercise echocardiography yields the highest diagnostic
      accuracy in women among all of the exercise stress tests. Patients who are unable
      to achieve maximal exercise capacity may undergo pharmacologic testing using
      dipyridamole or adenosine radionuclide perfusion or dobutamine echocardiography.
      Recent development of electron beam computed tomography accurately detects
      coronary artery calcium but has not been validated yet as a standard diagnostic
      test for CAD.

PMID- 11208257
TI  - The viral transmembrane superfamily: possible divergence of Arenavirus and
      Filovirus glycoproteins from a common RNA virus ancestor.
AB  - BACKGROUND: Recent studies of viral entry proteins from influenza, measles, human
      immunodeficiency virus, type 1 (HIV-1), and Ebola virus have shown, first with
      molecular modeling, and then X-ray crystallographic or other biophysical studies,
      that these disparate viruses share a coiled-coil type of entry protein. RESULTS:
      Structural models of the transmembrane glycoproteins (GP-2) of the Arenaviruses,
      lymphochoriomeningitis virus (LCMV) and Lassa fever virus, are presented, based
      on consistent structural propensities despite variation in the amino acid
      sequence. The principal features of the model, a hydrophobic amino terminus, and
      two antiparallel helices separated by a glycosylated, antigenic apex, are common
      to a number of otherwise disparate families of enveloped RNA viruses. Within the
      first amphipathic helix, demonstrable by circular dichroism of a peptide
      fragment, there is a highly conserved heptad repeat pattern proposed to mediate
      multimerization by coiled-coil interactions. The amino terminal 18 amino acids
      are 28% identical and 50% highly similar to the corresponding region of Ebola, a
      member of the Filovirus family. Within the second, charged helix just prior to
      membrane insertion there is also high similarity over the central 18 amino acids
      in corresponding regions of Lassa and Ebola, which may be further related to the
      similar region of HIV-1 defining a potent antiviral peptide analogue.
      CONCLUSIONS: These findings indicate a common pattern of structure and function
      among viral transmembrane fusion proteins from a number of virus families. Such a
      pattern may define a viral transmembrane superfamily that evolved from a common
      precursor eons ago.

PMID- 11208258
TI  - Endemic and epidemic dynamics of cholera: the role of the aquatic reservoir.
AB  - BACKGROUND: In the last decades, attention to cholera epidemiology increased, as
      cholera epidemics became a worldwide health problem. Detailed investigation of V.
      cholerae interactions with its host and with other organisms in the environment
      suggests that cholera dynamics is much more complex than previously thought.
      Here, I formulate a mathematical model of cholera epidemiology that incorporates
      an environmental reservoir of V. cholerae. The objective is to explore the role
      of the aquatic reservoir on the persistence of endemic cholera as well as to
      define minimum conditions for the development of epidemic and endemic cholera.
      RESULTS: The reproduction rate of cholera in a community is defined by the
      product of social and environmental factors. The importance of the aquatic
      reservoir depends on the sanitary conditions of the community. Seasonal
      variations of contact rates force a cyclical pattern of cholera outbreaks, as
      observed in some cholera-endemic communities. CONCLUSIONS: Further development on
      cholera modeling requires a better understanding of V. cholerae ecology and
      epidemiology. We need estimates of the prevalence of V. cholerae infection in
      endemic populations as well as a better description of the relationship between
      dose and virulence.

PMID- 11208259
TI  - Symptomatic hemorrhage after alteplase therapy not due to silent ischemia.
AB  - BACKGROUND: Stroke thrombolysis-related intracerebral hemorrhage may occur
      remotely from the anatomical site of ischemia. One postulated mechanism for this
      is simultaneous multiple embolization with hemorrhage into a "silent" area of
      ischemia. RESULTS: A patient suffered a disabling stroke affecting the right
      cerebral hemisphere. He was treated with intravenous alteplase and underwent
      extensive early imaging with multimodal MRI. Several hours after treatment he
      developed a brainstem hemorrhage despite having no evidence of ischemia on DWI
      MRI in the brainstem. CONCLUSION: Not all occurrences of remote ICH after stroke
      thrombolysis are secondary to multiple emboli with silent ischemia.

PMID- 11208261
TI  - [Results of the first phase of the ECVAM project "prevalidation and validation of
      three in vitro embryotoxicity tests"]
AB  - The results of the experimental prevalidation of three in vitro embryotoxicity
      tests in an ECVAM study are reported: the rat whole embryo culture assay (WEC),
      the micromass assay (MM) and the embryonic stem cell test (EST). Three test
      chemicals assigned to the three classes of embryotoxicity, non-, moderate- and
      strong embryotoxic, and also a positive and a negative control chemical were
      repeatedly tested in each test in two laboratories. The data obtained were
      evaluated independently by a biostatistician. It could be shown that the standard
      protocols (SOPs) for the three in vitro embryotoxicity tests could be transferred
      to a second laboratory and that reproducible results were obtained. The three
      methods were able to discriminate the test chemicals according to their
      embryotoxic potential. In addition, within the scope of this study, a test
      chemical database for in vitro embryotoxicity testing was established that will
      be used in the following formal validation of the three in vitro tests.

PMID- 11208260
TI  - The potential for research-based information in public health: identifying
      unrecognised information needs.
AB  - OBJECTIVE: To explore whether there is a potential for greater use of research
      based information in public health practice in a local setting. Secondly, if
      research-based information is relevant, to explore the extent to which this
      generates questioning behaviour. DESIGN: Qualitative study using focus group
      discussions, observation and interviews. SETTING: Public health practices in
      Norway. PARTICIPANTS: 52 public health practitioners. RESULTS: In general, the
      public health practitioners had a positive attitude towards research-based
      information, but believed that they had few cases requiring this type of
      information. They did say, however, that there might be a potential for greater
      use. During five focus groups and six observation days we identified 28
      questions/cases where it would have been appropriate to seek out research
      evidence according to our definition. Three of the public health practitioners
      identified three of these 28 cases as questions for which research-based
      information could have been relevant. This gap is interpreted as representing
      unrecognised information needs. CONCLUSIONS: There is an unrealised potential in
      public health practice for more frequent and extensive use of research-based
      information. The practitioners did not appear to reflect on the need for
      scientific information when faced with new cases and few questions of this type
      were generated.

PMID- 11208262
TI  - [Liver organ systems: valuation by gene expression]
AB  - The multitude of vital functions of the liver is largely dependent on the complex
      interaction of hepatocytes with "littoral-cells" and the liver-specific
      extracellular matrix. In vitro systems used to study the liver are almost
      exclusively based on the culture of single cells obtained by enzymatic disruption
      of the essentiel organ structure. In contrast, the slicing technique enables a
      standardized organ culture, while retaining the intact organ structure. However,
      previous experiments using this system have been restricted to short-term
      pharmacological studies and have used general cellular parameters to assess
      viability. The lack of liver specific validation has hindered the acceptance and
      application of this organ culture as an alternative to in vivo experiments. In
      this work we chose the regulation of liver-specific gene expression as an
      adequate viability criterion because, in contrast to the commonly used general
      cell physiology parameters, gene expression includes a cascade of differentially
      coordinated processes. Using hormonal responsiveness of precision-cut liver
      slices as a basis for comparison, the new developed interphase system was found
      to be superior to a perfusion system. With the application of this economical and
      easy-to-handle interphase system, the control of liver-specific gene expression
      by dexamethasone, cAMP and endotoxin in long-term cultures was found to be
      modulated in a manner similar to in vivo conditions.

PMID- 11208263
TI  - [ERGATT/ECVAM Workshop on Acceptance of Validated Alternative Methods: Amden III]
AB  - Since validated in vitro toxicity tests have so far not been accepted by
      regulators the third international ERGATT/ECVAM validation workshop was held from
      January 26-30, 1998, in Amden/Switzerland. Scientific and political reasons for a
      delay of the acceptance of alternative methods were identified in the areas of
      phototoxicity, skin penetration and skin corrosivity and strategies to promote
      the acceptance were suggested. The OECD will harmonise the formal of criteria for
      the regulatory acceptance of new experimentally validated tests and of
      established tests from industry for which in-house and literature data exist. In
      vitro tests for phototoxicity and skin penetration will be accepted shortly by
      the OECD. For skin corrosivity two in vitro tests will be put forward to the OECD
      later this year. The Amden III workshop suggests that, the same acceptance
      criteria must be used for animal and in vitro tests. Finally, the OECD should
      remove tests that cause pain and distress to test animals from the official OECD
      list of official test guidelines if validated alternative methods exist. When
      obsolete animal tests are taken from the list of official OECD test guidelines,
      they will not any longer be accepted at the international level. Thus, the third
      Amden workshop has contributed new concepts for the regulatory acceptance of
      alternative toxicity tests which are supported by regulators in Europe, the USA
      and the OECD.

PMID- 11208264
TI  - [Use of transgenic animals in the European Union]
AB  - Transgenic animals present unique possibilities for medical, agricultural and
      fundamental research, and as a means of producing valuable pharmaceutical and
      nutrient products. Their use has increased dramatically in recent years and is
      set to increase further in the near future. It has been claimed that transgenic
      animals might allow reduction and refinement in animal use, via more-precise gene
      targeting in breeding programmes. However, these objectives are threatened by
      transgenic procedures which may promote greater animal use, more-varied
      applications, and the greater likelihood of animal suffering. Current legislation
      on animal experimentation, for example, Directive 86/609/EU, was passed and
      implemented before the full implications of transgenesis were recognised. For
      this reason, ECVAM organised a workshop which was held in Southwell,
      Nottinghamshire, UK, on 7-11 April 1997. The aim of this workshop was to reach a
      consensus on a set of guidelines designed to assist regulatory authorities in
      their decision-making process. The conclusions of the workshop are subdivided
      into general considerations, proposals to use transgenic animals, production and
      use of transgenic animals, specific considerations relating to animals used as
      basic research/disease models, animals used in testing for toxicity and
      carcinogenicity, and transgenic farm animals. 14 recommendations have been
      derived from these conclusions and should make an important contribution to
      ensuring that the interests and welfare of animals are given due respect. They
      demonstrate a willingness by scientists to respond to public concerns and they
      should facilitate a consistent, harmonised and equitable regulatory approach
      within the EU.

PMID- 11208265
TI  - [Transgenic Animals within the 3R concept]
AB  - There are positive examples of transgenic animals where transgenic technology has
      allowed the use of less animals to answer a specific research question. On the
      other hand, it requires large numbers of animals to produce transgenic strains.
      And there remains the question, when these animals show clinical signs of
      disease, if they suffer more or less than their "pretransgenic" counterparts. To
      what extent transgenic animals further the cause of the 3Rs must be evaluated on
      an individual basis.

PMID- 11208266
TI  - [Transgenic animals and animal welfare]
AB  - Under the pressure of a public vote in Switzerland (7 June 1998) on an initiative
      to ban the production, use and patenting of transgenic animals, their value for
      biomedical research and development is intensely debated. In addition, the Swiss
      legislation has adopted (1992) a constitutional obligation to "take into account
      the dignity of creatures". The term "dignity of creatures", however, can be
      interpreted in anthropocentric or biocentric ways. The government has now
      formulated the legal implications of this term for transgenic animals and plants
      in various laws including the animal and environmental protection laws. This
      paper gives arguments for a fair evaluation of trangenic animals from an animal
      welfare point of view where not only the costs of animal suffering must be
      considered but also the probability of potential benefit for man. A self
      confident research community should allow such an evaluation procedure even in
      view of an outcome which could ban many uses of transgenic animals

PMID- 11208267
TI  - [Animal welfare problems concerning the use of transgenic animals]
AB  - Using transgenic animals as clinical models pose certain problems since they can
      suffer. Yet in single cases transgenic animals can reduce the suffering of
      (other) animals. The permission to generate transgenic animals is not yet clearly
      regulated in Switzerland. The term "dignity of creature", as formulated in the
      Swiss Constitution, has to be defined for the Swiss animal protection law. We
      present the recommendations of the commission for ethical questions concerning
      transgenic animals appointed by the Federal Council. Partly, these
      recommendations shall also be applied to the traditional breeding methods. We
      support the nomination of a national ethics committee for transgenic animals.

PMID- 11208268
TI  - [Ethical Problems of Cross-Species Transplantation from Animals to Humans]
AB  - The success of transplantation and the increasing demand for donor organs have
      led to an increasingly acute shortage of human organs and tissue for
      transplantation. In this situation xeno-transplantation is discussed as a
      possible alternative to allo-transplantation. Cross-species transplantation
      however involves certains risks and ethical problems, some of which are
      thematized in this abstract.

PMID- 11208269
TI  - [Xenotransplantation and animal welfare]
AB  - The problems of feasibility and public acceptance of using animals as foreign
      donors for organ transplants (xenotransplantation) are discussed from an animal
      protection point of view. It is proposed that a transparent information and a
      transdisciplinary composition of the members of decisive bodies is ensured to
      incorporate the current distrust towards xenotransplantation of a large part of
      the population. This strategy could lead to a consensus for or against such
      animal use of the whole society before it is technically possible and therefore
      irrevocable facts are created.

PMID- 11208270
TI  - [Komitee fur Tiergesundheit und. Teil II]

PMID- 11208271
TI  - [Alternative methods to animal experimentation lead to the discovery of a novel
      inflammation factor]
AB  - Simple testing models have been developed for the evaluation of chemical or
      biological compounds that influence the activity of leukocytes. Human blood
      neutrophil leukocytes are used. They are stimulated in various ways, and the
      effects of test compounds on the release of enzymes, the generation of oxygen
      radicals and cell damage are quantified. All assays are performed in microtiter
      plates and the responses are evaluated by multi-well photometry or fluorimetry.
      The models are apt to detect compounds acting on leukocytes as stimuli,
      inhibitors, and response modifiers. The use of these methods led to the discovery
      of a novel inflammatory peptide, NAP-1, which activates neutrophil leukocytes.
      NAP-1 consists of 72 amino acids and is generated by a variety of tissue cells.

PMID- 11208272
TI  - [Monoclonal antibodies: in vivo- and in vitro-production in laboratory scale with
      consideration of the legal aspects of animal protection]
AB  - Monoclonal antibodies are valuable tools in medical and biological research which
      can be used for identifying, characterizing and purifying medically and
      biologically important substances. Due to their high specificity monoclonal
      antibodies are more and more used in the diagnosis and therapy of infectious
      diseases and tumor illnesses. Large amounts of antibodies are needed for use in
      these areas and this necessitates mass production (g - kg range). Many production
      systems and possibilities for optimizing mass production have been described. In
      contrast, at universities and other research institutions the production of
      monoclonal antibodies in laboratory scale (mg range) is still carried out mostly
      in the ascites mouse. This article described our own experiences and results with
      the in vitro production in mg range. Using the German animal protection law
      (22.8.1986) as an example the legal aspects of animal protection in the
      production of monoclonal antibodies are discussed. In addition the legal
      regulations in Switzerland and the Netherlands are presented.

PMID- 11208273
TI  - [Testing the acute toxicity of chemicals using bacteria]
AB  - Two bacterial tests are used to screen the acute toxicity of 8 compounds which
      are known as pollutants in the air of stables. The procedures applied were batch
      microcalorimetry (E.coli) and the Microtox(R)-test (P. phosphoreum). It is shown
      that both bacterial "screening models" are suitable to evaluate the acute
      toxicity of the compounds tested. The test results are compared to results from
      other toxicity tests using higher developed organisms; additionally the
      comparison included compounds from the literature. It is found that the results
      from the different test systems are significantly correlated as far as linear
      correlation and as rank correlation are concerned. The range of the results
      supports the suggestion to apply two or more short-term tests involving different
      test organisms in a "test battery". Bacterial short-term assays may not
      completely replace experiments involving animals but they allow an estimation of
      the toxic potential of substances which have not yet been tested and may thus
      reduce the necessary amount of experiments with animals.

PMID- 11208274
TI  - [Potency testing of veterinary vaccines, rabies vaccines as an example]
AB  - Vaccines which are produced commercially should be controlled with respect to
      their efficacy (potency) and their "harmlessness" to the recipient animal. The
      basis for any potency test is the protection test in the target animal species.
      When a vaccine has been shown to be capable of protecting a particular species
      from a certain disease, alternative methods for potency testing often can be
      developed. The justification of the latter is that experiments which analyze the
      protection are cost-intensive, require a large number of animals and give only a
      moderate degree of reproducibility. Methods such as protection experiments in
      laboratory animals, the induction of the substances responsible for protection
      (such as antibodies) in target or laboratory animals as well as with in vitro
      tissue culture systems, or the quantitative determination of the immunogens (the
      components of a vaccine which should be responsible for protection) may be used
      only if their results correlate with those obtained from protection experiments
      in the target animal species. Rabies glycoprotein has been implicated as the main
      agent responsible for the induction of protection against rabies. The higher the
      content of glycoprotein in a rabies vaccine, the greater will be the potential of
      the vaccine to induce protection against the disease. Analyses of the rabies
      glycoprotein content in vaccines can make use of a number of methods which have
      proven acceptable (the immunodiffusion test, the antibody binding assay and the
      ELISA). However, in veterinary medicine most vaccines are associated with an
      adjuvant - a substance which should amplify the immune response of an animal
      against a vaccine. Since the adjuvants and vaccines in such preparations are
      inseparable, the presence of an adjuvant in a vaccine reduces the applicability
      of many in vitro methods. Thus, the above mentioned methods and possibilities for
      their adaptation to the analysis of adjuvanted vaccines will be discussed.

PMID- 11208275
TI  - Solving pathophysiological problems.
AB  - The aim of this paper was to analyze particular aspects of problem solving in
      pathophysiology. It is related to various kinds of knowledge presentation
      (textbook-type descriptions and computer programs) that are important for
      reasoning.

PMID- 11208276
TI  - Factors influencing the cellular location of proteolytic enzymes of Bacillus
      intermedius.
AB  - Thiol-dependent serine proteinase and glutamylendopeptidase of Bacillus
      intermedius 3-19 being prevailing enzymes in the total pool of extracellular
      proteinases (95%) of this microorganism in catalytic active form were detected on
      the membrane of the cells. Production of these enzymes was maximum on the medium
      containing inorganic phosphate and gelatin and decreased 2-4-fold on the medium
      with glucose and lactate. The level of the activity of extracellular enzymes
      correlated with that of corresponding membrane-bound proteins. The addition of
      CoCl2 (2 mM) into the medium caused essential increase in extracellular
      glutamylendopeptidase activity and promoted the release of membrane-bound enzyme
      into cultural fluid. Proteolytic activity was detected in cytoplasm also.
      Proteinases localized in cytoplasm were shown to differ in properties from those
      secreted.

PMID- 11208277
TI  - Soluble interleukin-6 receptor in plasma and in lymphocyte culture supernatants
      of healthy individuals and patients with systemic lupus erythematosus and
      rheumatoid arthritis.
AB  - The soluble IL-6 receptor (sIL-6R) occurring in various body fluids of healthy
      persons and patients with various diseases is an agonist since its complex with
      IL-6 binds to gp130 making IL-6 receptor negative cells responsive for IL-6. The
      generation as well as the functional role of soluble IL-6 receptor is poorly
      understood. We measured the sIL-6R levels by ELISA sandwich technology in sera
      and in supernatants of lymphocyte cultures without and after incubations with
      dexamethasone. Our results indicate, that the sIL-6R levels in sera of patients
      with inactive systemic lupus erythematosus (SLE) and active rheumatoid arthritis
      (RA) were higher than those of the control group, active SLE and inactive RA. In
      vitro dexamethasone treatment stimulated generation of sIL-6R in both healthy
      persons and in active SLE, however it strongly suppressed sIL-6R in both RA
      groups. At mRNA level, we found that in SLE both the mRNA coding the cell-bound
      and an alternatively spliced variant corresponding to soluble IL-6R transcript
      increases, however the strong decrease of sIL6R protein in RA was not found at
      mRNA level.

PMID- 11208278
TI  - Comparative morphology of the hepatic and coronary artery walls. Part I.
      Differences in the distribution and intensity of non-atherosclerotic intimal
      thickening and atherosclerosis.
AB  - We compared the morphology of the hepatic artery intima which is free of
      atherosclerosis, with that of the typically atherosclerosis-prone coronary
      artery. The study group comprised material collected from 116 autopsies. Subjects
      were aged between 1 month and 90 years. Specimens were collected from grossly
      normal arterial segments. An already known fact was confirmed: the presence and
      remarkable intensity of non-atherosclerotic intimal thickening in the coronary
      arteries since the beginning of life. On the contrary, hepatic artery intimal
      thickening was incidental during the first 4 decades of life and regular later
      on. During all the decades intimal thickness was decreased in the hepatic artery
      in comparison to the coronary artery. Initial atherosclerosis was noted during
      the 4th decade of life in the coronary artery and during the 8th and 9th decades
      in the hepatic artery. Intimal thickness was always lower in women compared to
      men. These findings reveal a positive correlation between the intensity of
      intimal hyperplasia and the incidence of atherosclerosis. The intimal pattern is
      of limited value in the determination of an unidentified subject age who
      underwent an autopsy. The thickness of the hepatic artery intima, which surpasses
      200 microns indicates that the subject is at least 40 years of age, while initial
      atherosclerosis--the 8th or 9th decades of life.

PMID- 11208279
TI  - Genotoxicity of chromium in human gastric mucosa cells and peripheral blood
      lymphocytes evaluated by the single cell gel electrophoresis (comet assay).
AB  - Hexavalent chromium compounds are well-recognized carcinogens. They easily
      penetrate the cell membrane and are reduced inside the cell to their trivalent
      form, which is supposed to react directly with DNA. Chromium is present in some
      workplaces as well as in water resources and food chain, so it can interact with
      the mucosa of the gastrointestinal tract. In order to elucidate the genotoxic
      potency of chromium in human gastric mucosa (GM) cells, the DNA-damaging effect
      of potassium dichromate (K2Cr2O7) was investigated using alkaline single cell gel
      electrophoresis (comet assay). Biopsy samples were obtained during gastroscopy
      from macroscopically healthy tissue of the stomach. Parallel test with human
      peripheral blood lymphocytes was also performed. Both types of cells were
      incubated at 37 degrees C with 1.6 mM of K2Cr2O7 for 1 h and after washing, were
      placed in a chromium-free medium to examine DNA repair. Alkaline single cell gel
      electrophoresis (comet assay) was used to assess DNA damage and repair. Chromium
      introduced a damage to DNA both in the GM cells and lymphocytes. The effect
      induced by K2Cr2O7 in GM cells was comparable with that caused in the
      lymphocytes. Treated cells were able to recover within a 60-min incubation in a
      chromium-free medium at 37 degrees C. The results obtained indicate that
      hexavalent chromium compounds, which may be found in the diet, can interact
      directly with DNA of the mucosa of the stomach.

PMID- 11208280
TI  - Composition of phospholipid fatty acids in erythrocyte membranes of children with
      chronic juvenile arthritis: clinical and biochemical correlations.
AB  - Systemic diseases of connective tissue, including chronic juvenile arthritis are
      associated with a number of metabolic disorders such as e.g. lipid disturbances.
      The purpose of the present work was to analyse the composition of fatty acids in
      erythrocyte phospholipids of children with juvenile chronic arthritis and to
      determine a correlation between the composition of these acids and patients'
      clinical status. The study was conducted on 47 children with juvenile chronic
      arthritis (jca) and 29 healthy subjects. The following fractions of phospholipids
      were obtained with the help of thin-layer chromatography: phosphatidylcholine,
      phosphatidylethanolamine, phosphatidylserine, phosphatidyloinositol, cardiolipin,
      sphingolipin. Fatty acids were analysed with the use of gas chromatograph
      (Hewlett-Packard 5890). Saturated fatty acids as well as mono- and
      polyunsaturated (n-3 and n-6) fatty acids were identified. The decrease in the
      percentage of linolenic acid, PUFA n-6 and PUFA n-3 was found in all the
      phospholipid fractions in children with jca when compared with control group.
      There was a concurrent increase in saturated fatty acids, mainly stearic and
      palmitic acids. The differences in the distribution of fatty acids in erythrocyte
      phospholipids were observed at early stage of the disease and they became more
      conspicuous as inflammatory process proceeded.

PMID- 11208282
TI  - Septal branches of right coronary artery as a source of blood supply to
      interventricular septum in morphological and clinical studies.
AB  - The aim of this article was to investigate septal branches of the right coronary
      artery in order to create both their typologies and to evaluate the usefulness of
      the vessels mentioned above for revascularisation procedures on the
      interventricular heart septum. The clinical studies were performed on 58 human
      hearts aged 28-80. Technical method of direct preparation, corrosive preparation
      and coronarographic picture assessment. The tests showed that the number of
      septal branches ranged from 5 to 11, their diameter from 0.7 to 1.2 mm. There
      were no main trunk or vessels with different dimensions than other arteries.
      Creation of septal vascularisation model was not possible because of rapid
      changes in studied vessels, their distribution and small diameters (about 1 mm)
      disqualifying them for direct revascularised operations on interventricular heart
      septum.

PMID- 11208281
TI  - Influence of dehydroepiandrosterone on platelet aggregation, superoxide dismutase
      activity and serum lipid peroxide concentrations in rabbits with induced
      hypercholesterolemia.
AB  - Special interest in the role of DHEA dates back to the finding of a correlation
      between low serum DHEA concentrations and a higher morbidity and mortality rate
      due to coronary diseases in humans. Animal studies with experimental
      atherosclerosis confirmed the anti-sclerotic effect of DHEA. The mechanism of
      DHEA action remains unclear. We determined the influence of
      dehydroepiandrosterone (DHEA) administration, a potential anti-atherogenic agent,
      on platelet aggregation, platelet superoxide dismutase (SOD) activity and serum
      lipid peroxide (LPO) levels in male rabbits fed on a normal and atherogenic diet.
      44 adult male New Zealand white rabbits were divided into 4 groups: 1--control
      group fed on standard rabbit food, 2--fed on an atherogenic diet, 3--fed on an
      atherogenic diet with DHEA, 4--fed on standard food with DHEA. We detected blood
      platelet aggregation following (ADP) and collagen activation by means of
      photometry. Platelet SOD activity was detected by means of fluorometry
      determining the inhibition of adrenaline auto-oxidation. The serum LPO
      concentration was measured by means of the colorimetric method. The serum DHEA-S
      concentration was measured by means of RIA methods, and serum lipid levels were
      measured by means of Biomerieux manufactured kits. Results demonstrate that (1)
      elevated LPO concentrations in rabbits with hyperlipidemia did not decrease
      following DHEA administration. (2) In rabbits fed on a normal diet, DHEA caused a
      decrease of LPO, which emphasizes the positive influence of this steroid on the
      oxidative stress in healthy animals. Such a result was not seen in the group with
      severe hyperlipidemia. (3) Rabbits with hyperlipidemia demonstrated a
      significantly decreased SOD activity. (4) In healthy animals as well as in those
      with hyperlipidemia, DHEA administration caused an increase of platelet SOD
      activity, the main enzyme of the antioxidant defence system, which protects the
      organism against free radical damage (5) (DHEA had no influence on platelets
      aggregation in both tested groups). IN CONCLUSION: DHEA administration improves
      platelet SOD activity, which protects cells against oxidative damage. The
      hypothesis that DHEA administration leads to an increase in antioxidant potency
      requires further investigations.

PMID- 11208283
TI  - Cerebrospinal meningitis with the presence of Acinetobacter spp.
AB  - The study was conducted on 16 strains of Acinetobacter sp. which were isolated
      from cerebrospinal fluid. The diagnostic material was analysed with the use of
      automatic BacT/Alert system (Organon Teknika). The analysis was performed in the
      Department of Microbiology, Medical University in Bydgoszcz. API 20NE system
      (bioMerieux) enabled the identification of 14 strains (87.5%) as A. baumannii, 1
      strain as A. haemolyticus and 1 strain as A. lwoffii. The micro-organisms were
      isolated from patients whose age ranged between 4 and 66 years. These patients
      were treated in the departments of Neurosurgery (75.0%), Neurology (18.8%) and
      Intensive Therapy (6.2%). The infection of cerebrospinal fluid was caused by
      injury and subsequent exposure to the bacteria present in external environment.
      Antibiotic-sensitivity of these micro-organisms was evaluated with the help of
      disc-diffusion method, observing standardisation conditions outlined by NCCLS.
      All the strains proved sensitive to carbapenems, 15 strains were sensitive to
      netilmicin, 7 strains--to tobramycin and 7 strains--to amikacin. All the strains
      displayed multiple resistance. The only exception was A. haemolyticus. The use of
      two-discs allowed for the detection of ESBLs in 7 A. baumannii strains. Positive
      results were most frequently obtained after the combination of sublactam and
      aztreonam. Due to microscopic resemblance between Acinetobacter spp., and
      bacteria of Neisseria, Moraxella and Haemophilus genus, microbiological
      diagnostics should not be restricted to microscopic assessment of cerebrospinal
      fluid and quick serological tests evaluating the antigens of the most frequent
      aetiological factors. Considering multiple resistance of Acinetobacter spp. to
      antibiotics, the treatment should be based on sensitivity tests and the ability
      of a given antibiotic to penetrate into cerebrospinal fluid. In our opinion, both
      reasonable antibiotic policy as well as observing the principles of hygiene and
      monitoring infections play equally important roles in the prevention of
      infections with Acinetobacter spp. Such combined measures may help to prevent the
      spreading of multiple resistant strains in hospital environment.

PMID- 11208284
TI  - Gas exchange and heart rate kinetics during binary sequence exercise in cystic
      fibrosis.
AB  - MATERIAL AND METHODS: Gas exchange and heart rate (HR) kinetics were investigated
      in 20 patients with cystic fibrosis (CF) by using a pseudorandom binary sequence
      (PRBS)-technique. Electrocardiogram was continuously recorded, and VO2, VCO2 and
      ventilation/min (VE) responses to a multifrequent input signal were measured by
      means of breath-by-breath analysis. Lag time and peak value in the time-domain,
      and amplitude ratios in the frequency-domain were calculated to characterize the
      crosscorrelation functions between input and responses, and compared to normal
      ranges. RESULTS: Time and frequency domain parameters are abnormal for VO2, VCO2
      and VE responses in moderately and severely ill patients, and for the HR response
      only in severely ill patients. Correlations are shown between those parameters,
      the severity of the illness evaluated by the Shwachman score and the level of
      impairment of the pulmonary function. CONCLUSION: The PRBS-technique is a useful
      tool to investigate the gas exchange and HR kinetics in CF patients, that offers
      many advantages: (1) no explicit mathematical models are assumed, (2) it is a
      walking test that may be used even in very young or severely ill patients, and
      (3) it challenges the ability to adapt to non-steady state exercise and is
      therefore representative for daily activities.

PMID- 11208286
TI  - Non-Hodgkin's lymphomas with primary localization in large bowel and rectum.
AB  - From 1989, at the Department of Medical Oncology of the Institute for Oncology
      and Radiology in Belgrade, seven patients with primary NHL of large bowel and
      rectum have been observed and treated, 3 males and 4 females. In 3 patients an
      urgent laparotomy without previous diagnostic procedures was performed, while 4
      patients had laparotomy only after radiographic and endoscopic diagnosis of a
      tumor. Six patients had radical surgery and 1 palliative only. Five patients had
      lymphoma localized in cecoascedental part of colon (2 centroblastic, 1
      lymphoplasmocytic, 1 Burkitt and 1 Burkitt's like), 1 patient had it in the
      transversal part of colon (centroblastic), and one in the rectum (diffuse
      centrocytic). By further investigation, in 2 cases with localization within
      transversal part of colon and rectum no other sites of NHL were found. They are
      under regular controls with 45+ and 45+ months disease free survival. Out of 5
      patients with localization within cecum or ascendent part of colon, in 2 cases
      with Burkitt/Burkitt-like histology retroperitoneal lymphadenopathy were found,
      one female had NHL central propagation, and the other one lymphoma
      generalization. Both patients had early death from lymphoma. The remaining three
      patients following chemotherapy with the ProMACE regimen (as they too had a post
      laparotomy stage II disease) achieved a complete response lasting for 36+, 41+
      and 66+ months. Since the median survival in our group of patients is at the
      moment 41+ months and the median has not yet been reached, our experience does
      not confirm literature data claiming bad prognosis of primary NHL of the colon
      and rectum. A long disease free survival can be obtained in these patients either
      with surgery only or surgery + chemotherapy, depending on disease stage and
      possibly initial topographic localization.

PMID- 11208285
TI  - Pretreatment determination of isohaemagglutinin titter values in patients with
      malignant lymphomas and metastatic solid tumors.
AB  - Isohaemagglutinin synthesis starts 2-4 months after birth, growing progressively
      and reaching adult values at the age of 5-10 years. Isohaemagglutinin
      concentration decreases with age. Isohaemagglutinins are mostly immunoglobulins
      belonging to the class IgM, but also IgA and IgG. Agglutination titter shows
      correlation with the total concentration of those three immunoglobulin isotypes.
      For the time being there are few data on the isohaemagglutinin titter level in
      various diseases. Purpose of this work is to determine whether there are any
      isohaemagglutinin titter alterations in patients with neoplasia.
      Isohaemagglutinin titter was investigated in 177 patients treated at the
      Institute of Oncology and Radiology and 340 blood donors. Out of 177 patients, 31
      had Hodgkin's lymphoma (HL), 89 had non-Hodgkin Lymphoma (NHL) and 57 had
      metastatic solid tumors (MST). Statistical evaluation included Kruskal-Wallis and
      Mann-Whitney tests. In all groups of patients isohaemagglutinin titters were
      considerably lower as compared with the healthy population (p < 1 x 10e-5). There
      was a significant difference in titter values (p = 0.003) between O blood group
      patients with NHL where anti-A1 titter was significantly lower (Med = 8; range: 1
      256) compared with anti-A1 titter in patients with O blood group suffering from
      MST (Med = 16; range: 2-64). Anti-B titter in the same groups of patients also
      showed lower values (p = 0.042); in NHL anti-B titter values was Med = 4, range:
      1-32 vs Med = 8, range: 1-64 in MST. In the group of patients with HL, A blood
      group was far more frequent (17/31) compared with the group with MST (22/57) (p =
      0.02). Pretherapy determination of isohaemagglutinin titter in patients with
      malignant diseases shows that it is significantly lower than the titter in
      healthy population. Abnormally low isohaemagglutinin titter value irrespective of
      the type and site of the malignant tumor, points to insufficiency of the IgM
      related humoral immune response, to malignancy as a systemic disease, and places
      isohaemagglutinins among biological markers.

PMID- 11208287
TI  - Early predictors of 30-day mortality in supratentorial ischemic stroke patients-
      first episode.
AB  - INTRODUCTION: Prognostic factors following stroke remain to be established. The
      aim of this study was to determine early prognostic factors related with a 30-day
      mortality in first episode ischemic stroke patients. MATERIALS AND METHODS: The
      study group comprised 329 consecutive patients, aged between 33 and 99 years
      (mean age +/- SD 69 +/- 12.6) admitted within 24 hours following their first
      supratentorial ischemic stroke, confirmed either by computer tomography (CT)
      and/or autopsy. The following data were assessed within 24 hours of
      hospitalization: gender, age, history of diabetes mellitus, history of ischemic
      heart disease, obesity, the neurological deficit at entry and after one day,
      level of consciousness at entry and after one day, electrocardiographic
      dysrhythmia at entry, blood pressure at entry and body temperature on the first
      day following stroke. We also assessed particular serum biochemical and
      hematological markers including: hematocrit, fibrinogen concentration, platelet
      count, white blood cell (WBC) count, gamma globulin level, glucose level,
      cholesterol level, the erythrocyte sedimentation rate (ESR), and creatinine
      kinase (CK) level. The end-point for assessment was early death (within 30 days).
      Statistical analysis consisted of univariate analysis and multiple regression.
      RESULTS: Univariate analysis demonstrated that an older age, increased
      neurological deficit at entry and on the next day, decreased consciousness at
      entry and on the next day, electrocardiographic dysrhythmia, increased body
      temperature and glucose level, decreased cholesterol level and increased CK level
      were significantly associated with death after 30 days (p < or = 0.05). During
      multivariate analysis, only a severe neurological deficit (Scandinavian Stroke
      Scale < or = 15 points) both at entry and on the next day (OR = 8.3; 95% CI: 2.83
      24.35), decreased consciousness within the first 24 hours of hospitalization (OR
      = 19.2; 95% CI: 2.84-127.77) and electrocardiographic dysrhythmia (OR = 5.2; 95%
      CI: 2.37-13.77) were associated with death after 30 days. CONCLUSION: A severe
      neurological deficit lasting 24 hours, decreased consciousness within 24 hours of
      hospitalization and electrocardiographic dysrhythmia are the most important
      indicators of 30-day mortality in patients with first-time ischemic stroke.

PMID- 11208288
TI  - Rhinospirography in evaluation of respiratory disorders in patients with central
      nervous system tumors.
AB  - The aim of the study was to define respiratory disorders caused by central
      nervous system tumors. We investigated 51 patients (31 men, 20 women, mean age
      58). They were divided into the following groups: patients with supra-,
      infratentorial and cranio-vertebral junction lesions. We analyzed: the
      localization of tumors based on CT and MRI examinations and intraoperative
      observation, the status of consciousness by GCS scale, neurological status and
      histological findings. For the estimation of dynamics of the respiratory changes,
      rhinospirography examination was repeated several times in the course of
      observation. The alterations of respiration were clearly visible in many cases.
      We have confirmed that respiratory disorders found by rhinospirography provide a
      source of important clinical information on the effect of the treatment and
      prognosis. We have also confirmed that changes in respiration are observed
      earlier than changes of consciousness.

PMID- 11208289
TI  - Pattern of drug use amongst antenatal patients in Benin City, Nigeria.
AB  - BACKGROUND: Drugs taken by pregnant women could have profound effect on pregnancy
      outcome for both the mother and fetus. In most developing country regulation of
      drug is poor, access is unrestricted and abuse of drugs especially antibiotics is
      rampant. The study was undertaken to determine the pattern and extent of drug
      consumption amongst pregnant women in Benin City. METHODS: A cross-sectional
      study of 1200 pregnant patients at various gestational ages was undertaken, using
      a structured questionnaire to obtain details of the extent and character of drug
      use before or during pregnancy. FINDINGS: Folic acid was taken by 76.08% of all
      the pregnant patients, while anti-malarial drugs were taken by 19.75%; 15.83%
      used the drugs on doctors' prescription and 3.92% without a doctor's
      prescription. The proportion of the mothers that consumed native herbs was
      12.08%. The use of native medication was more prevalent amongst nulliparous
      mothers (41.82%). Native herb consumption decreased with increase in parity. Both
      educated and illiterate mothers consumed herbal medications. Less than 1% of the
      mothers smoke cigarettes. INTERPRETATION: In Benin City drug use in pregnancy is
      characterized by a pattern of low consumption except folic acid and native herbs.
      This could be a major setback for any program of drug intervention, as in
      chemoprophylaxis for malaria in pregnancy. Much resource will be needed for
      patients' education for successful implementation of any planned program in the
      community.

PMID- 11208290
TI  - Total intravenous anaesthesia with methohexitone or propofol for knee arthroscopy
      in day-case surgery.
AB  - The aim of the study was to assess the usefulness of methohexitone and propofol
      in total intravenous anaesthesia applied during planned knee joint arthroscopy in
      day-case surgery. Studies comprised 186 patients divided into 2 groups depending
      on the anaesthetic used (methohexitone n = 112 or propofol n = 74). ECG, heart
      rate, systolic and diastolic blood pressure and blood saturation using
      pulsoxymetry were monitored during anaesthesia. The time of regaining
      consciousness was measured and the orientation test was performed 5 and 10
      minutes after regaining consciousness. Our results and observations confirm that
      total intravenous anaesthesia is useful in day-case surgery for knee joint
      arthroscopy. Both methohexitone and propofol cause cardiac and respiratory
      depression. Patients on propofol regain psychomotoric efficiency earlier then
      patients who received methohexitone.

PMID- 11208291
TI  - Particular fractions of microproteinuria in patients with stabile angina pectoris
      and without a clinical nephropathy.
AB  - The determination of microalbuminuria is a valuable method in the diagnosis of
      renal and vascular diabetes or hypertension complications. Recently,
      microalbuminuria appeared to be the predictor of coronary heart diseases (CHD).
      The presented study comprised 26 patients with stable angina pectoris (AP) and 27
      healthy volunteers. We simultaneously evaluated microproteinuria during the first
      morning and afternoon miction and the 24-h blood pressure. Amongst patients with
      AP all urine protein concentrations were increased (results in g/mol creatinine):
      alpha-1-microglobulin (1.04 + 0.13 vs. 0.47 + 0.05, p < 0.001) albumin (0.95 +
      0.15 vs. 0.61 + 0.05, p < 0.05) and IgG (1.00 + 0.17 vs. 0.55 + 0.05, p < 0.01)
      were higher, in comparison to control group values. Indices for diurnal blood
      pressure rhythm were significantly lower in the AP group for both systolic (1.07
      + 0.01 vs. 1.14 + 0.01 p < 0.001) and diastolic (1.09 + 0.02; vs. 1.21 + 0.03 p <
      0.01) pressures. A physiological increase of albumin from the afternoon sample
      was only observed in the control group. Thus, our AP patients demonstrated signs
      of subclinical nephropathy in both the proximal tubuli and glomeruli.

PMID- 11208292
TI  - Ultrasound picture of gastroesophageal junction in children with reflux disease.
AB  - The assessment of gastroesophageal junction morphology is very important in
      children with reflux disease. Authors present ultrasonographic measurements of
      subdiaphragmatic part of the esophagus and His angle. In children with reflux
      disease, marked shortening of subdiaphragmatic part of esophagus and completely
      obtuse His angle were found. Ultrasound imaging of gastroesophageal junction is
      valuable part of ultrasound diagnostics of reflux and may be helpful in
      establishing the etiology and choosing the treatment method.

PMID- 11208293
TI  - QT interval duration in 24-hour Holter monitoring after different interventional
      treatment of coronary artery disease in patients after the myocardial infarction.
AB  - QT interval prolongation is discussed as a possible risk factor of dangerous
      arrhythmias. The aim of this study was to evaluate the influence of different
      interventional treatment of coronary artery disease in patients after myocardial
      infarction on QT interval duration. Two groups of patients were analyzed. The
      first group (G1) consisted of 37 patients in whom PTCA was performed; the second
      group (G2)--42 pts after surgical myocardial revascularisation (CABG). The 24
      hour electrocardiography monitoring was performed in all the patients. Results
      were analyzed especially considering the average daily values of QT, QTp, QTc and
      RR duration. In patients after CABG we observed statistically significant
      prolongation of QTc interval duration what was not noticeable in patients after
      PTCA. The cardiosurgical procedure of coronary by-pass grafting in patients with
      coronary artery disease after the myocardial infarction in contrary of PTCA may
      lead to significant prolongation of QTc interval duration. This problem needs
      further investigation.

PMID- 11208294
TI  - Fibrinolysis system in patients with bronchial asthma.
AB  - Every inflammatory process, including that in the course of bronchial asthma may
      disturb the balance in blood coagulation and fibrinolysis system. The aim of the
      present study was to evaluate fibrinolysis in patients with bronchial asthma. The
      study group consisted of 41 patients with bronchial asthma, hitherto untreated
      (25 women, 16 men, at mean age 37.37 +/- 12.4 years) and 22 healthy adults
      (control group). In these subjects, the following parameters were established:
      euglobulin lysis time (ELT), the concentration of tissue plasminogen activator
      antigen (t-PA Ag), the concentration of urokinase plasminogen activator antigen
      (u-PA Ag), the activity of plasminogen activator inhibitor type 1 (PAI-1), the
      concentration of plasmin-antiplasmin complex (PAP) and fibrinogen/fibrin
      degradation products (FDP). It was found that patients with bronchial asthma had
      statistically significantly higher mean values of FDP (9.25 +/- 6.7 micrograms/ml
      vs. 5.0 +/- 5.9 micrograms/ml; p < 0.001), ELT (123.5 +/- 42.7 min vs. 97.4 +/-
      27.1 min; p < 0.001), t-PA Ag (8.36 +/- 3.66 ng/ml vs. 5.5 +/- 3.71 ng/ml; p <
      0.01) and PAP complexes (250.3 +/- 95.8 ng/ml vs. 193.4 +/- 60.7 ng/ml; p <
      0.02). Mean u-PA Ag concentration in patients with bronchial asthma was
      significantly lower than in control group (0.24 +/- 0.16 ng/ml vs. 0.53 +/- 0.18
      ng/ml; p < 0.01). No statistically significant differences were observed as to
      PAI-1 activity between patients with bronchial asthma and healthy subjects. The
      results of the present study suggest that increased concentrations of t-PA Ag,
      PAP and FDP complexes are the evidence for greater activity of fibrinolysis
      system in subjects with bronchial asthma.

PMID- 11208295
TI  - Children with acute lymphoblastic leukemia: is there any subgroup of children
      without elevated thrombin generation? A preliminary study utilizing measurements
      of thrombin-antithrombin III complexes.
AB  - The mechanisms contributing to thromboembolic complications in children with
      acute lymphoblastic leukemia (ALL) are complex, but it is believed that two
      factors are of critical importance, i.e. increased thrombin generation and
      decreased antithrombotic potential of the blood plasma. We evaluated generation
      of thrombin in three periods of observation of the children: a) prior to
      chemotherapy, b) after remission-inducing chemotherapy, and c) after infusion of
      L-asparaginase in the consolidation phase. The study group consisted of 23
      children (x = 6.8 years of age), and a control group of 11 children (x = 7.3
      years of age). Thrombin-antithrombin III complex (TAT) was selected as a marker
      of thrombin generation and it was measured by ELISA method. TAT levels prior to
      chemotherapy were found to be normal in a small subgroup of children (7/23--ca
      30%), i.e. they were within the control range (1.5-4.5 micrograms/l), but all the
      levels increased following remission-inducing chemotherapy. In contrast, in the
      major subgroup of children whose TAT levels were elevated at presentation (16/23-
      ca 70%) no significant changes were observed following chemotherapy. CONCLUSION:
      There is a subgroup of children with ALL whose thrombin generation is normal as
      measured by its marker--thrombin-antithrombin III (TAT). Only in those children
      thrombin generation increases following chemotherapy.

PMID- 11208296
TI  - Enzymatic efficiency of erythrocyte antioxidant barrier and lipid peroxidation in
      children from families with high risk of early atherosclerosis.
AB  - The most important risk factors contributing to the development of
      atherosclerosis include lipid disorders and the predisposition to early ischaemic
      heart disease in the family. Atherosclerotic process proceeds with age and it
      develops as a result of oxide LDL modification at the level of vascular wall.
      Oxygen-free radicals take part in this process, which may probably be opposed by
      the antioxidant system of the body. The aim of this study was to compare the
      intensity of lipid peroxidation and the activity of antioxidant enzymes in
      children from the families with the risk of early atherosclerosis and in children
      without such predisposition. The activity of katalase (CAT), superoxide dismutase
      (SOD) and glutathione peroxidase (GSH-Px) were determined and the concentration
      of malonic dialdehyde--a lipid peroxidation marker was established. The study was
      conducted on 76 children aged 4-17 years, mean age 12 +/- 0.6 years. The risk
      group consisted of 56 patients with the history of hypercholesterolaemia and
      early atherosclerosis in the members of their families up to 45 years of age.
      Control group was formed of 20 subjects without such history. MDA concentration
      as well as the activity of antioxidant enzymes were determined with the use of
      adequate methods of spectrophotometry. The results obtained were subject to
      statistical analysis. The activity of antioxidant enzymes displayed considerable
      fluctuations in both groups of children, but these differences remained
      statistically insignificant in all the cases. Higher MDA concentrations in serum
      and in erythrocytes were observed in the risk group. These differences proved
      statistically significant (alpha < 0.05). On the basis of the present study and
      the analysis performed, it was found that the activity of antioxidant enzymes
      (CAT, SOD, GSH-Px) cannot serve as a parameter differentiating between children
      from the families with the risk of early atherosclerosis and children without
      such predisposition. Children with positive family history of
      hypercholesterolaemia and early atherosclerosis may demonstrate intensive lipid
      peroxidation, but this hypothesis requires further investigations.

PMID- 11208297
TI  - Epidemiological and clinical characteristics of rotaviral diarrhoea in children
      from Gdansk, Gdynia and Sopot.
AB  - The aim of the present work was to analyse clinical picture of rotaviral
      diarrhoea and its incidence in children from Tri-city. The study was conducted on
      773 children aged 1 month-11 years, who were treated in selected hospitals in
      1997 due to acute diarrhoea. Apart from physical examination and collecting
      patients' medical history, each child was subjected to routine laboratory
      investigations in accordance with clinical indications. Rotaviral aetiology of
      the infection was confirmed in 275 out of 773 patients with acute diarrhoea. In
      80.7% cases, the disease affected children aged 7-36 months old and it was more
      frequent in boys than in girls. Acute diarrhoea was diagnosed mainly during cold
      months of the year, and the increase of its incidence was recorded between March
      and May. The duration of the disease usually did not exceed 3 days and its
      symptoms included fever, vomiting and dehydration which normally required
      parenteral administration of fluids. Statistical analysis was performed in order
      to estimate the differences in the incidence and intensity of the symptoms of
      rotaviral and bacterial diarrhoea. The present study showed that clinical picture
      of rotaviral diarrhoea in children from Tri-city was similar to that reported in
      literature on the subject, but there were differences regarding the seasonal
      occurrence of the infection which was probably related to the climate of analysed
      region.

PMID- 11208298
TI  - Soluble HLA class I antigens in serum of healthy individuals--population study.
AB  - Variability of concentrations of s-HLA-I depending on allelic specificity
      substantiated realisation of research in population of 248 healthy, unrelated
      individuals. Defined phenotypes from tissue typing of polymorphic HLA complex
      enabled concentrations measurements of 1553 serum samples for HLA--A, B, and C
      loci determined antigens. Semi-quantitative technique of inhibition
      microcytotoxic reaction according to Tait et al. (1981) and Mclean et al. (1983)
      with usage of policlonal sera anti-HLA was applied. For most of numbers of the
      allelic specificity the concentration of antigen material in soluble form (s-HLA
      I) in blood serum were nominally very high and high. For certain numbers of
      specificity e.g. HLA--A26, A29, B39, B52, B56, Cw5, Cw6 the percentage of sera,
      where the s-HLA concentrations were decreased was observed. The results were
      presented as mean values of inhibition microcytotoxic reaction--according to NIH
      classification. Authors point on usefulness of results for s-HLA comparative
      analysis of particular HLA allelic specificity, specific for certain diseases
      e.g. Cw7 for SNHL patients and B27 for ankylosing spongilitis.

PMID- 11208299
TI  - Self-care of young diabetics in practice.
AB  - To determine whether young diabetics follow the most important rules of diabetes
      educational programs as remembering to carry 'soluble sugars' and insulin shots
      in their daily life, the analysis using 263 simple and anonymous questionnaires
      was performed. The study involved 183 IDDM children from Kansas-USA (76 boys, 107
      girls) and 80 IDDM children from Silesia, Poland (36 boys, 44 girls) of mean age
      12.95 +/- 2.65, mean IDDM duration 4.77 +/- 3.15 years, mean HbA1c 8.53 +/-
      1.93%. We found: (1) 79.85% of all IDDM children carry something to treat or
      prevent hypoglycemia, more girls than boys, and more American than Polish ones (p
      < 0.01). (2) Only 59.92% of IDDM children carry 'soluble sugars' (no
      statistically significant differences between sexes and nationalities). (3) No
      correlation between carrying 'sugars' and age, metabolic control, number of
      glycemia measurements, forgetting insulin injections and kind of insulin therapy.
      (4) Duration of diabetes was not correlated with carrying 'sugars' whereas it was
      correlated with carrying 'other food' (p < 0.05). (5) 53.4% of children never
      forget insulin injections (p < 0.01). (6) Forgetting insulin shots was correlated
      with IDDM duration in boys group, with increasing level of HbA1c and with smaller
      number of glycemia measurements in all children groups, with the intensive
      insulin therapy in girls and Polish groups (p < 0.01 in all cases). CONCLUSIONS:
      1). Diabetic children quite often carry nothing or 'non-soluble sugars' with
      themselves to treat hypoglycemia. 2). Diabetic children more often forget to
      shoot insulin injections than to 'carry sugars'. 3). Children with a longer
      duration of diabetes more often forget their insulin injections. 4). Older girls
      with longer duration of IDDM demonstrating worse metabolic control check their
      glycemia less frequently and more often forget the insulin injections.

PMID- 11208300
TI  - Incidence of anorectal malformations in Lodz province.
AB  - PURPOSE: It is difficult to obtain reliable figures on incidence of anorectal
      malformations (ARM) from literature. The aim of the present study was to reveal
      the real incidence of these defects in a given area. MATERIAL AND METHODS:
      Between 1992 and 1997, 86 children with ARM were treated at the departments of
      paediatric surgery in Lodz. Parents of 30 (34.9%) children treated within the
      analysed period lived in the Lodz province. The real incidence of ARM in this
      area was calculated and birth parameters of children with ARM were compared with
      corresponding parameters of newborns born alive in Lodz. RESULTS: The studied
      incidence ranged from 1 in 1446 to 1 in 3035 in consecutive years and the average
      was 1 in 2295. Mean duration of pregnancy in children with low type ARM was 39.4
      weeks and in children with high type ARM--38.8 weeks. Mean birth body weight of
      children with low defects was 3030 g, and of neonates with high defects--3185 g.
      Apgar score was respectively 8.7 and 8.8. There was also no significant
      difference in examined parameters (p > 0.05) between ARM children and the
      population of born alive newborns of Lodz area (respectively 38.9; 3297; 8.9).
      CONCLUSIONS: Anorectal malformations are among the common congenital anomalies in
      children. In the analysed group of children with ARM duration of pregnancy, birth
      weight and Apgar score were similar to these observed in the whole population of
      newborns born alive in Lodz province.

PMID- 11208301
TI  - Perioperative management of a post heart transplantation patient with renal
      failure qualified to lung resection.
AB  - Since the first heart transplantation (1967, Christian Bernard), hundreds of
      similar procedures have been performed all over the world. Considerable advance
      made in immunosuppressive treatment improved survival rate and long-term
      efficiency of treatment improved survival rate and long-term efficiency of
      treatment. Many of these patients suffer from ailments requiring operations which
      are not connected with the transplanted organ. The present study describes a case
      of a post heart transplantation patient qualified to lung resection, in whom
      renal insufficiency occurred in the course of immunosuppressive therapy.

PMID- 11208302
TI  - 8q22-->qter duplication in a child with multiple congenital malformations: case
      report.
AB  - BACKGROUND: Congenital malformation syndromes are often caused by unbalanced
      chromosome translocations, which appear spontaneously or may be inherited from a
      healthy parent being the carrier of a balanced reciprocal translocation (rcp).
      Breakpoints, underlying chromosome fragment exchanges, may be located at any
      point of any chromosome and therefore, an infinite number of different
      translocations is possible. Special emphasis is placed both on the clinical
      characterization of every rare chromosomal aberration syndrome and on the
      determination of its breakpoints. OBJECTIVES: Diagnosis of a 8q22-->qter
      duplication in a child with multiple congenital malformations. MATERIAL AND
      METHODS: We determined the karyotypes of the five members of proband's family
      were established by using classical cytogenetic methods on whole blood obtained
      by venipuncture. RESULTS: We described a rare familial reciprocal translocation
      t(8; 14), observed in balanced form in mother and one healthy son, while being
      unbalanced in the son with congenital malformations. CONCLUSIONS: Balanced
      chromosome 8 aberration carriers should be aware of the procreation risks and
      need genetic counseling.

PMID- 11208303
TI  - Idiopathic hypoparathyroidism with intracranial calcifications and dominant skin
      manifestations.
AB  - Presented here is an unusual case of a 41-year-old man with idiopathic
      hypoparathyroidism strongly connected with dermatological, ophthalmological and
      neurological disorders. Since the age of 4 he had been treated ineffectively for
      mycosis resulting in complete baldness and atrophic nail plate changes. At the
      age of 35 he was diagnosed with idiopathic hypoparathyroidism. He underwent
      surgery twice due to bilateral cataract. CT scans of the head demonstrated
      numerous symmetrically located calcifications in both frontal lobes, subcortical
      nuclei, the paraventricular region, brain fornix, and both cerebellar
      hemispheres. The neuropsychological examination demonstrated the occurrence of
      psychosensory disorders under the form of hallucinations accompanied by a sense
      of fear and anxiety. It seems essential to investigate the parathyroid gland for
      any sign of pathology, especially amongst patients with severe dermatological
      and/or neuropsychological symptoms. Early diagnosis and treatment of patients
      with hypoparathyroidism may prevent the development of many serious complications
      or at least result in marked improvement of neurological manifestations.

PMID- 11208304
TI  - Wegener's granulomatosis--clinical analysis of 18 patients group.
AB  - In observed, during 15 years group, of 18 patients with established Wegener's
      granulomatosis WG diagnosis, important is period of time from onset of the
      manifestations to WG diagnosis--very diversified, between 3 to 96 months and
      heterogenerosity of clinical manifestations during establishing of the diagnosis.
      Separated from clinical and histopathological features in most of the patients
      the presence of the titre of antineutrophil cytoplasmic antibody (ANCA) in blood
      serum examinations was established--75% among 16 observed patients in whom such
      examination was possible to perform. There was no significant correlation between
      ANCA titre and prognosis of the WG course. Most of the patients developed upper
      respiratory tract, ears, lungs and kidney disease involvement. Cyclophosphamide
      (CF) and prednisolone (P) treatment improves clinical remission in most of the
      patients (88.8%) and possibility of the course of the disease control. However
      often recurrences are observed (50%) and side effects due to the long term CF and
      P treatment (60%). 38.8% of patients achieve long term remission of the
      manifestations. 3 deaths of WG patients were observed during that period.
      Patients require during treatment close collaboration and careful periodical
      control of treatment.

PMID- 11208305
TI  - Biomechanics of soft tissues.
AB  - Recent developments in Computer-Integrated and Robot-Aided Surgery (in
      particular, the emergence of automatic surgical tools and robots (as well as
      advances in Virtual Reality techniques, call for closer examination of the
      mechanical properties of very soft tissues (such as brain, liver, kidney, etc.).
      Moreover, internal organs are very susceptible to trauma. In order to protect
      them properly against car crash and other impact consequences we need to be able
      to predict the organ deformation. Such prediction can be achieved by proper
      mathematical modelling followed by a computer simulation. The ultimate goal of
      our research into the biomechanics of these tissues is development of
      corresponding, realistic mathematical models. This paper contains experimental
      results of in vitro, uniaxial, unconfined compression of swine brain tissue
      obtained by the author in Mechanical Engineering Laboratory, Japan, and discusses
      liver and kidney in vivo compression experiments conducted in Highway Safety
      Research Institute and the Medical Centre of The University of Michigan. The
      stress-strain curves for investigated tissues are concave upward for all
      compression rates containing no linear portion from which a meaningful elastic
      modulus might be determined. The tissue response stiffened as the loading speed
      increased, indicating a strong stress (strain rate dependence. As the step in the
      direction towards realistic computer simulation of injuries and surgical
      procedures, this paper presents two mathematical representations of brain, liver
      and kidney tissue stiffness. Biphasic and single-phase models are discussed. The
      biphasic model is shown to be inappropriate due to its inability to account for
      strong stress-strain relationship. Agreement between the proposed single-phase
      models and experiment is good for compression levels reaching 30% and for loading
      velocities varying over five orders of magnitude. Presented mathematical models
      can find applications in computer and robot assisted surgery, e.g. the realistic
      simulation of surgical procedures (including virtual reality), control systems of
      surgical robots, and non-rigid registration, as well as ergonomic design for
      injury prevention.

PMID- 11208306
TI  - New formula for calculating antibiotic critical concentration by the disk
      diffusion method.
AB  - New formula was designed for calculation of the antibiotic critical
      concentration: Cc = (1/pi Bh)e-A/B where h is agar depth, B is the slope, A is
      the intercept. The formula is derived from the second Fick's law. Neither
      diffusion constant nor critical time data apply. Three or more disks containing
      varied concentrations of the same antibiotic are used. Regression analysis of
      square of zone of inhibition radii is performed and subsequently the critical
      concentration is computed.

PMID- 11208307
TI  - Principles in laboratory animal research for experimental purposes.
AB  - The present work contains information about proper husbandry and care of
      laboratory animals, microbiological monitoring of their health and protecting
      them against suffering and distress. The author also gives some advice on the
      improvement and unification of experimental research results through the
      standardisation of laboratory animals used for the experiments as well as
      imposing proper conditions for animal husbandry.

PMID- 11208308
TI  - Diagnosis and treatment of primary biliary cirrhosis.
AB  - Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease that
      predominantly occurs in middle-aged women of various ethnic and racial
      populations. The disease slowly progresses over decades and is supposed to be
      caused by immune reactions against host antigens. Histologically, it is
      characterized by inflammatory destruction of intrahepatic small bile ducts,
      subsequent fibrosis, and finally liver cirrhosis. It is more frequently diagnosed
      now than in the past probably because of a greater awareness of the disease.
      There is only week association of PBC with genetic markers. Liver function tests
      reveal an elevation of serum alkaline phosphatase and gamma-glutamyl
      transpeptidase levels with or without elevated aminotransferase levels. The
      hallmark of the disease is the presence of antimitochondrial antibodies (AMAs),
      which are found in 95% of patients with PBC. AMAs have been shown to be directed
      against the 2-oxo-acid dehydrogenase complexes located on the inner membrane of
      the mitochondria. However, AMA titers do not correlate with the disease severity
      of progression, and the role of AMAs in the pathogenesis of PBC has not been
      shown. The disease is frequently associated with other autoimmune diseases,
      including Sjogren's syndrome, scleroderma and thyroid disorders. Most therapeutic
      efforts have been directed at altering the immune response. Ursodeoxycholic acid
      (UDCA) appears to be effective therapy in preventing or delaying the need for
      liver transplantation and improving survival. However, a number of patients
      receiving UDCA still develop progressive disease and go on to transplantation,
      which is an effective therapy at the end stage of the disease. Various prognostic
      models have been proposed to estimate the survival probability and assist in the
      determination of the optimum timing of liver transplantation.

PMID- 11208309
TI  - Use of local anaesthetic agents among New Zealand plastic surgeons--their
      practices and philosophies.
AB  - PURPOSE: Skin lesions are treated by a variety of medical practitioners. To
      describe the method and techniques of use of local anaesthetic (LA) for excision
      of skin lesions amongst a group of surgeons who are frequent users. METHODS: An
      open-ended questionnaire was designed to investigate the way LA was used for
      local excision and reasons behind the practice. All registered Plastic and
      Reconstructive Surgeons in New Zealand were sent the questionnaire. This group
      was chosen because they are high frequency users of local anaesthetic for
      excision of skin lesions. RESULTS: Questionnaires were sent to all 28 Plastic and
      Reconstructive Surgeons in New Zealand of which twenty-three (82%) responded. The
      reasons for selection of specific products relate to convenience of product (14),
      speed of onset (6), effect duration (4), ease to add bicarbonate (3), others (5).
      Lignocaine and bupivicaine were the most popular LA agent used except when there
      was concern about cardiac toxicity when Prilocaine was used instead. Adrenaline
      was used for vasoconstriction induced haemostasis, and avoided in anatomical
      areas with end arteries due to the risk of tissue ischaemia. This complication
      was identified as medicolegally indefensible despite a lack of scientific
      evidence in the literature. The techniques used to reduce patient discomfort of
      local anaesthetic infiltration relate to patient oriented techniques (15),
      injection related techniques (25), LA agent related techniques (19). Details of
      these specific techniques are presented in detail. CONCLUSIONS: LA uses vary
      according to the specific surgical situation, patient risk factors and according
      to the individual surgeon. The main reason for selection of a specific LA agent
      relates to convenience and not pharmacokinetics. Injection related techniques are
      the most common method to reduce pain from LA.

PMID- 11208310
TI  - Current knowledge on treatment of chronic hepatitis B in children.
AB  - So far the treatment of chronic hepatitis B has been based on the use of numerous
      agents, particularly interferon alpha which proved the most effective. Attempts
      are made to introduce new therapeutic methods (antiviral agents--nucleoside
      analogues, immunotherapy--anti HBV vaccine, gene therapy) in order to obtain
      higher percentage of patients with durable inhibition of HBV replication than it
      is observed after treatment with interferon alpha. The current work has been
      devoted to the presentation of the experiences with interferon alpha, lamivudine
      and anti HBV vaccine used in subjects with chronic type B hepatitis, with special
      reference to paediatric patients.

PMID- 11208311
TI  - Erythromelalgia--a thrombotic complication in chronic myeloproliferative
      disorders.
AB  - Erythromelalgia is a very specific, thrombotic syndrome related with
      thrombocythemia that may occur during the course of chronic myeloproliferative
      disorders (MPD), especially polycythemia vera (PV) and essential thrombocythemia
      (ET). This poorly understood clinical syndrome is characterized by red, congested
      distal extremities and painful burning sensations, usually confined to the ball
      of the foot and one or more toes or fingers. If left untreated, it may progress
      towards acrocyanosis and even peripheral gangrene. Sometimes, it may precede the
      diagnosis of MPD by months or years. The pathophysiological aspects of
      erythromelalgia as well as its differentiation with erythermalgia have been
      reviewed in this study.

PMID- 11208312
TI  - Fatty liver--current look at the old disease.
AB  - The report is devoted to the presentation of aetiological factors causing fatty
      liver, including alcohol, obesity, diabetes mellitus, hyperlipoproteinaemias and
      drugs. The author discusses morphological changes typical for the fatty liver
      such as large or small fatty droplets in hepatocytes and rarely coexisting
      hepatitis (so-called steatohepatitis). The work presents symptoms, changes in
      biochemical analyses of serum as well as methods of the liver visualisation used
      in the diagnostics of fatty liver. The treatment in based on the elimination of
      aetiological factors and properly balanced diet with support of pharmacotherapy
      in selected cases.

PMID- 11208313
TI  - Strategy for prenatal diagnosis of osteogenesis imperfecta by linkage analysis to
      the type I collagen loci COL1A1 and COL1A2.
AB  - To improve prenatal diagnosis of osteogenesis imperfecta (OI) in Lithuania,
      possibilities of indirect molecular genetic diagnosis were investigated in 11
      families with dominant OI. Segregation of polymorphic DNA markers closely linked
      to COL1A1 and COL1A2 genes with OI phenotype was investigated. Polymorphic DNA
      markers applied were individual haplotypes constructed using a set of restriction
      enzyme sites within or close to the genes. Comparison of phenotypic features with
      the concordant collagen locus showed that in four pedigrees with OI Sillence type
      I segregated with COL1A1, while two pedigrees with OI Sillence type I and OI type
      IV segregated with COL1A2. Out of six remaining pedigrees with OI Sillence type
      I, three were concordant at both loci, two pedigrees were discordant at the locus
      COL1A2 and non-informative at the locus COL1A1 and one pedigree was concordant at
      the locus COL1A1 and non-informative at the locus COL1A2. Informativity of DNA
      markers applied was also investigated in the Lithuanian OI families. The
      frequencies of six restriction enzyme site dimorphisms in type I collagen loci
      were estimated and polymorphism information content (PIC) values were calculated
      for each restriction site and for a combination of three sites. COL1A1 locus
      dimorphisms A/MspI, B/RsaI and F/MnlI, showed PIC values of 0.327, 0.191 and
      0.366, respectively, giving a combined PIC of 0.656 at the locus, while COL1A2
      locus dimorphisms C/EcoRI, D/MspI and E/RsaI RFLPs had PIC values of 0.357, 0.168
      and 0.331, respectively, giving a combined PIC of 0.655 at the locus.

PMID- 11208314
TI  - Patterns of free and esterified sterol fractions of the cerebral white matter in
      severe and moderate experimental hypoxia.
AB  - Cerebral sterols were examined in Wistar strain rats, subjected 4 h, 24 h, 14
      days or 2 months earlier to severe (2% oxygen) and moderate (7% oxygen)
      experimental hypoxia. From brains of the experimental animals myelin was isolated
      and examined by gas chromatography coupled with mass spectrometry (GC-MS) to
      separate and to identify free and esterified (following hydrolysis) cerebral
      sterols. In both types of hypoxia, the same compounds were identified in
      fractions of free and esterified sterols. Slight differences in sterol content
      were noted between the two experimental models, involving cholesterol, the main
      sterol of the myelin sheath, its smaller sterol precursors (desmosterol,
      lanosterol) and the less abundant sterols (beta-sitosterol, 24-ethyl-4-cholesten
      3-on, cholesta-3,5-dien, cholest-4-en-3-on, 22-propyl-3 beta-hydroxy-5,24
      cholestadien). Both types (severe and moderate) of hypoxia were found to induce
      similar alterations in patterns of cerebral sterols 24 h, 14 days and 2 months
      following the exposure. Quantitative differences in the sterol pattern were
      detected only at the very early stage (4 h) of the experiment.

PMID- 11208315
TI  - Antioxidant mechanisms in human peritoneal mesothelial cells (HPMC) exposed in
      vitro to the constituents of dialysis fluid.
AB  - OBJECTIVE: To assess effects of hyperosmolarity, high glucose concentration, and
      low pH with or without lactate sodium at the level of antioxidant mechanisms,
      such as the concentration of total intracellular glutathione (GSH/GSSG), the
      activity of catalase (CAT) and total superoxide dismutase (SOD) in mesothelial
      cells (MC) in vitro. METHODS: HPMC were obtained from omentum from nonuremic
      donors. The effect of pH (5.2-7.3) with or without sodium lactate (35 mM/L) was
      tested in Earle's salt after 30 min exposure, whereas the osmotic and metabolic
      effects of glucose, glycerol, mannitol, and amino acids were studied in a medium
      with 10% FCS after 4, 24, 72 and 104 h of exposure. The activity of antioxidant
      mechanisms was determined by spectrophotometry. RESULTS: In the cells exposed to
      Earle's salt pH 5.2 with lactate, the GSH/GSSG level, and CAT and SOD activity
      were substantially reduced. After 4 h of exposure, glycerol, glucose and mannitol
      increased the GSH/GSSG content in MC; after 24 h only glucose slightly increased
      the GSH/GSSG level. CONCLUSION: We conclude that although low pH with high
      lactate concentration decreased the activity of all studied antioxidant
      mechanisms in MC, the clinical relevance of these observations needs to be
      studied further.

PMID- 11208316
TI  - Changes in the structure and properties of corpus vitreous and the preservation
      of enzymatic composition of rabbit antioxidative system under the influence of
      sulphur hexafluoride gas.
AB  - PURPOSE: To evaluate clinical, physiochemical and biochemical changes in rabbit
      vitreous body caused by local injection of sulphur hexafluoride gas. MATERIAL AND
      METHODS: The volume of fluid vitreous fraction was measured with Na+, K+, Mg2+,
      Ca2+ levels and full proteins concentration in both vitreous fractions in 24 New
      Zealand rabbits at 2, 7 and 14 day after SF6 injection. The activity of
      superoxide dismutase, catalase and malonyl dialdehyde were used to evaluate the
      activity of antioxidative enzymatic system. Control group consisting of 6 New
      Zealand rabbits had no experimental procedures. RESULTS: In the investigated
      group, the fluid vitreous fraction volume was increased while gelatous one was
      diminished from 0.08 ml in control group to 0.32 ml in the study group (on day
      14). The level of Na+, K+, Mg2+, Ca2+ in the fluid fraction was unchanged. On day
      7, we noticed statistically significant increase in protein concentration in
      comparison with the control group and the study group on 14 day. The activity of
      superoxide dismutase and catalase as well as the level of malonyl dialdehyde were
      increased in the fluid vitreous fraction compared to the gelatous one in the
      control group. After the SF6 injection we did not observe any changes of
      superoxide dismutase and catalase activities in the gelatous part of vitreous
      body while in the fluid one there was statistically significant decrease in the
      enzymatic activity and the MDA level in the whole observation time. CONCLUSIONS:
      The injected sulphur hexafluoride gas caused the damage of the gelatous vitreous
      fraction with the increase in the fluid one. The oxygen free radicals might
      trigger these pathological processes.

PMID- 11208317
TI  - Neoplastic lesions of the human liver in relation to the activity of the
      cytochrome P-450 dependent monooxygenase system.
AB  - We studied the activity of Mixed function oxidase (MFO) in human livers affected
      by cancer. We determined the content of cytochrome P-450 and b5, as well as the
      activity of their corresponding reductases, according to generally accepted
      methods. Liver fragments corresponding with a) healthy tissue, b) tissue at the
      cancer border and, c) cancerous tissue were collected during surgery from
      patients with liver cancer. We noted that the developing liver cancer decreased
      the level of cytochrome P-450, even by a magnitude order. The activity of its
      corresponding reductase was higher in cancerous than in healthy tissues.
      Cytochrome b5 behaved in an analogous manner, although the decrease in its
      content was less significant. NADH-cytochrome b5 reductase activity changes were
      insignificant.

PMID- 11208318
TI  - Comparative morphology of the hepatic and coronary artery walls. Part II. The
      relation between the internal elastic membrane, non-atherosclerotic intimal
      thickening and atherosclerosis.
AB  - Evident difference in the occurrence of atherosclerosis between hepatic and
      coronary arteries justifies the search for local preconditions of this disease.
      In this study we compared the internal elastic membrane morphology of both
      arteries. It appeared to be mono- or polylinear (laminar) and continuous in the
      hepatic artery. This was in contrast to its fragmentation in the coronary artery
      since the beginning of life. Thus, the condition of the internal elastic membrane
      may play an important role in the development of non-atherosclerotic intimal
      thickening. Continuous elastica could make the migration of medial myocytes into
      the intima more difficult (hepatic artery). On the other hand, fragmented
      coronary artery elastica seems to facilitate this migration. In turn, intimal
      thickening is less or more advanced, respectively.

PMID- 11208319
TI  - Clinical and morphological studies on varieties of coronary vascularisation of
      diaphragmatic surface of human heart.
AB  - The aim of the present work was to determine vascularisation varieties of
      diaphragmatic heart surface which would be useful in cardiology and
      cardiosurgery, in particular. The methods used in the present study included
      morphological investigations (direct preparations) and clinical examinations
      (coronarography). The study was performed on posterior coronary vessels of 163
      human hearts aged 28-88. Ninety-one of these heats were analysed on the basis of
      intra vitam angiography. Three coronary vascularisation varieties of posterior
      heart surface were distinguished and the criteria of their determination in
      selective coronarography were postulated. Both research methods revealed that the
      right variety of coronary vascularisation occurred most often, while left variety
      was the least frequent. Symmetric variety which is optimal from the point of view
      of myocardial haemodynamics was found in 0.25% cases. The frequency of the right
      and symmetric varieties observed in the studies following both methods are
      comparable. In the case of left variety, the interpretation of blood supply to
      posterior surface on the basis of coronarography is much more difficult when
      compared with the remaining varieties. Coronarography may often be insufficient
      to determine the range of vascularisation of particular coronary arteries.

PMID- 11208321
TI  - Umbilical and middle cerebral artery blood velocimetry: relationship with
      placental volume.
AB  - OBJECTIVE OF THE STUDY: To investigate the relationship between placental volume
      and the resistance of fetal arteries: umbilical and middle cerebral. MATERIAL AND
      METHODS: In 82 pregnant women with unaffected pregnancy between 14 and 40 weeks
      of gestation measurements of placental volume were made according to the parallel
      planimetric technique. Doppler examinations of umbilical and middle cerebral
      arteries were performed by means of a duplex system. RESULTS AND CONCLUSION: PI
      in the umbilical artery (PIUA) correlated significantly negatively with placental
      volume, whereas no significant correlation was found for the PI in the middle
      cerebral artery (PIMCA) and placental volume. Middle cerebral artery to umbilical
      artery PI ratio (PIMCA/PIUA ratio) showed significant positive correlation with
      placental volume. PIUA showed significant negative correlation with the relative
      volume of placenta (expressed as multiple of median for the actual gestational
      age) before 25 weeks of gestation and weak positive correlation with the relative
      volume of placenta after 25 weeks of gestation. PIMCA showed weak negative
      correlation with the relative volume of the placenta after 25 weeks of gestation
      and no correlation before 25 weeks. PIMCA/PIUA ratio showed significant positive
      correlation with relative placental volume before 25 weeks and significant
      negative correlation with relative placental volume after 25 weeks.

PMID- 11208320
TI  - Effects of interaction between cadmium and selenium on heart metabolism in mice:
      the study of RNA, protein, ANP synthesis activities and ultrastructure in mouse
      heart.
AB  - Heavy metals tend to occur in increasingly many aspects of human activities.
      Studies of cadmium (Cd) have revealed that it is extremely toxic in its effects.
      It is known that selenium (Se) may suppress deleterious effects of Cd. We
      investigated the effects of dietary Cd-intoxication on the incorporation of
      precursors of RNA, protein and ANP (atrial natriuretic peptide) granule synthesis
      in mouse cardiocytes and compared them with the results of Se interaction with Cd
      intoxication. Functional condition of the heart was evaluated on the basis of the
      number of ANP granules synthesized in cardiocytes of the right atrium in the mice
      exposed to the tested elements. The experiment was conducted on 100 male white
      Balby mouse during the period of three months. The animals were divided into four
      groups. The control group I (C) was fed a standard Murigran diet. Group II (Cd)-
      received 50 ppm Cd as cadmium acetate in drinking water. Group III (Se) received
      a standard diet supplemented with 5.0 mg Se/kg DM/24 h as acid sodium selenate.
      The experimental animals in group IV (Cd + Se)--were fed a diet supplemented with
      Cd and Se in the same amounts as the above groups. Our results revealed that
      after 3 months long intoxication with Cd, 3H-uridine and 3H-alanine uptakes to
      cardiomyocytes were decreased by 33% and 40%, respectively, and fewer ANP
      granules were synthesized when compared with the controls. Ultrastructure of
      myocytes proved slightly distorted. Se-intoxicated cardiomyocytes indicated
      diminished incorporation of RNA synthesis precursors by 17% and 27% in the
      ventricle and atrium, respectively, in comparison with the controls. Some Se
      induced structural changes were observed. Finally, after Se in interaction with
      Cd intoxication, the uptake of 3H-uridine and 3H-alanine to cardiocytes was
      higher and the number of ANP granules increased. The values approximated those in
      the controls. We concluded that: prolonged Cd intoxication disturbed
      intercellular metabolism by damaging ultrastructural elements and suppressing the
      incorporation of precursors of RNA, protein and ANP granule synthesis. Se in
      interaction with Cd revealed protective effects against Cd toxicity. After Cd-Se
      intoxication neither metabolic activity nor cardiocyte ultrastructure showed
      significant differences from those in the controls.

PMID- 11208322
TI  - Fractal analysis of placenta mature villi in healthy, smoking and non-smoking
      women.
AB  - Not all the objects created by nature can be described by means of the classical
      Euclidean geometry rules. New, quickly developing fractal theory can provide
      another instrument for describing irregular surfaces of e.g. geometric structures
      and objects whose development results from growth, differentiation and
      degeneration processes. In the present study we decided to perform fractal
      analysis of mature, terminal villi of placenta taken from smoking and non-smoking
      women, during the third trimester of pregnancy. The aim of this study was to find
      another morphometric parameter, independent of subjective factors, which would
      provide new information about the studied structure. Placentas were taken from
      healthy women, untreated primiparas, who did not undergo any hormonal treatment,
      aged 18 to 27. The material was divided into: control group--placentas from non
      smoking women, and two experimental groups--placentas from non-smoking up to 30
      cigarettes daily and placentas from women smoking up to 30 cigarettes daily and
      placentas from women smoking over 30 cigarettes daily. Fractal dimension was
      determined by three methods: box counting, dilation and mass scaling method.
      Taking under consideration the results obtained in the present study it seems
      that fractal dimension, objectively and independently of many factors, allows to
      perform mathematical estimation of the parameter which is the terminal villi
      occurrence density within placenta. Among the applied fractal analysis methods,
      used for placenta terminal villi density grade estimation, the most useful seems
      to be the box counting method, whereas for estimating villi surface complication-
      the ratio--mass scaling method. Comparing obtained fractal dimension results, we
      have found that they increase together with the amount of cigarettes smoked
      during pregnancy.

PMID- 11208323
TI  - Subpopulations of the peripheral lymphocytes in the early clinical forms of Lyme
      disease.
AB  - The evaluation of the changes of lymphocytes: T(CD3), B (CD19), subpopulations
      CD4, CD8, active lymphocytes CD3 + HLA-DR+, lymphocytes with the receptor for
      IL2(CD3 + CD25+), NK cells as well as the CD4/CD8 ratio in 30 patients with the
      early localized (group I n = 7) and early disseminated (group II n = 23) type of
      Lyme disease, before (examination 1) and after the antibiotic therapy
      (examination 2) was performed. Group III was composed of 90 healthy people.
      Measurements were carried out in an COULTER EPIC XL cytoflowmeter, using Becton
      Dickinson antibodies. Statistical analysis was performed using AnStat software.
      In the examined groups, a decrease of the subpopulations of CD4, CD8 lymphocytes
      in comparison with healthy subjects was revealed, as well as a decrease of the
      CD4/CD8 ratio after treatment. A considerably lower percentage value of active
      lymphocytes CD3 + HLA-DR+ in both groups and the reduction of the NK
      subpopulation before and after treatment of early disseminated Lyme disease in
      comparison with healthy people was observed. The higher percentage values of the
      lymphocytes with IL-2 receptor were not statistically significant. The indicated
      essential changes in the subpopulations of T lymphocytes, characterized by a
      decrease before the antibiotic therapy and by the tendency towards an increase
      after that therapy of the percentage of CD4, CD8, NK and CD3 + HLA-DR+
      lymphocytes in peripheral blood, point out their role in the immunopathogenesis
      of the Lyme disease. The absence of the complete normalization of the examined
      parameters after the treatment, on the one hand, may provide evidence for some
      inertia of the elements of the immune system, on the other hand can also result
      from too short antibiotic therapy and maintenance of the antigenic stimulation.

PMID- 11208324
TI  - Comparison of bacterial flora found in the peritoneal cavity and drains after
      intraabdominal surgery.
AB  - The aim of this study was to evaluate bacterial flora infecting during the
      surgical procedures the peritoneal cavity and drains which were used after the
      surgery in 40 patients who underwent surgery for colon and rectum tumors. Smears
      from the peritoneal cavity, liquid removed from the drain taken at 3-4 days after
      the surgery and smears from the drain taken at the end of drainage of each
      patient were examined for bacterial content. The comparison of bacterial flora
      found in the peritoneal cavity with bacteria found in drains showed that the
      frequency of isolation of anaerobes decreased in contrast to aerobes which were
      more often cultured over the time of drainage (p < 0.05). Bacteroides spp,
      enterococci, and strains of Enterobacteriaceae were most often isolated from the
      peritoneal cavity, but over the time of drainage the frequency of isolation of
      coagulase-negative staphylococci including MRCNS increased as well as the number
      of patients infected with enterococci, whereas anaerobes and strains of
      Enterobacteriaceae were rarely isolated.

PMID- 11208325
TI  - Adherence of bile-isolated bacteria to the bile ducts mucosa as a pathogenic
      factor in the development of inflammatory lesions.
AB  - Bacterial infection of the bile system appears to be an important factor in the
      formation of stones. In view of the hypothesis that strains of E. c. form an
      essential factor in infections of the bile ducts, an attempt has been made to
      determine the connection between infections of the bile ducts and the adherence
      of E. c. to the epithelium of the gallbladder. The research covered 148 patients
      operated electively for cholecystolithiasis (121), cholecystocholedocholithiasis
      (26) and recurrent lithiasis (1). In bile collected from the gallbladder in the
      course of the operation, E. coli strains were isolated. Cholangioscopy performed
      in 26 patients enabled the macroscopic evaluation and grading of inflammatory
      lesions of bile duct mucosa. The mucosa of the gallbladder was evaluated
      histologically. The adherence test was performed using homologous and
      heterologous strains of E. c. isolated from the bile of gallstone patients. The
      adherence occurred most frequently in the neck of the gallbladder (71-100%) in
      those patients in whom an infectious process of the bile ducts mucosa was
      endoscopically diagnosed. The adherence of bacteria to the epithelium of the
      gallbladder did not depend on the type of inflammation (acute, chronic).

PMID- 11208326
TI  - Antibiotic-sensitivity of Moraxella catarrhalis isolated from clinical materials
      in 1997-1998.
AB  - Moraxella catarrhalis (M. catarrhalis) may normally be found in the upper
      respiratory tract. This bacterium, however, may cause infections such as acute
      otitis media, sinusitis, conjunctivitis, bronchitis chronica, pneumonia,
      endocarditis, septicaemia and meningitis. Haemophilus influenzae, Streptococcus
      pneumoniae and M. catarrhalis were the main causative agents responsible for
      respiratory tract infections. The major resistance problems associated with these
      species are those which cause resistance to beta-lactams. beta-lactamase was
      produced by > 80% M. catarrhalis strains. The susceptibility to ampicillin,
      amoxicillin/clavulanic acid, cefuroxime, erythromycin, ciprofloxacin was tested
      in 137 M. catarrhalis strains. All the strains resistant to ampicillin produced
      beta-lactamase and were sensitive to amoxicillin/clavulanic acid. For M.
      catarrhalis, the most active antimicrobials included cefuroxime (99%),
      ciprofloxacin (99%) and erythromycin (93%).

PMID- 11208327
TI  - Influence of rectus eye muscles tenotomy on the aqueous humor composition in
      rabbits.
AB  - INTRODUCTION: Anterior segment ischaemia manifesting in aqueous malformation may
      follow tenotomy of the extraocular muscles. MATERIAL AND METHODS: Tenotomy of 2
      or 4 rectus eye muscles was performed on the right eyes of 23 adult rabbits. The
      aqueous humor was withdrawn from the anterior chamber of both eyes in 7 rabbits
      on the 11th, on the 22nd in 8 and on the 32nd postoperative day in 8 rabbits.
      Aqueous natrium, potassium and glucose concentrations and protein electrophoresis
      were examined. RESULTS: The only significant change was lower mean aqueous
      potassium concentration in the operated eyes as compared to controls on the 11th
      postoperative day. CONCLUSION: Tenotomy of rectus eye muscles in healthy rabbits
      evoked a discrete blood-aqueous barrier break-down.

PMID- 11208328
TI  - Correction of hypertensive cardiac remodelling: comparison of different
      antihypertensive therapies.
AB  - The aim of the study was to compare the effects of long-term treatment with
      different types of antihypertensive drugs on left ventricular hypertrophy (LVH)
      and diastolic function in patients with essential hypertension. We examined 60
      patients with mild to moderate hypertension from 35 to 55 years old (middle age
      44.3 +/- 2.3 yrs) having no concomitant diseases. Patients were treated for six
      months with different types of antihypertensive drugs: 21 patient received
      nifedipine-retard 40 mg/day, 20--atenolol 100 mg/day, 10--losartan potassium 100
      mg/day, 9--perindopril 4 mg/day. Cardiac structure and function was studied by
      echocardiography. For the left ventricle (LV) the diastolic mass normalised for
      body surface area (LVMI), the ratio of the early and atrial mitral inflow
      velocities (E/A), isovolumetric relaxation time (IVRT), relative wall thickness
      (RWT) were measured. After six months of treatment LVMI decreased by 9% in
      nifedipine group (P < 0.01), by 10.5% in atenolol group (P < 0.01), by 12% in
      losartan group (P < 0.01) and by 8.2% in perindopril group (NS). RWT decreased in
      all groups, while diastolic dimension index remained unchanged. The reversal of
      LVH was not related to blood pressure reduction. It was more significant in
      patients with initially higher values of LVMI. Antihypertensive effects of the
      drugs were comparable. Long-term treatment with all types of selected drugs
      improves cardiac structure and function independently of their antihypertensive
      action. Our data suggest that on the basis of the influence on cardiac
      remodelling no preference for any studied drug can be discerned. The work had the
      following source of support: the atenolol (Falitonsin) and nifedipine-retard
      (Corinfar-retard) were provided by the AWD Company (Germany), losartan potassium
      has been provided by Merck Sharp & Dohme Company and perindopril (Prestarium) by
      the Servier Group.

PMID- 11208329
TI  - Age and sex as factors modifying the function of the blood-cerebrospinal fluid
      barrier.
AB  - INTRODUCTION: The aim of the study was to find out, if there was a difference in
      function of the blood/cerebrospinal fluid barrier (BCSFB) in females and males,
      and if those differences intensify with age. MATERIAL AND METHODS: 120 patients
      of both sexes who underwent subarachnoideal anesthesia were divided into 6
      groups, 20 patients each, considering sex and age criteria. Samples of venous
      blood (5 ml) and cerebrospinal fluid (1 ml) were collected from every patient
      simultaneously; then albumin permeability indexes (Qalb) were counted. The
      achieved results were compared using the t-Student test at the significance level
      of P < or = 0.05. RESULTS: The mean value of Qalb in patients aged 20-50 was
      significantly lower than in the group of patients aged 51-70, as well as in the
      group of patients over 71. The difference between mean Qalb values in patients
      aged 51-70 and those aged over 71 was also statistically significant. No
      statistically significant difference between mean Qalb values in females and in
      males in the corresponding age groups was found. In every age group the value of
      albumin permeability index was lower in females. CONCLUSIONS: 1) The permeability
      of BCSFB increases with age. 2) There was no statistically significant difference
      between the values of albumin permeability index in females and males in the
      corresponding age groups. The function of BCSFB in the corresponding age groups
      of males and females was the same.

PMID- 11208330
TI  - Comparison of influence of thiopentone, propofol and midazolam on blood serum
      concentration of noradrenaline and cortisol in patients undergoing non-toxic
      struma operation.
AB  - The stress hormones plasma concentration after intravenous anesthetics
      (thiopentone, propofol, midazolam) administration in patients who underwent non
      toxic struma operation was estimated. The goal of the study was to answer what
      stage of the general anesthesia and the surgery is the most dangerous for the
      cardiovascular system in term of stress hormones concentration and which of
      induction anesthetics used significantly alleviates undesirable reactions to
      surgical trauma and general anesthesia. 45 women aged 43 +/- 11, who underwent
      non-toxic struma operation and 16 women who underwent biliary gall-stones
      operation served as the 'study group and controls', respectively. Both groups
      were divided into 3 subgroups (in each a different anesthetic was used). Blood
      samples were taken at moments of increased stress during general anesthesia and
      operation. Intubation performed by laryngoscopy was found as the most stressful
      moment at which stress hormones are released intensively and can initiate
      cardiovascular disorders. According to our investigations, the suppression of the
      stress hormones (noradrenaline and cortisol) release was observed when propofol
      and midazolam were used for anesthesia induction for non-toxic struma surgery in
      contrast to thiopentone administration.

PMID- 11208331
TI  - Comparative analysis of plasma lipoprotein components assessed by
      ultracentrifugation in primary biliary cirrhosis and chronic hepatitis.
AB  - The evaluation of lipid and lipoprotein profiles in liver diseases has important
      cognitive aspects and provides practical information contributing to the
      diagnosis of liver pathology. There are few studies of this problem using the
      ultracentrifugation method. AIM OF THE STUDY: A comparison of lipid profile
      (obtained by plasma ultracentrifugation) in patients with primary biliary
      cirrhosis (PBC) and chronic hepatitis (CH). MATERIAL AND METHODS: 103
      percutaneous liver biopsies were routinely performed from 1994 to 1997. Blood
      samples were taken from all the patients at the time of biopsy for further
      evaluation of lipid profile. 15 patients with PBC and 15 patients with CH (of HBV
      or/and HCV etiology) were studied. RESULTS: In patients with CH mean total,
      esterified and free cholesterol levels (166 mg%, 117.6 mg% and 48.1 mg%,
      respectively) were significantly lower (p < 0.002; p < 0.004; p < 0.006,
      respectively) than in patients with PBC (237.5 mg%, 165.7 mg% and 71.8 mg%,
      respectively). The phospholipid concentration in sera of patients with PBC were
      significantly higher (271.1 mg%, p < 0.0004) than in patients with CH (187.6
      mg%), whereas apolipoprotein B and apoAII were significantly lower. Total,
      esterified and free cholesterol levels in LDL fraction were significantly higher
      in patients with PBC (175.3 mg%, p < 0.007; 117.9 mg%, p < 0.02; 57.6 mg%, p <
      0.01, respectively) than in patients with CH (113.7 mg%, 78.7 mg% and 35 mg%,
      respectively). The concentration of phospholipids in LDL fraction in patients
      with PBC was significantly higher (166.8 mg%; p < 0.003) in comparison with
      patients with CH (96.3 mg%). The differences in other lipoprotein fractions (VLDL
      and HDL) were not statistically significant. CONCLUSIONS: High levels of total,
      free and esterified cholesterol as well as phospholipids, apolipoprotein B and
      AII were observed by us in patients with PBC in comparison with patients
      suffering from CH. The increase of cholesterol (total, esterified and free) and
      the phospholipid concentration in serum, are a manifestation of their higher
      concentration in LDL fraction.

PMID- 11208332
TI  - Comparison of clinical features of cholecystolithiasis and functional dyspepsia.
AB  - 148 patients with cholecystolithiasis and 77 patients with functional dyspepsia
      were examined to isolate symptoms or a syndrome characteristic of 'pure' (i.e.
      uncomplicated and without any co-existing diseases) cholecystolithiasis and
      functional dyspepsia; to evaluate their specificity and sensitivity as well as to
      estimate the power of each symptom or a group of symptoms to differentiate both
      these conditions. Endoscopy, ultrasound scan and biochemical tests were performed
      in each patient to exclude co-existence of any other gastrointestinal disorders.
      Also irritable bowel syndrome was excluded according to Manning's criteria. It
      was found that both these conditions have most often seven co-existing dyspeptic
      symptoms and that each symptom separately has low sensitivity and specificity for
      cholecystolithiasis as well as functional dyspepsia. The diagnostic power of each
      symptom is weak and even summing them up into groups of symptoms does not
      increase their diagnostic power.

PMID- 11208333
TI  - HLA class I haplotypes in families of children with coeliac disease.
AB  - The purpose of the study was the analysis of HLA-AB haplotypes frequency in the
      families of children with coeliac disease. Haplotypes present in 46 probands'
      families including 69 affected children, 49 healthy siblings and 91 parents were
      verified. HLA antigens were typed by Terasaki and McClelland's routine two-step
      microcytotoxic assay in NIH modification. Among 138 haplotypes, the following
      were significantly more frequent in affected children: HLA-A1-B8 (3116 x 10(4)),
      HLA-A3-B8 (290 x 10(4)) and HLA-A2-B8 (217 x 10(4)). Total frequency of
      haplotypes including HLA-B8 antigen in comparison to control population equalled
      3986 x 10(4) vs. 763 x 10(4). HLA-A1-B8 haplotype frequency was twice lower in
      probands' healthy siblings and parents, equalling 1837 x 10(4) and 1868 x 10(4),
      respectively. Highly significantly more frequent HLA-A1-B8 haplotype found in
      probands' families may indicate the correlation between inherited gene products
      and increased risk of coeliac disease incidence.

PMID- 11208334
TI  - Association of lipid metabolism with subclinical diabetic cardiomyopathy in
      children and adolescents with type 1 diabetes.
AB  - Nowadays, it is known that atherosclerosis is not a disease affecting elderly
      people but that it starts as early as in childhood. Children with diabetes
      mellitus are particularly prone to early development of atherosclerosis. It seems
      advisable to evaluate the behaviour of lipoprotein (a), apolipoprotein B
      (atherogenic factors), and apolipoprotein A-I in this group of patients as
      possible causal or preventive factors of the developing diabetic cardiomyopathy.
      The purpose of this study was to evaluate the effect of the intensification of
      lipid metabolism disorders on systolic-diastolic parameters of heart ventricles
      in children and adolescents with insulin-dependent diabetes mellitus. The study
      was performed on 19 children and adolescents (11 boys and 8 girls) at the age of
      8.4-18.5 (x = 14.2) who have had insulin-dependent diabetes mellitus for 1.5 to
      14 years (x = 7.9 years). Control group consisted of 17 healthy children. All
      patients were subjected to full echocardiographic examination which measured the
      systolic-diastolic activity of both heart ventricles, and to examinations
      determining the presence of complications (including the subclinical ones).
      Additionally, patients had their lipid metabolism parameters defined, i.e.:
      Lp(a), apo A-I, apo B, triglycerides, cholesterol and its LDL and HDL fractions.
      CONCLUSIONS: 1. Children and adolescents with type 1 diabetes mellitus have
      higher concentration of Lp(a) and apolipoprotein B irrespective of the degree of
      diabetes control, which makes them prone to premature development of
      atherosclerosis. 2. Lipid metabolism disorders do not have direct influence on
      the development of diabetic cardiomyopathy in young patients with type 1 diabetes
      mellitus.

PMID- 11208335
TI  - Gastroesophageal reflux in infants with food allergy.
AB  - The authors present results of studies in a group of 58 children aged 4-36 months
      in whom food allergy has been diagnosed. Esophageal 24-hour pH-metric studies
      revealed the presence of gastroesophageal reflux (GER) in 27 cases (46.5%). In 13
      cases it was primary and independent of the allergic disease, and in 14 children
      it showed features of secondary gastroesophageal reflux. Conservative treatment
      appeared ineffective more frequently in the group of infants with primary reflux
      (in 23.1% of cases) than in children with secondary reflux and food allergy (in
      7.1% of cases). In 4 infants fundoplication according to Nissen was performed.

PMID- 11208336
TI  - Plasma levels of sICAM-1 in patients affected by psoriasis: no relation to
      disease severity.
AB  - The aim of the study was to determine the plasma level of sICAM-1 in acute
      psoriatic patients in contrast to normal subjects. Moreover, we have tried to
      answer whether disease severity index (PASI) correlates with plasma level of
      sICAM-1. We have determined the plasma levels of sICAM-1 by ELISA (Genzyme
      Corporation) in 23 patients with acute psoriasis before and after the treatment
      of the disease and in 11 controls. Patients with acute psoriasis have displayed
      higher levels of sICAM-1 (306.4 +/- 226.8 ng/ml) compared with the controls
      (141.2 +/- 49.2 ng/ml) and the same patients after clearing of the disease (154.7
      +/- 126.7 ng/ml). We have not found any correlation between plasma levels of
      sICAM-1 and severity index of psoriasis (PASI). We have concluded: the plasma
      levels of sICAM-1 are not related to disease severity in acute psoriasis.
      Clearing of the psoriasis is followed by significant fall of plasma sICAM-1.

PMID- 11208337
TI  - Clinical and parasitological appraisal of patients with imported malaria.
AB  - The study group comprised 118 patients suspected of malaria who underwent an
      examination following their return to Poland from the tropical countries.
      Evaluation of the admitted patients was based on epidemiological, clinical and
      parasitological criteria. The obtained data allowed to confirm acute malaria in
      20 patients (16.9%) and malaria in the past, in 32 patients (27.1%). In the
      remaining 65 patients (55.1%) we excluded malaria. Malaria caused by P. vivax was
      confirmed in 5 patients, by P. falciparum in 9 patients. A mixed invasion was
      diagnosed in 6 patients including: P. falciparum and P. vivax in 3 cases; P.
      vivax, P. ovale and P. malariae in 2 cases; P. falciparum, P. vivax and P. ovale
      in 1 patient. We noted no relationship between the severity of the clinical
      course and IFA results. It was found an atypical clinical course of malaria and
      diagnostic difficulties in patients who used chemosuppression for malaria
      prophylaxis.

PMID- 11208338
TI  - Hepatitis C virus infection in hospitalized children.
AB  - AIM: The aim of the study was the estimation of the incidence of HCV infection
      and the analysis of risk factors for the infection in hospitalized children.
      MATERIAL AND METHODS: Retrospective analysis of the data of 1263 patients treated
      in hospital wards of Chair and Department of Gastroenterology and Paediatric
      Diseases from July 1995 to March 1998; all the patients had hepatitis C virus
      antibodies determined. Hepatitis C virus antibodies were assessed with the use of
      enzyme immunoassay. All the positive results were confirmed by means of Lia Tek
      HCV or PCR HCV RNA method. History data regarding frequency of previous
      hospitalizations, operations, blood transfusions and invasive diagnostic
      procedures patients had undergone were included in analysis. RESULTS: HCV
      infection was diagnosed in 47 children which accounted for 3.7% of the group
      enrolled in the study. The majority, that is 96.2% of seropositive children had
      the history of hospitalization, while 73.2% of them underwent intervention
      procedures disrupting tissue continuity during previous hospitalizations.
      Physical examination analysis indicates that all the patients with antibodies
      against HCV could have acquired the infection through parenteral transmission.
      The data indicating another route of transmission were not obtained (e.g.
      familial transmission). CONCLUSIONS: 1. Serological tests for HCV infection
      should be performed on routine basis in frequently hospitalized children. 2. HCV
      infection resulting from iatrogenic transmission can be suspected in the majority
      of seropositive children.

PMID- 11208339
TI  - Peptic ulcer disease before and after introduction of new drugs--a comparison
      from surgeon's point of view.
AB  - During the last twenty years we have witnessed a revolutionary change in
      treatment and diagnosis of peptic ulcer disease (PUD). It was introduction of
      flexible fiberoptic instruments and new drugs: H-2 blockers, proton pump
      inhibitors (PPI) and treatment against Helicobacter pylori which affected most
      significantly the course of this illness. Although indications for surgical
      intervention have not been changed, practice of surgery in this regard has
      changed a lot. In this report two periods of time were analyzed and compared:
      years 1977-81 and 1992-96. Operation reports from the above defined periods were
      reviewed and all surgeries performed for PUD and its complications have been
      noted along with data regarding patients and indications for surgery as reported
      by operating surgeons. There were 360 surgeries for PUD performed in the 1977
      1981 period, and 246 in the years 1992-1996. Patients were divided into groups
      depending on indications for surgery. A significant reduction in the general
      number of operations performed was noted. The percentage of women operated upon
      increased. The mean age of patients in all indication groups was higher in the
      latter period. Patients operated for bleeding tended to be older than those in
      perforation and intractable disease groups. This was true in both periods of
      time. The number and percentage of patients operated for perforation increased.
      The natural course of PUD is changing; intractable disease as an indication for
      surgery is disappearing, the number of pyloric obstruction patients is
      diminishing, the incidence of bleeding and perforation remains constant. The mean
      age of patients and percentage of women is increasing.

PMID- 11208340
TI  - Perforated peptic ulcer--time trends and patterns over 20 years.
AB  - There are contradictory reports in current world literature regarding incidence
      of perforated peptic ulcers and male to female ratio in recent years. Old
      concepts of seasonal periodicity are being questioned. In our report we analyze
      what is changing with regard to demographical data of patients affected,
      incidence of perforation of peptic ulcer and ulcer location. This article reviews
      441 consecutive cases of this complication of peptic ulcer disease (PUD) treated
      in our department between January of 1977 and December of 1996. The source of
      analyzed data are operative reports. Several observations regarding number, age
      and sex of patients affected and ulcer location have been made.

PMID- 11208341
TI  - Application of cytology in diagnosing benign changes and breast cancers.
AB  - On the basis of cytology performed in a group of 386 women and 14 men admitted to
      the Breast Disease Outpatient Unit in the area of Sucha Beskidzka, a structure of
      changes in breast benign and malignant neoplasms was defined. The diagnostic
      value of cytology based on FNB and a secretion from mammary glands were
      evaluated. Expression of p53 and nm23 protein expression in the cells of the most
      common cancers was studied for prognostic values. The study demonstrated 81% of
      benign changes and 19% of cancers. With respect to cancers, cytology confirmed
      its usefulness since the findings were compatible in 94.44% with histopathologic
      results. Moreover, application of proliferation markers (p53 and nm23) allowed to
      evaluate the degree of malignancy and prognosis for further neoplastic process.

PMID- 11208342
TI  - Pulmonary sarcoidosis in a patient with essential thrombocythemia treated with
      interferon alpha: a short case report.
AB  - A patient with essential thrombocythemia was diagnosed with pulmonary sarcoidosis
      after interferon alpha therapy. Following interferon treatment the miliary
      pulmonary dissemination has appeared and after disruption of this therapy it
      resolved during two months. Few cases of sarcoidosis associated with interferon
      alpha treatment have been reported. These patients were treated for chronic
      myelogenous leukemia, chronic hepatitis C, and renal cell carcinoma. We report
      the first case of interferon-related sarcoidosis in an essential thrombocythemia
      patient.

PMID- 11208343
TI  - Neurogenic tumors of the digestive tract: report of two cases.
AB  - We report two female patients with neurogenic tumors of the digestive tract. In
      the first patient, the tumor of 10 cm diameter originated in the stomach and at
      preoperative CT imitated a peripancreatic cyst. In the second patient, the tumor
      of 6 cm diameter originated in the duodenum. Despite large size, the tumors were
      clinically indolent and escaped detection at routine endoscopic evaluation. In
      both cases the neoplasm was removed and postoperative histopathology combined
      with immunohistochemistry was consistent with diagnosis of digestive Schwannoma.

PMID- 11208344
TI  - Paroxysmal atrial fibrillation in a young female patient following marijuana
      intoxication--a case report of possible association.
AB  - Marijuana is one of the most popular drugs legally admitted for general sale in
      many countries. To consider it safe and unlikely to develop drug dependence is
      abusive. The use of marijuana as a herbal medication is being widely discussed in
      literature. The most promising effect of delta-9-etrahydrocannabinol seems to be
      observed in the case of nausea, following cancer chemotherapy. Despite its
      positive action on the human organism, marijuana smoking has been shown to exert
      adverse effects on the cardiovascular system causing well-tolerated tachycardia
      and/or hypotension. We also observed that marijuana abuse was associated with an
      increased risk of paroxysmal atrial fibrillation. The report presents a case of
      young healthy white subject suffering from paroxysmal atrial fibrillation
      following marijuana intoxication. The abuse of this substance was the most
      possible and identifiable risk factor for observed paroxysmal atrial
      fibrillation.

PMID- 11208345
TI  - False aneurysms of the proximal anastomosis of the arterial prosthesis and the
      abdominal aorta.
AB  - Due to a false aneurysms of the aortic-prosthetic anastomosis ten patients aged
      42-74 years underwent surgery. In three patients, an aneurysm occurred twice. One
      was operated on after the aneurysm had ruptured. Six patients were treated for
      hypertension. In the course of the primary procedure, in six cases aortic
      bifemoral grafts were implanted, in four--an aortic-femoral, and in two aortic
      biiliac grafts were used. In six patients end-to-end anastomoses were performed,
      and in four--end-to-side. Surgical corrections due to the occurrence of a false
      aneurysm were performed 3 months to 10 years after the original surgery. On
      reoperation, purulent matter was found in the site of the prosthesis. In two
      patients, aortic-intestinal fistulas were detected, and in one--an aortic-cecal
      fistula. In six patients the anastomoses were totally separated. In the course of
      13 procedures performed in false aneurysms, five times replaced, single sutures
      were applied to the entire circumference of the anastomosis in four cases,
      including one case where an oblong patch was also used, in three cases an extra
      segment was sutured between the aorta and the previously implanted prosthesis,
      and the aneurysmal sac was filled with wire in one patient. Eight patients were
      reoperated, including three repeated procedures due to a false aneurysm of the
      proximal anastomosis. Moreover, the patency of prostheses was restored, abscesses
      were surgically opened and procedures were performed in the colon. Four patients
      have survived, including one with bilateral amputation of lower limbs. The most
      common cause of death was myocardial infarction. Two patients died due to massive
      hemorrhage, and one as a result of uremia.

PMID- 11208346
TI  - Endometrial cancer in patients with breast carcinoma treated with tamoxifen:
      report of two cases and the literature overview.
AB  - Tamoxifen (TAM) is the endocrine treatment of choice in the first-line therapy
      for all stages of breast cancer, in both pre- and postmenopausal women. Some
      clinical studies indicated a small but significant increase in the risk of
      subsequent endometrial carcinoma in breast cancer women who take TAM as an
      adjuvant therapy. In this study, we present two cases of breast cancer patients
      in whom endometrial cancer was diagnosed during TAM treatment; the current status
      of knowledge on the relationship between TAM use and the risk of endometrial
      cancer is reviewed.

PMID- 11208347
TI  - Thermographic assessment of stellate ganglion block effectiveness during
      cardiosurgical procedures.
AB  - The study present thermographic assessment of the effectiveness of temporary
      stellate blockade performed during cardiosurgical procedures. The assumption
      behind this method was the increase in the temperature of upper extremity on the
      side of blockade, due to the broadening of arterial bed. MATERIAL AND METHOD: The
      study was conducted on a group of 30 patients (21 men and 9 women) operated due
      to coronary disease involving three vessels. Mean age of the patients was 53
      years. After introduction of anaesthesia blockade were performed with 2 ml 2%
      lignocainum and 8 ml 0.5% bupivacaine solution using peratracheal approach.
      Blockade effectiveness was assessed on the basis of images obtained in
      thermovisual camera, comparing the temperatures of upper extremity before and
      within 15 minutes after performing the blockade. Free blood outflow from radial
      artery, its diameter and length were also evaluated. The results obtained were
      subject to statistical analysis. RESULTS: Twenty-three patients (76.6%) displayed
      the increase in the temperature of upper extremity by 1-3 degrees C. Free blood
      outflow from radial artery was greater in this group than in the remaining
      patients. CONCLUSIONS: Thermography is a useful method for the assessment of
      stellate blockade effectiveness. Effective blockade results in the increased
      blood flow in radial artery.

PMID- 11208348
TI  - Anthracycline-induced cardiotoxicity: clinical course, risk factors,
      pathogenesis, detection and prevention--review of the literature.
AB  - Anthracycline antibiotics are widely used antineoplastic agents and their
      efficacy for the treatment of various haemopoietic or solid tumours has been well
      established in clinical practice. Cardiotoxicity is one of the most serious side
      effects of anthracyclines. The risk of cumulative, life-threatening toxic
      cardiomyopathy limits their therapeutic potential. In this article, acute,
      subacute, chronic and late-onset cardiac function impairment associated with
      anthracycline administration has been characterised. The current views on the
      methods of detection, pathogenesis and prevention of such toxicity have been
      reviewed.

PMID- 11208349
TI  - Myeloproliferative disorders--neurological complications.
AB  - Primary myeloproliferative disorders (MPD) are often associated with hemostasis
      abnormalities, which may cause many thrombotic or hemorrhagic complications
      during the course of the disease. Clinical consequences following abnormal
      hemostatic conditions include various neurological manifestations. It is
      extremely difficult to predict and evaluate the risk and chance, that MPD
      patients will develop neurological symptoms. The up-to-date background of
      pathological thrombocytosis, as well as the neurological aspects of abnormal
      hemostasis during the course of myeloproliferative disorders have been reviewed
      in this study.

PMID- 11208350
TI  - Head trauma and neuroprotection.
AB  - Traumatic brain injury is a serious clinical problem connected with high
      mortality rate and long-term neurobehavioral and socioeconomic consequences.
      Pathomechanism of such insult is complex and not clear in all aspects as yet.
      Thus, a primary mechanistic insult to the brain initiates metabolic and
      inflammatory processes which exacerbate the primary traumatic injury to neurons,
      leading to secondary brain damage. In this paper we present the main components
      of destructive cascade with relevant theoretical strategy for neuroprotection. It
      should be emphasized that pathological processes involved in secondary brain
      damage are complex and interrelated. It makes blockade of a single mechanism
      unlikely to prevent either early or delayed cellular death.

PMID- 11208351
TI  - Androgens and androgen receptor: do they play a role in breast cancer?
AB  - Although the role of androgens and AR in breast cancer genesis, development of
      breast cancer and tumor responsiveness to endocrine therapies is poorly
      understood, the widespread expression of AR suggests that it may be of biological
      and clinical importance in human breast cancer.

PMID- 11208352
TI  - Experimental model of hepatic venoocclusive disease (VOD) caused by dactinomycin-
      preliminary report about hepatoprotective effect of amifostine.
AB  - The purpose of the study was elaboration of the experimental model of hepatic
      venoocclusive disease (VOD) induced by dactinomycin and investigation of possible
      hepatoprotective effects of amifostine and heparin individually or in combination
      with dexamethasone. 198 Wistar strain male rats were used in the trial in two
      series of experiments. In the first series the experimental model of VOD induced
      by dactinomycin was elaborated on the group of 18 animals (divided into 3 groups
      receiving intraperitoneally isotonic salt solution, dactinomycin or nitrosamine).
      Nitrosamine--a well-known agent causing VOD--was used as positive control. Open
      biopsies of the liver and blood collections were repeated in order to determine
      liver enzymes' concentrations. Histopathological examinations demonstrated that
      dactinomycin caused liver lesion corresponding with VOD picture. Second series of
      animals was divided into 6 groups receiving the following drugs: I--0.9% NaCl
      solution, II--dactinomycin (ACT), III--ACT + fraxiparine s.c., IV--ACT +
      fraxiparine + dexamethasone, V--ACT + amifostine. Five animals from each group
      were sacrificed on the 3rd and 7th day after each cycle of drug administration.
      Blood was drawn in order to determine the following: AspAT, AlAT, Falk, GGTP and
      LDH. Intravital wedge biopsies under anesthesia with the use of inactin were also
      performed. Liver samples were stained with the use of H&E, p. a. S and Gomory's
      techniques. We did not find significant differences in liver enzymes' levels
      between the groups. Pathological changes corresponding with VOD picture of
      different intensification were found in liver samples from all the rats receiving
      ACT. Changes became more and more intensive after consecutive cycles. Lesion of
      central veins' and liver sinusoids' endothelium dominated. Fraxiparine
      administered individually or in combination with dexamethasone did not prevent
      the lesion. Administration of amifostine before ACT decreased pathomorphological
      changes in liver. Dactinomycin caused homogenous subclinical liver lesion
      corresponding with VOD. It may also occur in children receiving ACT in the course
      of nephroblastoma's treatment. But probably the changes are too subtle to
      manifest themselves clinically with exception of patients particularly sensitive
      (for example after previous radiotherapy). Lack of differences observed in liver
      enzymes' levels between the groups supports the explanation. Markers of lesion of
      liver vessels' endothelium should be looked for to make more specific diagnostics
      of VOD possible. Hepatoprotective properties of amifostine need further studies.
      CONCLUSIONS: 1. It is possible to create the experimental model of VOD induced by
      dactinomycin administration. 2. Amifostine seems to act hepatoprotectively to
      liver lesions caused by dactinomycin.

PMID- 11208353
TI  - Stimulation by nitric oxide of HCO3- secretion in bullfrog duodenum in vitro-
      roles of cyclooxygenase-1 and prostaglandins.
AB  - The effect of nitric oxide (NO) on HCO3- secretion was examined in vitro using
      the isolated preparation of bullfrog duodenum, in relation to cyclooxygenase
      (COX) isozymes and endogenous prostaglandins (PGs). The tissue was bathed in
      unbuffered Ringer solution gassed with 100% O2 on the mucosal side and HCO3-
      Ringer's solution gassed with 95% O2-5% CO2 on the serosal side. The HCO3-
      secretion was measured by a pH-stat method using 10 mM HCl as the titrant to keep
      the mucosal pH at 7.4. NOR-3 [(+/-)-(E)-Ethyl-2-[(E)-hydroxyimino]-5-nitro-3
      hexenamine] was used as a NO donor and added to the serosal solution. To analyze
      the NOR-3 action, the effects of dibutyryl guanosine-3', 5'-cyclic monophosphate
      (dbcGMP), methylene blue, indomethacin (nonselective COX-inhibitor) and NS-398
      (selective COX-2 inhibitor) on the HCO3- response were also examined. NOR-3 (1 x
      10(-4) and 3 x 10(-4) M) caused an increase of HCO3- secretion in a dose
      dependent manner, reaching the level of 2.5 times greater than basal values at 2
      hr later. Likewise, dbcGMP (1 x 10(-3) M) also caused a significant increase of
      the duodenal HCO3- secretion. The HCO3- stimulatory action of NOR-3 was
      significantly attenuated by methylene blue (5 x 10(-5) M) and indomethacin (1 x
      10(-5) M) but not by NS-398 (1 x 10(-5) M), and indomethacin also suppressed the
      HCO3- response to dbcGMP. The serosal release of PGE2 was significantly increased
      by both NOR-3 and dbcGMP, and these responses were inhibited by indomethacin but
      not NS-398. These results suggest that NO increases HCO3- secretion in Bullfrog
      duodenum in vitro, and this action is dependent on cGMP-related COX-1 activation
      and mediated by PGs.

PMID- 11208354
TI  - Catalytic heterogenity of polyclonal RNA-hydrolyzing IgM from sera of patients
      with lupus erythematosus.
AB  - Various catalytically active IgG antibodies or abzymes have been detected
      recently in the sera of patients with several autoimmune pathologies including
      systemic lupus erythematosus (SLE), where their presence is most probably
      associated with autoimmunization. Here we show for the first time that IgM from
      peripheral blood of patients with SLE possesses both DNase and RNase activities:
      these activities were also present in Fab fragments of the IgM. Both specific
      enzymic activities of IgM from sera of any single patient are usually 5-10 times
      higher than those of IgG antibodies. The same preparations of IgM hydrolyze RNA
      about two order of magnitude faster than DNA. The properties of the RNases of IgM
      and IgG distinguished them from other known pancreatic and human sera RNases. In
      addition, the specific activities of the RNase activity of polyclonal IgM with
      the polymer substrates [RNA > poly(U) > or = poly(A) >> poly(C)], the observed
      range of optimal pHs, of apparent Km values for substrates and of substrate
      specificities varied very much for different patients. The findings speak in
      favor of the generation of a relatively small or an extremely large pool of
      polyclonal catalytic IgM by the immune system of individual patients.

PMID- 11208355
TI  - Effect of melatonin on two stage skin carcinogenesis in Swiss mice.
AB  - Melatonin, a hormone secreted by the pineal gland, is known to have anti
      mutagenic and oncostatic actions. This beneficial action of melatonin has been
      explained in terms of its ability to scavenge free radicals and augment the
      activities of anti-oxidant enzymes. In the present study, we evaluated the effect
      of melatonin on benzo(a)pyrene-induced two stage skin carcinogenesis in mice and
      observed that it can not only decrease the number of animals bearing papillomas
      but also the number of papillomas per animal both in the initiation and promotion
      stages of skin carcinogenesis. It was also found that melatonin treated animals
      have low levels of lipid peroxides and that it can also prevent the binding of BP
      or its metabolites to DNA. In view of these evidence, it can be suggested that
      melatonin may function as an endogenous anti-mutagenic and oncostatic agent.

PMID- 11208356
TI  - Changes in abdominal wall after mesh implantation in rats.
AB  - On an incisional hernia model, we evaluated tissue reactions to three types of
      non-absorbable foreign materials, Prolene, Gore-Tex and flax, used for covering
      defects of the abdominal wall muscles in Wistar strain rats. The examinations
      were carried out in five 14-days intervals between the 35th and 91st days after
      the intervention. Our results with Gore-Tex showed the lowest tissue response,
      the lowest inflammatory cellular as well as fibroplastic reaction, it also
      completely covers the artificially made wall defect and induces no considerable
      peritoneal adhesion. In defects filled with Prolene mesh, we also observed no
      considerable cellular response and scarring. However, considerable peritoneal
      adhesions were found and the defect was filled to a great extent with lipidic
      tissue with irregularly distributed Prolene fibres. The use of flax material is
      least suitable since it induces extensive inflammatory reactions, which occur
      even after a very long time after the operation. Prolene was, as a matter of
      fact, second to Gore-Tex in the experimental evaluation of the biological
      tolerance. However, with respect to its ten times lower price, it can be
      recommended as a material of the first choice for covering defects of the
      abdominal wall in clinical use.

PMID- 11208357
TI  - Nitric oxide increases gene expression of Ca(2+)-ATPase in myocardial and
      skeletal muscle sarcoplasmic reticulum: physiological implications.
AB  - The aim of the study was to verify the hypothesis that NO-dependent regulation of
      sarcoplasmic reticulum Ca(2+)-ATPase (SERCA) gene expression can play an
      important role in prevention of calcium overload under the influence of
      detrimental factors. It was shown that 2 hours after the administration of the NO
      donor dinitrosyl iron complex (DNIC), the gene expression of myocardial SERCA was
      increased by 20% as compared to the control. In skeletal muscles, the maximum
      increase in SERCA expression was observed in 6 hours and amounted to 156% as
      compared with the initial value. Simultaneously DNIC enhanced the resistance of
      isolated heart and the organism as a whole to damaging effects of intracellular
      calcium overload induced by post-ischemic reperfusion or vigorous exercise,
      respectively. The results obtained confirm the existence of NO-dependent
      activation of SERCA expression and the important role of this mechanism in
      restriction of calcium overload.

PMID- 11208358
TI  - Effect of the ligation of spleen neurovascular pedicle on the morphology of
      hemolymph splenic nodes in Wistar rats.
AB  - Macro- and microscopic structure of hemolymph splenic nodes after ligature of
      spleen neurovascular pedicle was evaluated in 12 Wistar rats. The results
      obtained were compared with the nodes of the control group. It was found that
      spleen neurovascular pedicle ligation without removing the organ from abdominal
      cavity results in the enlargement of examined nodes and a change in their color
      intensity. Histological examination revealed considerable increase in erythroid
      elements filling mainly the medullary part of the node. The spleen underwent
      total atrophy. Retrogressive changes, typical for single-organ nodes were not
      observed. Non-hemolymph mesenteric nodes did not show any macroscopic
      compensatory changes.

PMID- 11208359
TI  - An attempt to assess the central action of captopril and enalaprilat.
AB  - The influence of captopril and enalaprilat on central nervous system in
      laboratory animals has been studied. The effects of the drugs on duration of
      ethanol (4 g/kg i.p.) and thiopental (70 mg/kg i.p.) induced sleep, body
      temperature, spontaneous locomotor activity and analgesic properties (hot plate
      and tail-flick test) have been investigated in mice. Captopril (5 and 20 mg/kg
      i.p.) and enalaprilat (5 and 20 mg/kg i.p.) were used in single administration or
      repeated one for 10 days. Moreover, pharmaco-EEG profile of captopril and
      enalaprilat in rabbits has been studied. We have shown that single administration
      of captopril (both doses) and single or prolonged administration of enalaprilat
      decreased the duration of ethanol and thiopental-induced sleep. Captopril (5
      mg/kg) and enalaprilat (5 and 20 mg/kg) increased pain threshold. Both studied
      drugs after their single or repeated administration did not influence spontaneous
      locomotor activity in mice. Captopril and enalaprilat decrease body temperature
      in mice. Examined ACEIs produce changes in EEG recording, more profoundly
      exhibited after administration of enalaprilat.

PMID- 11208360
TI  - Antitumor effect of electrochemical therapy on transplantable mouse cancers.
AB  - The aim of our study was to assess the antitumor effect of electrochemical
      therapy (ECT) in the mice bearing advanced transplantable tumours. Mouse mammary
      cancer 16/C (group 1) and fibrosarcoma F69-3 (group 2) were transplanted
      subcutaneously (s.c.) into the C3H or BALB/c mice, respectively. Twenty animals
      in each group bearing measurable s.c. tumours were randomly divided into two
      subgroups (experimental and control). Two electrodes were inserted into tumours
      and low level direct current (6-7 V, 5-21 mA) was passed. The animals were
      observed and tumors were measured twice a week. The animals were sacrificed and
      autopsied when the tumor diameter reached 2.0 cm. Two animals of each group
      (experimental and control) were sacrificed for histopathological tumor
      examination on the 1st and 6th day after ECT. A significant inhibition of tumor
      growth in mice subjected to ECT was observed, both in those with s.c. growing
      mammary cancer and with fibrosarcoma. This inhibition was associated with marked
      prolongation of survival time of ECT-treated mice. It appeared that the mice with
      mammary cancers were more susceptible to ECT therapy than those with growing s.c.
      fibrosarcoma. The histopathological studies of tumor specimens from ECT-treated
      mice showed extensive foci of necrosis with shrinkage of cell nuclei deprived of
      chromatin. In conclusion, the treatment which inhibits the growth of experimental
      mammary and fibrosarcoma tumors was demonstrated. However, in no mice complete
      regression of tumours was observed.

PMID- 11208361
TI  - Insertion/deletion polymorphism in the angiotensin-converting enzyme gene in
      myocardial infarction survivors.
AB  - INTRODUCTION: Insertion/deletion (I/D) polymorphism of the angiotensin-converting
      enzyme (ACE) gene influenced the plasma concentration of the ACE, and is D allele
      have been repetitively suggested as a risk factor for myocardial infarction (MI).
      MATERIAL AND METHODS: Two hundert thirty six male myocardial infarction survivors
      under 65 years and with body mass index and total plasma cholesterol levels under
      95% of the Czech population were included in the study. As control group, 302
      male controls (1% randomly selected group from the Czech population) were
      genotyped. I/D polymorphism in the ACE gene was determined using polymerase chain
      reaction. RESULTS: The prevalence of the I/I, I/D and D/D genotypes was 0.218,
      0.494 and 0.288, in the control group, and 0.178, 0.538 and 0.284, in the
      myocardial survivors, respectively. The male Czech population has the similar
      frequency of insertion and deletion alleles compared to other Caucasian
      populations. The frequencies of the alleles and genotypes of the ACE gene did not
      differ significantly between MI survivors and a control sample of the Czech
      population. CONCLUSION: It was shown that the I/D polymorphism in the gene for
      ACE is not a genetic risk factor for myocardial infarction in the Czech
      population.

PMID- 11208362
TI  - Plasma HDL-cholesterol has an effect on nitric oxide production and arachidonic
      acid metabolism in the platelet membranes of coronary heart disease patients
      without LDL-hypercholesterolemia.
AB  - AIM: To evaluate nitric oxide (NO) production and [3H]arachidonic acid (AA)
      incorporation into platelet membranes of coronary artery disease (CAD) patients
      with/without HDL-hypocholesterolemia. MATERIAL: 16 healthy controls (C), 14 CAD
      patients with plasma HDL-hypocholesterolemia (nCAD) and 14--without HDL
      hypocholesterolemia (nCAD). All subjects were without peripheral vascular disease
      and hypertension. The groups were matched for age, sex, BMI. The diagnosis of CAD
      was substantiated by coronary angiography. METHODS: Nitric oxide end products xNO
      (NO2- plus NO3-) levels in the platelet membranes were measured using anion
      exchange chromatography. [3H]AA release from labelled platelets was studied by
      the method of Neufeld and Majerus; radioactivity was measured by liquid
      scintillation counting. Levels of plasma HDL-cholesterol (HDL-Ch) and
      triglycerides were enzymatically determined. RESULTS: Significant increase (mean
      +/- SD; Mann-Whitney U test) of [3H]AA incorporation into platelet membrane
      phospholipids was noted in CAD patients in comparison with healthy subjects (p <
      0.001). A correlation (multiple regression analysis) was established between HDL
      C level and [3H]AA (r = -0.58, p < 0.05, n = 28); and between HDL-Ch and NOx
      levels (r = 0.76, p < 0.05, n = 28) in CAD patients. CAD patients had lower NOx
      than healthy subjects (p < 0.0001), NOx was lower in the group with decreased HDL
      Ch concentration (wCAD 36 +/- 5 vs. nCAD 42.3 +/- 6 mumol/mg, p < 0.002).
      CONCLUSIONS: CAD patients show decreased ability to produce platelet-derived NO
      that leads to higher platelet sensitivity to aggregating stimuli. Decreased
      plasma HDL-Ch may affect AA metabolism and NO production in the platelet
      membranes of CAD patients without LDL-hypercholesterolemia.

PMID- 11208363
TI  - High-dose anthracyclines in the treatment of advanced primitive neuroectodermal
      tumors in adults--a single institution experience.
AB  - Primitive neuroectodermal tumors (PNET) are rare malignancies of presumed neural
      crest origin, most often presenting as bone or soft tissue masses in the trunk or
      axial skeleton, in children and young adults. Treatment of advanced PNET in
      adults is not clearly defined in the literature. Data concerning dose-intensive
      chemotherapy regimens for poor-risk patients with those tumors are sparse, due to
      rarity of PNET in adults, their diverse presentation, the variable treatment
      procedures applied and the absence of direct comparisons. On the other hand, the
      role of anthracyclines in the treatment of advanced soft tissue sarcomas is well
      known and substantial. Six advanced PNET patients were treated at the Institute
      for Oncology and Radiology of Serbia, during last five years, with high-doses of
      doxorubicin or epidoxorubicin combined with cisplatin. The paper reviews each of
      our patients, discussing how does chemotherapy influence the outcome in these
      patients, in context of the feasibility of high-doses of anthracyclines in
      advanced settings. High dose anthracyclines (epidoxorubicin 150 mg/m2) in
      combination with cisplatin 120 mg/m2 induced a complete response lasting for 63+
      months in a patient with desmoplastic medulloblastoma of the cerebellum
      metastatic to bones and bone marrow. The same treatment but with the
      epidoxorubicin dose of 180 mg/m2 induced a complete response in a patient with
      olfactory neuroblastoma. Administration of high dose Doxorubicin (75 mg/m2) seems
      feasible in association with irradiation treatment in patients with extraosseal
      Ewing sarcoma/PNET but the place of high dose chemotherapy within this setting
      remains to be determined.

PMID- 11208364
TI  - Antenatal care: some characteristics of the booking visit in a major teaching
      hospital in the developing world.
AB  - BACKGROUND: The first (booking) visit is a very important component of antenatal
      care as service providers use the occasion to collect basic medical information
      that will form the basis to care for the patient throughout pregnancy. The study
      was undertaken to establish the socio-demographic characteristics of the patients
      booking at the UBTH, and determine areas where changes could be made to improve
      service uptake. MATERIAL AND METHODS: Between the months of February and August
      1998, 378 consecutive pregnant women initiating antenatal care were interviewed
      using a structured questionnaire. RESULTS: The majorities (52.1%) of the patients
      were middle class, while 87.5% have a secondary or tertiary education. The mean
      age of the mothers was 29.7 years, and a mean parity of 1.3. Primigravidae
      constituted 32.0% of the patients; the number of mothers booking declined with
      increasing parity. The mean gestational age at booking was 23.7 weeks. The sixth
      month was the peak period for the initiation of antenatal care. The decision to
      attend UBTH for antenatal care was taken by the husband alone in 52% of the
      cases. Late booking because of ignorance and financial constraints was observed
      in 41.5% and 25% of the patients respectively. CONCLUSION: Patients attending
      UBTH are educated and of low parity. Initiation of antenatal care is late due to
      ignorance and financial constraints. Male dominance influences patients' adequate
      utilisation of antenatal services. Provision for the expectant fathers to attend
      maternity care activities will improve service uptake.

PMID- 11208366
TI  - Correlation between Helicobacter pylori infection and food allergy in chronic
      gastritis.
AB  - The purpose of this study was to evaluate the intensity of gastric inflammatory
      changes in atopic patients infected with H. pylori, and to find out whether a
      long-term exposure to a sensitizing allergen intensified the acuteness of
      inflammatory changes. The examinations were performed on patients with atopic
      diathesis who suffered from dyspepsia and gastralgia. The examined group included
      72 women between 16 and 57 years of age (mean age: 36.5 years) and 38 men from 16
      to 60 years of age (mean age: 34.4 years). The control group included 40 patients
      with no traits of atopy (13 men and 27 women between 18 and 56 years old, mean
      age: 34.8 years) with chronic gastritis confirmed by endoscopic and
      histopathological tests. All patients were subjected to endoscopy of the upper
      alimentary tract. Biopsy specimens were taken for histopathological analyses.
      They were stained with eosin and hematoxylin (the H&E method), and with a
      modified Giemsa method. The evaluation included the presence of chronic
      inflammation of gastric mucosa, its activity and intensity. The presence of H.
      pylori colonization was determined with the use of histopathological method of
      staining. Significant differences were found concerning inflammation intensity in
      atopic patients additionally infected with H. pylori, in comparison with the
      group of patients with food allergy without bacterial colonization. The
      differences were found during the evaluation of mucosa of both the prepyloric
      area and body of the stomach (p < 0.001). Moreover, statistically significant
      differences were found in the inflammation intensity between the examined group
      and the control group with no symptoms of allergy. In atopic patients infected
      with Helicobacter pylori, a long-term exposure to food allergens increases the
      intensity of gastric mucosa inflammation.

PMID- 11208365
TI  - Angiotensin II type 1 receptor gene A1166C polymorphism is associated with the
      increased risk of pregnancy-induced hypertension.
AB  - OBJECTIVE: The aim of our study was to evaluate the relation of parental history
      of hypertension to the development of PIH, and to assess the potential role of
      plausible candidate loci in the susceptibility to PIH. STUDY DESIGN: Five
      polymorphisms: ACE gene I/D and Pst1 RFLP polymorphism, AGT gene M235T
      polymorphism, AGTR1 gene A1166C polymorphism, and chymase gene CMA/B polymorphism
      were studied in 126 women suffering from PIH in comparison with 150 healthy
      pregnant women. Genotyping was performed using methods based on polymerase chain
      reaction. RESULTS: Among the PIH patients, positive parental history of
      hypertension (hypertension in both parents, in mother alone or in father alone)
      was significantly more frequent than in healthy pregnant women. Having a
      hypertensive father or mother statistically significantly increased the risk of
      PIH (odds ratio 4.34, 95% CI, 1.86-10.13, and 2.33, 95% CI, 1.29-4.12
      respectively). CC genotype was significantly more frequent in women with PIH as
      compared with healthy controls and the C allele frequency was also significantly
      higher among the cases compared to controls. Having a CC genotype increased the
      risk of development of PIH 2.74 times (95% CI, 1.08-6.97). We observed no
      significant differences in genotype distributions or the allele frequencies of
      other examined polymorphisms. CONCLUSION: On the basis of the results of our
      study, we may suggest that AGTR1 gene A1166C polymorphism may predispose women to
      the development of PIH. It seems that ACE gene I/D and Pst1 RFLP polymorphism,
      AGT gene M235T polymorphism, and finally chymase gene CMA/B polymorphism do not
      play any significant role in the pathogenesis of PIH in Caucasian women.

PMID- 11208368
TI  - Various types of cholestatic jaundice in infants--causes and diagnostic problems.
AB  - The purpose of this review was to evaluate possible differentiation between
      various causes of different types of cholestatic jaundice in children. Analyses
      were performed in 33 infants from 3 weeks to 3.5 years old with symptoms of
      cholestatic jaundice. The most frequent causes of cholestasis were congenital
      atresia of extrahepatic bile ducts (30%) and the CMV infection (20%). On the
      basis of the performed examinations it should be concluded that in order to
      differentiate between the causes of cholestatic jaundice it is necessary to do a
      series of tests as there is no specific diagnostic method which would be
      effective.

PMID- 11208369
TI  - Multisensory principle of heart rate regulation.
AB  - We analyzed metabolic parameters during exercise in two groups of patients with
      implanted dual sensor VVIR. The first group was comprised of 14 patients (mean
      age 37.7 years) with implanted Topaz pacemakers and the second of 9 patients with
      a Legend Plus pacemaker (mean age 44.7 years). A control group consisted of 54
      healthy individuals (mean age 40.4 years). Testing was performed on treadmill,
      using a stepwise staircase loading CAEP protocol. The following directly measured
      and mathematically calculated parameters we used in assessing the metabolic
      impact of pacemaker function: minute ventilation (MV), MV/body surface, MV/body
      mass unit, oxygen consumption, oxygen consumption/body surface, oxygen
      consumption/heart rate (oxygen pulse), oxygen consumption/body mass unit, carbon
      dioxide production, respiratory index. For the majority of the observed
      parameters statistically significant difference was not found between the control
      group and the patients with dual sensor nor single sensor controlled rate
      response. However, oxygen pulse showed a statistically significant difference
      when comparing the group with single sensor controlled rate response with dual
      sensor controlled rate response as well as to the control group (p < 0.05). Also,
      the time of reaching the anaerobic threshold, as well as the duration of the
      exercise test were significantly longer in dual sensor guided rate. Since these
      pacemakers are particularly aimed at a population of still active patients, this
      finding confirms their contribution to the better quality of life and justifies
      their use in these patients.

PMID- 11208367
TI  - Levels of serum total cholesterol and LDL-cholesterol in patients with major
      depression in acute period and remission.
AB  - The aim of the study was to determine the level of total cholesterol and LDL
      cholesterol in blood samples taken from 102 patients with recurrent major
      depression (according to DSM-IV). The analysis was performed during the acute
      period of major depression in 3 subgroups: with and without suicidal ideation
      (S+, S-), and after suicidal attempts (AS), and during remission of depressive
      symptoms. Putative correlations between the level of total cholesterol and
      severity of depressive symptoms and between total serum cholesterol and LDL
      cholesterol and suicidal risk were evaluated. The patients did not suffer from
      any additional disorders, factors such as specific diet or pharmacotherapy, which
      could influence the levels of lipids, were absent. The subgroups were identified
      using clinical evaluation, medical records and Hamilton Depression Rating Scale-
      HAMD-S as well as a subscale of MMPI-DMS. Biochemical analyses were performed
      twice in all patients, in the acute period, before pharmacotherapy and after
      effective pharmacotherapy, in remission. The following parameters were evaluated:
      total serum cholesterol and LDL-cholesterol, T3, T4, TSH, ALT, AST, proteinogram.
      In all depressed patients with acute depression symptoms, low levels of total
      cholesterol and LDL-cholesterol were shown. The level of total cholesterol 160
      mg/dl or less and the level of LDL-cholesterol 100 mg/dl or less were observed in
      persons with suicidal behavior only (S+ and AS). Low total cholesterol and LDL
      cholesterol levels in persons in the acute period of major depression provided a
      useful parameter of suicide risk. A significant statistical correlation between
      the low level of total cholesterol and suicidal ideation was also found (r =
      0.82, p < 0.05) as well as between the low level of serum total cholesterol and
      severity of depression, as evaluated by HAMD-S (r = 0.27, p < 0.05). During the
      remission of depressive symptoms, total cholesterol level and LDL-cholesterol
      increased significantly (p < 0.05) but a significant difference (p < 0.05)
      between subgroups (S-, S+, AS) were still observed. Low total cholesterol and LDL
      cholesterol levels in remission in persons with the diagnosis of recurrent major
      depression may help to estimate the risk of suicidal behavior in the next
      depressive disorder. Possibly, low level of serum total cholesterol is a stable
      feature in some persons with recurrent major depression, probably dependent on
      their predisposition to autoaggression and presence of depressive disorder.

PMID- 11208370
TI  - General anaesthesia for laparascopic adrenalectomy.
AB  - Surgical treatment of adrenal disorders is increasingly performed under
      laparascopic approach. Both pneumoperitoneum and adrenal tumour manipulation may
      induce haemodynamic variations. The aim of this study was to compare the
      inhalational and intravenous anaesthetic management for laparascopic
      adrenalectomy. Between 1977 and 1999 there were performed 28 laparascopic
      adrenalectomies. At patients with functioning adenoma and hypertension the
      anaesthesia was maintained with isoflurane in 8 cases and sevoflurane in 6 cases,
      et 14 patients with non-functioning adrenal masses with propofol and fentanyl
      (TIVA). In addition to the circulatory and respiratory monitoring there were made
      serial laboratory determinations (acid-base state, serum potassium, blood
      glucose) during the operation. On the basis of measured parameters isoflurane and
      sevoflurane anaesthesia proved to be favourable in case of functioning adrenal
      adenoma and TIVA with propofol and fentanyl in case of non-functioning adenoma.

PMID- 11208371
TI  - Effect of surgical technique in subtotal and bilateral thyroidectomy on risk of
      postoperative parathyroid insufficiency development--our experience.
AB  - One of the postoperative complications after strumectomy is hypoparathyroidism.
      Therefore, the purpose of our study was to evaluate the effect of the surgical
      technique on the development of parathyroid gland insufficiency in our group of
      patients. Subtotal, bilateral strumectomies were performed according to
      Rothmund's suggestions. Randomized controlled trial was performed in two groups.
      In the first group of 19 patients, main trunk of the inferior thyroid artery was
      ligated and in the second one consisting of 18 patients, only the branches of
      this artery were ligated. Total calcium and PTH levels were evaluated pre- and
      postoperatively. Based on the biochemical and clinical data, no statistically
      significant differences in the development of postoperative hypoparathyroidism in
      relation to performed surgical techniques were observed.

PMID- 11208372
TI  - Evaluation of selected cytokines and mononuclear cell infiltration in gastric
      mucosa of children with food allergy.
AB  - The authors performed simultaneous evaluation of histological changes in gastric
      and duodenal mucosa, phenotypic evaluation of mononuclear cells infiltration and
      the levels of selected cytokines of gastric mucosa in children with diagnosed
      food allergy. It was determined that IL-4, IL-5, IL-10 and TNF-alpha were
      produced locally within alimentary tract mucosa; they may play pathogenic role in
      food hypersensitivity in children. Increase in the number of T lymphocytes (CD3+,
      CD8+) and B lymphocytes (CD20+) as well as mastocytes with positive reaction to
      Mast Cell Tryptase-Mastocyte antibody was also observed in gastric and duodenal
      mucosa of these patients.

PMID- 11208373
TI  - Increased trend of type 1 diabetes mellitus in children's population (0-14 years)
      in Upper Silesia region (Poland).
AB  - THE PURPOSE OF THE STUDY was to provide current and reliable information about
      trends in the incidence rates of Type 1 Diabetes in the Upper Silesia region in
      children aged 0-15 years in the period of 9 years. RESULTS: Incidence ratio in
      the examined population increased from 4.71 in 1989 up to 10.16/100,000/year in
      1997. In the analysed group no significant statistical differences dependent on
      sex were found. During the examined period, the incidence ratio has increased
      significantly. It was observed that the extent of change varied in different age
      groups. The youngest children (0-4 years old) showed the greatest increase of the
      incidence ratio from 1.09/10(5) in 1989 up to 6.75/10(5) in 1997. The highest
      incidence ratio was observed in the group of 10-14 year-olds. CONCLUSIONS: In the
      examined period dramatic increase (more than 200%) of the incidence ratio of type
      1 diabetes was reported in the children's population (0-14 year-olds) in Upper
      Silesia. The fastest increase in this ratio was established in the group of
      youngest children (0-4 years old).

PMID- 11208374
TI  - Interstitial 6q duplication in an adult male without growth delay or severe
      mental retardation.
AB  - We report on a 28 year-old male with peculiar facies, distal joint contractures
      and other multiple congenital anomalies. Cytogenetic analysis by G banding
      revealed a distal tandem interstitial duplication of the long arm of chromosome
      q6, dup.(6)(6q24.2-->q26). This chromosome abnormality was confirmed by
      fluorescence in situ hybridization with total chromosome 6 painting. This is
      probably the second documented case of 6q duplication without growth retardation
      or severe psychomotor retardation. The clinical findings in our patient are
      similar to that of whistling face syndrome (WFS) and, in fact, he was diagnosed
      with WFS as a child. The literature were reviewed and the phenotypic features of
      this patient were compared with those previously reported for both duplication 6q
      and whistling face syndromes. There is a significant overlap between the
      phenotypes of these two syndromes. Careful evaluation of the terminal end of the
      6q in cases suggestive of WFS might be warranted.

PMID- 11208375
TI  - Recurrent autoimmune LKM hepatitis with multiple relapses.
AB  - We describe three females who since childhood and puberty have presented with
      several relapsing episodes of acute or chronic LKM positive hepatitis. Many
      episodes resolved spontaneously with recovery of normal liver function, although
      treatment with steroids, steroids/azathioprine was used at occasions. No clear
      pattern of precipitating factors has emerged though in some cases possible
      temporal relationship of episodes to menarche, oral contraceptives use or
      pregnancy has suggested a role for female sex hormones. We discuss briefly the
      possible mechanisms of LKM positive hepatitis, particularly in terms of drugs as
      possible trigger factors.

PMID- 11208376
TI  - Early symptoms of Duchenne muscular dystrophy--description of cases of an 18
      month-old and an 8-year-old patient.
AB  - The paper presents the description of Duchenne progressive muscular dystrophy in
      an 18-month-old and an 8-year-old boy. The diagnosis was established on the basis
      of clinical symptoms, such as impaired motor development, hypertrophy of leg
      muscles, difficulty in walking; elevated serum phosphocreatine kinase activity
      and pathologic electromyographic recordings. The authors emphasize that the
      disease is characterized by increased activity of such enzymes as: alanine and
      aspartate aminotransferases, lactate dehydrogenase and aldolase--observed as
      early as in the first weeks of life, with normal gammaglutamyltranspeptidase
      activity suggests progressive muscular dystrophy and makes it possible to
      establish early diagnosis. Early diagnosis of the disease allows to start
      rehabilitation earlier, to select an appropriate type of anesthesia in case of
      surgical treatment and to advise parents within the framework of genetic
      counseling.

PMID- 11208378
TI  - Perifolliculitis capitis abscedens et suffodiens--a case report.
AB  - Perifolliculitis capitis abscedens et suffodiens is a rare suppurative disease of
      the scalp of unknown aetiology. The treatment is usually difficult and often
      disappointing. In the case presented in the current work, the remission was
      achieved with nine-month isotretinoin treatment.

PMID- 11208377
TI  - Bleeding from alimentary tract in pseudo Zollinger-Ellison syndrome.
AB  - The report describes a case of a four-month-old infant, who developed acute
      gastric ulcer while being hospitalised because of pneumonia. One year's
      observation of the patient, additional tests, especially gastroscopy with
      histopathological evaluation of biopsy specimen, determination of gastrin level
      in blood serum, and therapy analysis allow to establish a diagnosis of pseudo
      Zollinger-Ellison syndrome.

PMID- 11208379
TI  - Blood cultures evaluation by gas chromatography of volatile fatty acids.
AB  - The volatile fatty acid profiles were determined by a simple gas chromatographic
      method in 375 microbiologically positive and negative blood cultures. Aerobic
      bacteria yielded profiles with low content of acids, some of which were
      chromatographically negative. Anaerobic bacteria produced more acids and more
      distinctive profiles. The method makes it possible to confirm the microbiological
      findings and to select the blood cultures containing anaerobic bacteria within 30
      minutes.

PMID- 11208380
TI  - Doppler examinations in the prognosis of birth status of the newborn.
AB  - AIM OF THE STUDY: Determination of correlation between Doppler parameters in the
      evaluation of fetal state and biochemical and clinical determinants of birth
      status of the newborn. MATERIAL: 30 full-term pregnancies. METHODS: Doppler
      parameters were determined in maternal vessels (uterine and arcuate arteries),
      fetal vessels (middle cerebral arteries, renal artery and descending aorta) and
      in umbilical arteries and veins. Levels of uric acid, xanthine and hypoxanthine,
      which reflect oxygen deficiency, were assessed in amniotic fluid by means of HPLC
      method. Furthermore, clinical condition of a newborn (rating according to the
      Apgar scoring system), pH-metry and gasometry in umbilical blood were assessed.
      RESULTS: Significant correlation between determinants of fetal and neonatal
      condition and Doppler parameters were determined, that is: between uric acid
      concentration and blood flow in fetal cerebral arteries, between base excess, pH
      and blood flow in umbilical vessels, between clinical examination of birth status
      of the newborn and renal and arcuate arterial flow and between pO2 and S/D ratio
      in renal artery. CONCLUSIONS: On the basis of this correlation, the following
      conclusions were drawn: Doppler examinations are highly useful in the prediction
      of birth status of the newborn if the specific conditions and appropriate range
      of the examination are maintained, i.e.: 1) examination must be multivascular, 2)
      it should involve cerebral artery, parenchymal resistance vessels (for example
      renal artery), umbilical artery and vein, intramural uterine vessels (for example
      arcuate or spiral artery), 3) among blood flow parameters not only standard
      indices (S/D, RI, PI), but also arterial blood flow waves velocity, specific flow
      and transverse section field should be considered.

PMID- 11208381
TI  - Accuracy of t-PA, u-PA, PAI-1 and PAI-2 estimation in human bile by ELISA kits.
AB  - The aim of this study was to establish the accuracy of determination of
      fibrinolytic proteins in human bile using commercial kits. MATERIAL AND METHOD:
      Gall bladder bile was obtained from patient undergoing laparoscopic
      cholecystectomy. The concentrations of tissue plasminogen activator (tPA),
      urokinase (uPA) and plasminogen activator inhibitor-1 (PAI-1) and inhibitor-2
      (PAI-2) in bile were measured by enzyme linked immunoassay. Afterwards we
      conducted so called 'recovery test'. RESULTS: Recovery percents of t-PA, u-PA,
      PAI-1, PAI 2 were very high i.e. 91.94, 94.07, 93.95, 91.2. We concluded that
      human fibrinolytic proteins in bile could be detected very accurately using
      commercial kits.

PMID- 11208382
TI  - Toxicity of commonly used laxatives.
AB  - Laxatives have a particularly marked abuse potential. Since they are available
      without prescription, physicians have no influence whatsoever on frequency of
      intake and dosage. The stimulant laxatives are preferentially abused since they
      are particularly cheap and the nature of their effect makes them appear suitable
      to users for non-intended purposes; advertising sometimes reinforces such
      impressions. Stimulants of plant and chemical origin can certainly be regarded as
      aggressive chemical substances that are pharmacologically active. Available data
      suggest that it would be advisable to bring the use of these substances under
      medical supervision since their widespread abuse and the associated risks can
      only be substantially reduced by such action. This review summarises
      toxicological data of stimulant laxatives and other freely available but more
      safe compounds such as lactulose.

PMID- 11208383
TI  - Comparative morphology of the hepatic and coronary artery walls. Part III. The
      insignificance of medial morphologic features in the determination of an
      autopsied unidentified subjects age.
AB  - Since hepatic arteries are free of atherosclerosis any possible wall structure
      change may be attributed to age. We determined the media of hepatic and coronary
      arteries in view of this assumption. We measured its thickness and myocytic
      density (per 1 mm2 of cross-section) from specimens collected from autopsied
      subjects, aged up to 90 years. The media gradually thickens with age, although
      values noted during particular decades remain statistically insignificant. The
      myocytic density (in 1 mm2) was almost constant throughout life. The latter
      observation is incompatible, in comparison with data reported by other authors
      (diminution was expected).

PMID- 11208384
TI  - Application of ursodeoxycholic acid (UDCA) in the therapy of liver and biliary
      duct diseases in children.
AB  - The paper discusses the experience accumulated so far in the field of application
      of ursodeoxycholic acid (UDCA) in selected disorders of the liver and biliary
      ducts in the developmental age population. In the aforementioned diseases,
      chronic administration of UDCA is safe, reduces the clinical symptoms, improves
      the biochemical parameters, and even the histopathologic picture of the affected
      organ. Such a therapy should be instituted in order to improve the quality of
      life, reduce the incidence of complications and postpone the transplantation of
      the liver till the time the child is older.

PMID- 11208385
TI  - Glutamate transport is downregulated in the cerebral cortex of alcohol-preferring
      rats.
AB  - INTRODUCTION: Ethanol (EtOH) affects glutamatergic neurotransmission and this may
      underlie craving in alcoholics. The present study aimed to further elucidate the
      EtOH-induced modulation of glutamatergic neurotransmission in a model for
      alcoholism: the alcohol-preferring cAA rat. MATERIAL AND METHODS: Glutamate
      transporter binding and function was assessed in membrane and synaptosomal
      preparations from the cerebral cortex of alcohol-preferring cAA rats and alcohol
      naive cAA rats. RESULTS: [3H]L-glutamate transport activity (Vmax) was 699
      pmol.min-1.mg-1 in alcohol-naive cAA rats and 487 pmol.min-1.mg-1 in alcohol
      preferring cAA rats. The specific binding sites (Bmax) for [3H]D-aspartate were
      markedly decreased in alcohol-preferring cAA rats (2059 pmol/mg) as compared to
      alcohol-naive cAA rats (4275 pmol/mg). CONCLUSIONS: We hypothesize that the
      reduced density and function of glutamate transporter sites in alcohol-preferring
      cAA rats may represent an adaptive mechanism in order to counteract suppressed
      glutamatergic neurotransmission during chronic EtOH exposure.

PMID- 11208386
TI  - Formation of the D-loop structure complexes between DNA and oligonucleotides and
      affinity modification of DNA by chemically reactive derivatives of
      oligonucleotides lead to the recombination.
AB  - INTRODUCTION: Affinity modification of DNA by chemically reactive derivatives of
      complementary oligonucleotides (ODNs) and antisense ODNs has shown an application
      for the inhibition of gene expression and the growth of viruses and parasites in
      high organisms. Unfortunately, the rapid advancement of antisense therapeutic
      approaches is not parallel to the investigation of possible consequences of
      antisense and gene-directed ODNs on genetic material of the cells being treated.
      Here we tried for the first time to estimate a possible genetic impact of
      antisense ODNs and their chemically reactive derivatives on the cells using
      bacteria and the plasmid DNA. MATERIAL AND METHODS: Recombination of direct
      repeats, induced by the formation of reversible complexes of plasmid DNA with
      complementary ODNs and after covalent binding of the alkylating derivative of the
      ODNs with DNA, has been investigated. For this purpose, a polylinker sequence
      flanked by 165 bp direct repeats was inserted within the tet gene of pBR 327.
      This plasmid was used to construct DNA containing AT- and GC-rich sequences
      placed in the central region of the polylinker. RESULTS: Transformation of E.
      coli cells with the plasmids (and with mixtures of the plasmids with d(pN)17
      complementary to the AT- and GC-rich sequences) did not produce deletions. After
      modification of plasmids with alkylating derivatives of d(pN)17, the deletion of
      the polylinker DNA region (recombination) revealed the restoration of the tet
      gene function. The same effect was found at the cell transformations with the D
      loop complex of the plasmids with ODNs, but the frequency of the transformants
      was about 1.5-2 times lower. The data obtained demonstrate that the complexes of
      DNA with complementary ODNs and the modification of the plasmids by reactive ODN
      derivatives result in induction of the recombination process and in loss of
      genetic material.

PMID- 11208387
TI  - BsmI vitamin D receptor polymorphism and pathogenesis of parathyroid adenoma.
AB  - INTRODUCTION: The role of vitamin D receptor (VDR) gene polymorphism in the
      pathogenesis of hyperparathyrodism is not clear yet. The aim of this study was to
      examine the role of BsmI VDR gene polymorphism in patients with primary
      hyperparathyrodism (PHP) secondary to adenomas. MATERIAL AND METHODS: Fifty-two
      postmenopausal women with PHP, mean age 64.5 years, were compared with a normal
      age-matched female population (n = 81). RESULTS: Distribution of BsmI
      polymorphism in PHP group was: Bb 54% (28/52); BB 21% (11/52); bb 25% (13/52). In
      the control group, the distribution in PHP group as follows: Bb 49% (40/81); BB
      16% (13/81); bb 35% (28/81). No statistical differences were found between the
      two groups. In the PHP group, no statistical associations were found between
      different allelic distribution and age, creatinine, hematocrit, phosphorus,
      alkaline phosphatase (ALP), total calcium, serum parathyroid hormone (PTH), or
      gland weight. This data suggest that at least in this group, BsmI VDR gene
      polymorphism appears to be without relevance in clinical presentation and
      possibly tumorigenesis in PHP secondary to adenomas.

PMID- 11208389
TI  - Morphological changes of aortal smooth muscle cells exposed to calcitriol in
      culture.
AB  - INTRODUCTION: A number of observations suggest that vitamin D plays an important
      role in maintaining normal cardiovascular function, through its receptors in
      cardiac muscle or in aortal smooth muscle cells (SMCs). The purpose of this study
      was to determine the effect of vitamin D active metabolite--calcitriol
      [1,25(OH)2D3] on aortal SMCs. MATERIAL AND METHODS: The cells were isolated from
      the aortal media of newborn rats by enzymatic digestion and maintained for 6
      weeks in primary culture. 1.2 microM of calcitriol was added to the medium every
      second day. RESULTS: Light microscopic investigations revealed that the control
      SMCs formed multilayer with characteristic 'hills and valleys'. Uniform cellular
      growth patterns were observed after calcitriol treatment. Ultrastructural studies
      indicated more rapid modulation of SMCs from the 'contractile' to the 'synthetic'
      phenotype following calcitriol treatment. Elastic fibers were more abundant in
      treated than in control cultures. The scanning electron microscope showed an
      increase of regular microvilli on the surface of SMCs. Morphometrical analysis of
      nuclei demonstrated phenotypic heterogeneity in populations of aortal SMCs. These
      results suggest that 1) calcitriol can induce changes in the phenotype and in the
      growth pattern of aortal SMCs, which may be associated with the onset or
      progression of the atherosclerosis process, 2) the basis of phenotypic changes is
      related to the stimulation of proliferative activity in these cells.

PMID- 11208388
TI  - Soluble TNF and IL-2 receptors in patients with breast cancer.
AB  - INTRODUCTION: Cytokines were shown both to enhance tumour growth and formation of
      metastases and to inhibit proliferation of tumour cells. TNF alpha may mediate
      apoptosis and necrosis of cancer cells, while the exact role of IL-2 remains to
      be elucidated. Plasma levels of TNF alpha and TNF and IL-2 soluble receptors
      (sTNF-R, sIL-2R) should thus be in some relation to some biological
      characteristics of the breast cancer. MATERIAL AND METHODS: Plasma levels of TNF
      alpha, sTNF-R I and II and sIL-2R were measured in 31 women with different stages
      of breast cancer both before the institution of therapy and after 3 months of the
      treatment. RESULTS: Plasma levels of both types of sTNF-Rs were higher in
      patients with breast cancer than in controls (sTNF-R I--2166.6 +/- 568.9 vs.
      1121.3 +/- 260.6 pg/ml, p < 0.001, sTNF-R II--3792.8 +/- 958.9 vs. 1996.2 +/-
      404.3 pg/ml, p < 0.001) with no significant difference between clinical stages.
      Plasma levels of both sTNF-R (0.871, p < 0.001) and sIL-2R tightly correlated
      with each other. Plasma levels of TNF alpha decreased after treatment (from 3.92
      +/- 1.86 to 3.40 +/- 1.15 pg/ml, p < 0.01), but plasma levels of sTNF-Rs and sIL
      2R were not influenced by the therapy. CONCLUSION: Plasma levels of soluble TNF
      receptors may thus serve as a non-specific marker of the untreated breast cancer.
      Their relation to other biologic characteristics of this tumour is not clear. It
      remains also to be clarified if the long-term treatment leads to the
      normalization of sTNF-Rs plasma levels.

PMID- 11208390
TI  - Effect of splenectomy on the morphology of haemolymph splenic nodes in Wistar
      rats.
AB  - MATERIAL AND METHODS: In 12 Wistar rats the gross and microscopic structure of
      haemolymph splenic nodes was assessed after splenectomy and the obtained results
      were compared with those in the control group. RESULTS: It was found that
      splenectomy leads to generalised morphological changes of the mentioned nodes,
      including, among other, their blanching, enlargement, filling with a greater
      number of morphotic elements and decreased count of erythrocytes and products of
      their disintegration. The splenic nodes demonstrated no regressive changes,
      typical of uniorgan nodes. The remaining abdominal non-haemolymph nodes in the
      rats showed no compensatory changes on gross examination after splenectomy.

PMID- 11208391
TI  - Zinc level in selected tissues of ethanol and morphine intoxicated mice.
AB  - INTRODUCTION: In this work we determined zinc level in the brain, heart, lungs,
      liver, kidneys, spleen and thigh muscle of the ethanol- and morphine-intoxicated
      mice. MATERIAL AND METHODS: The experiment was conducted on mice, which were
      divided into four groups of ten mice each. They were given ethanol
      intragastrically, morphine--intraperitoneally, and a combination of ethanol and
      morphine. The concentration of zinc was determined spectrophotometrically, using
      spectrophotometer Pye Unicam SP-192. RESULTS: The narcotic drugs affected zinc
      level and zinc distribution in the tested tissues. All the narcotic agents caused
      an increase in zinc concentration in blood serum and a decrease of this
      microelement in the brain. Ethanol intoxication caused a decrease of zinc level
      in all the tissues except the heart. Morphine- as well as morphine-and-ethanol
      intoxication, however, caused an increase or decrease of this microelement.

PMID- 11208392
TI  - Plasminogen activators (t-PA and u-PA) and plasminogen activators inhibitors (PAI
      1 and PAI-2) in some myeloproliferative syndromes.
AB  - INTRODUCTION: Clinical observations and laboratory data indicate that patients
      with myeloproliferative syndrome (MPS) have hemostasis disorders that manifest
      with haemorrhagic diathesis or thrombotic disease. The role of fibrinolytic
      system is not clear in the pathomechanism of the disorders. In the study we aimed
      to evaluate fibrinolysis system in blood plasma of the patients with selected
      myeloproliferative syndromes on the basis of examinations of plasminogen
      activators (tissue--t-PA and urokinase-type--u-PA) and type 1 and type 2
      plasminogen activator inhibitors (PAI-1 and PAI-2). MATERIAL AND METHODS: Forty
      two patients (F/M 28/14) aged 36-78 years (average age--54 years) were enrolled
      into the study. Among the patients were 20 individuals with chronic myeloid
      leukaemia (CML), 17 with essential thrombocytemia (ET) and 5 with myelofibrosis
      (MF) treated in Provincial Haematological Outpatient Clinic in Bydgoszcz. Forty
      healthy volunteers (F/M 30/10) aged 24-65 (average 53) were included in control
      group. In citrate venous blood, the following parameters were determined:
      concentrations of antigen t-PA, u-PA, PAI-1, PAI-2, concentration of plasmin
      alpha-2-antiplasmin complexes (PAP) determined with the use of ELISA technique,
      PAI-1 activity with amidolytic method, euglobulin lysis time (ELT) according to
      Kowarzyk-Buluk and fibrinogen/fibrin degradation products (FDP) concentration
      with the use of Merskey's method. RESULTS: Performed evaluations show that
      besides normal ELT elevated concentrations of FDP and PAP complexes occur in the
      blood of patients with myeloproliferative syndromes (MPS.). In studied
      myeloproliferative syndromes, high concentration of PAI-1 Ag and very low
      activity of PAI-1 were observed. In the patients with MPS intensified
      plasminogenesis and increased fibrin degradation were demonstrated. The role of
      granulocyte elastase is considered in activation of fibrinolysis system.

PMID- 11208393
TI  - Predictors of the efficacy of intravenous natural interferon-beta treatment in
      chronic hepatitis C.
AB  - INTRODUCTION: Several pretreatment factors have been reported to be useful in
      predicting patients with a high probability for a sustained response to IFN-alpha
      treatment, however, predictors of the efficacy of interferon-beta treatment in
      chronic hepatitis C have not been fully assessed. MATERIAL AND METHODS: To
      clarify this issue, a prospective study of 52 patients with chronic hepatitis C
      was conducted. Patients were treated with human natural interferon-beta by drip
      infusion at doses of 6 MU/day for 8 weeks. The following characteristics were
      compared between patients with sustained response (SR) and no response (NR):
      gender, age, source of HCV infection, mean pretreatment serum ALT levels, liver
      histology, pretreatment serum HCV-RNA levels and HCV genotype. RESULTS: Seventeen
      of 52 patients (32.7%) demonstrated SR. The proportion of patients with
      undetectable HCV-RNA levels determined by branched DNA assay (< 0.5 x 10(6)
      eq/ml) was higher in patients with SR than in those with NR (88.2% vs. 22.9%; p =
      0.0001). Pretreatment HCV RNA levels determined by multicyclic reverse
      transcriptase polymerase chain reaction were lower in patients with SR than in
      those with NR (10(5.1 +/- 1.5) vs. 10(7.1 +/- 1.3) copies/ml; p = 0.0001). The
      rate of SR was higher in patients with genotype 2a or 2b than in genotype 1b
      (43.8% vs. 15.0%; p = 0.0382). Multivariate stepwise logistic regression analysis
      showed that a younger age and low pretreatment serum levels of HCV RNA were
      independent predictors of SR to treatment. This prospective study demonstrated
      that a younger age, low pretreatment viral load and HCV genotype 2a or 2b were
      factors influencing the SR to interferon-beta treatment, but a younger age and
      low pretreatment viral load were most important predictors of the efficacy of the
      treatment.

PMID- 11208394
TI  - Combination of diet, exercise and intermittent treatment of cimetidine on body
      weight and maintenance of weight loss. A 42 months follow-up study.
AB  - INTRODUCTION: The aim of the study was to investigate the long term effect of
      diet, exercise and intermittent treatment of cimetidine on body weight and
      maintenance of weight lost during treatment. MATERIAL AND METHODS: Fifty women
      and five men who had completed a 8 week randomized double-blind, placebo
      controlled trial of cimetidine for weight loss were invited to participate in an
      open, non-randomized follow-up study of 42 months. The study was designed to
      compare weight loss and/or weight gain in subjects who, dependent on their level
      of motivation, volunteered to participate in an intervention or non-intervention
      group. In the intervention group the subjects were treated with cimetidine for 8
      weeks twice a year, followed a diet restriction and performed regular exercise.
      In the non-intervention group the subjects had no behavioral treatment. Twenty
      two subjects volunteered to participate in the intervention program whereas 33
      subjects volunteered to participate in the non-intervention group. RESULTS: In
      the intervention group, non-significant reductions in body weight (1.9 +/- 5.5
      kg), BMI (0.6 +/- 1.7 kg/m2), body fat% (1.7 +/- 2.9) and waist circumference
      (2.1 +/- 5.9 cm) were found. In the non-intervention group there was a
      significant increase in body weight (7.5 +/- 5.3 kg), BMI (2.6 +/- 1.8 kg/m2),
      body fat% (3.0 +/- 3.3) and waist circumference (6.7 +/- 5.1 cm). Among the group
      of subjects initially treated with cimetidine for 8 weeks and who followed a
      subsequent intervention of additional 42 months (n = 16), there was a 15.1%
      weight loss. Among the group initially treated with placebo for 8 weeks and who
      volunteered to participate in the non-intervention group (n = 22), there was a
      weight gain of 8.6%. In conclusion, the combination of diet restriction, regular
      exercise and intermittent treatment of cimetidine appears to have long term
      effects on body weight and maintenance of weight loss.

PMID- 11208395
TI  - Results of surgical treatment of retinal detachments complicated with
      proliferative vitreoretinopathies with the use of perfluropropane (C3F8) gas.
AB  - The aim of the current study is the efficiency assessment of C3F8 gas usage in
      posterior vitrectomies in patients having retinal detachment of different
      etiologies with presence of proliferative vitreoretinopathies and retinal tears.
      34 patients have undergone posterior vitrectomy with the usage of
      perfluoropropane C3F8 gas for providing internal tamponade. Total attachment of
      retina has been attached in all 34 cases and C3F8 gas has been injected in each
      eye. The most frequent complications that have been revealed after the usage of
      C3F8 gas and their management are reflected in the article. Thus, we came to a
      conclusion that vitrectomy in combination with episcleral buckling, transvitreal
      drainage of subretinal liquid, diode endolaser coagulation of retina and internal
      tamponade with C3F8 gas is effective and pathogenetikally proved method for
      treatment of rhegmatogenous retinal detachments complicated with severe
      vitreoretinopathies. The achievement of perfect anatomical results depends on
      manifestation degree of proliferative vitreoretinopathy. This study was supported
      by grant of the Ministry of Health of Armenia.

PMID- 11208396
TI  - Detection of minor myocardial injury after successful percutaneous transluminal
      coronary angioplasty with or without stenting.
AB  - Cardiac troponins are sensitive and specific markers for the detection of minor
      myocardial injury. However, they have been rarely used to monitor myocardial
      injury after coronary stenting. The purpose of the study was to measure cardiac
      troponin I (cTnI) and cardiac troponin T (cTnT) levels after apparently
      successful percutaneous transluminal coronary angioplasty (PTCA) with or without
      coronary stenting and to compare their results with serum creatine kinase (CK)
      and its isoform, creatine kinase-MB (CKMB). CTnI and cTnT levels were compared
      with those of CK or CKMB in 50 consecutive patients with stable angina undergoing
      visually successful PTCA with stenting (n = 35) or without stenting (n = 15).
      Cardiac TnI, cTnT, CK and CKMB levels were measured before and 6, 24, and 48
      hours after the procedures was performed. None of the patients had abnormal cTnI
      or cTnT levels, CK activity, or CKMB levels before the procedures. Moreover, no
      patient showed electrocardiographic evidence of myocardial infarction. 13
      patients (26%) had abnormal peak values of one or more markers at 24 hours after
      coronary intervention. Troponin I was elevated in 10/35 patients after coronary
      stenting (29%) and in 2/15 patients after PTCA (13%) (P = 0.327). Troponin T was
      elevated in 6 patients (17%) and CKMB activity was elevated in 3 patients (9%) of
      the coronary stenting group. CTnI was more significant than CKMB (P = 0.023) in
      detecting minor myocardial injury. When compared with cTnI and CKMB, cTnT did not
      reach significance (P = 0.129 and 0.489, respectively). 5 out of the 13 patients
      with abnormal markers (38%) developed side branch occlusion after stenting. In
      conclusion, cTnI was a very sensitive marker in detecting minor myocardial injury
      after coronary angioplasty with or without stenting. The frequency of increased
      serum levels of cardiac troponins was higher in patients undergoing stent
      implantation than in those treated with angioplasty alone but did not reach
      significance. Side branch occlusion may have accounted for some, but not all,
      periprocedural minor myocardial injury in the stent group.

PMID- 11208397
TI  - Antioxidant defense in children with chronic viral hepatitis B and C.
AB  - INTRODUCTION: The aim of the study was estimation of antioxidant defence state in
      children with chronic viral hepatitis. MATERIAL AND METHODS: We examined 100
      children with chronic viral hepatitis who have serological and molecular markers
      of HBV or HCV infection. In all patients catalase (CAT), superoxide dismutase
      (SOD) and glutathione peroxidase (GSH-Px) activities in erythrocytes were
      assayed. RESULTS: We observed statistically significant decrease of CAT and SOD
      activities and increase of GSH-Px activity in children with chronic hepatitis B
      and C. CONCLUSIONS: Our data suggest the possibility of insufficiency of
      antioxidant barrier in children with chronic viral hepatitis.

PMID- 11208398
TI  - Estimation of antithyroid antibodies occurrence in children with coeliac disease.
AB  - INTRODUCTION: The coexistence of coeliac disease (CD) and the diseases of
      autoimmune origin is often discussed in literature. In this study the evaluation
      of antithyroid antibodies (antimicrosomal-TMA, anti-thyreoglobulin-ATG, thyroid
      peroxidase antibodies anti-TPO) occurrence against clinical and laboratory
      determinants of thyroid function is demonstrated in children with coeliac
      disease. MATERIAL AND METHODS: The study was conducted on 34 IgA-EmA positive
      children; control group consisted of 28 children with negative screening tests
      for coeliac disease. RESULTS: In both groups, the level of antithyroid antibodies
      (TMA, ATG, anti-TPO) and determinants of thyroid gland function (TSH, fT3, fT4)
      were evaluated; USG examination of thyroid gland was also performed. Elevated
      titres of antithyroid antibodies observed in children with coeliac disease
      (41.1%) in comparison to control group (3.56%) indicate the need for performing
      the screening tests for antithyroid antibodies in children with CD.

PMID- 11208399
TI  - Low doses of aprotinin in aortocoronary bypass surgery--advantages and
      disadvantages.
AB  - INTRODUCTION: Excessive blood loss, as a result of augmented postoperative
      drainage, is considered one of the most serious cardiosurgical complications. The
      compounding constitutive anemia seems particularly harmful for patients with
      coronary artery disease. Aprotinin (Trasylol), a non-specific serine protease
      inhibitor, is successfully used to reduce excessive postoperative bleeding in
      such patients. The aim of our study was to verify the hypothesis whether
      aprotinin used during cardiopulmonary bypass procedure affects hemostatic
      parameters, which might be crucial for the elevated risk of thromboembolic
      complications. MATERIAL AND METHODS: The group of 54 patients subjected to
      coronary artery surgical treatment included 30 patients, who were given
      intraoperatively 3 million KIU aprotinin each, and 24 subjects non-treated with
      aprotinin. Aliquots of blood were withdrawn at several time intervals, until the
      5th day after the operation. Whole blood platelet activation and reactivity (the
      expressions of P-selectin and glycoprotein Ib) were monitored by means of flow
      cytometry. In addition, several plasma parameters, like PAI-1, t-PA, D-dimers,
      prothrombin fragment F1 + 2, fibrinogen, ATIII activity, troponin I and CK-MB, as
      well as platelet count were determined at each time point. RESULTS: In this study
      we confirmed the essential advantage of the use of aprotinin: both the
      postoperative blood drainage and the blood units to be transfused postoperatively
      to cardiosurgical patients were vastly reduced in the aprotinin-treated subjects.
      The enhanced overall frequency of perioperative myocardial infarction events was
      not attributed to this group of patients, nor the non Q-wave infarctions were
      observed more often in patients treated with aprotinin. In these patients,
      fibrinolysis parameters tended to be depressed (with increased PAI-1 dominating
      over elevated t-PA) on the first day after the operation, and no significant
      differences with regard to fibrinogen, prothrombin fragment F1 + 2, troponin I
      and platelet count. There was a continuous rise in D-dimers in all the
      postoperative patients, which lasted until the third day and tended to reach
      plateau at the 5th day after the operation. We failed to reveal the preventive
      effects of aprotinin on platelet function: both platelet activation and
      reactivity remained apparently unchanged. Overall, our results rather support the
      reasoning on the advantageous effects of low doses of aprotinin. The use of this
      inhibitor reduces the risk of postoperative undesirable bleeding and results in a
      decreased postoperative drainage and reduced transfused blood units. On the other
      hand, however, a higher incidence of perioperative Q-wave infarction in the
      aprotinin-treated patients, although purely apparent and not statistically
      significant, might question the unlimited safety of the use of aprotinin in
      cardiovascular operations.

PMID- 11208400
TI  - Postheparin serum lipolytic activity in psoriatic males.
AB  - INTRODUCTION: As numerous papers have presented many disturbances of blood lipid
      composition and changes in lipolytic enzyme activity, it was considered
      appropriate to investigate the postheparin lipolytic activity in serum of
      psoriatic males. The course of serum lipolytic process provoked by intravenous
      application of heparin was observed by measuring the concentration of the major
      substrates and products: triglycerides (TG), free fatty acids (FFA) and glycerol
      (G) before intravenous bolus of heparin 10 units per 1 kg b.w. and after 30
      minutes. MATERIAL AND METHODS: The study group consisted of 30 psoriatic males
      with mean age 29.7 +/- 9.6 and mean BMI 24.2 +/- 3.3 and was compared with 35
      healthy males with corresponding mean age and mean BMI. The release of glycerol
      and FFA and the reduction of TG concentrations following intravenous heparin were
      observed. RESULTS: Psoriatic sera demonstrated higher concentrations of
      triglycerides, glycerol and free fatty acids before and after the lipolysis
      compared with the controls. The course of postheparin lipolysis in psoriatic
      males seems to be changed as compared with the control group.

PMID- 11208401
TI  - Minimally invasive saphenous vein harvesting for coronary artery bypass grafting-
      comparison of three less invasive methods.
AB  - INTRODUCTION: Saphenous vein is routinely harvested using one or a few long
      continuous skin incisions. This method is associated with typical healing
      complications such as oedemas, pain, necrosis, what often restricts proper
      rehabilitation. An alternative minimally invasive techniques may decrease these
      complications. MATERIAL AND METHODS: This prospective randomised trial compared
      outcomes associated with saphenous vein harvested using three minimally invasive
      techniques versus a traditional longitudinal incision. RESULTS: In the less
      invasive group we observed statistically significant improvement in all estimated
      parameters of wound healing, oedemas and pain. We present also costs analysis
      between the groups. CONCLUSIONS: We conclude that less invasive techniques of
      saphenous vein harvesting may be alternatively introduced in coronary bypass
      surgery.

PMID- 11208402
TI  - 2-Chlorodeoxyadenosine treatment of Waldenstrom's macroglobulinemia--the analysis
      of own experience and the review of literature.
AB  - INTRODUCTION: The aim of the study was to evaluate the results of treatment of
      Waldenstrom's Macroglobulinemia with 2-chlorodeoxyadenosine. The evaluation was
      based on our own experience as well as on the data published previously in the
      literature. MATERIAL AND METHODS: 25 patients with Waldenstrom's
      Macroglobulinemia (MW) were treated with 2-chlorodeoxyadenosine (2-CdA) at the
      dose of 0.14 mg/kg b.w./day for five consecutive days as 2-hour intravenous
      infusions. Chemotherapy was repeated every 28 to 35 days. RESULTS: In one case
      (4%) a complete remission and in 15 patients (60%) a partial remission was
      achieved. In 6 patients (24%) stabilization of the disease was observed while in
      3 patients (12%) progression was noted during the treatment. As a result of the
      therapy, the mean monoclonal protein concentration decreased from 28.7 g/l (range
      5.5-62.5 g/l) to 16.7 g/l (range 0-62.9 g/l) and the mean hemoglobin
      concentration increased from 10.6 g/dl (range 6.9-13.4) to 12.4 g/dl (range 8.2
      14.8 g/dl). CONCLUSION: Our own experience, as well as conclusions of other
      authors, confirm the effectiveness of 2-CdA in MW treatment. Both the results of
      treatment and intensity of side effects observed in our treatment group were
      comparable to those described in previous reports.

PMID- 11208403
TI  - Evaluation of taeniasis prevalence in the area supervised by the Provincial
      Sanitary-Epidemiological Unit in Szczecin between 1994 and 1998.
AB  - INTRODUCTION: The aim of the study was to investigate the prevalence of taeniasis
      in population supervised by the Provincial Sanitary-Epidemiological Unit in
      Szczecin between 1994 and 1998. MATERIAL AND METHODS: The prevalence of
      intestinal taeniasis in population of Szczecin Province was evaluated basing on
      data from the selection charts available in the Provincial and Field Sanitary
      Epidemiological Units between 1994 and 1998. The following parameters were
      analyzed: environment (urban, rural), sex and age groups of patients. Basing on
      these data the prevalence of taeniasis per 100,000 of citizens was calculated.
      The study presents also the prevalence of taeniasis according to the species.
      RESULTS: In the studied period 337 cases of infestation of tapeworms were
      registered. The incidence of taeniasis in the consecutive years tended to be
      decreasing. The incidence of taeniasis decreased from 10.33 cases per 100.000 of
      population in 1994 to 3.52/100.000 in 1998. The incidence rate was higher in
      urban residents than in rural residents. In the whole analyzed period 82% of
      cases were noted in patients aged 20-59; however, the highest incidence of
      taeniasis (30%) was observed in patients aged 40-49 years. Taenia saginata turned
      out to be the prevalent species. The percentage of unclassified taeniasis (Taenia
      species) was only 3.3% in the analyzed period of time. It is necessary to improve
      the accessibility of efficient health care units in the rural environment to make
      the evaluation of incidence of taeniasis reliable. CONCLUSIONS: Taeniasis,
      despite its lower prevalence in the consecutive years, is still an
      epidemiological problem. Better access to effective health care institutions in
      the rural area is extremely important for reliable evaluation of prevalence of
      tapeworm infestation.

PMID- 11208404
TI  - Impact of baseline level of 7-ketocholesterol on the rate of coronary
      reintervention in coronary artery disease patients--results of an observational
      study with questionnaire-based follow up.
AB  - INTRODUCTION: The aim of study was to assess the relation between plasma level of
      one of the oxysterols--7-ketocholesterol and angiographically evidenced coronary
      artery disease. MATERIAL AND METHODS: We measured plasma level of 7
      ketocholesterol, malondialdehyde, total cholesterol, HDL cholesterol,
      triglycerides, erythrocyte activity of superoxide dismutase in 233 patients who
      previously underwent coronary angiography for diagnosis of coronary artery
      disease. The follow-up of patients (28 months) was done on basis of
      questionnaires sent out to them. RESULTS: We found that the subgroup of patients
      with 7-ketocholesterol above the median value (62 ng/mL) has higher rate of
      coronary reintervention (8/54 pts vs. 5/43 pts in 7-ketocholesterol below 62
      ng/mL respectively, p = 0.284 Log-rank test). The finding was more pronounced,
      yet insignificant, in the subgroup of patients who underwent primary PTCA (6/19
      pts vs. 2/20 pts, p = 0.1 Log-rank test). There were 3 patients in high 7
      ketocholesterol subgroup who entered the study with previously undergone primary
      coronary intervention. There were not such patients in low 7-ketocholesterol
      subgroup. 4 deaths were observed in high 7-ketocholesterol subgroup, and one in
      low 7-ketocholesterol subgroup (they were predominantly not of cardiovascular
      origin). CONCLUSIONS: We failed to find a significant relation between 7
      ketocholesterol and coronary artery disease, though there is a trend of such
      relation in patients who undergo PTCA, evidenced by a slightly higher number of
      repeated revascularizations among patients with high 7-ketocholesterol. The study
      indicates the areas of further studies with agents capable of lowering oxysterols
      and assessing also other end points.

PMID- 11208405
TI  - Endometrial progesterone and estradiol receptors in patients with recurrent early
      pregnancy loss of unknown etiology--preliminary report.
AB  - INTRODUCTION: It is not possible to identify the cause of the recurrent early
      pregnancy loss in approximately half of the cases, and different results have
      been reported according to estrogen (ER) and progesterone receptors (PR). The
      objective of this work was to evaluate the PR and ER levels in the endometrium of
      patients with recurrent early pregnancy loss, and to compare them with those of
      patients with proven fertility. MATERIAL AND METHODS: Endometrial receptors (R)
      for estrogen and progesterone as well as estradiol (E2) and progesterone (P)
      levels were determined in patients with recurrent early pregnancy loss, and
      compared with patients with proven fertility. RESULTS: The E2 and P levels, and
      the E2/P ratio did not show significant differences among the groups. Estrogen
      receptor in the cytoplasm and nucleus was lower in those with miscarriages, but
      without significant differences between the groups. However, the cytoplasmic PR
      was lower in those with pregnancy loss (p < 0.04), while nuclear PR was lower in
      the control group (p < 0.04). CONCLUSION: Maybe low PR levels can be the cause of
      early pregnancy loss of unknown etiology, but this deserves further
      investigation.

PMID- 11208406
TI  - What intervals in oral therapy of isosorbide dinitrate in various doses are
      sufficient to prevent nitrate tolerance?
AB  - INTRODUCTIONS: The organic nitrates are effective anti-anginal drugs during
      initial treatment, but their therapeutic value is compromised by the rapid
      development of tolerance during sustained therapy. The only widely accepted
      method of preventing tolerance is the use of intermittent administration, but
      without specifying to what extent the length of interval is dependent on type and
      dose of nitrate. The aim of this study was to evaluate how long periods free of
      nitrates are sufficient to prevent tolerance in long-term therapy with oral
      sustained-release isosorbide dinitrate (ISDN). MATERIAL AND METHODS: In a double
      blind study, 38 patients with stable angina, received ISDN: 40 mg, 80 mg and 120
      mg or placebo in the first ingestion (1st) and in long-term therapy in four 7 day
      phases: 4-times-daily (4x), 3-times-daily (3x) with 12 h nitrate-free interval,
      twice-daily (2x) with 18 h interval and once-daily (1x). After 1st and on the
      last day of each long-term phases, exercise tests with the analysis of walking
      times: total, to angina and to ischaemia (WTI) were performed: preceding
      ingestion, 2 h and 6 h after. RESULTS: Six hours after 1st all doses WTI improved
      significantly in comparison to placebo (p < 0.0001): 40 mg by 52.5%, 80 mg by
      66.0% and 120 mg by 58.4%. None of the ISDN doses improved significantly WTI in
      4x phase; in 3x, only 40 mg by 12.1% (p < 0.05); in 2x, only 80 mg by 22.3% (p <
      0.05) and in once-daily, 80 mg by 27.2% and 120 mg by 36.2% (p < 0.01).
      CONCLUSION: 12 h nitrate-free interval is sufficient in order to prevent
      tolerance in long-term treatment of sustained-release ISDN with 40 mg dose, 18 h
      with 80 mg and 24 h with 120 mg doses.

PMID- 11208407
TI  - Administration of clemastine--H1 histamine receptor blocker in the prevention of
      haemodynamic disorders after protamine sulfate administration in patients
      subjected to coronary artery bypass grafting in extracorporeal circulation.
AB  - INTRODUCTION: Adverse effects of protamine administration after CPB: fall in
      arterial blood pressure and pulmonary hypertension are still a source of
      problems. CPB and protamine administration are both accompanied by increased
      histamine levels in blood. The aim of this study was to examine if clemastine can
      accelerate the normalisation of arterial blood pressure during the protamine
      administration after CPB during CABG operations. MATERIAL AND METHODS: Fifty
      three patients subjected to CABG operations were studied. Control group (n = 27)
      did not receive clemastine, Clemastine group (n = 26) received 2 mg i.v.
      clemastine, before CPB. After CPB were completed, patients were given protamine
      (heparin to protamine ratio--1:1.5) within 7 minutes, through peripheral vein.
      Changes in arterial blood pressure from the beginning of protamine administration
      to 2.5, 5, 7.5, 10, 15, and 30 minutes thereafter, as well as heart rate, CVP,
      doses of inotropic drugs and vasodilators were compared between the groups.
      RESULTS: No difference in heart rate, CVP, doses of inotropic drugs and
      vasodilators between the group was noted. An increase in arterial blood pressure
      5, 7.5, 10, and 15 minutes after the beginning of the protamine administration
      were greater in clemastine group than in control group. Groups were comparable
      with regard to surgical procedures and doses of anaesthetic drugs. It is now
      known that protamine exerts a negative effect on cardiac contractility either
      through a decrease in coronary perfusion pressure (vasodilatation), or through a
      direct toxic effect on cardiac muscle. The administration of clemastine before
      CPB can reduce peripheral vasodilatation and capillary leak related to histamine
      release during CPB. In the clemastine group, faster increase in arterial blood
      pressure toward a physiologic range was observed. We conclude that administration
      of clemastine is connected with the normalization of ABP during and after
      protamine reversal of heparin coagulation during CABG operations.

PMID- 11208408
TI  - Additional case of Keipert syndrome and review of the literature.
AB  - We report on a 7-year-old boy with unusual facial features, severe bilateral
      sensorineural hearing loss, and broad terminal phalanges. These findings are
      similar to those described by Keipert et al. in two brothers and by Balci and
      Dagli in two other male siblings. Our patient has, in addition, developmental
      delay and abnormal behaviour. To the best of our knowledge, this is only the
      third report of Keipert syndrome.

PMID- 11208409
TI  - Case report of schwannoma of the rectum--clinical and pathological contribution.
AB  - The case of benign schwannoma of the rectum primarily misdiagnosed as myogenic
      (neurogenic?) sarcoma is presented. A large tumor of 8 cm in diameter of the
      anterior rectal wall was removed with wide margins and an artificial anus was
      constructed. During 12 years of follow-up neither local recurrence nor distant
      metastases were observed. The patient is still alive and free of the disease. For
      that reason a surgery specimen of the tumor was pathologically reanalyzed and it
      showed features of type Antoni A and B tissues. These findings, together with
      strong reactivity for S-100 protein, Vimentin and negative for Actin supported
      the diagnosis of benign schwannoma. Because the localization of the tumor in the
      rectum is extremely rare, clinical and pathological features are presented and
      discussed.

PMID- 11208410
TI  - Cornual pregnancy--a case report.
AB  - Ectopic pregnancy is a rare phenomenon in mammals. The most common localization
      is an oviduct, ovary and abdominal cavity. Confirmation of the ectopic pregnancy
      is always a difficult medical problem. The diagnosis is mainly based on the
      patient's history and gynecological examination. This paper concerns a case
      report of cornual pregnancy, diagnosed in the 20th week of pregnancy. The
      diagnostic difficulties and procedures, surgical management and the patient's and
      newborn's outcome was described.

PMID- 11208411
TI  - Diagnosis and treatment of sigmoidal endometriosis--a case report.
AB  - Intestinal endometriosis is a rare but clinically significant complication. The
      most commonly involved sites are the rectosigmoid (up to 73%) and rectovaginal
      septum (13%). A case of a 53-year-old woman with intestinal endometriosis located
      in the sigmoid colon is presented with symptoms of pelvic pain and rectal
      bleeding. The diagnosis was established by means of colonoscopy which was
      performed 3 times before laparotomy. Bowel resection and pathologic study are
      necessary to relieve the symptoms and avoid neglecting a malignant tumor or other
      lesions. The postoperative course was uneventful and the patient was discharged
      after 13 days.

PMID- 11208412
TI  - Differential retinal-defocus magnitude during eye growth provides the appropriate
      direction signal.
AB  - INTRODUCTION: The rate of ocular growth can be modified by the imposition of
      either plus or minus lenses before the eyes, which creates changes in retinal
      defocus. Several hypotheses with relatively complicated mechanisms have been
      proposed to explain these changes, but the underlying mechanism has remained
      elusive. MATERIAL AND METHODS: Our new analysis using schematic models, however,
      provides a relatively simple and logically-consistent explanation of how retinal
      defocus magnitude alone during ocular growth gives the requisite sign for an
      appropriate change in ocular growth rate. RESULTS: During a normal genetically
      determined incremental increase in axial length, the presence of either an
      imposed plus or minus lens results in an increase or decrease, respectively, of
      the blur circle magnitude. Neuromodulators in the retina are proposed to regulate
      the sensitivity to retinal-image contrast by means of a local feedback mechanism,
      and the alteration in retinal-image contrast associated with the change in blur
      circle causes an increase or decrease, respectively, in the rate of release of
      neuromodulators as well as the rate of proteoglycan synthesis, the latter being
      associated with the structural integrity of the sclera. CONCLUSION: This provides
      the critical sign, as well as amplitude, information needed to modulate
      appropriately the rate of eye growth, to result in a decrease or increase,
      respectively, in the rate of ocular growth.

PMID- 11208414
TI  - Prenatal screening for fetal chromosomal abnormalities using ear length and shape
      as an ultrasound marker.
AB  - INTRODUCTION: To determine the range of fetal ear length and ear shape
      variability in healthy fetuses and in fetuses with aneuploidies in the population
      of patients of our institution and to evaluate the clinical value of fetal ear
      length and shape assessment in screening for fetal aneuploidies. MATERIAL AND
      METHODS: Fetal ear length was determined in 210 healthy and 15 aneuploid fetuses
      of pregnant women undergoing targeted ultrasound examination. Fetal ear shape was
      assessed in the coronal section of the head and classified into one of three
      categories: flat, slightly protruding, markedly protruding and curved in 175
      healthy and 14 aneuploid fetuses. RESULTS: Fetal ear length showed significant
      positive linear relationship with gestational age, which could be described by
      the following equation: Ear length (mm) = 0.968566 x gestational age (weeks) -
      4.81629. Fetal ear shortening below 79% of expected length yielded the
      sensitivity of 26.7% in the detection of fetal aneuploidy at the false positive
      rate of 4.8%. Finding of markedly protruding and curved ears predicted fetal
      aneuploidy with the sensitivity of 28.6% at the false positive rate of 1.7%. The
      combination of fetal ear shortening below 74% of expected length or markedly
      protruding and curved ears resulted in the sensitivity of 33.3% and false
      positive rate of 3.33% in the detection of fetal aneuploidies. CONCLUSION: Fetal
      ear shortening has been confirmed as a marker of fetal aneuploidies. Abnormal
      fetal ear shape has been shown to constitute an additional marker of fetal
      aneuploidies, increasing the clinical value of fetal ear length measurements.

PMID- 11208413
TI  - DNA microarray technology and application.
AB  - DNA microarrays (collections of DNA probes arranged on a shared base) have
      recently enlarged the spectrum of commercially available laboratory-ready kits in
      molecular biology. They are powerful new tools for the investigation of global
      changes in gene expression profiles in cells and tissues. Their assembly process
      is automatized and the DNA microarrays are further miniaturized. The DNA
      microarrays are used in search for various specific genes (e.g. connected with an
      infectious agent) or in gene polymorphism and expression analysis. They will be
      widely used to investigate expression of various genes connected with various
      diseases in order to find causes of these diseases and to enable their accurate
      treatment. Since the DNA microarray assembly technology has been based on methods
      widely used in the semiconductor industry, we can expect a rapid onset of the
      routine use of this revolutionary device.

PMID- 11208415
TI  - Pathogenesis of ascites in cirrhosis and portal hypertension.
AB  - Disturbance of the circulatory system frequently occurs in patients with
      cirrhosis. Cardiac index and plasma volume increase whereas mean arterial blood
      pressure and systemic vascular resistance decrease. Marked disturbance in
      vasoconstrictor and natriuretic systems also exist with activation mediators such
      as plasma renin, plasma noradrenaline, antidiuretic hormone and endothelin. Renal
      factors contribute to the pathogenesis of ascites formation although the exact
      mechanisms are yet to be elucidated. Several theories exist in relation to
      pathogenesis although none to date fully explain all of the findings observed in
      clinical practice. In this review, we examine the mechanisms that contribute to
      the development of ascites in patients with cirrhosis and portal hypertension.

PMID- 11208416
TI  - Mitochondrial diseases.
AB  - Prevalence of mitochondrial diseases equals 1:10,000 of life-born infants.
      Mutations of mitochondrial DNA are their most frequent cause. The study presents
      short description of some of these diseases. The diseases often result in
      encephalomyopathy, cardiomyopathy, vision disorders, dysacusis and metabolic
      disorders. Despite numerous studies problems associated with mitochondrial
      diseases have not been completely solved yet.

PMID- 11208417
TI  - Is TT virus (transfusion transmitted virus) a novel hepatotropic agent causing
      hepatitis?
AB  - The author presents the review of world literature regarding the infections with
      TT virus (Transfusion Transmitted Virus) that was discovered in Japan in 1997.

PMID- 11208418
TI  - Non-invasive methods of atrial function evaluation in heart diseases.
AB  - The article describes four essential components (hemodynamic, bioelectrical,
      hormonal, metabolic) of atrial function. The role atria play in heart hemodynamic
      performance by virtue of their reservoir, conduit and active contractile function
      is emphasized. Next, the authors relate various non-invasive diagnostic methods
      in cardiology to the estimation of particular types of atrial function in
      physiological and in selected pathological conditions. Only non-invasive and easy
      accessible in clinical practice diagnostic methods are presented. The use of
      echocardiography for the evaluation of hemodynamic function of atria and left
      atrial appendage is particularly exposed.

PMID- 11208419
TI  - Beta-lipoproteins influence the serum level of hepatitis C virus.
AB  - Low density lipoprotein receptor (LDLR) has been proposed as a candidate receptor
      for hepatitis C virus (HCV). According to previous reports, free beta
      lipoproteins in a human serum may regulate the rate of hepatocyte infection by
      competing with the virus. Therefore, serum HCV levels should be regulated by the
      rise and fall of serum beta-lipoproteins since the infection rate of virions
      influences HCV replication in hepatocytes and release of virions by hepatocytes.
      In this study, we examined the relationship between serum beta-lipoproteins and
      HCV-antigen (Ag) levels in patients with chronic type C hepatitis. Patients were
      selected based on strict criteria to eliminate other factors that might influence
      serum HCV levels. Serum concentrations of beta-lipoproteins and HCV-Ag were
      measured two or more times within 3 months for each patient. The result showed
      that HCV-Ag levels were negatively correlated with the increased beta
      lipoproteins. The results support the concept that LDLR is a HCV receptor and
      that beta-lipoproteins competitively inhibit the infection of hepatocytes with
      HCV through the LDLR.

PMID- 11208420
TI  - Activity of enzymes of adenyline compounds metabolism during crush and
      decompression of muscle tissue. Part I. Adenylate deaminase activity at
      experimental crush syndrome.
AB  - INTRODUCTION: The number of works on investigation of crush syndrome (CS)
      pathogenesis, of organs and enzymatic systems at traumatic toxicosis is rather
      limited. While the clinical current of trauma and the lethality prognosis depend
      on a degree of violations in them. Such investigations are necessary for
      opportune diagnosis and definition of a treatment tactic. To complete this
      deficiency, adenylate deaminase (AMPD) level was studied in twelve tissues at
      experimental CS in vivo. RESULTS: The experimental model of CS on white rats was
      caused by crush and decompression of femoral muscle tissue. The CS influence on
      AMPD activity was investigated in hemisphere, cerebellum, hypothalamus, pituitary
      body, heart, lung, liver, spleen, kidney, adrenal, crushed and not crushed
      muscles. In muscles, kidney, pituitary body and adrenal the activity decreased in
      2 hours crush but the compensation of effect is observed after 5 hours crush. In
      cerebellum, hemisphere, heart, liver and lung it decreased during both of crush
      times. After 2 and 5 hours crush in hypothalamus and in spleen AMPD activity
      appeared much higher than in control. After 2 hours crush at the end of 48 hours
      decompression, the activity in muscles, kidney, adrenal and pituitary body was
      lower, in cerebellum, hypothalamus, hemisphere and heart--higher than, in lung,
      spleen and liver--close to control. After 5 hours crush in the majority of
      studied tissues at the end of decompression, the activity was below of control.
      The greatest deviance was observed in muscles. As to brain in cerebellum and
      hemisphere the parameter was close to, in pituitary body and in hypothalamus it
      was 1,5-fold of control. CONCLUSION: AMPD level in the most of studied tissues
      differs from the control at definite time of crush and decompression. These
      results mean the possibility of nucleotides pool balance distortion and
      intermediates accumulation.

PMID- 11208421
TI  - Activity of cathepsin D and L in the heart muscle of coronary patients during
      coronary--aortal bypass graft operation.
AB  - During coronary--aortal bypass graft operation (CABG) the period of ischaemia
      with cardioplegia in coronaries, is followed by the phase of reperfusion. The
      role of lysosomal proteases in both ischaemic and reperfusion injuries of
      myocardium is not very well understood. Therefore, we decided to evaluate the
      changes in the activity of two lysosomal proteases: cathepsin D and L taking
      place in the heart muscle of the coronary sufferers during CABG. Small fragments
      of right atrium (SFRA) were taken out during CABG: 1) just before the injection
      of standard St. Thomas Hospital cold cardioplegic fluid (control) 2) just after
      completion of artificial circulation (peak of ischaemia) and 3) after 30-40 min.
      of reperfusion. Cathepsins were assayed in homogenates of SFRA at pH 3.6 with
      haemoglobin in the absence and presence of pepstatin (cathepsin D inhibitor).
      Some simple calculations allow for a better insight into what is going on with
      lysosomal enzymes of myocardium during CABG. Essentially, total and free activity
      of both cathepsin D and L in the myocardium of coronary patients did not undergo
      significant changes during CABG. However, the values of A expressing activation
      (A > 1) or inactivation (A < 1) of enzymes in intralysosomal (Ai) and
      extralysosomal (Ae) compartment varied to a large extent (regardless of the
      damage of lysosomes in vivo). During ischaemia Ai for both enzymes was 2.0-2.7
      while Ae for cathepsin L was about 0.7. During reperfusion Ae and Ai values
      ranged between 0.5 and 0.7. During CABG ischaemia period the prominent activation
      of both cathepsin D and L in intralysosomal compartment and inactivation,
      especially of cathepsin L, outside the lysosomes (outside cells) takes place
      probably reflecting more intensive endocytosis into cardiomyocytes. During
      reperfusion, the inactivation of both enzymes in both compartments takes place.
      Some changes seem to be irreversible, especially for cathepsin L.

PMID- 11208423
TI  - Is there any correlation between the total number of neutrophils in plasma and
      concentration of interleukin-8 in psoriatic patients?
AB  - INTRODUCTION: Interleukin-8 is a chemotactic agent for neutrophils which causes
      their simultaneous activation. This cytokine of the chemokines family contributes
      considerably to the processes observed in the psoriatic epidermis with the
      participation of neutrophils. MATERIAL AND METHODS: The level of IL-8 in plasma
      of psoriatic patients during the period of acute and chronic relapses, the number
      of neutrophils in blood, and the correlation between these parameters were
      analysed. The study included 55 patients affected by psoriasis (psoriasis
      severity and activity index ranging from 16.20 to 70.20) and 10 people of the
      control group. Psoriatic patients were divided into two groups: 'acute psoriasis'
      -with an acute relapse of the disease (up to one month)--15 patients, and
      'chronic psoriasis'--with a longer period of relapse--40 patients. IL-8 plasma
      levels were determined with the use of the ELISA method. The total number of
      neutrophils was assessed in blood and smears, and calculations were performed.
      RESULTS: The results of the study showed higher levels of IL-8 in the plasma of
      patients with acute psoriasis, however, an elevated number of neutrophils in this
      group was not statistically significant.

PMID- 11208422
TI  - Effects of Bretschneider cardioplegic fluid on the lysosomal cathepsins D and L
      of myocardium of coronary patients during coronary-aortal bypass graft operation.
AB  - We evaluated the effects of replacing the standard St. Thomas Hospital (ST)
      cardioplegic fluid with Bretschneider (BR) fluid during coronary-aortal bypass
      graft operation (CABG) in patients with coronary disease. BR fluid contains
      enormous concentration of histidine (approximately 0.2 mole L-1): thus increased
      levels of histamine or other metabolites might exert some cardiovascular effects.
      Therefore, the changes in the level of two lysosomal proteases: cathepsin D and L
      of myocardium were evaluated. Small fragments of right atrium (SFRA) were taken
      out during CABG: just before the injection of cold cardioplegia (control), at the
      peak of ischaemia and after reperfusion. Cathepsin D and L were assayed in SFRA
      homogenates at pH 3.6 (with haemoglobin as a substrate and pepstatin as cathepsin
      D inhibitor). The values of parameters Ai and Ae: being the indexes of
      intralysosomal (Ai) and extralysosomal (Ae) activation or inactivation of
      cathepsins were calculated. RESULTS: With BR cardioplegia--unlikely ST fluid-
      there is a significant increase in total activity (T) of both cathepsins but free
      (F) only for cathepsin L during ischaemia with come back (to the control level)
      during reperfusion period. T for both cathepsins and F for cathepsin L with BR
      are much greater than those with ST fluid both in ischaemia and reperfusion
      period. BR cardioplegia results in distinct, extralysosomal activation of
      cathepsin L during ischaemia instead of the inhibition found with ST fluid.

PMID- 11208424
TI  - Sialic acids of young and old red blood cells in healthy subjects.
AB  - A quite simple method for obtaining young and old erythrocytes is presented. Mean
      corpuscular volume, glutamic oxaloacetic transaminase activity which is one of
      the best age parameters, and contents of total sialic acids in erythrocyte
      membranes were determined in whole erythrocyte population and in low (old) and
      high (young) density fractions separated by centrifugation of packed cells
      obtained from 23 healthy subjects. Glutamic oxaloacetic transaminase (GOT)
      activity, and contents of total sialic acids in erythrocyte membranes were
      significantly higher in young cells then in old ones, or in the whole population
      of erythrocytes. The presented results suggest that this method is simple for
      obtaining two different fractions of erythrocytes and that erythrocytes lose
      intact sialic acids together with their membrane during erythrocytes senescence.

PMID- 11208425
TI  - Morphological examinations of hard tissues of periodontium and evaluation of
      selected processes of lipid peroxidation in blood serum of rats in the course of
      experimental periodontitis.
AB  - The problem of teeth loss as a result of periodontitis is growing continuously.
      In the study we aimed to show the correlation between the disease and lipid
      metabolism disorders. We performed morphological examinations of hard tissues of
      rats' periodontium in the course of experimental ligature-induced periodontitis
      and we demonstrated the destruction of alveolodental ligament. The following
      changes were observed: degenerative changes including necrosis within
      periodontium, progressive destruction of bone mass of alveolar process of the
      mandible in the region of inflammatory infiltration. Simultaneously, biochemical
      examinations of blood serum were performed revealing decrease of basic
      antioxidant enzymes activities: SOD, GSH-Px, GSH-R with simultaneous increase of
      MDA--the final product of lipid peroxidation.

PMID- 11208426
TI  - Restriction fragment length polymorphisms in the apolipoprotein B gene in
      survivors of myocardial infarction.
AB  - INTRODUCTION: The aim of this study was to investigate the association between
      Pvu II and Msp I polymorphisms of the human apolipoprotein B gene and risk of
      myocardial infarction in 90 survivors of myocardial infarction. Apolipoprotein B
      is important in the metabolism of lipoproteins and there is an evidence
      suggesting that this apolipoprotein plays a central role in atherogenesis. Some
      polymorphisms in the apolipoprotein B gene are associated with peripheral
      arterial disease, coronary artery disease and risk of myocardial infarction.
      MATERIAL AND METHODS: DNA was prepared from the whole blood. Samples from
      patients and control group were digested with Pvu II restriction enzyme. Filters
      were prepared by Southern blotting technique and hybridized with ApoB probe (LB25
      A). Genotypes for Msp I polymorphism were determined with polymerase chain
      reaction. RESULTS: The frequency of the rarer allele (P2) for Pvu II polymorphism
      in the apolipoprotein B gene was significantly higher in myocardial infarction
      group (P = 0.001) compared with healthy individuals. A significant association
      was also found between P2 allele and the age at which myocardial infarction
      occurred. CONCLUSION: The results suggest that in Polish population the
      individuals with P2 allele of the apolipoprotein B gene are at increased risk of
      developing myocardial infarction. No significant correlation with myocardial
      infarction event was found for the Msp I polymorphism.

PMID- 11208427
TI  - Pharmacological modification of ionic currents elicited in epithelia by sensory
      neuropeptides.
AB  - A stimulation of afferent neuronal endings in such epithelial organs as airways,
      colon and frog skin produces reversible hyperpolarization, usually explained as
      caused by neuropeptides released from sensory endings. The aim of this study was
      to examine pharmacological modifications of these electrophysiological reactions,
      which were evoked by the inhibition of Na+ or Cl- transepithelial transport by
      application of amiloride (AMI) and bumetanide (BUME). The tissues were mounted in
      a modified Ussing chamber which was additionally equipped with a nozzle connected
      to a peristaltic pump and acting as a stimulation device. In the resting, control
      conditions the transepithelial potential differences--PD of tracheal and colonic
      walls and frog skin were: -3.3 +/- 0.4, -3.0 +/- 0.4 and -16.5 +/- 4.1 mV,
      respectively and hyperpolarization after mechanical stimulation--dDP for the same
      organs was: -1.2 +/- 0.3, -1.2 +/- 0.3 and -2.4 +/- 0.4, respectively.
      Preincubation with AMI influenced the dPD in all tissues but the PD of the frog
      skin was only depolarized. Preincubation of the tissues with BUME diminished dPD
      in all organs. A hypothesis was put forward that epithelial hyperpolarization of
      tracheal and colonic walls depends on the combined augmentation of Na+ and Cl-
      transport processes, whereas epithelial hyperpolarization of frog skin depends
      entirely on Na+ currents and all these transepithelial ionic currents have an
      adapting value.

PMID- 11208428
TI  - Dendritic and cancer cells in the breast tumors--an immunohistochemical study:
      short communication.
AB  - Normal and dysplastic mammary glands express immunocompetent S-100 protein
      positive dendritic cells (DCs), which are located in a regular pattern, in the
      suprabasal cell layer of the ducts and alveolar nodules. The epithelial cells,
      however, are S-100 protein negative. Since some breast cancers also express the S
      100 protein, our aim was to check the diagnostic and prognostic value of the S
      100 protein distribution combined with the tumor grade and expression of
      synaptophysin (Syn), chromogranin A (Chg A), c-erbB-2 oncoprotein and p53 protein
      in infiltrating and metastatic breast tumors. Applying immunohistochemical
      methods, we show in paraffin- or frozen breast tissue sections that in some cases
      of the infiltrating breast carcinomas, S-100 protein positive cells do not
      appear, whereas in other cases, either S-100 protein positive DCs are closely
      associated with cancer cells, or the cancer cells themselves stain positive to S
      100 protein. However, we found no correlation between the S-100 protein
      expression and other investigated parameters.

PMID- 11208429
TI  - Effect of propranolol and midazolam therapy on hemodynamic parameters in rabbits.
AB  - Some of anesthetic drugs cause cardiac arrhythmia, myocardial depression, blood
      pressure as well as hepatic and renal blood flow decrease. The aim of the
      following research study was the evaluation of midazolam effect on hemodynamic
      parameters in propranolol-treated rabbits. The following parameters: cardiac
      output and stroke volume, peripheral blood resistance, heart rate and blood
      pressure were estimated in the hemodynamics study. Blood pressure was
      significantly higher in case of propranolol and midazolam therapy as compared
      with midazolam alone. Blood pressure inconstancy did not exceed 20% of the
      initial value. Midazolam did not improve the depressive effect of propranolol on
      heart rate. The peripheral vascular resistance in coherent propranolol and
      midazolam therapy oscillated at the values observed after sole midazolam
      administration. After midazolam administration with propranolol, insignificant
      increase of cardiac output and stroke volume during the first minutes of
      experimental protocol correlated with marked decrease of peripheral blood
      resistance at the same time.

PMID- 11208430
TI  - Lipid peroxides, anti-oxidants and nitric oxide in patients with pre-eclampsia
      and essential hypertension.
AB  - INTRODUCTION: The aim was to study the role of lipid peroxides, nitric oxide and
      anti-oxidants in pre-eclampsia and essential hypertension. MATERIAL AND METHODS:
      The study was done in 28 patients with pre-eclampsia and 30 patients of essential
      hypertension. The plasma concentrations of lipid peroxides as a measure of pro
      oxidant status, nitric oxide and RBC content of anti-oxidants were measured in
      these patients and compared with controls. RESULTS: It was observed that in
      patients with pre-eclampsia the plasma concentrations of nitric oxide and lipid
      peroxides were elevated with a decrease in those of anti-oxidants such as
      catalase and superoxide dismutase and a concomitant increase in that of
      glutathione peroxidase. On the other hand, in patients with essential
      hypertension, the concentrations of nitric oxide and superoxide dismutase were
      found to be low where as that of lipid peroxides were high. When the lipid
      peroxides/nitric oxide (LP/NO) ratio was calculated a far more significant rise
      in the concentrations of lipid peroxides compared to NO levels was noted
      especially in patients with pre-eclampsia and patients with uncontrolled
      essential hypertension. CONCLUSIONS: These results suggest that oxidants and anti
      oxidants are altered in human essential hypertension and pre-eclampsia and that
      they may play a significant role in their pathophysiology.

PMID- 11208431
TI  - Permissive role of neutrophils in pathogenesis of indomethacin-induced gastric
      lesions in rats.
AB  - INTRODUCTION: We examined the possible role of neutrophils in the pathogenesis of
      indomethacin-induced gastric lesions, in comparison with prostaglandin (PG)
      deficiency. MATERIAL AND METHODS: Rats were given indomethacin (35 mg/kg, s.c.)
      and killed 4 hr later. Gastric motility, mucosal PGE2 levels, and myeloperoxidase
      (MPO) activity were measured following indomethacin. Atropine was given s.c. 30
      min before administration of indomethacin, while 16, 16-dimethyl PGE2 (dmPGE2) or
      anti-rat neutrophil antiserum (ANS) was given i.v. 10 min or 1 hr, respectively,
      before indomethacin treatment. RESULTS: Indomethacin reduced PGE2 contents in the
      stomach and produced hemorrhagic lesions in the stomach, with an increase of
      gastric motility and MPO activity. Indomethacin-induced gastric lesions were
      significantly prevented by dmPGE2 as well as atropine, at any time points during
      a 4 hr-test period. By contrast, the pretreatment of ANS did not prevent the
      development of gastric lesions when examined at either 1, 2 or 3 hr following
      indomethacin, but significantly reduced the severity of these lesions at 4 hr
      after indomethacin treatment. Both dmPGE2 and atropine inhibited the increase of
      gastric motility and MPO activity in response to indomethacin, whereas ANS
      prevented the increase of MPO activity, without any effect on the gastric
      hypermotility. CONCLUSION: These results confirmed that indomethacin-induced
      gastric lesions occurred in association with gastric hypermotility, in both
      atropine and PG-sensitive manners, and further suggest that the neutrophil
      activation/migration is not sufficient by itself to induce damage in the stomach
      and may be implicated in the process of later extension of damage.

PMID- 11208432
TI  - Causes and pathomechanisms of oesophageal varices development.
AB  - Portal hypertension is a common clinical syndrome with chronic liver diseases and
      is characterised by a pathological increase in portal pressure. Moreover, portal
      hypertension is associated with increased portal blood flow. Increased vascular
      resistance in portal hypertension is because of an increase in both intrahepatic
      and portosystemic collateral resistance. Chronic elevations in systemic and
      splanchnic blood flow have been documented as key elements of hyperdynamic
      circulatory state of hypertensive animals and humans. Peripheral vasodilatation
      initiates the development of the classic profile of decreased systemic elevated
      splanchnic blood flow and elevated cardia index that characterises this state.
      Portosystemic collaterals develop as a result of portal hypertension. This is the
      central pathophysiological event that leads to bleeding from oesophagogastric
      varices and portosystemic encephalopathy. Collateral vessels respond to various
      vasoconstrictors and vasodilators.--Varices in the distal 5 cm of the distal
      oesophagus are easily identified by endoscopy because of their superficial
      location in the lamina propria and therefore are must apt to bleed and why the
      current practise of endoscopic therapy is likely to be successful in obliterating
      the varices. In patients with oesophageal varices the dilated deep intrinsic
      veins displace the superficial venous plexus, assume a supepitheal position and
      are endoscopically visible as teleangiectasia, cherry red spots, red colour
      signs, hemocystic spots, red wale markings or varices on varices. As alternative
      endoscopic way of treatment the paravariceal injection has been propagated by our
      group thus preserving the pathophysiologic collaterals and preventing early new
      formation of collaterals and rebleeding. Pathophysiologically the concept of
      erosion has been abandoned and replaced by the explosion theory: bleeding
      probably occurs when the expanding force by pressure and flow can no longer be
      counter-balanced by the variceal wall tension; at this point the varices rupture
      and bleed. When the varix distension has increased, the radius has increased and
      the wall thickness decreased. Thus early diagnosis of patients with a high
      tendency to bleed can easily be made by endoscopy, measuring portal and/or
      oesophageal-variceal pressure and characteristising the chronic liver disease
      according to the Child-Pugh-classification.

PMID- 11208433
TI  - Prevalence, course and risk factors of diabetic nephropathy in type-2 diabetes
      mellitus.
AB  - Contrary to the well-known features of diabetic nephropathy (DNP) in type-1
      diabetic patients (pts), the prevalence, course and risk factors of DNP in in
      type-2 diabetic pts are not clear. The aim of the present study was to assess the
      prevalence of microalbuminuria (MA) and macroalbuminuria (MAA), their
      relationship with other diabetic complications and with some known cardiovascular
      risk factors in 200 in type-2 diabetic pts (100 females and 100 males). 68 pts
      (33%) were normalbuminuric (NA), 55 (27.5%) had MA and 77 (38.5%) had MAA. There
      was no significant difference among these three groups in age, BMI or the time
      actually elapsed since the diabetes and hypertension were diagnosed. BMI was high
      in each group (28.8 +/- 5.29, 28.0 +/- 5.2 and 29.8 +/- 4.6 kg/m2 mean +/- SD).
      65% of pts with NA, 77% of those with MA and 81% of pts with MAA had
      hypertension. MAA pts were more frequently smokers and former smokers, than MA
      and NA pts (56% vs 32% and 22%). Average GRF values (ml/min/1.73 m2) were 71.9 +/
      26.8 in NA pts, 82.3 +/- 36.8 in MA pts and 56.3 +/- 32 in MAA pts. There was no
      significant correlation between the urinary albumin excretion (UAE) and glycemic
      control, serum (se) cholesterol and se HDL cholesterol. At the same time UAE
      showed a significant positive correlation with se trigliceride (P < 0.01), se
      uric acid (P < 0.01) and se creatinine (P < 0.01) while a significant negative
      correlation was found with GFR (P < 0.01). Diabetic non-proliferative retinopathy
      (RP) was detected even in NA pts (27%) while 51% of MAA pts were without RP. 56%
      of NA pts, 57% of MA pts and 93% of MAA pts had macroangiopathy. CONCLUSIONS: (1)
      renal function can be impaired even in type-2 diabetic pts with NA and MA, (2)
      well-known cardiovascular risk factors seem to have a close relation with renal
      damage in type-2 diabetes (3) renal lesions in type-2 diabetic pts may be caused
      by diseases other than diabetes (e.g. arteriosclerosis, hypertension) (4) unlike
      in type-1 diabetes, where the strict glycemic control is the main preventive
      factor of DNP, in type-2 diabetes, the control of hypertension, hyperlipidemia,
      obesity, hyperuricemia may have priority.

PMID- 11208434
TI  - Lung resection in a neoadjuvant protocol.
AB  - Neoadjuvant therapy was defined as a cytoreductive therapy administered prior to
      a definitive locoregional treatment--surgical resection. While surgical resection
      can be curative in patients diagnosed with localized early-stage non-small cell
      lung cancer, patients with nodal (N1, N2) disease are generally not candidates
      for exclusive surgery. Inductive therapy can improve the microscopic metastatic
      disease, eradicate the primary tumor and thereby improve survival.

PMID- 11208435
TI  - Modification of corporal weight, body fat distribution, blood lipids and glucose
      levels in oral contraceptive users.
AB  - The association between oral contraceptives and the modification of corporal
      weight and body fat distribution is controversial. The characteristics of the
      menstrual cycle, lipids and glucose levels were also analyzed. Thirty women who
      received ethinylestradiol 0.035 mg and norethindrone 0.400 mg for one year were
      studied. The following variables were analyzed every 3 months: weight, body mass
      index (BMI), hip perimeter, waist perimeter, waist-hip ratio (WHR), duration of
      menstrual cycle, quantity of uterine bleeding, as well as blood levels of
      cholesterol, triglycerides and glucose. Waist and hip perimeters increased during
      the third evaluation; as well as the BMI starting from the second evaluation. The
      triglycerides levels rose from the first evaluation. No modifications were found
      in the WHR, glucose and cholesterol levels and the duration of the menstrual
      cycle, but the quantity of uterine bleeding decreased from the third month. The
      oral contraceptive significantly increased BMI and triglycerides level, but no
      changes were detected in body fat distribution, cholesterol and glucose levels.
      Uterine bleeding decreased from the first evaluation.

PMID- 11208436
TI  - Twins in Jos Nigeria: a seven-year retrospective study.
AB  - INTRODUCTION: A retrospective analysis of twin pregnancy was carried out between
      1st January 1992 and 31st December 1998 to determine the incidence,
      epidemiological variables perinatal and maternal outcome of twin pregnancy in the
      institution. MATERIAL AND METHODS: The case notes of the 413 twin pregnancy, 6
      triplets and 1 quadruplet delivered during the period, and the labour records of
      all the deliveries were analyzed. Statistical analysis was with chi-squared test.
      The level of significance was set at 5%. RESULTS: The incidence of twin pregnancy
      was 28/1000, triplet 0.4/1000 and quadruplet 0.07/1000. The age range of the twin
      mothers was 15-47 years with a mean of 28 +/- 5.4 years. The parity range was 0
      14 years with a mean of 3.3 +/- 2.6. Rising maternal age and parity were
      associated with twinning rate. The mean fetal weight was 2.21 +/- 0.66 kg. There
      was no statistical significant difference in weight between the 1st and 2nd
      twins. Male babies however weighed heavier (p < 0.02) than the female infants.
      The incidence of low birth weight babies (< 2500 g) was 58.7% with a perinatal
      mortality rate of 278.4/1000. The perinatal outcome was worst for the very low
      birth weight babies (< 1500), 817.5/1000 8.5% of twin mothers had a retained 2nd
      twin. The perinatal outcome of the 27 unbooked mothers who delivered their 1st
      twin at home was (12) 44.4/1000, compared to the rate of 12.5/1000 (1) in 8
      booked mothers, who delivered the 1st twin in the hospital. Among the 771 babies
      who were alive at the time of presentation in the labour ward, delivery by
      caesarean section had a better perinatal outcome (6.8%), compared to spontaneous
      vaginal delivery (13.1%) and assisted breech delivery (21.4%). The unbooked twin
      mothers had a perinatal mortality rate of 318.7/1000 compared to booked mothers
      82.3/1000. The overall perinatal mortality rate was 186.4/1000. The clinical
      causes of death were prematurity 74.6%, retained 2nd twin 7.3%, antepartum
      haemorrhage 6.1%, severe pregnancy induced hypertension/eclampsia 3.0%, birth
      asphyxia 2.4%, congenital malformation 1.8%. The incidence of postpartum
      haemorrhage was 3% and there was no maternal mortality in the series. The
      institution will need to put in place adequate resuscitating facilities and
      manpower to manage the low birth weight infants so as to reduce the current high
      perinatal wastage.

PMID- 11208437
TI  - Outcomes of conservative treatment of primary vesicoureteral reflux in children.
AB  - INTRODUCTION: The purpose of the study was to evaluate the efficacy of
      conservative treatment of primary vesicoureteral reflux. MATERIAL AND METHODS:
      Material included 179 children aged 1-15. Methods included voiding cystography in
      all the patients. Normal result of the examination was assumed as the regression
      of reflux. RESULTS: Conservative treatment resulted in the regression of 58% of I
      degree-IV degree refluxes. CONCLUSIONS: The most significant factors determining
      the efficacy of conservative treatment of primary vesicoureteral reflux are:
      reflux grade and child's age at diagnosis.

PMID- 11208438
TI  - HLA class I antigens in families with coeliac disease.
AB  - The aim of the study was the analysis of the frequency of HLA class I antigens in
      the Polish population of children suffering from coeliac disease and their
      families, as well as the estimation of the relative risk of incidence, etiologic
      fraction (EF) and preventive fraction (PF) indexes. Forty-six probands' families
      were included in the typing: 69 children with coeliac disease confirmed
      clinically and histologically, 49 healthy siblings and 91 parents. The HLA
      antigens were typed with routine Terasaki an McClelland's two-stage
      microcytotoxic assay in NIH modification. The following antigens occurred
      significantly more frequently (p < 0.0000...1) in phenotypes of children with
      coeliac disease: HLA-A1 (chi 2 = 35.90; RR = 4.3; EF = 0.44), -B8 (chi 2 = 88.20;
      RR = 8.8; EF = 0.58) and Cw7 (chi 2 = 55.24; RR = 7.5; EF = 0.69). The positive
      correlation for the specificity of HLA-A1, -B8 was proved also in siblings (chi 2
      = 16.03; chi 2 = 18.10) and parents (chi 2 = 15.67; chi 2 = 32.67). The presence
      of antigens HLA-A1, -B8 in the phenotype may be the risk factor predisposing for
      the manifestation of hypersensitivity to gluten.

PMID- 11208439
TI  - Studies of the effectiveness of interferon alpha treatment for chronic hepatitis
      C in children.
AB  - INTRODUCTION: The significance of hepatitis C infection in Poland, particularly
      in a pathology of the developmental age still increased. The aim of the study was
      the analysis of interferon alpha therapy efficacy in children with chronic C
      hepatitis. MATERIAL AND METHODS: 30 children (aged from 3 years to 15 years, 16
      females, 14 males) were included in the study. In each patient HCV infection was
      confirmed by the serological, molecular (with identification of HCV genotype) and
      histopathological methods. The duration of observation of HCV-infected children
      after the diagnosis was made followed for at least 6 months. Transaminase level
      in each case was 50% higher than normal. The schema of interferon alpha treatment
      was: 3 MU 3 times a week subcutaneously for 25 weeks. Time of observation started
      at the beginning of the therapy and finished 1 year after the end of the
      treatment. RESULTS: The analysis of the HCV genotypes showed the predominance of
      the genotype 1 (66.7%): subtype 1a was found in 20% patients, subtype 1b--in
      43.5% children. Genotype 4 (subtype 4c4d or 4b) was confirmed in 30% patients,
      genotype 3 (subtype 3a) in 3.3% patients. In the histopathological picture of the
      liver predominated minimal or moderate inflammation activity (grading: 1--in 50%,
      2--in 46.6%, 3--in 3.4%) and little fibrosis (staging: 0--in 80%, 1--in 13.3%, 2-
      in 6.7%). In many children mild side effects of interferon alpha therapy were
      observed: pseudoinfluenzal symptoms (in 46.7%), lack of appetite (in 16.7%),
      abdominal pain (in 10%), thrombocytopenia (in 6.7%), granulocytopenia, hair loss,
      irritability, itching of the skin (in 3.4%). At the end of therapy in 36.7%
      patients serum HCV-RNA was undetectable. The percentage of children without serum
      HCV-RNA decreased 6 months after the end of therapy to 20% patients and a year
      after the end of therapy to only 13.6% children. In children with HCV-RNA
      elimination was observed early reduction of ALT level. For the definition of the
      predictive factors of good prognosis patients were divided into 2 groups: group I
      (without HCV-RNA elimination at the end of the treatment) and group II (patients
      HCV-RNA negative a year after the end of therapy). Both group of children were
      similar in respect of age, disease duration and interferon alpha dosis/m2. At the
      beginning of the treatment mean ALT level was statistically higher in group II
      than in group I. IL-2 level was significant higher in group II than at the
      beginning, after 2 and 4 months of the therapy. There were no significant
      differences in IL-1 beta, IL-4 and IL-6 level between patients in group I and II.
      The differences in ALT activity during IFN-therapy between 2 groups of patients
      were statistically significant; since second month of therapy higher ALT level
      was observed in a group of patients without HCV-RNA elimination. In the
      histopathological picture of the liver a year of the end of therapy in 20%
      children reduction of inflammatory activity and progression of fibrosis in both
      group of patients was observed. CONCLUSIONS: Because of a little efficacy, high
      costs, psychological load of young patients and possible following consequences
      of the interferon alpha therapy it is necessary to manage the further researches
      to find a new method of treatment of chronic C hepatitis. High ALT activity and
      elevated IL-2 level before treatment seems to be predictive factors of the good
      response to interferon alpha therapy.

PMID- 11208440
TI  - HBV-DNA level in blood serum as a predictor of good response to therapy with
      interferon-alpha-2b of patients with chronic hepatitis B.
AB  - The prevalence of hepatitis B infection in population in Poland is low and
      averages 1-1.5%. However, it means that about 380,000 Poles constantly or
      temporarily replicate HBV. Chronic HBV infection is associated with increased
      risk of serious liver diseases and it is estimated that 25-40% of patients with
      chronic hepatitis B will die prematurely of cirrhosis or primary liver cancer. Up
      to the present, interferon-alpha (IFN-alpha), with low response rate between 25
      55% and some limitations of therapy, has been the only available treatment for
      chronic hepatitis B. A favorable outcome of IFN-alpha therapy is associated with
      some prognostic factors, not accepted by all investigators, such as low level of
      HBV-DNA in serum. The aim of this study was to assess the efficacy of therapy
      with IFN-alpha 2b (Intron A), administered s.c. 5 MU x 3/week for 16 weeks, in 65
      patients with chronic hepatitis B, divided into groups according to the baseline
      HBV-DNA level. Except for serum HBV-DNA level, there were no demographical and
      biochemical differences between all the treated groups. The patients were
      followed-up for 12 months. Sustained response (SR) to the therapy (defined as
      ALAT normalization, loss of detectable HBV-DNA, seroconversion HBeAg to anti
      HBeAg and improvement in liver histology) was observed in 16 (57.14%) of patients
      in the group with HBVDNA level < 1000 pg/ml, in 6 (37.5%) with HBV-DNA level of
      1001-3000 pg/ml, in 4 (28.57%) with HBV-DNA level of 3001-5000 pg/ml and only in
      2 (28.57%) of patients in group with HBVDNA level > 5000 pg/ml. We conclude that
      IFN-alpha is particularly useful in therapy of patients with chronic hepatitis B
      with low levels of HBV-DNA. The baseline HBVDNA level < 1000 pg/ml in serum is
      the predictor of good response to IFN-alpha therapy.

PMID- 11208441
TI  - Reactivity of cerebral arteries after subarachnoid hemorrhage in rats after
      phosphoramidon administered.
AB  - The aim of the study was to quantify cerebral vasospasm in rats after
      subarachnoid hemorrhage (SAH) by morphometric examination of basilar artery and
      to evaluate the influence of Phosphoramidon on basilar artery constriction. The
      rat cisterna magna (CM) was cannulated and after 7 days SAH was developed by
      administration of 100 microliters autologic, non-heparinized blood to the CM. The
      sham subarachnoid hemorrhage was developed by intracisternal administration of
      100 microliters of artificial cerebrospinal fluid. After 60 min and after 24 h
      Phosphoramidon was injected into the CM in a dose of 40 nmol diluted in 50
      microliters of cerebrospinal fluid. After perfusion, the brain was removed from
      the skull and histological preparations of the basilar artery were made. The
      internal diameter and wall thickness of basilar arteries were measured by
      interactive morphometric method. The most severe vasospasm was found in rats
      after SAH and the administration of Phosphoramidon in the late phase after SAH
      caused the dilatation of the basilar artery. The presence of numerous
      infiltrations composed of neutrophils and macrophages correlated with advanced
      vasospasm (index of constriction 5 times lower than normal), suggesting the role
      of other factors participating in the late phase of vasospasms after SAH.

PMID- 11208442
TI  - Moderate systemic hypothermia and cold crystalloid cardioplegia influence on
      myocardial ischemic and revascularisative injury.
AB  - The number of granulocytes, their ability to generate superoxide anion (O2-) and
      the activities of Cu, Zn--superoxide dismutase (SOD-1), glutathione peroxidase
      (GSH-Px), catalase (CAT) as well as malonyldialdehyde (MDA) concentrations in
      erythrocytes in the blood extracted from the venous sinus and aorta under
      coronary artery bypass were examined with the use of St. Thomas Hospital
      cardioplegic solution. Specimens at the peak of ischemia of the right atrium for
      ultrastructural examination of the endothelial cells of capillary vessels and
      sarcomers were taken. The blood was obtained during cardiopulmonary bypass (CPB)
      before the aorta clamping and immediately after aorta declamping (peak of
      ischaemia) between 1-3 minute and 10-13 minute of reperfusion. Increase of the
      number of granulocytes both in the coronary sinus and aortal blood at all
      examined intervals as well as decrease in the number of ones in sinus compared
      with aortal blood was noted. The ability to produce superoxide anion radical
      decreased at the peak of ischemia and during reperfusion. The activity of SOD-1
      was lower both after the period of ischemia and reperfusion. The increase in
      aortal blood activity during reperfusion was characteristic of GSH-Px; the
      activity was higher in the blood sample from the coronary sinus taken during
      ischemia and initial reperfusion. With the exception of the initial reperfusion
      the activity of CAT diminished in all observed cases. MDA concentration did not
      demonstrate any significant changes with the exception of the initial reperfusion
      in the aortal blood and later towards the end of reperfusion in the blood from
      the coronary sinus. Ultrastructural studies indicated overhydration of the cells
      both in the endothelium and the intercellular space. The obtained data
      demonstrate that the applied cardioplegic solution protects the myocardium from
      harmful effects of reactive oxygen species produced as a result of ischemia and
      reperfusion.

PMID- 11208443
TI  - Changing epidemiology of hepatitis A virus infection--a comparative study in
      central eastern Poland (1990-1999).
AB  - A comparative seroepidemiological study (1990 vs. 1998/99) on HAV infection, was
      carried out in population from middle-eastern Poland. Anti-HAV was tested in 1450
      subjects from 0 to over 50 years of age and the results were compared with those
      observed in 1990, in 1000 individuals of the same age range and from the same
      geographical area. Overall anti-HAV prevalence was 58.4% in 1990 vs. 30.6% in
      1998/99. This decline of HAV infection in Polish population indicates that the
      number of non-immune adults is increasing, with higher risk of symptomatic
      infection in the near future. The surveillance and prevalence data presented here
      have implications for developing the strategy for use of hepatitis A vaccine.

PMID- 11208444
TI  - Utility of the triple test in the detection of abnormalities of the feto
      placental unit.
AB  - INTRODUCTION: The objective of the study was to examine the relationship between
      the concentrations of maternal serum AFP, total beta-hCG and uE3 and the presence
      of various pathologies of the feto-placental unit. MATERIAL AND METHODS: The
      triple test was performed in the group of 882 pregnant women between the 14th and
      21st week of gestation. The control group consisted of 863 pregnant women with
      unburdened obstetric anamnesis with an uneventful singleton pregnancy. The
      examined group consisted of 19 pregnant women with fetal aneuploidies and other
      pathologies of the feto-placental unit (oligohydramnios, vacuolization of the
      trophoblast). In the maternal sera concentrations of AFP, total beta-hCG and
      unconjugated estriol were determined. The risk of fetal trisomy 21 was calculated
      using DOWNS and PRISCA 3.0 software (cut-off 1: 295), Ulm Index was also
      calculated (cut-off 8.1). RESULTS: In the group of pregnant women with fetal
      chromosomal aneuploidies no significant changes of the examined parameters were
      established. In the cases of oligohydramnios AFP concentrations significantly
      increased, in the cases of fetal triploidy the concentrations of all examined
      parameters decreased. In the cases of vacuolization of the trophoblast
      concentration of the total beta-hCG increased. CONCLUSION: Oligohydramnios, fetal
      triploidy and vacuolization of the trophoblast caused significant changes of the
      concentrations AFP, total beta-hCG and unconjugated estriol in maternal sera.

PMID- 11208445
TI  - A case of Klinefelter's syndrome associated with unilateral renal aplasia.
AB  - We describe a 22-year-old patient with Klinefelter's syndrome associated with
      unilateral renal aplasia. Unilateral absence of kidney was detected in our
      ongoing screening for renal abnormalities by renal ultrasound in male
      hypogonadism. The present abnormality may be a co-existing entity or previously
      unrecognized abnormality associated with Klinefelter's syndrome since there is
      not reported systematic screening for urinary tract abnormalities in patients
      with Klinefelter's syndrome in the literature.

PMID- 11208446
TI  - Neurogenic pulmonary oedema in a 13-year-old boy in the course of symptomatic
      epilepsy--case report.
AB  - Pulmonary oedema with severe, dramatic course following CNS injury was termed
      neurogenic pulmonary oedema (NPO). NPO was mainly described as a consequence of
      grand mal seizures, subarachnoid bleeding, intracranial bleeding or head injury.
      However, the pathogenesis of NPO is not entirely clear yet. In the majority of
      cases, early or classic symptoms of pulmonary oedema are evident from several
      minutes up to several hours after CNS damage. Dyspnoea, chest pain, bloody
      expectoration are observed shortly after consciousness disorders, although NPO
      may occasionally be diagnosed on the basis of chest x-ray in patients with no
      clinical symptoms. Tachypnoea, tachycardia, rales without any changes in cardiac
      system are usually observed during physical examination. The ailments withdraw
      quickly in the majority of patients, who may require oxygen therapy at most. NPO
      has been well-known in adults, but our knowledge of its occurrence in children is
      still rather sparse. The current work presents a case of a 13-year-old boy with
      pulmonary oedema as a post-seizure complication.

PMID- 11208447
TI  - Subdural empyemas--a rare complication of meningococcal cerebrospinal meningitis
      in children.
AB  - Subdural empyemas are a rare, life-threatening complication of cerebrospinal
      meningitis. Two cases of subdural empyemas which occurred as early complications
      after cerebrospinal meningitis in infants are presented. Utilization of modern
      diagnostic methods, such as US and CT allowed to establish an early diagnosis,
      which made it possible to institute appropriate treatment, involving evacuation
      of the purulent content with local application of antibiotics followed by
      intravenous antibiotics well penetrating the fluid-filled compartments of the
      CNS. Early institution of treatment gave a chance of complete recovery in both
      presented cases.

PMID- 11208448
TI  - Echocardiographic assessment of right atrial thrombus related to the implanted
      port device in patient receiving chemotherapy for non-Hodgkin's lymphoma.
AB  - The case of a potentially life-threatening complication related to the use of
      implanted port device in a 8 year old Non-Hodgkin's Lymphoma patient receiving
      chemotherapy is described. The device was inserted in early 1997 and used
      repeatedly for chemotherapy without any complications. In late 1997 during
      routine screening for cardiac left ventricular function before re-introduction of
      chemotherapy, an abnormal 1.43 x 1.53 cm mass, consistent with a non-mobile
      thrombus was found in the right atrium. The initial thrombolytic therapy with
      recombinant tissue plasmin activator (rt-PA) infused by a central venous catheter
      was combined with daily echocardiographic examination in order to assess both the
      timing and mode of thrombus resolution. After 8 days systemic fibrinolytic
      therapy was discontinued as major hemorrhage from venipuncture sites occurred and
      the clot dissolution was not obtained. Patient underwent right atriotomy
      utilizing cardiopulmonary bypass and subsequent surgical thrombus removal was
      successful. The study evaluated the contribution of two-dimensional
      echocardiography (2D) in the follow-up of vascuport and other central venous
      catheter (CVC) location and early diagnosis of related complications such as
      thrombi. The authors consider that pulmonary flow analyzed with Doppler
      echocardiography as a reliable, suitable and non-invasive method to evaluate
      increased pulmonary artery pressure in children with right atrial thrombi and
      probability of pulmonary microembolism or embolism. As the incidence of right
      atrial thrombi is highly associated with the catheter tip position in the right
      atrium, in contrast to their positioning in the superior vena cava or in its
      junction with the right atrium, the authors recommend that special attention and
      effort should be given to placing of the catheter tip in the superior vena cava
      or in its junction with the right atrium avoiding the right atrium during the
      implantation procedure. The surgical right atrium thrombus removal in patients
      with no clot dissolution despite systemic thrombolytic treatment underscores the
      importance of surgical therapy in treating this life-threatening complication of
      indwelling catheters.

PMID- 11208449
TI  - Effectiveness of high resolution ECG spectral analysis in discrimination of
      patients prone to ventricular tachycardia and fibrillation.
AB  - INTRODUCTION: To improve the diagnostic power of high resolution
      electrocardiography for discriminating patients at risk of ventricular
      arrhythmias, new methods based on spectral analysis have been used in recent
      years. The purpose of this study was to evaluate the effectiveness of these
      methods for predicting the risk of ventricular tachycardia and ventricular
      fibrillation in patients after myocardial infarction. MATERIAL AND METHODS: High
      resolution ECG were recorded in 129 post-infarction patients and 23 healthy
      volunteers. Of the post-infarction patients: 62 presented with ventricular
      tachycardia, 23 with ventricular fibrillation, while 44 had no clinically
      relevant arrhythmias. The ECG signals were recorded in three orthogonal X, Y, Z
      leads and averaged using cross-correlation method. Spectral analysis was
      performed by fast Fourier transform and the parametric modeling method with
      autoregressive model. Spectral analysis data were evaluated quantitatively by
      computing normality factor for FFT and spectral factor for AR. RESULTS: Both
      methods were found to be useful for evaluating the risk of arrhythmias. The
      sensitivity of ventricular tachycardia risk evaluation was higher (81%--FFT, 73%-
      AR) than that of evaluating the risk of ventricular fibrillation (30%--FFT, 48%-
      AR). The specificity in post-infarction patients without arrhythmias (93%--FFT,
      84%--AR) was as high as that in healthy subjects (96%--FFT, 87%--AR).
      CONCLUSIONS: Spectral analysis of HRECG is an effective method for evaluating the
      risk of VT and VF in patients after myocardial infarction.

PMID- 11208450
TI  - Hyperacute infarction: early CT findings.
AB  - The aim of our study is to determine how early and reliably ischemic brain
      infarcts can be detected on CT scanning. We report two cases of an early CT
      finding of acute ischemic infarcts where CT examination was obtained within the
      first 3 hours of onset of neurological symptoms. CT examination showed blurred
      outlines and decreased attenuation of the left lentiform nucleus, loss of the
      white-gray matter interface in the left insular cortex and left cortical global
      hypoattenuation with obliteration of left cortical sulci in one patient. In
      second patient CT showed the following: hyperdense left middle cerebral artery,
      loss of clear margins of left lentiform nucleus, subtle focal cortical
      hypodensity in the left fronto-parietal area with signs of mass effect in the
      form of ventricular compression. CT is still the first choice in the deferential
      diagnosis of acute stroke. Although older literature positions have suggested
      that CT was negative during the first 48 hours, modern CT technology can
      demonstrate positive findings even in the first 3 hours of onset. This is
      important in patients with acute stroke, as thrombolytic therapy when elected,
      has to be given within the first 3-6 hours after onset of symptoms. To determine
      how early and reliably ischemic brain infarcts can be detected on CT scanning, we
      report two cases of an early CT finding of acute ischemic infarcts where CT
      examination was obtained within the first 3 hours of onset of neurological
      symptoms.

PMID- 11208451
TI  - Alcohol and the developing fetus--a review.
AB  - Fetal alcohol syndrome (FAS) is a collection of signs and symptoms seen in some
      children exposed to alcohol in the prenatal period. It is characterized mainly by
      physical and mental retardation, craniofacial anomalies and minor joint
      abnormalities. However, with the increasing incidence of FAS, there is a great
      variation in the clinical features of FAS. This article describes in detail these
      clinical features. Due to ethical reasons it is not possible to perform
      experiments on pregnant women. Hence to study the effects of alcohol, various
      animal and avian experimental models have been chosen. The various experimental
      findings and human correlation are described. The exact mechanism by which
      alcohol induces its teratogenic effects is not known. The possible mechanisms are
      discussed. Measures to prevent the occurrence of FAS have been suggested.

PMID- 11208452
TI  - Role of cytokines in pathogenesis of endometriosis.
AB  - Sampson's theory stating that endometrial cells and fragments desquamate during
      the menstrual period are transported through Fallopian tubes into the peritoneal
      cavity where they implant, proliferate and develop into endometriotic lesions is
      generally accepted [1]. Accumulating data suggest that deficient immunity against
      retrograde endometrium during menstruation may be involved in the pathophysiology
      of endometriosis. Recent studies in women with endometriosis have demonstrated
      functional changes in several immunologic components in the peritoneal fluid as
      well as in sera of those patients. It was shown, for instance, that a wide
      pattern of cytokines are involved during endometrial cells implantation,
      proliferation and forming of endometriotic lesions. Those factors play a critical
      role in decreased immunologic surveillance, recognition and destruction of
      ectopic endometrial cells and possible facilitation of the implantation of
      ectopic endometrial tissues. The present review summarises the current knowledge
      on the role of different cytokines in the pathophysiology of endometriosis.

PMID- 11208453
TI  - Vascular endothelial growth factor (VEGF) and its effect on angiogenesis.
AB  - The article discusses the role of vascular endothelial growth factor(VEGF) in
      angiogenesis in embryonic development, particularly the effect of VEGF on
      capillary formation in response to chronic tissue ischemia and hypoxia. The
      sources and action of numerous angiogenic and angiostatic factors responsible for
      morphologic development of endothelial cells and disturbances in VEGF and FGF
      secretion are also presented. Increased VEGF and VEGF receptor expression
      enhances vascular permeability and angiogenesis, and is the cause of tissue edema
      as well as tumor and metastasis formation. VEGF appears to have a beneficial
      effect only in ischemic diseases of the heart and peripheral vessels. The article
      highlights the therapeutic implication of VEGF suppression in other areas of
      ischemia.

PMID- 11208454
TI  - Newer uses of glucose-insulin-potassium regimen.
AB  - Diabetic ketoacidosis and moderate degree of hyperglycemia can be managed by
      glucose-insulin-potassium (GIK) regimen. The GIK regimen is also useful in the
      treatment of acute myocardial infarction (AMI). But, the exact mechanism(s) of
      the beneficial action of GIK regimen is not known. I suggest that glucose-insulin
      can suppress the secretion and antagonize the harmful effects of tumor necrosis
      factor alpha (TNF alpha) and macrophage migration inhibitory factor (MIF). If
      this is true, it suggests that GIK regimen may be useful in septicemia and septic
      shock, and other inflammatory conditions such as ulcerative colitis, Crohn's
      disease, rheumatoid arthritis, systemic lupus erythematosus and cancer,
      conditions in which TNF alpha and MIF appear to play a major role.

PMID- 11208455
TI  - A C2077T polymorphism of the type B human natriuretic peptide receptor gene is
      not associated with myocardial infarction.
AB  - INTRODUCTION: We examined previously the genomic structure of the human
      natriuretic peptide receptor type B (hNPRB) gene and reported a C2077T
      polymorphism located in exon 11 of the gene. We now have studied the C2077T
      polymorphism in myocardial infarction [MI] patients and non-MI [control] subjects
      to evaluate the value of this polymorphism as a marker for MI. MATERIAL AND
      METHODS: 302 subjects (163 MI patients and 139 non-MI age-matched control
      subjects) were studied. PCR-restriction fragment length polymorphism analysis
      (PCR-RFLP) was developed to detect the C2077T transition. RESULTS: The
      distribution of C2077T polymorphism genotypes in the MI patients (CC:CT:TT,
      47.2%:41.1%:11.7%) was not significantly different from that in the control
      patients (CC:CT:TT, 53.2%:40.3%:6.5%) (chi 2 = 2.73, p = NS). Allele frequencies
      of the C2077T polymorphism were f(C/T) 68.2%/31.8% in the MI group and
      73.4%/26.6% in the control group. However, no association was found between this
      polymorphism and clinical diagnosis of MI. CONCLUSION: Our data indicate that the
      C2077T polymorphism is not a useful marker of the relation between the hNPRB gene
      and MI in the Japanese and variations of the hNPRB gene that may be in linkage
      disequilibrium with this polymorphism do not play a causative role in MI.

PMID- 11208456
TI  - Decreases of brain serotonin following a food restriction schedule of 4 weeks in
      male and female rats.
AB  - Male and female rats fed on a restricted feeding (RF) schedule of 4 weeks to
      produce 20-25% reduction in body weight, were killed before (starved) and after
      (fed) the presentation of food to compare 5-hydroxytryptamine (5-HT) metabolism
      in the hypothalamus with respective freely feeding (FF) controls and to monitor
      sex differences in RF-induced changes of 5-HT. RF decreased plasma tryptophan
      concentration in RF starved and RF fed females and also in RF starved males. In
      the hypothalamus tryptophan levels decreased in RF starved and RF fed female rats
      and RF fed males. 5-HT decreased in both RF starved and RF fed male and female
      rats and the decreases were comparable in the two sexes. 5-hydroxyindoleacetic
      acid (5-HIAA), a major metabolite of 5-HT was not affected. Food restriction
      decreased 5-HT concentration in the rest of the brain of male but not female
      rats. Possible implications of the findings in the pathogenesis of food
      restriction/starvation related disease anorexia nervosa and its greater
      occurrence in women than men is discussed.

PMID- 11208457
TI  - Activity of enzymes of adenyline compounds metabolism during crush and
      decompression of muscle tissue. Part II. Adenosine deaminase activity at
      experimental crush syndrome.
AB  - INTRODUCTION: Publications on investigation of crush syndrome pathogenesis,
      particularly of enzymatic systems upon traumatic toxicosis are rather limited.
      Such investigations are necessary for opportune diagnosis and definition of a
      treatment tactic. To replenish this deficiency, the adenosine deaminase level was
      studied in 12 rat tissues at experimental crush syndrome in vivo. RESULTS: The
      experimental model of crush syndrome on white rats was induced by crush and
      decompression of femoral muscle tissue. The crush syndrome influence on activity
      of adenosine deaminase isoenzymes was investigated in hemisphere, cerebellum,
      hypothalamus, pituitary body, heart, lung, liver, spleen, kidney, adrenal, as
      well as in crushed and native muscles. In 2 and 5 hours after compression, the
      enzyme activity decreased in muscles, lung and heart; increased in hypothalamus;
      remains near the control value in kidney and spleen. In cerebellum the parameter
      practically does not vary during 2 hours compression, while increased in 5 hours.
      In adrenal, liver, pituitary body and hemisphere the data after 5 hours
      compression approximated the level of control value in account of compensating
      mechanism. In 48 hours decompression after 2 hours crush, the adenosine deaminase
      activity becomes higher than control value in hemisphere, hypothalamus,
      cerebellum, liver, heart, adrenal, intact muscle, lung and kidney; in the crushed
      muscle and spleen the activity is reduced down to 60% of control value. In 48
      hours decompression after 5 hours compression, the enzyme activity is higher than
      control value in hypothalamus, pituitary body, hemisphere, cerebellum, kidney,
      adrenal, heart and lung. The activity is reduced in muscles, spleen and liver.
      CONCLUSION: The level of adenosine deaminase in most of studied tissues differs
      from the control value depending on compression and decompression time. It is
      worthy of note that namely during decompression, the enzyme level deviates from
      the control in the majority of tissues.

PMID- 11208458
TI  - Influence of chronic cadmium exposure during pregnancy on DNA synthesis in
      different organs of rat offspring.
AB  - Though partly bound by placental metallothionein, cadmium easily enters fetal
      circulation and exerts toxic effects in offspring tissues and organs. The
      synthesis of DNA in different organs of rat offspring, whose dams were exposed to
      cadmium during pregnancy was examined in this study. Scintillation technique was
      applied for quantification of tritiated thymidine incorporation. In most studied
      organs a significant increase of DNA synthesis was noted, pronounced especially
      in small intestine and bone marrow (over 2-fold increase in comparison with
      controls). In view of known carcinogenic effects of cadmium in animals, our data
      suggest alteration of cell cycle in selected organs, which may correspond to
      increase of proliferation rate typical of neoplastic conditions. Further studies
      are necessary for correlating these findings with proliferation indices and
      expression of protooncogenes in situ.

PMID- 11208459
TI  - Attempt to identify hemolymph nodes in humans.
AB  - In the study, nodi limphatici pancreaticolienales obtained from 10 cadavers aged
      30-70 years were analyzed. The death causes were other than proliferative
      diseases of lymphatic and hemopoietic systems, or gastrointestinal tract
      diseases. After fixation in Bouin fluid, dehydration and embedding in paraffin,
      10 microns sections were prepared and subsequently stained with hematoxylin
      eosin. Additionally, hemosiderin reaction was performed on specimens from each
      analysed node. Positive hemosiderin reaction was found in none of the specimens.
      Certain theoretical aspects relating to hemolymph nodes were also presented in
      the paper. The authors conclude that there are no hemolymph nodes in the
      proximity of human splenic vessels.

PMID- 11208460
TI  - Helicobacter pylori, gastrin and cyclooxygenase-2 in lung cancer.
AB  - INTRODUCTION: Tumors arising in the lungs are in over 90% bronchogenic carcinomas
      that have been attributed predominantly to tobacco smoking, asbestos or air
      pollution but little is known about endogenous factors that could facilitate
      their development and invasiveness. The lungs originate embryologically from the
      same endoderm cells which form the epithelia lining the digestive tract, where
      gastrin is the major proliferative stimulus. AIMS: Since lung cancer patients
      were recruited mostly among smokers, who also have been found to exhibit
      significantly higher infection rate of Helicobacter pylori (HP) infection than
      non-smokers and, as since the HP-infected subjects show enhanced plasma levels of
      gastrin, we decided 1) to compare the seroprevalence of HP and the expression of
      its cytotoxin, CagA, in lung cancer patients with those in the age- and gender
      matched controls without cancer: 2) to determine the gene expression for gastrin
      and its receptors (CCKB-R) in lung cancer, 3) to assess the gastrin levels in
      plasma bronchial lavage and in tumor tissue and 4) to examine the expression of
      cyclooxygenase (COX)-1 and COX-2 in cancer tissue resection margin and intact
      bronchial mucosa. MATERIAL AND METHODS: The trial material included 50 patients
      with lung carcinoma and 100 age- and gender-matched controls. Anti-HP and anti
      CagA IgG seroprevalence was estimated by specific antisera using ELISA tests.
      Gene expression of gastrin, CCKB-R, COX-1 and COX-2 was examined using RT-PCR,
      while gastrin was measured by specific RIA. RESULTS: The seroprevalence of HP,
      especially that expressing CagA, is significantly higher in lung cancers than in
      healthy controls. Both gastrin and CCKB-R mRNA were detected in the cancer tissue
      and at the resection margin and similarly COX-2 mRNA was expressed in most
      cancers and resection margin but not in bronchial mucosa where only COX-1 was
      found. The lung cancer tissue and resection margin contained many folds larger
      amounts of immunoreactive gastrin than intact bronchial mucosa.

PMID- 11208461
TI  - Oleic acid serum phospholipid content is linked with the serum total- and LDL
      cholesterol in elderly subjects.
AB  - INTRODUCTION: Increased dietary intake of the olive oil has been found to lower
      several cardiovascular risk factors. Aim of our study was to check if there is
      any link between the oleic acid (OL-18:1n9) serum phospholipid (SPL) content and
      some of these factors in subjects living relatively far from the Mediterranean
      region and in habitual conditions, i.e. without any dietary intervention.
      MATERIAL AND METHODS: The investigated group included 62 out-patients older than
      51 yr. Serum lipids were measured using standard hospital laboratory methods, the
      LDL-cholesterol was calculated using Friedewald's formula. Gas chromatography was
      used for estimation of fatty acids (FA) in SPL, their values were calculated as
      relative percentages of all FA. RESULTS: There was a statistically significant
      inverse correlation between the OL SPL content and the serum total cholesterol
      (TCHOL) in all 62 patients (r = -0.294; p = 0.020). Analogous correlation was
      marginally significant for the LDL (r = -0.245; p = 0.055). After a division into
      2 groups based on the median of the OL, the group with OL higher than median had
      significantly lower both TCHOL and LDL (p = 0.014; p = 0.033, respectively). OL
      correlated positively with the alpha-linolenic acid (18:3n3; r = 0.281; p =
      0.027) but inversely with the stearic acid (18:0; r = -0.303; p = 0.017).
      CONCLUSION: The subjects with less OL in their SPL had higher TCHOL and LDL serum
      levels and also their fatty acid SPL spectrum showed some other features which
      may be characterized as undesirable. This is an independent argument emphasizing
      the need for enhancing OL dietary intake.

PMID- 11208462
TI  - Evaluation of organ sparing surgery results in patients with kidney cancer in
      scheduled operations.
AB  - INTRODUCTION: The aim of the study was retrospective analysis of nephron-sparing
      surgery results of 53 patients, performed due to unilateral small kidney tumors
      in the period of 1988-1998. MATERIAL AND METHODS: The patients were followed-up
      according to EORTC directions for 20 to 143 months after the surgery. We have
      treated 25 women and 28 men of the average age of 53.7. In ten patients partial
      nephrectomy was performed and the remaining 43 had the tumor enucleated. RESULTS:
      The average observation time without any recurrences and metastases was 63.8
      months, in 5.7% of patients local disease related recurrences and in 1.9% remote
      recurrences have been found. CONCLUSIONS: 1. Nephron-sparing surgery is a safe
      alternative to radical surgery in tumors of up to 4 cm in diameter. 2.
      Prospective 10-year survival time in our patients was 98%, including 92% of
      patients remaining without recurrence or metastases. 3. Positive prognostic
      factors are incidental diagnosis of a tumor and low staging and grading of a
      tumor.

PMID- 11208463
TI  - Interleukin-6 concentration in serum and cerebrospinal fluid in multiple
      sclerosis patients.
AB  - INTRODUCTION: The aim of the investigation was to determine pleiotropic cytokine
      IL-6 concentrations in serum and CSF of MS patients, with regard to clinical
      circumstances. MATERIAL AND METHODS: The study covered 27 MS patients: 23-51
      years old; in the 2-7 clinical stage according to Kurtzke's Scale; mean 3.6 +/-
      1.8; disease duration time ranged between 2-22 years. Serum and CSF interleukin-6
      were determined by the use of commercial ELISA kits. RESULTS: Increase of Il-6 in
      serum of MS patients was found (12.1 +/- 1.8 pg/ml) in comparison to the control
      group (6.6 +/- 4.5 pg/ml) (p = 0.03). Concentration of IL-6 in CSF of MS patients
      was 13.4 +/- 1.77 pg/ml and in the majority of patients it was higher than in the
      serum. The highest mean of IL-6 concentrations in serum and CSF have been found
      in patients at the longer disease duration time, although there were not
      statistically significant. We have found some degree of dependence between serum
      IL-6 concentration and the level of disability in Kurtzke's scale. CONCLUSIONS:
      IL-6 participation in the basic MS immune processes is confirmed by its elevated
      concentration in serum and CSF, its relation to disease severity with the more
      expressed rise in cerebrospinal fluid.

PMID- 11208464
TI  - Concentration of s-ICAM-1 in nasal polyps tissue.
AB  - INTRODUCTION: Polyps are a nasal condition considered to be inflammatory in
      nature. Pathophysiology of that disorder is not fully known. The role of ICAM-1
      in inflammatory and immune response through its involvement in leukocyte adhesion
      dependent phenomena is proved to be important. The aim of the study was to
      establish the role of sICAM-1 in the inflammatory process in nasal polyps.
      MATERIAL AND METHODS: 27 patients (23 males and 4 females) with nasal polyposis
      and 12 (7 males and 5 females) controls with septal deviation were included in
      the study. All patients underwent routine surgical treatment (polypectomy,
      septoplasty). The collected tissues of polyps and nasal mucosa were homogenized,
      placed in 0.04M EDTA and centrifuged. sICAM-1 concentration in supernatant of
      polyps and nasal mucosa tissue were determined with the ELISA method (Genzyme,
      UK). RESULTS: In the polyps tissue we found a significantly higher concentration
      of sICAM-1 compared to the nasal mucosa of healthy subjects (6.74 +/- 5.31 ng/ml
      vs 0.28 +/- 0.13 ng/ml; p < 0.001). The elevated concentration of sICAM-1 was
      positively correlated with total tissue eosinophil count (r = 0.51; p < 0.01) and
      the duration of the disease (r = 0.628; p < 0.001). No correlation was found
      between sICAM concentration and the age of the patients subjected to examination.
      CONCLUSIONS: The increased level of sICAM-1 in polyps tissue indicates the role
      of the molecule in the development of chronic inflammation and probably in the
      patophysiology of nasal polyps.

PMID- 11208466
TI  - Role of Chlamydia trachomatis in epididymitis. Part II: Clinical diagnosis.
AB  - The aim of the research was to analyse the complaints and symptoms in acute
      Chlamydia trachomatis (C.t.) epididymitis. The analysis of data from history and
      physical examination was made in dependence on detected Chlamydia infection in
      the group of 39 patients with the symptoms of acute epididymitis (1--12 men C.t.
      (+), 2--27 men C.t.(-)). Chlamydial epididymitis more commonly occurred in
      younger patients, and the symptoms of the disease persisted for a longer time
      than in the patients with epididymitis of another etiology. None of the men had
      suffered from nongonorrhoeal epididymitis before, while two of them (16.7
      percent) had had urethritis. The difference in etiology was also reflected in the
      patients' complaints. The discharge from the urethra was more common in the
      patients with Chlamydia infection (1--58.3 percent, 2--18.5 percent) while
      epididymis oedema and scrotum erythema where twofold scarcer. No exact
      correlation between C.t. presence and leukocyte reaction intensity in urethra was
      noticed. The occurrence of chlamydial epididymitis is not always preceded by
      symptoms of urethritis and only in some cases they are accompanied by the
      increase of polynuclear leukocytes in urethral discharge. Chlamydial epididymitis
      is of milder course when compared to epididymitis of another etiology.

PMID- 11208465
TI  - Role of Chlamydia trachomatis in epididymitis. Part I: Direct and serologic
      diagnosis.
AB  - The aim of the study was to evaluate the role of Chlamydia trachomatis (C.t.) in
      the etiopathogenesis of epididymitis. 39 patients with symptoms of acute
      epididymitis were examined. They were divided into two age groups: 1st--patients
      aged below 35 (24 patients) and 2nd--patients older than 35 yrs (15 patients).
      The patients' urethral swabs were examined and C.t., mycoplasma and other Gram
      positive and Gram-negative bacteria were searched for as well as leukocyte count
      was assessed. Anti-Chlamydia trachomatis antibodies of IgG and IgM classes were
      assayed in serum. Direct immunofluorescence (antigen detection) and
      immunoenzymatic (antibodies detection) methods were used in C.t. infection
      diagnostics. C.t. infection in urethra was found in 30.8 percent of patients
      suffering from epididymitis, whereas in the control group in 2 percent. C.t.
      infection was significantly more commonly found in patients below 35 (45.8
      percent) as compared with the older men (6.7 percent). The most common
      etiological factor in the younger group was C.t., while in the older group it was
      E. coli. IgG anti-C.t. antibodies were detected in the serum of 51.3 percent of
      the patients with acute epididymitis, as compared with 5.8 percent of the men in
      the control group. Specific IgG antibodies were found significantly more often in
      patients under 35 (66.7 percent) than in the older men (26.7 percent). Specific
      IgM antibodies were found in 15.4 percent of the patients, that is in 20.8
      percent of the younger patients and in 6.7 percent of the older ones. C.t. is the
      main etiologic agent of epididymitis in men under 35.

PMID- 11208467
TI  - Analysis of the bacterial strains isolated from urine samples of hospitalized and
      ambulatory patients.
AB  - Bacteria of Enterococcus spp. are now much more often isolated from various
      diagnostic materials in systemic infection, both in hospitalized and in
      ambulatory patients. The study included 571 enterococci strains isolated from
      urine in 1997. Species identification was performed by rapid ID32 STREP test
      (bioMerieux) for 327 analyzed strains. Enterococcus faecalis and Enterococcus
      faecium dominated (46.1% and 11.2%, respectively). Over 42% of strains were
      isolated from urine of patients with non-significant bacteriuria or as
      concomitant flora. In such cases, simplified identification was performed and the
      strains were determined as Enterococcus spp. The microorganisms analyzed
      originated primarily from the urine samples of patients hospitalized at the
      Department of Urology (41.8%), the Department of Neurology (11.9%) and the
      Department of Internal Medicine and Nephrology (9.9%). Enterococcus faecalis
      strains were second with respect to population count (263--10.6%), after
      Escherichia coli strains (464--18.8%), while Enterococcus faecium strains were
      the sixth (64--2.5%). Enterococcus genus took the first place among all
      microorganisms isolated from the urine samples. Antibiotic-sensitivity was
      determined for 323 enterococci strains originating from hospitalized and
      ambulatory patients. Enterococcus faecium strains, naturally resistant to beta
      lactam antibiotics, were sensitive to nitrofuranoin in more than 50% and to
      norfloxacin in about 20%. Among 254 analyzed Enterococcus faecalis strains, 80.0%
      were sensitive to ampicillin, nitrofurantoin and high concentrations of
      gentamicin as well as streptomycin. Enterococci strains isolated from
      hospitalized patients proved sensitive to ampicillin and carbapenems in 76.8%,
      while strains isolated from ambulatory patients were 100% sensitive to these
      drugs. Examination of enterococci isolated from urine of patients hospitalized
      showed 33.8% sensitive to norfloxacin and 84.6% sensitive to nitrofurantoin. All
      the enterococci strains were sensitive to glycopeptide antibiotics: vancomycin,
      teicoplanin.

PMID- 11208468
TI  - Evaluating the profile of selected cytokines in patients with food allergy and
      chronic gastritis.
AB  - INTRODUCTION: Evaluating the profile of selected cytokines in patients with food
      allergy and chronic gastritis. Cytokines are produced by many cells and they play
      a role of mediators in the development of local and systemic inflammatory
      reaction. The aim of the study was to determine serum concentrations of IL-4, IL
      5, IL-8, TNF alpha in patients with chronic gastritis and food allergy, who had
      been infected with H. pylori. MATERIAL AND METHODS: The study was conducted on
      patients with atopic diathesis, who were allergic to certain foods. The study
      group consisted of 71 patients, including 42 females aged 16-54 years (mean age
      35.5 years) and 29 males aged 18-60 years (mean age 36.2 years). One control
      group was formed of 40 non-atopic patients aged 18-56 years (mean age 34.8
      years), suffering from chronic gastritis. The other control group consisted of 30
      subjects with the diagnosis of functional dyspepsia. Serum levels of selected
      cytokines were determined with the kits manufactured by ENDOGEN (Cambridge MA,
      USA) using enzyme immunoassay ELISA. The concentrations of parameters were
      determined in two tests and they were given as mean value. RESULTS: Mean serum Il
      4 level in atopic patients was 27.85 pg/ml, while it was 13.26 pg/ml in non
      atopic subjects with chronic gastritis and 4.3 pg/ml in patients with functional
      dyspepsia. The concentration of IL-5 ranged between 0 and 111.3 pg/ml (mean
      value: 7.43 pg/ml) in subjects with food allergy. Comparative analysis of IL-4
      and IL-5 concentrations in atopic patients and in control subjects showed the
      presence of statistically significant differences (p < 0.001). The remaining
      cytokines, i.e. IL-8 and TNF alpha showed a significant increase in serum levels
      in patients chronic gastritis when compared to the subjects with functional
      dyspepsia, without inflammatory changes. CONCLUSIONS: Chronic exposure of the
      patients with food allergy to a given food allergen makes the levels of IL-4 and
      IL-5 rise. In atopic subjects with chronic gastritis and H. pylori infection, the
      increase in IL-4, IL-5, IL-8 and TNF alpha levels suggests that both infectious
      and allergic factors play an important role in the pathogenesis of inflammation.

PMID- 11208469
TI  - Metabolic activity of neutrophils in patients suffering from chronic viral
      hepatitis.
AB  - The aim of the study was to evaluate the functional state of peripheral blood
      neutrophils in patients with chronic active viral hepatitis. Twenty-six patients
      with HBV, HCV or CMV in different clinical status were included in the analysis.
      In the study, the number of leukocytes and neutrophils was determined. The
      metabolic activity of neutrophils was examined in NBT reduction tests i.e.
      spontaneous (NBTsp) test and the one stimulated with LPS E. coli (NBTst). The
      results were analysed in relation to disease advancement and the type of viral
      infection. The data obtained from the affected patients were compared with the
      results from 46 healthy subjects. Most patients displayed neutropenia. It was
      found that the number of NBT positive cells and the coefficient of neutrophil
      metabolic activity (CNMA) in NBT sp test were highly significantly increased. The
      majority of patients had reduced values in NBTst test, which suggested lack of
      response to LPS E. coli by neutrophils. These findings may reflect the state of
      inflammation in the body. NBT reduction tests may be useful in monitoring
      metabolic activity of neutrophils in patients with chronic active viral
      hepatitis.

PMID- 11208470
TI  - Interferon alpha for eradication of HCV and remission of chronic hepatitis in
      children.
AB  - Thirty two children (8 girls and 32 boys), aged 4-14, with chronic hepatitis C
      were treated with interferon alpha at a dose of 3 MU or 5 MU, given times weekly
      for 6 months. Five children (16%) were complete responders (defined as
      disappearance of viremia), none of them relapsed, 6 (19%) were partial responders
      (normalization of ALT), 3 (9%) were transient responders (ALT initially decreased
      but then rebounded to pre-treatment levels) and 18 (56%) were non responders.
      During the treatment, continuous decrease of median ALT, AST and GGT was noted,
      statistically significant differences were found for comparisons of values
      measured before and after treatment (for ALT p = 0.023, for AST p = 0.021 and for
      GGT p = 0.012). Histological evaluation revealed one case of progression (to
      liver cirrhosis) out of three investigated complete responders, 1/5 such cases of
      partial responders, 1/2 of transient responders and 14/18 of non-responders.
      Remission of hepatitis was found in 2/18 (10%) non-responders. There was no
      statistically significant difference between 16 children previously infected with
      HBV (anti-HBc positive but HBsAg negative at the time of our study) and the
      others with respect to biochemical and histological severity of hepatitis or in
      the response to treatment rate. CONCLUSIONS: Chronic hepatitis C in children may
      cause severe hepatitis or even liver cirrhosis. Virological, biochemical and
      histological features should be considered to evaluate the severity of the
      disease and response to interferon treatment. Past infection with HBV does not
      affect interferon sensitivity in children with chronic hepatitis C.

PMID- 11208471
TI  - Atrioventricular septal defect: clinical and diagnostic problems in children
      hospitalised in 1993-1998.
AB  - INTRODUCTION: Atrioventricular septal defect (AVSD) is one of the most frequent
      congenital heart diseases, making up 7.5% of all developmental anomalies of
      circulatory system. MATERIAL AND METHODS: Sixty-seven children with the diagnosis
      of atrioventricular septal defect were hospitalised at the Department of
      Paediatric Cardiology, Medical University in Gdansk, in 1993-1998. Patients' age
      ranged at diagnosis between 3 days and 17 years (mean age 35 months). The
      analysed group included 20 children with partial atrioventricular septal defect
      (group I) and 47 children with complete AVSD (group II). The diagnosis was based
      on anamnesis, physical examination, ECG, chest x-ray and echocardiography.
      Cardiac catheterisation and angiocardiography were performed in 28 children.
      RESULTS: On the basis of the results obtained, 6 children with Down syndrome were
      disqualified from the surgery due to persistent pulmonary hypertension. Fifty
      nine children--including all the patients from group I (20) and 39 children from
      group II were qualified for operations in extracorporeal circulation. Two
      children from group II required ventilation with the mixture containing NO in the
      early post-operative period. There were 8 deaths (12%). Three children from group
      II died preoperatively due to severe generalised infection in early infancy and 5
      infants from group II died immediately after operation. No deaths occurred in
      group I. In one case of a 4 year-old boy with partial atrioventricular septal
      defect, atrioventricular block developed immediately after surgery and required
      constant stimulation of the heart. In two children it was necessary to replace
      mitral valve (2 and 5 years after ASD I surgery). CONCLUSIONS: 1. Children with
      Down syndrome require screening echocardiography. 2. Non-invasive diagnostic
      examinations of atrioventricular septal defect are usually sufficient for the
      full assessment of the defect and the choice of further treatment. 3. The
      correction of the congenital heart disease such as atrioventricular septal defect
      should be completed in the first 6 months of life, particularly in children with
      complete AVSD.

PMID- 11208472
TI  - Blind liver biopsy in children--diagnostic significance and complications in
      authors' own material.
AB  - The purpose of the study is the analysis of liver biopsy performed in patients
      hospitalized at 3rd Department of Pediatric Diseases of Medical University in
      Bialystok in 1993-1998 with particular regard to the assessment of indications
      and the incidence of complications connected with the procedure. The procedure
      was conducted on the group of 250 patients aged 1-17 years with the use of
      Menghini needles. The indications for diagnostic liver puncture included chronic
      infection with HBV (228 children), chronic infection with HCV (6 children),
      chronic hypertransaminasemia (13 children), hepatomegaly (2 children) and
      hyperbilirubinemia (1 child). Complications were observed in 3 patients (1.2%).
      Blind liver biopsy is an important diagnostic tool in pediatric hepatology but
      possible occurrence of life-threatening complications suggests that it be used
      with caution. The paper was presented as a part of hepatological session of XXVI
      Congress of Polish Pediatricians in Mikolajki on 6-9th June 1999.

PMID- 11208473
TI  - Relationships between age-related changes of sex steroids, obesity and body fat
      distribution among healthy Polish males.
AB  - During the process of aging in males a trend toward an unfavourable body fat
      accumulation, especially within the visceral depots, is observed. This fact is
      presumed to be associated with the age-related decline in androgen levels among
      aging men. The aim of this study was to determine the relationships between sex
      steroid levels (DHEAS, estradiol, free and total testosterone) and BMI, percent
      fat mass, WHR values in 190 healthy and professionally active men, aged 22-67,
      inhabitants of the city of Wroclaw, Poland. Hormonal levels were measured using
      standard immunoassays. BMI was used as a measurement of obesity. Obesity was also
      assessed using percent fat mass equations according to the Crook formula. WHR was
      used as an index of fat distribution. All the correlations between sex steroids,
      BMI, WHR, percent fat mass and age were evaluated using statistical non
      parametric analyses (Spearman coefficient) in the entire group of examined
      subjects, and in two age-specific groups: a) younger males (aged 22-39) and b)
      older males (aged 40-67). The aging of Polish males is accompanied by both a
      significant increase of BMI, percent fat mass and WHR values, and by a decline in
      estradiol, gonadal and adrenal androgen levels. In the younger group only total
      testosterone levels were significantly negatively related to BMI, percent fat
      mass and WHR. Within the group of older men both estradiol and DHEAS levels are
      significantly positively related to WHR. The sex steroids seem to be associated
      with indices of overall obesity and distribution of fat in men, but these
      relationships differ considerably when they are evaluated in younger and older
      age categories. Worthy of notice is the fact that free testosterone levels are
      not related to any anthropometric parameters in any age category, although free
      testosterone (not total testosterone) is commonly recognised as a reliable and
      sensitive endocrinological indicator of the general psycho-physical status of an
      aging man.

PMID- 11208475
TI  - Kawasaki disease in an 18-month-old boy.
AB  - The authors present a case of Kawasaki disease with arrhythmia, aneurysms in the
      coronary vessels and disease recurrence in week 4. Despite late diagnosis,
      effective treatment with high doses of immunoglobulin and aspirin was introduced
      in the second week of the disease as well as during its relapse.

PMID- 11208474
TI  - Analysis of HBs antigen negative variant of hepatitis B virus: unique
      substitutions, Glu129 to Asp and Gly145 to Ala in the surface antigen gene.
AB  - We analyzed the surface gene (S gene) of a hepatitis B virus (HBV) isolate with
      mutations of envelope protein that rendered it undetectable by both a monoclonal
      hepatitis B surface antigen (HBsAg) enzyme-linked immunosorbent assay (ELISA) and
      polyclonal HBsAg radioimmunoassay (RIA). Sequencing of independently cloned
      products of HBV polymerase chain reaction revealed several point mutations within
      the S gene. Rare substitution was identified both at positions 129 (glutamine to
      asparagine) and at position 145 (glycine to alanine) in the 'a' determinant
      region, which is considered to be within a larger antigenic area known as the
      major hydrophilic region (MHR). A computer-assisted analysis of protein secondary
      structure could not find any significant difference between this mutant and wild
      type HBsAg. However, the substitution of substitution glycine to alanine at
      position 129 introduce a putative glycosylation site (Asn-Gly-Thr), which may
      interfere with the antigenicity of HbsAg. Also, HBV variant with substitution at
      position 145 (Gly to Ala) has been recently reported to be antigenically altered
      and to show impaired recognition by polyclonal hepatitis B hyperimmune globulin
      in vitro. These genetic mutations in the S gene inside MHR may allow to escape
      detection by standard HBsAg assays.

PMID- 11208476
TI  - Disseminated form of Langerhans cell histiocytosis discovered in stomatological
      examination--a case report.
AB  - Langerhans cell histiocytosis (LCH) is a disease involving formation of
      granulomatous infiltrations consisting of Langerhans cells, histiocytes,
      lymphocytes and eosinophilic granulocytes. Etiopathogenesis of this disease has
      not been fully clarified yet. It can present as a focal and disseminated form
      (acute and chronic). Rare incidence of this disease in the population causes
      progress in research and new therapeutic methods to be slow. Basing upon a case
      of a patient treated for gingivo-osseous lesions in the course of LCH, we tried
      to prove that a dental or maxillofacial surgeon may be the first contact medical
      professional who contributes to the diagnosis of LCH as a systemic disease.

PMID- 11208477
TI  - Congenital hypertrophic pyloric stenosis in twins.
AB  - The current report has been devoted to the presentation of the diagnosis and
      operative treatment of congenital hypertrophic pyloric stenosis in monozygotic
      twins. Special attention has been paid to a number of theories aiming to explain
      the aetiology and the mechanisms contributing to the development of congenital
      hypertrophic pyloric stenosis.

PMID- 11208478
TI  - Genetically determined coeliac disease in three family members.
AB  - The work presents 3 members of a family of 4, who were diagnosed to have coeliac
      disease (one classic and two latent forms of the disease). Genetic investigation
      regarding all three patients revealed the existence of HLA DQ A1*0501 allele
      associated with susceptibility to coeliac disease. Due to a much more frequent
      occurrence of atypical forms of coeliac disease in family members, than in
      general population, and due to risks resulting from tardy diagnoses and the lack
      of treatment, it is recommended that patients should be subjected to tests
      determining the presence of antiendomysial antibodies, as well as to genetic
      investigation with regards to latent coeliac disease.

PMID- 11208479
TI  - Imaging techniques in patients with biliary obstruction.
AB  - The most frequent causes of cholestasis include choledocholithiasis and neoplasms
      (pancreatic head carcinoma, ampullary carcinoma, cholangiocarcinoma). The authors
      discussed imaging modalities currently applied in the diagnostics of patients
      with suspected obstruction biliary tract obstruction. Special attention was paid
      to the efficacy of these techniques in detecting the obstruction and determining
      its level and nature. In general, US or CT are first performed in patients with
      cholestasis. The use of percutaneous cholangiography and retrograde
      cholangiopancreatography is often limited to therapeutic interventions. Magnetic
      resonance offers images similar to both conventional cholangiography and computed
      tomography. This technique offers complex evaluation of bile ducts and other
      abdominal organs.

PMID- 11208480
TI  - Macroscopic picture of gastric mucosa in endoscopic examination of patients with
      chronic gastritis and food allergy.
AB  - INTRODUCTION: The aim of the study was to evaluate the difference in macroscopic
      picture of the stomach in patients with food allergy and in non-atopic patients
      with H. pylori infection. MATERIAL AND METHODS: In the study, patients with
      atopic diathesis, suffering from dyspepsia or abdominal pain were analysed. The
      study group included 72 women aged 16-57 years (mean age 36.5 years) and 38 men
      aged 16 and 60 years (mean age 34.4 years). Control group was formed of 40
      patients without atopy (13 men and 27 women, aged 18-56 years--mean age 34.8
      years), with endoscopically and histologically confirmed gastritis. All the
      patients underwent endoscopy of upper gastrointestinal tract with the use of
      fiberoscope GIF-E OLYMPUS and video endoscopy monitor OEV 203 OLYMPUS (Japan).
      The following features of gastritis were considered in endoscopic assessment:
      oedema, reddening and fragility of mucous membrane, spotted and macular exudate,
      flat and raised erosions, proliferation and atrophy of mucosal folds, vascular
      network, intramural extravasation, mucosal structure. The results obtained were
      verified statistically with chi-squared independence tests for 2 x 2 tables.
      CONCLUSIONS: Statistical analysis of the incidence of these signs of inflammation
      in patients with food allergy did not show significant differences in relation to
      subjects with non-atopic gastritis.

PMID- 11208481
TI  - Melatonin and climactery.
AB  - Melatonin is a hormone synthesized in the pineal gland from tryptophan. It
      participates in several biological processes in the human being, such as
      circadian sleep rhythm, mood, reproductive processes and aging. Melatonin serum
      levels are increased in childhood and diminish importantly in older people. Serum
      levels are diminished in patients with insomnia and depressive mood.
      Experimentally, the melatonin inhibits the growth of mammary tumors in animals.
      With respect to endometrial cancer and Alzheimer's disease, the information is
      not conclusive. No changes have been found in melatonin levels in climacterical
      women. So its use has not fundament in postmenopausal women, however it can only
      be administered for short periods of time for the treatment of some sleep
      disturbances.

PMID- 11208482
TI  - Blood brain barrier and infection.
AB  - The blood brain barrier (BBB) is a highly dynamic structure and consists of
      endothelial cells, which are characterized by the presence of tight junctions and
      relative lack of endocytic vesicles. The tight junctions are reinforced by the
      foot processes of the astrocytes. The BBB functions through these specialised
      structures, to maintain the environment of the brain in a steady state by
      regulating the influx and efflux of substances. The protective effect of the BBB
      is however, lost during bacterial and viral infections. The primary mechanism
      operative are an increase in the permeability of the BBB and/or direct invasion
      of the brain by microorganisms. Since the BBB is relatively impermeable to
      chemotherapeutic agents the treatment of CNS infections is difficult. This paper
      aims to examine the various mechanisms by which infection spreads to the brain,
      and suggest measures for successful drug delivery into the brain during
      infections.

PMID- 11208483
TI  - Influence of the metabolic complications of liver cirrhosis on dietary intake.
AB  - The role of the nutrition is discussed in relation to chronic liver disease. An
      outline of the general principles involved in regulating nutrition in patients
      with advanced liver disease is given followed by an evaluation of the effects of
      malnutrition on the outcome of the disease. Major problems faced over the course
      of advanced liver disease are carbohydrate intolerance, sodium and fluid
      retention which may progress to hepatorenal syndrome, and hepatic encephalopathy.
      Interest on diet regulation in such cases has been recently reemphasized in
      multicenter studies particularly in the liver transplant setting and alcoholic
      liver disease. Controversies exist regarding albumin infusion after
      paracenthesis, low protein diet in hepatic encephalopathy and water restriction
      before sodium. The effect of nutrition on the outcome of liver disease and
      survival is not well established. However patients with better nutritional state
      do much better after transplant.

PMID- 11208484
TI  - What do we know about Kawasaki disease?
AB  - The authors present current theory of the aetiology and pathogenesis of Kawasaki
      disease with special reference to clinical presentation and cardiac
      complications. Current therapeutic management has also been discussed.

PMID- 11208486
TI  - Different sensitivity of mitochondrial and cytosolic monoamine oxidases to in
      vivo but not in vitro inhibition by specific irreversible inhibitors.
AB  - The sensitivity of mitochondrial and cytosolic monoamine oxidase (MAO) activities
      to inhibition by specific irreversible inhibitors was investigated. There were no
      significant differences in the sensitivity of MAO A and MAO B activities of these
      fractions to selective inhibitors. However, in vivo administration of pargyline
      caused a much more potent inhibition of cytosolic MAO than the mitochondrial
      enzymes. This suggests that cytosolic MAO activity does not represent an artifact
      (e.g. a product of proteolytic degradation) appearing after tissue
      homogenisation. The higher sensitivity of cytosolic MAO to inhibitors also points
      to different routes for pargyline to inhibit MAO in these subcellular fractions.

PMID- 11208487
TI  - Effect of polaprezinc on impaired healing of chronic gastric ulcers in adjuvant
      induced arthritic rats--role of insulin-like growth factors (IGF)-1.
AB  - Polaprezinc, N-(3-aminopropionyl)-L-histidinatozinc, has been shown to stimulate
      the production of insulin-like growth factor-1 (IGF-1) in mesenchymal cells, the
      polypeptide playing a role in the gastric epithelial wound repair. The present
      study was performed to examine the effect of polaprezinc on the impaired healing
      of chronic gastric ulcers in adjuvant-induced arthritic rats, in relation to IGF
      1. Arthritis was induced in male Dark Agouti (DA) rats by a single injection of
      Freund's complete adjuvant (FCA), and the gastric ulcers were induced by thermal
      cauterization (70 degrees C for 30 sec) 7 days after FCA injection. Omeprazole
      (30 mg/kg) was administered p.o. once daily, while recombinant human IGF-1 (rhIGF
      1) (30 micrograms/kg, s.c.) or polaprezinc (3-10 mg/kg, p.o.) was administered
      twice daily, starting from 3 days after ulceration for 14 days. The healing of
      gastric ulcers was significantly delayed in arthritic rats as compared to normal
      rats on day 10 and 17 following ulceration. The expression of IGF-1 mRNA was
      markedly increased in the ulcerated mucosa, but this response was apparently
      attenuated in arthritic rats. Repeated administration of polaprezinc accelerated
      the healing of gastric ulcers in both normal and arthritic rats, in a dose
      dependent manner, and this effect was more pronounced in arthritic rats.
      Likewise, treatment with omeprazole also significantly promoted the healing of
      gastric ulcers in both normal and arthritic rats. On the other hand, rhIGF-1
      significantly promoted the gastric ulcer healing in arthritic rats without any
      effect on that in normal rats. These results suggest that the impaired healing of
      chronic gastric ulcers in arthritic rats is, at least partly, accounted for by
      less expression of IGF-1, and the polaprezinc improves the delayed healing of
      gastric ulcers in arthritic rats, probably through an increase in IGF-1
      production.

PMID- 11208485
TI  - Significance of endothelial prostacyclin and nitric oxide in peripheral and
      pulmonary circulation.
AB  - BACKGROUND: Vasoprotective function of endothelial cells is associated, among
      others, with biosynthesis and release of nitric oxide (NO), prostacyclin (PGI2),
      prostaglandin E2 (PGE2), carbon monoxide (CO) and plasminogen activator (t-PA).
      These endothelial mediators calm down activated platelets and leukocytes, prevent
      the occurrence of parietal thrombotic events, promote thrombolysis, maintain
      tissue perfusion and protect vascular wall against acute damage and against
      chronic remodeling. Endothelial dysfunction in patients suffering from
      atherosclerosis or diabetes type 2 is associated not only with suppression in
      release of the above mediators but also with deleterious discharge of
      prostaglandin endoperoxides (PGH2, PGG2), superoxide anion (O2-, peroxynitrite
      (ONOO-), and plasminogen activator inhibitor (PAI-1). We looked for mechanisms of
      protective endothelial function, with a special respect to the differences
      between peripheral and pulmonary circulation. METHODS: Cultured endothelial cells
      of bovine aorta (BAEC) were used to study physiological and pharmacological
      mechanisms of increasing free cytoplasmic calcium [Ca2+]i. A porphyrinic sensor
      quantified the release of NO from BAEC. In cultured human umbilical vein
      endothelial cells (HUVEC) we looked for induction by bradykinin (Bk) of mRNAs for
      a number of enzymes. In blood perfused rat lungs we studied protective role of NO
      against injury inferred by lipopolysaccharide on pulmonary microcirculation that
      was accomplished by thromboxane A2 (TXA2), platelet activating factor (PAF),
      cysteinyl-leukotrienes (cyst-LTs) and the complement system. In vivo we analyzed
      the influence of Bk, perindopril and quinapril ('tissue type' angiotensin
      converting enzyme inhibitors, ACE-Is) on endothelial function in entire
      circulation of anaesthetized rats using a thrombolytic bioassay and EIA for 6
      keto-PGF1 alpha and t-PA antigen. RESULTS: In BAEC Bk via kinin B2 receptors
      raised in a concentration-dependent manner (1 pM-10 nM) free cytoplasmic calcium
      ions [Ca2+]i, that triggered the release of NO from BAEC. Calcium ionophore
      (A23187, 1-100 nM) as well as receptor agonists such as adenosine diphosphate
      (ADP, 10 nM-1 microM), adrenaline (Adr, 1-10 microM) or acetylcholine (Ach, 10
      100 microM) produced a similar rise in endothelial [Ca2+]i as did Bk at a
      nanomolar concentration. 'Tissue type' ACE-Is, e.g. quinapril or perindopril
      acted through accumulation of endogenous Bk. However, the potency of ACE-I to
      change endothelial function is by several orders of magnitude lower than that for
      exogenous Bk. In vivo the major difference between thrombolytic actions by
      quinapril or perindopril on one hand, and by exogenous Bk on the other was
      longevity of thrombolysis by ACE I and a distinct hypotensive action of exogenous
      Bk. Still, the long-lasting isolated thrombolytic effect of ACE I was mediated
      entirely by endogenous BK as evidenced by the preventive action of icatibant, a
      kinin B2 receptor antagonist. Moreover, in vivo the immediate thrombolysis by ACE
      I was mediated by PGI2 rather than by NO or t-PA, as shown by pharmacological
      analysis, and by direct blood assays of 6-keto-PGF1 alpha and t-PA antigen.
      Bradykinin as a mediator of pleiotropic endothelial action of several
      cardiovascular drugs (e.g. ACE-I) may complete its mission not only through B2
      receptor and [Ca2+]i--mediated release of PGI2 or NO. Here, we describe a new
      route of the Bk action. Bk mediated induction of the [Ca2+]i-independent, so
      called 'inducible', endothelial isoenzymes required for generation of CO, PGI2
      and PGE2. After 4 hours of incubation of HUVEC with Bk (10 nM) it induced mRNAs
      for haemooxygenase 1 (HO-1), cyclooxygenase 2 (COX-2), prostaglandin E synthase
      (PGE-S) whereas mRNA for nitric oxide synthase 2 (NOS-2) was weakly affected. We
      proved also that unlike in peripheral circulation, in pulmonary circulation only
      NO but not PGI2 would play a protective role. In the blood-perfused lung,
      endotoxaemia liberates lipids, such as TXA2, PAF and cyst-LTs. These toxic lipids
      along with the activated complement mediate pulmonary damage. Pulmonary
      endothelial nitric oxide is the only local protector against lung injury evoked
      by the phagocytised bacterial lipopolysaccharide. SUMMARY: Summing up, in
      peripheral circulation endogenous Bk is the most efficient activator of
      protective endothelial function. For instance, thrombolytic action of 'tissue
      type' ACE-I depends on the Bk-released PGI2. Acting as an agonist of endothelial
      B2 kinin receptors Bk rises [Ca2+]i with a subsequent activation of constitutive
      COX 1 and NOS-3. This is followed by an immediate release of PGI2 and NO.
      Moreover, acting as 'microcytokine' Bk induces mRNAs for HO-1, COX-2 and PGE S,
      the isoenzymes responsible for a delayed endothelial biosynthesis of CO, PGI2 and
      PGE2. (ABSTRACT TRUNCATED)

PMID- 11208488
TI  - Stoppage of blood flow in 3-methylcholanthrene-induced autochthonous primary
      tumor due to a novel combretastatin A-4 derivative, AC7700, and its antitumor
      effect.
AB  - BACKGROUND: Using several transplanted tumors in rats and mice, we have recently
      shown that the acute extensive necrosis of tumor nodules is caused by the
      systemic administration of AC7700, a novel combretastatin A-4 derivative, and
      that the necrosis can be attributed to irreversible stoppage of tumor blood flow
      (TBF). In this study, the antivascular and antitumor effects of AC7700 were
      tested on primary autochthonous tumor. MATERIAL AND METHODS: Primary sarcomas
      were induced in Fischer F344 rats by a single s.c. inoculation of 3
      methylcholanthrene (MC) (4 mg/0.5 ml/head). Changes in TBF due to AC7700 were
      measured by hydrogen clearance technique. Antitumor effects of AC7700 were
      evaluated by histology and tumor growth inhibition. RESULTS: The earliest primary
      tumor appeared 77 days after MC treatment and the last tumor appeared after 273
      days (median, 140 days). Once tumors occurred, they continued to grow slowly and
      never regressed spontaneously. The mean doubling time of tumors (n = 34) during
      exponential growth was 12.6 +/- 9.0 days (mean +/- SD) (range, 5.4-55.9 days).
      Blood flow in these slow-growing autochthonous tumors decreased highly
      significantly from 25.2 +/- 15.5 to 4.4 +/- 3.2 ml/min/100 g (24 electrodes)(P <
      0.001) within 30 min due to rapid i.v. injection (0.15 ml/min) of 10 mg/kg AC7700
      and the decreased TBF did not recover during the experimental period of 6 h. On
      the other hand, TBF did not change significantly due to 0.9% NaCl solution (10
      electrodes). In addition, TBF immediately began to decrease following slow
      infusion (0.005 ml/min) of 10 mg/kg AC7700 and decreased by approximately 80% (12
      electrodes) at 20 min after the start of AC7700 infusion. To evaluate the
      antitumor effect of AC7700 on the primary tumors, 10 mg/kg AC7700 was injected
      i.v. to tumor-bearing rats. Although in the natural course, such tumors never
      stop growing, the tumor growth was strongly inhibited by AC700 (n = 5). In 2
      cases, tumors never regrew for the observation period of 45 days. Biopsy and
      histological findings (n = 5) showed that tumors underwent extensive necrosis, as
      was observed previously for transplanted tumors following AC7700 administration.
      CONCLUSION: From the present experiment it was demonstrated not only in
      transplanted tumors but also in carcinogen-induced autochthonous primary tumors
      that acute and sustained stoppage of TBF led to strong antitumor effects. The
      novel anticancer compound AC7700 might become a very useful therapeutic strategy
      against refractory cancers.

PMID- 11208489
TI  - Contractility of smooth muscles and ultrastructure of their microfilaments in
      restriction of physical activity.
AB  - BACKGROUND: Depending on the intensity of hypodynamics (as a factor of ischemic
      heart disease) the aim of our investigation was to determine the contractility of
      smooth muscles of thoracic aorta with and without endothelium by biological
      active substances (prostaglandin F2 alpha and acetylcholine) and to compare with
      ultrastructural alterations of microfilaments. MATERIAL AND METHODS: A
      hypodynamic stress of 48-days duration was provoked via permanent and
      periodically recurrent intervention (when the hypodynamic state was altered with
      physical activity) in Chinchilla rabbits by placing them in metal hutches
      (according to B. M. Fiodorov). The relaxing effect of endothelium--dependent
      vasodilatator agonist (acetylcholine in concentration 10(-7) M, 10(-6) M, 10(-5)
      M, 10(-4) M) on smooth muscles (treated with vasoconstrictor prostaglandin F2
      alpha) was detected by means of a mechanotron 6 MXIC in isometric regime. The
      contraction force was expressed in percentage. One hundred percent was the
      maximum contraction that developed after administration of 2 x 10(-5) M
      prostaglandin F2 alpha solution to the smooth muscles preparation. For
      ultrastructure studies of microfilaments semithin sections of smooth muscles were
      examined with electron microscope 'Philips--300'. RESULTS: The research findings
      show that under the influence of acetylcholine the relaxing of endothelium of
      thoracic aorta smooth muscles (treated with prostaglandin F2 alpha) is more
      expressed in periodically recurrent intervention. CONCLUSION: Permanent
      hypodynamic stress of 48 days duration caused strongly expressed contractility of
      smooth muscles with is associated with ultrastructural damage of microfilaments
      (such as irregular formation, drop out in flakes, microfilaments becoming shorter
      and thicker).

PMID- 11208490
TI  - Tirilazad mesylate improve water immersion stress induced decrease in erythrocyte
      deformability in the rats.
AB  - BACKGROUND: Water immersion stress (WIS) in rats causes decrease in deformability
      of red blood cells (RBC). We hypothesize that this phenomenon is mediated by
      reactive oxygen species. Since tirilazad mesylate (U74006F) is a potent scavenger
      of free oxygen radicals, the aim of this study was to investigate possible
      influence of this drug on WIS induced decrease in RBC deformability in rats.
      MATERIAL AND METHODS: The rats were injected i.p. with tirilazad mesylate in a
      dose of 10 mg per kg body weight or vehiculum at the beginning of the experiment
      and immersed in water at 23 degrees C to the depth of xyphoid for 5 h. Control
      rats were kept in normal environment. After 6 h blood samples were collected for
      examination. An elongation index of RBC measured by Rheodyn SSD (Myrenne GmbH,
      Germany) was used as a parameter of deformability. Lipid peroxidation products
      have been assayed in RBC by BIOXYTECH LPO-586 kit. RESULTS: Tirilazad mesylate
      prevents a decrease in RBC deformability, but does not prevent an increase in
      concentration of lipid peroxidation products in erythrocytes during WIS.
      CONCLUSION: Positive effect of tirilazad on stress induced decrease in RBC
      deformability is not related to inhibition of lipid peroxidation within the
      erythrocytes.

PMID- 11208491
TI  - Heparin-induced modulation of insulin like-growth factor-I action on glucose
      level in control and fasted rats.
AB  - BACKGROUND: Insulin like-growth factor-I (IGF-I) circulates in serum bound to IGF
      binding proteins (IGFBPs), which are important regulators of IGF's biological
      activity. There are at least two classes of BPs: a high molecular weight complex
      (HMWBPs) and low molecular weight species (LMWBPs), with different affinity for
      IGF-I. Their specific role in regulation of IGF-I bioactivity is still
      controversial. Since: a) IGF-I plays an important role in glucose counter
      regulation; b) heparin was shown to alter IGF-I affinity to BPs; and c) fasting
      is known to change quantity and quality of serum BPs, we decided to measure the
      in vivo effect of heparin on blood IGF-I, BPs and glucose levels in control and
      fasted rats. MATERIALS AND METHODS: Control and fasted rats were injected i.v.
      with heparin (500 UI/100 g body weight) every hour during 3 hours of the
      experiment. Blood samples were collected before and 15 or 30 minutes after
      heparin injection and used for determination of free and bound IGF-I (RIA), BPs
      (radiometric assay) and glucose level (glucose oxidase method). RESULTS: Heparin
      treatment induced hypoglycaemia in fasted rats while it induced hyperglycemia in
      control one. The evidence was provided that heparin dissociates IGF-I from HMWBPs
      complex of control rat serum (predominant one in serum of these animals) and
      released IGF-I in turn is bound to LMWBPs--known as inhibitors of IGF-I dependent
      functions. In contrast, in fasted rat serum heparin dissociates IGF-I from LMWBPs
      (predominant complex in serum of these animals) making IGF-I free and available
      to stimulate IGF-I dependent functions. Therefore in control animals, which were
      administered heparin, blood glucose level was elevated and in fasted animals it
      was decreased. CONCLUSIONS: The data presented raise the possibility that IGF-BPs
      may have an important role in IGF-dependent glucose counter regulation and that
      heparin or heparin-like molecules may affect the process. Medical significance of
      heparin-induced hyperglycaemia in control animals should be taken into
      consideration since heparin is commonly used in clinical practice.

PMID- 11208492
TI  - The changes of alpha-amylase activity in serum and different tissues of female
      rat during sex cycle--isoelectrofocusing studies of alpha-amylase.
AB  - BACKGROUND: It has been suggested that hormonal changes may influence alpha
      amylase activity during sex cycle. The aim of this study was to evaluate these
      changes in serum and different tissues during sex cycle in female rats. MATERIAL
      AND METHODS: The animals were assigned to proestrus, estrus, and diestrus groups
      depending on vaginal smears. We measured the activities of alpha-amylase in the
      serum, liver, salivary glands, pancreas and ovary of female rats, serum level of
      calcium, rat luteinising hormone (rLH) and rat follicle stimulating hormone
      (rFSH). The serum and tissue amylases were also characterized by wide-range
      polyacrylamide gel isoelectrofocusing. RESULTS: Statistically significant changes
      of alpha-amylase activity were found only in the ovary. The activity of alpha
      amylase raised from proestrus (mean 303 +/- 124 IU/g) through estrus (mean 157 +/
      123 IU/g) and declined in diestrus (mean 81.9 +/- 51.6 IU/g). There were no
      statistically significant changes in the serum, liver, salivary glands and
      pancreas. We found two isoenzymes of alpha-amylase: one peak of amylase, present
      in the serum, liver, salivary gland and ovary with the mean isoelectric point of
      ca 5.34 and another present in ovary and pancreas with mean isoelectric point of
      ca 8.32. The only tissue found to contain both isoamylases was the ovary. We did
      not find any correlation between serum calcium level and alpha-amylase activity
      in the serum and ovary. CONCLUSION: The pattern of changes of alpha-amylase
      activity does not depend on the type of isoamylase in the tissue, but probably on
      the tissue influenced by the sex cycle. The changes of alpha-amylase activity are
      not mediated by calcium, they seem to result primarily from the profile of sex
      hormones affecting directly the target tissues.

PMID- 11208493
TI  - Changes in serum concentrations of markers of myocardial injury following
      treadmill exercise testing in patients with suspected ischaemic heart disease.
AB  - BACKGROUND: The treadmill exercise test (TEST) is frequently used in patients
      with suspected ischaemic heart disease to establish a diagnosis and estimate
      future risk. However, its predictive value is poor. We aimed to investigate
      whether measurement of biochemical markers of myocardial injury could improve the
      diagnostic value of the procedure. MATERIAL AND METHODS: Twenty-four subjects
      with suspected acute coronary syndrome underwent a treadmill exercise stress
      test. Of these 13 had had a previous myocardial infarction and two had a past
      history of coronary artery bypass grafting. Nine subjects were found to be
      positive for coronary ischaemia during the treadmill test. Serum cardiac markers
      (total creatine kinase [CK], CK-MB, Troponin I and Troponin T) were measured pre
      TEST, and 0, 1, 2, 4, 8 and 24 hours following the treadmill test. RESULTS: Total
      CK remained within the reference range for all subjects and showed no significant
      rise. However, mean serum concentrations of CK-MB were significantly higher than
      pre-test values at 2 hours (p < 0.03) following treadmill exercise testing in
      subjects who had a positive exercise stress test, but not in those with a
      negative test. In the subjects with a positive stress test, CK-MB levels returned
      to pre-Test value by 24 hours. Levels of neither serum troponin I, nor troponin T
      altered significantly at any point. CONCLUSION: The measurement of CK-MB, but not
      cardiac troponins may add to the diagnostic utility of the TEST.

PMID- 11208494
TI  - Power spectral components of heart rate variability in different types of cardiac
      remodelling in hypertensive patients.
AB  - BACKGROUND: The aim of the study was to evaluate whether there are any
      significant differences in cardiac autonomic regulation in distinct types of
      hypertensive cardiac remodelling. MATERIAL AND METHODS: We examined 86 patients
      with mild to moderate essential hypertension (EH). The parameters of left
      ventricle (LV) were measured by echocardiography: the diastolic mass normalized
      for body surface area (LVMI) and relative wall thickness (RWT). All patients were
      divided into three groups: normal LV geometry (23), concentric left ventricular
      hypertrophy (LVH) (29) and eccentric LVH (34). The control group included 30 age
      and sex-matched healthy volunteers. For calculation of heart rate variability
      (HRV) 512 RR intervals in supine rest and passive tilt were measured. Power
      spectral analysis with fast Furrier transform was used to obtain the total power,
      low frequency (LF) power (from 0.003 to 0.14 Hz), high frequency (HF) power (from
      0.15 to 0.40 Hz) and sympathovagal index (SVI) as LF:HF ratio. RESULTS: The
      parameters of HRV did not differ significantly among the groups studied. In the
      group with normal LV geometry there was observed a good response to tilt test
      resulting in an increase of SVI in three times (from 2.4 +/- 0.3 to 7.2 +/- 0.4),
      while in patients with both types of LVH there were no significant changes in SVI
      or even an inverse reaction to passive tilt. In the group with normal geometry
      patients with higher meanings of RWT had higher LF power (r = 0.52, p < 0.01),
      while in patients with LVH the increasement of LVMI and RWT was associated with
      reduction of HRV (rr = -0.43, -0.36, p < 0.05, respectively). CONCLUSIONS: Heart
      rate variability is significantly reduced in essential hypertension and is also
      closely connected with cardiac structure and function. Patients with normal LV
      geometry are characterized by a preserved response to tilt test. LVH produce
      significant disturbances of autonomic regulation possibly due to lower
      sensitivity of cardiac adrenoreceptors independently of the LVH pattern.

PMID- 11208495
TI  - Sudden rate drop intervention rate level in patients with new 'clarity'
      pacemakers and carotid sinus syndrome.
AB  - BACKGROUND: In patients in whom syncopal episodes are mainly caused by occasional
      drops in heart rate, Sudden Rate Drop intervention feature intends to provide
      high rate intervention pacing. New Vitatron Medical B.V. pacemaker system Clarity
      DDDR, provides AN option FOR recognizing Sudden Rate Drop and responding by
      intervention pacing until it detects the recovering. MATERIAL AND METHODS: In
      patients with carotid sinus syndrome it is possible to provoke this situation BY
      sinus carotidus massage. We have implanted 10 of these devices in our center, 2
      of which in patients with hypersensitive carotid sinus syndrome. In both
      patients, we activated sudden rate drop intervention on DDD mode pacing and
      applied protocol for testing the necessary level of Sudden Rate Drop Intervention
      Rate. Both patients gave their informed consent to be submitted to this testing.
      Pacemaker software assumes rate intervention level of 110 bpm. We tested our
      patients for rate levels of 90 and 110 bpm. Massaging the carotid sinus during 5
      seconds, we provoked Sudden Rate Drop Intervention 10 times, in each patient, 5
      times at intervention rate of 90 and 5 times at 110 bpm. Patients were unaware of
      the programmed intervention rate and were merely expected to report any different
      sensations experienced during the testing. RESULTS: In all 20 tests, pacemaker
      responded to sudden rate drop elicited by carotid sinus massage (100%), which was
      verified by selected event recordings. After the massage, neither of the patients
      registered any sensations at sudden rate drop intervention rate level of 90 bpm
      in a total od 10 tests (100%), while 8 out of 10 massages at 110 bpm intervention
      rate provoked palpitations (80%). On the grounds of this testing, we concluded
      that lowering of Sudden Rate Drop Intervention Rate Level from 110 BPM to 90 BPM
      does not affect the reliability of system reaction, but changes patient's
      awareness of heart beats. CONCLUSION: As a final conclusion, it should be said
      that basic prerogatives of a pacing system: safety and efficacy with minimal
      energy consumption, and in this case, quality of life option that a patients
      practically does not feel intervention when it occurs, are all met.

PMID- 11208496
TI  - Efficacy of sequential antiarrhythmic treatment in sinus rhythm maintenance after
      successful electrocardioversion in patients with chronic non-valvular atrial
      fibrillation.
AB  - BACKGROUND: Sequential use of antiarrhythmic drugs may improve prognosis in
      chronic atrial fibrillation (AF). We conducted a prospective study of the
      efficacy of sequential antiarrhythmic drug therapy in sinus rhythm (SR)
      maintenance after a successful electrocardioversion (CV) in pts with chronic AF.
      MATERIAL AND METHODS: 58 pts (64.3 +/- 4.3 years old) with chronic AF underwent
      CV. After SR restoration (Group I) pts received one of the following
      antiarrhythmic drugs (Drug I): propafenone, sotalol or disopyramide. In case of
      arrhythmia recurrence, second CV was performed and pts received another drug from
      those mentioned above (Drug II). If treatment proved to be unsuccessful pts
      received amiodarone (Drug III) and third CV was attempted. After first
      unsuccessful CV (Group II) pts received a loading dose of amiodarone and another
      CV was attempted. In case of SR restoration amiodarone was administered
      continuously. RESULTS: After 12 months 81% pts were on SR; 85% pts received
      amiodarone continuously. After 1 year 6 (10%) pts presented with SR treated with
      Drug I (median 71 days); Drug II proved to be ineffective in all patients (median
      27 days). 28 pts continued to receive amiodarone (no median). CONCLUSIONS:
      Sequential antiarrhythmic drug therapy improves arrhythmia prognosis in AF within
      a 12-month observation period. Amiodarone seems to be the most effective
      antiarrhythmic drug also in pts who required second CV proceeded by amiodarone
      treatment to restore SR.

PMID- 11208497
TI  - Effects of the T-type calcium channel blockade with oral mibefradil on the
      electrophysiologic properties of the human heart.
AB  - BACKGROUND: As the calcium T-channel blockade is a new pharmacological category
      with presumably unique electrophysiological effects, the influence of its only
      representative yet mibefradil was tested after the single oral dose. MATERIAL AND
      METHODS: 10 patients underwent the electrophysiologic examination. Normal
      baseline values in sinus node cycle length (SNCL), sinus node recovery time
      (SNRT), corrected sinus node recovery time (CSNRT), PA interval, atrial effective
      refractory period, AH interval, Wenckebach point (WP), atrioventricular nodal
      refractory period, and HV interval were measured using standard techniques. After
      that a single dose of 100 mg mibefradil was given and the testing repeated in 90
      minutes. RESULTS: Though non-significantly in a study-group limited in size due
      to global withdrawal of mibefradil, sinus node automaticity was suppressed
      (prolongation of SNRT by 5.1% and CSNRT by 11.5%) and heart rate lowered (SNCL
      prolonged by 2.8%) comparatively more than was the negative dromotropic effect on
      the atrioventricular node (negligible prolongation of AH interval by 1.1% and WP
      cycle by 0.4%). CONCLUSIONS: Demonstrated electrophysiological effects of oral
      mibefradil with more pronounced influence on the automaticity of the sinus node
      seem to be in agreement with the preclinical data on the predominant role of T
      channels in the pacemaker activity of the sinus node. According to the Framingham
      data on the risk of heart rate for the cardiovascular as well as all-cause
      mortality, calcium T-channel blockade offers a desirable profile for
      antihypertensive treatment. From this point of view development of new
      representatives of calcium T-channel blockers could be a useful contribution to
      clinical practice.

PMID- 11208498
TI  - Statistical dependence of clinical data on the chosen treatment of patients with
      a multivessel coronary artery disease.
AB  - BACKGROUND: In this study we tried to check which clinical data are connected
      with the choice of treatment in patients with a multivessel coronary artery
      disease. MATERIAL AND METHODS: The data of 137 patients with a multivessel
      coronary artery disease, were analysed retrospectively. The patients were divided
      into three groups: treated conservatively, CABG and PTCA. Multivessel coronary
      artery disease was recognised when there were atherosclerotic changes in more a 2
      vessels with a not less a 2 mm in diameter. Patients with previous CABG or a left
      main coronary artery disease were excluded. The data were analysed by means of
      several methods, variance analysis, correlation analysis, discriminant functions,
      chi-square test and T-Student test. RESULTS: For treatment decision making in
      multivessel coronary artery disease of statistical significance were: the state
      of the left anterior descendent artery below the first diagonal branch, the state
      of the first diagonal branch and peripheral parts of the left anterior descendent
      artery and right coronary artery, the systolic function of the antero-lateral,
      apical and phrenic segments of the left ventricle, the global left ventricular
      ejection fraction in angiography and echocardiography, local systolic
      disturbances of the left ventricular observed in echocardiography, the
      coexistence of symptoms of heart failure as well as unstable angina. CONCLUSION:
      Treatment decision making will always depend not only on diagnostic procedures
      but also on all the clinical data about the patient and the experience of
      coworking cardiology and surgery centres.

PMID- 11208499
TI  - Cholecystitis, gallstones and free radical reactions in human gallbladder.
AB  - BACKGROUND: The relationship between biophysical and biochemical processes of
      gallbladder bile and free radical reactions is still not known. The aim of our
      study was to investigate the correlation between free radical production and the
      degree of inflammation in gallbladder. MATERIAL AND METHODS: The degree of
      chronic cholecystitis was determined by observing the number of infiltrating
      lymphocytes and the mucosal epithelial change. The free radical reaction products
      were determined by measuring the chemiluminescent light intensity, the
      malondialdehyde (MDA) and dien concentration of bile. RESULTS: The content of
      free radical reaction products, like MDA and diene in bile slightly decreased
      with the severity of cholecystitis. The size of stones inversely correlated with
      the severity of inflammation. The chemiluminescent light intensity showed
      correlation with bilirubin concentration. Between 501 (mol/l range the bilirubin
      gave significantly higher chemiluminescent light intensity, than in the lower and
      in the higher concentration range. In this bilirubin concentration range diene
      concentration correlated inversely with chemiluminescent light intensity, while
      MDA concentration elevated with the bilirubin concentration. CONCLUSION:
      Correlation was found between the number of stones and the degree of
      cholecystitis which may indicate that free radical products are incorporated into
      the stones and do not stay in solution. The high chemiluminescent light intensity
      of the bile at the 501-1300 (mol/l bilirubin concentration range means that
      bilirubin participates at this concentration most reactively in free radical
      reactions. These results suggest, that there is a correlation between free
      radical reactions, gallstone formation and the degree of cholecystitis.

PMID- 11208500
TI  - Level of malondialdehyde after short-time omeprazole administration.
AB  - BACKGROUND: Omeprazole is a proton pump inhibitor of increasingly wide
      application in the treatment of different gastroenterological diseases. The
      purpose of the study was to evaluate the effect of omeprazole (O) on the level of
      plasma malondialdehyde (MDA). MATERIAL AND METHODS: Omeprazole was administered
      intraperitoneally to male Wistar rats twice a day, for 3 days, in two doses: O1
      0.57 mg/kg body weight (b.w.), O2-5.71 mg/kg b.w. Twelve hours after the last
      injection half of the animals were terminated (I). The remaining rats were kept
      for the next 6 weeks without any xenobiotics (II). The blood was taken from the
      still beating heart and then centrifuged. The plasma level of MDA was determined
      and compared to the 1 mg of the blood protein. RESULTS: A significant (p < 0.05)
      increase of MDA level was found in the O2II group, as compared with the O2I
      group. The level of MDA was higher after 6 weeks' period in relation to the
      animals that were terminated on the 4th day of the experiment. CONCLUSION: Three
      day omeprazole administration did not change the MDA level in the rat plasma.

PMID- 11208501
TI  - Effect of immunosuppressive cladribine treatment on serum leucocytes system in
      two-year clinical trial in patients with chronic progressive multiple sclerosis.
AB  - BACKGROUND: Multiple sclerosis is presumably cell-mediated autoimmune disorder
      with immune abnormalities as presence of activated T-cells and increase
      interleukin 2 (IL-2) and soluble IL-2 receptor (sIL-2R) levels in central nervous
      system and peripheral blood of patients. The aim of immunosuppressive treatment
      is to diminish such activation. The aim of this study was to evaluate the
      influence of immunosuppressive cladribine treatment with total dose of 2.1 mg/kg
      b.w. administered in 7 cycles for 12 months, on serum leucocytes in 34 chronic
      progressive multiple sclerosis (CPMS) patients observed for 2 years as well as IL
      2 and sIL-2R serum levels assessed before and right after the treatment. MATERIAL
      AND METHODS: The study was designed as a randomised, placebo-controlled, double
      blind trial. The patients were divided in two groups: group I, cladribine
      treated, n = 34; group II, placebo-treated, n = 35. Group III were healthy
      controls, n = 20. Leucocyte levels were determined with flow-cytometry. IL-2 and
      sIL-2R levels were assessed with enzyme-linked immunosorbent assay. RESULTS:
      Statistically significant gradual decrease of lymphocyte level was observed from
      7th week to 12th month after the beginning of treatment. During the following 12
      months, lymphocyte levels remained decreased in comparison to baseline. Mean
      values of IL-2 and sIL-2R levels measured 12 months after the treatment were
      found to be lowered by 20% (p. = 0.01) and by 24% (p. = 0.0005), respectively.
      CONCLUSION: The results obtained indicate fast and long-lasting decrease of serum
      leucocyte level and suppressive influence of cladribine treatment on immune
      processes in multiple sclerosis patients.

PMID- 11208502
TI  - Immunological investigation in children with juvenile chronic arthritis.
AB  - BACKGROUND: Immunological investigation is a part of the complex view on a child
      with juvenile chronic arthritis (JCA). We analyzed the data of a cohort of
      children with JCA in order to determine the real contribution of this
      investigation to their diagnosis and therapy. MATERIAL AND METHODS: We included
      the investigation of humoral immunity and autoantibodies of 78 children with JCA.
      18 children completed investigation of both humoral and cellular immunity of
      paired peripheral blood (PB) and synovial fluid (SF). Humoral immunity consisted
      from immunoglobulins, complement, circulating immune complexes, rheumatoid
      factors, soluble HLA I. molecules and antinuclear and antineutrophil cytoplasmic
      antibodies. Cellular immunity included cytometric studies of CD3, CD4, CD8,
      CD16/CD56, CD19, CD20, 23, CD3 HLA DR+, CD45 RA, CD45 RO, alpha/beta and
      gamma/delta T cells. To observe the status of Th1/Th2 balance in children with
      JCA, the cytokines IL-4, IFN gamma, TNF alpha and IL-6 were measured in the
      tissue culture of the synovial cells. RESULTS: The parameters of humoral immunity
      in serum showed wide variability. We could not confirm particular changes
      specific for the forms or stage of the disease. ANCA were positive in 21 out of
      78 children with JCA, 3 times both in PB and SF. More typical pattern could be
      followed in the comparison of PB and SF, with immunoglobulins and complement
      always found lower in SF than in PB. The cellular immunity was represented by the
      activation of lymphocytes mainly in SF, reverse ratio of CD45 RA and RO cells in
      PB and SF with marked predominance of memory T cells in the joint. High levels of
      sHLA in SF are the nonspecific marker of activation, the same is true for high
      levels of TNF alpha and IL 6 in SF cell culture supernatant. CONCLUSION: The
      described changes in immunological parameters of humoral and cellular immunity
      are not specific for JCA. In the individual cases they can contribute to the
      diagnosis and monitoring of the disease. The investigation of sHLA molecules and
      cytokine profile should be restricted only for research.

PMID- 11208503
TI  - Repeated cyclosporine therapy of peripheral arthritis associated with ankylosing
      spondylitis.
AB  - BACKGROUND: A case history of a patient with ankylosing spondylitis and
      peripheral arthritis unresponsive to the conventional drug therapy, but
      successfully controlled by the use of cyclosporin. MATERIAL AND METHODS: In a 68
      years old female patient with a 36 years history of typical ankylosing
      spondylitis a peripheral polyarthritis (hands, feet, wrists, and knees)
      developed. The patient did not suffer any other disease known to cause secondary
      spondylitis (psoriasis, inflammatory, bowel, disease). After the unsuccessful use
      of non-steroidal antiinflammatory drugs a combination therapy with cyclosporin (4
      mg/kg/day) and azapropazone (300 mg t.i.d.) was introduced. RESULTS: Clinical
      improvement was achieved after 6 months of combined therapy, the polyarthritis
      completely resolved after one year. Therefore cyclosporin was discontinued. After
      one year the polyarthritis reappeared therefore the cyclosporin therapy was
      reinstituted with success. CONCLUSION: Cyclosporin has proved consistently
      effective in our case to control the peripheral arthritis associated with
      ankylosing spondylitis.

PMID- 11208505
TI  - Incidence of vesicoureteral reflux in siblings of children with reflux--our own
      observations.
AB  - BACKGROUND: The aim of the study was to evaluate the incidence of primary
      vesicoureteral reflux in siblings of children with reflux. MATERIAL AND METHODS:
      Ninety-four subjects aged 2-6, the siblings of children with reflux were
      examined. Our methods included: urinalysis, urine cultures, ultrasound
      examination of abdominal cavity in all the examined subjects. Voiding cystography
      was conducted in selected cases. RESULTS: Primary vesicoureteral reflux was found
      in the total of 10% of the siblings of children with reflux. The incidence of
      reflux was the highest in the youngest age group. CONCLUSIONS: The incidence of
      primary vesicoureteral reflux in the siblings of affected children being at least
      ten times higher than population risk supports the necessity of screening in this
      group.

PMID- 11208504
TI  - Positive and negative strands of HCV-RNA in sera and peripheral blood mononuclear
      cells of chronically hemodialyzed patients.
AB  - BACKGROUND: Hepatitis C virus (HCV) RNA can be detected in sera and peripheral
      blood mononuclear cells (PBMC) of patients undergoing chronic hemodialysis.
      However, the natural course of HCV infection in this group of patients is not
      fully known. Although the exact mechanism of HCV replication is not completely
      explained, there is evidence that HCV replicate through synthesis of
      complementary negative (-) RNA strand, whereas positive (+) RNA strand serves as
      a template. Thus, the detection of negative HCV-RNA strand can be regarded as a
      marker of ongoing viral replication. MATERIAL AND METHODS: We investigated the
      prevalence of (+) and (-) strands of HCV-RNAs in sera and PBMC of 45 chronically
      hemodialyzed patients using PCR methods. We also determined HCV genotypes and
      their subtypes by Inno-LIPA method. RESULTS: Eight (17.8%) of analyzed patients
      were anti-HCV positive. In this group, we detected HCV-RNA (+) strands in sera
      and PBMC in 2 and 4 cases respectively, whereas HCV-RNA (-) ones were found in
      PBMC of 4 patients. Among the remaining 37 anti-HCV negative patients we found
      HCV-RNA positive strands in sera and PBMC in 2 and 3 cases respectively, whereas
      HCV-RNA negative strand was present in PBMC in one of them. CONCLUSIONS: Our
      results indicate that HCV actively replicate in PBMC in chronically hemodialyzed
      patients. In number of patients HCV-RNAs can be detected only in PBMC without
      concomitant presence of viremia or anti-HCV in sera. We did not find any
      correlation between genotypes of HCV and presence of HCV-RNAs strands in PBMC of
      the patients.

PMID- 11208506
TI  - Skin prick test response to enzyme enolase of the baker's yeast (Saccharomyces
      cerevisiae) in diagnosis of respiratory allergy.
AB  - BACKGROUND: The aim of the study is to prove that Saccharomyces cerevisiae
      enolase, the major allergen of the baker's yeast, induces allergic immediate
      response in patients with inhalant allergy sensitized to Candida albicans
      extract. MATERIAL AND METHODS: The study was performed in three groups of
      patients: I. 20 atopic patients with respiratory allergy sensitized to Candida
      albicans and inhalant allergens (mite, feather, pollens) II. 30 patients with
      respiratory allergy, positive skin tests to inhalant allergens but negative skin
      tests to Candida albicans and other fungi; III. 20 nonatopic, healthy
      individuals. Skin prick test of purified enolase from Saccharomyces cerevisiae
      (bakers yeast) at concentration 1 and 10 mg/ml was performed in all groups. The
      results were documented planimetrically. RESULTS: 95% of patients sensitized to
      Candida albicans extract showed positive skin reactions to Saccharomyces
      cerevisiae enolase, 10% of patients of group II and none of the patients of the
      control group had positive skin responses to enolase. The mean wheal size (mm2)
      in skin prick test to Candida albicans, Saccharomyces cerevisiae enolase at
      concentration 10 mg/ml was x = 15.17 +/- 11.08, 15.76 +/- 19.67 and at
      concentration 1 mg/ml 10.02 +/- 10.49, respectively. CONCLUSIONS: 1.
      Saccharomyces cerevisiae enolase induces an immediate allergic reaction in skin
      in subjects with respiratory allergy and positive skin prick test results to
      Candida albicans and other fungi. 2. Enolase can be an important allergenic
      component of the Candida albicans extract.

PMID- 11208507
TI  - Results of IDA-FLAG programme in the treatment of recurrent acute myeloblastic
      leukaemia--preliminary report.
AB  - BACKGROUND: Unsatisfactory treatment results of acute myeloblastic leukaemia
      inspire the search for new drugs, characterised by higher efficiency and lower
      toxicity. The aim of the study was the assessment of the efficiency and side
      effects associated with the implementation of IDA-FLAG protocol. MATERIAL AND
      METHODS: The assessment of treatment results and undesirable effects was based on
      the material of 4 children with the relapse of acute myeloblastic leukaemia,
      after a total of 6 IDA-FLAG protocols. RESULTS: Complete remission was obtained
      in 2 (50%) children, with mean remission time of 13.5 months. One of the children
      underwent the transplantation of haematopoietic cells from unrelated donor. The
      main side effect observed was bone marrow aplasia. Leucopenia, granulocytopenia,
      thrombocytopenia and anaemia persisted for approx. 20 days. Apart from
      haematological symptoms, the following were also observed: the symptoms of
      intolerance after ARA-C, aspergillosis of paranasal sinuses and lungs and severe
      coagulation disorders. CONCLUSION: IDA-FLAG protocol may be recommended for use
      in children with AML relapse and the undesirable effects observed are acceptable.

PMID- 11208508
TI  - Population data for the STR systems D8S1132, CD4, VWA and TH01 in the region of
      Podlasie (northeastern Poland).
AB  - BACKGROUND: STR systems are widely used in forensic casework due to their
      discriminating power and high sensitivity. The aim of the study was to determine
      allele frequencies and forensic efficiency parameters of the STRs D8S1132, CD4,
      VWA and TH01 in a population sample of Podlasie (Northeastern Poland). MATERIAL
      AND METHODS: Blood specimens were collected from the unrelated individuals in
      Podlasie, Poland. The DNA samples were extracted with Chelex method and amplified
      by PCR technique. The PCR products were analyzed by the PAG horizontal
      electrophoresis with discontinuous buffer system and then silver stained.
      RESULTS: All common alleles included in the allelic ladders were found. For all
      loci examined no deviations from Hardy-Weinberg equilibrium were found.
      CONCLUSION: The TH01, VWA and D8S1132 systems have been confirmed as particularly
      useful in the paternity testing and the individualization of biological evidence.

PMID- 11208509
TI  - Endogenous lipoid pneumonia associated with undifferentiated connective tissue
      disease (UCTD).
AB  - BACKGROUND: Lipoid pneumonia is a rare pulmonary disease, a form of pneumonia
      that has no classical radiological appearance, thus it can imitate other lung
      diseases. Lipoid pneumonia is usually classified into two major groups, depending
      on whether the source of oil/fat in the respiratory tract is from an exogenous or
      endogenous source. Undifferentiated connective tissue disease is a term used by
      rheumatologists to define a group of diffuse connective tissue disorders that
      lack definitive characteristics of any particular well-defined disorder. MATERIAL
      AND METHODS: A case study is reported of concomitant undifferentiated connective
      tissue disease and endogenous lipoid pneumonia. RESULTS: Histologically the
      macrophages appeared filled with lipid and were similar to atherosclerotic foam
      cell macrophages. Antibiotic and antimycotic treatments were ineffective.
      However, with concomitant steroid treatment, the patient exhibited absence of
      lung infiltration as well as other symptoms and was discharged. Therefore it is
      concluded that the lipoid pneumonia was steroid dependent. CONCLUSION: Since the
      patient's condition responded to steroid treatment, and it is clear that steroids
      inhibit phospholipase activity, the authors speculate that the subsequent
      decreased endoperoxide production may diminish lipid uptake by macrophages via
      decreasing modification of LDL or other lipid sources.

PMID- 11208511
TI  - Diabetic ketoacidosis in a patient with acromegaly.
AB  - Abnormalities of glucose metabolism are a common feature of acromegaly. Overt
      diabetes mellitus develops in about 10-15% of patients. We present an unusual
      complication of acromegaly: a 37-year old man with a 2-year history of acromegaly
      developed diabetic ketoacidosis 3 weeks after transsphenoidal adenomectomy. No
      specific cause for this sudden metabolic derangement could be demonstrated.
      Insulin need was very high in the first days after the onset of ketoacidosis, but
      was considerably reduced after initiation of treatment with octreotide and after
      successful re-operation.

PMID- 11208510
TI  - Clinical onset of the Crohn's disease after eradication therapy of Helicobacter
      pylori infection. Does Helicobacter pylori infection interact with natural
      history of inflammatory bowel diseases?
AB  - BACKGROUND: There are conflicting reports concerning the prevalence of
      Helicobacter pylori infection in patients with inflammatory bowel diseases: some
      studies connected Sulphasalazine therapy and lower incidence of Helicobacter
      pylori infection, but others showed lower prevalence of Helicobacter pylori
      infection in inflammatory bowel diseases despite the choice of therapy. CASE
      REPORT: A 28-year-old male patient presented in January 1996 with the symptoms of
      ulcer like dyspepsia. There was no significant abnormality on physical
      examination, laboratory testing and abdominal ultrasound. Histology examination
      of the biopsy specimen taken during the upper endoscopy revealed Helicobacter
      pylori associated active gastritis only in the corporal part of the stomach.
      After two weeks eradication therapy (Omeprazole, Amoxicillin) he was well. Three
      months later, at the control endoscopy, granulomatous gastritis of the corporal
      localization was detected, without Helicobacter pylori present. Antral mucosa
      appeared normal, both, on endoscopy and histology examination. In July 1996 he
      started with cramping abdominal pain, mild periodical fever and episodes of
      watery diarrhea. In laboratory results we found nonspecific signs of
      inflammation. We repeated upper endoscopy, colonoscopy and enteroclysis--with
      evidence of segmental stenotic lesions of the upper part of ileum and jejunum.
      Again, we confirmed granulomatous gastritis and small granuloma in the proximal
      jejunum. After starting the 5-ASA therapy in combination with Metronidazol,
      patient was better clinical condition, and laboratory results were normal. We
      suggested mesalamine maintenance therapy 1 gr. every day, and three years later
      he is well, in clinical remission of Crohn's disease. CONCLUSION: The clinical
      course of the Crohn's disease maybe "sui generis" connected with Helicobacter
      pylori infection- but the exact mechanisms remain to be discovered.

PMID- 11208512
TI  - In vitro evaluation of the embolic risk of diagnostic and therapeutic
      intravascular procedures.
AB  - BACKGROUND: The purpose of the study was to evaluate the risk of distal
      embolisation in a silicon model during different endovascular diagnostic and
      therapeutic procedures. MATERIAL AND METHODS: Endovascular technics, such as
      guidewire and catheter advancement, metal stent placement and balloon angioplasty
      were compared. Clots were produced from human blood sample. The transparent
      silicon model was filled with saline, flow was generated by an hydraulic pump.
      Stenosis was created by mechanical compression. The size of the circulating
      particles were measured with a mesh of nylon filters. RESULTS: No loose particles
      were detected using guidewire, pigtail and straight catheters. Balloon inflation
      induced embolisation of particles ranging from 100 microns to 10 mm in length.
      Deployment of self expandable metallic stents did not result in particle
      migration but secondary angioplasty inside the stent detached particles (ranging
      from 400 microns to 12 mm in length). Deployment of balloon expandable stent
      yielded in the stretching of the clot, which became sometimes longer than the
      stent, resulting in the detachment of the non covered portion. CONCLUSION: The
      risk of distal embolisation during guide-wires and catheters manipulation is not
      significant. Balloon catheters and secondary angioplasty after deployment of self
      expanding stents caused large particles detachment.

PMID- 11208513
TI  - Towards MRI guided surgical manipulator.
AB  - BACKGROUND: The advantages of surgical robots and manipulators are well
      recognized in the clinical and technical community. Precision, accuracy and the
      potential for telesurgery are the prime motivations in applying advanced robot
      technology in surgery. In this paper critical interactions between Magnetic
      Resonance Imaging equipment and mechatronic devices are discussed and a novel
      Magnetic Resonance compatible surgical robot is described. MATERIAL AND METHODS:
      Experimental results of the effects from several passive (metallic materials) and
      active (ultrasound motors) mechanical elements are demonstrated. The design
      principles for Magnetic Resonance compatible robots are established and the
      compatibility of the proposed robot is assessed by comparing images taken with
      and without the robot's presence within Signa SP/I GE Medical Systems scanner.
      RESULTS: The results showed that, in principle, it is possible to construct
      precision mechatronic devices intended to operate inside MR scanner. Use of such
      a device will not cause image shift or significant degradation of signal-to-noise
      ratio. An MR compatible surgical assist robot was designed and constructed. The
      robot is not affected by the presence of strong magnetic fields and is able to
      manoeuvre during imaging without compromising the quality of images. A novel
      image-guided robot control scheme was proposed. As a part of the control scheme,
      biomechanics-based organ deformation model was constructed and validated by in
      vivo experiment. It has been recognised that for robust control of an image
      guided surgical robot the precise knowledge of the mechanical properties of soft
      organs operated on must be known. As an illustration, results in mathematical
      modelling and computer simulation of brain deformation are given. CONCLUSION: The
      novel MR compatible robot was designed to position and direct an axisymmetric
      tool, such as a laser pointer or a biopsy catheter. New Robot control system
      based on the prediction of soft organ deformation was proposed.

PMID- 11208514
TI  - Bladder cancer--genetic overview.
AB  - BACKGROUND: This article review the serial genetic changes which are responsible
      to the initiation and progression of bladder cancer. Knowledge of the exact
      genetic alteration has a direct implication on the development of knew more
      sensitive and specific tool for an early diagnosis and better prognosis
      calculations. CONCLUSION: Bladder cancer develop and progress through a series of
      genetic alterations. Understanding of the genetic mechanisms which lead to
      malignant transformation gave rise to the development of various genetic
      mechanisms which lead to malignant transformation gave rise to the development of
      various genetic tools providing better ability of early detection and more
      accurate prognosis prediction.

PMID- 11208515
TI  - Insulin receptor--structural and functional characteristics.
AB  - The insulin receptor is a complex multifunctional protein located on the cell
      surface within the fluid mosaic matrix of the plasma membrane. Its ability to
      bind insulin is determined by structural and spatial specificity, high affinity
      and reversibility. Insulin action at the cellular level can be considered in
      three stages. The first stage includes the insulin receptor itself, the insulin
      substrate (IRS-1) and the molecules that interact with IRS-1. The second stage is
      that of cascade phosphorylation and dephosphorylation. The third stage concerns
      the final biological effects of the insulin cascade. The biological specificity
      of insulin binding and heterogeneity of insulin action in different cells has
      been well documented. This review intends to summarize the available data of
      structural and functional characteristics of insulin receptor.

PMID- 11208516
TI  - Focus on "Essential role for IL-6 in postresuscitation inflammation in
      hemorrhagic shock".

PMID- 11208517
TI  - Fiber type-specific expression of major proteolytic systems in fast- to slow
      transforming rabbit muscle.
AB  - The present study investigates the role of two major proteolytic systems in
      transforming rabbit and rat muscles. The fast-to-slow transformation of rabbit
      muscle by chronic low-frequency stimulation (CLFS) induces fast-to-slow
      transitions of intact, mature fibers and replacement of degenerating fibers by
      newly formed slow fibers. Ubiquitination, an indicator of the ATP-dependent
      proteasome system, and calpain activity were measured in homogenates of control
      and stimulated extensor digitorum longus muscles. Calpain activity increased
      similarly (approximately 2-fold) in stimulated rat and rabbit muscles. CLFS had
      no effect on protein ubiquitination in rat muscle but led to elevations in
      ubiquitin protein conjugates in rabbit muscle. Immunohistochemistry was used to
      study the distribution of micro-calpain and m-calpain and of ubiquitinated
      proteins in myosin heavy chain-based fiber types. The findings suggest that both
      proteolytic systems are involved in fiber transformation and replacement.
      Transforming mature fibers displayed increases in micro-calpain and accumulation
      of ubiquitin protein conjugates. The majority of these fibers were identified as
      type IIA. Enhanced ubiquitination was also observed in degenerating and necrotic
      fibers. Such fibers additionally displayed elevated m-calpain levels. Conversely,
      p94, the skeletal muscle-specific calpain, decayed rapidly after stimulation
      onset and was hardly detectable after 4 days of CLFS.

PMID- 11208518
TI  - Hypertonicity-induced phosphorylation and nuclear localization of the
      transcription factor TonEBP.
AB  - The accumulation of compatible osmolytes during osmotic stress is observed in
      virtually all organisms. In mammals, the hypertonicity-induced expression of
      osmolyte transporters and synthetic enzymes is conferred by the presence of
      upstream tonicity-responsive enhancer (TonE) sequences. Recently, we described
      the cloning and initial characterization of TonE-binding protein (TonEBP), a
      transcription factor that translocates to the nucleus and associates with TonE
      sequences in a tonicity-dependent manner. We now report that hypertonicity
      induces an increase in TonEBP phosphorylation that temporally correlates with
      increased nuclear localization of the molecule. TonEBP phosphorylation is not
      affected by a number of kinase inhibitors, including the p38 inhibitor SB-203580.
      In addition, in vitro binding assays show that the association of TonEBP with
      TonE sequences is not affected by phosphorylation. Thus TonEBP phosphorylation is
      an early step in the response of cells to hypertonicity and may be required for
      nuclear import or retention.

PMID- 11208519
TI  - Regional variation in myosin isoforms and phosphorylation at the resting tone in
      urinary bladder smooth muscle.
AB  - Urinary bladder filling and emptying requires coordinated control of bladder body
      and urethral smooth muscles. Bladder dome, midbladder, base, and urethra showed
      significant differences in the percentage of 20-kDa myosin light chain (LC20)
      phosphorylation (35.45 +/- 4.6, 24.7 +/- 2.2, 13.6+/- 2.1, and 12.8 +/- 2.7%,
      respectively) in resting muscle. Agonist-mediated force was associated with a
      rise in LC20 phosphorylation, but the extent of phosphorylation at all levels of
      force was less for urethral than for bladder body smooth muscle. RT-PCR and
      quantitative competitive RT-PCR analyses of total RNA from bladder body and
      urethral smooth muscles revealed only a slight difference in myosin heavy chain
      mRNA copy number per total RNA, whereas mRNA copy numbers for NH2-terminal
      isoforms SM-B (inserted) and SM-A (noninserted) in these muscles showed a
      significant difference (2.28 x 10(8) vs. 1.68 x 10(8) for SM-B and 0.12 x 10(8)
      vs. 0.42 x 10(8) for SM-A, respectively), which was also evident at the protein
      level. The ratio of COOH-terminal isoforms SM2:SM1 in the urethra was moderately
      but significantly lower than that in other regions of the bladder body. A high
      degree of LC20 phosphorylation and SM-B in the bladder body may help to
      facilitate fast cross-bridge cycling and force generation required for rapid
      emptying, whereas a lower level of LC20 phosphorylation and the presence of a
      higher amount of SM-A in urethral smooth muscle may help to maintain the high
      basal tone of urethra, required for urinary continence.

PMID- 11208520
TI  - alpha1H T-type Ca2+ channel is the predominant subtype expressed in bovine and
      rat zona glomerulosa.
AB  - The low voltage-activated (T-type) Ca2+ channel has been implicated in the
      regulation of aldosterone secretion from the adrenal zona glomerulosa by
      extracellular K+ levels, angiotensin II, and ACTH. However, the identity of the
      specific subtype mediating this regulation has not been determined. We utilized
      in situ hybridization to examine the distribution of three newly cloned members
      of the T-type Ca2+ channel family, alpha1G, alpha1H, and alpha1I, in the rat and
      bovine adrenal gland. Substantial expression of only the mRNA transcript for the
      alpha1H-subunit was detected in the zona glomerulosa of both rat and bovine. A
      much weaker expression signal was detected for the alpha1H transcript in the zona
      fasciculata of bovine. Whole cell recordings of isolated bovine adrenal zona
      glomerulosa cells showed the native low voltage-activated current to be inhibited
      by NiCl2 with an IC50 of 6.4 +/- 0.2 microM. Because the alpha1H subtype exhibits
      similar NiCl2 sensitivity, we propose that the alpha1H subtype is the predominant
      T-type Ca2+ channel present in the adrenal zona glomerulosa.

PMID- 11208521
TI  - Muscle LIM protein is upregulated in fast skeletal muscle during transition
      toward slower phenotypes.
AB  - Muscle LIM protein (MLP) is constitutively expressed in slow, but undetectable in
      fast, muscles of the rat. Here we show that MLP was upregulated at both the mRNA
      and protein levels under experimental conditions leading to transitions from fast
      to slower phenotypes. Chronic low-frequency stimulation and mechanical
      overloading by synergist removal both induced fast-to-slow shifts in myosin heavy
      chain (MHC) isoforms and expression of MLP in fast muscles. High amounts of MLP
      mRNA and protein were also present in fast muscles of the myotonic, hyperactive
      ADR mouse. Hypothyroidism evoked shifts in myosin composition toward slower
      isoforms and increased the MLP protein content of soleus (SOL) muscle but failed
      to induce MLP in fast muscles. Unweighting by hindlimb suspension elicited slow
      to-fast transitions in MHC expression without altering MLP levels in SOL muscle.
      Hyperthyroidism shifted the MHC pattern toward faster isoforms but did not affect
      MLP content in SOL muscle. We conclude that alterations in MLP expression are
      associated with transitions from fast to slower phenotypes but not with slow-to
      fast muscle fiber transitions.

PMID- 11208522
TI  - Effect of culture PO2 on macrophage (RAW 264.7) nitric oxide production.
AB  - Macrophages are commonly cultured at a PO2 of 149 Torr, but tissue macrophages in
      vivo live in an environment of much lower oxygen tension. Despite the many
      potential mechanisms for changes in oxygen tension to influence nitric oxide (NO)
      synthesis, there have been few reports investigating the effect of PO2 on
      macrophage NO production. With the use of a culture chamber designed to
      rigorously control oxygen tension, we investigated the effects of culture PO2 on
      macrophage NO production, inducible nitric oxide synthase (iNOS) activity, iNOS
      protein, and tumor necrosis factor production. NO production and iNOS activity
      were linearly related in the range of 39.4 to 677 Torr, but not in the range of
      1.03 to 39.4 Torr. Therefore, results obtained in vitro for the high oxygen
      tensions commonly used in cell culture were quantitatively and qualitatively
      different from results obtained in cells cultured at the lower oxygen tensions
      that more accurately reflect the in vivo environment. The influence of oxygen
      tension on NO production has implications for cell culture methodology and for
      the relationship between microcirculatory dysfunction and inflammatory responses
      in rodent models of sepsis.

PMID- 11208523
TI  - Excitability and contractility of skeletal muscle engineered from primary
      cultures and cell lines.
AB  - The purpose of this study was to compare the excitability and contractility of
      three-dimensional skeletal muscle constructs, termed myooids, engineered from
      C2C12 myoblast and 10T1/2 fibroblast cell lines, primary muscle cultures from
      adult C3H mice, and neonatal and adult Sprague-Dawley rats. Myooids were 12 mm
      long, with diameters of 0.1-1 mm, were excitable by transverse electrical
      stimulation, and contracted to produce force. After approximately 30 days in
      culture, myooid cross-sectional area, rheobase, chronaxie, resting baseline
      force, twitch force, time to peak tension, one-half relaxation time, and peak
      isometric force were measured. Specific force was calculated by dividing peak
      isometric force by cross-sectional area. The specific force generated by the
      myooids was 2-8% of that generated by skeletal muscles of control adult rodents.
      Myooids engineered from C2C12-10T1/2 cells exhibited greater rheobase, time to
      peak tension, and one-half relaxation time than myooids engineered from adult
      rodent cultures, and myooids from C2C12-10T1/2 and neonatal rat cells had greater
      resting baseline forces than myooids from adult rodent cultures.

PMID- 11208524
TI  - Cryptdin-3 induces novel apical conductance(s) in Cl- secretory, including cystic
      fibrosis, epithelia.
AB  - Opening of anion-conductive pathways in apical membranes of secretory cells
      lining mucosal surfaces is a critical step in salt and water secretion and, thus,
      hydration of sites including airway and intestine. In intestine, Paneth cells are
      positioned at the base of the secretory gland (crypt) and release defensin
      peptide, in mice termed cryptdins, into the crypt lumen. Because at least some
      defensins have been shown to form anion-conductive channels in phospholipid
      bilayers, we tested whether these endogenous antimicrobial peptides could act as
      soluble inducers of channel-like activity when applied to apical membranes. To
      directly evaluate the possibility of cryptdin-3-mediated apical anion conductance
      (G(ap)), we have utilized amphotericin B to selectively permeabilize basolateral
      membranes of electrically tight monolayers of polarized human intestinal
      secretory epithelia (T84 cells), thus isolating the apical membrane for study.
      Cryptdin-3 induces G(ap) that is voltage independent (deltaG(ap) = 1.90 +/- 0.60
      mS/cm2) and exhibits ion selectivity contrasting to that elicited by forskolin or
      thapsigargin (for cryptdin-3, Cl- = gluconate; for forskolin and thapsigargin, Cl
      >> gluconate). We cannot exclude the possibility that the macroscopic current
      induced by cryptdin could be the sum of cation and Cl- currents. Cryptdin-3
      induces a current in basolaterally permeabilized epithelial monolayers derived
      from airway cells harboring the deltaF508 mutation of cystic fibrosis (CF;
      deltaG(ap) = 0.80 +/- 0.06 mS/cm2), demonstrating that cryptdin-3 restores anion
      secretion in CF cells; this occurs independently of the CF transmembrane
      conductance regulator channel. These results support the idea that cryptdin-3 may
      associate with apical membranes of Cl--secreting epithelia and self-assemble into
      conducting channels capable of mediating a physiological response.

PMID- 11208525
TI  - State-dependent modification of ATP-sensitive K+ channels by phosphatidylinositol
      4,5-bisphosphate.
AB  - With inside-out patch recordings in ventricular myocytes from the hearts of
      guinea pigs, we studied ATP-sensitive K+ (K(ATP)) channels activated by
      phosphatidylinositol 4,5-bisphosphate (PIP2) with respect to sensitivity to ATP
      when in either a rundown state (RS) or a non-rundown state (NRS). Rundown of
      K(ATP) channels was induced by exposure either to ATP-free solution or to ATP
      free solution containing 19 microM Ca2+. Exposure of membrane patches to 10
      microM PIP2 reactivated channels with both types of rundown. The reactivation by
      PIP2 did not require ATP in the bath. The IC50 of channels recovered from RS and
      before the rundown was 37.1 and 31.1 microM, respectively. PIP2 irreversibly
      increased the mean current when the channel was in the NRS. This was associated
      with a shift of IC50 to 250.6 microM after PIP2 exposure. PIP2 activates NRS
      K(ATP) channels by decreasing their sensitivity to ATP, whereas PIP2 reactivates
      RS-K(ATP) channels independently of ATP without changing ATP sensitivity.

PMID- 11208526
TI  - Single rabbit stomach smooth muscle cell myosin heavy chain SMB expression and
      shortening velocity.
AB  - Isolated single smooth muscle cells (SMCs) from different regions of the rabbit
      stomach were used to determine a possible correlation between unloaded shortening
      velocity and smooth muscle (SM) myosin heavy chain (MHC) S1 head isoform
      composition (SMA, no head insert; SMB, with head insert). alpha-Toxin
      permeabilized isolated single cells were maximally activated to measure unloaded
      shortening velocity and subsequently used in an RT-PCR reaction to determine the
      SMA/SMB content of the same cell. SM MHC SMA and SMB isoforms are uniquely
      distributed in the stomach with cells from the fundic region expressing little
      SMB (38.1 +/- 7.3% SMB; n = 16); cells from the antrum express primarily SMB
      (94.9 +/- 1.0% SMB; n = 16). Mean fundic cell unloaded shortening velocity was
      0.014 +/- 0.002 cell lengths/s compared with 0.036 +/- 0.002 for the antrum
      cells. Unloaded shortening velocity in these cells was significantly correlated
      with their percent SMB expression (r2 = 0.58). Resting cell length does not
      correlate with the percent SMB expression (n = 32 cells). Previously published
      assays of purified or expressed SMA and SMB heavy meromyosin show a twofold
      difference in actin filament sliding speed in in vitro motility assays.
      Extrapolation of our data to 0-100% SMB would give a 10-fold range of shortening
      velocity, which is closer to the approximately 20-fold range reported from
      various SM tissues. This suggests that mechanisms in addition to the MHC S1 head
      isoforms regulate shortening velocity.

PMID- 11208527
TI  - Polyamines in pancreatic islets of obese-hyperglycemic (ob/ob) mice of different
      ages.
AB  - To further evaluate the role of polyamines in insulin production and cell
      replication in diabetic pancreatic islets, we have studied hyperplastic islets of
      obese-hyperglycemic mice of different ages and normal islets of the same strain.
      The aims of the study were to investigate the impact of the diabetic state and
      aging on polyamine contents and requirements in these islets. Cultured islets
      from lean and obese animals contained significantly less polyamines than freshly
      isolated islets. Spermine-to-spermidine ratio was elevated in freshly isolated
      islets from young obese mice compared with those from lean mice. In islets from
      old obese animals, spermidine content was decreased, whereas the content of
      spermine was not different from that of young obese mice. The physiological
      significance of polyamines was investigated by exposing islets in tissue culture
      to inhibitors of polyamine synthesis. This treatment caused a partial polyamine
      depletion in whole islets but failed to affect polyamine content of cell nuclei.
      Insulin content was not affected in polyamine-deficient islets of obese mice,
      irrespective of age, in contrast to decreased islet insulin content in polyamine
      depleted young lean animals. Polyamine depletion depressed DNA synthesis rate in
      obese mouse islets; in lean mice it actually stimulated DNA synthesis. We
      concluded that important qualitative and quantitative differences exist between
      islets from obese-hyperglycemic and normal mice with respect to polyamine content
      and requirements of polyamines for regulation of insulin content and cell
      proliferation. The results suggest that spermine may be involved in mediating the
      rapid islet cell proliferation noted early in obese-hyperglycemic syndrome, but
      changes in spermine concentration do not seem to account for the decline in islet
      cell DNA synthesis in aged normoglycemic animals.

PMID- 11208528
TI  - Troponin I chimera analysis of the cardiac myofilament tension response to
      protein kinase A.
AB  - Viral-mediated gene transfer of troponin I (TnI) isoforms and chimeras into adult
      rat cardiac myocytes was used to investigate the role TnI domains play in the
      myofilament tension response to protein kinase A (PKA). In myocytes expressing
      endogenous cardiac TnI (cTnI), PKA phosphorylated TnI and myosin-binding protein
      C and decreased the Ca2+ sensitivity of myofilament tension. In marked contrast,
      PKA did not influence Ca2+-activated tension in myocytes expressing the slow
      skeletal isoform of TnI or a chimera (N-slow/card-C TnI), which lack the unique
      phosphorylatable amino terminal extension found in cTnI. PKA-mediated
      phosphorylation of a second TnI chimera, N-card/slow-C TnI, which has the amino
      terminal region of cTnI, caused a decrease in the Ca2+ sensitivity of tension
      comparable in magnitude to control myocytes. Based on these results, we propose
      the amino terminal region shared by cTnI and N-card/slow-C TnI plays a central
      role in determining the magnitude of the PKA-mediated shift in myofilament Ca2+
      sensitivity, independent of the isoform-specific functional domains previously
      defined within the carboxyl terminal backbone of TnI. Interestingly, exposure of
      permeabilized myocytes to acidic pH after PKA-mediated phosphorylation of cTnI
      resulted in an additive decrease in myofilament Ca2+ sensitivity. The isoform
      specific, pH-sensitive region within TnI lies in the carboxyl terminus of TnI,
      and the additive response provides further evidence for the presence of a
      separate domain that directly transduces the PKA phosphorylation signal.

PMID- 11208529
TI  - Regulatory pathways and uptake of L-DOPA by capillary cerebral endothelial cells,
      astrocytes, and neuronal cells.
AB  - We examined the nature and regulation of the inward L-3,4-dihydroxyphenylalanine
      (L-DOPA) transporter in rat capillary cerebral endothelial (RBE4) cells, type 1
      astrocytes (DI TNC1), and Neuro-2a neuroblastoma cells. In all three cell types,
      the inward transfer of L-DOPA was largely promoted through the 2-aminobicyclo
      (2,2,1)-heptane-2-carboxylic acid-sensitive and sodium-independent L-type amino
      acid transporter. Only in DI TNC1 cells was the effect of maneuvers that increase
      intracellular cAMP levels accompanied by increases in L-DOPA uptake. Also, only
      in DI TNC1 cells was the effect of the guanylyl cyclase inhibitor LY-83583
      accompanied by a 65% increase in L-DOPA accumulation, whereas the nitric oxide
      donor sodium nitroprusside produced a 25% decrease in L-DOPA accumulation. In all
      three cell types, the Ca2+/calmodulin inhibitors calmidazolium and
      trifluoperazine inhibited L-DOPA uptake in a noncompetitive manner. Thapsigargin
      (1 and 3 microM) and A-23187 (1 and 3 microM) failed to alter L-DOPA accumulation
      in RBE4 and Neuro-2a cells but markedly increased L-DOPA uptake in DI TNC1 cells.
      We concluded that L-DOPA in RBE4, DI TNC1, and Neuro-2a cells is transported
      through the L-type amino acid transporter and appears to be under the control of
      Ca2+/calmodulin-mediated pathways. Astrocytes, however, are endowed with other
      processes that appear to regulate the accumulation of L-DOPA, responding
      positively to increases in intracellular Ca2+ and cAMP and to decreases in cGMP.

PMID- 11208530
TI  - Essential role for IL-6 in postresuscitation inflammation in hemorrhagic shock.
AB  - Interleukin-6 (IL-6) is produced within multiple tissues and can be readily
      detected in the circulation in resuscitated hemorrhagic shock (HS). Instillation
      of IL-6 into lungs of normal rats induces polymorphonuclear neutrophilic
      granulocyte (PMN) infiltration and lung damage, while infusion of IL-6 into the
      systemic circulation of rats during resuscitation from HS reduces PMN recruitment
      and lung injury. The current study was designed to determine whether or not IL-6
      makes an essential contribution to postresuscitation inflammation and which of
      the two effects of IL-6, its local proinflammatory effect or its systemic anti
      inflammatory effect, is dominant in HS. Wild-type and IL-6-deficient mice were
      subjected to HS followed by resuscitation and death 4 h later. IL-6-deficient
      mice subjected to HS did not demonstrate any features of postresuscitation
      inflammation observed in wild-type mice, including increased PMN infiltration
      into the lungs, increased alveolar cross-sectional surface area, increased PMN
      infiltration into the liver, increased liver necrosis, increased signal
      transducer and activator of transcription 3 activation, and increased nuclear
      factor-kappaB activity. These findings indicate that IL-6 is an essential
      component of the postresuscitation inflammatory cascade in HS and that the local
      proinflammatory effects of IL-6 on PMN infiltration and organ damage in HS
      dominate over the anti-inflammatory effects of systemic IL-6.

PMID- 11208531
TI  - Static stretch increases c-Jun NH2-terminal kinase activity and p38
      phosphorylation in rat skeletal muscle.
AB  - Physical exercise and contraction increase c-Jun NH2-terminal kinase (JNK)
      activity in rat and human skeletal muscle, and eccentric contractions activate
      JNK to a greater extent than concentric contractions in human skeletal muscle.
      Because eccentric contractions include a lengthening or stretch component, we
      compared the effects of isometric contraction and static stretch on JNK and p38,
      the stress-activated protein kinases. Soleus and extensor digitorum longus (EDL)
      muscles dissected from 50- to 90-g male Sprague-Dawley rats were subjected to 10
      min of electrical stimulation that produced contractions and/or to 10 min of
      stretch (0.24 N tension, 20-25% increase in length) in vitro. In the soleus
      muscle, contraction resulted in a small, but significant, increase in JNK
      activity (1.8-fold above basal) and p38 phosphorylation (4-fold). Static stretch
      had a much more profound effect on the stress-activated protein kinases,
      increasing JNK activity 19-fold and p38 phosphorylation 21-fold. Increases in JNK
      activation and p38 phosphorylation in response to static stretch were fiber-type
      dependent, with greater increases occurring in the soleus than in the EDL.
      Immunohistochemistry performed with a phosphospecific antibody revealed that
      activation of JNK occurred within the muscle fibers. These studies suggest that
      the stretch component of a muscle contraction may be a major contributor to the
      increases in JNK activity and p38 phosphorylation observed after exercise in
      vivo.

PMID- 11208532
TI  - Differential expression of KvLQT1 and its regulator IsK in mouse epithelia.
AB  - KCNQ1 is the human gene responsible in most cases for the long QT syndrome, a
      genetic disorder characterized by anomalies in cardiac repolarization leading to
      arrhythmias and sudden death. KCNQ1 encodes a pore-forming K+ channel subunit
      termed KvLQT1 which, in association with its regulatory beta-subunit IsK (also
      called minK), produces the slow component of the delayed-rectifier cardiac K+
      current. We used in situ hybridization to localize KvLQT1 and IsK mRNAs in
      various tissues from adult mice. We showed that KvLQT1 mRNA expression is widely
      distributed in epithelial tissues, in the absence (small intestine, lung, liver,
      thymus) or presence (kidney, stomach, exocrine pancreas) of its regulator IsK. In
      the kidney and the stomach, however, the expression patterns of KvLQT1 and IsK do
      not coincide. In many tissues, in situ data obtained with the IsK probe coincide
      with beta-galactosidase expression in IsK-deficient mice in which the bacterial
      lacZ gene has been substituted for the IsK coding region. Because expression of
      KvLQT1 in the presence or absence of its regulator generates a K+ current with
      different biophysical characteristics, the role of KvLQT1 in epithelial cells may
      vary depending on the expression of its regulator IsK. The high level of KvLQT1
      expression in epithelial tissues is consistent with its potential role in K+
      secretion and recycling, in maintaining the resting potential, and in regulating
      Cl- secretion and/or Na+ absorption.

PMID- 11208533
TI  - Tissue distribution and subcellular localization of the ClC-5 chloride channel in
      rat intestinal cells.
AB  - ClC-5 is the Cl- channel that is mutated in Dent's disease, an X-chromosome
      linked disease characterized by low molecular weight proteinuria, hypercalciuria,
      and kidney stones. It is predominantly expressed in endocytically active renal
      proximal cells. We investigated whether this Cl- channel could also be expressed
      in intestinal tissues that have endocytotic machinery. ClC-5 mRNA was detected in
      the rat duodenum, jejunum, ileum, and colon. Western blot analyses revealed the
      presence of the 83-kDa ClC-5 protein in these tissues. Indirect
      immunofluorescence studies showed that ClC-5 was mainly concentrated in the
      cytoplasm above the nuclei of enterocytes and colon cells. ClC-5 partially
      colocalized with the transcytosed polymeric immunoglobulin receptor but was not
      detectable together with the brush-border-anchored sucrase isomaltase. A
      subfractionation of vesicles obtained by differential centrifugation showed that
      ClC-5 is associated with the vacuolar 70-kDa H+-ATPase and the small GTPases rab4
      and rab5a, two markers of early endosomes. Thus these results indicate that ClC-5
      is present in the small intestine and colon of rats and suggest that it plays a
      role in the endocytotic pathways of intestinal cells.

PMID- 11208534
TI  - Expression of extracellular calcium-sensing receptor in human osteoblastic MG-63
      cell line.
AB  - We have previously shown the expression of the extracellular calcium (Ca2+o)
      sensing receptor (CaR) in osteoblast-like cell lines, and others have documented
      its expression in sections of murine, bovine, and rat bone. The existence of the
      CaR in osteoblasts remains controversial, however, since some studies have failed
      to document its expression in the same osteoblast-like cell lines. The goals of
      the present study were twofold. 1) We sought to determine whether the CaR is
      expressed in the human osteoblast-like cell line, MG-63, which has recently been
      reported by others not to express this receptor. 2) We investigated whether the
      CaR, if present in MG-63 cells, is functionally active, since most previous
      studies have not proven the role of the CaR in mediating known actions of Ca2+o
      on osteoblast-like cells. We used immunocytochemistry and Western blotting with
      the specific, affinity-purified anti-CaR antiserum 4637 as well as Northern blot
      analysis and RT-PCR using a riboprobe and PCR primers specific for the human CaR,
      respectively, to show readily detectable CaR protein and mRNA expression in MG-63
      cells. Finally, we employed the patch-clamp technique to show that an elevation
      in Ca2+o as well as the specific, allosteric CaR activator NPS R-467 (0.5
      microM), but not its less active stereoisomer NPS S-467 (0.5 microM), activate an
      outward K+ channel in MG-63 cells, strongly suggesting that the CaR in MG-63
      cells is not only expressed but is functionally active.

PMID- 11208535
TI  - Model organisms: new insights into ion channel and transporter function. L-type
      calcium channels regulate epithelial fluid transport in Drosophila melanogaster.
AB  - The neuropeptide CAP2b stimulates fluid transport obligatorily via calcium entry,
      nitric oxide, and cGMP in Drosophila melanogaster Malpighian (renal) tubules. We
      have shown by RT-PCR that the Drosophila L-type calcium channel alpha1-subunit
      genes Dmca1D and Dmca1A (nbA) are both expressed in tubules. CAP2b-stimulated
      fluid transport and cytosolic calcium concentration ([Ca2+]i) increases are
      inhibited by the L-type calcium channel blockers verapamil and nifedipine. cGMP
      stimulated fluid transport is verapamil and nifedipine sensitive. Furthermore,
      cGMP induces a slow [Ca2+]i increase in tubule principal cells via verapamil- and
      nifedipine-sensitive calcium entry; RT-PCR shows that tubules express Drosophila
      cyclic nucleotide-gated channel (cng). Additionally, thapsigargin-induced [Ca2+]i
      increase is verapamil sensitive. Phenylalkylamines bind with differing affinities
      to the basolateral and apical surfaces of principal cells in the main segment;
      however, dihydropyridine binds apically in the tubule initial segment.
      Immunocytochemical evidence suggests localization of alpha1-subunits to both
      basolateral and apical surfaces of principal cells in the tubule main segment. We
      suggest roles for L-type calcium channels and cGMP-mediated calcium influx in
      both calcium signaling and fluid transport mechanisms in Drosophila.

PMID- 11208536
TI  - bHLH transcription factor MyoD affects myosin heavy chain expression pattern in a
      muscle-specific fashion.
AB  - A strong correlative pattern between MyoD gene expression and myosin heavy chain
      IIB (MHC IIB) gene expression exists. To test whether this correlative
      relationship is causative, MHC gene expression in muscles from MyoD(-/-) mice was
      analyzed. The MHC IIB gene was not detectable in the MyoD(-/-) diaphragm, whereas
      the MHC IIB protein made up 10.0 +/- 1.7% of the MHC protein pool in the wild
      type (WT) mouse diaphragm. Furthermore, the MHC IIA protein was not detectable in
      the MyoD(-/-) biceps brachii, and the MHC IIB protein was overexpressed in the
      masseter. To examine whether MyoD is required for the upregulation of the MHC IIB
      gene within slow muscle after disuse, MyoD(-/-) and WT hindlimb musculature was
      unweighted. MyoD(-/-) exhibited a diminished response in the upregulation of the
      MHC IIB mRNA within the soleus muscle as a result of the hindlimb unweighting.
      Collectively, these data suggest that MyoD plays a role in the MHC profile in a
      muscle-specific fashion.

PMID- 11208537
TI  - Stress and the gastrointestinal tract III. Stress-related alterations of gut
      motor function: role of brain corticotropin-releasing factor receptors.
AB  - Alterations of gastrointestinal (GI) motor function are part of the visceral
      responses to stress. Inhibition of gastric emptying and stimulation of colonic
      motor function are the commonly encountered patterns induced by various
      stressors. Activation of brain corticotropin-releasing factor (CRF) receptors
      mediates stress-related inhibition of upper GI and stimulation of lower GI motor
      function through interaction with different CRF receptor subtypes. CRF subtype 1
      receptors are involved in the colonic and anxiogenic responses to stress and may
      have clinical relevance in the comorbidity of anxiety/depression and irritable
      bowel syndrome.

PMID- 11208538
TI  - Microbes and microbial toxins: paradigms for microbial-mucosal interactions II.
      The integrated response of the intestine to Clostridium difficile toxins.
AB  - Clostridium difficile, the major etiologic factor of antibiotic-associated
      diarrhea and colitis, mediates its effects by releasing two large protein
      exotoxins, toxins A and B. A major toxin effect is related to the disassembly of
      actin microfilaments, leading to impairment of tight junctions in human
      colonocytes. The mechanism of actin disaggregation involves monoglucosylation of
      the signaling proteins Rho A, Rac, and Cdc 42, which control stress fiber
      formation directly by toxins A and B. An important aspect of C. difficile
      infection is the acute necroinflammatory changes seen in patients with
      pseudomembranous colitis. The early mechanism of toxin-mediated inflammation
      involves toxin effects on cellular mitochondria, release of reactive oxygen
      species, and activation of mitogen-activated protein kinases and the
      transcription factor nuclear factor-kappaB. Injection of toxin A into animal
      intestine triggers secretion of fluid and intestinal inflammation characterized
      by epithelial cell destruction and neutrophil activation. A critical feature of
      C. difficile enterotoxicity is communication between enterocytes and lamina
      propria nerves, macrophages, and mast cells mediated via release of neuropeptides
      and proinflammatory cytokines.

PMID- 11208539
TI  - Role of promoter methylation in increased methionine adenosyltransferase 2A
      expression in human liver cancer.
AB  - Methionine adenosyltransferase (MAT), an essential enzyme that catalyzes the
      formation of S-adenosylmethionine (SAM), is encoded by two genes, MAT1A (liver
      specific) and MAT2A (non-liver-specific). We showed a switch from MAT1A to MAT2A
      expression in human liver cancer, which facilitates cancer cell growth. The
      present work examined the role of methylation in MAT2A transcriptional
      regulation. We found that the human MAT2A promoter is hypomethylated in
      hepatocellular carcinoma, in which the gene is upregulated transcriptionally, but
      hypermethylated in normal liver, in which the gene is minimally expressed.
      Luciferase activities driven by in vitro methylated MAT2A promoter constructs
      were 75-95% lower than activities driven by unmethylated constructs. SAM
      treatment of Hep G2 cells reduced MAT2A endogenous expression by 75%,
      hypermethylated the MAT2A promoter, and reduced luciferase activities driven by
      MAT2A promoter constructs by 65-75% while not affecting MAT1A's promoter
      activity. Treatment of adult rat and human hepatocytes with trichostatin A, an
      inhibitor of histone deacetylase, upregulated MAT2A expression by more than
      fourfold. Collectively, these results suggest that MAT2A expression is regulated
      by promoter methylation and histone acetylation.

PMID- 11208540
TI  - Swallowing reflex and brain stem neurons activated by superior laryngeal nerve
      stimulation in the mouse.
AB  - The purpose of the present study was to identify vagal subnuclei that participate
      in reflex swallowing in response to electrical stimulation of the left superior
      laryngeal nerve (SLN). SLN stimulation at 10 Hz evoked primary peristalsis,
      including oropharyngeal and esophageal peristalsis, and LES relaxation. It also
      induced c-fos expression in interneurons in the interstitial (SolI), intermediate
      (SolIM), central (SolCe), dorsomedial (SolDM) and commissural (SolC) solitary
      subnuclei. Neurons in parvicellular reticular nucleus (PCRt) and area postrema
      (AP) and motoneurons in the semicompact (NAsc), loose (NAl), and compact (NAc)
      formations of the nucleus ambiguus and both rostral (DMVr) and caudal (DMVc)
      parts of the dorsal motor nucleus of vagus were also activated. The activated
      neurons represent all neurons concerned with afferent SLN-mediated reflexes,
      including the swallowing-related neurons. SLN stimulation at 5 Hz elicited
      oropharyngeal and LES but not esophageal responses and evoked c-fos expression in
      neurons in SolI, SolIM, SolDM, PCRt, AP, NAsc, NAl, and DMVc but not in SolCe,
      NAc, or DMVr. These data are consistent with the role of SolI, SolIM, SolDM,
      NAsc, NAl, and DMVc circuit in oropharyngeal peristalsis and LES relaxation and
      SolCe, NAc, DMVc, and DMVr in esophageal peristalsis and LES responses.

PMID- 11208541
TI  - Effects of nutrients and serotonin 5-HT3 antagonism on symptoms evoked by distal
      gastric distension in humans.
AB  - Distal gastric distension may contribute to meal-related dyspeptic symptoms. This
      study's aims were to determine the effects of distinct nutrient classes on
      symptoms induced by distal gastric distension and their dependence on 5
      hydroxytryptamine(3) (5-HT3) receptors. Nine healthy subjects rated pain, nausea,
      and bloating induced by isobaric distal gastric distensions (6-24 mmHg) during
      duodenal lipid, carbohydrate, protein, or saline perfusion after treatment with
      placebo or the 5-HT3 receptor antagonist granisetron (10 microg/kg iv).
      Distensions produced greater pain, nausea, and bloating with lipid at 1.5
      kcal/min compared with saline (P < or = 0.02), primarily because of greater
      distal gastric volumes at each distending pressure. In contrast, carbohydrate and
      protein had no significant effect. At 3 kcal/min, lipid increased symptoms
      through a volume-independent as well as a volume-dependent effect. Granisetron
      did not affect symptom perception or gastric pressure-volume relationships. In
      conclusion, isobaric distal gastric distension produces more intense symptoms
      during duodenal lipid compared with saline perfusion. Symptom perception during
      distal gastric distension is unaffected by 5-HT3 receptor antagonism.

PMID- 11208542
TI  - Diurnal rhythmicity in intestinal SGLT-1 function, V(max), and mRNA expression
      topography.
AB  - Mechanisms underlying the circadian rhythmicity in intestinal sugar absorption
      remain unclear. To test whether this rhythmicity is caused by changes in Na(+)
      glucose cotransporter 1 (SGLT-1) function, we measured phloridzin-inhibitable
      sugar fluxes as an index of SGLT-1 activity. Jejunum obtained from rats killed at
      6-h intervals during a 12-h light-dark cycle (CT0 is circadian time 0 h, time of
      light onset) were mounted in Ussing chambers, and 3-O-methylglucose (3-OMG)
      fluxes were calculated before and after addition of phloridzin. 3-OMG-induced
      change in short-circuit current and absorptive flux were significantly greater at
      CT9 than at CT3. This increase was phloridzin inhibitable. Kinetic studies
      indicated a significant increase in SGLT-1 maximal velocity (V(max)) at CT9. Food
      intake between CT3 and CT9 was <10% of the daily total, indicating that the
      increased SGLT-1 activity was anticipatory. Diurnicity of SGLT-1 mRNA was
      confirmed by Northern blotting. Expression topography analyzed by in situ
      hybridization revealed more intense labeling along the entire villus axis at CT9
      and CT15 compared with CT3 and CT21. We conclude that diurnicity in intestinal
      sugar absorption is caused by periodicity in SGLT-1 V(max).

PMID- 11208543
TI  - Effect of E. coli heat-stable enterotoxin on colonic transport in guanylyl
      cyclase C receptor-deficient mice.
AB  - We studied the functional importance of the colonic guanylyl cyclase C (GCC)
      receptor in GCC receptor-deficient mice. Mice were anesthetized with
      pentobarbital sodium, and colon segments were studied in Ussing chambers in HCO3-
      Ringer under short-circuit conditions. Receptor-deficient mouse proximal colon
      exhibited similar net Na+ absorption, lower net Cl- absorption, and a negative
      residual ion flux (J(R)), indicating net HCO3- absorption compared with that in
      normal mice. In normal mouse proximal colon, mucosal addition of 50 nM
      Escherichia coli heat-stable enterotoxin (STa) increased the serosal-to-mucosal
      flux of Cl- (J(s-->m)(Cl)) and decreased net Cl- flux (J(net)(Cl)) accompanied by
      increases in short-circuit current (I(sc)), potential difference (PD), and tissue
      conductance (G). Serosal STa had no effect. In distal colon neither mucosal nor
      serosal STa affected ion transport. In receptor-deficient mice, neither mucosal
      nor serosal 500 nM STa affected electrolyte transport in proximal or distal
      colon. In these mice, 1 mM 8-bromo-cGMP produced changes in proximal colon J(s-
      >m)(Cl) and J(net)(Cl), I(sc), PD, G, and J(R) similar to mucosal STa addition in
      normal mice. We conclude that the GCC receptor is necessary in the mouse proximal
      colon for a secretory response to mucosal STa.

PMID- 11208544
TI  - Involvement of PI 3-kinase in IGF-I stimulation of jejunal Na+-K+-ATPase activity
      and nutrient absorption.
AB  - Mechanisms responsible for increased jejunal transport rates observed in tissues
      treated with orally administered insulin-like growth factor-I (IGF-I) were
      studied in 5-day-old colostrum-deprived piglets. Human recombinant IGF-I (3.5 mg.
      kg(-1). day(-1)) or control vehicle was given orogastrically for 4 days.
      Disaccharidase activity, fructose uptake, and Na+-glucose cotransporter SGLT-1
      protein abundance were similar between groups. Oral IGF-I produced greater rates
      of enterocyte Na+-K+-ATPase activity with no significant differences in Na+-K+
      ATPase abundance. Cellular mechanisms responsible for transport changes were
      studied in Ussing chambers. In control tissues, the presence of IGF-I in mucosal
      solutions increased basal short-circuit current (I(sc)), potential difference, D
      glucose-stimulated I(sc), and Na+-K+-ATPase activity; these changes were
      abolished by preincubation of tissues with wortmannin, a phosphatidylinositol 3
      kinase (PI 3-kinase) inhibitor. The results suggest that the effect of IGF-I on
      jejunal ion and nutrient transport involves activation of PI 3-kinase and
      stimulation of Na+-K+-ATPase activity in enterocytes.

PMID- 11208545
TI  - Insulin signal transduction in rat small intestine: role of MAP kinases in
      expression of mucosal hydrolases.
AB  - The postreceptor events regulating the signal of insulin downstream in rat
      intestinal cells have not yet been analyzed. Our objectives were to identify the
      nature of receptor substrates and phosphorylated proteins involved in the
      signaling of insulin and to investigate the mechanism(s) by which insulin
      enhances intestinal hydrolases. In response to insulin, the following proteins
      were rapidly phosphorylated on tyrosine residues: 1) insulin receptor substrates
      1 (IRS-1), -2, and -4; 2) phospholipase C-isoenzyme-gamma; 3) the Ras-GTPase
      activating protein (GAP) associated with Rho GAP and p62(Src); 4) the insulin
      receptor beta-subunit; 5) the p85 subunits of phosphatidylinositol 3-kinase (PI 3
      kinase); 6) the Src homology 2 alpha-collagen protein; 7) protein kinase B; 8)
      mitogen-activated protein (MAP) kinase-1 and -2; and 9) growth receptor-bound
      protein-2. Compared with controls, insulin enhanced the intestinal activity of
      MAP kinase-2 and protein kinase B by two- and fivefold, respectively, but did not
      enhance p70/S6 ribosomal kinase. Administration of an antireceptor antibody or
      MAP-kinase inhibitor PD-98059 but not a PI 3-kinase inhibitor (wortmannin) to
      sucklings inhibited the effects of insulin on mucosal mass and enzyme expression.
      We conclude that normal rat enterocytes express all of the receptor substrates
      and mediators involved in different insulin signaling pathways and that receptor
      binding initiates a signal enhancing brush-border membrane hydrolase, which
      appears to be regulated by the cascade of MAP kinases but not by PI 3-kinase.

PMID- 11208546
TI  - Isolation of functional polarized bile duct units from mouse liver.
AB  - The development of genetically altered murine animals has generated a need for in
      vitro systems in the mouse. We have now characterized a novel isolated bile duct
      unit (IBDU) preparation from the mouse to facilitate such studies. The mouse IBDU
      is isolated by portal perfusion of collagenase, blunt dissection, further
      enzymatic digestions, filtering through sized mesh, and culturing on Matrigel for
      16-72 h. This mouse IBDU forms a central, enclosed lumen lined by polarized
      cytokeratin-19-positive cholangiocytes with numerous microvilli on the apical
      membrane. The IBDU responds to secretory stimuli, including secretin, vasoactive
      intestinal peptide, IBMX, and forskolin, resulting in expansion of the central
      lumen from secretion as quantified by videomicroscopy. The secretory response to
      secretin is dependent on Cl- and HCO3-in the perfusate. These findings indicate
      that mouse IBDUs are intact, polarized, functional bile duct secretory units that
      permit quantitative measurements of fluid secretion from mouse bile duct
      epithelium for the first time. This method should facilitate studies of
      cholangiocyte secretion in genetically altered murine animal models.

PMID- 11208547
TI  - Role of sodium/hydrogen exchanger isoform NHE3 in fluid secretion and absorption
      in mouse and rat cholangiocytes.
AB  - Na+/H+ exchanger (NHE) isoforms play important roles in intracellular pH
      regulation and in fluid absorption. The isoform NHE3 has been localized to apical
      surfaces of epithelia and in some tissues may facilitate the absorption of NaCl.
      To determine whether the apical isoform NHE3 is present in cholangiocytes and to
      examine whether it has a functional role in cholangiocyte fluid secretion and
      absorption, immunocytochemical studies were performed in rat liver with NHE3
      antibodies and functional studies were obtained in isolated bile duct units from
      wild-type and NHE3-/- mice after stimulation with forskolin, using
      videomicroscopic techniques. Our results indicate that NHE3 protein is present on
      the apical membranes of rat cholangiocytes and on the canalicular membrane of
      hepatocytes. Western blots also detect NHE3 protein in rat cholangiocytes and
      isolated canalicular membranes. After stimulation with forskolin, duct units from
      NHE3-/- mice fail to absorb the secreted fluid from the cholangiocyte lumen
      compared with control animals. Similar findings were observed in isolated bile
      duct units from wild-type mice and rats in the presence of the Na+/H+ exchanger
      inhibitor 5-(N-ethyl-N-isopropyl)-amiloride. In contrast, we could not
      demonstrate absorption of fluid from the canalicular lumen of mouse or rat
      hepatocyte couplets after stimulation of secretion with forskolin. These findings
      indicate that NHE3 is located on the apical membrane of rat cholangiocytes and
      that this NHE isoform can function to absorb fluid from the lumens of isolated
      rat and mouse cholangiocyte preparations.

PMID- 11208548
TI  - Gender influence on jejunal migrating motor complex.
AB  - The role of gender and the menstrual cycle in small bowel motility has not been
      clearly elucidated. Jejunal motility was recorded with a nasojejunal catheter
      incorporating five solid-state pressure transducers in ambulatory menstruating
      women and men of comparable age over 24 h. All women were studied twice, in the
      early follicular (early-F) and midluteal (mid-L) phases of the menstrual cycle,
      verified by determining serum levels of gonadal steroids and gonadotropins. The
      propagation velocity of phase III was slow and the contraction amplitude was high
      in both menstrual cycle phases compared with men, and these parameters were
      correlated with serum estrogen levels in the mid-L phase. In the early-F phase,
      migrating motor complex (MMC) cycle duration during sleep was long compared with
      other groups and positively correlated with estrogen concentrations, whereas in
      the mid-L phase MMC cycle duration during sleep was negatively correlated with
      serum progesterone levels. In all groups, the frequency of phase III contractions
      was low and the intercontractile interval measured from pressure peak to peak was
      long during sleep compared with the awake state. Postprandial motility did not
      display gender difference in any parameter examined. The results demonstrate that
      the majority of patterns of motility are similar in menstruating women and men,
      whereas certain aspects of the MMC, most conspicuously propagation velocity and
      phase III contraction amplitude, differ. We have also documented circadian
      variation of phase III contraction frequency in both women and men.

PMID- 11208549
TI  - Apical and basolateral EGF receptors regulate gastric mucosal paracellular
      permeability.
AB  - Previous studies found that monolayers formed from canine oxyntic epithelial
      cells in primary culture displayed remarkable resistance to apical acidification
      and both mitogenic and migratory responses to epidermal growth factor (EGF)
      treatment. In our present studies, we found that EGF increased transepithelial
      resistance (TER) but not short-circuit current in these monolayers. Parallel
      effects of EGF on decreasing mannitol flux and increasing TER implicate direct
      regulation of paracellular permeability. EGF acting at either apical and
      basolateral receptors rapidly increased TER, but the apical response was
      sustained whereas the basolateral response was transient. (125)I-labeled EGF
      binding revealed specific apical binding, but receptor numbers were 25-fold lower
      than on the basolateral surface. Both apical and basolateral EGF activated
      tyrosine phosphorylation of EGF receptors (EGFR), beta-catenin, and cellular
      substrate as evident on confocal microscopy. Although apical EGF activated a
      lesser degree of receptor autophosphorylation than basolateral EGF,
      phosphorylation of beta-catenin was equally prominent with apical and basolateral
      receptor activation. Together, these findings indicate that functional apical and
      basolateral EGFR exist on primary canine gastric epithelial cells and that these
      receptors regulate paracellular permeability. The sustained effect of apical EGFR
      activation and prominent phosphorylation of beta-catenin suggest that apical EGFR
      may play a key role in this regulation.

PMID- 11208550
TI  - Circadian coupling between pancreatic secretion and intestinal motility in
      humans.
AB  - Human interdigestive intestinal motility follows a circadian rhythm with reduced
      nocturnal activity, but circadian pancreatic exocrine secretion is unknown. To
      determine whether circadian changes in interdigestive pancreatic secretion occur
      and are associated with motor events, pancreatic enzyme outputs, proximal jejunal
      motility, and plasma pancreatic polypeptide concentrations were measured during
      consecutive daytime and nighttime periods (12 h each) in seven healthy volunteers
      using orojejunal multilumen intubation. Studies were randomly started in the
      morning or evening. Nocturnally, motility decreased (motor quiescence: 67 +/- 22
      vs. 146 +/- 37 min; motility index: 3.59 +/- 0.33 vs. 2.78 +/- 0.40 mmHg/min;
      both P < 0.05) but amylase output increased (273 +/- 78 vs. 384 +/- 100 U/min; P
      < 0.05) and protease output remained unchanged (P > 0.05); consequently,
      enzyme/motility ratio increased. Amylase outputs were always lowest during phase
      I. Motor but not pancreatic circadian activities were associated with sleep.
      Pancreatic polypeptide plasma concentrations were unchanged. Consequently,
      intestinal motor and pancreatic exocrine functions may have different circadian
      rhythms, i.e., decreased motor and stable secretory activity during the night.
      However, the association between individual phases of interdigestive motor and
      secretory activity is preserved. The nocturnal increase in enzyme/motility ratio
      is probably not caused by increased cholinergic tone.

PMID- 11208551
TI  - Kupffer cell-initiated remote hepatic injury following bilateral hindlimb
      ischemia is complement dependent.
AB  - Intravital fluorescence microscopy was applied to the livers of male Wistar rats
      to test the hypothesis that complement mobilization stimulates Kupffer cells and
      subsequently initiates hepatic injury after hindlimb ischemia/reperfusion (I/R).
      Following 3 h of limb reperfusion, hepatocellular viability (serum levels of
      alanine transaminase and cell death via propidium iodide labeling) decreased
      significantly from levels in sham-operated animals. Inhibition of complement
      mobilization with soluble complement receptor type 1 (20 mg/kg body wt) and
      interruption of Kupffer cell function with GdCl(3) (1 mg/100g body wt) resulted
      in significant hepatocellular protection. Although the effects of hindlimb I/R on
      hepatic microvascular perfusion were manifest as increased heterogeneity, both
      complement inhibition and suppression of Kupffer cell function resulted in marked
      improvements. No additional hepatocellular protection and microvascular
      improvements were provided by combining the interventions. Furthermore,
      inhibition of complement mobilization significantly depressed Kupffer cell
      phagocytosis by 42% following limb reperfusion. These results suggest that the
      stimulation of Kupffer cells via complement mobilization is necessary but is not
      the only factor contributing to the early pathogenesis of hepatic injury
      following hindlimb I/R.

PMID- 11208552
TI  - Epithelial calcium transporter expression in human duodenum.
AB  - Calcium absorption in intestine and kidney involves transport through the apical
      membrane, cytoplasm, and basolateral membrane of the epithelial cells. Apical
      membrane calcium influx channels have recently been described in rabbit
      (epithelial calcium channel, ECaC) and rat (calcium transport protein, CaT1). We
      amplified from human duodenum a 446-base partial cDNA probe (ECAC2) having a
      predicted amino acid similarity of 97% to rat CaT1. Duodenum, but not ileum,
      colon, or kidney, expressed a 3-kb transcript. A larger transcript was also found
      in placenta and pancreas, and a different, faint transcript was found in brain.
      In duodenal biopsies from 20 normal volunteers, expression varied considerably
      but was not significantly correlated with vitamin D metabolites. This signal
      correlated with calbindin-D(9k) (r = 0.48, P < 0.05) and more strongly with the
      plasma membrane calcium ATPase PMCA1 (r = 0.83, P < 0.001). These data show that
      although individual variations in calcium channel transcripts are not vitamin D
      dependent, expression of genes governing apical entry and basolateral extrusion
      are tightly linked. This may account for some of the unexplained variability in
      calcium absorption.

PMID- 11208553
TI  - Endothelial E- and P-selectin expression in iNOS- deficient mice exposed to
      polymicrobial sepsis.
AB  - In vitro, nitric oxide (NO) decreases leukocyte adhesion to endothelium by
      attenuating endothelial adhesion molecule expression. In vivo, lipopolysaccharide
      induced leukocyte rolling and adhesion was greater in inducible NO synthase
      (iNOS)-/- mice than in wild-type mice. The objective of this study was to assess
      E- and P-selectin expression in the microvasculature of iNOS-/- and wild-type
      mice subjected to acute peritonitis by cecal ligation and perforation (CLP). E-
      and P-selectin expression were increased in various organs within the peritoneum
      of wild-type animals after CLP. This CLP-induced upregulation of E- and P
      selectin was substantially reduced in iNOS-/- mice. Tissue myeloperoxidase (MPO)
      activity was increased to a greater extent in the gut of wild-type than in iNOS-/
      mice subjected to CLP. In the lung, the reduced expression of E-selectin in iNOS
      /- mice was not associated with a decrease in MPO. Our findings indicate that NO
      derived from iNOS plays an important role in sepsis-induced increase in selectin
      expression in the systemic and pulmonary circulation. However, in iNOS-/- mice,
      sepsis-induced leukocyte accumulation is affected in the gut but not in the
      lungs.

PMID- 11208554
TI  - Molecular mechanisms for the antiapoptotic action of gastrin.
AB  - Gastrin (G17) has a CCK-B receptor-mediated growth-promoting effect on the AR42J
      rat acinar cell line. We examined whether G17 inhibits apoptosis induced by serum
      withdrawal of AR42J cells and CHO-K1 cells stably expressing CCK-B receptors (CHO
      K1/CCK-B cells). Cellular apoptosis was measured by flow cytometry and the
      terminal deoxynucleotidyltransferase-mediated dUTP-FITC nick end-labeling method.
      Serum withdrawal induced AR42J and CHO-K1/CCK-B cell apoptosis. Addition of 10 nM
      G17 reversed these effects. We examined the action of G17 (10 nM) on
      phosphorylation and activation of protein kinase B/Akt, a kinase known to promote
      cell survival. Akt phosphorylation and activation were measured by kinase assays
      and Western blots with an anti-phospho-Akt antibody. G17 stimulated Akt
      phosphorylation and activation. G17 induction of Akt phosphorylation was
      inhibited by the phosphoinositide 3-kinase (PI 3-kinase) inhibitors LY-294002 (10
      microM) and wortmannin (200 nM) but not by the mitogen-activated protein kinase
      kinase 1 inhibitor PD-98059 (50 microM). To study the role of p38 kinase in G17
      signaling to Akt, we examined the effect of G17 on p38 kinase activation and
      phosphorylation using kinase assays and Western blots with an anti-phospho-p38
      kinase antibody. G17 induced p38 kinase activity at doses and with kinetics
      similar to those observed for Akt induction. The p38 kinase inhibitor SB-203580
      inhibited G17 induction of Akt phosphorylation and activation at a concentration
      (10 microM) 10-fold higher than necessary to block p38 kinase (1 microM),
      suggesting the possible involvement of kinase activities other than p38 kinase.
      Transduction of AR42J cells with the adenoviral vector Adeno-dn Akt, which
      overexpresses an inhibitor of Akt, reversed the antiapoptotic action of G17. In
      conclusion, G17 promotes AR42J cell survival through the induction of Akt via PI
      3-kinase and SB-203580-sensitive kinase activities.

PMID- 11208555
TI  - Neuronal nitric oxide synthase: expression in rat parietal cells.
AB  - Nitric oxide synthases (NOS) are enzymes that catalyze the generation of nitric
      oxide (NO) from L-arginine and require nicotinamide adenine dinucleotide
      phosphate (NADPH) as a cofactor. At least three isoforms of NOS have been
      identified: neuronal NOS (nNOS or NOS I), inducible NOS (iNOS or NOS II), and
      endothelial NOS (eNOS or NOS II). Recent studies implicate NO in the regulation
      of gastric acid secretion. The aim of the present study was to localize the
      cellular distribution and characterize the isoform of NOS present in oxyntic
      mucosa. Oxyntic mucosal segments from rat stomach were stained by the NADPH
      diaphorase reaction and with isoform-specific NOS antibodies. The expression of
      NOS in isolated, highly enriched (>98%) rat parietal cells was examined by
      immunohistochemistry, Western blot analysis, and RT-PCR. In oxyntic mucosa,
      histochemical staining revealed NADPH-diaphorase and nNOS immunoreactivity in
      cells in the midportion of the glands, which were identified as parietal cells in
      hematoxylin and eosin-stained step sections. In isolated parietal cells, decisive
      evidence for nNOS expression was obtained by specific immunohistochemistry,
      Western blotting, and RT-PCR. Cloning and sequence analysis of the PCR product
      confirmed it to be nNOS (100% identity). Expression of nNOS in parietal cells
      suggests that endogenous NO, acting as an intracellular signaling molecule, may
      participate in the regulation of gastric acid secretion.

PMID- 11208556
TI  - Evolution of the Na-P(i) cotransport systems.
AB  - Membrane transport systems for P(i) transport are key elements in maintaining
      homeostasis of P(i) in organisms as diverse as bacteria and human. Two Na-P(i)
      cotransporter families with well-described functional properties in vertebrates,
      namely NaPi-II and NaPi-III, show conserved structural features with prokaryotic
      origin. A clear vertical relationship can be established among the mammalian
      protein family NaPi-III, a homologous system in C. elegans, the yeast system
      Pho89, and the bacterial P(i) transporter Pit. An alternative lineage connects
      the mammalian NaPi-II-related transporters with homologous proteins from
      Caenorhabditis elegans and Vibrio cholerae. The present review focuses on the
      molecular evolution of the NaPi-II protein family. Preliminary results indicate
      that the NaPi-II homologue cloned from V. cholerae is indeed a functional P(i)
      transporter when expressed in Xenopus oocytes. The closely related NaPi-II
      isoforms NaPi-IIa and NaPi-IIb are responsible for regulated epithelial Na
      dependent P(i) transport in all vertebrates. Most species express two different
      NaPi-II proteins with the exception of the flounder and Xenopus laevis, which
      rely on only a single isoform. Using an RT-PCR-based approach with degenerate
      primers, we were able to identify NaPi-II-related mRNAs in a variety of
      vertebrates from different families. We hypothesize that the original NaPi-IIb
      related gene was duplicated early in vertebrate development. The appearance of
      NaPi-IIa correlates with the development of the mammalian nephron.

PMID- 11208557
TI  - Role of non-NMDA receptors in vasopressin and oxytocin release from rat
      hypothalamo-neurohypophysial explants.
AB  - Glutamate is recognized as a prominent excitatory transmitter in the supraoptic
      nucleus (SON) and is involved in transmission of osmoregulatory information from
      the osmoreceptors to the vasopressin (VP) and oxytocin (OT) neurons. Explants of
      the hypothalamo-neurohypophysial system were utilized to characterize the roles
      of the non-N-methyl-D-aspartate (NMDA) glutamate receptor subtypes (non-NMDA-Rs),
      kainic acid receptors (KA-Rs), and aminopropionic acid receptors (AMPA-Rs) and to
      evaluate the interdependence of NMDA-Rs and non-NMDA-Rs in eliciting hormone
      release. Although both KA and AMPA increased hormone release, a specific agonist
      of the KA-Rs, SYM-2081, was not effective. This combined with the finding that
      cyclothiazide, an agent that inhibits the desensitization of AMPA-Rs, increased
      the VP response to both KA and AMPA indicates that the increase in hormone
      release induced by the non-NMDA agonists is mediated via AMPA-Rs, rather than KA
      Rs. Inhibition of osmotically stimulated VP and OT release by a specific AMPA-R
      antagonist indicated that AMPA-Rs are essential for mediating osmotically
      stimulated hormone release. NMDA-stimulated VP but not OT release was prevented
      by blockade of non-NMDA-Rs, but AMPA-stimulated VP/OT release was not prevented
      by NMDA-R blockade.

PMID- 11208558
TI  - Cytoskeletal protein contents before and after hindlimb suspension in a fast and
      slow rat skeletal muscle.
AB  - Transversal cytoskeletal organization of muscle fibers is well described,
      although very few data are available concerning protein content. Measurements of
      desmin, alpha-actinin, and actin contents in soleus and extensor digitorum longus
      (EDL) rat skeletal muscles, taken with the results previously reported for
      several dystrophin-glycoprotein complex (DGC) components, indicate that the
      contents of most cytoskeletal proteins are higher in slow-type fibers than in
      fast ones. The effects of hypokinesia and unloading on the cytoskeleton were also
      investigated, using hindlimb suspension. First, this resulted in a decrease in
      contractile protein contents, only after 6 wk, in the soleus. Dystrophin and
      associated proteins were shown to be reduced for soleus at 3 wk, whereas only the
      dystrophin-associated proteins were found to increase after 6 wk. On the other
      hand, the contents of DGC components were increased for EDL for the two
      durations. Desmin and alpha-actinin levels were unchanged in the same conditions.
      Consequently, it can be concluded that the cytoskeletal protein expression levels
      could largely contribute to muscle fiber adaptation induced by modified
      functional demands.

PMID- 11208559
TI  - Diminished satiation in rats exposed to elevated levels of endogenous or
      exogenous cholecystokinin.
AB  - Rats maintained on a high-fat (HF) diet exhibit reduced sensitivity to the
      satiation-producing effect of exogenous CCK. Because more CCK is released in
      response to HF meals than low-fat (LF) meals, we hypothesized that increased
      circulating CCK associated with ingestion of HF diets contributes to the
      development of decreased CCK sensitivity. To test this hypothesis, we implanted
      osmotic minipumps filled with either NaCl or CCK octapeptide into the peritoneal
      cavity. Subsequently, we examined the effect of intraperitoneal NaCl or CCK (0.5
      microg/kg) injection on 30-min food intake. CCK significantly reduced 30-min food
      intake less in rats implanted with CCK-releasing minipumps compared with those
      with NaCl-releasing minipumps. Because dietary protein is a potent releaser of
      endogenous CCK, we hypothesized that rats adapted to a high-protein (HP) diet
      might also exhibit reduced sensitivity to exogenous CCK. Therefore, in a second
      experiment, we examined CCK-induced reduction of food intake in rats maintained
      on LF and rats maintained on HF or HP. Ingestion of LF stimulates very little
      endogenous CCK secretion, whereas both HF and HP markedly increase plasma CCK
      concentrations. Both doses of CCK reduced food intake significantly less in HF
      and HP rats compared with LF rats. There were no differences in 24-h food intake,
      body weight, or body fat composition among LF-, HF-, and HP-fed rats. These
      results are consistent with the hypothesis that sustained elevation of CCK either
      by infusion of exogenous CCK or by dietary-induced elevation of plasma CCK
      contributes to the development of reduced sensitivity to exogenous CCK.

PMID- 11208561
TI  - Hypoalgesia and hyperalgesia with inherited hypertension in the rat.
AB  - Many studies indicate that blood pressure control systems can attenuate pain
      (hypoalgesia) of short duration; however, we recently found exaggerated
      nociceptive responses (hyperalgesia) of persistent duration in the spontaneously
      hypertensive rat (SHR). Here, we used SHR, Dahl Salt-Sensitive (SS), and
      normotensive control rats to evaluate the contribution of sustained elevations in
      arterial pressure to nociceptive responses. Compared with Sprague-Dawley and/or
      Wistar-Kyoto controls, SHR were 1) hypoalgesic in the hot plate test and 2)
      hyperalgesic in longer latency tail and paw-withdrawal tests and in two models of
      inflammatory nociception. These differences were not observed between SS and salt
      resistant controls fed a high-salt diet. Inflammatory hyperalgesia in SHR was
      correlated with neither paw edema nor the number of Fos-positive spinal cord
      neurons. Our results indicate that "pain" phenotype of the SHR is not restricted
      to hypoalgesia. This phenotype is related to genetic factors or to the autonomic
      systems that control blood pressure and not to sustained elevations in blood
      pressure, differences in spinal neuron activity, or inflammatory edema.

PMID- 11208560
TI  - Effect of heat stress on LPS-induced febrile response in D-galactosamine
      sensitized rats.
AB  - We have previously reported that heat conditioning augments lipopolysaccharide
      (LPS)-induced fever in rats, which is accompanied by an accumulation of heat
      shock protein (HSP) in the liver and the reduction of the plasma level of tumor
      necrosis factor (TNF-alpha) (Kluger MJ, Rudolph K, Soszynski D, Conn CA, Leon LR,
      Kozak W, Wallen ES, and Moseley PL. Am J Physiol Regulatory Integrative Comp
      Physiol 273: R858-R863, 1997). In the present study we have tested whether
      inhibition of protein synthesis in the liver can reduce the effect of this heat
      conditioning on the LPS-induced febrile response in the rat. D-galactosamine (D
      gal) was used to selectively inhibit liver protein synthesis. D-gal (500 mg/kg)
      or PBS as control was administered intraperitoneally 1 h before heat stress. LPS
      (50 microg/kg ip) was injected 24 h post-heat exposure. Treatment with D-gal
      blunted the febrile response to LPS. Moreover, heat-conditioned rats treated
      first with D-gal and subsequently with LPS demonstrated a profound fall in core
      temperature 10--18 h post-LPS. A significant increase of serum TNF-alpha
      accompanied this effect of D-gal on fever. Heat-conditioned animals receiving D
      gal showed an inhibition in inducible HSP-70 in the liver. These data support the
      role of hepatic function in modulating the febrile response to LPS.

PMID- 11208562
TI  - Functional desensitization to isoproterenol without reducing cAMP production in
      canine failing cardiocytes.
AB  - To corroborate alterations in the functional responses to beta-adrenergic
      receptor (beta-AR) stimulation with changes in beta-AR signaling in failing
      cardiomyocytes, contractile and L-type Ca(2+) current responses to isoproterenol
      along with stimulated cAMP generation were compared among cardiomyocytes isolated
      from canines with tachycardia-induced heart failure or healthy hearts. The
      magnitude of shortening of failing cardiomyocytes was significantly depressed (by
      22 +/- 4.4%) under basal conditions, and the maximal response to isoproterenol
      was significantly reduced (by 45 +/- 18%). Similar results were obtained when the
      responses in the rate of contraction and rate of relaxation to isoproterenol were
      considered. The L-type Ca(2+) current amplitude measured in failing
      cardiomyocytes under basal conditions was unchanged, but the responses to
      isoproterenol were significantly reduced compared with healthy cells.
      Isoproterenol-stimulated cAMP generation was similar in sarcolemmal membranes
      derived from the homogenates of failing (45 +/- 6.8) and healthy cardiomyocytes
      (52 +/- 8.5 pmol cAMP. mg protein(-1). min(-1)). However, stimulated cAMP
      generation was found to be significantly reduced when the membranes were derived
      from the homogenates of whole tissue (failing: 67 +/- 8.1 vs. healthy: 140 +/-
      27.8 pmol cAMP. mg protein(-1). min(-1)). Total beta-AR density was not reduced
      in membranes derived from either whole tissue or isolated cardiomyocyte
      homogenates, but the beta(1)/beta(2) ratio was significantly reduced in the
      former (failing: 45/55 vs. healthy: 72/28) without being altered in the latter
      (failing: 72/28, healthy: 77/23). We thus conclude that, in tachycardia-induced
      heart failure, reduction in the functional responses of isolated cardiomyocytes
      to beta-AR stimulation may be attributed to alterations in the excitation
      contraction machinery rather than to limitation of cAMP generation.

PMID- 11208563
TI  - Expression of carbonic anhydrase IV in mouse placenta.
AB  - Carbonic anhydrase (CA) facilitates acid-base transport in several tissues.
      Acidosis upregulates membrane-bound SDS-resistant hydratase activity in various
      tissues and CA IV mRNA in rabbit kidney. This study was designed to assess
      whether the expression of membrane-bound CA IV isozyme in mouse placenta is
      regulated developmentally and by maternal ammonium chloride loading at the end of
      pregnancy. For this purpose we used Northern blot analysis, Western blots of
      microsomal membranes, and immunocytochemistry. The expression of CA IV mRNA on
      Northern blots tripled from day 11 to day 15 and then remained stable until the
      end of pregnancy. Expression of CA IV immunoreactive protein on Western blot
      tripled from day 11 to day 15 and decreased almost to baseline by day 19. Strong
      staining for CA IV was detected by immunocytochemistry in labyrinthine
      trophoblast, in the endodermal layer of the yolk sac (both intra- and
      extraplacental) and in the uterine epithelium. Weak staining was observed in most
      fetal endothelial cells at 11 days but not later in gestation. Maternal acidosis
      did not upregulate the expression of CA IV mRNA or CA IV immunoreactive protein.
      Thus CA IV expression in mouse placenta is developmentally regulated. Maternal
      acidosis during the last quarter of pregnancy does not upregulate CA IV mRNA or
      CA IV immunoreactive protein.

PMID- 11208564
TI  - Organ-specific distribution of AP-1 in AP-1 luciferase transgenic mice during the
      maturation process.
AB  - Activator protein-1 (AP-1), a dimeric complex consisting of proteins encoded by
      the jun and fos gene families, is a transcription factor induced by a variety of
      signals including those eliciting proliferation, differentiation, and neoplastic
      transformation. Although AP-1 has been widely studied in the last decade,
      physiological levels of AP-1 in different tissues are unclear. In the present
      study, we analyzed AP-1 activity in several organs (liver, kidney, brain, lung,
      spleen, heart, skin) of AP-1-luciferase transgenic mice of various ages. Results
      of these studies indicate that the level of AP-1 in young mice is much higher
      than that in older mice, and, second, that the skin contains considerably higher
      levels of AP-1 than other organs. The level of phosphorylated extracellular
      signal-regulated protein kinase (ERK) in skin was higher in 1- and 2-day-old mice
      than in mice of other ages. In addition, phosphorylated p38 kinase was high in 2
      day-old and 1-wk-old mice, but phosphorylated c-Jun NH(2)-terminal kinase was not
      detected at any age. AP-1 activity and level of phosphorylated ERKs declined with
      maturation. These results imply that AP-1 activity mediated through an ERKs
      dependent pathway may be involved in skin development.

PMID- 11208565
TI  - The small intestine plays an important role in upregulating CGRP during sepsis.
AB  - Although studies have indicated that calcitonin gene-related peptide (CGRP), a
      potent vasodilatory peptide, is upregulated after endotoxic shock, it remains
      controversial whether this peptide increases during sepsis and, if so, whether
      the gut is a significant source of CGRP under such conditions. To study this,
      polymicrobial sepsis was induced by cecal ligation and puncture (CLP) followed by
      fluid resuscitation. Plasma levels of CGRP were measured at 2, 5, and 10 h after
      CLP (i.e., early, hyperdynamic sepsis) and at 20 h after CLP (late, hypodynamic
      sepsis). The results indicate that plasma CGRP did not increase at 2--5 h but
      increased by 177% at 10 h after CLP (P < 0.05). At 20 h after the onset of
      sepsis, however, the elevated plasma CGRP returned to the sham level. To
      determine the source of the increased plasma CGRP, the liver, spleen, small
      intestine, lungs, and heart were harvested, and tissue CGRP was assayed at 10 h
      after CLP in additional animals. Only the small intestine showed a significant
      increase in tissue levels of CGRP (by 129%, P < 0.05). Determination of portal
      vs. systemic levels of CGRP indicates that portal CGRP was 65.7 +/- 22.7% higher
      than the systemic level at 10 h after CLP, whereas portal CGRP in sham-operated
      rats was only 4.9 +/- 2.1% higher. Immunohistochemistry examination revealed that
      CGRP-positive stainings increased in the intestinal tissue but not in the liver
      at 10 h after the onset of sepsis. The distribution of CGRP stainings was
      associated with intestinal nerve fibers. These results, taken together,
      demonstrate that upregulation of CGRP occurs transiently during the progression
      of sepsis (at the late phase of the hyperdynamic sepsis), and the gut appears to
      be a major source of such an increase in circulating levels of this peptide.

PMID- 11208566
TI  - Chronic exercise alters caudal hypothalamic regulation of the cardiovascular
      system in hypertensive rats.
AB  - Previous studies have documented a deficit in the GABA neurotransmitter system
      within the caudal hypothalamus (CH) of spontaneously hypertensive rats (SHR). The
      reduction in inhibitory influence on this cardiovascular excitatory brain region
      is associated with an increased neuronal activity and resting blood pressure. The
      purpose of this study was to determine if chronic treadmill and wheel-running
      activities alter the ability of the CH to regulate cardiovascular function. SHR
      were exercised on a treadmill (5 times/wk) at moderate intensity or allowed free
      access to running wheels (7 days/wk) for a period of 10 wk. Resting blood
      pressures were obtained before and after the exercise training periods. After the
      exercise period, rats were anesthetized and microinjection experiments were
      performed. Treadmill-trained SHR exhibited a significantly blunted developmental
      rise in resting blood pressure after 10 wk of exercise. A similar yet less marked
      effect was observed in wheel-run rats. Microinjection of the GABA synthesis
      inhibitor 3-mercaptopropionic acid (3-MP) into the CH of nonexercised SHR did not
      produce any change in arterial pressure. In contrast, microinjection of 3-MP into
      the CH produced significant increases in blood pressure and heart rate in
      exercised SHR. These results demonstrate that exercise training can alter CH
      cardiovascular regulation in hypertensive rats and therefore may play a role in
      increasing cardiovascular health.

PMID- 11208567
TI  - Sleep changes induced by lipopolysaccharide in the rat are influenced by age.
AB  - In mammals, aging is associated with immune senescense. To examine whether the
      sleep changes occurring during immune challenge are affected by age, we assessed
      sleep alterations induced by the administration of lipopolysaccharide (LPS) in
      young and middle-aged rats. During vehicle, the middle-aged rats exhibited less
      pre-rapid eye movement sleep (pre-REMS) as well as REMS, due to a smaller number
      and shorter duration of REMS episodes, than young rats. LPS elevated body
      temperature, increased non-REMS, and suppressed both pre-REMS and REMS in the
      young as well as in the middle-aged rats. However, in the young animals, LPS
      significantly enhanced slow-wave activity in the electroencephalogram (EEG)
      within non-REMS, reflecting an increase in sleep intensity. In contrast, LPS
      attenuated EEG power in most frequency bands in the older animals. This finding
      indicates age-related changes in the modulation of sleep by LPS.

PMID- 11208568
TI  - Angiotensin-(1--7) in the ovine fetus.
AB  - In the adult animal, ANG-(1-7) may counterbalance some effects of ANG II. Its
      effects in the fetus are unknown. Basal ANG-(1-7), ANG I, ANG II, and renin
      concentrations were measured in plasma from ovine fetuses and their mothers (n =
      10) at 111 days of gestation. In the fetus, concentrations of ANG I, ANG-(1-7),
      and ANG II were 86 +/- 21, 13 +/- 2, and 14 +/- 2 fmol/ml, respectively. In the
      ewe, concentrations of ANG I were significantly lower (20 +/- 4 fmol/ml, P <
      0.05) as were concentrations of ANG-(1-7) (2.9 +/- 0.6 fmol/ml), whereas ANG II
      concentrations were not different (10 +/- 1 fmol/ml). Plasma renin concentrations
      were higher in the fetus (4.8 +/- 1.1 pmol ANG I x ml(-1) x h(-1)) than in the
      ewe (0.9 +/- 0.2 pmol x ml(-1) x h(-1), P < 0.05). Infusion of ANG-(1-7)
      (approximately 9 microg/h) for a 3-day period caused a significant increase in
      plasma concentrations of ANG-(1-7) reaching a maximum of 448 +/- 146 fmol/ml on
      day 3 of infusion. Plasma levels of ANG I and II as well as renin were unchanged
      by the infusion. Urine flow rate, glomerular filtration rate, and fetal arterial
      blood pressure did not change and were not different than values in fetuses
      receiving a saline infusion for 3 days (n = 5). However, the osmolality of
      amniotic and allantoic fluid was significantly higher in fetuses that received
      ANG-(1-7). Also, compared with the saline-infused animals, mRNA expression levels
      of renin, the AT(1) receptor, and AT(2) receptor were elevated in kidneys of
      fetuses that received infusions of ANG-(1-7). Infusion of an ANG-(1-7) antagonist
      ([D-Ala(7)]-ANG-(1-7), 20 microg/h) for 3 days had no effect on fetal blood
      pressure or renal function. In conclusion, although infusion of ANG-(1-7) did not
      affect fetal urine flow rate, glomerular filtration rate, or blood pressure,
      changes in fetal fluids and gene expression indicate that ANG-(1-7) may play a
      role in the fetal kidney.

PMID- 11208569
TI  - Effects of maturation and acute hypoxia on receptor-IP(3) coupling in ovine
      common carotid arteries.
AB  - Whereas previous studies have established that many mechanisms mediating
      pharmacomechanical coupling are subject to regulation, evidence of physiological
      regulation of the coupling efficiency between receptor activation and second
      messenger production is scarce. The present studies address the hypothesis that
      acute hypoxia and maturation can influence the mass of second-messenger
      production for each activated agonist-bound receptor ("receptor gain"). For this
      assessment, receptor density and agonist affinity values were used to calculate 5
      hydroxytryptamine (5-HT) concentrations that would produce standardized numbers
      of bound receptors (8.5 fmol/mg protein) in each experimental group and thus
      minimize effects of age or hypoxia on receptor density or agonist affinity. After
      3 min of exposure to these 5-HT concentrations, normoxic magnitudes of
      contraction were similar (as %potassium maxima) in fetal (50 +/- 14%) and adult
      (40 +/- 9%) arteries, but hypoxia (PO(2) approximately 9--12 Torr for 30 min)
      depressed contractile tensions with a significantly different time course and
      magnitude in fetal (30 +/- 10%) and adult (17 +/- 11%) arteries (P < 0.05). Basal
      inositol 1,4,5-trisphosphate (IP(3)) values (in pmol/mg protein) were
      significantly greater in fetal (94 +/- 16) than in adult (44 +/- 6) arteries, and
      integrated areas above baseline for the IP(3) time courses (in nmol-s/mg protein)
      were significantly greater in fetal than in adult arteries both in normoxic (14.3
      +/- 1.8 vs. 9.1 +/- 1.6) and hypoxic (15.0 +/- 2.1 vs. 8.6 +/- 1.2) conditions (P
      < 0.05). Hypoxia altered the IP(3) time courses both in the fetus and the adult
      but had no significant effect on IP(3 )mobilization or receptor gain. These data
      demonstrate that for the 5-HT(2a) receptor predominant in this preparation,
      receptor gain can be experimentally determined, is not influenced by acute
      hypoxia, but is greater in fetal than in adult ovine carotid arteries.

PMID- 11208570
TI  - Effect of water restriction on feeding and metabolism in dairy cows.
AB  - We investigated how lactating cows are able to cope with a sustained water
      restriction. In experiment 1, body weight and meal patterns were recorded with ad
      libitum access to water (baseline) and during 8 days of 25 and 50% restriction of
      drinking water relative to ad libitum intake. In experiment 2, indirect
      calorimetry was combined with nitrogen and energy balance and plasma hormone and
      metabolite measurements to assess the effects of 50% water restriction on
      digestion and metabolism. In experiment 1, food intake and body weight declined
      during the first 3 days of water restriction depending on the restriction level
      and stabilized thereafter at a lower level. The daily food intake reduction with
      50% water restriction was entirely due to a reduction of meal size. The size of
      the first meal on every day was markedly (>50%) reduced with 25 and 50% water
      restriction. In experiment 2, urea concentrations in milk and blood as well as
      plasma sodium and hematocrit were increased by 50% water restriction. Energy
      balance was not affected by 50% water restriction, but nitrogen balance became
      negative, because, relative to intake, nitrogen excretion via urine and milk was
      higher. The lower energy intake during 50% water restriction was compensated by a
      lower milk production, a higher digestibility of organic matter and energy, and,
      apparently, a more efficient energy use. Through these changes and a preserved
      water balance, the cows reached a new equilibrium at a lower water turnover
      level, which enabled them to cope with a sustained drinking water restriction of
      50%.

PMID- 11208571
TI  - Alterations of the renin-angiotensin system at the RVLM of transgenic rats with
      low brain angiotensinogen.
AB  - The transgenic rats TGR(ASrAOGEN) (TGR) with low levels of brain angiotensinogen
      were analyzed for cardiovascular reactivity to microinjections of ANG II and
      angiotensin receptor (AT(1)) antagonists [CV-11974, AT(1) specific; A-779, ANG-(1
      -7) selective; sarthran, nonspecific] into the rostral ventrolateral medulla
      (RVLM) of conscious rats. Microinjection of ANG II resulted in a significantly
      higher increase in the mean arterial pressure (MAP) of TGR than control [Sprague
      Dawley (SD)] rats, suggesting an upregulation of ANG II receptors in TGR. CV
      11974 produced an increase in MAP of SD but not in TGR rats. A-779 produced a
      depressor response in SD but not in TGR rats. Conversely, sarthran produced a
      similar decrease of MAP in both rat groups. The pressor effect of the AT(1)
      antagonist may indicate an inhibitory role of AT(1) receptors in the RVLM. On the
      other hand, ANG-(1--7) appears to have a tonic excitatory role in this region.
      The altered response to specific angiotensin antagonists in TGR further supports
      the functionally relevant decrease in angiotensins in the brains of TGR and
      corroborates the importance of the central renin-angiotensin system in
      cardiovascular homeostasis.

PMID- 11208572
TI  - Glutamatergic and GABAergic inputs to the RVL mediate cardiovascular adjustments
      to noxious stimulation.
AB  - Stimulation of cutaneous and muscle afferents induces several cardiovascular
      adjustments such as hypertension, tachycardia, and muscle vasodilation. Although
      previous studies have demonstrated that the rostral ventrolateral medulla (RVL)
      mediates sympathoexcitation and pressor responses to sciatic nerve stimulation
      (SNS), whether it also mediates blood flow adjustments remains unclear.
      Therefore, in the present study, we examined the role of the RVL in the
      vasodilation induced by SNS and the possible neurotransmitters involved. In
      Urethane-anesthetized, paralyzed, and artificially ventilated rats, SNS (square
      pulses, 1 ms, 20 Hz, 800--1200 microA, 10 s) produced increases in blood
      pressure, heart rate, blood flow, and vascular conductance of the stimulated
      limb. Unilateral microinjection of kainic acid (2 nmol/100 nl) into the RVL
      contralateral to the stimulated limb abolished cardiovascular adjustments to SNS.
      Unilateral microinjections of kynurenic acid (2 nmol/100 nl) selectively
      abolished the pressor response to SNS, whereas bicuculline (400 pmol/100 nl)
      abolished the increases in blood flow without changing the pressor response.
      These results suggest that glutamatergic synapses within the RVL mediate pressor
      responses, whereas GABAergic synapses may mediate the vasodilation to SNS.

PMID- 11208573
TI  - Effect of acute exercise on citrate synthase activity in untrained and trained
      human skeletal muscle.
AB  - Maximal citrate synthase activity (CS) is routinely used as a marker of aerobic
      capacity and mitochondrial density in skeletal muscle. However, reported CS has
      been notoriously variable, even with similar experimental protocols and sampling
      from the same muscles. Exercise training has resulted in increases in CS ranging
      from 0 to 100%. Previously, it has been reported that acute exercise may
      significantly affect CS. To investigate the hypothesis that the large variation
      in CS that occurs with training is influenced by alterations during the exercise
      itself, we studied CS in human vastus lateralis both in the rested and acutely
      exercised state while trained and untrained (n = 6). Tissues obtained from four
      biopsies (untrained rested, untrained acutely exercised, trained rested, and
      trained acutely exercised) were analyzed spectrophotometrically for maximal CS.
      Exercise training measured in a rested state resulted in an 18.2% increase in CS
      (12.3 +/- 0.3 to 14.5 +/- 0.3 micromol x min(-1) x g tissue(-1), P < or = 0.05).
      However, even greater increases were recorded 1 h after acute exercise: 49.4% in
      the untrained state (12.3 +/- 0.3 to 18.3 +/- 0.5 micromol x min(-1) x g tissue(
      1), P < or = 0.05) and 50.8% in the trained state (14.5 +/- 0.3 to 21.8 +/- 0.4
      micromol x min(-1) x g tissue(-1), P < or = 0.05). Ultrastructural analysis, by
      electron microscopy, supported an effect of acute exercise with the finding of
      numerous swollen mitochondria 1 h after exercise that may result in greater
      access to the CS itself in the CS assay. In conclusion, although unexplained, the
      increased CS with acute exercise can clearly confound training responses and
      artificially elevate CS values. Therefore, the timing of muscle sampling relative
      to the last exercise session is critical when measuring CS and offers an
      explanation for the large variation in CS previously reported.

PMID- 11208574
TI  - Carbon monoxide is the heme oxygenase product with a pyretic action: evidence for
      a cGMP signaling pathway.
AB  - We have recently reported that the central heme oxygenase (HO) pathway has an
      important role in the genesis of lipopolysaccharide fever. However, the HO
      product involved, i.e., biliverdine, free iron, or carbon monoxide (CO), has not
      yet been identified with certainty. Therefore, in the present study, we tested
      the thermoregulatory effects of all HO products. Body core temperature (T(c)) and
      gross activity of awake, freely moving rats was measured by biotelemetry.
      Intracerebroventricular administration of heme-lysinate (152 nmol), which induces
      the HO pathway, evoked a marked increase in T(c), a response that was attenuated
      by intracerebroventricular pretreatment with the HO inhibitor zinc
      deuteroporphyrin 2,4-bis glycol (200 nmol), indicating that an HO product has a
      pyretic action in the central nervous system (CNS) of rats. Besides, heme
      lysinate also increased gross activity, but no correlation was found between this
      effect and the increase in T(c). Moreover, intracerebroventricular biliverdine or
      iron salts at 152 nmol, a dose at which heme-lysinate was effective in increasing
      T(c), produced no change in T(c). Accordingly, intracerebroventricular treatment
      with the iron chelator deferoxamine elicited no change in basal T(c) and did not
      affect heme-induced pyresis. However, heme-induced pyresis was completely
      prevented by the soluble guanylate cyclase (sGC) inhibitor 1H
      [1,2,4]oxadiazolo[4,3,-a]quinoxaline-1-one. Because biliverdine and iron had no
      thermoregulatory effects and CO produces most of its actions via sGC, these data
      strongly imply that CO is the only HO product with a pyretic action in the CNS.

PMID- 11208576
TI  - Topical application of the phospholipid growth factor lysophosphatidic acid
      promotes wound healing in vivo.
AB  - The lipid mediator lysophosphatidic acid (LPA) regulates cell proliferation and
      enhances cell motility in vitro, both of which are important events in wound
      healing. To evaluate the effects of LPA in vivo, it was applied to a full
      thickness wound of rat skin. LPA in micromolar concentrations, or solvent, was
      applied daily. Animals were killed at 1, 3, 6, and 9 days after wounding and
      processed for histological evaluation, including hematoxylin-eosin staining and
      histochemical markers for macrophage-histiocytes, proliferating cells, and
      capillary endothelial cells. LPA treatment accelerated wound closing and
      increased neoepithelial thickness. Cytological evaluation showed no evidence for
      a secondary inflammation-mediated injury, infection, or increased keloid
      formation. Whereas LPA caused only a modest dose-dependent increase in
      proliferating cells, a marked increase in the immigration of histiocyte
      macrophage cells was observed as early as day 1. The peaks of several cytological
      features and immunohistological markers preceded those of the untreated side. Our
      data suggest that exogenously applied LPA in this model promotes healing and that
      macrophage-histiocytes are the primary LPA-responsive cells in vivo.

PMID- 11208575
TI  - Vasopressin pressor receptor-mediated activation of HPA axis by acute ethanol
      stress in rats.
AB  - The plasma arginine vasopressin (AVP), ACTH, and corticosterone levels and the
      hypothalamic corticotropin-releasing hormone (CRH) content were measured after
      oral administration of 1 ml of 75% ethanol to rats, a model known to induce acute
      gastric erosions and stress. Elevated plasma AVP, ACTH, and corticosterone levels
      were detected 1 h after ethanol administration. Treatment with the vasopressin
      pressor (V(1)) receptor antagonist [d(CH(2))(5)Tyr(Me)-AVP] before ethanol
      administration significantly reduced the ACTH and corticosterone level increases.
      A higher hypothalamic CRH content was measured at 30 or 60 min after ethanol
      administration. V(1) receptor antagonist injection, 5 min before ethanol
      administration, inhibited the rise in hypothalamic CRH content. The protein
      synthesis blocker cycloheximide prevented the hypothalamic CRH content elevation
      after stress. The AVP-, CRH-, and AVP + CRH-induced in vitro ACTH release in
      normal anterior pituitary tissue cultures was also prevented by pretreatment with
      the V(1) receptor antagonist. The results support the hypothesis that stress
      induced AVP may not only act directly on the ACTH producing anterior pituitary
      cells but also indirectly at the hypothalamic level via the synthesis and release
      of CRH.

PMID- 11208577
TI  - Feeding inhibition by urocortin in the rat hypothalamic paraventricular nucleus.
AB  - Ventricular administration of urocortin (UCN) inhibits feeding, but specific
      site(s) of UCN action are unknown. In the current studies we examined the effect
      of UCN in the hypothalamic paraventricular nucleus (PVN) on feeding. We tested
      UCN administered into the PVN in several paradigms: deprivation-induced,
      nocturnal, and neuropeptide Y (NPY)-induced feeding. We compared the effect of
      equimolar doses of UCN and corticotrophin releasing hormone (CRH) on NPY-induced
      and nocturnal feeding, determined whether UCN in the PVN produced a conditioned
      taste aversion (CTA) and induced changes in c-Fos immunoreactivity (c-Fos-ir)
      after UCN and NPY administration in the PVN. UCN in the PVN significantly
      decreased NPY and nocturnal and deprivation-induced feeding at doses of 1, 10,
      and 100 pmol, respectively. UCN anorectic effects lasted longer than those
      attributed to CRH. Ten and thirty picomoles UCN did not induce a CTA, whereas 100
      pmol UCN produced a CTA. UCN (100 pmol) in the PVN neither increased c-Fos-ir in
      any brain region assayed nor altered c-Fos-ir patterns resulting from PVN NPY
      administration. These data suggest the hypothalamic PVN as a site of UCN action.

PMID- 11208578
TI  - Physicochemical analysis of phasic menstrual cycle effects on acid-base balance.
AB  - In accordance with Stewart's physicochemical approach, the three independent
      determinants of plasma hydrogen ion concentration ([H(+)]) were measured at rest
      and during exercise in the follicular (FP) and luteal phase (LP) of the human
      menstrual cycle. Healthy, physically active women with similar physical
      characteristics were tested during either the FP (n = 14) or LP (n = 14).
      Arterialized blood samples were obtained at rest and after 5 min of upright
      cycling at both 70 and 110% of the ventilatory threshold (T(Vent)). Measurements
      included plasma [H(+)], arterial carbon dioxide tension (Pa(CO(2))), total weak
      acid ([A(Tot)]) as reflected by total protein, and the strong-ion difference
      ([SID]). The transition from rest to exercise in both groups resulted in a
      significant increase in [H(+)] at 70% T(Vent) versus rest and at 110% T(Vent)
      versus both rest and 70% T(Vent). No significant between-group differences were
      observed for [H(+)] at rest or in response to exercise. At rest in the LP,
      [A(Tot)] and Pa(CO(2)) were significantly lower (acts to decrease [H(+)])
      compared with the FP. This effect was offset by a reduction in [SID] (acts to
      increase [H(+)]). After the transition from rest to exercise, significantly lower
      [A(Tot)] during the LP was again observed. Although the [SID] and Pa(CO(2)) were
      not significantly different between groups, trends for changes in these two
      variables were similar to changes in the resting state. In conclusion, mechanisms
      regulating [H(+)] exhibit phase-related differences to ensure [H(+)] is
      relatively constant regardless of progesterone-mediated ventilatory changes
      during the LP.

PMID- 11208579
TI  - Relationship of ovarian hormones to hypoxemia in women residents of 4,300 m.
AB  - Prevalence of excessive erythrocytosis, the main sign of chronic mountain
      sickness (CMS), is greater in postmenopausal Andean women than in premenopausal
      women. It is uncertain whether this greater prevalence is related to the decline
      in female hormones and ventilatory function after the occurrence of the
      menopause. To study this, we compared the physiological variables involved in the
      physiopathology of CMS [end-tidal CO(2) (PET(CO(2)), Torr) and end-tidal O(2)
      (PET(O(2)), Torr), arterial oxygen saturation (Sa(O(2)), %), and Hb concentration
      (g/dl)] and progesterone and estradiol levels between postmenopausal and
      premenopausal women, both in the luteal and follicular phases. Women residing in
      Cerro de Pasco (n = 33; 4,300 m) aged 26--62 yr were studied. Postmenopausal
      women compared with premenopausal women in the luteal phase had lower PET(O(2))
      (48 +/- 4 vs. 53 +/- 2 Torr, P = 0.005) and Sa(O(2)) levels (82 +/- 12 vs. 88 +/-
      12%, P < 0.005) and higher PET(CO(2)) (34 +/- 2 vs. 29 +/- 3 Torr, P = 0.005) and
      Hb concentration (19 +/- 1 vs. 14 +/- 2 g/dl, P < 0.005). In addition, plasma
      progesterone was negatively correlated with PET(CO(2)) and positively correlated
      with PET(O(2)) and Sa(O(2)). No clear relationship was found among the cycle
      phases between estradiol and the variables studied. In conclusion, our results
      reveal that, before menopause, there is better oxygenation and lower Hb levels in
      women long residing at altitude, and this is associated with higher levels of
      progesterone in the luteal phase of the cycle.

PMID- 11208580
TI  - Caffeine stores and dopamine differentially require Ca(2+) channels in goldfish
      somatotropes.
AB  - The regulation of growth hormone (GH) secretion by intracellular Ca(2+) stores
      was studied in dissociated goldfish somatotropes. We characterized a caffeine
      activated intracellular store that had been shown to mediate GH release in
      response to gonadotropin-releasing hormone. The peak response of caffeine
      stimulation was reduced by approximately 28% by 100 microM ryanodine in a use
      dependent manner suggesting that the first 10 min of GH release is partially
      mediated by a caffeine-activated ryanodine receptor. The temporal sensitivities
      of caffeine- and dopamine-evoked GH release to blockade of Cd(2+)-sensitive
      Ca(2+) channels were compared. We demonstrated that the initial phase of dopamine
      evoked release was dependent on Ca(2+) channels, whereas the initial phase of
      caffeine-evoked release was sensitive only to pretreatment blockade. This would
      suggest that the maintenance of one class of caffeine-activated intracellular
      stores requires entry of Ca(2+) through Cd(2+)-sensitive Ca(2+) channels. This
      differential temporal requirement for Ca(2+) channels in Ca(2+) signaling may be
      a mechanism to segregate intracellular signaling pathways of multiple
      neuroendocrine regulators in the teleost pituitary.

PMID- 11208581
TI  - Acute changes in the response to peripheral leptin with alteration in the diet
      composition.
AB  - Dietary induced obesity in rodents is associated with a resistance to leptin. We
      have investigated the hypothesis that dietary fat per se alters the feeding
      response to peripheral leptin in rats that were fed either their habitual high-
      or low-fat diet or were naively exposed to the alternative diet. Osborne-Mendel
      rats were adapted to either high- or low-fat diet. Food-deprived rats were given
      either leptin (0.5 mg/kg body wt ip) or saline, after which they were provided
      with either their familiar diet or the alternative diet. Food intake of rats
      adapted and tested with the low-fat diet was reduced 4 h after leptin injection,
      whereas rats adapted and tested with a high-fat diet did not respond to leptin.
      Leptin was injected again 1 and 5 days after the high-fat diet-adapted rats were
      switched to the low-fat diet. Leptin reduced the food intake on both days. In
      contrast, when low-fat diet-adapted rats were switched to a high-fat diet, the
      leptin inhibitory response was present on day 1 but not observed on day 5.
      Peripheral injection of leptin increased serum corticosterone level and decreased
      hypothalamic neuropeptide Y mRNA expression in rats fed the low-fat but not the
      high-fat diet for 20 days. The data suggest that dietary fat itself, rather than
      obesity, may induce leptin resistance within a short time of exposure to a high
      fat diet.

PMID- 11208582
TI  - Role of PAC(1) receptor in adrenal catecholamine secretion induced by PACAP and
      VIP in vivo.
AB  - The present study was conducted to investigate the functional implication of the
      pituitary adenylate cyclase-activating polypeptide (PACAP) type I (PAC(1))
      receptor in the adrenal catecholamine (CA) secretion induced by either PACAP-27
      or vasoactive intestinal polypeptide (VIP) in anesthetized dogs. PACAP-27, VIP,
      and their respective antagonists were locally infused to the left adrenal gland
      via the left adrenolumbar artery. Plasma CA concentrations in adrenal venous and
      aortic blood were determined by means of a high-performance liquid chromatograph
      coupled with an electrochemical detector. Adrenal venous blood flow was measured
      by gravimetry. The administration of PACAP-27 (50 ng) resulted in a significant
      increase in adrenal CA output. VIP (5 microg) also increased the basal CA
      secretion to an extent comparable to that observed with PACAP-27. In the presence
      of PACAP partial sequence 6--27 [PACAP-(6--27); a PAC(1) receptor antagonist] at
      the doses of 7.5 and 15 microg, the CA response to PACAP-27 was attenuated by
      approximately 50 and approximately 95%, respectively. Although the CA
      secretagogue effect of VIP was blocked by approximately 85% in the presence of
      PACAP-(6--27) (15 microg), it remained unaffected by VIP partial sequence 10--28
      [VIP-(10--28); a VIP receptor antagonist] at the dose of 15 microg. Furthermore,
      the CA response to PACAP-27 did not change in the presence of the same dose of
      VIP--(10--28). The results indicate that PACAP-(6--27) diminished, in a dose
      dependent manner, the increase in adrenal CA secretion induced by PACAP-27. The
      results also indicate that the CA response to either PACAP-27 or VIP was
      selectively inhibited by PACAP-(6--27) but not by VIP-(10--28). It is concluded
      that PAC(1) receptor is primarily involved in the CA secretion induced by both
      PACAP-27 and VIP in the canine adrenal medulla in vivo.

PMID- 11208583
TI  - Purine and pyrimidine nucleotide-sensitive phospholipase A(2) in ampulla from
      frog semicircular canal.
AB  - This study was attempted to characterize pharmacologically the P2Y receptors
      triggering phospholipase A(2) (PLA(2)) activation in ampulla from frog
      semicircular canal. A microassay was developed to screen the abilities of UTP
      analogs to stimulate [(3)H]arachidonic acid release by labeled ampullas. At 26
      degrees C UTP induced a dose-dependent and saturable increase of PLA(2) activity
      (apparent activation constant 1.3 +/- 0.4 microM, Hill coefficient 0.9 +/- 0.2,
      maximal stimulating factor 2.0 +/- 0.1). The rank order of potency of agonists
      for PLA(2) activation was UTP > or = UDP > adenosine 5'-O-(2-thiodiphosphate) =
      adenosine 5'-O-(3-thiotriphosphate) > or = ATP = 2-methylthio-ATP > or = ADP =
      diadenosine tetraphosphate > or = alpha,beta-methylene-ATP = CTP > 2' and 3'-O-(4
      benzoylbenzoyl)-ATP > or = AMP = UMP >> uridine and adenosine. UTP- and 2
      methylthio-ATP-induced PLA(2) activations were inhibited by U-73122, GF-109203X,
      and methyl arachidonyl fluorophosphate. Basal activity was stimulated by phorbol
      ester and epinephrine and reduced by vasotocin, isoproterenol, prostaglandin
      E(2), cAMP, and forskolin. H-89 restored the cAMP- and forskolin-inhibited PLA(2)
      activities. Results indicate that P2Y receptor-mediated PLA(2) stimulation
      requires phopholipase C and protein kinase C activations and basal activity is
      inhibited by agonist-stimulated cAMP-dependent mechanisms.

PMID- 11208584
TI  - Effects of 17 beta-estradiol on levels and distribution of metallothionein and
      zinc in squirrelfish.
AB  - Females of the squirrelfish family (Holocentridae) accumulate higher levels of
      zinc in the liver than any other known animal. This zinc accumulation is made
      possible by high expression of the zinc-binding protein, metallothionein (MT). In
      the present study, the squirrelfish (Holocentrus ascensionis) MT cDNA was cloned
      and sequenced. The deduced amino acid sequence was very similar to other teleost
      MT. The role of estrogens on zinc metabolism was investigated by injecting male
      and immature female squirrelfish with 17 beta-estradiol (E(2)). E(2) treatment
      triggered transient increases in plasma zinc and vitellogenin (VTG) levels, and
      both of these variables showed very similar time courses. These results suggest
      that E(2) is responsible for the large hepatoovarian translocation of zinc
      observed in female squirrelfish and that VTG might be a vehicle for zinc. E(2)
      did not directly alter the levels of zinc or MT mRNA in the liver. However, the
      hepatic MT protein concentration increased differentially in the nuclear
      fraction. Thus E(2) is probably responsible for the association of MT with the
      nuclear fraction previously observed in untreated mature female squirrelfish.

PMID- 11208585
TI  - Role of inferior olive and thoracic IML neurons in nonshivering thermogenesis in
      rats.
AB  - Removal of the midbrain tonic inhibitory mechanism on nonshivering thermogenesis
      (NST) results in increased temperatures of the interscapular brown adipose tissue
      (IBAT) and rectum (T(IBAT) and T(rec), respectively) via an enhanced central
      sympathetic output. Because it is unlikely that neurons (primary) of the midbrain
      inhibitory mechanism tonically inhibit the IBAT monosynaptically, there must be
      secondary or tertiary neurons posterior to the midbrain. Such neurons, therefore,
      may increase their activity during enhanced NST after removal of the midbrain
      tonic inhibition. The aim of the present experiments was to localize these
      secondary or tertiary neurons and establish descending neuronal pathway(s) that
      may project to the major NST effector IBAT. T(IBAT) and T(rec) increases induced
      by removal of the tonic inhibition by midbrain procaine microinjections were
      accompanied with appearance of c-Fos-positive neurons in the inferior olive (IO)
      and the intermediolateral (IML) cell column of the thoracic spinal cord.
      Electrical stimulation of and L-glutamate microinjections into the IO increased
      T(IBAT) and T(rec). Midbrain procaine-induced T(IBAT) and T(rec) increases were
      blocked by electrolytic IO lesions. These results suggest that central thermal
      signals produced from the lower midbrain are transmitted to IBAT through the IO
      and IML and that the IO has a role in the central sympathetic functions.

PMID- 11208586
TI  - Effects of postnatal dexamethasone on blood-brain barrier permeability and brain
      water content in newborn lambs.
AB  - We showed that antenatal corticosteroids reduced blood-brain barrier permeability
      in fetuses at 60 and 80%, but not 90% of gestation, and decreased brain water
      content in fetuses. Our objective was to examine the effects of postnatal
      corticosteroids on regional blood-brain barrier permeability and brain water
      content in newborn lambs. Three dexamethasone treatment groups were studied in 3-
      to 5-day-old lambs. A 0.01 mg/kg dose was selected to estimate the amount of
      dexamethasone that might have reached fetuses via antenatal treatment of ewes in
      our previous studies. The other doses (0.25 and 0.5 mg/kg) were chosen to
      approximate those used clinically to treat infants with bronchopulmonary
      dysplasia. Lambs were randomly assigned to receive four intramuscular injections
      of dexamethasone or placebo given 12 h apart on days 3 and 4 of age. Blood-brain
      barrier function was measured with the blood-to-brain transfer constant (K(i)) to
      alpha-aminoisobutyric acid, brain plasma volume was measured with polyethylene
      glycol for the calculation of K(i,) and brain water was measured by wet-to-dry
      tissue weights. Postnatal treatment with corticosteroids did not reduce barrier
      permeability in newborn lambs. Brain blood volume was higher in the 0.25 and 0.5
      mg/kg dose dexamethasone groups than in the placebo group. Brain water content
      did not differ among the groups. We conclude that postnatal treatment with
      corticosteroids did not reduce regional blood-brain barrier permeability or brain
      water content but increased the brain plasma volume in newborn lambs. These
      findings are consistent with our previous work indicating that barrier
      permeability is responsive to corticosteroids at 60 and 80% of gestation and
      brain water regulation at 60% of gestation, but not in near-term fetuses or
      newborn lambs.

PMID- 11208587
TI  - Development of fetal vascular responses to endothelin-1 and acetylcholine in the
      sheep.
AB  - Responses to K(+), endothelin-1 (ET-1), and acetylcholine (ACh) of isolated
      adrenal, femoral, middle cerebral, and renal arteries from fetal [110--145 days
      gestational age (dGA, term approximately 148 dGA)] and 0- to 24-h newborn (NB)
      lambs were evaluated using the technique of wire myography. Responses at distinct
      developmental ages for each vascular bed were compared. In all arteries
      sensitivity to K(+)-induced vasoconstriction was similar at all fetal age points
      examined. In contrast, sensitivity to ET-1 increased with increasing fetal age in
      arteries from all vascular beds. The magnitude of the maximal vasoconstriction
      was positively correlated with GA for K(+) in adrenal, femoral, and cerebral
      arteries and for ET-1 in femoral, cerebral, and renal arteries. Cerebral arteries
      showed a greater sensitivity when compared with the other systemic arteries to
      K(+) and ET-1 at all fetal ages and to K(+) in NB. ACh evoked relaxatory
      responses in fetal and NB femoral and adrenal arteries. However, renal arteries
      relaxed comparatively less in response to ACh, and no vasodilation was noted in
      middle cerebral arteries at any age points examined. For femoral arteries ACh
      induced vasorelaxation decreased with increasing GA but was restored in arteries
      from NB lambs. In summary, the responsiveness of isolated resistance arteries
      varies with developmental age in the fetal and perinatal sheep and these effects
      are both agonist and vascular bed specific. The augmented sensitivity in response
      to ET-1 of middle cerebral compared with other systemic arteries may reflect the
      importance of cerebral blood flow control during this critical developmental
      period.

PMID- 11208588
TI  - Noradrenergic and GABAergic systems in the medial hypothalamus are activated
      during hypoglycemia.
AB  - Noradrenergic and GABAergic systems in the medial hypothalamus influence plasma
      glucose and may be activated during glucoprivation. Microdialysis probes were
      placed into the ventromedial nucleus (VMH), lateral hypothalamus (LHA), and
      paraventricular nucleus (PVH) of male Sprague-Dawley rats to monitor
      extracellular concentrations of norepinephrine (NE) and GABA. During systemic
      hypoglycemia, induced by insulin (1.0 U/kg), NE concentrations increased in the
      VMH (P < 0.05) and PVH (P = 0.06) in a bimodal fashion during the first 10 min
      and 20-30 min after insulin administration. In the VMH, GABA concentrations
      increased (P < 0.05) in a similar manner as NE. Extracellular NE concentrations
      in the LHA were slightly lower (P = 0.13), and GABA levels remained at baseline.
      The increases in NE and GABA in the VMH were absent during euglycemic clamp;
      however, NE in the PVH still increased, reflecting a direct response to
      hyperinsulinemia. On the basis of these data, we propose that the activity of
      noradrenergic afferents to the medial hypothalamus is increased during
      hypoglycemia and influences the activity of local GABAergic systems to activate
      appropriate physiological compensatory mechanisms.

PMID- 11208589
TI  - Effects of glucose supplementation on gastric emptying, blood glucose
      homeostasis, and appetite in the elderly.
AB  - The aims of this study were to evaluate the effects of dietary glucose
      supplementation on gastric emptying (GE) of both glucose and fat, postprandial
      blood glucose homeostasis, and appetite in eight older subjects (4 males, 4
      females, aged 65--84 yr). GE of a drink (15 ml olive oil and 33 g glucose
      dissolved in 185 ml water), blood glucose, insulin, gastric inhibitory
      polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), and appetite (diet
      diaries, visual analog scales, and food intake at a buffet meal consumed after
      the GE study) were evaluated twice, after 10 days on a standard or a glucose
      supplemented diet (70 g glucose 3 times a day). Glucose supplementation
      accelerated GE of glucose (P < 0.05), but not oil; there was a trend for an
      increase in GIP (at 15 min, P = 0.06), no change in GLP-1, an earlier insulin
      peak (P < 0.01), and a subsequent reduction in blood glucose (at 75 min, P <
      0.01). Glucose supplementation had no effect on food intake during each diet so
      that energy intake was greater (P < 0.001) during the glucose-supplemented diet.
      Appetite ratings and energy intake at the buffet meal were not different. We
      conclude that, in older subjects, glucose supplementation 1) accelerates GE of
      glucose, but not fat; 2) modifies postprandial blood glucose homeostasis; and 3)
      increases energy intake.

PMID- 11208590
TI  - Influence of rostral ventrolateral medulla on renal sympathetic baroreflex in
      conscious rabbits.
AB  - Previous studies with anesthetized animals have shown that the pressor region of
      the rostral ventrolateral medulla (RVLM) is a critical site in vasomotor control.
      The aim of this study was to develop, in conscious rabbits, a technique for
      microinjecting into the RVLM and to determine the influence of this area on renal
      sympathetic nerve activity (RSNA) and arterial pressure (AP) using local
      injections of glutamate, rilmenidine, ANG II and sarile. Rabbits were implanted
      with guide cannulas for bilateral microinjections into the RVLM (n = 7) or into
      the intermediate ventrolateral medulla (IVLM, n = 6) and an electrode for
      measuring RSNA. After 7 days of recovery, injections of glutamate (10 and 20
      nmol) into the RVLM increased RSNA by 81 and 88% and AP by 17 and 25 mmHg,
      respectively. Infusion of glutamate (2 nmol/min) into the RVLM increased AP by 15
      mmHg and the RSNA baroreflex range by 38%. By contrast, injection of the
      imidazoline receptor agonist rilmenidine (4 nmol) into the RVLM decreased AP by 8
      mmHg and the RSNA baroreflex range by 37%. Injections of rilmenidine into the
      IVLM did not alter AP or RSNA. Surprisingly, treatments with ANG II (4 pmol/min)
      or the ANG II receptor antagonist sarile (500 pmol) into the RVLM did not affect
      the resting or baroreflex parameters. Infusion of ANG II (4 pmol/min) into the
      fourth ventricle increased AP and facilitated the RSNA baroreflex. Our results
      show that agents administered via a novel microinjecting system for conscious
      rabbits can selectively modulate neuronal activity in circumscribed regions of
      the ventrolateral medulla. We conclude that the RVLM plays a key role in
      circulatory control in conscious rabbits. However, we find no evidence for the
      role of ANG II receptors in the RVLM in the moment-to-moment regulation of AP and
      RSNA.

PMID- 11208591
TI  - Modeling the kinematics of the canine midcostal diaphragm.
AB  - The hypotheses that the chest wall insertion (CW) is displaced laterally during
      inspiration and that this displacement is essential in maintaining muscle
      curvature of the costal diaphragmatic muscle fibers were tested. With the use of
      data from three dogs, caudal, lateral, and ventral displacements of CW during
      both quiet, spontaneous inspiration and during inspiratory efforts against an
      occluded airway were observed and recorded. We have developed a kinematic model
      of the diaphragm that incorporates these displacements. This model describes the
      motions of the muscle fibers and central tendon; the displacements of the
      midplane, muscle-tendon junction (MTJ), CW, and center of the muscle fiber
      central tendon arcs are modeled as functions of muscle fiber length. In the
      model, the center of the fiber arcs and MTJ both move caudally parallel to the
      midplane during inspiration, whereas CW moves both caudally and laterally. The
      observed lateral displacement of CW and the observed caudal displacement of MTJ,
      as functions of muscle fiber length, both approximate well the theoretical
      displacements that would be necessary to maintain curvature of the fiber arcs. In
      confirming our hypotheses, we have found that lateral displacement of CW is a
      mechanism by which changes in the shape of the costal diaphragm, as described by
      its curvature, are limited.

PMID- 11208592
TI  - Basal forebrain acetylcholine release during REM sleep is significantly greater
      than during waking.
AB  - Cholinergic neurons of the basal forebrain supply the neocortex with ACh and play
      a major role in regulating behavioral arousal and cortical
      electroencephalographic activation. Cortical ACh release is greatest during
      waking and rapid eye movement (REM) sleep and reduced during non-REM (NREM)
      sleep. Loss of basal forebrain cholinergic neurons contributes to sleep
      disruption and to the cognitive deficits of many neurological disorders. ACh
      release within the basal forebrain previously has not been quantified during
      sleep. This study used in vivo microdialysis to test the hypothesis that basal
      forebrain ACh release varies as a function of sleep and waking. Cats were trained
      to sleep in a head-stable position, and dialysis samples were collected during
      polygraphically defined states of waking, NREM sleep, and REM sleep. Results from
      22 experiments in four animals demonstrated that means +/- SE ACh release
      (pmol/10 min) was greatest during REM sleep (0.77 +/- 0.07), intermediate during
      waking (0.58 +/- 0.03), and lowest during NREM sleep (0.34 +/- 0.01). The finding
      that, during REM sleep, basal forebrain ACh release is significantly elevated
      over waking levels suggests a differential role for basal forebrain ACh during
      REM sleep and waking.

PMID- 11208593
TI  - Multiple aspects of mineralocorticoid selectivity.
AB  - Aldosterone regulates renal sodium reabsorption through binding to the
      mineralocorticoid receptor (MR). Because the glucocorticoid receptor (GR) is
      expressed together with the MR in aldosterone target cells, glucocorticoid
      hormones bound to GR may also intervene to modulate physiological functions in
      these cells. In addition, each steroid can bind both receptors, and the MR has
      equal affinity for aldosterone and glucocorticoid hormones. Several cellular and
      molecular mechanisms intervene to allow specific aldosterone regulatory effects,
      despite the large prevalence of glucocorticoid hormones in the plasma. They
      include the local metabolism of the glucocorticoid hormones into inactive
      derivatives by the enzyme 11beta-hydroxysteroid dehydrogenase; the intrinsic
      properties of the MR that discriminate between ligands through differential
      contacts; the possibility of forming homo- or heterodimers between MR and GR,
      leading to differential transactivation properties; and the interactions of MR
      and GR with other regulatory transcription factors. The relative contribution of
      each of these successive mechanisms may vary among aldosterone target cells
      (epithelial vs. nonepithelial) and according to the hormonal context. All these
      phenomena allow fine tuning of cellular functions depending on the degree of
      cooperation between corticosteroid hormones and other factors (hormonal or tissue
      specific). Such interactions may be altered in pathophysiological situations.

PMID- 11208594
TI  - Cellular regulation of endothelial nitric oxide synthase.
AB  - Renal function is highly dependent on endothelium-derived nitric oxide (NO).
      Several renal disorders have been linked to impaired NO bioavailability. The
      enzyme that is responsible for the synthesis of NO within the renal endothelium
      is endothelial NO synthase (eNOS). eNOS-mediated NO generation is a highly
      regulated cellular event, which is induced by calcium-mobilizing agonists and
      fluid shear stress. eNOS activity is regulated at the transcriptional level but
      also by a variety of modifications, such as acylation and phosphorylation, by its
      cellular localization, and by protein-protein interactions. The present review
      focuses on the complex regulation of eNOS within the endothelial cell.

PMID- 11208595
TI  - Renal effects of serine-7 analog of lymphoguanylin in ex vivo rat kidney.
AB  - Guanylin and uroguanylin compose a family of natriuretic, diuretic, and
      kaliuretic peptides that bind to and activate apical membrane receptor guanylyl
      cyclase signaling molecules in renal and intestinal epithelia. Recently, a
      complementary DNA encoding an additional member of the guanylin family of cGMP
      regulating peptides was isolated from lymphoid tissues of the opossum and was
      termed lymphoguanylin (LGN). A peptide analog of opossum LGN was synthesized
      containing a single disulfide bond with the internal cysteine-7 replaced by a
      serine residue (LGN(Cys7-->Ser7)). The biological activity of LGN(Ser) was tested
      by using a cGMP bioassay with cultured T84 (human intestinal) cells and opossum
      kidney (OK) cells. LGN(Ser) has potencies and efficacies for activation of cGMP
      production in the intestinal and kidney cell lines that are 100- and 1,000-fold
      higher than LGN, respectively. In the isolated perfused rat kidney, LGN(Ser)
      stimulated a maximal increase in fractional Na+ excretion from 24.8 +/- 3.0 to
      36.3 +/- 3.3% 60 min after administration and enhanced urine flow from 0.15 +/-
      0.01 to 0.24 +/- 0.01 ml. g(-1). min(-1). LGN(Ser) (0.69 microM) also increased
      fractional K+ excretion from 27.3 +/- 2.3 to 38.0 +/- 3.0% and fractional Cl-
      excretion from 26.1 +/- 0.8 to 43.5 +/- 1.9. A ninefold increase in the urinary
      excretion of cGMP from 1.00 +/- 0.04 to 9.28 +/- 1.14 pmol/ml was elicited by
      LGN(Ser), whereas cAMP levels were not changed on peptide administration. These
      findings demonstrate that LGN(Ser), which contains a single disulfide bond like
      native LGN, activates guanylyl cyclase-C (GC-C) receptors in T84 and OK cells and
      may be very helpful in studying the physiological importance of activation of GC
      C in vivo. LGN(Ser) also exhibits full activity in the isolated perfused kidney
      equivalent to that observed previously with opossum uroguanylin, suggesting a
      physiological role for LGN in renal function. Thus the single amino acid
      substitution enhances the activity and potency of LGN.

PMID- 11208596
TI  - Location and function of the epithelial Na channel in the cochlea.
AB  - In the cochlea, endolymph is a K-rich and Na-poor fluid. The purpose of the
      present study was to check the presence and to assess the role of epithelial Na
      channel (ENaC) in this organ. alpha-, beta-, and gamma-ENaC subunit mRNA, and
      proteins were detected in rat cochlea by RT-PCR and Western blot. alpha-ENaC
      subunit mRNA was localized by in situ hybridization in both epithelial (stria
      vascularis, spiral prominence, spiral limbus) and nonepithelial structures
      (spiral ligament, spiral ganglion). The alpha-ENaC-positive tissues were also
      positive for beta-subunit mRNA (except spiral ganglion) or for gamma-subunit mRNA
      (spiral limbus, spiral ligament, and spiral ganglion), but the signals of beta-
      and gamma-subunits were weaker than those observed for alpha-subunit. In vivo,
      the endocochlear potential was recorded in guinea pigs under normoxic and hypoxic
      conditions after endolymphatic perfusion of ENaC inhibitors (amiloride, benzamil)
      dissolved either in K-rich or Na-rich solutions. ENaC inhibitors altered the
      endocochlear potential when Na-rich but not when K-rich solutions were perfused.
      In conclusion, ENaC subunits are expressed in epithelial and nonepithelial
      cochlear structures. One of its functions is probably to maintain the low
      concentration of Na in endolymph.

PMID- 11208597
TI  - Role of 20-HETE in mediating the effect of dietary K intake on the apical K
      channels in the mTAL.
AB  - We have used the patch-clamp technique to study the effect of dietary K intake on
      the apical K channels in the medullary thick ascending limb (mTAL) of rat
      kidneys. The channel activity, defined by the number of channels in a patch and
      the open probability (NPo), of the 30- and 70-pS K channels, was 0.18 and 0.11,
      respectively, in the mTAL from rats on a K-deficient diet. In contrast, NPo of
      the 30- and 70-pS K channels increased to 0.60 and 0.80, respectively, in the
      tubules from animals on a high-K diet. The concentration of 20
      hydroxyeicosatetraenoic acid (20-HETE) measured with gas chromatography-mass
      spectrometry was 0.8 pg/microg protein in the mTAL from rats on a high-K diet and
      increased significantly to 4.6 pg/microg protein in the tubules from rats on a K
      deficient diet. Addition of N-methylsulfonyl-12,12-dibromododec-11-enamide (DDMS)
      or 17-octadecynoic acid (17-ODYA), agents that inhibit the formation of 20-HETE,
      had no significant effect on the activity of the 30-pS K channels. However,
      DDMS/17-ODYA significantly increased the activity of the apical 70-pS K channel
      from 0.11 to 0.91 in the mTAL from rats on a K-deficient diet. In contrast,
      inhibition of the cytochrome P-450 metabolism of arachidonic acid increased NPo
      from 0.64 to 0.81 in the tubules from animals on a high-K diet. Furthermore, the
      sensitivity of the 70-pS K channel to 20-HETE was the same between rats on a high
      K diet and on a K-deficient diet. Finally, the pretreatment of the tubules with
      DDMS increased NPo of the 70-pS K channels in the mTAL from rats on a K-deficient
      diet to 0.76. We conclude that an increase in 20-HETE production is involved in
      reducing the activity of the apical 70-pS K channels in the mTAL from rats on a K
      deficient diet.

PMID- 11208598
TI  - Renal interstitial adenosine metabolism during ischemia in dogs.
AB  - The present study was conducted to determine the metabolism of renal interstitial
      adenosine under resting conditions and during ischemia. By using a microdialysis
      method with HPLC-fluorometric analysis, renal interstitial concentrations of
      adenosine, inosine, and hypoxanthine were assessed in pentobarbital-anesthetized
      dogs. Average basal renal interstitial concentrations of adenosine, inosine, and
      hypoxanthine were 0.18 +/- 0.04, 0.31 +/- 0.05, and 0.35 +/- 0.05 micromol/l,
      respectively. Local inhibition of adenosine kinase with iodotubercidin (10
      micromol/l in perfusate) or inhibition of adenosine deaminase with erythro-9-(2
      hydroxy-3-nonyl)adenine (EHNA; 100 micromol/l in perfusate) did not change
      adenosine concentrations in the nonischemic kidneys (0.18 +/- 0.04 and 0.24 +/-
      0.05 micromol/l, respectively). On the other hand, treatment with
      iodotubercidin+EHNA significantly increased adenosine concentration (0.52 +/-
      0.07 micromol/l) with significant decreases in inosine and hypoxanthine levels
      (0.13 +/- 0.03 and 0.19 +/- 0.04 micromol/l, respectively). During 30 min of
      ischemia, adenosine, inosine, and hypoxanthine were significantly increased to
      0.76 +/- 0.29, 2.14 +/- 0.45, and 21.8 +/- 4.7 micromol/l, respectively. The
      treatment with iodotubercidin did not alter ischemia-induced increase in
      adenosine (0.84 +/- 0.18 micromol/l); however, EHNA alone markedly enhanced
      adenosine accumulation (13.54 +/- 2.16 micromol/l), the value of which was not
      augmented by an addition of iodotubercidin (15.80 +/- 1.24 micromol/l). In
      contrast, ischemia-induced increases in inosine and hypoxanthine were inversely
      diminished by the treatment with iodotubercidin+EHNA (0.90 +/- 0.20 and 9.86 +/-
      1.96 micromol/l, respectively). These results suggest that both adenosine kinase
      and adenosine deaminase contribute to the metabolism of renal interstitial
      adenosine under resting conditions, whereas adenosine produced during ischemia is
      mainly metabolized by adenosine deaminase and the rephosphorylation of adenosine
      by adenosine kinase is small.sent

PMID- 11208599
TI  - Peritubular fluid viscosity modulates H+ flux in proximal tubules through NO
      release.
AB  - We evaluated the effects of increasing the viscosity (eta) in peritubular
      capillary perfusates (PCP; 20 mM HNaPO4--Ringer, pH 7.4) on proximal convoluted
      tubule (PCT) acidification. Micropuncture experiments were performed with
      simultaneous luminal and peritubular perfusion. Changes in pH of a 20 mM HNaPO4-
      Ringer (pH 7.4 at t = 0) droplet placed in PCT lumen were measured with H+
      sensitive microelectrodes. By adding neutral dextran (molecular wt 300,000
      400,000) to the PCP, eta was increased. The effect of 10(-5) M ATP added to
      normal-eta PCP was evaluated. High eta increased H+ flux (85 and 97% when eta was
      increased 20 and 30%, respectively, above the control value). This increase was
      abolished by adding the nitric oxide antagonist N(omega)-nitro-L-arginine (L-NNA;
      10(-4) M) or the purinoreceptor antagonists suramin (10(-4) M) and reactive blue
      2 (3 x 10(-5) M). Addition of 5 x 10(-3) M L-arginine to the peritubular
      perfusate overcame the inhibitory effect of L-NNA on high-eta-induced increase in
      H+ flux. ATP increased H+ flux (80%), and this effect was blocked by L-NNA. These
      results suggest that changes in eta can modulate proximal H+ flux, at least in
      part, through ATP-dependent nitric oxide release from the endothelial cells of
      the peritubular capillaries.

PMID- 11208600
TI  - An endocytosis defect as a possible cause of proteinuria in polycystic kidney
      disease.
AB  - Because proteinuria has been demonstrated in patients with autosomal-dominant
      polycystic kidney disease (ADPKD), we have investigated whether proteinuria also
      occurs in the (cy/+) rat, a widely used model for ADPKD. Increased urinary
      excretion of proteins, in particular of albumin, can be found in 16-wk-old (cy/+)
      rats, with a gel electrophoresis pattern compatible with a tubular origin of
      proteinuria. Using FITC-labeled dextran as an in vivo tracer for renal tubular
      endosomal function, we could show that portions of cyst-lining epithelia from
      proximal tubules have lost the ability to endocytose, which is necessary for the
      reabsorption of low-molecular-weight proteins. By immunohistochemistry, the
      expression of other proteins implicated in endocytosis, such as the chloride
      channel ClC-5 and the albumin receptor megalin, correlated well with the presence
      and absence of FITC-dextran in cysts. As an example of growth factor systems
      possibly being affected by this endocytosis defect, we could detect increased
      urinary levels of insulin-like growth factor-I protein in (cy/+) animals. These
      data indicate that proteinuria and albuminuria in the aforementioned rat model
      for ADPKD are due to a loss of the endocytic machinery in epithelia of proximal
      tubular cysts. This may also affect the concentration of different growth factors
      and hormones in cyst fluids and thus modulate cyst development.

PMID- 11208601
TI  - Early streptozotocin-diabetes mellitus downregulates rat kidney AT2 receptors.
AB  - The interaction of ANG II with intrarenal AT1 receptors has been implicated in
      the progression of diabetic nephropathy, but the role of intrarenal AT2 receptors
      is unknown. The present studies determined the effect of early diabetes on
      components of the glomerular renin-angiotensin system and on expression of kidney
      AT2 receptors. Three groups of rats were studied after 2 wk: 1) control (C), 2)
      streptozotocin (STZ)-induced diabetic (D), and 3) STZ-induced diabetic with
      insulin implant (D+I), to maintain normoglycemia. By competitive RT-PCR, early
      diabetes had no significant effect on glomerular mRNA expression for renin,
      angiotensinogen, or angiotensin-converting enzyme (ACE). In isolated glomeruli,
      nonglycosylated (41-kDa) AT1 receptor protein expression (AT1A and AT1B) was
      increased in D rats, with no change in glycosylated (53-kDa) AT1 receptor protein
      or in AT1 receptor mRNA. By contrast, STZ diabetes caused a significant decrease
      in glomerular AT2 receptor protein expression (47.0 +/- 6.5% of C; P < 0.001; n =
      6), with partial reversal in D+I rats. In normal rat kidney, AT2 receptor
      immunostaining was localized to glomerular endothelial cells and tubular
      epithelial cells in the cortex, interstitial, and tubular cells in the outer
      medulla, and inner medullary collecting duct cells. STZ diabetes caused a
      significant decrease in AT2 receptor immunostaining in all kidney regions, an
      effect partially reversed in D+I rats. In summary, early diabetes has no effect
      on glomerular mRNA expression for renin, angiotensinogen, or ACE. AT2 receptors
      are present in glomeruli and are downregulated in early diabetes, as are all
      kidney AT2 receptors. Our data suggest that alterations in the balance of kidney
      AT1 and AT2 receptor expression may contribute to ANG II-mediated glomerular
      injury in progressive diabetic nephropathy.

PMID- 11208602
TI  - Molecular and biochemical characterization of prostacyclin receptors in rat
      kidney.
AB  - The prostacyclin (IP) message was detected by RT-PCR in the renal cortex, outer
      (OM) and inner medulla (IM), and in freshly isolated (IMCD-f) and cultured inner
      medullary collecting duct (IMCD-c), and also the E-prostanoid (EP)1,3,4 receptor
      subtypes, but not EP2. Digoxigenin in situ hybridization localized IP mRNA in the
      tubules of the OM and IM, and the vasculature, and also in the glomeruli,
      arteries, and tubules of the cortex. IP splice variants or subtypes could not be
      detected by RT-PCR followed by TA cloning, though several nonfunctional point
      mutations or single base pair deletions were observed. Iloprost (ILP), cicaprost
      (CCP), PGE2, and arginine vasopressin (AVP) stimulated cAMP in both IMCD
      preparations. In addition, AVP-stimulated cAMP in IMCD-f was inhibited by all
      three prostanoids, but not in IMCD-c. Calcium experiments were performed on IMCD
      c or microdissected IMCD (IMCD-m). CCP, ILP, and PGE2 did not alter intracellular
      calcium concentration ([Ca2+]i) in IMCD-c. However, on IMCD-m, both PGE2 and ILP
      increased [Ca2+]i levels equipotently and CCP had no effect. Pretreatment with
      the EP1 antagonist AH-6809 indicates that the response to ILP and PGE2 is
      mediated via EP1. These results suggest that IP receptors in the rat IMCD mediate
      the cAMP but not calcium signaling linked to PGI2; to date no subtypes or splice
      variants have been identified.

PMID- 11208603
TI  - Na+-to-sugar stoichiometry of SGLT3.
AB  - Sodium-glucose cotransporters (SGLTs) mediate active transport of sugar across
      cell membranes coupled to Na+, by using the electrochemical gradient as a driving
      force. In the kidney, there is evidence for two kinds of cotransporters, a high
      affinity, low-capacity system, and a low-affinity, high-capacity system, with
      differences in substrate specificity and kinetics. Three renal SGLT clones have
      been identified: SGLT1 corresponding to the high-affinity system, and SGLT2 and
      SGLT3 with properties reminiscent of the low-affinity system. We have determined
      the stoichiometry of pig SGLT3 (pSGLT3) by using a direct method, comparing the
      substrate-induced inward charge to 22Na or [14C]alpha-methyl-D-glucopyranoside
      uptake in the same oocyte. pSGLT3 stoichiometry is 2 Na+:1 sugar, the same as
      that for SGLT1, but different from SGLT2 (1:1). The Na+ Hill coefficient for
      SGLT3 is approximately 1.5, suggesting low cooperativity between Na+ binding
      sites. Thus SGLT3 has functional characteristics intermediate between SGLT1 and
      SGLT2, so, whereas SGLT3 stoichiometry is the same as that for SGLT1 (2:1), sugar
      affinity and specificity are similar to SGLT2.

PMID- 11208604
TI  - NHE3 activity and trafficking depend on the state of actin organization in
      proximal tubule.
AB  - The present study was addressed to define the contribution of cytoskeleton
      elements in the kidney proximal tubule Na+/H+ exchanger 3 (NHE3) activity under
      basal conditions. We used luminal membrane vesicles (LMV) isolated from
      suspensions of rat cortical tubules pretreated with either colchicine (Colch) or
      cytochalasin D (Cyto D). Colch pretreatment of suspensions (200 microM for 60
      min) moderately decreased LMV NHE3 activity. Cyto D pretreatment (1 microM for 60
      min) elicited an increase in LMV NHE3 transport activity but did not increase Na
      glucose cotransport activity. Cyto D pretreatment of suspensions did not change
      the apparent affinity of NHE3 for internal H+. In contrast, after Cyto D
      pretreatment of the suspensions, NHE3 protein abundance was increased in LMV and
      remained unchanged in cortical cell homogenates. The effect of Cyto D on NHE3 was
      further assessed with cultures of murine cortical cells. The amount of surface
      biotinylated NHE3 increased on Cyto D treatment, whereas NHE3 protein abundance
      was unchanged in cell homogenates. In conclusion, under basal conditions NHE3
      activity depends on the state of actin organization possibly involved in
      trafficking processes between luminal membrane and intracellular compartment.

PMID- 11208606
TI  - SGK integrates insulin and mineralocorticoid regulation of epithelial sodium
      transport.
AB  - The epithelial Na+ channel (ENaC) constitutes the rate-limiting step for Na+
      transport across tight epithelia and is the principal target of hormonal
      regulation, particularly by insulin and mineralocorticoids. Recently, the serine
      threonine kinase (SGK) was identified as a rapidly mineralocorticoid-responsive
      gene, the product of which stimulates ENaC-mediated Na+ transport. Like its close
      relative, protein kinase B (also called Akt), SGK's kinase activity is dependent
      on phosphatidylinositol 3-kinase (PI3K), a key mediator of insulin signaling. In
      our study we show that PI3K is required for SGK-dependent stimulation of ENaC
      mediated Na+ transport as well as for the production of the phosphorylated form
      of SGK. In A6 kidney cells, mineralocorticoid induction of the phosphorylated
      form of SGK preceded the increase in Na+ transport, and specific inhibition of
      PI3K inhibited both phosphorylation of SGK and mineralocorticoid-induced Na+
      transport. Insulin both augmented SGK phosphorylation and synergized with
      mineralocorticoids in stimulating Na+ transport. In a Xenopus laevis oocyte
      coexpression assay, SGK-stimulated ENaC activity was also markedly reduced by
      PI3K inhibition. Finally, in vitro-translated SGK specifically interacted with
      the ENaC subunits expressed in Escherichia coli as glutathione S-transferase
      fusion proteins. These data suggest that SGK is a PI3K-dependent integrator of
      insulin and mineralocorticoid actions that interacts with ENaC subunits to
      control Na+ entry into kidney collecting duct cells.

PMID- 11208605
TI  - Regulation of MAP kinase by calcium-sensing receptor in bovine parathyroid and
      CaR-transfected HEK293 cells.
AB  - Regulation of the extracellular signal-regulated kinase 1 and 2 (ERK1/2) pathway
      by the extracellular calcium (Ca2+o)-sensing receptor (CaR) was investigated in
      bovine parathyroid and CaR-transfected human embryonic kidney (HEKCaR) cells.
      Elevating Ca2+o or adding the selective CaR activator NPS R-467 elicited rapid,
      dose-dependent phosphorylation of ERK1/2. These phosphorylations were attenuated
      by pretreatment with pertussis toxin (PTX) or by treatment with the
      phosphotyrosine kinase (PTK) inhibitors genistein and herbimycin, the
      phosphatidylinositol-specific phospholipase C (PI-PLC) inhibitor U-73122, or the
      protein kinase C (PKC) inhibitor GF109203X and were enhanced by the PKC activator
      phorbol 12-myristate 13-acetate. Combined treatment with PTX and inhibitors of
      both PKC and PTK nearly abolished high Ca2+o-evoked ERK1/2 activation in HEKCaR
      cells, demonstrating CaR-mediated coupling via both Gq and G(i). High Ca2+o
      increased serine phosphorylation of the 85-kDa cytosolic phospholipase A2 (cPLA2)
      in both parathyroid and HEKCaR cells. The selective mitogen-activated protein
      kinase (MAPK) inhibitor PD98059 abolished high-Ca2+o)-induced ERK1/2 activation
      and reduced cPLA2 phosphorylation in both cell types, documenting MAPK's role in
      cPLA2 activation. Thus our data suggest that the CaR activates MAPK through PKC,
      presumably through Gq/11-mediated activation of PI-PLC, as well as through G(i)-
      and PTK-dependent pathway(s) in bovine parathyroid and HEKCaR cells and indicate
      the importance of MAPK in cPLA2 activation.

PMID- 11208607
TI  - Mechanisms of chloride transport in thymic lymphocytes.
AB  - This study examined mechanisms of Cl- transport in rat lymphocytes under a
      variety of conditions. Basal intracellular Cl- concentration ([Cl-]i) was not
      different between cells assayed in the presence of HCO3- or its absence (HEPES).
      Removal of external Cl- resulted in a fall in [Cl-]i and a rapid rise in
      intracellular pH (pH(i)). Both Cl- efflux and the rise in pH(i) were blocked by
      DIDS or removal of external Na+ but were unaffected by furosemide. The mechanisms
      governing Cl- influx were assessed in cells that had been Cl- depleted for 1 h.
      Reexposure to Cl- resulted in a rapid rise in [Cl-]i that was partially inhibited
      by pretreatment with DIDS (57%) and partially inhibited by pretreatment with
      furosemide (45%). Pretreatment with both compounds together completely blocked Cl
      influx. Cl- depletion caused a marked increase in pH(i) that rapidly declined
      toward normal when the cells were reexposed to Cl-. Preincubation with DIDS
      completely blocked this decrease in pH(i). In contrast, neither removal of Na+
      nor preincubation with furosemide affected the decline in pH(i) when the cells
      were reexposed to Cl-. We conclude that, in thymic lymphocytes, Cl-/HCO3- (or Cl
      /base exchange) regulates both Cl- influx and efflux. Cl- efflux is totally
      inhibited by DIDS and is mediated by a Na+-dependent Cl-/HCO3- exchanger. Cl-
      influx is partially DIDS sensitive and partially furosemide sensitive and is
      mediated by both a Na+-independent Cl-/HCO3- exchanger and by a Na+-K+-2Cl-
      cotransporter.

PMID- 11208608
TI  - UT-A3: localization and characterization of an additional urea transporter
      isoform in the IMCD.
AB  - UT-A3 has recently been identified as a splicing variant transcript of the UT-A
      gene present in the kidney. To study the cellular and subcellular localization of
      UT-A3, we raised a new polyclonal antibody to its COOH-terminal end. Immunoblots
      identified bands at 44 and 67 kDa predominately in the inner medulla and showed
      that the antibody does not recognize UT-A1. Deglycosylation with PNGase decreased
      the molecular mass of both forms to 40 kDa. UT-A3 is most abundant in the inner
      third of the inner medulla and is present in membrane fractions. Cell
      fractionation studies showed that UT-A3 is only detectable in inner medullary
      collecting duct (IMCD) cells. These observations were confirmed with
      immunolocalization studies demonstrating an exclusive labeling of IMCD cells.
      Double-labeling studies with anti-Na-K-ATPase demonstrated UT-A3 in intracellular
      membranes and in the apical region but were incompatible with a basolateral site
      for UT-A3. Although the function of this isoform in the inner medulla is unknown,
      the large abundance suggests that it may be important in the renal handling of
      urea.

PMID- 11208609
TI  - Role of 14-3-3epsilon, c-Myc/Max, and Akt phosphorylation in HIV-1 gp 120-induced
      mesangial cell proliferation.
AB  - Focal glomerulosclerosis (FGS) is the predominant glomerular lesion in patients
      with human immunodeficiency virus (HIV)-associated nephropathy. Initial mesangial
      cell hyperplasia and subsequent hypoplasia are common features of FGS. In the
      present study we evaluated the effect of HIV-1 glycoprotein (gp) 120 on human
      mesangial cell (HMC) growth. HIV-1 gp 120 stimulated HMC proliferation at lower
      concentrations, whereas it suppressed cell proliferation at higher
      concentrations. In parallel to the modulation of cell growth, gp 120 at low
      concentrations resulted in an increase in the expression of c-Myc, Max, and 14-3
      3epsilon proteins and phosphorylation of ATP-dependent tyrosine kinases (Akt) at
      Ser(473). However, the expression of these proteins decreased with increasing
      concentrations of gp 120. Furthermore, gp 120 also exhibited a dose-dependent
      inhibition of Akt phosphorylation at Ser-473 without any significant alteration
      of Akt expression. Little or no effects of gp 120 were observed on the expression
      of extracellular signal-regulated kinase (ERK), phospho-ERK, Bcl-2, and Bax
      proteins. At a higher concentration, gp 120 not only promoted HMC apoptosis but
      also enhanced expression of Fas and FasL. These results suggest that HIV-1 gp 120
      induces alterations in conflicting survival signaling pathways that contribute to
      the potential dual effects of gp 120 in promoting or inhibiting HMC
      proliferation.

PMID- 11208610
TI  - Mechanisms underlying renoprotection during renin-angiotensin system blockade.
AB  - Potential determinants of chronic renal disease (CRD) progression were studied in
      male Munich-Wistar rats subjected to 5/6 nephrectomy and treated with candesartan
      (Csn; n = 30) or enalapril (Ena; n = 27) from 5 wk postsurgery. Despite control
      of systolic blood pressure (SBP; 24 wk: Csn = 143 +/- 9; Ena = 148 +/- 8 mmHg),
      urinary protein excretion rates (U(pr)V) increased over 24 wk (Csn = 92 +/- 10;
      Ena = 99 +/- 8mg/day). Glomerulosclerosis scores (GS) at 24 wk were similar for
      Csn (42 +/- 7%) vs. Ena (42 +/- 4%), values close to those of untreated controls
      at 12 wk (43 +/- 4%). At 24 wk, SBP and UprV correlated strongly with GS,
      together accounting for 72% of the variance in GS. Renal cortex mRNA levels
      (determined by competitive RT-PCR) for transforming growth factor (TGF)-beta1 and
      monocyte chemoattractant protein (MCP)-1 were elevated in Csn and Ena at 12 wk
      and remained higher at 24 wk vs. sham. Strong correlations were evident among TGF
      beta1, MCP-1, and interleukin-1beta and renal injury at 24 wk. Cns and Ena are
      thus equally effective renoprotective agents in this model. During renin
      angiotensin system inhibition, renoprotection is dependent on control of both SBP
      and UprV. Incomplete suppression of renal cytokine gene expression may also
      contribute to CRD progression.

PMID- 11208611
TI  - Pendrin: an apical Cl-/OH-/HCO3- exchanger in the kidney cortex.
AB  - The identities of the apical Cl-/base exchangers in kidney proximal tubule and
      cortical collecting duct (CCD) cells remain unknown. Pendrin (PDS), which is
      expressed at high levels in the thyroid and its mutation causes Pendred's
      syndrome, is shown to be an anion exchanger. We investigated the renal
      distribution of PDS and its function. Our results demonstrate that pendrin mRNA
      expression in the rat kidney is abundant and limited to the cortex. Proximal
      tubule suspensions isolated from kidney cortex were highly enriched in pendrin
      mRNA. Immunoblot analysis studies localized pendrin to cortical brush-border
      membranes. Nephron segment RT-PCR localized pendrin mRNA to proximal tubule and
      CCD. Expression studies in HEK-293 cells demonstrated that pendrin functions in
      the Cl-/OH-, Cl-/HCO3-, and Cl-/formate exchange modes. The conclusion is that
      pendrin is an apical Cl-/base exchanger in the kidney proximal tubule and CCD and
      mediates Cl-/OH-, Cl-/HCO3-, and Cl-/formate exchange.

PMID- 11208612
TI  - Tuberculosis elimination: are we willing to pay the price?

PMID- 11208613
TI  - Pressure-volume curves: searching for the grail or laying patients with adult
      respiratory distress syndrome on procrustes' bed?

PMID- 11208614
TI  - Reducing asthma mortality with the asthma self-management plan system of care.

PMID- 11208615
TI  - The link between sleep apnea and cardiovascular disease: time to target the
      nonsleepy sleep apneics?

PMID- 11208616
TI  - What nobody needs to know about airborne infection.

PMID- 11208617
TI  - The buck stops here.

PMID- 11208618
TI  - The COMPACCS Study: questions left unanswered. The Committee on Manpower for
      Pulmonary and Critical Care Societies.

PMID- 11208619
TI  - Are asthma medications and management related to deaths from asthma?
AB  - There is controversy about the role of beta-agonists in asthma mortality, and the
      impact of asthma management plans remains unclear. We compared blood beta-agonist
      levels in patients dying from asthma with those in controls, and estimated the
      risks associated with specific classes of medication and patterns of management.
      We identified 89 asthma deaths and recruited 322 patients presenting to hospitals
      with acute asthma. A questionnaire was administered to the next of kin in 51
      cases, and to 202 controls. Blood drawn from 35 cases and 229 controls was
      assayed for salbutamol. Smoking, drinking, and family problems were significantly
      more likely among the cases of asthma death than among the controls. The two
      groups were reasonably well matched with regard to markers of chronic asthma
      severity. Cases of asthma death were significantly less likely than controls to
      use a peak flow meter. Written action plans were associated with a 70% reduction
      in the risk of death. Use of nebulized bronchodilators or oral steroids was
      significantly more likely in cases of asthma death. Mean blood salbutamol
      concentrations were 2.5 times higher in cases of asthma. The use of oral steroids
      for an attack of asthma reduced the risk of death by 90%. More widespread
      adoption of written asthma management plans, with less reliance on beta-agonists
      and closer medical supervision, should reduce asthma mortality.

PMID- 11208620
TI  - Sleep-disordered breathing and cardiovascular disease: cross-sectional results of
      the Sleep Heart Health Study.
AB  - Disordered breathing during sleep is associated with acute, unfavorable effects
      on cardiovascular physiology, but few studies have examined its postulated
      association with cardiovascular disease (CVD). We examined the cross-sectional
      association between sleep- disordered breathing and self-reported CVD in 6,424
      free-living individuals who underwent overnight, unattended polysomnography at
      home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)
      the average number of apneas and hypopneas per hour of sleep. Mild to moderate
      disordered breathing during sleep was highly prevalent in the sample (median AHI:
      4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16%)
      reported at least one manifestation of CVD (myocardial infarction, angina,
      coronary revascularization procedure, heart failure, or stroke). The
      multivariable-adjusted relative odds (95% CI) of prevalent CVD for the second,
      third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24),
      1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing
      was associated more strongly with self-reported heart failure and stroke than
      with self-reported coronary heart disease: the relative odds (95% CI) of heart
      failure, stroke, and coronary heart disease (upper versus lower AHI quartile)
      were 2.38 (1.22-4.62), 1.58 (1.02- 2.46), and 1.27 (0.99-1.62), respectively.
      These findings are compatible with modest to moderate effects of sleep-disordered
      breathing on heterogeneous manifestations of CVD within a range of AHI values
      that are considered normal or only mildly elevated.

PMID- 11208621
TI  - Propofol versus midazolam regarding their antioxidant activities.
AB  - Propofol and midazolam are commonly used as sedatives for critically ill
      patients. These patients usually suffer from the pathologic effects of oxidative
      stress, predominantly caused by an imbalance between the generation of reactive
      oxygen species and the antioxidant defense system. Therefore, the antioxidant
      activities of propofol and midazolam may be of clinical importance. We
      investigated the activities of these two sedatives against hydrophilic or
      lipophilic peroxyl radicals in a homogeneous solution and in the presence of
      erythrocyte membranes. A chemical analysis of the homogeneous solution revealed
      that propofol efficiently scavenged hydrophilic peroxyl radicals (50% inhibitory
      concentration [IC50] = 1.3 x 10(-4) M), whereas midazolam efficiently scavenged
      lipophilic radicals (IC50 = 1.5 x 10(-5) M). Further, in membrane systems,
      propofol inhibited the oxidative damage induced by either hydrophilic or
      lipophilic radicals (IC50 = 1.5 x 10(-5) M for hydrophilic radicals and IC50 =
      3.0 x 10(-4) M for lipophilic radicals), whereas midazolam did very little. In
      previous studies, we demonstrated that antioxidant activity is highly affected by
      the location and properties of the reaction site. The discrepancy in antioxidant
      activity between a homogeneous condition and in the presence of membranes can be
      well explained by this concept, and again emphasizes the importance of membranes
      in determining antioxidant activity. To further understand the biologic
      significance of these antioxidant properties, the effect of the two agents on
      endothelium-dependent relaxation was studied. Application of oxidative stress to
      aortic rings by treating them with peroxyl radicals led to a significant blockade
      of acetylcholine-induced relaxation after submaximal contraction with
      phenylephrine. Propofol pretreatment greatly attenuated the impairment in
      comparison with midazolam, which agrees with the concept of antioxidant activity
      in the presence of membranes. The results of the present study suggest that
      propofol has a greater potential to reduce oxidative stress than midazolam.

PMID- 11208622
TI  - Acute anti-inflammatory effects of inhaled budesonide in asthma: a randomized
      controlled trial.
AB  - Corticosteroids can have acute effects on airway function and methacholine airway
      responsiveness in asthma as early as 6 h after dosing, suggesting there may be an
      acute anti-inflammatory effect of inhaled corticosteroid in asthma. This study
      aimed to determine the effects of a single dose of inhaled budesonide on sputum
      eosinophils and mast cells in adults with asthma, and to examine whether the
      mechanism of clearance of eosinophils was by apoptosis. A randomized, double
      blind, placebo-controlled, crossover study was conducted. At the screening visit,
      adults with stable asthma (n = 41) ceased inhaled corticosteroid therapy for 4 d
      and those with significant sputum eosinophilia (> or = 7%) were randomized (n =
      26) to a single dose of budesonide 2,400 microg or placebo via Turbuhaler, on two
      separate study days. Symptoms and lung function were followed for 6 h, then
      sputum was induced and airway responsiveness to hypertonic saline determined.
      Sputum eosinophils (mean, SE) were significantly lower 6 h after budesonide (25%,
      4.5), compared with placebo (37%, 6.2, p < 0.05). There was a 2.2-fold (95% CI
      1.45 to 3.33) improvement in airway responsiveness with budesonide. No
      significant difference was seen on mast cells, apoptotic eosinophils, symptoms,
      or lung function. In conclusion, a single dose of inhaled corticosteroids has
      beneficial effects on airway inflammation and airway hyperresponsiveness as early
      as 6 h after dosing. This may be clinically useful as therapy during mild
      exacerbations of asthma.

PMID- 11208623
TI  - Airway responsiveness in early infancy predicts asthma, lung function, and
      respiratory symptoms by school age.
AB  - Asthma is the most common chronic childhood disease in developed nations. Little
      is known about the relationship between airway responsiveness in infancy and the
      development of asthma later in life. The relationship of airway responsiveness at
      1 mo with asthma, atopy, lower respiratory symptoms, and lung function at 6 yr of
      age was investigated prospectively in 95 white children from a randomly
      ascertained birth cohort. Baseline spirometry, airway responsiveness to
      histamine, and skin reactivity to common allergens were assessed at the age of 1
      mo and 6 yr. Total serum immunoglobulin E (IgE) was measured from cord blood and
      at 6 yr. Blood eosinophil counts were measured at 6 yr only. Family, symptom, and
      exposure histories at both time points were derived from questionnaire data.
      Independently of the other factors assessed, increased airway responsiveness at 1
      mo was significantly associated with the following parameters measured at six yr:
      decreased FEV(1) (p < 0.001); decreased FVC (p < 0.001); physician-diagnosed
      asthma (p < 0.001); and lower respiratory tract symptoms (p < 0.05). None of the
      other physiologic factors measured in infancy showed such consistent associations
      with important clinical and physiologic outcomes at age 6. These data suggest
      that airway responsiveness in early life defines a functional state that is
      associated with abnormal airway function, lower respiratory symptoms, and the
      emergence of asthma by 6 yr of age.

PMID- 11208624
TI  - Infection with Burkholderia cepacia in cystic fibrosis: outcome following lung
      transplantation.
AB  - As a result of concern over excessive mortality after lung transplantation, many
      transplant programs refuse to accept cystic fibrosis (CF) patients infected with
      Burkholderia cepacia. As a significant proportion of patients with CF in our
      community are infected with this organism, we have continued to provide lung
      transplantation as an option. A retrospective review was conducted of medical
      records of all patients with CF transplanted between March 1988 and September
      1996. Fifty-six transplant procedures were performed in 53 recipients with CF
      between March 1988 and September 1996. Twenty-eight had B. cepacia isolated
      pretransplant and 25 remaining positive post-transplant. Of the 53 recipients, 19
      have died (15 of 28 [54%] B. cepacia positive and 4 of 25 [16%] B. cepacia
      negative). B. cepacia was responsible for or involved in 14 deaths. Nine of the
      deaths occurred in the first 3 mo post-transplantation. One-year survival was 67%
      for B. cepacia positive patients and 92% for B. cepacia negative patients. Recent
      modifications in antimicrobial and immunosuppressive therapy since 1995 have
      resulted in no deaths early post-transplant in the last five patients
      transplanted. We conclude that early mortality in patients with CF infected with
      B. cepacia is significantly higher than in those not infected with B. cepacia.
      Modifications in post-transplant medical therapy may improve outcome.

PMID- 11208625
TI  - Response of the canine internal intercostal muscles to chest wall vibration.
AB  - Although high-frequency mechanical vibration of the rib cage reduces dyspnea, its
      effects on the respiratory muscles are largely unknown. We have previously shown
      that in anesthetized dogs, vibrating the rib cage during inspiration elicits a
      marked increase in the inspiratory electromyographic (EMG) activity recorded from
      the external intercostal muscles but does not affect tidal volume (VT). In the
      present studies, we have tested the hypothesis that the maintenance of VT results
      from the concomitant contraction of the internal interosseous (expiratory)
      intercostals. When the rib cage was vibrated (40 Hz) during hyperventilation
      induced apnea, a prominent activity was recorded from the external intercostals
      but no activity was recorded from the internal intercostals, including when the
      muscles were lengthened by passive inflation. The internal intercostals remained
      also silent when vibration was applied during spontaneous inspiration, and the
      phasic expiratory EMG activity recorded from them was unaltered when vibration
      was applied during expiration. Thus, the internal interosseous intercostals in
      dogs are much less sensitive to vibration than the external intercostals, and
      they do not interfere with the action of these latter during rib cage vibration.
      This lack of sensitivity might be the result of a reflex inhibition of the muscle
      spindle afferents by afferents from external intercostal muscle spindles.

PMID- 11208626
TI  - Endogenous surfactant turnover in preterm infants with respiratory distress
      syndrome studied with stable isotope lipids.
AB  - We studied surfactant kinetics on Day 1 of life in 11 preterm infants on
      mechanical ventilation by infusing stable isotope labeled palmitic (PA) and
      linoleic acid (LLA). Six infants received exogenous surfactant for the treatment
      of respiratory distress syndrome (RDS) and five did not meet treatment criteria
      because of minimal or no disease. The isotopic enrichment of plasma free PA and
      LLA and of surfactant phosphatidylcholine PA (PC-PA) and LLA (PC-LLA) from
      tracheal aspirates was measured by mass spectrometry. Significant isotopic
      enrichment could be measured in PC-PA and PC-LLA from all patients. The
      fractional synthesis rate (FSR) of PC-LLA was higher than that of PC-PA (22.7 +/-
      15.9 versus 12.1 +/- 7.7% per day, p = 0.018). Half-life (HL) of PC-PA was longer
      than that of PC-LLA (94.7 +/- 18.8 versus 46.6 +/- 32.6 h, p = 0.028). Patients
      who received exogenous surfactant had longer secretion times (ST) and delayed
      peak times (PK) but FSR and HL were unaffected. We concluded that: (1) surfactant
      kinetics can be measured in preterm infants with stable isotope labeled lipids;
      (2) surfactant FSR and HL calculated with PA and LLA gave different results; (3)
      patients treated with exogenous surfactant had similar FSRs compared with the
      nontreated subjects but had longer ST and delayed PK; (4) FSR from plasma free
      fatty acids (present study) was higher than that from plasma glucose in our
      previous work (Bunt JEH, Zimmermann LJI, Wattimena D, van Beek R, Sauer PJJ,
      Carnielli VP. Am J Respir Crit Care Med 1998;157:810-814) in a comparable
      population of preterm infants with RDS.

PMID- 11208627
TI  - Predictors of loss of lung function in the elderly: the Cardiovascular Health
      Study.
AB  - Pulmonary function, as measured by spirometry (FEV1 or FVC), is an important
      independent predictor of morbidity and mortality in elderly persons. In this
      study we examined the predictors of longitudinal decline in lung function for
      participants of the Cardiovascular Health Study (CHS). The CHS was started in
      1990 as a population-based observational study of cardiovascular disease in
      elderly persons. Spirometry testing was conducted at baseline, 4 and 7 yr later.
      The data were analyzed using a random effects model (REM) including an AR(1)
      error structure. There were 5,242 subjects (57.6% female, mean age 73 yr, 87.5%
      white and 12.5% African-American) with eligible FEV1 measures representing 89% of
      the baseline cohort. The REM results showed that African-Americans had
      significantly lower spirometry levels than whites but that their rate of decline
      with age was significantly less. Subjects reporting congestive heart failure
      (CHF), high systolic blood pressure (> 160 mm Hg), or taking beta-blockers had
      significantly lower spirometry levels; however, the effects of high blood
      pressure and taking beta-blockers diminished with increasing age. Chronic
      bronchitis, pneumonia, emphysema, and asthma were associated with reduced
      spirometry levels. The most notable finding of these analyses was that current
      smoking (especially for men) was associated with more rapid rates of decline in
      FVC and FEV1. African-Americans (especially women) had slower rates of decline in
      FEV1 than did whites. Although participants with current asthma had a mean 0.5 L
      lower FEV1 at their baseline examination, they did not subsequently experience
      more rapid declines in FEV1.

PMID- 11208628
TI  - Best compliance during a decremental, but not incremental, positive end
      expiratory pressure trial is related to open-lung positive end-expiratory
      pressure: a mathematical model of acute respiratory distress syndrome lungs.
AB  - A mathematical model of the acute respiratory distress syndrome (ARDS) lung,
      incorporating simulated gravitational superimposed pressure and alveolar opening
      and closing pressures, was used to study the mean tidal pressure-volume (PV)
      slope ("effective compliance") during incremental and decremental positive end
      expiratory pressure (PEEP) trials with constant tidal volume (VT) "ventilation."
      During incremental PEEP, the PEEP giving maximum mean tidal PV slope did not
      coincide with "open lung PEEP" (minimum PEEP preventing end expiratory collapse
      of 97.5% of alveoli inflated at end-inspiration), and it varied greatly with
      varying VT and "lung mechanics." Incremental PEEP with a low VT tests recruitment
      by the peak pressure, not prevention of collapse by PEEP. During decremental PEEP
      with a low VT, maximum mean tidal PV slope occurred with PEEP 2-3.5 cm H2O below
      open-lung PEEP, unless closing pressure was high. High VT, high "specific
      compliance," and high opening pressures caused slightly greater underestimation
      of open-lung PEEP. Maximum mean tidal PV slope was always higher (e.g., 93.7
      versus 16.69 ml/cm H2O), and the variation in PV slope with PEEP was greater,
      during decremental PEEP. The maximum PV slope during a decremental PEEP trial
      with a low VT may be a useful method to determine open-lung PEEP in ARDS, and
      should be studied clinically.

PMID- 11208629
TI  - Pretreatment with FK506 improves survival rate and gas exchange in canine model
      of acute lung injury.
AB  - The novel effects of FK506 on shock induced by lipopolysaccharide and phorbol
      myristate acetate (LPS/PMA) were studied using beagles. Five groups were studied:
      endotoxin shock control group (both 0.5 mg/kg of LPS and 30 microg/kg of PMA, n =
      6); methylprednisolone-treated endotoxin shock group (n = 5); FK506-treated
      endotoxin shock groups in which intravenous infusions of FK506 at 2.5 microg/kg/h
      (low dose, n = 5), 8 microg/kg/h (medium dose, n = 5), and 25 microg/kg/h (high
      dose, n = 5) were administered. In the control group, the survival rate was 33%.
      Also, arterial hypoxemia, systemic hypotension, and marked increases in pulmonary
      vascular resistance (PVR) and wet-to-dry weight ratio (W/D) were observed. FK506
      treatment at both medium and high doses significantly attenuated these LPS/PMA
      induced physiological changes, and the survival rates were 80 and 100%,
      respectively. On the other hand, in the methylprednisolone group, no obvious
      effects were observed. The present study suggests that FK506 could have
      prophylactic potential against acute lung injury in endotoxin shock.

PMID- 11208630
TI  - Regular versus as-needed short-acting inhaled beta-agonist therapy for chronic
      obstructive pulmonary disease.
AB  - Regular short-acting inhaled beta-agonist therapy is of uncertain benefit in
      patients with chronic obstructive pulmonary disease (COPD). We conducted a
      randomized, concealed, double-blind, placebo-controlled crossover trial in two
      periods, each of 3-mo duration, involving 53 patients with a smoking history of >
      20 pack-years, an FEV1 of < 70% predicted, and an FEV1/VC ratio of < 0.7 after
      inhalation of 200 microg albuterol. All patients received regular ipratropium
      bromide at 20 microg per puff in 2 puffs four times daily, beclomethasone at 250
      microg per puff or equivalent corticosteroid in 2 puffs twice daily, and open
      label inhaled albuterol as needed. Interventional therapy consisted of regular
      inhaled albuterol (100 microg per puff, in 2 puffs four times daily) versus
      placebo. Patients used twice as much active albuterol in the regular use period
      (mean: 8.07 puffs of coded and 4.68 puffs of open-label medication; total: 12.75
      puffs daily) than during the as-needed period (mean: 6.34 puffs of open-label
      albuterol daily). Despite greater beta-agonist use, patients showed similar
      results during treatment and control periods for all outcomes. Differences
      between active and placebo periods were: FEV1: -0.04 L (95% confidence interval
      [CI]: -0.09 to 0.01 L); slow vital capacity: 0.04 L (95% CI: -0.12 to 0.20 L); 6
      min walk test distance: -3.1 m (95% CI: -16.8 to 10.5 m); and Chronic Respiratory
      Questionnaire scores for dyspnea: 0.02 (95% CI: -0.13 to 0.16); fatigue: -0.02
      (95% CI: -0.25 to 0.20); mastery: 0.01 (95% CI: -0.20 to 0.24); and emotional
      function: 0.02 (95% CI: -0.20 to 0.24). We found that in patients with COPD, use
      of regular short-acting inhaled beta-agonists resulted in twice as much beta
      agonist use without physiologic or clinical benefit as did use on an as-needed
      basis.

PMID- 11208631
TI  - Static compliance of the respiratory system in healthy infants.
AB  - We recorded static deflation pressure-volume (PV) curves from near TLC to FRC in
      49 healthy, sedated, spontaneously breathing infants of 1 to 104 wk of age.
      Respiratory activity was transiently inhibited by inflating the respiratory
      system several times to a volume at an airway pressure of 30 cm H2O (V30).
      Passive deflation from V30 to FRC was then interrupted by multiple brief
      occlusions at the airway opening, in order to measure static recoil pressures.
      The expired volume from V30 to FRC was defined as V30E. Compliance of the
      respiratory system (Crs) was calculated as the slope of the linear portion of the
      PV curve from 5 to 15 cm H2O. Crs and V30E increased with increasing body length
      (p < 0.001). After adjustment for body length, males had greater Crs values than
      did females (p < 0.01). V30E was smaller in female infants (p < 0.05) and in
      infants whose mothers smoked during pregnancy (p < 0.04). Specific compliance
      (Crs/V30E) declined with increasing age (p < 0.01), but there were no differences
      related to sex or maternal smoking. We conclude that static deflation PV curves
      can be recorded in the age range from 1 to 104 wk, and that maternal smoking may
      produce hypoplastic lungs.

PMID- 11208632
TI  - Alteration of fatty acid profiles in different pulmonary surfactant phospholipids
      in acute respiratory distress syndrome and severe pneumonia.
AB  - Impairment of alveolar surfactant function has been documented in the acute
      respiratory distress syndrome (ARDS) and in severe pneumonia (PNEU); however, the
      underlying mechanisms are not completely understood. In the current report we
      present a detailed analysis of fatty acid (FA) profiles of different surfactant
      phospholipid (PL) classes isolated from bronchoalveolar lavage fluids (BALF) and
      large surfactant aggregates (LSA) from mechanically ventilated patients with ARDS
      (n = 8), ARDS associated with lung infection (ARDS + PNEU, n = 9), and PNEU (n =
      22). Healthy volunteers served as control subjects (n = 8). PLs were isolated by
      thin-layer chromatography, and the FA profile of each PL class was assessed by
      gas chromatography. In addition, the minimal surface tension (gamma min) of
      untreated LSA and of LSA after supplementation with additional dipalmitoylated
      phosphatidylcholine (DPPC) was analyzed (pulsating bubble surfactometer). As
      compared with control LSA, the percentage of palmitic acid in phosphatidylcholine
      (PC) was significantly decreased in all patient groups (ARDS 63.0 +/- 2.0%, ARDS
      + PNEU 64.6 +/- 4.9%, PNEU 65.6 +/- 1.5%, control subjects 80.1 +/- 1.7%),
      whereas the relative amount of unsaturated species in PC increased significantly
      in all groups. Phosphatidylglycerol (PG) and phosphatidylinositol (PI) presented
      similar FA profiles in control subjects, but differed in the patients. The FA
      pattern of sphingomyelin (SPH) and phosphatidylethanolamine (PE) displayed only
      minor changes under conditions of respiratory failure. As compared with control
      subjects a highly significant increase of gamma min from near zero to
      approximately 16 mN/m was observed in all patients and was found to be inversely
      correlated to the percentage of palmitic acid in PC of LSA or BALF. Accordingly,
      values for gamma min were significantly improved upon secondary supplementation
      of LSA with DPPC up to control values. We conclude that marked changes in the FA
      composition of the predominant surfactant PL classes occur, both in ARDS
      triggered by nonpulmonary events and PNEU. The marked reduction of palmitic acid
      in the PC fraction may be related to changes in surfactant function under these
      conditions.

PMID- 11208633
TI  - Effect of alpha4-integrin blockade on CD4+ cell-driven late airway responses in
      the rat.
AB  - The blockade of alpha4 integrins with a monoclonal antibody (TA-2) decreases late
      airway responses (LR) in ovalbumin (OVA)-sensitized and challenged rats. In this
      study, we used a model of CD4+ cell-driven LR to test the hypothesis that alpha4
      integrin blockade involves interference with T-cell activation in the inhibition
      of LR. Purified CD4+ cells from OVA-sensitized rats were transferred to
      unsensitized recipients, which received either TA-2 or a control antibody (cAb),
      and were OVA-challenged. A sham-challenged group was also studied. LR, calculated
      from pulmonary resistance after challenge, were reduced in the TA-2 group
      compared with the cAb group (p = 0.015). Total cell counts, macrophages,
      neutrophils, and lymphocytes in bronchoalveolar lavage (BAL), and CD3+ cells in
      airway sections, were unaffected. The cAb group had higher numbers of cells
      expressing interleukin-5 (IL-5) mRNA (55.2 +/- 3.39 cells/1,000, mean +/- SEM)
      and major basic protein (MBP) (6.2 +/- 0.4/100 cells) in bronchoalveolar lavage
      (BAL), than the TA-2 group (25.37 +/- 2.41 IL-5+ and 2.7 +/- 0.2 MBP+) and the
      sham group (12.37 +/- 0.96 IL-5+, 1.7 +/- 0.1 MBP+). Interferon gamma (IFN-gamma)
      mRNA+ cells were downregulated in both OVA-challenged groups, compared with the
      sham group. Our results suggest that the attenuation of LR and eosinophilia by
      alpha4-integrin blockade may involve interference with CD4+ cell activation and
      IL-5 expression.

PMID- 11208634
TI  - Improvement in aerosol delivery with helium-oxygen mixtures during mechanical
      ventilation.
AB  - In mechanically ventilated patients with airway obstruction, helium-oxygen (He
      O2) mixtures reduce airway resistance and improve ventilation, but their
      influence on aerosol delivery is unknown. Accordingly, we determined the effect
      of various He-O2 mixtures on albuterol delivery from metered-dose inhalers (MDIs)
      and jet nebulizers in an in vitro model of mechanical ventilation. Albuterol
      delivery from a MDI was increased when the ventilator circuit contained 80%
      helium and 20% oxygen (He-O2 80/20) versus O2: 46.7 +/- 3.3 versus 30.2 +/- 1.3
      (SE)% of the nominal dose (p < 0.001)-the difference was mainly due to decreased
      drug deposition in the spacer chamber, mean 39.2% and 55.2%, respectively (p <
      0.001). Nebulizer efficiency at a flow rate of 6 L/min was five times lower with
      He-O2 80/20 than O2, and the amount of nebulized drug was inversely correlated
      with gas density (r = 0.94, p < 0.0001). When the nebulizer was operated with O2,
      greater albuterol delivery was achieved when the ventilator circuit contained He
      O2 rather than O2. In summary, He-O2 mixtures in the circuit increased aerosol
      delivery for both MDIs and nebulizers in the mechanically ventilated model by as
      much as 50%. In conclusion, at appropriate flow rates and concentrations, He-O2
      in the ventilator circuit may improve aerosol delivery in mechanically ventilated
      patients with severe airway obstruction.

PMID- 11208635
TI  - Analysis of intracellular cytokines in CD4+ and CD8+ lung and blood T cells in
      sarcoidosis.
AB  - In pulmonary sarcoidosis, activated T cells accumulate in the lungs. We
      hypothesized that the balance between the T-helper type 1 (Th1) cytokines
      (interferon [IFN]-gamma and interleukin [IL]-2) and Th2 cytokines such as IL-4,
      IL-5, and IL-10 might explain differences in clinical outcome in pulmonary
      sarcoidosis, such as why patients of human leukocyte antigen (HLA) type DR17 have
      a much better prognosis than those of other HLA types. Peripheral blood
      lymphocytes (PBL) and lymphocytes obtained by bronchoalveolar lavage (BAL) from
      HLA-typed sarcoidosis patients, as well as PBL from healthy controls, were
      stimulated in vitro, fixed, and permeabilized with saponin. Thereafter, cells
      were stained with fluorescence- labeled antibodies specific for intracellular
      cytokines (IL-2, IL-4, IFN-gamma, and tumor necrosis factor (TNF)-alpha and cell
      surface markers CD4 and CD8, and were subjected to flow-cytometric analysis. In
      bronchoalveolar lavage fluid (BALF), there were significantly greater frequencies
      of T cells positive for IFN-gamma and TNF-alpha than there were among PBL, and
      significantly fewer cells positive for IL-4, in both the CD4+ and CD8+ subsets.
      HLA-DR17-positive patients showed a tendency toward a less pronounced Th1
      response that may be related to their good prognosis. Sarcoidosis patients had
      higher frequencies of cells positive for IFN-gamma, IL-4, and IL-2 in their blood
      than did healthy controls, a finding that may reflect the systemic nature of
      sarcoidosis. A clear Th1 cytokine profile of CD4+ as well as of CD8+ T cells was
      demonstrated in BALF from sarcoidosis patients. This was most pronounced for CD8+
      cells, which may therefore make an important contribution to the inflammatory
      process in the lungs in pulmonary sarcoidosis.

PMID- 11208636
TI  - Health status deterioration in patients with chronic obstructive pulmonary
      disease.
AB  - This study examined health status decline in patients with chronic obstructive
      pulmonary disease (COPD). Data are from the Inhaled Steroids in Obstructive Lung
      Disease (ISOLDE) trial. After an 8-wk run-in, 751 patients (566 male), mean age
      64 yr, were randomized to receive fluticasone propionate (FP) 500 microg twice
      daily (376 patients) or placebo (375 patients). Mean baseline postbronchodilator
      FEV1 was 50 +/- 15% predicted. Patients completed the St George's Respiratory
      Questionnaire (SGRQ) and the Short-Form 36 (SF-36) at baseline and every 6 mo for
      3 yr. FEV1 and smoking status were assessed at baseline and at 3-mo intervals. A
      total of 387 (212 FP) patients completed the trial. All SGRQ components (p = 0.03
      to 0.004) and Physical Function, Mental Health, Energy/ Vitality, and Physical
      Role Limitation scales of the SF-36 (p = 0.05 to 0.005) deteriorated faster in
      the placebo group. FEV1 and SGRQ scores correlated at baseline values (r = -0.25,
      p < 0.0001), as did change in FEV1 and change in SGRQ (Delta r = -0.24, p <
      0.0001). At baseline values smokers had worse SGRQ Total, Symptoms, and Impacts
      scores than ex-smokers. This difference was maintained throughout the study.
      Smoking status did not influence the rate of decline in health status. The SGRQ
      Total scores of FP-treated patients took 59% longer than placebo to deteriorate
      by a clinically significant amount. We conclude that health status decline in
      moderate to severe COPD can be reduced by high-dose fluticasone.

PMID- 11208637
TI  - Low-flow oxygen and bilevel ventilatory support: effects on ventilation during
      sleep in cystic fibrosis.
AB  - We measured ventilation in all sleep stages in patients with cystic fibrosis (CF)
      and moderate to severe lung disease, and compared the effects of low-flow oxygen
      (LFO2) and bilevel ventilatory support (BVS) on ventilation and gas exchange
      during sleep. Thirteen subjects, age 26 +/- 5.9 yr (mean +/- 1 SD), body mass
      index (BMI) 20 +/- 3 kg/m2, FEV1 32 +/- 11% predicted, underwent three sleep
      studies breathing, in random order, room air (RA), LFO2, and BVS +/- O2 with
      recording of oxyhemoglobin saturation (SpO2) (%) and transcutaneous carbon
      dioxide (TcCO2) (mm Hg). During RA and LFO2 studies, patients wore a nasal mask
      with a baseline continuous positive airway pressure (CPAP) of 4 to 5 cm H2O.
      Minute ventilation (V I) was measured using a pneumotachograph in the circuit and
      was not different between wake and non-rapid eye movement (NREM) sleep on any
      night. However, V I was reduced on the RA and LFO2 nights from awake to rapid eye
      movement (REM) (p < 0.01) and from NREM to REM (p < 0.01). On the BVS night there
      was no significant difference in V I between NREM and REM sleep. Both BVS and
      LFO2 improved nocturnal SpO2, especially during REM sleep (p < 0.05). The rise in
      TcCO2 seen with REM sleep with both RA and LFO2 was attenuated with BVS (p <
      0.05). We conclude that BVS leads to improvements in alveolar ventilation during
      sleep in this patient group.

PMID- 11208638
TI  - Meeting the needs of intensive care unit patient families: a multicenter study.
AB  - Intensive care unit (ICU) caregivers should seek to develop collaborative
      relationships with their patients' family members, based on an open exchange of
      information and aimed at helping family members cope with their distress and
      allowing them to speak for the patient if necessary. We conducted a prospective
      multicenter study of family member satisfaction evaluated using the Critical Care
      Family Needs Inventory. Forty-three French ICUs participated in the study. ICU
      characteristics, patient and family member demographics, and data on satisfaction
      were collected. Factors associated with satisfaction were identified using a
      Poisson regression model. A total of 637 patients were included in the study, and
      920 family members completed the questionnaire. Seven predictors of family
      satisfaction were found: one family-related factor, namely, family of French
      descent and six caregiver-related factors, namely, no perceived contradictions in
      information given by caregivers; information provided by a junior physician;
      patient to nurse ratio </= 3; knowledge of the specific role of each caregiver;
      help from the family's own doctor; and sufficient time spent giving information.
      Predictors of satisfaction are amenable to intervention and deserve to be
      investigated further with the goal of improving the satisfaction of ICU patients'
      family members.

PMID- 11208639
TI  - Increased airway responsiveness and decreased alveolar attachment points
      following in utero smoke exposure in the guinea pig.
AB  - Maternal smoking during pregnancy has been shown to result in abnormalities in
      lung function in newborn infants, including reduced expiratory flow and increased
      airway responsiveness to inhaled agonists. The mechanisms by which this occurs
      remain unclear. Using a guinea pig model of in utero smoke exposure, we measured
      airway responsiveness and lung morphology in a group of neonatal guinea pigs 21 d
      after delivery. Pregnant guinea pigs were exposed to cigarette smoke from Day 28
      to term (Day 68 of gestation). After delivery newborn animals did not receive any
      smoke exposure. Airway wall thickness, smooth muscle area, and the number of
      points where the alveoli attached to the airway adventitia were measured. Airway
      responsiveness was increased (p < 0.05) and the mean distance between alveolar
      attachment points was increased (mean 0.052 +/- SE 0.001 mm versus 0.046 +/-
      0.001, p = 0.001) in animals exposed to cigarette smoke in utero compared with
      nonexposed animals. Although not statistically significant, both the inner and
      outer airway wall and the smooth muscle area were greater in exposed animals
      compared with nonexposed animals. The increased mean distance between alveolar
      attachments in the smoke-exposed group was the result of a reduction in the
      number of attachments and an increase in the outer airway wall perimeter. These
      findings suggest that the increased airway responsiveness observed in postnatal
      animals, subsequent to in utero cigarette smoke exposure, may be the result of
      decreased alveolar attachment points to the airways and changes in airway
      dimensions.

PMID- 11208640
TI  - Nasal polyp-derived superoxide anion: dose-dependent inhibition by nitric oxide
      and pathophysiological implications.
AB  - The epithelium of the paranasal sinuses produces nitric oxide (NO), which
      probably plays a major role in the nonspecific defense of these cavities through
      its bacteriostatic and cilia motility stimulation properties. Abundant
      eosinophils of nasal polyps potentially generate superoxide anion (O2-*), but NO
      and O2-* inactivate reciprocally. The purpose of the present work was to evaluate
      the relationship between NO concentrations and nasal polyp production of O2-*.
      Polyp fragments from 24 patients were studied using histological examination and
      lucigenin-enhanced chemiluminescence (to assess O2-* production). The effect of
      various concentrations of exogenous NO on chemiluminescent signals was assessed.
      Basal and phorbol ester-stimulated O2-* production varied largely among patients,
      but both were highly related to eosinophilic infiltration. A slow releasing NO
      donor DETA NONOate (DETA/NO NOC-18) dose dependently inhibited lucigenin-enhanced
      chemiluminescence from phorbol ester-stimulated polyp fragments, with an EC50 of
      1.5 mM. The NO concentration in normal maxillary sinus was estimated about 10 ppm
      (i.e., 0.5 microM in aqueous phase) (Lundberg, et al. Nature Med 1995;1:370).
      Calculations revealed that the DETA NONOate 0.75 mM and 1.5 mM generate steady
      state concentrations of NO of 0.5 microM and 2.5 microM, respectively. In
      conclusion, the NO concentration present in paranasal sinuses appears to
      partially suppress (approximately 20-40%) O2-* production from polyp eosinophils.
      Conversely, phagocytic-derived O2-* could contribute to decrease sinus NO
      concentration, further altering this natural local defense. Together, these
      events could participate in chronic inflammation and contribute to the
      pathophysiology of nasal polyps.

PMID- 11208642
TI  - Surfactant protein A recruits neutrophils into the lungs of ventilated preterm
      lambs.
AB  - We tested the effects of surfactant protein A (SP-A) on inflammation and
      surfactant function in ventilated preterm lungs. Preterm lambs of 131 d gestation
      were ventilated for 15 min to initiate a mild inflammatory response, and were
      then treated with 100 mg/ kg recombinant human SP-C surfactant or with the same
      surfactant supplemented with 3 mg/kg ovine SP-A. Addition of SP-A to the SP-C
      surfactant did not change lung function. After 6 h of ventilation, cell numbers
      in the alveolar wash were 4.9 times higher in SP-A + SP-C-surfactant-treated
      animals. Cellular infiltrates consisted of neutrophils that produced less
      hydrogen peroxide than did cells from SP-C-surfactant-treated animals. Expression
      of adhesion molecules CD11b and CD44 was significantly greater after SP-A
      treatment, whereas the expression of CD14 was unchanged. Messenger RNAs (mRNAs)
      for the proinflammatory cytokines interleukin (IL)-1beta, IL-6, and IL-8, but not
      tumor necrosis factor-alpha, were increased in SP-A-treated lungs. Surfactant
      protein mRNAs and protein leakage into alveolar washes were not altered by SP-A,
      indicating that SP-A treatment produces no evidence of lung injury. The present
      study identifies an unanticipated role of SP-A in neutrophil recruitment in the
      lungs of preterm lambs.

PMID- 11208641
TI  - Transforming growth Factor-beta1 induces phenotypic modulation of human lung
      fibroblasts to myofibroblast through a c-Jun-NH2-terminal kinase-dependent
      pathway.
AB  - Myofibroblasts play an important role in the fibrogenic process of pulmonary
      fibrosis. Transforming growth factor (TGF)-beta is well known to induce the
      phenotypic modulation of fibroblasts to myofibroblasts; however, the
      intracellular signal regulating induction of the myofibroblastic phenotype of
      human lung fibroblasts (HLF) has not been determined. In the present study, we
      examined the role of the mitogen-activated protein kinase (MAPK) superfamily in
      inducing the phenotypic modulation of HLF to myofibroblasts characterized by
      alpha-smooth-muscle actin expression, in order to clarify this issue. The results
      showed that: (1) TGF-beta1 caused the phenotypic modulation of HLF to
      myofibroblasts in a dose- and a time-dependent manner; (2) TGF-beta1 induced
      increases in c-Jun-NH2- terminal kinase (JNK), p38 MAPK, and extracellular signal
      regulated kinase (Erk) phosphorylation and activity; (3) the inhibitors CEP-1347,
      SB 203580, and PD 98059 attenuated TGF-beta1-induced JNK, p38 MAPK, and Erk
      activity, respectively; and (4) CEP-1347, but not SB 203580 or PD 98059,
      attenuated the TGF-beta1-induced phenotypic modulation of HLF to myofibroblasts
      in a dose-dependent manner. These results indicate that TGF-beta1 is capable of
      inducing the myofibroblastic phenotype of HLF, and that JNK regulates the
      phenotypic modulation of TGF-beta1-stimulated HLF to myofibroblasts.

PMID- 11208643
TI  - Increased levels of nitrate and surfactant protein a nitration in the pulmonary
      edema fluid of patients with acute lung injury.
AB  - Levels of nitrite (NO2-) and nitrate (NO3-) were measured in pulmonary edema
      fluid and plasma from 34 patients with early acute lung injury (ALI) and 20
      patients with hydrostatic pulmonary edema. Pulmonary edema fluid from patients
      with ALI had significantly higher levels of NO2- + NO3- compared with pulmonary
      edema fluid from patients with hydrostatic pulmonary edema (108 +/- 13 microM
      versus 66 +/- 9 microM; means +/- SEM; p < 0.05). In addition, patients with
      shock had higher plasma NO2- + NO3- levels than those without shock (79 +/- 11
      microM versus 53 +/- 12 microM, p < 0.05). Acidemia and increased anion gap,
      markers of systemic hypoperfusion, were also associated with twofold higher
      plasma NO2- + NO3- levels (p < 0.01). Increased levels of NO2- + NO3- in edema
      fluid samples were associated with slower rates of alveolar fluid clearance.
      Nitrated pulmonary surfactant protein A (SP-A) was also detected in the edema
      fluid of patients with ALI after immunoprecipitation with a specific antibody
      against this protein. Previously, we have shown that nitration of SP-A impairs
      its host- defense properties. In aggregate, the results of this study indicate
      that reactive oxygen-nitrogen species may play a role in the pathogenesis of
      human ALI.

PMID- 11208644
TI  - Inhibition of phosphodiesterase 4 attenuates airway hyperresponsiveness and
      airway inflammation in a model of secondary allergen challenge.
AB  - We compared for the first time the therapeutic potential of a specific
      phosphodiesterase 4 (PDE4) inhibitor, rolipram, with anti-VLA-4 and anti-IL-5 in
      a model of secondary allergen exposure of previously sensitized and challenged
      mice. To address these issues, mice were sensitized and challenged with ovalbumin
      (OVA) (primary challenge). Six weeks later, sensitized/challenged mice were
      reexposed to OVA (secondary challenge) and airway response (resistance [RL] and
      dynamic compliance [Cdyn]) to inhaled methacholine was monitored. After secondary
      OVA challenge, RL significantly increased as did the number of lung inflammatory
      cells and IL-4 and IL-5 production in bronchoalveolar lavage fluid (BALF).
      Administration of rolipram, in a dose-dependent manner, significantly prevented
      both changes in RL and Cdyn, as well as eosinophil, lymphocyte, and neutrophil
      accumulation in the BALF; IL-4 and IL-5 levels in BALF were also significantly
      reduced. In contrast, treatment with anti-VLA-4 and anti-IL-5 only prevented
      changes in RL and eosinophil numbers and IL-5 production in BALF. Further, goblet
      cell hyperplasia was suppressed only by treatment with rolipram. None of the
      treatments affected OVA-specific antibody levels. These studies confirm that IL-5
      dependent eosinophilic inflammation plays an essential role in the development of
      certain aspects of airway function after rechallenge of sensitized mice and that
      lymphocytes and neutrophils are also important in the development of altered
      airway function. The use of agents that inhibit PDE4 may have an important role
      in the treatment of asthma in previously sensitized mice.

PMID- 11208645
TI  - Reduced epithelial expression of secretory component in small airways correlates
      with airflow obstruction in chronic obstructive pulmonary disease.
AB  - The epithelial polymeric immunoglobulin receptor/transmembrane secretory
      component (pIgR/SC) transports into secretions polymeric immunoglobulin A (pIgA),
      which is considered the first line of defense of the respiratory tract. The
      present study, done with quantitative immunohistochemistry, evaluated epithelial
      expression of secretory component (SC) and Clara cell protein (CC16) and
      neutrophil infiltration into the airways of eight patients with severe chronic
      obstructive pulmonary disease (COPD) who were undergoing lung transplantation, as
      compared with these processes in six nonsmoking patients with pulmonary
      hypertension who were used as controls and in lung specimens from five smokers
      without chronic bronchitis. Staining for SC was significantly decreased in the
      COPD patients as compared with the controls, both in large (mean optical density
      [MOD]: 23.4 [range: 21.1 to 27.8] versus 42.2 [range: 28.2 to 49.3], p = 0.003)
      and in small airways (MOD: 30.8 [range: 20.3 to 39.4] versus 41.5 [range: 39.2 to
      46.2], p = 0.003). SC expression in small airways correlated strongly with
      functional parameters such as FEV1 (Kendall's tau (K) = 0.76, p = 0.008), FVC (K
      = 0.64, p = 0.03), and midexpiratory flow at 50% of VC (MEF50) (K = 0.74, p =
      0.01). The reduced expression of SC in large airways correlated with neutrophil
      infiltration in submucosal glands (K = -0.47, p = 0.03). Expression of CC16 in
      the bronchial epithelium of COPD patients was also significantly decreased as
      compared with that of controls, especially in small airways (MOD: 28.3 [range:
      26.8 to 32.4] versus 45.8 [range: 40.7 to 56.0], p = 0.002), but no correlation
      was observed with lung function tests. In conclusion, this study shows that
      reduced expression of SC in airway epithelium is associated with airflow
      obstruction and neutrophil infiltration in severe COPD.

PMID- 11208646
TI  - Circulating endothelial cells in patients with septic shock.
AB  - The vascular endothelium has a central role in the control of microvascular tone,
      and it has been proposed that vascular endothelial damage occurs in septic shock,
      producing multiorgan failure. We have developed a method of detecting circulating
      endothelial cells (EC) that provides direct evidence of EC shedding in human
      sepsis. Human umbilical vein endothelial cells (HUVEC) were seeded in whole blood
      and recovered by isopycnic centrifugation to validate the technique. Blood
      samples were subsequently taken from 11 healthy volunteers, nine ventilated
      intensive care unit (ICU) control patients without sepsis, eight patients with
      sepsis but without shock, and 15 patients with septic shock. EC were identified
      by indirect immunofluorescence, using antibodies to von Willebrand factor (vWf)
      and the vascular endothelial growth factor receptor KDR. Mean HUVEC recovery was
      86% for 20 to 100 seeded cells/ml of blood. vWf-positive EC counts per milliliter
      were significantly higher (analysis of variance [ANOVA], p < 0.0001) in patients
      with sepsis (16.1 +/- 2.7 [mean +/- SEM]) and septic shock (30.1 +/- 3.3) than in
      healthy (1.9 +/- 0.5) or ICU controls (2.6 +/- 0.6). KDR-positive EC counts per
      milliliter were also significantly higher (ANOVA, p < 0.0001) in patients with
      sepsis (4.2 +/- 1.1/ml) and septic shock (10.4 +/- 1.2/ml) than in healthy (0.7
      +/- 0.3/ml) or ICU controls (0.5 +/- 0.2/ml). Cell counts made with anti-vWf
      antibody were consistently higher than those made with anti KDR antibody, but
      correlation between the two counts was high (r(2) = 0.93). The number of
      circulating KDR-positive EC was significantly higher in patients who died of
      septic shock than in survivors (12.0 +/- 1.6/ml versus 7.1 +/- 1.2/ml, p =
      0.026). An increase in circulating EC can be identified during sepsis and septic
      shock. This supports the hypothesis that endothelial damage occurs in human
      sepsis.

PMID- 11208647
TI  - The effect of repeated exposure to particulate air pollution (PM10) on the bone
      marrow.
AB  - Studies have shown that exposure to ambient particulate matter is related to an
      increased cardiopulmonary morbidity and mortality. The present study was designed
      to measure the effect of repeated exposure to urban air particles (PM10) on the
      rate of production and release of polymorphonuclear leukocytes (PMN) from the
      bone marrow into the peripheral blood. Rabbits exposed to PM10 (5 mg) twice a
      week for 3 wk, were given a bolus of 5'-bromo-2'-deoxyuridine (BrdU) to label
      dividing cells in the marrow that allows us to calculate the transit time of PMN
      in the bone marrow mitotic and postmitotic pools. The PM10 exposure (n = 8)
      causes a persistent increase in circulating band cells (p < 0.05) and a
      shortening of the transit time of PMN through the postmitotic pool in the marrow
      (64.4 +/- 2.2 h to 56.3 +/- 2.2 h, p < 0.05) if compared with vehicle-exposed
      control subjects (n = 6). PM10 exposure increases the bone marrow pool of PMN
      particularly the mitotic pool of PMN (p < 0.05). The PM10 were distributed
      diffusely in the lung and caused a mild mononuclear inflammation. The percentage
      of alveolar macrophages containing PM10 correlated significantly with the bone
      marrow PMN pool size (total pool r2 = 0.56, p < 0.012, mitotic pool r2 = 0.61, p
      < 0.007) and the transit time of PMN through the postmitotic pool (r2 = -0.42, p
      < 0.043). We conclude that repeated exposure to PM10 stimulates the bone marrow
      to increase the production of PMN in the marrow and accelerate the release of
      more immature PMN into the circulation. The magnitude of these changes was
      related to the amount of particles phagocytosed by alveolar macrophages.

PMID- 11208648
TI  - Contribution of small GTPase Rho and its target protein rock in a murine model of
      lung fibrosis.
AB  - Excess fibroblasts and inflammatory cells may play an important role in the
      pathogenesis of idiopathic pulmonary fibrosis (IPF). The small GTPase, Rho, and
      its target protein, Rho-associated coiled-coil-forming protein kinase (ROCK),
      have been recognized to be major regulators of cell locomotion mediated by
      reorganization of the actin cytoskelton. Activated ROCK inhibits myosin
      phosphatase, and this in turn induces phosphorylation of the myosin light chain
      (MLC). To determine the mechanisms underlying the deterioration process of IPF,
      we investigated the effect of Y-27632, a selective ROCK inhibitor, in a murine
      model of bleomycin (BLM)-induced lung fibrosis. The Aschcroft score and
      hydroxyproline content of the BLM-treated mouse lung decreased in response to Y
      27632 treatment. The number of broncoalveolar cells was decreased by Y-27632, and
      migration of macrophages, neutrophils, and fibroblasts in vitro was inhibited by
      Y-27632 regardless of various stimuli. Although expression of ROCK-II mRNA in the
      lung homogenates of the BLM-treated mice was increased approximately 9-fold,
      expression of ROCK-II protein showed only a slight tendency to increase. BLM
      elevated MLC phosphorylation levels, and Y-27632 inhibited BLM response. These
      findings indicate that the Rho/ROCK-mediated pathway plays an important role in
      IPF, and that blocking of this pathway leads to inhibition of IPF development.

PMID- 11208649
TI  - Caspase inhibition prevents cardiac dysfunction and heart apoptosis in a rat
      model of sepsis.
AB  - Despite intensive therapy, severe septic shock is commonly associated with
      myocardial dysfunction and death in humans. No new therapies have proven
      efficiency against cardiovascular alterations in sepsis. Here, we addressed the
      question of a beneficial effect of pharmacological inhibition of caspases on
      myocardial dysfunction following endotoxin treatment. Hearts from rats treated
      with endotoxin (10 mg/kg, intravenously) were isolated 4 h posttreatment for
      analysis. Assessment of myocardial contractility ex vivo and detection of
      apoptosis were performed. Hearts from endotoxin-treated rats displayed multiple
      caspase activities and also typical apoptosis pattern as detected by TUNEL, DNA
      fragmentation assays, and cytochrome c release as compared with control rats. z
      VAD.fmk (3 mg/kg, intravenously), a broad spectrum caspase inhibitor (but not the
      irrelevant peptide z-FA.fmk), in coinjection with endotoxin, not only reduced
      caspase activities and nuclear apoptosis but also completely prevented endotoxin
      induced myocardial dysfunction evaluated 4 h and even 14 h after endotoxin
      challenge. These data indicate that caspase activation plays an important role in
      myocardial cell dysfunction. Moreover, these results suggest that inhibitors of
      caspases may have important therapeutic applications in sepsis.

PMID- 11208650
TI  - Expression of the cysteinyl leukotriene 1 receptor in normal human lung and
      peripheral blood leukocytes.
AB  - The cysteinyl leukotrienes (CysLTs) are important mediators of human asthma.
      Pharmacologic and clinical studies show that the CysLTs exert most of their
      bronchoconstrictive and proinflammatory effects through activation of a putative,
      7-transmembrane domain, G-protein-coupled receptor, the CysLT1 receptor. The
      initial molecular characterization of the CysLT1 receptor showed by in situ
      hybridization, the presence of CysLT1 receptor messenger RNA (mRNA) in human lung
      smooth-muscle cells and lung macrophages. We confirmed the results of these in
      situ hybridization analyses for the CysLT1 receptor, and produced the first
      immunohistochemical characterization of the CysLT1 receptor protein in human
      lung. The identification of the CysLT1 receptor in the lung is consistent with
      the antibronchoconstrictive and antiinflammatory actions of CysLT1 receptor
      antagonists. We also report the expression of CysLT1 receptor mRNA and protein in
      most peripheral blood eosinophils and pregranulocytic CD34+ cells, and in subsets
      of monocytes and B lymphocytes.

PMID- 11208651
TI  - Septic shock and acute lung injury in rabbits with peritonitis: failure of the
      neutrophil response to localized infection.
AB  - The major goal of this study was to investigate the mechanisms that link the host
      response to a local infection in the peritoneal cavity with the development of
      sepsis and lung injury. Rabbits were infected by intraperitoneal inoculation of
      fibrin clots containing Escherichia coli at 10(8), 10(9), or 10(10) cfu/clot.
      Physiologic, bacteriologic, and inflammatory responses were monitored, and the
      lungs were examined postmortem. At a dose of 10(8) cfu/clot the animals had
      resolving infection, and a dose of 10(9) cfu/clot resulted in persistent
      infection at 24 h, with minimal systemic manifestations. In contrast, inoculation
      of 10(10) cfu/clot resulted in rapidly lethal local infection, with septic shock
      and lung injury. The onset of septic shock was associated with a paradoxical lack
      of identifiable polymorphonuclear leukocytes (PMN; neutrophils) in the peritoneal
      cavity. The absence of PMN in the peritoneum was due in part to lysis of
      intraperitoneal PMN, because the peritoneal fluids contained free myeloperoxidase
      and induced rapid death of normal rabbit PMN in vitro. Although most animals
      became bacteremic, only those with a severe systemic inflammation response
      developed lung injury. These data show that control of an infection in the first
      compartment in which bacteria enter the host is a critical determinant of the
      systemic response. Above a threshold dose of bacteria, failure of the local
      neutrophil response is a key mechanism associated with deleterious systemic
      responses. Bacteremia alone is not sufficient to cause lung injury. Lung injury
      occurs only in the setting of a severe systemic inflammatory response and an
      inadequate leukocyte response at the primary site of infection.

PMID- 11208652
TI  - Tumor necrosis factor receptor deficiency alters matrix metalloproteinase
      13/tissue inhibitor of metalloproteinase 1 expression in murine silicosis.
AB  - Murine exposure to silica is associated with enhanced tumor necrosis factor alpha
      (TNF-alpha) expression and matrix deposition. The regulation of TNF is mediated
      through TNF receptor (TNFR) activation of transcription factors. In the present
      work we have studied the importance of the individual TNFR in silica-induced lung
      inflammation and matrix deposition in mice. We studied RNA expression of TNF,
      alpha1(I) collagen, interstitial collagenase (MMP-13), and its inhibitor (TIMP-1)
      in the lungs of silica-treated mice. Furthermore, we correlated MMP-13/TIMP-1 RNA
      abundance with activation of the transcription factors AP-1 and NF-kappaB in the
      lungs of C57BL/6 mice, and of mice deficient in one of the two types of TNFR
      (p55(-/-) or p75(-/-)), exposed to silica (0.2 g/kg) or saline by intratracheal
      instillation. Animals were killed 28 d after exposure and lung hydroxyproline
      (HP), TNF, alpha1(I) collagen, MMP-13, and TIMP-1 RNA abundance was measured. AP
      1 and NF-kappaB activation was studied by gel-shift assays. Compared with C57BL/6
      mice, p55(-/-) and p75(-/-) mice significantly (*p < 0.05) decreased lung HP
      accumulation in response to silica. All murine strains enhanced TNF and alpha1(I)
      collagen mRNA in response to silica. Enhanced (p < 0.05) MMP-13 RNA expression
      was also observed in all murine strains in response to silica. Enhanced (p <
      0.05) TIMP-1 RNA expression was observed in C57BL/6 mice, but not in p55(-/-) or
      p75(-/-) mice, in response to silica. NF-kappaB activation was observed in all
      murine strains, whereas AP-1 activation was observed only in C57BL/6 mice after
      silica treatment. These data suggest that TNFR deletion modifies MMP-13/ TIMP-1
      expression in favor of matrix degradation.

PMID- 11208653
TI  - The spectrum of mutations in TSC1 and TSC2 in women with tuberous sclerosis and
      lymphangiomyomatosis.
AB  - Lymphangiomyomatosis (LAM) is a progressive and often fatal interstitial lung
      disease characterized by a diffuse proliferation of abnormal smooth muscle cells
      in the lungs. LAM is of unusual interest biologically because it affects almost
      exclusively young women. LAM can occur as an isolated disorder (sporadic LAM) or
      in association with tuberous sclerosis complex (TSC). Because only a minority of
      women with TSC develops symptomatic LAM, we hypothesized that a relationship
      might exist between the type of germline TSC1 or TSC2 gene mutation and the risk
      of developing LAM. We examined all 41 exons of the TSC2 gene and 21 coding exons
      of the TSC1 gene for mutations in a group of 14 women with both TSC and LAM using
      single-strand conformation polymorphism analysis. Seven mutations were found in
      TSC2 and one in TSC1. Of the seven patients with TSC2 mutations, two had the same
      in-frame exon 40 deletion and one had an exon 41 missense change. We conclude
      that germline mutations in the extreme carboxy-terminus of tuberin can result in
      LAM. Further studies will be required to determine whether mutations in exons 40
      and 41 are associated with an increased incidence and/or severity of LAM in women
      with TSC.

PMID- 11208654
TI  - Elevated levels of interleukin-8 in donor lungs is associated with early graft
      failure after lung transplantation.
AB  - Increased levels of the neutrophil chemokine interleukin (IL)-8 in the lungs of
      severe trauma patients can predict subsequent development of acute respiratory
      distress syndrome. Because the lungs of brain-dead organ donors can contain high
      levels of IL-8, we hypothesized that this may predispose to early graft failure
      in the recipient after lung transplantation. Twenty-six organ donors
      prospectively satisfying clinical criteria for lung donation underwent
      bronchoalveolar lavage and lung biopsy to determine the effect of neutrophil
      infiltration and IL-8 expression in the donor lung on graft function and survival
      in 26 respective recipients after lung transplantation. Nine recipients developed
      severe graft dysfunction, of whom six subsequently died (median survival: 24 d
      [range: 5 to 39 d]); all others survived beyond 6 mo. The IL-8 signal in the
      donor lung correlated with the percent neutrophils in bronchoalveolar lavage
      fluid (BALF) before implantation (42.4 +/- 7.24 [mean +/- SE]%, p = 0.03) and
      with the degree of impairment in graft oxygenation after implantation (p = 0.01).
      An increased level of IL-8 in the donor BALF was associated with the development
      of severe early graft dysfunction (p = 0.027) and with early recipient mortality
      (p = 0.0034). Use of donor lungs with high IL-8 levels is associated with a poor
      prognosis after lung transplantation. Attenuating the donor's inflammatory
      response before organ retrieval may improve early outcome after lung
      transplantation, and help maximize lung use from the existing donor pool.

PMID- 11208655
TI  - Leukotriene D4-induced activation of smooth-muscle cells from human bronchi is
      partly Ca2+-independent.
AB  - Cysteine-containing leukotrienes (cysteinyl-LTs) are potent bronchoconstrictors
      and play a key role in asthma. We found that histamine and LTD4 markedly
      constrict strips of human bronchi (HB) with similar efficacy. However, in human
      airway smooth-muscle (HASM) cells, LTD4, at variance with histamine, elicited
      only a small, transient change in intracellular calcium ion concentration. HASM
      cells express both Ca2+-dependent and -independent isoforms of protein kinase C
      (PKC) (i.e., PKC-alpha and PKC-alpha ). Western blot analysis showed that PKC
      alpha is activated by histamine and, to a lesser extent, by LTD4, whereas only
      LTD4 translocates PKC-alpha. This translocation was specifically inhibited by the
      LTD4 antagonist pobilukast. Phorbol-dibutyrate ester (PDBu) (a PKC activator)
      contracted HB strips to the same extent in the presence as in the absence of
      extra- and intracellular Ca2+. In the absence of Ca2+, LTD4 contracted HB strips
      to the same extent as did PDBu, suggesting the involvement of a Ca2+-independent
      PKC in LTD4-mediated signal transduction. PDBu-induced desensitization and the
      PKC inhibitor H7 abolished the slow and sustained LTD4-triggered contraction of
      HB strips in the absence of Ca2+, although H7 did not greatly affect the response
      in the presence of the ion. Thus, in human airways, we identified a novel LTD4
      transduction mechanism linked to bronchial smooth-muscle contraction, which is
      partly independent of Ca2+ and involves the activation of PKC-alpha.

PMID- 11208656
TI  - Expression of alpha-, beta-, and gamma-hENaC mRNA in the human nasal, bronchial,
      and distal lung epithelium.
AB  - The amount of fluid covering the epithelium of the airways and alveolar space is
      modulated by active transport of Na+ from the lumen through the apical membrane
      Na+ permeant ion channels towards the interstitial space. We have measured the
      subunit expression of the amiloride-sensitive human Na+ channel (hENaC) by
      concomitant assessment of alpha-, beta-, and gamma-hENaC mRNA in the nasal,
      bronchial, and peripheral lung epithelia of adult patients undergoing lobectomy
      secondary to lung cancer. The study employed quantitative competitive reverse
      transcriptase-polymerase chain reaction and qualitative in situ hybridization
      techniques. The hENaC mRNA content of each sample was normalized to the amount of
      epithelial cell-specific cytokeratin 18 (CK18) mRNA. Nasal epithelium contained
      significantly more (p < 0.05) alpha-hENaC mRNA (18 +/- 5 SD amol/fmol CK18), than
      bronchus (8 +/- 2 SD amol/fmol) and peripheral lung (9 +/- 2 SD amol/fmol). The
      ratio of gamma-hENaC/alpha-hENaC mRNA concentration was lowest in the nasal area,
      and it increased significantly towards the distal lung regions. The change in
      beta-hENaC mRNA was less profound. In situ hybridization studies of bronchial and
      peripheral lung sections selectively revealed expression of alpha-hENaC mRNA in
      superficial epithelium and submucosal glands of large airways, in bronchiolar
      epithelium, and in alveolar cells. We conclude that the relative expression of
      the hENaC subunit genes changes from the proximal to distal regions of the human
      respiratory tract.

PMID- 11208657
TI  - Margarine consumption and allergy in children.
AB  - Dietary fat consumption is hypothesized to influence atopy development by
      modulation of IgE production. The aim of our study was to assess whether
      margarine consumption is associated with allergic sensitization and diseases in
      children. Data of a cross-sectional health survey in 1998-1999 comprising 2,348
      children age 5 to 14 yr were analyzed. Information on type of fat used as spread
      during the past 12 mo, children's health, and sociodemographic factors were
      gathered by questionnaire. Allergic sensitization to common aeroallergens was
      assessed by specific serum IgE. Compared with butter consumption, margarine
      consumption was associated with allergic sensitization (adjusted odds ratio 1.30
      [95% confidence interval: 1.01 to 1.67]) and with rhinitis symptoms during the
      past 12 mo (1.41 [1.01 to 1.97]). Sex-stratified analysis showed that these
      associations were limited to boys (boys: sensitization 1.57 [1.12 to 2.20],
      rhinitis symptoms 1.76 [1.12 to 2.78]; girls: sensitization 0.99 [0.67 to 1.46],
      rhinitis symptoms 1.03 [0.63 to 1.70]). No statistically significant relation was
      observed between exclusive margarine consumption and ever physician-diagnosed hay
      fever or asthma in all children. In conclusion, the sex difference in the
      association of margarine consumption with allergic sensitization was in
      accordance with the higher IgE concentrations and atopy prevalence in boys
      compared with girls. Increased intake of certain polyunsaturated fatty acids
      might further stimulate IgE production in boys.

PMID- 11208658
TI  - Pathology of the surfactant system of the mature lung: second San Diego
      conference.
AB  - Knowledge of the surfactant system has grown immensely in the past decade. A
      variety of investigative strategies, including manipulation of surfactant protein
      gene expression in mice, has contributed dramatically to our understanding of the
      role of surfactant components in lung function. These approaches have fostered
      investigations that will further our knowledge of the role of lung surfactant in
      host defense and will provide information that should lead to improved strategies
      for the treatment of lung disease.

PMID- 11208659
TI  - International Consensus Conferences in Intensive Care Medicine: noninvasive
      positive pressure ventilation in acute Respiratory failure.

PMID- 11208660
TI  - Erratum: cyclophosphamide in paraquat poisoning.

PMID- 11208661
TI  - ATS guidelines for methacholine and exercise challenge testing.

PMID- 11208663
TI  - Cheung et al. Respond to "Are Appearances Deceiving?"

PMID- 11208662
TI  - Endogenous airway acidification: implications for asthma pathology.

PMID- 11208664
TI  - The effects of aging on layer 1 of primary visual cortex in the rhesus monkey.
AB  - The effect of age on layer 1 in primary visual cortex was determined in 19 rhesus
      monkeys of various ages. Twelve of the monkeys had been behaviorally tested. With
      age layer 1 becomes thinner and the glial limiting membrane becomes thicker. In
      the neuropil of layer 1 many of the dendrites in old monkeys appear to be
      degenerating and, as a consequence, electron micrographs from old monkeys display
      fewer dendritic and spine profiles per unit area than in young monkeys. As
      determined using both the disector and size-frequency methods, there is also a
      concomitant decrease in the numerical density of synapses with age. Although
      there is a significant correlation between the thinning of layer 1 in area 17 and
      age, there is no significant correlation between either the thinning of layer 1
      or its loss of synapses and any of the behavioral measures of memory function
      obtained from the 12 behaviorally tested monkeys. Similar morphological changes
      with age occur in layer 1 of prefrontal cortex of these same monkeys, but in area
      46 both the thinning of layer 1 and the loss of synapses show a significant
      correlation with behavioral measures of memory function. These differences
      between layer 1 in these two cortical areas presumably relate to the fact that
      prefrontal cortex has a greater role in subserving cognition than does primary
      visual cortex.

PMID- 11208665
TI  - Patterns of GABA(B)R1a,b receptor gene expression in monkey and human visual
      cortex.
AB  - In situ hybridization histochemistry and immunocytochemistry were used to examine
      GABA(B)R1a,b receptor mRNA and protein expression in areas 17 and 18 of the
      visual cortex of normal macaque monkeys and of monkeys that had been deprived of
      vision in one eye. In addition, the normal patterns of GABA(B)R1a,b protein
      expression were immunocytochemically studied in the human visual cortex. Overall
      levels of GABA(B)R1a,b transcript were higher in area 17 than in area 18. In area
      17 GABA(B)R1a,b mRNA levels were highest in layers IVC and VI, moderate in layers
      II-IVA and low in layers I, IVB and V. In area 18 GABA(B)R1a,b transcript
      expression was high in layers II and III, moderate in layers IV and VI and low in
      layers I and V. Immunocytochemistry revealed nearly identical patterns of
      GABA(B)R1a,b protein expression in areas 17 and 18 in monkey and human. Both
      pyramidal and non-pyramidal neurons were GABA(B)R1a,b immunoreactive. The
      majority of intensely immunoreactive neurons in layers II, III, V and VI were
      pyramidal cells. Numerous non-pyramidal cells were intensely immunoreactive in
      layer IV of area 17 but layer IV cells were only lightly immunoreactive in area
      18. Following 10 day periods of monocular deprivation, induced by intravitreal
      injections of tetrodotoxin, levels of GABA(B)R1a,b mRNA and protein were
      decreased in the deprived eye dominance columns of layers IVC and VI.

PMID- 11208666
TI  - The role of the inferior parietal cortex in linking the tactile perception and
      manual construction of object shapes.
AB  - We employed functional magnetic resonance imaging (fMRI) in 12 healthy subjects
      to measure cerebral activation related to a set of higher order manual
      sensorimotor tasks performed in the absence of visual guidance. Purposeless
      manipulation of meaningless plasticine lumps served as a reference against which
      we contrasted two tasks where manual manipulation served a meaningful purpose,
      either the perception and recognition of three-dimensional shapes or the
      construction of such shapes out of an amorphous plasticine lump. These tasks were
      compared with the corresponding mental imagery of the modelling process which
      evokes the constructive concept but lacks concomitant sensorimotor input and
      output. Neural overlap was found in a bilateral activity increase in the
      posterior and anterior intraparietal sulcus area (IPS and AIP). Differential
      activation was seen in the supplementary and cingulate motor areas, the left M1
      and the superior parietal lobe for modelling and in the left angular and ventral
      premotor cortex for imagery. Our data thus point to a congruent neural substrate
      for both perceptive and constructive object-oriented sensorimotor cognition in
      the AIP and posterior IPS. The leftward asymmetry of the inferior parietal
      activations, including the angular gyrus, during imagery of modelling along with
      the ventral premotor activations emphasize the close vicinity of the circuitry
      for cognitive manipulative motor behaviour and language.

PMID- 11208667
TI  - Development of cytochrome oxidase blobs in visual cortex of normal and visually
      deprived cats.
AB  - Cytochrome oxidase (CO) blobs are central to our understanding of the columnar
      organization and parallel pathways in primate and cat visual cortex. In primates,
      development of blobs and their relationship with other columnar features of the
      visual cortex begins pre-natally, before visual experience. In kittens, the
      supragranular layers differentiate post-natally, after eye opening, raising the
      possibility that visual experience may influence the development of blobs in cat
      V1. We have examined the development of blobs in unfolded and flattened sections
      through the visual cortex of normally reared, dark-reared, monocularly deprived
      and binocularly deprived kittens. Blobs were found in superficial layers of V1 of
      normally reared kittens as early as 2 weeks of age, although at this age the
      overall CO staining in V1 was lighter than in V2. By 6 weeks of age the blobs
      were adult-like. A patchy pattern of CO staining was also found in V2 of young
      kittens but not in adults. Visual experience was not necessary for expression of
      the blobs and monocularly deprived kittens had well developed blobs, indicating
      that strong Y cell drive is not necessary for the development of blobs in cat V1.
      CO blobs appear in kitten V1 very early in post-natal development and their
      expression is independent of visual experience, suggesting that they may be an
      intrinsic feature of V1 organization.

PMID- 11208668
TI  - Reduced GAP-43 mRNA in dorsolateral prefrontal cortex of patients with
      schizophrenia.
AB  - Schizophrenia has been associated with anatomical and functional abnormalities of
      the dorsolateral prefrontal cortex (DLPFC), which may reflect abnormal
      connections of DLPFC neurons. We measured mRNA levels of growth-associated
      protein (GAP-43), a peptide linked to the modifiability of neuronal connections,
      in post-mortem brain tissue from two cohorts of patients with schizophrenia and
      controls. Using the RNase protection assay (RPA), we found a significant
      reduction in GAP-43 mRNA in the DLPFC, but not in the hippocampus, of patients
      with schizophrenia. With in situ hybridization histo- chemistry (ISHH), performed
      on a separate cohort, we confirmed the reduction of GAP-43 mRNA in the DLPFC of
      patients with schizophrenia. We detected reduced GAP-43 mRNA per neuron in layers
      III, V and VI of patients with schizophrenia compared with normal controls and
      patients with bipolar disorder. Thus, glutamate neurons in DLPFC of schizophrenic
      patients may synthesize less GAP-43, which could reflect fewer and/or less
      modifiable connections than those in normal human brain, and which may be
      consistent with the deficits of prefrontal cortical function that characterize
      schizophrenia.

PMID- 11208669
TI  - Anatomical risk factors for phonological dyslexia.
AB  - Successful behavioral genetic studies require precise definition of a homogenous
      phenotype. This study searched for anatomical markers that might restrict
      variability in the reading disability phenotype. The subjects were 15 college
      students (8 male/7 female) diagnosed with a reading disability (RD) and 15
      controls (8 males/7 females). All subjects completed a cognitive and reading
      battery. Only 11 of the RD subjects had a phonological deficit [phonological
      dyslexia (PD): pseudo word decoding scores < 90 (27th percentile)]. Thirteen RD
      (9 PD) and 15 controls received a volumetric MRI scan. Four anatomical measures
      differentiated the PD group from the remainder of the subjects: (i) marked
      rightward cerebral asymmetry, (ii) marked leftward asymmetry of the anterior lobe
      of the cerebellum, (ii) combined leftward asymmetry of the planum and posterior
      ascending ramus of the sylvian fissure, and (iv) a large duplication of Heschl's
      gyrus on the left. When these four measures were normalized and summed, the
      resulting variable predicted short- and long-term phonological memory. By
      contrast, oral and written comprehension skills were predicted by a different
      anatomical variable: low cerebral volume. These findings provide neurobiological
      support for an RD phenotype characterized by phonological deficits in the
      presence of normal or superior comprehension. The study of individual variation
      in cortical structure may provide a useful link between genotype and behavior.

PMID- 11208670
TI  - Nicotinic receptors mediate the release of amino acid neurotransmitters in
      cultured cortical neurons.
AB  - Nicotine stimulation of cortical neurons obtained from gestation day 19 rats
      provoked a dose-dependent release of aspartate, glutamate, glycine and GABA,
      indicating a functional role for the nicotinic receptor in this model. This
      release was exclusively Ca2+-dependent (vesicular release) in the case of
      aspartate and dual Ca2+-dependent and Ca2+-independent) for glutamate, glycine
      and GABA. Nicotine also raised the membrane potential and the intracellular
      calcium concentration. These effects were specific, since they were reversed by
      hexamethonium, an antagonist of the nicotinic receptor. It was shown that L, N,
      and P/Q type Ca2+ channels are involved in nicotine-mediated Ca2+ entry into
      cortical neurons. Evaluation of the effects of nicotine on Ca2+ entry in isolated
      cells showed that 100% of the cells responded to nicotine, although the intensity
      of the response was variable: 63% of the neurons showed an increase in
      intracellular Ca(2+) of 152 +/- 5 grey levels, 25% of 88 +/- 12 grey levels and
      12% of 48 +/- 1 grey levels. Tetrodotoxin, which blocks voltage-dependent Na(+)
      channels, completely reversed nicotine-induced Ca2+ entry into single cells. This
      suggests that the Ca2+ increment is mediated by opening of Ca2+ channels and not
      by the nicotinic receptor.

PMID- 11208671
TI  - Integration of multiple-whisker inputs in rat somatosensory cortex.
AB  - Rats explore their surroundings through rhythmic movement of their mystacial
      vibrissae. At any given moment, multiple whiskers are simultaneously moved and
      may contact the surface of an object. The aim of this work is to understand how
      simultaneous multiple-whisker deflections are processed in the somatosensory
      cortex. Arrays of 25 electrodes were inserted into the vibrissal representation
      of barrel cortex of adult rats. Multi-unit responses were recorded during (i)
      stimulation of single whiskers, and (ii) simultaneous stimulation of two, three
      or four whiskers of a whisker arc or whisker row. The whole-array response
      elicited by the simultaneous stimulation of multiple-whiskers (observed response)
      was compared to a multiple-whisker response predictor, defined as the sum of the
      whole-array responses to the separate stimulation of the corresponding single
      whiskers. The observed response to stimulation of four whiskers was nearly always
      less than the predicted response, indicating a sublinear summation of multiple
      coincident inputs. Examining the poststimulus time course of sublinearity, we
      found that the earliest cortical response to whisker deflection - reflecting the
      thalamocortical volley - was linear, whereas the successive cortical response was
      highly sublinear. This suggests a cortical origin of the phenomenon.

PMID- 11208672
TI  - Plasticity of excitation and inhibition in the receptive field of primary
      auditory cortical neurons after limited receptor organ damage.
AB  - Permanent receptor organ damage can cause plasticity of topographic cortical maps
      of that receptor surface while temporary receptor organ damage, and conditions
      mimicking such damage, can unmask new excitatory inputs in central sensory
      neurons receiving input from that receptor surface. Cortical plasticity is
      associated with an anatomically or pharmacologically defined decrease in
      inhibition in cortex. It is therefore widely proposed that a reduction incentral
      inhibition underlies cortical neural plasticity. Here I demonstrate that small
      receptor organ damage results, in primary auditory cortical (A1) neurons, in loss
      of one component of functionally defined afferent inhibition but unmasking of
      another component of afferent inhibition along with new excitatory responses.
      Overall, there did not appear to be any change in the strength of afferent
      inhibition or in the strength of excitation. Thus, auditory receptor organ damage
      can unmask new excitatory inputs as well as inhibitory inputs from within the
      receptive field of the neurons.

PMID- 11208673
TI  - Role of variability in microvascular resistance on fractional flow reserve and
      coronary blood flow velocity reserve in intermediate coronary lesions.
AB  - BACKGROUND: Fractional flow reserve (FFR) and coronary blood flow velocity
      reserve (CFR) represent physiological quantities used to evaluate coronary lesion
      severity and to make clinical decisions. A comparison between the outcomes of
      both diagnostic techniques has not been performed in a large cohort of patients
      with intermediate coronary lesions. METHODS AND RESULTS: FFR and CFR were
      assessed in 126 consecutive patients with 150 intermediate coronary lesions
      (between 40% and 70% diameter stenosis by visual assessment). Agreement between
      outcomes of FFR and CFR, categorized at cut-off values of 0.75 and 2.0,
      respectively, was observed in 109 coronary lesions (73%), whereas discordant
      outcomes were present in 41 lesions (27%). In 26 of these 41 lesions, FFR was
      <0.75 and CFR>or=2.0 (group A); in the remaining 15 lesions, FFR was >or=0.75 and
      CFR<2.0 (group B). Minimum microvascular resistance, defined as the ratio of mean
      distal pressure to average peak blood flow velocity during maximum hyperemia,
      showed a large variability (overall range, 0.65 to 4.64 mm Hg x cm(-1) x s(-1))
      and was significantly higher in group B than in group A (2.42+/-0.77 versus
      1.91+/-0.70 mm Hg x cm(-1) x s(-1); P:=0.034). CONCLUSIONS: Our findings
      demonstrate the prominent role of microvascular resistance in modulating the
      relationship between FFR and CFR and emphasize the importance of combined
      pressure and flow velocity measurements to evaluate coronary lesion severity and
      microvascular involvement.

PMID- 11208674
TI  - Serial intravascular ultrasound analysis of the impact of lesion length on the
      efficacy of intracoronary gamma-irradiation for preventing recurrent in-stent
      restenosis.
AB  - BACKGROUND: The relation between lesion length and effectiveness of brachytherapy
      is not well studied. METHODS AND RESULTS: We compared serial (postintervention
      and follow-up) intravascular ultrasound findings in 66 patients with native
      coronary artery in-stent restenosis (ISR) who were treated with (192)Ir (15 Gy
      delivered 2 mm away from the radiation source). Patients were enrolled in the
      Washington Radiation for In-Stent Restenosis Trial (WRIST; ISR length, 10 to 47
      mm; n=36) or Long WRIST (ISR length, 36 to 80 mm; n=30). External elastic
      membrane, stent, lumen, and intimal hyperplasia (IH; stent minus lumen) areas and
      source-to-target (intravascular ultrasound catheter to external elastic membrane)
      distances were measured. Postintervention stent areas were larger in WRIST and
      smaller in Long WRIST patients (P:<0.0001). At follow-up, maximum IH area
      significantly increased in both WRIST and Long WRIST patients (P:<0.0001 for
      both), but this increase was greater in Long WRIST patients (P:=0.0006).
      Similarly, minimum lumen cross-sectional area significantly decreased in both
      WRIST and Long WRIST patients (P:<0.05 and P:<0.0001, respectively), but this
      decrease was more pronounced in Long WRIST patients (P:=0.0567). The maximum
      source-to-target distance was longer in Long WRIST than in WRIST, and it
      correlated directly with ISR length (r=0.547, P:<0.0001). Overall, the change in
      minimum lumen area and the change in maximum IH area correlated with the maximum
      source-to-target distance (r=0.352, P:=0.0038 and r=0.523, P:<0.0001 for WRIST
      and Long WRIST, respectively). The variability (maximum/minimum) in IH area at
      follow-up also correlated with the maximum source-to-target distance (r=0.378,
      P:<0.0001). CONCLUSIONS: Brachytherapy may be less effective in longer ISR
      lesions because of the greater variability and longer source-to-target distances
      in diffuse ISR.

PMID- 11208675
TI  - Lack of neointimal proliferation after implantation of sirolimus-coated stents in
      human coronary arteries: a quantitative coronary angiography and three
      dimensional intravascular ultrasound study.
AB  - BACKGROUND: Restenosis remains an important limitation of interventional
      cardiology. Therefore, we aimed to determine the safety and efficacy of sirolimus
      (a cell-cycle inhibitor)-coated BX Velocity stents. METHODS AND RESULTS: Thirty
      patients with angina pectoris were electively treated with 2 different
      formulations of sirolimus-coated stents (slow release [SR], n=15, and fast
      release [FR], n=15). All stents were successfully delivered, and patients were
      discharged without clinical complications. Independent core laboratories analyzed
      angiographic and 3D volumetric intravascular ultrasound data (immediately after
      procedure and at 4-month follow-up). Eight-month clinical follow-up was obtained
      for all patients. There was minimal neointimal hyperplasia in both groups (11.0+/
      3.0% in the SR group and 10.4+/-3.0% in the FR group, P:=NS) by ultrasound and
      quantitative coronary angiography (in-stent late loss, 0.09+/-0.3 mm [SR] and 
      0.02+/-0.3 mm [FR]; in-lesion late loss, 0.16+/-0.3 mm [SR] and -0.1+/-0.3 mm
      [FR]). No in-stent or edge restenosis (diameter stenosis >or=50%) was observed.
      No major clinical events (stent thrombosis, repeat revascularization, myocardial
      infarction, or death) had occurred by 8 months. CONCLUSIONS: The implantation of
      sirolimus-coated BX Velocity stents is feasible and safe and elicits minimal
      neointimal proliferation. Additional placebo-controlled trials are required to
      confirm these promising results.

PMID- 11208676
TI  - Mutations in the cardiac ryanodine receptor gene (hRyR2) underlie
      catecholaminergic polymorphic ventricular tachycardia.
AB  - BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia is a genetic
      arrhythmogenic disorder characterized by stress-induced, bidirectional
      ventricular tachycardia that may degenerate into cardiac arrest and cause sudden
      death. The electrocardiographic pattern of this ventricular tachycardia closely
      resembles the arrhythmias associated with calcium overload and the delayed
      afterdepolarizations observed during digitalis toxicity. We speculated that a
      genetically determined abnormality of intracellular calcium handling might be the
      substrate of the disease; therefore, we considered the human cardiac ryanodine
      receptor gene (hRyR2) a likely candidate for this genetically transmitted
      arrhythmic disorder. METHODS AND RESULTS: Twelve patients presenting with typical
      catecholaminergic polymorphic ventricular tachycardia in the absence of
      structural heart abnormalities were identified. DNA was extracted from peripheral
      blood lymphocytes, and single-strand conformation polymorphism analysis was
      performed on polymerase chain reaction-amplified exons of the hRyR2 gene. Four
      single nucleotide substitutions leading to missense mutations were identified in
      4 probands affected by the disease. Genetic analysis of the asymptomatic parents
      revealed that 3 probands carried de novo mutations. In 1 case, the identical twin
      of the proband died suddenly after having suffered syncopal episodes. The fourth
      mutation was identified in the proband, in 4 clinically affected family members,
      and in none of 3 nonaffected family members in a kindred with 2 sudden deaths
      that occurred at 16 and 14 years, respectively, in the sisters of the proband.
      CONCLUSIONS: We demonstrated that, in agreement with our hypothesis, hRyR2 is a
      gene responsible for catecholaminergic polymorphic ventricular tachycardia.

PMID- 11208677
TI  - Increased mortality with oral platelet glycoprotein IIb/IIIa antagonists: a meta
      analysis of phase III multicenter randomized trials.
AB  - BACKGROUND: Numerous clinical trials have established the benefits of intravenous
      glycoprotein IIb/IIIa inhibition in the management of coronary artery disease. In
      contrast, the recent large-scale, placebo-controlled, randomized trials of the
      oral glycoprotein IIb/IIIa antagonists have failed to provide commensurate
      reductions in late composite ischemic end points despite potent inhibition of
      platelet aggregation. METHODS AND RESULTS: The ORs for death, myocardial
      infarction, urgent revascularization, and major bleeding from the 4 large-scale,
      placebo-controlled, randomized trials with oral glycoprotein IIb/IIIa inhibitors
      were calculated and combined. Stratification by low-dose or high-dose therapy and
      the use of concurrent aspirin was also undertaken. In 33 326 patients followed
      for >30 days, a consistent and statistically significant increase in mortality
      was observed with oral glycoprotein IIb/IIIa therapy (OR, 1.37; 95% CI, 1.13 to
      1.66; P:=0.001). This effect was evident regardless of aspirin coadministration
      and treatment with either low-dose or high-dose therapy. Although a reduction in
      urgent revascularization was observed with oral glycoprotein IIb/IIIa inhibition,
      pooled analysis favored an increase in myocardial infarction that did not
      demonstrate statistical significance. CONCLUSIONS: Although we found a highly
      significant excess in mortality consistent across 4 trials with 3 different oral
      glycoprotein IIb/IIIa inhibitor agents, this was associated with a reduction in
      the need for urgent revascularization and no increase in myocardial infarction.
      These findings suggest the potential for a direct toxic effect with these agents
      and argue against a prothrombotic mechanism. Further investigation to elucidate
      the cause of this increased fatality risk is warranted.

PMID- 11208678
TI  - PPARalpha agonists inhibit tissue factor expression in human monocytes and
      macrophages.
AB  - BACKGROUND: Monocytic tissue factor (TF) expression may contribute to
      thrombogenicity associated with plaque rupture and may propagate thrombus
      formation at the site of vascular lesions. Induction of monocytic TF expression
      by endotoxin is mediated by the activation of transcription factors such as AP-1
      and NF-kappaB. Both these signaling pathways are modulated by peroxisome
      proliferator-activated receptor-alpha (PPARalpha). Therefore, we have studied the
      effects of fibrates and other PPARalpha agonists on the expression of TF. METHODS
      AND RESULTS: We show that PPARalpha protein, like primary human monocytes, is
      also expressed in the human monocytic THP-1 cell line. Fenofibric acid, WY14643,
      and GW2331 inhibited TF mRNA upregulation after stimulation of THP-1 cells with
      lipopolysaccharide or interleukin-1ss. In primary human monocytes and
      macrophages, the lipopolysaccharide- or interleukin-1ss-mediated induction of TF
      activity was also inhibited by fenofibric acid, WY14643, or GW2331. CONCLUSIONS:
      These data indicate that activation of PPARalpha results in the downregulation of
      the TF gene. Our results suggest a novel role for PPARalpha in the control of
      atherosclerotic plaque thrombogenicity through its effects on TF expression in
      monocytes and macrophages.

PMID- 11208680
TI  - Immunomodulating therapy with intravenous immunoglobulin in patients with chronic
      heart failure.
AB  - BACKGROUND: Congestive heart failure (CHF) is characterized by enhanced immune
      activation, and immune-mediated mechanisms may play a pathogenic role in this
      disorder. Based on the immunomodulatory effects of intravenous immunoglobulin
      (IVIG), we hypothesized that IVIG could downregulate inflammatory responses in
      CHF patients and have potential beneficial effects on the left ventricular
      ejection fraction (LVEF). METHODS AND RESULTS: Forty patients with chronic
      symptomatic CHF and LVEF of <40%, stratified according to cause (ie, ischemic and
      idiopathic dilated cardiomyopathy), were randomized in a double-blind fashion to
      receive therapy with IVIG or placebo for a total period of 26 weeks. Our main
      findings were that (1) IVIG, but not placebo, induced a marked rise in plasma
      levels of the anti-inflammatory mediators interleukin (IL)-10, IL-1 receptor
      antagonist, and soluble tumor necrosis factor receptors; (2) significantly
      correlated with these anti-inflammatory effects, IVIG, but not placebo, induced a
      significant increase in LVEF from 26+/-2% to 31+/-3% (P:<0.01), and this was
      found independent of the cause of heart failure; and (3) N-terminal pro-atrial
      natriuretic peptide decreased significantly after induction therapy and continued
      to decrease toward the end of study during IVIG therapy (P:<0.001) but remained
      unchanged during placebo. CONCLUSIONS: We demonstrated an IVIG-induced change in
      the balance between inflammatory and anti-inflammatory cytokines that favored an
      anti-inflammatory net effect in CHF. This effect was significantly correlated
      with an improvement in LVEF, suggesting a potential for immunomodulating therapy
      in addition to optimal conventional cardiovascular treatment regimens in CHF
      patients.

PMID- 11208679
TI  - PPARalpha activators inhibit tissue factor expression and activity in human
      monocytes.
AB  - BACKGROUND: Tissue factor (TF), expressed on the surface of monocytes and
      macrophages in human atherosclerotic lesions, acts as the major procoagulant
      initiating thrombus formation in acute coronary syndromes. Peroxisome
      proliferator-activated receptor-alpha (PPARalpha), a nuclear receptor family
      member, regulates gene expression in response to certain fatty acids and fibric
      acid derivatives. Given that some of these substances reduce TF activity in
      patients, we tested whether PPARalpha activators limit TF responses in human
      monocytic cells. METHODS AND RESULTS: Pretreatment of freshly isolated human
      monocytes or monocyte-derived macrophages with PPARalpha activators WY14643 and
      eicosatetraynoic acid (ETYA) led to reduced lipopolysaccharide (LPS)-induced TF
      activity in a concentration-dependent manner (maximal reduction to 43+/-8% with
      250 micromol/L WY14643 [P:<0.05, n=5] and to 42+/-12% with 30 micromol/L ETYA
      [P:>0.05, n=3]). Two different PPARgamma activators (15-deoxy(_Delta12,14)
      prostaglandin J(2) and BRL49653) lacked similar effects. WY14643 also decreased
      tumor necrosis factor-alpha protein expression in supernatants of LPS-stimulated
      human monocytes. Pretreatment of monocytes with WY14643 inhibited LPS-induced TF
      protein and mRNA expression without altering mRNA half-life. Transient
      transfection assays of a human TF promoter construct in THP-1 cells revealed
      WY14643 inhibition of LPS-induced promoter activity, which appeared to be
      mediated through the inhibition of nuclear factor-kappaB but not to be due to
      reduced nuclear factor-kappaB binding. CONCLUSIONS: PPARalpha activators can
      reduce TF expression and activity in human monocytes/macrophages and thus
      potentially reduce the thrombogenicity of atherosclerotic lesions. These data
      provide new insight into how PPARalpha-activating fibric acid derivatives and
      certain fatty acids might influence atherothrombosis in patients with vascular
      disease.

PMID- 11208681
TI  - Left ventricular hypertrophy with exercise and ACE gene insertion/deletion
      polymorphism: a randomized controlled trial with losartan.
AB  - BACKGROUND: Local cardiac renin-angiotensin systems may regulate left ventricular
      (LV) hypertrophic responses. The absence (deletion [D]) of a 287-bp marker in the
      ACE gene is associated with greater myocardial ACE levels and exercise-related LV
      growth than is its presence (insertion [I]), an effect potentially mediated
      through either increased activity of the cellular growth factor angiotensin II on
      the angiotensin type 1 (AT(1)) receptor or increased degradation of growth
      inhibiting kinins. We sought to confirm ACE genotype-associated exertional LV
      growth and to clarify the role of the AT(1) receptor in this association. METHODS
      AND RESULTS: One hundred forty-one British Army recruits homozygous for the ACE
      gene (79 DD and 62 II) were randomized to receive losartan (25 mg/d, a
      subhypotensive dose inhibiting tissue AT(1) receptors) or placebo throughout a 10
      week physical training program. LV mass, determined by cardiac magnetic
      resonance, increased with training (8.4 g, P:<0.0001 overall; 12.1 versus 4.8 g
      for DD versus II genotype in the placebo limb, P:=0.022). LV growth was similar
      in the losartan arm: 11.0 versus 3.7 g for DD versus II genotypes (P:=0.034).
      When indexed to lean body mass, LV growth in the II subjects was abolished,
      whereas it remained in the DD subjects (-0.022 versus 0.131 g/kg, respectively;
      P:=0.0009). CONCLUSIONS: ACE genotype dependence of exercise-induced LV
      hypertrophy is confirmed. Additionally, LV growth in DD (unlike II) subjects is
      in excess of the increase in lean body mass. These effects are not influenced by
      AT(1) receptor antagonism with the use of losartan (25 mg/d). The 2.4-fold
      greater LV growth in DD men may be due to the effects of angiotensin II on other
      receptors (eg, angiotensin type 4) or lower degradation of growth-inhibitory
      kinins.

PMID- 11208682
TI  - Mechanical circulatory support for advanced heart failure: effect of patient
      selection on outcome.
AB  - BACKGROUND: Use of wearable left ventricular assist systems (LVAS) in the
      treatment of advanced heart failure has steadily increased since 1993, when these
      devices became generally available in Europe. The aim of this study was to
      identify in an unselected cohort of LVAS recipients those aspects of patient
      selection that have an impact on postimplant survival. METHODS AND RESULTS: Data
      were obtained from the Novacor European Registry. Between 1993 and 1999, 464
      patients were implanted with the Novacor LVAS. The majority had idiopathic (60%)
      or ischemic (27%) cardiomyopathy; the median age at implant was 49 (16 to 75)
      years. The median support time was 100 days (4.1 years maximum). Forty-nine
      percent of the recipients were discharged from the hospital on LVAS; they spent
      75% of their time out of the hospital. For a subset of 366 recipients, for whom a
      complete set of data was available, multivariate analysis revealed that the
      following preimplant conditions were independent risk factors for survival after
      LVAS implantation: respiratory failure associated with septicemia (odds ratio
      11.2), right heart failure (odds ratio 3.2), age >65 years (odds ratio 3.01),
      acute postcardiotomy (odds ratio 1.8), and acute infarction (odds ratio 1.7). For
      patients without any of these factors, the 1-year survival after LVAS
      implantation including the posttransplantation period was 60%; for the combined
      group with at least 1 risk factor, it was 24%. CONCLUSIONS: Careful selection,
      specifically implantation before patients become moribund, and improvement of
      management may result in improved outcomes of LVAS treatment for advanced heart
      failure.

PMID- 11208683
TI  - Overnight shift from obstructive to central apneas in patients with heart
      failure: role of PCO2 and circulatory delay.
AB  - BACKGROUND: Obstructive (OSA) and central sleep apnea (CSA) can coexist in
      patients with congestive heart failure (CHF). However, the reason why OSA events
      occur at one time and CSA events at another has not been determined. We
      hypothesized that a change in PCO(2) would be associated with an alteration in
      apnea type: a decrease in PCO(2) should lead to CSA. METHODS AND RESULTS: To test
      this hypothesis, we evaluated minute ventilation (V(I)), transcutaneous PCO(2)
      (PtcCO(2)), circulation time, and periodic breathing cycle length during
      overnight polysomnography in 12 patients with CHF and coexisting OSA and CSA.
      V(I) was significantly greater (mean+/-SEM, 9.4+/-1.3 versus 8.0+/-0.9 L/min;
      P:<0.05) and PtcCO(2) was lower (39.4+/-1.0 versus 41.9+/-1.1 mm Hg, P:<0.01)
      during episodes of CSA than of OSA. These changes were associated with
      significant lengthening of circulation time (23.6+/-3.7 versus 21.1+/-3.6
      seconds, P:<0.01) and periodic breathing cycle length (53.7+/-3.5 versus 49.6+/
      2.9 seconds, P:<0.01). In addition, the proportion of obstructive events
      decreased (from 68.5+/-11.4% to 22.5+/-7.2%, P:<0.001) and of CSA events
      increased (from 31.5+/-11.4% to 77.5+/-7.2%, P:<0.001) from the first to the last
      quarter of the night in association with a significant decrease in PtcCO(2) (from
      42.6+/-0.9 to 40.8+/-0.9 mm Hg, P:<0.01). CONCLUSIONS: In patients with CHF, the
      shift from OSA to CSA is associated with a reduction in PCO(2). This appears to
      be related to an overnight deterioration in cardiac function as suggested by the
      concurrent lengthening of circulation time. Therefore, in CHF patients,
      alterations in cardiac function may influence apnea type.

PMID- 11208684
TI  - "Stable" ventricular tachycardia is not a benign rhythm : insights from the
      antiarrhythmics versus implantable defibrillators (AVID) registry.
AB  - BACKGROUND: Sustained ventricular tachycardia (VT) can be unstable, can be
      associated with serious symptoms, or can be stable and relatively free of
      symptoms. Patients with unstable VT are at high risk for sudden death and are
      best treated with an implantable defibrillator. The prognosis of patients with
      stable VT is controversial, and it is unknown whether implantable cardioverter
      defibrillator therapy is beneficial. METHODS AND RESULTS: Screening for the
      Antiarrhythmics Versus Implantable Defibrillators (AVID) trial identified
      patients with both stable and unstable VT. Both groups were included in a
      registry, and their clinical characteristics and discharge treatments were
      recorded. Mortality data were obtained through the National Death Index. The
      mortality in 440 patients with stable VT tended to be greater than that observed
      in 1029 patients presenting with unstable VT (33.6% versus 27.6% at 3 years;
      relative risk [RR]=1.22; P:=0.07). After adjustment for baseline and treatment
      differences, the RR was little changed (RR=1.25, P:=0.06). CONCLUSIONS: Sustained
      VT without serious symptoms or hemodynamic compromise is associated with a high
      mortality rate and may be a marker for a substrate capable of producing a more
      malignant arrhythmia. Implantable cardioverter-defibrillator therapy may be
      indicated in patients presenting with stable VT.

PMID- 11208685
TI  - Chemical cardioversion of atrial fibrillation or flutter with ibutilide in
      patients receiving amiodarone therapy.
AB  - BACKGROUND: Ibutilide is a class III drug that is used for the cardioversion of
      atrial arrhythmias, but it can cause torsade de pointes. Amiodarone also prolongs
      the QT interval but rarely causes torsade de pointes. There are no studies in
      which the concomitant use of the 2 agents was examined. The purpose of the
      present study was to assess the efficacy and safety of cardioversion with
      combination therapy in patients with atrial fibrillation or flutter. METHODS AND
      RESULTS: The study included 70 patients who were treated with long-term oral
      amiodarone and were referred for elective cardioversion of atrial fibrillation
      (57 of 70, 81%) or flutter (13 of 70, 19%). Patients were taking amiodarone
      (153+/-259 days, mean+/-SD) and were administered 2 mg intravenous ibutilide.
      Left ventricular ejection fraction was measured with echocardiography. The QT
      intervals were measured on 12-lead ECG. Fifty-five patients (79%) had structural
      heart disease. Patients were in arrhythmia for 196+/-508 days before
      cardioversion, with a left ventricular ejection fraction of 50+/-11%. In patients
      with atrial fibrillation, 22 (39%) of 57 and 7 (54%) of 13 patients with flutter
      converted within 30 minutes of infusion. Thirty-nine patients who did not convert
      after ibutilide were treated with electrical cardioversion, and 35 (90%) of 39
      patients were successfully converted. The QT intervals were further prolonged
      after ibutilide for the group from 371+/-61 to 479+/-92 ms (P:<0.001). There was
      1 episode of nonsustained torsade de pointes (1 of 70, 1.4%) after ibutilide.
      CONCLUSIONS: The use of ibutilide converted 54% of patients with atrial flutter
      and 39% of patients with atrial fibrillation who were treated with long-term
      amiodarone. Despite QT-interval prolongation after ibutilide, only 1 episode of
      torsade de pointes occurred. Our observations suggest that combination therapy
      may be a useful cardioversion method for chronic atrial fibrillation or flutter.

PMID- 11208687
TI  - Regulation of plasma endothelin by salt in salt-sensitive hypertension.
AB  - BACKGROUND: Salt dependency of blood pressure (BP) characterizes most models of
      experimental hypertension in which endothelins play a significant vasoconstrictor
      role. Despite this, there are no data on the regulation of plasma endothelin by
      salt balance in human hypertension. METHODS AND RESULTS: Plasma endothelin was
      measured in 47 patients with essential hypertension. Endothelin, catecholamine,
      and plasma renin activity (PRA) responses to 24-hour sodium deprivation
      (decreasing Na) were assessed in 29 of these patients. Endothelin was higher in
      hypertensive patients (4.6+/-0.2 fmol/mL) than in 20 control subjects (3.3+/-0.3
      fmol/mL, P:<0.002), was correlated with BP, and was negatively associated with
      PRA (P:<0.04). Salt-sensitive, salt-resistant, and indeterminate groups were
      defined by the tertiles of the t statistic for the difference in BP before and
      after decreasing Na. Systolic BP falls were -15+/-1, -2+/-2, and -9+/-1 mm Hg,
      respectively. PRA, its response to decreasing Na, and its level after decreasing
      Na were lowest (albeit nonsignificant) in salt-sensitive patients. Baseline
      catecholamine and endothelin levels did not differ among the groups. In response
      to decreasing Na, catecholamines increased more significantly in salt-sensitive
      patients (+2.4+/-0.9 nmol/L) than in the other groups (0.4+/-0.2 and 0.7+/-0.2
      nmol/L for indeterminate and salt-resistant groups, respectively; P:<0.03),
      whereas endothelin increased in the salt-sensitive group (0.8+/-0.3 fmol/mL),
      decreased in the salt-resistant group (-0.4+/-0.3 fmol/mL), and sustained minimal
      change in the indeterminate group (0.2+/-0.3 fmol/mL) (P:<0.04). Thus, endothelin
      levels in the salt-depleted state were highest in salt-sensitive patients (5.2+/
      0.4 fmol/mL) versus the other groups (3.4+/-0.4 and 4.4+/-0.4 fmol/mL for salt
      resistant and indeterminate groups, respectively) (P:<0.02). Changes in
      endothelin during decreasing Na and levels after decreasing Na were correlated
      with changes in catecholamines (P:<0.02). CONCLUSIONS: -Our data suggest that
      salt-depleted salt-sensitive hypertensives with blunted renin responses exhibit
      enhanced catecholamine-stimulated endothelin levels and may therefore respond
      better than unselected patients with essential hypertension to endothelin
      receptor blockers.

PMID- 11208686
TI  - The phytoestrogen genistein produces acute nitric oxide-dependent dilation of
      human forearm vasculature with similar potency to 17beta-estradiol.
AB  - BACKGROUND: Genistein, a phytoestrogen, may have estrogenic cardioprotective
      actions. We investigated whether genistein influences endothelium-dependent
      vasodilation in forearm vasculature of healthy human subjects and compared the
      effects of genistein with those of 17beta-estradiol. METHODS AND RESULTS: The
      brachial arterial was cannulated with a 27-gauge needle for drug infusion.
      Forearm blood flow responses were measured with strain-gauge plethysmography.
      Genistein (10 to 300 nmol/min, each dose for 6 minutes) produced a dose-dependent
      increase in forearm blood flow from 3.4+/-0.3 to 9.6+/-1.3 mL x min(-1) x 100 mL
      forearm(-1) (mean+/-SEM) in men (n=9, P:<0.0001 by ANOVA). The mean forearm
      venous concentration of genistein during infusion of the highest dose was 1.8+/
      0.3 micromol/L in 6 additional men. Genistein produced a similar increase in
      blood flow in premenopausal women. Daidzein, another phytoestrogen, was
      ineffective, but equimolar concentrations of 17beta-estradiol caused similar
      vasodilation to genistein. Responses to genistein and 17beta-estradiol were
      inhibited to the same degree by the NO synthase inhibitor N:(G)-monomethyl-L
      arginine. A threshold dose of genistein potentiated the endothelium-dependent
      vasodilator acetylcholine but not the endothelium-independent vasodilator
      nitroprusside. CONCLUSIONS: Genistein causes L-arginine/NO-dependent vasodilation
      in forearm vasculature of human subjects with similar potency to 17beta-estradiol
      and potentiates endothelium-dependent vasodilation to acetylcholine.

PMID- 11208688
TI  - Ventricular preexcitation in children and young adults: atrial myocarditis as a
      possible trigger of sudden death.
AB  - BACKGROUND: Sudden death (SD) in ventricular preexcitation (VP) syndrome is
      believed to be the result of atrial fibrillation with rapid ventricular response
      over the accessory pathway. Previous reports are anecdotal and often lack autopsy
      validation. METHODS AND RESULTS: Prevalence and clinicopathological features of
      VP were investigated in a series of 273 SDs in children and young adults (aged
      <or=35 years). Site of accessory atrioventricular (AV) connection was predicted
      by 12-lead ECG. Right and left AV ring together with the sinoatrial and AV septal
      junction were studied in serial histological sections. Ten patients (3.6%; male,
      mean age 24+/-7 years) had VP: 8 had Wolff-Parkinson-White (WPW) and 2 had Lown
      Ganong-Levine (LGL) syndrome. Six patients had previous symptoms, and SD occurred
      at rest in all but 1. Pathological substrates of LGL consisted of AV-node
      hypoplasia and right-sided atrio-Hisian tract, respectively. In the 8 WPW
      patients, 10 total accessory AV pathways consisting of ordinary myocardium were
      found (7 left lateral, 2 right posterolateral, and 1 septal). These pathways were
      close to the endocardium (mean distance, 750+/-530 microm) and 310+/-190 microm
      thick. In 4 WPW patients (50%), isolated acute atrial myocarditis was found,
      which was polymorphous in 1 and lymphocytic in 3. CONCLUSIONS: VP accounted for
      3.6% of SD in young people and was not preceded by warning symptoms in 40%. A
      left accessory pathway was the most frequent substrate, and its subendocardial
      location supports the feasibility of catheter ablation. Isolated atrial
      myocarditis may act as a trigger of paroxysmal atrial fibrillation that leads to
      SD.

PMID- 11208689
TI  - An HMG-CoA reductase inhibitor, cerivastatin, suppresses growth of macrophages
      expressing matrix metalloproteinases and tissue factor in vivo and in vitro.
AB  - BACKGROUND: Unstable atherosclerotic plaques that cause acute coronary events
      usually contain abundant macrophages expressing matrix metalloproteinases (MMPs)
      and tissue factor (TF), molecules that probably contribute to plaque rupture and
      subsequent thrombus formation. Lipid lowering with HMG-CoA reductase inhibitors
      reduces acute coronary events. METHODS AND RESULTS: To test whether lipid
      lowering with an HMG-CoA reductase inhibitor retards macrophage accumulation in
      rabbit atheroma, we administered cerivastatin to immature Watanabe heritable
      hyperlipidemic rabbits (cerivastatin group, n=10, cerivastatin 0.6 mg x kg(-1) x
      d(-1); control group, n=9, saline 0.6 mL x kg(-1) x d(-1)) for 32 weeks and
      measured macrophage accumulation and expression of MMPs and TF. Serum cholesterol
      levels after 32 weeks were 809+/-40 mg/dL (control group) and 481+/-24 mg/dL
      (treated group). Cerivastatin diminished accumulation of macrophages in aortic
      atheroma. Macrophage expression of MMP-1, MMP-3, MMP-9, and TF also decreased
      with cerivastatin treatment. Cerivastatin reduced the number of macrophages
      expressing histone mRNA (a sensitive marker of cell proliferation) detected by in
      situ hybridization but did not alter macrophages bearing a marker of death (TUNEL
      staining). Cerivastatin treatment (>or=0.01 micromol/L) also reduced growth,
      proteolytic activity due to MMP-9, and TF expression in cultured human
      monocyte/macrophages. CONCLUSIONS: These results suggest that lipid lowering with
      HMG-CoA reductase inhibitors alters plaque biology by reducing proliferation and
      activation of macrophages, prominent sources of molecules responsible for plaque
      instability and thrombogenicity.

PMID- 11208690
TI  - Role of Rho-associated kinase in neointima formation after vascular injury.
AB  - BACKGROUND: The Rho/Rho-associated kinase (Rho-kinase) system is implicated in
      various cellular functions, including migration, proliferation, and apoptosis.
      Because a possible role of the system is suggested in neointima formation after
      vascular injury, we sought to examine whether a new specific Rho-kinase
      inhibitor, Y27632, prevents neointima formation of the balloon-injured rat
      carotid artery, and if so, to investigate the effects of Y27632 on migration,
      proliferation, and apoptosis of smooth muscle cells (SMCs) in the injured artery.
      METHODS AND RESULTS: Y27632 was administered intraperitoneally from 1 day before
      to 14 days after vascular injury. Treatment with Y27632 inhibited phenylephrine
      induced Rho-kinase activation in the carotid artery on the basis of
      immunoblotting against the phosphorylated myosin-binding subunit of myosin
      phosphatase. Y27632 markedly prevented neointima formation at days 7 and 14. In
      controls, BrdU(+) proliferating and TUNEL(+) apoptotic SMCs were transiently and
      coincidentally increased in the neointima, with a peak at day 7. Y27632
      significantly increased the neointimal TUNEL(+) SMCs at days 7 and 14, but not
      BrdU(+) SMCs. Y27642 significantly decreased the number of intimal SMCs at day 4,
      while not affecting the number of BrdU(+) or TUNEL(+) SMCs. Reendothelialization
      after balloon injury was not significantly affected by Y27632 at days 7 and 14.
      CONCLUSIONS: Y27632 inhibited neointima formation by enhancing SMC apoptosis and
      probably by suppressing early SMC migration. Therefore, a role of Rho-kinase is
      suggested in neointima formation after vascular injury.

PMID- 11208691
TI  - Morphine mimics preconditioning via free radical signals and mitochondrial K(ATP)
      channels in myocytes.
AB  - BACKGROUND: We tried to determine whether morphine mimics preconditioning (PC) to
      reduce cell death in cultured cardiomyocytes and whether opioid delta(1)
      receptors, free radicals, and K(ATP) channels mediate this effect. METHODS AND
      RESULTS: Chick embryonic ventricular myocytes were studied in a flow-through
      chamber while flow rate, pH, and O(2) and CO(2) tension were controlled.
      Cardiomyocyte viability was quantified with propidium iodide (5 micromol/L), and
      production of free radicals was measured with 2',7'-dichlorofluorescin diacetate.
      PC with 10 minutes of simulated ischemia before 10 minutes of reoxygenation or
      morphine (1 micromol/L) or BW373U86 (10 pmol/L) infusion for 10 minutes followed
      by a 10-minute drug-free period before 1 hour of ischemia and 3 hours of
      reoxygenation reduced cell death to the same extent (*P:<0.05) (PC, 20+/-1%,
      n=7*; morphine, 32+/-4%, n=8*; BW373U86, 21+/-6%; controls, 52+/-5%, n=8). Like
      PC, morphine and BW373U86 increased free radical production 2-fold before
      ischemia (0.35+/-0.10, n=6*; 0.41+/-0.08, n=4* versus controls, 0.15+/-0.05, n=8,
      arbitrary units). Protection and increased free radical signals during morphine
      infusion were abolished with either the thiol reductant 2-mercaptopropionyl
      glycine (400 micromol/L), an antioxidant; naloxone (10 micromol/L), a
      nonselective morphine receptor antagonist; BNTX (0.1 micromol/L), a selective
      opioid delta(1) receptor antagonist; or 5-hydroxydecanoate (100 micromol/L), a
      selective mitochondrial K(ATP) channel antagonist. CONCLUSIONS: These results
      suggest that direct stimulation of cardiocyte opioid delta(1) receptors leads to
      activation of mitochondrial K(ATP) channels. The resultant increase of
      intracellular free radical signals may be an important component of the signaling
      pathways by which morphine mimics preconditioning in cardiomyocytes.

PMID- 11208692
TI  - Low-energy laser irradiation reduces formation of scar tissue after myocardial
      infarction in rats and dogs.
AB  - BACKGROUND: Low-energy laser irradiation (LELI) has been found to attenuate
      various biological processes in tissue culture and experimental animal models.
      The aim of the present study was to investigate the effect of LELI on the
      formation of scar tissue in experimentally induced chronic infarct in rats and
      dogs. METHODS AND RESULTS: Myocardial infarction (MI) was induced in 50 dogs and
      26 rats by ligation of the left anterior descending coronary artery. After
      induction of MI, the laser-irradiated (LI) group received laser irradiation
      (infrared laser, 803-nm wavelength) epicardially. Control MI-induced non-laser
      irradiated (NLI) dogs were sham-operated, and laser was not applied. All dogs
      were euthanized at 5 to 6 weeks after MI. Infarct size was determined by TTC
      staining and histology. The laser treatment (P:<0.05) lowered mortality
      significantly, from 30% to 6.5%, after induction of MI. The infarct size in the
      LI dogs was reduced significantly (P:<0.0001) (52%) compared with NLI dogs.
      Histological observation of the infarct revealed a typical scar tissue in NLI
      dogs and cellularity in most of the LI dogs. Only 14+/-3% of the mitochondria in
      the cardiomyocytes in the ischemic zone (4 hours after MI) of LI MI-induced rats
      were severely damaged, compared with 36+/-1% in NLI rats. Accordingly, ATP
      content in that zone was 7.6-fold (significantly) higher in LI than in NLI rats.
      CONCLUSIONS: Our observations indicate that epicardial LELI of rat and dog hearts
      after chronic MI caused a marked reduction in infarct size, probably due to a
      cardioprotective effect of the LELI.

PMID- 11208693
TI  - Oral matrix metalloproteinase inhibition and arterial remodeling after balloon
      dilation: an intravascular ultrasound study in the pig.
AB  - BACKGROUND: Inhibition of matrix metalloproteinase (MMP) activity after balloon
      angioplasty by intraperitoneal injection of batimastat reduces late lumen loss by
      inhibition of constrictive remodeling. In the present study, we investigated
      whether the oral MMP inhibitor marimastat inhibits constrictive remodeling in
      favor of neutral or expansive remodeling. METHODS AND RESULTS: In 26 pigs,
      balloon dilation was performed in 101 peripheral arteries. Pigs were treated with
      marimastat or served as controls and were euthanized 42 days after intervention.
      Intravascular ultrasound was performed at all time points. Vessel area (VA) loss
      was assessed by calculating the change in VA at termination relative to after
      intervention. Arteries were divided in 3 categories: expansive remodeling (VA
      loss < -5%), neutral (-5% <or= VA loss <or= +5%), and constrictive remodeling (VA
      loss > +5%). In the marimastat group, a significant reduction (53%) of late lumen
      loss was observed that was fully explained by impaired constrictive remodeling.
      In the marimastat group, the prevalence of constrictive remodeling was reduced
      (38% versus 75% in the control group) in favor of not only neutral but also
      expansive remodeling (21% and 42% versus 4% and 21% in the control group,
      respectively, P:<0.01). In contrast to the control group, acute luminal gain in
      the marimastat group did not correlate with late VA loss. CONCLUSIONS:
      Irrespective of the acute luminal gain by balloon dilation, the oral MMP
      inhibitor marimastat inhibited constrictive arterial remodeling in favor of both
      neutral and expansive remodeling.

PMID- 11208694
TI  - Treatment with a growth hormone secretagogue in a model of developing heart
      failure: effects on ventricular and myocyte function.
AB  - BACKGROUND: Exogenous administration of growth hormone (GH) and subsequently
      increased production of insulin-like growth factor-1 can influence left
      ventricular (LV) myocardial growth and geometry in the setting of congestive
      heart failure (CHF). This study determined the effects of an orally active GH
      secretagogue (GHS) treatment that causes a release of endogenous GH on LV
      function and myocyte contractility in a model of developing CHF. METHODS AND
      RESULTS: Pigs were randomly assigned to the following treatment groups: (1)
      chronic rapid pacing at 240 bpm for 3 weeks (n=11); (2) chronic rapid pacing and
      GHS (CP-424,391 at 10 mg x kg(-1) x d(-1), n=9); and (3) sham controls (n=8). In
      the untreated pacing CHF group, LV fractional shortening was reduced (21+/-2%
      versus 47+/-2%) and peak wall stress increased (364+/-21 versus 141+/-5 g/cm(2))
      from normal control values (P:<0.05). In the GHS group, LV fractional shortening
      was higher (29+/-2%) and LV peak wall stress lower (187+/-126 g/cm(2)) than
      untreated CHF values (P:<0.05). With GHS treatment, the ratio of LV mass to body
      weight increased by 44% from untreated values. Steady-state myocyte velocity of
      shortening was reduced with pacing CHF compared with controls (38+/-1 versus 78+/
      1 microm/s, P:<0.05) and was increased from pacing CHF values with GHS treatment
      (55+/-7 microm/s, P:<0.05). CONCLUSIONS: The improved LV pump function that
      occurred with GHS treatment in this model of CHF was most likely a result of
      favorable effects on LV myocardial remodeling and contractile processes. On the
      basis of these results, further studies are warranted to determine the potential
      role of GH secretagogues in the treatment of CHF.

PMID- 11208695
TI  - Effectiveness of a nonselective ET(A/B) and a selective ET(A) antagonist in rats
      with monocrotaline-induced pulmonary hypertension.
AB  - BACKGROUND: Both nonselective ET(A/B) receptor and selective ET(A) receptor
      antagonists can reduce pulmonary hypertension (PH) and right ventricular
      hypertrophy (RVH) in various animal models. Depending on their net effects after
      blockade of endothelial and smooth muscle ET(B) receptors, nonselective ET(A/B)
      antagonists could be more or less effective than selective ET(A) antagonists.
      METHODS AND RESULTS: Two weeks after injection of saline or 60 mg/kg
      monocrotaline (MCT), rats received 50 mg x kg(-1) x d(-1) of a selective
      (LU135252) or nonselective (BSF420627) antagonist for 3 weeks. This resulted in 4
      groups: control (n=15), MCT (n=60), MCT+ET(A) (n=39), and MCT+ET(A/B) (n=40).
      Five-week survival was 35% in the MCT group; this was increased to 56% in the
      MCT+ET(A) group (P:=0.10) and to 67% in the MCT+ET(A/B) group (P:=0.0015). Drug
      administration was stopped 48 hours before hemodynamic measurements to evaluate
      the chronic effects of therapy: PH in the MCT group (RV systolic pressure 87+/-1
      mm Hg) was improved similarly in both MCT+ET(A) and MCT+ET(A/B) groups (72+/-3
      and 70+/-3 mm Hg, respectively, P:<0.05). Severe RVH in the MCT group (RV/left
      ventricle+septum weight ratio 73+/-1%) was not affected by the selective
      antagonist (70+/-2%) but was reduced to 54+/-2% in the MCT+ET(A/B) group
      (P:<0.01). Pulmonary resistive properties, assessed from isolated lung pressure
      flow relationships, were improved similarly in survivors from both treated
      groups. CONCLUSIONS: Both the nonselective ET(A/B) antagonist BSF420627 and the
      selective ET(A) antagonist LU135252 are effective in this model of PH. Similar
      direct comparative studies in other models of PH and with various dosage regimens
      are warranted to define the optimal pharmacological approach of PH when ET
      receptor antagonists are used.

PMID- 11208696
TI  - Myocardial fibrosis in DOCA-salt hypertensive rats: effect of endothelin ET(A)
      receptor antagonism.
AB  - BACKGROUND: To test the hypothesis that endothelin-1 contributes to cardiac
      fibrosis, cardiac collagen deposition was studied in deoxycorticosterone acetate
      salt (DOCA-salt) hypertensive rats, in which the endothelin system is activated.
      The effects of the ET(A)-selective endothelin receptor antagonist A-127722 were
      evaluated. METHODS AND RESULTS: A-127722 (30 mg/kg per day) was administered for
      4 weeks. Myocardial fibrosis was evaluated after Sirius red F3BA staining.
      Systolic blood pressure was 103+/-1.6 mm Hg in unilaterally nephrectomized rats
      (Uni-Nx), 202+/-3.2 mm Hg in DOCA-salt rats (P:<0.01 versus Uni-Nx), and 182+/
      3.1 mm Hg in ET(A) antagonist-treated DOCA-salt rats (P:<0.01 versus DOCA-salt or
      Uni-Nx). In DOCA-salt rats, interstitial and perivascular collagen density was
      increased in the subendocardial and midmyocardial regions of the left ventricle
      (3- to 4-fold, P:<0.05), whereas in subepicardial myocardium, the increase was
      predominantly perivascular. The ET(A) antagonist prevented cardiac fibrosis in
      DOCA-salt rats. Procollagen I and III mRNA, which were increased in hearts of
      DOCA-salt rats, were normalized by ET(A) antagonist treatment. TGF-beta(1) mRNA
      and TGF-beta(1) protein increased at 1 week in DOCA-salt rats and were lowered in
      ET(A) antagonist-treated rats. CONCLUSIONS: ET(A) receptor-mediated collagen
      deposition in hearts of DOCA-salt rats results from increased procollagen
      synthesis associated with an initial increment in expression of TGF-beta(1).
      These results support the hypothesis of a role for endothelin-1 in cardiac
      collagen deposition in mineralocorticoid hypertension, which may have
      pathophysiological and pharmacological implications in hypertensive heart
      disease.

PMID- 11208697
TI  - Image in cardiovascular medicine. Prenatal diagnosis of idiopathic infantile
      arterial calcification.

PMID- 11208699
TI  - Diagnostic guidelines for Kawasaki disease.

PMID- 11208698
TI  - Recommendations for preparticipation screening and the assessment of
      cardiovascular disease in masters athletes: an advisory for healthcare
      professionals from the working groups of the World Heart Federation, the
      International Federation of Sports Medicine, and the American Heart Association
      Committee on Exercise, Cardiac Rehabilitation, and Prevention.

PMID- 11208700
TI  - Mechanical cardiac support 2000: current applications and future trial design:
      June 15-16, 2000 Bethesda, Maryland.

PMID- 11208701
TI  - Images in cardiovascular medicine. Computed tomography and magnetic resonance
      imaging of left ventricular thrombus.

PMID- 11208702
TI  - Graft patency rate and clinical outcome after coronary artery bypass surgery.

PMID- 11208703
TI  - Beta2-adrenergic receptor overexpression exacerbates development of heart failure
      after aortic stenosis.

PMID- 11208704
TI  - Myocarditis as a cause of sudden death.

PMID- 11208705
TI  - Plasminogen activator inhibitor genotype and brain infarction.

PMID- 11208706
TI  - Cardiovascular news.

PMID- 11208707
TI  - Postapproval drug surveillance and the first principle of medicine.

PMID- 11208708
TI  - Diagnosis of specialized intestinal metaplasia by optical coherence tomography.
AB  - BACKGROUND AND AIMS: Optical coherence tomography (OCT) is an imaging technique
      that produces high-resolution cross-sectional images in vivo. The aim of this
      study was to establish the sensitivity and specificity of OCT for diagnosing
      specialized intestinal metaplasia (SIM). METHODS: OCT was used to image the
      stomach and esophagus of 121 patients. A total of 288 biopsy-correlated OCT
      images were acquired. OCT criteria for SIM were formulated by analyzing 75 images
      of SIM. The SIM image criteria were retrospectively tested by applying them to
      images of gastric, squamous, SIM, and cardiac epithelium. The criteria were then
      tested prospectively to determine the sensitivity and specificity of OCT for
      diagnosing SIM. RESULTS: OCT images of SIM are characterized by (1) absence of
      the layered structure of normal squamous epithelium and the vertical "pit and
      crypt" morphology of gastric mucosa, (2) disorganized architecture with
      inhomogeneous tissue contrast and an irregular mucosal surface, and (3) presence
      of submucosal glands. These criteria were 100% sensitive and 93% specific for SIM
      when applied retrospectively and 97% sensitive and 92% specific when tested
      prospectively. CONCLUSIONS: OCT is highly sensitive and specific for SIM and may
      aid in the diagnosis and surveillance of this preneoplastic lesion.

PMID- 11208709
TI  - Clinical, biological, and histologic parameters as predictors of relapse in
      ulcerative colitis.
AB  - BACKGROUND & AIMS: Ulcerative colitis (UC) is a chronic relapsing inflammatory
      bowel disease. We aimed to assess whether clinical, biological, and histologic
      parameters in quiescent UC predict time to clinical relapse. METHODS: Seventy
      four patients with clinically and endoscopically determined inactive UC were
      followed up for 1 year or for a shorter period if they had a relapse. Serum
      erythrocyte sedimentation rate; C-reactive protein, interleukin (IL)-1beta, IL-6,
      and IL-15 values; anti-neutrophil cytoplasmic antibody titers; and rectal biopsy
      specimens were obtained at baseline, at 6 and 12 months, and/or at relapse.
      Multivariate survival analysis was performed to determine independent predictors
      of clinical relapse. RESULTS: Twenty-seven patients relapsed (19/42 women; 8/32
      men). Multivariate Cox regression analysis retained younger age (P = 0.003;
      hazard ratio, 0.4 per decade), greater number of prior relapses in women (P <
      0.001; hazard ratio, 1.6 per prior relapse), and basal plasmacytosis (P = 0.003;
      hazard ratio, 4.5) on rectal biopsy specimens as predictors of shorter time to
      clinical relapse. Kaplan-Meier survival curves showed the 20-30-year-old age
      group and women with more than 5 prior relapses to be groups with shorter times
      to relapse. CONCLUSIONS: Younger age, multiple previous relapses (for women), and
      basal plasmacytosis on rectal biopsy specimens were independent predictors of
      earlier relapse. These findings may help identify patients with inactive UC who
      will require optimal maintenance medical therapy.

PMID- 11208710
TI  - Efficient detection of hereditary nonpolyposis colorectal cancer gene carriers by
      screening for tumor microsatellite instability before germline genetic testing.
AB  - BACKGROUND & AIMS: The optimal strategy for the detection of hereditary
      nonpolyposis colorectal cancer (HNPCC) gene carriers remains uncertain. We
      evaluated whether microsatellite instability (MSI) analysis or MSH2 and MLH1
      protein immunostaining of tumors will screen individuals efficiently for germline
      MSH2 and MLH1 testing. METHODS: We performed a case-series study of 114 eligible
      families enrolled in our high-risk colorectal cancer (CRC) registry. Medical
      history data were collected on probands and relatives. MSI analysis was performed
      on proband tumors, and MSH2 and MLH1 protein immunostaining was assessed.
      Denaturing gradient gel electrophoresis was used to identify germline MSH2 or
      MLH1 mutations in probands found to have tumors with high-frequency MSI. RESULTS:
      Tumor tissue and adequate clinical data were available in 109 of the 114
      families. Amsterdam criteria and Bethesda guidelines were met by 23% and 70% of
      the families, respectively. High-frequency MSI was identified in the proband
      tumors in 47 of the 109 families (43%). Germline MSH2 and MLH1 gene testing was
      carried out in the probands of 32 of 47 families with MSI-H tumors. Mutations
      were detected in 16 families (9 in MSH2 and 7 in MLH1) and sequence variants of
      uncertain significance in 5 families (1 in MSH2 and 4 in MLH1). Germline
      mutations or sequence variants of uncertain significance were detected in 15 of
      19 (79%) of our Amsterdam families and in 6 of 13 (46%) of our non-Amsterdam
      families with MSI-H tumors. MSH2 and MLH1 protein immunostaining was assessed in
      38 of the 47 MSI-H tumors. Unequivocal loss of hMLH1 expression was found in 20
      tumors and loss of MSH2 expression in 9 tumors. Corresponding loss of protein
      expression was seen in 17 of 18 (94%) of tumors from probands with germline
      mutations or variants. CONCLUSIONS: The detection of high-frequency MSI or the
      loss of MSH2 or MLH1 immunostaining in CRCs are both useful criteria for
      selecting high-risk patients who should be tested for germline mutations in MSH2
      or MLH1.

PMID- 11208711
TI  - Alterations in rectal sensitivity and motility in childhood irritable bowel
      syndrome.
AB  - BACKGROUND & AIMS: Children with chronic abdominal pain have a heterogeneous
      clinical presentation, but no organic cause can be identified in most of them.
      Some children present with symptoms of irritable bowel syndrome (IBS). We
      hypothesized that visceral hypersensitivity and motor abnormalities may be
      underlying mechanisms in these children. METHODS: Rectal sensation and rectal
      contractile response to a meal were studied in 8 children with IBS and 8 children
      with functional abdominal pain (FAP) and were compared with those of 9 healthy
      volunteers (HVs). RESULTS: The threshold for pain, but not that for first
      sensation and urge to defecate, was significantly decreased in IBS patients (6 +/
      1 mm Hg) compared with FAP patients and HVs (17 +/- 1 and 22 +/- 2 mm Hg,
      respectively). In HVs and patients with FAP, ingestion of a meal induced a
      decrease in rectal volume with an early and late component. This motor pattern
      was absent in children with IBS. In IBS patients, no rapid volume waves were
      observed during fasting in contrast to FAP patients (2.7 +/- 0.3/10 min) and HVs
      (1.8 +/- 0.5/10 min). CONCLUSIONS: Children fulfilling the Rome II criteria for
      IBS have a significantly lowered threshold for pain and a disturbed contractile
      response to a meal. Comparable to results reported in adults, sensory and motor
      abnormalities might play a pathophysiologic role in childhood IBS.

PMID- 11208712
TI  - Tachykinins contribute to nerve-mediated contractions in the human esophagus.
AB  - BACKGROUND & AIMS: Tachykinins mediate nonadrenergic, noncholinergic excitation
      in the gastrointestinal tract, but their role in esophageal peristalsis remains
      unclear. METHODS: We used muscle strips from the distal third of human esophagus,
      obtained from patients undergoing esophagectomy for cancer, to investigate the
      contribution of tachykinins to nerve-mediated contractions. Isometric tension
      responses to agonists or electrical field stimulation were recorded in circular
      and longitudinal muscle strips. RESULTS: Tachykinins produced concentration
      dependent increases in tension in circular and longitudinal muscle strips, with
      the following order of potency: beta-Ala(8)-neurokinin (NK) A (4-10) > NKB >
      substance P, suggesting NK(2) receptor involvement. The NK(2) receptor
      antagonist, SR48968 (1 micromol/L), inhibited responses to tachykinins in both
      muscles. Nerve activation produced on- and off-contractions in circular muscle
      and a duration-contraction in longitudinal muscle. Atropine (10 micromol/L)
      insensitive nerve-evoked contractions were identified for the 3 types of
      responses. SR48968 produced concentration-dependent inhibition of atropine
      insensitive on- and off-contractions but had no effect on the duration
      contraction. At low stimulus frequency (1 Hz), on-contractions showed greater
      sensitivity to SR48968 than off-contractions. CONCLUSIONS: Nerve-mediated
      contractions in the human esophagus have a significant atropine-insensitive
      component. Tachykinins acting on NK(2) receptors can account for some, but not
      all, of this response, suggesting that other excitatory mechanisms also
      contribute.

PMID- 11208713
TI  - Regulated production of interferon-inducible T-cell chemoattractants by human
      intestinal epithelial cells.
AB  - BACKGROUND & AIMS: Human intestinal epithelial cells inducibly express neutrophil
      and monocyte chemoattractants, yet little is known about the regulated production
      of T-cell chemoattractants by the intestinal epithelium. IP-10, Mig, and I-TAC
      are 3 CXC chemokines that are known to act as CD4(+) T-cell chemoattractants.
      METHODS: We studied constitutive chemokine expression in human colon, and defined
      the regulated expression of these chemokines by reverse-transcription polymerase
      chain reaction, enzyme-linked immunosorbent assay, and immunohistology using
      cultured human intestinal epithelial cell lines and a novel adaptation of an in
      vivo human intestinal xenograft model. RESULTS: IP-10 and Mig were constitutively
      expressed by normal human colon epithelium, and their cognate receptor, CXCR3,
      was expressed by mucosal mononuclear cells. Interferon (IFN)-gamma stimulation
      increased mRNA expression and the polarized basolateral secretion of these
      chemokines by human colon epithelial cell lines; infection with enteroinvasive
      bacteria, or stimulation with the proinflammatory cytokines tumor necrosis factor
      alpha and interleukin 1alpha, strongly potentiated IFN-gamma-induced epithelial
      cell IP-10, Mig, and I-TAC production. Epithelial cell mRNA and protein
      expression of IP-10, Mig, and I-TAC were rapidly up-regulated in human intestinal
      xenografts in response to stimulation with IFN-gamma alone or in combination with
      IL-1. CONCLUSIONS: The constitutive and regulated production of the IFN-gamma
      inducible chemokines IP-10, Mig, and I-TAC by human intestinal epithelium, and
      the expression of their cognate receptor, CXCR3, by mucosal mononuclear cells,
      suggest that the intestinal epithelium can play a role in modulating physiologic
      and pathologic T cell-mediated mucosal inflammation.

PMID- 11208714
TI  - Characterization of epithelial chemoattractants for human intestinal
      intraepithelial lymphocytes.
AB  - BACKGROUND & AIMS: Although homing of intraepithelial lymphocytes (IEL) into
      intestinal epithelia seems to be guided by signals from epithelia, little is
      known concerning functional epithelial-derived chemoattractants for IEL. METHODS:
      Epithelial chemoattractants for IEL were analyzed using chemotaxis chamber
      system, enzyme-linked immunosorbent assay, and in situ hybridization using human
      epithelial lines and IEL lines. RESULTS: Epithelial-conditioned media induced IEL
      chemotaxis, and this activity was markedly enhanced by prestimulation of
      epithelia with interferon-(IFN)-gamma. This chemotaxis (stimulation +) was
      significantly inhibited by neutralizing antibodies to IFN-gamma inducible protein
      10 (IP-10) or to monokine induced by IFN-gamma (MIG). Furthermore, while high
      amounts of IP-10 and MIG were detected in epithelial-conditioned media after IFN
      gamma stimulation, equivalent concentrations of recombinant IP-10 and MIG
      reproduced IEL chemotaxis. Production of IP-10 and MIG in fresh epithelial cells
      was supported by in situ hybridization and enzyme-linked immunosorbent assay.
      Lastly, fresh human IEL constitutively expressed CXCR-3 (the common receptor for
      IP-10 and MIG), and fresh IEL also exhibited chemotaxis to by rIP-10, rMIG, and
      epithelial-conditioned media. CONCLUSIONS: Epithelial cells produce
      chemoattractants for IEL, and such chemokine production is regulated by
      proinflammatory cytokines such as IFN-gamma. IP-10 and MIG may serve as
      potentially important epithelial chemokines for IEL, especially under
      inflammatory conditions.

PMID- 11208715
TI  - Butyric acid induces apoptosis by up-regulating Bax expression via stimulation of
      the c-Jun N-terminal kinase/activation protein-1 pathway in human colon cancer
      cells.
AB  - BACKGROUND & AIMS: The colonic epithelial cells near the top of the crypt have
      been shown to undergo apoptosis. Because butyric acid (BA) is the major short
      chain fatty acid produced by fermentation of dietary fiber in the large bowel, it
      may be an important regulator of apoptosis in colorectal cancer. We investigated
      which signaling pathway is triggered by BA to undergo apoptosis in human
      colorectal cancer cells. METHODS: Human DiFi and FET colorectal cells were
      treated with BA to undergo apoptosis and were assayed for activation of c-Jun N
      terminal kinase (JNK), transcription factor activation protein 1 (AP1) and NF
      kappaB, and the proapoptotic molecule Bax. The contribution of specific pathways
      was assessed by examining the effects of dominant-negative mutants of JNK/AP1 or
      NF-kappaB on BA-induced Bax expression and apoptosis. RESULTS: BA-mediated DNA
      fragmentation and Bax induction were preceded by early stimulation of JNK, and
      the DNA-binding activities of AP1 and NF-kappaB. BA-induced enhancement of DNA
      fragmentation and stimulation of Bax promoter activity were blocked by the
      expression of dominant-negative mutants of JNK1 or AP1 but not NF-kappaB.
      CONCLUSIONS: These findings suggest that apoptosis triggered by BA involves
      transcriptional stimulation of the Bax gene via activation of the JNK/AP1 pathway
      in colonic epithelial cells.

PMID- 11208716
TI  - Hierarchical cleavage of focal adhesion kinase by caspases alters signal
      transduction during apoptosis of intestinal epithelial cells.
AB  - BACKGROUND & AIMS: Purified intestinal epithelial cells die of detachment-induced
      apoptosis due to loss of cell anchorage during isolation. Anchorage-dependent
      cells form focal adhesions, sites of enhanced cell-matrix attachment that confer
      survival signals. Focal adhesion kinase (FAK), a component of the focal adhesion
      signaling complex, transduces these antiapoptotic signals. In this report, the
      molecular events leading to cleavage of FAK by caspases during apoptosis and its
      functional implications are defined. METHODS: Cytosolic extracts of human
      intestinal epithelial cells undergoing detachment-induced apoptosis were analyzed
      by Western blotting, immunoprecipitation, and kinase assay. RESULTS: FAK is
      cleaved by the ordered proteolytic activity of 2 different members of the caspase
      3 family. The first cleavage is mediated by caspase-3, generating a 94/92
      kilodalton-terminal fragment, which is processed by caspase-6 to an 84-kilodalton
      fragment. After apoptosis is initiated, the level of FAK phosphorylation is
      rapidly decreased, and the phosphorylation pattern of FAK-associated proteins is
      dramatically modified, showing significant yet divergent changes in signal
      transduction. CONCLUSIONS: Cleavage of FAK during apoptosis of normal human cells
      is an example of the sequential, highly regulated, and coordinate action of
      caspases that not only dismantle a cell by proteolysis, but also alter the cell's
      signaling machinery.

PMID- 11208717
TI  - Oxidants potentiate Ca(2+)- and cAMP-stimulated Cl(-) secretion in intestinal
      epithelial T84 cells.
AB  - BACKGROUND & AIMS: Diarrhea is one of the major complications of inflammatory
      bowel disease. The role of oxidants in promoting net intestinal secretion is
      important, but the cellular mechanisms underlying their effects are unclear. We
      examined the effects and defined the cellular actions of the oxidant
      monochloramine (NH(2)Cl) on anion secretion in human colonic T84 cells. METHODS:
      Effects of NH(2)Cl on basal and agonist-stimulated short-circuit current (Isc) of
      T84 monolayers were determined. Apical Cl(-) and basolateral K(+) conductances
      were measured by efflux of (125)I(-) and (86)Rb(+), respectively. RESULTS:
      NH(2)Cl alone had little effect on Isc and (125)I(-) efflux. However,
      pretreatment with NH(2)Cl led to a concentration-dependent potentiation of the
      Ca(2+)-mediated Isc and of submaximal cAMP-mediated responses. These effects were
      associated with increased basolateral K(+) channel conductance and were blocked
      by increasing cellular Ca(2+) buffering capacity with Quin-2. Whole-cell voltage
      clamp experiments showed that NH(2)Cl potentiated Ca(2+) activation of
      basolateral K(+) channel conductance. CONCLUSIONS: Oxidants potentiate both
      Ca(2+)- and cAMP-stimulated Cl(-) secretion by a direct effect on calcium
      activated basolateral K(+) channel conductance, lowering its Ca(2+) activation
      threshold. This effect may play an important role in amplifying and prolonging
      the secretory response of inflamed intestinal mucosa and enhancing the severity
      of diarrhea.

PMID- 11208718
TI  - Interferon gamma induces enterocyte resistance against infection by the
      intracellular pathogen Cryptosporidium parvum.
AB  - BACKGROUND & AIMS: Interferon (IFN)-gamma plays an important role in the
      immunologic control of infection by the protozoan enteropathogen Cryptosporidium
      parvum. We tested the hypothesis that IFN-gamma may directly inhibit infection of
      enterocytes by this pathogen. METHODS: HT-29, Caco-2, and H4 human enterocyte
      cell lines were grown in monolayers and incubated with IFN-gamma before exposure
      with C. parvum. IFN-gamma receptor expression in the cell lines was determined by
      Western blot analysis. RESULTS: IFN-gamma inhibited C. parvum infection of both
      HT-29 and Caco-2 cells but not H4 cells. Response to IFN-gamma was related to the
      expression of the IFN-gamma receptor in the respective cell lines. The effect of
      IFN-gamma was partially reversed by inhibition of the JAK/STAT signaling pathway.
      IFN-gamma mediated its action by at least 2 mechanisms: (1) inhibition of
      parasite invasion and (2) by modification of intracellular Fe(2+) concentration.
      No role for tryptophan starvation or nitric oxide synthase activity was found.
      TNF-alpha and IL-1beta also had anti-C. parvum activity but had no synergistic
      effect with IFN-gamma. CONCLUSIONS: IFN-gamma directly induces enterocyte
      resistance against C. parvum infection; this observation may have important
      consequences for our understanding of the mucosal immune response to invasive
      pathogens.

PMID- 11208719
TI  - Epidermal growth factor receptor mediates stress-induced expression of its
      ligands in rat gastric epithelial cells.
AB  - BACKGROUND & AIMS: Epidermal growth factor (EGF)-like growth factors are induced
      after acute gastric injury and may play an important role in mucosal repair.
      However, the mechanisms that trigger these growth factors are poorly understood.
      We determined the role of EGF receptor (EGFR) in stress-induced expression of
      heparin-binding EGF-like growth factor (HB-EGF) in a rat gastric epithelial cell
      line (RGM1 cells). METHODS: RGM1 cells were transfected with a plasmid containing
      complementary DNA encoding a dominant-negative human EGFR (HERCD533). Cells were
      treated with hydrogen peroxide (0-400 micromol/L) or sorbitol (600 mmol/L).
      Tyrosine phosphorylation of EGFR was determined by immunoprecipitation and
      Western blotting with an antiphosphotyrosine antibody. HB-EGF messenger RNA and
      protein were determined with Northern and Western blotting, respectively. Cell
      growth was evaluated by cell number and [(3)H]thymidine incorporation. RESULTS:
      Oxidative stress and osmotic stress induced tyrosine phosphorylation of EGFR
      within 2 minutes, followed by a marked increase in HB-EGF and amphiregulin
      transcripts in RGM1 cells. Introduction of HERCD533 into the cells inhibited not
      only tyrosine phosphorylation of EGFR but also growth response to EGF.
      Furthermore, oxidative stress-induced HB-EGF messenger RNA expression was
      impaired in HERCD533-expressing cells. CONCLUSIONS: EGFR plays a crucial role in
      the stress-induced expression of EGF-like growth factors in gastrointestinal
      epithelial cells.

PMID- 11208720
TI  - Sucrase-isomaltase is an adenosine 3',5'-cyclic monophosphate-dependent
      epithelial chloride channel.
AB  - BACKGROUND & AIMS: We previously isolated a monoclonal antibody against a
      Necturus gallbladder epitope that blocks native adenosine 3',5'-cyclic
      monophosphate (cAMP)-dependent chloride channels in intestine, gallbladder,
      urinary bladder, and airway epithelia in various animals. METHODS: Using this
      antibody, we purified a 200-kilodalton protein that, when reconstituted in lipid
      bilayers, forms 9-pS chloride channels that are blocked by the antibody. RESULTS:
      Amino acid sequencing of the purified protein showed strong homology to rabbit
      sucrase-isomaltase, an abundant intestinal enzyme. Western blot analysis of the
      in vitro-translated sucrase-isomaltase was indistinguishable from that of the
      protein used in the lipid bilayer studies. Expression of this protein in Chinese
      hamster ovary cells and in Xenopus laevis oocytes yielded cAMP-dependent chloride
      currents that in the latter system were blocked by the antibody. CONCLUSIONS:
      Because the monoclonal antibody blocks cAMP-dependent currents in epithelia as
      well as those produced both by the reconstituted and by the heterologously
      expressed protein, sucrase-isomaltase is a cAMP-dependent epithelial chloride
      channel. Thus an enzyme that can also function as an ion channel has been
      described for the first time.

PMID- 11208721
TI  - Inhibition of complement C5 reduces local and remote organ injury after
      intestinal ischemia/reperfusion in the rat.
AB  - BACKGROUND & AIMS: Complement activation plays an important role in the local
      pathogenesis of ischemia/reperfusion (I/R) injury. We investigated the action of
      anti-C5 monoclonal antibody (mAb) on local and remote organ injuries after
      intestinal I/R in the rat. METHODS: Under anesthesia, functional anti-rat C5 mAb
      (18A), an isotype-matched control anti-C5 mAb (16C), or vehicle (phosphate
      buffered saline) was administered 60 minutes before the superior mesenteric
      artery was occluded for 90 minutes and reperfused for 60 minutes. Tissue injury
      was assessed by lactate dehydrogenase release, myeloperoxidase activity, and
      microvessel relaxation. Tumor necrosis factor (TNF)-alpha, interleukin (IL)
      1alpha, and intercellular adhesion molecule (ICAM)-1 expression was assessed by
      reverse-transcription polymerase chain reaction and immunohistochemistry.
      RESULTS: The loss of endothelium-dependent relaxation of microvessels from the
      superior mesenteric artery after I/R was significantly attenuated by 18A but not
      by 16C. Intestinal lactate dehydrogenase release after I/R was significantly
      reversed by 18A treatment. Anti-C5 treatment significantly inhibited the
      increased myeloperoxidase activity in the lung and intestine after intestinal
      I/R. Furthermore, increased intestinal TNF-alpha, IL-1alpha, and vascular ICAM-1
      expression after I/R were significantly inhibited by anti-C5 mAb. CONCLUSIONS:
      Anti-C5 therapy significantly improved intestinal I/R tissue injury as well as
      lung injury.

PMID- 11208722
TI  - Adaptive cytoprotection mediated by prostaglandin I(2) is attributable to
      sensitization of CRGP-containing sensory nerves.
AB  - BACKGROUND & AIMS: The phenomenon by which the gastric mucosa is protected in
      response to mild irritants has been called adaptive cytoprotection, a mechanism
      believed to be related to production of endogenous prostaglandins (PGs). We
      tested whether PGs generated by mild irritant prevent injury through the release
      of calcitonin gene-related peptide (CGRP) from the sensory nerves using
      prostanoid receptor-knockout mice. METHODS: The stomach was doubly cannulated and
      perfused with 1 mol/L NaCl or 50% ethanol. CGRP levels in the perfusate were
      determined by enzyme immunoassay, and the injured area was estimated at the end
      of perfusion. RESULTS: Preperfusion with mildly hypertonic saline (1 mol/L NaCl)
      increased generation of gastric PGE(2) and PGI(2) and reduced ethanol-induced
      mucosal damage. Exposure of ethanol after 1 mol/L NaCl increased intragastric
      CGRP levels from 166 +/- 27 to 713 +/- 55 pg/2 min (n = 4, P < 0.05), and the
      protective action of 1 mol/L NaCl was inhibited by indomethacin treatment. CGRP
      antagonist blocked 1 mol/L NaCl-induced protective effect. Intragastric perfusion
      of 50% ethanol after administration of PGI(2), but not of PGE(2), increased CGRP
      levels. Application of 1 mol/L NaCl to IP receptor-knockout mice (IP(-/-)) did
      not elicit the protective effects seen in the wild-type on ethanol-induced
      gastric mucosal lesions. Protective effect of 1 mol/L NaCl was observed in EP3
      receptor-knockout mice (EP3(-/-)). CGRP level during ethanol perfusion was not
      increased in IP(-/-) but was increased in EP3(-/-) and wild-type counterparts
      after preperfusion of 1 mol/L NaCl. CONCLUSIONS: These results indicate that the
      endogenous PGI(2) generated by 1 mol/L NaCl may have a protective role in gastric
      mucosal injury through enhancement of CGRP release from gastric mucosa. This
      mechanism may explain the adaptive cytoprotection observed after treatment with
      mild irritants.

PMID- 11208723
TI  - Na(+)-dependent fluid absorption in intact perfused rat colonic crypts.
AB  - BACKGROUND & AIMS: The traditional paradigm of fluid movement in the mammalian
      colon is that fluid absorption and secretion are present in surface and crypt
      cells, respectively. We have recently demonstrated Na(+)-dependent fluid
      absorption in isolated crypts that are devoid of neurohumoral stimulation. We now
      explore the mechanism of Na(+)-dependent fluid absorption in isolated rat colonic
      crypts. METHODS: Net fluid absorption was determined using microperfusion
      techniques and methoxy[(3)H]inulin with ion substitutions and transport
      inhibitors. RESULTS: Net fluid absorption was reduced but not abolished by
      substitution of either N-methyl-D-glucamine- Cl(-) or tetramethylammonium for
      Na(+) and by lumen addition of 5-ethylisopropyl amiloride, an amiloride analogue
      that selectively inhibits Na(+)-H(+) exchange. Net fluid absorption was also
      dependent on lumen Cl(-) because removal of lumen Cl(-) significantly (P < 0.001)
      reduced net fluid absorption. DIDS at 100 micromol/L, a concentration at which
      DIDS is an anion exchange inhibitor, minimally reduced net fluid absorption (P <
      0.05). In contrast, either 500 micromol/L DIDS, a concentration at which DIDS is
      known to act as a Cl(-) channel blocker, or 10 micromol/L NPPB, a Cl(-) channel
      blocker, both substantially inhibited net fluid absorption (P < 0.001). Finally,
      both the removal of bath Cl(-) and addition of bath bumetanide, an inhibitor of
      Na-K-2Cl cotransport and Cl(-) secretion, resulted in a significant increase in
      net fluid absorption. CONCLUSIONS: (1) Net Na(+)-dependent net fluid absorption
      in the isolated colonic crypt represents both a larger Na(+)-dependent absorptive
      process and a smaller secretory process; and (2) the absorptive process consists
      of a Na(+)-dependent, HCO(3)(-)-independent process and a Na(+)-independent, Cl(
      )-dependent, HCO(3)(-)-dependent process. Fluid movement in situ represents these
      transport processes plus fluid secretion induced by neurohumoral stimulation.

PMID- 11208724
TI  - Enhancement of jejunal absorption of conjugated bile acid by neurotensin in rats.
AB  - BACKGROUND & AIMS: Release of neurotensin (NT) from intestines is markedly
      stimulated by ingested fat, and NT may facilitate lipid digestion and absorption
      through various actions that are not fully understood. Our recent finding that NT
      stimulates hepatic output of bile acids only when bile delivery to the intestine
      is maintained has led us to investigate the effects of NT on bile acid absorption
      in the rat small intestine. METHODS: We measured the effects of intravenous
      infusion of NT (3-10 pmol x kg(-1) x min(-1)) on biliary recovery of (3)H
      taurocholate ((3)H-TC) and (3)H-cholate administered into proximal and distal
      intestines or into isolated intestinal segments in situ in biliary fistula rats.
      To further understand the underlying mechanisms involved, the effects of NT on
      intestinal absorption of (3)H-D-glucose, (3)H-leucine, (14)C-antipyrine, and
      (51)Cr-EDTA were investigated by monitoring the absorption of radioactivity into
      superior mesenteric venous blood. RESULTS: Infusion of NT, at doses that caused
      near physiologic increases in blood NT levels, increased biliary recovery of (3)H
      TC from the jejunum (3.4-fold) and ileum (1.7-fold), but did not enhance
      absorption of (3)H-cholate. NT also facilitated transcellular uptake of (3)H
      glucose and (3)H-leucine and increased paracellular uptake to (51)Cr-EDTA and
      (3)H-mannitol, but did not alter the absorption rate for (14)C-antipyrine.
      CONCLUSIONS: These results indicate that NT can exert a facilitative effect on
      intestinal bile acid absorption and return to liver. This effect of NT may
      involve increases in paracellular absorption and carrier-mediated transport by
      mechanisms not yet identified.

PMID- 11208725
TI  - Desensitization to the effects of intravenous octreotide in cirrhotic patients
      with portal hypertension.
AB  - BACKGROUND & AIMS: Octreotide has been suggested for the treatment of variceal
      bleeding, but detailed dose-finding studies are not available. We performed a
      dose-finding study investigating the hemodynamic effects of several forms of
      intravenous octreotide administration. METHODS: Splanchnic hemodynamics and
      plasma glucagon levels were measured in 68 cirrhotics in baseline conditions and
      (1) after a double-blind intravenous injection of octreotide (50 microg [n = 9]
      or 500 microg [n = 8]) or placebo (n = 7); (2) after a 50-microg octreotide bolus
      followed by continuous infusion of 50 microg/h (n = 8), 250 microg/h (n = 8), or
      placebo (n = 6); (3) after repeated 50-microg injections of octreotide (n = 9) or
      placebo (n = 6) after an initial bolus (50 microg octreotide); and (4) after a
      placebo bolus and continuous octreotide infusion (50 microg/h; n = 7). RESULTS:
      Placebo caused no significant changes. Octreotide caused a marked and transient
      decrease in portal pressure and azygos blood flow and an increase in mean
      arterial pressure. These effects lasted only 5 minutes despite addition of
      continuous octreotide infusions. Repeated octreotide injections had shorter, less
      marked effects than the first bolus. A continuous octreotide infusion did not
      decrease portal pressure. Glucagon levels were markedly reduced by octreotide,
      but gradually returned to baseline despite continuous infusions or repeated
      injections of octreotide. CONCLUSIONS: Octreotide injection caused marked but
      transient reductions in portal pressure and azygos blood flow. Adding a
      continuous octreotide infusion neither maintained nor prolonged its effects.
      Repeated boluses caused significant tachyphylaxis. This rapid desensitization to
      the effects of octreotide may explain the divergent effects achieved with
      octreotide infusions in acute variceal bleeding.

PMID- 11208726
TI  - Factors associated with poor health-related quality of life of patients with
      cirrhosis.
AB  - BACKGROUND & AIMS: Increasing interest is being given to health-related quality
      of life in chronic diseases. In cirrhosis, both physical functioning and mental
      well-being may be altered, but no study has investigated factors associated with
      a poor perceived health status. METHODS: We measured quality of life by Short
      Form-36 and Nottingham Health Profile questionnaires in 544 patients with
      cirrhosis. Data were compared with age- and gender-adjusted values of 2 random
      samples of the Italian population (more than 2000 subjects). Factors associated
      with poor perceived health status were identified by logistic regression.
      RESULTS: All domains of health-related quality of life, except pain, were altered
      in cirrhosis (by 9%-42%), mainly in younger patients. There were minor
      differences in relation to gender, whereas etiology had no effects. Severity of
      disease (Child-Pugh score) and, above all, muscle cramps were the factors most
      closely associated with poor health status perception. Self-rating of disease
      progression was associated with ascites and pruritus, whereas previous variceal
      sclerotherapy and the use of disaccharides had a protective effect. Most areas of
      daily life were affected by perceived health problems; this was mainly true for
      paid employment and sex life in men and home life and social life in women.
      CONCLUSIONS: Quality of life is variably impaired in cirrhosis, also in
      uncomplicated patients. Non-life-threatening symptoms, such as muscle cramps, are
      of major concern. These data are the basis for longitudinal studies measuring the
      effects of therapy and procedures on patient-derived health outcomes.

PMID- 11208727
TI  - Ethanol enhances retinoic acid metabolism into polar metabolites in rat liver via
      induction of cytochrome P4502E1.
AB  - BACKGROUND & AIMS: Long-term and excessive ethanol intake results in decreased
      plasma and hepatic levels of retinoic acid (RA), the most active derivative of
      vitamin A. The decrease of RA by ethanol treatment has been proposed to be a
      cytochrome P450 enzyme (CYP)-dependent process. However, the role of the major
      ethanol-induced CYP, CYP2E1, in the metabolism of RA has not been defined.
      METHODS: In vitro incubations of RA with microsomal fractions of liver tissue
      containing CYPs from either ethanol-exposed or non-ethanol-exposed rats were
      carried out using chemical inhibitors and antibodies against various CYPs. In
      vivo, both ethanol-exposed and non-ethanol-exposed rats were treated with or
      without chlormethiazole, a specific CYP2E1 inhibitor, for 1 month. RA and its
      catabolic metabolites were analyzed by high-performance liquid chromatography and
      spectral analysis. RESULTS: Incubation of RA with the liver microsomal fraction
      from ethanol-exposed rats resulted in greater disappearance of RA and increased
      appearance of 18-hydroxy-RA and 4-oxo-RA compared with control rat liver
      microsomal fractions. The enhancement of RA catabolism by ethanol was inhibited
      by both CYP2E1 antibody and specific inhibitors (allyl sulfide and
      chlormethiazole) in a dose-dependent fashion, whereas the metabolism of RA into
      polar metabolites was abolished completely by nonspecific CYP inhibitors
      (disulfiram and liarozole). Furthermore, treatment with chlormethiazole in
      ethanol-fed rats in vivo restored both hepatic and plasma RA concentrations to
      normal levels. CONCLUSIONS: Ethanol-induced CYP2E1 plays a major role in the
      degradation of RA, which may provide a possible biochemical mechanism for chronic
      and excessive ethanol intake as a risk for both hepatic and extrahepatic cell
      proliferation and carcinogenesis.

PMID- 11208728
TI  - Nitric oxide-mediated inhibition of DNA repair potentiates oxidative DNA damage
      in cholangiocytes.
AB  - BACKGROUND & AIMS: Chronic inflammation, a risk factor for the development of
      bile duct cancer, induces inducible nitric oxide synthase (iNOS) with nitric
      oxide (NO) generation, which promotes oxidative damage of DNA, a process that
      probably is important in the initiation and progression of malignancies. Because
      inhibition of DNA repair is required for accumulation of oxidative DNA lesions,
      our aim was to determine if NO also inhibits repair of oxidative DNA damage.
      METHODS: A cholangiocarcinoma cell line and a cholangiocyte cell line were
      transfected with iNOS. RESULTS: Extracts from transfected but not untransfected
      cells were unable to repair 8-oxodeoxyguanine (8-oxodG); this effect was
      irreversible because addition of dithiothreitol to cell extracts had no effect.
      NO inhibition of 8-oxodG repair was blocked by NO scavengers but not by
      peroxynitrite scavengers or inhibitors of the soluble guanylyl cyclase/protein
      kinase G pathway. NO also potentiated hydrogen peroxide-induced DNA damage.
      Finally, immunohistochemistry in human liver samples uniformly demonstrated de
      novo expression of iNOS and the presence of 3-nitrotyrosine and 8-oxodG formation
      in the biliary epithelia of 30 patients with primary sclerosing cholangitis (a
      premalignant disease of the biliary tract) compared with controls. CONCLUSIONS:
      Collectively, these data implicate NO-mediated inhibition of 8-oxodG base
      excision DNA repair processes as a mechanism potentiating DNA damage in human
      inflammatory diseases involving the biliary tract.

PMID- 11208729
TI  - Transcription of SST2 somatostatin receptor gene in human pancreatic cancer cells
      is altered by single nucleotide promoter polymorphism.
AB  - BACKGROUND & AIMS: The somatostatin receptor SST2 mediates the antiproliferative
      effect of stable somatostatin analogues. SST2 gene expression is lost in most
      human pancreatic carcinomas. We investigated the mechanisms that could be
      involved in this defect. METHODS: SST2 gene structure was investigated by
      sequencing and restriction fragment length polymorphism. Characterization of the
      polymorphism was performed by electrophoretic mobility shift, cross-linking, and
      transcription assays. RESULTS: No major deletion of the SST2 coding sequence was
      found in pancreatic carcinoma specimens, but 2 point mutations were frequently
      detected in the promoter sequence at positions -83 (A-->G) and -57 (C-->G) from
      the major transcription initiation site. These mutations were present in
      pancreatic cancer but also in normal pancreatic tissues or leukocytes and thus
      correspond to a genetic polymorphism. In the 2 human pancreatic cancer cell lines
      MiaPaCa-2 and AsPC-1, the naturally occurring mutation -57G had no effect on
      transcription of SST2 gene, whereas -83G mutation reduced it by 60%-70%. We
      showed that the -83G mutation creates a specific binding site for the nuclear
      factor I. Cotransfection experiments showed that the nuclear factor I-A1.1
      isoform was responsible for SST2 promoter repression. CONCLUSIONS: The -83G
      polymorphism identified on human SST2 gene promoter is responsible for the
      specific fixation of nuclear factor I and repression of SST2 transcription in
      human pancreatic cancer cells. However, its contribution to pancreatic
      tumorigenesis remains unknown.

PMID- 11208731
TI  - Diffuse esophageal leiomyomatosis with perirectal involvement mimicking
      Hirschsprung disease.
AB  - We describe a 25-year-old woman with diffuse esophageal leiomyomatosis. During
      childhood, achalasia was mistakenly diagnosed in this patient. Subsequently, she
      underwent cardiomyotomy and developed symptoms of Hirschsprung disease. These
      symptoms were caused by infiltration of the esophageal and rectal walls by benign
      muscular hypertrophy. The pseudo-Hirschsprung disorder was manifested by chronic
      severe constipation, with consistent manometric findings. Clitoral hypertrophy
      and vulvar and periurethral leiomyoma were also present. Genetic analysis
      demonstrating deletion of the COL4A5/COL4A6 locus and the discovery of
      microscopic hematuria implied that the patient could transmit both diffuse
      leiomyomatosis and the Alport syndrome.

PMID- 11208730
TI  - Familial gastrointestinal stromal tumor with hyperpigmentation: association with
      a germline mutation of the c-kit gene.
AB  - We describe 2 siblings with multiple gastrointestinal stromal tumors (GISTs) and
      cutaneous hyperpigmentation. Both had a point mutation of the c-kit gene. The
      patients were sisters who had exhibited cutaneous hyperpigmentation since their
      late teens, but the diagnosis of multiple gastrointestinal submucosal tumors was
      not made until they were 41 and 45 years old. Histologic examination showed that
      these tumors were GISTs expressing CD34 and Kit protein. Both patients died of
      GISTs. Single-strand conformation polymorphism analysis showed a mutation of c
      kit in tumor DNA extracted from paraffin-embedded specimens. Direct sequencing
      analysis showed that the point mutation occurred at codon 559 of exon 11 (Val-
      >Ala). The same single-point mutation was detected in DNA extracted from
      peripheral leukocytes obtained from the younger sister and her 2 children (who
      had similar general hyperpigmentation) as well as in DNA from a skin biopsy
      specimen taken from the older sister. The germline mutation at codon 559 of the c
      kit gene found in the present familial GISTs differed from that in a previously
      reported case of familial GISTs. We propose that GISTs caused by a germline
      mutation of the c-kit gene should be referred to as GIST-cutaneous
      hyperpigmentation disease.

PMID- 11208733
TI  - Autoantibodies in liver disease.

PMID- 11208732
TI  - Chromosomal organization of candidate genes involved in cholesterol gallstone
      formation: a murine gallstone map.
AB  - Epidemiologic and family studies indicate that cholesterol gallstone formation is
      in part genetically determined. The major contribution to our current
      understanding of gallstone genes derives from animal studies, particularly cross
      breeding experiments in inbred mouse strains that differ in genetic
      susceptibility to cholesterol gallstone formation (quantitative trait loci
      mapping). In this review we summarize how the combined use of genomic strategies
      and phenotypic studies in inbred mice has proven to be a powerful means of
      dissecting the complex pathophysiology of this common disease. We present a
      "gallstone map" for the mouse, consisting of all genetic loci that have been
      identified to confer gallstone susceptibility as well as putative candidate
      genes. Translation of the genetic loci and genes between mouse and human predicts
      chromosomal regions in the human genome that are likely to harbor gallstone
      genes. Both the number and the precise understanding of gallstone genes are
      expected to further increase with rapid progress of the genome projects, and
      multiple new targets for early diagnosis and prevention of gallstone disease
      should become possible.

PMID- 11208734
TI  - Immunology of the healthy liver: old questions and new insights.

PMID- 11208735
TI  - American Gastroenterological Association medical position statement: nausea and
      vomiting.

PMID- 11208736
TI  - AGA technical review on nausea and vomiting.

PMID- 11208737
TI  - Irritable bowel syndrome in childhood.

PMID- 11208738
TI  - Chemokines regulate lymphocyte homing to the intestinal mucosa.

PMID- 11208739
TI  - Apoptosis-programmed cell death and its relevance to gastrointestinal epithelium:
      survival signal from the matrix.

PMID- 11208740
TI  - Identification of a new chloride channel: a sweet story?

PMID- 11208741
TI  - Octreotide and its effects on portal circulation.

PMID- 11208742
TI  - Chronic liver disease and health-related quality of life.

PMID- 11208743
TI  - Novel medical therapies for crohn's disease: is there room for growth?

PMID- 11208744
TI  - Management of refractory ascites: are tips or taps tops?

PMID- 11208745
TI  - Predicting the outcome of hepatitis C virus infection.

PMID- 11208746
TI  - Prokinetics reduce bacterial translocation in cirrhosis: will sweeping the gut
      keep the fluid clean?

PMID- 11208749
TI  - Effects of Blood Pressure, Smoking, and Their Interaction on Carotid Artery
      Structure and Function.
AB  - -In the present study, we examined the relationships among carotid blood
      pressure, arterial geometry, and wall stress and determined the impact of
      hypertension, smoking status, and their interaction on these relationships. The
      study involved 679 subjects aged 49 to 82 years: 372 smokers (190 men and 182
      women) and 307 nonsmokers (110 men and 197 women). Blood samples were taken to
      determine total cholesterol levels. Central pulse pressure was derived from
      measured brachial artery pressure with a linear regression equation from data
      obtained in a subgroup of 276 subjects that related brachial and carotid pulse
      pressures; the latter was measured with applanation tonometry. Carotid intima
      media thickness (IMT), lumen diameter (D), and stiffness index (SI) were
      determined with high-resolution B-mode ultrasound. Mean and pulsatile
      circumferential stress (final sigma(C)) was calculated according to the Laplace
      relationship. Indexes of arterial geometry and function were adjusted for age,
      height, and heart rate. Hypertension (treated and/or screening blood pressure of
      >140/90 mm Hg) was present in 71 nonsmokers and 186 smokers. Nonsmokers and
      smokers did not differ in blood pressure and cholesterol levels. Hypertension and
      smoking individually and interactively significantly increased adjusted IMT, D,
      and SI. The radius-to-wall thickness ratio (R/IMT) (where R=D/2) and final
      sigma(C) were increased in hypertensives. SI was correlated with IMT (r=0.56,
      P:<0.001); radius-to-wall thickness ratio was inversely correlated with central
      pulse pressure (r=-0.38, P:<0.001). Smoking did not influence these
      relationships. In conclusion, carotid artery wall remodeling appears to follow
      Laplace's law but is insufficient to prevent an increase in circumferential
      stress in hypertensive subjects. Unlike hypertension, smoking does not influence
      the lumen-to-wall ratio but has a significant effect on wall stiffness.

PMID- 11208750
TI  - Baseline Characteristics and Early Blood Pressure Control in the CONVINCE Trial.
AB  - -Blood pressure (BP) control rates around the world are suboptimal. Part 2 of the
      National Health and Nutrition Educational Survey (NHANES) III indicates that only
      27.4% of hypertensive Americans aged 18 to 74 years have a BP of <140/90 mm Hg.
      We wanted to assess BP control during the first 2 years and to describe the
      baseline characteristics of patients enrolled in the Controlled ONset Verapamil
      INvestigation of Cardiovascular Endpoints (CONVINCE) Study, an international
      clinical trial that compares outcomes in hypertensive patients randomized to
      initial treatment with either controlled-onset extended-release verapamil or the
      investigator's choice of atenolol or hydrochlorothiazide. At randomization, BP
      was <140/90 mm Hg in only 20.3% of the 16 602 subjects (average+/-SD age 65.6+/
      7.4 years; 56% women, 84% white/7% black/7% Hispanic). The average BP at
      enrollment was 148/85 mm Hg for patients taking BP medications (n=13 879) and
      161/94 mm Hg for previously untreated patients (n=2723). After medication
      titration, with a transtelephonic computer that recommended an increase in the
      dose or number of antihypertensive agents whenever the BP was 140/90 mm Hg, 84.8%
      of the subjects attained the goal BP. During 2 years of treatment, BP control was
      maintained in 67% to 69% of the subjects (69% to 71% for systolic BP of <140 mm
      Hg and 90% for diastolic BP of <90 mm Hg). These data suggest that the control of
      systolic BP is more difficult than the control of diastolic BP. The US national
      goal of having 50% of hypertensives with a BP of <140/90 mm Hg may be achievable
      if a forced titration strategy is used. Interested investigators, free care and
      medications, and well-educated subjects may make the attainment of such a goal
      easier in the CONVINCE study than in the general population.

PMID- 11208751
TI  - Baseline Characteristics of Participants in the Antihypertensive and Lipid
      Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
AB  - -Diuretics and ss-blockers have been shown to reduce the risk of cardiovascular
      morbidity and mortality in people with hypertension in long-term clinical trials.
      No study has compared newer more costly antihypertensive agents (calcium
      antagonists, ACE inhibitors, and alpha-adrenergic blockers) with diuretics for
      reducing the incidence of cardiovascular disease in an ethnically diverse group
      of middle-aged and elderly hypertensive patients. The study is a randomized,
      double-blind, active-controlled clinical trial designed to determine whether the
      incidence of the primary outcome, fatal coronary heart disease or nonfatal
      myocardial infarction, differs between treatment initiation with a diuretic
      versus each of 3 other antihypertensive drugs. Men and women aged >/=55 years
      with at least 1 other cardiovascular disease risk factor were randomly assigned
      to chlorthalidone (12.5 to 25 mg/d), amlodipine (2.5 to 10 mg/d), lisinopril (10
      to 40 mg/d), or doxazosin (2 to 8 mg/d) for planned follow-up of 4 to 8 years.
      This report describes the baseline characteristics of the Antihypertensive and
      Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants. A
      total of 42 448 participants were randomized from 625 sites in the United States,
      Canada, Puerto Rico, and the US Virgin Islands. The mean age was 67 years, with
      35% aged >/=70 years. Among those randomized, 36% were black, 19% were Hispanic,
      and 47% were women. The sample includes a high proportion of people with diabetes
      (36%), patients with existing cardiovascular disease (47%), and smokers (22%).
      There were no important differences between the randomized treatment groups at
      baseline. ALLHAT will add greatly to our understanding of the management of
      hypertension by providing an answer to the following question: are newer
      antihypertensive agents similar, superior, or inferior to traditional treatment
      with diuretics?

PMID- 11208752
TI  - Vasopeptidase Inhibition Prevents Endothelial Dysfunction of Resistance Arteries
      in Salt-Sensitive Hypertension in Comparison With Single ACE Inhibition.
AB  - -To determine whether natriuretic peptides in addition to the renin-angiotensin
      system are involved in functional and structural vascular changes in salt
      sensitive hypertension, we compared equipotent hypotensive treatment with the
      dual neutral endopeptidase/ACE inhibitor omapatrilat (35 mg. kg(-1). d(-1)) or
      the ACE inhibitor captopril (100 mg. kg(-1). d(-1)). The reactivity and geometry
      of mesenteric resistance arteries from Dahl salt-sensitive rats were studied in
      vitro under perfused and pressurized conditions. Chronic salt administration
      increased systolic blood pressure by 57+/-4 mm Hg, whereas concentrations of
      atrial natriuretic peptide were reduced in heart and in plasma (P:<0.05). In
      addition, the medial cross-sectional area of small mesenteric arteries was
      increased and endothelium-dependent relaxation in response to acetylcholine and
      contraction in response to endothelin-1 were impaired in the mesenteric arteries
      of salt-sensitive rats on a high-salt diet (P:<0.05). Concomitant treatment with
      either omapatrilat or captopril reduced the increase in systolic blood pressure
      and hypertrophic remodeling to a similar degree (P:<0.05) but affected plasma and
      cardiac atrial natriuretic peptide levels differently (P:<0.05). In addition,
      omapatrilat normalized endothelium-dependent relaxations to a greater extent than
      captopril (P:<0.05). Furthermore, vasopeptidase inhibition increased cGMP levels
      compared with captopril (P:<0.05). Contractions to endothelin-1 were normalized
      by either antihypertensive drug. These results suggest that in the Dahl rat, with
      similar reductions in systolic blood pressure, omapatrilat is superior to
      captopril in preventing impaired endothelial function in small resistance
      arteries. Thus, vasopeptidase inhibition may have therapeutic advantages of the
      prevention of changes in vascular function and structure in salt-sensitive forms
      of hypertension.

PMID- 11208753
TI  - Synergistic Antihypertensive Effects of Nifedipine on Endothelium : Concurrent
      Release of NO and Scavenging of Superoxide.
AB  - Recent studies have suggested that part of the vasorelaxation caused by
      nifedipine, a 1,4-dihydropyridine Ca(2+) antagonist, depends on the endothelium.
      To study the effect of endothelium-dependent vasorelaxation, the release of NO
      and superoxide (O(2)(-)) in the presence of nifedipine in isolated cultured
      rabbit endothelial cells was measured. Highly sensitive electrochemical
      microsensors were placed onto the cell membrane, and the kinetics of NO and O(2)(
      ) were measured simultaneously with time resolutions of 0.1 and 0.05 ms,
      respectively. Nifedipine at its therapeutical concentrations stimulated NO
      release and scavenged O(2)(-) in endothelial cells. The linear relationship
      between NO concentration and nifedipine concentration was observed in the range
      between 0.01 and 1 nmol/L. NO concentration reached a maximum of 200+/-10 nmol/L
      at 1.2 nmol/L of nifedipine. The NO concentration was approximately 50% and 30%
      of the concentration measured in the presence of receptor-dependent
      (acetylcholine) and the receptor-independent (Ca(2+) ionophore A23187) NO
      synthase (eNOS) agonists, respectively. NO release stimulated by eNOS agonists
      was followed by the generation of the NO scavenger superoxide. The concentration
      of O(2)(-) was significantly lower after stimulation with nifedipine (peak 5+/
      0.5 nmol/L) than after stimulation with acetylcholine (15+/-1 nmol/L) and Ca(2+)
      ionophore (25+/-1 nmol/L). The average rate of NO release by nifedipine is
      relatively slow (17 nmol/L per second). This is in sharp contrast to the fast
      rate of NO release by acetylcholine and Ca(2+) ionophore (40 and 300 nmol/L per
      second, respectively). These experiments show that nifedipine, apart from its
      well-known Ca(2+) antagonistic properties in vascular smooth muscle cells,
      stimulates the release of significant concentration of NO in endothelium and also
      preserves NO concentration. Both these effects may be beneficial in the treatment
      of hypertension.

PMID- 11208754
TI  - Vascular Effects of ACE Inhibition Independent of the Renin-Angiotensin System in
      Hypertensive Renovascular Disease : A Randomized, Double-Blind, Crossover Trial.
AB  - -To evaluate whether ACE inhibition and angiotensin II type 1 blockade exert
      beneficial effects on NO availability independent of their blood pressure
      lowering effect, we used a double-blind crossover design to study vascular
      function in 18 patients with hypertensive renovascular disease during 6 weeks of
      therapy with enalapril (Ena) and valsartan (Val) compared with non-renin
      angiotensin system-mediated treatment with the alpha(1)-blocker doxazosin (Dox).
      Control measurements were performed in 13 age-matched volunteers. Forearm blood
      flow was assessed with venous occlusion plethysmography, and serotonin and
      nitroprusside were used as endothelium-dependent and -independent vasodilators,
      respectively. Blood pressure was similar during all treatment periods. Serotonin
      induced vasodilation was decreased in patients during Dox treatment (n=12)
      compared with control subjects (n=13) (increase 42+/-20% versus 107+/-65%,
      P:<0.05). Crossover from Dox to Val (n=6) had no effect on serotonin response
      (increase 50+/-14%), but crossover to Ena (n=6) caused a significant improvement
      (increase 79+/-39%, P:<0.05 versus Dox). In an assessment of all patients,
      serotonin-induced vasodilation during Ena (n=12, increase 75+/-31%) was increased
      compared with both Val and Dox (43+/-14% and 42+/-20%, respectively; both P:<0.05
      versus Ena). The nitroprusside response remained unaltered during all treatment
      periods. In conclusion, ACE inhibition improves the impaired endothelium
      dependent vascular function in patients with hypertensive renovascular disease.
      This effect is unrelated to blood pressure-lowering or angiotensin II-mediated
      effects.

PMID- 11208755
TI  - Interactive Effect of Ethnicity and ACE Insertion/Deletion Polymorphism on
      Vascular Reactivity.
AB  - -Bradykinin is a potent endothelium-dependent vasodilator that contributes to the
      blood pressure lowering effect of angiotensin-converting enzyme inhibition.
      Angiotensin-converting enzyme inhibitors are widely prescribed for the treatment
      of hypertension, although the efficacy of this therapy has been reported to vary
      among different ethnic groups. To determine whether vascular sensitivity to
      bradykinin is decreased in blacks compared with whites, we measured forearm blood
      flow with venous plethysmography in response to intraarterially-administered
      bradykinin (100, 200, and 400 ng/min) under salt-controlled conditions in 28 (14
      black, 14 white) normotensive subjects genotyped for the ACE insertion/deletion
      (I:/D) polymorphism. Acetylcholine (ACh) (15, 30, and 60 ug/min) and sodium
      nitroprusside (SNP) (0.8, 1.6, and 3.2 ug/min) were infused as endothelium
      dependent and endothelium-independent controls. Compared with whites, blacks
      exhibited a blunted vasodilator response to bradykinin (maximal blood flow:
      20.4+/-2.5 versus 10.9+/-1.4 mL. 100 mL(-1). min(-1), P:=0.004) and SNP (14.1+/
      1.6 versus 9.9+/-1.7 mL. 100 mL(-1). min(-1), P:=0.05) but not to ACh (10.5+/-2.8
      versus 6.6+/-1.0 mL. 100 mL(-1). min(-1), P:=0.21). White subjects who carried at
      least 1 ACE D allele demonstrated significantly greater vasodilator responses to
      bradykinin compared with those homozygous for the I: allele (DD or I:D versus
      I:I, F=5.6, P:<0.04). In contrast, only blacks homozygous for the ACE D allele
      had a significantly greater vasodilator response to bradykinin than those who
      carried the I: allele (DD versus ID or II, F=8.3, P:=0.01). The ethnic difference
      was most pronounced in subjects heterozygous at the ACE I/D locus in which blacks
      had a markedly attenuated response to bradykinin compared with whites (F=41.0,
      P:<0.001). There was no effect of ACE I/D genotype on the vasodilator responses
      to SNP or ACh in either ethnic group. These data confirm that vascular reactivity
      to bradykinin and the endothelium-independent vasodilator SNP is decreased in
      normotensive blacks compared with whites, consistent with attenuated vascular
      smooth muscle reactivity. The data suggest that genetic variation at the ACE gene
      locus interacts with ethnicity to impact the vascular response to bradykinin.

PMID- 11208756
TI  - Hemodynamic Overload-Induced Activation of Myocardial Mitogen-Activated Protein
      Kinases In Vivo : Augmented Responses in Young Spontaneously Hypertensive Rats
      and Diminished Responses in Aged Fischer 344 Rats.
AB  - Mitogen-activated protein (MAP) kinases have been shown to be activated by
      various growth factors in cultured or isolated cardiomyocytes. However, little is
      known about the regulation of MAP kinases in vivo, especially in clinically
      important conditions, such as hypertension and senescence. In this study, we
      assessed mechanical overload-induced activation of myocardial MAP kinases in
      beating hearts from hypertensive or senescent rats. Fifteen minutes of left
      ventricular hemodynamic overload activated MAP kinase activity by 2.2-fold
      (P:<0.05) in 4-week-old Wistar-Kyoto rats. The age-matched spontaneously
      hypertensive rats had greater MAP kinase activity than did Wistar-Kyoto rats both
      at baseline (1.4 times, P:<0.05) and after the hemodynamic overload (1.7 times,
      P:<0.05). Myocardial MAP kinase protein level, assessed by Western blot analysis,
      was also higher (1.6 times, P:<0.01) in spontaneously hypertensive rats. In
      contrast, aged (18-month-old) Fischer 344 rats, which were known to have a
      diminished capacity of hypertrophy in response to mechanical stress, had lower
      MAP kinase activity both at baseline (63%, P:<0.01) and after the hemodynamic
      overload (52%, P:<0.05). Their MAP kinase protein level was lower (38%, P:<0.01)
      than that in young (6-month-old) adults. Alterations in MAP kinase may contribute
      to changes in hypertrophic response in these animals.

PMID- 11208757
TI  - Upregulated Expression of Rat Heart Intercellular Adhesion Molecule-1 in
      Angiotensin II- but Not Phenylephrine- Induced Hypertension.
AB  - -Intercellular adhesion molecule-1 (ICAM-1), part of an immunoglobulin-like
      superfamily of adhesion molecules, is involved in several cardiovascular
      diseases. We investigated whether in vivo angiotensin II (Ang II) increases ICAM
      1 in rats. Sprague-Dawley rats were infused with vehicle or Ang II (750 ug. kg(
      1). d(-1) SC) for 7 days. The contribution of Ang II receptors to ICAM-1
      expression was investigated with a nonpeptide Ang II type 1 (AT(1)) receptor
      antagonist losartan (30 mg. kg(-1). d(-1) in drinking water). Systolic blood
      pressure was elevated in Ang II-treated animals compared with sham-treated
      controls, and losartan blocked this increase. Tumor necrosis factor (TNF)-alpha
      (5 ug/kg IP bolus), a prototype inducer of ICAM-1, was administered as a positive
      control for ICAM-1 expression. After treatment, hearts were frozen in liquid
      nitrogen; homogenates were subjected to SDS-PAGE and immunoblotted with an anti
      rat ICAM-1 monoclonal antibody. We detected a predominantly high-molecular-weight
      band in homogenates from non-TNF-alpha-treated rats, which was enhanced by 80+/
      5% in TNF-alpha-treated rats. This band measured approximately 200 kDa, which is
      the molecular weight of ICAM-1 in its native dimer form. The same band was
      detected in homogenates from sham and Ang II-treated rats, with the latter
      showing a 150+/-10% increase in ICAM-1 versus sham controls. Immunoprecipitation
      of rat heart homogenates with anti-rat ICAM-1 antibody resulted in a dominant
      band of the same molecular weight as samples not treated with antibody. Losartan
      prevented enhanced expression of ICAM-1 in the presence of Ang II but had no
      effect on basal ICAM-1 expression. Phenylephrine, an alpha-agonist (3 mg. kg(-1).
      d(-1) ), was infused for 1 week but had no effect on ICAM-1 expression, even
      though systolic blood pressure was elevated to the same level as in rats treated
      with Ang II. Thus, heart ICAM-1 expression is enhanced via AT(1) receptor
      activation independent of hypertension. Ang II-induced ICAM-1 expression was time
      and dose dependent, with maximal expression occurring within 5 to 7 days at 100
      to 750 ug/kg Ang II. Immunohistochemical staining demonstrated markedly increased
      ICAM-1 levels in the perivascular area in Ang II-infused rats.
      Monocyte/macrophage accumulation was significantly greater in Ang II-treated rat
      hearts than in sham-treated hearts (10+/-1; P:<0.001; n=5). Thus during
      inflammation, overexpression of ICAM-1 may contribute to cardiovascular damage in
      diseases characterized by increased activity of the renin-angiotensin system.

PMID- 11208758
TI  - Rat Coronary Endothelial Cell Membrane Potential Responses During Hypertension.
AB  - -The purpose of this study was to provide the first membrane potential profile in
      coronary endothelial cells from normotensive sham-operated control and 1-kidney,
      1-clip renal hypertensive rats. Dilator responses were assessed in cannulated
      coronary arteries from control and 1-kidney, 1-clip rats, and the perforated
      patch-clamp method was used to compare membrane potential responses between the
      intact endothelial cells. Under these conditions, acetylcholine (100 pmol/L to 10
      umol/L) induced similar large dilations of coronary arteries from control and 1
      kidney, 1-clip rats that were associated with endothelial cell hyperpolarizing
      responses of 16+/-3 and 18+/-2 mV, respectively. Substance P (10 fmol/L to 1
      nmol/L) and bradykinin (100 fmol/L to 10 nmol/L) also substantially dilated
      coronary arteries from control rats but only induced small (2 to 4 mV)
      endothelial cell hyperpolarizing responses. These dilations, which appeared
      independent of membrane potential changes, were highly blunted or absent in
      arteries from 1-kidney, 1-clip rats. Thus, dilator responses to acetylcholine
      that are associated with large endothelial hyperpolarizing responses are normal
      in the small coronary arteries of 1-kidney, 1-clip rats. However, dilator
      response to substance P and bradykinin, which apparently are not heavily
      dependent on endothelial cell hyperpolarizations, are selectively targeted for
      impairment in the coronary arteries of this model of hypertension

PMID- 11208759
TI  - Angiotensin-(1-7)-Stimulated Nitric Oxide and Superoxide Release From Endothelial
      Cells.
AB  - -The stimulation of endothelium-dependent NO release by angiotensin-(1-7) [Ang-(1
      7)] has been indirectly shown in terms of vasodilation, which was diminished by
      NO synthase inhibition or removal of the endothelium. However, direct measurement
      of endothelium-derived NO has not been analyzed. With a selective porphyrinic
      microsensor, NO release was directly assessed from single primary cultured bovine
      aortic endothelial cells. Ang-(1-7) caused a concentration-dependent release of
      NO of 1 to 10 umol/L, which was attenuated by NO synthase inhibition. [D
      Ala(7)]Ang-(1-7) (5 umol/L), described as a selective antagonist of Ang-(1-7)
      receptors, inhibited Ang-(1-7)-induced NO release only by approximately 50%,
      whereas preincubation of bovine aortic endothelial cells with the angiotensin II
      subtype 1 and 2 receptor antagonists EXP 3174 and PD 123,177 (both at 0.1 umol/L)
      led to an inhibition of 60% and 90%, respectively. A complete blockade of the Ang
      (1-7)-induced NO release was observed on preincubation of the cells with 1 umol/L
      concentration of the bradykinin subtype 2 receptor antagonist icatibant (HOE
      140), suggesting an important role of local kinins in the action of Ang-(1-7).
      Simultaneous direct measurement of superoxide (O(2)(-)) detected by an O(2)(-)
      sensitive microsensor revealed that the moderately Ang-(1-7)-stimulated NO
      release was accompanied by a very slow concomitant O(2)(-) production with a
      relative low peak concentration in comparison to the O(2)(-) production of the
      strong NO releasers bradykinin and, especially, calcium ionophore. Thus, Ang-(1
      7) might preserve the vascular system, among others, due to its low formation of
      cytotoxic peroxynitrite by the reaction between NO and O(2)(-).

PMID- 11208760
TI  - Systemic and Regional Hemodynamic Responses to Tempol in Angiotensin II-Infused
      Hypertensive Rats.
AB  - -Recent studies have indicated that angiotensin II (Ang II) can stimulate
      oxidative stress. The present study was conducted to assess the contribution of
      oxygen radicals to hypertension and regional circulation during Ang II-induced
      hypertension. With radioactive microspheres, the responses of systemic and
      regional hemodynamics to the membrane-permeable, metal-independent superoxide
      dismutase mimetic 4-hydroxy-2,2,6,6-tetramethyl piperidinoxyl (tempol) were
      assessed in conscious Ang II-infused hypertensive rats. Ang II-infused rats (80
      ng/min SC for 12 days: n=25) showed higher mean arterial pressure (MAP: 161+/-4
      mm Hg) and total peripheral resistance (TPR: 1.59+/-0.08 mm Hg. min(-1). mL(-1))
      than vehicle-infused normotensive rats (116+/-3 mm Hg and 0.95+/-0.04 mm Hg. min(
      1). mL(-1), respectively; n=23). The blood flow rates in the brain, spleen, large
      intestine, and skin were significantly reduced in Ang II-infused rats compared
      with vehicle-infused rats, whereas rates in the lung, heart, liver, kidney,
      stomach, small intestine, mesenterium, skeletal muscle, and testis were similar.
      Vascular resistance was significantly increased in every organ studied except the
      lung, in which the resistance was similar. Tempol (216 umol/kg IV) significantly
      reduced MAP by 30+/-4% from 158+/-7 to 114+/-5 mm Hg and TPR by 35+/-6% from
      1.57+/-0.17 to 0.95+/-0.04 mm Hg. min(-1). g(-1) in Ang II-infused rats (n=9) but
      had no effect on these parameters in vehicle-infused rats (n=8). In Ang II
      infused rats, tempol did not affect regional blood flow but significantly
      decreased vascular resistance in the brain (29+/-6%), heart (31+/-6%), liver
      (37+/-7%), kidney (30+/-7%), small intestine (38+/-6%), and large intestine (47+/
      7%). Ang II-infused hypertensive rats showed doubled vascular superoxide
      production (assessed with lucigenin chemiluminescence), which was normalized by
      treatment with tempol (3 mmol/L, n=7). Further studies showed that the NO
      synthase inhibitor, N:(omega)-nitro-L-arginine methyl ester (11 umol. kg(-1).
      min(-1) IV, n=11) markedly attenuated the systemic and regional hemodynamic
      responses of tempol in Ang II-infused rats. These results suggest that in this
      model of hypertension, oxidative stress may have contributed to the alterations
      in systemic blood pressure and regional vascular resistance through inactivation
      of NO.

PMID- 11208761
TI  - Endothelin-1-Independent and Angiotensin II-Independent Induction of
      Adrenomedullin Gene Expression.
AB  - -Adrenomedullin (AM) may function as an autocrine and/or paracrine factor in the
      heart, but the exact mechanisms regulating cardiac AM gene expression are
      unknown. The aim of the present study was to characterize the precise time course
      of induction of atrial and ventricular AM gene expression during pressure
      overload and to study whether endothelin-1 or angiotensin II plays a causal role
      in the activation of cardiac AM gene expression. The pressure overload was
      produced by arginine-vasopressin (AVP, 0.05 ug/kg per minute IV) infusion for 15
      minutes, 30 minutes, 1 hour, 2 hours, or 4 hours in conscious rats. A significant
      increase in left ventricular AM mRNA levels was seen after 2 hours of pressure
      overload in the left ventricle and after 30 minutes in the left atrium. The left
      atrial immunoreactive AM (ir-AM) levels decreased significantly after 2 hours of
      pressure overload. Plasma ir-AM levels increased slightly in response to 4 hours
      of AVP infusion. Bolus injections of bosentan (mixed ET(A)/ET(B) receptor
      antagonist, 10 mg/kg IV), losartan (AT(1) receptor antagonist, 10 mg/kg IV), and
      their combination had no effect on the increase of cardiac AM mRNA and ir-AM
      levels produced by 2 hours of pressure overload. In addition, losartan, bosentan,
      and their combination did not affect plasma ir-AM levels in the vehicle-infused
      and AVP-infused animals. The present study indicates that cardiac AM gene
      expression is rapidly upregulated in response to pressure. The induction of
      ventricular and atrial AM gene expression by pressure overload is angiotensin II
      independent and endothelin-1-independent.

PMID- 11208762
TI  - Pharmacodynamic Contribution to the Vasodilator Effect of Chronic AT(1) Receptor
      Blockade in SHR.
AB  - -The present study investigated the pharmacodynamic contribution of AT(1)
      receptor blockade to the regional hemodynamic effects of long-term treatment with
      the AT(1) receptor antagonist candesartan cilexetil in adult spontaneously
      hypertensive rats (SHR). Blood pressure and Doppler flowmetry measurements were
      made during and after withdrawal of candesartan cilexetil, representing times of
      maximal and negligible blockade of AT(1) receptor-mediated vasoconstriction.
      There was marked renal, mesenteric, and hindquarter vasodilation in SHR treated
      for 4 weeks with candesartan cilexetil (2 mg/kg per day in drinking water, n=8)
      compared with vehicle (n=8). Blood pressure increased after withdrawal of
      candesartan cilexetil but was still reduced after 6 days, whereas regional flows
      and conductances did not reduce significantly compared with the last day of
      treatment. There was more prolonged inhibition of angiotensin (Ang) I-induced
      than Ang II-induced pressor responses after withdrawal of candesartan cilexetil,
      but these returned to control levels before blood pressure reached fully
      hypertensive levels. The renal and mesenteric vasoconstrictor effects of
      exogenously administered Ang I and Ang II returned to control levels just 2 days
      after withdrawal of candesartan cilexetil. Therefore, sustained inhibition of
      tonic Ang-mediated vasoconstriction caused by blockade of the AT(1) receptor is
      not the only factor contributing to the hemodynamic profile after long-term
      administration of candesartan cilexetil. In addition, compared with the vehicle
      group, blood pressures at maximum vasoconstriction and maximum vasodilation (an
      indirect measure of vascular hypertrophy) were significantly reduced in
      candesartan cilexetil-treated SHR on the last day of treatment, as was mesenteric
      media wall-to-lumen ratio in a separate group of similarly treated SHR.
      Collectively, these findings indicate that Ang-mediated vasoconstriction rapidly
      normalizes on withdrawal of AT(1) receptor blockade and that regression of
      vascular hypertrophy is important in determining blood pressure and hemodynamic
      status in candesartan cilexetil-treated SHR at this time.

PMID- 11208764
TI  - Evaluating a Model of an NRE Mediated Tissue-Specific Expression of Murine Renin
      Genes.
AB  - -We have used comparative sequence analysis to evaluate a putative silencer
      element that has been proposed to be involved in the differential tissue
      expression of the murine renin genes: Ren-1 and Ren-2. In the mouse, these genes
      share a similar pattern of tissue-specific renin expression. One significant
      difference is seen in the submandibular gland (SMG) where renin expression from
      the Ren-2 locus is 100-fold greater than the expression from the Ren-1 locus. One
      model proposes that this differential expression arises from the interplay among
      a negative regulatory element and a cAMP responsive element, their respective
      binding factors, and the disruption of the negative regulatory element by an
      insertion (M2) that is found in Ren-2 but not in Ren-1. The abrogation of the
      negative regulatory element's function as a result of the M2 insertion was
      proposed to be specifically responsible for the higher level of Ren-2 expression
      in the SMG as compared with Ren-1. We have assessed this hypothesis by looking at
      an allelic variant in the closely related mouse species M. hortulanus. This
      species shares the same high level of Ren-2 expression in the SMG as seen in
      other Ren-2 positive mouse strains. However, the Ren-2 M. hortulanus allele does
      not appear to contain the disruptive M2 element according to restriction-enzyme
      mapping. Our sequence analysis confirms that the M. hortulanus Ren-2 allele
      contains the same sequence elements present in the DBA/2 Ren-2 allele except for
      the M2 element. Moreover, the proposed negative regulatory element is intact at
      the sequence level in Ren-2 M. hortulanus allele. This analysis suggests that any
      involvement of the negative regulatory element in differential Ren-1 and Ren-2
      expression in the SMG is not as straightforward as previously hypothesized.

PMID- 11208763
TI  - Thyroid Hormone Stimulates Renin Gene Expression Through the Thyroid Hormone
      Response Element.
AB  - -We previously reported that thyroid hormone stimulates renin synthesis in vivo
      and in vitro. Here, we analyzed the 5'-flanking sequence of the human renin gene
      for promoter activity responsive to thyroid hormone using Calu-6 cells, which
      secrete renin endogenously and express thyroid hormone receptor-ss. The
      luciferase reporter gene was cloned together with 5'-flanking portions of the
      human renin gene of various lengths into the pGL3-Basic vector. Luciferase
      activity assays were performed using the Dual Luciferase Reporter Assay System.
      3,3',5-Triiodo-L-thyronine stimulated the promoter activity of pGL3-Basic
      1111/+12 and pGL3-Basic-1298/+12 by 2.3+/-0.1- and 1.7+/-0.1-fold, respectively.
      Shorter constructs (pGL3-Basic-144/+12, pGL3-Basic-226/+12, pGL3-Basic-452/+12,
      and pGL3-Basic-953/+12) were not stimulated by thyroid hormone. These results
      suggest that there is a possible thyroid hormone response element (5'-AGG TCA GGT
      CAc aat GTT CCT-3') between nucleotides -1111 and -953. In 3 constructs with site
      directed mutations in this sequence, basal promoter activities were significantly
      increased, whereas promoter activation by thyroid hormone was abolished.
      Electrophoretic mobility shift assays showed that the -1111/-953 DNA fragment of
      the intact human renin gene was bound to nuclear proteins of Calu-6 cells;
      however, none of the 3 mutant probes were bound to any nuclear proteins. These
      results suggest that thyroid hormone stimulates the promoter activity of the
      human renin gene through thyroid hormone response element-dependent mechanisms in
      Calu-6 cells.

PMID- 11208765
TI  - Differential Distribution of Bradykinin B(2) Receptors in the Rat and Human
      Cardiovascular System.
AB  - -Bradykinin, a major vasodilator peptide, plays an important role in the local
      regulation of blood pressure, blood flow, and vascular permeability; however, the
      cellular distribution of the major bradykinin B(2) receptor in the cardiovascular
      system is not precisely known. Immunoblot analysis with an anti-peptide antibody
      to the bradykinin B(2) receptor or chemical cross-linkage with [(125)I]Tyr(0)
      bradykinin revealed a band of 69+/-3 kDa at varying intensity in the homogenates
      of the endothelium and tunica media of the rat aorta and endocardium.
      Immunostaining showed that the B(2) receptor is abundant in the endothelial
      linings of the aorta, other elastic arteries, muscular arteries, capillaries,
      venules, and large veins, where it localizes preferentially to the luminal face
      of the endothelial cells. In marked contrast, small arterioles (ie, the principal
      blood-pressure regulating vessels) of the mesenterium, heart, urinary bladder,
      brain, salivary gland, and kidney had a different staining pattern in which B(2)
      receptor was prominent in the perivascular smooth muscle cells of the tunica
      media. A similar distribution pattern was found in mouse as well as in human
      tissues, indicating that the particular distribution pattern of the B(2) receptor
      in arterioles is not a species-specific phenomenon. During development, the
      distribution of B(2) receptor in the heart changes; for example, in the heart of
      newborn rats, the B(2) receptor was abundant in the myocardium, whereas in the
      adult heart, the receptor was present in the endocardium of atria,
      atrioventricular valves, and ventricles but not in the myocardium. Thus, B(2)
      receptors are localized differentially in different parts of the cardiovascular
      system: the arterioles have smooth muscle-localized B(2) receptors, and large
      elastic vessels have endothelium-localized receptors.

PMID- 11208766
TI  - Effect of Chronic Blockade of the Kallikrein-Kinin System on the Development of
      Hypertension in Rats.
AB  - -The kallikrein-kininogen-kinin system is an important vasodilator and
      vasodepressor component of the cardiovascular system. Acting mainly through B(2)
      receptors, kinins may counterbalance the pressor effect of angiotensin II, salt,
      and mineralocorticoids plus salt. Using rats lacking the bradykinin precursors
      low- and high-molecular-weight kininogen or a B(2) kinin receptor antagonist
      (icatibant), we investigated whether absence or blockade of the kallikrein-kinin
      system alters blood pressure (BP) in rats given (1) chronic infusion of Ang II,
      (2) a normal or high salt diet, or (3) chronic administration of
      deoxycorticosterone acetate (DOCA) plus salt. We confirmed the genotype and
      phenotype of Brown Norway Katholiek rats (BNK) and found that they had a G-to-A
      point mutation on the kininogen gene compared with Brown Norway (BN) and Sprague
      Dawley (SD) rats, very low levels of high-molecular-weight kininogen (17+/-3
      ng/mL) compared with BN and SD (1814+/-253 and 2397+/-302 ng/mL, respectively;
      P:<0.01), and plasma low-molecular-weight kininogen concentrations below
      detectable limits compared with 1773+/-74 and 1781+/-140 ng/mL for BN and SD,
      respectively. Basal BP was the same in BNK and BN. Chronic infusion of icatibant
      did not alter BP in BN or Wistar rats. At doses that blocked the acute effect of
      bradykinin, icatibant did not potentiate the pressor effect of a chronic
      subpressor or pressor dose of angiotensin II in male and female Wistar rats nor
      that of a high salt diet (2%) plus unilateral nephrectomy in male Wistar rats.
      Moreover, blockade of the kallikrein-kininogen-kinin system in either BN rats
      given a very high dose of icatibant or kinin-deficient rats (BNK) did not
      potentiate the pressor effect of angiotensin II (nonpressor dose) or a high salt
      (3% NaCl) diet given for 2 weeks. Established DOCA-salt hypertension was not
      exaggerated in rats treated with icatibant but was partially attenuated by
      ramipril (1.5 mg. kg(-)(1). d(-)(1) for 7 days; P:<0.002). This antihypertensive
      effect was abolished by icatibant (P:<0.002, ramipril versus ramipril plus
      icatibant). These results suggest that endogenous kinins do not participate in
      the maintenance of normal blood pressure or antagonize the development of
      hypertension induced by chronic infusion of angiotensin II, a high salt diet, or
      DOCA-salt. However, kinins appear to play an important role in the
      antihypertensive effect of angiotensin-converting enzyme inhibitors in DOCA-salt
      hypertension.

PMID- 11208767
TI  - Role of Cyclooxygenase-2-Derived Metabolites and NO in Renal Response to
      Bradykinin.
AB  - -It has been reported that bradykinin (BK) can induce or activate both
      cyclooxygenase (COX) isoforms and that the renal effects of BK seem to be
      mediated by prostaglandins and NO. The first objective of this study was to
      evaluate the relative contribution of both COX isoforms in mediating the renal
      response to BK in anesthetized dogs. The second objective was to examine whether
      COX-2 inhibition potentiates the renal effects induced by NO reduction during BK
      administration. Intrarenal BK infusion (8 ng. kg(-1). min(-1), n=6) elicited a
      significant increment in renal blood flow, sodium excretion, urine volume, and
      the fractional excretion of lithium. COX-2 inhibition (nimesulide, 5 ug. kg(-1).
      min(-1), n=6) reduced the renal vasodilatation but did not significantly modify
      the natriuresis or diuresis secondary to BK. Administration of a nonspecific
      isozyme COX inhibitor (meclofenamate, 5 ug. kg(-1). min(-1); n=6) did not induce
      greater effects than those produced by nimesulide. NO synthesis reduction (N:(G)
      nitro-L-arginine methyl ester [L-NAME], 3 ug. kg(-1). min(-1)) prevented the
      renal vasodilatation and the increment in the fractional excretion of lithium
      induced by BK but did not affect the natriuretic or diuretic response.
      Simultaneous nimesulide infusion did not modify the renal effects of L-NAME
      during BK infusion (n=6). Finally, inhibition of both COX isoforms with
      meclofenamate, in dogs treated with L-NAME (n=6), completely prevented the
      vasodilator and excretory actions of BK. The results of this study suggest that
      (1) NO and prostanoids dependent on COX-2 seem to be involved in the renal
      vasodilatation induced by BK, and (2) there is an interaction between NO and COX
      1-derived metabolites in mediating the natriuretic and diuretic response to BK.

PMID- 11208768
TI  - Expression of Ca(2+) Transport Genes in Platelets and Endothelial Cells in
      Hypertension.
AB  - -Altered Ca(2+) handling is observed in different cells in essential
      hypertension. We investigated the expression of sarco(endo)plasmic reticulum
      Ca(2+)-ATPase (SERCA) and inositol 1,4,5-trisphosphate receptor (IP(3)R) isoforms
      in platelets and aortic endothelial cells (EC) isolated from spontaneously
      hypertensive (SHR) and Wistar-Kyoto (WKY) rats by ratio reverse-transcriptase
      polymerase chain reaction (RT-PCR) analysis and Western blotting. SERCA2b and
      SERCA3 were assessed at mRNA (EC and platelets) and at protein level (platelets).
      IP(3)R1, IP(3)R2, and IP(3)R3 mRNAs were demonstrated in both cell types, but
      only IP(3)R1 and IP(3)R2 proteins were detected in platelets. Compared with WKY,
      SHR EC and platelets showed higher SERCA3 and IP(3)R2 expression and lower
      IP(3)R1 expression. We then investigated the effect of lisinopril (20 mg. kg(
      )(1). d(-)(1); 10-week treatment of 4-week-old rats or 2-week treatment of adult
      rats) and captopril (100 mg. kg(-)(1). d(-)(1); 2-week treatment of adult rats).
      Consequently, expression patterns of SERCAs and IP(3)Rs were significantly
      modified. Except for SERCAs mRNA in platelets, all differences between SHR and
      WKY disappeared. However, SERCA3 remained the predominant isoform. Both EC and
      platelets demonstrated a high equal expression of IP(3)R2 mRNA. IP(3)R1 was the
      predominant platelet protein isoform, as it was in untreated WKY. mRNA was also
      isolated from pancreatic islets of WKY and SHR, but no effect of either rat
      strain or of lisinopril treatment was observed on the expression of the studied
      genes. We hypothesize that the identical expression pattern of SERCAs and IP(3)Rs
      after treatment with ACE inhibitors represents a different nonhypertensive
      configuration, which, through changes in intracellular Ca(2+) handling, improves
      endothelial and platelet dysfunction in SHR but has no effect in WKY.

PMID- 11208769
TI  - Vascular Effects of Progesterone : Role of Cellular Calcium Regulation.
AB  - -Vascular actions of progesterone have been reported, independently of estrogen,
      affecting both blood pressure and other aspects of the cardiovascular system. To
      study possible mechanisms underlying these effects, we examined the effects of P
      in vivo in intact rats and in vitro in isolated artery and vascular smooth muscle
      cell preparations. In anesthetized Sprague-Dawley rats, bolus intravenous
      injections of P (100 ug/kg) significantly decreased pressor responses to
      norepinephrine (0.3 ug/kg). In vitro, progesterone (10(-8) to 10(-5) mmol/L)
      produced a significant, dose-dependent relaxation of isolated helical strips,
      both of rat tail artery precontracted with KCl (60 mmol/L) or arginine
      vasopressin (3 nmol/L), and of rat aorta precontracted with KCl (60 mmol/L) or
      norepinephrine (0.1 umol/L). In isolated vascular smooth muscle cells,
      progesterone (5x10(-)(7) mol/L) reversibly inhibited KCl (30 mmol/L) -induced
      elevation of cytosolic-free calcium by 64.1+/-5.5% (P:<0.05), and in whole-cell
      patch-clamp experiments, progesterone (5x10(-6) mol/L) reversibly and
      significantly blunted L-type calcium channel inward current, decreasing peak
      inward current to 65.7+/-4.3% of the control value (P:<0.05). Our results provide
      evidence that progesterone is a vasoactive hormone, inhibiting agonist-induced
      vasoconstriction. The data further suggest that progesterone effects on vascular
      tissue may, at least in part, be mediated by modulation of the L-type calcium
      channel current activity and, consequently, of cytosolic-free calcium content.

PMID- 11208770
TI  - Salicylate Inhibits Phosphorylation of the Nonreceptor Tyrosine Kinases, Proline
      Rich Tyrosine Kinase 2 and c-Src.
AB  - -The anti-inflammatory effects of salicylate are well known, but the
      intracellular mechanisms underlying those effects remain to be clarified and are
      not explained solely by an influence on cyclooxygenase activity. In the present
      study, we have used cardiac fibroblasts stimulated by either angiotensin II (Ang
      II) or platelet-derived growth factor (PDGF) to demonstrate an inhibitory effect
      of salicylate on the phosphorylation of the nonreceptor tyrosine kinases, proline
      rich tyrosine kinase 2 (PYK2) and c-Src, by immunoprecipitation and
      immunoblotting methods. This inhibition was dose dependent, with a clear effect
      observed at concentrations between 5 and 20 mmol/L salicylate. Intracellular
      Ca(2+) chelation and protein kinase C (PKC) inhibition reduced Ang II and PDGF
      induced PYK2 and c-Src phosphorylation. Salicylate significantly inhibited the
      phosphorylation of both of the tyrosine kinases activated by either ionophore
      A23187 or thapsigargin treatment, which led to an elevation of cytosolic Ca(2+).
      Activation of PKC by phorbol ester phosphorylated both PYK2 and Src, and this
      effect also was attenuated by salicylate. In contrast, salicylate had no effect
      on either the transactivation of the epidermal growth factor receptor by Ang II
      or the phosphorylation of phospholipase C-gamma by PDGF. These studies indicate a
      novel site of action for salicylate on PYK2 and c-Src phosphorylation and suggest
      that this inhibitory effect on these important signaling intermediates may be
      through a Ca(2+)- and PKC-dependent mechanism.

PMID- 11208771
TI  - Antibodies to Lysophosphatidylcholine Are Decreased in Borderline Hypertension.
AB  - -Atherosclerosis is characterized by infiltration in the lesions of cytokine
      producing T cells and macrophages, where oxidized LDL may play an important role.
      However, little is known about the role of the immune system in the development
      of hypertension. Lysophosphatidylcholine (LPC) is formed by phospholipase A(2)
      induced hydrolysis and/or by oxidation of LDL and other phospholipid-containing
      membranes. The objective of the present study was to investigate the role of
      antibodies to LPC in borderline hypertension (BHT). Seventy-five men with BHT
      were compared with 75 age-matched normotensive (NT) men (diastolic blood pressure
      85 to 94 and <80 mm Hg, respectively). Antibody levels to LPC of IgM and IgG
      isotypes and IgG subclasses were determined with ELISAs. BHT men had
      significantly lower anti-LPC antibody levels of both IgG class (P:=0.0002) and
      IgM class (P:=0.0003) than did NT controls. Subclass analysis indicated that
      IgG(1) (P:=0.0005), but not IgG(2), was decreased. Anti-LPC antibodies or
      immunoglobulin subclasses thereof were negatively associated with atherosclerosis
      on the basis of intima-media thickness (P:=0.02), metabolic factors (P:=0.02),
      smoking (P:=0.02), and endothelin (P:=0.03). LPC has proinflammatory properties
      and is toxic at higher concentrations and thus may play a role in atherogenesis.
      Furthermore, LPC functions as a vasoconstrictor in experimental systems by
      inhibiting NO-mediated vasorelaxation. An intriguing possibility is that anti-LPC
      antibodies counteract these effects. Taken together, our data indicate that anti
      LPC antibodies may constitute a novel factor in the development of hypertension
      and atherosclerosis.

PMID- 11208772
TI  - Fluid Shear Stress Reduces 11ss-Hydroxysteroid Dehydrogenase Type 2.
AB  - -In pregnancy, invading trophoblasts represent the inner vascular border of
      maternal spiral arteries and are exposed to elevated shear stress (ss) in
      hypertensive disorders. Intracellular cortisol availability is regulated by 11ss
      hydroxysteroid dehydrogenases (11ss-HSDs), thus determining body fluid volume and
      vascular responses. The impact of ss on 11ss-HSD2 activity was studied in the
      human JEG-3 cell line, a model for trophoblasts. JEG-3 cells do not express 11ss
      HSD1; however, 11ss-HSD2 message and activity are measured via cortisol/cortisone
      conversion in cell lysates, and both are reduced by ss. The reduction in 11ss
      HSD2 activity via ss is dose dependent and completely reversible after the
      discontinuation of ss. cAMP-dependent protein kinase A activation increased the
      11ss-HSD2 activity yet did not prevent the ss response. The ss response was
      completely protein kinase C independent. The mitogen-activated protein kinase
      kinase inhibitor PD-098059 enhanced 11ss-HSD2 activity in static conditions yet
      only ameliorated the ss effect. Cytochalasin D disrupts focal adhesion (FA)
      cytoskeleton interactions and abolished the ss-induced tyrosine phosphorylation
      of FA kinase dose-dependently, thus maintaining 11ss-HSD2 activity. The 11ss-HSD2
      activity was only partially restored by the tyrosine kinase inhibitor genistein;
      however, herbimycin A almost completely abolished the ss effect on 11ss-HSD2
      activity. In conclusion, JEG-3 cells express 11ss-HSD2, which is downregulated by
      ss. Regulatory mechanisms involve transcriptional control and require intact FA
      cytoskeleton signaling and phosphorylation of FA kinase. Thus, ss adds to an
      enhanced intracellular availability of cortisol, which may ultimately support a
      vasoconstrictive vascular response.

PMID- 11208773
TI  - Mycophenolate Mofetil Reduces Renal Injury in the Chronic Nitric Oxide Synthase
      Inhibition Model.
AB  - -We and others have recently shown that mycophenolate mofetil (MMF) reduces renal
      inflammation and glomerular and interstitial injury in the 5/6 renal ablation
      model. In the present study, we investigated whether MMF limits renal injury in a
      model of chronic nitric oxide (NO) inhibition associated with a high-salt diet
      and characterized by progressive systemic hypertension, albuminuria, glomerular
      sclerosis and ischemia, interstitial expansion, and progressive macrophage
      infiltration. Adult male Munich-Wistar rats were distributed among 3 groups: HS,
      rats receiving a high-salt diet (3.2% Na); HS+N, HS rats orally treated with the
      NO inhibitor N(omega)-nitro-L-arginine methyl ester (L-NAME), 25 mg. kg(-1). d(
      1); and HS+N+MMF, HS+N rats orally treated with MMF, 10 mg. kg(-1). d(-1). Renal
      hemodynamics were studied after 15 days of treatment; histological and
      immunohistochemical studies were conducted after 30 days of treatment. MMF
      treatment did not reverse the hemodynamic alterations characteristic of this
      model. Renal injury in the HS+N group was associated with macrophage and
      lymphocyte infiltration. Treatment with MMF reduced glomerular and interstitial
      injury and limited macrophage and lymphocyte infiltration. These results suggest
      that renal inflammation is a strong independent factor in the pathogenesis of the
      nephropathy associated with the HS+N model.

PMID- 11208775
TI  - Are Angiotensin II Receptor Antagonists Safe in Patients With Previous
      Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema?

PMID- 11208774
TI  - Neurovascular Contact of Cranial Nerve IX and X Root-Entry Zone in Hypertensive
      Patients.
AB  - -Neurovascular contact of the left rostral ventrolateral medulla has been
      implicated in the pathogenesis of "essential" hypertension, and recent
      intervention studies suggest that surgical decompression of the ventrolateral
      medulla lowers blood pressure in these patients. We assessed the prevalence of
      this vascular anomaly in patients with essential hypertension by using an
      advanced MRI technique. We performed MRI of the brain stem in 125 hypertensive
      patients and in 105 age-matched, sex-matched, and body mass index-matched
      normotensive control subjects. Imaging of the root-entry zone of cranial nerves
      IX and X was performed by combining a high-resolution 3D constructive
      interference in steady-state sequence with a flow-sensitive time-of-flight
      technique, and images were independently assessed by 4 readers using predefined
      criteria. Left-sided neurovascular contact was found in 23% of the hypertensive
      patients and in 16% of the normotensive individuals (P:=0.12). Blood pressure
      level, heart rate, and number of antihypertensive medications in treated
      hypertensive patients were similar among patients with positive, borderline, and
      negative brain stem findings. Our findings cast doubt on the importance of left
      sided neurovascular contact as a frequent cause of essential hypertension or as a
      major factor determining the severity of hypertension in patients with this
      anomaly.

PMID- 11208776
TI  - MexR repressor of the mexAB-oprM multidrug efflux operon of Pseudomonas
      aeruginosa: identification of MexR binding sites in the mexA-mexR intergenic
      region.
AB  - The MexR repressor of the mexAB-oprM multidrug efflux operon of Pseudomonas
      aeruginosa was purified as a C-terminal histidine-tagged protein by metal chelate
      affinity chromatography. The purified protein was shown to bind ca. 200 bp
      upstream of mexA, at two sites, each of which contains a repeat of the nucleotide
      sequence GTTGA in inverse orientation. DNA sequence analysis identified mexA and
      mexR promoters within the MexR binding regions, consistent with the previously
      observed negative regulation of mexR and mexAB-oprM expression by MexR.
      Transcription of mexA from the promoter originating within the MexR binding site
      II was confirmed and shown to be markedly enhanced in a nalB (i.e., mexR) mutant
      of P. aeruginosa. A second mexA promoter was also identified, ca. 70 bp upstream
      of mexAB-oprM, and transcription from this promoter appeared to occur in both the
      wild type and a nalB mutant. Production of MexAB-OprM in wild-type cells may be
      due to expression from a constitutively expressed proximal promoter, while MexAB
      OprM hyperexpression in nalB mutants is due to the additional expression from a
      MexR-regulated distal promoter.

PMID- 11208778
TI  - Hyperactive glycogen synthase mutants of Saccharomyces cerevisiae suppress the
      glc7-1 protein phosphatase mutant.
AB  - A yeast glc7-1 mutant expressing a variant of protein phosphatase type 1 fails to
      accumulate glycogen. This defect is associated with hyperphosphorylated and
      inactive glycogen synthase, consistent with Glc7p acting directly to
      dephosphorylate and activate glycogen synthase. To characterize the glycogen
      synthesis defect of this mutant in more detail, we isolated 26 pseudorevertants
      of the glc7-1 mutant. All pseudoreversion events were due to missense mutations
      in GSY2, the gene encoding the major isoform of glycogen synthase. A majority of
      the mutations responsible for the suppression were in the 3' end of the gene,
      corresponding to the phosphorylated COOH terminus of Gsy2p. Phosphorylation of
      the mutant proteins was reduced, suggesting that they are poor substrates for
      glycogen synthase kinases. Suppressor mutations outside this domain did not
      decrease the phosphorylation of the resulting proteins, indicating that these
      proteins are immune to the regulatory effects of phosphorylation. Since no growth
      defect has been observed for strains with altered glycogen levels, the relative
      levels of fitness of GSY2 mutants that fail to accumulate glycogen and that
      hyperaccumulate glycogen were assayed by cocultivation experiments. A wild-type
      strain outcompeted both hypo- and hyperaccumulating strains, suggesting that
      glycogen levels contribute substantially to the fitness of yeast.

PMID- 11208777
TI  - Essential PchG-dependent reduction in pyochelin biosynthesis of Pseudomonas
      aeruginosa.
AB  - The biosynthetic genes pchDCBA and pchEF, which are known to be required for the
      formation of the siderophore pyochelin and its precursors salicylate and
      dihydroaeruginoate (Dha), are clustered with the pchR regulatory gene on the
      chromosome of Pseudomonas aeruginosa. The 4.6-kb region located downstream of the
      pchEF genes was found to contain three additional, contiguous genes, pchG, pchH,
      and pchI, probably forming a pchEFGHI operon. The deduced amino acid sequences of
      PchH and PchI are similar to those of ATP binding cassette transport proteins
      with an export function. PchG is a homolog of the Yersinia pestis and Y.
      enterocolitica proteins YbtU and Irp3, which are involved in the biosynthesis of
      yersiniabactin. A null mutation in pchG abolished pyochelin formation, whereas
      mutations in pchH and pchI did not affect the amounts of salicylate, Dha, and
      pyochelin produced. The pyochelin biosynthetic genes were expressed from a vector
      promoter, uncoupling them from Fur-mediated repression by iron and PchR-dependent
      induction by pyochelin. In a P. aeruginosa mutant lacking the entire pyochelin
      biosynthetic gene cluster, the expressed pchDCBA and pchEFG genes were sufficient
      for salicylate, Dha, and pyochelin production. Pyochelin formation was also
      obtained in the heterologous host Escherichia coli expressing pchDCBA and pchEFG
      together with the E. coli entD gene, which provides a phosphopantetheinyl
      transferase necessary for PchE and PchF activation. The PchG protein was purified
      and used in combination with PchD and phosphopantetheinylated PchE and PchF in
      vitro to produce pyochelin from salicylate, L-cysteine, ATP, NADPH, and S
      adenosylmethionine. Based on this assay, a reductase function was attributed to
      PchG. In summary, this study completes the identification of the biosynthetic
      genes required for pyochelin formation from chorismate in P. aeruginosa.

PMID- 11208779
TI  - Identification of a UPC2 homolog in Saccharomyces cerevisiae and its involvement
      in aerobic sterol uptake.
AB  - Saccharomyces cerevisiae normally will not take up sterols from the environment
      under aerobic conditions. A specific mutant, upc2-1, of the predicted
      transcriptional activator UPC2 (YDR213w) has been recognized as a strain that
      allows a high level of aerobic sterol uptake. Another predicted transcriptional
      activator, the YLR228c gene product, is highly homologous to Upc2p. In fact, at
      the carboxy terminus 130 of the last 139 amino acids are similar between the two
      proteins. Since these proteins are very similar, the effect of mutations in the
      YLR228c open reading frame (ORF) was compared with like alterations in UPC2.
      First, the YLR228c ORF was insertionally inactivated and crossed with various
      UPC2 constructs. Deletion of YLR228c and UPC2 in combination resulted in
      nonviability, suggesting that the two proteins have some essential overlapping
      function. The upc2-1 point mutation responsible for aerobic sterol uptake was
      duplicated in the homologous carboxy region of the YLR228c ORF using site
      directed mutagenesis. This mutation on a high-copy vector resulted in an increase
      in sterol uptake compared to an isogenic wild-type strain. The combination of
      both point mutations resulted in the greatest level of aerobic sterol uptake.
      When the YLR228c point mutation was expressed from a low-copy vector there was
      little if any effect on sterol uptake. Gas chromatographic analysis of the
      nonsaponifiable fractions of the various strains showed that the major sterol for
      all YLR228c and UPC2 combinations was ergosterol, the consensus yeast sterol.

PMID- 11208781
TI  - Identification of a genomic island present in the majority of pathogenic isolates
      of Pseudomonas aeruginosa.
AB  - Pseudomonas aeruginosa, a ubiquitous gram-negative bacterium, is capable of
      colonizing a wide range of environmental niches and can also cause serious
      infections in humans. In order to understand the genetic makeup of pathogenic P.
      aeruginosa strains, a method of differential hybridization of arrayed libraries
      of cloned DNA fragments was developed. An M13 library of DNA from strain X24509,
      isolated from a patient with a urinary tract infection, was screened using a DNA
      probe from P. aeruginosa strain PAO1. The genome of PAO1 has been recently
      sequenced and can be used as a reference for comparisons of genetic organization
      in different strains. M13 clones that did not react with a DNA probe from PAO1
      carried X24509-specific inserts. When a similar array hybridization analysis with
      DNA probes from different strains was used, a set of M13 clones which carried
      sequences present in the majority of human P. aeruginosa isolates from a wide
      range of clinical sources was identified. The inserts of these clones were used
      to identify cosmids encompassing a contiguous 48.9-kb region of the X24509
      chromosome called PAGI-1 (for "P. aeruginosa genomic island 1"). PAGI-1 is
      incorporated in the X24509 chromosome at a locus that shows a deletion of a 6,729
      bp region present in strain PAO1. Survey of the incidence of PAGI-1 revealed that
      this island is present in 85% of the strains from clinical sources. Approximately
      half of the PAGI-1-carrying strains show the same deletion as X24509, while the
      remaining strains contain both the PAGI-1 sequences and the 6,729-bp PAO1
      segment. Sequence analysis of PAGI-1 revealed that it contains 51 predicted open
      reading frames. Several of these genes encoded products with predictable function
      based on their sequence similarities to known genes, including insertion
      sequences, determinants of regulatory proteins, a number of dehydrogenase gene
      homologs, and two for proteins of implicated in detoxification of reactive oxygen
      species. It is very likely that PAGI-1 was acquired by a large number of P.
      aeruginosa isolates through horizontal gene transfer. The selection for its
      maintenance may be the consequence of expression of any one of the genes of
      unknown function or the genes which allow P. aeruginosa to survive under the
      conditions that generate reactive oxygen species. Alternatively, one or both of
      the transcriptional regulators encoded in PAGI-1 may control the expression of
      genes in the P. aeruginosa chromosome, which provides a selective advantage for
      strains that have acquired this genomic island.

PMID- 11208780
TI  - Two-component sensor required for normal symbiotic colonization of euprymna
      scolopes by Vibrio fischeri.
AB  - The light organ of the squid Euprymna scolopes is specifically colonized to a
      high density by the marine bacterium Vibrio fischeri. To date, only a few factors
      contributing to the specificity of this symbiosis have been identified. Using a
      genetic screen for random transposon mutants defective in initiating the
      symbiotic association or in colonizing the light organ to high density, we
      identified a mutant of V. fischeri that exhibited an apparent defect in symbiosis
      initiation. This mutant was not defective in motility, luminescence, or growth in
      minimal medium, suggesting that it lacks an essential, previously unidentified
      symbiotic function. By sequence analysis, we showed that the locus inactivated in
      this mutant encodes a predicted 927-amino-acid protein with a high degree of
      similarity to the sensor component of hybrid two-component regulatory systems. We
      have therefore designated this locus rscS, for regulator of symbiotic
      colonization-sensor. Sequence analysis revealed two hydrophobic regions which may
      result in the formation of a periplasmic loop involved in signal recognition;
      PhoA fusion data supported this proposed membrane topology. We have investigated
      the start site of rscS transcription by primer extension and identified a
      putative promoter region. We hypothesize that RscS recognizes a signal associated
      with the light organ environment and responds by stimulating a putative response
      regulator that controls protein function or gene expression to coordinate early
      colonization events. Further studies on RscS, its cognate response regulator, and
      the signaling conditions will provide important insight into the interaction
      between V. fischeri and E. scolopes.

PMID- 11208783
TI  - Infrequent genetic exchange and recombination in the mitochondrial genome of
      Candida albicans.
AB  - Previous analyses of diploid nuclear genotypes have concluded that recombination
      has occurred in populations of the yeast Candida albicans. To address the
      possibilities of clonality and recombination in an effectively haploid genome, we
      sequenced seven regions of mitochondrial DNA (mtDNA) in 45 strains of C. albicans
      from human immunodeficiency virus-positive patients in Toronto, Canada, and 3
      standard reference isolates of C. albicans, CA, CAI4, and WO-1. Among a total of
      2,553 nucleotides in the seven regions, 62 polymorphic nucleotide sites and seven
      indels defined nine distinct mtDNA haplotypes among the 48 strains. Five of these
      haplotypes occurred in more than one strain, indicating clonal proliferation of
      mtDNA. Phylogenetic analysis of mtDNA haplotypes resulted in one most
      parsimonious tree. Most of the nucleotide sites undergoing parallel change in
      this tree were clustered in blocks that corresponded to sequenced regions.
      Because of the existence of these blocks, the apparent homoplasy can be
      attributed to infrequent, past genetic exchange and recombination between
      individuals and cannot be attributed to parallel mutation. Among strains sharing
      the same mtDNA haplotypes, multilocus nuclear genotypes were more similar than
      expected from a random comparison of nuclear DNA genotypes, suggesting that
      clonal proliferation of the mitochondrial genome was accompanied by clonal
      proliferation of the nuclear genome.

PMID- 11208782
TI  - Enhanced symbiotic performance by Rhizobium tropici glycogen synthase mutants.
AB  - We isolated a Tn5-induced Rhizobium tropici mutant that has enhanced capacity to
      oxidize N,N-dimethyl-p-phenylendiamine (DMPD) and therefore has enhanced
      respiration via cytochrome oxidase. The mutant had increased levels of the
      cytochromes c(1) and CycM and a small increase in the amount of cytochrome aa(3).
      In plant tests, the mutant increased the dry weight of Phaseolus vulgaris plants
      by 20 to 38% compared with the control strain, thus showing significantly
      enhanced symbiotic performance. The predicted product of the mutated gene is
      homologous to glycogen synthases from several bacteria, and the mutant lacked
      glycogen. The DNA sequence of the adjacent gene region revealed six genes
      predicted to encode products homologous to the following gene products from
      Escherichia coli: glycogen phosphorylase (glgP), glycogen branching enzyme
      (glgB), ADP glucose pyrophosphorylase (glgC), glycogen synthase (glgA),
      phosphoglucomutase (pgm), and glycogen debranching enzyme (glgX). All six genes
      are transcribed in the same direction, and analysis with lacZ gene fusions
      suggests that the first five genes are organized in one operon, although pgm
      appears to have an additional promoter; glgX is transcribed independently.
      Surprisingly, the glgA mutant had decreased levels of high-molecular-weight
      exopolysaccharide after growth on glucose, but levels were normal after growth on
      galactose. A deletion mutant was constructed in order to generate a nonpolar
      mutation in glgA. This mutant had a phenotype similar to that of the Tn5 mutant,
      indicating that the enhanced respiration and symbiotic nitrogen fixation and
      decreased exopolysaccharide were due to mutation of glgA and not to a polar
      effect on a downstream gene.

PMID- 11208784
TI  - Effects exerted by transcriptional regulator PcaU from Acinetobacter sp. strain
      ADP1.
AB  - Protocatechuate degradation is accomplished in a multistep inducible catabolic
      pathway in Acinetobacter sp. strain ADP1. The induction is brought about by the
      transcriptional regulator PcaU in concert with the inducer protocatechuate. PcaU,
      a member of the new IclR family of transcriptional regulators, was shown to play
      a role in the activation of transcription at the promoter for the structural pca
      genes, leaving open the participation of additional activators. In this work we
      show that there is no PcaU-independent transcriptional activation at the pca gene
      promoter. The minimal inducer concentration leading to an induction response is
      10(-5) M protocatechuate. The extent of expression of the pca genes was observed
      to depend on the nature of the inducing carbon source, and this is assumed to be
      caused by different internal levels of protocatechuate in the cells. The basal
      level of expression was shown to be comparatively high and to vary depending on
      the noninducing carbon source independent of PcaU. In addition to the activating
      function, in vivo results suggest a repressing function for PcaU at the pca gene
      promoter in the absence of an elevated inducer concentration. Expression at the
      pcaU gene promoter is independent of the growth condition but is subject to
      strong negative autoregulation. We propose a model in which PcaU exerts a
      repressor function both at its own promoter and at the structural gene promoter
      and in addition functions as an activator of transcription at the structural gene
      promoter at elevated inducer concentration.

PMID- 11208785
TI  - Ammonia switch-off of nitrogen fixation in the methanogenic archaeon
      Methanococcus maripaludis: mechanistic features and requirement for the novel
      GlnB homologues, NifI(1) and NifI(2).
AB  - Ammonia switch-off is the immediate inactivation of nitrogen fixation that occurs
      when a superior nitrogen source is encountered. In certain bacteria switch-off
      occurs by reversible covalent ADP-ribosylation of the dinitrogenase reductase
      protein, NifH. Ammonia switch-off occurs in diazotrophic species of the
      methanogenic Archaea as well. We showed previously that in Methanococcus
      maripaludis switch-off requires at least one of two novel homologues of glnB, a
      family of genes whose products play a central role in nitrogen sensing and
      regulation in bacteria. The novel glnB homologues have recently been named
      nifI(1) and nifI(2). Here we use in-frame deletions and genetic complementation
      analysis in M. maripaludis to show that the nifI(1) and nifI(2) genes are both
      required for switch-off. We could not detect ADP-ribosylation or any other
      covalent modification of dinitrogenase reductase during switch-off, suggesting
      that the mechanism differs from the well-studied bacterial system. Furthermore,
      switch-off did not affect nif gene transcription, nifH mRNA stability, or NifH
      protein stability. Nitrogenase activity resumed within a short time after ammonia
      was removed from a switched-off culture, suggesting that whatever the mechanism,
      it is reversible. We demonstrate the physiological importance of switch-off by
      showing that it allows growth to accelerate substantially when a diazotrophic
      culture is switched to ammonia.

PMID- 11208786
TI  - Characterization of a novel transferrin receptor in bovine strains of Pasteurella
      multocida.
AB  - Analysis of bovine respiratory isolates of Pasteurella multocida demonstrated
      that six of nine strains tested were capable of growth dependent upon bovine
      transferrin and of specifically binding ruminant transferrins. A single 82-kDa
      protein was affinity isolated from the P. multocida strains with immobilized
      bovine transferrin. In contrast to what has been observed in other species,
      binding of this protein to immobilized transferrin was specifically blocked by
      the N-lobe subfragment of bovine transferrin. A single gene encoding the 82-kDa
      protein was flanked by a leucyl-tRNA synthetase gene and an IS1060 element, in
      contrast to other species where genes encoding the two receptor proteins (TbpB
      and TbpA) are found in an operonic arrangement. A similar gene arrangement was
      observed in all of the receptor-positive strains, in spite of the observation
      that they belonged to different genomic groups. Analysis of the deduced amino
      acid sequence of the receptor protein indicated that it is a member of the TonB
      dependent outer membrane receptor family, and although it is related to
      transferrin and lactoferrin receptor proteins (TbpAs and LbpAs) from other
      species, it differs substantially from other members of this group. Amino acid
      alignments suggest that the reduced size (20 kDa smaller) of the P. multocida
      TbpA is primarily due to the absence of larger predicted external loops.
      Collectively these results suggest that P. multocida has a single, novel receptor
      protein (TbpA) that is capable of efficiently mediating iron acquisition from
      bovine transferrin without the involvement of a second receptor protein (TbpB).

PMID- 11208788
TI  - Transfer protein TraY of plasmid R1 stimulates TraI-catalyzed oriT cleavage in
      vivo.
AB  - The effect of TraY protein on TraI-catalyzed strand scission at the R1 transfer
      origin (oriT) in vivo was investigated. As expected, the cleavage reaction was
      not detected in Escherichia coli cells expressing tral and the integration host
      factor (IHF) in the absence of other transfer proteins. The TraM dependence of
      strand scission was found to be inversely correlated with the presence of TraY.
      Thus, the TraY and TraM proteins could each enhance cleaving activity at oriT in
      the absence of the other. In contrast, no detectable intracellular cleaving
      activity was exhibited by TraI in an IHF mutant strain despite the additional
      presence of both TraM and TraY. An essential role for IHF in this reaction in
      vivo is, therefore, implied. Mobilization experiments employing recombinant R1
      oriT constructions and a heterologous conjugative helper plasmid were used to
      investigate the independent contributions of TraY and TraM to the R1 relaxosome
      during bacterial conjugation. In accordance with earlier observations, traY was
      dispensable for mobilization in the presence of traM, but mobilization did not
      occur in the absence of both traM and traY. Interestingly, although the cleavage
      assays demonstrate that TraM and TraY independently promote strand scission in
      vivo, TraM remained essential for mobilization of the R1 origin even in the
      presence of TraY. These findings suggest that, whereas TraY and TraM function may
      overlap to a certain extent in the R1 relaxosome, TraM additionally performs a
      second function that is essential for successful conjugative transmission of
      plasmid DNA.

PMID- 11208787
TI  - Natural genetic transformation of Streptococcus mutans growing in biofilms.
AB  - Streptococcus mutans is a bacterium that has evolved to be dependent upon a
      biofilm "lifestyle" for survival and persistence in its natural ecosystem, dental
      plaque. We initiated this study to identify the genes involved in the development
      of genetic competence in S. mutans and to assay the natural genetic
      transformability of biofilm-grown cells. Using genomic analyses, we identified a
      quorum-sensing peptide pheromone signaling system similar to those previously
      found in other streptococci. The genetic locus of this system comprises three
      genes, comC, comD, and comE, that encode a precursor to the peptide competence
      factor, a histidine kinase, and a response regulator, respectively. We deduced
      the sequence of comC and its active pheromone product and chemically synthesized
      the corresponding 21-amino-acid competence-stimulating peptide (CSP). Addition of
      CSP to noncompetent cells facilitated increased transformation frequencies, with
      typically 1% of the total cell population transformed. To further confirm the
      roles of these genes in genetic competence, we inactivated them by insertion
      duplication mutagenesis or allelic replacement followed by assays of
      transformation efficiency. We also demonstrated that biofilm-grown S. mutans
      cells were transformed at a rate 10- to 600-fold higher than planktonic S. mutans
      cells. Donor DNA included a suicide plasmid, S. mutans chromosomal DNA harboring
      a heterologous erythromycin resistance gene, and a replicative plasmid. The cells
      were optimally transformed during the formation of 8- to 16-h-old biofilms
      primarily consisting of microcolonies on solid surfaces. We also found that dead
      cells in the biofilms could act as donors of a chromosomally encoded antibiotic
      resistance determinant. This work demonstrated that a peptide pheromone system
      controls genetic competence in S. mutans and that the system functions optimally
      when the cells are living in actively growing biofilms.

PMID- 11208789
TI  - Diel expression of cell cycle-related genes in synchronized cultures of
      Prochlorococcus sp. strain PCC 9511.
AB  - The cell cycle of the chlorophyll b-possessing marine cyanobacterium
      Prochlorococcus is highly synchronized under natural conditions. To understand
      the underlying molecular mechanisms we cloned and sequenced dnaA and ftsZ, two
      key cell cycle-associated genes, and studied their expression. An axenic culture
      of Prochlorococcus sp. strain PCC 9511 was grown in a turbidostat with a 12 h-12
      h light-dark cycle for 2 weeks. During the light periods, a dynamic light regimen
      was used in order to simulate the natural conditions found in the upper layers of
      the world's oceans. This treatment resulted in strong cell cycle synchronization
      that was monitored by flow cytometry. The steady-state mRNA levels of dnaA and
      ftsZ were monitored at 4-h intervals during four consecutive division cycles.
      Both genes exhibited clear diel expression patterns with mRNA maxima during the
      replication (S) phase. Western blot experiments indicated that the peak of FtsZ
      concentration occurred at night, i.e., at the time of cell division. Thus, the
      transcript accumulation of genes involved in replication and division is
      coordinated in Prochlorococcus sp. strain PCC 9511 and might be crucial for
      determining the timing of DNA replication and cell division.

PMID- 11208790
TI  - Lowering S-adenosylmethionine levels in Escherichia coli modulates C-to-T
      transition mutations.
AB  - Deoxycytosine methylase (Dcm) enzyme activity causes mutagenesis in vitro either
      directly by enzyme-induced deamination of cytosine to uracil in the absence of
      the methyl donor, S-adenosylmethionine (SAM), or indirectly through spontaneous
      deamination of [5-methyl]cytosine to thymine. Using a Lac reversion assay, we
      investigated the contribution of the first mechanism to Dcm mutagenesis in vivo
      by lowering the levels of SAM. Escherichia coli SAM levels were lowered by
      reducing SAM synthetase activity via the introduction of a metK84 allele or by
      hydrolyzing SAM using the bacteriophage T3 SAM hydrolase. The metK84 strains
      exhibited increased C-to-T mutagenesis. Expression of the T3 SAM hydrolase gene,
      under the control of the arabinose-inducible P(BAD) promoter, effectively reduced
      Dcm-mediated genomic DNA methylation. However, increased mutagenesis was not
      observed until extremely high arabinose concentrations were used, and genome
      methylation at Dcm sites was negligible.

PMID- 11208791
TI  - p-Hydroxyphenylacetic Acid Metabolism in Pseudomonas putida F6.
AB  - Pseudomonas putida F6 was found to metabolize p-hydroxyphenylacetic acid through
      3,4-dihydroxyphenylacetic acid, 3,4-dihydroxymandelic acid, and 3,4
      dihydroxybenzaldehyde. Cell extracts of P. putida F6 catalyze the NAD(P)H
      independent hydroxylation of p-hydroxyphenylacetic acid to 3,4
      dihydroxyphenylacetic acid which is further oxidized to 3,4-dihydroxymandelic
      acid. Oxidation and decarboxylation of the latter yields 3,4
      dihydroxybenzaldehyde. A red-brown color accompanies all of the above enzyme
      activities and is probably due to the polymerization of quinone-like compounds.
      3,4-Dihydroxybenzaldehyde is further metabolized through extradiol ring cleavage.

PMID- 11208792
TI  - Analysis of lipooligosaccharide biosynthesis in the Neisseriaceae.
AB  - Neisserial lipooligosaccharide (LOS) contains three oligosaccharide chains,
      termed the alpha, beta, and gamma chains. We used Southern hybridization
      experiments on DNA isolated from various Neisseria spp. to determine if strains
      considered to be nonpathogenic possessed DNA sequences homologous with genes
      involved in the biosynthesis of these oligosaccharide chains. The presence or
      absence of specific genes was compared to the LOS profiles expressed by each
      strain, as characterized by their mobilities on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis gel and their reactivities with various LOS
      specific monoclonal antibodies. A great deal of heterogeneity was seen with
      respect to the presence of genes encoding glycosyltransferases in Neisseria. All
      pathogenic species were found to possess DNA sequences homologous with the lgt
      gene cluster, a group of genes needed for the synthesis of the alpha chain. Some
      of these genes were also found to be present in strains considered to be
      nonpathogenic, such as Neisseria lactamica, N. subflava, and N. sicca. Some
      nonpathogenic Neisseria spp. were able to express high-molecular-mass LOS
      structures, even though they lacked the DNA sequences homologous with rfaF, a
      gene whose product must act before gonococcal and meningococcal LOS can be
      elongated. Using a PCR amplification strategy, in combination with DNA
      sequencing, we demonstrated that N. subflava 44 possessed lgtA, lgtB, and lgtE
      genes. The predicted amino acid sequence encoded by each of these genes suggested
      that they encoded functional proteins; however, structural analysis of LOS
      isolated from this strain indicated that the bulk of its LOS was not modified by
      these gene products. This suggests the existence of an additional regulatory
      mechanism that is responsible for the limited expression of these genes in this
      strain.

PMID- 11208793
TI  - Structural and immunochemical characterization of the lipooligosaccharides
      expressed by Neisseria subflava 44.
AB  - Neisserial lipooligosaccharides (LOSs) are a family of complex cell surface
      glycolipids. We used mass spectrometry techniques (electrospray ionization,
      collision-induced dissociation, and multiple step), combined with fluorophore
      assisted carbohydrate electrophoresis monosaccharide composition analysis, to
      determine the structure of the two low-molecular-mass LOS molecules (LOSI and
      LOSII) expressed by Neisseria subflava 44. We determined that LOSI contains one
      glucose on both the alpha and beta chains. LOSII is structurally related to LOSI
      and differs from it by the addition of a hexose (either glucose or galactose) on
      the alpha chain. LOSI and LOSII were able to bind monoclonal antibody (MAb) 25-1
      LC1 when analyzed by Western blotting experiments. We used a set of genetically
      defined Neisseria gonorrhoeae mutants that expressed single defined LOS epitopes
      and a group of Neisseria meningitidis strains that expresses chemically defined
      LOS components to determine the structures recognized by MAb 25-1-LC1. We found
      that extensions onto the beta-chain glucose of LOSI block the recognition by this
      MAb, as does further elongation from the LOSII alpha chain. The LOSI structure
      was determined to be the minimum structure that is recognized by MAb 25-1-LC1.

PMID- 11208794
TI  - Periplasmic transit and disulfide bond formation of the autotransported Shigella
      protein IcsA.
AB  - The Shigella outer membrane protein IcsA belongs to the family of type V secreted
      (autotransported) virulence factors. Members of this family mediate their own
      translocation across the bacterial outer membrane: the carboxy-terminal beta
      domain forms a beta barrel channel in the outer membrane through which the amino
      terminal alpha domain passes. IcsA, which is localized at one pole of the
      bacterium, mediates actin assembly by Shigella, which is essential for bacterial
      intracellular movement and intercellular dissemination. Here, we characterize the
      transit of IcsA across the periplasm during its secretion. We show that an
      insertion in the dsbB gene, whose gene product mediates disulfide bond formation
      of many periplasmic intermediates, does not affect the surface expression or
      unipolar targeting of IcsA. However, IcsA forms one disulfide bond in the
      periplasm in a DsbA/DsbB-dependent fashion. Furthermore, cellular fractionation
      studies reveal that IcsA has a transient soluble periplasmic intermediate. Our
      data also suggest that IcsA is folded in a proteinase K-resistant state in the
      periplasm. From these data, we propose a novel model for the secretion of IcsA
      that may be applicable to other autotransported proteins.

PMID- 11208795
TI  - Exchange of Xcp (Gsp) secretion machineries between Pseudomonas aeruginosa and
      Pseudomonas alcaligenes: species specificity unrelated to substrate recognition.
AB  - Pseudomonas aeruginosa and Pseudomonas alcaligenes are gram-negative bacteria
      that secrete proteins using the type II or general secretory pathway, which
      requires at least 12 xcp gene products (XcpA and XcpP to -Z). Despite strong
      conservation of this secretion pathway, gram-negative bacteria usually cannot
      secrete exoproteins from other species. Based on results obtained with Erwinia,
      it has been proposed that the XcpP and/or XcpQ homologs determine this secretion
      specificity (M. Linderberg, G. P. Salmond, and A. Collmer, Mol. Microbiol. 20:175
      190, 1996). In the present study, we report that XcpP and XcpQ of P. alcaligenes
      could not substitute for their respective P. aeruginosa counterparts. However,
      these complementation failures could not be correlated to species-specific
      recognition of exoproteins, since these bacteria could secrete exoproteins of
      each other. Moreover, when P. alcaligenes xcpP and xcpQ were expressed
      simultaneously in a P. aeruginosa xcpPQ deletion mutant, complementation was
      observed, albeit only on agar plates and not in liquid cultures. After growth in
      liquid culture the heat-stable P. alcaligenes XcpQ multimers were not detected,
      whereas monomers were clearly visible. Together, our results indicate that the
      assembly of a functional Xcp machinery requires species-specific interactions
      between XcpP and XcpQ and between XcpP or XcpQ and another, as yet
      uncharacterized component(s).

PMID- 11208796
TI  - Anaerobic metabolism of 3-hydroxybenzoate by the denitrifying bacterium Thauera
      aromatica.
AB  - The anaerobic metabolism of 3-hydroxybenzoate was studied in the denitrifying
      bacterium Thauera aromatica. Cells grown with this substrate were adapted to grow
      with benzoate but not with 4-hydroxybenzoate. Vice versa, 4-hydroxybenzoate-grown
      cells did not utilize 3-hydroxybenzoate. The first step in 3-hydroxybenzoate
      metabolism is a coenzyme A (CoA) thioester formation, which is catalyzed by an
      inducible 3-hydroxybenzoate-CoA ligase. The enzyme was purified and
      characterized. Further metabolism of 3-hydroxybenzoyl-CoA by cell extract
      required MgATP and was coupled to the oxidation of 2 mol of reduced viologen dyes
      per mol of substrate added. Purification of the 3-hydroxybenzoyl-CoA reducing
      enzyme revealed that this activity was due to benzoyl-CoA reductase, which
      reduced the 3-hydroxy analogue almost as efficiently as benzoyl-CoA. The further
      metabolism of the alicyclic dienoyl-CoA product containing the hydroxyl
      substitution obviously required additional specific enzymes. Comparison of the
      protein pattern of 3-hydroxybenzoate-grown cells with benzoate-grown cells
      revealed several 3-hydroxybenzoate-induced proteins; the N-terminal amino acid
      sequences of four induced proteins were determined and the corresponding genes
      were identified and sequenced. A cluster of six adjacent genes contained the
      genes for substrate-induced proteins 1 to 3; this cluster may not yet be
      complete. Protein 1 is a short-chain alcohol dehydrogenase. Protein 2 is a member
      of enoyl-CoA hydratase enzymes. Protein 3 was identified as 3-hydroxybenzoate-CoA
      ligase. Protein 4 is another member of the enoyl-CoA hydratases. In addition,
      three genes coding for enzymes of beta-oxidation were present. The anaerobic 3
      hydroxybenzoate metabolism here obviously combines an enzyme (benzoyl-CoA
      reductase) and electron carrier (ferredoxin) of the general benzoyl-CoA pathway
      with enzymes specific for the 3-hydroxybenzoate pathway. This raises some
      questions concerning the regulation of both pathways.

PMID- 11208797
TI  - Effect of sequences of the active-site dipeptides of DsbA and DsbC on in vivo
      folding of multidisulfide proteins in Escherichia coli.
AB  - We have examined the role of the active-site CXXC central dipeptides of DsbA and
      DsbC in disulfide bond formation and isomerization in the Escherichia coli
      periplasm. DsbA active-site mutants with a wide range of redox potentials were
      expressed either from the trc promoter on a multicopy plasmid or from the
      endogenous dsbA promoter by integration of the respective alleles into the
      bacterial chromosome. The dsbA alleles gave significant differences in the yield
      of active murine urokinase, a protein containing 12 disulfides, including some
      that significantly enhanced urokinase expression over that allowed by wild-type
      DsbA. No direct correlation between the in vitro redox potential of dsbA variants
      and the urokinase yield was observed. These results suggest that the active-site
      CXXC motif of DsbA can play an important role in determining the folding of
      multidisulfide proteins, in a way that is independent from DsbA's redox
      potential. However, under aerobic conditions, there was no significant difference
      among the DsbA mutants with respect to phenotypes depending on the oxidation of
      proteins with few disulfide bonds. The effect of active-site mutations in the
      CXXC motif of DsbC on disulfide isomerization in vivo was also examined. A
      library of DsbC expression plasmids with the active-site dipeptide randomized was
      screened for mutants that have increased disulfide isomerization activity. A
      number of DsbC mutants that showed enhanced expression of a variant of human
      tissue plasminogen activator as well as mouse urokinase were obtained. These DsbC
      mutants overwhelmingly contained an aromatic residue at the C-terminal position
      of the dipeptide, whereas the N-terminal residue was more diverse. Collectively,
      these data indicate that the active sites of the soluble thiol- disulfide
      oxidoreductases can be modulated to enhance disulfide isomerization and protein
      folding in the bacterial periplasmic space.

PMID- 11208798
TI  - Subunit interactions and glutamine utilization by Escherichia coli imidazole
      glycerol phosphate synthase.
AB  - A selection strategy has been developed to identify amino acid residues involved
      in subunit interactions that coordinate the two half-reactions catalyzed by
      glutamine amidotransferases. The protein structures known for this class of
      enzymes have revealed that ammonia is shuttled over long distances and that each
      amidotransferase evolved different molecular tunnels for this purpose. The
      heterodimeric Escherichia coli imidazole glycerol phosphate (IGP) synthase was
      probed to assess if residues in the substrate amination subunit (HisF) are
      critical for the glutaminase activity in the HisH subunit. The activity of the
      HisH subunit is dependent upon binding of the nucleotide substrate at the HisF
      active site. This regulatory function has been exploited as a biochemical
      selection of mutant HisF subunits that retain full activity with ammonia as a
      substrate but, when constituted as a holoenzyme with wild-type HisH, impair the
      glutamine-dependent activity of IGP synthase. The steady-state kinetic constants
      for these IGP synthases with HisF alleles showed three distinct effects depending
      upon the site of mutation. For example, mutation of the R5 residue has similar
      effects on the glutamine-dependent amidotransfer reaction; however, k(cat)/K(m)
      for the glutaminase half-reaction was increased 10-fold over that for the wild
      type enzyme with nucleotide substrate. This site appears essential for coupling
      of the glutamine hydrolysis and ammonia transfer steps and is the first example
      of a site remote to the catalytic triad that modulates the process. The results
      are discussed in the context of recent X-ray crystal structures of glutamine
      amidotransferases that relate the glutamine binding and acceptor binding sites.

PMID- 11208800
TI  - Size comparisons among integral membrane transport protein homologues in
      bacteria, Archaea, and Eucarya.
AB  - Integral membrane proteins from over 20 ubiquitous families of channels,
      secondary carriers, and primary active transporters were analyzed for average
      size differences between homologues from the three domains of life: Bacteria,
      Archaea, and Eucarya. The results showed that while eucaryotic homologues are
      consistently larger than their bacterial counterparts, archaeal homologues are
      significantly smaller. These size differences proved to be due primarily to
      variations in the sizes of hydrophilic domains localized to the N termini, the C
      termini, or specific loops between transmembrane alpha-helical spanners,
      depending on the family. Within the Eucarya domain, plant homologues proved to be
      substantially smaller than their animal and fungal counterparts. By contrast,
      extracytoplasmic receptors of ABC-type uptake systems in Archaea proved to be
      larger on average than those of their bacterial homologues, while cytoplasmic
      enzymes from different organisms exhibited little or no significant size
      differences. These observations presumably reflect evolutionary pressure and
      molecular mechanisms that must have been operative since these groups of
      organisms diverged from each other.

PMID- 11208799
TI  - Chlorocatechols substituted at positions 4 and 5 are substrates of the broad
      spectrum chlorocatechol 1,2-dioxygenase of Pseudomonas chlororaphis RW71.
AB  - The nucleotide sequence of a 10,528-bp region comprising the chlorocatechol
      pathway gene cluster tetRtetCDEF of the 1,2,3,4-tetrachlorobenzene via the
      tetrachlorocatechol-mineralizing bacterium Pseudomonas chlororaphis RW71 (T.
      Potrawfke, K. N. Timmis, and R.-M. Wittich, Appl. Environ. Microbiol. 64:3798
      3806, 1998) was analyzed. The chlorocatechol 1,2-dioxygenase gene tetC was cloned
      and overexpressed in Escherichia coli. The recombinant gene product was purified,
      and the alpha,alpha-homodimeric TetC was characterized. Electron paramagnetic
      resonance measurements confirmed the presence of a high-spin-state Fe(III) atom
      per monomer in the holoprotein. The productive transformation by purified TetC of
      chlorocatechols bearing chlorine atoms in positions 4 and 5 provided strong
      evidence for a significantly broadened substrate spectrum of this dioxygenase
      compared with other chlorocatechol dioxygenases. The conversion of 4,5-dichloro-
      or tetrachlorocatechol, in the presence of catechol, displayed strong competitive
      inhibition of catechol turnover. 3-Chlorocatechol, however, was simultaneously
      transformed, with a rate similar to that of the 4,5-halogenated catechols,
      indicating similar specificity constants. These novel characteristics of TetC
      thus differ significantly from results obtained from hitherto analyzed catechol
      1,2-dioxygenases and chlorocatechol 1,2-dioxygenases.

PMID- 11208801
TI  - Cooperativity between KorB and TrbA repressors of broad-host-range plasmid RK2.
AB  - The KorB and TrbA proteins of broad-host-range plasmid RK2 are key regulators of
      the plasmid genes required for conjugative transfer. trbBp is the primary
      promoter responsible for expression of mating pair formation genes. We show that
      despite the targets for KorB and TrbA at trbBp being about 165 bp apart, 189 bp
      upstream of the transcription start point and overlapping the -10 region,
      respectively, these two proteins show up to 10-fold cooperativity for the
      repression of trbBp. Deletion analysis of TrbA showed that the C-terminal domain
      (CTD), which has a high degree of sequence conservation with the CTD of KorA, is
      required for this cooperativity with KorB. Western blotting demonstrated that the
      apparently mutual enhancement of repression is not due simply to elevation of
      repressor level by the presence of the second protein, suggesting that the basis
      for cooperativity is interaction between KorB and TrbA bound at their respective
      operators.

PMID- 11208802
TI  - Evidence of multiple regulatory functions for the PtsN (IIA(Ntr)) protein of
      Pseudomonas putida.
AB  - The ptsN gene of Pseudomonas putida encodes IIA(Ntr), a protein of the
      phosphoenol pyruvate:sugar phosphotransferase (PTS) system which is required for
      the C source inhibition of the sigma(54)-dependent promoter Pu of the TOL
      (toluate degradation) plasmid pWW0. Using two-dimensional gel electrophoresis, we
      have examined the effect of ptsN disruption on the general expression pattern of
      P. putida. To this end, cells were grown in the presence or absence of glucose,
      and a 1,117-spot subset of the P. putida proteome was used as a reference for
      comparisons. Among all gene products whose expression was lowered by this carbon
      source (247 spots [about 22%]), only 6 behaved as Pu (i.e., were depressed in the
      ptsN background). This evidenced only a minor role for IIA(Ntr) in the extensive
      inhibition of gene expression in P. putida caused by glucose. However, the same
      experiments revealed a large incidence of glucose-independent effects brought
      about by the ptsN mutation. As many as 108 spots (ca. 9% of the cell products
      analyzed) were influenced, positively or negatively, by the loss of IIA(Ntr). By
      matching this pattern with that of an rpoN::OmegaKm strain of P. putida, which
      lacks the sigma(54) protein, we judge that most proteins whose expression was
      affected by ptsN were unrelated to the alternative sigma factor. These data
      suggest a role of IIA(Ntr) as a general regulator, independent of the presence of
      repressive carbon sources and not limited to sigma(54)-dependent genes.

PMID- 11208803
TI  - Connection between poly-beta-hydroxybutyrate biosynthesis and growth on C(1) and
      C(2) compounds in the methylotroph Methylobacterium extorquens AM1.
AB  - Several DNA regions containing genes involved in poly-beta-hydroxybutyrate (PHB)
      biosynthesis and degradation and also in fatty acid degradation were identified
      from genomic sequence data and have been characterized in the serine cycle
      facultative methylotroph Methylobacterium extorquens AM1. Genes involved in PHB
      biosynthesis include those encoding beta-ketothiolase (phaA), NADPH-linked
      acetoacetyl coenzyme A (acetyl-CoA) reductase (phaB), and PHB synthase (phaC).
      phaA and phaB are closely linked on the chromosome together with a third gene
      with identity to a regulator of PHB granule-associated protein, referred to as
      orf3. phaC was unlinked to phaA and phaB. Genes involved in PHB degradation
      include two unlinked genes predicted to encode intracellular PHB depolymerases
      (depA and depB). These genes show a high level of identity with each other at
      both DNA and amino acid levels. In addition, a gene encoding beta-hydroxybutyrate
      dehydrogenase (hbd) was identified. Insertion mutations were introduced into
      depA, depB, phaA, phaB, phaC, and hbd and also in a gene predicted to encode
      crotonase (croA), which is involved in fatty acid degradation, to investigate
      their role in PHB cycling. Mutants in depA, depB, hbd, and croA all produced
      normal levels of PHB, and the only growth phenotype observed was the inability of
      the hbd mutant to grow on beta-hydroxybutyrate. However, the phaA, phaB, and phaC
      mutants all showed defects in PHB synthesis. Surprisingly, these mutants also
      showed defects in growth on C(1) and C(2) compounds and, for phaB, these defects
      were rescued by glyoxylate supplementation. These results suggest that beta
      hydroxybutyryl-CoA is an intermediate in the unknown pathway that converts acetyl
      CoA to glyoxylate in methylotrophs and Streptomyces spp.

PMID- 11208804
TI  - Role of alginate and its O acetylation in formation of Pseudomonas aeruginosa
      microcolonies and biofilms.
AB  - Attenuated total reflection/Fourier transform-infrared spectrometry (ATR/FT-IR)
      and scanning confocal laser microscopy (SCLM) were used to study the role of
      alginate and alginate structure in the attachment and growth of Pseudomonas
      aeruginosa on surfaces. Developing biofilms of the mucoid (alginate-producing)
      cystic fibrosis pulmonary isolate FRD1, as well as mucoid and nonmucoid mutant
      strains, were monitored by ATR/FT-IR for 44 and 88 h as IR absorbance bands in
      the region of 2,000 to 1,000 cm(-1). All strains produced biofilms that absorbed
      IR radiation near 1,650 cm(-1) (amide I), 1,550 cm(-1) (amide II), 1,240 cm(-1)
      (P==O stretching, C---O---C stretching, and/or amide III vibrations), 1,100 to
      1,000 cm(-1) (C---OH and P---O stretching) 1,450 cm(-1), and 1,400 cm(-1). The
      FRD1 biofilms produced spectra with an increase in relative absorbance at 1,060
      cm(-1) (C---OH stretching of alginate) and 1,250 cm(-1) (C---O stretching of the
      O-acetyl group in alginate), as compared to biofilms of nonmucoid mutant strains.
      Dehydration of an 88-h FRD1 biofilm revealed other IR bands that were also found
      in the spectrum of purified FRD1 alginate. These results provide evidence that
      alginate was present within the FRD1 biofilms and at greater relative
      concentrations at depths exceeding 1 micrometer, the analysis range for the
      ATR/FT-IR technique. After 88 h, biofilms of the nonmucoid strains produced amide
      II absorbances that were six to eight times as intense as those of the mucoid
      FRD1 parent strain. However, the cell densities in biofilms were similar,
      suggesting that FRD1 formed biofilms with most cells at depths that exceeded the
      analysis range of the ATR/FT-IR technique. SCLM analysis confirmed this result,
      demonstrating that nonmucoid strains formed densely packed biofilms that were
      generally less than 6 micrometer in depth. In contrast, FRD1 produced
      microcolonies that were approximately 40 micrometer in depth. An algJ mutant
      strain that produced alginate lacking O-acetyl groups gave an amide II signal
      approximately fivefold weaker than that of FRD1 and produced small microcolonies.
      After 44 h, the algJ mutant switched to the nonmucoid phenotype and formed
      uniform biofilms, similar to biofilms produced by the nonmucoid strains. These
      results demonstrate that alginate, although not required for P. aeruginosa
      biofilm development, plays a role in the biofilm structure and may act as
      intercellular material, required for formation of thicker three-dimensional
      biofilms. The results also demonstrate the importance of alginate O acetylation
      in P. aeruginosa biofilm architecture.

PMID- 11208806
TI  - Starchless mutants of Chlamydomonas reinhardtii lack the small subunit of a
      heterotetrameric ADP-glucose pyrophosphorylase.
AB  - ADP-glucose synthesis through ADP-glucose pyrophosphorylase defines the major
      rate-controlling step of storage polysaccharide synthesis in both bacteria and
      plants. We have isolated mutant strains defective in the STA6 locus of the
      monocellular green alga Chlamydomonas reinhardtii that fail to accumulate starch
      and lack ADP-glucose pyrophosphorylase activity. We show that this locus encodes
      a 514-amino-acid polypeptide corresponding to a mature 50-kDa protein with
      homology to vascular plant ADP-glucose pyrophosphorylase small-subunit sequences.
      This gene segregates independently from the previously characterized STA1 locus
      that encodes the large 53-kDa subunit of the same heterotetramer enzyme. Because
      STA1 locus mutants have retained an AGPase but exhibit lower sensitivity to 3
      phosphoglyceric acid activation, we suggest that the small and large subunits of
      the enzyme define, respectively, the catalytic and regulatory subunits of AGPase
      in unicellular green algae. We provide preliminary evidence that both the small
      subunit mRNA abundance and enzyme activity, and therefore also starch metabolism,
      may be controlled by the circadian clock.

PMID- 11208805
TI  - Identification and characterization of the dif Site from Bacillus subtilis.
AB  - Bacteria with circular chromosomes have evolved systems that ensure multimeric
      chromosomes, formed by homologous recombination between sister chromosomes during
      DNA replication, are resolved to monomers prior to cell division. The chromosome
      dimer resolution process in Escherichia coli is mediated by two tyrosine family
      site-specific recombinases, XerC and XerD, and requires septal localization of
      the division protein FtsK. The Xer recombinases act near the terminus of
      chromosome replication at a site known as dif (Ecdif). In Bacillus subtilis the
      RipX and CodV site-specific recombinases have been implicated in an analogous
      reaction. We present here genetic and biochemical evidence that a 28-bp sequence
      of DNA (Bsdif), lying 6 degrees counterclockwise from the B. subtilis terminus of
      replication (172 degrees ), is the site at which RipX and CodV catalyze site
      specific recombination reactions required for normal chromosome partitioning.
      Bsdif in vivo recombination did not require the B. subtilis FtsK homologues,
      SpoIIIE and YtpT. We also show that the presence or absence of the B. subtilis
      SPbeta-bacteriophage, and in particular its yopP gene product, appears to
      strongly modulate the extent of the partitioning defects seen in codV strains
      and, to a lesser extent, those seen in ripX and dif strains.

PMID- 11208807
TI  - Cytoplasmic filament-deficient mutant of Treponema denticola has pleiotropic
      defects.
AB  - In Treponema denticola, a ribbon-like structure of cytoplasmic filaments spans
      the cytoplasm at all stages of the cell division process. Insertional
      inactivation was used as a first step to determine the function of the
      cytoplasmic filaments. A suicide plasmid was constructed that contained part of
      cfpA and a nonpolar erythromycin resistance cassette (ermF and ermAM) inserted
      near the beginning of the gene. The plasmid was electroporated into T. denticola,
      and double-crossover recombinants which had the chromosomal copy of cfpA
      insertionally inactivated were selected. Immunoblotting and electron microscopy
      confirmed the lack of cytoplasmic filaments. The mutant was further analyzed by
      dark-field microscopy to determine cell morphology and by the binding of two
      fluorescent dyes to DNA to assess the distribution of cellular nucleic acids. The
      cytoplasmic filament protein-deficient mutant exhibited pleiotropic defects,
      including highly condensed chromosomal DNA, compared to the homogeneous
      distribution of the DNA throughout the cytoplasm in a wild-type cell. Moreover,
      chains of cells are formed by the cytoplasmic filament-deficient mutant, and
      those cells show reduced spreading in agarose, which may be due to the abnormal
      cell length. The chains of cells and the highly condensed chromosomal DNA suggest
      that the cytoplasmic filaments may be involved in chromosome structure,
      segregation, or the cell division process in Treponema.

PMID- 11208808
TI  - umuDC-dnaQ Interaction and its implications for cell cycle regulation and SOS
      mutagenesis in Escherichia coli.
AB  - The Escherichia coli SOS-regulated umuDC gene products participate in a DNA
      damage checkpoint control and in translesion DNA synthesis. Specific interactions
      involving the UmuD and UmuD' proteins, both encoded by the umuD gene, and
      components of the replicative DNA polymerase, Pol III, appear to be important for
      regulating these two biological activities of the umuDC gene products. Here we
      show that overproduction of the epsilon proofreading subunit of Pol III
      suppresses the cold sensitivity normally associated with overexpression of the
      umuDC gene products. Our results suggest that this suppression is attributable to
      specific interactions between UmuD or UmuD' and the C-terminal domain of epsilon.

PMID- 11208809
TI  - Nitrogen-regulated group 2 sigma factor from Synechocystis sp. strain PCC 6803
      involved in survival under nitrogen stress.
AB  - The expression of sll1689, an open reading frame from the cyanobacterium
      Synechocystis sp. strain PCC 6803 putatively encoding a member of the sigma(70)
      family of sigma factors, appears to be regulated by the nitrogen control
      transcription factor NtcA. Disruption of sll1689 had no noticeable effect on
      exponential growth, identifying its product as a member of the group 2,
      nonessential class of sigma(70)-like sigma factors; however, this disruption
      decreased the viability of the cells after long periods of nitrogen starvation.
      We have named this gene rpoD2-V. The expression of glnN, encoding a type III
      glutamine synthetase, was impaired in strains bearing an inactivated copy of the
      rpoD2-V gene.

PMID- 11208810
TI  - Transcript analysis of multiple copies of amo (encoding ammonia monooxygenase)
      and hao (encoding hydroxylamine oxidoreductase) in Nitrosomonas europaea.
AB  - The genes encoding ammonia monooxygenase (amoCAB), hydroxylamine oxidoreductase
      (hao), and the c-type cytochrome c-554 (hcy) are present in multiple copies in
      the genome of Nitrosomonas europaea. The upstream regions of the two copies of
      amoC, the three copies of hao, and one copy of hcy were cloned and sequenced.
      Primer extension reactions were done to identify transcription start sites for
      these genes, as well as for amoA. Putative sigma(70) promoter sequences were
      found associated with all but one of the mapped transcription start sites. Primer
      extensions were done with amoC primers using RNA harvested from cells incubated
      with and without ammonium. The experiments suggested that N. europaea cells may
      be able to use different promoters in the presence and absence of ammonium.

PMID- 11208811
TI  - Experimental evolution of enzyme temperature activity profile: selection in vivo
      and characterization of low-temperature-adapted mutants of Pyrococcus furiosus
      ornithine carbamoyltransferase.
AB  - We have obtained mutants of Pyrococcus furiosus ornithine carbamoyltransferase
      active at low temperatures by selecting for complementation of an appropriate
      yeast mutant after in vivo mutagenesis. The mutants were double ones, still
      complementing at 15 degrees C, a temperature already in the psychrophilic range.
      Their kinetic analysis is reported.

PMID- 11208812
TI  - Preferential cleavage of degradative intermediates of rpsT mRNA by the
      Escherichia coli RNA degradosome.
AB  - RNase E, the principal RNase capable of initiating mRNA decay, preferentially
      attacks 5'-monophosphorylated over 5'-triphosphorylated substrates. Site-specific
      cleavage in vitro of the rpsT mRNA by RNase H directed by chimeric 2'-O-methyl
      oligonucleotides was employed to create truncated RNAs which are identical to
      authentic degradative intermediates. The rates of cleavage of two such
      intermediates by RNase E in the RNA degradosome are significantly faster (2.5- to
      8-fold) than that of intact RNA. This verifies the preference of RNase E for
      degradative intermediates and can explain the frequent "all-or-none" behavior of
      mRNAs during the decay process.

PMID- 11208813
TI  - Na(+)/glutamine (asparagine) cotransport by Staphylococcus lugdunensis and
      Corynebacterium amycolatum.
AB  - Staphylococcus lugdunensis and Corynebacterium amycolatum each have a
      Na(+)/glutamine cotransporter that displays an ordered reaction sequence at the
      extracellular surface, with sodium binding (K(m) of 6.5 mM) before glutamine
      (K(m) of 50 microM). Asparagine is low-affinity substrate (K(m) approximately 1
      mM) for each system.

PMID- 11208816
TI  - Preoperative chemoradiotherapy for esophageal cancer.

PMID- 11208814
TI  - Drosophila melanogaster casein kinase II interacts with and phosphorylates the
      basic helix-loop-helix proteins m5, m7, and m8 derived from the Enhancer of split
      complex.
AB  - Drosophila melanogaster casein kinase II (DmCKII) is composed of catalytic
      (alpha) and regulatory (beta) subunits associated as an alpha2beta2
      heterotetramer. Using the two-hybrid system, we have screened a D. melanogaster
      embryo cDNA library for proteins that interact with DmCKIIalpha. One of the cDNAs
      isolated in this screen encodes m7, a basic helix-loop-helix (bHLH)-type
      transcription factor encoded by the Enhancer of split complex (E(spl)C), which
      regulates neurogenesis. m7 interacts with DmCKIIalpha but not with DmCKIIbeta,
      suggesting that this interaction is specific for the catalytic subunit of DmCKII.
      In addition to m7, we demonstrate that DmCKIIalpha also interacts with two other
      E(spl)C-derived bHLH proteins, m5 and m8, but not with other members, such as m3
      and mC. Consistent with the specificity observed for the interaction of
      DmCKIIalpha with these bHLH proteins, sequence alignment suggests that only m5,
      m7, and m8 contain a consensus site for phosphorylation by CKII within a
      subdomain unique to these three proteins. Accordingly, these three proteins are
      phosphorylated by DmCKIIalpha, as well as by the alpha2beta2 holoenzyme purified
      from Drosophila embryos. In line with the prediction of a single consensus site
      for CKII, replacement of Ser(159) of m8 with either Ala or Asp abolishes
      phosphorylation, identifying this residue as the site of phosphorylation. We also
      demonstrate that m8 forms a direct physical complex with purified DmCKII,
      corroborating the observed two-hybrid interaction between these proteins.
      Finally, substitution of Ser(159) of m8 with Ala attenuates interaction with
      DmCKIIalpha, whereas substitution with Asp abolishes the interaction. These
      studies constitute the first demonstration that DmCKII interacts with and
      phosphorylates m5, m7, and m8 and suggest a biochemical and/or structural basis
      for the functional equivalency of these bHLH proteins that is observed in the
      context of neurogenesis.

PMID- 11208817
TI  - Markers, markers everywhere..... Prognosis in colorectal cancer--time for a new
      approach.

PMID- 11208818
TI  - Phase II trial of intratumoral administration of ONYX-015, a replication
      selective adenovirus, in patients with refractory head and neck cancer.
AB  - PURPOSE: To determine the safety, humoral immune response replication, and
      activity of multiple intratumoral injections of ONYX-015 (replication selective
      adenovirus) in patients with recurrent squamous cell carcinoma of the head and
      neck (SCCHN). PATIENTS AND METHODS: This phase II trial enrolled patients with
      SCCHN who had recurrence/relapse after prior conventional treatment. Patients
      received ONYX-015 at a dose of 2 x 10(11) particles via intratumoral injection
      for either 5 consecutive days (standard) or twice daily for 2 consecutive weeks
      (hyperfractionated) during a 21-day cycle. Patients were monitored for tumor
      response, toxicity, and antibody formation. RESULTS: Forty patients (30 standard
      and 10 hyperfractionated) received 533 injections of ONYX-015. Standard treatment
      resulted in 14% partial to complete regression, 41% stable disease, and 45%
      progressive disease rates. Hyperfractionated treatment resulted in 10% complete
      response, 62% stable disease, and 29% progressive disease rates. Treatment
      related toxicity included mild to moderate fever (67% overall) and injection site
      pain (47% on the standard regimen, 80% on the hyperfractionated regimen).
      Detectable circulating ONYX-015 genome suggestive of intratumoral replication was
      identified in 41% of tested patients on days 5 and 6 of cycle 1; 9% of patients
      had evidence of viral replication 10 days after injection during cycle 1, and no
      patients had evidence of replication > or = 22 days after injection. CONCLUSION:
      ONYX-015 can be safely administered via intratumoral injection to patients with
      recurrent/refractory SCCHN. ONYX-015 viremia is transient. Evidence of modest
      antitumoral activity is suggested.

PMID- 11208819
TI  - K-ras and p16 aberrations confer poor prognosis in human colorectal cancer.
AB  - PURPOSE: Mutations in the K-ras gene are frequent in human cancer. ras activation
      in primary cells results in a cellular senescence phenotype that is precluded by
      inactivation of p16. At the clinical level, this may imply a differential
      behavior for tumors with alternative or cooperative activation of K-ras function
      and impairment of p16 pathways. PATIENTS AND METHODS: We have determined the
      presence of mutations in the K-ras gene and the methylation status of p16
      promoter in a series of 119 prospectively collected colorectal carcinomas. p53
      mutations and p14 alternative reading frame methylation status were also
      assessed. Associations with survival were investigated. RESULTS: K-ras mutations
      were present in 44 (38%) of 115 cases, and p16 methylation was present in 42
      (37%) of 113 cases. p53 mutations were detected in 50% (56 of 115) and p14
      methylation in 29% (32 of 112) of cases. K-ras and p16 alterations were
      independent genetic events. Presence of K-ras or p16 genetic alterations
      (analyzed independently) was associated with shorter survival, although
      differences were not statistically significant. Cox analysis of the two variables
      combined showed a diminished survival as the results of an interaction between
      p16 and K-ras. Alternative alteration of K-ras and p16 genes was an independent
      prognostic factor in human colorectal cancer in univariate and multivariate
      analysis. Differences were maintained when cases undergoing radical surgery and
      without distant metastases were considered. CONCLUSION: These results suggest
      that the combined K-ras and p16 analyses may be of prognostic use in human
      colorectal cancer.

PMID- 11208820
TI  - Randomized trial of preoperative chemoradiation versus surgery alone in patients
      with locoregional esophageal carcinoma.
AB  - PURPOSE: A pilot study of 43 patients with potentially resectable esophageal
      carcinoma treated with an intensive regimen of preoperative chemoradiation with
      cisplatin, fluorouracil, and vinblastine before surgery showed a median survival
      of 29 months in comparison with the 12-month median survival of 100 historical
      controls treated with surgery alone at the same institution. We designed a
      randomized trial to compare survival for patients treated with this preoperative
      chemoradiation regimen versus surgery alone. MATERIALS AND METHODS: One hundred
      patients with esophageal carcinoma were randomized to receive either surgery
      alone (arm I) or preoperative chemoradiation (arm II) with cisplatin 20 mg/m2/d
      on days 1 through 5 and 17 through 21, fluorouracil 300 mg/m2/d on days 1 through
      21, and vinblastine 1 mg/m2/d on days 1 through 4 and 17 through 20. Radiotherapy
      consisted of 1.5-Gy fractions twice daily, Monday through Friday over 21 days, to
      a total dose of 45 Gy. Transhiatal esophagectomy with a cervical esophagogastric
      anastomosis was performed on approximately day 42. RESULTS: At median follow-up
      of 8.2 years, there is no significant difference in survival between the
      treatment arms. Median survival is 17.6 months in arm I and 16.9 months in arm
      II. Survival at 3 years was 16% in arm I and 30% in arm II (P = .15). This study
      was statistically powered to detect a relatively large increase in median
      survival from 1 year to 2.2 years, with at least 80% power. CONCLUSION: This
      randomized trial of preoperative chemoradiation versus surgery alone for patients
      with potentially resectable esophageal carcinoma did not demonstrate a
      statistically significant survival difference.

PMID- 11208821
TI  - Phase II study of docetaxel, doxorubicin, and cyclophosphamide as first-line
      chemotherapy for metastatic breast cancer.
AB  - PURPOSE: This pilot phase II study investigated the efficacy and toxicity of
      docetaxel with doxorubicin and cyclophosphamide (TAC) as first-line chemotherapy
      for anthracycline-naive patients with metastatic breast cancer. PATIENTS AND
      METHODS: Fifty-four patients received a total of 359 courses consisting of
      docetaxel 75 mg/m2 given intravenously (IV) over 1 hour, preceded by IV
      doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 for a maximum of eight 3-week
      cycles. RESULTS: After an independent panel review, the overall objective
      response rate was 77% (complete response, 6%). Overall objective response rates
      in patients with visceral, bone, and liver involvement were 82%, 82%, and 80%,
      respectively. Median duration of response was 52 weeks, and median time to
      progression was 42 weeks. With a median follow-up of 32 months, the median
      survival had not yet been reached, whereas the 2-year survival was 57%. The main
      toxicities were hematologic (neutropenia grade 3/4 in 100% of patients and 95% of
      cycles; febrile neutropenia in 34% of patients and 9% of cycles). Documented
      grade 3 infection was seen in one patient (2%) in one cycle, and no toxic death
      was reported. Severe acute or chronic nonhematologic adverse events were
      infrequent, and docetaxel-specific toxicities (such as fluid retention and nail
      changes) were mild, with only one patient being discontinued for fluid retention.
      Congestive heart failure was seen in two patients (4%). CONCLUSION: TAC is an
      active and manageable regimen that has been chosen as the basis of five
      randomized phase III trials, including two pivotal studies comparing TAC to
      fluorouracil plus doxorubicin and cyclophosphamide in the metastatic and adjuvant
      treatment of breast cancer.

PMID- 11208822
TI  - Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older
      women.
AB  - PURPOSE: To identify predictors of adjuvant tamoxifen use, side effects, and
      discontinuation in older women. PATIENTS AND METHODS: We followed a cohort of 303
      women > or = 55 years of age diagnosed with stage I or stage II breast cancer for
      nearly 3 years. Data were collected from women's surgical records and from
      computer-assisted telephone interviews at 5, 21, and 33 months after primary
      tumor therapy. RESULTS: Two hundred ninety-two (96%) of 303 patients in the study
      provided information about tamoxifen use. Tamoxifen use was reported by 189
      patients (65%); 26 (15%) discontinued use during the follow-up period. Patients
      who were 65 to 74 years of age (relative to those 55 to 64 years of age), had
      stage II disease, were estrogen receptor-positive, saw a greater number of breast
      cancer physicians, and had better perceptions of their abilities to discuss
      treatment options with physicians had greater odds of tamoxifen use. Those who
      had better physical function, had received standard primary tumor therapy, and
      had obtained helpful breast cancer information from books or magazines had lesser
      odds of tamoxifen use. Patients > or = 75 years of age (relative to those 55 to
      64 years of age) and patients with better emotional health had significantly
      lesser odds of reporting side effects. Patients who were estrogen receptor
      positive were less likely to stop taking tamoxifen; patients who experienced side
      effects were more likely to stop taking tamoxifen. CONCLUSION: Deviations from a
      prescribed course of adjuvant tamoxifen occur relatively frequently. The clinical
      consequences of this deviation need to be identified.

PMID- 11208823
TI  - Response to cyclophosphamide, methotrexate, and fluorouracil in lymph node
      positive breast cancer according to HER2 overexpression and other tumor biologic
      variables.
AB  - PURPOSE: There is considerable interest in biologic markers able to predict the
      response of cancer patients to therapy. HER2 overexpression is a potential
      indicator of responsiveness to doxorubicin and paclitaxel and of unresponsiveness
      to tamoxifen in breast carcinoma patients. However, the significance of HER2
      overexpression in responsiveness to cyclophosphamide, methotrexate, and
      fluorouracil (CMF) has remained unclear. In this study, we investigated this
      issue in the 386 breast cancer patients in the first CMF controlled clinical
      trial with a 20-year follow-up. PATIENTS AND METHODS: Node-positive breast
      carcinoma patients were randomly assigned to receive either no further treatment
      after radical mastectomy (179 women) or 12 monthly cycles of adjuvant CMF
      chemotherapy (207 women). Overexpression of HER2 and the status of other tumor
      variables was assessed by immunohistochemistry in at least 324 (84%) of the 386
      patients. Statistical analyses were performed to assess the efficacy of CMF
      treatment for the subgroups defined by HER2 and the status of other variables
      using a Bayesian approach. The end points considered were relapse-free survival
      (RFS) and cause-specific survival (CSS). RESULTS: Bayesian analysis of the
      treatment effect for HER2 and other variables indicated a clinical benefit from
      CMF treatment in all subgroups defined according to variables status. In
      particular regarding HER2 status, Bayesian estimates of RFS hazard ratios were
      equal to 0.484 and 0.641 and estimates of CSS hazard ratios were equal to 0.495
      and 0.730 for HER2-positive and -negative tumors, respectively. CONCLUSION: CMF
      treatment showed a clinical benefit in the considered subgroups, defined
      according to HER2 and other tumor variables status. Patients with HER2-positive
      or HER2-negative tumors benefit from CMF treatment, and the poor prognosis
      associated with the HER2 overexpression in the untreated group could be
      completely overcome by the chemotherapy treatment.

PMID- 11208824
TI  - Efficacy of docetaxel 60 mg/m2 in patients with metastatic breast cancer
      according to the status of anthracycline resistance.
AB  - PURPOSE: To evaluate the efficacy of docetaxel 60 mg/m2 in metastatic breast
      cancer (MBC) according to the status of anthracycline resistance. PATIENTS AND
      METHODS: Ninety-nine patients with anthracycline-resistant MBC were treated with
      docetaxel 60 mg/m2 intravenously for a 90-minute period every 3 to 4 weeks.
      Anthracycline resistance was defined as primary and secondary resistance. Primary
      resistance was defined as progression during or within 6 months after completion
      of adjuvant anthracycline, and no MBC response to a first-line regimen that
      contained anthracycline. Secondary resistance was defined as progression after a
      documented clinical response to a first-line anthracycline treatment for MBC.
      Secondary resistance was further divided into three categories: (1) absolute
      resistance, or progression during treatment with anthracycline after a period of
      response; (2) relative resistance, or progression within 6 months after
      anthracycline administration ended; and (3) sensitive regrowth, or progression
      more than 6 months after the conclusion of anthracycline administration. RESULTS:
      The response rate in the 99 patients was 35.4% (95% confidence interval, 30.1% to
      44.8%). The response rates according to the status of anthracycline resistance
      were as follows: primary resistance (n = 46), 19.6%; secondary resistance (n =
      53), 49.1% (absolute resistance [n = 16], 56.3%); relative resistance (n = 17),
      47.1%; and sensitive regrowth (n = 20), 45.0%. The median time to treatment
      failure in patients with primary resistance was 2.9 months, compared with 5.2
      months in patients with secondary resistance (P = .0022). CONCLUSION: Docetaxel
      at a dose of 60 mg/m2 seemed to be effective in MBC with secondary resistance to
      anthracycline. The status of anthracycline resistance is important for the
      prediction of response to second-line treatment with docetaxel.

PMID- 11208825
TI  - Combined tamoxifen and luteinizing hormone-releasing hormone (LHRH) agonist
      versus LHRH agonist alone in premenopausal advanced breast cancer: a meta
      analysis of four randomized trials.
AB  - PURPOSE: The logic behind the application of luteinizing hormone-releasing
      hormone (LHRH) agonists in combination with tamoxifen in premenopausal women is
      that LHRH agonists on the one hand suppress the tamoxifen-induced stimulation of
      the pituitary-ovarian function and, on the other hand, seem as effective as
      surgical castration. This meta-analysis combines all randomized evidence to
      compare the combined treatment with LHRH agonist alone with respect to overall
      survival, progression-free survival, and objective response in premenopausal
      women with advanced breast cancer. PATIENTS AND METHODS: Four clinical trials
      randomizing a total of 506 premenopausal women with advanced breast cancer to
      LHRH agonist alone or to the combined treatment of LHRH agonist plus tamoxifen
      were identified. Meta-analytic techniques were used to analyze individual patient
      data from these trials. RESULTS: With a median follow-up of 6.8 years, there was
      a significant survival benefit (stratified log-rank test, P = .02; hazards ratio
      [HR] = 0.78) and progression-free survival benefit (stratified log-rank test, P =
      .0003; HR = 0.70) in favor of the combined treatment. The overall response rate
      was significantly higher on combined endocrine treatment (stratified Mantel
      Haenszel test, P = .03; odds ratio = 0.67). CONCLUSION: The combination of LHRH
      agonist plus tamoxifen is superior to LHRH agonist alone in premenopausal women
      with advanced breast cancer. Therefore, if a premenopausal woman with advanced
      breast cancer is thought to be suitable for endocrine treatment, it is proposed
      that the combination of a LHRH agonist plus tamoxifen be considered as the new
      standard treatment.

PMID- 11208826
TI  - Her-2/neu analysis in archival tissue samples of human breast cancer: comparison
      of immunohistochemistry and fluorescence in situ hybridization.
AB  - PURPOSE: The objective of our study was to compare the methods used in the
      literature to analyze HER-2/neu status on archival breast cancer tissue.
      Therefore, a series of antibodies was evaluated to assess their
      immunohistochemical (IHC) sensitivity in correlation to gene amplification
      determined by fluorescence in situ hybridization (FISH). MATERIALS AND METHODS:
      HER-2/neu overexpression was studied on paraffin sections of 85 invasive breast
      cancers using a panel of five monoclonal (9G6, 3B5, CB11, TAB250, GSF-HER2) and
      two polyclonal antibodies (A8010, A0485) in addition to the HercepTest (DAKO,
      Glostrup, Denmark). HER-2/neu gene amplification was determined by FISH using a
      dual-color probe (PathVysion; Vysis, Stuttgart-Fasanenhof, Germany). RESULTS: HER
      2/neu overexpression was demonstrated in 26% (9G6, TAB250, GSF-HER2), 27% (3B5,
      CB11), 33% (A8010) and 42% (A0485, HercepTest) of the tumors. FISH on paraffin
      sections identified gene amplification in 28% of the tumors. Strongly positive
      IHC results (3+) were always associated with gene amplification. Among the 16
      tumors presented with weakly positive IHC results (2+) using the HercepTest, 12
      (75%) lacked gene amplification. CONCLUSION: The comparison of IHC and FISH
      demonstrated an excellent correlation of high-level HER-2/neu overexpression (3+)
      with gene amplification; ie, FISH does not provide further information in these
      tumors. However, weakly positive IHC results (2+) obtained with the HercepTest
      share only a minor association with gene amplification.

PMID- 11208827
TI  - Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma: a
      Gynecologic Oncology Group study.
AB  - PURPOSE: In two large Gynecologic Oncology Group studies of patients with
      advanced or recurrent endometrial carcinoma and no previous systemic therapy,
      progestins have demonstrated activity against advanced or recurrent endometrial
      carcinoma with response rates between 15% and 25%. Tamoxifen has been reported as
      variously active or inactive with or without previous systemic therapy. The
      purpose of this study was to determine whether tamoxifen exhibits enough activity
      in patients with advanced or recurrent endometrial carcinoma, who have not
      received systemic therapy, to warrant a phase III trial. PATIENTS AND METHODS:
      Sixty-eight eligible patients with advanced or recurrent endometrial carcinoma
      received oral tamoxifen 20 mg bid until toxicity was unacceptable or disease
      progressed. RESULTS: Three complete (4%) and four partial (6%) responses were
      observed for an overall response rate of 10% (90% confidence interval [CI], 5.7%
      to 17.9%). Patients with tumors that were more anaplastic tended to respond less
      frequently. The median progression-free survival for all 68 eligible patients was
      1.9 months (90% CI, 1.7 to 3.2 months). The median survival was 8.8 months (90%
      CI, 7.0 to 10.1 months). CONCLUSION: Tamoxifen demonstrated modest activity at
      best against endometrial carcinoma and does not warrant further investigation as
      a single agent for this disease. Ongoing trials will assess the sequential use of
      tamoxifen and progestational agents.

PMID- 11208828
TI  - Occult tumor cells in bone marrow of patients with locoregionally restricted
      ovarian cancer predict early distant metastatic relapse.
AB  - PURPOSE: Based on conventional tumor staging, primary ovarian cancer is viewed as
      an intraperitoneal disease that rarely spreads to extraperitoneal organs.
      However, autopsy studies reveal a much higher rate of occult metastasis,
      indicating that extraperitoneal spread occurs with much greater frequency than
      previously appreciated. Consequently, we investigated the incidence of early
      hematogenous dissemination and its association with distant disease-free and
      overall survival. PATIENTS AND METHODS: Bone marrow aspirates from 108 patients
      newly diagnosed with International Federation of Gynecology and Obstetrics stage
      I to III ovarian cancer were prospectively analyzed with the novel anti
      cytokeratin (CK) antibody A45-B/B3. We investigated the frequency of CK-positive
      tumor cells in bone marrow and their effect on prognosis in relation to
      established risk factors for tumor progression. RESULTS: Tumor cells in bone
      marrow were detected in 32 (30%) of 108 patients. A CK-positive finding was
      unrelated to established risk parameters, except for poor nuclear grading of the
      primary tumor. At a median follow-up of 45 months (range, 12 to 77 months), the
      presence of occult metastatic cells in bone marrow was associated with the
      occurrence of clinically overt, extraperitoneal (predominantly extraskeletal)
      distant metastasis (relative risk [RR], 16.5; 95% confidence interval [CI], 6.2
      to 56.9; P < .0001) and death from cancer-related causes (RR, 2.3; 95% CI, 1.2 to
      4.3; P = .01). Multivariate analysis identified a positive bone marrow finding as
      an independent prognostic factor of reduced distant disease-free survival for all
      patients (RR, 13.8; 95% CI, 5.4 to 52.9; P < .0001) and for the 64 stage R0-1
      patients (RR, 7.3; 95% CI, 1.5 to 56.8; P = .0021). CONCLUSION: Our data signal
      that hematogenous dissemination of tumor cells occurs early and throughout all
      stages of ovarian cancer. The clinical significance of our findings is supported
      by the unfavorable prognosis in association with the presence of occult
      metastatic cells, especially in those patients who received an effective
      locoregional therapy.

PMID- 11208830
TI  - Phase II study of rituximab in combination with chop chemotherapy in patients
      with previously untreated, aggressive non-Hodgkin's lymphoma.
AB  - PURPOSE: To determine the safety and efficacy of the combination of the chimeric
      anti-CD20 antibody Rituxan (rituximab, IDEC-C2B8; Genentech Inc, South San
      Francisco, CA) and cyclophosphamide, doxorubicin, vincristine, and prednisone
      (CHOP) chemotherapy in patients with aggressive non-Hodgkin's lymphoma (NHL).
      PATIENTS AND METHODS: Thirty-three patients with previously untreated advanced
      aggressive B-cell NHL received six infusions of Rituxan (375 mg/m2 per dose) on
      day 1 of each cycle in combination with six doses of CHOP chemotherapy given on
      day 3 of each cycle. RESULTS: The ORR by investigator assessment confirmed by the
      sponsor was 94% (31 of 33 patients). Twenty patients experienced a complete
      response (CR) (61%), 11 patients had a partial response (PR) (33%), and two
      patients were classified as having progressive disease. In the 18 patients with
      an International Prognostic Index (IPI) score > or = 2, the combination of
      Rituxan plus CHOP achieved an ORR of 89% and CR of 56%. The median duration of
      response and time to progression had not been reached after a median observation
      time of 26 months. Twenty-nine of 31 responding patients remained in remission
      during this follow-up period, including 15 of 16 patients with an IPI score > or
      = 2. The most frequent adverse events attributed to Rituxan were fever and
      chills, primarily during the first infusion. Rituxan did not seem to compromise
      the ability of patients to tolerate CHOP; all patients completed the entire six
      courses of the combination. The bcl-2 translocation of blood or bone marrow was
      positive at baseline in 13 patients; 11 patients had follow-up specimens obtained
      (eight CR, three PR), and all had a negative bcl-2 status after therapy. Only one
      patient has reconverted to bcl-2 positivity, and all patients remain in clinical
      remission. CONCLUSION: This is the first report to demonstrate the safety and
      efficacy of the Rituxan chimeric anti-CD20 antibody in combination with standard
      dose CHOP in the treatment of aggressive B-cell lymphoma. The clinical responses
      are at least comparable to those achieved with CHOP alone with no significant
      added toxicity. The presence or absence of the bcl-2 translocation did not affect
      the ability of patients to achieve a CR with this regimen. The ability to achieve
      sustained remissions in patients with an IPI score > or = 2 warrants further
      investigation with a randomized study.

PMID- 11208829
TI  - Pivotal phase III trial of two dose levels of denileukin diftitox for the
      treatment of cutaneous T-cell lymphoma.
AB  - PURPOSE: The objective of this phase III study was to determine the efficacy,
      safety, and pharmacokinetics of denileukin diftitox (DAB389IL-2, Ontak [Ligand
      Pharmaceuticals Inc, San Diego, CA]) in patients with stage Ib to IVa cutaneous T
      cell lymphoma (CTCL) who have previously received other therapeutic
      interventions. PATIENTS AND METHODS: Patients with biopsy-proven CTCL that
      expressed CD25 on > or = 20% of lymphocytes were assigned to one of two dose
      levels (9 or 18 microg/kg/d) of denileukin diftitox administered 5 consecutive
      days every 3 weeks for up to 8 cycles. Patients were monitored for toxicity and
      clinical efficacy, the latter assessed by changes in disease burden and quality
      of life measurements. Antibody levels of antidenileukin diftitox and anti
      interleukin-2 and serum concentrations of denileukin diftitox were also measured.
      RESULTS: Overall, 30% of the 71 patients with CTCL treated with denileukin
      diftitox had an objective response (20% partial response; 10% complete response).
      The response rate and duration of response based on the time of the first dose of
      study drug for all responders (median of 6.9 months with a range of 2.7 to more
      than 46.1 months) were not statistically different between the two doses. Adverse
      events consisted of flu-like symptoms (fever/chills, nausea/vomiting, and
      myalgias/arthralgias), acute infusion-related events (hypotension, dyspnea, chest
      pain, and back pain), and a vascular leak syndrome (hypotension, hypoalbuminemia,
      edema). In addition, 61% of the patients experienced transient elevations of
      hepatic transaminase levels with 17% grade 3 or 4. Hypoalbuminemia occurred in
      79%, including 15% with grade 3 or 4 changes. Tolerability at 9 and 18
      microg/kg/d was similar, and there was no evidence of cumulative toxicity.
      CONCLUSION: Denileukin diftitox has been shown to be a useful and important agent
      in the treatment of patients whose CTCL is persistent or recurrent despite other
      therapeutic interventions.

PMID- 11208831
TI  - Primary cutaneous non-Hodgkin's lymphoma of Ann Arbor stage I: preferential
      cutaneous relapses but high cure rate with doxorubicin-based therapy.
AB  - PURPOSE: Establish frequency, presenting features, response and relapse patterns,
      and outcome of primary cutaneous non-Hodgkin's lymphoma (PCNHL). PATIENTS AND
      METHODS: Review of untreated patients, older than 16 years, presenting between
      1971 and 1993 with cutaneous lymphoma, not mycosis fungoides, and Ann Arbor stage
      I. RESULTS: We identified 46 patients, 27 males, with median age of 57 years.
      Treatment was radiotherapy in 10 patients, doxorubicin-based therapy in 33
      patients that was followed by radiotherapy in 25 patients, and other combination
      with radiotherapy in one patient. The complete response rate was 95%. After a
      median follow-up of 140 months (range, 61 to 284 months), 18 patients have
      relapsed, and 14 have died from lymphoma. The first failure was exclusively
      cutaneous in 50% of relapses. For the 44 treated patients, progression-free
      survival (PFS; actuarial +/- SE) was 61% +/- 7% and survival was 58% +/- 9% at 12
      years. For the 18 patients with diffuse large B-cell lymphoma, after doxorubicin
      based regimens, PFS was 71% +/- 12% (P = .0003) versus 0% after radiotherapy;
      survival was 77% +/- 12% versus 25% +/- 22% (P = 004), respectively. For the nine
      patients with follicular center-cell lymphoma treated with combined modality, the
      12-year PFS was 89% +/- 11% and survival 70% +/- 18%. CONCLUSION: PCNHL is rare,
      and its first relapse is exclusively cutaneous in 50% of patients. Patients with
      diffuse large B-cell lymphoma are curable with doxorubicin-based regimens but not
      with radiotherapy. Prospective studies in PCNHL should define the cytogenetics,
      the basis for cutaneous tropism, the prognosis of histologic subtypes, and the
      role of radiotherapy.

PMID- 11208832
TI  - Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in
      patients never achieving remission: a report from the Autologous Blood and Marrow
      Transplant Registry.
AB  - PURPOSE: To evaluate the results of high-dose chemotherapy and autologous
      hematopoietic stem-cell transplantation (autotransplants) in patients with
      diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete
      remission with conventional chemotherapy. PATIENTS AND METHODS: Detailed records
      from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients
      with diffuse aggressive NHL who never achieved a complete remission with
      conventional chemotherapy and subsequently received an autotransplant were
      evaluated. Transplants were performed between 1989 and 1995 and were reported to
      the ABMTR by 48 centers in North and South America. RESULTS: Seventy-nine (44%)
      of 184 patients achieved a complete remission or a complete remission with
      residual imaging abnormalities of unknown significance after autotransplantation.
      Thirty-four (19%) of 184 had a partial remission and 55 (31%) of 184 had no
      response or progressive disease. Eleven patients (6%) were not assessable for
      response because of early death. The probabilities of progression-free and
      overall survival at 5 years after transplantation were 31% (95% confidence
      interval [CI], 24% to 38%) and 37% (95% CI, 30% to 45%), respectively. In
      multivariate analysis, chemotherapy resistance, Karnofsky performance status
      score less than 80 at transplantation, age > or = 55 years at transplantation,
      receiving three or more prior chemotherapy regimens, and not receiving pre- or
      posttransplant involved-field irradiation therapy were adverse prognostic factors
      for overall survival. CONCLUSION: High-dose chemotherapy and autologous
      hematopoietic stem-cell transplantation should be considered for patients with
      diffuse aggressive NHL who never achieve a complete remission but who are still
      chemotherapy-sensitive and are otherwise transplant candidates.

PMID- 11208833
TI  - Prognostic value of positron emission tomography (PET) with fluorine-18
      fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin's
      lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods?
AB  - PURPOSE: A complete remission (CR) after first-line therapy is associated with
      longer progression-free survival (PFS). However, defining CR is not always easy
      because of the presence of residual masses. Metabolic imaging with fluorine-18
      fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) offers the
      ability to differentiate between viable and fibrotic inactive tissue. In this
      study, we evaluated the value of PET in detecting residual disease and, hence,
      predicting relapse after first-line treatment in patients with non-Hodgkin's
      lymphoma (NHL). PATIENTS AND METHODS: Ninety-three patients with histologically
      proven NHL, who underwent a whole-body [18F]FDG-PET study after completion of
      first-line chemotherapy and who had follow-up of at least 1 year, were included.
      Persistence or absence of residual disease on PET was related to PFS using Kaplan
      Meier survival analysis. RESULTS: Sixty-seven patients showed a normal PET scan
      after first-line chemotherapy; 56 of 67 remained in CR, with a median follow-up
      of 653 days. Nine of these patients with a residual mass considered as
      unconfirmed CR received additional radiotherapy. Only 11 of 67 patients relapsed
      (median PFS, 404 days). Persistent abnormal [18F]FDG uptake was seen in 26
      patients, and all of them relapsed (median PFS, 73 days). Because standard
      restaging also suggested residual disease, 12 patients received immediate
      secondary treatment. In 14 of 26 patients, only PET predicted persistent disease.
      From these patients, relapse was proven either by biopsy (n = 8) or by
      progressive disease on computed tomography or magnetic resonance imaging (n = 6).
      CONCLUSION: Persistent abnormal [18F]FDG uptake after first-line chemotherapy in
      NHL is highly predictive for residual or recurrent disease. In relapsing
      patients, PFS was significantly shorter after a positive scan than after a
      negative scan.

PMID- 11208834
TI  - Frequency of the Bcl-2/IgH rearrangement in normal individuals: implications for
      the monitoring of disease in patients with follicular lymphoma.
AB  - PURPOSE: To determine the incidence and frequency of the Bcl-2/IgH rearrangement
      in the peripheral blood of normal individuals to define the potential
      complication this may pose for the molecular monitoring of disease in patients
      with follicular lymphoma (FL). MATERIALS AND METHODS: The incidence and frequency
      of the major breakpoint cluster region rearrangement in DNA extracted from
      peripheral blood or lymphoblastoid cell lines from 481 normal individuals was
      determined using a TaqMan real-time polymerase chain reaction assay (PE Applied
      Biosystems, Foster City, CA). RESULTS: Twenty three percent of samples were
      positive for the Bcl-2/IgH rearrangement, with approximately 3% of these at
      levels of more than 1 in 10(4) cells. CONCLUSION: The presence of circulating Bcl
      2/IgH+ cells, other than those derived from the malignant clone, could confound
      the detection and quantitation of minimal residual disease in patients with FL,
      particularly at low levels of tumor burden.

PMID- 11208835
TI  - Interferon adjuvant to radical nephrectomy in Robson stages II and III renal cell
      carcinoma: a multicentric randomized study.
AB  - PURPOSE: Because interferon gave promising results in the management of
      metastatic renal cell carcinoma in the 1980s, a multicentric randomized
      controlled trial was planned to compare adjuvant recombinant interferon alfa-2b
      (rIFNalpha2b) with observation after radical nephrectomy in patients with Robson
      stages II and III renal cell carcinoma. Overall and event-free survival were to
      be evaluated together with prognostic factors. PATIENTS AND METHODS: Overall and
      event-free survival curves for 247 patients (124 controls and 123 treated) were
      estimated by the Kaplan-Meier method and compared using the log-rank test. Cox's
      multiple regression models were adopted to perform a joint analysis of treatment
      and prognostic factors. RESULTS: The 5-year overall and event-free survival
      probabilities were 0.665 and 0.671, respectively, for controls and 0.660 and
      0.567, respectively, for the treated group; the differences were not
      statistically significant (2P = .861 for overall and 2P = .107 for event-free
      survival with the log-rank test). Regarding prognostic factors, only grade, pT,
      and pN demonstrated a significant prognostic role. First-order interactions of
      treatment with pT and pN category were investigated; a significant interaction
      was found between pN and treatment. A harmful effect of rIFNalpha2b in the 97
      treated pN0 patients and a protective effect in the 13 treated pN2/pN3 patients
      were statistically significant. CONCLUSION: Adjuvant rIFNalpha2b is not indicated
      after radical nephrectomy for renal cell carcinoma. The protective effect in the
      small group of pN2/pN3 patients requires further investigation.

PMID- 11208836
TI  - Vascular endothelial growth factor 189 mRNA isoform expression specifically
      correlates with tumor angiogenesis, patient survival, and postoperative relapse
      in non-small-cell lung cancer.
AB  - PURPOSE: The purpose of this study was to evaluate the correlation between the
      expression of four different vascular endothelial growth factor (VEGF) mRNA
      isoforms (VEGF121, VEGF165, VEGF 189, and VEGF206) and the clinicopathologic
      characteristics, tumor angiogenesis, and outcome of patients with non-small-cell
      lung cancer. PATIENTS AND METHODS: We examined the expression of four different
      VEGF mRNA isoforms in 57 non-small-cell lung cancers using reverse transcriptase
      polymerase chain reaction and the tumor angiogenesis using immunohistochemical
      staining. RESULTS: All 57 lung cancer samples expressed the VEGF121, VEGF165, and
      VEGF189 mRNA isoforms, and three expressed the VEGF206 mRNA isoform. A high
      tumoral VEGF189 mRNA isoform expression ratio was associated with a high
      intratumoral microvessel count (P = .013), short survival (< 24 months; P =
      .001), and early postoperative relapse (< 12 months; P = .001). Survival and
      postoperative relapse time were significantly shorter in patients with a high
      compared with a low tumor VEGF189 mRNA isoform expression ratio (P = .0001 and P
      = .0086, respectively, log-rank test). In contrast, the VEGF165 and VEGF 206 mRNA
      isoform expression ratios showed no statistical correlation with tumor
      angiogenesis, postoperative relapse time, or survival. A high VEGF121 mRNA
      isoform expression ratio was associated with short survival (< 24 months) and
      early relapse (< 12 months). Multivariate analysis showed that VEGF 189 mRNA
      isoform expression, microvessel count, and nodal status were the most important
      independent prognostic factors for patient survival and postoperation recurrence.
      CONCLUSION: The VEGF189 mRNA isoform expression ratio shows a greater correlation
      with tumor angiogenesis, postoperative relapse time, and survival than do the
      expression ratios for the VEGF121, VEGF165, and VEGF206 mRNA isoforms and can be
      used as a prognostic indicator for patients with non-small-cell lung cancers.

PMID- 11208838
TI  - Lack of prognostic significance of p53 and K-ras mutations in primary resected
      non-small-cell lung cancer on E4592: a Laboratory Ancillary Study on an Eastern
      Cooperative Oncology Group Prospective Randomized Trial of Postoperative Adjuvant
      Therapy.
AB  - PURPOSE: To determine the prognostic and predictive significance of p53 and K-ras
      mutations in patients with completely resected non-small-cell lung cancer
      (NSCLC). PATIENTS AND METHODS: Patients were randomized preoperatively to receive
      adjuvant postoperative radiotherapy (Arm A) or radiotherapy plus concurrent
      chemotherapy (Arm B). p53 protein expression was studied by immunohistochemistry
      (IHC) and p53 mutations in exons 5 to 8 were evaluated by single-strand
      conformational analysis. K-ras mutations in codons 12, 13, and 61 were determined
      using engineered restriction fragment length polymorphisms. RESULTS: Four hundred
      eighty-eight patients were entered onto E3590; 197 tumors were assessable for
      analysis. Neither presence nor absence of p53 mutations, p53 protein expression,
      or K-ras mutations correlated with survival or progression-free survival. There
      was a trend toward improved survival for patients with wildtype K-ras (median, 42
      months) compared with survival of patients with mutant K-ras who were randomized
      to chemotherapy plus radiotherapy (median, 25 months; P = .09). Multivariate
      analysis revealed only age and tumor stage to be significant prognostic factors,
      although there was a trend bordering on statistical significance for K-ras (P =
      .066). Analysis of survival difference by p53 by single-stranded conformational
      polymorphism and IHC, interaction of p53 and K-ras, interaction of p53 and
      treatment arm, nodal station, extent of surgery, weight loss, and histology did
      not reach statistical significance. CONCLUSION: p53 mutations and protein
      overexpression are not significant prognostic or predictive factors in resected
      stage II or IIIA NSCLC. K-ras mutations may be a weak prognostic marker. p53 or K
      ras should not be routinely used in the clinical management of these patients.

PMID- 11208837
TI  - Twice-weekly paclitaxel and weekly carboplatin with concurrent thoracic radiation
      followed by carboplatin/paclitaxel consolidation for stage III non-small-cell
      lung cancer: a California Cancer Consortium phase II trial.
AB  - PURPOSE: Recent studies have suggested the superiority of concurrent
      chemoradiotherapy and the efficacy of paclitaxel/carboplatin in advanced non
      small-cell lung cancer (NSCLC). In view of those results, we sought to examine
      the safety and efficacy of administration of radiosensitizing paclitaxel twice
      weekly and carboplatin weekly with concurrent thoracic radiation therapy (XRT)
      followed by consolidation paclitaxel and carboplatin for stage III NSCLC in a
      multi-institutional phase II trial. PATIENTS AND METHODS: Induction
      chemoradiotherapy consisted of paclitaxel 30 mg/m2 delivered intravenously (IV)
      for 1 hour twice weekly for 6 weeks, carboplatin at a dose based on an area under
      the concentration-time curve (AUC) of 1.5 mg/mL x min, given IV once weekly for 6
      weeks, and concomitant XRT of 1.8 to 2.0 Gy daily for a total of 61 Gy. Patients
      who achieved a complete response, partial response, or stable disease received
      two 21-day cycles of consolidation chemotherapy consisting of paclitaxel 200
      mg/m2 IV for 3 hours and carboplatin at a dose based on an AUC of 6 mg/mL x min.
      RESULTS: Thirty-four patients were eligible. Their median age was 62 years
      (range, 39 to 73 years), 59% were female, 41% were male, 94% had a performance
      status of 0 or 1, 38% had stage IIIA NSCLC, and 62% had stage IIIB NSCLC. Common
      grade III and IV toxicities during the induction chemoradiation phase included
      esophagitis (38%) and neutropenia (12%). The most common adverse reaction during
      consolidation chemotherapy was grade III neutropenia in five patients (15%). The
      overall response rate was 71%, which was achieved in the induction phase. The
      median follow-up was 20 months, the median survival was 17 months, and 2-year
      actuarial survival rate was 40% (95% confidence interval, 20% to 65%).
      CONCLUSION: This regimen is tolerable and results are promising. We recommend
      further evaluation of this regimen in a phase III trial.

PMID- 11208839
TI  - Phase I/II study of escalating doses of vinorelbine in combination with
      oxaliplatin in patients with advanced non-small-cell lung cancer.
AB  - PURPOSE: Oxaliplatin is a platinum compound active in non-small-cell lung cancer
      (NSCLC) patients, and vinorelbine (VNB) is an active reference agent. This phase
      I/II study was performed to determine the dose-limiting toxicity (DLT), the
      maximum-tolerated dose (MTD), and the recommended dose (RD) of a VNB/oxaliplatin
      combination given to previously untreated patients with advanced NSCLC. PATIENTS
      AND METHODS: Oxaliplatin was given at the fixed dose of 130 mg/m2 (2-hour
      intravenous [IV] infusion) on day 1. VNB was administered on days 1 and 8 (10
      minute IV infusion), with doses starting at 22 mg/m2/d and escalated by 2 mg/m2
      increments until MTD. Treatment was repeated every 3 weeks. No special hydration
      measures or prophylactic granulocyte colony-stimulating factors were used.
      RESULTS: Twenty-seven patients (20 men, 7 women) received 110 cycles total at six
      different VNB dose levels. Neutropenia was the DLT. Although no patient
      experienced DLT at the highest dose level (32 mg/m2/d), multiple treatment delays
      (54% of cycles) and dose reductions (34% of cycles) were required at this dose
      level. Others toxicities were mainly limited to grade 1 peripheral neuropathy and
      grade 1/2 nausea/vomiting. The relative dose-intensity of administered VNB from
      dose levels 3 to 6 (26 to 32 mg/m2) remained stable, whereas grade 3/4
      neutropenia increased. All patients were assessable for activity; there were 10
      objective responses, including one complete response (37% response rate).
      CONCLUSION: The present combination can be safely administered in an outpatient
      setting. The RD is VNB 26 mg/m2 days 1 and 8 with oxaliplatin 130 mg/m2 day 1
      every 3 weeks.

PMID- 11208840
TI  - Solid cancers after bone marrow transplantation.
AB  - PURPOSE: To evaluate the incidence and associated risk factors of solid cancers
      after bone marrow transplantation (BMT). PATIENTS AND METHODS: We analyzed 2,129
      patients who had undergone BMT for hematologic malignancies at the City of Hope
      National Medical Center between 1976 and 1998. A retrospective cohort and nested
      case-control study design were used to evaluate the role of pretransplantation
      therapeutic exposures and transplant conditioning regimens. RESULTS: Twenty-nine
      patients developed solid cancers after BMT, which represents a two-fold increase
      in risk compared with a comparable normal population. The estimated cumulative
      probability (+/- SE) for development of a solid cancer was 6.1% +/- 1.6% at 10
      years. The risk was significantly elevated for liver cancer (standardized
      incidence ratio [SIR], 27.7; 95% confidence interval [CI], 1.9 to 57.3), cancer
      of the oral cavity (SIR, 17.4; 95% CI, 6.3 to 34.1), and cervical cancer (SIR,
      13.3; 95% CI, 3.5 to 29.6). Each of the two patients with liver cancer had a
      history of chronic hepatitis C infection. All six patients with squamous cell
      carcinoma of the skin had chronic graft-versus-host disease. The risk was
      significantly higher for survivors who were younger than 34 years of age at time
      of BMT (SIR, 5.3; 95% CI, 2.7 to 8.6). Cancers of the thyroid gland, liver, and
      oral cavity occurred primarily among patients who received total-body
      irradiation. CONCLUSION: The risk of radiation-associated solid tumor development
      after BMT is likely to increase with longer follow-up. This underscores the
      importance of close monitoring of patients who undergo BMT.

PMID- 11208841
TI  - Risks of young age for selected neurocognitive deficits in medulloblastoma are
      associated with white matter loss.
AB  - PURPOSE: To test the hypothesis that inadequate development of normal-appearing
      white matter (NAWM) is associated with the relationship between young age at the
      time of craniospinal irradiation (CRT) and deficient neurocognitive performance
      in survivors of childhood medulloblastoma. PATIENTS AND METHODS: Forty-two
      patients treated since 1985 participated in this cross-sectional study. All had
      been treated with CRT with or without chemotherapy and had survived 1 or more
      years after treatment. Neurocognitive evaluations were conducted with tests of
      intellect (intelligent quotient; IQ), verbal memory, and sustained attention.
      Quantitative magnetic resonance imaging, using a hybrid neural network, assessed
      the volume of NAWM. RESULTS: Neurocognitive test results were below normal
      expectations for age at the time of testing. A young age at CRT was significantly
      associated with worse performance on all neurocognitive tests except that of
      verbal memory. An increased time from completion of CRT was significantly
      associated with worse performance on all neurocognitive tests except that of
      sustained attention. After statistically controlling for the effects of time from
      CRT, we examined the association of NAWM with neurocognitive test results. These
      analyses revealed that NAWM accounted for a significant amount of the association
      between age at CRT and IQ, factual knowledge, and verbal and nonverbal thinking,
      but not sustained attention or verbal memory. CONCLUSION: The present results
      suggest that, at least for some cognitive functions, deficient development and/or
      loss of NAWM after CRT may provide a neuroanatomical substrate for the adverse
      impact of a young age at the time of CRT.

PMID- 11208842
TI  - Growth hormone replacement therapy in children with medulloblastoma: use and
      effect on tumor control.
AB  - PURPOSE: Progress has been made in the treatment of medulloblastoma, the most
      common childhood malignant brain tumor: However, many long-term survivors will
      have posttherapy growth hormone insufficiency with resultant linear growth
      retardation. Growth hormone replacement therapy (GHRT) may significantly improve
      growth, but there is often reluctance to initiate GHRT because of concerns of an
      increased likelihood of tumor relapse. PATIENTS AND METHODS: This study
      retrospectively reviewed the use of GHRT for survivors of medulloblastoma in 11
      neuro-oncology centers in North America who received initial treatment for
      disease between 1980 and 1993 to determine its impact on disease control. A
      Landmark analysis was used to evaluate the relative risk of relapse in surviving
      patients. RESULTS: Five hundred forty-five consecutive patients less than 15
      years of age at diagnosis were identified. Six-year progression-free survival
      (mean +/- SD) was 40% +/- 5% in children less than 3 years of age at diagnosis
      compared with 59% +/- 3% for older patients. Older patients with total or near
      total resections (P = .003) and localized disease at diagnosis (P < .0001) had
      the highest likelihood of survival. One hundred seventy patients (33% +/- 3% of
      the cohort) received GHRT. GHRT use varied widely among institutions, ranging
      from 5% to 73%. GHRT was begun a mean of 3.9 years after diagnosis, later in
      children younger than 3 years at diagnosis (5.4 years). By Landmark analyses, for
      those surviving 2, 3, and 5 years after diagnosis, there was no evidence that
      GHRT increased the rate of disease relapse. CONCLUSION: This large retrospective
      review demonstrates that GHRT is underutilized in survivors of medulloblastoma
      and is used relatively late in the course of the illness. GHRT is not associated
      with an increased likelihood of disease relapse.

PMID- 11208843
TI  - Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms'
      tumor in children older than 6 months: results of the Ninth International Society
      of Pediatric Oncology Wilms' Tumor Trial and Study.
AB  - PURPOSE: To determine the optimal duration of preoperative chemotherapy to
      further increase the proportion of stage I tumors by comparison of two regimens
      in the treatment of patients older than 6 months who have unilateral Wilms'
      tumor. PATIENTS AND METHODS: Eligible patients (n = 382) initially received four
      weekly doses of vincristine (VCR) and two courses of actinomycin D (AMD) and were
      randomized either to be operated on (4-week group [n = 193]) or to receive 4 more
      weeks of the same chemotherapy regimen (8-week group [n = 189]). The assessment
      criterion was the observed percentage of stage I tumors. After surgery, patients
      were assigned according to tumor stage and histology to four different treatment
      groups: stage I and favorable histology (n = 5) were to have no further treatment
      (NFT); stage I and standard histology or anaplasia (n = 244), VCR and AMD for 17
      weeks (AV); stages II and III and favorable or standard histology, VCR, AMD, and
      an anthracycline for 27 weeks (AVE) with no abdominal radiotherapy for stage II
      N0 disease (n = 75) or with a 15-Gy dose of abdominal irradiation (RTH) in case
      of stages IIN1 and III (n = 56). Anaplastic tumors staged higher than I or clear
      cell sarcoma of the kidney (14), AMD, VCR, an anthracycline, and ifosfamide for
      36 weeks (DEVI). RESULTS: No advantage was found in favor of prolonged
      preoperative treatment. The percentages obtained for the 4-week and the 8-week
      groups, respectively, were as follows: stage I, 64% versus 62%; intraoperative
      tumor rupture rate, 1% versus 3%; 2-year EFS, 84% versus 83%; and 5-year OS, 92%
      versus 87%. Two-year EFS and 5-year OS rates, respectively, of the different
      treatment groups were as follows: NFT, 100% for both EFS and OS; AV, 88% and 93%;
      AVE, 84% and 88%; AVE RTH, 71% and 85%; and DEVI, 71% and 71%. The rate of
      abdominal recurrences in stage II N0 nonirradiated patients was 6.6%. CONCLUSION:
      The 4-week schedule pre-nephrectomy chemotherapy regimen should be considered the
      standard treatment. Clinical trials should continue to improve the cure rate of
      high-risk patients and the quality of life of children with a more favorable
      prognosis.

PMID- 11208844
TI  - Feasibility of quantitative pain assessment in outpatient oncology practice.
AB  - PURPOSE: Although physicians view failure to assess pain systematically as the
      most important barrier to outpatient cancer pain management, little is known
      about pain assessment in this setting. We sought to determine whether pain is
      routinely assessed and whether routine quantitative pain assessment is feasible
      in a busy outpatient oncology practice. PATIENTS AND METHODS: We conducted a pre-
      and postintervention chart review of 520 randomly selected medical and radiation
      oncology patient visits at a community hospital-based private outpatient
      practice. The intervention consisted of training health assistants (HAs) to
      measure and document patient pain scores by using a visual analog scale. The main
      outcome measures included HA documentation of patient pain scores, quantitative
      and qualitative mention of pain in the physician note, and analgesic treatment
      before and after the intervention. RESULTS: After the intervention, HA
      documentation of pain scores increased from 1% to 75.6% (P < .0001). Physician
      documentation increased from 0% to 4.8% for quantitative documentation (P < .01),
      and from 60.0% to 68.3% for qualitative documentation (not significant). Of all
      the patients, 23.1% reported significant pain. Subgroups with greater pain
      included patients actively receiving radiation treatments and patients with lung
      cancer. Of patients with significant pain, 28.2% had no mention of pain in the
      physician note and 47.9% had no documented analgesic treatment. CONCLUSION:
      Quantitative pain assessment was virtually absent before our intervention but
      easily implemented and sustained in a busy outpatient oncology practice. Pain
      score collection identified a high prevalence of pain, patient subgroups at risk
      for pain, and a significant proportion of patients with pain that was neither
      evaluated nor treated by their oncologists.

PMID- 11208845
TI  - Randomized trial of procarbazine, lomustine, and vincristine in the adjuvant
      treatment of high-grade astrocytoma: a Medical Research Council trial.
AB  - PURPOSE: Meta-analyses of the published literature suggest a survival benefit to
      adjuvant chemotherapy for high-grade astrocytoma, which individual small trials
      have been unable to demonstrate reliably. The Medical Research Council Brain
      Tumour Working Party initiated the largest randomized trial of adjuvant
      chemotherapy for glioma in an attempt to provide a definitive answer. PATIENTS
      AND METHODS: After surgery, patients aged < or = 70 years, with World Health
      Organization grade 3 or 4 astrocytoma, were randomized to radiotherapy alone (RT)
      or RT plus procarbazine, lomustine, and vincristine (PCV) chemotherapy (RT-PCV)
      given at 6-week intervals to a maximum of 12 courses (procarbazine 100 mg/m2 days
      1 to 10, lomustine 100 mg/m2 day 1, and vincristine 1.5 mg/m2 (max 2 mg) day 1).
      A neuropathology panel independently reviewed all cases. To reliably detect a 10%
      increase in 2-year survival (from 15% to 25%), 600 patients were required.
      RESULTS: Between September 1988 and May 1997, 15 United Kingdom centers
      randomized 674 patients (RT = 339 patients; RT-PCV = 335 patients). With a median
      follow-up for survivors of 3 years, 617 patients have died, (RT = 310 patients;
      RT-PCV = 307 patients). Median survival was 9.5 months for RT and 10 months for
      RT-PCV (hazard ratio = 0.95; 95% confidence interval, 0.81 to 1.11; log-rank P =
      .50). Tests for interaction revealed no significant differences in treatment
      effect according to tumor grade, age, performance status, or extent of
      neurosurgery. CONCLUSION: This trial shows no benefit to PCV chemotherapy, and
      current data exclude an increase in median survival of more than 10 weeks and in
      a 1- or 2-year survival rate of more than 7% to 8%. This suggests that no
      chemotherapy control arms remain ethical in randomized trials in high-grade
      astrocytoma.

PMID- 11208846
TI  - Phase I and pharmacokinetic study of photodynamic therapy for high-grade gliomas
      using a novel boronated porphyrin.
AB  - PURPOSE: To determine the recommended dose, toxicity profile, and
      pharmacokinetics of a novel boronated porphyrin (BOPP) for photodynamic therapy
      (PDT) of intracranial tumors. PATIENTS AND METHODS: BOPP was administered alone
      in increasing doses (0.25, 0.5, 1.0, 2.0, 4.0, or 8.0 mg/kg) preoperatively in
      patients with intracranial tumors undergoing postresection PDT until dose
      limiting toxicity (DLT) was observed. RESULTS: Twenty-nine assessable patients
      with intracranial tumors received BOPP intravenously 24 hours before surgery. The
      recommended dose was 4 mg/kg. Dose escalation was limited by thrombocytopenia.
      The most common nonhematologic toxicity was skin photosensitivity.
      Pharmacokinetic parameters showed increased area under the plasma concentration
      time curve and maximum concentration with increased dose. Tumor BOPP
      concentrations also increased with increased dose. CONCLUSION: BOPP at a dose of
      4 mg/kg was well tolerated. DLT was thrombocytopenia, and photosensitivity was
      the only other toxicity of note. The efficacy of PDT using BOPP requires further
      exploration.

PMID- 11208847
TI  - Prognostic factors in localized primary synovial sarcoma: a multicenter study of
      128 adult patients.
AB  - PURPOSE: To identify most significant and therapeutically relevant prognostic
      factors in adults with localized primary synovial sarcomas (SS) and to confirm
      the usefulness of the French Federation of Cancer Centers (FNCLCC) grading
      system, the prognostic impact of which has been already proven in soft tissue
      sarcomas. PATIENTS AND METHODS: Data on 128 patients with nonmetastatic SS
      collected from a cooperative database by the FNCLCC Sarcoma Group between 1980
      and 1994 were studied retrospectively. Immunohistochemistry was performed at
      diagnosis in 77 cases (61%). The tumors were classified as biphasic (n = 45),
      monophasic fibrous (n = 72), and poorly differentiated (n = 10) subtypes.
      Histologic grade was determined according to the FNCLCC method, and vascular
      invasion was assessed in every case. RESULTS: The 5-year disease-specific
      survival (DSS) rate for this series of patients with localized SS was 62.9% (+/-
      9.6% [SD]) with a median follow-up time of 37 months (range, 8 to 141 months). In
      multivariate analysis, the adverse risk factors associated with decreased DSS
      were International Union Against Cancer/American Joint Committee on Cancer stage
      III/IVA disease, male sex, and truncal tumor locations. For metastasis-free
      survival (MFS), disease stage III/IVA, tumor necrosis, and monophasic subtypes
      were the major factors associated with a less favorable prognosis. Separately,
      when not using disease stage, tumor necrosis, and mitotic activity, histologic
      grade became the most significant prognostic factor for both DSS and MFS. In
      addition, larger tumors and older patients become associated with a significantly
      worse prognosis. Independent adverse risk factors for local recurrence-free
      survival included histologic grade 3 and truncal tumor location. CONCLUSION:
      These data confirm that not all SS present the same severe outcome. High-risk
      patients identified on the basis of these parameters may qualify for an
      aggressive treatment approach.

PMID- 11208848
TI  - Phase I trial of concurrent tirapazamine, cisplatin, and radiotherapy in patients
      with advanced head and neck cancer.
AB  - PURPOSE: To determine the maximum-tolerated dose of tirapazamine when combined
      with cisplatin and radiation in patients with T3/4 and/or N2/3 squamous cell
      carcinoma of the head and neck. PATIENTS AND METHODS: The starting schedule was
      conventionally fractionated radiotherapy (70 Gy in 7 weeks) with concomitant
      cisplatin 75 mg/m2 and tirapazamine 290 mg/m2 (before cisplatin) in weeks 1, 4,
      and 7 and tirapazamine alone 160 mg/m2 three times a week in weeks 2, 3, 5, and
      6. Positron emission tomography scans for tumor hypoxia (18F misonidazole) were
      performed before and during radiotherapy. RESULTS: We treated 16 patients with
      predominantly oropharyngeal primary tumors, including 10 patients with T4 or N3
      disease. Febrile neutropenia occurred toward the end of radiotherapy in three out
      of six patients treated on the initial dose level. Two of these patients also
      developed grade 4 acute radiation reactions. Another 10 patients were treated
      with the same doses, but the week 5 and week 6 tirapazamine doses were omitted.
      This resulted in less neutropenia and only one dose-limiting toxicity (DLT)
      (febrile neutropenia), and eight out of 10 patients completed treatment without
      any dose omissions. In these 10 patients, the acute radiation toxicities were not
      obviously enhanced compared with chemoradiotherapy regimens using concurrent
      platinum and fluorouracil. 18F misonidazole scans detected hypoxia in 14 of 15
      patients at baseline, with only one patient having detectable hypoxia at the end
      of treatment. With a median follow-up of 2.7 years, the 3-year failure-free
      survival rate was 69% (SE, 12%), the 3-year local progression-free rate was 88%
      (SE, 8%), and the 3-year overall survival rate was 69% (SE, 12%). CONCLUSION: DLT
      was due unexpectedly to febrile neutropenia, which could be overcome by omitting
      tirapazamine in weeks 5 and 6. The combination of tirapazamine, cisplatin, and
      radiotherapy resulted in remarkably good and durable clinical responses in
      patients with very advanced head and neck cancers. It warrants further
      investigation.

PMID- 11208849
TI  - Can we predict radiation-induced changes in pulmonary function based on the sum
      of predicted regional dysfunction?
AB  - PURPOSE: To determine whether changes in whole-lung pulmonary function test (PFT)
      values are related to the sum of predicted radiation therapy (RT)-induced changes
      in regional lung perfusion. PATIENTS AND METHODS: Between 1991 and 1998, 96
      patients (61% with lung cancer) who were receiving incidental partial lung
      irradiation were studied prospectively. The patients were assessed with pre- and
      post-RT PFTs (forced expiratory volume in one second [FEV1] and diffusion
      capacity for carbon monoxide [DLCO]) for at least a 6-month follow-up period, and
      patients were excluded if it was determined that intrathoracic recurrence had an
      impact on lung function. The maximal declines in PFT values were noted. A dose
      response model based on RT-induced reduction in regional perfusion (function) was
      used to predict regional dysfunction. The predicted decline in pulmonary function
      was calculated as the weighted sum of the predicted regional injuries: equation
      [see text] where Vd is the volume of lung irradiated to dose d, and Rd is the
      reduction in regional perfusion anticipated at dose d. RESULTS: The relationship
      between the predicted and measured reduction in PFT values was significant for
      uncorrected DLCO (P = .005) and borderline significant for DLCO (P = .06) and
      FEV1 (P = .08). However, the correlation coefficients were small (range,.18
      to.30). In patients with lung cancer, the correlation coefficients improved as
      the number of follow-up evaluations increased (range,.43 to.60), especially when
      patients with hypoperfusion in the lung adjacent to a central mediastinal/hilar
      thoracic mass were excluded (range,.59 to.91). CONCLUSION: The sum of predicted
      RT-induced changes in regional perfusion is related to RT-induced changes in
      pulmonary function. In many patients, however, the percentage of variation
      explained is small, which renders accurate predictions difficult.

PMID- 11208850
TI  - Comparison of diameter and perimeter methods for tumor volume calculation.
AB  - PURPOSE: Lesion volume is often used as an end point in clinical trials of
      oncology therapy. We sought to compare the common method of using orthogonal
      diameters to estimate lesion volume (the diameter method) with a computer
      assisted planimetric technique (the perimeter method). METHODS: Radiologists
      reviewed 825 magnetic resonance imaging studies from 219 patients with
      glioblastoma multiforme. Each study had lesion volume independently estimated via
      the diameter and perimeter methods. Cystic areas were subtracted out or excluded
      from the outlined lesion. Inter- and intrareader variability was measured by
      using multiple readings on 48 cases. Where serial studies were available in
      noncystic cases, a mock response analysis was used. RESULTS: The perimeter method
      had a reduced interreader and intrareader variability compared with the diameter
      method (using SD of differences): intrareader, 1.76 mL v 7.38 mL (P < .001);
      interreader, 2.51 mL v 9.07 mL (P < .001) for perimeter and diameter results,
      respectively. Of the 121 noncystic cases, 23 had serial data. In six (26.1%) of
      those 23, a classification difference occurred when the perimeter method was used
      versus the diameter method. CONCLUSION: Variability of measurements was reduced
      with the computer-assisted perimeter method compared with the diameter method,
      which suggests that changes in volume can be detected more accurately with the
      perimeter method. The differences between these techniques seem large enough to
      have an impact on grading the response to therapy.

PMID- 11208851
TI  - Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of
      malignancy: a pooled analysis of two randomized, controlled clinical trials.
AB  - PURPOSE: Two identical, concurrent, parallel, multicenter, randomized, double
      blind, double-dummy trials were conducted to compare the efficacy and safety of
      zoledronic acid and pamidronate for treating hypercalcemia of malignancy (HCM).
      PATIENTS AND METHODS: Patients with moderate to severe HCM (corrected serum
      calcium [CSC] > or = 3.00 mmol/L [12.0 mg/dL]) were treated with a single dose of
      zoledronic acid (4 or 8 mg) via 5-minute infusion or pamidronate (90 mg) via 2
      hour infusion. A protocol-specified pooled analysis of the two parallel trials
      was performed. Clinical end points included rate of complete response by day 10,
      response duration, and time to relapse. RESULTS: Two hundred eighty-seven
      patients were randomized and evaluated for safety; 275 were evaluated for
      efficacy. Both doses of zoledronic acid were superior to pamidronate in the
      treatment of HCM. The complete response rates by day 10 were 88.4% (P = .002),
      86.7% (P = .015), and 69.7% for zoledronic acid 4 mg and 8 mg and pamidronate 90
      mg, respectively. Normalization of CSC occurred by day 4 in approximately 50% of
      patients treated with zoledronic acid and in only 33.3% of the pamidronate
      treated patients. The median duration of complete response favored zoledronic
      acid 4 and 8 mg over pamidronate 90 mg with response durations of 32, 43, and 18
      days, respectively. CONCLUSION: Zoledronic acid is superior to pamidronate; 4 mg
      is the dose recommended for initial treatment of HCM and 8 mg for relapsed or
      refractory hypercalcemia.

PMID- 11208852
TI  - Melastatin expression and prognosis in cutaneous malignant melanoma.
AB  - PURPOSE: Melastatin (MLSN-1), a novel melanocyte-specific gene recently
      identified using a genomic approach, is expressed in murine and human melanoma
      cells at levels inversely proportional to metastatic rates in vivo. We studied
      the relationship between expression of melastatin mRNA in the primary cutaneous
      tumor and prognosis in patients with localized malignant melanoma. PATIENTS AND
      METHODS: Melastatin mRNA was evaluated by in situ hybridization in primary
      cutaneous melanoma from 150 patients with localized disease (American Joint
      Committee on Cancer [AJCC] stage I and II). Multivariate Cox proportional hazards
      regression analysis was performed to assess the prognostic utility of melastatin
      mRNA expression while adjusting for other prognostic indicators. RESULTS: Uniform
      melastatin mRNA expression in the primary tumor was correlated with prolonged
      disease-free survival (P < .0001). Multivariate analysis revealed that melastatin
      status, mitotic rate, and tumor thickness influence disease-free survival
      independently. The 8-year disease-free survival rate in AJCC stage I patients
      whose tumors diffusely expressed melastatin mRNA was 100%, whereas in stage I
      patients with melastatin loss, the disease-free survival rate was 77% +/- 15%
      (median +/- SE). In patients with stage II disease whose tumors diffusely
      expressed melastatin mRNA, the 8-year disease-free survival rate was 90% +/- 7%,
      whereas in patients with melastatin loss, the disease-free survival rate was 51%
      +/- 8%. CONCLUSION: Downregulation of melastatin mRNA in the primary cutaneous
      tumor is a prognostic marker for metastasis in patients with localized malignant
      melanoma and is independent of tumor thickness and other variables. Used in
      combination, melastatin status and tumor thickness allow for the identification
      of subgroups of patients at high and low risk of developing metastatic disease.

PMID- 11208853
TI  - Increased serum concentration of angiogenic factors in malignant melanoma
      patients correlates with tumor progression and survival.
AB  - PURPOSE: To determine the predictive value of the angiogenic serum factors
      angiogenin, vascular endothelial growth factor (VEGF), basic fibroblast growth
      factor (bFGF), and interleukin-8 (IL-8) for the prognosis of patients with
      malignant melanoma. PATIENTS AND METHODS: Angiogenin, VEGF, bFGF, and IL-8 were
      measured in sera of 125 melanoma patients with different stages of disease and
      with or without current therapy including interferon alfa and different
      cytostatics in comparison with 30 healthy controls using enzyme-linked
      immunosorbent assay. RESULTS: Serum levels of angiogenin, VEGF, bFGF, and IL-8
      were significantly increased in melanoma patients compared with healthy controls.
      Elevated serum concentrations of VEGF, bFGF, and IL-8 were associated with
      advanced disease stages and tumor burden. Cytostatic therapy of patients was
      accompanied by increased serum levels of angiogenin, bFGF, and IL-8. As shown by
      univariate analysis, elevated serum levels of VEGF (P = .0001 and .0036), bFGF (P
      < .00005 and < .00005), and IL-8 (P < .00005 and < .00005) were strongly
      correlated with a poor overall and progression-free survival, respectively.
      Multivariate analysis revealed stage of disease (P = .0238), tumor burden (P =
      .0347), VEGF (P = .0036), bFGF (P = .0252), and IL-8 (P = .0447) as independent
      predictive factors of overall survival. Tumor burden (P = .0081), VEGF (P =
      .0245), and IL-8 (P = .0089) were found as independent predictive factors of
      progression-free survival. CONCLUSION: Our data suggest that the angiogenic serum
      factors VEGF, bFGF, and IL-8 are useful predictive markers for overall and
      progression-free survival in melanoma patients.

PMID- 11208854
TI  - Phase I clinical trial of oral COL-3, a matrix metalloproteinase inhibitor, in
      patients with refractory metastatic cancer.
AB  - PURPOSE: This phase I clinical trial was designed to determine the maximum
      tolerated dose and dose-limiting toxicities of the matrix metalloproteinase (MMP)
      inhibitor COL-3 in patients with refractory solid tumors. PATIENTS AND METHODS:
      Thirty-five patients with different cancer types were enrolled. COL-3 doses were
      escalated from 36 mg/m2/d in successive cohorts of at least three patients.
      Circulating levels of MMP-2, MMP-9, vascular endothelial growth factor, and basic
      fibroblast growth factor were assessed during treatment. Pharmacokinetic
      parameters were assessed for single and multiple doses of drug. RESULTS:
      Cutaneous phototoxicity was dose-limiting at 98 mg/m2/d. With the use of
      prophylactic sunblock, COL-3 was well tolerated at 70 mg/m2/d. The dose of 36
      mg/m2/d was well tolerated without the use of sunblock. Other toxicities that did
      not seem to be related to dose or pharmacokinetics included anemia, anorexia,
      constipation, dizziness, elevated liver function test results, fever, headache,
      heartburn, nausea, vomiting, peripheral and central neurotoxicities, fatigue, and
      three cases of drug-induced lupus. Disease stabilization for periods of 26+
      months, 8 months, and 6 months were seen in hemangioendothelioma, Sertoli-Leydig
      cell tumor, and fibrosarcoma, respectively. There was a potentially statistically
      significant relationship between changes in plasma MMP-2 levels and cumulative
      doses of drug when progressive disease patients were compared with those with
      stable disease or toxicity (P = .042). CONCLUSION: COL-3 induced disease
      stabilization in several patients who had a nonepithelial type of malignancy.
      Phototoxicity was dose-limiting. We recommend the dose of 36 mg/m2/d for phase II
      trials.

PMID- 11208855
TI  - Ascertainment of the incidence of Beckwith-Wiedemann syndrome in the National
      Wilms Tumor Study Group.

PMID- 11208856
TI  - Blinding of clinical investigators.

PMID- 11208857
TI  - Hazards of quality-of-life data for clinical decision making.

PMID- 11208858
TI  - When the tumor is not the target, tell the children.

PMID- 11208859
TI  - Conflicting phase II efficacy data for Doxil.

PMID- 11208860
TI  - Bleomycin-induced lung toxicity and pentoxifylline.

PMID- 11208861
TI  - Complementary therapies in cancer patients.

PMID- 11208863
TI  - Antigen-specific inhibition of effector T cell function in humans after injection
      of immature dendritic cells.
AB  - Immunostimulatory properties of dendritic cells (DCs) are linked to their
      maturation state. Injection of mature DCs rapidly enhances antigen-specific CD4+
      and CD8+ T cell immunity in humans. Here we describe the immune response to a
      single injection of immature DCs pulsed with influenza matrix peptide (MP) and
      keyhole limpet hemocyanin (KLH) in two healthy subjects. In contrast to prior
      findings using mature DCs, injection of immature DCs in both subjects led to the
      specific inhibition of MP-specific CD8+ T cell effector function in freshly
      isolated T cells and the appearance of MP-specific interleukin 10-producing
      cells. When pre- and postimmunization T cells were boosted in culture, there were
      greater numbers of MP-specific major histocompatibility complex tetramer-binding
      cells after immunization, but these had reduced interferon production and lacked
      killer activity. These data demonstrate the feasibility of antigen-specific
      inhibition of effector T cell function in vivo in humans and urge caution with
      the use of immature DCs when trying to enhance tumor or microbial immunity.

PMID- 11208862
TI  - Fatal leukemia in interleukin 15 transgenic mice follows early expansions in
      natural killer and memory phenotype CD8+ T cells.
AB  - Inflammation likely has a role in the early genesis of certain malignancies.
      Interleukin (IL)-15, a proinflammatory cytokine and growth factor, is required
      for lymphocyte homeostasis. Intriguingly, the expression of IL-15 protein is
      tightly controlled by multiple posttranscriptional mechanisms. Here, we
      engineered a transgenic mouse to overexpress IL-15 by eliminating these
      posttranscriptional checkpoints. IL-15 transgenic mice have early expansions in
      natural killer (NK) and CD8+ T lymphocytes. Later, these mice develop fatal
      lymphocytic leukemia with a T-NK phenotype. These data provide novel evidence
      that leukemia, like certain other cancers, can arise as the result of chronic
      stimulation by a proinflammatory cytokine.

PMID- 11208864
TI  - Secreted lymphotoxin-alpha is essential for the control of an intracellular
      bacterial infection.
AB  - Although the essential role of tumor necrosis factor (TNF) in the control of
      intracellular bacterial infection is well established, it is uncertain whether
      the related cytokines lymphotoxin-alpha (LTalpha3) and lymphotoxin-beta (LTbeta)
      have independent roles in this process. Using C57Bl/6 mice in which the genes for
      these cytokines have been disrupted, we have examined the relative contribution
      of secreted LTalpha3 and membrane-bound LTbeta in the host response to aerosol
      Mycobacterium tuberculosis infection. To overcome the lack of peripheral lymph
      nodes in LTalpha-/- and LTbeta-/- mice, bone marrow chimeric mice were
      constructed. LT-/- chimeras, which lack both secreted LTalpha3 and membrane-bound
      LTbeta (LT1beta2 and LT2beta1), were highly susceptible and succumbed 5 wk after
      infection. LTbeta-/- chimeras, which lack only the membrane-bound LTbeta,
      controlled the infection in a comparable manner to wild-type (WT) chimeric mice.
      T cell responses to mycobacterial antigens and macrophage responses in LTalpha-/-
      chimeras were equivalent to those of WT chimeras, but in LTalpha-/- chimeras,
      granuloma formation was abnormal. LTalpha-/- chimeras recruited normal numbers of
      T cells into their lungs, but the lymphocytes were restricted to perivascular and
      peribronchial areas and were not colocated with macrophages in granulomas.
      Therefore, LTalpha3is essential for the control of pulmonary tuberculosis, and
      its critical role lies not in the activation of T cells and macrophages per se
      but in the local organization of the granulomatous response.

PMID- 11208865
TI  - Caspase activation is required for terminal erythroid differentiation.
AB  - The cysteine proteases known as caspases play a central role in most apoptotic
      pathways. Here, we show that caspase inhibitors arrest the maturation of human
      erythroid progenitors at early stages of differentiation, before nucleus and
      chromatin condensation. Effector caspases such as caspase-3 are transiently
      activated through the mitochondrial pathway during erythroblast differentiation
      and cleave proteins involved in nucleus integrity (lamin B) and chromatin
      condensation (acinus)without inducing cell death and cleavage of GATA-1. These
      observations indicate a new function for caspases as key proteases in the process
      of erythroid differentiation.

PMID- 11208866
TI  - Prostaglandin D2 selectively induces chemotaxis in T helper type 2 cells,
      eosinophils, and basophils via seven-transmembrane receptor CRTH2.
AB  - Prostaglandin (PG)D2, which has long been implicated in allergic diseases, is
      currently considered to elicit its biological actions through the DP receptor
      (DP). Involvement of DP in the formation of allergic asthma was recently
      demonstrated with DP-deficient mice. However, proinflammatory functions of PGD2
      cannot be explained by DP alone. We show here that a seven-transmembrane
      receptor, CRTH2, which is preferentially expressed in T helper type 2 (Th2)
      cells, eosinophils, and basophils in humans, serves as the novel receptor for
      PGD2. In response to PGD2, CRTH2 induces intracellular Ca2+mobilization and
      chemotaxis in Th2 cells in a Galphai-dependent manner. In addition, CRTH2, but
      not DP, mediates PGD2-dependent cell migration of blood eosinophils and
      basophils. Thus, PGD2 is likely involved in multiple aspects of allergic
      inflammation through its dual receptor systems, DP and CRTH2.

PMID- 11208867
TI  - Signal transducer and activator of transcription (STAT)-induced STAT inhibitor 1
      (SSI-1)/suppressor of cytokine signaling 1 (SOCS1) inhibits insulin signal
      transduction pathway through modulating insulin receptor substrate 1 (IRS-1)
      phosphorylation.
AB  - Signal transducer and activator of transcription (STAT)-induced STAT inhibitor 1
      (SSI-1) is known to function as a negative feedback regulator of cytokine
      signaling, but it is unclear whether it is involved in other biological events.
      Here, we show that SSI-1 participates and plays an important role in the insulin
      signal transduction pathway. SSI-1-deficient mice showed a significantly low
      level of blood sugar. While the forced expression of SSI-1 reduced the
      phosphorylation level of insulin receptor substrate 1 (IRS-1), SSI-1 deficiency
      resulted in sustained phosphorylation of IRS-1 in response to
      insulin.Furthermore, SSI-1 achieves this inhibition both by binding directly to
      IRS-1 and by suppressing Janus kinases. These findings suggest that SSI-1 acts as
      a negative feedback factor also in the insulin signal transduction pathway
      through the suppression of IRS-1 phosphorylation.

PMID- 11208868
TI  - Misregulated posttranscriptional checkpoints: inflammation and tumorigenesis.

PMID- 11208869
TI  - Differentiation of T regulatory cells by immature dendritic cells.

PMID- 11208870
TI  - Adjuvant therapy for all patients with breast cancer?

PMID- 11208871
TI  - Individual variation in p53 responsiveness.

PMID- 11208872
TI  - Public health burden of cancer in ataxia-telangiectasia heterozygotes.

PMID- 11208873
TI  - New chapter opens in Iranian research story.

PMID- 11208874
TI  - LIM kinase appears critical in metastasis, but how?

PMID- 11208875
TI  - Canada-U.S. mortality comparison highlights analytical pitfalls.

PMID- 11208876
TI  - International data comparisons: caveat emptor.

PMID- 11208877
TI  - When theories collide: experts develop different models for carcinogenesis.

PMID- 11208878
TI  - Stat bite: Smoking habits of young U.S. smokers counseled about tobacco use.

PMID- 11208879
TI  - Arm edema in breast cancer patients.
AB  - The improvement in the life expectancy of women with breast cancer raises
      important questions about how to improve the quality of life for women sustaining
      complications of breast cancer treatment. In particular, attention to common
      problems, such as arm edema, is of critical importance. We reviewed published
      breast cancer guidelines and literature identified via MEDLINE(R) searches in an
      effort to summarize the research literature pertinent to management of breast
      cancer-related arm edema, including incidence, prevalence, and timing; risk
      factors; morbidity; prevention; diagnosis; and efficacy of nonpharmacologic and
      pharmacologic interventions. We found that arm edema is a common complication of
      breast cancer therapy that can result in substantial functional impairment and
      psychological morbidity. The risk of arm edema increases when axillary dissection
      and axillary radiation therapy are used. Recommendations for preventive measures,
      such as avoidance of trauma, are available, but these measures have not been well
      studied. Nonpharmacologic treatments, such as massage and exercise, have been
      shown to be effective therapies for lymphedema, but the effect of pharmacologic
      interventions remains uncertain. Comparing results across studies is complicated
      by the fact that the definitions of interventions and measures of outcomes and
      risk stratification vary substantially among studies. As arm edema becomes more
      prevalent with the increasing survival of breast cancer patients, further
      research is needed to evaluate the efficacy of preventive strategies and
      therapeutic interventions.

PMID- 11208880
TI  - Prognosis and treatment of patients with breast tumors of one centimeter or less
      and negative axillary lymph nodes.
AB  - BACKGROUND: Uncertainty about prognosis and treatment of axillary lymph node
      negative patients with estrogen receptor (ER)-negative or ER-positive invasive
      breast tumors of 1 cm or less prompted the analysis of data from five National
      Surgical Adjuvant Breast and Bowel Project randomized clinical trials. METHODS:
      Two hundred thirty-five patients with ER-negative tumors and 1024 patients with
      ER-positive tumors were identified in these trials. Patients with ER-negative
      tumors received surgery alone or surgery and chemotherapy. Patients with ER
      positive tumors received surgery alone; surgery and tamoxifen; or surgery,
      tamoxifen, and chemotherapy. End points were relapse-free survival (RFS), event
      free survival, and overall survival. A result was considered to be statistically
      significant with a P value of.05 or less; all statistical tests were two-sided.
      RESULTS: The 8-year RFS of women with ER-negative tumors who received surgery
      alone or with chemotherapy was 81% and 90%, respectively (P = .06). Survival was
      similar in both groups (93% and 91%; P = .65). The 8-year RFS of women with ER
      positive tumors was 86% after surgery alone, 93% when tamoxifen was added (P =
      .01), and 95% after the addition of tamoxifen and chemotherapy (P = .07 compared
      with tamoxifen). Survival in the three groups was 90%, 92% (P = .41), and 97%,
      respectively. The difference between the latter two groups was significant (P =
      .01). Regardless of ER status or treatment, overall mortality was 8%; one half of
      the deaths were related to breast cancer. Several covariates affected the risk of
      recurrence in ER-negative and ER-positive patients. Risk was greater in women
      with tumors of 1 cm than in those with tumors of less than 1 cm, in women aged 49
      years or younger than in those aged 50 years or older, and in women with
      infiltrating ductal or lobular carcinoma than in those with other histologic
      tumor types. CONCLUSIONS: Chemotherapy and/or tamoxifen should be considered for
      the treatment of women with ER-negative or ER-positive tumors of 1 cm or less and
      negative axillary lymph nodes.

PMID- 11208881
TI  - Cancer in patients with ataxia-telangiectasia and in their relatives in the
      nordic countries.
AB  - BACKGROUND: Epidemiologic studies of the families of patients with ataxia
      telangiectasia (A-T), a recessive genetic neurologic disorder caused by mutation
      of the ATM gene, suggest that heterozygous carriers of an ATM mutation are at
      increased risk of cancer. A population-based study of cancer incidence in A-T
      families with unbiased selection and tracing of relatives would confirm this
      hypothesis. METHODS: We conducted a study in the Nordic countries of 1218 blood
      relatives of 56 A-T patients from 50 families. The relatives were identified from
      population registries, and the occurrence of cancer was determined from cancer
      registry files in each country and compared with national incidence rates. All
      statistical tests were two-sided. RESULTS: Among the 56 patients with A-T, we
      observed six cases of cancer (four leukemias and two non-Hodgkin's lymphomas)
      compared with 0.16 expected, yielding a standardized incidence ratio (SIR) of 37
      (95% confidence interval [CI] = 13 to 80). Among the 1218 relatives, 150 cancers
      were recorded, with 126 expected (SIR = 1.19; 95% CI = 1.01 to 1.40). Invasive
      breast cancer occurred in 21 female relatives of A-T patients (SIR = 1.54; 95% CI
      = 0.95 to 2.36), including five of the 50 mothers (all of whom are obligate ATM
      mutation carriers) (SIR = 7.1; 95% CI = 2.3 to 17). Relatives who were less
      likely to be carriers of a mutant ATM allele had no increase or only a modest,
      statistically nonsignificant increase in the risk of breast cancer. There was no
      evidence of increased risk for cancer at any other site. CONCLUSIONS: We
      confirmed the previously recognized high risk of lymphoma and leukemia in A-T
      patients. Our data are also consistent with an increased risk of breast cancer
      among blood relatives of A-T patients. The epidemiologic findings suggest,
      however, that, even if ATM mutations are responsible for some breast cancer
      cases, ATM is a relatively weak genetic risk factor for the disease.

PMID- 11208882
TI  - Induction of p53 expression in skin by radiotherapy and UV radiation: a
      randomized study.
AB  - BACKGROUND: p53 protein plays an important role in the response to DNA damage,
      and radiotherapy can cause radiation dermatitis. p53 and p21 levels increase in
      vitro when DNA is damaged by UVA, UVB, or gamma-radiation. To determine whether
      this response occurs in human skin and predicts the level of radiation
      dermatitis, we investigated levels of p53 and p21 in skin exposed to different
      types of radiation as part of a randomized study of women with breast cancer to
      evaluate topical steroid or emollient cream treatments for radiation dermatitis
      of their irradiated breast. METHODS: After surgery but before receiving
      tangential 5-mV photo-beam radiotherapy (2 Gy and 54 Gy) to the affected breast
      parenchyma, multiple areas on the backs of 50 women were irradiated with UVA and
      other areas were irradiated with UVB. Skin biopsy samples were taken from areas
      of normal unirradiated skin and all irradiated areas, and p53 and p21 were
      detected immunohistochemically. All statistical tests are two-sided. RESULTS: In
      skin irradiated with UVA or UVB, medians of 4.4% (range = 0%-40.5%) or 45.5%
      (range = 5.3%-74.6%) p53-positive keratinocytes, respectively, were observed.
      Radiotherapy produced medians of 31.0% (range = 0%-79.3%) p53-immunoreactive
      cells after 2 Gy of radiation and 83.2% (range = 37.6%-95.2%) after 54 Gy of
      radiation. Despite large interindividual differences in p53 response, comparable
      increases in epidermal p53 response were independent of the type of radiation. A
      correlation between p53 and p21 was also evident (r(s) =.78). In breast skin,
      there was no association between the p53 response and the degree of erythema (a
      measure of radiation dermatitis) and no statistically significant difference
      between treatment arms and p21/p53 responses. CONCLUSIONS: Individual responses
      to radiation-induced DNA damage varied widely and may be independent of the type
      of radiation. The epidermal p53 response does not predict the degree of radiation
      dermatitis.

PMID- 11208883
TI  - Nicotine yield from machine-smoked cigarettes and nicotine intakes in smokers:
      evidence from a representative population survey.
AB  - BACKGROUND: The relevance of nicotine yields from machine-smoked cigarettes for
      quantifying smokers' nicotine intakes and exposure to cigarette toxins has been
      called into question. However, most studies of the relationship between nicotine
      yield and nicotine intake have been on relatively small and unrepresentative
      samples and have included few smokers of "ultra-low" brands (i.e., those yielding
      around 1 mg of tar and 0.1 mg of nicotine). METHODS: We examined the relationship
      between salivary cotinine (a major metabolite of nicotine) concentrations and
      nicotine yields of machine-smoked cigarettes in a nationally representative
      sample of 2031 adult smokers of manufactured cigarettes surveyed in the 1998
      Health Survey for England. We used standard linear regression techniques to
      examine associations and two-sided tests of statistical significance. RESULTS:
      Cotinine concentrations varied widely between smokers at any level of nominal
      brand nicotine yield. On average, cotinine levels were slightly lower in smokers
      of lower nicotine-yielding brands, but these smokers differed in terms of sex,
      socioeconomic profile, and cigarette consumption. After we controlled for
      potential confounders, nicotine yield from the brand smoked accounted for only
      0.79% of the variation in saliva cotinine concentrations. Nicotine intake per
      cigarette smoked, as estimated from salivary cotinine level, did not correspond
      with machine-smoked yields at any level of nicotine yield. Nicotine intake per
      cigarette was about eight times greater than machine-smoked yields at the lowest
      deliveries (1.17 mg estimated nicotine intake per cigarette from brands averaging
      0.14-mg delivery from machine smoking) and 1.4 times greater for the highest
      yield cigarettes (1.31-mg estimated nicotine intake per cigarette from brands
      averaging 0.91 mg from machine smoking). CONCLUSIONS: Smokers' tendency to
      regulate nicotine intake vitiates potential health gains from lower tar and
      nicotine cigarettes. Current approaches to characterizing tar and nicotine yields
      of cigarettes provide a simplistic guide to smokers' exposure that is misleading
      to consumers and regulators alike and should be abandoned.

PMID- 11208884
TI  - Quality of informed consent: a new measure of understanding among research
      subjects.
AB  - BACKGROUND: The informed consent of participants is ethically and legally
      required for most research involving human subjects. However, standardized
      methods for assessing the adequacy of informed consent to research are lacking.
      METHODS AND RESULTS: We designed a brief questionnaire, the Quality of Informed
      Consent (QuIC), to measure subjects' actual (objective) and perceived
      (subjective) understanding of cancer clinical trials. The QuIC incorporates the
      basic elements of informed consent specified in federal regulations, assesses the
      therapeutic misconception (the belief that all aspects of a clinical trial are
      designed to directly benefit the subject), and employs the language and structure
      of the new National Cancer Institute template for informed consent documents. We
      modified the QuIC after receiving feedback from pilot tests with cancer research
      subjects, as well as validation from two independent expert panels. We then sent
      the QuIC to 287 adult cancer patients enrolled on phase I, II, or III clinical
      trials. Two hundred seven subjects (72%) completed the QuIC. To assess test
      retest reliability, a random sample of 32 respondents was selected, of whom 17
      (53%) completed the questionnaire a second time. The test-retest reliability was
      good with intraclass correlation coefficients of.66 for tests of objective
      understanding and.77 for tests of subjective understanding. The current version
      of the QuIC, which consists of 20 questions for objective understanding and 14
      questions for subjective understanding, was tested for time and ease of
      administration in a sample of nine adult cancer patients. The QuIC required an
      average of 7.2 minutes to complete. CONCLUSIONS: The QuIC is a brief, reliable,
      and valid questionnaire that holds promise as a standardized way to assess the
      outcome of the informed consent process in cancer clinical trials.

PMID- 11208885
TI  - Epstein-Barr virus detection in ductal carcinoma of the breast.

PMID- 11208887
TI  - Re: Biologic characteristics of interval and screen-detected breast cancers.

PMID- 11208888
TI  - Re: Population-based study of BRCA1 and BRCA2 mutations in 1035 unselected
      Finnish breast cancer patients.

PMID- 11208891
TI  - Intrafamilial transmission of human herpesvirus 8.

PMID- 11208894
TI  - Re: Randomized trial of a specialist genetic assessment service for familial
      breast cancer.

PMID- 11208892
TI  - Re: Population stratification in epidemiologic studies of common genetic variants
      and cancer: quantification of bias.

PMID- 11208895
TI  - Cyclic ADP-ribose as a potential second messenger for neuronal Ca2+ signaling.
AB  - Cyclic ADP-ribose (cADPR), a known endogenous modulator of ryanodine receptor
      Ca2+ releasing channels, is found in the nervous system. Injection of cADPR into
      neuronal cells primarily induces a transient elevation of intracellular Ca2+
      concentration ([Ca2+]i), and/or secondarily potentiates [Ca2+]i increases that
      are the result of depolarization-induced Ca2+ influx. Acetylcholine release from
      cholinergic neurons is facilitated by cADPR. cADPR modifies K+ currents or
      elicits Ca2+-dependent inward currents. cADPR is synthesized by both membrane
      bound and cytosolic forms of ADP-ribosyl cyclase in neuronal cells. cADPR
      hydrolase activity is weak in the membrane fraction, but high in the cytoplasm.
      Cytosolic ADP-ribosyl cyclase activity is upregulated by nitric oxide/cyclic GMP
      dependent phosphorylation. Stimulation of muscarinic and beta-adrenergic
      receptors activates membrane-bound ADP-ribosyl cyclase via G proteins within
      membranes of neuronal tumor cells and cortical astrocytes. These findings
      strongly suggest that cADPR is a second messenger in Ca2+ signaling in the
      nervous system, although many intriguing issues remain to be addressed before
      this identity is confirmed.

PMID- 11208896
TI  - Expression and localization of the CYP2B subfamily predominantly in neurones of
      rat brain.
AB  - Despite the very small amounts of cytochrome P450 (P450, CYP) enzymes expressed
      in different areas and cell populations of the brain as compared with the liver,
      there is significant evidence for their specific involvement in brain
      development, function and plasticity. Nevertheless, the current discussion about
      occurrence and importance of cerebral cytochrome P450s is determined by
      inconsistent interpretations of their function in general and with respect to
      single isoforms. Continuing a series of publications about brain P450 isoforms,
      we now present evidence for the constitutive expression of CYP2B1 and CYP2B2
      mRNAs in rat brain. Immunocytochemical and non-radioactive in situ hybridization
      studies revealed the same expression pattern throughout the brain predominantly
      in neuronal populations, but to some extent in astrocytes of corpus callosum and
      olfactory bulb. The well known testosterone-metabolizing capacity and the
      presence of CYP2B isoforms shown in steroid hormone-sensitive areas and neurones
      (e.g. hippocampus) clarify the significance of isoforms like CYP2B1 and CYP2B2
      for impairment of steroid hormone actions by P450 inducing environmental
      substances. We argue that cerebral P450 isoforms which are induced by xenobiotics
      and are able to metabolize these as well as endogenous substrates help us to
      understand fundamental aspects of brain's functioning.

PMID- 11208897
TI  - Peroxynitrite affects Ca2+ influx through voltage-dependent calcium channels.
AB  - The effect of peroxynitrite (OONO-) on voltage-dependent Ca2+ channels (VDCCs)
      was examined by measuring [45Ca2+] influx into mouse cerebral cortical neurones.
      OONO- time- and dose-dependently increased [45Ca2+] influx and this increase was
      abolished by manganese (III) tetrakis (4-benzoic acid) porphyrin, a scavenger for
      OONO-. Inhibition of cyclic GMP (cGMP) formation did not alter the OONO(-)
      induced [45Ca2+] influx. OONO-, as well as 30 mm KCl, significantly increased
      fluorescence intensity of cell-associated bis-(1,3-dibutylbarbituric acid)
      trimethine oxonol (bis-oxonol). Tetrodotoxin and membrane stabilizers such as
      lidocaine dose-dependently suppressed OONO(-)-induced [45Ca2+] influx. Although
      each of 1 microM nifedipine and 1 microM omega-agatoxin VIA (omega-ATX)
      significantly inhibited the OONO(-)-induced [45Ca2+] influx and the concomitant
      presence of these agents completely abolished the influx, 1 microM omega
      conotoxin GVIA (omega-CTX) showed no effect on the influx. On the other hand,
      OONO- itself reduced 30 mM KCl-induced [45Ca2+] influx to the level of [45Ca2+]
      influx induced by OONO- alone, and the magnitude of this reduction was as same as
      that of KCl-induced [45Ca2+] influx by omega-CTX. These results indicate that
      OONO- increases [45Ca2+] influx into the neurones through opening P/Q- and L-type
      VDCCs subsequent to depolarization, and inhibits the influx through N-type VDCCs.

PMID- 11208898
TI  - Group II metabotropic glutamate receptor activation protects striatal
      dopaminergic nerve terminals against MPP+-induced neurotoxicity along with brain
      derived neurotrophic factor induction.
AB  - We have studied the in vivo effect of the selective agonist for group II
      metabotropic glutamate receptors (2S, 2'R, 3'R)-2-(2'3'
      dicarboxycyclopropyl)glycine (DCG-IV) against MPP+-induced toxicity on rat
      striatal dopaminergic nerve terminals by using both microdialysis and
      immunohistochemical techniques. Perfusion of 1 mM DCG-IV during 1 h protected
      dopaminergic nerve terminals against the degeneration induced by a 15-minute
      perfusion of 1 mM MPP+. In addition, the microglial cell population was markedly
      activated 24 h after DCG-IV perfusion. The astroglial cell population was only
      markedly activated around the microdialysis probe. This protective effect seems
      to be dependent on protein synthesis since 1 mM cycloheximide, an inhibitor of
      protein synthesis, abolished the neuroprotective effect of 1 mM DCG-IV against
      MPP+ toxicity. Perfusion of DCG-IV induced an upregulation of striatal brain
      derived neurotrophic factor (BDNF) mRNA expressing cells which were confined
      precisely around the microdialysis probe. Taken together, our results suggest
      that the induction and release of brain-derived neurotrophic factor (BDNF) by
      activated glial cells induced by DCG-IV perfusion may account for its protective
      action against MPP+-induced dopaminergic terminal degeneration.

PMID- 11208899
TI  - Protein kinase C activation by 12-0-tetradecanoylphorbol 13-acetate in CG-4 line
      oligodendrocytes stimulates turnover of choline and ethanolamine phospholipids by
      phospholipase D and induces rapid process contraction.
AB  - Treatment of [3H]-choline- or [14C]-ethanolamine-labelled undifferentiated
      bipolar and differentiated multipolar CG-4 line oligodendrocytes with 12-0
      tetradecanoylphorbol 13-acetate (TPA) to activate protein kinase C stimulated the
      release of choline or ethanolamine metabolites to the medium over controls. Ro31
      8220, a PKC inhibitor, reduced TPA-stimulated release of choline- and
      ethanolamine-metabolites to basal levels. TPA treatment of both bipolar and
      multipolar cells caused rapid contraction of processes leaving rounded up cells:
      this effect was blocked by Ro31-8220. After 12-15 h exposure to TPA, bipolar
      undifferentiated CG-4 line cells extended short processes again and the cells
      became multipolar. Nocodozole, an agent which disrupts microtubules and caused CG
      4 line cells to round up, caused increased choline or ethanolamine-metabolite
      release to the medium over basal levels suggesting that some release during TPA
      treatment might occur due to process fragmentation. However, the
      transphosphatidylation reaction confirmed that phospholipase D was active in
      these cells. Exposure of bipolar undifferentiated CG-4 line cells to TPA resulted
      in down-regulatation of PKC-alpha and PKC-beta which could not be detected by
      Western blotting after a few hours; PKC-epsilon was down-regulated much more
      slowly but PKCs delta, zeta and iota were not influenced by 48 h exposure of
      cells to TPA. Formation of phosphatidylethanol in the transphosphatidylation
      reaction was markedly reduced in TPA down-regulated cells indicating a role for
      PKCs alpha and beta in phospholipase D activation in CG-4 line oligodendrocytes.

PMID- 11208900
TI  - Parallel modification of adenosine extracellular metabolism and modulatory action
      in the hippocampus of aged rats.
AB  - The neuromodulator adenosine can be released as such, mainly activating
      inhibitory A1 receptors, or formed from released ATP, preferentially activating
      facilitatory A2A receptors. We tested if changes in extracellular adenosine
      metabolism paralleled changes in A1/A2A receptor neuromodulation in the aged rat
      hippocampus. The evoked release and extracellular catabolism of ATP were 49-55%
      lower in aged rats, but ecto-5'-nucleotidase activity, which forms adenosine, was
      5-fold higher whereas adenosine uptake was decreased by 50% in aged rats. The
      evoked extracellular adenosine accumulation was 30% greater in aged rats and
      there was a greater contribution of the ecto-nucleotidase pathway and a lower
      contribution of adenosine transporters for extracellular adenosine formation in
      nerve terminals. Interestingly, a supramaximal concentration of an A1 receptor
      agonist, N6-cyclopentyladenosine (250 nM) was less efficient in inhibiting (17%
      in old versus 34% in young) and A2A receptor activation with 30 nM CGS21680 was
      more efficient in facilitating (63% in old versus no effect in young)
      acetylcholine release from hippocampal slices of aged compared with young rats.
      The parallel changes in the metabolic sources of extracellular adenosine and
      A1/A2A receptor neuromodulation in aged rats further strengthens the idea that
      different metabolic sources of extracellular adenosine are designed to
      preferentially activate different adenosine receptor subtypes.

PMID- 11208901
TI  - Survival activity of troglitazone in rat motoneurones.
AB  - Troglitazone (TGZ), an antidiabetic drug that improves insulin-resistance in the
      peripheral tissues, was tested for neurotrophic activity in motoneurones and
      other neurones in culture. In rat motoneurones, TGZ had a remarkable effect on
      survival, which was comparable or superior to that of brain-derived neurotrophic
      factor, a known potent neurotrophic factor for rat motoneurones. However, TGZ did
      not promote the survival of sensory, sympathetic, septal or hippocampal neurones.
      The effect of TGZ on motoneurones was additive to that of insulin-like growth
      factor-I and both activities were inhibited by phosphatidylinositol 3-kinase (PI3
      kinase) inhibitors, wortmannin and LY294002, suggesting the involvement of the
      activation of PI3-kinase in the activity of TGZ. Pioglitazone, another
      antidiabetic drug structurally similar to TGZ, did not show any activity,
      indicating that the agonistic activity of TGZ for peroxisome proliferator
      activated receptor-gamma is not involved in the survival activity. Chromanol, an
      antioxidant moiety of TGZ, showed little or no survival activity. These results
      indicate specific neurotrophic activity of TGZ for motoneurones through the
      activation of PI3-kinase and support the applicability of TGZ for the treatment
      of motor neurone diseases such as amyotrophic lateral sclerosis.

PMID- 11208902
TI  - Cholesterol-dependent modulation of tau phosphorylation in cultured neurons.
AB  - One of the hallmarks of Alzheimer's disease (AD) is the abnormal state of tau. It
      is both highly phosphorylated and aggregated into paired helical filaments (PHFs)
      in neurofibrillary tangles (NFTs). However, the mechanism underlying the
      hyperphosphorylation of tau in NFTs and neuronal degeneration in AD remains to be
      elucidated. The fact that hyperphosphorylation of tau in NFTs are also found in
      the patients with Niemann-Pick disease, type C (NPC), which is a cholesterol
      storage disease associated with defective intracellular trafficking of exogenous
      cholesterol, implies that perturbation of cholesterol metabolism may be involved
      in tau phosphorylation and neurodegeneration. Here, we report that cholesterol
      deficiency induced by inhibition of cholesterol biosynthesis in cultured neurons
      results in hyperphosphorylation of tau, accompanied by axonal degeneration
      associated with microtubule depolymerization. These changes were prevented by
      concurrent treatment with beta-migrating very low-density lipoprotein (beta-VLDL)
      or cholesterol. We propose that intracellular cholesterol plays an essential role
      in the modulation of tau phosphorylation and the maintenance of microtubule
      stability.

PMID- 11208903
TI  - Cyclic AMP and mitogen-activated protein kinases are required for glutamate
      dependent cyclic AMP response element binding protein and Elk-1 phosphorylation
      in the dorsal striatum in vivo.
AB  - Dopaminergic and glutamatergic signalling cascades are integrated in striatal
      medium spiny neurones by cyclic AMP response-element binding protein and Elk-1
      phosphorylation. Phosphorylated cyclic AMP response-element binding protein and
      phosphorylated Elk-1 contribute to c-fos expression by binding to the calcium and
      cyclic AMP response-element and the serum response element, respectively, in the
      c-fos promoter. The role of cyclic AMP and mitogen-activated protein kinase
      signalling cascades in glutamate-induced cyclic AMP response-element binding
      protein and Elk-1 phosphorylation and Fos expression was investigated using
      semiquantitative immunocytochemistry in vivo. Intracerebroventricular infusion of
      the sodium channel blocker, tetrodotoxin, decreased the glutamate-induced
      increase in phosphorylated cyclic AMP response-element binding protein,
      phosphorylated Elk-1, and Fos immunoreactivity. Intracerebroventricular infusion
      of the mitogen-activated and extracellular signal-regulated kinase inhibitor,
      PD98059, the p38 mitogen-activated protein kinase inhibitor, SB203580, or the
      cyclic AMP inhibitor, Rp-8-Br-cAMPS, decreased glutamate-induced phosphorylated
      cyclic AMP response-element binding protein, phosphorylated Elk-1, and Fos
      immunoreactivity. Simultaneous infusion of glutamate and Sp-8-Br-cAMPS, a cyclic
      AMP analogue, augmented induction of Fos immunoreactivity but not phosphorylated
      cyclic AMP response-element binding protein or phosphorylated Elk-1
      immunoreactivity. These data indicate that cyclic AMP and mitogen-activated
      protein kinase signalling cascades are necessary for glutamate to induce cyclic
      AMP response-element binding protein and Elk-1 phosphorylation and Fos expression
      in the striatum. Furthermore, neuronal activity plays an important role in
      glutamate-induced signalling cascades in vivo.

PMID- 11208904
TI  - Carbohydrate-protein interactions between HNK-1-reactive sulfoglucuronyl
      glycolipids and the proteoglycan lectin domain mediate neuronal cell adhesion and
      neurite outgrowth.
AB  - Lecticans, a family of chondroitin sulfate proteoglycans, represent the largest
      group of proteoglycans expressed in the nervous system. We previously showed that
      the C-type lectin domains of lecticans bind two classes of sulfated cell surface
      glycolipids, sulfatides and HNK-1-reactive sulfoglucuronylglycolipids (SGGLs). In
      this paper, we demonstrate that the interaction between the lectin domain of
      brevican, a nervous system-specific lectican, and cell surface SGGLs acts as a
      novel cell recognition system that promotes neuronal adhesion and neurite
      outgrowth. The Ig chimera of the brevican lectin domain bind to the surface of
      SGGL-expressing rat hippocampal neurons. The substrate of the brevican chimera
      promotes adhesion and neurite outgrowth of hippocampal neurons. The authentic,
      full-length brevican also promotes neuronal cell adhesion and neurite outgrowth.
      These activities of brevican substrates are neutralized by preincubation of cells
      with HNK-1 monoclonal antibodies and by pretreatment of the brevican substrates
      with purified SGGLs. Brevican and HNK-1 carbohydrates are coexpressed in specific
      layers of the developing hippocampus where axons from entorhinal neurons
      elongate. Our observations suggest that cell surface SGGLs and extracellular
      lecticans comprise a novel cell-substrate recognition system operating in the
      developing nervous system.

PMID- 11208905
TI  - On the mechanisms of neuroprotection by creatine and phosphocreatine.
AB  - Creatine and phosphocreatine were evaluated for their ability to prevent death of
      cultured striatal and hippocampal neurons exposed to either glutamate or 3
      nitropropionic acid (3NP) and to inhibit the mitochondrial permeability
      transition in CNS mitochondria. Phosphocreatine (PCr), and to a lesser extent
      creatine (Cr), but not (5R,10S)-(+)-5-methyl-10,11-dihydro-5H
      dibenzo[a,d]cyclohepten-5,10-imine hydrogen maleate (MK801), dose-dependently
      ameliorated 3NP toxicity when applied simultaneously with the 3NP in Mg2+-free
      media. Pre-treatment of PCr for 2 or 5 days and Cr for 5 days protected against
      glutamate excitotoxicity equivalent to that achieved by MK801 post-treatment. The
      combination of PCr or Cr pre-treatment and MK801 post-treatment did not provide
      additional protection, indicating that both prevented the toxicity attributable
      to secondary glutamate release. To determine if Cr or PCr directly inhibited the
      permeability transition, mitochondrial swelling and depolarization were assayed
      in isolated, purified brain mitochondria. PCr reduced the amount of swelling
      induced by calcium by 20%. Cr decreased mitochondrial swelling when inhibitors of
      creatine kinase octamer-dimer transition were present. However, in brain
      mitochondria prepared from rats fed a diet supplemented with 2% creatine for 2
      weeks, the extent of calcium-induced mitochondrial swelling was not altered.
      Thus, the neuroprotective properties of PCr and Cr may reflect enhancement of
      cytoplasmic high-energy phosphates but not permeability transition inhibition.

PMID- 11208906
TI  - Activation and redistribution of c-jun N-terminal kinase/stress activated protein
      kinase in degenerating neurons in Alzheimer's disease.
AB  - Cellular responses to increased oxidative stress appear to be a mechanism that
      contributes to the varied cytopathology of Alzheimer's disease (AD). In this
      regard, we suspect that c-Jun N-terminal kinase/Stress activated protein kinase
      (JNK/SAPK), a major cellular stress response protein induced by oxidative stress,
      plays an important role in Alzheimer disease in susceptible neurons facing the
      dilemma of proliferation or death. We found that JNK2/SAPK-alpha and JNK3/SAPK
      beta were related to neurofibrillary pathology and JNK1/SAP-Kgamma related to
      Hirano bodies in cases of AD but were only weakly diffuse in the cytoplasm in all
      neurons in control cases and in non-involved neurons in diseased brain. In this
      regard, in hippocampal and cortical regions of individuals with severe AD, the
      activated phospho-JNK/SAPK was localized exclusively in association with
      neurofibrillar alterations including neurofibrillary tangles, senile plaque
      neurites, neuropil threads and granulovacuolar degeneration structures (GVD),
      completely overlapping with tau-positive neurofibrillary pathology, but was
      virtually absent in these brain regions in younger and age-matched controls
      without pathology. However, in control patients with some pathology, as well as
      in mild AD cases, there was nuclear phospho-JNK/SAPK and translocation of phospho
      JNK/SAPK from nuclei to cytoplasm, respectively, indicating that the activation
      and re-distribution of JNK/SAPK correlates with the progress of the disease. By
      immunoblot analysis, phospho-JNK/SAPK is significantly increased in AD over
      control cases. Together, these findings suggest that JNK/SAPK dysregulation,
      probably resulting from oxidative stress, plays an important role in the
      increased phosphorylation of cytoskeletal proteins found in AD.

PMID- 11208907
TI  - Reduction of glyceraldehyde-3-phosphate dehydrogenase activity in Alzheimer's
      disease and in Huntington's disease fibroblasts.
AB  - New functions have been identified for glyceraldehyde-3-phosphate dehydrogenase
      (GAPDH) including its role in neurodegenerative disease and in apoptosis. GAPDH
      binds specifically to proteins implicated in the pathogenesis of a variety of
      neurodegenerative disorders including the beta-amyloid precursor protein and the
      huntingtin protein. However, the pathophysiological significance of such
      interactions is unknown. In accordance with published data, our initial results
      indicated there was no measurable difference in GAPDH glycolytic activity in
      crude whole-cell sonicates of Alzheimer's and Huntington's disease fibroblasts.
      However, subcellular-specific GAPDH-protein interactions resulting in diminution
      of GAPDH glycolytic activity may be disrupted or masked in whole-cell
      preparations. For that reason, we examined GAPDH glycolytic activity as well as
      GAPDH-protein distribution as a function of its subcellular localization in 12
      separate cell strains. We now report evidence of an impairment of GAPDH
      glycolytic function in Alzheimer's and Huntington's disease subcellular fractions
      despite unchanged gene expression. In the postnuclear fraction, GAPDH was 27%
      less glycolytically active in Alzheimer's cells as compared with age-matched
      controls. In the nuclear fraction, deficits of 27% and 33% in GAPDH function were
      observed in Alzheimer's and Huntington's disease, respectively. This evidence
      supports a functional role for GAPDH in neurodegenerative diseases. The
      possibility is considered that GAPDH:neuronal protein interaction may affect its
      functional diversity including energy production and as well as its role in
      apoptosis.

PMID- 11208908
TI  - ortho-substituted PCB95 alters intracellular calcium signaling and causes
      cellular acidification in PC12 cells by an immunophilin-dependent mechanism.
AB  - ortho-Substituted PCBs mobilize Ca2+ from isolated brain microsomes by
      interaction with FKBP12/RyR complexes. Investigation into the cellular importance
      of this mechanism was undertaken using PC12 cells by fluoroimaging the actions of
      specific PCB congeners on [Ca2+]i and pH. RyR and IP3R share a common
      intracellular Ca2+ store in PC12 cells. Perfusion of nM to low microM PCB95
      caused a transient rise of [Ca2+]i that was not completely dependent on
      extracellular Ca2+. Pre-incubation of the cells with ryanodine or FK506
      completely eliminated PCB95 responses, suggesting a primary action on the
      FKPP12/RyR-sensitive store. PCB95, but not PCB126, induced a gradual decrease in
      cytosolic pH that could be completely eliminated by FK506 pre-incubation of the
      cells. Direct respiration measurement using isolated brain mitochondria
      demonstrated that neither of the PCBs directly altered any stage of mitochondrial
      respiration. These results revealed that PCB95 disrupts intracellular Ca2+
      signaling in PC12 cells by interaction with the FKBP12/RyR complex that in turn
      accelerated cellular metabolism, possibly affecting signaling between ER and
      mitochondria. Since ortho-substituted PCBs have been shown to be neurotoxic and
      may affect neurodevelopment, studies on the molecular mechanism by which they
      alter cellular signaling may provide valuable information on the physiological
      roles of FKPB12 and RyR on neuronal functions.

PMID- 11208910
TI  - Acute ethanol exposure induces [Ca2+]i transients, cell swelling and
      transformation of actin cytoskeleton in astroglial primary cultures.
AB  - Acute exposure to 100 mM isotonic ethanol (EtOH) increased intracellular Ca2+
      concentration ([Ca2+]i), induced cell swelling, and transformed actin
      cytoskeleton in astroglial primary cultures from rat cerebral cortex.
      Fluorometric recordings of fluo-3AM- or fura-2AM-incubated astroglial cells
      revealed that EtOH induced [Ca2+]i transients in a small population of the cells.
      Cell swelling was estimated using a new method based on three-dimensional
      fluorescence imaging in conjunction with image analysis and graphic visualization
      techniques. The method provides detailed results concerning the reformation of
      structural shape and specific volume alterations, as well as total proportions
      between the different states. Astroglial cell swelling was registered and
      quantified in 7 of 39 cells chosen from 12 different coverslips. EtOH also
      induced reversible conformational changes in filamentous actin, appearing as
      increases in ring formations and a more dispersed appearance of the filaments.
      Filamentous actin was stained with Alexa phalloidin after incubation with EtOH
      for varied periods. The results presented here suggest that EtOH affects
      astrocytes in a way that could be of physiological relevance.

PMID- 11208909
TI  - Morphological and neurochemical identification of enteric neurones with mucosal
      projections in the human small intestine.
AB  - Data on the axonal projections of enteric neurones in the human intestine are
      still scarce. The present study aimed to identify the morphology and
      neurochemical coding of enteric neurones in the human small intestine, which are
      involved in the innervation of the mucosa. The lipophilic neuronal tracer DiI was
      applied to one mucosal villus of small intestinal resection specimens. The tissue
      was kept in organotypic culture and subsequently processed for
      immunohistochemistry. Neurones labelled from the mucosa were located in all
      ganglionated nerve networks, including the myenteric plexus. In all plexuses, at
      least five neurochemical types of neurones could be observed, i.e. SOM-IR
      neurones, SP-IR neurones, SOM/SP-IR neurones, VIP-IR neurones and neurones
      lacking immunoreactivity for any of these markers. Most of the DiI-labelled
      neurones were multidendritic; a minority of neurones could be identified as
      Dogiel type II cells, suggesting the existence of a subgroup of primary afferent
      neurones in the DiI-filled cell population. The ratio of labelled multidendritic
      neurones (assumed to be secretomotor) to labelled Dogiel type II neurones
      (assumed to be primary afferent) in the myenteric plexus is higher in large
      mammals (pig and human) than in small mammals (guinea pig). This might point to
      the existence of a different topographical distribution of subsets of primary
      afferent neurones and/or topographically distinct intrinsic mucosal reflex
      circuits in large mammals, including humans.

PMID- 11208911
TI  - Piroxicam and NS-398 rescue neurones from hypoxia/reoxygenation damage by a
      mechanism independent of cyclo-oxygenase inhibition.
AB  - We studied whether NS-398, a selective cyclo-oxygenase-2 (COX-2) enzyme
      inhibitor, and piroxicam, an inhibitor of COX-2 and the constitutively expressed
      COX-1, protect neurones against hypoxia/reoxygenation injury. Rat spinal cord
      cultures were exposed to hypoxia for 20 h followed by reoxygenation.
      Hypoxia/reoxygenation increased lactate dehydrogenase (LDH) release, which was
      inhibited by piroxicam (180-270 microM) and NS-398 (30 microM). Cell counts
      confirmed the neuroprotection. Western blotting revealed no COX-1 or COX-2
      proteins even after hypoxia/reoxygenation. Production of prostaglandin E2 (PGE2),
      a marker of COX activity, was barely measurable and piroxicam and NS-398 had no
      effect on the negligible PGE2 production. Hypoxia/reoxygenation increased nuclear
      factor-kappa B (NF-kappaB) binding activity, which was inhibited by piroxicam but
      not by NS-398. AP-1 binding activity after hypoxia/reoxygenation was inhibited by
      piroxicam but strongly enhanced by NS-398. However, both COX inhibitors induced
      activation of extracellular signal-regulated kinase (ERK) in neurones and
      phosphorylation of heavy molecular weight neurofilaments, cytoskeletal substrates
      of ERK. It is concluded that piroxicam and NS-398 protect neurones against
      hypoxia/reperfusion. The protection is independent of COX activity and not solely
      explained by modulation of NF-kappaB and AP-1 binding activity. Instead,
      piroxicam and NS-398-induced phosphorylation through ERK pathway may contribute
      to the increased neuronal survival.

PMID- 11208912
TI  - Effect of subchronic lithium treatment on citalopram-induced increases in
      extracellular concentrations of serotonin in the medial prefrontal cortex.
AB  - We investigated the effect of citalopram [a selective serotonin (5-HT) reuptake
      inhibitor; SSRI] and MKC-242 (a selective 5-HT1A agonist), following treatment
      with subchronic lithium (p.o., 1 week) on extracellular 5-HT concentrations in
      the medial prefrontal cortex (mPFC). Acute treatment with citalopram (3 and 30
      mg/kg) led to significant increases in extracellular 5-HT concentrations. The
      subchronic lithium group showed significantly higher basal levels of
      extracellular 5-HT than normal diet controls. Acute citalopram (3 and 30 mg/kg)
      treatment together with subchronic lithium treatment showed significant increases
      in the extracellular 5-HT concentrations, compared with citalopram treatment
      alone. Acute MKC-242 (1 mg/kg) treatment showed significant decreases in
      extracellular 5-HT concentrations, in both the normal diet and lithium diet
      groups to the same extent. The addition of lithium did not change the effect of
      the 5-HT1A agonist on extracellular 5-HT concentrations. This study suggests that
      lithium augmentation of the antidepressant effect of SSRI is mediated by the
      additional increases in extracellular 5-HT concentrations following the co
      administrations of lithium and SSRI.

PMID- 11208913
TI  - Scavenger receptor class B, type I is expressed in porcine brain capillary
      endothelial cells and contributes to selective uptake of HDL-associated vitamin
      E.
AB  - It is clearly established that an efficient supply to the brain of alpha
      tocopherol (alphaTocH), the most biologically active member of the vitamin E
      family, is of the utmost importance for proper neurological functioning. Although
      the mechanism of uptake of alphaTocH into cells constituting the blood-brain
      barrier (BBB) is obscure, we previously demonstrated that high-density
      lipoprotein (HDL) plays a major role in the supply of alphaTocH to porcine brain
      capillary endothelial cells (pBCECs). Here we studied whether a porcine analogue
      of human and rodent scavenger receptor class B, type I mediates selective
      (without concomitant lipoprotein particle internalization) uptake of HDL
      associated alphaTocH in a similar manner to that described for HDL-associated
      cholesteryl esters (CEs). In agreement with this hypothesis we observed that a
      major proportion of alphaTocH uptake by pBCECs occurred by selective uptake,
      exceeding HDL3 holoparticle uptake by up to 13-fold. The observation that
      selective uptake of HDL-associated CE exceeded HDL3 holoparticle up to fourfold
      suggested that a porcine analogue of SR-BI (pSR-BI) may be involved in lipid
      uptake at the BBB. In line with the observation of selective lipid uptake, RT-PCR
      and northern and western blot analyses revealed the presence of pSR-BI in cells
      constituting the BBB. Adenovirus-mediated overexpression of the human analogue of
      SR-BI (hSR-BI) in pBCECs resulted in a fourfold increase in selective HDL
      associated alphaTocH uptake. In accordance with the proposed function of SR-BI,
      selective HDL-CE uptake was increased sixfold in Chinese hamster ovary cells
      stably transfected with murine SR-BI (mSR-BI). Most importantly stable mSR-BI
      overexpression mediated a twofold increase in HDL-associated [14C]alphaTocH
      selective uptake in comparison with control cells. In line with tracer
      experiments, mass transfer studies with unlabelled lipoproteins revealed that mSR
      BI overexpression resulted in a twofold increase in endogenous HDL3-associated
      alphaTocH uptake. The results of this study indicate that SR-BI promotes the
      uptake of HDL-associated alphaTocH into cells constituting the BBB and plays an
      important role during the supply of the CNS with this indispensable
      micronutrient.

PMID- 11208914
TI  - Rat cerebral cortex corticotropin-releasing hormone receptors: evidence for
      receptor coupling to multiple G-proteins.
AB  - The wide distribution of corticotrophin-releasing hormone (CRH) receptors in
      brain and periphery appear to be important in integrating the responses of the
      brain, endocrine and immune systems to physiological, psychological and
      immunological stimuli. The type 1 receptors are highly expressed throughout the
      cerebral cortex, a region involved in cognitive function and modulation of stress
      responses, where they are coupled to the adenylyl cyclase system. Using
      techniques that analyse receptor-mediated guanine-nucleotide binding protein (G
      proteins) activation, we recently demonstrated that expressed type 1alpha CRH
      receptors are capable of activating multiple G-proteins, which suggests that CRH
      can regulate multiple signalling pathways. In an effort to characterize the
      intracellular signals generated by CRH in the rat cerebral cortex we sought to
      identify G-proteins activated by CRH in a physiological membrane environment. Rat
      cerebral cortical membrane suspensions were analysed for the ability of CRH to
      stimulate incorporation of [alpha-32P]-GTP-gamma-azidoanilide to various G
      protein alpha-chains. Our results show that CRH receptors are coupled to and
      activate at least five different G-proteins (Gs, Gi, Gq/11, Go and Gz) with
      subsequent stimulation of at least two intracellular signalling cascades. In
      addition, the photoaffinity experiments indicated that the CRH receptors
      preferentially activate the 45 kDa form of the Gs alpha-protein. This data may
      help elucidate the intracellular signalling pathways mediating the multiple
      actions of CRH especially under different physiological conditions.

PMID- 11208915
TI  - Neuronal death is an active, caspase-dependent process after moderate but not
      severe DNA damage.
AB  - Mild insults to neurons caused by ischemia or glutamate induce apoptosis, whereas
      severe insults induce non apoptotic death, such as necrosis. The molecular
      targets that are damaged by these insults and ultimately induce cell death are
      not fully established. To determine if DNA damage can induce apoptotic or non
      apoptotic death depending on the severity, neurons were treated with up to 128 Gy
      of ionizing radiation. Such treatment induced a dose-related increase in DNA
      single-strand breaks but no immediate membrane disruption or lipid peroxidation.
      Following moderate doses of < or = 32 Gy, neuronal death had many characteristics
      of apoptosis including nuclear fragmentation and DNA laddering. Nuclear
      fragmentation and membrane breakdown after moderate DNA damage could be blocked
      by inhibition of active protein synthesis with cycloheximide and by inhibition of
      caspases. In contrast, cell death after doses of > 32 Gy was not blocked by
      cycloheximide or caspase inhibitors, and membrane breakdown occurred relatively
      early in the cell death process. These data suggest that cell death after high
      dose irradiation and severe DNA damage can occur by non apoptotic mechanisms and
      that blocking apoptotic pathways may not prevent death after severe damage.

PMID- 11208916
TI  - Inducible nitric oxide synthase expression in brain cortex after acute restraint
      stress is regulated by nuclear factor kappaB-mediated mechanisms.
AB  - The underlying mechanisms by which physical or psychological stress causes
      neurodegeneration are still unknown. We have demonstrated that the high-output
      and long-lasting synthesizing source of nitric oxide (NO), inducible NO synthase
      (iNOS), is expressed in brain cortex during stress and that its overexpression
      accounts for the neurodegenerative changes seen after 3 weeks of repeated stress.
      Now we have found that acute stress (restraint for 6 h) increases the activity of
      a calcium-independent NOS and induces the expression of iNOS in brain cortex in
      adult male rats. In order to elucidate the possible mechanisms involved in this
      induction, we studied the role of transcription nuclear factor kappaB (NF
      kappaB), which is required for iNOS synthesis. We have observed that an acute
      restraint stress session stimulates the translocation of the NF-kappaB to the
      nucleus after 4 h and that the administration of the NF-kappaB inhibitor
      pyrrolidine dithiocarbamate [PDTC, 75 and 150 mg/kg intraperitoneally (i.p.)] at
      the onset of stress inhibits the stress-induced increase in iNOS expression.
      Since glutamate release and subsequent NMDA (N-methyl-D-aspartate) receptor
      activation has been recognized as an early change after exposure to stressful
      stimuli, and glutamate has been shown to induce iNOS in brain via a NF-kappaB
      dependent mechanism, we studied the possible role of excitatory amino acids in
      the induction of iNOS in our model. Pretreatment with the NMDA receptor
      antagonist dizocilpine (MK-801, 0.1 and 0.3 mg/kg i.p.) inhibits the stress
      induced NF-kappaB activation as well as the stress-induced increase in iNOS
      expression. Taken together, these findings indicate that excitatory amino acids
      and subsequent activation of NF-kappaB account for stress-induced iNOS expression
      in cerebral cortex, and support a possible neuroprotective role for specific
      inhibitors in this situation.

PMID- 11208917
TI  - Site of injury-directed induction of heme oxygenase-1 and -2 in experimental
      spinal cord injury: differential functions in neuronal defense mechanisms?
AB  - The heme oxygenase (HO) isozymes catalyze oxidation of the heme molecule to
      biliverdin and carbon monoxide (CO) with the release of chelated iron. Presently,
      we have defined, for the first time, propensity for site of injury-directed
      induction of isozymes--the stress-inducible isozyme, HO-1, responds distal
      (below) and the glucocorticoid (GC)-inducible HO-2 responds proximal (above) to
      the site of injury. We have also shown that reactive iron (Fe3+) and cGMP
      staining spatially resemble that of HO-1; which, in turn, colocalizes in motor
      neurons with transcription factors: Fas-associated protein containing death
      domain (FADD), tumor necrosis factor (TNF)-related apoptosis-inducing ligand
      (TRAIL) and p53. Spinal cord injury (SCI) was inflicted by clip compression for
      30 min, and analyses were carried out after 4 h or 16 h. When compared with
      spinal cord segments proximal to the site of injury, northern blot analysis
      showed remarkably higher levels of HO-1 mRNA distal (below) to the site of injury
      at both time points. In contrast, HO-2 mRNA levels were elevated proximal (above)
      to the site of injury and more prominently at 16 h post SCI. Immunohistochemical
      analyses were carried out using 2 x 5 mm segments above and below the compression
      site. When compared with segments above the site of injury, the intensity of HO-1
      immunostaining and the number of HO-1 positive neurons in the ventral horn motor
      neurons were prominently increased in segments below the injury. Western blot
      analysis confirmed the observations. HO-2 protein was mapped to the ventral horn
      motor neurons, oligodendrocytes, the Clarke's nucleus neurons and the ependymal
      cells. When compared with segments below the site of injury, neuronal HO-2
      staining intensity was increased above the site of injury, and most notably at 16
      h. These observations were also confirmed by western blotting and HO activity
      measurements. Tissue Fe3+ and cGMP staining were increased and prominently mapped
      below the site of injury, where cGMP colocalized with HO-1 in the nucleus of the
      motor neurons. Also, a site of injury-directed pattern of induction of FADD,
      TRAIL, and p53 immunoreactivity, and a widespread colocalization of the oncogenes
      with HO-1 protein, were found within motor neurons below the level of injury. We
      forward the hypothesis that HO-1 and HO-2 have different roles in the defense
      mechanisms of the injured nervous system. We hypothesize that HO-1 protects
      against further damage by contributing to controlled cell death through their
      intrinsic suicide program, while HO-2 is involved in suppression of inflammatory
      response by NO derived radicals.

PMID- 11208918
TI  - Modulation of electrically evoked acetylcholine release in cultured rat septal
      neurones.
AB  - The electrically evoked release of acetylcholine and its modulation via auto- and
      heteroreceptors were studied in primary cell cultures prepared from embryonic rat
      septum (ED 17). Cultures were grown for 1, 2 or 3 weeks on circular, poly D
      lysine-coated glass coverslips. They developed a dense network of non-neuronal
      and neuronal cells, only some of which were immunopositive for choline
      acetyltransferase. To measure acetylcholine release, the cells on the coverslips
      were pre-incubated with [3H]choline (0.1 micromol/L), superfused with modified
      Krebs-Henseleit buffer at 25 degrees C and electrically stimulated twice for 2
      min (S1, S2; 3 Hz, 0.5 ms, 90-100 mA). The electrically evoked overflow of [3H]
      from the cells consisted of approximately 80% of authentic [3H]Ach, was largely
      Ca2+-dependent and tetrodotoxin sensitive, and hence represents an action
      potential-evoked, exocytotic release of acetylcholine. Using pairs of selective
      agonists and antagonist added before S2, muscarinic autoreceptors, as well as
      inhibitory adenosine A1- and opioid mu-receptors, could be detected, whereas
      delta-opioid receptors were not found. Evoked [3H] overflow from cultures grown
      for 1 week, although Ca2+ dependent and tetrodotoxin sensitive, was insensitive
      to the muscarinic agonist oxotremorine, whereas the effect of oxotremorine on
      cells grown for 3 weeks was even more pronounced than that in 2-week-old
      cultures. In conclusion, similar to observations on rat septal tissue in vivo,
      acetylcholine release from septal cholinergic neurones grown in vitro is
      inhibited via muscarinic, adenosine A1 and mu-opioid receptors. This in vitro
      model may prove useful in the exploration of regulatory mechanisms underlying the
      expression of release modulating receptors on septal cholinergic neurones.

PMID- 11208919
TI  - Increased levels of oxidative stress markers detected in the brains of mice
      devoid of prion protein.
AB  - Although minor abnormalities have been reported in prion protein (PrP) knock-out
      (Prnp-/-) mice, the normal physiological function of PrP, the causative agent
      implicated in transmissible spongiform encephalopathies (TSE), remains
      unresolved. Since there are increasing correlations between oxidative stress and
      amyloidoses, we decided to investigate whether PrP plays a role in oxidative
      modulation. We found higher levels of oxidative damage to proteins and lipids in
      the brain lysates of Prnp-/- as compared to wild-type (WT) mice of the same
      genetic background. These two indicators, protein oxidation and lipid
      peroxidation, are hallmarks of cellular oxidative damage. Elevated levels of
      ubiquitin-protein conjugates were also observed in Prnp-/- mice, a probable
      consequence of cellular attempts to remove the damaged proteins as indicated by
      increased proteasome activity. Taken together, these findings are indicative of a
      role for PrP in oxidative homeostasis in vivo.

PMID- 11208920
TI  - Inhibition of insulin-like growth factor-1 receptor and IRS-2 signaling by
      ethanol in SH-SY5Y neuroblastoma cells.
AB  - The effect of ethanol on insulin-like growth factor-1 (IGF-I)-mediated signal
      transduction and functional activation in neuronal cells was examined. In human
      SH-SY5Y neuroblastoma cells, ethanol inhibited tyrosine autophosphorylation of
      the IGF-I receptor. This corresponded to the inhibition of IGF-I-induced
      phosphorylation of p42/p44 mitogen-activated/extracellular signal-regulated
      protein kinase (MAPK) by ethanol. Insulin-related substrate-2 (IRS-2) and focal
      adhesion kinase phosphorylation were reduced in the presence of ethanol, which
      corresponded to the prevention of lamellipodia formation (30 min). By contrast,
      ethanol had no effect on Shc phosphorylation when measured up to 1 h, and did not
      affect the association of Grb-2 with Shc. Neurite formation at 24 h was similarly
      unaffected by ethanol. The data indicate that the IGF-I receptor is a target for
      ethanol in SH-SY5Y cells However, there is diversity in the sensitivity of
      signaling elements within the IGF-I receptor tyrosine kinase signaling cascades
      to ethanol, which can be related to the inhibition of specific functional events
      in neuronal activation.

PMID- 11208921
TI  - Aging alters regional multichemical profile of the human brain: an in vivo 1H-MRS
      study of young versus middle-aged subjects.
AB  - Age-related differences in the multichemical proton magnetic resonance
      spectroscopy (1H-MRS) profile of the human brain have been reported for several
      age groups, and most consistently for ages from neonates to 16-year-olds. Our
      recent 1H-MRS study demonstrated a significant age-related increase of total
      chemical concentration (relative to creatine) in the prefrontal and sensorimotor
      cortices within young adulthood (19-31-year-olds). In the present study we test
      the hypothesis that the level of brain chemicals in the same cortices, which show
      increased chemical levels during normal development, are reduced with normal
      aging after young adulthood. The multichemical 1H-MRS profile of the brain was
      compared between 19 young and 16 middle-aged normal subjects across multiple
      brain regions for all chemicals of 1H-MRS spectra. Chemical concentrations were
      measured relative to creatine. Over all age groups the total relative chemical
      concentration was highest in the prefrontal cortex. Middle-aged subjects
      demonstrated a significant decrease of total relative chemical concentration in
      the dorsolateral prefrontal (F = 54.8, p < 10(-7), ANOVA), orbital frontal (F =
      3.7, p < 0.05) and sensorimotor (F = 15.1, p < 0.0001) cortices, as compared with
      younger age. Other brain regions showed no age-dependent differences. The results
      indicate that normal aging alters multichemical 1H-MRS profile of the human brain
      and that these changes are region-specific, with the largest changes occuring in
      the dorsolateral prefrontal cortex. These findings provide evidence that the
      processes of neuronal maturation of the human brain, and neurotransmitters and
      other chemical changes as the marker of these neuronal changes are almost
      finished by young adulthood and then reduced during normal aging toward middle
      age period of life. The present data also support the notion of heterochronic
      regressive changes of the aging human brain, where the multichemical brain
      regional profile seems to inversely recapitulate cortical chemical maturation
      within normal development.

PMID- 11208922
TI  - Gas chromatography-mass spectrometry analysis of endogenous cannabinoids in
      healthy and tumoral human brain and human cells in culture.
AB  - Endocannabinoids are lipid mediators thought to modulate central and peripheral
      neural functions. We report here gas chromatography-electron impact mass
      spectrometry analysis of human brain, showing that lipid extracts contain
      anandamide and 2-arachidonoylglycerol (2-AG), the most active endocannabinoids
      known to date. Human brain also contained the endocannabinoid-like compounds N
      oleoylethanolamine, N-palmitoylethanolamine and N-stearoylethanolamine.
      Anandamide and 2-AG (0.16 +/- 0.05 and 0.10 +/- 0.05 nmol/mg protein,
      respectively) represented 7.7% and 4.8% of total endocannabinoid-like compounds,
      respectively. N-Palmitoyethanolamine was the most abundant (50%), followed by N
      oleoyl (23.6%) and N-stearoyl (13.9%) ethanolamines. A similar composition in
      endocannabinoid-like compounds was found in human neuroblastoma CHP100 and
      lymphoma U937 cells, and also in rat brain. Remarkably, human meningioma
      specimens showed an approximately six-fold smaller content of all N
      acylethanolamines, but not of 2-AG, and a similar decrease was observed in a
      human glioblastoma. These ex vivo results fully support the purported roles of
      endocannabinoids in the nervous system.

PMID- 11208923
TI  - Antiapoptotic role of NF-kappaB in the auto-oxidized dopamine-induced apoptosis
      of PC12 cells.
AB  - Current concepts of the pathogenesis of Parkinson's disease (PD) center on the
      formation of reactive oxygen species (ROS), and dopamine has been considered to
      be a major source of ROS. Recently, it has been shown in a postmortem study that
      nuclear translocation of nuclear factor-kappa B (NF-kappaB) was observed in
      dopaminergic neurons of patient with PD. However, its role is not known. The
      present study examined the possible role of NF-kappaB in ODA (auto-oxidized
      dopamine)-induced apoptosis to understand the process of PD. Using the
      electrophoretic mobility shift assay, it was found that ODA activated the DNA
      binding activity of NF-kappaB. Suppression of the transcriptional activity of NF
      kappaB in PC12 cells by overexpression of a wild-type and a dominant negative
      mutant form (S32A/S36A) of inhibitor kappa B (IkappaB)-alpha led to increase of
      apoptotic cell death induced by treatment of ODA. In addition, overexpression of
      NF-kappaB in PC12 cells blocked ODA-induced cell death. However, JNK/SAPK
      activities, which mediate various stress signals, were similar among the
      parental, NF-kappaB- or dominant negative mutant IkappaB alpha-transfected cells.
      Therefore, these results suggest that activation of NF-kappaB during ODA-induced
      apoptosis may have a counteracting activity against the signals mediating
      apoptotic cell death and thereby delay the process of Parkinson's disease.

PMID- 11208925
TI  - Brain-derived neurotrophic factor mediates an excitoprotective effect of dietary
      restriction in mice.
AB  - Dietary restriction (DR; reduced calorie intake) increases the lifespan of
      rodents and increases their resistance to cancer, diabetes and other age-related
      diseases. DR also exerts beneficial effects on the brain including enhanced
      learning and memory and increased resistance of neurons to excitotoxic, oxidative
      and metabolic insults. The mechanisms underlying the effects of DR on neuronal
      plasticity and survival are unknown. In the present study we show that levels of
      brain-derived neurotrophic factor (BDNF) are significantly increased in the
      hippocampus, cerebral cortex and striatum of mice maintained on an alternate day
      feeding DR regimen compared to animals fed ad libitum. Damage to hippocampal
      neurons induced by the excitotoxin kainic acid was significantly reduced in mice
      maintained on DR, and this neuroprotective effect was attenuated by
      intraventricular administration of a BDNF-blocking antibody. Our findings show
      that simply reducing food intake results in increased levels of BDNF in brain
      cells, and suggest that the resulting activation of BDNF signaling pathways plays
      a key role in the neuroprotective effect of DR. These results bolster
      accumulating evidence that DR may be an effective approach for increasing the
      resistance of the brain to damage and enhancing brain neuronal plasticity.

PMID- 11208924
TI  - Phosphatidylinositol 3-kinase activity is required for the expression of glial
      fibrillary acidic protein upon cAMP-dependent induction of differentiation in rat
      C6 glioma.
AB  - Glial fibrillary acidic protein (GFAP) is an intermediate filament (IF) protein
      expressed upon maturation of astrocytes and upregulated during reactive
      astrogliosis. Its expression is modulated by several growth factors and hormones.
      Although an upregulation of intracellular cAMP is required for the induction of
      GFAP expression in astrocytes, little information is available on other
      downstream factors of the signal transduction pathways involved in the regulation
      of its expression. In this communication, we identified phosphatidylinositol 3
      kinase (PI 3-K) as a necessary enzyme for GFAP expression in rat C6 glioma cells.
      Use of the specific PI 3-K inhibitors wortmannin and LY294002 and transfection of
      C6 cells with a dominant negative PI 3-K construct, resulting in a decrease of
      the enzymatic activity of PI 3-K, inhibited the cAMP-dependent expression of
      GFAP. Furthermore, confocal laser scanning microscopy demonstrated that
      inhibition of the PI 3-K activity by LY294002 or wortmannin concomitant with
      induction of differentiation changes the cellular distribution leading to a
      pericentrosomal localization of GFAP and an altered cell shape lacking process
      formation. We conclude that the expression and cellular distribution of GFAP is
      mediated through a PI 3-K-dependent mechanism.

PMID- 11208927
TI  - Oxidative post-translational modifications of alpha-synuclein in the 1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of Parkinson's disease.
AB  - Structural and functional alterations of alpha-synuclein is a presumed culprit in
      the demise of dopaminergic neurons in Parkinson's disease (PD). Alpha-synuclein
      mutations are found in familial but not in sporadic PD, raising the hypothesis
      that effects similar to those of familial PD-linked alpha-synuclein mutations may
      be achieved by oxidative post-translational modifications. Here, we show that
      wild-type alpha-synuclein is a selective target for nitration following
      peroxynitrite exposure of stably transfected HEK293 cells. Nitration of alpha
      synuclein also occurs in the mouse striatum and ventral midbrain following
      administration of the parkinsonian neurotoxin 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP). Conversely, beta-synuclein and synaptophysin were not
      nitrated in MPTP-intoxicated mice. Our data demonstrate that alpha-synuclein is a
      target for tyrosine nitration, which, by disrupting its biophysical properties,
      may be relevant to the putative role of alpha-synuclein in the neurodegeneration
      associated with MPTP toxicity and with PD.

PMID- 11208931
TI  - Helen T. Parsons (1886-1977).

PMID- 11208926
TI  - The multidrug resistance protein MRP1 mediates the release of glutathione
      disulfide from rat astrocytes during oxidative stress.
AB  - The release of glutathione disulfide has been considered an important process for
      the maintenance of a reduced thiol redox potential in cells during oxidative
      stress. In cultured rat astrocytes, permanent hydrogen peroxide-induced oxidative
      stress caused a rapid increase in intracellular glutathione disulfide, which was
      followed by the appearance of glutathione disulfide in the medium. Under these
      conditions, the viability of the cells was not compromised. In the presence of
      cyclosporin A and the quinoline-derivative MK571, inhibitors of multidrug
      resistance proteins (MRP1 and MRP2), glutathione disulfide accumulated in cells
      and the release of glutathione disulfide from astrocytes during H2O2 stress was
      potently inhibited, suggesting a contribution of MRP1 or MRP2 in the release of
      glutathione disulfide from astrocytes. Using RT-PCR we amplified a cDNA from
      astroglial RNA with a high degree of homology to MRP1 from humans and mouse. In
      contrast, no fragment was amplified by using primers specific for rat MRP2. In
      addition, the presence of MRP1 protein in astrocytes was demonstrated by its
      immunolocalization in cells expressing the astroglial marker protein glial
      fibrillary acidic protein. Our data identify rat astrocytes as a MRP1-expressin,
      brain cell type and demonstrate that this transporter participates in the release
      of glutathione disulfide from astrocytes during oxidative stress.

PMID- 11208932
TI  - Guinea pigs as models for cholesterol and lipoprotein metabolism.
AB  - Guinea pigs carry the majority of their plasma cholesterol in LDL, making them a
      unique animal model with which to study hepatic cholesterol and lipoprotein
      metabolism. In this review, the benefits and advantages of using this particular
      model are discussed. How dietary factors such as soluble fiber, cholesterol and
      fatty acids that vary in saturation and chain length affect hepatic cholesterol
      homeostasis and influence the synthesis, intravascular processing and catabolism
      of lipoproteins is reviewed. In addition, alterations in hepatic cholesterol
      metabolism and plasma lipoproteins as affected by treatment with cholestyramine
      or 3-hydroxyl-3-methylglutaryl coenzyme A reductase inhibitors, exercise,
      marginal intake of vitamin C, ovariectomy (a model for menopause) and
      similarities to the human situation are addressed. A review of guinea pigs as
      models for early atherosclerosis development is also presented.

PMID- 11208933
TI  - Short-term zinc deficiency affects nuclear factor-kappab nuclear binding activity
      in rat testes.
AB  - We reported previously that feeding zinc-deficient diets for 14 d altered the
      oxidant defense system in the testes of young male rats and increased levels of
      lipid, protein and DNA oxidation in this tissue. In this study, we investigated
      the early involvement of oxidative stress in zinc deficiency-induced testicular
      pathology. Weanling male rats (17 d old) were given free access to a control (25
      microg Zn/g) or a zinc-deficient (0.5 microg Zn/g) diet, or restricted access to
      the control diet at a level of intake similar to that of rats fed the 0.5 microg
      Zn/g diet (restricted group) for 7 d. Rats fed the low zinc diet were
      characterized by low testes zinc and alkaline phosphatase activity compared with
      ad libitum and restricted controls. Testes protein and lipid oxidation variables
      did not differ among the groups. Higher than normal (P < 0.05) activities of CuZn
      (CuZnSOD) and Mn (MnSOD) superoxide dismutases were observed in the low zinc
      group. Glutathione peroxidase and glutathione reductase activities did not differ
      among the groups. Total glutathione concentrations were lower in the low zinc and
      restricted groups than in the control group (P < 0.05). The testes nuclear
      binding activities of two transcription factors sensitive to oxidants [nuclear
      factor (NF)-kappaB and AP-1] were assessed. AP-1 nuclear binding activity did not
      differ among the groups, but NF-kappaB nuclear binding activity was lower in the
      low zinc group than in the control groups (P < 0.05). We suggest that the
      reduction in NF-kappaB binding reflects an early response to zinc deficiency
      induced oxidative stress.

PMID- 11208934
TI  - Tea catechins prevent the development of atherosclerosis in apoprotein E
      deficient mice.
AB  - Green tea contains various antioxidative flavan-3ols (tea catechins), such as (-)
      epigallocatechin gallate (EGCg, the major catechin), which exert potent
      inhibitory effects on LDL oxidation in vitro and ex vivo in humans. In this
      study, the antiatherogenic effects of tea catechins were examined in
      atherosclerosis-susceptible C57BL/6J, apoprotein (apo)E-deficient mice. Male apoE
      deficient mice (10 wk old) were fed an atherogenic diet for 14 wk; during that
      time, one group (tea) was supplied drinking water supplemented with green tea
      extract (0.8 g/L), and another group (control) was offered the vehicle only. The
      tea extract consisted of the following (g/100 g): EGCg, 58.4; (-)
      epigallocatechin (EGC), 11.7; (-)-epicatechin (EC), 6.6; (-)-gallocatechingallate
      (GCg), 1.6; (-)-epicatechin gallate (ECg), 0.5; and caffeine, 0.4. The estimated
      actual intake of tea catechin was 1.7 mg/(d. mouse). Tea ingestion did not
      influence plasma cholesterol or triglyceride concentrations. Plasma lipid
      peroxides were reduced in the tea group at wk 8, suggesting that the in vivo
      oxidative state is improved by tea ingestion. Atheromatous areas in the aorta
      from the arch to the femoral bifurcation and aortic weights were both
      significantly attenuated by 23% in the tea group compared with the control group.
      Aortic cholesterol and triglyceride contents were 27 and 50% lower, respectively,
      in the tea group than in the control group. These results suggest that chronic
      ingestion of tea extract prevents the development of atherosclerosis without
      changing the plasma lipid level in apoE-deficient mice, probably through the
      potent antioxidative activity of the tea.

PMID- 11208935
TI  - Folate depletion and elevated plasma homocysteine promote oxidative stress in rat
      livers.
AB  - This study was designed to determine whether nutritional folate depletion exerts
      hepatic oxidative stress in relation to elevated plasma homocysteine. To mimic
      various extents of folate depletion status in vivo, male Wistar rats were fed an
      amino acid-defined diet containing either 8 (control), 2, 0.5, or 0 mg folic
      acid/kg diet. After a 4-wk feeding period, the plasma and hepatic folate
      concentrations of the rats decreased significantly with each decrement of dietary
      folate. Folate depletion did not significantly affect two major liver
      antioxidants: reduced glutathione and alpha-tocopherol. Conversely, folate
      depletion decreased Cu-Zn superoxide dismutase and glutathione peroxidase
      activities, but had no effect on catalase activity in liver homogenates. Lipid
      peroxidation products, as measured by thiobarbituric acid-reactive substances,
      were significantly higher in livers of folate-depleted rats than in those of the
      controls. This occurrence of hepatic oxidative stress in folate-depleted rats was
      confirmed by demonstrating an increased susceptibility of livers of folate
      depleted rats to lipid peroxidation induced by additional H2O2 or Fe(2+)
      treatments compared with the controls. Decreasing dietary folate intake resulted
      in graded increases in plasma homocysteine concentrations of folate-depleted
      rats. Elevated plasma homocysteine and decreased plasma and hepatic folate
      concentrations in folate-depleted rats were all strongly and significantly
      correlated with increased liver lipid peroxidation (/r/ > or = 0.58, P < 0.0003).
      These data demonstrate that folate depletion and elevated plasma homocysteine
      promote oxidative stress in rat livers.

PMID- 11208936
TI  - A polyunsaturated fatty acid diet lowers blood pressure and improves antioxidant
      status in spontaneously hypertensive rats.
AB  - gamma-Linolenic acid [GLA, 18:3(n-6)], eicosapentaenoic acid [EPA, 20:5(n-3)] and
      docosahexaenoic acid [DHA, 22:6(n-3)] have been reported to prevent
      cardiovascular diseases. However, they are highly unsaturated and therefore more
      sensitive to oxidation damage. We investigated the effects of a diet rich in
      these polyunsaturated fatty acids (PUFA) on blood pressure, plasma and
      lipoprotein lipid concentrations, total antioxidant status, lipid peroxidation
      and platelet function in spontaneously hypertensive rats (SHR) and normotensive
      Wistar Kyoto rats (WKY). Five-week-old SHR and WKY rats were fed for 10 wk either
      a diet containing Isio 4 oil or a diet rich in GLA, EPA and DHA (5.65, 6.39 and
      4.94 g/kg dry diet, respectively). The total antioxidant status was assayed by
      monitoring the rate of free radical-induced hemolysis. VLDL-LDL sensitivity to
      copper-induced lipid peroxidation was determined as the production of
      thiobarbituric acid reactive substances. After dietary PUFA supplementation, a
      significant decrease in blood pressure of SHR rats (-20 mm Hg) was observed and
      the total antioxidant status was enhanced. VLDL-LDL resistance to copper-induced
      peroxidation was increased in both strains. The PUFA supplementation did not
      change platelet maximum aggregation in SHR rats, but it decreased the aggregation
      speed. In hypertensive rats, GLA + EPA + DHA supplementation lowers blood
      pressure, enhances total anti-oxidant status and resistance to lipid
      peroxidation, diminishes platelet aggregation speed and lowers plasma lipid
      concentrations. Thus, it enhances protection against cardiovascular diseases.
      Therefore, nutritional recommendations for cardiovascular disease prevention
      should take into account the pharmacologic properties of GLA, EPA and DHA.

PMID- 11208937
TI  - Differential regulation of zinc transporter 1, 2, and 4 mRNA expression by
      dietary zinc in rats.
AB  - Zinc metabolism is well regulated over a wide range of dietary intakes to help
      maintain cellular zinc-dependent functions. Expression of transporter molecules,
      which influence zinc influx and efflux across the plasma and intracellular
      membranes, contributes to this regulation. We have examined in rats the
      comparative response of zinc transporters 1, 2, and 4 (ZnT-1, ZnT-2 and ZnT-4) to
      dietary zinc. ZnT-1 and ZnT-4 are expressed ubiquitously, whereas ZnT-2 is
      limited to small intestine, kidney, placenta and, in some cases, the liver. When
      zinc intake was low (<1 mg Zn/kg), ZnT-2 mRNA was extremely low in small
      intestine and kidney compared with an adequate intake (30 mg Zn/kg). ZnT-1 and
      ZnT-2 mRNAs were markedly greater in both tissues when a supplemental zinc intake
      (180 mg Zn/kg) was provided. ZnT-4 was refractory to changes in zinc intake. When
      zinc was provided as a single oral dose (70 mg/kg body), ZnT-1 and ZnT-2 mRNA
      levels were increased many fold in small intestine, liver and kidney, whereas ZnT
      4 gene expression was not changed. The expression of ZnT-1 and ZnT-2 is
      comparable to zinc-induced changes in metallothionein mRNA levels, suggesting a
      similar mode of regulation for these genes. The relative differential in
      regulation by zinc is ZnT-2 > ZnT-1 > ZnT-4. These data provide evidence that, in
      an animal model, zinc transporter expression is responsive to zinc under
      physiologically relevant conditions.

PMID- 11208938
TI  - Energy requirements of lactating women derived from doubly labeled water and milk
      energy output.
AB  - Instead of using an incremental approach to assess the energy requirements of
      lactation, a more comprehensive approach may be taken by measuring total energy
      expenditure (TEE), milk energy output and energy mobilization from tissue stores.
      The latter approach avoids assumptions regarding energetic efficiency and changes
      in physical activity and adiposity. The purpose of this study was threefold: to
      assess the energy requirements of lactation; to compare these estimates with
      energy requirements in the nonpregnant, nonlactating state and to test for
      energetic adaptations in basal metabolic rate (BMR) and physical activity during
      the energy-demanding process of lactation. Milk production and composition, body
      weight and composition, TEE, BMR and physical activity levels were measured in 24
      well-nourished women during exclusive breastfeeding at 3 mo postpartum and after
      the cessation of breastfeeding at 18 or 24 mo postpartum. TEE was measured by the
      doubly labeled water method, milk production by 3-d test-weighing, milk energy by
      bomb calorimetry on a 24-h milk sample, body composition by dual-energy x-ray
      absorptiometry and BMR by room respiration calorimetry. TEE, BMR and physical
      activity level (physical activity level = TEE/BMR) did not differ between the
      lactating and nonlactating state (TEE 10.0 +/- 1.5 versus 10.6 +/- 2.1 MJ/d).
      Mean milk energy output was equivalent to 2.02 +/- 0.33 MJ/d. Total energy
      requirements were greater during lactation than afterward (12.0 +/- 1.4 versus
      10.6 +/- 2.1 MJ/d, P: = 0.002). Energy mobilization from tissue stores (-0.65 +/-
      0.97 MJ/d) resulted in net energy requirements during lactation of 11.4 +/- 1.8
      MJ/d. Because adaptations in basal metabolism and physical activity were not
      evident in these well-nourished women, energy requirements during lactation were
      met primarily from the diet and only partially by mobilization of tissue stores.

PMID- 11208939
TI  - The metabolic availability of dietary triacylglycerols from two high oleic oils
      during the postprandial period does not depend on the amount of oleic acid
      ingested by healthy men.
AB  - Monounsaturated oils, virgin olive oil (VOO) and high oleic sunflower oil (HOSO)
      are suggested to have selective physiologic effects on humans in the fasting
      state. The aim of the study was to evaluate whether two oils with equal amounts
      of oleic acid but with different compositions of minor fatty acids and
      triacylglycerol molecular species (TAG) could produce different triacylglycerol
      rich lipoprotein (TRL)-TAG responses in the postprandial state. Eight
      normolipidemic men consumed the following three meals in random order on separate
      occasions with 2 wk between meals: control meal, control meal plus VOO and
      control meal plus HOSO. Plasma total TAG and TRL-TAG were measured hourly for 7 h
      after ingestion. TAG and sn-2 positional fatty acids within TAG were analyzed in
      the TRL fraction. Plasma total TAG concentrations in response to the dietary oils
      did not differ. However, TRL triglyceridemia was significantly lower after VOO
      intake (P < 0.05). The molecular species in the TRL fraction returned toward
      basal levels more quickly (P < 0.05) after VOO than HOSO intake. 2-Positional
      fatty acid analysis demonstrated higher proportions of stearic and palmitic acids
      and a lower proportion of oleic acid (P < 0.05) in TRL-TAG derived from HOSO.
      This study shows that VOO intake results in attenuated postprandial TAG
      concentration and faster TRL-TAG disappearance from blood compared with HOSO,
      suggesting that the oleic acid content may not be the main factor affecting TAG
      metabolism. Minor fatty acids such as linoleic acid and the 2-positional
      distribution of saturated stearic and palmitic acids into the TAG molecule may be
      important determinants of postprandial lipemia in normolipidemic men.

PMID- 11208940
TI  - Chlorogenic acid and caffeic acid are absorbed in humans.
AB  - Chlorogenic acid, an ester of caffeic acid and quinic acid, is a major phenolic
      compound in coffee; daily intake in coffee drinkers is 0.5-1 g. Chlorogenic acid
      and caffeic acid are antioxidants in vitro and might therefore contribute to the
      prevention of cardiovascular disease. However, data on the absorption of
      chlorogenic acid and caffeic acid in humans are lacking. We determined the
      absorption of chlorogenic acid and caffeic acid in a cross-over study with 4
      female and 3 male healthy ileostomy subjects. In such subjects, degradation by
      the colonic microflora is minimal and absorption can be calculated as the amount
      ingested minus the amount excreted in ileostomy effluent. The ileostomy subjects
      ingested 2.8 mmol chlorogenic acid and 2.8 mmol caffeic acid on separate days in
      random order and subsequently collected ileostomy fluid and urine for 24 h.
      Absorption of chlorogenic acid was 33 +/- 17% (mean +/- SD) and of caffeic acid
      95 +/- 4%. Traces of the ingested chlorogenic acid and 11% of the ingested
      caffeic acid were excreted in urine. Thus, one third of chlorogenic acid and
      almost all of the caffeic acid were absorbed in the small intestine of humans.
      This implies that part of chlorogenic acid from foods will enter into the blood
      circulation, but most will reach the colon.

PMID- 11208941
TI  - Cognitive and motor functions of iodine-deficient but euthyroid children in
      Bangladesh do not benefit from iodized poppy seed oil (Lipiodol).
AB  - Iodine supplementation before pregnancy in iodine-deficient women prevents
      cretinism and neuromotor deficits in their offspring. It is unclear whether
      iodine supplementation benefits cognitive function in iodine-deficient school
      aged children. We therefore conducted a double-blind, randomized, controlled
      trial of the effects of iodized poppy seed oil (Lipiodol) on cognitive and motor
      function and weight gain of iodine-deficient school children. The study was
      conducted with 305 children in grades 1 and 2 from 10 primary schools in two
      iodine-deficient areas in Bangladesh. The children were stratified by school and
      grade and randomly assigned to receive 400 mg of oral Lipiodol or a placebo. All
      children were given a battery of cognitive and motor function tests and had their
      weights, serum thyroxine (T4) and thyroid-stimulating hormone (TSH) and urinary
      iodine levels measured before and 4 mo after the intervention. On enrollment,
      both groups were moderately iodine deficient (median urinary iodine values:
      placebo group = 3.3 micromol/L, n = 148; iodine group = 3.1 micromol/L, n = 152;
      goiter prevalence in both groups >95%). However, their T4 and TSH levels were
      within the normal range. After 4 mo, there was a significant treatment effect on
      urinary iodine levels (P < 0.0001), but the levels of the treated group were
      still below normal (median = 7.9 micromol/L). No significant differences were
      found in T4 and TSH levels, weight gain, cognitive or motor function. The
      findings suggest that Lipiodol supplementation in moderately iodine-deficient
      children with normal T4 levels is unlikely to benefit their cognitive function.
      However, it remains possible that other iodine preparations may have benefits.

PMID- 11208942
TI  - Breast-feeding has a limited long-term effect on anthropometry and body
      composition of Brazilian mothers.
AB  - The effect of lactation on maternal nutrition is controversial. Some studies have
      shown that breast-feeding reduces maternal weight, whereas some have not. All
      studies have been restricted to the first 2 y after delivery. We investigated the
      effect of lactation on maternal nutrition 5 y after delivery. All mothers giving
      birth in the city of Pelotas, Brazil, in 1993 were interviewed and weighed soon
      after delivery; information was also obtained on prepregnancy weight. In 1994,
      information on breast-feeding duration and pattern was collected for a 20%
      subsample. They were seen again in 1998, and those eligible (nonsmokers, no
      subsequent pregnancy, last birth weight > or = 2500 g) underwent measurements for
      weight, height, waist, hip and arm circumferences, triceps and subscapular
      skinfolds. The following indices were calculated in 312 women: body mass index,
      waist/hip ratio, arm fat area, the percentage of body fat assessed through
      skinfolds, and weight and body mass index change since before conception. The
      percentage of body fat was also measured through bioimpedance for half of the
      sample. After adjustment for confounding, all outcomes generally showed a similar
      pattern, i.e., mothers who breast-fed for 6-11.9 mo had lower measurements than
      those with shorter or longer durations. However, only the association with
      bioimpedance was significant (P < 0.03), and that for arm fat area tended to be
      significant (P = 0.06). Exclusive or predominant breastfeeding at 4 mo was
      associated with lower waist circumference (P = 0.05) and the percentage of body
      fat measured through skinfolds (P = 0.04). This study suggests that the
      relationship between breast-feeding and long-term changes in maternal weight is
      complex and, in this population, not particularly strong.

PMID- 11208943
TI  - Metabolic evidence for adaptation to a high protein diet in rats.
AB  - This study was designed to assess the effects of long-term adaptation to a high
      protein diet on energy intake, body weight gain, body composition and splanchnic
      metabolic indicators in rats. For this purpose, adult male Wistar rats were fed
      either a 50 g/100 g dry matter (DM) protein diet (P50 group) or a 14 g/100 g DM
      protein diet (P14 group) for 21 d. These two groups were compared with a P14 pair
      fed (P14-pf) group that consumed the same daily energy as the P50 group. The
      energy intake of the P50 group was 16 +/- 1% less than that of the P14 group (P <
      0.05), and the P50 group had significantly lower body weight. The P50 group had
      significantly less adipose tissue compared with both P14 and P14-pf rats. The
      activities of the brush border membrane enzymes, neutral aminopeptidase and gamma
      glutamyl transferase, were significantly higher in the P50 group than in the P14
      rats. Similarly, the activities of alanine aminotransferase, arginase and serine
      dehydratase were significantly higher in the liver of P50 rats compared with P14
      rats. Both amino acid transporter system A and X(A,G-) activities, measured in
      freshly isolated hepatocytes, were significantly higher in the P50 group (8- and
      1.5-fold, P < 0.05, respectively) compared with the P14 group. The 1.5-fold
      increase in the steady-state activity of X(A,G-) was accompanied by a doubling of
      EAAT2 mRNA, involved in the system X(A,G-). This study provides confirmation that
      specific biochemical and molecular adaptive processes of the splanchnic area are
      involved in the response to variations in the protein content of the diet.

PMID- 11208944
TI  - High glycemic index starch promotes hypersecretion of insulin and higher body fat
      in rats without affecting insulin sensitivity.
AB  - In rats, prolonged feeding of high glycemic index (GI) starch results in basal
      hyperinsulinemia and an elevated insulin response to an intravenous glucose
      tolerance test (IVGTT). The aim of this study was to assess hepatic and
      peripheral insulin resistance (IR) using euglycemic hyperinsulinemic clamps.
      Insulin sensitivity, epididymal fat deposition and fasting leptin concentrations
      were compared in rats fed isocalorically a low or high GI diet for 7 wk (45%
      carbohydrate, 35% fat and 20% protein as energy) or a high fat diet (20%
      carbohydrate, 59% fat and 21% protein as energy) for 4 wk so that final body
      weights were similar. At the end of the study, high GI rats had higher basal
      leptin concentration and epididymal fat mass than the low GI group, despite
      comparable body weights. High GI and high fat feeding both resulted in the higher
      insulin response during IVGTT, but impaired glucose tolerance was seen only in
      rats fed high fat. The GI of the diet did not affect basal and clamp glucose
      uptake or hepatic glucose output, but high fat feeding induced both peripheral
      and hepatic IR. The findings suggest that hypersecretion of insulin without IR
      may be one mechanism for increased fat deposition in rats fed high GI diets.

PMID- 11208945
TI  - Food deprivation exacerbates mitochondrial oxidative stress in rat liver exposed
      to ischemia-reperfusion injury.
AB  - Mitochondria undergo oxidative damage during reperfusion of ischemic liver.
      Although nutritional status affects ischemia-reperfusion injury in the liver, its
      effect on mitochondrial damage has not been evaluated. Thus, this study was
      designed to determine whether starvation influences the oxidative balance in
      mitochondria isolated from livers exposed to warm ischemia-reperfusion. Fed and
      18- and 36-h food-deprived rats underwent partial hepatic ischemia followed by
      reperfusion. Mitochondria were isolated before and after ischemia and during
      reperfusion. Serum alanine transaminase was measured to assess liver injury. The
      mitochondrial concentrations of malondialdehyde, protein carbonyls and
      glutathione were determined as indicators of oxidative injury. Cell
      ultrastructure was assessed by transmission electron microscopy. Transaminase
      levels were greater in 18-h food-deprived than fed rats (after 120 min of
      reperfusion: 3872 +/- 400 vs. 1138 +/- 59 U/L, P < 0.01). Mitochondrial
      glutathione was lower in food-deprived than fed rats before and after ischemia,
      and during reperfusion. Food deprivation also was associated with significantly
      greater lipid and protein oxidative damage. Finally, more ultrastructural damage
      was observed during reperfusion in mitochondria from food-deprived rats.
      Prolonging the length of food deprivation to 36 h exacerbated significantly both
      the mitochondrial oxidative injury and the release of serum transaminases in rats
      (after 120 min of reperfusion: 5438 +/- 504 U/L, P < 0.01). Food deprivation was
      associated with greater mitochondrial oxidative injury in rat livers exposed to
      warm ischemia-reperfusion, and the extent of oxidative damage in mitochondria
      increased with the length of food deprivation.

PMID- 11208947
TI  - Dietary fatty acid composition in pregnancy alters neurite membrane fatty acids
      and dopamine in newborn rat brain.
AB  - The importance of maternal dietary fatty acids on arachidonic acid [AA; 20:4(n
      6)] and docosahexaenoic acid [DHA; 22:6(n-3)] in fetal brain nerve growth cone
      membranes and monoaminergic neurotransmitters was investigated. Rats were fed
      purified diets containing 20 g/100 g safflower oil with 74.3% 18:2(n-6), 0.2%
      18:3(n-3), soybean oil with 55.4% 18:2(n-6), 7.7% 18:3(n-3) or high fish oil with
      24.6% 22:6(n-3) through gestation. Tissue for rats within a litter were pooled at
      birth, brain growth cone membranes prepared and phosphatidylcholine (PC),
      phosphatidylserine (PS), phosphatidylethanolamine (PE) and phosphatidylinositol
      (PI) fatty acids quantified by gas-liquid chromatography. Dopamine, serotonin,
      and the metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid, and 5
      hydroxyindolacetic acid were quantified by HPLC. Growth cone membranes from
      offspring of rats fed safflower oil had significantly lower, and offspring of
      rats fed high 22:6(n-3) fish oil had significantly higher 22:6(n-3) in PE, PS and
      PI than the soybean oil group. The growth cone membrane PC, PE and PS 20:4(n-6)
      was significantly lower in the fish oil than in the soybean or safflower oil
      groups. Serotonin concentration was significantly higher in brain of offspring in
      the safflower oil compared with the soybean oil group. The newborn brain dopamine
      was inversely related to PE DHA and PS DHA (P < 0.001), but positively related to
      PC AA (P < 0.05). These studies show that maternal dietary fatty acids may alter
      fetal brain growth cone (n-6) and (n-3) fatty acids, and neurotransmitters
      involved in neurite extension, target finding and synaptogenesis. The functional
      importance, however, is not known at this time.

PMID- 11208946
TI  - Food supplementation with milk fermented by Lactobacillus casei DN-114 001
      protects suckling rats from rotavirus-associated diarrhea.
AB  - Group A rotavirus is the leading cause of diarrhea among children aged 3-36 mo
      worldwide. Introducing fermented milk products into the infant diet has been
      proposed for the prevention or treatment of rotavirus diarrhea. The preventive
      effect of milk fermented by the Lactobacillus casei strain DN-114 001 was studied
      in a model of germfree suckling rats supplemented daily from d 2 of life and
      infected with SA11 rotavirus at d 5 (RF group). One group was supplemented with
      nonfermented milk (RM) and two uninfected groups (CM and CF) received either
      nonfermented or fermented milk. Frequency and severity of diarrhea were observed.
      Rats were killed at various times from 0 to 120 h postinfection (p.i.). Bacteria
      were measured in the intestine, and rotavirus antigens were detected by ELISA in
      fecal samples and in different parts of the intestine. Histologic observations
      were made, including vacuolation, morphology of intestinal villi and number of
      mucin cells. RM rats had diarrhea for 6 d; compared with the CM group, they had
      alterations of the intestinal mucosa characterized by cellular vacuolation 48 and
      72 h p.i. and a lower number of sulfated mucin cells 72 and 96 h p.i. (P: <
      0.05). Early supplementation with fermented milk significantly decreased the
      clinical signs of diarrhea from 24 to 144 h p.i. (P: < 0.05) and prevented
      rotavirus infection in all sections of the intestine. Histologic lesions of the
      small intestine were greatly reduced (P: < 0.05) and the number of mucin cells
      remained unchanged. The data are discussed with respect to the possibility of
      reducing rotavirus diarrhea in young children by consumption of fermented milk.

PMID- 11208948
TI  - 17-beta-estradiol affects brain protein synthesis rate in ovariectomized female
      rats.
AB  - The purpose of this study was to determine whether 17-ss-estradiol affects the
      rate of brain protein synthesis in ovariectomized female rats. Experiments were
      conducted on three groups of 12-wk-old female rats: group 1 were ovariectomized
      to reduce the level of plasma estradiol, group 2 were ovariectomized and treated
      with estradiol and group 3 were sham-operated controls. The fractional rates of
      protein synthesis in brain of ovariectomized rats treated with estradiol were
      significantly greater than that in ovariectomized rats without estradiol
      treatment. In the cerebral cortex and cerebellum, the RNA activity [g protein
      synthesized/(g RNA. d)] significantly correlated (r > 0.87, P < 0.001) with the
      fractional rate of protein synthesis. The RNA concentration (mg RNA/g protein)
      was not related to the fractional rate of protein synthesis in any organ. The
      results suggest that estrogen treatment of ovariectomized female rats is likely
      to increase the rate of protein synthesis in the brain and that RNA activity is
      at least in part related to the fractional rate of brain protein synthesis.

PMID- 11208949
TI  - Wheat aleurone flour increases cecal beta-glucuronidase activity and butyrate
      concentration and reduces colon adenoma burden in azoxymethane-treated rats.
AB  - Processed wheat aleurone flour (WAF) is a source of insoluble fermentable dietary
      fiber that comes from the outer layers of the wheat kernel. A study was designed
      to evaluate WAF, wheat bran (WB) and alpha-cellulose as the source of dietary
      fiber (5 g/100 g of diet) in a semipurified high fat (20 g/100 g of as 1:1
      lard/sunflower seed oil) diet fed to male Sprague-Dawley rats in which intestinal
      tumors were induced using azoxymethane (AOM). WAF at 33 g/100 g of diet (WAF33)
      and WB at 16 g/100 g of diet (WB16) increased the weight of feces and produced
      significantly higher concentrations in the cecum of the short-chain fatty acid
      butyrate (P < 0.001) than did no fiber (NF) and WAF added at only 10 g/100 g (1.5
      g of dietary fiber) (WAF10). Cecal and fecal pH were both significantly lower in
      the WAF33 and WB16 treatments relative to control and no fiber treatments (P <
      0.001). The intestinal tumors in the rats were assessed at 6 mo after the study
      began, and the WAF33- or WB16-fed rats showed a trend (P = 0.06) with 43% fewer
      colon adenomas relative to control. There was a significant inverse relationship
      between ss-glucuronidase activity and colon adenomas in the rat colon (r2 = 0.37,
      P = 0.001). WAF fiber influenced some metabolic markers of fermentation in the
      colon in a manner similar to that of WB, which, independent of the bulking
      effect, was associated with a trend to reduced colon adenomas. Significantly
      increased cecal ss-glucuronidase activity and/or butyrate concentrations may have
      protective influences in this context by mechanisms not yet fully elucidated.

PMID- 11208950
TI  - Revision 2000: a statement for healthcare professionals from the Nutrition
      Committee of the American Heart Association.

PMID- 11208953
TI  - Maternal and prepubertal diet, mammary development and breast cancer risk.
AB  - At present, we do not know what causes sporadic breast cancer. Environmental
      factors,particularly diet, appear to explain at least 70% of newly diagnosed
      breast cancers, but it is not clear what these factors are. We propose that the
      lack of progress in this area is due to a lack of considering the effect of
      timing of environmental and dietary exposures on the breast. The evidence
      provided above suggests that an in utero exposure to an estrogenic environment
      including that caused by diet [high (n-6) PUFA or genistein]-increases breast
      cancer risk. This increase may be mediated by an increased presence of TEB in the
      mammary epithelial tree and increased ER-alpha levels, reduced ER-beta levels or
      both. Prepubertal estrogenic exposure, in contrast, reduces later risk of
      developing breast cancer. The protective effect of estrogens may be mediated by
      early epithelial differentiation, reduced presence of ER-alpha and increased
      levels of ER-beta in the mammary gland. The challenge we are now facing is to
      determine whether the data obtained mainly through the use of animal models is
      relevant to women and if so, how we might be able to modulate pregnancy and
      childhood estrogenic exposure by appropriate dietary modifications to reduce
      breast cancer risk in women.

PMID- 11208954
TI  - Evaluation of the in vitro and in vivo antitumor activities of vitamin C and K-3
      combinations against human prostate cancer.

PMID- 11208955
TI  - Vitamin E: mechanisms of action as tumor cell growth inhibitors.

PMID- 11208956
TI  - PC-SPES and prostate cancer.

PMID- 11208957
TI  - Role of gap-junctional communication in breast cancer progression and
      chemoprevention.

PMID- 11208958
TI  - The European Prospective Investigation into Cancer and Nutrition (EPIC): plans
      and progress.

PMID- 11208959
TI  - Clinical trials of breast and prostate cancer prevention.

PMID- 11208960
TI  - Evaluation of botanicals and dietary supplements therapy in cancer patients.

PMID- 11208961
TI  - Dietary change and cancer: challenges and future direction.

PMID- 11208966
TI  - Integrins: the missing link.

PMID- 11208967
TI  - Pore properties and ionic block of the rabbit epithelial calcium channel
      expressed in HEK 293 cells.
AB  - We have used the whole-cell patch-clamp technique to analyse the permeation
      properties and ionic block of the epithelial Ca2+ channel ECaC heterologously
      expressed in human embryonic kidney (HEK) 293 cells. Cells dialysed with 10 mM
      BAPTA and exposed to Ca2+-containing, monovalent cation-free solutions displayed
      large inwardly rectifying currents. Their reversal potential depended on the
      extracellular Ca2+ concentration, [Ca2+]o. The slope of the relationship between
      reversal potential and [Ca2+]o on a logarithmic scale was 21 +/- 4 mV, compared
      with 29 mV as predicted by the Nernst equation (n = 3-5 cells). Currents in
      mixtures of Ca2+ and Na+ or Ca2+ and Ba2+ showed anomalous mole fraction
      behaviour. We have described the current-concentration plot for Ca2+ and Na+ by a
      kinetic permeation model, i.e. the "step" model. Extracellular Mg2+ blocked both
      divalent and monovalent currents with an IC50 of 62 +/- 9 microM(n = 4) in Ca2+
      free conditions and 328 +/- 50 microM (n = 4-9) in 100 microM Ca2+ solutions.
      Mono- and divalent currents through ECaCs were blocked by gadolinium, lanthanum
      and cadmium, with a blocking order of Cd2+ >> Gd3+ > La3+. We conclude that the
      permeation of monovalent and divalent cations through ECaCs shows similarities
      with L-type voltage-gated Ca2+ channels, the main differences being a higher Ca2+
      affinity and a significantly higher current density in micromolar Ca2+
      concentrations in the case of ECaCs.

PMID- 11208968
TI  - Angiotensin II inhibits rat arterial KATP channels by inhibiting steady-state
      protein kinase A activity and activating protein kinase Ce.
AB  - We used whole-cell patch clamp to investigate steady-state activation of ATP
      sensitive K+ channels (KATP) of rat arterial smooth muscle by protein kinase A
      (PKA) and the pathway by which angiotensin II (Ang II) inhibits these channels.
      Rp-cAMPS, an inhibitor of PKA, did not affect KATP currents activated by
      pinacidil when the intracellular solution contained 0.1 mM ATP. However, when ATP
      was increased to 1.0 mM, inhibition of PKA reduced KATP current, while the
      phosphatase inhibitor calyculin A caused a small increase in current. Ang II (100
      nM) inhibited KATP current activated by the K+ channel opener pinacidil. The
      degree of inhibition was greater with 1.0 mM than with 0.1 mM intracellular ATP.
      The effect of Ang II was abolished by the AT1 receptor antagonist losartan. The
      inhibition of KATP currents by Ang II was abolished by a combination of PKA
      inhibitor peptide 5-24 (5 microM) and PKC inhibitor peptide 19-27 (100 microM),
      while either alone caused only partial block of the effect. In the presence of
      PKA inhibitor peptide, the inhibitory effect of Ang II was unaffected by the PKC
      inhibitor Go 6976, which is selective for Ca2+-dependent isoforms of PKC, but was
      abolished by a selective peptide inhibitor of the translocation of the epsilon
      isoform of PKC. Our results indicate that KATP channels are activated by steady
      state phosphorylation by PKA at normal intracellular ATP levels, and that Ang II
      inhibits the channels both through activation of PKCepsilon and inhibition of
      PKA.

PMID- 11208969
TI  - Agents that increase tyrosine phosphorylation activate a non-selective cation
      current in single rabbit portal vein smooth muscle cells.
AB  - The effects of agents that increase tyrosine phosphorylation were studied with
      whole-cell recording of membrane currents in single smooth muscle cells from the
      rabbit portal vein. In K+-free conditions with the chloride equilibrium potential
      at about -50 mV, intracellular application via the patch pipette of 200 microM
      sodium orthovanadate (Na3VO4), which inhibits tyrosine phosphatases, activated a
      "noisy" inward current at a holding potential of -50 mV. Intracellular dialysis
      with 100 microM (pY)EEI, a peptide activator of the cytosolic tyrosine kinase
      pp60c-src, and bath application of 5 microM insulin, which activates receptor
      coupled tyrosine kinases, also evoked a "noisy" inward current. The current
      voltage relationships and the reversal potential (about +10 mV) of the Na3VO4-,
      pp60c-src- and insulin-induced currents were similar to those of the
      noradrenaline-evoked non-selective cation current (Icat). The inward currents
      evoked by noradrenaline, Na3VO4, (pY)EEI and insulin were all greatly potentiated
      when the bathing calcium concentration was reduced from 1.5 mM to 50 microM. The
      single channel conductance estimated from spectral density analysis of the whole
      cell current was about 20 pS for noradrenaline, Na3VO4, (pY)EEI and insulin.
      Moreover for all agents the spectra were described by the sum of two Lorentzians
      with similar corner frequencies. Noradrenaline-evoked Icat was inhibited to a
      similar degree by the tyrosine kinase inhibitors genistein and tyrphostin 23 and
      their inactive analogues daidzein and tyrphostin A1, respectively. In the
      presence of Na3VO4, application of noradrenaline evoked a cation current of
      similar peak amplitude to control Icat although the rate of decay of Icat was
      enhanced in the presence of Na3VO4. This study shows that stimulation of both
      cytosolic and receptor-coupled tyrosine kinases evokes a non-selective cation
      current and the conductance is similar to that activated by noradrenaline.

PMID- 11208970
TI  - Proton sensitivity of rat cerebellar granule cell GABAA receptors: dependence on
      neuronal development.
AB  - The effect of GABAA receptor development in culture on the modulation of GABA
      induced currents by external H+ was examined in cerebellar granule cells using
      whole-cell and single-channel recording. Equilibrium concentration-response
      curves revealed a lower potency for GABA between 11 and 12 days in vitro (DIV)
      resulting in a shift of the EC50 from 10.7 to 2.4 uM. For granule cells before 11
      DIV, the peak GABA-activated current was inhibited at low external pH and
      enhanced at high pH with a pKa of 6.6. For the steady-state response, low pH was
      inhibitory with a pKa of 5.56. After 11 DIV, the peak GABA-activated current was
      largely pH insensitive; however, the steady-state current was potentiated at low
      pH with a pKa of 6.84. Single GABA-activated ion channels were recorded from
      outside-out patches of granule cell bodies. At pH 5.4-9.4, single GABA channels
      exhibited multiple conductance states occurring at 22-26, 16-17 and 12-14 pS. The
      conductance levels were not significantly altered over the time period of study,
      nor by changing the external H+ concentration. Two exponential functions were
      required to fit the open-time frequency histograms at both early (< 11 DIV) and
      late (> 11 DIV) development times at each H+ concentration. The short and long
      open time constants were unaffected either by the extracellular H+ concentration
      or by neuronal development. The distribution of all shut times was fitted by the
      sum of three exponentials designated as short, intermediate and long. At acidic
      pH, the long shut time constant decreased with development as did the relative
      contribution of these components to the overall distribution. This was concurrent
      with an increase in the mean probability of channel opening. In conclusion, this
      study demonstrates in cerebellar granule cells that external pH can either
      reduce, have no effect on, or enhance GABA-activated responses depending on the
      stage of development, possibly related to the subunit composition of the GABAA
      receptors. The mode of interaction of H+ at the single-channel level and
      implications of such interactions at cerebellar granule cell GABAA receptors are
      discussed.

PMID- 11208971
TI  - Effect of extracellular Ca2+ on the quinine-activated current of bullfrog taste
      receptor cells.
AB  - The bitter substance quinine activates a cation current from the frog taste
      receptor cell. We have analysed the noise associated with this current, and the
      effect of extracellular Ca2+ on the current, using whole-cell recording on single
      dissociated cells. Quinine induced an inward current from the taste receptor cell
      near the resting potential. The response was accompanied by an increase in
      current fluctuations. From the variance/mean ratio of the quinine-activated
      current, the single-channel conductance was estimated to be 12 pS in the nominal
      absence of extracellular Ca2+. In the presence of 1.8 mM Ca2+, this conductance
      decreased to 5 pS. These values broadly agree with those previously obtained from
      excised, outside-out membrane patches. The dependence of the current on quinine
      concentration had a K1/2 of 0.48 mM in the absence of extracellular Ca2+,
      consistent with measurements from excised patches. The K1/2 value increased to
      2.8 mM in 1.8 mM external Ca2+. The maximum current induced by quinine was also
      reduced by about 20% by Ca2+. The spectral power density distribution of the
      quinine-activated current could be described by the sum of two Lorentzian
      functions, with corner frequencies not substantially different in the absence and
      presence of 1.8 mM external Ca2+. The above results lend further support to the
      notion that the major component of the response of frog taste receptor cells to
      quinine comes from an ion channel directly activated by quinine.

PMID- 11208972
TI  - Hypertonic enhancement of transmitter release from frog motor nerve terminals:
      Ca2+ independence and role of integrins.
AB  - Hyperosmotic solutions cause markedly enhanced spontaneous quantal release of
      neurotransmitter from many nerve terminals. The mechanism of this enhancement is
      unknown. We have investigated this phenomenon at the frog neuromuscular junction
      with the aim of determining the degree to which it resembles the modulation of
      release by stretch, which has been shown to be mediated by mechanical tension on
      integrins. The hypertonicity enhancement, like the stretch effect, does not
      require Ca2+ influx or release from internal stores, although internal release
      may contribute to the effect. The hypertonicity effect is sharply reduced (but
      not eliminated) by peptides containing the RGD sequence, which compete with
      native ligands for integrin bonds. There is co-variance in the magnitude of the
      stretch and osmotic effects; that is, individual terminals exhibiting a large
      stretch effect also show strong enhancement by hypertonicity, and vice versa. The
      stretch and osmotic enhancements also can partially occlude each other. There
      remain some clear-cut differences between osmotic and stretch forms of
      modulation: the larger range of enhancement by hypertonic solutions, the relative
      lack of effect of osmolarity on evoked release, and the reported higher
      temperature sensitivity of osmotic enhancement. Nevertheless, our data strongly
      implicate integrins in a significant fraction of the osmotic enhancement,
      possibly acting via the same mechanism as stretch modulation.

PMID- 11208973
TI  - Insulin-like growth factor I alters renal function and stimulates renin secretion
      in late gestation fetal sheep.
AB  - While it is known that treatment with insulin-like growth factor I (IGF-I)
      stimulates growth of the fetal kidney, nothing is known about the short term or
      long term effects of IGF-I on fetal renal function. To investigate the acute
      effects of IGF-I on fetal renal function and on the activity of the fetal renin
      angiotensin system, studies were carried out in 12 chronically catheterized fetal
      sheep aged 120 +/- 1 days, before and during a 4 h I.V. infusion of IGF-I at 80
      ug h-1. Seven control fetuses were infused over the same period with vehicle
      (0.1% bovine serum albumin in 0.15 M saline). IGF-I infusion increased plasma IGF
      I concentrations by about 80%. There was a small fall in arterial PO2 (P < 0.01),
      arterial PCO2 increased (P < 0.05), plasma lactate levels increased (P < 0.01)
      and arterial pH fell (P < 0.05). Fractional bicarbonate reabsorption increased
      and bicarbonate excretion decreased (P < 0.05). Infusions of IGF-I had no
      sustained effect on fetal arterial pressure. Glomerular filtration rate (GFR) did
      not change significantly during IGF-I infusion, but renal blood flow (RBF) fell
      (P < 0.05). Therefore filtration fraction relative to control values increased (P
      < 0.05), suggesting that efferent arteriolar vasoconstriction had occurred. IGF-I
      infusion led to an antidiuresis (P < 0.01), a rise in urinary osmolality (P <
      0.05) and a fall in free water clearance (P < 0.01). Since fetal PO2 fell, it is
      probable that these effects were mediated by arginine vasopressin. The excretion
      rates of sodium, chloride and phosphate were all reduced by 4 h of infusion (P <
      0.05), because their fractional reabsorption rates were all increased (sodium, P
      < 0.01; chloride, P < 0.01; and phosphate, P < 0.05). Plasma renin concentration
      increased by 275 +/- 52% during infusion of IGF-I (P < 0.005). Plasma renin
      activity also increased (P < 0.005), while circulating angiotensinogen
      concentrations fell (P < 0.05). In the adult, IGF-I increases both RBF and GFR,
      enhances tubular reabsorption and stimulates the renin-angiotensin system. In the
      fetus, however, it decreased RBF and had no effect on GFR, but was associated
      with enhanced tubular function and intense stimulation of renin secretion. Some
      of these effects of IGF-I on fetal renal function may be involved in maturation
      of the kidney in preparation for life after birth.

PMID- 11208974
TI  - Cross-bridge interaction kinetics in rat myocardium are accelerated by strong
      binding of myosin to the thin filament.
AB  - To determine the ability of strong-binding myosin cross-bridges to activate the
      myocardial thin filament, we examined the Ca2+ dependence of force and cross
      bridge interaction kinetics at 15 degrees C in the absence and presence of a
      strong-binding, non-force-generating derivative of myosin subfragment-1 (NEM-S1)
      in chemically skinned myocardium from adult rats. Relative to control conditions,
      application of 6 microM NEM-S1 significantly increased Ca2+-independent tension,
      measured at pCa 9.0, from 0.8 +/- 0.3 to 3.7 +/- 0.8 mN mm-2. Furthermore, NEM-S1
      potentiated submaximal Ca2+-activated forces and thereby increased the Ca2+
      sensitivity of force, i.e. the [Ca2+] required for half-maximal activation
      (pCa50) increased from pCa 5.85 +/- 0.05 to 5.95 +/- 0.04 (change in pCa50
      (dpCa50) = 0.11 +/- 0.02). The augmentation of submaximal force by NEM-S1 was
      accompanied by a marked reduction in the steepness of the force-pCa relationship
      for forces less than 0.50 Po (maximum Ca2+-activated force), i.e. the Hill
      coefficient (n2) decreased from 4.72 +/- 0.38 to 1.54 +/- 0.07. In the absence of
      NEM-S1, the rate of force redevelopment (ktr) was found to increase from 1.11 +/-
      0.21 s-1 at submaximal [Ca2+] (pCa 6.0) to 9.28 +/- 0.41 s-1 during maximal Ca2+
      activation (pCa 4.5). Addition of NEM-S1 reduced the Ca2+ dependence of ktr by
      eliciting maximal values at low levels of Ca2+, i.e. ktr was 9.38 +/- 0.30 s-1 at
      pCa 6.6 compared to 9.23 +/- 0.27 s-1 at pCa 4. At intermediate levels of Ca2+,
      ktr was less than maximal but was still greater than values obtained at the same
      pCa in the absence of NEM-S1. NEM-S1 dramatically reduced both the extent and
      rate of relaxation from steady-state submaximal force following flash photolysis
      of the caged Ca2+ chelator diazo-2. These data demonstrate that strongly bound
      myosin cross-bridges increase the level of thin filament activation in
      myocardium, which is manifested by an increase in the rate of cross-bridge
      attachment, potentiation of force at low levels of free Ca2+, and slowed rates of
      relaxation.

PMID- 11208975
TI  - Origin and propagation of spontaneous excitation in smooth muscle of the guinea
      pig urinary bladder.
AB  - The origin and propagation of waves of spontaneous excitation in bundles of
      smooth muscle of the guinea-pig bladder were examined using intracellular
      recording techniques and visualization of the changes in the intracellular
      calcium concentration ([Ca2+]i). Bladder smooth muscle cells exhibited
      spontaneous transient increases in [Ca2+]i which originated along a boundary of
      each smooth muscle bundle and then spread to the other boundary with a conduction
      velocity of 2.0 1r1r>mm1> s-1. Spontaneous increases in [Ca2+]i were always
      preceded by action potentials. Nifedipine (10 microM) abolished increases in both
      [Ca2+]i and action potentials. Caffeine (10 1s1sFmM1F), ryanodine (50 microM) and
      cyclopiazonic acid (10 microM reduced the amplitude of the associated increases
      in [Ca2+]i without preventing the generation of action potentials. Spontaneous
      action potentials had conduction velocities of 40 1t1t>mm 1> s-1 in the axial
      direction and 1.3 1u1u>mm 1> s-1 in the transverse direction. The electrical
      length constants of the bundles of muscle were 425 microM in the axial direction
      and 12.5 microM in the transverse direction. Neurobiotin, injected into an
      impaled smooth muscle cell, spread more readily to neighbouring cells located in
      the axial direction than those located in the transverse direction. The spread of
      neurobiotin was inhibited by 18beta-glycyrrhetinic acid (18beta-GA, 40 microM), a
      gap junction blocker. Immunohistochemistry for Connexin 43 showed abundant
      punctate staining on the smooth muscle cell membranes. These results suggested
      that spontaneous action potentials and associated calcium waves occur almost
      simultaneously along the boundary of bladder smooth muscle bundles and then
      propagate to the other boundary probably through gap junctions.

PMID- 11208976
TI  - Optical recordings of taste responses from fungiform papillae of mouse in situ.
AB  - Single taste buds in mouse fungiform papillae consist of approximately 50
      elongated cells (TBCs), where fewer than three TBCs have synaptic contacts with
      taste nerves. We investigated whether the non-innervated TBCs were chemosensitive
      using a voltage-sensitive dye, tetramethylrhodamine methyl ester (TMRM), under in
      situ optical recording conditions. Prior to the optical recordings, we
      investigated the magnitude and polarity of receptor potentials under in situ
      whole-cell clamp conditions. In response to 10 mM HCl, several TBCs were
      depolarized by approximately 25 mV and elicited action potentials, while other
      TBCs were hyperpolarized by approximately 12 mV. The TBCs eliciting
      hyperpolarizing receptor potentials also generated action potentials on
      electrical stimulation. A mixture of 100 mM NaCl, 10 mM HCl and 500 mM sucrose
      depolarized six TBCs and hyperpolarized another three TBCs out of 13 identified
      TBCs in a taste bud viewed by optical section. In an optical section of another
      taste bud, 1 M NaCl depolarized five TBCs and hyperpolarized another two TBCs out
      of 11 identified TBCs. The number of chemosensitive TBCs was much larger than the
      number of innervated TBCs in a taste bud, indicating the existence of
      chemosensitivity in non-innervated TBCs. There was a tendency for TBCs eliciting
      the same polarity of receptor potential to occur together in taste buds. We
      discuss the role of non-innervated TBCs in taste information processing.

PMID- 11208977
TI  - Role of muscle tone in peristalsis in guinea-pig small intestine.
AB  - We investigated the involvement of muscle tone and circular muscle (CM)
      contraction in peristalsis in isolated guinea-pig small intestine. A segment of
      jejunum (approximately 13 cm) was mounted into a three chambered partitioned
      bath. Peristaltic waves were initiated in the oral chamber either by: (1)
      infusing fluid into the oral end of the jejunum; the ejected fluid was diverted
      via a cannula from reaching the intermediate and anal chambers, or by (2)
      intraluminal balloon distension of the empty oral segment. Tension of the
      circular muscle was measured in all three chambers. Peristaltic waves elicited by
      fluid infusion were evoked at an abrupt threshold. In contrast, peristaltic waves
      elicited by distension could be graded in amplitude according to stimulus
      intensity. Peristaltic waves evoked in an empty intestine exhibited similar
      propagation velocities to peristaltic waves associated with fluid propulsion.
      Nifedipine (200-400 nM) added to the intermediate chamber to block muscle
      contraction did not prevent peristaltic waves elicited by either stimulus from
      propagating into the anal chamber, although their amplitude was attenuated.
      Nifedipine to the site of stimulation (oral chamber) abolished peristaltic waves
      generated by either stimulus. Tetrodotoxin (1-2 microM), or a low Ca2+-high Mg2+
      solution to the intermediate chamber abolished the propagation of peristalsis
      from the oral to anal chambers. In conclusion, graded peristaltic waves can occur
      in an empty intestine. Therefore peristalsis is not necessarily an "all-or-none"
      phenomenon. Peristalsis depends on the spread of nervous activity along the
      bowel, rather than the reactivation of neural circuits caused by displacement of
      fluid in the lumen. However, local muscle tone and contraction are important for
      the initiation and maintenance of peristaltic propagation.

PMID- 11208978
TI  - Interactions between two different inhibitory systems in the human motor cortex.
AB  - Intracortical inhibition in the human motor cortex has been previously
      demonstrated using paired-pulse transcranial magnetic stimulation (TMS) protocols
      at short intervals (1-6 ms; short interval intracortical inhibition, SICI) with a
      subthreshold conditioning pulse preceding a suprathreshold test pulse, and at
      long intervals (50-200 ms; long interval intracortical inhibition, LICI) with
      suprathreshold conditioning and test pulses. We investigated whether different
      circuits mediate these inhibitory phenomena and how they interact. In nine
      healthy volunteers, we applied TMS to the motor cortex and recorded motor evoked
      potentials from the first dorsal interosseous muscle. With increasing test pulse
      strength, LICI decreases but SICI tends to increase. There was no correlation
      between the degree of SICI and LICI. We tested the interactions between SICI and
      LICI. SICI was reduced or eliminated in the presence of LICI. Loss of SICI was
      seen even with a conditioning stimulus too weak to induce significant LICI. Our
      findings demonstrate that different cell populations mediate SICI and LICI. The
      results are consistent with the hypothesis that LICI inhibits SICI through
      presynaptic GABAB receptors. Testing of SICI in the presence of LICI may be a non
      invasive way of evaluating inhibitory interactions in the human motor cortex.

PMID- 11208979
TI  - Respiratory effects of the external and internal intercostal muscles in humans.
AB  - The current conventional view of intercostal muscle actions is based on the
      theory of Hamberger (1749) and maintains that as a result of the orientation of
      the muscle fibres, the external intercostals have an inspiratory action on the
      lung and the internal interosseous intercostals have an expiratory action. Recent
      studies in dogs, however, have shown that this notion is only approximate. In the
      present studies, the respiratory actions of the human external and internal
      intercostal muscles were evaluated by applying the Maxwell reciprocity theorem.
      Thus the orientation of the muscle fibres relative to the ribs and the masses of
      the muscles were first assessed in cadavers. Five healthy individuals were then
      placed in a computed tomographic scanner to determine the geometry of the ribs
      and their precise transformation during passive inflation to total lung capacity.
      The fractional changes in length of lines with the orientation of the muscle
      fibres were then computed to obtain the mechanical advantages of the muscles.
      These values were finally multiplied by muscle mass and maximum active stress
      (3.0 kg cm-2) to evaluate the potential effects of the muscles on the lung. The
      external intercostal in the dorsal half of the second interspace was found to
      have a large inspiratory effect. However, this effect decreases rapidly in the
      caudal direction, in particular in the ventral portion of the ribcage. As a
      result, it is reversed into an expiratory effect in the ventral half of the sixth
      and eighth interspaces. The internal intercostals in the ventral half of the
      sixth and eighth interspaces have a large expiratory effect, but this effect
      decreases dorsally and cranially. The total pressure generated by all the
      external intercostals during a maximum contraction would be -15 cmH2O, and that
      generated by all the internal interosseous intercostals would be +40 cmH2O. These
      pressure changes are substantially greater than those induced by the parasternal
      intercostal and triangularis sterni muscles, respectively.

PMID- 11208981
TI  - How well do we manage and support patients and families with dominantly inherited
      renal disease?

PMID- 11208980
TI  - Exercising skeletal muscle blood flow in humans responds to reduction in arterial
      oxyhaemoglobin, but not to altered free oxygen.
AB  - We hypothesised that reducing arterial oxyhaemoglobin (O2Hba) with carbon
      monoxide (CO) in both normoxia and hyperoxia, or acute hypoxia would cause
      similar compensatory increases in human skeletal muscle blood flow and vascular
      conductance during submaximal exercise, despite vast differences in arterial free
      oxygen partial pressure (Pa,O2). Seven healthy males completed four 5 min one
      legged knee-extensor exercise bouts in the semi-supine position (30 +/- 3 W, mean
      +/- S.E.M.), separated by approximately 1 h of rest, under the following
      conditions: (a) normoxia (O2Hba = 195 ml l-1; Pa,O2 = 105 mmHg); (b) hypoxia (163
      ml l-1; 47 mmHg); (c) CO + normoxia (18% COHba; 159 ml l-1; 119 mmHg); and (d) CO
      + hyperoxia (19% COHba; 158 ml l-1; 538 mmHg). CO + normoxia, CO + hyperoxia and
      systemic hypoxia resulted in a 29-44% higher leg blood flow and leg vascular
      conductance compared to normoxia (P < 0.05), without altering blood pH, blood
      acid-base balance or net leg lactate release. Leg blood flow and leg vascular
      conductance increased in association with reduced O2Hba (r2 = 0.92-0.95; P <
      0.05), yet were unrelated to altered Pa,O2. This association was further
      substantiated in two subsequent studies with graded increases in COHba (n = 4)
      and NO synthase blockade (n = 2) in the presence of normal Pa,O2. The elevated
      leg blood flow with CO + normoxia and CO + hyperoxia allowed a approximately 17%
      greater O2 delivery (P < 0.05) to exercising muscles, compensating for the lower
      leg O2 extraction (61%) compared to normoxia and hypoxia (69%; P < 0.05), and
      thereby maintaining leg oxygen uptake constant. The compensatory increases in
      skeletal muscle blood flow and vascular conductance during exercise with both a
      CO load and systemic hypoxia are independent of pronounced alterations in Pa,O2
      (47-538 mmHg), but are closely associated with reductions in O2Hba. These results
      suggest a pivotal role of O2 bound to haemoglobin in increasing skeletal muscle
      vasodilatation during exercise in humans.

PMID- 11208982
TI  - Imaging techniques for the detection of vesicoureteric reflux: what and when?

PMID- 11208983
TI  - Keep your temper: how to avoid heat accumulation in haemodialysis.

PMID- 11208984
TI  - Should relative blood volume changes be routinely measured during the dialysis
      session?

PMID- 11208985
TI  - Recent issues concerning renal transplantation in systemic lupus erythematosus
      patients.

PMID- 11208986
TI  - Obesity as a risk factor in renal transplant patients.

PMID- 11208987
TI  - Sirolimus: a new promising immunosuppressive drug. Towards a rationale for its
      use in renal transplantation.

PMID- 11208988
TI  - Novel approaches to the non-invasive diagnosis of coronary-artery disease.

PMID- 11208990
TI  - Association of nitric oxide production and apoptosis in a model of experimental
      nephropathy.
AB  - BACKGROUND: In recent studies increased amounts of nitric oxide (NO) and
      apoptosis have been implicated in various pathological conditions in the kidney.
      We have studied the role of NO and its association with apoptosis in an
      experimental model of nephrotic syndrome induced by a single injection of
      adriamycin (ADR). METHODS: The alteration in the NO pathway was assessed by
      measuring nitrite levels in serum/urine and by evaluating the changes in vascular
      reactivity of the isolated perfused rat kidney (IPRK) system. Rats were
      stratified into control groups and ADR-induced nephropathy groups. These two
      groups were then divided into: group 1, animals receiving saline; and group 2,
      animals receiving aminoguanidine (AG) which is a specific inhibitor of inducible
      NO synthase. On day 21, rats were sacrificed after obtaining material for
      biochemical analysis. RESULTS: Histopathological examination of the kidneys of
      rats treated with ADR revealed focal areas of mesangial proliferation and mild
      tubulointerstitial inflammation. They also had significantly higher levels of
      proteinuria compared with control and treatment groups (P < 0.05). Urine nitrite
      levels were significantly increased in the ADR-nephropathy group (P < 0.05). In
      the IPRK phenylephrine and acetylcholine related responses were significantly
      impaired in the ADR-nephropathy group. Apoptosis was not detected in controls.
      However, in the ADR-nephropathy group, numerous apoptotic cells were identified
      in the tubulointerstitial areas. Double staining revealed numerous interstitial
      apoptotic cells to stain for ED1, a marker for monocytes/macrophages. Treatment
      with AG prevented the impairment of renal vascular bed responses and reduced both
      urine nitrite levels and apoptosis to control levels. CONCLUSION: We suggest that
      interactions between NO and apoptosis are important in the pathogenesis of the
      ADR-induced nephrosis.

PMID- 11208991
TI  - Analysis of anti-neutrophil cytoplasmic antibodies (ANCA): frequency and
      specificity in a sample of 191 homozygous (PiZZ) alpha1-antitrypsin-deficient
      subjects.
AB  - BACKGROUND: ANCA are autoantibodies directed against polymorphonuclear cell
      antigens, mainly proteinase 3 (PR3) and myeloperoxidase (MPO), which are
      implicated in the pathogenesis of small-vessel necrotizing vasculitis. Alpha1
      antitrypsin is the main inhibitor of neutral serine proteinase [i.e. human
      leukocyte elastase (HLE) and PR3] present in PMN alpha-granules (alphaGr). An
      association first reported by us between PR3 ANCA and the deficient PiZZ
      phenotype in ANCA-positive systemic vasculitis, now widely confirmed by others,
      led us to study the incidence and specificity of ANCA among PiZZ subjects.
      METHODS: We tested a population of 191 PiZZ (273 sera) for ANCA activity versus
      272 PiMM matched control subjects using alphaGr or antigen-specific ELISA [PR3,
      HLE, MPO, lactoferin (LF) and bactericidal/ permeability increasing protein
      (BPI)]. RESULTS: The incidence of antibodies directed against alphaGr and HLE but
      not PR3, MPO, LF or BPI was increased in the PiZZ as compared to the PiMM group
      (Fisher probability respectively P < 0.0001 and P < 0.05). CONCLUSIONS: ANCA not
      directed against classical antigens (MPO and PR3) may be found in PiZZ patients.
      However, these patients do not develop systemic vasculitis features. Therefore,
      alpha1-antitrypsin deficiency is not sufficient to induce ANCA positive
      vasculitides, and may only act as a second hit amplifying factor.

PMID- 11208992
TI  - Plasma total homocysteine concentration in nephrotic patients with idiopathic
      membranous nephropathy.
AB  - BACKGROUND: The atherothrombotic risk pattern of the nephrotic syndrome resembles
      that of hyperhomocysteinemia. However, the effect of nephrotic range proteinuria
      on homocysteine metabolism has never been studied. METHODS: The study included 11
      male nephrotic patients with idiopathic membranous nephropathy who underwent a
      treatment trial with adrenocorticotrophic hormone and 11 male non-nephrotic,
      renal function-matched control subjects. The nephrotic patients were studied
      before and after the treatment, which induced a marked reduction in urinary
      protein excretion and a moderate improvement in renal function in all cases.
      RESULTS: Plasma total homocysteine (tHcy) concentration did not change
      significantly during treatment, whereas the nephrotic patients had significantly
      lower tHcy than the non-nephrotic patients (14.2 +/- 3.4 micromol/l vs 19.0 +/-
      5.4 micromol/l). tHcy correlated significantly with serum concentrations of
      creatinine (r = 0.53, P < 0.05) and albumin (r = 0.43, P < 0.05), glomerular
      filtration rates (GFRs) (iohexol clearances) (r = -0.42, P < 0.05) and urinary
      albumin excretion (r = -0.47, P < 0.05). CONCLUSION: The expected tHcy-lowering
      effect of improved renal function may have masked a tHcy-elevating effect due to
      reduced proteinuria leading to no net change in tHcy during treatment. The notion
      of an increase in tHcy associated with remission of the nephrotic syndrome is in
      accordance with the significantly lower tHcy in the nephrotic renal patients
      compared with the non-nephrotic renal function-matched patients, and the
      relationships between tHcy and serum albumin concentrations as well as urinary
      albumin excretion. Thus, the results of this small study suggest that nephrotic
      range proteinuria directs homocysteine metabolism towards a decrease in tHcy.
      However, the findings need to be confirmed in larger patient populations and in
      different varieties of the nephrotic syndrome.

PMID- 11208993
TI  - Autosomal recessive hypophosphataemic rickets with hypercalciuria is not caused
      by mutations in the type II renal sodium/phosphate cotransporter gene.
AB  - BACKGROUND: At present the genetic defect for autosomal recessive and autosomal
      dominant hypophosphataemic rickets with hypercalciuria (HHRH) is unknown. Type II
      sodium/phosphate cotransporter (NPT2) gene is a serious candidate for being the
      causative gene in either or both autosomal recessive and autosomal dominant HHRH.
      In the present study we tested this hypothesis in one autosomal recessive family.
      METHODS: The gene structure of human NPT2 is known. We tested the complete open
      reading frame in the affected siblings by polymerase chain reaction in
      combination with automatic DNA sequencing for the presence of mutations. RESULTS:
      We did not observe disease-causing mutations in the NPT2 gene of the affected
      siblings. A T855C polymorphism resulting in a histidine to arginine transition
      was present in the open reading frame of NPT2. The polymorphism was present in
      both affected as well as unaffected family members. CONCLUSION: The hypothesis
      that a defect in the NPT2 gene could be an underlying cause for autosomal
      recessive HHRH could not be sustained in our study.

PMID- 11208994
TI  - Conservative treatment and anti-reflux surgery in adults with vesico-ureteral
      reflux: effect on urinary-tract infections, renal function and loin pain in a
      long-term follow-up study.
AB  - STUDY PURPOSE: To investigate the long-term effects in adults of conservative
      treatment and anti-reflux surgery for vesico-ureteral reflux on urinary-tract
      infections, renal function, and loin pain. METHODS: Of 115 adult patients with
      vesico-ureteral reflux diagnosed between 1968 and 1984, conservative treatment
      was given to 46 patients (36 women) and anti-reflux surgery was performed in 57
      patients (52 women). The remaining 12 patients underwent nephrectomy or
      heminephrectomy and were excluded from the study. The anti-reflux surgical
      methods used were the Politano-Leadbetter procedure in 44 patients (73 ureters)
      and the Hutch procedure in 19 patients (25 ureters). Six of these patients were
      operated on with both methods. RESULTS: The frequency of acute pyelonephritis was
      significantly reduced after anti-reflux surgery (P < 0.0001) as well as after
      diagnosis of vesico-ureteral reflux in the group given conservative treatment (P
      or < 0.001). The frequency of lower-urinary-tract infections was not altered in
      either group. Surgery had no effect on significant albuminuria (Albustix > or =
      2+) or on progressive renal functional deterioration. Forty-three patients
      reported recurrent loin pain at the time of diagnosis or anti-reflux surgery.
      Only one of the 12 patients in the conservative group, compared with 29 of the 31
      patients in the anti-reflux surgery group, obtained relief from loin pain during
      the follow-up. Nine patients in the anti-reflux surgery group reported
      restitution of reduced general well-being after surgery. These patients had
      experienced weariness and/or headache before surgery. Vesico-ureteral reflux was
      eliminated more frequently (P < 0.01) in the patients operated on by the Politano
      Leadbetter procedure (94%) than in those operated on by the Hutch procedure
      (68%). CONCLUSIONS: Loin pain is common in adults with vesico-ureteral reflux and
      is effectively eliminated by anti-reflux surgery. Anti-reflux surgery should be
      considered in adults with vesico-ureteral reflux and very frequent acute
      pyelonephritic attacks only if conservative treatment has failed to alleviate
      these symptoms. Anti-reflux surgery is not indicated with the aim of arresting
      renal functional deterioration.

PMID- 11208996
TI  - Autonomic neuropathy is linked to nocturnal hypoxaemia and to concentric
      hypertrophy and remodelling in dialysis patients.
AB  - BACKGROUND: Autonomic dysfunction and sleep apnoea are frequent complications of
      chronic renal failure. Since nocturnal hypoxaemia in sleep apnoea dampens
      autonomic reflexes, we postulated that altered autonomic control is in part
      linked to nocturnal hypoxaemia in uraemic patients. METHODS: To test the
      hypothesis we performed continuous monitoring of O(2) saturation during night by
      pulse oximetry (Ohmeda-Biox) as well as echocardiography, 24-h ambulatory blood
      pressure monitoring, and standard tests of autonomic function in 50 patients on
      chronic dialysis (40 on haemodialysis and 10 on CAPD). For haemodialysis patients
      all studies were performed during a mid-week non-dialysis day. RESULTS: Twenty
      five patients had at least one episode of nocturnal hypoxaemia (median 13,
      interquartile range 4-31) while the other 25 patients had no episodes at all.
      Minimal and average SaO(2) were strongly interrelated (r = 0.64, P = 0.0001). In
      a multiple regression model, besides age, average nocturnal SaO(2) was the only
      independent predictor of the parasympathetic function. Similarly, average
      nocturnal SaO(2) was the only independent predictor of the autonomic response to
      standing. Sex, 24-h mean arterial pressure, body mass index, haematocrit, serum
      albumin, serum parathyroid hormone and duration of dialysis treatment had no
      independent effect on the autonomic tests. Interestingly, the average nocturnal
      SaO(2) and the interaction between the responses to the autonomic tests were
      independently related to posterior-wall thickness. This interaction term
      represented also the stronger independent predictor of the relative wall
      thickness of the left ventricle. In a multiple logistic regression model the
      interaction parasympathetic-sympathetic function was the only independent
      predictor of concentric remodelling or hypertrophy, while average nocturnal
      SaO(2) entered into this model (P = 0.03) only after exclusion of the autonomic
      function interaction term. CONCLUSIONS: Thus, altered cardiovascular autonomic
      control appears to be linked to nocturnal hypoxaemia and to concentric
      hypertrophy or remodelling in dialysis patients. Since nocturnal hypoxaemia is an
      established cardiovascular risk factor, altered autonomic control is a potential
      mechanism whereby hypoxaemia may trigger cardiovascular events in dialysis
      patients. It remains to be seen whether the link between nocturnal hypoxaemia and
      autonomic dysfunction is a causal one.

PMID- 11208995
TI  - Malnutrition in long-term haemodialysis survivors.
AB  - BACKGROUND: Long survival is now common in patients with end-stage renal disease
      owing to improvement in dialysis techniques and kidney transplantation. As
      malnutrition is commonly reported in dialysis patients, we evaluated the
      nutritional status of patients treated with haemodialysis (HD) for more than 20
      years. METHODS: Ten patients (59.5 years old; 4F/6M; HD treatment for 304 months;
      group A) underwent an extensive nutritional examination and were compared to a
      control group of 10 patients treated with HD for an average of 51 months and
      strictly matched for age (58.6 years old), gender, and height (group B). The
      patients were treated on a similar basis (long-duration HD, cellulosic membranes,
      Daugirdas index >2). RESULTS: The body weight (BW) in group A had decreased
      gradually from the 11th year of HD treatment, whereas it had increased by an
      average of 1.9+/-4.4% since the beginning of the HD treatment in group B. The
      body mass index (BMI) was lower in group A (19.3 +/- 2.3 vs 21.4 +/- 2.8 kg/m(2);
      P = 0.05). The arm-muscle circumference (AMC), the arm-muscle area (AMA), and
      triceps skinfold (TSF) were lower in group A than in group B. The fat mass
      assessed with anthropometry (10.8 +/- 4.0 vs 14.8 +/- 4.2 kg) was significantly
      lower in group A. The deviation of actual BW from ideal BW (IBW) was
      significantly lower in group A than in group B (80.6 +/- 10.7% vs 89.6 +/- 9.0%;
      P = 0.028); The deviations of actual BW, TSF, and AMA from standard values of the
      NHANES II study were more marked in group A than in group B. On the other hand,
      daily energy and protein intakes (DEI and DPI) were identical in both groups and
      met the recommendations for dialysis patients when normalized to the actual BW.
      When normalized to the IBW, the DEI appeared low. Energy expenditure was not
      different between groups, and not different from the resting metabolism
      calculated from the Harris and Benedict formula. Average albumin, prealbumin, and
      IgF-1 were normal and not different between groups. Branched-chain amino acids
      (BCAA), and especially leucine, were correlated with BMI in group A but not in
      group B. Serum total and free carnitine were low in both groups. Three patients
      had ascorbic acid deficiency in group A but none in group B. CONCLUSIONS: Hence,
      despite adequate dialysis dose and protein intake, patients treated with HD for a
      long period of time became malnourished, whereas the classical nutritional
      markers remained in normal ranges. Among the potential causes leading to
      malnutrition, inadequate energy intake and micronutrient deficiencies were found
      in these patients.

PMID- 11208997
TI  - Low-potassium and glucose-free dialysis maintains urea but enhances potassium
      removal.
AB  - BACKGROUND: The influence of potassium (K) removal on dialysis efficiency as
      measured by urea elimination is not clear. In this prospective, randomized, cross
      over study we investigated the magnitude of K removal and its effect on urea (u)
      elimination during high-flux haemodialysis (HD). METHODS: Twelve stable, non
      diabetic HD patients were investigated during three one-week standardized HD
      periods (1.8 m(2) high-flux polysulphone dialyser, treatment time 240 min, Qb =
      300 ml/min, Qd = 500 ml/min, dialysate without glucose, bicarbonate 40 mmol/l),
      using dialysates containing 0 (0K), 1 (1K), and 2 (2K) mmol/l of K. Mass removal
      of K (M(K)) and u (M(U)) were measured during the mid-week treatment by partial
      dialysate collection. Urea reduction rate (URR) and Kt/V were determined.
      RESULTS: 0K, 1K and 2K treatments were perfectly comparable. Plasma K (PK)
      continuously declined reaching stable concentrations after 180 min. While 0K
      dialysate removed 117.1 mmol, 80.2 and 63.3 mmol (P < 0.001) were removed by 1K
      and 2K baths respectively. M(U) was not influenced by M(K) (r = 0.22) and
      amounted to 491.1 (0K), 508.6 (1K), and 506.2 (2K) mmol (NS) respectively.
      Accordingly, urea clearance, URR and Kt/V were constant during 0K, 1K and 2K
      treatments. CONCLUSIONS: Potassium-free dialysate significantly enhances
      potassium elimination. Potassium removal has no influence on urea elimination.
      High potassium removal, when needed, does not impair dialysis efficiency as
      measured by urea kinetics in high-flux, glucose-free, 40 mmol/l bicarbonate HD.

PMID- 11208998
TI  - Erythrocyte calcium influx is related to severity of ventricular arrhythmias in
      uraemic patients.
AB  - BACKGROUND: Myocardial disorders are a remarkable cause of morbidity and
      mortality in chronic haemodialysed patients (HD). They could be favoured by
      alteration of cell Ca(2+) handling. In previous studies we characterized an
      erythrocyte Ca(2+) influx, sensitive to membrane potential and inhibited by
      Ca(2+) antagonists. Since its maximal influx rate was decreased in HD patients,
      this study investigates if Ca(2+) influx alterations are related to myocardial
      disorders in HD patients. METHODS: Voltage-sensitive erythrocyte Ca(2+) influx
      was measured in 30 healthy controls and in 53 patients (47 HD patients and six
      patients with left ventricular hypertrophy and normal kidney function), using
      fura 2. In 29 HD patients and in six healthy subjects Ca(2+) influx was also
      determined in the presence of parathyroid hormone (PTH) in vitro. Patients were
      classified according to Lown's ventricular arrhythmias classification after 24-h
      Holter electrocardiograph (ECG) monitoring. Forty-six patients underwent
      echocardiography. RESULTS: Voltage-sensitive erythrocyte Ca(2+) influx was
      significantly reduced in HD patients. Maximal influx rate was significantly
      higher in HD patients of Lown's classes 3 and 4 (0.789 +/- 0.156 nmol/s, n = 8; P
      < 0.01) than in patients of classes 1 and 2 (0.499 +/- 0.055 nmol/s, n=15), or
      without ventricular arrhythmias (0.400 +/- 0.041 nmol/s, n = 24). Maximal influx
      rate was directly correlated to left ventricular mass index (LVM) (r = 0.353, P <
      0.05). Subjects with left ventricular hypertrophy and normal kidney function
      displayed erythrocyte Ca(2+) influx similar to that of normal subjects. Multiple
      regression indicates that LVM and Ca(2+) influx were independently related to
      severity of arrhythmias. When added to the influx assay, PTH increased the
      maximal influx rate only in patients with ventricular arrhythmias. CONCLUSION:
      Myocardial dysfunction and altered ventricular excitability could be related in
      uraemic HD patients to alterations of calcium transport, as found in the
      erythrocyte model. Reduced resistance to PTH could contribute to this phenomenon.

PMID- 11208999
TI  - Assessment of total body water from anthropometry-based equations using
      bioelectrical impedance as reference in Korean adult control and haemodialysis
      subjects.
AB  - BACKGROUND: Several indirect prediction equations to estimate total body water
      (TBW) with simple demographic and anthropometric data are commonly used by
      researchers and dialysis units. These equations are largely based on observations
      in subjects of the Western hemisphere. The purpose of this study was to
      investigate the possible application of anthropometry-based TBW equations to a
      Korean adult control population and maintenance haemodialysis (HD) patients using
      multifrequency bioelectrical impedance analysis (BIA) as reference. METHODS: We
      performed BIA and anthropometric measurements in 67 healthy adults and 101 HD
      patients. Four anthropometry-based equations were used: 58% of actual body weight
      (TBW-58), the Watson formula (TBW-W), the Hume formula (TBW-H), and the Chertow
      formula (TBW-C). Multifrequency BIA was performed at fasting state in controls
      and after HD. RESULTS: TBW-BIA was 34.6+/-6.9 l in control and 29.9+/-5.1 l in HD
      patients. TBW-58 and TBW-C gave significantly greater TBWs than TBW-BIA in both
      control and HD subjects. The correlation coefficients of TBW-BIA with calculated
      TBWs were lowest in TBW-58 (0.754 in control and 0.856 in HD subjects), and
      highest in TBW-C (0.944 in control and 0.916 in HD subjects). Mean prediction
      error was greatest in the Chertow formula for control and HD patients. Mean
      prediction error, limits of agreement, and root mean square error were lowest
      between TBW-BIA and TBW-H in control and between TBW-BIA and TBW-W in HD
      subjects. The correlation coefficient in the Bland-Altman plot was closer to zero
      and parallel with TBW-W than TBW-H in control and HD subjects. CONCLUSION:
      Currently available TBW equations overestimate TBW in both Korean normal control
      subjects and HD patients. Among them, the Watson formula appears to be the
      closest to TBW and to have the least bias. Based on this analysis, it is
      reasonable to use the Watson formula for the calculation of TBW in Korean adult
      control and HD subjects until an Asian-based TBW equation is available.

PMID- 11209000
TI  - Ultrasound guided puncture of the brachial artery for haemodialysis fistula
      angiography.
AB  - BACKGROUND: Arterio-venous (a-v) fistulae of haemodialysis patients frequently
      require function assessment by angiography. The purpose of the present study was
      to determine the efficacy and safety of ultrasound-guided transbrachial
      catheterization when a-v fistulae were evaluated. METHODS: Between July 1996 and
      December 1997, 208 dialysis patients, whose a-v fistulae (arterial inflow < 50
      ml/min or venous pressure > 150 mm Hg in three consecutive HD sessions) were at
      the wrist or elbow, underwent transbrachial angiography using an ultrasound
      guided 20-gauge IA needle to evaluate fistula function. Procedure-related
      symptoms or complications were noted in 28 patients and these were analysed.
      RESULTS: No apparent cases of vessel spasm or thrombosis were noted. Reported
      symptoms in 28 patients (13.5%) included local arm pain (3.3%), transient
      paresthesia (0.9%), mild ecchymosis (10.6%) and haematoma (0.9%). All
      complications were minor and none required surgical intervention. CONCLUSION:
      Ultrasound-guided puncture of the brachial artery is a safe, reliable and
      effective procedure in skilled hands and should be the preferred means of
      catheterization whenever haemodialysis angiography is performed.

PMID- 11209001
TI  - Effects of methionine loading on plasma and erythrocyte sulphur amino acids and
      sulph-hydryls before and after co-factor supplementation in haemodialysis
      patients.
AB  - BACKGROUND: Hyperhomocysteinaemia, which is potentially atherogenic, is common in
      chronic haemodialysis (HD) patients but the reason for this is not yet known. The
      methionine (Met) loading test (MLT) is used to test the capacity of homocysteine
      (Hcy) disposal by the trans-sulphuration pathway and thus may provide information
      on the metabolism of sulphur amino acids. The availability of vitamin B(6) and
      folic acid, as co-factors for Hcy metabolism may affect the response to MLT. In
      the present study, we compared the effect of Met loading on plasma and
      erythrocyte (RBC) sulphur amino acids and sulph-hydryls before and after co
      factor supplementation in healthy subjects and HD patients. METHODS: In 10 HD
      patients and 10 healthy subjects the effect of Met loading, 0.1 g/kg BW, on
      plasma and RBC methionine metabolites was studied over 7 h, before and after 4
      weeks supplementation with high daily doses of vitamin B(6) (200 mg) and folic
      acid (15 mg). RESULTS: MLT before vitamin supplementation in HD patients,
      compared to the healthy subjects, caused significantly greater increases in
      plasma Hcy levels (43+/-12 vs 15+/-5 micromol/l), cysteinesulphinic acid (CSA)
      (1.34 vs 0.36 micromol/l) and gamma-glutamylcysteine (0.98+/-0.83 vs -01+/-0.42
      micromol/l) and no decline in plasma cysteine (Cys) (0.5+/-33.9 vs -31+/-26
      micromol/l), but no significant differences in plasma taurine, cysteinylglycine,
      and glutathione concentrations. In RBCs there was a small increase in Hcy levels
      and a more marked increase in Tau levels, with no difference between the healthy
      subjects and HD patients. Vitamin supplementation in pharmacological doses failed
      to correct the abnormal responses to MLT in the HD patients. CONCLUSIONS: Oral
      methionine loading in HD patients leads to higher accumulation of Hcy and other
      Met metabolites in plasma and RBCs than in healthy subjects, indicating impaired
      metabolism of sulphur amino acids via the trans-sulphuration pathway.
      Supplementation with high doses of vitamin B(6) and folic acid does not correct
      this impairment, suggesting that it most probably is not due to lack of these co
      factors.

PMID- 11209002
TI  - Adequacy of dialysis reduces the doses of recombinant erythropoietin
      independently from the use of biocompatible membranes in haemodialysis patients.
AB  - BACKGROUND: The effect of the adequacy of dialysis on the response to recombinant
      human erythropoietin (rHuEpo) therapy is still incompletely understood because of
      many confounding factors such as iron deficiency, biocompatibility of dialysis
      membranes, and dialysis modality that can interfere. METHODS: We investigated the
      relationship between Kt/V and the weekly dose of rHuEpo in 68 stable
      haemodialysis (HD) patients (age 65+/-15 years) treated with bicarbonate HD and
      unsubstituted cellulose membranes for 6-343 months (median 67 months). Inclusion
      criteria were HD for at least 6 months, subcutaneous rHuEpo for at least 4
      months, transferrin saturation (TSAT) > or = 20%, serum ferritin > or = 100
      ng/ml, and haematocrit (Hct) level targeted to 35% for at least 3 months.
      Exclusion criteria included HBsAg and HIV positivity, need for blood transfusions
      or evidence of blood loss in the 3 months before the study, and acute or chronic
      infections. Hct and haemoglobin (Hb) levels were evaluated weekly for 4 weeks;
      TSAT, serum ferritin, Kt/V, PCRn, serum albumin (sAlb), and weekly dose of rHuEpo
      were evaluated at the end of observation. No change in dialysis or therapy
      prescription was made during the study. RESULTS: The results for the whole group
      of patients were: Hct 35 +/- 1.2%, Hb 12.1 +/- 0.6 g/dl, TSAT 29 +/- 10%, serum
      ferritin 204 +/- 98 ng/ml, sAlb 4.1 +/- 0.3 g/dl, Kt/V 1.33 +/-0.19, PCRn 1.11+/-
      0.28 g/kg/day, weekly dose of rHuEpo 123 +/- 76 U/kg. Hct did not correlate with
      Kt/V, whereas rHuEpo dose and Kt/V were inversely correlated (r = -0.49; P <
      0.0001). Multiple regression analysis with rHuEpo as dependent variable confirmed
      Kt/V as the only significant variable (P < 0.002). Division of the patients into
      two groups according to Kt/V (group A, Kt/V < or = 1.2; group B, Kt/V > or =
      1.4), showed no differences in Hct levels between the two groups, while weekly
      rHuEpo dose was significantly lower in group B than in group A (group B, 86 +/-
      33 U/kg; group A, 183 +/- 95 U/kg, P < 0.0001). CONCLUSIONS: In iron-replete HD
      patients treated with rHuEpo in the maintenance phase, Kt/V exerts a significant
      sparing effect on rHuEpo requirement independent of the use of biocompatible
      synthetic membranes. By optimizing rHuEpo responsiveness, an adequate dialysis
      treatment can contribute to the reduction of the costs of rHuEpo therapy.

PMID- 11209003
TI  - Intravenous iron for CAPD populations: proactive or reactive strategies?
AB  - BACKGROUND: The European best practice guideline [Nephrol Dial Transplant 1999;
      14 (Suppl 5)] (5A) for the management of anaemia suggests that > 85% of the CAPD
      population should have a haemoglobin level of > 11.0 g/dl. METHODS: We developed
      and implemented an outpatient-based protocol for intravenous iron sucrose (IV Fe)
      and erythropoietin (Epo) in CAPD patients showing iron deficiency despite oral
      iron therapy. We managed a total of 103 patients over 13 months of study. All
      CAPD patients were included, regardless of co-morbidity. Treatment developed in
      two phases: in phase 1 (reactive) (months 1-8), patients with markers of iron
      deficiency (ferritin < 100 ng/ml or ferritin 100-500 and percentage hypochromic
      red cells (%HRC) > or =5) were converted from oral iron to IV Fe (300 mg) and
      reviewed after 4-8 weeks according to haemoglobin (Hb). In phase 2 (proactive)
      (months 9-13), the criteria for iron therapy were extended: ferritin < 150 ng/ml
      or ferritin 150-500 and %HRC > or = 2. Patients then received IV Fe (200 mg) and
      were reviewed after 4 weeks according to Hb. RESULTS: The median haemoglobin
      increased from 11.0 (Inter quartile range, IQR, 10.1-12.6) g/dl to 11.7 (11.0
      12.7) g/dl (P = 0.06). The proportion of patients with absolute iron deficiency
      (ferritin < 100 ng/ml) decreased from 24 to 2%. The percentage of hypochromic red
      cells (%HRC) decreased from 4 (2-7) to 1 (1-4) (P < 0.01). CONCLUSIONS: An
      integrated Epo and IV Fe policy increased the number of patients reaching the
      European guideline from 50 to 75% with no increase in the population median Epo
      requirements (42 (IQR, 25-95) IU/kg/week vs 45 (27-101) (P = NS)). This study
      demonstrates the benefit of early (proactive) intervention in achieving
      population compliance within current guidelines for renal anaemia.

PMID- 11209004
TI  - Contrast-enhanced ultrasound voiding cystography as a screening examination for
      vesicoureteral reflux in the follow-up of renal transplant recipients: a new
      approach.
AB  - BACKGROUND: The aim of the study was to evaluate a new diagnostic procedure,
      ultrasound contrast-enhanced voiding cystography (USVC), for vesicoureteral
      reflux (VUR) in renal transplant recipients and to compare it with radionuclide
      voiding cystography (RVC). METHODS: Twenty-three renal transplant recipients with
      recurrent urinary tract infection were investigated simultaneously by RVC and
      USVC. After catheterization, the empty bladder was filled with normal saline
      (mean 250+/-30 ml) and 30-45 mBq of (99m)Tc-labelled colloid. At the end of
      filling the bladder, 19.5 ml of galactose-based, microbubble-containing echo
      enhancing agent, at a concentration of 200 mg/ml, was instilled. During the
      filling and voiding phases the movement of the radiotracer was recorded by a
      gamma camera and the presence of microbubbles in the urinary tract by ultrasound.
      RVC was used to detect and grade the degree of VUR. RESULTS: Nuclear studies
      identified VUR in 16 (69.6%) of 23 recipients with recurrent urinary tract
      infection: VUR grade I in three (13%) recipients, grade II in eight (34.8%) and
      grade III in five (21.7%) using a simplified grading system. USVC with contrast
      enhancement detected VUR in 14 (60.9%) recipients. Overall sensitivity and
      specificity of contrast-enhanced USVC was 75 and 71%, respectively. Statistical
      analysis showed that the accuracy of this procedure increased with higher grades
      of VUR and its sensitivity reached 100% for detection of VUR grade III.
      CONCLUSION: In our preliminary study, contrast-enhanced USVC has proved to be an
      effective examination, with the same accuracy rate as RVC in detecting grade III
      VUR episodes with low diagnostic accuracy for low reflux grades.

PMID- 11209005
TI  - Renal allograft rupture is associated with rejection or acute tubular necrosis,
      but not with renal vein thrombosis.
AB  - BACKGROUND: Whereas rejection was reported to be the most common cause of renal
      allograft rupture (RAR) in the pre-cyclosporin era, renal vein thrombosis (RVT)
      is purported to be the main cause of RAR in patients taking cyclosporin. The
      extremely low incidence of RVT in our series (0.11%) prompted us to analyse our
      collective with regard to RAR. METHOD: Between 1974 and 1999, 1811 renal
      transplants were performed. Patients with RAR, defined as a tear of the renal
      capsule and parenchyma, were identified and possible underlying factors studied.
      RESULTS: RAR was diagnosed in nine male and five female recipients (0.8%) with a
      median age of 36 years. Immunosuppression consisted of azathioprine and
      prednisolone in seven patients and of cyclosporin-based therapy in the seven
      others. At exploration five grafts were removed immediately: three because of
      irreversible rejection, one because of deep wound infection, and one with a
      twisted renal vein. Six of the nine salvaged kidneys have been functioning after
      a mean observation time of 45 months. In the pre-cyclosporin era RAR was
      associated with acute rejection in five out of seven cases as compared with only
      three of the seven on cyclosporin treatment. Core biopsies might have been the
      cause in three cases. CONCLUSION: RAR is a rare complication after renal
      transplantation. Acute rejection still represents the most frequent cause of RAR
      in the cyclosporin era.

PMID- 11209006
TI  - Outcome of renal replacement therapy in the very elderly.
AB  - BACKGROUND: In a retrospective case-note and computer database analysis we
      assessed the outcome of very elderly patients (> or = 75 years old) with end
      stage renal disease (ESRD) on renal replacement therapy (RRT). METHODS: Fifty
      eight individuals aged 75 or over (group 1) commenced RRT between 1 January 1991
      and 31 December 1995. Comparisons were made with other patients commencing RRT
      who were divided into two groups: group 2 (201 individuals 65-74 years old) and
      group 3 (379 patients <65 years old). All subjects were followed up until the
      point of assessment (30 June 1998), the time of death, or withdrawal from
      dialysis. Survival rates in the three groups were compared using Kaplan-Meier
      method. The number of hospital admissions, length of in-patient stay, and
      complications rate on RRT were assessed for group 1. RESULTS: One-year survival
      rates in groups 1, 2 and 3 were 53.5, 72.6, and 90.6% respectively and the 5-year
      survival rates were 2.4, 18.8, and 61.4% respectively. The very elderly spent 20%
      of their time in hospital, 46% had two co-morbid factors at the outset, and 26%
      developed multiple complications while on RRT. Withdrawal from dialysis remained
      the most common cause of death in this group of individuals (38%), followed by
      cardiovascular causes (24%) and infections (22%). CONCLUSION: Very elderly ESRD
      patients on RRT have a very poor outcome and, since they are the largest growing
      group of RRT patients, this has important implications for future health
      policies.

PMID- 11209007
TI  - Increase of physical activity level after successful renal transplantation: a 5
      year follow-up study.
AB  - BACKGROUND: Physical activity (PA) level of end-stage renal disease (ESRD)
      patients after renal transplantation (TP) is a largely unexplored field, although
      it is an important component of quality of life. METHODS: Using the Baecke self
      administered and the Five-City Project 7-day PA recall questionnaires, PA level
      was estimated in 32 consecutive ESRD patients (12 males, 20 females; mean age
      45.9+/-13.1 years; mean dialysis duration 23.5+/-21.8 months) admitted for renal
      TP and to whom no exercise programme of any kind was proposed. PA were recorded
      1, 3, 6, 12 and 60 months after TP. RESULTS: Immediate pre-TP PA level of renal
      transplant candidates was between 18 and 35% less than that of age-matched
      healthy subjects (P < 0.05), depending on gender and questionnaire. After an
      immediate decrease in PA level 1 month post-TP, mean PA level increased and
      reached a plateau 1 year after TP. This gain in PA capacity reached 30%, as
      compared with pre-TP values (P = 0.06 to P < 0.01). During the fifth year after
      TP, the mean level of PA was unchanged. A more qualitative analysis, allowed by
      the sub-score comparisons, showed that although the occupational status of the
      patients remained the same, they participated significantly more in moderate and
      even high intensity PA (leisure, sports, household chores) after TP. CONCLUSIONS:
      Most renal graft recipients are spontaneously more active after TP, an
      observation consistent with a better quality of life. Therefore, they should be
      advised precisely about how to resume more strenuous activities such as sports in
      order to avoid cardiac or musculoskeletal disorders in relation to their weakened
      pre-TP condition.

PMID- 11209008
TI  - Efficacy and drug interactions of the new HMG-CoA reductase inhibitors
      cerivastatin and atorvastatin in CsA-treated renal transplant recipients.
AB  - BACKGROUND: Hyperlipidaemia is an important risk factor for cardiovascular
      disease in renal transplant recipients. The aim of this study was to test the
      efficacy and possible drug-drug interactions of the new HMG-CoA reductase
      inhibitors (statins) atorvastatin and cerivastatin in cyclosporin A (CsA)-treated
      renal transplant patients. Subjects and methods. Thirty patients with stable
      graft function and LDL cholesterol of 130 mg/dl were randomly assigned to active
      treatment groups (10 mg atorvastatin or 0.2 mg cerivastatin), or a control group.
      CsA blood trough levels were controlled on a weekly basis and adapted if they
      changed more than 25% from baseline values (100-150 ng/ml). Lipid levels and
      routine laboratory parameters before and after a treatment period of 3 months
      were compared. RESULTS: In the group treated with cerivastatin no significant
      changes in CsA blood trough levels occurred (CsA 116+/-21 ng/ml vs 110+/-20
      ng/ml). In contrast, in the group treated with atorvastatin, four of 10 patients
      had a rise in CsA blood trough levels of more than 25% within 7-14 days of
      starting therapy. In the remaining patients no significant changes in CsA drug
      levels occurred. After therapy with atorvastatin or cerivastatin, total
      cholesterol, LDL cholesterol, and triglycerides were significantly lower compared
      with baseline conditions. No changes of CsA or lipoprotein levels were present in
      the control group. CONCLUSION: In our study population both statins were very
      effective in lowering elevated LDL cholesterol levels. Cerivastatin did not
      influence CsA blood trough levels, whereas atorvastatin increased CsA levels in
      four of 10 patients. Further research in a larger study is necessary in order to
      confirm these results and to investigate the possible reasons for this drug
      interaction.

PMID- 11209010
TI  - Intravascular ultrasound imaging before and after angioplasty for stenosis of
      arteriovenous fistulae in haemodialysis patients.
AB  - BACKGROUND: Complications of haemodialysis vascular access have emerged as a
      major cause of patient morbidity. Intravascular ultrasound imaging is a new
      technical modality providing visualization of the vessel lumen and wall structure
      in a cross-sectional fashion. Percutaneous transluminal angioplasty has long been
      used in the treatment of stenoses of arteriovenous fistulae. However, there is no
      detailed quantitative information on the stenotic lesion and the morphological
      change by angioplasty. METHODS: Intravascular ultrasound studies were performed
      in 40 haemodialysis patients with 63 stenoses in arteriovenous fistulae who had
      percutaneous transluminal angioplasty. The patients were qualitatively and
      quantitatively evaluated for echogenic patterns and morphological changes before
      and after angioplasty. RESULTS: Morphological plaque features in stenotic lesions
      were classified as 37 soft (58%), five hard (8%), 20 mixed (32%), and one
      calcified sites. Plaque fractures after angioplasty were detected in 45/63 (71%)
      instances. The lumen cross-sectional area was found to be dilated approximately
      threefold (from 3.8+/-2.4 to 11.1+/-4.5 mm(2)) and the external elastic membrane
      cross-sectional area was dilated approximately twofold (from 11.1+/-5.3 to 19.8+/
      8.1 mm(2)) after angioplasty. CONCLUSION: These results indicate that
      intravascular ultrasound allows both qualitative and quantitative assessments of
      arteriovenous fistulae in haemodialysis patients. The results further suggest
      that the mechanism of expansion of arteriovenous fistulae stenoses by
      percutaneous transluminal angioplasty involves stretching of the vessel wall as
      well as plaque fractures.

PMID- 11209009
TI  - Altered antioxidant defence in a mouse adriamycin model of glomerulosclerosis.
AB  - BACKGROUND: Antioxidant enzyme status changes in experimental models of chronic
      renal disease with glomerulosclerosis. Most of the studies are performed in rats.
      We now investigate whether a mouse model with more rapid development of
      glomerulosclerosis is suitable for the study of radical-associated renal disease.
      METHODS: Female BALB/c mice are injected intravenously with a single dose of
      adriamycin (10 mg/kg). The development of glomerular and interstitial injury is
      evaluated by means of renal function parameters and histology. Renal cortex
      activities of catalase, Cu/Zn and Mn superoxide dismutase and glutathione
      peroxidase are measured by enzymatic techniques, and their mRNA levels by
      Northern blot analysis. RESULTS: The mice develop proteinuria and
      hypercholesterolaemia; glomerulosclerosis is present 20 days after adriamycin
      injection. Involvement of reactive oxygen intermediates in the disease process is
      supported by an increased cortex level of glutathione (1.77+/-0.13 vs 1.31+/-0.12
      micromol/g kidney; P = 0.021) and ferric iron deposition in the
      tubulointerstitial compartment. Glomerulosclerosis and tubulointerstitial lesions
      are accompanied by decreased cortex activities of catalase (0.19+/-0.01 vs 0.23+/
      0.01 U/mg protein; P = 0.024), glutathione peroxidase (0.28+/-0.01 vs 0.32+/-0.01
      U/mg protein; P = 0.049) and Mn superoxide dismutase (6.61+/-0.91 vs 9.25+/-0.99
      U/mg protein, P = 0.020). We find decreased cortex mRNA levels only for
      glutathione peroxidase. CONCLUSION: The fast development of glomerulosclerosis
      combined with an altered antioxidant status makes this mouse adriamycin model a
      suitable alternative for the slower rat models.

PMID- 11209011
TI  - Spontaneous remission of HCV-induced cryoglobulinaemic glomerulonephritis.

PMID- 11209012
TI  - Laparoscopic renal denervation for intractable ADPKD-related pain.

PMID- 11209013
TI  - Desmopressin may be hazardous in thrombotic microangiopathy.

PMID- 11209014
TI  - End-stage renal disease in a bodybuilder: a multifactorial process or simply
      doping?

PMID- 11209015
TI  - Three cases of sequential liver-kidney transplantation from living-related
      donors.

PMID- 11209016
TI  - Vomiting, hyperkalaemia and cardiac rhythm disturbances.

PMID- 11209017
TI  - Parathyroidectomy in a hypercalcaemic patient with inappropriately normal plasma
      parathyroid hormone: an unusual way to arrive at the correct diagnosis.

PMID- 11209018
TI  - The haemodialysis patient with night sweats, ascites, and increased CA 125.

PMID- 11209021
TI  - Cyclo-oxygenase-2 and renal function.

PMID- 11209023
TI  - STOPPING at the CAPPP of good HOPE.

PMID- 11209024
TI  - A polymorphism in the gene for the endothelial nitric oxide synthase and diabetic
      nephropathy.

PMID- 11209025
TI  - Necrotizing glomerulonephritis associated with Hodgkin's disease.

PMID- 11209026
TI  - Tumour lysis syndrome in a patient with metastatic melanoma treated with
      biochemotherapy.

PMID- 11209027
TI  - Tranexamic-acid-induced acute renal cortical necrosis in a patient with
      haemophilia A.

PMID- 11209028
TI  - Acetaminophen toxicity induced non-oliguric acute tubular necrosis.

PMID- 11209029
TI  - Continuous rifampicin administration inducing acute renal failure.

PMID- 11209030
TI  - Response to recombinant human erythropoietin (rHu-Epo) in a patient with chronic
      renal failure and myelomonocytic leukaemia.

PMID- 11209031
TI  - Pharmacokinetic of nevirapine in haemodialysis.

PMID- 11209033
TI  - Successful treatment of digoxin intoxication by haemoperfusion with specific
      columns for beta2-microgloblin-adsorption (Lixelle) in a maintenance
      haemodialysis patient.

PMID- 11209032
TI  - Safety of interferon and ribavirin therapy in haemodialysis patients with chronic
      hepatitis C: results of a pilot study.

PMID- 11209034
TI  - Looking for new sources of organ donations.

PMID- 11209035
TI  - Epstein-Barr virus encephalitis in a renal allograft recipient diagnosed by
      polymerase chain reaction on cerebrospinal fluid and successfully treated with
      ganciclovir.

PMID- 11209037
TI  - PubMed Central: The GenBank of the published literature.

PMID- 11209038
TI  - Looking for the exit: How do malaria parasites escape from red blood cells?

PMID- 11209039
TI  - The six functions of Agrobacterium VirE2.

PMID- 11209040
TI  - Biomolecular processes in the fast lane.

PMID- 11209041
TI  - Ancient DNA and the origin of modern humans.

PMID- 11209042
TI  - Cancer epigenetics takes center stage.

PMID- 11209043
TI  - Lactic acid: New roles in a new millennium.

PMID- 11209044
TI  - Can mosaic tumor vessels facilitate molecular diagnosis of cancer?

PMID- 11209045
TI  - Transmitochondrial mice: proof of principle and promises.

PMID- 11209046
TI  - A molecular logic gate.
AB  - We propose a scheme for molecule-based information processing by combining well
      studied spectroscopic techniques and recent results from chemical dynamics.
      Specifically it is discussed how optical transitions in single molecules can be
      used to rapidly perform classical (Boolean) logical operations. In the proposed
      way, a restricted number of states in a single molecule can act as a logical gate
      equivalent to at least two switches. It is argued that the four-level scheme can
      also be used to produce gain, because it allows an inversion, and not only a
      switching ability. The proposed scheme is quantum mechanical in that it takes
      advantage of the discrete nature of the energy levels but, we here discuss the
      temporal evolution, with the use of the populations only. On a longer time range
      we suggest that the same scheme could be extended to perform quantum logic, and a
      tentative suggestion, based on an available experiment, is discussed. We believe
      that the pumping can provide a partial proof of principle, although this and
      similar experiments were not interpreted thus far in our terms.

PMID- 11209047
TI  - The role of rigidity in DNA looping-unlooping by AraC.
AB  - We applied two experiments useful in the study of ligand-regulated DNA binding
      proteins to AraC, the dimeric regulator of the Escherichia coli l-arabinose
      operon. In the absence of arabinose, AraC prefers to loop DNA by binding to two
      half-sites that are separated by 210 base pairs, and in the presence of arabinose
      it prefers to bind to adjacently located half-sites. The basis for this ligand
      regulated shift in binding appears to result from a shift in the rigidity of the
      system, where rigidity both in AraC protein in the absence of arabinose, and in
      the DNA are required to generate the free energy differences that produce the
      binding preferences. Eliminating the dimerization domains and connecting the two
      DNA binding domains of AraC by a flexible peptide linker should provide a protein
      whose behavior mimics that of AraC when there is no interaction between its
      dimerization and DNA binding domains. The resulting protein bound to adjacent
      half-sites on the DNA, like AraC protein in the presence of arabinose. When the
      two double-stranded DNA half-sites were connected by 24 bases of single-stranded,
      flexible DNA, wild-type AraC protein bound to the DNA in the presence and absence
      of arabinose with equal affinity, showing that AraC modulates its DNA binding
      affinity in response to arabinose by shifting the relative positions of its DNA
      binding domains. These results are consistent with the light switch mechanism for
      the action of AraC, refine the model, and extend the range of experimental tests
      to which it has been subjected.

PMID- 11209049
TI  - The "glycogen shunt" in exercising muscle: A role for glycogen in muscle
      energetics and fatigue.
AB  - Stimulated by recent (13)C and (31)P NMR studies of exercising muscle, we propose
      a model of the energetics of contraction. Previous studies of energetics have
      followed energy consumption. However, the rapidity of contraction, in 10-40 msec,
      requires that energy be delivered rapidly, so that the muscle has power
      requirements of rapid energy expenditure that are ultimately met by the slower
      averaged consumption of carbon and oxygen from blood. We propose that energy is
      supplied in milliseconds by glycogenolysis and that between contractions,
      glycogenesis refills the pools. The energy for glycogenesis is supplied by
      oxidative phosphorylation. This mechanism utilizes the rapid conversion of
      glycogen phosphorylase, the "fight-or-flight" enzyme, to its active form. Lactate
      is necessarily generated by this pathway to serve as a time buffer between fast
      and slow energy needs, which resolves the paradoxical generation of lactate in
      well oxygenated tissue. Consequences of the glycogen shunt are compatible with
      numerous biochemical and physiological experiments. The model provides a possible
      mechanism for muscle fatigue, suggesting that at low but nonzero glycogen
      concentrations, there is not enough glycogen to supply millisecond energy needs.

PMID- 11209048
TI  - A complex signaling module governs the activity of MalT, the prototype of an
      emerging transactivator family.
AB  - MalT, the specific activator of the maltose regulon, is the prototype of a family
      of high-molecular-mass ATP-binding bacterial transcription activators. On binding
      of its two positive effectors, the inducer maltotriose and ATP, MalT oligomerizes
      to an active state competent for promoter binding and transcription activation.
      In addition to its previously known DNA-binding domain, limited proteolysis
      showed that MalT contains three other domains, the boundaries of which were
      accurately delimited by N-terminal microsequencing. The N-terminal domain alone
      binds ATP. Maltotriose binding involves an extended region corresponding to
      domains 2 and 3, although weak binding to domain 3 alone was also observed.
      Moreover, maltotriose binding induces a conformational shift involving a movement
      of both domains 1 and 3 with respect to domain 2, leading to the active form of
      the protein. Sequence examination of the MalT homologues suggests that these
      three domains might constitute a signaling module.

PMID- 11209050
TI  - Refined crystal structure of DsRed, a red fluorescent protein from coral, at 2.0
      A resolution.
AB  - The crystal structure of DsRed, a red fluorescent protein from a
      corallimorpharian, has been determined at 2.0-A resolution by multiple-wavelength
      anomalous dispersion and crystallographic refinement. Crystals of the
      selenomethionine-substituted protein have space group P2(1) and contain a
      tetramer with 222 noncrystallographic symmetry in the asymmetric unit. The
      refined model has satisfactory stereochemistry and a final crystallographic R
      factor of 0.162. The protein, which forms an obligatory tetramer in solution and
      in the crystal, is a squat rectangular prism comprising four protomers whose fold
      is extremely similar to that of the Aequorea victoria green fluorescent protein
      despite low ( approximately 23%) amino acid sequence homology. The monomer
      consists of an 11-stranded beta barrel with a coaxial helix. The chromophores,
      formed from the primary sequence -Gln-Tyr-Gly- (residues 66-68), are arranged in
      a approximately 27 x 34-A rectangular array in two approximately antiparallel
      pairs. The geometry at the alpha carbon of Gln-66 (refined without stereochemical
      restraints) is consistent with an sp(2) hybridized center, in accord with the
      proposal that red fluorescence is because of an additional oxidation step that
      forms an acylimine extension to the chromophore [Gross, L. A., Baird, G. S.,
      Hoffman, R. C., Baldridge, K. K. & Tsien, R. Y. (2000) Proc. Natl. Acad. Sci. USA
      87, 11990-11995]. The carbonyl oxygen of Phe-65 is almost 90 degrees out of the
      plane of the chromophore, consistent with theoretical calculations suggesting
      that this is the minimum energy conformation of this moiety despite the
      conjugation of this group with the rest of the chromophore.

PMID- 11209051
TI  - Simultaneous observation of the O---O and Fe---O2 stretching modes in
      oxyhemoglobins.
AB  - Understanding of the chemical nature of the dioxygen moiety of oxyhemoglobin is
      crucial for elucidation of its physiological function. In the present work,
      direct Raman spectroscopic observation of both the FeO(2) and OO stretching modes
      unambiguously establishes the vibrational characteristics of the oxygen-bound
      heme moiety in the hemoglobins of Chlamydomonas eugametos and Synechocystis
      PCC6803. In addition to providing the resonance Raman assignment of the OO
      stretching mode (1136 cm(-1) for Chlamydomonas, 1133 cm(-1) for Synechocystis) in
      an oxyhemoglobin with an iron-porphyrin, this study also reports unusually low
      frequencies for the FeO(2) stretching modes (554 cm(-1)). The effect of strong
      hydrogen bonding to the bound oxygen is confirmed by changes in the frequency of
      the FeO(2) stretching mode on mutation of distal residues. These findings suggest
      an enzymatic function rather than an oxygen transport role for these hemoglobins.

PMID- 11209052
TI  - A family of tissue-specific resistin-like molecules.
AB  - We have identified a family of resistin-like molecules (RELMs) in rodents and
      humans. Resistin is a hormone produced by fat cells. RELMalpha is a secreted
      protein that has a restricted tissue distribution with highest levels in adipose
      tissue. Another family member, RELMbeta, is a secreted protein expressed only in
      the gastrointestinal tract, particularly the colon, in both mouse and human.
      RELMbeta gene expression is highest in proliferative epithelial cells and is
      markedly increased in tumors, suggesting a role in intestinal proliferation.
      Resistin and the RELMs share a cysteine composition and other signature features.
      Thus, the RELMs together with resistin comprise a class of tissue-specific
      signaling molecules.

PMID- 11209053
TI  - Mitochondrial DNA sequences in ancient Australians: Implications for modern human
      origins.
AB  - DNA from ancient human remains provides perspectives on the origin of our species
      and the relationship between molecular and morphological variation. We report
      analysis of mtDNA from the remains of 10 ancient Australians. These include the
      morphologically gracile Lake Mungo 3 [ approximately 60 thousand years (ka)
      before present] and three other gracile individuals from Holocene deposits at
      Willandra Lakes (<10 ka), all within the skeletal range of living Australians,
      and six Pleistocene/early Holocene individuals (15 to <8 ka) from Kow Swamp with
      robust morphologies outside the skeletal range of contemporary indigenous
      Australians. Lake Mungo 3 is the oldest (Pleistocene) "anatomically modern" human
      from whom DNA has been recovered. His mtDNA belonged to a lineage that only
      survives as a segment inserted into chromosome 11 of the nuclear genome, which is
      now widespread among human populations. This lineage probably diverged before the
      most recent common ancestor of contemporary human mitochondrial genomes. This
      timing of divergence implies that the deepest known mtDNA lineage from an
      anatomically modern human occurred in Australia; analysis restricted to living
      humans places the deepest branches in East Africa. The other ancient Australian
      individuals we examined have mtDNA sequences descended from the most recent
      common ancestor of living humans. Our results indicate that anatomically modern
      humans were present in Australia before the complete fixation of the mtDNA
      lineage now found in all living people. Sequences from additional ancient humans
      may further challenge current concepts of modern human origins.

PMID- 11209054
TI  - Function-structure analysis of proteins using covarion-based evolutionary
      approaches: Elongation factors.
AB  - The divergent evolution of protein sequences from genomic databases can be
      analyzed by the use of different mathematical models. The most common treat all
      sites in a protein sequence as equally variable. More sophisticated models
      acknowledge the fact that purifying selection generally tolerates variable
      amounts of amino acid replacement at different positions in a protein sequence.
      In their "stationary" versions, such models assume that the replacement rate at
      individual positions remains constant throughout evolutionary history.
      "Nonstationary" covarion versions, however, allow the replacement rate at a
      position to vary in different branches of the evolutionary tree. Recently,
      statistical methods have been developed that highlight this type of variation in
      replacement rates. Here, we show how positions that have variable rates of
      divergence in different regions of a tree ("covarion behavior"), coupled with
      analyses of experimental three-dimensional structures, can provide experimentally
      testable hypotheses that relate individual amino acid residues to specific
      functional differences in those branches. We illustrate this in the elongation
      factor family of proteins as a paradigm for applications of this type of analysis
      in functional genomics generally.

PMID- 11209055
TI  - Attractin/mahogany/zitter plays a critical role in myelination of the central
      nervous system.
AB  - The rat zitter (zi) mutation induces hypomyelination and vacuolation in the
      central nervous system (CNS), which result in early-onset tremor and progressive
      flaccid paresis. By positional cloning, we found a marked decrease in Attractin
      (Atrn) mRNA in the brain of the zi/zi rat and identified zi as an 8-bp deletion
      at a splice donor site of Atrn. Atrn has been known to play multiple roles in
      regulating physiological processes that are involved in monocyte-T cell
      interaction, agouti-related hair pigmentation, and control of energy homeostasis.
      Rat Atrn gene encoded two isoforms, a secreted and a membrane form, as a result
      of alternative splicing. The zi mutation at the Atrn locus darkened coat color
      when introduced into agouti rats, as also described in mahogany (mg) mice,
      carrying the homozygous mutation at the Atrn locus. Transgenic rescue experiments
      showed that the membrane-type Atrn complemented both neurological alteration and
      abnormal pigmentation in zi/zi rats, but that the secreted-type Atrn complemented
      neither mutant phenotype. Furthermore, we discovered that mg mice exhibited
      hypomyelination and vacuolation in the CNS associated with body tremor. We
      conclude from these results that the membrane Atrn has a critical role in normal
      myelination in the CNS and would provide insights into the physiology of
      myelination as well as the etiology of myelin diseases.

PMID- 11209056
TI  - CpG island protects Rous sarcoma virus-derived vectors integrated into
      nonpermissive cells from DNA methylation and transcriptional suppression.
AB  - CpG islands are important in the protection of adjacent housekeeping genes from
      de novo DNA methylation and for keeping them in a transcriptionally active state.
      However, little is known about their capacity to protect heterologous genes and
      assure position-independent transcription of adjacent transgenes or retroviral
      vectors. To tackle this question, we have used the mouse aprt CpG island to flank
      a Rous sarcoma virus (RSV)-derived reporter vector and followed the
      transcriptional activity of integrated vectors. RSV is an avian retrovirus which
      does not replicate in mammalian cells because of several blocks at all levels of
      the replication cycle. Here we show that our RSV-derived reporter proviruses
      linked to the mouse aprt gene CpG island remain undermethylated and keep their
      transcriptional activity after stable transfection into both avian and
      nonpermissive mammalian cells. This effect is most likely caused by the
      protection from de novo methylation provided by the CpG island and not by
      enhancement of the promoter strength. Our results are consistent with previous
      finding of CpG islands in proximity to active but not inactive proviruses and
      support further investigation of the protection of the gene transfer vectors from
      DNA methylation.

PMID- 11209058
TI  - A fibronectin fragment inhibits tumor growth, angiogenesis, and metastasis.
AB  - We have shown previously that a polymeric form of fibronectin is strongly
      antimetastatic when administered systemically to tumor-bearing mice. The
      polymeric fibronectin, sFN, is formed in vitro by treating soluble fibronectin
      with a 76-aa peptide, III1-C, which is derived from the first type III repeat in
      fibronectin. Here we show that the III1-C peptide and sFN also reduce tumor
      growth in mice, and that this effect correlates with a low density of blood
      vessels in the tumors of the treated mice. III1-C also polymerized fibrinogen,
      and the fibrinogen polymer, sFBG, had antitumor and antiangiogenic effects
      similar to those of sFN. Mice that had been injected s.c. with three different
      types of human tumor cells and treated with biweekly i.p. injections of III1-C,
      sFN, or sFBG over a 5-week period had tumors that were 50-90% smaller than those
      of control mice. Blood vessel density in the tumors of the treated mice was
      reduced by 60-80% at the end of the experiment. Xenograft tumors from a human
      breast carcinoma line (MDA-MB-435) were particularly susceptible to these
      treatments. Metastasis into the lungs from the primary s.c. tumors also was
      inhibited in the mice treated with III1-C and the two polymers. The III1-C
      peptide is an antiangiogenic and antimetastatic agent. Because of its ability to
      suppress tumor growth, angiogenesis, and metastasis, we have named the III1-C
      peptide anastellin [from anastello (Greek), inhibit, force a retreat].

PMID- 11209057
TI  - Soluble CD14 enriched in colostrum and milk induces B cell growth and
      differentiation.
AB  - Induction of resting B cell growth and differentiation requires a complex series
      of temporally coordinated signals that are initiated on contact with activated
      helper T cells. These signals complement one another, each rendering the B cell
      susceptible to factors supporting progressive activation. Here, we demonstrate
      that soluble CD14 (sCD14) bypasses the physiological sequelae of events that
      limit B cell activation. B cell growth and differentiation in vitro is induced by
      both native and recombinant forms of sCD14 at nanomolar concentrations. sCD14
      mediated cellular activation does not require membrane CD14 expression, depends
      on a region of CD14 that is not involved in lipopolysaccharide binding, and
      requires functional Toll-like receptor 4. Consistent with biological activity of
      sCD14 in vitro, its administration to neonatal mice enhances Ig secretion. The
      results presented establish sCD14 as a naturally occurring soluble B cell mitogen
      of mammalian origin.

PMID- 11209059
TI  - Point mutations in the murine fumarylacetoacetate hydrolase gene: Animal models
      for the human genetic disorder hereditary tyrosinemia type 1.
AB  - Hereditary tyrosinemia type 1 (HT1) is a severe autosomal recessive metabolic
      disease associated with point mutations in the human fumarylacetoacetate
      hydrolase (FAH) gene that disrupt tyrosine catabolism. An acute form of HT1
      results in death during the first months of life because of hepatic failure,
      whereas a chronic form leads to gradual development of liver disease often
      accompanied by renal dysfunction, childhood rickets, neurological crisis, and
      hepatocellular carcinoma. Mice homozygous for certain chromosome 7 deletions of
      the albino Tyr; c locus that also include Fah die perinatally as a result of
      liver dysfunction and exhibit a complex syndrome characterized by structural
      abnormalities and alterations in gene expression in the liver and kidney. Here we
      report that two independent, postnatally lethal mutations induced by N-ethyl-N
      nitrosourea and mapped near Tyr are alleles of Fah. The Fah(6287SB) allele is a
      missense mutation in exon 6, and Fah(5961SB) is a splice mutation causing loss of
      exon 7, a subsequent frameshift in the resulting mRNA, and a severe reduction of
      Fah mRNA levels. Increased levels of the diagnostic metabolite succinylacetone in
      the urine of the Fah(6287SB) and Fah(5961SB) mutants indicate that these
      mutations cause a decrease in Fah enzymatic activity. Thus, the neonatal
      phenotype present in both mutants is due to a deficiency in Fah caused by a point
      mutation, and we propose Fah(5961SB) and Fah(6287SB) as mouse models for acute
      and chronic forms of human HT1, respectively.

PMID- 11209060
TI  - Conditional immortalization of freshly isolated human mammary fibroblasts and
      endothelial cells.
AB  - Reports differ as to whether reconstitution of telomerase activity alone is
      sufficient for immortalization of different types of human somatic cells or
      whether additional activities encoded by other "immortalizing" genes are also
      required. Here we show that ectopic expression of either the catalytic subunit of
      human telomerase (hTERT) or a temperature-sensitive mutant (U19tsA58) of simian
      virus 40 large-tumor antigen alone was not sufficient for immortalization of
      freshly isolated normal adult human mammary fibroblasts and endothelial cells.
      However, a combination of both genes resulted in the efficient generation of
      immortal cell lines irrespective of the order in which they were introduced or
      whether they were introduced early or late in the normal proliferative lifespan
      of the cultures. The order and timing of transduction, however, did influence
      genomic stability. Karyotype analysis indicated that introduction of both
      transgenes at early passage, with hTERT first, yielded diploid cell lines.
      Temperature-shift experiments revealed that maintenance of the immortalized state
      depended on continued expression of functional U19tsA58 large-tumor antigen, with
      hTERT alone unable to maintain growth at nonpermissive temperatures for U19tsA58
      large-tumor antigen. Such conditional diploid lines may provide a useful resource
      for both cell engineering and for studies on immortalization and in vitro
      transformation.

PMID- 11209061
TI  - The evolutionary history of chromosomal super-integrons provides an ancestry for
      multiresistant integrons.
AB  - Integrons are genetic elements that acquire and exchange exogenous DNA, known as
      gene cassettes, by a site-specific recombination mechanism. Characterized gene
      cassettes consist of a target recombination sequence (attC site) usually
      associated with a single open reading frame coding for an antibiotic resistance
      determinant. The affiliation of multiresistant integrons (MRIs), which contain
      various combinations of antibiotic resistance gene cassettes, with transferable
      elements underlies the rapid evolution of multidrug resistance among diverse Gram
      negative bacteria. Yet the origin of MRIs remains unknown. Recently, a
      chromosomal super-integron (SI) harboring hundreds of cassettes was identified in
      the Vibrio cholerae genome. Here, we demonstrate that the activity of its
      associated integrase is identical to that of the MRI integrase, IntI1. We have
      also identified equivalent integron superstructures in nine distinct genera
      throughout the gamma-proteobacterial radiation. Phylogenetic analysis revealed
      that the evolutionary history of the system paralleled that of the radiation,
      indicating that integrons are ancient structures. The attC sites of the 63
      antibiotic-resistance gene cassettes identified thus far in MRIs are highly
      variable. Strikingly, one-fifth of these were virtually identical to the highly
      related yet species-specific attC sites of the SIs described here. Furthermore,
      antimicrobial resistance homologues were identified among the thousands of genes
      entrapped by these SIs. Because the gene cassettes of SIs are substrates for
      MRIs, these data identify SIs as the source of contemporary MRIs and their
      cassettes. However, our demonstration of the metabolic functions, beyond
      antibiotic resistance and virulence, of three distinct SI gene cassettes
      indicates that integrons function as a general gene-capture system for bacterial
      innovation.

PMID- 11209062
TI  - Bunyamwera bunyavirus nonstructural protein NSs is a nonessential gene product
      that contributes to viral pathogenesis.
AB  - Bunyamwera virus (family Bunyaviridae, genus Bunyavirus) contains a tripartite
      negative-sense RNA genome. The smallest RNA segment, S, encodes the nucleocapsid
      protein N and a nonstructural protein, NSs, in overlapping reading frames. We
      have generated a mutant virus lacking NSs, called BUNdelNSs, by reverse genetics.
      Compared with the wild-type (wt) virus, BUNdelNSs exhibited a smaller plaque size
      and generated titers of virus approximately 1 log lower. In mammalian cells, the
      mutant expressed greatly increased levels of N protein; significantly, the marked
      inhibition of host cell protein synthesis shown by wt virus was considerably
      impaired by BUNdelNSs. When inoculated by the intracerebral route BUNdelNSs
      killed BALB/c mice with a slower time course than wt and exhibited a reduced cell
      to-cell spread, and titers of virus in the brain were lower. In addition, the
      abrogation of NSs expression changed Bunyamwera virus from a noninducer to an
      inducer of an interferon-beta promoter. These results suggest that, although not
      essential for growth in tissue culture or in mice, the bunyavirus NSs protein has
      several functions in the virus life cycle and contributes to viral pathogenesis.

PMID- 11209063
TI  - Antigenic and genetic heterogeneity of Borrelia burgdorferi populations
      transmitted by ticks.
AB  - The genome of Borrelia burgdorferi encodes a large number of lipoproteins, many
      of which are expressed only at certain stages of the spirochete's life cycle. In
      the current study we describe the B. burgdorferi population structure with
      respect to the production of two lipoproteins [outer surface protein A (OspA) and
      outer surface protein C (OspC)] during transmission from the tick vector to the
      mammalian host. Before the blood meal, the bacteria in the tick were a
      homogeneous population that mainly produced OspA only. During the blood meal, the
      population became more heterogeneous; many bacteria produced both OspA and OspC,
      whereas others produced only a single Osp and a few produced neither Osp. From
      the heterogeneous spirochetal population in the gut, a subset depleted of OspA
      entered the salivary glands and stably infected the host at time points >53 hr
      into the blood meal. We also examined genetic heterogeneity at the B. burgdorferi
      vlsE locus before and during the blood meal. In unfed ticks, the vlsE locus was
      stable and one predominant and two minor alleles were detected. During the blood
      meal, multiple vlsE alleles were observed in the tick. Tick feeding may increase
      recombination at the vlsE locus or selectively amplify rare vlsE alleles present
      in unfed ticks. On the basis of our data we propose a model, which is different
      from the established model for B. burgdorferi transmission. Implicit in our model
      is the concept that tick transmission converts a homogeneous spirochete
      population into a heterogeneous population that is poised to infect the mammalian
      host.

PMID- 11209064
TI  - A default mode of brain function.
AB  - A baseline or control state is fundamental to the understanding of most complex
      systems. Defining a baseline state in the human brain, arguably our most complex
      system, poses a particular challenge. Many suspect that left unconstrained, its
      activity will vary unpredictably. Despite this prediction we identify a baseline
      state of the normal adult human brain in terms of the brain oxygen extraction
      fraction or OEF. The OEF is defined as the ratio of oxygen used by the brain to
      oxygen delivered by flowing blood and is remarkably uniform in the awake but
      resting state (e.g., lying quietly with eyes closed). Local deviations in the OEF
      represent the physiological basis of signals of changes in neuronal activity
      obtained with functional MRI during a wide variety of human behaviors. We used
      quantitative metabolic and circulatory measurements from positron-emission
      tomography to obtain the OEF regionally throughout the brain. Areas of activation
      were conspicuous by their absence. All significant deviations from the mean
      hemisphere OEF were increases, signifying deactivations, and resided almost
      exclusively in the visual system. Defining the baseline state of an area in this
      manner attaches meaning to a group of areas that consistently exhibit decreases
      from this baseline, during a wide variety of goal-directed behaviors monitored
      with positron-emission tomography and functional MRI. These decreases suggest the
      existence of an organized, baseline default mode of brain function that is
      suspended during specific goal-directed behaviors.

PMID- 11209065
TI  - Emotion-induced changes in human medial prefrontal cortex: I. During cognitive
      task performance.
AB  - Regional cerebral blood flow (BF) was examined in regions of the medial
      prefrontal cortex (MPFC) with positron-emission tomography while subjects
      performed two cognitive tasks, reading nouns aloud and generating appropriate
      verbs for the same nouns. The control task was passive viewing of the same words.
      BF was reduced in regions of the MPFC during word reading and naive verb
      generation, relative to a control state in which the subjects passively viewed
      nouns. Practicing verb generation produced improved performance, as measured by
      response time, which was strongly correlated with further reductions in MPFC and
      hypothalamic BF. After practice, when verb generation was performed on a novel
      list of words, reaction times slowed and the pattern of MPFC BF reverted to that
      seen in the word reading and naive conditions. A separate behavioral study of the
      verb-generation task indicated that anxiety, high during naive use-generation as
      measured by heart rate and self-report, decreased with practice on the task but
      returned with the introduction of a novel list of words. Taken together, these
      results suggest that the MPFC is part of a network, including the hypothalamus
      and brainstem, whose activity reflects a dynamic interplay between cognitive task
      performance and emotion.

PMID- 11209067
TI  - Dynamic imaging of coherent sources: Studying neural interactions in the human
      brain.
AB  - Functional connectivity between cortical areas may appear as correlated time
      behavior of neural activity. It has been suggested that merging of separate
      features into a single percept ("binding") is associated with coherent gamma band
      activity across the cortical areas involved. Therefore, it would be of utmost
      interest to image cortico-cortical coherence in the working human brain. The
      frequency specificity and transient nature of these interactions requires time
      sensitive tools such as magneto- or electroencephalography (MEG/EEG). Coherence
      between signals of sensors covering different scalp areas is commonly taken as a
      measure of functional coupling. However, this approach provides vague information
      on the actual cortical areas involved, owing to the complex relation between the
      active brain areas and the sensor recordings. We propose a solution to the
      crucial issue of proceeding beyond the MEG sensor level to estimate coherences
      between cortical areas. Dynamic imaging of coherent sources (DICS) uses a spatial
      filter to localize coherent brain regions and provides the time courses of their
      activity. Reference points for the computation of neural coupling may be based on
      brain areas of maximum power or other physiologically meaningful information, or
      they may be estimated starting from sensor coherences. The performance of DICS is
      evaluated with simulated data and illustrated with recordings of spontaneous
      activity in a healthy subject and a parkinsonian patient. Methods for estimating
      functional connectivities between brain areas will facilitate characterization of
      cortical networks involved in sensory, motor, or cognitive tasks and will allow
      investigation of pathological connectivities in neurological disorders.

PMID- 11209066
TI  - Emotion-induced changes in human medial prefrontal cortex: II. During
      anticipatory anxiety.
AB  - Regional cerebral blood flow (BF) was examined in the human medial prefrontal
      cortex (MPFC) with positron emission tomography during anticipatory anxiety.
      Transient anxiety was induced in normal subjects by having them anticipate a
      painful shock to the fingers of one hand. BF was decreased during anticipatory
      anxiety, relative to an eyes-closed resting condition, in two regions of the MPFC
      (Brodmann Areas 10/32 and 24/25). BF decreases in these areas were inversely
      correlated with anxiety self rating, such that the least anxious subjects
      exhibited the largest BF reductions, whereas the most anxious subjects showed no
      significant BF reduction or a slight increase. BF changes in MPFC and in the
      midbrain were correlated with each other and with anxiety self rating. These
      results are consistent with the hypothesis that BF reductions in MPFC, previously
      observed in cognitive tasks, reflect a dynamic balance between focused attention
      and subject anxiety and may occur from a functionally active baseline or default
      state. The characterization of such relationships within the human brain enables
      new insights into the integration of cognition and emotion.

PMID- 11209070
TI  - Mechanism of ribosomal peptide bond formation.

PMID- 11209068
TI  - Estradiol rapidly inhibits soluble guanylyl cyclase expression in rat uterus.
AB  - Previous reports that investigated the regulation of the NO/soluble guanylyl
      cyclase (sGC)/cGMP pathway by estrogenic compounds have focused primarily on the
      levels of NO, NO-producing enzymes, and cGMP in various tissues. In this study,
      we demonstrate that 17beta-estradiol (E2) regulates the alpha(1) and beta(1)
      subunits of the NO receptor, sGC, at the mRNA and protein levels in rat uterus.
      Using real-time quantitative PCR, we found that within 1 h of in vivo E2
      administration to rats, sGC mRNA levels begin to diminish. After 3 h, there is a
      maximal diminution of sGC mRNA expression (sGC alpha(1) 10% and sGC beta(1) 33%
      of untreated). This effect was blocked by the estrogen receptor antagonist, ICI
      182,780, indicating that estrogen receptor is required. The effect of E2 also was
      observed in vitro with incubations of uterine tissue, indicating that the
      response does not depend on the secondary release of other hormones or factors
      from other tissues. Puromycin did not block the effect, suggesting the effects
      occur because of preexisting factors in uterine tissues and do not require new
      protein synthesis. Using immunoblot analysis, we found that sGC protein levels
      also were reduced by E2 over a similar time course as the sGC mRNA. We conclude
      that sGC plays a vital role in the NO/sGC/cGMP regulatory pathway during
      conditions of elevated estrogen levels in the rat uterus as a result of the
      reduction of sGC expression.

PMID- 11209071
TI  - Fluid control in multichannel structures by electrocapillary pressure.
AB  - We demonstrate control of fluid motion in three-dimensional structures with
      thousands of microchannels. Fluids are manipulated via an electrocapillary
      pressure, originating from electrostatic control of the solid/fluid interfacial
      tension in the microchannels. Reversible fluid displacement has been achieved for
      all channel orientations with respect to gravity. The velocities of several
      centimeters per second are nearly two orders of magnitude higher than the
      velocities demonstrated by other electrofluidic actuation principles.

PMID- 11209069
TI  - Activation of a mitogen-activated protein kinase pathway is involved in disease
      resistance in tobacco.
AB  - Hypersensitive response (HR), a form of programmed cell death, is frequently
      associated with plant disease resistance. It has been proposed that mitogen
      activated protein kinase (MAPK) cascades regulate HR cell death based on
      pharmacological studies by using kinase inhibitors. However, direct evidence is
      lacking. Here, we demonstrate that NtMEK2, a MAPK kinase, is upstream of
      salicylic acid-induced protein kinase (SIPK) and wounding-induced protein kinase
      (WIPK), two tobacco MAPKs that are activated by various pathogens or pathogen
      derived elicitors. Expression of a constitutively active mutant of NtMEK2 induces
      HR-like cell death in tobacco, which is preceded by the activation of endogenous
      SIPK and WIPK. In addition, NtMEK2-SIPK/WIPK cascade appears to control the
      expression of 3-hydroxy-3-methylglutaryl CoA reductase (HMGR) and l-phenylalanine
      ammonia lyase (PAL), two defense genes encoding key enzymes in the phytoalexin
      and salicylic acid biosynthesis pathways. These results demonstrate that a plant
      MAPK cascade controls multiple defense responses against pathogen invasion.

PMID- 11209072
TI  - Proximity-induced superconductivity in DNA.
AB  - Conductivity measurements on double-stranded DNA molecules deposited by a combing
      process across a submicron slit between rhenium/carbon metallic contacts reveal
      conduction to be ohmic between room temperature and 1 kelvin. The resistance per
      molecule is less than 100 kilohm and varies weakly with temperature. Below the
      superconducting transition temperature (1 kelvin) of the contacts, proximity
      induced superconductivity is observed. These results imply that DNA molecules can
      be conducting down to millikelvin temperature and that phase coherence is
      maintained over several hundred nanometers.

PMID- 11209073
TI  - Resonant electron scattering by defects in single-walled carbon nanotubes.
AB  - We report the characterization of defects in individual metallic single-walled
      carbon nanotubes by transport measurements and scanned gate microscopy. A sizable
      fraction of metallic nanotubes grown by chemical vapor deposition exhibits
      strongly gate voltage-dependent resistance at room temperature. Scanned gate
      measurements reveal that this behavior originates from resonant electron
      scattering by defects in the nanotube as the Fermi level is varied by the gate
      voltage. The reflection coefficient at the peak of a scattering resonance was
      determined to be about 0.5 at room temperature. An intratube quantum dot device
      formed by two defects is demonstrated by low-temperature transport measurements.

PMID- 11209074
TI  - A three-dimensional synthetic metallic crystal composed of single-component
      molecules.
AB  - Molecular metals normally require charge transfer between two different chemical
      species. We prepared crystals of [Ni(tmdt)2] (tmdt,
      trimethylenetetrathiafulvalenedithiolate) and carried out crystal structure
      analyses and resistivity measurements. The analyses and measurements revealed
      that these single-component molecular crystals are metallic from room temperature
      down to 0.6 kelvin. Ab initio molecular orbital calculations suggested that pi
      molecular orbitals form conduction bands. The compact molecular arrangement,
      intermolecular overlap integrals of the highest occupied and lowest unoccupied
      molecular orbitals, and tight-binding electronic band structure calculation
      revealed that [Ni(tmdt)2] is a three-dimensional synthetic metal composed of
      planar molecules.

PMID- 11209075
TI  - String tension and stability of magic tip-suspended nanowires.
AB  - Multishell helical gold nanowires were recently imaged by electron microscopy. We
      show theoretically that the contact with the gold tips at either end of the wire
      plays a crucial role and that local minima in the string tension rather than the
      total wire free energy determine the nanowire stability. Density functional
      electronic structure calculations of the simplest and thinnest coaxial gold and
      silver wires of variable radius and chirality were carried out. We found a string
      tension minimum for a single-tube gold nanowire that is chiral and consists of
      seven strands, in striking agreement with observation. In contrast, no such
      minimum was found for silver, where the s-d competition leading to surface
      reconstruction is lacking.

PMID- 11209076
TI  - Orbital forcing of the marine isotope stage 9 interglacial.
AB  - Milankovitch orbital forcing theory has been used to assign time scales to many
      paleoclimate records. However, the validity of this theory remains uncertain, and
      independent sea-level chronologies used to test its applicability have been
      restricted largely to the past approximately 135,000 years. Here, we report U
      series ages for coral reefs formed on Henderson Island during sea-level high
      stands occurring at approximately 630,000 and approximately 330,000 years ago.
      These data are consistent with the hypothesis that interglacial climates are
      forced by Northern Hemisphere summer solar insolation centered at 65 degrees N
      latitude, as predicted by Milankovitch theory.

PMID- 11209077
TI  - Modern human ancestry at the peripheries: a test of the replacement theory.
AB  - The replacement theory of modern human origins stipulates that populations
      outside of Africa were replaced by a new African species of modern humans. Here
      we test the replacement theory in two peripheral areas far from Africa by
      examining the ancestry of early modern Australians and Central Europeans.
      Analysis of pairwise differences was used to determine if dual ancestry in local
      archaic populations and earlier modern populations from the Levant and/or Africa
      could be rejected. The data imply that both have a dual ancestry. The diversity
      of recent humans cannot result exclusively from a single Late Pleistocene
      dispersal.

PMID- 11209078
TI  - Natal homing in a marine fish metapopulation.
AB  - Identifying natal origins of marine fishes is challenging because of difficulties
      in conducting mark-recapture studies in marine systems. We used natural
      geochemical signatures in otoliths (ear bones) to determine natal sources in
      weakfish (Cynoscion regalis), an estuarine-spawning marine fish, in eastern North
      America. Spawning site fidelity ranged from 60 to 81%, comparable to estimates of
      natal homing in birds and anadromous fishes. These data were in contrast to
      genetic analyses of population structure in weakfish. Our findings highlight the
      need for consideration of spatial processes in fisheries models and have
      implications for the design of marine reserves in coastal regions.

PMID- 11209079
TI  - Migration along orthodromic sun compass routes by arctic birds.
AB  - Flight directions of birds migrating at high geographic and magnetic latitudes
      can be used to test bird orientation by celestial or geomagnetic compass systems
      under polar conditions. Migration patterns of arctic shorebirds, revealed by
      tracking radar studies during an icebreaker expedition along the Northwest
      Passage in 1999, support predicted sun compass trajectories but cannot be
      reconciled with orientation along either geographic or magnetic loxodromes (rhumb
      lines). Sun compass routes are similar to orthodromes (great circle routes) at
      high latitudes, showing changing geographic courses as the birds traverse
      longitudes and their internal clock gets out of phase with local time. These
      routes bring the shorebirds from high arctic Canada to the east coast of North
      America, from which they make transoceanic flights to South America. The
      observations are also consistent with a migration link between Siberia and the
      Beaufort Sea region by way of sun compass routes across the Arctic Ocean.

PMID- 11209080
TI  - A ribonucleotide reductase homolog of cytomegalovirus and endothelial cell
      tropism.
AB  - Human cytomegalovirus infects vascular tissues and has been associated with
      atherogenesis and coronary restenosis. Although established laboratory strains of
      human cytomegalovirus have lost the ability to grow on vascular endothelial
      cells, laboratory strains of murine cytomegalovirus retain this ability. With the
      use of a forward-genetic procedure involving random transposon mutagenesis and
      rapid phenotypic screening, we identified a murine cytomegalovirus gene governing
      endothelial cell tropism. This gene, M45, shares sequence homology to
      ribonucleotide reductase genes. Endothelial cells infected with M45-mutant
      viruses rapidly undergo apoptosis, suggesting that a viral strategy to evade
      destruction by cellular apoptosis is indispensable for viral growth in
      endothelial cells.

PMID- 11209081
TI  - A role for flavin monooxygenase-like enzymes in auxin biosynthesis.
AB  - Although auxin is known to regulate many processes in plant development and has
      been studied for over a century, the mechanisms whereby plants produce it have
      remained elusive. Here we report the characterization of a dominant Arabidopsis
      mutant, yucca, which contains elevated levels of free auxin. YUCCA encodes a
      flavin monooxygenase-like enzyme and belongs to a family that includes at least
      nine other homologous Arabidopsis genes, a subset of which appears to have
      redundant functions. Results from tryptophan analog feeding experiments and
      biochemical assays indicate that YUCCA catalyzes hydroxylation of the amino group
      of tryptamine, a rate-limiting step in tryptophan-dependent auxin biosynthesis.

PMID- 11209083
TI  - Categorical representation of visual stimuli in the primate prefrontal cortex.
AB  - The ability to group stimuli into meaningful categories is a fundamental
      cognitive process. To explore its neural basis, we trained monkeys to categorize
      computer-generated stimuli as "cats" and "dogs." A morphing system was used to
      systematically vary stimulus shape and precisely define the category boundary.
      Neural activity in the lateral prefrontal cortex reflected the category of visual
      stimuli, even when a monkey was retrained with the stimuli assigned to new
      categories.

PMID- 11209082
TI  - Transgenic monkeys produced by retroviral gene transfer into mature oocytes.
AB  - Transgenic rhesus monkeys carrying the green fluorescent protein (GFP) gene were
      produced by injecting pseudotyped replication-defective retroviral vector into
      the perivitelline space of 224 mature rhesus oocytes, later fertilized by
      intracytoplasmic sperm injection. Of the three males born from 20 embryo
      transfers, one was transgenic when accessible tissues were assayed for transgene
      DNA and messenger RNA. All tissues that were studied from a fraternal set of
      twins, miscarried at 73 days, carried the transgene, as confirmed by Southern
      analyses, and the GFP transgene reporter was detected by both direct and indirect
      fluorescence imaging.

PMID- 11209084
TI  - Role of ER export signals in controlling surface potassium channel numbers.
AB  - Little is known about the identity of endoplasmic reticulum (ER) export signals
      and how they are used to regulate the number of proteins on the cell surface.
      Here, we describe two ER export signals that profoundly altered the steady-state
      distribution of potassium channels and were required for channel localization to
      the plasma membrane. When transferred to other potassium channels or a G protein
      coupled receptor, these ER export signals increased the number of functional
      proteins on the cell surface. Thus, ER export of membrane proteins is not
      necessarily limited by folding or assembly, but may be under the control of
      specific export signals.

PMID- 11209085
TI  - Autoimmune dilated cardiomyopathy in PD-1 receptor-deficient mice.
AB  - Dilated cardiomyopathy is a severe pathology of the heart with poorly understood
      etiology. Disruption of the gene encoding the negative immunoregulatory receptor
      PD-1 in BALB/c mice, but not in BALB/c RAG-2-/- mice, caused dilated
      cardiomyopathy with severely impaired contraction and sudden death by congestive
      heart failure. Affected hearts showed diffuse deposition of immunoglobulin G
      (IgG) on the surface of cardiomyocytes. All of the affected PD-1-/- mice
      exhibited high-titer circulating IgG autoantibodies reactive to a 33-kilodalton
      protein expressed specifically on the surface of cardiomyocytes. These results
      indicate that PD-1 may be an important factor contributing to the prevention of
      autoimmune diseases.

PMID- 11209086
TI  - New strategies in the treatment of acute myelogenous leukemia (AML): in vitro
      culture of aml cells--the present use in experimental studies and the possible
      importance for future therapeutic approaches.
AB  - In vitro studies of cultured native acute myelogenous leukemia (AML) blasts and
      cell lines have contributed significantly to our present knowledge about the
      pathogenesis of AML. In the present article we review different techniques for
      preparation and in vitro culture of AML blasts. Well-characterized serum-free in
      vitro conditions can now be used in experimental studies of AML, and this makes
      comparisons between different studies easier. We also describe assays for
      characterization of AML progenitor subsets (i.e., suspension cultures, colony
      assays, long-term in vitro culture, xenotransplantation in immunocompromised
      mice), and we discuss the possible use of AML cell lines as experimental models
      in AML. Furthermore, clinical studies suggest that the in vitro growth
      characteristics of AML blasts assayed by short-term culture of the total native
      populations can be used as a predictor of prognosis after intensive chemotherapy.
      These in vitro assays may therefore be used for more accurate identification of
      prognostic parameters and thereby form a basis for the development of simplified
      laboratory techniques suitable for routine evaluation of patients undergoing risk
      adapted therapy. However, it will be equally important to further evaluate the
      clinical relevance of assays for primitive AML progenitors, and to develop
      simplified methods that can be used to characterize these progenitor subsets in
      the routine clinical evaluation.

PMID- 11209087
TI  - Gene transfer into nonhuman primate hematopoietic stem cells: implications for
      gene therapy.
AB  - Hematopoietic stem cells (HSCs) are desirable targets for gene therapy because of
      their self-renewal and multilineage differentiation abilities. Retroviral vectors
      are extensively used for HSC gene therapy. However, the initial human trials of
      HSC gene marking and therapy showed that the gene transfer efficiency into human
      HSCs with retroviral vectors was very low in contrast to the much higher
      efficiency observed in murine experiments. The more quiescent nature of human
      HSCs and the lower density of retroviral receptors on them hindered the efficient
      gene transfer with retroviral vectors. Since nonhuman primates have marked
      similarity to humans in all aspects including the HSC biology, their models are
      considered to be important to evaluate and improve gene transfer into human HSCs.
      Using these models, clinically relevant levels (around 10% or even more) of gene
      modified cells in peripheral blood have recently been achieved after gene
      transfer into HSCs and their autologous transplantation. This has been made
      possible by improving ex vivo transduction conditions such as introduction of Flt
      3 ligand and specific fibronectin fragment (CH-296) into ex vivo culture during
      transduction, and the use of retroviral vectors pseudotyped with the gibbon ape
      leukemia virus or feline endogenous retrovirus envelope. Other strategies
      including the use of lentiviral vectors and in vivo selective expansion of gene
      modified cells with the drug resistance gene or selective amplifier gene (also
      designated the molecular growth switch) are now being tested to further increase
      the fraction of gene-modified cells using nonhuman primate models. In addition to
      the high gene transfer efficiency, high-level and long-term expression of
      transgenes in human HSCs and their progeny is also required for effective HSC
      gene therapy. For this purpose, other backbones of retroviral vectors such as the
      murine stem cell virus and cis-DNA elements, such as the ss-globin locus control
      region and the chromatin insulator, also need to be tested in nonhuman primate
      models. Nonhuman primate studies will continue to provide an important framework
      for human HSC gene therapy. Well-designed nonhuman primate studies will also
      offer unique insights into the HSCs, immune system, and transplantation biology
      characteristic of large animals.

PMID- 11209088
TI  - Anti-VEGFR-2 scFvs for cell isolation. Single-chain antibodies recognizing the
      human vascular endothelial growth factor receptor-2 (VEGFR-2/flk-1) on the
      surface of primary endothelial cells and preselected CD34+ cells from cord blood.
AB  - Five specific single-chain antibodies recognizing the human vascular endothelial
      growth factor receptor-2 (VEGFR-2/KDR) were selected from a V-gene phage display
      library constructed from mice immunized with the extracellular domain of VEGFR-2
      (Ig-like domain 1-7). All five scFv antibodies (A2, A7, B11, G3, and H1) bound to
      the purified native antigen in enzyme-linked immunosorbent assay and Dot Blot,
      and showed no crossreactivity to the human VEGF-receptor 1 (VEGFR-1). The
      selected antibodies recognize a conformation-dependent epitope of the native
      receptor and do not recognize denatured antigen in Western blots, as well as
      linear overlapping peptides comprising the sequence of the human VEGFR-2. The
      five scFv antibodies bind to the surface of endothelial cells overexpressing
      human VEGFR-2 c-DNA (PAE/VEGFR-2 cells) as detected by surface immunofluorescence
      using confocal microscopy. In addition scFv A7 specifically detected VEGFR-2
      expressing endothelial cells in the glomerulus of frozen human kidney tissue
      sections. Therefore, A7 has potential clinical application as a marker for
      angiogenesis in cryosections of different human tissues. Additionally, two
      recombinant scFvs (A2 and A7) very efficiently recognize VEGFR-2 on PAE/VEGFR-2
      cells and freshly prepared human umbilical vein endothelial cells by fluorescence
      activated cell sorter (FACS) analysis. The scFv fragment A7, which was the most
      sensitive antibody in FACS analysis, recognizes human CD34+VEGFR-2+ hematopoietic
      immature cells within the population of enriched CD34+ cells isolated from human
      cord blood. The dissociation constant of A7 was determined to be K(d) = 3.8 x 10(
      9) M by BIAcore analysis. In conclusion, scFv fragment A7 seems to be an
      important tool for FACS analysis and cell sorting of vascular endothelial cells,
      progenitor cells and hematopoitic stem cells, which are positive for VEGFR-2 gene
      expression.

PMID- 11209089
TI  - Plasma levels of SDF-1 and expression of SDF-1 receptor on CD34+ cells in
      mobilized peripheral blood of non-Hodgkin's lymphoma patients.
AB  - CXCR4 is the receptor for the chemokine stromal derived factor-1 (SDF-1), is
      expressed on CD34+ cells, and has been implicated in the process of CD34+ cell
      migration and homing. We studied the mobilization of CD34/CXCR4 cells and the
      plasma levels of SDF-1 and flt3-ligand (flt3-L) in 36 non-Hodgkin's lymphoma
      patients receiving cyclophosphamide (Cy) plus G-CSF (arm A), Cy plus GM-CSF (arm
      B), or Cy plus GM-CSF followed by G-CSF (arm C) for peripheral blood stem cell
      (PBSC) mobilization and autotransplantation. We observed lower plasma levels of
      SDF-1 in PBSCs compared to premobilization bone marrow samples. The mean plasma
      SDF-1 levels were similar in PBSC collections in the three arms of the study. In
      contrast, SDF-1 levels in the apheresis collections of the "good mobilizers"
      (patients who collected a minimum of 2 x 10(6) CD34+ cells/kg in one to four PBSC
      collections) were significantly lower than the apheresis collections of the "poor
      mobilizers" (> or = 0.4 x 10(6) CD34+ cells/kg in the first two PBSC collections;
      288 +/- 82 pg/ml versus 583 +/- 217 pg/ml; p = 0.0009). The mean percentage of
      CD34+ cells expressing CXCR4 in the apheresis collections was decreased in the
      PBSC collections compared with premobilization values from 28% to 19.4%.
      Furthermore, the percentage of CD34+ cells expressing CXCR4 in the good
      mobilizers was significantly lower compared with the poor mobilizers (14.7 +/-
      2.1% versus 33.6 +/- 2.1%; p = 0.002). The good mobilizers had also significantly
      lower levels of flt3-L compared with the poor mobilizers (34 +/- 4 pg/ml versus
      106 +/- 11 pg/ml; p = 0.006), Finally, the levels of flt3-L strongly correlated
      with SDF-1 levels (r = 0.8; p < 0.0001). We conclude: A) low plasma levels of SDF
      1 and low expression of CXCR4 characterize patients with good mobilization
      outcome, and B) the levels of SDF-1 correlate with flt3-L, suggesting an
      association of these cytokines in mobilization of CD34+ cells.

PMID- 11209090
TI  - Major histocompatibility complex restriction between hematopoietic stem cells and
      stromal cells in vitro.
AB  - We have previously found that a significant number of hematopoietic progenitors
      accumulate in engrafted bones with the same major histocompatibility complex
      (MHC) as the transplanted bone marrow cells. In the present study, to further
      clarify the MHC restriction between hematopoietic stem cells (HSC) and
      microenvironment, we carried out cobblestone colony formation assays by culturing
      HSCs with MHC-matched or -mismatched stromal cell monolayers. The formation of
      cobblestone colonies under MHC-mismatched stromal cells significantly decreased
      in comparison with MHC-matched stromal cells. However, the decrease in
      cobblestone colony formation under MHC-mismatched stromal cells was not
      significant when using MHC class I-deficient HSC or stromal cells. Taken together
      with the results using B10 congenic strains, it is suggested that the MHC
      preference is restricted by MHC class Ia molecules. Treatment with monoclonal
      antibodies (mAbs) against MHC class Ia molecules of stromal cell phenotypes
      significantly enhanced the cobblestone colony formation, whereas treatment with
      mAbs against HSC phenotypes significantly inhibited it. The expression of
      cytokines to promote hematopoiesis was enhanced by the mAbs against stromal cell
      phenotypes. The enhancement of cytokine expression was also observed when stromal
      cells and HSCs were MHC-matched. These results suggest that signaling via the MHC
      molecules augments stromal cell activity and elicits the MHC restriction.

PMID- 11209091
TI  - Steel factor sustains SCL expression and the survival of purified CD34+ bone
      marrow cells in the absence of detectable cell differentiation.
AB  - CD34+ cells express the basic helix-loop-helix transcription factor SCL, which is
      essential for blood cell formation in vivo. In addition, their survival is
      critically dependent on hemopoietic growth factors. We therefore compared the
      effects of Steel factor (SF) and GM-CSF on the survival, proliferation, and
      differentiation of primary human CD34+ cells, as well as the role of SCL during
      these processes. GM-CSF suppresses apoptosis in CD34+ cells, which proliferate
      and differentiate into mature granulocytic and monocytic cells (CD34-CD13+) and
      loose SCL expression. In contrast, SF suppresses apoptosis without a significant
      increase in cell numbers, and the cells remain CD34+ and SCL+ with a blast-like
      morphology. Examination of apoptosis by the terminal deoxynucleotidyl transferase
      mediated dUTP-biotin nick end labeling (TUNEL) reaction and of the cell cycle
      status indicated that SF is both a survival factor and a mitogenic factor for
      CD34+ cells. There was, however, constant cell death in a fraction of the
      population, which could be rescued by GM-CSF. Co-addition of SF and GM-CSF
      prevents the downregulation of SCL observed in the presence of GM-CSF by itself,
      allows for prolonged survival and expansion of CD34+ cells in culture, inhibits
      monocytic differentiation and impairs granulocytic differentiation. Finally,
      exposure to an antisense SCL but not a control oligonucleotide decreases SCL
      protein levels and prevents the suppression of apoptosis by SF without affecting
      GM-CSF-dependent cell survival. These observations suggest that the hemopoietic
      transcription factor SCL regulates the survival of CD34+ cells in response to SF.

PMID- 11209092
TI  - dlk inhibits stem cell factor-induced colony formation of murine hematopoietic
      progenitors: Hes-1-independent effect.
AB  - Delta-like (dlk) is a family of transmembrane proteins containing epidermal
      growth factor-like repeat motifs homologous to the notch/delta/serrate family.
      Recent studies suggest that dlk is a negative regulator of adipocyte
      differentiation, a promoting factor of cobblestone area colony formation, and a
      molecule which influences stromal cell-pre-B cell interactions and augments
      cellularity of developing thymocytes. However, the role of dlk in regulating the
      growth and differentiation of hematopoietic progenitors remains unclear. In the
      present study, we examined the effect of dlk on the proliferation of murine
      hematopoietic progenitors by hematopoietic growth factors. Soluble dlk-IgG Fc
      chimeric protein completely inhibited the colony formation of lineage-marker
      negative (Lin-) bone marrow cells by GM-CSF, G-CSF, or macrophage-CSF (M-CSF) in
      the presence of stem cell factor (SCF). However, dlk failed to inhibit the colony
      formation of Lin- bone marrow cells by CSF, as described above, or M-CSF plus
      interleukin 3. Furthermore, dlk failed to inhibit the colony formation of Hes-1
      null fetal liver cells by M-CSF in the presence of SCF. These findings suggest
      that dlk is an important regulator of hematopoietic progenitor proliferation.
      Depending on the presence of SCF, dlk may act as a growth inhibitor, although dlk
      signaling does not mediate Hes-1 transcription factor.

PMID- 11209093
TI  - Immunogenicity of Ly5 (CD45)-antigens hampers long-term engraftment following
      minimal conditioning in a murine bone marrow transplantation model.
AB  - Various techniques are available for distinguishing donor from host cells
      evaluating the efficacy of conditioning regimen for experimental bone marrow
      transplantation (BMT). Techniques include the use of extracellular immunological
      markers, such as Ly5 (CD45), and intracellular biochemical markers, such as
      glucose-phosphate-isomerase (Gpi). Because Ly5 is an extracellular protein, the
      disparity between donor (Ly5.1) and host (Ly5.2) antigens may induce a weak
      immune response whereas with Gpi, no immune response is expected. This difference
      may be of particular concern in experimental transplantation approaches that use
      minimal conditioning such as low-dose total body irradiation (TBI). Such mild
      conditioning may not induce the immunosuppression required to overcome host
      rejection of Ly5 disparate cells. To compare the relative engraftment of Ly5.1
      and Gpi-1(a) donor marrow, B6 (Gpi-1(b)/Ly5.2) mice were irradiated with low
      level TBI (0-6 Gy) and transplanted with several bone marrow (BM) doses (2 x
      10(6)-5 x 10(7) cells). At 8, 26, and 52 weeks post-BMT, the level of donor
      engraftment was measured using flow cytometry (Ly5) or Gpi-electrophoresis. Lower
      engraftment levels were found in mice transplanted with Ly5 congenic BM in groups
      given low-dose TBI (< or = 4 Gy) and/or low doses of BM cells (BMC) (2 x 10(6)).
      However, when higher TBI or BMC doses were used, similar engraftment levels were
      found, suggesting sufficient immune suppression to allow equal engraftment of
      both sources of BM. These data suggest that even a minor phenotypic disparity
      between donor and host, such as Ly5, may necessitate high-dose TBI to prevent
      rejection. The combination of low-dose TBI or other nonmyeloablative conditioning
      strategies with small numbers of BMC may lead to reduced engraftment when
      extracellular immunological markers such as Ly5 are used for transplantation
      studies. Therefore, small immunological differences must be considered when using
      the Ly5 marker for engraftment.

PMID- 11209094
TI  - The cell cycle.

PMID- 11209095
TI  - The molecular perspective: the ribosome.

PMID- 11209096
TI  - Management of adult lower respiratory tract infection in primary care.

PMID- 11209098
TI  - Prospective study of the incidence, aetiology and outcome of adult lower
      respiratory tract illness in the community.
AB  - BACKGROUND: Acute lower respiratory tract illness in previously well adults is
      usually labelled as acute bronchitis and treated with antibiotics without
      establishing the aetiology. Viral infection is thought to be the cause in most
      cases. We have investigated the incidence, aetiology, and outcome of this
      condition. METHODS: Previously well adults from a stable suburban population
      consulting over one year with a lower respiratory tract illness were studied. For
      the first six months detailed investigations identified predetermined direct and
      indirect markers of infection. Evidence of infection was assessed in relation to
      presenting clinical features, indirect markers of infection, antibiotic use, and
      outcome. RESULTS: Consultations were very common, particularly in younger women
      (70/1000 per year in previously well women aged 16-39 years), mainly in the
      winter months; 638 patients consulted, of whom 316 were investigated. Pathogens
      were identified in 173 (55%) cases: bacteria in 82 (Streptococcus pneumoniae 54,
      Haemophilus influenzae 31, Moraxella catarrhalis 7), atypical organisms in 75
      (Chlamydia pneumoniae 55, Mycoplasma pneumoniae 23), and viruses in 61 (influenza
      23). Seventy nine (24%) had indirect evidence of infection. Bacterial and
      atypical infection correlated with changes in the chest radiograph and high
      levels of C reactive protein but not with (a) the GP's clinical assessment of
      whether infection was present, (b) clinical features other than focal chest
      signs, and (c) outcome, whether or not appropriate antibiotics were prescribed.
      CONCLUSIONS: Over 50% of patients have direct and/or indirect evidence of
      infection, most commonly bacterial and atypical pathogens, but the outcome is
      unrelated to the identified pathogens. Many patients improve without antibiotics
      and investigations do not help in the management of these patients. GPs can
      reassure patients of the causes and usual outcome of this self-limiting
      condition.

PMID- 11209099
TI  - Role of bronchoalveolar lavage in immunocompromised patients with pneumonia
      treated with a broad spectrum antibiotic and antifungal regimen.
AB  - BACKGROUND: In a retrospective study the value of bronchoalveolar lavage (BAL) in
      the diagnosis of pneumonia was investigated in 95 immunocompromised patients
      suffering from haematological disorders and receiving a regimen of broad spectrum
      antibiotics and antifungal agents (BSAR). METHODS: With the exception of four
      afebrile patients, all had fever, raised C reactive protein (CRP) levels, and new
      infiltrates visible on chest radiography. All patients underwent BAL to identify
      the organism causing the pneumonia and surveillance cultures were performed
      regularly for pathogens at different sites. Following classification of the
      isolates, patients with positive cultures were subdivided into two groups,
      pathogenic or contaminated. We investigated whether relevant pathogens were
      cultured only from the BAL fluid and whether they were susceptible to BSAR.
      RESULTS: Although 77 of the 95 patients were thrombocytopenic, bleeding during
      BAL occurred in only 15% of all patients. Ten days after the procedure the fever
      improved in 88% of patients, radiographic findings improved in 71%, and CRP
      levels improved in 75% of patients; 22% of patients died within 28 days.
      Pathologically relevant isolates were found in 65% of all patients. Respiratory
      pathogens were detected only in the BAL fluid of 29 of the 95 patients (35% Gram
      positive species, 40% Gram negative species, 11% Mycobacterium, 11% fungi, and 3%
      cytomegalovirus). In 16 of these 29 patients (55%) the pathogens cultured only
      from the BAL fluid were resistant to treatment. Pathogens detected only in the
      BAL fluid were not susceptible to a standard broad spectrum antibiotic and
      antifungal regimen including teicoplanin, ceftriaxon, tobramycin, and
      amphotericin B in 12 of the 29 patients (41%). CONCLUSIONS: Our data suggest that
      12 patients were treated with broad spectrum antimicrobial agents which were not
      directed at the appropriate organism on in vitro sensitivity tests without BAL.
      BAL is a relatively safe procedure in the diagnosis of pneumonia, supplying
      important information in immunocompromised patients as well as in
      immunocompromised patients receiving BSAR.

PMID- 11209097
TI  - BTS guidelines: guidelines on the selection of patients with lung cancer for
      surgery.

PMID- 11209100
TI  - Leucocyte response and anti-inflammatory cytokines in community acquired
      pneumonia.
AB  - BACKGROUND: In the host defence of the lung neutrophils (PMN) play a central
      role. Apart from antimicrobial properties, recent data indicate that PMN also
      exert anti-inflammatory effects by stimulation and release of cytokine
      antagonists such as interleukin-1 receptor antagonist (IL-1ra). METHODS: Cytokine
      release from lipopolysaccharide stimulated whole blood was studied in 18 patients
      with community acquired pneumonia (CAP) and severe co-morbidities at admission
      and after 24 hours. Release of IL-1ra, interleukin-1beta (IL-1beta), tumour
      necrosis factor alpha (TNFalpha), soluble TNF receptor type I (sTNF-RI), and IL-8
      was determined by ELISA. RESULTS: The mean (SD) leucocyte level at admission was
      12.5 (4.1)/nl. There was a significant correlation between the release of anti
      inflammatory cytokines such as IL-1ra and sTNF-RI and the leucocyte count at
      admission and after 24 hours. Additional in vitro experiments showed that co
      incubation of peripheral blood mononuclear cells with autologous PMN led to a
      marked dose dependent increase in IL-1ra and sTNF-RI release. CONCLUSION: These
      results indicate that PMN may be responsible for the increase in anti
      inflammatory cytokines in CAP. Strategies to increase neutrophil counts may exert
      beneficial effects, not only by augmenting the antimicrobial activity but also by
      modulating the inflammatory cytokine response.

PMID- 11209101
TI  - Patient preferences for autonomy in decision making in asthma management.
AB  - BACKGROUND: Lower patient preferences for autonomy in management decision making
      during asthma exacerbations have been associated with an increased risk for
      future hospital admissions. We sought to examine patient preferences for asthma
      self-management autonomy, and the clinical and psychosocial factors associated
      with autonomy preferences. METHODS: A cross sectional observational study was
      performed with data collected between June 1995 and December 1997 of 212 adult
      patients with moderate to severe asthma managed, at least in part, at two
      teaching hospitals. Subjects completed a survey of autonomy preferences, quality
      of life, clinical morbidity and health service use, asthma knowledge, self
      efficacy, coping styles, and psychosocial measures. RESULTS: Patients preferred
      clinicians to assume the major role in most decision making about their
      management. However, patients wished to remain in control in choosing when to
      seek care and wanted to share decisions regarding initiating changes in
      medications during a moderate exacerbation. Multiple regression analysis showed
      that concerns about adverse effects of medications, education level, an active
      coping style, perceptions of the propensity of physicians to involve them in
      treatment decision making, and concerns about costs causing delays in seeking
      medical care were associated with preferences for autonomy in decision making.
      Autonomy preferences were not related to measures of concurrent clinical asthma
      control or health related quality of life. CONCLUSIONS: In a group of patients
      with moderate to severe asthma, a high proportion of whom were from
      socioeconomically disadvantaged backgrounds, education level, perceived physician
      behaviour, cost barriers to care, and psychosocial factors (but not clinical
      asthma control or management) were related to patient preferences for autonomy in
      management decision making during asthma exacerbations. This has implications for
      asthma action plans and design of self-management programmes.

PMID- 11209103
TI  - Patient weighting of importance of asthma symptoms.
AB  - BACKGROUND: Quality of life measures are increasingly important in evaluating
      outcomes in asthma. If some asthma symptoms are more troublesome to patients than
      others, this may affect their contribution to outcome measures. This study was
      designed to assess the relative importance of common symptoms in adults with
      asthma. METHODS: A postal survey using conjoint analysis was performed in 272
      adults attending hospital outpatient clinics with moderately severe asthma.
      Patients were asked to chose between "symptom scenarios" offering different
      combinations of levels of five common asthma symptoms over one week. Two versions
      of the questionnaire were used with identical scenarios presenting symptoms in
      different orders. Different patients answered the two versions. Regression
      analysis was used to calculate symptom weights for daytime cough, breathlessness,
      wheeze and chest tightness, and sleep disturbance. RESULTS: Symptom order,
      percentage predicted peak expiratory flow (PEF), and symptoms in the week before
      the survey did not influence the choice of scenario. In both questionnaires
      patients were more likely to choose scenarios with low levels of cough and
      breathlessness than low sleep disturbance, wheeze or chest tightness. Regression
      weights for cough (-0.52) and breathlessness (-0.49) were twice those of wheeze (
      0.25), chest tightness (-0.27), and sleep disturbance (-0.25). For 12% of
      patients cough dominated patient preferences, regardless of all other symptoms.
      Age was inversely related to weight given by patients to breathlessness.
      CONCLUSIONS: The prominence of cough among other asthma symptoms was unexpected.
      Daytime cough and breathlessness had greater impact for patients than wheeze or
      sleep disturbance. Age influenced symptom burden, with younger patients giving
      greater weight to breathlessness than older patients. Conjoint analysis appears
      to be a useful method for establishing the relative importance of common
      symptoms.

PMID- 11209102
TI  - Association between obesity and asthma in 4-11 year old children in the UK.
AB  - BACKGROUND: There is evidence of a positive association between asthma and
      obesity in adults and in children. We investigated, in a large sample of English
      and Scottish primary school children, whether there is a consistent association
      between fatness and asthma symptoms in Britain. METHODS: A cross sectional
      analysis was made of 18 218 children aged 4-11 years who participated in the 1993
      or 1994 surveys of the National Study of Health and Growth (NSHG). Children
      belonged either to English or Scottish representative samples, or an English
      inner city sample. Asthma attacks in the previous year, occasional wheeze, or
      persistent wheeze were the symptoms used in the analysis. Body mass index (BMI)
      and the sum of triceps and subscapular skinfolds converted to standard deviation
      scores (SDS) were used to assess levels of fatness. RESULTS: A total of 14 908
      children (81.8%) were included in the analysis. In the multiple logistic analysis
      BMI and asthma (asthma attacks or wheeze) were associated in the representative
      sample (OR for the comparison of the 10th and 90th centiles of BMI 1.28, 95% CI
      1.11 to 1.48), but sum of skinfolds was unrelated to asthma symptoms in most
      analyses. The association between asthma and BMI was stronger in girls than in
      boys in the inner city sample, but less convincingly in the representative
      sample. CONCLUSIONS: Levels of obesity are associated with asthma symptoms
      regardless of ethnicity. The association is more consistent for BMI than for sum
      of skinfolds, partly because obese children are more advanced in their maturation
      than other children. There is some evidence that, as in adults, the association
      is stronger in girls than in boys, but only in the multiethnic inner city sample.

PMID- 11209104
TI  - A randomised controlled trial of four weeks versus seven weeks of pulmonary
      rehabilitation in chronic obstructive pulmonary disease.
AB  - BACKGROUND: Pulmonary rehabilitation programmes have been shown to improve both
      exercise tolerance and health status in patients with chronic obstructive
      pulmonary disease (COPD). The optimal duration for a pulmonary rehabilitation
      programme is, however, unknown. To assess whether the current pulmonary
      rehabilitation programme could be shortened a randomised controlled trial was
      conducted in 44 patients with COPD who were allocated to either a seven week or a
      four week course. METHODS: Patients were randomised to either our standard seven
      week twice weekly outpatient based programme or a comparable but shortened four
      week course. They were assessed at baseline and at completion by the Chronic
      Respiratory Questionnaire (CRQ), the Breathing Problems Questionnaire (BPQ), the
      incremental shuttle walking test (SWT), and the treadmill endurance test (TET).
      RESULTS: Twenty one patients (61% men) of mean (SD) age 68 (9.2) years and forced
      expiratory volume in one second ( FEV(1)) 1.08 (0.4) l completed a conventional
      seven week course and 23 (67% men) of mean (SD) age 69 (8.8) years and FEV(1)
      1.03 (0.3) l completed a shortened four week course. Patients who completed the
      seven week rehabilitation programme had greater improvements in all outcome
      measures than those undertaking the four week course. These differences reached
      clinical and statistical significance for the total CRQ score, which was the
      primary outcome variable (mean difference (95% confidence intervals (CI) of
      difference) -0.61(-0.15 to -1.08), p<0.05), and the CRQ domains of dyspnoea (
      0.80 (95% CI -0.13 to -1.48), p<0.05), emotion (-0.89 (95% CI -0.33 to -1.45),
      p<0.005), and mastery (-0.84 (95% CI -0.10 to -1.58), p<0.05). There were also
      trends towards greater improvements in exercise assessments in the seven week
      group but the differences did not reach statistical significance (SWT: mean
      difference -16.9 (95% CI 24.8 to -58.6), p=0.41; TET: geometric mean difference 
      1.21 (95% CI -0.60 to -2.47), p=0.56). CONCLUSIONS: A seven week course of
      pulmonary rehabilitation provides greater benefits to patients than a four week
      course in terms of improvements in health status. Larger prospective studies are
      required to determine the optimal duration of a pulmonary rehabilitation
      programme.

PMID- 11209106
TI  - Exhaled nitric oxide is reduced in infants with cystic fibrosis.
AB  - BACKGROUND: Exhaled nitric oxide levels are low in patients with cystic fibrosis
      (CF), despite the chronic inflammation present in the airways. This study aimed
      to determine whether levels of exhaled nitric oxide were reduced prior to the
      onset of respiratory symptoms in infants with CF. METHODS: The levels of exhaled
      nitric oxide were measured using a chemiluminescence analyser in five infants
      with CF and 11 healthy control subjects, both groups having a mean age of 48.6
      days. RESULTS: Mean levels of exhaled nitric oxide were significantly lower in
      infants with CF than in the control group (4.9 ppb v 12.1 ppb; p=0.01).
      CONCLUSIONS: This finding may be the key to understanding the inflammatory
      processes in early cystic fibrosis and may lead to novel treatment approaches.

PMID- 11209105
TI  - The shuttle walking test: a reproducible method for evaluating the impact of
      shortness of breath on functional capacity in patients with advanced cancer.
AB  - BACKGROUND: Breathlessness leading to exercise limitation is common in patients
      with advanced cancer and is ineffectively treated. There are few research data to
      guide clinicians on best practice. The shuttle walking test has been validated
      for some conditions such as chronic obstructive pulmonary disease but not for
      advanced cancer. One of the well documented difficulties of doing clinical
      research in palliative care is the acceptability of assessment tests. This study
      examined the reproducibility of the shuttle walking test in patients with
      advanced cancer to help facilitate the systematic evaluation of interventions
      designed to improve breathlessness. METHODS: Patients performed three shuttle
      walks on separate days with continuous monitoring of arterial oxygen saturation
      and heart rate; simple pulmonary function (FEV(1)) was also recorded. Data on
      quality of life, anxiety, and depression were collected throughout the study
      period using appropriate questionnaires. Breathlessness was measured before and
      after exercise using a visual analogue scale. RESULTS: Data from 22 patients were
      compared between visits 2 and 3. There were no significant differences between
      the FEV(1) (1.89 v 1.90, p=0.73), distance walked on each test (245 m v 256 m,
      p=0.14), end-exercise levels of heart rate (107/min v 108/min, p=0.11), oxygen
      saturation (93.4% v 93.2%, p=0.38), or breathlessness scores (p=0.62) on the two
      occasions. Indices of quality of life, anxiety, and depression were also not
      different between the two tests. The investigation was very acceptable to
      patients, families, and staff. CONCLUSIONS: The shuttle walking test is a
      reproducible test of functional capacity in ambulant patients with advanced
      cancer, WHO performance status 1 or 2. The data indicate that a practice session
      is needed. It is easy to carry out and acceptable for patients with advanced
      cancer.

PMID- 11209107
TI  - Paediatric origins of adult lung disease.

PMID- 11209108
TI  - Transverse myelopathy and radiculomyelopathy associated with pulmonary atypical
      Mycobacterium infections.
AB  - Myelopathy is a well recognised but rare association with Mycobacterium
      tuberculosis infection, but has not been described with atypical mycobacteria. We
      report two cases of disabling myelopathy in association with pulmonary infection
      by Mycobacterium kansasii and Mycobacterium malmoense; the myelopathy is presumed
      to be a para-infectious phenomenon.

PMID- 11209109
TI  - Chronic venous insufficiency and venous leg ulceration.
AB  - Venous ulcers are the most common form of leg ulcers. Venous disease has a
      significant impact on quality of life and work productivity. In addition, the
      costs associated with the long-term care of these chronic wounds are substantial.
      Although the exact pathogenic steps leading from venous hypertension to venous
      ulceration remain unclear, several hypotheses have been developed to explain the
      development of venous ulceration. A better understanding of the current
      pathophysiology of venous ulceration has led to the development of new approaches
      in its management. New types of wound dressings, topical and systemic therapeutic
      agents, surgical modalities, bioengineered tissue, matrix materials, and growth
      factors are all novel therapeutic options that may be used in addition to the
      "gold standard," compression therapy, for venous ulcers. This review discusses
      current aspects of the epidemiology, pathophysiology, clinical presentation,
      diagnostic assessment, and current therapeutic options for chronic venous
      insufficiency and venous ulceration. (J Am Acad Dermatol 2001;44:401-21.)
      LEARNING OBJECTIVE: At the conclusion of this learning activity, participants
      should be familiar with the 3 main types of lower extremity ulcers and should
      improve their understanding of the epidemiology, pathogenesis, risk factors,
      clinical presentation, diagnostic assessment, and current therapies for chronic
      venous insufficiency and venous ulcers.

PMID- 11209110
TI  - Cutaneous photoprotection from ultraviolet injury by green tea polyphenols.
AB  - BACKGROUND: In animal models, extracts from green tea have been shown to be
      remarkably effective at reducing the severity of adverse human health effects of
      overexposure to ultraviolet (UV) radiation. Although sunscreens and other
      photoprotective measures have traditionally been used for this purpose, there is
      a need for additional measures and natural products are increasingly being
      explored for that purpose. OBJECTIVE: Our purpose was to evaluate the effect of
      polyphenols from green tea on parameters associated with acute UV injury.
      METHODS: Areas of skin of normal volunteers were treated with an extract of green
      tea or one of its constituents. Thirty minutes later, the treated sites were
      exposed to a 2 minimal erythema dose solar simulated radiation. UV-treated skin
      was examined clinically for UV-induced erythema, histologically for the presence
      of sunburn cells or Langerhans cell distributions, or biochemically for UV
      induced DNA damage. RESULTS: Application of green tea extracts resulted in a dose
      dependent inhibition of the erythema response evoked by UV radiation. The (-)
      epigallocatechin-3-gallate (EGCG) and (-)-epicatechin-3-gallate (ECG)
      polyphenolic fractions were most efficient at inhibiting erythema, whereas (-)
      epigallocatechin (EGC) and (-)-epicatechin (EC) had little effect. On histologic
      examination, skin treated with green tea extracts reduced the number of sunburn
      cells and protected epidermal Langerhans cells from UV damage. Green tea extracts
      also reduced the DNA damage that formed after UV radiation. CONCLUSION:
      Polyphenolic extracts of green tea are effective chemopreventive agents for many
      of the adverse effects of sunlight on human health and may thus serve as natural
      alternatives for photoprotection.

PMID- 11209111
TI  - Family history of psoriasis, stressful life events, and recent infectious disease
      are risk factors for a first episode of acute guttate psoriasis: results of a
      case-control study.
AB  - BACKGROUND: The association of guttate psoriasis with streptococcal pharyngitis
      is well accepted. The association of other risk factors is less well defined.
      OBJECTIVE: We attempted to provide an estimate of the risk for guttate psoriasis
      associated with a recent infectious disease and to explore other potential risk
      factors, including family history of psoriasis and psychologic stress. METHODS:
      This was a case-control study. Cases were patients with a first diagnosis ever of
      acute guttate psoriasis, made by a dermatologist. Controls were patients newly
      diagnosed as having dermatologic conditions other than psoriasis and seen in the
      same outpatient services as the cases. Inclusion of cases and controls was
      restricted to patients older than 16 years. The Holmes and Rahe Social
      Readjustment Rating Scale was used to assess stressful life events during the 6
      months before diagnosis. A total of 73 cases (median age, 26 years) and 430
      controls (median age, 28 years) were included in the analysis. RESULTS: A family
      history of psoriasis was strongly associated with guttate psoriasis, the
      multivariate odds ratio being 7.0 (95% confidence interval, 3.7-13.5) for
      subjects who reported a history of the disease in parents or siblings. Stressful
      life events were also associated with guttate psoriasis. The multivariate odds
      ratio was 1.7 (95% confidence interval, 0.8-3.6) for subjects scoring 41 to 100
      and 2.6 (95% confidence interval, 1.3-5.2) for those scoring more than 100 on the
      Holmes and Rahe Scale. The risk increased with the reported history of any
      infectious disease. The analysis of specific diagnoses documented a high and
      significant association with acute pharyngitis, the adjusted odds ratio being 7.8
      (95% confidence interval, 1.8-32.5). CONCLUSION: The study confirmed that recent
      pharyngeal infection is a risk factor for guttate psoriasis. It also documented
      the strong association between guttate psoriasis and a family history of
      psoriasis. Finally, the study added evidence to the belief that stressful life
      events may represent risk factors for the onset of psoriasis. By relying on the
      clinical diagnosis we possibly underestimate the association of guttate psoriasis
      with infection.

PMID- 11209112
TI  - Beliefs and perceptions of patients with acne.
AB  - BACKGROUND: There is a paucity of information on the knowledge and understanding
      of patients with acne about their condition. OBJECTIVE: The objective of this
      study is to evaluate the knowledge, beliefs, and perceptions of acne patients
      regarding their understanding of acne pathogenesis, sources of information,
      treatment options, and expectations. METHODS: Patients referred to a community
      based dermatologist for management of acne vulgaris completed a self-administered
      questionnaire. Responses were correlated with demographic and clinical
      information. RESULTS: Seventy-four percent of patients waited more than 1 year
      before seeking medical attention for acne. Nonprescription products used most
      frequently were cleansers, acne pads, and lotions. Acne was most often believed
      to be caused by hormonal and genetic factors, although diet, poor skin hygiene,
      and infection were also implicated. Information on acne was obtained primarily
      from family physicians, mass media, friends, and family, but was largely believed
      to be inadequate. Acne was believed to be curable by 49% of patients with an
      anticipated treatment duration of less than 6 months. Male patients and those
      with severe acne preferred systemic therapy compared with female patients and
      those with lesser grades of acne. CONCLUSION: There is a need for accessible,
      accurate, community-based education on the natural history of acne, pathogenesis,
      risk of sequelae, the effectiveness and expected duration of treatment, and the
      importance of prompt medical attention.

PMID- 11209113
TI  - Immunopathologic characterization of the tissue response in endemic pemphigus
      foliaceus (fogo selvagem).
AB  - BACKGROUND: The research on endemic pemphigus foliaceus (fogo selvagem) has
      mainly focused on the humoral immune response, but little attention has been
      given to the function of cell-mediated immune response and the nature of the
      cellular elements of the tissue reaction in the lesions of fogo selvagem.
      OBJECTIVE: The purpose of this study was the immunophenotype characterization of
      the inflammatory cells as well as the expression of adhesion molecules and HLA-DR
      in the perilesional and lesional skin of fogo selvagem. METHODS: Twenty biopsy
      specimens of lesional and perilesional skin were analyzed by immunohistochemical
      techniques. The panel of monoclonal antibodies consisted of CD8, CD4, CD1a, HLA
      DR, IL-2R, LFA-1, ICAM-1, and PAN-B. RESULTS: The semiquantitative analysis of
      the cell population revealed a predominance of CD4 T lymphocytes in the tissue
      response of perilesional and lesional skin. The population of epidermal
      Langerhans cells was decreased in lesional skin when compared with the
      perilesional skin, whereas CD1a(+) dermal dendritic cells predominated in
      lesional skin. Keratinocyte expression of ICAM-1 and HLA-DR was negative in both
      lesional and perilesional skin. CONCLUSION: The overall results suggest the
      participation of the cell-mediated immunity in endemic pemphigus foliaceus (fogo
      selvagem). The lack of keratinocyte ICAM-1 expression may be related to the
      pattern of cytokines secreted by the CD4(+) T cells of the tissue reaction in
      fogo selvagem.

PMID- 11209114
TI  - Evaluation of sentinel lymph node status in spindle cell melanomas.
AB  - BACKGROUND: The propensity for spindle cell melanoma to metastasize to the lymph
      node is relatively low despite its relative thick depth. To date, there are no
      published reports on the sentinel lymph node (SLN) status in patients diagnosed
      with spindle cell melanoma and desmoplastic malignant melanoma (DMM). OBJECTIVE:
      Our purpose was to report our experience on the SLN status in spindle cell
      melanoma and DMM. METHODS: We undertook a retrospective database and medical
      record review from Oct 21, 1993 to Sept 29, 1999. At the University of California
      at San Francisco Melanoma Center, patients with tumor thickness greater than 1 mm
      or less than 1 mm with high-risk features are managed with preoperative
      lymphoscintigraphy, selective SLN dissection, and wide excision. RESULTS: Of 29
      patients diagnosed with spindle cell melanoma and DMM, 28 had negative SLNs and
      are free of disease except for one patient who experienced splenic, bony, and
      brain metastases. The mean follow-up in this population was 16.5 and 11 months,
      respectively. CONCLUSION: Our preliminary findings show that SLNs from patients
      diagnosed with spindle cell melanoma and DMM only rarely harbor micrometastasis
      despite their relative thickness. A larger number of cases from multicenter
      databases may further define the true biology of SLNs in this melanoma variant.

PMID- 11209115
TI  - CD4(+)CD7(-) T cells compose the dominant T-cell clone in the peripheral blood of
      patients with Sezary syndrome.
AB  - BACKGROUND: Absence of CD7 antigen expression in T cells defines a subset of
      normal CD4(+) CD45RO(+) CD45RA(-) memory cells and is furthermore observed in
      Sezary syndrome (SS). OBJECTIVE: Our purpose was to identify circulating T-cell
      clones in patients with SS and to elucidate whether the dominant T-cell clones
      express the CD7 antigen. METHODS: Peripheral blood lymphocytes of patients with
      SS were analyzed by two-color flow cytometry using antibodies to the V beta
      region of the T cell receptor (TCR) in combination with an antibody to CD7. In
      addition, T cells were analyzed for TCR-gamma gene rearrangement by polymerase
      chain reaction (PCR) techniques. RESULTS: Clonal T-cell expansion was detected in
      7 patients with SS by immunostaining of the TCR V beta regions. PCR analysis
      confirmed the presence of dominant T cell clones. Double-immunostaining revealed
      that in each case cells of the clonal V beta TCR rearrangement homogeneously
      express the CD4(+)CD7(-) phenotype. Furthermore, CD4(+)CD7(-) cells express the
      CD15s antigen but lack expression of CD26 and CD49d. CONCLUSION: Expansion of
      clonal T cells strongly correlates with the expansion of CD4(+)CD7(-) T cells in
      7 tested patients with SS. This supports our model that a subset of late
      differentiated, normal CD4(+)CD7(-) memory T cells may represent the physiologic
      counterpart of Sezary cells. Monitoring of circulating T cells with the
      CD4(+)CD7(-)CD15s(+)CD26(-)CD49d(-) phenotype proved to be useful for the
      identification of clonal T cells in patients with SS.

PMID- 11209116
TI  - Imiquimod 5% cream in the treatment of Bowen's disease.
AB  - BACKGROUND: Large-diameter lesions of Bowen's disease at sites such as the shin
      may be difficult to treat surgically and may require alternate treatment
      modalities. OBJECTIVE: We investigated whether imiquimod 5% cream, a topical
      immune response modifier that stimulates the production of interferon alfa and
      other cytokines, is an effective topical treatment for Bowen's disease. METHODS:
      This was a phase II, open-label study in 16 patients, treating a single biopsy
      proven plaque of Bowen's disease that was 1 cm or larger in diameter, with once
      daily self-application of imiquimod 5% cream for 16 weeks. A biopsy was performed
      on the treated area 6 weeks after the end of treatment, with patient follow-up at
      3 and 6 months. Lymphocyte CD4/CD8 ratios were analyzed in pretreatment and
      posttreatment biopsy specimens by immunophenotyping the lymphocytic infiltrate.
      RESULTS: Sixteen patients with Bowen's disease lesions ranging from 1 to 5.4 cm
      in diameter (0.7-21.6 cm(2) in area) were treated. Fifteen of these lesions were
      on the legs, and one was on the shoulder. Fourteen of the 15 patients (93% per
      protocol analysis) had no residual tumor present in their 6-week posttreatment
      biopsy specimens. One patient died of unrelated intercurrent illness before a
      biopsy specimen could be obtained. The median CD4/CD8 lymphocyte ratio in
      pretreatment biopsy specimens was 2:1, and this was reversed to a median of 1:2.2
      in the posttreatment specimens. Ten patients completed 16 weeks of treatment, but
      6 patients ceased treatment early (between 4 and 8 weeks) because of local skin
      reactions. CONCLUSION: Imiquimod 5% cream appears to be an effective treatment
      for Bowen's disease on the lower limbs. The 93% positive treatment response in
      biopsy-proven cases (excludes patient who died from an intercurrent illness who
      did not undergo a posttreatment biopsy) compares favorably with other current
      treatment modalities. The dosing schedule and length of treatment for Bowen's
      disease require further evaluation.

PMID- 11209117
TI  - Treatment of prurigo nodularis with topical capsaicin.
AB  - BACKGROUND: Prurigo nodularis is an eruption of lichenified or excoriated nodules
      caused by intractable pruritus that is difficult to treat. Therefore the
      antipruritic efficacy of capsaicin seemed to be of particular interest because
      this alkaloid, extractable from red pepper, interferes with the perception of
      pruritus and pain by depletion of neuropeptides in small sensory cutaneous
      nerves. OBJECTIVE: The aim of this concentration- and regimen-ranging study was
      to evaluate the efficacy, safety, and practicability of capsaicin in the topical
      treatment of prurigo nodularis in a large series of patients. METHODS: A total of
      33 patients with prurigo nodularis of various origins were selected to receive
      capsaicin (0.025% to 0.3%) 4 to 6 times daily for 2 weeks up to 10 months. The
      consecutive follow-up period was up to 6 months. In 7 patients, skin biopsy
      specimens were taken before, during, and after therapy and investigated
      histologically, immunohistochemically, and ultrastructurally. RESULTS: All 33
      patients could be evaluated for efficacy. After cessation of the symptoms of
      neurogenic inflammation, such as burning sensations or erythema, all of them
      experienced a complete elimination of pruritus within 12 days. In addition,
      capsaicin largely contributed to the gradual healing of the skin lesions. After
      discontinuation of the therapy, pruritus returned in 16 of 33 patients within 2
      months. At the ultrastructural level, no degenerative changes of cutaneous nerves
      could be found during or after capsaicin therapy. Depletion of substance P was
      demonstrated by confocal laser scanning microscopy thus confirming the specific
      effect of capsaicin in vivo. CONCLUSION: Topical treatment of prurigo nodularis
      with capsaicin proved to be an effective and safe regimen resulting in clearing
      of the skin lesions.

PMID- 11209118
TI  - Single-blind, randomized, prospective study on terbinafine and itraconazole for
      treatment of dermatophyte toenail onychomycosis in the elderly.
AB  - BACKGROUND: The 2 most common agents used to treat dermatophyte onychomycosis of
      the toe are terbinafine (continuous) and itraconazole (pulse). Although
      comparative studies have been performed evaluating the efficacy of these 2 agents
      in adults, no such studies have been reported specifically in the elderly subset.
      OBJECTIVE: This prospective, randomized, single-blind, non--industry-sponsored,
      comparative study evaluated the efficacy and safety of terbinafine (continuous)
      and itraconazole (pulse) therapies in the treatment of dermatophyte onychomycosis
      of the toe in the elderly population. METHODS: Elderly patients (> or =60 years
      old) with dermatophyte onychomycosis of at least 1 great toe were randomly
      assigned to receive either terbinafine 250 mg/day for 12 weeks or itraconazole
      (pulse) 200 mg twice a day for 1 week, given for 3 pulses. At month 6 from the
      start of therapy, if there was less than 50% reduction in the affected nail plate
      area compared with baseline, or if there was less than 3 mm outgrowth of
      unaffected nail plate as measured in midline, then patients who had been
      administered terbinafine (continuous) therapy were given an extra 4 weeks of the
      drug (total of 16 weeks of therapy), and those who had received itraconazole
      (pulse) therapy were given an extra pulse (fourth pulse). Patients were evaluated
      at 1.5, 3, 6, 12, and 18 months from the start of therapy. The efficacy measures
      included mycologic cure rate and clinical efficacy (mycologic cure plus clinical
      cure or clinical improvement so that 10% or less of nail plate was clinically
      involved). RESULTS: There were 101 elderly patients enrolled in the study with 50
      and 51 patients receiving terbinafine and itraconazole, respectively. The
      terbinafine group consisted of 28 men and 22 women, age (mean +/- standard error
      [SE]) 68.0 +/- 0.9 years, duration of onychomycosis (mean +/- SE) 18.2 +/- 1.4
      years, number of nails involved (mean +/- SE) 5.5 +/- 0.5, and percent baseline
      nail plate area involved (mean +/- SE) 67.5% +/- 4.2%. The corresponding figures
      for the itraconazole (pulse) group were 24 men and 27 women, age (mean +/- SE)
      68.8 +/- 0.8 years, duration of onychomycosis (mean +/- SE) 16.1 +/- 1.7 years,
      number of nails involved (mean +/- SE) 6.0 +/- 0.7, and percent baseline nail
      plate area involved (mean +/- SE) 74.9% +/- 3.8%, respectively, with no
      significant difference between the groups. At month 6, the number of patients
      that required an extra 4 weeks of terbinafine in the allylamine group or an extra
      itraconazole pulse in the triazole group was 13 of 50 and 23 of 51, respectively.
      The mycologic cure rate and clinical efficacy at 18 months from the start of
      therapy for the terbinafine group were 64.0% and 62.0%, respectively. The
      corresponding figures for the itraconazole (pulse) group were 62.7% and 60.8%,
      respectively, with no significant difference between the 2 groups. There were no
      dropouts during therapy. For both groups the drug appeared safe with no
      significant adverse events (AEs) or clinically significant laboratory
      abnormalities. All the AEs were mild and transient. There was high compliance
      with both regimens. CONCLUSIONS: In the elderly, for the treatment of
      dermatophyte toe onychomycosis, both terbinafine (continuous) and itraconazole
      (pulse) therapies are effective, safe, and associated with high compliance.

PMID- 11209119
TI  - Single-blind, randomized, prospective study of sequential itraconazole and
      terbinafine pulse compared with terbinafine pulse for the treatment of toenail
      onychomycosis.
AB  - OBJECTIVE: Efficacy and safety of sequential pulse therapy with itraconazole and
      terbinafine were compared with pulse terbinafine alone in the treatment of
      toenail onychomycosis. METHODS: This was a 72-week prospective, single-blind,
      randomized, multicenter, comparative, parallel group, nonindustry-sponsored
      trial. A total of 190 patients were recruited from 3 outpatient dermatology
      offices in North America. Patients were at least 18 years old and had a clinical
      and mycologic diagnosis of dermatophyte toenail onychomycosis. Patients were
      randomly assigned to receive sequential pulse therapy (IIT) with 2 pulses of
      itraconazole followed by 1 or 2 pulses of terbinafine (itraconazole pulse is 200
      mg twice daily for 1 week and terbinafine pulse is 250 mg twice daily for 1 week)
      versus 3 or 4 pulses of terbinafine (TTT). Main outcome measures at week 72
      evaluated mycologic cure rate (negative light microscopy and culture), clinical
      cure (nail appears completely or totally normal), complete cure (clinical and
      mycologic cure), and effective therapy (mycologic cure and clinical response with
      at least 5 mm of new, uninvolved nail growth). RESULTS: At week 72, in the IIT
      versus TTT groups, the mycologic cure rate was 54 of 75 (72.0%) versus 44 of 90
      (48.9%), clinical cure rate was 42 of 75 (56.0%) versus 35 of 90 (38.9%),
      effective therapy 49 of 75 (65.3%) versus 41 of 90 (45.6%), and complete cure 39
      of 75 (52.0%) versus 29 of 90 (32.2%), respectively. Both regimens were well
      tolerated with no new adverse effects being identified. The rate of permanent
      discontinuation of therapy because of adverse effects was 2 of 81 (2.5%) with IIT
      and 2 of 95 (2.1%) with TTT. Each of the adverse effects normalized over time.
      The number of patients who reported an adverse effect in the 2 groups was 12 of
      81 (14.8%) versus 22 of 95 (23.2%), respectively. All these adverse effects were
      reversible and mild to moderate in severity. CONCLUSION: Sequential pulse therapy
      with itraconazole and terbinafine is effective and safe for the treatment of
      dermatophyte toenail onychomycosis.

PMID- 11209120
TI  - A clinical and histologic comparison of electrosurgical and carbon dioxide laser
      peels.
AB  - BACKGROUND: A radiofrequency-controlled electrosurgical device (ESD) has been
      adapted for skin peeling. A high-voltage, low-amperage current converts an
      irrigant into an ionized vapor, causing molecular dissociation and superficial
      damage in adjacent tissue. OBJECTIVE: We compared the clinical and histologic
      effects of a scanning carbon dioxide (CO(2)) laser (ESC/Sharplan 40C) and the ESD
      (Visage Cosmetic Surgery System, Arthrocare). METHODS: This study was a matched
      clinical trial involving 9 subjects. Two strips (2 x 1 cm) of skin on the temple
      were alternately assigned to receive 2 passes with either the CO(2) laser
      (Silktouch mode, 260 handpiece, fluence 15 J/cm(2), 10 mm(2)) or the ESD (125 V =
      setting 4, 5 mm handpiece). Strips were wiped with moist gauze after the first
      pass, and 4-mm punch biopsy specimens were taken immediately and after 3 months.
      Clinical assessment of re-epithelialization, erythema, and hyperpigmentation was
      made at 1, 2, 4, and 12 weeks. RESULTS: Median erythema scores were significantly
      greater in skin treated with the CO(2) laser. Histologic examination showed
      greater epidermal loss and a significantly thicker zone of underlying thermal
      damage (average difference, 63 microm; 95% confidence interval, 40-87; P =.0002)
      in skin treated with the CO(2) laser compared with skin treated with the ESD.
      After 3 months, a band of superficial dermal fibrosis was thicker in skin treated
      with the CO(2) laser (average difference, 170 microm; 95% confidence interval, 69
      271; P =.0075). CONCLUSION: Two passes with the ESD elicited a more superficial
      skin peel than the CO(2) laser. Despite minimal thermal damage, superficial
      dermal fibrosis was seen at 3 months in skin treated with the ESD.

PMID- 11209121
TI  - Risk of synchronous and metachronous second nonmelanoma skin cancer when referred
      for Mohs micrographic surgery.
AB  - BACKGROUND: Patients with basal cell carcinoma and cutaneous squamous cell
      carcinoma are at substantial risk for the onset of a second nonmelanoma skin
      cancer (NMSC). OBJECTIVE: Our purpose was to determine the incidence of multiple
      (synchronous) NMSC at presentation to an academic Mohs micrographic surgery
      referral center and to note the incidence of second lesions occurring in a
      metachronous fashion. METHODS: A retrospective study was conducted of 456
      consecutive patients who presented for Mohs surgery over a 2-year period.
      Patients were assessed at initial visits for the presence of multiple NMSCs and
      were subsequently examined over 2 years for the onset of new NMSCs. RESULTS: More
      than 39% of patients initially referred for Mohs surgery with a basal cell or
      squamous cell carcinoma either presented with multiple primary lesions or
      experienced a subsequent NMSC within 2 years. These tumors were divided almost
      equally between multiple primary NMSC at presentation and subsequent
      (metachronous) tumors. CONCLUSION: Patients referred for Mohs surgery in an
      academic setting are a select group at extremely high risk of additional NMSCs at
      or shortly after presentation for the index lesion.

PMID- 11209122
TI  - MIB-1 monoclonal antibody to determine proliferative activity of Ki-67 antigen as
      an adjunct to the histopathologic differential diagnosis of Spitz nevi.
AB  - BACKGROUND: The histopathologic differential diagnosis of Spitz nevus (SN) from
      malignant melanoma (MM) may be difficult. OBJECTIVE: Our purpose was to determine
      the staining pattern and usefulness of MIB-1 antibody, which recognizes Ki-67
      antigen in formalin-fixed, paraffin-embedded tissue, as an adjunct to the
      histopathologic differential diagnosis of SN. METHODS: Twenty-five compound SNs,
      27 MMs, and 26 compound nondysplastic melanocytic nevi (MNs) were immunostained
      with the MIB-1 antibody. RESULTS: The mean counts of MIB-1--stained tumor cells
      of the epidermal and dermal components, both alone and together, were
      significantly lower in SNs and MNs than in MMs (P <.0001). The dermal counts
      showed the best discriminating power. In addition, the mean dermal/epidermal
      count ratios for MIB-1 in SNs and MNs (0.25 and 0.23, respectively) were
      significantly lower than the corresponding ratio (0.94) in MMs (P <.0001).
      CONCLUSION: MIB-1-stained tumor cell counts, especially of the dermal component,
      and dermal/epidermal MIB-1 count ratios may be helpful as an adjunct to the
      histopathologic differential diagnosis of SN.

PMID- 11209124
TI  - Langerhans cell histiocytosis.

PMID- 11209123
TI  - American Academy of Dermatology Consensus Conference on UVA protection of
      sunscreens: summary and recommendations. Washington, DC, Feb 4, 2000.

PMID- 11209125
TI  - Sun protection practices in preadolescents and adolescents: a school-based survey
      of almost 25,000 Connecticut schoolchildren.
AB  - Sun protection practices in children and adolescents fall well below national
      recommendations. We present the results of a survey of sun protection use and
      other health-related behaviors in a sample of Connecticut Caucasian students aged
      9 through 18 years (N = 24,645). Our objectives were to estimate the prevalence
      of sun protection use and to evaluate the relationship between sun protection use
      and health-risk behaviors and attitudes about appearance. We present data from
      1988 through 1995 from the Connecticut Health Check, a health risk appraisal
      survey sponsored by the Connecticut Department of Public Health. Students
      enrolled in public and private elementary junior as well as senior high schools
      took the self-administered anonymous survey, which included multiple-choice
      questions about use of sun protection, cigarettes, and alcohol and about body
      image and self-esteem. We report prevalence proportions for use of sun protection
      by demographic features. We compared the proportion of students in 3 categories
      of outcome (always, sometimes, and never use sun protection) who reported various
      health-risk behaviors. Twenty percent of the sample reported always using sun
      protection; this is well below national goals set forth in the Healthy People
      2000 recommendations. Sun protection use was inversely related to age and was
      higher among girls than boys at all ages. At all ages, students who did not use
      sun protection were more likely than those who did to report other health risk
      behaviors, such as use of cigarettes and alcohol. The data suggested that use of
      sun protection is associated with positive attitudes about appearance and self
      image. Use of sun protection may be one component of an overall mode of health
      awareness and behavior. Programs promoting safe sun practices should target boys
      and be integrated into an overall campaign aimed at other risk-taking behaviors.

PMID- 11209126
TI  - Surgical pearl: preventing self-inflicted injuries to the dermatologic surgeon.

PMID- 11209127
TI  - Surgical pearl: the vertical mattress tip stitch.

PMID- 11209129
TI  - HTLV-I-associated granulomatous T-cell lymphoma in a child.
AB  - Adult T-cell leukemia/lymphoma (ATLL) is a T-cell malignancy closely associated
      with human T-cell lymphotropic virus-1 (HTLV-I). Because of its long latency
      period, ATLL occurs almost exclusively in adults. We report a case of a 13-year
      old boy with an 8-year history of skin eruptions. After complete evaluation, a
      diagnosis of HTLV-I-associated lymphoma/leukemia was made. The T-cell lymphoma
      exhibited a granulomatous histomorphology. There have been very few reports of
      ATLL presenting in childhood and none, to our knowledge, demonstrating
      granulomatous histology. We conclude that ATLL may rarely present as a chronic
      granulomatous eruption in a child.

PMID- 11209130
TI  - Pyoderma gangrenosum associated with biphenotypic acute leukemia.
AB  - Pyoderma gangrenosum is a neutrophilic dermatosis that may be associated with
      myeloid malignancies. Less information is available about the association of
      pyoderma gangrenosum with lymphoid malignancies. We present, to our knowledge,
      the first case of pyoderma gangrenosum associated with biphenotypic acute
      leukemia wherein the malignant cells show a phenotype specific for myelogenic and
      lymphocytic leukemia. Histopathologic examination revealed rather nonspecific
      features without involvement of leukemic cells in the skin lesions. Treatment
      with systemic steroids was followed by characteristically rapid healing of the
      skin lesion.

PMID- 11209131
TI  - Mycosis fungoides in identical twins.

PMID- 11209132
TI  - Pseudoxanthoma elasticum: significance of limited phenotypic expression in
      parents of affected offspring.
AB  - The inheritance pattern of pseudoxanthoma elasticum (PXE) is controversial.
      Inheritance patterns are confounded by delayed diagnosis and mild or limited
      phenotypic expression among certain family members. Because testing for the
      genetic mutation(s) responsible for PXE is not routine, genetic counseling must
      be done with caution. We describe 4 families in which one or more children were
      diagnosed with PXE. Detailed examination of the parents was carried out,
      including skin biopsy and ophthalmologic examination. In 3 of the 4 families, one
      parent had limited phenotypic expression, such as ocular findings without skin
      lesions or very mild skin lesions with no ocular findings. In the other family,
      one parent had very mild skin and ocular disease. All 4 affected parents had
      diagnostic skin biopsy findings. In none of the 4 families was the inheritance
      pattern clear-cut. Although the inheritance pattern of PXE has been debated,
      clinically significant stigmata of PXE, which are not always readily apparent,
      can occur in successive generations. Therefore all first-degree relatives of
      affected patients should receive a full dermatologic examination as well as a
      funduscopic examination. If even mild typical skin or eye findings are present,
      then skin biopsy should be performed.

PMID- 11209133
TI  - Immunohistochemical detection of the c-met proto-oncogene product in the
      congenital melanocytic nevus of an infant with neurocutaneous melanosis.
AB  - Transgenic mice overexpressing hepatocyte growth factor/scatter factor (HGF/SF)
      demonstrate extensive pigmented nevi in both skin and leptomeninges of the
      central nervous system resembling human neurocutaneous melanosis. We
      immunohistochemically detected HGF/SF receptor, Met, in a congenital nevus of an
      infant with neurocutaneous melanosis, indicating that deregulation of HGF/SF-Met
      signaling in the critical period of development may lead to this fatal syndrome.

PMID- 11209134
TI  - No further studies are required: additional notes on avoiding manuscript
      rejection.

PMID- 11209135
TI  - "Devotional dermatoses": a new nosologic entity?

PMID- 11209136
TI  - Transplantation of autologous cultured melanocytes for treatment of large
      segmental vitiligo.

PMID- 11209137
TI  - Extraordinary delayed bleeding occurring after shave excision.

PMID- 11209138
TI  - Foscarnet-associated eosinophilic folliculitis in a patient with AIDS.

PMID- 11209139
TI  - Trichoblastoma or trichoblastic carcinoma?

PMID- 11209140
TI  - Longitudinal melanonychia in children.

PMID- 11209141
TI  - UVA1 for atopic dermatitis: medium dose superior to low dose.

PMID- 11209142
TI  - Should pentoxifylline be regarded as an effective treatment for Schamberg's
      disease?

PMID- 11209143
TI  - Signet-ring cell formation in cutaneous neoplasms.

PMID- 11209144
TI  - How to manage atrial fibrillation: an update on recent clinical trials.
AB  - The latter half of the 1990s was a time of extraordinary progress in the
      understanding and management of atrial fibrillation (AF). Evidence that "AF
      begets AF" has generated considerable interest regarding the mechanisms
      responsible for this phenomenon and has sparked the development of new concepts
      in both pharmacologic and nonpharmacologic therapy. The recognition that, in some
      patients, AF is initiated and possibly maintained by atrial tachycardia
      originating in the pulmonary veins has challenged accepted notions regarding the
      mechanisms responsible for arrhythmia. New antiarrhythmic drugs, devices,
      ablation techniques, and pacing techniques have been developed and tested.
      Strategies for the use of existing therapies have been evaluated, and new
      indications for existing therapies are under consideration. This article reviews
      several studies published in 1999 and 2000 that addressed the mechanisms and the
      management of AF.

PMID- 11209145
TI  - Value of exercise testing in assessing clinical state and prognosis in
      hypertrophic cardiomyopathy.
AB  - Hypertrophic cardiomyopathy (HCM) is a genetic disease of the sarcomeric
      contractile proteins. A majority of patients with HCM are limited in terms of
      functional capacity, and a minority of these patients die suddenly. The main aims
      of management are symptom alleviation and prevention of sudden cardiac death. In
      patients with HCM, cardiopulmonary exercise testing provides a much more accurate
      index of functional capacity than New York Heart Association classification
      status, and it is useful in assessing symptoms after various therapeutic
      strategies have been implemented. Exercise testing is also valuable in
      identifying patients with HCM who are at high risk of sudden cardiac death and is
      an integral part of the algorithm in risk stratification and delivery of
      prophylactic therapy. Also, cardiopulmonary exercise testing plays an important
      role in differentiating HCM from other conditions associated with left
      ventricular hypertrophy, such as physiologic athlete's heart. Therefore, during
      the last few years, cardiopulmonary exercise testing has provided insights into
      the diagnosis, determinants, and mechanisms of exercise limitation in HCM. This
      understanding aids physicians in targeting therapy and developing new treatment
      modalities.

PMID- 11209146
TI  - Coronary magnetic resonance angiography.
AB  - Despite advances in both prevention and treatment, cardiovascular disease remains
      the leading cause of morbidity and mortality in the United States. The current
      gold standard for the diagnosis of coronary artery disease is the x-ray coronary
      angiogram, which is both costly and associated with a small risk of morbidity.
      More than 1 million Americans are referred for this test annually, and despite
      the availability of numerous noninvasive tests to identify patients with coronary
      artery disease, > or =35% of patients referred for this test are found not to
      have disease. It therefore would be beneficial to use a noninvasive test to allow
      the presence of coronary atherosclerosis to be determined directly. Coronary
      magnetic resonance angiography, a technique that is aimed at establishing a
      noninvasive test for the assessment of significant coronary stenoses, obviates
      the risks of patient exposure to radiation of x-ray angiography and therefore
      represents a major step forward in diagnostic cardiology.

PMID- 11209147
TI  - Etiology, evaluation, and management of acute myocarditis.
AB  - The evaluation and management of acute myocarditis remain two of the most
      difficult challenges that general internists and cardiologists face today.
      Although the majority of cases are subclinical and self-limited, the true
      prevalence of myocarditis in the general population is unknown. In its most
      severe form, patients with myocarditis may present with rapidly progressive heart
      failure, cardiogenic shock, or complex arrhythmia. Indeed, acute myocarditis
      should be in the differential diagnosis of acute heart failure, particularly in
      young and previously healthy individuals.

PMID- 11209149
TI  - Complicated mitral valve repairs.
AB  - The standard of care for mitral regurgitation secondary to degenerative valvular
      disease is mitral valve repair whenever possible. Mitral valve repair is
      associated with better left ventricular function preservation, fewer
      complications, and improved survival as compared with mitral valve replacement.
      Most of the mitral valve pathology involves the posterior leaflet or annulus and
      usually can be repaired by using standard valve repair techniques. Difficulties
      may arise when trying to repair the somewhat uncommon anterior leaflet prolapse
      or calcified mitral annulus. This article reviews these more complex mitral valve
      repair techniques and their outcomes.

PMID- 11209148
TI  - ABCs of cardiovascular disease risk management.
AB  - The past 20 years have witnessed a marked decline in morbidity and mortality from
      cardiovascular disease. This decline has been due in large part to advances in
      coronary risk factor modification and a better understanding of the
      atherosclerotic process. Compelling scientific and clinical trial evidence proves
      that comprehensive risk factor modification extends patient survival and reduces
      cardiovascular and cerebrovascular events. This article reviews the ABCs of
      optimal medical and lifestyle management in patients with documented
      atherosclerotic vascular disease as well as in those adults who are at increased
      risk for the development of cardiovascular disease, based on contemporary
      clinical trial evidence.

PMID- 11209153
TI  - Choice of revascularization strategy for patients with coronary artery disease.

PMID- 11209154
TI  - Former addicts face barriers to treatment for HCV.

PMID- 11209155
TI  - Win or lose, Internet gambling stakes are high.

PMID- 11209156
TI  - What's the connection? No easy answers for people with eating disorders and drug
      abuse.

PMID- 11209161
TI  - Underuse of beta-blockers following myocardial infarction.

PMID- 11209163
TI  - Treatment strategies for migraine headache.

PMID- 11209164
TI  - Treatment strategies for migraine headache.

PMID- 11209166
TI  - Methodological issues in trials of acupuncture.

PMID- 11209167
TI  - Methodological issues in trials of acupuncture.

PMID- 11209169
TI  - Demands of an aging population for critical care and pulmonary services.

PMID- 11209170
TI  - Demands of an aging population for critical care and pulmonary services.

PMID- 11209172
TI  - Subsequent criminal activity among violent misdemeanants who seek to purchase
      handguns: risk factors and effectiveness of denying handgun purchase.
AB  - CONTEXT: Some states prohibit the purchase of handguns by persons convicted of
      selected misdemeanor crimes, but most do not. California has denied handgun
      purchases by violent misdemeanants since 1991; the effectiveness of these
      policies is unknown. OBJECTIVE: To determine the risk factors for new criminal
      activity among violent misdemeanants who seek to purchase handguns and whether
      denial of handgun purchase by violent misdemeanants affects their risk of arrest
      for new crimes, particularly gun and/or violent crimes. DESIGN: Retrospective,
      population-based cohort study. SETTING AND SUBJECTS: Persons aged 21 to 34 years
      who sought to purchase a handgun through a licensed dealer in California during
      1989-1991 and who had at least 1 violent misdemeanor conviction in the preceding
      10 years. The study cohorts consisted of 986 persons whose purchase applications
      were made in 1991 and were denied (denied persons) and 787 persons whose purchase
      applications were made in 1989-1990 and were approved (purchasers). MAIN OUTCOME
      MEASURES: Incidence and relative risk of first arrest in California for new gun
      and/or violent crimes and for nongun, nonviolent crimes during a 3-year follow-up
      after actual or attempted handgun purchase. RESULTS: During the 3-year follow-up,
      546 (33.0%) of 1654 subjects with follow-up information were arrested for a new
      crime, including 296 (31.9%) of 927 denied persons and 250 (34.4%) of 727
      purchasers. After adjusting for differences in age, sex, and prior criminal
      history, purchasers were more likely than denied persons to be arrested for new
      gun and/or violent crimes (relative hazard [RH], 1.29; 95% confidence interval
      [CI], 1.04-1.60), but not for nongun, nonviolent crimes (RH, 0.96; 95% CI, 0.78
      1.19). In both groups, risk of arrest was strongly related to age and number of
      convictions accrued prior to actual or attempted handgun purchase. CONCLUSION:
      Our results indicate that denial of handgun purchase to violent misdemeanants is
      associated with a specific decrease in risk of arrest for new gun and/or violent
      crimes.

PMID- 11209173
TI  - Relation between pediatric experience and treatment recommendations for children
      and adolescents with kidney failure.
AB  - CONTEXT: Children and adolescent patients with renal failure are frequently cared
      for by adult subspecialists. While peritoneal dialysis is used in less than 17%
      of adults with kidney failure, it is the preferred dialysis treatment for
      children. National data show that 45% of children receiving dialysis are treated
      with peritoneal dialysis and pediatric nephrologists report its use in 65% of
      patients receiving dialysis. Whether differences in peritoneal dialysis use among
      children are due to the pediatric experience of the clinician has not been
      examined. OBJECTIVE: To assess whether the pediatric experience of nephrologists
      directly affects treatment recommendations for children with kidney failure.
      DESIGN: Cross-sectional survey using 10 case vignettes per survey based on random
      combinations of 8 patient characteristics (age, sex, race, distance from
      facility, cause of renal failure, family structure, education, and compliance).
      SETTING AND PARTICIPANTS: National random sample of office-, hospital-, and
      academic medical center-based adult and pediatric nephrologists, stratified by
      geographic region and conducted June to November 1999. Of 519 eligible
      physicians, 316 (61%) responded, including 191 adult and 125 pediatric
      nephrologists. MAIN OUTCOME MEASURE: Treatment recommendations for peritoneal
      dialysis vs hemodialysis, compared based on nephrologists' pediatric experience.
      RESULTS: After controlling for patient characteristics, pediatric nephrologists
      were 60% more likely than adult nephrologists to recommend peritoneal dialysis
      for identical patients (odds ratio, 1.61; 95% confidence interval, 1.35-1.92).
      This was true regardless of dialysis training, years in practice, practice
      setting, geography, or patient characteristics. CONCLUSIONS: Our data indicate
      that pediatric specialization of clinicians influences treatment recommendations
      for children and adolescents with end-stage renal disease. Referring children to
      adult subspecialists may lead to differences in treatment choices and processes
      of care.

PMID- 11209174
TI  - Discrepancies between patient and physician estimates for the success of stem
      cell transplantation.
AB  - CONTEXT: Stem cell transplantation is associated with considerable morbidity and
      mortality. The extent to which patients and their physicians correctly estimate
      these risks is unknown. OBJECTIVE: To measure the expectations of patients and
      physicians prior to stem cell transplantation and correlate them with actual
      outcomes after transplantation. DESIGN: Prospective cohort study with baseline
      questionnaire administered July 1996 through November 1999 and follow-up to May
      2000. SETTING: Tertiary care transplant center in the United States.
      PARTICIPANTS: Of 458 surveys mailed, evaluable returned surveys were included for
      313 autologous and allogeneic stem cell transplantation patients and their
      physicians. MAIN OUTCOME MEASURES: Patient and physician expectations prior to
      transplantation (measured on 6-point Likert scales) of treatment-related
      mortality, cure with transplantation, and cure without transplantation; actual
      treatment-related mortality and disease-free survival among patients with at
      least 1 year of follow-up after transplantation (n = 263). RESULTS: Both patients
      and physicians were fairly accurate in estimating treatment-related mortality
      when actual mortality was less than 30%. However, in situations in which
      mortality was higher than 30%, such as with allogeneic transplantation for
      intermediate or advanced disease, physician expectations were lower, while
      patients remained optimistic. Similarly, physicians provided lower estimates of
      disease-free survival in cases of intermediate or advanced disease while patient
      expectations remained high and constant regardless of disease stage. CONCLUSIONS:
      Patients and their physicians have the most concordant and accurate expectations
      when the outcome of stem cell transplantation is likely to be favorable. However,
      patients with more advanced disease fail to recognize the higher risks associated
      with their situations.

PMID- 11209176
TI  - Second-trimester ultrasound to detect fetuses with Down syndrome: a meta
      analysis.
AB  - CONTEXT: Second-trimester prenatal ultrasound is widely used in an attempt to
      detect Down syndrome in fetuses, but the accuracy of this method is unknown.
      OBJECTIVE: To determine the accuracy of second-trimester ultrasound in detecting
      Down syndrome in fetuses. DATA SOURCES: English-language articles published
      between 1980 and February 1999 identified through MEDLINE and manual searches.
      STUDY SELECTION: Studies were included if they recorded second-trimester findings
      of ultrasonographic markers, chromosomal abnormalities, and clinical outcomes for
      a well-described sample of women. A total of 56 articles describing 1930 fetuses
      with Down syndrome and 130 365 unaffected fetuses were included. DATA EXTRACTION:
      Articles were independently reviewed, selected, and abstracted by 2 reviewers.
      Discrepancies in data abstraction were resolved by consensus with a third
      reviewer. Overall estimates of sensitivity, specificity, and positive and
      negative likelihood ratios were calculated for the following markers: choroid
      plexus cyst, thickened nuchal fold, echogenic intracardiac focus, echogenic
      bowel, renal pyelectasis, and humeral and femoral shortening. Results were
      stratified by whether markers were identified in isolation or in conjunction with
      fetal structural malformations. DATA SYNTHESIS: When ultrasonographic markers
      were observed without associated fetal structural malformations, sensitivity for
      each was low (range, 1%-16%), and most fetuses with such markers had normal
      outcomes. A thickened nuchal fold was the most accurate marker for discriminating
      between unaffected and affected fetuses and was associated with an approximately
      17-fold increased risk of Down syndrome. If a thickened nuchal fold is used to
      screen for Down syndrome, 15 893 average-risk women or 6818 high-risk women would
      need to be screened for each case of Down syndrome identified. For each of the
      other 6 markers, when observed without associated structural malformations, the
      marker had marginal impact on the risk of Down syndrome. Because the markers were
      detected in only a small number of affected fetuses, the likelihood of Down
      syndrome did not decrease substantially after normal examination findings (none
      of the negative likelihood ratios were significant). CONCLUSIONS: A thickened
      nuchal fold in the second trimester may be useful in distinguishing unaffected
      fetuses from those with Down syndrome, but the overall sensitivity of this
      finding is too low for it to be a practical screening test for Down syndrome.
      When observed without associated structural malformations, the remaining
      ultrasonographic markers could not discriminate well between unaffected fetuses
      and those with Down syndrome. Using these markers as a basis for deciding to
      offer amniocentesis will result in more fetal losses than cases of Down syndrome
      detected, and will lead to a decrease in the prenatal detection of fetuses with
      Down syndrome.

PMID- 11209175
TI  - Culture and immunological detection of Tropheryma whippelii from the duodenum of
      a patient with Whipple disease.
AB  - CONTEXT: Culture of Tropheryma whippelii has been established only once, in human
      fibroblast cell lines from a heart valve inoculum. Molecular-based diagnostic
      techniques, although highly sensitive, may be less specific. New diagnostic tools
      involving isolation of bacteria from contaminated intestinal biopsies and
      immunohistological detection need to be developed. OBJECTIVE: To describe a novel
      method for detection and culture of T whippelii strains. DESIGN, SETTING, AND
      SUBJECTS: Laboratory analysis of duodenal biopsy specimens from a patient with
      typical relapsing Whipple disease with intestinal involvement, performed
      Marseille, France, in March 2000. Biopsy specimens were decontaminated with
      antimicrobial agents and inoculated onto cell cultures. Mouse anti-T whippelii
      polyclonal antibodies were used to detect T whippelii in fixed specimens taken
      from the patient before and after relapse, compared with specimens from 10
      controls. The genotype of the isolate was determined by amplification and
      sequencing of 2 DNA fragments (ITS and 23S rRNA). MAIN OUTCOME MEASURE: Isolation
      and genotyping of a new strain(s) of T whippelii from the case patient's biopsy
      specimens. RESULTS: A strain was grown from the case patient's intestinal
      specimen that has a genotype different from the first strain isolated. During 2
      episodes of Whipple disease, T whippelii bacteria were detected by
      immunochemistry in the patient's duodenal biopsy specimens, but not in controls.
      CONCLUSIONS: A second strain of T whippelii has been isolated and a protocol for
      isolation from the intestine has been proven to be efficient. Immunodetection of
      T whippelii in intestinal biopsy specimens may provide a useful tool for the
      diagnosis and follow-up of patients with Whipple disease. Both techniques need
      further evaluation and confirmation.

PMID- 11209177
TI  - Liver transplantation and opioid dependence.

PMID- 11209178
TI  - Botulinum toxin as a biological weapon: medical and public health management.
AB  - OBJECTIVE: The Working Group on Civilian Biodefense has developed consensus-based
      recommendations for measures to be taken by medical and public health
      professionals if botulinum toxin is used as a biological weapon against a
      civilian population. PARTICIPANTS: The working group included 23 representatives
      from academic, government, and private institutions with expertise in public
      health, emergency management, and clinical medicine. EVIDENCE: The primary
      authors (S.S.A. and R.S.) searched OLDMEDLINE and MEDLINE (1960-March 1999) and
      their professional collections for literature concerning use of botulinum toxin
      as a bioweapon. The literature was reviewed, and opinions were sought from the
      working group and other experts on diagnosis and management of botulism.
      Additional MEDLINE searches were conducted through April 2000 during the review
      and revisions of the consensus statement. CONSENSUS PROCESS: The first draft of
      the working group's consensus statement was a synthesis of information obtained
      in the formal evidence-gathering process. The working group convened to review
      the first draft in May 1999. Working group members reviewed subsequent drafts and
      suggested additional revisions. The final statement incorporates all relevant
      evidence obtained in the literature search in conjunction with final consensus
      recommendations supported by all working group members. CONCLUSIONS: An
      aerosolized or foodborne botulinum toxin weapon would cause acute symmetric,
      descending flaccid paralysis with prominent bulbar palsies such as diplopia,
      dysarthria, dysphonia, and dysphagia that would typically present 12 to 72 hours
      after exposure. Effective response to a deliberate release of botulinum toxin
      will depend on timely clinical diagnosis, case reporting, and epidemiological
      investigation. Persons potentially exposed to botulinum toxin should be closely
      observed, and those with signs of botulism require prompt treatment with
      antitoxin and supportive care that may include assisted ventilation for weeks or
      months. Treatment with antitoxin should not be delayed for microbiological
      testing.

PMID- 11209186
TI  - Health care 2001: "top 10 trends" in a technology-driven future.

PMID- 11209179
TI  - Complementary strategies to prevent firearm injury.

PMID- 11209187
TI  - "Top 10" trends predictions were 100 percent accurate for year 2000.

PMID- 11209188
TI  - Major new regs coming for patient privacy, security.

PMID- 11209189
TI  - OSHA ergonomics standard has sweeping requirements.

PMID- 11209190
TI  - Improving the process for preop antibiotics.

PMID- 11209191
TI  - How to keep orientees on board.

PMID- 11209192
TI  - Boston project prepares RNs for OR.

PMID- 11209193
TI  - Complying with new sedation standard.

PMID- 11209194
TI  - HIPAA primer for surgery centers.

PMID- 11209195
TI  - Outpatient surgery doubles.

PMID- 11209197
TI  - AONE sends message on shortage.

PMID- 11209196
TI  - Simpler, more productive meetings.

PMID- 11209198
TI  - Businesses launch assault on errors.

PMID- 11209199
TI  - Congress finally passes BBA relief!

PMID- 11209200
TI  - Annual "Top 100" hospital list unveiled--26 federation hospitals included.

PMID- 11209201
TI  - Representative Marion Berry, D (AR-01). A healthcare legislative update: 107th
      Congress preview.

PMID- 11209202
TI  - Universal Health Services, Inc.

PMID- 11209203
TI  - 2001 post-election update. 107th Congress brings new health views to the U.S.
      Senate.

PMID- 11209204
TI  - Slicing through Internet data.

PMID- 11209205
TI  - Center takes data tracking to heart.

PMID- 11209206
TI  - Doctors sound off on I.T. concerns.

PMID- 11209207
TI  - Juggling skills a must for health care CSOs.

PMID- 11209208
TI  - A vendor consolidation scorecard for 2000.

PMID- 11209209
TI  - Retaining staff is key to success.

PMID- 11209210
TI  - New M&R benchmarks reveal HMO industry trends.

PMID- 11209211
TI  - Know your costs? Check these medical practice data for comparison.

PMID- 11209212
TI  - Are hospitals losing faith in managed care?

PMID- 11209213
TI  - Unlike hospitals, IPAs still rely heavily on capitation revenue.

PMID- 11209214
TI  - Utilization data confirm positive influence of capitation.

PMID- 11209215
TI  - Three surefire ways to cut your pharmacy costs.

PMID- 11209216
TI  - Harvard Pilgrim's financial distress holds lessons for other risk-bearing groups.
AB  - What lessons can be learned from the financial collapse and rehabilitation of
      Harvard Pilgrim Health Plan? One managed care expert says many of the factors
      that hurt Harvard Pilgrim can be seen in other plans across the nation.

PMID- 11209217
TI  - Make sure your stop-loss coverage can still do the job.
AB  - Is your stop-loss coverage still adequate? Here are the changes in conditions you
      need to evaluate to be sure you're still well covered.

PMID- 11209218
TI  - Analysis confirms pharmacy driving health care cost hikes.
AB  - Data insight: What drove last year's 6.6% increase in overall healthcare costs?
      Pharmacy cost increases. An analysis by the Center for Studying Health System
      Change also confirms that insurer premium increases are outstripping cost
      increases.

PMID- 11209219
TI  - IPAs improve utilization control with blended RVU/contact cap plan.
AB  - A Phoenix healthcare consultant has devised a way of helping specialists succeed
      financially under capitation contracts by combining cap payments with changes in
      internal RVU rates.

PMID- 11209220
TI  - [Open aortic valvuloplasty in surgical treatment of associated heart diseases].
AB  - The article presents indications to surgical correction of aortal stenosis and
      its variants in patients with rheumatic diseases combined with a lesion of other
      valves of the heart. The possibility to fulfill valve-saving plastic operations
      on the stenosed aortal valve was shown in 110 operations. The results obtained
      proved advantages of plastic operations over prostheses of the stenosed aortas
      without calcinosis universalis. Such operations allowed the intrahospital
      lethality to be considerably decreased. In later terms only two patients needed
      prostheses of the valve. The functional class was improved in the overwhelming
      majority of the patients.

PMID- 11209221
TI  - [Causes of exploratory thoracotomies in lung cancer].
AB  - Exploratory thoracotomies were studied in 80 patients with inoperable lung
      cancer. The X-ray and computed tomography findings were analyzed retrospectively.
      The main causes of inoperability of lung cancer were determined. The authors
      consider that CT findings are of greater importance as compared with the routine
      X-ray examination and linear tomography for determining the lung cancer
      operability.

PMID- 11209222
TI  - [Surgical correction of blood and lymph circulation in liver cirrhosis].
AB  - After modeling cirrhosis of the liver in experimental dogs the
      gastroesophagolienal hemo- and lymphocirculation and that of the greater omentum
      were transferred into the system of the vena cava inferior, the mesenterial
      outflow being preserved through the liver. The dynamic observation of the
      experimental animals has shown the intervention performed to be valid. In 6
      patients the gastroesophagolienal circulation and that of the greater omentum
      were transferred into the system of the vena cava inferior. The proposed method
      of surgical correction leads to lower portal pressure, to saved hepatopetal blood
      flow along the portal vein. The reestablished absorbing capacity of the greater
      omentum and the developed collateral lymph circulation decrease the transudation
      of the lymph into the abdominal cavity and increase its reabsorption.

PMID- 11209223
TI  - [Ultrasound study and computerized tomography in the diagnosis of
      choledocholithiasis].
AB  - A comparative analysis of the results of using the ultrasonic investigation and
      computed tomography in differential diagnosis of jaundice was made in 205
      patients. The reliability of USI in diagnosis of cholelithiasis was 54.3%, and
      that of standard CT was 55.9%. The authors have developed and used computed
      tomocholangiography (direct and indirect) in 187 patients with pronounced
      bilirubinemia. Indirect tomocholangiography was used in patients with
      bilirubinemia not more than 157 mkm/l. Contrasted main bile ducts were noted in
      95% of the patients. When the content of bilirubin in blood plasma was higher
      than the figures shown, the authors used the direct contrast of the bile ducts in
      combination with computed tomography. When using more perfect X-ray devices (CT)
      with the greater resolving power for diagnosis in jaundice patients, it was
      possible to get the overwhelming information about the state of the bile ducts.

PMID- 11209224
TI  - [Splanchnic hemodynamics in acute cholecystitis and mechanical jaundice].
AB  - The authors analyze results of the investigation of hemodynamics in the abdominal
      cavity vessels by the method of duplex scanning in 30 patients with acute
      cholecystitis, in 30 patients with mechanical jaundice and cholelithiasis and in
      30 healthy subjects. It was found that these patients had less blood flow along
      the upper mesenterial artery and the portal vein. As a compensation the blood
      flow increased along the hepatic artery.

PMID- 11209225
TI  - [Surgical treatment of rectal cancer in middle-aged and elderly patients].
AB  - This article presents results of surgical treatment of 439 patients with cancer
      of the rectum, including 310 (70.6%) patients older than 60. The
      transabdominoperineal extirpation of the rectum was made in 48.1% of the elderly
      and senile patients, the anterior (transabdominal) resection--in 33.6%, Gartman's
      operation--in 12.6%, transanal excision of the tumor--in 11 patients. Lethal
      outcomes after the surgical interventions was 4.8%.

PMID- 11209226
TI  - [Use of leukocytic suspension in the treatment of diffuse peritonitis].
AB  - Immunocorrection by means of transfusions of donor leukocytes was performed in 64
      patients. Transfusions of the leukocytic suspensions in short courses (2-3
      transfusions to one patient or 300-500 ml per a course) during the first three
      days after operation allowed the immune status of organism to be improved and
      increased the effectiveness of the antibacterial and infusion-detoxication
      therapy. The greatest medical effect was obtained when using the leukosuspension
      from donors with natural high (from 1:160 and higher) titers of antibodies to E.
      coli.

PMID- 11209227
TI  - [Diagnosis of heart contusions in patients with multiple trauma of the chest].
AB  - A complex investigation of effectiveness of different methods of detection of
      heart contusion in patients with combined traumas of the chest allowed detailed
      elucidation of the criteria of diagnostics of heart contusions by means of
      electrocardiography, integral rheography of the body, ultrasonography, enzyme
      diagnostics. A comparative analysis has shown that none of the available now
      methods can be taken as absolute. The complex use of these methods only can make
      the maximum objective diagnosis of heart contusion. This approach allowed the
      authors to make the amount of diagnostic errors 18% less in patients with a
      combined trauma of the chest and thus to improve the results of treatment.

PMID- 11209228
TI  - [Possibilities and results of organ-saving surgery in injuries of the spleen].
AB  - An analysis of 218 patients with spleen traumas treated surgically has been made.
      The organ-saving operations were made in 70 patients with a laser scalpel. The
      absolute and relative indications for such operations were determined.
      Complications and lethal outcomes in the early postoperative period in patients
      with the preserved spleen and after splenectomy were 21.1% and 12.9%, 30% and 13%
      correspondingly.

PMID- 11209229
TI  - [Immediate results of the treatment of gunshot wounds of the large intestine].
AB  - Under analysis were the strategy and results of treatment of 1264 patients with
      gunshot wounds of the colon. Isolated injuries of the colon were noted in 32.3%
      of the patients, 67.7% of the patients had combined wounds. The overall lethality
      was 12.1%. The methods of surgery were chosen depending on the character of the
      wounds.

PMID- 11209230
TI  - [The problem of posttraumatic fat embolism].
AB  - The article is devoted to the problem of fat embolism. In 63 patients with
      combined and isolated traumas the maximum frequency of fat embolism was diagnosed
      in the investigation of blood serum from the femoral artery. It can be supposed
      that no isolated injury of the lesser circulation circuit can occur in fat
      embolism. An investigation of the venous-arterial difference of fat globulemia
      has shown the main role of the so-called theory of shunting for fat embolism to
      be doubtful.

PMID- 11209231
TI  - [The effectiveness of auricular micro-needle acupuncture in the early
      postoperative period under conditions of day surgical unit].
AB  - The authors have developed a method of auricular microneedle analgesia--setting
      the microneedles in the area of the auricle floor for the period of up to 5 days
      which could reduce the pain syndrome.

PMID- 11209232
TI  - [Use of an artificial carrier of oxygen on the base of modified hemoglobin in
      patients with gastroduodenal hemorrhage].
AB  - Infusions of Helenpole used in 23 patients allowed for a short time to stabilize
      hemodynamics and to considerably improve the gas-transporting function of blood.
      The best curative effect in patients with hemorrhagic shock was obtained by means
      of intravenous jet infusions of the medicine, after stabilization of the
      hemodynamic indices with the help of an intravenous dropper (80-90 drops/min).
      The dose of the 1% solution of the medicine was 25-30 ml/kg of the patient's body
      weight.

PMID- 11209233
TI  - [Effects of methods of freezing and thawing of blood plasma on the activity of
      procoagulants and antithrombin-III].
AB  - The authors investigated the activity of procoagulants and antithrombin-III after
      freezing and thawing of blood plasma by different methods. It was shown that
      quick freezing and thawing using special apparatuses best of all preserved the
      coagulative properties of the plasma. The medical efficiency of quick-frozen
      plasma was shown to depend on the method of freezing and thawing.

PMID- 11209234
TI  - [Photo-hemo-correction in the complex treatment of patients with obliterating
      atherosclerosis of the arteries of the lower limbs].
AB  - Based on the assessment of clinical efficiency of the intravascular and
      percutaneous photomodification of blood with a helium-neon laser in 170 patients
      the authors have shown that it is expedient to include the photohemocorrection in
      the medical programs for the I-III degree ischemia.

PMID- 11209235
TI  - [A method of isolation and preparation of the radial artery for direct
      revascularization of the myocardium].
AB  - The authors describe a technique of the isolation, preparation and use of the
      radial artery for the aortocoronary shunting for ischemic heart disease. The
      method is anatomically valid and approbated in 300 operations on the open heart.
      Safety and efficiency of using the radial artery is due to its not traumatic
      isolation, original preparing for shunting and medicamental prevention of its
      spasm.

PMID- 11209236
TI  - [Method of the anterior resection of the rectum with formation of invagination
      colorectal anastomosis].
AB  - In order to prevent complications associated with incompetent sutures of the
      anastomosis in performing frontal resection of the rectum the invaginational
      immersion of the one-row catgut interintestinal anastomosisis was performed into
      the lumen of the inferioampullar portion of the rectum to a depth of 15-20 mm by
      means of traction by a plastic ring which was fixed when applying the anastomosis
      on the side of its lumen to the suture knots. The method was used in 12 patients
      without complications due to incompetence of the anastomosis sutures.

PMID- 11209237
TI  - [Characteristics of the diagnosis of purulent pyelonephritis].
AB  - Results of diagnosing pyelonephritis in 106 patients using ultrasonography, CT
      and thermovision were analyzed. Purulent pyelonephritis (PP) was diagnosed in 57
      patients, serous pyelonephritis--in 49 patients. The sensitivity of
      ultrasonography in the diagnosing of PP was more than 80%, that of CT--90%. The
      methods used allowed the 100% improvement of the differential diagnosis of renal
      abscess, apostematous nephritis and pyonephrosis. The greatest problems were met
      in the diagnosis of renal carbuncle which was detected in 50% of cases by
      ultrasonography and in 54% of patients by CT. The minimum sizes of the
      destruction focus when the diagnosis could be reliable were 2 cm for
      ultrasonography and 1.5 cm for CT. Only using the findings of CT could diagnose
      emphysematous pyelonephritis. Thermovision could not find any definite criteria
      of PP. The timely diagnosis of PP allowed the organ-saving operations to be
      fulfilled in the overwhelming amount of the patients. Positive results of the
      treatment using the above mentioned diagnostic methods were obtained in 98.8% of
      the patients.

PMID- 11209238
TI  - [Active drainage of the abdominal cavity in diffuse purulent peritonitis].
AB  - The method of active drainage of the abdominal cavity and of the gastrointestinal
      tract lumen for acute peritonitis described by the author is based on the
      intraabdominal cyclic compression-decompression method of action on the organs
      and tissues of the abdominal cavity using 2-4 hermetically sealed rubber gloves
      distended with the help of a respiratory system in the uninterrupted regimen of
      work during 2-3 days. The method was used in 24 patients. Six patients died. No
      complications due to the method of treatment were observed.

PMID- 11209239
TI  - [Injury of the esophagus in closed trauma of the neck].

PMID- 11209240
TI  - [Incarcerated congenital diaphragmatic hernia with the background of
      malformations of the intestine].

PMID- 11209241
TI  - [A rare wound of the bladder].

PMID- 11209242
TI  - [Apropos of the article by I.A. Eriukhin "Multiple organ dysfunction syndrome".
      The nature of the concept and the correctness of terminology"].

PMID- 11209243
TI  - [Clinical aspects, diagnosis and treatment of odontogenic mediastinitis].

PMID- 11209244
TI  - [Acute pancreatitis and bacterial translocation].

PMID- 11209245
TI  - [Erast Gavrilovich Salishchev (1851-1901)].

PMID- 11209246
TI  - [Bacterial complications after endoscopic procedures in patients with portal
      hypertension].

PMID- 11209247
TI  - [Transitory synovitis of the hip joint in children].

PMID- 11209248
TI  - On the job. Does this man need a shrink?

PMID- 11209249
TI  - [Cryptosporidiosis in the Andean region of Colombia: seroprevalence and
      recognition of antigens].
AB  - The objective of this study was to investigate, for the first time, the
      seroprevalence of cryptosporidiosis among urban and rural inhabitants in several
      departments of the Andean region of Colombia. The antigen recognition of
      Cryptosporidium parvum was also studied with sera. Between June 1996 and October
      1998 1,778 serum samples were collected from people selected through convenience
      sampling. The detection of anti-C. parvum antibodies (IgM, IgA, and IgG) was
      carried out with enzyme-linked immunosorbent assay, and antigen recognition was
      done with immunoblotting. A prevalence of 83.3% was found, and the antibody
      percentages were 72.2% for IgM, 27.7% for IgA, and 27.6% for IgG. Higher
      seropositivity percentages were found among women, persons less than 30 years
      old, and residents of rural areas. IgM seroprevalence decreased with age, while
      IgG and IgA seroprevalences increased with age. These three immunoglobulin
      isotypes most frequently recognized the antigens from 51 to 69 kDa, which can be
      considered immunodominant. Of note was the immunoreactivity of IgM and IgA to
      protein fractions from 12 to 14 kDa and from 42 to 48 kDa, respectively, which
      could indicate exposure to the parasite. These results indicate that
      cryptosporidiosis is endemic in the Andean region of Colombia, and that it is
      possible to attribute many cases of diarrheal syndrome to C. parvum.

PMID- 11209250
TI  - Nutritional status of children under 5 years of age in three hurricane-affected
      areas of Honduras.
AB  - Hurricanes and other natural disasters can produce crop destruction, population
      displacement, infrastructure damage, and long-term public health consequences
      that include increased malnutrition among the affected populations. This paper
      presents the results of anthropometric measurements taken of 295 children under 5
      years of age from three regions of Honduras that were affected by Hurricane
      Mitch, a major storm that struck Central America in the fall of 1998. The
      children in our study were sampled in three shelters in the capital city of
      Tegucigalpa; in the resettlement zone of Nueva Choluteca, Choluteca; and in the
      small urban area of Catacamas, Olancho. Our data indicated that, in comparison to
      the period before the hurricane, there was an elevated prevalence of wasting in
      all three of the study areas, and that there were also high levels of underweight
      in the Tegucigalpa and Nueva Choluteca study areas. There were statistically
      significant differences between the mean values of malnutrition indicators for
      Catacamas and those for the Tegucigalpa and Nueva Choluteca settlements. These
      differences suggest that resettled families were confronting a nutritional crisis
      in July and August of 1999, some 9 months after the hurricane struck.

PMID- 11209251
TI  - [Evaluation of the effectiveness of a new vaccine against human leptospirosis in
      groups at risk].
AB  - In order to evaluate the effectiveness of a new vaccine against human
      leptospirosis, a prospective cohort study was done with persons in the Cuban
      province of Holguin who were at risk of becoming ill with leptospirosis. The
      study included 118,018 persons from 15 to 65 years old who were considered to
      face either permanent or temporary risk. The vaccinated cohort consisted of
      101,137 persons. They received two vaccine doses, 6 weeks apart, of 0.50 mL via
      deep intramuscular injection into the deltoid muscle of the nondominant arm. The
      unvaccinated cohort consisted of 16,881 persons. Epidemiological surveillance
      began 21 days after the application of the second vaccine dose and continued for
      1 year. The same criteria for suspected and confirmed cases were maintained
      throughout the study period. At the end of the surveillance period effectiveness
      was calculated as being higher than 97%. It is estimated that the vaccination
      program prevented eight out of ten cases that would have otherwise occurred.
      Vaccine reactogenicity was also measured in a subsample of 1,500 persons between
      15 and 65 years old. The observed symptomatology was low. Slight pain at the
      injection site was the most frequent symptom (25%). The results of the study
      indicate the usefulness of the vaccine for disease prevention among people at
      risk, and its use is thus recommended.

PMID- 11209252
TI  - [History, effects and mechanisms of action of ecstasy (3,4
      methylenedioxyamphetamine): review of the literature].
AB  - This review focuses on 3,4-methylenedioxymethamphetamine, an illegal drug known
      as "ecstasy." Ecstasy was introduced in Brazil in 1994. Data are lacking on the
      epidemiology and usage pattern of the drug in Brazil. However, there is evidence
      that until now the use of ecstasy has been limited to middle-class or upper
      middle-class youth, so that most people, including health care professionals, are
      unfamiliar with the drug. However, ecstasy may be becoming more popular in
      Brazil, following a pattern seen in North America and Europe. Possible
      contributing to the drug's popularity is the fact that ecstasy is sold as a pill
      and is thus extremely easy to use. Ecstasy has a reputation for not being
      physically dangerous; however, there are many reports of adverse reactions
      associated with the drug. In addition, it is known that not all pills sold as
      ecstasy actually contain methylenedioxymethamphetamine. Since there is no quality
      control for the pills' contents, users never know exactly what they are taking.
      Thus, although users may perceive the effects of the drug as mostly positive,
      ecstasy is potentially dangerous. Primary and secondary interventions are needed
      to prevent the use of ecstasy and the occurrence of adverse reactions. To be
      effective, these measures must take into consideration the characteristics of the
      user population and the usage patterns. It is also essential to prepare health
      professionals for emergency medical interventions in cases of intoxication and
      complications resulting from the use of ecstasy.

PMID- 11209253
TI  - The use of socioeconomic factors in mapping tuberculosis risk areas in a city of
      northeastern Brazil.
AB  - In Brazil the challenge of meeting the needs of those living in deprived areas
      has generated discussions on replacing the existing approach to epidemiological
      surveillance with an integrated public health surveillance system. This new
      approach would supplant the traditional focus on high-risk individuals with a
      method for identifying high-risk populations and the areas where these persons
      live. Given the magnitude of the problem that tuberculosis (TB) poses for Brazil,
      we chose that disease as an example of how such a new, integrated public health
      surveillance system could be constructed. We integrated data from several sources
      with geographic information to create an indicator of tuberculosis risk for
      Olinda, a city in the Brazilian state of Pernambuco. In order to stratify the
      urban space in Olinda and to check for an association between the resulting TB
      risk gradient and the mean incidence of the disease between 1991 and 1996, we
      applied two different methods: 1) a "social deprivation index" and 2) principal
      component analysis followed by cluster analysis. Our results showed an
      association between social deprivation and the occurrence of TB. The results also
      highlighted priority groups and areas requiring intervention. We recommend follow
      up that would include treating acid-fast bacilli smear-positive pulmonary TB
      cases, tracing of these persons' contacts, and monitoring of multidrug-resistant
      cases, all in coordination with local health services.

PMID- 11209254
TI  - [Detection of antibodies against Trypanosoma cruzi in Somoto, Nicaragua, using
      indirect ELISA and IFI on blood samples on filter paper].
AB  - We standardized a solid-phase enzyme-linked immunosorbent assay (ELISA) in order
      to study the presence of Trypanosoma cruzi antibodies in asymptomatic persons who
      live in an area of Nicaragua endemic for Chagas' disease. The test was
      standardized to analyze filter-paper blood samples, which are easy to transport.
      In the first phase of our investigation, ELISA was used to study 18 samples of
      total serum and 18 eluates of blood from patients with chronic Chagas' disease;
      30 samples of serum and 30 eluates of blood from healthy people, used as negative
      controls; and 14 samples of serum and 14 eluates of blood from patients with
      cutaneous or visceral leishmaniasis, which were used to study cross-reactions.
      Both with the total-serum and the blood-eluate samples, the ELISA test provided
      100% sensitivity and 90% specificity. Cross-reactions in the patient samples were
      observed only with visceral leishmaniasis. The second phase of our investigation
      was a population study that included eight rural communities in the area of
      Somoto, Nicaragua. Through random sampling, filter-paper blood samples were
      collected from 2,434 people (1,335 men and 1,099 women) from the communities of
      Aguas Calientes, El Brocal, La Manzana, Las Playas, Los Canales, Santa Isabel,
      Santa Rosa, and Santa Teresa. Studied by ELISA and by indirect immunofluorescence
      (IIF), the samples included 260 found seropositive by ELISA (10.7%), of which 207
      were positive according to IIF (8.5%). With both techniques, the majority of
      seropositives were among women, but the difference between men and women was not
      statistically significant. There was a high level of agreement between the
      results obtained with the two techniques. There was an upward trend with age,
      with 5.4% of those found seropositive by ELISA being persons 10 years of age or
      younger and 42.7% of those found seropositive being older than 50. The vast
      majority of the individuals analyzed were asymptomatic.

PMID- 11209255
TI  - [Methodological aspects of determination of angiotensin-converting enzyme].

PMID- 11209256
TI  - [The specificity of lipid metabolism in hereditary arterial hypertension induced
      by stress].
AB  - Studies of lipid metabolites in the plasma and lymph of rats with hereditary
      arterial hypertension induced by stress (HAHIS) showed decreased plasma and lymph
      pool of total cholesterol (TC) in comparison with normotensive Wistar rats. In
      HAHIS animals, TC concentration in the lymph was lower than in the plasma. The
      concentrations of triglycerides and free fatty acids in the plasma and lymph of
      hypertensive animals were virtually the same and higher than in normotensive
      ones. Plasma concentration of malonic dialdehyde (MDA) in HAHIS rats was the same
      as in Wistar rats, while the lymph concentration of MDA was higher than in Wistar
      rats. The detected lipid metabolism characteristics reflect its genotypical and
      phenotypical rearrangement and are a component of the "metabolic syndrome",
      detected in patients with essential hypertension and animals with spontaneous
      arterial hypertension.

PMID- 11209257
TI  - [Biochemical characteristics of liver involvement in patients with
      antiphospholipid syndrome].
AB  - The incidence of hepatitis B and C virus and cytomegalovirus infection is high in
      patients with the antiphospholipid syndrome (APS). The specific features of virus
      infection in APS patients are determined by the activity of APS. During
      clinically manifest stage, the activities of aminotransferases, lactate
      dehydrogenase (LDH), and alkaline phosphatase increase, while during remission
      only aspartate aminotransferase and LDH levels remain high, for this latter
      enzyme high activities of isoenzymes LDH5 and LDH4 being recorded. These data
      indicate that the pathological process in APS involves not only the liver, but
      the sinusoidal endothelium as well. This seems to account for some other clinical
      and laboratory manifestations of APS, such as increased level of circulating
      immune complexes, dysfunction of physiological anticoagulants, etc.

PMID- 11209258
TI  - [Retention volume of some steroids during their separation by high performance
      liquid chromatography].
AB  - The volume of retention of corticosterone, hydrocortisone, aldosterone,
      dexamethasone, cortisone, methylprednisolone, and prednisolone during their
      separation by high-performance liquid chromatography was evaluated. The studies
      were performed on a Milichrome microcolumn chromatographer. The order of
      glucocorticoid release and volume of their retention were under study.
      Measurement of endogenous and exogenous plasma glucocorticoids is practically
      important in clinical medicine. Steroid concentrations indicate the
      pharmacodynamics and pharmacokinetics of exogenous glucocorticoids and their
      effects on the production of endogenous steroids and reflect the biorhythms of
      corticosterone and hydrocortisone.

PMID- 11209259
TI  - [Detection of natural anti-angiotensin converting enzyme antibodies in human
      serum using immunoenzyme technique ].
AB  - Solid-phase enzyme immunoassay (EIA) was developed for detecting natural
      antibodies to angiotensine-converting enzyme (ACE). Optimal conditions for
      detecting natural anti-ACE by EIA in the sera of donors and patients with
      disorders of arterial pressure are selected. The findings indicate that the level
      of natural anti-ACE is normally constant, while in the patients it is increased
      in 50% cases.

PMID- 11209260
TI  - [Chronic leukemias (lecture)].

PMID- 11209261
TI  - [The take-up of saturated and polyenic fatty acids by cells: pharmacokinetics,
      pharmacodynamics and mechanism of fibrate action (review of literature)].

PMID- 11209262
TI  - [Prevalence of rheumatoid factor in the healthy population of Moldova Republic].
AB  - A total of 1009 normal human sera (524 (51.9%) male and 485 (48.1%) female) were
      screened for rheumatoid factor (RF). The age of donors varied from 17 to 61
      years, mean age 34 was years. The screening was performed by 3 methods with the
      following antigenic RF substrates: modified human IgG (latex test), Fc fragment
      of rabbit IgG (Vaaler-Rose test), and their combination (Refa-Dac diagnostic
      agent). RF with activity of at least 3 IU/ml was detected in 3.1% subjects and
      with the activity higher than the common diagnostically significant level (20
      IU/ml) in 5.58% examinees. RF more often occurs in healthy women than in men,
      particularly at the age of 17-39 years.

PMID- 11209263
TI  - [Morphodensitometric evaluation of lymphocytes enzymatic status in pathogenesis
      of chronic alcoholism].
AB  - Activities of succinate dehydrogenase (SDH), alpha-glycerophosphate dehydrogenase
      (alpha-GPDH), and nonspecific esterase (NE) were studied in blood lymphocytes of
      healthy men and chronic alcoholics. SDH activity was notably decreased, while the
      levels of alpha-GPDH and NE were increased in alcoholics. The detected metabolic
      changes suggest lymphocyte dysfunction and hence, impairment of neuroimmune
      relationships, which may be the central component in the pathogenesis of chronic
      alcoholism.

PMID- 11209264
TI  - [The use of electrochemoluminescent method for detection of cytokines in various
      media].
AB  - Electrochemiluminescent (ECL) method was used for cytokine detection with TAG
      label (ruthenium(II) tris-bipyridine chelate N-hydroxysuccinimide ester). A
      quantitative ECL detection of IL-4 and IFN-gamma in physiological fluids and cell
      culture media is described. The results evidence that ECL is compatible to
      commercial kits or even more effective. The advantages of ECL are simple
      procedure, no need in washings, small volume of the assay, wide range of cytokine
      concentrations, high sensitivity, and good reproducibility. The method can be
      used in research and clinical laboratories.

PMID- 11209265
TI  - [Immunomagnetic adsorption of malignant cells (Review of literature)].

PMID- 11209266
TI  - [Comparative study of platelets from healthy human donors using light microscopy
      and flow cytometr "Cobas micros"].
AB  - Peripheral blood platelets of 25 normal subjects were examined by optic
      microscopy and flow cytometry. Blood was collected routinely into tubes for Cobas
      Micros flow scintillator with EDTA anticoagulant. Smears were made as a monolayer
      and stained by May-Grunwald's method in our modification. Morphologically, 5
      classes of platelets were distinguished under optic microscope: young, mature,
      old, macroplatelets, and irritated forms. The percentage of each class was
      estimated (i.e., normal platelet formula was determined). Comparison of platelet
      parameters obtained on a flow cytometer and optic microscopy data for subjects
      with high percentage of large platelets showed increased mean volume of platelets
      (MPV) and width of platelet volume (PDW). The curve reflecting platelet
      distribution by volume in these donors was characterized by strong inclination to
      the right and a flat plateau.

PMID- 11209267
TI  - [Automation and organization of technological process of urinalysis].
AB  - Results of introduction into practice of a working model of industrial technology
      of laboratory studies and KONE Specific Supra and Miditron M devices are shown as
      exemplified by clinical analysis of the urine. This technology helps standardize
      all stages and operations, improves the efficiency of quality control of
      laboratory studies, rationally organizes the work at all stages of the process,
      creates a system for permanent improvement of the efficiency of investigations at
      the preanalytical, analytical, and postanalytical stages of technological process
      of laboratory studies. As a result of introduction of this technology into
      laboratory practice, violations of quality criteria of clinical urinalysis
      decreased from 15 to 8% at the preanalytical stage and from 6 to 3% at the
      analytical stage. Automation of the analysis decreased the need in reagents 3
      fold and improved the productivity at the analytical stage 4-fold.

PMID- 11209268
TI  - [An achievements of laboratory medicine for clinical practice. New tests and
      technologies (about the conference in Ufa)].

PMID- 11209269
TI  - Marketplace. Demographics, economic cycles conspire to inflate health costs for
      years ahead.

PMID- 11209270
TI  - Perspectives. Congress in 2000 gets low marks on health, but shows signs of
      getting serious.

PMID- 11209271
TI  - Wandering OSHA's Web site.

PMID- 11209272
TI  - Follow the money. AMA's long-delayed annual report offers unsettling news on
      physicians' incomes.

PMID- 11209273
TI  - JCAHO's new tell-all. Standards require that patients know about below-par care.

PMID- 11209274
TI  - Hospital in custody fight. Florida officials may take facility away from parent
      company to keep it open.

PMID- 11209275
TI  - Outlook 2001. Depending on whom you work for, there's good news and bad news.

PMID- 11209276
TI  - HIPAA will be no holiday. Experts say exhaustive rules may require significant
      cultural and administrative changes.

PMID- 11209277
TI  - Dialing up high-tech medicine. L.A. university opens doors to its third
      telemedicine center to serve urban patients.

PMID- 11209279
TI  - Learning a valuable lesson. Teaching hospitals still beating their nonteaching
      counterparts in Medicare margins.

PMID- 11209278
TI  - Investors demand more analysis. Credit-rating agencies to issue quarterly reports
      on hospital financial data; S&P to charge fees.

PMID- 11209280
TI  - Mealtimes are a big deal.

PMID- 11209281
TI  - Therapy in bloom.

PMID- 11209282
TI  - Communicating with our elderly.

PMID- 11209283
TI  - Affordable assisted living.

PMID- 11209284
TI  - We cannot get there from here.

PMID- 11209285
TI  - More than kid stuff.

PMID- 11209287
TI  - How you gonna keep 'em down on the farm? Make the farm integral to their lives,
      that's how!

PMID- 11209286
TI  - New Rx for psychoses in Alzheimer's, Parkinson's.

PMID- 11209288
TI  - A touch of the Orient. Horticulturist brings far eastern beauty to the west.

PMID- 11209289
TI  - Television documentaries lifting hospital, medical center profiles.
AB  - The nation's hospitals and medical centers are enjoying the legacy of TV
      audiences' addiction to medical dramas. Cable television has met the challenge
      with documentary coverage of real live hospitals. The medium offers many benefits
      and few disadvantages for those marketing managers with the courage to welcome
      camera crews. Lynn Hopkins Cantwell is director of public relations and marketing
      for Children's National Medical Center, Washington, D.C., which was covered in a
      seven-instrument "Lifeline" documentary for the Discovery Channel. James G. Gosky
      is director of communications for The MetroHealth System, Cleveland, which was
      the subject of two installments of "Trauma: Life in th ER," produced for the
      Learning Channel. These marketing pros describe the myriad details they faced
      when their respective hospitals went "on camera." Among the key factors were good
      communications with all constituents, attention to detail, and follow-up.

PMID- 11209290
TI  - Facts about falls inspire safety program at St. Marys. Wisconsin hospital
      collaborates with community agencies.
AB  - In cooperation with senior citizen and health care organizations, St. Mary's
      Hospital, Madison, Wisc., developed a multi-faceted campaign to raise awareness
      about accident prevention among older persons. The campaign won recognition from
      professional peers.

PMID- 11209291
TI  - St. Peter's reclaims its identity in the face of rapid growth. Two-year process
      results in new name.
AB  - A 130-year-old, well-respected Albany, N.Y., hospital, St. Peter's, experienced
      growing pains as it became a system comprising 25 entities. We describe a
      branding initiative carefully designed to identify the new health care system
      with the "old friend."

PMID- 11209292
TI  - M.D. Anderson Network newsletter builds bonds with patients, survivors.
AB  - Network, the quarterly newsletter of The University of Texas M.D. Anderson Cancer
      Center, Houston, builds relationships. Created in 1985 to "empower cancer
      survivors in the effort to take back control of their lives," it proves its worth
      in a recent readership survey.

PMID- 11209293
TI  - Finding a larger newsletter audience. For New York Methodist, new approach is
      worthwhile.
AB  - New York Methodist Hospital met the challenges of intense competition in the
      Brooklyn, N.Y., market by switching its quarterly newsletter to an insert in the
      local editions of national publications. By so doing, it multiplied distribution
      tenfold, improved its credibility and freed up staff time for other projects.

PMID- 11209294
TI  - A good communications plan can defuse crisis situations.
AB  - Community Health Partners, Lorain, Ohio, met the challenge of two nurses' strikes
      with comprehensive internal communications and conscientious media monitoring.

PMID- 11209296
TI  - Cleveland Clinic Web site promotes status, provides helpful information.
AB  - Publisher Donald E.L. Johnson writes about The Cleveland Clinic Foundation's Web
      site that both promotes its status as a leading international group practice and
      medical center and gives patients access to useful medical and health care
      information.

PMID- 11209295
TI  - Where health care falls short. Tips on meeting the expectations of women.
AB  - The experts tell us how to adapt some basic marketing techniques and create new
      approaches in order to reach this influential market.

PMID- 11209297
TI  - Low-key marketing--Craig Hospital. Consistent focus on the patient's healing.
AB  - Craig Hospital, in suburban Denver, was pushed into the limelight when survivors
      of the Columbine High School shootings were patients for rehabilitation. But high
      profile cases are treated the same as all others by this world-renowned traumatic
      brain and spinal cord injury center: the well-being and recovery of the patient
      is never compromised for the sake of publicity. Ongoing marketing practices are
      decidedly low-key.

PMID- 11209298
TI  - Role reversal. The government is reviewing the boundaries between professionals
      working in the NHS.

PMID- 11209299
TI  - New look nursing. Three trusts are pioneering a scheme to end the distinction
      between doctors and nurses.

PMID- 11209300
TI  - Scots set to clarify law on PVS patients.

PMID- 11209301
TI  - Millennium nurse.

PMID- 11209302
TI  - International solutions.

PMID- 11209303
TI  - Exchange of life.

PMID- 11209304
TI  - Brown's big idea.

PMID- 11209305
TI  - Night and day.

PMID- 11209306
TI  - Trusts: we're getting better. The NHS Confederation is encouraging managers to
      make good employment practice a priority.

PMID- 11209307
TI  - Research funding.
AB  - The RCN Research and Development Co-ordinating Centre is striving to become the
      source of information on funding opportunities for nurses.

PMID- 11209308
TI  - The school bullying problem.
AB  - Research into school bullying has, to date, predominantly focused on prevalence
      and intervention programmes. This article reviews some of this previous work and
      goes on to explore and discuss the holistic management of bullying, and outlines
      the importance of the role of the school nurse.

PMID- 11209309
TI  - Developing patient satisfaction questionnaires.
AB  - Karen Collins provides a practical guide to undertaking a patient satisfaction
      survey. She outlines the background to patient satisfaction research and
      highlights some of the main issues surrounding patient satisfaction measures.

PMID- 11209310
TI  - Advocacy in nursing.
AB  - The role of nurse as advocate is fraught with potential dangers, for both the
      patient and the nurse. Owen Bennett argues that until there is a universally
      accepted definition, this will continue to be the case.

PMID- 11209311
TI  - Changing trends in the laboratory diagnosis of gastroenteritic infections.
AB  - The micro-organisms responsible for causing gastroenteritis have changed over the
      last few decades. This article chronicles those changes and describes the
      laboratory tests devised to improve diagnosis.

PMID- 11209312
TI  - Coeliac disease.
AB  - The classic gastrointestinal symptoms of coeliac disease are relatively well
      known. Alison Sullivan describes their management, emphasising the importance of
      keeping to an appropriate diet if a range of co-existing and associated diseases
      are to be avoided.

PMID- 11209313
TI  - Care of elderly skin.

PMID- 11209314
TI  - Dealing with complaints.

PMID- 11209315
TI  - Nursing in a different way.

PMID- 11209316
TI  - Finding literature.

PMID- 11209317
TI  - Protection money.

PMID- 11209318
TI  - Getting to know you.

PMID- 11209319
TI  - Staying power.

PMID- 11209320
TI  - A long way from home.

PMID- 11209321
TI  - Inclusion zone.

PMID- 11209322
TI  - Home economics.

PMID- 11209323
TI  - Stick up for me.

PMID- 11209324
TI  - A strong nursing presence in the Euro-corridors of power.

PMID- 11209325
TI  - A life in the day of....

PMID- 11209326
TI  - No place for poaching.

PMID- 11209327
TI  - The diversity and complexity of ENB course curricula.

PMID- 11209328
TI  - Revisiting the concepts of community care and community health nursing.
AB  - As care moves away from hospital settings, continual re-evaluation of community
      nursing and health care is essential for the wellbeing of patients. With the
      approach of the year 2000, Jean Clarke examines World Health Organization
      objectives, particularly in light of the Health for All (1998) policy.

PMID- 11209329
TI  - Type 2 diabetes.
AB  - Type 2 diabetes can cause blindness, kidney failure and peripheral neuropathy,
      and is associated with premature death. Mary MacKinnon reviews this complex major
      disease and describes new treatments that are due to be licensed in the UK in the
      coming year.

PMID- 11209330
TI  - Injection techniques and safety.

PMID- 11209331
TI  - Preparing for the future.

PMID- 11209332
TI  - Quality, availability, access--the key to good placements.

PMID- 11209333
TI  - What's in a name?

PMID- 11209335
TI  - Quality through equality.

PMID- 11209334
TI  - Nursing students should go to jail.

PMID- 11209336
TI  - Care of the community.

PMID- 11209337
TI  - Profile: Barry Adams in his own words.

PMID- 11209338
TI  - Barry Adams--the saga continues.

PMID- 11209339
TI  - "A battle for the very profession itself".

PMID- 11209340
TI  - Outpatient ... and out of luck?

PMID- 11209342
TI  - Beyond outrage.

PMID- 11209341
TI  - The possible dream.

PMID- 11209343
TI  - Raising voices, protecting patients.

PMID- 11209345
TI  - Profile: Pam Douglas nurse and whistleblower.

PMID- 11209344
TI  - Stop! ... in the name of quality care.

PMID- 11209346
TI  - Reaching new heights.

PMID- 11209347
TI  - Break point.

PMID- 11209348
TI  - Night terrors.

PMID- 11209349
TI  - Brought to heal.

PMID- 11209350
TI  - The art of listening.

PMID- 11209351
TI  - Cancer lottery.

PMID- 11209352
TI  - Pension plan.

PMID- 11209354
TI  - Auditing deaths from epilepsy.

PMID- 11209353
TI  - Going public.

PMID- 11209355
TI  - Bowel preparation for rectal and colonic investigation.
AB  - BACKGROUND: Nurses need to have a clear understanding of the reasons for
      effective bowel preparation for patients undergoing imaging of the rectum and
      colon. CONCLUSION: Depending on the specific investigation, a variety of
      effective oral and rectal preparations are available. One of the most important
      deciding factors in choosing which should be used is patient tolerance.

PMID- 11209356
TI  - Research, ethics and the data protection legislation.
AB  - As nursing research becomes more common, so does the issue of whether or not
      patients should be involved and, if so, to what extent. This article examines how
      the data protection legislation helps to protect patients, and whether they have
      the capability to decide to participate, or not.

PMID- 11209357
TI  - Information and support for people with eczema.
AB  - Growing concern at the increase in eczema sufferers, has led the National Eczema
      Society to collaborate with nurses and skincare specialists to produce
      information and support for sufferers and carers alike, which will enable them to
      manage their condition better.

PMID- 11209359
TI  - Getting to grips with business plans, audit and applications.
AB  - Practice profiles are reflective pieces written by nurses in practice and based
      on continuing professional development articles. This week Sheila Hobbs discusses
      article NS10. Brocklehurst N et al (1999) Getting into business: how nurses can
      make a difference.

PMID- 11209358
TI  - Larval therapy.
AB  - Larval therapy--the use of maggots as a form of wound care--has been shown to be
      an effective and fast way to treat some wounds. This article describes how this
      method can be used successfully in practice.

PMID- 11209360
TI  - Jobs for life.

PMID- 11209361
TI  - Plotting a course.

PMID- 11209362
TI  - Protocols for stoma care.

PMID- 11209363
TI  - Rich century, poor results.

PMID- 11209364
TI  - Cross talk.

PMID- 11209365
TI  - Every man for himself.

PMID- 11209366
TI  - Simply the best. Managers who get your vote.

PMID- 11209367
TI  - Future issue. Local employment policies must be women-friendly.

PMID- 11209368
TI  - It's over to you.

PMID- 11209369
TI  - Transplant opt out debate goes on.

PMID- 11209370
TI  - Dignity: a study of pre-operative patients.
AB  - When being prepared for surgery, pre-operative patients undergo a series of
      processes and procedures which can compromise their dignity. This article
      examines this phenomenon and suggests ways to reduce it effects.

PMID- 11209371
TI  - Guidelines for administering blood and blood components.
AB  - The Serious Hazards of Transfusion (SHOT) scheme has revealed that many patients
      have received incorrect blood or blood component. This article reports new
      national guidelines for ordering, administering and managing blood, blood
      components and blood transfusion.

PMID- 11209372
TI  - Informal carers of people with dementia: the new national carers framework.
AB  - Carers of people with dementia themselves have to endure heavy physical and
      emotional burdens. This article examines the government's new strategy Caring
      About Carers (DoH 1999).

PMID- 11209373
TI  - Devolution: the effects on health policy.
AB  - Health policy modernisation and political devolution in the UK creates a
      challenge for all involved. This article examines this challenge from a nursing
      perspective.

PMID- 11209374
TI  - Promoting urinary continence in residential care.

PMID- 11209375
TI  - Advising patients who have sexually transmitted diseases.

PMID- 11209376
TI  - Delegation dilemmas.

PMID- 11209377
TI  - The open approach.

PMID- 11209378
TI  - Food for thought.

PMID- 11209379
TI  - Money-go-round.

PMID- 11209380
TI  - Changing the record.

PMID- 11209381
TI  - When all your credit runs out.

PMID- 11209382
TI  - Open door.

PMID- 11209383
TI  - Stay in ... eat soup.

PMID- 11209384
TI  - Time is of the essence. It took a 'pushy' woman a month to secure a mammograph
      privately.

PMID- 11209385
TI  - The importance of the Care Standards Bill, this year's pay award and support for
      the pioneering spirit in nursing.

PMID- 11209386
TI  - Manchester Clinical Supervision Scale.

PMID- 11209388
TI  - Improving quality of primary health care in a Sudanese dispensary.
AB  - Nursing in a poverty-stricken war zone means working with poor facilities and
      coping with different attitudes. Sue Campbell explores how working overseas does
      not need to curtail the nurse's professional development, and shows how some of
      the trends followed in the UK can apply abroad.

PMID- 11209387
TI  - Communication problems of hearing-impaired patients.
AB  - AIM: The main objective of this national survey was to check the findings of an
      earlier pilot survey. This had found that patients who had a hearing-impairment
      and were in hospital were often seriously disadvantaged by their disability.
      METHOD: The survey was conducted by questionnaire and the sampling frame confined
      to hearing-impaired patients who had been in hospital during the previous three
      years. A total of 359 completed and valid questionnaires were returned. RESULTS:
      The responses confirmed the finding of the pilot survey. They indicated that
      there were serious shortcomings in the ability of many hospital staff to cope
      with the problems of hearing-impaired patients. CONCLUSION: Common causes of the
      problems were identified. The major factor was inadequate training of both nurses
      and doctors in deaf awareness and the associated communication skills. Other
      significant factors included patients concealing their disability, pressure of
      work and poor communication between staff. Appropriate training at all staff
      levels should eliminate a high proportion of these problems.

PMID- 11209389
TI  - The 'new genetics' and nursing: what does it have to do with me?
AB  - Recent developments in genetics mean that this previously specialised subject is
      now essential knowledge for all nurses. Heather Skirton and Christine Patch
      describe how fundamental knowledge of the new genetics will enable nurses to help
      patients through the maze of choices open to them.

PMID- 11209390
TI  - Nuclear medicine: will I glow in the dark, nurse?
AB  - Nursing in nuclear medicine is an unknown field for most nurses. This article
      sheds light on the impact nuclear medicine can have on patients and on the
      nursing role in caring for patients undergoing diagnosis and treatment using
      radioisotopes.

PMID- 11209391
TI  - Learning to apply infection control policies on the ward.

PMID- 11209393
TI  - A lesson in the age of litigation.

PMID- 11209392
TI  - Stoma care nursing.

PMID- 11209394
TI  - Rewarding experience.

PMID- 11209395
TI  - Millennium bug.

PMID- 11209396
TI  - Double helping.

PMID- 11209397
TI  - Making the beds.

PMID- 11209398
TI  - Blood lines.

PMID- 11209399
TI  - Where do the hours go?

PMID- 11209400
TI  - Protecting the vulnerable.

PMID- 11209401
TI  - Leaving the dark ages.

PMID- 11209402
TI  - Good news, but just a start.

PMID- 11209403
TI  - The policy context.

PMID- 11209404
TI  - Distance learning for post-registered nursing: the facts.
AB  - AIM: To explore nurses' perceptions and evaluate the potential of distance
      learning as a method of teaching for post-registered nurses working in the
      community. METHOD: The study used open-ended questions in focus groups. Each
      group consisted of nine students each with an interest in post-registration
      learning. The interviews were taped and transcribed (n = 18). RESULTS: The
      respondents saw distance learning as a necessary way of updating their knowledge,
      as long as the education provided was relevant to their practice. They also saw
      this method of learning as an opportunity to take responsibility for their own
      learning. There was a conflict of opinion, however, as some respondents felt the
      courses to be a flexible way to teach and learn, while others found the courses
      to be too focussed and not necessarily relevant. CONCLUSION: The study provides
      an insight into distance learning and what some post-registered nurses perceive
      to be important factors associated with it as a method of teaching. It suggests
      that post-registered nurses working in the community will benefit from distance
      learning as a method of teaching.

PMID- 11209405
TI  - Assessment and learning in post-registration nurse education.
AB  - Assessment in nurse education concentrates too much on academic abilities and
      fails to measure the practical nursing abilities of students. This article argues
      for a change in emphasis, so that assessment is seen as a part of learning,
      rather than a series of arbitrary hurdles to be negotiated.

PMID- 11209406
TI  - Computerised databases in infection control.
AB  - The use of databases in health care is expanding. Systems are now available
      specifically designed for the management of infection control information. This
      article examines the expanding role of such databases and looks at the advantages
      and disadvantages for nurses.

PMID- 11209407
TI  - The importance of mouth care in preventing infection.
AB  - Most patients can benefit from nurses taking an active interest in their oral
      hygiene. Gladys Xavier describes how effective mouth care can improve a patient's
      quality of life and prevent serious infections.

PMID- 11209408
TI  - Nursing the child with gastroenteritis.

PMID- 11209409
TI  - A right to quality of life.

PMID- 11209410
TI  - Your input is what counts.

PMID- 11209411
TI  - Bristol: the courage to question.

PMID- 11209412
TI  - Back to basics.

PMID- 11209413
TI  - Making things happen.

PMID- 11209414
TI  - Men at work.

PMID- 11209415
TI  - Run away success.

PMID- 11209416
TI  - Diagnosing Bond, James Bond.

PMID- 11209417
TI  - A private view.

PMID- 11209418
TI  - 1999 report into perioperative deaths: extremes of age.

PMID- 11209419
TI  - Spiritual care in nursing: a systematic approach.
AB  - Ian Govier suggests that patients will benefit if nurses adopt a systematic
      approach to assessing spiritual needs. However, it may be necessary to evaluate
      personal spirituality before applying this approach.

PMID- 11209420
TI  - Are nursing theories holistic?
AB  - Nursing theories, while claiming to present models of holistic nursing care, do
      not deal adequately with human spirituality. This article reviews several nursing
      theories to find out which of them incorporate holism, and, if they do, whether
      the theorist's definition of holism includes spirituality.

PMID- 11209421
TI  - Establishing a mental health liaison nurse service: lessons for the future.
AB  - Mental health liaison nursing teams are developing across the UK with a diverse
      range of roles and functions. This article provides a description of the
      development of one such service in a large hospital in outer London and an
      insight into some of the key factors for success when setting up such a service.

PMID- 11209422
TI  - The principles and practice of child protection.
AB  - Nurses working with children might find themselves exposed to issues of child
      abuse. Sharon Stower discusses how to recognise child abuse, the legislation that
      exists to protect children and the action available to healthcare staff in cases
      where abuse of a child is suspected.

PMID- 11209423
TI  - Improving communication when giving bad news.

PMID- 11209424
TI  - Travellers' checks.

PMID- 11209425
TI  - Out of the public glare.

PMID- 11209426
TI  - Delivering the goods.

PMID- 11209428
TI  - Prescribing: the challenge.

PMID- 11209427
TI  - 2000--faster, fairer and convenient.

PMID- 11209429
TI  - Stretching new wings.

PMID- 11209430
TI  - To prescribe or not to prescribe.

PMID- 11209431
TI  - For the record.

PMID- 11209432
TI  - Waving not drowning.

PMID- 11209433
TI  - Standing her ground.

PMID- 11209434
TI  - What's it all about?

PMID- 11209435
TI  - Across the great divide.

PMID- 11209436
TI  - Research is every nurse's business.

PMID- 11209437
TI  - Factors affecting the decision to place a relative with dementia into residential
      care.
AB  - AIM: To find out the reasons why carers might decide that they could not continue
      caring for a relative with dementia at home. METHOD: Semi-structured interviews
      with carers of relatives who have dementia, before placing their relative into
      residential care and then again four months after that placement. n = 4. RESULTS:
      Wandering, aggression, incontinence and physical dependency in people who have
      dementia are factors that might lead carers to consider placing their relative
      into residential care; stress associated with Christmas can be another
      influencing factor. CONCLUSION: Carers looking after a relative who has dementia
      would benefit if the relative was provided with increased day care and home
      respite sitting services; services should be increased at Christmas; and support
      staff should be knowledgeable about the specific needs of people who have
      dementia and their carers.

PMID- 11209438
TI  - Evidence-based practice: demolishing some myths.
AB  - Most nurses base their practice on evidence produced by research. This article
      examines alternative ways of working and demolishes commonly held nursing myths
      in the process.

PMID- 11209439
TI  - Please help! I'm newly qualified.
AB  - Newly qualified nurses often think they have been thrown in at the deep end. This
      article examines the reasons why, and looks at how preceptorship can help.

PMID- 11209440
TI  - Eczema.
AB  - Eczema is a multifactorial disease that needs a combination of therapies to
      improve the quality of life for those suffering its symptoms. This article shows
      how to recognise the different types of eczema, details possible triggers and
      gives treatment options.

PMID- 11209441
TI  - Understanding genetics and disease.

PMID- 11209443
TI  - Using the Internet.

PMID- 11209442
TI  - Nursing in a secure health setting.

PMID- 11209444
TI  - Is the healthcare workforce a barrier to cost containment?

PMID- 11209445
TI  - Is the healthcare workforce a barrier to cost containment?

PMID- 11209446
TI  - Is the healthcare workforce a barrier to cost containment?

PMID- 11209447
TI  - Is the healthcare workforce a barrier to cost containment?

PMID- 11209448
TI  - Indirect cost of ischemic heart disease to employers.
AB  - BACKGROUND: The management of healthcare programs by employers requires accurate
      information about the indirect and direct costs of important chronic diseases.
      OBJECTIVE: To determine the indirect costs of ischemic heart disease from the
      perspective of the employer in private industry in the United States. DESIGN:
      Indirect cost of illness analysis using the human capital approach, taking the
      perspective of the employer rather than that of society. METHODS: Ischemic heart
      disease was identified in a proprietary claims database of 3.1 million insured
      persons using an algorithm based on administrative codes. Economic data were
      derived from the Bureau of Labor Statistics, the Employment Management
      Association, and published sources. Work-loss data were taken from the National
      Center for Health Statistics' Health Interview Survey. The indirect cost was
      calculated as the sum of the costs due to morbidity and mortality. From the
      perspective of the employer, morbidity costs come from lost productivity, idle
      assets, and nonwage factors resulting from absenteeism and mortality costs are
      expenditures for replacing and retraining workers. This differs from calculations
      from the societal perspective, in which indirect costs are the value of an
      individual's lost income--both current and potential. RESULTS: The total indirect
      cost of ischemic heart disease to employers in private industry was $182.74 per
      enrollee. Ninety-five percent of the indirect cost was the consequence of work
      loss due to morbidity rather than of mortality costs. CONCLUSION: From the
      perspective of the employer, the indirect cost of ischemic heart disease is
      overwhelmingly due to morbidity costs.

PMID- 11209449
TI  - Disenrollment from Medicare HMOs.
AB  - BACKGROUND: Since the program's inception, there has been great interest in
      determining whether beneficiaries who enter and subsequently leave Medicare
      health maintenance organizations (HMOs) are more or less costly than those
      remaining in fee-for-service (FFS) Medicare. OBJECTIVES: To examine whether
      relatively high-cost beneficiaries disenroll from Medicare HMOs (disenrollment
      bias) and whether disenrollment bias varies by Medicare HMO market
      characteristics. In addition, we compare rates of surgical procedures and
      hospitalizations for ambulatory care-sensitive conditions for disenrollees and
      continuing FFS beneficiaries. DESIGN: Cross-sectional analysis of 1994 Medicare
      data. PARTICIPANTS AND METHODS: Medicare beneficiaries were first sampled from
      the 124 counties with at least 1000 Medicare HMO enrollees. From this pool, HMO
      disenrollees and a sample of continuing FFS beneficiaries were drawn. The FFS
      beneficiaries were assigned dates of "pseudodisenrollment." Expenditures and
      inpatient service use were compared for 6 months after disenrollment or
      pseudodisenrollment. RESULTS: The HMO disenrollees were no more likely than the
      continuing FFS beneficiaries to have positive total expenditures (Part A plus
      Part B) or Part B expenditures in the first 6 months after disenrollment.
      However, disenrollees were more likely to have Part A expenditures. Among
      beneficiaries with spending, disenrollees had higher total and Part B
      expenditures than continuing FFS beneficiaries. Moreover, the disparity in total
      and Part B spending between disenrollees and continuing FFS beneficiaries
      increased with HMO market penetration. Although Part A spending was higher for
      disenrollees with spending, it was not sensitive to changes in market share. The
      HMO disenrollees received more surgical procedures and were hospitalized for more
      of the ambulatory care-sensitive conditions than the FFS beneficiaries.
      CONCLUSIONS: On several measures, Medicare HMOs experienced favorable
      disenrollment relative to continuing FFS beneficiaries as recently as 1994, which
      increased as HMO market share increased.

PMID- 11209450
TI  - A comparison of abciximab use in MCO and non-MCO populations.
AB  - OBJECTIVE: To compare abciximab use in managed care organization (MCO) patients
      and non-MCO patients undergoing coronary angioplasty, specifically (1) the
      factors influencing abciximab use, (2) the impact of abciximab on hospital length
      of stay (LOS), and (3) differences in results in MCO and non-MCO patients. STUDY
      DESIGN: A retrospective observational study based on data from 87 US hospitals on
      13,384 angioplasty patients. PATIENTS AND METHODS: Multivariate analysis was used
      to control for a wide range of factors (patient demographics, health conditions,
      admission information, and hospital characteristics) that may influence the
      likelihood of receiving abciximab and hospital length of stay (LOS). Estimation
      was conducted via a 2-stage sample selection model. RESULTS: Comorbidities,
      hospital characteristics, and geographic regions influenced abciximab use in MCO
      and non-MCO populations. In the non-MCO population, women and minority group
      members were significantly less likely than white male patients to receive
      abciximab. Both MCO and non-MCO angioplasty patients who were given abciximab had
      significantly shorter LOSs (0.66 +/- 0.27 fewer days and 0.87 +/- 0.13 fewer
      days, respectively) than did patients who were not given this drug. CONCLUSIONS:
      Access to care for MCO and non-MCO populations differed. Non-MCO women and
      minorities were less likely than non-MCO white men to receive abciximab, but this
      difference was not observed in the MCO population. After controlling for high
      risk indications and selection bias, MCO and non-MCO patients who received
      abciximab had significantly shorter LOSs than did those who did not receive
      abciximab. This finding is consistent with the many clinical trials that have
      observed a reduction in ischemic complications associated with abciximab use.

PMID- 11209451
TI  - Drugs and the elderly, Part 2: Strategies for improving prescribing in a managed
      care environment.
AB  - OBJECTIVE: In part 1 of "Drugs and the Elderly" (December 2000 issue), we
      reviewed and summarized the vast amount of clinical information on medication use
      in the elderly for healthcare providers and administrators within managed care.
      In part 2, we explore the literature on improving prescribing, focusing on those
      approaches most likely to be useful within a managed care environment. STUDY
      DESIGN: We reviewed the general literature on medication use in the elderly,
      focusing on problems and systems approaches to the improvement of medication use
      in managed care. We created a topic list of general interest to health
      professionals within managed care and fit the available information into those
      topics. Thus, the result is an authoritative review rather than a systematic
      literature review. PATIENTS AND METHODS: Nonquantitative evaluation of the
      medical literature. RESULTS: We identified several hundred articles describing
      issues related to medication use in the elderly but only a trivial number that in
      any way addressed the managed care community directly. There is very little
      literature on how managed care can best incorporate the lessons of geriatric
      pharmacology and pharmacy. CONCLUSIONS: There is a paucity of literature for the
      managed care community of health professionals regarding pharmacology,
      pharmacoepidemiology, drug utilization review, and other issues related to the
      use of medication in the elderly population.

PMID- 11209452
TI  - Ambulatory drug utilization review: opportunities for improved prescription drug
      use.

PMID- 11209453
TI  - The employer's perspective.

PMID- 11209454
TI  - Can administrative database studies inform medication use policy decisions? An
      application of Occam's razor.

PMID- 11209455
TI  - Fiberoptic biosensors based on chemiluminescent reactions.
AB  - The chemiluminescence of luminol in the presence of H2O2 has been exploited to
      develop fiberoptic biosensors associated with flow injection analysis systems. A
      chlorophenol sensor was developed based on the ability of certain halophenols to
      enhance the peroxidase-catalyzed luminol chemiluminescence. Horseradish
      peroxidase immobilized on a collagen membrane was used. Ten chlorophenols have
      been tested with this chemiluminescent-based sensor. The lower detection limit
      was obtained with 4-chloro-3-methylphenol and was equal to 0.01 microM.
      Electrochemiluminescent-based fiberoptic biosensors for glucose and lactate were
      also developed using glucose oxidase or lactate oxidase immobilized on polyamide
      membranes. In the presence of oxidase-generated H2O2, the light emission was
      triggered electrochemically by means of a glassy carbon electrode polarized at
      +425 mV vs a platinum pseudo-reference electrode. The detection limits for
      glucose and lactate were 150 and 60 pmol, respectively, and the dynamic ranges
      were linear from 150 pmol to 600 nmol and from 60 pmol to 60 nmol, respectively.

PMID- 11209456
TI  - Development of a chemiluminescent optical fiber immunosensor to detect
      Streptococcus pneumoniae antipolysaccharide antibodies.
AB  - A chemiluminescent-based optical fiber immunosensor was developed for the
      detection of antipneumococcal antibodies. This was accomplished by developing a
      different chemical procedure utilizing 3-aminopropyl trimethoxysilane and
      cyanuric chloride to conjugate pneumococcal cell wall polysaccharides to the
      optical fiber tips, and by improving the sensitivity of the photodetection
      system. The lowest titer of antipneumococcal antibodies detected by the optical
      fiber was at a 1:819,200 dilution. The lowest corresponding value by standard
      enzyme-linked immunosorbent assay was at a 1:98,415 dilution. It was concluded
      that the optical immunosensor system is an accurate and sensitive method to
      detect antipneumococcal antibodies and may be an adequate tool to monitor
      antibodies in specimens such as saliva and urine.

PMID- 11209457
TI  - Biosensors based on immobilization of biomolecules by electrogenerated polymer
      films. New perspectives.
AB  - The concept and potentialities of electrochemical procedures of biomolecule
      immobilization are described. The entrapment of biomolecules within
      electropolymerized films consists of the application of an appropriate potential
      to an electrode soaked in an aqueous solution containing monomer and
      biomolecules. This method of biosensor construction is compared with a two-step
      procedure based on the adsorption of an aqueous amphiphilic pyrrole monomer
      biomolecule mixture on an electrode followed by the electropolymerization of the
      adsorbed monomers. Another approach is based on the electrogeneration of polymer
      films functionalized by specific groups allowing subsequently the attachment of
      biomolecules. The immobilization of biomolecules on these films by covalent
      binding or noncovalent interactions is described.

PMID- 11209458
TI  - Immunodetection by quartz crystal microbalance. A new approach for direct
      detection of rabbit IgG and peroxidase.
AB  - Biodetection is one of the most important challenges for the twenty-first
      century: many fields are concerned, mainly environmental and medical. The quartz
      crystal microbalance (QCM) may offer great possibilities for this purpose: a
      direct response signal, which characterizes the binding event between a sensitive
      layer, immobilized onto the surface transducer, and the analyte to be detected,
      can be obtained. However, for the detection of small biomolecules such as
      antigens, it is quite difficult to obtain an observable signal that corresponds
      directly to the binding event. In general, this is owing to the lack of mass
      sensitivity of the commonly used QCM, with 5- to 10-MHz quartz crystals. For
      improving this mass sensitivity, a 27-MHz quartz resonator was developed and
      incorporated in a flow-through microcell. Two biospecies, IgG rabbit and
      peroxidase enzyme, were studied with this ultra-sensitive QCM in terms of
      specificity, detection limit, and calibration curve.

PMID- 11209459
TI  - Microbial sensors of ultraviolet radiation based on recA'::lux fusions.
AB  - Escherichia coli strains containing plasmid-borne fusions of the recA promoter
      operator region to the Vibrio fischeri lux genes were previously shown to
      increase their luminescence in the presence of DNA damage hazards, and thus to be
      useful for genotoxicant detection. The present study expands previous work by
      demonstrating and investigating the luminescent response of these strains to
      ultraviolet radiation. Several genetic variants of the basic recA'::lux design
      were examined, including a tolC modification of membrane efflux capacity, a
      chromosomal integration of the recA'::lux fusion, a different lux reporter
      (Photorhabdus luminescens instead of V. fischeri, allowing the assay to be run at
      37 degrees C), and a different host bacterium (Salmonella typhimurium instead of
      E. coli). Generally, two modifications provided the fastest responses: the use of
      the S. typhimurium host or the P. luminescens lux reporter. Highest sensitivity,
      however, was demonstrated in an E. coli strain in which a single copy of the V.
      fischeri lux fusion was integrated into the bacterial chromosome.

PMID- 11209460
TI  - Sensitive immunodetection through impedance measurements onto gold functionalized
      electrodes.
AB  - This article deals with a direct electrochemical method of detecting antigens
      using new methods of functionalization of gold electrodes. Based on the reacting
      ability of gold with sulfhydryl groups, three protocols for the fixation of
      antibodies have been explored. They are based on either the self-assembling
      properties of functional thiols bearing long alkyl chains or the possibility of a
      direct coupling of antibody moieties. Coverage rates as high as 97% can be
      reached. The analysis of the electrochemical impedance behavior of such layers
      can lead to a sensitive method for the direct detection of the antibody/antigen
      interaction. The addition of a redox couple in the tested solution, acting as an
      amplifier, allowed detection limits for the antigens as low as a few
      picograms/milliliter to be reached.

PMID- 11209461
TI  - Biosensor for determination of glucose and sucrose in fruit juices by flow
      injection analysis.
AB  - Glucose and sucrose were measured with an amperometric method by using the flow
      injection analysis technique. A carbon paste electrode with a renewable surface
      containing glucose oxidase, horseradish peroxidase, and ferrocene was used in
      combination with the soluble enzymes invertase and mutarotase. The effect of
      invertase, mutarotase, and ascorbic acid on the electrode response was examined.
      Glucose and sucrose concentrations were determined with < 3% errors. The proposed
      method for glucose and sucrose measurements was validated in real samples of
      fruit juices. The results were also compared with those obtained with the
      ultraviolet method.

PMID- 11209462
TI  - Electropolymerization as a versatile route for immobilizing biological species
      onto surfaces. Application to DNA biochips.
AB  - Biosensors based on electronic conducting polymers appear particularly well
      suited to the requirements of modern biological analysis--multi-parametric
      assays, high information density, and miniaturization. We describe a new
      methodology for the preparation of addressed DNA matrices. The process includes
      an electrochemically directed copolymerization of pyrrole and oligonucleotides
      bearing on their 5' end a pyrrole moiety. The resulting polymer film deposited on
      the addressed electrode consists of pyrrole chains bearing covalently linked
      oligonucleotides (ODN). An oligonucleotide array was constructed on a silicon
      device bearing a matrix of 48 addressable 50 x 50 microns gold microelectrodes.
      This technology was successfully applied to the genotyping of hepatitis C virus
      in blood samples. Fluorescence detection results show good sensitivity and a high
      degree of spatial resolution. In addition, gravimetric studies carried out by the
      quartz crystal microbalance technique provide quantitative data on the amount of
      surface-immobilized species. In the case of ODN, it allows discrimination between
      hybridization and nonspecific adsorption. The need for versatile processes for
      the immobilization of biological species on surfaces led us to extend our
      methodology. A biotinylated surface was obtained by coelectropolymerization of
      pyrrole and biotin-pyrrole monomers. The efficiency for recognition (and
      consequently immobilization) of R-phycoerythrin-avidin was demonstrated by
      fluorescence detection. Copolymerization of decreasing ratios of pyrrole-biotin
      over pyrrole allowed us to obtain a decreasing scale of fluorescence.

PMID- 11209463
TI  - Comparison between electrochemical and optoelectrochemical impedance measurements
      for detection of DNA hybridization.
AB  - The principles of the electrochemical and optoelectrochemical impedance
      measurements on bare electrolyte/dielectric/semiconductor structures are
      described. The analysis of the experimental curves allows access to several
      indications concerning the electrical behavior of such structures. The
      application of these techniques to follow the electrical behavior of structures
      modified with two biological systems was investigated. The antibody/antigen
      recognition did not change the surface charge and, therefore, did not affect the
      impedance curves with respect to the applied potential. By contrast, the
      hybridization of two complementary DNA strands on the surface of the structure
      induced a variation of flat band potential of the semiconductor leading to a
      shift of impedance curves along the potential axis. This means that it is
      possible to detect directly the DNA hybridization without the use of labeled
      probes. The use of light allows the surface to be probed locally. In the future,
      the application of this technique for direct detection of hybridization on DNA
      chips should be possible.

PMID- 11209464
TI  - Sol-gel-derived prussian blue-silicate amperometric glucose biosensor.
AB  - A new type of inorganic biosensor is introduced. The sensor comprises glucose
      oxidase enzymes encapsulated in a sol-gel-derived Prussian blue-silicate hybrid
      network. Glucose is detected by the biocatalytic reduction of oxygen followed by
      catalytic reduction of hydrogen peroxide by the Prussian blue catalyst. The sol
      gel silicate entails a rigid encapsulating matrix, the Prussian blue provides
      chemical catalysis and charge mediation from the reduction site to the supporting
      electrode, and the enzyme is responsible for the biocatalysis. The feasibility of
      a dual optical/electrochemical mode of analysis is also demonstrated.

PMID- 11209465
TI  - Amperometric biosensors based on microflow injection system.
AB  - Novel electrochemical cells based on a microflow system combined with
      amperometric enzyme electrodes were developed and served for quantitative
      determination of various compounds, such as organophosphates and lactose. The
      resulting biosensors are selective and efficient owing to immobilization of the
      sensing elements on the electrodes. The sensors are easy to operate, and the
      procedures are rapid, accurate, reproducible, and inexpensive, requiring neither
      special skills and training nor complicated instrumentation. The use of a
      microflow cell ensures the continuous flux of a new substrate, thus preventing
      the accumulation or adsorption of products to the electrode. Miniaturization of
      the sensor has two main advantages: (1) it is easy to carry and therefore can be
      used outdoors as well, and (2) it allows working with low volumes of compounds
      and reagents, which is highly important when dealing with hazardous compounds.

PMID- 11209467
TI  - [The developing risks of the allergic child].
AB  - 6% of infants are allergic to egg. 50% of them are at risk of becoming sensitive
      to pneumoallergens and of whom 50% develop asthma. These evolutionary risks which
      are the allergy "course" of the child may be avoided by a precise interrogation
      which is orientated towards detection by in vitro tests of F x 5 for foods and
      Phadiatop for pneumoallergens. The responsible allergens may themselves be shown
      by skin tests, measurement of specific IgE by CAP-RAST made by UNICAP.

PMID- 11209466
TI  - Quenching of cascade reaction between triplet and photochrome probes with
      nitroxide radicals. A novel labeling method in study of membranes and surface
      systems.
AB  - We proposed a new method for the study of molecular dynamics and fluidity of the
      living and model biomembranes and surface systems. The method is based on the
      measurements of the sensitized photoisomerization kinetics of a photochrome
      probe. The cascade triplet cis-trans photoisomerization of the excited stilbene
      derivative sensitized with the excited triplet Erythrosin B has been studied in a
      model liposome membrane. The photoisomerization reaction is depressed with
      nitroxide radicals quenching the excited triplet state of the sensitizer. The
      enhanced fluorescence polarization of the stilbene probe incorporated into
      liposome membranes indicates that the stilbene molecules are squeezed in a
      relatively viscous media of the phospholipids. Calibration of the "triple"
      cascade system is based on a previously proposed method that allows the
      measurement of the product of the quenching rate constant and the sensitizer's
      triplet lifetime, as well as the quantitative detection of the nitroxide radicals
      in the vicinity of the membrane surface. The experiment was conducted using the
      constant-illumination fluorescence technique. Sensitivity of the method using a
      standard commercial spectrofluorimeter is about 10(-12) mol of fluorescence
      molecules per sample and can be improved using an advanced fluorescence
      technique. The minimal local concentration of nitroxide radicals or any other
      quenchers being detected is about 10(-5) M. This method enables the investigation
      of any chemical and biological surface processes of microscopic scale when the
      minimal volume is about 10(-3) microL or less.

PMID- 11209468
TI  - [Current childhood food allergies].
AB  - Changes of dietary habits, new food technology, international meals and
      increasing consumption of exotic food has changed the repartition of food
      allergens. Some food allergens are worrisome and symptoms severe (peanut and nut
      butters). Others are new and increase strongly: exotic fruits, sesame, mustard
      and lupin. Primary prevention include avoidance of such food in high risk
      infants. Product labeling must be improved.

PMID- 11209469
TI  - [Infant food allergy: digestive manifestations].
AB  - Food allergies are frequent in infants where digestive signs predominate. The
      symptoms are extremely variable and most often non-specific. The signs may be
      immediate or delayed. The pathology of eosinophilia seems to be frequent and may
      occur in all parts of the intestine. Diagnosis will be orientated to skin tests,
      prick and/or patch, measurement of IgE and search for eosinophils in digestive
      biopsies. Exclusion diet of the suspect food, followed by reintroduction of the
      food will give certainty to the diagnosis.

PMID- 11209470
TI  - [Childhood allergic rhinitis].
AB  - Allergic rhinitis is the most common chronic disease in children. This frequency
      is in strong progress. According to ISAAC' study, it concerns a child (6/7 years)
      on four and a teenager on two. The seasonal rhinitises are generally well
      treated. Perennial allergic rhinitises are chronic and often neglected. They are
      more often complicated or associated to asthma which represents the major
      evolutionary risk. In a general way, allergic rhinitis are sub-diagnosed and
      untreated while we have more and more effective therapeutic means. Although
      allergic rhinitis is not considered as a severe disease, its echo on children's
      quality of life, physical and psychological well-being, and capacity to learn. It
      has also important socio-economic consequences. A better coverage is imperative
      itself as far as the diagnosis based on the symptoms and the allergy cutaneous
      tests which are easy. The options for treating allergic rhinitis in the child are
      not so different as those for adult. Complete avoidance of inhalant allergens is
      not always possible and medication are quite always possible. Intranasal
      corticosteroids are sometimes prescribed. In persistent disease, allergen
      immunotherapy may be considered according to the last OMS consensus statement.

PMID- 11209471
TI  - [Asthma in children].
AB  - Asthma is the most common chronic condition in paediatrics. Nowadays the
      prevalence is of multi-factorial origin. Clinical symptoms in children are often
      deceptive (isolated cough, winter bronchitis, caused by effort) often to the
      point of delaying diagnosis. This depends on a network of clinical arguments
      established by indispensable complementary investigations (thoracic plate and
      exploration of respiratory function). Search for atopy is systematic whatever the
      age of the child. Therapeutic care includes educative programmes for both
      children and their parents. Basal treatment is necessary when the asthma is
      persistent. Recourse must be made to drugs of which the type and dosage vary
      according to the state of development. Inhaled corticosteroid is often indicated
      for a prolonged period. Indications for specific desensitization are now well
      codified. The concern cases where the allergy has a significant impact on the
      development of the asthma. Individualised reception plans give a better
      integration of asthmatic children into school.

PMID- 11209472
TI  - [Atopic dermatitis:epidemiologic, clinical features, the role of allergy
      (review)].
AB  - This review includes the main epidemiological, genetic, clinical, evolutionary,
      and treatment elements of atopic dermatitis with a special reference to allergy
      and non-allergy factors that trigger pulses of atopic dermatitis.

PMID- 11209473
TI  - [Vaccination with allergens in children].
AB  - Specific immunotherapy or allergen vaccination has been in routine use since 1911
      for the treatment of respiratory allergic diseases. It is more effective in
      children and young adults than later in life. Its efficacy has been demonstrated
      in double-blind placebo controlled studies in both allergic rhinoconjunctivitis
      and allergic asthma. The improvement of allergenic extracts (in particular by
      standardization), the better understanding of the mechanisms of action of
      immunotherapy, the use of local administration routes and the publication of
      guidelines have legitimate its definite role to play in the therapeutic
      management of allergic respiratory diseases in childhood.

PMID- 11209474
TI  - Developing customer databases.
AB  - There is a growing consensus among pharmaceutical companies that more product and
      customer-specific approaches to marketing and selling a new drug can result in
      substantial increases in sales. Marketers and researchers taking a proactive
      micro-marketing approach to identifying, profiling, and communicating with target
      customers are likely to facilitate such approaches and outcomes. This article
      provides a working framework for creating customer databases that can be
      effectively mined to achieve a variety of such marketing and sales force
      objectives.

PMID- 11209475
TI  - The death of the four "P"s: a premature obituary.
AB  - To paraphrase Mark Twain the report of the demise of the four "P"s has been
      greatly exaggerated. While new concepts such as the four "R"s of relevance,
      response, relationships, and results may add value, the four "P"s remain
      essential. Moreover, health care marketing can benefit from the addition of a
      fifth "P," Prompting customers to adopt and repeat behaviors that benefit them,
      and a fifth "R," Reminding customers of the health and quality-of-life benefits
      they have gained from health care plans and providers.

PMID- 11209476
TI  - Factors influencing the recommendation of nursing homes.
AB  - This article reviews and compares the perceptions of nursing homes by residents
      and their proxies (family, friends, etc.) and reports that residents tended to
      give higher ratings to services than do their proxies. The analysis attempts to
      determine why residents give higher marks, which group the facility should look
      to for feedback, and whether the ratings will help organize the strengths and
      weaknesses in the facility to produce positive word of mouth within the
      community.

PMID- 11209477
TI  - Researching the market for assisted living facilities.

PMID- 11209478
TI  - The road to e-health: marketing implications.

PMID- 11209479
TI  - Marketing health care to minorities: tapping an emerging market.
AB  - A number of myths have prevented the development of a formal health care
      marketing strategy for the 100 million-plus racial and ethnic group members in
      the United States, despite their relatively greater need for health services.
      This market continues to grow in numbers, resources, and influence as the
      majority market level off. Marketers must look to minorities for new business,
      but traditional health care marketers have a long way to go before they are in a
      position to truly maximize this opportunity.

PMID- 11209480
TI  - The newborn health agenda: need for a village-level midwife.

PMID- 11209481
TI  - The diabetes epidemic: need for a systematic response.

PMID- 11209482
TI  - Type 2 diabetes in southern Kerala: variation in prevalence among geographic
      divisions within a region.
AB  - BACKGROUND: Numerous surveys carried out in India report the high prevalence of
      type 2 diabetes. Such studies have not included the population of Kerala. We
      estimated the prevalence of type 2 diabetes mellitus in Neyyattinkara taluk,
      Thiruvananthapuram district, Kerala state. METHODS: All panchayat wards in the
      taluk were grouped into urban, highland, midland or coastal, and one ward from
      each stratum was randomly selected for the study. All households were listed and
      adults, 20 years or older, screened for high (> 110 mg/dl) random blood sugar
      (RBS) by a glucometer test. Those with high RBS were reassessed by a fasting oral
      glucose tolerance test (OGTT), consisting of initial examination of venous blood
      for fasting plasma glucose (FPG) values, administration of 75 g of glucose
      dissolved in distilled water, and examination of venous blood for postprandial
      plasma glucose (PPPG) exactly 2 hours after the administration of glucose.
      Diabetes was diagnosed according to the World Health Organization criteria as
      either FPG > 139 mg/dl, or PPPG > 199 mg/dl, or both. Impaired glucose tolerance
      (IGT) was diagnosed if PPPG was 140-199 mg/dl. RESULTS: Out of 4988 eligible
      subjects, 3899 were available for the study, a response rate of 78.2%. Response
      was highest in the highland area (86.2%), and lowest in the coastal area (73.6%).
      The overall crude prevalence rate of type 2 diabetes was 5.9%. It was highest in
      the urban (12.4%), followed by midland (8.1%), highland (5.8%), and coastal
      (2.5%) regions. Ageing was associated with greater prevalence of type 2 diabetes
      in all regions and both sexes. Women showed a higher prevalence in the highland
      and coastal areas and men in the urban and midland areas. When compared to a
      population with standard age structure suggested by the World Health Organization
      for international comparisons, prevalence in the age group 30-64 years was found
      to be 16.9% in the urban, 10.1% in the midland, 6.8% in the highland and 3.6% in
      the coastal regions, respectively. Overall age-adjusted prevalence of type 2
      diabetes in 30-64-year-olds in Neyyattinkara was 9.2% among men, 7.4% among
      women, and 8.2% for all persons. There was not much difference in prevalence if
      the American Diabetes Association criteria for diagnosis were used. The
      prevalence of impaired glucose tolerance was fairly low in this population. Out
      of 229 diabetics in the sample, 175 (76.5%) were already diagnosed and under
      treatment, while our survey identified 54 new diabetics (23.5%). CONCLUSION:
      Though prevalence of type 2 diabetes is high in this population, the detection
      rate is also high. However, impaired fasting glucose and impaired glucose
      tolerance are low. The reasons for this need to be elucidated.

PMID- 11209483
TI  - Influence of education and occupation on knowledge about diabetes control.
AB  - BACKGROUND: A global epidemic of diabetes has been predicted during the first
      quarter of the twenty-first century, with a substantial increase in its
      prevalence in India. Good management of diabetes is a necessary step towards its
      control and blood glucose testing forms an integral part of this. This study was
      undertaken to assess the importance of education and occupation in relation to
      knowledge about good control of diabetes. METHODS: Perception patterns regarding
      methods for testing blood glucose and metabolic control were assessed by the
      direct interview method in 793 patients with type 2 diabetes. Patients' knowledge
      levels were compared for different educational and occupational categories using
      the Normal test (z-test) and the Student's t-test. RESULTS: The difference
      between the mean ages of men and women diabetics was not significant (p > 0.1).
      It was found that 46.7% of the subjects were aware of the importance of blood
      glucose testing. Awareness regarding the importance of microalbuminuria, lipid
      profile and glycosylated haemoglobin was observed in 24.1%, 15.5% and 7.6% of
      patients, respectively. A positive impact of education on overall knowledge
      levels was observed. However, no definite relationship was found between
      knowledge and occupation. CONCLUSION: There was a total lack of knowledge
      regarding self-care of diabetes in all educational and occupational categories
      (including patients who were qualified doctors). This calls for an urgent need to
      create greater public awareness. This study may serve as a guideline for
      developing an educational package for different subsections of the community.

PMID- 11209484
TI  - Acinetobacter infection in neurosurgical intensive care patients.
AB  - BACKGROUND: This study was performed to analyse the incidence of Acinetobacter
      infections in neurosurgical patients in the postoperative period. METHODS: Two
      thousand three hundred and twenty postoperative cranial neurosurgical intensive
      care unit (ICU) patients were studied from March 1995 to August 1996; 419
      patients had a variety of infections and 42 patients had multiple infections.
      Acinetobacter was isolated in 103 patients (24.6% of total patients infected and
      4.4% of total patients analysed). Statistical analyses were performed to identify
      the risk factors, antibiotic sensitivity and outcome of therapy of Acinetobacter
      infection. RESULTS: Acinetobacter infection was not significantly related to the
      length of hospital stay prior to surgery but was related significantly to the
      length of stay in the ICU after surgery. Acinetobacter was isolated from
      sputum/tracheal secretions in 47/103 (45.6%), followed by cerebrospinal fluid
      [24/103 (23.3%)], urine [15/103 (14.56%)] and blood [15/103 (11.65%)].
      Acinetobacter infection was present in 54 (3.21%) of 1680 patients who had
      undergone routine/elective surgery and in 49 (7.66%) of 640 patients following
      emergency surgery. Elective/supportive ventilation for > 5 days, external
      ventricular cerebrospinal fluid drainage for > 5 days, intracranial pressure
      monitoring and prolonged indwelling Foley's urinary catheter during the
      perioperative period were independent risk factors (p < 0.005). Acinetobacter
      isolated from sputum/tracheal secretions were mostly sensitive to amikacin,
      cefotaxime and ceftriaxone; while those grown from the cerebrospinal fluid were
      more often sensitive to ciprofloxacin, amikacin and netilmycin. Twenty-four
      patients succumbed to Acinetobacter infection; in 11 of these patients the
      organism was resistant to all antibiotics. CONCLUSION: Acinetobacter is an
      important nosocomial infection in neurosurgical intensive care patients.

PMID- 11209485
TI  - Clinical manifestations and survival pattern of Wilson's disease.
AB  - BACKGROUND: Wilson's disease usually presents in childhood. Early recognition and
      treatment is crucial to retard the progression of this disease, which can be
      debilitating, if not fatal. We analysed the clinical manifestations and survival
      pattern of patients admitted at our centre from 1993 to 1996. METHODS: Hospital
      records of patients were reviewed to obtain the clinical manifestations. The
      survival status of patients was determined by a prospective follow up. The Kaplan
      Meier survival curve and univariate Cox proportional hazards model were used to
      determine the survival pattern and risk for death in Wilson's disease. RESULTS: A
      total of 60 patients were studied. The median age at onset of symptoms was 12
      years (range 5-52 years). The log rank test showed a significant difference in
      the mean (SD) survival between patients who presented with hepatic [87.36 (15.26)
      months] and neurological symptoms [114.33 (9.14) months]. Cox proportional
      hazards analysis showed a hazard ratio of 4.9 for patients with a hepatic
      presentation compared to those with neurological presentation. CONCLUSION: The
      presentation of Wilson's disease is not limited to the paediatric age group.
      Patients with a hepatic presentation had a five-fold higher risk of mortality
      when compared to those with a neurological presentation.

PMID- 11209486
TI  - Reactive oxygen species in health and disease.
AB  - With the advent of the use of oxygen as the terminal electron acceptor in aerobic
      respiration, came the curse in the form of reactive oxygen species (ROS).
      However, the evolving organism had developed elaborate defence machinery to
      escape from these reactive byproducts of its own metabolism, and also developed a
      mechanism for the utilization of these species in physiological processes to gain
      a survival advantage. ROS have been increasingly implicated in the ageing process
      and in different diseases such as cancer, Alzheimer's disease, Parkinson's
      disease, reperfusion injury, etc. They are also important in cellular phenomenon
      such as signal transduction pathways. We review the mechanisms of production of
      ROS in the cell, their interaction with cellular macromolecules, pathways of ROS
      induced cell death, the mechanisms for protection from ROS-induced damage as well
      as the key biological and disease processes where ROS play an important role.

PMID- 11209487
TI  - Further insight into the thrifty phenotype.

PMID- 11209488
TI  - Performing a pericardiocentesis.

PMID- 11209489
TI  - School drop-out: a public health approach.

PMID- 11209490
TI  - The pharmaceutical industry: our 'silent' partner in the practice of medicine.

PMID- 11209492
TI  - The knee joint replacement.

PMID- 11209491
TI  - Worldwide decline in birth rate--how is Africa affected?

PMID- 11209493
TI  - Helicobacter pylori does not cause gastric carcinoma in India.

PMID- 11209494
TI  - Helicobacter pylori and gastric carcinoma: evidence for the link.

PMID- 11209495
TI  - Some reflections on the development of psychiatry in India.

PMID- 11209496
TI  - Amalgam safety.

PMID- 11209497
TI  - Unconventional dentistry.

PMID- 11209498
TI  - Unconventional dentistry.

PMID- 11209499
TI  - The durability of intraoral devices.

PMID- 11209500
TI  - The need for standardization of practice among tongue piercers.

PMID- 11209501
TI  - Clostridium difficile colitis following antibiotic prophylaxis for dental
      procedures.
AB  - Clostridium difficile-induced diarrhea and colitis are common complications of
      therapeutic courses of antibiotics in the hospital setting. We report a case of
      Clostridium difficile colitis following antibiotic prophylaxis for endocarditis
      prior to dental procedures in the community setting. The infection necessitated
      hospital admission and a prolonged hospital stay. Dental practitioners must be
      aware of the significance of the disease and the risk associated with
      antibiotics, whether they are used for prophylaxis or treatment.

PMID- 11209502
TI  - Congenitally missing maxillary lateral incisors and orthodontic treatment
      considerations for the single-tooth implant.
AB  - Implant restorations have become a primary treatment option for the replacement
      of congenitally missing lateral incisors. The central incisor and canine often
      erupt in less than optimal positions adjacent to the edentulous lateral incisor
      space, and therefore preprosthetic orthodontic treatment is frequently required.
      Derotation of the central incisor and canine, space closure and correction of
      root proximities may be required to create appropriate space in which to place
      the implant and achieve an esthetic restoration. This paper discusses aspects of
      preprosthetic orthodontic diagnosis and treatment that need to be considered with
      implant restorations.

PMID- 11209504
TI  - Dentistry in 2020.

PMID- 11209503
TI  - In vitro comparison of peak polymerization temperatures of 5 provisional
      restoration resins.
AB  - BACKGROUND: The heat produced by provisional restoration materials may injure the
      dental pulp. This study measured and compared peak temperatures during
      polymerization of 5 materials used in the fabrication of provisional
      restorations. METHODS: The tested materials were 2 self-curing resins (Integrity
      and Protemp) and 3 dual-cure resins (Iso-Temp, TCB Dual Cure and Provipont DC). A
      mould the size of a maxillary molar tooth was fabricated to contain 0.5 cc of
      resin. The temperature rise of the different materials was recorded every 10
      seconds over a 10-minute period. RESULTS: The rise in temperature of Integrity
      (peak temperature of 33.8 degrees C) and Protemp Garant (35.6 degrees C) was
      significantly higher than the rise in temperature of Iso-Temp (29.5 degrees C),
      TCB Dual Cure (28.4 degrees C) and Provipont DC (29.5 degrees C). CONCLUSION: Use
      of the dual-cure resins in provisional restorations may reduce the risk of pulp
      injury.

PMID- 11209505
TI  - FDI--our window on the world of oral health.

PMID- 11209506
TI  - [Regeneration of the immune system after bone marrow transplantation].
AB  - After haematopoietic stem cell transplantation, reconstitution of bone marrow
      consists of two distinct phenomena, numerical recovery of bone marrow cellular
      elements on the one hand and functional recovery of cellular interactions on the
      other. Immune reactivity during the first month postgrafting is extremely low.
      Cytotoxic and phagocytic functions usually recover by day 100, while more
      specialized and cooperative functions of T and B cells remain impaired up to one
      year or more postgrafting. Regeneration of total CD4+ T cell number in adult (and
      especially in elderly) transplant recipients is severely limited and occurs
      largely by peripheral expansion of mature CD4+ T cells. While restoration of
      total CD8+ T cell number is commonly seen in adults, potentially important
      alterations in the subset composition of CD8+ populations remain. Contracted T
      cell repertoires for CD4+ and CD8+ T cells are consistently found in adults after
      T cell regeneration. This suggests that thymic function is frequently limiting in
      adults and that thymic-independent pathways are insufficient for restoring host
      immunocompetence. Although there are similarities in immune reconstitution after
      alllo- and autologous haematopoietic stem cell transplantations, allogeneic
      transplantation involves graft versus host disease and the use of
      immunosuppressive therapy to control it, both of which further interfere in the
      early developmental stages of immune reconstitution.

PMID- 11209507
TI  - [Experiences with determination of cardiac Troponin-I and CK-MB serum levels in
      acute coronary syndrome].
AB  - The consideration of the correct diagnosis and prognosis in acute coronary
      syndrome seems to be a great challenge for cardiologists. Measuring of the serum
      cardiac Troponin (cTI) level may help solution of this problem. According to the
      authors the myocardial infarction has been revealed with a great sensitivity and
      specificity by the cTI level (100%). Authors found a higher level of cTI even
      after 72 hours of the onset of symptoms of myocardial infarction. After
      thrombolysis the wash out phenomen was more expressive compared with the values
      of CK-MB enzymes. A moderate but significant increase was observed of the cTI
      level in unstable angina. The measuring of cTI in acute coronary syndrome gives
      an important information to the correct diagnosis. The prognostic considerations
      of cTI level in unstable angina are interpreted by authors according to relevant
      data of literature.

PMID- 11209508
TI  - [Normal percentiles of kidney size in children as measured by ultrasonography].
AB  - The most anomaly of kidney development and urinary tract diseases have an effect
      on the size of the kidneys. Kidney size (renal length and parenchymal thickness)
      is readily measurable by ultrasonography, but the evaluation remains subjective
      without the use of appropriate standards. The aim of authors was, to produce a
      centile chart for normal kidney size based on US measurement in healthy Hungarian
      children. Renal length and renal parenchymal thickness (upper pole, middle part
      and lower pole) as well body weight and height were measured in 330 children.
      Normograms (centile charts) with 10th, 50th and 90th centiles were produced for
      body weight/height and renal length/parenchymal thickness. Renal length
      correlated strongly with both body weight (r = 0.93, p < 0.001) and height (r =
      0.93, p < 0.001). The centile chart for renal size enables the objective
      evaluation of abnormal kidney size; it can help in the early recognition and
      follow up of urinary diseases.

PMID- 11209509
TI  - [Dr. Imre Fauszt (1908-1981)].

PMID- 11209510
TI  - [Medicine in ancient Mezopotamia].

PMID- 11209511
TI  - Anterior and posterior nasal fontanelles.

PMID- 11209512
TI  - Managing glottal incompetence following Teflon injection.

PMID- 11209513
TI  - Deep facial infection of odontogenic origin.

PMID- 11209514
TI  - Electronystagmography: nausea on extension of the neck.

PMID- 11209515
TI  - Recurrent laryngeal nerve paralysis: current concepts and treatment: Part III-
      Surgical options.

PMID- 11209516
TI  - Hydroxyapatite cranioplasty in fibrous dysplasia of the skull.
AB  - We describe the case of a woman who had complained of worsening headache during
      the previous year. Analysis of computed tomography imaging and biopsy led to a
      diagnosis of fibrous dysplasia of the skull. A symptomatic frontal bone lesion
      was removed, and the resulting defect was repaired with hydroxyapatite cement.
      Hydroxyapatite cement has several advantages over hydroxyapatite ceramic blocks
      and granules, and it is particularly well suited for calvarial reconstruction.

PMID- 11209517
TI  - The effect of recreational gunfire noise on hearing in workers exposed to
      occupational noise.
AB  - Hearing sensitivity for an experimental group of 278 industrial workers who
      engaged in recreational shooting was compared with that of an age-matched control
      group of 278 nonshooting industrial workers to examine the effect of gunfire
      exposure on auditory thresholds. The influence of age and the number of
      unprotected gunshot exposures per year also was examined. The subjects in the
      experimental group completed a questionnaire to define the types of firearms
      used, the number of years shooting, and the number of protected and unprotected
      gunshot exposures per year. Results revealed that hearing sensitivity for
      frequencies 3.0, 4.0, and 6.0 kHz for both ears in the experimental group was an
      average of approximately 5 to 10 dB poorer than that of the control subjects.
      Although both subject groups demonstrated poorer 3.0-to-6.0-kHz hearing
      sensitivity for left-ear compared with right-ear listening, the degree of
      asymmetry between ears was greater for the experimental subjects. Older shooters
      had more hearing loss and greater threshold asymmetry than younger shooters, but
      there was no significant relationship between hearing sensitivity and the number
      of unprotected exposures per year. This latter finding was attributed to a
      fourfold increase in the number of unprotected annual exposures that were
      reported by younger shooters, who had inherently better hearing than did the
      older shooters.

PMID- 11209518
TI  - MRI video diagnosis and surgical therapy of soft tissue trauma to the
      craniocervical junction.
AB  - We evaluated objective diagnostic methods for patients with possible upper
      cervical spine instability caused by trauma and correlated them with subsequent
      neurosurgical findings and outcomes. Between November 1995 and May 1998, we
      investigated 420 patients with functional magnetic resonance imaging (MRI) of the
      craniocervical junction. We evaluated the extracranial vertebral circulation by
      MRI angiography, with focus on the position of the dens and on the subarachnoid
      space during entire rotational maneuvers. We documented 72 cases (17.1%) of
      injuries to the alar ligaments that were accompanied by signs of instability.
      Twenty patients (4.8%) had a complete alar ligament rupture, and 52 (12.4%) had
      an incomplete rupture with coexisting instability. We referred these patients to
      a neurosurgeon. Surgery was eventually chosen for 42 patients (10.0%) with the
      intention of obtaining dorsal occipitocervical stabilization. The duration of
      time between the MRI evaluation and surgery ranged from 1 week to 1.5 years
      (mean: 3.5 mo). After the fifth postoperative day, almost all symptoms had
      disappeared. One year following surgery, 34 of the 42 patients (80.9%) still
      demonstrated successful fusion and an alleviation of their sensation of
      instability. Twenty-five of these patients (59.5%)--all of whom were unemployed
      before surgery--were able to resume a professional activity. In the eight
      patients (19.0%) who still had a loss of stability during the second and 14th
      weeks, we noticed that there were some negative effects of rehabilitation. Six of
      these patients developed pseudarthrosis or osteolysis of their bone grafts during
      the first 3 months after fusion, and three required a repeat operation. We
      conclude that functional MRI with lateral tilting and rotatory evaluation is a
      useful tool for investigating craniocervical instability. For patients who are
      recalcitrant to following a program of conservative therapy, surgical
      stabilization of the craniocervical junction appears to be justified.

PMID- 11209520
TI  - Large osteoma of the external auditory canal.

PMID- 11209519
TI  - Flexible esophagoscopy as part of routine panendoscopy in ENT resident and
      fellowship training.
AB  - We conducted a retrospective study to evaluate the use of flexible esophagoscopy
      as part of routine panendoscopy in an academic setting. We reviewed the results
      of 378 procedures that were performed over a 4-year period in an academic
      otolaryngology--head and neck surgery program for residents and fellows. Medical
      records were reviewed for early and late complications as well as for adequacy of
      the examination. We found no immediate or long-term complications associated with
      flexible esophagoscopy. Adequate examination was achieved in all but two cases
      (99%), both of which involved patients who had significant strictures related to
      radiation therapy and who were not able to be evaluated by rigid esophagoscopy.
      We conclude that flexible esophagoscopy is a safe and accurate means of
      evaluating the esophagus during a panendoscopic evaluation of the upper
      aerodigestive tract, and that it should be included in the diagnostic
      armamentarium of every otolaryngology--head and neck surgery resident and fellow.

PMID- 11209521
TI  - [Diagnostic criteria of atypical benign partial epilepsy syndrome in childhood].
AB  - The paper presents an analysis of clinical-neuropsychological peculiarities of
      the syndrome of atypical benign partial childhood epilepsy (pseudolennox
      syndrome) of 6 patients (3 boys, 3 girls). An age of the onset of the disease was
      between 1.5-4 years. There was polymorphism of paroxysms, their high frequency
      with an obligate presence of hemifacial fits and atypical absences. Night
      generalized tonic-clonic attacks and the falling attacks were found in 67% of the
      patients. Spectrum of the neurological disorders included disorders of speech and
      a slight cerebella symptomatology. Regional "rolandic" activity and diffuse
      epileptiformed disorders, increasing into a phase of a slow sleep, were
      registered by EEG. Resistance to anticonvulsive therapy was revealed. The authors
      had demonstrated a nosologic independence of pseudolennox syndrome and had
      considered worth while to pick it out in a group of cryptogenic partial forms of
      epilepsy together with the epileptic aphasia of Landu-Kleffner and an epilepsy
      with the continuous peak-waves during the slow sleep.

PMID- 11209522
TI  - [Rett's syndrome: diagnostic issues].
AB  - Rett's syndrome (RS) is a severe disease of an early childhood, affecting girls
      mainly and manifesting in autistic symptoms, severe mental regression and motor
      dysfunction. The aim of the study was to analyze both early stages of clinical
      symptomatology and EEG correlates of RS. 65 patients aged 2.5-13 years with
      classic RS were examined. It was found that affective and autistic manifestations
      were the main symptoms during the 1-st stage of RS in approximately 50% of the
      cases. Two variants of classic RS were described according to the degree of motor
      dysfunction and behavioral disturbances: RS with motor disorders; RS with
      schizophrenoform disorders. Analysis of 145 EEG of 62 patients with the III-d PS
      stage revealed a presence of some correlations between location of the focus of
      the rhythmic theta-activity and clinical manifestations as well as their
      prognostic value. Thus, the decrease of the index of the rhythmic theta-activity
      in the patients on the III-d stage of RS correlated significantly with the
      improvement of the attention, behavioral and social activity, while its increase
      correlated with both the change for the worse of the higher cortex functions and
      advance of the motor disorders.

PMID- 11209523
TI  - [Neuroimaging diagnosis and aspects of therapy of hemorrhagic stroke].
AB  - The peculiarities of the clinical manifestations of the hemorrhages into the
      brain were analyzed in 215 patients regarding both the degree of the blood break
      into the ventricular system and the size of the perifocal edema. It is
      demonstrated that the clinical picture, course and prognosis of the disease
      depend on the volume of the hemorrhage, the degree of the ventricular tamponage,
      presence of both acute occlusive hydrocephalus and secondary truncal syndrome.
      The presence of the blood in the ventricular system was not fatal, but, in some
      cases, led to the improvement of the patients' state because of the decrease of
      the voluminal influence of the hematoma. Therapy of patients with hemorrhagic
      strokes must be differential and be determined by the size of the perifocal edema
      in the ischemic tissue, the state of the system of the hemostasis as well as the
      presence of angiospasm of intracerebral vessels. Combined administration of
      calcium antagonists, antioxidants, antiedemic and antiprostaglandin preparations
      was grounded.

PMID- 11209525
TI  - [Psychometrics is not only for experiments].

PMID- 11209524
TI  - [Aspects of psychotherapy in diabetes mellitus with accompanying alcoholic
      intoxication].
AB  - 120 patients with different types of diabetes mellitus were divided into groups
      by the presence and intensity of accompanying alcoholic intoxication: group 1--no
      alcohol intake; group 2--rare alcohol intake; group 3--moderate alcohol intake;
      group 4--alcoholic abuse. Experimental psychological methods were used together
      with psychotherapeutic approaches: Wiesbaden's questionnaire (WIPPF), Lusher's
      and MMPI tests. For each group of the patients some recommendations are given for
      application of the above techniques. Thus in patients from the 1-3 groups it is
      worthwhile to perform a positive psychotherapy directed to the development of the
      body/sensation sphere (according to WIPPF), that is a care about physical and
      mental state (including autotraining and training of communication). In the
      alcohol abusing patients the main point should be fantasy/future sphere
      (according to WIPPF) in the ranges of the same positive psychotherapy directed to
      forming positive world view and correction of the interpersonal relations.

PMID- 11209526
TI  - [The 100th anniversary of the Korsakov Neurology and Psychiatry Journal].

PMID- 11209527
TI  - [Diagnostic and prognostic significance of the antibodies to the myelin basic
      protein in acute neuroinfections in children].
AB  - The development of severe CNS damages including encephalitis is highly probable
      in some respiratory and exanthemata viral infections (measles, rubella,
      parotitis). A high level of IgG antibodies to the myelin basic protein was found
      in patients with parotitis meningitis and rubella encephalitis but it was not
      high in 80% of patients with encephalitis of the unclear etiology and in 25% of
      cases with rubella encephalitis. More accurate analysis of clinical, neurovisual
      and immunologic data revealed a link of appearance of such complications with
      both the presence of more pronounced demyelinization and prolongation of the
      disease.

PMID- 11209528
TI  - [Autoantibodies to nerve growth factor and astroglial protein S-100 in Rett's
      syndrome].
AB  - The levels of autoantibodies (AAB) to nerve growth factor (NGF) and to S-100
      protein were examined in blood of both mentally normal girls and girls with
      Rett's syndrome (RS). The elevated titer of anti-NGF AAB, but not of anti-S-100
      AAB was determined in the blood of patients with RS. There was relative
      individual stability of anti-NGF AAB level which didn't depend on the stage of
      the disease. At the same time, a reverse correlation was found between the level
      of these antibodies and severity of the disease: the mild form of the disease
      (with relative preservation of the speech elements and locomotor functions as
      well as with the later age of the onset of the disease and the later development
      of the regressive symptoms) is characterized by the higher AAB level. Autoimmune
      processes role (anti-NGF AAB) in formation of RS clinical features is discussed.

PMID- 11209529
TI  - [World Health Organization in the beginning of the XXI century].

PMID- 11209531
TI  - [Laboratory methods in epilepsy and disorders of cerebral circulation].

PMID- 11209530
TI  - [Epidemiology of stroke in Siberia].
AB  - Based on WHO MONICA methods and diagnostic criteria, it is shown that first-ever
      stroke incidence and mortality in Siberia (a total number of residents included
      in the analysis varied from 450,000 to about 800,000) that are among the highest
      in the world. In Novosibirsk, for the period from 1982 through 1991 there was a
      trend towards decreasing stroke incidence and mortality rates, but for the period
      from 1992 through 1997 there was a trend towards increasing there rates in both
      men and women. Age-standardized (US white population was used as a standard)
      stroke incidence rates increased from west to east and from south to north across
      Siberia, with a corresponding increase in the proportion of hemorrhagic strokes.
      In 1987-1988, age-adjusted stroke incidence rate in Novosibirsk was 212 per
      100,000 residents per year, in Krasnoyarsk--325, in Tynda--329, in Anadyr--348.
      Stroke-case fatality rates ranged from 28% in Tynda to 41% in Anadyr. A
      multivariate regression analysis revealed that hypertension, left ventricular
      hypertrophy, ischemic heart disease. mitral valve disease, current cigarette
      smoking, excessing body mass index, winter season, and low ambient temperature
      are all significant and independent risk factors for the occurrence of ischemic
      stroke in Novosibirsk. A significant association between stroke occurrence and
      air pressure/geomagnetic activity change was found. Possible reasons for such
      unfavorable trends in stroke incidence in Siberia are discussed, and an optimal
      approach for improving organization of cerebrovascular disease care is suggested.

PMID- 11209532
TI  - [Molecular genetic risk factors of Alzheimer's disease].

PMID- 11209533
TI  - [Is a clinical nosologic direction in the Russian psychiatry completely exhausted
      itself?].

PMID- 11209534
TI  - Does body mass index of infertile women have an impact on IVF procedure and
      outcome?
AB  - PURPOSE: The objective was to explore whether body mass index (BMI) of women
      related to the different parameters of the in vitro fertilization (IVF) procedure
      and outcome. METHODS: This retrospective study on 398 couples analyzed
      epidemiological features, characteristics of ovarian stimulation, number and
      quality of retrieved oocytes, as well as pregnancy outcome according to three
      groups of BMI values: BMI < 20, 20 < or = BMI < 25 and BMI > or = 25 kg/m2.
      RESULTS: The prevalence of underweight and overweight women was 21.8% and 22.3%,
      respectively. The mean ratio follicle-stimulating hormone-luteinizing hormone
      increased significantly according to BMI. An increase in the mean number of
      consummated gonadotropin ampoules together with a decrease in the number of
      collected oocytes was observed in long stimulating protocol cycles when BMI > or
      = 25 kg/m2. The same observations were made in short stimulation protocol cycles
      of BMI < 20 and > or = 25 kg/m2. No significant difference could be found in
      clinical pregnancy and miscarriage rates between underweight, normal weight, and
      overweight patients. CONCLUSIONS: Both underweight and overweight have negative
      effects on IVF parameters and outcome leading to decreased chances of pregnancy.

PMID- 11209535
TI  - A comparison of psychological functioning in women at different stages of in
      vitro fertilization treatment using the mean affect adjective check list.
AB  - PURPOSE: The objectives were to identify the stage/s of IVF treatment where a
      woman is most vulnerable to psychological stress, and to assess the Mean Affect
      Adjective Check List (MAACL) as a measure of psychological functioning during IVF
      treatment, which has hitherto not been reported. METHODS: Thirty-seven women
      undergoing IVF treatment according to the long protocol of controlled ovarian
      stimulation completed the MAACL questionnaire at the following stages: (a) before
      treatment (visit 1), (b) before embryo transfer (visit 2), and (c) before
      pregnancy test (visit 3). RESULTS: Apart from anxiety scores for visit 2, the
      hostility, depression, and state anxiety scores for visit 3 were higher than the
      corresponding scores for visits 1 and 2 (P < 0.001). Anxiety scores for visits 2
      and 3 were similar. CONCLUSIONS: Psychological counseling should be targeted at
      women after embryo transfer and leading up to the pregnancy test. The MAACL is a
      useful method for measuring psychological stress in women during IVF treatment.

PMID- 11209536
TI  - Recombinant human follicle-stimulating hormone for ovulation induction in
      polycystic ovary syndrome: a prospective, randomized trial of two starting doses
      in a chronic low-dose step-up protocol.
AB  - PURPOSE: The aim was to compare the follicular response to 37.5 and 50 IU of
      recombinant follicle-stimulating hormone (FSH) as starting doses for ovulation
      induction in patients with polycystic ovary syndrome (PCOS). METHODS:
      Prospective, randomized, crossover study including 15 women with clomiphene
      citrate-resistant chronic anovulatory infertility. Patients were treated with
      subcutaneous recombinant FSH at starting doses of 37.5 IU and 50 IU,
      respectively, according to a low-dose step-up protocol. Each woman received both
      treatments, in a randomized order, with an interval of > or = 1 month between
      treatments. RESULTS: All treatment cycles were ovulatory after an appropriate
      follicular response and hormone levels were similar with both treatments,
      although the total quantity of FSH required and the mean daily dose required to
      induce identical follicular development were significantly lower with a starting
      dose of 37.5 IU FSH. The mean duration of treatment to achieve ovulation was
      approximately 13 days with both treatments but treatment periods > or = 20 days
      were required in some patients. CONCLUSIONS: In women with PCOS, a starting dose
      of 37.5 IU recombinant FSH may be adequate to induce follicular growth. However,
      the use of low starting doses may result in some cases in increased treatment
      periods and need for monitoring.

PMID- 11209537
TI  - IVF performance of women who have fluctuating early follicular FSH levels.
AB  - OBJECTIVES: The aim was to evaluate whether women who have early follicular
      follicle-stimulating hormone (FSH) levels > 12 mIU/ml have reduced response to
      follicular stimulation for in vitro fertilization (IVF) in a following month, in
      spite of normal FSH levels. MATERIAL AND METHODS: In a 3-year period from January
      1996 to December 1998, 303 women aged 38 years and above and/or who had
      previously responded poorly to superovulation for IVF gave blood samples for FSH,
      luteinizing hormone (LH), and estradiol (E2) on day 2 of menstruation before
      commencing treatment. RESULTS: In 117 (38.6%) of these women, FSH levels were >
      12 mIU/ml (range 12-114 mIU/ml). Sixty-six of these women gave a further 130
      blood samples for FSH measurement in the following months. Seventy-eight (60.0%)
      of the tests showed raised FSH value > 12 mIU/ml. Thirty women whose repeat FSH
      levels were < 12 mIU/ml underwent 41 IVF cycles (group 1). Sixty-three other
      women, older than 38 and/or who had a poor response to superovulation previously
      and whose FSH levels were < 12 mIU/ml, served as the control group (group II).
      There were no differences in the responses to superovulation and delivery rates
      between the two groups (14.6% vs. 12.7%). CONCLUSIONS: Women whose early
      follicular phase FSH levels were raised > 12 mIU/ml had an increased risk (> 50%)
      that in subsequent cycles levels would remain raised, and it was not possible to
      predict which individuals would have favorable FSH levels. If the cycle day 2 FSH
      level returns to a "normal" level of < 12 mIU/ml, women aged 40 and above had
      substantial cycle cancellation rates (43%), but patients who achieved the stage
      of embryo transfer had a good chance of conceiving, regardless of their age.

PMID- 11209538
TI  - Clinical correlation of cyclin D2 mRNA expression in human luteinized granulosa
      cells.
AB  - PURPOSE: The aim was to evaluate whether the expression of cyclin D2 mRNA in
      human luteinized granulosa cells correlates with the clinical parameters of women
      undergoing in vitro fertilization-embryo transfer (IVF-ET) programs. METHODS:
      Using reverse transcriptase-polymerase chain reaction (RT-PCR) techniques, the
      cyclin D2 mRNA in human luteinized granulosa cells of large follicles was
      measured. Correlation analysis between cyclin D2 mRNA expression and clinical
      parameters [age; day 3 follicle-stimulating hormone (FSH), luteinizing hormone
      (LH), and estradiol (E2); E2 and P4 at the day of human chorionic gonadotropin
      (hCG); total amount of gonadotropin and the number of days of gonadotropin
      administration; pregnancy outcome] were performed. RESULT(S): Cyclin D2 mRNA
      expression showed negative correlation with patient's age (R = -0.60, P < 0.005)
      and total amount of gonadotropins (R = -0.45, P < 0.03), and also showed positive
      correlation with serum E2 levels at the day of hCG administration (R = 0.55, P <
      0.02). Other clinical parameters showed no statistical significance. Cyclin D2
      mRNA expression of pregnant group was higher than that of nonpregnant group (P <
      0.03). CONCLUSIONS: Cyclin D2 mRNA expression in human luteinized granulosa cells
      positively correlates with clinical parameters of ovarian function and may be a
      novel marker for the health of human ovarian follicle.

PMID- 11209539
TI  - Effects of controlled ovarian hyperstimulation on oocyte quality in terms of the
      incidence of apoptotic granulosa cells.
AB  - PURPOSE: The aim was to investigate which ovarian hyperstimulation protocol
      performed in the same patients causes development of oocytes of good quality.
      METHODS: Twenty normo-ovulatory women underwent three different controlled
      ovarian hyperstimulation protocols for in vitro fertilization-embryo transfer.
      Patients underwent follicle aspiration after administration of human chorionic
      gonadotropin (hCG). The total number of retrieved oocytes, the number of mature
      oocytes, and the rate of mature oocytes were examined. Recovered granulosa cells
      were stained with Hoechst 33258 and examined by fluorescence microscopy to
      estimate the incidence of apoptotic cells. RESULTS: The total number of oocytes
      and the number of mature oocytes in gonadotropin-releasing hormone agonist
      (GnRHa) + human menopausal gonadotropin (hMG) + hCG and hMG + hCG cycles were
      higher than those in the natural cycle (P < 0.0001). The rate of mature oocytes
      in hMG + hCG cycle was the highest among the three protocols (P < 0.04). In the
      mural granulosa cells, the incidence of apoptotic cells in the GnRHa + hMG + hCG
      cycle was significantly higher than those of the natural (P < 0.002) and hMG +
      hCG cycles (P = 0.0002). The incidence of apoptotic cumulus granulosa cells in
      the GnRHa + hMG + hCG cycle was significantly higher than those of natural and
      hMG + hCG cycles (P < 0.002). Moreover, the incidence of apoptotic cumulus
      granulosa cells in the hMG + hCG cycle was significantly lower than that in the
      natural cycle (P < 0.01). CONCLUSIONS: These results indicated that hMG + hCG is
      the most appropriate controlled ovarian hyperstimulation protocol among the three
      examined with regard to oocyte quality.

PMID- 11209540
TI  - Low-dose aspirin does not increase implantation rates in patients undergoing
      intracytoplasmic sperm injection: a prospective randomized study.
AB  - PURPOSE: The aim was to evaluate the effect of aspirin on pregnancy and
      implantation rates in an unselected group of patients undergoing intracytoplasmic
      sperm injection (ICSI). METHODS: Two hundred and seventy-nine patients were
      randomized to receive 80 mg of aspirin (n = 139) or no treatment (r = 136)
      starting from the first day of controlled ovarian hyperstimulation. RESULTS:
      Duration of stimulation, gonadotropin consumption, peak estradiol, number of
      oocytes retrieved, fertilization rate, cleavage rate, and number of embryos
      transferred were similar in the two groups. Implantation and clinical pregnancy
      rates were 15.6% and 39.6% versus 15.1% and 43.4% in aspirin treated and
      untreated groups, respectively (P > 0.05). CONCLUSIONS: Low-dose aspirin
      administration does not improve implantation and pregnancy rates in an unselected
      group of patients undergoing ICSI.

PMID- 11209541
TI  - Characteristics of cryopreserved semen from men with lymphoma.
AB  - PURPOSE: This study compared the pretreatment semen quality in patients with
      Hodgkin's disease and non-Hodgkin's lymphoma with a group of healthy donors. We
      also examined the differences in prefreeze and postthaw semen quality among the
      different stages of Hodgkin's disease. METHODS: The study included 89 patients
      with Hodgkin's disease, 18 with non-Hodgkin's lymphoma, and 50 healthy sperm
      donors. RESULTS: In patients with Hodgkin's disease, the prefreeze and postthaw
      semen characteristics were significantly lower than those of the healthy donors.
      Similar results also were seen in patients with non-Hodgkin's lymphoma. No
      significant differences in the prefreeze semen quality were seen in patients with
      different stages of cancer. CONCLUSION: Patients with Hodgkin's disease and non
      Hodgkin's lymphoma in our study had poor semen quality when compared with healthy
      donors both before and after cryopreservation. As cancer therapy significantly
      impairs reproductive potential, sperm banking should be offered to these men
      before the start of their therapy.

PMID- 11209543
TI  - [Cutaneous tuberculosis yesterday and today].
AB  - Cutaneous tuberculosis were very frequent in Europe until the middle of the 20th.
      Century in which their incidence decreased drastically as a consequence of the
      specific treatments. On the other hand, the M. bovis caused infections which were
      previously very common have also been disappearing due to control of milk and the
      livestock produced for eating purposes. Cutaneous tuberculosis have classically
      been divided into two groups: typical tuberculosis, with follicular structure and
      demonstrated bacillus by culture or inoculation and atypical tuberculosis
      (tuberculids), in which there are no follicular structure and the bacillus is not
      isolated. Its relationship with tuberculosis is principally based on the personal
      and/or familial background and on the strong positivity of the Mantoux reaction.
      The concept of tuberculide has always been under debate. Above all in the second
      half of the 20th. Century, most of the authors were skeptical in regards to its
      tuberculous etiology. However, since the 1990's, determinations of bacillary DNA
      in the lesions by the PCR technique has made it possible to demonstrate the M.
      tuberculosis in them. At present, due to the probably re-emergence of
      tuberculosis in general as consequence of the immunodeficiency (AIDS), of the M.
      tuberculosis strains resistant to treatment, and of the cases imported by
      immigration, some increase in the incidence of cutaneous tuberculosis can be
      predicted in the future, although it need be feared that this will reach the
      amounts of other periods. On the other hand, immunodeficiences have made the
      anergic forms, such as tuberculosis cutis miliaris diseminata or tuberculous
      gumma, which were previously rare, less rare al present.

PMID- 11209544
TI  - [Palliative medicine in oncology].
AB  - The aim of Palliative Medicine is the study of the illness person and the
      preservation and defence of his dignity. It is not only not opposite to Curative
      Medicine but also complementary. It includes physical, psychological, social and
      spiritual factors. Palliative Medicine must be present from the diagnosis through
      the different evolutive stages of our patients. It is not only the care programs
      for terminally cancer patients. Surgery, radiotherapy and chemotherapy are used
      as specific palliation in some situations in order to improve quality of life,
      survival time or symptomatic control. Human dignity is based on the fact of
      being, apart from its circumstances or its abilities. When a patient tells us:-
      Doctor, I don't want to live. We should translate:--Doctor, I don't want to live
      ... this way. Then, we should wonder how are we taking care of this person. Good
      caring begins in a good information along the whole process. I summarize it, as
      progressive and bearable truth. The key to get an appropriate treatment of our
      patients is to combine the pharmacological, dietetic an physical treatment with a
      deep understanding of the human being that should inform the whole medical
      practise.

PMID- 11209542
TI  - Assessing the chromosome copy number in metaphase II oocytes by sequential
      fluorescence in situ hybridization.
AB  - PURPOSE: Aneuploidy in oocytes is the main cause of failed embryo implantation
      and of miscarriage. At present, only limited data on the prevalence of aneuploidy
      in freshly collected human oocytes are available and all studies have been
      performed with conventional methods for karyotyping. In this feasibility study,
      multiple-hybridization fluorescence in situ hybridization (FISH) was evaluated as
      an alternative method to determine the number of chromosomes in oocytes. METHODS:
      Fifty-two spare oocytes were collected from 23 patients treated with
      gonadotropins for intrauterine insemination or intracytoplasmic sperm injection.
      A conventional dual color FISH approach using mixtures of chromosome-specific
      standard alpha-satellite probes was applied consecutively to the chromosomes of
      the same metaphase II oocyte. Mixtures of three to six probes were designed in
      order to allow chromosome identification based on signal color and centromeric
      index. RESULTS: One hybridization cycle was possible in 52 uninseminated
      metaphase II oocytes, two hybridizations in 43 oocytes (82.7%), three
      hybridizations in 30 oocytes (57.6%), four hybridizations in 27 oocytes (51.9%),
      and five hybridizations in 15 oocytes (28.8%). Altogether, 591 chromosomes could
      be marked (47.4% of the entire chromosome complement, 11.4 chromosomes per
      oocyte). The most important single factor contributing to technical failure was
      loss of the oocyte from the slide. CONCLUSION: This feasibility study
      demonstrates that multiple-hybridization FISH can be used for the assessment of a
      larger proportion of the chromosome complement in oocyte as compared to previous
      studies based on FISH.

PMID- 11209545
TI  - [Physical pain and suffering in the child].
AB  - Since about ten years ago there has been a great interest in the treatment of
      pediatric pain, previously neglected in medical practice. A review of procedures
      of pain assessment is made: self-assessment, behavioural analysis and biological
      measurements. The main therapeutic procedures are also reviewed (drugs, physical
      agents and psychological treatment), emphasizing the interest of prophylaxis and
      parental participation in children's pain treatment.

PMID- 11209546
TI  - [Balneotherapy, health care and public health].
AB  - The actual interest of Spa-therapy in public health is considered as a way of
      improving health, well-being state or as prevention or treatment of different
      diseases. The various definitions of health are exposed and its possible
      influence in human beings, and in particular the complexity of the Spa-therapy.
      The possible positive effects of the Spa-therapy have been tested in the official
      Centers of several countries and have been considered of great value in Health
      Education its signification as a primary, secondary and tertiary health agent.

PMID- 11209547
TI  - [Serotonergic innervation of the auditory receptor].
AB  - The serotonergic inervation of the auditory receptor is composed by nerve fibres
      of multipolar neurons located on the superior lateral oliva. These neurons could
      correspond to outer elements of the nucleus reticularis caudalis. The peripheral
      projection on the auditory receptor is composed of varicose fibres distributed
      within the inner spiral bundle connecting on inner hair cells. Other fibres,
      after a spiral pathway within the Corti's tunnel, reach the outer hair cells.
      This new fascicle, with a particular origin and peripheral distribution,
      characterized as serotonergic and of unknown function, could be considered as a
      previously undescribed projection of the reticular formation on the auditory
      receptor.

PMID- 11209548
TI  - [Metabolic syndrome X in women].
AB  - The author exposes the present concept of metabolic syndrome X, which is a
      complex of Type II diabetes, obesity, hypertension and vascular problems. This
      syndrome has been known for many years, but it has been individualized as such
      only recently. This is due to the huge importance that obesity is reaching in
      developed countries, especially in the U.S.A. Today this is a very important
      health problem. In this work, in addition to the description of the syndrome,
      which is purely an internal medicine issue, its relation to some women-specific
      problems is also explained, especially to the so-called polycystic ovary.

PMID- 11209549
TI  - [Emerging mycoses].
AB  - The incidence of new pathogenic agents in the fungi group has been on the rise
      over the past few years. This can be explained by the similar increase in elderly
      patients, precarious situations or immunodeficient states, together with the high
      degree of instrumentation in hospitals and the indiscriminate use of antibiotics
      and antimycotics both to cure and prevent. This study includes emerging fungi,
      isolated in the aforementioned individuals, which belong to the filamentous and
      dimorphic fungi groups, and yeasts. In view of their number, only the main ones
      are mentioned, together with the clinical manifestations they produce and the
      grounds for their diagnosis and treatment.

PMID- 11209550
TI  - [Chlamydia pneumoniae and vascular pathology].
AB  - An updating of the microbiological and diagnostic characteristics of Chlamydia
      pneumoniae is carried out, and a hypothesis formulated for its probable role in
      the production of the atheromatous plaque. Furthermore, the immunological results
      obtained from patients with peripheral vascular pathology, pneumonia from C.
      pneumoniae, or other genital processes from C. trachomatis, and a healthy control
      group are included. The presence of C. pneumoniae was revealed by PCR techniques
      in biopsies from patients with vascular pathology in a high percentage,
      particularly in samples from the carotid artery (74%) or the aortic wall (83%).
      The true pathogenic power of Chlamydia in vascular processes in questioned.

PMID- 11209551
TI  - [Comparative study of iodine and thyroid gland in biological processes:
      development and reproduction].
AB  - Iodine is an scarce metalloid, essential for life, more abundant in the aquatic
      ecosystem than in land. Marine species do not need to store and transform the
      inorganic iodine into organic iodine through the thyroid gland. Adaptation to
      terrestrial ecosystem has required phylogenetic processes, and animal species
      have used different strategies to solve the iodine captation problem according to
      their needs. Jellyfish lack of thyroid gland while lampery developed the thyroid
      gland during evolution in order to adapt to the terrestrial ecosystem. This
      review is a comparative phylogenetic study of thyroid gland development and
      iodine physiology, includes functional disorders, as well as iodine captation
      ability and requirements during growth and reproduction in different species.

PMID- 11209552
TI  - [Physiopathologic implications of telomerase].
AB  - Telomerase is a specialized RNA-directed DNA polymerase that extends telomeres of
      eukaryotic chromosomes. Telomerase gene expression is active in germinal, stem
      and tumoral cells and repressed in normal human somatic cells. Activation of
      telomerase involves immortalization, while repression of this enzyme involves the
      shortening of telomeres in each round of chromosomal replication. Telomere
      shortening constitutes a mechanism for cells to control cell division and the
      entrance in the replicative senescence state. If the expression of this enzyme is
      forced, senescent human cells will extend their life span reaching the
      immortalization and malignization of the cells. Activation or depression of
      telomerase activity has important implications in aging and cancer therapy.
      Telomerase regulation is a multifactorial process in which telomerase expression,
      post-translational protein-protein interactions and protein phosphorylation are
      involved.

PMID- 11209553
TI  - [The health of the members of the Academy].
AB  - The present paper, analyses the health of the numerary members of the Academy
      since 1791 until 1998 as evaluated through mortality and supervivence registers
      from birth or until their entrance as members. A positive trend of 3.67 years in
      life expectancy appears as compared to male spaniards of their time. Finally,
      biasses of this work are discussed as well as possible factors that could have
      played a role in this life expectancy mirease.

PMID- 11209554
TI  - [Does internal medicine still survive?].
AB  - The author suggest in his lecture in the present of the well versed Royal Academy
      National of Medicine, the concept, current situation and future of Internal
      Medicine. After a brief explanation of its creation and development, in several
      european and north american medical schools, he analyzes the present situation of
      Internal Medicine coming to the conclusion that, as a result of the fragmentation
      of medicine into countless sub-specialties, its survival is even being questioned
      as a medical specialty itself.

PMID- 11209555
TI  - [Current interest of antipneumococcal vaccination].
AB  - Pneumonia acquired in Community (CAP) may be a primary disease occurring in
      healthy individuals or secondary to predisposing factors or comorbidity.
      Prevalence of CAP is 2.6 to 5% for all ages, in USA 12%, for over 65 years 30%.
      Streptococcus pneumoniae is the commonest pathogen 30-50%, H. influenzae in COPD,
      the atypical pneumonia Mycoplasma pn., M. catharralis, Legionella pn.,
      Enterobacteria, anaerobics often in hospital survey. In children is different
      RSV, Parainfluenzae type 3, Rhinovirus in the first 2 years old. Others are S.
      pneumoniae, H. influenzae, Chlamydia sp., etc. Appropriate empiric antibiotic
      therapy choices are based in guidelines. The most common pathogen is S.
      pneumoniae, isolates raised resistance rates to Penicillin to 20-50%, 40% in our
      country and also to Macrolides, with potential clinical failure (21-40%).
      Specially in elderly people and with the comorbidity are recommended the 23
      valent polysaccharide vaccine, effective in bacteremic pneumonia 70-80%. Is not
      effective in children under 2 years, for that is important conjugated vaccine Hib
      (toxoids T, D, CRM197, OMP Nm) to prevent carriers, otitis media and reduce
      exacerbation of these respiratory infections.

PMID- 11209556
TI  - [Present and future of infectious epidemiology].
AB  - A revision is made on the important biological phenomenon of microbial emergency,
      based on model infection diseases in which the author can give the own
      experimental results and experience. The concept of microbial emergency has
      shocked the traditional infectious epidemiology since 1983 when the HIV virus was
      discovered and the informatic network reached an optimum efficiency. In despite
      of the global risk of contagion it is necessary to consider the proximity effect
      in a space-time model as the main cause of infectious diseases diffusion.

PMID- 11209557
TI  - [Current considerations around the search for extraterrestrial life].
AB  - In this paper, the current cosmological topics are considered: a) The fourth
      centenary celebration of Giordano Bruno's death at the Roman's inquisition stake.
      This eminent philosopher, based on the Coppernican Revolution, concibed the
      Cosmos as a infinite universe with innumerable inhabited worlds. He acted on
      reason to believe not only in extraterrestrial life but in extraterrestrial
      intelligent life. Here we write a few words in his memory and honour. b) The
      active project SETI@home in the framework of today's classic program "Search for
      Extra-Terrestrial Intelligence", by means of the reception of radioelectrical
      signals. c) Search for extrasolar planets.

PMID- 11209558
TI  - [A century of evolution, and revolution, in research and development of drugs].

PMID- 11209559
TI  - Laboratory demonstration of vascular smooth muscle function using rat aortic ring
      segments.
AB  - This laboratory exercise uses a simple preparation and a straightforward protocol
      to illustrate many of the basic principles of vascular biology covered in an
      introductory physiology course. The design of this laboratory allows students to
      actively participate in an exercise demonstrating the regulation of arterial tone
      by endothelial and extrinsic factors. In addition, this hands-on laboratory
      allows students to gather data using well-known basic biomedical research
      techniques. Specifically, students are introduced to an isolated organ-chamber
      technique that is widely used to study cellular mechanisms of many tissues
      including vascular smooth muscle contraction and dilation. On the basis of
      student evaluations, participation in the experiments and interpreting data
      reinforce lecture materials on smooth muscle and endothelial cell function and
      illustrate mechanisms regulating vascular tone. Students come away with a greater
      understanding of vascular biology, a deeper appreciation of integrative
      physiology, and an understanding of the process of conducting tissue-chamber
      experiments.

PMID- 11209560
TI  - The Claude Bernard Distinguished Lecture. Teaching in the year 2061.

PMID- 11209561
TI  - Please pass the cauliflower: a recipe for introducing undergraduate students to
      brain structure and function.
AB  - Neurophysiology/pathophysiology content is a frequent source of anxiety for
      undergraduate students and their instructors. This learning module supplements
      traditional lecture and overhead presentations to offer a novel, nonthreatening,
      and entertaining introduction to neuropathology. The module is based on a
      ridiculous analogy between the human brain and the cauliflower. This module has
      been used with both underclassmen and more advanced health science undergraduate
      students and has produced enthusiastic student responses while deescalating both
      student and instructor anxiety.

PMID- 11209562
TI  - Who wants to be a physician? An educational tool for reviewing pulmonary
      physiology.
AB  - Traditional review sessions are typically focused on instructor-based learning.
      However, experts in the field of higher education have long recommended teaching
      modalities that incorporate student-based active-learning strategies. Given this,
      we developed an educational game in pulmonary physiology for first-year medical
      students based loosely on the popular television game show Who Wants To Be A
      Millionaire. The purpose of our game, Who Wants To Be A Physician, was to provide
      students with an educational tool by which to review material previously
      presented in class. Our goal in designing this game was to encourage students to
      be active participants in their own learning process. The Who Wants To Be A
      Physician game was constructed in the form of a manual consisting of a bank of
      questions in various areas of pulmonary physiology: basic concepts, pulmonary
      mechanics, ventilation, pulmonary blood flow, pulmonary gas exchange, gas
      transport, and control of ventilation. Detailed answers are included in the
      manual to assist the instructor or player in comprehension of the material. In
      addition, an evaluation instrument was used to assess the effectiveness of this
      instructional tool in an academic setting. Specifically, the evaluation
      instrument addressed five major components, including goals and objectives,
      participation, content, components and organization, and summary and
      recommendations. Students responded positively to our game and the concept of
      active learning. Moreover, we are confident that this educational tool has
      enhanced the students' learning process and their ability to understand and
      retain information.

PMID- 11209563
TI  - A visual aid for teaching ventilation-perfusion relationships.
AB  - To help students understand the concept of the ventilation-perfusion ratio (VA/Q)
      and the effects that VA/Q mismatching has on pulmonary gas exchange, a "sliding
      rectangles" visual aid was developed to teach VA/Q relationships. Adjacent
      rectangles representing "ventilation" and "perfusion" are slid past one another
      so that portions of the ventilation and perfusion rectangles are not touching,
      illustrating the concepts of dead-space ventilation (VD) and shunt flow (QS). The
      portion of the ventilation bar representing VD is further subdivided into
      anatomical and alveolar VD and used to show the effects of alveolar dead space on
      the PO2 (PAO2) and PCO2 of alveolar air (PACO2); movement away from the "ideal"
      point). Similarly, the portion of the perfusion bar representing QS is used to
      define anatomical and physiological shunts and the effect of shunts on the PO2
      (PaO2) and PCO2 of arterial blood (PaCO2). The genesis of the PAO2-PaO2 (A-a) PO2
      difference as well as the effects of VA/Q mismatching and diffusion abnormalities
      can all be discussed with this visual aid. This approach has greatly assisted
      some students in mastering this traditionally difficult area of respiratory
      physiology.

PMID- 11209564
TI  - The water-tower analogy of the cardiovascular system.
AB  - The cardiovascular system is a complex arrangement of hydraulic, yet living,
      components. The complexity of this system may make it difficult for students to
      see the "forest" instead of the "trees." To better explain the dynamics of
      cardiovascular function and control, an analogy has been drawn to the operation
      of a city water supply. In cities that use a water tower, fresh water is pumped
      up into the tower from a river or other source. The tower serves as a pressure
      reservoir for providing water to homes through a largely parallel arrangement of
      distribution pipes. Local homeowners control their own water usage through
      faucets, whereas the city maintains water pressure by monitoring the level in the
      tower. Key analogous points with the cardiovascular system are the heart as the
      city pump, the aorta as the water tower, arteries as parallel distribution pipes,
      and arterioles as faucets. Baroreceptor reflex control is discussed as well as
      such features as the capacitance role of veins, the skeletal muscle pump, and the
      competition between locally mediated vasodilation and sympathetically mediated
      vasoconstriction. Subjective student and peer evaluations have indicated that
      this analogy is effective in improving student comprehension of the
      cardiovascular system.

PMID- 11209565
TI  - Peer instruction improves performance on quizzes.
AB  - Peer instruction is a cooperative-learning technique that promotes critical
      thinking, problem solving, and decision-making skills. Benson's think-pair-share
      and Mazur's peer-instruction techniques are simple cooperative exercises that
      promote student's participation in class and increase student's interaction with
      each other and with the instructor in a large classroom. We borrowed concepts
      from Benson and Mazur and applied these concepts to enhance student involvement
      during the respiratory component of the medical physiology class. The medical
      physiology class consisted of 256 first-year medical students. The peer
      instruction technique was used for 10 classes. Each class of 50 min was divided
      into three or four short presentations of 12-20 min. Each presentation was
      followed by a one-question, multiple-choice quiz on the subject discussed.
      Questions ranged from simple recall to those testing complex intellectual
      activities. Students were given 1 min to think and to record their first answer.
      Subsequently, students were allowed 1 min to discuss their answers with their
      classmates and possibly correct their first response. The percentage of correct
      answers increased significantly (P < 0.05) after discussion for both recall and
      intellectual questions. These data demonstrate that pausing three to four times
      during a 50-min class to allow discussion of concepts enhanced the students level
      of understanding and ability to synthesize and integrate material.

PMID- 11209566
TI  - Effects of an applied supplemental course on student performance in elementary
      physiology.
AB  - The objective of this study was to determine whether students within a large (100
      160 students) didactic lecture-based course, "Elementary Physiology" (EP), who
      were given an active-learning opportunity would perform better on objective
      examinations over EP material compared with their classroom peers who did not
      have the same active-learning experience. This was achieved by offering the EP
      students the option of taking a supplemental one credit hour discussion-based
      course, "Case Studies in Physiology" (CSP). Approximately 14% of the EP students
      opted for the CSP course. The format of CSP consisted of a one-hour-per-week
      discussion of applied problems based on the factual information presented in EP.
      On a subjective scale of 1 to 4, the CSP students felt that the course helped
      them to understand the EP material (3.5). This was reflected in the EP
      examination results for which the CSP students scored significantly higher
      compared with their non-CSP peers (81.1% vs. 75.7%; P < 0.05). These results
      indicate that when active-learning methods, such as discussion of applied
      problems, are used as a supplement to didactic lectures in physiology,
      performance on objective examinations of lecture material is improved.

PMID- 11209567
TI  - Misconceptions in physiology.

PMID- 11209568
TI  - Combination of didactic lecture with problem-based learning sessions in
      physiology teaching in a developing medical college in Nepal.
AB  - Physiology teaching as an essential part of medical education faces tremendous
      criticism regarding curriculum design, methods of implementation, and application
      of knowledge in clinical practice. In the traditional method of medical
      education, physiology is taught in the first year and involves little
      interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara,
      Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an
      integrated curriculum drawn along the lines of the student-centered, problem
      based, integrated, community-based, elective-oriented, and systematic (SPICES)
      medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr
      Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as
      follows. For a particular topic, objectives are clearly defined and priority
      content areas are identified. An overview is given in a didactic lecture class to
      the entire batch of 100 students. Tutorial classes are conducted thereafter with
      smaller groups of students (25/batch) divided further into five subgroups of five
      students each. In these sessions, a problem is presented to the students as a
      focus for learning or as an example of what has just been taught. Each problem
      was accompanied with relevant questions to streamline the students' thought
      processes. A tutor is present throughout the session not as an instructor but as
      a facilitator of the learning process. A questionnaire sought students' opinion
      on the usefulness of this approach, relevance of the combination of problem-based
      learning (PBL) sessions and didactic lectures in understanding a particular topic
      and relating clinical conditions to basic mechanisms, and improvement of
      performance on the university final examination. The majority of the students
      opined that the combination of didactic lectures and PBL sessions was definitely
      beneficial regarding all the above-mentioned aspects of learning. The university
      results corroborated their opinion. Thus it may be considered that a judicious
      mixture of didactic lectures and PBL sessions is beneficial as a teaching module
      of physiology in medical schools.

PMID- 11209569
TI  - Managed care reform: state legislative trends in 1999.

PMID- 11209570
TI  - The ACS Capital Program: ensuring the care of the President.

PMID- 11209571
TI  - Are "impervious" surgical gowns really liquid-proof?

PMID- 11209572
TI  - PATH (physicians at teaching hospitals) audits.

PMID- 11209573
TI  - Gender and body mass index as related to the night-eating syndrome in obese
      outpatients.

PMID- 11209574
TI  - Male adolescents identify their weight gain practices, reasons for desired weight
      gain, and sources of weight gain information.

PMID- 11209575
TI  - Alternative health care education in dietetic training programs: a survey of
      perceived needs.

PMID- 11209576
TI  - Use and perceived effectiveness of strategies for enhancing food and nutrient
      intakes among elderly persons in long-term care.

PMID- 11209577
TI  - Position of the American Dietetic Association: food fortification and dietary
      supplements.
AB  - Wise food choices provide the necessary foundation for optimal nutrition. Science
      has not fully identified the specific chemical components that account for the
      benefits of healthy eating patterns. Selection of a variety of foods, using tools
      such as the USDA/HHS Dietary Guidelines for Americans and the USDA Food Guide
      Pyramid, is the best way to provide a desirable balance, without excessive
      intakes of macronutrients, micronutrients and other beneficial components of
      foods. Nevertheless, for certain nutrients and some individuals, fortification,
      supplementation, or both may also be desirable. Nutrient intakes from all these
      sources should be considered in dietary assessments, planning and
      recommendations. The recommendations of the National Academy of Sciences' Food
      and Nutrition Board provide a sound scientific basis for vitamin and mineral
      intakes. Intakes exceeding those recommendations have no demonstrated benefit for
      the normal, healthy population. Dietetics professionals should base
      recommendations for use of fortified foods or supplements on individualized
      assessment and sound scientific evidence of efficacy and safety. It is the
      position of the American Dietetic Association that the best nutritional strategy
      for promoting optimal health and reducing the risk of chronic disease is to
      wisely choose a wide variety of foods. Additional vitamins and minerals from
      fortified foods and/or supplements can help some people meet their nutritional
      needs as specified by science-based nutrition standards such as the Dietary
      Reference Intakes (DRI).

PMID- 11209578
TI  - Position of the American Dietetic Association: the impact of fluoride on health.
AB  - Fluoride is an important element for mineralization of body tissues. The use of
      topical and systemic fluoride for oral health has resulted in major reductions in
      dental caries and its associated disability. Fluoridation of public water
      supplies has been endorsed by over 90 professional health organizations as the
      most effective dental public health measure in existence. Still, about half of
      the US population fails to receive the maximum benefits possible from community
      water fluoridation and the use of fluoride products. Fluoride also plays a role
      in bone health. The role of high doses of fluoride for prevention of osteoporosis
      is undergoing active study and is considered experimental at this point.
      Dietetics professionals should routinely monitor and promote the use of systemic
      and topical fluorides, especially in children and adolescents. The American
      Dietetic Association strongly reaffirms its endorsement of the use of systemic
      and topical fluorides, including water fluoridation, at appropriate levels of
      intake, as an important public health measure. However, clients should be
      cautioned that experimental use of high intakes of fluoride should be avoided
      unless they are participating in clinical trials.

PMID- 11209579
TI  - Complexities beyond simple survival: challenges in providing care for HIV
      patients.

PMID- 11209580
TI  - MNT (medical nutrition therapy): an innovative employee-friendly benefit that
      saves.

PMID- 11209581
TI  - Effects of age on validity of self-reported height, weight, and body mass index:
      findings from the Third National Health and Nutrition Examination Survey, 1988
      1994.
AB  - OBJECTIVE: To compare self-reported to measured heights and weights of adults
      examined in the Third National Health and Nutrition Examination Survey (NHANES
      III), and to determine to what extent body mass index (BMI) calculated from self
      reported heights and weights affects estimates of overweight prevalence compared
      with BMI calculated from measured values. DESIGN: A complex sample design was
      used in NHANES III to obtain a nationally representative sample of the US
      civilian, noninstitutionalized population. During household interviews, survey
      respondents were asked their height and weight. Trained health technicians
      subsequently measured height and weight using standardized procedures and
      equipment. SUBJECTS: The analytical sample consisted of 7,772 men and 8,801 women
      20 years old and older. STATISTICAL ANALYSES PERFORMED: Only persons with
      measured and self-reported heights and weights were included in the analysis, and
      statistical sampling weights were applied. t Tests, Pearson product moment
      correlation coefficients, sensitivity, and specificity analyses were used to
      determine the validity of self-reported measurements and prevalence estimates of
      overweight, defined as BMI of 25 or greater. RESULTS: Age is an important factor
      in classifying weight, height, BMI, and overweight from self-reports.
      Statistically significant differences were found for the mean error (measured
      self-reported values) for height and BMI that were notably larger for older age
      groups. For example, the mean error for height ranged from 2.92 to 4.50 cm for
      women and from 3.06 to 4.29 cm for men, 70 years and older. Despite the high
      correlation between measured and self-reported data, the prevalence of overweight
      calculated from measured values was higher than that calculated from self
      reported values among older adults. When calculated with self-reported height,
      BMI was one unit lower than when calculated from measured height for persons > or
      = 70 years. Specificity was high but sensitivity decreased with increasing age
      cohorts. Regression equations are provided to determine actual height from self
      reported values for older adults. CONCLUSION/APPLICATIONS: Self-reported heights
      and weights can be used with younger adults, but they have limitations for older
      adults, ages > or = 60 years. In research studies and in clinical settings
      involving older adults, failure to measure height and weight can result in
      subsequent misclassification of overweight status. Therefore, registered
      dietitians are encouraged to obtained a measured weight and height using a
      calibrated scale and stadiometer.

PMID- 11209582
TI  - Is there a consumer backlash against the diet and health message?
AB  - OBJECTIVE: Anecdotal evidence exists that the public is becoming skeptical about
      nutrition messages. This article examines whether there is a backlash against
      dietary recommendations and whether it is associated with less healthful diets.
      DESIGN/PARTICIPANTS: Data are from a 1997-1998 Washington State random-digit-dial
      survey of 1,751 adults designed to monitor attitudes and behavior related to
      cancer risk and prevention. STATISTICAL ANALYSES: Responses to the nutrition
      backlash survey were weighted to reflect the Washington State population. Linear
      regression was used to examine associations of nutrition backlash with fat and
      fruit and vegetable intake. RESULTS: This survey did not find strong evidence
      that nutrition backlash was widespread. However, 70% of respondents thought that
      Americans are obsessed with the fat in their diet and that the government should
      not tell people what to eat. More than a quarter agreed with the statement that
      eating low-fat foods takes the pleasure out of eating. Nutrition backlash was
      associated with less healthful diets: individuals showing high backlash had a fat
      related diet habits score of 2.11 compared with a score of 1.73 among those
      showing low backlash (P for trend = .001), which corresponds to a difference of
      roughly 4 percentage points in percentage energy from fat. Individuals showing
      high backlash reported eating only 2.72 servings of fruits and vegetables per
      day, compared with 3.35 servings among those showing low backlash (P for trend =
      .001). APPLICATIONS/CONCLUSIONS: Nutrition professionals need to ensure that
      dietary recommendations are clear and positive to avoid the possibility that
      consumers may disregard nutrition messages entirely.

PMID- 11209583
TI  - The 30-second effect: an experiment revealing the impact of television
      commercials on food preferences of preschoolers.
AB  - OBJECTIVE: To examine whether televised food commercials influence preschool
      children's food preferences. DESIGN: In this randomized, controlled trial,
      preschool children viewed a videotape of a popular children's cartoon either with
      or without embedded commercials. Children were then asked to identify their
      preferences from pairs of similar products, one of which was advertised in the
      videotape with embedded commercials. Preschoolers' parents were interviewed to
      determine children's demographic characteristics and media use patterns.
      SUBJECTS: Forty-six 2- to 6-year-olds from a Head Start program in northern
      California. STATISTICAL ANALYSES: For demographic and media use characteristics,
      univariate data were examined and Student t and chi 2 tests were used to test for
      differences between the control and treatment groups. We calculated the Cochran Q
      statistic to assess whether the proportion of those choosing advertised food
      items was significantly higher in the treatment group than in the control group.
      RESULTS: Children exposed to the videotape with embedded commercials were
      significantly more likely to choose the advertised items than children who saw
      the same videotape without commercials (Qdiff = 8.13, df = 1, P < .01).
      CONCLUSIONS/APPLICATIONS: Even brief exposures to televised food commercials can
      influence preschool children's food preferences. Nutritionists and health
      educators should advise parents to limit their preschooler's exposure to
      television advertisements. Furthermore, advocates should raise the public policy
      issue of advertising and young children, especially given the recent epidemic of
      childhood obesity and the ever-changing media environment.

PMID- 11209584
TI  - Comparison of visual estimates of children's portion sizes under both shared
      plate and individual-plate conditions.
AB  - OBJECTIVE: This paper compares the accuracy of visual estimations of children's
      food intake in settings where several children eat together off 1 plate vs
      individual-plate eating scenarios. DESIGN: Eight trained observers were tested in
      their ability to estimate food portions consumed by children enacting common
      eating scenarios. Foods were categorized by food group and according to their
      presentation by individual-plate and shared-plate. Observed food weight estimates
      were compared to actual weights. SUBJECTS/SETTING: The 8 observers visually
      estimated 69 food portions of children eating alone and 26 portions where
      children were eating from a shared plate. This study was carried out in Sarlahi
      District, a rural, central lowland region of Nepal. STATISTICAL ANALYSES:
      Pearson's correlation coefficients were calculated to examine associations
      between estimated and actual weights. A fixed effects model was constructed to
      compare observers. RESULTS: Analyses revealed that observer estimates of food
      weights under field conditions were well correlated with actual weights for
      individual-plate (r = 0.89) and for shared-plate (r = 0.84) scenarios. Observers
      estimated food weights when children ate together on a shared plate less
      accurately than they did in settings where children ate alone. With the exception
      of 1 observer, observers did not differ significantly in their ability to
      estimate food weights. Accuracy of estimations was influenced by food weight with
      greater error associated with food quantities of less than 70 g. CONCLUSIONS:
      Visual estimation is a relatively accurate, valid method of assessing child food
      intake under rural field conditions, and the only method to obtain accurate
      information on dietary intake in regions where shared-plate eating is frequent.

PMID- 11209585
TI  - No differences in growth or body composition from age 12 to 24 months between
      toddlers consuming 2% milk and toddlers consuming whole milk.
AB  - OBJECTIVE: To determine whether consumption of 2% milk during the second year of
      life leads to reduced growth or lower percentage body fat compared with
      consumption of whole milk. SUBJECTS: Subjects were healthy toddlers who
      participated in a larger trial examining the effects of the timing of
      introduction of solid foods on growth. DESIGN: Three-day diet diaries,
      anthropometric measurements, and body composition determined by dual-energy x-ray
      absorptiometry were assessed at 12, 18, and 24 months of age. At age 12 months,
      the toddlers were similar in length, weight, percentage body fat, and total
      energy intake. From 12 to 24 months of age, milk consumption consisted of whole
      milk exclusively in one group (n = 23) and 2% milk exclusively in another group
      (n = 28). STATISTICAL ANALYSES: Differences between the 2 groups in
      anthropometric measurements, changes in anthropometric measurements, and dietary
      intakes were determined by Student t tests. Mean differences were considered
      significant at the P = .05 level. Data are presented as mean +/- standard
      deviation. RESULTS: Despite lower intakes of total fat and saturated fat in the
      2% milk group, there were no differences in height, weight, and percentage body
      fat. Total energy intake was not reduced in the 2% milk group. APPLICATIONS:
      Reductions in total fat and saturated fat intake in toddlers can be achieved
      through the use of 2% milk without compromising growth.

PMID- 11209586
TI  - Breast-feeding practices among WIC participants in Hawaii.
AB  - OBJECTIVE: To describe breast-feeding practices and identify correlates of breast
      feeding among participants in the Hawaii Special Supplemental Nutrition Program
      for Women, Infants, and Children (WIC) program. DESIGN: A cross-sectional survey.
      SUBJECTS/SETTING: We conducted structured, in-person interviews with 535 women at
      WIC clinics throughout Hawaii (95% response rate). The interview collected
      information on maternal characteristics and infant-feeding practices. STATISTICAL
      ANALYSES: Breast-feeding prevalence was examined by infant age and predictors of
      infant-feeding method were examined via bivariate tests and multivariable
      logistic regression analysis. Reported breast-feeding promotion efforts in health
      care settings outside of WIC were also examined. RESULTS: Most women (82%)
      attempted to breast-feed, albeit for short durations for many women; of the women
      who breast-fed in combination with formula feeding, 46% introduced formula within
      the first week after delivery. Significant predictors of breast-feeding
      initiation included previous breast-feeding experience, having a close relative
      or friend who breast-fed, multiparity, Asian/Pacific Island ethnicity (other than
      Filipino), and being foreign-born. Significant predictors of mixed feeding (vs
      exclusive breast-feeding) included working or attending school, age less than 20
      years, Hawaiian/part Hawaiian or Filipino ethnicity, being Hawaiian-born, and
      residing in Oahu county. CONCLUSIONS: Although most women in this population
      initiated breast-feeding, formula was usually introduced at an early age. This
      study identified several factors associated with breast-feeding initiation and
      exclusive breast-feeding, factors that may prove useful for the development of
      appropriate interventions to promote these behaviors.

PMID- 11209587
TI  - Nutrition education in health professions programs: a survey of dental, physician
      assistant, nurse practitioner, and nurse midwifery programs.
AB  - OBJECTIVE: This study determined the perceived needs and curriculum
      recommendations for nutrition education, and expected competencies in nutrition
      of graduates, of predoctoral dental, physician assistant, nurse practitioner, and
      midwifery programs. SUBJECTS: Surveys were mailed to all dental schools (n = 54)
      and physician assistant (n = 95), nurse practitioner (n = 150), and certified
      nurse midwifery programs (n = 42) in the United States. Surveys were addressed to
      the program directors of physician assistant, nurse practitioner, and certified
      nurse midwifery programs and the associate or assistant dean of academic affairs
      of dental schools. DESIGN: A 4-page survey was designed and pilot-tested. The
      survey included questions on respondents perceptions of and recommendations for
      their programs in nutrition education and expected nutrition competence level of
      their graduates. A reminder postcard was mailed 2 weeks after the initial mailing
      to nonrespondents; a second survey was mailed to nonrespondents 1 month after the
      postcard mailing. STATISTICAL ANALYSES: Data were analyzed using JMP-IN software.
      Frequencies, and chi 2 analyses, Wilcoxon rank sum test, Pearson chi 2 test.
      RESULTS: The overall response rate was 80.7% (n = 276). Perceived needs for
      competence in nutrition varied by respondents. Most of the physician assistant
      nurse midwifery, and nurse practitioner program directors had similar perceptions
      of graduates' competence in nutrition. Dental school academic administrators
      differed significantly from the program directors about the perceived need for
      knowing how to counsel on a modified diet and how and when to refer to a
      registered dietitian. Time was the most important factor that would enhance
      provision of nutrition education in the programs. Computer-based programs were
      the most frequently requested education tool to enhance nutrition education.
      APPLICATIONS/CONCLUSIONS: The disciplines agreed that graduates of dental schools
      and physician assistant, nurse practitioner, and nurse midwifery programs need
      some level of competence in nutrition relative to their discipline. Registered
      dietitians involved in health professions education can play an active role in
      developing practice-based, time-sensitive, and flexible strategies for nutrition
      education of these health professions groups.

PMID- 11209588
TI  - Biased over- or under-reporting is characteristic of individuals whether over
      time or by different assessment methods.
AB  - Seven studies with repeated measurements of energy intake and/or nitrogen intake
      were examined to determine whether misreporting is characteristic of some persons
      or occurs randomly. Four of the studies were validated by doubly labeled water
      measurements of energy expenditure. Reporting validity was expressed as the ratio
      of energy intake to energy expenditure. Ratios were consistently below the
      expected value of 1.0 for some subjects and consistently above 1.0 for others,
      indicating characteristic reporting validity within subjects. Two year-long
      studies provided 4 to 12 measurements and a total number of days sufficient to
      measure individual habitual intake. Subjects mean energy intake to basal
      metabolic rate (BMR) ratios were < 1.35 in 45% and 47% and < 1.35 at every
      measurement in 25% of subjects. This indicated persistent underreporting over
      time, because 1.35 x BMR is the minimum energy expenditure compatible with a
      normally active lifestyle. Three of the studies used more than 1 assessment
      method (validated by doubly labeled water and/or urinary nitrogen excretion).
      There was a tendency for persons determined to be underreporters by 1 method to
      be also underreporters when tested by other methods. We conclude that biased over
      or underreporting is characteristic of some persons. Thus, repeat measurements
      do not necessarily provide valid measures of individual intake, extreme intakes
      may reflect under- and overreporting rather than true low or high intakes, and
      subjects most prone to reporting bias may be repeatedly misclassified in
      quantiles of the distribution. This presents a challenge to dietitians
      nutritionists, and statisticians both for the design of surveys and the handling
      of flawed data.

PMID- 11209589
TI  - Validation for MEDFICTS, a dietary assessment instrument for evaluating adherence
      to total and saturated fat recommendations of the National Cholesterol Education
      Program Step 1 and Step 2 diets.
AB  - MEDFICTS is a dietary assessment instrument designed to evaluate patient
      adherence to the National Cholesterol Education Program Step 1 and Step 2 diets.
      It provides a quick way to record food intake, portion size, and frequency of
      intake while focusing on foods that are the primary contributors of total fat,
      saturated fat, and cholesterol in the average American diet (i.e., Meats, Eggs,
      Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the
      Table and Snacks). MEDFICTS was validated in a pilot study using 16 computer
      analyzed sets of 4-day food records randomly selected from 7-day food records
      collected in the Diet Modification Clinic at Baylor College of Medicine, Houston,
      Tex). MEDFICTS correctly identified the 11 patients consuming a Step 1 diet, the
      2 patients consuming the Step 2 diet and the 3 patients consuming an average
      American diet. Pearson correlation coefficients between MEDFICTS and the 4-day
      records were significant for percent energy from total fat (r = 0.81, P < .0002),
      saturated fat (r = 0.79, P < .0003), and cholesterol (r = 0.52, P < .039).
      Pearson correlation coefficients from 2 follow-up validation studies (3-day diet
      records [n = 22] through the Mary Imogene Bassett Research Institute,
      Cooperstown, NY, and a second study at the Diet Modification Clinic [n = 26])
      also correlated significantly with percent energy from total fat (r = 0.56, P <
      .006; r = 0.71, P < .0001), saturated fat (r = 0.60, P < .003; r = 0.71, P <
      .0001), and approached significance for cholesterol intake (r = 0.54, P < .009; r
      = 0.39, P < .051) respectively. MEDFICTS is a quick, efficient tool that can be
      used in cardiovascular health screening, clinical practice, or research for the
      assessment of adherence to Step 1 or 2 diets. It can be self administered, and
      when reviewed with a dietitian, can provide an opportunity for nutrition
      education.

PMID- 11209590
TI  - Avoid unnecessary drug-related carbohydrates for patients consuming the ketogenic
      diet.
AB  - The ketogenic diet is intended for use in patients with epilepsy whose seizures
      are resistant to conventional drug therapy. It is a diet high in fat and low in
      carbohydrate and protein content, and is intended to produce ketosis from the
      incomplete metabolism of fats. It is safe and effective--many patients with
      severe, drug-resistant epilepsy show improvement. Limiting carbohydrate intake in
      patients to obtain the necessary ratio of fats to carbohydrates and protein
      requires careful planning and, in children, parental involvement. Although the
      ketogenic diet is professionally planned, an unrecognized source of carbohydrates
      is prescription and over-the-counter medications. If the carbohydrate content of
      medications is overlooked, ketosis can be inhibited with potential loss of
      seizure control occurring. Thus, it is essential for care providers and parents
      to know the carbohydrate content of medications, including not only the typical
      sugar content, but also the content of reduced carbohydrate (e.g., glycerin).
      From information supplied by drug manufacturers, we determined the carbohydrate
      content of commonly used medications. By knowing the carbohydrate content of
      these often used medications, the additional carbohydrate content of the
      medications can be taken into account and adjustments can be made in the
      ketogenic diet.

PMID- 11209591
TI  - The social ecology of health: leverage points and linkages.
AB  - The authors demonstrate the usefulness of social ecology theory for improving the
      treatment and prevention of poor health. The social ecology of health, unlike the
      topics of previous triptychs in Behavioral Medicine, is a field without a clearly
      defined body of literature. We begin with an overview of the ecological
      perspective and ecological theory as outlined by Bronfenbrenner and colleagues,
      provide examples of how ecological concepts have been demonstrated to influence
      health, and discuss how these concepts can be used by health professionals. We
      present a heuristic model illustrating leverage points and linkages (i.e.,
      socioeconomic status, family, work, and school), for health, and we conclude with
      a consideration of the benefits of social ecology to health professionals and a
      summary of the limitations of the ecological model.

PMID- 11209592
TI  - Group interventions and the limits of behavioral medicine.
AB  - A wide range of interventions has been devised to address health hazards in the
      social and physical environment. The authors propose a 2-dimensional matrix to
      organize these interventions. The timing of interventions is divided into 4
      stages: preventing exposure to hazard (proactive primary prevention), preventing
      symptoms from appearing (reactive primary prevention), preventing early symptoms
      from becoming chronic or leading to disease (secondary prevention), and managing
      the disease (tertiary prevention). The level at which the intervention is
      targeted is divided into 2 categories: micro (individual or family) and macro
      (more aggregate social level). Large-scale interventions such as media campaigns
      can target either individual health behaviors (microlevel) or the environment
      (macrolevel). This typology is illustrated with interventions designed to prevent
      or ameliorate the health consequences of adverse employment changes such as job
      loss. The analysis concludes that behavioral medicine and public health
      approaches are differentially suited to different intervention types.

PMID- 11209593
TI  - Social ecology and behavioral medicine: implications for training, practice, and
      policy.
AB  - Social ecology offers a conceptual framework for understanding the etiology of
      multiple health problems and a basis for designing broad-gauge educational,
      therapeutic, and policy interventions to enhance personal and community well
      being. Implications of social ecology for behavioral medicine are considered in
      relation to the development of diagnostic and therapeutic practices, professional
      training programs, and health policies implemented at municipal, state, and
      national levels. By influencing the training and practices of healthcare
      professionals and the decisions of corporate and community leaders, behavioral
      medicine can expand the scope and impact of future interventions beyond the
      health gains achievable through provision of direct services to patient
      populations. Potential barriers to establishing ecologically based health
      programs and policies and directions for research at the interface of behavioral
      medicine, social ecology, and public health are discussed.

PMID- 11209594
TI  - Psychological stress may induce increased humoral and decreased cellular
      immunity.
AB  - Stress alters immune function and affects different immune cell populations in
      different ways. The authors examined whether psychological stress has different
      effects on the production of macrophage, T-helper 1(Th1) cell, and T-helper
      2(Th2) cell-derived cytokines. Forty-two college students were recruited and
      their blood was sampled on the day they were to take a stressful academic
      examination and again 4 weeks after the examination. The stress from the academic
      examination significantly increased IL-1 beta, IL-6, and IL-10 and decreased IFN
      gamma production. These findings suggest that examination stress may increase Th2
      cell-mediated humoral immunity and macrophage activities and may decrease Th1
      cell-mediated cellular immunity.

PMID- 11209595
TI  - Crystal structure of F2NO+AsF6- and method for extracting meaningful geometries
      from oxygen/fluorine disordered crystal structures.

PMID- 11209596
TI  - A Baker-Figgis isomer of conventional sandwich polyoxometalates.
      H2Na14[FeIII2(NaOH2)2(P2W15O56)2], a diiron catalyst for catalytic H2O2-based
      epoxidation.

PMID- 11209597
TI  - Dinuclear and heteropolynuclear complexes containing Mo2(4+) units.
AB  - The quadruply bonded compound Mo2(DpyF)4 (1), where DpyF- is the anion of N,N'
      di(2-pyridyl)formamidine, has been prepared by ligand substitution reactions of
      Mo2(OOCCF3)4 and either the neutral ligand, HDpyF, at ambient temperature or its
      lithium salt, LiDpyF, under refluxing conditions. An X-ray structural analysis
      shows that 1 has a paddlewheel structure with a [symbol: see text] distance of
      2.1108(6) A. Reaction of 1 with CoCl2 in methanol produces the paramagnetic
      compound [Mo2Co(DpyF)4][CoCl4].2MeOH (2). The Co(II) atom in the cation
      [Mo2Co(DpyF)4]2+ resides on a low-spin hexacoordinate environment (S = 1/2) with
      a Co...Mo separation of 2.979(6) A, suggesting there is no direct bonding
      interaction between the Co and Mo atoms. The Mo-Mo distance of 2.1096(5) A is
      similar to that in 1. Reaction of 1 and CuCl in methanol yields
      [Mo2Cu4(DpyF)4Cl2][CuCl2]2.2MeOHxEt2O (3). In the cation there are two copper
      atoms on each side of the Mo2 core. Each is coordinated to two pyridyl nitrogen
      atoms of the cis DpyF- ligands and loosely bridged to the other by a chloride
      ion. As a result, the Cu(I) atoms are not aligned with the Mo2 unit. The Cu to Mo
      separations are in the range 3.003(1)-3.015(1) A, and the Mo-Mo distance of
      2.127(1) A is comparable to those in 1 and 2.

PMID- 11209598
TI  - Di-tert-butyl phosphate complexes of cobalt(II) and zinc(II) as precursors for
      ceramic M(PO3)2 and M2P2O7 materials: synthesis, spectral characterization,
      structural studies, and role of auxiliary ligands.
AB  - Reaction of the metal acetates M(OAc)2xH2O with di-tert-butyl phosphate (dtbp-H)
      (3) in a 4:6 molar ratio in methanol or tetrahydrofuran followed by slow
      evaporation of the solvent results in the formation of metal phosphate clusters
      [M4(mu 4-O)(dtbp)6] (M = Co (4, blue); Zn (5, colorless)) in nearly quantitative
      yields. The same reaction, when carried out in the presence of a donor auxiliary
      ligand such as imidazole (imz) and ethylenediamine (en), results in the formation
      of octahedral complexes [M(dtbp)2(imz)4] (M = Co (6); Ni (7); Zn (8)) and
      [Co(dtbp)2-(en)2] (9). The tetrameric clusters 4 and 5 could also be converted
      into mononuclear 6 and 8; respectively, by treating them with a large excess of
      imidazole. The use of slightly bulkier auxiliary ligand 3,5-dimethylpyrazole (3,5
      dmp) in the reaction between cobalt acetate and 3 results in the isolation of
      mononuclear tetrahedral complex [Co(dtbp)2(3,5-dmp)2] (10) in nearly quantitative
      yields. Perfectly air- and moisture-stable samples of 4-10 were characterized
      with the aid of analytical, thermoanalytical, and spectroscopic techniques. The
      molecular structures of the monomeric pale-pink compound 6, colorless 8, and deep
      blue 10 were further established by single-crystal X-ray diffraction studies.
      Crystal data for 6: C28H52CoN8O8P2, a = 8.525(1) A, b = 9.331(3) A, c = 12.697(2)
      A, alpha = 86.40(2) degrees, beta = 88.12(3) degrees, gamma = 67.12(2) degrees,
      triclinic, P1, Z = 1. Crystal data for 8: C28H52N8O8P2Zn, a = 8.488(1) A, b =
      9.333(1) A, c = 12.723(2) A, alpha = 86.55(1) degrees, beta = 88.04(1) degrees,
      gamma = 67.42(1) degrees, triclinic, P1, Z = 1. Crystal data for 10:
      C26H52CoN4O8P2, a = b = 18.114(1) A, c = 10.862(1) A, tetragonal, P4(1), Z = 4.
      The Co2+ ion in 6 is octahedrally coordinated by four imidazole nitrogens which
      occupy the equatorial positions and oxygens of two phosphate anions on the axial
      coordination sites. The zinc derivative 8 is isostructural to the cobalt
      derivative 6. The crystal structure of 10 reveals that the central cobalt atom is
      tetrahedrally coordinated by two phosphate and two 3,5-dmp ligands. In all
      structurally characterized monomeric compounds (6, 8, and 10), the dtbp ligand
      acts as a monodentate, terminal ligand with free P=O phosphoryl groups. Thermal
      studies indicate that heating the samples at 171 (for 4) or 93 degrees C (for 5)
      leads to the loss of twelve equivalents of isobutene gas yielding carbon-free
      [M4(mu 4-O)(O2P(OH)2)6], which undergoes further condensation by water
      elimination to yield a material of the composition Co4O19P6. This sample of 4
      when heated above 500 degrees C contains the crystalline metaphosphate Co(PO3)2
      along with amorphous pyrophosphate M2P2O7 in a 2:1 ratio. Similar heat treatment
      on samples 6-8 results in the exclusive formation of the respective
      metaphosphates Co(PO3)2, Ni(PO3)2, and Zn(PO3)2; the tetrahedral derivative 10
      also cleanly converts into Co(PO3)2 on heating above 600 degrees C.

PMID- 11209599
TI  - Topologically constrained manganese(III) and iron(III) complexes of two cross
      bridged tetraazamacrocycles.
AB  - A family of Mn3+ and Fe3+ complexes of 4,11-dimethyl-1,4,8,11
      tetraazabicyclo[6.6.2]hexadecane (1) and 4,10-dimethyl-1,4,7,10
      tetraazabicyclo[5.5.2]tetradecane (2) has been prepared by the chemical oxidation
      of the divalent manganese and iron analogues. The ligands are ethylene cross
      bridged tetraazamacrocycles derived from cylam and cyclen, respectively. The
      synthesis and characterization of these complexes, including X-ray crystal
      structure determinations, are described. The structural evidence demonstrates
      that the tetradentate ligands enforce distorted octahedral geometries on the
      metal ions, with two cis sites occupied by labile ligands. Magnetic measurements
      reveal that the complexes are high spin with typical magnetic moments. Cyclic
      voltammetry shows reversible redox processes for the Fe3+/Fe2+ couples of the
      iron(III) complexes, while Mn3+/Mn2+ and Mn4+/Mn3+ couples were observed for the
      complexes with manganese(III). The manganese chemistry of 1 was studied in depth.
      The dichloro manganese(III) cation of 1 undergoes facile ligand substitution
      reactions at the labile, monodentate sites, for example substituting azide for
      chloride ligands. Air oxidation of the dichloro complex of Mn (1)2+ in basic
      solution does not give the expected mu-oxo dimeric product common to manganese.
      Instead, an unusual manganese(III)-OH complex has been isolated from this
      reaction and structurally characterized. A similar reaction under slightly
      different conditions gives a putative MnIII(OH)2 complex that metathesizes to
      MnIII(OMe)2 upon recrystallization from methanol.

PMID- 11209600
TI  - Imprinting structural information from a GpG ligand into the configuration of a
      chiral diamine ligand through second-sphere communication in platinum(II)
      complexes.
AB  - Cisplatin forms the cis-Pt(NH3)2(d(GpG)) cross-link with DNA. We have recently
      created novel d(GpG) conformations by using "retro models" (complexes having
      bulky carrier ligands designed to slow d(GpG) dynamic motion). Our results define
      four conformer classes: HH1, HH2, delta HT1, and delta HT2, with a head-to-head
      or head-to-tail base orientation and a phosphodiester backbone with a normal (1)
      or opposite (2) propagation direction. Moreover, each G residue can be syn or
      anti, and the base canting can be left-handed (L) or right-handed (R). Thus, 32
      variants of cis-Pt(NH3)2(d(GpG)) are conceivable, but the adduct is too dynamic
      to study. Thus far, by using retro models, we have obtained evidence for five
      variants with d(GpG) but only four with GpG. We therefore selected Me2DAPPt(GpG)
      complexes for study by 1H and 31P NMR spectroscopy, CD spectroscopy, and
      molecular mechanics and dynamics (MMD) calculations. Coordinated Me2DAP (N,N'
      dimethyl-2,4-diaminopentane) has N, C, C, N chiral centers designated, for
      example, as R,R,R,R. This ligand has greater flexibility and more readily
      inverted N centers than ligands used previously in GpG retro models. One goal was
      to determine whether the GpG ligand can control the configuration of a carrier
      ligand. (R,R,R,R)-Me2DAPPt(GpG) forms the anti, anti HH1 R variant almost
      exclusively. Equal populations of the two possible linkage isomers of (S,R,R,R)
      Me2DAPPt(GpG) are formed, both favoring the anti, anti HH1 R, variant; however,
      the isomer with the 5'-G cis to the S nitrogen has sharper signals, suggesting
      that interligand interactions are more favorable. Indeed, this linkage isomer was
      the major product of isomerization when (R,R,R,R)-Me2DAPPt(GpG) was kept at pH
      approximately 9.5 to allow N center equilibration. Steric clashes between the
      Me2DAP C-Me groups and the G O6 atoms found by MMD calculations appear to
      disfavor the HH1 conformer of (S,S,S,S)-Me2DAPPt(GpG) and (S,S,S,R)-Me2DAPPt(GpG)
      complexes. These two complexes have a significant population of the anti, syn
      delta HT1 conformer, as indicated by broad 1H NMR signals and by 31P NMR and CD
      data. Equilibration of (S,S,S,R)-Me2DAPPt(GpG) at pH 9.5 leads to a mixture of
      (S,S,S,S)-Me2DAPPt(GpG) and at least one isomer of (S,S,S,R)-Me2DAPPt(GpG). Thus,
      second-sphere communication (hydrogen bonding and steric interligand
      interactions) influences both GpG conformation and Me2DAP configuration.

PMID- 11209601
TI  - Cisplatin-DNA cross-link retro models with a chirality-neutral carrier ligand:
      evidence for the importance of "second-sphere communication".
AB  - We employ retro models, cis-PtA2G2 (A2 = a diamine, G = guanine derivative), to
      assess the cross-linked head-to-head (HH) form of the cisplatin-DNA d(GpG) adduct
      widely postulated to be responsible for the anticancer activity. Retro models are
      designed to have minimal dynamic motion to overcome problems recognized in models
      derived from cisplatin [A2 = (NH3)2]; the latter models are difficult to
      understand due to rapid rotation of G bases about the Pt-N7 bond in solution and
      the dominance of the head-to-tail (HT) form in the solid. Observation of an HH
      form is unusual for cis-PtA2G2 models. Recently, we found the first HH forms for
      a cis-PtA2G2 model with A2 lacking NH groups in a study of new Me2ppzPtG2 models.
      (Me2ppz, N,N'-dimethylpiperazine, has inplane bulk which reduces dynamic motion
      by clashing with the G O6 as the base rotates into the coordination plane from
      the ground state position approximately perpendicular to this plane G = 5'-GMP
      and 3'-GMP.) The finding of an HH form (albeit in a mixture with HT forms) with
      both G H8 signals unusually downfield encouraged us to study additional
      Me2ppzPtG2 analogues in order to explain the unusual spectral features and to
      identify factors that influence the relative stability of HT and HH forms.
      Molecular modeling techniques suggest HH structures with the H8's close to the
      deshielding region of the z axis of the magnetically anisotropic Pt atom,
      explaining the atypical shift pattern. When G = 1-Me-5'-GMP, we obtained NMR
      evidence that the HH rotamer has a high abundance (34%) and that the three
      rotamers have nearly equal abundance. These findings and the observation that the
      relative HT distributions varied little or not at all as a function of pH when G
      = Guo, 1-MeGuo, or 1-Me-5'-GMP are consistent with two of our earlier proposals
      concerning phosphate groups in HT forms of cis-PtA2(GMP)2 complexes. We proposed
      that a G phosphate group can form hydrogen bonds with the cis G N1H ("second
      sphere" communication) and (for 5'-phosphate) A2 NH groups. The new results with
      1-Me-5'-GMP led us to propose a new role for a 5'-phosphate group; it can also
      favor the HH form by counteracting the natural preference for the G bases to
      adopt an HT orientation. Finally, the HH form was also sufficiently abundant to
      allow observation of a distinct 195Pt NMR signal (downfield of the resonance
      observed for the HT forms) for several complexes. This is the first report of an
      HH 195Pt NMR signal for cis-PtA2G2 complexes.

PMID- 11209602
TI  - Synthesis and characterization of iridium 1,3,5-triaza-7-phosphaadamantane (PTA)
      complexes. X-ray crystal and molecular structures of [Ir(PTA)4(CO)]Cl and
      [Ir(PTAH)3(PTAH2)(H)2]Cl6.
AB  - The first 1,3,5-triaza-7-phosphaadamantane (PTA) ligated iridium compounds have
      been synthesized. The reaction of PTA with [Ir(COD)Cl]2 (COD = 1,5
      cyclooctadiene) under a CO atmosphere produces an inseparable mixture of
      [Ir(PTA)3(CO)Cl] (1) and the PTA analogue of Vaska's compound, [Ir(PTA)2(CO)Cl]
      (2). Compound 1 and [Ir(PTA)4(CO)]Cl (3) were prepared via ligand substitution
      reactions of PTA with Vaska's compound, trans-Ir(PPh3)2(CO)Cl, in absolute and
      95% ethanol, respectively. Complex 3 crystallizes in the orthorhombic space group
      Pbca with a = 20.3619(4) A, b = 14.0345(3) A, c = 24.1575(5) A, and Z = 8. Single
      crystal X-ray diffraction studies show that 3 has a trigonal bipyramidal
      structure in which the CO occupies an axial position. This is the first
      crystallographically characterized [IrP4(CO)]+ complex in which the CO is axially
      ligated. Compound 1 was converted into 3 by ligand substitution with 1 equiv of
      PTA in water. Interestingly, the reaction of 3 with excess NaCl did not result in
      the production of 1, but instead the formation of the dichloro species,
      [Ir(PTAH)2(PTA)2Cl2]Cl3 (4) (PTAH = protonated PTA). Dissolution of 1 or 3 in
      dilute HCl produced 4 and a dihydrido species, [Ir(PTAH)4(H)2]Cl5 (5), which were
      readily separated by inspection due to their different crystal habits. Compound 5
      crystallizes in the triclinic space group P1 with a = 12.4432(9) A, b =
      12.5921(9) A, c = 16.3231(12) A, alpha = 76.004(1) degrees, beta = 71.605(1)
      degrees, gamma = 69.177(1) degrees, and Z = 2. Complex 5 exhibits a distorted
      octahedral geometry with two hydride ligands in a cis configuration. A rationale
      consistent with these reactions is presented by consideration of the steric and
      electronic properties of the PTA ligand.

PMID- 11209603
TI  - Connecting pairs of dimetal units to form molecular loops.
AB  - Four compounds consisting of molecular loops formed from two quadruply bonded
      Mo2(DAniF)2 (DAniF = N,N'-di-p-anisylformamidinate) units linked by two
      dicarboxylate anions have been prepared in high purity and essentially
      quantitative yields. These compounds have been characterized by crystallography
      and NMR spectroscopy and display electrochemical behavior dependent on the nature
      of the dicarboxylate anion. However, the electronic communication between the two
      Mo2(4+) units is not strong. As denoted by the dicarboxylate linkers, the
      compounds are malonate, 1, 1,4-phenylendiacetate, 2, homophthalate, 3, and trans
      cyclopentane-1,2-dicarboxylate, 4.

PMID- 11209604
TI  - Supramolecular squares with Mo2(4+) corners.
AB  - Seven complexes obtained by reacting the quadruply bonded complex [Mo2(cis
      DAniF)2(CH3CN)4](BF4)2 (DAniF = N,N'-di-p-anisylformamidinate) and
      (Bun4N+)2(Carb2-), where Carb2- is a dicarboxylate anion, have been found to have
      a ratio of dimetal unit to dicarboxylate of 1:1. As noted by the carboxylate
      linker, the compounds are oxalate, 1, fumarate, 2, ferrocene dicarboxylate, 3,
      4,4'-biphenyldicarboxylate, 4, acetylenedicarboxylate, 5, tetrafluorophthalate,
      6, and carborane dicarboxylate, 7. Structural characterization of 1-4 revealed a
      square of dimolybdenum units linked by the dicarboxylate anions, each having an
      interstice capable of accommodating specific solvent molecules. Results of NMR
      studies of all seven compounds are consistent with the presence of a highly
      symmetrical structure. These compounds display a rich electrochemical behavior
      that is affected by the nature of the carboxylate group.

PMID- 11209605
TI  - Terpsichorean movements of pentaammineruthenium on pyrimidine and isocytosine
      ligands.
AB  - Pentaammineruthenium moves on ambidentate nitrogen heterocycles by both rotation
      and linkage isomerization, which may affect the biological activity of potential
      ruthenium metallopharmaceuticals. The rapid rotation rates of [(NH3)5RuIII]
      coordinated to the exocyclic nitrogens of isocytosine (ICyt) and 6
      methylisocytosine (6MeICyt) have been determined by 1H NMR. Since these rotamers
      can be stabilized by hydrogen bonding between the coordinated ammines and the N1
      and N3 endocyclic nitrogens, rotamerization is under pH control.
      Spectrophotometrically (UV-vis) measured pKa values for the two endocyclic sites
      for the ICyt complex are 2.78 and 9.98, and for 6MeICyt are 3.06 and 10.21, which
      are probably weighted averages for ionization from N3 and N1, respectively.
      Activation parameters for the rotamerizations were determined by variable
      temperature NMR at pKa1 < pH < pKa2 for the complexes with (ICyt-kappa N2)-,
      (6MeICyt kappa N2)-, and 2AmPym kappa N2. For [(6MeICyt kappa N2)(-)
      (NH3)5RuIII]2+, delta H* = 1.6 kcal/mol, delta S* = -37 cal/mol K, and Ea = 2.2
      kcal/mol. Due to strong RuIII-N pi-bonding, the activation enthalpies are
      approximately 10 kcal lower than the expected values for the free ligands.
      Rotameric structure is correlated with pKa values, pH-dependent reduction
      potentials, and 1H NMR parameters. Linkage isomers of [(2AmPym)(NH3)5Ru]n+ are
      reported in which RuII is coordinated to the endocyclic nitrogen (N1) and RuIII
      to the exocyclic nitrogen (N2). The rate constant for the kappa N2-->kappa N1
      isomerization as part of an ECE mechanism is 3.9 s-1 at pH 3. The pH dependence
      of the acid-catalyzed hydrolysis of [(2AmPym kappa N1)(NH3)5Ru]2+ is determined.

PMID- 11209606
TI  - Syntheses and characterizations of metal complexes derived from cis,cis-1,3,5
      triaminocyclohexane-N,N',N"-triacetic acid.
AB  - A convenient six-step procedure is developed to routinely prepare the hexadentate
      ligand cis,cis-1,3,5-triaminocyclohexane-N,N',N"-triacetic acid (H3tachta) as an
      HCl salt. Complexes of gallium(III) and indium(III), [Ga(tachta)] and
      [In(tachta)], are synthesized from the reactions of the ligand and the
      corresponding metal precursors. Copper(II), palladium(II), and cobalt(II)
      complexes, [Cu(Htachta)], [Pd(Htachta)], and [Co(Htachta)], are obtained from the
      reactions of H3tachta with the corresponding metal chlorides. The structures of
      H3tachta.3HCl.2H2O (C12H28Cl3N3O8) and [Ga(tachta)] (C12H18GaN3O6) are
      characterized. The crystal of H3tachta.3HCl.2H2O is monoclinic, of the space
      group P2(1)/c, with a = 15.1688(4) A, b = 8.4708(2) A, c = 15.9408(2) A, beta =
      108.058(1) degrees, and Z = 4; that of [Ga(tachta)] is cubic, of space group Pa3,
      with a = 14.0762(1) A and Z = 8. The gallium atom of [Ga(tachta)] is six
      coordinated in the solid state, and the complex assumes a pseudooctahedronal
      geometry with the completely deprotonated hexadentate ligand encapsulating the
      metal ion.

PMID- 11209607
TI  - Atom transfer reactions of (TTP)Ti(eta 2-3-hexyne): synthesis and molecular
      structure of trans-(TTP)Ti[OP(Oct)3]2.
AB  - Atom and group transfer reactions were found to occur between heterocumulenes and
      (TTP)Ti(eta 2-3-hexyne), 1 (TTP = meso-5,10,15,20-tetra-p-tolylporphyrinato
      dianion). The imido derivatives (TTP)Ti=NR (R = iPr, 2; tBu, 3) were produced
      upon treatment of complex 1 with iPrN=C=NiPr, iPrNCO, or tBuNCO. Reactions
      between complex 1 and CS2, tBuNCS, or tBuNCSe afforded the chalcogenido
      complexes, (TTP)Ti=Ch (Ch = Se, 4; S, 5). Treatment of complex 1 with 2 equiv of
      PEt3 yielded the bis(phosphine) complex, (TTP)Ti(PEt3)2, 6. Although (TTP)Ti(eta
      2-3-hexyne) readily abstracts oxygen from epoxides and sulfoxides, the reaction
      between 1 and O=P(Oct)3 did not result in oxygen atom transfer. Instead, the
      paramagnetic titanium(II) derivative (TTP)Ti[O=P(Oct)3]2, 7, was formed. The
      molecular structure of complex 7 was determined by single-crystal X-ray
      diffraction: Ti-O distance 2.080(2) A and Ti-O-P angle of 138.43(10) degrees.
      Estimates of Ti=O, Ti=S, Ti=Se, and Ti=NR bond strengths are discussed.

PMID- 11209608
TI  - Syntheses, structures, and luminescence of novel lanthanide complexes of
      tripyridylamine, N,N,N',N'-tetra(2-pyridyl)-1,4-phenylenediamine and N,N,N',N'
      tetra(2-pyridyl)biphenyl-4,4'-diamine.
AB  - Two novel blue luminescent bridging ligands N,N,N',N'-tetra(2-pyridyl)-1,4
      phenylenediamine (tppd) and N,N,N',N'-tetra(2-pyridyl)-1,1-biphenyl-4,4'-diamine
      (tpbpd) have been synthesized. Several novel lanthanide complexes containing
      2,2',2"-tripyridylamine (2,2',2"-tpa), 2,2',3"-tpa, tppd, or tpbpd ligands have
      been synthesized and characterized structurally, which include Pr(hfa)3(2,2',2"
      tpa), I, Ln(tmhd)3(2,2',3"-tpa), 2 (Ln = Dy, 2a; Eu, 2b; Tb, 2c; Sm, 2d),
      [Eu(tmhd)3][Pr(hfa)3](2,2',3"-tpa), 3, [Pr(hfa)3]2(tppd), 4, and
      [Ln(hfa)3]2(tpbpd), 5, where Ln = Pr (5a), Eu (5b), tmhd = 2,2,6,6-tetramethyl
      3,5-heptanedionato, and hfa = hexafluoroacetylacetonate. The Dy(III), Eu(III),
      and Tb(III) complexes display a bright photoluminescence, which can be achieved
      by either a direct excitation process or an indirect excitation process.
      Compounds 2a-2d can be sublimed readily.

PMID- 11209609
TI  - Dinuclear calcium complex with weakly NH...O hydrogen-bonded sulfonate ligands.
AB  - The novel intramolecularly NH...O hydrogen-bonded Ca(II)-aryl sulfonate complex,
      [Ca2(SO3-2-t-BuCONHC6H4)2(H2O)4]n(2-t-BuCONHC6H4SO3)2n (1), sulfonate anion,
      (HNEt3)(SO3-2-t-BuCONHC6H4) (2a), (PPh4)(SO3-2-t-BuCONHC6H4) (2b), (n-Bu4N)(SO3-2
      t-BuCONHC6H4) (2c), and sulfonic acid, 2-t-BuCONHC6H4SO3H (3), were synthesized.
      The structures of 1, 2a, and 2b depict the presence of the formation of NH...O
      hydrogen bonds between the amide NH and S-O oxygen for a series of compounds as
      determined by IR and 1H NMR analyses both in the solid state and in the solution
      state. Thus, the NH...O hydrogen bonds with neutral amide groups are available
      for investigation of the electronic state of the O- anion. The combined data from
      the IR and 1H NMR spectra indicate that the sulfonic acid, sulfonate anion, and
      Ca(II) complex have a substantially weak intramolecular NH...O hydrogen bond
      between the SO3 oxygen and amide NH. In the detailed comparison with the intense
      NH...O hydrogen bonds for the carboxylate, weak NH...O hydrogen bonds for
      sulfonate is due to the strong conjugation of the SO3- group with the lower
      nucleophilicity.

PMID- 11209610
TI  - Excision of zirconium iodide clusters from highly cross-linked solids.
AB  - Highly cross-linked cluster precursors KZr6I14B, Zr6I12B, KZr6I14C, and Zr6I12C
      were, successfully excised in deoxygenated water, and the resulting red aqueous
      solutions of clusters exhibit better kinetic stability with respect to
      decomposition than their chloride and bromide analogues. On traversing the Cl-->I
      series, NMR measurements show increasing deshielding of the interstitial atoms (Z
      = B, C) in Zr6ZX12 clusters and cyclic voltammetry reveals increasingly positive
      reduction potentials for the [(Zr6BX12)(H2O)6]+ ions. Several new cluster
      complexes have been crystallized from aqueous or methanolic solutions.
      Crystallographic data for these compounds are as follows:
      [(Zr6BI12)(H2O)6]Ix11.7(H2O) (1), triclinic, P1, a = 10.2858(7) A, b = 11.3045(8)
      A, c = 20.808(1) A, alpha = 77.592(1) degrees, beta = 79.084(1) degrees, gamma =
      77.684(1) degrees, Z = 2; [(Zr6BI12)]+[I(CH3OH)6]- (2), hexagonal, R3, a =
      17.706(1) A, c = 13.910(1) A, Z = 3, [(Zr6CI12)(H2O)6]I(2).4(H2O) (3), triclinic,
      P1, a = 10.1566(5) A, b = 10.4513(5) A, c = 10.7549(6) A, alpha = 117.552(1)
      degrees, beta = 96.443(1) degrees, gamma = 96.617(1) degrees, Z = 1.

PMID- 11209611
TI  - Pressure dependence of peroxynitrite reactions. Support for a radical mechanism.
AB  - Activation volumes (delta V++) have been determined for several reactions of
      peroxynitrite using the stopped-flow technique. Spontaneous decomposition of
      ONOOH to NO3- in 0.15 M phosphate, pH 4.5, gave delta V++ = 6.0 +/- 0.7 and 14 +/
      1.0 cm3 mol-1 in the presence of 53 microM and 5 mM nitrite ion, respectively.
      One-electron oxidations of Mo(CN)8(4-) and Fe(CN)6(4-), which are first order in
      peroxynitrite and zero order in metal complex, gave delta V++ = 10 +/- 1 and 11
      +/- 1 cm3 mol-1, respectively, at pH 7.2. The limiting yields of oxidized metal
      complex were found to decrease from 61 to 30% of the initially added
      peroxynitrite for Mo(CN)8(3-) and from 78 to 47% for Fe(CN)6(3-) when the
      pressure was increased from 0.1 to 140 MPa. The bimolecular reaction between CO2
      and ONOO- was determined by monitoring the oxidation of Fe(CN)6(4-) by
      peroxynitrite in bicarbonate-containing 0.15 M phosphate, pH 7.2, for which delta
      V++ = -22 +/- 4 cm3 mol-1. The Fe(CN)6(3-) yield decreased by approximately 20%
      upon increasing the pressure from atmospheric to 80 MPa. Oxidation of
      Ni(cyclam)2+ by peroxynitrite, which is first order in each reactant, was
      characterized by delta V++ = -7.1 +/- 2 cm3 mol-1, and the thermal activation
      parameters delta H++ = 4.2 +/- 0.1 kcal mol-1 and delta S++ = -24 +/- 1 cal mol-1
      K-1 in 0.15 M phosphate, pH 7.2. These results are discussed within the context
      of the radical cage hypothesis for peroxynitrite reactivity.

PMID- 11209612
TI  - In situ NMR observation of mono- and binuclear rhodium dihydride complexes using
      parahydrogen-induced polarization.
AB  - Starting from the binuclear complex [RhCl(NBD)]2 (NBD = 2,5-norbornadiene) in the
      presence of the phosphines L = PMe3, PMe2Ph, PMePh2, PEt3, PEt2Ph, PEtPh2, or P(n
      butyl)3, various mononuclear dihydrides of the type Rh(H)2CIL3, i.e., those of
      the homogeneous hydrogenation catalysts RhCIL3, have been obtained upon addition
      of parahydrogen, and their 1H NMR spectra have been investigated using
      parahydrogen-induced polarization (PHIP). Furthermore, the two binuclear
      complexes (H)(Cl)Rh(PMe3)2(mu-Cl)(mu-H)Rh(PMe3) and (H)(Cl)Rh(PMe2Ph)2(mu-Cl)(mu
      H)Rh(PMe2Ph) have been detected and characterized by means of this in situ NMR
      method. Analogous complexes with trifluoroacetate instead of chloride, i.e.,
      Rh(H)2(CF3COO)L3, have been generated in situ starting from Rh(NBD)(acac) in the
      presence of trifluoroacetic acid in combination with the phosphines L = PPh3,
      PEt2Ph, PEt3, and P(n-butyl)3, and their 1H NMR parameters have been determined.

PMID- 11209613
TI  - Lithium halide adducts of imidotellurium(IV) ligands: synthesis and X-ray
      structures of [Li(THF)2L](mu 3-I)[LiI(L)] [L = tBuNTe(mu-NtBu)2TeNtBu] and
      [(THF)3Li3(mu 3-I)(Te(NtBu)3)].
AB  - The reaction of the chelating ligand tBuNTe(mu-NtBu)2TeNtBu (L) with LiI in THF
      yields [Li(THF)2L](mu 3-I)[LiI(L)] (3). This complex is also formed by the
      attempted oxidation of [Li2Te(NtBu)3]2 with I2. An X-ray analysis of 3 reveals
      that the tellurium diimide dimer acts as a chelating ligand toward (a)
      [Li(THF)2]+ cations and (b) a molecule of LiI. An extended structure is formed
      via weak Te...I interactions [3.8296(7)-3.9632(7) A] involving both mu 3-iodide
      counterions and the iodine atoms of the coordinated LiI molecules. Crystal data:
      3, triclinic, space group P1, a = 10.1233(9) A, b = 15.7234(14) A, c =
      18.8962(17) A, alpha = 86.1567(16) degrees, beta = 84.3266(16) degrees, gamma =
      82.9461(16) degrees, V = 2965.8(5) A3, Z = 2. The oxidation by air of
      [Li2Te(NtBu)3]2 in toluene produces the radical (Li3[Te(NtBu)3]2), which exhibits
      an ESR spectrum consisting of a septet of decuplets (g = 2.00506, a(14N) = 5.26
      G, a(7Li) = 0.69 G). The complexes [(THF)3Li3(mu 3-X)(Te(NtBu)3)] (4a, X = Cl;
      4b, X = Br; 4c, X = I) are obtained from the reaction of [Li2Te(NtBu)3]2 with
      lithium halides in THF. The iodide complex, 4c, has a highly distorted, cubic
      structure comprised of the pyramidal [Te(NtBu)3]2- dianion which is linked
      through three [Li(THF)]+ cations to I- Crystal data: 4c, triclinic, space group
      P1, a = 12.611(8) A, b = 16.295(6) A, c = 10.180(3) A, alpha = 98.35(3) degrees,
      beta = 107.37(4) degrees, gamma = 108.26(4) degrees, V = 1829(2) A3, Z = 2.

PMID- 11209614
TI  - Molecular structures of carbonyl-linked bis(dioxolene) complexes: can a carbonyl
      group act as an effective ferromagnetic coupler?
AB  - Molecular structures of two bis(ZnIIdioxolene) complexes are described:
      (TpCum,MeZn)(2)1-H2 (C106H123.50B2N12O10Zn2), tetragonal, P4/ncc, a = 25.1810(2)
      A, b = 25.1810(2) A, c = 34.7744(2) A, alpha = 90 degrees, beta = 90 degrees,
      gamma = 90 degrees, Z = 8; (TpCum,MeZn)(2)1-H (C101H120B2N12O6Zn2), triclinic,
      P1, a = 13.6624(2) A, b = 13.80920(10) A, c = 26.62340(10) A, alpha = 96.6910(10)
      degrees, beta = 91.8560(10) degrees, gamma = 109.0190(10) degrees, Z = 2. One of
      the complexes, (TpCum,MeZn)(2)1-H2, has two protonated catecholate ligands, while
      the other complex, (TpCum,MeZn)(2)1-H, has one protonated catecholate and one
      semiquinone ligand. When reacted with PbO2, a labile S = 1, bis(ZnIIsemiquinone)
      complex is formed in which the two semiquinones are attached to a common carbonyl
      group.

PMID- 11209616
TI  - Square pyramidal dialkoxo-bound monooxo-vanadium(V) complex and its behavior in
      solution.

PMID- 11209615
TI  - Influence of the inner coordination sphere on the Ru(III)--cyanamido ligand-to
      metal charge transfer chromophore.

PMID- 11209618
TI  - Unexpected reactivity of Rh(TPP)I(CO) toward an alkoxide in CH2Cl2: synthesis and
      crystal structure of Rh(TPP)(CH2Cl).

PMID- 11209617
TI  - Fixing carbon dioxide with copper: crystal structure of [LCu(mu-C2O4)CuL][Ph4B]2
      (L = N,N',N"-triallyl-1,4,7-triazacyclononane).

PMID- 11209619
TI  - Heteroleptic platinum(II) complexes with crown thioether and phosphine ligands.
      I: Crystal structures of [Pt(9S3)(dppm)](PF6)2 and
      [Pt(9S3)(PPh3)2](PF6)(2)X2CH3NO2.

PMID- 11209620
TI  - Facile and mild deboronation of o-carboranes using cesium fluoride.

PMID- 11209621
TI  - Synthesis and ion-binding studies of a platinum(II) terpyridine complex with
      crown ether pendant. X-ray crystal structure of [Pt(trpy)(S-benzo-15-crown-5)PF6.

PMID- 11209622
TI  - A neutral triangular supramolecule formed by Mo2(4+) units.

PMID- 11209623
TI  - Protonation of coordinated N2 on tungsten with H2 mediated by sulfido-bridged
      dinuclear molybdenum complexes.

PMID- 11209624
TI  - Conducting randomized, controlled trials. Experience with the dysfunctional
      uterine bleeding intervention trial.
AB  - OBJECTIVE: To conduct a randomized, controlled trial (RCT) to examine issues
      associated with therapeutic alternatives to standard hysterectomy for women with
      dysfunctional uterine bleeding. STUDY DESIGN: Participants were to be randomly
      assigned to one of three treatment groups: hysterectomy, endometrial ablation and
      medical management. Recruitment was targeted at 375 women. RESULTS: Despite
      multiple recruitment strategies, recruitment was weak, with only five women
      enrolled after six months. Providers and women screened for eligibility often
      expressed discomfort with randomization. The protocol was amended to an elective
      treatment cohort design with a randomization component. Recruitment improved,
      with 37 women enrolled after four months. CONCLUSION: The success of RCTs may be
      affected by multiple factors. Acceptance of the protocol by patients and
      providers is essential. The RCT may present providers with a conflict between the
      goals of research and of providing optimal individualized care. Thus, RCTs may
      not always be appropriate for studies designed to examine best treatments in
      clinical practice, and nonrandomized designs may provide appropriate alternatives
      in some cases.

PMID- 11209625
TI  - Preinduction cervical ripening techniques compared.
AB  - OBJECTIVE: To assess the clinical efficacy of pharmacologic, mechanical and
      combination techniques of cervical ripening. STUDY DESIGN: From March 1997 to
      August 1998, all cervical-ripening patients at Lehigh Valley Hospital were
      randomly assigned to three groups: intravaginal misoprostol, intracervical Foley
      catheter, or combination prostaglandin E2 (PGE2) gel and Foley catheter.
      Inclusion criteria included Bishop score < or = 5 and no contraindication to
      labor. The remaining delivery process was actively managed according to
      established guidelines. Multiple variables in perinatal outcome were analyzed,
      with the cesarean section rate and time from ripening to delivery as the main
      outcome variables. RESULTS: Of the 205 patients, 65 were randomized to the
      misoprostol group, 71 to the Foley group and 69 to the catheter-and-gel group.
      There were no differences between groups in delivery indications, maternal
      demographics, ultrasound findings, labor interventions, intrapartum times, mode
      of delivery, postpartum complications or neonatal outcomes. The misoprostol group
      demonstrated a higher rate of uterine tachysystole and required oxytocin less
      when compared to the two catheter groups. CONCLUSION: The higher rate of uterine
      tachysystole with misoprostol did not increase the cesarean section rate. The
      higher rate of oxytocin required by the two catheter groups did not increase the
      delivery time intervals. There appears to be no benefit to adding intracervical
      or intravaginal PGE2 gel to the intracervical Foley balloon. The misoprostol and
      catheter ripening techniques have similar safety and efficacy.

PMID- 11209626
TI  - Prenatal eradication of Hb Bart's hydrops fetalis.
AB  - OBJECTIVE: To evaluate the effectiveness of prenatal prevention of Hb Bart's
      hydrops fetalis. STUDY DESIGN: The study was a prospective descriptive analysis
      of pregnant women attending an antenatal clinic between June 1990 and June 1998.
      The study consisted of two periods, the first half with no prenatal diagnosis
      (PND) (1990-1994) and the second half with PND. During the study period, all
      cases of Hb Bart's hydrops fetalis were prospectively collected and postnatally
      confirmed. In the second period, prenatal strategy to control severe thalassemia
      was introduced. The strategy included (1) carrier identification by retrospective
      (history review for known risk) and prospective screening (simple erythrocyte
      osmotic fragility test) in women without known risks, (2) the couples at risk
      were offered genetic counseling and cordocentesis, (3) analysis of fetal blood
      for diagnosis, and (4) counseling for termination of pregnancy. RESULTS: During
      the first half of the study, the prevalence of Hb Bart's hydrops fetalis was
      0.305 (89 in 29,399 deliveries). There were no fetuses with Hb Bart's hydrops
      fetalis among 16,360 screened pregnancies in the second half. However, of 6,856
      pregnancies in the second half not screened due to a late first visit, 10 (0.15%)
      fetuses had Hb Bart's hydrops fetalis. Among the screened group, cordocentesis
      was performed in 361 pregnancies at risk, 170 and 191 from retrospective and
      prospective screening, respectively; and 75 (20.8%) were proven to have Hb Bart's
      disease, which was diagnosed before hydropic changes occurred. CONCLUSION: The
      strategy proved effective in preventing Hb Bart's hydrops fetalis, and extensive
      experience with it suggests that it be considered an effective way to control
      severe thalassemia.

PMID- 11209627
TI  - Gonadotropin-releasing hormone for infertility in women with primary hypothalamic
      amenorrhea. Toward a more-interventional approach.
AB  - OBJECTIVE: To assess the effectiveness of a protocol of pulsatile gonadotropin
      releasing-hormone (GnRH) in treating infertility in women with primary
      hypothalamic amenorrhea. STUDY DESIGN: Retrospective analysis of 44 cycles
      treated at an infertility center. Twenty-four patients with primary hypothalamic
      amenorrhea were treated intravenously with pulsatile GnRH using 5 micrograms per
      bolus every 90 minutes. Ultrasound monitoring and cervical assessment by Insler's
      scoring system allowed timed injection of human chorionic gonadotropin (hCG) and
      intrauterine insemination if needed. Luteal support was provided with hCG.
      RESULTS: The ovulation rate was 95% with the 5-microgram dose. A single follicle
      was produced in 91% of cycles. The overall pregnancy rate per ovulatory cycle was
      45%, and the pregnancy rate per patient was 83%. In patients treated previously
      with exogenous gonadotropins, poor results were observed. Only one case of mild
      overstimulation was reported. CONCLUSION: Pulsatile GnRH is an effective and safe
      method of treating infertility in women with primary hypothalamic amenorrhea,
      thus simulating normal ovulation; however, more-interventional management,
      including the qualitative estrogenic response, may lead to optimal results and
      increase the pregnancy rate.

PMID- 11209628
TI  - Early diagnosis of ectopic pregnancy. Does use of a strict algorithm decrease the
      incidence of tubal rupture?
AB  - OBJECTIVE: To determine if tubal rupture rates are decreased when a strict
      diagnostic algorithm is employed in the evaluation of women with suspected
      ectopic pregnancy as compared to individualized diagnostic methods. STUDY DESIGN:
      Between 1994 and 1996, a group of investigators at Charleston Area Medical Center
      employed a strict diagnostic algorithm consisting of serum quantitative human
      chorionic gonadotropin (hCG) levels, progesterone levels, ultrasound and
      endometrial curettage in order to expedite diagnosis when ectopic pregnancy was
      suspected (group A patients). Other practitioners employed traditional criteria
      in similar clinical situations (group B patients). Medical records of patients
      diagnosed with ectopic pregnancy in this period were retrospectively reviewed.
      Demographic data, clinical and laboratory characteristics, and rate of tubal
      rupture were compared. RESULTS: Sixty-one of 122 patients were diagnosed with
      ectopic pregnancy by strict criteria. These patients did not differ significantly
      from those evaluated by an individualized approach in regard to age, gravidity,
      parity or risk factors for ectopic pregnancy. Menstrual age, hCG levels and
      progesterone levels were similar as well. Group A patients had a median
      diagnostic interval of 2 days, with a range of 0-16. Group B patients had a
      median diagnostic interval of 8 days, with a range of 0-44 (P < .001). Of
      patients evaluated by this strict algorithm, 3.3% experienced rupture as compared
      to 23% of patients in group B (P < .001). CONCLUSION: Use of a strict diagnostic
      algorithm in the evaluation of patients with suspected ectopic pregnancy resulted
      in decreased tubal rupture rates. Such an algorithm could be disseminated to all
      locations for triage of patients and use in a standardized manner. This practice
      could result in a reduction in loss of reproductive function and mortality
      secondary to ectopic pregnancy.

PMID- 11209629
TI  - Risks and adverse outcomes of sexually transmitted diseases. Patients' attitudes
      and beliefs.
AB  - OBJECTIVE: To determine women's awareness and level of understanding of the risks
      and sequelae of sexually transmitted diseases (STDs). STUDY DESIGN: The study was
      a cross-sectional survey of 103 women seen at an urban center. We recruited women
      from several clinical sites: (1) patients with signs or symptoms of an STD seen
      in a busy women's urgent care unit, (2) women enrolled in clinical studies for
      STDs or bacterial vaginosis, (3) patients admitted to the hospital and found to
      have an STD, and (4) women at high risk based on age and sexual activity. A
      trained female interviewer administered the survey to women agreeing to
      participate. The questionnaire assessed the patient's awareness of various STDs
      and their association with adverse outcomes. The survey also evaluated women's
      knowledge regarding STD prevention. Descriptive analyses were performed using SAS
      (Cary, North Carolina) on the 103 patients surveyed. RESULTS: The median age of
      our survey population was 23, 66% were nonwhite, and 37% were on public
      assistance or uninsured. The population was at high risk for STDs based on the
      reported history of infection with Neisseria gonorrhoeae and Chlamydia
      trachomatis (6% and 38%, respectively). Of the 103 women surveyed, 33% had never
      heard of pelvic inflammatory disease (PID), and 79.6% could not identify any
      adverse sequelae of PID. Sixty-five percent were unaware that PID increases the
      risk of ectopic pregnancy, and 56.3% were unaware that it could result in chronic
      pelvic pain. When asked if they knew of any methods to prevent or reduce their
      risk of STDs, only 18% mentioned barrier contraception (condoms). Over 57% of
      respondents could not name a way to prevent STDs. CONCLUSION: Increased
      educational efforts targeted at high-risk individuals are necessary to improve
      knowledge of STDs and their adverse sequelae. With greater knowledge and
      awareness, individuals and couples may be more likely to practice protective
      behaviors, such as reducing high-risk exposure, and to increase preventive
      measures, such as barrier contraception use.

PMID- 11209630
TI  - Early postpartum discharge at a university hospital. Outcome analysis.
AB  - OBJECTIVE: To determine whether implementation of an early hospital discharge
      policy was effective in safely reducing hospital stay and acceptable to patients.
      STUDY DESIGN: The study was a prospective, observational trial. Early discharge
      was defined as discharge from the hospital either on the first day after vaginal
      delivery or on the second day after delivery by cesarean section. A "stayover
      mom" policy was subsequently implemented to allow a mother the option to remain
      in the hospital overnight after discharge. This prospective study was divided
      into three consecutive three-month periods: (1) routine care (n = 576), (2) early
      discharge (n = 622), and (3) early discharge with stay-over mom (n = 574).
      Primary outcome measurements were length of hospital stay and patient
      willingness. RESULTS: With proper review of written instructions, all eligible
      patients were willing to be discharged early. As compared with the routine care
      group, the length of hospital stay was shorter by 0.8 days (95% CI, 0.4-1.2 days)
      in the early discharge group (P < .01) and by 1.1 days (95% CI, 0.5-1.7 days) in
      the early discharge with stayover mom group (P < .005). The stayover mom policy
      was more desirable because of limitations in obtaining timely transportation and
      concern about the infant warranting continued observation. The need for maternal
      readmission was rare (15 cases, 0.8% of total), with endometritis equally common
      (n = 3 in each group). CONCLUSION: Early postpartum discharge, especially
      including a stayover mom policy, was acceptable to our predominantly Medicaid
      population. The reduced hospital stay was not associated with increased maternal
      morbidity.

PMID- 11209631
TI  - Persistent postpartum urinary retention in contemporary obstetric practice.
      Definition, prevalence and clinical implications.
AB  - OBJECTIVE: To prospectively evaluate the prevalence, presumed etiologies and
      clinical implications of persistent postpartum urinary retention in modern
      obstetric practice. STUDY DESIGN: The study population comprised 8,402
      consecutive, unselected parturients delivered in a university-affiliated
      maternity hospital over a one-year period. If a woman was unable to void
      spontaneously until the third postpartum day despite intermittent use of a Foley
      catheter, a diagnosis of persistent postpartum urinary retention was established.
      Patients were treated by insertion of a Foley catheter for up to two weeks and
      subsequently by a suprapubic catheter. Obstetric data were collected from the
      hospital records. RESULTS: Four patients (0.05% of the study population), aged 29
      37 years, developed persistent postpartum urinary retention. Risk factors
      included vaginal delivery after cesarean section, prolonged second stage of
      labor, epidural analgesia, and delayed diagnosis and intervention. Urodynamic
      evaluation, performed on two patients one month after removal of the suprapubic
      catheter, revealed genuine stress incontinence in one and detrusor instability in
      another. None had had any lower urinary tract symptoms before pregnancy and
      delivery. CONCLUSION: Persistent postpartum urinary retention in contemporary
      obstetric practice is rare but may be associated with long-term bladder
      dysfunction. Early diagnosis and intervention are required to prevent
      irreversible bladder damage.

PMID- 11209632
TI  - Acute exacerbation of recurrent pelvic inflammatory disease. Laparoscopic
      findings in 141 women with a clinical diagnosis.
AB  - OBJECTIVE: To evaluate the accuracy of the clinical diagnosis of recurrent pelvic
      inflammatory disease (PID) and to determine the positive and negative predictive
      value of laboratory tests for the diagnosis of PID. STUDY DESIGN: According to a
      prospective study design, 141 consecutively hospitalized patients with the
      clinical diagnosis of PID were evaluated. The basic inclusion criterion was a
      history of at least one episode of PID. Standard laboratory tests were performed,
      specimens for aerobic and anaerobic culture and for Chlamydia trachomatis
      isolation were obtained, and temperature was regularly monitored. All patients
      underwent laparoscopy under general anesthesia within 24 hours of admission.
      RESULTS: The clinical diagnosis of PID was confirmed by laparoscopy in 30% of
      patients. In almost one-third of patients, at laparoscopy the pelvic organs were
      within normal limits. Adhesions without signs of PID were found in 16%. The third
      most-frequent finding was endometriosis (14%). Neither the individual monitored
      parameters nor their combination reached satisfactory positive and negative
      predictive values for diagnosing PID. CONCLUSION: Recurrent clinical symptoms and
      laboratory signs of PID should be an indication for confirming or excluding the
      clinical diagnosis by laparoscopy.

PMID- 11209633
TI  - Pregnancy rate and embryo loss in the NK1.1+ T cell-depleted mouse.
AB  - OBJECTIVE: To determine the role of natural killer cell (NK) 1.1+ T cells in
      pregnancy and in embryo loss. STUDY DESIGN: Four groups of C57 mice, consisting
      of 20 animals each, were studied. Groups A and B included pregnant females
      treated with anti-NK1.1 monoclonal antibodies until they gave birth or non-NK1.1
      depleted antibodies, respectively. In order to evaluate the role of NK1.1+ T
      cells in pregnancy, female mice in group C were treated with anti-NK1.1
      monoclonal antibodies every seven days starting seven days prior to mating until
      they gave birth. Control mice in group D were not NK1.1-depleted. NK1.1+ T cell
      depletion was determined by flow cytometric analysis. RESULTS: Depletion of
      NK1.1+ T cells did not significantly change the pregnancy rate, nor did it
      significantly alter the number of live births. Numbers of live births tended to
      decrease in NK1.1-depleted mice, with a mean number of live births of 4.66 as
      compared with 6.09 in NK1.1-depleted and nondepleted mice, respectively.
      Similarly, mice treated with anti-NK1.1 monoclonal antibodies every seven days
      starting seven days prior to mating became pregnant at a rate of 40% as compared
      with 60% in non-NK1.1-depleted controls. A comparable trend was observed in the
      number of live births, with a mean number of live births of 5.0 as compared with
      6.1 in NK1.1-depleted and non-NK1.1-depleted mice, respectively. CONCLUSION: In
      the NK1.1-depleted mouse model, NK1.1+ T cells do not have any direct effect on
      pregnancy rate or on early embryo loss.

PMID- 11209634
TI  - High prevalence of high grade squamous intraepithelial lesions and microinvasive
      carcinoma in women with a cytologic diagnosis of low grade squamous
      intraepithelial lesions.
AB  - OBJECTIVE: To evaluate the histologic nature of low grade intraepithelial lesion
      (LSIL) in a region with a high prevalence of invasive cervical carcinoma and to
      propose a management protocol. STUDY DESIGN: Comparing the follow-up of 877 women
      with LSIL during a 43-month period, taking into consideration the histologic
      nature determined by colposcopic biopsy, endocervical curettage, conization or
      hysterectomy as the final pathologic diagnosis. RESULTS: During the study period,
      from July 1994 to February 1998, a total of 128,925 Pap smears were performed at
      our institute, with 877 (0.68%) diagnosed as LSIL. Among these, 722 women with
      CIN1-SIL and 32 with human papillomavirus-related changes (HPV-SIL) were enrolled
      in the study. Of the 543 women with CIN 1/squamous intraepithelial lesion, 145
      (27%) cases of high grade squamous intraepithelial lesion were disclosed
      histologically, as were 16 (3%) cases of microinvasion. Among those followed at
      an interval of three months with a Pap smear alone, the persistence rate was
      46.8%, while the regression rate was 40%. Thirty-two women with HPV/SIL underwent
      histologic evaluation, revealing 18% CIN 2/3 with no microinvasion. CONCLUSION: A
      high percentage of CIN 2/3 as well as microinvasive lesions will go unnoticed in
      the absence of colposcopic evaluation.

PMID- 11209635
TI  - Postpartum angiographic embolization for vulvovaginal hematoma. A report of two
      cases.
AB  - BACKGROUND: Puerperal hematomas can become a life-threatening obstetric
      emergency. Their incidence is 1 or 2/1,000 deliveries. When mainstay methods of
      suture and packing fail, arterial embolization becomes an excellent alternative
      to definitive treatment, laparotomy. CASES: A 32-year-old woman, para 2-0-2-2,
      developed extreme rectal and vulvar pain one hour postpartum. A 12 x 10-cm
      vulvovaginal hematoma was identified, drained, sutured and packed. Bleeding
      continued, blood products were administered, and selective angiographic
      embolization of the pudendal and inferior gluteal arteries was successfully
      performed. A 31-year-old woman, para 1-0-1-1, developed a left vaginal hematoma
      immediately postpartum. She failed vaginal packing and underwent angiographic
      arterial embolization successfully. The patient was discharged on the fourth
      postpartum day. At six weeks postpartum, neither patient had evidence of hematoma
      formation. CONCLUSION: In the setting of a puerperal hematoma refractory to
      conventional first-line therapy, arterial embolization provides a rational,
      effective alternative for achieving hemostasis with minimal morbidity.

PMID- 11209636
TI  - 10% hydroxyethyl starch for plasma expansion in the treatment of severe ovarian
      hyperstimulation syndrome. A case report.
AB  - BACKGROUND: Severe ovarian hyperstimulation syndrome is a complication of
      hormonal therapy for in vitro fertilization and carries the risk of renal
      failure. The injection of 6% hydroxyethyl starch has been used as a preventive
      measure. CASE: A 33-year-old woman was admitted with severe ovarian
      hyperstimulation syndrome after receiving gonadotropins as part of our in vitro
      fertilization protocol. Despite treatment with saline, albumin and abdominal
      taps, oliguria developed on the third day. The patient was transferred to the
      general intensive care unit and treated with 10% hydroxyethyl starch, furosemide
      and a further abdominal tap. Recovery was rapid. CONCLUSION: Ten percent
      hydroxyethyl starch is an efficient plasma expander. It is safe, biohazard free
      and cost-effective. It seems to effectively control severe ovarian
      hyperstimulation syndrome and to overcome acute prerenal failure. Larger
      prospective studies are necessary to further evaluate its role in the treatment
      of severe ovarian hyperstimulation syndrome.

PMID- 11209637
TI  - Contribution of diminished ovarian reserve to hypofertility associated with
      endometriosis.
AB  - OBJECTIVE: To determine if ovarian reserve, as measured by day 3 levels of E2 and
      FSH, was different in patients with endometriosis as compared to controls. STUDY
      DESIGN: Case-control study of 75 women with laparoscopically staged endometriosis
      and 75 age-matched controls undergoing in vitro fertilization/embryo transfer for
      male factor infertility. RESULTS: In women with stage III/IV endometriosis
      (revised American Fertility Society staging), day 3 E2 and FSH levels were
      significantly higher than control levels (51.9 pg/mL and 12.6 mIU/mL versus 34.7
      pg/mL and 9.7 mIU/mL, P < .03). In contrast, women with stage I/II endometriosis
      did not differ significantly when compared to controls (36.8 pg/mL and 10.4
      mIU/mL versus 34.0 pg/mL and 10.2 mIU/mL). The total group showed significantly
      higher E2 levels (41.8 pg/mL versus 34.1 pg/mL, P < .03), but no significant
      differences in FSH levels were observed. CONCLUSION: These data show that women
      with stage III/IV endometriosis have relatively diminished ovarian reserve, while
      this situation is not noted in women with stage I/II endometriosis. This
      observation is consistent with progressive loss of ovarian reserve in women with
      increasing stages of endometriosis independent of age.

PMID- 11209638
TI  - Treatment of cervical pregnancy with cerclage, curettage and balloon tamponade. A
      report of three cases.
AB  - BACKGROUND: Cervical pregnancy is a rare form of ectopic pregnancy, historically
      requiring hysterectomy to control life-threatening hemorrhage. However, with
      early diagnosis, conservative procedures can preserve the uterus and fertility.
      CASES: Three cases of cervical pregnancy were treated successfully with
      curettage. Two cases utilizing precurettage and postcurettage hemostatic
      techniques were treated with curettage alone. A third case, not employing
      precurettage hemostatic maneuvers, required uterine artery embolization to
      control bleeding and avoid hysterectomy. CONCLUSION: Curettage alone, when
      preceded by cervical infiltration with a vasoconstricting agent, placement of a
      cerclage suture high on the cervix and followed by cervical canal tamponade with
      a Foley catheter balloon, can successfully treat early cervical pregnancy.

PMID- 11209639
TI  - Colon cancer during pregnancy. A case report.
AB  - BACKGROUND: The reported incidence of cancer during pregnancy is between 0.07%
      and 0.1%. The incidence of colorectal carcinoma in pregnancy was 1 per 13,000
      liveborn deliveries during 1981-1989. CASE: A 33-year-old woman, gravida 2, para
      1, was admitted at 30 weeks' gestational age with a history of rectal bleeding
      and right upper quadrant pain. Abdominal ultrasound and magnetic resonance
      imaging revealed a mass located on the posterior part of the right liver and a
      fetus with vertex presentation. Primary cesarean section and a right
      hemicolectomy and wedge biopsy from the metastatic lesion on the right side of
      the liver at 34 weeks' gestation was performed. Histologic examination confirmed
      serosal and lymph node invasion of moderately differentiated mucous-secreting
      adenocarcinoma of the cecum and adenocarcinoma metastatic to the liver. The
      patient received systemic chemotherapy. CONCLUSION: Only 1 of 41 cases of colon
      cancer during pregnancy above the peritoneal reflection has been reported to be
      localized to the cecum. Our case is the second such one. Women with colorectal
      carcinoma during pregnancy usually have a poor prognosis, which may be
      attributable to younger age and delay in diagnosis since the initial symptoms
      often are presumed attributed to normal pregnancy, as in this case.

PMID- 11209640
TI  - A tale of two head and neck societies.

PMID- 11209641
TI  - Justice triumphs for surgeon prosecuted under "anti-dumping" law.

PMID- 11209642
TI  - Fraud and abuse: past, present, and future.

PMID- 11209643
TI  - Health plan accountability: state and federal initiatives.
AB  - Patients' rights legislation is high on the agenda of more than a few legislators
      this year, both nationally and at the state level. Although many proposals are
      being considered by state and federal lawmakers, one of the more significant
      legislative measures under debate would hold health plans legally accountable for
      medical treatment decisions they make, control, or influence. Of course, under
      the current professional liability system, only physicians and hospitals are
      legally responsible for the quality of patient care. Not surprisingly, then, the
      expansion of professional liability law to include managed care organizations
      (MCOs) is a contentious issue.

PMID- 11209644
TI  - Best healthcare facility. Venture House, Queens, NY. Thanhauser + Esterson
      Architects.

PMID- 11209645
TI  - Can it happen here? Panic over mad cow had already infected Europe. Now it's our
      turn.

PMID- 11209646
TI  - No fall insurance.

PMID- 11209647
TI  - Tapping and resolving consumer concerns about health care.

PMID- 11209648
TI  - A prescription for mental distress: the principles of psychosomatic medicine with
      the physical manifestation requirement in N.I.E.D. (Negligent Infliction of
      Emotional Distress) cases.

PMID- 11209649
TI  - The Americans with (or without) Disabilities Act: pre-employment medical
      inquiries and the non-disabled.

PMID- 11209650
TI  - Medical records and your privacy: developing federal legislation to protect
      patient privacy rights.

PMID- 11209651
TI  - Port-access surgery: pros and cons.

PMID- 11209652
TI  - Gene therapy for coronary artery disease.

PMID- 11209653
TI  - Optimal temperature for routine cardiopulmonary bypass.

PMID- 11209654
TI  - Pediatric interventional cardiology: the cardiologist's role and relationship
      with pediatric cardiothoracic surgery.
AB  - The advances in pediatric interventional cardiac catheterization have changed the
      therapeutic strategy for many patients with CHD. The procedure of choice for
      valvar stenosis, recoarctation, collateral vessel occlusion, and branch PA
      stenosis has moved from the operating room to the catheterization laboratory.
      Effective and safe transcatheter interventions now exist for closure of ASDs,
      VSDs, and PDAs and are considered viable alternatives to surgical closure. Other
      interventional catheterization procedures are currently being investigated to
      complement the surgical management of patients with complex anatomy, including
      covered stents for repair of aortic aneurysms, covered stents to complete the
      Fontan circulation in patients after a modified Glenn shunt, multiple stent
      designs for all vascular stenoses, percutaneous PA band, and transcatheter
      resurrection of the pulmonary valve in patients with severe pulmonary
      regurgitation. The rapid advances in the technology used in the catheterization
      laboratory will serve to improve the care we provide for our patients and extend
      the range of interventions performed outside of the operating room. Pediatric
      cardiologists and congenital heart surgeons must understand each other's
      interventional techniques and how they can be used in a coordinated fashion. This
      may involve staged therapy with transcatheter intervention before surgery,
      transcatheter interventions in the operating room, or modifications of surgical
      techniques to facilitate future interventional catheterization completion of a
      staged repair of complex disease. This interaction is essential for the optimal
      management of our patients with both straightforward lesions and complex anatomy.

PMID- 11209655
TI  - Turbine blood pumps.
AB  - After years of development and preclinical testing, clinical trials of the
      MicroMed DeBakey VAD began in November 1998 in Europe and in June 2000 in the
      United States. As of August 2000, 44 patients in Europe and 3 patients in the
      United States have undergone implantation with the MicroMed DeBakey VAD. In
      conclusion, data from the European clinical trial of the MicroMed DeBakey VAD
      support the safety and performance of the device. Results show that the device
      provides adequate left ventricular and circulatory support in patients with end
      stage heart failure without unduly jeopardizing patient safety. Moreover, the
      device provides advantages not inherent to commercially available pulsatile
      devices: (1) miniature size, enabling implantation in smaller patients; (2) ease
      of implantation; (3) reduced surgical bleeding; and (4) a low incidence of
      postoperative infections, often a limiting factor with other devices. The
      MicroMed DeBakey VAD European clinical trial is the first demonstration of the
      compatibility of continuous blood flow with adequate tissue perfusion and overall
      maintenance of life for up to 4.5 months. This initial experience with the
      MicroMed DeBakey VAD suggests that the pump can provide circulatory support to
      bridge patients to cardiac transplantation and may provide an improved quality of
      life for the patient with end-stage heart failure.

PMID- 11209656
TI  - Recent advances in reconstructive surgical management of hypoplastic left heart
      syndrome.

PMID- 11209657
TI  - Aortic surgery in the Marfan syndrome.

PMID- 11209658
TI  - Videoscopic mitral valve repair and replacement using the port-access technique.

PMID- 11209659
TI  - Single-stage complete unifocalization and repair for tetralogy of Fallot,
      pulmonary atresia, and major aortopulmonary collateral arteries.

PMID- 11209660
TI  - Winter mortality in relation to climate.
AB  - We report further details of the Eurowinter survey of cold related mortalities
      and protective measures against cold in seven regions of Europe, and review these
      with other evidence on the relationship of winter mortality to climate. Data for
      the oldest subject group studied, aged 65-74, showed that in this vulnerable
      group, high levels of protection against indoor and outdoor cold at given outdoor
      temperatures were found mainly in countries with cold winters, and were
      associated with low levels of excess mortality at a given level of outdoor cold.
      Regions such as London that had poor protection against cold and/or high baseline
      mortalities had higher levels of winter excess mortality than expected for the
      coldness of their winters.

PMID- 11209661
TI  - Cold climate and coronary mortality in Sweden.
AB  - In many European countries there is a tendency towards higher coronary mortality
      in the northern parts of the country. Furthermore the highest coronary mortality
      rates are found in the colder parts of Europe. We studied the regional variation
      in coronary mortality in the 284 Swedish municipalities during a ten-year period
      and the relation to the cold exposure in each municipality during the same time
      period. METHODS: Mortality rates for each municipality were acquired from the
      death certificates and indirectly standardised against the country. Temperature
      readings from measurements 5 times a day during daytime were used to form a cold
      index. We also compensated for wind chill by using Siples wind chill index.
      Multiple regression models were used. Second degree polynomials were used for the
      explanatory variables. RESULTS: There was a strong relation between the cold
      exposure in a municipality and coronary mortality. The cold index alone could
      explain 39% of the regional variation in coronary mortality. In a multiple
      regression model, cold index was the strongest explanatory variable. The coronary
      mortality in the coldest decile of the population was 40% higher than in the
      country as a whole. CONCLUSIONS: There is a strong regional association between
      cold exposure and coronary mortality in Sweden. However, in this type of study,
      it is not possible to determine whether this association is a causal one or not.

PMID- 11209662
TI  - Winter mortality in Emilia-Romagna, Italy.
AB  - In this epidemiological study we have studied during 1997 in Emilia-Romagna
      (population about four million) Italy, mortality from ischaemic heart disease,
      hypertension, cerebrovascular and respiratory disease in 50-89 year-olds. The
      data were collected from "Ufficio Risorse Informative" and "servizio
      Meteorologico" of the Emilia-Romagna region. The results show high indices of
      deaths in the elderly, the highest being those of the 80-89 year-olds, during the
      winter with a maximum in January. There were some differences between males and
      females with regard to cold-related mortality of the different diseases.
      Comparing mortality rates of persons living in the North (Piacenza) and in the
      South (Rimini) of Emilia-Romagna, a consistent lower mortality was found in the
      people of Rimini. These results confirm the close relationship between advanced
      age, cold and excess mortality in Emilia-Romagna. The results suggest that at
      least two factors may be involved in explaining excess winter mortality: the
      sympathetic system changes in the elderly and the effects of cold on some
      haemostatic factors.

PMID- 11209663
TI  - Seasonal patterns of morbidity and mortality in the elderly in Ireland.
AB  - Weather conditions have been shown to have a strong association with health
      Status. (1,2) In this study we examined the relationship between meteorological
      conditions (average daily temperature, humidity, precipitation, and wind
      strength) and the seasonal morbidity (emergency hospital admissions and drug
      prescribing) and mortality patterns in the elderly (over 65 years) over a four
      year period in Ireland. Temperature (summer/winter variation of 10 degrees C) had
      the strongest (inverse) association with total mortality (correlation coefficient
      of 0.895). Circulatory diseases showed the strongest seasonal trend in mortality
      and a weaker trend for admissions. For respiratory diseases, the morbidity and
      admission seasonal patterns were similar. Circulatory and respiratory drug
      prescribing showed no strong seasonal pattern. On examination of the excess
      winter mortality in four different regions, it was found that the smallest
      summer/winter temperature difference (9.96 degrees C) occurred in Cork and was
      associated with the highest percentage difference in total mortality. The highest
      temperature difference (10.80 degrees C) occurred in Monaghan and this area was
      associated with the lowest percentage difference in total mortality.

PMID- 11209664
TI  - Mortality from cardiovascular diseases and its relationship to air temperature
      during the winter months in Dublin and Oslo/Akershus.
AB  - In many countries increased winter mortality from cardiovascular diseases (CVD)
      has been documented. A causal relationship between change in air temperature and
      change in number of deaths has been suggested. There is also evidence for a delay
      between a fall in air temperature and death (lag effect). We have investigated
      these relationships using mortality data for CVD (ICD-9: 390-459) and daily air
      temperatures in selected winter months (December to March) from two densely
      populated areas in Norway and Ireland, Oslo/Akershus and Dublin. A specially
      designed computer programme was used to select data from specific days in the ten
      years period. The days selected depended on the temperature change chosen between
      two consecutive days. We examined 2 types of temperature change, a large change
      and little or no change. An analytical technique involving the use of Spearman's
      correlations coefficients was used to investigate delays in mortality following a
      particular change in temperature. For groups of selected days, an inverse
      relation between mortality and air temperature was found. For neither the
      Oslo/Akershus nor the Dublin data was it possible to see a sudden increase in
      mortality following a large, sudden decrease in temperature and no evidence for a
      delay between a change in temperature and a change in mortality rate was found.

PMID- 11209665
TI  - Seasonal variation of deaths in Finland--is it still diminishing?
AB  - The seasonal variation of deaths in Finland during the period 1961-1995, and its
      possible diminution over time was examined on a daily and monthly basis. The
      daily pattern of deaths over the year was asymmetric, with a very steep rise in
      December (peak on December 26), a slow rise in late winter and spring, a
      secondary rise in June (peak on June 24) and a trough in late August. The
      December peak was 26% higher than the August trough and showed no diminution over
      the period studied. The second peak in June was 12% higher than the annual
      minimum and was particularly pronounced in deaths from ischaemic heart disease
      and among people dying at ages 35 to 64 years. The winter excess in all natural
      mortality was estimated to be 7.4% of all annual deaths, and it showed some
      diminution over time, from 8.4% in 1961 to 6.3% in 1995, mainly because of the
      steeper decline in mortality in late winter in the 1980s and 1990s compared with
      the previous periods.

PMID- 11209666
TI  - Cold and ischaemic heart disease.
AB  - As part of a comprehensive program, including an exercise test, a long-term ECG
      recording, a psychic stress test, and administration of nitrogylcerin, 268
      patients with an acute myocardial infarction (AMT) were submitted to a cold
      pressor test, holding the right hand in ice water for 10 minutes.
      Electrocardiogram (ECG), blood pressure (BP), and heart rate (HR) were determined
      before and at 2 minutes intervals during cold exposure. The patients were
      followed for one year for re AMI, no AMI, and death, sudden (SD) or not sudden
      (OSD). Patients with SD showed a significantly higher rise in diastolic BP than
      those with no AMI (0.001 < P < 0.01) or OSD (0.01 < P < 0.05). HR increased more
      in SD than in no AMI patients (0.001 < P < 0.01). Different physiological and
      metabolic reactions to cold exposure will be discussed.

PMID- 11209667
TI  - Cold and ischaemic heart disease in the elderly.

PMID- 11209668
TI  - Seasonal cold, excursional behaviour, clothing protection and physical activity
      in young and old subjects.
AB  - Previous reports indicate that everyday excursional exposures may play a part in
      increased winter mortality (Donaldson et al 1997) and that the avoidance of cold
      stress is associated with low indices of cold related mortality in Europe
      (Eurowinter Group 1997). However, few prospective data have been reported on
      excursional data and risk factors for arterial disease. In a field study carried
      out on 21 young (mean age 23.5) and 24 elderly healthy subjects (mean age 73.6)
      there were no significant differences between winter and summer in the number or
      duration of outside excursions. Never the less, elderly subjects had
      significantly more clothing insulation (clo), both indoors and outdoors in the
      winter than in the summer (p < or = 0.001) and this was also the case for young
      subjects. The urine temperature of the elderly in the winter was significantly
      lower (p < or = 0.01) than in the summer but this was not seen in the young.
      Elderly physical activity was significantly higher in the winter than in the
      summer (p < or = 0.05) but not for the young. Thus, elderly subjects showed no
      material change in excursional behaviour in the winter, even though clothing
      protection was arguably inadequate in view of lower body temperature, accompanied
      by increased physical activity. Blood pressure was significantly higher in the
      winter (p < or = 0.01) in the elderly, though the extent to which activity levels
      contributed to this contrast is uncertain from these data.

PMID- 11209669
TI  - Seasonal variation of risk factors for cardiovascular disease and diet in older
      adults.
AB  - We have already published much of our data on the seasonal variation of
      cardiovascular disease risk factors in a cohort of 65-74 year old men and women
      living in Cambridge, UK. In this paper we give a concise overview of our findings
      and include previously unpublished data relating to diet. Seasonal variation in
      intake of fat, copper, beta-carotene and vitamins A, C and E were all found with
      increased fat, beta-carotene and vitamin A intakes in autumn and winter while
      vitamin C and E intakes peaked in summer. Seasonal variation of vitamin C intake
      and serum ascorbate concentrations were particularly pronounced. We postulate
      that low vitamin C levels in winter could be associated raised plasma fibrinogen
      and plasminogen activator-1 (PAI-1) concentrations and therefore with increased
      cardiovascular risk.

PMID- 11209670
TI  - Dependence of cold-related coronary and respiratory symptoms on age and exposure
      to cold.
AB  - Cold causes cardiopulmonary stress often perceived as shortness of breath or
      chest pain, and causes exacerbation of these symptoms in persons suffering heart
      or lung disease. We investigated the prevalence of these symptoms and their
      association with sex, age and cold exposure in a population-based sample of 1,785
      persons who lived in three areas of Finland. The exposure to cold was measured by
      the annual number cold days (mean daily temperature below 0 degree C) in the
      resident locality and weekly hours spent in the cold in winter. Shortness of
      breath was 25% and chest pain 52% more common in females than in males, and their
      prevalence increased by 24% and 77%, respectively, for every 10 years of age. The
      prevalence of shortness of breath increased by 5% and chest pain by 6% for every
      10 cold days in the resident locality, and by 6% and 7% for every 10 hours spent
      in the cold, respectively. We suggest that environmental cold, measured by the
      number of cold days throughout the year and weekly hours spent in the cold, may
      provoke cardiopulmonary symptoms independent of sex and age.

PMID- 11209671
TI  - Physiological and haematological responses to cold exposure in the elderly.
AB  - Throughout Europe, including Norway, increased winter mortality from
      cardiovascular diseases (CVD) is well described. However, while there are
      associations between high CVD mortality and cold climate, the reason for the
      excess deaths is not entirely known. Recent epidemiological evidence suggests
      that brief outdoor exposure to cold conditions may be linked to increased winter
      mortality in the elderly. However, the question as to whether alterations in the
      haemostatic system following exposure to cold could be responsible for the
      increased winter risk has been little investigated in elderly subjects. In this
      study, we have compared the effect of exposing lightly clothed healthy elderly
      men and women (60-70 years) for 90 minutes to either a mild cold stress (16
      degrees C) or thermoneutral conditions (28 degrees C). Measurements of a variety
      of autonomic and haematological parameters were made in order to compare to what
      extent exposure to cold stress affects production of thrombogenic risk factors.
      The overall autonomic responses clearly showed that the subjects were mildly cold
      exposed. The main changes in the blood system were a cold exposure increase in
      hemoconcentration and an increase in the fibrinolytic parameter, t-PA. This
      coupled with other changes support previous findings and it is concluded that
      short term mild cold exposure in the elderly initiates a mild inflammatory
      reaction and a tendency for an increased state of hypercoagulability.

PMID- 11209672
TI  - Atmospheric heat exchange of the human being, bioclimate assessments, mortality
      and thermal stress.
AB  - In epidemiological investigations of the impact of the atmospheric environment on
      mortality usually only air temperature, in addition to sometimes relative
      humidity, are used, although it is generally known that the heat exchange
      conditions of the human body also depend on water vapour pressure, wind velocity,
      and short- and long-wave radiation. The state-of-the-art approach to this problem
      is the application of complete heat budget models which allow
      thermophysiologically significant assessments of the above-mentioned
      meteorological variables taking metabolic rate and isolation of clothing into
      account. The application of such a model to 30-year mortality data of Baden
      Wurttemberg (SW-Germany) shows, in winter, increasing daily mortality rate with
      decreasing "perceived temperature." (a term which relates temperature to a fixed
      standard condition). A sudden warming during a cold period also results in an
      increase in mortality, a certain contradiction which has not yet been able to be
      explained. During cold spells a marked increase in mortality with a delay of 3
      days can be observed. Above normal values last for about 4 weeks and will then be
      partially compensated by an "undershot". Generally the explanation of variance in
      winter is distinctly lower than in summer, probably because in winter there is
      rarely direct exposure to outdoor conditions. The degree of cold stress is likely
      to serve only as an indicator for indoor conditions which promote infectious
      diseases.

PMID- 11209673
TI  - Indoor climate and health.

PMID- 11209674
TI  - Thermal factors--indoor climate.
AB  - From 1950 and until today, building technology has developed continuously,
      especially concerning insulation and sealing (2). Therefore the Norwegian houses
      of today resist cold and wind very well. But there are still factors that can
      provide thermal discomfort. Some of these factors can for instance be open indoor
      solutions, placement and number of windows and sources of heat, upgrading and
      maintenance of old houses. Important thermal parameters are draught and air
      velocity, vertical air temperature differences, asymmetry of thermal radiation,
      floor temperature and relative humidity (4).

PMID- 11209675
TI  - Living in a Norwegian house.

PMID- 11209676
TI  - Thermal and relative humidity conditions in the houses of the aged living in
      Ireland, and their risk of effective acute cold stress.

PMID- 11209677
TI  - Accidental hypothermia in the elderly.
AB  - Accidental hypothermia is known to be a hazard to elderly people in temperate and
      cold climate. This is a review of the literature focusing on risk factors,
      clinical presentation and treatment of hypothermia in the elderly. The most
      important risk factors are connected to ageing itself and to the morbidity often
      found in elderly hypothermia victims. Knowledge about treatment of severe
      accidental hypothermia in elderly people is based on experience from few cases
      and some minor prospective studies mainly on rewarming of younger patients.
      Clinical treatment protocols seems to be based on experience from younger
      patients. Based on general knowledge in geriatric medicine and experience from
      three recent cases of hypothermia in the elderly, the use of careful, active
      external rewarming and a low stress strategy are recommended for elderly
      patients.

PMID- 11209678
TI  - Rewarming from hypothermia. Newer aspects on the pathophysiology of rewarming
      shock.
AB  - The fatal circulatory derangements often observed when resuscitating victims of
      accidental hypothermia by rewarming are recognized as a falling cardiac output
      and a sudden drop in blood pressure, termed "rewarming shock". The real cause of
      this rewarming shock, or rewarming collapse, is, so far, unknown. This review
      presents current information exploring different aspects of the compromised
      circulatory function during hypothermia and especially after rewarming and
      supports the hypothesis that posthypothermic circulatory instability may be
      caused by cardiac insufficiency and alteration of the peripheral vascular bed.
      Cellular calcium overload, disturbed calcium homeostasis, changes in myocardial
      myofilament responsiveness to intracellular calcium as well as impaired high
      energy phosphate homeostasis could all be proposed as important factors leading
      to the changes observed in the hypothermic heart. Together with alteration of
      capillary function, increased capillary leakage of plasma protein, changes in
      intra- and extravascular volume-homeostasis and alteration of autonomous vascular
      control they all contribute to a maintained low cardiac output during and after
      rewarming which is associated with a fatal outcome.

PMID- 11209679
TI  - Strategies for prevention of cold stress in the elderly.
AB  - Human health and wellbeing require simple and effective strategies for prevention
      and alleviation of harmful effects of cold exposure. Adoption of a strategy
      should consider the type of cold stress; (1) whole body cooling, (2) extremity
      cooling, (3) convective cooling (wind chill), (4) conductive cooling (contact),
      and (5) airway cooling. The prime goal is to prevent tissue cooling. The risk,
      nature and magnitude of strain depend largely on the cooling effect, which
      results from the interaction of climate factors (mainly air temperature and
      wind), protection (clothing) and metabolic heat production (activity,
      "behaviour"). The effects (strain) of tissue cooling are acute, progressive or
      chronic. Acute effects are primarily thermoregulatory reflexes mediated by the
      sympathetic system and comprise immediate cardiovascular and respiratory
      reactions. Progressive effects are characterized by gradual temperature drop in
      peripheral or core tissues. This results in pain, neuro-muscular insufficiency,
      sensory loss and, eventually, cold injury. Chronic effects are likely to affect
      peripheral nerves and vessels, as well as cardio-respiratory function. The
      progressive degradation of physiological functions in the elderly increases the
      risk of harmful effects with cold exposure. This requires careful examination of
      relevant assessment criteria, as well as the development of simple and efficient
      strategies for prevention of cold stress.

PMID- 11209680
TI  - Are cold exposure and reduction of growth hormone secretion in the elderly
      synergetic risk factors in cardiovascular diseases?

PMID- 11209681
TI  - Seasonal relationship between date of birth and date of death in Finnish
      centenarians.

PMID- 11209682
TI  - [Expression of single-chain Fv antibody for anti-beet necrotic yellow vein virus
      in Escherichia coli].
AB  - The heavy chains variable region gene (VH) of monoclonal antibody against beet
      necrotic yellow vein virus (BNYVV) was amplified from total DNA extracted from
      anti-BNYVV hybridoma cells by PCR. Sequencing showed that the VH belongs to mouse
      subgroup II(A) and contains 360 bp, which code one hundred and twenty amino
      acids. The VH and VL genes were inserted into a plasmid which contains a linker
      sequence for constructing scFv gene. The new vector named pTC scFv. The scFv was
      produced in Escherichia coli and appeared binding activity with BNYVV antigen by
      ELISA method.

PMID- 11209683
TI  - Development of PCR-based markers linked to the fertility restorer gene for the
      polima cytoplasmic male sterility in rapeseed (Brassica napus L.).
AB  - Bulked segregant analysis was used to identify RAPD markers linked to the Rfp of
      pol cms in rapeseed (Brassica napus L.) from the fertile and sterile DNA bulks.
      DNA bands amplified from 1040 random 10-mer primers were screened. Two
      polymorphic bands S1019(720) and S1036(810) were found linked to the Rfp locus at
      the same side with a map distance of 5.8 cM and 12.3 cM respectively. These
      polymorphic fragments were cloned and sequenced. Nucleotide sequence information
      was used to design 20-24-mer oligo nucleotide primers for PCR amplification. The
      SCAR markers that generated from the long primers showed the same pattern of
      segregation as the original RAPD markers in the backcross population. The SCAR
      markers would facilitate selection on the Pol CMS restorer lines in rapeseed.

PMID- 11209684
TI  - [Construction and analysis of soybean genetic map].
AB  - Molecular linkage maps provide a powerful tool for the analysis of plant genome
      structure and function including the detection of quantitative trait loci (QTL).
      The molecular linkage map of soybean was constructed using an 88-individual RIL
      population derived from a cross between cultivated Changnong 4 and semi-wild
      Xinmin 6. The map contains 22 linkage groups and 240 markers, including 100 RFLP,
      33 SSR, 62 RAPD, 42 AFLP, 1 SCAR and 2 morphological markers. It covers
      approximately 3,713.5 cM of soybean genome. Analysis of 72 RFLP markers showed
      that 16 of them revealed two or more independent loci and it suggested that there
      is an extensive homologous region in soybean genome. This map compared very well
      with the other published soybean maps.

PMID- 11209685
TI  - [Analysis of 16S rDNA sequence and DNA-DNA hybridization of rhizobia isolated
      from Indigofera sp].
AB  - Based on the previous studies on numerical taxonomy and SDS-PAGE of whole-cell
      protein, the rhizobia strains isolated from Indigofera sp. in loess plateau area
      of North-west China constituted a new cluster, the 16S rDNA sequence of
      representative strain SHL042 was tested, and the phylogenetic tree was produced.
      In this tree, the strain SHL042, R. tropici A, R. tropici B, R. leguminosarum, R.
      etli, R. hananesis, R. mongolense and R. gallicum constituted a branch of
      phylogenetic. Within this branch, the similarity values of 16S rDNA sequences
      were 95.4%, 95.5%, 96.3%, 95.8%, 96.3%, 97.9% and 97.7% respectively. The values
      were more than 95%. This indicated that these species should belong to the same
      genus. The values of DNA homology in the new cluster were all more than 80%, but
      the values between SHL042 and the strains of these species were less than 50%.
      Thus, the strain SH714 represented a new rhizobia species.

PMID- 11209686
TI  - [Expression of 3'-truncated preS/S gene in transgenic mice].
AB  - The 3'-truncated preS/S region from HBV genome, encoding a transcriptional
      transactivator, was cloned and a recombination expression vector for 3'-truncated
      HBV preS/S sequences under the control of the CMV promoter was constructed by
      recombination DNA techniques. Then, the expression vector DNA was microinjected
      into pronuclei of fertilized mouse oocytes. Founders of transgenic mice
      harbouring the recombination gene which can be expressed were screened by
      polymerase chain reaction (PCR) at genomic DNA level and confirmed by ELISA
      andlysis at protein level. Two of 15 mice in one series of microinjections showed
      the expression of 3'-truncated preS/S gene from HBV genome. The expression vector
      of 3'-truncated preS/S gene might be helpful for further studies of relationship
      between the expression production of 3'-truncated preS/S sequence and HBV
      associated oncogenesis in vitro. The transgenic mice with expressing 3'-truncated
      preS/S gene will provide new insight into its roles in the development of human
      hepatocelluar carcinoma (HCC) in vivo.

PMID- 11209687
TI  - [Genetic analysis of sow productivity traits].
AB  - Genetic analysis was conducted on the data of 3 populations with 1686 litters
      including Erhualian pigs, Large White and first cross. The phenotypic and genetic
      parameters among litter weight at birth (LW), average piglet weight at birth
      (APW), litter weight at 20 days (LW20), average piglet weight at 20 days (APW20),
      litter weight at 45 days (LW45), average piglet weight at 45 days (APW45) were
      estimated by sire model. The results indicated that Erhualian pigs had stronger
      maternal ability and slower growth rate compared to Large White. The first four
      traits (LW, APW, LW20, APW20) had larger maternal effects, while LW45 and APW45
      had smaller maternal effects. The heritabilities of LW, APW, LW20, APW20, LW45,
      APW45 were 0.251, 0.277, 0.341, 0.330, 0.235, 0.186, respectively. The results
      indicated that direct selection was effective. According to our results, we
      considered that it was fit to select two traits (LW, LW20) out of these six
      traits to reflect sow productivity. Litter weight at birth could reflect the
      prolificacy of sow, litter weight at 20 days could reflect the maternal ability
      of sow.

PMID- 11209688
TI  - [The research on the expression of rabbit defensin (NP-1) gene in transgenic
      tomato].
AB  - Rabbit defensin NP-1 is one kind of alpha-defensins. It is composed of 33 amino
      acids. It was firstly extracted from polymorphonnuclear neutrophile of rabbits.
      It displayed resistance to bacteria, fungi and virus, especially high resistance
      to bacteria. In our experiments NP-1 gene was constructed into a plant expression
      vector. Eight transgenic plants containing the rabbit defensin gene (NP-1) were
      obtained through agrobacterium-mediated transformation. The transgenic plants
      were analysized by PCR, Southern hybridization, Northern dot blot hybridization
      and in vitro microbicidical activity against E. coli and Fusarium oxysporum. The
      results showed that NP-1 gene was transformed into the tomato, and the transgene
      displayed physiological-level expression. The transgenic tomato also showed
      resistance to pathogen Fusarium oxysporum in vivo. Our experiments paved a way
      for pathogen resistance breeding of tomato.

PMID- 11209689
TI  - [Induction of polyploid in the Pacific abalone by caffeine-heat shock
      treatments].
AB  - Polyploid of Pacific abalone, Haliotis discus hannai Ino, was induced by blocking
      Polar body I with caffeine-heat shock treatments. Fertilized eggs were treated
      with caffeine concentrations at: 2.5 mmol/L, 5 mmol/L and 10 mmol/L; heat shock
      temperatures at 24 degrees C, 26 degrees C, 28 degrees C, lasting for 10 min to
      30 min, total 5 periods of time, beginning at 10 min post-fertilization. Both
      fertilizing and incubating at 21 degrees C sea water. The results of studies
      showed that the effective procedure for inducing triploid appeared to be 5 mmol/L
      and 10 mmol/L Caffeine concentration, heat shock temperature 26 degrees C,
      duration 10 min to 15 min, all beginning at 10 min after insemination. The
      percentage of triploid was 64.6%-77.8%, Comprehensive efficiency index of
      polyploid induction was 0.57-0.61. Under the condition of 5 mmol/L caffeine
      concentration and the temperature 26 degrees C for 30 min duration at 10 min post
      fertilization, 2.8%-3.6% tetraploid embryos could be produced.

PMID- 11209691
TI  - [Mutagenic analysis on the polyhedrin gene (polh) of Bombyx mori nuclear
      polyhedrosis virus (BmNPV)].
AB  - In our early studies, the abnormal shape of the polyhedra of Bombyx mori nuclear
      polyhedrosis virus (BmNPV) induced by chemical mutagens of MMC. 9-AA and EMS
      occurred, and the genome of the mutated BmNPV obtained from the successive test
      had some change in the restriction endonuclease partners of EcoRI, BglII and
      BamHI. The present studies showed that the arrangement of the crystal lattice of
      the polyhedrin was disorderly, and the SDS-PAGE electropherogram of the
      polyhedrin depicted distinct change in comparison with control group. The results
      of sequencing analysis showed that many point mutations with characteristics of
      the base substitution had occurred at some sites of the BmNPV polh gene in three
      mutated groups, and these results funther revealed molecular mutagenesis of the
      mutagens effective to BmNPV. It was not confirmable that the point mutations of
      polh gene in the mutated BmNPV have relationship to abnormal shape of the
      polyhedra.

PMID- 11209690
TI  - [Induction of protective immune responses in rhesus monkey by immunization with
      recombinant plasmids of polyvalent epitopes of Plasmodium falciparum using
      cholera toxin B as adjuvant].
AB  - The immunogenicity and protective efficacy of the DNA vaccine which include
      cholera toxin B subunit (CTB) and polyvalent protective epitopes of Plasmodium
      falciparum (awte gene) was assessed using rhesus monkeys as animal models.
      Recombinant plasmids of pCMV-CTB-AWTE were given to five rhesus monkeys three
      times with two weeks intervals by intramuscle (i.m.) route, immunization dose was
      500 micrograms per plasmid per animal. High levels of anti-CTB and anti-malaria
      epitopes antibodies and P. falciparum epitope specific CTL activity were
      elicited. The vaccinated groups was challenged with 1.25 x 10(8) of P. cynomolgi
      parasites. All monkeys of the control group was patent for at least 34 days, the
      DNA vaccinated groups wasn't infected during the 60 days we detected. The
      cocktail DNA vaccine which contains multi-stage and multi-epitope antigen gene
      shows excellent immunogenicity and protective efficacy, the results also suggests
      that DNA vaccine plays an important role against malaria infection.

PMID- 11209692
TI  - [Establishment of a method for GUS gene transferring into wheat (Triticum astivum
      L.) embryos by low energy ion beam implantation].
AB  - Physical parameters influencing transformation of wheat mediated by low energy
      ion beam, including type of ion, parameters of ion energy, dose and dose rate,
      were studied. Ar+ was regarded as suitable ions implanted in transformation. 20
      25 keV of energy, 4.68 x 10(16) ions/cm2 of dose, 2.6 x 10(15) ions/cm2 of dose
      rate were chosen as appropriate implantation parameters. The suitable culture
      conditions for induction and growth of callus and the optimal selection scheme
      were established, After implantation and selection, resistant calli and
      hygromycin-resistant plantlets were obtained from three varieties. Molecular
      analysis data proved that GUS gene had integrated into the wheat genome. The
      mature embryo transformation efficiency of wherat variety Yangmai 5, Yangmai 158,
      Wanmai 32 reached 9.5%, 10.8%, 11.2% measured in produced hygromycin-resistant
      callus and 1.4%, 3.4%, 1.7% measured in regenerated plants, respectively, This
      experiment provides a basis for further investigation of wheat transformation
      system. Low energy ion beam mediated transformation can be extended to other
      plant recalcitrant to Agrobacterium tumefaciens as soon as methodological
      parameters are optimized.

PMID- 11209693
TI  - [Production of herbicide-resistant rice with transforming heterogene].
AB  - Using pAHC20 (containing Bar gene), pWRG1515 (containing GUS gene and hygromycin
      phosphotransferase gene), and pCAMBIA3300 RG with Bar gene and snowdrop lectin
      (GNA) gene as donor DNA, the micro-adventitious shoots and the calli induced from
      mature embryos of Oryza sativa 87203, Eyi105, Shangnong aromatic glutinous rice
      as recipients were transformed with particle bombardment and Agrobacterium
      tumefaciens strain LBA4404 containing pAL4404, respectively. After chosen with
      phosphinothricin and antibiotic, GUS detection and PCR analysis, The results
      showed that the foreign genes had been transformed microprojectile-mediated to
      Oryza sativa Eyi105, the regeneration plants were obtained, and, 5 transgenic
      calli of Oryza sativa Eyi105 were obtained with Agrobacterium-mediated
      transformation.

PMID- 11209694
TI  - [A study of genetic character of cultivar Shiyuan 321 from G. barbadense x G.
      thurberi x G. hirsutum using isozyme and RAPD techniques].
AB  - To study the genetic character of trispecific hybrid cultivar Shiyuan 321, we
      analyzed this cultivar and its parents by isozyme and RAPD techniques. The main
      results are as follows: (1) Esterase isozyme analysis showed that there was one
      specific band among cultivar Suiyuan 321 and its parents, G. thurberi and G.
      barbadense; (2) Six specific DNA fragments amplified by 4 primers were found
      among cultivar Shiyuan 321 and its parents G. barbadense, G. thurberi; (3) By
      comparing RAPD differences among Shiyuan 321 and its parents, it is indicated
      that the genetic heterogeneity of cultivar Shiyuan 321 is very high at its
      genomic DNA level. The above results proved that Shiyuan 321 is a trispecific
      cultivar from G. barbadense x G. thurberi x G. hirsutum as well as a new
      germplasm.

PMID- 11209696
TI  - [Detection of differentially expressed genes in hepatocellular carcinoma using
      DNA microarray].
AB  - Large scale gene expression profiles between normal hepatocytes and
      hepatocellular carcinomas are detected with high throughput microarray. DNA
      microarrays were made by spotting PCR products of 4,096 human cDNAs onto a
      specially treated glass slides. The probes were prepared by labelling normal
      tissue mRNA and cancer tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through
      reverse transcription. The arrays were then hybridized against the cDNA probe
      mixture and the fluorescent signals were scanned. The obtained data were analyzed
      from 4 repeated experiments. There are 903 genes of which the average ratios
      between Cy3 signal and Cy5 signal are greater than 3.0. These genes identified
      through this approach are potential candidates for hepatocellular carcinoma
      diagnosis and therapy.

PMID- 11209697
TI  - [Affect of heredity, disease and environment on the life-span of personage in
      History Book of Song Dynasty].
AB  - The data have been sorted and calculated by statistics for personages' life-span
      according to surname and Yin-Yang type and disease according to the cause of
      pattern over 793 personage from the biography of emperor families' and official
      in feudal times and subjects of the feudal ruler in History Book of Song Dynasty.
      (1) For there are some genetic diseases causing their earlier death in surname
      Zhao's, the average value of life-span is shorter than the other surname of Wang,
      Li, Zhang, Liu and Chen's. Because the average value among those five surnames
      are not different each other, the character of the distribution of every one's
      tally with neuter alleles. (2) The average value in a population on a type of
      mild Yin and Yang is higher than the type of Yang only, P < 0.05. (3) Disease and
      bad environment are the limiting factors for life. Besides, to rise the
      resistance ability is an important path way for increasing our life-span. The
      attribute of a genetic system in Yin or Yang is an objective existence. Influence
      on life by genetics may vary with various disease and environment, but different
      disease is controlled genetically. A bad environment may affect life, but neuter
      environment would be affected the life through attribute of a genetic system in
      Yin or Yang type indirectly.

PMID- 11209695
TI  - [STR polymorphisms in five Chinese ethnic groups(2)].
AB  - Population genetic studies were performed in Chinese Han, Hui, Mongolian, Tibetan
      and Uygur. Allele frequency distributions were analyzed for ten loci, i.e.,
      D3S1358, VWA, CSF1PO, FGA, THO1, TPOX, D5S818, D13S317 and D7S820 by GeneScan.
      The results showed that there were 60 STR alleles and 149 genotypes in Han; 63
      STR alleles and 144 genotypes in Hui; 69 STR alleles and 173 genotypes in
      Mongolian; 77 STR alleles and 168 genotypes in Tibetan; 70 STR alleles and 148
      genotypes in Uygur. Significant differences were identified among ethnic groups
      (African-American, US-Caucasian and Chinese-Oriental), but similarity was found
      among the five Chinese populations, and immunogenomics and pharmacogenomics
      studied in this report. These findings indicated that the nine STR loci and
      amelogenin locus were very useful for individual identification in forensic
      science.

PMID- 11209698
TI  - [Studies of the origin of malignant rhabdoid tumor(MRT)--experimental researches
      on the MRT evolving in nude mice inoculated with violently variable HeLa cells].
AB  - Under the prerequisite that the incidence of cancer or tumor in negatively
      controlled nude mice inoculated subcutaneously with feline or canine kidney cell
      cultures purified in vitro at passage 3 or higher (the modal chromosome number of
      FKC on passage 3 was 38 of diploid at the rate of 80%) was 0%(0/22) and 0%(0/10)
      respectively, and the incidence of progressively negative growing tumor in
      controlled nude mice inoculated subcutaneously with repeatedly-frozen- and thawed
      HeLa cell cultures of X strain was 20%(1/5), the negative growing malignant tumor
      (MT) was found in half of the nude mice inoculated subcutaneously with HeLa cell
      cultures of H strain(with modal chromosome number of 78 +/- 2 of sub-tetraploid
      at the rate of 40%), the progressively-growing malignant tumor was found in all
      the other 40 nude mice inoculated subcutaneously with HeLa cell cultures of other
      strains, with the incidence of MT in nude mice with KB strain (with modal
      chromosome number of 60 +/- 3 of hyperdiploid at the rate of 72%-76%) 10/10, the
      incidence of poorly-differentiated MT originated from epithelia in nude mice with
      X strain (with modal chromosomal number of 62 +/- 3 of hyperdiploid at the rate
      of 69%) 25/25, and the incidence of MRT in nude mice with in vitro cultured tumor
      cell NM20/X strain (with modal chromosome number of 68 +/- 3 of both hyperdiploid
      and subtetraploid at the rate of 52%) 5/5. After being continuously cultivated
      for 20 passages in vitro, HeLa cell of X strain was subcutaneously inoculated
      into nude mice and cultivated for 1 passage in vivo within 15 days, and then the
      developed growing MT was collected as HeLa cell of NM20/X strain on passage 0 and
      continuously cultivated for 11 passages to prepare for transplanting into nude
      mice again. Therefore, the highly variable strain of HeLa cells can be
      successfully selected by alternate cultivation in vitro and in vivo. Occasionally
      in another experiment, the progressively-growing MRT was found in all the 4 nude
      mice of one test group inoculated subcutaneously with 0.17 ml cell-cultures of
      super-high density containing 12.75 x 10(7) HeLa cells of KB strain on passages
      10-11(with the rate of chromosome aberration high to 20% on passages 10-11
      including 18% dicentric chromosome and 2% breakage chromosome). Although the
      incidence of MRT in nude mice inoculated subcutaneously with violently variable
      HeLa cells of NM20/X strain on passage 11, HeLa cells of KB strain on passages 10
      11 reaches 100%(5/5) & 100%(4/4) respectively, yet it is requested that the
      inoculated live cell number is huge (5-12 x 10(7) cells per nude mouse), the
      tumor emerges immediately, develops violently, grows very fast, and has an
      extremely aggressive malignancy, the tumor is rich in the blood vessel giving a
      full supply of blood for it, and the mean value of major diameter X minor
      diameter of the tumor is essentially up to the standard of 30 mm x 20 mm in 16-22
      days after the inoculation of the cells into the nude mice. The first finding of
      MRT in model animals provides an opportunity for answering the origin problem of
      MRT. Based on this reason, human uterus vertical epithelium may be an original
      tissue of MRT, thus opening up a new era for the research of MRT origin. It is
      also concluded as follows: 1. Cellular tumorigenicity is different among
      differently-karyotypic cells. 2. Highly variable strain of tumor cell line can be
      selected quickly and successfully in nude mouse. 3. Cellular tumorigenicity may
      be increased if chromosome aberration is very high. 4. The genetic
      characteristics of chromosomes of HeLa cells determines their tumorigenicity,
      chromosome number variation of HeLa cells has positive relationship with their
      carcinogenesis or tumorigenicity, and the turn of HeLa cells concerning their
      tumorigenicity from weak to strong is KB, X and NM20/X strains (excluding H
      strain, in which tumorigenicity remains to be determined by further experiments)
      respectively.

PMID- 11209699
TI  - Identification of RAPD markers tightly linked to wheat powdery mildew resistance
      gene Pm6.l.
AB  - Pm6 transferred from Triticum timopheevii L. to common wheat, is an effective
      resistance gene to powdery mildew disease caused by Erysiphe graminis f. sp.
      tritici. The RAPD technique, employing a total of 700 decamer primers, was used
      to identify polymorphic markers between resistant (IGVI463) and susceptible
      (Prins) near-isogenic lines. Primer OPV20 produced a 2,000 base pair (bp)
      reproducible fragment only in the resistant near-isogenic line. The 2,000-bp DNA
      fragment was present in all other introgression lines containing Pm6. Using the
      F2 mapping population from a cross of IGVI-463 (PI170914/7*Prins) x Prins, Pm6
      was shown to be closely linked to the marker OPV20-2000 at a genetic distance of
      3.0 +/- 2.2 cM. The marker was successfully used in detecting the presence of Pm6
      in different genetic backgrounds.

PMID- 11209700
TI  - [Identification of the barley chromosome in wheat by GISH and RFLP].
AB  - The barley chromosome in wheat was identified by genomic in situ hybridization
      (GISH) in which biotin labelled total genomic DNA of barley Betzes was used as
      probe and the unlabelled total DNA of common wheat Chinese Spring (CS) as
      blocking DNA. A series of wheat materials were tested as follows: two disomic
      alien substitution and monosomic alien addition lines, 2n = 43; two monosomic
      alien substitution lines, 2n = 42; seven disomic alien substitution lines, 2n =
      42. RFLP probe psr131 on the short arm of the homologous group 2 was used to
      analyze the barley chromosome in wheat. The result indicated that there was a
      same band in barley Betzes and substitution line A5. The chromosome 2A of A5 was
      substituted by the chromosome 2H of barley. These materials will be useful in
      transferring the valuable genes in the chromosome 2H to wheat.

PMID- 11209701
TI  - [Genetic diversity of Fagoyrum tataricum cultivated in north Liangshan Prefecture
      of Yi Nationality, Sichuan, China].
AB  - In the present paper is stated the accomplishment of the studies of 17
      populations of cultivated Fagopyrum tataricum (L.) Gaertn. from the counties of
      Yuexi and Ganluo in North Liangshan Autonomous Prefecture of Yi Nationality,
      Sichuan Province, China by means of starch gel electrophoresis and cluster
      analysis of agrobiology features. Seven enzymes, and 15 loci were assessed. The
      result shows that the genetic diversity of F. tataricum within population is
      higher than in the South Prefecture and in species F. esculentum from other
      areas. The A, P, Ho and He are 1.9, 52.1%, 0.190 and 0.262 respectively. The FST
      is 0.199 which is close to the average level of wild plants. A conservation
      strategy of the genetic resource of F. tataricum is suggested. Two populations of
      local variety "Youchiqiao" have the richest genetic diversity, P = 60.0%, Ho =
      0.260 and 0.301 and they should be protected particularly. Two populations of
      local variety "Xiaomiqiao" with higher genetic diversity, as well as three
      populations of local varieties of "Qiukuqiao", "Equkuqiao" and "Geluokuqiao" with
      special genetic position should be protected too.

PMID- 11209702
TI  - [Analysis of isozyme and RAPD for the germplasm lines from G. hirsutum x G.
      bickii].
AB  - To study the effectiveness of Gossypium interspecific hybrid breeding on
      molecular level, the six germplasm lines from interspecific hybrids between G.
      hirsutum and G. bickii were analysed by the techniques of RAPD and isozyme
      electrophoresis. The main results were summarized as follows: (1) The basic
      zymograms of peroxidase isozyme of the six germplasm lines were similar to their
      G. hirsutum parent, but two out of the germplasm lines showed one specific band
      of the wild parent of G. bickii (pI 4.85); (2) The RAPD fingerprint showed
      distinct difference of genomic DNA among the germplasm lines; (3) The four
      specific DNA fragments of G. bickii were observed in RAPD patters of four out of
      the six germplasm lines.

PMID- 11209703
TI  - [Studies of the active site, thermostability and thermophilicity of the
      thermostable alkaline phosphatase by site-directed mutagenesis].
AB  - Through PCR-mediated mutagenesis, three mutants E68S, S70A and E68SS70A around
      active site S(69) were obtained. Their enzymatic characteristics was determined.
      It was found that the specific activity of E68S ascended 8 times while its
      optional reactive temperature climbed 20 degrees C and its Tm descended 3 degrees
      C; the specific activity of S70A ascended 1 time while its optional reactive
      temperature climbed 5 degrees C and its Tm descended 2 degrees C; the specific
      activity of E68SS70A descended 50% while its optional reactive temperature
      climbed 5 degrees C and its Tm descended 19 degrees C. These result implied that
      the amino acids, beside the active site, were contributed not only to enzymatic
      activity but also to its thermostability and thermophilicity. The work provided
      the direction for mutation to improve enzymatic specific activity and studying
      the mechanism of thermostability and thermophilicity.

PMID- 11209704
TI  - [Differentiation genes are involved in homologous recombination in Streptomyces
      coelicolor].
AB  - In S. coelicolor, the rapid increase of SCP2* plasmid conjugation efficiency and
      that of plasmid homologous recombination efficiency associates with development
      of aerial mycelium. Results of test of SCP2* plasmid conjugation and plasmid
      homologous recombination in one bld mutant and in three whi mutants show that
      while whiA mutant causes unstable plasmid conjugation efficiency, the other three
      mutants show no influence on plasmid conjugation, plasmid homologous
      recombination efficiency drops however more than 10 times in the four mutants.

PMID- 11209705
TI  - [Painting the chromosomes of fishes with human sex chromosome-specific DNA
      probes].
AB  - Chromosome painting is one of the effective methods in studying the evolution of
      genomes. The chromosomes of the species of fishes--M. aculeatus, M. albus and D.
      rerio were painted respectively with human X and Y chromosome-specific DNA
      probes. The results showed that some homologous segments of human X chromosome
      were found in the genomes of all the three kind of fishes, all the segments were
      scattered on several pairs of homologous chromosomes in each kind of fish. But no
      homologous segment of the human Y chromosome was found.

PMID- 11209706
TI  - [Isolation and characterization of the porcine glial fibrillary acidic protein
      (GFAP) gene by CATS].
AB  - Primers for the glial fibrillary acidic protein (GFAP) gene were designed from a
      human cDNA sequence aligned with the mouse GFAP gene on the principle of
      comparative anchor tagged sequence (CATS). The 412 bp PCR product isolated from
      Chinese Erhualian pig genome was characterized as the porcine GFAP gene by
      comparing the sequence with the GenBank database. The chromosomal location of the
      GFAP gene is on pig Chr: 12(p11-(2/3)p13) using pig x rodent somatic cell hybrid
      panel.

PMID- 11209707
TI  - [Association of microsatellite genomic heterozygosity with inbred pig performance
      under successive inbreeding].
AB  - Genomic scanning using microsatellites was carried out in a pig family that has
      undergone 5 successive generations of inbreeding. A total of 56 microsatellite
      markers were utilized, which were derived from swine chromosome 01, 02, 11, 13,
      17, 18 and gave a considerable coverage of these chromosomes. Genomic
      heterozygosity was estimated as an average of marker heterozygosity over all 6
      chromosomes. Analysis of variance using a generalized linear model indicated that
      genomic heterozygosity was positively and significantly associated with slaughter
      weight (SWT) and average daily slaughter gain (ADSG), but inconsistently and non
      significantly associated with backfat depth (BFDP). Association effects of GH on
      SWT and ADSG increased from generation 1 to generation 2, and, then, reduced
      gradually with generations while levels of inbreeding accumulated. The maximum
      effect was observed in generation 2, which was estimated to be 22.43 kg for SWT
      and 0.132 kg/d for ADSG. The effect of marker heterozygosity on SWT and ASDG
      differed dramatically from chromosome to chromosome: the largest effect was
      observed with chromosome 13 (i.e. 6.306 kg for SWT and 0.032 kg/d for ADSG),
      followed by chromosome 01, 17, 18, 02 and 11. Marker heterozygosity was not found
      to be significantly associated with BFDP for all chromosomes. These results give
      rise to three implications. First, genes (e.g. QTL) contributing to traits of
      economic importance are not equally distributed among these chromosomes, which
      represents the difference in determination of quantitative traits across
      chromosomes or at DNA level. Second, the association of genomic or marker
      heterozygosity with pig performance varies from chromosome to chromosome, or with
      generations of inbreeding. This phenomenon provides an evidence that
      heterozygosity-performance association is not straight-forward, but rather
      complex as a result of complicated gene actions and interactions, and sometimes
      may even be much more complicated when confounded and misled by inabequate or
      improper markers utilized. Last, decreased heterozygous advantage or heterozygous
      disadvantage, in some cases, is very much likely as a result of the high linkage
      disequilibrium under high levels of inbreeding, where one or several deleterious
      alleles might be linked with neutural markers in much high probability.

PMID- 11209708
TI  - [QTLs analysis of tiller angle in rice (Oryza sativa L.)].
AB  - Tiller angle is one of important characters that constitute plant type with great
      significance in breading. A pair of japonica/indica lines, which were
      significantly different in tiller angle, were used in this study. A DH population
      were constructed via anther culture of F1 hybrids. The tiller angles of 115 DH
      lines were measured. QTL analysis was conducted based on the constructed
      molecular linkage map. Three QTLs (qTA-9a, qTA-9b and qTA-12) were detected on
      chromosome 9 and 12 respectively, Their variation were 22.7%, 11.9% and 20.9%
      respectively and their additive effects were all negative, showing this character
      was controlled by genes from big tiller angle parent ZYQ8. The application of the
      tiller angle that was controlled by major genes and minor genes in rice breeding
      is also discussed.

PMID- 11209709
TI  - [Chromosome location of a semidwarf gene sd-t in indica rice (O. sativa L.)].
AB  - For investigating the linkage group to which the semidwarf gene sd-t belongs, the
      crosses between Aitaiyin 2(ATY2), a variety of sd-t carrier in indica rice, and
      marker stocks as well as the trisomic lines of IR36 were made. The results
      indicated that the sd-t gene was linked to the marker genes Prp-b (Purple pericap
      b), lg(ligueless) and Wh(White hull). The recombination values estimated were
      2.85% +/- 0.52% for sd-t to Prp-b, 27.90% +/- 3.81% for sd-t to lg and 38.62% +/-
      2.99% for sd-t to Wh, respectively. It was inferred that the sd-t gene was
      located on chromosome 4 according to the established relationship between
      chromosomes and linkage groups.

PMID- 11209710
TI  - [Studies of biochemical markers of four isonucleus-alloplasmic lines of common
      wheat].
AB  - The peroxidase isozyme and the soluble peoteins of four isonucleus-alloplasmic
      lines of common wheat--D2-CA8057 (fertile, BC14), CMS line msD2-CA8057(BC11), CMS
      line msA-CA8057(BC12), CA8057 (nucleus donor) in different developmental stages
      were studies by polyacrylamide gel electrophoresis (PAGE) and gradient SDS-PAGE
      respectively. The peroxidase isozyme of bionucleus-stage anther, milk-stage
      endosperm and the soluble proteins of bionucleus-stage anther, leaf (the
      beginning and ending overwinter), dry-seed endosperm among fertile line, msD2
      CA8057 and msA-CA8057 were evidently different (but few differences between
      CA8057 and D2-CA8057). These differences resulted from the pecially-regulated
      expression of (male-sterile) cytoplasmic genes to nuclear genes and could be used
      to identify the four isonucleus-alloplasmic lines. These results showed that msD2
      CA8057 and msA-CA8057 were two different kinds of new CMS pattern.

PMID- 11209711
TI  - [Purification and biochemical characterization of high-molecular-weight-glutenin
      subunits 14 and 15].
AB  - The high molecular weight glutenin subunits 14 and 15 were purified from
      cultivars of bread wheat (Triticum aestivum) Xiaoyan 6 by preparative sodium
      dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) appled a new method
      for visualizing protein in gels. N-terminal amino acid sequences were homologous
      comparing with other High-Molecular-Weight glutenin subunits. The result
      suggested that they were basic protein analyzed by two-dimensional
      electrophoresis of IEF(Isoelectric Focussing) x SDS-PAGE and NEPHGE(Non
      Equilibrium PI-gradient Electrophoresis) x SDS-PAGE.

PMID- 11209712
TI  - [Development of Triticum aestivum-Haynaldia villosa 6VS ditelosomic substitution
      line via phlb mutant].
AB  - Chinese Spring phlb mutant (C S phlbphlb) was crossed to Triticum aestivum
      Haynaldia villosa 6V (6A) alien substitution line and F1 back was crossed with C.
      S phlbphlb. One LV 02 with varied H. villosa 6V chromosome and one LV 02-01 with
      40 T. aestivum chromosome, one H. villosa 6V and 6VS chromosome were screened in
      BC1F1 and BC1F2 respectively by C-banding and the fluorescence in situ
      hybridization (FISH). In segregated generation of LV 02-01, eight T. aestivum-H.
      villosa 6VS ditelosomic substitution lines were screened by FISH and C-banding.

PMID- 11209713
TI  - [Gene analysis of Chinese barley dwarf germplasm resources. II. Location of the
      dwarf genes on chromosomes].
AB  - Twenty dwarf sources of Chinese barley were crossed to a set of marker stocks.
      Based on the linkage tests with the marker traits and genes, the dwarfing genes
      in Chinese dwarf barley were located on different chromosomes. Fifteen of the 20
      dwarf sources were recessive mono-locus. Among them, BQK carried a pair of
      dwarfing genes on its short arms of 2(2H) chromosome, linking to the wide outer
      glume gene w; HZA 77 etc. 10 dwarf sources held dwarfing genes allelic to semi
      brachytic gene uz on their long arms of 3(3H) chromosomes respectively; 91G318,
      91D27, 11012.2 and JJ had dwarfing genes on their long arms of 4(4H) chromosomes,
      which linked with the hooded awn gene K. The remaining five dwarf sources were
      two-locus. Two recessive loci were found to be on 2HS and 4HL respectively in
      DQQK, ZLL and ZLLQK. A pair of incomplete dominant genes were located on 2HS, and
      another pair of recessive ones located on 3HL in 1974E. Two recessive loci of Yan
      66 were separately located on its 3HL and 4HL.

PMID- 11209714
TI  - [Genetic analysis of mutant genes and RAPD marker of mutant gene of narrow
      leaflet in soybean].
AB  - Mutant E182 with "narrow leaflet-4 seeded pod" was selected from descendents of
      EMS-treated seeds of soybean variety Lu Dou No. 4 (LD4) with "ovate leaflet
      without 4 seeded pod". Genetic analyses of F2 individuals of crossing between
      mutant E182 and parent LD4 indicated that segregation ratio between ovate and
      narrow leaflet was 3:1, so was segregation ratio between "without 4 seeded pod"
      and "4 seeded pod". Segregation ratios of four character types in F2 population
      of 1,654 individuals were beyond 9:3:3:1 of two pairs of independent gene,
      showing linkage inheritance. Reccmbinant ratio between mutant genes of narrow
      leaflet and 4 seeded pod was 11.24% +/- 0.81%. On the other hand, mutant E182,
      parent LD4 and F2, F3 individuals of their hybrids were analyzed by means of RAPD
      technique. The marker OPY6-1300 linked with the mutant gene of narrow leaflet was
      generated, and genetic distance of the marker and mutant gene was 8 cent Morgan
      (cM), being 10 cM nearer than RFLP marker of narrow leaflet generated by
      shoemaker.

PMID- 11209715
TI  - [Studies of FISH and karyotype of Gossypium barbadense].
AB  - Based on the fluorescent in situ hybridization (FISH) of somatic chromosome of
      Gossypium barbadense with the probe of genomic DNA (gDNA) of Gossypium arboreum,
      two sets of chromosomes were easily distinguished by signals hybridized or not.
      The FISH directly proved that G. barbadense originated from two different diploid
      species, but was not in concordance with the former point that every chromosome
      of A sub-genome of tetraploid species was bigger than that of other sub-genome (D
      genome). The karyotype formula of G. barbadense based on its FISH was 2n = 4x =
      52 = 38 m + 14sm(6sat). There were three pairs of satellite chromosomes which
      were all sm types. Their satellites located in short arms but originated
      differently from their chromosomes of sub-genome. Fragment translocations occured
      in the long arms of homologous chromosomes of number 5, 6 and 9 of A sub-genome.
      It was suggested that the translated fragments come from D sub-genome. The
      fragments are fairly large with the relative lengths of 19.21%, 17.69% and 12.88%
      of their whole chromosomes, respectively. At least five pairs of chromosomes in D
      sub-genome show some hybridized signals of gDNA probe of G. arboreum in their
      centromere regions, which indicated that there would be chromatin introgressions
      from A sub-genome.

PMID- 11209716
TI  - [Molecular analysis of polymorphisms for B-LII beta(beta 1 exon) locus in some
      Chinese native chicken].
AB  - Molecular genetic polymorphisms were studied for MHC-B-LII beta(beta 1 exon)
      locus in ten breeds of chicken by PCR-RFLPs. Thirty-seven genotypes were detected
      in these chicken. In the 305 bp fragment derived from MHC-B-LII beta(beta 1 exon)
      locus digested with Hha I, EcoRV, HaeIII, Xba I, there were significant
      difference with the frequencies of genotype and combined genotype among
      individuals or breeds. Statistical results showed Hardy-Weinberg equilibrium in
      polymorphic sites were inconsistent among various breeds. Sequencing results
      suggested there are more polymorphism at the level of amino acid than at that of
      nucleotide. Furthermore, as antigen binding site, the highly polymorphisms of
      beta 1 exon sequence was a reflection to the antigen diversity of immune systems.
      Moreover, it was implied that there was highly association between genetic
      polymorphisms of beta 1 exon and reproduction performance in chicken.

PMID- 11209717
TI  - Identification of molecular genetic markers tightly linked to downy mildew
      resistant genes in grape.
AB  - Bulk segregant analysis (BSA), randomly amplified polymorphic DNA (RAPD) and
      sequence characterized amplified region (SCAR) methods were used to tag the downy
      mildew-resistant genes of grape with molecular markers. Parents and their 60
      individuals of an F1 progeny resulting from a cross 88-110 between 83-4-96 (Vitis
      quinquangularis, downy mildew-resistant) and Muscat Rose (V. vinifera, downy
      mildew-susceptible), three F2 progenies resulting from three crosses of self
      cross and inter-cross of 88-110 F1 seedlings, as well as another interspecific F1
      hybrids of 88-84 cross [Xun-3 (V. quinquangularis, downy mildew-resistant) x Ugni
      Blanc (V. vinifera, downy mildew-susceptible)] and the wild grapes native to
      China were used for the study. Among 280 Operon primers, 160 gave distinct band
      patterns. One RAPD marker OPO06-1500 was tightly linked to a major gene resistant
      to Plasmopara viticola (RPv-1). Based on Mapmaker software analysis, the map
      distance between RPv-1 and OPO06-1500 was 1.7 cM. Marker OPO06-1500 was cloned
      and sequenced. According to the sequence, two specific primers were designed to
      amplify all plant materials. RAPD marker was converted into SCAR marker (SCO06
      1500). One distinct single band only in resistant plants was amplified, whose
      size was the same as that of the RAPD marker. The SCAR marker's popularity was
      confirmed, and it could be used for the identification of hybrid resistant to P.
      viticola and will be potentially useful in the development of new resistant grape
      cultivars.

PMID- 11209718
TI  - [A new method for constructing linkage maps of molecular markers: three-point
      selfcross method].
AB  - The method for constructing linkage maps has almost been so far the three-point
      testcross in higher organisms. This method is, however, considerably limited to a
      requirement of a parent or line with three recessive genes that can be obtained
      by only cross breeding. In this paper, the three-point selfcross method for
      mapping was proposed. This method can also provide us with informations of
      mapping as the same as the three-point testcross method. However, the three-point
      selfcross method does not have any limitation of requiring a parent with three
      recessive genes. It was theoretically proved that this method could be used to
      map molecular marker loci in small sample of F2 population. Exactly to test both
      the methods for mapping, Fisher information content was applied to prove that the
      three-point selfcross method is powerful for mapping. Further to test this
      method, data of the first 6 loci were chosen from 12 RFLP loci detected in 333 F2
      individuals in SAMPLE. RAW file in MAPMAKER/EXP version 3.0 that Lander et al.
      (1987) provided. The result showed that, like MAPMAKER program, the three-point
      selfcross method is powerful to detect linkage relationship among loci, to order
      them on linkage groups and to calculate distances between nearest neighbor loci.
      Besides, this method could provide us with the other information of map such as
      the positive or negative interference and couple or repulsion configuration.

PMID- 11209719
TI  - [Ad multos annos. 30 years of sonographic tissue characterization].

PMID- 11209720
TI  - [Renal artery stenosis: screening, diagnostic and therapeutic options].
AB  - Hypertension is a frequent disease and renal artery stenosis, as a potential
      cause of hypertension, can be cured. Therefore, we frequently need to exclude a
      renal artery stenosis in patients with hypertension in our daily routine. This
      calls for a screening procedure which is non-invasive, highly effective and not
      too expensive. This paper describes the advantages and limitations of colour
      Doppler ultrasound in diagnosing renal artery stenosis. Colour Doppler ultrasound
      with intrarenal Doppler analysis is an ideal tool in the screening for relevant
      renal artery stenosis in patients with hypertension. This technique, however,
      requires a careful approach and extrarenal abnormalities need to be considered.

PMID- 11209721
TI  - [Computer-supported tissue characterization in musculoskeletal ultrasonography].
AB  - A new diagnostic system combining conventional gray-scale ultrasonography (US)
      and computer-assisted texture analysis of sonograms makes it possible to
      differentiate more easily between specific neuromuscular diseases. The first step
      involves myosonography with strictly standardized US. In a group of 72 patients
      with histologically and molecular-genetically confirmed diagnosis 63 patients
      (88%) were diagnosed by conventional US as having Duchenne's muscular dystrophy,
      spinal muscular atrophy, hereditary sensomotor neuropathy or inflammatory
      myopathy. Secondly, in a double blind setting computer-assisted texture analysis
      was used on the same sample of subjects. Tissue Texture can be characterized by
      the brightness as well as the micro- and macro-structure of the tissue. The use
      of these parameters leads to a sensitivity of 77 to 94% and a specificity of 81
      to 98%. In conclusion, the combination of both techniques allows us to avoid
      invasive diagnostic procedures in a substantial group of patients.

PMID- 11209722
TI  - [Evaluation of doppler ultrasonography criteria for the differential diagnosis of
      pancreatic tumors].
AB  - AIM: In order to improve the differential diagnosis of pancreatic lesions,
      dopplersonographic criteria for the tumours were evaluated. METHODS: 35 patients
      diagnosed by conventional ultrasound as having a tumour of pancreas were further
      investigated by B-mode sonography, fundamental and echo-enhanced power-Doppler
      sonography focusing on specific properties of the tumours. The results were
      correlated to the histological findings. RESULTS: Ductal carcinomas and
      cystadenocarcinomas are often hypovascularized in comparison to the surrounding
      tissue. In contrast to this, neuroendocrine tumours and cystadenomas are mostly
      hypervascularized. Tumours associated with pancreatitis show different
      vascularization patterns depending on inflammation and the extent of necrosis.
      CONCLUSIONS: Pancreatic tumours display different vascularization patterns in the
      echo-enhanced power-Doppler sonography. These characteristics can be useful for
      the differential diagnosis of pancreatic tumours.

PMID- 11209723
TI  - [Doppler ultrasonographic diagnosis of increased intracranial pressure by
      comparison of flow velocities in the extra- and intracranial secitons of the
      internal carotid artery].
AB  - AIM: By comparison of the flow velocities in the intracranial and extracranial
      parts of the internal carotid artery the influence of an increased intracranial
      pressure on cerebral perfusion can be determined. Aim of the study was to
      establish normal values in healthy infants not displaying clinical signs of
      increased intracranial pressure. METHOD: 108 healthy infants (35 girls, 73 boys)
      with a gestational age of 42 +/- 14 weeks and a weight of 2440 +/- 2310 g were
      investigated. In all infants Doppler sonographic flow measurements were performed
      within the petrosal part (extracranial) and the cerebral part (intracranial) of
      the internal carotid artery. From the flow profile the peak systolic (Vs),
      enddiastolic (Ved) and time average (TAV) flow velocities were estimated. In all
      infants the I/E-ratio of the intracranial and extracranial flow velocities was
      calculated. RESULTS: Flow velocities within the intracranial section of the
      vessel were lower than in the extracranial part, due to the greater angle of
      incidence (33 +/- 8 degrees) between the pars cerebralis and the Doppler beam. In
      the pars petrosa of the internal carotid artery Vs was 59.7 +/- 21.4, Ved 14.6 +/
      9.5 and TAV 17.2 +/- 11.8 cm/sec. Within the pars cerebralis Vs was 48.8 +/-
      22.1, Ved 12.3 +/- 8.4 and TAV 12.9 +/- 7.5 cm/sec. I/E-ratio of intracranial and
      extracranial flow velocities was 0.83 +/- 0.14 for Vs, 0.88 +/- 0.29 for Ved and
      0.82 +/- 0.24 for TAV. CONCLUSION: The relation between intracranial and
      extracranial flow velocities within the internal carotid artery as described by
      the I/E-ratio is constant. Alterations of the flow velocities intracranially such
      as in cases of increased intracranial pressure, may cause changes of the I/E
      ratio. Determining the I/E-ratio may be a valuable method for the assessment of
      increased intracranial pressure.

PMID- 11209724
TI  - [Laparoscopic intraoperative differential diagnosis of adnexal tumors. A pilot
      study of 20 premenopausal patients].
AB  - AIM: The purpose of the study was to determine the feasibility and potential
      clinical value of laparoscopic intraoperative sonography in the female genital
      tract. PATIENTS AND METHOD: Intraoperative ultrasound was performed in 20
      consecutive premenopausal patients with adnexal masses during laparoscopy using a
      7.5 MHz semiflexible transducer. RESULTS: Laparoscopic ultrasound of the female
      genital tract improves image resolution. Furthermore, this new method allows
      accurate localisation of early tubal pregnancy and may be helpful if laparoscopic
      evaluation of the inner genital tract is impaired by severe adhesions. In 7 out
      of 20 patients, the therapeutical procedure was clearly influenced by the
      laparoscopic ultrasound findings, resulting in a benefit for the patients in all
      seven cases. CONCLUSION: Intraoperative laparoscopic ultrasound may improve
      minimal invasive management of adnexal masses.

PMID- 11209725
TI  - [Amplitude-coded color doppler ultrasonography in pediatrics].
AB  - OBJECTIVE: The goal of this study was to evaluate the use of amplitude coded
      colour Doppler sonography (aCDS) in infants and children. METHODS: We analysed
      our own experiences in 270 patients (mean age: 6.3 years, range: newborn--16
      years) with various paediatric aCDS applications. The aCDS results of 460
      individual investigations were correlated with conventional CDS results, clinical
      findings and the results of other imaging modalities. Additionally, relevant
      literature is reviewed and discussed. RESULTS: ACDS is a valuable tool in
      paediatric sonography. It enriches the diagnostic field of ultrasound,
      particularly in regard to renal, abdominal, oncological and small part
      applications. ACDS could successfully be performed in 92.4% of investigations.
      Overall accuracy was 86.6% (in regard to the total number), sensitivity was 92%
      (calculated for the number of successful investigations), additional diagnostic
      information was gained in 18.6% to 48% of patients--depending on the field of
      application. CONCLUSION: ACDS is applicable to the majority of infants and
      children, in spite of the risk of motion artefacts. It is a valuable addition to
      conventional paediatric ultrasound and colour Doppler sonography. In conjunction
      with new modalities like three-dimensional sonography, harmonic imaging and
      ultrasound contrast agents it promises to continuously widen sonographic
      diagnostic potential.

PMID- 11209726
TI  - Do we need MR images for diagnosing tendon ruptures of the distal biceps brachii?
      The value of ultrasonographic imaging.
AB  - AIM: To assess the usefulness of ultrasound in the diagnosis of rupture of the
      distal biceps brachii muscle by demonstrating the clear differentiation between
      the distal biceps muscle and the surrounding soft tissue in a standardized
      section of the elbow. METHOD: Under sonographic guidance five biceps muscles of
      three cadavers were marked with a needle in the region of the elbow joint.
      Thereafter an anatomical preparation of the distal biceps brachii muscle followed
      to verify the correct positioning of the needle. Real time ultrasound was
      performed with a 7.5 MHz linear array transducer. The standard section of the
      elbow and the images on the screen correspond to the guidelines provided by the
      German Society of Ultrasonography in the Locomotor Apparatus (DEGUM). RESULTS: In
      all five cases the needle tip could be found in the middle of the distal biceps
      muscle. It was possible to perform a sonographically guided puncture of the
      muscle and to differentiate between distal biceps brachii and surrounding soft
      tissues using a high resolution transducer of the newest generation in ultrasound
      technology. CONCLUSION: Our investigation confirmed our clinical ultrasound
      findings in distal biceps tendon ruptures. The echo-intense signal is replaced by
      a hypoechogenic signal representing the haematoma in the area of the distal
      biceps brachii muscle. In addition to the clinical examination in case of a
      ruptured distal biceps muscle ultrasound of the elbow is a valuable and reliable
      imaging method to support the diagnosis. MRI of the elbow is not always necessary
      to confirm the diagnosis.

PMID- 11209727
TI  - Sonographic imaging of a spinoglenoid cyst.
AB  - Spinoglenoid cysts can be the reason for suprascapular nerve entrapment syndrome
      resulting an isolated atrophy of the infraspinatus muscle. The syndrome usually
      presents painless and is frequently observed in professional volleyball players.
      The incidence of these cysts in volleyballplayers is still unknown. Diagnosis is
      made by neurological examination using electromyography and magnetic resonance
      imaging. Our case shows the potential of ultrasound as a possible imaging method
      of ganglion cysts that could be used as a screening method to prevent
      suprascapular neuropathy.

PMID- 11209728
TI  - [Tips and ticks: intrarenal doppler ultrasonography in the diagnosis of renal
      artery stenosis].

PMID- 11209729
TI  - [Ultrasonography in gastroenterology. Report on the seminar at Euroson School, 12
      15 July 2000].

PMID- 11209730
TI  - [Hypotheses and facts].

PMID- 11209731
TI  - [ACUTE, TACTICS, TARGET, GUSTO-IV, MIRACL, COPERNICUS and Vel-HeFT. New study
      results in cardiology].

PMID- 11209732
TI  - [A drug for smoking cessation?].

PMID- 11209733
TI  - [Forms of thrombophilia and their treatment].

PMID- 11209734
TI  - Progesterone receptor modulators at the start of a new millennium.

PMID- 11209735
TI  - [Organization of early detection of patients with tuberculosis in Moscow].
AB  - The tuberculosis mortality rate is largely determined by the organization of
      early identification of patients with this disease in the general population. At
      present the volume of prophylactic surveys has reduced, but, nevertheless, they
      are the method of choice in detecting tuberculosis in time. Since the prevalence
      of tuberculosis greatly differs in different populations, prophylactic
      examinations must be differential in relation to the risk of disease or
      epidemiological hazards. Increasing the coverage of prophylactic examinations of
      risk groups by 10% allows one to increase the identification of patients with
      tuberculosis by 1.6 times in them, that by 8.0% enhances it by 1.9 times. Since
      the socioeconomic conditions have changed and the logistics is poor, the most
      effective existing actions should be taken.

PMID- 11209736
TI  - [Detection of pulmonary tuberculosis in general health care facilities].
AB  - The paper deals with medical aspects how to organize the detection of
      tuberculosis in all populations. It is stressed that it is necessary now to
      enhance activities in polyclinics by increasing the quality of examination of
      those who visit doctors. The specialized service must reorganize its work with
      tuberculosis risk groups by enhancing organizational measures and increasing the
      quality of examination.

PMID- 11209737
TI  - [Detection of patients with respiratory tuberculosis in high-risk groups ar
      general polyclinic].
AB  - The paper presents the results of elucidation of numerous tuberculosis risk
      factors. Eight most significant criteria were selected by using the
      multifactorial analysis. They were used to develop an algorithm for selecting
      patients in risk groups at the polyclinic. Follow-ups of these groups of patients
      were shown to enhance the detection rate of tuberculosis, thus greatly reducing
      material expenditures.

PMID- 11209738
TI  - [Problems in modernization of Russian fluorographic service].

PMID- 11209739
TI  - [Comparative assessment of diagnostic capacities of thoracic fluorography, film x
      ray study and small-dose digital x-ray study].
AB  - The efficiency of small-dose digital X-ray study (SDDXRS) of the chest versus
      film X-ray study (FXRS) and fluorography was studied during prophylactic surveys.
      SDDXRS competes only with FXRS in evaluating the normal anatomic structures and
      it compares much favourably with fluography. In chest abnormalities, SDDXRS,
      unlike FXRS, cannot reveal fine linear shadows, detect bullae in the lung, the
      upper margin of pleural exudates, changes in the bones worse, but shows soft
      focal shadows of the decay cavity, abnormal changes behind the shadow of the
      heart. The efficiency of SDDXRS was superior to fluography in detecting
      tuberculosis in all points, at the same time SDDXRS virtually have no spoilage
      that is about 18% at fluography.

PMID- 11209740
TI  - [Problems in standartization of population fluorographic screening].
AB  - The authors have developed the methodology and techniques for standardizing
      fluorographic screening by using computed technology. The proposed does not
      require any manually written registration, the accounting of both patient and
      fluorogram in-and-outflows, the keeping on-going medical documents and paper
      archives. At the same time the technique allows one to form computerized lists,
      the dates of patients' visits, to control radiologists' activities, to supervise
      control over the use of hospital and mobile equipment, to plan expendable
      materials, etc. The efficiency and novelty of the technology are based on the
      computerization to make a diagnosis, and to set up a centralized bank of data on
      patients. This provides favorable conditions for continuous monitoring of
      fluographic screening of the population at any level of management and
      administration.

PMID- 11209741
TI  - [Tuberculosis in internist's practice].

PMID- 11209742
TI  - [Potentialities of immunochromatographic technique in detection of tuberculosis].

PMID- 11209743
TI  - [Improvement of epidemiological analysis in tuberculous infection].

PMID- 11209744
TI  - [Tuberculosis mortality in Sverdlovsk Region].
AB  - Tuberculosis mortality is 9.3 times higher in men than in women. Women more
      commonly recover and less frequently die from progressive tuberculosis. The main
      causes of death are fibrocavernous or infiltrative tuberculosis, and caseous
      pneumonia. In young people, the most common cause of death is tuberculosis of the
      meninga or central nervous system, women more frequently die from caseous
      pneumonia. Prisoners more commonly die from infiltrative tuberculosis and more
      rarely from fibrocavernous tuberculosis than the general population of
      Sverdlovsk. The most common causes of death of patients with tuberculosis who die
      in the first year of its diagnosis are caseous pneumonia and fibrocavernous
      tuberculosis. The factors predisposing to poor prognosis were late detection of
      the disease, treatment refusal, severe concomitant diseases, and intolerance of
      antituberculous agents.

PMID- 11209746
TI  - [Endocrinological parameters of patients with acute progressive pulmonary
      tuberculosis].
AB  - Examining the levels of the hormones insulin and cortisole that play a
      significant role in nonspecific protection in tuberculosis indicates the
      heterodirectional pattern of changes in endocrinological parameters in relation
      to the clinical form of acute progressive tuberculosis. In drug-treated patients
      with caseous pneumonia, the high level of cortisole decreased and the content of
      insulin reached the lower normal range with 18.2% of cases having
      hypoinsulinemia. Patients with disseminated pulmonary tuberculosis had an
      inversely proportion ratio of the hormones, which reflected the specific features
      of acute progression of this clinical form. In acute progressive infiltrative
      tuberculosis, the levels of cortisole and insulin significantly increased during
      chemotherapy. Nevertheless, whatever changes were observed in hormonal levels,
      variations in the parameters indicate the long-term activity of specific
      inflammation in acute progressive pulmonary tuberculosis.

PMID- 11209745
TI  - [Liver function at the stage of intensive tuberculosis treatment of patients with
      diabetes mellitus].
AB  - Intensive pulmonary tuberculosis treatment was performed in 65 patients with this
      disease concurrent with diabetes according to the WHO recommendations. Among them
      there were 44 new cases and 21 cases with relapse. Comparing the hepatic
      functional parameters before the first intensive stage of treatment and after its
      termination (following 2-3 months) showed a regular and statistically significant
      increase in the activity of aminotransferases and a clear tendency for increases
      in the values of total bilirubin and thymol tests. These changes were equally
      pronounced with both treatment regimens in patients with types both I and II
      diabetes mellitus and within normal ranges and allowed the drug treatment
      regimens to be continued.

PMID- 11209747
TI  - Enabling guidelines for computer-based decision support.

PMID- 11209748
TI  - Apolipoprotein B versus lipoprotein lipids: vital lessons from the AFCAPS/TexCAPS
      trial.

PMID- 11209749
TI  - Circadian rhythms of sterol 12alpha-hydroxylase, cholesterol 7alpha-hydroxylase
      and DBP involved in rat cholesterol catabolism.
AB  - Circadian rhythms of important enzymes involved in the conversion of cholesterol
      to bile acids [sterol 12alpha-hydroxylase (12alpha-hydroxylase) and cholesterol
      7alpha-hydroxylase (7alpha-hydroxylase)] and an albumin site D-binding protein
      (DBP) were examined in rats. When the animals were fed freely, they usually ate
      in the dark and the circadian rhythms of activities of 12alpha-hydroxylase and
      7alpha-hydroxylase showed the same peaks (at 10 p.m.) and lows (at 2 p.m.). Their
      mRNA levels were determined at four timepoints: 3 a.m., 10 a.m., 3 p.m. and 10
      p.m. A maximum of the rhythm of 12alpha-hydroxylase was observed at 3 p.m. and
      the minimum at 3 a.m. These results are distinct from those of 7alpha
      hydroxylase, whose maximum point was at 10 p.m. and minimum at 3 p.m. When the
      rats were fed only in the day-time (from 9 a.m. to 5 p.m.), a marked shift of the
      activity and mRNA rhythms was observed with both enzymes. The circadian rhythms
      of the activities of both enzymes showed the same peaks (at 3 p.m.), but the mRNA
      levels of 12alpha-hydroxylase were distinct from those of 7alpha-hydroxylase,
      whose maximum point was at 3 a.m. and minimum at 10 p.m. Differences between the
      maximum and the minimum points of each enzyme mRNA level were statistically
      significant (P < 0.01 for 12alpha-hydroxylase and 0.05 for 7alpha-hydroxylase).
      Moreover, circadian rhythms of DBP were also markedly shifted with the change of
      feeding period. The maximum mRNA level was observed at 10 p.m. instead of 10 a.m.
      and the minimum was at 10 a.m. instead of 10 p.m.

PMID- 11209750
TI  - Mannosidase action, independent of glucose trimming, is essential for proteasome
      mediated degradation of unassembled glycosylated Ig light chains.
AB  - In order to study the role of N-glycans in the ER-associated degradation of
      unassembled immunoglobulin light (Ig L) chains, we introduced N-glycan acceptor
      sites into the variable domain of the murine Ig L chain kappaNS1, which is
      unfolded in unassembled molecules. We investigated the fate of kappaNS1
      glycosylated at position 70 (K70) and of a double mutant (kappa18/70) in stably
      transfected HeLa cells. Degradation of both chains was impaired by lactacystin, a
      specific inhibitor of the proteasome. The mannosidase inhibitor dMNJ also blocked
      degradation in a step preceding proteasome action, as did two protein synthesis
      inhibitors, cycloheximide and puromycin. In contrast, ER glucosidase inhibitors
      dramatically accelerated the degradation of the chains when added either pre- or
      posttranslationally. The accelerated degradation was sensitive to lactacystin,
      dMNJ and cycloheximide, too. None of these drugs, except lactacystin, affected
      the degradation of unglycosylated kappaNS1 chains. We conclude that ER
      mannosidases and proteasome activities, but not glucose trimming (and therefore,
      most likely not the calnexin/calreticulin UDP:glucose glycoprotein glucosyl
      transferase cycle), are essential for ER-associated degradation (ERAD) of soluble
      glycoproteins. A role for a short-lived protein, acting before or simultaneously
      to ER mannosidases, is suggested.

PMID- 11209751
TI  - Characterization of a receptor for heat shock protein 70 on macrophages and
      monocytes.
AB  - Heat shock proteins (Hsps) and molecular chaperones isolated from tumors or
      virally infected cells elicit an efficient CD8+ T cell response against bound
      antigenic peptides. This immune response is mediated by presentation of the
      peptides on MHC class I complexes of antigen-presenting cells (APCs), but the
      cellular mechanism of this presentation process is not yet understood. Here we
      provide evidence for the existence of a proteinaceous receptor on the surface of
      APCs that is specific for mammalian Hsp70. Using a flow cytometry-based assay,
      saturable binding of Hsp70 to the cell surface of macrophages and peripheral
      blood monocytes, but not of lymphocytes, can be demonstrated. The affinity of the
      receptor is in the sub-micromolar range (Kd < 100 nM). Only mammalian
      Hsc70/Hsp70, but not bacterial Hsp70, is bound with high affinity. Subsequent to
      binding, Hsp70 is taken up by endocytosis, resulting in an intracellular
      localization. Our results suggest that receptor-mediated endocytosis forms the
      basis for the demonstrated efficacy of Hsp70-peptide complexes as anti-tumor
      vaccines.

PMID- 11209752
TI  - Yeast translational activator Cbs2p: mitochondrial targeting and effect of
      overexpression.
AB  - The yeast translational activator protein Cbs2p is imported into mitochondria
      without obvious proteolytic processing. To test the importance of amino-terminal
      amino acids for mitochondrial targeting we fused varying portions of the N
      terminus with green fluorescent protein and examined the intracellular
      distribution of the reporter protein. We show that the 25 N-terminal amino acids
      are sufficient to direct the majority of the fusion protein into mitochondria.
      Cbs2p derivatives lacking 9 to 35 amino acids from the N-terminus fail to
      complement the respiratory deficiency of a deltacbs2 strain, but are still
      imported into mitochondria. Therefore Cbs2p contains at least one independent
      mitochondrial targeting information in addition to the N-terminal signal. We
      further analyzed the effect of over-expression of Cbs2p on mitochondrial
      function. Elevated concentrations of Cbs2p lead to slightly impaired
      mitochondrial gene expression, probably as the result of the formation of
      inactive Cbs2p aggregates.

PMID- 11209753
TI  - Mutational scanning of a hairpin loop in the tryptophan synthase beta-subunit
      implicated in allostery and substrate channeling.
AB  - The tryptophan synthases from Escherichia coli and Salmonella typhimurium are
      tetrameric enzymes, with an elongated TrpA.TrpB.TrpB.TrpA structure. Structural
      studies have identified residues 277-283 of TrpB as a potentially important
      region for the allosteric communication between the TrpA and TrpB subunits and
      for the transport of indole between their active sites through a hydrophobic
      tunnel. To explore the functional role of this region, we analyzed the effects of
      19 single and double mutations in TrpB on the tryptophan synthase (TSase) and
      serine deaminase (SDase) activities of the TrpB2 dimer, either in the presence or
      in the absence of the TrpA subunit. The mutations of residues 273-283 could be
      divided into 4 classes. Mutations 1278A, F280G and M282A decreased the SDase and
      TSase activities of TrpB2 to similar extents. F280A decreased the SDase activity
      of TrpB2 more than its TSase activity, whereas the reverse was true for Y279L.
      F280A decreased the activation factor of TrpB2 by TrpA, whereas F280G increased
      it. The reaction steps and intramolecular contacts that could be affected by the
      mutations are described. The sequence 278-IYFGM-282, which is present in E. coli
      and S. typhimurium, is only found in 5 out of 42 organisms, whereas the sequence
      VLHGX is found in 21 organisms. Our results identified several mutations that
      could be used as structural probes to analyze precisely the roles of residues 278
      282 and their evolution.

PMID- 11209754
TI  - The difference in the carboxy-terminal sequence is responsible for the difference
      in the activity of chicken and rat liver fructose-2,6-bisphosphatase.
AB  - The fructose-2,6-bisphosphatase domain of the bifunctional chicken liver enzyme 6
      phosphofructo-2-kinase/fructose-2,6-bisphosphatase shares approximately 95% amino
      acid sequence homology with that of the rat enzyme. However, these two enzymes
      are significantly different in their phosphatase activities. In this report, we
      show that the COOH-terminal 25 amino acids of the two enzymes are responsible for
      the different enzymatic activities. Although these 25 amino acids are not
      required for the phosphatase activity, their removal diminishes the differences
      in the activities between the two enzymes. In addition, two chimeric molecules
      (one consisting of the catalytic core of the chicken bisphosphatase domain and
      the rat COOH-terminal 25 amino acids, and the other consisting of most of the
      intact chicken enzyme and the rat COOH-terminal 25 amino acids) showed the same
      kinetic properties as the rat enzyme. Furthermore, substitution of the residues
      Pro456Pro457Ala458 of the chicken enzyme with GluAlaGlu, the corresponding
      sequence in the rat liver enzyme, yields a chicken enzyme that behaves like the
      rat enzyme. These results demonstrate that the different bisphosphatase
      activities of the chicken and rat liver bifunctional enzymes can be attributed to
      the differences in their COOH-terminal amino acid sequences, particularly the
      three residues.

PMID- 11209755
TI  - Crystal structure of the caspase activator human granzyme B, a proteinase highly
      specific for an Asp-P1 residue.
AB  - Granzyme B is the prototypic member of the granzymes, a family of trypsin-like
      serine proteinases localized in the dense cytoplasmic granules of activated
      natural killer cells and cytotoxic T lymphocytes. Granzyme B directly triggers
      apoptosis in target cells by activating the caspase pathway, and has been
      implicated in the etiology of rheumatoid arthritis. Human granzyme B expressed in
      a baculovirus system has been crystallized without inhibitor and its structure
      has been determined to 3.1 A resolution, after considerably improving the
      diffraction power of the crystals by controlled humidity changes. The granzyme B
      structure reveals an overall fold similar to that found in cathepsin G and human
      chymase. The guanidinium group of Arg226, anchored at the back of the S1
      specificity pocket, can form a salt bridge with the P1-Asp side chain of a bound
      peptide substrate. The architecture of the substrate binding site of granzyme B
      appears to be designed to accommodate and cleave hexapeptides such as the
      sequence Ile-Glu-Thr-Asp-/Ser-Gly present in the activation site of pro-caspase
      3, a proven physiological substrate of granzyme B. These granzyme B crystals,
      with fully accessible active sites, are well suited for soaking with small
      synthetic inhibitors that might be used for a treatment of chronic inflammatory
      disorders.

PMID- 11209756
TI  - Primary structure of potato kunitz-type serine proteinase inhibitor.
AB  - The serine proteinase inhibitor (PSPI-21) isolated from potato tubers (Solanum
      tuberosum L.) comprises two protein species with pI 5.2 and 6.3, denoted as PSPI
      21-5.2 and PSPI-21-6.3, respectively. They were separated by anion exchange
      chromatography on a Mono Q FPLC column. Both species tightly inhibit human
      leukocyte elastase, whereas their interaction with trypsin and chymotrypsin is
      substantially weaker. The sequences of both PSPI-21-5.2 and PSPI-21-6.3 were
      determined by analysis of overlapping peptides obtained from the oxidized or
      reduced and S-pyridylethylated proteins after digestion with trypsin or pepsin.
      Both species of PSPI-21 are composed of two chains, named chains A and B, which
      are linked by a disulfide bridge between Cys(146) and Cys(157). The other
      disulfide bridge is located within the A chains between Cys(48) and Cys(97). The
      amino acid sequences of the large A chains of the two forms, consisting of 150
      amino acids residues each, differ in a single residue at position 52. The small
      chains B, containing 37 and 36 residues in PSPI-21-6.3 and PSPI-21-5.2,
      respectively, have nine different residues. The entire amino acid sequences of
      the two inhibitors show a high degree of homology to the other Kunitz-type
      proteinase inhibitors from plants.

PMID- 11209757
TI  - Activation of proPHBSP, the zymogen of a plasma hyaluronan binding serine
      protease, by an intermolecular autocatalytic mechanism.
AB  - The hyaluronic acid binding serine protease (PHBSP), an enzyme with the ability
      to activate the coagulation factor FVII and the plasminogen activator precursors
      and to inactivate factor VIII and factor V, could be isolated from human plasma
      in the presence of 6M urea as a single-chain zymogen, whereas under native
      conditions only its activated two-chain form was obtained. The total yield of
      proenzyme (proPHBSP) was 5-6 mg/l, corresponding to a concentration of at least
      80-100nM in plasma. Upon removal of urea, even in the absence of charged surfaces
      a rapid development of amidolytic activity was observed that correlated with the
      appearance of the two-chain enzyme. The highest activation rate was observed at
      pH 6. ProPHBSP processing was concentration-dependent following a second order
      kinetic and was accelerated by catalytic amounts of active PHBSP, indicating an
      intermolecular autocatalytic activation. Charged macromolecules like poly-L
      lysine, heparin, and dextran sulfate strongly accelerated the autoactivation,
      suggesting that in vivo proPHBSP activation might be a surface-bound process. The
      intrinsic activity of the proenzyme was determined to be 0.25-0.3%, most likely
      due to traces of PHBSP. The presence of physiological concentrations of known
      plasma inhibitors of PHBSP, like alpha2 antiplasmin and C1 esterase inhibitor,
      but not antithrombin III/heparin, slowed down zymogen processing. Our in vitro
      data suggest that the autoactivation of proPHBSP during plasma fractionation is
      induced by the removal of inhibitors of PHBSP and is accelerated by charged
      surfaces of the chromatographic resins.

PMID- 11209758
TI  - Human and rat dipeptidyl peptidase III: biochemical and mass spectrometric
      arguments for similarities and differences.
AB  - Dipeptidyl peptidase (DPP III) was purified from rat and human erythrocytes using
      an identical procedure. Electrophoretic analyses revealed the same molecular size
      and pI for both enzymes. The molecular mass of the human enzyme, measured by
      matrix-assisted laser desorption/ionization MS, was 82500+/-60 Da. Its tryptic
      peptide mass profile was determined using the same technique, and the amino acid
      sequence of two internal peptides was obtained by tandem MS and Edman
      degradation. A search of databases revealed a high similarity between the human
      erythrocyte and rat liver DPP III: 21 matches out of 34 detected peptides were
      found, covering 40% of the total sequence. Matched peptides included the peptide
      harboring the characteristic HELLGH sequence motif, and a stretch of 19 identical
      amino acids, containing Glu, a putative ligand of active site zinc. Both enzymes
      preferred Arg-Arg-2-naphthylamide, and were activated by micromolar Co2+,
      differing in their pH optima and kcat/Km. Zn2+ ions, sulfhydryl reagents, and
      aminopeptidase inhibitors, especially probestin, inhibited the rat DPP III more
      potently. The two enzymes showed the highest affinity for angiotensin III (Ki < 1
      microM) and a preference for ahydrophobic residue at the P1' site. However,
      significant differences in the binding constants for several peptides indicated
      non-identity in the active site topography of human and rat erythrocyte DPP III.

PMID- 11209759
TI  - Recombinant anti-stefin A Fab fragment: sequence analysis of the variable region
      and expression in Escherichia coli.
AB  - Human stefin A is an inhibitor of lysosomal cysteine proteinases cathepsin B, H,
      L and S. In the present report we describe the cloning and expression of anti
      stefin A Fab fragment A22 in E. coli. We have determined the nucleotide sequences
      of the antibody heavy and light chain and compared them to the murine
      immunoglobulin germ line sequences. Expression of the two antibody chains was
      achieved using a single vector with a PhoA promoter and coding regions placed
      after the signal sequences, directing them to the periplasmic space. The A22 Fab
      fragment was extracted from the periplasmic space and expression was confirmed by
      Western blot analysis. The recombinant A22 Fab fragment had an affinity for
      stefin A comparable to the original monoclonal antibody, as determined by ELISA.

PMID- 11209760
TI  - Green fluorescent protein photobleaching: a model for protein damage by
      endogenous and exogenous singlet oxygen.
AB  - Characterization of protein damage during photosensitization of chlorin e6
      treated cells was performed using the green fluorescent protein (GFP). The GFP
      chromophore damage caused by singlet oxygen was studied in COS 7 kidney cells and
      E. coli bacteria following light irradiation. Electron spin resonance (ESR)
      revealed the generation of endogenous singlet oxygen (1O2) by photoactivated GFP,
      an effect similar to that produced by the exogenous photosensitizer chlorin e6. A
      light dose-dependent photobleaching effect of GFP was pronounced at low pH or
      upon photosensitization with chlorin e6. However, the 1O2 quenchers beta-carotene
      and sodium azide minimized GFP photo-bleaching. Gel electrophoresis of
      photosensitized GFP followed by fluorescence multi-pixel spectral imaging
      revealed the binding of chlorin e6 to GFP, affecting the photobleaching efficacy.
      Fluorescence multi-pixel spectral imaging of GFP-transfected COS 7 cells
      demonstrated the presence of GFP in the cytoplasm and nucleus, while chlorin e6
      was found to be concentrated in the perinuclear vesicles. Exposure of the cells
      to light induced GFP photobleaching in the close vicinity of chlorin e6 vesicles.
      We conclude that photoactivated GFP generates endogenous 1O2, inducing
      chromophore damage, which can be enhanced by the cooperation of exogenous chlorin
      e6.

PMID- 11209761
TI  - 193 nm photolysis of aromatic and aliphatic dipeptides in aqueous solution:
      dependence of decomposition quantum yield on the amino acid sequence.
AB  - The values of molar absorption coefficient and quantum yields of
      photodecomposition and peptide bond scission were determined for a number of
      aromatic and aliphatic dipeptides under 193 nm laser irradiation in neutral argon
      saturated aqueous solution. Under these conditions we could show that no
      dependence of the dipeptide decomposition quantum yield on the sequence of amino
      acid residues exists, neither for aromatic dipeptides nor for aliphatic ones.

PMID- 11209762
TI  - NADPH:Protochlorophyllide oxidoreductase uses the general import route into
      chloroplasts.
AB  - Chloroplast differentiation in angiosperm plants depends on the light-dependent
      conversion of protochlorophyllide to chlorophyllide by NADPH:protochlorophyllide
      oxidoreductase (PORA; EC 1.6.99.1), a nuclearly encoded protein. The protein
      import of the precursor form of PORA into plastids was shown previously to
      strictly depend on the presence of its substrate protochlorophyllide. PORA seemed
      to follow a novel, posttranslationally regulated import route. Here we
      demonstrate that the precursor of PORA from barley is imported into isolated
      barley plastids independently of protochlorophyllide. PORA as well as PORB import
      is competed for by the precursor of the small subunit of Rubisco. The data
      demonstrate that the PORA precursor uses the general import pathway into
      plastids. Furthermore, en route into chloroplasts the pea POR precursor can be
      cross-linked to the protein import channel in the outer envelope Toc75 from pea.

PMID- 11209763
TI  - Superoxide reactivates nitric oxide-inhibited catalase.
AB  - Catalase binds nitric oxide (NO) to generate ferricatalase-NO, an inhibited form
      of the enzyme. Superoxide (O2-) is also an inactivator of the enzyme. We found,
      however, that O2- efficiently converted the inhibited ferricatalase-NO to the
      active ferricatalase without producing detectable intermediates. The reaction
      slowed down when O2- was disproportionated to H2O2 and O2 by superoxide
      dismutase, but H2O2 could displace the heme-bound NO slowly to regenerate
      ferricatalase. Reactivation was observed even under simultaneous generation of NO
      and O2-, suggesting that ferricatalase-NO reacts with O2- fast enough to compete
      with the rapid reaction of O2- and NO. Formation of peroxynitrite by the
      simultaneous generation of NO and O2- was only partially inhibited by
      ferricatalase, presumably due to slow binding of NO to catalase in comparison
      with the reaction of NO and O2-.

PMID- 11209764
TI  - Perspective: gene divergence, population divergence, and the variance in
      coalescence time in phylogeographic studies.
AB  - Molecular methods as applied to the biogeography of single species
      (phylogeography) or multiple codistributed species (comparative phylogeography)
      have been productively and extensively used to elucidate common historical
      features in the diversification of the Earth's biota. However, only recently have
      methods for estimating population divergence times or their confidence limits
      while taking into account the critical effects of genetic polymorphism in
      ancestral species become available, and earlier methods for doing so are
      underutilized. We review models that address the crucial distinction between the
      gene divergence, the parameter that is typically recovered in molecular
      phylogeographic studies, and the population divergence, which is in most cases
      the parameter of interest and will almost always postdate the gene divergence.
      Assuming that population sizes of ancestral species are distributed similarly to
      those of extant species, we show that phylogeographic studies in vertebrates
      suggest that divergence of alleles in ancestral species can comprise from less
      than 10% to over 50% of the total divergence between sister species, suggesting
      that the problem of ancestral polymorphism in dating population divergence can be
      substantial. The variance in the number of substitutions (among loci for a given
      species or among species for a given gene) resulting from the stochastic nature
      of DNA change is generally smaller than the variance due to substitutions along
      allelic lines whose coalescence times vary due to genetic drift in the ancestral
      population. Whereas the former variance can be reduced by further DNA sequencing
      at a single locus, the latter cannot. Contrary to phylogeographic intuition,
      dating population divergence times when allelic lines have achieved reciprocal
      monophyly is in some ways more challenging than when allelic lines have not
      achieved monophyly, because in the former case critical data on ancestral
      population size provided by residual ancestral polymorphism is lost. In the
      former case differences in coalescence time between species pairs can in
      principle be explained entirely by differences in ancestral population size
      without resorting to explanations involving differences in divergence time.
      Furthermore, the confidence limits on population divergence times are severely
      underestimated when those for number of substitutions per site in the DNA
      sequences examined are used as a proxy. This uncertainty highlights the
      importance of multilocus data in estimating population divergence times;
      multilocus data can in principle distinguish differences in coalescence time (T)
      resulting from differences in population divergence time and differences in T due
      to differences in ancestral population sizes and will reduce the confidence
      limits on the estimates. We analyze the contribution of ancestral population size
      (theta) to T and the effect of uncertainty in theta on estimates of population
      divergence (tau) for single loci under reciprocal monophyly using a simple
      Bayesian extension of Takahata and Satta's and Yang's recent coalescent methods.
      The confidence limits on tau decrease when the range over which ancestral
      population size theta is assumed to be distributed decreases and when tau
      increases; they generally exclude zero when tau/(4Ne) > 1. We also apply a
      maximum-likelihood method to several single and multilocus data sets. With
      multilocus data, the criterion for excluding tau = 0 is roughly that l tau/(4Ne)
      > 1, where l is the number of loci. Our analyses corroborate recent suggestions
      that increasing the number of loci is critical to decreasing the uncertainty in
      estimates of population divergence time.

PMID- 11209765
TI  - Fixation of new alleles and the extinction of small populations: drift load,
      beneficial alleles, and sexual selection.
AB  - With a small effective population size, random genetic drift is more important
      than selection in determining the fate of new alleles. Small populations
      therefore accumulate deleterious mutations. Left unchecked, the effect of these
      fixed alleles is to reduce the reproductive capacity of a species, eventually to
      the point of extinction. New beneficial mutations, if fixed by selection, can
      restore some of this lost fitness. This paper derives the overall change in
      fitness due to fixation of new deleterious and beneficial alleles, as a function
      of the distribution of effects of new mutations and the effective population
      size. There is a critical effective size below which a population will on average
      decline in fitness, but above which beneficial mutations allow the population to
      persist. With reasonable estimates of the relevant parameters, this critical
      effective size is likely to be a few hundred. Furthermore, sexual selection can
      act to reduce the fixation probability of deleterious new mutations and increase
      the probability of fixing new beneficial mutations. Sexual selection can
      therefore reduce the risk of extinction of small populations.

PMID- 11209766
TI  - Runaway sexual selection when female preferences are directly selected.
AB  - We introduce models for the runaway coevolution of female mating preferences and
      male display traits. The models generalize earlier results by allowing for direct
      natural selection on the preference, arbitrary forms of mate choice, and fairly
      general assumptions about the underlying genetics. Results show that a runaway is
      less likely when there is direct selection on the preference, but that it is
      still possible if there is a sufficiently large phenotypic correlation between
      the female's preference and the male's trait among mated pairs. Comparison of
      three preference functions introduced by Lande (1981) shows that open-ended
      preferences are particularly prone to a runaway, and that absolute preferences
      require very large differences between females in their preferences. We analyze
      the causes of the runaway seen in a model developed by Iwasa and Pomiankowski
      (1995).

PMID- 11209767
TI  - A deterministic genetic model for sympatric speciation by sexual selection.
AB  - A deterministic haploid genetic model confirms and explores in more detail the
      results of our previous individual-based simulation model for sympatric
      speciation by sexual selection. With the deterministic model, we are able to
      elucidate parameter dependence by phase plane analysis. We clarify how and why
      sympatric speciation by sexual selection can happen in a number of ways: (1)
      Female preferences for or against particular types of males have different
      effects. Whereas the former affects how readily speciation is invoked, the latter
      changes the stability of speciation equilibrium. (2) When there is no cost on
      male ornamentations, speciation is triggered regardless of initial haplotype
      frequencies if sufficient female preference is provided. (3) There exists a
      threshold for female initial frequencies for speciation to be invoked, but male
      initial frequencies have little effect. (4) A small cost on female mate choice
      does not cancel speciation, but when large, it greatly reduces the possibility of
      speciation.

PMID- 11209768
TI  - Gene interactions from maternal effects.
AB  - Theoretical analyses have demonstrated a potential role for epistasis in many of
      the most important processes in evolution. These analyses generally assume that
      an individual's genes map directly to its phenotype and epistasis results from
      interactions among loci that contribute to the same biochemical or developmental
      pathways (termed physiological, or within-genotype, epistasis). For many
      characters, particularly those expressed early in life, an individual's phenotype
      may also be affected by genes expressed by its parents. The presence of these
      parental effects allows for interactions between the genes present in the
      parental and offspring genomes. When the phenotypic effect of a locus in the
      offspring depends on the alleles possessed by its parents, genotype-by-genotype,
      or among-genotype, epistasis occurs. The among-genotype epistasis resulting from
      parental effects may contribute to ruggedness of adaptive landscapes because
      early mortality often accounts for much of the variance in fitness in
      populations. To demonstrate how parent-offspring interactions can result in among
      genotype epistasis, I use a two-locus model, with one maternal effect locus and
      one direct effect locus, each with two alleles. Dynamical equations are presented
      for the two-locus model and are directly contrasted with the dynamical equations
      derived for a model for physiological epistasis. The relationship between the
      evolutionary dynamics resulting from these two forms of epistasis is discussed.
      Three scenarios are presented to illustrate systems in which maternal-offspring,
      genotype-by-genotype epistasis may occur. The implications of maternal-offspring
      epistasis for quantitative-trait-loci studies are also discussed.

PMID- 11209769
TI  - The evolutionary dynamics of direct phenotypic overdominance: emergence possible,
      loss probable.
AB  - An evolutionary dynamical system with explicit diploid genetics is used to
      investigate the likelihood of observing phenotypically overdominant heterozygotes
      versus heterozygous phenotypes that are intermediate between the homozygotes. In
      this model, body size evolves in a population with discrete demographic episodes
      and with competition limiting reproduction. A genotype-phenotype map for body
      size is used that can generate the two qualitative types of dominance
      interactions (overdominance versus intermediate dominance). It is written as a
      single-locus model with one focal locus and parameters summarizing the effects of
      alleles at other loci. Two types of evolutionarily stable strategy (ESS;
      continuously stable strategy, CSS) occur. The ESS is generated either (1) by the
      population ecology; or (2) by a local maximum of the genotype-phenotype map.
      Overdominant heterozygotes are expected to arise if the population evolves toward
      the second type of ESS, where nearly maximum body sizes are found. When other
      loci with partially dominant inheritance also evolve, the location of the maximum
      in the genotype-phenotype map repeatedly changes. It is unlikely that an evolving
      population will track these changes; ESSs of the second type now are at best
      quasi-stationary states of the evolutionary dynamics. Considering the
      restrictions on its probability, a pattern of phenotypic overdominance is
      expected to be rare.

PMID- 11209770
TI  - Molecular evolution, adaptive radiation, and geographic diversification in the
      amphiatlantic family Rapateaceae: evidence from ndhF sequences and morphology.
AB  - Rapateaceae (16 genera, approximately 100 species) is largely restricted to the
      tepuis and sandplains of the Guayana Shield in northern South America, with
      Maschalocephalus endemic to West Africa. The family has undergone extensive
      radiation in flower form, leaf shape, habit, and habitat. To analyze the
      evolution of these distributions and traits, we derived a molecular phylogeny for
      representatives of 14 genera, based on sequence variation in the chloroplast
      encoded ndhF gene. The lowland subfamily Rapateoideae is paraphyletic and
      includes the largely montane subfamily Saxofridericioideae as a monophyletic
      subset. Overall, the morphological/anatomical data differ significantly from ndhF
      sequences in phylogenetic structure, but show a high degree of concordance with
      the molecular tree in three of four tribes. Branch lengths are consistent with
      the operation of a molecular clock. Maschalocephalus diverges only slightly from
      other Monotremae: it is the product of relatively recent, long-distance
      dispersal, not continental drift--only its habitat atop rifted, nutrient-poor
      sandstones is vicariant. The family appears to have originated approximately 65
      Mya in inundated lowlands of the Guayana Shield, followed by: (1) wide geographic
      spread of lowland taxa along riverine corridors; (2) colonization of Amazonian
      white-sand savannas in the western Shield; (3) invasion of tepui habitats with
      frequent speciation, evolution of narrow endemism, and origin of hummingbird
      pollination in the western Shield; and (4) reinvasion of lowland white-sand
      savannas. The apparent timing of speciation in the Stegolepis alliance about 6-12
      Mya occurred long after the tepuis began to be dissected from each other as the
      Atlantic rifted approximately 90 Mya. Given the narrow distributions of most
      montane taxa, this suggests that infrequent long-distance dispersal combined with
      vicariance accounts for speciation atop tepuis in the Stegolepis alliance.

PMID- 11209771
TI  - Plant genetics affects arthropod community richness and composition: evidence
      from a synthetic eucalypt hybrid population.
AB  - To examine how genetic variation in a plant population affects arthropod
      community richness and composition, we quantified the arthropod communities on a
      synthetic population of Eucalyptus amygdalina, E. risdonii, and their F1 and
      advanced-generation hybrids. Five major patterns emerged. First, the pure species
      and hybrid populations supported significantly different communities. Second,
      species richness was significantly greatest on hybrids (F1 > F2 > E. amygdalina >
      E. risdonii). These results are similar to those from a wild population of the
      same species and represent the first case in which both synthetic and wild
      population studies confirm a genetic component to community structure. Hybrids
      also acted as centers of biodiversity by accumulating both the common and
      specialist taxa of both parental species (100% in the wild and 80% in the
      synthetic population). Third, species richness was significantly greater on F1s
      than the single F2 family, suggesting that the increased insect abundance on
      hybrids may not be caused by the breakup of coadapted gene complexes. Fourth,
      specialist arthropod taxa were most likely to show a dominance response to F1
      hybrids, whereas generalist taxa exhibited a susceptible response. Fifth, in an
      analysis of 31 leaf terpenoids that are thought to play a role in plant defense,
      hybrids were generally intermediate to the parental chemotypes. Within the single
      F2 family, we found significant associations between the communities of
      individual trees and five individual oil components, including oil yield,
      demonstrating that there is a genetic effect on plant defensive chemistry that,
      in turn, may affect community structure. These studies argue that hybridization
      has important community-level consequences and that the genetic variation present
      in hybrid zones can be used to explore the genetic-based mechanisms that
      structure communities.

PMID- 11209772
TI  - Costs of plasticity in foraging characteristics of the clonal plant Ranunculus
      reptans.
AB  - In clonal plants, evolution of plastic foraging by increased lengths of leaves
      and internodes under unfavourable conditions may be constrained by costs and
      limits of plasticity. We studied costs and limits of plasticity in foraging
      characteristics in 102 genotypes of the stoloniferous herb Ranunculus reptans. We
      grew three replicates of each genotype with and three without competition by the
      naturally co-occuring grass Agrostis stolonifera. We used regression and
      correlation analyses to investigate potential costs of plasticity in lengths of
      leaves and stolon internodes, developmental instability costs of these traits,
      and a developmental range limit of these traits. We used randomization procedures
      to control for spurious correlations between parameters calculated from the same
      data. Under competition the number of rosettes, rooted rosettes, and flowers was
      58%, 40%, and 61% lower, respectively, than in the absence of competition. Under
      competition lengths of leaves and stolon internodes were 14% and 6% smaller,
      respectively, than in the absence of competition. We detected significant costs
      of plasticity in stolon internode length in the presence of competition when
      fitness was measured in terms of the number of rosettes and the number of flowers
      (selection gradients against plasticity were 0.250 and 0.214, respectively).
      Within-environment variation (SD) in both foraging traits was not positively
      correlated with the corresponding plasticity, which indicates that there were no
      developmental instability costs. More plastic genotypes did not have less extreme
      trait values than less plastic genotypes for both foraging traits, which
      indicates that there was no developmental range limit. We conclude that in R.
      reptans costs of plasticity more strongly constrain evolution of foraging in the
      horizontal plane (i.e., stolon internode length) than in the vertical plane
      (i.e., leaf length).

PMID- 11209773
TI  - Evidence of adaptive divergence in plasticity: density- and site-dependent
      selection on shade-avoidance responses in Impatiens capensis.
AB  - We investigated the conditions under which plastic responses to density are
      adaptive in natural populations of Impatiens capensis and determined whether
      plasticity has evolved differently in different selective environments. Previous
      studies showed that a population that evolved in a sunny site exhibited greater
      plasticity in response to density than did a population that evolved in a
      woodland site. Using replicate inbred lines in a reciprocal transplant that
      included a density manipulation, we asked whether such population differentiation
      was consistent with the hypothesis of adaptive divergence. We hypothesized that
      plasticity would be more strongly favored in the sunny site than in the woodland
      site; consequently, we predicted that selection would be more strongly density
      dependent in the sunny site, favoring the phenotype that was expressed at each
      density. Selection on internode length and flowering date was consistent with the
      hypothesis of adaptive divergence in plasticity. Few costs or benefits of
      plasticity were detected independently from the expressed phenotype, so
      plasticity was selected primarily through selection on the phenotype.
      Correlations between phenotypes and their plasticity varied with the environment
      and would cause indirect selection on plasticity to be environment dependent. We
      showed that an appropriate plastic response even to a rare environment can
      greatly increase genotypic fitness when that environment is favorable. Selection
      on the measured characters contributed to local adaptation and fully accounted
      for fitness differences between populations in all treatments except the woodland
      site at natural density.

PMID- 11209774
TI  - Density dependence and population differentiation of genetic architecture in
      Impatiens capensis in natural environments.
AB  - We identified environment-dependent constraints on the evolution of plasticity to
      density under natural conditions in two natural populations of Impatiens
      capensis. We also examined the expression of population divergence in genetic
      variance-covariance matrices in these natural environments. Inbred lines,
      originally collected from a sunny site with high seedling densities and a
      woodland site with low seedling densities, were planted in both original sites at
      natural high densities and at low density. Morphological and life-history
      characters were measured. More genetic variation for plastic responses to density
      was expressed in the sun site than in the woodland site, so the evolutionary
      potential of plasticity was greater in the sun site. Strong genetic correlations
      between the same character expressed at different densities and correlations
      among different characters could constrain the evolution of plasticity in both
      sites. Genetically based trade-offs in meristem allocation to vegetative growth
      and reproduction were apparent only in the high-resource environment with no
      overhead canopy and no intraspecific competition. Therefore, genetic constraints
      on the evolution of plasticity depended on the site and density in which plants
      were grown, and correlated responses to selection on plastic characters are also
      expected to differ between sites and densities. Population differentiation in
      genetic variance-covariance matrices was detected, but matrix structural
      differences, as opposed to proportional differences, were detected between
      populations only in the sun site at natural high density. Thus, population
      divergence in genetic architecture can occur rapidly and on a fine spatial scale,
      but the expression of such divergence may depend on the environment.

PMID- 11209775
TI  - Plasticity to light cues and resources in Arabidopsis thaliana: testing for
      adaptive value and costs.
AB  - Plants shaded by neighbors or overhead foliage experience both a reduction in the
      ratio of red to far red light (R:FR), a specific cue perceived by phytochrome,
      and reduced photosynthetically active radiation (PAR), an essential resource. We
      tested the adaptive value of plasticity to crowding and to the cue and resource
      components of foliage shade in the annual plant Arabidopsis thaliana by exposing
      36 inbred families from four natural populations to four experimental treatments:
      (1) high density, full sun; (2) low density, full sun; (3) low density, neutral
      shade; and (4) low density, low R:FR-simulated foliage shade. Genotypic selection
      analysis within each treatment revealed strong environmental differences in
      selection on plastic life-history traits. We used specific contrasts to measure
      plasticity to density and foliage shade, to partition responses to foliage shade
      into phytochrome-mediated responses to the R:FR cue and responses to PAR, and to
      test whether plasticity was adaptive (i.e., in the same direction as selection in
      each environment). Contrary to expectation, we found no evidence for adaptive
      plasticity to density. However, we observed both adaptive and maladaptive
      responses to foliage shade. In general, phytochrome-mediated plasticity to the
      R:FR cue of foliage shade was adaptive and counteracted maladaptive growth
      responses to reduced PAR. These results support the prediction that active
      developmental responses to environmental cues are more likely to be adaptive than
      are passive resource-mediated responses. Multiple regression analysis detected a
      few costs of adaptive plasticity and adaptive homeostasis, but such costs were
      infrequent and their expression depended on the environment. Thus, costs of
      plasticity may occasionally constrain the evolution of adaptive responses to
      foliage shade in Arabidopsis, but this constraint may differ among environments
      and is far from ubiquitous.

PMID- 11209776
TI  - Evolution of reproductive strategies in the sexually deceptive orchid Ophrys
      sphegodes: how does flower-specific variation of odor signals influence
      reproductive success?
AB  - The orchid Ophrys sphegodes Miller is pollinated by sexually excited males of the
      solitary bee Andrena nigroaenea, which are lured to the flowers by visual cues
      and volatile semiochemicals. In O. sphegodes, visits by pollinators are rare.
      Because of this low frequency of pollination, one would expect the evolution of
      strategies that increase the chance that males will visit more than one flower on
      the same plant; this would increase the number of pollination events on a plant
      and therefore the number of seeds produced. Using gas chromatography-mass
      spectrometry (GC-MS) analyses, we identified more than 100 compounds in the odor
      bouquets of labellum extracts from O. sphegodes; 24 compounds were found to be
      biologically active in male olfactory receptors based on gas chromatography with
      electroantennographic detection (GC-EAD). Gas chromatography (GC) analyses of
      odors from individual flowers showed less intraspecific variation in the odor
      bouquets of the biologically active compounds as compared to nonactive compounds.
      This can be explained by a higher selective pressure on the pollinator-attracting
      communication signal. Furthermore, we found a characteristic variation in the GC
      EAD active esters and aldehydes among flowers of different stem positions within
      an inflorescence and in the n-alkanes and n-alkenes among plants from different
      populations. In our behavioral field tests, we showed that male bees learn the
      odor bouquets of individual flowers during mating attempts and recognize them in
      later encounters. Bees thereby avoid trying to mate with flowers they have
      visited previously, but do not avoid other flowers either of a different or the
      same plant. By varying the relative proportions of saturated esters and aldehydes
      between flowers of different stem positions, we demonstrated that a plant may
      take advantage of the learning abilities of the pollinators and influence flower
      visitation behavior. Sixty-seven percent of the males that visited one flower in
      an inflorescence returned to visit a second flower of the same inflorescence.
      However, geitonogamy is prevented and the likelihood of cross-fertilization is
      enhanced by the time required for the pollinium deposited on the pollinator to
      complete its bending movement, which is necessary for pollination to occur. Cross
      fertilization is furthermore enhanced by the high degree of odor variation
      between plants. This variation minimizes learned avoidance of the flowers and
      increases the likelihood that a given pollinator would visit several to many
      different plants within a population.

PMID- 11209777
TI  - Formulation and estimation of the effective size of stage-structured populations
      in Fritillaria camtschatcensis, a perennial herb with a complex life history.
AB  - The effective population size (Ne) is formulated based on a stage-structured
      population model and is estimated for two populations of Fritillaria
      camtschatcensis (L.) Ker-Gawl. (Liliaceae), a perennial, mainly clonally
      reproducing herb. Plants in these populations change life-history stages year by
      year, either upward or downward across three unambiguously identifiable stages:
      one-leaf, nonflowering; multileaf nonflowering; and multileaf, flowering stages.
      Plants of all stages produce clonal progeny (bulblets) each year, and death of
      plants occurs only in the first stage. The populations are nearly at equilibrium
      in both population size and stage structure. Ne is estimated to be 20-30% of the
      census population size (N), leading to the prediction that a population size of
      about 20,000 or more will be needed to conserve the normal level of the gene
      diversity (Ne > or = 5000). With the current demographic pattern of this species,
      accelerated growth of the first-stage plants with reduced survival of the second-
      and third-stage plants will increase both the annual (Ny/N) and generation time
      (Ne/N) effective sizes of population.

PMID- 11209778
TI  - Global phylogeography of a cryptic copepod species complex and reproductive
      isolation between genetically proximate "populations".
AB  - The copepod Eurytemora affinis has a broad geographic range within the Northern
      Hemisphere, inhabiting coastal regions of North America, Asia, and Europe. A
      phylogenetic approach was used to determine levels of genetic differentiation
      among populations of this species, and interpopulation crosses were performed to
      determine reproductive compatibility. DNA sequences from two mitochondrial genes,
      large subunit (16S) rRNA (450 bp) and cytochrome oxidase I (COI, 652 bp), were
      obtained from 38 populations spanning most of the species range and from two
      congeneric species, E. americana and E. herdmani. Phylogenetic analysis revealed
      a polytomy of highly divergent clades with maximum sequence divergences of 10% in
      16S rRNA and 19% in COI. A power test (difference of a proportion) revealed that
      amount of sequence data collected was sufficient for resolving speciation events
      occurring at intervals greater than 300,000 years, but insufficient for
      determining whether speciation events were approximately simultaneous. Geographic
      and genetic distances were not correlated (Mantel's test; r = 0.023, P = 0.25),
      suggesting that populations had not differentiated through gradual isolation by
      distance. At finer spatial scales, there was almost no sharing of mtDNA
      haplotypes among proximate populations, indicating little genetic exchange even
      between nearby sites. Interpopulation crosses demonstrated reproductive
      incompatibility among genetically distinct populations, including those that were
      sympatric. Most notably, two geographically distant (4000 km) but genetically
      proximate (0.96% 16S, 0.15% COI) populations exhibited asymmetric reproductive
      isolation at the F2 generation. Large genetic divergences and reproductive
      isolation indicate that the morphologically conservative E. affinis constitutes a
      sibling species complex. Reproductive isolation between genetically proximate
      populations underscores the importance of using multiple measures to examine
      patterns of speciation.

PMID- 11209779
TI  - Mechanisms of conspecific sperm precedence in Drosophila.
AB  - The postmating, prezygotic isolating mechanism known as conspecific sperm
      precedence (CSP) may play an important role in speciation, and understanding the
      mechanism of CSP is important in reconstructing its evolution. When a Drosophila
      simulans female mates with both a D. simulans male and a D. mauritiana male, the
      vast majority of her progeny are fathered by D. simulans, regardless of the order
      of mating. The dearth of hybrid progeny does not result from inviability of eggs
      fertilized by heterospecific sperm or from the relative inviability of
      heterospecific larvae. Instead, CSP apparently results from a prefertilization
      obstacle to heterospecific sperm. We identified two independent barriers to
      heterospecific fertilization, sperm displacement and incapacitation, whose action
      depends on the order of mating. When a D. simulans female mates first with a
      conspecific male, the seminal fluid from this mating incapacitates heterospecific
      sperm transferred two days later. This sperm incapacitation occurs with no change
      in the retention of stored sperm over time, but does not occur when the
      conspecific mating lasts for only 5 min. When the order of matings is reversed,
      the seminal fluid from the second mating physically displaces heterospecific
      sperm from storage, even if the conspecific copulation lasts only 5 min.
      Conspecific sperm are not susceptible to displacement by a second conspecific
      copulation, but are susceptible to interference by heterospecific sperm if the
      conspecific copulation is interrupted after 12 min. Curing the D. mauritiana
      males of their infection with the endosymbiont Wolbachia had no effect on CSP.
      Sperm displacement and incapacitation involve the same basic mechanisms seen in
      second-male sperm precedence within species, supporting the hypothesis that CSP
      is an evolutionary by-product of adaptations affecting sperm competition within
      species.

PMID- 11209780
TI  - Reproductive costs of heat shock protein in transgenic Drosophila melanogaster.
AB  - Senescence may evolve when genes have antagonistic effects between early
      reproduction and later age-specific mortality. Although widely consistent with
      data of quantitative genetics, this model has yet to be validated with the
      identification of a specific locus presenting such trade-offs. The molecular
      chaperone hsp70 may be a candidate for such a gene. Heat induced expression of
      the Hsp70 protein in adults decreases rates of age-specific mortality during
      normal aging, while maternally experienced heat shock depresses the production of
      mature progeny. Here we show that maternal heat shock reduces the proportion of
      egg hatch but not the viability of successfully hatched offspring. To assess
      whether heat induced maternal expression of hsp70 causes reduced egg hatch, we
      measured the proportion of eggs that hatch from females engineered to overexpress
      hsp70 transgenes. We used the same transgenic strains that extend longevity upon
      hsp70 expression and found that Hsp70 is sufficient to suppress egg hatch. The
      proportion of egg hatch as a function of hsp70 expression was not reduced in the
      first eggs laid after maternal heat shock, but appears in later laid eggs, which
      were at preoogenic and early vitellogenic stages during the maternal expression
      of hsp70. The contervailing effects of hsp70 upon fecundity and subsequent age
      specific mortality exemplify antagonistic pleiotropy, and this trade-off could
      contribute to the evolution of Drosophila senescence.

PMID- 11209781
TI  - Evolution of abdominal pigmentation differences across species in the Drosophila
      dunni subgroup.
AB  - The Drosophila dunni subgroup displays a nearly perfect latitudinal cline in
      abdominal pigmentation that likely resulted from selective forces acting in the
      habitat of each species during speciation. Here we characterize the nature of
      this clinal variation by developing a quantitative measure to assess variation in
      abdominal pigmentation within and between the D. dunni subgroup species. Using
      discriminant analysis, we confirm the existence of a cline and find that our
      quantitative measure of pigmentation distinguishes each of the species with
      singular efficacy. We then combine our quantitative phenotypic analysis of
      pigmentation with the phylogeny of the D. dunni subgroup species and map the
      species relationships into the three-dimensional morphological space defined by
      our pigmentation measures. In this manner, we can visualize how the species have
      traversed the morphological pigmentation space during the course of speciation.
      Our analysis reveals that natural selection has caused overall intensity of
      pigmentation among the northernmost species of the cline to converge. Along with
      this convergence in phenotype has been a relaxation in expression of sexual
      dimorphism in these species, indicating a possible shift in the relative
      intensity of natural and sexual selection. Our analysis indicates an accelerated
      rate of change in pigmentation for the darkest species in addition to this
      species evolving a novel abdominal pigmentation trait.

PMID- 11209782
TI  - Genetic and developmental analysis of abdominal pigmentation differences across
      species in the Drosophila dunni subgroup.
AB  - Abdominal pigmentation pattern varies dramatically among the species of the
      Drosophila dunni subgroup across the islands of the Caribbean. Previously, we
      developed a quantitative measure of abdominal pigmentation to assess phenotypic
      variation within and between species of this group. In this paper, we use this
      quantitative measure in an interspecific genetic analysis to decipher the
      underlying genetic basis of pigmentation differences between one of the lightest
      and the darkest species in the group. Our analysis shows that pigmentation
      expression in different areas of the abdomen is under separate genetic control.
      For these different abdominal regions, we detected a wide range of genetic
      effects, including X-linked, autosomal additive, near single-gene dominant, and
      sex-specific effects. Combining these genetic results with our earlier phenotypic
      and phylogenetic analyses, we present a simple conceptual model to explain how
      change in the control of expression of pigmentation has evolved throughout the D.
      dunni subgroup.

PMID- 11209783
TI  - Predisposed to adapt? Clade-level differences in characters affecting swimming
      performance in damselflies.
AB  - Previous studies have shown that two or three lineages of Enallagma damselflies,
      which historically co-existed with fish, recently invaded and adapted to living
      with large dragonfly predators in fishless waters. In adapting to live with these
      new predators, lineages shifted behaviorally to using swimming as an evasive
      tactic against attacking predators, evolved morphological features that made them
      faster swimmers, and evolved biochemical features to increase refueling strenuous
      activities like swimming. However, these habitat shifts have occurred in only one
      of the two primary clades within the genus in North America. Here, I show that
      clade-level differences exist among species in the ancestral, fish-lake habitat
      that should make habitat shifts easier to accomplish in the clade in which they
      have occurred. Specifically, fish-lake species in the clade in which habitat
      shifts occurred have much higher propensities to swim in the laboratory, swim
      faster when they do swim, and have higher mass-specific activities for arginine
      kinase than do species in the other primary clade, in which no extant species are
      found in fishless waters. These results are discussed in the context of the
      dynamics of founder events and the potential implications for community
      structure.

PMID- 11209784
TI  - Interpreting colonization of the Calathus (Coleoptera: Carabidae) on the Canary
      Islands and Madeira through the application of the parametric bootstrap.
AB  - The Canary Islands have proven to be an interesting archipelago for the
      phylogeographic study of colonization and diversification with a number of recent
      studies reporting evolutionary patterns and processes across a diversity of
      floral and faunal groups. The Canary Islands differ from the Hawaiian and
      Galapagos Islands by their close proximity to a continental land mass, being 110
      km from the northwestern coast of Africa. This close proximity to a continent
      obviously increases the potential for colonization, and it can be expected that
      at the level of the genus some groups will be the result of more than one
      colonization. In this study we investigate the phylogeography of a group of
      carabid beetles from the genus Calathus on the Canary Islands and Madeira,
      located 450 km to the north of the Canaries and 650 km from the continent. The
      Calathus are well represented on these islands with a total of 29 species, and on
      the continent there are many more. Mitochondrial cytochrome oxidase I and II
      sequence data has been used to identify the phylogenetic relationships among the
      island species and a selection of continental species. Specific hypotheses of
      monophyly for the island fauna are tested with parametric bootstrap analysis.
      Data suggest that the Canary Islands have been colonized three times and Madeira
      twice. Four of these colonizations are of continental origin, but it is possible
      that one Madeiran clade may be monophyletic with a Canarian clade. The Calathus
      faunas of Tenerife and Madeira are recent in origin, similar to patterns
      previously reported for La Gomera, El Hierro, and Gran Canaria.

PMID- 11209785
TI  - An experimental study of intraspecific variation, developmental timing, and
      heterochrony in fishes.
AB  - Heterochrony is widely regarded as an important evolutionary mechanism, one that
      may underlie most, if not all, morphological evolution, yet relatively few
      studies have examined variation in the sequence of development. Even fewer
      studies have been designed so that intraspecific variation in the relative
      sequence of developmental events can be assessed, although this variation must be
      the basis for evolutionary change. Intraspecific variation in developmental
      ossification sequences was documented from the zebrafish (Danio rerio) by Cubbage
      and Mabee (1996) and from the Siamese fighting fish (Betta splendens) by Mabee
      and Trendler (1996), but a quantitative analysis of the patterns within this
      variation was not made. Here, we quantify the effect of rearing temperature on
      the sequence of ossification and characterize the levels and patterns of
      intraspecific variation in these fishes. For Danio, there were no temperature
      effects on the sequence of bone development across the cranium, cranial region
      development, cartilage versus dermal bones, or lateral line bone versus
      nonassociated bones. Likewise the level of variation in relative sequence
      (position) of ossification was low, about two ranks, across temperatures. At
      higher temperatures, we found higher levels of variation in iterated cranial
      bones and less in bones forming early in the sequence. No temperature effects on
      variation were found among regions, between lateral line-associated bones and
      nonassociated bones, between median and paired bones, or across the entire
      sequence, indicating concordant variability among the three temperatures.
      Individual bones with the highest levels of variability were not consistent among
      temperatures. Baseline patterns of intraspecific variation in Danio were compared
      to those of Betta. For both species, the level of intraspecific variation in
      sequence position was low and the variability of cranial bones was concordant.
      Individual bones with the highest levels of variability were not consistent
      between species. In both species, variation was widespread (distributed evenly
      across the sequence). We used comparisons (among regions, between dermal and
      cartilage bones, between lateral line-associated and other bones, between median
      and paired bones, between iterated and noniterated bones, between feeding
      associated bones and others) to see which subsets were most variable and thus
      potentially useful in predicting high levels of evolutionary change. The only
      subset of bones that was significantly more variable than others was cartilage
      bones. If interspecific patterns are parallel to these intraspecific differences,
      cartilage bones would be expected to show higher levels of heterochrony. Although
      concordance across the cranial ossification sequence and among regions in Danio,
      Betta, and two other teleosts, Oryzias and Barbus, suggests an evolutionarily
      conserved pattern of ossification, identity in sequence position across taxa was
      not observed for any bone. Thus, variation existed in sequence position across
      temperatures and species. Intraspecific variation of this sort may influence the
      morphological outcome and evolutionary trajectories of species.

PMID- 11209786
TI  - Mitochondrial DNA phylogeography of the polytypic North American rat snake
      (Elaphe obsoleta): a critique of the subspecies concept.
AB  - Subspecies have been considered artificial subdivisions of species, pattern
      classes, or incipient species. However, with more data and modern phylogenetic
      techniques, some subspecies may be found to represent true species. Mitochondrial
      DNA analysis of the polytypic snake, Elaphe obsoleta, yields well-supported
      clades that do not conform to any of the currently accepted subspecies. Complete
      nucleotide sequences of the cytochrome b gene and the mitochondrial control
      region produced robust maximum-parsimony and maximum-likelihood trees that do not
      differ statistically. Both trees were significantly shorter than a most
      parsimonious tree in which each subspecies was constrained to be monophyletic.
      Thus, the subspecies of E. obsoleta do not represent distinct genetic lineages.
      Instead, the evidence points to three well-supported mitochondrial DNA clades
      confined to particular geographic areas in the eastern United States. This
      research underscores the potential problems of recognizing subspecies based on
      one or a few characters.

PMID- 11209787
TI  - Reconstructing plumage evolution in orioles (Icterus): repeated convergence and
      reversal in patterns.
AB  - Several empirical studies suggest that sexually selected characters, including
      bird plumage, may evolve rapidly and show high levels of convergence and other
      forms of homoplasy. However, the processes that might generate such convergence
      have not been explored theoretically. Furthermore, no studies have rigorously
      addressed this issue using a robust phylogeny and a large number of signal
      characters. We scored the appearance of 44 adult male plumage characters that
      varied across New World orioles (Icterus). We mapped the plumage characters onto
      a molecular phylogeny based on two mitochondrial genes. Reconstructing the
      evolution of these characters revealed evidence of convergence or reversal in 42
      of the 44 plumage characters. No plumage character states are restricted to any
      groups of species higher than superspecies in the oriole phylogeny. The high
      frequency of convergence and reversal is reflected in the low overall retention
      index (RI = 0.66) and the low overall consistency index (CI = 0.28). We found
      similar results when we mapped plumage changes onto a total evidence tree. Our
      findings reveal that plumage patterns and colors are highly labile between
      species of orioles, but highly conserved within the oriole genus. Furthermore,
      there are at least two overall plumage types that have convergently evolved
      repeatedly in the three oriole clades. This overall convergence leads to
      significant conflict between the molecular and plumage data. It is not clear what
      evolutionary processes lead to this homoplasy in individual characters or
      convergence in overall pattern. However, evolutionary constraints such as
      developmental limitations and genetic correlations between characters are likely
      to play a role. Our results are consistent with the belief that avian plumage and
      other sexually selected characters may evolve rapidly and may exhibit high
      homoplasy. The overall convergence in oriole plumage patterns is an interesting
      evolutionary phenomenon, but it cautions against heavy reliance on plumage
      characters for constructing phylogenies.

PMID- 11209788
TI  - The evolution of sexual size dimorphism in the house finch. II. Population
      divergence in relation to local selection.
AB  - Recent colonization of ecologically distinct areas in North America by the house
      finch (Carpodacus mexicanus) was accompanied by strong population divergence in
      sexual size dimorphism. Here we examined whether this divergence was produced by
      population differences in local selection pressures acting on each sex. In a long
      term study of recently established populations in Alabama, Michigan, and Montana,
      we examined three selection episodes for each sex: selection for pairing success,
      overwinter survival, and within-season fecundity. Populations varied in intensity
      of these selection episodes, the contribution of each episode to the net
      selection, and in the targets of selection. Direction and intensity of selection
      strongly differed between sexes, and different selection episodes often favored
      opposite changes in morphological traits. In each population, current net
      selection for sexual dimorphism was highly concordant with observed sexual
      dimorphism--in each population, selection for dimorphism was the strongest on the
      most dimorphic traits. Strong directional selection on sexually dimorphic traits,
      and similar intensities of selection in both sexes, suggest that in each of the
      recently established populations, both males and females are far from their local
      fitness optimum, and that sexual dimorphism has arisen from adaptive responses in
      both sexes. Population differences in patterns of selection on dimorphism,
      combined with both low levels of ontogenetic integration in heritable sexually
      dimorphic traits and sexual dimorphism in growth patterns, may account for the
      close correspondence between dimorphism in selection and observed dimorphism in
      morphology across house finch populations.

PMID- 11209789
TI  - Major histocompatibility complex variation in the Arabian oryx.
AB  - In the 1960s, the Arabian oryx was one of the most endangered species in the
      world, extinct in the wild and surviving in only a few captive herds. The present
      day population of over 2000 descends from a small number of founders and may have
      restricted genetic variation for important adaptive genes. We have examined the
      amount of genetic variation for a class II gene in the major histocompatibility
      complex thought to be the most important genetic basis for pathogen resistance in
      vertebrates. We found three very divergent alleles, which on average, differed by
      24 nucleotides and 15 amino acids in the 236-bp fragment we examined. Using
      single-strand conformation polymorphism, we found that in a sample of 57 animals,
      the alleles were in Hardy-Weinberg proportions, although one allele was found
      only in four heterozygous individuals. The average heterozygosity for the 22
      amino acid positions involved in antigen binding was 0.165, three times as high
      as that for the 56 amino acids not involved with antigen binding. Because the
      three alleles have such divergent sequences, it is likely that they may recognize
      peptides from quite different pathogens. As a result, maintenance of these
      variants should be considered as a goal in the captive breeding program of the
      Arabian oryx.

PMID- 11209790
TI  - Selection on age at reproduction in Drosophila melanogaster: female mating
      frequency as a correlated response.
AB  - We examined the effect of selection for age at reproduction on female mating
      frequency and fertility in female Drosophila melanogaster. Selection for
      increased age at reproduction (and hence increased lifespan) resulted in higher
      late life female mating frequencies, while females selected for younger ages at
      reproduction showed increased early life mating frequencies. These results
      indicate that the response to selection on age at reproduction has involved
      changes in the scheduling of female reproductive behavior.

PMID- 11209791
TI  - Molecular evidence for selection on female color polymorphism in the damselfly
      Ischnura graellsii.
AB  - The significance of female color polymorphism in Odonata remains controversial
      despite many field studies. The importance of random factors (founder effects,
      genetic drift and migration) versus selective forces for the maintenance of this
      polymorphism is still discussed. In this study, we specifically test whether the
      female color polymorphism of Ischnura graellsii (Odonata, Coenagrionidae) is
      under selection in the wild. We compared the degree of genetic differentiation
      based on RAPD markers (assumed to be neutral) with the degree of differentiation
      based on color alleles. Weir and Cockerham's theta values showed a significant
      degree of population differentiation for both sets of loci (RAPD and color
      alleles) but the estimated degree of population differentiation (theta) was
      significantly greater for the set of RAPD loci. This result shows that some sort
      of selection contributes to the maintenance of similar color morph frequencies
      across the studied populations. Our results combined with those of previous field
      studies suggest that at least in some I. graellsii populations, density-dependent
      mechanisms might help to prevent the loss of this polymorphism but cannot explain
      the similarity in morph frequencies among populations.

PMID- 11209792
TI  - Copulating with multiple mates enhances female fecundity but not egg-to-adult
      survival in the bruchid beetle Callosobruchus maculatus.
AB  - Postcopulatory sexual selection theory has come a long way since the evolutionary
      implications of sperm competition were first spelled out by Parker (1970).
      However, one of the most enduring questions remains: why do females copulate with
      multiple males? Here we show that females copulating with multiple males lay more
      eggs than those copulating repeatedly with the same male. We also show egg-to
      adult survival to be more variable when females copulate multiply with different
      males and less variable when they copulate multiply with the same male. This
      supports the notion that egg-to-adult survival may depend on the genetic
      compatibility of males and females. However, pre-adult survival was highest when
      females copulated repeatedly with the same male rather than with different males.
      Thus, it would appear that polyandry in this species does not function to reduce
      the risk of embryo failure resulting from fertilization by genetically
      incompatible sperm.

PMID- 11209793
TI  - Little evidence for sympatric speciation in island birds.
AB  - It has been suggested that the presence of sister species in small circumscribed
      areas, such as isolated lakes or islands, might imply that these species
      originated sympatrically. To investigate this possibility in birds, we searched
      for endemic, congeneric species on isolated islands in the ocean. Among 46
      islands and small archipelagos chosen because they contain at least one species
      of endemic land bird, we identified seven pairs of endemic congeners (excluding
      flightless rails). Of these seven, only four pairs are potentially sister species
      and thus possible candidates for sympatric speciation. However, three of these
      four pairs have always been considered the results of double invasion from a
      mainland source (in two of these cases, molecular-phylogenetic work has either
      confirmed a double invasion or is ambiguous). The one remaining pair may have
      speciated allopatrically on a small archipelago. Additional phylogenetic studies
      are required to understand these cases, and our results should also be considered
      in light of the large number of island-bird extinctions in historic time. We
      conclude that, at present, there is little evidence for sympatric speciation in
      island birds.

PMID- 11209794
TI  - Species recognition as a possible function for variations in position and shape
      of the sexually dimorphic tusks of Mesoplodon whales.
AB  - Beaked whales of the genus Mesoplodon are characterized by the presence of a
      single pair of sexually dimorphic tusks. Variation in the position and shape of
      these tusks was examined in four sympatric species and was found to be consistent
      with the hypothesis that these differences may have evolved to aid species
      recognition between sympatric and otherwise morphologically similar species of
      this genus.

PMID- 11209795
TI  - Gene flow between Drosophila pseudoobscura and D. persimilis.

PMID- 11209796
TI  - The road not taken.
AB  - The annual Janet Doe Lecture was established in 1966 to honor Janet Doe, emerita
      librarian of the New York Academy of Medicine. The lecture focuses on either the
      history or philosophy of health sciences librarianship. This lecture addresses
      three fundamental values of the field, highlighting basic beliefs of the
      profession that are at risk: privacy, intellectual property rights, and access to
      quality information. It calls upon readers to make the everyday choices required
      to keep the value system of health sciences librarianship in place. Robert
      Frost's poignant poem "The Road Not Taken" provides the metaphor for examining
      choices in an information economy.

PMID- 11209797
TI  - Using a journal availability study to improve access.
AB  - PURPOSE: Identify journal collection access and use factors. SETTING AND
      SUBJECTS: University of North Carolina at Chapel Hill's Health Sciences Library
      patrons. METHODOLOGY: Survey forms and user interactions were monitored once a
      week for twelve weeks during the fall 1997 semester. The project was based on a
      1989 New Mexico State University study and used Kantor's Branching Analysis to
      measure responses. RESULT: 80% of reported sought journal articles were found
      successfully. Along with journal usage data, the library obtained demographic and
      behavioral information. DISCUSSION AND CONCLUSIONS: Journals are the library's
      most used resource and, even as more electronic journals are offered, print
      journals continue to make up the majority of the collection. Several factors
      highlighted the need to study journal availability. User groups indicated that
      finding journals was problematic, and internal statistics showed people
      requesting interlibrary loans for owned items. The study looked at success rates,
      time, and ease of finding journals. A variety of reasons contributed to not
      finding journals. While overall user reports indicated relatively high success
      rate and satisfaction, there were problems to be addressed. As the library
      proceeds in redesigning both the physical space and electronic presence, the
      collected data have provided valuable direction.

PMID- 11209798
TI  - Online tables of contents for books: effect on usage.
AB  - OBJECTIVES: To explore whether the presence of online tables of contents (TOC) in
      an online catalog affects circulation (checkouts and inhouse usage). Two major
      questions were posed: (1) did the presence of online tables of contents for books
      increase use, and, (2) if it did, what factors might cause the increase? METHOD:
      A randomized and stratified design was used in tracking usage of 3,957 book
      titles that were previously divided into two groups: one with TOC and one without
      TOC. Stratification was done for year of imprint, location, subject, previous
      use, circulating or non-circulating status, and presence of TOC. The use was
      tracked by the online catalog statistics in the InnoPac online catalog for
      fourteen months. RESULTS: The study found that tables of contents do increase
      usage. It also showed a correlation in the size of the effect based on the
      currency of the titles. In general, even after adjusting for all of the variables
      (publication date, location, circulation status, subject, and previous use), the
      odds of a title being used increased by 45% if the titles had online tables of
      contents, a statistically significant impact at the 0.05 level. CONCLUSIONS: This
      case-control study presents new information about the impact on circulation and
      inhouse use when tables of contents for books are added to the online catalog
      record. The study helps to establish the positive role of tables of contents in
      online catalogs. The research establishes TOC as a major parameter that can be
      successfully studied using quantitative methods. The study also provides
      information professionals with some guidance on when enhancement of TOC is likely
      to be most effective in increasing the use of existing collections.

PMID- 11209800
TI  - Republican Scientific-Medical Library, The Republic of Armenia: progress and
      programs.
AB  - In 1990, the Republican Scientific-Medical Library (RSML) of the Ministry of
      Health of Armenia in collaboration with the Fund for Armenian Relief created a
      vision of a national library network supported by information technology. This
      vision incorporated four goals: (1) to develop a national resource collection of
      biomedical literature accessible to all health professionals, (2) to develop a
      national network for access to bibliographic information, (3) to develop a
      systematic mechanism for sharing resources, and (4) to develop a national network
      of health sciences libraries. During the last decade, the RSML has achieved
      significant progress toward all four goals and has realized its vision of
      becoming a fully functional national library. The RSML now provides access to the
      literature of the health sciences including access to the Armenian medical
      literature, provides education and training to health professionals and health
      sciences librarians, and manages a national network of libraries of the major
      health care institutions in Armenia. The RSML is now able to provide rapid access
      to the biomedical literature and train health professionals and health sciences
      librarians in Armenia in information system use. This paper describes the
      evolution of the RSML and how it was accomplished.

PMID- 11209799
TI  - A rural virtual health sciences library project: research findings with
      implications for next generation library services.
AB  - PURPOSE: The Shared Hospital Electronic Library of Southern Indiana (SHELSI)
      research project was designed to determine whether access to a virtual health
      sciences library and training in its use would support medical decision making in
      rural southern Indiana and achieve the same level of impact seen by targeted
      information services provided by health sciences librarians in urban hospitals.
      METHODS: Based on the results of a needs assessment, a virtual medical library
      was created; various levels of training were provided. Virtual library users were
      asked to complete a Likert-type survey, which included questions on intent of use
      and impact of use. At the conclusion of the project period, structured interviews
      were conducted. RESULTS: Impact of the virtual health sciences library showed a
      strong correlation with the impact of information provided by health sciences
      librarians. Both interventions resulted in avoidance of adverse health events.
      Data collected from the structured interviews confirmed the perceived value of
      the virtual library. CONCLUSION: While librarians continue to hold a strong
      position in supporting information access for health care providers, their roles
      in the information age must begin to move away from providing information toward
      selecting and organizing knowledge resources and instruction in their use.

PMID- 11209801
TI  - Ethics and access to teaching materials in the medical library: the case of the
      Pernkopf atlas.
AB  - Conflicts can occur between the principle of freedom of information treasured by
      librarians and ethical standards of scientific research involving the propriety
      of using data derived from immoral or dishonorable experimentation. A prime
      example of this conflict was brought to the attention of the medical and library
      communities in 1995 when articles claiming that the subjects of the illustrations
      in the classic anatomy atlas, Eduard Pernkopf's Topographische Anatomie des
      Menschen, were victims of the Nazi holocaust. While few have disputed the
      accuracy, artistic, or educational value of the Pernkopf atlas, some have argued
      that the use of such subjects violates standards of medical ethics involving
      inhuman and degrading treatment of subjects or disrespect of a human corpse.
      Efforts were made to remove the book from medical libraries. In this article, the
      history of the Pernkopf atlas and the controversy surrounding it are reviewed.
      The results of a survey of academic medical libraries concerning their treatment
      of the Pernkopf atlas are reported, and the ethical implications of these issues
      as they affect the responsibilities of librarians is discussed.

PMID- 11209802
TI  - Non-librarian health professionals becoming librarians and information
      specialists: results of an Internet survey.
AB  - OBJECTIVES: To obtain basic information about non-librarian health professionals
      who become librarians and information specialists. METHODS: The survey was a Web
      based questionnaire. A non-random sample of persons was obtained by posting
      messages to several large Internet electronic discussion groups. Individuals who
      met the selection criteria and were willing to participate filled out a Web-based
      form designed using common gateway interface (CGI) programming. RESULTS: 118
      forms were analyzed. Three subgroups of participants were identified and
      statistical comparisons among these groups were carried out for many of the
      quantitative questions. Information concerning reasons they left their original
      field; factors influencing their choice of the field of library and information
      science; reactions of family, friends, and colleagues; and interactions with
      patrons and other information about this group was obtained and summarized. A
      health sciences background was seen as helpful in the new career as information
      specialist. Most people were happy with their new profession despite negative
      reactions from colleagues, relatives, and, occasionally, patrons. Feelings of
      regret and abandonment of their patients were noted by some. Many persons did not
      know that peers had made similar career changes. CONCLUSIONS: A health sciences
      background imparts an expertise in both the vocabulary and subject matter of
      medicine that non-biomedical individuals would not ordinarily have. Although
      becoming a librarian may be perceived as a very positive career change for an
      individual, societal opinion and pressure can make such a career change
      difficult. Nevertheless, participants in this survey demonstrate a high level of
      satisfaction with their new careers and are quite happy with their work.

PMID- 11209803
TI  - Need a bloody nose be a nosebleed? or, lexical variants cause surprising results.

PMID- 11209804
TI  - Historically significant journal articles: their identification in older bound
      journal volumes designated for weeding and the creation of new access to these
      articles.

PMID- 11209805
TI  - What we don't know.

PMID- 11209806
TI  - The library as laboratory.

PMID- 11209807
TI  - Customizing for clients: developing a library liaison program from need to plan.
AB  - Building on the experiences of librarian representatives to curriculum committees
      in the colleges of dentistry, medicine, and nursing, the Health Science Center
      Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison
      Work Group to create a formal Library Liaison Program to serve the six Health
      Science Center (HSC) colleges and several affiliated centers and institutes. The
      work group's charge was to define the purpose and scope of the program, identify
      models of best practice, and recommend activities for liaisons. The work group
      gathered background information, performed an environmental scan, and developed a
      philosophy statement, a program of liaison activities focusing on seven primary
      areas, and a forum for liaison communication. Hallmarks of the plan included
      intensive subject specialization (beyond collection development), extensive
      communication with users, and personal information services. Specialization was
      expected to promote competence, communication, confidence, comfort, and
      customization. Development of the program required close coordination with other
      strategic plan implementation teams, including teams for collection development,
      education, and marketing. This paper discusses the HSCL's planning process and
      the resulting Library Liaison Program. Although focusing on an academic health
      center, the planning process and liaison model may be applied to any library
      serving diverse, subject-specific user populations.

PMID- 11209808
TI  - A tribute to knowledge.

PMID- 11209809
TI  - A small window on Janet Doe's life.

PMID- 11209811
TI  - Neoangiogenesis in squamous cell carcinoma of the larynx - biological and
      prognostic associations.
AB  - Tumor angiogenesis has been related to tumor growth and an increased probability
      of metastatic spread. Previous studies have led to conflicting views regarding
      the prognostic significance of angiogenesis in squamous cell carcinoma of the
      head and neck. To evaluate the role of tumor angiogenesis in the biology of
      squamous cell carcinoma of the larynx, we quantified the microvascular network in
      59 primary laryngeal carcinomas and looked for an association with outcome.
      Microvessels were stained immunohistochemically using antibodies for factor VIII
      related antigen and the antibody JC70 (CD-31). In each case, microvessels were
      counted in three fields at x200 magnification, in areas of most intense
      neovascularization. We found a significantly higher number of microvessels in
      tumors showing deeper levels of invasion.

PMID- 11209812
TI  - Histopathological analyses of silent pituitary somatotroph adenomas using
      immunohistochemistry, in situ hybridization and confocal laser scanning
      microscopic observation.
AB  - To characterize the morphological and functional aspects of silent somatotroph
      adenomas with paradoxical responses of GH in TRH or GnRH provocation tests, which
      are considered to be a useful strategy for endocrinological identification of
      silent somatotroph adenomas, we examined three silent somatotroph adenomas
      histopathologically. The adenomas were investigated by immunohistochemistry,
      including the highly sensitive catalyzed signal amplification system, the non
      radioisotopic in situ hybridization method, and confocal laser scanning
      microscopy. GH production and GH-immunopositive secretory granules in the adenoma
      cells were demonstrated histopathologically, and the adenomas were interpreted as
      being densely granulated somatotroph adenomas. Endocrinological identification of
      silent somatotroph adenomas in combination with paradoxical responses of GH in
      TRH or GnRH provocation tests may elucidate the increasing number of silent
      somatotroph adenomas that have been regarded as mammotroph or clinically inactive
      adenomas. One should be aware of the differences between the previously reported
      silent somatotroph adenomas, most of which are sparsely granulated somatotroph
      adenomas, a somatotroph adenomas with paradoxical and the silent somatotroph
      adenomas, most of which are sparsely granulated somatotroph adenomas, and the
      silent somatotroph adenomas with paradoxical responses of GH in TRH or GnRH
      provocation tests, which are densely granulated somatotroph adenomas.

PMID- 11209813
TI  - Experimental induction of ring fibers in regenerating skeletal muscle.
AB  - Light microscopy and electron microscopy were used to study the formation of ring
      fibers induced experimentally in regenerating muscle subjected to tenotomy
      induced tension deficiency. Anterior tibial rat muscles were injured by
      intramuscular injection of mepivacain, tenotomized at varying stages of the
      regenerative process, and analyzed 30 days after sectioning the tendon. The
      combination of regeneration and tenotomy led to the appearance of ring fibers at
      different developmental stages. Ring fibers were not observed in regenerating
      control muscles and were scarce in tenotomized controls. Our results showed that
      the regenerative phase in which tension deficiency was established had a
      significant influence on the number of developing ring fibers; the number
      increased when tenotomy was performed during subsarcolemmic myofibrillogenesis in
      regenerating fibers. As a consequence, one might hypothesize that tension
      deficiency during muscle fiber repair plays a critical role in ring fiber
      formation.

PMID- 11209814
TI  - Cytological evaluation of the tissue-implant reaction associated with S/C and I/P
      implantation of ALCAP and HA bioceramics in vivo.
AB  - It is well documented that several ceramic materials are highly compatible and
      non-immunogenic with host tissues. Recent studies have demonstrated the need for
      further investigation of these devices in vivo to further elucidate the possible
      mechanisms involved in biocompatibility. The purpose of this investigation was to
      study the morphological characteristics of the fibrous tissue capsule resulting
      from the implantation of aluminum calcium phosphate (ALCAP) and hydroxyapetite
      (HA) bioceramics. Implants of ALCAP and HA were implanted into 10 adult male rats
      subcutaneously (S/C) and intraperitoneally (I/P). At 90 days post-implantation,
      the animals were euthanized, and the ceramic devices, the fibrous tissue, and
      vital organs were harvested. Evaluation of routine stained sections (5 microm,
      hematoxylin & eosin) of the fibrous tissue capsule surrounding the HA and ALCAP
      ceramics revealed the following: 1) all the ceramic devices had fibrous
      connective tissue capsules of slightly varying degrees of thickness at the time
      of sacrifice, depending on the site of implantation and type of material, and 2)
      there were statistically significant differences (p < 0.05) in the numbers and
      types of cellular components with respect to implantation site. The number of
      macrophages, neutrophils, fibroblasts, degree of vascularity, and thickness of
      the fibrous tissue matrix was found to be statistically different between the S/C
      implanted ceramic groups. The number of macrophages, neutrophils, fibroblasts,
      and collagen content comparing the fibrous tissue surrounding the ALCAP and HA
      ceramics (I/P), was found to be statisically different.

PMID- 11209815
TI  - A case of esophageal sarcomatoid carcinoma with molecular evidence of a
      monoclonal origin.
AB  - A case of polypoid tumor of the esophagus consisting of a sarcomatous tumor
      partly covered with superficial squamous cell carcinoma is described. The
      sarcomatous component consisted of anaplastic spindle and pleomorphic tumor cells
      that mimicked malignant fibrous histiocytoma (MFH). Both the sarcomatous and
      carcinomatous components were positive for p53 immunohistochemically. Further
      molecular analysis revealed that the two components had the same somatic mutation
      in the p53 gene. These results suggest a monoclonal origin of this biphasic
      tumor.

PMID- 11209816
TI  - Absence of connections between spinal nerves and the spinal cord in a twin fetus:
      a very rare malformation occasionally evidenced at autopsy.
AB  - We describe a rare case of spinal cord malformation in a dichorionic diamniotic
      twin fetus aborted at 20 weeks' gestation due to acute chorioamnionitis with
      placental dysmaturity probably caused by a maternal viral infection. At autopsy,
      there were no connections between the spinal nerves and the spinal cord. The
      spinal cord lacked the posterior median fissure and gray matter; only a few
      neurons were present in the anterior and lateral gray columns. No chromosome
      anomalies were found. Although we cannot reconstruct the pathogenetic chain of
      events leading to this malformation, we believe that it is correlated with a
      maternal viral infection. We hypothesize that this viral infection altered the
      delicate balance between the factors inducing and those inhibiting fetal spinal
      neural differentiation.

PMID- 11209817
TI  - Aggressive fibromatosis of the larynx: report of a new case in an adult patient
      and review of the literature.
AB  - We describe a case of aggressive fibromatosis of the larynx occurring in a 75
      year-old man. The lesion manifested with voice hoarseness and swallowing
      difficulty. A computerized tomographic scan of the neck revealed distortion of
      the glottic profile. A malignant tumor was suspected. Although a laryngoscopy
      driven biopsy was non-diagnostic, total laryngectomy was done, since the lesion
      was not deemed amenable to conservative therapy. Grossly, the glottic rim was
      infiltrated by a hard, grey-white tissue showing a tentacular outline. Tissue
      sections featured a moderately cellular lesion composed of spindle cells with
      bland, tapered nuclei, enmeshed in a variably collagenized ground substance.
      Delicate spindle cell fascicles surrounded the native submucosal seromucous
      glands and had invaded the thyroid cartilage and the thyroid gland as well. The
      spindle cells were immunopositive for actins and vimentin, and negative for
      keratins, epithelial membrane antigen, desmin, and S-100 protein. No further
      therapy was administered. Periodic follow-up visits were negative. The patient
      died 5 years after surgery of myocardial infarction with no clinical evidence of
      lesion recurrence. Based on the available literature, our data confirm that
      laryngeal fibromatosis in adult patients is a locally infiltrating and
      progressive disease. Total laryngectomy with clear margins is needed as to avoid
      the high risk of local recurrence.

PMID- 11209818
TI  - Intrahepatic cholangitis and arteritis after transcatheter arterial embolization
      in a patient with tumor-like lesion-associated autoimmune hepatitis.
AB  - Autoimmune hepatitis is a chronic liver disease characterized by immune-mediated,
      progressive hepatocellular damage, although the target autoantigen remains
      speculative. Intrahepatic biliary lesions are not a feature of this disease. We
      describe herein a female patient, 57 years, with autoimmune hepatitis who
      developed hepatic regenerative mass after acute exacerbation of hepatitis. This
      hepatic regenerative mass was clinically diagnosed as hepatocellular carcinoma
      and was surgically resected after transcatheter arterial embolization therapy.
      Widespread nonsuppurative destructive granulomatous cholangitis as well as
      necrotizing, granulomatous arteritis of the intrahepatic small arteries were
      found in the surgically resected hepatic regenerative mass. The bile duct lesions
      were histologically and immunohistochemically very similar to the granulomatous
      cholangitis of primary biliary cirrhosis. We would like to propose that these
      unusual lesions in the intrahepatic bile ducts and intrahepatic arteries
      represent a reaction of this patient to an anti-cancer drug included in
      chemoembolization. No such cases have been reported so far.

PMID- 11209819
TI  - The prognostic value of DNA ploidy in small renal cell carcinoma.
AB  - The objective was to study the prognostic value of Deoxyribonucleic Acid (DNA)
      ploidy status in small renal cell carcinomas (RCC). The nuclear DNA content of
      renal cell carcinoma tissues from patients who underwent radical or partial
      nephrectomy has been analyzed by flow cytometry. The results of the DNA ploidy
      have been correlated to the size of tumors and disease progression. Of the 50
      patients with RCC studied, 8 (16%) progressed. Tumors with non-diploid DNA
      patterns were found in 24 (48%) of the 50 patients and in 4 of the 8 patients who
      progressed. Overall the median tumor size in our series was 50 mm. A tumor
      diameter of 50 mm or less was measured in 26 patients (group I) and above 50 mm
      in 24 (group II). Non-diploid DNA patterns were found in 11 (42.3%) and 13
      (54.2%) patients in groups I and II, respectively. This difference between the
      groups was not significant. Only one patient in group I (3.8%) developed
      metastatic disease and died 72 months after the operation. In group II, 7
      patients (29.2%) presented tumor progression and 5 died of metastatic disease.
      The survival probability in group I was 95% at 5 and 8 years (95% CI 70% to 99%)
      and for group II 94% at 5 years (95% CI 67%-99%) and 67% at 8 years (95% CI 39%
      83%). DNA ploidy is an inaccurate predictor of tumor behavior in patients with
      RCC, even in small tumors. Tumor size is a more significant predictor of outcome.

PMID- 11209820
TI  - Widespread risks of dental fluorosis in cotton rats (Sigmodon hispidus) residing
      on petrochemical waste sites.
AB  - Fluoride has been identified as a ubiquitous contaminant of soils where
      petrochemical wastes have been disposed. The purpose of this study was to assess
      how widespread toxicity risks are to resident vertebrates from chronic exposure
      to fluoride in the soil of petrochemical-contaminated waste sites. In total, 573
      wild cotton rats (Sigmodon hispidus) were examined. The rats that were seasonally
      collected from 12 contaminated and 12 ecologically matched reference sites across
      Oklahoma over a 3-yr period. The risks of cotton rats exposed to fluoride were
      analyzed by means of gross examination, histopathology, and scanning electron
      microscopy of rat incisors. Cotton rats from reference sites showed no pathologic
      changes in incisors (98%). In comparison, 46% of cotton rats from contaminated
      sites had various degrees of dental lesions. The prevalence and severity of
      dental lesions in cotton rats from contaminated sites were significantly
      influenced by season. There was a 45% increase in prevalence and a 65% increase
      in severity of dental lesions from summer to winter. This study demonstrated that
      cotton rats are very sensitive biomonitors for assessing toxicity risks from
      soils contaminated with fluoride and that such assessments should consider
      seasonal influences.

PMID- 11209821
TI  - Comparative effects of dieldrin on hepatic ploidy, cell proliferation, and
      apoptosis in rodent liver.
AB  - Dieldrin-induced hepatocarcinogenesis, which is seen only in the mouse,
      apparently occurs through a nongenotoxic mechanism. Previous studies have
      demonstrated that dieldrin induces hepatic DNA synthesis in mouse, but not rat
      liver. A number of nongenotoxic hepatocarcinogens have been shown to increase
      hepatocyte nuclear ploidy following acute and subchronic treatment in rodents,
      suggesting that an induction of hepatocyte DNA synthesis may occur without a
      concomitant increase in cell division. The current study examined the effects of
      dieldrin on changes in hepatocyte DNA synthesis, mitosis, apoptosis, and ploidy
      in mouse liver (the sensitive strain and target tissue for dieldrin-induced
      carcinogenicity) and the rat liver (an insensitive species). Male F344 rats and
      B6C3F1 mice were treated with 0, 1, 3, or 10 mg dieldrin/kg diet and were sampled
      after 7, 14, 28, or 90 d on diet. Liver from mice fed 10 mg dieldrin/kg diet
      exhibited significantly increased DNA synthesis and mitosis at 14, 28, or 90 d on
      diet. In rats, no increase in DNA synthesis or mitotic index was observed. The
      apoptotic index in liver of mice and rats did not change over the 90-d study
      period. Exposure of mice to only the highest dose of dieldrin produced a
      significant increase in octaploid (8N) hepatocytes and a decrease in diploid (2N)
      hepatocytes, which were restricted primarily to centrilobular hepatocytes, with
      the periportal region showing little or no change from control. No changes in
      hepatocyte nuclear ploidy were observed in the rat. This study demonstrates that
      exposure to high concentrations of dieldrin is accompanied by increased nuclear
      ploidy and mitosis in mouse, but not rat, liver. It is proposed that the observed
      increase in nuclear ploidy in the mouse may reflect an adaptive response to
      dieldrin exposure.

PMID- 11209822
TI  - Exposure of Inuit in Greenland to organochlorines through the marine diet.
AB  - High organochlorine concentrations have been found among the Inuit in eastern
      Canada and in Greenland. The present study was undertaken to assess the exposure
      to organochlorines in relation to age, sex, and diet in a general population
      sample of Inuit from Greenland. Survey data and plasma concentrations of 14
      polychlorinated biphenyl (PCB) congeners and 16 pesticides, including 5 toxaphene
      congeners, were recorded in a random population survey of 408 adult indigenous
      Greenlanders. In a two-stage design, the survey response rate was 66%, and 90% of
      those randomly selected for blood testing participated. This was equivalent to an
      overall response rate of 59%. The median plasma concentration of the sum of PCB
      congeners was 13.3 microg/L; the lipid-adjusted value was 2109 microg/kg. The PCB
      concentration was twice as high as among the Inuit of Nunavik, Canada, 25 times
      higher than in a control group from southern Canada, and several times higher
      than the values found in European studies. Concentrations were similarly elevated
      for all PCB congeners and pesticides. The PCB congener pattern was similar to
      previous observations from the eastern Canadian Arctic and Greenland.
      Concentrations showed statistically significant positive associations with age,
      marine diet, and male sex in multiple linear regression analyses. The
      exceptionally high plasma concentrations of several organochlorines among the
      Inuit of Greenland are attributed to a lifelong high intake of seafood, in
      particular marine mammals. Concentrations of PCB adjusted for the consumption of
      marine food increased until approximately 40 yr of age, which is equivalent to
      the birth cohorts of the early 1950s. The age pattern indicates that
      bioaccumulation of PCB started in the 1950s, which is a likely date for the
      introduction of the compounds into the Arctic environment.

PMID- 11209823
TI  - Evaluation of myelotoxicity in cotton rats (Sigmodon hispidus) exposed to
      environmental contaminants. I. In vitro bone-marrow progenitor culture.
AB  - Bone marrow is extremely sensitive to toxicants, and in vitro culture of bone
      marrow progenitor cells has been shown to be a sensitive indicator of bone-marrow
      injury in laboratory rodents. The ability of a bone-marrow progenitor cell assay
      to detect myelotoxicity in a wild rodent model (cotton rat, Sigmodon hispidus)
      that inhabits many contaminated ecosystems in the southern United States was
      examined. Responsiveness of progenitor cells to recombinant murine granulocyte
      macrophage colony-stimulating factor (GM-CSF) and cotton rat lung-conditioned
      medium (LCM) was determined to optimize culture conditions for cotton rats.
      Myelotoxicity was induced in cotton rats by treating animals with either
      cyclophosphamide (8 or 80 mg/kg) or dexamethasone (500 microg/kg) over a 5-d
      period. Administration of a high dose of cyclophosphamide caused nearly total
      suppression of colony formation of granulocyte-macrophage progenitor cells (CFU
      GM). Marked histological changes in both the bone marrow and spleen were also
      observed in cotton rats treated with a high dose of cyclophosphamide. Although
      histological lesions were not apparent, the number of CFU-GM in the bone marrow
      of low-dose cyclophosphamide- and dexamethasone-treated cotton rats was
      significantly suppressed compared to controls. The number of CFU-GM was
      consistently higher using LCM than recombinant murine GM-CSF. This reproducible,
      quantitative, in vitro bone-marrow progenitor cell culture system was a sensitive
      indicator of myelotoxicity in wild cotton rats and should be useful for
      monitoring chronic exposures to low levels of environmental toxicants in wild
      rodent populations.

PMID- 11209824
TI  - Evaluation of myelotoxicity in cotton rats (Sigmodon hispidus) exposed to
      environmental contaminants. II. Myelotoxicity associated with petroleum
      industrial wastes.
AB  - Various chemical mixtures exist in soil contaminated with petrochemical wastes,
      yet no comprehensive assessment of their impact on terrestrial ecosystems has
      been conducted. The purpose of this study was to evaluate hematotoxicity risks to
      wild populations of cotton rats (Sigmodon hispidus) residing in habitats
      previously contaminated by petroleum industrial wastes. Resident cotton rats were
      monitored on nine contaminated sites and nine ecologically matched reference
      sites in Oklahoma. The possible toxicological interactions of petrochemical
      wastes on bone marrow was investigated by using the assay of colony formation of
      granulocyte-macrophage progenitor cells. There was a consistent significant 21 to
      39% decrease in the number of colony-forming units of granulocyte-macrophage (CFU
      GM) in cotton rats from petrochemical-contaminated sites compared to matched
      reference sites, with no marked changes in hematological or histopathological
      parameters. These results suggest that bone-marrow progenitor cell culture is a
      sensitive indicator for the assessment of ecotoxicity risks associated with
      petrochemical wastes that are generated by the oil refining industry. Long-term
      exposure to hazardous wastes associated with the petroleum industry may represent
      a subtle risk to the hematopoietic system in humans.

PMID- 11209825
TI  - Cybersickness in the presence of scene rotational movements along different axes.
AB  - Compelling scene movements in a virtual reality (VR) system can cause symptoms of
      motion sickness (i.e., cybersickness). A within-subject experiment has been
      conducted to investigate the effects of scene oscillations along different axes
      on the level of cybersickness. Sixteen male participants were exposed to four 20
      min VR simulation sessions. The four sessions used the same virtual environment
      but with scene oscillations along different axes, i.e., pitch, yaw, roll, or no
      oscillation (speed: 30 degrees/s, range: +/- 60 degrees). Verbal ratings of the
      level of nausea were taken at 5-min intervals during the sessions and sickness
      symptoms were also measured before and after the sessions using the Simulator
      Sickness Questionnaire (SSQ). In the presence of scene oscillation, both nausea
      ratings and SSQ scores increased at significantly higher rates than with no
      oscillation. While individual participants exhibited different susceptibilities
      to nausea associated with VR simulation containing scene oscillations along
      different rotational axes, the overall effects of axis among our group of 16
      randomly selected participants were not significant. The main effects of, and
      interactions among, scene oscillation, duration, and participants are discussed
      in the paper.

PMID- 11209827
TI  - Adapting verbal protocol methods to investigate speech systems use.
AB  - This paper presents a method to gather data from user interactions with a speech
      system. This method is based on existing verbal protocol methods usually used in
      Cognitive Psychology. The main aim of this method is to elicit the users'
      expectations and interpretations that are formed when interacting with the
      system, and can impede the dialogue success when they are erroneous. This article
      also provides an illustration of the application of this method based on an
      actual study with a conversational speech system under realistic conditions of
      use.

PMID- 11209826
TI  - An investigation of the effects of touchpad location within a notebook computer.
AB  - This study evaluated effects of the location of a notebook computer's integrated
      touchpad, complimenting previous work in the area of desktop mouse location
      effects. Most often integrated touchpads are located in the computer's wrist
      rest, and centered on the keyboard. This study characterized effects of this
      bottom center location and four alternatives (top center, top right, right side,
      and bottom right) upon upper extremity posture, discomfort, preference, and
      performance. Touchpad location was found to significantly impact each of those
      measures. The top center location was particularly poor, in that it elicited more
      ulnar deviation, more shoulder flexion, more discomfort, and perceptions of
      performance impedance. In general, the bottom center, bottom right, and right
      side locations fared better, though subjects' wrists were more extended in the
      bottom locations. Suggestions for notebook computer design are provided.

PMID- 11209828
TI  - Identification and analysis of unsatisfactory psychosocial work situations: a
      participatory approach employing video-computer interaction.
AB  - A method for psychosocial evaluation of potentially stressful or unsatisfactory
      situations in manual work was developed. It focuses on subjective responses
      regarding specific situations and is based on interactive worker assessment when
      viewing video recordings of oneself. The worker is first video-recorded during
      work. The video is then displayed on the computer terminal, and the filmed worker
      clicks on virtual controls on the screen whenever an unsatisfactory psychosocial
      situation appears; a window of questions regarding psychological demands, mental
      strain and job control is then opened. A library with pictorial information and
      comments on the selected situations is formed in the computer. The evaluation
      system, called PSIDAR, was applied in two case studies, one of manual materials
      handling in an automotive workshop and one of a group of workers producing and
      testing instrument panels. The findings indicate that PSIDAR can provide data
      that are useful in a participatory ergonomic process of change.

PMID- 11209829
TI  - Self-motion perception: assessment by real-time computer-generated animations.
AB  - We report a new procedure for assessing complex self-motion perception. In three
      experiments, subjects manipulated a 6 degree-of-freedom magnetic-field tracker
      which controlled the motion of a virtual avatar so that its motion corresponded
      to the subjects' perceived self-motion. The real-time animation created by this
      procedure was stored using a virtual video recorder for subsequent analysis.
      Combined real and illusory self-motion and vestibulo-ocular reflex eye movements
      were evoked by cross-coupled angular accelerations produced by roll and pitch
      head movements during passive yaw rotation in a chair. Contrary to previous
      reports, illusory self-motion did not correspond to expectations based on
      semicircular canal stimulation. Illusory pitch head-motion directions were as
      predicted for only 37% of trials; whereas, slow-phase eye movements were in the
      predicted direction for 98% of the trials. The real-time computer-generated
      animations procedure permits use of naive, untrained subjects who lack a
      vocabulary for reporting motion perception and is applicable to basic self-motion
      perception studies, evaluation of motion simulators, assessment of balance
      disorders and so on.

PMID- 11209830
TI  - The test-retest reliability of a new occupational risk factor questionnaire for
      outcome studies of low back pain.
AB  - This study reports the test-retest reliability of a 25-item occupational risk
      factor questionnaire that can be self-administered in clinical settings and used
      in outcome studies of low back pain or return to work programs. Subjects were 24
      patients (workers on sick leave due to acute low back pain), 29 co-workers on
      active duty in the same jobs in a utility company, and 53 supervisors. Eighty-six
      subjects were re-tested within a mean interval of 7-10 days; one group of 20
      supervisors was re-tested within 81 days. The questionnaire was self-administered
      during individual interviews. Reliability was estimated by the kappa statistic as
      the agreement on the scores within the raters in each group. The agreement ranged
      from 'slight' (0.15) to 'almost perfect' (0.93) when the re-test interval was
      less than 43 days. Patients and non-patients were consistent in their assessment
      of the job demands. rights reserved.

PMID- 11209831
TI  - Self-reported and measured time of vibration exposure at ultrasonic scaling in
      dental hygienists.
AB  - In the present study, our objective was to quantify the daily duration of
      vibration exposure from ultrasonic scaling in dental hygienists and to compare
      different methods of self-estimates to time-recorded measurements. The exposure
      time was self-estimated by use of diary and interview methods in 10 subjects. We
      found that the measured total daily exposure time was limited, only on average
      12min, with a great variation, however, between and within the subjects. Self
      assessed duration of exposure was overestimated, on average three times higher
      with a diary and even more at an interview (8 times). In conclusion, the
      objectively measured exposure time was short and clearly overestimated in self
      reports.

PMID- 11209833
TI  - Embedding ergonomics in hospital culture: top-down and bottom-up strategies.
AB  - In England there has been increasing emphasis on the use of ergonomics to tackle
      manual handling problems for the last seven years (MHO, 1992, 1998; HSAC, 1998).
      At Nottingham City Hospital NHS Trust, I have tried to incorporate an ergonomic
      approach throughout a wide range of activities since 1994. This paper does not
      seek to report a research project, simply to share the experience of trying to
      tackle hospital manual handling risks by taking an ergonomic approach. It will
      explain what this has involved, where it has been successful and where there have
      been difficulties. In the five years since the implementation of this strategy
      three measures have been used to monitor trends. These are (1) manual handling
      incidents: showing a 33% reduction; (2) days lost from musculoskeletal-related
      sickness absence: 36% reduction; and (3) completed risk actions: rising from 33%
      completion to over 75% completion.

PMID- 11209832
TI  - Implementation of a participatory ergonomics program in the rehabilitation of
      workers suffering from subacute back pain.
AB  - This paper describes a participatory ergonomics program aimed at early return to
      regular work of workers suffering from subacute occupational back pain and
      assesses the perceptions of the participants on the implementation of ergonomic
      solutions in the workplace. The participatory ergonomics program was used in the
      rehabilitation of workers suffering from subacute back pain for more than 6
      weeks, a program that was associated with an increased rate of return to work.
      The perceptions of the participatory ergonomics participants were assessed 6
      months after completion of the ergonomic intervention through a questionnaire
      sent to employer representatives, union representatives and injured workers of
      participating workplaces. About half of the ergonomic solutions were implemented
      according to the perception of the participants, with a substantial agreement
      between respondents.

PMID- 11209834
TI  - A case study in iterative keyboard design using participatory design techniques.
AB  - Replacing a keyboard can be stressful for operators who take calls all day,
      particularly when special functions must be sacrificed. This study applied
      several participatory design techniques to involve over 3,000 operators in the
      redistribution of function keys on their replacement keyboard. Video analysis and
      manual data logging methods were surprisingly accurate when measured against
      software logs. User acceptance was excellent. In the initial cutover program,
      operator performance levels returned to normal very quickly, resulting in over
      confidence and unrealistic expectations of post-implementation performance for
      the remaining call centres because the focus was on the technology rather than on
      the impact of technology on business benefits. As a consequence, business plan
      requirements for future projects have now been changed to accommodate predictions
      of post-implementation performance and taking into account other changes
      happening at the same time.

PMID- 11209835
TI  - Standing and very slow walking: foot pain-pressure threshold, subjective pain
      experience and work activity.
AB  - Prolonged standing is described as uncomfortable by exposed workers, but the
      discomfort has not been linked to precise descriptions of workplace activity. We
      observed 10 sales and kitchen workers ("group 1") who worked standing. We
      compared the plantar pain-pressure threshold (PPT) of "group 1" (10 standing
      workers) to that of "group 2" (11 researchers who could choose their posture
      freely). Group 1 spent an average time of 62% standing still compared to 5% for
      group 2. Despite the fact that group 1 were primarily confined to defined areas
      and stood for 62% of the time, their mean time standing still was only 7 s. They
      walked 35% of the time, but 57% of walking sequences were only one or two steps.
      Group 1 PPT declined by 23% over the work day compared to 5% among group 2 (p <
      0.05, ANOVA). Foot PPT is a promising quantitative indicator of effects of
      standing work.

PMID- 11209836
TI  - Influence of measurement accuracy on the application of the 1991 NIOSH equation.
AB  - A relatively neglected topic in manual materials handling (MMH) research is the
      impact of the accuracy of task parameter measurements on the application of
      various assessment methods. A laboratory experiment was conducted to investigate
      the accuracy of NIOSH equation parameter measurements made by eight subjects
      following a 4-h training session. Five individual tasks were measured; two were
      single tasks and three were part of a multiple-component simulated palletizing
      operation. Significant differences between reference parameter measurements and
      average measurements made by subjects were found. The sensitivity analysis showed
      that frequency and horizontal location are the most important parameters. These
      parameters also tended to have the highest measurement errors. Recommendations
      for increasing the effectiveness of training programs for NIOSH equation users
      based on the results of the study are presented.

PMID- 11209837
TI  - Quantitative nested PCR for human cytomegalovirus DNA: analysis using NucleoScan
      2001.
AB  - A quantitative nested DNA PCR for human cytomegalovirus (CMV) was developed using
      PCR mimic DNA as an internal standard. A combination of ultra-thin gel and
      enhanced detection of ethidium bromide-stained PCR bands allowed us to achieve a
      25-fold increase in sensitivity over the conventional gel electrophoreses, down
      to 0.1 ng of DNA per band. When the technique was applied to measuring CMV load
      in CMV positive leucocyte DNA preparations its sensitivity spanned the range from
      single to hundreds of CMV DNA copies in 0.1 microg of total white blood cell DNA.

PMID- 11209838
TI  - Outbreak of aseptic meningitis by echo 4: prevalence of clinical cases among
      adults.
AB  - Twenty five cases of meningitis occurred in urban areas surrounding a city
      (Modena) in Northern Italy, in the period May-July 1999. When the patients were
      admitted to the Infectious Diseases Division of the University of Modena and
      Reggio Emilia Hospital and studied by virological and serological methods, the
      meningitis proved to have an enteroviral origin and enterovirus ECHO 4 type was
      responsible for all cases of illness. An epidemiological characteristic of the
      enteroviral meninigitis outbreak was the adult age in 23 out of the 25 patients
      (mean age 24.50 +/- 7.84 years). The monthly distribution of the aseptic
      meningitis cases was the following: five cases occurred in May, 13 in June and
      seven in July. The origin of the spread of the virus infection and the reason for
      its sudden end remained unknown. The unusual drop in temperature which occurred
      in the geographic area involved in the aseptic meningitis outbreak at the
      beginning of August could have interfered with the slowdown in virus circulation.

PMID- 11209839
TI  - Stability of feline caliciviruses in marine water maintained at different
      temperatures.
AB  - Since human caliciviruses are responsible for viral gastroenteritis transmitted
      by contaminated foods and the viruses barely propagate in cell culture, feline
      caliciviruses were employed as a model for the measurement of their stability in
      marine water. Survival of four strains of feline calicivirus in marine water was
      measured when the seed viruses were diluted 1/10 with marine water and maintained
      at 4 degrees C, 10 degrees C, and 20 degrees C respectively. Among the virus
      strains studied, a considerable amount of infective viruses remained at 10
      degrees C or lower temperature conditions even for a period of 30 days.

PMID- 11209840
TI  - Behaviour of the pharmaceutical probiotic preparation VSL#3 in human ileostomy
      effluent containing its own natural elements.
AB  - The pharmaceutical probiotic VSL#3 (300 billion cfu/g lactic acid bacteria &
      bifidobacteria) was inoculated into human ileostomy effluent (HIE) to assess its
      behaviour vs the ileo-caecal tract. Separately, yogurt bacteria (yog) and
      bifidobacteria (Bif) present in VSL#3 were also inoculated into HIE. During 37
      degrees C incubation (anaerobic condition) at zero, six and 24 hours, both cell
      growth in control HIE and indigenous Bif growth in HIE+yog were observed. Cells
      remained viable and metabolically active as shown by the increase in L(+) lactic
      acid in HIE+VSL#3 and HIE+yog and the pH decreased (approx. 5.5 compared with the
      6.2 of control HIE). Total SCFA Short Chain Fatty Acids decreased in HIE+yog and
      HIE+VSL#3 at 6h and in all cultures at 24h; butyric acid decreased in HIE+Bif and
      HIE+VSL#3. Generally in vivo the bacteria remain in the ileo-caecal tract no
      longer than six h, therefore VSL#3 bacteria seem able to pass this barrier
      viably, colonizing the large bowel.

PMID- 11209842
TI  - Antimicrobial use and susceptibility rates in isolates from intensive care unit
      and other nosocomial inpatient and outpatient areas.
AB  - Our objective was to evaluate the relation between antimicrobial use and
      susceptibility in the intensive care unit (ICU) and non-ICU inpatient areas in
      the Bolzano regional hospital. For the isolates of S. aureus, coagulase negative
      staphylococci, Enterococcus sp., P. aeruginosa and E. coli we found a pattern of
      significant stepwise decrease in the frequency of antimicrobial susceptibility to
      penicilloic beta-lactam antibiotics and first generation cephalosporins; the
      highest senitivity rates occurred among isolates from outpatients, followed in
      decreasing order by rates among isolates from non-ICU inpatients and from ICU
      patients; the rate of use of this group of antimicrobial agents was relatively
      high in the intensive care unit (13,1%). For P. aeruginosa we observed
      significantly lower susceptibility-rates to second, third and fourth generation
      cephalosporins, carbapenems and monobactams for non-ICU inpatient areas than for
      outpatient or ICU areas; this paralleled with the low use of this group of agents
      in the ICU area (4,9%). Also, for P. aeruginosa the prevalence of susceptibility
      to ciprofloxacin and norfloxacin in inpatient areas was lower than in the
      outpatient or ICU-areas; the rate of quinolone-use was relatively low in the ICU
      area (4,2%).

PMID- 11209841
TI  - Molecular analysis of Klebsiella pneumoniae strains isolated in pediatric wards
      by ribotyping, pulsed field gel electrophoresis and antimicrobial
      susceptibilities.
AB  - The purpose of this study was to investigate the usefulness of different
      molecular typing techniques in the surveillance and control of the spread of
      extended-spectrum-beta-lactamase-(ESBL) producing Klebsiella pneumoniae in the
      pediatric department of the "Agostino Gemelli" hospital of the Catholic
      University in Rome, over a period of nine months. The strains were characterized
      by ribotyping using HindIII as restriction enzyme and pulsed field gel
      electrophoresis (PFGE) using XbaI as endonuclease. Sixty six K. pneumoniae
      clinical strains were isolated during this period, the first 32 were isolated in
      the summer of 1998. Among these first isolates, ribotyping generated 26 different
      patterns whereas PFGE produced 16 patterns. The remaining 34 strains were
      isolated during January and April 1999 and all of them were ESBL producers.
      Ribotyping clustered the strains into 6 patterns whereas PFGE generated only 3
      patterns. PCR revealed the presence in 10 isolates of both bla(TEM) and bla(SHV)
      genes and 24 strains carried only the bla(SHV) gene. In our experience ribotyping
      revealed a higher power of differentiation with respect to PFGE and was of great
      help in the surveillance of the infection.

PMID- 11209843
TI  - Adhesion of a Staphylococcus aureus strain to biomaterials does not select
      methicillin-resistant mutants.
AB  - Bacterial adhesion to polymethylmethacrylate and to silicon elastomer, materials
      frequently used in clinical applications, has been investigated to assess whether
      adhesion selects methicillin-resistant mutants in the bacterial population in
      contact with the materials. The methicillin susceptibility of a susceptible
      Staphylococcus aureus (ATCC 25923) was measured by a modification of plate
      antibiogram Kirby-Bauer method, which allows optimised detection of small
      variations in antibiotic susceptibility. In both adherent and non-adherent
      bacterial subpopulations, the presence of mecA gene, which encodes for the
      protein PBP 2a responsible for methicillin resistance was searched for by
      Polymerase Chain Reaction (PCR). The contact with the two polymers did not induce
      in the bacteria population any phenotypic increase in methicillin resistance, or
      the selection of mutants carrying the mecA gene.

PMID- 11209844
TI  - Adhesion to a polymeric biomaterial affects the antibiotic resistance of
      Staphylococcus epidermidis.
AB  - The antibiotic-resistance both of adherent bacteria to polymethylmethacrylate
      (PMMA) and of bacteria which, although exposed to the material, had not undergone
      adhesion, was measured as bacterial growth inhibition area onto a plate
      antibiogram, according to Kirby-Bauer and using a dedicated image analyzer
      system. The adhesion onto PMMA induces a marked (about 30%) increase in
      resistance to beta-lactam antibiotics (cefamandole, cefazolin, imipenem and
      ampicillin) and a lower (about 15%) but significant increase to the macrolide
      erythromycin, to two aminoglycosides (amikacin, netilmicin) and to vancomycin,
      chloramphenicol and trimethoprim-sulfamethoxazole.

PMID- 11209845
TI  - Usefulness of genus-specific PCR and Southern blot species-specific hybridization
      for the detection of imported malaria cases in Italy.
AB  - A PCR method involving a genus-specific oligonucleotides set and Southern blot
      hybridization with four species-specific probes to P. falciparum, P. vivax, P.
      malariae and P. ovale was evaluated for the detection of malaria parasites in
      blood samples from 101 patients with clinically suspect malaria infection
      imported to Italy. Plasmodium falciparum was the main species detected. As
      determined by microscopy, 53 (52.4%) patients had malaria and of these: 40
      (75.5%) were infected with P. falciparum; 7 (13.2%) with P. vivax; 1 (1.9%) with
      P. ovale; 3 (5.7%) with P. malariae; 1 (1.9%) with P. vivax or P. ovale; and 1
      (1.9%) with P. falciparum or P. vivax. Ninety-seven out 101 blood samples were
      submitted to ParaSight-F test which showed a sensitivity of 94.73%, and a
      specificity of 93.22%, as compared to microscopy. The PCR assay using the genus
      specific oligonucleotide primer set (pg-PCR) was able to detect 53 (52.4%)
      infections and showed a sensitivity of 100% and a specificity of 100%, when
      compared to microscopy. The parasite species were identified by Southern blot
      hybridization using species-specific probes and 40 (75.5%) samples were P.
      falciparum positive, 5 (9.4%) P. vivax positive, 4 (7.5%) P. ovale positive, and
      2 (3.8%) P. malariae positive. When the Southern blot results were compared to
      those of blood-film diagnosis, we observed some disagreement. In particular,
      compared to Southern blot, microscopy underestimated P. ovale infection; blood
      film analysis recognised only 1 P. ovale sample, whereas Southern blot recognised
      4 P. ovale positive samples (by microscopy, 2 of these were detected as P. vivax,
      1 as P. ovale or P. vivax, and the other as P. falciparum or P. vivax). Southern
      blot hybridization was unable to identify one P. falciparum and one P. vivax
      positive case detected by microscopy. We also plan to use a reference nested-PCR
      assay to clarify the disagreement observed between microscopy and Southern blot
      hybridization.

PMID- 11209846
TI  - Development of a set of multiplex PCR assays for the simultaneous identification
      of enterotoxigenic, enteropathogenic, enterohemorrhagic and enteroinvasive
      Escherichia coli.
AB  - Diarrheagenic E. coli comprise a diverse group of microorganisms responsible for
      gastrointestinal diseases in humans. On the basis of their virulence traits they
      are distinguished from the non-pathogenic E. coli and classified in several
      categories. Molecular methods represent the most reliable techniques for
      distinguishing pathogenic from non-pathogenic E. coli and characterising their
      pathogenic features. In this paper we report the development of a set of three
      multiplex PCR assays for the simultaneous and rapid identification of
      diarrheagenic E. coli belonging to ETEC, EPEC, EHEC and EIEC groups. Assay 1
      utilizes primer pairs specific for genes coding for ST and LT toxins of ETEC, and
      for the E. coli beta-glucuronidase (uidA); assay 2 detects the presence of the
      eae and bfpA genes of EPEC, and assay 3 recognizes stx1 and stx2 of EHEC, and ial
      of EIEC. This technique has been validated on 190 E. coli isolated in Angola,
      Italy and Mozambique from feces of children with diarrhea. Results obtained with
      the set of multiplex PCR demonstrated 100% accordance with those obtained for the
      same isolates by PCR on single target genes. The proposed set of multiplex PCRs
      is the first reported assay that allows the simultaneous characterization of the
      four categories of diarrheagenic E. coli.

PMID- 11209847
TI  - Salmonella typhimurium-endocarditis secondary to an acquired environmental
      infection: a case report.
AB  - A diabetic, cardiopathic and anemic 44-year-old farmer presented with a seven-day
      history of remittent fever with evening peaks. Two months before he had undergone
      amputation of the V-finger of the left hand secondary to a phlegmon caused by an
      agricultural injury. Prior to amputation, anaerobic culture analysis of phlegmon
      pus and selective procedures used to isolate Gram-positive cocci and/or
      Pseudomonas spp. resulted negative. The diagnosis of endocarditis was supported
      by isolation of S. typhimurium from blood and by echocardiography showing
      endocarditic lesions. The source of infection was identified by PCR ribotyping as
      the same Salmonella typhimurium strain that was present, but not sought, both in
      the anatomic explanted tissues and from blood samples of the patient. The
      infection was successfully treated with a combination of gentamicin and
      ampicillin with consequent improvement in the general clinical picture of the
      patient. We believe this is the first reported case of S. typhimurium
      endocarditis secondary to a phlegmon resulting from an environmental source of
      infection.

PMID- 11209848
TI  - Identification of Mycobacterium xenopi by gas chromatography.
AB  - For the purposes of the following study we cultured 32 strains of Mycobacterium
      xenopi isolated from clinical specimens and several strains of other slowly
      growing mycobacteria. The cultures were grown in liquid medium and then analysed-
      after saponification, methylation, extraction with organic solvent and washing of
      the organic phase--using a highly sensitive manual gas-liquid chromatographic
      assay for the determination of secondary alcohol 2-OH-docosanol. The percentage
      of this compound was compared with that previously measured in strains of
      Mycobacterium xenopi grown on solid medium. The presence of this specific alcohol
      was always apparent, even though its quantity was lower than that obtained by
      growing mycobacteria on solid medium. The absence of interference peaks around
      the compound was checked by analyzing strains of other slowly growing
      mycobacteria in the same conditions.

PMID- 11209849
TI  - "In vitro" spontaneous production of B-chemokines by endocervical and endometrial
      short-term bioptic cultures.
AB  - Several studies indicate that HIV-1 is present in the cervico-vaginal tissues and
      secretions of infected women representing an important determinant of both sexual
      and mother-to-child transmission. HIV-1 genital shedding is influenced by various
      factors; among these, proinflammatory cytokines, in particular the beta/C-C
      chemokine group (RANTES, MIP-1alpha and MIP-1beta), are known to suppress HIV-1
      replication and thus might affect both sexual and vertical transmission. This
      study aimed to standardize a procedure to measure "in vitro" uterine spontaneous
      chemokine production by means of short-term cultures of endocervical and
      endometrial bioptic fragments. In most cases, "in vitro" chemokine production was
      observed in both fragment cultures. These results further confirm that beta/C-C
      chemokines exist in the female genital tract and that uterine mucosa actively
      produces basal levels of these immuno-active substances. This method constitutes
      a useful approach to evaluate cytokine production and expression in the female
      genital tract, their influence on HIV-1 expression and infectivity in this site,
      and their possible role in viral transmission.

PMID- 11209850
TI  - A history of plant virology. Cross protection.
AB  - Cross protection is a type of induced resistance developing in plants against
      viruses. Its basis is that prior infection with one virus affords protection
      against closely related ones. Its history started about seventy years ago, when
      the Dutchman Thung and the Englishman Salaman described the phenomenon
      independently. During the 1930s, several virologists confirmed the discovery,
      which was considered the first possibility to protect plants against virus
      infection. Growing interest also led plant virologists to formulate the first
      hypotheses on its mechanism, with the onset of a still unsolved debate. The
      hypotheses, that have been succeeded until the 1970s, included (i) antibody
      formation, (ii) exhaustion of essential metabolites, (iii) limited sites for
      virus multiplication, and (iv) specific adsorption by new cell compounds. These
      hypotheses were re-proposed and discussed on several occasions without arriving
      at a final conclusion. The statement of molecular genetics of viruses produced
      new interesting "theories", fundamentally based on the interference between virus
      strains. A model developed by the Americans Palukaitis and Zaitlin in 1984
      indicates that excess of progeny positive-sense RNA of the protecting strain
      would sequester the minus-strand RNA of the challenging strain. Other models
      involve a function of the coat protein, or gene recombination. However, no model
      that could unify all the various facets of cross protection has hitherto been
      proposed. All that has not stopped the phenomenon having practical application.
      From the first attempts against a severe disease of cocoa in West Africa realized
      by Posnette in the 1940s, a number of crops (such as tomato, tobacco, citrus,
      cucurbits, grapevine, soybean, papaya, and so on) have been submitted to this
      practice. During the 1980s, cross protection came to a standstill because of the
      development of new resistant or tolerant cultivars. Its story is by no means
      ended, and much work is needed to understand its limits and possibilities.

PMID- 11209851
TI  - Protonation effects on the inclusion complexation of 6-deoxy-6-diethylamino-beta
      cyclodextrin with 2-anthracenesulfonate, 2-naphthalenesulfonate, 2,6
      naphthalenedisulfonate, and 2,7-naphthalenedisulfonate in aqueous solutions.
AB  - At pH values 5.5 and 10.3, 6-deoxy-6-diethylamino-beta-cyclodextrin (DD-beta-CD)
      as well as beta-CD forms 1:1 inclusion complexes with 2-anthracenesulfonate
      (2AS), 2-naphthalenesulfonate (2NS), 2,6-naphthalenedisulfonate (2,6NDS), and 2,7
      naphthalenedisulfonate (2,7NDS). The equilibrium constants (K) for the formation
      of the 1:1 inclusion complexes have been evaluated from the absorbance and/or
      fluorescence intensity changes. With respect to the beta-CD inclusion complexes
      of 2AS, 2NS, 2,6NDS, and 2,7NDS, the K values at pH 5.5 are nearly the same as
      the corresponding ones at pH 10.3. In the case of the DD-beta-CD inclusion
      complexes, the K values of 2AS and 2NS similarly do not depend on the pH value.
      However, the K values of 2,6NDS and 2,7NDS for DD-beta-CD at pH 5.5 have been
      found to be more than two times greater than the corresponding ones at pH 10.3,
      suggesting the electrostatic attraction between the protonated diethylamino group
      of DD-beta-CD and the sulfonato group of the NDSs.

PMID- 11209852
TI  - Vibrational spectra of succinonitrile and its [1,4-13C2]-,[2,2,3,3,-2H4]- and 1,4
      13C-2,2,3,3-2H4]-isotopomers and a force field of succinonitrile.
AB  - [1,4-13C2]-succinonitrile, [2,2,3,3-2H4]-succinonitrile, [1,4-13C2-2,2,3,3-2H4]
      succinonitrile have been synthesized and, for the first time, the infrared and
      Raman spectra of these succinonitrile isotopomers have been discussed in detail.
      The spectra were recorded at ambient temperature and at the temperature of liquid
      nitrogen and assignments of the vibrational bands of all above isotopomers have
      been made. In addition to this, the force field of succinonitrile in its two
      configurations, gauche and trans, have been calculated using all experimental
      frequencies and the ab-initio method. Also, the assignments of the vibrational
      bands of the 'normal' succinonitrile molecule have been achieved using the
      results of the force field calculations to support the assignments for the normal
      succinonitrile, as well as for the isotopomers.

PMID- 11209853
TI  - Identification and estimation of extra-framework aluminium in acidic mazzite by
      diffuse reflectance spectroscopy.
AB  - Diffuse reflectance spectroscopy has been used to investigate structural
      modification of mazzite zeolite subjected to calcination, acid leaching and
      acetylacetone treatments. Extra-framework aluminium species, formed upon
      expulsion of aluminium from the framework, are detected by DRS because they are
      involved in aluminium-oxygen charge transfer transitions. Impregnation of the
      calcined ammonium-exchanged and acid leached samples with ethanolic acetylacetone
      will convert the broadened 260-280 nm band of extra-framework aluminium with
      distorted symmetry to a distinct well-defined 285 nm band. The appearance of this
      band is due to the transformation of the aluminium atoms with a different
      coordination number to structures with highly ordered octahedral symmetry.
      Washing the acetylacetone treated samples with hot ethanol leads to extraction of
      some of the complexed aluminium. The presence of an extracted aluminium
      triacetylacetonate complex in the eluant is verified by the same
      spectrophotometer used in its conventional mode. This suggests that a dual DR and
      UV-VIS spectrophotometry is an appropriate approach to study such topics.

PMID- 11209854
TI  - Vibrational study on structural transitions of potassium pelargonate
      CH3(CH2)7CO2K.
AB  - Anhydrous potassium pelargonate (KC9) undergoes four thermal transitions from
      room temperature to 450 degrees C. A normal mode analysis was made for the
      molecule in phase I at room temperature and the molecule was considered to have
      an all-trains conformation. With increasing temperature, partial melting of the
      alkyl chains occurred in phase II and complete melting was observed in phase III,
      as confirmed by vibrational spectra. In addition, orientational disorder of the
      carboxylate groups was suggested in phase II. This transition behavior of
      potassium pelargonate was compared with the behavior of nonane and pelargonic
      acid.

PMID- 11209855
TI  - Water in toluene revisited: vibrational patterns in the stretching region.
AB  - The symmetric (v1) and antisymmetric (v3) stretching bands of water monomers in
      toluene are revisited using two approaches: (i) calculation of dipole
      autocorrelation functions (ii) the solvatochromic behaviour of both vibration
      frequency shifts. The time constants extracted from the autocorrelations account
      for meaningful differences between the couplings established by the antisymmetric
      and symmetric vibrations with the solvent. The dipole autocorrelation function
      for the symmetric stretching band fits well a Lorentzian spectral density and
      shows a higher contribution to hindered rotation relatively to the one obtained
      from the antisymmetric stretching. The spectral shifts of stretching frequencies
      in toluene and in other relevant solvents were interpreted as arising from the
      electronic and orientational polarisations. Characteristic donor/acceptor
      interactions also contribute to the red shift and were tested by using empirical
      solvent basicity scales such as Kamlet-Taft beta and the recently proposed SB.
      The deviations detected in toluene as regards the continuum dielectric
      predictions are quantitatively treated and account for the specific interaction
      between the water and the molecular pi electron system referred to in the
      literature.

PMID- 11209856
TI  - Spectroscopy study on the photochromism of Schiff bases N,N'-bis(salicylidene)
      1,2-diaminoethane and N,N'-bis(salicylidene)-1,6-hexanediamine.
AB  - The photochromism of Schiff bases N,N'-bis(salicylidene)-1,2-diaminoethane (BSE)
      and N,N'-bis(salicylidene)-1,6-cyclohexanediamine (BSH) was studied by steady
      state and time-dependent fluorescence, UV Vis absorption spectroscopy and
      theoretical chemistry calculations. The experimental results show that BSH can
      perform the photochromism easier than BSE, may be due to the molecular topology
      difference.

PMID- 11209857
TI  - Aggregate formation of Rhodamine 6G in anisotropic solvents.
AB  - The aggregation of Rhodamine 6G in liquid crystalline solutions was studied using
      polarised spectroscopy and in a guest-host system based on homogeneous
      homeotropic alignment. The orientation of the dye molecules (guest) was
      controlled using an electric field, and this enabled the contrast ratio R of the
      dye to be obtained by electrically switching. The excitonic treatment of the
      absorption spectra suggests a coplanar structure for the dimeric aggregates.

PMID- 11209858
TI  - Towards a single crystal Raman spectrum of kaolinite at 77 K.
AB  - The Raman spectra at 77 K of the hydroxyl stretching of kaolinite were obtained
      along the three axes perpendicular to the crystal faces. Raman bands were
      observed at 3616, 3658 and 3677 cm(-1) together with a distinct band observed at
      3691 cm(-1) and a broad profile between 3695 and 3715 cm(-1). The band at 3616
      cm(-1) is assigned to the inner hydroxyl. The bands at 3658 and 3677 cm(-1) are
      attributed to the out-of-phase vibrations of the inner surface hydroxyls. The
      Raman spectra of the in-phase vibrations of the inner-surface hydroxyl-stretching
      region are described in terms of transverse and longitudinal optic splitting. The
      band at 3691 cm(-1) is assigned to the transverse optic and the broad profile to
      the longitudinal optic mode. This splitting remained even at liquid nitrogen
      temperature. The transverse optic vibration may be curve resolved into two or
      three bands, which are attributed to different types of hydroxyl groups in the
      kaolinite.

PMID- 11209859
TI  - Spectroscopic study on the photoinduced reaction of fullerene C60 with aliphatic
      amines and its dynamics--strong short wavelength fluorescence from the adducts.
AB  - The photoinduced electron donor acceptor interactions of C60 with eight kinds of
      aliphatic amines, namely dicthylamine (DEA), triethylamine (TEA), tri-n-amylamine
      (TAA), propylethylamine (PPA), n-butylamine (BTA), n-heptylamine (HPA) and
      dodecylamine (DDA) and ethylenediamine (EDA) are reported by a comprehensive
      spectroscopic study. Experiments show that there is a good discipline with
      different structure and the length of n-alkyl group both in their ground and
      excited states. At the same time, a slow reaction takes place between C60 and
      various amines with a gradual increase in the concentration of various aliphatic
      amines or the standing of solution, which can be dramatically catalyzed by UV
      radiation. The final products can all emit a strong fluorescence at the
      relatively shorter wavelength around 519 nm. On this basis, the dynamic
      properties of C60/aphaliticamines including the enthalpy of activation
      (deltaH++et) and entropy activation (deltaS++et), together with all sorts of
      influence factors are firstly investigated in this work. The possible reaction
      mechanisms are explored, also.

PMID- 11209861
TI  - Near infrared spectra (4000-10 500 cm-1) of phenol-OH and phenol-OD in carbon
      tetrachloride.
AB  - The near infrared spectra (3800-10 500 cm(-1) of phenol-OH and phenol-OD are
      studied in carbon tetrachloride solution. The bandwidth of the v(OH) and v(OD)
      stretching vibrations increases with the vibrational quantum number in contrast
      to results obtained by nonresonant ionization spectroscopy (S.I. Ishiuchi et al.,
      Chem. Phys. Lett. 283 (1998) 243). The bandwidth of the v(CH) vibrations obtained
      by a deconvolution procedure also increases with the frequencies associated with
      the vibrational transitions. The anharmonicity of the v(CH) vibrations ranges
      between 51 and 72 cm(-1). Numerous absorptions are observed in the near infrared
      spectra. These absorptions are tentatively assigned to combinations involving the
      fundamental transitions which have been recently calculated at different levels
      of theory (D. Michalska et al., J. Phys. Chem. 100 (1996) 17786). The
      experimental, theoretical and harmonic v(OH) and vi(CH) frequencies are compared.

PMID- 11209860
TI  - Photophysical properties of 2,5-diphenyl-1,6,6a-trithiapentalene revealed by time
      resolved spectroscopy.
AB  - The fluorescence decay from S2(pi, pi*) state of 2,5-diphenyl-1,6,6a
      trithiapentalene (DP-TTP) in cyclohexane, tetrahydrofuran and acetonitrile
      solutions of a quantum yield of approximately 0.02-0.04 were measured. The
      results indicate that, the dominant process of radiationless deactivation of the
      S2 state, is internal conversion to the S1 state. Upon laser pulse excitation
      (lambda(ex) = 532 nm) from the S1(pi, pi*) state, DP-TTP in deoxygenated
      benzonitrile, acetonitrile, ethanol and tetrahydrofuran solutions give rise to
      transient triplet triplet absorption (lambdaTmax = 700-720 nm). Kinetic data are
      presented for intrinsic triplet lifetimes, self-quenching and quenching by
      oxygen.

PMID- 11209862
TI  - Complex formation in the indolo[2,3-b]quinolines--methylene blue systems in
      aqueous solutions.
AB  - Changes in the absorption spectra of methylene blue (MB) aqueous solutions
      containing an indoloquinoline can be described by assuming complex formation
      between MB and the indolinoquinoline. At the low concentration range of the two
      reactants a simple 1:1 complex stoichiometry was postulated on the basis of the
      Benesi-Hildebrand, Scott and Scatchard linearization of spectroscopic data and
      augmented by the formation of an isosbestic point. The estimated association
      constants were correlated with the ab initio calculated electronic properties of
      indolo[2,3-b]quinolines.

PMID- 11209863
TI  - Interfacial study of benzenesulfinate chemisorbed on silver.
AB  - The oxidative stability of self-assembled monolayer (SAM) of thiols on silver was
      examined with matrix-assisted laser desorption ionization (MALDI) time-of-flight
      (TOF) mass spectrometry (MS). A benzenesulfinate (BS) monolayer on silver was
      also prepared and investigated with MALDI-TOF-MS and surface-enhanced Raman
      scattering (SERS). The presence of sulfinate, sulfonate, and thiosulfonate
      fragment ions reveals that thiolate monolayers oxidize in the air. The relative
      abundance of C6H5SO2- and C6H5SO3- species in the mass spectra of the monolayer
      with different air-exposure times provides an estimation of the oxidation
      progress. In the vibrational spectrum, the large red shift of v(SOO-), combined
      with the lack of a shift of v(C-S) upon adsorption, indicates its bidentate O
      coordination. The orientation of the confined molecules, based on the Raman
      surface selection rules, was derived from the preferential enhancement of the
      different functional groups. The benzene ring of BS was found almost normal to
      the metal surface as a result of the intermolecular forces; that geometry
      excludes the possibility of the pi-system of the benzene ring from participating
      as another binding site. The SER spectra of BS obtained via a selective etching
      process confirms these observations.

PMID- 11209864
TI  - The surface enhanced Raman scattering effects of composite nanocrystals of Ag
      TiO2.
AB  - The composite particles of Ag-TiO2 both in a nanocrystal form was prepared by
      photoreduction of AgNO3 in the rutile colloidal solution. The surface plasmon
      absorption (SPA) band of the silver clusters supported on the TiO2 nanocrystal
      was red shift, and a strong surface enhanced Raman scattering (SERS) effect for
      the composite particles of Ag-nanocrystalline TiO2 was observed. The SERS effect
      is relating to the red shift phenomenon of SPA band, which could be explained by
      induced-resonance effect.

PMID- 11209865
TI  - Excited-state dipole moments of some hydroxycoumarin dyes using an efficient
      solvatochromic method based on the solvent polarity parameter, EN(T).
AB  - Excited-state dipole moments of some hydroxycoumarins, extensively used as laser
      dyes, have been determined using the solvatochromic method based on the
      microscopic solvent polarity parameter EN(T). Agreement between experimental and
      Austin model 1 (AM 1) calculated dipole moment changes has been found to be close
      in most of the cases. Our results are expected to be quite reliable in view of
      the fact that the correlation of the solvatochromic Stokes shifts is superior to
      that obtained using bulk solvent polarity functions. The dipole moments in the
      excited state, for all the molecules investigated, are higher than the
      corresponding values in the ground state. The increase in dipole moment upon
      excitation has been explained in terms of the nature of emitting state and
      resonance structure.

PMID- 11209866
TI  - Spectral studies on metal-ligand bonding in complexes of 1-acetyl-2
      (coumariniminecarboxamide-3-yl)hydrazine.
AB  - Several new transition metal complexes derived from 1-acetyl-2
      (coumariniminecarboxamide-3-yl)hydrazine (HL) have been prepared and
      characterized by elemental analyses, 1H-NMR, magnetic susceptibility, IR, UV, EPR
      and thermal analyses. Stereochemistries are proposed for the complexes on the
      basis of the spectral and magnetic studies. The i.r. data indicate that the
      carbonyl oxygen of the carboxamide constituents chelating backbone in most
      complexes. The visible and EPR spectral studies indicated that the Cu(II)
      complexes have a tetragonal geometry. From the EPR spectrum of the Cu(II)
      complexes, various parameters were calculated.

PMID- 11209867
TI  - Quantum chemistry predicted correlations between geometric isomerism
      (conformation) of -OH and =NH substituents and typical group frequencies of
      nucleic acid bases: cytosine.
AB  - Results of a search for correlations between typical group mode frequencies and
      conformation of -OH and =NH substituents is reported. The study is based on
      quantum chemical data (HF/6-31G (d, p) and MP2 (full)/6-31G (d, p)
      approximations) of 13 isomers of cytosine. It is closely related to
      investigations of stability and energetics of all isomers of the more common
      nucleic acid bases, which revealed correlations between conformation (geometric
      isomerism) of OH and =NH substituents on the one hand and conversion energies,
      relaxation of internal structural parameters, electric field gradients, etc. on
      the other hand. In the majority of cases alteration of conformation of these
      substituents is accompanied by systematic frequency shifts of stretching, in
      plane and out-of-plane bending (torsional) modes conventionally assigned to such
      groups and by alteration of quantum chemically predicted estimates of harmonic
      valence force constants and structural parameters dominating the mode
      frequencies. For identification of group modes 'fractional' mass (other than
      'natural' mass) isotope shifts of frequency and normal vectors proved useful.
      Likewise, estimation of effects of force constant and structural parameter
      alterations on frequency shifts by first order perturbation theory of the FG
      problem of partial structures contributed valuable insight into the origin of the
      shifts.

PMID- 11209868
TI  - Fourier transform Raman spectroscopy of Syncrude sweet blend distillation
      fractions derived from Athabasca bitumen.
AB  - The C-H stretching region in FT-Raman spectra of Syncrude sweet blend (SSB) and
      three distillation fractions (naphtha, light gas oil and heavy gas oil) was
      analyzed in detail in this investigation. The frequencies and intensities of the
      11 aliphatic and three aromatic C-H bands used to fit the spectrum of SSB were
      equal to the averages (weighted sums) of the corresponding quantities in the
      spectra of the fractions. The additivity of the spectra, thought to be a
      consequence of the large number of discrete compounds contained in each fraction,
      makes it possible to estimate the composition of other SSB samples using the
      spectra of the fractions reported in this work. In the aromatic C-H region, total
      intensities can be used to calculate the distribution of aromatics among the
      distillation fractions; these data also permit calculation of the fractional
      aromaticity (per cent aromatic carbon) for SSB and each fraction, with accuracies
      comparable to those obtained using NMR spectroscopy.

PMID- 11209869
TI  - Approximate molecular orbital anharmonic parameters for the infrared spectrum of
      H2O.
AB  - The vibrational spectrum of H2O was calculated at MP2/6-31G(extended) and MP2/6
      311G* levels taking into account anharmonicities through a simple approach to
      second-order perturbation theory in which molecular energy and dipole moment are
      expanded as Taylor series in normal coordinates with no cross terms, to simplify
      calculations. The series coefficients are obtained separately for each normal
      coordinate through polynomial regression of calculated single point property
      values corresponding to a few distorted molecular geometries. The energy
      coefficients are used to calculate the harmonic frequencies and the chi(ii)
      anharmonicity constants, and so the band origins. For the band intensities,
      second-order perturbation theory equations derived earlier for diatomic molecules
      are used for each mode. Estimated frequencies have accuracy equivalent to those
      of previous complete perturbation calculations at the same ab initio levels,
      being at most 2.6% above the experimental values for the MP2/6-31G(extended)
      level. The fundamental intensity estimates are equivalent to those for the
      complete treatments, with the exception of that at MP2/6-31G(extended) level for
      the bending mode, which is 7% above the experimental value. Estimated overtone
      intensities by both complete treatments and the simple approach may still differ
      in magnitude from the experimental values, though to a lesser extent for the
      formers.

PMID- 11209870
TI  - Core molecular orbital contribution to N2O isomerization as studied using
      theoretical electron momentum spectroscopy.
AB  - Core molecular orbital contribution to the electronic structure of N2O isomers
      has been studied using quantum mechanical density functional theory combined with
      a plane wave impulse approximation method. Momentum distributions of wave
      functions for inner shell molecular orbitals of the linear NNO, cyclic and linear
      NON isomers of N2O are calculated through the (e, 2e) differential cross sections
      in momentum space. This is possible because this momentum distribution is
      directly proportional to the modulus squared of the momentum space wave function
      for the molecular orbital in question. While the momentum distributions of the
      NNO and cyclic N2O isomers demonstrate strong atomic orbital characteristics in
      their core space, the outer core molecular orbitals of the linear NON isomer
      exhibit configuration interactions between them and the valence molecular
      orbitals. It is suggested that the frozen core approximation breaks down in the
      prediction of the electronic structure of such an isomer. Core molecular orbital
      contributions to the electronic structure can alter the order of total energies
      of the isomers and lead to incorrect conclusions of the stability among the
      isomers. As a result, full electron calculations should be employed in the study
      of N2O isomerization.

PMID- 11209871
TI  - Experimental and ab initio MO studies on the IR spectra and structure of
      pyridinium dicyanomethylide and trimethylammonium dicyanomethylide.
AB  - The structures of the title ylides have been studied by both quantitative
      infrared (IR) spectra and ab initio HF and MP2 force field calculations. Good
      agreement has been found between theoretical and experimental data for their
      spectral and structural characteristics. According to both IR data and geometry
      parameters the dicyanomethide groups in the ylides studied have a pronounced
      carbanionic character. The analysis of the calculated net electric charges
      however shows only moderate (below 0.6 e-) intramolecular charge transfers
      between the pyridinium (trimethylammonium) and dicyanomethide fragments of the
      species studied.

PMID- 11209872
TI  - Interobserver repeatability and validity of an observation method to assess
      physical loads imposed on the upper extremities.
AB  - Interobserver repeatability and validity were assessed for a new
      semiquantitative, time-based observation method for the estimation of physical
      loads imposed on the upper extremities. Six risk factors of upper extremity
      disorders were included in the method: repetitive use of hand, use of hand force,
      pinch grip, non-neutral wrist posture, elevation of upper arm, local mechanical
      pressure. Two occupational health nurses were trained to use the method. They
      observed 127 work cycles at a food-processing plant and a paper mill. The method
      was validated against expert observations from the video, continuous recordings
      of myoelectric activity (EMG) of forearm muscles, and wrist posture measured with
      goniometers. Interobserver repeatability was good or moderate for repetitive use
      of hand, hand force, pinch grip (range kappa = 0.58-0.71 on the right; 0.60-0.61
      on the left side). Interobserver repeatability was moderate or poor for non
      neutral wrist posture, elevation of the upper arm and local mechanical pressure.
      Validity ranged from moderate to good for repetitive use of hand, use of hand
      force, pinch grip and non-neutral wrist posture when expert observation was used
      as reference standard. When observations were validated against force estimations
      (EMG) and wrist goniometer data, validity was poor. In the absence of generally
      accepted reference values, arbitrarily chosen limits were used for the
      proportional duration of some physical load factors. Studies should be carried
      out to assess the limits that best differentiate between safe and hazardous jobs.

PMID- 11209873
TI  - Mobile (cellular) phone use and driving: a critical review of research
      methodology.
AB  - Studies have examined possible effects of concurrent mobile phone use on driving
      performance. Although interference is often apparent, determining the
      implications of such findings for 'real world' driving is problematic. This paper
      considers some relevant methodological issues including the definition of
      procedures and terms, operationalization of task elements, sampling of task
      components, and the provision of experimental controls. Suggestions are made
      about how methodological rigor could be improved.

PMID- 11209874
TI  - A quantitative model of work-related fatigue: background and definition.
AB  - Fatigue has been identified as a major risk factor for shiftworkers. However, few
      organizations or governments currently manage work-related fatigue in any
      systematic or quantitative manner. This paper outlines an approach to managing
      fatigue that could improve shiftwork management. Using shift start and finish
      times as an input, the outlined model quantifies work-related fatigue on the
      basis of its known determinants; that is shift timing and duration, work history
      and the biological limits on sleep length at specific times of day. Evaluations
      suggest that work-related fatigue scores correlate very highly with sleep-onset
      latency, neurobehavioural impairment and subjective sleepiness. The model is
      useful in that it allows comparisons to be made between rosters independent of
      shift length and timing or the total number of work hours. Furthermore, unlike
      many models of sleepiness and fatigue, individual's sleep times are not required
      as hours of work are used as the input. It is believed the model provides the
      potential quantitatively to link the effects of shiftwork to specific
      organizational health and safety outcomes. This simple approach may be especially
      critical at a time when many organizations view longer and more flexible hours
      from their employees as an immediate productivity gain.

PMID- 11209875
TI  - Impact of added rest breaks on the productivity and well being of workers.
AB  - The impact of frequent short rest breaks on the productivity and well being of a
      group of 30 workers in a meat-processing plant was studied. Two rest break
      schedules were tested, both of which provided 36 min of extra break time over the
      regular break schedule (30-min lunch and two 15-min breaks). In the first
      experimental rest break schedule, workers were given 12 3-min breaks evenly
      distributed over the workday (3-min break for every 27 min of work). In the
      second schedule, workers were given four 9-min breaks evenly distributed over the
      workday (9-min break every 51 min of work). Outcome measures included production
      rate and discomfort and stress ratings. Results showed that neither of the two
      experimental rest break schedules had a negative effect on production, and the 9
      min break schedule improved discomfort ratings for the lower extremities. The
      workers in the study mostly preferred the 9-min rest break schedule, indicating
      that workers in general might not as readily accept fragmentation of break time
      into short, frequent breaks.

PMID- 11209876
TI  - Abstract and reduced-context representations in fault-finding training.
AB  - The ability to transfer problem-solving expertise to new situations is regarded
      as an important practical skill but it is known to be sensitive to contextual
      differences. Employing abstract and reduced-context training tasks has been
      proposed as a method of fostering transferable skill but the evidence supporting
      this approach is limited. The research reported here aimed at assessing the
      effectiveness of training with diagnostic tasks of varying degrees of contextual
      detail. The criterion test used to measure training effectiveness was a context
      rich diagnostic task that involved locating faults in a representation of a water
      supply and drainage system (WSDS). In the first study reported (baseline study),
      subjects were trained and tested on the WSDS task. Various training interventions
      were employed and a set of diagnostic heuristics proved to be the most effective.
      Two pilot studies were then carried out to determine whether training with
      abstract diagnostic tasks could produce transfer to the criterion test, the WSDS.
      Little evidence of transfer was found; therefore, it was decided to incorporate
      some context into training but not so much as to obscure important, conceptual
      task features. This was achieved by constructing reduced-context representations
      (RCO) of the WSDS at more than one level of abstraction (main study). Training
      with those representations took less time than training with the WSDS but
      transfer to the criterion test (the WSDS) was equally efficient. During training
      with the RCO representations, a technique of refusing costly test information was
      employed which is thought to have helped subjects discover efficient search
      strategies and consistently transfer them to the criterion test. This was
      contrasted with the verbal diagnostic heuristics of the baseline study, which had
      proved to be effective, but which were not always transferred consistently to the
      criterion test. This raises the question as to whether diagnostic strategies are
      necessarily best conveyed solely in verbal form, if the intention is to train
      transferable skill.

PMID- 11209877
TI  - Gender differences in lifting technique.
AB  - The importance of different motion patterns in the assessment of work technique
      is rarely addressed in the literature and even less information can be found
      regarding gender differences. In this study the possible gender differences in
      lifting technique from lifting experiments on 12 female and 10 male participants
      were examined. The participants performed squat and stoop lifts of a box.
      Movements were measured by means of opto-electronic measurement systems.
      Kinematic data derived from the measurements revealed some differences between
      the men and the women, e.g. in trunk motion and knee angle ranges. The hip-knee
      interjoint coordination was more synchronized for women than for men in terms of
      the relative phase angle. It is concluded that so far gender differences in
      motion patterns have not been sufficiently explored and that men and women need
      to be considered separately in the evaluation of work technique in manual
      handling tasks. Advantages and disadvantages of different coordination patterns
      need to be further investigated.

PMID- 11209878
TI  - The use of mirrors during an assembly task: a study of ergonomics and
      productivity.
AB  - Industrial assembly tasks often require awkward, sustained neck and/or shoulder
      postures that can lead to increased musculoskeletal discomfort and reduced
      productivity. The aim of this study was to investigate the effects of mirror and
      periscope visual aids as ergonomic interventions designed to eliminate awkward
      postures of the cervicobrachial region during assembly tasks. Participants
      simulated a simple assembly task by using a cordless screwdriver to drive screws
      into a pre-tapped aluminium block. Trials of 15 min were run for each of four
      distinct assembly workstation configurations: industry standard (in-line
      screwdriver, work at elbow height, no visual aid); pistol grip (pistol grip
      screwdriver, work at shoulder height, no visual aid); mirror (in-line
      screwdriver, work at elbow height, single mirror visual aid); and periscope (in
      line screwdriver, work at elbow height, two-mirror visual aid system). Muscular
      activity, discomfort, body posture, productivity and operator subjective
      assessment were recorded to determine the effects of the visual aid
      interventions. The results show that when comparing the interventions to the
      industry standard condition, there was a 45% reduction in average cervical
      erector spinae activity, a 90% reduction in average neck flexion angle and a 72%
      reduction in neck discomfort with the interventions. When comparing these
      interventions to the pistol grip condition there was an 80% reduction in activity
      of the dominant side deltoid, a 92% reduction in shoulder flexion angle and an
      81% decrease in shoulder discomfort with the interventions. Productivity was
      greatest in the industry standard configuration followed by the pistol grip (9%
      lower), the periscope (13% lower) and the mirror (23% lower) configurations. A
      follow-up study that compared the productivity of the periscope configuration
      with that of the industry standard configuration showed that within a 4-h work
      period this productivity differential decreased by over 33%.

PMID- 11209879
TI  - Antiquity of the biological sulphur cycle: evidence from sulphur and carbon
      isotopes in 2700 million-year-old rocks of the Belingwe Belt, Zimbabwe.
AB  - Sulphur and carbon isotopic analyses on small samples of kerogens and sulphide
      minerals from biogenic and non-biogenic sediments of the 2.7 x 10(9) years(Ga)
      old Belingwe Greenstone Belt (Zimbabwe) imply that a complex biological sulphur
      cycle was in operation. Sulphur isotopic compositions display a wider range of
      biological fractionation than hitherto reported from the Archaean. Carbon
      isotopic values in kerogen record fractionations characteristic of rubisco
      activity methanogenesis and methylotrophy and possibly anoxygenic photosynthesis.
      Carbon and sulphur isotopic fractionations have been interpreted in terms of
      metabolic processes in 2.7 Ga prokaryote mat communities, and indicate the
      operation of a diverse array of metabolic processes. The results are consistent
      with models of early molecular evolution derived from ribosomal RNA.

PMID- 11209880
TI  - Genetic variation in a Pacific Island land snail: population history versus
      current drift and selection.
AB  - Previous studies of Partula land snails from the Society Islands, French
      Polynesia, have shown that there can be striking differences in shell shape,
      colour and banding pattern between nearby populations, even in the absence of any
      obvious geographical barriers to the movement of snails, or environmental
      gradients. Elsewhere, there may be relative uniformity over large distances.
      Analysis of a mitochondrial gene from Partula taeniata (Morch) shows a similar
      pattern. The relative frequencies of two mitochondrial haplotypes change abruptly
      over small distances, seemingly independent of the environment. Although the
      transition roughly coincides with clines in the frequencies of some morphological
      characteristics, it appears to be unrelated to others. It is likely that many of
      the differences accumulated while populations were isolated from one another,
      through the effects of random genetic drift and selection. Isolation of
      populations may have occurred as a result of demographic changes, or during the
      process of colonization if occasional long-distance migrants establish
      populations ahead of the main invading front. Current genetic drift, even without
      restrictions to gene flow, may contribute to genetic patchiness on a small scale,
      although it is likely that conspicuous characteristics such as shell colours and
      banding patterns are also influenced by selection.

PMID- 11209881
TI  - Selective extinction and rapid loss of evolutionary history in the bird fauna.
AB  - The extinction of species results in a permanent loss of evolutionary history.
      Recent theoretical studies show that this loss may be proportionally much smaller
      than the loss of species, but under some conditions can exceed it. Such
      conditions occur when the phylogenetic tree that describes the evolutionary
      relationships among species is highly imbalanced due to differences between
      lineages in past speciation and/or extinction rates. I used the taxonomy by C. G.
      Sibley and B. L. Monroe Jr to estimate the global loss of bird evolutionary
      history from historical and predicted extinctions, and to quantify the ensuing
      changes in balance of the bird phylogenetic tree. In the global bird fauna,
      evolutionary history is being lost at a high rate, similar to the rate of species
      extinction. The bird phylogenetic tree is highly imbalanced, and the imbalance is
      increased significantly by anthropogenic extinction. Historically, the elevated
      loss of bird evolutionary history has been fuelled mostly by phylogenetic non
      randomness in the extinction of species, but the direct effect of tree imbalance
      is substantial and could dominate in the future.

PMID- 11209882
TI  - Back-casting sociality in extinct species: new perspectives using mass death
      assemblages and sex ratios.
AB  - Despite 150 years of interest in the ecology of dinosaurs, mammoths, proto
      hominids and other extinct vertebrates, a general framework to recreate patterns
      of sociality has been elusive. Based on our recent discovery of a contemporary
      heterospecific mass death assemblage in the Gobi Desert (Mongolia), we fit
      predictions about gender-specific associations and group living in extant
      ungulates to extinct ones. We relied on comparative data on sex-ratio variation
      and body-size dimorphism, basing analyses on 38 additional mass mortality sites
      from Asia, Africa, Europe and North America that span 50 million years. Both
      extant and extinct species died in aggregations with biased adult sex ratios, but
      the skew (from 1:1) was greater for extinct dimorphic taxa, suggesting that
      sociality in these extinct species can be predicted from spatial and demographic
      traits of extant ones. However, extinct rhinos, horses and zebras were
      inconsistent with predictions about adult sex ratios, which underscores the
      inherent difficulty in backcasting historic patterns to some monomorphic taxa.
      These findings shed light not only on the sociality of extinct species but
      provide a sound, although limited, footing for interpretation of modern death
      assemblages within the context of the emerging science of taphonomy and
      palaeobehaviour.

PMID- 11209883
TI  - Explaining social learning of food preferences without aversions: an evolutionary
      simulation model of Norway rats.
AB  - Norway rats (Rattus norvegicus) transmit preferences for novel foods socially by
      smelling each other's breath. However, rats fail to learn aversions, acquiring a
      preference even if the rat whose breath they smell has been poisoned. Rats can
      distinguish between sick and healthy conspecifics and social learning of both
      preferences and aversions is present in other species - hence it is unclear why
      rats cannot learn aversions socially. We constructed an evolutionary simulation
      in which a population of rats foraged from a central location, exploiting food
      sites that could contain edible or toxic foodstuffs. We examined the relationship
      between toxin lethality and selection for individual versus social learning and
      discrimination between sick and healthy conspecifics in order to allow learning
      of both preferences and aversions. At low lethality levels individual learning
      was selected for and at intermediate levels we found social learning of both
      preferences and aversions. Finally, given high lethality levels the simulated
      rats would employ social learning but failed to learn aversions, matching the
      behaviour of real rats. We argue that Norway rats do not learn aversions socially
      because their environment may contain only highly lethal toxins which make
      interaction with a sick conspecific an extremely rare event.

PMID- 11209884
TI  - Feeding behaviour of free-ranging penguins determined by oesophageal temperature.
AB  - Sea birds play a major role in marine food webs, and it is important to determine
      when and how much they feed at sea. A major advance has been made by using the
      drop in stomach temperature after ingestion of ectothermic prey. This method is
      less sensitive when birds eat small prey or when the stomach is full. Moreover,
      in diving birds, independently of food ingestion, there are fluctuations in the
      lower abdominal temperature during the dives. Using oesophageal temperature, we
      present here a new method for detecting the timing of prey ingestion in free
      ranging sea birds, and, to our knowledge, report the first data obtained on king
      penguins (Aptenodytes patagonicus). In birds ashore, which were hand-fed 2-15 g
      pieces of fish, all meal ingestions were detected with a sensor in the upper
      oesophagus. Detection was poorer with sensors at increasing distances from the
      beak. At sea, slow temperature drops in the upper oesophagus and stomach
      characterized a diving effect per se. For the upper oesophagus only, abrupt
      temperature variations were superimposed, therefore indicating prey ingestions.
      We determined the depths at which these occurred. Combining the changes in
      oesophageal temperatures of marine predators with their diving pattern opens new
      perspectives for understanding their foraging strategy, and, after validation
      with concurrent applications of classical techniques of prey survey, for
      assessing the distribution of their prey.

PMID- 11209885
TI  - Pyrazine odour makes visually conspicuous prey aversive.
AB  - Unpalatable insects frequently adopt multimodal signals to ward off predators,
      incorporating sounds and odours into their colourful displays. Pyrazine is an
      odour commonly used in insect warning displays, and has previously been shown to
      elicit unlearned biases against common warning colours, e.g. yellow and red in
      naive predators. We designed two experiments to test for similar effects of
      pyrazine on the conspicuousness of prey, perhaps the most ubiquitous aspect of
      aposematic coloration. In the first experiment, we offered predators (Gallus
      gallus domesticus) a choice between conspicuous crumbs and cryptic crumbs in the
      presence or absence of pyrazine. In the second experiment, we manipulated the
      birds' experience of conspicuous prey during an initial training phase. Only in
      the presence of pyrazine did birds show a bias against conspicuously coloured
      food, and this occurred whether or not they had previously experienced food that
      contrasted with the background. This emergent behaviour relied upon the visual
      and odorous signal components being presented together. These unlearned, yet
      hidden, responses against conspicuousness demonstrate that there are initial
      benefits to prey being conspicuous when the multimodal nature of warning signals
      is accounted for.

PMID- 11209886
TI  - Primer effects of a brood pheromone on honeybee behavioural development.
AB  - Primer pheromones are thought to act in a variety of vertebrates and
      invertebrates but only a few have been chemically identified. We report that a
      blend of ten fatty-acid esters found on the cuticles of honeybee larvae, already
      known as a kairomone, releaser pheromone and primer pheromone, also act as a
      primer pheromone in the regulation of division of labour among adult workers.
      Bees in colonies receiving brood pheromone initiated foraging at significantly
      older ages than did bees in control colonies in five out of five trials.
      Laboratory and additional field tests also showed that exposure to brood
      pheromone significantly depressed blood titres of juvenile hormone. Brood
      pheromone exerted more consistent effects on age at first foraging than on
      juvenile hormone, suggesting that the primer effects of this pheromone may occur
      via other, unknown, mechanisms besides juvenile hormone. These results bring the
      number of social factors known to influence honeybee division of labour to three:
      worker-worker interactions, queen mandibular pheromone and brood pheromone.

PMID- 11209887
TI  - Convergent evolution of worker policing by egg eating in the honeybee and common
      wasp.
AB  - Mutual policing, where group members suppress each others' reproduction, is
      hypothesized to be important in the origin and stabilization of biological
      complexity. Mutual policing among workers in social insects can reduce within
      colony conflict. However, there are few examples. We tested for worker policing
      in the common wasp Vespula vulgaris. Workers rapidly removed worker-laid eggs but
      left most queen-laid eggs (four out of 120 worker eggs versus 106 out of 120
      queen eggs remained after 1h). Ovary dissection (1150 workers from six colonies)
      revealed that a small but significant number of workers have active ovaries (4%)
      equivalent to approximately five to 25 workers per colony. Consistent with
      effective policing of worker reproduction, microsatellite analysis of males (270
      individuals from nine colonies) detected no workers' sons. Worker policing by egg
      eating has convergently evolved in the common wasp and the honeybee suggesting
      that worker policing may have broad significance in social evolution. Unlike the
      honeybee, relatedness patterns in V. vulgaris do not explain selection for
      policing. Genetic analysis (340 workers in 17 nests) revealed that workers are
      equally related to the queen's and other workers' sons (worker-worker relatedness
      was 0.51 +/- 0.04, 95% confidence interval). Worker policing in V. vulgaris may
      be selected due to the colony-level benefit of conflict suppression.

PMID- 11209888
TI  - Male contributions to egg production: the role of accessory gland products and
      sperm in Drosophila melanogaster.
AB  - Drosophila melanogatser seminal fluid components, accessory gland proteins (Acps)
      and sperm, induce females to deposit high numbers of fertilized eggs for about 11
      days. This high and sustained level of egg deposition requires that oogenesis be
      stimulated to provide the necessary mature oocytes. To investigate the relative
      timing and contributions of Acps and sperm in the egg-production process, we
      examined the rates of oogenic progression and egg deposition in females mated to
      genetically altered males that have seminal fluid deficient in Acps and/or sperm,
      and subjected these data to path analysis. We found that Acps and sperm are
      complementary stimuli necessary for inducing high rates of oogenic progression
      and rapid egg deposition. While egg deposition and oogenic progression can be
      induced by Acps alone, both Acps and sperm are required for maximum stimulation
      of oogenic progression and egg deposition immediately after mating.

PMID- 11209889
TI  - Indirect partner choice through manipulation of male behaviour by female fowl,
      Gallus gallus domesticus.
AB  - The direct and indirect consequences of female copulatory behaviour for
      copulation success have seldom been quantified. In feral fowl, most copulations
      were forced by males and copulation success was determined by two factors. First,
      female differential resistance and solicitation directly affected copulation
      success and were displayed non-randomly with respect to male social status.
      Second, another female copulatory behaviour, the distress call, had an indirect
      effect on both copulation success and the quality of copulation partners.
      Distress calls triggered male attention to a copulation, which increased the
      probability of higher-ranking males than the copulating male disrupting the
      copulation and inseminating the calling female. Females preferentially uttered
      distress calls when mounted by low-ranking males. Both copulation resistance and
      distress calling influenced copulation success, but only distress calling
      increased the probability of copulation disruption by other males. Consistent
      with the effect of direct selection, differential distress calling indirectly
      biased copulation success in favour of dominant males. Female fowl may thus
      ameliorate the effect of male sexual coercion by manipulating male behaviour.

PMID- 11209890
TI  - The evolution of cooperative breeding through group augmentation.
AB  - Some individuals (helpers) in cooperatively breeding species provide alloparental
      care and often suppress their own reproduction. Kin selection is clearly an
      important explanation for such behaviour, but a possible alternative is group
      augmentation where individuals survive or reproduce better in large groups and
      where it therefore pays to recruit new members to the group. The evolutionary
      stability of group augmentation is currently disputed. We model evolutionarily
      stable helping strategies by following the dynamics of social groups with varying
      degrees of subordinate help. We also distinguish between passive augmentation,
      where a group member benefits from the mere presence of others, and active
      augmentation, where their presence as such is neutral or harmful, but where
      helping to recruit new group members may still be beneficial if they in turn
      actively provide help for the current reproductives ('delayed reciprocity'). The
      results show that group augmentation (either passive or active) can be
      evolutionarily stable and explain costly helping by non-reproductive
      subordinates, either alone or leading to elevated help levels when acting in
      concert with kin selection. Group augmentation can thus potentially explain the
      weak relationships between relatedness and helping behaviour that are observed in
      some cooperatively breeding species. In some cases, the superior mutualistic
      performance of cooperatively behaving groups can generate an incentive to stay
      and help which is strong enough to make ecological constraints unnecessary for
      explaining the stability of cooperatively breeding groups.

PMID- 11209891
TI  - The ontogeny of the homing pigeon navigational map: evidence for a sensitive
      learning period.
AB  - Homing pigeons can learn a navigational map by relying on the heterogeneous
      distribution of atmospheric odours in the environment. To test whether there
      might be a sensitive period for learning an olfactory-based navigational map, we
      maintained a group of young pigeons in an aviary screened from the winds until
      the age of three to four months post-fledging. Subsequently, the screens were
      removed and the pigeons were exposed to the winds and the environmental odours
      they carry for three months. One control group of pigeons was held in a similar
      aviary but exposed to the winds immediately upon Hedging, while another control
      group of pigeons was allowed free-flight. When the pigeons from the three groups
      were released from two distant release sites at about six months of age post
      fledging, the two control groups were found to be equally good at orientating and
      returning home, while the experimental pigeons held in the shielded aviary for
      the first three months post-fledging were unable to orientate homeward and they
      were generally unsuccessful in returning home. This result supports the
      hypothesis that environmental experience during the first three months post
      fledging is critical for some aspect of navigational map learning and that
      navigational map learning displays sensitive period-like properties.

PMID- 11209892
TI  - Heritability of arrival date in a migratory bird.
AB  - The behaviour of long-distance migratory birds is assumed to partly be under the
      influence of genes, as demonstrated by selection experiments. Furthermore,
      competition for early arrival among males may lead to condition-dependent
      migration associated with fitness benefits of early arrival achieved by
      individuals in prime condition. Here I present field data on the repeatability
      and the heritability of arrival date in a trans-equatorial migratory bird, the
      barn swallow Hirundo rustica, and I test for a genetic correlation between
      arrival date and the expression of a condition-dependent secondary sexual
      character. The repeatability was statistically significant and the heritability
      of arrival date was estimated to be 0.54 (s.e. = 0.15). There was no significant
      evidence of this estimate being inflated by environmental or maternal condition
      during rearing. Arrival date and migration are condition dependent in the barn
      swallow, with males with the most exaggerated secondary sexual characters also
      arriving the earliest. There was a significant genetic correlation between
      arrival date and tail length in male barn swallows, providing indirect evidence
      for a genetic basis of this condition dependence. Given the high level of
      heritability, arrival date could readily respond to selection caused by
      environmental change.

PMID- 11209893
TI  - The effects of testosterone on a viral infection in greenfinches (Carduelis
      chloris): an experimental test of the immunocompetence-handicap hypothesis.
AB  - The immunocompetence-handicap hypothesis suggests that the honesty of quality
      signals could be guaranteed if testosterone (T) suppresses immune function while
      enhancing male ornaments. In addition, it has been proposed that the cost of
      enhancing ornaments should be highest for males with small ornaments. Recently,
      the assertion that T causes obligate immunosuppression has been questioned. In
      this study, we tested whether elevated T levels would increase susceptibility to
      a viral infection, and whether this hypothesized effect would be most pronounced
      in males with small ornaments. We surgically inserted T implants into 15 male
      greenfinches (Carduelis chloris) and control implants into a further 15 males.
      All birds were then infected with a naturally occurring virus (Sindbis virus,
      Alphavirus genus), and each bird's daily viraemia (blood virus concentration) was
      measured for seven days. The specific antibody response was measured for eight
      weeks. T-implanted males did not exhibit increased viraemia or decreased antibody
      response, and males with small and large ornaments did not respond differently to
      T implantation. We did, however, find that T implantation decreased viraemia
      early in the course of the infection and increased viraemia late in the
      infection. Thus, our results demonstrate that T may act both to increase and to
      decrease viraemia.

PMID- 11209895
TI  - High-performance liquid chromatographic separation of enantiomers of synthetic
      amino acids on a ristocetin A chiral stationary phase.
AB  - A macrocyclic glycopeptide, ristocetin A, was used as chiral stationary phase for
      the high-performance liquid chromatographic separation of enantiomers of 28
      unnatural amino acids, such as analogues of phenylalanine, tyrosine and
      tryptophan, and analogues containing 1,2,3,4-tetrahydroisoquinoline, tetraline or
      1,2,3,4-tetrahydro-2-carboline skeletons. Excellent resolutions were achieved for
      most of the investigated compounds by using reversed-phase or a new polar-organic
      mobile phase system. The conditions of separation were optimized by variation of
      the mobile phase composition, temperature and flow-rate.

PMID- 11209894
TI  - Long-distance interactions in Cyclopean vision.
AB  - We report on evidence for selective long-distance interactions in Cyclopean
      binocular vision. When presented with a pair of Cyclopean test bars observers
      could discriminate trial-to-trial uncorrelated variations in the mean
      orientation, orientation difference, separation and mean location of the test
      bars while ignoring random variations in the orientation, width and location of a
      third bar placed between the two test bars. We propose that the human visual
      system contains Cyclopean long-distance comparators (i) that compare the outputs
      of two narrow receptive fields some distance apart while being insensitive to
      stimuli located between those receptive fields, and (ii) the outputs of which
      carry orthogonally labelled indicators of orientation difference, mean
      orientation, separation and mean location. In the evolutionary context, one role
      for the proposed mechanisms might be to encode information about the silhouettes
      of animals whose camouflage is broken by the binocular vision of predators.

PMID- 11209896
TI  - Separation of tanshinones from Salvia miltiorrhiza Bunge by high-speed counter
      current chromatography using stepwise elution.
AB  - High-speed counter-current chromatography (HSCCC) was successfully used for
      isolation and purification of tanshinones from the roots of Salvia miltiorrhiza
      Bunge by stepwise elution. A set of three solvent systems and other experimental
      conditions were determined by analytical HSCCC. Using the optimized conditions,
      the preparative HSCCC separation was performed on 50 mg of crude light petroleum
      extract yielding pure tanshinones of tanshinone HA (7 mg), tanshinone I (3 mg)
      and cryptotanshinone (4 mg) all at purities of over 95% in a single run.

PMID- 11209897
TI  - Analysis of carbohydrates in drinks by high-performance liquid chromatography
      with a dynamically modified amino column and evaporative light scattering
      detection.
AB  - A high-performance liquid chromatographic method with a dynamically modified
      amino column and evaporative light-scattering detector (ELSD) was established for
      the direct analysis of the carbohydrates in some drinks. A separation column
      (Zorbax Rx-SIL, 250 mm x 4.6 mm I.D., 5 microm, Hewlett-Packard, USA) which was
      modified by ethylenediamine and a guard column (Zorbax Rx-SIL, 12.5 mm x 4.6 mm
      I.D., 5 microm) were used. The mobile phase was a mixture of water-acetonitrile
      (1:2.6, v/v) containing 0.03% (v/v) ethylenediamine. Regression equations
      revealed linear relationship (correlation coefficients=0.996-0.999) between the
      mass of carbohydrates injected and the carbohydrates peak areas detected by ELSD.
      The detection limits of ELSD (S/N=3) were between 0.2 and 1.2 microg for
      different carbohydrates. This method is simple and sensitive.

PMID- 11209898
TI  - Fast enantioseparations of basic analytes by high-performance liquid
      chromatography using cellulose tris(3,5-dimethylphenylcarbamate)-coated zirconia
      stationary phases.
AB  - In this work, we study the influence of the mobile phase and column temperature
      on the enantioresolution of basic compounds on microparticulate porous zirconia
      coated with cellulose tris(3,5-dimethylphenylcarbamate) (CDMPC). The chiral
      analytes are amino compounds, including a number of beta-blockers. Analytes are
      eluted with hexane-alcohol mobile phases. We investigated the effect of alcohol
      (type and concentration), basic eluent additives, and column temperature on the
      parameters that control resolution (column efficiency, retention and
      selectivity). Conditions for achieving an adequate separation in the least time
      have been determined for numerous racemic mixtures. For most solutes, baseline
      resolution of the enantiomeric pair was achieved in less than 1 min; 12 of 13
      pairs were separated in less than 2 min.

PMID- 11209899
TI  - Direct characterization of isoquinoline alkaloids in a crude plant extract by ion
      pair liquid chromatography-electrospray ionization tandem mass spectrometry:
      example of Eschscholtzia californica.
AB  - An ion-pair HPLC-ESI-MS-MS method has been developed for the direct and rapid
      characterization of isoquinoline alkaloids in a crudely purified extract of the
      aerial parts of Eschscholtzia californica (Papaveraceae). This plant was chosen
      because of its increasing use in pharmaceutical industries and because its well
      known alkaloid composition allows the optimization of the experimental procedure
      through an on-line analytical sequence. Thus, 14 isoquinoline alkaloids of
      different types were detected and characterized. The identities of these
      compounds were confirmed unambigously by their fragmentation and UV spectra
      obtained by LC-diode-array detection. Various experiments including tandem mass
      spectrometry and in-orifice collision induced dissociation were performed and
      prove that MS-MS is a very efficient technique to identify these compounds. An
      explanation for each isoquinoline alkaloid type MS-MS fragmentation pattern is
      proposed and indicates similar neutral and/or radical losses. The order of the
      fragmentation depended on the type of compound but the lost fragments were
      similar.

PMID- 11209900
TI  - Micelle-mediated extraction and preconcentration of ginsenosides from Chinese
      herbal medicine.
AB  - The feasibility of employing micelle-mediated extraction as an alternative and
      effective method for the solubilization, purification and/or preconcentration of
      active ingredients from herbal products is demonstrated for the first time using
      the root of American ginseng as a model. When compared to methanol and water, an
      aqueous surfactant solution containing 10% Triton X-100 yielded faster kinetics
      and higher recovery for the extraction of various ginsenosides. An experimental
      design approach (uniform design) was demonstrated as a novel and useful method
      for the optimization of experimental factors involved in the micelle-mediated
      extraction process. For the preconcentration of ginsenosides prior to
      chromatographic determination, a salting-out agent (sodium sulfate) was employed
      to make the efficient cloud point extraction of both hydrophobic and hydrophilic
      ginsenosides into the surfactant-rich phase possible, as well as to increase the
      preconcentration factor by reducing the volume of the surfactant-rich phase.

PMID- 11209901
TI  - Pressurized liquid extraction of berberine and aristolochic acids in medicinal
      plants.
AB  - Berberine and aristolochic acids I and II present naturally in medicinal plants
      were extracted using a laboratory-made pressurized liquid extraction (PLE) system
      in the dynamic mode. As the target analytes were present naturally in the
      medicinal plants, spiking was not done and comparison with ultrasonic extraction
      and Soxhlet extraction was performed to assess the method accuracy. The effect of
      temperature, volume of solvent required and particle size were investigated.
      Method precision (RSD, n=5) between 1.98 and 3.4% was achieved for the extraction
      of berberine and aristolochic acids I and II in medicinal plants and lower than
      8% for lower levels of aristolochic acid II in medicinal plants.

PMID- 11209902
TI  - Determination of nonylphenol ethoxylate oligomers by liquid chromatography
      electrospray mass spectrometry in river water and non-ionic surfactants.
AB  - Liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) for
      the quantitative determination of five nonylphenol ethoxylate (NPE) oligomers in
      river water was described. These NPE oligomers were separated on a poly(vinyl
      alcohol) gel column using acetonitrile-30 mM ammonium acetate as the mobile phase
      followed by ESI-MS detection without any sample concentration steps. The sample
      was only filtered using the disposable filter and the aliquot (100 micro1) of
      this sample was injected into the LC-ESI-MS system. All NPE oligomers were
      detected using the [M+NH4]-ion. Detection limits ranged from 160 pg/ml (NPE4) to
      240 pg/ml (NPE2), repeatability and reproducibility ranged from 4.2% (NPE2) to
      6.2% (NPE6) and from 7.4% (NPE5) to 9.8% (NPE6).

PMID- 11209903
TI  - Gas chromatography for in situ analysis of a cometary nucleus. II. Analysis of
      permanent gases and light hydrocarbons with a carbon molecular sieve porous layer
      open tubular column.
AB  - Considering the severe constraints of space instrumentation, a great improvement
      for the in situ gas chromatographic (GC) determination of permanent and noble
      gases in a cometary nucleus is the use of a new carbon molecular sieve porous
      layer open tubular (PLOT) column called Carbobond. No exhaustive data dealing
      with this column being available, studies were carried out to entirely
      characterize its analytical performances, especially when used under the
      operating conditions of the cometary sampling and composition (COSAC) experiment
      of the European Space Agency (ESA) Rosetta space mission to be launched in 2003
      for a rendezvous with comet 46 P/Wirtanen in 2011. The high efficiency and speed
      of analysis of this column at both atmospheric and vacuum outlet column pressure
      is demonstrated, and the kinetic mass transfer contribution of this carbon
      molecular sieve adsorbent is calculated. Besides, differential adsorption
      enthalpies of several gases and light hydrocarbons were determined from the
      variation of retention volume with temperature. The data indicate close
      adsorption behaviors on the Carbobond porous layer adsorbent and on the carbon
      molecular sieve Carboxen support used to prepare the packed columns. Moreover,
      taking into account the in situ operating conditions of the experiment, a study
      of two columns with different porous layer thicknesses allowed one to optimize
      the separation of the target components and to select the column parameters
      compatible with the instrument constraints. Comparison with columns of similar
      selectivity shows that these capillary columns are the first ones able to perform
      the same work as the packed and micro-packed columns dedicated to the separation
      of this range of compounds in GC space exploration.

PMID- 11209904
TI  - Identification of impurities affecting commercial ethylene glycol UV
      transmittance.
AB  - As a raw material for making polyesters, ethylene glycol has a special
      specification of UV transmittance. At present, ethylene glycol produced by some
      plants still has low UV transmittance rendering it unsuitable for use in
      polyester production. In this paper, a method was developed for the
      identification of the impurities that cause commercial ethylene glycol to have
      low UV transmittance, using solid-phase extraction (SPE) and some analytical
      techniques such as high-performance liquid chromatography, gas chromatography
      mass spectrometry and gas chromatography-Fourier transform infrared spectroscopy.
      The major UV-absorbing impurities were identified as some alkyl homologues of 2
      hydroxycyclopent-2-en-1-one, including 2-hydroxy-3,5-dimethylcyclopent-2-en-1
      one, 2-hydroxy-3-methylcyclopent-2-en-1-one, 2-hydroxy-3,4-dimethylcyclopent-2-en
      1-one, 2-hydroxy-3-ethyl-4-methylcyclopent-2-en-1-one and 2-hydroxy-3
      ethylcyclopent-2-en-1-one. Their concentrations were estimated to be less than 2
      microg ml(-1). It is believed that with the above results, ethylene glycol
      producing plants might make process improvements to remove these impurities more
      effectively and more easily.

PMID- 11209905
TI  - Resolution of positional isomers by capillary electrochromatography.
AB  - Electroseparations have been very successful in increasing efficiencies and
      reducing analysis times. The analytical technique originally applied to open tube
      capillaries (capillary electrophoresis) has been used as a basis to develop
      renewed interest in electrochromatography. This paper describes the use of
      capillary electrochromatography to separate two positional isomers and describes
      a comparison between gas chromatography (GC), capillary electrochromatography
      (CEC) and nano-HPLC. The resolution of these isomers is quite crucial, since one
      of the isomers is the impurity in a pharmaceutically active drug.

PMID- 11209906
TI  - 2000: the drug problem in the European Union.

PMID- 11209907
TI  - Controversy--water fluoridation.

PMID- 11209909
TI  - Medical school entry.

PMID- 11209908
TI  - Water fluoridation: safe and effective.

PMID- 11209911
TI  - Undetected hyperglycaemia among hospital in-patients.
AB  - To assess the prevalence of previously undiagnosed hyperglycaemia consistent with
      a diagnosis of Diabetes Mellitus in a consecutive series of hospital in-patients.
      Retrospective case note review. University Teaching Hospital. 800 consecutive
      hospitalised patients aged over 50 years. The main outcome measures the
      prevalence of hyperglycaemia [corrected]. We searched the biochemistry laboratory
      computerised database for results of all biochemistry tests carried out during
      each patient's admission. The medical records of those with at least one plasma
      glucose value in the hyperglycaemic range (glucose > or =11.1 mmol/l and/or > or
      =7.0 mmol/l on casual and/or fasting measurements respectively) were reviewed by
      two observers using a standardised method and a check list for data collection.

PMID- 11209910
TI  - The current epidemiology of SIDS in Ireland.
AB  - This paper examines some epidemiological factors associated with SIDS to give a
      general profile of SIDS cases occurring in Ireland between the years 1993 to
      1997. There has been a dramatic decrease in the incidence of the Sudden Infant
      Death Syndrome (SIDS) in the Republic of Ireland in the last decade from an
      average rate of 2.2/1000 live-births in the 1980s to 0.8/1000 live-births in the
      years 1993-1997, a decrease of 100 deaths a year. The fall in the SIDS rate has
      been seen in many countries and is felt to be associated with Reduce The Risks
      (RTR) of SIDS campaigns and the avoidance of the prone sleeping position. The use
      of the prone sleep position averaged at 6% of children being put prone in the
      years 1993-1997 but the prone position has progressively decreased from 13% of
      children being put prone in 1994 to only 2% in 1997. The profile of the Irish
      SIDS cases is similar to that of SIDS cases in other countries following similar
      RTR campaigns with a male predominance, the characteristic clustering of deaths
      in the first six months of life and the majority of cases (75%) occuring in the
      night sleep period. The loss of the seasonal variation of the time of death is
      also shown and factors such as lower socio-economic status, unemployment and
      medical card eligibility were seen in higher proportions in SIDS families than in
      the general population. A high percentage of SIDS mothers smoked (73%). Higher
      smoking rates were seen among younger and single mothers and smoking rates were
      inversely related to educational level and socioeconomic grouping. An urgent
      question that needs to be addressed is how socioeconomic disadvantage increases
      the SIDS risk and what factors influence socioeconomically disadvantaged families
      to adopt life style and parenting practices such as smoking that influence their
      children's health.

PMID- 11209912
TI  - Smoking and quitting among Irish teenage males.
AB  - Nicotine addiction in adulthood is usually preceded by exposure to cigarettes in
      adolescence. A minimal exposure may be sufficient to produce addiction.
      Strategies to reduce adult smoking must address those factors, which influence
      teenage smoking. In this study we aimed to establish the prevalence of smoking in
      male secondary schools, to measure the association between student's smoking
      status and parental, peer and sibling smoking and to describe attempted quitting.
      An anonymous questionnaire was given to 1070 male secondary school pupils in two
      schools in County Louth. Twenty-seven percent of respondents smoked every day or
      on most days. Having a best friend who smoked was associated with personal
      smoking (O.R. 11.75, C.I. 8.6-16.08) as was sibling smoking (O.R. 3.49, C.I. 2.67
      4.57.) Seventy percent of smokers stated that they wanted to stop and 75% that
      they had tried to stop. Only five smokers (1.2%) had been advised to quit by
      their general practitioner. We conclude that smoking is as prevalent among
      teenage boys in Ireland as it has been shown to be elsewhere and that most
      teenagers are unable rather than unwilling to stop.

PMID- 11209913
TI  - Rotavirus gastroenteritis among paediatric patients at Tralee general hospital.
AB  - Rotavirus infection among paediatric patients in Tralee general hospital was
      monitored over 4 years (1994 - 1998). A total of 2,319 specimens from
      gastroenteritis patients less than 7 years old were tested by latex agglutination
      assay, of which 203 (8.75%) were deemed positive. An inverse correlation was
      observed between age and susceptibility to infection, with the very young (under
      2 years) most frequently infected. The virus was almost equally distributed among
      males (53%) and females (47%) testing positive for rotavirus. A distinctive early
      Spring peak of infection was evident annually, although the largest peak was
      identified in December 1997. This correlated with a significant change in
      circulating genotype as determined by RT-PCR based genotyping analysis of 45
      rotavirus samples. In 1997, rotavirus accounted for 64% of all identified
      paediatric enteric agents at Tralee General for which an infectious agent could
      be identified. The average hospital stay was 3.2 days, and the direct hospital
      costs for rotavirus associated gastroenteritis was estimated at pounds sterling
      31,232 per annum.

PMID- 11209914
TI  - "Saves" project.

PMID- 11209915
TI  - To push or not to push--a personal experience.

PMID- 11209916
TI  - How do General Practitioners learn of their patient's deaths?
AB  - OBJECTIVES: To investigate the methods by which General Practitioners learn, or
      do not learn, of their patients deaths, when the deaths occur in an institution
      in which the General Practitioner has no direct role in their care. DESIGN: Using
      a semi-structured telephone questionnaire the relevant General Practitioners were
      asked of the method, if any, by which they had learned of their patients deaths,
      and their views on this. SETTING: Sligo, Ireland. RESULTS: In 6 (16%) of the 37
      cases, the GP was informed of the death within one working day by hospital staff.
      In 22 (59%) of the cases, the GP had learned of the death through other means. In
      9 (26%) of the cases the GP had not learned of the death. In 28 (75%) of the
      cases, the GPs were dissatisfied with either the fact that they did not know of
      the death, or even if they did know, the method by which they learned of the
      patients death. CONCLUSION: General Practitioners, for a variety of reasons, wish
      to learn of their patient's deaths within a short length of time of such deaths
      occurring. When deaths occur in an institution in which the GP has no direct role
      in the care of their patients, the information is not forwarded to the GP within
      a reasonable length of time in the vast majority of cases. Such institutions need
      to realise the importance of this simple act, and to make it routine to forward
      the information.

PMID- 11209917
TI  - Prophylaxis in RSV infection (Palivizumab)--is it worthwhile?
AB  - Respiratory syncytial virus (RSV) is a recognised cause of lower respiratory
      tract infection in infants and young children. It causes severe respiratory
      disease in preterm infants with or without chronic lung disease. This study,
      conducted at Waterford Regional Hospital, evaluates the incidence of RSV
      infection in hospitalised children, its seasonal variation, and effectiveness of
      its prevention. Thirty eight percent of admitted children with bronchiolitis were
      RSV positive in the year 1999 November to March is the peak season for this
      infection. A highly selected group of 7 preterm children with or without chronic
      lung disease received Palivizumab prophylaxis. Not one of them acquired RSV
      infection. The high cost of Palivizumab was the main factor for its restricted
      use. Palivizumab was found to be effective in preventing RSV infection in our
      study. Since we had a small number of patients, further studies are needed for
      its economic and judicious use. Respiratory syncytial virus (RSV) is virulent
      easily transmissible and the most common cause of lower respiratory tract disease
      in children of less than 2 years of age. Up to 98% of children attending day care
      will be infected in single RSV season. Between 0.5% and 3.2% of children with RSV
      infection require Hospitalisation. Approximately 90,000 hospital admissions and
      4500 deaths per year were reported in United States. In Ireland 2807 patients
      were admitted with Bronchiolitis in 1998. Major risk factors for hospitalisation
      due to RSV are Prematurity, chronic lung disease, congenital heart disease,
      compromised immunity and age younger then 6 weeks in otherwise healthy children.
      No effective treatment of RSV positive bronchiolitis beside supportive care in
      the form of adequate nutrition and oxygen therapy is available. Antiviral
      therapies such as Ribavirin has not been proved to be effective in RSV infection.
      Bronchodilators show variable results. Corticosteroids were not found effective.
      There is no effective vaccine available as yet. There is no proven method for
      active immunity. Various immunoglobulins are available for acquiring passive
      immunity against RSV infection. PREVENT study group in Jan. 1997 showed
      intravenous immunoglobulin (RSV- IGIV) use in reducing 41% to 63% hospitalisation
      in RSV patients. But RSV-IGIV was not licensed outside the United States because
      of risk of transmission of blood borne products, difficulty in administration ie.
      intravenous access, large fluid volume (15 ml/kg), high protein load (750 mg/kg),
      shortage of supply and need to postpone live vaccine (eg. MMR, varicella).
      monoclonal antibody Palivizumab was developed for prophylaxis against RSV
      infection. Clinical safety and efficacy of Palivizumab were demonstrated in
      IMpact trial published in Sept. 1998. Reduction in hospitalisation up to 55% was
      noted in this study. It was a pivotal randomised, double blind, placebo
      controlled phase 3 study conducted in 139 centres throughout Canada, United
      States and United Kingdom. We looked at our experience in patients admitted with
      bronchiolitis in Waterford Regional Hospital. We described the outcome of
      carefully selected Seven children of high risk group for Palivizumab prophylaxis.
      Its clinical Implications and cost effectiveness was evaluated in this study.

PMID- 11209918
TI  - Natriuretic peptides inhibit apoptosis and prolong the survival of serum-deprived
      PC12 cells.
AB  - Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were
      investigated to determine effects on apoptotic DNA fragmentation and survival in
      serum-deprived PC12 cells. Both peptides caused prolonged cGMP (but not cAMP)
      elevations lasting for > or = 6 h. The cGMP elevations were 10-, 50- and 68-fold
      for ANP and 26-, 100- and 148-fold for BNP at 1, 10 and 100 nM, respectively. BNP
      caused dose-dependent increases in cell survival rates during 3 days of serum
      deprivation. BNP (1 nM) increased 24 h survival rate from 36% to 67%. ANP (1 nM),
      BNP (1 nM) and 8-bromo-cGMP (0.1 mM) inhibited by 74.8%, 46.7% and 86.8%,
      respectively, the apoptotic DNA fragmentation in serum-deprived PC12 cells,
      measured by our recently developed quantitative technique using capillary
      electrophoresis with laser-induced fluorescence detector (CE-LIF). The data
      suggest prolonged cGMP elevations caused by ANP or BNP inhibit apoptotic DNA
      fragmentation and prolong the survival of serum-deprived PC12 cells.

PMID- 11209919
TI  - Disappearance of beta2-adrenergic receptors on astrocytes in canine distemper
      encephalitis: possible implications for the pathogenesis of multiple sclerosis.
AB  - It has been reported that astrocytes in the white matter of patients with
      multiple sclerosis (MS) lack beta2-adrenergic receptors. This abnormality might
      explain why astrocytes in active MS plaques aberrantly express major
      histocompatibility (MHC) class II molecules, which play an important role in the
      immunological cascade leading to myelin destruction. Canine distemper (CD) virus
      primarily infects astrocytes and causes a demyelinating disease in dogs that
      closely resembles MS. In control dogs, including three dogs with another
      inflammatory disease, beta2-adrenergic receptor immunoreactivity was observed on
      both neurons and astrocytes. In dogs with CD encephalitis, beta2-adrenergic
      receptors were present on neurons, but were absent on astrocytes in acute
      lesions, demyelinated lesions, and normal-appearing white matter. Similar to MS,
      several astrocytes in demyelinated lesions expressed MHC class II. These findings
      suggest that MS and the demyelinating stages of CD encephalitis have a common
      pathogenetic factor, and that the loss of astrocytic beta2-adrenergic receptors
      in MS might be induced by a viral infection of astrocytes.

PMID- 11209920
TI  - Judging semantic and episodic incongruity: a magnetoencephalographic study.
AB  - Evoked magnetic fields over the entire head were measured during a semantic
      judgment task, in which conditions of the pre-test learning session were
      manipulated. Subjects learnt related and unrelated category-noun pairs, and were
      then asked to judge the relationship between category and noun. Unrelated pairs
      evoked activation around 400 ms in the left temporal area. In addition, newly
      presented related pairs, of which the categories were used to learn unrelated
      pairs, also evoked similar activities. Our findings suggest that these activities
      are not only related to the semantic incongruity between a pair of words as in
      previous studies, but also to the episodic incongruity between the learning and
      measurement sessions.

PMID- 11209921
TI  - Beta-VLDL protects against A beta(1-42) and apoE toxicity in human SH-SY5Y
      neuroblastoma cells.
AB  - The toxic effects of beta-amyloid (A beta) (1-42), apolipoprotein E (apoE)
      isoforms, and apoE/A beta complexes were studied in human SH-SY5Y neuroblastoma
      cells and fibroblasts using MTT reduction. In SH-SY5Y cells, A beta(1-42) gave
      time-dependent toxicity over 2-48 h, which was reduced by co-incubation with
      rabbit beta-very low density lipoproteins (beta-VLDL). Human recombinant apoE3
      and E4 isoforms were also toxic by themselves and also potentiated A beta effects
      when used alone, but not when associated with beta-VLDL. None of the treatments
      were toxic to human fibroblasts. These results suggest that beta-VLDL has a
      protective role on A beta-induced neurotoxicity and that the status of apoE or
      the conformation of lipoprotein containing apoE particles may be important for
      determining the contribution of apoE to neurodegeneration.

PMID- 11209922
TI  - Neuromagnetic evidence for early access to cognitive representations.
AB  - How do physical and cognitive properties of stimulus words influence the
      neuromagnetic response of the human brain? Are the physiological correlates of
      these properties dissociable and at which latencies can they be observed? Short
      and long words, as well as rare and common words, were repeatedly presented in a
      memory task while neuromagnetic brain responses were recorded using MEG. Word
      length and frequency were reflected by brain responses at overlapping but
      distinct intervals. The influence of the physical factor, length, started at
      approximately 100 ms after onset of written words, immediately followed by a
      physiological manifestation of the non-physical cognitive stimulus property, word
      frequency, which was first apparent at 120-160 ms. There was a differential
      frequency effect: neurophysiological correlates of short words showed the
      frequency influence much earlier than did longer words. These data indicate that
      non-physical cognitive aspects of word stimuli can be reflected in early
      neuromagnetic responses, and that the latency of these physiological correlates
      of cognitive stimulus properties may depend on the physical stimulus make-up.

PMID- 11209923
TI  - Functional connections between the HVC and the shelf of the zebra finch revealed
      by real-time optical imaging technique.
AB  - Auditory-motor interaction is essential for the understanding of avian song
      learning and maintenance. The HVC is thought to be the most important station for
      auditory-motor integration in the avian song system. However, little is known
      about where and how auditory inputs are conveyed into the HVC. The shelf, a multi
      auditory recipient region located along the ventral border of the HVC, is thought
      to be a possible source of auditory inputs to the HVC. Here, we investigated the
      functional neural connections between the HVC and surrounding area of the HVC
      including the shelf in zebra finch brain slices, using the real-time optical
      recording technique. Unexpectedly electrical stimulation of the shelf region did
      not induce signal propagation into the HVC, but stimulation within the HVC
      propagated strong signals into the shelf. These results suggest that the shelf is
      the region that receives output signals from the HVC, rather than a major source
      of auditory inputs to the HVC.

PMID- 11209924
TI  - Event-related potentials and audiovisual stimuli: multimodal interactions.
AB  - In a discrimination task event-related potentials (ERPs) were recorded in human
      participants to simultaneously presented visual and auditory stimuli with
      relevant and irrelevant auditory and visual features. Stimuli consisted of
      combinations of a sine-wave tone (either target or non-target frequency) and a
      rectangle of particular (target or non-target) orientation. In two conditions
      either the auditory or the visual discrimination was easier. Stimuli with just
      one target feature elicited attention-related ERP components (selection
      negativity and N2b in the visual, and N2b in the auditory modality) only if that
      feature could be easily discriminated. This finding shows the hierarchical
      organization of attentional processing of auditory and visual features. Target
      stimuli in both conditions elicited visual and auditory attention-related
      components. This finding, together with the similarity of ERPs to stimuli without
      target features suggest, that these components cannot be considered as on-line
      correlates of elementary discrimination processes.

PMID- 11209925
TI  - Steroids differentially inhibit the nicotinic acetylcholine receptor.
AB  - The effect of various natural and synthetic steroids on the function of the
      nicotinic acetylcholine receptor (AChR) was studied at the single-channel level.
      AChR channel kinetics was affected by some substitutions in the
      cyclopentaneperhydrophenantrene ring. Functionally relevant substitutions
      shortened channel open state duration, an effect that varied for different
      steroids. The presence of a polar group at C11 contributed to the inhibitory
      potency of the steroid. Among mono-hydroxylated steroids such as 11- and 17-OH
      progesterone, the highest potency was displayed by the former showing a level
      similar to that of the reference compound, hydrocortisone. When the effects were
      analyzed in terms of the octanol-water partition coefficient, a linear
      relationship was unexpectedly found between the hydrophilicity of the steroids
      and their inhibitory potency.

PMID- 11209926
TI  - An actin-binding protein, CAP, is expressed in a subset of rat taste bud cells.
AB  - Single cell cDNA libraries were constructed from taste bud cells of rat
      circumvallate papillae. Using three steps of screening, including differential
      hybridization, sequence analyses and in situ hybridization, a clone encoding a
      rat homolog of yeast adenylyl cyclase-associated protein (CAP) was identified to
      be highly expressed in a subset of taste bud cells.

PMID- 11209927
TI  - Phonological aspects of word recognition as revealed by high-resolution spatio
      temporal brain mapping.
AB  - We describe, for the first time, the use of high-resolution event-related brain
      potentials (hrERP) to identify the spatio-temporal characteristics of neural
      systems involved in phonological analysis. Subjects studied a visual word/non
      word that was followed by the brief presentation of a prime letter (e.g. House,
      M) with the instruction to anticipate the word/non-word formed by replacing the
      word's first letter with the prime letter. After the prime letter, an auditory
      target word/non-word was presented that either matched/mismatched expectations
      (e.g., Mouse/Barn). ERPs were recorded to the onset of the auditory targets and
      scalp topographical maps were derived for the phonological mismatch negativity
      (PMN). The PMN reflected phonological analysis and examination of the peak
      topography revealed that the response was characterized by a prominent frontal,
      right-asymmetrical distribution. Spatial de-blurring (using current source
      density maps) indicated that the PMN scalp topography resulted primarily from an
      active left anterior source. The current results provide the initial evidence for
      the localization of the intra-cranial generator(s) involved in phonological
      analysis.

PMID- 11209928
TI  - Event-related potentials of recognizing happy and neutral faces.
AB  - In event-related potentials (ERPs) studies, recognition memory is associated with
      two positivities: one over parietal regions, and one over frontal regions. With
      nameable neutral stimuli, such as words or common objects, the parietal effect is
      usually left lateralized, and the frontal effect is usually right lateralized. We
      investigated the lateralization of these effects for nonnameable emotional
      stimuli: unfamiliar faces with happy and neutral expressions. The parietal effect
      was bilateral, suggesting that the left lateralization of this effect in studies
      using nameable stimuli reflected verbal processing. The frontal effect was left
      lateralized for happy faces, but right lateralized for neutral faces. This
      finding is consistent with the valence hypothesis, which posits that processing
      of pleasant emotions is lateralized to the left hemisphere.

PMID- 11209929
TI  - Magnetoencephalographic (MEG) localization of the auditory N400m: effects of
      stimulus duration.
AB  - The effects of stimulus duration on the elicitation and equivalent current dipole
      (ECD) localization of the auditory N400(m) were studied in two subject groups,
      either familiar or unfamiliar with Finnish language, using a sentence-processing
      paradigm with incongruent ending words of either short or long duration. Long
      duration words elicited a broad response at around 400 ms, the generator
      location(s) of which could not be reliably determined using ECD estimation. In
      contrast, short-duration words elicited a sharp, strong-amplitude response at
      about 400 ms latency and it's source location could be reliably determined as
      being in the vicinity of auditory cortex. Subjects unfamiliar with the Finnish
      language elicited no response at the 400 ms range. Thus, the use of short
      duration words appears to be an important prerequisite for the elicitation and
      localization of N400m. The differential amplitude behaviour of the N400m between
      the two subject groups further suggests that comprehension of the semantic
      content of the speech message is also required.

PMID- 11209931
TI  - Immunological identification of the mammalian H3 histamine receptor in the mouse
      brain.
AB  - Affinity-purified antibodies raised against the peptide sequence H3 (349-358)
      receptor specifically recognized two protein species with Mr 62,000 and 93,000 in
      adult mouse forebrain membranes. Both immunoreactive species were suppressed
      greatly by preincubation of the antibody with the respective peptide.
      Immunohistochemical analysis using affinity-purified anti-H3 (349-358) antibodies
      yielded a high degree of coincidence with ligand-autoradiographical information,
      with high levels detected in the CA3 and dentate gyrus of the hippocampus,
      laminae V of the cerebral cortex, the olfactory tubercle, Purkinje cell layer of
      the cerebellum, substantia nigra, globus pallidus, thalamus and striatum. This
      study suggests further biochemical evidence for multiple H3 receptor subtypes and
      the widespread distribution of the H3 receptor in the mammalian brain.

PMID- 11209930
TI  - Evidence for a modulatory role of Ih on the firing of a subgroup of midbrain
      dopamine neurons.
AB  - A previous investigation has suggested that the hyperpolarization-activated
      cation current Ih does not contribute to the spontaneous firing of midbrain
      dopaminergic neurons. This conclusion was reached using Cs(-1). We have re
      examined this question with extracellular recordings in slices using the more
      specific blocker ZD7288. In two-thirds of the cells, low concentrations of ZD7288
      induced a decrease of the spontaneous firing. The maximal inhibition was about
      40% and the mean IC50 was 1.6 microM. This effect was probably direct because it
      persisted in the presence of antagonists of various receptors. These
      concentrations of ZD7288 had no effect in the remaining one third of the examined
      cells. However, the highest concentration of ZD7288 (300 microM) abolished the
      firing of all dopaminergic neurons, probably by a mechanism unrelated to the
      blockade of Ih. We conclude that Ih controls to a certain extent the firing of a
      majority of midbrain dopaminergic neurons.

PMID- 11209932
TI  - Ibogaine alters synaptosomal and glial glutamate release and uptake.
AB  - Ibogaine has aroused expectations as a potentially innovative medication for drug
      addiction. It has been proposed that antagonism of the NMDA receptor by ibogaine
      may be one of the mechanisms underlying its antiaddictive properties; glutamate
      has also been implicated in ibogaine-induced neurotoxicity. We here report the
      effects of ibogaine on [3H]glutamate release and uptake in cortical and
      cerebellar synaptosomes, as well as in cortical astrocyte cultures, from mice and
      rats. Ibogaine (2-1000 microM) had no effects on glutamate uptake or release by
      rat synaptosomes. However, ibogaine (500-1000 microM) significantly inhibited the
      glutamate uptake and stimulated the release of glutamate by cortical (but not
      cerebellar) synaptosomes of mice. In addition, ibogaine (1000 microM) nearly
      abolished glutamate uptake by cortical astrocyte cultures from rats and mice. The
      data provide direct evidence of glutamate involvement in ibogaine-induced
      neurotoxicity.

PMID- 11209933
TI  - Preconditioning with spreading depression activates specifically protein kinase
      Cdelta.
AB  - Preconditioning with brief ischemia or spreading depression (SD) confers
      tolerance in cortical neurons to subsequent episode of ischemia. In myocardium a
      similar preconditioning is achieved by mechanisms, which are mediated by protein
      kinase C (PKC) alpha, delta, epsilon or zeta isoform. We induced SD by cortical
      application of KCl in the rat and analyzed cortical tissues after recovery of 30
      min, 4 h and 12 h. While no changes at protein levels or activity of PKCalpha,
      epsilon or zeta were detected, a considerable increase in membrane translocation
      of PKCdelta was seen at 30 min and 12 h. A significant increase at mRNA level,
      protein amount and autophosphorylation at 12 h confirmed the late activation of
      PKCdelta, which may be involved in neuronal protection by preconditioning.

PMID- 11209934
TI  - LIF is more potent than BDNF in promoting neurite outgrowth of mammalian auditory
      neurons in vitro.
AB  - Neurotrophic factors are known to play a crucial role in the elongation and
      guidance of auditory nerve fibres to their targets within the organ of Corti.
      Maintenance of these neural connections following deafness would clearly
      influence the efficacy of therapies for hearing recovery. The growth factors
      leukaemia inhibitory factor (LIF), brain-derived neurotrophic factor (BDNF) and
      transforming growth factor-beta 5 (TGF-beta5) were tested for their efficacy in
      promoting neurite outgrowth from dissociated cultures of early postnatal rat
      auditory neurons. Our results indicate that while BDNF enhances neurite outgrowth
      in a strong fashion, LIF is more potent; moreover, the combined administration of
      both factors has even greater neuritogenic capacities. TGF-beta5, although
      neurotrophic, has no neuritogenic activity on cultured auditory neurons. LIF and
      BDNF may therefore be potential candidates when developing pharmacological
      therapies for hearing recovery.

PMID- 11209935
TI  - Transport of endosomal early antigen 1 in the rat sciatic nerve and location in
      cultured neurons.
AB  - Early endosomal antigen 1 (EEA1) is known to be a marker of early endosomes and
      in cultured hippocampal neurons it preferentially localizes to the dendritic but
      not the axonal compartment. We show in cultured dorsal root ganglia and superior
      cervical ganglia neurons that EEA1 localizes to the cell bodies and the neurites
      of both sensory and sympathetic neurons. We then show in vivo using a ligated rat
      sciatic nerve that EEA1 significantly accumulates on the proximal side and not on
      the distal side of the ligation. This suggests that EEA1 is transported in the
      anterograde direction in axons either as part of the homeostatic process or to
      the nerve ligation site in response to nerve injury.

PMID- 11209936
TI  - Olfactory centres in Alzheimer's disease: olfactory bulb is involved in early
      Braak's stages.
AB  - In Alzheimer's disease (AD), neurofibrillary tangles spread from the entorhinal
      cortex to the limbic system, then to neocortical areas, according to the Braak's
      stages. Olfaction is impaired in early stages of AD. The aim of this study was to
      describe the pathology of the cortical olfactory centres in relation to Braak's
      stages determining the earliest site of pathology. We examined 15 control and 15
      AD cases. The primary olfactory cortices were involved in more advanced Braak's
      stages, while olfactory bulbs were damaged in very early (i.e. Braak's stage 0 or
      1) stages. These results are supporting the fact that olfaction might be an early
      marker in AD and argues against the hypothesis that AD pathology is spreading
      through the olfactory system.

PMID- 11209937
TI  - Complement anaphylatoxin C3a is selectively protective against NMDA-induced
      neuronal cell death.
AB  - The anaphylatoxin C3a is a potent inflammatory polypeptide released at sites of
      complement activation. To test whether C3a might alter neuronal outcome following
      an ischemic insult, we determined the effects of purified human C3a on murine
      primary cortical cell cultures exposed to apoptotic or excitotoxic paradigms. C3a
      prevented neither serum deprivation-induced apoptotic neuronal death, nor
      AMPA/kainate-mediated excitotoxicity. However, in mixed cultures of neurons and
      astrocytes, C3a dose-dependently protected neurons against NMDA toxicity (47%
      neuroprotection using 100 nM C3a, p < 0.01, n = 12). The neuroprotective effect
      of C3a was observable only in the presence of astrocytes. These observations
      suggest that C3a is involved in excitotoxicity-mediated neuronal death through
      astrocyte stimulation and extend its role beyond immune functions.

PMID- 11209938
TI  - The effects of propofol on NMDA- or nitric oxide-mediated neurotoxicity in vitro.
AB  - Acute brain ischemia causes neurotoxic cascades including NMDA receptors and NO.
      Propofol, an i.v. anesthetic, is thought to have a neuroprotective effect. We
      investigated the influence of propofol on NMDA/NO neurotoxicity using Shibuta's
      established model of primary brain cultures. Cortical neurons prepared from E16
      were used after 13-14 days in culture. The neurons were exposed to various
      concentrations of propofol with NMDA or NO-donor. The survival rates of neurons
      exposed to 30 microM NMDA with or without 300 microM propofol were 12.1 +/- 2.2%
      and 11.9 +/- 2.2%, respectively. The survival rates exposed to 30 microM NO-donor
      with or without 300 microM propofol were 11.2 +/- 4.2% and 14.0 +/- 3.9%,
      respectively. These results suggest that neuroprotective effect of propofol is
      limited and propofol does not offer advantages over thiopental against NMDA/NO
      induced cytotoxicity.

PMID- 11209939
TI  - Disrupted neural responses to phonological and orthographic processing in
      dyslexic children: an fMRI study.
AB  - Developmental dyslexia, characterized by difficulty in reading, has been
      associated with phonological and orthographic processing deficits. fMRI was
      performed on dyslexic and normal-reading children (8-12 years old) during
      phonological and orthographic tasks of rhyming and matching visually presented
      letter pairs. During letter rhyming, both normal and dyslexic reading children
      had activity in left frontal brain regions, whereas only normal-reading children
      had activity in left temporo-parietal cortex. During letter matching, normal
      reading children showed activity throughout extrastriate cortex, especially in
      occipito-parietal regions, whereas dyslexic children had little activity in
      extrastriate cortex during this task. These results indicate dyslexia may be
      characterized in childhood by disruptions in the neural bases of both
      phonological and orthographic processes important for reading.

PMID- 11209940
TI  - MRI of subacute hemorrhagic transformation in the rat suture occlusion model.
AB  - In this study we investigated the utility of different MRI techniques for the
      detection and predictability of hemorrhagic transformation (HT) in a rat model of
      transient focal cerebral ischemia. Hemorrhagic infarction was reliably identified
      with gradient-echo sequences and developed between 2 and 7 days following the
      insult. None of the investigated early MRI features of the ischemic lesions
      (including the apparent diffusion coefficient and post-reperfusion blood-brain
      barrier damage) was a good predictor of HT severity at 7 days. This indicates
      that subacute HT at 2-7 days occurs independently of the severity of acute tissue
      and BBB damage.

PMID- 11209941
TI  - Time estimation in schizophrenia: an fMRI study at adjusted levels of difficulty.
AB  - fMRI was performed in nine male schizophrenia patients and 15 healthy male
      controls during an auditory time estimation (timing), a frequency (i.e. pitch)
      discrimination task, and rest. An adaptive psychophysical approach, the weighted
      up-down method, was used to adjust individual performance to a level of 75%
      probability for correct answers. Although performing on the same level of
      individual difficulty, schizophrenia patients revealed less activations in
      prefrontal cortex and caudate nucleus, comparing time vs rest. Timing specific
      differences (i.e. timing vs pitch) between patients and controls were found in
      the posterior putamen, anterior thalamus, and right medial prefrontal cortex,
      with patients showing relative hypoactivity. Impairment in time estimation in
      schizophrenia might be mediated by specific fronto-thalamo-striatal dysfunction.

PMID- 11209943
TI  - Chromosomal mapping and organization of the human histamine H3 receptor gene.
AB  - The histamine H3 receptor (H3R) was recently cloned, and two isoforms, termed H3L
      and H3S, differing in the third intracytosolic loop, were isolated but the
      chromosomal mapping and organization of its gene remained unknown. PCR analysis
      of a human x rodent cell hybrid panel indicated that the H3R gene is located in
      the telomeric region of chromosome 20q. Alignment of human H3R cDNA sequences
      with DNA sequences of this chromosome revealed that its coding region comprises
      three exons interrupted by two introns located in the second transmembrane domain
      (TM2) and second intracytosolic loop, respectively. Thus the organization of the
      H3R gene indicates that the H3L and H3S isoforms, that we characterized not only
      in rodents but also in humans, are generated by retention and deletion,
      respectively, of a pseudo-intron located in the third intracytosolic loop.

PMID- 11209942
TI  - Intrathecal administration of PNA targeting galanin receptor reduces galanin
      mediated inhibitory effect in the rat spinal cord.
AB  - Peptide nucleic acids (PNA) are nucleic acid analogues containing neutral amide
      backbone, forming stable and tight complexes with complementary DNA/RNA. However,
      it is unclear whether unmodified PNA can efficiently penetrate neuronal tissue in
      order to act as antisense reagent. Here we show that intrathecal (i.t.) injection
      of an unmodified antisense PNA complementary to the rat galanin receptor type 1
      (GalR1) mRNA is able to block the inhibitory effect of i.t. administered galanin
      on spinal nociceptive transmission. Autoradiographic ligand binding studies using
      [125I]galanin show that the unmodified PNA is able to reduce the density of
      galanin binding sites in the dorsal horn. Thus, unmodified PNA applied i.t.
      appears to function as an effective antisense reagent in rat spinal cord in vivo.

PMID- 11209944
TI  - Satiety threshold during maintained cocaine self-administration in outbred mice.
AB  - Male Swiss Webster mice maintained cocaine self-administration in a regular and
      dose-dependent manner. These characteristics made it possible to apply the
      satiety threshold model of drug self-administration developed recently for
      cocaine self-administration in rats. Non-linear regression analysis revealed that
      cocaine satiety threshold was 1.3 +/- 0.6 mg/kg and the functional half-life of
      the cocaine was 8.1 +/- 2.2 min. Whether the self-administration of cocaine was
      maintained by lever presses or nose pokes did not influence the inter-injection
      intervals. The results are consistent with the pharmacological model of
      maintained cocaine self-administration. The ability to determine addiction
      relevant phenotypes (the satiety threshold and functional half-life of cocaine)
      in inbred strains of mice may help to identify the genetic determinants of
      cocaine self-administration behavior.

PMID- 11209945
TI  - Coordinated expression of Hoxa2, Hoxd1 and Pax6 in the developing diencephalon.
AB  - Coordinated expression of Hoxa2, Hoxd1 and Pax6 proteins were found to coincide
      with the three developmental stages of the diencephalon, as described for the
      mouse brain. In the first stage (embryonic day (E) 10-12) Hoxa2, Hoxd1 and Pax6
      (an early marker gene of the diencephalon) were expressed as early as E10.5 in
      prosomeres (p), p2 and p3. All three proteins continue to exhibit overlapping
      domains of expression at E12.5-13 (beginning of the second stage) when the
      primitive dense cell layer begins to differentiate into the internal germinal,
      external germinal and mantle layers. Towards the end of the second stage (E15),
      Pax6 expression was down-regulated whereas Hoxa2 and Hoxd1 continued to exhibit
      overlapping domains of expression for both protein and mRNA. Hoxd1 expression
      decreased significantly in the third stage of diencephalic development (E16
      postnatal) such that only Hoxa2 expression persisted in the diencephalon of
      newborn mice. The temporal and spatial expression of these three proteins imply
      that coordinated waves of Hoxa2, Hoxd1 and Pax6 expression may be required to
      provide positional information for the specification of the diencephalon.

PMID- 11209946
TI  - Neuroprotection from glutamate toxicity with ultra-low dose glutamate.
AB  - The protective effects of ultra-low doses (ULD) of glutamate against glutamate
      toxicity was studied in primary rat spinal, cortical and cerebellar neurons.
      Neurons were exposed to four subtoxic, ultra-low concentrations of glutamate (10(
      18) M, 10(-20)M, 10(-22) M and 10(-30) M) for 72 h and then subsequently
      challenged with toxic concentrations (25 microM) of glutamate. Neuron viability
      was consistently 10% higher in spinal and cortical neurons pre-exposed to
      glutamate concentrations of 10(-18) M and 10(-22) M, and in cerebellar neurons
      pre-exposed to 10(-20) M and 10(-30) M. Using laser scanning confocal microscopy
      and the fluorescent calcium probe fluo-3, we found no alterations in
      intracellular calcium dynamics in the protected cells. This protective effect is
      consistent with a growing body of evidence for tolerance induced by low-dose
      toxin exposure but is the first time that such tolerance has been demonstrated
      with ultra-low glutamate exposure. Our data show that pre-exposure of neuronal
      cells to ULD glutamate can protect against subsequent exposure to toxic levels of
      glutamate.

PMID- 11209948
TI  - Independent short-term variability of spike-like (600 Hz) and postsynaptic (N20)
      cerebral SEP components.
AB  - Human scalp-derived somatosensory evoked potentials (SEP) elicited by median
      nerve stimulation contain an early (20 ms latency) high-frequency (600 Hz)
      wavelet burst which is supposed to reflect non-invasively the timing of rapidly
      repeating population spikes in thalamocortical afferences and/or the receiving
      neocortical cell populations. This burst is superimposed onto the slower (< or =
      100 Hz) primary cortical response (N20) representing intracortically generated
      postsynaptic events. The present study addressed the temporal dynamics and
      correlation of these response components in awake human subjects and found that
      at a 3 min time scale the burst response was significantly more variable than the
      concomitant N20, and that the burst and N20 varied independently of each other.
      Thus, wavelet burst and N20 represent parallel and partly independent steps in
      sensory processing at cortical input stages in awake human subjects. We propose
      that the N20 represents a stable somatosensory input whereas the more fluctuating
      high-frequency burst could index variable modes of processing, such as a floating
      focus of attention.

PMID- 11209947
TI  - Evidence for glutamate receptor mediated transmission at mechanoreceptors in the
      skin.
AB  - The functional role of Merkel cells in the mechanosensitivity of the slowly
      adapting type I responses has been a controversial issue for many years. Here we
      show, for the first time, that glutamate receptor-mediated transmission is
      largely responsible for the static component of the slowly adapting type I
      response. An isolated sinus hair preparation was used to study the two types (I
      and II) of slowly adapting units. A broad spectrum ionotropic glutamate receptor
      antagonist kynurenate (1-10 mM) caused reliable and dose-dependent reductions in
      the static component of type I unit responses to mechanical stimulation. In
      addition, an amino acid transmitter candidate aspartate applied to the
      preparation selectively increased responses in type I units but not responses in
      type II units. This evidence establishes that the Merkel cell is a mechano
      electric transducer, and challenges prevailing views that the Merkel cell acts
      merely as a support or target cell in the epidermis.

PMID- 11209949
TI  - Partial lesions in the anterior forebrain pathway affect song production in adult
      Bengalese finches.
AB  - The avian song system consists of two main parts: the descending motor pathway
      and the anterior forebrain (AF) pathway. The former directly controls the motor
      act of singing, but the role of the AF pathway in real-time song production is
      not understood; lesioning a nucleus in the AF pathway in adult zebra finches did
      not cause any notable effects. Here we show that in a related species of
      songbirds, the Bengalese finch, a partial lesion located in Area X, a nucleus of
      the avian basal ganglia that is part of the AF pathway, causes a transient but
      substantial song motor deficit. This is the first demonstration that the AF
      pathway is involved in real-time song production in adulthood.

PMID- 11209950
TI  - Hippocampal, parahippocampal and occipital-temporal contributions to associative
      and item recognition memory: an fMRI study.
AB  - The temporal lobe regions involved in memory retrieval were examined using fMRI.
      During an associative recognition test, participants made memory judgments about
      the study color of previously presented drawings of objects, and during item
      recognition tests they made old/new judgments about previously studied objects or
      new objects. Associative recognition compared with old item recognition led to
      activations in bilateral hippocampal and parahippocampal regions, as well as in
      the left middle occipital gyrus. Old item recognition compared with new item
      recognition led to activation in the left middle occipital gyrus and the left
      middle temporal gyrus, and relative deactivations in bilateral hippocampal
      regions. The results indicate that partially distinct temporal lobe regions are
      involved during recognition memory for item and associative information.

PMID- 11209951
TI  - Disparity tuning in macaque area V4.
AB  - Neural processing of stereoscopic depth is conventionally associated with the
      dorsal (spatial) pathway in primate visual cortex. The role of depth information
      in the ventral (object) pathway has been less certain. We found prominent tuning
      for stereoscopic disparity in area V4, an intermediate stage in the ventral
      pathway. Eighty percent of the cells in our sample exhibited significant
      disparity tuning over the -1.0 degree to 1.0 degree range, and the majority
      showed > 2:1 response differences. Tuning function shapes were similar to those
      reported previously in other visual areas. We observed a significant tuning bias
      towards crossed (near) disparities. This could reflect an emphasis in the ventral
      pathway on foreground objects or parts of objects projecting towards the viewer.

PMID- 11209952
TI  - Musicians and the gamma band: a secret affair?
AB  - While listening to music, a significant high degree of phase synchrony in the
      gamma frequency range globally distributed over the brain was found in subjects
      with musical training (musicians) compared with subjects with no such training
      (non-musicians). No significant differences were found in other EEG frequency
      bands. Listening to neutral text did not produce any significant differences in
      the degree of synchronization between these two groups. For musicians, left
      hemispheric dominance was found during listening to music. The right hemisphere
      was found to be dominant for non-musicians in text listening. The high degree of
      synchronization in musicians could be due to their high ability to retrieve
      musical patterns from their acoustic memory, which is a cogent condition for both
      listening to and anticipating musical sounds.

PMID- 11209953
TI  - First evidence of a delay-dependent working memory-enhancing effect of modafinil
      in mice.
AB  - This study investigated the effects of pretest injection of modafinil on delayed
      spontaneous alternation rates (SA) used to evaluate working memory in C57 Bl/6
      mice. In a first experiment, systemic modafinil at 64 mg/kg, but not at 8 mg/kg
      or 32 mg/kg doses produced a significant increase of alternation scores
      (intertrial interval (ITI) 60s) when compared with controls. In a second
      experiment, modafinil (64 mg/kg) enhanced the alternation rates mainly at long
      (60 s and 180 s) but not at short (5 s) ITIs. Exploratory latencies and activity
      in a four hole-board apparatus were not modified by modafinil administration.
      These experiments are the first to demonstrate a delay-dependent working memory
      enhancing effect of modafinil.

PMID- 11209954
TI  - Differential prefrontal cortex and amygdala habituation to repeatedly presented
      emotional stimuli.
AB  - Repeated presentations of emotional facial expressions were used to assess
      habituation in the human brain using fMRI. Significant fMRI signal decrement was
      present in the left dorsolateral prefrontal and premotor cortex, and right
      amygdala. Within the left prefrontal cortex greater habituation to happy vs
      fearful stimuli was evident, suggesting devotion of sustained neural resources
      for processing of threat vs safety signals. In the amygdala, significantly
      greater habituation was observed on the right compared to the left. In contrast,
      the left amygdala was significantly more activated than the right to the contrast
      of fear vs happy. We speculate that the right amygdala is part of a dynamic
      emotional stimulus detection system, while the left is specialized for sustained
      stimulus evaluations.

PMID- 11209955
TI  - Unseen stimuli modulate conscious visual experience: evidence from inter
      hemispheric summation.
AB  - Emotional facial expression can be discriminated despite extensive lesions of
      striate cortex. Here we report differential performance with recognition of
      facial stimuli in the intact visual field depending on simultaneous presentation
      of congruent or incongruent stimuli in the blind field. Three experiments were
      based on inter-hemispheric summation. Redundant stimulation in the blind field
      led to shorter latencies for stimulus detection in the intact field. Recognition
      of the expression of a half-face expression in the intact field was faster when
      the other half of the face presented to the blind field had a congruent
      expression. Finally, responses to the expression of whole faces to the intact
      field were delayed for incongruent facial expressions presented in the blind
      field. These results indicate that the neuro-anatomical pathways (extra-striate
      cortical and sub-cortical) sustaining inter-hemispheric summation can operate in
      the absence of striate cortex.

PMID- 11209956
TI  - Expression of the high-affinity glutamate transporter EAAT4 in mammalian cerebral
      cortex.
AB  - RT-PCR, immunocytochemistry and Western blotting were used to study the
      expression of the glutamate transporter EAAT4 in the cerebral cortex of cat and
      mouse. By means of RT-PCR we were able to detect EAAT4 mRNA in the cerebral
      cortex of both species. Sequencing ensured the specificity of the amplified
      fragment. Immunocytochemistry and Western blotting enabled us to localize EAAT4
      protein in cat and mouse cerebral cortex. Intense EAAT4 immunoreactivity was
      found in the soma and dendrites of neurons mainly of layers II, III and V. For
      both species, the signal in the cerebellum was very intense and confined to the
      molecular and Purkinje cell layer.

PMID- 11209957
TI  - Long-term effects of short-lasting early local inflammatory insult.
AB  - We examined the long-term effects of a short-lasting (approximately 24 h)
      inflammatory insult generated by injections of 0.25% carrageenan (1 microl/g)
      into the hindpaws of newborn (P0) rat pups. At P60 animals which experienced this
      early inflammatory insult showed significant alterations in the withdrawal
      responses to noxious stimulation of the affected paws. Furthermore, in the
      absence of ongoing inflammation, the withdrawal latencies to heat stimulation and
      withdrawal thresholds to mechanical stimulation were increased by such
      experience. In the presence of ongoing CFA-induced inflammation, however, the
      same early experience decreased these parameters of response to noxious
      stimulation. These data suggest that early inflammatory insult may differentially
      affect the aspects of nociceptive circuitry involved in transient pain
      sensitivity and in inflammation-induced hyperalgesia.

PMID- 11209958
TI  - An fMRI study of stimulus equivalence.
AB  - In order to study brain activation during the formation of equivalence relations,
      12 subjects underwent fMRI during matching-to-sample (MTS) tests of (1)
      previously trained arbitrary relationships between iconic stimuli and the
      untrained, emergent relations of (2) symmetry, (3) transitivity, and (4) symmetry
      with transitivity, plus a test of verbal fluency (VF). Brain activation was
      similar in all MTS tasks and in the VF task. In particular, both types of task
      activated dorsolateral prefrontal cortex (DLPFC) and posterior parietal cortex
      bilaterally. However VF, but not the MTS tasks, activated Broca's area. In three
      of the four MTS tasks, behavioural accuracy was significantly correlated with
      left lateralisation of DLPFC activity. Brain activation patterns during
      equivalence thus resembled those involved in semantic processing underlying
      language, without involving regions concerned with the simple sub-vocal
      articulation of stimulus names.

PMID- 11209959
TI  - Definite segregation of cortical neurons projecting to the dorsal column nuclei
      in the rat.
AB  - The dorsal column nuclei (DCN) receive a substantial contingent of projections
      that arise from a number of somatosensory and motor cortical areas. We
      investigated the spatial organization of these projections in the rat by placing
      small deposits of two retrograde fluorescent tracers in adjacent foci within the
      DCN. Single-labeled neurons were abundant in layer V of the primary somatosensory
      (SI) and motor areas, and in the posterior parietal cortex. More sparse labeling
      was found in the medial agranular cortex (or MII), and the second somatosensory
      area. A somatotopic-like arrangement of these neurons was more clearly noticed in
      the granular zones of SI. Double-labeled neurons were very uncommon, and appeared
      at border regions where single-labeled cells intermingled. The segregation of
      these projections supports some differential modulatory effects that the cortex
      exerts on the somatosensory processing that takes place in the DCN.

PMID- 11209960
TI  - Antigens of monoclonal antibody NB3C4 are novel markers for oligodendrocytes.
AB  - We produced NB3C4, a novel monoclonal antibody specific for oligodendrocytes,
      using human neuroblastoma IMR-32 cells. NB3C4 specifically recognized
      oligodendrocytes in the CNS, although it bound to neuroblastoma IMR-32 cells and
      oligodendrocytes in vitro. Double immunofluorescence staining of rat brain using
      NB3C4 and anti-GST-pi, anti-glial fibrillary acidic protein (GFAP), or anti
      neurofilament 200 (NF) antibody revealed that anti-GST-pi antibody identified an
      oligodendrocyte marker recognizing NB3C4-positive cells, while both anti-GFAP and
      anti-NF antibody did not. Western blotting of rat brain homogenates showed that
      NB3C4 bound three proteins of 22-28 kDa, while the anti-GST-pi recognized a 27
      kDa protein. Therefore, antigens recognized by NB3C4 could be novel markers for
      oligodendrocytes.

PMID- 11209961
TI  - Mice over-expressing galanin have elevated heat nociceptive threshold.
AB  - The neuropeptide galanin may have a role in modulation of nociceptive input at
      spinal level. Here we report that mice over-expressing galanin exhibit
      significant elevation of nociceptive threshold to thermal stimulation in
      comparison to wild-type mice as assessed by the tail flick and paw heat
      irradiation tests. No change in response to mechanical or cold stimulation was
      seen. The elevated heat nociceptive threshold in the galanin over-expressing mice
      was reversed by intrathecal application of the putative galanin receptor
      antagonist M-35, galanin-(1-12)-pro-bradykinin-(2-9). The results thus support
      that galanin has an inhibitory function in rodent spinal cord.

PMID- 11209962
TI  - Sex-specific developmental changes in amygdala responses to affective faces.
AB  - It is hypothesized that adolescent development involves a redistribution of
      cerebral functions from lower subcortical structures to higher regions of the
      prefrontal cortex to provide greater self-control over emotional behavior. We
      further hypothesized that this redistribution is likely to be moderated by sex
      specific hormonal changes. To examine developmental sex differences in affective
      processing, 19 children and adolescents underwent fMRI while viewing photographs
      of faces expressing fear. Males and females differed in the pattern of their
      amygdala vs prefrontal activation during adolescent maturation. With age, females
      showed a progressive increase in prefrontal relative to amygdala activation in
      the left hemisphere, whereas males failed to show a significant age related
      difference. There appear to be sex differences in the functional maturation of
      affect-related prefrontal-amygdala circuits during adolescence.

PMID- 11209963
TI  - The suprachiasmatic nucleus projects to posterior hypothalamic arousal systems.
AB  - The suprachiasmatic nucleus (SCN) temporally organizes behavior in part by
      sustaining arousal during the wake period of the sleep/wake cycle to consolidate
      adaptive waking behavior. In this study, we demonstrate direct projections from
      the SCN, in both the rat and the human brains, to perikarya and proximal
      dendrites of two groups of posterior hypothalamic neurons with axonal projections
      that suggest they are important in the regulation of arousal, one producing
      hypocretins (HCT) and the other melanin-concentrating hormone (MCH). In addition,
      we demonstrate that both HCT and MCH-producing neurons are immunoreactive for
      glutamate (GLU). These observations support the hypothesis that direct
      projections from the SCN to the posterior hypothalamus mediate the arousal
      function of the circadian timing system.

PMID- 11209964
TI  - The future of fluoroquinolones.
AB  - The mutant prevention concentration (MPC) is a new measure of antibiotic potency
      above which a microbe must attain two concurrent resistance mutations for growth.
      For some C-8-methoxy fluoroquinolone-pathogen combinations, the value of MPC is
      below human serum drug concentration achieved with standard doses. Although
      untested clinically, such a low value of MPC, coupled with high serum
      concentration, should allow these fluoroquinolones to restrict severely the
      selection of resistant mutants when used as monotherapy. Compounds that cannot
      meet the MPC-pharmacokinetic criterion will enrich resistant mutants unless they
      are a part of combination therapy. Separation of fluoroquinolones into groups
      suitable for monotherapy or for combination therapy, followed by appropriate
      adminstration, may help extend the lifespan of the fluoroquinolones.

PMID- 11209965
TI  - Predictors of liver-related complications in patients with chronic hepatitis C.
AB  - Chronic hepatitis C is the leading cause of decompensated liver disease requiring
      liver transplantation and a major cause of hepatocellular carcinoma (HCC). In
      liver clinic series, about 20% of those chronically infected with hepatitis C
      virus (HCV) develop cirrhosis over 20 years. From epidemiological data, however,
      it is clear that certain subgroups of patients are more likely to develop liver
      related complications than others. Both host and viral factors have been
      implicated in individual susceptibility to adverse outcomes. The impact of host
      factors, such as alcoholism, is now well defined, and viral factors, such as
      genotype and viral load, appear to be less influential than previously
      considered. Coinfections with HIV, hepatitis A virus (HAV) and hepatitis B virus
      (HBV) may influence the rate of fibrotic progression and the subsequent
      development of complications in patients with chronic hepatitis C. The stage of
      fibrosis on biopsy and biochemical markers, such as a low serum albumin, can help
      identify patients who are more likely to develop complications. The role of the
      immune system in modifying the course of HCV is only now being defined. This
      editorial explores the role of host and viral factors in the development of liver
      related complications in HCV-infected individuals.

PMID- 11209966
TI  - Brain imaging and the effects of caffeine and nicotine.
AB  - Caffeine and nicotine are the most common psychostimulant drugs used worldwide.
      Structural neuroimaging findings associated with caffeine and nicotine
      consumption are limited and primarily reflect the putative relationship between
      smoking and white matter hyperintensities (WMH), a finding that warrants further
      appraisal of its clinical implications. The application of newer brain imaging
      modalities that measure subtle haemodynamic changes or tissue-based chemistry in
      order to better elucidate brain functional processes, including mechanisms
      underlying addiction to nicotine and caffeine and the brain functional
      consequences, provide intriguing findings. Potential influences of caffeine and
      nicotine on the functional contrast, or metabolic response, to neural activation
      also necessitates the careful appraisal of the effects that these commonly used
      drugs may have on the results of functional imaging.

PMID- 11209967
TI  - Immunopathogenesis of HTLV-I-associated myelopathy/tropical spastic paraparesis.
AB  - The main pathological feature of human T-lymphotropic virus type I (HTLV-I)
      associated myelopathy/tropical spastic paraparesis (HAM/TSP) is chronic
      inflammation of the spinal cord characterized by perivascular cuffing of
      mononuclear cells accompanied by parenchymal lymphocytic infiltration. Although
      the exact mechanism of the pathogenesis of HAM/TSP is still obscure,
      immunological abnormalities arising from a high HTLV-I proviral load in
      peripheral blood lymphocytes (PBL) play an important role in the pathological
      process of spinal cord lesions in HAM/TSP patients. The relationship between HLA
      haplotype and the risk of the occurrence of HAM/TSP will be elucidated by results
      from studies of HLA allele typing. In addition, recent data indicate that HTLV-I
      and its expression are localized in infiltrated lymphocytes within the spinal
      cord lesions of HAM/TSP patients rather than in resident central nervous system
      (CNS) parenchymal cells. Although a bystander damage of the surrounding CNS
      tissues, in which CD8+ HTLV-I-specific cytotoxic T lymphocyte (CTL) attack HTLV-I
      infected lymphocytes, might be involved in the pathological events of the spinal
      cords of HAM/ TSP patients as one of the actual pathogenetic mechanisms,
      heightened transmigrating activity of HTLV-I-infected CD4+ T lymphocytes to the
      CNS tissues may have a key role in the development of HAM/TSP. Therefore,
      although the exact mechanism underlying the high HTLV-I proviral load in PBL in
      HAM/TSP patients is still unknown, we must consider therapeutic approaches in
      HAM/TSP that eliminate HTLV-I-infected CD4+ T lymphocytes.

PMID- 11209968
TI  - The replacement of oestradiol and progesterone in very premature infants.
AB  - The idea of replacing 17beta-oestradiol (E2) and progesterone (P) in preterm
      infants is based on the observation that during pregnancy E2 and P plasma
      concentrations rise in the mother and the fetus by a factor of 100. Disruption of
      the placental supply of these hormones is a physiological event for an infant
      delivered at term. A preterm infant is deprived from this supply at an earlier
      developmental stage. In vitro and in vivo data are discussed, and they highlights
      the potential benefit of E2 and P on the development of different organ systems.
      The postnatal replacement of E2 and P has the aim of maintaining in utero plasma
      concentrations. In the first randomized clinical study in 30 extremely preterm
      infants, E2 and P were replaced postnatally for a total of 6 weeks. With a median
      intravenous replacement of 8.4 micromol/kg/day of E2 (4.2-22.9) and 67.4
      micromol/kg/day of P (35.7-87.0), plasma levels of E2 and P were maintained
      within the intrauterine reference values of 7.3-22.0 nmol/L and 0.95-1.9
      micromol/L, respectively. Three- to sixfold higher dosages were needed via the
      transepidermal route. Trends towards an improved postnatal bone mineral accretion
      and a reduced incidence of chronic lung disease were found. Further studies are
      warranted to clarify the potentially important role of E2 and P for the postnatal
      development of an extremely preterm infant.

PMID- 11209969
TI  - Autologous blood stem cell transplantation as therapy for autoimmune diseases.
AB  - Autologous stem cell transplantation (ASCT) is starting to be investigated as a
      potential therapy for severe refractory autoimmune disease including
      rheumatological, neurological and haematological diagnoses. Increasing numbers of
      cases are now reported in the literature. Data from all transplanted patients are
      being collated in a centralized register by the European Group for Blood and
      Marrow Transplantation (EBMT) and the European League against Rheumatism (EULAR)
      to enable effective evaluation of the safety and efficacy of this promising
      technique. Thus far, results have been encouraging; however, more treatment
      related deaths were reported in multiorgan diseases such as scleroderma and less
      in diseases such as rheumatoid arthritis, which confirms the importance of
      careful patient selection. Optimization of mobilization, conditioning regimen and
      graft manipulation is required to maximize efficacy without increasing mortality
      and morbidity. The use of maintenance therapy after ASCT in order to prevent
      relapse needs to be explored. Following individual case reports and small cohort
      studies, the next step is likely to involve multicentre randomized controlled
      trials.

PMID- 11209970
TI  - Intracoronary radiotherapy for prevention of restenosis after percutaneous
      coronary interventions.
AB  - More than 50 different pharmacological and mechanical interventions have been
      tested to date for prevention of vascular restenosis without success.
      Intracoronary radiotherapy is the first one showing promise of significantly
      attenuating neointimal proliferation, causing positive vascular remodelling and
      thus inhibiting restenosis. This promising modality has moved from animal
      experiments via safety and feasibility testing into the phase of clinical trials
      of efficacy in large numbers of patients. While ongoing research continues to
      search for new sources and delivery techniques, currently available technology is
      being optimized. The randomized clinical trials conducted to date have shown
      consistently a reduction of target site restenosis rates by 55-79%. Lower
      incidence of major adverse cardiac events after radiotherapy has also been
      demonstrated, primarily as a result of reduction in target site and target vessel
      revascularization rates. However, experimental and clinical research has
      identified two major complications of this approach: stenosis at the ends of the
      radiation zone ('edge effect' or 'candywrapper') as well as late thrombosis
      (beyond 30 days after intervention) of the angioplasty or stent site. If these
      two adverse effects can be minimized, intracoronary radiotherapy may prove to be
      a major breakthrough in percutaneous coronary interventions.

PMID- 11209971
TI  - The GlucoWatch biographer: a frequent automatic and noninvasive glucose monitor.
AB  - The GlucoWatch (Cygnus, Inc, Redwood City, CA, USA) biographer provides
      automatic, frequent and noninvasive blood glucose measurements for up to 12 h.
      The device extracts glucose through intact skin where it is measured by an
      amperometric biosensor. Clinical trials in a variety of environments have shown
      that the biographer provides accurate and precise glucose measurements when
      compared with serial fingerstick blood glucose measurements. Mean difference
      between these measurements was 0.26 mmol/L in the home environment (r = 0.80).
      Over 94% of biographer readings were in the clinically acceptable A+B region of
      the Clarke Error Grid. A slight positive bias is observed for the biographer
      readings at low glucose levels. Biographer precision, as measured by coefficient
      of variation (CV)%, is approximately 10%. The low glucose alert function of the
      biographer was able to detect up to 75% of hypoglycaemic episodes with a low
      false alert level. Skin irritation, characterized by erythema and oedema was
      either nonexistent or mild in over 87% of subjects and resolved in virtually all
      subjects without treatment in several days. The GlucoWatch biographer has been
      shown to be a safe and effective method to track glucose level trends and
      patterns, which should enable improved glycaemic control for many patients.

PMID- 11209972
TI  - High-density lipoprotein: gene-based approaches to the prevention of
      atherosclerosis.
AB  - Although the atheroprotective role of high-density lipoprotein (HDL) has been
      well documented in epidemiological and animal studies, highly effective
      therapeutic approaches for the selective increase of plasma HDL levels or
      function are not yet available. Several mechanisms by which HDL exerts an
      atheroprotective effect have been proposed on the basis of experiments in vitro
      and in vivo. These mechanisms include directing excess cellular cholesterol from
      the peripheral tissues to the liver in 'reverse cholesterol transport',
      inhibiting oxidative modification or aggregation of LDL, and modulating
      inflammatory responses to favour vasoprotection. This review gives an overview of
      the genes regulating these mechanisms, such as those encoding apolipoprotein AI,
      lecithin:cholesterol acyltransferase (LCAT), scavenger receptor B1 (SR-BI), and
      the ATP-binding cassette transporter 1 (ABC1), and the potential to exploit them
      to develop gene-based therapeutic approaches to increase the level or function of
      HDL.

PMID- 11209973
TI  - Association of CagA-positive infection with Helicobacter pylori antibodies of IgA
      class.
AB  - cagA gene, the best known virulence factor of Helicobacter pylori, codes for an
      immunodominant CagA protein. In this study, CagA antibodies of the IgG class were
      measured by immunoblot or enzyme immunoassay in subjects with positive H. pylori
      serology, and the presence of CagA antibodies was compared with that of H. pylori
      antibodies of IgA and IgG classes. Serum samples were available for a total of
      1,481 subjects, including gastroscopied patients with biopsy-verified H. pylori
      infection, smoking men with a normal or low serum pepsinogen I level indicating
      atrophic corpus gastritis, and subjects who later developed gastric cancer and
      their matched controls. CagA antibodies were significantly more prevalent among
      individuals with elevated H. pylori antibody titres of the IgA class than in
      those with IgG antibodies only, with the exception of a small subgroup of
      individuals who later developed gastric cancer. CagA-positive H. pylori strains
      seem to induce an immune response with a markedly higher frequency of IgA than
      what is found in inflammation caused by CagA-negative strains. The presence of
      serum IgA antibodies to H. pylori seems to indicate a higher risk for CagA
      positive H. pylori infection and possibly more severe late sequelae of the
      disease.

PMID- 11209974
TI  - Genetics of platelet receptor single-nucleotide polymorphisms: clinical
      implications in thrombosis.
AB  - Several single-nucleotide polymorphisms (SNPs) of platelet receptors have been
      implicated to be associated with an increased risk of arterial thrombosis; this
      review focuses on the mechanisms and the clinical significance of two specific
      single-nucleotide polymorphisms, ie the GP IIIa L33P (=PlA1/2) and the GP Ia 807
      C/T. Whereas the mechanism of P1A2 is thought to result from 'gain of receptor
      function' (and there is still considerable controversy on this subject), the
      collagen receptor SNP is associated with an increased number of receptors on the
      platelet surface, thus offering a plausible explanation for the observed
      increased interaction with collagen and the increased risk of thrombotic events
      reported in some studies but not in others. Overall, the presently available
      (controversial) data do still not allow the conclusion that the GPIIIa
      polymorphism alone represents a cardiovascular risk factor in the general
      population. A number of mechanisms and a series of studies suggest, however, that
      it may be a risk factor in certain subgroups of patients or in a number of
      clinical situations. The GPIa SNP discussed seems to be a mild risk factor that
      is particularly important in synergism with known risk factors, such as smoking,
      hypertension, diabetes or proteinuria, etc, which may enhance its contribution to
      the overall cardiovascular risk.

PMID- 11209975
TI  - Platelet activation by ADP: the role of ADP antagonists.
AB  - ADP plays a key role in haemostasis and thrombosis. Despite its early
      identification in 1961 as the first known aggregating agent, the molecular basis
      of ADP-induced platelet activation is only beginning to be understood. Two
      purinergic receptors contribute separately to the complex process of ADP-induced
      platelet aggregation: the P2Y1 metabotropic receptor responsible for mobilization
      of ionized calcium from internal stores, which initiates aggregation, and P2Y
      receptor coupled to adenylyl cyclase inhibition, which is essential for the full
      aggregation response to ADP and stabilization of platelet aggregates. The latter
      is the molecular target of the ADP-selective antiaggregating drugs ticlopidine
      and clopidogrel and the ATP analogues of the AR-C series. In addition, it is
      probably defective in patients with a bleeding diathesis characterized by
      selective impairment of platelet responses to ADP. Finally, the P2X1 ionotropic
      receptor is also present in platelets, but its role is not yet known. Studies
      with P2Y1 knock-out mice as well as the use of selective P2Y1 antagonists have
      shown that, in addition to the P2Y receptor, which is the target of clopidogrel,
      the P2Y1 receptor is an important potential target for new antithrombotic drugs.

PMID- 11209976
TI  - Role of von Willebrand factor in platelet thrombus formation.
AB  - Haemostasis is the process that arrests bleeding from wounds, preventing blood
      from flowing outside of the vascular bed. Thrombosis is an abnormal condition in
      which the vascular lumen becomes occluded by a mass constituted primarily of
      aggregated platelets and polymerized fibrin. These thrombi impede the normal flow
      of circulating blood, becoming the acute cause of diseases that represent a great
      health concern in the developed world. Haemostasis and thrombosis are two aspects
      of the same function, ie the biological response to vascular injury leading to
      formation of a thrombus, which is platelet-rich specifically in the arteries. In
      either situation, von Willebrand factor is a crucial participant in the process
      as its main biological activity is to support platelet adhesion and aggregation
      in vessels where rapid blood flow challenges the firm attachment of thrombi to
      the vascular wall or exposed extravascular tissues. Advances in understanding the
      structure and function of von Willebrand factor indicate that this protein, for
      its unique biomechanical properties, may be a potentially useful target of
      antithrombotic drugs.

PMID- 11209977
TI  - Cyclo-oxygenase products and atherothrombosis.
AB  - The advent of selective inhibitors of the cyclo-oxygenase (COX)-2 enzyme has
      afforded the opportunity to reduce the incidence of gastrointestinal
      complications of traditional nonsteroidal anti-inflammatory drugs (NSAIDs). The
      widespread use of these drugs has increased interest in their role in the
      cardiovascular system. Although deletion of the prostacyclin receptor (the IP)
      accelerates atherogenesis in the mouse, retention of one copy of the IP is
      atheroprotective. This is consistent with the failure of biochemically defined,
      selective doses of a COX-2 inhibitor to accelerate atherogenesis in the mouse,
      despite suppressing prostacyclin biosynthesis by roughly 60%. Inhibition of both
      COX isozymes, by contrast, markedly retards atherogenesis. Consistent with these
      observations, antagonism of the thromboxane receptor (the TP) retards
      atherogenesis and diminishes the proliferative response to vascular injury in the
      mouse. Even partial suppression of prostacyclin (without coincident inhibition of
      platelet COX-1-dependent thromboxane formation) by COX-2 inhibitors may be
      undesirable in acute vascular occlusive syndromes. However, these drugs are
      unlikely to accelerate progression of the underlying vascular disease. By
      contrast, the effects of TP antagonists, aspirin, and even traditional NSAIDs on
      atherosclerotic plaque progression merit further evaluation in humans.

PMID- 11209978
TI  - Antiphospholipid antibodies in arterial thrombosis.
AB  - The high correlation between the IgG isotype of anticardiolipin antibodies (aCLs)
      and clinical thrombosis was first documented in 1983, and this observation was
      confirmed in subsequent studies. In addition, the frequency of fetal loss and
      thrombocytopenia was increased in this group of patients. These findings were
      termed the antiphospholipid syndrome (APS). This syndrome was mostly seen in
      patients with systemic lupus erythematosus (SLE), but it soon became clear that
      also other patients not suffering from defined SLE might exhibit features of APS.
      aCL in APS patients are detected in immunoassays by using solid phase cardiolipin
      as a putative antigen. However, antibodies directed against phospholipid-binding
      plasma or serum proteins, beta2-glycoprotein I (beta2-GPI), in particular, are
      also detected. Many recent studies have indicated that one of predominant
      antibodies that has been identified as aCL in APS patients is against beta2-GPI
      rather than any of the negatively charged phospholipids. The epitopes recognized
      by anti-beta2-GPI antibodies raised in APS patients are composed of discontinuous
      amino acid sequences from the IV domain of human beta2-GPI. These epitopes are
      cryptic when beta2-GPI does not interact with anionic phospholipids. An early
      event in atherosclerosis is the accumulation of cholesterol-laden foam cells,
      which originate mainly from monocyte-macrophage cells by their uptake of
      chemically modified low-density lipoprotein (LDL). We found that beta2-GPI binds
      directly to oxLDL, and that the complex of oxLDL and beta2-GPI is subsequently
      recognized by aCL (anti-beta2-GPI) to be taken up by macrophages. While the
      pathogenesis of this accelerated atherosclerosis is likely to be multifactorial,
      it is possible that antiphospholipid antibodies, including aCL (anti-beta2-GPI
      antibodies), may have contributed to the formation of atherosclerotic lesion.

PMID- 11209980
TI  - Autoantibodies associated with atherosclerosis.
AB  - Atherosclerosis is a multifactorial pathological process. In recent years, the
      immune factors associated with its initiation and progression have been
      investigated intensively. Several autoantigens and their respective
      autoantibodies have been suggested as factors in atherogenesis. This manuscript
      provides a review of autoantibodies directed towards oxidized low-density
      lipoprotein (oxLDL), cardiolipin, beta2-glycoprotein-I and heat-shock protein
      60/65, and their association with human and murine atherosclerosis.

PMID- 11209979
TI  - Lupus anticoagulant in cardiovascular diseases: the role of beta2-glycoprotein I.
AB  - The presence of antiphospholipid antibodies (aPL) in plasma is an important risk
      factor for the development of thrombosis. A major breakthrough came in 1990 with
      the finding that aPL do not react with phospholipids per se, but are directed
      towards beta2-glycoprotein I, a plasma protein with affinity for anionic
      phospholipids. Afterwards other plasma proteins with affinity for phospholipids
      have been identified as possible antigens for aPL. Human beta2-glycoprotein I is
      a heavily glycosylated plasma protein that has been implicated in the binding of
      aPL to negatively charged phospholipids. We recently solved the crystal structure
      of beta2-glycoprotein I. In this review we will discuss what the 3-dimensional
      structure teaches us about the role of beta2-glycoprotein I in the pathogenesis
      of the thrombotic complications characteristic of the antiphospholipid syndrome.

PMID- 11209981
TI  - Treatment of thrombosis associated with immunological risk factors.
AB  - The clinical management of the antiphospholipid syndrome is aimed at assessing
      the thrombotic risk of an individual in order to undertake primary prevention for
      the asymptomatic subject positive for antiphospholipid antibodies or prophylaxis
      of major ischaemic events for the patient who has already experienced thrombosis.
      Lack of immunological parameters with a clear predictive value and the current
      concept that thrombosis is a multifactorial disease suggest that all the known
      acquired and genetic thrombotic risk factors should be taken into account in
      antiphospholipid syndrome. Low-dose aspirin and hydroxychloroquine have been
      proven useful in primary prevention. While convincing evidence has been provided
      that aspirin and hydroxychloroquine do not prevent secondary thrombosis, much
      debate has recently developed on the level of oral anticoagulation needed to
      guarantee this prevention. Main concerns are also related to duration of
      anticoagulation therapy, risk of bleeding, and the increased risk of thrombosis
      as a result of withdrawal of the anticoagulant. Low-molecular-weight heparin has
      recently emerged as a valid and safe alternative for those conditions that
      require transient interruption or withdrawal of anticoagulation. Although
      treatment of the catastrophic antiphospholipid syndrome is largely empirical, the
      therapeutic approach based on plasmapheresis associated with immunosupression or
      intravenous immunoglobulin seems to be the most promising. Most attention has
      recently been paid to the role of oxidative stress in the pathogenesis of
      antiphospholipid syndrome, as a correlation between lipid peroxidation and
      antiphospholipid antibodies has been demonstrated. Our studies showed that lipid
      peroxidation may contribute to the activation of the clotting system observed in
      antiphospholipid syndrome and that markers of both procoagulant state and
      increased lipid peroxidation can be modified by experimental antioxidant
      treatment.

PMID- 11209982
TI  - Hyperhomocysteinaemia and atherothrombosis.
AB  - Homocysteine (Hcy) is a sulfhydryl amino acid derived from the metabolic
      conversion of methionine that is dependent on vitamins (folic acid, B12 and B6)
      as cofactors or cosubstrates. In 1969, McCully first reported the presence of
      severe atherosclerotic lesions in patients with severe hyperhomocysteinaemia and
      hypothesized the existence of a pathogenic link between hyperhomocysteinaemia and
      atherogenesis. Several case-control and cross-sectional studies confirmed the
      initial hypothesis of McCully, showing that also moderate hyperhomocysteinaemia
      is associated with a heightened risk of occlusive arterial disease. Less
      consistent results have been reported by prospective cohort studies of subjects
      who were healthy at the time of their enrollment, whereas prospective cohort
      studies of patients with overt coronary artery disease or other risk conditions
      consistently confirmed the association between moderate hyperhomocysteinaemia and
      the risk of cardiovascular morbidity and mortality. More recently, an association
      between moderate hyperhomocysteinaemia and heightened risk of venous
      thromboembolism has been documented, suggesting that hyperhomocysteinaemia might
      be involved not only in atherogenesis, but also in thrombogenesis. The mechanisms
      by which hyperhomocysteinaemia might contribute to atherogenesis and
      thrombogenesis are incompletely understood. The mainstay of treatment of
      hyperhomocysteinaemia is folic acid, alone or in combination with vitamins B12
      and B6. Although it is quite clear that vitamins effectively reduce the plasma
      levels of total Hcy, we do not yet know whether they will decrease the risk of
      vascular disease. The results of ongoing randomized, placebo-controlled, double
      blinded trials on the effects of vitamins on thrombotic risk will help in
      defining whether the relationship between hyperhomocysteinaemia and thrombosis is
      causal, and will potentially have a dramatic impact on the prevention of
      thromboembolic events.

PMID- 11209983
TI  - Acute and prolonged treatment with low-molecular-weight heparin therapy in
      patients with unstable coronary artery disease.
AB  - Unstable angina and non-ST-segment elevation myocardial infarction (MI) are known
      as unstable coronary artery disease (UCAD). They are syndromes that share a
      common pathobiology and represent a frequently encountered and potentially life
      threatening medical condition. Acute-phase treatment with aspirin is associated
      with a significant reduction in death and non-fatal MI in patients with UCAD.
      This benefit is enhanced by the addition of unfractionated heparin (UFH) to the
      treatment strategy; however, UFH requires careful monitoring and titration. In
      contrast, low-molecular-weight heparins (LMWHs), produced by chemical or
      enzymatic depolymerization of UFH, yield a predictable and consistent
      pharmacokinetic profile and anticoagulant response making them an attractive
      alternative treatment to UFH in patients with UCAD. In several studies, acute
      phase treatment with LMWH has been shown to be at least as effective and safe as
      UFH. The optimal duration of treatment with LMWH is an important question that
      has been influenced by the observation that reactivation of coagulation occurs
      following the early and abrupt discontinuation of heparin treatment. In early
      trials, such as FRISC (Fragmin during instability in coronary artery disease) and
      FRIC (Fragmin in unstable coronary artery disease), the results of extended
      treatment were inconclusive; however, the trial populations included patients of
      relatively low risk and used a once-daily dosing regimen. In the TIMI 11B
      (Thrombolysis in myocardial infarction) extended treatment beyond the few days of
      acute treatment with enoxaparin did not add to the beneficial LMWH effect, but in
      this study 40% of the high-risk patients did not continue on extended treatment.
      The findings derived from the FRISC II trial, which used a twice-daily dose of
      dalteparin sodium, suggest a benefit for up to 45 days with extended treatment in
      high-risk UCAD patients. Although an early invasive treatment strategy is
      particularly beneficial, patients in whom early revascularization is not possible
      should be considered for extended treatment with dalteparin sodium awaiting
      percutaneous coronary intervention.

PMID- 11209984
TI  - Heparin-induced thrombocytopenia: laboratory diagnosis and management.
AB  - Heparin-induced thrombocytopenia (HIT), a drug-induced immunohaematological
      adverse reaction, is a rare but potentially very severe condition. The main
      problem for this complex syndrome is its recognition and management, which should
      be as early as possible to avoid the development of life-threatening
      complications. Most studies have reported heterogeneous populations of patients
      with other diseases that potentially induce thrombocytopenia. There is no gold
      standard diagnostic criteria, and we have established a score with anamnestic
      criteria that allows us to evaluate the likelihood of HIT. In clinical practice,
      the diagnosis is based on the analysis of clinical features and laboratory tests.
      Platelet aggregation test (PAT) and an ELISA test (heparin platelet-induced
      antibodies) are generally performed by expert laboratories to confirm the
      occurrence of HIT. In our experience, both tests are concordant in the majority
      of patients. PAT seems to correlate better with the clinical features while ELISA
      appears more specific. Regarding their limits, both are complementary in the
      determination of HIT diagnosis coupled to the clinical score system. The
      treatment often requires a multidisciplinary approach. Danaparoid (Orgaran) or
      lepirudin (Refludan) are the two alternative treatments for HIT patients with
      marketing approval. To avoid further exposure to heparin, every HIT patient
      should carry a written document that confirms the immunoallergy.

PMID- 11209985
TI  - Future possibilities in the regulation of the extrinsic pathway: rFVIIa and TFPI.
AB  - Following vessel wall injury, tissue factor (TF) is being exposed and forms
      complexes with the already activated FVII (FVIIa) present in the circulating
      blood, providing a limited amount of thrombin molecules that activate a number of
      coagulation proteins as well as the platelets. As a result of activation with
      thrombin the platelet surface exposes negatively charged phospholipids to which
      activated coagulation proteins bind tightly, and full thrombin generation occurs,
      resulting in the conversion of fibrinogen into fibrin. After the first FXa is
      formed, the tissue factor pathway inhibitor (TFPI) forms a complex with FXa. In
      the next step a quaternary complex is being formed, TF/FVIIa/FXa/TFPI, which
      inhibits the first step of the haemostatic pathway. Recombinant FVIIa (rFVIIa)
      has been developed for use as a haemostatic agent (NovoNordisk A/S, Denmark).
      Inactivated rFVIIa (rFVIIai) has also been prepared, and it has similar binding
      capacity to TF as rFVIIa but it blocks the catalytic activity of the TF complex.
      In various animal models rFVIIai has been demonstrated to prevent or diminish
      immediate thrombus formation at the site of vessel wall injury (athroplasty or
      other forms of mechanical injury) as well as the development of long-term intima
      thickening. Also, topical application of rFVIIai was found to block the formation
      of a thrombus. rFVIIai was shown to have an anti-inflammatory effect in
      lipopolysaccharide (LPS)-induced sepsis, and postischaemic reperfusion injury was
      found to be reduced by the administration of rFVIIai. In a limited number of
      patients undergoing percutaneous transluminal coronary angioplasty (PTCA),
      rFVIIai was observed to allow PTCA to be performed at lower doses of heparin than
      what has been reported previously. Recombinant TFPI has been shown to attenuate
      the lethal inflammatory and coagulopathic response. Furthermore, topical
      application of rFVIIai has been found to increase the patency rate in a model of
      graft surgery.

PMID- 11209986
TI  - Thrombomodulin: a linker of coagulation and fibrinolysis and predictor of risk of
      arterial thrombosis.
AB  - Thrombomodulin (TM) binds thrombin, changes thrombin conformation and allows
      thrombin to activate protein C and thrombin-activatable fibrinolysis inhibitor
      (TAFI). Activated protein C and TAFI inhibit coagulation and fibrinolysis,
      respectively. TM is, thus, a linker of endogenous control of coagulation and
      fibrinolysis. Plasma soluble TM, cleaved products of cellular TM, also have
      anticoagulant and antifibrinolytic properties. TM plays an important role in
      thromboresistance. Prospective studies show that a high plasma TM level is
      associated with a low risk of developing coronary heart disease. The plasma TM
      level may reflect the level of endothelial TM expression. TM expression levels
      are influenced by multiple gene polymorphisms. Several of the polymorphisms are
      probably associated with coronary heart disease.

PMID- 11209987
TI  - Hypofibrinolysis and increased PAI-1 are linked to atherothrombosis via insulin
      resistance and obesity.
AB  - Plasminogen activator inhibitor 1 (PAI-1) is the primary physiological inhibitor
      of plasminogen activation in vivo. Circulating PAI-1 levels are elevated in
      patients with coronary heart disease and may play an important role in the
      development of atherothrombosis by decreasing fibrin degradation. Increased PAI-1
      expression can also directly influence vessel wall remodelling. Prospective
      cohort studies have underlined the association between increased plasma PAI-1
      levels and the risk of coronary events, but the predictive capacity of PAI-1
      disappeared after adjustments for insulin resistance markers. The insulin
      resistance syndrome, which is characterized partly by obesity with visceral fat
      accumulation, is considered as a major regulator of PAI-1 expression. Recently,
      production of PAI-1 by adipose tissue, in particular by fat from omentum, has
      been evidenced, and it has been proposed that it could be responsible for the
      elevated plasma PAI-1 level observed in insulin resistance. The role of stroma
      cells, tumour necrosis factor (TNF)-alpha and transforming growth factor (TGF)
      beta as possible enhancers of PAI-1 synthesis are presently emphasized.
      Glucocorticoids and insulin may also be implicated. Moreover, a weak genetic
      control of plasma PAI-1 concentration has been described in patients with high
      plasma levels of PAI-1. The role of PAI-1 in the development of adipose tissue
      metabolism is important to consider as PAI-1 -/- mice submitted to a high-fat
      diet showed changes in cell composition of adipose tissue and in plasma insulin
      and triglyceride levels.

PMID- 11209988
TI  - Fibrinolytic factors and atherothrombotic events: epidemiological evidence.
AB  - The fibrinolytic system is important in thrombus resolution at the site of
      atherosclerotic plaque rupture. The usual levels of plasma fibrinolytic factors
      have been hypothesized to be important in predicting atherothrombotic events. In
      this report, prospective clinical, prospective epidemiological, and genetic
      epidemiological studies of fibrinolytic factors and incident cardiovascular
      disease are reviewed. Many prospective studies have reported an unadjusted
      positive association between plasma fibrinolytic markers (eg, tissue plasminogen
      activator antigen or plasminogen activator inhibitor antigen) and risk of
      cardiovascular disease. The association tends to be strong and demonstrate a dose
      response, but often becomes statistically nonsignificant after adjustment for
      other risk factors. About half of the genetic epidemiological studies suggest
      that a polymorphism of a gene coding for fibrinolysis may be associated with
      cardiovascular disease, but that the relative risk is modest, at best. Thus,
      epidemiological evidence to date is inconclusive about whether impaired
      fibrinolysis may be a 'cause' of atherothrombotic events. In fact, alterations of
      plasma fibrinolytic factors might be a 'consequence' of atherosclerosis. At
      present, it seems premature to recommend routine measurement of fibrinolytic
      factors to identify patients at risk of cardiovascular disease events. Some
      directions for future research on this topic are offered.

PMID- 11209989
TI  - St. John's Wort.
AB  - OBJECTIVE: The objective of this article is to review the current knowledge of
      the pharmacology, sites of action, and therapeutic effectiveness of St. John's
      Wort. METHOD: The method used was a review of the available literature, using
      keywords to search the medline database. Bibliographies of the papers, thus
      obtained, were searched for further documents not referenced by medline. We
      reviewed papers from this collection. RESULTS: This review reveals that most of
      the available data on efficacy and safety of St. John's Wort involve its use in
      mild to moderate depression. Much, but not all of the prevailing opinion is
      positive. Nevertheless, the quality of therapeutic trials vary so greatly that
      definitive conclusions are not possible. Both the source and mode of St. John's
      Wort's therapeutic effect are unclear. We need further controlled studies of
      effectiveness, safety, and mode of action. In addition to its use in depression,
      there are reports suggesting possible therapeutic effects in other conditions
      such as certain malignancies and infections, but these are far too preliminary to
      permit any conclusions.

PMID- 11209990
TI  - Anxiety and functional status in older primary care patients.
AB  - OBJECTIVE: The aim of this study was to test the hypothesis that anxiety in older
      primary care patients is associated with functional impairment after controlling
      for depression and medical comorbidity. METHOD: Primary care patients (n = 303),
      aged sixty or older were interviewed with a series of instruments designed to
      measure psychiatric symptoms including anxiety, depression, medical illness
      burden, and both examiner-rated and self-reported functional status. Anxiety was
      measured by the anxiety item of the Hamilton Rating Scale for Depression and the
      anxiety items of the Medical Outcomes Study Short Form SF-36. Multiple regression
      techniques were used to examine the association of anxiety with functional status
      after controlling for age, gender, education, medical burden, and depression.
      RESULTS: When controlled for depression and medical morbidity, increased anxiety
      predicted poorer social function. Anxiety was not independently associated with
      more basic activities of daily living. CONCLUSIONS: Further studies with more
      comprehensive measures of anxiety are warranted to clarify the relationships
      between anxiety and functional status.

PMID- 11209991
TI  - The design, implementation, and acceptance of a primary care-based intervention
      to prevent depression relapse.
AB  - OBJECTIVE: This article describes the conceptual underpinnings, implementation,
      and participation rates of a twelve-month low-intensity primary care-based
      intervention to prevent depression relapse. The intervention was designed to
      address the inherent problems in delivery of effective maintenance treatment in a
      population based sample of primary care patients. METHODS: Patients at high risk
      of relapse based on psychiatric history who recovered from depression six to
      eight weeks after initiation of pharmacotherapy by their primary care physician
      were eligible; 194 were randomized to receive the intervention. The intervention
      combined education about depression, motivation-enhancing shared decision-making
      regarding the use of maintenance pharmacotherapy, and cognitive-behavioral
      strategies. The program included two visits with a Depression Prevention
      Specialist working in tandem with the primary care physician at the primary care
      clinic, with supervision and back up from a consulting psychiatrist, proactive
      follow-up telephone calls and mailed personalized feedback. RESULTS: Ninety-three
      percent of patients attended both in-person visits; 97 percent attended one
      visit. Eighty percent of patients completed all three follow-up telephone calls,
      and 85 percent returned at least one mailed feedback form; 48 percent returned
      all four forms. Offered a menu of options for self-management, most patients
      chose medication as well as a variety of behavioral strategies. At six months, 72
      percent ofpatients and at twelve months 62 percent of patients remained on
      antidepressant medication. CONCLUSIONS: We conclude that it is feasible to
      integrate a low intensity, twelve-month relapse prevention intervention for
      depression into a primary care clinic.

PMID- 11209992
TI  - The relationship between trauma, PTSD, and medical utilization in three high risk
      medical populations.
AB  - OBJECTIVE: Increased use of medical and psychiatric services has been reported as
      a correlate of exposure to trauma. Recent studies suggest that: 1) physical and
      sexual abuse traumas are particularly associated with increased utilization and
      2) posttraumatic stress disorder (PTSD), a common sequela of abuse, mediates the
      relationship between trauma exposure andelevated utilization. The goal of this
      study was to explore the relationships between trauma, abuse, PTSD, and medical
      utilization in three medical help seeking groups reported to be at high risk for
      trauma exposure. METHOD: One hundred and seven patients receiving care at a
      university-affiliated medical center were surveyed for trauma history and PTSD
      using the Trauma History Questionnaire (THQ) and the PTSD Checklist (PCL). The
      sample included: forty-eight gynecologic outpatients, thirty-five inpatients with
      seizure disorders, and twenty-four psychiatric inpatients with non-PTSD admitting
      diagnoses. Medical utilization data were obtained from a computerized medical
      center data base. RESULTS: Ninety-six patients reported a trauma history. Of
      these patients, sixty-six reported abuse and forty-five qualified for PTSD
      diagnoses. Total number of traumas and reported sexual and physical abuse
      correlated significantly with elevated medical utilization and PTSD prevalence.
      PTSD diagnosis was not significantly correlated with utilization, but the five
      highest utilizers received PTSD diagnoses. CONCLUSIONS: Study results supported
      hypotheses regarding the relation of trauma exposure to medical utilization, but
      were less clear about the mediating role of PTSD. These findings suggest that
      routine screening of high-risk patient groups might promote timely identification
      of trauma history and PTSD, and subsequently impact health care utilization.

PMID- 11209993
TI  - Childhood experiences and adult behavior in a group of women with pain accounted
      for by psychological factors and a group recovered from major depression.
AB  - OBJECTIVE: In this study twenty-four women with pain accounted for by
      psychological factors (DSM-IV, 307.80) and twenty-four with major depression
      diagnosed according to DSM-III-R were compared to study the relationship between
      pain and depression. METHOD: They were examined by a semi-structured, tape
      recorded interview to study their childhood experiences and adult behavior. The
      interviews were rated by two independent and blind raters. Interrater correlation
      (Cohen-Kappa) varied between good and close agreement. RESULTS: Of childhood
      experiences, "brutality between parents," "brutality toward child," and "sexual
      abuse" were often found in both groups and were more strongly represented in
      these than in comparison groups of former studies. As adults, the pain group had
      experienced more serious illness (p = 0.037) and surgery (p = 0.014). The
      depression group more often had a history of depression (15/24 vs. 4/24; p =
      0.001). The pain group spoke negatively of its physicians (p = 0.001), was more
      hostile during the interview (p = 0.041), was less convinced of the benefit of
      the hospital stay (p = 0.029), felt less self-responsible, and was more
      pessimistic (p = 0.013). The pain patients also provoked negative emotions in the
      raters, whereas the latter's reaction to the depression group was compassion and
      interest (p = 0.0005) (Pearson's chi2 and Fisher's exact tests). CONCLUSIONS: The
      results show that negative childhood experiences are prominent and similar in
      patients with pain accounted for by psychological factors and in patients after
      major depression. Adult behavior, however, is very different.

PMID- 11209994
TI  - The clinical applications of Mini-Mental State Examination in geropsychiatric
      inpatients.
AB  - OBJECTIVE: This study investigated the association between Mini-Mental State
      Examination (MMSE) scores and diagnosis, computerized tomographic scans or
      electroencephalogram findings in geropsychiatric inpatients (age > or = 65).
      METHOD: We analyzed the MMSE records of patients sixty-five and older who had
      been hospitalized in our psychiatric ward during a nine-year period. Case data
      were collected by review of chart records. RESULTS: In these patients, MMSE
      scores were significantly different among the seven diagnostic groups included.
      Demented patients had the lowest MMSE scores. Patients who had abnormal findings
      on computerized tomographic scans or electroencephalogram had lower MMSE than
      patients with normal findings. CONCLUSION: Our findings suggest that the MMSE is
      a useful screening instrument for organicity in the geropsychiatric inpatients.
      However, because of the lower average MMSE score in geropsychiatric inpatients,
      the optimal cut-offpoint of MMSE for dementia should be lower than those used in
      other populations.

PMID- 11209995
TI  - Postpartum depression and factitious disorder: a new presentation.
AB  - This article discusses a presentation of Munchausen Syndrome by Proxy. It is
      believed this factitious disorder was precipitated and grew out of the context of
      a postpartum depression. To our knowledge, no such case has been reported in the
      past and implications for new exclusion criteria defining a fictitious disorder
      are raised. Furthermore, reintegration of the perpetrator back to family is
      discussed and suggestions are made for follow-up.

PMID- 11209996
TI  - Alpha-vascular responses after short-term and long-term inhibition of nitric
      oxide synthesis.
AB  - Apart from the direct actions of nitric oxide (NO) on vascular smooth muscle,
      this factor may regulate cardiovascular functions through specific actions on
      alpha-adrenergic constrictor mechanisms. In this study we aim to establish
      whether the inhibition of the synthesis of this mediator could alter the
      vasoconstrictor responses mediated by alpha-adrenoceptor stimulation. We have
      been able to demonstrate that the blockage of the NO synthase really does exist,
      when both short- and long-term treatments with Nomega-nitro-Larginine methyl
      ester (L-NAME) are carried out. We have evaluated the concentration-dependent
      contractions induced by the selective alpha1-adrenoceptor agonists methoxamine
      and phenylephrine in isolated rat aorta rings in the following groups of animals:
      control, short-term L-NAME-treated (100 mg/kg i.p. 20 min before subjecting the
      animals to the experiments) and long-term L-NAME-treated (100 mg/kg per day in
      the drinking water for 7, 21, or 45 days). We have also evaluated the pressor
      responses to methoxamine and to the selective alpha-adrenoceptor agonist B-HT 920
      using the pithed rat preparation in the same groups of animals. The contractile
      responses to methoxamine and phenylephrine were similar in the rat aorta
      preparations from control and short-term L-NAME-treated animals. On the contrary,
      in the rat aorta preparations from long-term L-NAME-treated animals these
      responses were clearly reduced when compared with the corresponding responses in
      those from control animals, the reduction being more marked when the treatment
      lasted longer. The pressor responses to methoxamine were also similar in control
      and short-term L-NAME-treated pithed rats. Nevertheless, the responses to B-HT
      920 were greater in the latter. On the other hand, the dose-response curves to
      both alpha-adrenoceptor agonists were shifted to the right in a non-parallel
      manner in rats treated long term with L-NAME, the shift being, in the case of B
      HT 920, more accentuated when the treatment lasted 21 or 45 days than when it
      lasted only 7 days. These results indicate that the short-term decrease in NO
      synthesis does not modify the vascular smooth muscle responses mediated by alpha1
      adrenoceptor stimulation, but it does induce a potentiation of sympathetic
      vasoconstriction mediated by alpha2-adrenoceptors. Nevertheless, the long-term
      inhibition of NO synthesis causes a compensating decrease in the alpha1- and
      alpha2-vascular smooth muscle contractile responses.

PMID- 11209997
TI  - Protective effect of SM-20550, a selective Na+ - H+ exchange inhibitor, on
      ischemia-reperfusion-injured hearts.
AB  - The protective effects of Na+ - H+ exchange inhibitors SM-20550 (SM) and 5-(N
      ethyl-N-isopropyl)-amiloride (EIPA) against ischemia-reperfusion injury were
      investigated in guinea pig Langendorff hearts. The changes in intracellular pH
      (pHi), high-energy phosphates, and biologic intracellular active ions ([Na+]i and
      [Ca2+]i) were regarded using the 31P-NMR and specific fluorescent signals from
      the heart tissues together with simultaneous recordings of the left ventricular
      developed pressure (LVDP). The recovery rate of LVDP from ischemia (40 min) by
      reperfusion was 36.8% in the control experiments, whereas in the presence of SM
      10(-7) M, a gradual increase to 75.9% (55.5% with 10(-8) M), in contrast to EIPA
      (10(-7) M), 47.5% was observed. SM 10(-7) M restored the ATP level by 70% in 40
      min reperfusion, which was already higher than the control in the latter half (20
      40 min) of the ischemic period. The recovery rate of phosphocreatine by
      pretreatment of the heart with SM 10(-7) M was 75% in 40 min reperfusion. The pHi
      estimated from Pi/phosphocreatine chemical shift became highly acidic in ischemic
      heart so that SM 10(-7) M caused slight but significant pHi reduction from
      control pHi of 5.89 to 5.75. The level returned to pHi at around 7.38 during 30
      40 min reperfusion, and the recovery was significantly greater than the control
      pHi of 7.24. The fura-2 Ca2+ or SBFI-Na+ signals during Langendorff ischemia
      heart increased, and rapidly returned to the control level after the reperfusion.
      SM suppressed the [Na+]i or [Ca2+]i elevation induced in the late stage during
      ischemia, resulting in LVDP restoration after reperfusion; Diastolic Ca2+ in the
      end period of ischemia, SM 10(-7) M 194% versus drug-free 220.7%. Na+: SM 10(-7)
      M 121.6% versus drug-free 128.0%. The present results suggest that the selective
      Na+ - H+ exchange inhibitor SM is promising as a potent and specific protective
      agent against ischemia-reperfusion injuries with Ca2+ overload induced via Na+ -
      H+, Na+ - Ca2+ exchange.

PMID- 11209998
TI  - Suppression of cell proliferation by tissue plasminogen activator during the
      early phase after balloon injury minimizes intimal hyperplasia in
      hypercholesterolemic rabbits.
AB  - Thrombus formation is a key component of the pathogenesis of restenosis after
      arterial balloon injury. The purpose of this study was to determine whether
      intimal hyperplasia could be attenuated by infusion of recombinant tissue
      plasminogen activator (tPA). Forty-two Kurosawa and Kusanagi hypercholesterolemic
      rabbits were divided into tPA (n = 20) and control (n = 22) groups, the former
      receiving 7 days of continuous tPA infusion (0.6 mg/kg/day) via ear veins. The
      walls of the common iliac arteries were injured using 2.5-mm balloon catheters
      and then examined histologically 7, 14, 21, and 28 days later. Cell proliferation
      was assessed by immunohistochemical analysis of proliferating cell nuclear
      antigen (PCNA), and transforming growth factor (TGF)-beta immunohistochemistry
      was carried out to estimate cell proliferation and differentiation. It was
      observed that 28 days after balloon injury, intimal cross-sectional areas in the
      tPA group were significantly smaller than in controls (0.11 +/- 0.03 mm2 vs. 0.57
      +/- 0.08 mm2, p < 0.01), as were ratios of the cross-sectional areas of the
      intima and media (0.21 +/- 0.07 vs. 1.06 +/- 0.18, p < 0.05). In addition, the
      numbers of PCNA-positive medial cells were significantly lower (0.06 +/- 0.01 vs.
      0.36 +/- 0.08, p < 0.05) and TGF-beta-positive vessel wall areas were
      significantly smaller in tPA-treated animals 7 days after balloon injury (0.47 +/
      0.28% vs. 4.55 +/- 1.44%, p < 0.05). Thus infusion of tPA after arterial balloon
      injury appears to decrease medial cell proliferation and suppress intimal
      hyperplasia.

PMID- 11209999
TI  - Renin-angiotensin system contribution to cardiac hypertrophy in experimental
      hyperthyroidism: an echocardiographic study.
AB  - The objective of this study was to evaluate, using echocardiography, the
      involvement of the renin-angiotensin system (RAS) in left ventricular (LV)
      hypertrophy development in experimental hyperthyroidism. Thyrotoxicosis was
      produced by a daily intraperitoneal injection of L-thyroxine (T4), 0.1 mg/kg per
      day for 15 days in Wistar rats. Control (euthyroid) rats received intraperitoneal
      daily injection of the thyroxine solvent. Two series of experiments were
      performed. In the first series, euthyroid (n = 10) and hyperthyroid (n = 14) rats
      were surgically prepared with a femoral artery catheter. After a 3-day recovery
      period, blood pressure and heart rate were measured and blood samples were
      collected in conscious and unrestrained rats. In the second series of experiment,
      measurement of LV geometry was realized with two-dimensional time-movement
      echocardiography on the 15th day of treatment in control conditions and after
      long-term treatment with the angiotensin II type I receptor antagonist valsartan
      (10 mg/kg per day for 15 days) in both euthyroid and hyperthyroid rats. The dose
      and duration of T4 treatment was sufficient to induce a significant degree of
      hyperthyroidism with characteristic features including tachycardia, systolic
      hypertension, myocardial hypertrophy, hyperthermia, and weight loss. In addition,
      we measured an increase in free fractions of thyroid hormones, and a threefold
      increase in plasma renin activity. Echocardiographic examinations in rats
      revealed a strong correlation between LV weight and echocardiographic LV mass.
      Hyperthyroid rats exhibited an increased LV mass with a marked increase in the LV
      end-diastolic posterior wall and septal thickness. Chronic treatment with
      valsartan prevented this concentric LV hypertrophy (p < 0.01), with full
      prevention of the LV posterior wall hypertrophy (p < 0.001) and decreased LV
      septal hypertrophy (p < 0.05). In conclusion, the cardiovascular alterations of
      hyperthyroidism were reproduced with thyroid hormone injections in rats.
      Activation of the RAS in hyperthyroid rats was accompanied by increased LV mass.
      Using valsartan, we demonstrated that the RAS impinged on the LV remodelling in
      our experimental hyperthyroidism model. A chronic treatment with an angiotensin
      II type I receptor antagonist prevented the development of the concentric LV
      hypertrophy associated with thyrotoxicosis.

PMID- 11210000
TI  - On the mechanisms of cholinergic control of the sinoatrial node discharge.
AB  - It has been proposed that cholinergic agonists inhibit the sinoatrial node
      discharge by shifting the activation range of the hyperpolarization-activated
      inward current If to more negative values or by increasing potassium conductance.
      In the former instance, cesium will potentiate the cholinergic inhibition by
      blocking any residual If; in the latter instance, Cs+ and Ba2+ will antagonize
      the inhibitory action by blocking K+ channels. The changes in discharge induced
      by high and low concentrations of carbachol were studied using an
      electrophysiologic technique in isolated guinea pig sinoatrial node perfused in
      vitro in the absence and presence of different concentrations of Cs+ and Ba2+. In
      Tyrode solution, high carbachol concentrations (0.5-2 microM) slowed the
      sinoatrial node by hyperpolarizing the membrane and by reducing the amplitude of
      diastolic depolarization; and stopped the sinoatrial node by preventing the
      attainment of threshold potential. Adding Cs+ (10 mM) to carbachol increased the
      rate in slowly discharging sinoatrial node and induced spontaneous discharge in
      quiescent sinoatrial node. In high [K+]o (approximately 12 mM), carbachol slowed
      or stopped the slow responses and adding Cs+ accelerated or induced discharge.
      Both in Tyode and in high [K+]o, in the presence of Cs+, carbachol did stop the
      sinoatrial node. In the presence of carbachol, Ba2+ (0.1 mM) accelerated or
      induced discharge, as Cs+ did. Atropine (1 microM) prevented both the slowing or
      suppression by carbachol and the acceleration of sinoatrial node by Cs+ in the
      presence of carbachol. Low carbachol concentrations (0.05-0.1 microM) decreased
      the rate to a similar extent in the absence and the presence of a low
      concentration of Cs+ (2 mM, which blocks If but not K+ channels), but markedly
      less in the presence of 0.5-0.75 mM Ba2+ (which block K+ channels but not If). We
      conclude that cholinergic agonists slow or stop the sinoatrial node by a shifting
      the membrane potential toward the more negative subsidiary pacemaker range and
      away from the threshold. The results with Cs+ and Ba2+ indicate that both high
      and low concentrations of carbachol decrease sinoatrial node discharge by
      activating the I(K,ACh) channels rather than by decreasing If.

PMID- 11210001
TI  - Factors affecting endothelin-induced venous tone in conscious rats.
AB  - There may be a relation between altered venous function, endothelin (ET)-1, and
      an impairment in the activity of endothelial-derived nitric oxide (NO) and
      prostanoids in salt-dependent hypertension. The present study examined the
      effects of salt intake on ET-induced changes in venomotor tone and the effects of
      blockade of NO synthase with N(G)-nitro-L-arginine methyl ester (L-NAME) and of
      cyclooxygenase with indomethacin on venomotor tone caused by the ET(B) selective
      agonist sarafotoxin 6c (S6c) in awake rats. Rats were anesthetized for permanent
      placement of catheters for measurements of arterial and venous pressures. A
      silicone balloon catheter was also fixed in the right atrium to produce brief
      circulatory arrest. Venomotor tone was estimated from measurements of mean
      circulatory filling pressure (MCFP) in conscious rats. There were no differences
      in mean arterial pressure, heart rate, or MCFP responses to short-term
      administration of ET-1 or S6c at different levels of salt intake. L-NAME or
      indomethacin did not change MCFP or the response of MCFP to short-term injection
      of S6c. In conclusion, neither basal MCFP nor integrated venomotor responses to
      short-term injection of ET-1 or S6c were altered by short-term changes in salt
      intake, blockade of NO synthase or cyclooxygenase. These data do not support the
      hypothesis that increased salt intake alters reactivity of veins to ET-1, NO, or
      prostanoids.

PMID- 11210002
TI  - Effects of acute global low-flow ischemia on triggered arrhythmias in d-sotalol
      induced long Q-T intervals in perfused rabbit hearts.
AB  - Little information is available on how acute ischemia modifies the
      electrophysiologic substrate associated with long Q-T interval conditions. We
      studied the effects of low-flow ischemia (10 min at 5.0 ml/min followed by 10 min
      of 2.5 ml/min) in Langendorff perfused rabbit hearts during control and in hearts
      20 min after the addition to the perfusate of 92 microM d-sotalol, which reliably
      produced triggered activity. Epicardial electrograms, a left ventricular
      endocardial monophasic action potential (MAP), and simulated X and Y lead
      electrocardiograms were used to characterize myocardial activation and recovery
      during ventricular pacing. In the control hearts, conduction velocity as
      indicated by the mean epicardial activation time accelerated for most of the
      period of ischemia (maximum decrease of -9.4 +/- 7.9%). The mean activation
      recovery interval, MAP duration, and Q-T interval were moderately decreased (-4.9
      +/- 8.6%, -7.5 +/- 4.4%, and -4.6 +/- 2.3%, respectively). The mean standard
      deviation of the activation-recovery interval (epicardial heterogeneity of
      recovery) was increased by 34.6 +/- 23.4%. d-Sotalol had no effect on conduction
      but prolonged myocardial recovery time, increased heterogeneity, and produced
      triggered arrhythmias in all hearts. Within 2 min of ischemia triggered activity
      was eliminated. With d-sotalol, ischemia slowed conduction and produced
      relatively larger decreases in the activation-recovery interval, MAP duration,
      and Q-T interval (-11.8 +/- 10.3%, -13.9 +/- 12.0%, and -15.8 +/- 11.2%). The
      increased epicardial heterogeneity seen with d-sotalol was attenuated by
      ischemia. Thus ischemia superimposed on long Q-T conditions had antiarrhythmic as
      well as arrhythmogenic effects.

PMID- 11210003
TI  - Increase in myofibrillar Ca2+ sensitivity induced by UD-CG 212 Cl, an active
      metabolite of pimobendan, in canine ventricular myocardium.
AB  - We performed experiments in canine ventricular trabeculae loaded with aequorin to
      elucidate the mechanism of positive inotropic effect of UD-CG 212 Cl (4,5-dihydro
      6-[2-(4-hydroxyphenyl)-1H-benzimidazole-5-yl]-5-methyl-3(2H)-pyridazinone), an
      active metabolite of pimobendan. The maximum response to UD-CG 212 Cl achieved at
      10(-5) M was 18% of ISOmax and it was associated with an increase in Ca2+
      transients of 7% of ISOmax. For a given increase in force, the increase in Ca2+
      transients induced by UD-CG 212 Cl was less than that induced by elevation of
      [Ca2+]o. The positive inotropic effect of UD-CG 212 Cl was not associated with an
      impairment of relaxation and it was abolished by carbachol. In conclusion, UD-CG
      212 Cl has a positive inotropic effect partly due to an increase in myofibrillar
      Ca2+ sensitivity that is exerted via cross talk with a signal transduction
      pathway that involves cAMP.

PMID- 11210004
TI  - Transforming growth factor-beta regulation of endothelin expression in rat
      vascular cell and organ cultures.
AB  - Transforming growth factor (TGF)-beta increases the production of the vasoactive
      peptide endothelin (ET) in cultures of vascular endothelial cells (EC) and
      vascular smooth muscle cells (VSMC), but the physiologic or pathologic
      significance of this regulation has not been determined. The present studies test
      the hypothesis that when EC and VSMC are in direct contact or close proximity, ET
      expression is, at least in part, dependent on TGF-beta. The effects of TGF-beta
      on ET-1 mRNA (Northern analysis and reverse transcription polymerase chain
      reaction) and peptide (radioimmunoassay) levels were assessed in rat EC and VSMC
      and vascular organ cultures. TGF-beta2 (1 ng/ml) increased ET-1 mRNA in VSMC and
      EC plus VSMC cultures and increased ET-1 peptide in EC, VSMC, and EC plus VSMC
      cultures. TGF-beta2 also increased ET-1 mRNA and peptide in vascular organ
      cultures. Antibodies that neutralized the activities of TGF-beta1 and TGF-beta2
      decreased ET-1 mRNA in EC plus VSMC cultures and in vascular organ cultures.
      These data indicate that when EC and VSMC are in direct contact or close
      proximity, TGF-beta increases ET expression and active TGF-beta is present and
      promotes ET expression. These data suggest that TGF-beta is a determinant of
      vascular ET expression in vivo, and that TGF-beta regulation of ET expression
      would affect cardiovascular function in health and disease.

PMID- 11210005
TI  - Different contribution of endothelial nitric oxide in the relaxation of human
      coronary arteries of ischemic and dilated cardiomyopathic hearts.
AB  - Coronary artery disease and congestive heart failure (CHF) have been associated
      with a reduction in nitric oxide (NO) release or bioavailability from the
      vascular endothelium. The objectives of this study were to compare the role of NO
      in human coronary vessels isolated from nonischemic dilated (DCM) (n = 10) and
      ischemic (ICM) (n = 12) cardiomyopathic hearts. Segments were mounted on a wire
      myograph to record changes in isometric tension. All experiments were performed
      in the presence of indomethacin (10 microM). Contractions induced by angiotensin
      II (0.1 microM) or a depolarizing physiologic solution containing 40 mM KCl, were
      of similar amplitude in DCM and ICM. In vessels precontracted with angiotensin
      II, acetylcholine (1 microM) caused an endothelium-dependent relaxation of rings
      from DCM but a paradoxical contraction of rings from ICM; NO synthase inhibition
      with Nomega-nitro-L-arginine (L-NNA, 100 microM) did not affect acetylcholine
      induced relaxation or contraction of DCM or ICM vessels, respectively. By
      contrast, substance P (0.1 microM) induced an endothelium-dependent relaxation in
      both groups of vessels; this relaxation was prevented (p < 0.05) by L-NNA in
      vessels from ICM hearts but only reduced (p < 0.05) by L-NNA in vessels from DCM
      hearts. In depolarized conditions, acetylcholine contracted (p < 0.05) whereas
      substance P induced a complete relaxation (p < 0.05) of vessels from both groups:
      substance P-induced relaxation was abolished (p < 0.05) by L-NNA. Our data
      suggest that in the presence of indomethacin, NO does not contribute to
      acetylcholine-induced relaxation of human epicardial coronary arteries isolated
      from DCM hearts. Furthermore, whereas NO and a secondary endothelium-derived
      relaxing factor sensitive to high K+ contribute to substance P-induced relaxation
      of rings from DCM hearts, only NO is involved in ICM hearts.

PMID- 11210006
TI  - Time trends of occupational pesticide-related injuries in Costa Rica, 1982-1992.
AB  - To evaluate time trends of occupational pesticide-related injuries in Costa Rica,
      a survey was carried out three times over a ten-year period at a national
      reporting system for occupational accidents and diseases among wage-earning
      workers. The sample comprised the accidents reported during the months of June of
      the years 1982, 1987, and 1992. The overall incidence rates were 1.8, 2.7, and
      2.5 per 1,000 agricultural workers, respectively. Rates among female workers
      increased (3.1, 3.7, 5.4) and were elevated as compared with male workers (1.7,
      2.6, 2.3). The trend for topical lesions was upgoing (1.2, 1.4, 2.1), consistent
      with an increased use of fungicides and lack of safety measures for pesticides
      with low acute toxicity. Systemic poisonings peaked in 1987 (0.6, 1.2, 0.5),
      declining in 1992 with increased use of biologic pest control and pyrethroid
      insecticides less toxic than cholinesterase inhibitors, and improved safety
      during nematocide applications on banana plantations. In 1992, despite the
      largest decline of systemic poisonings in the banana-producing Atlantic Region,
      poisonings as well as topical injuries were still four times more frequent in
      this region than in the rest of the country. Restriction of highly toxic
      pesticides together with implementation of occupational safety measures can
      reduce systemic poisonings in developing countries. Such policies need to be
      extended to other pesticides to prevent less life threatening but often disabling
      skin and eye injuries.

PMID- 11210007
TI  - Use of an asbestos exposure score and the presence of pleural and parenchymal
      abnormalities in a lung cancer case series.
AB  - To assess whether there was an association between asbestos exposure and
      abnormalities on chest x-rays or CT scans, chest radiographs and CT scans of 103
      asbestos-exposed patients with known lung cancer were reviewed for pleural or
      parenchymal abnormalities. Asbestos exposure was assessed using an asbestos
      exposure index that integrated time and intensity of reported exposure via a
      weighting scheme. Chest CT scans were clearly more sensitive in detecting pleural
      or parenchymal abnormalities than were standard PA chest x-rays. Furthermore,
      there was a significant correlation between higher asbestos exposure index scores
      and abnormalities on CT scans. Multivariable logistic regression models were used
      to investigate the relationship between the asbestos exposure index score and
      pleural or parenchymal abnormalities after adjusting for gender, pack-years of
      smoking, and cell type. None of these variables was associated with abnormalities
      on chest x-rays or CT scans. An asbestos exposure score > 10 was associated with
      pleural or parenchymal abnormalities (OR = 4.93; 95%CI 1.05-23.12). The results
      suggest that assessment of asbestos exposures by means of an algorithm-based
      index can classify the exposures accurately for epidemiologic studies.

PMID- 11210008
TI  - Pulmonary function of workers exposed to ammonia: a study in the Eastern Province
      of Saudi Arabia.
AB  - To determine the effect of chronic exposure to ammonia on pulmonary function
      among ammonia workers, 77 workers were randomly selected from an ammonia factory
      in the Eastern Province of Saudi Arabia and 355 were selected as controls from
      the administrative staffs of four industrial groups in Eastern Province.
      Spirometry was carried out and FEV1, FVC, and FEV1/FVC% were calculated. The
      ammonia level in the working environment was determined spectrophotometrically.
      30% of the air samples had ammonia concentrations that exceeded the threshold
      limit value. Significant reductions in FEV1 % predicted and FVC % predicted were
      observed in ammonia workers exposed to higher cumulative ammonia levels (above 50
      mg/m3-years). FEV1% predicted and FEV1/FVC% were significantly lower in
      symptomatic than in asymptomatic workers in the exposed group. These findings may
      raise the possibility that exposure to a high cumulative ammonia level produces a
      combined restrictive/obstructive ventilatory defect.

PMID- 11210009
TI  - Health effects of occupational exposures to vehicle emissions in Shanghai.
AB  - The authors investigated the health effects of occupational exposures to vehicle
      emissions in 745 bus drivers, conductors, and taxi drivers, compared with 532
      unexposed controls, in Shanghai. Logistic regression and general linear models
      were used to examine the relationship between exposure and respiratory illness.
      Results showed that the prevalences of some respiratory symptoms and chronic
      respiratory diseases were significantly higher (p < 0.05) in the exposed group
      than in the controls. The adjusted odds ratios for throat pain, phlegm, chronic
      rhinitis, and chronic pharyngitis were 1.95 (95% CI 1.55-2.46), 3.90 (95% CI 2.61
      5.81), 1.96 (95% CI 1.11-3.46), and 4.19 (95% CI 2.49-7.06), respectively. Also,
      there were exposure time response relationships for the prevalences of phlegm and
      chronic respiratory disease. Pulmonary function and blood lead levels were not
      significantly correlated with exposure status. The results suggest that
      occupational exposure to vehicle emissions may induce detectable adverse health
      effects.

PMID- 11210010
TI  - Worksite and personal factors associated with carpal tunnel syndrome in an
      Egyptian electronics assembly factory.
AB  - The study objective was to identify personal and work-related risk factors
      associated with carpal tunnel syndrome (CTS) in electronics assembly, operators
      relative to clerical workers in the same factory. Of 422 workers in a television
      assembly factory located in Ismailia, Suez Canal Area, Egypt, 198 (46.9%)
      participated. The electronics assembly workers were more likely to report CTS
      (odds ratio = 11.41, 95% CI = 3.6 -40.26) than were the clerical workers. The
      significant risk factors were longer work years (odds ratio = 1.11, 95% CI = 1.03
      1.20) and precision-type hand grip (odds ratio = 6.5, 95% CI = 1.08-39.23). The
      results suggest an association between electronics assembly and CTS. Work years
      and precision grip are possible risk factors for CTS and should be studied more
      thoroughly. Tools to reduce the need for precision grip may help reduce CTS.

PMID- 11210011
TI  - Pediatric environmental health: perceptions from a survey questionnaire.
AB  - To expand the base of knowledge regarding perceptions about potential
      environmental threats to children's health, a survey was conducted in the
      Northwest United States. Samples of Head Start parents, PTA presidents, public
      health officials, school nurses, naturopathic physicians, family practitioners,
      and pediatricians were mailed a questionnaire inquiring into the nature and
      degree of concerns about pediatric environmental health. The response rate was
      24%. Trends in the data showed disparities in perceptions regarding levels of
      concern and exposure concerns between respondent categories. Disparities also
      existed regarding information resources used for children's environmental health.
      Recognizing differences in perceptions of children's environmental health, as
      demonstrated in these results, may be useful for risk communication and resource
      allocation, especially in the context of the wide variety of health belief
      models. Such knowledge may help clarity situations with environmental health risk
      concerns, including clinical, public health, and educational circumstances.

PMID- 11210012
TI  - Household firewood use and the health of children and women of Indian communities
      in Chiapas, Mexico.
AB  - A follow-up study in two rural communities in the state of Chiapas, Mexico,
      compared families that used an improved stove for cooking with those that used
      traditional open-fire stoves, to assess the risks of respiratory symptoms in
      children and women exposed to wood smoke. 16-hour measurements showed that the
      concentration of particles less than 10 microm in diameter was significantly
      lower in households with the better stoves in the kitchen area, where children
      usually play, i.e., 158 microg/m3 vs 305 microg/m3 (p = 0.03). Multivariate
      models showed that using the better stove tended to protect against symptoms such
      as the common cold in children (RR 0.24; 9.5% CI 0.05, 1.02). Use of more
      firewood was linked to greater risks of experiencing difficulty breathing (RR
      1.15; 95% CI 1.04, 1.27) and the common cold (RR 1.09; 95% CI 1.01, 1.18) in
      women. The use of stoves that require less wood for cooking reduces the risks of
      respiratory symptoms that may contribute to complicated respiratory diseases and
      mortality.

PMID- 11210013
TI  - Silicosis and tuberculosis: Part 2--a radiographic presentation of nodular
      tuberculosis and silicosis.
AB  - Indolent nodular pulmonary tuberculosis (TB) in workers exposed to silica dust
      may go undetected clinically and radiographically, especially in the absence of
      identification of tubercle bacilli in sputum. Illustrative cases demonstrating
      the radiographic manifestations of coexistent pulmonary silicosis and the
      indolent form of nodular TB are presented. Alterations in the usual chronologic
      progress, a rapid advance in nodular profusion or size outside the expected time
      frame, and distinct pattern alterations are features indicating the presence of
      TB associated with silicosis.

PMID- 11210014
TI  - Methodologic considerations in estimating burden of disease from environmental
      risk factors at national and global levels.
AB  - Evidence from environmental burden-of-disease studies can provide valuable input
      in the decision-making process in environmental health, facilitating priority
      setting and cost effectiveness evaluation. This paper discusses important aspects
      of environmental burden-of-disease estimates in the light of) published examples.
      To produce reliable and comparable burden-of-disease estimates for environmental
      and occupational risk factors, harmonized methods are needed. Such methods should
      address the feasibility of data collection at national, regional, and global
      levels, the reliability of estimates, the uncertainty around estimates, and
      scenario tools to investigate the health gains of options for preventive action
      in different domains of policy. Any such method will require a framework (i.e.,
      causal inference model) able to take into account the contributions of distal and
      proximal causes, and the possible interactions between risk factors.

PMID- 11210015
TI  - Efforts to stop repression bias by protecting whistleblowers.

PMID- 11210016
TI  - Cardiovascular effects in viscose rayon workers exposed to carbon disulfide.
AB  - The objectives of this study were to investigate the cardiovascular effects in
      workers currently exposed to carbon disulfide (CS2) below the threshold limit
      value (TLV) of 31 mg/m3 and to determine the prevalence of coronary heart disease
      (CHD) after long-term exposure. 172 men (91 workers exposed to CS2 in a viscose
      rayon factory and 81 referent workers) were examined using a medical and job
      history questionnaire, Rose's questionnaire, and electrocardiography at rest, and
      by measuring blood pressure and serum lipids and lipoproteins. Personal exposures
      were monitored simultaneously with active sampling and findings were analyzed
      according to the NIOSH 1600 method. As a result of technical and organizational
      improvements, personal CS2 exposures were well below the TLV (5.4-13.02 mg/m3).
      No significant effect of CS2 on blood pressure or lipids (total cholesterol, HDL
      and LDL cholesterol, triglycerides, and apolipoproteins AI and B) was found, even
      after allowance for confounding factors. The prevalence of CHD (ECG abnormalities
      and chest pain) was higher in the viscose rayon workers than in the workers with
      no exposure but reached statistical significance for men with exposure histories
      often years and more only (cumulative CS9 index > or = 150 mg/m3, the most highly
      exposed group). The findings suggest that the coronary risk is increased in
      workers previously exposed to high CS2 concentrations but not in those exposed to
      CS2 levels below the current TLV.

PMID- 11210017
TI  - Water contamination: a legacy of the union carbide disaster in Bhopal, India.

PMID- 11210018
TI  - Phase two responds to the HSE request.

PMID- 11210019
TI  - Fluid dairy product quality and safety: looking to the future.
AB  - The fiercely competitive nature of the US beverage industry will drive the fluid
      milk sector of the dairy industry to improve product quality and shelf life to
      enable dairy beverages to compete with innovative new introductions as well as
      with currently popular shelf-stable products. The recent substantial growth in
      the volume of flavored milk sales specifically suggests that attention is needed
      to improve these products. Further, increasing public awareness and regulatory
      attention directed toward food safety issues highlight the need for the dairy
      industry to proactively address and eliminate emerging food safety issues that
      may negatively impact the image of dairy products. Shelf life and sensory
      profiles of high temperature short time pasteurized fluid milk products are
      presented, illustrating the need for greater attention to controlling
      contaminating microorganisms in processed fluid milk products. Bacterial spoilage
      patterns of flavored versus unflavored milks are compared, and suggestions are
      presented for extending flavored product shelf lives. Strategies currently
      applied to extend shelf life are reviewed. Food safety issues facing the dairy
      industry are presented within the context of an overview of foodborne illnesses
      in the United States. The pressing need to determine thermal resistance
      characteristics of Mycobacterium paratuberculosis is described.

PMID- 11210020
TI  - Effect of composition of colostrum and transition milk from Holstein heifers on
      specificity rates of antibiotic residue tests.
AB  - The objective of this study was to evaluate the effects of colostrum and
      transition milk composition on specificity rates of antibiotic residue screening
      tests. Milk from 25 primigravid Holstein heifers was collected from either first,
      second, or third milking (colostrum) and from either fifth, sixth, or seventh
      milking (transition milk) following parturition. Milk sampled was visibly normal
      and heifers were not treated with an antibiotic within 30 d before parturition.
      Quarter foremilk samples were collected aseptically and analyzed for mastitis
      pathogens. A sample from the total composite milk was analyzed for somatic cell
      counts (SCC), milk protein and fat, immunoglobulin concentrations and for
      antibiotics using four antibiotic residue screening tests. Mastitis pathogens
      were present in colostrum from 36% of heifers (n = 9) and from 16% of heifers (n
      = 4) in the subsequent transition milk. Mean SCC were 2,458,000 and 866,000
      counts/ml and IgG1 concentrations were 22.7 and 3.07 mg/ml for colostrum and
      transition milk, respectively. Specificity rates of the screening tests ranged
      from 0.16 to 0.88 for colostrum and 0.60 to 1.0 for transition milk. Increased
      milk protein and IgG1 concentrations in milk were associated with an increase in
      the probability of a false positive outcome for the Charm Cowside (Charm
      Sciences, Inc., Malden, MA), CITE Snap (IDEXX Laboratories, Westbrook, ME), and
      Penzyme (Cultor Food Science, Milwaukee, WI) tests. Fat content of milk was
      positively related to an increase in false positive rates for the CITE Snap test.
      Milk should not be tested for antibiotic residues before the sixth milking after
      parturition to avoid high rates of false positive outcomes.

PMID- 11210021
TI  - Factors associated with milk urea concentrations in Ontario dairy cows.
AB  - All DHI test-day data, including milk urea concentrations measured by infrared
      test method, were collected from 60 commercial Ontario Holstein dairy herds for a
      13-mo period between December 1, 1995, and December 31, 1996. The objectives of
      this study were to describe the relationships between milk urea concentrations
      and seasonal factors, sampling factors, cow factors, and test-day production of
      milk, milk fat, protein, and SCC. Milk urea was associated with month and season;
      concentrations were the highest from July to September. Milk urea was generally
      lower in first-lactation cows. Milk urea was lowest during the first 60 d of
      lactation, higher between 60 and 150 d in milk, and lower after approximately 150
      d in milk. In herds on an alternating a.m./p.m. test schedule, milk urea was
      generally lower in a.m. than p.m. tests. There was a positive nonlinear
      association between milk urea and milk yield, fat-corrected milk, and energy
      corrected milk. There was a negative nonlinear association between milk urea and
      both milk fat and total protein percentages. While there was a negative nonlinear
      association between cow-level milk urea and linear score, the study found no
      association between herd average milk urea and herd average linear score. The
      associations described in this study using Dairy Herd Improvement test-day
      samples from commercial dairy herds and using an infrared test to measure milk
      urea are generally consistent with results from studies that used individual
      animals housed under research conditions and chemical methods to measure milk
      urea. Because milk urea varies by season, month, parity group, stage of
      lactation, and sample type, studies should control for these variables. Because
      of the apparent effect of a.m. and p.m. sampling on urea concentration, producers
      on an alternating a.m./p.m. test schedule should test routinely to establish a
      herd pattern for urea and submit the same sampling time consistently or both.

PMID- 11210022
TI  - Peripartum responses of dairy cows fed energy-dense diets for 3 or 6 weeks
      prepartum.
AB  - Pregnant cows (n = 189) in two commercial dairy farms were assigned randomly to
      be fed energy-dense diets for either 3 or 6 wk before expected calving. Cows fed
      diets for less than or equal to 26 d were designated the short (S) treatment
      group, and those fed greater than 26 d were the long (L) treatment group. Cows in
      L tended to have improved energy status during the first 2 wk postpartum, as
      indicated by higher insulin concentrations and a tendency for lower nonesterified
      fatty acid concentrations. Treatment did not affect plasma beta-hydroxybutyrate
      concentrations. Cows in L tended to gain more body condition during the late dry
      period. Total body condition loss from parturition through 6 wk postpartum was
      not different between treatments, but the rate of change varied over this period.
      Cows in S lost more body condition during the first 3 wk postpartum than cows in
      L. In farm 1 only, cows in L lost more body condition from 3 to 6 wk postpartum
      and had a higher incidence of metritis and a longer interval to first service
      than cows in S. Cows in L had higher milk protein content through 60 d in milk
      compared with cows in S. Additionally, cows in L in farm 1 produced 4.4 kg/d less
      milk, tended to have lower milk fat content and yields, and higher somatic cell
      counts through 150 d in milk than cows in S. Overall, increasing the length of
      time cows were fed the energy-dense diet prepartum elicited significant changes
      in farm 1, but had little effect in farm 2. Based on these results, L treatment
      may improve energy status immediately postpartum, but long-term effects varied
      between farms, perhaps due to other unmeasured management differences.

PMID- 11210023
TI  - Quantitative descriptive analysis and principal component analysis for sensory
      characterization of ultrapasteurized milk.
AB  - Quantitative descriptive analysis was used to describe the key attributes of nine
      ultrapasteurized (UP) milk products of various fat levels, including two lactose
      reduced products, from two dairy plants. Principal components analysis identified
      four significant principal components that accounted for 87.6% of the variance in
      the sensory attribute data. Principal component scores indicated that the
      location of each UP milk along each of four scales primarily corresponded to
      cooked, drying/lingering, sweet, and bitter attributes. Overall product quality
      was modeled as a function of the principal components using multiple least
      squares regression (R2 = 0.810). These findings demonstrate the utility of
      quantitative descriptive analysis for identifying and measuring UP fluid milk
      product attributes that are important to consumers.

PMID- 11210024
TI  - Potential for milk containing penicillin G or amoxicillin to cause residues in
      calves.
AB  - The potential for antibiotic residues in calves from consuming milk containing
      penicillin G or amoxicillin was investigated. Six calves were fed milk replacer,
      6% body weight twice daily, containing 0.293, 2.92, or 5.85 microg of
      penicillin/ml (ppm) G or 0.25, 1.0, or 2.0 microg of amoxicillin/ml for three
      consecutive feedings. Urine and blood samples were collected after each feeding.
      Serum and urine samples were tested with a microbial receptor assay and a
      microbial growth inhibition assay to indicate potential drug residues. Penicillin
      G and amoxicillin were detected in the serum and urine of several calves 3 h
      after drinking spiked milk replacer. Possible violative drug residues in the
      calves were detected by the microbial growth inhibition assay up to 15 h after
      drinking spiked milk replacer. Penicillin G, but not amoxicillin, could be
      detected in urine 24 h after the final feeding of spiked milk replacer.
      Subsequently, six calves were fed milk replacer containing 11.7 microg of
      penicillin G/ml (ppm) twice daily, 6% body weight per feeding. Calves were
      slaughtered 3 h after the final feeding. Mean (+/-SD) concentrations of
      penicillin G measured by high-pressure liquid chromatography in liver, kidney,
      muscle, and serum were 0.409 (+/-0.167) microg/g, 0.031 (+/-0.012) microg/g 0.008
      (+/-0.002) microg/g, and 0.013 (+/-0.006) mg/ml, respectively. This study
      indicates that calves fed milk with amoxicillin or penicillin G could possibly
      have violative residues if slaughtered within 24 h after feeding. Violative drug
      residues in liver tissue were found in calves slaughtered 3 h after consuming
      milk replacer containing 11.7 microg of penicillin G/ml (ppm).

PMID- 11210025
TI  - Plasma ascorbate concentrations are not correlated with milk somatic cell count
      and metabolic profile in lactating and dry cows.
AB  - The purpose of this study was to determine the effects of stage and the number of
      lactation on plasma ascorbate concentration and to establish the association
      between plasma ascorbate concentrations and plasma glucose, insulin,
      nonesterified fatty acids (NEFA), beta-hydroxybutyrate (BHBA), aspartate
      aminotransferase (AST), milk somatic cell count (SCC), milk yield, and body
      condition score (BCS) in dairy cows. Holstein cows (n = 193) from three different
      herds were used in this study. Animals were randomly selected, and assigned to
      five groups according to stage of lactation (group 1, dry cows; group 2, 1 to 28
      d; group 3, 29 to 56 d; group 4, 57 to 140 d; group 5, 141 to 280 d), and the
      number of lactation (primiparous or multiparous). Plasma ascorbate concentration,
      plasma glucose concentration, serum insulin concentration, plasma NEFA
      concentration, plasma BHBA concentration, serum AST concentration, milk SCC, milk
      yield, and BCS were measured. The results of this study demonstrate that plasma
      ascorbate concentrations do not change in response to stage of lactation, or
      number of lactations. Among the several variables studied, none was found that,
      singly or in combinations, could explain variations in ascorbic acid
      concentrations.

PMID- 11210026
TI  - Is intersucking in dairy cows the continuation of a habit developed in early
      life?
AB  - Intersucking, i.e., cattle sucking the udder of heifers or cows, is a frequent
      problem in dairy herds and may lead to udder damage, mastitis, milk loss, and
      culling of breeding animals. Using epidemiological methods, we conducted an
      observational cross-sectional study to investigate risk factors for intersucking
      in Swiss dairy cows. We asked 114 randomly selected dairy farmers about a broad
      spectrum of environmental factors possibly associated with intersucking, such as
      housing conditions, management, and feeding of calves, heifers, and cows. Thirty
      of the 114 farms were confronted with intersucking in cows. The mean proportion
      of intersucking cows per farm was 1.6%. From a total of 3077 cows (Swiss Brown
      Cattle, Simmental, and Holstein Friesian) we recorded 49 cows that had performed
      or were currently intersucking. In 69% of these cows, intersucking had been
      observed as heifers. Using path analysis and multivariable stepwise backward
      logistic and linear regression analyses, we revealed that the most important risk
      factor for intersucking cows was the presence of intersucking heifers on a farm
      (odds ratio = 7.8). The results suggest that intersucking in cows is the
      continuation of a habit that was already established in a cow's subadult life.
      This emphasizes the importance of looking not only at the animal's current
      environmental situation but also considering its entire life history for the
      prevention of behavioral problems.

PMID- 11210027
TI  - The effect of cation-anion difference on calcium requirement, feed intake, body
      weight gain, and blood gasses and mineral concentrations of dairy calves.
AB  - Our objective was to examine the effects of two diets with different cation-anion
      differences on Ca requirements in the growing calf. Holstein calves (n = 48, 24
      males) were blocked at 56 to 70 d after birth (80+/-10 kg of body weight)
      according to sex and birth date and assigned randomly in a 2 x 3 factorial
      arrangement of dietary treatments containing cation-anion differences as meq (Na
      + K) - (Cl + S)/kg of diet dry matter and Ca content of 1) 0 and 0.35%, 2) 0 and
      0.50%, 3) 0 and 0.65%, 4) 200 and 0.35%, 5) 200 and 0.50%, and 6) 200 and 0.65%.
      Feed intake and average daily gain did not differ among treatment groups. Plasma
      pH and Ca were unaffected by dietary Ca content or dietary cation-anion
      difference. Plasma Cl and P decreased linearly with increasing Ca content in the
      diet. Plasma HCO3 increased linearly with increased dietary Ca content. Plasma
      HCO3 and partial pressure of CO2 were higher in calves fed the 200 compared with
      calves fed the 0 cation-anion difference diets. Plasma Cl was, however, lower in
      calves fed the 200 compared with calves fed the 0 meq diets. An interaction of Ca
      content and dietary cation-anion difference was detected for plasma P content.
      Urinary pH increased linearly with increasing dietary Ca content. Calves fed the
      200 meq dietary cation-anion difference had higher urinary pH values than those
      fed the 0 meq diet. Urinary P excretion was not altered by dietary cation-anion
      difference or Ca content of the diet. Calves fed the 0 meq diet had higher
      urinary cocnentrations of Ca and Cl when compared with those fed the 200 meq
      diet. Bone ash, P, Ca, Mg, and K content of the 10th rib were not affected by
      dietary treatments. Breaking strength of the seventh and ninth ribs increased
      quadratically with increasing dietary Ca content. Dietary cation-anion difference
      had no effect on the breaking strength of the seventh and ninth ribs. Varying the
      dietary cation-anion difference from 0 to 200 meq/kg of dietary dry matter had no
      effect on Ca requirement of the growing calf.

PMID- 11210028
TI  - In vitro mixed ruminal microorganism fermentation of whole cottonseed coated with
      gelatinized corn starch and urea.
AB  - We conducted an in vitro mixed ruminal microorganism fermentation study to
      determine the effect of coating whole cottonseed with gelatinized corn starch and
      feed grade urea. Treatments were arranged as a 3 x 4 factorial to provide three
      concentrations of starch (0.0, 2.5, and 5.0%) and four concentrations of urea
      (0.0, 0.25, 0.5, and 1.0%). All treatments were prepared from one lot of whole
      cottonseed. Batch culture fermentations were conducted using anaerobic medium
      that contained 20% (vol/vol) ruminal fluid in 160-ml serum bottles. Whole
      cottonseed was ground to pass through a 6-mm screen and weighed amounts (0, 0.4,
      0.8, and 1.2 g) were added to the serum bottles. As starch increased, H2, CH4,
      total volatile fatty acids, and molar proportions of propionate increased
      linearly, whereas pH, molar proportions of acetate, and the acetate to propionate
      ratio decreased linearly. L-Lactate concentrations were highest with 2.5% starch
      compared with 0 or 5.0%. As the amount of urea in the coating increased, pH and
      CH4 increased linearly, whereas H2 concentrations decreased linearly. Ammonia
      concentrations exhibited a quadratic response due to moderate increases with the
      addition of 0.25 and 0.5% urea, and a greater increase was observed with 1.0%
      urea. Interactions between starch and urea were observed for H2, CH4, NH3, and L
      lactate. Concentrations of H2 decreased and CH4 was relatively constant as urea
      increased in the presence of 0 and 2.5% starch, but increased with 5% starch. L
      Lactate concentrations were unchanged (0% starch), higher (2.5% starch), or lower
      (5.0% starch) as urea increased. Ammonia concentrations increased after urea
      exceeded 10% of the starch concentration. The addition of urea did not prevent
      the decline in pH, but did reduce H2 and CH4 accumulation with 2.5% starch.

PMID- 11210029
TI  - Effects of alimet on nutrient digestibility, bacterial protein synthesis, and
      ruminal disappearance during continuous culture.
AB  - A dual effluent continuous culture system was used to investigate the effects of
      inclusion of Alimet (Novus International, Inc., St. Louis, MO) feed supplement
      [an 88% aqueous solution of dl, 2-hydroxy-4-(methylthio) butanoic acid (HMB)] in
      the diet on nutrient digestibility, bacterial protein synthesis and ruminal
      disappearance of HMB. Four fermenters were fed three times daily a basal diet
      that consisted of 50% grain mixture and 50% forage for 9 d. In experiment 1, four
      concentrations of HMB (0, 0.20, 0.77, and 1.43% DM basis) were added to the diet
      and fed to the fermenters twice daily. In experiment 2, two concentrations of
      dietary HMB (0 and 0.88% DM basis) were fed twice daily and evaluated with two
      solids retention times (16.7 vs. 25.0 h) and two liquid dilution rates (0.15 vs.
      0.125 h(-1)). Increasing the amount of HMB in the diet did not affect nutrient
      digestibility, volatile fatty acid concentrations, or ruminal escape of HMB.
      Bacterial protein synthesis was improved with the addition of HMB during high and
      low retention times. The extent of HMB escaping ruminal degradation ranged from
      21.6 to 43.2% and was highest at the lower retention time. It can be concluded
      that a fraction of HMB survives rumen microbial degradation and, therefore,
      provides a rumen-protected form of methionine at the same time that it improves
      bacterial protein synthesis.

PMID- 11210030
TI  - Effects of alcohol ethoxylate and pluronic detergents on the development of
      pasture bloat in cattle and sheep.
AB  - A series of studies was conducted to determine the efficacy and possible modes of
      action of a water-soluble mixture of alcohol ethoxylate and pluronic detergents
      (AEPD; Blocare 4511, ANCARE, Auckland, NZ) in preventing pasture bloat in
      ruminants grazing or fed freshly harvested alfalfa. Ten cannulated Suffolk
      wethers were offered freshly harvested alfalfa; five were given a daily
      intraruminal dose of 40 ml of 50% AEPD (vol/vol) 1 h before feeding, and five
      (controls) were dosed with water. Viscosity of ruminal fluid was reduced (P <
      0.001) in AEPD-treated wethers, relative to the controls, for the first 2 h after
      feeding but not at 4 h after feeding and beyond. Treatment with AEPD did not
      affect dry matter (DM) intake, digestibility of DM, acid detergent fiber, or
      neutral detergent fiber, or N digestion and retention, implying that AEPD likely
      would not affect milk production. In a crossover grazing study, five of the
      wethers were given AEPD in drinking water (0.1%, vol/vol); treatment with AEPD
      was 100% effective for preventing bloat in sheep grazing early-bloom alfalfa for
      4 h daily. Replicate grazing studies were conducted with cattle in Lethbridge,
      AB; Lacombe, AB; and Kamloops, BC. Treated animals received AEPD in the water
      (0.06%, vol/vol) and grazed vegetative alfalfa for 6 h daily. As it did with
      sheep, AEPD treatment effectively precluded the bloat observed in control
      animals. Consequently, AEPD may be a valuable tool for alfalfa pasture-based
      dairy production although further study is required to develop an integrated
      model for optimal administration under a variety of climatic conditions.

PMID- 11210031
TI  - Chemical composition, ensiling characteristics, and apparent digestibility of
      summer annual forages in a subtropical double-cropping system with annual
      ryegrass.
AB  - A 2-yr study was conducted to determine the chemical composition and
      digestibility of silages made from forage sorghum, pearl millet, and tropical
      corn managed to optimize forage quality. Silages were ensiled in upright concrete
      silos lined with plastic and fed to heifers to determine in vivo apparent
      digestibility. Samples were collected before and after ensiling to determine
      ensiling characteristics and forage quality. After ensiling, tropical corn had
      the greatest dry matter (DM), the lowest crude protein, and the greatest water
      soluble concentrations. Tropical corn silage had a pH of 3.96. The pH of forage
      sorghum silage was 4.09, and pearl millet had a pH of 4.50. Pearl millet had the
      lowest concentration of preensiled water-soluble carbohydrate, which likely
      caused the high pH in the silage. There were no differences among the forages in
      DM loss during ensiling in yr 2. Heifers fed pearl millet silage consumed more
      DM, but digestible DM intake was not different among the three groups of heifers.
      The results of this experiment indicate that pearl millet would be less desirable
      as a crop intended solely for silage production. Both forage sorghum and tropical
      corn could be grown specifically for ensiling based on DM digestibility. The
      decision on which crop to use should be based on factors such as production
      costs, forage yields, and local growing conditions rather than silage quality.

PMID- 11210032
TI  - Refinements in primary rumen epithelial cell incubation techniques.
AB  - The objectives of this study were to 1) determine if the number of rumen
      epithelial cells in primary cell incubation affects the rate of metabolite
      production, and 2) determine the optimum mode of data expression to standardize
      reporting criteria. Sections of rumen epithelial tissue were excised from five
      Holstein heifers and subjected to serial tryptic digestion to isolate cells.
      Isolated cells had a mean viability of 86% (+/- 1.29) and were incubated at
      concentrations of 0.5, 1, 5, 10, 20, and 40 million cells per flask. Oxidation of
      [1-14C]butyrate to 14CO2 and production of acetoacetate (ACAC), beta
      hydroxybutyrate (BHBA), lactate, and pyruvate were measured for cell dilution
      comparisons. Cell number, cell dry matter, cell crude protein, epithelial wet
      tissue weight, body weight, and metabolic body weight were measured to generate
      12 different forms of data expression. Coefficients of variation were calculated
      for each type of expression. Expressing data per cell number resulted in the
      lowest variation. Oxidation of [1-14C]butyrate to 14CO2 and pyruvate production
      per million cells did not significantly differ between treatments for 90-min
      incubation. Acetoacetate and lactate concentrations were greatest at 0.5 and 1
      million cells/flask, respectively, with no differences between 5 to 40 million
      cells/flask. Production of BHBA for 1 million cells/flask was greater than 0.5
      and 40 million cells/flask, but did not change between cell concentrations 5 to
      20 million. The BHBA:ACAC concentration ratios for 0.5 and 1 million cell
      dilutions were both 1.1 to 1 indicating low mitochondrial redox potentials.
      Concomitantly, lactate:pyruvate ratios for 0.5 and 1 million cells were greater
      than other cell dilutions, indicating a high cytosolic redox potential. The
      suggested range of rumen epithelial cells to include in incubations is 5 to 20
      million cells/flask. This will minimize experimental error associated with using
      low cell numbers and the potential for reduced metabolite production caused by
      incubating large cell quantities. When rumen tissue taken from animals of the
      same species, size, and stage of development; data adjusted by cell number is
      preferred. However, it is recommended that cell protein, cell DM, and animal
      metabolic weight be included to facilitate future comparison between species and
      laboratories.

PMID- 11210033
TI  - Intestinal disappearance and mesenteric and portal appearance of amino acids in
      dairy cows fed ruminally protected methionine.
AB  - An experiment was conducted to compare the rates of disappearance of amino acids
      (AA) from the small intestine and their net appearance in the blood draining only
      the small intestine (mesenteric-drained viscera) and the whole gastrointestinal
      tract (portal-drained viscera) of cows fed a silage-based diet supplemented or
      not with ruminally protected Met. Five lactating dairy cows (118+/-4 DIM)
      equipped with duodenal and ileal cannulae (n = 2) or a duodenal cannula only (n =
      3), two of which were multicatheterized, were fed a TMR top dressed with 0 or 72
      g of ruminally protected Met per day. The addition of ruminally protected Met to
      the diet increased the duodenal flux of Met leading to a higher apparent
      digestibility of Met in the small intestine. Sixty-six percent of Met from
      ruminally protected Met bypassed the rumen and 82% of that Met disappeared from
      the small intestine. Arterial plasma Met concentrations numerically increased
      with ruminally protected Met (45 vs. 18 microM), while total AA concentration
      decreased. Feeding ruminally protected Met resulted in higher concentrations of
      urea-N and glucose in arterial plasma. Milk production and milk composition were
      unaffected. The disappearance of essential AA across the small intestine was
      equivalent (101%) to their flux through the mesenteric-drained viscera while the
      portal:mesenteric-drained viscera flux ratio for each essential AA varied from
      38% for Thr to 76% for Phe. The portal:mesenteric-drained viscera flux ratio for
      Met was 66%. These results confirm observations made with pigs and sheep.

PMID- 11210034
TI  - Effects of forage neutral detergent fiber and yeast culture on performance of
      cows during early lactation.
AB  - Sixty Holstein cows were assigned to two treatments at 21 d before calving and
      were group-fed a prepartum diet with or without yeast culture. After parturition,
      cows were individually fed one of five treatments for 140 d: 1) 21% forage
      neutral detergent fiber (NDF) without yeast culture, 2) 21% forage NDF with yeast
      culture, 3) 17% forage NDF without yeast culture, 4) 17% forage NDF with yeast
      culture, and 5) 25% forage NDF with yeast culture for 30 d and then switched to
      diet 4 for 110 d. Cows fed yeast culture prepartum were also fed yeast culture
      postpartum (60 g/d). A quadratic increase to 25, 21, and 17% forage NDF occurred
      during the first 30 d in milk (DIM) for dry matter intake, milk yield, and milk
      protein yield. No differences were observed for yeast culture or interaction of
      yeast culture and forage NDF for the first 30 DIM. Feeding 17 versus 21% forage
      NDF increased milk protein percentage and tended to increase dry matter intake as
      a percentage of body weight from 31 to 140 DIM. During this period, yeast culture
      tended to increase milk fat percentage and appeared to have positive effects on
      dry matter intake, milk yield, and milk fat yield when supplemented to diets with
      21% forage NDF but not with 17% forage NDF. Feeding 17% forage NDF may be too low
      for the first 30 DIM but may improve animal performance after 30 DIM compared to
      21% forage NDF.

PMID- 11210035
TI  - Effects of milk fat, cocoa butter, or selected fat replacers on flavor volatiles
      of chocolate ice cream.
AB  - Selected volatile compounds of chocolate ice creams containing 0.6, 4.0, 6.0, or
      9.0% milk fat or containing 2.5% milk fat, cocoa butter, or one of three fat
      replacers (Simplesse, Dairy Lo, or Oatrim) were analyzed by gas chromatography
      and gas chromatography-mass spectrometry using headspace solid-phase
      microextraction. The headspace concentration of most of the selected volatile
      compounds increased with decreasing milk fat concentration. Fat replacers
      generally increased the concentration of volatiles found in the headspace
      compared with milk fat or cocoa butter. Few differences in flavor volatiles were
      found between the ice cream containing milk fat and the ice cream containing
      cocoa butter. Among the selected volatiles, the concentration of 2,5-dimethyl-3(2
      methyl propyl) pyrazine was the most highly correlated (negatively) with the
      concentration of milk fat, and it best discriminated among ice creams containing
      milk fat, cocoa butter, or one of the fat replacers.

PMID- 11210036
TI  - Effect of prepartum dietary protein level on performance of primigravid and
      multiparous Holstein dairy cows.
AB  - This study compared the effects of two levels of crude protein (CP) fed during
      late gestation on the performance, blood metabolites, and ovarian activity of
      Holstein cows. One-hundred and six cows (42 primigravid and 64 multiparous) 32 d
      before calving were divided into two groups and fed diets containing moderate
      (12.7% CP, 36% rumen undegradable protein, (RUP) or high (14.7% CP, 40% RUP)
      protein. Higher prepartum CP diet increased milk production during the first 120
      d in milk (DIM), but most of that effect was detected for the primigravid cows.
      Primigravid cows fed the prepartum diet higher in protein produced 2.0 kg/d more
      milk and 3.1 kg/d more 3.5% fat-corrected milk (FCM) during early lactation.
      Yields of milk fat and protein in early lactation were also increased by the high
      prepartum CP diet fed to primigravid cows. During the complete lactation, the
      response to prepartum dietary protein differed between primigravid and
      multiparous cows. Yields of milk, 3.5% FCM, and milk fat and protein were not
      affected by the prepartum diet for primigravid cows, but decreased for
      multiparous cows fed the high protein diet. However, primigravid cows fed the
      high prepartum protein diet had a higher 305-d mature equivalent milk yield.
      Colostrum composition, blood metabolites, ovarian activity, and disease incidence
      were not influenced by prepartum protein. Data from this study suggest that the
      current prepartum protein recommendation seems to be adequate for multiparous
      cows, but late-gestation primigravid cows might benefit from diets with a CP
      content above 12.7%.

PMID- 11210037
TI  - Effect of dietary sulfur and selenium concentrations on selenium balance of
      lactating Holstein cows.
AB  - The effects of dietary sulfate and selenium concentrations on selenium balance in
      dairy cows were investigated. Midlactation Holstein cows (n = 30) were fed diets
      containing either 0.1 or 0.3 mg of supplemental Se (from sodium selenate)/kg of
      dry matter and 0, 0.2, or 0.4% added S from a mix of calcium and magnesium
      sulfate in a factorial arrangement. The experiment lasted 112 d. Dry matter
      intake was linearly reduced with increasing S, but the effect was greater when
      0.3 mg/kg of Se was fed (significant interaction). Treatment effects for yields
      of milk, milk fat, and milk protein were similar to those for dry matter intake.
      Increased dietary S linearly reduced plasma Se concentrations. Increasing dietary
      S linearly reduced apparent (42.7, 33.1, and 30.1%) and estimated true (50.5,
      46.0, and 42.3%) Se digestibility. Excretion of Se via feces (1.6 vs. 2.8 mg/d)
      and urine (0.5 vs. 1.3 mg/d) was higher and output in milk (0.4 vs. 0.3 mg/d) was
      lower for cows fed 0.3 mg/kg of Se compared with 0.1 mg/kg, but no Se effect was
      found for estimated true Se digestibility. Dietary S from sulfate reduced Se
      balance especially when cows were fed diets with less than 0.3 mg of Se/kg of
      diet dry matter.

PMID- 11210038
TI  - The effects of milk yield and stage of lactation on the partitioning of nutrients
      in lactating dairy cows.
AB  - The objective of the experiment was to examine, using indirect calorimetry, the
      effects of milk yield and stage of lactation on the response in milk and body
      tissue energy, and heat production, to a reduction (decrement) in nutrient intake
      (assessed as metabolizable energy intake). Eight lactating dairy cows, four
      representing each of two stages of lactation [either mean initial days in milk
      (DIM) 158 (SD 6.1) or 414 (SD 51.1)] were used. Each cow underwent four 17-d
      periods incorporating two physiological states [number of mammary glands milked:
      either four (periods 1 and 2), or two (periods 3 and 4)], and two levels of
      metabolizable energy intake within each physiological state [either sufficient to
      meet requirements for zero tissue balance plus 10 MJ/d (periods 1 and 3)] or
      these allowances reduced by 20 MJ/d in the subsequent period (periods 2 and 4,
      respectively). Partitioning was calculated from the changes in metabolizable
      energy intake, milk energy, tissue energy, and heat production between DIM groups
      and between four and two gland milking (milk yield) components of the study.
      Partitioning of the changes in metabolizable energy intake was not influenced by
      DIM, but milk yield response was greater in the early lactation cows compared
      with the late group. Cows milked in four glands (higher milk yield) partitioned a
      significantly greater proportion of decremental changes in metabolizable energy
      intake to milk energy and less to tissue energy, than when milked in only two
      glands (lower milk yield).

PMID- 11210039
TI  - Insulin regulates milk production and mammary gland and hind-leg amino acid
      fluxes and blood flow in lactating goats.
AB  - We investigated the roles of insulin and amino acid (AA) in regulating milk
      production and the uptake of AA and blood flow (BF) by the mammary gland and hind
      leg of goats (n = 4). During two periods, either saline or AA (65 g/d) was
      infused i.v. for 7.5 d, and, beginning on d 5, goats were subjected to a
      hyperinsulinemic-euglycemic clamp. The insulin clamp elevated plasma insulin
      levels threefold and insulin-like growth factor-1 by 27%, and euglycemia was
      maintained by the infusion of glucose. Arterial, mammary, and tarsal vein blood
      samples were obtained on d 4 and 8 of each period, and blood flow was monitored
      continuously by probes. Insulin and insulin plus AA infusions increased the
      yields of milk by 13 to 18% and protein by 10 to 21%, but AA infusion alone had
      no effect. The insulin clamp reduced milk fat content by 21 to 31% and yield by 8
      to 19%, and reduced the yields of milk fatty acids >C16. The insulin clamp
      increased mammary blood flow by 42%, but insulin and AA infusions both increased
      hind-leg BF by 29 to 52% and by 25%, respectively. Net uptakes of most plasma AA
      by the udder were reduced by insulin, whereas AA infusion had no effect. For the
      leg, the uptake of His and Thr were decreased by insulin, whereas the infusion of
      AA stimulated the uptake of total essential AA. Insulin increased the uptake of
      glucose by the udder but not by the leg. This study suggests that the udder and
      leg tissues respond differently to infusions of insulin and AA; the udder was
      more responsive to insulin, while the leg was more responsive to AA concentralion
      (supply), at least in terms of AA uptake and net anabolism (protein gain or
      secretion).

PMID- 11210040
TI  - Evaluation of sire predicted transmitting abilities for evidence of X-chromosomal
      inheritance in north american sire families.
AB  - This study tested for differences between genetic merits of sons and daughters of
      sires and for evidence of segregating quantitative trait loci on the X
      chromosomes of North American Holsteins. Son PTA adjusted for sire PTA was used
      as the dependent variable to test for biases and for genes that were passed from
      sire to daughter but not to son. The test of variability across sires of sons
      merely indicated an unaccounted source of variation, for which genes on X
      chromosomes might be responsible. Critical values for this test and power were
      determined by simulation for a variety of populations and traits differing in
      heritability, size of the X chromosome effect, and allelic frequency. Simulated
      genes on the X chromosome were detected with high power at intermediate
      frequencies of the favorable allele. The power of the test increased as the size
      of the effect increased and as genetic variance attributed to autosomes
      decreased. The test was then applied to recently evaluated data from US and
      Canadian Holstein populations. Genetic evaluations for >17,000 bulls from the US
      and >9000 from Canada were included. Results suggested that little extra
      variation was present for some traits formally evaluated in North America, but
      that genes on the X chromosome were unlikely to be the cause.

PMID- 11210041
TI  - Heritabilities and correlations among body condition scores, production traits,
      and reproductive performance.
AB  - The objectives of this study were to estimate the heritability of body condition
      scores (BCS) from producer and consultant-recorded data and to describe the
      genetic and phenotypic relationships among BCS, production traits, and
      reproductive performance. Body condition scores were available at calving,
      postpartum, first service, pregnancy check, before dry off, and at dry off from
      the Dairy Records Management Systems in Raleigh, NC, through the PCDART program.
      Heritabilities, genetic correlations, and phenotypic correlations were estimated
      assuming an animal model using average information REML. Herd-year-season effects
      and age at calving were included in all models. Prior calving interval was
      included in models for second and third lactations. Analyses that included
      reproductive traits were conducted with and without mature equivalent milk as a
      covariable. Heritability estimates for BCS ranged from 0.09 at dry-off to 0.15 at
      postpartum in first lactation. Heritability estimates ranged from 0.07 before dry
      off to 0.20 at pregnancy check in second lactation and from 0.08 before dry-off
      to 0.19 at first service in third lactation. Genetic correlations between
      adjacent BCS within first lactation were greater than 0.96 with the exception of
      calving and postpartum (0.74). In second lactation, adjacent genetic correlations
      were 1.0 with the exception of calving and postpartum (0.84). Genetic
      correlations across lactations were greater than 0.77. Phenotypic correlations
      between scoring periods were highest for adjacent scoring periods and when BCS
      was lowest. Phenotypic correlations were lower than genetic correlations, i.e.,
      less than 0.70. Higher BCS during the lactation were negatively related to
      production, both genetically and phenotypically, but the relationship was
      moderate. Higher BCS were favorably related genetically to reproductive
      performance during the lactation.

PMID- 11210042
TI  - Parallel computing applied to breeding value estimation in dairy cattle.
AB  - Continuous genetic evaluation of dairy cattle with test-day models is desired in
      Finland. However, the computing time for the genetic evaluation is 4 d and
      exceeds the minimum of a weekend. Three parallel implementations of the
      preconditioned conjugate gradient iterative solver were programmed and compared
      to identify the best strategy for solving mixed model equations using parallel
      computing. The programs were used to solve two random regression test-day models
      with approximately 7.28 and 49.9 million unknowns. The latter model will be used
      in the Finnish dairy cattle evaluation. Computing times for the smaller model
      with the four processors available were 52, 32, and 27% of the single processor
      program when the complexity of the parallel program was increased. In practice,
      the best program required the most programming because the other parallel
      programs could not solve the larger model because of excess memory requirements.
      Parallel computing with four processors reduced the time to obtain solutions of
      Finnish dairy cattle evaluations to under 2 d. Benefit from parallel computing
      will be increased if amount of computing memory is increased.

PMID- 11210043
TI  - Genetic parameters for cystic ovarian disease in dutch black and white dairy
      cattle.
AB  - Cystic ovarian disease (COD) is one of the most frequently diagnosed
      gynecological findings in dairy cattle. It causes temporary infertility and is
      likely to affect reproduction as well as production parameters in cows. The
      objectives of this study were to investigate the heritability of COD in a Dutch
      Black and White population and to estimate the genetic and phenotypic
      relationships with milk production traits. In the data set used, the overall
      incidence of COD was 7.7% (1204 COD diagnoses in 15,562 lactations). The farm
      incidence varied between 1.9 and 11.3%. The estimated heritabilities on the
      underlying and observable scales were 0.102 and 0.087, respectively. The genetic
      correlations between COD and 305-d milk, fat, and protein yields were 0.345,
      0.379, and 0.441, respectively. We concluded that a genetic predisposition for
      COD exists in Dutch Black and White dairy cattle. The genetic correlations
      between COD and yield traits indicate that ongoing selection for production will
      increase the incidence of COD.

PMID- 11210044
TI  - Identification and characterization of elevated microbial counts in bulk tank raw
      milk.
AB  - The bacterial composition of bulk tank milk from 13 farms was examined over a 2
      wk period to characterize sudden elevations in the total bacterial count referred
      to as "spikes." Bulk tank milk samples collected at each pick-up were analyzed
      for standard plate count, Petrifilm aerobic count, somatic cell count, gram
      negative organisms, and streptococci. Twenty standard plate count spikes were
      observed: 12 associated with streptococci, 4 associated with gram-negative
      organisms, 2 associated with streptococci and gram-negative organisms, and 2 that
      were not definitively characterized. Spikes ranged from 14,000 to 600,000 cfu/ml.
      Streptococcus uberis was isolated as the predominant organism from 11 spikes, and
      Escherichia coli was isolated from 4 spikes. Statistical analysis of total
      bacterial counts indicated a high correlation (r = 0.94) between standard plate
      counts and Petrifilm aerobic count. Regression analysis of standard plate counts
      and Petrifilm aerobic counts yielded the equation log10 (standard plate count) =
      0.73 + 0.85log10 (Petrifilm aerobic count), indicating that the correlation,
      although strong, is not one to one. In a related pilot study, triplicate bulk
      tank milk samples were collected and analyzed for total bacterial count and
      presumptive streptococcus, gram-negative, and staphylococcus counts. Two-way
      ANOVA of these triplicate data indicated a lack of significant variation among
      the triplicate samples, suggesting that one sample can reliably gauge the
      microbial status of the entire bulk tank.

PMID- 11210045
TI  - Deep-stacked broiler litter as a protein supplement for dairy replacement
      heifers.
AB  - Fifty Holstein dairy heifers, [two replications of 25 heifers; average body
      weight (BW) 227 kg], were assigned to one of the following treatments for 105 d.
      Treatments 1 through 4 are given as the percentage of supplemental crude protein
      (CP) from soybean meal and deep-stacked broiler litter, respectively: 1) 100 and
      0%; 2) 67 and 33%; 3) 33 and 67%; 4) 0 and 100%; and 5) 67% of supplementary CP
      from deep-stacked broiler litter and 33% from a source of rumen undegradable
      protein (RUP). All rations were formulated to contain 15% CP and 68% TDN on a dry
      matter basis. Dry matter intake was not significantly different among treatments
      at 10.1, 10.2, 10.4, 9.4, and 9.1 kg/d for treatments 1 through 5, respectively.
      Average daily BW gains (1.35, 1.37, 1.28, 1.17, and 1.24 kg/d for treatments 1
      through 5, respectively) decreased linearly as the level of litter feeding
      increased and was not influenced by increasing RUP in treatment 5. Feed
      efficiency was not affected by the level of deep-stacked broiler litter feeding.
      Ruminal ammonia and plasma urea nitrogen concentrations decreased linearly as the
      level of litter feeding increased. Feeding additional RUP decreased ruminal
      ammonia concentration in treatment 5 to a level similar to treatment 4. This
      suggests that the protein in deep-stacked broiler litter may be more undegradable
      than that in soybean meal and that RUP in broiler litter may be higher than
      previously thought. Results from this study indicate that deep-stacked broiler
      litter has potential as a low-cost CP source for growing dairy heifers.

PMID- 11210046
TI  - Effect of the fat globule sizes on the meltdown of ice cream.
AB  - The meltdown of ice cream is influenced by its composition and additives and by
      fat globule size. The objective of this study was to examine the effect of fat
      globule size and fat agglomerate size on the meltdown stability of ice cream.
      Therefore, an ice cream mix (10% milk fat) was homogenized at pressures ranging
      from 0 to 30 MPa in single-stage, double-stage, and selective homogenization
      processes. The ice cream, produced on a continuous ice cream freezer, was
      characterized by an optimized meltdown test while, in addition, the fat globule
      sizes and the free fat content were determined in the mix and the molten ice
      cream. The meltdown was dependent on the fat agglomerate sizes in the unfrozen
      serum phase. Agglomerates smaller than a critical diameter led to significantly
      higher meltdown rates. Homogenization pressures of at least 10 MPa were
      sufficient to produce a stable ice cream. Furthermore, proof was provided that
      double-stage homogenization is not necessary for fat contents up to 10% and that
      selective homogenization is possible to produce stable ice creams. Based on these
      results a model was deduced describing the stabilizing mechanisms during the
      meltdown process.

PMID- 11210047
TI  - On reflectometric measurement of a refractive index of milk.
AB  - The refractive index of milk samples was measured with a reflectometer. Fresnel's
      formula for intensity reflectance and the concept of critical angle were applied
      to measured data. Milk samples were also measured with surface plasmon resonance
      sensor for refractive index assessment. The experiments were carried with
      commercial milk that had fat volume concentrations of 0.004, 1.53, and 3.55%. We
      observed that simultaneously quantitative information about the refractive index
      and absorption of milk, as a function of fat concentration, could be obtained
      with both devices.

PMID- 11210048
TI  - Cation-exchange purification of mutagenized bovine beta-casein expressed in
      transgenic mouse milk: its putative Asn68-linked glycan is heterogeneous.
AB  - Bovine beta-casein (A2 genetic variant) was mutagenized to (L70S/P71S) and
      expressed in transgenic mouse milk. This protein now carries the signal
      (N68S69S70S71) that mimics a consensus eukaryotic glycosylation signal (N-X-S/T)
      (3). Hypothetically this protein should be glycosylated at N68 by any eukaryotic
      organism producing it. This novel protein was purified from transgenic mouse milk
      by Mono-S cation-exchange fast protein liquid chromatography (FPLC). The novel
      beta-casein was separated without cross contamination from mouse caseins by using
      acetate buffer (pH 5.0) in the presence of 6 M urea, octyl-glucopyranoside and 2
      beta-mercaptoethanol. The purified (L70S/P71S) beta-casein showed an N-linked
      oligosaccharide attached to Asn68 and different lectin binding profiles compared
      with the same protein expressed in yeast. The mouse-expressed beta-casein
      (L70S/P71S) was specific to Concanavalin A, wheat germ agglutinin, Erythrina
      cristagalli agglutinin, and Ulex europaeus, indicating its oligosaccharide
      structure is different in the mammary gland of mouse than the reported
      glycosylated beta-casein expressed in Pichia pastoris (4). In addition, the five
      serine residues located at amino terminus of wild type bovine beta-casein were
      shown to be normally phosphorylated as in native bovine beta-casein.

PMID- 11210050
TI  - Proteolysis of beta-casein as a marker of Grana Padano cheese ripening.
AB  - Proteolysis has a critical role in defining the typical organoleptic
      characteristics of Grana Padano, a well-known Italian cheese. During the ripening
      process, hydrolysis of beta-casein produces different fragments, the most
      abundant and widely studied of which are gamma-caseins, three polypeptides
      containing the HOOC-terminal portion of beta-casein. By sodium dodecyl sulfate
      PAGE and a specific anti-beta-casein monoclonal antibody, two beta-casein-derived
      bands were identified in Grana Padano cheese: betaa and betab. Thanks to the
      identification of the amino acid sequences, it was shown that: a) betaa contains
      gamma1-casein [beta-casein (29-209)] and the correlated peptide [beta-casein (30
      209)]; b) betab contains gamma2-casein [beta-casein (106-209)] and gamma3-casein
      [beta-casein (108-209)]. The production of betaa and betab by the three enzymes
      most involved in cheese proteolysis (pepsin, chymosin, and plasmin) was evaluated
      by performing in vitro digestions. A significant correlation between abundance of
      some polypeptides and ripening process was shown.

PMID- 11210049
TI  - Isolation, characterization, and influence of native, nonstarter lactic acid
      bacteria on Cheddar cheese quality.
AB  - To determine whether adventitious nonstarter lactic acid bacteria (NSLAB) might
      affect cheese flavor and quality, we studied a population of NSLAB present in 30
      premium quality Cheddar cheeses (3-mo ripened) produced at a commercial facility
      in the United States. DNA fingerprinting analysis with a sensitive strategy for
      arbitrary priming polymerase chain reaction showed that 75 isolates corresponded
      to at least 18 distinct nonstarter organisms. According to ribotype database
      comparisons of representatives from the 18 groups, 9 matched Lactobacillus
      (closest to paracasei species), 8 matched Streptococcus thermophilus, and 1
      matched to a Lactococcus species. This finding indicated that among the 75 NSLAB
      isolates, Lactobacillus made up 64%, S. thermophilus 32%, and Lactococcus 4%.
      Isolates representing 11 NSLAB groups were characterized for protease, peptidase,
      and diacetyl production. Based on this phenotypic analysis, two Lactobacillus
      isolates were evaluated as adjuncts in Cheddar cheese. All of the NSLAB
      identified from the adjunct cheese at 3 mo by DNA fingerprinting consisted of the
      adjunct lactobacilli, showing that the adjunct strains predominated throughout
      the early stages of ripening. The impact of adjunct lactobacilli was evident
      after 6 mo when free amino acids significantly increased and sensory scores
      improved in adjunct cheese as compared with a control cheese. The largest impact
      was found in adjunct cheese containing a blend of both lactobacilli strains.
      These results show that certain adventitious NSLAB positively contribute to
      flavor development.

PMID- 11210051
TI  - A survey of lipolytic and glycolytic end-products in commercial Cheddar enzyme
      modified cheese.
AB  - The concentrations of L- and D-lactic acid and free fatty acids, C4:0 to C18:3,
      were quantified in a range of commercial enzyme-modified Cheddar cheeses. Lactic
      acid in Cheddar enzyme-modified cheeses varied markedly depending on the
      manufacturer. Differences in the ratio of L- to D-lactic acid indicate that
      cheeses of different age were used in their manufacture or contained varying
      levels of nonstarter lactic acid bacteria. The level of lipolysis in enzyme
      modified cheese was higher than in natural Cheddar cheese; butyrate was the
      predominant free fatty acid. The addition of exogenous acetate, lactate, and
      butyrate was also indicated in some enzyme-modified cheeses and may be used to
      confer a specific flavor characteristic or reduce the pH of the product.
      Propionate was also found in some enzyme-modified cheese products and most likely
      originated from Swiss-type cheese used in their manufacture. Propionate is not
      normally associated with natural Cheddar cheese flavor; however, it may be
      important in the flavor and aroma of Cheddar enzyme-modified cheese. Levels of
      lipolysis and glycolysis appear to highly controlled as interbatch variability
      was generally low. Overall, the production of enzyme-modified Cheddar cheese
      involves manipulation of the end-products of glycolysis (lactate, propionate, and
      acetate) and lipolysis to generate products for specific applications.

PMID- 11210052
TI  - Optimization of the PCR for detection of Staphylococcus aureus nuc gene in bovine
      milk.
AB  - Staphylococcus aureus is an economically important and a major mastitis-causing
      pathogen that also poses food safety and antimicrobial resistance threats.
      Substances in mastitic milk inhibit the Taq DNA polymerase reaction (Taq PCR)
      making it of limited use for detecting S. aureus mastitis. In the study reported
      here, a set of oligonucleotide primers of 21 and 24 bases was used in Taq-PCR to
      amplify DNA from S. aureus (isolates from bovine mastitis). A specific amplicon
      of 270 bp was generated as predicted. Replacing Taq DNA polymerase with Thermus
      thermophilus (Tth) DNA polymerase alone (Tth-PCR) raised the sensitivity of S.
      aureus detection in milk from experimentally infected cows from 65 to 80%.
      Combining the use of Tth DNA polymerase and the purification of crude DNA extract
      using Chelex-100 before PCR raised the sensitivity to 100%. In a random survey
      involving 100 milk samples from cattle not infected with S. aureus, the test was
      100% specific. With milk samples from clinical cases of bovine mastitis, 100%
      sensitivity and specificity were also observed. It is concluded that Tth-PCR on
      milk samples with the purification of crude DNA extracts using Chelex-100 is as
      sensitive as but faster than conventional milk bacteriological culture techniques
      and is highly specific. The modified PCR correlates with elevated somatic cell
      counts, detects evidence of chronic and resolving infection based on S. aureus
      specific DNA and circumvents the endogenous inhibitory effects of milk.

PMID- 11210053
TI  - Tail docking dairy cattle: effects on cow cleanliness and udder health.
AB  - To determine whether tail docking would influence cow cleanliness and udder
      health in a free-stall system, we monitored milking cows after half the animals
      in a herd were docked. A sample of 223 docked and 190 undocked cows (reducing to
      169 and 105 over the study as cows were dried off) were monitored for 8 wk. Cow
      cleanliness was scored in two areas: along the spine, and the rump adjacent to
      the tail at 1, 2, 3, 5, and 8 wk after docking. Cleanliness was evaluated by
      counting squares that were soiled (0 to 14 on a 5- x 17.5-cm grid) and judging
      soiling severity on a scale from 0 (clean) to 3 (thickly caked). Udder
      cleanliness was scored with the same scale (0 to 3) and by counting the number of
      teats with debris on them. Udder health was assessed by measuring SCC of two milk
      samples and the number of animals diagnosed as mastitic by the on-farm
      veterinarian. No treatment differences were found in four measures of cow
      cleanliness, two measures of udder cleanliness, or udder health. However, cow
      cleanliness did differ over time, and analysis of a subsample of cows illustrated
      individual differences in cleanliness.

PMID- 11210054
TI  - Effects of the persistent dominant follicle on the ability of follicle
      stimulating hormone to induce follicle development and ovulatory responses.
AB  - Three experiments were conducted to evaluate the effect of an induced first wave
      persistent dominant follicle on folliculogenesis and ovulatory responses induced
      by FSH. On d 6 of a synchronized estrous cycle (d 0 = estrus), cows were treated
      with a Syncromate-B implant and two injections of PGF2, (25 mg, 0700 h; 15 mg,
      1900 h, i.m.). Cows in the control group retained a first-wave persistent
      dominant follicle, but in the aspirated group, the first-wave dominant follicle
      was removed via transvaginal aspiration on d 10 (d 0 = estrus). Beginning on d
      12, cows received 32 mg of FSH-P i.m. in decreasing doses at 12-h intervals over
      a 4-d period. On d 15, the Syncromate-B implant was removed, and cows were
      ovariectomized (experiment 1, n = 8) or inseminated (experiment 2, n = 11) at 10
      and 22 h after the onset of estrus. Cows in experiment 3 received a used
      controlled intravaginal drug releasing (CIDR) device and two injections of
      PGF2alpha (25 mg, 0700 h; 15 mg, 1900 h; i.m.) on d 6. On d 8, the first-wave
      dominant follicle was aspirated (n = 6) or left intact (n = 5), and FSH treatment
      was initiated (20 mg of Folltropin in decreasing doses at 12-h intervals over a 4
      d period), and on d 10 the used CIDR device was removed from all cows. Ovarian
      follicle size and number were examined daily by ultrasonography from d 5 of the
      estrous cycle. The persistent dominant follicle increased in size from 10.7 mm on
      d 5 to 15.4 mm on d 10 (experiments 1 and 2), and from 9 mm on d 5 to 20.4 mm on
      d 11 (experiment 3). From d 11 to 14, the number of class 1 (2 to 5 mm) follicles
      was lower in the aspirated group than in the control group; the number of class 2
      (6 to 9 mm) follicles was higher on d 12 and 13 for the aspirated group
      (experiments 1 and 2). The number of class 3 (> or =10 mm) follicles was higher
      in the aspirated group on d 14 to 16, but the same on d 17. Ovarian and embryo
      responses to superovulation did not differ between groups. In experiment 3, the
      numbers of class 1, 2, and 3 follicles, as well as ovarian and embryo responses
      following ovulation did not differ between groups. Initiation of exogenous FSH
      treatment appears to override any systemic inhibitory effect that a persistent
      dominant follicle may be exerting at the pituitary and possibly the ovary.

PMID- 11210055
TI  - A cross-cultural study of suicide intent in parasuicide patients.
AB  - As part of the WHO/EURO Multicentre Study on Parasuicide, the level of suicide
      intent among female and male parasuicide patients from various European regions
      was compared. From nine regions, a total of 1,212 parasuicide patients, 752
      females and 460 males, were included in the study. Although some statistical
      significant differences in level of suicide intent between the regions and
      genders were found, the effect sizes of these relationships were so small that
      the differences have neither theoretical nor practical significance. As far as
      level of suicide intent is concerned, the WHO study has succeeded in recruiting a
      relatively homogeneous group of self-harming patients across borders of region,
      culture, and country.

PMID- 11210056
TI  - Trends in suicide ideation and suicidal behavior among high school students in
      the United States, 1991-1997.
AB  - To examine trends in suicide ideation and behavior over time, the authors analyze
      data from nationally representative samples of between 10,904 and 16,296 students
      participating in the 1991, 1993, 1995, and 1997 Youth Risk Behavior Surveys.
      These data describe the proportion of United States students in grades 9 through
      12 that reported having (1) seriously considered attempting suicide, (2) made a
      plan to attempt suicide, (3) attempted suicide, and (4) made an injurious suicide
      attempt. From 1991 to 1997, the percentage of students seriously considering
      suicide and the percentage that made a suicide plan showed significant linear
      decreases. However, the percentage of students that made an injurious suicide
      attempt showed a significant linear increase. These trends make it unlikely that
      relevant national health objectives for the year 2000 will be met. Additional
      efforts are needed to identify and disseminate strategies that effectively reduce
      suicidal thoughts and behaviors among adolescents.

PMID- 11210057
TI  - Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: worldwide
      patterns of use and misuse.
AB  - Paracetamol (acetaminophen) is one of the most frequently used drugs in
      intentional overdoses. We have investigated associations between its availability
      and its use for overdose and suicide around the world by means of a postal
      questionnaire and literature review. Countries that limit the quantity of
      paracetamol available in a single purchase generally report lower rates of
      paracetamol-related morbidity and mortality. National policy decisions regarding
      restrictions on its availability need to weigh the inconvenience caused to the
      many who use the drug safely against those of the few in whom overdose may be
      fatal. We recommend restricting the quantity of drug available as a single
      purchase as the most pragmatic means of reducing paracetamol-related suicide and
      liver failure.

PMID- 11210058
TI  - Risk of future suicide attempts in adolescent psychiatric inpatients at 18-month
      follow-up.
AB  - This study investigated potential predictors of suicidal behavior in adolescents
      during an 18-month follow-up period. Subjects included 60 adolescent psychiatric
      inpatients initially assessed in a private psychiatric hospital. Follow-up
      suicidality was most strongly predicted by high intake levels of hopelessness,
      and an increase in or persistent problems with depression during follow-up. Some
      family functioning variables measured at intake were predictive of suicidal
      behavior at the univariate level but did not add to the predictive ability of
      individual functioning variables. A mediational model was proposed in which the
      impact of family functioning on adolescent suicidality is mediated by its impact
      on individual functioning.

PMID- 11210060
TI  - Domestic violence, separation, and suicide in young men with early onset
      alcoholism: reanalyses of Murphy's data.
AB  - Partner violence and partner separation at the time of completed suicide were
      investigated in 42 male alcoholics originally described by Murphy (1992). Half of
      the men had domestic violence histories. Partner-violent men were younger, had an
      earlier age of onset of alcoholism, and were more likely to be separated from
      their partner at the time of death than partner-nonviolent men. Loss of a close
      personal relationship, often a domestic partner, is common during the last year
      of life among alcoholic men completing suicide. Domestic violence appears to
      typify many of their domestic relationships, particularly among younger men and
      men with early onset alcoholism.

PMID- 11210059
TI  - Cultural orientation, family cohesion, and family support in suicide ideation and
      depression among African American college students.
AB  - This study extends previous research by examining the role of communalism, family
      cohesion, and family support in suicide ideation and depression in African
      American college students. Participants were 188 African American introductory
      psychology students (126 female, 61 male) from a historically black college. (1)
      Results showed that communalism, family cohesion, and family support were
      positively associated with each other. Higher levels of family cohesion and
      family support were associated with lower levels of suicide ideation and
      depression. Linear regression analyses showed a main effect for communalism and
      family support. Having strong communal values was positively related to suicide
      ideation and depression. Having strong family support was associated with fewer
      experiences of suicide ideation and depression. Stepwise regression analyses
      indicated that family support explained more variance in suicide ideation and
      depression than family cohesion. Implications of these results for future
      research and practice are discussed.

PMID- 11210061
TI  - Prison suicides in Austria, 1975-1997.
AB  - Suicide prevention in custody is hampered by the lack of funds and professional
      staff. In order to evaluate the prison suicide phenomenon, a study was conducted
      evaluating all suicides that occurred in Austrian prisons between 1975 and 1997
      (n = 220). In addition to evaluating the number of male versus female suicides,
      the preferred suicide methods were studied, as well as suicide risk of different
      circumstances of custody. Suicide rates of distinguishable, important subgroups
      of prisoners were calculated. The suicide rate for prisoners on remand was 236.0
      per 100,000, and for offenders classified as mentally ill it was 205.4 per
      100,000. That is about 8 times higher than the suicide rate in Austria's general
      population (1975-1997: 24.6 per 100,000). The suicide rate for sentenced
      offenders was 81.3 per 100,000, about twice the suicide rate in Austria's general
      male population. We recommend that psychologists or psychiatrists concentrate on
      the suicide prevention of high-risk offenders after screening the newly admitted
      offenders for their propensity to suicide.

PMID- 11210062
TI  - Correctional suicide prevention in the year 2000 and beyond.
AB  - Although the problem of suicide in jail and prison historically has been ignored,
      significant insight has been gained over the past several decades due primarily
      to increasing litigation. This article provides a brief overview of the progress
      in research, programming, and policy. The new millennium offers exciting
      opportunities for continued growth in correctional suicide prevention. The key
      areas of process research, risk assessment, and public and penological policy
      changes are reviewed and considered vital for the field's advancement.

PMID- 11210063
TI  - The multi-attitude suicide tendency scale: further validation with adolescent
      psychiatric inpatients.
AB  - The present study was designed to examine the construct validity and psychometric
      properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric
      inpatients. This new scale has four subscales: attraction to life, repulsion by
      life, attraction to death, and repulsion by death. Confirmatory factor analysis
      of the scale items provided support for the fit of the 28-item, four-factor
      model. Results of logistic regression analyses revealed that high scores on the
      repulsion by life and the attraction to death subscales were useful in assessing
      the risk for suicide attempts. Results of the hierarchical regression analysis
      showed that high repulsion by life and low attraction to life subscale scores
      contributed to the prediction of scores on the suicide probability scale. We also
      examined gender differences on the four subscales and the psychological
      correlates of each subscale.

PMID- 11210064
TI  - Primo Levi's death: physicians and the ruling of suicide.

PMID- 11210065
TI  - Persistent presence of Bacteroides forsythus as a risk factor for attachment loss
      in a population with low prevalence and severity of adult periodontitis.
AB  - BACKGROUND: Previous longitudinal studies investigating the role of
      microorganisms in periodontitis have focused on subjects with a high prevalence
      and severity of disease. The complex profile of microbial species in severe cases
      of periodontitis might not allow us to differentiate which bacterial species
      initiate disease or which species simply proliferate after disease progression.
      This prospective longitudinal study followed a group of 205 subjects who showed a
      low prevalence and severity of adult periodontitis, and thus allowed us to
      monitor early microbiological changes in the development of periodontitis.
      METHODS: Subgingival plaque was collected from proximal surfaces of a posterior
      sextant at 6-month intervals for 2 years. During the monitoring period, 44
      subjects had either attachment loss or attachment gain. Using multiplex
      polymerase chain reaction (PCR), all plaque samples from those 44 subjects were
      analyzed for the presence of Actinobacillus actinomycetemcomitans, Bacteroides
      forsythus, and Porphyromonas gingivalis. RESULTS: Both subjects with attachment
      loss and those with attachment gain had a high prevalence of these 3 periodontal
      pathogens. The mere presence of any of the 3 species at a site could not predict
      future attachment loss at that specific site. However, subjects with a persistent
      presence of B. forsythus at any site across all visits had 5.3 times higher odds
      of having at least one site in their mouth losing attachment compared to subjects
      with occasional or no presence of B. forsythus. CONCLUSIONS: The persistence of
      B. forsythus identified subjects at higher risk, but not which specific sites in
      those subjects would lose attachment.

PMID- 11210066
TI  - Gingival overgrowth as the initial paraneoplastic manifestation of Hodgkin's
      lymphoma in a child. A case report.
AB  - BACKGROUND: The purpose of this paper is to present the first case of gingival
      overgrowth, premature root resorption, and alveolar bone loss, which preceded the
      diagnosis of a stage IVB Hodgkin's lymphoma (HL) in a 9-year-old boy. METHODS:
      The child presented complaining of gingival pain which first appeared 3 months
      prior. Clinical examination revealed inflamed, hyperplastic gingivae, while x-ray
      showed premature root resorption and alveolar bone loss. Medical work-up was
      significant for cervical lymphadenopathy. Gingival biopsy, followed by lymph node
      resection, was performed twice. RESULTS: Histological examination of both
      gingival biopsies disclosed a mixed inflammatory infiltrate, while classical
      Hodgkin's lymphoma of the nodular sclerosis type was diagnosed from the second
      lymph node biopsy. Chemotherapy was instituted with mustard-vincristine
      procarbazine-prednizone and adriamycine-bleomycine-vinblastine-dacarbazine.
      Remission of the lymphoma was observed with concomitant regression of the
      gingival overgrowth. CONCLUSIONS: The inflammatory gingival overgrowth, premature
      root resorption of deciduous teeth, and alveolar bone loss in this case, in
      conjunction with the regression of gingival overgrowth which followed the
      completion of chemotherapy, are strongly indicative of a paraneoplastic
      manifestation of HL. The postulated mechanism for the development of the
      manifestation is the constitutive activation of the transcription factor NF-kB.
      The gingival inflammatory reaction was probably further aggravated by the
      bacterial-stimulated cytokine secretion released by monocytes.

PMID- 11210067
TI  - Detection of hepatitis C virus RNA from gingival crevicular fluid and its
      relation to virus presence in saliva.
AB  - BACKGROUND: To search for a possible source of hepatitis C virus (HCV) in saliva,
      the presence and shedding patterns of HCV in gingival crevicular fluid (GCF) and
      saliva of HCV viremic patients were assessed based on clinical, biochemical,
      histological, virological, and oral health parameters. METHODS: Saliva and GCF
      samples of 50 HCV viremic patients were collected to detect HCV RNA by a modified
      commercial polymerase chain reaction (PCR) assay. Clinical oral examination was
      performed and periodontal status at the collection sites was monitored. The
      results were correlated to specified parameters. RESULTS: HCV RNA was detected in
      59% (29/49) of the GCF specimens and in 35% (17/48) of the saliva specimens. In
      saliva specimens, HCV RNA was detected only in cases which also had detectable
      HCV RNA in the GCF samples (P=0.00002) and was significantly related to the
      presence of blood in saliva (P=0.03). Higher, but not significant, values of oral
      clinical parameters at the sites of fluid collection were found in GCF specimens
      harboring HCV RNA. In GCF specimens with no blood detected, HCV RNA was more
      often present in cases with higher plasma viral load (P=0.05). CONCLUSIONS: The
      results suggest that besides blood, the other most probable source of HCV in
      saliva is GCF. Unknown endogenous HCV inhibitory mechanisms in the oral cavity
      may explain the discrepancies in HCV appearance between saliva and GCF. The
      results provide a biologic basis for further investigation of the role of HCV in
      the pathogenesis of periodontal disease.

PMID- 11210068
TI  - Will implants survive well in patients with a history of inflammatory periodontal
      disease?

PMID- 11210069
TI  - Relationship between crevicular aspartate aminotransferase levels and periodontal
      disease progression.
AB  - BACKGROUND: Aspartate aminotransferase (AST), an enzyme released from necrotic
      cells, has been identified in gingival crevicular fluid (GCF), and elevated
      levels are associated with periodontal tissue destruction. The aim of this study
      was to examine the relationship between elevated GCF levels of AST and
      periodontal disease progression. METHODS: Over a 12-month period, 8 to 10
      interproximal sites in 41 periodontitis subjects (PS) and 15 healthy subjects
      (HS) were monitored. Clinical measurements included relative attachment level
      (RAL), probing depth, and bleeding on probing (BOP). Semiquantitative levels of
      GCF AST (< 800 microIU, > or = 800 microIU, and > or = 1,200 microIU) were
      determined using a chairside assay. At the 6- and 12-month visits, scaling and
      root planing and prophylaxis were performed in the PS and HS, respectively.
      Sensitivity, specificity, positive predictive values (PPV), and negative
      predictive values (NPV) were calculated for 2 diagnostic criteria (AST > or = 800
      microIU, AST > or = 1,200 microIU) utilizing 4 thresholds of disease progression
      as determined by 2 methods (absolute change in relative attachment level and
      cumulative sum [CUSUM]). RESULTS: The percentage of sites exhibiting AST > or =
      800 microIU, AST > or = 1,200 microIU, and BOP in the PS was significantly
      (P<0.02) lower at 6 and 12 months compared to baseline. The use of crevicular AST
      activity to monitor periodontal disease progression was associated with many
      false-positive results. Overall, low specificities, PPV, and odds ratios were
      demonstrated by the assay when using 2 diagnostic criteria and 4 thresholds of
      disease progression. The high NPV suggest that a negative AST test result was
      indicative of a periodontally stable site. CONCLUSIONS: These results demonstrate
      that elevated levels of AST were present at sites that did not subsequently
      exhibit disease progression. The high prevalence of AST-positive sites due to
      gingival inflammation diminished the test's ability to discriminate between
      progressive and stable, but inflamed, sites.

PMID- 11210070
TI  - A comparative study utilizing open flap debridement with and without enamel
      matrix derivative in the treatment of periodontal intrabony defects: a 12-month
      re-entry study.
AB  - BACKGROUND: Previous studies have demonstrated that enamel matrix derivative
      (EMD) has the ability to improve clinical parameters when used to treat
      intraosseous defects. The purpose of the present study was to compare at 12
      months postsurgery sites treated with open flap debridement (OFD) alone to those
      treated with OFD and EMD. METHODS: Twenty-three subjects with at least 2
      intrabony defects were chosen. Fifty-three defects received EMD in conjunction
      with OFD. Thirty-one defects in these same 23 subjects were treated with OFD
      alone. Stents were fabricated to serve as fixed reference points. Re-entries were
      performed at least 1 year after initial surgery. Soft tissue measurements were
      recorded prior to initial surgery and prior to re-entry for gingival (GI) and
      plaque (PI) indices, probing depth (PD), gingival margin position, and clinical
      attachment level (CAL). Hard tissue measurements were recorded during the initial
      and re-entry surgery for level of crestal bone and depth of defect. Statistical
      analysis was conducted using the method of generalized estimating equations to
      determine changes in GI, PI, PD, CAL, fill of the osseous defect, and crestal
      resorption. Percent of defect fill was also calculated. RESULTS: In all
      categories, treatment with EMD (test) was superior to treatment without EMD
      (control). Average PI and GI were not significantly different either initially or
      prior to re-entry. The average PD reduction was 2.7 mm greater with EMD than
      controls. The average CAL gains were 1.5 mm greater, and the average fill of
      osseous defect 2.4 mm greater with EMD than controls. The average percent of
      defect fill after adjusting for crestal bone loss was more than 3 times greater
      for EMD versus control-treated sites (74% defect fill with EMD versus 23% defect
      fill for control sites). CONCLUSIONS: This study indicates that treatment of
      periodontal intraosseous defects with EMD is clinically superior to treatment
      without EMD (open flap debridement) in every parameter evaluated. Re-entry data
      demonstrate that percent fill of osseous defects treated with EMD compares
      favorably with the treatment results utilizing bone grafts or membrane barriers,
      according to published literature.

PMID- 11210071
TI  - Long-term results of guided tissue regeneration therapy with non-resorbable and
      bioabsorbable barriers. I. Class II furcations.
AB  - BACKGROUND: The aim of this 5-year follow-up study was to clinically and
      radiographically evaluate the long-term results after guided tissue regeneration
      (GTR) therapy of Class II furcation defects using non-resorbable and
      bioabsorbable barriers. METHODS: Nine pairs of contralateral Class II furcation
      defects were treated in 9 patients with advanced periodontitis. Within each
      patient, one defect received a non-resorbable (expanded polytetrafluoroethylene
      [ePTFE]; control, C) barrier and the other a bioabsorbable (polyglactin 910;
      test, T) barrier by random assignment. At baseline, 6, and 60 +/- 3 months after
      surgery, clinical parameters and standardized radiographs were obtained. Gain of
      bone density within furcation areas was assessed using subtraction radiography.
      RESULTS: Six and 60 months after GTR therapy, statistically significant (P <0.05)
      horizontal attachment (CAL-H) gain was observed in both groups (C6: 1.7 +/- 0.8
      mm; C60: 1.6 +/- 1.2 mm; T6: 2.0 +/- 0.7 mm; T60: 2.2 +/- 0.9 mm). However, 1
      furcation assessed as Class I six months after GTR therapy with a bioabsorbable
      barrier had progressed to Class III after 5 years, and in another patient, 5
      years after placement of an ePTFE barrier, 1 furcation had lost all the CAL-H
      gain that had been observed at 6 months. Subtraction analysis revealed similar
      area gain in both groups 6 and 60 months postsurgically (C6: 0.3 +/- 0.5; C60 1.0
      +/- 1.7; T6: 0.4 +/- 0.4; T60: 1.1 +/- 1.7). CONCLUSIONS: CAL-H gain achieved
      after GTR therapy in Class II furcations was stable after 5 years in 16 of 18
      defects. The study failed to show a statistically significant difference in
      stability of CAL-H gain between control and test groups 5 years after GTR
      therapy.

PMID- 11210072
TI  - Cigarette smoking negatively affects healing response following flap debridement
      surgery.
AB  - BACKGROUND: The purpose of the present parallel design, controlled clinical trial
      was to evaluate the treatment outcome following flap debridement surgery (FDS) in
      cigarette smokers compared to non-smokers. METHODS: After initial therapy, 57
      systemically healthy subjects with moderate to advanced periodontitis who
      presented with one area (at least 3 teeth) where surgery was required were
      selected. Twenty-eight patients (mean age: 39.6 years, 20 males) were smokers (>
      or = 10 cigarettes/day); 29 patients (mean age: 43.9 years, 7 males) were non
      smokers. Full-mouth plaque (FMP) and bleeding on probing (BOP) scores, probing
      depth (PD), clinical attachment level (CAL), and recession depth (RD) were
      assessed immediately before and 6 months following surgery. Only sites with
      presurgery PD > or = 4 mm were used for statistical analysis. RESULTS: Presurgery
      FMP and BOP were similar in smokers and non-smokers and significantly decreased
      postsurgery in both groups. Overall, PD reduction and CAL gain were greater,
      although not significantly, in non-smokers (2.4 +/- 0.9 mm and 1.6 +/- 0.7 mm,
      respectively) than in smokers (1.9 +/- 0.7 mm and 1.2 +/- 0.7 mm, respectively).
      For moderate sites (PD 4 to 6 mm), no significant differences in PD and CAL
      changes were found between groups. For deep sites (PD > or = 7 mm), PD reduction
      was 3.0 +/- 1.0 mm in smokers and 4.0 +/- 0.8 mm in non-smokers, and CAL gain
      amounted to 1.8 +/- 1.1 mm in smokers and 2.8 +/- 1.0 mm in non-smokers (P =
      0.0477). In smokers, 16% of deep sites healed to postsurgery PD values < or = 3
      mm as compared to 47% in non-smokers (P = 0.0000); 58% of deep sites in smokers
      showed a CAL gain > or = 2 mm, as compared to 82% in non-smokers (P = 0.0000).
      CONCLUSIONS: Results of the study indicated that: 1) FDS determined a
      statistically significant PD reduction and CAL gain in patients with moderate to
      advanced periodontitis; 2) smokers exhibited a trend towards less favorable
      healing response following FDS compared to non-smokers, both in terms of PD
      reduction and CAL gain; and 3) this trend reached clinical and statistical
      significance at sites with initial deep PD.

PMID- 11210073
TI  - Potential associations between chronic respiratory disease and periodontal
      disease: analysis of National Health and Nutrition Examination Survey III.
AB  - BACKGROUND: Associations between poor oral health and chronic lung disease have
      recently been reported. The present study evaluated these potential associations
      by analyzing data from the National Health and Nutrition Examination Survey III
      (NHANES III), which documents the general health and nutritional status of
      randomly selected United States subjects from 1988 to 1994. METHODS: This cross
      sectional, retrospective study of the NHANES III database included a study
      population of 13,792 subjects > or = 20 years of age with at least 6 natural
      teeth. A history of bronchitis and/or emphysema was recorded from the medical
      questionnaire, and a dichotomized variable combined those with either chronic
      bronchitis and/or emphysema, together considered as chronic obstructive pulmonary
      disease (COPD). Subject lung function was estimated by calculating the ratio of
      forced expiratory volume (FEV) after 1 second (FEV1)/forced vital capacity (FVC).
      Oral health status was assessed from the DMFS/T index (summary of cumulative
      caries experience), gingival bleeding, gingival recession, gingival probing
      depth, and periodontal attachment level. Unweighted analyses were used for
      initial examination of the data, and a weighted analysis was performed in a final
      logistic regression model adjusting for age, gender, race and ethnicity,
      education, income, frequency of dental visits, diabetes mellitus, smoking, and
      alcohol use. RESULTS: The mean age of all subjects was 44.4 +/- 17.8 years (mean
      +/- SD): COPD = 51.2 +/- 17.9 years and subjects without COPD = 43.9 +/- 17.7
      years. Subjects with a history of COPD had more periodontal attachment loss than
      subjects without COPD (1.48 +/- 1.35 mm versus 1.17 +/- 1.09 mm, P = 0.0001).
      Subjects with mean attachment loss (MAL) > or = 3.0 mm had a higher risk of COPD
      than those having MAL < 3.0 mm (odds ratio, 1.45; 95% CI, 1.02 to 2.05). A trend
      was noted in that lung function appeared to diminish with increasing periodontal
      attachment loss. CONCLUSIONS: The findings of the present analysis support
      recently published reports that suggest an association between periodontal
      disease and COPD.

PMID- 11210074
TI  - Detection of platelet-activating factor in gingival tissue surrounding failed
      dental implants.
AB  - BACKGROUND: Dental implant therapy has entered routine clinical practice.
      However, the failure rate of implants at 5 years, due to biological factors, is
      still around 7%. The pathogenesis of implant loss involves a complex network of
      cells and inflammatory mediators. This study evaluated platelet-activating factor
      (PAF), a potent phospholipid mediator of inflammation, in soft tissue surrounding
      failed dental implants versus healthy implants. METHODS: PAF was estimated on
      extracted lipids by bioassay on washed rabbit platelets; inflammatory cell
      populations were assessed semiquantitatively after staining, and microvessel
      density was evaluated after immunohistochemical staining. RESULTS: Biologically
      active PAF was detected in the lipid extracts of samples excised from gingival
      tissue of patients with failed implants, but not in samples from patients with
      osseointegrated implants or from healthy edentulous subjects. The amount of PAF
      detected in failed implants was significantly higher than in healthy implants,
      suggesting a local production of this mediator. CONCLUSIONS: The presence of PAF
      was associated with histopathological findings of local inflammation and
      increased blood vessel density.

PMID- 11210075
TI  - Fluid dynamics of gingival tissues in transition from physiological condition to
      inflammation.
AB  - BACKGROUND: An increase in gingival sulcular fluid filtration is a common
      clinical sign of early gingivitis. The aim of this study was to describe the
      fluid dynamics of the gingival interstitial tissues at the level of the sulcus in
      the transition towards inflammation. METHODS: In 13 anesthetized rabbits, a silk
      ligature was placed around incisors close to the gingival margin, in order to
      prevent mechanical cleaning of plaque deposition. After 2 to 7 days, animals were
      anesthetized and interstitial fluid pressure measured using glass micropipettes
      connected to a servonull pressure system at the level of the free and attached
      gingiva. RESULTS: Interstitial pressure was 3.8 +/- 2.9 cmH2O, significantly
      higher than the normal physiological value (about -1 cmH2O). Colloid osmotic
      pressure of interstitial fluid samples collected using the wick technique was
      measured using an osmometer whose membrane had a molecular cut-off of 30 kD and
      averaged 12.8 +/- 2.8 cmH2O (unchanged relative to control). Mean gingival
      sulcular fluid flow, measured by placing a PE tube (0.5 mm OD, 0.28 mm ID) in the
      sulcus, was 0.16 +/- 0.12 microl/h; the mean colloid osmotic pressure was 13.6 +/
      6.6 cmH2O, corresponding to a protein concentration of approximately 2.8 g/dl.
      Proteins of gingival fluid may leak from inflamed gingival interstitium or derive
      from bacteria of dental plaque. Histological analysis of gingival biopsies showed
      neutrophilic polymorphonuclear leukocyte infiltrates in both the dermis and
      epidermis layer. CONCLUSIONS: Based on hydraulic and colloid osmotic data, the
      Starling pressure gradient favored filtration from gingival interstitium to the
      sulcular space, a condition opposite to that observed in healthy gingiva where
      fluid filtration is absent.

PMID- 11210076
TI  - Relationship of sulcular sulfide level to severity of periodontal disease and
      BANA test.
AB  - BACKGROUND: Volatile sulfur compounds (VSC), such as hydrogen sulfide and methyl
      mercaptan, are toxic metabolites produced by periodontal pathogens. Their
      relationship to periodontal disease severity is not yet fully understood. Hence,
      the aims of this study were to: 1) examine the relationship between sulcular
      sulfide (pS) levels and severity of periodontal disease and 2) examine the link
      between pS level and the BANA (benzoyl-DL-arginine-naphthylamide) test. METHODS:
      Seventy systemically healthy subjects with a mean age of 53.0 +/- 13.8 years
      participated. Three sites were selected from each subject based upon radiographic
      bone loss (RBL): RBL < 2 mm, healthy; RBL > or = 2 to < 4, low to moderate; RBL >
      or = 4 mm, severe. Periodontal parameters, probing depth (PD), clinical
      attachment level (CAL), and bleeding on probing (BOP), were recorded. The pS
      level was measured using a portable sulfide monitor in a digital score ranging
      from 0.0 (< 10(-7) M of S) to 5.0 (> or = 10(-2) M of S) in increments of 0.5.
      The presence of specific bacteria in subgingival plaque was detected using BANA
      test. RESULTS: The mean pS level was 0.10 +/- 0.23, 0.36 +/- 0.48, and 1.10 +/-
      0.87 for healthy, low to moderate, and severe disease sites, respectively, and
      was statistically different (P<0.001). The pS level was positively correlated
      with the BANA test, and was higher in untreated subjects than maintenance
      subjects (P<0.01). CONCLUSIONS: The pS level may be a potential indicator for
      detecting severity of periodontal disease and identifying bacteria that are
      capable of hydrolyzing BANA.

PMID- 11210077
TI  - Relationship between sulcular sulfide level and oral malodor in subjects with
      periodontal disease.
AB  - BACKGROUND: The relationship between oral malodor and sulfide levels in
      periodontal pockets (pS) has not yet been determined. The aims of this study
      were: 1) to identify the correlation among oral malodor, pS levels, and the BANA
      (benzoyl-DL-arginine-naphthylamide) test and 2) to recognize the interaction
      between oral malodor, demographic factors, tongue coating, and periodontal
      condition. METHODS: Eighty-one periodontal patients participated in this study. A
      portable sulfide monitor and organoleptic method were used to evaluate oral
      malodor. Demographic data included age, gender, race, and smoking habits. The
      volume of tongue coating and periodontal condition for all teeth were assessed.
      The pS levels of 3 different radiographic bone loss (RBL) sites: RBL < 2 mm,
      healthy; RBL > or = 2 to < 4 mm; low to moderate; RBL > or = 4 mm, severe, were
      measured using an industrial sulcular sulfide-monitoring device. Subgingival
      plaque samples from the above 3 sites and tongue scraping were examined by the
      BANA test. RESULTS: The volume of tongue coating (P<0.001), extent of periodontal
      disease (P<0.05), pS levels of the sites with low to moderate bone loss (P<0.05),
      and BANA score of tongue scrapings (P<0.05) were significantly associated with
      oral malodor. Stepwise multiple regression analysis examined the degree of
      association between oral malodor and potential explanatory variables. The volume
      of tongue coating and percent of sites BOP (bleeding on probing) were
      significantly associated with oral malodor. Females and smoking habit were
      negatively correlated with organoleptic measurements. CONCLUSIONS: The pS level
      of the representative sites with low to moderate bone loss demonstrated a modest
      association with oral malodor. Oral malodor in periodontal patients was primarily
      associated with tongue coating and gingival inflammation.

PMID- 11210078
TI  - Interactions of lymphotoxin alpha (TNF-beta), angiotensin-converting enzyme
      (ACE), and endothelin-1 (ET-1) gene polymorphisms in adult periodontitis.
AB  - BACKGROUND: Adult periodontitis is a complex multifactorial disease whose
      etiology is not well defined. To investigate whether the genes encoded within the
      HLA class III region may confer susceptibility to periodontitis, polymorphisms in
      the ET-1 and TNF-beta genes were analyzed together with the I/D polymorphism of
      the ACE gene. METHODS: We determined allele and genotype frequencies of the NcoI
      bi-allelic polymorphism of the TNF-beta gene, the I/D (insertion/deletion)
      polymorphism of the ACE gene, and the TaqI polymorphism of the ET-1 gene in 63
      Caucasian patients with adult periodontitis and 95 orally healthy controls.
      RESULTS: We found a significant difference in a 3 locus combination of genotypes
      between patients and controls (P<0.05). In the next analyses, no significant
      differences were found in allele frequencies of single genes, but we did find a
      significant difference in the genotype distribution between cases and controls
      for TNF-beta (P<0.03). Differences were also observed for 2 locus combinations of
      ACE and TNF-beta genotypes (P<0.03), and the ET-1 and TNF-beta (P<0.05) genes.
      Evidence of deviation from Hardy-Weinberg equilibrium was observed in the
      periodontitis group for TNF-beta, with an absence of the B1B1 homozygotes in
      patients. CONCLUSIONS: This study is of an exploratory nature. Considering the
      number of significant results, however, at least a part of the observed
      associations may obviously be real and our findings suggest that interactions of
      the TNF-beta, ET-1, and ACE genes may be involved in susceptibility to adult
      periodontitis.

PMID- 11210079
TI  - Tobacco smoking and neutrophil activity in patients with periodontal disease.
AB  - BACKGROUND: Tobacco smoking has considerable negative effects on periodontal
      health. The mechanisms behind these effects are incompletely understood but may
      be related to the host response. The aim of the present study was to investigate
      the influence of tobacco smoking on the gingival crevicular fluid (GCF) levels of
      elastase, lactoferrin (LF), alpha-1-antitrypsin (alpha-1-AT), and alpha-2
      macroglobulin (alpha-2-MG) under periodontally diseased conditions. METHODS: The
      study population included 15 smokers (5 women and 10 men) aged 34 to 69 years and
      17 non-smokers (5 women and 12 men) aged 31 to 81 years. Clinical registration of
      gingival index (GI), plaque index (PI), probing depth, as well as sampling of GCF
      were made at 3 sites with severe lesions and 3 sites with moderate lesions in
      each individual. The elastase activity was measured with a chromogenic low
      molecular substrate and the LF, alpha-1-AT, and alpha-2-MG concentrations with
      ELISA. RESULTS: The results showed that, with regard to severe lesions, smokers
      had a significantly lower concentration of alpha-2-MG as well as significantly
      lower total amounts of alpha-2-MG and alpha-1-AT than non-smokers. With regard to
      moderate lesions, smokers tended to exhibit a lower concentration of alpha-2-MG,
      but the difference was not statistically significant. Comparing moderate and
      severe lesions, smokers exhibited no gradual increase with disease severity in
      contrast to non-smokers, who showed significantly or almost significantly
      increased levels of LF and alpha-2-MG in severe as compared to moderate lesions.
      CONCLUSIONS: The present results indicate that the levels of alpha-2-MG and alpha
      1-AT are suppressed in smokers with periodontitis, suggesting that smoking
      interferes with these protease inhibitors. This may be one mechanism by which
      smoking affects the inflammatory response.

PMID- 11210081
TI  - Congenital adrenal hyperplasia: from genetics and biochemistry to clinical
      practice, Part 1.
AB  - Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders with
      defects in the synthesis of cortisol. The synthesis of other steroids such as
      mineralocorticoids and adrenal/gonadal sex steroids may also be affected. The
      clinical presentation of the various forms of CAH depend on the following: (1)
      the affected enzyme, (2) the residual enzymatic activity, (3) the physiologic
      consequences of deficiencies of the end-products and excess of precursors. The
      first part of this two-part review discusses the genetics, biochemistry, and
      clinical presentation of the different forms of CAH. Understanding the genetics
      and pathophysiology of each of the various enzyme mutations is essential for the
      evaluation and management of the different clinical forms of CAH.

PMID- 11210080
TI  - A multidisciplinary approach to the diagnosis and treatment of early-onset
      periodontitis: a case report.
AB  - BACKGROUND: The diagnosis and treatment of early-onset forms of periodontitis
      (EOP) represent a major challenge to periodontists. In this case report, we
      describe a multidisciplinary approach for the treatment of a patient with severe
      generalized juvenile periodontitis (GJP). Our approach incorporates clinical
      laboratory evaluation with conventional concepts of periodontal pathogenesis and
      therapeutics to diagnose and effectively treat EOP. METHODS: The 17-year-old
      female patient presented with clinical and radiographic evidence of severe
      attachment loss. Microbiological testing showed the presence of known periodontal
      pathogens including Actinobacillus actinomycetemcomitans, Prevotella intermedia,
      and Porphyromonas gingivalis. Routine immunological tests did not reveal any of
      the functional defects thought to play a role in the pathogenesis of EOP After
      initiation of therapy, which consisted of scaling and root planing, supplemented
      with administration of systemic antibiotics, a reduction in probing depth and
      gain in clinical attachment could be demonstrated. Microbiological testing was
      used to monitor the composition of the periodontal microbiota and to adjust
      antimicrobial therapy accordingly. RESULTS: Using a non-surgical approach to
      treatment, except for 2 root amputations performed without flap reflection, we
      have been able to stabilize this patient's periodontal condition over the course
      of a 2-year follow-up period. CONCLUSIONS: This treatment strategy provides an
      efficacious alternative to more aggressive forms of therapy and should therefore
      be considered for the treatment of patients with severe EOP.

PMID- 11210082
TI  - Characteristics of women pediatricians.
AB  - To contrast women pediatricians (n = 807) with other U.S. women physicians, we
      used data from the Women Physicians' Health Study, a national, randomly sampled
      questionnaire survey (total n = 4,501). Compared with other women physicians,
      women pediatricians worked less and reported lower incomes but also reported less
      work stress and less career dissatisfaction. Pediatricians were less likely to
      counsel/perform screening regarding cholesterol, HIV, smoking, and alcohol but
      more likely regarding skin cancer or sunscreen use, nutrition, and weight. Given
      current emphases on trying to improve U.S. children's health practices, these
      findings are of concern.

PMID- 11210083
TI  - Frequent breastfeeding and food refusal associated with failure to thrive. A
      manifestation of the vulnerable child syndrome.
AB  - This paper acquaints pediatricians and health care personnel with the triad of
      poor weight gain, frequent breastfeeding, and food refusal in infants during the
      second 6 months of life. The histories of six infants aged 8-11 months, with
      failure to thrive, food refusal, and frequent breastfeeding, are presented. All
      the mothers were facing significant stresses, which may have decreased their
      breast milk supply, and were leading them to use breastfeeding for their comfort
      and/or the comfort of their infant. The infants responded with continued frequent
      breastfeeding, refusal of complementary foods, and decreased weight gain. These
      infants fit the characteristics of the vulerable child syndrome. Treatment of
      these infants required evaluation and treatment of the mothers' psychosocial
      issues along with a behavioral feeding program. Even with this multidisciplinary
      approach, these infants showed very slow catch-up growth. Pediatricians and
      health care personnel should use and build on this information in the evaluation
      and treatment of infants with similar problems.

PMID- 11210084
TI  - Do parents choose appropriate automotive restraint devices for their children?
AB  - This study aims to describe parental choices of childhood automotive restraints
      and compare them with guidelines based on weight and height. Parents were
      surveyed and their children's heights and weight were measured. Results indicated
      that many parents believed their child fit a lap or shoulder belt when their
      children were too short to fit these devices. For children weighing < 40 pounds,
      45% of parents believed the lap belt fit. Thirteen percent of 4-7-year-olds used
      booster seats, appropriate for 72% by sitting height criteria; and 33% of
      children < or = 7 years used the lap/shoullder belt, appropriate for 8% by
      sitting height criteria. Implications are that parental perceptions of fit may
      lead to inappropriate restraint choices for children. Practitioners should
      discuss child restraint use with parents in the context of their child's weight
      and height.

PMID- 11210085
TI  - An asymptomatic infant with a neck mass.

PMID- 11210086
TI  - Dural sinus thrombosis complicating hypernatremic dehydration in a breastfed
      neonate.

PMID- 11210087
TI  - Fever-induced protracted ballismus in choreoathetoid cerebral palsy.

PMID- 11210088
TI  - Stress-induced movement disorders.

PMID- 11210089
TI  - Respiratory support of children with a retropharyngeal abscess with nasal CPAP.

PMID- 11210090
TI  - Assessing growth patterns.

PMID- 11210091
TI  - Severe acute renal failure due to hemoglobinuria after use of WinRho for the
      treatment of idiopathic thrombocytopenic purpura.

PMID- 11210092
TI  - Clinical significance of ventilation/perfusion scans in collagen disease
      patients.
AB  - The purpose of this study was to detect disturbances in pulmonary circulation in
      collagen disease patients by means of a non-invasive technique. METHODS:
      Ventilation/perfusion scans with 133Xe gas and 99mTc-macroaggregated albumin
      (MAA) were performed in 109 patients with various collagen diseases. Functional
      images of V, Vol, Q and V/Q ratio were obtained at total lung capacity. Wash-out
      time was calculated from the wash-out curve. Whole body scans were performed in
      65 patients to evaluate intra-pulmonary shunts. RESULTS: Increased V/Q areas were
      observed in 74 patients (67.9%), suggesting some impairment of pulmonary
      perfusion. Decreased perfusion, probably due to vasculitis or intravascular
      microcoagulation, was observed often, even in patients without pulmonary
      fibrosis. Shunt ratios over 10% were observed in 8 of the 65 patients (12.3%),
      indicating formation of PA-PV shunts secondary to peripheral vascular impairment.
      Wash-out time was prolonged in 37 patients (33.9%), shortened in 18 (16.5%), and
      within the normal range in 54 (49.6%). The prolonged and normal wash-out times in
      the patients with pulmonary fibrosis may represent obstructive changes in the
      small airways superimposed on the fibrosis. CONCLUSION: Ventilation/perfusion
      scans are a very useful tool for evaluating collagen lung diseases, and they
      might contribute to treatment decisions for the patients.

PMID- 11210093
TI  - Technetium-99m MIBI single photon emission computed tomography as an indicator of
      prognosis for patients with lung cancer-preliminaly report.
AB  - PURPOSE: We performed technetium-99m hexakis-2-methoxyisobutylisonitrile (Tc-99m
      MIBI) single photon emission computed tomography (SPECT) in 23 patients with
      primary lung cancer between July 1993 and March 1996. We evaluated the
      relationships among the uptake ratio, retention index and the prognosis after
      radiation therapy and/or chemotherapy. MATERIALS AND METHODS: Tc-99m MIBI SPECT
      was performed at 30 minutes and at 3 hours after intravenous injection of 600 MBq
      of Tc-99m MIBI with three gamma camera detectors (GCA-9300A/HG) on transverse
      SPECT images. Regions of interest were set in the area of abnormal uptake of Tc
      99m MIBI and in the contralateral normal lung. The ratio of uptake in the lesion
      to that in the contralateral normal lung was obtained on early images (early
      ratio; ER) as well as delayed images (delayed ratio: DR). The retention index
      (RI) was calculated as follows: RI = (DR - ER)/ER x 100. The ratio was compared
      with survival time and prognostic factors. RESULTS: There was no correlation
      between ER and DR. The patients with high RI survived longer than those with low
      RI (median survival, 19.4 months vs. 9.4 months; p = 0.0104 by the Mantel-Cox
      test). CONCLUSION: These results suggest that RI is the most useful among Tc-99m
      MIBI indices of primary lung cancer in predicting prognosis.

PMID- 11210094
TI  - Comparison of Emory and Cedars-Sinai methods for assessment of left ventricular
      function from gated myocardial perfusion SPECT in patients with a small heart.
AB  - To evaluate the effect of left ventricular (LV) size on the calculation of LV
      function from gated myocardial SPECT with Emory and Cedars-Sinai programs, we
      performed 99mTc-tetrofosmin gated SPECT on 49 patients with ischemic heart
      disease. End-diastolic volume (EDV), end-systolic volume (ESV), and ejection
      fraction (EF) were semi-automatically calculated by each program. All patients
      underwent left ventriculography (LVG) within 3 months before and after the SPECT
      study. We grouped the patients into 22 with a calculated ESV obtained from LVG of
      over 50 ml (group A) and 27 with an ESV value of 50 ml or below (group B). We
      then compared the ESV values from gated SPECT with those from LVG in each group.
      In group A, the ESV from both Emory and Cedars-Sinai programs similarly
      correlated well with those from LVG (r = 0.92 and r = 0.93, respectively), but in
      group B, the ESV calculated from the Cedars-Sinai program correlated less with
      those from LVG (r = 0.53) than those from the Emory program did (r = 0.70). The
      calculated LV volumes had more errors in the Cedars-Sinai program than in the
      Emory program, when a patient had a small heart.

PMID- 11210095
TI  - Relation between myocardial response to dobutamine stress and sympathetic nerve
      activation in patients with idiopathic dilated cardiomyopathy: a comparison of
      123I-MIBG scintigraphic and echocardiographic data.
AB  - It is likely that a close association exists between findings obtained by two
      methods: dobutamine stress echocardiography and 123I-MIBG scintigraphy. Both of
      these methods are associated with beta-adrenergic receptor mechanisms. This study
      was conducted to demonstrate the relation between myocardial response to
      dobutamine stress and sympathetic nerve release of norepinephrine in the failing
      heart. In 12 patients with heart failure due to idiopathic dilated
      cardiomyopathy, the myocardial effects of dobutamine stress were evaluated by low
      dose dobutamine stress echocardiography: and sympathetic nerve function was
      evaluated by scintigraphic imaging with iodine-123 [123I] meta
      iodobenzylguanidine (MIBG), an analogue of norepinephrine. Echocardiography
      provided quantitative assessment of wall motion and left ventricular dilation;
      radiotracer studies with 123I-MIBG provided quantitative assessment of the heart
      to-mediastinum (H/M) uptake ratio and washout rate. Results showed that H/M
      correlated with baseline wall motion (r = 0.682, p = 0.0146), wall motion after
      dobutamine stress (r = 0.758, p = 0.0043), the change in wall motion (r = 0.667,
      p = 0.0178), and with left ventricular diastolic diameter (r = 0.837, p =
      0.0007). In addition, the 123I-MIBG washout rate correlated with baseline wall
      motion (r = 0.608, p = 0.0360), wall motion after dobutamine stress (r = 0.703, p
      = 0.0107), and with the change in wall motion (r = 0.664, p = 0.0185). Wall
      motion, especially in the myocardial response to dobutamine stress, is related to
      sympathetic nerve activity in heart failure.

PMID- 11210096
TI  - A new method to estimate rCBF using IMP and SPECT without any blood sampling.
AB  - We developed and evaluated a method to measure rCBF without any blood sampling by
      using iodine- 123 IMP and SPECT. An integral of arterial input function, the
      integral taken from the value 0 to T of the variable Ca(t)dt, can be expressed as
      TC(T)/CO, where TC(T) is radioactivity delivered to the body in T minutes and CO
      is cardiac output. If T is acceptably small, rCBF can be determined by means of a
      microsphere model analysis with IMP as Cb(T)/(TC(T)/CO), where Cb(T) is cerebral
      radioactivity at T minutes. We derived TC(T) and CO from a chest dynamic scan.
      The method was applied to 45 patients who underwent rCBF studies (58 studies)
      with arterial blood sampling (ABS). Data from the chest scan were analyzed in
      comparison with ABS data in the first 28 studies, and equations for correction
      yielding an accurate TC(T)/CO were derived. The validity of the proposed method
      was evaluated in the subsequent 30 studies. The method yielded rCBF (rCBF-test)
      which agreed well with rCBF obtained by a two-compartment model analysis of
      dynamic SPECT and ABS data (rCBF-ref) with the mean and SD of differences between
      rCBF-test and rCBF-ref being 1.0 and 2.7 ml/100 g/min, respectively. In eleven
      subjects who underwent more than two studies, a percentage change in rCBF-test
      between the studies also closely approximated that of rCBF-ref (y = 1.11 x +
      2.63, r = 0.92). The method can be used with acceptable reliability to measure
      rCBF without any blood sampling.

PMID- 11210097
TI  - Double-injection method for sequentially measuring cerebral blood flow with N
      isopropyl-(123I)p-iodoamphetamine.
AB  - We investigated the accuracy of a double-injection method for sequentially
      measuring cerebral blood flow (CBF) with N-isopropyl-(123I)p-iodoamphetamine
      (IMP) in simulation studies based on patient data and in clinical studies. The
      unidirectional clearance of IMP from the blood to the brain (K1; nearly equal to
      CBF) in the first and second sessions was calculated by means of a microsphere
      model. The K1 values in the first session (K1I) were calculated from
      Cb(5)/Int_CaI, where Cb(5) and Int_CaI are values for brain radioactivity 5 min
      after the first injection and for arterial blood radioactivity obtained by 5-min
      continuous sampling. The K1 values in the second session (K1II) were calculated
      by means of the following four methods. Method 1: [Cb(tz + 5) - Cb(tz)]/[Int_CaII
      - Ca(tz) x 5], where Cb(tz+5) and Cb(tz) are the brain radioactivity levels 5 min
      after the second injection and at the time the second session was started (tz),
      respectively. Int_CaII and Ca(tz) are the arterial blood radioactivity levels
      obtained by 5-min continuous sampling after the second injection and at tz,
      respectively. Method 2: [Cb(tz + 5) - Cb(tz)]/[Int_CaI x R], where R is the
      injection dose ratio. Method 3: [Cb(tz + 5) - Cb(tz) x exp(- K1I x
      5/lambda)]/Int_CaII, where lambda is the population averaged partition
      coefficient. Method 4: same as Method 3 except that K1I was replaced by K1II
      obtained by means of Method 2. Theoretically, Method 4 appeared to be the best of
      the four methods. The change in K1 during the second session obtained by Method 1
      or 2 largely depended on R and tz, whereas Method 3 or 4 yielded a more reliable
      estimate than Method 1 or 2, without largely depending on R and tz. Since Method
      2 was somewhat superior to other methods in terms of noninvasiveness and
      simplicity, it also had the potential for routine clinical use. The
      reproducibility of two sequential measurements of K1 was investigated with
      clinical data obtained without any intervention. The response of CBF to
      acetazolamide challenge was also assessed by the above four methods. The
      knowledge gained by this study may assist in selecting a method for sequentially
      measuring CBF with a double injection of IMP.

PMID- 11210098
TI  - Simultaneous assessment of Tc-99m-sestamibi and I-123-BMIPP myocardial
      distribution in patients with myocardial infarction: evaluation of left
      ventricular function with ECG-gated myocardial SPECT.
AB  - 123I-labeled 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid (BMIPP) is a
      branched-chain free fatty acid that is used to evaluate various cardiac diseases.
      The aim of the present study was to investigate the relationship between
      myocardial perfusion (99mTc-sestamibi) and BMIPP uptake, and to correlate
      perfusion and metabolic alterations with regional left ventricular dysfunction in
      patients with myocardial infarction (MI). ECG-gated dual-isotope myocardial SPECT
      was performed on 130 patients with MI with sestamibi (555 MBq) and BMIPP (148
      MBq). The patients were classified into 3 groups according to PTCA therapy and
      the interval between the onset of infarction and RI injection (OR time). Group A
      (n = 56) included patients whose OR time was less than one month and who had
      undergone successful PTCA, Group B (n = 36) had OR times of less than one month
      and had conservative medical therapy, and Group C (n = 38) had OR times of over
      one month. The severity scores of the dual-isotope images were calculated from
      the defect scores in 9 segments. From the ECG-gated SPECT data with sestamibi,
      the left ventricular ejection fraction (LVEF; %) and regional wall motion were
      determined automatically using the QGS program LVEF obtained from gated SPECT
      correlated well with the severity scores for sestamibi and BMIPP (r = -0.68 and 
      0.76, respectively). The delta severity scores (BMIPP scores - sestamibi scores)
      of Group A were significantly higher than those of the other two groups (3.6 +/-
      3.0 vs. 1.5 +/- 1.7 and 1.0 +/- 1.4, p < 0.001 ). The rate of dysfunctional
      segments with normal sestamihi distribution was significantly higher in Group A
      than in Group C (20.7% vs. 6.7%, p < 0.001). ECG-gated dual-isotope SPECT is
      useful since myocardial perfusion, fatty acid metabolism and left ventricular
      function can be analyzed during a single examination, so that this procedure has
      the potential to provide comprehensive information when evaluating patients with
      ischemic heart disease.

PMID- 11210099
TI  - Search for PET probes for imaging the globus pallidus studied with rat brain ex
      vivo autoradiography.
AB  - We have evaluated the feasibility of using four positron emission tomography
      (PET) tracers for imaging the globus pallidus by ex vivo autoradiography in rats.
      The tracers investigated were [11C]KF18446, [11C]SCH 23390 and [11C]raclopride
      for mapping adenosine A2A, dopamine D1 and dopamine D2 receptors, respectively,
      and [18F]FDG. The highest uptake by the globus pallidus was found for [11C]SCH
      23390, followed by [18F]FDG, [11C]KF18446 and [11C]raclopride. The receptor
      specific uptake by the globus pallidus was observed in [11C]KF18446 and [11C]SCH
      23390, but not in [11C]raclopride. Uptake ratios of globus pallidus to the
      striatum for [18F]FDG and [11C]KF18446 were approximately 0.6, which was twice as
      large as that for [11C]SCH 23390. In a rat model of degeneration of
      striatopallidal gamma-aminobutyric acid-ergic-enkephalin neurons induced by
      intrastriatal injection of quinolinic acid, the uptake of [11C]KF18446 by the
      striatum and globus pallidus was remarkably reduced. To prove the visualization
      of the globus pallidus by PET with [18F]FDG and [11C]KF18446, PET-MRI
      registration technique and advances in PET technologies providing high-resolution
      PET scanner will be required. The metabolic activity of the globus pallidus could
      then be measured by PET with [18F]FDG, and [11C]KF18446 may be a candidate tracer
      for imaging the pallidal terminals projecting from the striatum.

PMID- 11210100
TI  - Assessment of liver function in chronic liver diseases and regional function of
      irradiated liver by means of 99mTc-galactosyl-human serum albumin liver
      scintigraphy and quantitative spectral analysis.
AB  - Scintigraphy with 99mTc-diethylenetriamine pentaacetic acid galactosyl human
      serum albumin (99mTc-GSA) was performed on 102 patients, then the hepatic
      extraction fraction (HEF), the rate constant for liver uptake of the tracer from
      the blood (K1) and the hepatic blood flow index (HBFI) were determined by
      spectral analysis. The HEF, K1 and HBFI values correlated moderately or closely
      with various indices of hepatic function, and the HEF and K1 values decreased
      according to the stage of liver dysfunction. The HEF and K1 values linearly and
      nonlinearly correlated with HH15 and LHL15, respectively. The HEF, K1 and HBFI
      values for the irradiated portion of 20 patients before and alter irradiation
      were compared. The HEF value in patients with a cirrhotic liver significantly (p
      < 0.002) decreased compared with that in patients with a normal liver at a dose
      of less than 40 Gy, whereas the HBFI value in patients with a normal liver
      significantly (p < 0.05) decreased compared with that in patients with a
      cirrhotic liver at a dose of 40 Gy or greater. This method appears to be a
      simple, non-invasive and useful tool with which to quantitatively evaluate liver
      function and it also helps clarify changes in regional function of the irradiated
      liver.

PMID- 11210101
TI  - Nontumorous decrease in Tc-99m GSA accumulation.
AB  - Nontutimorous decrease in 99mTc-GSA accumulation has not been well covered in the
      literature. Understanding of this phenomenon is, however, essential for accurate
      evaluation of regional hepatic function. Scintigrams (transaxial SPECT) of 269
      patients who underwent 99mTc-GSA liver scintigraphy were reviewed for the
      presence of nontumorous decreases in 99mTc-GSA accumulation. Nontumorous
      decreases in 99mTc-GSA accumulation were seen in 32 of 269 patients (12%). In 16
      of the 32 patients (6%), nontumorous decreases in 99mTc-GSA accumulation
      corresponded to regional decrease in portal venous flow. The causes of such
      decrease in portal venous flow were portal thrombus of hepatocellular carcinomas
      in eight patients, portal venous stenosis or occlusion by hilar
      cholangiocarcinomas in five patients, inter alia. In eight patients (3%), the
      regions with decreased 99mTc-GSA accumulation correlated with massive hepatic
      necrosis in fulminant hepatitis, scar in hepatitis, or confleuent in portal
      venous flow, lobar biliary stasis, or both. In four patients (1.5%), the exact
      causes of nontumorous decrease in 99mTc-GSA accumulation could not be determined.

PMID- 11210102
TI  - Discordant uptake of Tc-99m PMT and Tc-99m GSA by two hepatocellular carcinoma
      lesions.
AB  - Tc-99m PMT and Tc-99m GSA can be taken up by hepatocellular carcinoma (HCC), but
      there has been no report concerning HCC showing accumulation of both of Tc-99m
      PMT and Tc-99m GSA. In this paper we describe a case of two simultaneously
      developed HCCs, one of which took up both tracers but the other took up neither
      of them.

PMID- 11210103
TI  - A method for identifying underlying causes of death in epidemiological study.
AB  - To obtain the underlying causes of death in individuals of a cohort (male only),
      the items of date of birth, date of death and address code at the time of death
      were linked between the data of resident cards and the death tapes of National
      Vital Statistics supplied by the Ministry of Health and Welfare. As a result, the
      persons who have the same information for above mentioned three items between the
      resident cards and the death tapes accounted for 97.4%. If the persons who had
      the same information for three items except one item were considered to be
      identical, they accounted for 99.4%. It would be concluded that underlying cause
      of death can be obtained by record linkage of death tapes of National Vital
      Statistics with three informations in residence cards, dates of birth, dates of
      death and address codes at the time of death, even without names of the
      individual in the death tapes. The matched rate would be high enough for
      epidemiological studies.

PMID- 11210104
TI  - Relationships between cigarette smoking, alcohol drinking, the ALDH2 genotype and
      adenomatous types of colorectal polyps in male self-defense force officials.
AB  - Alcohol drinking as well as cigarette smoking has been associated with
      development of colorectal polyps, Asians such, as Japanese, Chinese and Korean
      have high frequency of genetic polymorphism in low Km aldehyde dehydrogenase
      (ALDH2) gene which greatly regulates alcohol intake. In the present study, we
      investigated associations of this polymorphism and lifestyles with colorectal
      polyps in self-defense forces personnels in Japan. All subjects received
      colonoscopy at a retirement health examination. The ALDH2 genotype was determined
      using polymerase chain reaction and restriction fragment length polymorphism
      method. Frequency of the ALDH2 genotype was not different between those with
      colorectal polyps (n=69) and those without the polyps (n=131). Smoking was
      associated with development of colorectal polyps (OR=4.7, 95% confidence
      interval=1.9-11.5) in the ALDH2 proficient genotype. The association appeared to
      be enhanced by drinking alcohol since a synergistic effect of smoking and alcohol
      drinking (> or =60 ml/day) was indicated (OR=9.9, 95% confidence interval=2.9
      34.1) by logistic regression analysis. In the ALDH2 deficient genotype, however,
      we could not evaluate interactions of smoking and alcohol drinking on colorectal
      polyp development because of the small sample size of heavy alcohol drinkers. The
      genotype analysis would be useful in evaluating effects of environmental factors
      on outcomes for each genetically defined subpopulation.

PMID- 11210105
TI  - Mortality among persons with a history of Kawasaki disease in Japan: existence of
      cardiac sequelae elevated the mortality.
AB  - OBJECTIVE: To clarify whether patients with Kawasaki disease have a higher death
      rate than the age-matched healthy population after the disease occurrence. STUDY
      DESIGN: Between July 1982 and December 1992, 52 collaborating hospitals collected
      data on all patients having a new definite diagnosis of Kawasaki disease.
      Patients were followed until December 31, 1997, or death. The expected number of
      deaths was calculated from Japanese vital statistics data and compared with the
      observed number. RESULTS: Of 6576 patients enrolled, 25 (19 males and 6 females)
      died. The standardized mortality ratio (SMR) was 1.35. In spite of the high SMRs
      during acute phase, the mortality rate was not high after the acute phase for all
      patients. Although the SMR after the acute phase was 0.76 for those without
      cardiac sequelae, 6 males (no females) with cardiac sequelae died during this
      period and the SMR for the male group with cardiac sequelae was 2.77. CONCLUSION:
      The mortality rate among males with cardiac sequelae due to Kawasaki disease was
      2.8 times as high as in general population, whereas mortality rates for females
      with the sequelae and both males and females without sequelae were not elevated.

PMID- 11210106
TI  - A reproductive health survey on unintended pregnancy in Yamagata, Japan:
      feasibility of the survey and test-retest reliability and validity of a
      questionnaire.
AB  - We have designed a survey to investigate factors related to unintended pregnancy
      using a newly devised questionnaire. This pilot study was conducted to examine
      the feasibility of the study and the test-retest reliability and the validity of
      the questionnaire. Samples were 107 cervical and breast cancer screening
      participants aged 35-49 year-old in 1999 in Yamagata, Japan. The same
      questionnaires were mailed twice to examine the test-retest reliability. Women's
      medical records for cancer screening were used to examine the validity of the
      questionnaire. Ninety-six women agreed to participate in the study and 89.6% of
      them responded to the first survey. The agreements between two surveys were
      substantial to perfect for the nominal and ordinal data, and for the continuous
      data, the standard deviations (SDs) were less than 1 and the correlation
      coefficients were over 0.6. The comparison between medical record and
      questionnaire derived data showed perfect agreements for reproductive items
      except age at last birth (SD: 0.71, correlation coefficient: 0.97), and fair
      agreements for drinking and smoking habits. Obtaining information on unintended
      pregnancy by questionnaire is feasible, and the test-retest reliability and the
      validity of the questionnaire are satisfactory. Currently we are conducting a
      survey with a larger sample.

PMID- 11210107
TI  - Gender differences in the association between psychosocial factors and depressive
      symptoms in Japanese junior high school students.
AB  - To determine psychosocial factors associated both with depressive symptoms and
      with gender differences in depressive symptoms among junior high school students,
      we conducted self-administered questionnaires using a sample of 2,660 students of
      13 public junior high schools in Okinawa, Japan. Depressive symptomatology was
      measured by the Center for Epidemiologic Studies Depression Scale (CES-D). The
      psychosocial variables examined were life stresses, social support, health
      practices, self-esteem, and locus of control. Depressive symptoms were positively
      associated with life stresses and negatively associated with health practices,
      social support, self-esteem, and internal locus of control. In addition, female
      students were likely to report more depressive symptoms, life stresses, and low
      self-esteem and poor health practices. After controlling for the psychosocial
      variables differed by gender, gender differences in depressive symptoms were
      eliminated. In conclusion, for depressive symptoms of junior high school
      students, life stresses might be risk factors, but positive health practices,
      social support, high self-esteem, and internal locus of control might be
      protective factors. Gender differences in depressive symptoms could be explained
      by the females' elevation on these psychosocial variables.

PMID- 11210108
TI  - Seasonal variation in mortality from ischemic heart disease and cerebrovascular
      disease in Okinawa and Osaka: the possible role of air temperature.
AB  - Okinawa is located in a subtropical area and is well-known for low mortality due
      to ischemic heart disease (IH-D) and cerebrovascular disease (CVD). However, the
      factors that contribute to these low mortality rates remain unclear. We examined
      the seasonal variation in the mortality due to IHD and CVD among Okinawa and
      Osaka residents, aged 45 to 84 years, between 1992 and 1996. In addition, we
      studied if there was a relationship between the monthly mortality rate from IHD
      or CVD and the monthly mean daily air temperature in Naha City and Osaka City.
      Data on the monthly mean daily air temperature was obtained from the
      meteorological stations in Naha City and Osaka City. Our results showed that
      there were inverse correlations between the monthly mean daily temperature in a
      city and each of the monthly mortality from IHD in Okinawa (r=-0.794, p<0.01),
      the monthly mortality from CVD in Okinawa (r=-0.837, p<0.001), and the monthly
      mortality from CVD in Osaka (r=-0.954, p<0.001). In Osaka, the monthly mortality
      rate from IHD was at or near its minimum value when the mean daily temperature
      was approximately 25 degrees C (in September), and it increased in a linear
      fashion as the mean monthly temperature fell (r=-0.975, p<0.001). The difference
      between the monthly mortality from IHD or CVD among the Okinawa and the Osaka
      residents increased in the winter season in comparison with that in the other
      seasons, with the exception for IHD in July and in August. These findings
      indicate that the lower mortality from IHD and CVD in Okinawa is affected, at
      least in part, by Okinawa's warm winter.

PMID- 11210109
TI  - A case-control study of Creutzfeldt-Jakob disease in Japan: transplantation of
      cadaveric dura mater was a risk factor.
AB  - A case-control study was conducted to reveal the relative risk of cadaveric dura
      mater graft transplantation for Creutzfeldt-Jakob disease. Fifty-two cases with
      Creutzfeldt-Jakob disease that were reported to the surveillance of the disease,
      and 102 age- and sex-matched hospital controls were selected. Information on
      family history, occupations, and medical history was collected. Eight cases and
      no control had a history of cadaveric dura mater graft transplantation. Surgical
      operations without the dura mater graft, blood transfusion, and acupuncture did
      not elevate the risk.

PMID- 11210110
TI  - Does hyperuricemia affect mortality? A prospective cohort study of Japanese male
      workers.
AB  - A positive association between hyperuricemia and cardiovascular disease has been
      reported, but no study has evidenced yet the precise role of serum uric acid in
      the development of cardiovascular disease. In addition, no epidemiological
      studies have so far documented a decreased risk of cancer among people with
      hyperuricemia, even though the antioxidant action of uric acid has recently been
      stressed to inhibit DNA damage. The present prospective cohort study investigates
      the relationship between hyperuricemia and health hazards in a Japanese working
      population. The subjects were 49,413 Japanese male railroad workers, aged 25-60
      years at enrollment. Serum uric acid and other baseline data were provided by
      annual health-survey records from 1975 to 1982. The vital status of the subjects
      was traced until the end of 1985 for those who remained alive. During an average
      5.4-year study period, 984 deaths were recorded. Those with serum uric acid over
      8.5 mg/dl showed elevated relative risks (RRs) of death in all causes (RR 1.62,
      p<0.01), coronary heart disease ( RR 1.52), stroke (RR 2.33, p<0.01), hepatic
      disease (RR 3.58, p<0.01), and renal failure ( RR 8.52, p<0.01), as compared with
      those with serum uric acid levels of 5.0-6.4mg/dl. The RR of death in all causes
      still remains statistically significant when adjusted by age and serum total
      cholesterol (2.00, p<0.01), age and alcohol intake (1.85, p<0.001), age and
      smoking (1.69, p<0.001), age and gout treatment (1.61, p<0.05), and also age and
      BMI (1.50, p< 0.05). On the other hand, the RR of all causes decreased but was
      still above 1.0 when adjusted by age and blood glucose (1.62), age and systolic
      blood pressure (1.32), age and GOT (1.23), and also age and history of
      cardiovascular disease (1.17). These results showed that hyperuricemia has a
      strong association with the RRs of death in all causes, coronary heart disease,
      stroke, hepatic disease and renal failure, and indicated that serum uric acid
      seems to be a considerable risk factor for reduced life expectancy.

PMID- 11210111
TI  - Prevalence of HBV infection among the healthy Nepalese males: a serological
      survey.
AB  - Sera from 478 healthy Nepalese male population, inhabiting various districts of
      five development regions of Nepal were collected from October 1996 to March 1997
      and examined for the presence of HBsAg by third generation ELISA and Latex
      agglutination test in the laboratory of Central Department of Microbiology,
      Tribhuvan University, Kirtipur. The surface antigen was detected by ELISA in 4.0%
      (19/478) of subjects studied. However, different results were obtained in Latex
      agglutination test. The correlation between the results obtained from these two
      different tests is statistically significant (chi2=85.11, P<0.05). The results
      obtained from ELISA showed the probability of Nepal to fall in WHO category of
      intermediate endemicity zone for hepatitis B infection. The percent positivity of
      HBsAg was found to increase steadily from Eastern (2%) to Far Western (6.2%)
      development regions. Among the districts studied, Kailali district gave
      characteristically high prevalence followed by Rukum and Kaski. Other, districts
      representing for the prevalence are Sankhuwasabha, Jhapa, Ramechhap, Sarlahi,
      Dhanusa, Baglung, Gulmi, Palpa and Dang. None of the samples represented from
      Kathmandu valley were positive for HBsAg. The age groups of 16-20 years and 36-40
      years were found to be associated with the hepatitis B infection. Furthermore,
      various percent prevalence of the infection were encountered from 16 to 40 years
      subjects and a single case was also observed from 63 years old man. All the
      samples recorded positive for HBsAg from ELISA were assayed for the amount of ALT
      as a liver function test. Where, 15.8% (3/19) of the infected subjects had
      impaired liver function, hence it showed that, the subjects with high ALT to be
      the possible carrier of the HBV. Conversely, the remaining 84.2% (16/19) of the
      total HBsAg positive subjects were concluded to have the infection either at
      incubation or at prodrome period.

PMID- 11210112
TI  - Flavor release of diacetyl and 2-heptanone from cream style dressings in three
      mouth model systems.
AB  - The release of volatile compounds from a cream style dressing, which consisted of
      a thickening agent dispersed in the water phase of an oil in water (o/w) type of
      emulsion, was studied by the purge-and-trap (PT), dynamic head space mastication
      (DHM) and dynamic headspace (DH) model systems for diacetyl and 2-heptanone as
      two volatile compounds. Big differences were detected in the quantity of
      volatiles released by the three models for both diacetyl and 2-heptanone: PT
      released the most, followed by DHM and DH. Nitrogen gas bubbling in PT and
      plunger up-and-down motion in DHM mimic mouth movements and promoted volatile
      release more than DH. The quantity of volatiles released depended on the nitrogen
      gas flow rate and isolation period with both the PT and the DHM model. Static
      headspace measurements indicated that no interaction occurred between the
      volatiles and the dispersion thickening agent, nor between the volatiles and
      protein of saliva.

PMID- 11210113
TI  - Gene cloning and characterization of alpha-glucuronidase of Bacillus
      stearothermophilus no. 236.
AB  - The alpha-glucuronidase gene of Bacillus stearothermophilus No. 236 was cloned,
      sequenced, and expressed in Escherichia coli. The gene, designated aguA, encoded
      a 691-residue polypeptide with calculated molecular weight of 78,156 and pI of
      5.34. The alpha-glucuronidase produced by a recombinant E. coli strain containing
      the aguA gene was purified to apparent homogeneity and characterized. The
      molecular weight of the alpha-glucuronidase was 77,000 by SDS-PAGE and 161,000 by
      gel filtration; the functional form of the alpha-glucuronidase therefore was
      dimeric. The optimal pH and temperature for the enzyme activity were pH 6.5 and
      40 degrees C, respectively. The enzyme's half-life at 50 degrees C was 50 min.
      The values for the kinetic parameters of Km and Vmax were 0.78 mM and 15.3 U/mg
      for aldotriouronic acid [2-O-alpha-(4-O-methyl-alpha-D-glucopyranosyluronic)-D
      xylobiose]. The alpha-glucuronidase acted mainly on small substituted xylo
      oligomers and did not release methylglucuronic acid from intact xylan.
      Nevertheless, synergism in the release of xylose from xylan was found when alpha
      glucuronidase was added to a mixture of endoxylanase and beta-xylosidase.

PMID- 11210114
TI  - Modulation of cholesterol concentration in Caco-2 cells by incubation with
      different n-6 fatty acids.
AB  - Incorporation of exogenous cholesterol was compared in human adenocarcinoma colon
      cells (Caco-2) after incubation with 100 microM of either linoleic acid (LA,
      18:2n-6), gamma-linolenic acid (GLA, 18:3n-6), arachidonic acid (AA, 20:4n-6) or
      adrenic acid (or n-6 docosatetraenoic acid, DTA, 22:4n-6). In both cells 7 days
      after seeding and 14 days after confluency, incubation with LA significantly
      raised the proportion of 18:2n-6 but not its long-chain metabolites in cellular
      phospholipid. Incubation with GLA increased the levels of 18:3n-6, 20:3n-6, and
      20:4n-6. Incubation with AA increased the levels of 20:4n-6 and 22:4n-6, and
      incubation with DTA increased the levels of 22:4n-6 as well as its retro
      conversion metabolite, 20:4n-6. A subsequent addition of cholesterol (180 microM)
      to the medium significantly raised the cellular cholesterol level but less so in
      the cells 7 days after seeding incubated with GLA. The increase in cellular
      cholesterol level was generally greater in the cells of 7 days after seeding,
      particularly those incubated with long-chain highly unsaturated n-6 fatty acids,
      than in those of 14 days after confluency. These findings suggest that the cell
      growth and the extent of unsaturation in cell membrane phospholipid fatty acids
      modulate the incorporation of the exogenous cholesterol into the Caco-2 cells.

PMID- 11210115
TI  - Plasma cholesterol-lowering effect on rats of dietary fiber extracted from
      immature plants.
AB  - Crude dietary fiber samples were prepared from beet, cabbage, Japanese radish,
      onion and mung bean sprouts (BF, CF, RF, OF and MF, respectively). These samples
      contained total dietary fiber at the levels of 814, 699, 760, 693 and 666 g/kg,
      respectively. To examine the effect of these dietary fiber sources on the plasma
      cholesterol concentration, male Sprague-Dawley rats were fed on a fiber-free (FF)
      diet or on an FF diet supplemented with 5% or 10% dietary fiber. Dietary fiber
      extracted from vegetables, wood cellulose (CL), pectin (PE) and guar gum (GG)
      were used as the fiber sources. Compared with the rats fed on the FF diet, a
      significant reduction in the plasma cholesterol concentration was observed in the
      rats fed on BF, CF, RF, MF, PE or GG after a 21-d feeding period. Cecal acetate,
      n-butyrate and total short-chain fatty acids were significantly higher in the
      rats fed on these dietary fibers, except for CF, than in those fed on the FF
      diet. A negative correlation was apparent between the total dietary fiber
      content, hemicellulose content and pectin content of each dietary fiber source
      and the plasma cholesterol concentration. These results suggest that some
      vegetable fibers exert a plasma cholesterol-lowering effect through cecal
      fermentation of these fibers.

PMID- 11210116
TI  - Time-dependent structure and activity changes of alpha-chymotrypsin in
      water/alcohol mixed solvents.
AB  - Secondary structure of alpha-chymotrypsin in water/ethanol was investigated by
      circular dichroic (CD) spectroscopy. The changes in catalytic activity were
      discussed in terms of structural changes of the enzyme. Alpha-chymotrypsin formed
      beta-sheet structure in water/ethanol (50/50 by volume), but it was substantially
      less active as compared to that in water. At water/ethanol 10/90, alpha
      chymotrypsin took on a native-like structure, which gradually changed to beta
      conformation with concomitant loss of activity. Change of solvent composition
      from water/ethanol 50/50 to 90/10 or 10/90 by dilution with water or ethanol,
      respectively, led to partial recovery of native or native-like structure and
      activity. In water/methanol, alpha-chymotrypsin tended to form stable beta-sheet
      structure at water/methanol ratios lower than 50/50, but the catalytic activity
      decreased with time. Change to alpha-helix structure with substantial loss in
      catalytic activity was observed when alpha-chymotrypsin was dissolved in
      water/2,2,2-trifluoroethanol with water contents lower than 50%. In water/2,2,2
      trifluoroethanol 90/10, alpha-chymotrypsin initially had the CD spectrum of
      native structure, but it changed with time to that characteristic of beta-sheet
      structure.

PMID- 11210117
TI  - Nematicidal alkaloids and related compounds produced by the fungus Penicillium
      cf. simplicissimum.
AB  - A new nematicidal alkaloid, peniprequinolone (1), together with the known
      alkaloids penigequinolones A and B (2a, 2b), 3-methoxy-4-hydroxy-4-(4'
      methoxyphenyl)quinolinone (3), and 3-methoxy-4,6-dihydroxy-4-(4'
      methoxyphenyl)quinolinone (4), were isolated from Penicillium cf. simplicissimum
      (Oudemans) Thom. Cyclopenin (5) and a compound (6a/6b) structurally related to
      cyclopenin also were isolated from the fungus, and their structures were
      established by spectroscopic analysis. The biological activities of 1, 2, 3, 4,
      and 5 were examined by a bioassay with root-lesion nematodes.

PMID- 11210118
TI  - New anthocyanins from purple pods of pea (Pisum spp.).
AB  - Two new anthocyanins were isolated from purple pods of pea (Pisum spp.). Their
      structures were identified as delphinidin 3-xylosylgalactoside-5-acetylglucoside
      and its deacetylated derivative by the usual chemical degradation methods and by
      spectroscopic methods such as UV-VIS, MS and NMR. Both pigments showed moderate
      stability and antioxidative activity in a neutral aqueous solution.

PMID- 11210119
TI  - DNA repair effect of traditional sweet pepper Fushimi-togarashi: seen in
      suppression of UV-induced cyclobutane pyrimidine dimer in human fibroblast.
AB  - The aqueous fraction of Fushimi sweet pepper increased the repair effect of the
      solvent control against UV-induced cyclobutane pyrimidine dimers in human
      fibroblast to 150%, but ordinary sweet pepper did not have a statistically
      significant effect. When Fushimi sweet pepper was boiled, the activity of the
      aqueous fraction was elevated to 209% of the control (p<0.05), while that of the
      grilled state was decreased to 125% of the control. The repair activity of a
      dialyzate (MW<12,000) of the aqueous fraction from Fushimi sweet pepper showed
      191% of the control (p<0.05). The dialyzate was contained 1.9% in the weight of
      the fresh fruit body of Fushimi sweet pepper, and the activity can be stable in
      its boiling state, and it might be therefore considered to be the worthy source
      for expecting the DNA repair activity in human diet.

PMID- 11210120
TI  - Analyses of polyphenols in cacao liquor, cocoa, and chocolate by normal-phase and
      reversed-phase HPLC.
AB  - The antioxidant polyphenols in cacao liquor, a major ingredient of chocolate and
      cocoa, have been characterized as flavan-3-ols and proanthocyanidin oligomers. In
      this study, various cacao products were analyzed by normal-phase HPLC, and the
      profiles and quantities of the polyphenols present, grouped by molecular size
      (monomers to approximately oligomers), were compared. Individual cacao
      polyphenols, flavan-3-ols (catechin and epicatechin), and dimeric (procyanidin
      B2), trimeric (procyanidin C1), and tetrameric (cinnamtannin A2)
      proanthocyanidins, and galactopyranosyl-ent-(-)-epicatechin (2alpha-->7, 4alpha-
      >8)-(-)-epicatechin (Gal-EC-EC), were analyzed by reversed-phase HPLC and/or
      HPLC/MS. The profile of monomers (catechins) and proanthocyanidin in dark
      chocolate was similar to that of cacao liquor, while the ratio of flavan-3-ols to
      the total amount of monomeric and oligomeric polyphenols in the case of pure
      cocoa powder was higher than that in the case of cacao liquor or chocolate.

PMID- 11210121
TI  - Dietary effects of eicosapentaenoic and docosahexaenoic acid esters on lipid
      metabolism and immune parameters in Sprague-Dawley rats.
AB  - Sprague-Dawley rats were fed eicosapentaenoic (EPA) and docosahexaenoic acid
      (DHA) ethyl esters at the 2% level for 3 weeks to clarify their effects on immune
      functions. In the rats fed EPA or DHA, serum cholesterol, triglyceride, and
      phospholipid (PL) levels were significantly lower than those in the rats fed
      safflower oil. In PL fractions of serum, liver, lung, splenocytes, and peritoneal
      exudate cells (PEC), increases in linoleic and dihomo-gamma-linolenic acid
      contents and a decrease in arachidonic acid (AA) content were observed in the
      rats fed EPA or DHA. In addition, the EPA content increased in the rats fed EPA
      and DHA. In the rats fed EPA or DHA, a decrease of LTB4 productivity and an
      increase of LTBs productivity were observed in the PEC, in response to the
      treatment with 5 microM calcium ionophore A23187 for 20 min. The changes in
      leukotriene production were more marked in EPA-fed rats than in DHA-fed rats.
      These results suggest that dietary EPA affects lipid metabolism and leukotriene
      synthesis more strongly than DHA.

PMID- 11210122
TI  - Effect of soy and milk whey protein isolates and their hydrolysates on weight
      reduction in genetically obese mice.
AB  - The effect on genetically obese mice of a milk whey protein isolate (WPI) and soy
      protein isolate (SPI) and their hydrolysates (WPI-H, SPI-H) on the rate of body
      fat disappearance was investigated. Male yellow KK mice were made obese by
      feeding with a high-fat diet containing 30% fat from 6 to 10 weeks of age. They
      were then fed with an energy-restricted low fat (5.0%) and high protein (35% WPI,
      WPI-H, SPI or SPI-H) diet for 2 weeks at the 60% level of energy intake by mice
      on laboratory feed. During the weight reduction period, the body weight of the
      WPI, WPI-H, SPI and SPI-H groups changed by -9.1, -9.1, -10.0 and -11.1 g/14
      days, respectively, the reduction being significantly lower in the SPI-H group
      than in the WPI and WPI-H groups. The plasma total cholesterol level was
      significantly lower with the SPI diet, and the plasma glucose level was lower
      with the SPI and SPI-H diets than with the WPI and WPI-H diets. Although the body
      protein content was comparable in all the groups, the body fat content was
      significantly lower with the SPI diet than with the WPI diet, and was also
      significantly lower with the SPI-H diet than with the WPI and WPI-H diets. The
      weight of the perirenal fat pads was significantly lower with the SPI-H diet than
      with the WPI and WPI-H diets. These results indicate that SPI and SPI-H are
      suitable protein sources in an energy-restricted diet for treating obesity.

PMID- 11210124
TI  - Comparison of substrate specificities of transglutaminases using synthetic
      peptides as acyl donors.
AB  - Transglutaminase (TGase) is an enzyme that catalyzes acyl transfer reactions
      between primary amines and Gln residues in proteins or peptides. Substrate
      specificities of TGase, Ca2+-independent microbial transglutaminase (MTGase), and
      Ca2+-dependent tissue type transglutaminase from guinea pig liver (GTGase) and
      fish, Red sea bream (Pagrus major), liver (FTGase), for acyl donors were
      investigated using synthetic peptides containing Gln residues and Gln analogues
      with different lengths of side chain. MTGase dose not recognize the Gln analogues
      as a substrate and has strict substrate specificities toward L-Gln. Substrate
      peptides with a variety of sequences around the Gln residue, GXXQXXG (X=G, A, S,
      L, V, F, Y, R, N, E, L) were synthesized and used as acyl donors. As an acyl
      acceptor, the fluorescent reagent monodancyl cadaverine was used and the
      reactions analyzed with RP-HPLC. Substitution of the C-terminal of a Gln residue
      with a hydrophobic amino acid accelerated the reaction by GTGase and FTGase. N
      terminal substitution of Gln residues had similar effects on the reaction by
      MTGase.

PMID- 11210123
TI  - Splice isoforms of transcription factor Elf-1 affecting its regulatory function
      in transcription-molecular cloning of rat Elf-1.
AB  - To elucidate the role of Elf-1 in Fc epsilonRI alpha chain expression, rat Elf-1
      cDNAs were isolated and characterized. The rat Elf-1 cDNA of 2744 bp contained an
      open reading frame of 1848 bp. In addition to the full length rat Elf-1 cDNA
      (named type 1), two splice isoforms were isolated. One of the two isoforms lacked
      the amino acid residues from 85th to 120th (type 2), and the other from 85th to
      175th (type 3). Similar isoforms were also observed in human tissue.
      Overexpression of rat Elf-1 (type 1) using a transient coexpression system
      inhibited of the alpha chain promoter activity. The inhibition activity was
      different between the isoforms; the inhibition activity of type 2 was lower than
      that of type 1, and type 3 did not have an inhibitory effect. This observation
      suggested that each Elf-1 isoform played a different role in the gene expression
      under its control.

PMID- 11210125
TI  - Cloning, sequencing, and expression of the gene encoding a cell-bound multi
      domain xylanase from Clostridium josui, and characterization of the translated
      product.
AB  - The nucleotide sequence of the Clostridium josui FERM P-9684 xyn10A gene,
      encoding a xylanase Xyn10A, consists of 3,150 bp and encodes 1,050 amino acids
      with a molecular weight of 115,564. Xyn10A is a multidomain enzyme composed of an
      N-terminal signal peptide and six domains in the following order: two
      thermostabilizing domains, a family 10 xylanase domain, a family 9 carbohydrate
      binding module (CBM), and two S-layer homologous (SLH) domains. Immunological
      analysis indicated the presence of Xyn10A in the culture supernatant of C. josui
      FERM P-9684 and on the cell surface. The full-length Xyn10A expressed in a
      recombinant Escherichia coli strain bound to ball-milled cellulose (BMC) and the
      cell wall fragments of C. josui, indicating that both the CBM and the SLH domains
      are fully functional in the recombinant enzyme. An 85-kDa xylanase species
      derived from Xyn10A by partial proteolysis at the C-terminal side, most likely at
      the internal region of the CBM, retained the ability to bind to BMC. This
      observation suggests that the catalytic domain or the thermostabilizing domains
      are responsible for binding of the enzyme to BMC. Xyn10A-II, the 100-kDa
      derivative of Xyn10A, was purified from the recombinant E. coli strain and
      characterized. The enzyme was highly active toward xylan but not toward p
      nitrophenyl-beta-D-xylopyranoside, p-nitrophenyl-beta-D-cellobioside, or
      carboxymethylcellulose.

PMID- 11210126
TI  - Biogenic amines in Drosophila virilis under stress conditions.
AB  - The effect of heat stress (38 degrees C) on the content of DL-beta-(3,4
      dihydroxyphenyl)alanine (DOPA), dopamine, tyramine, octopamine, and their
      precursor Tyr was studied in adults of two lines of Drosophila virilis
      contrasting in their stress response. In individuals of line 101 responding to
      stress by a hormonal stress reaction, the contents of DOPA, dopamine, octopamine,
      and Tyr were lower than those of line 147 that did not respond to the stress.
      However, heat stress caused an increase in the contents of DOPA, dopamine,
      octopamine, and Tyr in line 101, whereas the equivalent titers in line 147 remain
      unchanged.

PMID- 11210127
TI  - Prophage, phiPV83-pro, carrying panton-valentine leukocidin genes, on the
      Staphylococcus aureus P83 chromosome: comparative analysis of the genome
      structures of phiPV83-pro, phiPVL, phi11, and other phages.
AB  - Staphylococcus aureus P83 has Panton-Valentine leukocidin (PVL)-like genes, lukM
      and lukF-PV. Here, lukM and lukF-PV genes were found on the genome of a prophage,
      which was designated as phiPV83-pro. The precise genome size was 45,636 bp with
      att core sequences of 10 base pairs. Sixty-four ORFs were identified on the
      phiPV83-pro genome, including two extra operons, lukM-lukF-PV and orfs63-64. The
      lukM-lukF-PV cluster was located 2.1 kb upstream of the attL site. The most
      striking feature of the phiPV83-pro genome was a constituent of at least 4
      regions from phi11, phiPVL, and other phages, i.e., (i) att sites identical with
      those of phi11, (ii) a cos sequence and the genes encoding packaging and head
      proteins of phiPVL (occupied half region of phiPV83-pro), and (iii) the other two
      regions which showed no significant similarity with known phages (occupied about
      40% of phiPV83-pro). Furthermore, two insertion sequences, ISSA1 and ISSA2 were
      integrated into attL site and orf44, respectively. PhiPV83-pro was not induced as
      phage particles from S. aureus P83 regardless of its treatment with mitomycin C.
      The insertion of ISSA1 into the attL site was one of the reasons of the failure
      of the induction of the phage particles by mitomycin C treatment of the strain
      P83.

PMID- 11210128
TI  - Metabolism of chiral ionylideneacetic acids on the abscisic acid biosynthetic
      pathway in Cercospora.
AB  - A Chiralcel OJ column was used to determine the absolute configuration of
      naturally occurring alpha-ionylideneacetic acid from Cercospora rosicola and
      gamma-ionylideneacetic acid from C. cruenta as (R) enantiomers in accordance with
      their biosynthetic product, (S)-ABA. Both enantiomers of [1, 2-(13)C2]-alpha and
      gamma-ionylideneacetic acids were prepared and fed to C. rosicola and C. cruenta.
      Six combinations of feeding experiments comparatively and unequivocally
      demonstrated stereoselectivity in the biosynthetic conversions, including
      stepwise hydroxylation at C-1' and 4'. Enzymatic isomerization from the gamma to
      alpha-intermediate was suggested not to be involved in ABA biosynthesis in C.
      rosicola.

PMID- 11210129
TI  - Identification of a compound in Chamaecyparis taiwanensis inhibiting the ice
      nucleating activity of Pseudomonas fluorescens KUIN-1.
AB  - Inactivation of the ice-nucleating activity of Pseudomonas fluorescens KUIN-1 by
      compounds in the leaves from coniferous trees were investigated, and the
      inactivated material was identified. Intact cells of the strain KUIN-1 and the
      acetone or methanol extracts of leaves of various coniferous trees were allowed
      to react for 30 min at 18 degrees C. Antinucleation compounds were obtained from
      Chamaecyparis taiwanensis. When the acetone extract from the leaves of coniferous
      trees was added to the cell suspension (about 10(6) cells/ml) in 50 mM potassium
      phosphate buffer (pH 7.0), the ice nucleating temperature, T50, was significantly
      decreased (T50 < -5 degrees C). This inhibitor was isolated by using TLC, then
      identified as hinokitiol based on UV-VIS, IR, and mass spectral data. When intact
      cells of the strain KUIN-1 were incubated with hinokitiol, limonene, and alpha
      pinene of the principal constituent of the leaves of coniferous trees in 50 mM
      potassium phosphate buffer (pH 7.0), the ice-nucleating activity decreased, but
      not in alpha-terpinene. Furthermore, the ice-nucleating activities from other ice
      nucleating bacteria also decreased in the presence of hinokitiol. This inhibition
      was proportional to the concentration of hinokitinol. The pH and thermal
      stabilities of the ice-nucleating activity of the cells were changed by the
      addition of hinokitiol (10 mM).

PMID- 11210130
TI  - Ecdysteroids in stress responsive and nonresponsive Drosophila virilis lines
      under stress conditions.
AB  - After exposure to thermal stress or a control temperature, the relative abundance
      of ecdysone (E) and 20-hydroxyecdysone (20E) was measured in a wild-type line of
      Drosophila virilis (101) that is stress responsive and in a mutant line (147)
      that is not stress responsive. In line 101, the 20E content was higher and E
      content lower in females than in males. The abundance of E and 20E in females of
      line 147 was significantly higher than that in females of line 101. Females of
      line 101 were found to respond to 60 min of heat stress (38 degrees C) by an
      increase in the abundance of both E and 20E, while in males of this line the
      amount of 20E increased and that of E declined. A role of the ecdysteroids in the
      control of reproduction of D. virilis under stress is discussed.

PMID- 11210131
TI  - Novel method for producing hypoallergenic wheat flour by enzymatic fragmentation
      of the constituent allergens and its application to food processing.
AB  - A novel method is proposed to produce hypoallergenic wheat flour suitable for
      patients allergic to wheat. Wheat flour was mixed with a cellulase solution, and
      the mixture was incubated at 50 degrees C for 1 h to hydrolyze the carbohydrate
      allergens. The hydrolysate was further incubated with actinase at 40 degrees C
      for 1 h while gently stirring to decompose the proteinaceous allergens. The
      product was evaluated for its allergenicity by an enzyme-linked immunosorbent
      assay, the results of which suggested negative allergenicity in most cases. The
      product changed to a batter state that was difficult to process by the usual
      methods. Gelatinization of the starch in the product and the addition of a
      surfactant were beneficial for food processing.

PMID- 11210132
TI  - A cold acclimation protein with refolding activity on frozen denatured enzymes.
AB  - We found that a cold acclimation protein from an ice-nucleating bacterium, Patoea
      ananas KUIN-3, has refolding activity on frozen denatured protein. Based on a SDS
      PAGE analysis, we confirmed that the cold shock-treated cells of strain KUIN-3
      could produce some cold acclimation proteins that inhibit their syntheses by the
      addition of chloramphenicol during the cold acclimation. Among such proteins,
      Hsc25 had refolding activity similar to GroELS. Hsc25 was purified to apparent
      homogeneity by (NH4)2SO4 precipitation and some chromatographies. The purified
      Hsc25 was composed of 8 subunits of 25,000 each with a molecular mass of 200,000
      and had refolding activity against denatured enzymes, which were denatured by
      heat-treatment at 100 degrees C, cryopreservation at -20 degrees C, or guanidine
      hydrochloride, in a manner similar to GroELS. The N-terminal sequence of Hsc25
      was Met-Arg-Ala-Ser-Thr-Tyr-His-Ala-Ala-Arg-. Furthermore, Hsc25 had a high level
      of activity at low temperature (12 degrees C). Also, the dissociation constants,
      KD (M) as the binding specificity for enolase, mutarotase, isocitrate
      dehydrogenase, and lactate dehydrogenase were 1.82x10(-10), 4.35x10(-9), 8.98x10(
      12), and 3.05x10(-11), respectively. The affinity of Hsc25 for frozen danatured
      enzymes was higher than the affinity for heat denatured enzymes when compared
      with the affinity of GroEL. These results are the first report on the
      characterization of a purified chaperon that was induced by cold acclimation.

PMID- 11210133
TI  - Efflux system for pyridoxine in Schizosaccharomyces pombe.
AB  - Pyridoxine-charged Schizosaccharomyces pombe released pyridoxine rapidly at 30
      degrees C: very low amounts of three other B6 vitamers were also released. The
      rate of efflux was temperature-dependent. The initial rate of efflux was
      dependent on the concentration of pyridoxine in the cells: the rate was almost
      zero at lower than 0.02 mM and became saturated at higher than 0.2 mM. Na+,
      sodium azide, and dinitrophenol increased the rate in both the presence and
      absence of D-glucose. Mg++, thiamine, and menadione inhibited the efflux. The
      intracellular concentration of ATP did not significantly affect the efflux rate.
      The system may be dependent on a membrane potential of the yeast cells. It was
      found that the fission yeast cells have a gate or carrier system for efflux of
      pyridoxine, which was distinct from that in Saccharomyces cerevisiae.

PMID- 11210134
TI  - Alpha-oxidation of long-chain unsaturated fatty acids in the marine green alga
      Ulva pertusa.
AB  - When long-chain unsaturated fatty acids such as oleic, linoleic, and linolenic
      acid were incubated with crude enzymes from the marine green alga Ulva pertusa,
      the corresponding (R)-2-hydroperoxy acids were formed with a high enantiomeric
      excess (>99%).

PMID- 11210135
TI  - cDNA cloning of the Cry1Aa receptor variants from Bombyx mori and their
      expression in mammalian cells.
AB  - We cloned cDNA of three variants of BtR175, a putative Bombyx mori receptor for
      Bacillus thuringiensis Cry1Aa delta-endotoxin by PCR. These variants were likely
      to be allelic to BtR175. cDNA of BtR175b, the most distant variant from BtR175,
      was introduced into mammalian cells. BtR175b protein was expressed in the plasma
      membrane of the cells and showed binding activity to Cry1Aa.

PMID- 11210136
TI  - Effects of corticosterone on connectin content and protein breakdown in rat
      skeletal muscle.
AB  - We examined the effects of a glucocorticoid, corticosterone, on calpain activity,
      connectin content and protein breakdown in rat muscle. The results indicated that
      calpain activity was increased by corticosterone and thus breakdown of connectin
      was stimulated followed by increased breakdown of skeletal muscle protein.

PMID- 11210137
TI  - Stability and bioavailability of antioxidants in garland (Chrysanthemum
      coronarium L.).
AB  - The stability and bioavailability of the major antioxidants in garland
      (Chrysanthemum coronarium L.), chlorogenic acid, 3,5-dicaffeoylquinic acid and 4
      succinyl-3,5-dicaffeoylquinic acid, were investigated together with caffeic acid.
      These compounds were stable in artificial digestive juice, but more than 90% of
      them disappeared from plasma within 30 min after intravenous injection into rats.
      When they were orally administered, only caffeic acid could be detected.

PMID- 11210138
TI  - Analysis of catalytic residues of Thermoactinomyces vulgaris R-47 alpha-amylase
      II (TVA II) by site-directed mutagenesis.
AB  - To confirm that the catalytic residues (Asp325, Glu354, and Asp421) are necessary
      for the hydrolysis of starch, pullulan, and cyclodextrins, we constructed TVA II
      mutated by site-directed mutagenesis. The mutated enzymes (D325N, E354Q, and
      D421N) had markedly reduced levels of activity, less than 0.006% of the wild
      type, indicating that these three residues are the catalytic sites for these
      substrates. Even E354D had reduced levels of activity, less than 0.05% of wild
      type. These four mutated enzymes retained a trace of activity. From the result of
      hydrolysis patterns for maltohexaose, in particular, D421N, unlike D325N and
      E354Q, catalyzed transglycosylation rather than hydrolysis. The results suggest
      that Asp421 could function to capture water molecules.

PMID- 11210139
TI  - Purification and characterization of cyclohexanone 1,2-monooxygenase from
      Exophiala jeanselmei strain KUFI-6N.
AB  - Baeyer-Villiger cyclohexanone 1,2-monooxygenase (CHMO) was purified 17.1-fold
      from cell extracts of the fungus Exophiala jeanselmei grown on cyclohexanol to
      electrophoretically homogeneity by serial chromatographies. The molecular mass of
      the native enzyme was approximately 74 kDa by gel filtration and SDS-PAGE. Some
      enzymic characterizations were studied. The NH2-terminal amino acid residues were
      Ala-Lys-Ser-Leu-Asp-Val-Leu-Ile-Val-Gly-Ala-Gly-Phe-Gly-Gly-Ile-Tyr-Gln-Leu-,
      with similarity to the bacterial CHMOs of FAD-binding and NADPH-dependent type
      Baeyer-Villiger monooxygenases.

PMID- 11210140
TI  - Polygodial, a potent attachment-inhibiting substance for the blue mussel, Mytilus
      edulis galloprovincialis from Tasmannia lanceolata.
AB  - A highly potent attachment-inhibitor, polygodial, was isolated from a hexane
      extract of the leaves of Tasmannia lanceolata. The attachment-inhibiting activity
      of polygodial against the blue mussel was increased 4-fold when used in
      combination with sorbic acid, anethole, and indole.

PMID- 11210141
TI  - Synthesis and potato cell expansion-inducing activity of the stereochemically
      restricted bicyclic analogue of 7-epi-jasmonic acid.
AB  - The stereochemically restricted bicyclic analogue of 7-epi-jasmonic acid was
      synthesized from a known bicyclo[3.3.0]octane derivative. The enol triflate
      derived from the bicyclic compound was subjected to palladium-catalyzed coupling
      with allyltributyltin to give the desired carbon skeleton. Selective catalytic
      hydrogenation and subsequent acidic hydrolysis gave a new bicyclic analogue of 7
      epi-jasmonic acid. The ACC conjugate of the bicyclic analogue was also
      synthesized. This ACC conjugate exhibited only slightly weaker potato cell
      expansion-inducing activity than that of the JA standard.

PMID- 11210142
TI  - Effects of a fermented milk drink containing Lactobacillus casei strain Shirota
      on the immune system in healthy human subjects.
AB  - Nine healthy volunteers drank fermented milk containing 4 x 10(10) live cells of
      Lactobacillus casei strain Shirota daily for 3 weeks, and their NK activity and
      other immunological functions were measured. NK activity significantly increased
      (p<0.01) 3 weeks after the start of intake and remained elevated for the next 3
      weeks. The effect was particularly prominent in low-NK-individuals.

PMID- 11210143
TI  - Microbial degradation of disodium terephthalate by alkaliphilic Dietzia sp.
      strain GS-1.
AB  - An alkaliphilic Dietzia sp., strain GS-1, which degraded disodium terephthalate
      (DT), was isolated from soil. Strain GS-1 degraded 19.3 mM of DT in 168 h at pH
      10. The maximum degradation velocity was 0.46 mM/h. The resting cells efficiently
      degraded 28.7 mM of DT in 51 h at 28 degrees C and pH 10. The degradation
      velocity was 0.41 mM/(h g-wet cell).

PMID- 11210144
TI  - Characterization of a vitamin B12 compound in the edible purple laver, Porphyra
      yezoensis.
AB  - The edible purple laver, Porphyra yezoensis, contained 51.49+/-1.51 microg of
      vitamin B12 compounds per 100 g dry weight of the laver (mean +/- SEM, n = 4). A
      vitamin B12 compound was purified from the lyophilized purple laver and partially
      characterized. The silica gel 60 TLC and reversed-phase HPLC patterns of the
      purified pink-colored compound were identical to those of authentic vitamin B12,
      but not to those of vitamin B12 analogues inactive for humans.

PMID- 11210145
TI  - Secretion of hen egg white lysozyme from Kluyveromyces lactis.
AB  - Hen egg white (HEW) lysozyme was correctly processed and efficiently secreted
      from an alternative yeast, Kluyveromyces lactis. We constructed secretion vectors
      using PHO5, PGK, and LAC4 promoters, and found that the highest secretion was
      obtained under the direction of the PGK promoter in non-selective rich medium. K.
      lactis secreted HEW lysozyme with two-fold higher efficiency than S. cerevisiae,
      estimated by using a K. lactis-S. cerevisiae shuttle vector.

PMID- 11210146
TI  - Specific toxic effect of dinoflagellate Heterocapsa circularisquama on the
      rotifer Brachionus plicatilis.
AB  - Heterocapsa circularisquama (Dinophyceae), a noxious red tide dinoflagellate, is
      known to have a specifically lethal effect on shellfish, especially bivalves such
      as pearl oyster (Pinctada fucata), but no detrimental effects of this alga on
      fishes have not been observed so far. In this study, we found that H.
      circularisquama was toxic to a microzooplankton, a rotifer (Brachionus
      plicatilis) in a cell concentration-dependent manner, while the cultured
      supernatant or ultrasonic ruptured H. circularisquama had no significant toxic
      effect on the rotifer. Since no such toxic effects on the rotifer were observed
      in Chattonella marina, Heterosigma akashiwo, or Cochlodinium polykrikoides, other
      species of harmful red tide plankton, H. circularisquama may have a strictly
      specific toxic mechanism against the rotifer as well as bivalves.

PMID- 11210147
TI  - Synthesis of all four possible stereoisomers of 5,9-dimethylpentadecane, the
      major sex pheromone component of the coffee leaf miner moth, Perileucoptera
      coffeella.
AB  - All of the four possible stereoisomers of 5,9-dimethylpentadecane, the major sex
      pheromone component of the coffee leaf miner moth (Perileucoptera coffeella),
      were synthesized by using the methyl esters of (S)- and (R)-3-hydroxy-2
      methylpropanoic acid as chiral sources for the purpose of determining the
      stereochemistry of the pheromone.

PMID- 11210148
TI  - Purification and characterization of nitrite-oxidizing enzyme from heterotrophic
      Bacillus badius 1-73, with special concern to catalase.
AB  - Nitrite-oxidizing enzyme I (NiOx I) was purified from a heterotrophic bacterium,
      Bacillus badius I-73. The enzyme was a homotetramer of a heme-containing peptide,
      and was similar to catalases from various sources in its N-terminal amino acid
      sequence. The purified enzyme also catalyzed H2O2 degradation. The nitrite
      oxidation reaction required ascorbic acid and oxygen. Successive H2O2 feeding
      could be substituted for ascorbic acid. These indicated that NiOx I is a catalase
      and nitrite was oxidized by a peroxidase-like reaction.

PMID- 11210149
TI  - Introduction of enterostatin (VPDPR) and a related sequence into soybean
      proglycinin A1aB1b subunit by site-directed mutagenesis.
AB  - Enterostatin (VPDPR), having anoretic and hypocholesterolemic activities, and its
      homologue LPYPR, a hypocholesterolemic peptide found in the glycinin A5A4B3
      subunit, were introduced into the corresponding site (TNGPQ) of the proglycinin
      A1aB1b subunit by site-directed mutagenesis. Modified proglycinins were expressed
      in E. coli and recovered from the insoluble fraction. VPDPR and LPYPR were
      released by the action of chymotrypsin and trypsin as expected. The overall
      yields of purified VPDPR and LPYPR were 40% and 62%, respectively.

PMID- 11210150
TI  - Molecular cloning, overexpression, and purification of a major xylanase from
      Aspergillus oryzae.
AB  - The gene encoding xylanase G2 (xynG2) was isolated from a genomic library of
      Aspergillus oryzae KBN616, used for making shoyu koji. The structural part of
      xynG2 was found to be 767 bp. The nucleotide sequence of cDNA amplified by RT-PCR
      showed that the open reading frame of xynG2 was interrupted by a single intron
      which was 71 bp in size and encoded 232 amino acids. Direct N-terminal amino acid
      sequencing showed that the precursor of XynG2 had a signal peptide of 44 amino
      acids. The predicted amino acid sequence of XynG2 has strong similarity to other
      family 11 xylanases from fungi. The xynG2 gene was successfully overexpressed in
      A. oryzae and the overpexpressed XynG2 was purified. The molecular weight of
      XynG2 estimated on sodium dodecyl sulfate-polyacrylamide gel electrophoresis was
      21,000. This was almost the same as the molecular weight of 20,047 calculated
      from the deduced amino acid sequence. The purified XynG2 showed an optimum
      activity at pH 6.0 and 58 degrees C. It had a Km of 5.1 mg/ml and a Vmax of 123
      micromol/min/mg when birch wood xylan was used as a substrate.

PMID- 11210151
TI  - Enzymatic preparation of genuine prosapogenin, 20(S)-ginsenoside Rh1, from
      ginsenosides Re and Rg1.
AB  - It was found that a lactase preparation from Penicillium sp. nearly
      quantitatively hydrolyzed ginsenosides Re and Rg1, which are major saponins in
      roots of Panax ginseng, to a minor saponin, 20(S)-ginsenoside Rh1 [6-O-beta-D
      glucopyranosyl-20(S)-protopanaxatriol]. This is the first report on the enzymatic
      preparation of ginsenoside Rh1 with a high efficiency. This enzyme also readily
      hydrolyzed ginsenoside Rg2 to ginsenoside Rh1.

PMID- 11210152
TI  - Tyrosine72 residue at the bottom of rim domain in LukF crucial for the sequential
      binding of the staphylococcal gamma-hemolysin to human erythrocytes.
AB  - Staphylococcal bi-component cytotoxins, leukocidin (Luk), Panton-Valentine
      leukocidin (PVL), and gamma-hemolysin (Hlg) consist of LukF and LukS, LukF-PV and
      LukS-PV, and LukF and Hlg2, respectively, and Luk and Hlg share LukF. LukF-PV can
      not substitute for LukF for Hlg, despite 73% identity in amino acid sequence and
      close similarity in the 3-dimensional structure between them. Here, we
      demonstrated that the absence of hemolytic activity of LukF-PV in cooperation
      with Hlg2 is due to the failure of the binding of LukF-PV to human erythrocytes.
      We identified Y72 residue at the bottom of rim domain in LukF as the crucial
      residue for its binding, which is a prerequisite to the subsequent binding of
      Hlg2 to human erythrocytes. The data obtained showed that a mutant of LukF-PV in
      which T71 residue was replaced by the corresponding residue of LukF, Y72, endowed
      LukF-PV with the binding capability to human erythrocytes which was accompanied
      by its hemolytic activity in the presence of Hlg2.

PMID- 11210153
TI  - Haemolytic index and performance of a magnetically coupled rotary pulsatile pump
      with potential for ventricular assist.
AB  - A novel magnetically coupled rotary vane pump is described which has the
      potential to be used as a ventricular assist device. The pump has an excellent
      haemodynamic performance. When tested, pumping blood, against a range of
      pressures from 20 to 100 mm Hg the volumetric output varied within reasonable
      limits. The pump could deliver 5.1 litres per minute against a pressure of 180 mm
      Hg before the magnetic coupling disengaged. With specially moulded magnets
      improved coupling can be achieved. The haemolytic index was determined using a
      circuit conforming to ASTM: F04-40-101. The NIH (normalised index of haemolysis)
      was found to be 0.3 and the MIH (modified index of haemolysis) 0.26 which is
      unacceptably high for long term perfusion. The pump has several outstanding
      features, it is hermetically sealed, it needs no valving, a desirable property in
      a ventricular assist pump, and it has a pulsatile action. In a non magnetically
      coupled form it performed satisfactorily in left ventricular assist mode and as a
      total cardiopulmonary bypass pump in short term experiments with dogs.

PMID- 11210154
TI  - Plasma sample preparation by ultrafiltration for FTIR analysis.
AB  - Total body water (TBW) may be significantly altered with disease. Isotope
      dilution techniques, considered to be the "gold standard" methods for measuring
      TBW, are expensive, time consuming and require considerable expertise, especially
      during the sample preparatory phase. In this study, a new method, ultrafiltration
      (UF), was hypothesised to be an efficient alternative to vacuum sublimation (VS)
      in the preparation of plasma samples for Fourier Transform Infra Red (FTIR)
      determination of TBW. Deuterium Oxide (D2O) concentrations were prepared in human
      plasma and subjected to both techniques. FTIR analysis was carried out on the
      resulting VS and UF solutions and on D2O concentrations in distilled water. The
      resulting absorbance values were then statistically compared. Urea concentrations
      prepared in D2O-containing plasma were also compared to "blank" plasma to
      investigate the effect of high plasma urea concentration on the resulting H2O/D2O
      mixture obtained during UF Paired t-tests showed that the VS plasma samples
      (p=0.003), but not the UF samples (p=0.9), were significantly different to D2O
      standards prepared in distilled water. While there was no evidence of an effect
      of urea on UF at low (0.4 g/L) D2O concentration, a marginal (p=0.04) effect
      occurred at a higher (1.6 g/L) D2O level. Throughput of samples was much more
      efficient with the UF technique. These findings indicate that the new UF method
      is an accurate, more efficient method of plasma sample preparation than the VS
      method in the FTIR determination of TBW.

PMID- 11210155
TI  - Three-dimensional clinical measurement of bilateral hip and knee rotations.
AB  - This paper reports a technique of using an electromagnetic system to measure
      three-dimensional bilateral hip and knee joint rotations during walking and of
      using peak cross-correlation between rotation angles to describe the pattern of
      rotations. Three-dimensional rotations of thigh and shank during gait were
      recorded using five receivers of the electromagnetic system synchronised with
      four foot-switches. Thirteen normal subjects were tested on two separate
      occasions to examine repeatability of the measurements. The relationship between
      the rotations was represented as lags at peak cross-correlation. Twelve
      parameters of the lags at peak cross-correlation were calculated. The analysis
      showed that the joint rotation could be measured reliably and the cross
      correlation analysis provided parameters that were generally suitable for
      defining characteristics of hip and knee joint rotations during gait.

PMID- 11210156
TI  - Evaluation of a second set of lateral lasers for easier patient positioning in
      radiotherapy.
AB  - On modern linear accelerators patient set-up is often awkward due to the height
      of the isocentre. A second set of lateral lasers was mounted approximately 20 cm
      below the isocentre allowing patient positioning at an ergonomical height. A
      small randomised study involving 16 heavy patients treated for pelvic
      malignancies demonstrated that using the lower lasers for patient set-up is not
      only likely to reduce strain on staff but also speed up the set-up process.

PMID- 11210157
TI  - Evaluation of the mechanical alignment of a linear accelerator with an electronic
      portal imaging device (EPID).
AB  - Mechanical misalignment of a medical linear accelerator can be caused by any
      combination of source position displacement relative to the collimator rotational
      axis, collimator jaw asymmetry, or when the rotational axes of the gantry and the
      collimator do not intersect. A test procedure sensitive to all of these problems
      has been developed using an Electronic Portal Imaging Device (EPID). Each marker
      is placed on top of the EPID housing and on the treatment couch, then two images
      are acquired for gantry positions 180 degrees apart. By comparing the positions
      of the markers and their distances to the beam centre, mechanical alignment of
      the linear accelerator can be assessed. By comparing the positions of the beam
      centre for another two images acquired at collimator angles 180 degrees apart,
      the three potential sources of misalignment can be distinguished. Results with
      Siemens' Beam View were presented and determination accuracy of better than 0.25
      mm can be achieved.

PMID- 11210158
TI  - A quality assurance index for brachytherapy treatment plan verification.
AB  - A method is described which provides an independent verification of a
      brachytherapy treatment plan. The method is applicable to any common geometric
      configuration and utilises a simple equation derived from a common form of non
      linear regression. The basis for the index value is the relationship between the
      treatment time, prescribed dose, source strength and plan geometry. This
      relationship may be described mathematically as: Total Treatment Time
      proportional to (Prescribed Dose/Source Strength) x (a geometric term) with the
      geometric term incorporating three geometric components, namely the distance from
      source positions to points of dose normalisation d, the total length of the dwell
      positions L, and the number of source trains or catheters N. A general equation
      of the form GF = k (d)(-alpha) (L)(-beta) (N)(-gamma) is used to describe the
      plan geometry, where GF is what we have termed the geometric factor, k is a
      constant of proportionality and the exponents are derived from the non-linear
      regression process. The resulting index is simple to calculate prior to patient
      treatment and sensitive enough to identify significant error whilst being robust
      enough to allow for a normal degree of geometric distortion.

PMID- 11210159
TI  - Monte Carlo calculation for microplanar beam radiography.
AB  - In radiography the scattered radiation from the off-target region decreases the
      contrast of the target image. We propose that a bundle of collimated, closely
      spaced, microplanar beams can reduce the scattered radiation and eliminate the
      effect of secondary electron dose, thus increasing the image dose contrast in the
      detector. The lateral and depth dose distributions of 20-200 keV microplanar
      beams are investigated using the EGS4 Monte Carlo code to calculate the depth
      doses and dose profiles in a 6 cm x 6 cm x 6 cm tissue phantom. The maximum dose
      on the primary beam axis (peak) and the minimum inter-beam scattered dose
      (valley) are compared at different photon energies and the optimum energy range
      for microbeam radiography is found. Results show that a bundle of closely spaced
      microplanar beams can give superior contrast imaging to a single macrobeam of the
      same overall area.

PMID- 11210160
TI  - Biomathematical modelling of physiological fluids using a Casson fluid with
      emphasis to peristalsis.
AB  - In this paper, the peristaltic flow of rheologically complex physiological fluids
      when modelled by a non-Newtonian Casson fluid in a two-dimensional channel is
      considered. Of interest is the difference between peristaltic transport of
      Newtonian and non-Newtonian fluids. A perturbation series method of solution of
      the stream function in amplitude ratio is sought. It is found that Newtonian
      fluid is an important sub-class of non-Newtonian fluids that may adequately
      represent some physiological phenomena. It is shown that for a Casson fluid, when
      certain simplifications and approximations are made in the most generalised form
      of constitutive equation, the fluid may be adequately represented as an
      improvement of a Newtonian fluid.

PMID- 11210161
TI  - The temporal organization of life: the impact of multi-frequency non-linear
      biologic time structure upon the host-cancer balance.
AB  - The current scientific paradigm, based upon an erroneous assumption of linear
      biologic reality and simple cause and effect relationships, has outlived its
      usefulness. In order to begin to turn the voluminous data the reductive process
      provides us with daily into meaningful understanding of life, it is essential to
      integrate these data within a complex, multi-frequency temporo-spatial framework.
      This rhythmic chronobiology more accurately depicts the life process, as well as
      its evolutionary and ongoing vital interaction with the pulsating cosmic
      resonance structure. Examples of the kinds of thinking and experiments necessary
      to exploit this new paradigm are provided.

PMID- 11210162
TI  - Prognostic factors in advanced non-small cell lung cancer: elevated serum levels
      of neuron specific enolase indicate poor prognosis.
AB  - BACKGROUND: Non-small cell lung cancer (NSCLC) is resistant to chemotherapy and
      prognosis of advanced NSCLC patients is considered to be dependent on various
      prognostic factors. METHODS: We analyzed prognostic factors in patients with
      advanced NSCLC who had been enrolled in clinical trials conducted by the Okayama
      Lung Cancer Study Group between 1978 and 1992 using two kinds of multivariate
      analysis, Cox's multivariate analysis and recursive partitioning and amalgamation
      (RPA) analysis. RESULTS: The first analysis was performed on 261 patients using
      28 variables. Performance status (PS), clinical stage, liver metastasis or serum
      albumin level was an independent prognostic factor by Cox's analysis. In the
      second analysis performed on 128 patients having data on neuron specific enolase
      (NSE), NSE was the most important prognostic factor. Using the RPA method, three
      subgroups with significantly different survival potentials were defined. Among
      them, patients with normal serum NSE levels and good PS were found to obtain a
      markedly favorable prognosis [median survival time (MST) 22.1 months, 3-year
      survival rate 42.9%], whereas the survival of patients with elevated serum NSE
      levels and bone metastasis was extremely short (MST 4.7 months, 3-year survival
      rate 0%). CONCLUSIONS: These results indicate that analysis of prognostic factors
      including serum levels of NSE is useful for predicting the survival of patients
      with advanced NSCLC.

PMID- 11210163
TI  - A phase II study of VP-16-fosfamide-cisplatin combination chemotherapy plus early
      concurrent thoracic irradiation for previously untreated limited small cell lung
      cancer.
AB  - BACKGROUND: At present the addition of thoracic irradiation to combination
      chemotherapy is a standard treatment for limited staged small cell lung cancer.
      However, there is still controversy about the optimum timing of chest
      irradiation. We conducted a phase II study of etoposide (VP-16)-ifosfamide
      cisplatin (VIP) combination chemotherapy plus early concurrent thoracic
      irradiation for the patients with previously untreated limited small cell lung
      cancer in order to assess if the treatment modality could improve the response
      rate and the toxicity. METHODS: Forty-four patients with limited small cell lung
      cancer were treated with etoposide-ifosfamide-cisplatin and concurrent thoracic
      irradiation. Combination chemotherapy consisted of etoposide 100 mg/m2 (on days 1
      3), ifosfamide 1000 mg/m2 (on days 1 and 2) and cisplatin 100 mg/m2 (on day 1).
      Concurrent thoracic irradiation consisted of a total of 4000 cGy over 4 weeks
      starting on the first day of the first chemotherapy. All patients who showed a
      complete response were given prophylactic cranial irradiation for 2.5 weeks.
      RESULTS: Forty-four of the 49 patients who entered the study from May 1994 to
      August 1998 were evaluable. The median age was 59 years and 40 patients had a
      performance status of 0 or 1. The median survival time was 22.5 months. Twenty
      eight patients (62%) showed a complete response and 16 (38%) a partial response.
      Twenty-four patients (54%) developed grade 3 or 4 neutropenia; there was a 9%
      RTOG score 3 or 4 esophagitis. CONCLUSION: VIP combination chemotherapy and early
      concurrent thoracic irradiation for patients with limited stage small cell lung
      cancer revealed excellent antitumor response with tolerable toxicity.

PMID- 11210164
TI  - Single agent paclitaxel as a first-line therapy in advanced urothelial carcinoma:
      its efficacy and safety in patients even with pretreatment renal insufficiency.
AB  - BACKGROUND: Cisplatin-based chemotherapy is the mainstay of the treatment for
      advanced urothelial cancer, but patients with renal insufficiency before therapy
      are usually contraindicated to receiving platinum-based chemotherapy. Paclitaxel
      is one of the most promising agents against advanced urothelial carcinoma in
      recent trials and it can be easily tolerated even in patients with compromised
      renal function. We conducted a study in order to evaluate the efficacy and safety
      of paclitaxel as a first-line therapy in advanced urothelial carcinoma patients.
      METHODS: Thirteen advanced chemo-naive urothelial carcinoma patients with a
      median age of 71 years were studied, seven of them demonstrating renal
      insufficiency (pretreatment serum creatinine > or = 1.5 mg/dl). All 13 patients
      received a minimum of two cycles of paclitaxel 175 mg/m2, delivered by
      intravenous infusion for 3 h every 3 weeks. RESULTS: Four of the 13 patients
      responded to treatment, a response rate of 30.8%, with two of these achieving
      complete remission and two showing partial responses. The median overall survival
      period of all 13 patients was nine months (95% Cl: 6.51-11.49) and our study
      revealed a statistical tendency in the difference of median overall survival time
      between responders and non-responders (13 months versus 7.5 months, log-rank p =
      0.038), although the number of cases was limited. The differences in response
      rate and median overall survival time, comparing patients with renal
      insufficiency and those with normal renal function, were not significant.
      Treatment-related toxicity was mild, with only two (15.4%) patients suffering
      from grade 3-4 leukopenia. No treatment-related mortality was noted. CONCLUSIONS:
      Single-agent paclitaxel can be used as a first-line therapy in advanced
      urothelial carcinoma patients, and is especially suitable for those with
      pretreatment renal insufficiency, since the antitumor activity is significant
      while toxicity is well tolerated.

PMID- 11210165
TI  - Preoperative concurrent chemoradiotherapy against muscle-invasive bladder cancer:
      results of partial cystectomy in elderly or high-risk patients.
AB  - BACKGROUND: Good local control has been reported in cases of muscle-invasive
      bladder cancer treated by chemoradiotherapy and transurethral resection (TUR).
      However, definitive irradiation or extensive chemotherapy is often intolerable
      for elderly or poor-risk patients. We report here benefits of partial cystectomy
      after concurrent low-dose chemoradiotherapy for high-risk patients. METHODS:
      Thirty-seven patients with localized muscle-invasive bladder cancer (T2-T4) were
      treated with concurrent cisplatin (50-100 mg/body x 2 courses) and pelvic
      irradiation (40 Gy) preoperatively. Among 17 patients (46%) who achieved complete
      response (CR), 10 were not suitable for radical cystectomy and underwent partial
      cystectomy. Radical cystectomy was performed in 24 cases [CR = 6, partial
      response (PR) = 18]. Two patients (one CR and one PR) rejected open surgery and
      were treated by TUR of the primary site. One no change (NC) patient received no
      further treatment because of mental disorder. RESULTS: Median follow-up was 12
      months (range 2-37 months). Fifteen of 36 evaluable cases (42%) achieved a
      pathological T0 response (no residual tumor). Estimated 3-year disease-free
      survival was 56% for all patients and 100% for T0 responders. Seven of 21
      patients with pathological persistent tumor developed local recurrence (three
      patients) or distant metastasis (four patients). All of the 10 patients (eight
      with T0 response and two with a small residual tumor nest) who underwent partial
      cystectomy were recurrence-free for an observation period of up to 3 years.
      CONCLUSIONS: Bladder preservation by partial cystectomy may be a choice for
      patients who show a good response to preoperative chemoradiotherapy and are not
      suitable for radical cystectomy.

PMID- 11210166
TI  - Statistical analysis of geographical features of lung cancer mortality in Japan.
AB  - BACKGROUND: There is concern about the increase in death rates from lung cancer
      and that it may become the leading cause of death in the near future.
      Considerable geographical variations exist in lung cancer mortality in Japan. It
      seems that the difference cannot be explained by smoking rates, although no data
      are available to prove this. The evidence implies some unknown risk factors in
      the development of lung cancer. As an alternative approach, we used geographical
      or demographic information according to municipality. To explore other factors in
      lung cancer development, the geographical features of trends in lung cancer
      mortality in Japan were examined using long-term data. METHODS: We summarized the
      20-year municipality-specific standardized mortality ratios (SMRs) by fitting a
      straight line to the scatter plot of the SMR versus calendar year for each
      municipality, resulting in an average and a rate of change of SMR. Using the
      average or rate of change in the SMR as the response variable, we carried out a
      multiple linear regression analysis for all of Japan and a non-parametric
      regression analysis for the distance from the municipal office to the nearest
      coastline, using the ACE algorithm. RESULTS: The average SMR decreased with
      distance from the coastline and increased with increasing population size of the
      municipality. The average SMR was high at or near the coastline irrespective of
      the direction of the nearest coastline. CONCLUSIONS: It was considered that
      something related to coastline other than population size may be associated with
      the development of lung cancer.

PMID- 11210167
TI  - Comparison of in vitro growth-inhibitory activity of carboplatin and cisplatin on
      leukemic cells and hematopoietic progenitors: the myelosuppressive activity of
      carboplatin may be greater than its antileukemic effect.
AB  - BACKGROUND: Carboplatin [cis-diammine(cyclobutane-1, 1
      dicarboxylato)platinum(II)] has been shown to be an active agent for acute
      myeloid leukemia. This second-generation platinum drug has less nephrotoxicity
      and ototoxicity but more myelotoxicity than does the first-generation platinum
      drug cisplatin. The study was designed to elucidate whether their
      myelosuppressive activities equal their antileukemic effects. METHODS: Cisplatin
      and carboplatin were used to treat four leukemic cell lines (CEM, HL60, K562 and
      U937), blast cells from 10 leukemic patients and hematopoietic progenitors from
      five umbilical cord blood samples. RESULTS: The mean IC50 of leukemic cell lines
      was 0.4 and 6.2 microg/ml, the mean IC50 of patients' leukemic blasts was 2.0 and
      22.4 microg/ml and the mean IC50 of hematopoietic progenitors (BFU-E, CFU-E and
      CFU-GM) was 1.8 and 1.7 microg/ml for cisplatin and carboplatin, respectively.
      CONCLUSIONS: Carboplatin required a 10 times higher drug concentration than
      cisplatin to induce a similar degree of growth inhibition on leukemic cells.
      However, the hematopoietic progenitors responded equally to cisplatin and
      carboplatin at the same drug concentration. The results suggest that the
      myelosuppressive activity of carboplatin is greater than its antileukemic effect.

PMID- 11210168
TI  - Does alcohol drinking have an influence on suicides in cancer sufferers? A
      population-based study of 1515 suicide victims.
AB  - BACKGROUND: [corrected] We investigated whether alcohol drinking contributes to
      suicides in cancer sufferers when compared with non-cancer suicides. We also
      explored the suicide method used in cancer suicides. METHODS: The population
      based, prospectively collected data sample consisted of 1515 completed suicides
      committed in the province of Oulu, Finland, during the period 1988-99. Victims
      who suffered from cancer were compared with other suicides. RESULTS: Cancer
      patients who committed suicide were significantly less commonly under the
      influence of alcohol than non-cancer suicide victims (84.8% vs 54.7%). Mental
      disorders were less prevalent among cancer patients than non-cancer patients. The
      cancer patients were significantly older and more often retired and a trend that
      a greater proportion of cancer suicide victims were male was noted. Shooting and
      poisoning were the most common suicide methods among cancer patients. CONCLUSION:
      An early recognition and evaluation of the extent of the suicidal tendencies
      among cancer patients is of great importance in clinical oncology, since
      preventive interventions would be effective especially for those without comorbid
      alcoholism at the time of the suicide.

PMID- 11210169
TI  - Two cases of non-Hodgkin's lymphoma in first degree relatives.
AB  - Two cases of non-Hodgkin's lymphoma (NHL) generated within 6 months in first
      degree relatives, a father and a son, are presented. The NHL was a diffuse large
      B-cell type in the father and a small cleaved follicular type in the son.
      Cytogenetic and molecular studies of the lymphoma cells revealed the
      rearrangement of the immunoglobulin heavy chain (JH) gene in both patients, the
      mutation of p53 gene in the father and t(14; 18) (q32; q21) in the son. Both
      patients had low serum immunoglobulin levels. It is not known whether the
      occurrence of NHL in this family was incidental or pathogenetically related,
      since there was no clear common molecular abnormality between the father and the
      son. The pathogenetic mechanism of this familial occurrence of NHL is discussed.

PMID- 11210170
TI  - Biliary tract cancer mortality rates by prefectures in Japan.

PMID- 11210171
TI  - Aberrant methylation of genes in low-grade astrocytomas.
AB  - The underlying basis of the malignant progression of astrocytomas is a specific
      and cumulative series of genetic alterations, most of which are confined to high
      grade tumors. In contrast, a proportion of low-grade astrocytomas have a
      relatively normal-appearing genome when examined with standard genetic screening
      methods. These methods do not detect epigenetic events such as aberrant
      methylation of CpG island, which result in transcriptional silencing of important
      cancer genes. To determine if aberrant methylation is involved in the early
      stages of astrocytoma development, we assessed the methylation status of 1,184
      genes in each of 14 low-grade astrocytomas using restriction landmark genome
      scanning (RLGS). The results showed nonrandom and astrocytoma-specific patterns
      of aberrantly methylated genes. We estimate that an average of 1,544 CpG island
      associated genes (range, 38 to 3,731) of the approximately 45,000 in the genome
      are aberrantly methylated in each tumor. Expression of a significant proportion
      of the genes could be reactivated by 5-aza-2-deoxycytidine-induced demethylation
      in cultured glioma cell lines. The data suggest that aberrant methylation of
      genes is more prevalent than genetic alterations and may have consequences for
      the development of low-grade astrocytomas.

PMID- 11210172
TI  - Presurgical mapping with magnetic source imaging: comparisons with intraoperative
      findings.
AB  - We compare noninvasive preoperative mapping with magnetic source imaging to
      intraoperative cortical stimulation mapping. These techniques were directly
      compared in 17 patients who underwent preoperative and postoperative
      somatosensory mapping of a total of 22 comparable anatomic sites (digits, face).
      Our findings are presented in the context of previous studies that used magnetic
      source imaging and functional magnetic resonance imaging as noninvasive
      surrogates of intraoperative mapping for the identification of sensorimotor and
      language-specific brain functional centers in patients with brain tumors. We
      found that magnetic source imaging results were reasonably concordant with
      intraoperative mapping findings in over 90% of cases, and that concordance could
      be defined as "good" in 77% of cases. Magnetic source imaging therefore provides
      a viable, if coarse, identification of somatosensory areas and, consequently, can
      guide and reduce the time taken for intraoperative mapping procedures.

PMID- 11210173
TI  - Alterations of the p53 and pRB pathways in human astrocytoma.
AB  - Human astrocytomas are characterized by a number of molecular changes affecting
      two critical tumor suppressor pathways: the pRB and the p53 pathways. Genetic
      alterations functionally eliminate pRB and p53 themselves or upstream and/or
      downstream molecules such as products of the Ink4a/ARF locus, p16Ink4a and
      p14ARF. As a result, malignant cells are defective in critical cell cycle and
      apoptosis regulatory elements contributing to unrelenting tumour growth and
      invasion. Current research aims to discover effective means of reconstituting p53
      and pRB pathway components in an effort to attenuate the aggressive phenotype of
      astrocytoma.

PMID- 11210174
TI  - EGFRvIII as a promising target for antibody-based brain tumor therapy.
AB  - Cell surface receptors are attractive candidates for targeted therapy of cancer.
      Growth factors and their receptors play important roles in the regulation of cell
      division, development, and differentiation. Among those, the epidermal growth
      factor receptor (EGFR) was the first identified to be amplified and/or rearranged
      in malignant gliomas. The most common rearranged form, EGFR type III variant
      (EGFRvIII), has a deletion in its extracellular domain that results in the
      formation of a new, tumor-specific target found in glioblastoma multiforme, as
      well as in breast, ovarian, prostate, and lung carcinomas. Monoclonal antibodies
      have been developed with specific activity against this mutant receptor. These
      antibodies are internalized into the cell after receptor binding. Specific
      antibodies, either unarmed or armed with cytotoxic agents, including
      radioisotopes and toxins, have shown a promising role for EGFRvIII as a target
      for brain tumor therapy.

PMID- 11210175
TI  - Analysis of neuropathological images.

PMID- 11210176
TI  - A neurosurgeon's perspective on the neuropathology of low-grade gliomas.

PMID- 11210177
TI  - Brain tumor radiosurgery: current status and strategies to enhance the effect of
      radiosurgery.

PMID- 11210178
TI  - Length of uninterrupted repeats determines instability at the unstable mouse
      expanded simple tandem repeat family MMS10 derived from independent SINE B1
      elements.
AB  - Mouse expanded simple tandem repeats (ESTRs) provide highly informative loci for
      analyzing spontaneous and induced germline mutation. We have conducted an
      extensive sequence database search and identified 17 new members of the highly
      unstable rodent-specific ESTR family called MMS10. This family has arisen by
      independent expansions of a common GGCAGA repeat unit from within a subset of
      both ancestral and modern SINE B1 elements during the course of mouse evolution.
      Analysis of the interspersion patterns of variant repeats along alleles of 20 of
      these MMS10 loci revealed two distinct classes of tandem arrays: one composed of
      uninterrupted GGCAGA repeats and the second with generally larger arrays
      interrupted by variant units. Surveys of allelic diversity at 11 representative
      members of these two classes of loci in various laboratory strains and BXD
      recombinant inbred lines revealed that the level of repeat instability was
      positively correlated with the length of uninterrupted repeats. Turnover
      processes at MMS10 loci, therefore, appear similar to the type of mechanism
      observed at human microsatellites. The MMS10 family thus provides a potentially
      useful murine model for studying dynamic mutation at simple tandem repeats.

PMID- 11210179
TI  - Smcy transgene does not rescue spermatogenesis in sex-reversed mice.
AB  - In mouse, the Sxr(b) deletion interval (delta Sxr(b)) maps to the small short arm
      of the Y chromosome and is known to contain gene(s) required for normal
      spermatogenesis; in particular, Spy, which is essential for the postnatal mitotic
      proliferation of spermatogonia. This deletion interval is approximately 1-2 Mb
      and contains eight known genes. In this paper we report the construction of YAC
      transgenic mice containing different regions of the delta Sxr(b) interval
      including Zfy1, Ube1y, Smcy, and Eif2s3. Two male and one female founder mice,
      transgenic for all four genes, were sterile. However, a fertile transgenic,
      carrying a full-length copy of the Smcy gene integrated into central Chr 12, was
      identified. Smcy is a highly conserved Y chromosome-located gene, encoding
      peptides corresponding to epitopes of the male-specific antigen, H-Y. The Smcy
      transgene was ubiquitously expressed in all organs and tissues tested in male and
      female carriers. Introduction of the transgene into an X Sxr(b)/O genetic
      background did not rescue the early arrest of spermatogenesis characteristic of
      these males. These data indicate that the presence of Smcy is not sufficient to
      restore spermatogenesis, making it a highly unlikely candidate for Spy.

PMID- 11210181
TI  - Submucosal gland distribution in the mouse has a genetic determination localized
      on chromosome 9.
AB  - Submucosal glands (SMG) are important secretory glands that are present in the
      major airways and bronchioles of humans. In mice the structure, cellular
      composition, and density of SMG are similar to those seen in humans, but the
      glands are present only in the trachea. Characterization of SMG is important as
      they secrete bacteriocidal products such as lactoferrin, lysozyme, and defensins
      believed to be of importance in the innate defense system. Serous cells in SMG
      are the primary site of cystic fibrosis transmembrane conductance regulator
      (CFTR) gene expression and the initial site of histological abnormality in cystic
      fibrosis (CF) individuals. In this study, we examined four inbred strains of mice
      (A/J, C57BL/6N, FVB/N, and BALB/CAnN) and revealed that the extent to which
      glands descend in the mouse trachea varied between inbred strains. In particular,
      the A/J and C57BL/6N strains exhibited few SMG extending further than the first
      or second intercartilaginous space (mean depth of 0.4+/-0.11 and 1.5+/-0.32
      tracheal rings respectively) in the trachea, whereas the FVB/N and BALB/CAnN
      strains had SMG extending beyond the fourth space (mean depths of 3.3+/-0.46 and
      5.6+/-0.45 rings respectively). We have previously shown that in congenic C57Bl/
      6N Cftr mutant mice (CF mice), the SMG are distributed more distally than in wild
      type C57Bl/6N but are indistinguishable from BALB/CAnN wild-type or CF mice. The
      implication that SMG distribution is influenced by Cftr gene expression (or a
      gene closely linked to Cftr) led us to investigate the genetic difference between
      C57Bl6/N and BALB/CAnN mice. In recombinant inbred strain (RIS) analysis (with
      BALB/CJ and C57BL/6J progenitors), two loci were identified as being linked to
      the SMG phenotype (peak likelihood statistic levels of 8.8 and 9.9 on Chrs 9 and
      10 respectively, indicating suggestive linkage). A subsequent segregation
      analysis of an F2 intercross between the C57BL/6N and BALB/CAnN mice indicated
      that there were at least two major genetic factors responsible for SMG
      distribution. The loci indicated in the RI analysis were included in a targeted
      genome scan involving 235 F2 intercross animals (C57BL/6N and BALB/CAnN strain
      intercross). The genome scan confirmed the locus on Chr 9 (between genetic
      markers D9Mit11 and D9Mit182), designated Smgdl, as significantly linked to the
      SMG distribution phenotype (peak LOD score 5.8) within a 95% confidence interval
      of 12 cM.

PMID- 11210180
TI  - Cloning, expression, genomic localization, and enzymatic activities of the mouse
      homolog of prostate-specific membrane antigen/NAALADase/folate hydrolase.
AB  - Human Prostate Specific Membrane Antigen (PSMA), also known as folate hydrolase I
      (FOLH1), is a 750-amino acid type II membrane glycoprotein, which is primarily
      expressed in normal human prostate epithelium and is upregulated in prostate
      cancer, including metastatic disease. We have cloned and sequenced the mouse
      homolog of PSMA, which we have termed Folh1, and have found that it is not
      expressed in the mouse prostate, but primarily in the brain and kidney. We have
      demonstrated that Folh1, like its human counterpart, is a glutamate-preferring
      carboxypeptidase, which has at least two enzymatic activities: (1) N-acetylated
      alpha-linked L-amino dipeptidase (NAALADase), an enzyme involved in regulation of
      excitatory signaling in the brain, and (2) a gamma-glutamyl carboxypeptidase
      (folate hydrolase). The 2,256-nt open reading frame of Folh1 encodes for a 752
      amino acid protein, with 86% identity and 91% similarity to the human PSMA amino
      acid sequence. Cells transfected with Folh1 gained both NAALADase and folate
      hydrolase activities. Examination of tissues for NAALADase activity correlated
      with the mRNA expression pattern for Folh1. Fluorescent in situ hybridization
      (FISH) revealed Folh1 maps to only one locus in the mouse genome, Chromosome 7D1
      2.

PMID- 11210182
TI  - Murine phosphatidylserine-specific phospholipase A1 (Ps-pla1) maps to chromosome
      16 but is distinct from the lpd (lipid defect) locus.
AB  - We have previously generated a mouse transgenic line with an insertional mutation
      designated lpd that demonstrates a phenotype of hypertriglyceridemia and fatty
      liver. Since the recently identified phosphatidylserine-specific phospholipase A1
      (PS-PLA1) demonstrates significant homology to triglyceride lipases, we reasoned
      that the mouse Ps-plaI gene may be the disrupted gene within the lpd locus. Using
      a rat PS-PLA1 cDNA sequence to search the EST database, we identified a mouse EST
      homolog AA839424. Sequencing analysis of AA839424 revealed a putative Ps-pla1
      protein of 456 amino acids with extensive overall structural conservation with
      human and rat PS-PLA1 and with triglyceride lipases. Conserved sequences in Ps
      pla1 include a lipase consensus sequences GxSxG, a catalytic triad, and eight of
      the ten conserved cysteine residues that are required for tertiary structure.
      Mouse Ps-plal carries a phosphatidylserine-binding motif that is absent in all
      triglyceride lipases. Using a mouse whole-genome radiation hybrid (WG-RH) mapping
      panel (T31), we mapped mouse Ps-pla1 to Chromosome (Chr) 16 between genetic
      markers D16Mit194 and D16Mit38, which is 17.1 cM centromeric to the lpd locus. On
      the basis of chromosome location, we conclude that Ps-pla1 and lpd are distinct
      genes in lipid metabolism.

PMID- 11210183
TI  - The murine chaperonin 10 gene family contains an intronless, putative gene for
      early pregnancy factor, Cpn10-rs1.
AB  - Early pregnancy factor (EPF) is a secreted protein with growth regulatory and
      immunomodulatory properties. Human platelet-derived EPF shares amino acid
      sequence identity with chaperonin 10 (Cpn10), a mitochondrial matrix protein
      which functions as a molecular chaperone. The striking differences in cellular
      localization and function of the two proteins suggest differential regulation of
      production reflecting either alternative transcription of the same gene or
      transcription from different genes. In mammals and more distantly related genera,
      there is a large gene family with homology to CPN10 cDNA, which includes
      intronless copies of the coding sequence. To determine whether this could
      represent the gene for EPF, we have screened a mouse genomic library and
      sequenced representative Cpn10 family members, looking for a functional gene
      distinct from that of Cpn10, which could encode EPF. Eight distinct genes were
      identified. Cpn10 contains introns, while other members are intronless. Six of
      these appear to be pseudogenes, and the remaining member, Cpn10-rs1, would encode
      a full-length protein. The 309-bp open reading frame (ORF) is identical to that
      of mouse Cpn10 cDNA with the exception of three single-base changes, two
      resulting in amino acid changes. Only one further single nucleotide difference
      between the Cpn10-rs1 and Cpn10 cDNAs is observed, located in the 3' UTR. Single
      nucleotide primer extension was applied to discriminate between Cpn10-rs1 and
      Cpn10 expression. Cpn10, which is ubiquitous, was detected in all tissue samples
      tested, whereas Cpn10-rs1 was expressed selectively. The pattern was completely
      coincident with known patterns of EPF activity, strongly suggesting that Cpn10
      rs1 does encode EPF. The complete ORF of Cpn10-rs1 was expressed in E. coli. The
      purified recombinant protein was found to be equipotent with native human
      platelet-derived EPF in the bioassay for EPF, the rosette inhibition test.

PMID- 11210184
TI  - Fine-mapping and construction of a bovine contig spanning the ovine callipyge
      locus.
AB  - The callipyge (CLPG) gene was fine-mapped by linkage analysis to a 4.6-cM
      chromosome interval on distal ovine OAR18q, flanked by microsatellite markers
      IDVGA30 and OY3. The OAR18q linkage map and human HSA14q transcript map were
      aligned by genotyping two bovine-hamster whole-genome radiation hybrid panels
      with the microsatellite markers, as well as with sequences corresponding to HSA
      14q genes. Using Type I loci mapping to the IDVGA30-OY3 interval as anchor
      points, we have constructed a 1.4-Mb bovine BAC contig containing the IDVGA30-OY3
      interval. We demonstrate that the IDVGA30-OY3 interval spans approximately 770 kb
      and contains at least four genes: YY1, WARS, DLK1, and GTL2.

PMID- 11210185
TI  - Isolation and molecular characterization of rasfadin, a novel gene in the
      vicinity of the bovine prion gene.
AB  - A novel gene, rasfadin (RASSF2) was identified close to the bovine prion gene,
      and its genomic structure was derived with a combination of exon trapping and
      RACE. The gene covers at least 28 kb and maps to the same chromosomal region as
      the prion gene in cattle, sheep, and human. The RASSF2 ORF is composed of 987
      base pairs divided into nine exons and shows a high nucleotide (88%) and amino
      acid similarity (95%) with a previously described human cDNA, KIAA0168. The
      bovine 3'UTR region is significantly shorter than the human counterpart, but
      shares with it two highly conserved nucleotide blocks. The expression of the gene
      was investigated in brain, liver, and spleen. Alternative splicing yields a
      shorter product in the liver composed of only four exons. Computer analysis
      showed a highly significant similarity of the rasfadin protein with the Ras
      association (Ral-GDS/AF-6) domain family 2 and with the afadin family,
      respectively, for the longer brain/spleen and the shorter liver variants.

PMID- 11210186
TI  - Cloning, expression and chromosomal location of NKX6B TO 10Q26, a region
      frequently deleted in brain tumors.
AB  - Nkx6-2 (former Gtx) is a murine-homeobox-containing gene localized distally on
      Chromosome (Chr) 7. Analysis of the expression pattern, together with DNA binding
      assays, suggests that this gene product might be important for differentiated
      oligodendrocyte function and in the regulation of myelin gene expression. We now
      report on the cloning and characterization of the human homolog (NKX6B). DNA
      sequence analysis of an 11-kb genomic fragment revealed that the complete human
      gene spans 1.2 kb and is composed of three exons. NKX6B is predicted to encode a
      polypeptide of 277 amino acids with 97% identity to mouse Nkx6-2. Northern blot
      experiments showed that NKX6B expression is tightly controlled in a tissue
      specific fashion with the highest site of expression being the brain. Finally,
      using STS content mapping and RH analyis, we demonstrated that NKX6B maps to the
      10q26, a region where frequent loss of heterozygosity has been observed in
      various malignant brain tumors. These results may implicate NKX6B as a candidate
      tumor suppressor gene for brain tumors, particularly for oligodendrogliomas.

PMID- 11210187
TI  - Gene structure alternative splicing, and chromosomal localization of pro
      apoptotic Bcl-2 relative Bim.
AB  - Bim is a proapoptotic protein of the Bcl-2 family that shares only the short BH3
      domain with other members. It has three isoforms, apparently produced by
      alternative splicing. The demonstration that Bim is essential for certain
      apoptotic responses and to prevent overproduction of hematopoietic cells suggests
      that it may be a tumor suppressor. We have, therefore, investigated the
      organization of the mouse Bim gene, delineating its promoter and splicing, and
      positioned the gene on both mouse and human chromosomes. Bim has six exons, but
      the third is a facultative intron that is spliced out in the mRNAs for the
      smaller isoforms (BimL and BimS), but not that encoding the largest isoform
      (BimEL). The 0.8-kb region 5' to exon 1, which contains a TATA-less promoter and
      binding sites for several transcription factors, can drive expression of a
      reporter gene. Mouse Bim localizes to the distal third of Chromosome (Chr) 2,
      near the F-G boundary, and its human counterpart to Chr 2q12 or q13. Deletions of
      these bands have been reported in ten tumors (eight hematopoietic), reinforcing
      the possibility that Bim is a tumor suppressor. These findings should help to
      clarify the regulation of Bim expression and to assess whether mutations
      involving Bim contribute to neoplastic and other diseases.

PMID- 11210188
TI  - Transgenic mice for the preparation of puromycin-resistant primary embryonic
      fibroblast feeder layers for embryonic stem cell selection.

PMID- 11210189
TI  - Identification of a novel, alternatively spliced isoform and single nucleotide
      polymorphisms in the murine Pea-15 gene.

PMID- 11210190
TI  - The murine type 1 diabetes loci, Idd1, Idd3, Idd5, Idd9, and Idd17/10/18, do not
      control thymic CD4-CD8-/TCRalphabeta+ deficiency in the nonobese diabetic mouse.

PMID- 11210191
TI  - Identification, expression analysis, and mapping of B3galt6, a putative
      galactosyl transferase gene with similarity to Drosophila brainiac.

PMID- 11210192
TI  - Genetic mapping of spinal dysmyelination in cross-bred American Brown Swiss
      cattle to bovine Chromosome 11.

PMID- 11210193
TI  - Breakpoint mapping positions the callipyge gene within a 450-kilobase chromosome
      segment containing the DLK1 and GTL2 genes.

PMID- 11210194
TI  - 129/Sv mice--a model system for studying germ cell biology and testicular cancer.
AB  - Some forms of testicular germ cell tumors (TGCTs) arise from primordial germ
      cells (PGCs) during fetal development. In both humans and mice, genetic control
      of susceptibility is complex, involving both Mendelian and polygenic factors.
      Identification and characterization of TGCT genes will provide insight not only
      into the basis for inherited susceptibility, but also into the genetic control of
      the development of the PGC lineage. Recent work has revealed the identity of
      several susceptibility genes that are inherited as Mendelian traits, the
      chromosomal location of yet-to-be identified TGCT susceptibility genes, as well
      as clues to the nature of developmental pathways involved in tumorigenesis. In
      this review we summarize current understanding of the biology and genetics of
      TGCTs in mice and discuss the relevance of this work to testicular cancer in
      humans.

PMID- 11210195
TI  - Multiple obesity QTLs identified in an intercross between the NZO (New Zealand
      obese) and the SM (small) mouse strains.
AB  - The inheritance of adiposity levels has been investigated in an intercross of the
      obese, diabetes-prone NZO and the small, lean SM mouse strains. Adiposity index
      (AI) was defined as the sum of four fat pad weights divided by body weight. DNA
      pools from fat and lean mice were analyzed with microsatellite variants to screen
      the genome for quantitative trait loci (QTLs) affecting AI. Ten significant QTLs
      affecting AI were identified on Chromosome (Chr) 1 (three loci), Chr 2, Chr 5
      (two loci), Chr 6 (two loci), Chr 7, and Chr 17. Most of the QTLs appear to be
      novel. Several QTLs differentially affect specific fat depots. Thus, Chr 2 and
      Chr 7 QTLs affect gonadal more than inguinal fat, while the converse is true for
      the Chr 17 QTL. Gender influences the expression of several of the QTLs. For
      example, effects of the proximal Chr 1 QTL (Obq7) on AI appears to be primarily
      in males. The proximal AI QTL on Chr 6 (Obq13) maps near the neuropeptide Y (Npy)
      locus. Sequence analysis of the Npy gene revealed a 1-nucleotide deletion within
      a highly conserved portion of the 3' untranslated region in strain NZO. However,
      the deletion is polymorphic among mouse strains. Furthermore, lack of association
      between this same variant and AI in previously analyzed crosses raises doubt that
      it is the basis of Obq13. The present cross is the fourth in a series of
      intercrosses among 10 inbred strains arranged such that each strain is crossed
      with each adjacent strain within a circle. This design affords multiple
      opportunities to analyze each segregating QTL.

PMID- 11210196
TI  - CCCSAPR: a new approach to drug policy research in the twenty-first century.
      California Collaborative Center for Substance Abuse Policy Research.
AB  - The California Collaborative Center for Substance Abuse Policy Research (CCCSAPR)
      was established in 1997 to provide a nucleus for policy research in addiction and
      allied fields throughout the nine University of California campuses and allied
      research endeavors. The primary goal of CCCSAPR is that of providing data on
      statewide and national substance abuse issues toward the development and
      maintaining of a coherent substance abuse policy in the state of California. The
      authors present the history and scope of the Center as a new approach to drug
      policy research for a new century.

PMID- 11210197
TI  - Drug abuse treatment on demand in San Francisco: preliminary findings.
AB  - This article reports on a process and capacity evaluation of San Francisco's
      Treatment on Demand Initiative, which was launched in 1997 to increase
      availability of publicly-funded substance abuse treatment. For the process
      evaluation, data from public documents, interviews with community key informants,
      and newspaper articles were analyzed. For the capacity evaluation, budget
      documents and admissions data for publicly-funded substance abuse treatment in
      San Francisco for fiscal years 1995-1998 were analyzed. Results from the process
      evaluation document the development of the community-oriented Treatment on Demand
      Planning Council, and its efforts to not only expand treatment, but to create a
      continuum of services to address the needs of San Francisco's richly diverse
      communities, to provide service enhancements, and to prioritize service needs.
      Process evaluation results also highlight the complexities of implementing
      treatment on demand, including the difficulty of opening new programs. Results
      from the capacity evaluation indicate that the San Francisco budget supporting
      publicly-funded treatment increased from $32 million to $45.2 million over four
      years. During the same period, the number of persons entering the system in a
      single year increased by 18%, and the number of admissions in a single year
      increased by 15%. Implications of these findings are discussed.

PMID- 11210198
TI  - Addiction pharmacotherapy 2000: new options, new challenges.
AB  - There are many indicators that substance abuse research and treatment are going
      to become better integrated. Hopefully, this development will produce new
      treatment options and will improve access and effectiveness of care. Among the
      most significant factors in this period of change are the advances in addiction
      pharmacotherapy. For the treatment of alcoholism, disulfiram has been joined by
      naltrexone, and soon acamprosate will be added to the list of available
      pharmacotherapies. Individuals with opiate dependence who, for 25 years, were
      limited to a single medication (methadone) now have LAAM as an available
      treatment. Furthermore, there is eager anticipation that buprenorphine/naloxone
      will bring many more opiate users into treatment since it appears that this
      medication will be available to doctors outside the traditional narcotics
      treatment program settings. Other opiate addiction treatment options, including
      sustained-release naltrexone and lofexidine, are in active development. The
      greatest area of challenge for pharmacotherapy research is the search for
      stimulant addiction medications. NIDA has extensive efforts underway to
      discover/develop medicines that can help in the treatment of cocaine and
      methamphetamine users. During the next decade, those who embrace these new
      treatments and integrate them into standard care will offer their patients the
      best chance for recovery.

PMID- 11210199
TI  - Bridging the gap between research and drug abuse treatment.
AB  - There is a gulf between researchers and practitioners, due in part to conditions
      that existed before they began training, and partially due to their continued
      separation during training and practice. This article reviews some of the
      differences and offers suggestions for institutional and personal changes to
      bring researchers and practitioners more into accord.

PMID- 11210200
TI  - Severely and persistently mentally ill substance abusers: clinical and policy
      issues.
AB  - Communities that are struggling to provide effective treatment for the
      challenging population of severely mentally ill clients who use alcohol and drugs
      have a growing research base on which to make policy decisions. Integrating
      outpatient treatment for mental health and addictive disorders appears to be more
      effective than treatment in two separate systems. Integrated treatment at a
      single site allows for individualizing treatment priorities without fragmenting
      care. Harm reduction approaches provide a low threshold entry, which can be
      followed by interventions to enhance motivation. Managing patient benefits to
      discourage drug use reduces the likelihood of their becoming homeless,
      hospitalized or incarcerated. Inadequate treatment capacity plays a large role in
      the growing number of disturbed clients who end up in the criminal justice
      system. Effective community treatment requires vigorous collaboration between
      care providers. Ultimately, professional training programs need to produce
      clinicians who are competent and comfortable addressing alcohol and other drug
      use to implement effective treatment systems.

PMID- 11210202
TI  - Concepts of dependence among Brazilian alcohol- and drug-dependent patients.
AB  - Studies suggest that the concepts that drug dependent persons have about their
      problems could influence adherence to treatment and outcome. The objective of
      this study was to compare these concepts in different groups of patients. Three
      groups of drug-dependent patients (diagnosed according to DSM-III-R criteria)
      were compared: 64 dependent on alcohol only, 56 dependent only on other drugs and
      39 dependent on both alcohol and drugs. They were asked: "What do you think about
      your problem?" and the responses were qualitatively analyzed and classified into
      themes. For the whole sample, the main themes mentioned were: the function of
      alcohol and drugs in their lives (50%), the etiology of dependence (32%) and
      reasons for initial use (21%). Patients dependent on alcohol associated their use
      with coping, while patients dependent on other drugs reported pleasure seeking.
      In regard to etiology, most patients classified their dependence as a habit.
      Patients dependent on alcohol tended to attribute an organic etiology to their
      problem, while those dependent on other drugs most frequently considered moral
      aspects as important. This study suggests that there are differences between
      these three groups in the appraisal of their problem. Professionals interested in
      treatment matching need to take these findings into account, as they may
      influence compliance and treatment outcome.

PMID- 11210201
TI  - The relationship between crime and drugs: what we have learned in recent decades.
AB  - The focus of this article is criminal drug users and their changing behavior. Two
      important considerations are addressed within this topic. First, an overview of
      drug use is given, including a brief historical perspective on its treatment as
      well as its implications on crime. The article also discusses why substance abuse
      treatment in the criminal population is necessary and on what scale.
      Specifically, the etiology of the relationship between crime, violence and
      substance abuse is explored. It then delves into what has worked and what hasn't.
      Finally, recommendations are made regarding where the research indicates we
      should go from here.

PMID- 11210203
TI  - Retrospective study of similarities and relations between American drug-free and
      European therapeutic communities for children and adults.
AB  - This article focuses on the similarities and relations between the European
      therapeutic community for children and adults on the one hand and the American
      drug-free "concept" therapeutic community on the other. Both approaches are
      reviewed in a historical and comparative perspective with special attention to
      several critical issues: democracy versus hierarchy, self-help versus
      professionalism, psychoanalysis versus behaviorism and concept versus social
      learning. These two different TC-approaches can be considered as subdivisions of
      one modality, namely an environment for social learning in which living together
      in a group can be regarded as the primary agent of growth and human development.
      In recent years there has been a tendency towards further integration of these
      two approaches.

PMID- 11210204
TI  - A review of the nonmedical use of ketamine: use, users and consequences.
AB  - Ketamine is a dissociative anesthetic with an accepted place in human medicine.
      Ketamine also has psychedelic properties, and there has been a recent increase in
      nonmedical use linked with the growth of the "dance culture." This has attracted
      little comment in the formal literature but has been the subject of many reports
      in the media. Myths and misunderstandings are common. The psychedelic properties
      of ketamine have also led to its use as an adjunct to psychotherapy. This review
      is intended as a resource for the wide range of persons now requesting accurate
      information about the nonmedical use of ketamine. It accepts the current
      necessity of sometimes referring to anecdotal reports while seeking to encourage
      an increase in formal research. The review includes the history of ketamine, its
      growing role as a "dance drug," the sought-after effects (including the near
      death experience) for which it is taken in a nonmedical context, how these are
      produced, common mental and physical adverse effects, and the ketamine model of
      schizophrenia.

PMID- 11210205
TI  - Who is using cannabis as a medicine and why: an exploratory study.
AB  - This article reports on an exploratory study of medical cannabis users.
      Interviews were completed with 50 self-identified medical cannabis users
      recruited through notices in newspapers and on bulletin boards. They reported
      using cannabis for a variety of conditions including HIV-AIDS-related problems,
      chronic pain, depression, anxiety, menstrual cramps, migraine, narcotic addiction
      as well as everyday aches, pains, stresses and sleeping difficulties. A majority
      also used cannabis for recreational purposes, and many were longer-term cannabis
      users. However, there were some notable exceptions. Almost all smoked cannabis
      and many did so two to three times a day. Few admitted negative experiences with
      cannabis, although some problems evident to the researchers were not clearly
      admitted. Those who told their doctors about their medical cannabis use found
      doctors noncommittal or supportive. The results raise questions about the
      definition of medical cannabis use and about policies that might be developed to
      accommodate such use. Limitations of the study are noted and further research
      suggested. Research priorities include population surveys, studies involving
      larger, more representative samples of medical cannabis users and studies of
      medical cannabis use among people with HIV-AIDS.

PMID- 11210206
TI  - Social relationships of crime-involved women cocaine users.
AB  - Social relationships play a significant role in drug use and recovery, perhaps
      especially for women. Research on social relationships among crime-involved women
      drug users is reviewed, including both well established findings and more recent
      topics of inquiry. Several open questions about social relationships of women
      drug users are then examined in data from a study conducted in the Miami
      (Florida) metropolitan area in 1994-1996. For a study of barriers to drug
      treatment for crime-involved women cocaine users, over 400 women were interviewed
      in treatment programs and an equal number were recruited on the street.
      Respondents were asked about their social relationships during the last 30 days
      on the street in regard to both legal and illegal activities. This included crime
      partnerships, help obtaining cocaine, living arrangements, help with living
      expenses, children and help with child care, help with several ordinary problems,
      and pressures to enter treatment. The analysis looks at how much social support
      crime-involved women cocaine users have in their ordinary daily activities, who
      provides this support, and findings from this data set relative to open questions
      in the literature.

PMID- 11210208
TI  - Knowledge always on call: for docs, practicing medicine will mean providing
      information more than providing care.

PMID- 11210207
TI  - Corona mortis: an anatomic study in seven cadavers and an endoscopic study in 28
      patients.
AB  - BACKGROUND: The corona mortis is defined as the vascular connections between the
      obturator and external iliac systems. While detailed information on the arterial
      anastomoses in corona mortis is available, a complete description of the venous
      system is lacking. Although the tiny anastomoses behind the pubic symphysis
      between the obturator and external iliac arteries have been described in
      classical anatomy textbooks, these texts neglect to mention that these
      anastomoses can be life threatening. Attention needs to be paid to these
      anastomoses between the arterial and the venous system located over the superior
      pubic ramus during laparoscopic procedures. METHODS: Fifty retroinguinal regions
      were dissected in seven cadavers and 28 patients. RESULTS: During the
      dissections, a venous anastomosis on the superior pubic ramus was a consistent
      finding in 96% of cases. This vein coursed vertically to the inferior border of
      the superior pubic ramus and connected to the obturator vein. Accessory branches
      of the obturator artery were observed in only 8% of the dissections. The tiny
      connections between the obturator and external iliac arteries are less important,
      since their diameter is <1 mm. CONCLUSIONS: We have termed the venous connection
      between the external iliac and obturator veins over the superior pubic ramus "the
      communicating vein". This structure forms the corona mortis. Surgeons dealing
      with direct, indirect, femoral, or obturator hernias need to be aware of these
      anastomoses and their close proximity to the femoral ring. In classical anatomy
      textbooks, a description of the veins that form corona mortis is found less often
      than descriptions of the arteries. Since a venous connection is more probable
      than an arterial one, its importance must be appreciated by surgeons in order to
      avoid venous bleeding.

PMID- 11210209
TI  - How to successfully influence laboratory test utilization.
AB  - In 1994, we discovered that our hospital was higher than the 75th percentile in
      the average number of laboratory tests performed per inpatient discharge compared
      with other teaching hospitals with a case mix index of greater than 1.35. Because
      of the diversity and volume of tests offered, no single project would have
      significantly affected the number of tests ordered per patient. Pathologists
      together with the administrative director and section managers identified areas
      of potential improvement, noting tests that were high volume, expensive,
      difficult to perform, or of questionable medical benefit. We relied on a
      combination of administrative changes and physician education initiatives to
      influence physician test-ordering behavior. The impact of these initiatives was
      measured by reviewing monthly revenue and usage reports before and after changes
      were implemented. Each of these initiatives helped to gradually decrease the
      average number of inpatient tests per discharge from 44 in the first quarter of
      1994 to 29 in the third quarter of 1999. Compared with our peer group, our
      hospital's rank has steadily improved from the 75th to the 15th percentile.

PMID- 11210210
TI  - Direct access testing in the clinical laboratory: should laboratories offer
      testing services directly to the consumer?
AB  - This article outlines the author's views on the many issues to consider if a
      laboratory plans to initiate a program to offer clinical laboratory testing
      directly to the public. Direct access testing and why is it important are
      discussed in detail. The regulatory issues are outlined with some alternatives
      for laboratories in states with restrictive regulations. To illustrate many of
      the operational issues to consider, the author describes the Personal Diagnostic
      Center (PDC) in Kansas City. Finally, some of the key business issues are
      mentioned, including several approaches to promote this type of testing program.

PMID- 11210212
TI  - Integrated reporting and interpretation of clinical results.
AB  - Some clinical information systems vendors are making significant progress in
      improving the presentation of integrated clinical information to the physician.
      Many, however, are emphasizing advanced access and distribution methods, (e.g.,
      Internet) rather than enhancing presentation formats and content. Although we
      seemingly have the technology tools in hand, and are closer today than ever
      before, a simple, easy to interpret, user- and context-sensitive presentation of
      a set of correlated clinical information remains an elusive goal.

PMID- 11210211
TI  - Technology assessment: measuring the outcomes of laboratory practice.
AB  - The collision of explosive growth in biomedical technology and pressure to
      contain cost requires that managers of health-care services base decisions to
      introduce new technology on hard evidence that the benefits outweigh the costs of
      the new technology. Outcomes research measures the impact of new technology and
      changes in clinical practice on patient well-being or financial performance.
      Outcomes research in the clinical laboratory requires a systematic collection of
      data that is best accomplished in conjunction with a broader health services
      research effort that includes a multi-disciplinary team of laboratorians,
      clinicians, administrators, and statisticians. The major requirement for
      successful outcomes research is an integrated information system that includes
      clinical, demographic, administrative, claims, financial, and survey information.

PMID- 11210214
TI  - Access to medical information: 10 ethical guidelines.

PMID- 11210213
TI  - Defining/measuring the value of clinical information.
AB  - Laboratory test results are of limited use in the absence of corresponding
      clinical information. The range of necessary and pertinent information is broad,
      but may be as narrow as knowing the patient's age and gender or the site from
      where a culture specimen was collected, up to the knowledge of the complete
      clinical history and physical examination for proper interpretation of a test
      result. Several issues are involved in the utilization of the clinical laboratory
      from the perspective of clinical appropriateness. In this article, we try to
      define and elaborate on how critical clinical information is for the pathologists
      and clinicians alike with the ultimate goal of optimal patient care.

PMID- 11210215
TI  - The changing role of the medical technologist from technologist to information
      specialist.
AB  - Pathology laboratory services are dependent on the laboratory information system
      (LIS) to organize the work, manage the operation, and communicate the results for
      effective laboratory medicine. For maximum efficiency, staffing for the LIS
      should be an integral component of laboratory operations and is facilitated by a
      two-tier structure. A core LIS staff provides system support and continuous
      services. A group of bench medical technologists have multitasking
      responsibilities, including LIS support for a specific laboratory work area. The
      two components form a team that uses staff efficiently to provide ongoing
      operational services and flexibility for problem solving and new functionality
      implementation.

PMID- 11210216
TI  - The 21st century laboratory: information technology and health care.

PMID- 11210217
TI  - The electronic medical record: implications for the laboratory.
AB  - This article describes experiences over the past 5 years with the application of
      a computerized patient record system and an electronic result inquiry system at
      Mayo Clinic. These systems now handle 56,000 results and 170,000 inquiries daily-
      94% relating to the laboratory. The goal of aligning laboratory services with
      clinical objectives is outlined with an emphasis on converting data into
      information and knowledge that can be used to improve patient care. Efficiencies
      noted thus far include a substantial reduction (68%) in phone inquires after
      deployment of electronic result inquiry. The electronic medical record has gone
      from concept to reality. As we transition into this new environment and attempt
      to fulfill the implicit hopes and promises this tool affords, we would wish to
      quantify its effect. One department lending itself to enumeration is laboratory
      services. The perspectives shared are gleaned from the Mayo experience and
      personal observations of the practice of laboratory medicine elsewhere.

PMID- 11210218
TI  - Information management: moving from test results to clinical information.

PMID- 11210219
TI  - Implementation of data security and data privacy provisions will bring sweeping
      changes to laboratory service providers.
AB  - The Health Insurance Portability and Accountability Act included substantial
      changes involving handling of health information by establishing national
      standards for electronic transactions, data privacy, and data security. The first
      final rule for electronic transaction standards was published August 17, 2000.
      The remaining final rules are expected to be published in Winter 2000. Providers,
      such as clinical laboratories, will have 26 months from the data of publication
      to comply. The civil monetary fines for noncompliance are substantial. This
      article will review the key provisions of the data security and data privacy
      proposed rules. These provisions will touch virtually every aspect of electronic
      claims submissions, electronic data transactions, and the electronic storage of
      medical information. The proposed rules will require a coordinated approach by
      providers to develop the policies and procedures, and the technical and physical
      infrastructure to protect health information. Moreover, providers will need to
      identify a privacy officer, to review existing privacy policies to compare the
      proposed rule with any existing state laws to determine which may be more
      stringent, and to develop new policies to address the particular requirements of
      the final rule.

PMID- 11210220
TI  - Case studies in ethics. Expect the unexpected.

PMID- 11210222
TI  - Determination of exchangeable protons in natural organic matter using a home-made
      hydrogen/carbon analyser.
AB  - A home made hydrogen/carbon analyser was used to determine the portion of
      exchangeable protons in aquatic humic substances. For this purpose, equal sample
      amounts were dissolved in H2O and D2O, respectively, dried and combusted in a
      stream of oxygen. The amount of water resulting from combustion was measured by
      an infrared detector which recorded the OH bending vibration of H2O. The bands
      stemming from HOD or D2O were not registered by the detection unit. Thus,
      combustion of organic samples containing exchangeable protons dissolved in D2O
      resulted in a significantly smaller signal compared to the signal observed for
      the same sample dissolved in H2O. The relative intensity loss of the H2O signal
      observed after combustion was used to derive the portion of exchangeable protons
      in a standard reference material, a humic substance isolated by the International
      Humic Substances Society (Suwannee River fulvic acid). According to this method
      about 20% of the sample protons could be identified as exchangeable protons. With
      regard to titration data the portion of protons bound to non acidic hydroxy
      functions could be estimated. The validity of this procedure was proved by
      combustion experiments using commercially available deuterated substances as well
      as organic model compounds dissolved in D2O and H2O, respectively.

PMID- 11210221
TI  - Making choices: to commute or not to commute?

PMID- 11210223
TI  - Microwave heated vapor-phase digestion method for biological sample materials.
AB  - A microwave heated, vapor-phase nitric acid-hydrogen peroxide digestion method
      for pulverized, biological sample materials was developed. Sample masses up to
      200 mg were digested using calibrated quartz inserts inside first generation
      type, low-pressure, Teflon-PFA microwave vessels. In the first step, samples were
      digested in the vapor-phase for 80 min using a progressive heating pattern. Three
      mL of 70% nitric acid and 0.5 mL of 30% hydrogen peroxide were used as digestion
      reagents. In the second step, the small residue left after first step digestion
      was dissolved in 1.4% nitric acid or additionally with 0.5% hydrofluoric acid by
      heating for 15 min. The digestion method was optimized using pike (Esox lucius)
      muscle as a test material. The method was further optimized using three certified
      reference materials. Ca, Cu, Fe, Mg and Zn were determined from NIST-SRM 1577a
      bovine liver by ICP-AES. Cr and Ni were determined from NIST-SRM 8433 corn bran
      and NRCC DOLT-2 dogfish liver by GFAAS. For all elements the values obtained were
      close or within certified limits. Spike recoveries were between 96 to 107%.
      Digestion efficiency ranged from 91 to 99%.

PMID- 11210224
TI  - DNA electrochemical biosensors.
AB  - Disposable electrochemical DNA-based biosensors are reviewed; they have been used
      for the determination of low-molecular weight compounds with affinity for nucleic
      acids and for the detection of the hybridisation reaction. The first application
      is related to the molecular interaction between surface-linked DNA and the target
      pollutants or drugs, in order to develop a simple device for rapid screening of
      toxic or similar compounds. The determination of such compounds was measured by
      their effect on the oxidation signal of the guanine peak of calf thymus DNA
      immobilised on the electrode surface and investigated by chronopotentiometric
      analysis. The DNA biosensor is able to detect known intercalating compounds, such
      as daunomycin, polychlorinated biphenyls (PCBs), aflatoxin B1, and aromatic
      amines. Applicability to river and waste water samples is also demonstrated.
      Disposable electrochemical sensors for the detection of a specific sequence of
      DNA were realised by immobilising synthetic single-stranded oligonucleotides onto
      a graphite screen-printed electrode. The probes became hybridised with different
      concentrations of complementary sequences present in the sample. The hybrids
      formed on the electrode surface were evaluated by chronopotentiometric analysis
      using daunomycin as indicator of the hybridisation reaction. The hybridisation
      was also performed using real samples. Application to apolipoprotein E (ApoE) is
      described, in this case samples have to be amplified by PCR and then analysed by
      DNA biosensor. The extension of such procedures to samples of environmental
      interest or to contamination of food is discussed.

PMID- 11210225
TI  - Biohybrid microarrays--impedimetric biosensors with 3D in vitro tissues for
      toxicological and biomedical screening.
AB  - To investigate the effectiveness of potential anticancer therapeutics or
      therapies, efficient screening methods are required. On the one hand,
      multicellular 3D aggregates (spheroids) are a powerful in vitro model for
      simulating the in vivo situation and on the other hand, planar electrode
      structures are generally highly suitable for automation and parallel testing.
      Here, the detection of the effect of active substances on spheroids positioned on
      electrodes of substrate integrated electrode arrays is exemplarily investigated.
      As a 3D tissue model a reaggregation system of T47D clone 11 tumor cells is used.
      The effect of cytotoxins (DMSO, Triton X-100) on spheroids can be detected by
      recording the effective impedance of planar electrodes covered by spheroids. The
      equivalent circuit model parameter of electrodes covered by cytotoxin treated
      spheroids are determined from recorded impedance spectra and compared to the
      parameter of electrodes covered by control spheroids as well as not covered
      electrodes. Spheroids on electrodes mainly influence the electrode impedance in
      the frequency range of 10 kHz to 1 MHz. The results are discussed in view of an
      optimal electrode/spheroid-interface for sensing the effects of therapeutics with
      high sensitivity.

PMID- 11210226
TI  - Multiparametric microsensor chips for screening applications.
AB  - The identification of drug targets for pharmaceutical screening can be greatly
      accelerated by gene databases and expression studies. The identification of
      leading compounds from growing libraries is realized by high throughput screening
      platforms. Subsequently, for optimization and validation of identified leading
      compounds studies of their functionality have to be carried out, and just these
      functionality tests are a limiting factor. A rigorous preselection of identified
      compounds by in vitro cellular screening is necessary prior to using the drug
      candidates for the further time consuming and expensive stage, e.g. in animal
      models. Our efforts are focused to the parallel development, adaptation and
      integration of different microelectronic sensors into miniaturized biochips for a
      multiparametric, functional on-line analysis of living cells in physiologically
      environments. Parallel and on-line acquisition of data related to different
      cellular targets is required for advanced stages of drug screening and for
      economizing animal tests.

PMID- 11210227
TI  - Automatization for development of HPLC methods.
AB  - Within the frame of inprocess analytics of the synthesis of pharmaceutical drugs
      a lot of HPLC methods are required for checking the quality of intermediates and
      drug substances. The methods have to be developed in terms of optimal selectivity
      and low limit of detection, minimum running time and chromatographic robustness.
      The goal was to shorten the method development process. Therefore, the screening
      of stationary phases was automated by means of switching modules equipped with 12
      HPLC columns. Mobile phase and temperature could be optimized by using Drylab
      after evaluating chromatograms of gradient elutions performed automatically. The
      column switching module was applied for more than three dozens of substances,
      e.g. steroidal intermediates. Resolution (especially of isomeres), peak shape and
      number of peaks turned out to be the criteria for selection of the appropriate
      stationary phase. On the basis of the "best" column the composition of the "best"
      eluent was usually defined rapidly and with less effort. This approach leads to
      savings in manpower by more than one third. Overnight, impurity profiles of the
      intermediates were obtained yielding robust HPLC methods with high selectivity
      and minimized elution time.

PMID- 11210228
TI  - Detection of metal ions in aqueous solution by voltohmmetry.
AB  - A new electrochemical detection principle is described for the trace analysis of
      dissolved species which can be deposited at polycrystalline thin-film metal
      electrodes and which change the surface resistance of the electrode. Because the
      latter parameter is measured in dependence on the applied electrode potential
      this method is called voltohmmetry. The preparation of the required thin-film
      electrodes and the experimental set-up is introduced and discussed. Typical
      voltohmmetric experiments are illustrated by measurements of Tl+/Tl at
      polycrystalline gold electrodes with a thickness of 15 nm. The analytical
      capabilities of this new approach are discussed. It is already possible to
      determine heavy metals such as Tl+, Pb2+ or Cd2+ in the range of a few
      microgram/L by surface resistance-potential measurements at thin-film electrodes
      with a simple cyclic technique. Further developments of voltohmmetry are
      envisaged.

PMID- 11210229
TI  - Synthesis and application of 4-(N,N-dimethylaminosulfonyl)-7-N-methylhydrazino
      2,1,3-benzoxadiazole (MDBDH) as a new derivatizing agent for aldehydes.
AB  - In a five step synthesis, 4-(N,N-dimethylaminosulfonyl)-7-N-methylhydrazino-2,1,3
      benzoxadiazole (MDBDH) was prepared in high yields as a stable new derivatizing
      agent for carbonyl compounds. Reagent and derivatives have not been described in
      literature before. Major advantage of this substance compared with similar
      reagents is its improved solubility in polar solvents, e.g. methanol and ethanol.
      MDBDH reacts with aldehydes in the presence of an acidic catalyst under formation
      of the corresponding hydrazones. These are separated by means of reversed-phase
      liquid chromatography and detected UV/vis spectroscopically at wavelengths around
      450 nm, depending on the individual hydrazone. MDBDH reacts with oxidizers as
      nitrogen dioxide and nitrite to only one product, 4-(N,N-dimethylaminosulfonyl)-7
      methylamino-2,1,3-benzoxadiazole (MDBDA), which can easily be separated from the
      hydrazones of lower aldehydes. Due to large molar absorptivities and absorption
      maxima at wavelengths > 430 nm, limits of detection range from 4 x 10(-8) to 6 x
      10(-8) mol.L-1, and limits of quantification range from 1 x 10(-7) to 2 x 10(-7)
      mol.L-1 for the individual hydrazones. The method was applied to the
      determination of aldehydes in automobile exhaust.

PMID- 11210230
TI  - Fast enantioselective separation of clevidipine and a dihydropyridine substituted
      acid by SFC on Chiralpak AD.
AB  - Conditions for the fast separation of the enantiomers of a dihydropyridine
      substituted acid on a 50 x 4.6 mm ID short Chiralpak AD column with 2-propanol
      modified carbon dioxide as the mobile phase are presented. A high throughout of
      samples can be accomplished through the continuous sample loading of the loop of
      the injector. If a continuous data collection was used 10 separations could be
      performed in about 5 min with a precision of 0.6% RSD for the area ratio (n =
      10). The parent drug clevidipine can also be analyzed and its enantiomeric
      composition determined after alkaline hydrolysis into its acid, either through
      hydrolysis followed by extraction to dichloromethane or by direct analysis of the
      hydrolysis media. About 1 min is required for each run. Using 0.1 M of methanolic
      sodium hydroxide 2 min are sufficient for the hydrolysis, and, including
      weighing, only 5 min are required to analyze clevidipine.

PMID- 11210231
TI  - Automated solid phase dynamic extraction--extraction of organics using a wall
      coated syringe needle.
AB  - Extractions of liquid samples were carried out using wall coated needles prepared
      from stainless steel capillary columns instead of syringe needles. This micro
      extraction technique was applied to the analysis of pesticides in water.
      Important parameters influencing the extraction such as sample velocity,
      extraction time and also the desorption parameters were investigated and
      optimized. Automation of this technique was realized using a conventional
      automatic sampler. Limits of detection were improved using the multiple
      extraction/desorption technique. Chromatographic data and limits of detection
      were compared with those obtained by solid phase micro extraction (SPME). Using a
      needle with a 7 microns film yielded limits of detection varying from 0.001-0.1
      microgram/L and were in the same range as those resulting from the extraction
      using a 100 microns polydimethylsiloxane (PDMS) SPME fiber. The main advantages
      of the needle extraction technique were the significantly higher extraction speed
      and the practical aspects of a stable steel needle compared to those of a fragile
      fiber. The extraction speed using a needle with a 7 microns film was up to five
      times higher than the speed of SPME using a 100 microns PDMS fiber. The steel
      needle could be stressed mechanically in a higher extent than a SPME fiber.
      Sample volumes and aliquots of liquid media could be handled and moved from one
      bottle to another using the automatic sampler.

PMID- 11210232
TI  - Reference materials service for chemical measurements in Germany.

PMID- 11210233
TI  - Microwave assisted digestion of atmospheric aerosol samples followed by
      inductively coupled plasma mass spectrometry determination of trace elements.
AB  - A microwave digestion method in a closed vessel was developed for the
      determination of trace metals in atmospheric aerosols using inductively coupled
      plasma mass spectrometry (ICP-MS). A recovery study for the elements V, Cr, Mn,
      Fe, Co, Ni, Cu, Zn, As, Se, Cd, Sb, and Pb was conducted using multi-elemental
      standard solutions, NIST 1633b Trace Elements in Coal Fly Ash, and NIST 1648
      Urban Particulate Matter. A simple digestion method using only HNO3/H2O2 gave
      good recoveries (90%-108%) for all elements except Cr in SRM 1648, but yielded
      low recoveries for SRM 1633b. A more robust method using HNO3/H2O2/HF/H3BO3
      yielded higher recoveries (82%-103%) for the lighter elements (V-Zn) in SRM
      1633b, and improved the Cr recovery in SRM 1648, but decreased the Se recovery in
      both SRMs. A comparative analysis of aerosol samples obtained at a remote
      mountain location Nathiagali, Pakistan (2.5 km above mean sea level), and
      Mayville, New York, downwind from the highly industrialized Midwestern United
      States, was carried out using Instrumental Neutron Activation Analysis (INAA) for
      the elements Cr, Mn, Fe, Co, Zn, As, Se, and Sb. The simple digestion method
      yielded excellent agreement for Cr, Fe, Zn, As, Se, and Sb, with slopes of the
      ICP-MS vs. INAA regressions of 0.90-1.00 and R2 values of 0.96-1.00. The
      regressions for Mn and Co had slopes of 0.82 and 0.84 with R2 values of 0.83 and
      0.82, respectively. Addition of HF/H3BO3 did not improve the correlation for any
      of the elements and degraded the precision somewhat. The technique provides
      sensitivity and accuracy for trace elements in relatively small aerosol samples
      used in atmospheric chemistry studies related to SO2 oxidation in cloud droplets.
      The ability to determine concentrations of a very large number of elements from a
      single analysis will permit source apportionment of various trace pollutants and
      hence strategies to control the sources of air pollution. This is particularly
      important as the health effects of particulate matter are increasingly
      recognized.

PMID- 11210234
TI  - Extraction and detection of arsenicals in seaweed via accelerated solvent
      extraction with ion chromatographic separation and ICP-MS detection.
AB  - An accelerated solvent extraction (ASE) device was evaluated as a semi-automated
      means of extracting arsenicals from ribbon kelp. The effect of the experimentally
      controllable ASE parameters (pressure, temperature, static time, and solvent
      composition) on the extraction efficiencies of arsenicals from seaweed was
      investigated. The extraction efficiencies for ribbon kelp (approximately 72.6%)
      using the ASE were fairly independent (< 7%) of pressure, static time and
      particle size after 3 ASE extraction cycles. The optimum extraction conditions
      for the ribbon kelp were obtained by using a 3 mL ASE cell, 30/70 (w/w) MeOH/H2O,
      500 psi (1 psi = 7 KPa), ambient temperature, 1 min heat step, 1 min static step,
      90% vol. flush, and a 120 s purge. Using these conditions, two other seaweed
      products produced extraction efficiencies of 25.6% and 50.5%. The inorganic
      species present in the extract represented 62.5% and 27.8% of the extracted
      arsenic. The speciation results indicated that both seaweed products contained 4
      different arsenosugars, DMA (dimethylarsinic acid), and As(V). One seaweed
      product also contained As(III). Both of these seaweed products contained an
      arsenosugar whose molecular weight was determined to be 408 and its structure was
      tentatively identified using ion chromatography-electrospray ionization-mass
      spectrometry/mass spectrometry (IC-ESI-MS/MS).

PMID- 11210235
TI  - Determination of elements by nuclear analytical methods.
AB  - The working principle of nuclear analytical methods (NAMs) is not influenced by
      the chemical bond. Consequently, they are independent counterparts to the well
      known chemical procedures. NAMs obey fundamental laws or can be described and
      understood thoroughly. This qualifies them as candidates for reference methods.
      Although following similar nuclear reaction schemes, they comprise bulk analyzing
      capability (neutron and photon activation analysis) as well as detection power in
      surface near regions of solids (ion beam techniques). Prominent features of NAMs
      are sensitivity, selectivity, multielement determination and linearity of the
      calibration function covering a concentration range of several orders of
      magnitude. Moreover, ion beam techniques allow depth profiling with nm-resolution
      in several cases while the ion microprobe additionally offers a lateral
      resolution in the micron-scale. As NAMs require expensive apparatus (nuclear
      reactor, accelerator in radioactive control areas) their availability is
      restricted to a small number of suitably equipped institutes. However, they are
      able to solve complex analytical tasks, take part in key comparisons and play an
      essential role in the certification of reference materials.

PMID- 11210237
TI  - Determination of vitamins A and E in milk samples by fluorescence in micellar
      media.
AB  - The fat-soluble vitamins A and E in milk samples were determined by fluorescence
      at room temperature in an aqueous media of micellar solutions. Different types of
      surfactants were studied; the cationic hexadecyltrimethylammonium bromide (CTAB),
      the anionic sodium dodecylsulfate (SDS) and the non-ionic
      polyoxyethylene(23)laurylether (Brij 35). The detection limits ranged between 50
      and 90 ng.L-1 for both vitamins in CTAB and Brij 35. The method has been applied
      to the determination of vitamins A and E in milk samples.

PMID- 11210236
TI  - Comparative assessment of two sequential chemical extraction schemes for the
      fractionation of cadmium, chromium, lead and zinc in surface coastal sediments.
AB  - Two existing sequential chemical extraction schemes, involving respectively five
      and six leaching steps with solutions of increasing dissolving power, were
      compared. The methods have been applied to surface sediment samples collected in
      a marine estuary zone potentially exposed to contamination arising from nearby
      industrial activities. A certified reference material (MURST-ISS-A1) consisting
      of an Antarctic bottom sediment for which no information regarding phase
      dependent concentration is available, was also analyzed. In order to evaluate the
      partition of metals among different geochemical forms, the concentrations of
      cadmium, chromium, lead and zinc were measured in the liquid extracts by Zeeman
      corrected flame atomic absorption and by inductively coupled plasma-atomic
      emission spectrometry. The total metal concentrations were determined after
      strong acid attack, and the adequacy of this total digestion/dissolution
      technique was verified by its application to the reference material. Comparison
      of total metal concentrations with the sum of concentrations associated with the
      individual phases was employed to assess possible analyte losses or
      contaminations. Precisions for both sequential procedures were comparable, but
      some inconsistencies in mass balances were found in one of the samples for the
      distribution of Zn in the soluble/exchangeable fractions and for Cd in the bound
      to carbonates form. In addition, the six steps procedure produced lower
      concentration values in the case of elements associated to the residual fraction.
      For the five steps method mass balances showed acceptable agreement, with average
      recoveries in the 87 to 106% range. On the whole, differences in metal
      distributions were observed, being more marked for the bottom sediment.
      Significant proportions of the studied elements, with the exception of Cr, were
      found as easily extractable forms. X-ray diffraction and petrographic observation
      of the surface sediments allowed qualitative correlation between the leaching
      results obtained and the presence of defined geochemical phases.

PMID- 11210239
TI  - Diabetes and vascular disease.
AB  - Cardiovascular and cerebrovascular disease are two of the most important causes
      of morbidity and mortality in the USA and worldwide. The impact of these
      conditions is even more profound in patients with diabetes. The aims of the
      Vascular Disease Working Group in the articles that follow are to review the
      impact of cerebrovascular and cardiovascular disease in the general population,
      and, specifically, in the patient with diabetes, and to suggest appropriate
      treatment. Important steps to decreasing the risk of these diseases in diabetic
      patients are strict glycaemic control, control of hypertension, and modification
      of dyslipidaemia.

PMID- 11210238
TI  - Determination of phosphate in urine by sequential injection analysis.
AB  - Two simple turbidimetric methods for the determination of phosphate in urine are
      presented and compared. One method is based on the calcium phosphate
      crystallisation, and the other one on the inhibitory action of phosphate on the
      calcium carbonate crystallisation. The analytical features of both methods were:
      linear range = 0.2-1.5 g L-1, LOD = 14 mg L-1 and RSD 1.1-2.0% for the calcium
      phosphate method, linear range = 0.1-1.8 mg L-1, LOD = 0.01 mg L-1 and RSD 0.97
      1.90% for the inhibitory method. Urines with high calcium content (> or = 400 mg
      L-1) can interfere the method based on the crystallisation of calcium phosphate.
      This interference was solved using a cation exchange resin as a part of the
      manifold. Considering the low toxicity of used reagents, these methods can be
      considered as a contribution to Green Analytical Chemistry.

PMID- 11210240
TI  - Risk factors for vascular disease in patients with diabetes.
AB  - The risks of cardiovascular and cerebrovascular disease in patients with diabetes
      are greater than those in persons without diabetes. This is due, in part, to the
      metabolic effects of insulin resistance. Other contributing factors include
      hyperglycaemia, dyslipidaemia, hypertension, hypercoagulability,
      homocysteinaemia, smoking, and obesity. Risk factor modification, where possible,
      can reduce the risk of complications of diabetes and macrovascular disease.

PMID- 11210241
TI  - Pathogenesis of vascular disease.
AB  - Only recently are we beginning to understand the complex interplay of factors
      involved in vascular disease and diabetes. Insulin resistance provides a starting
      point to explain the many factors that lead to the more severe vascular disease
      characteristic of diabetes. Insulin resistance syndrome comprises insulin
      resistance and compensatory hyperinsulinaemia as well as hypertension,
      dyslipidaemia, macrovascular disease, and increased plasminogen activator
      inhibitor-1 activity. The development of type 2 diabetes may be viewed as the
      inability of the pancreas to continue to overcome insulin resistance, even with
      excessive insulin production.

PMID- 11210242
TI  - Vascular disease prevention in patients with diabetes.
AB  - Prevention is the key to reducing the vascular sequelae of diabetes. Prevention
      starts with good glycaemic control and continues with a comprehensive programme
      of risk modification, such as lipid-lowering therapy, antihypertensive treatment,
      and improved lifestyle. With regard to lipid modification, agents such as statins
      may provide additional, non-lipid effects in both the diabetic and non-diabetic
      patient. This review discusses recent studies supporting risk reduction,
      available treatments, and recommendations applicable to the diabetic patient.

PMID- 11210243
TI  - The impact of cerebrovascular disease.
AB  - Stroke may be affected by pathologic conditions such as atherosclerosis, vascular
      injury, coagulopathy, and increased platelet aggregability. Knowledge of the
      pathophysiology of stroke is critical in order to effectively prevent or treat
      this disabling state. Cerebrovascular disease is the third leading cause of death
      in the USA. It is also associated with significant morbidity, leading to
      extremely high health care costs and lost productivity. Total estimated costs of
      stroke are estimated to be more than $45 billion annually. This is an especially
      important issue for patients with diabetes, who are at higher risk for stroke and
      have a worse clinical outcome than non-diabetic patients. This review describes
      the impact of vascular disease, particularly cerebrovascular disease, and
      describes the pathophysiology of the disease. Interventions that result in
      reduction of stroke will likely result in decreased health care costs and
      improved clinical outcomes.

PMID- 11210244
TI  - Attachment of human gingival fibroblasts to periodontally involved root surface
      following scaling and/or etching procedures: a scanning electron microscopy
      study.
AB  - This study evaluated, in vitro, fibroblast attachment to periodontally involved
      root surfaces which were either root planed or acid/chelated by different agents.
      Specimens were divided into 3 groups of 12 specimens each. The root surfaces were
      root planed with a Gracey 7/8 curette, an EMS or an Amdent piezo-electric scaler
      and treated with saline, citric acid, tetracycline hydrochloride or EDTA to
      produce different surface textures. They were then cultured with fibroblasts for
      72 h and examined by scanning electron microscopy. There was a significantly
      greater number of fibroblasts attached to specimens treated with citric acid,
      tetracycline and EDTA than to those root planed only. Furthermore, fibroblasts
      were more likely to attach to rough-surfaced than to smooth-surfaced specimens.

PMID- 11210245
TI  - Relationship between the presence or absence of gingival bleeding and the
      enzymatic BANA test.
AB  - When periodontal disease started to be considered a bacterial infection mainly
      mediated by subgingival plaque, the basic problem faced by periodontists was the
      identification and/or quantification of periodontopathogenic bacteria. However,
      clinical methods continue to be of great value for the diagnosis of periodontal
      disease. In the present study we show a significant correlation between an index
      widely used in clinical practice, the Gingival Index of Loe (1967), based on the
      presence or absence of bleeding on probing, and the methodology of the BANA test
      for the detection of the specific enzymatic activity of microorganisms involved
      in periodontal disease. More sensitive and specific clinical parameters, taken
      together with other microbiologic methods, will be useful in daily clinical
      practice even before periodontal treatment.

PMID- 11210246
TI  - Evaluation of Er:YAG laser and EDTAC on dentin adhesion of six endodontic
      sealers.
AB  - The effect of Er:YAG laser application and EDTAC on the adhesion of epoxy resin
      based endodontic sealers to human dentin was evaluated in vitro. A total of 99
      extracted human maxillary molars with their crowns worn flat were used. The teeth
      were divided into 3 groups: group 1, the dentin surface received no treatment;
      group 2, EDTAC was applied to the dentin surface for 5 min; group 3, the dentin
      surface received Er:YAG laser application (2.25 W potency; 11 mm focal distance;
      4 Hz frequency; 200 mJ energy; 62 J total energy; 313 mean impulse). Three teeth
      from each group were analyzed by scanning electron microscopy for changes in
      dentin surface. The epoxy resin root canal sealers used were: AH Plus, Topseal,
      Sealer 26, AH 26, and Sealer Plus. The zinc oxide eugenol-based sealer Fillcanal
      was used as control. Adhesion was measured with a Universal testing machine. The
      results showed a statistically significant difference at the level of 1% among
      the dentin treatments. The dentin treated with Er:YAG laser showed greater
      adhesion with the sealers than dentin treated with EDTAC which was greater than
      dentin that received no treatment. The Tukey test showed the formation of 5
      groups in decreasing order of adhesion: AH Plus, Topseal and Sealer 26, AH 26,
      Sealer Plus, and Fillcanal (Grossman cement).

PMID- 11210247
TI  - Reaction of rat connective tissue to implanted dentin tube filled with mineral
      trioxide aggregate, Portland cement or calcium hydroxide.
AB  - The subject of this study was to observe the rat subcutaneous connective tissue
      reaction to implanted dentin tubes filled with mineral trioxide aggregate,
      Portland cement or calcium hydroxide. The animals were sacrificed after 7 or 30
      days and the undecalcified specimens were prepared for histological analysis with
      polarized light and Von Kossa technique for mineralized tissues. The results were
      similar for the studied materials. At the tube openings, there were Von Kossa
      positive granules that were birefringent to polarized light. Next to these
      granulations, there was an irregular tissue like a bridge that was Von Kossa
      positive. The dentin walls of the tubes exhibited in the tubules a structure
      highly birefringent to polarized light, usually like a layer and at different
      depths. The mechanism of action of the studied materials has some similarity.

PMID- 11210248
TI  - Microhardness of Nd:YAG laser irradiated enamel surfaces.
AB  - Several studies have been conducted in order to verify effects of laser
      irradiation on dental structures. However, different settings and methods
      employed have led to inconclusive results. The aim of this study was to evaluate
      the effects of several settings of Nd:YAG laser irradiation on enamel
      microhardness. Fifteen groups of 10 human third molars each were submitted to
      Vickers microhardness indentations prior to and after laser irradiation. The data
      were submitted to the t-test for dependent samples (P < 0.05) for statistical
      evaluation. Lower total delivered energy (under 30 J) resulted in no
      statistically significant difference of microhardness between irradiated and non
      irradiated samples, whereas higher energy settings decreased enamel surface
      microhardness significantly. This can be due to the significant temperature rise
      during irradiation. Thus, we conclude that laser irradiation, under the
      conditions of this study, is not suitable for improving enamel properties,
      because of decreased microhardness of irradiated samples.

PMID- 11210249
TI  - Microhardness of enamel restored with fluoride and non-fluoride releasing dental
      materials.
AB  - Demineralization caused by frequent ion loss can be detected by a decrease in
      enamel microhardness. The purpose of this study was to determine the
      microhardness of the enamel adjacent to restorations with fluoride and non
      fluoride dental materials after demineralization and remineralization treatments
      using crowns of 6 recently extracted unerupted third molars which were sectioned
      into 4 parts. Five penetrations were made in the enamel of the control group and
      in the enamel adjacent to restorations made with Vitremer, Heliomolar or Z100, to
      obtain the Knoop microhardness. There was no significant statistical difference
      between the microhardness of the enamel of the control group and the enamel
      adjacent to the restorations made with Vitremer and Heliomolar (p < 0.01), nor
      between the enamel adjacent to the Heliomolar and Z100 restorations. However,
      there was a statistically significant difference when the Z100 group was compared
      to the control group and to the Vitremer group. The results point out that some
      phenomena occurred which interferred with the ionic loss and, consequently, the
      microhardness of the enamel of the Vitremer and Heliomolar groups, because it was
      not possible to observe any difference between the microhardness of the enamel of
      the control group and the groups restored with Vitremer and Heliomolar.

PMID- 11210250
TI  - Modeling capacity of ENDOflash files in simulated root canals.
AB  - With the development of rotary nickel-titanium files and their applications in
      Endodontics, the concepts of root canal preparation have changed. The objective
      of this research is to evaluate the transportation of simulated root canals
      caused by stainless steel ENDOflash rotary files compared to nickel-titanium
      ProFile files (.04, .06 and Orifice Shapers). Twenty-four simulated root canals
      with a 30 degrees curvature were randomly divided into 2 groups and prepared with
      ENDOflash or ProFile files according to manufacturers' instructions. Comparison
      between the simulated root canals before and after instrumentation showed
      significant differences (p < 0.001) between the groups, with greater
      transportation observed with ENDOflash files. One case of deformation was
      observed with a ProFile instrument (#20/.04) and there were no fractures.

PMID- 11210252
TI  - Compliance with supportive periodontal therapy. Part II: Risk of non-compliance
      in a 10-year period.
AB  - Supportive periodontal therapy (SPT) is needed for the success of periodontal
      therapy; however, patient compliance is poor. Part II of this study analyzes
      compliance during a 10-year period in an attempt to identify the profile of
      patients with a higher risk of becoming non-compliant. Data from the records of
      874 patients from a private periodontal clinic who had completed active
      periodontal treatment up to 10 years before and had begun supportive periodontal
      therapy were analyzed for risk of non-compliance and compliance. The factors
      evaluated were gender (326 males and 548 females), type of therapy (surgical or
      non-surgical) and age (< or = 30 years, 31 to 40, 41 to 50, and > or = 51 years
      old) and the association amongst them. In the period studied, compliance with SPT
      was 45.8%. Forty-three percent of males and 47% of females discontinued SPT. In
      the surgical group 43.9% were non-compliant and in the non-surgical group 53.2%
      were non-compliant. Fifty-nine percent of the patients < or = 30 years of age
      were also non-compliant. Female patients < or = 30 years and > or = 51 years of
      age that underwent non-surgical therapy were found to be of higher risk for non
      compliance in the 10-year period studied.

PMID- 11210251
TI  - Compressive strength of interocclusal recording materials.
AB  - Many materials are used for making interocclusal records to mount casts on dental
      articulators. The strength of these materials during the compressive forces
      encountered in the mounting process is important because any deformation will
      cause incorrect occlusal relationships. This investigation compared the
      deformation of 4 thicknesses (2 mm, 5 mm, 10 mm, 20 mm), when subjected to 25 N
      compressive force, of 3 interocclusal recording materials: condensation silicone,
      recording wax, and rubber-based polyvinylsiloxane. Significant differences were
      recorded for all materials of 20 mm, 10 mm and 2 mm thickness. However, there was
      no significant difference among the 5 mm groups. Interocclusal records should be
      made of a minimal thickness, using a recording material which exhibits minimal
      distortion during compression.

PMID- 11210253
TI  - Changes in periodontal conditions of children and adolescents from Araraquara,
      Brazil: 1995-1998.
AB  - The aim of this study was to compare the periodontal conditions in 7-15-year-olds
      from Araraquara, SP, Brazil in 1998 with data from 1995. A systematic random
      sample was drawn from the population of children and adolescents enrolled in all
      public schools in 1998. The survey was conducted by trained examiners using the
      CPITN and WHO diagnostic criteria. Results showed an increase in the percentage
      of students of all ages with healthy periodontal conditions (from 14% in 1995 to
      33% in 1998; p < 0.01). An increase in the mean number of healthy sextants (from
      3.2 to 4.4; p < 0.0001), a decrease in the mean number of bleeding sextants (from
      2.5 to 1.2; p < 0.0001) and no difference in the mean number of sextants with
      calculus were also observed. At the age of 15, 54% of the students had 5-6
      healthy sextants in 1998 compared to 19% in 1995 (p < 0.01). Despite the
      improvement observed in the periodontal conditions, efforts must be increased in
      order to achieve the WHO goal for the year 2010 of no more than one sextant
      affected by bleeding or calculus at the age of 15.

PMID- 11210254
TI  - Oral squamous cell carcinoma: a retrospective study of 740 cases in a Brazilian
      population.
AB  - The purpose of this study was to evaluate, retrospectively, the profile of
      patients with oral squamous cell carcinoma. They were referred to two hospitals
      of Belo Horizonte (MG, Brazil) between 1986 and 1996. The medical records of 740
      patients presenting oral squamous cell carcinoma were reviewed in detail. The TNM
      classification and staging, age, gender, race, occupation, and site of the
      primary tumor were recorded. The male-to-female ratio was 4.8:1. The mean age was
      58.6 years. Most of the patients were in their sixties and were farm workers. The
      tumors were found principally on the tongue. There was a close relationship
      between some habits (tobacco and alcohol consumption) and the development of oral
      squamous cell carcinoma. Most of the patients sought medical care in the first
      year, even though almost half of them had lesions in stage T4. The identification
      of the characteristics of this specific population might reflect either
      accomplishments or problems in oral cancer control and can enable the development
      of a primary prevention program for oral squamous cell carcinoma.

PMID- 11210255
TI  - Gingival erosive lichen planus: case report.
AB  - A case of gingival erosive lichen planus is presented with special emphasis on
      its clinical and microscopic characteristics. The differential diagnosis and the
      controversy associated with the malignant potential of oral lichen planus is also
      discussed.

PMID- 11210256
TI  - Odontoma-producing intraosseous calcifying odontogenic cyst: case report.
AB  - The present report describes a case of odontoma-producing intraosseous calcifying
      odontogenic cyst in a 36-year-old Black male in the right mandibular bicuspid
      region. The lesion involved an unerupted permanent canine, which was displaced to
      the mandible base and a calcified mass that was later recognized as an odontoma.
      The lesion was surgically removed.

PMID- 11210257
TI  - Hydroxylapatite implants with or without collagen in the zygomatic arch of rats.
      Histological study.
AB  - The authors studied the behavior of calcium phosphate materials used as inlay
      implants into bone cavities prepared in the zygomatic arch of rats. Fifty male
      albino rats were divided into four groups as follows: group I-preparation of bone
      cavities which did not receive any implant material as controls; group II
      implants of Interpore 200; group III-implants of experimental hydroxylapatite;
      group IV-implants of experimental hydroxylapatite combined with collagen. The
      animals were sacrificed after 5, 15, 30, 60 and 120 days and the specimens were
      submitted to histological analysis. Results showed that the experimental
      hydroxylapatite used in group III presented better osteogenic properties compared
      to the other materials. All tested materials were biocompatible, although group
      IV presented a more intense inflammatory response.

PMID- 11210258
TI  - AgNORs in hyperplasia, papilloma and oral squamous cell carcinoma.
AB  - Ten inflammatory fibrous hyperplasias, ten papillomas, and nineteen oral squamous
      cell carcinomas were analyzed by the AgNOR technique to determine if different
      disturbances of oral epithelia presented different AgNOR counts. The papilloma
      group showed higher mean AgNOR counts (3.15 +/- 0.58) than the hyperplasia group
      (1.98 +/- 0.24) and smaller than the well-differentiated oral squamous cell
      carcinoma group (6.56 +/- 1.25) and poorly differentiated oral squamous cell
      carcinoma group (7.07 +/- 1.60). The differences among the groups of lesions were
      statistically significant (P < 0.05) except between the well differentiated oral
      squamous cell carcinoma group and the poorly differentiated oral squamous cell
      carcinoma group. Our findings suggest that the cellular proliferation ratio in
      papillomas is greater than hyperplasias and smaller than carcinomas.

PMID- 11210259
TI  - Comparative study of two digital radiographic storage phosphor systems.
AB  - The objective of this study was to evaluate the image quality and dynamic range
      of two digital radiographic storage phosphor systems: Digora (Soredex, Finland)
      and DenOptix (Gendex, USA). Four objects were analyzed and eight exposure times
      employed, totaling 64 images that were analyzed by 5 examiners using a scale from
      1 to 4 to classify the images. The scores were submitted to analysis of variance
      and the results showed statistical differences among the averages attributed to
      the systems, to the exposition times and to the objects (p 0.01 Pound). Digora
      presented a larger dynamic range and, in general, a better image quality.
      Although these 2 systems present the same photon detector, they present different
      results in relation to the evaluated items.

PMID- 11210260
TI  - Epithelial alterations of secondary palate formation.
AB  - This study was undertaken to examine the normal and abnormal epithelial
      alterations of secondary palate in rats. Control and dexamethasone-treated
      embryos and fetuses of Wistar rats were evaluated by macroscopic and scanning
      electron microscopic analysis prior to, during, and after fusion of palatal
      processes. Normal alterations of the surface topography included growth and
      disorganization of medial edge epithelial cells followed by fusion and posterior
      migration to both the oral and nasal aspects of the palate. No evidence of
      epithelial cell death or transformation was observed. Dexamethasone-treated
      fetuses showed epithelial cells increased in size with a large amount of
      desquamation, followed by deposition of a disorganized cell layer with keratin
      like characteristics. This allowed no fusion of palatal processes.

PMID- 11210261
TI  - The facilitating role of mobile dental van programs in promoting professional
      dental education.
AB  - The main goal of the University of Texas Health Science Center (UTHSCSA) dental
      van programs is to provide training in delivering care to diverse segments of the
      population. The UTHSCSA is the Academic Health Center for all of South Texas, a
      region with 25% of the State's population and 60% Hispanic. About 60% of the
      region's counties are federally designated dental health personnel shortage
      areas. Interdepartmental efforts with the participation of dental hygiene,
      community dentistry, oral diagnosis, periodontics and general practice carried
      out two programs during the 1994-95 academic year. At the Saint Philip of Jesus
      Clinic, a charity clinic, and at the Willows Development Center for Severely and
      Profoundly Mentally Retarded, the dental van was used to provide preventive and
      restorative care. A questionnaire to measure the value of the programs indicated
      that students perceived them as important educational activities which increased
      their confidence in treating persons in the community, especially persons with
      disabilities. Program output was quantitatively assessed. An average of 8
      preventive procedures, 7 fillings, 2 sealants and 1 extraction or referral were
      provided each working day. Eighty patients were seen at the Saint Philip Clinic
      (2.5 visits per patient) and 130 patients were seen at the Willows Development
      Center. Overall, 80 students and 6 faculty participated in providing screening,
      treatment and referral services. Dental van programs promote access to dental
      care and increase the visibility of dental schools within the university and
      community. Current tendencies to halt new program initiatives and phase out
      existing programs due to shifting financial priorities should be carefully
      considered in view of the 1995 Institute of Medicine (IOM) report on the future
      of dental education.

PMID- 11210262
TI  - Clinical and histological evaluation of granuloma gravidarum: case report.
AB  - Granuloma gravidarum is a benign lesion of the oral mucosa which occurs during
      pregnancy. This case report presents the clinical and histological evaluation and
      treatment of a granuloma gravidarum in a patient in the 9th month of pregnancy.

PMID- 11210263
TI  - Maxillary lateral incisor with two root canals: fusion, gemination or dens
      invaginatus?
AB  - Endodontic retreatment of a maxillary right lateral incisor with two root canals
      is described. The diagnosis of fusion, gemination or dens invaginatus could not
      be made, due to conflicting findings, and to previous root canal treatment that
      erased the original configuration of the pulp chamber.

PMID- 11210264
TI  - Craniometaphyseal dysplasia: case report.
AB  - Craniometaphyseal dysplasia is a rare genetic bone remodeling disorder
      characterized by undertubulation of the long bones, especially in the lower
      extremities, causing deformities of the metaphyses of the long bones, and
      sclerosis of the skull base or cranial bone hyperostosis. The authors report a
      case of craniometaphyseal dysplasia in an 8-year-old Brazilian child, emphasizing
      the importance of precocious diagnosis of this rare genetic disorder.

PMID- 11210265
TI  - A rare case of lip ulcer infected by Klebsiella pneumoniae: case report.
AB  - The aetiology of mouth ulcers is diverse and may include several types of trauma,
      systemic disease and infection. The size, depth, outline, base, aspect of the
      floor, pain, time of evolution and resolution of oral ulcers are discussed. Both
      past and present medical history, biopsy, blood tests and microbiological tests
      are also considered in order to assure precise identification. This paper reports
      a case of a lip ulcer caused by Klebsiella pneumoniae.

PMID- 11210266
TI  - In vitro study of the effect of aged eugenol on the flow, setting time and
      adhesion of Grossman root canal sealer.
AB  - In the present study, the effect of aged eugenol (up to 180 days) on the flow,
      setting time and adhesion of Grossman root canal sealer was evaluated, following
      the American Dental Association specification number 57 for root canal sealers.
      An Instron Universal testing machine 4444 was used for testing adhesion. There
      were statistically significant differences between groups, with a higher flow,
      lower setting time and adhesion for aged eugenol. It can be concluded that time
      affects eugenol, with consequent effects on Grossman sealer.

PMID- 11210267
TI  - Homogenous implant in rat tibias of matrix preserved in 98% glycerin:
      histomorphologic study.
AB  - As a chemical medium for preservation of tissues, glycerin has shown good results
      because it maintains the cellular integrity despite the tissue dehydration it
      causes. Taking advantage of the osteoinducing properties of the osseous matrix
      and glycerin as a proper medium for tissue preservation, osseous matrix was
      implanted in rat tibias. Twenty-four rats were used, each receiving two surgical
      wounds. In one of the wounds an osseous matrix preserved in 98% glycerin was
      implanted and the other received a matrix without preservatives. Six animals were
      sacrificed on days 10, 20, 30 and 60 post-implant. After routine histological
      processing, the specimens were stained in hematoxylin-eosin and Masson's
      trichrome. The results showed that the matrixes preserved in glycerin presented
      faster resorption with replacement by newly formed tissue.

PMID- 11210268
TI  - Fluoride release and uptake from glass ionomer cements and composite resins.
AB  - The aim of this investigation was to evaluate fluoride release and uptake from 4
      glass ionomer cements (GICs)--Vitremer (VIT), Fuji II LC (FII LC), Fuji IX (FIX),
      Chelon Fill (CHE)--and 2 composite resins (CRs)--Heliomolar (H) and Zeta-100 (Z
      100). Eight discs (8 mm x 2 mm) were made of each material and were stored in
      plastic vials containing artificial saliva at 37 degrees C. In group 1 (N = 3),
      the specimens were immersed in artificial saliva which was changed daily for 25
      days. In group 2 (N = 5), besides receiving the same treatment as group 1, the
      specimens were immersed, after 24 hours, in a fluoride solution (1% NaF) for 1
      min before daily saliva change. An ion-specific electrode (9609 BN-Orion)
      connected to an ion analyzer (SA-720 Procyon) was used to determine the amount of
      fluoride released at days 1, 2, 5, 10, 15, 20 and 25. Data were analyzed using
      two way ANOVA and Friedman's test. GICs released more fluoride during the first
      day and after this period the mean fluoride released decreased. Composite resin H
      released fluoride during the first day only and Z-100 did not release fluoride.
      In terms of NaF treatment, CRs did not show fluoride uptake, whereas the GICs
      showed fluoride uptake (VIT = FII LC = CHE > FIX).

PMID- 11210269
TI  - Capacity of denture plaque/biofilm removal and antimicrobial action of a new
      denture paste.
AB  - The efficacy of a paste for complete dentures was analyzed in terms of denture
      plaque/biofilm removal and antimicrobial action against specific microorganisms
      by determination of colony forming units of mutans group streptococci and yeast
      from 120 full denture wearers with a healthy palatine mucosa. The patients were
      given a questionnaire to evaluate the experimental product in terms of important
      characteristics. The paste was widely accepted by the patients, and effective in
      denture plaque removal and antimicrobial action. The species of yeasts most
      frequently isolated were C. albicans, C. tropicalis and C. glabrata. We conclude
      that it is possible for complete denture wearers to keep their dentures clean
      with the regular use of a paste-like hygienic product.

PMID- 11210270
TI  - The influence of five impression techniques on the dimensional accuracy of master
      models.
AB  - A high-grade steel model with different preparation angles of 3 degrees, 7
      degrees and 11 degrees in one- and two-step impression techniques were made for
      the determination of the influence of the preparation angle on the dimension
      loyalty of the resulting master casts. Using a 3-D-measuring instrument, analysis
      of the data showed that with the correction technique the model abutments led to
      a reduction in dependency on the preparation angle. The general reduction in
      stump height of the abutments was independent of the preparation angle. The
      double-mix technique showed decent increased abutments and is thus recommended
      for impressions of supragingival preparations.

PMID- 11210271
TI  - Effect of saccharin on antibacterial activity of chlorhexidine gel.
AB  - Although chlorhexidine is the most effective agent against dental plaque it is
      extremely bitter. To prepare formulations, it is necessary to use flavoring and
      sweetening, which can inhibit the antibacterial effect of chlorhexidine.
      Saccharin has been considered a compatible substance to use in chlorhexidine
      rinse or gel preparations; however, the effect of a range of concentrations has
      not been studied. To evaluate the effect of different concentrations of saccharin
      on the antibacterial activity of chlorhexidine gel, hydroxy-ethyl-cellulose gels
      containing 1.0% chlorhexidine digluconate and 0.0 to 1.0% sodium saccharin were
      prepared. Activity against Streptococcus mutans was evaluated using the agar
      diffusion method and determination of MIC values. The inhibitory zones of growth
      were 7.83 +/- 0.54 mm when no saccharin was added to the chlorhexidine gel and
      7.75 +/- 0.50, 7.63 +/- 0.48, 6.21 +/- 0.40, 4.13 +/- 0.38, when the
      concentrations of saccharin in the gels were 0.02, 0.10, 0.5, and 1.0%,
      respectively. The range of MIC values was 1-2 micrograms/ml, with saccharin
      concentrations of 0%, 0.02, and 0.1%. In contrast, the MIC values were 4-8 and 8
      16 micrograms/ml with saccharin concentrations of 0.5% and 1.0%, respectively.
      The paired "t" test showed that 0.5 and 1.0% sodium saccharin inhibit the
      antibacterial activity of 1% digluconate chlorhexidine gel. These in vitro
      results suggest that saccharin may inhibit the efficacy of chlorhexidine against
      mutans streptococci, depending on the concentration.

PMID- 11210273
TI  - Cephalometric evaluation of patients with anterior open-bite.
AB  - Cephalometric evaluations of the skeletal pattern of 30 patients with anterior
      open-bite malocclusion were compared to those of 30 individuals with a normal
      overbite. The posterior/anterior face height ratio (PFH/AFH) was the only
      skeletal characteristic statistically different in the two groups. The other
      cephalometric measurements were not found to be statistically different in the
      malocclusion and normal overbite groups (SN-GoGn, SN-PP, gonial angle, LFH/AFH
      ratio), indicating that there is no skeletal origin in the group with anterior
      open-bite in this study.

PMID- 11210272
TI  - Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide
      paste, Sealapex and Dycal.
AB  - The objective of this study was to investigate the antimicrobial action of
      mineral trioxide aggregate (MTA), Portland cement, calcium hydroxide paste (CHP),
      Sealapex and Dycal. The chemical elements of MTA and two Portland cements were
      also analyzed. Four standard bacterial strains: Staphylococcus aureus (ATCC
      6538), Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853),
      Bacillus subtilis (ATCC 6633), one wild fungus, Candida albicans (ICB/USP-562),
      and one mixture of these were used. Thirty Petri plates with 20 ml of BHI agar
      were inoculated with 0.1 ml of the experimental suspensions. Three cavities, each
      one measuring 4 mm in depth and 4 mm in diameter, were made in each agar plate
      using a copper coil and then completely filled with the product to be tested. The
      plates were pre-incubated for 1 h at environmental temperature followed by
      incubation at 37 degrees C for 48 h. The diameters of the zones of microbial
      inhibition were then measured. Samples from diffusion and inhibition halos were
      extracted from each plate and immersed in 7 ml BHI broth and incubated at 37
      degrees C for 48 h. Analyses of chemical elements present in MTA and in two
      samples of Portland cement were performed with a fluorescence spectrometer Rx.
      The results showed that the antimicrobial activity of CHP was superior to those
      of MTA, Portland cement, Sealapex and Dycal, for all microorganisms tested,
      presenting inhibition zones of 6-9.5 mm and diffusion zones of 10-18 mm. MTA,
      Portland cement, and Sealapex presented only diffusion zones and among these,
      Sealapex produced the largest zone. Dycal did not show inhibition or diffusion
      zones. Portland cements contain the same chemical elements as MTA except that MTA
      also contains bismuth.

PMID- 11210274
TI  - Risk indicators for periodontal diseases in Guatemalan adolescents.
AB  - A random sample of sixty-two 11-15-year-old adolescents from 17 different
      locations in Guatemala were selected for this study. Pocket depth, Plaque Index,
      and bleeding upon probing were recorded from 6 randomly selected sites in each
      subject (a total of 372 sites). Subgingival plaque samples were subsequently
      collected from these sites and processed by several assays. For cost reasons, in
      each pair of sites different assays were performed as follows: sites #1, #2--BANA
      test for T. denticola, P. gingivalis, B. forsythus and screening of plaque
      samples with polyclonal antibodies (ELISA system) for A. actinomycetemcomitans;
      sites #3, #4--detection of yeasts by SAB agar; sites #5, #6--detection of
      Entamoeba gingivalis by the Heidenhain iron hematoxylin modified technique. A
      total of 66% of the children had at least one site that bled upon probing, 42%
      exhibited at least one site with pocket depth > 3 mm, and 79% exhibited a high
      Plaque Index, with the percent of sites affected being 30%, 12% and 41%,
      respectively. In sites #1, #2 (N = 124), the BANA test assay and A.
      actinomycetemcomitans tested positive in 77% and 47% of the children accounting
      for 59% and 31% of the sites, respectively. In sites #3, #4 (N = 124), yeasts
      were detected in 43% of the children and 29% of the sites. In sites #5, #6 (N =
      124), Entamoeba gingivalis was detected in 21% of the children and in 11% of the
      sites. The risk for severe gingival inflammation and/or increased probing depth
      was 1.5 and 5.2 times higher if a positive BANA test or A. actinomycetemcomitans
      test was found in a particular site. No associations could be found for yeasts
      and Entamoeba gingivalis.

PMID- 11210275
TI  - Periodontal disease associated with Langerhans' cell histiocytosis: case report.
AB  - A clinical case of Langerhans' cell histiocytosis, type eosinophilic granuloma,
      in a young adult patient is presented. Because of the occurrence of oral
      manifestations in initial stages of the disease, there is a need for a
      differential diagnosis, especially with the early-onset periodontitis.

PMID- 11210276
TI  - Assisting women to establish breastfeeding: exploring midwives' practices.
AB  - Breastfeeding is recognised by many mothers, families and health professionals to
      be important for the health and wellbeing of mothers and babies. Successful
      breastfeeding depends on the acquisition of basic skills, accurate information
      and practice, and is strongly influenced by the support provided following
      childbirth. Midwives' practices may therefore have the potential to influence
      breastfeeding outcomes. Correct positioning and attachment of the newborn at the
      breast is a crucial component of the successful establishment of breastfeeding. A
      literature review revealed that minimal research exists on the practices that
      midwives use when assisting women to initiate breastfeeding. A series of focus
      group interviews were therefore conducted to stimulate in-depth exploration of
      midwives' understanding and practices in the positioning and attachment of a
      newborn infant at the breast. Eighteen midwives, each of whom had worked at least
      12 months in the postnatal environment of a large metropolitan hospital in
      Adelaide, participated in the focus group discussions. Using thematic analysis,
      the following broad themes emerged from discussions--education, problem-solving,
      support, midwives' views about breastfeeding and influences on midwives'
      practice. These themes identify the roles and practices that midwives take on
      when assisting women to establish breastfeeding following childbirth, and also
      raise awareness of influences on their practice.

PMID- 11210277
TI  - Long-term expressing of breastmilk.
AB  - This article focuses on the breastfeeding experience of a midwife after the birth
      of her first child. He was born with a bilateral cleft lip and palate and despite
      attempting to breastfeed it was not possible physiologically. The decision was
      made to express breastmilk long-term and feed the baby by Chu Chu teat and
      squeeze bottle. This article describes the hints and ideas found along the way to
      make long-term expressing of breastmilk easier. It comes from personal
      experience, literature and asking other women in similar situations how they
      managed.

PMID- 11210278
TI  - Rates of breastfeeding in Australia by state and socioeconomic status: evidence
      from the 1995 National Health Survey.
AB  - OBJECTIVE: To estimate rates of breastfeeding in the first year of life in
      Australia, according to state and socioeconomic status. METHODOLOGY: Analysis of
      data from the 1995 Australian National Health Survey. RESULTS: Estimated
      breastfeeding rates are 81.8% on discharge from hospital, 57.1% fully breastfed
      at three months and 62.6% fully or partially breastfed at three months. At six
      months, it is estimated that 18.6% of babies are fully breastfed and 46.2% fully
      or partially breastfed. At one year, 21.2% of infants are receiving some
      breastmilk. Comparison between states demonstrates that there is considerable
      variation in breastfeeding practice within Australia. Rates of breastfeeding also
      vary according to the socioeconomic status of the geographic area in which the
      child is living, with a strong inverse relationship between rates of
      breastfeeding and socioeconomic status. CONCLUSION: Australia's target for
      breastfeeding in the year 2000 is to have 80% of babies at least partially
      breastfed for the first six months of life. Although Australia has good rates of
      initiation of breastfeeding these levels are not maintained over time, and it
      seems unlikely that we will reach the year 2000 targets.

PMID- 11210279
TI  - Breastfeeding attachment hands-off technique competency checklist.

PMID- 11210280
TI  - Does maternal obesity adversely affect breastfeeding initiation and duration?
AB  - OBJECTIVE: To examine the relationship between maternal obesity and the
      initiation and duration of breastfeeding. METHODS: Analysis was made of the 1995
      National Health Survey, in which personal interviews were conducted on a
      multistage area sample of private dwellings and a list sample of non-private
      dwellings in all States and Territories of Australia. Mothers between the ages of
      17 and 50 years (n = 1991) with children under the age of four years in 1995
      participated in the study. RESULTS: Of the group of mothers with a body mass
      index (BMI) of 20-25, 89.2% (95% confidence interval (CI) 87.4-91.0) initiated
      breastfeeding, compared with 82.3% (95% CI 77.6-87.0) of mothers with a BMI of 30
      or more. There was also a significant difference between the mean and median
      duration of breastfeeding of obese and non-obese mothers (BMI 30 and over, < 25,
      respectively). These differences remained significant when maternal smoking, age
      and other sociodemographic factors were taken into consideration. CONCLUSIONS:
      Health professionals should be aware that obese women may be at increased risk of
      not breastfeeding or stopping breastfeeding prematurely.

PMID- 11210281
TI  - Support for breastfeeding in the first postpartum month: perceptions of
      breastfeeding women.
AB  - Support for breastfeeding, particularly in the early weeks, remains a challenge
      for health professionals. Focus group interviews with South Australian
      metropolitan mothers about their first month postpartum explored perceptions of
      available breastfeeding support. Women discussed breastfeeding support as related
      to place, people and timing. Findings of this retrospective qualitative study
      indicate that breastfeeding women perceived midwives as unable to provide the
      support and relationship they needed due to limitations of time and inconsistent
      rosters of staff. Additionally, confusion was reported to arise from conflicting
      advice given by midwives. The issues raised by participants provide an
      opportunity for midwives to consider reshaping their practices to meet the
      perceived needs of breastfeeding women in the early postpartum period.

PMID- 11210282
TI  - Meperidine: second-line agent with first-line prescribing practices.
AB  - Results from this survey need to be viewed within the context of the small number
      of responses (20%), which may not fully represent the knowledge base of all house
      officers. Recommendations established by the Agency for Health Care Policy and
      Research (AHCPR) define standards of care for acute and chronic pain management
      and address many of the problems seen nationally with meperidine and its
      metabolite, normeperidine. Data from this survey have assisted us in providing
      educational programs which are in line with these guidelines for house officers.

PMID- 11210284
TI  - The febrile traveler.

PMID- 11210283
TI  - Gilles de la Tourette's syndrome: "merde and foutu cochon".

PMID- 11210286
TI  - Better than medicine.

PMID- 11210285
TI  - Bilateral cystic ovarian teratomas.

PMID- 11210287
TI  - Garlic: the panacea with bad breath.

PMID- 11210288
TI  - Preconceptual folic acid: opportunity for preconceptual counseling offers
      opportunity to help prevent neural tube defects.

PMID- 11210289
TI  - An overview of HCFA's acute myocardial infarction national project.

PMID- 11210290
TI  - Invasive disease attributed to Streptococcus pneumoniae, 1998-1999.

PMID- 11210291
TI  - Tobacco control report card: Rhode Island, 2000.

PMID- 11210292
TI  - Mammographic screening--a review.

PMID- 11210293
TI  - Who's the criminal?

PMID- 11210294
TI  - A managed care contract check-list.

PMID- 11210295
TI  - Treating the many to benefit the few: the modest reach of preventative
      medications.

PMID- 11210296
TI  - Clinical management of psoriasis: principles and practice.
AB  - A chronic condition that compromises many patients' quality of life, psoriasis is
      treatable with a range of agents, either alone or in combination. Clinical
      management strategies using these therapies can be organized as a stepped-care
      approach. For mild disease, corticosteroids and other topical therapies (step 1)
      are often appropriate. When lesions are more pronounced or extensive,
      phototherapy (step 2) is often the treatment of choice, and topical treatments or
      the step 3 agent acitretin can be added to enhance or accelerate therapeutic
      responses. Step 3 agents, which also include cyclosporine and methotrexate, may
      be contemplated when psoriasis is moderate or severe. Acitretin may cause acute
      adverse effects, including mucocutaneous effects, which can be avoided by
      reducing dosage. Methotrexate treatment can lead to bone marrow suppression and
      hepatotoxicity, and cyclosporine can cause nephrotoxicity. The clinical uses of
      these agents are illustrated in part through case presentations drawn from the
      authors' practices, and the supportive role of the National Psoriasis Foundation
      is reviewed.

PMID- 11210297
TI  - [Macrolide antibiotic clarithromycin (Klabax) in treatment of community-acquired
      respiratory tract infections].

PMID- 11210299
TI  - [Pathogens in community-acquired pneumonia at the edge of the new millenium].

PMID- 11210298
TI  - [Augmentin (amoxicillin-clavulanate) and timentin (ticarcillin-clavulanate) in
      treatment of purulent wounds of skin and soft tissues].

PMID- 11210300
TI  - [Etiology of community-acquired bronchitis and pneumonia in young children and
      the choice of antibacterial therapy].

PMID- 11210301
TI  - [Clarithromycin and tumor chemotherapy].

PMID- 11210302
TI  - [Importance of pharmacokinetic studies for antibiotic therapy in children with
      pneumonia].

PMID- 11210303
TI  - [Secretolytic preparations and antibiotics in treatment of the acute and chronic
      nasal, nasal sinus, and middle ear diseases in children].

PMID- 11210304
TI  - [beta-Lactams. Structure and biological activity relationship].

PMID- 11210305
TI  - [Non-sporulating anaerobic bacteria and anastomosis failure in patients with
      gastric carcinoma].
AB  - Cases of anastomosis suture failure within the period from 1977 to 1987 and from
      1988 to 1998 in 139 patients after various surgical operations for gastric
      carcinoma were analyzed. Infection in the cases of the anastomosis sUture failure
      at the early terms was mainly due to representatives of Enterobacteriaceae and at
      the later terms the failure was mainly due to non-sporulating anaerobes belonging
      to Bacteroidaceae. The data are indicative of the fact that the use of
      antimicrobials requires a differential approach.

PMID- 11210306
TI  - [Comparative morphological analysis of the articular cartilage, epiphyseal plate,
      spongy bone, and synovial membrane of the knee joint in children treated and not
      treated with ciprofloxacin].
AB  - Comparative data on he postmortem morphological examination of the knee joint in
      children treated and not treated with ciprofloxacin while alive are presented.
      Nine children were ill with mucoviscidosis and 8 children were ill with aplastic
      anemia. The patients were ill with mucoviscidosis and 8 children were ill with
      aplastic anemia. The patients were treated with ciprofloxacin in a daily dose of
      20 to 40 mg/kg body weight at the average for 148 days. The condition of the
      articular cartilage, growth area, spongy bone and synovial membrane of the knee
      joint was examined visually, histologically and morphologically. It was revealed
      that ciprofloxacin had no chondrotoxic effect. The structure affected in some
      cases by the ciprofloxacin treatment was the synovial membrane which developed
      subacute synovitis not clinically manifested (latent) in life. The phenomenon is
      explained.

PMID- 11210307
TI  - [Minimally invasive coronary artery bypass surgery].
AB  - From 19.06.97 to 06.01.2000 36 patients with coronary heart disease underwent
      direct myocardium revascularization surgery by minimally invasive method (through
      minithoracotomy, off-pump and on the beating heart), anastomosis between left
      internal mammaria artery and anterior descending artery (ADA). The majority of
      the patients (55.6%) had one-vessel damage of ADA coronary bed, in the patients
      with damage of two and more vessels full revascularization of coronary bed was
      achieved by two coronary arteries bypass at once or by combination of minimally
      invasive coronary bypass (MICB) with PTCA. MICB is performed in specially
      selected patients according to stuct indications. Technique of operation, early
      postoperative course, possibilities of combination of MICB with other methods of
      treatment is described. Potential of MICB is discussed.

PMID- 11210308
TI  - [Diagnosis and treatment heart and pericardium wounds].
AB  - The experience of diagnosis and treatment of heart and pericardium wounds in 152
      patients are presented. In obecure diagnosis the authors prefer X-ray examination
      and echocardiography. Total lethality was 23.6%. Its high level is due to injury
      of coronary arteries and intracardiac structures, other thoracic and abdominal
      organs. The left anterolaferal thoracotomy is the optimum approach in wounds of
      the heart and pericardium. The most frequent complication of postoperative period
      is pericarditis, its echographic symptoms were revealed in 91% examinys. Non
      steroid and steroid antiinflammatory drugs are effective for prophylaxis and
      treatment of pericarditis.

PMID- 11210309
TI  - [One-stage combined operations on kidney and other organs].
AB  - Patients with combined diseases of the kidney, organs of abdominal cavity and
      retroperitoneal space require original decisions in the choice of surgical
      approach and sequence of interventions on different organs. The experience of one
      stage combined nephrectomies and kidney resections in 36 patients with lung,
      stomach, intestine, liver and other organs' diseases are presented. 11 patients
      had primary renal carcinoma, the kidneys were affected by other malignant tumors
      in 15 patients. Primary benign processes in the kidneys were found in 3 patients
      and also in 7 patients these processes were the consequence of earlier performed
      operations. Interventions on 3-6 organs were necessary in 11 cases. It makes
      sense to begin one-stage combined transperitoneal interventions with "clean"
      stages--without section of gastrointestinal tract's lumen. 1 patient died because
      of peritonitis due to insufficiency of sutures of colon anastomosis. The follow
      up ranged from 6 months to 12 years. The recurrences and metastases were found in
      9 operated patients within 7 to 20 months, and there were no symptoms of diseases
      in 24 patients. It is concluded that extended radical one-stage operations on the
      organs of abdominal cavity and retroperitoneal space combined with operations on
      the kidney are endurable and effective if the surgical technique is thorough.

PMID- 11210310
TI  - [Pressing problems of gastric and duodenal ulcer surgery].
AB  - Main types of surgical operations for the treatment of ulcer disease were
      elaborated towards the end of XIX century and improved constantly for the better
      by surgeons. Vagotomy is the outstanding achievement of the XX century. It
      enabled lowering of mortality, and frequency of postresection syndromes and
      improved patients' quality of life. The discovery of Helicobacter pylori (Hp) has
      changed our knowledge about ulcer disease pathophysiology. Eradication of Hp with
      omeprasol and antibiotics sharply improved the treatment, decreased the relapses.
      In this connection number of elective surgical operations decreased, but number
      of emergency increased. Importance of Hp in pathophysiology of ulcer disease is
      overestimated. Chronic Hp gastritis, destroying protective mucosal barrier clear
      the way for destructive action ofacidopeptic component of gastric juice and ulcer
      formation. The comparative evaluation of different surgical operations is given
      and optimal methods for the treatment of complicated and uncomplicated duodenal
      and gastric ulcers are recommended.

PMID- 11210311
TI  - [Diagnosis and surgical treatment of arterial hypertension of adrenal origin].
AB  - 230 patients with arterial hypertension of adrenal origin were treated. 205 of
      them underwent adrenalectomy with surrounding paranephral fat. There were no
      lethal outcomes. Endogenic adrenocorticism was diagnosed in 134 patients.
      Cushing's syndrom was in 96 patients, Cushing's disease--in 34, ACTH-ectopic
      syndrome--in 2, adrenocortical cancer--in 2. Primary hyperaldosteronism was
      diagnosed in 42 cases: idiopathic hyperaldosteronism in 23 patients,
      aldosteronproducing adenoma (Conn's syndrome)--in 19. Tumors of chromaffine
      tissue were defected in 30 patients. All the patients underwent complex
      examination (hormonal profile, US, CT, MRT, angiography if it was necessary).
      Symptomatic arterial hypertension of adrenal origin was diagnosed during one year
      in 10% patients only because of absence of typical clinical picture. Use of
      complex examination has permitted to make a correct topical diagnosis and to
      choose optimum treatment policy in all the cases.

PMID- 11210312
TI  - [Radical surgical treatment of Barrett's esophagus].
AB  - In the light of modern scientific knowledge, pathogenesis of Barrette's esophagus
      (BE) is presented as an integral neoplastic process. Indications to operation and
      policy of radical surgical treatment in BE, including in combined esophageal
      diseases (burn and peptic strictures, reflux esophagitis, short esophagus) were
      developed. From 1990 to 2000 radical operations were performed in 14 patients (11
      males, 3 females) with BE. Mean age was 54.1 years. About 80% patients had
      clinical signs of reflux esophagitis at the moment of hospitalization. In all the
      patients the diagnosis of BE was verified in microscopic examination of operative
      material. 4 patients with cylindrical metaplasia associated with ulcers and
      esophageal peptic strictures were operated, 3 patients--with epithelium
      dysplasia, 7 patients--with adenocarcinoma. All the patients underwent
      extirpation of thoracic portion of esophagus with one-stage plasty with
      isoperistaltic gastric tube, supplemented with mediastinal and abdominal
      lymphodissection in cancer. Affection of the regional lymph nodes was revealed in
      43% patients with esophageal adenocarcinoma. 50% patients had complications in
      postoperative period. There were no cases of hospital lethality. The expansion of
      indications for early surgical treatment of BE at the stage of meta-, and
      dysplasia, before adenocarcinoma development, is thought valid.

PMID- 11210313
TI  - [Assessment of pancreatoduodenal resection completion methods].
AB  - The nearest outcomes of 305 pancreatoduodenal resections (PDR) for malignant and
      benign diseases of the pancreas head and periampullar zone are presented.
      Necessity of differential approach to choice of method of pancreatodigestive
      anastomosis formation is demonstrated. In unectatic main duct of the pancreas and
      unchanged pancreatic parenchyma there is a high risk of postoperative
      pancreatitis and lethal outcome which achieved 29.8% in the group of 57 patients.
      In patients with diameter of main pancreatic duct more than 3 mm and fibrotic
      changes of its parenchyma, the majority of methods of pancreas inclusion the in
      digestive canal were characterized by favorable results, lethality was 7.7% among
      248 patients. Recently, the increase of rate of PDR with pylorus preservation
      permits to apply widely pancreato-, bilio-, and duodenoenteroanastomosis on the
      same jejunal loop.

PMID- 11210314
TI  - [Treatment of extrahepatic bile ducts injuries due to laparoscopic
      cholecystectomy].
AB  - The department of hepatic surgery of I.M. Sechenov Moscow Medical Academy has
      gained experience of treatment of 25 patients with injuries of bile ducts
      inficted in laparoscopic cholecystectomy (LCE). All the patients underwent LCE in
      other hospitals. 4 patients were hospitalized with recent injuries (within 24
      hours after injury) and 21--later. Injuries of the duct in LCE characterized by
      early clinical manifestation, injury in proximal portion of hepatic duct,
      technical difficulties of anastomosis creation during the first operation due to
      thin-walled duct of small diameter. Reconstructive operations yielded good
      results in 22 patients. Recurrent strictures were revealed in 3 patients who
      required repeated intervention. There were no lethal outcomes.

PMID- 11210316
TI  - [Ultrasonic diagnosis of focal damages in thoracoscopic operations].
AB  - 5-year experience of developed in PAMS A.V. Vishnevsky Institute of Surgery RAMS
      ultrasonic examination (USE) of the lung in thoracoscopic operations for focal
      lung lesions (FLL) is presented. Pilot experience of ultrasonic topical and
      differential diagnosis of FII opens a new page in diagnosis of respiratory
      diseases. Over 5 years 74 USE of FLL were performed. FLL were found in 91% cases.
      Detailed topical diagnosis of allows to design the lung resection with the best
      functional result. In postoperative X-ray examination neither atelectases nor
      zones of stable hypoventilation were detected. Normal echographic picture of lung
      tissue and echosemiotics of different focal lesions are descubed. The experience
      of diagnosis by echographic signs of FLL shows teasibility of differentiation of
      hamartomas from tuberculomas and focal metastatic lesions. The payential of
      differential diagnosis is illustrated. Differential diagnosis supported
      enucleation in superficial hamartomas and resection in suspected malignant tumor
      or tuberculosis. Use of intraoperative USE in the majority of cases of focal
      lesions located both in depth of lung tissue and subpleurally warrants the
      success of operation in thoracoscopic variant.

PMID- 11210315
TI  - [Thoracoabscessotomy in combined treatment of lung gangrene].
AB  - Patients with gangrene and gangrenous abscess of the lung belong to the most
      severe group of patients with purulent lung diseases. Conservative treatment is
      not effective, lethality after lung resection or pneumonectomy ranges from 20 to
      70%, therefore the study of less traumatic but life-saving operations is topical.
      From 1996 to 1998, 296 patients with purulent destructive processes in the lung
      were hospitalized, 34 of them had gangrene or gangrenous abscess of the lung with
      significant intoxication. Thoracoabscessostomy by original method with
      consecutive necrectomies, sanitation of purulent cavity was performed in 27
      patients. After operation 2 patients died, 25 patients were discharged with
      clinical recovery in satisfactory conditions, with dry cavity in the lung. In
      remote terms the cavities are cicatrized or transform to spurious cysts.
      Indications for thoracoabscessostomy are formulated. It is method of choice in
      the treatment of patients with gangrenous lung abscess, when conservative
      treatment is not effective, but the risk of radical operation is very high.

PMID- 11210317
TI  - [Is reliable prophylaxis of postoperative venous thromboembolic complications
      possible?].
AB  - Thrombosis of deep veins of lower extremities and pelvis is found in every third
      operated patient on the average, pulmonary embolism--in 0.5-0.8% cases. The
      results of nonspecific and specific prophylaxis of these complications are
      reviewed in the article. Intermittent pneumatic compression, compressive elastic
      stockings and standard or low-molecular heparin administration are most
      effective. Prophylactic measures do not exclude completely possibility of venous
      thromboembolic complications, but permit to control reliably this danger. The
      author has an experience of cavafilter implantation in 147 patients.

PMID- 11210318
TI  - [Prophylaxis of laryngeal nerve injuries in thyroid surgery].
AB  - The problem of injury of recurrent laryngeal nerve (RLN) is topical despite large
      usage and detailed development of surgical treatment of thyroid gland (TG). The
      results of 3603 operations on TG were analyzed. The 1st group consisted of 560
      patients operated in 1981-1988 by O.V. Nikolaev's method without dissection of
      RLN, the 2nd group--3043 patients operated in 1989-1998 with intraoperative
      imaging of RLN on the one or two sides. In the 1st group the injury of RLN was
      revealed in 39 (7.0%) patients, in 4 of them--bilateral. In 2nd group it was
      revealed in 10 (0.3%) patients. Present data lead to a conclusion that
      intraoperative imaging of RLN in operation on the thyroid gland is necessary.

PMID- 11210319
TI  - [Ultrasonic examinations of thyroid newgrowths].
AB  - The results of complex ultrasonic, histological and cytological examination of
      148 patients with newgrowths thyroid were analyzed. Grey-scale mode, colored and
      energy Doppler scanning, three-dimensional reconstruction of vessels were used. A
      new classification of nodular vascular pattern types based on 3-D reconstruction
      is proposed. The majority of malignant formations were characterized by
      perinodular hypervascularization and internodular hypovascularization (82.4%),
      adenomas--by peri- and intranodular hypervascularization (88.9%), colloid nodes-
      by perinodular hypervascularization (85.5%), the blood flow was absent in simple
      cysts (85.3%). It was established that complex of these methods increases
      informative value of ultrasonic examination in diagnosis of thyroid nodular
      diseases: in malignant neoplasms the sensitivity is 92.9%, specificity--86.1%,
      diagnostic accuracy--86.9%, in adenomas--93.4%, 79.2% and 82%, in colloid nodes-
      75.7%, 84.1% and 79.8%, respectively. In cystic masses diagnostic value of
      Doppler methods didn't change: sensitivity was 90.4%, specificity--63%,
      diagnostic accuracy--80.5%. The combined ultrasonic examination provides a
      differential approach to treatment of patients with thyroid nodular masses and
      decreases the number of unjustified surgical interventions.

PMID- 11210320
TI  - [Extracorporeal detoxication in combined treatment of surgical sepsis].
AB  - The methods of extracorporeal detoxication acquire special importance in combined
      treatment of sepsis. The sessions of plasmapheresis, hemodialysis and isolated
      ultrafiltration were performed in 61 of 83 patients with sepsis. Indications to
      these methods are determined, their efficacy is evaluated. It is established that
      administration of antibiotics and immunoglobulins after sessions of
      plasmapheresis and hemodialysis to achieves therapeutic drug concentration in
      blood. It is difficult to select the dose of antibiotics and immunodrugs in
      permanent round-the-clock ultrafiltration since the part of them are eliminated
      through the filters. Overall lethality was 20.4% (17 of 83 patients died), in the
      group of patients with severe polyorganic insufficiency and septic shock who
      needed extracorporeal detoxication--27%.

PMID- 11210321
TI  - [Ambulatory surgical interventions in patients with proctological diseases].
AB  - The results of 629 operations for the most frequent proctological diseases
      (hemorrhoid, anal scissure, rectal fistula, acute paraproctitis) were analyzed.
      134 operations were performed in outpatient clinic, 225--in one-day hospital and
      270 (control group)--in coloproctology department. The place of operation did not
      influence postoperative period and temporary disability time. The mean stay of
      patient in outpatient department and hospital surgical unit was 3.8 and 324
      hours, respectively. Since the second day after operation in specialized
      department it is possible to perform therapeutic manipulations outpatient in
      coloproctology room without negative sequences for patient's health. Cost of the
      ambulatory operation constituted 28.4% of hospital stay for patients with similar
      interventions. Surgical treatment of the above diseases could be performed in
      outpatients setfing in more than 50% patients. The bed resources must be used for
      patients who need long-term and intensive treatment in specialized department.

PMID- 11210322
TI  - [Determination of colon resection limits in diverticulosis].
AB  - Results of surgical treatment of 112 patients with colon diverticulosis are
      analyzed. It is established that during operation it is necessary to perform such
      scope of resection which permits to create anastomosis between colon parts
      without their discoordination. The risk of complications from anastomosis
      decreases to 3.7%. The creation of anastomosis with significant discoordination
      leads to high risk of its insufficiency. It is desirable to resect the colon's
      parts with moderate discoordination. When the extension of of resection margins
      due to parts with moderate discoordination is dangerous, it is possible to create
      the anastomosis with ileo- or colostoma. In this case the risk of inflammatory
      complications remains, but conservative treatment of these complications in the
      conditions of feces efflux is effective.

PMID- 11210323
TI  - [Use of topical medicines to reach a definite hemostasis during hepatic
      resection].

PMID- 11210324
TI  - Occupational disease in Connecticut, 2000.
AB  - This study was designed to establish the magnitude and distribution of reported
      occupational diseases in Connecticut based on 1998 data. Occupational disease is
      a reportable disease in Connecticut, yet is under-reported particularly for
      chronic conditions. The number of reported occupational diseases was 3,556 from
      workers' compensation reports, 1,444 from physician reports, and 5,510 from the
      Connecticut OSHA-Labor Department survey. Musculoskeletal disorders dominate the
      reports in all three databases, ranging from 46% to 62% of all illness reports.
      Skin conditions range from 8% to 18%; lung conditions from 9% to 16%; and
      infections from 1% to 18%. There are approximately 1.52 million workers in
      Connecticut, which results in a rate of 36.2 cases of occupational disease per
      10,000 workers based on the Bureau of Labor Statistics figures. These conditions
      are broken down by type, industry, and cause. Improved identification of work
      linkages can lead to better treatment and job placement, as well as improved
      prevention.

PMID- 11210325
TI  - Cytochrome P-450 drug interactions and the selective serotonin reuptake
      inhibiting antidepressants.

PMID- 11210326
TI  - The future of managed care in Connecticut.

PMID- 11210327
TI  - Azithromycin.

PMID- 11210328
TI  - The human side.

PMID- 11210330
TI  - Address of the Executive Director. CSMS House of Delegates--semi-annual meeting 8
      November 2000.

PMID- 11210331
TI  - Prevalence, capsular type distribution, anthropometric and obstetric factors of
      group B Streptococcus (Streptococcus agalactiae) colonization in pregnancy.
AB  - OBJECTIVE: To establish the prevalence, serotype distribution, anthropometry and
      obstetric factors of Group B Streptococcus (GBS) colonization in pregnant women.
      DESIGN: Cross sectional survey. SETTING: Chinhoyi General Hospital. SUBJECTS: 206
      pregnant women attending the antenatal clinic at Chinhoyi General Hospital were
      systematically randomly sampled. MAIN OUTCOME MEASURES: All the isolates were
      serotyped on the basis of capsular polysaccharide (CHO) antigen designated, Ia,
      Ib, II, III, IV and V. RESULTS: 65 (31.6%) were carriers of GBS. The serotypes
      found were, type III (41.8%), type V (37.4%), type Ia (11.0%), type IV (3.3%),
      type Ib (3.3%) type II (1.0%) and 2.0% of the isolates were non-typable. All
      isolates were sensitive to penicillin and resistant to gentamycin. Colonization
      was more common in women with parity 0 to 2 (4.6%) and age group 20 to 24 years
      (43.1%). There was some evidence (p = 0.063) to suggest that GBS was more often
      isolated from the vagina (12.6%) than from the rectum (6.3%). CONCLUSION: There
      was a high prevalence of GBS colonization among pregnant women in Chinhoyi. Types
      III and V were the most common serotypes found.

PMID- 11210332
TI  - Haematology reference values for healthy elderly blacks residing in Harare,
      Zimbabwe.
AB  - OBJECTIVES: To determine reference values for elderly blacks and to compare them
      to those in use in local hospitals and in other countries in the region. DESIGN:
      Cross sectional study. SETTING: Sekuru Kaguvi Hospital, Harare, Zimbabwe.
      SUBJECTS: 151 persons of age 45 years or more. MAIN OUTCOMES MEASURES:
      Haematological parameters investigated were Hb, Hct, MCV, MCH, MCHC, Plt, RBC and
      WBC. RESULTS: 56 males and 95 females tok part in the study. RBC, Hb and Hct mean
      values were significantly higher (p=0.004, p<0.001 and p<0.001, respectively) in
      males than in females. However, no significant differences between sexes were
      found in WBC (p=0.137), MCHC (p=0.273), MCV (p=0.090) and MCH (p=0.074). Platelet
      counts were significantly higher (p=0.040) in females [median (Q1, Q3): 251 (117,
      478)] than in males, 226 (122, 251). These haematogological vales were notably
      different compared with those in current use in local hospitals. The mean values
      obtained for each index were comparable with those obtanied in other countries in
      the same region (Southern Africa) as Harare. The reference values for the elderly
      blacks are presented. CONCLUSION: The importance of gender and population
      specific reference values cannot be over emphasised. The reference values
      obtained in the current study should be appropriate for evaluating haematological
      test results in elderly blacks in Zimbabwe.

PMID- 11210333
TI  - Comparison of wheelchair accessibility of public buildings pre and post the
      International Year of Disabled Persons (IYDP) in Harare, Zimbabwe: a case study.
AB  - OBJECTIVE: To compare the accessibility to wheelchair users of public buildings
      built pre and post the International Year of the Disabled Persons (1981) in
      Harare central business district in Zimbabwe. DESIGN: A case study. SETTING:
      Harare central business district. SUBJECTS: 20 public buildings with at least two
      floors open to all users in the central business district of Harare, Zimbabwe.
      MAIN OUTCOME MEASURES: Wheelchair accessibility of public buildings. RESULTS:
      There were no significant differences in the median percentage compliance of
      parking areas (p = 0.546), ramps (p = 0.155) and toilets (p = 0.648) between the
      buildings built before the International Year of the Disabled Persons (IYDP) and
      those built after the IYDP. The overall median compliance of parking areas, ramps
      and toilets was 14% (Q1 = 14, Q3 = 21), 54% (Q1 = 43, Q3 = 62) and 45% (Q1 =
      31.5, Q3 = 70), respectively. However, there was some evidence (p = 0.067) to
      suggest that compliance of entrances was better IYDP [median = 100% (Q1 = 90, Q3
      = 100)] than pre IYDP [median = 80% (Q1 = 70, Q3 = 100)]. Meanwhile there was a
      significant difference in the median percentage compliance of elevators (p =
      0.014) between pre[median = 90% (Q1 = 80, Q3 = 90)] and post [median = 100% (Q1 =
      100, Q3 = 100)] IYDP. CONCLUSION: Overall compliance was poor. It is recommended
      that people with disabilities and the experts in the area of physical ability
      management be consulted and involved in the design and construction of these
      buildings.

PMID- 11210334
TI  - Tru-cut biopsy of palpable breast lesions: a practical option for pre-operative
      diagnosis in developing countries.
AB  - OBJECTIVES: To establish the role of Tru-cut needle biopsy in the pre-operative
      diagnosis of breast lesions in a developing country. DESIGN: Prospective cross
      sectional study. SUBJECTS: 112 consecutive patients with palpable breast lesions
      who had both Tru-cut and excision biopsy as a pre-operative diagnostic procedure.
      RESULTS: Four (3.6%) patients had specimens that were inadequate for histological
      diagnosis. Tru-cut biopsy diagnosed 42 of the remaining 108 as malignant and 66
      as benign, but only 40 and 61 respectively were confirmed to be correctly so by
      excision biopsy. Tru-cut biopsy, therefore, achieved a sensitivity of 88.9% (95%
      CI 79.7 to 98.1) specificity of 96.8% (95% CI 92.5 to 100) and an over all
      diagnostic accuracy of 93.5% (95% CI 88.9 to 98.2). There was a false positive
      rate of 4.8%, a false negative rate of 7.6% and a positive predictive value of
      95.2%. The pathologist was able to make a correct specific histological diagnosis
      in 76.2% of all the adequate Tru-cut samples. CONCLUSION: If Tru-cut biopsy is
      done instead of excision biopsy, it will sufficiently reduce waiting time and
      reduce cost (four fold). It is well tolerated by patients. We regard the
      procedure as a useful adjunct and indeed a practical option for accurate pre
      operative diagnosis of palpable breast lesions.

PMID- 11210335
TI  - Rectus abdominis myocutaneous flap in reconstruction for advanced male breast
      cancer: case report.
AB  - A case of advanced male breast cancer which masqueraded as recurrent abscess of
      the right breast is presented to highlight the role of contra-lateral rectus
      abdominis pedicled myocutaneous flap in providing adequate skin and soft tissue
      cover in male breast reconstruction. This was carried out for this patient
      following a modified radical mastectomy for stage III (T2b, N2, M0) intraductal
      carcinoma of the breast. The patient has remained well without clinical features
      of distant metastasis at a follow up period of two years despite periodic
      excision of locally recurrent cancer nodules from the affected breast.

PMID- 11210336
TI  - Current concepts in the management of acute ischaemic stroke.

PMID- 11210337
TI  - Diagnosis of neurological infections in AIDS patients: possibilities for
      Zimbabwe.

PMID- 11210338
TI  - Preliminary study of body mass index and its relationship to percent body fat in
      Harare, Zimbabwe.
AB  - OBJECTIVES: The aims of this paper were to document the body mass index (BMI) and
      anthropometric characteristics of the city of Harare urban dwellers of Zimbabwe.
      To investigate the relationship between BMI, sum of skin folds (SSF) and percent
      body fat (PBF). DESIGN: Cross sectional study. SETTING: Designated fitness
      awareness locations in the city of Harare during the 1998 physiotherapy awareness
      week. SUBJECTS: The participants were 140 apparently healthy adults, males (n =
      71) and females (n = 69). MAIN OUTCOME MEASURE: Body Mass Index. RESULT: The
      minimum and maximum values of BMI were 17.7 and 33.3 for men, 17.6 and 47.8 for
      women. BMI was not found to increase with aging but PBF on the contrary did. The
      mean BMI value for the males and females was 24.89 +/- 3.18 and 27.8 +/- 5.89
      respectively. There was no significant difference in mean BMI between sexes (p =
      0.331). Weight was also similar by gender (p = 0.4691). In both sexes, the BMI
      showed a significant positive correlation with PBF, SSF, body weight and age (for
      males r = 0.721, 0.731, 0.900, 0.369, p < 0.01 respectively; and in females r =
      0.786, 0.804, 0.940, 0.404 and p < 0.01 respectively). CONCLUSION: Women were
      found to have higher BMI, PBF, SSF than their male counterparts. On the average,
      men were found to be taller, with no significant difference in weight. There was
      a linear relationship between BMI and PBF, and all the variables investigated
      except age and stature in both sexes. Because of the differences of environment
      and industrialisation, estimation of BMI should involve such factors as
      ethnicity, race, gender and age.

PMID- 11210339
TI  - Ethics and HIV research in Zimbabwe.
AB  - A plethora of articles are now being published in both local and international
      journals on research activities conducted on the human immunodeficiency virus
      (HIV) in Zimbabwe. Some of the bioethical issues they raise, however, are neither
      unique to HIV nor unique to developing countries. In this article we discuss
      several of these issues, including the failure to provide interventions of known
      efficacy, ethical relevance of study design, informed consent, and exploitation.
      A challenge raised by much of the research in HIV/AIDS is whether, or under what
      conditions, it is ethical in research to fail to provide an intervention of known
      efficacy. The further we diverge from this situation, in which an effective, easy
      to implement intervention is available, to situations that resemble the
      controversial international clinical trials to prevent perinatal transmission of
      HIV the less clear the ethical mandate becomes. In relation to clinical trials
      the debate has focused on whether the standard of care in the United States--an
      expensive and complex regimen of Zidovudine--must be provided to all HIV infected
      pregnant women who join a research study in developing countries. Different
      scientists and scholars in bioethics have drawn the line differently in terms of
      what interventions routinely available in the developed world must be provided to
      research participants in developing countries. At an extreme, no one suggests
      that the most expensive and complex of Western tertiary care, for example, renal
      dialysis or coronary bypass, must be provided in research conducted in Zimbabwe.
      Indeed, public debates about the HIV perinatal transmission trials have not even
      focused on whether the women in the trials should be provided with HIV
      combination therapy as they would be in the West or whether they should even have
      the Zidovudine continued post partum.

PMID- 11210340
TI  - Ethical issues in clinical and industry-sponsored research.

PMID- 11210341
TI  - Antiretrovial (ARV) drug utilisation in Harare.
AB  - OBJECTIVE: To investigate ARV utilisation in Harare in order to gather necessary
      data to help in the formulation of treatment guidelines to be used in Zimbabwe.
      DESIGN: A cross sectional study. SETTING: Doctors' rooms and retail pharmacy
      outlets. SUBJECTS: 68 primary care physicians, 80 pharmacists and 92 patients.
      MAIN OUTCOME MEASURES: Number of physicians prescribing antiretroviral agents
      (ARVs) and pharmacists stocking ARVs. Type of ARV utilised, cost to the patient
      and information on ARV available. RESULTS: Out of the 68 private practitioners
      interviewed 18 were prescribing ARVs during the period of study. There were 92
      patients on ARVs whose mean age was 35 +/- 5 years and consuming an average total
      of 17 tablets daily. Thirteen out of the 18 doctors had access to laboratory
      facilities to determine CD4 counts and viral load. The rest were using other
      approaches to treat and manage HIV/AIDS patients. About a quarter, 27.0%, of the
      retail pharmacists stocked ARVs. The majority, 82.0%, of the patients appeared to
      be on Zidovudine (AZT) mainly in combination with other drugs. The most popular
      combination was that of AZT, Lamivudine (3TC) and Indinavir prescribed to 29.0%
      of the patients, followed by that of Didanosine (DDI) and hydroxyurea prescribed
      to 17% of patients. At least 17% of the patients were on AZT monotherapy. There
      was no significant difference (p = 0.06) in the number of tablets consumed by
      patients who had other conditions secondary to HIV infection. Only 39 out of the
      92 patients reported untoward experiences with ARVs. The major problem being
      associated gastro-intestinal disturbance which accounted for 56% of the reports.
      It was not possible to ascertain adherence. CONCLUSION: There appeared to be
      therapeutic anarchy in the private sector in Harare in the way ARVs were being
      used. Patients need to be told that deciding to take one of the combinations
      means making a serious commitment to the drugs on schedule if they want to enjoy
      the benefit. At the same time there is need to develop and publicize HIV/AIDS
      treatment guidelines and effective Information, Education and Communication (IEC)
      materials specific to Zimbabwe.

PMID- 11210342
TI  - Anorectal trauma in children.
AB  - OBJECTIVES: To determine the pattern and magnitude of the problem of anorectal
      injuries at the University of Calabar Teaching Hospital. DESIGN: Prospective
      cross sectional descriptive study. SETTING: Department of Surgery, College of
      Medical Sciences, University of Calabar, Nigeria. SUBJECTS: 51 consecutive
      paediatric patients treated for anorectal injuries over a three year period. MAIN
      OUTCOME MEASURES: Mechanism of rectal injury, contributing factors, anatomic
      region injured, length of hospital stay, complications and outcome.

PMID- 11210343
TI  - Perinatal practices in two rural districts of Zimbabwe: a community perspective.
AB  - OBJECTIVE: To describe perinatal practices from a community perspective and
      identify factors associated with perinatal death. DESIGN: Cross sectional
      community based survey. SETTING: Murewa and Madziwa rural areas, Zimbabwe.
      SUBJECTS: Women aged 15 to 50 years who had been pregnant within the 24 months
      preceding the survey. MAIN OUTCOME MEASURES: Where delivered, where preferred to
      deliver, model of delivery, use of herbs in labour, duration of labour, assistant
      at delivery, time of delivery, condition of baby at birth, resuscitation methods,
      birth weight, initiation of breast feeding, illness in the first week and outcome
      of pregnancy. RESULTS: 644 women were interviewed; 581/644 stated where they
      would have liked to deliver and 505/644 stated where they actually delivered
      their last baby. The majority 369/581 (62.4%) preferred to delivery at a
      government hospital and 240/505 (47.5%) actually delivered at a government
      hospital. Of the home deliveries only 27/581 (4.6%) preferred to deliver at home
      and yet 123/505 (24.4%) actually delivered at home. Primary care clinics were
      less preferred 151/581 (25.5%) as a place for delivery and 89/505 (17.6%)
      actually delivered there. Labour lasting more than 12 hours occurred in 20.4% of
      deliveries. Nurses were the commonest attendants at delivery 309/508 (60.4%) and
      morbidity following delivery was noted in 72/495 (14.5%). Resuscitation was
      carried out in 61/72 infants. Beating/shaking 36/61 (58.0%) and pouring cold
      water over the baby 11/61 (18.0%) were the commonest methods of resuscitation.
      Being delivered by a doctor compared to a nurse and being in Murewa district were
      statistically significant risk factors for mortality with Odds Ratio (OR) 5.21
      (95% CI 2.86 to 9.51) and 3.90 (95% CI 1.51 to 10.09) respectively. The odds of
      dying when delivered by breech extraction were high, but not statistically
      significant OR 3.73 (95% CI 0.92 to 13.97) when compared to being delivered by
      vertex delivery. Labour more than 12 hours, use of herbs in pregnancy and time of
      delivery were not significantly associated with mortality with OR (95% CI) of
      1.02 (0.40 to 2.19), 0.92 (0.00 to 4.38), 1.05 (0.56 to 1.97) respectively. On
      logistic regression analysis only being delivered in Murewa district remained
      significant. CONCLUSION: The utilisation of primary health care centres for
      delivery was unexpectedly low and home deliveries were unacceptably high.
      Increased mortality when delivered by a doctor and high early neonatal morbidity
      suggest poor monitoring and delayed intervention in labour. Infant morbidity
      following delivery was high and methods for neonatal resuscitation inappropriate.
      There is a need for more studies looking into health worker skills particularly
      in the areas of partogram use and neonatal resuscitation in these districts.

PMID- 11210344
TI  - [Cryoglobulins and cryoglobulinemia].

PMID- 11210345
TI  - [Coronary insufficiency and metabolic hormone ratio in patients with myocardial
      infarction in the course of a long prospective study].
AB  - An angiographic study of coronary bed status and relationships of insulin,
      cortisol, somatotropin (ST), T3, T4, glucose in 109 Q-wave myocardial infarction
      (MI) patients aged 47 +/- 0.8 years was performed at rest and during
      veloergometric stress-test ischemia modelling of exercise tolerance in early (21
      26 days) and late (> 5 years) follow-up. The hormones level was found to be
      significantly related to coronary insufficiency as a result of coronary
      atherosclerosis both at rest and during muscular stress-test. Coronary failure
      limiting activity of metabolic processes in the myocardium by chronic hypoxia
      induces changed proportion of hormones regulating energy metabolism processes. In
      MI hypometabolic syndrome is developing with specific hormonal "ischemic profile"
      in which during exercise insulin and thyroxin become leading hormones regulating
      intracellular exchange of energy; the level of cortisol and ST decreases.
      Increased need in glucose as a main energy substrate during ischemia and
      therefore in insulin leads to disturbed carbohydrate metabolism in 33% of
      patients recorded 3-5 years after MI. The above metabolic changes manifest with
      increased glucose tolerance and/or clinical signs of diabetes mellitus.

PMID- 11210346
TI  - [Efficiency of endobronchial laser therapy in patients with chronic bronchitis].
AB  - Clinical effectiveness of endobronchial laser therapy (EBLT) was studied in 18-56
      year-old patients with chronic bronchitis (CB) running for 2-18 years. A parallel
      luminescent and histochemical tests measured histamine, serotonin and
      catecholamines in bronchial mucosa. It was found that alveolar macrophages,
      lymphocytes and mucus of CB patients contain significantly higher amounts of
      histamine and serotonin though low amounts of catecholamines than those of
      healthy subjects. Levels of monoamines in alveolar macrophages, lymphocytes,
      neutrophils, mast and APUD cells, mucus in of CB patients correlated with the
      disease phase, duration, features of endobronchitis, bronchial obstruction and
      severity of respiratory insufficiency. EBLT produced a positive effect on CB
      course and bronchial mucosa bioamines. It was superior to conventional therapy in
      lowering of histamine and serotonin in alveolar macrophages, lymphocytes and
      mucus as well as in raising catecholamines.

PMID- 11210347
TI  - [Fibrinolytic therapy of patients with pulmonary artery thromboembolism by tissue
      plasminogen activator and streptokinase preparations].
AB  - Changes in clinical and hemodynamic indices, hemostatic system during therapy
      with plasminogen tissue activator and streptokinase drugs were studied in 49
      patients with massive and submassive forms of pulmonary thromboembolism.
      Conduction of fibrinolytic therapy with plasminogen tissue activator vs
      streptokinase produced more marked and rapid change in the main hemodynamic
      parameters which characterized blood recovery in pulmonary artery. A correlation
      was revealed between the change in hemostatic system after thrombolytic therapy
      and development of hemorrhagic complications. Preferable introduction of
      plasminogen tissue activator is shown when thromboemboli locate in the trunk or
      in both main pulmonary arteries and in the presence of an occlusive lesion in
      lobular arteries.

PMID- 11210348
TI  - [Six-minute walking test for the evaluation of the status of patients with
      chronic cardiac failure].
AB  - The paper presents the results of application of the modified 6-minute walking
      test for assessment of exercise tolerance in follow-up of patients with ischemic
      heart disease (IHD) complicated by chronic cardiac failure (CCF). At admission
      and after 3-4 weeks of treatment 52 IHD patients underwent the walking test and
      described subjective effects according to modified Borg's questionnaire. The
      repeated test registered increased walking distance and subjective response. The
      results of the study confirm validity of using 6-minute walk test in combination
      with modified Borg questionnaire in routine hospital and outpatient practice as a
      simple, safe and informative method of control over IHD patients' condition and
      assessment of their treatment efficacy.

PMID- 11210349
TI  - [Psychovegetative changes and their correction in patients with peptide ulcer].
AB  - The study of the psychovegetative status in 106 duodenal ulcer patients
      discovered alterations in this status. Different treatments were employed, among
      them--acupuncture with low-frequency alternating magnetic field. The latter had a
      positive effect on emotional and personality spheres, vegetative regulation,
      shortened the relief of the basic symptoms, scarring of the ulcer defect.

PMID- 11210350
TI  - [Effects of halotherapy on free radical oxidation in patients with chronic
      bronchitis].
AB  - Registration of luminol-dependent chemoluminescence of blood cells and iron
      induced chemoluminescence of the serum was used to study generation of active
      oxygen forms and lipid peroxidation in patients with chronic bronchitis (CB). 49
      patients with lingering CB showed inhibition of blood cell function and
      enhancement of lipid peroxidation. The addition of halotherapy to combined
      treatment of these patients promoted correction of the disorders and improvement
      of CB course.

PMID- 11210351
TI  - [Genetic aspects of essential arterial hypertension (summing up the 8th and 9th
      European Conferences on Arterial Hypertension].

PMID- 11210352
TI  - [Renal involvement in convalescents after icterohemorrhagic leptospirosis].
AB  - Icterohemorrhagic spirochetosis convalescents develop slowly regressing renal
      dysfunctions most frequent of which are chronic renal failure, pyelonephritis and
      tubulointersticial nephritis, arterial hypertension. Renal disorders may be due
      to immunopathological reactions followed by activation of bacterial microflora.
      Damage from commissures at the sites of prior hemorrhage is also possible. In
      bovine leptospirosis renal damage is not so severe but it tends to progression.
      So, renal affection in leptospirosis is a specific pathology observed in any
      clinical form of the disease and demands surveillance in the regions of local
      focuses.

PMID- 11210353
TI  - [Therapy of patients with chronic pancreatitis of alcoholic etiology by dalagrin
      and laser therapy of the blood].
AB  - Effectiveness of dalargin and intravenous laser blood beaming (ILBB) in combined
      treatment of chronic alcoholic pancreatitis (CAP) was studied in 105 patients (8
      females and 97 males) with CAP duration 1 to 25 years. Pancreatic function and
      treatment effects were studied by routine clinical investigations, advanced
      laboratory, biochemical tests, radioimmunossays. Pancreatic disorders in
      alcoholics present with high blood levels of trypsin and lipase, low levels of
      insulin and C-peptide. Serum concentrations of hydrocortisone and gastrin were
      elevated. Combined treatment of CAP with adjuvant dalargin and ILBB not only
      relieves clinical symptoms but also promotes normalization of pancreatic
      function.

PMID- 11210354
TI  - [Effect of dilren on hemodynamics of patients with essential hypertension].
AB  - Changes in hemodynamics and circadian rhythms in the course of dilren-300
      treatment were studied in 20 patients with hypertension stage II. Tetrapolar
      chest rheography, echo-CG, ECG, measurements of arterial pressure by N. S.
      Korotkov were made 6 times a days (at 2, 6, 10 a.m. and 2, 6, 10 p.m.). The
      information was processed statistically. Dilren -300, administered at 8.00 a.m.
      for 10 days, had a hypotensive, vasodilating and weak negative chronotropic
      effect. The drug reduced myocardial energy consumption, eliminated circadian
      rhythms of heart rate, arterial pressure, cardiac performance and others observed
      before the treatment.

PMID- 11210355
TI  - [Laxigal effectiveness in constipation of various etiology].
AB  - The efficiency of laxigal (sodium picosulfate) was evaluated in 66 patients aged
      38-73 years with the irritated bowel syndrome (IBS), inert colon, and
      dolichocolon. Twenty-eight patients had defecations twice a week, 26 once a week
      or less. Twelve patients had no spontaneous defecations. Laxigal was administered
      in a dose of 10-24 droplets before sleeping. Good effect was attained in 42 (64%)
      patients and satisfactory in 24 (36%). Good effect is more often observed in
      patients with IBS and dolichocolon, while in patients with inert colon the
      results were usually no better than satisfactory. After long (3 weeks and longer)
      therapy with laxigal its dose could be reduced by 30-50% without loss of effect.
      Laxigal induces no diarrhea, abdominal pain, decrease in electrolyte composition
      or other serum shifts, does not disorder hepatorenal functions.

PMID- 11210356
TI  - [Difficulties in the diagnosis and modern approaches to therapy of the
      thromboembolism of small branches of the pulmonary artery].

PMID- 11210357
TI  - [Diagnostic and therapeutic policy in nodular goiter].

PMID- 11210358
TI  - [A case of total variable immunodeficiency].

PMID- 11210359
TI  - [Difficulties in differential diagnosis of pericardial effusion].

PMID- 11210360
TI  - [Development of the idea of staged clinical education (1842-1845). Communication
      1. The decision to establish departmental and hospital ambulatory clinics at the
      Medical Department of Moscow University].

PMID- 11210361
TI  - [Memorable dates from the history of medicine in 2000].

PMID- 11210362
TI  - [Pathophysiology of cardiovascular disorders in obstructive respiratory distress
      during sleep].

PMID- 11210363
TI  - [Principles for constructing an image of the world. The Hippocratic manuscript De
      aeribus and the search for the middle of the world].

PMID- 11210364
TI  - ["Hebraeorum Hippokrates rei medicae peritissimus fuit." On the reception of
      pseudo-Solomon metaphors on old age (Koh. 12.1-6) in early modern medicine].

PMID- 11210365
TI  - ["Quod naturae ipsae sint morborum medicatrices." Hippocratism of Georg Ernst
      Stahl].

PMID- 11210367
TI  - [Ethical guidelines, patient rights and physician behavior in clinical drug
      trials (1892-1931)].

PMID- 11210366
TI  - [Ernst Haeckel and Rudolf Virchow: the dispute over the character of science in
      the controversy over Darwinism].

PMID- 11210368
TI  - ["Slippery slope", evaluation and self-evaluation: on the history of the
      euthanasia debate in the periodical Ethics].

PMID- 11210369
TI  - [The "medico-historical cabinet". A forgotten collection in the Nurnberg Germanic
      National Museum].

PMID- 11210370
TI  - Assumptions concerning orthogonality in threshold-scaled versus cone-contrast
      colour spaces.

PMID- 11210371
TI  - Risking ethical insolvency: a survey of trends in criminal DNA databanking.

PMID- 11210372
TI  - Expert testimony by persons trained in ethical reasoning: the case of Andrew
      Sawatzky.

PMID- 11210373
TI  - Commentary: the wizard of oughts.

PMID- 11210374
TI  - Commentary: weighing and comparing expert testimony by medical ethicists.

PMID- 11210375
TI  - Rebuttal: expert ethics testimony.

PMID- 11210376
TI  - Response: Narcissus meets Pandora.

PMID- 11210377
TI  - Genetic privacy laws and patients' fear of discrimination by health insurers: the
      view from genetic counselors.

PMID- 11210378
TI  - A survey of physician training programs in risk management and communication
      skills for malpractice prevention.

PMID- 11210379
TI  - Language and reality at the end of life.

PMID- 11210380
TI  - Is there a lingua franca for bioethics at the end of life?

PMID- 11210381
TI  - A concise rebuttal.

PMID- 11210382
TI  - Lessons to be learned from Harvard Pilgrim HMO's fiscal roller coaster ride.

PMID- 11210383
TI  - Administrative developments: new human subject research guidelines for IRBs.

PMID- 11210384
TI  - Employment: NLRB empowers residents to unionize.

PMID- 11210385
TI  - ERISA: U.S. Supreme Court holds treatment decisions made by HMO physician
      employees do not breach fiduciary duty.

PMID- 11210386
TI  - ERISA: health benefit plans discriminating against providers.

PMID- 11210387
TI  - Ethics: English high court orders separation of conjoined twins.

PMID- 11210388
TI  - Discovery issues: confidentiality of medical board records.

PMID- 11210389
TI  - Evidence: Supreme Court of Georgia denies law firm access to hospital records.

PMID- 11210390
TI  - Policy: Kaiser Commission report on personal perspectives.

PMID- 11210391
TI  - Medicare: coverage approved for participation in clinical trials.

PMID- 11210392
TI  - A look at the safety profile of over-the-counter naproxen sodium: a meta
      analysis.
AB  - As the trend for Americans to self-medicate continues to increase, it becomes
      important to review the safety of over-the-counter (OTC) medications. This
      article will review the safety of an OTC analgesic, Aleve (naproxen sodium). The
      objective of this meta-analysis is to evaluate the frequency of occurrence of all
      adverse events in subjects taking various doses of OTC naproxen sodium as
      compared to placebo. These varying doses and dosage regimens were studied
      individually and consisted of 220 to 880 mg administered in single, multiple, and
      PRN (as needed) doses of naproxen sodium. This meta-analysis confirmed the
      favorable safety profile of naproxen sodium at OTC doses and established that the
      overall occurrence of adverse events with naproxen sodium was comparable and in
      some cases significantly lower than placebo. These results indicate that
      treatment with naproxen sodium may be highly beneficial from a clinical and
      economical perspective and safe when adhering to labeled directions.

PMID- 11210393
TI  - Pharmacokinetic/pharmacodynamic evaluation of the NHE inhibitor eniporide.
AB  - The aim of this study was to investigate the pharmacokinetics and
      pharmacodynamics of the new cardioprotective sodium/proton exchange (NHE-1)
      inhibitor eniporide in humans. Eniporide was administered intravenously to
      healthy volunteers in doses between 2.5 and 100 mg. Concentrations of parent drug
      and its metabolite were measured by HPLC, and the data were analyzed by
      noncompartmental and compartmental pharmacokinetic methods. Platelet-swelling
      time was determined in each subject as a biomarker to assess pharmacodynamic
      activity. Eniporide showed linear pharmacokinetics with an average half-life of
      approximately 2 hours. The mean total body clearance was 34.4 L/h. The mean
      volume of distribution (Vdss) was 77.5 L, and the mean residence time was 2.3
      hours. An average of 43% of the dose was recovered unchanged from urine. A
      pharmacokinetic two-compartment model was found suitable to provide excellent
      curve fits of the measured plasma concentration profiles. Plasma concentrations
      of the major metabolite were lower than that of the parent drug. An average of
      27% of the dose was found in urine as that metabolite. The effect on platelet
      swelling could be well characterized by a direct Emax model. The average
      concentration for half-maximum effect (IC50) was 12 ng/mL. Eniporide was found to
      have predictable linear pharmacokinetics in the investigated dose range. Platelet
      swelling time was shown to be a reproducible individual biomarker for
      pharmacodynamic activity, with great potential for a surrogate that predicts
      clinical outcome, since this effect is mediated through the same mechanism of
      action (NHE-1 inhibition) as the desired cardioprotective activity.
      Pharmacokinetic/pharmacodynamic modeling allowed a first estimate of the degree
      of NHE inhibition in the investigated dose range.

PMID- 11210394
TI  - Pharmacodynamic modeling of pantoprazole's irreversible effect on gastric acid
      secretion in humans and rats.
AB  - The relationship between the pharmacokinetics of pantoprazole, an irreversible
      proton pump inhibitor, and its effect on gastric acid secretion was evaluated in
      humans and rats. Pantoprazole pharmacokinetics were studied in 6 rats (5 mg/kg,
      i.v.) and 22 healthy volunteers (10 to 80 mg, i.v. and oral). Gastric acid
      secretion under maximum pentagastrin stimulation was measured after i.v.
      administration of placebo or pantoprazole in 31 rats (0.12 to 1.15 mg/kg) for 4
      hours and in 31 subjects (20 to 120 mg) for 24 hours. Pantoprazole has short half
      lives of 0.5 hours in rats and 0.8 hours in humans. After administration of the
      highest dose, acid secretion was fully inhibited within 1 hour and for the whole
      observation period in both species. An irreversible pharmacodynamic response
      model was successfully developed and validated. The apparent reaction rate
      constants of pantoprazole with the proton pumps were 0.691 L/mg/h in rats and
      0.751 L/mg/h in humans, and the apparent recovery rates of the pumps were 0.053 h
      1 and 0.031 h-1, respectively. The maximum inhibition and the overall effect of
      pantoprazole are related to exposure, and the onset is related to initial
      pantoprazole concentrations. It was concluded that this irreversible response
      model accurately describes the effect of i.v. and oral pantoprazole on gastric
      secretion and may be used to predict effects under other dosage regimens.

PMID- 11210395
TI  - Theophylline metabolism after cardiac surgery.
AB  - The effect and metabolism of theophylline administration after cardiac surgery
      has never been reported. Two series of 2-hour intravenous aminophylline
      administrations (3 mg/kg/h) were conducted in 10 adult patients on the operative
      day (acute phase) and on the 4th or 5th postoperative day (recovery phase). Both
      blood and urine samples were collected for 24 hours after dosing. Heart rate
      increased in both phases, but the cardiac index increased with the decrease of
      diastolic blood pressure only in the acute phase (p < 0.05). Plasma concentration
      levels of theophylline tended to be slightly higher in the acute phase, and renal
      clearance increased in the recovery phase (p < 0.05). The urinary ratio of 3
      methylxanthine to theophylline was significantly higher in the acute phase (p <
      0.05). This suggests that cytochrome P4501A2 is partially activated rather than
      depressed and that N-demethylation is promoted more than hydroxylation
      immediately after surgery.

PMID- 11210396
TI  - Pharmacokinetic and pharmacodynamic modeling of NN703, a growth hormone
      secretagogue, after a single po dose to human volunteers.
AB  - The objective of this study was to describe the pharmacokinetics and
      pharmacodynamics of NN703, a growth hormone (GH)-releasing secretagogue, after po
      administration to healthy human male subjects. The study was designed as a
      randomized, placebo-controlled, double-blind, dose-escalating, single-dose trial
      of NN703 covering eight dose levels. Each of the dose levels had 6 subjects on
      active treatment and 2 subjects on placebo. NN703 was administered po as a
      solution. Blood samples for serum concentrations of NN703 and GH were collected
      before dosing and up to 24 hours after dosing. Serum concentrations of NN703 were
      determined using a validated analytical method, based on solid-phase extraction
      and LC/MS/MS detection. A two-compartmental model with zero-order input was used
      to describe the pharmacokinetics of NN703. The parameters of the elimination
      phase were fitted simultaneously, whereas the parameters describing the
      absorption phase were allowed to vary between the dose levels. The
      pharmacodynamics of NN703 was described by use of an indirect-response model
      containing both a threshold value and a modulator for the development of
      tolerance. It was concluded that the absorption of NN703 after po administration
      was nonlinear; the bioavailability increased with the dose. The serum
      concentration of NN703 required for half-maximal stimulation of GH was determined
      to be 485 ng/ml. The proposed indirect-response model requiring a threshold
      concentration and development of tolerance provided a useful mean of quantifying
      the effects of NN703. Furthermore, the development of tolerance shown based on
      pharmacokinetic/pharmacodynamic modeling of single-dose data presented here has
      been confirmed following multiple dosing in healthy male subjects.

PMID- 11210397
TI  - Pharmacokinetics of naratriptan in adolescent subjects with a history of
      migraine.
AB  - Naratriptan is a novel 5-HT1 agonist developed to treat acute migraine. The study
      objective was to characterize the pharmacokinetics of oral naratriptan in
      adolescent migraine patients outside a migraine attack. Subjects received a
      single 2.5 mg naratriptan tablet. Serial serum samples for naratriptan
      concentrations were collected over 24 hours. Blood pressure, pulse rate, and 12
      lead ECG were recorded at baseline and at regular intervals after dosing. Seven
      patients--3 males and 4 females, 12 to 16 years of age--received drug and
      completed the study. The geometric mean and 95% confidence interval maximum
      concentration (Cmax) was 8.0 ng/mL (5.9-10.7), elimination half-life (t1/2) was
      4.9 hours (4.5-5.4), area under the concentration-time curve (AUC) was 74.6
      ng.h/mL (56.6-98.2), and apparent total clearance (Cl/F) was 558.8 mL/min (424.3
      735.9). The median time to maximal concentration (tmax) was 4 hours, with a range
      of 1.5 to 4. Blood pressure, pulse rate, and ECG parameters did not change
      significantly from baseline. No serious adverse events or subject withdrawal
      after drug administration occurred. Oral naratriptan pharmacokinetic parameters
      in adolescents were similar to values reported in adults. Naratriptan doses for
      adolescents older than 12 years of age would be expected to be similar to adult
      doses.

PMID- 11210398
TI  - Effect of low- and high-fat meals on tacrolimus absorption following 5 mg single
      oral doses to healthy human subjects.
AB  - Tacrolimus (FK506, Prograf) is a macrolide lactone antibiotic widely used by the
      oral route for the prophylaxis of organ rejection in patients who have received
      allogenic liver or kidney transplants. This study investigated the influence of a
      high- versus a low-fat meal, relative to the fasting state (three treatments
      total), on the rate and extent of tacrolimus absorption following a single 5 mg
      oral dose. The protocol employed a three-period, randomized, crossover design
      employing 5 x 1 mg capsules in 15 healthy male nonsmoking, drug-free volunteers,
      20 to 45 years of age, who were within 15% of their ideal body weight. Food had a
      clinically significant effect in reducing relative bioavailability, as well as
      slowing absorption, but did not affect terminal exponential half-life
      (approximately 34 hours). Mean maximum tacrolimus blood concentration (Cmax)
      values were 25.6, 5.88, and 9.03 ng/mL for the fasting, high-fat, and low-fat
      treatments, respectively; mean area under the blood concentration-time curve
      (AUC(0-infinity) values were 272, 181, and 201 (ng/mL)-h, respectively; and mean
      time of Cmax (tmax) values were 1.37, 6.47, and 3.20 hours, respectively.
      Differences in parameters between the fasting and each fed treatment were
      statistically significantly different (p < 0.05). Statistically significant
      differences also existed in tmax between the two meals. Results also indicated
      the safety of single 5 mg oral tacrolimus doses administered to healthy
      volunteers.

PMID- 11210399
TI  - The influence of food on the bioavailability of a twice-daily controlled release
      carbamazepine formulation.
AB  - Carbatrol, a new dosage form of carbamazepine (CBZ), was developed consisting of
      three different types of pellets (immediate release, controlled release, and
      enteric release). The objective of this study was to explore the influence of
      food on absorption of CBZ. This was a randomized, open-label, single-dose
      crossover study conducted in 12 healthy volunteers. Treatments were 2 x 200 mg
      Carbatrol with a high-fat meal, fasted, or sprinkled over applesauce (but
      otherwise fasted). Each subject received one dose of each treatment separated by
      a washout period of at least 2 weeks. CBZ bioequivalence was established based on
      the equivalence of AUC (extent of absorption) in all three conditions. Carbatrol
      may be taken with or without food or the capsule opened and sprinkled on food.

PMID- 11210400
TI  - Lack of effect of food on the pharmacokinetics of an extended-release oxybutynin
      formulation.
AB  - The effect of food on the pharmacokinetics of 15 mg oxybutynin XL was evaluated
      in a single-dose, randomized, crossover, open-label study in healthy volunteers.
      A validated, stereospecific, high-performance liquid chromatography assay was
      used to simultaneously determine the plasma concentrations of R- and S-oxybutynin
      and active metabolite R- and S-desethyloxybutynin. The mean AUC and Cmax values
      for each of the four analytes in the fed treatment were within +/- 20% of the
      fasting treatment values. The 90% confidence intervals for the treatment ratios
      (fed/fasted) for log-transformed Cmax and AUCinf values for the drug isomers and
      AUCinf values for the metabolite isomers were all within the 80% to 125% range.
      Only the ranges for the Cmax values for R- and S-desethyloxybutynin were slightly
      wider but were well within the 70% to 143% criteria recommended for Cmax when
      comparing effect of food. Lack of effect of food on oxybutynin XL is consistent
      with the previous observation that the osmotically controlled formulations are
      nearly insensitive to the gastrointestinal environment, including food.
      Oxybutynin XL was well tolerated, and the safety results were comparable whether
      administered alone or with food. In conclusion, oxybutynin XL administration does
      not require any caution to be exercised regarding food.

PMID- 11210401
TI  - Sevelamer hydrochloride (Renagel), a nonabsorbed phosphate-binding polymer, does
      not interfere with digoxin or warfarin pharmacokinetics.
AB  - Sevelamer hydrochloride (Renagel) is a nonabsorbed phosphate-binding polymer
      marketed for the treatment of hyperphosphatemia in adult patients receiving
      hemodialysis. Sevelamer also exhibits bile acid-binding properties resulting in
      LDL cholesterol lowering. Potential drug interactions between digoxin and
      warfarin and sevelamer were studied. These two drugs were chosen because they are
      known to bind to the bile acid-binding polymers, cholestyramine and colestipol.
      Studies were single dose, crossover, with or without six 2.4 g doses of
      sevelamer. Plasma concentrations were determined using validated analytical
      methods. The pharmacokinetic profiles of digoxin and warfarin were not altered by
      the simultaneous and continued administration of sevelamer. Values for the ratio
      of ln[AUC(0-infinity)], ln[AUC(0-t)], and ln[Cmax] with and without sevelamer
      were close to 100%, and the 90% confidence intervals for these ratios were within
      the 80% to 125% range. It was concluded that sevelamer does not interfere with
      the absorption or excretion of digoxin or warfarin.

PMID- 11210402
TI  - Sevelamer hydrochloride (Renagel), a phosphate-binding polymer, does not alter
      the pharmacokinetics of two commonly used antihypertensives in healthy
      volunteers.
AB  - Sevelamer hydrochloride (Renagel) is a nonabsorbed phosphate-binding polymer
      approved for the treatment of hyperphosphatemia in adult hemodialysis patients.
      The authors studied the potential effect of sevelamer on the pharmacokinetics of
      two antihypertensive drugs, enalapril (20 mg) and metoprolol (100 mg), commonly
      used in end-stage renal disease patients. Two studies were conducted. Both were
      single dose, crossover design with or without a 2.4 g dose of sevelamer in
      healthy volunteers. Within each study, there was a 7-day washout interval between
      the two dose administrations. There were 28 volunteers in the enalapril study and
      32 in the metoprolol study. The mean plasma concentrations versus time profiles
      of enalapril, enalaprilat, and metoprolol were not altered by the simultaneous
      administration of sevelamer. Values for the ratio of ln[AUC(0-infinity)],
      ln[AUC(0-t)], and ln(Cmax] with and without sevelamer were approximately 100%,
      and the 90% confidence intervals for the ratios of these parameters with and
      without sevelamer were within the 80% to 125% range in all cases except for the
      ln[Cmax] of enalapril, which had an upper confidence bound of 125.4%. The authors
      conclude that sevelamer does not interfere with the absorption and elimination of
      enalapril and metoprolol.

PMID- 11210403
TI  - Lack of interaction between levofloxacin and oxycodone: pharmacokinetics and drug
      disposition.
AB  - Previous studies have demonstrated a significant reduction in the oral
      bioavailability of trovafloxacin and ciprofloxacin when administered
      concomitantly with an intravenous opiate such as morphine. This decrease in
      absorption results in a 36% and 50% lower AUC for trovafloxacin and
      ciprofloxacin, respectively, which could cause clinical failures. The authors
      investigated the possibility of a similar interaction between oxycodone and
      levofloxacin. Eight healthy volunteers were randomized in an open-label, two-way
      crossover study to receive oxycodone, 5 mg p.o. Q4H, and levofloxacin, 500 mg
      p.o. 1 hour after starting the oxycodone or levofloxacin 500 mg p.o. alone. Blood
      samples were drawn at 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours for
      Cmax, tmax, and AUC determinations. There was not a significant difference (p >
      0.05) in AUC (48.59 +/- 8.52 vs. 49.9 +/- 9.93), Cmax (7.73 +/- 2.6 vs. 6.6 +/-
      2.0), and tmax (1.1 +/- 0.6 vs. 1.6 +/- 1.1) for levofloxacin versus
      levofloxacin/oxycodone regimens. It was concluded that oral oxycodone and
      levofloxacin can be administered concomitantly without a significant decrease in
      AUC, Cmax, or tmax.

PMID- 11210404
TI  - Lack of an effect of azithromycin on the disposition of zidovudine and
      dideoxyinosine in HIV-infected patients.
AB  - Two studies were conducted in HIV-infected subjects to assess the potential for
      azithromycin to interact with zidovudine and dideoxyinosine. Both studies used 12
      subjects. The zidovudine study dosed subjects with 1200 mg/day of azithromycin (n
      = 7) (later changed to 600 mg/day [n = 5]) for Days 8 to 21 of a 21-day course of
      100 mg, five times/day of zidovudine. Subjects treated with 200 mg of
      dideoxyinosine twice daily for 21 days received 1200 mg of azithromycin or an
      equivalent amount of placebo/day for Days 8 to 21. Antiretroviral plasma and
      urine sampling were conducted on Days 1, 7, and 21 for zidovudine and on Days 7
      and 21 for dideoxyinosine. Peripheral mononuclear cells were also collected for
      quantitation of phosphorylated zidovudine. Azithromycin had no significant impact
      on the Cmax and AUC of zidovudine, although it significantly decreased the
      zidovudine tmax by 44% and increased the intracellular exposure to phosphorylated
      zidovudine by 110%. Azithromycin had no significant effect on dideoxyinosine
      pharmacokinetics. Based on the results of these studies, it is concluded that
      azithromycin may be safely coadministered with both zidovudine and
      dideoxyinosine.

PMID- 11210405
TI  - Evaluation of the potential pharmacokinetic interaction between almotriptan and
      fluoxetine in healthy volunteers.
AB  - This study was designed to assess the pharmacokinetics of almotriptan, a 5HT1B/1D
      agonist used to treat migraine attacks, when administered in the presence and
      absence of fluoxetine. Healthy male (n = 3) and female (n = 11) volunteers
      received (1) 60 mg fluoxetine daily for 8 days and 12.5 mg almotriptan on Day 8
      and (2) 12.5 mg almotriptan on Day 8, according to a two-way crossover design.
      Plasma and urinary almotriptan concentrations were measured by HPLC methods.
      Treatment effects on pharmacokinetic parameters were assessed by analysis of
      variance. Mean almotriptan Cmax was significantly higher following combination
      treatment with fluoxetine (52.5 +/- 11.9 ng/ml vs. 44.3 +/- 10.9 ng/ml, p =
      0.023). Mean AUC0-infinity was not significantly affected by fluoxetine
      coadministration (353 +/- 55.7 ng.h/ml vs. 333 +/- 33.6 ng.h/ml, p = 0.059).
      Confidence interval analysis (90%) of log-transformed pharmacokinetic parameters
      showed that the confidence interval for AUC0-infinity was within the 80% to 125%
      limit for equivalence, but Cmax was not (90% CI 106%-134% of the reference mean).
      Adverse events were mild to moderate in intensity, and no clinically significant
      treatment effects on vital signs or ECGs were observed. The results show that
      fluoxetine has only a modest effect on almotriptan Cmax. Concomitant
      administration of the two drugs is well tolerated, and no adjustment of the
      almotriptan dose is warranted.

PMID- 11210406
TI  - Visual hallucination and tremor induced by sertraline and oxycodone in a bone
      marrow transplant patient.
AB  - The authors report a case of probable serotonin syndrome caused by the
      coadministration of sertraline and oxycodone. A 34 year-old male patient
      experienced visual hallucinations and severe tremor after dramatically increasing
      his dosage of oxycodone while on stable amounts of sertraline and cyclosporin.
      Discontinuation of cyclosporin did not result in resolution of his symptoms.
      Consideration of a possible sertraline-oxycodone interaction led to withholding
      sertraline, which resulted in symptom resolution. Serotonin syndrome has been
      noted with sertraline in combination with other drugs, but this is the first
      report in combination with a narcotic analgesic. Possible pharmacological
      mechanisms are discussed. In complicated patients that are taking multiple
      medications, physicians should be aware of this possible interaction to avoid
      delay in the diagnosis of serotonin syndrome.

PMID- 11210407
TI  - [Composition of circulating immune complexes in acute toxoplasmosis].
AB  - The circulating immune complexes (CIC) that form in the hot just in early
      Toxoplasma gondii invasion can be present in the blood bed for a while. At the
      same time, the data on the antigenic composition of CIC in toxoplasmosis are
      fragmentary and rather contradictory. The investigation used enzyme immunoassay
      (EIA) to detect specific CIC that contain antigens to T. gondii tachyzoites in
      the sera of different populations and studied their antigenic composition by
      immunoblotting after 2-6% polyethylene glycol 6000-induced deposition. Examining
      464 sera from groups of individuals with varying-stage T. gondii invasion
      indicated CIC in each, but showing their different frequency. CIC were virtually
      present in all sera from children who had been diagnosed as having congenital
      toxoplasmosis. In groups of seropositive pregnant women, CIC detection rates were
      noticeably higher in the samples showing both IgG and IgM antibodies (40.2 and
      66.4%, respectively). CIC were also revealed in 9.8% of the seronegative blood
      donors; however, immunoblotting failed to confirm that they had no components
      that specifically reacted with T. gondii tachyzoite antigen antibodies. There
      were some differences in the composition of CIC in the serum yielding positive
      results in both EIA and immunoblotting. The serum CIC from pregnant women that
      exhibited only IgG antibodies contained mainly T. gondii antigens having
      molecular weights of 67 and 30 kD. The serum CIC from children with congenital
      toxoplasmosis and from pregnant women with serologically detected IgM antibodies
      to Toxoplasma antigens were found to contain 55-58-, 48-, 44-, 38-, 30-, and 26
      kD components. The same molecular weight proteins were detected by
      electrophoretic studies of Toxoplasma excretory-secretory antigen (ESA).
      Comparing the findings suggests that in acute toxoplasmosis, the circulating
      complexes mainly contain ESA of the tachyzoites which appear in human blood just
      at the onset of invasion. Thus, this study demonstrates that specifically CIC are
      detectable in the sera of individuals infected with T. gondii and their antigenic
      composition varies with the stage of disease. In the authors' opinion, the
      detection of specific CIC and the determination of their antigenic composition
      may be serve an additional test in diagnosing acute toxoplasmosis.

PMID- 11210408
TI  - [Phenotypic variability in P. vivax with short- and long-term incubation period].
AB  - The combined transmission of P. vivax phenotypes was studied. The phenotypes were
      determined by the duration of a latent parasitic development stage by comparing
      the intervals from first manifestations of malaria with short- and long-term
      incubations to its relapse. The study used data on 2493 patients treated with
      chloroquine (900 mg base for adults) alone at follow-ups in the North-Eastern
      Delhi (India) in 1988-1992. The combined transmission of P. vivax phenotypes was
      shown to differ in malaria with short- and long-term incubation. The P. vivax
      phenotype with manifestations on an average a year following infection in
      patients with mainly short-term incubation malaria and that with manifestations
      on an average year and a half after infection in a group of patients with primary
      long-term incubation malaria were significantly more frequently. Long-term
      incubation malaria shows simultaneously a larger number of phenotypes than does
      short-term incubation one. Patients with long-term incubation malaria display a
      combination of 2 phenotypes (6%) significantly less frequently than that of 3
      different phenotypes or more (17%). The similar combinations were observed in the
      equal number of patients with short-term incubation malaria (7%).

PMID- 11210409
TI  - [Adaptive property of hantaviruses during their isolation from cultured VERO-E6
      cells in relation to the type of the ecological host].
AB  - As a result of virological studies, 185 lung tissue specimens from 4 rodent
      species caught near Khabarovsk were isolated and fixed in the passages of
      cultured Vero-6 cells of 68 hantavirus strains. The capacity of the strains to
      adapt to the cells was assessed by using the adaptive index involving the mean
      rates of successful isolation, its duration, hantavirus antigen titer in the
      material used for infection. The strains of hantavirus serotypes were noted for
      the highest adaptive properties, which are ecologically associated with rodents
      of the family Mus, such as field and East-Asiatic mice. Lower adaptive capacities
      were established for the strains of hantavirus serotypes, which are ecologically
      related to rodents of the family Cricetidae, such as large and large-toothed
      redback voles. The differences found in the adaptive capacities of hantavirus
      strains cultured in Vero-E6 cells reflect the degree of specialization of some
      hantavirus serotypes to particular host rodent species during their long-term
      coevolution.

PMID- 11210410
TI  - [Duration of the larvicidal effect of spore crystalline mass of bacteria Bacillus
      thuringiensis spp. israelensis and Bacillus sphaericus in the laboratory
      setting].
AB  - The duration of action of sporocrystalline mass of Bacillus thuringiensis spp.
      Israelensis (Bti) and Bacillus sphaericus (Bsph) against three-age larvae of An.
      stephensi mosquitoes was studied in the laboratory setting. The duration of
      action depends on its initial concentration. The optimal concentration should be
      at least 10(5) spores/ml for An. stephensi larvae. Decreasing the concentration
      reduces the duration of larvicidal action. Increasing the number of the larvae
      placed also diminishes the duration of action shown by Bti. This has no
      significant influence on the duration of action by Bsph. The presence of dead
      larvae in the test vessel increases the duration of action by Bti only by 4 times
      whereas Bsph acts rather long. The follow-ups lasted 60 weeks with full death of
      the larvae placed again. A significant water resistance of Bti sporocrystalline
      mixture was found. The mixture retained its larvicidal activity 6 months
      following its presence in the dechlorinated water without larval placement. Bsph
      was less resistant and its complete inactivity was noted under the same
      conditions just following 2 months.

PMID- 11210411
TI  - [Homeopathic preparation Cheblin-CK-1 in the pathogenetic therapy of
      echinococcosis].
AB  - This study was experimental and clinical. The experiments were made on 80 cotton
      rats. The clinical study covered 289 patients operated on for echinococcosis.
      Earlier studies indicated that echinococcosis is accompanied by secondary
      immunodeficiency and amino acid metabolic disorders. The homeopathic drug Cheblin
      CK-1 used normalized amino acid metabolism 40 days after treatment in these
      patients. The same properties were displayed by homeopathic drugs.

PMID- 11210412
TI  - [Improving the sanitary and epidemiologic surveillance system is a necessary
      condition for enhancing the efficiency of preventive measures against parasitic
      diseases].
AB  - The paper presents a pattern of the improved sanitary and epidemiological
      surveillance system against parasitic diseases in Russia at the present stage. A
      great deal of species of causative agents of parasitic diseases, a great variety
      of ways and factors of their transmission show that there is a need for its
      further optimization by taking into account local, natural, climatic and social
      conditions of the population's life and activities and paying a particular
      attention to the system's key point, namely to the evaluation of the risk of
      infection, which is the basis of planning preventive measures against parasitic
      diseases.

PMID- 11210413
TI  - [Testing CK group preparations in hymenolepiasis in white mice].
AB  - The drugs CK-1 and CK-2 are a kerosene milky-stage walnut (Juglans spp.) extract.
      The drugs CK-3, CK-4, and CK-5 are derived from monkshood (Aconitum) roots,
      garlic (Allium sativum), and Ferula, respectively. Albino mice were infected with
      hymenolepiasis by the procedure of B.A. Astafyev et al. (1989). The mice were
      aged 3 weeks, weighed 7-8 g, and spontaneous invasion-free. The doses of 25 to
      100 mg/kg were tested. The antihelminthic effects of the extragent of the drugs-
      aircraft kerosine purified by the authors' procedure--were additionally examined.
      The purified aircraft kerosine was found to have moderate antihelminthic effects,
      but failed to provide 100% antihelminthic activity when given even in very high
      doses (500 mg/kg or more). The drug CK-1, 100 mg/kg, completely eliminated
      hymenolepiasis in the experimental animals. Other drugs CK-3, CK-4, and CK-5 used
      in doses of 100 mg/kg body weight failed to provide 100% antihelminthic
      efficiency.

PMID- 11210415
TI  - [Ecological and epizootic characteristics of various zonal types of natural
      reservoirs of alveococcosis in the Omsk region].
AB  - Natural foci of alveococcis of various zonal types were found in the Omsk region.
      The final pathogen hosts are red (aspen and birch forests, northern and southern
      forest-steppe, steppe) and corsac (southern forest-steppe and steppe) foxes and,
      perhaps, wolves (southern taiga). There are intermediate hosts, that are small
      mammals of 10 species, among which Clethrionomys voles (northern redbacked, large
      toothed redbacked, and bank voles in the southern taiga; northern redbacked voles
      in the aspen and birch forests and northern forest-steppe), root ones (in the
      northern and southern forest-steppe, and steppe), narrow-skulled ones and house
      mice (in the southern forest-steppe and steppe) are of the greatest
      epizootological significance. The seasonal and biotopical dynamics of the spatial
      pattern of a natural alveococcis foci was established in the subareas of the
      south taiga and northern forest-steppe.

PMID- 11210414
TI  - [Clinical and epidemiological characteristics of hymenolepiasis in the Ivano
      Frankovsk region].
AB  - Based on their retrospective epidemiological analysis and examination of 56
      outpatient case histories, the authors have studied the clinical and
      epidemiological regularities of hymenolepiasis in the Ivano-Frankovsk region,
      which is characterized by: 1) its epidemic and familial pattern, mainly
      afflicting rural populations, young schoolchildren in particular; 2) high
      contagiousness and incidence of multiinvasions in the tense foci; 3) a number of
      the most typical syndromes identified in the clinical picture of helminthic
      infections, which may serve as criteria for selecting patients for laboratory
      studies.

PMID- 11210416
TI  - [Sensitivity of malaria mosquito larvae to bacterial insecticides in relation to
      handling].
AB  - The conditions for cultivation of malaria mosquito larvae were found to exert a
      great impact on their sensitivity to bactoculicide. Elevating keeping
      temperatures for An. sacharovi and An. pulcherrimus by 10-11 degrees C causes 2-4
      fold increases in LC50. There are virtually no impacts of larval population
      during their development or temperature-population density relationships. Ten
      fold increases in larval population density under which An. stephensi larvae have
      been grown result in 3-fold decreases in LC50. There are no impacts of
      temperatures and temperature-population density relationships either. There are
      also great larval species-specific differences in their sensitivity to
      bactoculicide.

PMID- 11210417
TI  - [Characteristics of the course of intestinal amebiasis concurrent with other
      diseases].

PMID- 11210418
TI  - [Borrelia infection in Ixodes ticks in the Cheliabinsk region].

PMID- 11210419
TI  - [Further study of the circulation of arboviruses in the Astrakhan region (1998
      1999)].

PMID- 11210421
TI  - [Detection of pentastomes in Russia].

PMID- 11210420
TI  - [Epidemic leptospirosis outbreaks caused by leptospires of Pomona serological
      group in the Altai region].

PMID- 11210422
TI  - [Organ pathology in chronic tissue-dwelling helminthic infections: role of blood
      and tissue eosinophilia, immunoglobulinemia E, G4, and immune response-inducing
      factors].
AB  - The results of earlier clinical, pathomorphological, and immunological studies of
      organic visceral and tissue lesions in helminthic infections [2, 3, 8, 10, 11,
      14, 46] and present clinical and immunological ones [4-6, 44, 45] were analyzed
      and discussed in the light of a fundamental literature data review. The chronic
      visceral pathology in tissue-dwelling helminthic infections is associated with
      super- and reinfections [1, 2, 16, 36], with an inadequate immune response of
      humans to the invasion of zoonotic agents [2, 6, 13, 20] and with an individual
      invalidity of an immune response to infections [1, 2, 6, 16, 54]. The persistent
      course of infections, especially zoonotic, leads to organic pathology, sometimes
      irreversible [2, 13, 15, 21, 34, 46] if an individual (population) does not
      respond by immunity or by acquired (inherited) tolerance of invasion [1, 2, 3,
      11, 16, 20, 36]. Transplacental transfer of Opisthorchis felineus antigens in the
      hyperendemic foci of the infection does not prevent superinfections, but does
      prevent the acute phase of disease and significantly mitigates the organic
      lesions in the chronic phase in spite of a very high intensity of infection [7,
      10, 11]. Paramyosines (Pmes), proteins expressed on the tegument of Schistosoma
      mansoni and S. japonicum, show their immunogenic effect [42]. Antibodies to PM of
      Lumbricoidea and to a cardiac muscle myosin peptide (alpha-mp), known to induce
      experimental allergic myosites [55], were revealed in the sera of 32
      trichinellosis, toxocarosis, opisthorchiasis, and hydatid echinococcosis patients
      with organic visceral abnormalities. The levels of antibodies against alpha-mp
      correlated with the severity of pathology [44]. S. mansoni PM peptide smp97 is a
      homologue of alpha-mp [25]. This fact suggests that there is a relationship
      between the development of an immune response to Pmes immunological processes in
      helminthiases. The relationship between organic visceral pathology and a
      competitive with serum IgE serum IgG4 hyperproduction at the early [6] and late
      stages of the studied helminthic infections was revealed. One may resume that
      this balance of production of these isotypes is not beneficial for the
      development of disease as IgG4-antibody hyperproduction is not beneficial for
      reinfection resistance [26, 28, 54]. One of the mechanisms may be serum IgG4
      blocking the antibody-dependent cytotoxic effect, as it was supposed for
      unspecific IgE hyperproduction [47]. The selected development of cardiomyopathy
      or obstructive fibrosis in the lung after trichinellosis [2, 6, 45],
      endomyocardiofibrosis in the foci of filariases [21, 31] suggests that their
      development like resistance or susceptibility to infections [54] should be
      programmed.

PMID- 11210423
TI  - George Austin, MD.

PMID- 11210424
TI  - Intra-ischemic hypothermia attenuates intercellular adhesion molecule-1 (ICAM-1)
      and migration of neutrophil.
AB  - Adhesion of neutrophil to the endothelium and subsequent transmigration has been
      reported to contribute to progression of focal ischemia. Hypothermia has been
      known to attenuate ischemic insult through various mechanisms of action. The
      authors evaluated the effect of hypothermia on expression of intercellular
      adhesion molecule-1 (ICAM-1) protein and on transmigration of neutrophil with
      immunohistochemical method. Transient focal ischemia model in rats was employed,
      and animals received 2 h of either normothermic or hypothermic ischemia. To
      confirm the effectiveness of hypothermia on neuroprotection, cortical infarct
      area was compared between the two groups. Our results demonstrated that
      hypothermia reduced both the number of microvessels expressing ICAM-1 and that of
      neutrophils migrating into ischemic tissue. Comparison of cortical infarct area
      showed persistent protective effect. This study indicates that reduction of ICAM
      1 expression and subsequent reduction of migrating neutrophil in hypothermia can
      contribute to attenuation of ischemic damage.

PMID- 11210426
TI  - The influence of ruptured cerebral aneurysm localization on the blood flow
      velocity evaluated by transcranial Doppler ultrasonography.
AB  - The relationship between changes of blood flow velocities in cerebral arteries
      measured by transcranial Doppler ultrasonography and aneurysm localization was
      investigated in a group of 165 patients after aneurysmal subarachnoid hemorrhage
      (SAH). Mean blood flow velocities (MFV) in the middle cerebral artery (MCA) and
      anterior cerebral artery (ACA) were registered. In patients with aneurysm of
      internal carotid artery and MCA (group A) statistically significant higher values
      of MFV from the 1st to the 5th day and on the 12th, 13th, 14th, 15th, and 19th
      day after SAH were found compared to patients with aneurysm of the anterior
      communicating artery, ACA, and pericallosal artery (group B). Pathological values
      of MFV exceeding 120 cm sec-1 in MCA were registered during 14 days in group A
      and during eight days in group B. Blood flow velocities in ACA were statistically
      significantly higher in group B on the 2nd, 7th, 9th and 11th day compared to
      group A. Pathological values of MFV exceeding 90 cm sec-1 in ACA were registered
      during nine days in both groups. MFV differences between group A and group B in
      38 patients subjected to delayed surgery were not observed. The influence of
      aneurysm localization was observed between the 7th and 14th day after SAH.
      Critical MFV values for vasospasm in the MCA should be 120 cm sec-1 and in the
      ACA 90 cm sec-1.

PMID- 11210425
TI  - Neurotransmitter distribution in the second trimester fetal human corpus
      striatum.
AB  - One experimental strategy that may offer hope in the neurodegenerative disorder
      Huntington's disease (HD) has been neural transplantation. In HD, most of the
      pathological changes occur in the corpus striatum. Fetal human striatal implants
      will most likely be the first transplant strategy attempted in clinical trials to
      replace lost neurons and/or prevent the degeneration of neurons destined to die.
      The temporal expression of neurotransmitters in the developing human corpus
      striatum is a key factor in determining the optimum age of transplantable tissue.
      To this end, an immunocytochemical analysis of various neurotransmitters was
      performed on second trimester human brains. Antibodies against acetylcholine,
      gamma-aminobutyric acid, enkephalin, neuropeptide-Y and substance P were used in
      ten human fetal brains ranging from 13 to 21 weeks gestation. The presence and
      pattern of distribution for these neurotransmitters varied in the different parts
      of the corpus striatum (globus pallidus, putamen, caudate nucleus). These results
      are compared to the already existing data for the adult human corpus striatum.

PMID- 11210427
TI  - Magnetoencephalographic investigation of somatosensory homunculus in patients
      with peri-Rolandic tumors.
AB  - In order to investigate functional topography of the hand somatosensory cortex in
      five patients with peri-Rolandic tumors (four frontal lobes and one parietal
      lobe), we recorded somatosensory evoked fields (SEFs) using
      magnetoencephalography (MEG) after stimulation of the median nerve (MN) and the
      five digits. The results obtained were compared with those of five normal healthy
      subjects. In all five patients, SEFs following MN and digit stimulation showed
      the previously described respective N20m and N22m components of primary sensory
      response. Single dipole modeling was applied to determine the three dimensional
      cortical representations of the N20m and N22m components. The cortical
      representations of the hand were identical to those of normal subjects, arranging
      in an orderly somatotopic way from lateral inferior to medial superior in the
      sequence thumb, MN, index, middle, ring, and little fingers. This sensory
      homunculus was confirmed by cortical recording of the somatosensory evoked
      potentials (SEPs) at the time of surgery. Thus, we demonstrate that SEFs,
      recorded on MEG in conjunction with source localization techniques, are useful to
      non-invasively investigate the functional topography of the human hand
      somatosensory cortex in pathological conditions.

PMID- 11210429
TI  - Influence of acupuncture upon expressing levels of basic fibroblast growth factor
      in rat brain following focal cerebral ischemia--evaluated by time-resolved
      fluorescence immunoassay.
AB  - We investigate the expression of basic fibroblast growth factor (bFGF) during
      ischemia-reperfusion with or without electroacupuncture (EA) treatment, and
      observe the effect of EA on ischemic cerebral injury. In the present study, a
      sensitive sandwich time-resolved fluoroimmunoassay (TR-FIA) method was developed
      to quantitatively analyze the levels of bFGF in rat brain. The results indicated
      that the obvious cerebral infarction and swelling were observed after ischemia
      reperfusion, and the opening amount of cerebral blood micrangium was increased.
      In the meantime, the expression of bFGF was also improved in striatum and
      frontoparietal cortex. EA alleviated the ischemic injuries induced by MCAO and
      markedly upregulated the opening amount of the micrangium. Owing to application
      of EA, the expression of bFGF was notably enhanced in striatum and cortex. The
      results give us some hints for the neuroprotective mechanism of EA, that is, EA
      may partially exert protective effects on neurons through regulating the blood
      dynamics and the endogenous expression of bFGF.

PMID- 11210428
TI  - GABAA receptor antisense epilepsy: histological changes following infusion of
      antisense oligodeoxynucleotide to GABAA receptor gamma 2 subunit into rat
      hippocampus.
AB  - A deficiency of neuronal inhibition mediated by gamma-aminobutyric acid (GABA)
      via the GABAA receptor complex has been hypothesised to be a central factor in
      epileptogenesis. Intrahippocampal infusion of antisense oligodeoxynucleotide
      (ODN) to the GABAA receptor gamma 2 subunit in rats leads to electrographic
      limbic status epilepticus. In this model, epileptic phenomena are accompanied by
      loss of hippocampal neurones. The purpose of the present study was to investigate
      the time-course of morphological changes following hippocampal antisense
      'knockdown' of the GABAA receptor gamma 2 subunit. gamma 2 subunit antisense ODN
      was infused continuously into the right hippocampus for periods between 1 and 5
      days. After about 4 days of infusion, pronounced neurodegenerative changes were
      consistently observed within the ipsilateral hippocampus. In general, marked loss
      of CA3 pyramidal cells was found. The notion that the histological changes
      induced by the antisense ODN were specific to the applied ODN sequence was
      supported by the finding that a mismatch control ODN did not induce
      neurodegenerative changes, except for a small lesion in the immediate vicinity of
      the infusion site. Extensive ipsilateral hippocampal infiltration with monocytes
      and macrophages was a feature of antisense ODN infusion, but was considerably
      less pronounced after the infusion of control ODN. Immunocytochemistry using an
      antibody labeling glial fibrillary acidic protein (GFAP), revealed marked
      astroglial hypertrophy/proliferation after 4 days of antisense treatment, i.e.,
      coincident with the development of neurodegeneration, in the ipsilateral
      hippocampus. At this time GFAP-immunoreactivity was also evident in the
      contralateral hippocampus, indicating contralateral spread of seizure activity.

PMID- 11210430
TI  - Approaches to the sellar and parasellar region: anatomic comparison of endonasal
      transsphenoidal, sublabial-transsphenoidal, and transethmoidal approaches.
AB  - Various surgical approaches have been described for treating lesions which arise
      in the sellar region. The popular transnasal-transsphenoidal and transethmoidal
      transsphenoidal approaches avoid the morbidity associated with transcranial
      operations while allowing enough exposure to successfully remove most lesions
      that arise in and around the sella. The goal of the present study was to
      accurately quantify the amount of exposure to the sellar and suprasellar region
      that the transethmoidal-transsphenoidal, endonasal-transphenoidal, and sublabial
      transsphenoidal approaches provide. Each of the three approaches was performed on
      14 formalin fixed heads with the aid of the operative microscope. The distances
      of relevant surgical landmarks, and the amount of exposure superior and anterior
      to the dorsum sella as well as the lateral exposure obtained through each of
      these approaches was carefully recorded. The mean distances were then used to
      calculate the volume of exposure offered by each approach. It was found that the
      sublabial-transsphenoidal approach afforded the greatest volume of exposure
      superior and anterior to the dorsum sella. The endonasal-transsphenoidal and the
      transethmoidal approaches were both found to offer less suprasellar volume
      exposure, with the transethmoidal approach offering the least. The authors
      believe the information obtained through this study illustrates some important
      anatomical relationships which can be used to advantage by the surgeon to tailor
      the most appropriate approach, depending upon the precise location of the lesion
      either within the sella or suprasellar region.

PMID- 11210431
TI  - Dynamic cerebral autoregulation testing as a diagnostic tool in patients with
      carotid artery stenosis.
AB  - Evaluation of dynamic cerebral autoregulation might yield a physiologically more
      adequate measure of cerebral hemodynamic impairment in carotid artery stenosis
      than CO2-reactivity. This study re-evaluates and compares the Valsalva maneuver
      (VM) and phase shift during deep breathing. Nineteen patients with severe carotid
      artery stenosis and 17 age-matched controls were examined using transcranial
      Doppler sonography and non-invasive blood pressure recordings (Finapres). Phase
      shift was determined by cross-spectral analysis, responses to VM were graded by
      the formerly-introduced autoregulation slope index (ASI) and the new Valsalva
      time index (VTI). Phase shift and autoregulatory indices were significantly
      reduced on the affected side (p < 0.001). Correlations with CO2-reactivity were
      significant when pooling values of controls and patients (r from 0.54 to 0.78; p
      < 0.001). Correlations except for the VTI (r = -0.65; p = 0.002) were not
      significant considering only the affected side in patients. Correlations of
      pooled values between phase shift and VM-derived indices were significant (VTI r
      = -0.62; p < 0.001; ASI r = 0.49; p < 0.001), within patients only when comparing
      side-to-side differences (VTI r = -0.58; p = 0.009; ASI r = 0.52; p = 0.023). In
      conclusion, detection of impaired cerebral autoregulation is possible both by
      deep breathing and VM. The new VTI seems to be more suitable than the
      conventional ASI. Inter-method agreement concerning the extent of impairment is
      only acceptable for intra-individual side-to-side differences. Since absolute
      values of one autoregulation testing method or CO2-reactivity alone might fail,
      various tests should be combined for comprehensive assessment of cerebral
      hemodynamic impairment.

PMID- 11210432
TI  - Clinical application of an ultrasonically activated scalpel in neurosurgery.
AB  - Ultrasonically activated scalpel (UAS) is a surgical device utilizing ultrasonic
      energy to cut and coagulate tissues simultaneously. The actions and features of
      UAS are considerably different from those of conventional ultrasonic cavitational
      aspirators (UCA) that have been used frequently in the neurosurgical field. The
      UAS has been used routinely in a number of general surgeries, including
      laparoscopic surgeries and open surgeries of the lung and liver. However,
      neurosurgical application of UAS has not been reported. We used UAS in surgical
      resection of intracranial tumors consisting of five meningiomas, two gliomas, and
      one metastatic brain tumor, and monitored thermal changes in tissues using
      thermoencephaloscopy to investigate the possibility of heat injury by UAS. It was
      used to achieve both dissection of the attachment of meningiomas and internal
      decompression of the tumors and allowed efficient resection of various tumors
      with minimal bleeding by adjustment of the combination of coagulation and cutting
      powers at five different positions. The attachment of meningiomas was coagulated
      and cut easily and safely by UAS. Moreover, infrared thermographic study showed
      that the degree of temperature increase and the area of elevated temperature were
      extremely limited in UAS. The current study suggests that it is a promising
      device in neurosurgery.

PMID- 11210433
TI  - Reduction cranioplasty for craniocerebral disproportion due to chronic subdural
      hematoma in infants. A technical report.
AB  - Advanced craniocerebral disproportion due to chronic subdural hematoma in infants
      which is resistant to conventional treatments requires reduction cranioplasty as
      the last resort. The present paper deals with our experience with two such cases
      originated from head injury. Since the volume of the hematoma cavity was
      calculated based on the pre-operative CT scans, we devised a mathematical formula
      to design how the cranial vault could be reconstructed for reduction. This
      enabled us to pre-determine the extent of cranial reduction which was tailored to
      each patient. Furthermore, the present methodology is characterized by the
      modification that the midline bone strip overlying the superior sagittal sinus
      was shortened at its anterior end and bent down using the posterior end as a
      hinge. Since the follow-up results were favorable, this technique of reduction
      cranioplasty is reported in detail.

PMID- 11210434
TI  - The neurochemical basis for the applications of the greater omentum in
      neurosurgery.
AB  - The omentum has been utilized in neurosurgery for over 30 years. However, the
      anatomical and physiological bases for its applications have not been described
      in great detail. In this paper, we will review the current status of the omentum
      applications for the management of central nervous system disorders.

PMID- 11210435
TI  - L-selectin inhibition does not reduce injury in a rabbit model of transient focal
      cerebral ischemia.
AB  - Neutrophils are known to mediate injury in acute ischemic stroke especially
      during reperfusion. Migration of neutrophils into regions of ischemic injury
      involves binding to the endothelial cells via interactions with various adhesion
      molecules. One adhesion molecule, L-selectin, is found on the surface of
      leukocytes, and is shed prior to leukocyte infiltration. We studied whether a
      humanized antibody to L-selectin (HuDREG200) might limit ischemic injury in an
      experimental stroke model. New Zealand White rabbits underwent transorbital
      occlusion of the left middle cerebral, anterior cerebral and internal carotid
      arteries using aneurysm clips for 2 h followed by 6 h of reperfusion. Treatment
      with a saturating dose (4 mg kg-1) of HuDREG200 (n = 8) or vehicle (n = 8) was
      administered 20 min after occlusion and given as a single i.v. bolus. Hemispheric
      ischemic neuronal damage (IND) as seen on hematoxylin and eosin stained sections
      was no different between groups (HuDREG200, 23.3% +/- 6%; vehicle, 19.6% +/- 6%;
      mean +/- SEM, n.s., t-test). Immunohistochemical staining with neutrophil
      elastase confirmed the presence of neutrophils within regions of IND in control
      brains, but treatment did not alter their numbers within ischemic tissue. We
      conclude that antagonism of neutrophil adhesion at the level of L-selectin does
      not alter ischemic injury in experimental stroke.

PMID- 11210436
TI  - Glutamate enhances DNA fragmentation in cultured spinal motor neurons of rat.
AB  - The role of glutamate in the mechanism of spinal motor neuron death is not fully
      understood. With addition of glutamate to primary culture of 11-day-old rat
      spinal cord, terminal deoxynucleotidyl transferase-mediated dUTP-biotin in situ
      nick end labeling (TUNEL) positive nuclei were found in spinal large motor
      neurons from 24 h, and the number of TUNEL positive large motor neurons greatly
      increased at 48 h. In contrast, only a small number of large motor neurons became
      TUNEL positive at 48 h with addition of vehicle to the primary spinal cord
      culture. The present results show that excessive amount of glutamate enhances DNA
      fragmentation in developing large motor neuron of cultured spinal cord by
      involving in apoptotic process of the neurons.

PMID- 11210437
TI  - Spatial and temporal distribution of Bax in rat spinal cord during normal aging.
AB  - Amytrophic lateral sclerosis is characterized by relentlessly progressive
      degeneration of spinal cord motor neurons. During the disease, the bcl-2 family
      genes have been reported to alter their expression levels. To understand the
      meaning of these changes, the expression pattern of Bax in rat spinal cord and
      its changing pattern during normal aging were investigated by immunohistochemical
      staining. Spatial expression of the protein showed a diffuse distribution pattern
      with immunoreactivity more prominent in the anterior hom. With advancement of
      age, the cell densities of Bax-positive cells tended to increase. The increasing
      expression of Bax might be positively associated with amyotrophic lateral
      sclerosis. This work demonstrates for the first time how Bax expression changes
      in rat spinal cord during normal aging.

PMID- 11210439
TI  - Fluid loading in rats increases serum brain natriuretic peptide concentration.
AB  - Hyponatremia after subarachnoid hemorrhage has been linked to high plasma
      concentration of atrial natriuretic peptide and brain natriuretic peptide. Volume
      expansion therapy to prevent symptomatic vasospasm, such as intensive
      hypertensive and hypervoremic therapy, may alter systemic concentration of these
      peptides. We therefore examine brain natriuretic peptide secretion in rats in
      response to acute volume expansion, infusing to 10 ml of saline over 1 h. In the
      10 ml group, brain natriuretic peptide concentrations showed a significant
      increase from pre-infusion concentrations 1 h after initiation of infusion, but
      had begun to fall 1 h later. We suspect that high plasma concentration of brain
      natriuretic peptide after subarachnoid hemorrhage is partly caused by
      hypervoremic therapy.

PMID- 11210438
TI  - Metabolic alterations in cerebrospinal fluid from double hemorrhage model of
      dogs.
AB  - Even though cerebral vasospasm after subarachnoid hemorrhage (SAH) causes
      cerebral ischemia or infarction, the metabolic alterations in cerebrospinal
      fluids (CSF) after SAH have not been studied. This study was undertaken to
      measure the levels of glucose, lactate, pyruvate and glutamate in CSF from double
      hemorrhage dog models. Thirty-two mongrel dogs of either sex, weighing 18-24 kg,
      underwent double hemorrhage by percutaneous needle puncture of the cistema magna
      and injection of autologous blood on day 0 and day 2. The dogs were then
      sacrificed on day 3, 5 and 7, after collecting CSF. In another study, the dogs
      were treated with mitogen-activated protein kinase (MAPK) inhibitors PD98059 and
      U0126, and caspase-2 and caspase-3 inhibitors from day 3 to day 6 after initial
      blood injection. CSF was collected on day 7 before dogs were sacrificed. The
      concentration of glucose, lactate, pyruvate and glutamate in CSF was measured by
      photometrical method. Compared with CSF collected on day 0, glucose was decreased
      on days 5-7, lactate was increased on days 2-7, pyruvate was increased on days 2
      7, and glutamate was increased on days 3-7 (p < 0.05). In the groups treated with
      MAPK or caspase inhibitors, most of the metabolic alterations remained unchanged
      as compared with CSF from untreated dogs. Clinically, caspase inhibitors-2 and 
      3, and MAPK inhibitor U0126 all failed to prevent vasospasm. MAPK inhibitor
      PD98059 partially prevented vasospasm. Our data demonstrated a metabolic
      alteration of glucose, glutamate, lactate and pyruvate in CSF during cerebral
      vasospasm. This metabolic change in consistent with the time course of cerebral
      vasospasm. This study suggests that brain energy metabolites and excitative amino
      acids are altered during cerebral vasospasm.

PMID- 11210440
TI  - The effects of the pre-treatment of intravenous nimodipine on Na(+)-K+/Mg+2
      ATPase, Ca+2/Mg+2 ATPase, lipid peroxidation and early ultrastructural findings
      following middle cerebral artery occlusion in the rat.
AB  - Excessive calcium influx has been implicated in the pathophysiology of ischemic
      cerebral damage. The effects of nimodipine, a calcium antagonist, on the Na(+)
      K+/MG+2 ATPase activity, Ca+2/Mg+2 ATPase, lipid peroxidation, and early
      ultrastructural findings were examined at the acute stage of ischemia in the rat
      brain. Ischemia was produced by permanent unilateral occlusion of the middle
      cerebral artery. In Group I, the rats which had no ischemia and not received
      medication were used for determining Na(+)-K+/Mg+2 ATPase, Ca+2/Mg+2 ATPase, the
      extent of lipid peroxidation by measuring the malondialdehyde content and normal
      ultrastructural findings. In Group II, the rats which had only subtemporal
      craniectomy without occlusion and received saline solution were used for
      determining the effect of the surgical procedure on the biochemical indices and
      ultrastructural findings. In Group III, the rats received saline solution
      following the occlusion in the same amount of nimodipine and in the same duration
      as used in Group IV. In Group IV, nimodipine pre-treatment 15 min before
      occlusion (microgram kg-1 min-1 over a 10 min period) was applied i.v. Na(+)
      K+/Mg+2 ATPase and Ca+2/Mg+2 ATPase activities decreased significantly and
      promptly as early as 10 min and remained at a lower level than the contralateral
      hemisphere in the same group and at the normal level in Group I. Nimodipine pre
      treatment immediately attenuated the inactivation of Na(+)-K+/Mg+2 ATPase (p <
      0.05) but there was no change on Ca+2/Mg+2 ATPase activity (p < 0.05).
      Malondialdehyde content increased significantly in Group III following ischemia
      as early as 30 min. Nimodipine pre-treatment decreased the malondialdehyde level
      in Group IV (p < 0.05). This study supports the possibility that nimodipine pre
      treatment effects the membrane stabilizing properties via inhibiting the lipid
      peroxidation and subsequently restoring some membrane bound and lipid dependent
      enzymes' activity such as Na(+)-K+/Mg+2 ATPase and the ultrastructural findings.

PMID- 11210441
TI  - Specific genetic markers of endurance performance and VO2max.
AB  - Specific genetic markers of endurance performance and VO2max. Exerc. Sport Sci.
      Rev., Vol. 29, No. 1, pp 15-19, 2001. Recent advances have revolutionized genetic
      studies of quantitative traits. Mitochondrial DNA and creatine kinase variations
      may influence VO2max. Other data strongly suggest that angiotensin-converting
      enzyme genotype affects VO2max and endurance performance capacity, but the
      mechanisms are unclear. A recent genome-wide scan study also has provided
      candidate loci requiring further study.

PMID- 11210442
TI  - Surface electromyography for noninvasive characterization of muscle.
AB  - Surface electromyography for noninvasive characterization of muscle. Exerc. Sport
      Sci. Rev., Vol. 29, No. 1, pp 20-25, 2001. Linear electrode arrays are used for
      noninvasive muscle characterization to study individual motor unit properties and
      the myoelectric manifestations of muscle fatigue during sustained contractions.
      The location of an electrode pair with respect to the innervation zone(s), the
      deterministic rather than stochastic nature of the signal, and the possibility of
      noninvasive fiber typing are discussed.

PMID- 11210443
TI  - Low back stability: from formal description to issues for performance and
      rehabilitation.
AB  - Low back stability: from formal description to issues for performance and
      rehabilitation. Exerc. Sport Sci. Rev. Vol. 29, No. 1, pp. 26-31, 2001. The
      concept of stability, together with notions of design and the application of
      stabilization exercise, is briefly synthesized. The objective is to challenge
      muscle systems to achieve sufficient functional stability but in a way that
      spares the spine of excessive exacerbating load.

PMID- 11210444
TI  - Electron paramagnetic resonance: a high-resolution tool for muscle physiology.
AB  - Electron paramagnetic resonance: a high-resolution tool for muscle physiology.
      Exerc. Sport Sci. Rev., Vol. 29, No. 1, pp 3-6, 2001. Skeletal muscle function
      can be altered by changes in protein structure and motion. Electron paramagnetic
      resonance (EPR) paired with site-directed spin labeling has been used to study
      the relationships between (a) muscle force and myosin structure and (b) muscle
      relaxation and Ca-ATPase motion and structure.

PMID- 11210445
TI  - Objective measurement of physical activity in youth: current issues, future
      directions.
AB  - Objective measurement of physical activity in youth: current issues, future
      directions. Exerc. Sport Sci. Rev., Vol. 29, No. 1, pp 32-36, 2001. Second
      generation activity monitors have revolutionized the way in which we measure
      youth physical activity. Use of the monitors avoids the problems associated with
      self-report methods and allows for the estimation of physical activity patterns
      over time. This article examines important methodological issues related to the
      use of activity monitors in children and adolescents.

PMID- 11210446
TI  - Impact forces and muscle tuning: a new paradigm.
AB  - Impact forces and muscle tuning: a new paradigm. Exerc. Sport Sci. Rev., Vol. 29,
      No. 1, pp 37-41, 2001. We propose that repetitive impact forces during physical
      activities are not important from an injury perspective but are the reason for
      changes in myoelectric activity (muscle tuning) to minimize soft tissue
      vibrations. Changes in myoelectric activity (intensity, frequency, timing),
      comfort, and performance provide supporting evidence for this new paradigm.

PMID- 11210447
TI  - Regulation of lipid mobilization and oxidation during exercise in obesity.
AB  - Regulation of lipid mobilization and oxidation during exercise in obesity. Exerc.
      Sport Sci. Rev. Vol. 29, No. 1, pp 42-46, 2001. Obesity is associated with
      metabolic disorders that may be related to alterations in lipid mobilization and
      oxidation. Although exercise is essential for successful weight management, the
      regulation of fatty acid metabolism during exercise in obesity is unclear. This
      review discusses factors that regulate fat metabolism during exercise and the
      effects of endurance training on these responses.

PMID- 11210448
TI  - Animal genetic models for complex traits of physical capacity.
AB  - Animal genetic models for complex traits of physical capacity. Exerc. Sport Sci.
      Rev., Vol. 29, No. 1, pp 7-14, 2001. Understanding the genetic basis for variance
      in complex physical traits such as aerobic capacity has become an attainable
      goal. A starting point is the development or identification of animal genetic
      models that contrast the low and high values for the trait of interest. Genes
      that cause natural trait variation can ultimately be determined from animal
      models via genetic linkage.

PMID- 11210449
TI  - Community as client: environmental issues in the real world. A SimCity computer
      simulation.
AB  - The ability to think critically has become a crucial part of professional
      practice and education. SimCity, a popular computer simulation game, provides an
      opportunity to practice community assessment and interventions using a systems
      approach. SimCity is an interactive computer simulation game in which the player
      takes an active part in community planning. SimCity is supported on either a
      Windows 95/98 or a Macintosh platform and is available on CD-ROM at retail stores
      or at www.simcity.com. Students complete a tutorial and then apply a selected
      scenario in SimCity. Scenarios consist of hypothetical communities that have
      varying types and degrees of environmental problems, e.g., traffic, crime,
      nuclear meltdown, flooding, fire, and earthquakes. In problem solving with the
      simulated scenarios, students (a) identify systems and subsystems within the
      community that are critical factors impacting the environmental health of the
      community, (b) create changes in the systems and subsystems in an effort to solve
      the environmental health problem, and (c) evaluate the effectiveness of
      interventions based on the game score, demographic and fiscal data, and amount of
      community support. Because the consequences of planned intervention are part of
      the simulation, nursing students are able to develop critical-thinking skills.
      The simulation provides essential content in community planning in an interesting
      and interactive format.

PMID- 11210450
TI  - Developing clinical practice environments supporting the knowledge work of
      nurses.
AB  - Registered nurses represent the largest group of healthcare knowledge workers.
      They accomplish their knowledge work by engaging in the roles of data gatherer,
      information user, knowledge user, and knowledge builder. To successfully
      implement these roles, nurses rely on healthcare settings to provide supportive
      clinical practice environments that recognize their information and knowledge
      management needs. The authors describe the various knowledge-worker roles,
      delineate computerized mechanisms that can support these roles, and examine the
      ability of current healthcare settings to provide an environment conducive to
      successful knowledge-worker role performance. The article concludes with specific
      recommendations for development of clinical practice environments supportive of
      nurses' knowledge work.

PMID- 11210451
TI  - Computer-mediated support group use among parents of children with cancer--an
      exploratory study.
AB  - This study describes aspects of computer group use as a vehicle for self-help by
      parents of children with cancer. Using an electronic mail system, data were
      gathered from 73 parents who had participated in online support groups. Most
      participants were Caucasian, well educated, and reported annual incomes of more
      than $50,000. The perceived benefits of the computer group involvement were
      getting information, sharing experiences, receiving general support, venting
      feelings, gaining accessibility, and using writing. The disadvantages included
      "noise," negative emotions, large volume of mail, and lack of physical contact
      and proximity. The findings indicate that computer group use is more common in
      parents with relatively high socioeconomic status. There are certain advantages
      and disadvantages of computer group use that need to be recognized and addressed
      by health professionals and users.

PMID- 11210452
TI  - Nurse practitioner use of computer technologies in practice.
AB  - A study was undertaken to determine computer use by nurse practitioners in public
      clinics, private practice, health maintenance organizations, and other settings
      in the greater San Francisco Bay Area. The descriptive research used a survey
      design. Subjects were 200 nurse practitioners. The survey instrument was
      developed by the researcher. Of the 104 respondents, 86 (83%) used computers at
      work. "Obtaining client records from other agencies or departments" was rated the
      most useful computer application for improving client care. "Internet searches"
      was rated the next most useful computer application; "entering client record
      information" was rated the third most useful. Use of computer applications varied
      by practice setting. Only 7 (25%) nurse practitioners in private practice
      accessed client records from other agencies, as did 17 (57%) in public clinics,
      and nearly all, 29 (94%), in HMOs. The research demonstrated that nurse
      practitioners underused computer applications that would improve client care in
      their practice.

PMID- 11210453
TI  - [Reactive invagination of the neuroepithelium in anlages of the human neocortex,
      tectum of the midbrain, and the retina at various stages of development].
AB  - Intensity of invagination of neuroepithelium of neocortex of human embryonal
      anlages of neocortex, tectum of the midbrain and retina was studied as a response
      to mechanic damage of ventricular zone induced in the course of preparation of
      the anlages to explanation. It was shown that no invagination formed in 24 hrs of
      the explantation. In neocortical anlage intensity of invagination was meximal in
      6.5 wks embryo. In tectum invagination intensity of th explants lowered gradually
      from wk 5 to wk 7.

PMID- 11210454
TI  - [Characteristics of the functional organization of neuronal groups in
      functionally diverse zones of the human cerebral cortex from birth to 20 years of
      age].
AB  - Using computer analysis of histological specimens of motor and posterior
      associative cortex of the man aged from birth up to 20 yrs age and individual
      peculiarities of focal groups sublayer III3 of areas 4p, 6op and 37ac, periods of
      intensive and slow growth of the area of profile fields (PF) of cell groups and
      total area (TA) of neurons in the group were established. It was shown that
      greater changes of cell groups PF area and neuron TA occurred in the area 4p
      during first 3 yrs, while in areas 6op and 37ac from birth up to 7 yrs and 8-9
      yrs appropriately. Specific features of the group development in functionally
      different areas of human brain cortex was demonstrated.

PMID- 11210455
TI  - [Layer-to-layer distribution of neurons and macroglial cells in various zones of
      the cat auditory cortex (quantitative study)].
AB  - Quantitative analysis of layer-to-layer distribution of neurons and
      macrogliocytes in zones AI, AII, Ep and Ins of cat brain was performed in
      specimens stained after Einarson. Zones of auditory cortex were shown not to
      differ in density of neuron distribution. In every zone the neuron number in
      layers II, III and VI was significantly higher than in layers IV and V and in
      layers III and IV of zones AI and AII the number of neurons with macroglial
      satellites was almost twices higher than in the same layers of zones Ep and Ins.
      Fraction of neurons with different number of satellites shows significant
      diversities as well. In layers IV, V and VI of zones AI and AII both total number
      of macrogliocytes and perineuronal satellites was significantly higher than in
      zones Ep and Ins. The number of perineuronal satellitocytes correlates both with
      neuron axonal length and the level of the cell functional activity.

PMID- 11210456
TI  - [Postischemic reorganization of dendritic architectonics of the hippocampal CA3
      region in albino rats predisposed to seizures].
AB  - Total short term ischemia of brain was induced experimentally in albino rats (10
      min long clamp of heart vascular bundle). Using Golgi Silver nitrate impregnation
      geometry of pyramidal neurons dendritic tree was studied in sector of hippocampus
      in norm, postischemic period (d 1.30 and 90) healthy animals and those
      predisposed to cramps. Significant reduction of dendrite volume, total length,
      dendrite territory, parameters of dendrite arborization were shown on the
      background of stable numerical density of neurons in all animals who survived
      brain ischemia. The extent of reduction, volume and duration of changes of
      parameters of dendritic tree geometry was higher in animals predisposed to cramps
      than in high threshold animals without cramps. Possible mechanisms of
      postischemic neuron "epileptization" were discussed.

PMID- 11210457
TI  - [Ultrastructure of the trigeminal principal sensory nucleus in the norm and
      during pain threshold stimulation].
AB  - Ultrastructural organization of main sensory trigeminal nucleus neurons and
      synapses was studied in norm and in threshold pain irritation of teeth pulp of
      the cat. The neurons were divided into small and large ones. The latter were
      identified according to ultrastructural organization of perikaryon and
      significant number of axo-somatic synapses, formed by presynaptic terminals of
      different size. These neurons react to threshold pain irritation. Changes were
      observed more often in axonic terminals than in the endings of specific pain
      afferent fibres.

PMID- 11210459
TI  - [Effect of embryonal nerve tissue transplantation on regeneration of dorsal roots
      of the rat spinal nerves].
AB  - Using cobalt salts axonal ionophoresis posttraumatic regeneration of TXII dorsal
      roots nerve fibres in the zone of hemisection in conditions of 14 wks embryo
      spinal cord transplantation into the zone of trauma of spinal cord. Regro
      Invasion of dorsal roots nerve fibres into recipients posterior cords and
      Lissawers tract through the transitional zone "spinal cord--dorsal roots" was
      observed on posttransplantation d 14-120. It was show that afferent axons
      predominantly spread in substantia alba and substantia grisea caudal to the level
      of spinal cord transection with only individual fibres invading rostrad through
      the neuronal plate. In the transplants neurons were encountered up to d 120 of
      the observation although transplant neuropil was limited from recipient tissue
      brain by a glial and connective tissue scar. The influence of embryonal nervous
      tissue transplantation on intraspinal regeneration of dorsal roots afferents was
      discussed.

PMID- 11210458
TI  - [Sensory neurons and Schwann cells during pharmacologic stimulation of the nerve
      regeneration].
AB  - Using the model of rat sciatic nerve transection and crush injury we studied
      influence of pyrimidine derivative xymedon on efficacy of regeneration of
      myelinated axons, number and phenotype of surviving sensory neurons (expressing
      GAP-43 and Bcl-2) and Schwann cells (S100, GAP-43, PCNA) on the 7th, 15th, 30th,
      60th and 90th day after nerve injury. We found out that xymedon counteracts
      posttraumatic death of sensory neurons, stimulates regeneration of myelinated
      fibres and proliferation of Schwann cells.

PMID- 11210460
TI  - [Innervation of the humerus metaepiphysis in newborn and one year old children].
AB  - Analysis of home and foreign literature on metaepiphyseal cartilage innervation
      and blood supply was presented, data on these organ diseases substantiate
      theoretical and clinical significance of the study was performed. Using macro
      microscopic preparation, histological study, automatic image analyzer branches of
      humerus proximal metaepiphysis were shown to originate from axillary and
      subscapulary nerves. Nerves and vessels penetrating in the cartilaginous canals
      form neurovascular complexes. Cartilaginous canals are located unevenly. Nervous
      structures were found in the canals and their characteristics was given.

PMID- 11210461
TI  - [Structure of lymphatic vessels in the human thighs].
AB  - Peculiarities of construction of muscular coat of lymphatics of human legs (long,
      polylymphangion muscular bands, longitudinally oriented, localized in deep layers
      of lymphatics walls and forming branches into adjacent valves of lymphangions)
      are the base for grouped contractions of lymphangions in them. Predominance of
      these muscular fascicles in muscular coat of lymphatics of thigh provide combined
      action of group of adjacent lymphangions versus gravitation force in the walking
      man.

PMID- 11210462
TI  - [Morphological characteristics of the lymphoid tissues in the newborn children].
AB  - Quantitative and qualitative analysis and statistical processing of thymus,
      trachea, duodenum ileum, coecum and appendix in newborns demonstrated that by the
      moment of birth peripheral immunogenesis organs were not equally formed due to
      peculiarities of their function in postnatal ontogenesis. Lymphoid nodules were
      absent in tracheal mucosa and adjacent lymph nodes showed loss of lymphoid noules
      aswell. However intensive formation of lymphoid structures took place in the
      walls of the gut, especially large intestine. The appendix, lymphoid tissue of
      which was not, in fact, developed at all, made an exception.

PMID- 11210463
TI  - [Inguinal lymph nodes of Rhesus macaque in hypokinesia and combined action of
      hypokinesia and hypergravity].
AB  - Peculiarities of microanatomy and cytoarchitecture of inguinal lymph nodes were
      studied under the effect of hypokinezia and combined effect of hypokinezia and
      hypergravitation experimentally in mature macaque rhesus monkeys for the first
      time. The data obtained indicate that on the background of intensive impairing
      effect of hypokinezia combined action was not only neutralized but the effect of
      hypokinezia also intensifies immunological action of lymph nodes of monkeys. This
      was supported by morphological signs and changes in correlation between lymphoid
      cells: number growth of lymphoid nodules with widened germinal centres and high
      fraction of mitotically dividing cells, the presence of dense thymus dependent
      (paracortical) zone and more dense medullar bands, filled basically with small
      lymphocytes and lowered level of destructive processes in all structural
      components of lymph nodes.

PMID- 11210464
TI  - [Structural characteristics of the adrenal cortex from rats with stress-induced
      hereditary arterial hypertension in the late postnatal ontogenesis].
AB  - The comparative investigation of the adrenal cortex in hypertensive (INHERITED
      STRESS-INDUCED ARTERIAL HYPERTENSION--ISIAH) and normotensive strain (Wistar) 12
      months age rats was performed. The structural signs such as the lowering of the
      mitochondria volume involved in steroid synthesis in showed more notable age
      related reduction of steroidogenesis in the adrenal glomerular and fascicular
      zones and in the ISIAH rats. The lowering of the cell steroidogenesis was
      compensated by the adrenal glomerular and fascicular zones and hypertrophy as a
      result the adrenocorticocytes hyperplasia. At the same time the more considerable
      sclerotic changes of the adrenal cortex periendothelial space were demonstrated
      in the ISIAH rats. The results obtained give evidence that reducing potential of
      compensatory possibilities of the adrenal cortex of the ISIAH rats in the late
      postnatal ontogenesis period cause high probability of adaptative-compensatory
      mechanisms failure and pathological process aggravation in these animals.

PMID- 11210465
TI  - [Effect of xenobiotics on alveolar macrophages].
AB  - Under the action of hexachlorcyclogexan in concentration not exceeding the
      pesticides residues in food staffs the prominent adaptive mechanisms stress of
      gematoalveolar barier is seen. However, the adaptation has the extensive
      character and is caused by increase of alveolar monocytes in broncho-alveolar
      lavage. The phagocytosis functional reservers exceed the control values, but
      phagocytes activity and phagocytory index remain decreased and reach norms just
      after the xenobiotic abolition.

PMID- 11210466
TI  - [Effect of the long-term enteral administration of sorbents on the structural
      organization of microvillus mucosa in the small intestine].
AB  - Long term use of diatomite and ceolite, SUMS-1 sorbents in ration exerts
      irreversible effect on structural organization of microarea of mucosa small
      intestinal villus causing changes that indicate activation of absorption, barrier
      function of interstitium, stimulation of the ansendothelial fluid perfusion into
      blood and lymphatic capillaries. SUMS-1 and ceolite showed the highest
      stimulative effect.

PMID- 11210467
TI  - [Applied (topographic) anatomy in Russia at the verge of XX-XXI centuries].

PMID- 11210468
TI  - [Afferent and efferent pathways between the heart and hypothalamus].

PMID- 11210469
TI  - [Experience in the course project preparation at the Department of Human
      Physiology].

PMID- 11210470
TI  - [Enzyme activity in the cerebrospinal fluid in patients with brain gliomas].
AB  - The spinal fluid activities of aspartate aminotransferase (AAT), alkaline
      phosphatase (AP), and gamma-gluthamyl transferase were studied in 32 patients
      with cerebral gliomas to clarify the diagnostic role of these enzymes. There were
      different changes in their activities in groups of patients with low-differential
      and differential gliomas. Its was ascertained that higher AAT activity was due to
      the fact that blood had entered spinal fluid; increased AP activity may be
      regarded to be an indicator of higher permeability of the blood-brain barrier.

PMID- 11210471
TI  - [Pathomorphological characteristics of cerebral arterioles and capillaries in
      surgical epileptic patients with generalized seizures].
AB  - Clinical and morphological analyses of brain biopsy specimens from epileptic
      patients undergone surgery have indicated that the brain vascular system in
      epilepsy has the most vulnerable site, namely: pre-capillary arterioles and
      capillaries. At the same time, the paper describes some dissimilarities of
      qualitative and quantitative characteristics of the above vessels from their
      changes in hypertensive angiopathy. There was a relationship of arteriolar
      changes to the duration and severity of epilepsy. The use of silver-impregnated
      serial brain sections revealed 5 types of cerebral capillary morphological
      changes that could be arranged in successive stages of transformation
      (neocapillarogenesis). There was an association of the activation of
      neocappilarogenesis with the duration and severity of epilepsy. It forms an
      impression that the life of a capillary is shorter due to its accelerated
      morphofunctional evolution particularly in patients with advanced epilepsy. This
      is accompanied by the rates of neocapillarogenesis that is regarded as a
      compensatory and adaptive response of the brain capillary system.

PMID- 11210472
TI  - [Circulating immune complexes in acute concussion of the brain].
AB  - The aim of the study was to study the count of circulating immune complexes (CIC)
      in the blood of children with acute concussion of the brain. The fact that CIC at
      high concentrations that can penetrate into the brain through the blood-brain
      barrier and cause complications as vasculitis, microangiopathy, proliferative
      processes in the meninges, enlarged ventricles of the brain, and atrophy of its
      tissue was borne in mind. The studies revealed a significant progressive CIC
      increase within 3 weeks. For correction of blood CIC levels, laser exposure was
      applied to the carotid and vertebral arteries and acupuncture points. For
      comparison, thymaline in age-specific doses was used. Laser radiation showed a
      significant fall of CIC at days 19-21, particular when applied to the acupuncture
      points. Thymaline did not affect blood CIC levels. Laser application to the
      acupuncture points in children with acute brain concussion should reduce the
      incidence of complications of brain injury disease.

PMID- 11210474
TI  - [Apoptosis: mechanism, regulation, and importance for neurooncology].

PMID- 11210473
TI  - [Psychosurgical approach in neurosurgery].

PMID- 11210475
TI  - [Intravascular blood aspiration in large and giant parawedge aneurysm surgery].
AB  - The efficiency of a procedure of intravascular blood aspiration (IVBA) in
      patients with large and giant parawedge aneurysms of the internal carotid. The
      study was based on the analysis of clinical data and outcomes of surgical
      treatment in 20 patients with the aneurysms. The paper presents different
      procedures for IVBA, a complex of methods for preoperative examination of
      patients and intraoperative prediction of possible ischemic complications and
      defines indications for the IVBA procedure. Complete and partial aneurysm
      exclusion was achieved in 15 (75%) and 2 (10%) patients; the neck and walls of
      aneurysm were strengthened with surgical gauze in 2 (10%) patients. Incompetent
      clipping was observed in one case. There was recovery in 17 (85%), improvement in
      2 (10%), 1 (5%) patients. No deaths occurred. The IVBA procedure for aneurysm is
      indicated for large and giant thin-walled non-thrombotic aneurysms of the
      parawedge carotid segment. It permit effective proximal monitoring of carotid
      blood flow and creates favourable conditions for preparing and excluding
      aneurysm, and, if necessary, forming a carotid lumen. Intraoperative monitoring
      of brain function is highly important and obligatory for early prediction and
      prevention of ischemic complications. Under intraoperative monitoring of brain
      function, fractional IVBA makes it effective even if collateral circulation is
      inadequate.

PMID- 11210476
TI  - [Neurosurgical clinic on Solianka str].

PMID- 11210477
TI  - [Endoscopic interventions in tumors of the pineal area, posterior regions of the
      III ventricle, and the posterior cranial fossa].
AB  - The study was undertaken to develop and introduce low-invasive differential
      endoneurosurgical correction of spinal fluid circulatory disorders in tumors of
      the pineal area, posterior portions of the third ventricle and the posteranial
      fossa. The authors present their experience in surgically treating 12 patients by
      using endoscopy. Surgical techniques, endoscopic semiotics of tumors of the above
      site, metastases along the liquor pathways are described. The outcomes of this
      treatment are analyzed. An algorithm of surgical treatment is proposed. Certain
      advantages of endoscopic interventions over conventional treatments in the
      treatment of tumor-induced occlusive hydrocephalus justify their inclusion into a
      comprehensive examination and treatment of patients of this study group.

PMID- 11210478
TI  - Handheld computers making the rounds with physicians. Devices put medical know
      how--literally--in the palm of your hand.

PMID- 11210479
TI  - Physicians toe regulatory line. Practices develop "voluntary" compliance plans.

PMID- 11210480
TI  - Can I depend on coverage in my absence?

PMID- 11210481
TI  - Impact of directly observed therapy on tuberculosis in Memphis and Shelby County.

PMID- 11210483
TI  - The phthisis still with us. Tuberculosis: the white plague is not yet a ghost of
      the past.

PMID- 11210482
TI  - A rare cause of dyspnea and fibrocystic pulmonary disease.
AB  - Tracheobronchomegaly (TBM) is a disorder of the major airways characterized by an
      enlargement of the trachea and main stem bronchi. It is thought to result from a
      congenital connective tissue defect that results in the trachea and main bronchi
      becoming flaccid. Although TBM is considered rare, it may be more common than is
      generally recognized, and may be a seldom-diagnosed cause of chronic lung
      disease.

PMID- 11210484
TI  - [Prevalence of goiter and iodine deficiency in Saxony is less than previously
      assumed. A study 6 years after discontinuation of general iodization of table
      salt].
AB  - BACKGROUND: Germany is a known area of goitre endemicity. In East Germany (former
      German Democratic Republic), iodization of pre-packed table salt was introduced
      in 1985 and was only abolished after German reunification in 1990. Public
      awareness campaigns have concentrated on the use of iodized salt in the products
      of bakers and butchers as well as canned and frozen food since. Reports in the
      literature give figures of goitre prevalence (13 to 69%) inconsistent with each
      other and with our own clinical experience (about 30%). METHOD: We undertook a
      prospective cross-sectional study with a non randomly selected population
      (craftsmen and -women) covering Saxony in 1996, 1,129 and 1,594 adults were
      examined in 1996 and 1997, respectively, using a questionnaire, ultrasound, and
      measurement of urinary iodine excretion (1996 only). RESULTS: We found the
      following (mean) results in men/women in 1996: thyroid volume 23.0 +/- 1.3/17.1
      +/- 1.5 ml, prevalence of goitre 32.1/31.3%, prevalence of thyroid nodules
      21.1/23.0%, urinary iodine excretion (per creatinine) 86.4 +/- 1.3/104 +/- 24.1
      nmol/mmol (97.1 +/- 1.4/117 +/- 27.1 micrograms/g). In 1997 the results were as
      follows: thyroid volume 20.9 +/- 1.2/15.7 +/- 2.1 ml, prevalence of goitre
      25.6/23.6%, prevalence of thyroid nodules 16.4/19.8%. CONCLUSION: Whilst goitre
      and iodine deficiency are still endemic in Saxony, both have been improving
      despite the abolition of general table salt iodization.

PMID- 11210485
TI  - [Pathogenesis of bronchial asthma--unveiling new therapeutic prospects].
AB  - BACKGROUND: Bronchial asthma is a chronic inflammatory disease of the lower
      respiratory tract. It is characterized by nonspecific bronchial
      hyperresponsiveness, which may lead to variable, reversible airflow obstruction
      in affected patients. Despite therapeutic improvements, the worldwide prevalence
      and morbidity of asthma have risen during the past decades. An improved
      understanding of underlying pathological features and mechanisms of asthmatic
      inflammation is essential to achieve an enhanced asthma symptom control and may
      lead to prevention in the future. RESULTS: Besides the impact of genetic and
      environmental factors, scientific interest has especially been focused on the
      molecular and cellular biology of the asthmatic response. Mucosal inflammation in
      asthmatics is mainly orchestrated by T cells and derived cytokines.
      Immunoglobulin E and mast cells play a pivotal role in the initiation and
      pathogenesis of the early asthmatic reaction, while recruitment and activation of
      eosinophils seem to be crucial for the persistent asthma phenotype with chronic
      airflow obstruction. Additionally, smooth muscle cells, parasympathetic nerve
      fibers, bronchial epithelial cells and a vast amount of mediators may either
      promote or inhibit the inflammatory pathology of bronchial asthma. CONCLUSION:
      The recent insights from molecular biology have found their correlate in actual
      therapeutic guidelines, and have further led to the development of new innovative
      asthma drugs such as monoclonal antibodies against IgE or IL-5. Hopefully, future
      progress in revealing pathogenetic mechanisms of asthma may lead to further
      therapeutic improvement and eventually reverse the trend of rising asthma
      morbidity in western societies.

PMID- 11210486
TI  - [Preoperative risk assessment and perioperative management of HIV-infected
      patients].
AB  - PROBLEM: Due to their impaired immune function, unusual multimorbidity, and
      extensive concomitant medication HIV-infected patients impose special and
      specific demands on those who deal with their perioperative care. PREOPERATIVE
      ASSESSMENT: Beside standardized diagnostic and therapeutic preparations the
      preoperative knowledge, quantification, and treatment of HIV-associated
      opportunistic disorders and chronic organ damage are of particular importance.
      This requires an extended problem-orientated work-up. Furthermore, antiretroviral
      medication may interact with perioperatively administered pharmaceutics and lead
      to hardly foreseeable synergistic and antagonistic adverse effects. In contrast,
      "drug holidays" favor the development of HIV drug resistance. OPERATIVE
      MANAGEMENT: Anesthetic and surgical procedures basically depend on the underlying
      indication and consequently follow common principles. Laparoscopic techniques do
      not have any specific advantage in HIV-infected subjects. PERIOPERATIVE
      MORBIDITY: During their postoperative course, HIV-infected patients have to be
      more often admitted to intensive care unit and kept on artificial respiration
      unplannedly. Perioperative morbidity of HIV-infected patients increases with the
      stage of their disease. It is, however, not significantly elevated compared to
      that of HIV-negative subjects in similar preoperative health condition.

PMID- 11210487
TI  - [Diagnosis and therapy of Gaucher disease. Current recommendations of German
      therapy centers in the year 2000].
AB  - BACKGROUND: Gaucher's disease is the autosomally recessively inherited deficiency
      of the lysosomal enzyme glucocerebrosidase. Increasing storage of
      glucocerebrosides leads to a multisystem disease, the prevalence of which is
      about 1:40,000 in central Europe and up to 1:2,000 in some other countries (e.g.
      Israel). The acute and chronic neuronopathic forms of the disease (formerly
      defined as Gaucher types 2 and 3) account for only 5 to 10% of all Gaucher
      patients in Central Europe and Germany and are thus less frequent than the non
      neuronopathic disease (formerly defined as Gaucher type 1). Gaucher's disease is
      usually associated with spleno- and hepatomegaly, fatigue, skeletal
      complications, and several corresponding hematological and laboratory
      abnormalities. In 5 to 10% of the patients there are also central nervous
      symptoms such as myoclonic seizures, oculomotoric apraxia and a slight mental
      retardation. METHODS: Four specialized centers care for more than 2/3 of all
      German Gaucher patients today. These centers present their consensus
      recommendations for state-of-the-art diagnosis and treatment of Gaucher's
      disease. RESULTS: Recent epidemiological data indicate that only 10 to 20% of all
      Gaucher patients are correctly diagnosed (and treated) in Germany. The diagnosis
      today can be done in all patients by noninvasive methods, i.e. determination of
      the glucocerebrosidase activity in peripheral leukocytes and of the genetic
      defect. The current enzyme replacement therapy with glucocerebrosidase has proven
      effective to improve and often normalize hematological abnormalities,
      hepatosplenomegaly, skeletal complications and quality of life, provided that the
      therapy is started early and is given at adequate dosages. CONCLUSION: In view of
      the availability of an effective therapy, efforts should be made to increase the
      awareness of Gaucher's disease in differential diagnosis, to help to diagnose the
      disease with noninvasive techniques at early stages, and to provide practical
      guidelines for adequate treatment.

PMID- 11210488
TI  - [Rhabdomyolysis as a rare complication of theophylline poisoning].
AB  - CASE REPORT: A case of a 73-year-old male with theophylline overdose complicated
      by rhabdomyolysis is reported. After uncontrolled self-medication with an unknown
      number of theophylline slow release 350 mg tablets and furosemide 40 mg tablets
      he was admitted with unspecific clinical signs like tachyarrhythmia, vomiting and
      restlessness. Maximum theophylline concentration was 66.5 mg/l, other abnormal
      laboratory findings included hypokalemia (2.8 mmol/l) and hyponatremia (123
      mmol/l). The maximum creatinkinase level was measured after admission (32.29
      mumol/s/l) accompanied by a serum myoglobin level of 3,789 micrograms/l.
      Immediate treatment with oral activated charcoal and continuous veno-venous
      hemodialysis (CVVH) was instituted, together with intravenous potassium and
      sodium chloride substitution, forced diuresis and continuous administration of
      intravenous metoprolol. The theophylline, creatinkinase and myoglobin levels
      decreased rapidly and there was no second rise in theophylline found. The patient
      survived without sequelae. CONCLUSION: Rhabdomyolysis is a rare complication of
      theophylline intoxication. In literature only a small number of cases are
      reported. Our results illustrate the necessity of a purposeful and fast
      management to successfully prevent renal failure or death. Some pathogenetic
      mechanisms of theophylline-induced rhabdomyolysis, epidemiologic data, risk
      factors and therapeutical principles will be demonstrated by a detailed
      literature survey.

PMID- 11210489
TI  - [An unusual etiology of erythrocytosis in a 23-year-old primiparous woman in the
      22nd week of pregnancy].
AB  - CASE REPORT: A 23-year-old pregnant woman presented with erythrocytosis and a
      spuriously elevated HbA1c. Family history revealed that her father has been
      treated with phlebotomies for the last 2 years because of erythrocytosis of
      unknown cause. An examination of the family members demonstrated that the patient
      and her father were carriers of the hemoglobin (Hb) variant Hb Andrew
      Minneapolis. DISCUSSION: Hb Andrew-Minneapolis belongs to a group of hemoglobin
      variants with a high oxygen affinity resulting in compensatory erythrocytosis.
      The carriers of such hemoglobin variants are usually clinically asymptomatic,
      exercise tolerance appears unimpaired and there is no higher incidence of
      cardiovascular diseases. There is no clear-cut evidence that a maternal
      hemoglobinopathy with high oxygen affinity is accompanied by negative
      consequences for the fetus or a higher abortion rate. CONCLUSION:
      Hemoglobinopathies with a high oxygen affinity are a rare but important
      differential diagnosis of polycythemia. Under these circumstances erythrocytosis
      has to be accepted as the primary mode of compensation and does not require
      treatment, as long as blood viscosity is kept within tolerable limits. An
      excessively elevated or lowered HbA1c without a history or symptoms of diabetes
      should lead to further investigations concerning the possibility of
      hemoglobinopathy.

PMID- 11210490
TI  - [Necrobiotic xanthogranuloma with skin and liver amyloidosis].
AB  - BACKGROUND: Necrobiotic xanthogranuloma is a largely unknown disease. Both the
      frequency of this disease and the involvement of internal organs have clearly
      been underestimated until now. CASE REPORT: A patient was admitted because of
      ulcerating, xanthomatous, subcutaneous nodules, scleritis and conjunctivitis.
      Laboratory studies revealed an elevated erythrocyte sedimentation rate, a
      monoclonal IgG-lambda protein, a pancytopenia and later a hypocomplementemia.
      Furthermore, a hepatosplenomegaly and esophageal varices were found. A skin
      biopsy specimen showed a granulomatous infiltrate consisting of lymphocytes,
      histiocytes, plasma cells, foam cells as well as Touton and bizarre-appearing
      foreign-body giant cells and cholesterol clefts typical of necrobiotic
      xanthogranuloma besides a deposit of amyloid. A liver biopsy sample disclosed an
      amyloidosis of the parenchyma, too. Neither a therapy with chlorambucil and
      prednisolone nor with interferon alpha-2a resulted in improvement. CONCLUSION:
      Apart from treatment of skin lesions and ophthalmic manifestations further
      investigations are necessary because necrobiotic xanthogranuloma can be
      associated with malignancy and can involve internal viscera like lungs, heart and
      liver.

PMID- 11210491
TI  - [Cerebral calcinosis].

PMID- 11210493
TI  - Discovery of hyperthermophilic microorganisms.

PMID- 11210492
TI  - [Impaired CD95-(Fas,APO-1-)apoptosis regulation is a progression factor in early
      MALT-type lymphoma genesis].
AB  - BACKGROUND: MALT-type lymphomas are B cell tumors arising for so far unknown
      reasons on the background of chronic inflammation, e.g. Helicobacter pylori
      associated gastritis. T cells are supposed to have a positive impact on tumor
      growth, but fail in their control function. We therefore examined the interaction
      of T cells with malignant B cells in vitro and focused on T cell control which
      normally operates by CD95L/CD95-mediated apoptosis. PATIENTS AND METHODS:
      Malignant B cells were isolated from tumor tissues of 7 patients with low-grade
      MALT-type lymphoma and 4 patients with DLBL and cocultured in vitro with
      activated T cells. Normal memory B cells were used as control. We developed a T/B
      coculture assay for investigation of CD95L/CD95-mediated apoptosis. The influence
      of T cells on CD95 expression and survival of B cells was measured by FACS
      analysis. RESULTS: Activated T cells induced CD95 expression and thus enhanced
      sensitivity to CD95L-mediated apoptosis in normal memory B cells. However,
      malignant B cells from 3 out of 7 low-grade MALT-type lymphomas and all 4 gastric
      DLBLs resisted apoptosis, although the cells showed enhanced CD95 expression.
      CONCLUSION: Resistance to CD95L/CD95-mediated apoptosis allows malignant B cells
      from MALT-type lymphoma to escape T cell control and leads to prolonged survival.
      This phenomenon acts as a progression factor in early lymphomagenesis.

PMID- 11210494
TI  - Genome of Pyrococcus horikoshii OT3.

PMID- 11210496
TI  - Genome of Aquifex aeolicus.

PMID- 11210495
TI  - Genomic sequence of hyperthermophile, Pyrococcus furiosus: implications for
      physiology and enzymology.

PMID- 11210497
TI  - Genome of Thermotoga maritima MSB8.

PMID- 11210498
TI  - Classification of glycoside hydrolases and glycosyltransferases from
      hyperthermophiles.

PMID- 11210499
TI  - Beta-glycosidase from Sulfolobus solfataricus.

PMID- 11210500
TI  - Xylose isomerases from Thermotoga.

PMID- 11210501
TI  - Beta-mannanases from Thermotoga species.

PMID- 11210502
TI  - beta-Mannosidase from Thermotoga species.

PMID- 11210503
TI  - Alpha-D-galactosidases from Thermotoga species.

PMID- 11210504
TI  - Pyrococcus furiosus: large-scale cultivation and enzyme purification.

PMID- 11210505
TI  - alpha-Glucosidase from Pyrococcus furiosus.

PMID- 11210506
TI  - Amylolytic enzymes from hyperthermophiles.

PMID- 11210507
TI  - Cellulolytic enzymes from Thermotoga species.

PMID- 11210508
TI  - A phylogenetic perspective on hyperthermophilic microorganisms.

PMID- 11210509
TI  - Hyperthermophilic xylanases.

PMID- 11210510
TI  - Continuous cultivation of hyperthermophiles.

PMID- 11210511
TI  - Chitinase from Thermococcus kodakaraensis KOD1.

PMID- 11210512
TI  - Characterization of beta-glycosylhydrolases from Pyrococcus furiosus.

PMID- 11210513
TI  - Beta-Endoglucanase from Pyrococcus furiosus.

PMID- 11210514
TI  - alpha-Amylases and amylopullulanase from Pyrococcus furiosus.

PMID- 11210515
TI  - beta-Glucosidase CelB from Pyrococcus furiosus: production by Escherichia coli,
      purification, and in vitro evolution.

PMID- 11210516
TI  - Purification, characterization, and molecular modeling of pyrolysin and other
      extracellular thermostable serine proteases from hyperthermophilic
      microorganisms.

PMID- 11210517
TI  - Pyrrolidone carboxylpeptidase from Thermococcus litoralis.

PMID- 11210518
TI  - Genome of Methanocaldococcus (Methanococcus) jannaschii.

PMID- 11210519
TI  - Protease I from Pyrococcus furiosus.

PMID- 11210520
TI  - Archaeal proteasomes.

PMID- 11210521
TI  - Thiol protease from Thermococcus kodakaraensis KOD1.

PMID- 11210522
TI  - Proline dipeptidase from Pyrococcus furiosus.

PMID- 11210523
TI  - Prolyl oligopeptidase from Pyrococcus furiosus.

PMID- 11210524
TI  - Homomultimeric protease and putative bacteriocin homolog from Thermotoga
      maritima.

PMID- 11210525
TI  - Carboxylesterase from Sulfolobus solfataricus P1.

PMID- 11210526
TI  - Purification and characterization of yeast exocyst complex.

PMID- 11210527
TI  - Expression and properties of Rab4 and its effector rabaptin-4 in endocytic
      recycling.

PMID- 11210528
TI  - Purification of EEA1 from bovine brain cytosol using Rab5 affinity chromatography
      and activity assays.

PMID- 11210530
TI  - Fluorescence methods for monitoring interactions of Rab proteins with
      nucleotides, Rab escort protein, and geranylgeranyltransferase.

PMID- 11210529
TI  - Expression, purification, and characterization of Rab5 effector complex, rabaptin
      5/rabex-5.

PMID- 11210531
TI  - Measurement of Rab5 protein kinase B/akt and regulation of ras-activated
      endocytosis.

PMID- 11210532
TI  - Expression, purification, and biochemical properties of rabkinesin-6 domains and
      their interactions with Rab6A.

PMID- 11210533
TI  - Expression and functional analyses of Rab8 and Rab11a in exocytic transport from
      trans-Golgi network.

PMID- 11210534
TI  - Expression and properties of Rab7 in endosome function.

PMID- 11210535
TI  - Expression, purification, and properties of Rab8 function in actin cortical
      skeleton organization and polarized transport.

PMID- 11210536
TI  - Properties of Rab13 interaction with rod cGMP phosphodiesterase delta subunit.

PMID- 11210537
TI  - Subcellular localization of Rab17 by cryo-immunogold electron microscopy in
      epithelial cells grown on polycarbonate filters.

PMID- 11210538
TI  - Expression and properties of Rab25 in polarized Madin-Darby canine kidney cells.

PMID- 11210539
TI  - Purification of TRAPP from Saccharomyces cerevisiae and identification of its
      mammalian counterpart.

PMID- 11210540
TI  - Structural and functional organization of ADP-ribosylation factor (ARF) proteins.

PMID- 11210541
TI  - Expression and properties of ADP-ribosylation factor (ARF6) in endocytic
      pathways.

PMID- 11210542
TI  - Expression and analysis of ARNO and ARNO mutants and their effects on ADP
      ribosylation factor (ARF)-mediated actin cytoskeletal rearrangements.

PMID- 11210543
TI  - Expression, purification, and measurements of activity of ARNO1, a guanine
      nucleotide exchange factor for ADP-ribosylation factor 1 (ARF1).

PMID- 11210544
TI  - Expression, purification, and biochemical properties of EFA6, a Sec7 domain
      containing guanine exchange factor for ADP-ribosylation factor 6 (ARF6).

PMID- 11210545
TI  - Isolation and properties of GRP1, an ADP-ribosylation factor (ARF)-guanine
      nucleotide exchange protein regulated by phosphatidylinositol 3,4,5
      trisphosphate.

PMID- 11210546
TI  - Functional analysis of ADP-ribosylation factor (ARF) guanine nucleotide exchange
      factors Gea1p and Gea2p in yeast.

PMID- 11210547
TI  - Structural basis for Rab function: an overview.

PMID- 11210548
TI  - Isolation, cloning, and characterization of brefeldin A-inhibited guanine
      nucleotide-exchange protein for ADP-ribosylation factor.

PMID- 11210550
TI  - Prenylation of Rab proteins in vitro by geranylgeranyltransferases.

PMID- 11210549
TI  - Expression, purification, and properties of ADP-ribosylation factor (ARF) GTPase
      activating protein-1.

PMID- 11210551
TI  - Expression, analysis, and properties of yeast ADP-ribosylation factor (ARF)
      GTPase activating proteins (GAPs) Gcs1 and Glo3.

PMID- 11210552
TI  - Purification and properties of ARD1, an ADP-ribosylation factor (ARF)-related
      protein with GTPase-activating domain.

PMID- 11210553
TI  - Purification and characterization of GIT family of ADP-ribosylation factor (ARF)
      GTPase-activating proteins.

PMID- 11210554
TI  - Assay and purification of phosphoinositide-dependent ADP-ribosylation factor
      (ARF) GTPase activating proteins.

PMID- 11210555
TI  - Biological properties and measurement of phospholipase D activation by ADP
      ribosylation factor (ARF).

PMID- 11210556
TI  - Use of aminoglycoside antibiotics and related compounds to study ADP-ribosylation
      factor (ARF)/coatomer function in Golgi traffic.

PMID- 11210557
TI  - Adaptor protein 1-dependent clathrin coat assembly on synthetic liposomes and
      Golgi membranes.

PMID- 11210558
TI  - Receptor-dependent formation of COPI-coated vesicles from chemically defined
      donor liposomes.

PMID- 11210559
TI  - Antibody and oligonucleotide probes to distinguish intracellular expression and
      localization patterns of Rab GDP-dissociation inhibitor isoforms.

PMID- 11210560
TI  - ADP-ribosylation factor (ARF) as regulator of spectrin assembly at Golgi complex.

PMID- 11210561
TI  - Purification, properties, and analysis of yARL3.

PMID- 11210562
TI  - Preparation and assay of recombinant ADP-ribosylation factor-like protein-1
      (ARL1).

PMID- 11210563
TI  - Purification and properties of rat liver Sec23-Sec24 complex.
AB  - We have demonstrated a protocol for purifying functional Sec23-24 complex from
      rat liver cytosol. Because the rat liver Sec23-24 complex is highly susceptible
      to proteolysis, we have noted several modifications which have allowed us to
      overcome the problem of degradation. If care is taken to prevent proteolysis,
      this procedure typically yields 2 mg of functional complex. The Sec23-24 complex
      can then be used to study Sar1 GTP hydrolysis in the Sec23 GTPase activation
      assay. Additionally, Sec23-24 can reconstitute ER vesicle formation in the
      presence of Sar1 and Sec13-31, allowing for the identification of novel proteins
      or compounds that affect cargo export.

PMID- 11210564
TI  - Purification of functional Sec13p-Sec31p complex, a subunit of COPII coat.

PMID- 11210565
TI  - Expression, purification, and functional assays for self-association of dynamin
      1.

PMID- 11210566
TI  - Analysis of phosphoinositide binding by pleckstrin homology domain from dynamin.

PMID- 11210567
TI  - Mapping dynamin interdomain interactions with yeast two-hybrid and glutathione S
      transferase pulldown experiments.

PMID- 11210568
TI  - Interactions of dynamin and amphiphysin with liposomes.

PMID- 11210569
TI  - Activation of dynamin GTPase activity by phosphoinositides and SH3 domain
      containing proteins.

PMID- 11210570
TI  - Expression and analysis of properties of septin CDCrel-1 in exocytosis.

PMID- 11210571
TI  - Expression, purification, and biochemical properties of Ypt/Rab GTPase-activating
      proteins of Gyp family.

PMID- 11210572
TI  - Purification and properties of Rab3 GDP/GTP exchange protein.

PMID- 11210573
TI  - Expression of wild-type and mutant green fluorescent protein-Rab1 for
      fluorescence microscopy analysis.

PMID- 11210574
TI  - Purification and properties of Rab3 GTPase-activating protein.

PMID- 11210575
TI  - Rabphilin-3: a target molecule for Rab3 small G proteins.

PMID- 11210576
TI  - Doc2 alpha as modulator of Ca(2+)-dependent exocytosis.

PMID- 11210577
TI  - Purification and properties of a GTPase-activating protein for yeast Rab GTPases.

PMID- 11210579
TI  - [Precocious and polymorphic factitious disorder].
AB  - OBJECTIVE: Pathomimia is a mental disease more frequently diagnosed in women,
      characterised by a wide range of somatic or psychiatric symptoms, and a chronic
      course with severe complications. CASE REPORT: A 22-year-old woman was suffering
      from severe factitious disorders with thermopathomimia, dermopathomimia, self
      injuries with induced abscess, Lasthenie de Ferjol syndrome, and psychiatric
      factitious disorder. A very precocious age at onset and a previous history of 37
      surgical operations were found. DISCUSSION: This case history is particularly
      relevant in showing the clinical multiplicity of factitious disorders.

PMID- 11210578
TI  - [Acute pyelonephritis. Randomized multicenter double-blind study comparing
      ciprofloxacin with combined ciprofloxacin and tobramycin].
AB  - OBJECTIVES: To investigate the effects of an intravenous injection of tobramycin
      (T) in female patients with acute uncomplicated pyelonephritis treated with
      ciprofloxacin (CIP) (500 mg bid per os). METHODS: It was a randomized,
      multicenter, double-blind study conducted in six departments of emergency
      medicine. The main exclusion criteria were: previous history of urinary tract
      malformation of lithiasis, a recent urological procedure, pregnancy, diabetes
      mellitus, immunodepression, or severe sepsis. The primary criteria for evaluation
      were: the percentage and rate of clinical recovery, as well as bacteriological
      efficacy. RESULTS: 118 women were enrolled, 60 in the tobramycin group and 58 in
      the placebo group. E. coli was the most commonly isolated organism; all organisms
      were susceptible to ciprofloxacin and tobramycin. Two women in the CIP + T group
      and four women in the CIP + P group failed to respond clinically. The recovery
      rate was similar in the two groups (96 and 93% respectively). CONCLUSION:
      Administration of a dose of tobramycin did not demonstrate its clinical benefit
      in treatment of acute uncomplicated pyelonephritis treated by oral ciprofloxacin.

PMID- 11210580
TI  - [Cold parapharyngeal abscess in spondylodiscitis].
AB  - BACKGROUND: The principle danger of pharyngeal abscess is the risk of rupture
      overflow into the upper respiratory track. Pyogenic abscesses are the most
      frequent and tuberculosis is rare. We report two cases of retro and
      parapharyngeal abscesses with tuberculous spondylodiscitis. CASE REPORTS: The
      first case occurred in a 54-year-old woman, the second in a 19-year-old man. Both
      had a laterocervical swelling associated with a oropharyneal bulge that
      progressed over several months. Computed tomography showed abscess formation and
      spinal disease in both cases. Drainage of the abscess led to the distological
      diagnosis of tuberculosis. Medical management was successful with resolution of
      the abscess and spinal lesions. DISCUSSION: Spinal tuberculosis should be
      suspected in patients with a parapharyngeal abscess without detectable portal
      that progresses slowly. A biopsy specimen is required for diagnosis. Magnetic
      resonance imaging can provide early evidence of spondylodiscities. Medical
      treatment is indicated.

PMID- 11210581
TI  - [Cyclosporiasis: an emerging intestinal protozoan infection].

PMID- 11210582
TI  - [Double appendicitis: a rare clinical form in appendix duplication].

PMID- 11210583
TI  - [Calcitonin-secreting neuroendocrine carcinoma of the pancreas with  splenic
      invasion and paraneoplastic hypercalcemia].

PMID- 11210584
TI  - ["Overlap" syndromes. Autoimmune hepatitis--primary biliary liver cirrhosis;
      autoimmune hepatitis--primary sclerosing cholangitis].

PMID- 11210585
TI  - [40th ICAAC. Catheter-related septicemia].
AB  - A GROWING PROBLEM: Insertion or use of intravascular material is increasingly
      associated with septicemia. Septicemia occurs in 1 out of 1000 patients
      undergoing a non-surgical invasive cardiac procedure. The frequency of
      septicemia, particularly due to Gram-negative bacteria, is increasingly frequent
      in stem-cell graft recipients. PREVENTION MEASURES: Educational programs, for
      both patients and health givers, emphasizing the importance of aseptic can reduce
      the incidence of Gram-negative bacteria catheter-related septicemias.

PMID- 11210586
TI  - [Teaching human anatomy by the American medical faculty. The example of
      Stanford].

PMID- 11210587
TI  - [Ambulatory chemotherapy schedule for metastatic colorectal cancer].

PMID- 11210588
TI  - [Iatrogenic risk of self-medication by the pregnant patient].
AB  - REALITY OF SELF-MEDICATION IN PREGNANCY: Pregnant women use self-medication
      readily. Such behavior must not be overlooked by physicians and midwives during
      pregnancy. More epidemiology data would be useful. IATROGENIC RISKS: Drug
      toxicity, generally related to the advancement of somatic development of the
      embryo and fetus, can appear at variable stages during pregnancy. Moreover, the
      pharmacokinetic properties of drugs are different during pregnancy. These facts
      must be taken into account when assessing the risk of uncontrolled drug use by
      pregnant women. RECOMMENDATIONS FOR PREGNANT WOMEN: Obstetricians, midwives and
      primary care physicians caring for pregnant women should explain the risks of
      self-medication. The specific features of disease during pregnancy should be
      considered when giving relevant information.

PMID- 11210589
TI  - [Atherosclerosis--the role of nitric oxide].
AB  - ATHEROSCLEROSIS: Currently regarded as a multifactorial disease, atherosclerosis
      involves several factor including: oxidized LDL, endothelial cells, macrophages,
      immune cells, vascular smooth muscle cells. The endothelium appears to play a key
      role through the production of vasomotor, antiaggregate and leukocyte
      antiadhesion molecules. NITRIC OXIDE: NO is one of the most important mediators
      of endothelial antiatherothrombotic functions. Loss of endothelial production,
      called "endothelial dysfunction", i.e. loss of endothelial vasorelaxing,
      antiaggregate and leukocyte antiadhesion properties, could lead to increased
      fatty streak formation and acute arterial events (thrombus formation, vascular
      spasm). ANIMAL EXPERIMENTS: Although animal models strongly suggest a major role
      for NO in the pathophysiology of atherosclerosis, human studies with nitrates
      have been disappointing to date. The local effect of NO is probably closely
      adapted to local conditions. Therefore, massive delivery of NO as is achieved
      with nitrates could not repair endothelial dysfunction.

PMID- 11210590
TI  - [An unusual stent of the renal artery].

PMID- 11210591
TI  - [Predictive factors of virologic response to antiretroviral treatment with a
      protease inhibitor in HIV infection].
AB  - OBJECTIVE: To investigate factors related to early virological response among a
      cohort of 224 patients who started a protease inhibitor (PI) for the first time.
      To determine which factors are associated with persistent response among patients
      with early response. PATIENTS AND METHODS: Early complete response was defined as
      an undetectable plasma viral load 2 to 3 months after treatment onset (< 400
      copies/ml, Quantiplex HIV 2.0 Chiron diagnostics), incomplete response as at
      least 1 log reduction of viral load. In patients with an undetectable plasma
      viral load at 2 or 3 months, we also assessed the persistence of the response on
      the same regimen. Virology failure was defined by two consecutive viral load
      levels above the detection limit. RESULTS: In the total cohort, 66% of the
      patients had an early complete response, 11% a partial response and 23% no
      response. Complete virological response was significantly more frequent in naive
      (89%) than in pretreated (59%) patients (p < 0.001). Multivariate analysis of
      factors predictive of early response in pretreated patients (n = 169) showed that
      viral load (p = 0.001), the number of nucleoside analogs previously received (p =
      0.06) and a full or partial treatment switch (p = 0.10) were associated with
      complete response. Analysis of later response in the 45 naive patients with
      prolonged follow-up showed that 22% had treatment failure after 3 to 16 months.
      None of the baseline variables (viral load, CD4+ cell count or nature of the PI)
      were associated with duration of response. The only factor associated with
      persistent response in pretreated patients was a low number of antiretroviral
      drugs previously received (log-rank test, p = 0.04). CONCLUSIONS: The absence of
      previous antiretroviral treatment as the main factor associated with an early
      complete virological response. In patients pretreated with nucleoside analogs who
      presented early virological success, the number of drugs previously received,
      often associated with full or partial switch of nucleoside analog, significantly
      influence the persistence of response to a given triple-drug regimen.

PMID- 11210592
TI  - Handle with care! Complex scoring systems in measuring health-related quality of
      life. Commentary on Wilson et al. "The SF-36 summary scales: problems and
      solutions".

PMID- 11210593
TI  - Ministers of Health, Environment, Traffic, Economy: you need to have lunch
      together!

PMID- 11210594
TI  - The SF-36 summary scales: problems and solutions.
AB  - To determine the accuracy of the SF-36 summary mental and physical health scales
      in reflecting their underlying subscales using the traditional method of scoring
      based on factor coefficients derived through principle components analysis and
      orthogonal rotation. A representative Australian population survey containing the
      SF-36 was used to obtain factor coefficients from principle components analysis
      and orthogonal rotation for scoring the physical component summary (PCS) and the
      mental component summary (MCS) of the SF-36 in the traditional way. In addition
      two other methods were used to produce coefficients. The first method used
      maximum likelihood extraction and oblique rotation. The second method fit a
      structural equation model to the data in a confirmatory factor analysis. The
      coefficients derived by each of the methods were applied to the data of a second
      representative population survey. This survey also provided data on physical and
      mental health status which allowed comparison of the summary scores and
      underlying subscales according to various health states. Neither of the scoring
      methods based on the exploratory factor analyses methods (orthogonal and oblique)
      produced summary scale scores, by age group, that adequately reflected the
      underlying subscales. When coefficients derived using structural equation
      modeling were fit to the data in a confirmatory factor analysis the MCS and PCS
      accurately reflected their underlying subscale scores. They also produced MCS and
      PCS scores for the various health states as would be expected from the underlying
      subscales. The traditional methods of scoring the SF-36 summary scales produce
      results that would not be expected from the underlying subscales. The problem was
      only corrected by fitting a structural equation model to the data in a
      confirmatory factor analysis. The results advise caution in the use of the SF-36
      summary scales and suggests that alternative methods of developing factor
      coefficients need to be employed in studies using the SF-36 summary scales.

PMID- 11210595
TI  - Reproductive factors and incidence of breast cancer: an international ecological
      study.
AB  - Ecological studies can help in understanding the relation of reproductive history
      of breast cancer. We analyzed data from 9416 women, comprising the control groups
      of seven countries (Australia, People's Republic of China, Colombia, (former)
      German Democratic Republic, Israel, Philippines, and Thailand) from the WHO
      international, multi-center case-control study of female cancers. Positive
      correlations with country-specific breast cancer incidence were observed for
      (median) duration of reproductive life (r > or = 0.95, p < 0.005), age at
      menopause (r > or = 0.84, p < 0.025) and delay to first birth (r > or = 0.59, p <
      0.22) (when People's Republic of China was omitted, r > or = 0.85, p < 0.07). The
      association of age at first birth with breast cancer incidence was weakly
      positive in the whole sample (age-adjusted r = 0.18, p = 0.73), but weakly
      negative in the age groups 15-29 and 30-39 years and weakly positive in the age
      groups 40-49 and 50-64 years. A strong inverse correlation was observed between
      age at menarche and breast cancer incidence (r < or = -0.84, p < 0.03). These
      international ecological correlations agree with the associations previously
      reported for single populations, between higher incidence of breast cancer and
      younger age at menarche, older age at menopause, longer duration of reproductive
      life, and (possibly) longer delay to first birth. In contrast, age at first birth
      is only weakly related to breast cancer incidence across populations, indicating
      that this variable represents different constructs when measured ecologically
      versus individually.

PMID- 11210596
TI  - [Reproducibility of a German scale for assessing the need for inpatient treatment
      in surgery].
AB  - During the past years, the assessment of the appropriateness of hospital
      utilization has become increasingly important in the German health care system.
      Previous evaluations by regional review organizations in several states
      demonstrated the need for a standardized, reliable, and valid instrument to
      evaluate the appropriateness of inpatient care. Objective of the study is to test
      the reliability of a German adaptation of the "Appropriateness Evaluation
      Protocol" (AEP). Among all 2672 admissions from the department of surgery of a
      regional medical center during one calendar year, 54 patients were randomly
      selected to evaluate the inter-rater reliability and 51 patients to test intra
      rater reliability. Overall agreement, specific agreement and Kappa statistics
      were estimated for every hospital admissions and all consecutive hospital days.
      The German AEP showed an inter-rater agreement of 74% (62-86%) for hospital
      admissions (Kappa = 0.44) and 84% (79%-88%) for all hospital days (K = 0.55).
      Intra-rater reliability was 88% (79%-97%) for hospital admissions (K = 0.60) and
      88% (85%-92%) for all hospital days (K = 0.70). The observed agreement is
      independent of length of hospital stay and proportion of appropriate days. A
      standardized instrument with known metric properties is essential for quality
      management in hospitals to prepare for an increasingly consolidating health care
      market in Germany. The German AEP is a reliable instrument, which will allow to
      identify inefficiencies in the management of surgical inpatients.

PMID- 11210597
TI  - [Vaccination against hepatitis B in school: factors influencing acceptance and
      evaluation of general vaccination coverage ].
AB  - The second vaccination campaign against Hepatitis B in Lausanne concerned 1243
      students of the seventh grade. This campaign was actively supported by
      personalized information given to each adolescent in the class room. The
      decisions were collected in the same way, and in necessary the nurse phoned the
      parents for further information. In comparison with the previous year, the
      coverage had grown from 63.5% to 78.5%, but varied in each class between 42% and
      92%, whatever the class type. The factors which influence acceptance of the
      vaccination are coverage for the other vaccines, origin, and class, which has up
      to five times more effect than the other factors. Assessment of the vaccination
      coverage against Diphteria, Tetanus, Poliomyelitis, Pertussis, Measles and MMR is
      given in relation to the acceptance of the Hepatitis B vaccination and the class
      type.

PMID- 11210598
TI  - Body weight: the male and female perception.
AB  - The aim of the present study was to examine the relationship between actual body
      weight, characterization of one's weight, and satisfaction with it. 246 students
      of medicine in the third (clinical) stage of their studies at the University of
      Vienna responded to a questionnaire asking about their weight and attitudes
      regarding their personal body weight. The results indicate that many young women
      and men are either unable to characterize their weight (as normal, underweight,
      overweight, or obese) or guess incorrectly. The results point to the fact that a
      lot of women and men do not estimate their body weight in correspondence to the
      valid definition of the BMI. Women in particular seem to model themselves more on
      the current beauty ideal than men. Women seem to be more influenced by the
      current ideal of slenderness than their male counterparts. Women are more
      frequently dissatisfied with their weight, and see themselves as considerably
      heavier than they actually are. Because of this perception, women attempt to
      reduce weight more often than men. This type of dissatisfaction with one's body
      weight and excessive attention paid to body image, particularly weight, are
      considered as risk factors for the development of eating disorders. Not
      surprisingly, women are significantly more prone to these conditions than are
      men.

PMID- 11210599
TI  - Nicotine dependence among the population of a big Polish city.
AB  - Determinants of nicotine dependence types among current and former tobacco
      smokers were assessed in a random sample of Lodz inhabitants (25-64 years of
      age), part of the WHO CINDI project. Among current smokers there were 46.3%
      people with strong nicotine dependence, while in the group of ex-smokers the
      corresponding proportion was 10.8%. It has been found that sex, age and education
      did not affect the distribution of degree of the nicotine dependence. Prevalence
      of strong nicotine dependence among Polish regular smokers is high compared to
      other CINDI countries.

PMID- 11210600
TI  - [1000 thyroidectomies--personal experience and results].
AB  - The authors made one thousand thyroidectomies in the course of five years. In the
      submitted paper they discuss indications, for surgery, the extent of the
      operations, the results of the histological findings. They describe the surgical
      procedure, required preoperative examinations and postoperative monitoring. They
      analyze different postoperative complications incl. their frequency in the
      discussed group. They emphasize a physiological surgical technique, verifications
      of the recurrent nerve, care of the parathyroid bodies and collaboration with
      endocrinologists.

PMID- 11210601
TI  - [Percutaneous lumbar sympathectomy--presentation of a new trans-diskal approach].
AB  - The authors present the technique of chemical lumbar sympathectomy by an
      anatomically new medial transdiscal approach. On a group of 80 operations they
      analyze the indication criteria, complications and results of this method. They
      compare the percutaneous technique of severing of the sympathetic nerve with the
      classical surgical approach. In 41 patients where a modified transdiscal approach
      was used the authors did not encounter any serious complications. Using thin
      needles (minimum 23-G) they recommend this method as an alternative of the
      classical approach of Kappis.

PMID- 11210602
TI  - [Surgical treatment of spontaneous esophageal perforation--Boerhaave syndrome].
AB  - Spontaneous rupture of the oesophagus (Boerhaave's syndrome) is a life
      threatening disease the successful treatment of which depends on early diagnosis
      and effective comprehensive treatment. The authors present an account on three
      patients who were successfully treated on account of spontaneous rupture of the
      oesophagus.

PMID- 11210603
TI  - [Early carcinoma of the esophagus].
AB  - In 1991-1999 the authors performed at the First Surgical Clinic of the Faculty
      Hospital in Olomouc extirpation of the oesophagus on account of carcinoma in 133
      patients. This number comprised only four patients with a tumour in its early
      stage. In all these instances an adenocarcinoma in Barrett's oesophagus was
      involved. The authors emphasize, that the generally poor prognosis of patients
      with carcinoma of the oesophagus is influenced to a considerably extent by its
      late diagnosis. The finding of carcinoma of the oesophagus in the early stage of
      the disease is usually possible only in case of malignization of Barrett's
      oesophagus. This is the reason why Barrett's oesophagus should be dealt with only
      in specialized departments concerned with diseases of the oesophagus in general.

PMID- 11210604
TI  - [Surgical treatment of pulmonary aspergilloma and its complications].
AB  - The authors present an account of their experience with the surgical treatment of
      44 patients with pulmonary aspergilloma who were treated at the Clinic of
      Pneumology and Thoracic Surgery of the Third Medical Faculty Charles University
      in Prague during 1957-1999. The diagnosis of the disease before surgery was made
      in 39 patients (88.6%), in five patients it was established only after
      histological examination following resection of the lung. The presence of an
      aspergilloma was observed most frequently in a TB cavern (n = 30) and in
      bronchiectatic cavities (n = 9) with the most frequent localization in the upper
      pulmonary lobes (n = 38) and prevalence on the right side (n = 23). The most
      frequent symptom of the disease was haemoptysis (n = 39). All patients with the
      established diagnosis were treated before surgery by antimycotics. Treatment was
      however not successful and therefore the patients were indicated for surgery. The
      preoperative diagnosis of aspergilloma was based on X-ray or CT examination,
      serological examination (positive in 92.8%) and cultivation of sputum (positive
      in 58.9%). The most frequent surgical operation was lobectomy (n = 20),
      segmentectomy (n = 9), atypical resection (n = 8), pneumonectomy (n = 3);
      cavernostomy was performed in four patients. The most serious postoperative
      complication was a bronchopleural fistula with subsequent empyema (n = 2). During
      the postoperative period three patients died from respiratory failure associated
      with bronchopneumonia (6.8%). The authors recommend, based on their own
      experience, an active approach in patients with pulmonary aspergilloma and
      consider surgery as the main therapeutic method.

PMID- 11210605
TI  - [Aortic reconstruction in neonates with hypoplastic left heart syndrome]  .
AB  - The surgical technique and tactics of the Norwood operation in neonates with
      hypoplastic left heart syndrome represent a surgical challenge. The Norwood
      operation was performed from the midline sternotomy approach, in extracorporeal
      circulation and deep hypothermic circulatory arrest was used for reconstruction
      of the hypoplastic aorta. Operation consisted of reconstruction of the "neoaorta"
      and the aortic arch from the original hypoplastic ascendent aorta, pulmonary
      trunk and a patch cut from a pulmonary homograft or pericardium, excision of the
      atrial septum and an arterial shunt from a Goretex vascular graft 3.5 or 4 mm in
      diameter. In patients with well developed aortic arch it was possible to
      reconstruct the aorta using Damus-Kaye-Stansel operation without circulatory
      arrest. Out of 12 operated patients with this defect, two (16.7%) died during the
      early postoperative period, one patient died late. The postoperative course was
      often complicated. In 6 (50.0%) patients the second step of Norwood operation,
      the bidirectional cavopulmonary anastomosis, was performed without mortality.
      According to our experience, it was necessary to prepare patients adequately
      before the first surgery. Perfect reconstruction of the aorta and a well
      functioning shunt had the crucial significance.

PMID- 11210607
TI  - [Hemodynamic changes after sclerotherapy of esophageal varices in children].
AB  - The authors present an account on favourable late results of sclerotization of
      oesophageal varices in children. After sclerotization not only an immediate
      effect can be observed such as arrest of haemorrhage but also long-term
      favourable effects are found in the venous circulation of the splanchnic area.

PMID- 11210606
TI  - [Evaluation of 26 esophagectomies from the aspects of complications and survival
      time].
AB  - The authors analyze a group of 26 patients with oesophageal carcinoma operated in
      the course of five years with regard to postoperative complications and period of
      survival. In seven instances they used Ivor-Lewis operation, 17 times Orringer's
      operation, twice a palliative retrosternal bypass. Twenty one times they used the
      stomach for replacement of the oesophagus, five times the left hemicolon
      antiperoristaltically. The preoperative ASA classification was on average 3. The
      moribidity was 74%. Respiratory complications were most frequent--18x, paresis of
      the left vocal cord--7x, a fistula in the anastomosis--5x. The hospital mortality
      was 27%, its causes being cardiac failure, MOF, fistulae in the anastomosis. In
      seven instances the authors performed tracheostomy. Of 19 surviving patients 13
      died after an average period of 10 months. Six patients survive on an average for
      11 months.

PMID- 11210608
TI  - [Pleuro-dural communication].
AB  - Traumatic pleuro-dural communication causing pneumocephalus needs rapid
      diagnostics and surgical treatment, so as to prevent the development of possible
      complications.

PMID- 11210609
TI  - [Surgical procedures on the external carotid artery].
AB  - A clinical series of five patients operated on for symptomatic cerebral blood
      flow deterioration is discussed. They presented with either hemispheral symptoms
      (hemiparesis, amaurosis fugax) or signs of diffuse cerebral hypoxia. In the
      presence of unilateral or bilateral internal carotid artery (ICA) occlusion a
      critical stenosis of the external carotid artery (ECA) was confirmed either by
      duplex ultrasound or angiography. In all these cases ECA was reconstructed by
      means of common vascular surgical techniques. The use of intraluminal (i.l.)
      shunt was mandatory. There were neither early nor late deaths in this group. In
      one patient a transient stroke occurred three days following standard carotid
      endarterectomy performed after ECA surgery on the contralateral side. After the
      mean follow-up of 46 months all patients remain neurologically asymptomatic. In
      selected cases the ECA reconstruction offers an effective and beneficial tool for
      surgical management of critical cerebral perfusion impairment.

PMID- 11210610
TI  - [Laparoscopy in the diagnosis, classification and therapy of nonpalpable
      undescended testes].
AB  - OBJECTIVE: The use of laparoscopy in children for the diagnosis, classification
      and treatment of non-palpable testes. High forms of undescended testes in an
      abdominal or high inguinal position are a diagnostic and therapeutic problem in
      paediatric surgery. METHOD: The authors evaluate retrospectively the laparoscopic
      approach used in 68 boys for the diagnosis, classification and treatment of 79
      undescended testes. The mean age of the operated boys was 4.58 years. In 22
      (27.9%) agenesis or atrophy of the testis was found (Type I). Thirty-two (40.5%)
      testes in an abdominal position (Type II) were mobilized laparoscopically, moved
      to the groin and the operation was completed by open orchidopexy. In 25 cases
      (31.6%) the laparoscopic method described by Fowler-Stephens was used treatment
      was completed by orchidopexy in the second stage (Type III and IV). RESULTS: No
      serious complications were recorded during or after operation. In two instances
      (2.5%) after the two-stage Fowler-Stephens operation atrophy of the testis
      developed. CONCLUSION: Miniinvasive laparoscopy is considered at present the
      standard method for the localization and treatment of non-palpable testes.

PMID- 11210611
TI  - [Injuries of the small intestine in polytrauma].
AB  - The authors inform on the increasing number of penetrating abdominal injuries
      during the last five years, especially in the criminal injuries. Diagnostic
      methods in a stabilised patient are analysed, diagnostic and therapeutic
      laparoscopy is preferred to lavage of the abdominal cavity in indicated cases.
      Urgent surgical revision is recommended in patients in a critical state on
      account of quickly increasing compartment syndrome, although staged laparotomy is
      needed. The timing of surgical methods is emphasised in serious associated
      injuries. Conclusions are illustrated with surgical results.

PMID- 11210612
TI  - [Devastating injuries--new therapeutic approaches].
AB  - Nowadays the number of devastating injuries is increasing, as a consequence of
      traffic accidents and criminal incidents, too. Patients are often admitted in a
      critical state, the mortality rate in these cases is very high (50% and more). To
      decrease this high mortality, new treatment approaches must be chosen incl. the
      method called damage control. Knowledge of leading foreign centres are evaluated
      together with our clinical experience.

PMID- 11210614
TI  - [Personal experience with mechanical intestinal anastomoses].
AB  - The authors evaluated the results of operations of the large intestine and rectum
      on account of cancer, covering a 4-year period. In all instances a stapler or
      Valtrac were used. Dehiscence of the anastomosis was recorded in one instance.

PMID- 11210613
TI  - [Does a pelvic compartment exist? Personal experience].
AB  - The authors analyze a group of 7 patients transferred to their hospital for
      instable fractures of the pelvic circle and lumbar spine. The pelvic compartment
      was manifested 24-48 hours after injury. Early diagnostics are based on the use
      of new imaging techniques, spiral CT examination is preferred, and angiography in
      stabilized patients. Early surgical intervention is aimed at evacuation of
      haematomas, revision of vessels, release of the ureters and temporary
      nephrostomy.

PMID- 11210615
TI  - [Distal crural bypass as a limb salvage procedure--case report].
AB  - The authors present a case of a patient with a progredient moist gangrene of the
      right foot. In this patient, amputation of the lower limb was indicated because
      of an unfavourable angiographic finding, after unsuccessful conservative
      treatment. With regard to the fact, that the patient had undergone amputation of
      the other lower limb in the crus, revision of the posterior tibial artery was
      decided. Preoperative angiography did not confirm the previous unfavourable
      angiographic finding. After the implantation of a distal crural venous bypass
      (posterior tibial artery--supramalleolar part), healing of the extremity occurred
      in a relatively short time period. The authors agree with the opinion that distal
      crural and pedal bypasses cannot be always indicated on the basis of routinely
      performed angiography. Revision of crural arteries and possible preoperative
      angiography can change the situation and lead to the salvage of the limb.

PMID- 11210616
TI  - [Pathogenic properties of Corynebacterium diphtheriae].
AB  - The main pathogenic properties of 73 C. diphtheriae strains (their adhesive,
      invasive and cytotoxic activity) were characterized in the cultures of cells HEp
      2 and Vero. The quantitative determination of the toxigenicity of 381 strains in
      the indirect hemagglutination test was made, and the strains were distributed by
      the degree of their toxigenicity. The characteristics of C. diphtheriae obtained
      with the use of in vitro experimental models, coincided with the severity of
      clinical manifestations of the diphtheria in humans, which made it possible to
      regard the models used in this study as adequate. On the basis of the chosen
      criteria the characterized strains could be subdivided into highly, moderately
      and low virulent and the degree of their potential epidemic danger could be
      determined.

PMID- 11210617
TI  - [Pathogenicity factors of various vibrios and aeromonads].
AB  - A review of literature on the pathogenicity factors of non-cholera vibrios and
      Aeromonas is presented. A detailed analysis of such pathogenicity factors as
      hemolysins, lecithinases, cytotoxins, adhesins, etc. is given. Information on
      some mechanisms of the pathogenetic action of these factors on warm-blooded
      animals is presented. The necessity of more extensive research on pathogenicity
      and persistence factors in opportunistic bacteria causing sapronotic infections
      is emphasized.

PMID- 11210618
TI  - [Helicobacter pylori in gastrointestinal diseases and in healthy individuals].

PMID- 11210619
TI  - [Outbreak of acute enteric infections in a children boarding-school: iceberg
      phenomenon (part 1)].

PMID- 11210620
TI  - [Cases of ornithosis in Moscow: most recent data].

PMID- 11210621
TI  - [Outbreak of acute enteric infections in a children boarding school: iceberg
      phenomenon (part 2). Answers to questions and authors' commentary].

PMID- 11210622
TI  - [Modern outlook at viral hepatitis A epidemiology in Moscow].

PMID- 11210623
TI  - [Dibazol: a remedy for prophylaxis of acute respiratory infections among students
      of military colleges].

PMID- 11210624
TI  - [Occurrence of Staphylococcus aureus enterotoxigenic strains isolated from
      pregnant women with pathology].
AB  - 137 S. aureus strains, isolated from the larynx of pregnant women in cases of
      pathology, were studied for the formation of staphylococcal enterotoxins of types
      A and B (SEA and SEB) by the indirect hemagglutination test. The study revealed
      that SEA was produced by 35.0% and SEB, by 56.6% of the strains under study. The
      proportion of SEA and SEB producers among staphylococci isolated from mothers and
      children was, respectively, 18.4% and 20.0%, 89.41% and 67.5%. The number of
      enterotoxigenic staphylococci in the upper respiratory tract of newborn infants
      and mothers practically coincided with that in mothers. The occurrence of SEA-
      and SEB-producing enterotoxigenic strains in the medical personnel was 25.5% and
      62.7% respectively.

PMID- 11210625
TI  - [Diagnostic value of a novel nutrient medium for isolation and cultivation of
      pathogens causing enteric yersiniosis and pseudotuberculosis].
AB  - A new nutrient medium for isolation and cultivation of the causative agents of
      enteric yersiniosis and pseudotuberculosis was found to have advantages over Endo
      medium in its differentiating and inhibiting properties. This medium permitted
      the easy differentiation of Yersinia pseudotuberculosis from Y. enterocolitica,
      as well as from Escherichia coli, Shigella flexneri, Klebsiella pneumoniae, K.
      rhinoscleromatis, Hafnia, Enterobacter and Citrobacter by color; from Proteus
      inconstans by swarming. In addition, weakly swarming of P. vulgaris differed by
      their light bluish color and Pseudomonas aeruginosa, by the brilliance and size
      of colonies. Endo medium could be used only for differentiation of E. coli from
      lactose-negative Yersinia colonies, Klebsiella (by mucous growth) and, to a
      certain extent, all Proteus species (by swarming). The medium under test and the
      control medium inhibited the growth of Staphylococcus aureus. In contrast to Endo
      medium, the medium under test partially inhibited the growth of K.
      rhinoscleromatis and the swarming of P. inconstans. The new medium is now
      introduced into practice.

PMID- 11210626
TI  - [DNA, RNA, and protein biosynthesis in cells of Yersinia pseudotuberculosis at
      various cultivation temperatures].
AB  - Y. pseudotuberculosis cells cultivated at temperatures of 37 degrees C and 8
      degrees C were found to be capable of incorporating exogenic precursors into DNA,
      RNA and protein. The linear growth of thymidine incorporation occurred during 8
      hours of cultivation at 37 degrees C, then the amount of the incorporated label
      decreased. At 8 degrees C the level of thymidine incorporation into DNA gradually
      increased for 80 hours and longer, but not reaching the level of incorporation
      observed at 37 degrees C. The incorporation of uridine into RNA of Y.
      pseudotuberculosis cells reached its maximum after 4 hours of cultivation at 37
      degrees C, at a lower temperature of cultivation the incorporation of uridine
      into bacterial cells was almost linear, though slower, and lasted for 20 hours.
      The content of radioactive alanine in Y. pseudotuberculosis protein increased
      during 16 hours of cultivation at a high temperature, while at 8 degrees C the
      growth of the incorporation level lasted for at least 40 hours. For all
      precursors under study the incorporation rate into the cell biopolymers at the
      initial stages of cultivation was higher at 37 degrees C, than at a lower
      temperature.

PMID- 11210627
TI  - [Effect of cultivation temperature on nucleic acid level in bacteria Listeria
      monocytogenes and Yersinia pseudotuberculosis].
AB  - The relationship between the multiplication of bacteria, the content of nucleic
      acid and the specific rate of their growth during their batch cultivation in
      nutrient broth and mineral medium at temperatures of 37 degrees C and 4-6 degrees
      C was studied in the causative agents of saprozoonotic infections with L.
      monocytogenes and Y. pseudotuberculosis used as typical representatives of such
      bacteria. The content of DNA was shown to remain practically unchanged after the
      alteration of cultivation temperature and the conditions of nutrition. The linear
      relationship between the content of RNA and specific growth rate was registered
      both at 37 degrees C and 4-6 degrees C. However a higher content of RNA at low
      temperatures was found to correspond to one and the same specific growth rate,
      which was linked with the additional synthesis of this nucleic acid.

PMID- 11210628
TI  - [Effect of hydroxylamine hydrochloride on lipopolysaccharide fatty acid
      composition in Shigella dysenteriae 1].
AB  - Changes in the fatty acid composition of S. dysenteriae 1 lipid A after the
      treatment of lipopolysaccharide (LPS) with hydrosylamine hydrochloride (HH) and 4
      degrees C, 37 degrees C and 56 degrees C were studied with the use of gas-liquid
      chromatographicmass-spectrometry. The treatment with HH led to a decrease in the
      toxicity of LPS, but produced no changes in the content of the main fatty acid
      components of lipid A (lauric, myristic, oxymyristic and palmitic acids). At the
      same time the total number of minor fatty acid derivatives decreased from 11 (in
      the original LPS) to 5 in LPS treated with HH at 56 degrees C.

PMID- 11210629
TI  - [Vibrio cholerae O139 bacteriophages].
AB  - Cholera bacteriophages have been isolated from 27 lysogenic cultures of V.
      cholerae O139. As shown the pages under study belong to two morphological groups
      A1 and F1 and serological types II and XII. The use of prophage typing and the
      sensitivity test to specific phage made it possible to differentiate V. cholerae
      strains, serogroup O139.

PMID- 11210630
TI  - [Role of modern factors in the interaction between men and microorganisms.
      Importance of the national health system for prophylaxis and treatment of
      infectious diseases].

PMID- 11210631
TI  - [Prospective observation of pyo-septic infections in frame of epidemiologic
      surveillance].
AB  - The main principles of prospective observation in cardiosurgical hospitals have
      been worked out. The method of dynamic observation on hospital pyo-septic
      infections (HPSI) has shown its high effectiveness and permitted the more
      complete and timely detection of morbidity, as well as the determination of the
      groups and factors of risk. In the process of prospective observation and the
      timely realization of epidemic control measures a considerable decrease in HPSI
      morbidity has been achieved.

PMID- 11210632
TI  - [Immunosuppressive components of extracellular polysaccharide from Pseudomonas
      aeruginosa clinical strains].
AB  - The immunosuppressive activity of lipopolysaccharide (LPS) contained in filtrates
      of newly isolated P. aeruginosa cultures was studied. The experimental model of
      delayed hypersensitivity to non-bacterial antigen in CBA mice and gel filtration
      through Sephadex G-200 were used. In addition to the already known LPS component
      with direct immunosuppressive action and having a mol.wt. of 150-800 kD, a new
      component was detected. It was found to be in inactive state and could be
      activated by redox treatment, thus becoming capable of inducing capacity for
      immunosuppression in Escherichia coli. This component had a mol.wt. of 50-70 kD
      and lost its activity after heating.

PMID- 11210633
TI  - [Impaired immune response associated with ABO antigen system in patients with
      purulent abscesses and dysentery].
AB  - On the basis of a considerable number of facts--the results of the immunological
      survey of 197 patients with purulent infections of soft tissues and 103
      shigellosis patients--the character and manifestation of immunological
      disturbances were found to depend on the genetic markers of blood (antigens of
      the AB0 system) which proved to differ in different type of pathology in
      patients.

PMID- 11210634
TI  - [Production and characterization of monoclonal antibodies to group-specific
      antigenic determinant of group A streptococcal polysaccharides].
AB  - Hybridomas producing monoclonal antibodies (McAb) to group A streptococcal
      polysaccharide (A-PS) were obtained. Of these, 3 clones were selected: 2 clones
      producing IgG3, precipitating McAb and 1 clone producing IgM nonprecipitating
      McAb. The results of the competitive inhibition in the enzyme immunoassay
      suggested that precipitating and nonprecipitating McAb reacted with nonidentical
      epitopes of A-PS, though determinants, specifically reacting with the given McAb,
      had a common site which included N-acetyl-D-glucosamine. On the surface of
      bacteria, in addition to protein M, the presence of the given determinants of A
      PS was established in the direct immunofluorescence test. The newly developed
      method of direct immunofluorescence with the use of specially selected
      precipitating McAb was the basis for the development of rapid diagnosticum,
      permitting the identification of group A streptococci.

PMID- 11210635
TI  - [Intensity of the humoral immune response to herpesviruses as an indicator the
      body immune deficiency].
AB  - The state of the local immunity system of the oral cavity was studied by the
      level of saliva immunoglobulins in patients with different processes on their
      mucous membranes: herpetic infection, respiratory allergosis and malignant tumors
      of the mouth cavity and the laryngopharynx. The suppression of the production of
      sIgA, was accompanied by the enhanced production of antibodies to the most
      widespread herpesviruses (herpes simplex virus, cytomegalovirus and Epstein-Barr
      virus). The maximum levels of serum IgG to herpesviruses were determined in
      patients with malignant tumors. The role of herpesviruses in the pathogenesis of
      immunodeficient states is discussed.

PMID- 11210636
TI  - [Immunocorrective effect of proteolytic enzymes on antibody genesis in mice
      subjected to infectious burn trauma and treatment with antibiotics].
AB  - As revealed in this study, massive burn trauma manifestly suppresses the genesis
      of antibodies to T-dependent antigen (sheep red blood cells). The administration
      of ampicillin to the burned animals enhances immunosuppression, while gentamicin
      produces no essential impact on immune processes under these conditions.
      Proteolytic enzymes, terrilytin and terridecase, have corrective influence on
      disturbances in immune response in animals with burns. Enzyme in the immobilized
      form (terridecase) has a more pronounced immunotropic activity in this type of
      pathology.

PMID- 11210637
TI  - [Skin microbiocenosis in patient with chronic dermatoses].
AB  - The skin microflora of patients with chronic dermatoses (atopic dermatitis and
      psoriasis) have been studied by the original "Bactotests" method. The data thus
      obtained indicate that the clinical picture of the disease is related to the
      severity of skin dysbacteriosis. The electron-microscopic study of 2
      staphylococcal strains isolated from patients has revealed the presence of the
      immunoglobulin cover (capsule-like outer sheath consisting of immunoglobulins and
      other humoral protective factors) on the cell wall of these bacteria.

PMID- 11210638
TI  - [Effect of bifidobacteria and lactobacillus and antibiotics in combination with
      common gnotobiological isolation on the survival of mice with acute radiation
      sickness].
AB  - The influence of the combined use of bacterial preparations (Bifidobacterium and
      Lactobacillus) and antibiotics (ciprofloxacin, lomefloxacin and amikacin) on the
      survival rate of irradiated mice placed under the conditions of general
      gnotobiological isolation was studied. Bacterial strains used in combination with
      quinolones (ciprofloxacin, lomefloxacin) significantly increased the mean
      survival time of the animals (p < 0.05) when introduced in a dose of 1.0 x 10(9)
      microbial cells per mouse on days 1, 3, 5, 7, 9, 11, 13 and 15 after irradiation.
      At the same time a short course of treatment with bacterial preparations (two
      injections on days 5 and 7 after irradiation) proved to be insufficient for
      increasing the survival rate of the animals. The mean survival time of the
      irradiated mice was higher after the use of bacterial preparations in combination
      with lomefloxacin or ciprofloxacin than after their use with amikacin.

PMID- 11210639
TI  - [Use of loading doses of bifidumbacterin forte for treatment of patients with
      acute enteric infections].
AB  - The clinical observation of patients with acute enteric infections (AEI), treated
      with loading doses of Bifidumbacterin forte during the first 2 days of the
      disease, was carried out. The preparation was shown to produce a positive effect
      on the course of AEI: salmonellosis, alimentary toxicoinfections, acute,
      dysentery. The early decrease of the manifestations of intoxication, pain
      syndrome, diarrhea, as well as the acceleration of convalescence in comparison
      with standard treatment, were noted. The most essential dynamics was registered
      in salmonellosis patients. The analysis of clinical results allowed to recommend
      the use of loading doses of Bifidumbacterin forte, a probiotic with high
      colonization potential to normalize the microbiocenosis of the intestine in AEI.

PMID- 11210640
TI  - [Pathogenicity factors of Corynebacterium diphtheriae circulating in the
      Primorski region under conditions of mass immunization of population].
AB  - The study of the main pathogenicity factors of C. diphtheriae (adhesive activity,
      toxigenicity, detection of tox+ gene) circulating in the Primorski Territory has
      been made. As revealed in this study, at the period of declined epidemic process
      due to mass immunization of the adult and child population against diphtheria the
      selection of C. diphtheriae strains with weak toxigenicity and low adhesiveness
      was observed. No strains having tox+ genes have been detected among C.
      diphtheriae nontoxigenic strains circulating in the Primorski Territory.

PMID- 11210641
TI  - [Identification of nontuberculous mycobacteria by methods of molecular biology].
AB  - A number of clinical and laboratory strains of microorganisms belonging to
      different species of mycobacteria of the nontuberculous complex were tested with
      the use of the polymerase chain reaction and the restriction analysis. The unique
      restriction profiles of the following species of mycobacteria have been obtained:
      M. fortuitum VI, M. kansasii I, M. intracellulare, M. avium.

PMID- 11210642
TI  - [Computer-controlled maintenance of the dissolved oxygen level in a medium during
      controlled cultivation of Neisseria meningitidis].
AB  - A new method for controlling the processes of N. meningitidis cultivation by the
      content of oxygen dissolved in the medium with the use of a computer, including
      the software, technical and methodological provision of the computer-operated
      control system, has been developed. The processes of the cultivation of N.
      meningitidis, groups A and B, under fully controlled conditions have been
      realized. The computer-operated control of the content of oxygen in the medium,
      the most important parameter of the process, has been shown to be essentially
      more effective than manual control. Information, accumulated in the course of the
      experiment, may be used in future for correction of mathematical models and
      optimization of the process. This will by necessary for obtaining biomass with
      predetermined properties in the development of new diagnostic and vaccine
      preparations.

PMID- 11210643
TI  - [Effect of Actoflor preparations on survival of Escherichia coli M-17 and
      Salmonella enteritidis under starvation conditions in mixed cultures].
AB  - The viability of E. coli M-17 and S. enteritidis under starvation conditions in
      mono- and mixed cultures was studied. E. coli M-17 showed greater capacity for
      survival in mixed cultures than in monocultures, while for S. enteritidis the
      contrary was true. Preparations "Actoflor" enhanced the antagonistic activity of
      E. coli M-17, ensuring its absolute selective advantage under starvation
      conditions in mixed cultures. The role of E. coli M-17 low-molecular
      exometabolites is discussed; they are probably an important factor in the
      antagonistic activity of these microorganisms.

PMID- 11210644
TI  - [Industrially produced eubiotics as materials for isolation and study of DNA].
AB  - The optimum and available methods for the isolation of DNA from bacteria, used as
      the basis of the industrial manufacture of eubiotics (colibacterin,
      lactobacterin, biobactone) have been developed. The proposed approach makes it
      possible to isolate DNA, suitable for genosystematic studies under laboratory
      conditions, directly from producer strains.

PMID- 11210645
TI  - [Effect of preparations of protein Yop encoded by Yersinia pestis calcium
      dependence plasmid on mice].
AB  - The impact of the preparations of Y. pestis secreted proteins Yop (YopH-M, YopB,
      YopD-N, YopE) on mice immunized with 3 s.c. injections was studied. Though these
      proteins failed to protect the animals from plague, they stimulated the
      immunobiological transformation in the immunized animals. YopB and YopD-N were
      found to have the highest immunobiological activity with respect to mice. The
      preparation of YopB induced the production of the highest titers of specific
      antibodies and stimulated cell-mediated immune response. The injection of YopD-N
      to mice led to a considerable decrease in the proliferative capacity of
      splenocytes in vitro in response to stimulation with nonspecific mitogen ConA, as
      well as to pathological changes in the kidneys.

PMID- 11210646
TI  - [Synthesis of protective antigens during submerged cultivation of Vibrio
      cholerae].
AB  - The effectiveness of dot immunoanalysis for evaluating the dynamics of the
      synthesis of O-antigen, cholera toxin, neuraminidase, adhesin CFA1 in the process
      of the reactor cultivation of V. cholerae used for the production of oral
      chemical cholera vaccine is shown. The established regularities of the synthesis
      of the protective antigens of V. cholerae in the process of scaled-up cultivation
      are discussed.

PMID- 11210647
TI  - [Bactericidal properties of hemo-cytolysin from Vibrio cholerae non O1 P-11702
      strain in a panel of indicator cultures for detection of vibriocins].
AB  - The influence of the preparation of hemo-cytolysin, obtained from V. cholerae non
      O1 strain P-11702 and inducing lysis of both red blood cells and V. cholerae
      cultures using a panel of indicator cultures for the detection of vibriocins, was
      studied. The set of indicator cultures contained 2 Shigella flexneri strains, 1
      S. dysenteriae strain, 3 S. sonnei strains, 3 Escherichia coli strains and 2 V.
      cholerae strains, one of them being atypical. Hemo-cytolysin exhibited lytic
      activity with respect to S. dysenteriae, S. sonnei strains and 1 V. cholerae
      strain. i.e. to 4 out of 11 indicator strains. V. cholerae atypical strain proved
      to be resistant to the preparation in contrast to 33 V. cholerae typical strains,
      studied previously.

PMID- 11210648
TI  - [Comparison of various PCR methods for the detection of Chlamydia trachomatis,
      Ureaplasma urealyticum, and Mycoplasma hominis in women with impaired
      reproductive function].
AB  - The comparative evaluation of the PCR test "Polimik" (Research and Production
      Firm "Litekh", Moscow) and the PCR test of the Novosibirsk Institute of
      Bioorganic Chemistry (NIBC) was carried out. The results obtained with the use of
      the PCR test "Polimik" and the PCR test of the NIBC of the detection of C.
      trachomatis and M. hominis coincided in 97.8% and 97.4% of cases. For U.
      urealyticum, the coincidence of the results of both PCR tests was 81.2%. Among
      women who visited gynecologists for reproductive function disturbances, the use
      of the PCR tests made it possible to detect C. trachomatis in 19 (5.5%) out of
      343 cases, U. urealyticum in 96 (39.0%) out of 246 cases and M. hominis in 25
      (16.9%) out of 148 cases. The results of the investigation revealed that the
      occurrence of C. trachomatis infection in Novosibirsk was comparable with that in
      other regions of the world among the low-risk groups of the population. The
      detection frequency of M. hominis and U. urealyticum with the use of the PCR
      tests showed that the occurrence of infections caused by these causative agents
      coincided with the data obtained in other countries.

PMID- 11210649
TI  - [Search for biological remedies for fungi of the Candida genus].
AB  - 51 bacterial strains were studied with a view to find out anticandidial activity;
      of these, 15 strains were found to have activity, more on less expressed with
      respect to fungi of the genus Candida. In most cases the anticandidial activity
      of an antagonist strain was manifested to a similar degree against several
      Candida strains. The preliminary analysis of antifungal substances produced by
      microbial strains makes it possible to suggest their antibiotic nature.

PMID- 11210650
TI  - [Improving a process of cultivation of bifidobacteria in a bioreactor to obtain
      lyophilized seed culture].
AB  - The parameters of the cultivation process and the characteristics of the culture
      growth have been analyzed. The phases of the population growth have been
      determined. The existence of short stages differing in the physiological state of
      the cells, their resistance to damaging factors and metabolic activity within the
      deceleration phase of the growth of bifidobacteria has been experimentally
      substantiated. To harvest the biomass, the period of the completion of the
      cultivation process has been chosen. The lyophilized seed culture in which a high
      percentage of viable cells is preserved for one year has been obtained.

PMID- 11210652
TI  - [Russia at the final stage of eradication of poliomyelitis].

PMID- 11210651
TI  - [Bioterrorism: national and global threats].

PMID- 11210653
TI  - [Implementation of the federal law of the Russian Federation "On
      immunoprophylaxis of infectious diseases" (vaccination against hepatitis B in
      Krasnoiarsk region )].

PMID- 11210654
TI  - [PCR test systems for genetic identification of enterohemorrhagic Escherichia
      coli].
AB  - The analysis of modern data on the development of amplification test systems for
      the gene indication of enterohemorrhagic E. coli (EHEC) is presented. In this
      work the emphasis is laid on the importance of using specific primers whose
      nucleotide sequence is closely linked with genes controlling the key factors of
      EHEC pathogenicity; these factors include the determinants of the synthesis of
      adhesins and invasins (bfp, eae, tir), shiga-like toxins (stx1, stx2),
      enterohemolysin (ehx), serine protease (epsA) and specific LPS of O-antigen
      (rfb). The problem of using primers whose sequence is not linked with virulence
      genes, but which may also be used for the gene indication of E. coli O157:H7
      (uid, fliC) is discussed.

PMID- 11210655
TI  - [Pathogenicity of Burkholderia pseudomallei: extracellular and surface antigen
      functions].
AB  - The data of literature and the results of investigations carried out by the
      authors on the analysis of B. pseudomallei pathogenicity factors. They include
      mucoid, endotoxin, lecithinase, proteases, hemolysins, etc. In addition to
      fimbriae and pili, the adhesive properties of B. pseudomallei are supposed to be
      associated with surface capsule-like structures whose composition includes Ag8.
      The characterization of exoproteases, hemolysins and lethal toxins is given. The
      virulence and immunogenicity of B. pseudomallei were shown to be linked with the
      components of surface glycoprotein Ag8. The conclusion has been made that the
      analyzed pathogenicity factors are of importance for deciphering the pathogenesis
      of melioidosis.

PMID- 11210656
TI  - [Factors contributing to preservation of Vibrio cholerae in water reservoirs].
AB  - The summarized data of literature concerning the survival of V. cholerae in the
      environment and the influence of abiotic and biotic factors on this process are
      presented. These data make it possible to regard cholera as sapronosis and to
      form an idea of the role of factors contributing to the survival of V. cholerae
      in the environment and to its spread among human population.

PMID- 11210658
TI  - [Semeiology, examination and diagnosis of lesions of the oral mucosa].
AB  - Tracking down the oral mucosa lesions require precise interrogation and cervico
      facial, buccal and general examination. Diagnosis needs more often biopsy if not
      contra-indicated. The opportunity of further examinations and tests is discussed.

PMID- 11210657
TI  - [Nosologic descriptions of lesions of the oral mucosa].
AB  - This article describes extensively and systematically oral mucosa diseases.
      Macroscopical aspects are particularly described in order to give the dentist all
      important elements of differential diagnosis. This nosological description is
      based on a clinical approach: white and pigmented lesions are distinguished from
      ulcerated and benign so as malignant tumoral lesions. Specifically on the oral
      mucosa located lesions and oral mucosa lesions of systemic diseases are
      described.

PMID- 11210659
TI  - [The role of the dentist in the diagnosis, screening and followup of lesions of
      the oral mucosa.
AB  - The early detection and follow up of oral mucosa lesions are a must for every
      dentist. The importance of these activities is tremendous for oral cancerous and
      precancerous lesions, so every dentist is officially responsible for this
      important role in the public health. The modalities of such early detection and
      follow up are described.

PMID- 11210660
TI  - [Principles and therapeutic elements of lesions of the oral mucosa].
AB  - The management of lesions of the oral mucosa requires precise knowledges and
      expertise in clinical care. This review article summarise the principles of the
      most validated therapeutical features about lesions of the oral mucosa. Global
      management procedures are described. Therapeutic modalities involving drugs,
      surgery, radiotherapy, chemotherapy, immunotherapy, electrotherapy, gene therapy
      and photodynamic therapy are detailed as well.

PMID- 11210661
TI  - Role of uncondensed 1,2,4-triazine compounds and related heterobicyclic systems
      as therapeutic agents--a review.
AB  - The role of uncondensed 1,2,4-triazine compounds and related heterobicyclic
      systems in AIDS and Cancer is reviewed. Their medicinal applications are also
      reported.

PMID- 11210662
TI  - Some reactions of 2-cyanomethyl-3-methyl-3H-imidazo[4,5-b]pyridine with
      isothiocyanates. Antituberculotic activity of the obtained compounds.
AB  - Some reactions of 2-cyanomethyl-3-methyl-3H-imidazo[4,5-b]pyridine with
      isothiocyanates were carried out. New derivatives of imidazo[4,5-b]pyridine with
      different substituents in 2-position and derivatives of the new pyrido-imidazo
      thiazine ring system were synthesized. Most of the obtained compounds were tested
      for their in vitro antituberculotic activity.

PMID- 11210663
TI  - Polysubstituted pyrazoles, Part 4: Synthesis, antimicrobial and antiinflammatory
      activity of some pyrazoles.
AB  - As a continuation of an earlier interest in polysubstituted pyrazoles, the
      synthesis of some derivatives of 1H-pyrazol-4-yl-2-oxo-but-3-enoic acid and ethyl
      4-hydroxy-1H-pyrazole-3-carboxylates of potential antimicrobial and
      antiinflammatory activity is described. One compound showed in vitro
      antibacterial activity and two compounds displayed in vivo antiinflammatory
      potency in rats.

PMID- 11210664
TI  - Structure activity relationship of antiproliferative N-acyl-aspartic acid
      dimethyl ester. 2. Variation of the aspartyl moiety.
AB  - Structural variations of the L-aspartic acid substructure of (S)-N-3
      phenoxycinnamoylaspartic acid dimethyl ester which shows a selective
      antiproliferative activity against THP-1 tumor cells, demonstrated that the L
      aspartic acid moiety is absolutely mandatory for antiproliferative activity as
      well as for selectivity.

PMID- 11210665
TI  - [Intramolecular alkylation of aromatic compounds. 35. Di- and 
      tetrahydropyridinemethylindolines as potential precursors of  ergolines]  .
AB  - In the presence of methyl chloroformate, compound 6a is reduced by NaCNBH3
      yielding the 1,6-dihydropyridine derivative 7. Under the same conditions the
      indoline 10 accessible from 6a via 9a gives a mixture of the 1,4- and 1,6
      dihydropyridine derivatives 11 and 12. As by-product of the reduction the borane
      adduct 13 is detected. In contrast the methoiodide 1 is reduced by NaBH4 or DIBAH
      giving a separable mixture of the diastereomers of the tetrahydropyridines 2 and
      3; on catalytic hydrogenation the piperidine derivative 4 is formed. Cleavage of
      the enolether moiety in 3a and 7 provides the corresponding piperidones 5 and 14,
      respectively. Using prolonged reaction time 7 is hydrolized quantitatively
      furnishing the 1,4-diketone 15.

PMID- 11210666
TI  - Fluorine-containing heterocycles: synthesis and some reactions of new 3-amino-2
      functionalized-6-(2'-thienyl)-4-trifluoromethylthieno [2,3-b]pyridines.
AB  - 3-Cyano-6-(2'-thienyl)-4-trifluoromethylpyridine-2(1H)-thione (2) was prepared
      and reacted with chloroacetone or phenacyl bromide to yield the 2-acetyl or
      benzoyl-3-amino-6-(2'-thienyl)-4-trifluoromethylthieno[2,3-b]pyridines (3a, b).
      In contrast, the reaction of 2 with chloroacetamide or its N-aryl derivatives
      gave the corresponding 2-carbamoylmethyl thiopyridines 4a-c. Upon treatment of
      these educts with K2CO3 or C2H5ONa in ethanol, they underwent intramolecular
      Thorpe-Ziegler cyclization to afford 3-amino-2-carbamoyl-6-(2'-thienyl)-4
      trifluoromethyl-thieno[2,3-b]pyridine (5a) and its N-aryl analogs 5b, c.
      Compounds 5a-c underwent some reactions to yield new pyrido[3',2':4,5]thieno[3,2
      d]pyrimidines and pyrido[3',2':4,5]thieno[3,2-d][1,2,3] triazines.

PMID- 11210667
TI  - Stability of several LHRH antagonists against proteolytic enzymes and
      identification of degradation products by mass spectrometry.
AB  - In this study stabilities of several LHRH antagonists against proteolytic enzymes
      are compared. For the enzymatic tests 15 proteases which differ in both substrate
      specificity and pH optimum were selected. The cyclic and two linear antagonists
      proved to be extraordinarily stable against the enzymes used over an incubation
      time of 50 h. Some degradation products were identified by high-performance
      liquid chromatography combined with mass spectrometry.

PMID- 11210668
TI  - Film formation, reproducibility of production and curing with respect to release
      stability of functional coatings from aqueous polymer dispersions.
AB  - The formation of film coatings from aqueous polymer dispersions is a complex
      process, highly dependent on additives and process parameters. Release
      instability of modified release coatings from aqueous polymer dispersions is a
      frequently described problem that hinders the general application of such
      dispersions. However, if some important prerequisites are fulfilled, storage
      stability should be achievable. Most important are: (a) The appropriate
      plasticizing time has to be considered, incorporating sparingly soluble
      plasticizers in the dispersion. (b) Necessary pore formers increase the
      permeability of the coating to a desired and constant extent only if they are
      compatible with the polymer. (c) Coating in the fluidized bed at or slightly
      above the minimum film forming temperature may lead to only incomplete film
      formation. Curing at higher temperatures improves the polymer particles
      coalescence to a physically stable state. Other stability aspects such as
      physical and chemical aging, migration of plasticizers and drugs and
      incompatibilities are also discussed.

PMID- 11210669
TI  - Rapid and simple method for detection of fenofibric acid in human serum by high
      performance liquid chromatography.
AB  - A sensitive HPLC method for the determination of fenofibric acid (FA), the active
      form of fenofibrate in serum is described. FA from human serum samples was
      isolated by an easy one-step extraction procedure with a mixture of n-hexane and
      ethylacetate (90:10, v/v). The recovery was 84.8% of the total Fa in serum. The
      compound was separated isocratically on a reversed phase with acetonitrile and
      0.02 M phosphoric acid (55:45, v/v) at a flow-rate of 1.0 ml/min. Absorbance at
      287 nm was recorded for quantification. Validation presents a detection limit of
      0.03 microgram/ml and a quantification limit of 0.1 microgram/ml (relative
      standard deviation at 0.1 microgram/ml = 7.1%). For an extensive validation of
      this method we determined the serum levels of FA in one young male volunteer and
      examined the pharmacokinetics of standard, mikronized and slow release
      formulation of fenofibrate after oral intake. This method is a rapid and reliable
      tool for quantitative determination of fenofibric acid in pharmacokinetic
      investigations.

PMID- 11210671
TI  - [Separation of oxetacaine and its metabolites]  .
AB  - Oxetacaine (1), known as Tepilta, may be biotransformed to 2-5. After having
      tried to separate 1-5 by GC we succeeded in finding the HPLC method on Silicagel
      Si 60 with the eluent MeOH/TBME/HClO4.

PMID- 11210670
TI  - Absorbance data of hypericin and pseudohypericin used as reference compounds for
      medicinal plant analysis.
AB  - The evaluation of the absorbance data of hypericin and pseudohypericin revealed
      the molar/specific coefficients of absorbance in methanol-pyridine (99:1, v/v) at
      the maximum of the longest wavelength to be 51936/1030 and 43486/836,
      respectively. The absorbance data of hypericin were also determined in methanol.
      They were not significantly different from those in the presence of pyridine. The
      decrease of the coefficients by water addition was found to be the same for
      hypericin and pseudohypericin. It was concluded that hypericin and
      pseudohypericin reveal the same homoassociation behavior.

PMID- 11210672
TI  - Scaling up feasibility of the production of solid lipid nanoparticles (SLN).
AB  - Solid lipid nanoparticles (SLN/Lipopearls) are widely discussed as colloidal drug
      carrier system. In contrast to polymeric systems, such as polylactic copolyol
      capsules, these systems show up with a good biocompatibility, if applied
      parenterally. The solid lipid matrices can be comprised of fats or waxes and
      allow protection of incorporated active ingredients against chemical and physical
      degradation. The SLN can either be produced by "hot homogenisation" of melted
      lipids at elevated temperatures or a "cold homogenization" process. This paper
      deals with production technologies for SLN formulations, based on non-ethoxylated
      fat components for topical application and high pressure homogenization (APV
      Deutschland GmbH, D-Lubeck). Based on the chosen fat components, a novel and easy
      manufacturing and scaling up method was developed to maintain chemical and
      physical integrity of encapsulated active and carrier.

PMID- 11210673
TI  - Studies on dressings for oral cavity mucosa. Part 5: Properties of xerogel
      stomatological dressings with one-side antiadhesive coating.
AB  - The adhesion of xerogel dressings based on Eudragit (E), and methylcellulose (Mc)
      is in within the range of 143-270 g, and dissolution time of xerogel dressings in
      water is 3.4 h, and in artifical gastric juice 2.8 h. The 50% release time for
      Kunitz protease inhibitor ranges from 3.2-11.5 h.

PMID- 11210674
TI  - Long-term stability characterization of a controlled release gastrointestinal
      therapeutic system coated with a cellulose acetate pseudolatex.
AB  - The objective of the present study was to study the long term effects of storage
      of osmotically controlled gastrointestinal therapeutic system (GITS) in
      exaggerated conditions of temperature and humidity. Bilayered osmotic tablets
      were obtained with atenolol, Polyox N80, Carbopol 934P and magnesium stearate in
      one layer, and Polyox 303, Carbopol 974, sodium chloride and magnesium stearate
      in the other layer. A customized cellulose acetate (CA) pseudolatex was used to
      provide semipermeable housing around the tablet and an orifice was drilled into
      the drug layer to obtain the Atenolol GITS. The GITS were stored at 4 degrees C
      (refrigeration), 25 degrees C, 37 degrees C, 45 degrees C, 55 degrees C, 37
      degrees C/11% RH, 37 degrees C/51% RH, and 37 degrees C/91% RH. Quantitative X
      ray diffraction and dissolution studies were performed at regular intervals for
      one year. Aqueous CA polymeric film formation continued in GITS stored at higher
      temperature by gradual evaporation of moisture and coalescence of polymer. At
      lower temperatures atenolol crystallinity increased with time, but at higher
      temperatures the crystallinity was decreased. At higher humidity, a decrease in
      crystallinity was observed. A decrease in dissolution rate and extent was
      observed at higher temperature and higher humidity conditions. Exaggerated
      temperature and humidity conditions affected the dissolution profile by modifying
      the CA pseudolatex membrane and crystallinity of atenolol.

PMID- 11210675
TI  - Penetration of verapamil hydrochloride in the presence of sodium glycocholate as
      penetration enhancer through mucous membrane.
AB  - A model buccal drug formulation (BDF) with verapamil hydrochloride (VH) is in the
      form of a thin elastic disk made of two layers. The aim of this paper was to
      determine the influence of sodium glycocholate (SG) as a penetration enhancer in
      a BDF on the in vitro penetration rate of VH through pig oesophageal mucosa. It
      was found that VH penetrates mucosa. In 6 h 10.35 mg/cm2 of drug diffused from
      saturated solution in a buffer of pH 5.3 white from diffused only 7.78 mg/cm2 and
      4.68 mg/cm2 of VH, respectively saturated buffers of pH 6.8 and 7.3. In 6 h
      approximately 1.3 mg/cm2 of VH penetrate the mucosa from the control BDF model
      which does not contain the penetration enhancer. Conversely the content of SG in
      the model BDF contributes to the increase in drug penetration rate.

PMID- 11210676
TI  - Effect of gonadectomy on cyclosporine pharmacokinetics in male and female rats.
AB  - The present paper reports about the effect of gonadectomy on cyclosporine (CyA)
      pharmacokinetics in rats. The oral administration of CyA (10 mg/kg b.w.) to male
      rats caused two-fold higher drug blood levels than those reached by females at 24
      h after the last dose (334.10 +/- 126.70 vs. 161.49 +/- 53.39 ng/ml, p < 0.05).
      These levels increased by about 25% in orchiectomized male rats (419.47 +/-
      132.63 ng/ml) but they returned to control values after testosterone treatment
      (330.99 +/- 130.80 ng/ml). On the other hand, CyA blood levels (90.66 +/- 22.25
      ng/ml) decreased after ovariectomy, even more in the case of gonadectomized
      female rats receiving estradiol replacement (67.83 +/- 24.15 ng/ml). With regards
      to drug distribution, the concentrations of CyA in the liver, the kidneys and the
      spleen at 24 h after the last dose were about 8, 5 and 6-fold higher than blood
      levels, respectively, regardless of animal gender. These partition coefficients
      were increased to 11, 7 and 9-fold by male castration suggesting a more extensive
      drug distribution. Contrariwise, drug tissue levels in ovariectomized rats
      decreased. The changes of drug blood and tissue levels among groups were not
      associated to the variations of metabolite concentrations in the liver or blood.
      Therefore, gonadectomy exerts a complex effect on CyA pharmacokinetics in rats
      and makes complementary studies necessary to clarify how differences in sexual
      hormone secretion alter CyA disposition.

PMID- 11210677
TI  - Photosensitizing activity of thiocolchicoside: photochemical and in vitro
      phototoxicity studies.
AB  - The phototoxic drug thiocolchicoside (2-dimethoxy-2-glucosidoxythiocolchicine,
      1), is photolabile under irradiation with UV-A light from TL 100 W-P Philips
      bulbs (at lambda max 355 nm) light and also with a N2 laser (at 337 nm) in
      aerobic and anaerobic conditions. Irradiation of a methanol solution of 1
      produces two photoproducts without a glucoside group. One of these lost the
      methylthio-group, while the other is oxidized (only under aerobic conditions) to
      sulfoxide. The formation of singlet oxygen by photolysis of 1 was evidenced by
      trapping with 2,5-dimethylfuran (GC-MS), furfuryl alcohol, 1,3-cyclohexadiene-1,4
      diethanoate (HPLC) and by the histidine test as 1O2 scavengers. Thiocolchicoside
      has been shown to photosensitize the reduction of nitro blue tetrazolium by
      direct electron transfer mechanism, when irradiated under the same conditions as
      for photolysis. Oxygen may also be involved in this electron transfer reaction to
      form the superoxide anion radical. Thiocolchicoside was screened in vitro in
      different concentrations for UV-Vis-induced phototoxic effects in a
      photohemolysis test, in the presence and absence of different radical scavengers,
      singlet oxygen and superoxide radical quenchers. In addition, 1 photosensitized
      the peroxidation of linoleic acid, monitored by the UV-detection of dienic
      hydroperoxides. Studies on peripheral blood mononuclear cells (lymphocytes)
      demonstrated phototoxic effects on them. Protection by GSH, DABCO, sodium azide
      and SOD are indicative of both Type I and II photosensitization pathways mediated
      by free radicals and singlet molecular oxygen.

PMID- 11210678
TI  - Effect of diazepam and midazolam on the antinociceptive effect of morphine,
      metamizol and indomethacin in mice.
AB  - The influence of midazolam and diazepam on antinociceptive effect of morphine (10
      mg/kg), metamizol (500 mg/kg) and indomethacin (10 mg/kg) was investigated in a
      mouse model using the tail-flick and hot-plate tests. All drugs were injected
      intraperitoneally. Benzodiazepines were administered to mice 30 min before
      applying the analgesic drugs. Measurement of nociception was performed within 2 h
      after benzodiazepine administration. Diazepam at doses of 0.25 mg/kg and 2.5
      mg/kg injected with morphine was found to decrease the antinociceptive effect of
      morphine. Similarly, diazepam decreased the antinociceptive effect of metamizol
      (only in the tail-flick test) and indomethacin. Midazolam used at doses of 1.25
      mg/kg and 2.5 mg/kg decreased the antinociceptive effect of morphine, metamizol
      (only in the tail-flick test) and indomethacin.

PMID- 11210679
TI  - Effect of the aqueous extract of Rumex patientia on xylol and hyaluronidase
      induced capillary permeability compared to indomethacin.
AB  - In this study, the effect of an aqueous extract of Rumex patientia L.
      (Polygonaceae) (D-1) on capillary permeability which was induced by xylol and
      hyaluronidase was investigated. Experiments were conducted on rabbits according
      to Monakova and Matusis methods. The effects of D-1 were compared to those of
      indomethacin, which was used as a control throughout the experiment. Both D-1
      (100 mg/kg) and indomethacin (10 mg/kg) were administered orally. As a result, D
      1 inhibited capillary permeability, which was induced by xylol and hyaluronidase,
      and it was found that it was as effective as indomethacin.

PMID- 11210680
TI  - Flavonoids of Melaleuca quinquenervia.
AB  - From the leaves of Melaleuca quinquenervia (Clav.) S. T. Blake, the new flavonoid
      5,7,3',4'-tetrahydroxyflavone 2'-O-beta-D-glucopyranuronide, as well as eight
      known flavonol glycosides have been isolated and characterized. The structures
      were established by chromatography, chemical degradation and UV spectroscopy and
      confirmed by ESI-MS and NMR spectroscopy. This is the first report on the
      isolation and identification of these flavonoids in the genus Melaleuca.

PMID- 11210681
TI  - Grids and high kilo-volt-peak-setting in bedside chest radiographic examinations.
AB  - Bedside chest radiographic examinations in intensive care units with grids are
      impaired by artefacts caused by angulation of the grid (grid cut-off). Two
      different grids--a grid with a high strip density of 70 lines per cm and the
      "InSight portable imaging system"--were examined in an intensive care unit with
      respect to their susceptibility to angulation, image quality and handling of the
      grid. Five radiologists compared 50 radiographs of each grid considering ten
      image quality criteria. Using the "InSight portable imaging system" major
      artefacts were undetectable even at an angulation of 10%; no adjustment of the
      grid was required, which reduced the amount of time needed to take the radiograph
      by 26%. The increase in dosage demanded by the employment of the grids at low
      kilovolt peak setting could be partially compensated by the use of high kilovolt
      peak setting. The image quality of the "InSight portable imaging system" together
      with a high kilovolt peak setting is satisfactory, and due to its simplified
      handling, the portable imaging system has proved to be suitable for bedside chest
      radiography in intensive care.

PMID- 11210682
TI  - A pitfall of neck vessels Doppler ultrasound: left subclavian artery occlusion
      without vertebral steal syndrome.
AB  - In most cases, ostial occlusion of the subclavian artery induces a reversal of
      the blood flow in the ipsilateral vertebral artery. This hemodynamic diversion is
      obviously brought out by Doppler ultrasound of the neck vessels. Nevertheless,
      when the subclavian ostial lesions are less severe or in case of anatomical
      variations, the alterations of the vertebral flux are more discrete. An accurate
      Doppler examination is then required to avoid pitfalls. In the light of a
      particularly complex case, we reviewed the Doppler signs of vertebral blood flow
      in normal conditions and in patent or less obvious subclavian steals.

PMID- 11210683
TI  - [Use of dental CT software progarms (Dentascan) for optimal arthroscopic CT of
      knee menisci].
AB  - The need for CT automated multiaxial programs of reconstruction, able to
      accommodate with complex curvilinear anatomic structures has recently been
      satisfied by Dental Software Programs--"DENTASCAN"--essentially developed for
      implantology. Taking advantage of the very close likeness of dental archs and
      menisci of the knee in terms of form--variable complex curvilinear structures-
      and size, our study shows the advantages of "DENTASCAN" program to optimize the
      study of the menisci with Spiral Arthro-CT (SACT). The results obtained on a
      series of 228 menisci are compared with Conventional Arthrography (CA). 11.85% of
      additional lesions are found with SACT and 30.2% of all lesions demonstrated by
      CA are also more adequately described by SACT associated with "DENTASCAN".
      Moreover, fissures and ulcerations of the tibio-femoral cartilages, undiagnosed
      by preliminary CA are found in 20, 8% of patients with SACT. We conclude that
      SACT is much more effective and reproducible than CA for the study of the knee
      and we promote the use of Dental CT Software Programs like "DENTASCAN" for the
      study of the femorotibial and meniscus complex. Additional work is now necessary
      to compare the effectiveness of SACT with MRI or arthro-MRI of the knee with
      valuation of arthroscopy.

PMID- 11210684
TI  - MR imaging of the shoulder: imaging techniques and anatomy.
AB  - Since the development of dedicated surface coils and the more widespread use of
      state-of-the-art arthrographic techniques, MR imaging of the shoulder has come to
      maturity. In this article the imaging techniques of conventional MR imaging and
      MR arthrography of the shoulder are reviewed. The complex anatomy, the many
      anatomic variations and diagnostic variants and pitfalls and discrimination of
      pathologic entities from normal findings are discussed. Familiarity with the
      normal anatomy is a prerequisite to achieve a high diagnostic accuracy in the
      detection of a variety of pathologic conditions of the shoulder joint.

PMID- 11210685
TI  - MR arthrography of the rotator cuff and capsulolabral complex.
AB  - MR arthrography of the shoulder has reached maturity in recent years. As opposed
      to conventional MRI of the shoulder it is less prone to artefacts frequently
      leading to equivocal interpretation. The spectrum of pathology in which MR
      arthrography has significant advantages is reviewed, with emphasis on the rotator
      cuff and the capsulolabral complex.

PMID- 11210686
TI  - [Intraluminal duodenal diverticulosis complicated by hemorrhage].

PMID- 11210687
TI  - MR features of cavernous angioma.

PMID- 11210688
TI  - Dentin adhesives for the twenty-first century.
AB  - The efforts of numerous clinical scientists have resulted in the development of
      tooth bonding systems that have changed the way clinical dentistry is practiced.
      The adhesion between polymeric restorative materials and dentin has been
      optimized to the point that little improvement can be expected within the next
      decade or even more. Already, the adhesion between the two substrates is greater
      than the inherent tensile strength of dentin itself. Improvements however, will
      undoubtedly occur in the manner in which the materials are used clinically. Such
      achievements are necessary to standardize performance as well as to eliminate
      postoperative sensitivity.

PMID- 11210689
TI  - Esthetic post-and-core treatment.
AB  - The dilemma that confronts the practitioner in the area of post-endodontic
      rehabilitation is a positive one. The variety of products and techniques
      available offer practical solutions to most restorative problems. Patients have
      benefited [figure: see text] from recent developments in post-and-core
      technology, and continue to reap the benefits of research and development. The
      ideal system of products for the endodontic-restorative continuum includes: an
      esthetic resin fiber post a composite core an automixed resin luting cement
      current techniques that combine the automixed resin luting cement and composite
      core into the same component.

PMID- 11210690
TI  - Porcelain inlays and onlays.
AB  - Dentistry has been witness to tremendous changes in technology, introducing new
      techniques and materials. New procedures are being performed faster, are more
      reliable, are painless, and are more esthetic. These changes not only have been
      extremely motivational for dentists, but also for patients. Patients are aware
      that esthetic approaches in dentistry can change one's appearance, and are coming
      to the dentist willingly.

PMID- 11210691
TI  - Diagnosis and treatment planning for ceramic restorations.
AB  - Esthetic dentistry's intention is to deliver all phases of dentistry in a natural
      and attractive manner. Whether restorative and laboratory procedures or
      periodontal, orthodontic, or surgical procedures, ultimately the end results need
      to be natural in appearance and esthetically pleasing to the patient and dentist.
      The intention of this case study was to emphasize the relationship between the
      patient, dentist, and laboratory technician. The ability of all three to work
      efficiently demands incredible communication skills. A mutual respect in
      knowledge, desires, and skills creates the foundation to initiate this
      relationship. Communication skills and respect need to follow time-tested
      principles of restorative and prosthetic dentistry to be successful.

PMID- 11210692
TI  - Proportional smile design using the recurring esthetic dental (red) proportion.
AB  - Dentists have needed an objective way in which to evaluate a smile. A method for
      determining the ideal size and position of the anterior teeth has been presented
      here. Use of the FIVE to evaluate the RED proportion and the width-to-height
      ratio, tempered with sound clinical judgment, gives pleasing and consistent
      results. With the diversity that exists in nature, rarely does the final result
      follow all the mathematical rules of proportional smile design. This approach may
      serve as a foundation on which to base initial smile design, however. When one
      begins to understand the relationship between beauty, mathematics, and the
      surrounding world, one begins to appreciate their interdependence.

PMID- 11210693
TI  - Shades of a color. Illusion or reality?
AB  - Attaining the highest clinical level in esthetic and cosmetic dentistry
      necessitates the development of artistic skills; of balancing illusion with
      reality. The shade of a tooth is a combination of color and light and varies in
      different light conditions. Understanding the differences in color shades is the
      basis to creating illusions. Understanding light and color, and the reality of
      illusions, allows the clinician to design and sculpt a smile, to modify a flawed
      display artistically so that patients may perceive it as natural and more
      attractive, and to design laminates and veneers, class III, class IV, and
      cervical cavities.

PMID- 11210694
TI  - Occlusal function. Beyond centric relation.
AB  - With the emphasis placed on esthetics today, anterior guidance has an important
      role in the development of a stable, anatomic, functional, and esthetic result.
      To develop a predictable and stable result requires a multidisciplinary approach
      to esthetics and function. The orthodontist is a major contributor in helping the
      restorative dentist achieve the anatomic and functional harmony that is needed
      for long-term stable function and esthetics. Harmony in function creates long
      lasting smiles. In their continued quest for optimal results, and as members of
      their interdisciplinary teams, orthodontists should remind themselves of what
      Gottlieb wrote in 1986 in an editorial in the Journal of Clinical Orthodontics:
      "There is a difference between a beautiful alignment of teeth and an alignment of
      beautiful teeth. The orthodontist's job is not complete until there is a
      beautiful alignment of beautiful teeth."

PMID- 11210695
TI  - Implant-osseous osteotomy for correction of the misaligned anterior maxillary
      implant.
AB  - The trend has been to use angled abutments to compensate for implants that have
      poor emergence profiles. This trend has resulted in increasing unfavorable forces
      being placed on the implant, poor soft tissue emergence and contours, or creation
      of areas that the patient cannot maintain properly. The end results are an
      esthetic compromise and ultimately implant failure. This case illustrates that a
      misplaced or misaligned integrated implant can be repositioned successfully
      within the maxillary alveolus. Careful treatment planning, flap design, and soft
      tissue manipulation must be considered to maintain the vascularity and
      integration within the implant-osseous segment as well as the soft tissue. The
      byproduct of maintaining vascular integrity is normal soft tissue morphology,
      especially of the interdental papillae (see Fig. 6).

PMID- 11210696
TI  - Lasers and air abrasion. New modalities for tooth preparation.
AB  - Hard tissue lasers and air abrasion units have a place in the modern dentist's
      armamentarium. Speed, comfort, ease of approach, public relations, and patient
      appeal are some of the advantages. The dentist's own comfort and satisfaction,
      knowing that he or she is doing the best dentistry without frightening the
      already fearful patient, should help the dentist decide which one of the
      modalities to incorporate into his or her practice.

PMID- 11210697
TI  - Latest advances in laser systems and periodontal surgery.
AB  - The author explores the incipient role of laser technology in periodontics and
      general dentistry. A short history of laser use in dentistry is offered, and the
      clinical results of surgery on hard and soft tissues with different types of
      lasers are reviewed.

PMID- 11210698
TI  - Biocomposition and reaction of pulp tissues to restorative treatments.
AB  - Dentistry has experienced exponential growth in the biologic and physiologic
      knowledge of enamel, dentin, and pulp tissues. In one decade, material
      development has exceeded clinical testing limits, allowing their arrival to the
      commercial market without proper validation. This article clarifies the enigma of
      acid etching; explaining and clarifying the diverse opinions and issues of
      material toxicity between in vitro and in vivo usage test perspectives. This
      article also demystifies the biology of pulp healing regarding calcium hydroxide
      and adhesive systems to promote dentin bridge formation. Lastly, this article
      provides biologically lucid pulp exposure treatment regimens with agents such as
      NaOCl, allowing clinicians to increase their long-term clinical success.

PMID- 11210699
TI  - Contemporary posterior direct composites using state-of-the-art techniques.
AB  - The dental team that wishes to increase the use of posterior composite
      restorations will benefit greatly by the information and step-by-step techniques
      found in this article (Fig. 7A and B). Starting with a clean slate and analyzing
      the chemistries, the physical nature of resin-based composites, and the systems
      and devices available to use them most efficiently, the author presents a state
      of-the-art, evidence-based technique. By cutting out many of the steps that
      follow traditional methods with traditional materials and instruments for the
      placement of silver amalgam, sophisticated practitioners will readily understand
      the reasoning behind this successful, contemporary, direct posterior composite
      technique (Fig. 8A-J).

PMID- 11210700
TI  - Advances in restorative materials.
AB  - This article has presented basic up-to-date information concerning the selection,
      properties, and clinical uses of current restoratives that are tooth colored and
      adhesive. This area in dentistry is advancing at an exponential rate, and it is
      essential that all practitioners pay constant attention to the information about
      all materials as they appear on the market. Coupled with a thorough knowledge of
      treatment planning and case design, results such as seen in Figure 4 make
      restorative practice a rewarding endeavor for clinicians and patients. Interest
      in the scientific background, development, and performance of restorative
      materials must be at a high level to avoid being snared by advertising promises.

PMID- 11210701
TI  - Materials and techniques for achieving clinical excellence with indirect
      composite restorations.
AB  - Indirect resin restoration technology continues to grow at an unbelievable rate.
      This article has outlined some of the materials available within this category.
      There are others that the author has not had the opportunity to work with. At
      this time, the author believes the primary indication for the use of this class
      of material is esthetic inlays and onlays as well as a well-planned conservative
      [figure: see text] fixed partial denture in a low stress area. If unclear about
      the best material to use in a given situation, the dentist should consult the
      laboratory technician to discuss the technician's experience and confidence with
      the different systems. Many times the physical properties of the material are not
      as important as the ability of the technician and his or her experience with the
      different handling properties of the available systems when examining the short
      term and long-term success of the restoration.

PMID- 11210702
TI  - Creating tight, anatomically correct interproximal contacts.
AB  - Achievement of an excellent contact, one that provides a natural look and feel,
      reproducing the natural tooth contact or sometimes improving it, can be achieved
      in many ways. Understanding the separate issues of tightness and anatomy is
      crucial to achieving the desired result. In most cases, use of a contoured
      sectional matrix and McKean-style ring is the surest way to achieve the desired
      result. Unusual circumstances, such as wide preparations and malpositioned teeth,
      call for innovative techniques, some of which are illustrated in this article.

PMID- 11210703
TI  - [Ocular injuries and triage after the bombing attack on the United States embassy
      in Nairobi (Kenya)].
AB  - BACKGROUND: As a result of the terrorist bombings of the United States Embassies
      in Daressalam (Tansania) and Nairobi (Kenya) on August 7, 1998, over 200 people
      were killed. 5000 persons were injured severely. The purpose of this article is
      to provide a review of our experiences in the evaluation and treatment of
      patients with multiple simultaneous ocular injuries sustained in the Nairobi
      attack. PATIENTS AND METHODS: We treated eight survivors of the assault, four of
      them with extremely severe eye injuries. A three-tiered system of triage
      developed. The first level occurred on scene, in which minor injuries were
      treated locally and more severe injuries were transported by aeromedical
      evacuation to Landstuhl Regional Medical Center (LMRC), in Germany among other
      locations. Surgical exploration of all patients arriving at LRMC was performed
      and surgical repair was undertaken when appropriate and technically possible.
      Patients requiring vitreoretinal surgery were transferred either to Saarland
      University Eye Hospital, Homburg, Germany, or Walter Reed Army Medical Center,
      Washington, DC. RESULTS: Only one eye required enucleation, due to an almost
      complete extrusion of the retina. It was possible to stabilize even severely
      injured eyes with multiple intraocular foreign bodies. CONCLUSIONS: Modern
      microsurgical techniques such as temporary keratoprothesis, perforating
      keratoplasty, and pars plana vitrectomy can now save eyes and often allow
      restoration of usuable visual acuity where this once have been deemed impossible.

PMID- 11210704
TI  - [Laser tyndallometry and monitoring of treatment in 20 children with juvenile
      uveitis].
AB  - BACKGROUND: Treatment of children with juvenile uveitis requires adequate control
      of inflammation while minimizing systemic or ocular side effects. The study was
      performed to evaluate the potential use of the laser flare-cell meter in
      monitoring and adjustment of therapy in juvenile uveitis. PATIENTS AND METHODS:
      Retrospectively, we monitored 20 children (11 girls and 9 boys) with an age range
      from 3 to 15 years presenting with juvenile iridocyclitis (10/20), intermediate
      (5/20) or posterior (5/20) uveitis. During the follow-up period (median 25.2
      months, range: 2 to 83 months) multiple clinical controls were performed. We
      recorded clinical data, present therapy, and measurements using the laser flare
      cell meter (Kowa FC-1000). RESULTS: Laser flare-cell meter measurements were
      easily obtained and highly reliable even in these young patients. During follow
      up, 36 recurrences of intraocular inflammation were detected in 19 eyes. Relapses
      of inflammation as well as a response to treatment were seen at an early stage.
      Semiquantitative observations of cells and aqueous flare in the anterior chamber,
      or visual acuity of patients were less reliable in predicting recurrences.
      CONCLUSIONS: Laser tyndallometry offers a reliable, examiner-independent method
      to assess intraocular inflammation in children with juvenile uveitis and to
      adjust the necessary treatment.

PMID- 11210705
TI  - [Air endotamponade in 52 vitrectomies due to proliferative diabetic retinopathy-
      retrospective comparison with 40 vitrectomies without endotamponade].
AB  - BACKGROUND: In patients with proliferative diabetic retinopathy rebleeding after
      pars plana vitrectomy is one of the most common complications. We tried to reduce
      the rate of that complication by using an air endotamponade. PATIENTS AND
      METHODS: The following study is a retrospective comparison of 2 patient groups
      both after pars plana vitrectomy due to proliferative diabetic retinopathy. Group
      1 was managed with air as endotamponade (n = 52, mean age 61.2 years), group 2
      without any endotamponade (n = 40, mean age 59.4 years). Classification of the
      proliferative diabetic retinopathy as described by Kroll et al. [5] in both
      groups: 23 and 29 patients with stage A resp., 24 and 10 patients with stage B
      resp., 5 and 1 patient with stage C respectively. RESULTS: 77% of group 1
      patients had an increase os vision by mean of 4.8 vision steps, in 70% of the
      group 2 patients vision increased by mean of 7.2 vision steps. Complications in
      both groups as follows: Rebleeding within 14 days 15% vs. 33%, development of
      secondary glaucoma in 9.6% and 17.5% resp., revitrectomy within 14 days were
      necessary in 3.8% resp. 2.5% of the patients, later revitrectomy in 13.5% vs.
      42.5% of all patients. SUMMARY: Air endotamponade turned out to be appropriate to
      reduce the rate of postoperative vitreous rebleeding after pars plana vitrectomy
      due to proliferative diabetic retinopathy. We found no increase of secondary
      glaucoma or cataract.

PMID- 11210706
TI  - [Congenital nystagmus: indication, results and dosage of Kestenbaum surgery in 34
      patients].
AB  - BACKGROUND: Abnormal, nystagmus related head postures can be treated by
      Kestenbaum's procedure, if the concept of artificial divergence (Cuppers
      procedure) is not expected to work. In this retrospective study, we evaluated the
      effects of Kestenbaum surgery in order to establish dosage recommendations.
      PATIENTS AND METHODS: Solely patients who received Kestenbaum surgery (maximum 3
      mm dosage difference between both eyes, i.e., without additional artificial
      divergence) for a horizontal head turn (HT) due to nystagmus were included in
      this study. Exclusion criteria were previous eye muscle surgery, strabismus,
      lacking binocular vision, and cerebral disease. The millimetres of surgery and
      the pre- and 3-6 months-postoperative findings (HT and visual acuity at 5 m
      distance, stereopsis) were evaluated. RESULTS: Of the 34 patients, 21 had a HT to
      the left side and 20 were male. The age at surgery (median, 10%- and 90%
      quantile) was 7 years (4-32), the total amount of surgery 32 mm (20-40), and the
      preoperative HT 30 degrees (20-40). Postoperatively (n = 31), the HT amounted to
      7 degrees (0-20). The reduction of HT was 67% (25-100), the efficacy of surgery
      0.8 degree (0.3-1.0) per millimetre total amount of surgery on both eyes
      together. Four patients needed further surgery due to residual HT.
      Postoperatively, the maximum visual acuity was available without HT or with
      significantly less HT than preoperatively. Stereopsis showed a trend of
      improvement. CONCLUSIONS: The Kestenbaum procedure has a dose/effect ratio
      similar to that of recess/resect surgery for strabismus. Due to a long term
      efficacy of 1.5 degrees/mm, a dosage (in millimetres) on each eye of two thirds
      of the HT (in degrees) can be recommended. Physiological and methodical factors
      (false measurements) have to be discussed as an explanation for apparently low
      efficacy of surgery.

PMID- 11210707
TI  - [Driving ability after reversal of phenylephrine 10% induced mydriasis by
      dapiprazole 0.5%; a prospective study on 65 eyes].
AB  - BACKGROUND: Particularly outpatients want to reach the ability for driving a car
      as soon as possible after pupillary dilatation. Dapiprazole is an alpha-1
      adrenergic inhibitor that antagonizes the mydriatic effect of phenylephrine in a
      direct competitive way. The aim of this study was to determine restoration of
      traffic related functions after dapiprazole application in accordance with the
      guidelines of the German Society of Ophthalmology (DOG). SUBJECTS: 65 eyes of 33
      subjects were tested (17 females, 16 males). All had driving licenses without
      restrictions. Before mydriasis and after reversal with dapiprazole traffic
      related functions were evaluated (photopic visual acuity, mesopic vision,
      sensitivity to glare, colour vision, accommodation, visual field). RESULTS: No
      relevant changes of the parameter responsible for the ability to drive a motor
      vehicle could be shown after reaching premydriatic pupil diameters. CONCLUSIONS:
      There is evidence that reaching normal pupil diameters after reversal of
      mydriasis by dapiprazole is a valid sign of restoration of traffic related
      functions.

PMID- 11210709
TI  - [Significance of postoperative face-down positioning after surgery for idiopathic
      macular holes: consecutive case-control study].
AB  - BACKGROUND: Postoperative face-down positioning is considered to be a critical
      part in macular hole surgery with short-acting gas. However, the significance of
      this posturing remains uncertain using long-acting gas tamponade. PATIENTS AND
      METHODS: Fifty consecutive eyes with idiopathic full-thickness macular holes
      underwent macular hole surgery with a follow up time of 6-12 months. The results
      of a cohort (25 eyes) with complete C3F8 (16%) vitreous fill without posturing
      was compared to a cohort (25 eyes) with SF6 (20%) with strict postoperative face
      down positioning for two weeks. RESULTS: With SF6 tamponade the anatomic success
      rate was 64% in the C3F8 cohort a complete closure was achieved in 88%. In the
      SF6 cohort, visual recovery of three lines or better was attained in 44%,
      resulting in a visual acuity of 20/50 or better in 12%. The mean postoperative
      visual acuity was 20/125 with a mean rise of 1.4 lines. In the C3F8 cohort, 72%
      improved for at least three lines with a mean postoperative visual acuity of
      20/63 and a mean visual recovery of 3.3 lines. Visual acuity of 20/50 or better
      was noted in 48% of eyes. CONCLUSION: The significantly higher success rate using
      C3F8 tamponade without positioning compared to SF6 gas tamponade with positioning
      confirms the cumulative tamponade duration being a crucial factor in macular hole
      surgery. Using a tamponade with short-acting gas only strict postoperative
      positioning ensures the contact of the gas bubble with foveal tissue and gains
      significance with reducing bubble size. While a potential for significant visual
      recovery in certain cases is evident, all in all a broad variability of the
      postoperative success rate can be stated. In contrast, even in supine position
      C3F8 attains a continuous tamponade enforcing a sufficient glial wound healing
      without any positioning.

PMID- 11210708
TI  - [Acute retinal necrosis syndrome: analysis, therapy and long-term follow up of 14
      eyes].
AB  - PURPOSE: Acute retinal necrosis syndrome (ARN) might be complicated by retinal
      detachment, vasculopathy and optic neuropathy and has a poor prognosis despite
      intensive medical and surgical therapy. PATIENTS AND METHODS: A series of 10
      consecutive patients (14 eyes) with ARN were followed for 36 months (average of
      20 months +/- 10). We present the results of the clinical evaluation for
      diagnostic and therapeutic modalities. RESULTS: Viral etiology was confirmed in 9
      of 10 aqueous-humor samples. Intraocular antibody synthesis against Varicella
      Zoster Virus was found in 7, against Herpes-Simplex Virus in 5 and against
      Cytomegalovirus in 2 samples. Three eyes had a mild clinical course with a visual
      acuity of 0.6 or better. Vitrectomy and silicone-oil tamponade preserved visual
      acuity from 0.3 to 0.1. ARN lead to blindness in 5 eyes due to vasculopathy,
      optic neuropathy or retinal detachment. An arterial branch occlusion was
      successfully overcome with i.v. heparin treatment in one patient. CONCLUSION:
      Aqueous-humor analysis supports clinical diagnosis. Early vitrectomy and silicone
      oil tamponade stabilizes retinal structure and preserves visual acuity. Occlusive
      vasculopathy and optic neuropathy are the main causes leading to blindness.

PMID- 11210710
TI  - [Peripapillary melanoma; 10-year follow-up].
AB  - In early stages choroidal peripapillary choroidal melanoma may be confused with a
      choroidal nevus or melanocytoma. CASE REPORT: A 41-year old female was diagnosed
      having a choroidal nevus in close proximity to the optic nerve head.
      Unfortunately the patient did not show up for annual review of this lesion. Ten
      years after the patient was examined for the second time. A massive increase in
      tumor size and prominence was noted including serous retinal detachment. Medical
      work up excluded any metastatic growth, and the globe was enucleated. Three years
      later, the patient is still healthy and there are no signs of metastatic
      spreading. HISTOLOGICAL WORK UP: Heavily pigmented peripapillary choroidal
      melanoma with fascicularly vasocentric proliferative structure, but no
      infiltration of the sclera or the lamina cribrosa of the optic nerve. The tumor
      cells were of midgrade size and some of the nucleoli were slightly enlarged.
      Mitosis and a syncytial structure were present. Immunohistochemically S-100
      proteins, HMB 45 and NSE were found. The TNM classification was: ICD-O C 69.3;
      pT2, G1, S0, V0, pNx, pMx, microscopically RO. CONCLUSION: Pigmented
      juxtapapillary tumors resembling choroidal nevi require annual surveillance.

PMID- 11210711
TI  - [Lipaemia retinalis due to metabolic syndrome--case report].
AB  - BACKGROUND: Lipaemia retinalis is a rarely described ocular manifestation of
      hyperlipidemia. We report on a female patient with visual loss and visual field
      defects associated with lipaemia retinalis due to a metabolic syndrome. PATIENT:
      A 45-year-old female patient presented with bilateral slowly progressing visual
      loss. Additionally, there were eruptive xanthomatas all over the body. Visual
      acuity measured 0.2 in both eyes. There was a bilateral creamy discoloration of
      retinal vessels with a salmon-colored fundus. The peripheral visual field was
      reduced. Laboratory findings indicated a severe mixed hyperlipidemia
      (triglyceride 11,694 mg/dl, cholesterol 1724 mg/dl). Immediately initiated
      therapy to normalize the metabolism resulted in improvement of clinical symptoms.
      CONCLUSION: Lipaemia retinalis is an useful clinical indicator for
      triglyceridemia. Persistent lipaemia retinalis may lead to visual loss and visual
      field defects and may be a sign of severe metabolic disturbances. To prevent
      cardiovascular complications immediate treatment is necessary.

PMID- 11210712
TI  - [Langerhans-cell histiocytosis of the orbit; diagnosis, treatment and outcome in
      three patients -- children and adults].
AB  - BACKGROUND: Langerhans cell histiocytosis usually affects children. Systemic
      Langerhans cell histiocytosis may be present in 37% of affected children. Ten per
      cent of all children die of the disease. CASE REPORTS: Patient 1. A 9-year-old
      boy presented with painful upper lid swelling OD. Ultrasonography revealed a
      space-occupying lesion adjacent to a lytic defect of the frontal bone as shown on
      coronal CT. MRI showed marked contrast enhancement of the mass which came close
      to the intracranial fossa. The vascularized tumor was excised using an anterior
      orbitotomy with upper lid crease incision. No evidence of local or systemic
      recurrence was present three years postoperatively. Patient 2. A 19-year-old male
      presented with foreign body sensation, double vision OS and numbness of the left
      face of six weeks' duration. The ocular findings revealed a sixth nerve palsy OS.
      Otherwise, the eyes were unremarkable. Sensitivity of cranial nerve V2 was
      decreased. CT revealed an osteolytic process in the lateral orbital wall and
      sphenoid wing. MRI demonstrated a space-occupying lesion involving the temporalis
      muscle laterally, the pterygopalatine fossa medially with intracranial extension
      into the temporal lobe. Surgical excision was performed using a transcranial
      approach. Signs and symptoms had completely resolved six months after surgery
      with no evidence of local or systemic recurrence. Patient 3. A 30-year-old male
      presented with right-sided headache, painful upper lid swelling and vertical
      diplopia. Coronal CT scan revealed a lytic defect in the frontal bone laterally.
      Curettage and complete excision were performed using an infrabrow incision.
      Follow-up examination four years later revealed an intact ocular motility with no
      evidence of local or systemic recurrence. In all three cases the tumor showed
      characteristic light-microscopy and immunohistochemical features of Langerhans
      cell histiocytosis. CONCLUSION: Langerhans cell histiocytosis of the orbit is an
      important differential diagnosis of osteolytic and/or space-occupying lesions not
      only in children, but also in adults. A diagnostic biopsy followed by surgical
      excision and/or local and systemic corticoid- and chemotherapy are essential
      regarding the prognosis of local and systemic disease.

PMID- 11210713
TI  - The effect of cocoa procyanidins on the transcription and secretion of
      interleukin 1 beta in peripheral blood mononuclear cells.
AB  - Recent data has demonstrated that cacao liquor polyphenols (procyanidins) have
      antioxidant activity, inhibit mRNA expression of interleukin-2 and are potent
      inhibitors of acute inflammation. Given the widespread ingestion of cocoa in many
      cultures, we investigated whether cocoa, in its isolated procyanidin fractions
      (monomer through decamer), would modulate synthesis of the pro-inflammatory
      cytokine, interleukin-1 beta. Both resting and phytohemagglutinin (PHA)
      stimulated peripheral blood mononuclear cells (PBMC) were investigated at the
      levels of transcription and protein secretion. Individual cocoa fractions were
      shown to augment constitutive IL-1 beta gene expression, although values varied
      between subjects. Interestingly, the smaller fractions of cocoa (monomer
      tetramer) consistently reduced IL-1 beta expression of PHA-stimulated cells by 1
      15%, while the larger oligomers (pentamer-decamer) increased expression by 4-52%.
      These data, observed at the transcription level, were reflected in protein levels
      in PHA-induced PBMC. The presence or absence of PHA did not alter the effects of
      the cocoa procyanidins with the exception of the pentamer. This study offers
      additional data for the consideration of the health-benefits of dietary
      polyphenols from a wide variety of foods, including those benefits associated
      specifically with cocoa and chocolate consumption.

PMID- 11210714
TI  - Antioxidant actions of du-zhong (Eucommia ulmoides Oliv.) toward oxidative damage
      in biomolecules.
AB  - This study aimed to investigate the antioxidant effect of water extracts of Du
      zhong (WEDZ) on oxidative damage in biomolecules such as deoxyribose, DNA, and 2'
      deoxyguanosine (2'-dG) as induced by Fenton reaction. The WEDZ used included
      leaves, raw cortex, and roasted cortex. All of the WEDZ inhibited the oxidation
      of deoxyribose induced by Fe(3+)-EDTA/H2O2/ascorbic acid in a concentration
      dependent manner. At a concentration of 1.14 mg/mL, the inhibitory effect of the
      extracts of leaves, roasted cortex, and raw cortex was 85.2%, 68.0% and 49.3%,
      respectively. The extract of leaves inhibited the strand-breaking of DNA induced
      by the Fenton reaction at concentrations of 5 and 10 micrograms/microL. This
      inhibitory effect was similar to mannitol whereas the extracts of raw cortex and
      roasted cortex had no inhibitory effect at all. WEDZ also inhibited the oxidation
      of 2'-dG to 8-OH-2'-dG induced by Fe(3+)-EDTA/H2O2/ascorbic acid. Gallic acid had
      a prooxidant effect, but trolox and mannitol had an antioxidant effect. The leaf
      extract had a marked inhibitory effect on Fenton reaction induced oxidative
      damage in biomolecules. The extract of roasted cortex exhibited modest inhibition
      while the extract of raw cortex had the least inhibitory effect on oxidative
      damage in biomolecules. This is in contrast to gallic acid in the same reaction
      system, whose higher reducing power and weaker chelating ability may contribute
      to its prooxidant effect. In the present study, leaf extract of Du-zhong had
      inhibitory effect on oxidative damage in biomolecules. Therefore, drinking of Du
      zhong tea (leaf extract) over a long period of time may have anticancer
      potential.

PMID- 11210715
TI  - Placental leucine aminopeptidase/oxytocinase in maternal serum and placenta
      during normal pregnancy.
AB  - Placental leucine aminopeptidase (P-LAP), which is identical with cystine
      aminopeptidase as oxytocinase, was found to be homologous with rat insulin
      regulated membrane aminopeptidase (IRAP) by sequence comparison. In the current
      study, we determined the P-LAP levels in maternal serum and placenta during
      healthy pregnancy. P-LAP activities in maternal serum increased with gestation
      and rose to the peak of 80 IU/ml at 38 weeks of gestation. Northern blot analysis
      revealed the increase of P-LAP mRNA levels in placenta in the third trimester
      compared to the first trimester. P-LAP protein and related activities could be
      detected in the conditioned medium of placental tissue, while they could not be
      detected in that of human umbilical vein endothelial cells. Immunohistochemically
      P-LAP was positively stained in the apical membrane of syncytiotrophoblast cells
      throughout the gestation. These results established the normal range of serum and
      tissue P-LAP levels during pregnancy and the possible source of serum P-LAP,
      which will be helpful to elucidate the physiological and clinical roles of P
      LAP/oxytocinase/IRAP.

PMID- 11210717
TI  - Influence of enalapril on established pressure-overload cardiac hypertrophy in
      low and normal renin states in female rats.
AB  - To determine whether effects of angiotensin converting enzyme (ACE) inhibitors on
      well-established pressure overload-induced cardiac hypertrophy and coronary
      remodeling depend upon normal plasma renin levels, the influence of enalapril on
      ventricular mass and coronary vascular resistance (CVR) was determined in a low
      renin female rat model of chronic pressure overload, (deoxycorticosterone acetate
      hypertension, DOCA), and compared to its effect in a normal-renin model, (aortic
      construction, AC). Six weeks after experiment initiation, plasma renin activity
      of DOCA-treated rats was reduced to approximately 12% that of sham-treated and AC
      treated groups. Enalapril was then added to the drinking water of half the
      animals in each group for two additional weeks. Comparing experimental groups to
      controls, this delayed enalapril treatment had 1) no effect on the elevated
      arterial pressures, 2) no effect on the elevated coronary resistance, and, in the
      DOCA group, 3) no effect on cardiac hypertrophy. However, this brief enalapril
      treatment reduced absolute and relative ventricular weights of AC rats. These
      data suggest that circulating renin is required for the anti-hypertrophic
      efficacy of late-onset brief treatment with enalapril. Since enalapril-induced
      reversal of cardiac hypertrophy in AC rats was not accompanied by reversal of
      coronary remodeling, growth signals other than angiotensin II may be involved in
      coronary remodeling.

PMID- 11210716
TI  - Evidence of relaxant effect of omeprazole in rabbit corpus cavernosum in vitro.
AB  - The present experiments were designed to investigate the effects of omeprazole, a
      H(+)-K+ ATPase inhibitor, on corporal smooth muscle tone in vitro. All
      spontaneous contractile activity in the corpus cavernosum was blocked following
      omeprazole (0.1 mM-1 mM) administration. However atropine (1 microM), Nw-nitro L
      arginine methyl ester (L-NAME, 30 microM) or indomethacin (10 microM) did not
      affect the spontaneous contraction. Omeprazole (10 microM-1 mM) concentration
      dependently induced relaxation in corporal smooth muscle precontracted with 10
      microM phenylephrine or 80 mM KCl. Pretreatment of corporal tissue with L-NAME
      (30 microM), indomethacin (10 microM), ammonium chloride (7.5 mM), sodium acetate
      (7.5 mM), tetraethyl ammonium chloride (0.5 mM) or glibenclamide (1 microM) had
      no effect on the omeprazole induced relaxant responses. Nimodipine, an L-type
      Ca++ channel blocker, relaxed corporal strips precontracted with 80 mM KCl.
      Collectively, these results indicate that the inhibition of spontaneous
      contraction and the relaxation of precontracted corporal smooth muscle by
      omeprazole is probably mediated by the blockade of calcium channels. Further work
      is needed to determine the cellular mechanism(s) of action by which omeprazole
      acts on corpus cavernosum smooth muscle.

PMID- 11210718
TI  - Hypercortisolemia does not affect the branchial osmoregulatory responses of the
      marine teleost Sparus sarba.
AB  - The effect of cortisol treatment on branchial Na(+)-K(+)-ATPase subunit mRNA
      abundance, enzyme activity, chloride cell number/morphometrics and serum
      electrolyte levels were investigated for the marine teleost Sparus sarba. Groups
      of fish received intraperitoneal injections of cortisol at a concentration of 4
      micrograms/g body weight, daily, over a seven-day period. This dose of cortisol
      was sufficiently high enough to maintain a condition of hypercortisolemia as
      serum cortisol levels in treated fish were eleven fold higher than controls at
      time of sacrifice. By using branchial Na(+)-K(+)-ATPase alpha- and beta-subunit
      cDNA clones we were able to demonstrate that cortisol administration to S. sarba
      caused a significant elevation in the abundance of alpha-mRNA whereas the levels
      of beta-mRNA were unchanged. In addition Na(+)-K(+)-ATPase activity remained
      unaltered by cortisol administration. Branchial chloride cell number, exposure,
      apical area as well as serum Na+ and Cl- levels remained unchanged after cortisol
      administration. The results of this study suggest that elevated cortisol level
      may not necessarily translate into modulated branchial Na(+)-K(+)-ATPase activity
      and chloride cell function in hypo-osmoregulating marine fish.

PMID- 11210719
TI  - Adrenomedullin (ADM), acting through ADM(22-52)-sensitive receptors, is involved
      in the endotoxin-induced hypotension in rats.
AB  - The possible involvement of adrenomedullin (ADM) in the endotoxin-induced
      hypotension has been investigated in the rat. Lipopolysaccharide (LPS, 500
      micrograms/kg intraperitoneum) caused a severe decrease in the blood pressure
      (BP), reaching maximum 2-3 h after the injection and subsiding after 12 h. The
      putative ADM-receptor antagonist ADM(22-52) (3 nmol/kg) counteracted LPS-induced
      BP lowering at 1 and 2 h, and reversed it at 3 and 6 h. CGRP(8-37), a selective
      antagonist of the CGRP1 receptors, was ineffective. Both ADM(22-52) and CGRP(8
      37) did not evoke significant changes in the basal BP. Our findings provide
      strong support to the view ADM overproduction plays a major role in the LPS
      induced decrease in BP, and suggest a potentially important therapeutic effect of
      the blockade of ADM(22-52)-sensitive receptors during endotoxic shock.

PMID- 11210720
TI  - Supraphysiological level of estrogen exposure in vivo increases lymphoid cell
      death in mice.
AB  - Estrogen can enhance or reduce lymphocyte functions in vitro depending on dose
      and exposure duration. The purpose of this study was to determine the effect of
      in vivo 17 beta-estradiol (E2) on apoptosis and necrosis in lymphoid tissue of
      female C567BL/6 mice. Animals were ovariectomized (OVX), ovariectomized and 17
      beta-estradiol supplemented (OVX + E2; 71 micrograms E2 per day for 14 days),
      sham ovariectomized (SHAM), or unhandled controls (CONTROL). Thymus and spleen
      were removed aseptically, cells dispersed into single cell suspensions in RPMI
      1640, and measures of cell damage performed: an annexin V flow cytometric assay
      for markers of apoptosis and an enzyme-linked immunoassay for measures of DNA
      fragmentation and necrosis. OVX + E2 mice had 620 +/- 72 pg/ml 17 beta-estradiol
      in serum in contrast to OVX mice which had 7.6 +/- 5 pg/ml, the SHAM mice which
      had 2.8 +/- 1 pg/ml of serum E2, and the CONTROL mice which had 3.9 +/- 0.8 pg/ml
      of serum E2 (p < 0.001). There was a significantly lower percentage of viable
      thymocytes in OVX + E2 mice compared to the other treatment conditions (p <
      0.001, respectively). There was also a significantly higher percentage of annexin
      V positive thymocytes in OVX + E2 mice (p < 0.005). Measures of DNA fragmentation
      by ELISA were higher in splenocytes from OVX + E2 mice than in the OVX, SHAM or
      CONTROL mice (p < 0.005). These results suggest that supraphysiological levels of
      estrogen in vivo induce damage in lymphoid cells; however, the impact of estrogen
      associated lymphoid tissue damage on specific immune functions remains to be
      determined.

PMID- 11210721
TI  - Intrathecal endomorphin-1 produces antinociceptive activities modulated by alpha
      2-adrenoceptors in the rat tail flick, tail pressure and formalin tests.
AB  - It is known that spinal morphine produces antinociception that is modulated by
      alpha 2-adrenoceptors. Endomorphin-1, a newly-isolated endogenous opioid ligand,
      shows the greatest selectivity and affinity for the mu-opiate receptor of any
      endogenous substance found to date and may serve as a natural ligand for the mu
      opiate receptor. We examined the antinociceptive effects of endomorphin-1
      administered intrathecally (i.t.) in the rat tail flick, tail pressure and
      formalin tests. Intrathecal endomorphin-1 produced dose-dependent antinociceptive
      effects in the three tests. ED50 (CI95) values for antinociception of i.t.
      endomorphin-1 in the tail flick test and tail pressure test were 1.9 (0.96-3.76)
      nmol and 1.8 (0.8-4.2) nmol, respectively. ED50 (CI95) values for phase 1 and
      phase 2 in the formalin test were 12.5 (7.9-19.8) nmol and 17.5 (10.2-30) nmol,
      respectively. Pretreatment with i.t. beta-funaltrexamine (a mu-opioid receptor
      selective antagonist) significantly antagonized the antinociceptive effects of
      endomorphin-1 in the three tests. Beta-funaltrexamine alone had not effects on
      the three tests. The antinociceptive effects of endomorphin-1 were also
      antagonized by i.t. yohimbine (an alpha 2-adrenoceptor selective antagonist). The
      combination of ineffective doses of i.t. clonidine (an alpha 2-adrenoceptor
      agonist) and endomorphin-1 produced a significant antinociception in the three
      tests. The results showed that intrathecal endomorphin-1 produced antinociception
      in a dose-dependent manner in the rat tail flick, tail pressure and formalin
      tests, which was mediated by spinal mu-opioid receptors and modulated by alpha 2
      adrenoceptors.

PMID- 11210722
TI  - Systemic administration of d-amphetamine induces long-lasting oxidative stress in
      the rat striatum.
AB  - The long-term effect of d-amphetamine (AMPH) on the induction of oxidative stress
      was examined in vivo in the rat brain. In this study, 2,3-dihydroxybenzoic acid
      (2,3-DHBA) and malonaldehyde (MDA) were used as the index of the hydroxyl radical
      and lipid peroxidation, respectively. The levels of 2,3-DHBA, MDA and dopamine
      (DA) in striatal homogenates were examined 7 days following injection of a single
      large dose of AMPH (7.5 mg/kg, i.p.) in rats pretreated with desipramine (10
      mg/kg, i.p.), an agent that inhibits the metabolism of AMPH. Our results showed
      that 2,3-DHBA and MDA levels were significantly increased by AMPH, whereas DA and
      its metabolites, DOPAC and HVA were depleted in the striatum. Pretreatment with
      the glutamate NMDA receptor subtype antagonist MK-801 (1 mg/kg, i.p.) attenuated
      the increases of 2,3-DHBA and MDA, and provided partial protection against the
      long-lasting loss of DA produced by AMPH. Overall, the results demonstrate that
      AMPH could induce sustained production of free radical and oxidative damage, and
      lead to DA terminal degeneration in the striatum of the rat.

PMID- 11210723
TI  - Role of capsaicin sensory nerves and EGF in the healing of gastric ulcer in rats.
AB  - Accumulating evidence indicates that capsaicin sensitive afferent fibers play a
      pivotal role not only in gastroprotection but also in ulcer healing. Denervation
      of capsaicin sensitive afferent fibers exerts an adverse action on these effects.
      However, whether such an action is mediated through a depression on epidermal
      growth factor (EGF) is undefined. In this study, the effects of denervation of
      sensory neurons with capsaicin (100 mg/kg, s.c.) on acetic acid-induced chronic
      gastric ulcers and their relationship with the EGF expression in salivary glands,
      serum and gastric mucosa were investigated. Capsaicin significantly increased
      ulcer size, decreased gastric mucosal cell proliferation at the ulcer margin,
      angiogenesis in the granulation tissue and also gastric mucus content. Ulcer
      induction by itself dramatically elevated EGF levels in salivary glands and serum
      on day 1 and 4, and also in the gastric mucosa on day 4. However, capsaicin
      completely abolished these effects. It is concluded that stimulation of EGF
      expression in salivary glands and serum may be one of the mechanisms by which
      capsaicin sensitive nerves contribute to the gastroprotective and ulcer healing
      actions in the stomach.

PMID- 11210725
TI  - [The future trend of life science researches in Japan].

PMID- 11210724
TI  - Acetyl-seryl-aspartyl-lysyl-proline is a novel natural cell cycle regulator of
      renal cells.
AB  - A natural tetrapeptide, acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) is a
      physiological negative regulator of hematopoiesis. The precursor of AcSDKP,
      thymocin beta 4, is expressed in many tissues including kidney. The present study
      examined the antiproliferative effect of AcSDKP in two renal cell lines, namely,
      renal interstitial fibloblasts cell line (NRK 49F) and renal proximal tubular
      epitherial cells (LLC-PK1). An addition of AcSDKP for 48 hours in theses cells
      resulted in a concentration-dependent attenuation in the proliferation rate
      (significant difference to non-treated cells was observed at 10(-9) to 10(-5) M
      AcSDKP) determined by a colorimetry of alamer blue oxidation. The cell cycle
      analysis of NRK 49F cells treated with AcSDKP showed that AcSDKP significantly
      reduced the ratio of S-phase to G2/M-phases. Thus, physiological concentrations
      of AcSDKP is capable of altering cell cycle to inhibit the proliferation of renal
      cells.

PMID- 11210726
TI  - [Vasculitis--changes of the concept and the relation to ANCA].

PMID- 11210727
TI  - Insights into the pathogenesis of rheumatoid arthritis from application of anti
      TNF therapy.

PMID- 11210728
TI  - Haemopoetic stem cell transplantation in autoimmune diseases, with special
      reference to rheumatoid arthritis.

PMID- 11210729
TI  - [Molecular mechanisms governing autoantibody production in patients with SLE].

PMID- 11210730
TI  - [Signal pathways in immune systems: IL-1 R/Toll-like receptor family].

PMID- 11210731
TI  - [Action of transforming growth factor-beta and diseases].

PMID- 11210732
TI  - [Clinical applications and limitations for use of immunosuppressive drugs in
      inflammatory connective tissue diseases].

PMID- 11210733
TI  - [Current status and problems in human gene therapy].

PMID- 11210734
TI  - [Treatment strategy of pediatric rheumatic diseases: up-date].

PMID- 11210735
TI  - [Autophagy and apoptosis].

PMID- 11210736
TI  - [Intercellular adhesion molecule-1 (ICAM-1) mediated gene delivery to rheumatoid
      synovial cells using the Fab fragments of anti-ICAM-1 monoclonal antibody].

PMID- 11210737
TI  - [Antigen-specific T cells transduced with interleukin-10 ameliorate
      experimentally induced arthritis without impairing the systemic immune response
      to the antigen].
AB  - For the treatment of rheumatoid arthritis, efficient drug delivery methods to the
      inflamed joints need to be developed. Since T cells expressing an appropriate
      autoantigen-specific receptor can migrate to inflamed lesions, it has been
      reasoned that they can be employed to deliver therapeutic agents. In order to
      examine the ability and efficiency of such T cells as a vehicle, we employed an
      experimentally induced model of arthritis. Splenic T cells from DO 11.10 T cell
      receptor transgenic mice specific for OVA were transduced with murine IL-10.
      Adoptive transfer of the IL-10-transduced DO 11.10 splenocytes ameliorated OVA
      induced arthritis, in spite of the presence of around 95% non-transduced cells.
      Using GFP as a marker for selection, the number of transferred cells needed to
      ameliorate the disease was able to be reduced to 10(4). Preferential accumulation
      of the transferred T cells was observed in the inflamed joint, and the
      improvement in the disease was not accompanied by impairment of the systemic
      immune response to the antigen, suggesting that the transferred T cells exert
      their antiinflammatory task locally, mainly in the joints where the antigen
      exists. In addition, IL-10-transduced DO 11.10 T cells ameriolated mBSA-induced
      arthritis when the arthritic joint was co-injected with OVA in addition to mBSA.
      These results suggest that T cells specific for a joint specific antigen would be
      useful as a therapeutic vehicle in rheumatoid arthritis for which the arthritic
      autoantigen is still unknown.

PMID- 11210738
TI  - [Treatment of murine collagen-induced arthritis by ex-vivo EC-SOD gene transfer].

PMID- 11210739
TI  - [Gene therapy for rheumatoid arthritis by apoptosis-related gene transfer].

PMID- 11210740
TI  - [Amelioration of adjuvant arthritis by gene therapy suppressing Src activity].

PMID- 11210741
TI  - Treatment of arthritis with cyclin-dependent kinase inhibitor gene.

PMID- 11210742
TI  - [Identification and characterization of pathogenic autoreactive T cells in
      patients with idiopathic thrombocytopenic purpura].

PMID- 11210743
TI  - [Diversity and cross-recognition of self-reactive T cells in primary biliary
      cirrhosis].

PMID- 11210745
TI  - [Allergen-peptide immunotherapy against Japanese cedar pollinosis].

PMID- 11210744
TI  - [Molecular mechanism of cancer-associated retinopathy and tumor antigens].

PMID- 11210746
TI  - [Identification of peptide superagonists using combinatorial chemistry and mass
      spectrometry].

PMID- 11210747
TI  - [NALT immune system for the development of AIDS mucosal vaccine].

PMID- 11210748
TI  - [Efficient replication of human immunodeficiency virus type 1 in cytokine induced
      CD 4+ T helper 1 (Th 1)- and Th 2-type conditions].
AB  - Potent stimuli for CD 4+ T cell differentiation are cytokines. Among them, IL-12
      or IL-4 induce naive CD 4+ T cells to Th 1 or Th 2 cells, respectively. In this
      study we found that macrophage-tropic (M-tropic) HIV-1 strains more efficiently
      replicated in interleukin 12 (IL-12) induced T helper 1 (Th 1)-type culture
      derived from normal CD 4+ T cells than T-cell-line-tropic (T-tropic) strains did.
      In contrast, T-tropic strains preferentially infected IL-4 induced Th 2-type
      culture derived from same donor CD 4+ T cells. Additional studies using chimeric
      viruses demonstrated that the V 3 region of gp 120 was the principle determinant
      for this efficient replication. It was also isolated T-tropic viruses from an
      acutely infected patient who had been evidenced as severe CD 4 depletion during
      short time course. These results indicate that HIV-1 isolates exhibit differences
      in the ability to infect CD 4+ T cell subset such as Th 1 or Th 2 cells, and that
      this difference may partly correlate with the viral pathogenesis. The findings
      suggest that immunological condition is one of the factors responsible for
      inducing selection of HIV-1 strains.

PMID- 11210749
TI  - [Crosstalking between HIV and HHV-8 via IL-6 in AIDS].

PMID- 11210750
TI  - [Role of chemokine in HIV infection].

PMID- 11210751
TI  - [HIV-1: entry inhibitors and skin immunization].

PMID- 11210752
TI  - [Cytokine and fibrotic diseases in the skin].

PMID- 11210753
TI  - [Role of cytokine in renal fibrosis].

PMID- 11210755
TI  - [Cytokines and liver fibrosis].

PMID- 11210754
TI  - [The role of IL-18 on the pathogenesis of Crohn's disease].

PMID- 11210756
TI  - Cytokine and atherosclerosis: a possible role of osteopontin in development in
      diabetic macroangiopathy.

PMID- 11210757
TI  - [Organ transplantation and oral tolerance].

PMID- 11210758
TI  - [Characterization of humoral immunosuppressive factors induced after allogeneic
      blood transfusion and their application for organ transplantation].

PMID- 11210759
TI  - [Clinical impact of lymphocyte sensitivity to immunosuppressants].

PMID- 11210760
TI  - [Immunosuppression in living donor liver transplantation from ABO blood type
      incompatible donors].

PMID- 11210761
TI  - [MCTD and pulmonary hypertension].

PMID- 11210762
TI  - [Meningitis in mixed connective tissue disease].

PMID- 11210763
TI  - [Treatment of membranous lupus nephritis].

PMID- 11210764
TI  - [Scleroderma renal crisis (SRC): hypertensive, normotensive].

PMID- 11210765
TI  - [MPO-ANCA related angiitis].

PMID- 11210766
TI  - [Central nervous system involvement in systemic lupus erythematosus].

PMID- 11210767
TI  - [Hemophagocytic syndrome].

PMID- 11210768
TI  - [Antiphospholipid syndrome and renal diseases: a report of two cases].

PMID- 11210769
TI  - [COX-2--what are the clinical implications?].

PMID- 11210770
TI  - [Innovation in COX-2 technology].

PMID- 11210771
TI  - [Education of rheumatology for medical students].

PMID- 11210772
TI  - [Clinical significance of magnetic resonance imaging of skeletal muscles in
      idiopathic inflammatory myopathies of adults].
AB  - The purpose of this study was to evaluate the clinical significance of magnetic
      resonance imaging (MRI) of skeletal muscles in Japanese patients with idiopathic
      inflammatory myopathies (IIM). MRI was performed in 23 adult patients with IIM,
      including 10 with polymyositis, 12 with dermatomyositis, and 1 with focal
      myositis. Seven (73%) of 11 patients with active IIM and 2 (17%) of 12 patients
      with inactive IIM showed hyperintensity of T 2-weighted images and normal
      intensity of T 1-weighted images, indicating "edema-like abnormalities" (MRI
      findings for active myositis). Muscle lipomatosis and fibrosis were demonstrated
      in four patients and 1 patient, respectively. Considerable selectivity of muscles
      in developing inflammatory disorders was found. In quadriceps muscles, for
      example, vastus muscles seemed to be more often affected in DM patients, whereas
      adductors were more often affected in PM patients. Serial examination of muscle
      MRIs was carried out in 4 patients and the findings paralleled the disease
      activities. The muscle MRI findings did not necessarily correlate with other
      findings, such as the presence of muscle weakness, elevated serum creatine kinase
      levels, myogenic electromyogram, or muscle biopsy findings. The muscle MRI was
      considered to be an additional useful tool for the diagnosis, evaluation of
      disease activity, and planning treatment of IIM.

PMID- 11210773
TI  - [Radiological evaluation of foot deformities in rheumatoid arthritis].
AB  - Deformities of the feet are common in patients with rheumatoid arthritis (RA). We
      investigated whether there was any correlation among forefoot deformities, flat
      foot or articular destruction of the midfoot and hindfoot, in 146 feet of 73 RA
      patients whose age varied from 26 to 81 years (mean 58.5 years). In all patients,
      anteroposterior (AP) and lateral radiographs of the feet with weight bearing were
      obtained. The hallux valgus angle (HVA), the intermetatarsal angle between the
      1st and 2nd metatarsals (M 1 M 2), and the intermetatarsal angle between the 1st
      and 5th metatarsals (M 1 M 5) were measured on AP radiographs. On slateral
      radiographs, the height of the arch was measured and articular destruction of the
      talocalcaneal, talocrural, talonavicular, cuneonavicular and cuneometatarsal
      joints was measured and classified using Steinbrocker's classification. The
      average HVA was 23.4 degrees, the average M 1 M 2 was 11.1 degrees, and the
      average M 1 M 5 was 28.4 degrees. There was no correlation between forefoot
      deformities and flat foot. There were significant correlations between arthritic
      destruction of the cuneometatarsal joint and HVA, M 1 M 2 and M 1 M 5. The
      correlations between arthritic destruction of the cuneonavicular joint and HVA or
      M 1 M 2 were also significant, although weaker. Thas, we found some relationships
      between forefoot deformity and arthritics destruction of midfoot joints.
      Especially, the correlations between arthritic destruction of the cuneonavicular
      and cuneometatarsal joints and forefoot deformities were significant. Many
      radiographic methods for the assessment of RA have been reported, however, it is
      difficult to assess sarthritic destruction of rheumatoid feet with the existing
      methods. Accordingly, a new method should be established.

PMID- 11210774
TI  - [Autoimmune cholangitis (AIC) associated with myositis in monozygotic twins].
AB  - A 53-year-old female suffered from joint pain and muscle weakness in all
      extremities in 1991. Laboratory data showed increased creatine phosphokinase (CK)
      and aldolase. Liver dysfunction and weakness of proximal muscles also appeared
      and polymyositis (PM) was suspected. Two years later, she was diagnosed with
      dermatomyositis (DM) through skin and muscle biopsy. Because elevation of biliary
      enzymes and transaminases were continued, liver biopsy was performed in 1997.
      Histopathological findings of her liver were compatible with primary biliary
      cirrhosis (PBC). Similar conditions were noticed in her identical twin as well.
      DM associated with PBC is unusual and cases of monozygotic twins with both
      conditions are very rare. The difference between PBC and autoimmune cholangitis
      (AIC) which has recently reported and the genetic influence on the pathogenesis
      of DM and AIC are also discussed.

PMID- 11210775
TI  - [Polyarthralgia as the initial manifestation of isolated ACTH deficiency].
AB  - A 57-year-old man, employed as a taxi driver, noticed arthralgia of his fingers
      beginning in May 1999. He was unable to work due to the arthralgia and the
      accompanying general malaise and anorexia, and was thus admitted to a local
      hospital in July 1999. Since a diagnosis of rheumatic disease was suspected due
      to elevated inflammatory reactions and joint symptoms, he was referred to our
      hospital in September 1999. Although no joint swelling was observed, severe
      tenderness was present in both the fingers and wrists. His grasping power had
      decreased markedly and fever was intermittently observed. All autoantibodies
      aside from antinuclear antibody were negative. Given that hyponatremia (126
      mEq/l) and fasting hypoglycemia were demonstrated, an endocrinological
      examination, in particular for hypopituitary-adrenal function, was performed.
      Both plasma and urinary cortisol concentrations were very low, and an associated
      low concentration of plasma ACTH (6.0 pg/ml) was noted. The ACTH circadian rhythm
      was absent and there was no response to the administration of corticotropin
      releasing hormone. All other pituitary hormones were secreted at normal levels
      and brain MRI revealed a normal appearance of a pituitary gland. Based on these
      findings, the patient was diagnosed as having isolated ACTH deficiency.
      Arthralgia and general malaise both improved soon after replacement of
      glucocorticoid, and CRP levels were normalized. Isolated ACTH deficiency should
      be considered in the differential diagnosis of patients suffering from
      polyarthralgia, given that fever and increased inflammatory reactions
      occasionally develop and that rheumatic symptoms are also present, as in the
      present case.

PMID- 11210776
TI  - [Two cases of acute lupus peritonitis].
AB  - We report two cases of systemic lupus erythematosus (SLE) diagnosed when acute
      peritonitis was appeared. Case 1 was a 20 year-old woman suffering from
      stomachache and right lower abdominal pain. Case 2 was a 40 year-old woman with
      diarrhea, epigastralgia, pollakisuria. In both cases, their peritoneal fluids
      were exudative with positive autoantibodies. After high dose steroid therapy,
      abdominal symptoms and ascites improved promptly. However, due to the
      complication of lupus nephritis, additional therapy was necessary. To
      characterize the feature of lupus peritonitis (LP), we examined the clinical and
      laboratory findings of LP from the literature. In patients with acute LP,
      abdominal pain, vomiting, diarrhea were significantly more common compared with
      chronic LP patients (P < 0.05), and fever, arthritis, central nervous system
      involvement and cystitis were more common. In patients with chronic LP, pleural
      effusion and pericardial effusion were more common compared with acute LP
      patients. Gastrointestinal manifestations such as abdominal pain, vomiting and
      diarrhea were more common in patients with acute LP compared with patients with
      chronic LP. Most patients with chronic LP were asymptomatic, ascites and
      serositis being the only clinical findings. The response to steroid therapy was
      better in acute LP.

PMID- 11210777
TI  - [Susceptibility genes in rheumatoid arthritis].

PMID- 11210778
TI  - [Current concepts of joint replacement].

PMID- 11210779
TI  - An autopsy case of accidental asphyxiation in a storage room for apples.
AB  - A 12-year-old boy died in a storage room and his mother was rescued from the same
      storage room, where many apples were being stored. The atmosphere in the room was
      strictly controlled and the concentration of oxygen (O2) was recorded. The cause
      of death was suffocation. According to the records, the concentration of O2 was
      about 2.7% when the boy died. On the other hand, it was about 3.4% when his
      mother entered the room and she survived, although she remained unconscious for
      about four hours. These findings show that the absolute concentration of O2
      causing acute death due to O2 deficiency is approximately 2.5-3.0%.

PMID- 11210780
TI  - [Advances in perimetry].

PMID- 11210781
TI  - [Assessment of visual function before and after macular surgery by pattern visual
      evoked cortical potentials].
AB  - PURPOSE: To investigate pre- and postoperative visual function in patients with
      macular hole and those with epiretinal macular membrane (ERM) by means of visual
      evoked cortical potential (VECP). MATERIAL AND METHODS: VECP was recorded from 15
      eyes with macular hole and 9 eyes with ERM prior to and 3 months after surgical
      treatment. Check sizes of 30' for transient stimulation, and 7.5', 15', 30', 60'
      and 120' for steady-state stimulation were applied. RESULTS: In transient VECPs,
      the P 100 component was prolonged and attenuated in both diseases before surgery,
      and it remained unchanged after surgery. In the eyes with macular hole, the
      amplitudes of steady-state VECPs showed significant reduction in 15' and 30'
      check sizes before surgery, and recovered only in 15' check size after surgery.
      The preoperative spatial frequency curve of ERM was lowered in the whole
      frequency range measured. CONCLUSIONS: VECP reflected the area of macular hole
      and ERM. VECP changes after surgery were considered to depend on the degree of
      surgical invasion.

PMID- 11210782
TI  - [Usefulness of frequency doubling technology as a screening test for glaucoma].
AB  - PURPOSE: To evaluate the usefulness of frequency doubling technology (FDT) as a
      screening test. MATERIAL AND METHODS: One-hundred and six eyes of 106 patients
      with primary open-angle glaucoma and 66 eyes of 66 normal subjects were examined
      in a screening program using FDT. The test results were evaluated by comparison
      with the results obtained by Humphrey Field Analyzer (HFA) and/or the appearance
      of the optic disk. RESULTS: The sensitivity and specificity of FDT regarding the
      existence of abnormal points worse than mild relative loss were 88% and 95%,
      respectively. At least one abnormal point worse than mild relative loss in FDT
      was detected in over 90% of the abnormal hemifields equal to or worse than stage
      2 of Aulhorn's classification modified by Greve, but it was 55% and 65% in stages
      0-1 and 1, respectively. Nerve fiber layer defects were found in 67% of the
      hemifields, which was judged as abnormal in FDT but normal in HFA. CONCLUSION:
      FDT is useful for detection of glaucomatous visual field defects in stage 2 or
      worse. FDT may detect early glaucomatous visual field defects overlooked in HFA
      testing.

PMID- 11210783
TI  - [Two cases of digitalis toxicity with reversible and severe decrease of visual
      acuity].
AB  - BACKGROUND: We performed electrophysiologic tests on two patients with digitalis
      toxicity who first had photophobia and xanthopsia and revealed reversible reduced
      visual acuity and binocular central scotoma. CASES: The patients were a 72-year
      old male and a 54-year-old male who had symptoms of digitalis toxicity. FINDINGS:
      The corrected visual acuity was severely decreased during digitalis toxicity,
      0.02 oculus dexter (OD) and 0.1 oculus sinister (OS) in case 1 and 0.04 OD and
      0.2 OS in case 2. But visual acuity recovered as the blood levels of digitalis
      decreased to the normal level and the corrected visual acuity was 0.7 OD and 0.8
      OS in case 1 and 0.8 OD and 0.9 OS in case 2. We recorded 30 Hz-flicker
      electroretinogram (ERG), single flash ERG, photopic ERG, and scotopic ERG when
      digitalis blood levels were elevated and normal. Decreased amplitudes of 30 Hz
      flicker ERG and photopic ERG suggested that photoreceptor function was disturbed
      at digitalis toxicity and cone dysfunction was more severely disturbed than rod
      dysfunction. CONCLUSION: 30 Hz-flicker ERG, as well as electrocardiogram and
      digitalis blood level, is a relatively convenient and useful measure of digitalis
      toxicity. It is necessary consiler toxicity when severe visual dysfunction is
      observed in patients with digitalis therapy.

PMID- 11210784
TI  - [Development of corneal storage medium--first report. Examination of rabbit
      cornea].
AB  - PURPOSE: To develop and evaluate a new corneal storage medium with a simple
      formula by histological methods. METHODS: We compared two corneal storage media,
      containing minimum essential medium (MEM) and 2.5% chondroitin sulfate, pH 7.33
      and osmolality of 320 mOsm/kg, to OPTISOL-GS. The differences in the two media
      were the molecular weight (MW) and source of chondroitin sulfate. MW of Medium I
      was 27,500 and MW of Medium II was 33,700. A cornea with scleral rim obtained
      from a Japanese white rabbit was stored in either Medium I or Medium II and the
      fellow cornea was stored in OPTISOL-GS for 7 or 14 days at 4 degrees C.
      Histological examination of corneal endothelial cells was performed both by
      scanning electron microscopy and by transmission electron microscopy. RESULTS: At
      day 7, there was no significant difference in histological findings among the
      rabbit corneas stored in OPTISOL-GS, Medium I, or Medium II. At day 14, corneas
      stored in OPTISOL-GS or Medium I showed similar histological findings. In Medium
      II, endothelial cells showed marked degeneration. CONCLUSION: The results of
      experiments with rabbit cornea indicated that OPTISOL-GS and Medium I could
      preserve endothelial cellular structure better than Medium II. The difference
      between Medium I and Medium II was only the MW of the chondroitin sulfate used.
      The MW may be an important factor to determine suitable chondroitin sulfate for
      developing a corneal storage medium.

PMID- 11210785
TI  - [Usefulness of routine ophthalmologic examination for cytomegalovirus retinitis
      in acquired immunodeficiency syndrome patients].
AB  - PURPOSE: To evaluate the usefulness of routine ophthalmologic examinations for
      cytomegalovirus retinitis in acquired immunodeficiency syndrome (AIDS) patients.
      METHODS: Clinical symptoms of cytomegalovirus (CMV) retinitis in patients with
      AIDS who had circulating CD4+ T lymphocytes 50/microliter or less and received
      monthly ophthalmological examinations (examined group) were compared with those
      of the patients detected by non-routine ophthalmological examinations (unexamined
      group). RESULTS: The patients in whom early CMV retinitis was detected by monthly
      ophthalmological examinations had no subjective symptoms or iritis. The size of
      CMV retinitis was smaller than 2 disc diameters and it did not extend to the
      papillomacular area in a majority of the patients. On the other hand, the size of
      CMV retinitis in the unexamined group was larger than 10 disc diameters and it
      extended to the papillomacular area in most cases. The visual prognosis of the
      examined group was better than that of the unexamined group. CONCLUSIONS: To
      protect visual acuity, it is important to conduct monthly ophthalmological
      examinations in patients with AIDS whose serum CD4+ T lymphocyte counts are 50
      cells/microliter or less.

PMID- 11210786
TI  - [Prognosis of endogenous fungal endophthalmitis and utility of Ishibashi's
      classification].
AB  - PURPOSE: Prognostic evaluations of eyes with endogenous fungal endophthalmitis
      were made according to the classification proposed by Ishibashi. PATIENTS AND
      METHODS: We surveyed endogenous fungal endophthalmitis cases at four Nihon
      University Hospitals and 20 branch hospitals. Sixty eyes of 34 patients were
      classified into five stages according to Ishibashi's proposal, and therapeutic
      methods and visual prognosis in each stage were then evaluated. RESULTS: Systemic
      antifungal drugs were efficacious in 82% of stage II and 69% of stage IIIa cases.
      Even among stage III b cases, antifungal drugs were efficacious in 42%. Among the
      unresponsive cases, only half had been given the maximum dosage of antifungal
      drugs. Half of the eyes in which vitrectomy was performed at stage III b achieved
      a postoperative visual acuity of 0.5 or better and none had a visual acuity of
      less than 0.03. CONCLUSION: Based on the above results, we concluded that
      systemic antifungal drugs should be administered at the maximum dosage in stage
      II and III a cases. If these eyes progress to stage III b despite the maximum
      dosage, vitrectomy is indicated. For stage III b eyes, the maximum dosage should
      be administered first. If the maximum dosage is not efficacious, vitrectomy
      should be carried out before progression to stage IV.

PMID- 11210787
TI  - [A case of malignant myoepithelioma in the lacrimal gland].
AB  - BACKGROUND: A case of malignant myoepithelioma in the lacrimal gland is reported.
      CASE: The patient, a 77-year-old male with increasing proptosis in the left eye
      was referred to us. Steroid therapy was not effective, therefore lateral
      orbitotomy was performed. RESULT: On pathological examination, the proper
      structure of actini was normal, but the cord of actini revealed the destruction
      layer tapering into the surrounding area. The tumor was composed of sarcomatoid
      changes with spindle-shaped cells, collagen fibers, and myxoid pattern.
      immunohistochemically, tumor cells were positive for epithelial membrane antigen
      (EMA) and alpha-smooth muscle actin (alpha-SMA). Electronmicroscopy showed
      desmosomes in intercellular junctions. CONCLUSION: Recently, there have been
      attempts to distinguish myoepithelioma from pleomorphic adenoma on the basis of
      cellular organization. In our case, duct formation was less than in pleomorphic
      adenoma. Therefore we diagnosed this tumor as malignant myoepithelioma.

PMID- 11210788
TI  - [A case of central retinal vein occlusion followed by branch retinal artery
      occlusion].
AB  - BACKGROUND: The influence of retinal artery circulation on central retinal vein
      occlusion (CRVO) is not well known. CASE: A 73-year-old man with hypertension
      complained of transient visual loss in his left eye. At initial examination,
      ophthalmoscopy of his left eye showed mild dilatation and tortuosity of the
      retinal vein and a few dot hemorrhages. Fluorescein angiography disclosed normal
      arm-to-retina circulation time and no leakage of dye, but delayed retinal
      circulation time. These findings indicated venous stasis retinopathy of CRVO. In
      spite of intravenous infusion of prostaglandin E1 and vasodilative treatment,
      four days after initial examination, the patient's left eyeground showed
      complication of branch retinal artery occlusion (BRAO). A fibrinolytic agent was
      given intravenously, but four weeks later, his left eyeground developed typical
      hemorrhagic retinopathy. The hemodynamics of retrobulbar arterial circulation
      were investigated by color Doppler imaging. CONCLUSION: We report a case of
      venous stasis retinopathy of CRVO associated with BRAO, that developed
      hemorrhagic retinopathy despite treatment with prostaglandin E1 and other
      vasodilative agents. We think that arterial insufficiency might be responsible
      for the conversion from venous stasis retinopathy to hemorrhagic retinopathy of
      CRVO.

PMID- 11210789
TI  - [A case of malignant melanoma occurring 63 years after evisceration].
AB  - BACKGROUND: We report a rare case of a 69-year-old woman with malignant melanoma
      of her right socket, who had undergone evisceration of her right globe for
      unknown reasons at the age of 6. CASE: A 69-year-old woman presented with the
      complaint of inability to keep the prosthesis in her socket. A large blackish
      brown mass was seen behind the eyelids, and biopsy of this tissue revealed a
      mixed type malignant melanoma. A right exenteration was performed and
      histopathologic examination demonstrated a large tumor mass anterior and adjacent
      to the remains of the eviscerated globe. CONCLUSION: During evisceration, uveal
      pigment may be incompletely removed from the globe, or may be inadvertently
      scattered in the orbit. This case may demonstrate the development of a malignant
      melanoma from the uvea of an eviscerated globe. We recommend that careful long
      term follow-up be performed on patients who have undergone evisceration.

PMID- 11210790
TI  - [Bioethics in educational examinations and patient treatment].

PMID- 11210791
TI  - [Ethics in transplantation].

PMID- 11210792
TI  - [Socio-economic and ethical aspects of ambulatory treatment for neoplasms in
      Germany].

PMID- 11210793
TI  - [Legal aspects of European ethical conventions].

PMID- 11210794
TI  - [Legal basis for execution of clinical protocols].

PMID- 11210795
TI  - [Philosophical basis of bioethics].

PMID- 11210796
TI  - [Ethical aspects of gene therapy].

PMID- 11210797
TI  - [Ethical aspects of clinical probes for diagnosing neoplasms from the
      pathologists' point of view].

PMID- 11210798
TI  - [Ethical aspects of examining patients without access to legal representation-
      history and current situation in Germany].

PMID- 11210799
TI  - [Awareness of responsibility by German physicians in the last 50 years].

PMID- 11210800
TI  - [Reciprocal relationships among ethics, politics and economics in medicine based
      on studies from the German Health Service].

PMID- 11210801
TI  - [Interpretation of medical investigation results].

PMID- 11210802
TI  - Basic research for cardiovascular reconstruction, organ transplantation and organ
      protection under the limits of German animal protection law.

PMID- 11210803
TI  - Sixth of November of 1939. Collegium Novum hall 56 "Sonderaktion Krakau".

PMID- 11210804
TI  - Bioethics, rooted in "Weltethos" or in Christian culture?

PMID- 11210806
TI  - [Education of medical students in the field of bioethics--agreement with newly
      sanctioned programs of study].

PMID- 11210805
TI  - [Ministerial care and palliative medicine. Multiple types of care for people
      suffering from neoplasms based on the SUPPORT Project].

PMID- 11210807
TI  - [The significance of ethics in medical education].

PMID- 11210808
TI  - [Psycho-oncologic care--interdisciplinary problem. Herfordzki's model].

PMID- 11210809
TI  - [Ethics in medicine from an interdisciplinary perspective].

PMID- 11210810
TI  - [Procedures regarding dying patients. Experience with ethical consultations].

PMID- 11210811
TI  - [Ethical aspects of treatment interruption].

PMID- 11210812
TI  - [German legislation regarding organ transplantation].

PMID- 11210813
TI  - [Ethical aspects of organ transplantation].

PMID- 11210814
TI  - [The Croatian Society for Infant, Child and Adolescent Psychiatry: present state
      and proposals for improving the development of child and adolescent psychiatric
      services in Croatia].
AB  - The paper presents the current state of child and adolescent psychiatry in the
      Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent
      psychiatry in the entire Republic point to the lack of staff in this subspecialty
      profession. The subspecialty was approved by the Ministry of Health in 1994. The
      city of Zagreb satisfies the criteria of some European countries as regards the
      number of staff, but not as regards the organization of the service for child and
      adolescent psychiatry (e.g. lack of university hospital department as the base
      for medical teaching and further specialist training). In other and larger
      centers in the Republic the situation is well below the criteria achieved in this
      profession, particularly in the countries of the European Union and the USA.
      Still, psychiatric services in some towns tend to support the development of
      child and adolescent psychiatry in their environment by providing facilities and
      staff. There are still attempts, even in the health service itself, to overcome
      this lack of personnel and organization by transferring numerous cases from the
      domain of child and adolescent psychiatry to experts in other medical specialties
      or non-medical professionals, instead of improving the development of child and
      adolescent psychiatry. In some countries of the European Union and the USA it has
      already reached the monospecialty status, a tendency supported by the UEMS, which
      also makes efforts to coordinate programs of specialist training in the European
      countries. The described situation certainly has consequences in the of mental
      health care of children, adolescents and their families, because their treatment
      often begins only when a disorder has visibly developed. Its clinical
      manifestations can take very different forms.

PMID- 11210815
TI  - [Lyme borreliosis in Croatia from 1987 to 1998--epidemiologic aspects].
AB  - Lyme borreliosis is one of the most common diseases originating from natural foci
      in the Republic of Croatia. Some 200 cases are reported every year to the
      Epidemiological Department of Croatian National Institute of Public Health, but
      data from hospital treatment and individual limited research show that the number
      of infected is certainly higher. Officially reported cases have been used and
      analysed in this article. Although, aware of the limits of such a source, the
      results gained with this analysis point to certain epidemiological
      characteristics of Lyme borreliosis in Croatia, which can be useful. Clinical
      manifestations might vary, depending on the part of the world, i.e. type of
      Borrelia involved. In Croatia, skin manifestations are predominant--erythema
      (chronicum) migrans. The disease generally does not occur in Southern Croatia; it
      has been only sporadically reported in the area south of Zadar. Although the
      tick, the vector of this disease, can be found everywhere in Croatia, data about
      vector species and their presence in the coastal area are not complete or they
      are missing. Therefore, additional entomological, epidemiological, and clinical
      research are necessary to clarify the absence of Lyme borreliosis in Southern
      Croatia.

PMID- 11210816
TI  - [Characteristics of SHV-2 beta-lactamase from 2 hospitals in Zagreb].
AB  - The aim of the investigation was to determine the properties of SHV-2 type of
      beta-lactamase from two hospitals in Zagreb. The production of SHV-2 beta
      lactamase was determined in 22 clinical isolates of K. pneumoniae by isoelectric
      focusing, PCR and PCR/Nhe test. The organisms were collected from the Sestre
      Milosrdnice Hospital and Dubrava Hospital in Zagreb during 1994-1995. Nine out of
      22 strains transferred resistance to E. coli recipient. In spite of the fact that
      SHV-2 beta-lactamase is a cefotaximase, only 18% of the strains were resistant to
      cefotaxime with standard inoculum size but the percentage of resistant strains
      rose to 39% when the inoculum size was increased to 10(7) CFU/ml. The frequency
      of transfer was lower when more stringent conditions were applied (higher
      concentration of cefotaxime in the medium) but the transconjugants obtained with
      such conditions, displayed higher level of resistance to third generation
      cephalosporins. The genes responsible for resistance to aminoglycosides were
      usually transferred on the same plasmid with the genes encoding ESBLs. All
      strains produced an enzyme with the isoelectric point of 7.6, yielded an amplicon
      with SHV specific primers and had positive PCR/Nhe test.

PMID- 11210817
TI  - [In situ PCR in the diagnosis of acute leukemia].
AB  - Cytomorphologic and cytochemical bone marrow analysis is essential in the
      diagnosis of acute leukemia. Immunophenotyping and conventional cytogenetics,
      just as fluorescent in situ hybridization (FISH) are other diagnostic procedures,
      as well as genome analysis by PCR (polymerase chain reaction). PCR is inevitable
      in searching for minimal residual disease, because it may detect very small
      amount of malignant hematopoietic cells even when a patient is in complete
      remission (less than 5% malignant cells in bone marrow and disappearance from
      peripheral blood) which helps better monitoring of patients. By in situ
      hybridization (ISH) it is possible to associate specific cell type with genome
      alteration, but the method is not sensitive enough. By combining ISH and PCR a
      novel technique with increased sensitivity was developed, PCR in situ, which
      enables nucleic acid amplification in an intact cell. In this case report we
      present two patients whose bone marrow aspirates were analyzed also by PCR in
      situ.

PMID- 11210818
TI  - [Treatment of pseudarthroses of the olecranon with the anatomical hook plate].
AB  - We report the results in seven patients treated surgically for nonunion of the
      olecranon. Four nonunions occurred after primary treatment with tension band
      wiring and three nonunions occurred after open reduction internal fixation with
      plates and screws or lag screws only. All patients were treated with cancellous
      bone grafting and open reduction internal fixation using anatomical hook plates.
      All nonunions united within 6 months after the treatment. In all patients the
      range of motion of the elbow improved significantly.

PMID- 11210820
TI  - [The role of iron in neoplasms].
AB  - The purpose of this review is to concisely summarize the current knowledge of
      iron participation in the carcinogenic process, especially from the standpoint of
      redox regulation, and to introduce a hypothesis for the mechanism. In both
      animals and humans, primary neoplasms develop more frequently at body sites of
      excessive iron deposits. Iron exerts its carcinogenic effects by catalysing
      formation of hydroxil radicals, suppressing activity of host defence cells and
      promoting cancer cell multiplication. Manipulations of cellular iron metabolism
      for modulating normal and malignant cell proliferation is described. Quantitative
      evaluation of body iron and iron-withholding proteins has prognostic value in
      cancer patients. Procedures associated with lowering host iron intake and
      inducing host cell iron efflux can assist in prevention and management of
      neoplastic disease.

PMID- 11210819
TI  - [Corrective osteotomy in the treatment of degenerative changes in the knee
      joint].
AB  - Angular deformity of the knee can be corrected by high tibial osteotomy or distal
      femoral osteotomy. In this research we have analysed effects of corrective
      osteotomy in knees with varus or valgus deformity. In this research we present a
      long-term evaluation of 67 patients older than 40 with angular deformity of the
      knee in which high tibial osteotomy and distal femoral osteotomy were performed
      at the Department of Orthopaedic Surgery, School of Medicine, University of
      Zagreb, in the period 1982-1992. Operation was performed bilaterally in 14
      patients. There were 66 knees with varus deformity and 15 with valgus deformity
      out of a total of 81 knees. The most patients with valgus deformity were
      corrected by supracondylar osteotomy and the most with varus deformity by
      osteotomy of proximal tibia. The average preoperative duration of symptoms was
      6.1 years. The average age was 57.5 at the moment of operation. The mean follow
      up was 7 years (range 3-13 years). We assessed the degree of arthrosis according
      to Ahlbock in five-grade scale. The mean arthrosis was 2.0 preoperatively, 2.2
      postoperatively and 2.6 at the last follow-up examination. Although the patients
      with valgus deformity had smaller degree of arthrosis preoperatively than
      patients with varus deformity, arthrosis developed equally in both groups despite
      the fact that the operation was performed. We measured joint tilt according to
      Shoja and Insall. The patients with varus deformity had joint tilt 7 degrees
      before operation, -4.3 degrees after operation and -2.4 degrees at the last
      control. The patients with varus deformity had femurotibial angle of 185 degrees
      preoperatively, 173 degrees postoperatively, and 175 degrees at the last follow
      up examination. The average revarisation of 2 degrees occurred despite
      overcorrection. The patients with valgus deformity had femurotibial angle of 164
      degrees preoperatively, of 178 degrees postoperatively and of 180 degrees at the
      last follow-up examination. Revarisation progressed 2 degrees on average after
      varisation osteotomy was performed in the knees with valgus deformity. There was
      no statistically significant correlation between pain and femurotibial angle and
      pain and degree of arthrosis preoperatively, postoperatively and at the last
      follow-up examination. The patients were assessed according to the system
      developed at the Hospital for Special Surgery (HSS). The mean preoperative HSS
      score was 2.91 (2.82 varus and 3.33 valgus deformity), and postoperative 4.47
      (4.42 varus and 4.47 valgus). The mean score at the last follow-up evaluation was
      4.05 (varus 4.03 and valgus 4.13). The patients assessed the improvement
      themselves and it was 1 to 14 (6.1) years. Although the indications for
      aloarthroplasty of the knee are more frequent nowadays, the authors recommend not
      to forget corrective osteotomy in the treatment of angular deformity of the knee
      with osteoarthritis.

PMID- 11210821
TI  - [Exercise-induced bronchospasm and its prevention].
AB  - Exercise-induced bronchospasm (EIB) is a type of nonspecific bronchial
      hyperreactivity. It affects mostly children and younger adults with asthma (75%
      95%) and allergic rhinitis (40%), but it is also found in 3-11% of the
      nonasthmatic and nonatopic younger population. Pathophysiology of this phenomenon
      is not clear and there are some attempts to explain it with hyperosmolality of
      bronchial epithelia, exchange of heat and water (reactive hyperemia) in airways
      and reflex vagal bronchospasm. Unrecognized and uncontrolled symptoms of EIB can
      lead patients to avoid general and occupational physical activities and sports.
      Diagnosis of EIB is focused on medical history and on pulmonary function testing
      after standardized exercise testing protocols on treadmill, cycle ergometer or by
      free running. Non-pharmacological and pharmacological prophylactic measures are
      the most important approach in the therapy of EIB. Inhalation of beta 2-agonists
      or cromolyns is the first choice in pharmacological prevention of EIB. With
      adequate therapy, symptoms of EIB can be controlled enough to maintain everyday
      as well as sports activities.

PMID- 11210822
TI  - [Continuing medical education in Croatia and the European Union].
AB  - The Continuing Medical Education (CME), with attention to other forms of
      Continuing Professional Development (CPD) in Croatia and the today endeavors in
      the European Union, are presented. In European Union the formal CME is in its
      starting. The "European Accreditation Council for Continuing Medical Education"
      (EACCME) of the UEMS is established, which has formulated the principles of
      continuing education, the credit hours and their realizing, that would enable the
      mutual recognition of education in all European countries. In Croatia the
      starting of CME was at beginning of the 20th century, when the professional
      societies of Croatian Medical Association were founded. CPD was almost
      exclusively connected to activities of "Andrija Stampar" School of Public Health,
      to the School of Medicine in Zagreb and partly in Rijeka, which established a
      great number of postgraduate studies. The CME i.e. the courses of education were
      tightly connected to activities of the Croatian Medical Association, of its
      professional societies and its Academy of Medical Sciences, but also to
      activities of School of Medicine in Zagreb and Rijeka, and recently in Split and
      Osijek. Since 1995 the third partner, the Croatian Medical Chamber joined too.
      The number of CME meetings during 1998 is presented. The approximate calculation
      for needed annual courses of CME for all medical specialties in Croatia is
      presented. The formation of the National Authority for CME is suggested, in which
      all the interested institutions should be represented.

PMID- 11210823
TI  - [Communicable diseases in Croatia].

PMID- 11210824
TI  - Can gene therapy overcome the problem of hypoxia in radiotherapy?

PMID- 11210825
TI  - Hydrocephalus in mice following X-irradiation at early gestational stage:
      possibly due to persistent deceleration of cell proliferation.
AB  - The pathogenesis of X-ray-induced congenital hydrocephalus was studied. Pregnant
      mice were irradiated at 1.4 Gy on gestational day 7 (G7). Four hours after
      irradiation, extensive cell death was evident in the neuroepithelium and
      underlying mesoderm of the head region, and proliferating cell nuclear antigen
      (PCNA)-immunoreactive cells almost disappeared. Embryos with thinner lamina
      terminalis of the telencephalon, when compared with that of the control, were
      found in the irradiated group on G9. As early as G11 in some irradiated embryos
      the telencephalic wall was thinner and lateral ventricles were larger than those
      of the control. The choroid invagination from the lamina terminalis began on G11
      in the control brain, but not in the affected brain. During the following
      development, fetuses with readily apparent hydrocephalus were consistently found
      among irradiated fetuses. In these brains the brain mantle was thinner, the
      corpus striatum and thalamic regions were smaller, and lateral ventricles were
      larger than those of the control. Even on G11 and G13 the frequencies of PCNA
      positive cells in the brain mantle and other brain regions were lower in the
      hydrocephalic brain than those of the control, suggesting a decelerated
      proliferation of successive cell generations following exposure to X-rays. The
      cerebral aqueduct was open in the hydrocephalic brain during the fetal period
      when the lateral ventricles were dilated. The head was vaulted after birth but
      the cerebral aqueduct was not completely occluded even in these animals. These
      findings suggested that cell death in the neuroepithelium followed by a
      persistent deceleration of neural cell proliferation, resulting in the hypoplasia
      of brain parenchyma with compensatory ventricular dilatation, is important for
      the establishment of hydrocephalus.

PMID- 11210826
TI  - The effect of caffeine on p53-dependent radioresponses in undifferentiated mouse
      embryonal carcinoma cells after X-ray and UV-irradiations.
AB  - The effect of caffeine was studied on the radioresponses of undifferentiated
      mouse embryonal carcinoma cells (EC cells) with or without the functional p53.
      The radioresponses studied included radiosensitivity, the activation of p53,
      apoptosis with characteristic DNA ladder formation and cell cycle progression. An
      undifferentiated mouse EC cell line, ECA2, and a newly established p53-deficient
      EC cell line, p53 delta, were used in the present study. The status of the p53
      gene did not significantly affect the colony survivals of undifferentiated EC
      cells to X-rays and UV. Although a post-irradiation treatment with caffeine
      sensitized both lines to X-rays marginally, the sensitization was prominent for
      UV regardless of the p53 status of the cells. The activation of a p53 responsible
      lacZ reporter construct was observed in stably transfected ECA2 cells after X-ray
      and UV irradiations. Caffeine suppressed the X-ray induced activation of the lacZ
      reporter, while it drastically enhanced the activation after UV irradiation. X
      rays and UV readily triggered the apoptosis of ECA2 cells with the characteristic
      DNA ladder. Although UV-induced DNA ladder formation was enhanced by caffeine,
      that induced by X-rays was unaffected. Therefore, the effects of caffeine on the
      p53-dependent radioresponses were found to be agent specific: suppression for the
      X-ray induced and augmentation for the UV induced. In contrast to p53-proficient
      ECA2 cells, smear-like DNA degradation was observed for irradiated p53 delta
      cells, suggesting the presence of a mode of cell death without DNA ladder
      formation. UV induction of the smear-like DNA degradation was enhanced in the
      presence of caffeine. Regardless of the state of the p53 gene, G1/S arrest was
      not observed in X-ray and UV irradiated EC cells. X-ray induced G2/M arrest in
      both lines, which was abrogated by caffeine, while G2/M arrest after UV was
      unaffected by a caffeine treatment. These results indicate that the
      radioresponses of undifferentiated EC cells differ considerably from those of
      somatic cells, and that these radioresponses were modulated by a post-irradiation
      treatment with caffeine.

PMID- 11210827
TI  - UVC-induced apoptosis in human epithelial tumor A431 cells: sequence of apoptotic
      changes and involvement of caspase (-8 and -3) cascade.
AB  - Human epidermoid tumor A431 cells underwent apoptosis following exposure to
      ultraviolet C (UVC). The apoptosis was of the interphase death type, and mostly
      occurred within one cell cycle, independent of the cell-cycle phases. We further
      examined the detailed sequential order of apoptotic changes in cells after UVC
      exposure and the involvement of caspases using six caspase inhibitors. The loss
      of mitochondrial transmembrane potential (delta psi m) appeared in the earliest
      phase; subsequently, the chromatin condensation and DNA-fragmentation occurred.
      Cell shrinkage and loss of the plasma-membrane integrity, judged by propidium
      iodide (PI) staining, were observed in the later phase. A broad-spectrum caspase
      inhibitor, z-VAD-fmk, completely prevented all apoptotic changes, except for the
      depletion of delta psi m. Both Ac-DEVD-CHO and Ac-IETD-CHO, inhibitors of caspase
      -3 and -8, respectively, effectively inhibited typical chromatin condensation to
      almost the same extent. However, the nuclei still showed partial condensation. A
      caspase -9 inhibitor, Ac-LEHD-CHO, did not prevent chromatin condensation, though
      it partially inhibited cell-size reduction and PI-stainability. None of the
      caspase inhibitors could inhibit the delta psi m reduction. These results
      strongly suggest that the collapse of delta psi m is not a part of the central
      apoptotic machinery, and that caspase cascade(s), especially caspase-8 to -3,
      play an important role in UVC-induced apoptosis in A431.

PMID- 11210828
TI  - Ionizing radiation and bacterial challenge alter splenic cytokine gene
      expression.
AB  - Irradiation increases susceptibility to bacterial infection. Exogenous
      proinflammatory cytokines can alter the response of mice to gamma radiation, but
      the role of endogenous inflammatory cytokines after bacterial infection in
      irradiated animals is not known. Gene expression of hematopoietic (GM-CSF) and
      proinflammatory (IL-1 beta, IL-6 and TNF-alpha) cytokines were examined in
      spleens of B6D2F1/J female mice after irradiation alone (1.0- and 7.0-Gy), and
      after irradiation followed by Klebsiella pneumoniae s.c. challenge 4 days
      postirradiation by using the reverse transcription-polymerase chain reaction (RT
      PCR) and Southern blot hybridization. At 4, 8, and 24 h after bacterial challenge
      in 7.0-Gy-irradiated mice, GM-CSF mRNA increased (p < 0.05). TNF-alpha mRNA in
      irradiated mice were slightly decreased, whereas after bacterial challenge, TNF
      alpha mRNA elevated at 30 h in 7.0-Gy-irradiated mice; at 4, and 8 h in 1.0-Gy
      irradiated mice, and at 1 h in sham-irradiated mice (p < 0.05). IL-6 mRNA
      displayed a biphasic response in 7.0-Gy-irradiated mice, and, after bacterial
      challenge, in both irradiated mice (1.0- and 7.0-Gy) and sham-irradiated mice. IL
      1 beta mRNA remained at or below normal for 8 h and increased at 24 h after
      bacterial challenge on day 4 in 7.0-Gy-irradiated mice. These results indicate
      that sublethal gamma radiation alters the patterns of the hematopoietic and
      proinflammatory cytokine responses to bacterial challenge in vivo. Consequently,
      treatment protocols may need to take into account changes in cytokine gene
      responses to resolve infection after irradiation.

PMID- 11210829
TI  - Expression of ICAM-1 and acute inflammatory cell infiltration in the early phase
      of radiation colitis in rats.
AB  - Inflammatory cell infiltration of the colon is observed at an early stage of
      radiation-induced colitis. The emigration of inflammatory cells from the
      circulation requires interactions between cell adhesion molecules on the vascular
      endothelium and molecules on the surface of leukocytes. To elucidate this
      process, the present work analyzes the kinetics of the expression of
      intercellular adhesion molecule-1 (ICAM-1) and the accumulation of inflammatory
      myeloperoxidase (MPO)-positive cells in relation to the appearance of acute
      radiation colitis prior to an overt radiation-induced ulcer. Colon tissues were
      obtained from Wistar Kyoto rats at various times after 22.5 Gy irradiation to the
      rectum. Histologically, crypt depletion and numerous inflammatory cells were
      observed 4 days after irradiation, and mucosal ulcer 6 days after irradiation.
      ICAM-1 immunopositivity was present in the endothelial cells of small vessels in
      the mucosa of both control and irradiated rats. ICAM-1 mRNA expression was
      detected in normal colon and irradiated colon by reverse transcription-PCR. In
      Northern blotting, ICAM-1 mRNA levels were found to increase markedly in the
      irradiated colon compared to the normal colon. In Western blotting. ICAM-1
      protein expression also increased with a peak one day after irradiation, and
      remained elevated up to 6 days thereafter. The number of MPO-positive cells in
      lamina propria mucosa increased in a time-dependent fashion from 6 h to 6 days
      after irradiation. These data suggest that up-regulation of ICAM-1 in endothelial
      cells and accumulation of MPO positive cells play important roles in the
      development of radiation-induced colonic ulcer.

PMID- 11210830
TI  - Exposure to strong magnetic fields at power frequency potentiates X-ray-induced
      DNA strand breaks.
AB  - We examined the effect of an extremely low-frequency magnetic field (ELFMF) at 5,
      50 and 400 mT on DNA strand breaks in human glioma MO54 cells. A DNA damage
      analysis was performed using the method of alkaline comet assay. The cells were
      exposed to X-rays alone (5 Gy), ELFMF alone, or X-rays followed by ELFMF at 4
      degrees C or on ice. No significant difference in the tail moment was observed
      between control and ELFMF exposures up to 400 mT. X-ray irradiation increased DNA
      strand breaks. When cells were exposed to X-rays followed by ELFMF at 50 and 400
      mT, the tail moment increased significantly compared with that for X-rays alone.
      When the exposure of cells was performed at 37 degrees C, no significant change
      was observed between X-rays alone and X-rays plus 400 mT. We previously observed
      that exposure to 400 mT ELFMF for 2 h increased X-ray-induced mutations
      (Miyakoshi et al, Mutat. Res., 349: 109-114, 1996). Additionally, an increase in
      the mutation by exposure to the ELFMF was observed in cells during DNA
      synthesizing phase (Miyakoshi et al., Int. J. Radiat. Biol., 71: 75-79, 1997).
      From these results, it appears that exposure to the high density ELFMF at more
      than 50 mT may potentiate X-ray-induced DNA strand breaks.

PMID- 11210831
TI  - Similarity between the effects of carbon-ion irradiation and X-irradiation on the
      development of rat brain.
AB  - The effects of carbon-ion irradiation and X-irradiation on the development of rat
      brain were compared. Twenty pregnant rats were injected with bromodeoxyuridine
      (BrdU) at 9 pm on day 18 of pregnancy and divided into five groups. Three hours
      after injection (day 19.0) one group was exposed to 290 MeV/u carbon-ion
      radiation by a single dose of 1.5 Gy. Other groups were exposed to X-radiation by
      1.5, 2.0 or 2.5 Gy, or sham-treated, respectively. Fetuses were removed from one
      dam in each group 8 h after exposure and examined histologically. Extensive cell
      death was observed in the brain mantle from the irradiated groups. The cell death
      after 1.5 Gy carbon-ion irradiation was remarkably more extensive than that after
      1.5 Gy X-irradiation, but comparable to that after 2.0 Gy or 2.5 Gy X
      irradiation. The remaining rats were allowed to give birth and the offspring were
      sacrificed at 6 weeks of age. All of the irradiated offspring manifested
      microcephaly. The size of the brain mantle exposed to 1.5 Gy carbon-ion radiation
      was significantly smaller than that exposed to 1.5 Gy X-radiation and larger than
      that exposed to 2.5 Gy X-radiation. A histological examination of the cerebral
      cortex revealed that cortical layers II-IV were malformed. The defect by 1.5 Gy
      carbon-ion irradiation was more severe than that by the same dose of X
      irradiation. Although the BrdU-incorporated neurons were greatly reduced in
      number in all irradiated groups, these cells reached the superficial area of the
      cortex. These findings indicated that the effects of both carbon-ion irradiation
      and X-irradiation on the development of rat brain are similar in character, and
      the effect of 1.5 Gy carbon-ion irradiation compares to that of 2.0-2.5 Gy X
      irradiation.

PMID- 11210832
TI  - Effects of the restriction of food and water intake on the distribution and
      retention of radioiodine in mice.
AB  - The effects of the restriction of food and water intakes on gastrointestinal
      absorption, distribution to organs and excretion of 131I were investigated in
      C3H/He mice. The animals were divided into four groups and administered orally 37
      kBq carrier-free Na 131I in 0.25 ml normal saline. One group of animals was given
      food and water ad libitum throughout the experimental period. Food and water to
      the remaining groups were restricted before and/or after the administration of
      131I. The animals in each group were sacrificed 4 h and 24 h after
      administration, and the activity of 131I in thyroid, blood, liver, kidney,
      gastrointestinal tract, urine, feces, and carcass was measured. There was a
      significant increase in the retention of 131I in the thyroid and the
      concentration of 131I in the blood due to the restriction of food and water after
      the administration of 131I. In contrast, a significant decrease in the urinary
      excretion was observed in these animals. In those animals, which fasted before
      administration only, the retention of 131I in the thyroid and other organs were
      decreased. Therefore, for an accurate diagnosis and effective therapy with
      radioiodine as well as effective radiation protection, the intake of food and
      water should be taken into account.

PMID- 11210833
TI  - RAMC Journal 1948 Vol 91 101-124. The Burma campaigns--1942-1945. A history of
      casualty evacuation.

PMID- 11210834
TI  - [Effectiveness of lymphotropic therapy in patients with tuberculosis in relations
      to genetic markers].
AB  - To study whether a combination of the carriage of genetic blood markers:
      haptoglobin phenotypes and red blood cell glucose-6-phosphate dehydrogenase, 60
      patients with destructive tuberculosis were given a new drug treatment regimen by
      using regional lymphotropic therapy with 10% isoniazid. The efficiency of the
      treatment and residual changes were found to be directly related to what a
      patient has as genetic background. Defining the types of combinations of genetic
      markers may predict the course of disease, the efficiency of treatment, and
      outcomes.

PMID- 11210835
TI  - [Hepatorenal correlations in patients with pulmonary tuberculosis in the presence
      of viral hepatitis B markers and organic chlorine pesticides: radionuclide
      studies].
AB  - Excretory hepatic function (EHF) and effective renal plasma flow (ERPF) were
      studied in 115 patients with pulmonary tuberculosis by the data of radionuclide
      studies. The patients were divided into 2 groups: Group 1 included 89 patients
      whose blood samples showed viral hepatitis B markers (VHBM) and organic chlorine
      pesticides (OCP) and Group 1 comprised 26 patients without VHBM and OCP. More
      than 50% of the examinees were found to have impairments in both EHF and ERPF. In
      some of them, these disorders progressed during treatment. There was a
      correlation between these parameters, which makes it necessary to search for new
      pathogenetic exposures in order to improve hepatic and renal functions in
      patients with blood VHBM and OCP.

PMID- 11210836
TI  - [Early surgical treatment of new restrictive forms of pulmonary tuberculosis].
AB  - The outcomes of surgical treatment were analyzed in 264 new cases of restrictive
      pulmonary tuberculosis subjected to pulmonectomy without pretreatment with drugs
      in the preoperative period. Sixty one patients who had refused to have surgery or
      operated on after treatment were as a control. Indications for such policy were
      defined. These included limited tuberculomas and cavernous tuberculosis without
      local seeding, perifocal infiltration, exacerbations and preserved cellular and
      humoral immunity and non-specific protection factors. The outcomes of surgical
      interventions in the experimental group were slightly better. They had fewer
      complications, rapid recovery of working capacity, low per cent of disability
      than patients operated on after preoperative chemotherapy. There was no increase
      in the incidence of relapses.

PMID- 11210837
TI  - [Outcomes of surgical interventions in patients with infiltrative pulmonary
      tuberculosis].
AB  - Thirty eight patients underwent surgery. The most significant causes of
      ineffective therapeutical measures in patients were their treatment incompetences
      (100%), multidrug resistance of Mycobacteria tuberculosis (47.3%), lung tissue
      destruction (68.4%), concomitant alcoholism (47.3%), relapses of specific lung
      damage (23.7%). If medical treatment is ineffective in patients with infiltrative
      pulmonary tuberculosis for 6 months, it is expedient to make a surgical
      intervention that promotes recovery (96%) and restore working capacity (84%) in
      them.

PMID- 11210838
TI  - [Effects of ftorotan and isoflurane on homeostatic parameters in patients with
      pulmonary tuberculosis ar reoperation].
AB  - Metabolic parameters were studied in 32 patients who underwent resurgery for
      complicated forms of pulmonary tuberculosis. Isoflurane caused deeper anesthesia
      than did ftorotan, exerted no toxic effect on hepatic function, did not alter the
      levels of serum immunoglobulins in the plasma of patients in the early
      postoperative period, which allows it to be recommended for its use in this group
      of patients.

PMID- 11210839
TI  - [Enhancing the impact of chemotherapy of tuberculosis with parenteral
      administration of dissolved ozone].
AB  - Thirty three patients with acute progressive chronic pulmonary tuberculosis who
      were admitted to be intolerable since they had gross damage and gained no
      benefits from chemotherapy due to the multidrug resistance of Mycobacteria
      tuberculosis were given an additional course of intravenous dissolved ozone
      administration (PO3). Before PO3 administration, more than half (57.4%) of the
      patients received only 1 or 2 antituberculous drugs (ethambutole and ethionamide
      or ethambutole and oprofloxacin). PO3 produced a pronounced disintoxifying
      effect, resulting in cessation of bacterial isolation. The stabilization of a
      tuberculous process was verified by clinical, X-ray, and laboratory studies in
      75.8% of patients. This made it possible to perform bulky operations on the lung.
      When there was a postoperative progression of the underlying process in the
      single lung, chemotherapy was supplemented by intravenous PO3, which also
      promoted the stabilization of the process. The use of PO3 expands the spectrum of
      used agents and enhances the impact of chemotherapy in the treatment of patients
      isolating multidrug-resistant M. tuberculosis in both pre- and postoperative
      periods, this increases the rate of operability in the most serious patients.

PMID- 11210840
TI  - Outside interests.

PMID- 11210841
TI  - The effect of androstenedione/estrone supplementation on cortical and cancellous
      bone in the young intact female monkey: a model for the effects of polycystic
      ovarian disease on the skeleton?
AB  - The goal of this study was to determine the effects of chronically elevated blood
      androstenedione and estrone levels on the quality and quantity of both cancellous
      (trabecular) and cortical bone in a young (mean age 9.4 years) female primate
      model (M. fascicularis). Thirteen intact female monkeys received continuous
      androstenedione/estrone supplementation via subcutaneous implants over a 24-month
      period to simulate the human condition known as polycystic ovarian disease
      (PCOD). A group of 16 untreated intact age-matched female monkeys served as
      controls. Lumbar spine and whole body bone mineral density (BMD) status was
      determined mid-study by dual photon absorptiometry (DPA); subsequent analysis of
      the bone related to data obtained following the 2-year treatment period without
      further BMD measurement. Bone markers, including serum acid phosphatase, total
      bone alkaline phosphatase, bone gla protein and tartrate-resistant acid
      phosphatase were measured at the end of the study. At necropsy, the lumbar
      vertebrae and femora were recovered in order to analyze the bone mineral quality
      and quantity of cancellous and cortical bone respectively and to compare these
      with the control group. Mineralization profiles of the vertebrae and femora were
      obtained using the density fractionation technique. Chemical analysis of the
      three largest fractions retrieved by density fractionation was performed to
      evaluate differences in %Ca, %P, Ca/P ratio and mineral content (%Ca + %PO4)
      between control and experimental groups. In addition, unfractionated bone powder
      was examined by X-ray diffraction to identify any changes in crystal size.
      Coronal sections of vertebrae were analyzed for structural parameters using
      histomorphometry and image analysis. Cross-sections taken at the midshaft
      diaphyseal femora were analyzed for structural macroscopic and intracortical
      parameters. There was a significant increase in BMD at the L2-L4 region in the
      treatment group compared with the control groups (p < 0.005) as measured at 1
      year into the trial. Serum acid phosphatase was significantly lower (p < 0.05) in
      the treatment group compared with the controls near study termination. A
      nonsignificant shift in the mineralization profile of the vertebrae towards less
      dense bone was observed in the treatment group, while there was a significant
      shift in the mineralization profile towards more dense bone in the treated femora
      compared with controls (p < 0.05) after a 2-year period. There was no difference
      between treatment and control groups in terms of size/strain of the cortical or
      cancellous bone crystal as detected by X-ray diffraction. There was a significant
      increase in cancellous bone area (B.Ar.) (p < 0.02) and a significant increase (p
      < 0.05) in mean trabecular width with a corresponding decrease in trabecular
      separation (p < 0.03) in the experimental group compared with the controls. There
      were no significant changes in osteoid parameters (perimeter, area or width) or
      eroded perimeter measurements in the experimental group compared with the
      controls. In the experimental group, trabecular strut analysis showed a
      significant increase in the number of nodes (p < 0.02) and in the total strut
      length (p < 0.003) compared with the controls. There was also a significant
      increase in the node to node (p < 0.04) and node to terminus (p < 0.004) strut
      length in the treatment group compared with the controls. A significant increase
      in B.Ar. without concurrent indices of ongoing remodelling differing from
      controls suggests that cancellous bone of the vertebral body in the treated young
      female primate had been receptive to the anabolic stimulus of
      androstenedione/estrone supplementation over the 2-year period. In contrast,
      macroscopic parameters of cortical bone such as perimeter, area and width were
      preserved over the 2-year course, while intracortical remodeling was evident with
      increased percent porosity (p < 0.001), osteonal bone (p < 0.01) and osteonal
      density (p < 0.01) observed in the treatment group compared with the controls.
      The endocrine profile of both elevated androstenedione and estrone levels in an
      intact female primate of reproductive age may identify differential effects of
      the condition known as polycystic ovarian disease on the skeletal compartments.

PMID- 11210842
TI  - Biologist webwatch.

PMID- 11210843
TI  - Biologist webwatch.

PMID- 11210844
TI  - European Science Foundation policy briefing: use of animals in research.

PMID- 11210845
TI  - Scientific procedures on living animals in Great Britain 1999.

PMID- 11210846
TI  - Greater protection of rats, mice and birds in USA.

PMID- 11210847
TI  - Vote of thanks for Dr Jon Richmond's second Annual FRAME Lecture.

PMID- 11210848
TI  - LASA meeting on genetically modified research animals: applications, challenges
      and ethical use.

PMID- 11210850
TI  - Selected titles.

PMID- 11210849
TI  - RSPCA/UFAW rodent welfare meeting. Universities Federation for Animal Welfare.

PMID- 11210851
TI  - Sialoblastoma: report of a congenital case with dysembryogenic alterations of the
      adjacent parotid gland.

PMID- 11210852
TI  - Hepatocellular carcinoma with solitary metastasis in pleomorphic adenoma of the
      submandibular gland.

PMID- 11210853
TI  - Lipomatous polyposis of the colon.

PMID- 11210854
TI  - Pseudomembranes in collagenous colitis.

PMID- 11210855
TI  - Newly-developed diamond points for conservative operative procedures.
AB  - The rapid decrease in the size of dental restorations has increased the demand
      for the smallest rotary cutting instrument possible. The width of cavities
      prepared with two experimental diamond points and the smallest commercial diamond
      point were compared and significant differences found. SEM observation of the
      head surfaces of the three diamond points revealed that the experimental points
      had comparable cutting characteristics with the commercial diamond point.

PMID- 11210856
TI  - Effect of collagen removal on shear bond strength of two single-bottle adhesive
      systems.
AB  - This study evaluated the effect of collagen removal on the shear bond strength
      for two single-bottle adhesive systems. The ultrastructure of the dentin after
      treatments and the dentin-resin interface were examined under SEM. The buccal and
      lingual surfaces of 80 extracted human third molars were ground to expose dentin.
      Teeth were randomly assigned to four groups and received the following
      treatments: Group 1(P&B 2.1), Prime & Bond 2.1 adhesive was applied according to
      the manufacturer's directions and Restorative Z100 composite resin was bonded to
      the dentin surface; Group 2 (P&B 2.1/NaOCl), the same procedures were followed as
      for Group 1 except that the surfaces were treated with 10% sodium hypochlorite
      (NaOCl) for one minute after acid conditioning; Group 3 (SB), Single Bond (3M)
      was applied according to the manufacturer's recommendations; Group 4 (SB/NaOCl),
      the same procedure was followed for Group 2, using Single Bond. The specimens
      were stored in humidity at 37 degrees C for 24 hours and tested in a shear mode
      at a crosshead speed of 0.5 mm/minute. The Kruskal-Wallis test and Multiple
      Comparisons were used for statistical analysis of the data. A one-minute exposure
      of dentin to 10% NaOCl following acid conditioning resulted in a significant
      increase of the dentin shear bond strength for Prime & Bond 2.1. The same
      treatment for Single Bond resulted in a significant reduction in bond strength.
      Groups 1 and 3 were not statistically different from each other. The presence of
      a collagen layer resulted in the formation of a hybrid layer and similar values
      of adhesion for both adhesive systems. The results may suggest that collagen
      removal improves the bond strength for this acetone-based adhesive system but
      several such systems would need to be investigated.

PMID- 11210857
TI  - Immunocytochemical detection of MMP-3 and -10 expression in hepatocellular
      carcinomas.
AB  - Structural changes in the extracellular matrix (ECM) are necessary for cell
      migration during tissue remodeling and tumor invasion. The matrix
      metalloproteinases (MMPs) and their inhibitors have been shown to be critical
      modulators of ECM composition and are thus crucial in neoplastic cell invasion
      and metastasis. Expression of MMP-2, -3, -9, -10, and -13 was investigated in
      human hepatocellular carcinomas (HCCs) employing an indirect alkaline phosphatase
      conjugated immunocytochemical technique. Evaluation of the results was based on
      (a) the persent of neoplastically transformed cells/surrounding stroma that
      reacted positively and (b) a measure of staining intensity [graded from A
      (highest) to D]. The two forms of stromelysin, MMP-3 and -10, share 82% sequence
      homology, but exhibit differences in cellular synthesis and inducibility by
      cytokines and growth factors in vitro. Strong overall expression of MMP-3 and -10
      was found in HCCs, especially in the ECM adjacent to blood vessels. Positive
      immunoreactivity could be seen for these two MMPs in the ECM surrounding over 90%
      of the neoplastically transformed cells (++++), and the staining intensity was
      also the strongest possible (A,B). No immunoreactivity was detected using
      antibodies directed against MMP-2, -9, and -13.

PMID- 11210858
TI  - [Matrix metalloproteinases. Point of attack for a new cancer therapy].

PMID- 11210859
TI  - Laryngeal preservation with supracricoid partial laryngectomy results in improved
      quality of life when compared with total laryngectomy.
AB  - OBJECTIVES/HYPOTHESES: Study 1: To assess the oncologic outcome following
      supracricoid partial laryngectomy (SCPL). Study 2: To compare the quality of life
      (QOL) following SCPL to total laryngectomy (TL) with tracheoesophageal puncture
      (TEP). Study 3: To analyze whole organ TL sections to determine the percentage of
      lesions amenable to SCPL STUDY DESIGN: Study 1: A retrospective review of
      patients who underwent SCPL. Study 2: A non-randomized, prospective study using
      QOL instruments to compare patients who underwent either SCPL or TL Study 3: A
      retrospective histopathologic study of TL specimens assessed for the possibility
      of performing an SCPL. METHODS: Study 1: Twenty-five patients with carcinoma of
      the larynx underwent SCPL between June 1992 and June 1999. Various rates of
      oncologic outcome were calculated. Study 2: Thirty-one patients participated in
      the QOL assessment. This included the SF-36 general health status measure, the
      University of Michigan Head and Neck Quality of Life (HNQOL) instrument, and the
      University of Michigan Voice-Related Quality of Life (VRQOL) instrument. Study 3:
      Ninety surgical specimens were obtained and studied from the total laryngectomy
      cases in the Tucker Collection. Multiple sites were evaluated for the presence of
      carcinoma A computer program was written to classify whether the patient was
      amenable to SCPL. RESULTS: Study 1: The overall local control rate was 96%
      (24/25). The local control rate following SCPL with cricohyoidoepiglottopexy
      (CHEP) was 95% (20/21). The local control rate following SCPL with
      cricohyoidopexy (CHP) was 100% (4/4). Study 2: The SCPL had significantly higher
      domain scores than TL and TEP in the following categories for the SF-36: physical
      function, physical limitations, general health, vitality, social functioning,
      emotional limitations, and physical health summary. The significantly higher
      domains for the SCPL when compared with the TL and TEP for the HNQOL were eating
      and pain. Finally, when voice-related QOL was assessed with the V-RQOL, the
      domains of physical functioning and the total score were significantly better
      with SCPL when compared with TL and TEP. Study 3: Forty of 90 (44%) laryngeal
      whole organ specimens were determined to be resectable by SCPL. In 16 (18%)
      specimens, the patients could have undergone SCPL with CHEP and in 24 (27%)
      specimens the patients could have undergone SCPL with CHP. Among the 40 (44%)
      specimens determined to be able to have undergone SCPL, 19 were glottic (1 T1, 15
      T2, 3 T3) and 21 were supraglottic (9 T2, 12 T3). CONCLUSIONS: 1) A review of the
      literature and an analysis of the data in this study indicate that excellent
      local control may be expected following SCPL. 2) The QOL following SCPL, as
      measured by three validated QOL instruments, is superior to TL with TEP. 3) A
      histologic assessment of whole organ sections of TL specimens indicates that many
      patients who have been subjected to TL may have been candidates for SCPL. 4) If
      the indications and contraindications are rigorously adhered to, SCPLs are
      reasonable alternatives to TL in selected cases.

PMID- 11210860
TI  - Steroid-dependent anosmia.
AB  - OBJECTIVE: To document the response to steroids in patients remaining anosmic
      following endoscopic nasal and sinus polypectomy. STUDY DESIGN: A prospective
      study of 24 patients with nasal and sinus polyps who were anosmic prior to
      endoscopic nasal and sinus surgery. Those who remained anosmic after surgery were
      treated with steroids. Most patients had asthma, allergic rhinitis, or both. A
      few had aspirin sensitivity. METHODS: All 24 patients had testing of their sense
      of smell before and after surgery. Those who remained anosmic postoperatively
      were first treated with topical nasal and then oral steroids and then tested
      again. RESULTS: Twelve of the 24 remained anosmic after surgery and were found to
      be unresponsive to nasal steroids, but oral steroids were found to restore the
      sense of smell to normal in most patients. Few patients continued to take the
      medication for long periods of time mainly because of a fear of side effects.
      Recent studies have suggested the role of systemic steroids in olfactory
      secretion, which may explain the mechanism for this response. CONCLUSION:
      Patients who remain anosmic after the removal of nasal and sinus polyps can be
      treated with oral steroids resulting in improvement of their sense of smell.
      Further research is needed on a molecular level to determine the reason for this
      and also why oral but not nasal steroids are helpful in these patients.

PMID- 11210861
TI  - Cancer induction in the DMBA hamster cheek pouch: a modified technique using a
      promoter.
AB  - OBJECTIVE: To evaluate a modified method of carcinogenesis induction using the
      9,10-dimethyl-1,2-benzanthracene (DMBA) sustained-release suture technique
      followed by arecaidine promotion in the hamster cheek pouch model. STUDY DESIGN:
      Prospective, controlled animal study. METHODS: Number 3-0 cotton sutures were
      impregnated with DMBA and coated with silicone elastomer. These sutures were
      placed in the cheek pouch of Syrian hamsters in the submucosal space to a length
      of approximately 1.5 cm. The suture placement was confirmed every 2 weeks and
      replaced if lost. After 12 weeks, the DMBA-coated sutures were removed. The cheek
      pouches were everted and painted with a solution of arecaidine three times weekly
      for up to an additional 4 weeks or until the tumor reached a size of 100 mm2.
      RESULTS: We placed sutures in 165 Syrian hamster cheek pouches. Of these, 133
      hamsters (80.6%) produced squamous cell carcinomas that reached a size of 100 mm2
      and then were randomly selected for treatment in a new drug trial. Twenty-six
      hamsters (15.8%) were found dead and 6 (3.6%) were killed because of severe
      inflammation. CONCLUSIONS: The DMBA hamster cheek pouch model is a reliable and
      efficient animal model for inducing squamous cell carcinoma and can be used to
      study upper aerodigestive tract tumors.

PMID- 11210862
TI  - Facial purpura.
AB  - OBJECTIVES: Patients with facial purpura can have acute and dramatic illnesses.
      For this reason, the clinician must be aware of certain diagnoses that can
      present as facial purpura and know how to initiate treatment efficiently.
      According to our review of the literature, no paradigm currently exists for the
      diagnosis and management of facial purpura Our goal is to develop a schema for
      the identification and management of facial purpura. STUDY DESIGN: Case series.
      METHODS: A case series of five cases is presented followed by a systematic
      development of a differential diagnosis based on etiology of the lesion. RESULTS:
      Facial purpura can be classified into conditions that are primarily or
      secondarily vasculitic, thrombocytopenic, neoplastic, infectious, toxic, and
      miscellaneous, which encompasses episodic reports that do not fit into the other
      categories. A paradigm to diagnose patients with facial purpura is developed
      based on clinical presentation and etiology. To demonstrate the utility of our
      algorithm, the five cases presented are re-examined using the algorithm. To our
      knowledge, this represents the first reported series of facial purpura in the
      modern English literature. A flow chart based on our diagnostic paradigm is
      presented. CONCLUSION: Clinicians caring for patients with facial purpura must
      recognize the acute conditions that require emergent medical intervention. Once
      these diagnoses have been considered, the clinician can employ a systematic
      approach to the diagnosis based on etiology. This study provides a useful
      reference for the otolaryngologist when encountering a patient with facial
      purpura.

PMID- 11210863
TI  - A comparison of monopolar electrosurgery to a new multipolar electrosurgical
      system in a rat model.
AB  - OBJECTIVES/HYPOTHESIS: The purpose of this study is to compare collateral tissue
      damage and wound healing in incisions created by electro-dissociation and
      conventional electrosurgery. Conventional electrosurgery has been used as an
      alternative to the scalpel to improve hemostasis. However, the heat generated by
      this instrument can cause tissue damage surrounding the incision, limiting its
      use around nerves and large blood vessels. A new technology, Coblation
      (Arthrocare Corp., Sunnyvale, CA), uses "electro-dissociation" to achieve similar
      results by creating charged particles from a conductive medium to make an
      incision while simultaneously achieving hemostasis. This new approach to
      electrosurgery may reduce soft tissue damage. STUDY DESIGN:  METHODS: Two
      prospective, matched design experiments were performed. In experiment I, both
      devices were set at the same electrical power in watts and then used to create an
      incision on the tongue of rats. In experiment II, the electrical power settings
      of both devices were adjusted until they created incisions of the same size.
      Epithelial destruction and collateral tissue damage were measured in
      histologically prepared tissue in both experiments, and the wound healing process
      was observed in experiment II at 0, 3, 7, and 14 days after surgery. RESULTS: The
      results showed that the electro-dissociation method created significantly less
      epithelial destruction and collateral tissue damage in both experiments.
      Granulation tissue formation was also significantly less extensive in the
      electrodissociation-induced incision after 7 and 14 days of recovery.
      CONCLUSIONS: Wound healing may be faster than with conventional electrosurgery if
      the Coblation device is used.

PMID- 11210864
TI  - Botulinum toxin: basic science and clinical uses in otolaryngology.
AB  - The role of botulinum toxin as a therapeutic agent is expanding rapidly in
      otolaryngology. Botulinum toxin is a protease that blocks the release of
      acetylcholine from nerve terminals. Its effects are transient and nondestructive,
      and largely limited to the area in which it is administered. These effects are
      also graded according to dose, allowing for individualized treatment of patients
      and disorders. Botulinum toxin has been used primarily to treat disorders of
      excessive or inappropriate muscle contraction. In the field of otolaryngology,
      these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm;
      vocal tics and stuttering; cricopharyngeal achalasia; various tremors and tics;
      hemifacial spasm; temporomandibular joint disorders; and a number of cosmetic
      applications. Botulinum toxin treatment has recently begun to show some benefit
      in the control of pain from migraine and tension headache. It may also prove
      useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea,
      and rhinorrhea. In over 20 years of use in humans, botulinum toxin has
      accumulated a considerable safety record, and in many cases represents relief for
      thousands of patients unaided by other therapy.

PMID- 11210865
TI  - Arytenoid appearance and vertical level difference between the paralyzed and
      innervated vocal cords.
AB  - OBJECTIVES/HYPOTHESIS: In unilateral vocal fold paralysis, it has been generally
      accepted that the paralyzed vocal fold presents at a higher level than a normally
      innervated vocal fold. In this study, we correlate the appearances of the
      paralyzed arytenoid and the differences in level between the paralyzed and
      innervated vocal folds. STUDY DESIGN: Retrospective review using video-recorded
      images of larynx. METHODS: A total of 38 patients were selected for this study
      who reported symptoms of voice change attributable to a paralyzed vocal fold
      unilaterally. Video recordings were obtained using the laryngeal telescope. The
      heights were assessed according to the paralyzed positions, status (inspiration
      or phonation), and appearances of the paralyzed arytenoid. The appearances of
      paralyzed arytenoid were further clarified as the portions of the medial surface
      of the arytenoid that were visualized. RESULTS: In medial paralysis, the
      paralyzed vocal fold appeared mainly as being at an equal vertical level or as
      having no distinct difference from normal vocal fold during phonation. However, a
      few cases of medial paralysis showed a lower than normal or higher than normal
      vocal fold during phonation, depending on the appearance of the paralyzed
      arytenoid. In lateral paralysis, most of the paralyzed vocal folds were not
      higher than the innervated vocal folds during phonation. CONCLUSIONS: The heights
      of paralyzed vocal folds were variable depending on the paralyzed positions, the
      status of the larynx, and appearances of the paralyzed arytenoid. The fact that
      the paralyzed vocal fold is at a higher level than the normal vocal fold should
      be reconsidered.

PMID- 11210866
TI  - Immune dysfunction in refractory sinusitis in a tertiary care setting.
AB  - OBJECTIVE: To examine the contribution of the primary immunodeficiency states,
      which are uncommon in the general population, to refractory sinusitis. STUDY
      DESIGN: We retrospectively reviewed the charts of 316 patients with sinusitis who
      were referred to the Allergy and Immunology Clinic for immunological evaluation
      from 1991 to 1997. METHODS: Of the 316 patients, 79 were selected for further
      study. Inclusion criteria included at least one sinus surgery and/or sinusitis
      diagnosed by endoscopy and/or computed tomography (CT) scan at least three times
      in the previous year. Patients with human immunodeficiency virus (HIV), allergic
      fungal sinusitis, cystic fibrosis, and primary ciliary dyskinesia were excluded.
      The results of their immunological evaluation for atopy, T-lymphocyte function,
      and immunoglobulin levels were examined. RESULTS: The average age of these 79
      patients was 44 years (+/- 14.5 standard deviation [SD]). They had, on average,
      2.94 (+/- 2.19 SD) previous operations and had mean sinus CT scores (Lund-McKay)
      of 11.2 (+/- 5.0 SD). Forty of 79 (50.6%) patients had at least one positive
      result on skin test to an aeroallergen. Delayed hypersensitivity skin testing
      revealed that 22 of 55 patients (40%) were anergic. Of the 60 patients with in
      vitro T-lymphocyte function testing, 54.8% showed abnormal proliferation in
      response to recall antigens, 11.3% had decreased response to alloantigen, and
      26.3% demonstrated decreased response to T-cell mitogens. Determination of
      quantitative immunoglobulins showed low immunoglobulin G in 14 of 78 patients
      (17.9%), low immunoglobulin A in 13 of 78 (16.7%), and low immunoglobulin M in 4
      of 78 (5.1%). Common variable immunodeficiency (CVID) was diagnosed in 9.9% of
      patients, and selective IgA deficiency was found in 6.2%. CONCLUSIONS: This
      retrospective review reveals an unexpectedly high incidence of immune
      dysfunction. These results suggest that immunological testing should be an
      integral part of the evaluation of patients with refractory sinusitis.

PMID- 11210867
TI  - Changes in serum interferon-gamma, interleukin-4, and interleukin-12 cytokine
      levels in anti-histamine type 2-treated allergic rhinitis patients.
AB  - OBJECTIVES/HYPOTHESIS: Markedly elevated immunoglobulin E (IgE) synthesis
      characterizes allergic diseases. Interferon-gamma (IFN-gamma) and interleukin-4
      (IL-4) regulate IgE synthesis. It has been shown that immunotherapy and histamine
      type 2 (H2) receptor antagonists induce a clinical improvement, decrease IgE
      antibodies, and increase T-cell subsets, which express a suppressor function. In
      addition, immunotherapy brings about a reduction in the amount of IL-4 in T-cell
      clones of allergic individuals. The purpose of this study was to investigate the
      profile of cytokines IFNgamma and IL-4 that occurs in vivo in anti-H2-treated
      patients with allergic rhinitis (AR). METHODS: Enrolled were 65 AR patients with
      sensitivity to a single allergen, the Parietaria, 36 of whom were randomly
      assigned to treatment with ranitidine at a dosage of 1 mg/kg per day
      intravenously for 20 days, and 29 to placebo treatment. RESULTS: A comparison of
      the serum cytokine values recorded before and after anti-H2 treatment showed a
      significant increase in INF-gamma serum level (P = .003) and a decrease in IL-4
      (P = .016). Negligible variations were found in the placebo-treated group.
      CONCLUSION: H2 antagonists probably induce their effects by enhancing the amount
      of IFN-gamma and by reducing IL-4 cytokines, which, respectively, induce a
      decrease and an increase in the IgE synthesis.

PMID- 11210868
TI  - Quantitative analysis of mucin and lectin in maxillary sinus fluids in patients
      with acute and chronic sinusitis.
AB  - OBJECTIVES: Sinusitis is characterized by quantitative and qualitative changes in
      mucus biosynthesis that contribute to sinus disease. In general, patients with
      acute sinusitis complain of purulent rhinorrhea, whereas those with chronic
      sinusitis complain of mucoid or mucopurulent rhinorrhea Locally produced mucin
      largely contributes to the high viscoelasticity of mucus in sinusitis. In this
      study, the authors attempt to quantify the concentrations of mucin and lectin in
      the maxillary sinus fluids from these patients. STUDY DESIGN: To assess the
      concentrations of mucin and lectin in aspirates of 11 acutely and 11 chronically
      inflamed maxillary sinuses, the concentration of mucin was measured by enzyme
      linked immunosorbent assay (ELISA) and that of lectin by sandwiched enzyme-linked
      lectin assay (ELLA). RESULTS: The concentrations of mucin and lectin that were
      measured using monoclonal antibodies (HCS 4, HCS 14, and HCS 18) and Ulex
      europaeus agglutinin-1 (UEA-1) in chronic sinusitis were higher than those in
      acute sinusitis. The concentration of total protein in chronic sinusitis was
      lower than that in acute sinusitis. Each mucin and lectin versus total protein
      ratio in chronic sinusitis was higher than that in acute sinusitis. CONCLUSIONS:
      These data suggest that hypersecretion in chronic sinusitis may result from
      locally increased mucin production. Comprehension of this mechanism may be a
      strategy to prevent the viscous cycle of paranasal sinus fluids in chronic
      sinusitis.

PMID- 11210869
TI  - Regulation of mucociliary motility by nitric oxide and expression of nitric oxide
      synthase in the human sinus epithelial cells.
AB  - OBJECTIVES: This study was performed to investigate the changes in ciliary beat
      frequency (CBF) after treatment with Larginine in the human sinus mucosa and to
      determine the distribution of inducible nitric oxide synthase (iNOS) and
      endothelial nitric oxide synthase (eNOS) in the healthy sinus mucosa. STUDY
      DESIGN/METHODS: CBF was measured in the sphenoid sinus mucosa of 12 patients who
      underwent trans-septal trans-sphenoidal hypophysectomy for the treatment of
      pituitary gland tumor. CBF was measured over 24 hours in Dulbecco's modified
      Eagle's medium (DMEM) after treatment with L-arginine, its inactive spatial
      isomer D-arginine, or an NOS inhibitor, N(G)-nitro-L-arginine methyl ester (L
      NAME). DMEM without treatment with these materials was used as a control. Other
      pieces of the mucosa were exposed to L-NAME and its inactive spatial isomer D
      NAME after preincubation with L-arginine. The specimens were
      immunohistochemically stained for iNOS and eNOS. RESULTS: CBF increased 24 hours
      after treatment with L-arginine as compared with control groups. CBF increased in
      proportion to the increasing concentrations of L-arginine. There was no
      significant change after treatment with D-arginine or L-NAME. CBF increased after
      treatment with L-arginine at 30 minutes and maintained for 24 hours. L-NAME
      inhibited the increase in CBF by L-arginine, but D-NAME showed no such effect.
      Immunoreactivity to both iNOS and eNOS was frequently observed in the ciliated
      epithelial cells and was stronger to eNOS than to iNOS. CONCLUSIONS: From the
      results of this study it is suggested that nitric oxide (NO) produced by iNOS and
      eNOS using L-arginine may increase CBF in the healthy sinus mucosa and that NO
      may have a regulatory function in ciliary motility in the human sinus mucosa.

PMID- 11210870
TI  - Effectiveness of adenoidectomy and laser tympanic membrane fenestration.
AB  - OBJECTIVE: Adenoidectomy alone or with tonsillectomy (A+/-T) is an effective
      surgical intervention in the management of otitis media in children, especially
      when it is performed in conjunction with insertion of pressure equalization tubes
      (PETs). Otorrhea and persistent tympanic membrane (TM) perforation are frequent
      complications. This study evaluates the effectiveness of intermediate duration
      middle ear ventilation using laser tympanic membrane fenestration (LTMF) without
      tube insertion and as an adjunct to adenoidectomy in resolving middle ear disease
      within the first 90 days after surgery. STUDY DESIGN: This pilot study was a
      multicenter, prospective clinical cohort trial. Institutional review board
      approval and informed consent were obtained. The study involved four tertiary
      care pediatric otolaryngology departments. Fifty children (96 ears) were treated
      with LTMF in conjunction with A+/-T from June 1, 1998, through March 30, 1999.
      Ages ranged from 9 months to 12 years. Patients undergoing A+/-T who would have
      been recommended for PET insertion instead underwent middle ear ventilation with
      LTMF using the Oto-LAM device (ESC/Sharplan, Yokneam, Israel). Patients were seen
      at 30, 60, and 90 days postoperatively. Resolution of otitis media with effusion
      was determined by clinical examination, which included pneumatic otoscopy,
      audiometry, and tympanometry. RESULTS: Of the treated ears, 88%, 86%, and 83% had
      clinical resolution of middle ear disease at 30, 60, and 90 days, respectively.
      Preoperatively, 45% (n = 85) of ears had normal hearing; 92% (n = 49) had normal
      hearing at 90 days. Eighty-nine percent (n = 92) had type C2 or B tympanograms
      preoperatively, and 12% (n = 60) had type C2 or B at 90 days. CONCLUSION: Laser
      tympanic membrane fenestration in conjunction with adenoidectomy was effective in
      restoring normal middle ear function at 90 days post-treatment in greater than
      80% of children who otherwise may have had placement of PETs.

PMID- 11210872
TI  - Autologous fibrin sealant reduces pain after tonsillectomy.
AB  - OBJECTIVES/HYPOTHESIS: Pain is a major cause of morbidity after tonsillectomy.
      Although various efforts have been made to reduce pain, the use of oral
      analgesics, which can have adverse side effects, remains the standard of care. It
      is hypothesized that fibrin sealant, used to achieve hemostasis and enhance
      healing in many surgical procedures, might help decrease pain after this
      operation. STUDY DESIGN: A prospective, randomized, blinded study was performed
      on 20 children aged 5 to 17 years who were undergoing tonsillectomy, to evaluate
      the efficacy of FIBRIN SEALANT in reducing postoperative pain. METHODS: All
      patients pre-donated 40 mL of blood from which autologous concentrated fibrinogen
      was prepared by cryoprecipitation. In the fibrin sealant group, fibrinogen and
      topical bovine thrombin were sprayed onto the surgical site to form fibrin
      sealant at the conclusion of tonsillectomy. The 10 patients in the control group
      (C) received no fibrin sealant. Patients rated their level of pain immediately
      after surgery and at regular intervals for 3 days after surgery using the Wong
      Baker Faces Pain Rating Scale (1-6). Emesis, postoperative bleeding, medications,
      and adverse events were also evaluated. RESULTS: At 7.00 P.M. on postoperative
      day (POD) 0, the mean +/- SD fibrin sealant group pain score (2.9+/-0.41 units)
      was significantly lower than for the C group (4.1+/-0.43 units; P < or = .05).
      There was also a trend in favor of less pain in the fibrin sealant group at 7:00
      P.M. on POD 1, with a mean of 3.5+/-0.43 units versus 2.4+/-0.48 units for C (P =
      .15). The odds of a patient in C experiencing emesis were 8.16 times higher, (P <
      or = .05) than for patients in the fibrin sealant group. CONCLUSIONS: Fibrin
      sealant significantly reduced pain the evening after pediatric tonsillectomy and
      also decreased the chance of experiencing emesis. Thus fibrin sealant may be
      clinically useful as an adjunct to tonsillectomy.

PMID- 11210871
TI  - Prevention of vomiting after tonsillectomy in children: granisetron versus
      ramosetron.
AB  - OBJECTIVE/HYPOTHESIS: Granisetron, a selective 5-hydroxytryptamine type 3
      receptor antagonist, is effective for the prevention of vomiting after
      tonsillectomy in children. Ramosetron (Nasea; Yamanouchi; Tokyo, Japan), another
      new antagonist of 5-hydroxytryptamione type 3 receptor, has more potent and
      longer-acting properties than granisetron (Kytril; Smith Kline Beecham, London,
      UK) against cisplatin-induced emesis. This study was undertaken to compare the
      efficacy and safety of granisetron and ramosetron for the prevention of vomiting
      after pediatric tonsillectomy. STUDY DESIGN: Prospective, randomized, double
      blinded study. METHODS: Ninety pediatric patients, aged 4 to 10 years, received
      intravenously granisetron 40 microg/kg or ramosetron 6 microg/kg (n = 45 each) at
      the end of surgery. The same standard general anesthetic technique and
      postoperative analgesia were used throughout. Emetic episodes and safety
      assessment were performed during the first 24-hour period and the next 24-hour
      period after anesthesia. RESULTS: The rates of patients being emesis-free during
      the period from 0 to 24 hours after anesthesia were 89% with granisetron and 93%
      with ramosetron, respectively (P = .357); the corresponding rates during the
      period from 24 to 48 hours after anesthesia were 71% and 93%, respectively (P =
      .006). No clinically serious adverse events attributable to the study drugs were
      observed in any of the groups. CONCLUSION: Ramosetron is a better antiemetic than
      granisetron for the long-term prevention of postoperative vomiting in children
      undergoing general anesthesia for tonsillectomy.

PMID- 11210873
TI  - Specificity of parotid sialendoscopy.
AB  - OBJECTIVE: To present our initial experience with sialendoscopy of the parotid
      duct. STUDY DESIGN:  METHODS: Diagnostic and interventional sialendoscopy
      procedures were performed in 79 and 55 cases, respectively. Diagnostic
      sialendoscopy was used to classify ductal lesions into sialolithiasis, stenosis,
      sialodochitis, and polyps. Interventional sialendoscopy was used to treat these
      disorders. The type of endoscope used, the type of sialolithiasis fragmentation
      and/or extraction device used, the total number of procedures, the type of
      anesthesia, and the number and size of the sialoliths removed were the dependent
      variables. The outcome variable was the endoscopic clearing of the ductal tree
      and resolution of symptoms. RESULTS: Diagnostic sialendoscopy was possible in all
      cases, with an average duration of 26+/-14 minutes and no complications.
      Interventional sialendoscopy was successful in 85% of cases, with an average
      duration of 73+/-43 minutes (+/- standard deviation). Multiple procedures were
      performed in 45% of cases, general anesthesia was used in 24%, and parotidectomy
      in 2%. Multiple sialoliths were found in 58% of ducts and associated with more
      procedures under general anesthesia and longer operations. The average size of
      sialoliths was 3.2+/-1.3 mm; larger stones were associated with more procedures
      under general anesthesia, longer and multiple procedures, use of fragmentation,
      and sialendoscopy failures. Sialolithiasis fragmentation was required in 10% of
      cases, with a success rate of 70%. Semirigid sialendoscopes performed better than
      flexible ones. Complications were mostly minor but were encountered in 12% of
      cases. CONCLUSIONS: Diagnostic sialendoscopy is a new technique for evaluating
      salivary duct disease, a technique which is associated with low morbidity.
      Interventional sialendoscopy allows the extraction of sialoliths in most
      patients, preventing open gland excision.

PMID- 11210874
TI  - A simple method to estimate the secretion of saliva from minor salivary glands
      using iodine-starch reaction.
AB  - OBJECTIVE/HYPOTHESIS: This study was undertaken to detect the faculty of
      secretion of saliva from minor salivary glands by analyzing a color reaction on a
      test tape containing iodine and starch that was applied on the lower lip. STUDY
      DESIGN: A study involving 63 patients with oral dryness, 7 patients with Sjogren
      syndrome, and 70 healthy individuals was performed. METHODS: A test tape (1 x 1
      cm) containing iodine and starch was set on the mucosal area anterior to the
      labia frenulum for 30 seconds. Because the number of blue spots was considered to
      correspond to the number of ostia of the salivary gland on the lower lip that was
      examined, the number of blue spots occurring as a reaction of iodine and starch
      on the test tape was counted and was compared among three groups. In addition,
      the relationship between the histopathological findings and the number of spots
      was analyzed. RESULTS: The average number of spots in the patients with oral
      dryness (4.52+/-3.18 [mean +/- SD]) was lower than that in healthy individuals
      (9.49+/-2.52, P <.01), and that in the patients with Sjogren syndrome (2.14+/
      1.35) was the lowest among all groups in the study. Moreover, this reduction in
      the number of spots in those patients was accompanied by histopathological
      changes of the minor salivary glands. CONCLUSION: These findings suggest that
      this simple, noninvasive method can be successfully used for the estimation of
      the faculty of secretion of saliva from the minor salivary glands.

PMID- 11210875
TI  - Microwave decalcification of human temporal bones.
AB  - OBJECTIVES/HYPOTHESIS: Morphological and immunohistochemical studies of human
      temporal bones are challenging as a result of difficulties in obtaining reliably
      fixed specimens and the lengthy time required for decalcification, typically 4 to
      7 months. A novel method of processing human temporal bones using a microwave
      oven to accelerate decalcification is described. This procedure provides a rapid
      means of decalcifying temporal bones with good preservation of tissue morphology
      and antigenicity. METHODS: Human temporal bone specimens obtained at autopsy (n =
      12, from specimens aged 43-91 y) were fixed within 6.5 hours of death by
      transtympanic perilymphatic perfusion of the inner ear. Decalcification was
      carried out using ethylenediaminetetra-acetic acid (EDTA) in a microwave oven and
      required only 3 to 6 weeks. Specimens were then dehydrated, embedded in paraffin,
      sectioned, and mounted on slides for morphological and immunohistochemical
      evaluation. RESULTS: Microscopic examination revealed no obvious artifacts
      attributable to the microwave decalcification process. The quality of
      morphological preservation was largely dependent on the postmortem fixation
      interval and adequacy of perilymphatic perfusion. Immunohistochemical analysis
      demonstrated strong positive staining for the enzyme Na,K-ATPase, an integral
      membrane protein. CONCLUSIONS: This study demonstrates that microwave
      decalcification provides an efficient and reliable means of processing human
      temporal bones for histological and histochemical examination. Decalcification
      time is significantly reduced with no apparent adverse effects on structural
      preservation or antigenicity.

PMID- 11210876
TI  - Free radical production by antibiotic-killed bacteria in the guinea pig middle
      ear.
AB  - OBJECTIVES: Oxygen free radicals are implicated in the pathogenesis of otitis
      media Recent investigations with animal models have demonstrated that free
      radical-mediated damage of the middle ear mucosa, measured as lipid
      hydroperoxide, occurs when the middle ear cavity is inoculated with Streptococcus
      pneumoniae. The present study was conducted to examine the effect of antibiotics
      on free radical-mediated damage in pneumococcal acute otitis media. STUDY DESIGN:
      Animal model of acute otitis media. METHODS: Seventy-eight guinea pigs underwent
      bilateral middle ear inoculation with 100 microl of 1) sterile saline as a
      control, 2) 50 microg/mL amoxicillin, 3) 10(7) colony forming units (CFU)/mL
      Streptococcus pneumoniae killed with 50 microg/mL amoxicillin, or 4) 10(7) CFU/mL
      S. pneumoniae. Animals were killed on postoperative day 1 or 5, and the middle
      ear mucosa was examined for lipid peroxidation as evidence of free radical
      damage. RESULTS: Mucosal lipid hydroperoxide was significantly elevated compared
      with control subjects on day 1 in both the antibiotic-killed S. pneumoniae group
      and the S. pneumoniae-infected group. On day 5, the S. pneumoniae-infected mucosa
      had significantly higher lipid hydroperoxide levels compared with the antibiotic
      killed group and the control subjects. Histological studies confirmed mucosal
      edema and the presence of inflammatory cells in the infected groups. CONCLUSIONS:
      Antibiotic-killed bacteria seem to produce free radical-mediated damage to the
      middle ear mucosa in the early phase of acute otitis media. The clinical
      implication of this study is that free radical damage to the middle ear mucosa
      may occur in otitis media despite appropriate antibiotic therapy.

PMID- 11210877
TI  - Mucosal immunity of the middle ear: analysis at the single cell level.
AB  - OBJECTIVE: Studies have suggested that the middle ear is a potential site of
      immunological regulation and that the middle ear mucosa constitutes a part of the
      mucosal immune system. We clarify the characteristics of the middle ear mucosa
      with respect to immune potential. STUDY DESIGN: We investigated lymphocyte
      subsets, mRNA of cytokines, and induction of antigen-specific IgA-producing cells
      in the middle ear mucosa in specific pathogen-free C57BL/6 mice. RESULTS: Flow
      cytometric analysis showed a certain amount (10%-15%) of gammadelta T cells among
      CD3+ T cells. P6-specific IgA-producing cells were induced by intranasal
      immunization with P6 together with cholera toxin. RT-PCR assay of mucosal T cells
      detected mRNA of Th2 type cytokines such as IL-5 and IL-10. CONCLUSION: These
      findings support the fact that the middle ear is potentially an effector site of
      the mucosal immunity.

PMID- 11210878
TI  - How does endotoxin trigger inflammation in otitis media with effusion?
AB  - OBJECTIVES: The relationship among microorganisms, endotoxin, and inflammatory
      mediators in otitis media with effusion (OME) was examined. STUDY DESIGN:
      Analysis of 152 middle ear effusions aspirated at the time of ventilation tube
      insertion from children with OME. METHODS: Effusion samples were cultured for
      pathogenic bacteria The two primary cytokines, interleukin-1beta (IL1beta) and
      tumor necrosis factor (TNFalpha), and the adhesion molecules, intercellular and
      vascular adhesion molecule (ICAM-1 and VCAM-1), were quantified using the enzyme
      linked immunosorbent assay (ELISA) technique. Endotoxin concentration was
      measured with a limulus amebocyte lysate assay, and total protein concentration
      was quantified using the Biorad microassay. RESULTS: The cultures of pathogenic
      bacteria were positive in 33 of the 152 effusions (22%), which contained more
      endotoxin and more of the primary cytokines than the 119 culture-negative
      effusions. Endotoxin and the primary cytokines were positively correlated, both
      in the whole material and in the sterile effusions alone. The adhesion molecules
      were positively correlated with each other, but not with endotoxin or the primary
      cytokines. CONCLUSIONS: We found a positive correlation between endotoxin and the
      primary cytokines TNFalpha and IL1beta in culture-positive OME effusions as well
      as in culture-negative ones, suggesting endotoxin-induced local production of
      TNFalpha and IL1beta in the middle ear. ICAM-1 and VCAM-1 were also present in
      the middle ear, but their concentrations were not directly correlated to
      endotoxin or the primary cytokines.

PMID- 11210879
TI  - Nitric oxide contributes to control of effusion in experimental otitis media.
AB  - OBJECTIVES/HYPOTHESIS: Nitric oxide (NO) is a small, short-lived free radical
      involved in cellular signaling and known to play a role in inflammation. It is
      generated on demand by the enzyme nitric oxide synthase (NOS) on arginine. We
      have previously found that mRNA encoding NOS is produced in the middle ear during
      otitis media. The role of NO was therefore explored in an experimental model of
      immune-mediated otitis media. STUDY DESIGN AND METHODS: Guinea pigs were
      systemically immunized and later challenged in the middle ear with the same
      antigen. One ear of each animal was challenged with antigen alone. In the
      opposite ear, antigen was combined with a potent inhibitor of NOS, N(G)-amino-L
      arginine (L-NAA). After survival for 24, 48, or 72 hours, the middle ears were
      evaluated for otitis media. RESULTS: Inhibition of NOS resulted in significantly
      increased middle ear effusion at all three time periods. This increase was
      blocked by the addition of excess 1-arginine, which bypasses the inhibitory
      effects of L-NAA. The infiltration of cells into the middle ear lumen and the
      hyperplasia of the middle ear mucosa were unaffected by L-NAA administration.
      CONCLUSIONS: The results suggest that NO is involved in regulating the
      permeability of the middle ear vascular, the transudation of serum into the
      middle ear mucosa, and/or the movement of extracellular fluid across the middle
      ear mucosal epithelium.

PMID- 11210880
TI  - Ionomeric cement in the human middle ear cavity: long-term results of 23 cases.
AB  - OBJECTIVES: The long-term results of the implantation of glass ionomer cement in
      the human mastoid and middle ear were studied. STUDY DESIGN: A prospective study
      of the survival of bone cement in the middle ear. METHODS: Ionocem (IONOS,
      Medizinische Produkte Gmbh & Co., Seefeld/Obb, Germany), a two-compound bone
      material that forms a stable, water-proof junction with bone, was implanted in 23
      middle ears of 23 patients (13 male and 10 female patients). Closure of the
      dehiscence of the tegmen was performed in 7 cases, obliteration of the mastoid
      cavity in 10 cases, and ossicular chain reconstruction in 6 cases. RESULTS: The
      follow-up period was 5.1 years. Complications attributable to operation were not
      seen, but adverse tissue reaction with severe middle ear infection and abundant
      otorrhea occurred in six cases after 12 months, requiring repeat operation. In
      three more cases, a spontaneous extrusion of the bone cement was seen after 4
      years. The bone cement was totally extruded in nine cases. The mean survival time
      was 28 months. CONCLUSIONS: The use of Ionocem for obliteration of the mastoid
      cavity or for the closure of dehiscence of the tegmen has a high risk of
      extrusion. Therefore, it is not the first-choice material to use for obliteration
      or tegmen defect closure in the middle ear.

PMID- 11210881
TI  - The relationship between dental overbite and eustachian tube dysfunction.
AB  - OBJECTIVE: The purpose of this study was to investigate the association between
      deep dental overbite and eustachian tube dysfunction (ETD). DESIGN: Case-control
      study. SETTING: Tertiary care pediatric otolaryngology outpatient clinic at the
      Children's Hospital, Boston, Massachusetts. PATIENTS: 105 patients between the
      ages of 2 and 6 years. STUDY MEASUREMENTS: Dental overbite, overjet, and occlusal
      relationships were measured by an observer who was unaware of ETD status. ETD was
      defined as having ventilation tubes in place or having the recommendation for
      ventilation tube placement by an attending pediatric otolaryngologist. In
      addition, demographic information and medical and social histories were
      prospectively recorded. RESULTS: In a multivariate logistic regression model,
      children with deep bites were 2.8 times more likely to have ETD than those
      without deep bites (P = .03). Other independent risk factors for ETD identified
      in this model were family history of otitis media (OM) and age less than 3 years.
      CONCLUSIONS: Children with deep dental overbites are at a significantly increased
      risk for developing ETD.

PMID- 11210882
TI  - Excision of the preauricular sinus: a comparison of two surgical techniques.
AB  - OBJECTIVES: To compare the long-term recurrence rate of the standard technique
      (simple sinectomy) and the supra-auricular approach (wide local excision) for the
      surgical management of preauricular sinuses. STUDY DESIGN: Retrospective cohort.
      METHODS: Fifty-four patients with a preauricular sinus excised between May 1986
      and December 1996 were included in this study. All patients were categorized into
      one of two groups based on the type of surgery performed: the standard technique
      or the supra-auricular approach. The medical records were then reviewed and the
      latest information concerning the recurrence of a preauricular sinus were updated
      by phone interview. The recurrence rate of these two groups was statistically
      analyzed by the Fisher exact test. RESULTS: Forty-nine of 54 patients were
      successfully contacted with data updated and analyzed. The 32% recurrence rate of
      the standard excision (n = 25) was significantly higher than the 3.7% recurrence
      rate of the supraauricular approach (n = 27; two-tailed test, P = .01).
      CONCLUSION: The supra-auricular approach for excision of a preauricular sinus has
      a statistically lower recurrence rate in comparison to the standard technique.

PMID- 11210883
TI  - Optic nerve decompression in the comatose and conscious patients after trauma.
AB  - OBJECTIVE: To investigate the efficacy of early optic nerve decompression in
      comatose and conscious patients with indirect traumatic optic neuropathy. STUDY
      DESIGN: Retrospective analysis of 65 optic nerve decompressions. METHODS: The
      total collective of optic nerve decompressions comprised 65 patients treated
      within the period between February 1987 and December 1998. Thirteen of these 65
      patients (average age, 32 y) were comatose and required critical care treatment,
      so visual acuity could not be measured. The indication for surgical decompression
      in all patients was based on the ophthalmological examination and the finding on
      computed tomography (CT) scan of a lesion inside the optic nerve canal or the
      orbit apex, respectively. RESULTS: In the comatose patients the time interval
      between trauma and surgery was 16.1+/-12.1 hours (mean +/- standard deviation).
      During the subsequent postoperative examinations (on average, 12.3 mo
      postoperatively) five patients showed a normal visual acuity (20/20), two
      patients a visual acuity of 20/30 and 20/50, and one a visual acuity of 20/200.
      Three patients (three eyes) remained amaurotic. Two patients died of the general
      and severe consequences of injury. The beneficial visual acuity results achieved
      within the group of comatose patients were equivalent to those achieved within
      the group of patients who were conscious during the preoperative examination. The
      success rate, defined as an improvement of three lines with a final visual acuity
      of at least 20/1000, was 57.7% versus 61.5%. CONCLUSION: The results confirm our
      concept of early decompression of the optic nerve, based on close
      interdisciplinary cooperation and the ophthalmological findings.

PMID- 11210885
TI  - Alternative voice after laryngectomy using a sound-producing voice prosthesis.
AB  - OBJECTIVE: To improve the voice quality of female laryngectomees and/or
      laryngectomees with a hypotonic pharyngoesophageal (PE) segment by means of a
      pneumatic artificial source of voice incorporated in a regular tracheoesophageal
      (TE) shunt valve. STUDY DESIGN: Experimental, randomized, crossover trial.
      METHODS: The new sound source consists of a single silicone lip, which performs
      an oscillatory movement driven by expired pulmonary air flowing along the outward
      striking lip through the TE shunt valve. A prototype of this pneumatic sound
      source is evaluated in vitro and in six laryngectomees. In vivo evaluation
      includes speech rate, maximal phonation time, perceptual voice evaluation of read
      aloud prose by an expert listener, speech intelligibility measurements with 12
      listeners, and self-assessment by the patients. Moreover, extensive acoustical
      and aerodynamic in vivo registrations are performed using a newly developed data
      acquisition system. RESULTS: The current prototype seems beneficial in female
      laryngectomees with a hypotonic PE segment only. For them the sound-producing
      voice prosthesis improves voice quality and increases the average pitch of voice,
      without decreasing intelligibility or necessitating other pressure and airflow
      rates than regular TE shunt speech. Pitch regulation of this prosthetic voice is
      possible, yet limited. CONCLUSIONS: The mechanism is feasible and does not result
      in unacceptable airflow resistance. For this new mechanism of alaryngeal voice to
      become an established technique for postlaryngectomy voice restoration, a voice
      suitably pitched for male laryngectomees has to be generated and a large part of
      the melodic and dynamic range of the sound source has to be attainable within
      physiological airflow rates.

PMID- 11210884
TI  - The role of topical antibiotic prophylaxis in patients undergoing contaminated
      head and neck surgery with flap reconstruction.
AB  - OBJECTIVES/HYPOTHESIS: Patients undergoing contaminated head and neck surgery
      with flap reconstruction have wound infection rates of 20% to 25% with parenteral
      antibiotic prophylaxis. Studies suggest that perioperative antimicrobial
      mouthwash reduces oropharyngeal flora and may prevent wound infections. We
      hypothesized that the addition of topical antibiotics to a parenteral
      prophylactic regimen would reduce the incidence of wound infection in these high
      risk patients. STUDY DESIGN: We performed a randomized, prospective clinical
      trial. METHODS: Patients received either 1) parenteral piperacillin/tazobactam
      (3.375 g every 6 hours for 48 h) or 2) parenteral piperacillin/tazobactam plus
      topical piperacillin/tazobactam administered as a mouthwash immediately before
      surgery and once a day for 2 days postoperatively, with piperacillin/tazobactam
      added to the intraoperative irrigation solution. The wounds of all patients were
      evaluated daily using predefined objective criteria. RESULTS: Sixty-two patients
      met inclusion criteria and were enrolled in the study. The overall wound
      infection rate was 8.1% (95% confidence interval [CI], 2.7%-17.8%). Two of 31
      patients (6.4%) who received parenteral antibiotics alone developed a wound
      infection compared with 3 of 31 patients (9.7%) randomly assigned to receive
      topical plus parenteral antibiotics. This difference was not statistically
      significant (P = >.05). Infection rate was not associated with flap type
      (rotational vs. free tissue transfer), mandibular reconstruction, age, gender,
      tumor site, stage, surgical duration, or blood loss. CONCLUSIONS: These results
      suggest that piperacillin/tazobactam is a highly effective antibiotic for
      prevention of wound infection in patients undergoing flap reconstruction
      following contaminated head and neck surgery. However, the addition of topical
      piperacillin/tazobactam does not appear to enhance the prophylactic benefit of
      parenteral antibiotics alone.

PMID- 11210886
TI  - Submandibular gland transfer: a new method of preventing radiation-induced
      xerostomia.
AB  - OBJECTIVE: Radiation-induced xerostomia is a significant morbidity of radiation
      therapy in the management of patients with head and neck cancers. We have
      recently reported a method of transfer of one submandibular gland to the
      submental space in a small pilot series of eligible surgical patients. The
      submental space was shielded during postoperative radiation therapy. The
      transferred gland continued to function after the completion of radiation therapy
      and none of the patients developed xerostomia. The purpose of this article is to
      present the technique of submandibular gland transfer in detail and to evaluate
      the postoperative survival and function of the transferred submandibular glands.
      DESIGN: Prospective clinical trial. METHODS: The submandibular gland was
      transferred on eligible patients as part of their surgical intervention. The
      patients were followed clinically, with salivary flow and radioisotope studies.
      RESULTS: We performed the surgical transfer of the submandibular salivary gland
      in 24 of 25 patients placed on the protocol. All the glands survived transfer and
      functioned well postoperatively as demonstrated on the salivary flow and the
      radioisotope studies. The surgical transfer was relatively simple and added 45
      minutes to the surgical procedure. There were no complications attributed to the
      submandibular gland transfer. CONCLUSIONS: We have successfully demonstrated that
      the submandibular gland can be surgically transferred to the submental space with
      its function preserved. The gland seems to continue functioning even after
      radiation therapy with the appropriate shielding. This surgical transfer
      procedure has the potential to change the way we currently manage patients with
      head and neck cancer.

PMID- 11210887
TI  - Endoscopic evaluation of the infratemporal fossa.

PMID- 11210888
TI  - An effective, inexpensive, temporary surgical obturator following maxillectomy.

PMID- 11210889
TI  - Prosthetic obturation of tracheoesophageal fistula.

PMID- 11210890
TI  - Ventilation silicone T-shaped tube insertion.

PMID- 11210891
TI  - A new endoscopic surgical method for unilateral choanal atresia.

PMID- 11210892
TI  - Zolpidem and driving impairment.
AB  - Zolpidem, a non-benzodiazepine hypnotic, was identified in the blood of 29
      subjects arrested for impaired driving. Zolpidem concentrations ranged from 0.05
      to 1.4 mg/L (mean 0.29 mg/L, median 0.19 mg/L). In the subjects whose cases we
      reviewed where zolpidem was present with other drugs and/or alcohol, symptoms
      reported were generally those of CNS depression. Symptoms included slow movements
      and reactions, slow and slurred speech, poor coordination, lack of balance,
      flaccid muscle tone, and horizontal and vertical gaze nystagmus. In five separate
      cases, where zolpidem was the only drug detected (0.08-1.40 mg/L, mean 0.65 mg/L,
      median 0.47 mg/L), signs of impairment included slow and slurred speech, slow
      reflexes, disorientation, lack of balance and coordination, and "blacking out."
      Although no quantitative relationship between blood concentrations and degree of
      driving impairment is currently possible, it is reasonable to conclude that
      because of its specific activity as a sleep inducer, blood concentrations
      consistent with therapeutic doses of zolpidem have the potential to affect
      driving in a negative way, and that concentrations above the normal therapeutic
      range would further impair a person's level of consciousness and driving ability.

PMID- 11210893
TI  - DNA typing results from two urban subpopulations of Pakistan.
AB  - A population genetic characterization of the Araeen and Raajpoot ethnic
      subpopulations of Lahore City, Pakistan was undertaken in order to assess the
      utility of DNA typing for forensic purposes in Pakistani populations. One hundred
      unrelated individuals from each group were genotyped for four independently
      assorting loci: HLA DQAI, CSF1PO, TPOX, and TH01. Allele frequencies were
      calculated, one- and two-locus tests for association were conducted, and the
      samples were compared by contingency table tests and F-statistic estimation.
      Although there is expected to be some genetic divergence between the two groups,
      forensic needs may be satisfied with a single Pakistani database of DNA profiles.
      The present data suggest that nine independently assorting loci will be
      sufficient to provide estimated profile probabilities of the order of 10(-9) but
      a set of 13 loci, as employed in the U.S., would better compensate for the
      dependencies introduced by family membership and evolutionary history.

PMID- 11210894
TI  - The structure, frequency, and forensic application of the STR locus D16S543 in
      the Japanese population.
AB  - D16S543 is a complex STR locus consisting of five types of repeat units. The
      frequency distribution and genetic characteristics of this locus in Japanese were
      investigated using blood samples from 124 unrelated Japanese and 15 families.
      Alleles were detected using denatured polyacrylamide gels followed by automated
      analysis on an ABI 373 sequencer using Genescan software 672. Twenty-one alleles
      were identified, ranging in size from 281 to 489 bp. An allelic ladder containing
      the 21 alleles was constructed and used as a typing standard. The repeat unit
      arrays allowed the 21 alleles to be classified into three distinct groups,
      including alleles 1 to 7 in group I, alleles 8 to 14 in group II, and alleles 15
      to 22 in group III. The alleles in group II were characterized by the insertion
      of one repeat unit of CAGG, one of AAAG, and three of AAGG, while the group III
      alleles differed from those of groups I and II by the insertion of a total of 32
      repeat units ranging in 5 types. Within each group, the alleles differed from
      each other only in one 5' side tetranucleotide AAGG. The power of discrimination
      (Pd) and the estimated heterozygosity were calculated to be 0.989 and 0.934,
      respectively. Typing of this locus was successfully applied in four old forensic
      materials. The study presented herein demonstrates that D16S543 is a highly
      polymorphic and applicable locus in Japanese.

PMID- 11210895
TI  - Determination of drug levels in larvae of Protophormia terraenovae and Calliphora
      vicina (Diptera: Calliphoridae) reared on rabbit carcasses containing morphine.
AB  - Two species of blow flies (Diptera: Calliphoridae) were reared on tissues from
      rabbits administered different dosages of morphine. These species, Protophormia
      terraenovae and Calliphora vicina are among the first wave of insects colonizing
      a dead body. Two series of 3 rabbits were given dosages of 10, 20, and 40 mg/h of
      morphine over a 3 h period via ear artery perfusion. A morphine blood level
      plateau was attained after 1 h of perfusion. Two other rabbits were used as
      controls. Samples of tissues collected from rabbits using a coelioscopic
      technique were determined to have morphine concentrations similar to those
      encountered in human overdoses and were correlated with dosages of morphine
      administered. All samples from control rabbits were negative for morphine. Larvae
      and puparia of both species were regularly collected from each rabbit for
      toxicological analysis. Concentrations of morphine in larvae reared on rabbit
      carcasses containing morphine were significantly lower than concentrations found
      in the tissues. There was a decrease in concentration in morphine observed in
      transition from feeding 3rd instar larva to puparium. A correlation between
      larval concentration and tissue concentration was found only in feeding 3rd
      instar larvae.

PMID- 11210896
TI  - Natural DNA mixtures generated in fraternal twins in utero.
AB  - Analysis of multiple genetic loci using short tandem repeats (STR) is widely used
      in human identity testing because the extensive polymorphism at these loci allows
      for a high degree of discrimination among individuals. We recently received a
      forensic case that included several pieces of evidence and reference blood
      samples. Upon initial testing, one of the suspects had a DNA profile that
      included three alleles at four of the nine loci tested (vWA, FGA, TH01, and
      D5S818). At each locus, two of the alleles appeared to be "major" alleles with a
      third "minor" allele present. The profile appeared to be a mixture of two people.
      Contamination of this first reference sample was suspected and a second, unopened
      blood specimen was requested from this individual. The DNA profile from this
      second reference specimen was identical to that of the original specimen at each
      locus. One of the evidence samples also displayed an identical mixed DNA profile
      matching that of the reference specimens mentioned above. The relative peak
      heights of the two "major" and one "minor" allele remained constant in all three
      samples. Additional background information revealed that the suspect had not
      received a bone marrow transplant or blood transfusion. However, it was disclosed
      that this individual is a fraternal (dizygotic) twin. We hypothesize that an
      exchange of blood cells between the fetuses occurred in utero and that the
      additional alleles present in these reference samples are derived from cells
      contributed by his twin sibling. No additional specimens from the suspect or his
      twin could be obtained for confirmation, and our hypothesis remains untested.
      Forensic scientists should be aware of this possibility when faced with a DNA
      profile in which extra alleles at multiple loci are detected.

PMID- 11210897
TI  - A silica-based mitochondrial DNA extraction method applied to forensic hair
      shafts and teeth.
AB  - The purpose of this study is to evaluate the applicability of a nonorganic DNA
      extraction method for use in the analysis of environmentally compromised forensic
      hair shaft and tooth samples. The condition of the samples included cases of
      water decomposition, severe incineration, and varying stages of putrefaction.
      Enzymatic amplification and manual sequencing of the first segment of the
      mitochondrial hypervariable region were performed successfully on each of the 20
      autopsied individuals. The results indicate that the silica-based extraction
      method produces mtDNA suitable for genetic identification from forensic samples
      including hair shafts and teeth.

PMID- 11210898
TI  - Scanning electron microscopy determination of string mozzarella cheese in gastric
      contents.
AB  - As part of a suspected homicide investigation, a sampling of the gastric contents
      from the victim was forwarded to the U.S. Food and Drug Administration's Forensic
      Chemistry Center (FCC) for analysis of specific, selected components. The victim
      was known to have consumed string mozzarella cheese, as a snack, less than 24 h
      before his disappearance and the subsequent discovery of the body. The
      investigation sought to confirm or dismiss speculation the victim may have been
      fed a meal or eaten additional food prior to his death. Analysis of the stomach
      contents involved examination by stereoscopic light microscopy (SLM) and
      isolation, processing, and analysis of suspect materials by scanning electron
      microscopy (SEM). Several wax-like, off-white to cream-colored objects were noted
      by SLM examination and removed from the gastric contents. Through a series of
      fixation, sectioning, drying, and coating steps, these objects were prepared for
      analysis by SEM. Comparison of the suspect material with laboratory control
      string mozzarella cheese showed excellent correlation between the analyzed
      samples, confirming the suspect material from the stomach contents as string
      mozzarella cheese.

PMID- 11210899
TI  - Using brain MERMER testing to detect knowledge despite efforts to conceal.
AB  - This experiment examined the accuracy and reliability of the memory and encoding
      related multifaceted electroencephalographic response (MERMER) technique for
      detecting information related to events subjects have experienced, despite
      subjects' efforts to conceal that knowledge. Information obtained through
      interviews was used to develop stimulus sets consisting of words and phrases
      presented to subjects visually by computer. Sets were composed of three types of
      stimuli: life experience-related (Probes), stimuli the subject was asked to
      memorize and respond to (Targets), and irrelevant information (Irrelevants). Each
      set of stimuli was tested on two individuals: (1) one individual who had
      participated in the event in question--and thus had the relevant information
      stored in his/her brain, and (2) one who had not. Six subjects were tested.
      Electrical brain responses to the stimuli were recorded non-invasively from the
      scalp and analyzed. MERMERs, (memory and encoding related multifaceted
      electroencephalographic responses), of which the P300 is a sub-component, were
      used to determine whether the subject had the relevant information stored in his
      brain (information present) or not (information absent), thus indicating whether
      or not each subject had participated in the real-life event in question.
      Bootstrapping was used to analyze and compare the responses to the three types of
      stimuli. As predicted, MERMERs were elicited by Probe stimuli only in the
      subjects who had participated in the investigated event, by Target stimuli in all
      subjects, and in no case by Irrelevant stimuli. For each of the six subjects,
      brain MERMER testing correctly determined whether the subject had participated in
      and consequently knew about the event in question (information present) or had
      not participated (information absent). The statistical confidence for this
      determination was 99.9% in five cases and 90.0% in one case. The article
      concludes with a discussion of areas of future research and the potential for
      using this new technology as an investigative tool in criminal cases.

PMID- 11210900
TI  - Supermarket tampering: cocaine detected in syringes and in fruit.
AB  - Product tampering, as detailed by the Federal Anti-Tampering Act of 1983 (1), is
      a felony punishable by both fine and imprisonment. The rationale for product
      tampering ranges from pranks and attention seeking acts to extortion, terrorism,
      and homicide. One such case submitted for analysis involved four medical syringes
      found in a supermarket and suspected of being used to tamper with various
      products. One of the syringes was found piercing a pear while the other three
      syringes were found with needles exposed in other parts of the supermarket.
      Microscopic analysis was used to collect residue from the syringe barrels and the
      pear. A multidiscipline approach involving SLM, PLM, including microchemical
      analysis, FTIR, and GC/MS analyses, performed on the residual liquid found in the
      syringe barrels and in the suspect pear, confirmed the presence of cocaine. This
      multidisciplinary approach is often necessary when there is a possible health
      risk to the public and rapid response is important. With this approach, it was
      quickly determined which drugs or poisons were used in this tampering.

PMID- 11210901
TI  - Examination of lightbulb filaments after a car crash: difficulties in
      interpreting the results.
AB  - A drunk car driver was involved in a fatal crash with a scooter at night.
      Examination of the lightbulbs from the vehicles revealed some mechanical and
      analytical incompatibilities. The laboratory's initial observations led to
      complementary police investigations which finally solved the first
      incompatibility. The different precautions taken by the technical police
      investigators on the crime scene finally allowed the forensic scientists to
      establish the functional state of the lightbulbs during the crash.

PMID- 11210902
TI  - Postmortem microscopic changes observed at the human head hair proximal end.
AB  - Only two types of human hair roots (proximal ends) derived from decomposing
      scalps are reported in the literature. The most common representation of the
      putrid root includes a postmortem dark root band in published photomicrographs.
      In this study, 22 cases were reviewed in which there was reliable time of death
      documentation from medical investigator reports. A review of these cases finds
      that the most common putrid hair proximal end change does not contain the
      postmortem root band. Four primary types of hair proximal end postmortem change
      were identified. This study finds no correlation of time of death with scalp hair
      proximal end decomposition. In addition two examples are presented that suggest
      that hair roots do not decompose after fresh removal from the scalp and exposure
      to the outside elements.

PMID- 11210903
TI  - Polyclonal systemic immunoblast proliferation: an unusual hematologic entity
      presenting as a medical examiner case.
AB  - A 43-year-old woman who was receiving oral antibiotics for several days for a
      superficial foot infection developed a persistent rash, fever, and
      lymphadenopathy, despite discontinuation of the antibiotic and administration of
      steroids for a presumed drug reaction. Hours after a subsequent visit to the
      emergency room for worsening symptoms, she died at home. At autopsy, there was a
      florid, systemic proliferation of polyclonal plasma cells and immunoblasts
      infiltrating nearly every organ and tissue of the body, most notably the lymph
      nodes and spleen. The polyclonal nature of the process was confirmed by
      immunofixation electrophoresis and immunohistochemistry. Cases of fatal
      polyclonal systemic immunoblast proliferations are extremely rare, and the
      trigger for such proliferations is not always known. We review the literature on
      this unusual entity and discuss the clinical and pathologic findings.

PMID- 11210904
TI  - Wounding characteristics of glaser safety ammunition: a report of three cases.
AB  - Handgun ammunition that contains multiple pellets (birdshot) comes in two forms.
      We describe here the autopsy and radiographic findings in three individuals who
      were fatally wounded with Glaser safety ammunition and contrast the findings to
      those reported in shot shell injuries.

PMID- 11210905
TI  - Pesticide poisoning initially suspected as a natural death.
AB  - A pesticide poisoning victim suspected initially as having died a natural death
      was autopsied. The victim was a 47-year-old male. Macroscopically, signs of acute
      death and, in particular, general erosion in the mucosa of the airways and
      esophagus were observed. In the gastric contents, which had a pungent smell and a
      greenish-brown color, 5.00 g/L of propanil, 1.27 g/L of carbaryl, 0.38 g/L of
      ethylbenzene, and 0.32 g/L of xylene were detected. In the blood (serum), 21.6
      mg/L of propanil, 8.1 mg/L of carbaryl, 1.7 mg/L of ethylbenzene, and 4.0 mg/L of
      xylene were identified. Postmortem methemoglobinemia (45%) was recognized. The
      cause of death was considered to have been pesticide poisoning; propanil was
      probably most responsible for his death. The police considered the case to be
      "death with illness as the suspected cause." By performing an autopsy, however,
      we were able to clarify that the cause of death was pesticide poisoning.

PMID- 11210906
TI  - Cardiac rupture following blunt trauma.
AB  - A case of cardiac rupture following blunt trauma with no additional injuries is
      described. This can be a difficult diagnosis because of the presence of
      additional injuries and the lack of clinical symptoms. Here, there was a rupture
      of the pericardium, all chambers of the heart and the thoracic aorta.

PMID- 11210907
TI  - Mitochondrial DNA analysis of the presumptive remains of Jesse James.
AB  - We report here the results of mtDNA analysis of remains exhumed in July, 1995
      from Mt. Olivet Cemetery in Kearney, Nebraska, that are thought to be those of
      Jesse James. The remains were poorly preserved, presumably due to wet and
      slightly acidic soil conditions, and insufficient DNA for analysis was obtained
      from two bone samples. However, two of four teeth, and two hairs recovered in
      1978 from the original burial site on the James Farm, did yield reproducible
      mtDNA sequences. These mtDNA sequences from the teeth and hairs were all
      identical, suggesting that they came from the same individual; furthermore, this
      mtDNA sequence was identical to mtDNA sequences determined from blood samples
      from two maternal relatives of Jesse James. Therefore, either the remains are
      indeed those of Jesse James, or they are from an unrelated individual who, by
      chance, happens to have the same mtDNA sequence. To assess the probability that
      an unrelated individual would have the same sequence, we searched the forensic
      mtDNA database, and found that this sequence does not appear among the 2426 mtDNA
      sequences therein. Hence, the mtDNA analysis supports the identification of the
      exhumed remains from Mt. Olivet Cemetery as those of Jesse James.

PMID- 11210909
TI  - Uruguayan population data for eight STR loci (using the PowerPlex 1.2 kit).

PMID- 11210908
TI  - Allele frequency for D1S80 locus in Tamil population (South India).

PMID- 11210910
TI  - Allele frequencies and haplotypes of ten Y-specific STRs in the Japanese
      population.

PMID- 11210911
TI  - Population data on eight STR loci in Buenos Aires (Argentina).

PMID- 11210912
TI  - Population data for nine fluorescent based STR loci among four important tribal
      populations of India.

PMID- 11210913
TI  - Allele frequencies for four STR loci (D16S539, TH01, TPOX, and CSF1PO) in African
      American and Caucasian populations from Marion County, Indiana, USA.

PMID- 11210914
TI  - Distribution of alleles D16S539, D7S820, D13S317 in a southern Italian population
      sample.

PMID- 11210915
TI  - Allele frequency distributions for D1S1656, D8S1132, D10S2325, D18S51, and D21S11
      loci in a north Italy population.

PMID- 11210916
TI  - A population-genetic study of the DYS385 haplotypes in two Spanish populations
      and the African immigrant population in Spain.

PMID- 11210917
TI  - The AICEF/GITAD: Latin American Academy of Criminalistics and Forensic Studies.

PMID- 11210918
TI  - Misinterpretation of a urinary 6-monoacetyl morphine concentration.

PMID- 11210919
TI  - Detection of deviations from genetic equilibrium--a commentary on Budowle B,
      Moretti TR, Baumstark AL, Defenbaugh DA, Keys KM. Population data on the thirteen
      CODIS core short tandem repeat loci in African Americans, US Caucasians,
      Hispanics, Bahamians, Jamaicans, and Trinidadians. J Forensic Sci 1999;44:1277
      86.

PMID- 11210920
TI  - HPLC analysis of ballpoint pen inks stored at different light conditions.
AB  - A method for comparison of ink entries on documents stored in different light
      conditions is presented. Various blue inks were exposed to light, both daylight
      and artificial light from fluorescent tubes. Inks were then extracted from the
      document and analyzed by HPLC (high performance liquid chromatography).
      Significant changes in composition were noted on exposure to light. These changes
      were followed by using ternary diagrams constructed for dyes generally present in
      blue-colored inks--Crystal Violet, Methyl Violet, and Tetramethyl Para
      Rosaniline. Also, the amount of the various compounds formed by decomposition of
      these dyes on exposure to light was measured and employed for comparison of inks.
      An example of the use of the proposed method in casework is given.

PMID- 11210921
TI  - Discrimination of 1990s original automotive paint systems: a collaborative study
      of black nonmetallic base coat/clear coat finishes using infrared spectroscopy.
AB  - The 1990s saw the introduction of significantly new types of paint binder
      chemistries into the automotive finish coat market. Considering the pronounced
      changes in the binders that can now be found in automotive paints and their
      potential use in a wide variety of finishes worldwide, the Paint Subgroup of the
      Scientific Working Group for Materials (SWGMAT) initiated a validation study to
      investigate the ability of commonly accepted methods of forensic paint
      examination to differentiate between these newer types of paints. Nine automotive
      paint systems typical of original equipment applications were acquired from
      General Motors Corporation in 1992. They consisted of steel panels coated with
      typical electrocoat primers and/or primer surfacers followed by a black
      nonmetallic base coat and clear coat. The primary purpose of this study was to
      evaluate the discrimination power of common forensic techniques when applied to
      the newer generation original automotive finishes. The second purpose was to
      evaluate interlaboratory reproducibility of automotive paint spectra collected on
      a variety of Fourier transform infrared (FT-IR) spectrometers and accessories
      normally used for forensic paint examinations. The results demonstrate that
      infrared spectroscopy is an effective tool for discriminating between the major
      automotive paint manufacturers' formulation types which are currently used in
      original finishes. Furthermore, and equally important, the results illustrate
      that the mid-infrared spectra of these finishes are generally quite reproducible
      even when comparing data from different laboratories, commercial FT-IR
      instruments, and accessories in a "real world," mostly uncontrolled, environment.

PMID- 11210922
TI  - Diversity and heterogeneity in mitochondrial DNA of North American populations.
AB  - Variation in the mitochondrial DNA (mtDNA) control region as detected by sequence
      specific oligonucleotide (SSO) probes is described for 2282 individuals from
      African-American, European-American, and Hispanic subpopulations from five
      broadly defined regions of North America (Northeast, Southeast, Central,
      Northwest, Southwest). Population diversity estimates were uniformly high for all
      subpopulations and for each major ethnic group. Only the Pennsylvania Hispanic
      group was remarkable with respect to its mitochondrial DNA types, having both six
      low frequency population specific types (ranging from 1.2-8.6%) and three high
      frequency shared types (10-20% each). There was no statistically significant
      subpopulation heterogeneity present within any of the three major groups at
      either the subpopulation level or the regional level (p > 0.01). However,
      statistically significant heterogeneity was measured when comparing the three
      major groups to each other, with the variance component attributable to this
      large division accounting for 18.60% of the total variance (p < 0.001). Overall
      mtDNA is a satisfactory forensic typing locus within broadly defined African
      American, European-American, and Hispanic groups from North America, based on the
      high diversity estimates and absence of heterogeneity, as characterized by SSO
      typing.

PMID- 11210923
TI  - Quality assurance testing of an explosive trace analysis laboratory.
AB  - During 1989, the Forensic Explosives Laboratory (FEL) established a weekly
      quality assurance testing regime in its explosives trace analysis laboratory. The
      purpose of the regime is to prevent the accumulation of explosives traces within
      the laboratory at levels which could, if other precautions failed, result in the
      contamination of samples and controls. This paper describes the regime and
      summarizes the results from approximately eight years of tests. Lessons learned
      and improvements made over the period are also discussed.

PMID- 11210924
TI  - Investigating the effect of changing ammunition on the composition of organic
      additives in gunshot residue (OGSR).
AB  - The measurement of the organic additives in smokeless gunpowder is an attractive
      approach for the detection of handgun use because it provides compositional
      information that can help associate residues and unfired gunpowder. We
      investigate several factors that will be required to advance the characterization
      of organic gunshot residue (OGSR) as a useful forensic tool, including evaluating
      residue contamination from previously fired ammunition, particle-to-particle
      compositional variability, and compositional features resulting from the type of
      firing primer used. Using ammunition loaded with known smokeless powders
      containing different stabilizers, a sequence of shots was fired from a .357
      magnum revolver, and the muzzle exit residues were collected. Compositional
      analysis of the residues, both in bulk and as single particles, showed only a
      trace of the previously fired powder in the first shot and none in subsequent
      shots. In an additional experiment testing conventional leaded and the new lead
      free firing primers, the OGSR composition was found not to depend on the primer
      type.

PMID- 11210925
TI  - Detection limits for GC/MS analysis of organic explosives.
AB  - Method detection limits are determined and compared for analysis of liquid
      injections of organic explosives and related compounds by gas chromatography-mass
      spectroscopy utilizing electron impact (EI), negative ion chemical ionization
      (NICI), and positive ion chemical ionization (PICI) detection methods. Detection
      limits were rigorously determined for a series of dinitrotoluenes,
      trinitrotoluene, two nitroester explosives, and one nitramine explosive. The
      detection limits are lower by NICI than by EI or PICI for all explosives
      examined, with the exception of RDX. The lowest detection limit for RDX was
      achieved in the PICI ionization mode. Judicious choice of the appropriate
      ionization mode can enhance selectivity and significantly lower detection limits.
      Major ions are reported for each analyte in EI, PICI, and NICI detection modes.

PMID- 11210926
TI  - Speaker identification utilizing noncontemporary speech.
AB  - The noncontemporariness of speech is important to both of the two general
      approaches to speaker identification. Ear-witness identification is one of them;
      in that instance, the time at which the identification is made is
      noncontemporary. A substantial amount of research has been carried out on this
      relationship and it now is well established that an auditor's memory for a voice
      decays sharply over time. It is the second approach to speaker identification
      which is of present interest. In this case, samples of a speaker's utterances are
      obtained at different points in time. For example, a threat call will be recorded
      and then sometime later (often very much later), a suspect' s exemplar recording
      will be obtained. In this instance, it is the speech samples that are
      noncontemporary and they are the materials that are subjected to some form of
      speaker identification. Prevailing opinion is that noncontemporary speech itself
      poses just as difficult a challenge to the identification process as does the
      listener's memory decay in earwitness identification. Accordingly, series of
      aural-perceptual speaker identification projects were carried out on
      noncontemporary speech: first, two with latencies of 4 and 8 weeks followed by 4
      and 32 weeks plus two more with the pairs separated by 6 and 20 years. Mean
      correct noncontemporary identification initially dropped to 75-80% at week 4 and
      this general level was sustained for up to six years. It was only after 20 years
      had elapsed that a significant drop (to 33%) was noted. It can be concluded that
      a listener's competency in identifying noncontemporary speech samples will show
      only modest decay over rather substantial periods of time and, hence, this factor
      should have only a minimal negative effect on the speaker identification process.

PMID- 11210927
TI  - Production of intoxication states by actors--acoustic and temporal
      characteristics.
AB  - This paper is the second of a series; the first has been published (J Forensic
      Sci, 1998;43:1153-62). The goal in the initial pair of experiments was to
      determine if speakers (actors) could effectively mimic the speech of intoxicated
      individuals and also volitionally reduce the degradation to their speech that
      resulted from severe inebriation. To this end, two highly controlled experiments
      involving 12 actor-speakers were carried out. It was found that, even when sober,
      nearly all of them were judged drunker (when pretending) than when they actually
      were severely intoxicated. In the second experiment, they tried to sound sober
      when highly intoxicated; here most were judged less inebriated than they were.
      The goal of this second paper is to identify some of the speech characteristics
      that allowed the subjects to achieve the cited illusions. The focus here is on
      four paralinguistic factors: fundamental frequency (F0), speaking rate, vocal
      intensity, and nonfluency level. For the simulation of intoxication study, it was
      found that F0 was raised along with increased intoxication but raised even more
      when this state was feigned. A slowing of speaking rate was associated with
      increasing intoxication, but this shift also was greater when the speaker
      simulated intoxication. The most striking contrast was found for the
      nonfluencies; they were doubled for actual intoxication, but quadrupled when
      intoxication was simulated. On the other hand, the shifts exhibited by the
      subjects when they attempted to sound sober were not as clear cut. Indeed, no
      systematic relationships were found here for either F0 or vocal intensity. Both
      speaking rate and the number of nonfluencies shifted appropriately, but these
      changes were not statistically significant. In sum, discernable suprasegmental
      relationships occurred for both studies (but especially the first); further, it
      is predicted that useful cues also will be found embedded in the segmentals (the
      sounds of speech).

PMID- 11210928
TI  - The design and assessment of mock mass disasters for dental personnel.
AB  - Mass disasters represent a significant challenge for dental personnel who are
      frequently called upon to provide identifications. Recently-published materials
      have highlighted the need to prepare such groups for the disaster challenge and
      to report inadequacies in existing preparation methods with an emphasis on team
      integration, organization, and the psychological and emotional effects of such
      work. Many studies have retrospectively reported errors that have been made in
      disaster situations, but few have addressed the issues proactively. In an effort
      to provide a prepared team of dental members, a mock disaster exercise
      (Operation: DENT-ID) is conducted annually in Vancouver, Canada. The present
      study analyzes the effectiveness of this exercise in relation to team
      organization, assessment of preparedness, and the emotional and psychological
      issues. An index of preparedness is developed and described. This index, in the
      form of a questionnaire, can be given to participants in mock disasters to assess
      the effectiveness of such exercises. While the focus of this paper is on the
      assessment of dental personnel, the indices and methods used can be applied to
      any group working within the disaster team. Results indicate that the increase in
      preparedness as a result of the exercise was highly significant.

PMID- 11210929
TI  - An investigation of the psychological characteristics of stalkers: empathy,
      problem-solving, attachment and borderline personality features.
AB  - This study examined the psychological characteristics of a sample of self
      reported stalkers in comparison with a control group, on measures of empathy,
      problem-solving skills, attachment, and borderline personality features. Stalkers
      were identified by their endorsement of specific behavioral items, consistent
      with a widely adopted definition of stalking, denoting behaviors that: (a) are
      repeatedly directed toward an identified target; (b) are intrusive and unwanted;
      and (c) evoke fear in the victim. Stalkers scored significantly higher than
      controls on measures of insecure attachment and borderline personality features,
      suggesting that the stalking group demonstrates a general pattern of inadequate
      interpersonal attachment, has limited abilities to form and maintain appropriate
      relationships, is emotionally labile and unstable, and experiences ambivalence
      regarding their interpersonal relationships. Treatment implications are discussed
      herein.

PMID- 11210930
TI  - Demonstration and interpretation of bridging vein ruptures in cases of infantile
      subdural bleedings.
AB  - Report of two cases of lethal infantile subdural bleedings (SDB). Bridging vein
      (BV) ruptures were directly proven as the source of the (minimal) SDB by a
      postmortem X-ray. In the controversial discussion concerning the causes of
      infantile SDB, proof of the occurrence of several BV ruptures is seen as an
      important sign of a trauma of significant degree. Although infantile SDB
      undoubtedly can result from accidental as well as intentional injuries, and
      therefore, the SDB itself does not allow far-reaching conclusions as to the cause
      of injury, the presence of several BV ruptures combined with an SDB of
      insignificant volume, in an infant dead or in a deep coma on clinical
      presentation, is not compatible with the supposition of a minor fall as the
      cause. We have not observed such findings as the result of a minor accidental
      event for more than 15 years.

PMID- 11210931
TI  - Continuous quality improvement as a management concept for death investigation
      systems.
AB  - Continuous quality improvement (CQI) represents a management technique where the
      basic approach to managing quality consists of setting a standard for a work
      process, measuring variation in the work process in relation to the standard, and
      then implementing programs to decrease variation and improve end results.
      Everyone providing a service becomes involved both in understanding how quality
      is measured and in discussing how to improve quality. A team approach is adopted
      and instead of focusing on poor quality outcomes and how to avoid them, the team
      becomes involved in setting continuously improving standards for better
      performance and in finding ways to meet those standards. The objective is to meet
      or exceed consumer or user expectations. Relevant related concepts such as survey
      research, needs determination and outcomes analysis, and the importance of a
      mission statement are discussed using a medical examiner system as an example.

PMID- 11210932
TI  - Intratracheal gas analysis for volatile substances by gas chromatography/mass
      spectrometry--application to forensic autopsies.
AB  - Intratracheal gas analysis was carried out by gas chromatography/mass
      spectrometry (GC/MS) in 20 burned body cases (13 males and 7 females). Volatile
      aromatic and aliphatic hydrocarbons were detected by GC/MS using a GS-Q column
      with the intratracheal gas as well as the blood in 19 cases. The characteristic
      patterns of mass chromatograms for gasoline, kerosene (gas oil), and liquid
      petroleum gas could be differentiated from each other using the intratracheal
      gas. The burned body in one case showed no presence of volatile substances in the
      intratracheal gas, nor intratracheal soot, although high concentrations (1
      microg/g and more) of volatile substances were detected on the clothes. The
      victim also had normal CO-Hb concentrations (0.1 to 0.2%) in the heart blood. The
      results of intratracheal gas analysis were consistent with signs of the vital
      reaction. In conclusion, intratracheal gas analysis provides a supportive method
      for diagnosing the cause of death in burned bodies, and yields for at least 48
      hours valuable information on volatile hydrocarbons (being detected in deliberate
      or accidental fire cases) to which the body had been exposed just before death.

PMID- 11210933
TI  - Characterization of the ecdysteroid UDP-glucosyltransferase (egt) gene of
      Anticarsia gemmatalis nucleopolyhedrovirus.
AB  - The Anticarsia gemmatalis nucelopolyhedrovirus (AgMNPV) egt gene was cloned,
      sequenced and its expression characterized by RT-PCR and western blot analysis.
      Sequence analysis of the gene indicated the presence of an open reading frame
      (ORF) of 1482 nucleotides, which codes for a polypeptide of 494 amino acids.
      ATATA box and a conserved regulatory sequence (CATT) found in other baculovirus
      early genes were present in the promoter region of the egt gene. A poly-A
      consensus sequence was present in the 3' untranslated region (3'-UTR) of the
      gene. Homology comparisons showed that the EGT protein of AgMNPV is most closely
      related (95.9% amino acid sequence identity) to the EGT from the Choristoneura
      fumiferana DEF nucleopolyhedrovirus (CfDEF). Transcriptional analysis of the
      AgMNPV egt gene showed that egt-specific transcripts can be detected both early
      and late in infection. The EGT protein was detected, by western blot analysis, in
      the intra- (from 12 to 48 h post-infection) and extra-cellular (from 12 to 96 h
      post-infection) fractions of infected insect cells. The AgMNPV Bgl II-F fragment,
      which has homology to the AcMNPV ie-1 gene, was cloned and used to cotransfect
      SF21 cells with the cloned AgMNPV egt gene. EGT activity was observed, suggesting
      that AgMNPV ie-1 can transactivate egt expression.

PMID- 11210935
TI  - Sequence analysis of the RNA polymerase gene of foot-and-mouth disease virus
      serotype Asia1.
AB  - The complete nucleotide (nt.) sequence of the RNA polymerase (3D) gene and 81 nt.
      in the 3'-untranslated region of foot-and-mouth disease virus (FMDV) serotype
      Asial (IND63/72) was determined and compared with the sequence of other FMDV
      serotypes. The 3D genomic region was 1410 nt. long encoding 470 amino acids with
      an inframe stop codon (TAA) at nt. position 1411-1413. The deduced amino acid
      sequence of the protein showed 8 conserved motifs as reported in other
      picornaviruses, 2 of which are 100% identical across the serotypes. Antigenic
      regions in the polymerase protein were predicted and found to be located at the N
      terminus of the protein. The phylogenetic analysis showed that the FMD viruses
      were segregated into different clusters based on geographical origin; the Asia1
      virus did not cluster tightly with any of the geographical groups.

PMID- 11210934
TI  - Nucleotide sequence and transcriptional analysis of a putative basic DNA-binding
      protein of Helicoverpa armigera nucleopolyhedrovirus.
AB  - A putative basic DNA-binding protein (BDBP) gene was identified in the fragment
      EcoRI-K of the Helicoverpa armigera single-nucleocapsid nucleopolyhedrovirus
      (HearNPV) genome. The ORF is 330 nucleotides long encoding a basic protein of 109
      amino acids with a molecular mass of 11.6 kDa. It is the first BDBP identified in
      single nucleocapsid NPVs and a homologue of Autographa californica MNPV (AcMNPV)
      P6.9. A consensus late transcription motif, ATAAG, was found at 57 nt upstream of
      the translational start codon and a polyadenylation signal was observed at 172 nt
      downstream of the stop codon. A major transcript of 620 nt was first observed in
      HearNPV-infected Hz2e5 cells 16 h post infection. Primer extension analysis
      revealed that this transcript initiated from the first residue of the consensus
      ATAAG late transcription start motif. Comparison with other baculoviral BDBPs
      showed that they all contained two conserved cAMP- and cGMP-dependent protein
      kinase phosphorylation motifs, R-R-R-S. The HearNPV P6.9 homologue is the longest
      BDBP found so far in baculoviruses.

PMID- 11210936
TI  - Molluscum contagiosum virus expresses late genes in primary human fibroblasts but
      does not produce infectious progeny.
AB  - Molluscum contagiosum virus (MCV), a member of the family Poxviridae, can be
      isolated from skin-lesion material of patients with molluscum contagiosum
      infection. MCV replicates efficiently in human keratinocytes in vivo but viral
      replication has not been observed in vitro in cell or tissue culture systems. We
      investigated a variety of established cell lines for productive MCV infection and
      found that: (i) MCV induces a typical cytopathogenic effect (CPE) only in human
      primary fibroblast cells (MRC5 ATCC-CCL 171 and HEPM ATCC-CRL 1486) but not in
      permanent eucaryotic cell lines of human or simian origin; (ii) UV irradiated MCV
      virions and heat inactivated virions do not induce a CPE; (iii) decreasing
      amounts of MCV viral DNA are detectable in infected human embryonic fibroblasts
      for at least 14 days post infection (p.i.); (iv) MCV early mRNAs are detectable
      by RT-PCR between one and two hours p.i. and remain detectable upon passaging of
      the infected cells; (iv) transcripts of viral late genes (mc095L and mc106L) are
      detectable by RT-PCR from day 5 p.i.; (v) MCV viral antigens can be detected on
      the surface of infected cells using human and rabbit polyclonal antisera against
      MCV from 24 h p.i.; (vi) a CPE can not be observed if cell free supernatants or
      homogenizates of MCV infected cells are used to try passage of the virus onto
      uninfected human embryonic fibroblasts, indicating that infectious viral progeny
      is not produced. This is the first report demonstrating long time persistence of
      MCV viral DNA and expression of late proteins in an in vitro cell culture system.

PMID- 11210937
TI  - Identification of a strong promoter of bacteriophage MB78 that interacts with a
      host coded factor and regulates the expression of a structural protein.
AB  - A strong promoter of bacteriophage MB78 which controls the expression of a small
      structural protein of the phage has been identified and characterized. Analysis
      of its nucloetide sequence upstream of the translational start site revealed the
      presence of conserved -10 (TAATAT) and -35 (TTCTCCT) regions. It was observed
      that transcription initiates with thymidine residue, 86 nt upstream of the
      translational start site. Transcription seems to undergo alternate up and down
      regulation. This promoter is efficiently recognized by sigma 70 RNA polymerase
      and a host factor also binds to it. Binding of RNA polymerase is independent of
      binding of the host factor.

PMID- 11210938
TI  - Conserved and non-conserved regions in the Sendai virus genome: evolution of a
      gene possessing overlapping reading frames.
AB  - We have sequenced the entire genome of a virulent field isolate of Sendai virus,
      the Hamamatsu strain, and compared the sequence with that of a distant related
      strain, the Z strain. Calculation of synonymous and non-synonymous (amino acid
      changing) nucleotide substitutions revealed regions where changes were permissive
      and non-permissive, and the experimentally determined functional region were
      found to be conserved, showing that important regions for function were conserved
      during evolution. In the cistron-overlapping regions in the P gene, one reading
      frame was conserved, whereas the other overlapping frame was flexible. The
      priority of one frame could be a strategy for evolution of an overlapping gene of
      RNA viruses. We found that the carboxyl two thirds of the C protein was conserved
      over the amino-terminal one third, possessing priority to the overlapping P
      polypeptide. This suggests that the carboxyl two thirds of the C protein have a
      functional importance. We also found a highly variable region between the L
      coding frame and the 5' trailer sequence. The relevance of these findings to
      actual viral replication should be clarified in the future.

PMID- 11210940
TI  - Phylogenetic analysis of hop and grapevine isolates of hop stunt viroid supports
      a grapevine origin for hop stunt disease.
AB  - We have examined sequence variability among nine isolates of hop stunt viroid
      (HSVd) collected from hop gardens in Tohoku district in Japan, the only area in
      the world where hop stunt disease is endemic. Six different consensus and one
      consensus sequences as well as 12 sequence variants were detected in the nine
      HSVd-hop isolates, which suggested the sequence of HSVd-hop was remarkably
      variable. A neighbor-joining analysis was carried out on the new HSVd-hop
      sequences together with 44 previously described variants of HSVd isolated from
      hop and other species. All the HSVd-hop sequences recovered from hops cultivated
      in the Tohoku district of Japan as well as the type isolate and two Korean
      isolates form a cluster with the HSVd-g subtype 1 commonly recovered from
      grapevine. This close relationship between HSVd-hop and -grapevine isolates
      strongly supports the grapevine origin for hop stunt disease.

PMID- 11210939
TI  - Antigenic and molecular analyses reveal that the equine rotavirus strain H-1 is
      closely related to porcine, but not equine, rotaviruses: interspecies
      transmission from pigs to horses?
AB  - We have sequenced the genes encoding the inner capsid protein VP6 and the outer
      capsid glycoprotein VP7 of the subgroup (SG) I equine rotavirus strain H-1
      (P9[7], G5). The VP6 and VP7 proteins of the equine rotavirus strain H-1 shared a
      high degree of sequence and deduced amino acid identity with SG I porcine strains
      and serotype G5 porcine strains, respectively. Previous sequence analyses of the
      genes encoding the outer capsid spike protein VP4 and the nonstructural proteins
      NSP1 and NSP4 of equine H-1 strain also revealed a high degree of sequence and
      deduced amino acid homology with the prototype porcine rotavirus strain OSU
      (P9[7], G5). We have also confirmed and extended the VP4 and VP7 antigenic
      relatedness of equine rotavirus strain H-1 to porcine strains of P9[7] and G5
      serotype specificities isolated in the United States, Venezuela, Argentina, and
      Australia based on cross-neutralization studies. In addition, the pathogenicity
      of tissue culture-adapted equine H-1, H-2, FI-14, FI-23, and L338, and porcine
      OSU rotavirus strains was compared in the neonatal mouse model. The 50% diarrhea
      dose (DD50) of equine H-1 was similar to that of porcine OSU and equine H-2 and
      L338 strains, while the DD50 of equine H-2 was > or = 50 or 315-fold lower than
      those of equine FI-14 or FI-23, respectively. Our sequence comparison of NSP4 of
      the rotavirus strains tested potentially identified amino acid residue 136,
      within the variable region spanning amino acids 130 to 141, as playing a role in
      virulence. Taken together, there is strong support to suggest that the equine
      rotavirus strain H-1 may represent an example of interspecies transmission from
      pigs to horses.

PMID- 11210941
TI  - Characterization of peptide substrates and viral enzyme that affect the cleavage
      site specificity of the human spumaretrovirus proteinase.
AB  - Oligopeptides that correspond to proteolytic cleavage site junctions of the
      native Gag and Pol proteins are specifically cleaved by retroviral aspartate
      proteases (PRs). The role of the flap subdomain of the PR of the human
      spumaretrovirus (HSRV) and of substrate peptides in cleavage site specificity was
      analyzed by site-directed mutagenesis. Native and mutant peptides were subjected
      to proteolysis by the authentic and mutated recombinant viral enzyme. The results
      reveal that Glu residue 54 of the HSRV PR is an essential specificity determinant
      for proteolytic processing of the structural proteins. Peptides that represent in
      vivo cleavage sites were susceptible to proteolysis by the recombinant HSRV PR,
      but one peptide located at the junction between the PR and reverse transcriptase
      domains was completely resistant to cleavage. Thus the data indicate that a
      proteolytic cleavage between these domains does not occur in vivo. Naturally
      occurring and mutant forms of the cleavage-resistant peptide were therefore
      analyzed by circular dichroism to determine if differences existed in the
      secondary structures of the peptides that did or did not serve as substrates. The
      data show that differences in the secondary structure of the native and mutant
      peptides analyzed does not seem to play a crucial role for cleavage site
      specificity in HSRV PR. Instead highly conserved hydrophobic residues at distinct
      positions of the HSRV cleavage site junctions contribute to the specificity
      observed as reported for HIV-1 PR.

PMID- 11210943
TI  - Spike gene analysis of the DE072 strain of infectious bronchitis virus: origin
      and evolution.
AB  - The entire S2 gene of the DE072 strain of infectious bronchitis virus (IBV) was
      sequenced. The nucleotide and amino acid sequence was most similar to the D1466
      strain and was 84.8% and 89.9% identity, respectively. The nucleotide and amino
      acid sequence similarity among the DE072 strain and other IBV strains was less
      than 71.9% and 76.6%, respectively. Phylogenetic analysis, based on both
      nucleotide and amino acid sequence, showed that IBV isolates were divided into
      two distinct groups. The DE072 strain clustered only with the D1466 strain, and
      all of the other strains were distinct from those two viruses. Further the
      nucleotide sequence analysis of the entire spike glycoprotein gene of the DE072
      strain demonstrated that most of the gene contained a D1466-like sequence, and
      five putative cross-over sites were identified. Based on cross-over site,
      phylogenetic trees were constructed for different regions of the spike gene, and
      a difference in topology between these trees was observed. Considering the
      difference in S2 gene sequence identity and tree topology, we assume that DE072
      and D1466 viruses share a different origin from other isolates of IBV.
      Furthermore, entire spike gene analysis indicates that the DE072 strain has
      undergone recombination event as well as extensive antigenic variation.

PMID- 11210942
TI  - Expression of immunogenic Puumala virus nucleocapsid protein in transgenic
      tobacco and potato plants.
AB  - Transgenic plants, expressing recombinant proteins, are suitable alternatives for
      the production of relevant immunogens. In the present study, the expression of
      Puumala virus nucleocapsid protein in tobacco and potato plants (Nicotiana
      tabacum and Solanum tuberosum) and its immunogenicity was investigated. After
      infection of leaf discs of SR1 tobacco and tuber discs of potato cv. "Desiree"
      with the Agrobacterium strain LBA4404 (pAL4404, pBinAR-PUU-S) containing the 1302
      bp cDNA sequence of S-RNA segment of a Puumala virus, transgenic tobacco and
      potato plants expressed the Puumala virus nucleocapsid protein under control of
      the cauliflower 35S promoter. The recombinant proteins were found to be identical
      to the authentic Puumala virus nucleocapsid protein as analyzed by
      immunoblotting. Expression of the nucleocapsid protein was investigated over four
      plant generations (P to F4) and found to be stable (1 ng/3 microg dried leaf
      tissue). Transgenic tobacco plants were smaller compared to controls. The
      transformed potato plants were morphologically similar to control plants and
      produced tubers as the control potatoes. The S-antigen was expressed at a level
      of 1 ng protein/5 microg and 1 ng protein/4 microg dried leaf and root tissues,
      respectively, and remained stable in the first generation of vegetatively
      propagated potato plants. The immunogenicity of the Puumala virus nucleocapsid
      protein expressed in Nicotiana tabacum and Solanum tuberosum was investigated in
      New Zealand white rabbits. They were immunized with leaf extracts from transgenic
      tobacco and potato plants, and the serum recognized Puumala virus nucleocapsid
      protein. Transgenic plants expressing hantaviral proteins can thus be used for
      the development of cost-effective diagnostic systems and for alternative
      vaccination strategies.

PMID- 11210944
TI  - The hamster polyomavirus--a brief review of recent knowledge.
AB  - The hamster polyomavirus (HaPV) was first described in 1967 as a virus associated
      with skin epithelioma of the Syrian hamster. The tumors appear spontaneously in a
      hamster colony bred in Berlin-Buch (HaB). Virus particles isolated from skin
      epitheliomas cause lymphoma and leukemia when injected into newborn hamsters from
      a distinct colony bred in Potsdam, Germany (HaP). The viral genome has been
      totally sequenced and the overall genetic organization establishes HaPV as a
      member of the polyomaviruses. HaPV is a second example of an middle T (MT)
      antigen encoding polyomavirus and nucleotide sequence homologies designates the
      mouse polyomavirus (Py) as the closest relative. Lymphomas induced by HaPV in HaP
      hamsters do not contain virus particles but instead accumulate different amounts
      of nonrandomly deleted free and/or integrated viral genomes. Transgenic mice
      produced by microinjection of HaPV DNA into the pronucleus of fertilized eggs of
      Gat: NMRI mice developed both, epitheliomas and lymphomas. Both tumor types
      contain extrachromosomal DNA. HaPV DNA was found to replicate in hamster lymphoid
      and fibroblast cell lines. Fully reproductive cycles could be detected only in
      GD36 lymphoblastic leukemia cells. HaPV carries the full transforming properties
      of a polyomavirus in vitro. Immortalization of primary rat cells is essentially
      carried out by the HaPV large T (LT) antigen and coexpression of HaPV MT and HaPV
      small T (ST) antigen is required for full transformation of rat fibroblasts. The
      preferential binding of HaPV MT to c-Fyn, a Src family kinase, has been proposed
      as a mechanism leading to lymphoid malignancies. Heterologous expression of HaPV
      VP1 allowed the formation of virus like particles (VLPs) resembling HaPV
      particles. The high flexibility of HaPV-VP1 for insertion of foreign peptides
      offers a broad range of potential applications, especially in vaccine
      development.

PMID- 11210945
TI  - Interosseous membrane anatomy and functional mechanics.
AB  - Longitudinal forearm stability is maintained through the interaction of several
      anatomic structures. One such structure, the interosseous membrane, is a fibrous
      tissue with an oblique orientation from the radius to the ulna. The membrane
      maintains the interosseous space between the radius and ulna through forearm
      rotation and actively transfers forces from the radius to the ulna. The
      interosseous membrane's unique functional capabilities result from its anatomic
      and histologic organization, which produces a stiff structure with elastic
      properties capable of maintaining large loads. The interosseous membrane's load
      transferring ability reduces the forces placed on the radiocapitellar
      articulation, thereby protecting this joint. However, large chronic loading
      results in attenuation of the membrane fibers, thereby reducing longitudinal
      stability. Large sustained loads occur after radial head resection with
      concurrent interosseous membrane tears, resulting in the proximal migration of
      the radius and disruption of the distal radioulnar joint. Ultimately, the
      treatment option for severe membrane disruption combined with proximal migration
      of the radius is the creation of a single bone forearm.

PMID- 11210946
TI  - The collateral ligaments of the elbow: anatomy and clinical correlation.
AB  - Stability of the elbow is provided by the congruous nature of the bony
      articulations and the medial and lateral collateral ligament complexes. The
      medial ligament provides additional support to valgus stress. The lateral
      ligament prevents rotational instability between the distal humerus and the
      proximal radius and ulna. Collateral ligament insufficiency typically is
      posttraumatic and can occur on either side of the joint. An understanding of the
      normal anatomy is required to make the correct diagnosis and complete a
      successful surgical reconstruction.

PMID- 11210947
TI  - Osseous anatomy of the scapula.
AB  - Detailed anatomy and morphometry of the scapula were obtained to provide
      information for surgical procedures such as hardware fixation, drill hole
      placement, arthroscopic portal placement, and prosthetic positioning. Twenty-six
      measurements were made in 15 pairs of scapulas from cadavers. The average length
      of the scapulas from the superior to the inferior angle was 155 +/- 16 mm (mean
      +/- standard deviation). The thickness of the medial border 1 cm from the edge
      was 4 +/- 1 mm. The superior border was sharp and thin, and the suprascapular
      notch was present as a foramen in two scapulas. The distance from the base of the
      suprascapular notch to the superior rim of the glenoid was 32 +/- 3 mm. The
      length of the spine from the medial edge of the scapula to the lateral edge of
      the acromion was 134 +/- 12 mm. The anteroposterior width of the spine at 1 and 4
      cm from the medial edge was 7 +/- 1 and 18 +/- 3 mm, respectively; the width at
      the lateral edge (spinoglenoid notch) was 46 +/- 6 mm. The acromion measured 48
      +/- 5 mm x 22 +/- 4 mm and was 9 +/- 1 mm thick. The acromial shape was flat in
      23%, curved in 63%, and hooked in 14% of scapulas. The distance from the glenoid
      to the acromion was 16 +/- 2 mm. The glenoid dimensions were 29 +/- 3 mm
      (anteroposterior) x 36 +/- 4 mm (superoinferior) and faced posterior by 8 +/- 4
      degrees. Anteroposterior thickness of the head of the scapula 1 cm from the
      surface was 22 +/- 4 mm. The thickness of the coracoid was 11 +/- 1 mm. The
      average length of the coracoacromial ligament was 27 +/- 5 mm. Scapulas from male
      cadavers were significantly larger than scapulas from female cadavers in 19
      measurements.

PMID- 11210948
TI  - Clinical significance of skeletal muscle architecture.
AB  - Skeletal muscle architecture is one of the most important properties that
      determines a muscle's force and excursion capability. In the current review,
      basic architectural terms first are reviewed and then specific examples relevant
      to upper extremity anatomy are presented. Specific examples of anatomic
      considerations required for surgical reconstruction after radial nerve palsy also
      are detailed. Together, these data show not only the wide variety of
      architectural designs in human muscles, but the importance of considering
      architectural design when making surgical decisions.

PMID- 11210949
TI  - Biomechanical analysis of the brachioradialis as a donor in tendon transfer.
AB  - Anatomic and biomechanical properties of the passive brachioradialis muscle were
      investigated to understand the limited excursion of this muscle seen during
      tendon transfer surgery. First, architectural measurements were performed on
      three fiber bundles obtained from four regions of the brachioradialis (10
      specimens) chosen to represent the range of muscle fiber lengths across the
      brachioradialis. Next, in separate specimens (eight specimens), passive excursion
      was measured by securing the distal tendon stump to a servomotor. A constant load
      of 4.9 N was applied to the tendon, while the distal tendon was released from the
      surrounding tissue in 3-cm increments. Within the four regions studied, muscle
      fiber length varied significantly from 104.2 +/- 6.2 mm to 179.8 +/- 6.1 mm. As
      the brachioradialis was released, an average of 3 mm of mobility was obtained for
      each interval whereas for the succeeding three intervals, an average of 5.3 mm of
      mobility was obtained. This resulted in 22.2 +/- 2.3 mm of mobility when each
      specimen was fully released. These data show that there is no intrinsic muscle
      fiber length limitation to excursion, but that excursion is limited by other
      intermuscular connections to adjacent connective tissue and other muscles.

PMID- 11210950
TI  - Magnetic resonance imaging of the upper extremity: advances in technique and
      application.
AB  - Vast advances in technology have taken place in the field of radiology led by the
      introduction of magnetic resonance imaging. The added advantages of exquisite
      soft tissue contrast and multiplanar imaging capabilities have revolutionized the
      understanding of complex anatomic relationships and diagnoses. The current
      authors will focus on the introduction of new advances in magnetic resonance
      imaging of the upper extremity that may prove helpful in the diagnosis and
      treatment of upper extremity abnormalities.

PMID- 11210951
TI  - Wear-through of a modular polyethylene liner: four case reports.
AB  - Four patients in whom the S-ROM Total Hip System Polydial polyethylene liner was
      used illustrate the importance of, and difficulties in, detecting polyethylene
      wear-through before a complete acetabular revision is necessary. The patients in
      these cases had full thickness polyethylene wear-through 11 or more years after
      total hip arthroplasties. Dorr and Livermore wear measurements from radiographs
      of the patients underestimated the actual wear and did not indicate wear-through.
      Because excessive head penetration was not evident radiographically with the S
      ROM components, the cases showed the necessity of using additional measures to
      diagnose wear-through, particularly with these components. Repeat radiographs at
      a higher kilovoltage were used to better visualize the outline of the femoral
      head, and hip aspiration was used to diagnose metallosis. These cases also showed
      the importance of yearly followup evaluations, especially 10 or more years after
      surgery for patients with the S-ROM Polydial locking mechanism.

PMID- 11210952
TI  - Articular cartilage abnormalities in dysplastic hips without joint space
      narrowing.
AB  - Three-dimensional magnetic resonance imaging in the coronal and sagittal planes
      was performed in 25 normal hips of 16 volunteers and 70 dysplastic hips of 50
      patients with clinical symptoms but without radiologic joint space narrowing. A
      high prevalence of cartilage abnormalities was detected, mostly located at the
      anterosuperior area in the hip: 31 hips (44%) in the acetabular cartilage and
      five hips (7%) in the femoral cartilage showed a mild to moderate defect of
      cartilage thickness. The presence of cartilage abnormalities had a statistically
      significant correlation with age of the patients and severity of hip pain. Of 31
      hips with cartilage abnormalities, sagittal magnetic resonance images showed
      abnormalities in 30 (97%), whereas coronal magnetic resonance images revealed
      abnormalities only in 11 (35%). A high incidence of cartilage abnormalities in
      the preradiologic stage suggests the need for more sensitive modalities for early
      diagnosis. Magnetic resonance imaging in the sagittal plane allows detailed
      assessment of early cartilage abnormalities.

PMID- 11210953
TI  - Atraumatic osteonecrosis of the patella.
AB  - Atraumatic secondary osteonecrosis of the patella is a rare entity and has been
      reported in only several case reports. The purpose of this study was to define
      the clinical and radiographic characteristics and outcome of this disease.
      Osteonecrosis of the patella was found in 25 knees in 19 patients. The mean age
      was 42 years (range, 21-63 years). Eighteen (95%) patients had greater than 2 g
      of lifetime corticosteroid exposure, and six (32%) patients had systemic lupus
      erythematosus. Osteonecrosis was found in the superior pole of the patella in all
      23 knees (17 patients) that had magnetic resonance imaging. Osteonecrosis was
      apparent on plain radiographs in five knees (20%) in four patients, and only one
      knee (4%) in one patient had collapse of the posterior articulating surface of
      the patella. One (4%) patient presented with anterior knee pain localized to the
      patella. At a mean followup of 4 years (range, 2-18 years), none of the patients
      had an intervention that focused on treating the patellar lesion. Patellar
      osteonecrosis is characterized by patients with coincident lesions of the distal
      femur and the proximal tibia and lesions localized to the superior pole of the
      patella. It is a nonprogressive disease that does not warrant surgical
      exploration.

PMID- 11210954
TI  - Graduated compression stockings: knee length or thigh length.
AB  - The mechanisms by which graduated compression stockings prevent deep venous
      thrombosis are not completely understood. In the current study the physiologic
      effect of low-pressure graduated compression stockings on the venous blood flow
      in the lower limb and the practical aspects of their use were assessed. Patients
      having elective orthopaedic surgery at a university orthopaedic department were
      randomized into five groups to wear two different types of graduated compression
      stockings in thigh and knee lengths. Patients in the fifth control group did not
      wear graduated compression stockings. Venous occlusion strain gauge
      plethysmography was used to measure venous flow. After 20-minutes bed rest there
      was a highly significant increase in venous capacitance and venous outflow in
      patients in all of the four groups wearing stockings. There was no difference in
      the mean of the percentage change of venous capacitance in patients in the four
      groups wearing stockings. The knee length Brevet stockings were less efficient in
      increasing the venous outflow. There was no significant change in the venous
      capacitance and venous outflow in patients in the control group. Visual
      assessment of the fit and use of stockings was done, and patients' subjective
      opinion of comfort was sought. The knee length graduated compression stockings
      wrinkled significantly less, and significantly fewer patients reported discomfort
      with them. All stockings were reported to be difficult to use. Thigh and knee
      length stockings have a significant effect on decreasing venous stasis of the
      lower limb. Knee length graduated compression stockings are similarly efficient
      in decreasing venous stasis, but they are more comfortable to wear, and they
      wrinkle less.

PMID- 11210955
TI  - Health related quality of life in patients with dysvascular transtibial
      amputation.
AB  - Sixty adults with transtibial amputations completed a validated outcomes
      instrument assessing their prosthesis related quality of life. All had their
      amputations because of peripheral vascular disease or nonsalvageable diabetic
      foot infection. Of the patients, 46 were male and 14 were female. Forty-four had
      diabetes. All of the subjects used a prosthesis for a minimum of 6 months. The
      Prosthetic Evaluation Questionnaire measured prosthesis function (usefulness,
      residual limb health, and appearance), mobility (ambulation and transfers),
      psychosocial response (perceived responses, frustration, and social burden), well
      being, and satisfaction. Scoring was accomplished using a linear analog scale,
      with poor responses rated as 0 and excellent responses rated as 100. Mobility
      scores were the lowest (ambulation, 55.3; transfer, 64.6). Functional scores were
      slightly better (usefulness, 65.7; residual limb health, 79.7; and appearance,
      73.3). Psychosocial response scored best (perceived responses, 86.6; frustration,
      69.1; and social burden, 66.4). The overall well-being scale graded at 67.0, and
      overall satisfaction scored at 65.2. Although experts in rehabilitation would
      expect function and mobility scores to be highest and psychosocial scores to be
      lowest, this population actually perceived the reverse to be true. These data
      provide realistic expectations for patients faced with transtibial amputation and
      a benchmark to measure newer treatment modalities or technical innovations.

PMID- 11210956
TI  - A method for evaluating the results of tendon transfers for foot drop.
AB  - A system for assessing the results of tibialis posterior tendon transfers in the
      treatment of foot drop secondary to nerve palsy is proposed. There are seven
      sections to this scoring system: pain, need for orthosis, ability to wear normal
      shoes, activity level, muscle power of ankle dorsiflexion, degree of active ankle
      dorsiflexion, and foot posture. The total score is 100. The results are
      classified as excellent for scores between 85 and 100, good between 70 and 84,
      fair between 55 and 69, and poor for scores below 55. The results of 18 patients
      (mean followup, 64.6 months) who had a tibialis posterior tendon transfer were
      assessed using this method. Four patients (22.2%) had an excellent result, seven
      (38.8%) had a good result, two (11.1%) had a fair result, and five (27.7%) had a
      poor result. The average score was 67.2, suggesting an overall fair result for
      this operation. In nine patients, there was correlation between the outcome when
      assessed with this method and with patient rating. In two patients, the outcomes
      were better when assessed with this method than with patient rating, whereas the
      reverse was true in seven other patients. Thus, this system may provide a more
      objective and critical evaluation of tibialis posterior transfers for foot drop.

PMID- 11210957
TI  - Variations in the skeletal morphologic features of the wrist.
AB  - Increased attention to and interest in the wrist and the field of hand surgery
      has brought about the discovery, rediscovery, and better description of
      variations in the skeletal morphologic features of the hand and wrist. In the
      second through fifth carpometacarpal joints, the fourth carpometacarpal
      articulation is the area of greatest variability. In the midcarpal joint, the
      scaphotrapeziotrapezoid and the capitolunate (hamate) articulations are areas of
      considerable variability in their skeletal morphologic features. New knowledge
      and awareness of variations in skeletal morphologic features in the carpus offer
      a better understanding and the opportunity to revisit various injury patterns
      and/or orthopaedic problems, and normal kinetics and kinematics to assess the
      effect and any differences that may be related to these different skeletal
      morphologic features.

PMID- 11210958
TI  - Tibial turn-up for long distal femoral bone loss.
AB  - Since 1990, seven patients have been treated by the authors with the tibial turn
      up procedure. They have ranged in age from 8 to 37 years; four were skeletally
      mature adults and three were children. All seven patients were faced with a
      clinical situation that required surgical removal of a long portion of their
      affected distal femur. Three of the adult patients initially were treated for
      osteosarcoma with long distal femoral resections and allograft arthrodesis of the
      knee. The allografts ultimately failed, two because of aseptic failure and one
      because of infection. One patient required distal femoral removal for chronic
      osteomyelitis and pathologic fracture. Of the three children who were treated,
      two had turn-ups after long resection of the distal femur for bone malignancy,
      and one had a secondary turn-up after failure of a long distal femoral
      endoprosthesis. The technique uses the normal ipsilateral tibia as a vascularized
      pedicle graft to restore femoral length. The ultimate result, even after very
      high above knee resection, is a long above knee amputation stump. The followup of
      the patients in the current study ranged from 2 to 8 years. All patients achieved
      healing and were able to wear above knee prostheses. The tibial turn-up is an
      effective procedure that results in a long functional above knee amputation stump
      even after very high above knee resections.

PMID- 11210959
TI  - Treatment of giant cell tumor of the distal radius.
AB  - The results of surgical treatment of giant cell tumors of the distal radius were
      reviewed in 12 patients between 1982 and 1995. All 12 patients had Grade III
      lesions. Six of the 12 patients were treated using intralesional curettage with
      local excision, and the other six patients underwent en bloc resection with total
      condyle (four of the six by osteoarticular allograft, and the other two by
      fibular autograft) reconstruction with the aim of preserving the functional
      joint. There were no early or late complications such as infection, graft
      fracture, implant failure, or nonunion. No local tumor recurrence was seen in
      either group during the average followup of 6 years (range, 3-16 years). The best
      functional result was seen in the patients treated with intralesional curettage.
      The functional result of the resection group was good, achieving an average of
      69% (range, 56%-83%) of their range of motion and 70% (range, 63%-77%) of their
      grip strength on the contralateral side. Intralesional excision should not be
      excluded as a possible treatment of Grade III lesions, although en bloc resection
      was used more commonly for these lesions because of tumor surgery reasons. Grade
      III lesions were treated with curettage when the tumor did not invade the wrist,
      destroy more than 50% of the cortex, or break through the cortex with an
      extraosseous mass in more than one plane. Reconstruction with osteoarticular
      allograft after en bloc resection is recommended in this non-weightbearing joint
      when there is contraindication for curettage of the lesion.

PMID- 11210960
TI  - Displaced femoral neck fractures in the elderly: outcomes and cost effectiveness.
AB  - The optimal treatment for displaced femoral neck fractures in elderly patients is
      a matter of controversy. Four surgical options are well supported in the
      orthopaedic literature: reduction with internal fixation, unipolar
      hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty. Based on
      a review of the outcomes literature regarding treatment of femoral neck fractures
      and a cost-effectiveness analysis, an algorithm for surgical treatment of
      displaced femoral neck fractures in elderly patients is presented. Cost
      effectiveness analysis of these four surgical treatment options shows that
      arthroplasty is the most cost-effective treatment when complication rate,
      mortality, reoperation rate, and function are evaluated during a 2-year
      postoperative period. These data were strongly supported by a two-way sensitivity
      analysis that varied the effectiveness of the interventions and the costs.
      Literature derived outcome studies show that elderly patients with displaced
      femoral neck fractures achieve the best functional results with a well healed
      femoral neck without osteonecrosis after reduction and internal fixation.
      Achieving this result may be difficult, and it is not as cost effective as
      arthroplasty.

PMID- 11210961
TI  - Arthroscopic reduction and internal fixation of tibial plateau fractures in
      skiing.
AB  - Arthroscopic reduction and internal fixation of tibial plateau fractures can
      facilitate restoration of articular congruity while permitting rigid fracture
      stabilization. Twenty-five patients who underwent arthroscpoic reduction and
      internal fixation of a tibial plateau fracture were reviewed. The average age of
      the patients was 45. At a mean followup of 24 months, 76% of patients rated their
      result as excellent and 16% as good. Eighty-four percent returned to full
      sporting activity. There were no episodes of nonunion, failure of fixation, wound
      infection, deep venous thrombosis, compartment syndrome, or arthrofibrosis.
      Preoperative fracture depression averaged 7.7 mm (range, 1-18 mm). Fracture
      depression at final followup averaged 0.8 mm (range, 0-5 mm). Sixty-four percent
      of patients had associated intraarticular injury diagnosed and treated at the
      time of arthroscopy. Arthroscopic reduction and internal fixation provides an
      accurate assessment of, and allows definitive treatment for, intraarticular
      injuries associated with tibial plateau fractures. The technique allows less soft
      tissue stripping than with traditional arthrotomy, better visualization of the
      articular surface, early return to physical activities, and obviates the need for
      meniscal detachment and repair.

PMID- 11210962
TI  - Neutralization of fibroblast growth factor-2 reduces intraarticular adhesions.
AB  - Adhesion is a serious complication after trauma or surgery. Because adhesion
      formation is essentially a fibrogenetic process, a series of growth factors are
      assumed to be involved in its development. If this is true, it may be possible
      that inhibition of the growth factor activity suppresses adhesion formation. The
      current study was conducted to verify this hypothesis on fibroblast growth factor
      2 using an intraarticular adhesion model in the rabbit knee. Forty Japanese White
      rabbits were used. They were divided randomly into five groups of eight animals,
      and in three of them, activity of endogenous fibroblast growth factor-2 was
      suppressed locally by a neutralizing antibody. The remaining two groups served as
      controls, and formation of adhesions was evaluated 4 weeks after surgery. The
      results showed that the administration of the antibody reduced the extent of
      adhesions macroscopically, whereas histologic observation and collagen content
      measurement suggested the adhesion tissue was not affected significantly.
      Corresponding to the macroscopic findings, contraction of the knee was improved
      in the antibody groups. The findings showed that suppression of fibroblast growth
      factor-2 activity reduces adhesions. It is expected that control of the cytokine
      activity may become a novel method for reducing adhesions.

PMID- 11210963
TI  - Selective drug resistant human osteosarcoma cell lines.
AB  - Chemotherapy in combination with surgery has been shown to be effective for the
      control of osteosarcoma. Development of resistance to chemotherapeutic agents is
      a recurring clinical problem. To investigate this phenomena, human osteosarcoma
      cells, TE-85, were exposed to increasing doses of Taxol or Taxotere during a 9
      month period. Highly resistant subclones (TE-85TXL; TE-85TXR, respectively) were
      developed. Chemosensitivities are presented for TE-85 cell line and these new
      lines to Taxol, Taxotere, doxorubicin, cisplatin, and topotecan. Drug
      concentrations that inhibited cell growth by 50% compared with untreated cells
      were determined. The TE-85TXL cells showed resistance greater than 1,000-fold to
      Taxol and Taxotere and 60-fold to doxorubicin. The TE-85TXR cells showed
      resistance greater than 1,000-fold to Taxol, 800-fold to Taxotere, and 90-fold to
      doxorubicin. There was little cross resistance to topotecan and enhanced
      sensitivity to cisplatin. The role of P-170 glycoprotein in Taxol and Taxotere
      resistance was explored. Coincubation with verapamil, to block the actions of P
      170 glycoprotein, partly reversed resistance to Taxol, Taxotere, and doxorubicin
      in both cell lines. Anti-P-170 glycoprotein antibodies revealed positive staining
      in TE-85TXL and TE-85TXR cell lines. Flow cytometry revealed reduced accumulation
      of doxorubicin in resistant cells. These data indicate that a human osteosarcoma
      cell line will develop resistance to Taxol and Taxotere, which is mediated in
      part by the P-170 glycoprotein.

PMID- 11210964
TI  - Combined effects of estrogen and progesterone on the anterior cruciate ligament.
AB  - Previous studies from the authors' laboratory have established the presence of
      estrogen and progesterone receptors in the human anterior cruciate ligament. The
      purpose of the current study was to investigate the combined effects of 1beta
      estradiol and progesterone on cell proliferation and procollagen synthesis of the
      human anterior cruciate ligament fibroblasts. Fibroblast proliferation and
      procollagen synthesis in response to logarithmic concentrations of 17beta
      estradiol (0.0025 ng/mL, 0.025 ng/mL, 0.25 ng/mL) and progesterone (1 ng/mL, 10
      ng/mL, 100 ng/mL) were assessed with the measurement of 3H-thymidine
      incorporation and Types I and III procollagen specific equilibrium
      radioimmunoassays. On Days 1, 3, and 5 there was a dose dependent decrease in the
      fibroblast proliferation and procollagen Type I synthesis with increasing
      estradiol concentrations. The effect was attenuated with increasing progesterone
      concentrations. Controlling for estrogen levels, a dose dependent increase in
      fibroblast proliferation and procollagen Type I synthesis was observed with
      increasing progesterone concentrations. The effect was more pronounced at lower
      concentrations of estrogen, suggesting estrogen levels were the dominant factor.
      The effects of estrogen and progesterone became less apparent by Day 7. No
      significant differences in Type III procollagen synthesis were seen with varying
      estradiol concentrations at any of the designated times. These early physiologic
      changes in fibroblast proliferation and Type I procollagen synthesis may provide
      a biologic explanation for the increased anterior cruciate ligament injury rate
      observed in female athletes, suggesting the acute cyclical hormonal variations in
      the female athlete during menstruation predispose her to ligamentous injury.

PMID- 11210965
TI  - Cleidocranial dysostosis and the unity of the Homeric epics: an essay.
AB  - Numerous years ago, in this journal, Beasley diagnosed the character Thersites
      from Homer's Iliad with cleidocranial dysostosis. Additional evidence from the
      text is presented to support a diagnosis of cleidocranial dysostosis, and it is
      pointed out that this diagnosis may have implications in studying the question
      whether the two Homeric epics (the Iliad and the Odyssey) were composed by the
      same author.

PMID- 11210966
TI  - The anatomy of the ligaments of the wrist and distal radioulnar joints.
AB  - The ligaments of the wrist are responsible for guiding and constraining the
      complex motion of the carpal bones relative to the forearm bones, the
      metacarpals, and contiguous carpal bones. The majority of wrist ligaments are
      found within the joint capsule as organized thickenings composed of parallel
      collagen fascicles, small caliber nerves and blood vessels, and lined on their
      deep surfaces by synoviocytes. The palmar radiocarpal ligament complex is
      composed of the radioscaphocapitate, long radiolunate, radioscapholunate and
      short radiolunate ligaments. The ulnocarpal ligaments include the ulnolunate,
      ulnotriquetral and ulnocapitate ligaments. Dorsally, the radiocarpal joint is
      spanned by the dorsal radiocarpal ligament. Palmar ligaments connecting the
      proximal and distal carpal rows include the scaphotrapeziotrapezoid,
      scaphocapitate, triquetrocapitate and triquetrohamate ligaments. Within each row
      are interosseous ligaments connecting adjacent carpal bones, each divisible into
      dorsal and palmar components. There are unique regions within some of the
      ligaments, such as a zone of fibrocartilage in the proximal regions of the
      scapholunate and lunotriquetral interosseous ligaments, and strong deep regions
      connecting the trapezoid, capitate, and hamate. The distal radioulnar joint is
      connected by the triangular fibrocartilage complex, composed of a
      fibrocartilaginous disc and the palmar and dorsal radioulnar ligaments. The
      ulnocarpal ligaments attach to the palmar radioulnar ligament rather than
      directly to the ulna, allowing increased independence between wrist and forearm
      motion.

PMID- 11210967
TI  - Comparative mobility of muscles as a guide in surgical exposures. 1940.

PMID- 11210968
TI  - Arterial patterns of the deep and superficial palmar arches.
AB  - The vascular patterns of the palmar arches and their interconnecting branches
      present a complex and challenging area of study. Improvements in microsurgical
      techniques have made a better understanding of vascular patterns and vessel
      diameters more important. Forty-five fresh limbs from cadavers were amputated at
      the level of the midhumerus. Ward's red latex or Batson's compound was injected
      under pressure to visualize the arterial system in the hand. After hardening of
      the injected material, the skin, subcutaneous tissues, and tendons were removed.
      The specimens were digested in concentrated potassium or sodium hydroxide leaving
      the bony elements and a cast of the arterial system. The superficial palmar arch
      is most easily classified into two categories: complete or incomplete. An arch is
      considered to be complete if an anastomosis is found between the vessels
      constituting it. An incomplete arch has an absence of a communication or
      anastomosis between the vessels constituting the arch. Complete superficial
      palmar arches were seen in 84.4% of specimens. In the most common type, the
      superficial arch was formed by anastomosis between the superficial volar branch
      of the radial artery and the ulnar artery. This was seen in 35.5% of specimens.
      In 31.1%, the arch was formed entirely of the ulnar artery. Incomplete
      superficial arches were seen in 15.5% of specimens. In 11.1%, the ulnar artery
      forms the superficial arch but does not contribute to the blood supply to the
      thumb and index finger. The deep palmar arch was found to be less variable with
      44.4% formed by an anastomosis between the deep volar branch of the radial artery
      and the inferior deep branch of the ulnar artery. Injection followed by chemical
      debridement allows direct visualization and measurement of the arches and the
      smaller arterial branches that are visualized poorly with other techniques. Based
      on the vessel measured, vessels of the superficial and deep arches are of
      sufficient size to allow microvascular repair, although repair of the
      communicating branches, the dorsal carpal rete, and its branches, probably is not
      feasible because of their small size.

PMID- 11210969
TI  - Vascularity of the carpus.
AB  - Relatively few studies investigating the vascular patterns of the carpus have
      been performed. Technical difficulties in identifying small vessels in three
      dimensions and in determining their location within the thick ligaments about the
      wrist have led to conflicting anatomic reports. Studies on cadavers in which
      improved techniques with arterial injection, chemical debridement, and
      decalcification were used allowed the arterial anatomy of the carpus to be
      delineated more accurately. The current authors review these arterial patterns,
      with attention given to the extraosseous and intraosseous vascularities.

PMID- 11210970
TI  - Vascular anatomy of the distal radius: implications for vascularized bone grafts.
AB  - The vascular anatomy of the distal radius and ulna is complex with a series of
      longitudinal vessels anastomosing with a series of arches. This complex
      anastomotic network of vessels has a consistent spatial relationship to
      surrounding anatomic structures and is constant in nature. Knowledge of the
      vascular anatomy of the distal radius and ulna has allowed the creation of
      numerous reverse flow pedicled vascularized bone grafts, which can be applied to
      carpal pathologic features to assist in the healing of difficult fractures or
      avascular necrosis. The anatomy and terminology of the vascular network and the
      implications, indications, and applications of this anatomy to carpal pathologic
      features is reviewed.

PMID- 11210971
TI  - Upper extremity peripheral nerve anatomy: current concepts and applications.
AB  - The nerve anatomy of the upper extremity is studied constantly through surgical
      findings, electrodiagnostic studies, and cadaveric dissections. Although it is
      recognized that the anatomy is not changing rapidly, knowledge of the anatomic
      relationships and their significance is increasing. The purpose of the current
      study is to provide a comprehensive analysis of the nerve anatomy of the upper
      extremity to include innervation patterns, critical landmarks, and clinical
      applications, with particular focus on recent contributions in the literature.

PMID- 11210972
TI  - Anatomy and functional significance of the long extensors to the fingers and
      thumb.
AB  - Intrinsic and extrinsic hand muscles power finger extension. These two muscle
      groups have different anatomy that allows complimentary function at the
      interphalangeal joints and opposing function at the metacarpophalangeal joints.
      Independent extension of each finger is not possible because of anatomic
      constraints including the juncturae tendinum and intertendinous fascia between
      the extrinsic extensor tendons on the dorsum of the hand. Anatomic variations of
      the extrinsic extensor tendons are frequent and knowledge is important when
      assessing the traumatized or diseased hand.

PMID- 11210973
TI  - Palmar and digital flexor tendon pulleys.
AB  - Retinacular structures, called pulleys, maintain the flexor tendons of the hand
      in constant relationship to the joint axes and promote economy and efficiency in
      finger flexion. This system is composed of the transverse carpal ligament, the
      palmar aponeurosis pulley, and the digital flexor pulley system. Of these three
      components, the digital pulleys are the most critical to finger flexion. In their
      normal state, these pulley components are ideal in all aspects including
      configuration and location, which accomodates a 260 degrees arc of motion without
      impingement and with minimum friction while at the same time using muscle tendon
      excursion that is well within the natural range of the muscle. An absent pulley
      results in an increased moment arm and requires increased tendon excursion to
      produce the same arc of motion. Because muscle excursion is not a limitless
      factor and is directly proportional to muscle fiber length, the effectiveness of
      tendon excursion is dependent on maintenance of the critical relationship between
      pulleys and the adjacent joints. Preservation and reconstruction of this system
      is based on knowledge of the anatomy and an understanding of the relative
      functional significance of each component of the system.

PMID- 11210974
TI  - The dorsal aponeurosis, intrinsic, hypothenar, and thenar musculature of the
      hand.
AB  - The intrinsic muscles of the hand consist of seven interossei and four lumbrical
      muscles. With the extrinsic long extensors, the intrinsic muscles act via the
      dorsal aponeurosis to control finger motion. The interossei also control finger
      abduction and adduction, and flexion of the metacarpophalangeal joints. The
      lumbricals are the main extensors of the interphalangeal joints. The complex
      structure of the dorsal aponeurosis allows coordination and individual joint
      motion. The muscles of the hypothenar and thenar eminences also insert into the
      dorsal aponeurosis and the skeleton of the small finger and thumb, respectively,
      and are responsible for the specialized motion. Knowledge of the anatomy is
      necessary for understanding the function in treating abnormalities and trauma to
      the intricate structures of the hand.

PMID- 11210985
TI  - Nurse telephone-triage.

PMID- 11210986
TI  - Two cheers for inhaled insulin.

PMID- 11210987
TI  - Osteoporosis in patients with organ transplants: a neglected problem.

PMID- 11210988
TI  - Can survival be prolonged for patients with hormone-resistant prostate cancer?

PMID- 11210989
TI  - Helicobacter pylori and sudden-infant-death syndrome.

PMID- 11210990
TI  - Retaining trust.

PMID- 11210991
TI  - Habituation technique in study of development of fetal behaviour.

PMID- 11210992
TI  - New cells from old.

PMID- 11210993
TI  - Efficacy of inhaled human insulin in type 1 diabetes mellitus: a randomised proof
      of-concept study.
AB  - BACKGROUND: Effective glycaemic control in type 1 diabetes mellitus usually
      requires two or more insulin injections daily. Inhaled intrapulmonary delivery of
      insulin offers a potential new way to deliver meal-related insulin, eliminating
      the need for preprandial injections. METHODS: 73 patients with type 1 diabetes
      mellitus were studied in an open-label, proof-of-concept, parallel-group
      randomised trial. Patients in the experimental group received preprandial inhaled
      insulin plus a bedtime subcutaneous ultralente insulin injection. Patients in the
      control group received their usual insulin regimen of two to three injections per
      day. Participants monitored their blood glucose four times daily, and adjusted
      insulin doses weekly to achieve preprandial glucose targets of 5.6-8.9 mmol/L.
      The primary outcome measure was change in glycosylated haemoglobin (HbA1c) after
      12 weeks. Secondary outcomes were fasting and postprandial glucose response to a
      mixed meal; hypoglycaemia frequency and severity; pulmonary function; and
      patients' satisfaction. FINDINGS: Changes in HbA1c were indistinguishable between
      groups (difference 0.2% [95% CI -0.2 to 0.5]). Changes in fasting and
      postprandial glucose concentrations, and occurrence and severity of hypoglycaemia
      were also similar between groups. Inhaled insulin was well tolerated and had no
      effect on pulmonary function (ie, spirometry, lung volumes, diffusion capacity,
      and oxygen saturation). INTERPRETATION: This proof-of-concept study shows that
      preprandial insulin can be given by inhalation in individuals with insulin
      deficient type 1 diabetes as a less invasive alternative to conventional
      preprandial insulin injections.

PMID- 11210995
TI  - Clinical picture: human babesiosis.

PMID- 11210994
TI  - Bone-targeted therapy for advanced androgen-independent carcinoma of the
      prostate: a randomised phase II trial.
AB  - BACKGROUND: Prostate carcinoma is linked to osteoblastic metastasis. We therefore
      investigated the value of bone-targeted consolidation therapy in selected
      patients with advanced androgen-independent carcinoma of the prostate. METHODS:
      103 patients received induction chemotherapy, consisting of ketoconazole and
      doxorubicin alternating with estramustine and vinblastine. After two or three
      cycles of induction chemotherapy, we randomly assigned 72 patients who were
      clinically stable or responders to receive doxorubicin with or without strontium
      89 (Sr-89) every week for 6 weeks. FINDINGS: Overall 62 of the 103 (60%, 95% CI
      50-70) patients had a 50% or greater reduction in serum prostate-specific antigen
      concentration that was maintained for at least 8 weeks, and 43 (42%, 32-52) had
      an 80% or greater reduction. 49 (52%) patients with bone pain at registration had
      complete resolution of pain. After follow-up of 67 patients until death, the
      estimated median survival for all 103 patients was 17.5 months (range 0.5-37.7).
      For the 36 patients randomly assigned to receive Sr-89 and doxorubicin, the
      median survival time was 27.7 months (4.9-37.7), and for the 36 who received
      doxorubicin alone it was 16.8 months (4.4-34.2) (p=0.0014). The hazard ratio was
      2.76 (95% CI 1.44-5.29). INTERPRETATION: Bone-targeted consolidation therapy
      consisting of one dose of Sr-89 plus doxorubicin once a week for 6 weeks, when
      given to patients with stable or responding advanced androgen-independent
      carcinoma of the prostate after induction chemotherapy, improved overall
      survival.

PMID- 11210996
TI  - Frequency and predictors of osteoporotic fractures after cardiac or liver
      transplantation: a follow-up study.
AB  - BACKGROUND: Osteoporosis and related fractures are a major complication after
      organ transplantation. The aim of this study was to find out the frequency and
      predictors of osteoporotic fractures after cardiac or liver transplantation.
      METHODS: 235 consecutive patients who had a cardiac transplant (n=105; 88 men, 17
      women) or a liver transplant (130; 75 men, 55 women) were followed. Vertebral
      fractures were assessed by a standardised analysis of spinal radiographs before
      and annually after transplantation. Clinical and non-vertebral fracture data were
      noted from hospital records. FINDINGS: In the first and second years after
      transplantation, the proportion of patients (Kaplan-Meier estimates) who had at
      least one vertebral fracture was slightly higher in the cardiac group (first year
      21%, second year 27%) than in the liver group (first year 14%, second year 21%).
      In the third and fourth years, one third of patients from both groups had had one
      or more vertebral fractures. Non-vertebral fractures occurred in nine patients
      (7%) after liver transplantation and avascular necrosis of the hip head in three
      patients (3%) after cardiac transplantation. In both groups, no dose-dependent
      effect of immunosuppressive therapy on fracture development could be identified.
      Independent predictors assessed by multivariate analysis were age (hazard ratio
      [95% CI] increase of 5 years, 1.71 [1.1-2.7]) and lumbar bone-mineral density
      (decrease of 1 SD t score, 1.97 [1.2-3.2]) in cardiac transplantation patients,
      and vertebral fractures before transplantation (6.07 [1.7-21.7]) in the liver
      group. INTERPRETATION: The high frequency of osteoporotic fractures in the 2
      years after transplantation and the limitations of reliable fracture-risk
      predictions, show the need to investigate preventive therapies.

PMID- 11210997
TI  - Observations on recurrent syncope and presyncope in 641 patients.
AB  - BACKGROUND: Syncope is a common disorder that is potentially disabling and
      affects both young and old. Once neurological, cardiological, and metabolic
      causes have been excluded, there remains a group in which diagnosis is unclear;
      some may have an autonomic basis. We therefore did a retrospective study on
      consecutive patients referred to our tertiary referral autonomic centres between
      1992 and 1998 with recurrent syncope and presyncope, in whom non-autonomic
      causes, before referral, had been sought and excluded. The object was to find out
      whether autonomic investigation helped diagnosis. METHODS: Data from case notes
      and from the autonomic database on 641 patients were analysed. Syncopal patients
      with a known or provisional diagnosis of autonomic failure were excluded from
      analysis. The role of screening tests in establishing or excluding an autonomic
      cause was assessed. Response to additional autonomic tests (such as head-up tilt
      with or without venepuncture, and food challenge and exercise) was documented.
      Some patients underwent further testing if non-autonomic neurological,
      psychiatric, and other disorders were considered. FINDINGS: Screening autonomic
      function tests indicated orthostatic hypotension and confirmed chronic autonomic
      failure in 31 (4.8%) patients. Neurally mediated syncope was diagnosed in 279
      (43.5%) on the basis of clinical features and autonomic testing. Most had
      vasovagal syncope (227 [35%]); other causes included carotid sinus
      hypersensitivity (37 [5.8%]), and a group of 15 (2.3%) were associated with rarer
      causes such as micturition and swallowing. Miscellaneous cardiovascular causes
      (systemic hypotension, arrhythmias), or drugs, contributed to syncope in 53
      (8.3%). Non-autonomic neurological causes included vestibular dysfunction (32
      [5%]) and epilepsy (11 [1.7%]). In 56 (8.7%) a psychiatric cause was thought to
      be contributory. In 179 (27.9%), syncope was of unknown cause. INTERPRETATION: In
      recurrent syncope and presyncope, when cardiac, neurological, and metabolic
      causes have been excluded, autonomic investigation can aid management by making,
      confirming, or excluding various factors or diagnoses.

PMID- 11210998
TI  - Brain dopamine and obesity.
AB  - BACKGROUND: The cerebral mechanisms underlying the behaviours that lead to
      pathological overeating and obesity are poorly understood. Dopamine, a
      neurotransmitter that modulates rewarding properties of food, is likely to be
      involved. To test the hypothesis that obese individuals have abnormalities in
      brain dopamine activity we measured the availability of dopamine D2 receptors in
      brain. METHODS: Brain dopamine D2 receptor availability was measured with
      positron emission tomography (PET) and [C-11]raclopride (a radioligand for the
      dopamine D2 receptor). Bmax/Kd (ratio of the distribution volumes in striatum to
      that in cerebellum minus 1) was used as a measure of dopamine D2 receptor
      availability. Brain glucose metabolism was also assessed with 2-deoxy
      2[18F]fluoro-D-glucose (FDG). FINDINGS: Striatal dopamine D2 receptor
      availability was significantly lower in the ten obese individuals (2.47 [SD
      0.36]) than in controls (2.99 [0.41]; p < or = 0.0075). In the obese individuals
      body mass index (BMI) correlated negatively with the measures of D2 receptors
      (r=0.84; p < or = 0.002); the individuals with the lowest D2 values had the
      largest BMI. By contrast, neither whole brain nor striatal metabolism differed
      between obese individuals and controls, indicating that striatal reductions in D2
      receptors were not due to a systematic reduction in radiotracer delivery.
      INTERPRETATION: The availability of dopamine D2 receptor was decreased in obese
      individuals in proportion to their BMI. Dopamine modulates motivation and reward
      circuits and hence dopamine deficiency in obese individuals may perpetuate
      pathological eating as a means to compensate for decreased activation of these
      circuits. Strategies aimed at improving dopamine function may be beneficial in
      the treatment of obese individuals.

PMID- 11210999
TI  - Congestive heart failure in a hypertensive patient (don't forget the
      stethoscope).

PMID- 11211000
TI  - Pseudoexfoliation syndrome and aneurysms of the abdominal aorta.
AB  - We assessed the association between pseudoexfoliation syndrome, a common age
      related fibrillopathy of unknown cause, and vascular diseases, especially
      aneurysms of the abdominal aorta. In a prospective single-blind study we
      ophthalmoscopically examined 55 patients with aneurysms of the abdominal aorta
      and 41 controls with carotic-artery occlusion. 24 of 55 patients with aortic
      aneurysm showed signs of manifest (17 of 55 patients) or early-stage (seven of
      55) pseudoexfoliation syndrome. Eight of 41 control patients showed manifest
      (seven of 41 patients) and early (one of 41) ocular pseudoexfoliation (p=0.016).
      These findings, including histopathological examinations, suggest an association
      between aneurysms of the abdominal aorta and pseudoexfoliation syndrome.

PMID- 11211001
TI  - Genetic resistance factor for HIV-1 and immune response to varicella zoster
      virus.
AB  - A 32 bp deletion in the chemokine receptor CCR5 gene modulates HIV-1 infection.
      However, whether this CCR5 gene variation modifies immunity to common herpesvirus
      infections is unknown. We investigated whole blood IgG concentrations of 157
      normal adult blood donors. Also we assessed whether the 32 bp deletion of CCR5
      (delta32CCR5) was associated with circulating IgG to four herpesviruses:
      varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and herpes simplex
      virus type 1 and type 2. Individuals who carried delta32CCR5 were 9.2 times more
      likely to be seronegative for varicella zoster virus than non-carriers (95% CI
      2.9-29.1), but no differences were seen for the other herpesviruses studied.
      Variation in CCR5 may modulate humoral immunity to varicella zoster virus.

PMID- 11211002
TI  - Constitutively raised serum concentrations of mast-cell tryptase and severe
      anaphylactic reactions to Hymenoptera stings.
AB  - Anaphylactic IgE-mediated reactions to Hymenoptera stings vary in their severity
      for reasons that are not clear. We investigated patients with a history of
      systemic anaphylatic reactions to honeybee or wasp stings. Nine (75%) of 12
      patients with raised tryptase concentrations but only 28 (28%) of 102 patients
      with lower tryptase concentrations, had a history of severe sting reactions
      (p=0.004). Raised baseline serum concentrations of mast-cell tryptase and
      mastocytosis are potential risk factors for severe allergic reactions to
      Hymenoptera venom.

PMID- 11211003
TI  - Losartan and fetal toxic effects.
AB  - We report a case of maternal exposure to the antihypertensive drug losartan
      during weeks 20-31 of pregnancy. We saw the fetal toxic effects of
      oligohydramnios (decreased amniotic fluid), fetal pulmonary hypoplasia, fetal
      hypoplastic skull bones, and subsequent fetal death. This pattern of
      abnormalities is similar to those seen in exposure to angiotensin-converting
      enzyme (ACE) inhibitors during pregnancy, and were probably caused by losartan.

PMID- 11211004
TI  - How medical students learn spatial anatomy.
AB  - Despite its importance in clinical tasks, spatial learning is poorly understood.
      We did a randomised, single-blind study on 146 medical students to assess the
      effectiveness of student-controlled multiple views on the spatial learning
      process. High spatial ability of the student, and self-directed examination of an
      object from multiple different perspectives improves spatial learning.

PMID- 11211005
TI  - 105,000 body parts retained in the UK, census says.

PMID- 11211006
TI  - Memory gain means more pain for transgenic mice.

PMID- 11211007
TI  - A genetic explanation for premature ovarian failure?

PMID- 11211008
TI  - Are health internet companies heading for extinction?

PMID- 11211009
TI  - Authorities overstretched as earthquake death toll increases.

PMID- 11211010
TI  - Brazil's government to redress health-care inequalities.

PMID- 11211011
TI  - Namibian government to prosecute healers.

PMID- 11211012
TI  - Slow start to South Africa's antenatal HIV programme.

PMID- 11211013
TI  - Reliable assessment of the effects of treatment on mortality and major morbidity,
      I: clinical trials.
AB  - This two-part review is intended principally for practising clinicians who want
      to know why some types of evidence about the effects of treatment on survival,
      and on other major aspects of chronic disease outcome, are much more reliable
      than others. Although there are a few striking examples of treatments for serious
      disease which really do work extremely well, most claims for big improvements
      turn out to be evanescent. Unrealistic expectations about the chances of
      discovering large treatment effects could misleadingly suggest that evidence from
      small randomised trials or from non-randomised studies will suffice. By contrast,
      the reliable assessment of any more moderate effects of treatment on major
      outcomes--which are usually all that can realistically be expected from most
      treatments for most common serious conditions--requires studies that guarantee
      both strict control of bias (which, in general, requires proper randomisation and
      appropriate analysis, with no unduly data-dependent emphasis on specific parts of
      the overall evidence) and strict control of random error (which, in general,
      requires large numbers of deaths or of some other relevant outcome). Past
      failures to produce such evidence, and to interpret it appropriately, have
      already led to many premature deaths and much unnecessary suffering.

PMID- 11211014
TI  - Proliferation-inducing viruses in non-permissive systems as possible causes of
      human cancers.
AB  - Animal viruses, some of which are probably unable to replicate in human cells,
      could be transmitted to people where they may be linked to tumours currently not
      attributed to viruses. Several human virus types have oncogenic potential in
      animals. A potential risk for acquiring such infections by handling and
      preparation of animal products was analysed against the background of available
      epidemiological reports. Human tumours should be systematically assessed for
      proliferation-inducing viruses in non-permissive systems.

PMID- 11211015
TI  - Is the normalisation of blood pressure in bleeding trauma patients harmful?

PMID- 11211016
TI  - Basiliximab in paediatric liver-transplant recipients.

PMID- 11211017
TI  - Basiliximab in paediatric liver-transplant recipients.

PMID- 11211018
TI  - Effect of pregnancy on chronic hepatitis C.

PMID- 11211019
TI  - Violence in the USA.

PMID- 11211020
TI  - Nearwork and myopia in young children.

PMID- 11211021
TI  - Antipsychotic drugs and venous thromboembolism.

PMID- 11211022
TI  - Antipsychotic drugs and venous thromboembolism.

PMID- 11211023
TI  - Prevention of nevirapine-associated rash.

PMID- 11211024
TI  - Prevention of nevirapine-associated rash.

PMID- 11211025
TI  - Fibre supplementation.

PMID- 11211026
TI  - IVF for unmarried women.

PMID- 11211027
TI  - Group B streptococci for neonatal disease.

PMID- 11211028
TI  - Group B streptococci for neonatal disease.

PMID- 11211029
TI  - Bilateral testicular tumour in neurofibromatosis type 1.

PMID- 11211030
TI  - Antibiotic therapy and peritonitis.

PMID- 11211031
TI  - Academic harassment.

PMID- 11211032
TI  - Presentation of in-vitro fertilisation results.

PMID- 11211033
TI  - BSE report.

PMID- 11211034
TI  - A challenge for reform in South Korea.

PMID- 11211035
TI  - FDAMA's written request list: medicines for children.

PMID- 11211036
TI  - Lovesickness.

PMID- 11211037
TI  - Dynamic strength capabilities of small-stature females to eject and support added
      head weight.
AB  - BACKGROUND: Naval Air Warfare Center Aircraft Division investigated the abilities
      of small-stature females (< or = 120 lb) to fly under G-stress using the Dynamic
      Flight Simulator (DFS) and its tactical fight/attack cockpit, displays and
      controls. OBJECTIVES: Determine ability to exert NACES ejection seat actuation
      pull force under static, acceleration and simulated flight conditions; support up
      to 5 lb of added head weight (AHW) under catapult, arrestment, and aerial combat
      maneuver G-loads; and reach all controls. METHODS: Seven female subjects (six
      small and one medium stature) participated. The AHW task included three helmet
      weights, 3.5 lb (standard configuration), 4.25 lb and 5 lb and subjects were
      tasked to accurately read cockpit displays. Muscular exertion and fatigue (arm,
      shoulder, neck) assessment used electromyography (EMG). Limits in overall reach
      and throttle and stick movements were measured. RESULTS: Subjects successfully
      ejected using a two-hand grip under G-stress. Subjects read all displays
      supporting 5 lb under +6 Gz. Most small-stature subjects could not fully support
      their heads wearing 3.5 lb helmet during flat spin conditions. CONCLUSIONS:
      Within the scope of these tests, small-stature subjects demonstrated the strength
      to safely initiate ejection during severe physically-taxing dynamic conditions
      but had difficulty supporting AHW under -Gx stress. Human factors deficiencies
      were noted in the areas of torso harness fit, inertia reel placement relative to
      shoulder width, and the ability maintain a full range of stick motion.

PMID- 11211038
TI  - Simulated shuttle egress: comparison of two Space Shuttle protective garments.
AB  - BACKGROUND: In a previous study from our laboratory, we observed carbon dioxide
      (CO2) accumulation in the helmet of the NASA Launch and Entry Suit (LES) during a
      simulated emergency egress from the Space Shuttle. Of 12 subjects, 8 were unable
      to complete the egress simulation with a G-suit inflation pressure of 1.5 psi.
      The purpose of this report was to compare CO2 accumulation and egress walking
      time in the new Advanced Crew Escape Suit (ACES) with that in the LES. METHODS:
      Four male subjects who previously were unable to complete the egress in the LES
      performed a simulated egress while wearing the ACES with the G-suit inflated to
      1.5 psi. The egress simulation consisted of 6 min of seated rest, 2 min of
      standing, and 5 min of walking on a treadmill at 1.56 m x s(-1) (3.5 mph) and 0%
      grade. The helmet visor was closed with the subjects receiving 100% oxygen
      throughout the simulation. Inspired CO2 and walking time were measured. RESULTS:
      The rate of CO2 accumulation was significantly less (ACES: 0.53 +/- 0.03, LES:
      1.07 +/- 0.15 %CO2 x min(-1); p = 0.05) and walk time was greater in the ACES
      (ACES: 5.0 +/- 0.0, LES: 2.7 +/- 0.2 min; p = 0.002). CONCLUSIONS: Changes in the
      design of the ACES from the LES resulted in a decreased rate of CO2 accumulation
      and an improved egress walking time compared with the LES.

PMID- 11211039
TI  - A questionnaire for the assessment of the multiple dimensions of motion sickness.
AB  - BACKGROUND: A limited number of attempts have been made to develop a
      questionnaire that assesses the experience of motion sickness. Further, many
      available questionnaires quantify motion sickness as a unidimensional construct.
      METHOD: Exploratory and confirmatory factor analyses of motion sickness
      descriptors were used to derive and verify four dimensions of motion sickness,
      which were defined as gastrointestinal, central, peripheral, and sopite-related.
      These dimensions of motion sickness were then used to construct a motion sickness
      assessment questionnaire (MSAQ) that was administered to individuals who were
      exposed to a rotating optokinetic drum. RESULTS: Total scores from the MSAQ
      correlated strongly with overall scores from the Pensacola Diagnostic Index (r =
      0.81, p < 0.001) and the Nausea Profile (r = 0.92, p < 0.001). CONCLUSIONS: The
      MSAQ is a valid instrument for the assessment of motion sickness. In addition,
      the MSAQ may be used to assess motion sickness as a multidimensional rather than
      unidimensional construct.

PMID- 11211040
TI  - Prevalence of drugs and alcohol in fatal civil aviation accidents between 1994
      and 1998.
AB  - BACKGROUND: The use of drugs and alcohol in aviation is closely monitored by the
      FAA Office of Aviation Medicine's (OAM's) Civil Aeromedical Institute (CAMI)
      through the toxicological analysis of specimens from pilots who have died in
      aviation accidents. METHOD: Frozen specimens received from local pathologists
      were tested and the results entered into a computer database for future analysis.
      The data were sorted based on the class of drug, controlled dangerous substance
      schedules II, and I controlled dangerous substance schedules III-V, prescription
      drugs, over-the-counter drugs, and alcohol. RESULTS: Specimens from 1683 pilots
      were analyzed between 1994 to 1998. Controlled dangerous substances, CDS,
      (schedules I and II) were found in 89 of the pilots analyzed. Controlled
      dangerous substances (schedules III-V) were found in 49 of the pilots tested.
      Prescription drugs were found in 240 of the pilots analyzed. Over-the-counter
      drugs were found in 301 of the pilots analyzed. Alcohol at or above the legal
      limit of 0.04% was found in 124 pilots. No abused drugs were found in Class 1 air
      transport fatal pilots. CONCLUSION: This research supports the very low incidence
      rate of drugs found in the FAA random drug-testing program. Over-the-counter
      medications are the most frequently found drugs in fatal aviation accidents and
      many of these drugs could impair a pilot's ability to safely fly an aircraft.
      This data is helpful to the FAA in developing programs to reduce the usage of
      dangerous drugs and identify potentially incapacitating medical conditions that
      may cause an accident. Data collected from this research can be used to evaluate
      the effectiveness of the FAA drug-testing program.

PMID- 11211041
TI  - Clinical risk factors for venous thrombosis associated with air travel.
AB  - BACKGROUND: Recent reports have linked air travel with venous thrombo-embolism
      (VTE). Risk factors and associated features of this link are poorly understood.
      We have accumulated clinical data from a relatively large cohort of patients with
      traveler's thrombosis. METHODS: A total of 86 patients who developed venous
      thromboembolism within 28 d of flying were questioned concerning traveling
      habits, medical history (including risk factors for VTE) and characteristics of
      the index flight. RESULTS: Of the patients, 72% had at least one risk factor for
      VTE (excluding thrombophilia) prior to their flight. Of interest, 87% of VTE
      cases occurred following either a return trip or after an outward journey
      involving long trips made up of sequential flights. In only two cases could no
      identifiable risk factor or earlier journey be found. Duration of flights ranged
      from 2 to 30 h. Of responders, 38% presented with chest symptoms; 92% with VTE
      developed symptoms within 96 h of their flight. CONCLUSION: We conclude that the
      majority of VTE associated with air travel occur in those with identifiable risk
      factors prior to their flight, and that sequential flights may increase this
      risk.

PMID- 11211042
TI  - Psychiatric considerations in military aerospace medicine.
AB  - Military aerospace medicine requires a psychiatric selection and certification
      process that determines not only the absence of significant mental disorders, but
      also the presence of positive qualities in the realms of motivation, ability and
      stability: not all normal people are fit to fly. Other issues of aerospace
      psychiatry involve maintenance of mental resilience and hardiness during a flying
      career, aeromedical decisions about when to remove from flight duties and when to
      return, criteria for waivers for psychiatric conditions, use of medications for
      treatment of psychiatric symptoms, questions of substance abuse, and research in
      such areas as genetics. This report reviews the basis for military aerospace
      psychiatry, primarily as practiced in the United States Air Force (USAF), and
      presents some of its underlying principles as they apply to clinical situations.

PMID- 11211043
TI  - Malnutrition, urocanic acid, and sun may interact to suppress immunity in
      sojourners to high altitude.
AB  - Irradiation of skin by ultraviolet radiation in mice and humans leads to a
      suppression of cell-mediated immunity. This process is initiated when one of the
      photoreceptors in skin, trans-urocanic acid, is photoisomerized to cis-urocanic
      acid, an immunomodulator. High levels of L-histidine, histamine, and trans
      urocanic acid are found in humans and animals when they are protein malnourished.
      Mice fed on an elevated L-histidine diet have more trans-urocanic acid in the
      skin and are more susceptible to UV-induced immune suppression. Sojourners to
      high altitudes are malnourished, suffer protein catabolism, are exposed to sun,
      and often acquire infectious diseases. There is evidence that sunscreens may not
      adequately protect the immune system. Furthermore, UV intensity increases with
      altitude. We propose a testable hypothesis: UV radiation causes photoimmune
      suppression in sojourners to high altitude and this allows infectious diseases to
      develop. The mechanism we propose includes protein malnutrition, high levels of
      trans-urocanic acid, ultraviolet radiation, formation of cis-urocanic acid,
      immune suppression, and infection.

PMID- 11211044
TI  - You're the flight surgeon. 29-yr-old pilot, accompanied by his wife and 6-yr-old
      boy, each ill with nausea, abdominal cramping and watery diarrhea.

PMID- 11211045
TI  - Interpretation of pulmonary function testing during hyperbaric oxygen therapy.

PMID- 11211046
TI  - Outreach and resolutions.

PMID- 11211047
TI  - Concept of a Neck Protective Device (CNPD).
AB  - During impact or sudden acceleration, the cervical and thoracic region of the
      spine of operators of Habitable Mobile Vehicles (HMV) may be exposed to extensive
      trauma since "whiplash"-type motion typically leads to impairment of a cervical
      joint. Furthermore, the frequent necessity of supporting added mass above the
      shoulders (e.g., crash helmet, displays, oxygen mask) can magnify the moment of
      inertia of the head. This additional mass affects the biomechanics of a Helmet
      Head-Neck System and determination of the tolerable magnitudes of acceleration
      which it can undergo. Even if the body of the operator is restrained by seat
      belts, such acceleration can arise in all three vectors (Gx, Gy, and Gz). The
      population at risk for injury due to such forces are individuals exposed to
      forces generated in racing cars, involved in automobile impacts or emergency
      landing of aircraft, in normal landing on carriers or in piloting of 5th
      generation fighter planes, and in other aspects of operator activity in HMV.
      Various methods of fixation of the head to prevent cervical injury are described
      in the literature: cervical collars, inflated thoracic defensive members,
      airbags, cervical supports, etc. However, all of these have some deficiencies
      related either to one-time availability or the restricted range of head motion
      which they produce. Widely used automatic retaining systems composed of belts
      with forced pull and airbags, while successful in other regards, do not
      adequately protect the head and neck of the operators who are chronically exposed
      to iterated percussion, and other acceleration forces under diverse extreme
      conditions.

PMID- 11211048
TI  - Ode to history and celebration of space medicine: 50 years of vision from the
      AsMA Space Medicine Branch. Aero Medical Association.

PMID- 11211049
TI  - Dynamic strength capabilities of small-stature females to perform high
      performance flight tasks.
AB  - BACKGROUND: Naval Air Warfare Center Aircraft Division investigated the abilities
      of small-stature females (< or = 120 lb.) to fly under G-stress using the Dynamic
      Flight Simulator (DFS) and its tactical fight/attack cockpit, displays and
      controls. The objective was to determine if these individuals possess sufficient
      upper-body muscular endurance to perform tasks required during fighter-pilot
      training, aerial combat maneuvers, and failure modes. METHODS: Five female
      subjects (four small-stature and one medium) participated. DFS tasks featured
      bombing runs, surface-to-air missile (SAM) avoidance, and single engine failure.
      Muscular exertion and fatigue (arm, shoulder, neck) were assessed using
      electromyography. RESULTS: During the most physically taxing simulation (SAM
      avoidance), flight performance did not significantly degrade over time. No
      statistically significant increase in muscular fatigue was found during the
      bombing simulation, though there was some evidence of degraded fine muscle
      control. Evidence of flexor and extensor muscular fatigue was associated with the
      single-engine-failure simulation. CONCLUSIONS: Within the scope of these tests,
      small-stature individuals demonstrated the strength and endurance to safely fly
      physically strenuous missions. However, a larger subject sample is necessary to
      increase the statistical power of the results.

PMID- 11211050
TI  - Can antiglycolipid antibodies present in HIV-infected individuals induce immune
      demyelination?
AB  - Of the eight clinically defined neuropathies associated with HIV infection, there
      is compelling evidence that acute and chronic inflammatory demyelinating
      polyneuropathy (IDPN) have an autoimmune pathogenesis. Many non-HIV infected
      individuals who suffer from sensory-motor nerve dysfunction have autoimmune
      indicators. The immunopathogenesis of demyelination must involve neuritogenic
      components in myelin. The various antigens suspected to play a role in HIV
      seronegative IDPN include (i) P2 protein; (ii) sulfatide (GalS); (iii) various
      gangliosides (especially GM1); (iv) galactocerebroside (GalC); and (v)
      glycoproteins or glycolipids with the carbohydrate epitope glucuronyl-3-sulfate.
      These glycoproteins or glycolipids may be individually targeted, or an immune
      attack may be raised against a combination of any of these epitopes. The
      glycolipids, however, especially GalS, have recently evoked much interest as
      mediators of immune events underlying both non-HIV and HIV-associated
      demyelinating neuropathies. The present review outlines the recent research
      findings of antiglycolipid antibodies present in HIV-infected patients with and
      without peripheral nerve dysfunction, in an attempt to arrive at some consensus
      as to whether these antibodies may play a role in the immunopathogenesis of HIV
      associated inflammatory demyelinating polyneuropathy.

PMID- 11211051
TI  - Mild hypothermia mitigates post-ischemic neuronal death following focal cerebral
      ischemia in rat brain: immunohistochemical study of Fas, caspase-3 and TUNEL.
AB  - Mild hypothermia is considered to have a protective effect during ischemic
      neuronal cell death. The present study provides experimental evidence for this
      beneficial role of mild hypothermia using reversible middle cerebral artery
      occlusion (MCAo) in a Sprague-Dawley (SD) rat model. MCAo was induced in rats for
      1 h followed by reperfusion at different periods. Hematoxylin-eosin (HE) staining
      in normothermic (NT) 37 degrees C and hypothermic (HT) 33 degrees C groups of
      rats confirmed cerebral infarcts. The mean per cent infarct area was
      significantly reduced in the HT group of rats. Immunohistochemical analysis was
      done using anti-Fas and caspase-3 antibodies. The immunohistochemical expression
      of Fas and caspase-3 was demonstrable as early as 5 h after reperfusion, but the
      expression pattern maximized at 24 h after reperfusion. The expression of Fas and
      caspase-3 proteins showed a clear decrease in the HT group over the NT group. In
      situ detection of DNA fragmentation was done using the terminal deoxynucleotidyl
      transferase-mediated dUTP-biotin nick end-labeling method (TUNEL). TUNEL-positive
      cells were first observed at 5h after reperfusion and progressively increased by
      24h. A higher number of TUNEL-positive cells was found in the NT group, but they
      were significantly decreased in the HT group. Further, DNA fragmentation was
      confirmed by size fractionation in agarose gel. These findings demonstrate a
      positive relation between the expression of Fas, caspase-3 and TUNEL-positive
      cells.

PMID- 11211052
TI  - Thiophene, a sulfur-containing heterocyclic hydrocarbon, causes widespread
      neuronal degeneration in rats.
AB  - Thiophene is a sulfur-containing heterocyclic hydrocarbon that has been detected
      in a number of environmental sources as various derivatives. Previous studies
      with rats have shown that thiophene induces selective degeneration of granule
      cells in the cerebellum, as observed with methyl mercury. To study the
      neurotoxicity of thiophene, Wistar rats received daily intramuscular injections
      of 0.2 mL thiophene for 3 days. Ataxia and convulsions were noted in all animals
      within 24 h after the final dose. Histologically, multiple foci of necrosis were
      observed in the cerebellum, predominantly in the granular layer. Neuronal damage
      was also found in the cerebral cortex, inferior colliculus and inferior olive.
      These findings suggest that thiophene causes widespread neuronal degeneration in
      rats and that the regional distribution of brain lesions induced by thiophene is
      different from that caused by methyl mercury poisoning.

PMID- 11211053
TI  - Amyloid precursor protein beta-secretase (BACE) mRNA expression in human neural
      cell lines following induction of neuronal differentiation and exposure to
      cytokines and growth factors.
AB  - Recently, a novel amyloid precursor protein beta-secretase (designated BACE) was
      identified. Because activated microglia and astrocytes play a role in
      amyloidogenesis in Alzheimer's disease, the constitutive and glial
      cytokine/growth factor-regulated expression of BACE was studied in human neural
      cell lines. By reverse transcription-polymerase chain reaction (RT-PCR) analysis,
      BACE mRNA expression was identified in various human neural and non-neural cell
      lines. By northern blot analysis, the expression of BACE mRNA composed of five
      distinct transcripts (>8.0, 7.0, 6.0, 4.4 and 2.6 kb) was elevated markedly in
      NTera2 teratocarcinoma cells following retinoic acid-induced neuronal
      differentiation. But the levels of three major BACE mRNA species (7.0, 6.0 and
      4.4 kb) were not significantly altered in NTera2-derived neurons, SK-N-SH
      neuroblastoma or U-373MG astrocytoma following exposure to tumor necrosis factor
      alpha, interleukin (IL)-1beta, IL-6, interferon-gamma, transforming growth factor
      beta1, epidermal growth factor, basic fibroblast growth factor, brain-derived
      neurotrophic factor, dibutyryl cyclic adenosine monophosphate or phorbol 12
      myristate 13-acetate. These results indicate that BACE mRNA is expressed
      constitutively in human neural cells and its expression is upregulated during
      neuronal differentiation, but it is unlikely to be regulated by activated glia
      derived cytokines and growth factors.

PMID- 11211054
TI  - Immunohistochemical analysis of brainstem lesions in infantile spasms.
AB  - Whether the cerebral or subcortical lesions are involved in the pathogenesis in
      infantile spasms (IS) remains to be determined. To investigate the functional
      lesions of the subcortical structures in IS, the brainstem expression of
      neurotransmitters, neuropeptides and calcium-binding proteins in IS autopsy cases
      of lissencephaly and of perinatal hypoxic ischemic encephalopathy (HIE/IS) was
      investigated. The IS patients consisted of four subjects each of lissencephaly
      and HIE. They suffered from both West and Lennox-Gastaut syndromes. The healthy
      and disease controls were composed of four subjects without neuromuscular
      disorders and six cases of HIE (HIE/C), neither of whom had the epileptic
      syndrome. In these subjects the expressions of tryptophan hydroxylase (TrH),
      tyrosine hydroxylase (TH), parvalbumin (PV), methionine-enkephalin (ME) and
      substance P (SP) were immunohistochemically determined in serial sections of the
      midbrain, pons and medulla oblongata. The immunoreactivity of neurons and
      neuronal processes for TH was altered in the mesencephalic periaqueductal gray
      matter, locus ceruleus, and dorsal vagal nucleus in the patients. The HIE/IS
      cases showed reduced TrH-immunoreactivity in the medullary raphe nuclei. The
      brainstem auditory tract was poorly discernible on anti-PV immunostaining in the
      IS patients. The immunoreactivity for ME in the spinal trigeminal nucleus was
      severely affected in the IS patients, while that for SP was comparatively well
      preserved. It is suggested that the presence of common brainstem lesions in IS is
      irrespective of etiologies. It is intriguing that some of the changes seemed to
      be interrelated with the neurophysiological abnormalities being reported in IS
      patients.

PMID- 11211056
TI  - Cerebral vasculitis in chronic mucocutaneous candidiasis: autopsy case report.
AB  - An autopsy case of chronic mucocutaneous candidiasis (CMCC) is reported here, in
      which cerebral vasculitis developed in the final stage. A 32-year-old man who had
      suffered from superficial candidial infection since his childhood was diagnosed
      as having CMCC. During the past 7 years the patient had developed various
      associated disorders including insulin-dependent diabetes mellitus (IDDM), common
      variable immunodeficiency (CVID), candidial esophagitis, multiple digestive tract
      ulcers and pyothorax. In 1998, at the age of 32, he developed convulsions that
      were accompanied by impairment of consciousness, and which were temporarily
      treated with steroid pulsed-medication. Epileptic status associated with
      widespread cerebral infarctions occurred subsequently, however, and the patient
      died of sepsis 2 months later. At autopsy, multiple cerebral infarctions and
      arterial thrombosis were evident. These were histologically proven to be primary
      vasculitis which was confined solely to the brain, and this was verified by
      general pathological examination. Thus, some as yet unknown cerebrovascular
      factors might be involved in the onset of an autoimmune-related vasculitis in
      patients with a longstanding immunodeficiency state such as CMCC.

PMID- 11211055
TI  - Convulsive effects of thiophene, a heterocyclic hydrocarbon: behavioral,
      electrographic and c-Fos immunocytochemical studies.
AB  - The behavioral, electrographic and histopathological changes induced by the
      heterocyclic hydrocarbon thiophene were investigated in rats following
      intramuscular injection of 0.3 mL thiophene for 5 days. Generalized convulsions
      were noted in 29 out of 34 animals (85%) between 1 and 28 h after the final dose.
      Electroencephalography revealed that the discharges in the hippocampus and
      forebrain occurred simultaneously, although epileptic activity emerged more
      strongly from the hippocampus than from any other region. Neuron damage was
      detected histologically in the temporal and parietal neocortex, piriform gyrus,
      amygdaloid nucleus and cerebellar cortex, but not in the hippocampus. In
      contrast, c-Fos was induced widely in the cerebral cortex and hippocampus, and
      was most marked in the dentate gyrus. These findings suggest that the hippocampus
      plays a crucial role in seizure onset following thiophene injection.

PMID- 11211057
TI  - Brain surface ependymoma.
AB  - A case of brain surface ependymoma is reported here. A 41-year-old woman
      presented with weakness of the right upper limb. Magnetic resonance imaging
      revealed a left fronto-parietal cystic tumor with a calcified mural nodule. Total
      removal of the tumor was performed. This tumor was located within the surface
      portion of the fronto-parietal parenchyma and was sharply demarcated from the
      surrounding brain tissue, and there was no continuity with the ventricles.
      Histological examination of this tumor showed monotonous proliferation of tumor
      cells with moderate cellularity and occasional mitoses, forming true ependymal
      rosettes and perivascular pseudorosettes with fibrillary background. A clear cell
      component resembling oligodendroglioma was partly noted. The tumor cells showed
      positive immunoreaction for glial fibrillary acid protein and vimentin.

PMID- 11211058
TI  - Pathology of CAG repeat diseases.
AB  - Neuronal intranuclear inclusions have become the neuropathological signature of
      the CAG repeat diseases, although their cytotoxicity is a matter of controversy.
      It has been demonstrated that the inclusions in dentatorubral-pallidoluysian
      atrophy (DRPLA) and Machado-Joseph disease (MJD) were immunopositive for several
      transcription factors such as TATA-binding protein (TBP), TBP-associated factor
      (TAF(II)130), Sp1, cAMP-responsive element-binding protein (CREB) and CREB
      binding protein, suggesting that neuronal degeneration in polyglutamine diseases
      may result from nuclear depletion of transcription factors containing the
      glutamine-rich domain. It was also revealed that, in the DRPLA brain, expanded
      polyglutamine stretches were diffusely accumulated in neuronal nucleoplasm. This
      nuclear pathology involved many neurons in various nervous system regions, such
      as the cerebral cortex, thalamus, substantia nigra, pontine nuclei, reticular
      formation and inferior olive, in addition to the previously recognized affected
      regions. The diffuse nuclear labeling was also detected in MJD, Huntington's
      disease, and spinal and bulbar muscular atrophy, suggesting that this nuclear
      pathology may be a characteristic feature and may exert certain influence on
      certain nuclear functions of many neurons in the CAG repeat diseases.

PMID- 11211060
TI  - Medical publishing: remembrance of things past and intimations of the future.

PMID- 11211059
TI  - Interaction of expanded polyglutamine stretches with nuclear transcription
      factors leads to aberrant transcriptional regulation in polyglutamine diseases.
AB  - At least eight inherited neurodegenerative diseases are known to be caused by
      expanded CAG repeats encoding polyglutamine (polyQ) stretches. Although
      cytotoxicities of expanded polyQ stretches have been suggested, the molecular
      mechanisms of neurodegeneration remain unclear. The nuclear translocation of
      mutant proteins containing expanded polyQ stretches has been demonstrated as a
      prerequisite for the expression of their cytotoxicity. Hypothesizing that nuclear
      proteins that interact with mutant proteins, particularly, those that bind to the
      expanded polyQ stretches, are involved in the pathogenetic mechanisms underlying
      neurodegeneration, nuclear proteins were screened for their capability of binding
      to expanded polyQ stretches. It was found that expanded polyQ stretches
      preferentially bind to TAF(II)130, a coactivator involved in cAMP-responsive
      element-binding protein (CREB)-dependent transcriptional activation. The binding
      of TAF(II)130 with expanded polyQ stretches strongly suppresses CREB-dependent
      transcriptional activation, suggesting that interference with transcription due
      to the binding of expanded polyQ stretches with TAF(II)130 and redistribution of
      TAF(II)130 are involved in the pathogenetic mechanisms underlying
      neurodegeneration.

PMID- 11211061
TI  - Psychological variables in hypertension: relationship to casual or ambulatory
      blood pressure in men.
AB  - OBJECTIVE: The evidence linking hypertension with personality or psychological
      characteristics, such as anger, anxiety, or depression, remains equivocal. This
      may be due in part to limitations of personality theory, confounding by awareness
      of hypertension, and/or inherent difficulties in measuring blood pressure. This
      study was designed to investigate the association between mild hypertension as
      defined by both ambulatory and casual (clinic) blood pressure measurements and
      various measures of personality and psychological characteristics. METHODS: We
      examined this association in a population-based sample of 283 men between the
      ages of 30 and 60 years from eight work sites in New York City, using an
      ambulatory blood pressure monitor and controlling for age, race/ethnicity, and
      body mass index. RESULTS: We found no consistent difference between participants
      with mild hypertension and those with normal blood pressure on any of the
      psychological variables assessed, including Type A behavior pattern, state and
      trait anger, anger expression, anxiety, symptoms of psychological distress, locus
      of control, or attributional style. Results were not due to the use of
      antihypertensive medication by some of the participants with hypertension nor to
      the dichotomization of blood pressure into those with and without mild
      hypertension. This contrasts with previous findings from this study showing a
      sizable association of ambulatory blood pressure and hypertension with job strain
      (a situational measure), age, and body mass index. CONCLUSIONS: These null
      results suggest that situational, biological, and perhaps behavioral factors are
      the primary determinants of mild hypertension and that the predictive
      significance of psychological or dispositional factors is low or negligible in
      those without overt cardiovascular disease.

PMID- 11211062
TI  - Coping with breast cancer: patient, spouse, and dyad models.
AB  - OBJECTIVE: The objectives of this study were 1) to assess similarities and
      differences between patients with breast cancer and their spouses in terms of
      coping strategies and adjustment (psychosocial and psychological) to cancer and
      2) to investigate the pattern of relationships between the patients' and spouses'
      coping strategies and between each of these strategies and the patient's
      adjustment to the illness using three types of models: patient, spousal, and
      dyadic coping. METHODS: Seventy-three patients with breast cancer and their
      spouses completed questionnaires that measured distress (Brief Symptom
      Inventory), psychosocial adjustment, and coping strategies. RESULTS: The
      patients' distress was greater than their spouses', but a similar level of
      psychosocial adjustment was reported. The patients used more strategies involving
      problem-focused coping than their spouses. The use of emotion-focused coping,
      which included ventilation and avoidance strategies, was highly related to
      distress and poor adjustment on the part of the patient. The spouses' emotion
      focused coping and distress were related to that of the patients. Dyad emotion
      focused coping measures were highly associated with the patients' distress and
      adjustment. CONCLUSIONS: Spousal and dyad coping are important factors in a
      patient's adjustment to breast cancer.

PMID- 11211063
TI  - A randomized, double-blind, placebo-controlled crossover study of the effect of
      exogenous melatonin on delayed sleep phase syndrome.
AB  - OBJECTIVE: The effects of exogenous melatonin on sleep, daytime sleepiness,
      fatigue, and alertness were investigated in 22 patients with delayed sleep phase
      syndrome whose nocturnal sleep was restricted to the interval from 24:00 to 08:00
      hours. This study was a randomized, double-blind, placebo-controlled crossover
      trial. Subjects received either placebo or melatonin (5 mg) daily for 4 weeks,
      underwent a 1-week washout period, and then were given the other treatment for an
      additional 4 weeks. Patients could take the melatonin between 19:00 and 21:00
      hours, which allowed them to select the time they felt to be most beneficial for
      the phase-setting effects of the medication. METHODS: Two consecutive overnight
      polysomnographic recordings were performed on three occasions: at baseline
      (before treatment), after 4 weeks of melatonin treatment, and after 4 weeks of
      placebo treatment. RESULTS: In the 20 patients who completed the study, sleep
      onset latency was significantly reduced while subjects were taking melatonin as
      compared with both placebo and baseline. There was no evidence that melatonin
      altered total sleep time (as compared with baseline total sleep time), but there
      was a significant decrease in total sleep time while patients were taking
      placebo. Melatonin did not result in altered scores on subjective measures of
      sleepiness, fatigue, and alertness, which were administered at different times of
      the day. After an imposed conventional sleep period (from 24:00 to 08:00),
      subjects taking melatonin reported being less sleepy and fatigued than they did
      while taking placebo. CONCLUSIONS: Melatonin ameliorated some symptoms of delayed
      sleep phase syndrome, as confirmed by both objective and subjective measures. No
      adverse effects of melatonin were noted during the 4-week treatment period.

PMID- 11211064
TI  - SF-36: evaluation of quality of life in severe and mild insomniacs compared with
      good sleepers.
AB  - OBJECTIVE: Despite many studies, the impact of chronic insomnia on daytime
      functioning is not well understood. The aim of our study was to detect this
      impact by evaluating quality of life (QoL) using a validated instrument, the 36
      item Short Form Health Survey of the Medical Outcomes Study (SF-36), in three
      matched groups of severe insomniacs, mild insomniacs, and good sleepers selected
      from the general population. METHODS: Three matched groups of 240 severe
      insomniacs, 422 mild insomniacs, and 391 good sleepers were recruited from the
      general French population after eliminating those with DSM-IV criteria for
      anxiety or depression. All subjects were asked to complete the SF-36. Scores for
      each QoL dimension were calculated and compared statistically among the three
      groups. RESULTS: Severe insomniacs had lower QoL scores in eight dimensions of
      the SF-36 than mild insomniacs and good sleepers. Mild insomniacs had lower
      scores in the same eight dimensions when compared with good sleepers. No
      dimension was significantly more altered than the other. CONCLUSIONS: The mental
      health status and role of emotional QoL dimensions were worse in severe and mild
      insomniacs than in good sleepers. This result held even though we screened for
      psychiatric diseases, which shows a clear interrelation between insomnia and
      emotional state. General health status was also worse in severe and mild
      insomniacs than in good sleepers. However, we could conclude only that insomnia
      was related to a worse health status and not whether it was a cause or
      consequence of this worse health status. Finally, the degradation of QoL scores
      was correlated with the severity of insomnia.

PMID- 11211065
TI  - Alexithymia and polysomnographic measures of sleep in healthy adults.
AB  - OBJECTIVE: This study examined associations between alexithymia and objective
      characteristics of sleep (latencies, stages, and amount and patterning of REM
      sleep) that may contribute to subjective reports of poor sleep quality and
      impaired dream recall among alexithymic people. METHODS: Fifty healthy, normally
      sleeping adults from the community completed the 20-item Toronto Alexithymia
      Scale and slept uninterrupted for one night in the laboratory while
      polysomnography was conducted. Various measures of sleep latency, sleep stages,
      and REM sleep-related variables were obtained, and analyses correlated these
      sleep measures with alexithymia, controlling for age, sex, and level of depressed
      affect. RESULTS: Higher alexithymia scores were significantly related to
      increased stage 1 (light) sleep and decreased stage 3/4 (deep) sleep. Alexithymia
      was unrelated to overall sleep efficiency or percentage of stage 2 sleep.
      Alexithymia was related to more frequent REM episodes and more stage 1 sleep
      during and immediately after REM episodes but was unrelated to the absolute
      amount of REM sleep. Alexithymia was also related to an earlier onset of the
      first REM episode. CONCLUSIONS: Alexithymia is associated with more light sleep
      and less deep sleep, which may contribute to subjective reports of poor sleep and
      increased sleepiness, fatigue, and somatic symptoms. Although alexithymia is not
      associated with an overall reduction of REM sleep, the increased frequency of
      episodes of REM that are interrupted and followed by light sleep rather than
      complete awakenings may contribute to limited dream recall.

PMID- 11211066
TI  - Plasma levels of neuroactive steroids are increased in untreated women with
      anorexia nervosa or bulimia nervosa.
AB  - OBJECTIVE: Animal data suggest that neuroactive steroids, such as 3alpha,5alpha
      tetrahydroprogesterone (3a,5a-THP), dehydroepiandrosterone (DHEA), and its
      sulfated metabolite (DHEA-S), are involved in the modulation of eating behavior,
      aggressiveness, mood, and anxiety. Anorexia nervosa (AN) and bulimia nervosa (BN)
      are eating disorders characterized by abnormal eating patterns, depressive and
      anxious symptoms, enhanced aggressiveness, and endocrine alterations. Previous
      studies reported decreased blood levels of DHEA and DHEA-S in small samples of
      anorexic patients, whereas no study has been performed to evaluate the secretion
      of these neuroactive steroids in BN as well as the production of 3alpha,5alpha
      THP in both AN and BN. Therefore, we measured plasma levels of DHEA, DHEA-S,
      3alpha,5alpha-THP and other hormones in patients with AN or BN and explored
      possible relationships between neuroactive steroids and psychopathology. METHOD:
      Ninety-two women participated in the study. There were 30 drug-free AN patients,
      32 drug-free BN patients, and 30 age-matched, healthy control subjects. Blood
      samples were collected in the morning for determination of hormone levels. Eating
      related psychopathology, depressive symptoms, and aggressiveness were rated by
      using specific psychopathological scales. RESULTS: Compared with healthy women,
      both AN and BN patients exhibited increased plasma levels of 3alpha,5alpha-THP,
      DHEA, DHEA-S, and cortisol but reduced concentrations of 17beta-estradiol. Plasma
      testosterone levels were decreased in anorexic women but not in bulimic women.
      Plasma levels of neuroactive steroids were not correlated with any clinical or
      demographic variable. CONCLUSIONS: These findings demonstrate increased morning
      plasma levels of peripheral neuroactive steroids in anorexic and bulimic
      patients. The relevance of such hormonal alterations to the pathophysiology of
      eating disorders remains to be elucidated.

PMID- 11211067
TI  - Impact of cadaveric organ donation on Taiwanese donor families during the first 6
      months after donation.
AB  - OBJECTIVE: Organ donation is a complex decision for family members of Asian
      donors. The impact of cadaveric organ donation on both Chinese and Western donor
      families has not been well investigated within a cultural framework. The purposes
      of this study were to follow Chinese family members' appraisal of their decision
      to donate organs, to explore the possible negative and positive impacts of organ
      donation on their family life, and to determine what help they expected from
      healthcare providers during the first 6 months after donation. METHODS: Twenty
      two family members (10 men and 12 women) of cadaveric organ donors who signed
      consent forms at an organ transplant medical center in Taiwan participated in
      this project and completed in-depth interviews during the sixth month after
      donation. RESULTS: Participants were 25 to 56 years old (mean = 48.15 +/- 8.31
      years). The type of kinship of the participants included the donor's parents,
      older sister, and spouse. Subjects reported several negative impacts: worry about
      the donor's afterlife (86%), stress due to controversy among family members over
      the decision to donate (77%), and stress due to others' devaluation of the
      donation (45%). Positive impacts reported by the subjects included having a sense
      of reward for helping others (36%), having an increased appreciation of life
      (32%), having closer family relationships (23%), and planning to shift life goals
      to the study of medicine (9%). Subjects expected the transplant team to provide
      information about organ recipients (73%), to submit the necessary documents so
      that family members could receive healthcare payments from the insurance company
      (68%), to help resolve legal proceedings and settlements associated with
      accidents (64%), and to not overly publicize their decision to donate (64%).
      CONCLUSIONS: Although all of the subjects reported that organ donation was the
      right decision, the decision to donate did not protect Taiwanese donor families
      from negative psychocognitive bereavement. The impacts of organ donation were
      affected by the subject's social cultural, spiritual, and legal context and the
      nature of their bereavement.

PMID- 11211068
TI  - Psychological stress and antibody response to immunization: a critical review of
      the human literature.
AB  - OBJECTIVE: The objective of this review was to evaluate the evidence for the
      hypothesis that psychological stress influences antibody response to immunization
      in humans. METHODS: A critical review of the literature was conducted. RESULTS:
      The evidence supports an association between psychological stress and suppression
      of humoral immune (antibody) response to immunization. This association is
      convincing in the case of secondary immune response but weak for primary
      response. The lack of consistent evidence for a relation with primary response
      may be attributed to a failure to consider the critical points when stress needs
      to be elevated in the course of the production of antibody. Lower secondary
      antibody responses were found among patients with chronically high levels of
      stress (severe enduring problems or high levels of trait negative affect). These
      responses were found most consistently among older adults. Lower secondary
      responses were also found for those reporting acute stress or negative affect,
      but only in studies of secretory immunoglobulin A antibody in which psychological
      and antibody measures were linked very closely in time. Health practices did not
      mediate relations between stress and antibody responses; however, there were
      indications that elevated cortisol levels among stressed patients could play a
      role. Evidence also suggests the possible influences of dispositional stress
      reactivity and low positive affect in the inhibition of antibody production.
      CONCLUSIONS: The literature supports a relationship between psychological stress
      and antibody responses to immunizations. The data are convincing in the case of
      secondary response but weak for primary response. More attention to the kinetics
      of stress and antibody response and their interrelations is needed in future
      research.

PMID- 11211070
TI  - Fibre morphology and soda-sulphite pulping of switchgrass.
AB  - This paper describes the fibre morphology of switchgrass (Panicum virgatum L.)
      and its pulping characteristics using sodium hydroxide and a combination of
      sodium hydroxide and sodium sulphite as the cooking agents. It was found that the
      fibre length of switchgrass is similar to that of poplar despite its high
      population of short fibre elements (< 0.2 mm). The switchgrass used in this study
      had a lignin content comparable to that of poplar, but a particularly high
      content of extractable materials. The soda pulp from switchgrass showed excellent
      mechanical properties and showed a great potential as a reinforcement component
      in newsprint making.

PMID- 11211069
TI  - Pain and emotion: effects of affective picture modulation.
AB  - OBJECTIVE AND METHODS: Two experiments examined the impact of viewing unpleasant,
      pleasant, and neutral photographic slides on cold-pain perception in healthy men
      and women. In each experiment, participants viewed one of three slide shows
      (experiment 1 = fear, disgust, or neutral; experiment 2 = erotic, nurturant, or
      neutral) immediately before a cold-pressor task. Skin conductance and heart rate
      were recorded during the slide shows, whereas visual analog scale ratings of pain
      intensity and unpleasantness thresholds and pain tolerance were recorded during
      the cold-pressor task. RESULTS: Viewing fear and disgust slides decreased pain
      intensity and unpleasantness thresholds, but only the fear slides decreased pain
      tolerance. In contrast, viewing erotic, but not nurturant, slides increased pain
      intensity and unpleasantness threshold ratings on the visual analog scale in men,
      whereas neither nurturant nor erotic slides altered pain tolerance. CONCLUSIONS:
      These results are consistent with a motivational priming model that predicts that
      unpleasant affective states should enhance pain and that pleasant affective
      states should attenuate it.

PMID- 11211071
TI  - The effect of low light flux and nitrogen deficiency on the chemical composition
      of Spirulina sp. (Arthrospira) grown on digested pig waste.
AB  - Evaluation of the effect of low light flux and nitrogen deficiency on growth and
      chemical composition of Spirulina sp. (straight filaments strain, SF) in batch
      cultures utilizing a complex medium containing sea-water supplemented with
      anaerobic effluents from digested pig waste, was undertaken. Cultivation was
      carried out either at a light flux of 66 (lower) or 144 micromol photon m(-2) s(
      1) (higher), utilizing bench raceways. Biomass concentration (as dry weight)
      after 12 days of cultivation in the complex medium was similar (P < 0.05) to the
      one observed in a chemically defined medium (Zarrouk), regardless of the light
      intensity. Protein content of the biomass in the complex medium was significantly
      lower (P < 0.05), compared to the Zarrouk medium, regardless of the light flux.
      However, biomass from the complex medium was enriched in total lipids (28.6%),
      when cultures were exposed to the lower light flux. On the other hand, the
      palmitoleic acid percentage of total fatty acids was significantly higher (P <
      0.05) at a higher light intensity and a high level of gamma linolenic acid (GLA)
      as a percentage of total fatty acids was observed (28.13%) in the biomass
      harvested from the complex medium at the lower light intensity. Finally,
      polysaccharide content was significantly higher (P < 0.05) at the high light
      intensity and a very high content of total polysaccharides (28.41%) was observed
      in the complex medium.

PMID- 11211072
TI  - Utilization of byproducts from the tequila industry: part 1: agave bagasse as a
      raw material for animal feeding and fiberboard production.
AB  - Agave bagasse was successfully separated into fractions that were used in sheep
      feeding trials. Agave bagasse can be substituted for corn stubble in the sheep's
      diet which resulted in improved weight gain. Agave bagasse was also processed
      into long and short fiber fractions with a hammermill and fiberboards of medium
      and high specific gravities being produced. Medium specific gravity agave
      fiberboards had moisture and mechanical properties comparable to medium specific
      gravity fiberboards made using aspen fiber. All high specific gravity agave
      fiberboards made from short or long fibers were stronger in bending than the ANSI
      standard for hardboards.

PMID- 11211073
TI  - Network structures and thermal properties of polyurethane films prepared from
      liquefied wood.
AB  - Polyurethane (PU) films were prepared by solution-casting after co-polymerization
      of liquefied woods (LWs) and polymeric methylene diphenylene diisocyanate (PMDI).
      The resulting PU films had various [NCO]/[OH] ratios ranging from 0.6 to 1.4 and
      contained 5.0-16.8% dissolved woody components at the [NCO]/[OH] ratio of 1.0.
      The crosslink densities of the films with [NCO]/[OH] ratios of 0.6-1.4 increased
      remarkably with increasing [NCO]/[OH] ratio. Similarly, there were large
      increases in glass transition temperatures (Tg). These characteristics could be
      attributed to effective incorporation of PMDI into the LW. The crosslink
      densities and Tg of the PU films prepared at the [NCO]/[OH] ratio of 1.0
      increased because the amounts of dissolved woody components in the films
      increased. It is concluded that the dissolved woody components acted as
      crosslinking points in PU network formations. The thermal degradation of the PU
      films at an [NCO]/[OH] ratio of more than 0.8 or with more than 10.6% dissolved
      wood started above 262 degrees C under an N2 atmosphere. The thermostability was
      lost at low crosslink density or with large amount of co-polymerized glycerol
      structures in the PU networks.

PMID- 11211075
TI  - Evaluation of the transformation of organic matter to humic substances in compost
      by coupling sec-page.
AB  - Humic acids (HAs) from soil and compost at the beginning (S0) and at the end of
      the stabilization process after 130 days (S130) have been fractionated by
      coupling size exclusion chromatography (SEC) and polyacrylamide gel
      electrophoresis (PAGE). Preparative quantities of HA fractions (HAFs) with
      different molecular sizes (MSs) and exactly defined electrophoretic mobility
      (EMs) have been obtained from all samples and the HAFs weight content has been
      studied. A high degree of similarity in HAFs weight content between soil HA and a
      stabilized compost HAs130 has been observed. Such data seem to be reliable for
      monitoring the evolution of the compost organic matter to humic substances for
      their agricultural uses.

PMID- 11211074
TI  - Aspergillus niger absorbs copper and zinc from swine wastewater.
AB  - Wastewater from swine confined-housing operations contains elevated levels of
      copper and zinc due to their abundance in feed. These metals may accumulate to
      phytotoxic levels in some agricultural soils of North Carolina due to land
      application of treated swine effluent. We evaluated fungi for their ability to
      remove these metals from wastewater and found Aspergillus niger best suited for
      this purpose. A. niger was able to grow on plates amended with copper at a level
      five times that inhibitory to the growth of Saccharomyes cerevisiae. We also
      found evidence for internal absorption as the mechanism used by A. niger to
      detoxify its environment of copper, a property of the fungus that has not been
      previously exploited for metal bioremediation. In this report, we show that A.
      niger is capable of removing 91% of the copper and 70% of the zinc from treated
      swine effluent.

PMID- 11211076
TI  - Production of ethanol and xylitol from corn cobs by yeasts.
AB  - Saccharomyces cerevisiae and Candida tropicalis were used separately and as co
      culture for simultaneous saccharification and fermentation (SSF) of 5-20% (w/v)
      dry corn cobs. A maximal ethanol concentration of 27, 23, 21 g/l (w/v) from 200
      g/l (w/v) dry corn cobs was obtained by S. cerevisiae, C. tropicalis and the co
      culture, respectively, after 96 h of fermentation. However, theoretical yields of
      82%, 71% and 63% were observed from 50 g/l dry corn cobs for the above cultures,
      respectively. Maximal xylitol concentration of 21, 20 and 15 g/l from 200 g/l
      (w/v) dry corn cobs was obtained by C. tropicalis, co-culture, and S. cerevisiae,
      respectively. Maximum theoretical yields of 79.0%, 77.0% and 58% were observed
      from 50 g/l of corn cobs, respectively. The volumetric productivities for ethanol
      and xylitol increased with the increase in substrate concentration, whereas,
      yield decreased. Glycerol and acetic acid were formed as minor by-products. S.
      cerevisiae and C. tropicalis resulted in better product yields (0.42 and 0.36
      g/g) for ethanol and (0.52 and 0.71 g/g) for xylitol, respectively, whereas, the
      co-culture showed moderate level of ethanol (0.32 g/g) and almost maximal levels
      of xylitol (0.69 g/g).

PMID- 11211077
TI  - Adapting substrate formulas used for shiitake for production of brown Agaricus
      bisporus.
AB  - A pasteurized, non-composted substrate (basal mixture) consisting of oak sawdust
      (28%), millet (29%), rye (8%), peat (8%), alfalfa meal (4%), soybean flour (4%),
      wheat bran (9%), and CaCO3 (10%) was adapted from shiitake culture to produce the
      common cultivated mushroom (brown; portabello), Agaricus bisporus. Percentage
      biological efficiency (ratio of fresh mushroom harvested/oven-dry substrate
      weight, %BE) ranged from a low of 30.1% (when wheat straw was substituted for
      sawdust) to 77.1% for the basal mixture. Special, high gas-exchange bags were
      required to optimize mycelial growth during spawn run. Our formula may allow
      specialty mushroom growers to produce portabello mushrooms on a modified,
      pasteurized (110 degrees C for 20 min) substrate commonly used for shiitake
      production without the added expense of compost preparation.

PMID- 11211078
TI  - Biomass steam gasification--an extensive parametric modeling study.
AB  - A model for steam gasification of biomass was developed by applying thermodynamic
      equilibrium calculations. With this model, the simulation of a decentralized
      combined heat and power station based on a dual fluidized-bed steam gasifier was
      carried out. Fuel composition (ultimate analysis and moisture content) and the
      operating parameters, temperature and amount of gasification agent, were varied
      over a wide range. Their influences on amount, composition, and heating value of
      product gas and process efficiencies were evaluated. It was shown that the
      accuracy of an equilibrium model for the gas composition is sufficient for
      thermodynamic considerations. Net electric efficiency of about 20% can be
      expected with a rather simple process. Sensitivity analysis showed that
      gasification temperature and fuel oxygen content were the most significant
      parameters determining the chemical efficiency of the gasification.

PMID- 11211079
TI  - Production of oxalic acid from sugar beet molasses by formed nitrogen oxides.
AB  - Production of oxalic acid from sugar beet molasses was developed in a series of
      three reactors. Nitrogen oxides formed were used to manufacture oxalic acid in
      the second and third reactor. Parameters affecting the reaction were determined
      to be, air flow rate, temperature, the amount of V2O5 catalyst and the
      concentrations of molasses and H2SO4. The maximum yields in the second and third
      reactors were 78.9% and 74.6% of theoretical yield, respectively. Also, kinetic
      experiments were performed and the first-order rate constants were determined for
      the glucose consumption rate. Nitrogen oxides in off-gases from the final reactor
      were absorbed in water and concentrated sulphuric acid and reused in the
      following reactors giving slightly lower yields under similar conditions. In this
      novel way, it was possible to recover NO(x) and to prevent air pollution.
      Meanwhile, it was possible to reduce the unit cost of reactant for oxalic acid
      production. A maximum 77.5% and 74.1% of theoretical yield was obtained by using
      the absorption solutions with NO(x).

PMID- 11211080
TI  - Comparative treatability of Moso bamboo and southern pine with CCA preservative
      using a commercial schedule.
AB  - The United States Department of Agriculture introduced several bamboo species
      into the southern United States in the 1920s. One of the species included was
      Moso bamboo (Phyllostachys pubescens), a species native to China. This species
      grows well in South Carolina. In rural areas, bamboo splits are frequently used
      for fences and stakes for supporting crop plants. However, the decay resistance
      of bamboo is very low. In this study, Moso bamboo splits and southern pine lumber
      were treated in a commercial wood-treating plant using a full-cell process with
      Chromated Copper Arsenate (CCA) preservative to target retentions of 4.0 and
      6.4kg/m3. Results indicate that bamboo is much more difficult to treat than
      southern pine. Using the same treatment procedures for southern pine, bamboo
      could only achieve approximately 22% of the target CCA retention.

PMID- 11211081
TI  - Effects of various media and supplements on laccase production by some white rot
      fungi.
AB  - White rot fungi produce three main extracellular enzymes involved in
      ligninolysis; laccase, lignin peroxidase and manganese peroxidase. Though all
      white rot fungi do not produce all three enzymes, laccase occupies an important
      place in ligninolysis. The present paper reports its production by some white rot
      fungi; Daedalea flavida, Phlebia brevispora, Phlebia radiata and Polyporus
      sanguineus under different nutritional conditions. Of the various basal media
      tested, mineral salts malt extract broth proved to be the best medium for laccase
      production. Sugarcane bagasse proved to be the best laccase inducer among the
      various supplements added to different media.

PMID- 11211082
TI  - Effects of ammonia nitrogen of H2 and CH4 production during anaerobic digestion
      of dairy cattle manure.
AB  - A number of researchers have verified the inhibitory effects of elevated H2
      concentrations on various anaerobic fermentation processes. The objective of this
      work was to investigate the potential for using hydrogen gas production to
      predict upsets in anaerobic digesters operating on dairy cattle manure. In an
      ammonia nitrogen overload experiment, urea was added to the experimental
      digesters to obtain increased ammonia concentrations (600, 1,500, or 3,000 mg
      N/l). An increase in urea concentration resulted in an initial cessation of H2
      production followed by an increase in H2 formation. Additions of 600, 1,500, or
      3,000 mg N/l initially resulted in the reduction of biogas H2 concentrations.
      After 24 h, the H2 concentration increased in the 600 and 1,500 mg N/l digesters,
      but production remained inhibited in the 3,000 mg N/l digesters. Both methane and
      total biogas production decreased following urea addition. Volatile solids
      reduction also decreased during these periods. The digester effluent pH and
      alkalinity increased due to the increased NH4 formed with added urea. Based on
      these results, changes in H2 concentration could be a useful parameter for
      monitoring changes due to increased NH3 in dairy cattle manure anaerobic
      digesters.

PMID- 11211083
TI  - Assessment of the effect of azo dye RP2B on the growth of a nitrogen fixing
      cyanobacterium--Anabaena sp.
AB  - Certain nitrogen fixing cyanobacteria are diazotrophic, which profoundly impacts
      the aquatic ecosystem chemically and biologically. Although certain types are
      banned due to their carcinogenicity, azo dyes are commonly used in the dyeing or
      textile industry. This work investigates the effect of azo dye on the growth of
      cyanobacteria. Anabaena sp. isolated from the Da Jia Brook is an odor producing,
      nitrogen fixing cyanobacterium. The growth rates of Anabaena sp. in the media
      with or without nitrogen source were 3.56 x 10(-2) mg/ml day and 2.44 x 10(-2)
      mg/ml day, respectively. Anabaena sp. could not use azo dye RP2B as the nitrogen
      source. Experimental results indicated that the growth of Anabaena sp. was
      inhibited in the medium containing RP2B. The degree of inhibition increased from
      50% to 81% with an increasing concentration of RP2B (0-50 mg/l). The IC-50
      (inhibitory concentration) of RP2B on the growth of Anabaena sp. was 5 mg/l (as
      based on dry weight) or 7 mg/l (as measured by chlorophyll a).

PMID- 11211084
TI  - Changes in biogas production due to different ratios of some animal and
      agricultural wastes.
AB  - The biogas production and some biochemical parameters of anaerobic fermentation
      at 30 degrees C for 40 days were studied for eight experimental groups of
      fermentation media, as affected by two factors: (1) the type of the animal waste
      (sheep waste, S and goat waste, G), and (2) the ratio of waste to olive cake
      which constitutes four levels (100:0 for S1 and G1; 80:20 for S2 and G2; 60:40
      for S3 and G3 and 40:60 for S4 and G4). The results indicated that there was a
      significant decrease (P < 0.05) in the biogas production with an increase in the
      proportion of olive cake in place of animal waste. However, there was a
      significant increase in the biogas production for the S4 treatment compared with
      G4, reflecting an effect induced by the type of animal waste. The biogas
      production amounted to (l/kg VS/40 d): 62 (S1), 53 (S2), 49 (S3), 40 (S4), 58
      (G1), 50 (G2), 44 (G3) and 25 (G4). The reduction in total solid (TS) weight,
      volatile solids (VS), neutral-detergent fiber decreased significantly (P < 0.05)
      with the increase in olive cake proportion in the digester. The reductions in VS
      were (% in DM): 58.2 (S1), 37.8 (S2), 26.6 (S3), 22.6 (S4), 58.1 (G1), 36 (G2),
      33.4 (G3), 14.4 (G4). The rates of energy consumption were (MJ/kg DM/40 d): 15.36
      (S1), 10.12 (S2), 7.84 (S3), 6.68 (S4), 14.16 (G1), 9.68 (G2), 8.41 (G3), 3.29
      (G4).

PMID- 11211085
TI  - Enhanced effect of sulfonylurea (SU) in copolymer comprising a sugar moiety and
      SU derivative as double ligands on insulin secretion from MIN6 cells.
AB  - Copolymers composed of sulfonylurea (SU) as an antagonist of ATP-sensitive K+
      channel and sugar moieties as double ligands were synthesized. Insulin secretion
      from MIN6 cells (insulinoma cell line) in contact with the copolymers was
      evaluated. MIN6 cells attached to the poly(N-p-vinylbenzyl-D-maltonamide-co-SU)
      [P(VMA-co-SU)]-coated dishes were in the more aggregated form as compared to
      other polymer-coated surfaces. By introducing SU into the sugar bearing
      homopolymer, an enhanced effect on insulin secretion from MIN6 cells was observed
      due to the specific interaction between SU ligands and SU receptors on the beta
      cell membrane. P(VMA-co-SU) composed of SU and non-reducing glucose moieties
      demonstrated enhanced insulin secretion from MIN6 cells and faster proliferation
      of MIN6 cells as compared to poly(N-p-vinylbenzyl-D-lactonamide-co-SU) [P(VLA-co
      SU)] probably owing to the glucose transporters presence on the MIN6 cell
      membrane. Insulin secretion from MIN6 cells pretreated with diazoxide as an
      agonist of ATP-sensitive K+ channel was suppressed.

PMID- 11211086
TI  - Controlled release of vascular endothelial growth factor by use of collagen
      hydrogels.
AB  - In vivo profile of vascular endothelial growth factor (VEGF) release from
      collagen hydrogels was investigated comparing that of hydrogel degradation while
      angiogenesis induced by the released VEGF was assessed. Collagen sponges were
      chemically cross-linked with different amounts of glutaraldehyde for various time
      periods. When 125I-labeled collagen hydrogels incorporating VEGF were
      subcutaneously implanted into the back subcutis of mice, the hydrogel
      radioactivity decreased with time, the decrement profile depending on the cross
      linking conditions. The radioactivity was retained for longer time periods as the
      glutaraldehyde concentration and cross-linking time increased. Implantation study
      of collagen hydrogels incorporating 125I-labeled VEGF revealed that the remaining
      VEGF radioactivity decreased with time and the retention period was prolonged
      with the decreased hydrogel biodegradation. The slower the hydrogel degradation,
      the longer the period of VEGF retention. The collagen hydrogel incorporating VEGF
      induced significant angiogenesis around the implanted hydrogel, in marked
      contrast to VEGF in the solution form and VEGF-free empty hydrogel. The retention
      period of angiogenesis became longer with a decrease of the in vivo degradation
      rate of hydrogels. It is possible that the slower degraded hydrogel achieves a
      longer period of VEGF release, resulting in prolonged angiogenetic effect. We
      concluded that in our hydrogel system, biologically-active VEGF was released as a
      result of in vivo degradation of the hydrogel.

PMID- 11211087
TI  - Covalent grafting of polythymidylic acid onto amine-containing polystyrene latex
      particles.
AB  - The covalent grafting of a 35-base poly(thymidylic) acid (dT35) onto aminated
      polystyrene latex has been studied. The oligonucleotide was activated by 1,4
      phenylene diisothiocyanate (PDC) prior to grafting reaction. The influence of
      various experimental conditions related either to the medium (pH, ionic strength)
      or to the latex (nature and surface charge density, presence of adsorbed nonionic
      surfactant) was studied. Discrimination between covalent grafting and adsorption
      was achieved by desorbing the non-covalently grafted dT35 induced by consecutive
      washings with a suitable buffer solution. The amount of covalently grafted
      oligonucleotide directly correlated to the concentration and accessible
      functional groups at the particle surface.

PMID- 11211089
TI  - Evaluation of interfacial properties of hyaluronan coated
      poly(methylmethacrylate) intraocular lenses.
AB  - Polymethylmethacrylate intraocular lenses (IOLs) were surface-modified by the
      linking of a overlayer of hyaluronan. In vitro experiments show that the
      hydrophilic HA overlayer prevents fibroblasts adhesion and greatly reduces
      Staphyloccous epidermidis adhesion to the IOL surface. To gain insights into the
      interfacial properties of untreated and hyaluronan-coated PMMA IOLs, force
      distance curves were obtained by atomic force microscopy, using standard and
      modified tips. These measurements allow clear appreciation of the marked
      difference between the mechanical and chemico-physical properties at the aqueous
      interface of the uncoated and hyaluronan-coated lenses.

PMID- 11211090
TI  - Bioactive functionalized polymer of malic acid for bone repair and muscle
      regeneration.
AB  - A bioactive poly(beta-hydroxyalkanoate) derived from malic acid was prepared and
      tested on bone repair and muscle regeneration. This functionalized and
      hydrolyzable polymer was obtained after several steps, the first one being the
      anionic copolymerization of three malolactonic acid esters. Chemical
      modifications were carried out on the terpolymer to turn benzyl-protecting groups
      into carboxyl groups and allyl groups into sulfonate groups. The resulting
      polymer bore carboxylate, sulfonate, and sec-butyl pendent groups in 65/25/10
      molar proportions and were aimed at interacting with heparan binding growth
      factors. This polymer did not present any toxic effect in cell viability of HepG2
      cells, over a large range of concentrations (0.01-0.25 mgl(-1)). Its ability to
      improve wound healing was tested in vivo and positive results are reported.
      Furthermore, the bioactivity of this polymer was evaluated using the regeneration
      model of Extensor digitorum longus (EDL) rat muscle. The study displayed a
      significant increase in the muscle regeneration and maturation.

PMID- 11211088
TI  - A useful marker for evaluating tissue-engineered products: gap-junctional
      communication for assessment of the tumor-promoting action and disruption of cell
      differentiation in tissue-engineered products.
AB  - An in vitro system for evaluating the safety of tissue-engineered products is a
      convenient because of its rapidity and low cost. On the basis of recent studies,
      intercellular channels called gap-junctions are considered to play an important
      role on the tumor-promotion stage during the tumorigenesis induced by
      polyurethanes. Further, we also demonstrate the significance of the intercellular
      communication during neuronal cell differentiation. From these results, we
      propose a survey of the function of the gap-junctional communication as a
      probable useful marker for evaluating the safety of tissue-engineered products.

PMID- 11211091
TI  - Recombinant growth hormone delivery systems based on vinylpyrrolidone
      hydroxyethyl methacrylate copolymer matrices: monitoring optimization by
      capillary zone electrophoresis.
AB  - Experimental conditions for the fabrication of two new polymeric devices (i.e.
      films and slabs) useful for the controlled release of recombinant growth hormone
      (GH) are given. The release rate is controlled by the resorption profile of the
      vinylpyrrolidone-hydroxyethyl methacrylate (VP-HEMA) tested systems which is
      related to the copolymer composition. The suitability of capillary
      electrophoresis (CE) for following the complete preparation of the different VP
      HEMA devices is shown. Moreover, CE allows simultaneous monitoring of the
      controlled release of GH and dissolved polymer during in vitro experiments. From
      these results, guidelines are given for the fabrication of polymeric devices
      containing protein as active drug as well as for the correct selection of
      conditions during in vitro experiments.

PMID- 11211092
TI  - In vitro evaluation of the biofunctionality of osteoblasts cultured on DegraPol
      foam.
AB  - The biofunctionality of osteoblasts cultured on DegraPol-foam, a biodegradable,
      elastic, and highly porous polyesterurethane-foam, was determined here to examine
      the possible use of this structure as bone repair material. Osteoblasts from rat
      tibia and from the cell line (MC3T3-E1) exhibited relatively high attachment and
      low doubling time that result in a confluent cell multilayer on the surface of
      the foam. They produced high concentrations of collagen type I and osteocalcin,
      and expressed increasing alkaline phosphatase activity. Exposure to 1,25
      dihydroxy vitamin D (Vit. D) increased dose- and time-dependent alkaline
      phosphatase activity and osteocalcin concentration, and decreased the level of
      collagen type I and cell density. Maximal effects of Vit. D on alkaline
      phosphatase activity (2.2 fold), osteocalcin (1.5 fold), collagen type I (50%
      reduction), and on cell density (35% reduction) were found at 100 ng Vit. D ml(
      1). Osteoblasts cultured on DegraPol-foam in the presence of Vit. D exhibited
      more spreading and less spindle-like morphology than cells cultured in the
      absence of Vit. D. Cell ingrowth into the pores of the foam was not affected by
      Vit. D treatment. Taken collectively, the osteoblasts, capability of responding
      to Vit. D confirms the osteoblast compatibility of DegraPol-foam and the possible
      use of this scaffold in the bone healing process.

PMID- 11211093
TI  - In vitro study of blood-contacting properties and effect on bacterial adhesion of
      a polymeric surface with immobilized heparin and sulphated hyaluronic acid.
AB  - The blood-contacting properties and the effect on bacterial adhesion of a
      material based on polyurethane and poly(amido-amine) (PUPA), both in its native
      form and with the anticoagulant molecules heparin or sulphated hyaluronic acid
      (HyalS3.5) electrostatically bonded to its surface, were evaluated and compared
      in vitro. The presence of the biological molecules on the surface was revealed by
      a dye test and ATR/FTIR analysis. Bound heparin was found to maintain its
      physiological action, in terms of thrombin inactivation, as well as did free
      heparin. Moreover, it reduced the degree of platelet adhesion. On the contrary,
      bound HyalS3.5 lost its anticoagulant activity, though it reduced platelet
      adhesion. The number of platelets on both modified surfaces was low. Their shape
      distribution, as determined by SEM, did not differ significantly on the two
      modified surfaces or with respect to the bare PUPA surface. HyalS3.5 and heparin
      also inhibited adhesion of Staphylococcus epidermidis to the material. A possible
      relationship between the platelet and bacterial adhesion is ascribed to the
      mediating role of plasma proteins.

PMID- 11211094
TI  - Thermally reversible VPBA-NIPAM copolymer gels for nucleotide adsorption.
AB  - A thermosensitive gel matrix was prepared by free radical copolymerization of N
      isopropylacrylamide (NIPAM) with a boronic acid-carrying monomer (i.e. 4
      vinylphenylboronic acid, VPBA). The synthesis of the gel was performed at 70
      degrees C in an alcohol-water mixture, using azobisisobutyronitrile and
      methylenebisacrylamide as the initiator and the crosslinker, respectively. To
      produce thermosensitive gels with a higher diol-binding affinity, an amino
      containing comonomer, N-[3-(dimethylamino)propyl]methacrylamide (DMAPM) was
      included in the gel formation recipe. Thermally reversible VPBA-NIPAM and VPBA
      DMAPM-NIPAM gels with different swelling properties were obtained by changing the
      feed concentrations of VPBA and DMAPM. To test the usability of the produced gels
      as sorbents in nucleotide adsorption, beta-nicotinamide adenine dinucleotide
      (beta-NAD) was selected as a model biomolecule. Then the adsorption isotherm for
      beta-NAD was obtained at +4 degrees C in HEPES buffer medium with a pH of 8.5.
      The support material was in a highly swollen form under these conditions, due to
      its thermosensitive character. This property was then used to enhance beta-NAD
      adsorption onto the gel matrix. Equilibrium adsorption capacities up to 70 mg
      beta-NAD/g dry gel could be achieved with the thermosensitive support prepared
      with the 12.9 mol% VPBA feed. The gels produced with higher VPBA and DMAPM feed
      concentrations exhibited higher equilibrium adsorption capacities for beta-NAD.

PMID- 11211095
TI  - Functional evaluation of poly-(N-p-vinylbenzyl-O-beta-D-galactopyranosyl-[1-4]-D
      gluconamide)(PVLA) as a liver specific carrier.
AB  - Hepatocytes express the specific C-type lectin, asialoglycoprotein (ASGP)
      receptor, on the surface to remove the ligand-bearing proteins from circulation.
      The specific expression and ligand specificity are thought to be the ideal
      characters for the target of drug or gene delivery. Various galactose-bearing
      molecules were synthesized for this purpose. However, the biological or
      functional interaction of these molecules with the ASGP receptor still remains to
      be elucidated. In this study. we evaluated the functional ability of synthetic
      galactose polymer ligand, poly-(N-p-vinylbenzyl-O-beta-D-galactopyranosyl-[1-4]-D
      gluconamide) (PVLA), to interact with recombinant ASGP receptors using mouse ASGP
      receptor (mouse hepatic lectin; MHL) gene-transfected CHO cells. PVLA-coated
      beads bound to and were endocytosed by the whole (MHL-1/-2) ASGP receptor
      expressing CHO cells like hepatocytes while PVMA (poly-(N-p-vinylbenzyl-O-beta-D
      glucopyranosyl-[1-4]-D-gluconamide) did not. Interestingly, PVLA-coated beads
      were also endocytosed by either MHL-1 or MHL-2 alone expressing cells, which are
      known to be incapable of endocytosing natural ligands. In addition, the
      endocytosis of PVLA-coated beads by MHL-expressing CHO cells or primary
      hepatocytes was inhibited only by soluble PVLA but not by the same galactose
      molecular concentration of soluble asialofetuin. Furthermore, PVLA-coated beads
      were endocytosed by primary hepatocyte to a significantly higher degree than
      asialofetuin-coated beads in vitro. These results suggest that PVLA has higher
      affinity to the ASGP receptor than the natural ligands in blood. Consistently, it
      was demonstrated that intravenously injected FITC-labeled PVLA but not PVMA
      drastically accumulated in parenchymal cells of the liver in vivo. Taken
      together, PVLA exhibiting higher affinity with hepatocytes than natural ligands
      is thought to be an attractive and practical carrier-ligand for liver targeting.

PMID- 11211096
TI  - Poly(2-hydroxy ethyl methacrylate)-alkaline phosphatase: a composite biomaterial
      allowing in vitro studies of bisphosphonates on the mineralization process.
AB  - We have immobilized the mineralizing agent alkaline phosphatase (AlkP) in a
      hydrophilic polymer: poly(2-hydroxy ethyl methacrylate) - (pHEMA) - in a
      copolymerization technique. Histochemical study on polymer sections revealed that
      AlkP has retained its enzymic activity. The image analysis of sections using a
      tessellation method showed a lognormal distribution of the area of the tiles
      surrounding AlkP particles, thus confirming a homogeneous distribution of the
      enzyme in the polymer. Pellets of pHEMA-AlkP were incubated with a synthetic body
      fluid containing organic phosphates (beta-glycerophosphate). Mineral deposits
      with a rounded shape (calcospherites) were obtained in about 17 days. We have
      investigated the effects of three bisphosphonic pharmacological compounds
      (etidronate, alendronate and tiludronate) on this system which mimics the
      mineralization process of cartilage and woven bone. Bisphosphonates at a
      concentration of 10(-2) M totally inhibited AlkP in solution at a concentration
      of 10(-4) mg/ml. Inhibition has been reported being due to the chelation of a
      metal cofactor (Zn2+). Etidronate and alendronate appeared to similarly inhibit
      the calcospherite deposition onto the pHEMA-AlkP material. Both bisphosphonates
      possess three sites for the mineral complexion by Ca chemisorbtion. On the other
      hand, tiludronate having only two sites, was associated with a reduced inhibitory
      effect on mineralization but larger crystals were obtained. The pHEMA-AlkP
      material contains an immobilized enzyme in a hydrogel and mimics the
      physiological conditions of matrix vesicles entrapped within the cartilage (or
      bone) matrix. It provides an interesting method to study the effects of
      pharmacological compounds on the mineralization process in bone and cartilage in
      a non cellular and protein-free model.

PMID- 11211097
TI  - Clinical long-term in vivo evaluation of poly(L-lactic acid) porous conduits for
      peripheral nerve regeneration.
AB  - It was the purpose of this study to evaluate the clinical long-term effects of
      PLLA degradation in vivo on nerve regeneration in the rat sciatic nerve model.
      Thirty-one Sprague Dawley rats were utilized. Two groups of animals were
      selected. The control group of 10 animals received a 12 mm reversed isograft into
      the right sciatic nerve from 5 donor animals. The experimental group (n = 21)
      received a 12 mm empty PLLA conduits placed into a 12 mm defect in the right
      sciatic nerve. The left leg served as an internal control. Walking track analysis
      was performed monthly through 8 months. At the end of 4 and 8 months, animals in
      the control isograft and experimental group had the medial and lateral
      gastrocnemius muscles harvested and weighed for comparison. The
      midconduit/isograft and the distal nerve in these same animals were harvested and
      histomorphologically analyzed. Multiple samples were collected and expressed as
      means +/- standard error. A two-sample t-test and Wilcoxon rank sum test was used
      to compare the variables. Significance level was set at alpha = 0.05. After
      Bonferroni correction for multiple testing, a p value of < or = 0.01 was
      considered statistically significant. Throughout all time periods, the PLLA
      conduit remained structurally intact and demonstrated tissue incorporation and
      vascularization. There was no evidence of conduit collapse or breakage with limb
      ambulation. Moreover, there was no evidence of conduit elongation at 8 months as
      previously observed with the 75:25 poly(DL-lactic-co-glycolic acid) (PLGA)
      conduits. The mean absolute value of the sciatic functional index (SFI)
      demonstrated no group differences from isograft controls measured over the 8
      months except at 3 months where the isograft values were higher (p = 0.0379) and
      at 7 months were the isograft group was significantly lower (p = 0.0115). At 4
      and 8 months, the weight of the gastrocnemius muscles of the experimental group
      was not significantly different from isografts. At 4 months the number of
      axons/mm2 and nerve fiber density was not significantly different between the
      isograft control and experimental groups in either the midconduit/isograft or
      distal nerve. At 8 months the number of axons/mm2 was significantly lower in the
      isograft compared to the midconduit experimental group (p = 0.006). The number of
      axons/mm2 in the distal nerve and the nerve fiber density in the midconduit and
      distal nerve were not significantly different between the two groups. The study
      confirmed our initial hypothesis that PLLA conduits are a viable scaffold for
      clinical long-term nerve gap replacement. We are critically aware however that
      longer evaluation of polymer degradation is warrented. Further studies on these
      individual nerve components are continuing, with the ultimate goal being the
      fabrication of a bioactive conduit that meets or exceeds the functional results
      of isografts.

PMID- 11211098
TI  - Developing porosity of poly(propylene glycol-co-fumaric acid) bone graft
      substitutes and the effect on osteointegration: a preliminary histology study in
      rats.
AB  - Bioresorbable bone graft substitutes could eliminate disadvantages associated
      with the use of autografts, allografts and other synthetic materials. We
      investigated a bioresorbable bone graft substitute made from the unsaturated
      polyester poly(propylene fumarate) which is crosslinked in the presence of
      soluble and insoluble calcium filler salts. This compact bone graft substitute
      material develops porosity in vivo by leaching of the soluble filler salts. In
      attempt to develop materials whose in vivo porosity can be designed such that
      implant degradation would occur at a rate that remains supportive of the overall
      structural integrity of the repairing defect site, we studied the early tissue
      response upon implantation in a bony defect. Three grout formulations of varying
      solubilities using slightly soluble hydroxyapatite (HA) and soluble calcium
      acetate (CA) were evaluated in 3 mm holes made in the anteromedial tibial
      metaphysis of 200 g Sprague Dawley rats (n = 16 per formulation for a total of 48
      animals). Grout formulations cured in situ. Animals from each formulation were
      sacrificed in groups of 8 at 4 days and 3 weeks postoperatively. Histologic
      analysis of the healing process revealed improved in vivo osteointegration of
      bone graft substitutes when a higher loading of calcium acetate was employed. All
      formulations maintained implant integrity and did not provoke sustained
      inflammatory responses. This study suggested that the presence of a soluble salt
      permits in vivo development of porosity of a poly(propylene fumarate) based bone
      graft substitute material.

PMID- 11211099
TI  - Bone formation at a rabbit skull defect by autologous bone marrow cells combined
      with gelatin microspheres containing TGF-beta1.
AB  - The objective of the present study is to investigate the addition effect of
      transforming growth factor (TGF)-beta1 on the bone formation at a rabbit skull
      defect induced by autologous bone marrow (BM). Following application of gelatin
      microspheres containing TGF-beta1, with or without BM cells to skull bone
      defects, bone formation at the defect was assessed by soft X-ray, dual energy X
      ray absorptometry (DEXA), and histological examinations. After implantation for 6
      weeks, gelatin microspheres containing 0.05 microg of TGF-beta1 plus 10(6) of BM
      cells induced bone formation at the 6 mm diameter bone defect. The defect was
      histologically closed by newly formed bone tissue, whilst both gelatin
      microspheres containing 0.05 microg of TGF-beta1, and 10(6) and 10(7) of BM cells
      were ineffective. A DEXA experiment revealed that combination of gelatin
      microspheres containing TGF-beta1 with BM cells enhanced the bone mineral density
      at the skull defect to a significantly greater extent than other agents. These
      findings indicate that a combination of gelatin microspheres containing TGF-beta1
      enabled BM cells to enhance the osteoinductive ability, resulting in bone
      formation even at the cell number at which BM cells alone were ineffective.

PMID- 11211100
TI  - Cytoskeletal interactions determine the electrophysiological properties of human
      EAG potassium channels.
AB  - The electrophysiological properties of ether a go-go (EAG) potassium channels are
      modified during the cell cycle when they are expressed in heterologous systems.
      In Chinese hamster ovary (CHO) mammalian somatic cells we found that the cell
      cycle-dependent modulation of human EAG (hEAG) channels occurs during the M
      phase. This modulation has three components: reduction in current density,
      increased sensitivity to block by intracellular sodium, and increased selectivity
      for potassium ions. In this work, these three properties have been used to define
      the mitotic phenotype of EAG currents. The signaling pathway leading to such
      changes of channel properties is unknown. We tested the hypothesis that
      cytoskeletal interactions might affect the electrophysiological changes observed
      during the cell cycle. The disruption of actin filaments induces a significant
      increase in current density, without inducing the cell-cycle-related phenotype.
      In contrast, disturbance of the microtubules, achieved by pharmacological means
      or by mechanical excision of the membrane patch, does induce the cell-cycle
      related phenotype. Our results demonstrate that hEAG channels establish complex
      interactions with cytoskeletal elements, and that these interactions strongly
      influence the properties of the channels. We also conclude that the
      electrophysiological changes observed during the cell cycle are most likely due
      to reorganization of the cytoskeleton during the G2/M transition.

PMID- 11211101
TI  - Quartz glass pipette puller operating with a regulated oxy-hydrogen burner.
AB  - Quartz glass electrodes are superior to conventional glass electrodes for low
      noise recording. They have better electrical characteristics and hydrophobic
      surfaces which resist creeping of salt solutions. We used oxy-hydrogen heating
      with program-controlled gas pressure to melt quartz glass capillaries. Usually,
      the relative wall thickness (the quotient of the outer and inner diameters do/di)
      of capillaries is, at best, maintained up to the electrode tip. If tips with
      thicker walls can be produced, coating and other surface treatments can be
      avoided. We found that programmed heating periods without pull allowed an
      fivefold increase of do/di in the tip region. Since do/di is inversely
      proportional to input capacity, the recording noise was minimized and became
      insignificant relative to amplifier and holder noise. A sample patch-clamp
      recording is shown.

PMID- 11211102
TI  - Modulation of recombinant T-type Ca2+ channels by hypoxia and glutathione.
AB  - T-type Ca2+ channels are expressed in a wide variety of central and peripheral
      neurons and play an important role in neuronal firing and rhythmicity. Here we
      examined the effects of hypoxia on the recently cloned T-type Ca2+ channel
      alpha1G, alpha1H and alpha1I subunits, stably expressed in HEK 293 cells. In
      cells expressing the human alpha1H or the rat alpha1I subunit, Ca2+ channel
      currents were inhibited reversibly by hypoxia (PO2<110 mm Hg). The degree of
      inhibition was more marked in cells expressing the a1H subunit. This hypoxic
      inhibition was not voltage dependent. In cells expressing the rat alpha1G
      subunit, hypoxia caused no detectable reduction in Ca2+ channel activity.
      Regardless of the channel type examined, hypoxia was without effect on the
      kinetic properties of the Ca2+ current (activation, inactivation and
      deactivation) or on steady-state inactivation. Ca2+ current through the alpha1H
      subunit was enhanced by the reducing agent reduced glutathione (GSH; 2 mM) and
      inhibited by oxidised glutathione (GSSG; 2 mM). In contrast, Ca2+ current through
      the alpha1G subunit was unaffected by GSH. In alpha1H cells, neither GSH nor GSSG
      had any effect on the ability of hypoxia to reduce Ca2+ current amplitudes. Thus,
      different members of the T-type Ca2+ channel family are differently regulated by
      hypoxia and redox agents. Hypoxic regulation of the alpha1H subunit appears to be
      independent of changes in levels of the intracellular redox couple GSSG:GSH.

PMID- 11211103
TI  - Muscarinic stimulation does not induce rhoA/ROCK-mediated Ca2+ sensitization of
      the contractile element in chicken gizzard smooth muscle.
AB  - We have attempted to determine whether muscarinic stimulation induces RhoA/ROCK
      mediated Ca2+ sensitization of contractions in chicken gizzard smooth muscles.
      rhoA is a small GTP-binding protein, and ROCK is a rhoA-associated coiled coil
      forming serine/threonine kinase. The relationship between the cytosolic Ca2+
      level ([Ca2+]i) and muscle force in the presence of a high K+ concentration was
      not different from that in the presence of carbachol. Verapamil inhibited muscle
      force in proportion to the decrease in [Ca2+]i in both the muscle stimulated with
      high K+ and that stimulated with carbachol. In addition, Y-27632 (10 microM), a
      ROCKs inhibitor, had no effect on the contractions. In the alpha-toxin
      permeabilized muscles, Ca2+ induced a greater contraction in the presence of
      guanosine 5'-O-(3-thiotriphosphapte) (GTP[gamma-S]), whereas carbachol with GTP
      was not effective. The GTP[gamma-S]-induced Ca2+ sensitization was completely
      inhibited by Clostridium botulinum exoenzyme C3. Western blot analysis revealed
      both rhoA and ROCKII in the muscle extract. In addition, reverse transcriptase
      polymerase chain reaction (RT-PCR) analysis revealed the expression of both ROCKI
      and ROCKII mRNAs. These results suggest that Ca2+ sensitization in the chicken
      gizzard is elicited via a rhoA/ROCKs pathway, and that this pathway may be
      responsible for the augmentation of contraction by GTP[gamma-S] in the
      permeabilized muscles. If such a pathway does exist, however, carbachol-induced
      contraction may not be coupled to it, which explains the absence of Ca2+
      sensitization in the intact chicken gizzard stimulated by carbachol.

PMID- 11211104
TI  - Alteration of the membrane lipid environment by L-palmitoylcarnitine modulates
      K(ATP) channels in guinea-pig ventricular myocytes.
AB  - Sarcolemmal adenosine 5'-triphosphate-sensitive K+ channels (K(ATP)) are
      dramatically up-regulated by a membrane phospholipid, phosphatidyl-inositol-4,5
      bisphosphate (PIP2). During ischaemia, L-palmitoylcarnitine (L-PC), a fatty acid
      metabolite, accumulates in the sarcolemma and deranges the membrane lipid
      environment. We therefore investigated whether alteration of the membrane lipid
      environment by L-PC modulates the K(ATP) channel activity in inside-out patches
      from guinea-pig ventricular myocytes. L-PC (1 microM) inhibited KATP channel
      activity, without affecting the single channel conductance, through interaction
      with Kir6.2. L-PC simultaneously enhanced the ATP sensitivity of the channel
      [concentration for half-maximal inhibition (IC50) fell from 62.0+/-2.7 to 30.3+/
      5.5 microM]. In contrast, PIP2 attenuated the ATP sensitivity (IC50 343.6+/-54.4
      microM) and restored Ca2+-induced inactivation of KATP channels (94.1+/-13.7% of
      the control current immediately before the Ca2+-induced inactivation).
      Pretreatment of the patch membrane with 1 microM L-PC, however, reduced the
      magnitude of the PIP2-induced recovery to 22.7+/-6.3% of the control (P<0.01 vs.
      94.1+/-13.7% in the absence of L-PC). Conversely, after the PIP2-induced
      recovery, L-PC's inhibitory action was attenuated, but L-PC partly reversed the
      PIP2-mediated decrease in the ATP sensitivity (IC50 fell from 310+/-19.2 to
      93.1+/-9.8 microM). Thus, interaction between L-PC and PIP2 in the plasma
      membrane appears to regulate K(ATP) channels.

PMID- 11211106
TI  - The distribution of calcium in toad cardiac pacemaker cells during spontaneous
      firing.
AB  - Isolated, spontaneously active pacemaker cells from the sinus venosus region of
      the toad heart were loaded with the calcium indicator fluo-3. The cells were
      examined with a confocal microscope to investigate the distribution of calcium
      during spontaneous activity. Three classes of calcium-related signals were
      present. First, intense, localised, time-invariant signals were detected from
      structures distributed across the cell interior. Based on the insensitivity to
      saponin and the distribution in the cell, these signals appear to arise from fluo
      3 located in the sarcoplasmic reticulum and the nuclear envelope. Second,
      spatially uniform signals from the cytoplasm were present at rest and showed
      spontaneous increases in [Ca2+]i which propagated along the cell. These Ca2+
      transients were uniform in intensity across the diameter of the cell and we could
      detect no significant delay in the middle of the cell compared to the edges.
      However, within the nucleus the Ca2+ transient showed a clear delay compared to
      the cytoplasm. Third, localised, transient increases in [Ca2+]i (Ca2+ sparks)
      which did not propagate were also detectable. These could be detected both near
      the surface membrane and in the interior of the cell and reduced in magnitude and
      increased in duration in the presence of ryanodine. The frequency of firing of
      Ca2+ sparks significantly increased in the 200-ms period preceding a spontaneous
      Ca2+ transient. These results suggest that pacemaker cells contain sarcoplasmic
      reticulum which is distributed across the cell. The Ca2+ transient is uniform
      across the cell indicating that near-synchronous release of Ca2+ from the
      sarcoplasmic reticulum is achieved. Ca2+ sparks occur in pacemaker cells though
      their role in pacemaker function remains to be elucidated.

PMID- 11211105
TI  - Characterization of the large-conductance Ca-activated K channel in myocytes of
      rat saphenous artery.
AB  - We used the patch-clamp method to characterize the BK channel in freshly isolated
      myocytes from the saphenous branch of the rat femoral artery. Single-channel
      recordings revealed that the BK channel had a conductance of 187 pS in
      symmetrical 150 mM KCl, was blocked by external tetraethylammonium (TEA) with a
      KD(TEA) of approx. 300 microM at +40 mV, and by submicromolar charybdotoxin
      (CTX). The sensitivity of the BK channel to Ca was especially high (KD(ca)
      approx. 0.1 microM at +60 mV) compared to skeletal muscle and neuronal tissues.
      We also investigated the macroscopic K current, which under certain conditions is
      essentially sustained by BK channels. This conclusion is based on the findings
      that the macroscopic current activated upon depolarization follows a single
      exponential time course and is virtually fully blocked by 100 nM CTX and 5 mM
      external TEA. We made use of this occurrence to assess the voltage and Ca
      dependence of the macroscopic BK current. In intact myocytes, the BK channel
      showed a strong and voltage-dependent reduction of the outward current (62% at
      +40 mV), most likely due to block by intracellular Ba and polyamines. The results
      obtained from macroscopic and unitary current indicate that approx. 2.5% of the
      BK channels are active under physiological conditions, sustaining approx. 20 pA
      of outward current. Given the high input resistance of these cells, few BK
      channels are required to open in order to cause a significant membrane
      hyperpolarization, and thus function to limit the contraction resulting from
      acute increases in intravascular pressure, or in response to hypertensive
      pathologies.

PMID- 11211107
TI  - Both linopirdine- and WAY123,398-sensitive components of I K(M,ng) are modulated
      by cyclic ADP ribose in NG108-15 cells.
AB  - The "M-like" current in NG108-15 cells has two components carried by different K+
      channels: a fast-deactivating component, analogous to IK(M) in sympathetic
      neurones and carried by KCNQ2/3 channels, and a more slowly deactivating
      component carried by murine erg1 (merg1) channels. The former is selectively
      blocked by linopirdine (< or =10 microM), the latter by WAY123,398 (< or =10
      microM). Bradykinin (100 nM) inhibited 76% of the KCNQ component of current
      compared with 12% of the merg component. Cyclic ADP ribose (cADPR, 2 microM),
      introduced via the patch pipette, caused a rundown of both current components.
      Acetylcholine (100 microM) inhibited 89% of the KCNQ component of current
      compared to 34% of the merg component. After 15 min of intracellular dialysis
      with the cADPR antagonist 8-amino-cADP ribose (100 microM), the inhibition
      reduced to 40% and 19% and after 30 min it was further reduced to 8% and 5% for
      the KCNQ currents and merg currents respectively. These data show that both KCNQ
      and merg currents in NG108-15 cells can be modulated by either bradykinin or M1
      muscarinic receptors. The inhibition of the KCNQ current component is more
      pronounced than that of the merg component. These results suggest that cADPR
      might be involved in M1-muscarinic inhibition of both KCNQ2/3 and merg1 channels.

PMID- 11211108
TI  - Cyclooxygenase 2 and neuronal nitric oxide synthase expression in the renal
      cortex are not interdependent in states of salt deficiency.
AB  - Neuronal nitric oxide synthase (nNOS) and cyclooxygenase-2 (COX-2) expression in
      the kidney are localized to the cortical thick ascending limb of the loop of
      Henle (cTALH), including the macula region, and increase after salt restriction.
      Because of the similar localization and regulation of nNOS and COX-2 expression,
      we have examined whether there is a functional interrelationship between the
      expression of the two enzymes. Male Sprague Dawley rats were fed for 1 week
      either a low-salt diet (0.02% w/w) which produced moderate increases of nNOS and
      COX-2 expression, or low salt combined with the angiotensin I converting enzyme
      inhibitor ramipril (10 mg/kg per day), which produced strong increases of
      renocortical nNOS and COX-2 expressions. To inhibit nNOS or COX-2 activities,
      animals received in addition N(G)-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg
      per day) or rofecoxib (10 mg/kg per day) for 1 week, respectively. L-NAME
      treatment did not change COX-2 expression and conversely rofecoxib treatment did
      not change nNOS expression in the kidney cortex under any experimental
      conditions. L-NAME but not rofecoxib attenuated renin mRNA levels. Rofecoxib
      markedly reduced renal prostanoid excretion. These findings suggest that under
      these conditions the control of nNOS and COX-2 gene expression in the macula
      densa regions of the kidney cortex are not dependent on each other.

PMID- 11211109
TI  - An intact central nervous system is not necessary for insulin-mediated increases
      in leg blood flow in humans.
AB  - Insulin mediates an increase in blood flow in the skeletal muscle. This may be
      brought about through recruitment of sympathetic vasodilatory nervous activity in
      the central nervous system (CNS). Insulin may also mediate the vasodilatation by
      locally acting mechanisms in the skeletal muscle, which in turn could be
      modulated by vasoconstrictive sympathetic nervous activity. Five men with
      complete motoric lesions of their cervical spinal cord (SCI) and nine healthy (H)
      men underwent a hyperinsulinemic (480 mU x min(-1) x m(-2)), euglycemic clamp
      combined with arterio-venous catheterization of one leg and microdialysis of the
      thigh muscle. In response to hyperinsulinemia leg blood flow increased similarly
      in the two groups. Leg glucose extraction and uptake were significantly lower in
      SCI compared with H. Two hours post clamp, leg glucose uptake rates had not yet
      returned to basal values. Norepinephrine concentrations in arterial plasma and in
      the dialysate (reflecting extracellular fluid) did not change in response to
      insulin in either group, but increased in response to suprapubic bladder tapping
      in the SCI. Potassium balance measured by microdialysis shifted from a net
      release to a net uptake in response to insulin, with no difference between SCI
      and H. In conclusion, the mechanism by which insulin mediates an increase in
      skeletal muscle blood flow is not due to a CNS recruitment of sympathetic
      vasodilatory nervous activity. Nor is the insulin-mediated vasodilatation
      modulated by vasoconstrictive sympathetic nervous activity. The vasodilatation
      seen in response to hyperinsulinemia is a locally acting mechanism. People with
      SCI are markedly insulin resistant compared with able-bodied individuals.

PMID- 11211110
TI  - IK.ACh activation by arachidonic acid occurs via a G-protein-independent pathway
      mediated by the GIRK1 subunit.
AB  - The molecular target of arachidonic-acid-derived metabolites, serving as second
      messengers that activate atrial acetylcholine-activated potassium current
      (IK.ACh) in addition to G-protein beta/gamma subunits (Gbeta/gamma), is unknown.
      Co-expression of two isoforms of G-protein-activated, inwardly rectifying
      potassium channels (GIRKs) in oocytes of Xenopus laevis revealed that these
      heterologous co-expressed GIRKs, which are responsible for the formation of
      IK.ACh in the atrium, are activated by arachidonic acid metabolites, like their
      counterparts in atrial cells. The expression of homooligomeric GIRK1(F137S) and
      GIRK4wt channels revealed that this activatory mechanism is specific to the GIRKI
      subunit. Sequestrating available Gbeta/gamma by overexpression of C-betaARK (a
      Gbeta/gamma binding protein) failed to abolish the activation of GIRK currents by
      arachidonic acid. From our experiments we conclude that the GIRKI subunit itself
      is the molecular target for regulation of GIRK channels by arachidonic acid
      metabolites.

PMID- 11211111
TI  - Role of receptor protein tyrosine phosphatase alpha (RPTPalpha) and tyrosine
      phosphorylation in the serotonergic inhibition of voltage-dependent potassium
      channels.
AB  - The activity of voltage-gated potassium (Kv) channels can be dynamically
      modulated by several events, including neurotransmitter-stimulated biochemical
      cascades mediated by G-protein-coupled receptors. By using a heterologous
      expression system, we show that activating the 5-HT2C receptor inhibits both
      Kv1.1 and Kv1.2 channels through a tyrosine phosphorylation mechanism. The major
      molecular determinants of channel inhibition were identified as two tyrosine
      residues located in the N-terminal region of the Kv channel subunit. Furthermore,
      we demonstrate that receptor protein tyrosine phosphatase alpha (RPTPalpha), a
      receptor protein tyrosine phosphatase, co-ordinates the inhibition process
      mediated via 5-HT2C receptors. We therefore propose that the serotonergic
      regulation of human Kv1.1 and Kv1.2 channel activity by the 5-HT2C receptor
      involves the dual coordination of both RPTPalpha and specific tyrosine kinases
      coupled to this receptor.

PMID- 11211112
TI  - Early and long-term changes of equine skeletal muscle in response to endurance
      training and detraining.
AB  - Twenty-four 4-year-old Andalusian (Spanish breed) stallions were used to examine
      the plasticity of myosin heavy chain (MHC) phenotype and the metabolic profile in
      horse skeletal muscle with long-term endurance-exercise training and detraining.
      Sixteen horses underwent a training programme based on aerobic exercises for 8
      months. Afterwards, they were kept in paddocks for 3 months. The remaining eight
      horses were used as controls. Three gluteus medius muscle biopsy samples were
      removed at depths of 20, 40 and 60 mm from each horse before (month 0), during
      (month 3) and after (month 8) training, and again after 3 months of detraining
      (month 11). MHC composition was analysed by electrophoresis and
      immunohistochemistry with anti-MHC monoclonal antibodies. Fibre areas, oxidative
      capacity and capillaries were studied histochemically. The activities of key
      muscle enzymes of aerobic (citrate synthase and 3-hydroxy-acyl-CoA-dehydrogenase)
      and anaerobic (phosphofructokinase and lactic dehydrogenase) metabolism and the
      intramuscular glycogen and triglyceride contents were also biochemically
      analysed. Early changes with training (3 months) included hypertrophy of type IIA
      fibres, a reduction of MHC-IIX with a concomitant increase of MHC-IIA, a rise in
      the number of high-oxidative fibres and in the activities of aerobic muscle
      enzymes and glycogen content. Long-term changes with training (8 months) were a
      further decline in the expression of MHC-IIX, an increase of slow MHC-I,
      additional increases of high-oxidative fibres, capillary density, activities of
      aerobic enzymes and endogenous glycogen; intramuscular lipid deposits also
      increased after 8 months of training whereas the activities of anaerobic enzymes
      declined. Most of exercise-induced alterations reverted after 3 months of
      detraining. These results indicate that endurance-exercise training induces a
      reversible transition of MHC composition in equine muscle in the order IIX-->IIA-
      >I, which is coordinated with changes in the metabolic properties of the muscle.
      Furthermore, a dose-response relationship was evident between the duration (in
      total) of training and the magnitude of muscle adaptations.

PMID- 11211113
TI  - Involvement of the catecholaminergic system in glucagon-induced thermogenesis in
      Muscovy ducklings (Cairina moschata).
AB  - Physiological studies have shown that glucagon is a potential mediator of
      nonshivering thermogenesis (NST) in birds. The present work was undertaken in
      order to investigate whether the observed thermogenesis results from a direct
      action of glucagon on avian thermoregulatory mechanisms or in fact requires the
      participation of other agents such as catecholamines. Our experiments were
      performed using cold-acclimated (CA) ducklings which developed muscle NST. A
      comparison was made with thermoneutral (TN) ducklings of the same age. Our
      principal results showed that: (1) at ambient temperature (25 degrees C),
      circulating norepinephrine (NE) was markedly decreased in CA ducklings (-42%),
      while circulating epinephrine (E) did not undergo any consistent change; (2) in
      CA and TN ducklings, an intraperitoneal injection of glucagon (360 microg x kg(
      1)) was followed after 10 min by prominent lipolysis and a large increase in
      circulating NE (4- to 6-fold) and E (14- to 17-fold), which was sustained for at
      least 1 h. The elevation of circulating NE was less pronounced in CA ducklings.
      The thermogenic action of glucagon in birds is probably indirect and involves at
      least the mobilization of lipids and sympatho-adrenal stimulation. The changes in
      peripheral noradrenergic activity during cold acclimation could be associated
      with adaptive changes leading to NST.

PMID- 11211114
TI  - Cell volume-sensitive sodium channels upregulated by glucocorticoids in U937
      macrophages.
AB  - Glucocorticoids exert their anti-inflammatory action in part by influencing
      macrophages. As regulation of macrophage function involves ion channels, the
      present study was performed to elucidate the influence of glucocorticoids on
      macrophage ion channel activity. To this end, the effects of corticosteroids on
      the sodium conductance in human monocytic cells (U937) was studied using whole
      cell and outside-out patch-clamp techniques. Increasing extracellular osmolarity
      from 310 to 420 mosmol/kg led to cell shrinkage followed by marked activation of
      inward whole-cell current from -36+/-2 to -72+/-9 pA (n=13; recorded at -150 mV
      voltage with CsCl intracellular solution, NaCl extracellular solution) while
      outward current remained unchanged. The increase of inward current was
      accompanied by a positive shift of reversal potential and was sensitive to
      amiloride (100 microM). The activation of inward current by shrinkage was not
      observed when external sodium was replaced by potassium, indicating that the
      shrinkage-stimulated conductance is sodium selective. Outside-out single-channel
      measurements revealed a unitary conductance of 6+/-1 pS (n=5) for the sodium
      selective amiloride-sensitive current. Pretreating the cells with
      deoxycorticosterone (100 nM/6 h) markedly upregulated the shrinkage-activated Na+
      current. In conclusion, human macrophage-like U937 cells express a sodium
      selective shrinkage-activated channel which is upregulated by corticosteroids.
      Activation of the channel may increase cell volume, an effect of glucocorticoids
      in other cells.

PMID- 11211115
TI  - Na+-independent proton secretion in MDCK-C11 cells.
AB  - In this work we studied the proton secretion mechanisms in recently cloned MDCK
      C11 cells. We measured intracellular pH (pHi) in monolayers grown on permeable
      filters, using the pH-sensitive probe BCECF and an inverted epifluorescence
      microscope. The cells have a basal pHi of 7.20+/-0.01 (n=136) and after an acid
      releasing NH4Cl pulse pHi recovered at a rate (dpHi/dt) of 0.167+/-0.006 pH
      units/ per minute (n=20). This rate decreased significantly when Na+ was removed
      from both cell surfaces, and was further reduced when they were both perfused
      with a solution containing no Na+ and K+. pHi recovery fell again in the presence
      of concanamycin (at a concentration of 4.6x10(-8) M; a specific inhibitor of the
      vacuolar H+-ATPase). When Na+ was removed from the apical or the basolateral
      side, pHi recovery (in pH units per minute) was significantly reduced to 0.099+/
      0.008 (n=11) and 0.086+/-0.01 (n=10), respectively. The Na+-independent mechanism
      of pHi recovery was significantly inhibited by the presence of 5 x 10(-5) M
      Schering 28080 (an inhibitor of the H+-K+-ATPase) at the apical side (0.065+/
      0.01 versus 0.099+/-0.008 pH units per minute, P<0.05), but not at the
      basolateral side (0.072+/-0.01 versus 0.086+/-0.01 pH units per minute). On the
      other hand, concanamycin inhibited the Na+-independent pHi recovery when applied
      apically (0.0304+/-0.005 pH units per minute, n=7) and basolaterally (0.025+/
      0.004 pH units per minute, n=7). From these results we conclude that monolayers
      of MDCK-C11 cells have a Na+/H+ exchanger and a concanamycin-sensitive H+-ATPase
      on their apical and basolateral membranes; and a K+-dependent, Schering 28080
      sensitive H+-K+-ATPase on their apical side.

PMID- 11211116
TI  - GABA(C) receptors in neuroendocrine gut cells: a new GABA-binding site in the
      gut.
AB  - Although GABA(C) receptors play a crucial role in the mammalian central nervous
      system, their functional expression in peripheral tissues has not yet been
      studied. Using the gut neuroendocrine tumor cell line STC-1 as a model, we
      provide first evidence for the functional expression of GABA(C) receptors in the
      gut: mRNAs of the GABA(C) receptor subunits rho1 and rho2 were detected in STC-1
      cells by reverse transcription polymerase chain reaction (RT-PCR). Applying anti
      rho-antibodies, specific immunostaining for GABA(C) receptors was observed. For
      functional characterization, the effects of GABA(C) receptor activation on
      [Ca2+]i and hormone secretion were studied. The selective GABA(C) receptor
      agonist cis-4-aminocrotonic acid (CACA) induced dose-dependent increases both of
      [Ca2+]i and of hormone (cholecystokinin) secretion. The stimulatory effects of
      CACA were antagonized by the GABA(C) receptor blockers (1,2,5,6-tetrahydropyridin
      4-yl)methylphosphinic acid (TPMPA) and 3-aminopropyl(methyl)phosphinic acid (3
      APMPA). These results demonstrate that GABA(C) receptors play an important role
      in neuroendocrine gastrointestinal secretion.

PMID- 11211118
TI  - How to calculate the single-breath nitric oxide diffusing capacity in rabbits.
AB  - Nitric oxide (NO) is a novel indicator gas for investigating alveolar capillary
      gas exchange conditions. In clinical practice, pulmonary gas uptake is determined
      by measuring the single-breath diffusing capacity (DL,NO). Different algorithms
      are employed to calculate DL,NO. To compare the accuracy of those most commonly
      used, we performed single-breath experiments on 12 artificially ventilated
      rabbits. In each animal four manoeuvres, executing breath-holds of 2, 4, 6 and 8
      s, were carried out. In each case we administered 55 ml of an indicator gas
      mixture containing 0.05% NO. Alveolar gas was analysed by respiratory mass
      spectrometry. The two algorithms for calculating DL,NO based on the conventional
      solution of the breath-holding equation [Ogilvie et al. (1957) J Clin Invest 36:1
      17 and Jones and Meade (1961) Q J Exp Physiol 46:131-143], were compared with the
      three-equation technique [Graham et al. (1980) IEEE Trans Biomed Eng 27:221-227]
      as the reference. The deviation between DL,NO calculated from the conventional
      methods and the reference decreased linearly with increasing duration of NO
      uptake (deltat). The mean deviations declined from 16.6% (Jones and Meade) or
      7.7% (Ogilvie) at deltat=4 s to 5.7% (Jones and Meade) or 2.4% (Ogilvie) at
      deltat=10 s. The larger mean values are due to the conventional solution where
      three-tenths of the inflation time is subtracted from deltat. These findings
      qualify the common prediction that the latter method yields DL,NO values of the
      highest accuracy. We therefore recommend Ogilvie's procedure if the three
      equation technique cannot be employed.

PMID- 11211119
TI  - Influence of exercise intensity on ERK/MAP kinase signalling in human skeletal
      muscle.
AB  - The mitogen-activated protein (MAP) kinase pathways have been highlighted as a
      possible link between exercise and adaptive changes in skeletal muscle. In this
      study, the effect of exercise intensity on the activation of the ERK/MAP kinase
      pathway was investigated in human skeletal muscle. One-leg exercise at low (40%
      maximal oxygen consumption, VO2max for 30 min) and high (75% VO2max for 30 min)
      intensity resulted in 11.5+8. I-fold and 39.7+/-6.3-fold (mean +/-SEM) increases
      in ERK1/2 phosphorylation (P<0.001), respectively. The phosphorylation of MEK1/2,
      the upstream kinase of ERK1/2, increased with exercise intensity (P<0.05) to
      2.5+/-0.9 and 4.8+/-1.1 times the basal level at the low and high intensity,
      respectively. The statistical analysis revealed a systematic difference between
      basal, low and high intensity exercise levels for both kinases. There was no
      change in the phosphorylation of either kinase in the non-exercised leg. The
      phosphorylation of the transcription factor cyclic AMP response element binding
      protein (CREB), a possible downstream target of the ERK/MAP kinase signalling
      pathway, was unaffected by exercise. The phosphorylation of ERK1/2 was
      significantly higher in purified freeze-dried compared to crude wet muscle after
      exercise, whereas the opposite pattern was observed for CREB. In conclusion,
      phosphorylation of ERK1/2 and MEK1/2 increases in an exercise intensity-dependent
      manner in human skeletal muscle and this seems to originate in the muscle fibres
      themselves.

PMID- 11211120
TI  - Potential-dependent steady-state kinetics of a dicarboxylate transporter cloned
      from winter flounder kidney.
AB  - The two-electrode voltage-clamp technique in combination with tracer uptake
      experiments was used to investigate the dependence of dicarboxylate transport
      kinetics on membrane potential in Xenopus laevis oocytes expressing the flounder
      renal high-affinity-type sodium dicarboxylate cotransporter (fNaDC-3). Steady
      state succinate-dependent currents in the presence of Na+ were saturable with an
      apparent affinity constant for succinate, K0.5,succ, of 60 microM. K0.5,succ was
      independent of membrane potential, suggesting succinate binding at the surface of
      the fNaDC-3 protein. The maximal succinate-dependent current, deltaImax,
      increased with hyperpolarization, suggesting that the empty carrier may
      translocate net charge. Succinate-induced currents showed sigmoidal dependence on
      Na+ concentration, and K0.5,Na+ decreased with hyperpolarization, suggesting Na+
      binding in an ion well. Lowering the external Na+ concentration to 20 mM
      increased K0.5,succ approximately threefold. Succinate-induced currents were
      inhibited by Li+ with an Ki,Li+ of approximately 0.5 mM, and a Hill coefficient
      of below unity indicating the interaction of one Li+ ion with an inhibitory site
      at fNaDC-3.

PMID- 11211117
TI  - Effects of anisotropy on the development of cardiac arrhythmias associated with
      focal activity.
AB  - The anisotropy that normally exists in the myocardium may be either enhanced in
      peri-infarction zones by loss of lateral cell connections or reduced by
      redistribution of gap junctions. To test how the degree of anisotropy affects the
      development of ectopic focal activity, we carried out computer simulations in
      which a model of an ectopic focus is incorporated as the central element of a two
      dimensional sheet of ventricular cells. At low values of intercellular coupling
      conductance (Gc), the focus region is spontaneously active, but the limited
      intercellular current flow inhibits propagation. At high Gc, automaticity is
      suppressed by the loading effects of the surrounding cells. At intermediate Gc,
      the ectopic activity may propagate into the sheet. In the case of isotropic
      coupling, the minimum size of the focus region for propagation to occur (in terms
      of number of collaborating cells within the focus) is as small as approximately
      ten cells, and this number decreases with increasing anisotropy. Thus, the
      presence of anisotropy facilitates the development of ectopic focal activity. We
      conclude that the remodeling that occurs in peri-infarction zones may create a
      substrate that either facilitates (enhanced anisotropy) or inhibits (reduced
      anisotropy) the development of cardiac arrhythmias associated with ectopic focal
      activity.

PMID- 11211121
TI  - Inwardly rectifying K+ channels in the basolateral membrane of rat pancreatic
      acini.
AB  - Previous studies of the whole-cell K+ conductance suggest the presence of
      inwardly rectifying K+ channels (Kir) in rat pancreatic acini (RPAs). Here we
      investigate the properties of Kir of RPAs using patch-clamp techniques. The whole
      cell current-to-voltage relationship of freshly isolated RPAs was steeper for
      inward currents than for outward currents when the extracellular K+ concentration
      ([K+]o) was raised. With a high [K+]o (145 mM), external application of Ba2+ and
      Cs+ blocked the inward K+ current in a voltage-dependent manner. The apparent
      IC50 of Ba2+ was 8.5+/-1.9 microM and 1.1+/-0.2 microM at -70 mV and -130 mV,
      respectively (n=5). The IC50 of Cs+ was 3.5+1.1 mM and 0.2+0.1 mM at -60 mV and 
      120 mV, respectively (n=4). Application of Ba2+ (0.1 mM) to the extracellular
      solution reversibly depolarized RPAs from -43+1.1 mV to -37+/-1.2 mV (n=20). In
      the cell-attached configuration with 145 mM KC1 in the pipette solution, we
      observed inwardly rectifying channels with a high open probability (PO) of 0.85+/
      0.02 (n=6) and a slope conductance (Gs) of 30+/-2.8 pS (n=13). The same type of
      channel was observed in the outside-out patch. We could also observe a very small
      conductance K+ channel which was resistant to 0.1 mM Ba2+ and did not show inward
      rectification (n=11). RT-PCR analysis of RPA confirmed the presence of
      transcripts for Kir2.1, Kir2.3 and Kir7.1 subfamilies as molecular candidates for
      the observed channels. The above results demonstrate the presence of Kir channels
      in the basolateral membrane of the RPA, which may be important for the K+
      recycling process during electrolyte secretion as well as for maintaining a
      hyperpolarized membrane.

PMID- 11211122
TI  - Conservation of pH sensitivity in the epithelial sodium channel (ENaC) with
      Liddle's syndrome mutation.
AB  - Gain-of-function mutations of the epithelial Na+ channel (ENaC) cause a rare form
      of hereditary hypertension, Liddle's syndrome. How these mutations lead to
      increased channel activity is not yet fully understood. Since wild-type ENaC (wt
      ENaC) is highly pH-sensitive, we wondered whether an altered pH-sensitivity of
      ENaC might contribute to the hyperactivity of ENaC with Liddle's syndrome
      mutation (Liddle-ENaC). Using Xenopus laevis oocytes as an expression system, we
      compared the pH-sensitivity of wt-ENaC (alphabetagammarENaC) and Liddle-ENaC
      (alphabeta(R564stop)gammarENaC). Oocytes were assayed for an amiloride-sensitive
      (2 microM) inward current (deltaIami) at -60 mV holding potential and cytosolic
      pH was altered by changing the extracellular pH in the presence of 60 mM sodium
      acetate. Alternatively, cytosolic acidification was achieved by proton loading
      the cells using a proton-coupled oligopeptide transporter (PepT-1) co-expressed
      in the oocytes together with ENaC. Cytosolic but not extracellular acidification
      substantially reduced deltaIami while cytosolic alkalinisation had a stimulatory
      effect. This pH-sensitivity was largely preserved in oocytes expressing Liddle
      ENaC. The inhibition of wt-ENaC and Liddle-ENaC by cytosolic acidification was
      independent of so-called sodium-feedback inhibition, since it was not associated
      with a concomitant increase in intracellular Na+ concentration estimated from the
      reversal potential of deltaIami. In addition C-terminal deletions in the alpha or
      gamma subunits or in all three subunits of ENaC did not abolish the inhibitory
      effect of cytosolic acidification. We conclude that ENaC's pH-sensitivity is not
      mediated by its cytoplasmic C-termini and that an altered pH-sensitivity of ENaC
      does not contribute to the pathophysiology of Liddle's syndrome.

PMID- 11211123
TI  - GLUT-4 expression is not consistently higher in type-1 than in type-2 fibres of
      rat and human vastus lateralis muscles; an immunohistochemical study.
AB  - In whole muscle homogenates, the glucose transporter-4 (GLUT-4) content is
      reported to be higher in muscles consisting predominantly of oxidative (type-1)
      muscle fibres than in muscles consisting predominantly of glycolytic (type-2)
      fibres. From these findings, it has been deduced that in rat muscle, oxidative
      fibres have an intrinsically higher level of GLUT-4 protein than glycolytic
      fibres. No data is available concerning human muscle. Moreover, the fibre-type
      specific expression of GLUT-4 has not yet been examined directly. In this study,
      the relative abundance of GLUT-4 protein expression in individual fibres of
      different types within a muscle was compared directly in immunohistochemical
      assays. The human vastus lateralis muscle and a selection of rat muscles were
      studied using a novel GLUT-4 antiserum. It is concluded that the pattern of fibre
      type-specific GLUT-4 expression differs between human and rats and varies between
      the different muscles studied, indicating that non-fibre-type-specific factor(s)
      affect expression of GLUT-4. The observation that within a muscle a fibre-type
      specific expression of GLUT-4 was observed indicates that fibre-type-specific
      factors contribute to GLUT-4 expression as well. Thus, it can be postulated that
      both fibre-type-dependent and fibre-type-independent factors affect GLUT-4
      expression.

PMID- 11211124
TI  - Advantages of smaller body mass during distance running in warm, humid
      environments.
AB  - The purpose of this study was to examine the extent to which lighter runners
      might be more advantaged than larger, heavier runners during prolonged running in
      warm humid conditions. Sixteen highly trained runners with a range of body masses
      (55-90 kg) ran on a motorised treadmill on three separate occasions at 15, 25 or
      35 degrees C, 60% relative humidity and 15 km x h(-1) wind speed. The protocol
      consisted of a 30-min run at 70% peak treadmill running speed (sub-max) followed
      by a self-paced 8-km performance run. At the end of the submax and 8-km run,
      rectal temperature was higher at 35 degrees C (39.5+/-0.4 degrees C, P<0.05)
      compared with 15 degrees C (38.6+/-0.4 degrees C) and 25 degrees C (39.1+/-0.4
      degrees C) conditions. Time to complete the 8-km run at 35 degrees C was 30.4+/
      2.9 min (P<0.05) compared with 27.0+/-1.5 min at 15 degrees C and 27.4+/-1.5 min
      at 25 degrees C. Heat storage determined from rectal and mean skin temperatures
      was positively correlated with body mass (r=0.74, P<0.0008) at 35 degrees C but
      only moderately correlated at 25 degrees C (r=0.50, P<0.04), whereas no
      correlation was evident at 15 degrees C. Potential evaporation estimated from
      sweat rates was positively associated with body mass (r=0.71, P<0.002) at 35
      degrees C. In addition, the decreased rate of heat production and mean running
      speed during the 8-km performance run were significantly correlated with body
      mass (r=-0.61, P<0.02 and r=-0.77, P<0.0004, respectively). It is concluded that,
      compared to heavier runners, those with a lower body mass have a distinct thermal
      advantage when running in conditions in which heat-dissipation mechanisms are at
      their limit. Lighter runners produce and store less heat at the same running
      speed; hence they can run faster or further before reaching a limiting rectal
      temperature.

PMID- 11211126
TI  - Dietary phosphate and parathyroid hormone alter the expression of the calcium
      sensing receptor (CaR) and the Na+-dependent Pi transporter (NaPi-2) in the rat
      proximal tubule.
AB  - Dietary phosphate (Pi) intake and parathyroid hormone (PTH) are essential
      regulators of proximal tubular (PT) Pi reabsorption; both factors are associated
      with adaptive changes in PT apical brush border membrane (BBM) Na/Pi-cotransport
      activity and specific transporter protein (NaPi-2) content. Urinary Pi excretion
      is also inversely correlated with luminal Ca2+ concentration ([Ca2+]) both in a
      PTH-dependent and -independent fashion. A cell-surface, Ca2+(/polyvalent cation)
      sensing receptor (CaR) has been localized to the PT BBM with unknown function. To
      investigate whether PTH and/or dietary Pi intake could affect the distribution or
      the expression of the CaR, we evaluated their effects on rat kidney CaR and the
      NaPi-2 expression by Western blot analysis and immunofluorescence microscopy. A
      chronic high-Pi (1.2%) versus low-Pi (0.1%) diet and acute PTH (1-34) infusion
      significantly reduced the PT BBM expression of both NaPi-2 and CaR proteins. CaR
      specific immunoreactivity in nephron segments other than the PT was not affected
      by PTH or Pi intake. These results suggest that reduced renal PT CaR expression
      by a high-Pi diet and by increased circulating PTH levels could contribute to the
      local control of PT handling of Ca2+ and Pi.

PMID- 11211125
TI  - KCNE1 reverses the response of the human K+ channel KCNQ1 to cytosolic pH changes
      and alters its pharmacology and sensitivity to temperature.
AB  - Previous studies have shown that heteromultimeric KCNQ1/KCNE1 (KvLQT1/minK)
      channels and homomultimeric KCNQ1 (KvLQT1) channels exhibit different current
      properties, e.g. distinct kinetics and different sensitivities to drugs. In this
      study we report on the divergent responses to internal pH changes and further
      characterize some of the current properties of the human isoforms of KCNQ1 and
      KCNE1 expressed in Chinese hamster ovary (CHO) cells or Xenopus laevis oocytes.
      Decreasing the bath temperature from 37 degrees C to 20 degrees C increased the
      half-activation time by a factor of 5 for KCNQ1/KCNE1 currents (IKs) but by only
      twofold (not significant) for KCNQ1 currents (IK) in CHO cells. Acidification of
      cytosolic pH (pHi) increased IKs but decreased 1K whereas intracellular
      alkalinization decreased I(Ks) but increased IK. pHi-induced changes in
      intracellular Ca2+ activity ([Ca2+]i) did not correlate with the current
      responses. At 20 degrees C mefenamic acid (0.1 mM) significantly augmented IKs
      but slightly decreased IK. It changed the slow activation kinetics of I(Ks) to an
      instantaneous onset. The form of the current/voltage (I/V) curve changed from
      sigmoidal to almost linear. In contrast, at 37 degrees C, mefenamic acid also
      increased I(Ks) but slowed the activation kinetics and shifted the voltage
      activation to more hyperpolarized values without markedly affecting the sigmoidal
      shape of the I/V curve. The potassium channel blockers clotrimazole and
      tetrapentylammonium (TPeA) inhibited I(Ks) with a lower potency than I(K). These
      results show that coexpression of KCNE1 reversed pH regulation of KCNQ1 from
      inhibition to activation by acidic pHi. In addition, KCNE1 altered the
      pharmacological properties and sensitivity to temperature of KCNQ1. The pH
      dependence of I(Ks) might be of clinical and pathophysiological relevance in the
      pathogenesis of ischaemic cardiac arrhythmias.

PMID- 11211128
TI  - A custom-made two-photon microscope and deconvolution system.
AB  - We describe in detail a custom-built two-photon microscope based on a modified
      confocal scanhead (Olympus Fluoview) and mode-locked Ti:sapphire laser (Coherent
      Mira 900). This system has internal detectors as well as external whole-field
      detection and an electrooptical modulator for blanking the beam on flyback and
      effecting fast changes in excitation intensity. This microscope can be used in
      deep, scattering samples for quantitative measurements with a wide range of
      fluorophores (GFP, fura, calcium green, calcium orange, fluo-3, DiI, DiO,
      fluorescein, rhodamine), for fluorescent photobleaching recovery and for
      uncaging. Images obtained with this system can be deconvolved with the Estimation
      Maximization algorithm using the program XCOSM (freeware available at:
      http://www.ibc.wustl.edu/bcl/ xcosm/).

PMID- 11211127
TI  - Changes of the potassium currents in rat aortic smooth muscle cells during
      postnatal development.
AB  - This study was designed to investigate the role and regulation of arterial K+
      channels during postnatal development. Rat thoracic aortic segments were
      suspended for isometric tension and resting membrane potential (RMP) recording.
      Contraction in response to 4-aminopyridine (4-AP) was similar in 4-, 8- and 12
      week-old rats but was higher in 1-day-old rats. Contraction in response to
      tetraethylammonium (TEA) increased after 4 weeks. TEA increased the contractions
      evoked by noradrenaline in the aorta from 8- and 12-week-old rats but not from 1
      day- and 4-week-old rats. RMP did not change during development. Patch-clamp
      studies of freshly isolated smooth muscle cells from the same aortas bathed in
      Ca2+-free medium showed a voltage-dependent K+ current (IK) sensitive to 4-AP.
      This current remained stable at all ages whereas the density of the total IK,
      recorded in the presence of Ca2+, showed a twofold increase between 4 and 8
      weeks. This current was highly sensitive to TEA and charybdotoxin. The binding
      site density of 125I-labelled charybdotoxin was threefold higher in the membranes
      of aortas from 12-week-old compared to 4-week-old rats. These results indicate
      that changes in K+ channel distribution occur in the rat aorta during postnatal
      development. These are related to an increase in the expression of charybdotoxin
      sensitive Ca2+-activated K+ channels.

PMID- 11211129
TI  - A novel brain trauma model in the mouse: effects of dexamethasone treatment.
AB  - We describe a novel methodological approach for inducing cold lesion in the mouse
      as a model of human cortical contusion trauma. To validate its reproducibility
      and reliability, dexamethasone (Dxm) was repeatedly applied to demonstrate
      possible antioedematous drug effects. Following the induction of anaesthesia with
      halothane, the dura was exposed via trephination. Using a micromanipulator a pre
      cooled (-78 degrees C) copper cylinder, 3 mm in diameter, was pressed down to a
      depth of 1 mm onto the dura for 30 s under microscopic control. The body
      temperature was held constant at 37 degrees C throughout the procedure. Blood
      pressure (BP), measured by a modified photosensor-monitored tail-cuff method, and
      acid-base status were not significantly different when analysed before and after
      cold lesion and prior to sacrifice. However, there was a marginal mixed
      respiratory and metabolic acidosis. The antioedematous action of Dxm was studied
      in four standard pre-and post-treatment paradigms: 2x0.5 mg/kg (II), 2x12.5 mg/kg
      (III) and 4x6.25 mg/kg (IV: 3x pre-, 1x post-treatment: V: 1x pre-, 3x post
      treatment). Physiological saline injections served as controls. High doses of Dxm
      (III-V) significantly attenuated the cold-lesion-induced loss of body mass. Dxm
      treatment also resulted in a reduction of brain water content (III; P<0.05), and
      brain swelling (IV; P<0.05) in the lesioned hemisphere, relative to controls. In
      conclusion, we have characterized a novel cold lesion model in the mouse to mimic
      traumatic brain injury and the beneficial effect of Dxm treatment on the extent
      of brain oedema.

PMID- 11211130
TI  - Effect of internal carotid artery occlusion on vertebral artery blood flow: a
      duplex ultrasonographic evaluation.
AB  - The aim of this study was to evaluate the effect of unilateral internal carotid
      artery occlusion on blood flow volume and blood flow velocities in both vertebral
      arteries using duplex Doppler ultrasonography in the cervical segment. Forty
      patients with unilateral extracranial internal carotid artery occlusion confirmed
      by angiography were studied, and the results were compared with those obtained in
      57 age-matched patients in whom cervical duplex ultrasonography showed no
      abnormalities. We measured the diameter, flow velocities, and blood flow volume
      in both vertebral arteries, and the side-to-side differences were also
      calculated. Eleven patients (27.5%) with an occluded internal carotid artery had
      increased peak systolic velocity in the ipsilateral vertebral artery, and 6 (15%)
      had increased peak systolic velocity in the contralateral vertebral artery. The
      mean peak systolic velocity and the mean blood flow volume were statistically
      greater in the ipsilateral vertebral arteries than in the same-side vertebral
      arteries of the control group (P < .05). We also detected a mean increase of
      14.29% of the net blood flow volume in the vertebral arteries compared with the
      control group. Patients with extracranial unilateral internal carotid artery
      occlusion may have a compensatory increase in both the peak systolic velocity and
      the blood flow volume in both vertebral arteries.

PMID- 11211131
TI  - Types of neurovascular symptoms and carotid plaque ultrasonic textural
      characteristics.
AB  - The aim of this study was to identify the echo morphology and stenosis of carotid
      plaques that corresponded to ipsilateral asymptomatic status, amaurosis fugax,
      hemispheric transient ischemic attack, and stroke. One hundred ninety-two plaques
      (150 patients), producing stenosis in the range of 50% to 99% and associated with
      various neurovascular manifestations, were studied. These plaques were imaged on
      duplex scans, and a series of textural features was produced in a computer to
      distinguish quantitatively their various echo patterns. Amaurosis fugax
      corresponded to dark, severely stenosed atheromas (90%); hemispheric transient
      ischemic attack and stroke corresponded to plaques with intermediate echoic
      characteristics and intermediate stenosis (80%); and asymptomatic status
      corresponded to bright, moderately stenosed plaques (70%; P < .05). The
      significance of these findings is discussed.

PMID- 11211132
TI  - Assessment of endometrial receptivity by transvaginal color Doppler and three
      dimensional power Doppler ultrasonography in patients undergoing in vitro
      fertilization procedures.
AB  - The objective of this study was to investigate the usefulness of transvaginal
      color Doppler and three-dimensional power Doppler ultrasonography for the
      assessment of endometrial receptivity. A total of 89 patients undergoing in vitro
      fertilization procedures were evaluated for endometrial thickness and volume,
      endometrial morphology, and subendometrial perfusion on the day of embryo
      transfer. Neither the volume nor the thickness of the endometrium on the day of
      embryo transfer had a predictive value for conception during in vitro
      fertilization cycles (P > .05). Patients who became pregnant were characterized
      by a significantly lower resistance index, obtained from subendometrial vessels
      by transvaginal color Doppler ultrasonography (resistance index = 0.53 +/- 0.04
      versus 0.64 +/- 0.04, pregnant versus not pregnant, respectively; P < .05), and a
      significantly higher flow index (13.2 +/- 2.2 versus 11.9 +/- 2.4; P < .05), as
      measured by a three-dimensional power Doppler histogram. No difference was found
      in the predictive value of scoring systems analyzing endometrial thickness and
      volume, endometrial morphology, and subendometrial perfusion by color Doppler and
      three-dimensional power Doppler ultrasonography. The high degree of endometrial
      perfusion shown by color Doppler ultrasonography and on three-dimensional power
      Doppler histograms on the day of embryo transfer can indicate a more favorable
      endometrial milieu for successful in vitro fertilization.

PMID- 11211133
TI  - Outcome of pregnancy after prenatal diagnosis of umbilical vein varix.
AB  - Previous studies of umbilical vein varix diagnosed prenatally have been small,
      and the results have been contradictory. We wanted to determine whether
      prenatally diagnosed umbilical vein varix is associated with an increased risk of
      fetal anomalies or poor perinatal outcomes. We identified all cases of fetal
      intra-abdominal umbilical vein varix diagnosed on the basis of prenatal
      ultrasonography at Brigham and Women's Hospital between 1988 and 1998. Cases were
      reviewed to determine the presence of other sonographic findings as well as
      pregnancy and neonatal outcomes. We identified 25 cases and included those 23 for
      which follow-up was available. In 11 cases (48%), pregnancies and neonatal
      outcomes were normal, with full-term delivery, appropriate birth weight, and no
      evidence of anomalies. Three cases (13%) had preterm deliveries, and 1 had Kell
      isoimmunization requiring postnatal transfusion. In the remaining 8 cases (35%),
      structural anomalies were present. One fetus had a chromosomal abnormality
      (69,XXX). Prenatal diagnosis of fetal umbilical vein varix appears to be
      associated with a high rate of fetal anomalies. Detection of an umbilical vein
      varix should prompt a thorough examination of the fetus, including a fetal survey
      and echocardiogram. Isoimmunization should be ruled out, and consideration of
      karyotyping should be discussed if other anomalies are present.

PMID- 11211134
TI  - Variation in fetal femur length with respect to maternal race.
AB  - We sought to evaluate whether the expected fetal femur length, based on
      biparietal diameter, varies in second-trimester fetuses with respect to maternal
      race. The study population was composed of all fetuses scanned from 15 to 20
      completed weeks' gestation during a 2-month period (June to August 1998).
      Maternal race was documented at the time of the ultrasonographic examination.
      Biparietal diameter and femur length were prospectively documented. The variance
      from the expected femur length, given the biparietal diameter, was calculated,
      and the mean variations were compared according to maternal race. The study
      subgroups were composed of the fetuses of 39 Asian mothers, 31 black mothers, and
      the first 100 white mothers. The mean values of the variance from the expected
      fetal femur length by biparietal diameter +/- 1 SD for the various racial groups
      were as follows: fetuses of Asian mothers, -0.66 +/- 1.64 mm; fetuses of black
      mothers, 0.88 +/- 1.57 mm; and fetuses of white mothers, 0.13 +/- 1.66 mm (P =
      .0007). To isolate the differences among the 3 racial groups, the mean values of
      the variance from the expected femur length by biparietal diameter for the
      fetuses of Asian and black mothers were compared with the mean value for the
      fetuses of white mothers (Asian versus white mothers, P = .014; black versus
      white mothers, P = .026). A significant difference in the mean variance from the
      expected femur length by biparietal diameter was identified among the fetuses of
      women in the second trimester with respect to racial group. Less-than-expected
      femur lengths were noted among the fetuses of Asian mothers, and greater-than
      expected femur lengths were noted among the fetuses of black mothers, compared
      with the femurs of fetuses of white mothers. The implications for the use of
      fetal femur length as a component of the genetic sonogram in patients of various
      races require further study.

PMID- 11211135
TI  - Usefulness of echocystography in the study of vesicoureteral reflux.
AB  - The aim of our study was to assess the usefulness of contrast-enhanced sonography
      in detecting and staging vesicoureteral reflux in pediatric patients. Forty-nine
      children between birth and 5 years of age were studied for vesicoureteral reflux.
      Echocystography with the use of an endovesical signal enhancer was performed
      first, followed immediately by conventional voiding cystourethrography. The
      findings obtained by echocystography and voiding cystourethrography were
      consistent in 89 (90.8%) of 98 ureterorenal units (a ureterorenal unit is 1
      kidney with its own ureter). Reflux was demonstrated by voiding
      cystourethrography in 13 cases; in 9 of these cases diagnosis had also been made
      by echocystography. Five cases of reflux detected by echocystography were not
      identified by voiding cystourethrography. With voiding cystourethrography as the
      standard of reference, sensitivity was 69%; specificity, 94%; positive predictive
      value, 64%; and negative predictive value, 95%. In conclusion, echocystography is
      a useful tool for the diagnosis of vesicoureteral reflux. Its ability to detect
      reflux is similar to that of cystography in cases of high-grade reflux, and it
      may be an appropriate complementary technique to voiding cystourethrography,
      because it avoids exposure to radiation.

PMID- 11211136
TI  - Abdominal three-dimensional power Doppler imaging.
AB  - Three-dimensional ultrasonic angiography is a new power Doppler ultrasonographic
      imaging mode that appears to improve the visualization of vascular anatomy in
      abdominal sonography. This study illustrates the utility of three-dimensional
      ultrasonic angiography in the abdomen, especially with respect to liver and
      portal vein anatomy, vascularization of the kidney, and vessels localized in the
      retroperitoneum.

PMID- 11211137
TI  - Ultrasonographically guided biopsy of the prostate gland.

PMID- 11211138
TI  - Sonographic-pathologic correlation of the hyperechoic border of an atypical
      hepatic hemangioma.

PMID- 11211139
TI  - Idiopathic diffuse ectasia of the intrahepatic and extrahepatic arteries.

PMID- 11211140
TI  - Fetal scalp cysts: challenge in diagnosis and counseling.

PMID- 11211141
TI  - Contrast-enhanced, wide-band harmonic gray scale imaging of hepatocellular
      carcinoma: correlation with helical computed tomographic findings.
AB  - We evaluated the usefulness of contrast-enhanced, wide-band harmonic gray scale
      imaging for the diagnosis of hepatocellular carcinoma and compared it with
      helical computed tomography. Forty-eight patients with 61 hepatocellular
      carcinoma lesions were scanned by contrast-enhanced, wide-band harmonic gray
      scale imaging after an intravenous bolus injection of the contrast agent
      Levovist. Fifty-seven of the 61 hepatocellular carcinoma lesions showed
      hypervascular enhancement, and intratumoral vessels could be observed in 40 of
      the 57 lesions. Helical computed tomography revealed a high-attenuation area in
      54 of the 61 lesions, whereas the other lesions showed an equivocal-attenuation
      area. Contrast-enhanced, wide-band harmonic gray scale imaging is a useful method
      for diagnosing the vascularity of hepatocellular carcinoma.

PMID- 11211142
TI  - Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver:
      accuracy of ultrasonography in transplant patients.
AB  - The purpose of this study was to assess the usefulness of ultrasonography in the
      detection of hepatocellular carcinomas and dysplastic nodules in patients with
      liver cirrhosis. Pretransplantation sonograms in 52 patients with liver cirrhosis
      who underwent orthotopic liver transplantation were evaluated retrospectively.
      The numbers of hepatocellular carcinomas and dysplastic nodules were assessed in
      the explanted liver specimens and compared with pretransplantation
      ultrasonographic results. Eighteen hepatocellular carcinomas in 16 patients and
      20 dysplastic nodules in 11 patients were present in the explanted livers. The
      size of hepatocellular carcinomas ranged from 0.6 to 5.0 cm (mean, 2.1 cm) in
      diameter, and that of dysplastic nodules ranged from 0.5 to 1.7 cm (mean, 1.0 cm)
      in diameter. Pretransplantation ultrasonography enabled detection of 6 of 18
      hepatocellular carcinoma and 0 of 20 dysplastic nodule lesions; lesion detection
      sensitivity for hepatocellular carcinomas and dysplastic nodules was 33% and 0%,
      respectively. Patient sensitivity and specificity for hepatocellular carcinomas
      were 38% (6 of 16) and 92% (33 of 36), and those for dysplastic nodules were 0%
      and 95% (39 of 41), respectively. On the basis of our results, ultrasonography is
      insensitive for detection of hepatocellular carcinomas and dysplastic nodules in
      patients with advanced liver cirrhosis.

PMID- 11211143
TI  - Induction of tumor-reactive cytotoxic T-lymphocytes using a peptide from NY-ESO-1
      modified at the carboxy-terminus to enhance HLA-A2.1 binding affinity and
      stability in solution.
AB  - NY-ESO-1 is an attractive candidate tumor antigen for the development of
      immunotherapy for a wide variety of cancers. It is expressed in multiple types of
      tumors, but its normal tissue distribution is predominantly limited to the testes
      and ovaries; furthermore, both humoral and cellular immune responses can be
      mounted against this protein. Three overlapping HLA-A2.1-restricted T-cell
      epitopes have been identified within NY-ESO-1. In this investigation, the authors
      evaluated the in vitro immunogenicity of these peptides. From 2 of 12 HLA-A2.1+
      patients with metastatic melanoma, peptide-reactive cytotoxic T-lymphocytes were
      generated using either NY-ESO-1:157-167 or NY-ESO-1:157-165 but not NY-ESO-1:155
      163. Because NY-ESO-1:157-165 is a 9 amino acid peptide completely contained
      within NY-ESO-1:157-167, it seemed likely that this peptide was the minimal
      determinant, and thus it was selected for continued study. An amino acid
      substitution of C to V was introduced into NY-ESO-1:157-165 at P9 to attempt to
      improve its immunogenicity by enhancing its binding affinity to HLA-A2.1 and
      increasing its stability in solution, because the C residue is readily oxidized,
      leading to dimerization of the peptide. From 5 of 20 HLA-A2.1+ patients with
      metastatic melanoma, NY-ESO-1:157-165(165V) stimulated cytotoxic T-lymphocytes in
      vitro, which recognized peptide-pulsed target cells and HLA-A2.1+ NY-ESO-1+ tumor
      cells, suggesting that this peptide may be clinically valuable for the treatment
      of patients with NY-ESO-1+ tumors.

PMID- 11211144
TI  - Breast cancer in mice: effect of murine MUC-1 immunization on tumor incidence in
      C3H/HeOuj mice.
AB  - Mucin-1 (MUC-1), which is overexpressed in more than 90% of human breast cancers,
      is a potential target for immunotherapy. To develop a mouse model appropriate for
      the immunotherapy of human cancer, mouse mucin-1 (muc-1) fusion protein,
      containing ten tandem repeats, was made and used to immunize C3H/HeOuj mice,
      which supposedly have a high incidence of breast cancer. C3H/HeOuj mice were
      injected eight times with 5 microg oxidized mannan muc-1-glutathione-S
      transferase (MMFP) with or without cyclophosphamide, which is used to increase
      cellular immunity. At 80 age weeks, only 12.1% (4 of 33) mice of the untreated
      C3H/HeOuj mice had mammary tumors. The reason for the low incidence of breast
      cancer in these mice is not known, but all the mammary tumors were MUC-1+ breast
      adenocarcinomas and were transplantable to C3H/HeOuj mice. The incidence was
      11.4% (4 of 35) in mice injected with MMFP: 38.2% (13 of 34) in mice given
      cyclophosphamide; and 14.3% (2 of 14) in mice treated with glutathione-S
      transferase. That is, cyclophosphamide increased the incidence of mammary tumors,
      and metastases were found in only these mice. Fewer tumors (6 of 34 or 17.6%
      compared with 13 of 34 or 38.2% with cyclophosphamide only) occurred in the group
      immunized with MMFP and cyclophosphamide. Mice immunized with MMFP had high
      levels of muc-1 antibodies and cellular immune responses (the frequency of the
      precursor of the cytotoxic Tlymphocyte cell was 1 of 40,000 to 1 of 100,000),
      which were not found in control groups. The occurrence of muc-1 immunity,
      particularly the presence of large amounts of anti-mucin-1 antibodies, had no
      effect on tumor incidence. Thus, the immunization with murine muc-1 reduced the
      tumor incidence in only cyclophosphamide-treated mice and led to strong muc-1
      antibody production and to cellular responses. These findings have implications
      for human tumor immunotherapy in which strong antibody and weak cellular
      responses are to be expected and, indeed, have been found.

PMID- 11211145
TI  - Semiallogeneic cancer vaccines formulated with granulocyte-macrophage colony
      stimulating factor for patients with metastatic gastrointestinal adenocarcinomas:
      a pilot phase I study.
AB  - The authors report the results of a phase I clinical study using semiallogeneic
      cancer vaccines formulated with granulocyte-macrophage colony-stimulating factor
      (GM-CSF) to treat patients with metastatic adenocarcinomas of the
      gastrointestinal tract. A specially engineered cell line, FO1-12, was used to
      generate semiallogeneic hybrids by fusion with patient-derived tumor cells; the
      hybrids express HLA class I and II haplotypes derived from both parental cells.
      For treatment, the vaccine was mixed with GM-CSF, irradiated, and injected
      intradermally into patients at weekly or biweekly intervals. Vaccinations were
      associated with minimal or no toxicity and showed that semiallogeneic hybrids
      formulated with GM-CSF can induce a specific antitumor immune response in some
      patients, as measured by a delayed-type hypersensitivity response to autologous
      tumor cells. Because of the simplicity, feasibility, and flexibility of this
      immunotherapeutic approach, semiallogeneic hybrid vaccines have the potential to
      be used in the treatment of virtually any type of cancer.

PMID- 11211146
TI  - Engineering and characterization of a novel fusion protein incorporating B7.2 and
      an anti-ErbB-2 single-chain antibody fragment for the activation of Jurkat T
      cells.
AB  - The provision of the T-cell costimulatory molecule B7 to tumor cells can be an
      effective way to trigger a tumor-specific cytolytic T-cell response. One way to
      provide B7 to tumor cells would be to couple an antitumor antibody directly to
      B7. Such a molecule should target tumors displaying antigen and provide the
      costimulatory signal to T cells, resulting in the initiation of an antitumor T
      cell response. To this end, a fusion protein was designed that incorporates a
      single-chain antibody fragment (scFv) to erbB-2 (Her2/neu), an oncogene product
      overexpressed by 30% to 50% of breast carcinomas, and the ECD of B7-2 (CD86).
      This fusion protein, expressed and purified from Pichia pastoris, was shown to
      retain binding activity to both counter receptors, erbB-2 and CD28. The fusion
      protein was also shown to target erbB-2-positive tumor cells and to deliver a
      CD28-specific T-cell costimulatory signal. These results suggest that a fusion
      protein engineered to target tumor cells and signal T cells for activation may be
      an effective means of cancer immunotherapy. Further studies should be performed
      to characterize the fusion protein in erbB-2 tumor-bearing mice for in vivo tumor
      targeting, biodistribution, and efficacy.

PMID- 11211147
TI  - Human inflammatory cells within the tumor microenvironment of lung tumor
      xenografts mediate tumor growth suppression in situ that depends on and is
      augmented by interleukin-12.
AB  - The human tumor microenvironment includes a mixture of tumor cells, inflammatory
      cells, fibroblasts, and endothelial cells, all of which are tethered to an
      extracellular matrix. It has been difficult to study the dynamic interactions of
      these cells in human tumors in situ for obvious ethical and logistical
      considerations that prohibit experimental manipulations of tumors while still in
      patients. Fresh tissue from human lung tumor biopsy implanted into SCID mice was
      shown to remain viable, and the histologic appearance of the tumor
      microenvironment was maintained in the tumor xenografts for at least 3 months. In
      this study, the authors established that the inflammatory cells within human
      tumor xenografts can suppress tumor growth, and that this suppression is a
      result, in part, of endogenously produced interleukin-12 (IL-12) because IL-12
      neutralizing antibodies enhance the growth of the tumor xenografts. The tumor
      inhibitory activity of the inflammatory leukocytes is also enhanced by the local
      and sustained release of human recombinant IL-12 into the tumor microenvironment
      from cytokine-loaded biodegradable microspheres. Neither the anti-IL-12
      neutralizing antibody nor the delivery of exogenous IL-12 from microspheres had
      any effect on tumor xenografts in the absence of the inflammatory leukocytes. In
      conclusion, the inflammatory cells within the tumor microenvironment of human
      lung tumor xenografts are functional and can suppress tumor growth, and the
      dynamic effects of the inflammatory cells can be modulated by exogenous
      cytokines.

PMID- 11211148
TI  - Low-dose vaccinia virus-mediated cytokine gene therapy of glioma.
AB  - Recombinant viruses can produce cytokines in tumors mobilizing an immune response
      to tumor cells. In this study, the authors investigated gene expression, in vivo
      antitumor efficacy, and safety of attenuated recombinant vaccinia virus (rVV)
      carrying murine cytokine genes interleukin (IL)-2 (rVV-mIL-2), IL-12 (rVV-mIL
      12), and both IL-2 and IL-12 (rVV-2-12) in an athymic nude mice model.
      Significant tumor inhibition (p < 0.05) was observed in a preestablished
      subcutaneously implanted C6 glioma model using rVVs at doses ranging from 10(2)
      to 10(7) plaque forming units (PFU). An antitumor effect did not depend on the
      dose of the rVV-mIL-2 and rVV-mIL-12 viruses. All constructed rVVs induced a high
      level of cytokine expression in vitro and in vivo. Most groups injected with high
      doses of recombinant viruses encoding cytokine genes (10(5) to 10(7) PFU) showed
      signs of cytokine toxicity, whereas in the low-dose treatment groups (10(2) to
      10(3) PFU) toxicity was greatly reduced. The antitumor activity of rVV-mIL-12 was
      associated with increases in both the percentage and number of natural killer T
      cells in the spleen. Local detection of interferon-y and tumor necrosis factor
      alpha was also correlated with tumor growth arrest induced by the treatment. High
      dose VV control vector per se induced tumor inhibition by activating Mac-1+ cells
      in blood, but the antitumor effect was less pronounced compared with rVV-carrying
      cytokine genes (p < 0.05). These results suggest that attenuated recombinant
      strains of VV at low doses may potentially be efficient vectors for cancer
      immunotherapy.

PMID- 11211149
TI  - Meta-analysis to assess the efficacy of interferon-alpha in patients with
      follicular non-Hodgkin's lymphoma.
AB  - The authors wanted to determine whether adding interferon-alpha (IFN-alpha) to
      chemotherapy regimens, in either induction or maintenance settings, provides
      additional survival benefits in follicular non-Hodgkin's lymphoma (NHL). A meta
      analysis was performed based on published data from randomized controlled
      clinical trials involving nine separate study populations. Patients receiving IFN
      alpha (in either induction or maintenance therapy) had significantly increased 5
      year and progression-free survival rates at 3 and 5 years compared with
      concurrent controls. The advantages of IFN-alpha therapy were most marked in
      studies using anthracycline-containing induction chemotherapy; in these studies,
      patients who received IFN-alpha had approximately 20% increased progression-free
      survival rates compared with controls and a lesser survival advantage. The
      available literature did not allow a determination of the relative benefit of IFN
      alpha in induction or maintenance treatments for NHL or a determination of the
      optimum duration of IFN-alpha treatment. Although questions remain about its
      optimal use. IFN-alpha appears to prolong survival time in patients with
      follicular NHL.

PMID- 11211150
TI  - Phase I trial of intravenous peptide-pulsed dendritic cells in patients with
      metastatic melanoma.
AB  - Sixteen patients with metastatic stage IV melanoma were treated with use of
      intravenous infusions of dendritic cells (DC) derived by incubation of plastic
      adherent peripheral blood mononuclear cells (PBMC) with IL-4 and GM-CSF for 8
      days in serumless AIM-V medium, followed by overnight pulsing with peptides. The
      tyrosinase368-376 (370D) and gp100(209-217 (210M)) peptides restricted to HLA
      class I A*0201 each differed from wild type by one amino acid modified to
      increase HLA binding. Median age was 49, with nine men and seven women. All
      patients, except one, had visceral disease. Patients received escalating doses of
      peptide-pulsed DCs at 10e7, 3 x 10e7, and 10e8 cells/dose twice at 2 weeks apart,
      with toxicity and clinical and immune responses as the principal endpoints. The
      first infusion of DCs was fresh, and frozen DCs were given for the second
      infusion of each cycle. Mean DC purity by flow cytometry was 49%, with a mean HLA
      DR level of 57%, CD86 of 41%, CD58 of 46%, and mean CD14 cells of 0.9%. Toxicity
      was minimal, with two patients having transient grade III DC-related toxicity.
      Ten patients received one cycle of treatment and six patients received two cycles
      of treatment. One patient had a complete remission (CR) of lung and pleural
      disease after two cycles of DC therapy. Two additional patients had stable
      disease and two patients had mixed responses. Overall immunity was assessed by
      recall skin testing with peptides, gamma interferon ELISA assays of peptide
      specific cytolytic T cell (CTL) stimulated twice with peptide, IL-2, and IL-7
      over 24 days, and peptide-specific tetramer assays performed before and after
      vaccination. Five of 16 patients had an immune response to gp100 or tyrosinase by
      gamma interferon ELISA assay; four of five were clinically stable or had tumor
      regression. These data suggest that melanoma antigen peptide-pulsed DC given
      intravenously are not toxic, and regression or stability of tumor appeared to
      correlate with the detection of a peptide-specific immune response in the
      peripheral blood.

PMID- 11211151
TI  - Phase I pilot trial of the bispecific antibody MDXH210 (anti-Fc gamma RI X anti
      HER-2/neu) in patients whose prostate cancer overexpresses HER-2/neu.
AB  - The goal of this study was to evaluate, in patients with prostate cancer, the
      toxicity profile and biologic activity of the bispecific antibody MDXH210, which
      has specificity for the non-ligand-binding site of the high-affinity
      immunoglobulin G receptor (Fc gamma RI) and the extracellular domain of the HER
      2/neu proto-oncogene product. Patients with prostate cancer that expressed HER
      2/neu were entered into a phase I dose-escalation trial of MDXH210. Patients
      received an intravenous infusion MDXH210 during a period of 2 h three times per
      week for 2 weeks and were monitored for toxicity. Pharmacokinetic and
      pharmacodynamic parameters were measured and included the biologic end points of
      monocyte-bound MDXH210, cytokine production, and clinical response. Seven
      patients were treated with MDXH210 doses ranging from 1 to 8 mg/m2. In general,
      MDXH210 was well tolerated, with only mild infusion-related malaise, fever,
      chills, and myalgias. No dose-limiting toxic effects were observed. Biologic
      effects included induction of low plasma concentrations of tumor necrosis factor
      alpha and interleukin-6 observed immediately after MDXH210 infusion and 70%
      saturation of circulating monocyte-associated Fc gamma RI with MDXH210 at a dose
      level of 4 to 8 mg/m2. Five of six patients had stable prostate-specific antigen
      levels during the course of 40 days or more. Circulating plasma HER-2/neu levels
      decreased by 80% at days 12 and 29 (p = 0.03 and 0.06, respectively, by the
      Wilcoxon signed rank test). MDXH210 can be given safely to patients with HER
      2/neu-positive prostate cancer in doses of at least 8 mg/m2. At the doses
      studied, biologic activity was demonstrated and characterized by binding of
      MDXH210 to circulating monocytes, release of monocyte-derived cytokines, a
      decrease in circulating HER-2/neu, and short-term stabilization of prostate
      specific antigen levels.

PMID- 11211152
TI  - Patients with melanoma metastases at cutaneous and subcutaneous sites are highly
      susceptible to interleukin-2-based therapy.
AB  - The authors evaluated the records of 371 patients with metastatic melanoma who
      received treatment with high-dose bolus interleukin-2. Patients with metastases
      only at cutaneous or subcutaneous sites had a higher objective response rate
      (50%) than did patients with metastases at these sites plus visceral sites (14%)
      or patients with metastases at visceral sites only (13%) (p<0.0001). Five
      patients with disease at cutaneous or subcutaneous sites plus visceral sites
      experienced regression only at the cutaneous or subcutaneous sites with
      progression at the visceral sites. Therefore, in the presence of visceral
      disease, the response rate at cutaneous or subcutaneous sites was only 17%
      compared with 50% when disease was at the latter sites only (p<0.001). These data
      suggest that melanoma lesions at cutaneous or subcutaneous sites are highly
      susceptible targets to interleukin-2-based therapies, but the presence of
      visceral disease is associated with a significant inhibition of response at
      cutaneous or subcutaneous sites.

PMID- 11211153
TI  - Agranulocytosis and hemolytic anemia in patients with renal cell cancer treated
      with interleukin-12.
AB  - Interleukin-12 (IL-12) is a cytokine with effects on immune function and
      hematopoiesis. In this article, the authors describe two patients with renal cell
      cancer in whom grade 4 neutropenia and grade 3 hemolytic anemia developed,
      respectively, during treatment with twice-weekly intravenous recombinant human
      interleukin-12 (rhIL-12) during a phase 1 trial. The severe neutropenia was
      associated with bone marrow agranulocytosis and a preponderance of large granular
      lymphocytes in the peripheral blood, whereas the hemolytic anemia was negative
      for the Coombs test and associated with splenomegaly. The agranulocytosis and
      hemolytic anemia persisted after the rhIL-12 was stopped, but both subsequently
      responded to treatment with cyclophosphamide. steroids, or both. These findings
      indicate that rhIL-12 can induce unique hematologic toxic effects that can be
      reversed with immunosuppressive drugs.

PMID- 11211154
TI  - Effect of surgical insertion on the local shell properties of SILASTIC II
      silicone gel breast implants.
AB  - The reasons for the failure of silicone gel breast implants are unclear. One
      potential failure mechanism is the weakening of the implant shell during its
      insertion into the breast. Such local weakening could eventually lead to implant
      failure. We recently reported on the effect of implant surgery on the overall
      mechanical properties of SILASTIC II gel-filled implants. In the earlier study,
      the mechanical properties of 34 Dow Corning SILASTIC II gel-filled breast
      implants from the same manufacturing lot were measured. Twenty of the thirty four
      implants were not implanted but were evaluated to establish a baseline of control
      data. The other fourteen lot-matched implants were inserted into a subglandular
      pocket through an inframammary incision in a cadaver breast and then removed. The
      experimental augmentation scenario was designed to represent actual breast
      implantation as closely as possible. The mechanical properties of the anterior
      and posterior sides of the control implants (not implanted) and explants
      (implanted in a cadaver) were measured and compared to determine whether
      differences existed between the explant and control groups. We found that the
      implantation surgery process did slightly reduce the average tensile strength.
      Although not as statistically significant, other mechanical properties such as
      breaking energy and moduli were less for the explants than the controls. The
      reduction was a relatively small percentage in the context of overall shell
      properties. Elongation and tear resistance were unaffected. Our findings
      suggested that the surgical act of implanting a breast implant has a small but
      detectable weakening effect on the average tensile strength, breaking energy and
      moduli of the elastomeric shell of the device. The present study is an extension
      of the previous investigation. Here we have analyzed the explant shell region
      where the surgeon's fingers forced the implant through the incision. Our results
      indicate that the implant shell can be locally damaged due to the implantation
      process.

PMID- 11211155
TI  - Poly(amino acid) bioadhesives for tissue repair.
AB  - We report here on poly(amino acid)-based bioadhesives with potential to bond to
      soft tissues. The systems investigated included homopolymer poly(amino acids),
      mixtures of poly(amino acids) and amino acids, and blends of different poly(amino
      acids). Adhesive performance was tested in tension on glass surfaces, chondroitin
      sulfate surfaces, as well as bovine cartilage surfaces. The amino acid structural
      units contained acidic, basic, or polar side chains and were found to adhere
      reasonably well to the surfaces of glass and chondroitin sulfate. The formation
      of polymer-monomer complexes with the addition of a basic monomer such as L
      lysine to negatively charged polymers such as poly(L-aspartic acid) and poly(L
      glutamic acid) was found to result in greater adhesive strength relative to
      homopolymers. Further improvement in adhesion was observed in blends of poly(L
      lysine) with polar poly(amino acids) such as poly(L-asparagine). Adhesion on wet
      cartilage surfaces was the weakest measured but a priming approach designed to
      form electrostatic or hydrogen bonds appears promising. We believe the strength
      of the adhesives studied here is based on the ability of their constituent
      polymers and monomers to form molecular entanglements and crosslinks for load
      transfer. We also believe hydrogen bonds and electrostatic forces play a role in
      the adhesion of the systems to the substrates probed in this work.

PMID- 11211156
TI  - Sustained release of mitomycin-C from poly(DL-lactide) /poly(DL-lactide-co
      glycolide) films.
AB  - Mitomycin-C (MMC)-loaded poly(DL-lactide) (PLA)/poly(DL-lactide-co-glycolide)
      (PLGA) films which have different drug loading capacities and thicknesses were
      prepared by a solvent-evaporation technique. Degradation and release studies were
      conducted at 37 degrees C in pH 7.4 phosphate buffered saline. The results showed
      that both the rate and the percentage of released MMC increased as the glycolide
      content in the copolymer increased from 10 to 30% (w/w) and the drug load
      increased from 0.5 to 2 mg MMC per 300 mg of polymer. In contrast, they decreased
      depending upon increasing film thickness from 80 to 300 microm and polymer
      molecular weight. It was found that the drug release mechanism is diffusion
      controlled according to a non-Fickian diffusion mechanism.

PMID- 11211157
TI  - Design and microstructuring of PDMS surfaces for improved marine biofouling
      resistance.
AB  - In this study room temperature vulcanized (RTV) silicone surfaces with designed
      surface microstructure and well-defined surface chemistry were prepared. Their
      resistance to marine macrofouling by barnacles Balanus improvisus was tested in
      field experiments for deducing optimal surface topography dimensions together
      with a better understanding of macrofouling mechanisms. Polydimethylsiloxane
      (PDMS) surfaces were microstructured by casting the PDMS pre-polymer on
      microfabricated molds. The master molds were made by utilizing photolithography
      and anisotropic etching of monocrystalline silicon wafers. Several iterative
      casting steps of PDMS and epoxy were used to produce large quantities of
      microstructured PDMS samples for field studies. The microstructured PDMS surface
      consisted of arrays of pyramids or riblets creating a surface arithmetic mean
      roughness ranging from 5 to 17 microm for different microstructure sizes and
      geometries, as determined by scanning electron microscopy. Chemophysical
      properties of the microstructured films were investigated by electron
      spectroscopy for chemical analysis, time-of-flight secondary ion mass
      spectroscopy and dynamic contact angle measurements. Films were chemically
      homogeneous down to the submicron level. Hydrophobicity and contact angle
      hysteresis increased with increased surface roughness. Field tests on the west
      coast of Sweden revealed that the microstructure containing the largest riblets
      (profile height 69 microm) reduced the settling of barnacles by 67%, whereas the
      smallest pyramids had no significant influence on settling compared to smooth
      PDMS surfaces. The effect of dimensions and geometry of the surface
      microstructures on the B. improvisus larvae settling is discussed.

PMID- 11211158
TI  - Synthesis, analytical characterization, and osteoblast adhesion properties on RGD
      grafted polypyrrole coatings on titanium substrates.
AB  - The covalent attachment of an Arg-Gly-Asp (RGD) containing peptide to
      polypyrrole(PPy)-coated titanium substrates has been investigated in order to
      develop a bioactive material of potential use in orthopedic fields. Polypyrrole
      has been employed as the coating polymer because of its suitability to be
      electrochemically grown directly onto metallic substrates of different shapes,
      leading to remarkably adherent films. The synthetic peptide Cys-Gly-(Arg-Gly-Asp)
      Ser-Pro-Lys, containing the cell-adhesive region of fibronectin (RGD), has been
      grafted to the polymer substrate via the cysteine residue using a procedure
      recently developed in the authors laboratory. The effectiveness of grafting was
      monitored by X-ray photoelectron spectroscopy (XPS), which assessed the presence
      of the peptide grafted onto the polymer surface exploiting the cysteine sulfur as
      target element. Neonatal rat calvarial osteoblasts were attached to RGD-modified
      PPy-coated Ti substrates at levels significantly greater than on unmodified PPy
      coated Ti and glass coverslip substrates.

PMID- 11211159
TI  - The effect of fluorinated surface modifying macromolecules on the surface
      morphology of polyethersulfone membranes.
AB  - Polyethersulfone (PES) has been recently adopted for membrane materials in
      applications such as ultrafiltration and haemodialysis. As a biomaterial, the
      factors which affect the blood compatibility of PES membranes include surface
      energetics, hydrophobicity, and surface morphology. Surface fluorination of
      materials has been found to create surfaces with improved blood compatibility and
      chemical stability. One novel approach to generating fluorinated polymer surfaces
      has included the use of fluorinated surface modifying macromolecules (SMMs).
      These macromolecules have been reported to establish fluorinated functional
      groups at surfaces of polymeric materials without significantly affecting the
      physical properties of the base polymer. However, to date there has been
      relatively little information published on the nature of the surface structure
      for PES materials containing these SMMs. In this study, synthesized SMMs with
      varying chemical compositions were characterized and blended with PES, and
      fabricated into flat sheet membranes. The bulk thermal transitions of PES
      materials were not significantly altered by the addition of 4 wt% SMMs. Contact
      angle data showed that the addition of SMMs in PES created more hydrophobic
      surfaces, accompanied by an increase in surface heterogeneity. X-ray
      photoelectron spectroscopy studies confirmed the presence of elemental fluorine
      at the surface. Through microscopy studies, it was shown that surface
      modification was achieved by the migration of SMM concentrated microdomains to
      the air-membrane interface. The generated microdomains (approximately 1-2 microm
      in diameter) are dispersed within the top 8 microm of the surface. The
      concentration of microdomains was gradually depleted from the surface to the bulk
      of the membrane. A schematic of the morphology for SMMs within the PES membrane
      surface was proposed.

PMID- 11211160
TI  - Infectious agents in coronary lesions obtained by endatherectomy: pattern of
      distribution, coinfection, and clinical findings.
AB  - BACKGROUND: Cytomegalovirus (CMV), Chlamydia pneumoniae (C. pneumoniae), and
      Helicobacter pylori (H. pylori) have been implicated in atherosclerosis and
      restenosis after angioplasty. The patterns of distribution within coronary
      lesions and possible coinfections of these pathogens in the coronary vasculature
      had not previously been evaluated. DESIGN: A prospective, observational clinical
      study. METHODS: Large coronary specimens (9-105 mm long) were obtained by
      endatherectomy of 53 patients undergoing aortocoronary bypass surgery. Samples
      were taken from two different sites of every lesion, resulting in a total of 106
      probes. Presence of each pathogen was determined by polymerase chain reaction,
      subsequent hybridization, and DNA sequencing. RESULTS: Cytomegalovirus and C.
      pneumoniae were detected in 30 and 32% of the samples, respectively; H. pylori
      was not detectable. The pathogens were not homogeneously distributed. A
      concurrent infection with both pathogens was observed in five of 106 (5%) lesions
      and five of 53 (9%) patients. Restenotic lesions were more often found in
      specimens in which cytomegalovirus was detected (five of 16 versus two of 37).
      Patients with C. pneumoniae-positive coronary lesions more commonly presented
      with unstable angina. CONCLUSIONS: Inhomogeneous infections with cytomegalovirus
      and C. pneumoniae of coronary atherosclerotic lesions are found to be prevalent
      when serial analysis is performed. Concurrent infection with both pathogens
      occurs coincidentally; however, possible clinical implications of this new
      observation and the pathogenic impact on atherosclerosis need further
      investigation.

PMID- 11211161
TI  - Sex differences in morphology of coronary artery plaque assessed by intravascular
      ultrasound.
AB  - BACKGROUND: Results of autopsy studies have suggested that there are sex
      differences in morphology of coronary-artery plaques, but these differences have
      yet to be adequately evaluated in vivo. DESIGN AND METHODS: We performed
      preintervention intravascular ultrasound (IVUS) measurements on coronary plaques
      in a consecutive series of 76 men and 30 women with unstable angina pectoris.
      Both the target lesion and an adjacent reference site were evaluated. Arterial,
      plaque, and luminal areas were measured by planimetry. Plaques were classified as
      either calcified or uncalcified, and relative density of plaque was
      quantitatively assessed by videodensitometry, using a linear gray scale
      normalized with respect to density of adventitia. RESULTS: Although women were
      older than men (mean age 55.0 +/- 10.9 versus 60.4 +/- 12.2 years, P = 0.02),
      their target lesions were less dense (74.6 +/- 23.4 versus 86.2 +/- 22.2% of
      adventitial density, P = 0.02) and less often found to be calcified (20.0 versus
      38.2%, P = 0.05). Similarly, reference sites in female subjects were less dense
      (77.6 +/- 15.3 versus 97.1 +/- 19.4% of adventitial density, P = 0.01). There was
      no sex difference in the severity of coronary stenosis. CONCLUSIONS: Both
      qualitative and quantitative sex differences in in-vivo morphology of coronary
      plaques morphology were detected by IVUS measurement. Plaques in women appear
      less videodense and are less often calcified than are those in men. Future
      studies employing sequential IVUS examinations are needed in order to determine
      whether these morphologic differences relate to a delay in initiation of plaques,
      slower progression of plaques, or other sex-specific modulators of plaque
      composition.

PMID- 11211162
TI  - Diffusion of gamma globulin into the arterial wall identifies localized entry of
      lipid and cells in atherosclerosis.
AB  - BACKGROUND: The localization of atheromatous lesions in vulnerable arteries and
      their relatively rare occurrence in other arteries of the same subject cannot be
      explained by current theories of the aetiology of atherosclerosis. OBJECTIVE: To
      determine whether abnormal diffusion of gamma globulin into the arterial wall
      from the lumen will identify defects of barrier function allowing localized entry
      of lipid and cells in atherosclerosis. METHODS: Paraffin sections of left
      anterior descending coronary arteries and corresponding internal thoracic
      arteries from 80 human subjects aged 1-65 years were stained for gamma globulin
      by the immunoperoxidase technique. Duplicate sections were stained with orcein to
      demonstrate the elastin structure. RESULTS: The barrier function of the luminal
      surface of the thickened intima was associated with the presence of an elastin
      lamina beneath the endothelial cells. With advancing age, the coronary arteries
      exhibited breakdown of this barrier function in localized areas with entry into
      the arterial wall of gamma globulin, lipid and cells. This was rare in the
      internal thoracic artery. CONCLUSION: Lack of continuity or incomplete formation
      of this sub-endothelial lamina, which was seen particularly in the coronary
      artery, was associated with localized entry into the arterial wall of gamma
      globulin, lipid and cells from the circulating blood and with the development of
      atheromatous lesions.

PMID- 11211163
TI  - There is no effect on remodeling of vascular wall 4 weeks after local delivery of
      antithrombin in a porcine model of coronary overstretching.
AB  - BACKGROUND: Antithrombin III is an effective endogenous inhibitor of thrombin
      with antiproliferative and anti-inflammatory capabilities. Systematic
      administration of direct thrombin inhibitors as well as of antithrombin has
      proven effective at reducing formation of neointima after injury to vessel wall
      in various animal models. Local delivery of antithrombin attenuates deposition of
      platelets after balloon injury to porcine coronary vessels. OBJECTIVE: To test
      our hypothesis that local delivery of antithrombin affects remodeling of vessel
      wall after balloon injury to the left anterior descending artery (LAD) in pigs.
      METHODS: With a balloon:vessel diameter ratio of 1.5 deep vessel-wall injury was
      performed with conventional balloon angioplasty in the LAD in 16 pigs. After
      balloon injury the pigs were administered locally two doses of 2.5 ml
      antithrombin (250 U) or, as a control, two doses of 2.5 ml albumin (10 mg). All
      pigs were administered 200 U/kg bodyweight heparin before catheterization. The
      animals were then kept in stalls and fed normal grain. After approximately 4
      weeks the animals were killed and lesions were assessed by computer-assisted
      image analysis. The areas of each vessel-wall layer and the percentage area
      stenosis were calculated. As a measure of injury, the length of rupture of the
      lamina elastica interna was measured. RESULTS: The injury was found to be equally
      profound in pigs of these groups. There was no significant difference between the
      groups concerning the areas of vessel-wall layers. The percentage area stenosis
      was similar for pigs in these two groups (36.5 +/- 14.9% for pigs in the
      antithrombin group versus 35.4 +/- 16.2% for pigs in the control group, NS).
      CONCLUSIONS: Local delivery of 250 U antithrombin to the LAD in pigs did not
      affect remodeling of the vessel wall 4 weeks after balloon injury.

PMID- 11211164
TI  - Acute exposure to a high cholesterol diet attenuates myocardial ischemia
      reperfusion injury in cholesteryl ester transfer protein mice.
AB  - BACKGROUND: Previous experiments have demonstrated that acute exposure to a high
      cholesterol diet (HCD) increases the severity of myocardial infarction in
      animals. Recent results suggest that the process is modulated by multiple genes
      and their interactions with circulating cholesterol. DESIGN: In the present study
      cholesteryl-ester-transfer-protein (CETP) transgenic mice were generated and fed
      a normal rodent-chow diet, HCD for 1 week, or a HCD for 6 weeks in order to
      define the role of CETP in myocardial infarction after acute exposure to a HCD.
      METHODS: Cholesterol levels in mice of all groups were measured. Separate groups
      of mice were exposed to 30 min of in-vivo occlusion of coronary artery and 2 h of
      reperfusion. We assessed the sizes of the ischemic zone and infarct using Evans
      blue and 2,3,5-triphenyltetrazolium chloride. RESULTS: The extent of infarction
      (percentage infarct/area at risk) was significantly less (P < 0.05) after 1 week
      of a HCD (18.7 +/- 7.0%) than those for the normal diet group (51.4 +/- 5.5%) and
      the group fed a HCD for 6 weeks (44.4 +/- 5.2%). Additionally, there was
      significantly less infiltration of neutrophils into the ischemic-reperfused mouse
      hearts for mice fed a HCD for 1 week. Levels of reduced and oxidized glutathione
      in the hearts of CETP mice were measured for separate groups of animals. The
      reduced:oxidized-glutathione ratio was significantly (P < 0.01) lower for mice
      fed a HCD for 1 week (1.5 +/- 0.1) than it was for mice fed a normal diet (3.6 +/
      0.3) and a HCD for 6 weeks (3.3 +/- 0.2). CONCLUSIONS: These data suggest that
      activity of CETP in hypercholesterolemic mice has an acute effect on size of
      infarct after 1 week of a HCD. This suggests that CETP induces tolerance of
      ischemia in the mice fed a HCD via mild oxidative stress.

PMID- 11211165
TI  - Serial evaluation of coronary flow reserve by transesophageal doppler
      echocardiography after angioplasty of proximal left anterior descending coronary
      artery: a 6-month follow-up study.
AB  - BACKGROUND: Coronary flow reserve can be estimated by transesophageal Doppler
      echocardiography (TDE). OBJECTIVE: To evaluate the coronary flow reserve by TDE,
      serially over 6 months' follow-up, after successful percutaneous transluminal
      coronary angioplasty (PTCA) of proximal left anterior descending coronary artery
      (LADA). METHODS AND RESULTS: We performed TDE examination of 30 patients (mean
      age 55 +/- 9 years) 72 h, 3 months, and 6 months after PTCA of LADA. Selective
      angiography of LADA was repeated 72 h and 6 months after PTCA of LADA. Velocity
      of flow in LADA was measured before and 2 min after cessation of intravenous
      infusion of dipyridamole (0.56 mg/kg in 4 min). The dipyridamole: rest mean
      diastolic velocity ratio was considered as an index of coronary flow reserve
      (CFR). For 20 of 21 patients with CFR > 2 there was no restenosis, whereas
      coronary angiography revealed restenosis in eight of nine patients with CFR < 2.
      The sensitivity was 88.9% and the specificity was 95.2%. For the 21 patients
      without restenosis mean CFR was 2.1 +/- 0.1 72 h after PTCA, had increased to 3.1
      +/- 0.3 (P < 0.0001) 3 months after PTCA, and remained stable thereafter (3.0 +/-
      0.9). CONCLUSION: CFR after PTCA of proximal LADA can be evaluated serially by
      transesophageal Doppler echocardiography. CFR of LADA in patients without
      restenosis is increased 3 months after PTCA and remains stable thereafter.

PMID- 11211166
TI  - Histopathologic validation of in-vivo angioscopic observation of coronary
      thrombus after angioplasty in a porcine model.
AB  - BACKGROUND: Coronary angioscopy has been reported to be superior to angiography
      and intravascular ultrasound for detecting intracoronary thrombus. However, in
      vivo histopathologic validation of angioscopic detection of intracoronary
      thrombus had not been performed. OBJECTIVE: To perform histopathologic validation
      of in-vivo angioscopic detection of coronary thrombus. DESIGN: An experimental,
      blinded comparison of angioscopy and histopathology. METHODS: Coronary angioscopy
      was performed from 0 to 14 days after angioplasty in 39 porcine coronary
      arteries. When thrombus was detected by angioscopy, it was subclassified into
      white, mixed red-white, or red thrombus according to color. By histopathology the
      presence of thrombus was determined and subclassified into platelet-rich, mixed
      platelet-erythrocyte, or erythrocyte-rich thrombus. RESULTS: Angioscopy correctly
      classified 19 of 21 coronary thrombi (sensitivity 90%) but incorrectly classified
      nine of 18 arteries without formation of thrombus as having a thrombus
      (specificity 50%). Positive and negative predictive values were 68 and 82%,
      respectively. The angioscopic subclassification of thrombus into white, mixed red
      white, or red thrombi was not correlated to the corresponding histopathologic
      morphology (platelet-rich, mixed platelet-erythrocyte, or erythrocyte-rich) of
      the observed thrombi (chi2 test: P = 0.5). CONCLUSIONS: Angioscopic detection of
      thrombus in vivo had high sensitivity and negative predictive value but low-to
      moderate specificity and positive predictive value. Visual assessment of color of
      angioscopically detected thrombi seemed not to reflect histopathologic morphology
      of thrombus according to the definitions used in the present study.

PMID- 11211167
TI  - Changes in the use of medications after acute myocardial infarction: possible
      impact on mortality after myocardial infarction and long-term outcome.
AB  - OBJECTIVE: To describe the change in the use of medication after acute myocardial
      infarction (AMI) and discuss its possible impact on risk and risk indicators for
      death. PATIENTS: All patients discharged alive after hospitalization for AMI at
      Sahlgrenska Hospital (covering half the community of Goteborg, i.e. 250,000 of
      500,000 inhabitants) during 1986-1987 (period I) and at Sahlgrenska Hospital and
      Ostra Hospital (covering the whole community of Goteborg, 500,000 inhabitants)
      during 1990-1991 (period II). METHODS: Overall mortality was retrospectively
      evaluated during 5 years of follow-up. RESULTS: In all, 740 patients were
      included in the study during period I and 1448 during period II. The 5-year
      mortalities were 44.1% for period I patients and 39.3% for period II patients (P
      = 0.036). The relative risk of death for period II patients was 0.78 [95%
      confidence interval (CI) 0.67-0.89, P = 0.0005] after adjustment for differences
      at baseline. There was a significant interaction with a history of congestive
      heart failure; improvement in duration of survival was found only for patients
      without such a history. During period I, only 3% of patients were administered
      fibrinolytic agents, compared with 33% of patients during period II (P < 0.0001).
      During period I, aspirin was prescribed for 13% of patients discharged from
      hospital compared with 79% during period II. Other changes in treatment on going
      from period I to period II included increases in prescription of beta-blockers
      and angiotensin converting enzyme inhibitors. After adjustment for various risk
      indicators for death, relative risk of death for those administered fibrinolytic
      agents was 0.60 (95% CI 0.18-2.02) for patients in the period-I cohort and 0.68%
      (95% CI 0.51-0.91) for those in the period-II cohort. Adjusted relative risk of
      death for those prescribed aspirin upon discharge from hospital was 0.81 (95% CI
      0.52-1.25) for period-I patients and 0.71 (95% CI 0.56-0.91) for period-II
      patients. The adjusted relative risk of death for those administered beta
      blockers was 0.72 (95% CI 0.55-0.96) for period-I patients and 0.70 (95% CI 0.55
      0.90) for period-II patients. CONCLUSION: Increased use of fibrinolytic agents
      and aspirin for AMI as well as a moderate increase in use of beta-blockers and
      angiotensin converting enzyme inhibitors was associated with a parallel reduction
      in age-adjusted mortality during the 5 years after discharge from hospital.
      However, this improvement was seen only for patients without histories of
      congestive heart failure.

PMID- 11211168
TI  - Soluble adhesion molecules, endothelial function and vitamin E in type 1
      diabetes.
AB  - BACKGROUND: Elevated levels of soluble adhesion molecules are found in subjects
      with vascular disease and inconsistently in subjects with conditions predisposing
      them to atherosclerosis, such as hypercholesterolaemia and diabetes. Oxidized low
      density lipoprotein (LDL), protein kinase C and lower than normal levels of NO
      appear to be important for expression of adhesion molecules, raising the
      possibility that vitamin E is useful for downregulating levels. We have recently
      shown that administration of 1000 IU vitamin E for 3 months will improve
      endothelial vasodilator function (EVF) in uncomplicated type-1 diabetes.
      OBJECTIVE: To determine whether levels of soluble adhesion molecules in young
      subjects with uncomplicated diabetes are elevated, whether there is a
      relationship between levels of soluble adhesion molecule and EVF as well as
      parameters of diabetes and lipid levels and whether an improvement in EVF related
      to vitamin E therapy is also associated with a decrease in levels of soluble
      adhesion molecules. DESIGN: A randomized, placebo-controlled, study. RESULTS:
      There was no difference between levels of soluble vascular cell adhesion molecule
      1 (VCAM-1; 621 +/- 17 versus 635 +/- 37 ng/ml) and P-selectin (59 +/- 2 versus 57
      +/- 6 ng/ml) for the diabetic and control groups. For the diabetic cohort, levels
      of soluble VCAM-1 were inversely related to flow-mediated vasodilatation of the
      brachial artery (r = -0.41, P < 0.005) and directly related to levels of total
      cholesterol (r = 0.44, P < 0.005) and LDL cholesterol (r = 0.42, P < 0.01) and
      duration of diabetes (r = 0.55, P < 0.0005) but there was no relationship with
      susceptibility of LDL to oxidation or vitamin-E content of LDL. Levels of soluble
      P-selectin were directly related to duration of diabetes (r = 0.43, P < 0.05) and
      inversely related to size of LDL particles (r = 0.32, P < 0.05) but were not
      related to EVF. Vitamin E produced no change in levels of soluble P-selectin and
      VCAM-1. CONCLUSIONS: Levels of soluble VCAM-1 and P-selectin in young subjects
      with type-1 diabetes and no evidence of overt vascular disease do not appear to
      be elevated and are not influenced by vitamin-E supplementation.

PMID- 11211169
TI  - Comparison of deposits of versican, biglycan and decorin in saphenous vein and
      internal thoracic, radial and coronary arteries: correlation to patency.
AB  - BACKGROUND: Matrix proteoglycans versican, biglycan and decorin are important
      determinants of vessel-wall structure and pathology. Thickened myxoid intimas
      typical of restenosis and early atherosclerosis are enriched in versican and
      biglycan, proteoglycans that promote proliferation and migration of smooth muscle
      cells and bind lipoproteins. In contrast, compact fibrous intimas are
      characterized by decorin. OBJECTIVE: To compare the distribution patterns of
      these matrix proteoglycans, and changes induced by organ culture in coronary
      artery, saphenous vein, internal thoracic artery (ITA), and radial artery, and
      correlate differences to patency. METHODS: Vessels were collected at the time of
      bypass surgery and heart transplantation and either fixed for
      immunohistochemistry or prepared for organ culture. Vessels in culture were
      labelled with [3H]-glucosamine and processed for autoradiography and
      immunohistochemistry. Distribution patterns for proteoglycans and radio-labelling
      were determined morphometrically. RESULTS: Distribution profiles in coronary
      artery and saphenous vein were similar, with relatively high levels of
      subendothelial versican and biglycan and low levels of decorin. In culture
      subendothelial incorporation of [3H]-glucosamine and immunostaining for versican
      and biglycan, but not decorin, were significantly increased. In contrast, the
      thin intima of the ITA was relatively enriched in decorin compared with the
      medial layers and in culture intimal staining for decorin increased markedly
      compared with a modest increase for biglycan and no change for versican. There
      was an even distribution in radial artery of all three proteoglycans across the
      intima without subendothelial accumulations. In culture there was an increase in
      staining intensity for proteoglycans of the radial artery. Neither the ITA nor
      radial artery exhibited an increase in subendothelial incorporation of [3H]
      glucosamine in culture. CONCLUSIONS: The distributions of proteoglycans, and
      responses to culture correlate to the known differences in patency between
      grafted saphenous vein and ITA and predict that the radial artery will outperform
      the saphenous vein but might not be as good as the ITA for long-term patency.

PMID- 11211170
TI  - Left anterior descending artery length in left and right coronary artery
      dominance.
AB  - BACKGROUND: Coronary stenosis of the left anterior descending artery (LAD) is
      respected by cardiologists because of its negative influence on morbidity and
      mortality. An important anatomical consideration is the length of the LAD.
      OBJECTIVE: To investigate the relationship between length of LAD and coronary
      dominance. DESIGN: Retrospective comparison of 100 consecutive angiograms with
      left coronary dominance with 100 consecutive angiograms with right coronary
      dominance. The relationship between the length of the LAD and coronary dominance
      was analyzed. METHODS: We retrospectively compared 100 consecutive angiograms
      with left coronary dominance (the posterior descending artery being supplied by
      the circumflex artery) with 100 consecutive angiograms with right coronary
      dominance (the posterior descending artery being supplied by the right coronary
      artery). LADs were categorized into three types: type A, LAD terminating before
      the cardiac apex; type B, LAD reaching the apex but not supplying the
      inferoapical segment of the left ventricle; and type C, LAD wrapping around the
      apex and supplying the inferoapical segment. LAD typing was also analyzed in
      relation to gender. RESULTS: It was found that the LAD wrapped around the apex in
      87% of cases of left coronary dominance but only in 47% of patients with right
      coronary dominance, and that the long LADs were more frequently seen in women
      than in men, irrespective of coronary dominance. CONCLUSIONS: We found that the
      LAD in left coronary dominance is usually long and wraps around the apex, and
      believe that angiographic interventions in such cases have important clinical
      significance.

PMID- 11211171
TI  - Dickinson W. Richards, MD: through a grand-daughter's eyes.

PMID- 11211172
TI  - Bibliography. Current world literature.

PMID- 11211173
TI  - Mucosal damage and recovery of the intestine after prolonged preservation and
      transplantation in dogs.
AB  - BACKGROUND: Although much is known about the mucosal damage that occurs after
      intestinal warm ischemia and reperfusion and its recovery, little is known about
      the effect of cold preservation and transplantation on the mucosa. We studied the
      electrophysiological, biochemical, and histological changes of the intestinal
      mucosa after preservation for 24 hr and subsequent transplantation. METHODS: The
      small intestines from adult mongrel dogs were harvested. The intestines were
      orthotopically autotransplanted immediately (control group) or after preservation
      for 24 hr (preservation group). Jejunal and ileal tissues were taken before
      harvesting, at the end of preservation, 1 hr after reperfusion, and on
      postoperative days 3, 7, 14, and 28. The Ussing chamber method was used to study
      the electrophysiologic changes. Tissue maltase, diamine oxidase, and ornithine
      decarboxylase were measured. A histological analysis was also performed. RESULTS:
      Control group grafts showed no evident deterioration in electrophysiology,
      biochemistry, or morphology. In contrast, preservation group grafts exhibited
      electrophysiological and biochemical degradation, complete denudation of the
      villi, and crypt injury (especially in the ileum) after reperfusion.
      Electrophysiologic function and the mucosa biochemical marker recovered within 3
      days in the jejunum and within 7-14 days in the ileum; however, histological
      recovery of mucosal injury required 28 days in the jejunum and more than 28 days
      in the ileum. CONCLUSIONS: Our study showed that despite severe destruction of
      mucosal integrity by prolonged preservation and transplantation, the intestinal
      mucosa has an enormous regenerative capacity. Our study also showed that
      regeneration was more pronounced in the jejunum than in the ileum.

PMID- 11211174
TI  - Effect of liver transplantation on islet allografts: up-regulation of Fas ligand
      and apoptosis of T lymphocytes are associated with islet graft tolerance.
AB  - BACKGROUND: Liver allografts in spontaneously tolerant strain combinations can
      protect other organs of the same donor origin from rejection and reverse ongoing
      rejection in previously placed grafts. The aims of this study were to examine
      whether liver allografts have the same protective effect on islet allografts and
      to investigate the underlying mechanisms. METHODS: PVG islets were transplanted
      beneath the kidney capsule of streptozotocin-induced diabetic DA rats with or
      without liver allografting. The cellular infiltrate, and the extent of apoptosis
      and of Fas ligand (FasL) expression in the islet grafts were evaluated on days 2,
      4, and 7 after transplantation by means of immunostaining and the in situ
      terminal deoxynucleotide transferase-mediated dUTP nick end labeling assay. Donor
      and recipient mixed lymphocyte reactions (MLR) were determined at 7 days or 100
      days after islet transplantation. RESULTS: Islet allografts transplanted alone
      were rapidly rejected within 5-8 days. Rejection was delayed, but not prevented,
      when islets were transplanted simultaneously with the liver. Liver
      transplantation 1 month before islet transplantation resulted in long-term
      survival (>100 days) of islet grafts in three of seven animals, whereas the other
      four died of liver rejection with functional islet grafts. Liver transplantation
      on day 4 after islet grafting reversed ongoing islet rejection and led to
      indefinite islet graft survival in three of seven cases. There was a progressive
      increase of cellular infiltration in all of the islet allografts, but the
      intensity of the infiltrate did not correlate with the outcome of the islet
      allografts. Islet rejection was characterized by an early dominance of
      monocytes/macrophages and CD25+ T cells in the infiltrates, a high incidence of
      apoptotic beta cells in grafts, and a sensitized status in the MLR. Tolerance of
      islet allografts was associated with increased numbers of dendritic cells in the
      graft infiltrates, up-regulation of FasL, and prominent apoptosis of alloreactive
      leukocytes in the islet grafts, as well as donor-specific MLR suppression in long
      term survivors. CONCLUSIONS: These results demonstrate that the extent of the
      protective effect of liver transplantation on islet allografts varies with the
      time of liver grafting, ranging from delay in islet rejection to complete islet
      acceptance. Islet graft tolerance induced by liver transplantation is the result
      of an immune process that involves up-regulation of Fas ligand expression on, and
      apoptosis of, islet graft infiltrating lymphocytes.

PMID- 11211175
TI  - A novel iron chelator in combination with a P-selectin antagonist prevents
      ischemia/reperfusion injury in a rat liver model.
AB  - BACKGROUND: Hepatic ischemia/reperfusion (I/R) injury is associated with early
      and late graft failure after liver transplantation. A major mechanism is
      leukocyte adhesion to endothelium followed by release of reactive oxygen
      intermediates. We examined whether desferriexochelin 772SM (D-Exo), a lipid
      soluble iron chelator that prevents hydroxyl radical formation, can enhance the
      capacity of recombinant P-selectin glycoprotein ligand immunoglobulin (rPSGL-Ig),
      a glycoprotein that binds to P-selectin and inhibits neutrophil adhesion, to
      protect against I/R injury in an ex vivo rat liver model. METHODS: Rat livers
      were harvested and stored for 6 hr at 4 degrees C in University of Wisconsin
      solution and then perfused with oxygenated whole blood for 2 hr. Three groups
      were studied (n=6 rats/group): an untreated control group; a group that received
      0.4 mg/kg rPSGL-Ig intraportally at the time of harvest; and a group that
      received 0.4 mg/kg rPSGL-Ig plus 1 micromol D-Exo intraportally both at the time
      of harvest and at the onset of reperfusion. Liver portal venous blood flow was
      assessed during perfusion, and at the end of each experiment, liver samples were
      collected for blinded histological evaluation and biochemical analyses. RESULTS:
      Livers treated with D-Exo + rPSGL-Ig had significantly higher blood flow than
      livers treated with rPSGL-1Ig alone (P<0.05), and both treatment groups had
      higher blood flow than controls (P<0.001). Production of carbonyl proteins, a
      protein oxidation product, was significantly reduced in the D-Exo + rPSGL-1Ig
      group (P<0.02 vs. controls), but not in the rPSGL-Ig alone group. Total reduced
      glutathione was significantly higher than controls in the D-Exo + rPSGL-Ig group
      (P<0.001 vs. controls), but not in the rPSGL-Ig alone group, indicating less
      oxidative stress in the D-Exo-treated group. Production of malondialdehyde, an
      index of lipid peroxidation, was significantly less than controls in both
      treatment groups (P<0.03). Histopathological findings paralleled these results
      with Banffs scores of 3.3+/-0.5, 1.8+/-0.4, and 1.3+/-0.5 in the control, rPSGL
      Ig alone, and D-Exo plus rPSGL-Ig groups, resp. CONCLUSION: rPSGL-Ig provides
      partial protection against I/R injury to ex vivo rat livers; however, the
      addition of D-Exo substantially increases protection by reducing oxidative
      injury. These findings may have clinical relevance in preventing the consequences
      of I/R injury after liver transplantation.

PMID- 11211176
TI  - Apoptosis of superantigen-activated T cells induced by mycophenolate mofetil
      treatment.
AB  - BACKGROUND: Mycophenolate mofetil (MMF), an ester prodrug of mycophenolic acid
      (MPA), is a potent immunosuppressive agent used in clinical organ
      transplantation. MPA preferentially inhibits the type II isoform of inosine
      monophosphate dehydrogenase, depletes GTP, suppresses transfer of mannose and
      fucose to glycoproteins, and prevents lymphocyte proliferation in vivo. Whether
      MMF can also delete activated T cells in vivo by triggering an apoptotic signal
      was addressed in this study. To this end we analyzed the activity of MMF in mice
      injected with the bacterial superantigen staphylococcal enterotoxin B (SEB).
      Superantigens bind to MHC class II molecules without requirement for processing,
      and activate subsets of CD4+ and CD8+ T cells whose T cell receptor beta chains
      express Vbeta family-specific homologous sequences. This model that shares
      several features with direct allorecognition has the unique advantage of allowing
      a precise monitoring of activated T cells. METHODS: BALB/c mice treated with MMF
      (100 mg/kg/ day) or vehicle were injected with SEB. Serum cytokines, CD4+ and
      CD8+ Vbeta8+ cells were monitored in blood and lymphoid tissues, and apoptosis
      was determined by externalization of membrane phosphatidyl serine, double strand
      DNA breaks, and expression of B220 antigen by Vbeta8+ cells. RESULTS: MMF
      treatment decreased tumor necrosis factor alpha, interferon gamma, and
      interleukin-10 secretion induced by SEB. It did not modify other early activation
      events (blast transformation, CD69 and CD25 expression) but completely inhibited
      SEB-induced expansion of Vbeta8+ cells by inducing apoptosis of SEB-reactive T
      cells. A similar effect was observed in CD95-ligand-deficient mice. Repeated SEB
      injections associated with MMF resulted in a marked decrease of CD8+ Vbeta8+ T
      cells. SEB-induced increase of Vbeta8+ thymocytes was not prevented by MMF
      treatment. CONCLUSION: Results obtained in this in vivo model suggest that MMF
      treatment may induce deletion of activated peripheral T cells and decrease early
      cytokine responses.

PMID- 11211177
TI  - Endotoxin-mediated delayed islet graft function is associated with increased
      intra-islet cytokine production and islet cell apoptosis.
AB  - BACKGROUND: Primary nonfunction resulting in immediate graft loss is responsible
      for the failure of a large number of islet transplants. Evidence is accumulating
      to single out endotoxin contamination of the various reagents needed for islet
      isolation as a major cause of early graft loss. METHODS: Islets isolated with
      endotoxin-containing (400 endotoxin units/ml) collagenase type V and "endotoxin
      free" (3.1 endotoxin units/ml) Liberase were compared. Graft function was
      assessed using a syngeneic murine model of marginal islet mass transplantation.
      Pro-inflammatory cytokine production by islets was measured by ELISA in culture
      supernatants, and quantitative reverse transcriptase-PCR. Islet cell apoptosis
      was measured using the annexin assay. RESULTS: Graft function was significantly
      delayed when islets were isolated with endotoxin-containing collagenase. Addition
      of endotoxin to the Liberase solution similarly delayed graft function. After 18
      hr in culture, collagenase-isolated islets released higher amounts of
      proinflammatory cytokines compared with Liberase-isolated islets (interleukin-6:
      2,185+/-1,174 pg/ml vs. 520+/-201 pg/ml; tumor necrosis factor-alpha: 304+/-298
      pg/ml vs. 0; IL-1beta: 12.5 pg/ml+/-12.5 vs. 0). This observation correlated with
      higher cytokine mRNA expression in collagenase-isolated islets. The percentage of
      apoptotic islet cells immediately after isolation was 17.2%+/-9.4 in collagenase
      isolated islets and 7.1%+/-2.1 in Liberase-isolated islets. CONCLUSIONS: We
      propose that endotoxin contamination is the primum movens of a chain of events
      that involves intra-islet cytokine production and release and islet cell
      apoptosis, and endotoxin contamination can ultimately lead to primary nonfunction
      in vivo. This emphasizes the fact that using endotoxin-free reagents during
      isolation is a key factor for successful islet transplantation.

PMID- 11211178
TI  - A human CD46 transgenic pig model system for the study of discordant
      xenotransplantation.
AB  - BACKGROUND: The chronic shortage in the supply of human organs available for
      allotransplantation has turned attention toward the use of animals as potential
      donors, with pigs as the most likely species under consideration. Hyperacute
      rejection, the initial and immediate barrier to a pig-to-primate xenograft, has
      been addressed by generation of transgenic pigs that express the human membrane
      bound complement-regulatory proteins CD59 and/or CD55. Difficulty has been
      encountered in generation of transgenic animals that express a third membrane
      bound complement-regulatory protein, CD46. METHODS: We have generated transgenic
      animals by using a large genomic construct that encompasses the entire human CD46
      gene. RESULTS: We report the first description of transgenic mice and pigs that
      express high levels of human CD46 in a cell and tissue type-specific manner,
      resembling patterns of endogenous CD46 expression observed in human tissues.
      Furthermore, when human CD46 transgenic porcine hearts were transplanted into
      baboons, the grafts did not succumb to hyperacute rejection, and survival
      extended for up to 23 days. Under the same conditions, nontransgenic grafts
      underwent hyperacute rejection within 90 min. CONCLUSIONS: This is the first
      report to describe generation of transgenic pigs that express human CD46, and the
      first in vivo demonstration of the ability of human CD46 expressed on pig organs
      to regulate complement activation and overcome hyperacute rejection upon
      transplantation of a vascularized organ into nonhuman primates.

PMID- 11211179
TI  - Graft function and survival depend primarily on host factors in compromised
      recipient models of orthotopic liver transplantation in the rat.
AB  - BACKGROUND: Experimental models of liver transplantation use normal recipients,
      although most patients undergoing liver transplantation suffer from acute or
      chronic liver failure. This study was designed to analyze the outcome of
      orthotopic liver transplantation in compromised rat hosts. METHODS: Recipient
      animals were either rats with D-galactosamine-induced acute or rats with chronic
      liver failure secondary to common bile duct ligation. Liver damage was evaluated
      by monitoring enzymes, bilirubin, ammonia levels, prothrombin, thrombin time, and
      cytokines. In vivo function of hepatocytes and sinusoidal endothelial cells were
      evaluated by indocyanine green and hyaluronic acid uptake. Transplantation was
      performed in normal, acute, and chronic liver failure rats at different time
      points using either freshly harvested or cold-preserved syngeneic livers.
      RESULTS: Survival with fresh grafts decreased significantly when transplants were
      performed 48 hr after the induction of acute liver failure. No rats with acute
      liver failure survived transplantation with grafts stored for 12 or 24 hr
      although in chronic failure survival was more 80%. Survival of acute liver
      failure rats receiving 6 hr preserved grafts was 16.6% compared with 83.3%
      observed with fresh grafts transplanted at the same time point after D
      galactosamine injection. Elevated tumor necrosis factor-alpha and interleukin
      1beta levels as well as impaired sinusoidal endothelial cell function were
      detected in acute liver failure rats with 6 h preserved grafts. CONCLUSION: These
      results suggest that preoperative status and different host factors have a
      significant effect on outcome and graft function after liver transplantation in
      rats.

PMID- 11211180
TI  - Distribution of upper limb skin cancers in relation to arteriovenous fistula side
      in renal transplant recipients.
AB  - BACKGROUND: Renal transplant patients have an increased incidence of skin
      cancers, predominantly on sun-exposed surfaces. Clinical observation identified
      some patients with an increased number of viral warts, keratoses, and skin
      malignancies on the side of the arteriovenous fistula. METHODS: In a population
      of 980 patients who underwent transplantation in Oxford, we identified 68
      patients with known fistula site who had developed cutaneous malignancies on the
      upper limbs. We compared the distribution of skin malignancies in relation to the
      side of the arteriovenous fistula with regard to histologically confirmed Bowen's
      disease, squamous cell carcinoma, basal cell carcinoma, and keratoacanthoma.
      RESULTS: No significant difference was found between the distribution of skin
      cancers, total malignancies or subgroups, in the fistula limbs compared with the
      nonfistula limbs. CONCLUSION: We have been unable to demonstrate that the
      presence of an arteriovenous fistula predisposes to the development of cutaneous
      malignancies.

PMID- 11211181
TI  - Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic
      method for invasive aspergillosis in liver transplant recipients.
AB  - BACKGROUND: Invasive aspergillosis (IA) is an important cause of mortality in
      liver transplant patients. Clinical and microbiological diagnosis is difficult,
      and it is frequently achieved only after autopsy. Early diagnosis and antifungal
      therapy could improve the survival of these patients. METHODS: A retrospective
      case-control study of IA in liver transplant recipients (OLT) was performed to
      determine the value of the detection of galactomannan Aspergillus antigen in
      serum using a sandwich-ELISA test (Platelia, Sanofi Diagnostic Pasteur). Stored
      frozen serum specimens obtained during the posttransplantation period were used.
      RESULTS: Fourteen cases of IA were diagnosed in 240 OLT recipients (IA incidence:
      5.8%) during 5 years with 13 deaths (mortality: 93%). Nine case patients and 33
      control patients met the criteria required for being considered "valid" for
      antigenemia analysis. In five of the nine case patients, a serum sample was
      positive for Aspergillus antigenemia detection. The median value was 5.7 ng/ml
      (range: 1.6-6.6). Sensitivity of the test was 55.6%, specificity was 93.9%, the
      positive predictive value was 71.4%, and the negative predictive value was 88.6%.
      The likelihood ratio of a positive test was 9.2. CONCLUSIONS: Galactomannan
      detection in serum could be useful for an early diagnosis of IA in OLT
      recipients.

PMID- 11211182
TI  - Renal transplantation in a patient with end stage renal disease due to
      cholesterol embolism.
AB  - BACKGROUND: Renal failure due to cholesterol emboli is mostly irreversible.
      Therefore chronic renal replacement therapy is necessary. However, to the best of
      our knowledge no published experience exists with renal transplantation in
      patients with end-stage renal disease (ESRD) due to cholesterol embolization
      (CE). METHODS: Renal transplantation was performed in a 64-year-old man who
      suffered from ESRD due to CE after coronary angiography. Because our patient
      presented with a typical profile of cardiovascular risk factors effective long
      term control of these risk factors before and after transplantation was a
      mandatory prerequisite before considering transplantation. RESULTS: After one
      rejection episode serum creatinine values have been stable and no major
      complications have occurred during a follow-up of 18 months. No signs of
      recurrent cholesterol emboli into the donated kidney were seen in renal biopsies
      performed due to graft rejection. CONCLUSION: Cholesterol embolization is an
      uncommon reason for ESRD and mainly occurs after invasive vascular procedures in
      patients with hyperlipidemia, arterial hypertension, and smoking. Because ESRD
      due to CE often is irreversible, chronic renal replacement therapy may be
      necessary. As demonstrated in our report, renal transplantation should be
      considered. However, in this setting effective long-term control of the
      underlying risk factors before and after renal transplantation has to be ensured.

PMID- 11211183
TI  - Successful long-term kidney-pancreas transplants regardless of C-peptide status
      or race.
AB  - BACKGROUND: We have previously shown that our patient population of 60% minority
      races has end-stage renal disease primarily as a result of diabetes mellitus and
      hypertension. It therefore was logical to explore the restoration of normal
      insulin production and renal function by simultaneous pancreas-kidney (SPK)
      transplantation, without regard to race. This study represents new analyses
      integrating race with C-peptide status and reports the outcome of 136 SPK
      transplantations performed over the last 10 years. RESULTS: Of the 49 African
      Americans with diabetes mellitus and end-stage renal disease, 60% were type I and
      40% were type II, based on C-peptide levels. In comparison, only 16% of
      Caucasians were type II. The average age at onset of diabetes mellitus was 15.7
      years for type I compared with 20.7 years for type II (P>0.05). The actuarial 10
      year survival rates for the 136 SPKs were 91.79% (patient), 85.07% (pancreas),
      and 83.58% (kidney). The type I and type II survival rates were similar in the
      two diabetic groups. CONCLUSIONS: The data strongly suggest that pretransplant C
      peptide status does not influence the outcome of SPK transplantation in patients
      with renal failure from diabetes mellitus. SPK transplants should be offered to
      all suitable diabetic patients with renal failure regardless of C-peptide status
      or race.

PMID- 11211184
TI  - The addition of mycophenolate mofetil for suppressing hepatitis B virus
      replication in liver recipients who developed lamivudine resistance--no
      beneficial effect.
AB  - BACKGROUND: Mycophenolate mofetil is used as an immunosuppressive agent in liver
      transplant recipients. Its active compound, mycophenolic acid, also inhibits the
      replication of Epstein-Barr virus and human immunodeficiency virus. Based on a
      study indicating the effectiveness of mycophenolate mofetil on hepatitis B virus
      (HBV) replication in infected human hepatocyte cells in culture, we examined the
      efficacy of mycophenolate mofetil in suppressing HBV replication in lamivudine
      resistant liver allograft recipients with recurrent HBV infection. METHOD: The
      study population included four liver allograft recipients (three males, one
      female), median age 51 years (range 41-57 years), with recurrent HBV infection
      who proved to be resistant to lamivudine. All received standard maintenance
      immunosuppression therapy. Median pretreatment serum alanine aminotransferase
      level was 75 mu/L (range 39-182 mu/L) and HBV DNA level (quantitative dot blot),
      70 pg/ml (range: 10-5,000 pg/ml). Mycophenolate mofetil, 1.0 g p.o. twice daily,
      was administered for 8 weeks, concomitant with a reduction in the maintenance
      corticosteroid and cyclosporine doses. RESULTS: After mycophenolate mofetil was
      administered, the serum alanine aminotransferase level increased in two patients,
      did not change in one, and decreased in one. Serum HBV DNA levels increased in
      three patients and decreased (nonsignficantly) in only one patient. Two patients
      complained of abdominal pain and nausea. CONCLUSIONS: Mycophenolate mofetil at
      the dosage used is not effective in suppressing HBV replication after liver
      transplantation.

PMID- 11211185
TI  - Living-related liver transplantation for type II citrullinemia using a graft from
      heterozygote donor.
AB  - BACKGROUND: Type II citrullinemia (CTLN2) characterized by a liver-specific
      argininosuccinate synthetase deficiency is an adult onset genetical disorder
      caused by the mutation of SLC25A13 gene, which results in fulminant
      hyperammonemia often with poor prognosis. METHODS: A 16-year-old Japanese boy
      presented fulminant hyperammonemia and encephalopathy and recovered after
      aggressive medical treatment. The patient was diagnosed as CTLN2 by plasma amino
      acid pattern and detection of the mutated SLC25A13 gene. We performed living
      related liver transplantation (LRLT) using a graft from the genetically proven
      heterozygote father. RESULTS: Serum amino acid concentration was normalized
      within a day after transplantation without protein restriction and medication.
      The patient's postoperative course was natural. The patient is back in school 6
      months after surgery. CONCLUSIONS: Living-related liver transplantation using a
      graft from genetically proven heterozygote donors might be a permissible
      treatment modality for CTLN2. Long-term observation may be necessary to make a
      definite conclusion possible.

PMID- 11211186
TI  - Pharmacokinetics and tolerability of 40-0-[2-hydroxyethyl]rapamycin in de novo
      liver transplant recipients.
AB  - BACKGROUND: 40-0-[2-Hydroxyethyl]rapamycin (RAD), a novel macrolide with potent
      immunosuppressive and antiproliferative activities, prevents rejection in animal
      allotransplantation models. This phase I trial assessed the effects of bile
      diversion, administration route, and time after transplant on RAD
      pharmacokinetics after single-dose administration in de novo liver allograft
      recipients. The influence of RAD on cyclosporine (CsA) pharmacokinetics and the
      safety of RAD were also evaluated. METHODS: Twenty-six de novo liver allograft
      recipients were assigned to one of four treatment groups based on the presence or
      absence of a T tube, administration route (nasogastric or nasoduodenal), and
      timing of RAD administration. Patients received a single 7.5-mg RAD dose on one
      to three occasions in addition to CsA (Neoral) and corticosteroids. Steady-state
      cyclosporine profiles with and without RAD coadministration were evaluated.
      Results. Recipients with bile diversion demonstrated lower peak concentration
      (Cmax) than those without, but overall drug exposure (AUC) was not altered. Cmax
      and AUC were not influenced by administration route. A trend towards higher Cmax
      on postoperative day 3 than on postoperative day 1 was noted, although AUC was
      not altered. Single-dose RAD coadministration did not affect steady-state CsA
      pharmacokinetics. RAD was well tolerated and caused few drug-related adverse
      effects. RAD administration did not increase infection rates or produce
      clinically significant changes in laboratory parameters. Conclusions. In de novo
      liver transplant recipients, the overall extent of RAD absorption was not
      influenced by bile diversion, administration route, or time of administration.
      CsA pharmacokinetics were not affected by single-dose RAD coadministration. RAD
      capsules administered in single doses of 7.5 mg were well tolerated and safe.

PMID- 11211187
TI  - Incidence of renal artery stenosis in pediatric en bloc and adult single kidney
      transplants.
AB  - BACKGROUND: The incidence, time of onset, and outcome of transplant renal artery
      stenosis (TRAS) in pediatric en bloc (PT) and adult single-kidney (AT)
      transplants were reviewed. METHODS: Forty-three cases (7 PT and 36 AT) of
      suspected TRAS were selected out of 367 functioning grafts (35 of them PT).
      Diagnosis was performed by digital subtraction arteriography. Percutaneous
      transluminal angioplasty (PTA) was performed when needed. RESULTS: Seven (20%) PT
      and 24 (7.1%) AT presented TRAS. Time of onset was 7+/-1 months in PT and 18+/-17
      months in AT (P<0.05). PTA was performed in all cases of TRAS in PT and in 19 AT.
      One PT and 7 AT had re-stenosis. There was no significant difference in renal
      function after treatment. Control of blood pressure improved in both groups.
      CONCLUSIONS: Recipients of PT grafts showed a higher incidence and earlier onset
      of TRAS. Re-stenosis was more frequent in AT.

PMID- 11211188
TI  - Human papillomavirus infection and anogenital condyloma in bone marrow transplant
      recipients.
AB  - BACKGROUND: Secondary malignant diseases are late complications after allogeneic
      bone marrow transplantation (BMT). Anogenital lesions associated with human
      papillomavirus (HPV) infection have been described in renal transplant recipients
      but not after BMT. HPV types 16 and 18 are strongly linked to the malignant
      transformation. METHODS: In a series of 238 patients with allogeneic BMT, three
      had anogenital lesions. We looked for HPV in DNA extracted from embedded tissue
      to study HPV genotypes, p53 expression, and ploidy. RESULTS: In two patients, HPV
      sequences were detected. One of them, with giant condyloma, had HPV type 18 and
      two aneuploid clones, but p53 expression was not found. CONCLUSION: As in solid
      organ transplant recipients, anogenital condyloma may develop after BMT. Because
      the oncoprotein of HPV is able to bind and to degrade p53, it may lead to genetic
      instability, and subsequently to malignant transformation.

PMID- 11211189
TI  - Inhibition of herpes simplex virus type 1 by the experimental immunosuppressive
      agent leflunomide.
AB  - BACKGROUND: Despite advances in antiviral chemotherapy, herpes simplex virus type
      1 (HSV-1), continues to complicate the clinical course of many allograft
      recipients. We have previously demonstrated that the experimental
      immunosuppressive agent leflunomide inhibits production of cytomegalovirus by
      interference with virion assembly. We test the hypothesis that this agent exerts
      similar antiviral activity against HSV-1. METHODS AND RESULTS: Plaque assay of
      virus yield from endothelial or Vero cells after inoculation with each of four
      clinical HSV-1 isolates demonstrated a dose-dependent reduction of virus
      production in the presence of pharmacologic concentrations of A77 1726, the
      active metabolite of leflunomide. DNA dot blot and biochemical assay of viral DNA
      polymerase activity indicated that A77 does not inhibit viral DNA synthesis.
      Rather, as visualized by transmission electron microscopic method, this agent
      seems to disrupt virion assembly by preventing nucleocapsid tegumentation.
      CONCLUSIONS: These findings, in demonstrating that leflunomide exerts antiviral
      activity against HSV-1 by mechanisms similar to those we have previously shown
      with cytomegalovirus, imply that this agent may possess broad spectrum activity
      against other herpesviruses.

PMID- 11211190
TI  - Bovine islets are less susceptible than human islets to damage by human
      cytokines.
AB  - BACKGROUND: The potential benefits of islet xenografting in type 1 diabetes
      include the intriguing, but still unanswered, possibility that the grafted
      xenoislets may be less subjected to human autoimmune attack. Cytokines may play a
      major role in the pathogenesis of autoimmune diabetes by causing impairment of
      insulin release and pancreatic islet cell toxicity. METHODS: We compared insulin
      secretion, islet cell death and survival, inducible nitric oxide synthase (iNOS)
      mRNA expression, nitrite production, and Bcl-2 and Bax mRNA expression in
      isolated human and large mammal (bovine) islets exposed to 50 U/ml recombinant
      human interleukin-1, 1,000 U/ml recombinant human tumor necrosis factor-alpha and
      1,000 U/ml recombinant human interferon-gamma. RESULTS: After 24-hr exposure, a
      marked decrease of glucose-stimulated insulin secretion was observed with human,
      but not with bovine islets. After 48-hr exposure, human, but not bovine,
      pancreatic islets showed a significantly higher percentage of apoptotic cells
      compared to controls. Treatment of human islets with human cytokines induced up
      regulation of iNOS mRNA, increased levels of nitrites, and down-regulation of Bcl
      2 mRNA, with unchanged levels of Bax mRNA. These parameters were not affected by
      cytokines in bovine islets. CONCLUSIONS: Bovine islets are less susceptible than
      human islets to the effects of human cytokines, which may be a potential
      advantage of xenotransplantation.

PMID- 11211191
TI  - Coronary artery endothelial dysfunction after ischemia-reperfusion and acute
      untreated rejection in a canine heterotopic heart transplantation model.
AB  - BACKGROUND: Acute rejection is a common problem in heart transplantation and may
      contribute to the development of cardiac allograft vasculopathy. This study was
      designed to evaluate the mechanisms of coronary endothelial dysfunction
      associated with ischemia-reperfusion and acute untreated rejection. METHODS: Two
      groups of mongrel dogs (n=7 per group) underwent heterotopic cervical heart
      transplantation without immunosuppression. Allografts were harvested on
      posttransplant day 1 (group 1) and day 5 (group 2). A third group of unoperated
      dogs served as control (group 3). After harvesting, epicardial coronary arteries
      were studied in organ chamber for endothelium-dependent and independent
      reactivity. RESULTS: Group 1 displayed multifocal ischemic damage without any
      rejection while hearts from group 2 reached grade IV rejection.
      Immunohistochemical studies for von Willebrand factor showed expression on
      coronary endothelial cells in all animals with scattered areas of denudation in
      transplanted groups. Endothelium-dependent responses to acetylcholine, calcium
      ionophore A23147, and bradykinin were unaffected in groups 1 and 2. Endothelial
      relaxations to sodium fluoride (Gi-protein activator) was significantly reduced
      in group 1 and significantly increased in group 2 compared with control.
      Responses to serotonin and UK14304 (receptors linked to Gi-protein) were
      significantly increased in group 2. Responses to thrombin were decreased in both
      groups. Endothelium-independent responses were unaffected. CONCLUSIONS: In the
      canine model of heterotopic heart transplantation, the early (24 hr) endothelial
      dysfunction seen after transplantation is specific to the thrombin receptor and
      the Gi-protein signaling pathway. Acute untreated rejection did not modify the
      alteration in endothelial reactivity to thrombin but enhanced the sensibility of
      the Gi-protein signaling pathways.

PMID- 11211192
TI  - Induction of antigraft and antirecipient antibody responses after fully
      allogeneic and semiallogeneic rat small bowel transplantation.
AB  - BACKGROUND: Given the potential influence of alloantibodies on organ graft
      outcome, this study investigated the induction of antigraft and antirecipient
      antibodies after allogeneic and semiallogeneic rat small bowel transplantation.
      METHODS: Fully allogeneic, unidirectional rejection and unidirectional graft
      versus-host disease (GvHD) heterotopic small bowel transplantation was performed
      using DA, PVG, and (PVGxDA)F1 donor-recipient combinations. Serum was obtained
      before and at time points after transplantation and incubated with blood from
      untransplanted DA and PVG rats. Antibody binding to T cells was detected by whole
      blood flow cytometry using FITC-conjugated anti-rat IgM murine monoclonal
      antibody. Antibody levels were determined by reference to a standard curve of
      fluorescent intensity generated using a serum sample with known anti-target cell
      IgM activity. Data are presented as arbitrary units/ml (AU/ml). RESULTS: In the
      PVG-->DA combination, five of six DA recipients had detectable anti-graft (PVG)
      antibodies by day 4 after transplantation (mean 72 AU/ml) and all animals were
      positive by day 6 (976 AU/ml). Antirecipient (DA) antibodies were also induced,
      however, they were only apparent after 6 days in five of eight animals (90
      AU/ml). Antigraft (DA) antibody responses were also induced in the DA-->PVG
      combination (day 6-218 AU/ml), however no antirecipient (PVG) response was
      apparent. Transplantation induced antirecipient (DA) antibodies in the
      unidirectional GvHD model (day 6-90 AU/ml) and an anti-graft (PVG) response in
      the unidirectional rejection model (day 6-60 AU/ml). However, the latter was
      quantitatively lower than that generated in the PVG-->DA combination (day 6-976
      AU/ml). CONCLUSIONS: Antigraft and antirecipient antibody responses are
      simultaneously induced after fully allogeneic small bowel transplantation,
      despite rejection being the predominant clinical feature. Further studies are
      required to elucidate their influence on graft outcome.

PMID- 11211193
TI  - Accumulating monocytes in the vasculature of rat renal allografts: phenotype,
      cytokine, inducible no synthase, and tissue factor mRNA expression.
AB  - BACKGROUND: Necrotic patches and hemorrhagic lesions develop in the renal tissue
      between day 4 and day 5 after transplantation of fully allogeneic DA rat kidneys
      to LEW recipients. These lesions are at least in part due to destruction and
      obstruction of blood vessels. Damage of graft endothelial cells and blood
      coagulation are likely to be mediated by intravascular graft leukocytes. However,
      this cell population has not been thoroughly characterized before. METHODS: We
      perfused untreated control kidneys, renal isografts, and allografts on day 4
      after transplantation with phosphate-buffered saline/ethylenediaminetetraacetic
      acid to harvest leukocytes from both the blood stream as well as from the
      marginal intravascular pool. The mRNA expression of typical products of activated
      monocytes was analyzed in reverse-transcriptase polymerase chain reaction
      experiments. Graft monocytes were purified and their immunophenotype was
      investigated by flow cytometry. RESULTS: Allograft rejection led to a 10-fold
      increase in the number of intravascular graft leukocytes compared to isografts. A
      mean number of about 100x10(6) leukocytes was harvested from a single allogeneic
      kidney, about 73% of these cells were monocytes and most of them displayed an
      activated phenotype. Compared to isografts, intravascular allograft leukocytes
      displayed an increased expression of tumor necrosis factor-alpha, inducible NO
      synthase and tissue factor. CONCLUSIONS: Our study shows that large numbers of
      activated monocytes accumulate inside allograft vessels. As they express genes
      the products of which might damage the allograft by inducing cell death or
      thrombosis, we speculate that they directly participate in allograft destruction.

PMID- 11211194
TI  - Successful outcome with a "quintuple approach" of posttransplant
      lymphoproliferative disorder.
AB  - BACKGROUND: The treatment of posttransplant lymphoproliferative disorder (PTLD)
      remains empirical. We review our treatment of seven cases of PTLD consisting of
      five interventions: 1) reduction of immunosuppression; 2) antiviral drugs; 3)
      interferon-alpha; 4) gamma-globulins; and 5) anti-CD19 monoclonal antibodies.
      METHODS AND RESULTS; Seven consecutive patients who had undergone a simultaneous
      pancreas-kidney, liver, heart, or kidney transplantation were treated. One
      patient acquired a primary EBV infection with an oligoclonal immunoblastic
      lymphoma early after pancreas-kidney transplantation; all others developed a
      monoclonal polymorphic or immunoblastic lymphoma 2 to 123 months after
      transplantation. In all patients extranodal sites were involved, in three the
      graft was also involved. Five patients received the full quintuple approach and
      all rapidly obtained a complete remission (CR) with a median follow-up of 31
      months (7-74 months). Of the two patients who did not receive interferon-alpha
      for fear of graft rejection one responded slowly with a CR after 7 months, and
      the other obtained a rapid CR followed by a relapse at 4 months. All three
      patients with a liver or heart transplant could keep their graft. All patients
      are still alive with a median follow-up of 31 months (7-74 months). CONCLUSION:
      This combined approach resulted in a favorable outcome in patients with high risk
      monoclonal PTLD after solid organ transplantation.

PMID- 11211195
TI  - A randomized and prospective study comparing treatment with high-dose intravenous
      immunoglobulin with monoclonal antibodies for rescue of kidney grafts with
      steroid-resistant rejection.
AB  - BACKGROUND: The aim of this study was to compare the effectiveness of intravenous
      immunoglobulin (IVIg) versus monoclonal anti-CD3 as a treatment for steroid
      resistant rejections. From January 1995 to June 1997, 30 patients were analyzed.
      They were randomized into two groups. Resistant rejections were diagnosed by core
      biopsy. Group A received 500 mg/ kg/day IVIg (Sandoglobulin) for 7 consecutive
      days, whereas group B received 5 mg/day of OKT3 for 14 consecutive days. Daily T
      cell CD3+ peripheral count was performed for 14 days for group B. The
      immunosuppression was similar for both groups. Cyclosporine was stopped during
      both treatments. METHODS: Demographic factors, HLA mismatch, creatinine levels
      before and after treatment, and the incidence of rejections after treatment (up
      to 1 month) were taken into account for this study. RESULTS: Data from different
      samples were compared using Fisher's exact test. Graft and patient survival were
      analyzed using the Kaplan-Meier method. The were no significant differences found
      in age, graft origin, HLA mismatch, or time of follow-up until the episode of
      rejection. Success was achieved for 11 (73.3%) of 15 of group A and 13 (86.6%) of
      15 of group B (P=0.79). Creatinine levels before and after treatment were as
      follows: A, 2.99+/-1.30 mg/dl and 2.1+/-0.70 mg/dl versus B, 3.1+/-1.1 mg/dl and
      2.5+/-0.8 mg/dl. Besides, we did not observe differences in the creatinine 1
      month after treatment (A: 2.35+/-0.78 mg/dl; B: 2.51+/-1.10 mg/dl; P=0.66) nor in
      the third month (A: 1.83+/-0.58 mg/dl; B: 2.30+/-0.89 mg/dl; P=0.24). The
      incidence of rejections after treatment was 5 (46%) of 11 for group A and 9 (75%)
      of 12 for group B (P=0.4). The patient survival rates 2 years after treatment
      were 87 and 92% for A and B groups, respectively. Graft survival was identical
      (80% in both groups). CONCLUSION: Should the favorable result presented in this
      report be confirmed in larger number of patients, IVIg could become the
      preferable choice of rejection treatment for steroid-resistant rejection because
      of a complete absence of the unwanted side effects commonly associated with OKT3.

PMID- 11211196
TI  - Nosocomial outbreak of parvovirus B19 infection in a renal transplant unit.
AB  - BACKGROUND: Parvovirus B19 (B19) infection is known to cause chronic infection
      leading to anemia in immunocompromised patients. Although nosocomial B19
      infections in immunocompetent patients have been documented, no outbreaks in
      immunocompromised patients have been previously reported. Whether transmission
      can occur from a patient with chronic infection is also unknown. METHODS: An
      outbreak of B19 infection in a renal transplant unit was investigated by
      molecular analysis of the virus strains and a case-control study. RESULTS: Three
      patients had genetically identical virus strains suggesting the occurrence of
      nosocomial transmission. The index case transmitted infection many weeks after
      the onset of her clinical symptoms. Other patients at risk of acquiring infection
      were those most intensively immunosuppressed. Viral load in the serum correlated
      with the hematological response. A rebound in the viral load was associated with
      clinical relapse and the failure of i.v. immunoglobulin therapy. CONCLUSION:
      Nosocomial transmission of B19 can occur from immunocompromised patients even
      when they are in the chronic stage of the infection. The clinical and virological
      response to i.v. immunoglobulin therapy is variable and depends on the overall
      level of immunosuppression of the patient.

PMID- 11211197
TI  - Occult nonhematopoietic malignancies present at autopsy in solid organ transplant
      patients who died within 100 days.
AB  - BACKGROUND: Patients are at an increased risk for developing malignancies after
      transplantation. Lymphomas, skin malignancies, Kaposi's sarcomas, and
      cervical/vulvar neoplasms are the most common, but visceral malignancies are also
      well documented, with a reported frequency ranging from 1% to 6%. These visceral
      tumors represent a mix of neoplasms that were clinically occult at the time of
      transplantation and those that arise de novo after transplantation. Little
      information, however, is available on the frequency of clinically occult
      malignancies at the time of transplantation and their contribution to the number
      of posttransplant malignancies. METHODS: A retrospective study was performed of
      all patients who received an organ transplant from January 1981 to June 1997 and
      died within 100 days, a time interval in which epithelial malignancies found at
      autopsy were presumed to have been present, but clinically occult, at the time of
      transplantation. RESULTS: A total of 375 patients were studied who received the
      following organ transplants: 231 liver, 52 heart, 26 heart and lung, 32 lung, and
      34 kidney. Eleven malignancies were identified for an overall frequency of 2.9%
      and included three thyroid carcinomas, three carcinoids of the small bowel, two
      lung carcinomas, one laryngeal carcinoma, one renal cell carcinoma, and one
      seminoma. CONCLUSION: The 2.9% frequency of malignancies seen in this study
      suggests that a small, but significant, number of patients have occult
      malignancies at the time of transplantation and that these occult tumors
      contribute substantially to the number of malignancies that present clinically
      after transplantation.

PMID- 11211199
TI  - The use of pretransplant erythropoietin to normalize hemoglobin levels has no
      deleterious effects on renal transplantation outcome.
AB  - BACKGROUND: The aim of this study was to establish the outcome of renal
      transplantation in patients given pretransplant erythropoietin (EPO) treatment
      targeted at reaching a normal hemoglobin concentration (Hb), compared to those
      given EPO-treatment aimed at maintaining subnormal Hb. METHODS: A total of 416
      patients from Scandinavian countries and with renal anaemia were enrolled to
      examine the effects of increasing Hb from a subnormal level (90-120 g/liter) to a
      normal level (135-160 g/liter) by EPO treatment. Half of the patients were
      randomized to have their Hb increased, with the other half randomized to maintain
      a subnormal Hb. Thirty-two patients from the normal Hb group and 24 patients from
      the subnormal group received a renal graft during the study period. The outcomes
      of these transplantations were examined prospectively for 6 months. RESULTS:
      Preoperative Hb levels were 143+/-17 and 121+/-14 g/liter in the two groups,
      respectively (P<0.0001). The Hb remained higher in the normal Hb group during the
      first 2 weeks after transplantation. The percentage of patients requiring
      postoperative blood transfusions in the normal Hb group was 16%, compared with
      50% in the subnormal group (P<0.01). No statistically significant difference in
      the proportion of functioning grafts or in the serum creatinine levels could be
      detected. No correlation between EPO treatment and creatinine levels after
      transplantation was found. The frequency of adverse events was similar in the two
      groups. CONCLUSIONS: EPO treatment aimed at reaching a normal Hb in renal
      transplant recipients reduces the postoperative requirement for blood
      transfusions and has no deleterious effects on kidney graft function.

PMID- 11211198
TI  - Safety, tolerability, and efficacy of cyclosporine microemulsion in heart
      transplant recipients: a randomized, multicenter, double-blind comparison with
      the oil-based formulation of cyclosporine--results at 24 months after
      transplantation.
AB  - BACKGROUND: The widespread use of cyclosporine has improved the survival of
      cardiac transplant patients as a result of reduced morbidity and mortality from
      rejection and infection. The original oil-based form of cyclosporine demonstrated
      unpredictable absorption resulting in an increased frequency of acute and chronic
      rejection in patients with poor bioavailability. The primary end. points of the
      present, prospective, randomized multicenter, double-blind trial were to compare
      the efficacy of the micro-emulsion form of cycolsporine (CsA-NL) with the oil
      based formulation as determined by cardiac allograft and recipient survival and
      the incidence and severity of the acute rejection episodes and to determine the
      safety and tolerability of CsA-NL compared with Sandimmune CsA-(SM) in the study
      population. The 6-month analysis of the study showed reduced number of CsA-NL
      patients requiring antilymphocyte antibody therapy for rejection, fewer
      International Society of Heart and Lung Transplantation grade > or =3A rejections
      in female patients and fewer infections. Our report represents the final analysis
      of the results 24 months after transplantation. METHODS: A total of 380 patients
      undergoing de novo cardiac transplants at 24 centers in the United States,
      Canada, and Europe were enrolled in this double-blind, randomized trial
      evaluating the efficacy and safety of CsA-NL versus CsA-SM. Acute allograft
      rejection was diagnosed by endomyocardial biopsy and graded according to the
      International Society of Heart and Lung Transplantation nomenclature. Kaplan
      Meier analysis and Fisher's exact test were used for comparisons between groups.
      RESULTS: After 24 months, allograft and recipient survival were identical in both
      groups. There were fewer CsA-NL patients (6.9%) requiring antilymphocyte antibody
      therapy for rejection than in the CsA-SM-treated patient group (17.7%, P=0.002).
      There were fewer discontinuations of study drug for treatment failures in the CsA
      NL groups (7; 3.7%) compared with the CsA-SM group (18; 9.4%, P=0.037). The
      average corticosteroid dose was lower in the CsA-NL group (0.37 mg/kg/day)
      compared with the CsA-SM group (0.48 mg/kg/day, P=0.034) over the 24-month study
      period. Overall, there was no difference in blood pressure or creatinine between
      the two study groups. CONCLUSIONS: The final results of this multi-center,
      randomized study of two forms of cyclosporine confirmed that there were fewer
      episodes of rejection requiring antilymphocyte antibodies and fewer study
      discontinuations for treatment failures in CsA-NL-treated patients compared to
      those treated with CsA-SM. The use of CsA-NL did not predispose these patients to
      a higher risk of adverse events.

PMID- 11211200
TI  - Reinnervation of syngeneic pancreatico-duodenal grafts in rats.
AB  - BACKGROUND: Knowledge on the reinnervation of transplanted organs is scarce, and
      the aim of the study was therefore to evaluate to what degree syngeneic pancreas
      grafts were reinnervated in rats. METHODS: Syngeneic pancreatico-duodenal
      transplantations were performed in normoglycemic Wistar-Furth rats. Native and
      transplanted pancreas and duodenum were removed 4 or 40 weeks after implantation,
      and processed for indirect immunofluorescence using antibodies directed against
      vasoactive intestinal peptide, substance P (SP), calcitonin gene-related peptide
      (CGRP), neuropeptide Y (NPY), tyrosine hydroxylase (TH), or the general neuronal
      marker protein gene product 9.5. RESULTS: Four weeks after transplantation a
      moderate to rich number of protein gene product 9.5-positive nerve fibers were
      found homogeneously distributed through the pancreas, probably representing the
      intrapancreatic nervous system, because the grafted pancreas lacked both a
      sympathetic (TH/NPY) and sensory (SP/CGRP) innervation 4 weeks after
      implantation. In a few of the animals there was a marked increase in SP
      immunoreactive nerves (lacking CGRP), most conspicuous in the duodenal portion,
      both 4 and 40 weeks after transplantation probably secondary to a chronic
      pancreatitis. The fibers seemed to emanate from intrapancreatic ganglia and
      possibly also from enteric neurons in adjacent parts of the duodenum. A few
      scattered vasoactive intestinal peptide-containing nerve fibers probably also
      emanating from local ganglia could be seen throughout the grafted pancreas both 4
      and 40 weeks after transplantation. At 40 weeks after transplantation sympathetic
      (TH- and NPY-positive) nerve fibers were regularly seen, whereas CGRP-positive
      nerve fibers were still virtually lacking in the pancreas. To trace the origin of
      the ingrowing nerve fibers, the tracer True Blue was injected into the grafted
      pancreas of some rats 38 weeks after transplantation, i.e., 2 weeks before
      killing. True Blue-labeled nerve cell bodies were numerous in the celiac ganglion
      (presumably sympathetic nerves) and few in dorsal root ganglia (sensory nerves).
      CONCLUSIONS: The data suggest that the transplanted rat pancreas becomes
      reinnervated by mainly sympathetic nerve fibers.

PMID- 11211201
TI  - The impact of simultaneous pancreas-kidney transplantation on long-term patient
      survival.
AB  - BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK) ameliorates the
      progression of microvascular diabetic complications but the procedure is
      associated with excess initial morbidity and an uncertain effect on patient
      survival when compared with solitary cadaveric or living donor renal
      transplantation. We evaluated mortality risks associated with SPK, solitary renal
      transplantation, and dialysis treatment in a national cohort of type 1 diabetics
      with end-stage nephropathy. METHODS: A total of 13,467 adult-type 1 diabetics
      enrolled on the renal and renal-pancreas transplant waiting list between 10/01/88
      and 06/30/97 were followed until 06/30/98. Time-dependent mortality risks and
      life expectancy were calculated according to the treatment received subsequent to
      wait-list registration: SPK; cadaveric kidney only (CAD); living donor kidney
      only (LKD) transplantation; and dialysis [wait-listed, maintenance dialysis
      treatment (WLD)]. RESULTS: Adjusted 10-year patient survival was 67% for SPK vs.
      65% for LKD recipients (P=0.19) and 46% for CAD recipients (P<0.001). The excess
      initial mortality normally associated with renal transplantation and the risk of
      early infectious death was 2-fold higher in SPK recipients. The time to achieve
      equal proportion of survivors as the WLD patients was 170, 95, and 72 days for
      SPK, CAD, and LKD recipients, respectively (P<0.001). However, the adjusted 5
      year morality risk (RR) using WLD as the reference and the expected remaining
      life years were 0.40, 0.45, and 0.75 and 23.4, 20.9, and 12.6 years for SPK, LKD,
      and CAD, respectively. There was no survival benefit in SPK recipients > or =50
      years old (RR=1.38, P=0.81). CONCLUSIONS: Among patients with type 1 DM with end
      stage nephropathy, SPK transplantation before the age of 50 years was associated
      with long-term improvement in survival compared to solitary cadaveric renal
      transplantation or dialysis.

PMID- 11211202
TI  - Retransplantation of the liver in children.
AB  - BACKGROUND: Because of the poor outcome of hepatic retransplantation, it is still
      debated whether this procedure should be performed in an era of donor organ
      scarcity. The aim of this study was to analyze outcome of hepatic
      retransplantation in children, to identify risk factors influencing this outcome,
      and to assess morbidity and causes of death. METHODS: A series of 97 children
      after a single transplantation and 34 children with one retransplantation was
      analyzed. RESULTS: The 1-, 3-, and 5-year survival of children with a
      retransplantation was 70, 63, and 52%, respectively, compared with 85, 82, and
      78%, respectively, for children after a single transplantation (P=0.009).
      Survival of children with a retransplantation within 1 month after primary
      transplantation was worse (P=0.007) and survival of children with a late
      retransplantation was comparable (P=0.66) with single transplantation. In early
      retransplantations, the Child-Pugh score was higher, donors were older and
      weighed more, and more technical variant liver grafts were used compared with
      single transplantations. Biliary atresia and a high Child-Pugh score were
      associated with decreased patient survival after retransplantation. Sepsis was
      the most important complication and cause of death after retransplantation.
      CONCLUSIONS: Retransplantation is a significant event after pediatric liver
      transplantation. Outcome after hepatic retransplantation in children is inferior
      compared with single transplantation. This difference is explained by low
      survival after early retransplantation and can be explained by the poor clinical
      condition of the children at time of retransplantation, especially in children
      with biliary atresia, and by the predominant use of technical variant liver
      grafts in retransplantations.

PMID- 11211203
TI  - Comparison of famciclovir and lamivudine in the long-term treatment of hepatitis
      B infection after liver transplantation.
AB  - BACKGROUND: Preliminary results of short-term famciclovir and lamivudine therapy
      in patients with hepatitis B virus (HBV) infection after liver transplantation
      revealed promising results. In a retrospective study the efficacy of long-term
      treatment with these substances was compared. METHODS: A total of 53 HBV-infected
      adults (48 reinfections and 7 de novo infections) received antiviral treatment. A
      total of 32 of these patients were treated with famciclovir 3x500 mg, 20 of them
      were later switched to lamivudine. Fourteen patients received lamivudine, 150
      mg/day orally, as first line therapy and 7 patients after failure of famciclovir
      prophylaxis. Follow-up time was 8 to 62 months (mean 35 months). Response to
      therapy (HBV-DNA negative) was compared using Kaplan-Meier estimates. Potential
      influence factors (HBV-DNA and HBeAg pretransplant, HDV coinfection, pretreatment
      with famciclovir and immunosuppression) on treatment response were analyzed by
      log. Rank test (univariate); then a multivariate analysis (Cox multiple stepwise
      regression model) was applied. RESULTS: A total of 19 and 76% of the patients
      treated with famciclovir and lamivudine resp. became HBV-DNA negative; 0 and 24%
      HBsAg negative. Lamivudine was also effective as second line therapy. In a
      multivariate analysis of all 73 treatment courses, lamivudine treatment and HDV
      coinfection were significant factors for better treatment response; regarding
      only the lamivudine group, negative HBeAg pretransplant was significant. Viral
      breakthrough after prolonged treatment occurred in 55% (lamivudine) to 80%
      (famciclovir) of treatment courses but was only accompanied by mild hepatitis.
      CONCLUSIONS: Lamivudine and famciclovir are potent drugs for the treatment of HBV
      infection after liver transplantation. The antiviral capacity of lamivudine is
      superior even after pretreatment with famciclovir but after prolonged treatment
      viral breakthrough is often observed.

PMID- 11211204
TI  - Liver transplantation for fulminant hepatic failure.

PMID- 11211205
TI  - Real-time display of the stomach slow wave and its parameters in a newly designed
      electrogastrographic system.
AB  - We designed a new three-channel electrogastrographic (EGG) system, which was
      easily operated on the Windows 95 platform and could automatically provide slow
      wave parameters. The purpose of the present study was to test its reliability and
      accuracy in clinical recording. The system included a signal acquisition device
      assembled on a printed circuit board. Recorded myoelectrical signals were
      filtered, amplified, digitized, and transmitted via this device into a notebook
      personal computer (PC). Based on the short-term Fourier transform the software
      could transfer the time domain of the signal into the frequency domain. Real-time
      displayed slow wave parameters, including dominant frequency/power, percent of
      normal frequency (2-4 cpm), instability coefficient in frequency/power, and power
      ratio, were automatically renewed every 64s. Twenty healthy subjects (M/F, 12/8;
      age, 23-51 years) were enrolled to measure both fast and postprandial
      myoelectrical activities for each 30-min recording. Our results indicated that
      meal ingestion significantly increased dominant frequency (3.15+/-0.20 vs 3.23+/
      0.23 cpm; P < 0.05) and power (26.1+/-3.8 vs 28.4+/-3.9 dB; P < 0.05). The power
      ratio of the meal effect was 2.02+/-2.07. Other parameters, including instability
      coefficient and percent of normal frequency, remained similar despite food
      ingestion. This newly designed EGG system is acceptable for clinically measuring
      gastric myoelectrical activity; the real-time display of many EGG parameters is
      an advantage with this new system.

PMID- 11211206
TI  - Distribution and molecular forms of adrenomedullin and proadrenomedullin N
      terminal 20 peptide in the porcine gastrointestinal tract.
AB  - Adrenomedullin (AM) and proadrenomedullin N-terminal 20 peptide (PAMP) are potent
      hypotensive peptides that are generated from the same precursor and expressed in
      a variety of mammalian tissues. The purpose of this study was to elucidate the
      distribution and endogenous molecular forms of AM and PAMP. To this end, we used
      new radioimmunoassays that recognize the ring structure of AM and the C-terminal
      region of PAMP to compare the distribution of AM and PAMP in porcine
      gastrointestinal tissues. Immunoreactive AM was abundant in the duodenum (0.334+/
      0.132 fmol/mg) and ileum (0.439+/-0.235 fmol/mg), and ubiquitous in other
      gastrointestinal tissues. The duodenal and ileal concentrations of AM were about
      4 to 14 times higher than those in other gastrointestinal tissues. Similarly,
      immunoreactive PAMP was abundant in the duodenum (0.577+/-0.417 fmol/mg) and
      ileum (1.575+/-1.445 fmol/mg) and ubiquitous in other gastrointestinal tissues.
      The concentrations of immunoreactive AM and PAMP were highest in the ileum.
      Characterization of these peptides in the ileum, using high-performance liquid
      chromatography, showed that they were authentic. Furthermore, the concentrations
      of immunoreactive AM and PAMP in the mucosa and submucosa of the ileum were
      significantly higher than those in whole ileum. These results suggest that AM and
      PAMP play physiological roles in the porcine small intestine.

PMID- 11211208
TI  - High sensitivity of a novel ELISA for anti-M2 in primary biliary cirrhosis.
AB  - The use of an ELISA for the detection of anti-M2, a specific autoantibody in
      primary biliary cirrhosis (PBC), has been common in Japan. However, there are
      some problems in the sensitivity of this ELISA, especially in PBC patients
      showing antimitochondrial antibody (AMA)-negative sera or low AMA titers by
      immunofluorescence. Recently, a new ELISA for anti-M2 was developed, using
      porcine heart mitochondrial protein as the antigen. We report here comparative
      studies of the new and the former anti-M2 ELISAs. Porcine heart mitochondrial
      protein was prepared and used as the antigen for the new ELISA for anti-M2.
      Sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of this
      protein showed three major M2 antigen proteins. As the second antibody,
      peroxidase-conjugated anti-human mouse monoclonal IgM, in addition to monoclonal
      IgG, was included. The sera of 171 PBC patients were examined. As controls, we
      examined the sera of 167 non-PBC patients and the sera of 115 normal controls.
      The cut-off index was set at 10 U/ml, based on the results for the normal
      controls. No sera from the non-PBC patients or the normal controls were positive
      for anti-M2 by either the new or the former ELISA. However, the positivity rate
      for anti-M2 in PBC patients with the new ELISA was 78%; in contrast, that with
      the former ELISA was only 54%; this difference was significant (P = 0.00001). In
      particular, in 65 patients showing AMA titers of 1:20 or less, the positivity
      rate with the new ELISA was 51%; in contrast, that with the former ELISA was only
      17%. As the sensitivity of the new ELISA is significantly higher than that of the
      former ELISA, especially for sera from patients showing AMA-negativity or low
      titers of AMA, the new ELISA is considered to be more effective than the former
      ELISA for use in anti-M2 screening assays in patients with PBC.

PMID- 11211207
TI  - Expression patterns of cell cycle-related proteins in a rat cirrhotic model
      induced by CCl4 or thioacetamide.
AB  - To analyze the aberrant expression of cell cycle-related proteins and their
      biological significance in relation to cirrhosis, we compared the cirrhotic
      patterns induced by two different types of cirrhotic agents, CCl4 and
      thioacetamide (TAA) in rats. CCl4 or TAA treatment was given to rats for 8 or 30
      weeks, respectively, and the livers were removed at 9, 20, and 30 weeks after the
      experiment began. The TAA-induced fibrotic pattern was different from the CCl4
      induced one, in terms of the formation of fibrous connective tissue and the
      proliferation of bile ductule cells. Cholangiofibrosis and clear cell foci were
      also observed in TAA-treated rats at 30 weeks. Histological examination revealed
      severe cirrhotic changes at 9 weeks in CCl4-treated rats and at 30 weeks in TAA
      treated rats. Immunoblotting for cyclin D1, E, A, B, and proliferating cell
      nuclear antigen (PCNA) and their counterpart protein kinases (CDK2, 4, and CDC2)
      showed significant overexpression in rats with severely cirrhotic livers. The p53
      tumor suppressor protein increased dramatically in the CCl4-treated group, while
      it was not detected in the livers of TAA-treated rats. Upregulation of p21WAF1, a
      CDK inhibitory protein, was detected in TAA-treated rats, but not in CCl4-treated
      rats. Immunohistochemical data for cyclin D1, E, and PCNA were well correlated
      with immunoblotting data; these proteins were increased in hepatocytes
      surrounding the cirrhotic lesions, suggesting that hepatocyte regeneration is
      correlated with cell cycle-related protein expression in cirrhotic liver. In the
      TAA-treated rats, the expression of these proteins was increased both in
      hepatocytes and in ductule cells. Our data suggest that liver cirrhosis induced
      by CCl4 or TAA is associated with alterations in cell cycle-related proteins, and
      that the expression of these proteins is responsible for hepatocyte regeneration
      in the damaged liver and may be involved in liver carcinogenesis.

PMID- 11211209
TI  - Jejunal carcinoid tumor mimicking leiomyosarcoma: preoperative diagnosis by
      endoscopic biopsy.
AB  - Primary carcinoid tumor of the jejunum is rare, and is an unusual cause of
      massive gastrointestinal bleeding. A case of primary jejunal carcinoid tumor in a
      39-year-old woman who presented with massive hematochezia is described. Both
      upper and lower gastrointestinal endoscopies showed no abnormalities. An
      abdominal computed tomographic scan, small-bowel barium contrast studies, and
      small-bowel endoscopy showed a subserosal mass, of 5 x 4 cm, with a cavity
      suggesting central necrosis, and a deep mucosal ulceration, located in the
      proximal jejunum. Although these clinical presentations were strongly suggestive
      of a leiomyosarcoma, histologic examination of biopsy samples obtained by
      enteroscopy confirmed the diagnosis of jejunal carcinoid tumor. The patient
      underwent radical jejunal resection and recovered uneventfully. In spite of the
      large size of the tumor, there was one solitary lymph node metastasis, but no
      evidence of liver metastases. This kind of jejunal carcinoid tumor, presenting
      with massive gastrointestinal bleeding and a subserosal bulky growth mimicking a
      leiomyosarcoma, has not been reported previously. Moreover, this is a rare case
      of a jejunal carcinoid which was diagnosed preoperatively by small bowel
      endoscopic biopsy.

PMID- 11211210
TI  - Nonrotation of the midgut with appendiceal mucocele in an adult.
AB  - Nonrotation of the midgut in adults and appendiceal mucocele are both rare
      pathological conditions. We report here the first case of nonrotation of the
      midgut associated with appendiceal mucocele. The patient was a 51-year-old man
      admitted to hospital with ileus. An upper gastrointestinal series and a barium
      enema revealed nonrotation of the midgut without midgut volvulus and with a mass
      in the ileocecal area. Laparotomy revealed an appendiceal mucocele adhering to
      the urinary bladder and the rectum. The mucocele had partly ruptured; yellowish
      mucinous material had entered the abdominal cavity, resulting in pseudomyxoma
      peritonei. Histological examination revealed a mucinous tumor of the appendix
      with borderline malignancy. In this patient, the ileus was caused by the
      appendiceal mucocele rather than being caused by nonrotation of the midgut.

PMID- 11211211
TI  - Superficial depressed early carcinoma that developed into protuberant advanced
      carcinoma in the transverse colon.
AB  - A screening colonoscopic examination in a 70-year-old man revealed a nonpolypoid
      type superficial depressed early carcinoma, about 2cm in diameter, in the
      transverse colon. The lesion was not resected and was observed because of
      coexisting nonresectable hepatocellular carcinoma (HCC). Fifteen months later,
      follow-up examinations revealed a polypoid type protuberant advanced carcinoma,
      about 6 cm in diameter, at the same site. Because complete response of the HCC
      had been induced by transarterial embolization, the colon carcinoma was
      operatively resected. There is an indefinite concept that colorectal carcinomas
      develop without substantial morphological changes, and no superficial depressed
      carcinoma that developed into a protuberant type advanced carcinoma has been
      reported. The case reported here provides evidence that some polypoid carcinomas
      arise from superficial depressed precursors. There is some intermingling between
      the two postulated colorectal carcinogenic pathways, the conventional polypoid
      pathway named the "adenoma-carcinoma sequence", and the nonpolypoid pathway,
      including so-called "de-novo" carcinogenesis.

PMID- 11211212
TI  - Antibacterial action of tryptanthrin and kaempferol, isolated from the indigo
      plant (Polygonum tinctorium Lour.), against Helicobacter pylori-infected
      Mongolian gerbils.
AB  - We evaluated the effect of tryptanthrin and kaempferol, both isolated from
      Polygonum tinctorium Lour., against Helicobacter pylori colony formation in vitro
      and in H. pylori-infected Mongolian gerbils. H. pylori suspension was mixed with
      solution of tryptanthrin and/or kaempferol and placed onto agar plates. These
      plates were incubated at 37 degrees C, under 10% CO2 for 5 days, and the H.
      pylori colonies were counted. For the in vivo experiment, Mongolian gerbils were
      inoculated with H. pylori ATCC 43504 orally. After 4 weeks, the infected gerbils
      were given tryptanthrin and/or kaempferol, administered orally, twice a day for
      10 days. The animals were killed and the number of live H. pylori in their
      stomachs was determined. In vitro both tryptanthrin and kaempferol significantly
      decreased the numbers of H. pylori colonies a dose-dependent manner. An additive
      effect on colony formation was observed with the combined use. In the in vivo
      experiment, oral administration of tryptanthrin and/or kaempferol significantly
      decreased the numbers of colonies in the gerbils' stomachs. We concluded that
      tryptanthrin and kaempferol were effective against H. pylori in vivo.

PMID- 11211213
TI  - Hepatic adenomas treated with percutaneous ethanol injection in a patient with
      glycogen storage disease type Ia.
AB  - We report a 20-year-old man with glycogen storage disease type Ia (GSD Ia) who
      presented multiple hepatocellular adenomas (HCAs) in 1993 and in whom
      percutaneous ethanol injection (PEI) was conducted as treatment for some
      enlarging tumors beneath the liver surface. In a 6-year follow-up period, we
      observed gradual enlargement of some of the HCAs, and the rapid growth of a newly
      developed tumor. In August 1996, one slow-growth HCA was 52 mm in diameter and
      was located beneath the surface of the liver. We conducted PEI therapy to prevent
      its spontaneous rupture. During the following year, another tumor developed
      beneath the liver surface, but showed extremely rapid growth, reaching 51 mm in
      diameter, from being undetectable, within 12 months. PEI therapy was again
      conducted for this newly developed tumor. Although additional PEI therapy was
      required for each tumor, because of suspected recurrence, no findings of discrete
      recurrence have been detected by computed tomography and magnetic resonance
      imaging for more than 2 years, up to the time of this study. We consider PEI to
      be a useful and effective therapeutic modality for individual HCAs in patients
      with GSD Ia.

PMID- 11211214
TI  - What is the role of adrenomedullin and proadrenomedullin N-terminal 20 peptide
      produced in the gastrointestinal tract?

PMID- 11211215
TI  - Hepatocellular adenoma in type Ia glycogen storage disease.

PMID- 11211216
TI  - High amoxycillin resistance in Helicobacter pylori isolated from gastritis and
      peptic ulcer patients in western Nigeria.

PMID- 11211217
TI  - Cashing in your chips: speculation on the future of diagnostic laboratories in
      the era of DNA chips.

PMID- 11211218
TI  - Type III secretion systems and pathogenicity islands.
AB  - Some bacterial pathogens have evolved by acquiring pathogenicity islands (PIs),
      which are clusters of genes encoding virulence traits. PIs encoding the secretion
      of effector molecules via type III secretion (TTS) systems have been discovered
      in several gram-negative pathogens. TTS systems are involved in contact-dependent
      secretion of virulence factors and can facilitate delivery of toxins directly
      into target cells. The expanding list of bacteria found to contain clusters of
      TTS genes includes members of the genera Yersinia, Salmonella, Shigella,
      Escherichia, Pseudomonas, Bordetella, Burkholderia, Chlamydia and a number of
      plant pathogens or symbionts. This review discusses the current knowledge of the
      role of TTS PIs in pathogenicity, the genetic organisation and evolution of such
      systems,and the potential for using TTS systems as targets for novel treatments.

PMID- 11211219
TI  - Antibody isotypes to a Paracoccidioides brasiliensis somatic antigen in sub-acute
      and chronic form paracoccidioidomycosis.
AB  - This report describes the differences in isotype antibody reactivity against a
      crude Paracoccidioides brasiliensis antigenic preparation in the sub-acute (SAF)
      and chronic (CF) forms of paracoccidioidomycosis before treatment. IgG antibodies
      were detected in all patients, with a slightly but not significantly higher
      reactivity in the SAF. IgG1 antibodies were present, frequently at high levels,
      in both forms, whereas IgG3 was always low or absent. IgG2 antibodies were
      detectable in most patients, but at high levels in only a few CF patients. IgG4
      was found mainly in SAF patients, whereas IgA was detected almost only in CF
      patients, probably due to a Th2 pattern of immune response in the more severe
      SAF, and the characteristic mucosal involvement of the CF, respectively.
      Immunoblot analysis showed that, in addition to the 43-kDa immunodominant
      fraction, other less well-characterised fractions were also recognised
      differentially by the isotypes and deserve further investigation.

PMID- 11211220
TI  - Verocytotoxin-producing Escherichia coli (VTEC) O157 and other VTEC from human
      infections in England and Wales: 1995-1998.
AB  - A total of 3429 isolations of verocytotoxin-producing Escherichia coli O157 (VTEC
      O157) was confirmed from human sources in England and Wales during the period
      1995-1998. The largest annual total was 1087 in 1997. Most infections occurred in
      the third quarter of each year. The overall rate of infection ranged from 1.28 to
      2.10/100,000 population and showed regional variation. The highest incidence was
      in children aged 1-4 years. Annually, between 5% and 11% of strains were from
      patients who had travelled abroad. There were 67 general outbreaks of infection
      represented by 407 (11.9%) VTEC O157 isolates. Outbreaks involved transmission by
      contaminated food or water, person-to-person spread and direct or indirect animal
      contact, and five were associated with foreign travel. The majority (76%) of
      strains carried verocytotoxin (VT) 2 genes and 23.3% were VT1+VT2. Most strains
      had the flagellar antigen H7, but c. 14% were non-motile. Approximately 20% of
      isolates were resistant to antimicrobial agents, predominantly streptomycin,
      sulphonamides and tetracycline. In addition to VTEC O157, strains of serogroup
      O157 that did not possess VT genes were identified. These were either derivatives
      of VTEC O157 that had lost VT genes or were strains with H antigens other than H7
      that have never been associated with VT production. Strains of VTEC other than
      O157 were characterised. Most were associated with diarrhoea, bloody diarrhoea or
      haemolytic uraemic syndrome and had virulence markers in addition to VT.

PMID- 11211221
TI  - Multiple outbreaks of Norwalk-like virus gastro-enteritis associated with a
      Mediterranean-style restaurant.
AB  - The role of diverse infectious agents, particularly Norwalk-like viruses (NLV),
      in three successive gastro-enteritis outbreaks in one setting (a restaurant) was
      evaluated. Methods included standard bacteriological tests, specific tests for
      Escherichia coli, tests for verocytotoxins, electron microscopy (EM) for viruses
      and reverse transcription-PCR (RT-PCR) methodology for NLV. No pathogenic
      bacteria were detected. Verocytotoxin genes, although detected by PCR in the
      first outbreak, could not be confirmed in the E. coli isolated, so they did not
      appear to be of significance. NLV was the main agent detected in each of the
      three outbreaks. DNA sequencing and phylogenetic analysis of the amplified
      products obtained from the RT-PCR positive specimens indicated that only one NLV
      strain was involved in each outbreak, but the NLV strains responsible for the
      three outbreaks were different from each other. PCR technology for detection of
      NLV proved highly sensitive, but failed to detect one specimen which was positive
      by EM. The restaurant associated with the outbreaks is a Mediterranean-style
      restaurant where food from a common platter is typically eaten with fingers. The
      findings indicate that NLV was introduced by guests or staff and was not due to a
      long-term reservoir within the setting.

PMID- 11211222
TI  - Effect of short-chain carbohydrates on human intestinal bifidobacteria and
      Escherichia coli in vitro.
AB  - Plate counts and small subunit (SSU) rRNA abundance were used to study the
      effects of fructo-oligosaccharides (FOS), fructose, or galacto-oligosaccharides
      (GOS) on bifidobacterial populations in human faecal microbiotas. The bacteria
      were grown in pH-controlled anaerobic fermentation vessels. Untreated cultures
      and fructose-amended fermenters were used as controls. Bifidobacterium longum, B.
      adolescentis and B. angulatum comprised the dominant bifidobacterial populations
      throughout the experiment. No major differences were found in the four
      treatments, in terms of viable counts of the organisms or of total populations of
      bifidobacteria at any time point. However, large differences were observed with
      respect to the abundance of bifidobacterial SSU rRNA between the treatments.
      Greatest bifidobacterial SSU rRNA abundance was seen in FOS cultures, with the
      lowest in the untreated control fermentation. GOS and fructose also increased
      bifidobacterial SSU rRNA. Cultures supplemented with FOS and GOS were also
      associated with lower colony counts and SSU rRNA abundance for Escherichia coli,
      compared with fructose-supplemented and control fermenters. At the 24-h time
      point, the untreated control contained 19.8 microg of enterobacterial SSU rRNA/ml
      of culture fluid, compared with 11.4 microg/ml for the fructose fermentation, and
      2.6 and 0.5 microg/ml for the FOS and GOS culture vessels, respectively.

PMID- 11211223
TI  - Antagonism against Vibrio cholerae by diffusible substances produced by bacterial
      components of the human faecal microbiota.
AB  - Cholera vibrios sometimes survive, probably in low-level silent populations, in
      the small intestine of chronic carriers or pass through the gastrointestinal
      tract of a few individuals without causing diarrhoea or colonisation. To
      understand these situations, the present study used plate cultures (ex-vivo test)
      to investigate the frequency of appearance of an inhibitory halo against Vibrio
      cholerae produced by faecal specimens from 92 healthy volunteers (40 females, 52
      males) aged 4-61 years. The frequency of inhibitory halo was 20.6% in the whole
      group. An apparently higher percentage (27.3%) was observed in the age range 20
      40 years when compared with the range 4-19 years (10.7%), but not the range 41-61
      years (20.0%). Frequency was significantly higher in males (30.8%) than females
      (7.5%). The dominant microbiota of a volunteer whose faeces produced an
      inhibitory halo was isolated by plate culture of decimal dilutions in an
      anaerobic chamber. Potential isolates of 26 apparently different morphologies
      were associated with germ-free NIH mice. One week later, the inhibitory test
      showed an antagonistic halo around the faeces from the associated animals, but
      not from the axenic mice. Of the 26 bacteria isolated, two (Lactobacillus sp. and
      Peptostreptococcus sp.) produced a compound antagonistic against V. cholerae in
      an in-vitro assay. When bi-associated with germ-free mice those strains
      eliminated the vibrio from the intestinal ecosystem in c. 5 days.

PMID- 11211224
TI  - Investigation of the simian polyomavirus SV40 as a potential causative agent of
      human neurological disorders in AIDS patients.
AB  - Neurological diseases and a variety of neoplasms frequently occur in AIDS
      patients. Human JC and BK polyomaviruses have been associated with neurological
      disorders in such patients. SV40 polyomavirus sequences have been detected in
      human brain tumours, other neoplasms and normal tissues. JCV, BKV and SV40 DNA
      sequences were investigated in cerebrospinal fluid (CSF) samples from 12 AIDS
      patients affected by different neurological disorders, by PCR assay and filter
      hybridisation with specific internal oligoprobes, and DNA sequencing. Three of
      the 12 CSF samples were positive for JCV (one sample) or SV40 (one) DNA, or both
      (one). No sample was positive for BKV DNA. JCV- and SV40-specific genomic regions
      were confirmed by DNA sequencing. CSF samples from the two patients diagnosed
      clinically as having progressive multifocal leukoencephalopathy (PML) contained
      either JCV (one sample) or SV40 (one) DNA. The CSF found to contain both JCV and
      SV40 DNA originated from a patient with a cerebral mass lesion of unknown
      aetiology. These results suggest that SV40 may be involved in the aetiology of
      PML in AIDS patients, and raise the possibility that SV40 and JCV may act
      synergically in vivo to enhance their pathogenicity.

PMID- 11211225
TI  - Emergence of a high-level cefotaxime-resistant Streptococcus pneumoniae strain in
      New Zealand.
AB  - An increase in the number of cefotaxime-resistant pneumococci referred for
      surveillance to a central laboratory in New Zealand occurred in 1997-1998. The
      MIC of cefotaxime for 113 of 216 cefotaxime-resistant isolates of Streptococcus
      pneumoniae referred was > or = 4 mg/L. Most of the 113 isolates exhibited the
      same antibiotic resistance pattern and belonged to serotype 19F. To investigate
      the genetic relatedness of the isolates, 48 serotype 19F pneumococci with varying
      susceptibility to cefotaxime were further typed by macro-restriction analysis by
      use of pulsed-field gel electrophoresis. These results suggested that a
      multiresistant 19F strain of S. pneumoniae with high-level cefotaxime resistance
      had emerged from a pre-existing serotype 19F strain.

PMID- 11211226
TI  - PCR primers that can detect low levels of Mycobacterium leprae DNA.
AB  - There are several specific PCR-based methods to detect Mycobacterium leprae DNA,
      but the amplicons are quite large. For example, primers that target the 36-kDa
      antigen gene and are in common diagnostic use yield a 530-bp product. This may be
      a disadvantage when examining samples in which the DNA is likely to be damaged
      and fragmented. Therefore, two sets of M. leprae-specific nested primers were
      designed, based on existing primer pairs which have been shown to be specific for
      M. leprae. Primers that targeted the 18-kDa antigen gene gave an outer product of
      136 bp and inner product of 110 bp. The primers based on the RLEP repetitive
      sequence yielded a 129-bp outer product and 99-bp nested product. With dilutions
      of a standard M. leprae killed whole-cell preparation as the source of DNA, both
      single-stage and nested PCR were performed after optimisation of the experimental
      conditions. Compared with the 36-kDa antigen gene primers, the 18-kDa antigen
      gene outer primers were 100-fold more sensitive and the RLEP outer primers were
      1000-fold more sensitive. As an illustration of two possible applications of
      these new primers, positive results were obtained from three skin slit samples
      from treated lepromatous leprosy patients and three archaeological samples from
      human remains showing typical leprosy palaeopathology. It was concluded that
      these new primers are a useful means of detecting M. leprae DNA which is damaged
      or present at a very low level.

PMID- 11211227
TI  - Role of heparan sulphate proteoglycans as potential receptors for non-piliated
      Pseudomonas aeruginosa adherence to non-polarised airway epithelial cells.
AB  - Tight junctions seal polarised surface epithelial respiratory cells so as to
      prevent the passage of bacteria and toxins through the epithelial sheet.
      Disruption of tight junctions, which may occur during injury and repair processes
      of airway epithelium, favours potential bacterial interaction with receptors from
      cell basolateral membranes. Earlier studies reported that non-polarised and
      untight epithelial respiratory cells are highly susceptible to Pseudomonas
      aeruginosa adherence and internalisation. As heparan sulphate proteoglycans (HSP)
      from cell basolateral membranes in epithelial cells without tight junctions may
      become accessible to bacterial ligands, the present study investigated their role
      as potential receptors for non-piliate P. aeruginosa ligands. Treatment of cells
      with heparitinase I and II significantly reduced (51.2% and 51.7%, respectively)
      P. aeruginosa adherence to epithelial respiratory cells without tight junctions.
      The internalisation of bacteria was not affected by treatment with heparitinases.
      Treatment of the bacteria with heparin and heparan sulphate also significantly
      reduced their adherence to respiratory cells (34.3% and 43.7%, respectively).
      Treatment of cells with other enzymes (trypsin, lipase and chondroitinase ABC) or
      treatment of bacteria with chondroitin-4-sulphate did not modify the adherence to
      respiratory cells significantly. Both affinity chromatography and Western
      blotting assays showed the interaction of different P. aeruginosa outer-membrane
      proteins (OMPs) with heparin. Several bacterial strains showed differences in
      their profile of heparin-binding OMPs, but all exhibited low mol. wt (< 30 kDa)
      reactive proteins. Reactivity of whole bacterial cells with heparin was also
      observed by transmission electron microscopy. These results suggest that HSP are
      potential receptors for P. aeruginosa adherence to non-polarised and untight
      epithelial respiratory cells.

PMID- 11211228
TI  - Expression of type 1 fimbriae (SEF 21) of Salmonella enterica serotype
      enteritidis in the early colonisation of the rat intestine.
AB  - The involvement of type 1 fimbriae in colonisation of the rat gastrointestinal
      tract in vivo was investigated with Salmonella enterica serotype Enteritidis LA5
      and a mutant of LA5 denoted EAV3 unable to elaborate type 1 fimbriae (SEF 21).
      Rats were given a single dose of LA5 or EAV3 or a 1:1 mixture of both. LA5 was
      found in higher numbers in the stomach and small intestine than EAV3 at 6 h after
      infection with a single strain, but not after 6 days. LA5 did not out-compete
      EAV3 when the strains were administered together. Indeed, after 6 and 21 days,
      EAV3 was found in the distal small intestine and large intestine in far higher
      numbers than LA5. These findings suggest that SEF 21 have an important role(s) in
      the early stages of infection in vivo. However, SEF 21 expression may
      disadvantage the pathogen in the longer term as indicated by EAV3 out-competing
      LA5 in the gut at 21 days.

PMID- 11211229
TI  - Pulmonary colonisation with Pneumocystis carinii in an immunosuppressed HIV
      negative patient: detection and typing of the fungus by PCR.
AB  - Mostly Pneumocystis carinii isolates from patients with acute pneumocystosis
      (PCP) have been typed until now. This report describes the typing of P. carinii
      organisms obtained from an HIV-negative patient without PCP. The patient
      underwent a broncho-alveolar lavage (BAL) to investigate an abnormal chest X-ray.
      He was diagnosed with sarcoidosis. However, a low level of P. carinii organisms
      undetectable by microscopy was detected in BAL fluid by two subsequent nested PCR
      assays: one assay amplifying a portion of the mitochondrial large subunit RNA
      gene and a second one amplifying the internal transcribed spacers (ITS) 1 and ITS
      2 of the nuclear rRNA operon. This low level of the fungus did not reflect acute
      PCP. Indeed, the clinical outcome was improvement despite the absence of specific
      treatment. The patient was considered to be only colonised by the fungus.
      Analysis of sequences of ITS PCR products led to identification of genotype Gg.
      This information constitutes the first data concerning P. carinii ITS genotype
      from a patient without acute PCP and HIV. This type has been described previously
      in AIDS patients diagnosed with PCP. These results show that PCR and ITS
      genotyping could represent efficient tools for the further investigation of the
      role played by HIV-negative patients with pulmonary colonisation in the human
      reservoir of P. carinii.

PMID- 11211230
TI  - Enterohaemorrhagic Escherichia coli O157:H7: a red herring?

PMID- 11211231
TI  - Detection of adenovirus and rotavirus antigens by an immuno-gold lateral flow
      test and ultrasound-enhanced latex agglutination assay.

PMID- 11211232
TI  - Diurnal changes of tyrosine, dopamine, and dopamine metabolites content in the
      retina of rats maintained at different lighting conditions.
AB  - The aim of the study was to investigate the daily rhythms of tyrosine (Tyr),
      dopamine (DA), 3,4-dioxyphenylacetic acid (DOPAC), and homovanillic acid (HVA)
      content in the retina of rats maintained under different lighting conditions.
      Studied substances were measured by highly sensitive high-performance liquid
      chromatography (HPLC) with an electrochemical detection method. It was found that
      the levels of Tyr, DA, DOPAC, and HVA change diurnally in the retina of adult
      Wistar rats maintained under standard cyclic lighting (12-h light/12-h dark). The
      maximum was found during the light phase of 12:12 light:dark photoperiod. Diurnal
      changes of DA, DOPAC, and HVA persisted in constant darkness. When the rats were
      maintained in constant lighting conditions for 2 d (light intensity, 200 lx), the
      rhythms of tyrosine, DA, and DOPAC completely disappeared. However the level of
      HVA was higher during the subjective day. The presence of diurnal rhythm of
      melatonin content in the retina of rats was confirmed by HPLC with an
      amperometric detection method. Since the presence of time cues is not necessary
      for manifestation of diurnal changes of DA and its metabolite content, it was
      concluded that the circadian oscillator drives these rhythms. Probably DA can
      serve as a zeitgeber for retinal circadian rhythms.

PMID- 11211233
TI  - Corticosteroids regulate the gene expression of FGF-1 and FGF-2 in cultured rat
      astrocytes.
AB  - The present data show that the gene expression of FGF-1 and FGF-2 is regulated by
      corticosteroids in rat type 1 astrocytes. In particular, the gene expression of
      FGF-1 is modulated by corticosteroids acting both on type I (minerocorticoid) and
      type II (glucocorticoid) receptors. In fact, at short times of exposure (2 h) a
      slight decrease in FGF-1 mRNA levels is induced by deoxycorticosterone, a steroid
      able to interact with the type I receptors; a similar effect is observed at 6 h
      following exposure to corticosterone or its 5alpha-reduced metabolite,
      dihydrocorticosterone. Conversely, at longer times of exposure (24 h)
      corticosterone is able to strongly increase FGF-1 mRNA levels. Both effects of
      corticosterone (inhibition and stimulation) were duplicated by dexamethasone,
      indicating that both effects occur via the type II receptors. Interestingly, the
      5alpha-3alpha-reduced metabolite of deoxycorticosterone,
      tetrahydrodeoxycorticosterone, which does not interact with either corticosteroid
      receptors, is able to stimulate (at 6 and 24 h of exposure) the gene expression
      of FGF-1. It is possible that this effect might be induced via the GABA(A)
      receptor, since muscimol, an agonist of this receptor, exerts a similar effect.
      The situation is different in the case of FGF-2. The mRNA levels of this growth
      factor are only stimulated by steroids interacting with type II receptors.
      Altogether, these observations indicate that corticosteroids modulate the levels
      of FGF-1 and FGF-2 gene expression in astroglial cells by interaction with
      classical (type I and II) or nonclassical (GABA(A) receptor) steroid receptors.

PMID- 11211234
TI  - Phosphorylation of the common neurotrophin receptor p75 by p38beta2 kinase
      affects NF-kappaB and AP-1 activities.
AB  - The signaling pathways invoked by ligand binding to the common neurotrophin
      receptor p75NTR are incompletely understood. Using the yeast two-hybrid system,
      we identified the mitogen-activated protein (MAP) kinase p38beta2 as a specific
      interactor with the 5th and 6th alpha helices of the p75NTR intracytoplasmic
      region. The consequences of this interaction were studied, using primary cultures
      of Schwann cells and the 293T cell line. Phosphorylation of p75NTR by p38beta2
      was induced in vitro and in vivo by MAP kinase kinases (MKK) 6 activation. This
      pathway demonstrated feedback in that nerve growth factor (NGF) binding increased
      p38beta2 activity, causing an increase of nuclear factor-kappaB (NF-kappaB)
      activation and a decrease of AP-1 activation. The mechanisms described explain at
      least in part why NGF binding to p75NTR increases cell survival in certain
      circumstances.

PMID- 11211235
TI  - Neuroprotective role for the p50 subunit of NF-kappaB in an experimental model of
      Huntington's disease.
AB  - Prototypical NF-kappaB consists of a transcription factor dimer of p50 and p65,
      and an inhibitory subunit called I-kappaB. NF-kappaB is activated in neurons in
      response to excitotoxic, metabolic, and oxidative stress. Cell-culture data
      suggest that activation of NF-kappaB can prevent neuronal apoptosis, but its role
      in vivo is unclear and the specific kappaB subunits involved are unknown. In
      Huntington's disease (HD), striatal neurons degenerate, and a similar pattern of
      neuronal vulnerability occurs in rats and mice following exposure to the
      mitochondrial toxin 3-nitropropionic acid (3NP). We report that mice lacking the
      p50 subunit of NF-kappaB exhibit increased damage to striatal neurons following
      administration of 3NP. The neuronal death occurs by apoptosis as indicated by
      increased caspase activation and DNA fragmentation into oligonucleosomes. NF
      kappaB activity is markedly increased in striatum 24-72 h following 3NP
      administration in wild-type mice, but not in mice lacking p50, indicating that
      p50 is necessary for the vast majority of 3NP-induced NF-kappaB DNA-binding
      activity in striatum. Cultured striatal neurons from p50-/- mice exhibited
      enhanced oxidative stress, perturbed calcium regulation, and increased cell death
      following exposure to 3NP, suggesting a direct adverse effect of p50 deficiency
      in striatal neurons.

PMID- 11211237
TI  - Polycyclic aromatic hydrocarbons in placenta.
AB  - Concentrations of chrysene, benz [a] anthracene, benzo [a]-pyrene, benzo [b]
      fluoranthene, indeno [1,2,3-c,d] pyrene, dibenz [a,h] anthracene, and benzo
      [g,h,i] perylene were measured in placentas from 200 women from two cities in
      Ukraine, Kyiv and Dniprodzerzhinsk. The participants had no special exposures and
      were chosen from among subjects in an ongoing study of reproductive health. All
      seven of the polycyclic aromatic hydrocarbons (PAHs) were found in all placentas,
      with the sole exception of benzo [a] pyrene in one placenta. Chrysene was present
      at the highest concentrations, with median 1.38 ng/g dry weight. Dibenz [a,h]
      anthracene and benzo [g,h,i] perylene had the lowest concentrations; each had
      median 0.73 ng/g dry weight. Concentrations in Kyiv were slightly higher than
      those in Dniprodzerzhinsk, but the difference was significant only for dibenz
      [a,h] anthracene. Dibenz [a,h] anthracene and benzo [g,h,i] perylene increased
      significantly with maternal body mass index, but other PAHs showed no such
      pattern. Placentas from deliveries in autumn or winter had slightly but not
      significantly higher concentrations. Concentrations were not related to maternal
      age. There were too few smokers in the sample for meaningful evaluation. No
      associations were seen between any of the placental PAH concentrations and birth
      weight of the infant.

PMID- 11211236
TI  - Regional hypomyelination and dysplasia in transgenic mice with astrocyte-directed
      expression of interferon-gamma.
AB  - Interferon-gamma (IFN-gamma), traditionally associated with a variety of
      physiological and pathological processes of the immune system, manifests an array
      of biological effects on cells of the nervous system. Clinical and in vitro
      studies support a key role for IFN-gamma in the pathogenesis of immune-mediated
      demyelinating disorders such as multiple sclerosis (MS). To investigate the role
      of this cytokine within the central nervous system (CNS), transgenic mice were
      derived in which IFN-gamma transgene expression was selectively targeted to
      astrocytes, a potentially important cellular source of this cytokine. Here we
      report that astrocyte-directed expression of IFN-gamma results in regional
      hypomyelination and selective disruption of brain histogenesis, which included
      severe cerebellar and hippocampal dysplasia. Transgenic mice were markedly ataxic
      and the majority died prior to reaching sexual maturity. This study demonstrates
      that astrocyte-directed expression of IFN-gamma profoundly affects the
      differentiation and morphogenesis of the brain and provides additional evidence
      that this cytokine has deleterious consequences on myelin-producing cells,
      independent of the cellular source.

PMID- 11211238
TI  - Effect of natural antioxidants and apocynin on LPS-induced endotoxemia in rabbit.
AB  - The objective of this study was to compare the prophylactic effects of the
      natural antioxidant from spinach (NAO) and apocynin, on the hepatic oxidative
      stress and liver damage induced by lipopolysaccharide (LPS). Male New Zealand
      rabbits were challenged with LPS with or without 8 days of antioxidant
      pretreatment. Pretreatment with NAO, but not apocynin, significantly (p < 0.05)
      decreased the levels of hydroperoxides and malondialdehyde (MDA) in the liver
      cytosolic fraction and the activity of NADPH oxidase-generated superoxide in the
      microsomal fraction, compared to LPS alone. The activity of glutathione
      peroxidase (G-POX) was significantly (p < 0.05) increased in the LPS-treated
      group, whereas treatment with NAO, but not apocynin, significantly (p < 0.05)
      decreased G-POX activity. Pretreatment with the same antioxidants had no
      significant effects on superoxide dismutase (SOD) activity, whereas an increased
      level of catalase (CAT) was obtained in all LPS-treated groups. TUNEL
      immunohistochemical staining in the LPS-treated animals indicated that there was
      no increase in apoptosis outside of necrotic foci. However, apoptotic hepatocytes
      were observed within areas of focal necrosis in animals exposed to LPS alone or
      LPS plus apocynin. Hepatocyte cell proliferation was tested by the proliferating
      cell nuclear antigen (PCNA) tool, which indicated a proliferative effect in the
      LPS group, whereas the effect disappeared in the antioxidant-treated groups. The
      prophylactic effect of NAO on liver pathology and the significant decreases in
      lipid peroxidation products and NADPH oxidase activity suggest the use of NAO as
      an efficient strategy for treatment of endotoxemia.

PMID- 11211239
TI  - Lack of peripheral neuropathy in Beagle dogs after 53 weeks oral administration
      of thalidomide capsules.
AB  - Thalidomide (Thalomid) is approved for use in the US to treat complications from
      leprosy. Peripheral neuropathy is a dose-limiting adverse event in humans. As
      part of a nonrodent regulatory toxicology study, Beagle dogs were fed orally via
      encapsulation for 53 weeks. A component of this study was to determine if the
      dogs developed peripheral neuropathy. Twenty-eight male and 28 female Beagle dogs
      approximately 8-10 months of age were used. They were dosed at 43, 200 or 1000
      mg/kg for 53 weeks followed by a 4-week treatment-free recovery period. Nerve
      function was assessed by electrophysiological measurements of the tibial nerve
      prior to dosing and at weeks 13, 27, 38 and 51. Representative dogs from each
      group were sacrificed at 26, 53 and 58 weeks and histologic and ultrastructural
      evaluations were performed on the sural nerve. Thalidomide had no effect on
      sensory nerve conduction velocity, duration or amplitude of the action potential.
      At 27 weeks, mean sensory nerve action potential amplitude for females at 43
      mg/kg was significantly greater than control but was not evident at 39 weeks.
      Mean duration of sensory nerve action potential seemed to increase with similar
      magnitude over time in all dose groups including controls. Histological and
      ultrastructural evaluation of sections of sural nerve did not identify treatment
      induced differences between control and thalidomide-dosed animals after 26 and 53
      weeks of treatment. Additionally, no differences were observed following a 5-week
      treatment-free period at week 58. In contrast to humans, Beagle dogs did not
      develop thalidomide-induced peripheral neuropathy under conditions of the study.

PMID- 11211240
TI  - Inhibitory effects of the medicinal herb, Thonningia sanguinea, on liver drug
      metabolizing enzymes of rats.
AB  - In this study we examined the effect of the aqueous extract of Thonningia
      sanguinea (T.S.) on 7-ethoxyresorufin O-deethylase (EROD, CYP1A1), 7
      pentoxyresorufin O-dealkylase (PROD, CYP2B1/2), 7-methoxyresorufin O-demethylase
      (MROD, CYP1A2), aniline hydroxylase (aniline, CYP2E1), p-nitrophenol hydroxylase
      (PNPH, CYP2E1) and erythromycin N-demethylase (ERDM, CYP3A1) in rat liver in
      vitro and in vivo. Although T.S. extract increased ERDM activity in induced rat
      liver microsomes, it showed a dose-dependent inhibitory effect in vitro on other
      P450 monooxygenase activities particularly EROD and PROD, which are mediated
      primarily by CYP1A1 and CYP2B1/2, respectively. PROD, EROD and MROD activities
      were also decreased by 18%, 19% and 40%, respectively, in hepatic microsomes
      prepared from rats treated with T.S. extract for 3 days. Kinetic analysis of CYP
      activity of 3-methylchloranthrene-induced microsomes demonstrated that T.S.
      inhibited EROD and MROD activities by a noncompetitive and competitive mechanism,
      respectively. The analysis of alterations produced by T.S. on PROD kinetic
      parameters in phenobarbital-induced microsomes suggested that the inhibition is
      noncompetitive. Pretreatment of rats with T.S. prolonged pentobarbital and
      phenobarbital sleeping time; however, plasma phenobarbital concentration
      determined on awakening showed no significant difference between control and T.S.
      treated rats. T.S. was also found to be a potent inhibitor of the liver cytosolic
      glutathione S-transferase. These data suggest that selective modulation of CYP
      isoenzymes by T.S. might contribute to protection of the liver from xenobiotic
      induced intoxication or to alteration of the action of drug(s) concomitantly
      administered besides its antioxidative properties.

PMID- 11211241
TI  - Amelioration of fluoride-induced hypocalcaemia by vitamins.
AB  - Oral administration of sodium fluoride (40 mg/kg body weight) from day 6 of
      gestation to day 21 of lactation caused, compared with vehicle control,
      significantly lowered level of calcium and phosphorus in the serum of both P and
      F1 generation rats. Administration of vitamin C (50 mg/kg body weight), D (2
      ng/0.2 ml olive oil/animal), E (2 mg/0.2 ml olive oil/animal) and a combination
      (vitamin C + D + E) along with NaF caused significant amelioration in serum
      calcium in P generation and serum phosphorus in both P and F1 generation rats as
      compared with only NaF-treated group. Serum calcium concentration was only
      partially recovered (P and F1 generation) on NaF withdrawal during lactation, as
      well as, on cotreatment (F1 generation) with vitamins. However, serum phosphorus
      level was significantly recovered on NaF withdrawal.

PMID- 11211242
TI  - Comparison of the phagocytic response of rat and hamster alveolar macrophages to
      man-made vitreous fibers in vitro.
AB  - Rats and hamsters are well known for their disparate response to inhaled mineral
      fibers/particles. Alveolar macrophages (AM) play an important role in the
      pulmonary clearance and retention of mineral fibers/particles mainly through the
      process of phagocytosis. The aim of this study was to investigate whether there
      exist differences in the phagocytic response and release of reactive oxygen
      species (ROS) between rat and hamster AM upon exposure to man-made vitreous
      fibers (MMVF) in vitro. AM were obtained by bronchoalveolar lavage and macrophage
      enriched cultures were exposed to MMVF10 and MMVF21 fibers for 20 h. The
      phagocytic response of macrophages was determined by computer-assisted video
      microscopy and the superoxide anion production was evaluated by cytochrome c
      reduction. A significantly higher percentage of rat AM underwent frustrated
      phagocytosis of both types of MMVF compared to hamster AM. This was associated
      with a higher ROS release by rat AM compared to hamster AM. These data may help
      to explain the cellular mechanisms underlying the disparate pulmonary response of
      rat and hamster to inhaled particulate matter.

PMID- 11211243
TI  - Astrocyte phenotype and prevention against oxidative damage in neurotoxicity.
AB  - Astrocytes possess a potent array of protective systems. These are chiefly
      targeted against oxidised products and radicals, which are frequently present in
      increased amounts following exposure of nervous tissue to a range of toxic
      insults. Following exposure to the toxic chemicals astrocytes commonly respond by
      alteration in phenotype with upregulation of a large number of molecules,
      including those controlling the protective systems. This article summarizes
      evidence, largely obtained from in vitro studies, which supports the concept that
      some of the changes in astrocyte phenotype are associated with increased
      protection against the cytotoxicity caused by the oxidative damage that results
      from exposure to range of neurotoxicants.

PMID- 11211244
TI  - Urinary cotinine levels of smokeless tobacco (Maras powder) users.
AB  - Smokeless tobacco is used in various forms in some countries of the world. "Maras
      otu" is a kind of smokeless tobacco usage in the Southeastern region of Turkey.
      The use of smokeless tobacco causes nicotine addiction and dependence. Moreover
      this type of smokeless tobacco usage is one of the risk factors for oral cancers
      and genotoxic damages for users. Cotinine is widely used as a biomarker of
      tobacco consumption and intake of nicotine. Therefore, urine samples were
      collected from people who are using Maras powder and smoking cigarettes, and
      passive smokers, and the levels of cotinine investigated. The purpose of this
      study is to determine the cotinine levels of Maras powder users and to compare
      the results with cigarette smokers and passive smokers. Urinary cotinine levels
      of subjects were determined by using capillary gas chromatography with FID
      detection. The mean (+/- SD) urinary cotinines have been determined as 6467.35+/
      3198 microg/g creatinine for 26 Maras powder users, 1943.92+/-1443 microg/g
      creatinine for 26 cigarette smokers and 198.62+/-420.82 microg/g creatinine for
      26 passive smokers. A significant difference has been found between cotinine
      levels of Maras powder users and cigarette smokers, which is three times higher
      in Maras powder users (p<0.001). The present study suggests that smokeless
      tobacco poses a threat to public health and it should not be viewed as a safe
      alternative to cigarettes.

PMID- 11211245
TI  - Validation of publication of new names and new combinations previously
      effectively published outside the IJSEM.

PMID- 11211246
TI  - Thioflavicoccus mobilis gen. nov., sp. nov., a novel purple sulfur bacterium with
      bacteriochlorophyll b.
AB  - A novel phototrophic purple sulfur bacterium was isolated from a flat, laminated
      microbial mat in a salt marsh near Woods Hole, Massachusetts, USA. The cells were
      monotrichously flagellated motile cocci with internal photosynthetic membranes of
      the tubular type. The main photosynthetic pigments were bacteriochlorophyll b and
      the carotenoid 3,4,3',4'-tetrahydrospirilloxanthin. The marine bacterium showed
      optimal growth in the presence of 2% salts. It was obligately phototrophic and
      strictly anaerobic. It grew photoautotrophically and photoassimilated acetate,
      pyruvate and ascorbate as the only organic substrates. In the presence of
      sulfide, elemental sulfur globules were formed inside the cells. Elemental sulfur
      was further oxidized to sulfate. The DNA base composition of the new bacterium
      was 66.5 mol% G+C. The 16S rDNA nucleotide sequence was most similar to strains
      of Thiococcus pfennigii, there being approximately 92-93% sequence similarity.
      The new bacterium is described as a new species and a new genus, and the name
      Thioflavicoccus mobilis is proposed; the type strain is 8321T (= ATCC 700959T).

PMID- 11211248
TI  - Hyphomicrobium chloromethanicum sp. nov. and Methylobacterium chloromethanicum
      sp. nov., chloromethane-utilizing bacteria isolated from a polluted environment.
AB  - Two chloromethane-utilizing facultatively methylotrophic bacteria, strains CM2T
      and CM4T, were isolated from soil at a petrochemical factory. On the basis of
      their morphological, physiological and genotypical properties, strain CM2T (= VKM
      B-2176T = NCIMB 13687T) is proposed as a new species of the genus Hyphomicrobium,
      Hyphomicrobium chloromethanicum, and strain CM4T (= VKM B-2223T = NCIMB 13688T)
      as a new species of the genus Methylobacterium, Methylobacterium
      chloromethanicum.

PMID- 11211247
TI  - Phylogenetic and DNA-DNA hybridization analyses of Bradyrhizobium species.
AB  - The 16S rDNA sequence of Bradyrhizobium liaoningense was determined and analysed
      together with sequences of other Bradyrhizobium species and related taxa. In
      addition, DNA-DNA hybridizations were performed between representative strains of
      the three Bradyrhizobium species. Bradyrhizobium liaoningense is genotypically
      highly related to Bradyrhizobium japonicum, whereas Bradyrhizobium elkanii is
      more distantly related to these two species. The fact that Afipia, Agromonas,
      Blastobacter, Nitrobacter and Rhodopseudomonas are phylogenetically more closely
      related to Bradyrhizobium japonicum than to Bradyrhizobium elkanii is discussed.

PMID- 11211249
TI  - Clostridium hungatei sp. nov., a mesophilic, N2-fixing cellulolytic bacterium
      isolated from soil.
AB  - Two strains of obligately anaerobic, mesophilic, cellulolytic, N2-fixing, spore
      forming bacteria were isolated from soil samples collected at two different
      locations near Amherst, MA, USA. Single cells of both strains were slightly
      curved rods that measured between 2 and 6 microm in length and approximately 0.5
      microm in diameter. The spores were spherical, terminally located, distended the
      sporangium and measured 0.8-1.0 microm in diameter. The cells of both isolates
      (designated strain ADT and strain B3B) stained Gram-negative, but did not have a
      typical Gram-negative cell wall structure as demonstrated by transmission
      electron microscope analysis. The cells of both strains were motile with
      subpolarly inserted flagella and exhibited chemotactic behaviour towards
      cellobiose and D-glucose. Both strains fermented cellulose, xylan, cellobiose,
      cellodextrins, D-glucose, D-xylose, D-fructose, D-mannose and gentiobiose. In
      addition, strain B3B fermented L-arabinose. For both strains, fermentation
      products from cellulose were acetate, ethanol, H2 and CO2, as well as small
      amounts of lactate and formate. The G+C content of strain AD was 40 mol% and that
      of strain B3B was 42 mol%. Based on their morphological, physiological and
      phylogenetic characteristics, it was concluded that the two isolates are
      representatives of a novel species of Clostridium. The name Clostridium hungatei
      is proposed for the new species. The type strain of Clostridium hungatei sp. nov.
      is strain ADT (= ATCC 700212T).

PMID- 11211250
TI  - Desulfosporosinus meridiei sp. nov., a spore-forming sulfate-reducing bacterium
      isolated from gasolene-contaminated groundwater.
AB  - Eight strains of spore-forming, sulfate-reducing bacteria, isolated from
      groundwater contaminated with motor fuel [mostly benzene, toluene ethylbenzene
      and xylene (BTEX) compounds] in sandy soil near Perth, Australia, were closely
      related to Desulfosporosinus (previously Desulfotomaculum) orientis DSM 765T
      (95.3-97.3% 16S rDNA sequence similarity). Whole-cell fatty acids were dominated
      by even-carbon, straight-chain saturated and mono-unsaturated fatty acids, in
      particular 16:0, 16:1cis9, 14:0 and 18:1cis11. The strains grew at temperatures
      between 4 and 42 degrees C and in medium containing up to 4% NaCl. The eight
      strains clustered into two main groups based on phylogeny, randomly amplified
      polymorphic DNA (RAPD)-PCR patterns and nutritional characteristics.
      Representatives of the two groups, strain S5 (group A) and strain S10T (group B)
      had 81% DNA-DNA homology with each other and therefore should be accommodated in
      the same species. Strain S10T had less than 38% homology with Desulfosporosinus
      orientis DSM 765T, the most closely phylogenetically related type strain
      available. The new strains were distinguished from Desulfosporosinus orientis DSM
      765T by different banding patterns in a RAPD-PCR, and phenotypically by their
      inability to utilize fumarate as a carbon and energy source with sulfate as the
      electron acceptor and by their lower tolerance to NaCl. The DNA G+C contents were
      46.8 and 46.9 mol% for strains S5 and S10T, respectively (Desulfosporosinus
      orientis DSM 765T 45.9 mol%). It is proposed that these new strains be placed in
      a new species of the genus Desulfosporosinus. The name Desulfosporosinus meridiei
      is proposed, with strain S10T as the type strain (= DSM 13257T = NCIMB 13706T).

PMID- 11211251
TI  - Carboxydobrachium pacificum gen. nov., sp. nov., a new anaerobic, thermophilic,
      CO-utilizing marine bacterium from Okinawa Trough.
AB  - A new anaerobic, thermophilic, CO-utilizing marine bacterium, strain JMT, was
      isolated from a submarine hot vent in Okinawa Trough. Cells of strain JMT were
      non-motile thin straight rods, sometimes branching, with a cell wall of the Gram
      positive type, surrounded with an S-layer. Chains of three to five cells were
      often observed. The isolate grew chemolithotrophically on CO, producing equimolar
      quantities of H2 and CO2 (according to the equation CO+H2O-->CO2+H2) and
      organotrophically on peptone, yeast extract, starch, cellobiose, glucose,
      galactose, fructose and pyruvate, producing H2, acetate and CO2. Growth was
      observed from 50 to 80 degrees C with an optimum at 70 degrees C. The optimum pH
      was 6.8-7.1. The optimum concentration of sea salts in the medium was 20.5-25.5 g
      l(-1). The generation time under optimal conditions was 7.1 h. The DNA G+C
      content was 33 mol %. Growth of isolate JMT was not inhibited by penicillin, but
      ampicillin, streptomycin, kanamycin and neomycin completely inhibited growth. The
      results of 16S rDNA sequence analysis revealed that strain JMT belongs to the
      Thermoanaerobacter phylogenetic group within the Bacillus-Clostridium subphylum
      of Gram-positive bacteria but represents a separate branch of this group. On the
      basis of morphological and physiological features and phylogenetic data, this
      isolate should be assigned to a new genus, for which the name Carboxydobrachium
      is proposed. The type species is Carboxydobrachium pacificum; the type strain is
      JMT (= DSM 12653T).

PMID- 11211252
TI  - Actinomyces marimammalium sp. nov., from marine mammals.
AB  - Three strains of a previously undescribed Actinomyces-like bacterium were
      isolated from samples taken from two dead seals and a porpoise. Biochemical
      testing and PAGE analysis of whole-cell proteins indicated the strains were
      phenotypically similar to each other but different from previously described
      Actinomyces and Arcanobacterium species. Comparative 16S rRNA gene sequencing
      studies showed the organisms from marine animals were genetically closely related
      and represent a hitherto unknown subline within the genus Actinomyces (sequence
      divergence values > 6% with recognized species). Based on phylogenetic and
      phenotypic evidence it is proposed that the unknown bacterium from the seals and
      a porpoise should be classified as Actinomyces marimammalium sp. nov. The type
      strain is CCUG 41710T.

PMID- 11211253
TI  - Herbaspirillum frisingense sp. nov., a new nitrogen-fixing bacterial species that
      occurs in C4-fibre plants.
AB  - The enrichment of nitrogen-fixing bacteria from the C4-fibre plants, Spartina
      pectinata, Miscanthus sinensis, Miscanthus sacchariflorus and Pennisetum
      purpureum, with nitrogen-free semi-solid media led to the isolation of
      Herbaspirillum-like strains among other diazotrophic bacteria. On the basis of
      physiological properties, phylogenetic analysis comparing 16S rDNA sequences and
      DNA-DNA hybridization experiments of chromosomal DNA the new isolates could be
      grouped together in a new species with the proposed name Herbaspirillum
      frisingense sp. nov. Morphological characteristics, such as cell size and shape,
      colony appearance, motility and flagellation are largely identical to the known
      species Herbaspirillum rubrisubalbicans and Herbaspirillum seropedicae. On the
      basis of utilization of adipate (-), N-acetyl-D-glucosamine (+), meso-erythritol
      (-), L-rhamnose (-) and meso-inositol (-) Herbaspirillum frisingense sp. nov. can
      be distinguished from other known Herbaspirillum spp. Nitrogen-fixing capability
      was examined by PCR amplification of the nifD gene and an acetylene reduction
      assay, and was found with all isolates tested. 16S rDNA sequence similarity to
      the other Herbaspirillum spp. is 98.5-99.1%. In genomic DNA-DNA hybridization
      experiments Herbaspirillum frisingense sp. nov. forms a homogeneous group with 70
      100+/-10% similarity, clearly distinct from Herbaspirillum seropedicae and
      Herbaspirillum rubrisubalbicans with 1-34% similarity. 16S rRNA-targeted
      oligonucleotide probes, specific for the whole genus Herbaspirillum and for three
      Herbaspirillum species were designed and are suitable for fluorescence in situ
      hybridization. The DNA G+C content of Herbaspirillum frisingense sp. nov. is 63+/
      2 mol%, in agreement with the values of 61-65% for the genus. PCR fingerprinting
      exhibits a consistent pattern for groups of strains isolated from the same plant,
      suggesting a low genomic diversity among bacteria inhabiting C4-gramineous plant
      tissues. Low genetic DNA diversity seems to be common between probable endophytic
      bacterial isolates of the same taxon. The type strain of Herbaspirillum
      frisingense sp. nov. is GSF30T (= DSM 13128T).

PMID- 11211254
TI  - Arthrobacter siderocapsulatus Dubinina and Zhdanov 1975AL is a later subjective
      synonym of Pseudomonas putida (Trevisan 1889) Migula 1895AL.
AB  - The taxonomic position of Arthrobacter siderocapsulatus Dubinina and Zhdanov
      1975AL was investigated using 16S rDNA, fatty acid and phenotypic analyses. The
      type strain (NCIMB 11286T) showed 99.85% 16S rDNA similarity to the type strain
      of Pseudomonas putida. Phenotypic properties of the two strains were compared
      using API 20NE and BIOLOG kits. Identical reactions were recorded for all tests,
      except for assimilation of malonic acid. The two strains also showed almost
      identical cellular fatty acid profiles. On the basis of evidence presented in
      this and earlier studies, it is proposed that Arthrobacter siderocapsulatus is a
      later subjective synonym of Pseudomonas putida (Trevisan 1889) Migula 1895AL.

PMID- 11211256
TI  - Reclassification of Desulfobacterium phenolicum as Desulfobacula phenolica comb.
      nov. and description of strain SaxT as Desulfotignum balticum gen. nov., sp. nov.
AB  - A mesophilic, sulfate-reducing bacterium (strain SaxT) was isolated from marine
      coastal sediment in the Baltic Sea and originally described as a 'Desulfoarculus'
      sp. It used a large variety of substrates, ranging from simple organic compounds
      and fatty acids to aromatic compounds as electron donors. Autotrophic growth was
      possible with H2, CO2 and formate in the presence of sulfate. Sulfate,
      thiosulfate and sulfite were used as electron acceptors. Sulfur and nitrate were
      not reduced. Fermentative growth was obtained with pyruvate, but not with
      fumarate or malate. Substrate oxidation was usually complete leading to CO2, but
      at high substrate concentrations acetate accumulated. CO dehydrogenase activity
      was observed, indicating the operation of the CO dehydrogenase pathway (reverse
      Wood pathway) for CO2 fixation and complete oxidation of acetyl-CoA. The rod
      shaped cells were 0.8-1.0 microm wide and 1.5-2.5 microm long. Spores were not
      produced and cells stained Gram-negative. The temperature limits for growth were
      between 10 and 42 degrees C (optimum growth at 28-32 degrees C). Growth was
      observed at salinities ranging from 5 to 110 g NaCl l(-1), with an optimum at 10
      25 g NaCl l(-1). The G+C content of the DNA was 62.4 mol%. Vitamins were required
      for growth. Based on the 16S rRNA gene sequence, strain SaxT represents a new
      genus within the delta-subclass of the Proteobacteria. The name Desulfotignum
      balticum gen. nov., sp. nov. is proposed. After the 16S rDNA sequences of all
      members of the genus Desulfobacterium were published (GenBank accession nos.
      AJ237601-AJ237604, AJ237606, AJ237607), the need to reclassify most members of
      the genus Desulfobacterium became obvious due to their strong phylogenetic
      affiliation to other genera. Here, we propose to reclassify Desulfobacterium
      phenolicum as Desulfobacula phenolica comb. nov. Desulfotignum balticum,
      Desulfobacterium phenolicum and Desulfobacula toluolica contain cellular fatty
      acids which have so far only been found in members of the genus Desulfobacter.

PMID- 11211255
TI  - Azospirillum doebereinerae sp. nov., a nitrogen-fixing bacterium associated with
      the C4-grass Miscanthus.
AB  - A new group of nitrogen-fixing Azospirillum sp. bacteria was isolated from the
      roots of the C4-gramineous plant Miscanthus. Polyphasic taxonomy was performed,
      including auxanography using API galleries, physiological tests and 16S rRNA
      sequence comparison. The ability of the isolates to fix dinitrogen was evaluated
      by amplification of the nifD gene, immunodetection of the dinitrogenase reductase
      and acetylene-reduction assay. On the basis of these results, the nitrogen-fixing
      isolates represent a new species within the genus Azospirillum. Its closest
      phylogenetic neighbours, as deduced by 16S rDNA-based analysis, are Azospirillum
      lipoferum, Azospirillum largimobile and Azospirillum brasilense with 96.6, 96.6
      and 95.9% sequence similarity, respectively. Two 16S rRNA-targeting
      oligonucleotide probes were developed which differentiate the new species from
      the other Azospirillum species by whole-cell fluorescence hybridization. Strains
      of the new species are curved rods or S-shaped, 1.0-1.5 microm in width and 2,0
      3.0 microm in length, Gram-negative and motile with a single polar flagellum.
      Optimum growth occurs at 30 degrees C and at pH values between 6.0 and 7.0. No
      growth takes place at 37 degrees C. They have a respiratory type of metabolism,
      grow well on arabinose, D-fructose, gluconate, glucose, glycerol, malate,
      mannitol and sorbitol. They differ from A. largimobile and A. lipoferum by their
      inability to use N-acetylglucosamine and D-ribose, from A. lipoferum by their
      ability to grow without biotin supplementation and from A. brasilense by their
      growth with D-mannitol and D-sorbitol as sole carbon sources. Nitrogen fixation
      occurs in microaerobic nitrogen-limited conditions. For this species, the name
      Azospirillum doebereinerae sp. nov. is suggested, with strain GSF71T as the type
      strain (= DSM 13131T; reference strain Ma4 = DSM 13400). Its G+C content is 70.7
      mol%.

PMID- 11211257
TI  - Phylogenetic position of Bartonella vinsonii subsp. arupensis based on 16S rDNA
      and gltA gene sequences.
AB  - The nucleotide sequences of the genes encoding 16S rRNA and citrate synthase
      (gltA) from a recently described member of the genus Bartonella, Bartonella
      vinsonii subsp. arupensis, isolated from mice and from the blood of a patient
      suffering from bacteraemia, were determined and compared with sequences of the
      16S rDNA and gltA genes of other members of the genus Bartonella in order to
      determine its relative phylogenetic position. B. vinsonii subsp. arupensis
      appeared to be closely related to B. vinsonii subsp. vinsonii, another rodent
      associated taxon, and to B. vinsonii subsp. berkhoffii, which was described
      recently in dogs.

PMID- 11211258
TI  - Genotypic and chemotaxonomic evidence for the reclassification of Pseudomonas
      woodsii (Smith 1911) Stevens 1925 as Burkholderia andropogonis (Smith 1911)
      Gillis et al. 1995.
AB  - It was reported before that [Pseudomonas] woodsii and Burkholderia andropogonis
      are phenotypically indistinguishable and probably represent the same taxon, for
      which the name B. andropogonis has been proposed. In the present study, it was
      found that [P.] woodsii and B. andropogonis strains were indistinguishable by
      whole-cell protein electrophoresis and have a highly similar cellular fatty acid
      composition. A high DNA-DNA binding value of 95% was found between the type
      strains of both species. In addition, the 16S rDNA sequence of [P.] woodsii
      strain LMG 2362T was very similar to that of B. andropogonis LMG 2129T (99.0%).
      The chemotaxonomic and genotypic data confirm that [P.] woodsii and B.
      andropogonis represent the same species, for which it is proposed to retain the
      name B. andropogonis.

PMID- 11211259
TI  - Amycolatopsis sacchari sp. nov., a moderately thermophilic actinomycete isolated
      from vegetable matter.
AB  - The taxonomic position of a group of moderately thermophilic actinomycetes
      isolated from vegetable matter was determined using a suite of genotypic and
      phenotypic properties. The organisms were found to share a range of chemical and
      morphological markers typical of members of the genus Amycolatopsis. A
      representative of the group, strain K24T, formed a distinct phyletic line within
      the range of variation occupied by the genus Amycolatopsis in the 16S rDNA tree.
      The strains have many phenotypic properties in common and some of these
      distinguish the group from representatives of the validly described species of
      Amycolatopsis. It is clear from the combined datasets that the strains merit
      recognition as a new species of Amycolatopsis. The name proposed for the new
      species is Amycolatopsis sacchari; the type strain is K24T (= DSM 44468T = KCTC
      9863T).

PMID- 11211260
TI  - Phylogeny of the filamentous bacterium 'Nostocoida limicola' III from activated
      sludge.
AB  - Five strains of the filamentous bacterium 'Nostocoida limicola' III were
      successfully isolated into pure culture from samples of activated sludge biomass
      from five plants in Australia. 16S rRNA gene sequence analyses showed that all
      isolates were members of the Planctomycetales, most closely related to Isosphaera
      pallida, but they differed phenotypically from this species in that they did not
      glide and were not thermotolerant. The ultrastructure of these 'N. limicola' III
      isolates was also consistent with them being Planctomycetales, in that they
      possessed complex intracellular membrane systems compartmentalizing the cells.
      However, the arrangements of these intracellular membranes differed between
      isolates. These data confirm that 'N. limicola' III is phylogenetically unrelated
      to both 'N. limicola' I and 'N. limicola' II, activated sludge filamentous
      bacteria which share morphological features in common with 'N. limicola' III and
      which have been presumed historically to be the same or very similar bacteria.

PMID- 11211262
TI  - Taxonomic studies on the genus Cystofilobasidium: description of
      Cystofilobasidium ferigula sp. nov. and clarification of the status of
      Cystofilobasidium lari-marini.
AB  - A new species of the genus Cystofilobasidium is described as Cystofilobasidium
      ferigula sp. nov. The new taxon represents the teleomorphic stage of Cryptococcus
      ferigula and was obtained in mating experiments using three strains deposited in
      the Portuguese Yeast Culture Collection (mating types A1) and a recent isolate
      (mating type A2). Cystofilobasidium ferigula is characterized using an integrated
      approach encompassing morphological studies, investigation of the ultrastructure
      of the septal pore, a comparative study of physiological traits, determination of
      the DNA base composition, DNA reassociation experiments and PCR fingerprinting.
      During the course of this study, a close similarity of microsatellite-primed PCR
      fingerprints was detected between Cystofilobasidium lari-marini and
      Cystofilobasidium capitatum. DNA-DNA reassociation experiments gave high homology
      values, which indicates that Cystofilobasidium lari-marini must be regarded as a
      synonym of Cystofilobasidium capitatum.

PMID- 11211261
TI  - Molecular evolution of the Chlamydiaceae.
AB  - Phylogenetic analyses of surface antigens and other chlamydial proteins were used
      to reconstruct the evolution of the Chlamydiaceae. Trees for all five coding
      genes [the major outer-membrane protein (MOMP), GroEL chaperonin, KDO
      transferase, small cysteine-rich lipoprotein and 60 kDa cysteine-rich protein]
      supported the current organization of the family Chlamydiaceae, which is based on
      ribosomal, biochemical, serological, ecological and DNA-DNA hybridization data.
      Genetic distances between some species were quite large, so phylogenies were
      evaluated for robustness by comparing analyses of both nucleotide and protein
      sequences using a variety of algorithms (neighbour-joining, maximum-likelihood,
      maximum-parsimony with bootstrapping, and quartet puzzling). Saturation plots
      identified areas of the trees in which factors other than relatedness may have
      determined branch attachments. All nine species were clearly differentiated by
      distinctness ratios calculated for each gene. The distribution of virulence
      traits such as host and tissue tropism were mapped onto the consensus phylogeny.
      Closely related species were no more likely to share virulence characters than
      were more distantly related species. This phylogenetically disjunct distribution
      of virulence traits could not be explained by lateral transfer of the genes we
      studied, since we found no evidence for lateral gene transfer above the species
      level. One interpretation of this observation is that when chlamydiae gain access
      to a new niche, such as a new host or tissue, significant adaptation ensues and
      the virulence phenotype of the new species reflects adaptation to its environment
      more strongly than it reflects its ancestry.

PMID- 11211263
TI  - Sporobolomyces yunnanensis sp. nov., a Q-10(H2)-containing yeast species with a
      close phylogenetic relationship to Erythrobasidium hasegawianum.
AB  - A ballistoconidia-forming yeast strain, CH 2.141T, isolated from a semi-dried
      leaf sample collected in Yunnan, China, was found to have Q-10(H2) as its major
      ubiquinone. Molecular phylogenetic analysis based on the nucleotide sequences of
      small subunit (18S) rDNA and the internal transcribed spacer region (including
      5.8S rDNA) indicated that the strain was closely related to the two described Q
      10(H2)-containing yeast species, Erythrobasidium hasegawianum and Sporobolomyces
      elongatus, with a closer relationship to the former. A DNA-DNA reassociation
      experiment showed that strain CH 2.141T represents a new yeast species, for which
      the name Sporobolomyces yunnanensis sp. nov. is proposed.

PMID- 11211264
TI  - Phylogenetic structure of the Sporopachydermia cereana species complex.
AB  - A large number of isolates previously referred to as members of the
      'Sporopachydermia cereana species complex' were examined by various DNA
      characterization methods, leading to the conclusion that the complex is in fact
      made up of 10 species, one of which contains three varieties. The sequences of
      the internal transcribed spacer (ITS) region and the D1/D2 divergent domains of
      the large subunit rDNA were determined for representatives of each taxon and
      specific primers based on differences in the ITS were designed for rapid
      identification of five of the taxa. Whereas the data provide additional elements
      for the calibration of the ITS as a criterion for species delineation, the
      emerging pattern is that the ITS region does not function as well as the D1/D2
      domains as an evolutionary clock. Some taxa appear to be specific for the
      geographical regions where they were isolated, and the distribution of many taxa
      is mutually exclusive.

PMID- 11211266
TI  - A taxonomic note on the authorship and date of valid publication of Rhodococcus
      sputi.
AB  - Authorship of the name Rhodococcus sputi is variously attributed to Tsukamura
      1978 or Tsukamura and Yano 1985. DNA-DNA binding data indicate that this species
      and Rhodococcus obuensis Tsukamura 1983 and Rhodococcus chubuensis Tsukamura 1983
      are subjective (heterotypic) synonyms. Although these organisms have been placed
      in the genus Gordonia as Gordonia sputi, the correct name of the taxon created by
      unification of these three species is directly affected by the date of valid
      publication of these species as members of the genus Rhodococcus. Thus, the name
      R. sputi only has priority if the authorship is attributed to Tsukamura 1978. The
      question of authorship and priority is clarified in the present work.

PMID- 11211265
TI  - Radical changes to chlamydial taxonomy are not necessary just yet.

PMID- 11211267
TI  - Determination of the systematic position of the genus Asticcacaulis Poindexter by
      a polyphasic analysis.
AB  - The genus Asticcacaulis, to date, comprises two species of unicellular, stalked
      bacteria, developing a stalk at a site which is not coincidental with the centre
      of the pole of the cell. Multiplication is similar to that demonstrated by the
      prosthecate species of the genera Caulobacter, Brevundimonas and Maricaulis. A
      polyphasic approach, comprising 16S rRNA gene sequencing, lipid analysis and NaCl
      tolerance characterizations, was used to clarify the taxonomy of the two
      Asticcacaulis species. From the analysis of the 16S rRNA gene sequences, a close
      phylogenetic relationship between the species that comprise the genera
      Asticcacaulis, Caulobacter and Brevundimonas could be deduced wherein the three
      genera form three distinct branches. The individual genera could also be
      discerned by different characteristic polar lipids. The species of Asticcacaulis
      differed from species of Caulobacter and Brevundimonas by the lack of 1,2-diacyl
      3-O-[6'-phosphatidyl-alpha-D-glucopyranosyl]glycerol. They also did not contain
      1,2-di-O-acyl-3-O-[D-glucopyranosyl-(1-->4)-alpha-D-glucuronopyranosyl]glycerol,
      which is found in most Brevundimonas species but not in strains of the genus
      Caulobacter. The morphological differences seen between the two species
      Asticcacaulis excentricus and Asticcacaulis biprosthecium are mirrored by the
      observed 16S rDNA sequence similarity value of 95.3%, which is relatively low
      compared to the interspecies similarity values observed within the genera
      Brevundimonas or Caulobacter.

PMID- 11211268
TI  - Genomic approaches to typing, taxonomy and evolution of bacterial isolates.
AB  - The current literature on bacterial taxonomy, typing and evolution will be
      critically examined from the perspective of whole-genome structure, function and
      organization. The following three categories of DNA band pattern studies will be
      reviewed: (i) random whole-genome analysis; (ii) specific gene variation and
      (iii) mobile genetic elements. (i) The use of RAPD, PFGE and AFLP to analyse the
      whole genome will provide a skeleton of polymorphic sites with exact genomic
      positions as whole-genome sequence data become available. (ii) Different genes
      provide different levels of evolutionary information for determining isolate
      relatedness depending on whether they are highly variable (prone to recombination
      events and horizontal transfer), housekeeping genes with only a small number of
      single nucleotide differences between isolates or part of the rrn multigene
      family that is prone to intragenomic recombination and concerted evolution.
      Comparative analyses of these different gene classes can provide enhanced
      information about isolate relatedness. (iii) Mobile genetic elements such as
      insertion sequences, transposons, plasmids and bacteriophages integrate into the
      bacterial genome at specific (e.g. tRNA genes) or non-specific sites to alter
      band patterns produced by PFGE, RAPD or AFLP. From the literature it is not clear
      what level of genetic element duplication constitutes non-relatedness of
      isolates. A model is presented that incorporates all of the above genomic
      characteristics for the determination of isolate relatedness in taxonomic, typing
      and evolutionary studies.

PMID- 11211269
TI  - Reclassification of bioindicator strains Bacillus subtilis DSM 675 and Bacillus
      subtilis DSM 2277 as Bacillus atrophaeus.
AB  - On the basis of high DNA-DNA reassociation values and confirmatory automated
      RiboPrint analysis, two aerobic spore-forming strains hitherto allocated to
      Bacillus subtilis and used as bioindicators (DSM 675, hot-air sterilization
      control; DSM 2277, ethylene oxide sterilization control) are reclassified as
      Bacillus atrophaeus.

PMID- 11211270
TI  - Clostridium hiranonis sp. nov., a human intestinal bacterium with bile acid
      7alpha-dehydroxylating activity.
AB  - The Clostridium-like organisms TO-931T and HD-17, isolated from human faeces,
      have high levels of bile acid 7alpha-dehydroxylating activity. Sequencing of
      their 16S rDNA demonstrated that they belong to cluster XI of the genus
      Clostridium and that they represent a new and distinct line of descent.
      Clostridium bifermentans and Clostridium sordellii in cluster XI also possess
      bile acid 7alpha-dehydroxylating activity. DNA-DNA hybridization experiments with
      the isolates, TO-931T and HD-17, and C bifermentans and C. sordellii revealed
      that the isolates are a single species distinct from C. bifermentans and C
      sordellii. On the basis of phylogenetic analysis, using 16S rDNA sequences, and
      DNA-DNA hybridization analysis, it is concluded that strains TO-931T and HD-17
      are members of a new species of the genus Clostridium, for which the name
      Clostridium hiranonis is proposed. The type strain is strain TO-931T (= JCM
      10541T = DSM 13275T).

PMID- 11211271
TI  - Lactobacillus cypricasei sp. nov., isolated from Halloumi cheese.
AB  - Four strains of a hitherto unknown bacterium isolated from Halloumi cheese were
      compared by using phenotypic and phylogenetic studies. Comparative 16S rRNA gene
      sequencing demonstrated that the strains were identical to each other and
      represent a new subline within the genus Lactobacillus. The unknown bacterium was
      readily distinguished from other described Gram-positive catalase-negative taxa
      by means of biochemical tests and electrophoretic analysis of whole-cell
      proteins. On the basis of phylogenetic and phenotypic evidence, it is proposed
      that the unknown bacterium be classified as Lactobacillus cypricasei sp. nov. The
      type strain of L. cypricasei is CCUG 42961T (= CIP 106393T).

PMID- 11211272
TI  - Re-examining the 16S rDNA sequence of Halomonas salina.
AB  - Previous reports of 16S rDNA sequencing of members of the family Halomonadaceae
      Franzmann et al. 1989 include two different sequences that were both attributed
      to the type strain of Halomonas salina (Valderrama et al. 1991) Dobson and
      Franzmann 1996 (basonym Deleya salina Valderrama et al. 1991). The two sequences
      are sufficiently different for them to belong to two different species within the
      genus Halomonas. In order to determine which of the two sequences corresponded to
      that of the type strain of Halomonas salina, the designated type strains of this
      species were obtained from the ATCC and the DSMZ. It was possible to show that
      only one of the previous sequences corresponded to the sequences obtained from
      DSMZ 5928T and ATCC 49509T.

PMID- 11211273
TI  - Arcanobacterium pluranimalium sp. nov., isolated from porpoise and deer.
AB  - Two strains of a previously undescribed Arcanobacterium-like bacterium were
      isolated from a dead harbour porpoise and a dead sallow deer. Biochemical testing
      and PAGE analysis of whole-cell proteins indicated that the strains were
      phenotypically closely related to each other and distinct from previously
      described Actinomyces and Arcanobacterium species. Comparative 16S rRNA gene
      sequencing studies showed the bacterium to be a hitherto unknown subline within
      the genus Arcanobacterium. Based on phylogenetic and phenotypic evidence, it is
      proposed that the unknown bacterium be classified as Arcanobacterium
      pluranimalium sp. nov. The type strain of Arcanobacterium pluranimalium is CCUG
      42575T (= CIP 106442T).

PMID- 11211274
TI  - Vibrio cyclotrophicus sp. nov., a polycyclic aromatic hydrocarbon (PAH)-degrading
      marine bacterium.
AB  - Strain P-2P44T was isolated from creosote-contaminated marine sediments by using
      a most-probable number procedure in which phenanthrene was the sole carbon and
      energy source. Growth experiments showed that P-2P44T utilized several two- and
      three-ring polycyclic aromatic hydrocarbons (PAHs) as substrates, including
      naphthalene, 2-methylnaphthalene and phenanthrene. Additionally, gas
      chromatography experiments showed that P-2P44T degraded several other PAHs,
      though it was unable to use them as sole sources of carbon and energy.
      Phylogenetic analyses confirmed that strain P-2P44T is a member of the genus
      Vibrio, most closely related to Vibrio splendidus. However, strain P-2P44T shared
      only 98.3% 16S rDNA identity and 35% DNA-DNA reassociation with the type strain
      of V. splendidus. Strain P-2P44T differed phenotypically from V. splendidus.
      Together, these differences indicated that strain P-2P44T represents a novel
      species in the genus Vibrio, for which the name Vibrio cyclotrophicus sp. nov. is
      proposed; the type strain is P-2P44T (= ATCC 700982T = PICC 106644T).

PMID- 11211275
TI  - Reclassification of [Pseudomonas] doudoroffii (Baumann et al. 1983) into the
      genus Oceanomonas gen. nov. as Oceanomonas doudoroffii comb. nov., and
      description of a phenol-degrading bacterium from estuarine water as Oceanomonas
      baumannii sp. nov.
AB  - A bacterium, isolate GB6T, capable of degrading phenol in the presence of
      elevated salinity was isolated from the estuary of the River Wear, UK. The
      bacterium was subjected to biochemical and molecular analysis to determine its
      taxonomic status. These studies indicated that the bacterium was a distinct
      species closely related to [Pseudomonas] doudoroffii. However, the phylogenetic
      analysis indicated that [Pseudomonas] doudoroffii was misclassified, as noted
      previously. Analysis of the characteristics of isolate GB6T and the type strain
      of [Pseudomonas] doudoroffii confirmed that these bacteria belonged to the same
      novel genus, which we have named Oceanomonas gen. nov. The type strain of
      Oceanomonas doudoroffii (Baumann et al. 1983) comb. nov. is ATCC 27123T (= DSM
      7028T. The DNA-DNA homology between isolate GB6T and [Pseudomonas] doudoroffii is
      low and phenotypic differences between the two organisms are evident. Isolate
      GB6T (= ATCC 700832T = NCIMB 13685T) is therefore proposed as the type strain of
      a new species, Oceanomonas baumannii sp. nov.

PMID- 11211276
TI  - Sphingomonas alaskensis sp. nov., a dominant bacterium from a marine oligotrophic
      environment.
AB  - Seven Gram-negative strains, isolated in 1990 from a 10(6)-fold dilution series
      of seawater from Resurrection Bay, a deep fjord of the Gulf of Alaska, were
      identified in a polyphasic taxonomic study. Analysis of 16S rDNA sequences and
      DNA-homology studies confirmed the phylogenetic position of all strains in the
      genus Sphingomonas and further indicated that all of the strains constitute a
      single homogeneous genomic species, distinct from all validly described
      Sphingomonas species. The ability to differentiate the species, both
      phenotypically and chemotaxonomically, from its nearest neighbours justifies the
      proposal of a new species name, Sphingomonas alaskensis sp. nov., for this taxon.
      Strain LMG 18877T (= RB2256T = DSM 13593T) was selected as the type strain.

PMID- 11211277
TI  - Ornithinimicrobium humiphilum gen. nov., sp. nov., a novel soil actinomycete with
      L-ornithine in the peptidoglycan.
AB  - A Gram-positive bacterium originating from garden soil was taxonomically studied.
      Cells are non-motile, non-sporulating, irregular rods and cocci. The cell wall
      peptidoglycan contains L-ornithine as diagnostic diamino acid and an interpeptide
      bridge consisting of L-Orn<--L-Ala<--Gly<--D-Asp. The major menaquinone is MK
      8(H4). 13-Methyl tetradecanoic acid and 14-methyl pentadecanoic acid are the
      predominant fatty acids. The polar lipids are phosphatidylinositol,
      phosphatidylglycerol, diphosphatidylglycerol, three unknown glycolipids and three
      unknown phospholipids. Mycolic acids are absent. The DNA G+C composition is 70
      mol%. The acyl type of the glycan chain of peptidoglycan is acetyl. Glucose is
      the dominating whole cell sugar; arabinose, rhamnose and xylose are present in
      traces. Results of 16S rDNA sequence comparisons revealed that strain HKI 0124T
      represents a novel lineage within the suborder Micrococcineae of the order
      Actinomycetales adjacent to the recently described genus Ornithinicoccus. On the
      basis of the clearly pronounced morphological, physiological, chemotaxonomic and
      phylogenetic differences between strain HKI 0124T and all members of the suborder
      Micrococcineae, it is proposed to assign strain HKI 0124T to a new genus and
      species, Ornithinimicrobium humiphilum gen. nov., sp. nov. The type and only
      strain is HKI 0124T (= DSM 12362T = CIP 106634T).

PMID- 11211279
TI  - Factors differentiating women and men who successfully maintain weight loss from
      women and men who do not.
AB  - The current study explored the relative contribution of exercise, coping
      responses, cognitive attributions, and emotional experiences to successful weight
      loss maintenance in men and women. The data were collected via a large community
      based survey on dieting and weight loss commissioned by Consumer Union. Men and
      women who met our criteria for successful (n = 277 men, n = 329 women) and
      unsuccessful (n = 277 men, n = 329 women) weight-loss maintenance were included
      in the sample. Successful weight-loss maintainers (Maintainers) reported having
      lost at least 10% of their highest adult weight and having maintained that weight
      loss for at least the three years immediately prior to the survey. Unsuccessful
      weight-loss maintainers (Regainers) reported not ever having been able to
      maintain a significant weight loss and having lost and regained a minimum of 10
      to 19 pounds at least once. In response to a dietary lapse, Maintainers, as
      compared with Regainers, reported being more likely to use direct coping and less
      likely to seek help. The results imply that the most useful variables for
      differentiating between successful and unsuccessful weight-loss maintainers may
      involve how they respond to a dietary lapse.

PMID- 11211278
TI  - A revision of Rhizobium Frank 1889, with an emended description of the genus, and
      the inclusion of all species of Agrobacterium Conn 1942 and Allorhizobium
      undicola de Lajudie et al. 1998 as new combinations: Rhizobium radiobacter, R.
      rhizogenes, R. rubi, R. undicola and R. vitis.
AB  - Rhizobium, Agrobacterium and Allorhizobium are genera within the bacterial family
      Rhizobiaceae, together with Sinorhizobium. The species of Agrobacterium,
      Agrobacterium tumefaciens (syn. Agrobacterium radiobacter), Agrobacterium
      rhizogenes, Agrobacterium rubi and Agrobacterium vitis, together with
      Allorhizobium undicola, form a monophyletic group with all Rhizobium species,
      based on comparative 16S rDNA analyses. Agrobacterium is an artificial genus
      comprising plant-pathogenic species. The monophyletic nature of Agrobacterium,
      Allorhizobium and Rhizobium and their common phenotypic generic circumscription
      support their amalgamation into a single genus, Rhizobium. Agrobacterium
      tumefaciens was conserved as the type species of Agrobacterium, but the epithet
      radiobacter would take precedence as Rhizobium radiobacter in the revised genus.
      The proposed new combinations are Rhizobium radiobacter, Rhizobium rhizogenes,
      Rhizobium rubi, Rhizobium undicola and Rhizobium vitis.

PMID- 11211280
TI  - Further results on the reliability of the Parental Bonding Instrument (PBI) in an
      Italian sample of schizophrenic patients and their parents.
AB  - The reliability of the Italian version of the Parental Bonding Instrument (PBI)
      was assessed in a group of 26 schizophrenic patients and their parents. In both
      groups, internal consistency indices were satisfactory and mean PBI scores at
      test and retest were stable. The test-retest reliability coefficients for the PBI
      scales of parents ranged from .65 to .67, those of the patients from .32
      (paternal-protection score) to .67 (maternal-care score). The less satisfactory
      test-retest reliability of patients' paternal protection score was due to minor
      intra-category rather than inter-category variations in their ratings. This
      suggests difficulties with a four-point rating scale, which might depend partly
      on the generally poor schooling of the sample, but it may also reflect
      uncertainty of schizophrenic patients concerning fathers' controlling behavior.
      Further studies should pay attention to this factor. Patients' PBI mean scores
      are compatible with an affection-less control rearing style, while those of their
      parents, characterized by similar poor care but less control, are consistent with
      a pattern of weak parental bonding.

PMID- 11211281
TI  - Coping and catastrophizing in chronic pain: a psychometric analysis and
      comparison of two measures.
AB  - We analyzed and compared the psychometric properties of two measures of
      strategiesfor coping with pain:The Coping Strategies Questionnaire (CSQ) and the
      Cognitive Coping Strategies Inventory (CCSI). The CSQ and CCSI were repeatedly
      administered to 30 chronic pain patients. Several subscales of both measures
      showed inadequate internal consistency, and test-retest (one week interval)
      reliability lower than 0.7. For each inventory, moderate to strong
      intercorrelations between several subscales were observed. The Catastrophizing
      subscale was the only subscale for which there was clear evidence of construct
      validity. Results indicated that both measures showed similar psychometric
      difficulties, and question the construct validity of subscales other than
      Catastrophizing. Catastrophizing, however, more closely reflects appraisal
      processes than a coping strategy per se. We suggest that measures that use more
      parsimonious and empirically derived coping strategy subscales and that also
      assess appraisal factors would assist in advancing our understanding of coping
      with chronic pain.

PMID- 11211282
TI  - Item characteristics of the Michigan Alcoholism Screening Test.
AB  - Items of the Michigan Alcoholism Screening Test (MAST) were individually
      evaluated regarding disproportional responding. The item with the lowest degree
      of endorsement (Item 18, related to liver problems) was found to have
      correspondingly low relationships with other MAST items and with the total score.
      Weighted items concerned with drug-related arrests were found to detract from the
      otherwise relatively homogeneous MAST items. Traditional statistical approaches
      for homogeneity suggest high level internal consistency with the deletion of the
      aforementioned items. A factor analytic test of homogeneity was confirmed.
      Recommendations are presented concerning modification of the MAST scoring
      procedures.

PMID- 11211283
TI  - A content analysis of smoking craving.
AB  - The purpose of this study was to conduct a content analysis of smoking craving in
      order to investigate more precisely the subjective nature of the construct with
      the goal of informing assessment. Thirty-two smokers interested in cessation
      treatment provided free response written descriptions of the level of craving
      they normally experience. These responses were analyzed for subjective content
      along five theoretical domains: physiological, affective, cognitive, behavioral,
      and synonyms (of craving). Although there were no differences in the relative
      proportion of broad content terms smokers used to describe their craving (e.g.,
      cognitive versus affective), this analysis revealed considerable diversity in the
      specific terms smokers used. Some smokers described their craving in purely
      physiological terms whereas others used primarily cognitive terms, and still
      others used affective terms. To assume that smoking craving is qualitatively
      similar across persons, then, may mask important variations that define the
      individual experience of craving.

PMID- 11211284
TI  - Placebo insight: the rationality of insight-oriented psychotherapy.
AB  - It is widely believed that the insight-oriented psychotherapies provide their
      clients with valid methods of self-exploration that lead to bona fide self
      knowledge. It also is widely believed that clients' insights must be true in
      order to be therapeutically effective. Both these claims are implausible. I argue
      that because clients face significant epistemic pressures in the therapeutic
      encounter, the insight-oriented psychotherapies are highly susceptible to
      generating placebo insights, that is, illusions, deceptions, and adaptive self
      misunderstandings that convincingly mimic veridical insight but have no genuine
      explanatory power. The insight-oriented psychotherapies also are highly
      susceptible to generating therapeutic artefacts that appear to confirm the
      insights acquired by clients. The powerful treatment methods to which clients are
      subjected generate some of the very psychological and behavioral facts that
      clients claim to "discover" in their explorations. This impugns the scientific
      status of the insight-oriented psychotherapies.

PMID- 11211285
TI  - Introduction: antiscientific attitudes within psychotherapy: philosophical,
      scientific, and political/psychological considerations.

PMID- 11211286
TI  - Dangers of anecdotal reports.
AB  - The anecdotal case study tradition in psychoanalysis has a long, hallowed history
      and continues to seem the best way to describe our clinical encounters. But
      reliance on memory in the absence of witnesses or other kinds of corroboration
      (such as audio recording) can (a) protect standard theory from necessary
      corrections; (b) lead to the underreporting of technical mistakes, outright
      clinical failures, and, paradoxically, innovative approaches; (c) tempt us to
      substitute, by way of narrative smoothing, what ought to happen for what actually
      transpired; and (d) lead to the loss of an invaluable, one-of-a-kind set of
      observations that can never be replaced.

PMID- 11211287
TI  - Antiscientific attitudes: what happens when scientists are unscientific?
AB  - Scientists sometimes engage in quite unscientific behavior in order to influence
      their peers or to obtain secondary gain. We explore some of the causes and
      consequences of these acts, using examples of different ways in which
      antiscientific attitudes are manifest among scientists.

PMID- 11211288
TI  - Antiscientific attitudes within psychotherapy: concluding comments.
AB  - In all of the articles of this special section (Beutler & Harwood, Erwin,
      Jopling, and Spence), the authors express their commitment to a conventional view
      of truth and objectivity, a view which serves as a precondition for their
      commitment to a true science of psychotherapy. In my concluding comments, I first
      describe the particular focus of each author's concerns about current standards
      of truth and objectivity in the field. I then anticipate the ways in which their
      arguments might be challenged by those who now challenge the possibility of truth
      and objectivity (in any conventional sense) within psychotherapy, or, more
      broadly, within the human sciences, or, more radically, within the physical
      sciences.

PMID- 11211290
TI  - The rejection of natural science approaches to psychotherapy: language and the
      world.
AB  - Many postmodernists appeal to theses about the relationship between language and
      reality as one basis for rejecting natural science approaches to psychotherapy.
      The theses include one or more of the following: (a) There are multiple worlds
      rather than just one, (b) worlds are constructed rather than discovered, and (c)
      worlds are not independent of mind and language. I refer to the conjunction of
      these three propositions as the multiple worlds-constructionist view. After
      examining the most systematic defense of the multiple worlds-constructionist
      view. I conclude that it fails, and that each component of the view is false.

PMID- 11211289
TI  - A comparison of dose-response curves in cognitive-behavioral and psychodynamic
      psychotherapies.
AB  - Changes in patient- and therapist-rated process items, and patient-rated symptom
      severity assessed over a maximum of 30 sessions of psychodynamic or cognitive
      behavioral psychotherapy were compared in an outpatient mental-health clinic.
      Patients' ratings in psychodynamic psychotherapy on two of the process items were
      superior to ratings by patients in cognitive-behavioral therapy, and interactions
      with time were discovered for an interpersonal item. Comparisons between patients
      who reported their initial symptom severities as most severe and those with less
      severe symptoms also were made, with results indicating differential effects of
      treatment according to perceptions of symptom severity. Interactions between
      length of stay in treatment and number of sessions also were investigated.
      Findings indicated that patients benefit from psychotherapy over time and support
      the usefulness of a contextual model for psychotherapy funding.

PMID- 11211291
TI  - Social problem-solving abilities and personality disorder characteristics among
      dual-diagnosed persons in substance abuse treatment.
AB  - We examined the relation of self-appraised social problem-solving abilities and
      personality-disorder characteristics to the adjustment and compliance of persons
      with dual diagnoses in substance-abuse treatment. It was hypothesized that
      elements of the problem-orientation component would remain predictive of
      depressive behavior and distress after considering personality-disorder
      characteristics among 117 persons receiving inpatient-substance-abuse treatment.
      Furthermore, self-appraised problem-solving abilities were expected to predict
      the occurrence of "dirty" drug and alcohol screens during treatment and
      compliance with the first scheduled community follow-up visit. Results supported
      predictions concerning the relation of problem-solving confidence to depressive
      behavior, distress, and substance-use screens; however, a paradoxical relation
      was observed between the problem-orientation variables and compliance with the
      first outpatient visit. The results are interpreted within the context of
      contemporary models of social problem solving and the implications for cognitive
      behavioral assessment and intervention are considered.

PMID- 11211292
TI  - Couple functioning in depression: the roles of sociotropy and autonomy.
AB  - We evaluated the hypothesis that interpersonal relationships of depressed persons
      would vary as a function of the personality variables sociotropy and autonomy.
      Depressed psychiatric patients who reported being in a current intimate
      relationship for at least six months were administered measures of sociotropy,
      autonomy, and several aspects of relationship functioning. Results indicated that
      sociotropy was related significantly to patients' reporting their own behavior as
      demanding and their partners' behavior as withdrawing, whereas autonomy was
      related to patients' reporting their partners' behavior as demanding and their
      own behavior as withdrawing. Autonomy also was related to greater relationship
      dissatisfaction, and there was a trend for autonomy to be related to greater
      criticism of the partner. The results are consistent with a model in which
      sociotropy and autonomy increase vulnerability to depression, in part, through
      their effects on interpersonal relationships.

PMID- 11211293
TI  - Transmigrant mandibular canines: a record of 28 cases and a retrospective review
      of the literature.
AB  - The transmigrant mandibular canine is a rare phenomenon. Most authors have
      described singular cases of unilateral or bilateral occurrence; however, a few
      authors have published more cases. This paper describes 28 cases exhibiting
      transmigratory canines. The observations are compared with observations from 39
      earlier reports. Women are affected more than men. The left canine undergoes
      transmigration more commonly than does the right canine. Transmigration and
      impaction appear to be more common. Most of the patients do not have any
      symptoms, and these canines are often discovered at the radiological examination
      before orthodontic treatment. The etiology is obscure; however, abnormal
      displacement of the tooth bud in embryonic life is a commonly accepted
      explanation. Prolonged retention of the deciduous canine is a good clinical sign
      for a thorough radiological examination, preferably including an
      orthopantomographic radiograph. This would help in preventive measures. However,
      once established, a transmigrated canine requires surgical extraction. If
      possible, and if space is available and the patient is willing, all orthodontic
      efforts should be made to restore the normal position of this functionally very
      useful tooth in the human dentition.

PMID- 11211294
TI  - Obstructive sleep apnea: a canonical correlation of cephalometric and selected
      demographic variables in obese and nonobese patients.
AB  - One hundred male obstructive sleep apnea (OSA) patients were classified into 2
      groups on the basis of body mass index (BMI): 43 nonobese (BMI < 30 kg/m2) and 57
      obese (BMI > or = 30 kg/m2) patients. A comprehensive cephalometric analysis with
      a multivariate statistical method was performed in order to define the different
      principal components (PCs) of cervico-craniofacial skeletal and upper airway soft
      tissue morphology in each group and how they contributed to selected elements of
      the patient demographic data, ie, apnea-hypopnea index (AHI), nocturnal
      oxyhemoglobin saturation, and BMI. Thirty cephalometric variables of cervico
      craniofacial skeletal morphology were reduced to 8 PCs describing 84.4% and 85.4%
      of the total variance in obese and nonobese OSA patients, respectively. Sixteen
      cephalometric variables of hyoid bone position and head posture were reduced to 4
      PCs describing 84.4% and 85.9% of the total variance in obese and nonobese OSA
      patients, respectively. Twenty cephalometric variables of upper airway soft
      tissue morphology were reduced to 7 PCs describing 89.5% and 84.6% of the total
      variance in obese and nonobese OSA patients, respectively. For further analysis
      of PCs, a stepwise multiple regression analysis was chosen. Two dependent
      variables of interest are the minimal distance of the posterior pharyngeal airway
      space (PASmin) and AHI. PASmin accounted for 95.3% (obese OSA group) and 74.3%
      (nonobese OSA group) with 7 PCs and AHI for 46% with 3 PCs in both groups. Three
      canonical variables and their correspondents with different loadings were
      established differently for both OSA groups. A canonical correlation successfully
      clarified the complexity of simultaneous relationship of the relevant variables.
      These analyses are proved useful to demonstrate the relationship of cervico
      craniofacial skeletal and upper airway soft tissue morphology and selected
      demographic data. This lays down a basis for understanding the complicated
      pathogenic components of obese and nonobese OSA patients.

PMID- 11211295
TI  - Re: Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary
      expansion in adults: report on 47 cases. Angle Orthod. 1999;70:129-144.

PMID- 11211296
TI  - Anterior space relations and lower incisor alignment in 9-year-old children born
      in the 1960s and 1980s.
AB  - The anterior arch spaces and the effect of early loss of deciduous canines have
      been studied in 2 different cohorts of 9-year-old children. One group of 119
      children was from Norway and consisted of 56 girls and 63 boys, and 1 group of
      133 children was from Sweden and consisted of 72 girls and 61 boys. Within these
      cohorts, half of the children were born in the 1960s and half in the 1980s. The
      1960s group has been compared with the 1980s group to look for anterior arch
      changes occurring during this period of time. The children who had lost a lost
      deciduous canine at the age of 9 years were also compared with the children with
      all deciduous canines remaining. Groups were compared with analysis of variance.
      It was found that children with a lost deciduous canine at the age of 9 years
      belong to a group with less available arch space and are a crowded group when
      compared with an earlier study. For the girls, this was also associated with
      larger teeth. Anterior arch space did not differ between the 1960s and the 1980s
      groups except for the Swedish boys, where there was less available mandibular
      arch space in the 1980s group. The irregularity index for the 4 mandibular
      incisors was increased in the 1980s group compared with the 1960s group. This
      could indicate a secular trend toward an increased prevalence of malocclusion in
      the present population.

PMID- 11211297
TI  - Effective condylar growth and chin position changes in activator treatment: a
      cephalometric roentgenographic study.
AB  - Effective condylar growth (a summation of condylar remodeling, glenoid fossa
      remodeling, and condylar position changes within the fossa) and its influence on
      the position of the chin was analyzed in 40 class II, division I malocclusions
      treated successfully with activators. Additionally, the amount of mandibular
      rotation was assessed. Lateral head films in habitual occlusion from before and
      after an average treatment period of 2.6 years were evaluated. The Bolton
      Standards (32 untreated individuals with ideal occlusion) served as controls. Two
      different treatment effects were evaluated: overall growth change and treatment
      effects (overall growth changes minus age-related Bolton values). In comparison
      with the Bolton group, the activator patients exhibited an increase in the amount
      of vertical effective condylar growth (3.0 mm; P < .001), a decrease in the
      amount of sagittal effective condylar growth (0.6 mm; P < .05), and an increase
      in the amount of vertical development of the chin (1.8 mm; P < .001). No group
      differences could be found for sagittal development of the chin. In the Bolton
      group, the mandible rotated posteriorly, and in the activator group it rotated
      anteriorly (2.7 degrees; P < .001). The present investigation revealed that
      effective condylar growth can be increased and the chin position can be changed
      by activator treatment. Thus activator treatment induces skeletal changes,
      although not always in the desired (sagittal) therapeutic direction.

PMID- 11211298
TI  - Changes in circumferential neck measurements during movements of the head in
      children and their relevance to extraoral traction.
AB  - One of the causes of facebow injuries to patients wearing extraoral traction has
      been the catapult effect of the simple elasticized materials used in the past. A
      variety of safety or self-releasing modular systems to counteract this catapult
      effect are currently available. However, the strap extension provided by these
      modules varies considerably. To reduce the catapult effect to a minimum, it is
      desirable to fit a system with the minimal travel that will accommodate any
      changes in distance between the facebow and the back of the head or neck. To
      ascertain the minimal travel required for the straps, circumferential neck
      measurements were carried out on 105 children aged between 9 and 14 years. The
      change in circumference was recorded for 3 different head positions. The mean
      distance change between the back of the neck and the end of the facebow was 25 mm
      per side, with a range of 4 mm to 50 mm. This study suggests that on average,
      modules with a 25-mm extension will be required for cervical traction.

PMID- 11211299
TI  - The effect of growth hormone on craniofacial growth and dental maturation in
      Turner syndrome.
AB  - Serial cephalometric and panoramic radiographs from a mixed longitudinal group of
      28 subjects with Turner syndrome (TS), age 4.4-19.0 years, were evaluated for
      annualized growth increments of the craniofacial complex and dental development
      and were compared with a longitudinal control group from the Burlington growth
      study. The short and retrognathic face characteristic of the syndrome was due
      largely to the increased cranial base angle, decreased posterior face height, and
      decreased mandibular length, all of which were significantly different from the
      controls. Although increases in statural height occurred in the TS children who
      were treated with human growth hormone (GH), there was little or no effect on
      growth of the jaws, particularly in the older subjects, and the characteristic
      facies of the syndrome persisted. Dental development was advanced in all TS
      subjects, and GH administration had no effect on the rate of dental development.

PMID- 11211300
TI  - The influences of molar intrusion on the inferior alveolar neurovascular bundle
      and root using the skeletal anchorage system in dogs.
AB  - The skeletal anchorage system (SAS) was developed as intraoral rigid anchors for
      open-bite correction by intrusion of molars. Since the application of SAS is a
      new modality in orthodontic treatment, the influences of radical molar intrusion
      on the root and the inferior alveolar neurovascular bundle were unknown. The
      purpose of this research is to verify the effect of molar intrusion on the
      neurovascular bundle, the level of osseointegration of bone screws, and root
      resorption. The results of this study showed mandibular molars were intruded 3.4
      mm on the average over 7 months in dogs. The miniplates were well stabilized with
      osseointegrated bone screws and the peri-implant soft tissues showed slight
      inflammatory changes. Neither nerves nor blood vessels were damaged. Root
      resorption was observed but was repaired with new cementum. We concluded that the
      SAS utilizing transmucosal titanium miniplates as an immovable orthodontic
      anchorage could provide a new modality for molar intrusions without serious
      iatrogenic problems.

PMID- 11211301
TI  - Design and effectiveness of a computer-based continuing education program for
      orthodontists.
AB  - The design of computer-based continuing education for health professionals is an
      important consideration for Internet delivery because the size of graphic files
      greatly affects the speed with which information is delivered. Orthodontists who
      had indicated an interest in computer-based continuing education were shown via
      CD-ROM either a dynamic version of a computer continuing education program (with
      transitions and animations to liven up the content) or a plain version (identical
      content except that the transitions and animations were omitted). The program
      provided new information about superelastic arch wires for the initial stage of
      orthodontic treatment. For both versions, over 90% of the viewers thought the
      program was well done and provided useful information. Six of the orthodontists
      who received the dynamic version felt that the animations were distracting rather
      than helpful; only one who received the plain version felt that it was lifeless.
      A follow-up questionnaire showed that two-thirds of those who viewed the program
      had subsequently reviewed the performance data for the initial wire they were
      using and 20% had changed it, so the computer program was effective in changing
      clinical behavior. Those who saw the plain version also were more likely to have
      changed their clinical procedures. For Internet delivery of information to highly
      motivated professionals, it appears that transitions and animations are not
      necessary and may be more likely to decrease than increase the effectiveness of
      the teaching material.

PMID- 11211302
TI  - What do they want, anyway?

PMID- 11211303
TI  - Intranet-based quality improvement documentation at the Veterans Affairs Maryland
      Health Care System.
AB  - The Pathology and Laboratory Medicine Service of the Veterans Affairs Maryland
      Health Care System is inspected biannually by the College of American
      Pathologists (CAP). As of the year 2000, all documentation in the Anatomic
      Pathology Section is available to all staff through the VA Intranet. Signed,
      supporting paper documents are on file in the office of the department chair. For
      the year 2000 CAP inspection, inspectors conducted their document review by use
      of these Web-based documents, in which each CAP question had a hyperlink to the
      corresponding section of the procedure manual. Thus inspectors were able to
      locate the documents relevant to each question quickly and efficiently. The
      procedure manuals consist of 87 procedures for surgical pathology, 52 procedures
      for cytopathology, and 25 procedures for autopsy pathology. Each CAP question
      requiring documentation had from one to three hyperlinks to the corresponding
      section of the procedure manual. Intranet documentation allows for easier sharing
      among decentralized institutions and for centralized updates of the laboratory
      documentation. These documents can be upgraded to allow for multimedia
      presentations, including text search for key words, hyperlinks to other
      documents, and images, audio, and video. Use of Web-based documents can improve
      the efficiency of the inspection process.

PMID- 11211304
TI  - Primary cutaneous T-cell-rich B-cell lymphoma: clinically distinct from its nodal
      counterpart?
AB  - The cases of two patients with Stage IE primary cutaneous T-cell-rich B-cell
      lymphoma (TCRBCL) are described. In both, the lesion showed a dense infiltrate by
      numerous small T lymphocytes with scattered histiocytes and large atypical B
      lymphoid cells. Polymerase chain reaction assays demonstrated that the B cells
      were monoclonal, with immunoglobulin heavy-chain gene rearrangement. No clonal
      rearrangements of the T-cell receptor gamma gene were observed. Both patients
      were disease-free at 4 months and at 5 years after therapy, respectively.
      Although rare, primary cutaneous T-cell-rich B-cell lymphoma appears to have a
      better prognosis than its nodal counterpart, with or without skin involvement.

PMID- 11211305
TI  - Fetal brain to liver weight ratio as a measure of intrauterine growth
      retardation: analysis of 182 stillborn autopsies.
AB  - The fetal brain/liver weight ratio of 182 stillborn fetuses was analyzed for its
      value as a measure of intrauterine growth retardation. The ratio was evaluated as
      a test for the detection of small-for-gestational age fetuses, compared with the
      ponderal index, and evaluated for correlation with maternal histories that were
      compatible with fetal growth retardation. Both brain/liver ratio and ponderal
      index were insensitive and relatively nonspecific indicators of low fetal body
      weight in this population. Brain/liver weight ratio was considerably more
      sensitive in those cases that were at least 20 weeks of gestational age, and
      specificity increased as the cut-off point was increased above 3. Those cases
      with maternal history or placental findings compatible with asymmetrical-type
      intrauterine growth retardation were statistically more likely to have elevated
      brain/liver weight ratios and depressed ponderal indices, but there was
      considerable overlap among cases with different disease types. Prosectors of
      fetal autopsies must make use of all the information available to them. The fetal
      brain/liver weight ratio and the ponderal index may be useful, but they are not
      satisfactory indicators of intrauterine growth retardation by themselves, and
      they also may be inadequate for the detection of growth retardation etiology.

PMID- 11211306
TI  - Reversible transdifferentiation: interconversion of somatotrophs and lactotrophs
      in pituitary hyperplasia.
AB  - Previous studies conclusively demonstrated transformation of somatotrophs into
      bihormonal mammosomatotrophs in gestational lactotroph hyperplasia during
      pregnancy. Similar transdifferentiation of somatotrophs into thyrotrophs through
      bihormonal intermediate thryrosomatotrophs was documented during thyrotroph
      hyperplasia in both rodent and human pituitaries in hypothyroidism. The cessation
      of the stimulation resulted in reversal of the process in both conditions. The
      conversion of lactotrophs into somatotrophs was suggested but not documented
      previously in the human gland. The present study was undertaken to investigate
      cases of somatotroph hyperplasia by transmission electron microscopy,
      immunoelectron microscopy using double immunogold labeling for growth hormone and
      prolactin, as well as combined immunocytochemistry and in situ hybridization.
      Adenohypophysial tissue was removed from a 38-year-old man and a 29-year-old
      woman with long-standing acromegaly due to ectopic overproduction of growth
      hormone-releasing hormone (GRH) by bronchial carcinoid tumors. For comparison,
      two pituitary biopsies were studied: one from a 38-year old woman with idiopathic
      lactotroph hyperplasia and one from a 14-year-old boy with secondary lactotroph
      hyperplasia due to a suprasellar craniopharyngioma. In the patients with
      somatotroph hyperplasia, the prevailing cell type was the hyperplastic
      somatotroph joined by mammosomatotroph deriving from lactotrophs, whereas
      monohormonal lactotrophs were rare. The predominance of mammosomatotrophs and
      active lactotrophs was documented in the patient with idiopathic lactotroph
      hyperplasia, whereas the case of the patient with secondary lactotroph
      hyperplasia was characterized by monohormonal lactotrophs and somatotrophs, but
      mammosomatotrophs were rare. That finding in the pituitary of the boy suggests
      that participation of mammosomatotrophs in lactotroph hyperplasia is not
      unconditional Our findings conclusively demonstrate conversion of lactotrophs
      into mammosomatotrophs during somatotroph hyperplasia, providing further evidence
      for the potential of reversible transdifferentiation between somatotrophs and
      lactotrophs in response to functional demand.

PMID- 11211307
TI  - Altered distribution of beta-catenin, and its binding proteins E-cadherin and
      APC, in ulcerative colitis-related colorectal cancers.
AB  - The beta-catenin pathway plays a central role in transcriptional signaling and
      cell-cell interactions in colonic epithelium. Alterations of the expression of
      beta-catenin, and its binding partners E-cadherin and the adenomatous polyposis
      coli protein (APC), are frequent events in sporadic colorectal cancer. Ulcerative
      colitis (UC)-related cancers originate in a field of chronic inflammation and
      therefore may have different alterations in the beta-catenin pathway than
      sporadic cancers. To test this hypothesis, expression and subcellular
      localization of beta-catenin, E-cadherin, and APC were detected by
      immunohistochemistry in paraffin sections from 33 UC-related and 42 sporadic
      colorectal cancers. Although beta-catenin and E-cadherin expression were
      predominantly limited to the lateral cell membrane in normal colonic epithelium,
      both tumor groups showed an overall shift from membranous to cytoplasmic
      expression for these proteins. An increase in nuclear localization of beta
      catenin and a decrease in cytoplasmic APC expression also were seen in both
      cancer groups compared with normal epithelium. Abnormal beta-catenin expression
      was more closely linked to E-cadherin alterations in UC-related cancers than in
      sporadic cancers. In contrast, abnormal beta-catenin expression was more closely
      linked to APC alterations in sporadic cancers than in UC-related cancers. These
      data suggest that alterations of the beta-catenin pathway are important in both
      UC-related and sporadic colorectal cancers. However, differences in the
      expression patterns of beta-catenin, E-cadherin, and APC between UC-related and
      sporadic colorectal cancers suggest that the specific alterations in this pathway
      may differ in these two cancer groups.

PMID- 11211310
TI  - Effects of bisphosphonate on the release of MMP-2 from cultured human
      osteoblasts.
AB  - Production of matrix metalloproteinases (MMPs) influences bone resorption. We
      investigated the role of bisphosphonates, potent inhibitors of bone resorption,
      on the production of MMP-2 from human osteoblasts. Bisphosphonates alone did not
      influence the amount of MMP-2 produced by human osteoblasts. However, in the
      presence of physiological concentrations of plasmin, bisphosphonates reduced the
      amount of MMP-2 in osteoblasts-conditioned media. Furthermore, bisphosphonates
      treatment induced degradation of MMP-2 in the presence of plasmin. Our results
      indicated that bisphosphonate, a divalent cation chelator, negatively regulated
      the longevity of MMP-2 in soluble phase plasmin-containing environment. These
      findings suggest that bisphosphonates inhibit bone resorption by abrogating MMP-2
      protection induced by plasmin-mediated degradation.

PMID- 11211308
TI  - Human small cell lung carcinoma and carcinoid tumor regulate dendritic cell
      maturation and function.
AB  - The induction of apoptosis in dendritic cells (DC) is a key mechanism by which
      tumors escape immune recognition and elimination. In fact, a number of studies
      have showed the correlation between the number of DC within the tumor and the
      clinical prognosis, suggesting that increased infiltration of tumor tissue by DC
      was associated with better patient survival and low incidence of metastatic
      disease. We compared the number of DC and their distribution pattern in human
      small-cell lung carcinoma and bronchial carcinoid tumor (CT) tissues.
      Immunohistochemical analysis revealed the presence of cells expressing DC markers
      CD1a and CD83 in small-cell lung carcinoma tissues and the complete absence of
      these cells in CT samples. Next, we examined whether human lung tumor cells
      produce soluble factors that inhibit differentiation of hematopoietic precursors
      into mature DC. The addition of small-cell lung carcinoma-conditioned medium to
      CD34+ precursor cell cultures significantly inhibited colony-forming units of DC
      formation when compared with nontreated control DC cultures. Furthermore, DC
      generation and differentiation was completely abrogated in CD34+ cell cultures
      treated with CT-conditioned medium, suggesting that CT-derived factors blocked
      CD34+ cell differentiation into DC or induced their apoptosis. Finally, flow
      cytometry analysis of cultured DC confirmed these results. Thus, analysis of our
      data suggests that human lung tumors produce factors that inhibit DC generation
      or maturation and may also induce apoptotic death of DC precursors in vitro.

PMID- 11211309
TI  - Clear cell sarcoma shows immunoreactivity for microphthalmia transcription
      factor: further evidence for melanocytic differentiation.
AB  - Microphthalmia transcription factor, a melanocytic nuclear protein critical for
      the embryonic development and postnatal viability of melanocytes, is a master
      regulator in modulating extracellular signals. Recently, microphthalmia
      transcription factor expression was shown to be both a sensitive and specific
      marker of epithelioid melanoma. We investigated the sensitivity of D5, an anti
      microphthalmia transcription factor antibody, for diagnosis of clear cell sarcoma
      (also known as malignant melanoma of soft parts). Immunoreactivity in a nuclear
      pattern for D5 was present in 8 of 12 (75%) tumors. D5 staining was strong in
      three tumors, moderate in two, and weak in three. S-100 protein expression was
      seen in all 12 cases that had clear cell sarcoma examined. HMB-45 staining was
      seen in 11 of 12 (92%) tumors. Focal Melan-A positivity was seen in 3 of 7 (43%)
      tumors. Although D5 was shown in a previous study to be a highly sensitive and
      specific marker for epithelioid melanomas, the results of this study expand the
      spectrum of tumors showing immunoreactivity for D5. D5 immunoreactivity in clear
      cell sarcoma provides further evidence for melanocytic differentiation in this
      unusual tumor.

PMID- 11211311
TI  - Wing-shaped end-to-end anastomosis for the treatment of high jejunal atresia.
AB  - Six infants with jejunal atresia, one infant with ileal atresia, and one infant
      with colonic atresia were managed by a newly developed wing-shaped end-to-end
      anastomosis. The technique was accomplished by anastomosing the tip of the
      dilated proximal bowel to the diminutive distal bowel, which had been divided
      into two parts, including the mesentery. The completed anastomosis resembled
      extended wings, and this technique was therefore named wing-shaped anastomosis.
      This technique for anastomosis is effective in preventing functional obstruction
      because no axial deviation between the proximal and distal anastomotic bowels
      exists, and the mucosal absorptive surface is completely preserved.

PMID- 11211312
TI  - Interferon-gamma stimulates the expression of CX3CL1/fractalkine in cultured
      human endothelial cells.
AB  - CX3CL1/Fractalkine, a CX3C chemokine, is a potent agonist for the chemotaxis and
      adhesion of monocytes and lymphocytes. It was first identified as a membrane
      protein in endothelial cells activated with IL-1 or TNF-alpha. We have found the
      enhanced expression of fractalkine in human umbilical vein endothelial cells
      stimulated with interferon-gamma (IFN-gamma). Pretreatment of the cells with
      cycloheximide did not inhibit the expression of fractalkine mRNA. The majority of
      fractalkine protein was found in the cell lysate, and an antibody-blocking
      experiment disclosed that fractalkine contributes to the adhesion of mononuclear
      cells to endothelial monolayers stimulated with IFN-gamma. Vascular endothelial
      cells produce fractalkine in response to IFN-gamma, and this may play an
      important role in immune responses by eliciting a traffic of mononuclear cells
      through the vascular wall.

PMID- 11211313
TI  - Herpesvirus alkaline deoxyribonuclease; a possible candidate as a novel target
      for anti-herpesvirus therapy.
AB  - Herpesvirus alkaline deoxyribonucrease (DNase) is coded in the genome of all
      herpesvirus species determined total sequence and is conserved in structure. In
      order to determine whether the enzyme could be a target for a novel
      antiherpesvirus therapy, the anti-herpes simplex virus type 1 (HSV-1) activity of
      antisense oligonucleotide for HSV-1 alkaline DNase was studied. Six antisense
      phosphorothioate oligonucleotides, targeted to an internal AUG start codon, were
      designed and evaluated. One of the oligonucleotides, UL12-4, inhibited wild type
      and thymidine kinase-deficient HSV-1 replication to 21.5 and 19.5% at 40 microM,
      respectively. The quantity of alkaline DNase mRNA and DNase activity in HSV-1
      infected Vero cells was reduced to one eighth and 66.9% of control, respectively,
      by treatment with 40 microM of UL12-4, but no effect was observed on the quantity
      of HSV-1 glycoprotein H mRNA (gamma2 gene) or on the replication of Vero cells.
      These results indicate that UL12-4 inhibits HSV-1 replication by decreasing the
      amount of alkaline DNase mRNA. The herpesvirus alkaline DNase could be a novel
      target for anti-herpesvirus drug.

PMID- 11211314
TI  - Acute disseminated encephalomyelitis developed after acute herpetic
      gingivostomatitis.
AB  - A child with acute disseminated encephalomyelitis (ADEM) developed after acute
      herpetic gingivostomatisis was described. Inspite of the improvement of his
      gingivostomatitis, his consciousness gradually deteriorated and he was admitted
      to Nakadori General Hospital. His consciousness level was drowsiness and
      increased bilateral patellar reflexes were shown. Because magnetic resonance
      imaging (MRI) T2-weighted scan showed areas of high signal intensity disseminated
      in superior portion of medulla oblongata, dorsal portion of pons, basal nuclei
      and thalamus, he was suspected as having ADEM. Anti-herpes simplex virus (HSV) 1
      IgG and IgM antibodies elevated in both blood and cerebrospinal fluid. From these
      results, HSV1 infection was thought to be the preceding infection of ADEM.
      Methylprednisolone therapy (20 mg/kg daily) for 3 days, followed by prednisolone
      (2 mg/kg) was started, with an excellent response. In addition, administration of
      acyclovir was also continued, considering the complication of HSV encephalitis.
      MRI T2-weighted scan performed at 2 months later after the onset of ADEM revealed
      disappearance of the lesions. He was discharged without remaining disorders. It
      is difficult to distinguish between ADEM and HSV encephalitis because both of
      these diseases show various neurological symptoms. In our case, MRI was the most
      useful method for correct diagnosis of ADEM. We concluded that ADEM is important
      as a disease of central nervus system due to HSV1 infection, in addition to
      encephalitis.

PMID- 11211315
TI  - Focal segmental glomerulosclerosis: unremitting proteinuria of long duration as a
      possible etiology?
AB  - A Japanese boy aged 9 years referred to our hospital because of steroid-resistant
      proteinuria. He had a 6-year history of unremitting proteinuria and was diagnosed
      as having minimal-change disease (MCD) by the repeated renal biopsies performed
      at the age of 3.5 years and 8.5 years, respectively. His proteinuria fluctuated
      ranging from 115 mg/100 ml to 645 mg/100 ml, and serum total protein ranged from
      59 g/liter to 63 g/liter. The third renal biopsy at the presentation also
      revealed MCD. Thereafter he was treated with an anti-thrombocyte agent combined
      with an angiotensin converting enzyme inhibitor. Despite unremitting proteinuria
      of long duration, he did not have any complaints. At the age of 11.5 years,
      severe tubulointerstitial lesion was observed in the fourth renal biopsy. The
      fifth renal biopsy 6 months after the fourth finally revealed the lesion of focal
      segmental glomerulosclerosis (FSGS). Although the interpretation of his repeated
      renal biopsies were considered to be limited, these clinical observation
      suggested that his unremitting proteinuria of long duration might have been
      attributed to subsequent progression FSGS.

PMID- 11211316
TI  - Secondary infections of AIDS autopsy cases in Japan with special emphasis on
      Mycobacterium avium-intracellulare complex infection.
AB  - In order to study the frequency of secondary infections of AIDS autopsy cases in
      Japan, especially the frequency of Mycobacterium aviumintracellulare complex
      (MAC) infection, retrospective autopsy study was conducted between 1986 and 1997
      at the affiliated hospital of Institute of Medical Sciences, University of Tokyo.
      Secondary infections of various organs from 43 AIDS autopsy cases were examined
      using histopathology, genetic diagnosis of tuberculosis, Ziehl-Neelsen stain for
      acid-fast bacilli and immunohistochemistry. Nontuberculous mycobacterial
      infection (Mycobacterium avium) was observed in 17 cases (40%) out of 43 using
      polymerase chain reaction (PCR), but M. tuberculosis infection was not observed.
      Ziehl-Neelsen staining showed a positive reaction in lung and spleen tissues of 7
      AIDS autopsy cases. Immunohistochemistry using anti-BCG antibody revealed
      positivity in 7 AIDS autopsy cases. CD4 counts of 17 AIDS patients with
      mycobacterial infection were less than 18.7/microl. Other opportunistic
      infections were also examined by histopathology. Secondary infections were
      present in every case, and these included cytomegalovirus infection (32 cases),
      Pneumocystis carinii (15 cases), Candida (16 cases), Aspergillus (12 cases),
      Cryptococcus (6 cases), Toxoplasma (6 cases), methicillin-resistant
      Staphylococcus aureus (3 cases), herpes virus (1 case) and Entamoeba histolytica
      (1 case). Malignant lymphoma was recognized in 14 cases and Kaposi's sarcoma in
      6. This is the systemic report on secondary infections of AIDS autopsy cases in
      Japan. In diagnosis of mycobacterial infections, PCR was more useful than
      staining for acid-fast bacilli and immunohistochemistry. Secondary infections
      (especially mycobacterial infection) were closely associated with the low CD4
      count.

PMID- 11211317
TI  - The new look of premises liability.

PMID- 11211318
TI  - Paying the piper: the crisis in chronic care.
AB  - The current article reviews the broad outlines of the crisis in chronic care with
      emphasis on Southern California, a region where the powerful forces buffeting
      health and long term care have reached gale force intensity. The article argues
      that a partial solution to the crisis lies in flexible local partnerships among
      patients, families, providers, and payers focused on helping the chronically ill
      cope with the tasks of daily life. Such partnerships would emphasize supportive
      care, prevention, family preservation, assistive devices, and family income
      supplementation through facilitation of productive work, aspects of chronic care
      neglected by current financing and service delivery practices. A case example,
      the Southern California-based Partners in Care Foundation's Family Care Network,
      illustrates these essential components of a revitalized, responsive chronic care
      system.

PMID- 11211319
TI  - Typology of quality of life experiences among persons living with HIV.
AB  - This article develops a typology of 2,038 participants in 13 innovative HIV/AIDS
      treatment model service demonstration projects targeted to traditionally
      underserved populations. The typology is based on self-reported health-related
      quality of life levels. Eight clusters were identified that classify HIV/AIDS
      patients based on their reported health-related quality of life. Participants
      were clustered based on their overall levels of quality of life, as well as by
      deficits in specific areas of functioning such as energy level, physical
      impairment, and role impairment. However, factor analysis suggests that health
      related quality of life as perceived by the HIV-positive participants is best
      represented as a single underlying dimension and an ordering of the types shows
      that they are consistently related, in the same order, to several criterion
      measures of impairment. The results suggest that a general categorization of
      patients with HIV in terms of quality of life is more meaningful than an
      assessment of the relative areas of impairment. Since the impairment ratings were
      also self-reported, analyses relating quality of life clusters to actual symptom
      levels and healthcare utilization are needed. Implications for the assessment of
      health-related quality of life and the evaluation of service delivery programs
      for persons living with HIV are discussed.

PMID- 11211321
TI  - Use of adult day services and home health care services by older adults: a
      comparative analysis.
AB  - This study compares adult day services (ADS) and home health care (HHC) users on
      the indicators of personal characteristics, physical health, mental health and
      social network contacts. Analysis includes all 62 reported ADS users and a random
      sample of 91 HHC users from the Longitudinal Study of Aging. Results indicate
      that ADS users are younger, have greater cognitive impairment, need more
      supervisory assistance with activities of daily living (ADLs), and have more
      social contacts than HHC users. The findings also underscore the importance of
      emphasizing the functional and cognitive limitations in differentiating home- and
      community-based services. Instead of exclusively focusing on physical needs,
      authors suggest strategies that ensure integrated care models to address
      physical, mental and social needs of elders in both settings.

PMID- 11211320
TI  - Service needs and factors related to quality of life at time of service
      enrollment among persons living with HIV.
AB  - This article explores the relationships of HIV risk factors, service needs, and
      vulnerabilities to health-related quality of life in a sample of 1,371
      participants newly enrolled into 13 innovative HIV/AIDS treatment model service
      demonstration projects. These projects targeted services to traditionally
      underserved populations. Eight distinct quality of life clusters of HIV patients
      were used in this analysis along with patient self-identified risk factors. The
      quality of life clusters were based on patient self-reported quality of life
      dimensions. The eight clusters were differentiated based on relative strengths
      and weaknesses in physical functioning, energy levels, and social functioning.
      Data on patient need-vulnerability factors and demographic characteristics were
      related to these eight clusters using the data modeling method of Exhaustive
      CHAID (Chi-squared Automatic Interaction Detector). Through this method, the
      characteristics most likely to be associated with higher and lower levels of
      quality of life at the time of enrollment into services were identified. The
      results provide further support that quality of life assessment is a useful
      clinical tool for monitoring patient progress.

PMID- 11211323
TI  - Clinton's regulations may be model for patient-rights legislative push.

PMID- 11211322
TI  - Case management decision making: goal transformation through discretion and
      client interpretation.
AB  - This study examines the decision-making strategies employed by case managers in a
      state-funded home care program for the elderly. Specifically, this study applies
      Lipsky's (1980) theory of street-level bureaucracy to gerontological research on
      case management decision making in an effort to demonstrate the presence of case
      management discretion, and the impact of that discretion on home care
      implementation. Drawing upon individual interviews and focus group interviews,
      results suggest the applicability of the proposed framework, and indicate the
      need for policy planners to identify factors for case manager discretion that
      result in undesirable home care goal transformation.

PMID- 11211324
TI  - Ohio struggles to rescue managed Medicaid program.

PMID- 11211325
TI  - 'Blueprint for the future' may lessen HMOs' impact. Interview by Frank Diamond.

PMID- 11211326
TI  - Compensation monitor. When pressure's on, raises get better.

PMID- 11211327
TI  - How medical managers avoid mindsets that are minefields.

PMID- 11211328
TI  - Florida leads the way in attempting disease management for Medicaid.

PMID- 11211329
TI  - An opportunity for HMOs to use marketing to increase enrollee satisfaction.
AB  - PURPOSE: To identify the combination of marketing components (i.e., service,
      price, access, and promotion) of commercial health maintenance organizations
      (HMOs) that are related to overall enrollee satisfaction. The researchers focus
      on factors that commercial HMOs control directly--specifically, health care
      organization and financing. DESIGN: Descriptive (mail order). METHODOLOGY: This
      study uses national data provided by a major health benefits consulting firm,
      which collected data from a 1997 calendar year mail survey of HMO administrators.
      The administrators responded to an extensive survey, which tapped selected HMO
      marketing-mix components and the percentage of surveyed members who indicated
      satisfaction with their HMOs. To test hypotheses, researchers treated marketing
      mix components as independent variables and enrollee satisfaction as the
      dependent variable. PRINCIPAL FINDINGS: This study found statistically
      significant relationships between overall satisfaction and HMO providers'
      quality; access, particularly to specialists and out-of-network providers;
      waiting times for physician services; customer service; and disease
      prevention/health promotion programs. The researchers did not find significant
      relationships between overall satisfaction and accreditation by the National
      Committee for Quality Assurance (NCQA), the presence of physician gatekeepers,
      numbers of providers, or financial indicators. The relationship between overall
      satisfaction and utilization was mixed. This study's findings are largely
      consistent with the literature, consumer- and professional-group position papers,
      and the President's Advisory Commission on Consumer Protection and Quality in the
      Health Care Industry. CONCLUSIONS: HMOs can use marketing as a way to address
      problems and pursue opportunities identified by enrollees. As these findings
      demonstrate, certain features of HMO design are more appealing to patients. By
      focusing on these preferences, HMOs can adopt a responsive market orientation
      that gives rise to more effective marketing mixes and hence improves enrollee
      satisfaction. With improved satisfaction, enrollees generate less need for
      government intervention through regulation or legislation.

PMID- 11211330
TI  - When claims are audited, following compliance laws matters.

PMID- 11211331
TI  - There once was a man who could not feel disgust.

PMID- 11211332
TI  - Managed care outlook. HMO members willing to pay to manage benefits online.

PMID- 11211333
TI  - A woman's right to stay. New rules would offer asylum to battered women.

PMID- 11211334
TI  - Where we come from. Recent advances in genetics are starting to illuminate the
      wanderings of early humans.

PMID- 11211335
TI  - Rustling up a plan. Can the U.S. prevent a mad cow medical crisis?

PMID- 11211336
TI  - Improved AIDS treatments bring life and hope--at a cost.

PMID- 11211337
TI  - Medical privacy rules give patients and marketers access to health data.

PMID- 11211338
TI  - Pregnant women get no bologna--or shark or brie.

PMID- 11211339
TI  - [History of the Geneva Society of Mental Health Promotion, 1906-2000].

PMID- 11211340
TI  - [Feminization of the medical profession and the division of labor between men and
      women: masculine hunting grounds and feminine niches].

PMID- 11211341
TI  - [Cultural and social pluralism, what implications for the practice of medicine?].

PMID- 11211343
TI  - [Introduction: medicine, history, society].

PMID- 11211344
TI  - [The patient and his entourage in the XVIIIth century: mediations in the
      correspondence consultations of Dr. Tissot].

PMID- 11211345
TI  - [Variola and goiter: two public health conceptions].

PMID- 11211346
TI  - [Birth and evolution of legal psychiatry in Switzerland, 1890-1950].

PMID- 11211347
TI  - [Sterilization of sick and mentally handicapped patients in the Fribourg and
      Geneva cantons in the XXth century].

PMID- 11211348
TI  - [Abortion practice in Geneva in thirty years].

PMID- 11211349
TI  - [Physicians and sex education in the school milieu in the canton of Vaud].

PMID- 11211350
TI  - [The birth of "painless childbirth"].

PMID- 11211351
TI  - [How instruments better the world: the electron microscope between science and
      medicine in Geneva (1945-1970)].

PMID- 11211352
TI  - Service learning in the undergraduate health administration curriculum: theory
      and practice.
AB  - Changing the focus of the health care system from individual to population-based
      health presents challenges for health administration programs as they search for
      innovative ways to educate students who can work in interdisciplinary and diverse
      environments. The increased utilization of service learning in health profession
      schools suggests that service learning is a way to contribute to student
      learning, social awareness and the health of community. Undergraduate health
      administration programs can take on the same challenge by integrating service
      learning into their curriculum. This study introduces the service learning
      concept into the health administration curriculum, demonstrates service learning
      models and recommends several health administration courses for service learning
      integration.

PMID- 11211353
TI  - The role of gender in MPH graduates' salaries.
AB  - Several studies have demonstrated that workforce roles and salaries differ
      substantially between men and women in administrative positions within the health
      care industry. Recent studies of graduates with masters of business
      administration (MBA) and masters of health administration (MHA) degrees have
      indicated that women tend to experience lower salaries, given like
      responsibilities. However, the impact of gender on salary has been less studied
      among masters of public health (MPH) graduates in the health care field. Our
      objective was to assess the impact of gender on salary among MPH degree
      graduates. Using a cross-sectional survey of all graduates from the MPH program
      at Yale University between 1991-1997 (n = 201, response rate = 51%), we
      ascertained graduates' reported salary in the first job post-graduation and
      reported salary in their current position. Bivariate and multivariate analyses
      were used to assess the unadjusted and adjusted associations between gender and
      salary. Salaries in both the first job post-graduation and in the current job
      differed significantly by gender, with women earning less than men (p-values <
      .05). Moreover, these differences persisted after controlling for a set of human
      capital measures including pre-MPH work experience, age at graduation, years
      since graduation, area of specialization within the MPH degree, and type of work
      site (governmental or nonprofit versus for-profit). Unlike studies of MBA and MHA
      graduates, however, this study did not find evidence that the gender-related
      salary gap widened as the years since graduation increased, although the sample
      size did not allow comprehensive testing of this trend.

PMID- 11211354
TI  - Gender differences in the early careers of health care managers.
AB  - In health care, as in many other fields, women's occupational advancement appears
      to occur more slowly than men's. Two main theories purport to explain this
      phenomenon: 1) the "glass ceiling" perspective which focuses on structural
      arrangements and/or the attitudes of those who make promotion decisions, and 2)
      "supply side" approaches which argue that characteristics of women themselves
      explain their relative lack of progress. There is also another view that
      challenges the glass ceiling, suggesting that it affects predominantly older
      cohorts of women, and that younger entrants experience few advancement obstacles.
      This study examines these questions using a population of health administrators
      who graduated between May, 1984 and May, 1995. Gender comparisons reveal
      considerable similarity between men and women graduates on a variety of early
      career outcome variables, disputing supply side arguments and suggesting that
      barriers to women, if they exist, become important after the early career period.

PMID- 11211355
TI  - Interprofessional learning modules at Dalhousie University.
AB  - Interprofessional education has been advocated to improve teamwork in the health
      sector. This paper reports on the first two years of operational experience by a
      School of Health Services Administration (SHSA) with three-hour interprofessional
      learning modules (IPLMs). SHSA students participated along with students from
      nursing, medicine, social work, physiotherapy, occupational therapy, pharmacy,
      speech language pathology, audiology, dental hygiene, dentistry, leisure studies,
      health education and kinesiology. The five IPLMs required for SHSA students were:
      professional roles and values, integrity in scholarly activity, disability,
      interpersonal violence and HIV/AIDS. This article describes the development,
      delivery and evaluation of these modules from an SHSA perspective. The IPLMs'
      evaluation findings indicated that IPLMs are worthwhile, but have taken years and
      ongoing senior management support to operationalize; inclusion of health services
      administration is worthwhile but challenging; vigilance is needed to retain an IP
      rather than module content focus; and faculty and facilitator development, along
      with student preparation and debriefing, is required. Student feedback was
      favourable; faculty members have gained by their involvement; and field
      practitioner support has been sustained. Evaluation and reflection are critical
      to IPLM evolution. The norms, strengths and constraints of the university must be
      taken into account, and thus IPLMs must be adapted for each educational setting.
      Schools of health services administration must decide whether they wish to be
      involved in interprofessional learning.

PMID- 11211356
TI  - Teaching information management.
AB  - Managing in the present chaotic hospital financing environment requires
      integrated clinical/financial data systems and people who know how to use them.
      Health care management students of the present and future will need to understand
      how these information systems are structured and used. This article describes a
      graduate course in integrated clinical/financial information management as it has
      evolved at Yale University. The course provides students a vicarious experience
      in information management through class sessions and exercises using a database
      of real patient and cost center level information. Health care management of the
      future will depend on interdisciplinary collaboration and partnerships in
      education between provider organizations and academic programs. Both are modeled
      in the course.

PMID- 11211357
TI  - International health services management education: an overview of major efforts
      and lessons learned during the 1990s.
AB  - In this paper, the authors examine select major pedagogical and methodological
      issues concerning health care management executive training and academic program
      development in the former Soviet sphere of influence during the 1990s. Experience
      from programs offered during the 1990s has direct implications for the continued
      development of health care management programs and faculty in the United States.
      In essence, each of the nations that were involved represented an experimental
      setting for the introduction and improvement of management skills in the health
      care sector and the development of professional health care managers. Evaluative
      findings should help to inform future efforts to construct and deliver effective
      international and domestic management educational programs.

PMID- 11211358
TI  - Therapy for anorexia nervosa.

PMID- 11211359
TI  - More on the DICA-IV.

PMID- 11211360
TI  - Reactive attachment disorder.

PMID- 11211361
TI  - Olanzapine and hypertriglyceridemia.

PMID- 11211362
TI  - Introduction--ADHD comorbidity and treatment outcomes in the MTA.

PMID- 11211363
TI  - ADHD comorbidity findings from the MTA study: comparing comorbid subgroups.
AB  - OBJECTIVES: Previous research has been inconclusive whether attention
      deficit/hyperactivity disorder (ADHD), when comorbid with disruptive disorders
      (oppositional defiant disorder [ODD] or conduct disorder [CD]), with the
      internalizing disorders (anxiety and/or depression), or with both, should
      constitute separate clinical entities. Determination of the clinical significance
      of potential ADHD + internalizing disorder or ADHD + ODD/CD syndromes could yield
      better diagnostic decision-making, treatment planning, and treatment outcomes.
      METHOD: Drawing upon cross-sectional and longitudinal information from 579
      children (aged 7-9.9 years) with ADHD participating in the NIMH Collaborative
      Multisite Multimodal Treatment Study of Children With Attention
      Deficit/Hyperactivity Disorder (MTA), investigators applied validational criteria
      to compare ADHD subjects with and without comorbid internalizing disorders and
      ODD/CD. RESULTS: Substantial evidence of main effects of internalizing and
      externalizing comorbid disorders was found. Moderate evidence of interactions of
      parent-reported anxiety and ODD/CD status were noted on response to treatment,
      indicating that children with ADHD and anxiety disorders (but no ODD/CD) were
      likely to respond equally well to the MTA behavioral and medication treatments.
      Children with ADHD-only or ADHD with ODD/CD (but without anxiety disorders)
      responded best to MTA medication treatments (with or without behavioral
      treatments), while children with multiple comorbid disorders (anxiety and ODD/CD)
      responded optimally to combined (medication and behavioral) treatments.
      CONCLUSIONS: Findings indicate that three clinical profiles, ADHD co-occurring
      with internalizing disorders (principally parent-reported anxiety disorders)
      absent any concurrent disruptive disorder (ADHD + ANX), ADHD co-occurring with
      ODD/CD but no anxiety (ADHD + ODD/CD), and ADHD with both anxiety and ODD/CD
      (ADHD + ANX + ODD/CD) may be sufficiently distinct to warrant classification as
      ADHD subtypes different from "pure" ADHD with neither comorbidity. Future
      clinical, etiological, and genetics research should explore the merits of these
      three ADHD classification options.

PMID- 11211364
TI  - Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.
AB  - OBJECTIVE: To conduct a post hoc investigation of the utility of a single
      composite measure of treatment outcome for the NIMH Collaborative Multisite
      Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity
      Disorder (MTA) at 14 months postbaseline. BACKGROUND: Examination of multiple
      measures one at a time in the main MTA intent-to-treat outcome analyses failed to
      detect a statistically significant advantage of combined treatment (Comb) over
      medication management (MedMgt). A measure that increases power and precision
      using a single outcome score may be a useful alternative to multiple outcome
      measures. METHOD: Factor analysis of baseline scores yielded two "source factors"
      (parent and teacher) and one "instrument factor" (parent-child interactions). A
      composite score was created from the average of standardized parent and teacher
      measures. RESULTS: The composite was internally consistent (alpha = .83),
      reliable (test-retest over 3 months = 0.86), and correlated 0.61 with clinician
      global judgments. In an intent-to-treat analysis, Comb was statistically
      significantly better than all other treatments, with effect sizes ranging from
      small (0.28) versus MedMgt, to moderately large (0.70) versus a community
      comparison group. CONCLUSIONS: A composite of ADHD variables may be an important
      tool in future treatment trials with ADHD and may avoid some of the statistical
      limitations of multiple measures.

PMID- 11211365
TI  - Clinical relevance of the primary findings of the MTA: success rates based on
      severity of ADHD and ODD symptoms at the end of treatment.
AB  - OBJECTIVES: To develop a categorical outcome measure related to clinical
      decisions and to perform secondary analyses to supplement the primary analyses of
      the NIMH Collaborative Multisite Multimodal Treatment Study of Children With
      Attention-Deficit/Hyperactivity Disorder (MTA). METHOD: End-of-treatment status
      was summarized by averaging the parent and teacher ratings of attention
      deficit/hyperactivity disorder and oppositional defiant disorder symptoms on the
      Swanson, Nolan, and Pelham, version IV (SNAP-IV) scale, and low symptom-severity
      ("Just a Little") on this continuous measure was set as a clinical cutoff to form
      a categorical outcome measure reflecting successful treatment. Three orthogonal
      comparisons of the treatment groups (combined treatment [Comb], medication
      management [MedMgt], behavioral treatment [Beh], and community comparison [CC])
      evaluated hypotheses about the MTA medication algorithm ("Comb + MedMgt versus
      Beh + CC"), multimodality superiority ("Comb versus MedMgt"), and psychosocial
      substitution ("Beh versus CC"). RESULTS: The summary of SNAP-IV ratings across
      sources and domains increased the precision of measurement by 30%. The secondary
      analyses of group differences in success rates (Comb = 68%; MedMgt = 56%; Beh =
      34%; CC = 25%) confirmed the large effect of the MTA medication algorithm and a
      smaller effect of multimodality superiority, which was now statistically
      significant (p < .05). The psychosocial substitution effect remained negligible
      and nonsignificant. CONCLUSION: These secondary analyses confirm the primary
      findings and clarify clinical decisions about the choice between multimodal and
      unimodal treatment with medication.

PMID- 11211366
TI  - Impairment and deportment responses to different methylphenidate doses in
      children with ADHD: the MTA titration trial.
AB  - OBJECTIVE: Results of the NIMH Collaborative Multisite Multimodal Treatment Study
      of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were analyzed to
      determine whether a double-blind, placebo-controlled methylphenidate (MPH)
      titration trial identified the best MPH dose for each child with attention
      deficit/hyperactivity disorder (ADHD). METHOD: Children with ADHD assigned to MTA
      medication treatment groups (n = 289) underwent a controlled 28-day titration
      protocol that administered different MPH doses (placebo, low, middle, and high)
      on successive days. RESULTS: A repeated-measures analysis of variance revealed
      main effects for MPH dose with greater effects on teacher ratings of impairment
      and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on
      parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect
      sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid
      diagnosis, site, or treatment group. CONCLUSIONS: The MTA titration protocol
      validated the efficacy of weekend MPH dosing and established a total daily dose
      limit of 35 mg of MPH for children weighing less than 25 kg. It replicated
      previously reported MPH response rates (77%), distribution of best doses (10-50
      mg/day) across subjects, effect sizes on impairment and deportment, as well as
      dose-related adverse events.

PMID- 11211367
TI  - Methylphenidate dosage for children with ADHD over time under controlled
      conditions: lessons from the MTA.
AB  - OBJECTIVES: To examine the trajectory of methylphenidate (MPH) dosage over time,
      following a controlled titration, and to ascertain how accurately the titration
      was able to predict effective long-term treatment in children with attention
      deficit/hyperactivity disorder (ADHD). METHOD: Using the 14-month-treatment
      database of the NIMH Collaborative Multisite Multimodal Treatment Study of
      Children With Attention-Deficit/Hyperactivity Disorder (MTA), the outcome of the
      initial placebo-controlled, double-blind, randomized daily switch titration of
      MPH was compared with the subsequent maintenance pharmacotherapy. Children
      received monthly monitoring visits and, when needed, medication adjustments.
      RESULTS: Of the 198 children for whom MPH was the optimal treatment at titration
      (mean +/- SD dose: 30.5 +/- 14.2 mg/day), 88% were still taking MPH at the end of
      maintenance (mean dose 34.4 +/- 13.3 mg/day). Titration-determined dose and end
      of-maintenance dose were significantly correlated (r = 0.52-0.68). Children
      receiving combined pharmacotherapy and behavioral treatment ended maintenance on
      a lower dose (31.1 +/- 11.7 mg/day) than did children receiving pharmacotherapy
      only (38.1 +/- 14.2 mg/day). Of the 230 children for whom titration identified an
      optimal treatment, 17% continued both the assigned medication and dosage
      throughout maintenance. The mean number of pharmacological changes per child was
      2.8 +/- 1.8 (SD), and time to first change was 4.7 months +/- 0.3 (SE).
      CONCLUSIONS: For most children, initial titration found a dose of MPH in the
      general range of the effective maintenance dose, but did not prevent the need for
      subsequent maintenance adjustments. For optimal pharmacological treatment of
      ADHD, both careful initial titration and ongoing medication management are
      needed.

PMID- 11211368
TI  - School refusal in children and adolescents: a review of the past 10 years.
AB  - OBJECTIVE: To critically review the past 10 years of research on school refusal
      in children and adolescents. METHOD: Literature on school refusal published from
      1990 onward was reviewed following a systematic search of PsycINFO. The review
      focuses on definitional issues, epidemiology and school refusal identification,
      diagnostic considerations, family functioning, assessment, treatment, and follow
      up studies. RESULTS: While definitional and conceptual issues are still evident,
      promising developments have occurred in relation to assessment and treatment
      practices and understanding of the family context of school refusal. CONCLUSIONS:
      From a clinical viewpoint, school refusal cases require comprehensive assessment
      and treatment. Advances have been made in the treatment of school refusal.
      However, additional controlled studies evaluating interventions for school
      refusal are needed.

PMID- 11211369
TI  - Treatment of school refusal: one-year follow-up.
AB  - OBJECTIVE: To conduct a 1-year follow-up of anxious-depressed school-refusing
      adolescents who participated in an 8-week study of imipramine versus placebo,
      each in combination with cognitive-behavioral therapy. METHOD: Sixty-five percent
      (41 of 63) of the randomly assigned subjects returned for follow-up evaluation,
      which consisted of diagnostic interviews, clinician rating scales for anxiety and
      depression, family functioning measure, and a questionnaire regarding interim
      treatments and school programs. RESULTS: From the adolescent and/or parent
      perspective, 64.1% met criteria for an anxiety disorder and 33.3% met criteria
      for a depressive disorder. Remission rates and acquisition rates for specific
      anxiety and depressive disorders were determined. In the follow-up period, 67.5%
      received at least one psychotropic medication trial and 77.5% had outpatient
      therapy. Higher level of somatic complaints on the Anxiety Rating for Children
      Revised Physiological subscale at baseline predicted more severe depression on
      the Children's Depression Rating Scale-Revised at follow-up (p = .029).
      CONCLUSIONS: In this naturalistic follow-up study, there was high utilization of
      mental health interventions. In addition, a substantial number of subjects met
      criteria for anxiety and/or depressive disorders 1 year after treatment.
      Investigation of duration of acute treatments and evaluation of maintenance
      treatments for school refusal is needed.

PMID- 11211370
TI  - Evaluation of a preventive intervention for maltreated infants and toddlers in
      foster care.
AB  - OBJECTIVE: To determine the effectiveness of an intervention designed to improve
      outcomes for infants and toddlers in foster care. METHOD: Records were reviewed
      for all children who were adjudicated as in need of care in a specific parish in
      Louisiana between 1991 and 1998. This period included 4 years before and 4 years
      after a comprehensive intervention was implemented. Children adjudicated between
      1991 and 1994 were the comparison group, and those adjudicated between 1995 and
      1998 were the intervention group. RESULTS: After the intervention, more children
      were freed for adoption and fewer children were returned to their birth families
      than before the intervention. There was no difference in length of time in care
      before and after the intervention. With regard to the same child returning in a
      subsequent incident of maltreatment, relative risk reduction for the intervention
      group ranged from 53% to 68%. With regard to the same mother maltreating another
      child subsequently, relative risk reduction for the intervention group ranged
      from 63% to 75%. CONCLUSIONS: A comprehensive preventive intervention for
      maltreated infants and toddlers in foster care substantially reduced rates of
      recidivism but had no effect on length of time in care.

PMID- 11211371
TI  - Fluvoxamine for children and adolescents with obsessive-compulsive disorder: a
      randomized, controlled, multicenter trial.
AB  - OBJECTIVE: To determine the safety and efficacy of fluvoxamine for the treatment
      of children and adolescents with obsessive-compulsive disorder (OCD) with a
      double-blind, placebo-controlled, multicenter study. METHOD: Subjects, aged 8 to
      17 years, meeting DSM-III-R criteria for OCD were recruited from July 1991 to
      August 1994. After a 7- to 14-day single-blind, placebo washout/screening period,
      subjects were randomly assigned to fluvoxamine 50 to 200 mg/day or placebo for 10
      weeks. Subjects who had not responded after 6 weeks could discontinue the double
      blind phase of the study and enter a long-term, open-label trial of fluvoxamine.
      Analyses used an intent-to-treat sample with a last-observation-carried-forward
      method. RESULTS: Mean Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
      scores with fluvoxamine were significantly (p < .05) different from those with
      placebo at weeks 1, 2, 3, 4, 6, and 10. Significant (p < .05) differences between
      fluvoxamine and placebo were observed for all secondary outcome measures at all
      visits. Based on a 25% reduction of CY-BOCS scores, 42% of subjects taking
      fluvoxamine were responders compared with 26% taking placebo. Forty-six (19
      fluvoxamine, 27 placebo) of 120 randomized subjects discontinued early. Adverse
      events with a placebo-adjusted rate greater than 10% were insomnia and asthenia.
      CONCLUSIONS: Fluvoxamine has a rapid onset of action and is well tolerated and
      efficacious for the short-term treatment of pediatric OCD.

PMID- 11211372
TI  - Effects of modafinil in children with attention-deficit/hyperactivity disorder:
      an open-label study.
AB  - OBJECTIVE: To examine the effect of once-daily dosing of modafinil, a stimulant
      that has a long duration of action, on clinical features of attention
      deficit/hyperactivity disorder (ADHD) in children. METHOD: An open-label design
      was used to compare the Conners Parent and Teacher Rating Scale-Revised (L)
      (CPRS, CTRS), the ADHD Rating Scale-IV, and the Test of Variables of Attention
      (TOVA), without and with medication, in children with ADHD. Eleven children with
      ADHD, ranging in age from 5 to 15 years, took modafinil for an average of 4.6
      weeks. RESULTS: Average TOVA ADHD scores improved by 2.43 SD (p = .0009). CTRS
      and CPRS ADHD index T scores improved by an average of 14.1 (p = .0009) and 17.7
      points (p = .001), respectively. The mean ADHD Rating Scale-IV scores improved
      from the 88th percentile to the 75th percentile (p = .047). One subject withdrew
      from the study because of an adverse event that was resolved completely with
      medication withdrawal. Other side effects were mild and responded to dose
      adjustment. No subjects required more than one dose per day. CONCLUSIONS:
      Modafinil may be a useful once-daily treatment for children with ADHD. Further
      study using a double-blind, placebo-controlled design is needed.

PMID- 11211373
TI  - Open trial of interpersonal therapy in adolescents with moderate to severe major
      depression: effectiveness of novice IPT therapists.
AB  - OBJECTIVE: To evaluate the effectiveness of interpersonal therapy (IPT)
      implemented by well-supervised, novice IPT therapists in treating adolescents
      with moderate to severe mood disorders of lengthy duration. METHOD: Twenty-five
      adolescents with moderate to severe major depression, lasting an average of 8
      months, received 12 weeks of IPT. All participants were assessed with the
      Schedule for Affective Disorders and Schizophrenia for School-Age Children
      Present and Lifetime Version, the Beck Depression Inventory (BDI), the Hamilton
      Rating Scale for Depression (HRSD), and the Children's Global Assessment Scale (C
      GAS) at baseline and follow-up. RESULTS: The majority of participants improved
      substantially on the BDI, the HRSD, and the C-GAS; 84% met remission criteria on
      the HRSD (score < 7); and 80% met remission criteria on the BDI (score < 10).
      CONCLUSIONS: Results demonstrate that IPT is effective in treating moderately to
      severely depressed adolescents, that IPT is effective with depression lasting
      several months, and that IPT can be effectively implemented by well-supervised
      clinicians with no prior training in IPT.

PMID- 11211374
TI  - Teacher reports of DSM-IV ADHD, ODD, and CD symptoms in schoolchildren.
AB  - OBJECTIVE: To examine the prevalence of DSM-IV symptoms of attention
      deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct
      disorder and age, gender, and comorbidity differences between ADHD subtypes.
      METHOD: Teachers completed a DSM-IV-referenced symptom inventory for 3,006
      schoolchildren aged between 3 and 18 years. RESULTS: The screening prevalence
      rate of ADHD behaviors was 15.8%; rates for individual subtypes were 9.9% for
      inattentive, 2.4% for hyperactive-impulsive, and 3.6% for combined. The
      inattentive type was relatively uncommon in preschool children (3.9%), whereas
      the hyperactive-impulsive type was least common in teenagers (0.8%). Screening
      prevalence rates were higher for African-American (39.5%) than white (14.2%)
      students, but did not vary significantly (p < .05) as a function of geographic
      region or socioeconomic status. ADHD subtypes were rated as more impaired than
      the non-ADHD group on most measures and were easily differentiated on the basis
      of comorbid symptoms, social skills impairment, and special education services.
      CONCLUSIONS: The findings of this and similar studies show relatively high
      convergence for the prevalence of ADHD behaviors and differences between ADHD
      subtypes.

PMID- 11211375
TI  - Problems with null hypothesis significance testing.

PMID- 11211376
TI  - Genetics of childhood disorders: XXIII. ADHD, Part 7: The serotonin system.

PMID- 11211377
TI  - Writing an op-ed commentary on nursing.

PMID- 11211378
TI  - Nurses' use of palliative care practices in the acute care setting.
AB  - This study examines the reported use of palliative care practices by nurses
      caring for terminally ill patients in the acute care setting. Randomly selected
      nurses (n = 180) from six randomly selected hospitals in Connecticut completed a
      self-administered questionnaire. Factors associated with use of palliative care
      practices were examined by using bivariate and multivariate analyses. Most nurses
      surveyed (88.5%) reported using palliative care practices when caring for their
      terminally ill patients. Factors associated with greater use included greater
      knowledge about hospice, having practiced nursing for less than 10 years, and
      having had hospice training in the past 5 years. A substantial proportion of
      nurses reported that they never discuss hospice (51.7 per cent of nurses) and
      prognosis (26.6 per cent of nurses) with their terminally ill patients.
      Educational preparation (bachelor's degree versus less education) was not
      associated with greater use of palliative care practices. Palliative care
      practices are commonly used by nurses in the acute care setting. However, many
      report having limited training and substantial gaps in knowledge about hospice
      among this group of nurses, suggesting greater attention to palliative care and
      hospice may be warranted in nursing educational programs.

PMID- 11211379
TI  - Developing BSN leaders for the future: the Fuld Leadership Initiative for Nursing
      Education (LINE).
AB  - The Helene Fuld Leadership Initiative in Nursing Education (LINE) program was
      designed to enhance beginning leadership competencies of baccalaureate nursing
      students. Given the increasing need for strong and effective leadership
      throughout the health care system, and the demands new graduates encounter as
      they move into practice, the LINE program is built on the premise that leadership
      skills must be instilled at the undergraduate level. The program achieves its
      goal through an intensive 5-day institute focused on assessing and developing the
      leadership competencies of nurse educators and their clinical partners to enable
      them to be effective agents of curriculum change in their home institutions. The
      institute also assists participants to redesign their baccalaureate nursing (BSN)
      curricula to ensure that students learn to: (1) work effectively within and
      across complex, integrated organizational and institutional boundaries; (2) think
      and act from the perspective of a system; and (3) communicate, negotiate, lead,
      and facilitate change within health care organizations. D. Goleman's (1998)
      framework of emotional intelligence, which addresses both personal competence
      (managing oneself) and social competence (handling one's relationships with
      others) provides the framework for operationalizing leadership in the BSN
      curriculum. To date, 26 BSN programs and their clinical partners have
      participated in the LINE program, which has the potential to influence the
      beginning leadership development of more than 2,400 BSN students. Program
      outcomes reveal that education-practice collaboration, professional networking,
      individual leadership development of nurse educators and their clinical partners
      as change agents, and the integration of leadership experiences at all levels of
      the BSN curriculum are important in developing beginning leadership competencies
      in BSN students.

PMID- 11211380
TI  - Insights and inquiry.

PMID- 11211381
TI  - An application of an effective interdisciplinary health-focused cross-cultural
      collaboration.
AB  - The phenomenon of cross-cultural collaboration is not new. What is lacking in the
      literature, however, is a discussion of how health professionals from various
      cultures, collaborating together, have addressed their patients' health care
      needs to improve their quality of life. Because of increased interest in global
      health issues, it seems logical that health professionals from various countries
      form collaborative partnerships to investigate and address these health issues.
      Although treatments to health problems are offered, it is not generally
      communicated in the literature how cross-cultural collaboration played a role in
      managing the process to solve the problem. By applying the concepts for global
      managers outlined by P. R. Harris and R. T. Moran (1996), this article describes
      how the investigators established a successful cross-cultural collaboration for
      conducting health research between teams in the United States and Russia.

PMID- 11211382
TI  - Cultural diversity: getting to a viewing point.

PMID- 11211383
TI  - An external mentor program: stimulus for faculty research development.
AB  - This article describes a faculty development model to stimulate rapid growth in
      research and scholarship in a school of nursing during an institution-wide
      initiative to strengthen the research stature of the university. The program was
      designed to establish targeted mentoring relationships with productive
      researchers from institutions outside the home institution to assist faculty with
      research program development. The external mentor program is described along with
      the methods of implementation and outcomes after 2.5 years. The success of this
      program has led to adoption of the model by other schools in the university.

PMID- 11211384
TI  - Scholarship of practice for a practice profession.
AB  - At a time of shrinking resources, rapidly changing health care environments, and
      increased demands for solutions to pressing health issues, concerns regarding the
      relevance of nursing research for practice are again being raised. After the
      national debate surrounding definitions of scholarship across disciplines and
      having established respectability for past and current contributions to knowledge
      development, nursing may now begin to reconceptualize what constitutes
      scholarship in a practice profession. This article addresses two central
      questions related to the scholarship of nursing practice: (1) How is scholarship
      of practice in a practice of profession defined? and (2) What characteristics
      differentiate the new conceptualizations of scholarship of practice from
      traditional research models? The results include a delineation of scholarship of
      practice and a differentiation of characteristics between scholarship of practice
      and traditional research approaches. Implications for nursing education are also
      addressed.

PMID- 11211385
TI  - Ethics instruction in nursing education.

PMID- 11211386
TI  - Describing the RN-BSN learner perspective: concerns, priorities, and practice
      influences.
AB  - This focus group study describes the concerns and priorities of women who are
      Registered Nurse Students (RNs) students (N = 35) enrolled in RN-Bachelor of
      Science in Nursing (BSN) programs located within a large metropolitan region. The
      study also explores the influences of BSN education on the nursing practice
      patterns of the RN students from the participants' viewpoints. Five focus groups
      were conducted. Findings revealed that accurate academic advisement, curriculum
      flexibility, and computer technology are important to RN-BSN students. RNs were
      concerned about the demands of the changing health care environment, meeting
      multiple and competing role demands, and meeting the financial demands of school.
      Although the participants did not believe that BSN education had affected their
      direct care of patients, they identified changes in indirect care practices. This
      study suggests that nursing school deans, administrators, and faculties should
      offer opportunities for RNs to develop skills in assertiveness, problem solving,
      and communication. Additionally, study findings suggest that RNs need the
      opportunity to reflect on various strategies for incorporating their new
      knowledge into their established practice.

PMID- 11211387
TI  - Education. Blueprints for the future.

PMID- 11211389
TI  - Self-insurance with assurance.

PMID- 11211388
TI  - Survey of distance technology use in AACN member schools.
AB  - The American Association of Colleges of Nursing surveyed its members by using a
      104-item instrument to determine the state of the art in distance technology use.
      Survey results indicated a recent acceleration of course offerings through
      distance technology at all levels of nursing education. The most cited reason for
      this was to improve access to nursing education. Resources for distance
      technology tended to reside in public, rather than private, institutions. Trends
      were for greater use of video and computer-based technologies. Although
      technology use is increasing, computers and other technologies are not used in
      the didactic or clinical educational experience in many schools. Areas for
      further evaluation are identified.

PMID- 11211390
TI  - First annual hospital OPPS update published.

PMID- 11211391
TI  - The next challenge: employee training on privacy, security. American Health
      Information Management Association.

PMID- 11211392
TI  - Using OIG guidances for long-term success.

PMID- 11211393
TI  - Is wireless technology at hand for healthcare?

PMID- 11211394
TI  - Understanding HIPAA transactions and code sets.
AB  - The recently published final regulations for transactions and code sets under
      HIPAA are the light at the end of the tunnel in the quest for uniform healthcare
      standards--and the first step on a long road to HIPAA implementation. What are
      the standard transactions and code sets? This article takes an in-depth look.

PMID- 11211395
TI  - A quick take on clearinghouses.

PMID- 11211396
TI  - When health information and fiscal management meet.
AB  - HIM professionals have skills that can allow them to contribute to the bottom
      line in many ways. The author describes areas where HIM expertise can make a
      difference in evaluating an organization's fiscal performance through analysis of
      services driven by health information.

PMID- 11211397
TI  - Ten steps to successful chargemaster reviews.
AB  - Is your chargemaster current, compliant, and comprehensive? In the age of APCs,
      healthcare facilities would do well to answer these questions regularly. Here's
      how an HIM professional can help.

PMID- 11211399
TI  - Long-term care cost accounting: simple is often better.

PMID- 11211398
TI  - A new approach to chargemaster management.
AB  - After examining their charge description master management processes, HIM
      professionals, in conjunction with clinical and support departments, redesigned
      and automated several practice aspects. Turnaround times were reduced and end
      users are happier. Here's how they did it.

PMID- 11211400
TI  - Want to know more? Looking for more information about billing and reimbursement
      issues? Save this handy resource list.

PMID- 11211401
TI  - Creating a diverse HIM work force.

PMID- 11211402
TI  - Information security: it takes a community.

PMID- 11211403
TI  - Practice brief. Health informatics standards and information transfer: exploring
      the HIM role. American Health Information Management Association.

PMID- 11211404
TI  - Knowledge management: another avenue for HIM professionals.

PMID- 11211405
TI  - CPT changes for 2001.

PMID- 11211406
TI  - Lead your own image marketing campaign.

PMID- 11211407
TI  - Sorting out the inpatient rehabilitation PPS.

PMID- 11211408
TI  - Developing cost-effective, productive physician relations.

PMID- 11211409
TI  - AMCs need to develop capacity for innovation, Commonwealth Fund report says.

PMID- 11211410
TI  - Health care leaders no longer can afford to wing it when it comes to finance.

PMID- 11211411
TI  - After trend of IDS integration, some organizations have chosen to disintegrate.

PMID- 11211412
TI  - Marketing vs. the 800-pound gorilla.

PMID- 11211413
TI  - Hospitals can reduce costs, improve quality by adopting proven risk management
      guides.

PMID- 11211414
TI  - Bush, Congress offer opportunities, risks.

PMID- 11211415
TI  - Nematodes: worms of the world.
AB  - Intestinal nematodes remain a world health issue. Their ubiquitous nature makes
      them difficult to control, and treatment is ineffective when the source of the
      infection can not be eradicated. International travel and immigration from
      developing countries have effectively increased the numbers of people infected in
      the US, especially in the northeast and southern coastal areas. It is important
      to provide sensitive and accurate methods to diagnose these parasites.
      Additionally, the WHO and other agencies must remain vigilant and continue their
      efforts to improve the health of vulnerable populations throughout the world.

PMID- 11211416
TI  - Process redesign in the clinical laboratory: a success story.

PMID- 11211417
TI  - Sifting through the data to find the best LIS.

PMID- 11211418
TI  - Reviewing admission necessity.

PMID- 11211419
TI  - Weight gain and longterm complications with atypical antipsychotics.

PMID- 11211420
TI  - State of South Dakota's child: 2000.
AB  - For the second consecutive year, 1999 brought an increase in the total number of
      births in South Dakota. Low birth weight newborns also increased during this year
      to 5.9%, representing the highest rate observed since 1974. Although the total
      percent of low birth weight increased, the percent of very low birth weight
      slightly decreased. Also observed is an increase in the use of prenatal care in
      the first trimester of pregnancy. The infant mortality rate for the state
      decreased slightly but remains higher than what is noted nationally. The rate of
      neonatal mortality is also slightly higher than the national rate. South Dakota's
      rate of post neonatal mortality remains considerably higher than the national
      rate but did decrease in 1999. The special topic of this year's report is brain
      development and the role of early experience. The state's new Bright Start
      program for pregnant women and their infants is described.

PMID- 11211421
TI  - Peyote use during pregnancy.
AB  - Peyote is a substance with varied potential. Used properly it may be a spiritual
      aid but used in excess, it can be a hallucinogenic agent with teratogenic
      potential. There is a growing community of devout people who use it as part of
      their religious observance. The active ingredient, mescaline, has been linked to
      a specific group of fetal abnormalities when the substance is used
      inappropriately.

PMID- 11211422
TI  - Immunohistochemistry in surgical pathology is here to stay.

PMID- 11211423
TI  - Heads above the crowd.

PMID- 11211424
TI  - Hack attack.

PMID- 11211425
TI  - Expert for hire.

PMID- 11211426
TI  - End of the paper chase.

PMID- 11211427
TI  - It's all about people. For many healthcare CIOs, fulfillment requires more than
      money.

PMID- 11211428
TI  - Track training electronically. Using technology to avoid the bottlenecks that
      human foibles can create.

PMID- 11211429
TI  - Extensive monitoring during auditory brainstem implant surgery.
AB  - In patients with reduced auditory nerve function, for example due to tumour
      removal or an accident, hearing rehabilitation can be elicited by an auditory
      brainstem implant (ABI). The electrode array of the ABI manufactured by Cochlear
      Ltd., Sydney, consists of 21 circled contacts in a silicon carrier. This is
      inserted in the lateral recess of the fourth ventricle. Since 1996, in Hannover
      eight patients have been implanted with a cochlear ABI Nucleus 21 + 1. All of
      them were profoundly deaf on both sides due to neurofibromatosis type 2 (NF2). To
      find the optimal electrode position during surgery, a multimodal monitoring by
      auditory evoked potentials (AEP), electromyography (EMG) and somatosensory evoked
      potentials (SEP) was performed. When monitoring AEPs, the function of the implant
      can be checked first by the stimulus artefact. By analysing the AEPs in more
      detail, the optimal positioning of the electrode on the cochlear nucleus can be
      found. If systems other than the auditory system are stimulated this will be
      revealed in one or more of the AEP, EMG and SEP recordings. According to the
      literature, AEPs stimulated by an ABI consist of three vertex positive peaks with
      latencies shorter than 4 ms. Typical AEPs are correlated with good post-operative
      hearing sensation. Comparing these AEPs with AEPs stimulated acoustically or
      electrically at different sites of the auditory system, it can be assumed that
      the first peak corresponds to J3, the second to J4 and the last to J5. From this
      comparison it can also be concluded that no potentials should occur later than 5
      ms. This corresponds to our findings. Post-operatively, side-effects occurred
      when areas of the electrode array were stimulated that showed potentials with
      latencies longer than 5 ms intra-operatively. Our results indicate that
      monitoring is an essential aid for the surgeon in finding the optimal electrode
      position. Positioning solely with reference to anatomical landmarks may not be
      enough to find the optimal functional position.

PMID- 11211430
TI  - Auditory brainstem implant in auditory rehabilitation of patients with
      neurofibromatosis type 2: Hannover programme.
AB  - An auditory brainstem implant (ABI) is indicated for patients suffering from
      bilateral neural deafness. The most affected patients are those with
      neurofibromatosis type 2 (NF2). An implantation is possible either at the same
      time as, or after, surgical removal of an acoustic neuroma. This paper
      demonstrates the results of eight out of 11 patients with NF2, seven of whom
      received an ABI after tumour removal. Pre-operatively, all of them were deaf.
      Post-operatively, the first fitting served to determine the individual
      stimulation parameters for each electrode. The stimulation-dependent side-effects
      were eliminated by reducing the stimulus intensity without causing negative
      effects on the hearing with the ABI. Only in one case was an open set
      understanding achieved within the first year. However, all patients had a better
      speech understanding when they combined their hearing with the ABI and their lip
      reading abilities. There is no correlation between the performance with ABI and
      the tumour size or the duration of deafness.

PMID- 11211431
TI  - Auditory brainstem implantation in primates: lessons for human surgery and
      application.
AB  - We report on the surgical technique for surface electro-auditory prosthesis (EAP)
      implantation, pathological changes occurring at the cochlear nucleus complex
      (CNC), and its relation with electrical stimulation. Fourteen Macaca fascicularis
      were operated upon for a translabyrinthine bilateral auditory neurectomy, and
      simultaneous unilateral EAP implantation. Six animals were not stimulated, and
      the remaining eight were connected to an external active device. Stimulation was
      planned for 1000 hours. Biotolerance to the materials was adequate without
      significant reactions in the CNC surface, but an ependymal reaction. Lesions
      attributed to surgical trauma were also found. Two animals being stimulated could
      not complete the planned course due to cable break or EAP extrusion. One
      stimulated animal developed an asymptomatic brainstem abscess. A good knowledge
      of CNC topography is required to avoid surgical trauma. Externally connected
      devices may facilitate extrusion of the EAP or ascending infections.

PMID- 11211432
TI  - Surgical experiences in 58 cases using the Nucleus 22 multichannel auditory
      brainstem implant.
AB  - Patients with bilateral total deafness due to lesions of the vestibulocochlear
      nerve can be treated by electrical stimulation of the second auditory neuron. A
      22-channel multi-electrode implant with transcutaneous transmission was developed
      that allows the selection of the most useful electrodes. Acoustic neuromas were
      removed from 49 out of 58 patients by ENT surgeons and neurosurgeons working in
      collaboration and using either a translabyrinthine or suboccipital approach. The
      central electroauditory prosthesis was implanted in the same procedure. Six
      patients were deaf after previous acoustic neuroma surgery without recurrence,
      three had diagnoses other than neurofibromatosis type 2 (NF2). There were no
      complications due to the implantation procedure. Side effects could be excluded
      by stimulation of the auditory electrodes alone. Most of the patients used their
      ABI daily. They reported perception of different sounds and frequencies,
      enhancement of lip-reading ability, and three of the patients were able to use
      the telephone.

PMID- 11211433
TI  - Stimulation of the cochlear nucleus with multichannel auditory brainstem implants
      and long-term results: Freiburg patients.
AB  - Since 1992 18 patients with bilateral retrocochlear deafness have been provided
      with a multichannel auditory brainstem implant (ABI). The surgical procedure
      implies tumour removal and ABI implantation in one stage. Most implantations were
      via the translabyrinthine approach. The long-term follow-up varied between nine
      and 80 months. In one case auditory perception could not be achieved and in a
      second case post-operative stimulation was not possible as the subject died due
      to lung emboli. In all the other cases auditory perception was achieved and only
      two subjects became non-users during the follow-up period. The presented long
      term results suggest that deaf neurofibromatosis type 2 patients regain acoustic
      contact with the environment, enlarge their communication skills and improve
      their quality of life by using a multichannel auditory brainstem prosthesis.

PMID- 11211434
TI  - Topodiagnosis of deafness: strategy for treatment of neurofibromatosis type 2.
AB  - Neurofibromatosis type 2 (NF2) causes bilateral hearing loss due to tumour growth
      in the cerebellopontine angle. We report the results of promontory testing and
      transtympanic electrocochleography on subjects with deafness due to NF2 referred
      for an auditory brainstem implant. All 19 ears tested revealed loss of cochlear
      microphonics. Nine ears (mainly without previous treatment) revealed auditory
      perception during promontory stimulation, indicating cochlear deafness. One of
      these subjects has been successfully provided with a cochlear implant. The other
      10 ears (mainly after previous surgery) revealed negative promontory stimulation,
      indicating additional retrocochlear deafness. These findings indicate that
      neurofibromas initially cause a cochlear deafness, so that a cochlear implant can
      be used if the auditory nerve can be preserved. This option has to be considered
      in rehabilitating patients with bilateral tumours due to NF2.

PMID- 11211435
TI  - Auditory brainstem implants: current neurosurgical experiences and perspective.
AB  - The objective of this study was to present aspects of the current treatment
      protocol, such as patient evaluation and selection for therapy, multimodality
      monitoring for optimal auditory brainstem implant (ABI) positioning and
      radiological evaluation, that might have an impact on the functional results of
      ABI. Out of a series of 145 patients with bilateral vestibular schwannomas 10
      patients received an ABI, eight of which are reported here. Patient selection was
      based on disease course, clinical and radiological criteria (according to the
      Hannover evaluation and prognosis scaling of neurofibromatosis type 2 (NF2)),
      extensive otological test battery and psycho-social factors. ABI placement was
      controlled by multimodality electrophysiological monitoring in order to activate
      the auditory pathway and to prevent false stimulation of the cranial nerve nuclei
      or long sensory or motor tracts. Results of hearing function were correlated with
      patients' ages, duration of deafness, tumour extension, tumour-induced
      compression or deformation of the brainstem, and numbers of activated electrodes
      without any side-effects. Out of 59 patients with pre-operative deafness eight
      patients received an ABI of the Nucleus 22 type. All these patients became
      continuous users without any side effects and experienced improved quality of
      life. Speech reception in combination with lip-reading was markedly improved,
      with further improvement over a long period. A short duration of deafness may be
      favourable for achieving good results, while age was not a relevant factor.
      Lateral recess obstruction may necessitate a more meticulous dissection, but did
      not prevent good placement of the ABI in the lateral recess. Pre-existing
      brainstem compression did not prevent good results, but brainstem deformation and
      ipsi- and contralateral distortion were followed by a less favourable outcome.
      Among the factors that can be influenced by the therapy management are the
      selection of patients with a slow progressing NF2 disease, a short duration of
      deafness, a careful analysis of brainstem deformation and consideration of either
      side for implantation. Long-standing brainstem deformation might not lead to
      recovery, but instead lead to a low number of active electrodes and possibly only
      moderate results. ABI treatment is a safe procedure that can increase a patient's
      quality of life considerably. ABI placement along with neurophysiological control
      helps to prevent side effects and to improve acoustic activation. Further studies
      on structural and functional changes of the brainstem after previous tumour
      compression and distortion should increase our understanding and facilitate a
      decision on the best side for ABI implantation.

PMID- 11211436
TI  - Retrosigmoid approach for auditory brainstem implant.
AB  - The present paper reports our experience with the surgical retrosigmoid
      transmastoid (RS-TM) technique for implanting auditory brainstem implants (ABIs).
      From April 1997 to August 1998, four patients with neurofibromatosis type 2 (NF2)
      were operated on for vestibular schwannoma removal with ABI implantation. The
      subjects (three men and one women) ranged in age from 22 to 31 years. Tumour size
      ranged from 12 to 30 mm. A classical RS-TM approach was performed. After tumour
      excision, identification of landmarks (VIIth, VIIIth and IXth cranial nerves,
      choroid plexus) to the foramen of Luschka was carefully carried out. The choroid
      plexus was partially removed and the tela choroidea divided and deflected. The
      floor of the lateral recess of the fourth ventricle and the convolution of the
      dorsal cochlear nucleus became visible. The electrode array was then inserted
      into the lateral recess and placed in the correct position with the help of
      electrically-evoked auditory brain stem responses. Auditory sensations were
      induced in all patients with various numbers of electrodes. Different pitch
      sensations could be identified with different electrode stimulation. Details of
      the results are presented. In our series, the RS-TM approach represents the
      elective route for ABI insertion.

PMID- 11211437
TI  - First Croatian auditory brainstem implantation.
AB  - A deaf female patient was diagnosed with bilateral acoustic neurinomas. Diagnosis
      incorporated the standard audiological battery for sensorineural hearing loss,
      computed tomography and magnetic resonance imaging. The left side had been
      operated on four years previously in another clinic using the suboccipital
      approach. The auditory brainstem implant surgery was performed on the 'second
      side' using the same approach. It was an uneventful operation with good anatomy
      and no serious post-operative complications. Post-operatively, the patient
      performed exceptionally well, with up to 50 per cent of words recognized in the
      opened set and 85 per cent in the closed set, both without lip-reading.

PMID- 11211438
TI  - First auditory brainstem implantation in Poland: auditory perception results over
      12 months.
AB  - Auditory brainstem implants (ABIs) are a modern method of treatment of total
      bilateral deafness in cases of extracochlear origin. In most cases therapy is
      applied in patients with neurofibromatosis type 2 (NF2). This paper presents the
      results of surgical treatment and rehabilitation in a 28-year-old woman with
      bilateral, multiple tumours of the central nervous system causing total deafness.
      Simultaneous removal of the tumours and implantation of ABI allowed treatment of
      the potentially lethal pathology and hearing restoration. Improving auditory
      skills and excellent tests results were noted in the year following implantation.

PMID- 11211439
TI  - Multichannel auditory brainstem implantation: the Australian experience.
AB  - The multichannel auditory brainstem implant (ABI) provides the potential for
      hearing restoration in patients with neurofibromatosis type 2 (NF2). Programmes
      for auditory brainstem implantation have been established in two Australian
      centres. Eight patients have been implanted under the protocol of an
      international multi-centre clinical trial. Three patients had ABI insertion at
      the time of first side tumour removal, four at second side tumour removal and one
      after previous bilateral surgery where there was some residual tumour. The
      translabyrinthine approach was used in all cases. Successful positioning of the
      electrode array was achieved in seven of eight patients, all of whom achieved
      auditory perception with electrical stimulation. Intra-operative electrically
      evoked auditory brainstem response testing was successful in four patients and
      was useful in confirming correct electrode position. In six cases post-operative
      psychophysical and auditory perception testing demonstrated that useful auditory
      sensations were achieved. Five of these patients regularly used the implant. In
      one patient electrode placement was unsuccessful and only non-auditory sensations
      occurred on stimulation. In the remaining patients non-auditory sensations were
      minimal and avoidable by selective electrode programming. Auditory brainstem
      implantation should be considered in patients with NF2. The greatest benefit is
      seen in patients without debilitating disease who have non-aidable hearing in the
      contralateral ear.

PMID- 11211440
TI  - Multichannel auditory brainstem implant: US clinical trial results.
AB  - Since 1994, a US Food and Drug Administration clinical trial evaluated the
      multichannel auditory brainstem implant (ABI) on 92 subjects with
      neurofibromatosis type 2 (NF2). The trial has shown that 85 per cent of patients
      receive auditory sensations. A small number of patients demonstrate a clinically
      significant degree of open-set sentence recognition in the sound-alone condition;
      however, when the ABI is combined with lip-reading cues, 93 per cent of patients
      demonstrate improved sentence understanding at three to six months. In addition,
      the majority of recipients report daily use of their devices, and satisfaction
      with the decision to receive the ABI.

PMID- 11211441
TI  - First auditory brainstem implant in the Czech Republic.
AB  - In the Czech Republic, the first implantation of a stimulation electrode into the
      brainstem was performed on 11 January 1999 in the Department of ORL, Head and
      Neck Surgery, The First Medical Faculty, Charles University in Prague, University
      Hospital Motol. The selected patient was a 40-year-old woman with
      neurofibromatosis type 2 (NF2) who had previously undergone bilateral vestibular
      schwannoma surgery. Both tumours had been radically removed, the left-sided
      tumour in 1987, the right-sided one in 1988. She had been completely deaf since
      the last operation, i.e., for 11 years. The surgery was realized by the
      international cooperation of three teams. Placement of the electrode pad of the
      Nucleus CI21 + 1M system on the ventral and dorsal cochlear nuclei was performed.
      Electrically evoked auditory brainstem responses (EABRs) proved the correct
      position of the electrode array. The post-operative course was uneventful. Six
      weeks after the surgery the patient received her speech processor. Since that
      time, the patient already absolved several sessions of a speech processor tune
      up. She uses the device as an aid in lip-reading. No adverse or pathological side
      effects have been observed. The patient was the 45th person in Europe to receive
      an ABI and the first in the Czech Republic.

PMID- 11211442
TI  - Anatomical variations of landmarks for implantation at the cochlear nucleus.
AB  - A knowledge of the microanatomy of the cochlear nucleus complex and its
      variations is essential for successful implantation and for the design of
      stimulation devices. One hundred cerebellopontine angle specimens were dissected
      under surgical conditions using the Zeiss NC31 surgical microscope. The
      topographical anatomy of the exit of the vestibulocochlear nerve, the cochlear
      nucleus and the surface of the medulla and their relation to the surrounding
      structures was recorded and measured. The mean distances between the exits of the
      VIIth and VIIIth cranial nerves were 4.7 +/- 0.9 mm, between the VIIth and IXth
      6.3 +/- 1.2 mm and between the VIIIth and IXth 5.5 +/- 1.0 mm. The visible area
      of the cochlear nucleus covered a square of 10.0 +/- 2.9 by 3.3 +/- 1.0 mm. A
      major AICA-loop had to be re-routed in 17 per cent of specimens. The taenia of
      the choroid plexus was present in 92 per cent and had to be cut in 51 per cent in
      order to enter the foramen of Luschka, that had a mean size of 3.5 by 2.0 mm. It
      was wide open in 24 per cent, open only after incision of the arachnoid in 53 per
      cent, functionally closed but opened by extensive dissection in 18 per cent and
      anatomically occluded in five per cent of the specimens. The typical straight
      vein at the cochlear nucleus leading to the entrance of the foramen of Luschka
      was found in 76 per cent of specimens. Constant anatomical landmarks are very
      helpful for finding the cochlear nucleus, but variations may endanger dissection
      and implantation in a remarkable number of cases.

PMID- 11211443
TI  - [Anomalties of the interatrial septum and latent atrial vulnerability in
      unexplained ischemic stroke in young adults].
AB  - Seventy-four consecutive patients (18 to 55 years) underwent programmed atrial
      stimulation in the investigation of unexplained ischaemic stroke after a full
      work-up including transoesophageal echocardiography to exclude abnormalities of
      the interatrial septum (patent foramen ovale and/or atrial septal aneurysm). The
      parameters recorded during atrial electrophysiological investigation were: the
      effective atrial refractory period, loco-regional intra-atrial conduction, the
      index of latent atrial vulnerability and the inducibility by the extrastimulus
      technique. Seventy five per cent of patients with a patent foramen ovale and/or
      an atrial septal aneurysm were inducible compared with only 38% of patients with
      normal interatrial septa on transoesophageal echocardiography (p = 0.001). Fifty
      two per cent of patients with an anomaly of the atrial septum had latent atrial
      vulnerability compared with 26% of those with normal transoesophageal
      echocardiography (p = 0.02). These results confirm the relationship between
      atrial septal anomalies and latent atrial vulnerability in unexplained ischaemic
      stroke of young adults.

PMID- 11211444
TI  - [Heart surgery under cardiopulmonary bypass during the neonatal period remains a
      high-risk procedure].
AB  - Congenital Heart disease with a poor prognosis has to be operated early but with
      an acceptable surgical risk and a good chance of survival. The aim of this study
      was to analyse the indications, the operative mortality and medium-term survival
      of neonates undergoing cardiac surgery under cardiopulmonary bypass from 1991 to
      1998. Three hundred and twenty nine operations were programmed in 326 neonates,
      18% (329/1805) of all open heart surgical procedures. Anatomical detransposition
      of the great arteries was the commonest operation (N = 226). Correction was
      complete (biventricular) in 97% of cases (317/326). Twenty-eight neonates died.
      The operative mortality was 8.5%, much higher than that of children of 3 months
      or over (1.5%; p < 0.0001). There were 8 late deaths, all in the first
      postoperative year. The overall medium-term survival rate was 88.9 +/- 1.7%. It
      was 100% after correction of truncus arteriosus without interruption of the
      aortic arch; 94.2 +/- 1.5% after anatomical detransposition; 85.7 +/- 9.4% after
      commissurotomy of aortic stenosis; 79.2 +/- 8.3% for all the complex forms of
      interruption of the aortic arch; 75 +/- 9.7% for total anomalous pulmonary venous
      drainage and 42.9 +/- 18.7% after the Norwood palliative procedure of hypoplastic
      left heart syndrome. The authors conclude that early cardiac surgery saves the
      large majority of neonates suffering from complex congenital cardiac disease with
      poor prognosis. Survival stabilises one year after the operation. Other
      techniques or treatments are necessary to lower present surgical risk (8.5%) to
      that of surgery under cardiopulmonary bypass of children over 3 months of age
      (1.5%).

PMID- 11211445
TI  - [Efficacy of colchicine in recurrent acute idiopathic pericarditis].
AB  - Acute idiopathic pericarditis is complicated by recurrence in 15 to 30% of cases.
      The preventive treatment of recurrences is not well codified. Aspirin, non
      steroidal anti-inflammatory drugs and corticoids are the commonest prescribed
      treatments. The objective of this study was to assess the value of colchicine in
      the prevention of recurrences of acute idiopathic pericarditis. Twenty-eight
      cases of recurrent acute pericarditis (2 episodes, 1 month between each episode)
      admitted to a department of internal medicine between 1989 and 1999 were
      reviewed. Analysis was concentrated on the 13 idiopathic forms. The subjects were
      7 women and 6 men with an average age of 41 years (10-62) at the time of the
      first episode of acute pericarditis. These 13 patients were treated with
      colchicine (1 to 2 mg/day) after failure of conventional treatment (aspirin
      13/13, NSAID 13/13, steroids 9/13 and pericardiocentesis 3/13). Ten patients were
      followed up regularly (6 months after starting colchicine) and were improved with
      respect to number, duration and intensity of their recurrences. The average
      duration of colchicine therapy was 17 +/- 14 months (6-48). Progressive
      withdrawal of NSAID and steroids was obtained in 8/10 cases. The authors conclude
      that colchicine is useful in the prevention of recurrence of acute pericarditis.
      It may be proposed as treatment of choice, especially in the idiopathic forms.

PMID- 11211446
TI  - [Normal coronary angiography. Survival and functional status at 6 years].
AB  - Despite the development of non-invasive diagnostic techniques, the absence of
      significant coronary stenosis is observed in 10 to 30% of coronary angiographic
      studies. The authors report the survival and functional status at 6 years of 172
      consecutive patients with symptoms of angina without significant angiographic
      coronary stenosis. The average age was 60.8 years with a sex ratio of 1.1 and
      chest pain as the indication for coronary angiography in over 90% of cases. The
      global mortality after an average of 75.6 months follow-up was 11%, lower in
      women (8.5%) than in men (13.3%) with an annual mortality of 16.3 per thousand.
      Sudden death was observed in 4 patients and a third of deaths was of cardiac
      origin. The persistence of symptoms was reported by 58% of patients, mainly
      atypical chest pain. Despite the result of coronary angiography, nearly half of
      the patients were followed up annually by a cardiologist, two thirds remained on
      anti-anginal therapy, 20% were treated by psychotropic agents and hospital
      admission to the cardiology department was required in 22% of cases during follow
      up. None of the patients had myocardial infarction. Survival and myocardial
      function after normal coronary angiography therefore appear to be good in
      contrast with the functional status of these patients.

PMID- 11211447
TI  - [Does patient age influence the indications for investigating asympatomatic Wolff
      Parkinson-White syndrome?].
AB  - Sudden death may be the presenting symptom of a Wolff-Parkinson-White syndrome.
      Electrophysiological investigation is the best method of identifying high risk
      cases. The aim of this study was to determine whether this investigation should
      be proposed to all patients, irrespective of age. Transoesophageal stimulation
      was performed in 85 asymptomatic patients with the Wolff-Parkinson-White
      syndrome. Of the 85 subjects, 13 were under 20 years of age, 30 under 30 years,
      15 under 40 years, 16 under 50 years and 11 between 50 and 69 years of age. A
      protocol of incremental stimulation until 2nd degree AVB was attained and
      programmed atrial stimulation with one or two extrastimuli delivered on 2 paced
      cycles (600 and 400 ms) was used under basal conditions and with Isoprenaline. A
      malignant form of the condition was defined as the demonstration of two
      abnormalities: rapid conduction in the bundle of Kent (over 240/min) under basal
      conditions or over 300/min after Isoprenaline, and if it induced sustained atrial
      fibrillation (> 1 min). The results were: [table: see text] In conclusion, the
      number of malignant forms of the Wolff-Parkinson-White syndrome is exactly the
      same, irrespective of age. Elderly patients remain at risk of malignant WPW
      syndrome because of the increased incidence of atrial fibrillation. Therefore,
      the authors recommend systematic evaluation of this syndrome if the patient has
      an active life-style especially with regard to sporting activities.

PMID- 11211448
TI  - [Treatment of left atrial thrombosis by low-molecular-weight heparin. A
      preliminary study of 6 cases].
AB  - Left atrial thrombosis is a serious complication of atrial fibrillation because
      of its embolic potential, especially for the cerebral circulation. These thrombi
      are usually treated by oral anticoagulation. The authors studied the efficacy and
      tolerance of a low molecular weight heparin. Enoxaparin, in the treatment of this
      condition. This was a prospective study carried out over a 1 year period. Patient
      recruitment came from the transoesophageal echocardiography laboratory: of 15
      thrombi detected, 6 were treated by ambulatory Enoxaparin therapy. Five of the 6
      patients had no signs of left atrial thrombosis after 3 weeks of Enoxaparin
      therapy. The left atrial thrombus of the 6th patient remained hyperechogenic and
      had decreased in length from 27 to 24 mm. No cases of bleeding, haematoma,
      embolism or thrombopenia were observed with this treatment. This preliminary
      study shows that low molecular weight heparin may be used as an alternative to
      classical oral anticoagulation for the treatment of left atrial thrombosis.

PMID- 11211449
TI  - [White coat hypertension].
AB  - White coat hypertension and the white coat effect are common clinical problems.
      Although they have similar names, they do not correspond to strictly identical
      entities. The white coat effect is an increase in blood pressure induced by the
      physician. It may be observed for all degrees of mean blood pressure and it is
      usually assessed by the difference between conventional and ambulatory blood
      pressure values. White coat hypertension is a qualitative status associating
      clinical hypertension and "normotension" outside the physician's office. In
      practice, the application of these definitions presents many difficulties. The
      usual methods of evaluating the white coat effect are a poor marker of the true
      effect as measured by continuous blood pressure monitoring. White coat
      hypertension has many definitions, both with respect to the threshold of clinical
      hypertension and to that of ambulatory normotension. Any attempt at evaluating
      the prognosis of these two conditions are faced with these considerations.
      However, the cardiovascular consequences which result appear to be mild and,
      usually, do not justify drug therapy. Their principal implications are above all
      diagnostic as they may lead to the erroneous assumption of severe or drug
      resistant hypertension.

PMID- 11211450
TI  - [Mitral valve prolapse, arrhythmias and sudden death].
AB  - Some of the classical concepts of mitral valve prolapse (MVP) should be reviewed
      in the light of recent publications. It is a condition, according to strict
      echocardiographic criteria excluding near physiological abnormalities, which
      affects 2 to 3% of the adult population in the industrialised world. Only
      repetitive atrial arrhythmias and complex ventricular arrhythmias are more common
      in this condition than in control groups, the differences being more pronounced
      in cases of mitral regurgitation. The risk of syncope or sudden death is 0.1% per
      year, hardly any different to that of the rest of the general adult population
      (0.2%). However, this risk may attain 0.9 to 2% in cases with mitral
      regurgitation. The causes of sudden death are unclear (haemodynamic,
      neurohumoral, arrhythmic, etc...), although there is evidence in favour of
      malignant ventricular arrhythmias. Detailed clinical, electrophysiological,
      isotopic and anatomopathological studies have raised doubts as to the direct
      responsibility of the vascular malformation (or its eventual consequences on the
      atrial and ventricular chambers) in this mode of fatal outcome. On the other
      hand, localised or diffuse myocardial disease is often observed, usually a- or
      pauci-symptomatic, associated with MVP, the responsibility of which is more
      plausible. Therefore, the physician should adopt a flexible attitude towards
      these patients, reassuring those with benign symptoms at low risk and following
      up or actively treating the rarer malignant forms (especially familial, syncopal
      with mitral regurgitation and/or severe arrhythmias).

PMID- 11211451
TI  - [Ambulatory management of chronic cardiac failure. Possible value of health
      networking].
AB  - Cardiac failure is one of the commonest medical conditions. It usually affects
      the elderly and is responsible for repeated hospital admission with its high cost
      for the social security. Several attempts at ambulatory management in certain
      countries have been successful. Their application may be possible in France. The
      setting up of health systems like the ones which exist for diabetes, could be a
      solution to the problem.

PMID- 11211452
TI  - [Coronary subclavian steal syndrome after internal mammary artery bypass
      grafting. A cause of severe postoperative recurrent myocardial ischemia].
AB  - A 65-year-old underwent a triple bypass: internal artery mammary-descending
      coronary artery, aorta diagonal-lateral coronary (sequential). Three weeks later
      he started to have severe angina pectoris with ST depression in anterior EKG
      leads. A left transradial coronary angiography was performed. The examination
      showed a total occlusion of the left subclavian artery 2 cm after the aortic arch
      and a retrograde flow in the internal mammary artery (IMA). Via transfemoral
      approach, angiography showed the patency of the aorto-veinous sequential graft
      and a retrograde flow through anastomosis in the left mammary artery. The patient
      underwent a reimplantation of the IMA on the brachiocephalic artery. One month
      later the patient is doing well without chest pain. A coronary subclavian steal
      syndrome should be suspected in case of recurrent ischaemia after IMA bypass,
      particularly if there is more than 20 mmHg systolic pressure differential between
      the arms. Left transradial approach achieved diagnostic in case of total left
      subclavian artery occlusion.

PMID- 11211453
TI  - [Idiopathic left ventricular aneurysm presenting with ventricular tachycardia. A
      case report].
AB  - Left ventricular aneurysm presenting with ventricular tachycardia was observed in
      a 48 year old man. Aetiological investigation was negative. The differences
      between aneurysm and diverticulum and the aetiologies of aneurysms are discussed.
      The treatment of the arrhythmias caused by this condition is discussed with the
      help of a review of the literature.

PMID- 11211454
TI  - [Anomalous origin of coronary arteries from three separate ostia in the right
      sinus of valsalva. A case port and review of the literature].
AB  - The authors report the case of a patient undergoing coronary angiography for a
      lateral myocardial infarction related with atherosclerosic lesions but associated
      with a rare anomalous origin of all three coronary arteries from separate ostia
      in the right sinus of Valsalva. Anomalous origin of coronary arteries from the
      opposite sinus are potentially serious especially among young subjects and when a
      vessel runs between the aorta and pulmonary artery. Clinical presentation,
      angiographic diagnostic and treatment strategies are discussed.

PMID- 11211455
TI  - The use of lasers in dermatology.
AB  - There are now a range of lasers capable of effective treatment of vascular,
      pigmented and other skin lesions with a high degree of selectivity. Understanding
      the complex interactions between laser irradiation and often diverse lesion
      morphology is the key to determining the appropriateness of treatment.

PMID- 11211456
TI  - Human oocyte cryopreservation.
AB  - Despite early success with sperm and embryo cryopreservation, human oocyte
      cryopreservation has met with limited success both in terms of survival and
      subsequent fertilization. However, compared with embryo cryopreservation, oocyte
      freezing has great potential for eliminating the ethical and legal problems of
      embryo storage.

PMID- 11211457
TI  - Investigating eosinophilia in patients returned from the tropics.
AB  - In patients who have returned from the tropics, eosinophilia usually signifies
      infection with worms. This paper gives an approach to investigating these
      patients systematically. The key element is a good travel history leading to
      targeted investigations.

PMID- 11211458
TI  - Simvastatin: building on success.
AB  - Over a decade after launch, simvastatin remains the most widely-prescribed statin
      in the UK. This has resulted from a growing body of long-term outcome data, a
      steadily expanded range of indications, an extended dose range and proven cost
      efficacy.

PMID- 11211459
TI  - Vaginal hysterectomy.
AB  - Vaginal hysterectomy represents the ultimate minimal access hysterectomy. The
      indications for the procedure extend well beyond those of prolapse. Good training
      and advances in surgical technique allow the removal of enlarged fibroid uteri as
      well as vaginal oophorectomy. This article also considers the complications which
      may follow.

PMID- 11211460
TI  - Pharmacological treatment of depression: the role of paroxetine.
AB  - Depression is reaching epidemic proportions in the western world. With each
      successive generation more people are becoming more severely depressed at a
      younger age.

PMID- 11211461
TI  - Acute medical emergencies: the physician's role.

PMID- 11211462
TI  - Provision of an electronic library at the clinical frontline: evaluation of
      impact on hospital medical staff.
AB  - Doctors need convenient access to the latest information if they are to meet the
      demands of clinical governance and evidence-based medicine. Forest Healthcare NHS
      Trust used its intranet to provide clinical areas with direct 24-hour access to
      library materials.

PMID- 11211464
TI  - Beware of groin pain in the elderly athlete.

PMID- 11211463
TI  - Revision total hip arthroplasty without blood transfusion.

PMID- 11211465
TI  - Vault haematoma after vaginal hysterectomy.

PMID- 11211468
TI  - Laser revascularization in the management of coronary artery disease.
AB  - In recent years, laser therapy has been evaluated for the treatment of patients
      with angina who have coronary artery disease which is not amenable to
      conventional revascularization techniques. The results of transmyocardial
      revascularization and percutaneous myocardial revascularization are reviewed.

PMID- 11211466
TI  - Post-intubation tracheal stenosis.

PMID- 11211467
TI  - The future of pathology in the UK: modernization or rationalization?

PMID- 11211469
TI  - [Treatment of hypertension in the prevention of cardiovascular damage].

PMID- 11211470
TI  - [Difficulties regarding the development of palliative treatment].
AB  - Palliative care is the branch of medicine which studies and applies the best way
      to cure when the traditional method is no longer able to interrupt the course of
      the disease until death. Two of the main characteristics of this kind of cure is
      to offer a support system to help the patient's family during the illness and to
      involve psychological care of the patient. The different approach with the
      patient and the new role of the doctor are just two obstacles of the spread of
      the palliative cure.

PMID- 11211471
TI  - [Pasteurella pestis: pardon for infamy].

PMID- 11211472
TI  - [Etiology and epidemiology of extrauterine pregnancy].
AB  - In the last years, ectopic pregnancy has become a frequent problem, especially in
      the industrialized countries. Women aged 30-40 years are mostly affected. Infact,
      in this ten-years period, more and more women feel the desire of pregnancy at
      ripe age, first of all because of their job. This study shows 136 cases of
      extrauterine pregnancy, observed at our hospital, I and II Institute of Obstetric
      and Gynecological Clinic of "Policlinico Umberto I" in Rome from January 1997 to
      December 1999. The object of this analysis is to determine the characteristics
      and ethiologic factors of this pathology.

PMID- 11211473
TI  - Age-related trend for blood pressure circadian rhythm in normotensive healthy
      subjects: estimates provided by the clinospectror method.
AB  - The present study investigates how blood pressure (BP) circadian rhythm (CR)
      changes in its rhythmic properties as a function of chronological age in
      normotensive healthy subjects (NHS). The age-related trend for BP CR was
      investigated via the Clinospectror method, a periodic-linear analysis of
      regression for rhythmic parameters. The study was performed on 437 NHS (219 males
      and 218 females, ranging in age from 1 year to 102 years), who were monitored in
      their 24-h BP via a noninvasive automated recorder. An age-related trend was
      detected for the three properties of BP CR, i.e., mesor (M), amplitude (A) and
      acrophase (cent). Such a trend was positive for M and A, and negative for cent.
      According to the clinospectrometric formula, the BP CR can be classified as a
      "dianaclinous rhythm", i.e., a rhythm which increases in its oscillatory level
      and extent with advancing years. The documented age-related trend for the
      rhythmic properties suggests that the biological clock which regulates the BP CR
      in human beings undergoes a resetting of its mechanisms of tonic, amplitude and
      phasic modulation as a function of chronological age. The readjustment of the
      pressure clock may be regarded as one of the physiological features which
      characterize the aging process in human beings.

PMID- 11211475
TI  - [Assessment of hepatocyte AgNORs expression in chronic hepatopathy].
AB  - The high incidence of liver chronic diseases has aroused strong interest in
      researching and trying to discover the biomolecular basis. In this context the
      study of nucleolar organizing regions could be interesting as a prognostic factor
      for chronic hepatitis and for liver neoplastic disease. The Authors report on the
      results of their study performed on 39 selected samples from 4 different
      inflammatory hepatic disorders.

PMID- 11211474
TI  - [Causality relationship of drug adverse reactions: experience in the use of HIV
      protease inhibitors].
AB  - PURPOSE: To establish the exact cause and effect relationship between protease
      inhibitors (PIs) and adverse events. MATERIALS AND METHOD: Prospective, cohort,
      multicenter study on HIV-positive patients who are beginning treatment with a PI.
      Causal relationships are evaluated using the RUCAM algorithm. RESULTS: Since the
      beginning of the study 1207 patients have been enrolled. Average time of
      observation is 10.7 months. To date, 784 adverse events have been observed,
      distributed as follows: excluded 3.8%, improbable 18.5%, possible 41.3%, probable
      30.1%, and highly probable 6.3%. Saquinavir shows a statistically significant
      difference in the rate of non-correlated events with respect to other groups.
      CONCLUSIONS: Over 20% of adverse events during PI treatment are shown to be non
      correlated to these drugs. Saquinavir shows the highest rate of non-correlated
      events.

PMID- 11211476
TI  - [Hospices from the DPCM 20/1/2000 perspective: requirements to ensure a better
      quality of "residual life"].
AB  - INTRODUCTION: In this paper, the authors analyse the increasing number of
      oncological patients, above all the terminal ones. The aim of hospice is to
      guarantee a high quality residual life. Hospice must not be regarded as a place
      of sweet death; on the contrary it's a hospital where palliative cares take
      place. It is, then, an alternative to home in the most critical phases of
      illness. CONSIDERATIONS: Despite a lasting interest in the matter, a law setting
      up a standard has been lacked until DPCM of 20/1/2000 that established
      structural, technological and managerial requirements for the centres of
      palliative cares. New hospices must be built in sunny places, in close contact
      with nature and easily reachable both by private and public means of transport.
      The law provides for three areas: a residential area, an evaluation and therapy
      area and a general area of support.

PMID- 11211477
TI  - [Anaplastic, insular, and medullary carcinoma of the thyroid].
AB  - Anaplastic carcinoma, insular carcinoma and medullary carcinoma (both familiar
      and sporadic forms) represent the 7-25% of all thyroid tumors. Anaplastic
      carcinoma is one of most aggressive human tumors and the therapeutic options
      proposed have failed to improve the prognosis of these patients. Insular
      carcinoma is a not well known thyroid neoplasia described for the first time in
      1984 and showing intermediate biological behaviour between differentiated and
      anaplastic forms. Medullary carcinoma arises from parafollicular"C" cells of the
      gland and then may be considered a neuroendocrine tumor. Choice therapy is
      surgery, tiroxine is only substitutive, familiar screening is mandatory.
      Chemotherapy (dacarbazine or cisplatin and doxorubicine), radiotherapy and
      recently octreotide anologues, may be useful for relapsing not operable forms.

PMID- 11211478
TI  - Recent advances in the molecular analysis of human malignant mesothelioma.
AB  - PURPOSE: To evaluate the role of asbestos, somatic genetic alterations, and
      simian virus 40 (SV40) in the formation of malignant mesothelioma (MM). DESIGN:
      To review recent cytogenetic and molecular genetic advances in MM. RESULTS:
      Exposure to asbestos is a major factor contributing to the development of most
      MMs. The accumulation of recurrent cytogenetic deletions in most MMs suggests a
      multistep process in this malignancy characterized by the loss and/or
      inactivation of multiple tumor suppressor genes (TSGs). Karyotypic, comparative
      genomic hybridization (CGH), and loss of heterozygosity (LOH) analyses of MMs
      have demonstrated frequent deletions of specific chromosomal regions within 1p,
      3p, 6q, 9p, 13q, 15q, and 22q. Positional candidate gene approaches have
      identified TSGs within two of these regions, i.e., CDKN2A at 9p21 and NF2 at
      22q12, which are frequently altered in MMs. In addition, recent studies have
      demonstrated the presence and expression of SV40 in many MMs. Proposed mechanisms
      by which asbestos and SV40 contribute to the development of MM are reviewed.
      CONCLUSIONS: The identification of new TSGs involved in MM and understanding the
      role of these genes and of SV40 in the pathogenesis of this malignancy may lead
      to design of more effective therapeutic strategies.

PMID- 11211480
TI  - [Diabetes mellitus and pancreas. The brilliant intuition of a great Italian
      clinician of the 19th century].

PMID- 11211479
TI  - [Familial Mediterranean fever: report of a case].
AB  - Familial Mediterranean fever is an autosomal recessive hereditary disease
      characterised by recurrent fever, poliserositis, chest and/or abdominal pain. Up
      to date diagnosis is based on clinical symptoms, familial anamnesis and response
      to colchicine. It is an inflammatory reaction affecting serosal tissues but until
      recently different hypotheses have been suggested to explain the greatly
      increased chemotactic activity of the polymorfonuclear leucocytes. Identification
      of the function of the MEFV gene on chromosome 16 and its protein allows us to
      understand the pathogenesis of familial Mediterranean fever as well as provides a
      new diagnostic test and therapeutic measures. We describe a case of an young
      patient and review the literature.

PMID- 11211481
TI  - [Diagnosis of Helicobacter pylori infection: a new test].

PMID- 11211482
TI  - It's Bush. Now What?

PMID- 11211483
TI  - Partisan politics spells trouble for health care.

PMID- 11211484
TI  - Healthcare finance: the opportunities are wide open.

PMID- 11211485
TI  - The defined-contribution plan: the next generation of healthcare financing.
AB  - In response to rising health insurance premiums, many purchasers of coverage are
      evaluating the possibility of implementing defined-contribution health insurance
      plans. Under a defined-contribution plan, employers or the government pay a
      specified portion of the premium, and the consumer chooses a plan from a menu of
      options, paying the balance of the premium based on their plan selection. A shift
      to a defined-contribution model will have far-reaching implications for
      consumers, employer and government purchasers, payers, and providers. Providers
      will face changes in consumption patterns and the need to develop a brand image,
      market their strengths directly to consumers, educate consumers about their
      services and pricing, and reconfigure infrastructures to be able to respond
      efficiently to consumer demands.

PMID- 11211486
TI  - HIPAA privacy standards raise complex implementation issues.
AB  - In November 1999, under the mandate of the Health Insurance Portability and
      Accountability Act (HIPAA) of 1996, HHS issued proposed standards to protect the
      privacy of electronically transmitted personal health information. With
      publication of the final standards due soon, healthcare organizations must
      prepare to implement new processes and information systems to comply with the
      HIPAA requirements. The privacy standards are intended to accomplish three broad
      objectives: define the circumstances in which protected health information may be
      used and disclosed, establish certain individual rights regarding protected
      health information, and require that administrative safeguards be adopted to
      ensure the privacy of protected health information. Among the required
      administrative safeguards are designation of a privacy officer, implementation of
      compliance training programs for all applicable staff, establishment of a
      complaint system, and implementation of appropriate sanctions for violations of
      privacy requirements.

PMID- 11211487
TI  - Percentage compensation arrangements: suspect, but not illegal.
AB  - Percentage compensation arrangements, in which a service is outsourced to a
      contractor that is paid in accordance with the level of its performance, are
      widely used in many business sectors. The HHS Office of Inspector General (OIG)
      has shown concern that these arrangements in the healthcare industry may offer
      incentives for the performance of unnecessary services or cause false claims to
      be made to Federal healthcare programs in violation of the antikickback statute
      and the False Claims Act. Percentage compensation arrangements can work and need
      not run afoul of the law as long as the healthcare organization carefully
      oversees the arrangement and sets specific safeguards in place. These safeguards
      include screening contractors, carefully evaluating their compliance programs,
      and obligating them contractually to perform within the limits of the law.

PMID- 11211488
TI  - Nursing homes face quality-of-care scrutiny under the False Claims Act.
AB  - The Federal government has brought a series of civil actions against nursing home
      operators for alleged violations of the Federal False Claims Act. According to
      government prosecutors, if a nursing home submits Medicare or Medicaid claims for
      care the government considers substandard, the claims are false for that reason
      alone. However, the government's theory ignores the fact that the detailed
      Federal statutes and regulations that govern nursing homes, as well as the
      agencies that enforce them (the "regulatory enforcement scheme"), allow homes
      that have been found to provide substandard care to continue receiving Medicare
      and Medicaid payment while they correct their deficiencies. Until recently, most
      of the cases had settled, and the government's theory had not been addressed in a
      published court decision. In a recent case, however, a Federal judge refused to
      grant the defendant facility's motion to dismiss and permitted the government's
      case to proceed.

PMID- 11211489
TI  - Process-centered revenue-cycle management optimizes payment process.
AB  - By implementing a process-centered revenue cycle, healthcare organizations and
      group practices can achieve a seamless payment process with clear lines of
      accountability to achieve target outcomes. The integrated, end-to-end, revenue
      cycle process involves four key components: jobs, skills, staffing, and
      structure; information and information systems; organizational alignment and
      accountability; and performance measures and evaluation measures. The Henry Ford
      Health System (HFHS), based in Detroit, Michigan, exemplifies the type of results
      that are achievable with this model. HFHS includes a group practice with more
      than 1,000 physicians in 40 specialties. After implementing a process-centered
      revenue cycle, HFHS dramatically improved registration and verification
      transactions and optimized revenues.

PMID- 11211490
TI  - Differing definitions of "provider" can affect Medicare payment.

PMID- 11211491
TI  - Setting priorities for implementation of electronic transaction standards.

PMID- 11211492
TI  - Setting the highest ethical leadership standards ensures a higher standard of
      results.

PMID- 11211493
TI  - Data trends. Miscoding leads to lost revenue.

PMID- 11211494
TI  - Heterogeneity and differential expression of MUP proteins as a genetic basis of
      the physiological activity of androgen-dependent pheromones.

PMID- 11211495
TI  - Increased corticofugal plasticity after pyramidotomy in adult rats.

PMID- 11211496
TI  - Modulation of pain of different genesis by microelectrostimulation.

PMID- 11211497
TI  - Prolonged regulatory effect of thyroliberin on conditioned vegetative responses
      in hedgehogs.

PMID- 11211499
TI  - The role of the smooth endoplasmic reticulum in neuronal adaptation to fatiguing
      stimulation.

PMID- 11211498
TI  - The mechanism of the synchronization of pulse flows in neural networks of the
      visual system.

PMID- 11211501
TI  - Changes in the functional asymmetry of the brain in wrestlers.

PMID- 11211500
TI  - Correlation of the EL-4 lymphoma cell apoptosis with the expression of heat shock
      proteins.

PMID- 11211502
TI  - Characteristics of the EEG interhemispheric asymmetry in right- and left-handed
      subjects as a reflection of the interaction between the cerebral cortex and
      cerebral regulatory systems.

PMID- 11211503
TI  - Metabolic/food programming of enzyme systems in digestive and nondigestive organs
      of rats.

PMID- 11211504
TI  - Opioid modulation of pain threshold in fish.

PMID- 11211506
TI  - Formation of the centers of early spring phytoplankton bloom in Kola Bay.

PMID- 11211505
TI  - The defensin receptor: a possible mechanism responsible for reduced excitability
      of the neuronal sensory membrane.

PMID- 11211507
TI  - The relationship of the number of hydrobiont species with morphometric
      characteristics and the productivity of lakes.

PMID- 11211508
TI  - Contribution of soil to atmospheric CO2 balance in Russia.

PMID- 11211509
TI  - Energetics of green cell stress resistance: a concept.

PMID- 11211510
TI  - The role of specific cell surface in phytoplankton productivity.

PMID- 11211511
TI  - Spring production cycle of phytoplankton in the Kara Sea.

PMID- 11211512
TI  - Ciliary locomotion of the mollusk is different from that of the planaria.

PMID- 11211513
TI  - Specific structural features of the pectoral arch and phylogenetic relations in
      some mammalian taxa.

PMID- 11211514
TI  - A new subspecies of the European bison, Bison bonasus montanus ssp. nov.
      (Bovidae, Artiodactyla).

PMID- 11211515
TI  - Effect of red wood ants on carabid behavior: experimental studies at the
      individual level.

PMID- 11211516
TI  - Effect of zooplankton pressure on the dependence of the chlorophyll a
      concentration on the total phosphorus content in water.

PMID- 11211517
TI  - Multiple effects of B chromosomes in maize populations.

PMID- 11211518
TI  - The circulatory system of phoronid larvae.

PMID- 11211519
TI  - Probable mechanisms of the gravitational sensitivity of cells.

PMID- 11211520
TI  - In vitro and in vivo effects of a perfluorocarbon emulsion on cells of the rat
      central nervous system.

PMID- 11211522
TI  - Disorders of intraorganismal systemic communications during carcinogenesis.

PMID- 11211523
TI  - Overlapping genes and variability of the genetic code.

PMID- 11211524
TI  - Cracking down on ecstasy. Law enforcement is treating the 'hug drug' as if it
      were the next cocaine. Is it?

PMID- 11211521
TI  - The influence of sea squirt lectin on growth and adhesion of HeLa tumor cells.

PMID- 11211525
TI  - China's bitter harvest. The theft and sale of human body parts.

PMID- 11211526
TI  - New-style mammograms detect cancer. So do the old. Either way you wait.

PMID- 11211527
TI  - A thyroid problem can mimic almost anything.

PMID- 11211528
TI  - MMR vaccination and autism: the tip of the iceberg.

PMID- 11211529
TI  - Successful immunization of children: barriers and strategies.

PMID- 11211530
TI  - Diabetes and hypertension in the Americas.

PMID- 11211531
TI  - Causal link between MMR vaccination and autism: fact or fiction?

PMID- 11211532
TI  - The legal and ethical issues raised by the practice of alternative and
      homeopathic medicine in the Caribbean.

PMID- 11211533
TI  - The feasibility of a porcine model of acute coronary occlusion and reperfusion
      using off-pump coronary artery bypass grafting.
AB  - We developed an open-chest porcine model of acute coronary occlusion and surgical
      reperfusion, and attempted to prevent intra-operative ischaemic ventricular
      fibrillation (VF) by a Retrograde Intracoronary Glyceryl trinitrate (RIG)
      infusion into the occluded vessel. Five Yorkshire pigs (weight 50 +/- 1.1 kg),
      randomized into 3 groups, underwent median sternotomy under general anaesthesia.
      One pig (Group 1, control) underwent sternotomy and pericardiotomy only. Four
      pigs underwent acute left anterior descending (LAD) coronary occlusion. Two pigs
      were not reperfused (Group 2). Two pigs underwent surgical reperfusion (Group 3)
      via left internal mammary artery (LIMA) grafting to the LAD using the Off-Pump
      Coronary Artery Bypass (OPCAB) technique. Ischaemic injury was assessed using 7
      lead electrocardiography (ECG) and transthoracic/epimyocardial echocardiography
      (ECHO). Group 1: transient intraoperative hypotension and VF occurred. Successful
      resuscitation and 10-week survival (until sacrifice) with normal left ventricular
      (LV) function was achieved. Group 2: there were ECG and ECHO evidence of acute LV
      ischaemic dysfunction in both pigs. The surviving pig had persistent anterior
      hypokinesis at 8 1/2 months. The other died intra-operatively following
      progressive ischaemic LV dysfunction despite resuscitative attempts. Group 3: the
      surviving pig had normal LV function at 8 months. Initial anterior LV akinesis
      normalized within 7 days. The other developed post-occlusion haemodynamic
      instability and died intra-operatively despite reperfusion. In this porcine
      model, acute LAD artery occlusion modified by the novel RIG infusion technique,
      followed by surgical reperfusion (OPCAB) is feasible. This model would facilitate
      further development of OPCAB surgical expertise and understanding of the
      pathophysiology of ischaemia-reperfusion injury.

PMID- 11211534
TI  - Early metabolic defects for developing diabetes mellitus among offspring of
      patients with type 2 diabetes are independent of gender.
AB  - The aim of the study was to investigate if the female offspring of patients with
      Type 2 diabetes have more metabolic defects for developing diabetes mellitus than
      their male counterparts. Thirty-four offspring (10 males, 24 females) of patients
      with Type 2 diabetes mellitus aged 28.9 +/- 1.5 years (mean +/- SEM) underwent a
      standard oral glucose tolerance tests (OGTT; 75 g glucose in 300 ml water).
      Anthropometric indices, plasma lipids and blood pressure were measured while
      insulin resistance (IR) and sensitivity (%S) were assessed using the Homeostasis
      Model Assessment (HOMA) method. All the offspring had normal glucose tolerance
      but high HOMA-derived IR values (27.2 +/- 4.2 vs. 22.5 +/- 2.7 pmol/mmol/l, p >
      0.05) and low %S (48.1 +/- 5.1 vs. 50.6 +/- 3.9%, p > 0.05), all of which did not
      differ on gender comparisons. Multiple linear regression analyses suggest that
      gender had no influence on the outcome of the result (p = 0.37). Again, body mass
      index (BMI), fasting serum insulin, plasma glucose, triglyceride, total
      cholesterol, HDL-cholesterol and LDL-cholesterol were all similar in both genders
      (p > 0.05). The results suggest that though the offspring manifested metabolic
      defects for developing diabetes in later life, this susceptibility is independent
      of gender in the population studied. Further studies with a larger sample size
      are warranted to confirm these findings in this population.

PMID- 11211535
TI  - The influence of persistent hyperglycaemia on hyperfibrinogenaemia and
      hyperviscosity in diabetes mellitus.
AB  - The effect of hyperglycaemia on hyperfibrinogenaemia and its consequence on
      plasma viscosity was investigated in 69 diabetic patients during the course of
      hypoglycaemic treatment. Glycaemic control was assessed by measurement of
      glycosylated haemoglobin (HbA1). Plasma fibrinogen concentration (PFC) was
      determined by a clot-weight method. The relative plasma viscosity (RPV) was
      measured by capillary viscometry. The mean PFC and RPV were significantly (p <
      0.001) elevated in the diabetic patients as compared with a non-diabetic control
      group. Both PFC and RPV showed a distinct, step-wise increase with progressively
      poorer glycaemic control. The data strongly indicate that persistent
      hyperglycaemia is associated with a frank hyperfibrinogenaemia and hyperviscous
      plasma in most of the diabetic patients studied. These abnormal haemorrheological
      changes could impact adversely on both the haemostatic process and circulation in
      diabetic patients.

PMID- 11211536
TI  - The efficacy of acarbose in type 2 diabetes mellitus in Jamaica.
AB  - The efficacy and tolerability of acarbose was studied in type 2 diabetic patients
      eating a typical Jamaican diet. The study was an open label parallel group study
      without placebo control. Of the 51 subjects recruited, five (9.8%) did not
      complete the study and were excluded from further analysis. Six (13%) of the
      remaining 46 had adverse side effects and did not complete the protocol. Of the
      remaining 40 (Gp A), acarbose was added to their previous regime of diet alone (n
      = 15), [Gp B], oral hypoglycaemic agents, OHAs (n = 17), [Gp C], or insulin (n =
      8), Gp D]. In addition, during the run-in period all subjects had one session
      each with a dietitian and a diabetes educator. Over a 3-month period, significant
      reductions in average glucose (mmol) were observed in Gp B 10.5 +/- 1.1 to 8.4 +/
      0.9 (p < 0.027) and, from 11.0 +/- 1.0 to 8.7 +/- 0.7 (p < 0.01) in Gp C.
      Similarly, total glycosylated haemoglobin fell from 14.8 +/- 1.1% to 12.2 +/-
      1.0% (p < 0.016) in Gp B, from 14.9 +/- 1.1 to 11.9 +/- 1.1% (p < 0.002) in Gp C,
      and from 14.1 +/- 1.4 to 11.8 +/- 1.4 (p < 0.02) in Gp D. Twenty-three per cent
      (23%) of the patients experienced flatulence; 7.5%, changes in bowel habits and
      5%, abdominal cramps and discomfort. Acarbose is effective as monotherapy and as
      combination therapy with oral hypoglycaemic agents or insulin. Side effects were
      common, but tolerable.

PMID- 11211537
TI  - Coronary artery bypass graft outcome: the Trinidad and Tobago experience.
AB  - The study is retrospective review of the demographic, clinical, angiographic, and
      operative data of the first 205 consecutive CABG operations performed by
      Caribbean Heart Care at the Eric Williams Medical Sciences Complex (EWMSC),
      Trinidad and Tobago, between November 1993 and December 1997. The aim of the
      study was to determine the in-hospital and intermediate-term follow-up results.
      The mean age of patients was 59 +/- 10 years and 78% were male. Sixty-four per
      cent were of East Indian descent, whereas 16% were of African descent. Forty
      eight per cent of the patients were hypertensive, 46% were diabetic, 33% had
      hyperlipidaemia, 20% had a recent history of cigarette smoking and 16% were
      obese. Sixty-five per cent had a positive family history of ischaemic heart
      disease. The average time interval between angiography and surgery was 2.3
      months. At the time of angiography, 63.5% of patients had Canadian Cardiac
      Society (CCS) class 3 or 4 angina. The mean ejection fraction was 61 +/- 15%.
      Wall motion abnormalities were seen in 67% of patients. Significant stenoses of
      the left anterior descending artery, right circumflex artery, circumflex and
      ramus coronary arteries were present in 91%, 78%, 54% and 5%, respectively. Many
      patients (67%) had severe diffuse disease on angiography. The mean intensive care
      stay was 2.2 +/- 0.8 days. In-hospital mortality was 3.9% (8/205). The most
      frequent post-operative complication was haemorrhage (2.6%). Acute renal failure
      occurred in 2.1%; pulmonary collapse, 1.6%; stroke, 1% and cardiac arrest, 1%.
      Both sternal wound infections and systemic sepsis occurred in 0.5%. Intermediate
      term follow-up data were obtained for 92% (189/205). The duration of follow-up
      ranged from 1 to 5 years (mean 3.7 years). During the follow-up period, 7
      patients (3.4%) died. Angina severity was reduced from a mean CCS score of 2.61
      +/- 0.95 before CABG to 1.22 +/- 0.55 at the time of follow-up (p < 0.0001).
      Overall 4-year mortality compared favourably with data from international
      studies. Among survivors, quality of life improved as evidenced by the reduction
      in the mean angina score.

PMID- 11211538
TI  - Surgery for patent ductus arteriosus. Still the gold standard.
AB  - The surgical treatment of Patent Ductus Arteriosus (PDA) at the University
      Hospital of the West Indies, Kingston, Jamaica, was examined over an eight-year
      period. The results of standard surgical modalities were comparable to large
      published series. A review of the literature regarding the treatment options for
      PDA does not support a change in management strategy in favour of non-surgical
      methods. The treatment of PDA at this centre has shown excellent long-term
      results, with minimal mortality and morbidity.

PMID- 11211540
TI  - Risk factors associated with ischaemic stroke in Guadeloupe.
AB  - We carried out a case control study at the University Hospital of Pointe-a-Pitre,
      Guadeloupe, during eight months. Seventy patients with ischaemic stroke and
      seventy age- and sex-matched controls were involved. A standard questionnaire
      reported clinical characteristics and medical history. Seventy-six per cent of
      patients suffered from hypertension. Obesity and diabetes were more frequent in
      the case group than in the control group. Serum creatinine concentration (86 vs
      74 mumol/l; p < 0.001), total cholesterol (5.9 vs. 5.2 mmol/l; p < 0.001),
      apolipoprotein B (1.2 vs 1.0 g/l; p < 0.001) and lipoprotein (a) (82 vs 48 mg/dl;
      p < 0.001) were significantly higher in patients than controls. Multiple logistic
      regression analysis revealed that in addition to serum creatinine, serum
      apolipoprotein B, hypertension, obesity, serum lipoprotein (a) and diabetes
      mellitus were associated independently and significantly with ischaemic stroke.
      These findings have implications for clinical practice and further research
      particularly with respect to serum creatinine concentration as a marker of renal
      damage from hypertension and as a risk factor itself for cerebrovascular disease.

PMID- 11211539
TI  - The role of labelled red blood cell scintigraphy in the detection of acute
      gastrointestinal bleeding.
AB  - This paper describes the experience with 99m Technetium labelled red blood cell
      (99mTc RBC) scintigraphy in twenty-two patients presenting with acute
      gastrointestinal (GI) tract bleeding. Studies were positive in thirteen cases-
      eight from the lower GI tract and five from the upper. The data from surgical
      intervention were available in ten cases. Scintigraphy cannot diagnose the cause
      of GI bleeding, as it is a nonspecific study. Its usefulness lies in its ability
      to accurately diagnose the bleeding site, as was shown in this study where there
      was good surgical correlation. The simplicity, reproducibility and reliability of
      the technique, particularly when bleeding rates are low and intermittent, make
      it, in our view, the first line of investigation in any patient with suspected
      bleeding from the colon or upper GI tract if endoscopic evaluation is not
      possible in the latter. Its current under-utilisation in the Caribbean may be a
      reflection of the lack of nuclear imaging facilities.

PMID- 11211541
TI  - Impact on blood pressure control of a six-month intervention project.
AB  - The aim of this study is to evaluate the impact of a six-month structured
      education programme on blood pressure (BP) control in patients with uncontrolled
      hypertension. All patients attending the Specialist Hypertension Clinic,
      University Hospital of the West Indies (UHWI), between January 4 and March 29,
      1999, with blood pressure > 140/90 mmHg (n = 80), were randomly divided into
      Group 1, cases (n = 42) and Group 2, controls (n = 38). A 40-item pretested
      questionnaire, administered at the baseline and final visits of both groups,
      elicited demographic, lifestyle and knowledge data. Group 1 attended monthly
      structured interventions for six months. Except for diastolic blood pressure
      among male controls, diastolic blood pressure and systolic blood pressure were
      significantly reduced at the end of the intervention period (p < 0.01). Knowledge
      improved among the male patients (p < 0.01). Among the female patients, activity
      scores were significantly increased (p < 0.01), weight (p < 0.05) and BMI (p <
      0.05) were significantly reduced. There were no differences in these variables
      among the controls. This intervention had a benefit in blood pressure control.

PMID- 11211542
TI  - Evaluation of neonatal sepsis screening in a tropical area. Part I: Major risk
      factors for bacterial carriage at birth in Guadeloupe.
AB  - This prospective study reports on screening for neonatal sepsis among 3,372 live
      births out of 6,060 consecutive deliveries at the University Hospital of Pointe-a
      Pitre, Guadeloupe, during a 30-month period. Group B Streptococcus (GBS) was the
      most common pathogen, representing 46% (89/194) of positive blood cultures and
      52% (335/637) of positive gastric aspirates. Although only 3,372 (55%) of all
      live births were screened, 637 (10%) had gastric bacterial carriage at birth; of
      those, 335 (5.5%) involved GBS. Similarly, there were 194 (3.2%) positive blood
      cultures, of which 89 (1.5%) involved GBS. In this report, all newborns who
      presented with a positive GBS blood culture had at least one of the external
      tests positive for GBS (gastric, ear canal, rectum and placenta). Thirty-seven
      per cent (14/38) of positive neonatal blood cultures occurred in newborns with
      foetid liquor while in deliveries with intrapartum fever 16.5% (32/195) of blood
      cultures were positive. In our clinical practice, characteristics that were
      evident in the delivery room (without knowledge of prenatal follow-up) such as
      foetid liquor, intrapartum fever, prolonged rupture of membranes, foetal
      tachycardia and meconium staining were associated with the great majority of
      neonatal sepsis.

PMID- 11211543
TI  - The impact of the Women's Centre of Jamaica Foundation programme for adolescent
      mothers on repeat pregnancies.
AB  - A random sample (n = 260) of primiparous Jamaican adolescent mothers (12-16 years
      old) who gave birth in 1994 in the parishes of Kingston and St Andrew, St
      Catherine and Manchester was selected from vital records and interviewed in 1998
      for this historical cohort study. Among programme participants, the incidence of
      repeat pregnancy was 37 per cent compared with 60 percent among non-participants.
      Programme participation reduced the risk of one or more repeat pregnancies by 45
      per cent with 95% confidence interval (0.22, 0.91). Programme participants were
      also 1.5 times (1.005, 2.347) more likely to complete high school than non
      participants; however, this effect did not achieve statistical significance. The
      results confirmed that the WCJF Programme exerts a considerable effect on the
      incidence of repeat pregnancy among participants. The benefits of programme
      participation were greatest among residents of the Kingston Metropolitan Area
      from single-parent, female-headed households with average monthly incomes below
      J$10,000, who wanted to continue their education after the first live birth.

PMID- 11211544
TI  - Risky behaviour in Jamaican adolescent patients attending a sexually transmitted
      disease clinic.
AB  - The prevalence of sexually transmitted diseases (STD) and risky behaviour
      patterns were studied in 165 adolescents attending a STD clinic in Jamaica. A
      standardised structured questionnaire, clinical algorithms for STD and
      serological tests for HIV and syphilitic infection were applied. High prevalences
      of risky behaviour including young age at onset of sexual activity, especially in
      boys, (mean age 12.5 +/- 2.5 years); unprotected sexual intercourse (only 4% used
      condoms consistently); multiple sexual partners (mean 3.8 +/- 2.4 and 1.8 +/- 1.2
      for boys and girls, respectively) were found. Marijuana, used by 60% of the boys,
      was an independent risk factor for dysuria (adjusted Odds Ratio (OR), 2.0; 95%
      CI, 1.6-3.4). Repeated episodes of STD (33%), coinfection with HIV (1.2%),
      syphilis (1.2%) and teenage pregnancy (13%) were prominent findings. Educational
      strategies which promote behaviour intervention at an early age, frequent and
      consistent use of condoms, abstinence or delayed onset of sexual activity are
      essential to reducing the HIV/AIDS and STD risk in adolescents in Jamaica.

PMID- 11211545
TI  - The use of herbal teas and remedies in Jamaica.
AB  - We investigated the prevalence of the use of herbs among adults and children in
      Jamaica in 1996. Two concurrent surveys were conducted in randomly selected urban
      and rural areas: among adults and among caretakers of young children. From over
      90% of the selected households, all caretakers of children under 6 years and one
      randomly selected adult (18 years or older) were interviewed using structured
      questionnaires. The 457 adults reportedly used 156 types of herbs: a mean of 6 +/
      3 (mean +/- standard deviation) by the urban adults, and 10 +/- 6 by the rural
      adults (t-test, p < 0.001). Almost 100% of respondents had at some time used
      herbs for teas or for treating illnesses. The most common method of preparation
      was by infusion or boiling in water, then adding sugar. Urban respondents, women
      and those who were employed were more likely to buy medicines than to use herbal
      remedies. One hundred and sixty-seven caretakers of 203 children under 6 years
      were interviewed. The mean number of herbs given to each child was between 2 and
      3. The most common herbs were introduced within the first 6 months of life. Many
      caretaker factors were associated with herbal use. Public health implications
      include the potential toxicity of some herbs, the possibility that herbal teas
      given to young children may displace more nutritious foods and delay presentation
      to health care facilities. The findings will allow policy makers to target those
      most likely to use herbal preparations or to give them to young children, and
      target herbs to be analyzed for toxic or beneficial properties.

PMID- 11211546
TI  - Images and diagnoses. Synovial sarcoma.

PMID- 11211547
TI  - Images and diagnoses. Neurofibromatosis 1 (NF1)(Von Recklinghausen's disease).

PMID- 11211548
TI  - Rapid weight gain and benign intracranial hypertension in an AIDS patient on
      treatment with highly active anti-retroviral therapy (HAART).
AB  - We present the case of a 30-year-old woman with HIV/AIDS who experienced a 47%
      weight gain over a period of a year after commencing treatment with highly active
      anti-retroviral therapy (HAART) and went on to develop benign intracranial
      hypertension (BIH). She was not on any other medication associated with BIH.
      Although weight gain has been reported in patients on treatment with protease
      inhibitors, such gains have been minimal to moderate. We are unaware of any
      previous report of this degree of weight gain or BIH in a patient on protease
      inhibitors.

PMID- 11211549
TI  - Leptospirosis occurring in two children after fresh water immersion.
AB  - Leptospirosis is relatively uncommon in children. Two cases of severe
      leptospirosis occurred in teenaged boys who shared a common exposure via
      immersion in fresh water. While both patients had laboratory-confirmed
      leptospirosis, their symptoms differed in many respects.

PMID- 11211550
TI  - Severe pulmonary barotrauma.
AB  - Pulmonary barotrauma is a well-known but rarely seen complication of mechanical
      intermittent positive pressure ventilation. It is thought to be related to raised
      pressures within alveoli which lead to their eventual rupture and the subsequent
      development of respiratory embarrassment. Mishaps related to faulty one-way
      valves in the self-inflating, bag-ventilation devices commonly used in
      cardiopulmonary resuscitation (CPR) can, although rarely, lead to severe
      barotrauma. In this report, we describe a case of pulmonary barotrauma that
      appeared to be related to the "locking" of the "Ambu" bag's one-way valve in the
      inspiratory position during routine CPR.

PMID- 11211551
TI  - Pseudodementia in a twenty-one-year-old with bipolar disorder and vitamin B12 and
      folate deficiency.
AB  - A twenty-one-year-old female known to suffer from bipolar type I disorder
      developed features of a pseudodementia. Following prompt initial response to
      treatment with antidepressants, there was an early recurrence of cognitive
      impairment. Blood investigations confirmed a macrocytic anaemia and vitamin B12
      and folate deficiencies. There was dramatic resolution of cognitive impairment
      after vitamin replacement. This suggested the occurrence of a reversible
      nutritional dementia and reinforced the need to rule out secondary organic causes
      of psychiatric symptoms even in patients previously diagnosed with a primary
      psychiatric disorder.

PMID- 11211552
TI  - Immunization of health care workers in the CARICOM countries.

PMID- 11211553
TI  - The politics and policies of caring for the elderly in an age of retrenchment: a
      symposium.

PMID- 11211554
TI  - The middle-class elderly and Medicaid financial eligibility policies for nursing
      home coverage.
AB  - Benefits for the middle-class elderly are generally distributed through such
      social insurance programs as Social Security Old Age Insurance and Medicare. The
      inclusion of long-term nursing home services for the elderly in Medicaid provides
      an opportunity to gauge the relationship of the "middle class" to a means-tested
      public assistance program. This article develops the analysis by focusing on the
      nature of the recent changes in financial eligibility, the use of so-called
      Medicaid planning strategies by the elderly to gain eligibility, and a discussion
      of competing scenarios for the evolution of these policies in the near future.
      The analysis finds that the middle-class elderly are both an elusive
      socioeconomic group and a powerful cultural symbol which simultaneously
      constrains and supports their inclusion as recipients of Medicaid nursing home
      coverage.

PMID- 11211555
TI  - Hospice: an organizational systems model for the integration of acute and long
      term care.
AB  - In recent years, the realization of a need for increased integration of acute
      care and long-term care (LTC) systems has grown. For the most part, however, a
      person requiring both types of care is treated as though he or she is two
      discrete individuals with separate needs. Organizations that have the integration
      of acute and LTC as a goal serve relatively small numbers of people. Integration
      efforts could be facilitated through the identification and application of an
      organizational systems model. Hospice can provide such a model. The hospice
      interdisciplinary team integrates not only multiple disciplines but also acute
      care and LTC. The hospice model is also appropriate from a financial standpoint
      in that Medicare hospice funding has employed a prospective payment system (PPS)
      since the inception of the Medicare Hospice Benefit. In this article, the
      application of the hospice model to the integration of the acute care and LTC
      systems in the U.S. is demonstrated, using a subsystem approach.

PMID- 11211556
TI  - Community and long-term facility care in Canada.
AB  - By 1969, federal/provincial agreements had resulted in universally-insured access
      to hospital and medical services for all Canadians. In the absence of similar
      agreements for community and long-term care, each province has designed,
      implemented, and modified its own policies and programs during the last three
      decades. However, the communal values and the universal access to hospital and
      medical services which underpinned the national health plan influenced these
      policies and programs. Over time, the provincial programs have become more
      similar to each other but significant differences remain. However, all the
      provincial programs combine the assessment and delivery of short- and long-term
      community care and almost all combine the assessment of need for community care
      with that for long-term facility care placement. This article examines the
      development and changes in the community care and long-term facility care sectors
      in Canada over the recent past. Despite financial constraints which have resulted
      in the downsizing of hospitals and reductions in the ratio of long-term beds to
      the population aged 75 and over, community care budgets have increased
      substantially during this time. The article also discusses the major issues now
      confronting Canadian policy-makers and planning in regards to these programs and
      explores the potential impact of factors such as changes in funding and the
      organization and delivery of other health care services on long-term care.

PMID- 11211557
TI  - Long-term care: a woman's world.
AB  - Long-term care is a world disproportionately comprised of women as consumers and
      as providers. Women comprise 75 percent of nursing home residents, 97 percent of
      professional caregivers, and the vast majority of family caregivers for elderly
      relatives at home. This article explores how and why long-term care, both in an
      institutional setting and home-based, is primarily utilized by women. The gender
      differences in the provision of care are also examined. The three key approaches
      to payment for long-term care (private payer, insurance, and Medicaid) are a
      focus with an emphasis on the role of Medicaid. Long-term care looms as an
      explosive issue and an accessible target for future program cutbacks. Since women
      are the predominant customers and providers of long-term care, this should be a
      priority issue for the feminist agenda.

PMID- 11211558
TI  - Long-term care financing: are current methods enough?
AB  - Financing long-term care services can be extremely cost prohibitive to the
      average United States citizen. Given the complex patchwork of multidisciplinary
      services that may be required, operational issues and system efficiencies often
      draw considerable attention. Notwithstanding these challenges, this article
      reviews the major sources of long-term care financing, including some lesser
      known options. Potential advantages and disadvantages are presented. A
      descriptive analysis of existing policies and consumer practices raises the
      question of whether recent incremental reforms will lead to future solutions for
      the major constituents most affected by their implementation.

PMID- 11211560
TI  - Neuroscience in the past--likely trends in future.

PMID- 11211559
TI  - U.S. medical students choice of careers and its future impact on health care
      manpower.
AB  - During the last 10-15 years, the health care system of this country has faced
      major challenges, among them, spiraling increases of health care costs, physician
      manpower maldistribution, excessive production of subspecialists, shortages of
      primary care physicians (family practice, general internal medicine, and general
      pediatrics), and lack of access to health care, predominantly among the poor and
      disadvantaged populations. As a way of shedding light on some of these
      challenges, the authors conducted a study among junior medical students from the
      University of Texas Medical School at Houston which focused on some of the
      factors that might influence medical students' choice of careers. In this
      article, the authors review the most salient findings for some of the problems
      that currently plague the health care system of this nation. Certainly, the
      outcome of this study has important educational and health service delivery
      implications not only in the United States but abroad as well, particularly among
      developing nations.

PMID- 11211561
TI  - Superior cervical ganglionectomy leads to dampening of amplitude of temperature
      rhythm in rats.
AB  - The circadian rhythm of body temperature (CRT) is a robust marker of the
      endogenous pacemaker function and is one of the most frequently studied rhythms.
      Melatonin, the main secretion of the pineal gland seems to have more of a
      thermomodulatory role in controlling the body temperature than having a direct
      role in thermoregulation. The sympathetic innervation to the pineal via the
      superior cervical ganglion determines the melatonin secretion, and superior
      cervical ganglionectomy (SCGx) decreases the secretion of melatonin. The present
      study was conducted on the Wistar rats (n = 12) to determine the role of
      melatonin in modulation of CRT. Adult male rats were either ganglionectomised (n
      = 6) or sham ganglionectomised (n = 6). Rectal temperature was recorded for CRT
      analysis. Cosinar analysis of the temperature record was done to get the
      acrophase, amplitude and mesor. Our results show that SCGx decreases the
      amplitude to the rhythm but has no effect on the mesor of the rhythm. Our study
      confirms that melatonin has little role to play in the thermoregulation and its
      role is mainly in thermomodulation.

PMID- 11211562
TI  - Serotonergic mechanism in imipramine induced antinociception in rat tail flick
      test.
AB  - Substantial evidence has accumulated that spinally projecting serotonergic
      neurons modulate nociception. However, the exact receptor subtypes that mediate
      the antinociceptive response of serotonin within the spinal cord continue to be a
      subject of debate. Therefore, we explored the effect of serotonergic system on
      imipramine induced antinociception by using 5-Hydroxytryptamine-3 (5HT3) receptor
      antagonist ondansetron and 5-Hydroxytryptamine-2 (5HT2) receptor antagonist
      mianserine, and depletion of brain 5-Hydroxytryptamine (5HT) with p-chlorophenyl
      alanine (PCPA). Male wistar strain rats were pretreated with either ondansetron
      (0.5 mg/kg, i.p.) or mianserine (1 mg/kg, i.p.). After 15 minutes, rats received
      injection of imipramine (10 mg/kg). Nociception was assessed by tail-flick
      method. Imipramine (2 mg, 5 mg, 10 mg, and 20 mg/kg) produce antinociceptive
      response in the dose dependent manner. Prior treatment with 5HT3 antagonist,
      Ondansetron and 5HT2 antagonist, mianserine reduce the antinociceptive response
      of imipramine. In PCPA treated rats imipramine (10 mg/kg) failed to produce
      antinociception. These results indicate that the 5HT plays an important role in
      imipramine induced antinociception.

PMID- 11211564
TI  - Body weight regulatory mechanisms evidenced on meal-time restrictions.

PMID- 11211563
TI  - Development of differential tolerance to the sedative and anti-stress effects of
      benzodiazepines.
AB  - Differential degree of tolerance has been reported to develop for anticonvulsant,
      sedative and skeletal muscle relaxant effects of benzodiazepines (BZDs). Acute
      treatment with BZDs reportedly reduces the formation of gastric stress ulcers and
      attenuates stress-induced immunosuppression. The present study investigates
      whether tolerance develops to these antistress effects of BZDs by using diazepam
      and chlordiazepoxide as representative drugs. A single dose of diazepam (5 mg/kg,
      i.p.) or chlordiazepoxide (20 mg/kg, i.p.) produced a significant reduction in
      locomotor activity, a measure of sedative effect and antagonized the effect of
      restraint stress (RS) on gastric mucosal lesions and anti-sheep red blood cell
      (SRBC) antibody titre. With chronic treatment (X 7 d), there was a marked
      tolerance to the sedative effect of both the studied BZD drugs, while much less
      tolerance developed to their ulcer protective action. However, no tolerance was
      observed to the attenuating effect of diazepam and chlordiazepoxide on RS-induced
      immunosuppression. Thus, the results of the present study indicate that different
      mechanisms may be involved in the development of tolerance to the sedative,
      antiulcer and immunomodulatory effects of BZDs.

PMID- 11211565
TI  - Relevance of serum alkaline phosphatase as a diagnostic aid in lung pathology.

PMID- 11211566
TI  - Anaerobic power and cardiorespiratory evaluation in untrained males (18-19
      years).

PMID- 11211567
TI  - Endogenous depression, thyroid function and acupuncture.

PMID- 11211568
TI  - Effect of glibenclamide in gabapentin antinociception.

PMID- 11211569
TI  - An overview of pathophysiology and treatment of insulin resistance.
AB  - Insulin resistance has emerged out as a concept linking diabetes mellitus and
      hypertension. Clinically it is characterized by hyperinsulinemia, hypertension,
      central obesity, abnormal lipid profile and cardiovascular complications. Insulin
      resistance is often associated with presence of anti-insulin antibodies and
      absent or dysfunctional insulin receptors. At molecular level insulin resistance
      appears to occur at the level of G-protein, kinase activation, glucose carriers
      (GLUT) and gene expression. Although with advent or research, the molecular
      mechanisms of insulin resistance are becoming more clear and there is development
      of new therapeutic agents like insulin sensitizers (thizolidinediones), in
      clinical practice, as of today, a patient with insulin resistance is looked upon
      as hypertensive or having diabetes mellitus. Accordingly he is taking either
      antihypertensives or antidiabetic drugs or both. It is thus essential to look
      into effects of these agents on insulin sensitivity. In recent years some
      scattered studies have been conducted to evaluate the effect of various
      antihypertensives and antidiabetics on insulin sensitivity. An antihypertensive
      or antidiabetic drug should directly benefit the cardiovascular risk profile of
      these patients. Although various newer approaches are explored to have a
      therapeutic benefit in insulin resistance, it is still a long way in the
      research, when a suitable pharmacological agent with least untoward effects will
      be available for the treatment of insulin residence.

PMID- 11211570
TI  - Effect of yogic exercises on physical and mental health of young fellowship
      course trainees.
AB  - A study was undertaken to observe any beneficial effect of yogic practices during
      training period on the young trainees. 54 trainees of 20-25 years age group were
      divided randomly in two groups i.e. yoga and control group. Yoga group (23 males
      and 5 females) was administered yogic practices for the first five months of the
      course while control group (21 males and 5 females) did not perform yogic
      exercises during this period. From the 6th to 10th month of training both the
      groups performed the yogic practices. Physiological parameters like heart rate,
      blood pressure, oral temperature, skin temperature in resting condition,
      responses to maximal and submaximal exercise, body flexibility were recorded.
      Psychological parameters like personality, learning, arithmetic and psychomotor
      ability, mental well being were also recorded. Various parameters were taken
      before and during the 5th and 10th month of training period. Initially there was
      relatively higher sympathetic activity in both the groups due to the new
      work/training environment but gradually it subsided. Later on at the 5th and 10th
      month, yoga group had relatively lower sympathetic activity than the control
      group. There was improvement in performance at submaximal level of exercise and
      in anaerobic threshold in the yoga group. Shoulder, hip, trunk and neck
      flexibility improved in the yoga group. There was improvement in various
      psychological parameters like reduction in anxiety and depression and a better
      mental function after yogic practices.

PMID- 11211571
TI  - The effects of vasopressin in isolated rat hearts.
AB  - The roles of cGMP, prostaglandins, the entry of extracellular Ca2+ through slow
      channels, endothelium and V1 receptors in the negative inotropic, chronotropic
      and coronary vasoconstrictor responses to arginine vasopressin (AVP) have been
      investigated in isolated perfused rat hearts. The bolus injection of 5 x 10(-5) M
      AVP produced a significant decrease in contractile force, heart rate and coronary
      flow. AVP also significantly decreased contractile force, heart rate and coronary
      flow in hearts pretreated with an inhibitor of soluble guanylate cyclase
      methylene blue (10(-6) M), an effective drug for removing endothelium saponin
      (500 micrograms/ml), an inhibitor of cyclooxygenase indomethacin (10(-5) M) or a
      calcium channel antagonist verapamil (5 x 10(-7) M). The potent V1 receptor
      antagonist [Deamino-Pen1, Val4, D-Arg8]-vasopressin (9 x 10(-5) M) did not alter
      effects of AVP but the very potent V1 receptor antagonist [beta-Mercapto-beta,
      beta-cyclopentamethylene-propionyl1, O-Me-Tyr2, Arg8]-vasopressin (8 x 10(-5) M)
      abolished these effects. Our results suggest that AVP produces negative
      inotropic, chronotropic and coronary vasoconstrictor effects in isolated perfused
      rat hearts. cGMP, prostaglandin release and Ca2+ entry does not involve in the
      effects of AVP. These effects are endothelium independent and mediated by V1
      receptors. The use of V1 receptor antagonist [beta-mercapto-beta, beta
      cyclopentamethylene-propionyl1, O-Me-Tyr2, Arg8]-vasopressin may be beneficial
      for preventing the negative inotropy, chronotropy and coronary vasoconstriction
      induced by AVP.

PMID- 11211572
TI  - Lateral difference in reaction times to lateralized auditory stimuli.
AB  - Evidence suggests that Reaction time (RT) is affected by human behaviour in that
      stimuli are processed and conducted faster and more accurately when they are
      presented directly to the specialised hemisphere and responded to more quickly
      when stimulus and response are mediated by the same hemisphere. The purpose of
      the current study was to investigate the effect of laterality using one parameter
      reaction time (RT) on ipsilateral reactions to monuaural latralized stimuli.
      Twenty-four undergraduate polytechnic students and 10 representative level Rugby
      players participated in the study by reacting unilaterally to single and choice
      RT using simple and complicated sensor motor reactions (SMR). Results Shorter
      reaction times by the dominant hand while testing simple and complicated audio
      SMR, without reference to sex and sport skills results have been explained in
      terms of specialisation of left hemisphere in different aspects of information
      processes mechanisms, geared towards programming of the movement.

PMID- 11211573
TI  - Research in reproduction: the Indian scenario in the last decade [II].
AB  - Developing new, improved and totally safe, effective and acceptable
      contraceptives based on the recent advances in cellular and molecular biology of
      reproduction is a new challenge to biomedical scientists involved in research in
      reproductive biology. The present article reviews some of the major contributions
      made during the last decade by scientists working in India in developing new
      strategies and technologies for better human reproductive health and fertility
      regulation.

PMID- 11211574
TI  - Effect of Chyawanprash and vitamin C on glucose tolerance and lipoprotein
      profile.
AB  - Chyawanprash is an ancient Indian dietary supplement containing vitamin C (34
      mg/100 g) derived from amla (Emblica officinalis). In addition, Chyawanprash also
      contains several other herbal products. The present study was designed to compare
      the effects of vitamin C with those of Chyawanprash. Ten normal healthy adult
      male volunteers (age 20-32 years) participated in the 16-week study. They were
      placed randomly in either the Chyawanprash group (n = 5) or vitamin C group (n =
      5). Those in the former received 15 g/d of Chyawanprash while those in the latter
      received 500 mg/d vitamin C during the first 8 weeks of the study. For the next 8
      weeks, no supplement was given. For each individual, an oral glucose tolerance
      test was performed, and lipoprotein profile in peripheral serum samples was
      determined at 0 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks. In the
      Chyawanprash group, the 8 weeks Vs 0 weeks value (mean +/- S.D.) respectively for
      various indices which were significantly different were fasting plasma glucose
      (100.2 +/- 5.58 mg/dl vs 116.2 +/- 11.6 mg/dl), area under 2-h plasma glucose
      curve (245.9 +/- 15.13 mg.dl-1.h vs 280.8 +/- 37.09 mg.dl-1.h), HDL cholesterol
      (53.2 +/- 4.56 mg/dl vs 42.7 +/- 7.17 mg/dl), LDL cholesterol (82.4 +/- 8.80
      mg/dl vs 98.26 +/- 12.07 mg/dl), LDL/HDL ratio (1.56 +/- 0.28 vs 2.38 +/- 0.63).
      In the Vitamin C group, only the LDL/HDL ratio was significantly lower at 8 weeks
      than at 0 weeks (1.99 +/- 0.44 vs 2.29 +/- 0.43). All the variables that changed
      significantly were no longer significantly different from the 0 weeks value at 16
      weeks. Chyawanprash reduces postprandial glycemia in the oral glucose tolerance
      test and reduces blood cholesterol level to a significantly greater extent than
      vitamin C.

PMID- 11211575
TI  - Efficacy of naturopathy and yoga in bronchial asthma--a self controlled matched
      scientific study.
AB  - Asthma is one of the common psychosomatic illness influenced by many factors.
      Bronchodilators give temporary relief and have side effects. The present study is
      aimed at finding the efficacy of a non-pharmacological approach of naturopathy
      and Yoga in bronchial asthma. A total no of 37 patients (19 men, 18 women) with
      mean age 35.06 yrs (men), 40.74 yrs (women) admitted to INYS, Bangalore, for the
      period of 21 days. The treatment included 1. Diet therapy 2. Nature cure
      treatment and 3. Yoga therapy. The various parameters including lung function
      test were measured on admission and once a week. Results showed the significant
      improvement in PEFR, VC, FVC, FEV1, FEV/FEC %, MVV, ESR and absolute eosinophil
      count. The patients reported a feeling of well being, freshness and comfortable
      breathing. Naturopathy and yoga helps in inducing positive health, alleviating
      the symptoms of disease by acting at physical and mental levels.

PMID- 11211576
TI  - Induction of seminiferous tubular atrophy by single dose of 5-fluorouracil (5-FU)
      in Wistar rats.
AB  - Antimetabolite, 5-fluorouracil (5-FU) is known to cause testicular damage by
      epithelial sloughing and cell killing. However, it is not known whether 5-FU
      induces tubular atrophy and the fate of exfoliated germ cells. Present study was
      conducted to evaluate these effects of 5-FU on rat testis. Animals were injected,
      single dose of 5-FU (10.50 & 100 mg/kg, i.p.) and sampled at 1, 3, 15 and 30 day
      following the treatment. The testes were perfusion fixed by Bouin's fluid. Five
      micron thick paraffin sections of testes and epididymis were stained with
      haematoxylin and eosin. Slides were examined for the incidence of abnormal
      tubules (per 200 tubules), tubular diameter (STD), epithelial height (SEH) and
      for the presence of germ cells in the epididymis. Data were analysed by Mann
      Whitney 'U' test. The testes weight, STD, SEH were decreased (P < 0.05-0.01) in
      treated animals. The abnormal tubules were increased in a dose dependent manner
      with atrophic tubules seen on 30 d. The exfoliated germ cells have not blocked
      the post testicular ductal system and found in the epididymis in a dose dependent
      manner. The present study concludes that 5-FU causes tubular shrinkage and
      atrophy. Further, epididymis is involved in the phagocytosis of germ cells.

PMID- 11211578
TI  - Can we finally get it right with cancer pain control?

PMID- 11211577
TI  - Effect of systemically administered nitric oxide donor, sodium nitroprusside on
      picrotoxin-induced convulsions in rats.
AB  - Nitric oxide (NO), the gaseous neurotransmitter has been reported to have an
      endogenous anticonvulsant property. This has prompted proposals to develop NO
      donors as anticonvulsant drugs. In the present study, the effect of NO donor,
      sodium nitroprusside (SNP) on picrotoxin (PCT)-induced convulsions was
      investigated. A convulsant dose of PCT (5 mg/kg) was administered 5, 10, 15 and
      30 min after intraperitoneal injection of graded doses (0.7, 1.25 and 2.5 mg/kg)
      of SNP. SNP at doses 0.7 and 1.25 mg/kg increased dose dependently the severity
      of PCT-induced convulsions. But, pretreatment with the higher dose (2.5 mg/kg) of
      SNP was protective against PCT-induced convulsions. However, post treatment (5
      and 10 min) with the same dose exacerbated convulsions and caused death of the
      animals. These results indicate that the vasodilator effect of SNP and an
      increased perfusion of PCT into brain may be responsible for the proconvulsant
      action of SNP. A decreased entry of PCT because of marked vasodilation and
      hypotension has been speculated for an inhibition of convulsions in animals
      pretreated with a higher dose of SNP. In conclusion, the results reveal the non
      suitability of SNP to be developed as an anticonvulsant.

PMID- 11211579
TI  - The use of patient information leaflets in surgery.

PMID- 11211580
TI  - Islet cell tumours: diagnosis and medical management.
AB  - Islet cell tumours are difficult to diagnose. They are rare tumours that secrete
      hormones resulting in symptoms and signs that are often mistaken for more common
      conditions. Benign and solitary tumours are surgically resected, while medical
      therapy aims at symptom control and palliation of malignant disease.

PMID- 11211581
TI  - Islet cell tumours: surgical treatment.
AB  - The majority of neuroendocrine tumours of the pancreas are malignant and surgical
      resection is the mainstay of treatment. The tumours are often small and
      intraoperative tumour localization is an important part of the operation. The
      type of tumour will dictate specific treatment.

PMID- 11211582
TI  - Thyroid disease in pregnancy.
AB  - Some interesting recent developments have influenced the modern management of
      thyroid disease in pregnancy and enhanced our understanding of the interaction
      between maternal and fetal thyroid function, including the complex role of the
      placenta. This article will review the latest ideas in this area.

PMID- 11211583
TI  - Organizing the care of lung cancer patients.
AB  - For years lung cancer has been the Cinderella of malignant disease, perceived as
      being self-inflicted and incurable. The government has put cancer management high
      on its agenda and is setting targets for clinicians to aim at. This article looks
      at the changes which are occurring in the way lung cancer is managed.

PMID- 11211584
TI  - Managing patients with meconium-stained amniotic fluid.
AB  - Meconium-stained amniotic fluid might signify underlying acute or chronic fetal
      hypoxia with adverse perinatal outcome, especially if associated with
      cardiotocographic abnormality. Management requires awareness of this potential
      risk, appropriate intrapartum care and a combined obstetricneonatal approach.
      Amnioinfusion can be an effective preventative measure.

PMID- 11211585
TI  - Disulfiram revisited.
AB  - Disulfiram can be important in helping motivated alcoholics to remain abstinent.
      Prescribers should be aware of disulfiram's toxicity, and how to recognize and
      manage reactions. A number of other agents are available to help alcoholics
      remain sober, although these do not necessarily obviate use of disulfiram. Also,
      disulfiram may have a wider role in the management of the addictions, e.g. in
      cocaine use.

PMID- 11211586
TI  - Improving reporting of sharp injuries.
AB  - There is considerable under-reporting of contaminated needlestick and other sharp
      object injuries among health-care workers. Some general and psychological factors
      contribute to such low reporting. Continued training of staff, a sympathetic
      attitude and clarification of some general issues might improve reporting of such
      incidents.

PMID- 11211587
TI  - Spinal anaesthesia for caesarean section: current clinical practice.
AB  - Spinal anaesthesia has evolved as the preferred anaesthetic technique for most
      cases of caesarean section. Having been extensively studied and refined over the
      years, there are few situations where a spinal is absolutely contraindicated.
      While general anaesthesia will always have a place in obstetrics, in experienced
      hands a spinal offers safety, efficacy and an improvement in maternal morbidity.

PMID- 11211588
TI  - The effect of 1-year rotations on stress in preregistration house officers.
AB  - A comparison of stress levels in preregistration house officers demonstrated
      lower levels in those completing 1-year rotations compared with those completing
      6-month posts in two different hospitals. One-year rotations provide a more
      stable environment, allow new doctors to become familiar with the workings of an
      organization from several viewpoints and permit a better sense of working within
      a multiprofessional team than the traditional arrangements.

PMID- 11211589
TI  - A mentorship scheme for senior house officers.
AB  - Many junior doctors are unsure as to how their aspirations and developing
      abilities will match up to the demands of specialty training. They need sensitive
      and realistic guidance if they are to make the right career choice in a highly
      competitive market.

PMID- 11211590
TI  - Writing a case report: an editor's eye view.
AB  - 'That was a nice presentation. Why not write it up for a journal?' With such
      words a thousand case reports are born. But they are like birds tossed over a
      stormy ocean: only a few gain a foothold in the rigging of passing ships--for the
      rest, oblivion. So, how do you persuade an editor to accept your wonderful case
      report? Here are some reflections from the editor's standpoint.

PMID- 11211591
TI  - Extrapancreatic tumour hypoglycaemia.

PMID- 11211592
TI  - Basilar artery aneurysm: an unusual cause of intractable hiccups.

PMID- 11211593
TI  - A triple dose of iron deficiency anaemia.

PMID- 11211594
TI  - Retrospective ethics: a block to progress?

PMID- 11211595
TI  - Use of patient information leaflets in surgery.

PMID- 11211596
TI  - Management of acute heart failure.

PMID- 11211597
TI  - Wisdom tooth extraction under general anaesthesia.

PMID- 11211598
TI  - Human rabies in Montreal, Quebec--October, 2000.

PMID- 11211599
TI  - Human rabies in Canada--1994-2000.

PMID- 11211600
TI  - Drinking water quality and health-care utilization for gastrointestinal illness
      in greater Vancouver.
AB  - The risk of microbial disease associated with drinking water is presently a
      priority concern among North American water jurisdictions. Numerous past
      outbreaks, together with recent studies suggesting that drinking water may be a
      substantial contributor to endemic (non-outbreak related) gastroenteritis,
      demonstrate the vulnerability of many North American cities to waterborne
      diseases and have fuelled ongoing debates in Canada and the United States
      concerning the need for stricter water quality guidelines, changes in watershed
      management policies, and the need for additional water treatment. The Greater
      Vancouver Regional District (GVRD) water supply system serves approximately two
      million consumers from a system consisting of three unfiltered surface water
      supplies (Figure 1). Although GVRD policies reduce the potential for fecal
      contamination of the source water supplies by humans and domestic animals, the
      GVRD watersheds support many wildlife species that can potentially shed organisms
      pathogenic to humans. Because GVRD's water treatment strategy relies principally
      on watershed protection and chlorination*, and these two strategies together do
      not eliminate all risk of waterborne disease transmission, it is possible that
      some disease-causing organisms reach the consumer.

PMID- 11211601
TI  - Update: West Nile Virus activity--eastern United States, 2000.

PMID- 11211602
TI  - Perspectives. States struggle to piece together puzzle of uninsured.

PMID- 11211603
TI  - Whither the atypical (dysplastic) nevus?

PMID- 11211604
TI  - Judging academic pathology chairpersons.

PMID- 11211605
TI  - Chairpersons of pathology in the United States. Benchmarks for academic
      publications and professional credentials.
AB  - Chairpersons of pathology often are viewed as departmental role models in
      academic medical centers. To objectify this view, we undertook a systematic
      survey of publication records and professional certification among 126
      chairpersons in the United States. The median of the total number of scientific
      publications by the cohort was 105 since graduation from medical school, and the
      median yearly number of peer-reviewed papers was 3.34 per person (mean, 4.25). A
      random 10% of the study population was analyzed further with reference to the
      percentage of publications that reflected basic science research; 41% of the
      total literature contributions of this subgroup fit that description, and only
      38% of the chairpersons in the subgroup had 80% or more non-service-related
      publications. Of all chairpersons, 85% had obtained primary board certification
      in anatomic pathology, clinical pathology, or both, and 25% of the group had
      earned at least 1 subspecialty board certificate in addition. These numbers
      reflect an evolution in the professional backgrounds of chairpersons of pathology
      such that demands for academic scholarship and proficiency in hospital practice
      and management seem to pertain to that group.

PMID- 11211606
TI  - To IRB or not to IRB? That is no longer the question.

PMID- 11211607
TI  - Critical analysis of histologic criteria for grading atypical (dysplastic)
      melanocytic nevi.
AB  - Low concordance in grading atypical (dysplastic) melanocytic nevi (AMN) has been
      reported, and no systematic evaluation is available. We studied 123 AMN with
      architectural and cytologic atypia (40 associated with atypical-mole syndrome),
      classified according to standard criteria by 3 independent observers. Histologic
      variables included junctional and dermal symmetry, lateral extension, cohesion
      and migration of epidermal melanocytes, maturation, regression, nuclear features,
      nuclear grade, melanin, inflammatory infiltrate location, and fibroplasia. AMN
      (43 junctional and 80 compound) were graded mild (31), moderate (61), and severe
      (31). AMN-severe correlated with 3 or more nuclear abnormalities (especially
      pleomorphism, heterogeneous chromatin, and prominent nucleolus) and absence of
      regression, mixed junctional pattern, and suprabasilar melanocytes on top of
      lentiginous hyperplasia. AMN-severe diagnostic accuracy was 99.5% using these
      criteria, but only the absence of nuclear pleomorphism differentiated AMN-mild
      from AMN-moderate. No architectural features distinguishing AMN-mild from AMN
      moderate were selected as significant by the discriminant analysis. AMN from
      atypical-mole syndrome revealed subtle architectural differences, but none were
      statistically significant in the discriminant analysis. Histologic criteria can
      reliably distinguish AMN-severe but fail to differentiate AMN-mild from AMN
      moderate. AMN from atypical-mole syndrome cannot be diagnosed using pathologic
      criteria alone.

PMID- 11211608
TI  - Using a continuous transformation of the Breslow thickness for prognosis in
      cutaneous melanoma.
AB  - Although the Breslow thickness provides the most important histologic information
      for prognosis in cutaneous melanoma, controversies and uncertainty remain about
      how best to use thickness. It is unclear whether cut points should be used, or,
      if they are used, which are optimal. We studied new data collected from more than
      1,000 patients followed up for a relatively long period. From Cox proportional
      hazards models of survival we learned that more cut points provide more
      prognostic information than using, for example, just 1 cut point at 1.7 mm.
      Nevertheless, a continuous transformation provides an effective alternative that
      captures the information that thickness provides, and it avoids the pitfalls of
      using multiple cut points. In a multivariate model, this transformation provided
      strong prognostic information, and the result produced a prognostic score for
      cutaneous melanoma. This score provides a practical way that Cox model results
      can be used, and we believe it consolidates the prognostic information provided
      by traditional histologic and clinical variables. When newer prognostic variables
      are introduced, we suggest that they be used with this continuous transformation
      of thickness rather than with cut points in thickness.

PMID- 11211609
TI  - PS6K amplification characterizes a small subset of anaplastic meningiomas.
AB  - PS6K, a putative oncogene mapped to chromosome 17q23, encodes a serine/threonine
      kinase, which phosphorylates ribosomal subunit 6 and is part of the insulin
      receptor signal transduction pathway involved in the regulation of messenger RNA
      translation, protein synthesis, cell cycle progression, and cell size.
      Comparative genomic hybridization studies have detected 17q23 amplifications in a
      subset of meningiomas, particularly those with aggressive histologic features.
      PS6K amplifications have been reported in breast cancer, another hormonally
      driven neoplasm. We assessed PS6K dosage in 94 archival paraffin-embedded
      meningiomas using dual-color fluorescence in situ hybridization. We found high
      level PS6K amplifications in 3 of 22 anaplastic grade III meningiomas.
      Amplification was confirmed by differential polymerase chain reaction in 1 of
      these cases. In contrast, no amplifications were identified in 37 benign (grade
      I) and 35 atypical (grade II) meningiomas. To our knowledge, this represents the
      first report of gene amplification in primary human meningiomas. Given its
      exclusive association with anaplastic meningiomas, PS6K amplification likely
      occurs during the malignant progression of a small subset of anaplastic tumors.
      Further studies are needed to map the 17q23 amplicon to determine whether
      additional genes in this region are amplified in high-grade meningiomas.

PMID- 11211610
TI  - Cellular dyscohesion in fine-needle aspiration of breast carcinoma. Prognostic
      indicator for axillary lymph node metastases?
AB  - The role of fine-needle aspiration (FNA) in the diagnosis of breast carcinoma is
      established. We evaluated whether the degree of cellular dyscohesion and the
      nuclear grade in FNA material of breast carcinomas are reliable prognostic
      predictors for ipsilateral axillary lymph node metastasis. FNA specimens from 98
      women with infiltrating ductal and infiltrating lobular carcinomas were evaluated
      by 2 observers for degree of cellular dyscohesion and nuclear grade. Follow-up
      specimens from lumpectomy and/or mastectomy with axillary dissection were
      available for each patient. By univariate analysis, degree of cellular
      dyscohesion and nuclear grade were not predictive of axillary lymph node
      metastasis regardless of tumor size. High histologic grade, size greater than 2
      cm, and patient age younger than 52 years were significant predictors of
      metastasis. By multivariate analysis, size greater than 2 cm and age younger than
      52 years were statistically significant for lymph node metastasis. In contrast
      with a published study, the results of the present study fail to show cellular
      dyscohesion in FNA specimens as predictive of lymph node metastasis; however, the
      scoring method for determining the degree of cellular dyscohesion is reproducible
      between 2 independent observers.

PMID- 11211611
TI  - p53, but not c-Ki-ras, mutation and down-regulation of p21WAF1/CIP1 and cyclin D1
      are associated with malignant transformation in gastric hyperplastic polyps.
AB  - To investigate tumorigenesis in the gastric hyperplastic polyp (HP), we evaluated
      19 HPs with and 50 HPs without dysplasia (including carcinoma in situ), as
      compared with normal mucosa and fundic gland polyps. Helicobacter pylori density
      was highest in HPs without dysplasia. Apoptotic activity and Ki-67 and p53
      expression also were higher in dysplasia in HPs than in normal mucosa, fundic
      gland polyps, or HPs themselves. The p21WAF1/CIP1 and cyclin D1 levels, in
      contrast, were highest in HPs. In HPs without dysplasia, size was correlated
      positively with the degree of stromal inflammation and with p53 and cyclin D1
      expression. p53 and c-Ki-ras mutations were detected in 41% (8/19) and 5% (1/19)
      of dysplasia (including carcinoma in situ) in HPs. Our results demonstrate that
      the HP enlarges with enhanced cell turnover and overexpression of p53,
      p21WAF1/CIP1, and cyclin D1, associated with H pylori-related inflammation, and
      that p53 but not c-Ki-ras mutations may have an important role in dysplastic
      change in HPs.

PMID- 11211612
TI  - H-ras oncogene mutation in dedifferentiated liposarcoma. Polymerase chain
      reaction-restriction fragment length polymorphism analysis.
AB  - Point mutations of the ras gene family (K-ras, H-ras, and N-ras) are thought to
      be involved in the development of a variety of human tumors. Dedifferentiated
      liposarcoma is characterized by the coexistence of well-differentiated (WD) and
      high-grade anaplastic (HG) components. The presence of point mutations at codons
      12 and 13 of the H-ras gene was studied in 34 liposarcomas, comprising 15 well
      differentiated liposarcomas and 19 dedifferentiated liposarcomas, and in 8
      storiform-pleomorphic type malignant fibrous histiocytomas (MFHs) using
      polymerase chain reaction-restriction fragment length polymorphism and direct
      sequencing analysis. The 2 components of dedifferentiated liposarcoma were
      analyzed independently. H-ras mutations were seen only in dedifferentiated
      liposarcomas (4/19 [21%]), 1 in WD components and 3 in HG components. The
      mutation was not seen in any of 15 cases of well-differentiated liposarcoma. MFHs
      showed an H-ras mutation in 1 (12%) of 8 cases. Our results seem to suggest that
      the H-ras mutation is a relatively uncommon event in dedifferentiated
      liposarcoma, which may demonstrate an epiphenomenon of dedifferentiation in
      dedifferentiated liposarcoma.

PMID- 11211613
TI  - Sinonasal tract eosinophilic angiocentric fibrosis. A report of three cases.
AB  - Eosinophilic angiocentric fibrosis (EAF) is a rare submucosal fibrosis without a
      well-developed differential diagnosis. Three cases of sinonasal tract EAF were
      identified in 2 women and 1 man, aged 49, 64, and 28 years, respectively. The
      patients experienced a nasal cavity mass, maxillary pain, or nasal obstructive
      symptoms of long duration. The process involved the nasal septum (n = 2), nasal
      cavity (n = 1), and/or the maxillary sinus (n = 1). There was no evidence for
      Wegener granulomatosis, Churg-Strauss syndrome, Kimura disease, granuloma
      faciale, or erythema elevatum diutinum. Histologically, the lesions demonstrated
      a characteristic perivascular "onion-skin" fibrosis and a full spectrum of
      inflammatory cells, although eosinophils predominated. Necrosis and foreign body
      type giant cells were not identified. Surgical excision was used for all
      patients, who are all alive but with disease at last follow-up. Sinonasal tract
      EAF is a unique fibroproliferative disorder that does not seem to have systemic
      associations with known diseases. The characteristic histomorphologic features
      permit accurate diagnosis.

PMID- 11211614
TI  - Nonneoplastic endometrial signet-ring cells. Vacuolated decidual cells and
      stromal histiocytes mimicking adenocarcinoma.
AB  - We describe 5 patients (mean age, 50 years; all had uterine bleeding) whose
      routine endometrial biopsy and curettage specimens contained prominent signet
      ring cells. Each specimen contained loose aggregates of signet-ring cells
      scattered within the endometrial stroma that were characterized by peripherally
      displaced, small, uniform nuclei with indistinct nucleoli and showed no mitotic
      activity. The central portion of the cytoplasm was occupied by single or multiple
      cytoplasmic vacuoles. In all cases, the signet-ring cells were reactive for
      vimentin and negative for epithelial membrane antigen and cytokeratin. Four cases
      were focally positive for muscle-specific actin or smooth muscle actin and
      negative for CD68, Mac387, periodic acid-Schiff, mucicarmine, and alcian blue. In
      these 4 cases, the surrounding endometrial stroma showed decidual changes, and
      the signet-ring cells demonstrated a morphologic continuum with more typical
      decidualized stroma. As such, the signet-ring cells in these cases were
      vacuolated, decidualized endometrial stromal cells. In the remaining case, the
      vacuolar contents of the signet-ring cells were periodic acid-Schiff-positive and
      resistant to diastase predigestion, and the cells reacted with Mac387 and CD68.
      The surrounding stroma showed no decidual reaction. Thus, the signet-ring cells
      in this case were of histiocytic differentiation. Endometrial stroma occasionally
      may contain nonneoplastic signet-ring cells that closely mimic adenocarcinoma. At
      least 2 directions of differentiation, decidual and histiocytic, are possible.

PMID- 11211615
TI  - Diagnostic usefulness of CD23 and FMC-7 antigen expression patterns in B-cell
      lymphoma classification.
AB  - CD23 and FMC-7 are normal B-cell antigens used during diagnostic
      immunophenotyping of suspected lymphoproliferative disorders, but the diagnostic
      usefulness of antigenic expression patterns of simultaneous 2-color staining and
      flow cytometric analysis has not been reported. We evaluated the FMC-7 and CD23
      expression pattern in 201 cases of B-cell lymphoma from tissue biopsy specimens
      by multiparameter flow cytometry. The CD23-/FMC-7+ pattern was the most common
      pattern in large cell, mantle cell, and marginal zone lymphomas. The CD23 and FMC
      7 antigen, along with the CD5 coexpression pattern, permitted accurate
      classification of all 71 cases of small lymphocytic, mantle cell, and marginal
      zone types of lymphoma. The widest variation of patterns was with follicular cell
      lymphoma, although most cases expressed the CD23 +/-/FMC-7+ pattern (+/-, partial
      or minor subset expression). The CD23 and FMC-7 antigen expression pattern was
      predictive of subtypes in more than 95% of lymphoma cases and could narrow the
      differential diagnosis in the remaining cases. We conclude the flow cytometric
      CD23/FMC-7 expression pattern achieved by dual staining facilitates accurate and
      reproducible classification of B-cell lymphomas and has diagnostic usefulness.

PMID- 11211617
TI  - Comparison of four enzyme immunoassays with a western blot assay for the
      determination of type-specific antibodies to herpes simplex virus.
AB  - Most current enzyme immunoassays (EIAs) differentiate inadequately between types
      1 and 2 herpes simplex virus (HSV) antibodies since significant cross-reactivity
      exists. We compared 4 IgG type-specific EIAs using a Western blot assay for
      resolution of discrepant results. The Diamedix had sensitivities of 100% for
      types 1 and 2 but specificities of only 71% and 61%, respectively. The cross
      reactivity rate was 82% in positive samples tested. For HSV types 1 and 2, the
      Zeus sensitivities were 92% and 98%, respectively; specificities were 72% and
      79%, respectively; the cross-reactivity rate was 54%. For HSV types 1 and 2, the
      Wampole sensitivities were 98% and 95%, respectively; specificities were 68% and
      85%, respectively; the cross-reactivity rate was 47%. For HSV types 1 and 2, the
      Meridian sensitivities were 98% and 90%, respectively; specificities were 96% and
      100%, respectively; no cross-reactivity was found between positive samples
      tested. While the Diamedix, Zeus, and Wampole assays showed good sensitivity,
      they lacked type specificity. The Meridian EIA offers the highest specificity
      along with no observed cross-reactivity. This EIA may be an easier, reliable
      alternative to Western blot for the determination of HSV type-specific
      antibodies.

PMID- 11211616
TI  - Bone marrow involvement by nasal NK cell lymphoma at diagnosis is uncommon.
AB  - To look for subtle evidence of marrow involvement in nasal NK cell lymphoma at
      diagnosis, we retrospectively studied trephine biopsy specimens from 25
      consecutive patients by 2 sensitive techniques: CD56 immunohistochemistry and
      Epstein-Barr virus-encoded RNA in situ hybridization (EBER ISH). Only 2 patients
      had marrow involvement by NK cell lymphoma at diagnosis. In 3 additional
      patients, marrow involvement developed during or after systemic recurrence. All 5
      positive cases were revealed by EBER ISH, but only 3 cases showed CD56
      immunoreactivity. Among the 5 cases, only 2 were recognized by morphologic
      assessment. All 5 patients died, often within a short period, compared with a
      mortality of 50% for patients without demonstrable marrow involvement. Marrow
      involvement is distinctly uncommon in nasal NK cell lymphoma at diagnosis, and
      EBER ISH is the most sensitive technique for the demonstration of occult NK cell
      lymphoma. Despite the low frequency of marrow involvement in nasal NK cell
      lymphoma, EBER ISH is worthwhile to identify the minor subgroup of patients with
      a high likelihood of early death due to disease and when autologous bone marrow
      or peripheral blood stem cell transplantation is contemplated.

PMID- 11211618
TI  - Prothrombin measurement using a patient self-testing system. Oral Anticoagulation
      Monitoring Study Group.
AB  - We enrolled 82 patients receiving oral anticoagulation in a pilot trial of a
      point-of-care (POC) prothrombin time (PT) device in a patient self-testing (PST)
      application in 7 US and Canadian hospital-based anticoagulation centers. The
      properly selected and suitably trained patients were given the PT device to test
      at home for 6 weeks. Patients returned within 3 hours of the self-test to the
      hospital clinic where a repeated test was performed by a health care professional
      using the patient's POC device (clinic). Blood specimens were obtained for
      routine laboratory PT determinations by the local hospital laboratory (hospital)
      and a reference laboratory. International Normalized Ratio agreement between the
      home test and the clinic test was excellent. Home results correlated well with
      reference laboratory results. Using the reference laboratory as a standard, 68%
      of hospital and 66% of home results matched the patient's therapeutic range
      classification of the reference laboratory result. Participants overwhelmingly
      reported satisfaction and willingness to perform the self-test. Our results
      confirm the equivalence of the PST PT and a reference laboratory result and
      suggest that PST PT technology is an appropriate and useful adjunct to routine
      oral anticoagulation monitoring methods.

PMID- 11211619
TI  - Point-of-care prothrombin time measurement for professional and patient self
      testing use. A multicenter clinical experience. Oral Anticoagulation Monitoring
      Study Group.
AB  - We enrolled 386 subjects in a multicenter study of a point-of-care (POC)
      prothrombin time (PT) testing device. POC tests were performed by health care
      professionals using venous and finger-stick specimens and by patients using
      finger-stick specimens. Venous blood also was analyzed in the local hospital
      laboratory and a national reference laboratory. Accurate POC results were
      obtained by professionals using both types of specimens. Patients' results were
      equivalent to those of professionals. The identification of the patient's
      therapeutic status based on the International Normalized Ratio (INR) was
      equivalent for POC and local hospital laboratory PT results; 75% of local
      laboratory results and 77% of POC results were within 0.4 INR of reference
      laboratory results, while 93% of either system (POC or local laboratory) were
      within 0.7 INR. Patients overwhelmingly reported satisfaction with the self-test,
      including the finger stick and device operation. The INR from the POC device is
      clinically equivalent to the laboratory INR for assessment of anticoagulation
      status and management decisions in professional and self-testing environments.
      Patients can learn to perform accurate PT testing, and POC PT testing is feasible
      in patients' homes.

PMID- 11211620
TI  - Apolipoprotein A-I-derived amyloid in atherosclerosis. Its association with
      plasma levels of apolipoprotein A-I and cholesterol.
AB  - Wild-type apolipoprotein A-I (apo A-I)-derived amyloid commonly occurs in
      atherosclerotic plaques. To clarify apo A-I amyloid formation, plasma levels of
      apo A-I and cholesterol were related to the presence of amyloid in
      atherosclerotic plaques in 15 patients with peripheral atherosclerosis, subjected
      to arterial reconstruction. Plasma levels of apo A-I and high-density lipoprotein
      (HDL) cholesterol were slightly higher in patients with apo A-I-derived amyloid
      than in those without, but the difference was not significant. Levels of low
      density lipoprotein cholesterol and total cholesterol were significantly higher
      in the group with amyloid. High concentrations of apo A-I in the arterial intima
      are probably of greater importance to amyloid formation than high plasma levels
      of the protein. During atherosclerosis, the acute phase reactant serum amyloid A
      may displace apo A-I from HDL, leading to increased concentration of lipid-free
      apo A-I in the intima and conformational changes of apo A-I, which make it more
      fibrillogenic. Some forms of amyloid fibrils have been shown to be cytotoxic. Apo
      A-I-derived amyloid is possibly a pathogenically important factor in
      atherosclerosis.

PMID- 11211621
TI  - Influence of sodium intake on the reliability of active renin as a measure of the
      renin-angiotensin system in essential hypertension.
AB  - Plasma renin activity (PRA), active renin (AR), prorenin, and angiotensinogen
      were assessed in 486 hypertensive and 175 normotensive subjects with a sodium
      intake of 10 or 200 mEq/d during supine and upright posture and after infusion of
      angiotensin II. PRA and AR levels were compared in hypertensive subjects in each
      condition. With low sodium intake, particularly while upright, there was a
      significant correlation between PRA and AR. In upright subjects with low sodium
      intake who had a PRA of 2.4 ng/mL per hour or less (1.85 nmol.L-1.h-1 or less),
      the correlation was also strong. With high sodium intake, the correlation was
      weaker. With intermediate sodium excretion, the correlation was intermediate.
      Prorenin was less predictive of PRA than was AR, and angiotensinogen had a
      marginal role. Using PRA during sodium restriction while upright as the standard
      for determining renin status, the precision of AR for predicting renin status was
      excellent. AR may be used for surrogate assessment of the renin-angiotensin
      system activity when the system is activated.

PMID- 11211622
TI  - Second opinions in diagnostic anatomic pathology.

PMID- 11211623
TI  - Urinalysis and urine culture.

PMID- 11211624
TI  - Why we need an international agreement on tobacco control.

PMID- 11211625
TI  - Editors' note: the power of pictures.

PMID- 11211626
TI  - The "truth" Tobacco Memorial.

PMID- 11211627
TI  - Cigarettes and the US Public Health Service in the 1950s.
AB  - The conclusion of the United States Surgeon General's Advisory Committee on
      Smoking and Health in 1964 that excessive cigarette smoking causes lung cancer is
      cited as the major turning point for public health action against cigarettes. But
      the surgeon general and US Public Health Service (PHS) scientists had concluded
      as early as 1957 that smoking was a cause of lung cancer, indeed, "the principal
      etiologic factor in the increased incidence of lung cancer." Throughout the
      1950s, however, the PHS rejected further tobacco-related public health actions,
      such as placing warning labels on cigarettes or creating educational programs for
      schools. Instead, the agency continued to gather information and provided
      occasional assessments of the evidence as it came available. It was not until
      pressure mounted from outside the PHS in the early 1960s that more substantive
      action was taken. Earlier action was not taken because of the way in which PHS
      scientists (particularly those within the National Institutes of Health) and
      administrators viewed their roles in relation to science and public health.

PMID- 11211628
TI  - Trends in cigarette smoking in 36 populations from the early 1980s to the mid
      1990s: findings from the WHO MONICA Project.
AB  - OBJECTIVES: This report analyzes cigarette smoking over 10 years in populations
      in the World Health Organization (WHO) MONICA Project (to monitor trends and
      determinants of cardiovascular disease). METHODS: Over 300,000 randomly selected
      subjects aged 25 to 64 years participated in surveys conducted in geographically
      defined populations. RESULTS: For men, smoking prevalence decreased by more than
      5% in 16 of the 36 study populations, remained static in most others, but
      increased in Beijing. Where prevalence decreased, this was largely due to higher
      proportions of never smokers in the younger age groups rather than to smokers
      quitting. Among women, smoking prevalence increased by more than 5% in 6
      populations and decreased by more than 5% in 9 populations. For women, smoking
      tended to increase in populations with low prevalence and decrease in populations
      with higher prevalence; for men, the reverse pattern was observed. CONCLUSIONS:
      These data illustrate the evolution of the smoking epidemic in populations and
      provide the basis for targeted public health interventions to support the WHO
      priority for tobacco control.

PMID- 11211630
TI  - Variation in youthful risks of progression from alcohol and tobacco to marijuana
      and to hard drugs across generations.
AB  - OBJECTIVES: Much research has documented that youthful substance use typically
      follows a sequence starting with use of alcohol or tobacco or both and
      potentially proceeding to marijuana and then hard drug use. This study explicitly
      examined the probabilities of progression through each stage and their
      covariates. METHODS: A secondary analysis of data from the National Household
      Survey on Drug Abuse (1979-1997) was conducted with particular sensitivity to the
      nature of substance use progression, sampling procedures, and reliability of self
      report data. RESULTS: Progression to marijuana and hard drug use was uncommon
      among persons born before World War II. The stages phenomenon essentially emerged
      with the baby boom and rose to a peak among persons born around 1960.
      Subsequently, progression risks at each stage declined. Progression risks were
      also higher among younger initiators of alcohol, tobacco, or marijuana use.
      CONCLUSIONS: The recent increase in youthful marijuana use has been offset by
      lower rates of progression to hard drug use among youths born in the 1970s. Dire
      predictions of future hard drug abuse by youths who came of age in the 1990s may
      be greatly overstated.

PMID- 11211629
TI  - Ten-year changes in smoking among young adults: are racial differences explained
      by socioeconomic factors in the CARDIA study?
AB  - OBJECTIVES: This study investigated whether socioeconomic factors explain
      racial/ethnic differences in regular smoking initiation and cessation. METHODS:
      Data were derived from the CARDIA study, a cohort of 5115 healthy adults aged 18
      to 30 years at baseline (1985-1986) and recruited from the populations of 4 US
      cities. Respondents were followed over 10 years. RESULTS: Among 3950 respondents
      reexamined in 1995-1996, 20% of Whites and 33% of African Americans were smokers,
      as compared with 25% and 32%, respectively, in 1985-1986. On average, African
      Americans were of lower socioeconomic status. Ten-year regular smoking initiation
      rates for African American women, White women, African American men, and White
      men were 7.1%, 3.5%, 13.2%, and 5.1%, respectively, and the corresponding
      cessation rates were 25%, 35.1%, 19.2%, and 31.3%. After adjustment for
      socioeconomic factors, most 95% confidence intervals of the odds ratios for
      regular smoking initiation and cessation in African Americans vs Whites included
      1. CONCLUSIONS: Less beneficial 10-year changes in smoking were observed in
      African Americans, but socioeconomic factors explained most of the racial
      disparity.

PMID- 11211631
TI  - Influence of a counteradvertising media campaign on initiation of smoking: the
      Florida "truth" campaign.
AB  - OBJECTIVES: The purpose of this study was to assess the short-term effects of
      television advertisements from the Florida "truth" campaign on rates of smoking
      initiation. METHODS: A follow-up survey of young people aged 12 to 17 years (n =
      1820) interviewed during the first 6 months of the advertising campaign was
      conducted. Logistic regression analyses were used to estimate the independent
      effects of the campaign on smoking initiation while other factors were controlled
      for. RESULTS: Youths scoring at intermediate and high levels on a media effect
      index were less likely to initiate smoking than youths who could not confirm
      awareness of television advertisements. Adjusted odds ratios between the media
      index and measures of initiation were similar within categories of age, sex,
      susceptibility, and whether a parent smoked. CONCLUSIONS: Exposure to the "truth"
      media campaign lowered the risk of youth smoking initiation. However, the
      analysis did not demonstrate that all such media programs will be effective.

PMID- 11211632
TI  - Simulated effect of tobacco tax variation on population health in California.
AB  - OBJECTIVES: This study simulated the effects of tobacco excise tax increases on
      population health. METHODS: Five simulations were used to estimate health
      outcomes associated with tobacco tax policies: (1) the effects of price on
      smoking prevalence; (2) the effects of tobacco use on years of potential life
      lost; (3) the effect of tobacco use on quality of life (morbidity); (4) the
      integration of prevalence, mortality, and morbidity into a model of quality
      adjusted life years (QALYs); and (5) the development of confidence intervals
      around these estimates. Effects were estimated for 1 year after the tax's
      initiation and 75 years into the future. RESULTS: In California, a $0.50 tax
      increase and price elasticity of -0.40 would result in about 8389 QALYs (95%
      confidence interval [CI] = 4629, 12,113) saved the first year. Greater benefits
      would accrue each year until a steady state was reached after 75 years, when
      52,136 QALYs (95% CI = 38,297, 66,262) would accrue each year. Higher taxes would
      produce even greater health benefits. CONCLUSIONS: A tobacco excise tax may be
      among a few policy options that will enhance a population's health status while
      making revenues available to government.

PMID- 11211633
TI  - The new battleground: California's experience with smoke-free bars.
AB  - OBJECTIVES: This study examined the tobacco industry's tactics in the political,
      grassroots, and media arenas in attempting to subvert California's smoke-free bar
      law, and the efforts of health advocates to uphold and promote the law by using
      the same 3 channels. METHODS: Interviews with key informants involved in the
      development and implementation of the smoke-free bar law were conducted.
      Information was gathered from bill analyses, internal memoranda, tobacco industry
      documents, media articles, and press releases. RESULTS: The tobacco industry
      worked both inside the legislature and through a public relations campaign to
      attempt to delay implementation of the law and to encourage noncompliance once
      the law was in effect. Health groups were able to uphold the law by framing the
      law as a health and worker safety issue. The health groups were less successful
      in pressing the state to implement the law. CONCLUSIONS: It is possible to enact
      and defend smoke-free bar laws, but doing so requires a substantial and sustained
      commitment by health advocates. The tobacco industry will fight this latest
      generation of clean indoor air laws even more aggressively than general workplace
      laws.

PMID- 11211634
TI  - Environmental tobacco smoke and periodontal disease in the United States.
AB  - OBJECTIVES: Cigarette smoking is a leading risk factor for periodontal disease.
      This cross-sectional study investigated the relation between environmental
      tobacco smoke (ETS) and periodontal disease in the United States. METHODS: Data
      were obtained from the Third National Health and Nutrition Examination Survey
      (1988-1994). The outcome was periodontal disease, defined as 1 or more
      periodontal sites with attachment loss of 3 mm or greater and a pocket depth of 4
      mm or greater at the same site. Exposure to ETS at home and work was self
      reported. The study analyzed 6611 persons 18 years and older who had never smoked
      cigarettes or used other forms of tobacco. RESULTS: Exposure to ETS at home only,
      work only, and both was reported by 18.0%, 10.7%, and 3.8% of the study
      population, respectively. The adjusted odds of having periodontal disease were
      1.6 (95% confidence interval = 1.1, 2.2) times greater for persons exposed to ETS
      than for persons not exposed. CONCLUSIONS: Among persons in the United States who
      had never used tobacco, those exposed to ETS were more likely to have periodontal
      disease than were those not exposed to ETS.

PMID- 11211635
TI  - Association of smoking with serum and dietary levels of antioxidants in adults:
      NHANES III, 1988-1994.
AB  - OBJECTIVES: This study examined the association of smoking with serum levels and
      dietary intakes of antioxidants in a nationally representative sample. METHODS:
      This study classified 7873 apparently healthy adults aged 17 to 50 years from
      National Health and Nutrition Examination Survey III (NHANES III) data as
      nonsmokers or as smokers if their serum cotinine levels were either lower than 14
      ng/mL or 14 ng/mL or greater, respectively. SUDAAN software was used for the
      statistical analysis. RESULTS: Smokers of both sexes had significantly (P < .001)
      lower serum levels of vitamin C, alpha-carotene, beta-carotene, beta
      cryptoxanthin, and lutein/zeaxanthin. Reduction in the serum vitamin E, lycopene,
      and selenium levels in smokers was slight. Smokers also had significantly lower
      dietary intakes of vitamin C and beta-carotene. A significant (P < .001) inverse
      relation was found between serum vitamin C and beta-carotene levels and cotinine
      levels independent of diet effect, and a positive relation (P < .001) was found
      between serum levels and dietary intakes. CONCLUSIONS: Antioxidants appear to
      have differing declines in serum levels as a result of reduced dietary intakes
      and the effects of smoking.

PMID- 11211636
TI  - The impact of behavioral counseling on stage of change in fat intake, physical
      activity, and cigarette smoking in adults at increased risk of coronary heart
      disease.
AB  - OBJECTIVES: This study assessed stages of change in fat intake, physical
      activity, and cigarette smoking during a randomized controlled trial of
      behavioral counseling. METHODS: Twenty general practices (primary health care
      centers) were randomized to lifestyle counseling by behavioral methods or to
      usual health promotion. A total of 883 patients were selected for the presence of
      1 or more of the following risk factors: cigarette smoking, high cholesterol, or
      a combination of a high body mass index and low physical activity. Stage of
      change (precontemplation, contemplation, preparation, and action/maintenance) was
      assessed at baseline and after 4 and 12 months. RESULTS: The odds of moving to
      action/maintenance for behavioral intervention vs control patients at 4 months
      were 2.15 (95% confidence interval [CI] = 1.30, 3.56) for fat reduction, 1.89
      (95% CI = 1.07, 3.36) for increased physical activity, and 1.77 (95% CI = 0.76,
      4.14) for smoking cessation. The likelihood of achieving action/maintenance was
      related to baseline stage for all 3 behaviors. CONCLUSIONS: Brief behavioral
      counseling based on advice matched to stage of readiness for change may be
      valuable in encouraging healthy lifestyles among patients in primary care at
      raised risk of cardiovascular disease.

PMID- 11211637
TI  - The benefits of interventions for work-related stress.
AB  - OBJECTIVES: This quantitative meta-analysis sought to determine the effectiveness
      of occupational stress-reducing interventions and the populations for which such
      interventions are most beneficial. METHODS: Forty-eight experimental studies (n =
      3736) were included in the analysis. Four intervention types were distinguished:
      cognitive-behavioral interventions, relaxation techniques, multimodal programs,
      and organization-focused interventions. RESULTS: A small but significant overall
      effect was found. A moderate effect was found for cognitive-behavioral
      interventions and multimodal interventions, and a small effect was found for
      relaxation techniques. The effect size for organization-focused interventions was
      nonsignificant. Effects were most pronounced on the following outcome categories:
      complaints, psychologic resources and responses, and perceived quality of work
      life. CONCLUSIONS: Stress management interventions are effective. Cognitive
      behavioral interventions are more effective than the other intervention types.

PMID- 11211638
TI  - Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a
      29-year follow-up of the Whitehall Study.
AB  - OBJECTIVES: This study examined (1) the relation of employment grade in middle
      age to self-reported poor health and functional limitations in old age and (2)
      whether socioeconomic status at approximately the time of retirement modifies
      health differentials in old age. METHODS: Survivors of the Whitehall Study cohort
      of men were resurveyed. Respondents were aged 40 to 69 years when they were
      originally screened in 1967 to 1970. RESULTS: Compared with senior
      administrators, men in clerical or manual (low-grade) jobs in middle age had
      quadruple the odds of poor physical performance in old age, triple the odds of
      poor general health, and double the odds of poor mental health and disability. At
      most, 20% of these differences were explained by baseline health or risk factors.
      Men who moved from low to middle grades before retirement were less likely than
      those who remained in low grades to have poor mental health. CONCLUSIONS:
      Socioeconomic status in middle age and at approximately retirement age is
      associated with morbidity in old age.

PMID- 11211639
TI  - Smoking during pregnancy in Finland: determinants and trends, 1987-1997.
AB  - OBJECTIVES: This study examined determinants of and trends in smoking during
      pregnancy in Finland from 1987 through 1997. METHODS: A repeated cross-sectional
      investigation of 694,926 women was conducted. RESULTS: The prevalence of smoking
      during pregnancy remained similar from 1987 through 1997 (at 15%). In 1997,
      prevalences of smoking were alarmingly high among young (37%), single (30%), and
      less educated (25%) women and among women living in northern (20%) and eastern
      (19%) Finland. These determinants were persistent over time, with the exception
      of an increase in regional differences. CONCLUSIONS: Despite increasing knowledge
      of adverse effects, smoking during pregnancy has not declined in Finland over the
      past decade.

PMID- 11211640
TI  - Exposure of adolescent girls to cigar images in women's magazines, 1992-1998.
AB  - OBJECTIVES: This study assessed the exposure of adolescent girls to cigar images
      in women's magazines from 1992 to 1998. METHODS: Data were obtained from the 5
      women's magazines with the highest readership of adolescent girls. RESULTS: We
      found a significant upward trend in cigar images portrayed in women's magazines
      and a significant increase in the portrayal of women cigar smokers over the
      period observed. Cigar images were less likely than cigarette images to promote
      tobacco or nontobacco products. Among advertisements, nearly all those that
      featured cigars promoted nontobacco products; advertisements featuring cigarettes
      overwhelmingly promoted tobacco products. CONCLUSIONS: Between 1992 and 1998,
      adolescent readers of women's magazines were increasingly exposed to images of
      cigars.

PMID- 11211641
TI  - The cigar revival and the popular press: a content analysis, 1987-1997.
AB  - OBJECTIVES: The purpose of this study was to examine print media coverage of
      cigars during the period 1987 to 1997. METHODS: A content analysis of 790 cigar
      focused newspaper and magazine articles was conducted. RESULTS: Cigar-focused
      articles increased substantially over the study period, paralleling increased
      cigar consumption. Articles focused on cigar business (39%) and events (19%).
      Only 4% of articles focused on health effects. Sixty-two percent portrayed cigars
      favorably. The tobacco industry was mentioned in 54% of articles and portrayed
      positively in 78%. Forty-two percent of the individuals quoted or described in
      articles were affiliated with the tobacco industry; only 5% were
      government/public health figures. CONCLUSIONS: Print coverage of cigars failed to
      communicate health risk messages and contributed to positive images of cigars.

PMID- 11211642
TI  - Television campaigns and adolescent marijuana use: tests of sensation seeking
      targeting.
AB  - OBJECTIVES: This study evaluated the effectiveness of targeted televised public
      service announcement campaigns in reducing marijuana use among high-sensation
      seeking adolescents. METHODS: The study used a controlled interrupted time-series
      design in 2 matched communities. Two televised antimarijuana campaigns were
      conducted in 1 county and 1 campaign in the comparison community. Personal
      interviews were conducted with 100 randomly selected teenagers monthly in each
      county for 32 months. RESULTS: All 3 campaigns reversed upward developmental
      trends in 30-day marijuana use among high-sensation seekers (P < .002). As
      expected, low-sensation seekers had low use levels, and no campaign effects were
      evident. CONCLUSIONS: Televised campaigns with high reach and frequency that use
      public service announcements designed for and targeted at high-sensation-seeking
      adolescents can significantly reduce substance use in this high-risk population.

PMID- 11211643
TI  - Tobacco use and quit attempts among methadone maintenance clients.
AB  - OBJECTIVES: This study examined tobacco use prevalence, types of tobacco used,
      interest in quitting, and prior quit attempts among persons in methadone
      maintenance treatment. METHODS: Counselors collected surveys from 84% (550 of
      655) of all clients in a 4-county metropolitan area. RESULTS: Most clients (77%)
      smoked cigarettes. Of the 59 former tobacco users, only 6 reported using a
      cessation pharmacotherapy to quit. Three quarters of the current smokers had
      attempted to quit at least once, with an average of 5 attempts. Most smokers
      (80%) were "somewhat" or "very" interested in quitting. CONCLUSIONS: The quit
      ratio among methadone maintenance treatment clients was 12%, compared with 50%
      nationwide. To reduce morbidity and mortality, cessation interventions must be
      developed and disseminated.

PMID- 11211644
TI  - Support for smoke-free restaurants among Massachusetts adults, 1992-1999.
AB  - OBJECTIVES: The authors examined trends and predictors of public support for
      smoke-free restaurants in Massachusetts. METHODS: Since 1992, the Massachusetts
      Behavioral Risk Factor Surveillance System has asked survey respondents about
      their attitudes toward smoking in restaurants. Analyses using data from 1992 to
      1999 characterized changes over time in support for smoke-free restaurants and
      the role of demographic and smoking-related factors in predicting support.
      RESULTS: During 1992 to 1999, the rate of support for smoke-free restaurants
      increased from 37.5% to 59.8%, with similar increases among current, former, and
      never smokers. After adjustment for smoking status, support was associated with
      socioeconomic characteristics, race/ethnicity, and household smoking rules. Among
      current smokers, lighter smokers and those who were trying to quit were more
      likely to endorse smoke-free restaurants. CONCLUSIONS: There has been a
      substantial increase in support for smoke-free restaurants among both smokers and
      nonsmokers in Massachusetts.

PMID- 11211646
TI  - Intention to use the female condom following a mass-marketing campaign in Lusaka,
      Zambia.
AB  - OBJECTIVES: This report examines intention to use the female condom among men and
      women in Lusaka, Zambia, who were exposed to mass-marketing of the female condom.
      METHODS: The study used data from a representative sample of consumers at outlets
      that sell or distribute the female condom and the male condom. RESULTS: In spite
      of a high level of awareness of the female condom, use of this method in the last
      year was considerably lower than use of the male condom. Intention to use the
      female condom in the future was highest among respondents who had used only the
      female condom in the last year. CONCLUSIONS: The female condom is likely to be
      most important for persons who are unable or unwilling to use the male condom.

PMID- 11211645
TI  - Maternal smoking and the risk of early weaning: a meta-analysis.
AB  - OBJECTIVES: This study reviewed evidence on the effect of maternal smoking on
      early weaning. METHODS: The following databases and journals were searched:
      Medline, Scientific Citation Index, Pediatrics, Journal of Pediatrics, New
      England Journal of Medicine, and Lancet. Analysis was restricted to studies in
      which infants who had never been breastfed were excluded or the prevalence of
      breastfeeding initiation was more than 90%. RESULTS: In smoking vs nonsmoking
      mothers, the random effects odds ratio for weaning before 3 months was 1.93 (95%
      confidence interval [CI] = 1.55, 2.40). An adjusted odds ratio of 1.50 (95% CI =
      1.34, 1.68) was shown in studies that had lost-to-follow-up rates below 15% and
      included adequate adjustment for confounding. CONCLUSIONS: Maternal smoking
      increases the risk of early weaning.

PMID- 11211647
TI  - Where children sit in cars: the impact of Rhode Island's new legislation.
AB  - OBJECTIVES: This study evaluated the impact of Rhode Island's legislation
      requiring children younger than 6 years to sit in the rear of motor vehicles.
      METHODS: Roadside observations were conducted in Rhode Island and Massachusetts
      in 1997 and 1998. Multivariate regression was used to evaluate the proportion of
      vehicles carrying a child in the front seat. RESULTS: Data were collected on 3226
      vehicles carrying at least 1 child. In 1998, Rhode Island vehicles were less
      likely to have a child in the front seat than in 1997 (odds ratio = 0.6; 95%
      confidence interval = 0.5, 0.7), whereas no significant changes in child
      passenger seating behavior occurred in Massachusetts during that period.
      CONCLUSIONS: Rhode Island's legislation seems to have promoted safer child
      passenger seating behavior.

PMID- 11211648
TI  - Importance of attributable risk in monitoring adverse events after immunization:
      hepatitis B vaccination in children.
AB  - OBJECTIVES: Most vaccine safety data present only the postvaccination incidence
      of all adverse events rather than an estimate of attributable risk. This study
      sought to illustrate the difference between the 2 estimates with data from a
      hepatitis B immunization program. METHODS: The incidence of health problems
      occurring before and after each dose of hepatitis B vaccine in a cohort of 1130
      children were compared. RESULTS: Although 47.5% of all children reported an
      adverse event during the 4 weeks following each of the 3 doses, adverse events
      attributable to immunization occurred in only 10.6% of children. CONCLUSIONS:
      Postimmunization incidence systematically overestimates the risk of adverse
      events. Estimating actual attributable risk is necessary to avoid false beliefs
      regarding immunization.

PMID- 11211649
TI  - When is a cigar not a cigar? African American youths' understanding of "cigar"
      use.

PMID- 11211650
TI  - Diabetes care in community health centers: a reasonable standard of comparison?

PMID- 11211651
TI  - Improving diabetes care in community health centers.

PMID- 11211652
TI  - Does a fifth mechanism exist to explain lightning injuries?

PMID- 11211653
TI  - Money and medical science.

PMID- 11211654
TI  - Promises and challenges in tissue engineering.

PMID- 11211655
TI  - Contributions of the vacuum tube to early electrophysiological research.

PMID- 11211656
TI  - Human exposure to radio frequency and microwave radiation from portable and
      mobile telephones and other wireless communication devices--a COMAR technical
      information statement.

PMID- 11211657
TI  - Starting up an EMBS student branch.

PMID- 11211658
TI  - Automated control in biomedicine.

PMID- 11211659
TI  - Automated regulation of hemodynamic variables.

PMID- 11211660
TI  - Multitasked closed-loop control in anesthesia.

PMID- 11211661
TI  - The subcutaneous route to insulin-dependent diabetes therapy.

PMID- 11211662
TI  - The intravenous route to blood glucose control.

PMID- 11211663
TI  - Cloning biological synergies improves control of elbow neuroprosthesis.

PMID- 11211665
TI  - Robotic assistants aid surgeons during minimally invasive procedures.

PMID- 11211666
TI  - Repairing the damage.

PMID- 11211664
TI  - Surface-stimulation technology for grasping and walking neuroprosthesis.

PMID- 11211667
TI  - Pleistocene diets. Would we be healthier if we ate more like our ancient
      ancestors? What you need to know.

PMID- 11211668
TI  - ANAC's role in Cuba: what should it be?

PMID- 11211669
TI  - Correlates of sleep quality in persons with HIV disease.
AB  - This study used the Symptom Experience dimension of the revised UCSF Symptom
      Management Conceptual model to examine correlates of sleep quality in HIV
      infected persons. According to this model, person, health/illness, and
      environment categories influence perception of a symptom. The average person in
      the sample (N = 58) reported being HIV-infected for 8.5 years and was 46 years
      old, not working, and a person of color. Depending on the level of data, either
      chi square or Pearson correlations were computed between the person,
      health/illness, and environment categories and the dependent variable, sleep
      quality, as measured by the Pittsburgh Sleep Quality Index. Person variables
      significantly related to sleep quality were employment status, trait anxiety, and
      general well-being. Health/illness variables significantly related to sleep
      quality were length of time living with HIV disease and five health status
      measures (depressive symptoms, state anxiety, symptom severity, daytime
      sleepiness, and functional status). The environmental variables associated with
      sleep quality were sleeping alone, having a separate bedroom, and sleeping in a
      noisy room. Correlates of better sleep quality are positive general well-being,
      less anxious personality trait and emotional state, less daytime sleepiness, less
      depressive symptoms, and less symptom severity. Correlates of worse sleep quality
      are impaired functional status and longer duration of living with HIV disease.

PMID- 11211670
TI  - Effects of individualized acupuncture on sleep quality in HIV disease.
AB  - Although it may begin at any point, sleep disturbance often appears early in HIV
      disease and contributes to decreased quality of life during the course of the
      illness. Relatively few studies have explored the complex nature of poor sleep
      quality in HIV disease or tested interventions to improve sleep quality. The
      purpose of this study was threefold: explore the nature of sleep quality in HIV
      disease, test the relationship between pain and sleep quality, and test the
      effectiveness of acupuncture delivered in a group setting for improving sleep
      quality in those who are HIV infected. A pretest, posttest, preexperimental
      design was used to test the effects of acupuncture on sleep quality.
      Participating in the study were 21 HIV-infected men and women between the ages of
      29 and 50 years who reported sleep disturbance three or more times per week and
      who scored greater than 5 on the Pittsburgh Sleep Quality Index. The Wrist
      Actigraph was used to measure sleep activity, and the Current Sleep Quality Index
      was used to measure sleep quality for 2 nights before and after a 5-week
      acupuncture intervention (10 treatments). Acupuncture was individualized to
      address insomnia and other symptoms reported by the participants. Sleep activity
      and sleep quality significantly improved following 5 weeks of individualized
      acupuncture delivered in a group setting.

PMID- 11211671
TI  - Mother-child interaction in the presence of maternal HIV infection.
AB  - This comparative study evaluated mother-child interaction in southeastern U.S.
      mother-child dyads where the mother was HIV positive and determined if the
      presence of maternal HIV infection was associated with differences in the quality
      of the mother-child interaction. A comparison was made between two groups of
      mother-child dyads, one where the mother was HIV positive (N = 25) and one where
      the mother was not HIV positive (N = 25). The Barnard model of mother-infant
      interaction guided this study. The quality of interaction within the dyads was
      assessed using the Nursing Child Assessment Teaching Scales (NCATS). Associated
      maternal, child, and environmental factors were described using an interview
      form, Centers for Epidemiologic Studies Depression Scale, and the Bayley Infant
      Neurodevelopmental Screener. The quality of mother-child interaction in the two
      groups was compared using chi square and paired t tests. Findings from this
      research showed no statistically significant difference in mother-child
      interaction (measured by NCATS) between the HIV-positive and HIV-negative groups.
      Although maternal symptoms of depression were noted in more of the HIV-positive
      mothers, covariant analysis failed to show this factor had any significant
      influence on mother-child interaction scores between the groups. It was noted
      that total sample (N = 50) group mean scores on NCATS maternal subscale and total
      interaction were significantly lower than published population norms. As the
      mother-child interaction has critical implications for the child, strategies to
      improve reciprocity need to be developed in this population, and attention must
      be paid to mental health needs of HIV-positive women.

PMID- 11211672
TI  - The status of HIV/AIDS nursing in Australia: a specialty in decline?
AB  - Since the introduction of highly active antiretroviral therapy (HAART), occasions
      of service for patients with HIV/AIDS have altered drastically. HIV/AIDS nurses
      perceived that this change in activity had caused an exodus from the specialty by
      experienced nurses, and those that remained were rapidly deskilling. A survey of
      nurses working in HIV/AIDS in Australia and New Zealand was conducted to assess
      the impact of HAART on nursing skills and retention. More than 72% of respondents
      reported that they had lost some or many clinical HIV/AIDS nursing skills. About
      37% of nurses reported that they were losing confidence in their knowledge of the
      management of opportunistic infections and cancers. About 27% reported larger
      numbers of nurses leaving their specialty area than in previous years. To enable
      nurses to respond rapidly to a potential decline in the effectiveness of HAART,
      this loss in skills and knowledge must be addressed.

PMID- 11211673
TI  - Predictors of quality of life in AIDS patients.
AB  - BACKGROUND: While much work has been completed in relation to measuring and
      defining the varying dimensions of quality of life in HIV/AIDS, very little
      research attention has been directed toward identifying factors that influence or
      enhance quality of life. OBJECTIVE: This study examined whether variables
      relating to demographic characteristics, severity of illness, psychological
      status, or level of engagement in nursing care would predict quality of life in
      persons with advanced or late stage HIV/AIDS. METHODS: A convenience sample of
      162 hospitalized male and female patients with AIDS participated in this study.
      The participants completed the HIV Symptom Checklist, the Beck Depression
      Inventory, the HIV-QAM (a measure of changes in the status of hospitalized AIDS
      patients due to nursing care), and two measures of engagement in nursing care.
      The Living With HIV Scale was used as the measure of quality of life. The two
      components of this scale were analyzed independently. RESULTS: The strongest
      predictor of decreased quality of life scores was depression (accounting for 23%
      of the variance), with symptoms accounting for 9.75% and female gender accounting
      for an additional 8%. Two measures of patient engagement with nursing care
      providers contributed a total of 13.44% of the variance in quality of life
      scores. CONCLUSIONS: The findings emphasize the importance of recognizing and
      treating depression in persons with HIV/AIDS. The number of symptoms and their
      frequency also has a profound effect on quality of life. Although modest, study
      findings suggest that quality of life for an acutely ill, hospitalized patient
      with AIDS is enhanced through more active involvement or engagement in the
      process of nursing care.

PMID- 11211674
TI  - AIDS, nursing, and physician-assisted suicide: Part 2.
AB  - Nurses who work in HIV/AIDS care often hold conflicting views from each other
      about appropriate nursing roles in relation to physician-assisted suicide.
      Regardless of whether the individual nurse supports or opposes physician-assisted
      suicide, nurses in HIV/AIDS care need to have a broad knowledge base of the legal
      and ethical issues related to physician-assisted suicide. This article has as its
      major purpose to provide nurses with the knowledge base they need to assist them
      in their work in clinical practice, education, policy development, and research.

PMID- 11211676
TI  - Landmark study on lipodystrophy demonstrates evolving perceptions by physicians
      who treat people living with HIV.

PMID- 11211675
TI  - Protection of human subjects: turbulent times.

PMID- 11211677
TI  - American International Health Alliance joins Medical Advocates for Social Justice
      to launch HIV/AIDS Russian language Internet partnership.

PMID- 11211678
TI  - The strain of cervical sprains.

PMID- 11211679
TI  - Words on standardized languages.

PMID- 11211680
TI  - Words on standardized languages.

PMID- 11211681
TI  - Words on standardized languages.

PMID- 11211682
TI  - Words on standardized languages.

PMID- 11211684
TI  - Election aftermath. How will the 2000 vote affect health care?

PMID- 11211685
TI  - 'It's not all in your head': irritable bowel syndrome.

PMID- 11211686
TI  - Emergency! Acute cholecystitis.

PMID- 11211687
TI  - Dysphagia: going down and staying down.

PMID- 11211688
TI  - Certified registered nurses: results of the Study of the Certified Workforce.

PMID- 11211689
TI  - Meperidine--a liability.

PMID- 11211690
TI  - Counting nurses: what is community health-public health nursing?

PMID- 11211692
TI  - Book of the Year Awards. The most valuable texts of 2000, as chosen by AJN's
      panel of judges.

PMID- 11211691
TI  - Rethinking the relationship between nursing and diversity.

PMID- 11211693
TI  - RN,C: what's in a letter?

PMID- 11211694
TI  - The journey of lifelong learning.

PMID- 11211695
TI  - You're not one of us. When discrimination based on national origin becomes a
      problem.

PMID- 11211696
TI  - Nursing comes to light. A tragedy and a film, both astonishing, illuminate our
      everyday heroes.

PMID- 11211697
TI  - Staffing: the ANA's primary concern.

PMID- 11211698
TI  - [Evaluation of antibiotic preparations for children from a standpoint of water
      solubilities].
AB  - The evaluation of seven widely-used antibiotic preparations [five cephem
      antibiotics; cefaclor (CCL), cefpodoxime proxetil (CPDX-PR), cefdinir (CFDN),
      cefditoren pivoxil (CDTR-PI), cefcapene pivoxil (CFPN-PI), one macrolide;
      clarithromycin (CAM) and one penem; faropenem sodium (FRPM)] for children were
      performed from a standpoint of water-solubilities, both as a preparation and as a
      component drug. As the results, these preparations showed great differences in
      the water-solubilities when added 10 ml water to 0.5 g of each preparation. That
      is, their solubilities differed from about 40% (CFPN-PI) to 100% (FRPM) as a
      preparation, and from nearly 0% (CAM) to 100% (FRPM, CCL) as a component drug.
      Additionally, about a half of the insoluble residues were found to be the
      component drug, in the cases of three preparations (CPDX-PX, CFDN, CDTR-PI) which
      were solubilized at 80-90%. From these results, it was suggested that the
      marketed antibiotic preparations for children might be classified into three
      categories; i.e., [A] preparation for solution and suspension (FRPM, CCL), [B]
      preparation suitable to suspension (CPDX-PR, CFDN, CDTR-PI), and [C] fine granule
      preparation for children unsuitable to suspension (CFPN-PI, CAM). Consequently,
      the names for dosage-forms of these preparations should be standardized.

PMID- 11211699
TI  - [Clinical effects of cefoselis (CFSL) on infections in obstetric and gynecologic
      field and prevention of postoperative infections].
AB  - Clinical effects of cefoselis (CFSL) on various infections and prevention of
      postoperative infections in the field of obstetrics and gynecology were
      investigated with a total of 100 patients of 8 facilities in Yamagata and the
      following results were obtained: 1. For the patients (n = 70) who received the
      treatment with CFSL at 2 g/day for 5 days to prevent postoperative infections,
      the treatment was effective for such infections in 68 of 69 (98.6%) except one to
      whom the treatment was discontinued during the course. 2. For the patients with
      infections (n = 30) who were treated with CFSL at 2-4 g/day for 5-7 days, the
      treatment was markedly effective in 8/30 (26.7%), effective in 21/30 (70%) and
      not effective in 1/30 (3.3%). The overall rate of efficacy was 29/30 (96.7%).
      Based on the clinical effects for each isolate, the bacteriological efficacy was
      evaluated as 29/29 and the rate of bacterial eradication for each isolate was
      23/29 (79.3%). 3. Laboratory test revealed liver functional abnormalities in one
      patient and eruption, a subjective/objective symptom caused by CFSL was noted in
      two patients. These results suggest that CFSL is effective for various infections
      in obstetric and gynecologic field and also the prevention of postoperative
      infections.

PMID- 11211700
TI  - Food poisoning associated with the ingestion of fiddleheads--Quebec 1999.

PMID- 11211701
TI  - Waterborne outbreak of gastroenteritis associated with a contaminated municipal
      water supply, Walkerton, Ontario, May-June 2000.

PMID- 11211702
TI  - An outbreak of Salmonella enteritidis linked to baked goods from a local bakery
      in lower Mainland, British Columbia.

PMID- 11211703
TI  - Does smoking contribute to community acquired pneumonia?

PMID- 11211704
TI  - Are evaluation and research mutually exclusive for division of general practice?

PMID- 11211705
TI  - The clown doctors.
AB  - BACKGROUND: In 1996 The Humour Foundation was established in Australia, drawing
      on inspiration from the work of Patch Adams and the Clown Care Unit in New York.
      The mission statement of the Foundation is to introduce and promote the health
      benefits of humour to patients, their families and health care professionals.
      OBJECTIVE: To describe the work of the Clown Doctors in Australia and the role of
      humour in relieving suffering. DISCUSSION: Clown Doctor Units have been
      established at several major hospitals throughout Australia. They use performance
      skills, humour, empathy and sensitivity to support, nourish, divert and help
      patients (and staff) cope with difficult situations.

PMID- 11211706
TI  - Happiness and humour. A medical perspective.
AB  - BACKGROUND: The medical profession's focus on dealing with negative mental states
      has led to the suggestion of classifying 'happiness' as a major affective
      disorder (pleasant type). OBJECTIVE: To describe the symptoms and signs of
      happiness and discuss its health benefits. DISCUSSION: Epidemiological data
      suggests that happiness is related to personality factors such as high self
      esteem, feelings of personal control and extroversion and is unrelated to
      demographic factors or the ownership of consumer goods. Humour is a communication
      device specifically designed to elicit joy and happiness and is effective in
      relieving anxiety and stress and enhances communication in medical settings.
      Recapturing the optimistic enchantment with life that is a part of childhood may
      be a key to happiness and health.

PMID- 11211707
TI  - Finding your funny bone. Incorporating humour into medical practice.
AB  - BACKGROUND: Many people confuse seriousness with professionalism. Humour enables
      you to separate who you are from the difficult work you do. OBJECTIVE: To
      illustrate ways humour and fun can be incorporated into day to day working life.
      DISCUSSION: People are more productive, cooperative and flexible when they have
      fun at work. Becoming a humour consumer of tapes, jokes, TV shows, movies or
      funny books, strengthens your sense of humour, relieves stress and improves
      relationships.

PMID- 11211708
TI  - How humour keeps you well.
AB  - BACKGROUND: The beneficial effect of humour on health has long been recognised
      anecdotally and intuitively but studying and quantifying that effect is
      difficult. 'Studying humour is like dissecting a frog--you may know a lot but you
      end up with a dead frog.' (Mark Twain) OBJECTIVE: To describe some of the
      psychological and physiological effects of laughter and the health benefits of
      humour. DISCUSSION: Stress reduction has been shown to improve outcomes in the
      treatment of many health problems. While there are inherent difficulties in
      structuring studies to assess the impact of humour and laughter on health,
      positive psychological and physiological responses to laughter have been
      demonstrated in a variety of settings. In particular, laughter has a role in
      stress hormone reduction, improving mood, enhancing creativity, pain reduction,
      improving immunity and reducing blood pressure.

PMID- 11211709
TI  - Haemorrhoids. Essentials of clinical management.
AB  - BACKGROUND: Haemorrhoids are a frequent and familiar concern of patients in the
      GP surgery setting. OBJECTIVE: In this article, practical guidelines regarding
      the diagnosis and treatment of haemorrhoidal disease will be discussed.
      DISCUSSION: Careful diagnostic skills are required to recognise the differences
      between internal and external haemorrhoids and other significant anorectal
      pathology. With appropriate diagnosis, most haemorrhoids can be treated
      successfully nonsurgically in an office setting.

PMID- 11211710
TI  - Renal colic and recurrent urinary calculi. Management and prevention.
AB  - BACKGROUND: Urinary calculi are a relatively common problem and up to 80% of
      patients with calculi who are untreated will experience one or more recurrences
      within five years. OBJECTIVE: This paper outlines the causes of urinary calculi
      and presents evidence for the less conventional treatment of renal colic with
      NSAIDs such as intramuscular diclofenac in preference to traditional pethidine
      injections. The paper also deals with ways to prevent recurrence of stone
      formation. DISCUSSION: Effective treatment requires a clear understanding of the
      cause, and investigations need to be directed toward establishing this.
      Prevention is the cornerstone of management and requires patients to have a clear
      understanding of the problem. Follow up of these patients is essential.

PMID- 11211711
TI  - Intracavernosal injection therapy. Does it still have a role in erectile
      dysfunction?
AB  - BACKGROUND: Male erectile dysfunction (ED) is a common problem in the community.
      It may go unnoticed unless specific questions are asked. The range of management
      options has increased markedly over the past two decades. OBJECTIVE: This article
      revisits the option of intracavernosal injection therapy for male erectile
      dysfunction. DISCUSSION: Erectile dysfunction has attracted considerable interest
      and research. The recent availability of an orally effective medication
      (sildenafil) has brought about a paradigm shift in its management.

PMID- 11211712
TI  - The near fatal lick.

PMID- 11211713
TI  - The art of exchanging.

PMID- 11211714
TI  - The AFP tradition continues....

PMID- 11211715
TI  - Practice tip. The pulley suture.

PMID- 11211716
TI  - Developing palliative care services in regional areas. The Ipswich Palliative
      Care Network model.
AB  - BACKGROUND: Although there are over 350 palliative care services present in
      Australia and New Zealand, the distribution of these is patchy. Patients in some
      regional and rural areas have little or no access to specialist services, and
      manage with the enthusiasm and general expertise of local practitioners.
      OBJECTIVE: This paper discusses the problems encountered in maintaining skills in
      palliative care in the face of small patient numbers and poor resources, and
      describes a solution that was developed in Ipswich, Queensland. DISCUSSION: The
      twin problem of GP skills maintenance and adequate community service provision in
      palliative care can be overcome by developing a general practice based service in
      conjunction with local health authorities and the community. Highlighting the
      benefits to the health authority and the community of maximal general
      practitioner involvement is the most important lever in securing cooperation.

PMID- 11211718
TI  - Enhanced primary care. Small step, giant change.

PMID- 11211717
TI  - The unkindness of cancers. Names change but the problem stays the same.

PMID- 11211719
TI  - Implementation of the enhanced primary care items requires ongoing education and
      evaluation.
AB  - OBJECTIVE: The study aimed to evaluate the uptake and usage of the Federal
      Government's Enhanced Primary Care (EPC) items by general practitioners in outer
      urban general practice. METHOD: Faxed questionnaire with telephone follow up of a
      random sample of 347 GPs in South West Sydney, in March and April 2000. RESULTS:
      There was a response rate of 70.6%. Seventy-three percent of respondents reported
      they had heard of the EPC package and 27% of all the respondents had used one or
      more of the items. Twenty-three percent had claimed for health assessments
      (median number 3), 4.5% for care plans (median number 3) and 4% for case
      conferences (median number 1). Just under half of the GPs who had claimed for
      health assessments had conducted them in the patient's home. Most GPs either had
      no system for the use of the items or planned to use them opportunistically.
      Forty-nine percent of GPs had an age-sex register and those who did were more
      likely to have claimed for an EPC item and to have specific plans for their use.
      CONCLUSION: While most GPs had heard of the EPC items, only a minority had used
      them and few planned to use them systematically within their practice. There is a
      need to address barriers to the uptake of the EPC items and to provide greater
      support to GPs and health professionals involved with their implementation,
      especially for care plans and case conferences. Evaluation of the EPC items needs
      to be an integral part of the implementation process.

PMID- 11211720
TI  - Care planning and case conferencing. Building effective multidisciplinary teams.
AB  - BACKGROUND: The new Medicare items that cover care plans and multidisciplinary
      case conferences for patients with complex and chronic medical conditions have
      introduced new challenges in primary health care. General practitioners may be
      required to develop new skills if they are to work effectively with other
      professionals and carers where health is not their only priority. OBJECTIVES:
      This paper reports briefly on findings from a particular research project into
      the key factors that contribute to effective multidisciplinary teams. Principles
      from this research that can be applied to GPs being involved in multidisciplinary
      care plans and case conferences will be examined. DISCUSSION: Key factors
      discussed include the importance of efficiency, flexibility, an holistic view of
      the patient, communication and personal and professional characteristics that
      contribute to a successful outcome in multidisciplinary patient care.

PMID- 11211722
TI  - 75+ health assessments.
AB  - BACKGROUND: The Enhanced Primary Care package (EPC) includes item numbers for
      annual health assessment of people aged 75 years and over. Nursing or allied
      health staff can perform these as home visits and save the general practitioner
      considerable time. OBJECTIVE: Explanatory notes for conducting these assessments
      are described with reference to the RACGP guidelines in print or on the internet.
      DISCUSSION: 75+ health assessments (75+ HA) represent an opportunity for GPs to
      improve the functional status of their elderly patients at the same time as
      building team work with nursing and allied health professionals.

PMID- 11211721
TI  - Colorectal cancer screening--what the guidelines don't tell you.

PMID- 11211723
TI  - Colorectal cancer in women--the need for prevention.

PMID- 11211724
TI  - Sustainable practice ... for men too.

PMID- 11211725
TI  - International law and global public health.

PMID- 11211726
TI  - [Spinocerebellar degeneration and Ca channel abnormality].

PMID- 11211727
TI  - [Molecular and clinical features of SCA 7].

PMID- 11211728
TI  - [Spinocerebellar ataxia type 8(SCA 8)].

PMID- 11211729
TI  - [Molecular genetic analysis in the clinical neuro-oncology].

PMID- 11211730
TI  - [Classification of spinocerebellar degeneration (SCD)].

PMID- 11211731
TI  - Evaluation of distal and proximal axonal degeneration in patients with carpal
      tunnel syndrome.
AB  - In patients with carpal tunnel syndrome, varying degrees of demyelination and
      axonal degeneration occur in the median nerve. Only a few studies have examined
      axonal degeneration produced at proximal to the lesion. In this study proximal
      axonal degeneration was evaluated and compared with other parameters. In 40
      consecutive CTS patient hands, distal latency (DL), compound muscle action
      potential amplitude (CMAP) and motor conduction velocity (MCV) were analyzed by
      conventional motor nerve conduction studies. Intrafascicular compound nerve
      action potential amplitude (N-CNAP) at the elbow after wrist simulation and its
      nerve conduction velocity (NCV) between wrist and elbow were also analyzed. The
      negative correlation of DL with CMAP was statistically significant (r = 0.577, p
      < 0.001). CMAP was correlated with either MCV (r = 0.537, p < 0.001) or N-CMAP (r
      = 0.710, p < 0.001). A significant correlation of MCV with NCV (r = 0.517, p <
      0.001) was also indicated. There were no any other significant correlation among
      the parameters. In CTS the degree of demyelination and axonal degeneration
      influence the prognosis for nerve recovery after decompressive surgery. DL is
      mainly influenced by demyelination that results in conduction block and slowing
      at the carpal tunnel. CMAP and N-CNAP indicate the degree of axonal degeneration
      at distal and proximal to the compression site. As in electrophysiologic
      evaluation of mononeuropathies, proximal axonal degeneration is best assessed by
      both stimulation and recording electrode locationing proximal to the lesion.
      Recording of intrafascicular nerve action potential was a little invasive method,
      but it provided important informations. The negative correlation between DL and
      CMAP implies that distal axonal degeneration can occur in proportion to the
      conduction disturbance. Moreover, N-CNAP had a higher correlation with CMAP. The
      greater the distal axonal degeneration, the more the proximal axonal
      degeneration. Conduction velocity represents the velocity of the fastest
      conduction fiber, not the degree of axonal degeneration.

PMID- 11211732
TI  - [Hemorrhages of dorsal root ganglia and sensory disturbance in congenitally
      hydrocephalic HTX rats].
AB  - Recently we reported the frequent occurrence of hemorrhages in the dorsal root
      ganglia of congenitally hydrocephalic HTX rats, an animal model of human
      congenital hydrocephalus. Therefore, we hypothesized that sensory disturbance
      might be present in these rats. In order to evaluate the sensory abnormality
      quantitatively, we injected 50 microliters of 5% formalin into the footpad of the
      left hind paw of hydrocephalic (n = 5) and non-hydrocephalic HTX rats (n = 5) and
      Wistar rats (n = 5) on postnatal days 17-23, and then recorded the licking
      response time for 60 min after injection. The mean licking time in the early (0
      10 min) and late (10-60 min) phases was significantly longer in hydrocephalic HTX
      rats than in non-hydrocephalic HTX and Wistar rats (P < 0.05). Histologically,
      hemorrhages in the dorsal root ganglia were found in all five hydrocephalic
      animals, of which two had shown thalamic degeneration. These findings suggest
      that lesions in the dorsal root ganglia and thalamus may correspond to the
      sensory disturbance observed in congenitally hydrocephalic HTX rats.

PMID- 11211733
TI  - [Relationship between hyperglycemia following head injury and neurological
      outcome].
AB  - Severe head injury is associated with a stress response that includes
      hyperglycemia, which has been shown in both experimental and clinical studies to
      exacerbate the severity of brain injury during ischemic conditions. To define the
      relationship between serum glucose levels and the outcome of patients suffering
      from closed head injury, we retrospectively reviewed the clinical courses of 88
      consecutive head-injured patients. The patients were divided into two groups
      according to their GCS score on admission: severely head-injured group (GCS score
      of 8 or less) in 36 patients; moderately head-injured group (GCS score of 9 to
      12) in 52 patients. Severely head-injured group had significantly higher serum
      glucose levels than moderately head-injured group (mean +/- standard error of the
      mean; 201 +/- 4.6 mg/dl vs. 171.4 +/- 3.8 mg/dl) (p < 0.01). Patients who
      subsequently resulted in severe disability, vegetative state, or death had
      significantly higher serum glucose levels than patients who had good recovery or
      moderate disability (204.9 +/- 5.9 mg/dl vs. 162.9 +/- 5.1 mg/dl) (p < 0.01).
      Cases with a fatal clinical course were mostly associated with high glucose
      levels. All patients who showed a serum glucose level greater than 240 mg/dl on
      admission were dead. These data suggest that the hyperglycemia on admission is a
      frequent component of the stress response to head injury, a significant indicator
      of severity of injury and a potent predictor of the outcome from head injury.

PMID- 11211734
TI  - [Unusual MR findings of Wernicke encephalopathy with cortical involvement].
AB  - We report a 48-year-old chronic alcoholic man, who developed consciousness
      disturbance, oculomotor paresis, and flaccid tetraplegia. His dietary habit was
      very poor since one month prior to the present admission and he was drinking
      alcoholic beverage. On admission on April 19, 1999, he showed disturbance of
      consciousness, tetraparesis without sensory disturbance, gaze paresis, and
      vertical nystagmus on downward gaze. His blood thiamine level was 12 ng/ml
      (normal range: 23.8-45.9). MRI demonstrated symmetric hyperintense lesions in the
      motor and premotor cortices bilaterally, in addition to other changes indicating
      Wernicke's encephalopathy. His motor weakness and oculomotor disturbance improved
      after treatment with intravenous thiamine. His cortical MRI also normalized. We
      believe that his cortical abnormality was responsible for his motor paresis and
      this is an unusual and unique finding for Wernicke's encephalopathy.

PMID- 11211735
TI  - [Isolated abducens nerve palsy caused by the compression of the basilar artery: a
      case report].
AB  - Several pathological etiologies are responsible for abducens nerve palsy, but a
      neuro-vascular compression of the basilar artery has rarely been recognized as
      one of the causes. We performed magnetic resonance imaging of the brainstem of 71
      year-old female patient with left abducens nerve palsy using constructive
      interference in the steady state (CISS) method, which allowed high-resolution T 2
      weighted imaging and detection of the artery and nerves as high and low intensity
      area respectively. MRI with CISS revealed the compression of the abducens nerve
      by the basilar artery at the root exit zone. During the first examination her
      systolic blood pressure was over 180 mmHg, so we prescribed hypotensive agents
      until it to normalized. Her symptom of abducens nerve palsy improved after a few
      days. It is conceivable that compression of the basilar artery may have caused
      isolated abducens nerve palsy as disclosed by MRI with CISS.

PMID- 11211736
TI  - [An operated case of bitemporal lobe epilepsy associated with old infarction in
      the left occipital lobe].
AB  - A 15-year-old female, who presented with bitemporal lobe epilepsy associated with
      old infarction in the left occipital lobe, was reported. MRI with fluid
      attenuated inversion recovery sequence demonstrates cortical atrophy with
      hyperintensity of the white matter in the left occipital lobe as well as volume
      loss and hyperintensity of the left hippocampus. Interictal positron emission
      tomography with [18F]fluorodeoxy glucose (FDG-PET) and single photon emission
      computed tomography with technetium-99m-ethyl-cysteinate dimer indicate
      hypometabolism and hypoperfusion in the left occipital lobe and the left temporal
      lobe, respectively. Scalp recorded EEG did not lateralize the side of the
      epileptogenic zone. Chronic subdural electrode recording demonstrated that the
      ictal onset zones were located in the bilateral side of the temporal lobe. Eighty
      nine percent of 19 spontaneous seizures were left sided onset. The anterior
      temporal lobectomy with hippocampectomy was performed for the left side. Although
      temporal lobe epilepsy is sometimes a bilateral disease, unilateral lobectomy for
      a strong predominant side, based on the MRI and FDG-PET findings, is effective
      for some patients.

PMID- 11211737
TI  - [A case of cerebral venous thrombosis with reversible brain parenchymal lesions:
      usefulness of diffusion weighted imaging and measurement of apparent diffusion
      coefficient].
AB  - A 47-year-old man with a history of thrombophlebitis of his left leg for several
      years presented with a mild left hemiparesis and ipsilateral hypesthesia.
      Magnetic resonance imaging showed subacute thrombosis of the superior sagittal
      sinus and a cortical vein of the right cerebral hemisphere. A linear hyperintense
      area was found in the white matter of the right postcentral gyrus on T 2- and
      diffusion weighted axial imagings on the 7 days after the onset. The patient was
      treated conservatively, and his clinical course was uneventful. His neurological
      dysfunctions recovered within approximately three weeks after the onset. The
      white matter lesion in the right postcentral gyrus also disappeared one month
      later. The apparent diffusion coefficients (ADCs) in the white matter of the pre-
      and postcentral gyrus were measured bilaterally on the ADC mapping imaging. In
      the subacute stage, the ADC values in the white matter of the right pre- and
      postcentral gyrus were 0.50 x 10(-3) mm2/sec and 0.91 x 10(-3) mm2/sec,
      respectively. The %ADC indicating the ratio of ADC value of the lesion to that of
      the contralateral brain tissue was calculated. The %ADCs in the white matter of
      the pre- and postcentral gyrus were 64.9% and 124.5% respectively. In the chronic
      stage, the ADC values in the white matter of the right pre- and postcentral gyrus
      were 0.96 x 10(-3) mm2/sec and 0.99 x 10(-3) mm2/sec, and the %ADCs improved to
      106.7% and 106.5% respectively. The lesions in the white matter of the right pre-
      and postcentral gyrus were reversible. The former was thought to be mainly
      ascribed to cellular edema and the latter was vasogenic edema. The present case
      showed when %ADC of the ischemic lesion in cerebral venous thrombosis was higher
      than 60%-70%, conservative therapy alone is sufficient effective for the
      improvement of neurological deficits.

PMID- 11211738
TI  - [Tiny aneurysms of cortical arteries presenting as an acute subdural hematoma: a
      case report].
AB  - A case of an acute subdural hematoma due to the rupture of a tiny aneurysm of a
      cortical artery is described. A 68-year-old man lightly hit the right side of his
      head. About 1 hour later, he became drowsy and exhibited moderate hemiparesis on
      the left side on admission. Computed tomographic scanning demonstrated an acute
      subdural hematoma on the right temporoparietal region. In the past, he had
      undergone the clipping of a non-ruptured aneurysm and a subdural-peritoneal shunt
      operation on the same side in another hospital. On surgical evacuation of the
      subdural hematoma, a pulsating bleeding from a ruptured tiny aneurysm of a
      cortical artery was observed. There were also some similar tiny aneurysms on
      other cortical arteries. A photograph of such a tiny aneurysm was first taken and
      presented.

PMID- 11211739
TI  - [Cerebral venous angioma with parenchymal high intensity on T 2-weighted images].

PMID- 11211740
TI  - [Lipoma of the insula: MRI features].

PMID- 11211741
TI  - [Adrenergic receptor and knockout mouse: 2). Alpha adrenergic receptor knockout
      mouse].
AB  - The sympathetic nervous system regulates cardiovascular function by activating
      adrenergic receptors which are known to have a critical role in regulating
      transmitter release from sympathetic nerves and from adrenergic neurons in the
      central nervous system. alpha 2A adrenergic receptor knockout mouse (alpha 2A-KO)
      showed an increase in sympathetic activity with resting tachycardia, depletion of
      cardiac tissue norepinephrine concentration. Knockout mouse study reveals that
      the alpha 2B adrenoceptor (alpha 2B AR) mediates the hypertensive response, and
      the alpha 2A AR mediates the hypotensive response, induced by alpha 2 agonists.
      Both the alpha 2A and alpha 2C AR subtypes are required for normal presynaptic
      control of transmitter release from sympathetic nerves. alpha 2A AR subtype
      inhibits transmitter release at high stimulation frequencies, whereas the alpha
      2C AR subtype modulates neurotransmission at lower levels of nerve activity. Salt
      induced hypertension experiment using alpha 2B-KO and alpha 2C-KO revealed that
      alpha 2B AR subtype is necessary to raise BP in response to dietary salt loading.
      Lack of adequately functional renal alpha 2B AR is thought to preclude
      reabsorption of sodium. alpha 1B-KO study revealed that alpha 1B AR is a mediator
      of the blood pressure response and the aorta contractile response induced by
      alpha 1 agonists.

PMID- 11211742
TI  - [The effects of intravenous nicardipine on jugular venous oxygen saturation].
AB  - We investigated the effects of intravenous nicardipine on jugular venous oxygen
      saturation (SjO2) in patients undergoing superficial temporal artery-middle
      cerebral artery anastomosis. Anesthesia was induced with intravenous thiamylal
      and fentanyl, and maintained by isoflurane and nitrous oxide in oxygen. In the
      presence of stable condition after the induction, nicardipine 0.5 microgram.kg
      1.min-1 was administered intravenously for 180 minutes. Mean arterial pressure,
      heart rate, SjO2 and bladder temperature were recorded. Three hours after
      continuous infusion of nicardipine, plasma levels of nicardipine in artery and
      jugular vein were measured by liquid chromatography. The arterial concentration
      of nicardipine reached 23.9 +/- 8.06 ng.ml-1. The area under the curve between
      the arterial and jugular venous nicardipine during infusion was significantly
      different. Mean arterial pressure was reduced in response to administration of
      nicardipine. There were no significant changes in heart rate, bladder temperature
      and SjO2. We concluded that the current dose of nicardipine reached effective
      concentration for systemic hypotension without influencing SjO2.

PMID- 11211743
TI  - [Low concentration/high volume is more effective than high concentration/low
      volume for postoperative continuous epidural analgesia with the combination of
      bupivacaine and fentanyl].
AB  - In 40 females undergoing gynecologic laparotomy, lumbar epidural analgesia using
      a disposable infusion pump was continued for postoperative 48 hours. Then the
      analgesic effect of epidural bupivacaine (4.8 mg.kg-1) plus fentanyl (12
      micrograms.kg-1) diluted with normal saline was prospectively compared between
      the two groups; high concentration/low volume group (HC/LV, 96 ml of total volume
      and 2 ml.h-1 of infusion rate, n = 20) versus low concentration/high volume group
      (LC/HV, 240 ml of total volume and 5 ml.h-1 of infusion rate, n = 20). On
      postoperative day 1, LC/HV group showed the significantly lower visual analog
      scale and verbal pain score at rest than HC/LV group (P < 0.05). No significant
      differences in the incidence of side effects were observed between the groups.
      These results suggest that when the equivalent dose is given, the volume rather
      than the concentration of the solution is important for postoperative continuous
      epidural analgesia with the combination of bupivacaine and fentanyl.

PMID- 11211744
TI  - [A case of hyperperfusion syndrome treated successfully by propofol].
AB  - Carotid endoarterectomy was performed for a 67-year-old male with severe stenosis
      in the right carotid artery under propofol-fentanyl anesthesia. After the
      surgery, blood pressure was controlled by sodium nitroprusside to maintain at the
      preoperative level. On the first postoperative day, he was alert and without
      neurological deficit, but he became restless with the left hemiparesis appearing
      on the next day. ECD-SPECT revealed hyperperfusion of the right hemisphere.
      Propofol was administered at the dose of 3-5 mg.kg-1.h-1 to normalize the
      perfusion. It appears that the cerebral blood flow was normalized. Hyperperfusion
      after carotid endoarterectomy can be controlled by propofol.

PMID- 11211745
TI  - [The influence of age on hemodynamics and the dose requirements of propofol and
      buprenorphine in total intravenous anesthesia].
AB  - A retrospective study was performed to determine the influence of age on
      hemodynamics and awakening time in total intravenous anesthesia (TIVA) with
      propofol and buprenorphine for spinal surgery. Twenty patients (26-79 yr) were
      studied and allocated into following four groups by age: 26-49 yr, 50-59 yr, 60
      69 yr, and elderly 70-79 yr. All patients were premedicated with midazolam (2.5-5
      mg) i.m. Anesthesia was induced (60-180 ml.h-1) and maintained (20-60 ml.h-1)
      with propofol infusion with 40% oxygen in air, added with vecuronium and one
      single dose of buprenorphine (0.08-0.2 mg; 1.37-2.63 micrograms.kg-1) before
      incision. Mean arterial pressure was stable and did not differ in four groups.
      Heart rate was decreased (P < 0.01) in the elderly group compared with the group
      younger than 50 yr. Bradycardia (below 50 beat.min-1) occurred in 60% of the
      elderly group. An adequate dose of buprenorphine (microgram) was proposed as: 208
      - 1.8 x age (yr) + 0.3 x weight (kg) (r = 0.90, P < 0.01). The induction and
      maintenance rates (ml.h-1) of propofol were decreased with age and increased with
      weight (P < 0.05). However, the maintenance dose of propofol (3.9-8.5 mg.kg-1.h
      1) did not correlate with age. Awakening time was prolonged (P < 0.05) in the
      elderly group (17.0 +/- 7.2 min) as compared with the group of younger than 50 yr
      (8.0 +/- 3.9 min). The three patients requiring postoperative analgesics were
      younger than 60 yr. This study suggests that we should reduce the dose of
      buprenorphine with age in TIVA using propofol. About 50% of the dose given to the
      patient younger than 50 yr was considered adequate in the elderly group.

PMID- 11211746
TI  - [Anesthetic management for mitral valve replacement in a patient with idiopathic
      hypereosinophilic syndrome].
AB  - We have experienced anesthetic management for mitral valve replacement in a 48
      year-old female with idiopathic hypereosinophilic syndrome. Preoperative
      examination showed mild biventricular dysfunction. Anesthesia was induced and
      maintained with meticulous administration of fentanyl and midazolam in 66%
      oxygen. Administration of dopamine, dobutamine and prostaglandin E1 contributed
      to reducing afterload and maintaining cardiac output. The operative and
      postoperative courses were uneventful. Hypereosinophilic syndrome is one of the
      identified causes of restrictive cardiomyopathy. Anesthesia for patients with
      hypereosinophilic syndrome must be carried out carefully, because heart or
      respiratory failure is the most dangerous complication. In patients with
      hypereosinophilic syndrome requiring general anesthesia, perioperative steroid
      cover is advisable. This may reduce or prevent serious lung complications.

PMID- 11211747
TI  - [An immediately post-operative death of a patient undergoing right external
      carotid artery-posterior cerebral artery bypass].
AB  - We experienced an immediately post-operative death due to rupture of a giant
      basilar aneurysm four hours after right external carotid artery-posterior
      cerebral artery bypass surgery. As we had had preanesthetic discussions with
      neurosurgeons repeatedly, they did not seek for a cause of the death on our
      anesthetic management. However, in general, not few surgeons believe that many
      postsurgical complications may be mainly due to anesthetic management but not to
      surgery as they believe that their surgical procedures are always faultless.
      Therefore, we should have a wealth of anesthetic knowledge to respond to any
      surgeon's questions regarding anesthetic management and to precisely explain a
      causal relation between postsurgical complications and anesthesia. In addition,
      we should have frequent discussions with surgeons on postsurgical management in
      sick patients. These may reduce misapprehensions of surgeons, patients and their
      family for anesthesia.

PMID- 11211748
TI  - [Anesthesia for emergency surgery in a patient with Shy-Drager syndrome].
AB  - A 53-year-old man with Shy-Drager syndrome underwent emergency surgery for the
      resection of the larynx under general anesthesia. Anesthesia was induced with
      fentanyl 0.1 mg and thiopental 100 mg, and endotracheal intubation was
      facilitated with vecuronium 8 mg. The onset of action of vecuronium was very
      slow. Anesthesia was maintained with about 1% of sevoflurane, with nitrous oxide
      3 l.min-1 in oxygen 3 l.min-1. Norepinephrine was effective for hypotension while
      dopamine was not. He was extubated on the first postoperative day without any
      complications. The effects of vecuronium, norepinephrine, and dopamine might be
      changed in the patient with Shy-Drager syndrome.

PMID- 11211749
TI  - [Pulmonary embolism during laparoscopic cholecystectomy detected by sudden
      decrease in end-tidal carbon dioxide pressure].
AB  - We report a case of intraoperative pulmonary embolism, detected by a sudden
      decrease in end-tidal carbon dioxide pressure (PETCO2). The patient was a 56-year
      old female without any history of pulmonary disease. The patient was intubated
      and ventilated manually during the operation under anesthesia with sevoflurane,
      nitrous oxide, and vecuronium. The percutaneous oxygen saturation (SpO2) and
      PETCO2 were monitored continuously. Twenty minutes after starting the
      laparoscopic procedure, PETCO2 decreased suddenly from values between 34 and 38
      mmHg to 24 mmHg, and SpO2 decreased from 99% to 95%. Nitrous oxide was
      discontinued. Removal of the drape revealed profound subcutaneous emphysema.
      Postoperative pulmonary scanning revealed areas with reduced pulmonary perfusion
      (Fig. 2). An intravenous bolus of heparin (3000 IU) was given immediately,
      followed by 10,000 IU heparin over the next 24 hours. The patient was discharged
      on the fifteenth postoperative day without any sequelae. Although monitoring
      pulmonary arterial pressure is generally considered a more reliable method for
      the early detection of pulmonary embolism, an invasive monitoring procedure, such
      as the insertion of a Swan-Ganz catheter, is usually not indicated in
      laparoscopic surgery. For the early detection of pulmonary embolism, we therefore
      recommend the continuous monitoring of PETCO2 during laparoscopic surgery.

PMID- 11211750
TI  - [Perioperative management of life-threatening intra-abdominal bleeding with intra
      aortic balloon occlusion catheter].
AB  - Intra-thoracic aortic clamping using an intra-aortic balloon occlusion catheter
      (IABOC) is employed for patients with life-threatening intra-abdominal and/or
      extra-abdominal bleeding in spite of massive transfusion. For perioperative
      management, we inserted an IABOC preoperatively into a 59-year-old man with life
      threatening intra-abdominal bleeding from an abscess formed around his
      traumatically injured pancreas. We could perform a safe operation in which
      bleeding was controlled by intermittently occluding the IABOC and the patient was
      thus prevented from developing into severe hemorrhagic shock. We experienced a
      usefulness of IABOC for a patient with life-threatening intra-abdominal bleeding
      uncontrolled due to intra-abdominal adhesion during the perioperative period.
      However, organ dysfunctions caused by ischemia and reperfusion following intra
      aortic balloon occlusion must be prevented by shortening the occlusion time
      through use of an intermittent method such as described above.

PMID- 11211751
TI  - [A case of ventricular tachycardia immediately after electroconvulsive therapy in
      a schinzophrenic patient].
AB  - A 33 year-old man weighting, 93 kg with schizophrenia underwent repeated
      electroconvulsive therapy (ECT) under general anesthesia with thiamylal 200 mg
      and suxamethonium 80 mg. On his fourth ECT, he developed ventricular tachycardia
      (VT) immediately after the treatment under general anesthesia with the same
      agents. The duration of VT was approximately 30 s. The VT returned to sinus
      rhythm without any special treatment. We speculate that light anesthesia with a
      small amount of thiopental associated with release of serum potassium caused by
      suxamethonium induced increased release of catecholamine by ECT to cause VT.
      After that incident, the patient underwent ECT six times under general anesthesia
      with thiamylal 250 mg and vecuronium 8 mg, in combination with preventive
      injection of magnesium sulfate 20 g without any cardiovascular complications. We
      conclude that the anesthetic management of patients undergoing ECT under general
      anesthesia should be paid a careful attention for cardiovascular instability,
      even if they do not have any heart diseases.

PMID- 11211752
TI  - [Anesthetic experience of emergency coronary artery bypass graft operation in a
      patient with cardioamyloidosis].
AB  - A 76-year-old woman with acute myocardial infarction underwent an emergency
      coronary artery bypass graft operation. She developed cardiac failure and sick
      sinus syndrome before the surgery because she was with cardioamyloidosis.
      Therefore, intra-aortic balloon pumping and the pacemaker were used to maintain
      the hemodynamics prior to the operation. Anesthesia was induced with midazolam 5
      mg, morphine 30 mg and pancuronium 5 mg, and maintained with 0.3-0.5% isoflurane
      in 50% nitrous oxide and 50% oxygen. Morphine 10 mg was also injected during the
      surgery, and the total dose of morphine 40 mg was administered. The pacemaker at
      80 bpm was inserted and mexiletine 0.5 mg.kg-1.h-1 was given to prevent
      ventricular arrhythmias at weaning from cardio-pulmonary bypass. The surgical
      operation was successfully performed and the postoperative course was uneventful.
      A combination of light inhalation anesthesia with narcotics may be a choice for
      anesthetic management of patients with cardioamyloidosis as this method has less
      influence on hemodynamics.

PMID- 11211753
TI  - [Anesthetic management for thoracoscopic bullae resection using epidural
      anesthesia].
AB  - We report the anesthetic management for elective thoracoscopic bullae resection
      (TBR) using high thoracic epidural (TE) anesthesia in awake patients. Pain and
      cough reflex caused by the surgical procedure could be controlled well with high
      TE anesthesia using 20-25 ml of 2% lidocaine. Respiratory and hemodynamic
      conditions remained stable during the surgical procedure. High TE anesthesia
      using a large dose of local anesthetic is thought to be suitable for TBR.

PMID- 11211754
TI  - [Hydrothorax during diagnostic laparoscopy].
AB  - An 83-yr-old, 44-kg woman with a 2-month history of abdominal distension received
      diagnostic laparoscopy. Except for chronic treated hypertension, she was healthy.
      The preoperative chest X-ray demonstrated small pleural effusion occupying the
      lower left hemithorax, but she did not present with dyspnea or chest pain. After
      premedication with intravenous ranitidine 50 mg, anesthesia was induced with
      thiopental 150 mg, vecuronium 7 mg and maintained by 1-2% sevoflurane in 50%
      N2O/O2. SpO2 decreased after insufflation of CO2, but breath sound was audible on
      both lungs. At completion of operation, chest X-ray revealed the left hemilateral
      hydrothorax and 650 ml of pleural fluid was suctioned. Blood gas improved and the
      tracheal tube was removed. The diagnosis of tuberculous peritonitis was
      established by the demonstration of granulomas of the peritoneum. We speculated
      on four reasons for the increased pleural effusion on the left thorax: 1)
      Increase of systemic and capillary pressure caused by CO2 insufflation. 2)
      Increase of capillary permeability by tuberculous pleuritis. 3) Decrease of
      colloid osmotic pressure by hypoalbuminemia. 4) Decreased pleural fluid removal
      because of venous compression caused by increased intrathoracic pressure.
      Peritoneal insufflation of CO2 to create the pneumoperitoneum may induce
      hydrothorax in patients with tuberculous pleuritis.

PMID- 11211755
TI  - [Anesthesia for a patient with cardiac sarcoidosis].
AB  - Anesthesia for a 49-year-old man with cardiac sarcoidosis is reported.
      Preoperative cardiac examination showed left ventricular dysfunction (ejection
      fraction = 27%) and myocardial conduction defects. In addition, his previous
      history included atrial fibrillation and cerebral infarction. Transesophageal
      echocardiography showed thrombus in the left appendage. Anesthesia was induced
      with fentanyl and diazepam and maintained with fentanyl and isoflurane.
      Perioperative hemodynamic monitoring included direct arterial pressure, central
      venous and pulmonary artery pressure and continuous cardiac output. In addition,
      transesophageal echocardiography was useful for watching thrombus in the left
      appendage. His hemodynamic condition was stable and no neurological complication
      was noted after anesthesia.

PMID- 11211756
TI  - [Marked bradycardia during anesthetic induction treated with temporary cardiac
      pacing in a patient with latent sick sinus syndrome].
AB  - A 59 year-old woman with latent sick sinus syndrome was scheduled to undergo
      ophthalmic surgery including phacoemulsification and aspiration, vitrectomy,
      photocoagulation and intraocular lens under general anesthesia. Preoperative ECG
      showed sinus rhythms of 77 bpm without bradycardia or a sinus pause. Total
      intravenous anesthesia with propofol, fentanyl, ketamine and vecuronium was
      employed for the induction of anesthesia immediately followed by severe
      bradycardia with a rate of 36-40 bpm including sinus arrest and atrio/nodal
      escaped beats. Intravenous atropine was ineffective to restore the heart rate and
      then urgent temporary pacing was successfully applied to overcome bradycardia.
      The patient recovered uneventfully from anesthesia. She complained of being dizzy
      and faint with prominent bradycardia due to sick sinus syndrome three months
      after the surgery. Therefore she underwent permanent cardiac pacemaker
      implantation successfully. Temporary pacing is mandatory when anesthesia is given
      to surgical patients with latent sick sinus syndrome.

PMID- 11211757
TI  - [Comparison by simulation of the efficiency of surgical blood order equation
      (SBOE) with that of maximum surgical blood order schedule (MSBOS)].
AB  - The maximum surgical blood order schedule (MSBOS) is used to promote efficient
      blood ordering practice for surgical patients. A surgical order equation (SBOE)
      was developed to calculate the number of units of red blood cells that should be
      ordered considering specific patient variables. We compared the efficiency of
      SBOE with that of the MSBOS by simulations. A retrospective study compared the
      SBOE with the MSBOS for ordering red blood cells units (MAP) in patients for six
      types of operations at our hospital. The SBOE was calculated as follows: SBOE
      (units) = mean blood loss (g)/200 - (preoperative Hb - postoperative Hb) divided
      by (40/body weight (kg)). The SBOE reduced the ordered units more effectively
      than the MSBOS. The SBOE reduces crossmatch-to-transfusion ratio (C/T ratio) from
      1.2 to 1.6 but it would reduce the ordered units in statistical significance in
      only two of six types of operations. In conclusion, the SBOE could improve C/T
      ratio.

PMID- 11211758
TI  - [Effect of colforsin daropate hydrochloride after cardiopulmonary bypass].
AB  - We evaluated the effects of colforsin daropate hydrochloride (CDH) after
      cardiopulmonary bypass (CPB) in comparison with milrinone. CDH or milrinone were
      given during and after CPB combined with cathecholamines so as to maintain mean
      arterial pressure (mABP > 60 mmHg) and cardiac index (CI > 3.0 l.min-1.m-2).
      Hemodynamics measurement was done immediately after CPB (A 1), one hour after CPB
      (A 2) and after the chest closure (A 3). In CDH group, mABP was significantly
      higher compared with milrinone group. Also, CDH group showed a significant
      reduction in the cases of combined use of dobutamine (at A 2, A 3) and
      norepinephrine (at A 1, A 2) compared with milrinone group. In conclusion,
      colforsin daropate hydrochloride exerts more inotropic effect and could reduce
      the necessity of combined use of cathecholamine compared with milrinone.

PMID- 11211759
TI  - [A comparison of the effectiveness of transtracheal heating and humidification
      system in maintaining body temperature during general anesthesia with low flow
      gases].
AB  - We evaluated the effectiveness of transtracheal heating and humidification system
      in maintaining body temperature during general anesthesia with low flow gases in
      12 gastric cancer patients. Patients were divided into two group; Control group A
      in which a hot-water circulating system was used and group B in which a
      transtracheal heating and humidification system by ANAMED HUMITUBE was used,
      during gastric cancer operation. Compared to the hot-water circulating system,
      the transtracheal heating and humidification system is more effective for
      maintaining body temperature and humidification after abdominal lavage by warm
      saline water. But there was no difference between the two groups about awakening
      from general anesthesia. We concluded that transtracheal heating and
      humidification system by ANAMED HUMITUBE is effective in maintaining body
      temperature under general anesthesia with low flow gases.

PMID- 11211760
TI  - [The Baxter AS 50 syringe pump: a comparison with propofol-specific syringe
      pumps].
AB  - We used a Baxter AS 50 syringe pump for intravenous anesthesia with propofol, and
      compared it with a Grasby 3500 and a Terumo STC-525 X pumps, which are
      specifically designed for propofol infusion. The AS 50 pump is a programmable
      syringe infusion pump, which allows us to register up to 70 drug names in 10
      categories and various infusion modes for drugs. There are 14 types of continuous
      infusion mode, a custom dilution mode, and three types of time infusion modes.
      The continuous infusion mode in mg.kg-1.h-1 is available for propofol anesthesia.
      Operation of this pump is simple and user-friendly, as with for the other
      propofol-specific pumps. Although the AS 50 pump is limited to a maximum bolus
      rate of 438 ml.h-1, this restriction is not a serious problem in clinical
      practice. The AS 50 pump is also equipped with an RS-232 C digital interface port
      to allow external remote monitoring or automated control. On-line simulation of
      blood propofol concentration is possible with a simulation program such as
      Propofol-Mon. Our impression is that the AS 50 pump is compact, easy to use,
      accurate and reliable for propofol anesthesia.

PMID- 11211761
TI  - [Evaluation of off-pump coronary artery bypass grafting based on systemic
      inflammatory response syndrome].
AB  - Assessment of the less-invasiveness of off-pump coronary artery bypass grafting
      (OP-CAB) was made by the view point of systemic inflammatory response syndrome
      (SIRS). Single vessel OP-CAB with median sternotomy (MS(+)OP-CAB group, n = 13),
      single vessel OP-CAB without median sternotomy (MS(-)OP-CAB group, n = 9), two
      vessels conventional coronary artery bypass grafting (C-CAB) by normothermic
      extra corporeal circulation with steroid (methylprednisolone) (s(+)C-CAB group, n
      = 13), and two vessels C-CAB without steroid (s(-)C-CAB group, n = 13) were
      compared with each other. The criteria for SIRS was two or more of the following
      conditions: (1) temperature > 38.0 degrees C, (2) respiratory rate > 20
      breaths/min, (3) heart rate > 90 beats/min, (4) white blood cells > 12,000
      cells/mm3. Patients' date such as age, sex, risk factors, ejection fraction,
      operation time, aortic or LAD clamping time, frequency of SIRS, duration of SIRS,
      total application number of SIRS, mean application number of SIRS,
      hospitalization period, rate of renal or liver dysfunction were compared, and the
      following results were obtained. 1) MS(+)OP-CAB group had less-invasiveness than
      s(-)C-CAB group. The invasiveness of extra corporeal circulation was clear. 2)
      s(+)C-CAB group had equal invasiveness to MS(+)OP-CAB group. The anti-SIRS effect
      and organ protect effect of steroid was suggested. 3) MS(-)OP-CAB group had equal
      invasiveness to MS(+)OP-CAB group. The invasiveness of median full sternotomy was
      not so strong.

PMID- 11211762
TI  - [A case of Marie-Bamberger syndrome caused by growth hormone-producing lung
      cancer: problems associated with peri- and postoperative management of patients
      with growth hormone-producing tumors from the standpoint of the "second attack"
      theory].
AB  - Marie-Bamberger syndrome is identical to pulmonary hypertrophic osteoarthropathy,
      and the causative factors have not been thoroughly clarified yet. Therefore,
      further studies of each case would seem to be useful to shed some light on the
      pathogenesis. We reported a 48-year-old man with primary lung cancer associated
      with clubbing of the fingers and hypertrophic osteoarthropathy. Chest CT
      portrayed a 10 x 6.5-cm bulky mass with central necrosis in the left upper lobe.
      The serum level of growth hormone (GH) showed about a twenty-fold increase over
      the normal upper limit. With the emergence of SIRS (Systemic Inflammatory
      Response Syndrome), the patient's general condition took a downhill course. We
      considered this state to be an oncological emergency and performed a semi-urgent
      operation. Immunohistochemical evaluation revealed a poorly differentiated
      adenocarcinoma with GH production. After treatment, the serum level of GH
      normalized and the clubbing and the periosteal changes of the bones resolved,
      which suggests that GH plays an etiologic role in Marie-Bamberger syndrome.
      Recent studies have indicated that GH has immunostimulatory effects. From the
      standpoint of the "second attack" theory, surgical stress seems to act on the
      immune system already activated by GH (so called "priming") in the form of a
      second attack, and trigger an excessive inflammatory response leading to
      postoperative organ injury in patients who suffer from GH-producing tumors. Thus,
      we should recognize this immanent risk and perform peri- and postoperative
      management for patients with GH-producing tumors.

PMID- 11211763
TI  - [Efficacy of additional Dor approach to coronary bypass grafting in severe left
      ventricular dysfunction with large akinetic area].
AB  - Between January 1994 and August 1999, we experienced 16 cases of coronary artery
      bypass grafting (CABG) in severe left ventricular dysfunction with left
      ventricular ejection fraction (LVEF) < or = 40%. Four had additional
      endoventricular patch plasty in large postinfarction akinetic scars, the so
      called Dor approach, to CABG (group D). Eleven had only CABG, or CABG and mitral
      annuloplasty (group C). One had linear repair after the resection of the left
      ventricular aneurysm. One died of sustained low output syndrome 5 months after
      the operation in group C. Fractioning shortening and left ventricular diastolic
      diameter were not changed after the operation in group C. On the other hand, in
      group D, there were no complications after the operation, LVEF was significantly
      improved from 31.5 +/- 4.9% to 62.5 +/- 5.9% (p < 0.01) and the left ventricular
      end-diastolic volume index was reduced from 118 +/- 23 ml/m2 to 74 +/- 12 ml/m2
      (p < 0.01). The Dor approach is considered to be a safe and effective additional
      procedure to CABG in severe patients with a large akinetic antero-septal segment.

PMID- 11211765
TI  - [Two cases of patch closure of pericardial defects using fascia lata after
      pulmonary resection with pericardiectomy].
AB  - We reported two cases of patch closure of pericardial defects using fascia lata
      after pulmonary resection with pericardiectomy. We confirm many advantages of
      this method-cheap, low risk of infection, tight tissue and easy technique in a
      short time with no skilled hand.

PMID- 11211764
TI  - [Efficacy of modified ultrafiltration in reoperation for valvular disease].
AB  - We evaluated the efficacy of modified ultrafiltration (MUF) in reoperation for
      valvular disease. Fourteen patients were divide into two groups consisting of a
      control group (n = 6) and a MUF group (n = 8). MUF was carried out for fifteen
      minutes immediately after the completion of cardiopulmonary bypass. The blood
      flow through the ultrafilter was 300 ml/min and about 1,200 ml of water was
      removed. The hematocrit elevated significantly from 25% to 31% in the MUF group
      (p < 0.05). The percentage of the increase in body weight after the operation in
      the MUF group was significantly less than that in the control group (3.3 +/- 3.1%
      vs 8.3 +/- 4.3%, p < 0.05). The PaO2/FIO2 after the operation in the MUF group
      was significantly higher than that in the control group (376 +/- 125 mmHg vs 242
      +/- 79 mmHg, p < 0.05). The duration of mechanical ventilation in the MUF group
      was significantly less than that in the control group (1.1 +/- 1.1 days vs 5.3 +/
      3.3 days, p < 0.05). In conclusion, MUF is useful to hemoconcentrate, reduce
      postoperative body weight gain and promote early recovery of pulmonary function
      in reoperation for valvular disease.

PMID- 11211766
TI  - [Experiences of minimally invasive great saphenous vein graft harvest using with
      endopath].
AB  - We have experienced 20 cases of minimally invasive great saphenous vein graft
      harvest using with endoscopy, Endopath, from March 1999. As we experienced cases,
      we can harvest great saphenous vein graft, about 30-40 cm in size, from only two
      4-cm incisions for about 50 minutes. There are no wound infection, pain, and
      edema. Great saphenous vein graft harvesting with Endopath is less invasive,
      painless after surgery and makes patients satisfied about cosmetic problem.

PMID- 11211767
TI  - [Tricuspid valve replacement using right heart bypass in patient with liver
      cirrhosis].
AB  - A successful case with liver cirrhosis underwent re-tricuspid valve replacement
      (TVR) using right heart bypass is reported herein. A 59-year-old lady previously
      undergone tricuspid valve replacement with bioprosthetic valve had suffered from
      exertional fatigue as the feature of congestive heart failure. She also presented
      severe liver dysfunction owing to chronic hepatitis and cardiac liver cirrhosis.
      She was diagnosed with structural deterioration of bioprosthesis in tricuspid
      position. She underwent re-TVR with right heart bypass consisted of centrifugal
      pump, heparin coating circuit and blood reservoir. This system lacked of
      membranous oxygenator in order not to activate various kinds of chemical mediator
      which leads to postoperative liver dysfunction. Postoperative course was
      uneventful and she is doing well 1 year after the operation. Although the
      mortality of the TVR in the patient with cirrhosis remains still high, this new
      technique seems to provide better outcome in this kind of patients.

PMID- 11211768
TI  - [Inferior mini-sternotomy for off-pump CABG using bilateral internal thoracic
      arteries].
AB  - Case 1: A 72-year-old woman with effort angina underwent coronary artery bypass
      grafting. A preoperative coronary angiogram showed 90% stenosis in the proximal
      main RCA, and total occlusion in the proximal LAD, distal of which was an area
      well supplied by collaterals from the RCA. This patient had previously undergone
      right upper lobectomy due to lung cancer. With a skin incision of 8 cm, the LITA
      was inserted into the LAD and the RITA was inserted into the mid RCA through an
      inferior mini-sternotomy while the heart was beating. Case 2: A 69-year-old man
      with effort angina underwent CABG. A preoperative coronary angiogram showed 90%
      stenosis in the proximal main RCA, 75% stenosis in the PDA and total occlusion in
      the proximal LAD, distal of which was an area well supplied by collaterals from
      the RCA. With a skin incision of 11 cm, the LITA was inserted into the LAD, the
      RITA into the mid-RCA and the radial artery graft attached to the RITA was
      grafted to the PDA through an inferior mini-sternotomy while the heart was
      beating. In both cases, the sternum was not cut transversely in order to prevent
      injury to the ITAs and pseudo-joint formation. With the use of this technique,
      exposure of the LAD and RCA was excellent. Postoperative recovery in both
      patients was uneventful and postoperative angiograms revealed widely patent
      grafts. This technique was very useful when performing off-pump CABG using
      bilateral ITAs.

PMID- 11211769
TI  - [The estimation of the effectiveness of GRF glue in the respiratory].
AB  - We had reported on the basis of experimental findings that the efficacy of
      protecting the suture line in tracheoplasty by using a self-fascia lata and GRF
      glue. This time we investigated the effectiveness of GRF glue in the respiratory
      surgery on the basis of clinical findings. All ten cases in which GRF glue was
      used resulted in an excellent outcome, namely, GRF glue prevented from air
      leakage, bleeding and leakage of chyle. Moreover, it was not recognized that any
      grave side effects occurred in any cases after using GRF glue. We could conclude
      that GRF glue was a useful material for the respiratory surgery, especially for
      the case that had a dead space after lobectomy. However its price is not
      inexpensive, therefore, there seems need to restrict the use of GRF glue--for
      example--to cases of Giant bulla resection, residual of a large dead space as a
      postoperative possibility and chemotherapy performed before an operation, and so
      on.

PMID- 11211770
TI  - [A case of surgically treated left atrial myxoma following acute multiple
      embolism including cerebral embolism].
AB  - The patient was a 59-year-old female who was admitted to the hospital due to
      acute pain of bilateral legs, a numbness of right hand and anarthria. Angiography
      of extremities revealed total occlusion of right ulnar artery, left radial artery
      and bilateral popliteal arteries. Brain MRI revealed multiple small infarctions.
      Echocardiography revealed a mass in the left atrium. She was diagnosed as
      multiple embolism including cerebral embolism caused by left atrial myxoma. Open
      heart surgery immediately after the attack is generally considered
      contraindicated due to problems of hemorrhagic infarction or brain edema. But,
      relapse of embolism may deteriorate the condition and miss the timing of surgery.
      Thus we performed removal of left atrial myxoma 4 days after the attack. The
      postoperative course was uneventful. This is a few report about open heart
      surgery immediately after the attack. We report about the indication and the
      optimal timing of open heart surgery following cerebral embolism.

PMID- 11211771
TI  - [A case of tracheo-bronchial stenosis after extended end-to-end aortic arch
      anastomosis for interrupted aortic arch treated with suspension of the ascending
      artery and pulmonary artery].
AB  - A 9-day-old boy had pulmonary artery banding and extended end-to-end aortic arch
      anastomosis for ventricular septal defect (VSD) and type A interrupted aortic
      arch. Severe dyspnea gradually developed. At 3 months of age, intracardiac repair
      of VSD was performed. Weaning from the ventilator was difficult. Endoscopic
      examination and chest CT revealed stenosis of the right and left main bronchi and
      compression of tracheal bifurcation and the right and left main bronchi by the
      ascending aorta and pulmonary artery. Suspension of the ascending aorta and
      pulmonary artery was performed 15 days after VSD closure. Nine days after this
      procedure, the patient was weaned from respirator. Postoperative course was
      uneventful. Bronchial stenosis may be caused from extended end-to-end aortic arch
      anastomosis.

PMID- 11211772
TI  - [A case report on two stage operation of dissecting aneurysm of DeBakey IIIb type
      associated with dense pulmonary adhesion].
AB  - Successful surgical treatment of chronic dissecting aneurysm (DeBakey IIIb type)
      in a 50-year-old man was reported. His left lung was tightly adhered to the
      aneurysm and the chest wall, because he had a previous operation history for
      pyothorax. This patient showed copious pulmonary bleeding by the pulmonary injury
      during adhesiotomy. We selected the two stage operation for deducting operation
      risks, and finished the first operation at the end of adhesiotomy. Some pieces of
      e-PTFE sheet had been put between lung and thoracic wall, or aneurysm. After a
      week, waiting the cure of this pulmonary injury, the second operation was
      performed with a small quantity of pulmonary bleeding. There wasn't fresh
      pulmonary adhesion because of protection by e-PTFE sheet. The two stage operation
      was useful in cases associated with dense pulmonary adhesion.

PMID- 11211773
TI  - [Desmoid tumor of the chest wall infiltrating into the brachial plexus: report of
      a resected case].
AB  - We report a case of a desmoid tumor which developed in the apex of the chest
      wall. A 18-year-old woman was admitted with left shoulder pain. Chest X-ray
      showed a mass shadow in the left upper lung field. Chest MRI demonstrated the
      mass infiltrated into the left brachial plexus. A desmoid tumor was suspected on
      percutaneous needle biopsy. Resection of the tumor was performed. The mass was 13
      x 9 x 5 cm in size and diagnosed pathologically as desmoid tumor. Adjunctive
      postoperative radiation therapy of 60 Gy was done. Postoperative course was
      uneventful except motor disturbances of the left fingers. At 15 months
      postoperatively, there was no evidence of recurrence.

PMID- 11211774
TI  - [A case treated with thoracoscopic wedge resection for cT1N0M0 lung cancer
      complicated with both chronic obstructive pulmonary disease (COPD) and
      hypofunction of left ventricle in a octogenarian].
AB  - A 81-year-old man who had medical treatment for both COPD and essential
      hypertension was admitted to our institution for evaluation of shadows of a mass
      in the right upper field on chest X-rays. The tumor was 3.0 cm in diameter on
      chest CT and diagnosed to be bronchogenic squamous cell carcinoma on the basis of
      findings of bronchoscopic brushing. The thoracoscopic wedge resection was
      undergone for cT1N0M0 lung cancer in the high-risk patient. Postoperative course
      was uneventful and the patient was discharged one month after the operation. He
      is now doing well without relapse of cancer a year and half after the operation.

PMID- 11211775
TI  - [Leiomyoma of the esophagus shown as a cervical tumor].
AB  - A 44-year-old female was admitted to our hospital because of the left cervical
      tumor. Radiologic examination showed that the tumor was 5 cm in diameter and was
      inhomogeneous. The tumor was spread to the upper mediastinum. Esophagoscopy
      showed that the tumor was covered by the normal mucosa. Percutaneous fine needle
      biopsy did not appear the histopathological diagnosis. The patient underwent
      surgical resection through the cervical approach and the tumor was located
      between the mucosal and muscular layers of the esophagus. The tumor was
      enucleated without any complication. Histopathological diagnosis was leiomyoma.
      Postoperative course was uneventful. Expecting diagnosis and positive complete
      resection is recommended for leiomyoma of the esophagus.

PMID- 11211776
TI  - [Clinical study of operated nine thymic carcinomas].
AB  - Nine cases of thymic carcinoma (5 males and 4 females) were operated in our
      hospital between 1990 and 1998. These cases included 4 squamous cell carcinomas,
      2 small cell carcinomas, 2 undifferentiated carcinomas and one adenocarcinoma.
      Preoperative chemotherapy were performed in 3 cases. All cases underwent median
      sternotomy followed by mediastinal irradiation, 4 had total resection of the
      tumor, 2 had subtotal resection and 3 had exploratory thoracotomy followed by
      mediastinal irradiation. Adjuvant chemotherapy were administered in 4 cases and
      re-operation were performed in 2 cases. We applied Masaoka's clinical staging for
      thymoma, nine cases consisted of 6 stage III cases, 2 stage IV b cases and one
      stage IV a case. Within 2 years after operation, 3 cases (two complete resection
      cases and one exploratory thoracotomy case) were died of the carcinoma. However,
      two cases of squamous cell carcinoma have been alive more than 5 years after
      surgery followed by chemoradiation. The remaining 4 patients are alive either
      with or without the carcinoma after 7 to 28 months after operation. Thymic
      carcinoma is not so common mediastinal tumor but is expected to increase in the
      future. The treatment of thymic carcinoma remains a controversial matter and the
      survival is poor compared with invasive thymoma, but multimodal-therapy would
      contribute to improvement of the results in treatment for thymic carcinoma
      especially in squamous cell carcinoma.

PMID- 11211777
TI  - [A case report of Ebstein's anomaly treated with Hetzer's procedure].
AB  - A 27-year-old male who had been diagnosed with Ebstein's anomaly was admitted
      with uncontrollable congestive heart failure. The echocardiogram revealed severe
      tricuspid valve incompetence and the electrocardiogram showed atrial
      fibrillation. He underwent Hetzer's repair procedure for tricuspid valve
      incompetence and Minzioni's right atrial isolation technique to restore sinus
      rhythm. His congestive heart failure quickly disappeared and sinus rhythm was
      restored after operation. He was discharged 3 weeks postoperatively and remains
      well 22 months after his operation. Hetzer's technique for tricuspid valve repair
      in Ebstein's anomaly restructures the valve mechanism at the level of the true
      tricuspid anulus by using the most mobile leaflet for valve closure without
      plication of the atrialized chamber. We conclude that Hetzer's procedure is an
      effective operation for Ebstein's anomaly.

PMID- 11211779
TI  - [A study on chest radiographs in medical check-ups for over-staying foreigners].
AB  - During the past nine years from 1991 to 1999, Minatomachi Medical Center and
      other organizations have provided free medical check-ups for foreigners in
      Kanagawa, Tokyo and Chiba. Eighty-five percent of the total of the 2370 examined
      were over-staying foreigners who were not covered by national health insurance
      system. The ratio of male to female was two to one and the most of them were in
      the twenties and thirties. As for their ethnic origins from forty-three
      countries, the Filipinos were the largest numbers, followed by Koreans, Iranians,
      Bangladeshi, and Chinese/Taiwanese. As a result of chest radiographs, 82% were
      normal, 8.3% mostly normal, 9.6% tuberculosis shadow (TBS) including active, non
      active and previous, 0.09% suspected pneumonia, 0.05% suspected cardiac disease,
      and 0.05% suspected sarcoidosis. The TBS and active tuberculosis (ATB) rates of
      all examined were 9.6% and 0.69% respectively. There was no significant
      difference in each TBS and ATB rate between the two sexes. Seen from the age
      group, it was found that the more aged they were, the higher the TBS and the ATB
      rates were. The TBS and the ATB rates were 24.6% and 2.73% in the Koreans, 10.7%
      and 0% in the Chinese/Taiwanese, 10.2% and 0.65% in the Filipinos, 11.3% and
      1.44% in the South-East Asians, 6.3% and 0.25% in the South Asians, 2.3% and 0%
      in the Iranians, 3.7% and 0% in the sub-Saharan Africans, 8.5% and 0.61% in the
      Latin Americans, and 0% and 0% in the Europeans/North Americans. Based on a
      presumed ATB rate of 0.75%, approximately two thousand cases with ATB could be
      calculated to exist among the estimated 270,000 over-staying foreigners. It is,
      therefore, important to give them more frequent medical check-ups for early
      detection of latent cases with ATB.

PMID- 11211778
TI  - [The causes of death in patients with non-MDR pulmonary tuberculosis in our
      hospital].
AB  - We studied the causes of death in 295 patients (mean (+/- SD) age 70.5 +/- 13.2
      y.o.) with active non-MDR pulmonary tuberculosis who died in our hospital between
      1991 and 1999. A hundred and twenty eight patients (43.4%, group A) died of
      tuberculosis, while 167 patients (56.6%) of other accompanying diseases. In 46
      patients of the latter (15.6%, group B), pulmonary tuberculosis gave an
      unfavorable impact on their clinical course. In these patients the extent of
      pulmonary tuberculosis on chest roentgenograph was similar with the remaining 121
      patients who also died of the accompanying diseases (41.0%, group C) and was less
      severe than those of the group A patients. Their nutritional conditions measured
      by serum albumin and choline-esterase level on admission, however, were as low as
      those of the group A patients and distinctly worse than those of the group C
      patients. Most patients of groups A and B died within 3 months after admission,
      while less than half patients of group C died during the same period. The age
      frequency distribution of the patients in groups B and C had a single peak in the
      age group 70 to 89, while that in group A showed two peaks, one similar peak as
      in groups B and C, and another peak in the age group 50 to 59. The numbers of
      homeless patients, of the patients with extensive cavitary lesions, and of the
      patients who died of ARDS (Adult Respiratory Distress Syndrome) or severe
      pneumothorax in group A were the most also in the age group 50 to 59, indicating
      that the patients' delay in admitting to hospitals was the major cause of high
      motality in this age group. As to detailed causes of death in group A, patients
      died of respiratory failure (32 cases), emaciation (28 cases), progression of
      pulmonary tuberculosis (20 cases), ARDS (15 cases), tuberculosis-related diseases
      such as pneumothorax, hemoptysis, and DIC (24 cases). In groups B and C patients
      died of organ failure (36 cases), infectious diseases (33 cases) and malignancy
      (30 cases). The total number of died patients has increased, and the proportion
      of cases dying of ARDS and infectious diseases has increased statistically
      significantly recently.

PMID- 11211780
TI  - [In vitro antimycobacterial activities of a new quinolone, balofloxacin].
AB  - Balofloxacin (BLFX), a newly developed fluoroquinolone, was studied for its in
      vitro antimycobacterial activity by the agar dilution method with 7H11 agar
      medium. The MIC90s were as follows: 0.39 microgram/ml for M. tuberculosis, > 50
      micrograms/ml for M. avium, > 50 micrograms/ml for M. intracellulare, 0.39
      microgram/ml for M. kansasii, 0.39 microgram/ml for M. fortuitum, > 50
      micrograms/ml for M. abscessus, and 50 micrograms/ml for M. chelonae. The
      antimycobacterial activity of BLFX was comparable or slightly inferior to that of
      levofloxacin (LVFX). Considering the present findings and pharmacokinetics of
      BFLX, it appears that BFLX may achieve favorable outcome in the treatment of
      patients with infection due to M. tuberculosis, M. kansasii, or M. fortuitum
      similar to that of ofloxacin or LVFX.

PMID- 11211781
TI  - [Effectiveness and problems of PZA-containing 6-month regimen for the treatment
      of new pulmonary tuberculosis patients].
AB  - One third of the world population has been infected with Mycobacterium
      tuberculosis, and the number of tuberculosis will increase worldwide without more
      effective programs of tuberculosis control. Despite of the presence of very
      potent anti-tuberculosis drugs the global tuberculosis situation is still very
      serious, and such gloomy feature are caused, at least partly, by the failures in
      the treatment of tuberculosis. The most important factor for the failure in
      chemotherapy is incompliance of the patients to the regimens. History of the
      chemotherapy of tuberculosis can be said as the history of the efforts to reduce
      such defaulters. Modern chemotherapy of tuberculosis has started from the
      discovery of streptomycin. Streptomycin monotherapy could improve temporally
      symptoms and bacteriological status, but could not cure the patients with
      moderately advanced pulmonary tuberculosis because of the emerge of drug
      resistant tuberculosis. This problem was overcome by combining use of para
      aminosalicylate and/or isoniazid developed later on. About 97% of patients with
      pulmonary tuberculosis became bacteriologically quiescent by the 12 months of
      streptomycin, para-aminosalicylate and isoniazid. Since 1950s through 1970s three
      drug combination of streptomycin, para-aminosalicylate and isoniazid had been the
      standard regimen for the treatment of tuberculosis. By the introduction of
      rifampicin, the duration of chemotherapy could be shortened to 9 months.
      Subsequent to the successful animal experiments carried out by Grosset which
      demonstrated that the addition of pyrazinamide for initial 2 months to the
      standard two-drug combination (isoniazid and rifampicin) could remarkably shorten
      the duration of chemotherapy, many clinical trials have been done all over the
      world to compare the efficacy and safety of pyrazinamide-containing intensified
      short-course regimen with those of standard regimen without pyrazinamide. Sputum
      negative conversion rates after 2 months of treatment with PZA-regimen was 70
      95%, and the relapse rates after the completion of the treatment course were less
      than 4%. The incidence of adverse events was less than 4%. The pyrazinamide
      containing 6 months short-course regimens has been established as a new standard
      regimen for the initial treatment of pulmonary tuberculosis worldwide. But, in
      Japan, this regimen had not been adapted as the standard until April 1996 because
      of undue fear for high incidence of liver toxicity induced by pyrazinamide.
      However, in many clinical trials carried out in various parts of the world did
      not show any causative relationship between the higher incidence of liver
      toxicity and pyrazinamide. According to our own experience in Fukujuji Hospital,
      Japan Anti-tuberculosis Association, the frequency of drug induced hepatitis
      among 632 patients with normal liver function at the onset of chemotherapy was
      7.9 percent (50/632) when treated with pyrazinamide-containing regimens, and was
      similar to that among 412 patients treated with other regimens without
      pyrazinamide (7.3 percent 30/412). These figures were higher than those reported
      in the literatures. The risk factors of drug-induced hepatitis so far reported
      included elderly, positive hepatitis C virus antibody, low serum albumin and so
      on. Such known risk factors could not wholly explain the higher rate of liver
      dysfunction observed among our Japanese patients. We have examined additional
      factors affecting the frequency of drug-induced hepatitis in our hospital, and
      noticed that the past history of gastrectomy and over-dosing of isoniazid (> or =
      7.5 mg/kg) and/or pyrazinamide (> or = 30 mg) were relating to the higher
      incidence of drug-induced hepatitis. Another important finding is that the
      relapse rate among patients complicated with diabetes mellitus is significantly
      higher than that of the patients without diabetes mellitus (6.31/100 person-years
      vs 0.90/100 person-years, P < 0.001). Further research will need whether the
      patients complicated with diabetes mellitus have any immunological deficient to
      kill Mycobacterium tuberculosis. WHO, CDC and ATS recommended that 4-drug regimen
      including pyrazinamide for the initial treatment of all cases of tuberculosis.
      Considering that the incidence of initial resistance to isoniazid is 4.4% in
      Japan, we should start to treat all cases of newly diagnosed tuberculosis with
      pyrazinamide-containing regimen (isoniazid, rifampicin, pyrazinamide, plus
      streptomycin or ethambutol). To do this, further studies on the risk factors of
      drug-induced hepatitis are urgently needed.

PMID- 11211782
TI  - [Usefulness of self ligation mediated polymerase chain reaction: a rapid method
      for fingerprinting in molecular epidemiology of tuberculosis].
AB  - Restriction fragment length polymorphism (RFLP) analysis based on the insertion
      sequence IS 6110 has been used as one of the powerful tools for epidemiological
      study of tuberculosis. However this technique requires more than 1 micro-gram of
      DNA and two days for completion. To overcome these inconvenience, we have
      modified a PCR-based method, self ligation mediated PCR (SL-PCR) on the molecular
      epidemiological study. This method uses a pair of primers whose orientations are
      from inside to outside of IS 6110. The DNA fragments flanking IS 6110 are
      amplified by the PCR by using the Sau 3A I digested and ligated chromosomal DNA
      of Mycobacterium tuberculosis strains. By using this method, M. tuberculosis
      strains can be differentiated within 8 hours.

PMID- 11211783
TI  - [Recent advances in the research on TGF-beta/Smad signaling pathways].

PMID- 11211784
TI  - [Molecular mechanism of inactivation of TGF-beta receptors during
      carcinogenesis].

PMID- 11211785
TI  - [Gastrointestinal tumorigenesis in Smad4 mutant mice].

PMID- 11211786
TI  - [Aberrations of Smad genes in human digestive tract cancers].

PMID- 11211787
TI  - [Regulation of morphogenesis and regeneration of the kidney by the activin
      signaling system].

PMID- 11211788
TI  - [Applications of puromycin for evolutionary molecular engineering of proteins and
      analysis of gene networks].

PMID- 11211789
TI  - [Protein folding and its structural topology].

PMID- 11211790
TI  - [The frontier of the artificial heart].

PMID- 11211791
TI  - Inhibitory effect of Rumex Japonicus Houtt on the porphyrin photooxidative
      reaction.
AB  - Rumex Japonicus Houtt (RJH), a plant indigenous to Okinawa, Japan, has been used
      traditionally by the local people for treatment of acute and chronic cutaneous
      diseases; however, its pharmacological effect is not clearly understood. To
      investigate its active function, we examined the antioxidative effect of RJH on
      the hematoporphyrin-induced photooxidative reaction. We measured intracellular
      reactive oxygen species (ROS) in cultured transformed human vascular endothelial
      cells (ECV-304) by flow cytometry, lipid peroxide (LPO) in erythrocyte ghosts by
      spectrofluorometry, and hemolysis by spectrophotometry. Results showed the
      generation of intracellular ROS in ECV-304, LPO production in erythrocyte ghosts,
      and hemolysis after visible light irradiation in the presence of hematoporphyrin.
      In the RJH root extract treated group, generation of intracellular ROS, LPO
      production, and hemolysis were inhibited significantly. It has been reported that
      the RJH root contains emodin and chrysophanic acid. In our study, three fractions
      were separated from the RJH root extract by thin layer chromatography (TLC). We
      found that fraction 1 (near the origin) showed a strong inhibitory effect on LPO
      levels; however, fraction 2 (equal to emodin) and fraction 3 (equal to
      chrysophanic acid) showed no inhibitory effect on LPO levels. Our experiments
      verified that RJH has an antioxidative effect against photohemolysis and supports
      our hypothesis that RJH may have potential as a protective agent against
      oxidative stress associated with some diseases such as porphyrias.

PMID- 11211792
TI  - Pedunculated melanoma with pulmonary and bony metastases.
AB  - We report a patient with pedunculated melanoma. Rounded and epithelioid-type
      melanoma cells had proliferated in the epidermis and massively into the deep
      dermis in the pedunculated nodule. At the base of the pedicle, lengtiginous-type
      melanoma cells formed nests of various sizes in the epidermis extending ten or
      more rete ridges beyond the site of invasion. Thus, this case shows that a
      pedunculated melanoma is not necessarily a variant of nodular melanoma. Six years
      after the primary operation, late recurrence was detected in regional lymph
      nodes, and nine years after the initial operation, the patient was found to have
      three large metastatic nodules, up to 8.5 cm in longest diameter, in her lung and
      bone. Although she died six months after the metastasectomy, prompt surgical
      excision of the primary tumor and metastasectomy can provide longer survival.

PMID- 11211793
TI  - Amblyomma testudinarium tick bite: one case of engorged adult and a case of
      extraordinary number of larval tick infestation.
AB  - This paper reports two recent cases of tick bite due to Amblyomma testudinarium.
      The first case was an 86-year-old farmer infested with a fully engorged adult
      tick attached on his inguinal region. The second case was a 57-year-old male
      infested with an extraordinarily large number of larval ticks (> 100 larvae). The
      ticks were identified as A. testudinarium based on morphological characteristics.
      To our knowledge, the latter case is the eleventh case of larval tick bites among
      all tick species and the fourth case with larval A. testudinarium in Japan.

PMID- 11211794
TI  - Three cases of polyarteritis nodosa cutanea and a review of the literature.
AB  - We describe three cases of polyarteritis nodosa cutanea (PNC) showing necrotizing
      arteritis and only cutaneous lesions without systemic symptoms or visceral
      involvement for eleven, six, and three years after the onset of the disease.
      Since it was first described, there has been continuous controversy as to whether
      PNC progresses to systemic PN. Some cases have been described which had begun
      with a cutaneous lesion and progressed to the systemic form 19 and 18 years after
      the onset of the disease, so we believe that long term follow-up of this disease
      is essential.

PMID- 11211796
TI  - A case of acinic cell adenocarcinoma on the left hemifacial area.
AB  - Acinic cell adenocarcinoma is a rare salivary gland tumor which predominantly
      occurs in the parotid gland. A 46-year-old man presented with a left preauricular
      mass of one month duration; the pathologic report showed acinic cell
      adenocarcinoma. He was transferred to the oral and maxillofacial surgery
      department, and a total parotidectomy was performed. We present this interesting
      case of acinic cell adenocarcinoma from the parotid gland with cutaneous
      involvement.

PMID- 11211795
TI  - Colchicine treatment in a patient with neutrophilic dermatosis associated with
      rheumatoid arthritis.
AB  - Neutrophilic dermatoses (ND) are characterized by epidermal and dermal
      infiltrates of polymorphonuclear leukocytes (PMN), without any infectious or
      other detectable agents as a cause. We describe a case of ND, which very rapidly
      improved upon colchicine treatment. The patient was a 67-year-old female with an
      8-month history of dusky-red, tender, swollen plaques and nodules with
      superimposed vesicles and bullae on the buttocks, hands, and ankles associated
      with rheumatoid arthritis. The diagnosis of ND was made on the basis of the
      clinical and histopathological features of the skin lesions. She was treated with
      0.6 mg of oral colchicine twice daily. Within one week, the erythematous plaques
      and arthralgia began to recede and disappeared within four weeks. In our case,
      colchicine seemed to improve the signs and symptoms of ND and appeared to be more
      effective than the other drugs we had used.

PMID- 11211797
TI  - Sweet's syndrome with abscess-like lesions in a patient with acute myelogenous
      leukemia.
AB  - We describe a 49-year-old man with acute myelogenous leukemia associated with
      Sweet's syndrome and abscess-like lesions mimicking an infectious disease.
      Although blisters may be included in the clinical spectrum, frank non-infectious
      abscesses have not been reported as far as we know. Clinicians should be familiar
      with this clinical and histopathologic variant of Sweet's syndrome. It is
      mandatory to make every effort to find an infectious cause for abscesses before a
      diagnosis of Sweet's syndrome is made.

PMID- 11211798
TI  - Non-ulcerative basal cell carcinoma arising on the genitalia.
AB  - We report two cases of basal cell carcinoma (BCC) arising on the genitalia. The
      first case was a 49-year-old male who became aware of a dull erythematous plaque
      with a keratotic surface on his scrotal skin, and the second case was a 44-year
      old female suffering from a keratotic plaque on her right vulvar region. Neither
      lesion was ulcerative. Both were resected under local anesthesia following a
      clinical diagnosis of angiokeratoma for the former and seborrheic keratosis or
      BCC for the latter lesion. Histopathological study revealed that both lesions
      were BCC. Many questions regarding the pathogenesis of BCC still remain to be
      clarified. Because most of the reported cases have been ulcerative lesions and
      the genital region is an uncommon site for BCCs, caution should be taken in cases
      in whom a clinically non-ulcerative tumor suspected to be angiokeratoma or
      seborrheic keratosis arises in this region.

PMID- 11211799
TI  - Unusual annular pustular psoriasis in a patient with type C hepatitis.

PMID- 11211800
TI  - E-cadherin expression is frequently reduced in infiltrative basal cell carcinoma.

PMID- 11211801
TI  - Evolution of Dowling Degos disease.

PMID- 11211802
TI  - [Clinical usefulness of cross-linked N-telopeptide of type I collagen (NTx) as a
      bone metastatic marker in patients with prostate cancer--comparison with serum
      PICP, PINP and ICTP].
AB  - Type I collagen cross-linked N-telopeptide (NTx) in urine, the degraded form of
      type I collagen cross-linked in bone, has been evaluated as a marker of bone
      resorption. In this study, the clinical usefulness of NTx as a marker of bone
      metastasis of prostate cancer was compared with that the carboxyterminal
      propeptide of type I procollagen (PICP), the aminoterminal propeptide of type I
      procollagen (PINP), and the pyridinoline cross-linked carboxyterminal telopeptide
      of type I collagen (ICTP) in serum. We assessed 37 cases of prostatic cancer in
      which the diagnosis had been confirmed pathologically. The patients were 15
      patients with prostatic cancer with bone metastasis (before treatment or during a
      relapse) (Group 1); 11 patients, with bone metastasis, but for whom treatment was
      effective and condition had stabilized (Group 2); and 11 patients, with localized
      prostatic cancer and no evidence of bone metastasis (Group 3). The serum PICP,
      PINP, and ICTP levels and concentration of NTx in urine were compared among the
      three groups with the Mann-Whitney U test, with p values less than 0.05
      considered significant. Urine NTx concentrations in Groups 1, 2 and 3 were 539.3
      +/- 202.9, 160.6 +/- 97.6 and 48.6 +/- 7.6 nMBCE/mMCr, respectively. The
      differences between the Group 1 and Group 2 and between Group 1 and Group 3 were
      significant (p < 0.01 and p < 0.001). The differences between Group 1 and Group 3
      and between Group 2 and Group 3 were significant for serum PICP, PINP and ICTP
      concentrations (p < 0.05). The correlation coefficient between urine NTx and each
      serum bone metabolic marker was 0.8 for PICP, 0.4 for PINP and 0.5 for ICTP.
      These bone metabolic markers are promising clinical markers of bone metastatic
      and may be useful for prediction of therapeutic efficacy and recurrence in bone
      and quantification of the extent of bone metastates.

PMID- 11211803
TI  - [Clinical study of prostate cancer: statistical analysis of 107 cases in the past
      12 years].
AB  - One hundred and seven patients with prostate cancer were treated at Mie
      University Hospital during the past 12 years between 1988 and 1999. They were
      between 53 and 83 years old, with an average age of 70.8 years old. The clinical
      stage was defined as A, B, C and D in 3 (2.8%), 19 (17.8%), 50 (46.7%) and 35
      (32.7%) patients, respectively. At initial diagnosis, the tumor was well,
      moderately and poorly differentiated adenocarcinoma in 26 (24.3%), 47 (43.9%) and
      34 (31.8%) patients, respectively. The median follow-up period was 52.3 months.
      The overall 1, 3 and 5-year survival rates were 98.0%, 86.8% and 75.2%,
      respectively. The 5-year survival rates for stage A, B, C and D were 100%, 93.8%,
      82.1% and 56.9%, respectively. A significant difference (p = 0.017) in 5-year
      survival rate was noted between stage C and D. The 5-year survival rate was 100%
      for well differentiated, 78.0% for moderately differentiated, and 53.2% for
      poorly differentiated adenocarcinoma. A significant difference (p = 0.0016) in
      the 5-year survival rate was noted between well differentiated and poorly
      differentiated adenocarcinoma. According to the therapy, the 5-year survival rate
      in stage C was 86.2% for the radical prostatectomy group and 84.0% for the
      endocrine therapy group. There was no significant difference between these 2
      treatment groups. Endocrine therapies, classified into maximum androgen blockade
      (MAB) and endocrine therapy other than MAB were performed for stage D as an
      initial therapy. Although the prognosis in the patients treated with MAB was
      better than that with other endocrine therapies, there was no significant
      difference between these 2 endocrine treatment groups.

PMID- 11211804
TI  - [Results of treatment for germ cell tumor--dose intensity of chemotherapy and
      residual masses after chemotherapy].
AB  - We reviewed the treatment results in 44 patients with germ cell tumor and the
      significance of % dose intensity of Cisplatin and tumor marker half-life of
      induction chemotherapy and discussed the necessity of surgical resection of the
      postchemotherapy residual tumor. The 5-year survival rate calculated by the
      Kaplan-Meier method was 83.6% in total, and 95.2, 75.8 and 47.6% for good,
      intermediate and poor prognosis, respectively. Of the 29 metastatic cases treated
      by chemotherapy, 5 (17.2%) achieved complete response (CR) and 15 (51.7%) partial
      response, and % dose intensity of Cisplatin were 75.4% in total and 86.4 +/- 8.6,
      71.6 +/- 11.1, 84.3 +/- 8.3 and 62.2 +/- 11.0% in CR, PR, NC and PD. Dose
      intensity was correlated with the clinical response and the prognosis. Of the 12
      PR cases without teratoma elements, two had salvage surgery, five had additional
      chemotherapy and five were followed by surveillance. One case followed by
      surveillance died of the disease, another one with additional chemotherapy was
      alive with the disease and the others were alive with no evidence of disease.
      Surgical resection is an effective treatment to remove residual masses, but
      observation may also be considered in the cases without teratoma elements.

PMID- 11211805
TI  - [A compound tumor in the adrenal medulla--pheochromocytoma combined with
      ganglioneuroma: a case report].
AB  - We report a case of a compound adrenal medullary tumor. A 63-year-old woman was
      referred to our hospital for examination of a right adrenal tumor, incidentally
      found by abdominal computed tomography (CT). CT and magnetic resonance imaging
      (MRI) revealed a round heterogeneous tumor, 5 cm in diameter, on the upper pole
      of the right kidney. A view of the total body scan demonstrated the uptake into
      the tumor after the injection of 123I-metaiodobenzyl-guanidine. Serum and urinary
      adrenaline levels were slightly elevated, and urinary excretion of
      vanillylmandelic acid was markedly elevated. Her blood pressure was normal. From
      these findings, the tumor was suspected to be a pheochromocytoma of the right
      adrenal gland and was resected reteroperitoneally. Pathological diagnosis was a
      compound adrenal medullary tumor, which was composed of pheochromocytoma and
      ganglioneuroma. This combination of the adrenal medullary tumor is extremely
      rare, and to date this case may be the sixth case in the Japanese medical
      literature.

PMID- 11211806
TI  - [A case of retroperitoneal teratoma difficult to distinguish from adrenal
      myelolipoma].
AB  - A 59-year-old man presented to our hospital suspected of having cholelithiasis.
      Computed tomography (CT) scan revealed a left retroperitoneal solid tumor
      cephalad to the kidney, 7 x 8 x 9 cm in size with mostly a fatty density area and
      focal calcification. Magnetic resonance imaging (MRI) on T1 and T2 weighted
      images showed a high intensity mass. Angiography revealed the hypovascular tumor.
      Although we had suspected it to be an adrenal myelolipoma, tumorectomy was
      performed because of its size. Pathological diagnosis was mature teratoma.
      Although retroperitoneal teratoma contains fas, cyst, soft tissue and
      calcification, the proportion of fat in the tumor is usually less than that of
      adrenal myelolipoma. In our case, the tumor contained more fat than the 'typical'
      retroperitoneal teratoma, which led to the misdiagnosis.

PMID- 11211807
TI  - [Surgical removal of renal cell carcinoma after partial splenic embolization in a
      patient with liver cirrhosis: a case report].
AB  - Partial splenic embolization is used to treat patients with liver cirrhosis
      accompanied by hypersplenism for improving thrombocytopenia and leukopenia. We
      report a case in which partial splenic embolization was used before nephrectomy
      because both renal cell carcinoma and liver cirrhosis were present. A 75-year-old
      woman visited our hospital complaining of abdominal distension. Computed
      tomography revealed a 5.5 cm left renal tumor. Liver cirrhosis, ascitis,
      splenomegaly was observed. Blood tests revealed pancytopenia; platelet count was
      2.9 x 10(4)/mm3. The patient was treated by partial splenic embolization in an
      attempt to ensure a safe nephrectomy. After the embolization, her platelet count
      increased immediately to 19.2 x 10(4)/mm3, and left nephrectomy was performed
      successfully.

PMID- 11211808
TI  - [Papillary renal cell carcinoma complicated with emphysematous pyelonephritis: a
      case report].
AB  - A case of papillary renal cell carcinoma complicated with emphysematous
      pyelonephritis is reported. A 75-year-old woman with diabetes mellitus was
      admitted to our hospital with macroscopic hematuria and a child's head-sized firm
      mass in the left hypochondrium. Computed tomographic (CT) scanning revealed a
      huge left renal tumor with hydronephrosis. The patient had acute pyelonephritis
      and antibacterial therapy was initiated. Ten days later, conservative therapy was
      not effective and CT scan revealed emphysematous necrotic tissue in the tumor. We
      performed percutaneous drainage. Then dark red liquid and gas were discharged.
      Her general condition was improving. Left radical nephrectomy was performed. The
      mass was solid and pathological diagnosis was papillary renal cell carcinoma with
      necrotic tissue and coated by a thick pseudocapsule. She has remained free of
      disease for 27 months after operation.

PMID- 11211809
TI  - [Right ureteral stenosis due to endometriosis occurring in the residual appendix:
      report of a case].
AB  - A 48-year-old female was found to have right flank pain at another hospital and
      transabdominal ultrasonography showed right hydronephrosis. She was referred to
      our department for further examination. She had undergone right oophorectomy and
      total hysterectomy 3 years before. Intravenous pyelography showed right
      hydronephrosis and retrograde pyelography revealed ureteral stenosis at the lower
      portion of the right ureter. Endometriosis had developed at the site of previous
      surgery on the appendix. A mass was formed in an extensive area including the
      endometriotic lesion, due to adhesion following previous surgery or other
      reasons, and extended to the retroperitoneum, thereby inducing right ureteral
      stenosis. The postoperative course was uneventful. The pathological diagnosis was
      endometriosis of the residual appendix.

PMID- 11211810
TI  - [A case of traumatic priapism].
AB  - We report a case of high flow priapism secondary to arteriovenous fistula
      produced by perineal trauma in a 43-year-old patient. Diagnosis was based on the
      result of gasometry in cavernous blood and color doppler sonography.
      Superselective embolization of the deep artery of the penis was performed with
      good results. After 6 months of treatment, erection and sexual function were
      normal. Our case demonstrates that this procedure is a safe and effective therapy
      for high flow priapism.

PMID- 11211811
TI  - [A case of polypoid form of parameatal urethral cyst].
AB  - A 45-year-old man first noticed a soft tumor on his left lip of the urethral
      meatus at the age of 15. The lesion had gradually been increasing in size during
      the last 10 years. He presented to our clinic with division of urinary stream
      which had been persisting for about nine months. The tumor was resected, and
      histopathological examination revealed that it was a mucous cyst. The cyst had an
      outer wall of stratified squamous epithelium and an inner wall of stratified
      columnar epithelium. Since the inner wall was covered with epithelium originating
      from the urethral mucosa and the lesion was located outside the urethral meatus,
      a diagnosis of parameatal urethral cyst was made. Recently, parameatal urethral
      cyst has rarely been reported since it is often clinically in significant and
      remains asymptomatic. In our patient, the tumor showed polyploid growth and
      caused difficulty in urination. The mechanism of its development is considered
      based on a review of the literature.

PMID- 11211812
TI  - Acute epididymo-orchitis with abscess formation due to Pseudomonas aeruginosa:
      report of 3 cases.
AB  - We report 3 patients with acute epididymo-orchitis with abscess formation due to
      Pseudomonas aeruginosa, which is relatively unusual and difficult to treat. All
      patients presented with swollen testicles, pain and high fever. First, they were
      treated empirically with several antibiotics. After several weeks of antibiotics
      therapy, the swelling of scrotum still persisted. In one patient, dark yellow pus
      drained from a fistula of the scrotum. Finally, an orchiectomy was performed on
      all patients. During the operation, an abscess was found in each testis. Each
      culture of the pus yielded P. aeruginosa, which is susceptible to many
      antibiotics.

PMID- 11211813
TI  - [Leiomyosarcoma of the scrotum: a case report].
AB  - Leiomyosarcoma of the scrotum is a rare tumor. Up to 1999, only 29 cases have
      been reported in the literature worldwide. A 27-year-old man presented with a
      mass on the left side of the scrotum which had been painless and had gradually
      enlarged over the previous 10 years. During the following 3 months, however, it
      became painful and he was then referred to our hospital. Physical examination
      revealed a solid mass on the left side of the scrotum, measuring 7 cm in
      diameter, which was not adhering to the testis or to the vas deferens. The tumor
      was surgically resected. The histological examination confirmed the diagnosis of
      well differentiated leiomyosarcoma. Adjuvant therapy was considered unnecessary.
      The follow-up at 41 months revealed no local recurrence or distant metastasis.

PMID- 11211814
TI  - [The clinical statistics of the operations at the Department of Urology, Tokatsu
      Hospital: from 1994 to 1999].
AB  - We investigated the clinical statistics of the operations and inpatients since
      the establishment of the department in June 1994 up to May 1999. The total number
      of inpatients was 1,269 (1,047 males and 222 females), and a total of 1,098
      operations were performed. Extracorporeal shock wave lithotriopy (ESWL) was also
      introduced in 1997, and in addition, it seemed that the number of operations and
      inpatients would be increasing in future.

PMID- 11211815
TI  - [Studies on adsorption of the organic phosphorus pesticide with the macroporous
      resin].
AB  - Macroporous adsorbing resins prepared by styrene are selected as absorbent in the
      static and dynamic adsorption experiments of organic phosphorus pesticide. These
      resins are attempted to be applied in blood purification to detoxify and save the
      patient's life.

PMID- 11211816
TI  - [In vitro dissolution study on the hydroxyapatite biocoatings].
AB  - This paper has studied the dissolution behavior of the plasma sprayed and
      electrochemically prepared hydroxyapatite(HA) biocoatings in the simulated body
      fluid. XRD and SEM show that the plasma sprayed coating and post-heat treated HA
      coatings are more soluble, and CaO and alpha-TCP in the coatings gradually
      disappear and CaCO3 forms during the immersion. The composition of the
      electrocrystallized and alkaline-treated HA coatings is basically unchanged, and
      the coatings are more stable in the simulated body fluid.

PMID- 11211817
TI  - [The effect of polylactide screws on fracture healing].
AB  - This experiment aimed at investigating the effect of a kind of home-bred poly-DL
      lactide screws on fracture healing. An operation was performed so as to make
      bilateral lateral condylar fractures of the femur in 8 dogs. The left sides were
      fixed with 2 home-bred PDLLA(Mv = 43 x 10(4)) screws, and the contralateral sides
      were fixed with 2 metalic screws to be used as controls. The animals were
      sacrificed at 2, 4, 8, and 12 weeks after surgery. Optic microscopy and SEM
      photography were done. The results of optic microscopy showed that fibrous callus
      formed already in both groups by 2 weeks after surgery, and bilateral fractures
      united uneventfully by 12 weeks. Although the course of fracture healing in
      experimental group was slower than that in control group, the osteogenesis in
      experimental group appeared to be normal. The SEM examination demonstrated that
      collagenous fibers arranged regularly and calcified normally in both groups at 12
      weeks. And many square and rhomboid granules produced from the degradation of
      PDLLA material were found in experimental group at 12 weeks. Therefore, it is
      suggested that this kind of home-bred PDLLA screws should be applicable to
      fractures where the tissues are rich in blood supply.

PMID- 11211819
TI  - [The adsorption on attapulgite and cross-linked agar beads entrapped
      attapulgite(CAA)].
AB  - The adsorption of four drugs with certain toxicity, i.e. chlorpromazine,
      quinidine, diazepam and phenobarbital on attapulgite and Cross-linked Agar Beads
      Entrapped Attapulgite(CAA) was determined in this study. The results revealed
      that attapulgite possessed high adsorption for the cation drugs(chlorpromazine
      and quinidine), moderate adsorption for diazepam, and slight adsorption for
      phenobabital. The adsorption in attapulgite was quite quick and came to
      equilibrium in about 30 min. No significant difference(P > 0.05) of adsorption on
      attapulgite was observed at 30 min and 60 min. The adsorbent selectivity on CAA
      was the same as that on attapulgite. The speed of the adsorption was slower on
      CAA than on attapulgite, but the quantity adsorpted on CAA and that on
      attapulgite had no marked difference(P > 0.05) after 60 min. CAA preserved the
      adsorption property of attapulgite fundamentally. CAA overcame the dispersibility
      of attapulgite distinctly and showed good hemocompatibility and a fair blood flow
      rate in hemoperfusion. It may play an important role in the separation of blood
      components and in hemopurification.

PMID- 11211818
TI  - [Study on the biocompatibility and toxicology of biomaterials--poly(epsilon
      caprolactone)].
AB  - Four observation indexes were selected to evaluate the biocompatibility and
      toxicology of biodegradable materials poly(epsilon-caprolactone)(PCL), which is
      synthesized in our laboratory using Ti(OBu)4 as an initiator. The results showed
      that PCL films had a mild inflammatory reaction in the early days of planting and
      after 3 months the inflammation basically disappeared. We conclude that PCL
      material possesses good biocompatibility and has a good developmental prospect.

PMID- 11211820
TI  - [In vitro study of C3a des Arg produced by plasma incubation with blood
      purification materials].
AB  - This study was performed to evaluate the degree of complement C3 activation of
      five biomedical polymers (cellulose acetate (CA), polymethylmethacrylate (PMMA),
      polysulphone (PS), polyethersulphone (PES), sulphonated polyethersulphone(PES
      SO3) which are used to make hemofilters. The concentration of the activation
      derivative C3a des Arg was measured by radioimmunoassay (RIA) in human plasma
      after incubation with these five polymers for 30, 60, 90 and 120 minutes. The
      experimental results indicated that the presence of polymers caused an increase
      in C3a des Arg. The potential to activate complement C3 decreased in sequence of
      CA, PMMA, PES, PS and PES-SO3. CA activated the most complement C3. PES-SO3
      activated the least complement C3, and the concentration of C3a des Arg decreased
      with the increase in sulphonation degree. The investigation demonstrates that
      with good biocompatibility PES is a promising material to make biocompatible
      hemofilters. Furthermore, it indicates that PES containing sulphonate groups can
      achieve a marked reduction in complement activation and supports the sulphonation
      as a means of improving the biocompatibility of PES for blood purification
      application. RIA is a reliable and precise quantitative determination of human
      C3a des Arg and is suitable for testing the activation of complement of various
      synthetic materials that are utilized or to be utilized in the medical field.

PMID- 11211821
TI  - [Effects of adhesive proteins on endothelialization of PC crosslinking yak
      pericardial materials--an experimental study].
AB  - To investigate the conditions of endothelialization of biomaterials, we examined
      in vitro the growth properties of endothelial cells on PC treated yak pericardial
      materials. After rinsed in normal saline (0.9%), the surface of PC crosslinking
      yak pericardial materials was precoated with three kinds of adhesive proteins-
      Laminin (La), Fibronectin(FN) and Collagen-I(CL-I). Ednothelial cells(EC) from
      the canine were seeded on the precoated materials, and on the uncoated materials
      as control. The result showed that in the La and FN groups the seeded EC survived
      and grew on the patches, while in the CL-I group and uncoated group the seeded EC
      on and around the patches did not continue to live. Conclusively, in this
      experiment, PC yak pericardial materials had cytotoxicity; the cytotoxicity of PC
      crosslinking yak pericardial materials could be decreased by La and FN
      precoating; La and FN promoted the adhesion and growth of EC on the PC yak
      pericardial materials patches; the materials met the needs of endothelialization
      in vitro, prominently in the La group; there was significant difference in
      endothelialization between La and FN groups (P < 0.05); CL-I had no part in
      promoting EC adhesion and growth.

PMID- 11211823
TI  - [The construction and physical-mechanical characterization of polymer foams of D.
      L-PLA].
AB  - This study was intended to construct biogradable polymer foam used in tissue
      engineering. The D. L-PLA was supplied by chengdu institute of organic chemistry.
      Biogradable polymer membranes were prepared with a novel solvent-casting
      particulate-leaching technique, then, the constituent membranes with the proper
      order were laminated to produce three-dimensional foams with continuous pore
      structure and morphology. Afterwards, the physical-mechanical property of polymer
      foams were tested. The test results indicated that the lamination process did not
      change the physical-mechanical property of the polymer membranes.

PMID- 11211822
TI  - [Cytocompatible evaluation for skin reproducing membrane of medical fibroin].
AB  - This study was intended to evaluate the cytocompatibility of skin reproducing
      membrane of medical fibroin. Cell growth rate test and hemolysis test were
      conducted to investigate the cytotoxicity and hemolysis reaction for skin
      reproducing membrane. The results showed there was no obvious cytotoxicity for
      this kind of membrance. The hemolysis rate was 1.15%. In conclusion, skin
      reproducing membrane is a material of good cytocompatibility.

PMID- 11211824
TI  - [The effect of adding cefobid upon the physiochemical properties of calcium
      phosphate cement].
AB  - This study was conducted to analyze the physiochemical properties of different
      mass ratio compounds of cefobid-load calcium phosphate cement(CPC). The compounds
      of 0%, 2.9%, 4.8% and 7.4% mass ratio cefobid-load CPC were made respectively.
      The setting time was observed; the compressive strength of compounds was measured
      by a material testing machine; the construction of compounds was observed by
      scanning electron microscopy(SEM) and analyzed by EIG. The results showed that
      both the setting time and the ratio of hole did not change obviously after the
      addition of cefobid, but the ultimate compressive strength decreased slowly and
      the results of the four groups were (21.98 +/- 1.06)MPa, (21.38 +/- 0.95)MPa,
      (19.22 +/- 1.11)MPa and (13.5 +/- 1.65)MPa respectively. These data indicate
      there is no obvious effect on the physicochemical properties of calcium phosphate
      cement after the addition of cefobid between 0% and 4.8%. The compounds have
      irregular holes and hence a good ability of compressive strength. It might be a
      new bone grafting material for the reparation of infection-related bone defects.

PMID- 11211825
TI  - [Three-dimensional finite element analyses on the transtibial residual limb and
      its prosthetic socket].
AB  - This paper presents a method for developing a nonlinear finite element model to
      analyze the load transfer between the transtibial residual limb and its
      prosthetic socket. The model was developed on the basis of three-dimensional
      geometry of the residual limb, internal skeleton, soft liner and socket.
      Interface elements, were used to connect the skin and the liner to simulate the
      friction/slip boundary conditions. The analyses were performed in two steps to
      simulate the donning procedure and the load-bearing situation. The model can be
      used to predict the pressures, shear stresses and slip between the residual limb
      and its socket under different external loads. Four models with different degrees
      of socket rectifications were analyzed.

PMID- 11211826
TI  - [Recent advance in studies of new intraaortic axial flow pump: "dynamic aortic
      valve"].
AB  - We have previously proposed and demonstrated the feasibility of a new concept of
      intraaortic axial flow blood pump, termed "Dynamic Aortic Valve(DAV)". Implanted
      in the position of aortic valve, DAV can serve as either an assistant pump or a
      mechanical valve subjected to the power input. It has several merits over the
      traditional axial blood pumps: (1) better anatomic compatibility and biologic
      compatibility; (2) little foreign material is to be introduced into the
      corporeality; (3) better resistance to infection; (4) puncturing power line could
      be eliminated; (5) promoting the failing heart to recovery; (6) simpler structure
      and better durability. In our recent studies, the structure of DAV is further
      simplified and performance improved greatly. The structure of DAV is merely an
      impeller fixed to a magnetic rotor while held by a central shaft hanging from a
      rigid supporting cage. The rotor-impeller can be driven by an alternative
      magnetic field derived from a remote magnet, implying that the magnetic source
      can even be arranged extracorporeally. The DAV can be driven by a rotational
      magnet placed at a distance of 60 mm. At the state of maximal output of hydraulic
      power, the flow rate (FR) generated by DAV reaches 5 L/min against an afterload
      of 70 mmHg(1 mmHg = 0.133 KPa). The maximal pressure differential (PD) maintained
      by DAV is 131 mmHg. The results further revealed the feasibility of the concept
      of DAV.

PMID- 11211827
TI  - [Mechanical mechanism in plastic stage of fracture union--application of bone
      surface remodeling theory].
AB  - In this paper is presented a discussion on the mechanical mechanism in the
      plastic stage of fracture union. We adopt the bone surface remodeling theory in
      conjunction with finite element method, choose the strain energy density as
      mechanical stimulus, work at a three-dimensional finite element model, and then
      we investigate the mechanical mechanism in the plastic stage of fracture union in
      three types: exterior osteotylus, interior bony defect and exterior bony defect,
      using long bone surface remodeling software "BRSS97" we design. The results show
      that osteotylus can be completely absorbed, and bony defect can recover. For all
      the three types, the final bone configuration resembles normal state bone
      configuration. It proves that long bone configuration in the plastic stage of
      fracture union is the result of the adaptation of bone to loading environment.

PMID- 11211828
TI  - [Different flow augmentations in coronary, carotid and renal arteries with ECP in
      experimental canines].
AB  - Different flow augmentations were found in canine's coronary, carotid and renal
      arteries with ECP because of their different anatomical locations in aorta. We
      used the Electromagnetic Blood Flowmeters to measure the blood flow pre-ECP and
      during ECP. The results showed ECP increased the diastolic flow of coronary,
      carotid and renal arteries by 24.48% +/- 1.29%, 27.18% +/- 0.94% and 20.68% +/-
      0.80% respectively, decreased their systolic flow by 4.77% +/- 0.48%, 6.45% +/-
      0.99% and 9.60% +/- 0.70%, but augmented their mean flow by 18.24% +/- 2.01%,
      19.38% +/- 1.47% and 8.42% +/- 0.94% respectively in experimental dogs. These
      data demonstrate that ECP can greatly increase the mean flow of coronary and
      carotid arteries but at the same time patently decrease the systolic flow of
      renal artery.

PMID- 11211829
TI  - [Effects of stress level on the biomechanical behavior of the temporomandibular
      joint disc in domestic pigs].
AB  - This study aimed to examine the responses of the temporomandibular joint (TMJ)
      disc against compression, to clarify the property of viscoelasticity and
      permeability of the disc, and to provide experimental data for further analyzing
      the mechanism of stress dissipation within the TMJ disc. With the use of confined
      compression mechanics and biphasic theory, creep experiments on eight TMJ discs
      of four domestic pigs were performed under three stress levels(0.07 MPa, 0.13 MPa
      and 0.30 MPa). The results showed that at 0.07 stress level, the compressive
      stiffness at 2 seconds of the anterior band(AB), intermediate zone(IZ) and
      posterior band(PB) of the disc was 4.48 MPa, 3.93 MPa and 6.31 MPa, respectively;
      the coefficient K of permeability was 0.272 x 10(-12) m4/NS, 0.30 x 10(-12)
      m4/NS, and 0.042 x 10(-12) m4/NS. At 0.30 Mpa level, the compressive stiffness
      increased to 14.07 MPa, 13.68 Mpa and 14.00 MPa; the coefficient K lowered to
      0.017 x 10(-12) m4/NS, 0.012 x 10(-12) m4/NS and 0.005 x 10(-12) m4/NS. In
      conclusion, the TMJ disc has viscoelastic and biobiphasic properties against
      compression. The stiffness of the disc increases with the increment of stress
      level but the coefficient of permeability decreases. These findings demonstrate
      that the modulation of stress and of permeability may be two important factors
      influencing stress dissipation and shock absorption behavior of the disc during
      compressive and impact loads.

PMID- 11211830
TI  - [The design and comparative biomechanical study of TDP&CS].
AB  - A new internal fixation device(TDP&CS) for subtrochanteric fracture of the femurs
      was designd and compared with Gamma nail and Jewwet nail biomechanically. A model
      with 5 mm bone deficit presenting as fracture fixation (mFF) and a model with
      nail holes presenting as fracture healed and nails removed(mFHNR) were designed.
      Four-point anti-bent test, anti-axial compression test and anti-torsion test were
      continually performed on mFF, and four-point anti-bent and anti-torsion tests
      were performed on mFHNR. The results showed that in mFF group, TDP&CS was
      stronger than Jewwet nail(P < 0.05) in all the three tests, but it was not
      statistically different from Gamma nail. In mFHNR group, TDP&CS had better
      features than Gamma nail and Jewett nail in anti-bent and anti-torsion tests (P <
      0.05). These data indicate that TDP&CS is a good internal fixation device for
      subtrochanteric fracture of the femurs, it is as good as Gamma nail and better
      than Jewett nail in fixing the fracture, and its nail holes could do less injury
      to the bone as compared with those of the Gamma nail and Jewett nail.

PMID- 11211831
TI  - [Analysis of impulse response of rectangular ultrasound transducer].
AB  - A new expression for calculating the impulse response of rectangular pistonlike
      transducers, proper to any points of acoustic field, is presented. The radiated
      field of ultrasound transducer can be analyzed using impulse response method,
      avoiding paraxial and farfield approximation. The velocity potential at an
      observation point is expressed as the convolution of the excitation velocity and
      the impulse response. A time-amplitude shift method for the far field impulse
      response of small aperture transducers is presented. The radiated field of
      rectangular transducers is calculated through the new method and the previous
      method and excellent agreement is observed.

PMID- 11211832
TI  - [Study on statistical method of distribution for erythrocyte morphological
      features by computerized image processing].
AB  - This study sought to develop a new statistic method for the semiautomatic
      analysis and classification of erythrocyte morphology based on the morphological
      features and shape analysis of erythrocytes by computer image processing. Shape
      factor as the description of the erythrocyte morphological features was used for
      the shape classification of erythrocytes. And the models and algorithms of
      erythrocytes image segmentation, cell body shape recognition and measure can be
      implemented through the VC++. The present method can efficiently and semi
      automatically provide the statistical analysis of erythrocyte morphology, and can
      give the distribution of erythrocyte morphological features. The result showed
      that there was a significant difference between the distribution curves of the
      normal erythrocyte morphology (one apex) and hemolytic anemia's (two apices). By
      this way, it can be obtained the proportion data of different cell bodies'
      shapes. This method could provide some information for the study and diagnosis of
      the diseases (e.g. hemolytic anemia, pre-leukemia) related to erythrocyte
      morphology.

PMID- 11211833
TI  - [A quantitative study of poincare dispersed-dot plot for heart rate variability].
AB  - Poincare dispersed-dot plot is an important nonlinear dynamics method that can
      effectively describe the attractor shape. Yet studies in the past generally
      processed the plot in a graphic mode without further discussion on the
      quantitative indices. That was not suited for clinical application and studies.
      So, based on the shape of Poincare dispersed-dot plot, we propose a group of
      quantitative parameters of Poincare dispersed-dot plot: plot square(SQ), long
      axis (LA), short axis(SA), and angle related to long-axis and short-axis(ALS).
      According to the characters of the heart rate Poincare dispersed-dot plot, we
      have posed the 'tortoise crawling and counting' algorithm to get these four
      quantitative parameters. We have tested these four quantitative parameters with
      clinical and animal experiment data. The results demonstrate that these four
      parameters are of certain specificity to heart diseases, indicating that these
      parameters might be useful for clinical diagnosis.

PMID- 11211834
TI  - [Matching of brain sections based on fourier descriptors].
AB  - We developed an algorithm based on Fourier Descriptors(FD) to match brain
      sections and specially aimed to pool electro-physiological data from individual
      animals and composite the results on a single brain. To test this algorithm,
      curvilinear features were first extracted from each section image of the midbrain
      of the rat resulting in three closed boundaries. A set of boundaries of 38
      consecutive sections was then taken as standard templates for matching with any
      other brain sections processed in a similar way. Each section was represented by
      Fourier descriptors of these boundaries. Matching was done by minimizing the
      similarity function between an experimental brain section and the set of standard
      templates. This algorithm has been successfully used for the study of functional
      organization of AM-sound sensitive auditory neurons in the midbrain.

PMID- 11211835
TI  - [Analysis of ultrasonic backscattering microstructure feature of human spleen
      based on "WD cepstrum"].
AB  - A new method "WD cepstrum" for analysing ultrasonic scattered signals based on
      wavelets decomposition before cepstrum has been developed and then applied to
      process the backscattered signals of normal and pathological human spleen in
      vitro. The mean scatterer spacing(MSS) has been estimated. The results show that
      the MSS data of the two tissues are quite different and "WD cepstrum" is more
      effective for reflecting the microstructure feature of tissue. The results also
      illustrate that "WD cepstrum" is an effective method for signal analysis of
      ultrasonic scattering and characterization of tissue scatterers.

PMID- 11211836
TI  - [Study of the correlation between in vitro and in vivo evaluation methods on
      biomaterials--DNA test and muscular implant test].
AB  - With the wide-spread use of biomaterials, the safety evaluation on biomaterials
      has become a very important step. This study on the correlation between DNA test
      and muscular implant test was done for finding out good in vitro evaluation
      method. The tissue toxicities of seven biomaterials were examined. Good
      correlation between DNA test and muscular implant test was demonstrated by
      Spearman sequential correlation analysis.

PMID- 11211837
TI  - [The multimedia molecular biological image processing system].
AB  - With the use of computer image processing technology and molecular biological
      technology, we have developed a new multimedia molecular biological information
      processing system to detect the characteristic parameter of molecular biological
      electrophoresis image. The system can determine the macromolecules densities and
      molecular weight of the DNA amplified fragment or restriction endonuclease
      hydrolytic fragment protein and other macromolecules. The clinical use and
      biological application indicate that the system is useful to gene diagnosis and
      molecular biological researches.

PMID- 11211838
TI  - [An approach to achieve classification of QRS waves with wavelet multiresolution
      analysis and fractal dimension].
AB  - This paper discussed the theoretical analysis of multiresolution ECGs
      decomposition and expounds the calculation of the fractal dimension. Based on
      Mallat's multiresolution analysis and fractal dimension of the series, a new
      approach to classify the QRS complex was provided: the QRS complex was decomposed
      with a quadratic spline wavelet. At scale 4, the fractal dimension of the
      decomposed series was calculated, the values of modulus maxima of wavelet
      transform and the fractal dimension were used as discriminatory criteria to
      classify QRS. The method was simple and had high anti-noise ability.

PMID- 11211839
TI  - [The research advance of brain derived neurotrophic factor].
AB  - Recent research advances in neuroscience show that neurotrophic factors are
      proteins that affect selectively various kinds of neurons of CNS and PNS. Brain
      derived neurotrophic factor (BDNF) is another neurotrophic factor that was first
      reported by Barde, a German chemist, thirty years later after the nerve growth
      factor had been found out. BDNF plays an important role in the growth,
      development, differentiation, maintenance and regeneration of various types of
      neurons in the CNS and has potential application to the treatment of brain injury
      and neurodegenerative diseases such as Alzheimer's disease, Parkinson's syndrome,
      Huntington's chorea and amyotrophic lateral sclerosis. In this paper, the
      structure, function and potential clinical application of BDNF were reviewed.

PMID- 11211840
TI  - [Pharmacologic stress myocardial perfusion imaging].
AB  - This paper expounds the imaging methods, mechanism of action, hemodynamic
      responses, efficacy and side effects of three pharmacologic stressors
      (dipyridamole, adenosine and dobutamine) for clinical use in experiment of
      diagnosis, thus providing vital reference materials for clinical pharmacologic
      stress myocardial perfusion imaging.

PMID- 11211841
TI  - [Optimizing design in tissue engineering].
AB  - Tissue engineering may provide an alternative to organ transplantation and tissue
      transplantation which are both suffering from the limited condition of supply, so
      it is one of the research high-lights. This article puts forward the viewpoint of
      optimizing design according to its components and makes relevant suggestion; the
      aim is to lay a foundation for tissue engineering.

PMID- 11211842
TI  - [The advance of research for technique of fusing physiological information].
AB  - With the increase of human life's pace and people's psychological burden, the
      spectrum of morbidities changed, and the dynamic disease which is caused by the
      maladjustment between heart and body becomes the main menace to human being.
      Through fusing various physiological information, dynamic disease can be
      diagnosed effectively. The paper discussed the principle of analyzing
      physiological system's dynamic property and evaluating dynamically human body's
      health level. It emphasized on introducing the progress of foreign research, and
      analyzed briefly the problems needed to be dealt with and the future resrarch
      direction of this field.

PMID- 11211843
TI  - [The design of axial flow pump].
AB  - Axial flow pump has been the hot point of the research field of circulatory
      support. This article has outlined the basic principle of its design and the
      methodology of its experimental study, and explained that excellent engineer
      design, avoiding turbulence, cavitation and wake, and reducing the destroy of red
      blood cells were the goal to get in design process. The computer-supported design
      and virtual experiment offered the high efficient tool for the above design. The
      axial pump has a broad scope in future clinical application.

PMID- 11211844
TI  - [The realization methods of 3D ultrasonic blood flow mapping].
AB  - 3D ultrasonic blood flow mapping has undergone significant technological
      refinements in image acquisition, signal processing and display techniques since
      its introduction in 1982. This paper describes the realization methods of 3D
      ultrasonic blood flow mapping systems. The performances of different systems are
      evaluated from the views of 3D localization, design of wall filters, velocity
      estimation and 3D visualization.

PMID- 11211845
TI  - [A system of microcomputer analysis for biological oxygen consumption and its
      application].
AB  - This paper introduces a microcomputer system of data analysis and methods of
      measuring oxygen consumption for biological materials. The system overcame some
      disadvantages of operating inconvenience and difficulties of collective and
      analytic data by traditional means. The system possesses functions of automatic
      enactment, collection, save/take and analysis for many experimental data. It can
      be used to measure oxygen consumption of tissues, cells and mitochondria.

PMID- 11211846
TI  - [Stress-corrosion test of TIG welded CP-Ti].
AB  - In this study TIG (Tungsten Inert Gas) welded CP-Ti were subjected to stress
      corrosion test under 261 MPa in artificial saliva of 37 degrees C for 3 months.
      No significant difference was noted on mechanical test (P > 0.05). No color
      changed and no micro-crack on the sample's surface yet. These results indicate
      that TIG welded CP-Ti offers excellent resistance to stress corrosion.

PMID- 11211847
TI  - [Construction and nucleotide sequence assay of human anti-HBs variable region
      single-chain antibody gene].
AB  - The VH and Vk gene which were acquired using phage display technology have been
      combined by a linker encoding a flexible peptide (Gly4 Ser)3 to form a single
      chain. Its nucleotide sequence was assayed after cloning the scFv gene into
      middle plasmid. The successful construction of single-chain gene lays the
      foundations for the subsequent expression and production of double functional
      antibody.

PMID- 11211848
TI  - [Electron spin resonance studies on inhibiting methemoglobin in erythrocyte with
      exogenous ascorbic acid].
AB  - Research on inhibiting the methemoglobin (MetHb) in erythrocyte by means of
      exogenous ascorbic acid is helpful to elucidating whether exogenous antioxidant
      inhibits the oxidative denaturation of hemoglobin when the erythrocyte does not
      inhibit such denaturation with its own antioxidation system. Using electron spin
      resonance (ESR) technique, we have studied the oxidative denaturation of
      hemoglobin and the inhibition of MetHb in erythrocyte with the exogenous ascorbic
      acid. The results indicate that there is the ESR absorption of high spin MetHb (g
      = 6) at the 5th, 35th and 90th min after the blood was mixed with NaNO2. The ESR
      absorption of high spin MetHb increases with time. Yet, in the case where the
      blood was mixed with exogenous ascorbic acid in advance, the ESR absortpion of
      high spin MetHb (g = 6) only appears at the 35th min among the ESR measures at
      the 5th, 35th, and 90th min after the blood was mixed with NaNO2. These findings
      suggest that exogenous antioxidant can inhibit the oxidative denaturation of
      hemoglobin when the erythrocyte does not inhibit such dematuration with its own
      antioxidation system.

PMID- 11211849
TI  - Systemic lupus erythematosus: women's health issues.

PMID- 11211850
TI  - The stability of and intercorrelations among cardiovascular, immune, endocrine,
      and psychological reactivity.
AB  - One hundred fifteen college students were exposed to an evaluative speech task
      twice, separated by 2 weeks. At both sessions, we assessed cardiovascular,
      endocrine, immune, and psychological response at baseline and during the task. We
      found stability across sessions for stress-induced increases in anxiety and task
      engagement, heart rate, blood pressure, norepinephrine (but not epinephrine),
      cortisol, natural killer cell cytotoxicity, and numbers of circulating CD3+,
      CD8+, and CD56+ (but not CD4+ or CD19+) lymphocytes. The stable cardiovascular,
      immune, and endocrine reactivities were intercorrelated, providing evidence of a
      unified physiological stress response across these outcomes. Although stable
      stress-induced increases in task engagement were associated with the
      physiological stress responses, stress-induced anxiety was not.

PMID- 11211851
TI  - Review of the treatment literature for encopresis, functional constipation, and
      stool-toileting refusal.
AB  - This review summarizes the literature on randomized, controlled, published
      studies involving medical, behavioral, psychological, and biofeedback treatments
      for encopresis/functional constipation and stool-toileting refusal in preschool
      age and school-age children. Nine such studies were located in the literature
      involving school-age children. No randomized, controlled treatment studies
      involving preschool-age children have been published. This review revealed no
      evidence to support the routine use of psychotherapy or anal sphincter
      biofeedback in the treatment of pediatric fecal elimination dysfunctions, beyond
      those benefits derived from a comprehensive medical-behavioral intervention.
      Further, this review indicated that paradoxical constriction of the External Anal
      Sphincter does not influence the treatment outcome of either biofeedback or
      medical-behavioral interventions. There are remarkably few controlled treatment
      outcome studies in this most important clinical area. More research is needed
      that employs standard treatment outcome variables.

PMID- 11211852
TI  - Why do we have IgE-mediated immediate hypersensitivity?

PMID- 11211854
TI  - Do you know that there is a museum dedicated to Florence Nightingale in Turkey?

PMID- 11211853
TI  - [Multidisciplinary orthodontic treatment of adults: apropos of several cases].
AB  - Adult orthodontic's treatment requires the intervention of different specialists
      in order to establish a treatment schedule ensuring an esthetic and a functional
      result.

PMID- 11211855
TI  - Debate: Albumin administration should not be avoided.
AB  - The recent Cochrane report on albumin administration is analysed and criticised
      on the grounds of clinical methodology, content and interpretation. Although it
      is naive and illogical to treat hypoalbuminaemia with albumin infusions, a more
      balanced view on the use of albumin for resuscitation in acute hypovolaemia is
      necessary. Once the acute phase of critical illness is past, interstitial volume
      is often expanded causing oedema, with a low plasma volume. We argue for the use
      of salt-poor albumin solutions in this situation and conclude that, on current
      evidence, the assertion that albumin should be avoided in all situations is
      irrational and untenable.

PMID- 11211857
TI  - Cholecystectomy and bowel function.

PMID- 11211856
TI  - Debate: Albumin administration should be avoided in the critically ill.
AB  - The benefit of albumin administration in the critically ill patient is unproven.
      Epidemiological evidence suggests that there is an increase in death among
      patients with burns, hypoalbuminaemia, and hypotension treated with human albumin
      solution (HAS). In critical illness, hypoalbuminaemia is a result of
      transcapillary leak, decreased synthesis, large volume body fluid losses, and
      dilution caused by fluid resuscitation. When treating patients with
      hypoalbuminaemia, efforts must be centred around correction of the underlying
      disorder rather than reversal of hypoalbuminaemia. Problems with using albumin
      arise because it is an expensive blood product, and can result in systemic
      changes that include cardiovascular, haematological, renal, pulmonary, and
      immunological effects.

PMID- 11211858
TI  - MALT lymphomas and Helicobacter pylori?

PMID- 11211859
TI  - Guidelines for the management of iron deficiency anaemia.

PMID- 11211861
TI  - [Coordination Center for Clinical Study in Mainz--a new impetus for clinical
      research].

PMID- 11211860
TI  - [Pathology of paraneoplastic syndromes of the central and peripheral nervous
      systems and muscle ].
AB  - INTRODUCTION AND DEVELOPMENT: The paraneoplastic neurological syndromes are
      alterations associated with neoplasias. However, they are not caused by
      metastases or complications such as infections, vascular disorders, metabolic or
      nutritional alterations or secondary effect of treatment. The paraneoplastic
      syndromes are often associated with the creation of autoantibodies against
      antigens produced by the neoplastia, but also may be against other cells or
      target molecules of the patient. Sometimes, especially with antibodies directed
      against cell membrane proteins, there is a close relationship between the
      antibody and the target organ, as for example antibodies against the
      acetylcholine receptor in myasthenia gravis. On other occasions, especially when
      the antigen is intracellular, the mechanism of the autoantibody reaction is not
      known. Finally, in a third group, the antibody associated with a particular
      paraneoplastic neurological alteration has not been identified. In this paper we
      describe the main paraneoplastic neurological pictures and known antibodies,
      including the molecular aspects and the neoplasias most frequently related to
      them.

PMID- 11211862
TI  - Knee pain in a 40-year-old man.

PMID- 11211863
TI  - New functional aspects of cathepsin D and cathepsin E.
AB  - Cathepsin D (CD) and cathepsin E are representative lysosomal and nonlysosomal
      aspartic proteinases, respectively, and play an important role in the degradation
      of proteins, the generation of bioactive proteins, antigen processing, etc.
      Recenty, several lines of evidence have suggested the involvement of these two
      enzymes in the execution of neuronal death pathways induced by aging, transient
      forebrain ischemia, and excessive stimulation of glutamate receptors with
      excitotoxins. CD has also been shown to mediate apoptosis induced by various
      stimuli and p53-dependent tumor suppression. To gain more insight into in vivo
      functions of CD, mice deficient in this enzyme were generated. The mutant animals
      showed a progressive atrophy of the intestinal mucosa, a massive destruction of
      lymphoid organs, and a profound accumulation of ceroid lipofuscin, and developed
      a phenotype resembling neuronal ceroid lipofucinosis, suggesting that CD is
      essential for proteolysis of proteins regulating cell growth and tissue
      homeostasis. It has also been shown that CD molecules secreted from human
      prostate carcinoma cells are responsible for the generation of angiostatin, a
      potent endogenous inhibitor of angiogenesis, suggesting its contribution to the
      prevention of tumor growth and angiogenesis-dependent growth of metastases.
      Interestingly, pro-CD from human breast carcinoma cells showed a significantly
      lower angiostatin-generating activity than that from prostate carcinoma cells.
      Since deglycosylated CD molecules from both carcinoma cells showed a low
      angiostatin-generating activity, this discrepancy appeared to be attributed to
      the difference in the carbohydrate structures of CD molecules between the two
      cell types and to contribute to their potency to prevent tumor growth and
      metastases.

PMID- 11211864
TI  - Transglutaminase-dependent modulation of transcription factor Sp1 activity.
AB  - Modification of transcription factors would result in significant changes in the
      expression of related genes. Recently, the presence of transglutaminase (TGase)
      has been reported in nuclei, the biological significances of which have attracted
      a great concern. In this study, we tested the possibility that nuclear TGase
      would crosslink and regulate the activity of a glutamine-rich transcription
      factor Sp1. The addition of purified guinea pig liver TGase increased the binding
      activity of Sp1 to the target DNA sequence by gel electrophoretic mobility shift
      assay. The activity of the human p21WAF1 promoter containing six Sp1 binding
      sites was increased by the cotransfection of the TGase 2 gene, and two Sp1 sites
      at -82 and -69, relative to the transcription start site, were essential for the
      increased activity in human renal embryonic 293T cells. The activity of a minimal
      promoter containing three consensus Sp1 binding sites was increased by co
      transfection of human TGase 2 gene. The amount of Sp1 protein was increased
      dramatically in TGase 2-transfected 293T cells and the Sp1 protein itself from
      HeLa cell nuclear extracts was crosslinked readily by purified TGase at 37
      degrees C in the presence of Ca2+. These results suggest that the nuclear TGase
      might modulate the activity of the Sp1 transcription factor probably via the
      posttranslational or transcriptional modification of the factor by TGase.

PMID- 11211865
TI  - Flow cytometric analysis and chromosome sorting of barley (hordeum vulgare L).
AB  - Flow cytometric analysis was systematically performed to optimize the
      concentration and duration of hydroxyurea (DNA synthesis inhibitor) and
      trifluralin (metaphase blocking reagent) treatments for synchronizing the cell
      cycle and accumulating metaphase chromosomes in barley root tips. A high
      metaphase index (76.5% in the root tip meristematic area) was routinely achieved.
      Seedlings of about 1.0-cm length were treated with 1.25 mM hydroxyurea for 14 h
      to synchronize the root tip meristem cells at the S/G2 phase. After rinsing with
      hydroxyurea, the seedlings were incubated in a hydroxyurea-free solution for 2 h
      and were treated with 1 microM trifluralin for 4 h to accumulate mitotic cells in
      the metaphase. The consistent high metaphase index depended on the uniform
      germination of seeds prior to treatment. High-quality and high-quantity isolated
      metaphase chromosomes were suitable for flow cytometric analysis and sorting.
      Flow karyotypes of barley chromosomes were established via univariate and
      bivariate analysis. A variation of flow karyotypes was detected among barley
      lines. Two single chromosome types were identified and sorted. Bivariate analysis
      showed no variation among barley individual chromosomes in AT and GC content.

PMID- 11211866
TI  - Interaction of PRK1 receptor-like kinase with a putative elF2B beta-subunit in
      tobacco.
AB  - PRK1, a receptor-like kinase that is expressed in pollen, pollen tubes, and
      ovaries, has been shown to play important roles in pollen development and embryo
      sac development in Petunia inflata. We have used the kinase domain of PRK1 as a
      bait in the yeast two-hybrid system to identify PRK1-interacting proteins. The
      screening resulted in isolation of a cDNA encoding a protein highly homologous to
      the human and yeast beta-subunit of translation initiation factor 2B (eIF2B
      beta), which was designated NeIF2Bbeta. eIF2B is a guanine nucleotide exchange
      protein that functions in the regulation of translation in eukaryotic cells.
      Deletion mutants of NeIF2Bbeta were analyzed for their interaction with PRK1, and
      the results suggested that the N-terminal half of NeIF2Bbeta, especially the
      region between residue 103 and 235, is important for the interaction. This
      protein association was confirmed by in vitro binding assay of the recombinant
      NeIF2Bbeta and PRK1 proteins. Despite high sequence homology between NeIF2Bbeta
      and its yeast counterpart, the NeIF2Bbeta cDNA could not rescue the phenotype of
      the yeast mutant strain lacking the GCD7 gene encoding eIF2B-beta, when
      transferred into the mutant strain.

PMID- 11211867
TI  - Cloning and characterization of a 22 kDa outer-membrane protein (Omp22) from
      Helicobacter pylori.
AB  - Helicobacter pylori is a causative agent of gastritis and peptic ulceration in
      humans. As the first step towards development of a vaccine against H. pylori
      infection, we have attempted to identify protective antigens. A potential target
      of vaccine development would be a H. pylori specific protein, which is surface
      exposed and highly antigenic. We identified a 22 kDa outer-membrane protein
      (Omp22) from H. pylori, which was highly immunoreactive. By screening a H. pylori
      genomic DNA library with rabbit anti-H. pylori outer-membrane protein antibodies,
      the omp22 gene was cloned and 1.4 kb of the nucleotide sequence was determined.
      One open reading frame, encoding a 179-residue polypeptide, was identified and
      the amino acid sequence deduced showed homology with peptidoglycan-associated
      lipoproteins. The sequence was conserved among other H. pylori strains. Omp22
      protein is expressed as a precursor polypeptide of 179 residues and undergoes
      lipid modification and cleavage of an 18 amino acid signal peptide to yield a
      mature protein. Omp22 protein in H. pylori as well as recombinant Omp22 protein
      expressed in E. coli was localized into the outer membrane and exposed on the
      cell surface. Omp22 may have the potential as a target antigen for the
      development of a H. pylori vaccine.

PMID- 11211868
TI  - Costimulatory effect of Fas in mouse T lymphocytes.
AB  - To induce proper immune responses, T lymphocytes require two types of stimuli,
      antigen-specific and costimulatory signals. Among costimulatory molecules, CD28
      engagement promotes the survival and proliferation of both naive and memory T
      cells. In addition, it is now believed that Fas may play a role in T cell
      activation in the human system. It is, however, controversial whether Fas can act
      as a costimulatory signal in the murine system. Thus, we investigated fundamental
      differences in the capacity to induce proliferation of T cells between Fas and
      CD28 in mice. Fas-mediated T cell proliferation was observed only with a full
      mitogenic dose of anti-CD3 antibodies, whereas CD28 engagement was able to
      enhance T cell proliferation in the presence of a suboptimal level of anti-CD3
      antibody. Furthermore, Fas-engaged T cells showed faster response in the
      upregulation of CD25 and CD69 expression than CD28-engaged ones. Here, we report
      that Fas might play a role in mature T cell activation in the mouse system
      through a different mechanism from that in CD28 costimulation.

PMID- 11211869
TI  - Identification, expression, and nuclear location of murine Mage-b2 protein, a
      tumor-associated antigen.
AB  - MAGE-1, which was originally identified by reacting with cytolytic T lymphocytes
      derived from the blood of melanoma patients, is a member of a gene family
      consisting of 17 structurally related genes. The MAGE genes are expressed only in
      the testis among normal tissues and in a number of human tumors of various
      histological types. Murine MAGE (also called SMAGE or Mage) genes were found in a
      study aimed at detecting mouse genes homologous to human MAGE genes. However, the
      biological functions of MAGE and Mage are currently unknown. To understand the
      biological functions of Mage, in the present study a recombinant SMAGE2 (Mage-b2)
      protein of 43 kDa was produced and monoclonal antibodies reactive with Mage-b2
      protein were generated. One monoclonal antibody, smpG4A, specifically recognized
      a 43 kDa protein in lysates of Mage-b2 mRNA-positive sarcoma cells and of the
      testis. Immunohistochemistry showed that Mage-b2 is located in the nucleus of
      Mage-b2 mRNA-positive sarcoma cells. These results should contribute to
      understanding the biological functions of Mage.

PMID- 11211870
TI  - Downregulation of MHC class II expression by oxidant-induced apoptosis in EBV
      transformed B-cells.
AB  - The expression of MHC class II molecules is actively regulated upon various
      cellular stimuli. Since apoptosis is an inducible cellular process, it was asked
      whether cells undergoing apoptosis would also modulate their expression of class
      II molecules. Using an EBV-transformed B-cell line, the cell surface expression
      of HLA-DR molecules was analyzed by fluorescence-activated flow cytometry on
      normal and oxidant-treated apoptotic cells. A rapid and continuous decrease in
      HLA-DR expression was observed in apoptotic cells. RNA analysis and
      semiquantitative RT-PCR of cytoplasmic beta-actin mRNA showed that apoptotic
      cells contain partially degraded RNA and much lower amounts of beta-actin mRNA.
      Nevertheless, when compared after normalization of intact mRNA amounts, the HLA
      DRB mRNA signals were of similar strength in normal and apoptotic cells as
      determined by semiquantitative RT-PCR. Thus, the decrease in the number of class
      II molecules during apoptosis underlies no specific program for downregulation of
      HLA-DRB mRNA transcription but is due to a nonspecific degradation of RNA
      molecules accompanied by cell death.

PMID- 11211871
TI  - Gene delivery into rat glomerulus using a mesangial cell vector.
AB  - To develop an effective protocol of gene transfer into glomeruli, an ex vivo gene
      delivery system using rat mesangial cells (RMC) as a vector was examined. RMC
      genetically engineered with a retrovirus harboring the Escherichia coli beta
      galactosidase gene was used to estimate the efficacy of gene delivery and the
      location of the cells within the kidney. The RMC expressing beta-galactosidase,
      RMCLZ1, was cultured in vitro and the cells were injected into the left kidney
      through the renal artery of a normal Sprague Dawley rat. At least 1 x 10(6)
      RMCLZ1 was required for effective gene delivery into glomeruli. One hour and 1,
      4, and 14 d after injection, glomeruli were isolated from the left kidneys
      injected with the cells and the expression of beta-galactosidase in each
      glomeruli was evaluated. One hour and 1 d after injection, more than 90 and 80%,
      respectively, of glomeruli from the left kidney showed strong beta-galactosidase
      activity, while no activity of beta-galactosidase was found in the glomeruli from
      the right kidneys. The number of glomeruli stained by X-gal and the intensity
      decreased with time. Fourteen days after injection, about 35% of the glomeruli
      retained the RMCLZ1. X-gal and periodic acid-Schiff staining of frozen sections
      obtained 14 d after injection allowed the estimation of the site where the
      mesangial cells injected were located. The mesangial cells were found mainly in
      two different locations, the glomerular capillary and the mesangium. The majority
      (about 90%) of the mesangial cells were located in the glomerular capillary and
      about 9% of the cells were in the mesangial area. Occasionally, the positive
      staining was found in proximal tubules and the interlobular artery. Although
      additional methods are required for the site-specific targeting of the mesangial
      area, the ex vivo gene transfer to glomeruli is feasible and may be a useful tool
      for future investigations in the pathological mechanisms of glomerular injury.

PMID- 11211872
TI  - Role of hippocalcin in Ca2+ -induced activation of phospholipase D.
AB  - The role of hippocalcin as a novel mediator in the PKC-independent Ca2+ -induced
      phospholipase D (PLD) activation pathway was investigated. Hippocalcin was
      expressed in the Sf9 insect cell expression system because the myristoylation of
      this protein is essential for its function. PLD and Cdc42 proteins were prepared
      from a rat brain cell membrane and cytosol, respectively. The recombinant
      hippocalcin was expressed in the Sf9 cell using expression vector pVL1393. The
      hippocalcin expressed was purified as a single band on PAGE following the
      hydrophobic phenyl HPLC and TSKgel G3000SW gel filtration HPLC. The molecular
      size of the rat brain hippocalcin expressed in this system was estimated to be 22
      kDa. Myristoylated hippocalcin migrated faster than the non-myristoylated form on
      SDS-PAGE. Less than 10% of the total hippocalcin expressed was myristoylated in
      this baculovirus expression system. PLD was extracted from rat brain membranes
      and chromatographically enriched 70-fold. From the rat brain cytosol, Cdc42 was
      purified to near homogeneity. While hippocalcin alone did not activate PLD, it
      increased PLD activity activated with Cdc42 1.8-fold in the presence of calcium
      (300 nM free calcium). In the absence of calcium in the reaction mixture, the
      effect of hippocalcin to facilitate Cdc42-activated PLD activity was abolished.
      This result suggests that hippocalcin might be one of the regulatory proteins in
      the PKC-independent Ca2+ -mediated PLD activation pathway in conjunction with the
      Cdc42 protein.

PMID- 11211873
TI  - Isolation and characterization of a class I SLG gene from Chinese cabbage
      (Brassica campestris).
AB  - In Brassica species, self-incompatibility in the recognition reaction between
      self and non-self pollens is determined by two genes, SLG and SRK, at the S
      locus. We have cloned and characterized a genomic DNA fragment containing a
      complete open reading frame of the SLG gene from Chinese cabbage. The genomic
      clone, named BcSLG2, was found to possess the region that shares a homology of
      77% in amino acid identity with the SLG46 gene of Brassica campestris. Northern
      blot analysis revealed that the BcSLG2 gene expression is restricted to the
      pistil of Chinese cabbage flower. In situ hybridization showed that in the
      pistil, the gene is expressed predominantly in the stigmatic tissue. Much lower
      expression in the tapetum was also detectable at an immature stage of the flower
      development. Southern blot hybridization with the BcSLG2 DNA probe showed
      polymorphism in the SLG gene organization of the Chinese cabbage plants. These
      results will provide valuable information in understanding the S gene complex of
      the Chinese cabbage plants.

PMID- 11211874
TI  - Expression and characterization of fibroblast growth factor 8 from Mexican
      axolotl, Ambystoma mexicanum.
AB  - Fibroblast growth factor (FGF) has been known to regulate the proliferation and
      differentiation of a variety of cell types via interaction with a specific FGF
      receptor on the cell surface. In the present study, Fgf8 cDNA of Mexican axolotl,
      Ambystoma mexicanum, was expressed in Escherichia coli as an MBP-FGF8 fusion
      protein. The cell proliferation activity of the recombinant FGF8 (rFGF8) was
      measured by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazoliumbromide (MTT)
      assay. The addition of rFGF8 to the culture medium enhanced proliferation of
      BALB/c 3T3 and BHK21 cells about 1.4-1.5 fold. To analyze the binding activity of
      rFGF8 to the cell surface, cell surface enzyme linked immunosorbent assay was
      developed. Comparison of the structure of basic FGF with the computer-simulated
      structure of FGF8 suggested that Tyr-58, Glu-132, Tyr-139, and Leu-179 might be
      the potential receptor binding sites. Amino acid substitution muteins of FGF8
      were constructed by PCR-derived directed mutagenesis and the muteins were
      overexpressed in E. coli. The rFGF8 muteins were purified and their binding
      activities were analyzed. Substitution of Tyr-58 or Glu-132 or Leu-179 of the
      FGF8 with alanine reduced the binding affinity, while substitution of Tyr-139
      with alanine did not alter the binding affinity. These results imply that Tyr-58,
      Glu-132, and Leu-179 of FGF8 might be involved in its binding to the cell
      surface.

PMID- 11211875
TI  - The first successful prenatal diagnosis on a Korean family with citrullinemia.
AB  - DNA prenatal diagnosis was successfully performed on a family with citrullinemia.
      The father carried the G324S mutation and the mother carried the IVS6-2A > G
      mutation in the argininosuccinate synthase gene. They had a previous child with
      citrullinemia who died in the week after birth owing to complicated
      hyperammonemia. The lost child turned out to be a compound heterozygote. DNA was
      extracted from the cultured amniotic cells after amniocentesis done at 18-week
      gestation. For the detection of the G324S mutation, the PCR and restriction
      fragment length polymorphism method was used, and for the IVS6-2A > G mutation,
      allele-specific PCR was performed. The fetus was found to carry G324S but not
      IVS6-2A > G, suggesting a heterozygote carrier. Pregnancy was continued and a
      healthy boy was born. Plasma amino acid analysis performed on the third day after
      birth was normal and the serial ammonia level was in the normal range. A
      molecular study on his genomic DNA after birth also agreed with the previous
      fetal DNA analysis. He is now 2-months old with normal growth and development.

PMID- 11211876
TI  - Dose-dependent selective priming of Th1 and Th2 immune responses is achieved only
      by an antigen with an affinity over a certain threshold level.
AB  - Helper CD4+ T lymphocytes can be divided into two subsets, Th1 and Th2. The types
      of Th subsets activated during the adaptive immune response inductiondetermine
      the efficacy of immune responses against thee antigens introduced. Selective
      differentiation of subsets of CD4+ T lymphocytes has been known to be influenced
      by several factors, such as the cytokine environment around the T cells, the
      specificity of antigen recognition bythe T cell receptor, the expression of
      costimulatory molecules, and/ or the dose of the antigen applied to stimulate the
      T cells. In this study, we tried to determine the influence of the antigen dose
      on the selective priming of T lymphocytes when an inefficient antigen was applied
      since all the conclusions drawn from previous experiments were based on
      experiments with immune systems which responded well against the antigens
      introduced. When the recombinant hen egg-white lysozyme (HEL) was used too
      stimulate immune responses in HEL low-responder C57B3L/6 mice, dose-dependent
      selective priming of immune responses was not observed. However, when the variant
      antigen, which had been characterized as an efficientantigen in anti-HEL immune
      response induction in the low-responder mice, was applied, dose-dependent
      selective priming of Th immune responses was clearly demonstrated. These results
      suggested that dose-dependent selective priming of Th immune responses could be
      achieved only by the antigens with an affinity over a certain level.

PMID- 11211877
TI  - Proteome analysis of light-induced proteins in Synechocystis sp. PCC 6803:
      identification of proteins separated by 2D-PAGE using N-terminal sequencing and
      MALDI-TOF MS.
AB  - The cyanobacterium Synechocystis sp. PCC 6803 is an ideal model organism for the
      proteome study of light-induced gene expression because the whole genomic
      sequence has been determined. The soluble proteins extracted from light- and dark
      cultured cells were separated by two-dimensional polyacrylamide gel
      electrophoresis. Light-induced protein spots electroblotted on a polyvinyldiene
      difluoride membrane were analyzed by N-terminal Edman sequence determination and
      followed by CyanoBase. The tryptic digests of some proteins were also confirmed
      by matrix-assisted laser desorption ionization/time-of-flight (MALDI-TOF) and MS
      Fit search. Interestingly, eight proteins were related to photosynthesis and
      respiration (RbcS/L, CbbA, Gap2, AtpB, CpcB, PsbO, and PsbU). Four proteins
      (SodB, DnaK, GroEL2, and Tig) were involved in cellular processes and the
      functions of another two proteins (rehydrin and membrane protein) were unknown.
      The proteome analysis by N-terminal Edman sequencing and MALDI-TOF enabled us to
      characterize one-shot protein profiles expressed under different physiological
      conditions.

PMID- 11211878
TI  - The Na+ -Ca2+ exchanger is essential for embryonic heart development in mice.
AB  - The cardiac Na+ -Ca2+ exchanger 1 (NCX1) is thought to be the major calcium
      extrusion mechanism and to play an important role in the regulation of
      intracellular calcium in the heart. The Na+ -Ca2+ exchanger is particularly
      abundant in the heart, although it is found in a variety of other tissues. To
      investigate the role of NCX1, we have generated NCX1-deficient mice. Mice
      heterozygous for the NCX1 mutation showed no discernable phenotype, grew
      normally, and were fertile; however, no viable homozygote was observed among 175
      offspring obtained from intercrosses of heterozygotes. All the homozygous mutant
      mice died in utero before E10.5. Morphological analysis indicated that
      homozygotes of NCX1 mutation at E9.5 died with an underdeveloped heart with a
      dilated pericardium. Microscopic analysis of these embryos showed myocardial cell
      loss due to apoptosis. The apoptosis was first observed in E8.5 mutant heart.
      Areas outside the heart appeared normal in the mutant embryos at E8.5. In
      contrast, at E9.0, various regions of mutant embryos showed extensive cell loss.
      These results suggest that mutant embryos die owing to cardiac abnormalities
      caused by apoptotic cell loss, indicating that NCX1 is essential for normal
      development of the heart.

PMID- 11211879
TI  - Excision repair of 2,5-diaziridinyl-1,4-benzoquinone (DZQ)-DNA adduct by
      bacterial and mammalian 3-methyladenine-DNA glycosylases.
AB  - The mechanisms of anticancer activity of 2,5-diaziridinyl-1,4-benzoquinone (DZQ)
      are believed to involve the alkylation of guanine and adenine bases. In this
      study, it has been investigated whether bacterial and mammalian 3-methyladenine
      DNA glycosylases are able to excise DZQ-DNA adduct with a differential substrate
      specificity. DZQ-induced DNA adduct was first formed in the radiolabeled
      restriction enzyme DNA fragment, and excision of the DNA adduct was analyzed
      following treatment with homogeneous 3-methyladenine-DNA glycosylase from E.
      coli, rat, and human, respectively. Abasic sites generated by DNA glycosylases
      were cleaved by the associated lyase activity of the E. coli formamidopyrimidine
      DNA glycosylase. Resolution of cleaved DNA on a sequencing gel with Maxam-Gilbert
      sequencing reactions showed that DZQ-induced adenine and guanine adducts were
      very good substrates for bacterial and mammalian enzymes. The E. coli enzyme
      excises DZQ-induced adenine and guanine adducts with similar efficiency. The rat
      and human enzymes, however, excise the adenine adduct more efficiently than the
      guanine adduct. These results suggest that the 3-methyladenine-DNA glycosylases
      from different origins have differential substrate specificity to release DZQ-DNA
      lesions. The use of 3-methyladenine-DNA glycosylase incision analysis could
      possibly be applied to quantify a variety of DNA adducts at the nucleotide level.

PMID- 11211880
TI  - Efficient intracellular delivery of GFP by homeodomains of Drosophila Fushi
      tarazu and Engrailed proteins.
AB  - The 60 amino acid long homeodomain of Antennapedia (Antp), either alone or as a
      fusion protein with 30-40 amino acid long foreign polypeptides, has been reported
      to cross biological membranes by an energy- and receptor-protein-independent
      mechanism. Moreover, the 16 amino acid long third helix of the Antp homeodomain,
      so-called penetratin, possesses translocation properties when fused to fewer than
      100 amino acids as well. These findings led us to study whether such a protein
      tansduction property is shared by other homeodomains. We report here that
      homeodomains of two homeoproteins, Fushi-tarazu and Engrailed, are able to
      transduce a 238 amino acid long green fluorescent protein into cultured cells as
      efficiently as other well-known protein transduction domains, such as an internal
      oligopeptide of Tat and penetratin. These findings suggest that such transduction
      activity of homeodomains might have some physiological roles and that it can be
      exploited for development of efficient transduction vectors for research use and
      protein therapy.

PMID- 11211881
TI  - Identification of novel genes differentially expressed in PMA-induced HL-60 cells
      using cDNA microarrays.
AB  - Identification of normal growth and differentiation-inducing proteins and their
      interaction in normal development have made it possible to elucidate the
      molecular basis of normal development and the mechanisms uncoupling growth and
      differentiation during tumor development. The development of cancer and the
      experimental reversal of tumorigenicity are accompanied by complex changes in
      patterns of gene expression. cDNA microarrays provide a powerful tool for
      studying these phenomena. In the present study, a high-density microarray of
      human cDNA elements was used to search for differences in gene expression
      associated with differentiation of human promyelic leukemia HL-60 cells.
      Microarrays containing 3,063 human cDNAs were printed on glass slides with high
      speed robotics. These DNA 'chips' were used to quantitatively monitor
      differential expression of the cognate human genes using a highly sensitive two
      color hybridization assay. The identification of known and novel phorbol ester
      regulated genes in hematopoietic progenitor cells demonstrates the sensitivity of
      the assay.

PMID- 11211882
TI  - My aching back: a serious complaint in children.

PMID- 11211883
TI  - Clinically challenging mammographic artifacts: a pictorial guide.
AB  - Artifacts on mammographic images detract from the overall quality of the images
      and often present clinical and technical troubleshooting difficulties for the
      interpreting radiologist, technologist, and medical physicist and for the
      equipment and processor service personnel. This presentation demonstrates several
      types of mammographic artifacts that may pose a clinical challenge. They are
      arranged in the following categories: (1) particularly dangerous artifacts, (2)
      masses, (3) calcifications, (4) density variations, and (5) miscellaneous
      artifacts. Examples of such findings as summation shadows, normal anatomic
      variations, and incorrect positioning are also demonstrated as artifacts in this
      guide, because they may affect image quality or patient radiation dose. Under the
      Mammography Quality Standards Act, the lead interpreting physician has the
      responsibility for ensuring that the facility meets quality assurance
      requirements and is required to follow up with the technologist on poor-quality
      images. It is vital to recognize and correct for artifacts, whether they simulate
      non-existent lesions or obscure real pathology, because misinterpretation can
      lead to undesirable consequences.

PMID- 11211884
TI  - Decline of hepatitis C virus load in serum during the first 24 h after
      administration of interferon-beta as a predictor of the efficacy of therapy.
AB  - BACKGROUND/AIMS: Hepatitis C virus (HCV) kinetics during interferon (IFN)-alpha
      treatment have been evaluated recently, however, little is known about the
      resultant viral kinetics in IFN-beta treatment. In this study, we evaluated HCV
      kinetics during the first 24 h of IFN-beta treatment, and also assessed their
      relationship to therapeutic outcomes. METHODS: We measured HCV RNA levels at 0
      and 24 h after the initiation of IFN-beta treatment, and we calculated the decay
      slope, viral half-life, and viral production and clearance. Then we analyzed
      these factors as they related to therapeutic responses with IFN-beta as well as
      to clinical variables, i.e. genotype, diversity of hyper variable region, and
      histological findings. RESULTS: Patients with sustained responses (SR) displayed
      steeper decay slopes of the viral load than those without SR (2.87 +/- 1.41 vs.
      1.82 +/- 1.66, P = 0.031). On the other hand, the decay slope was not affected by
      the clinical variables. The values of viral half-life and viral production and
      clearance showed no significant correlation to the response and the clinical
      variables. CONCLUSION: This study demonstrated that the decay slope of the viral
      load during the first 24 h is related to the virological response to IFN-beta
      treatment.

PMID- 11211885
TI  - Inhibition of hepatitis B virus production associated with high levels of
      intracellular viral DNA intermediates in iron-depleted HepG2.2.15 cells.
AB  - BACKGROUNDS/AIMS: The effects of iron-depletion on hepatitis B virus (HBV)
      replication were examined in HepG2.2.15 cells. METHODS: Proliferating cells were
      iron-depleted with desferrioxamine (DFO), at 20 or 100 microM for 48 h. Levels of
      viral mRNAs, cytoplasmic DNA replicative intermediates and virion production were
      examined. A comparative study was performed with hydroxyurea, a specific
      inhibitor of ribonucleotide reductase. RESULTS: In desferrioxamine treated cells,
      virion production is dramatically decreased, while viral replicative
      intermediates accumulate in the cytoplasm. DFO, like hydroxyurea, blocks cell
      cycle progression in the G1/S transition or S phase with a corresponding 2-fold
      increase of viral mRNAs. As expected, hydroxyurea leads to a strong reduction of
      virion production associated with low levels of intracellular replicative
      intermediates. CONCLUSIONS: These results strongly suggest that iron depletion
      affects the HBV life cycle indirectly through the cell cycle arrest and directly
      through the inhibition of the viral DNA secretion. They also indicate the need to
      re-evaluate with caution the iron depletion protocols on HBV infected patients
      since a decrease of viral markers in the serum following iron-depletion may not
      reflect a decrease of viral replicative forms, but on the contrary, could be
      associated with active viral DNA synthesis.

PMID- 11211886
TI  - Maintenance of primary murine hepatocyte functions in multicomponent polymer
      capsules--in vitro cryopreservation studies.
AB  - BACKGROUND/AIMS: The potential of a new encapsulation system has been evaluated
      as an artificial housing for liver cells. METHODS: Murine hepatocytes were
      encapsulated in specially designed multicomponent capsules formed by
      polyelectrolyte complexation of sodium alginate, cellulose sulphate and
      poly(methylene-co-guanidine) hydrochloride, the permeability of which has
      previously been characterised. RESULTS: We demonstrate here the absence of
      cytotoxicity and the excellent biocompatibility of these capsules towards primary
      culture of murine hepatocytes. Experimental results demonstrated that the
      encapsulated hepatocytes retained their specific functions--transaminase
      activity, urea synthesis and protein secretion--over the first 4 days of culture
      in minimum medium. The cryopreservation of encapsulated hepatocytes, for periods
      of up to 4 months, did not alter their functional capacities, as no major
      differences were observed between unfrozen and frozen encapsulated cells for the
      functions tested. CONCLUSIONS: Because of the absence of cytotoxicity, and the
      ease of handling and cryopreservation, while maintaining liver specific
      functions, the described system appears to be valuable for murine liver cell
      encapsulation. It is also a promising tool for fundamental research into drug
      metabolism, intercellular regulation, metabolic pathways, and the establishment
      of banks for the supply and storage of murine hepatocytes.

PMID- 11211887
TI  - Duck hepatitis B virus polymerase gene mutants associated with resistance to
      lamivudine have a decreased replication capacity in vitro and in vivo.
AB  - BACKGROUND/AIMS: Hepatitis B virus mutants of the polymerase gene are frequently
      selected during lamivudine therapy for chronic hepatitis B. To study the biology
      of these mutants, we analyzed their replication capacity in the duck hepatitis B
      virus (DHBV) infection. METHODS: The B and C domain polymerase mutants
      corresponding to the clinical isolates were engineered by site directed
      mutagenesis in the DHBV genome in different expression vectors. RESULTS: The
      study of the enzymatic activity of the mutated viral polymerase polypeptides
      analyzed in a cell free system demonstrated a lower priming activity and a
      decreased capacity of elongation of viral minus strand DNA that was consistent
      with the lower replication capacity of these mutants in transfected leghorn male
      hepatoma cells compared to wild type genome. These mutants had a lower
      replication capacity in primary hepatocytes and in in vivo transfected ducklings.
      Although resistant to lamivudine, these mutants remained sensitive to PMEA.
      CONCLUSION: YMDD mutants of the DHBV reverse transcriptase have a decreased
      replication capacity both in vitro and in vivo, and are not cross-resistant to
      PMEA. These results may be important to design new antiviral strategies to combat
      the replication of the lamivudine resistant viral strains.

PMID- 11211888
TI  - Rapid seroprotection against hepatitis B following the first dose of a Pre-S1/Pre
      S2/S vaccine.
AB  - BACKGROUND/AIMS: Will immunization with an experimental Pre-S1/Pre-S2/S hepatitis
      B vaccine (Bio-Hep-B) induce faster seroprotection using fewer doses as compared
      with a yeast derived S vaccine (Engerix B). METHODS: Healthy volunteers, n = 36,
      mean age 23 y, randomized to receive 2 or 3 doses of both vaccines given months 0
      and 6, or 0, 1 and 6. RESULTS: Following primary immunization, seroprotection
      occurred in 6, 39, 53 and 60% in the Bio-Hep-B group at weeks 1, 2, 3 and 4,
      compared with 0, 12, 18 and 12.5% in the Engerix-B vaccinees, respectively. Six
      months following injection of the first dose, seroprotection was 70 and 25% in
      Pre-S/S and S vaccinees respectively. Area under the curve in vaccinees of Bio
      Hep-B; versus Engerix-B showed mean anti-HBs level of 365 +/- 166 and 85 +/- 48
      mIU/ml x day respectively (P = 0.012). At month 7, 100% seroprotection was
      achieved in both groups while anti-HBs rose from 81 to 28,800 mIU/ml and from 12
      to 923 mIU/ml in recipients of Bio-Hep-B and Engerix-B respectively (P < 0.025).
      CONCLUSIONS: Bio-Hep-B induces rapid seroprotection against hepatitis B in 60-70%
      of vaccinees, within 4-24 weeks after the first dose. Two instead of the
      conventional three doses of the Pre-S/S vaccine may be sufficient to induce
      adequate seroprotection.

PMID- 11211889
TI  - A randomized, double-blind controlled trial of interferon alpha-2b and ribavirin
      vs. interferon alpha-2b and amantadine for treatment of chronic hepatitis C non
      responder to interferon monotherapy.
AB  - BACKGROUND/AIMS: Interferon-based regimens (alone or with ribavairin) are
      standard therapies for chronic hepatitis C. The aim of this study was to compare
      a 24-week regimen of interferon alpha-2b + ribavirin (IFN + RIBA) to interferon
      alpha-2b + amantadine (IFN + AMANT) in non-responders to previous interferon
      monotherapy. METHODS: In a multi-center, double-blind clinical trial, 118
      patients (non-responders to previous interferon monotherapy) were equally
      randomized into the two arms: interferon alpha-2b (3 MU thrice weekly) and
      ribavirin (800 mg daily) vs. interferon alpha-2b (3 MU thrice weekly) and
      amantadine (200 mg daily). RESULTS: After 24 weeks of therapy, HCV RNA became
      undetectable in 34.8% (95% CI: 23.7-49.2) of IFN + RIBA and 19.6% (95% CI: 10.6
      34.7) of IFN + AMANT (P = 0.10). This response was sustained in 3.9% (95% CI: 1.0
      14.9) of IFN + RIBA and 0% of IFN + AMANT (P = 0.16). Ten patients from IFN +
      AMANT (17%) and 12 patients (20%) from IFN + RIBA were discontinued before
      completion of therapy. Of these, 7% in IFN + AMANT and 12% in IFN + RIBA were
      discontinued due to adverse effects. CONCLUSIONS: Re-treatment of interferon non
      responders with a 24-week course of IFN + AMANT was not associated with any
      sustained viral eradication. Although IFN + RIBA in this group was associated
      with a reasonable end of treatment response, relapses were common and sustained
      responses were low.

PMID- 11211890
TI  - Schistosomiasis mansoni and viral B hepatitis in woodchucks.
AB  - BACKGROUND/AIMS: An interaction between human schistosomiasis and viral hepatitis
      B has often been suggested, but never established. The experimental investigation
      has been hampered by the lack of a suitable model. Only woodchucks are
      susceptible to both Schistosoma mansoni and a B-like hepatitis virus (WHV)
      infections. This study explores the relevance of this unique model regarding
      hepatitis/schistosomiasis interactions. METHODS: Woodchucks (Marmota monax and
      Marmota marmota) were infected with: (a), S. mansoni; (b), WHV; or (c), both S.
      mansoni and WHV. RESULTS: Following the experimental parasitic infection of
      woodchucks, with or without WHV, schistosomiasis presented a peculiar and severe
      course in early infection, involving mostly the intestines. Subsequently, the
      intestinal and hepatic lesions underwent considerable modulation and the
      periovular granulomas decreased in size and number, while the parasitic infection
      tended to self-cure within the 9 months following infection. Nine woodchucks
      inoculated with the hepatitis virus alone presented with several degrees of acute
      and chronic hepatitis, with one of them dying of hepatocarcinoma 1 year after
      inoculation. Four woodchucks with concomitant viral and schistosome infections
      presented with a simple additive pattern of lesions, without any evidence of
      modification or aggravation of either one of the two infections. Similarly, no
      significant impact of schistosomiasis on WHV serum markers could be seen.
      CONCLUSIONS: Schistosomiasis and viral hepatitis in woodchucks run parallel
      courses, with neither apparent special histological features derived from the
      association of the two conditions, nor modulation of WHV replication.
      Schistosomiasis itself, however, was observed to run a peculiar course in the
      woodchuck. The present data are important for consideration in further
      experiments exploring the interplay between schistosomiasis and viral hepatitis
      induced liver damage in this unique experimental host.

PMID- 11211891
TI  - The effects of interferon alpha-2b in combination with ribavirin on health
      related quality of life and work productivity.
AB  - BACKGROUND/AIMS: Interferon plus ribavirin is the most effective therapy for
      chronic hepatitis C. The aim of this study was to evaluate the effect of chronic
      hepatitis C and therapy on health-related quality of life and work functioning.
      METHODS: Nine hundred and twelve patients with hepatitis C infection were
      randomized in a controlled trial of Interferon alpha 2b 3 MU tiw for 24 or 48
      weeks plus ribavirin 1000-1200 mg or placebo. Questionnaire-based assessments of
      health-related quality of life and work functioning were performed before,
      during, and after treatment. Outcome measures included the SF-36 Health Survey
      and additional generic and specific scales. Work functioning was assessed as
      missed days, shorter hours or less productivity at work. RESULTS: Pre-treatment,
      patients had significant impairment in five of eight SF-36 concepts compared to
      matched population norms. Sustained responders had a return to normal for four of
      these five concepts. Quality of life did not improve in non-responders.
      Improvements in histology, viral load or ALT values predicted improvements in
      quality of life. Sustained responders also had improvements in work functioning
      and productivity. CONCLUSIONS: Hepatitis C patients had impaired quality of life.
      After combination therapy, sustained virologic responders achieved benefits in
      their quality of life and work functioning.

PMID- 11211892
TI  - Bioencapsulated hepatocytes for experimental liver support.

PMID- 11211893
TI  - Bacterial translocation: cause or consequence of decompensation in cirrhosis?

PMID- 11211894
TI  - Dendritic cells: regulators of hepatic immunity or tolerance?

PMID- 11211895
TI  - De novo tumours after liver transplantation in adults. What is the actual risk?

PMID- 11211896
TI  - The Wilson's disease gene and phenotypic diversity.

PMID- 11211897
TI  - Images in hepatology. Fistulization of a hepatocellular carcinoma into the
      duodenum.

PMID- 11211898
TI  - Orlistat associated subacute hepatic failure.

PMID- 11211899
TI  - Selective arterial embolization for life threatening hemobilia after transjugular
      intrahepatic portosystemic shunt placement.

PMID- 11211900
TI  - Improvement of magnetic resonance spectroscopic abnormalities but not pallidal
      hyperintensity followed amelioration of hepatic encephalopathy after occlusion of
      a large spleno-renal shunt.

PMID- 11211901
TI  - Hepatic undifferentiated embryonal sarcoma: malignant evolution of mesenchymal
      hamartoma? Study of one case with immunohistochemical and flow cytometric
      emphasis.

PMID- 11211902
TI  - Drug biotransformation by human hepatocytes. In vitro/in vivo metabolism by cells
      from the same donor.
AB  - BACKGROUND/AIMS: Cultured human hepatocytes are considered a close model to human
      liver. However, the fact that hepatocytes are placed in a microenvironment that
      differs from that of the cell in the liver raises the question: to what extent
      does drug metabolism in vitro reflect that of the liver in vivo? This issue was
      examined by investigating the in vitro and in vivo metabolism of aceclofenac, an
      analgesic/anti-inflammatory drug. METHODS: Hepatocytes isolated from programmed
      liver biopsies were incubated with aceclofenac, and the metabolites formed were
      investigated by HPLC. During the course of clinical recovery, patients were given
      the drug, and the metabolites, largely present in the urine, were analyzed. In
      vitro and in vivo data of the same individual were compared. RESULTS: The
      relative abundance of oxidized metabolites in vitro (i.e. 4'OH-aceclofenac + 4'OH
      diclofenac vs. total hydroxylated metabolites; Spearman's p = 0.855), as well the
      hydrolysis of aceclofenac (4'OH-diclofenac vs. 4'OH-aceclofenac + 4'OH
      diclofenac; p = 0.691) correlated well with in vivo data. The conjugation of the
      drug in vitro (24.6 +/- 7.6%) was lower than that in vivo (44.9 +/- 5.3%). The
      rate of 4'OH-aceclofenac formation in vitro correlated with the amount of
      metabolites excreted in urine after 16 h (p = 0.95). CONCLUSIONS: The in vitro/in
      vivo metabolism of the drug was surprisingly similar in each patient. The
      variability observed in vitro reflected an existing phenotypic variability among
      donors.

PMID- 11211903
TI  - Daily variation of azygos and portal blood flow and the effect of propranolol
      administration once an evening in cirrhotics.
AB  - BACKGROUND/AIMS: Esophageal variceal bleeding occur more often at night, however,
      the mechanism for this remains unclear. This study investigated the daily
      variation of azygos blood flow (AzBF) and portal blood flow (PBF) and the effects
      of propranolol administration given once in evening in cirrhotics. METHODS: Blood
      flow were measured using magnetic resonance imaging. Hemodynamic parameters were
      determined at 08:00, 16:00 24:00 and again 08:00 h, and were measured at baseline
      and after 14 days oral administration of propranolol (30 mg, n = 7) or placebo (n
      = 7) at 19:00 h in 14 patients. RESULTS: A daily fluctuation of AzBF and PBF was
      observed, peaking at 24:00 h in nine patients. In three other patients, peak AzBF
      and PBF were observed both at 16:00 and 24:00 h. Two patients were constant
      throughout the day. When the daily variation was compared, ANOVA showed a
      significant difference (P < 0.001). Propranolol administration at 19:00 h reduced
      AzBF (-40.7 +/- 17.9% vs. baseline, P < 0.001) and PBF (-26.5 +/- 10.7% vs.
      baseline, P < 0.01) at 24:00 h. CONCLUSIONS: We found that in most cirrhotics,
      AzBF and PBF peaks at midnight. Dosing of propranolol in the evening may be
      important for its role in preventing variceal bleeding.

PMID- 11211904
TI  - Bacterial translocation of enteric organisms in patients with cirrhosis.
AB  - BACKGROUND/AIMS: The aim of the study was to investigate the prevalence and
      associated risk factors for bacterial translocation in patients with cirrhosis, a
      mechanism involved in the pathogenesis of bacterial infections in experimental
      cirrhosis. METHODS: Mesenteric lymph nodes were obtained for microbiological
      culture from 101 patients with cirrhosis and from 35 non-cirrhotic patients.
      RESULTS: Enteric organisms were grown from mesenteric lymph nodes in 8.6% of non
      cirrhotic patients. In the 79 cirrhotic patients without selective intestinal
      decontamination, the prevalence of bacterial translocation significantly
      increased according to the Child-Pugh classification: 3.4% in Child A, 8.1% in
      Child B and 30.8% in Child C patients (chi2 = 6.106, P < 0.05). However,
      translocation by Enterobacteriaceae, the organisms commonly responsible for
      spontaneous bacteremia and peritonitis in cirrhosis, was only observed in 25% of
      the cases. The prevalence of bacterial translocation in the 22 cirrhotic patients
      undergoing selective intestinal decontamination, all Child-Pugh class B and C,
      was 4.5%. The Child-Pugh score was the only independent predictive factor for
      bacterial translocation (odds ratio 2.22, P = 0.02). CONCLUSIONS: Translocation
      of enteric organisms to mesenteric lymph nodes is increased in patients with
      advanced cirrhosis and is reduced to the level found in non-cirrhotic patients by
      selective intestinal decontamination.

PMID- 11211905
TI  - Overexpression of endothelin-1 in bile duct ligated rats: correlation with
      activation of hepatic stellate cells and portal pressure.
AB  - BACKGROUND/AIMS: Hepatic stellate cells (HSC) are involved in the pathogenesis of
      liver fibrosis; although ET-1 is increased in cirrhosis, its pathophysiological
      role in fibrogenesis and portal hypertension remains controversial. The aim of
      this study was to investigate splanchnic hemodynamics and to correlate them with
      changes in ET-1 expression and HSC activation in bile duct ligated (BDL) rats.
      METHODS/RESULTS: Expression of the ET-1 gene was increased early as measured by
      quantitative reverse transcriptase-polymerase chain reaction (6-fold 3 days after
      BDL) whereas ET-1 peptide measured by RIA increased significantly only in the
      late phase (30-fold at 28 days). There was a linear correlation between portal
      pressure and the amount of ET-1 in the portal vein (r = 0.66; P = 0.003), as well
      as between ET-1 and the volume fraction of myofibroblasts (r = 0.80, P < 10(-7))
      as assessed by morphometry and immunohistochemical staining using alpha-smooth
      muscle actin. CONCLUSIONS: During chronic liver injury activation of HSCs and of
      preproET-1 mRNA is accentuated in the early phase after BDL. The late increase in
      ET-1 peptide may indicate that this peptide is only secondarily involved in HSC
      activation. The correlation between ET-1 in portal vein and portal pressure
      suggests that ET-1 may play an important role in the development of portal
      hypertension.

PMID- 11211906
TI  - Visualization of the transport of primary and secondary bile acids across liver
      tissue in rats: in vivo study with fluorescent bile acids.
AB  - BACKGROUND/AIMS: Lysyl fluorescein conjugated bile acid analogues (LFCBAA)
      closely parallel their natural counterparts. To assess LFCBAA as a tool for the
      visualization of bile acid transport within liver tissue. METHODS: Wistar rats
      were administered physiological concentrations of the primary bile acid analogue
      cholyllysyl fluoroscein (CLF) and of the secondary bile acid analogue
      lithocholyllysyl fluorescein (LLF) and serial liver biopsies were taken at fixed
      intervals. Both compounds were also injected retrogradely into the biliary tree.
      Frozen sections were examined by fluorescence microscopy. RESULTS: Both CLF and
      LLF were rapidly taken up from sinusoidal blood but differed significantly in
      their hepatic handling. CLF was rapidly transported into bile, whereas LLF
      transport was slower and produced significantly more bile duct fluorescence. LLF
      clearance showed a lobular gradient with last remaining bile acid being confined
      largely to zone 3. Both compounds were avidly taken up by cholangiocytes after
      injection intravenously or retrogradely into the biliary tree. CONCLUSIONS:
      Visualization of LFCBAA by fluorescence microscopy may yield further information
      regarding hepatobiliary bile acid localization during studies of physiological
      and pathological mechanisms involved in transport of bile acids. The presence of
      both compounds within cholangiocytes strongly suggests that they may undergo a
      degree of chole-hepatic recirculation.

PMID- 11211907
TI  - A prognostic model for predicting survival in cirrhosis with ascites.
AB  - BACKGROUND/AIMS: Parameters evaluating renal function and systemic hemodynamics
      are of prognostic significance in cirrhosis with ascites but are rarely used in
      the evaluation of survival of these patients. The aim of the current study was to
      develop a prognostic model to estimate survival of patients with cirrhosis and
      ascites. METHODS: 216 Cirrhotic patients admitted to hospital for the treatment
      of ascites were evaluated. Thirty-two demographic, clinical and laboratory
      variables, including parameters assessing liver and renal function and systemic
      hemodynamics, were analyzed as predictive factors of survival by using a Cox
      regression model. RESULTS: Four variables had independent prognostic value: renal
      water excretion, as assessed by measuring diuresis after water load, mean
      arterial pressure, Child-Pugh class, and serum creatinine. According to these
      features a prognostic index was calculated that allows to estimate survival in
      patients with cirrhosis and ascites. The model accurately predicted survival in
      an independent series of 84 patients with cirrhosis and ascites. CONCLUSION: A
      prognostic model that uses four easily available variables and predicts prognosis
      in cirrhotic patients with ascites has been developed. This model may be useful
      in the evaluation of patients with ascites for liver transplantation.

PMID- 11211908
TI  - Dynamics of albumin in plasma and ascitic fluid in patients with cirrhosis.
AB  - BACKGROUND/AIMS: To determine dynamics of albumin in plasma and ascitic fluid of
      patients with cirrhosis. METHODS: Forty-seven patients were classified in four
      groups: I--patients without fluid retention; II--patients with ascites not
      resistant to subsequent diuretic treatment; III--recompensated patients during
      diuretic treatment; and IV--patients with diuretic-resistant ascites.
      Transvascular and transperitoneal albumin transports were quantified by 131I
      /125I-labelled human albumin. RESULTS: TER(P) (i.e. the fraction of intravascular
      albumin (IVM) passing from plasma into the interstitial space per hour) was
      increased in all groups. In group IV patients the transport rate of albumin from
      plasma into the ascitic fluid (TER(PA)) was significantly higher than the
      transport rate from the ascitic fluid back into the plasma: TER(AP) (0.45 vs.
      0.26% IVM/h, P < 0.002). In group II patients TER(PA) was similar to TER(AP)
      (0.27 vs. 0.25% IVM/h, ns). A direct correlation was found between TER(PA) and
      TER(AP) in both groups of patients (r = 0.78, P < 0.001). CONCLUSION: In non
      resistant ascites, there is a steady state between the transport of albumin into
      the peritoneal cavity and back into the plasma, but in resistant ascites the
      former transport is elevated. Thus, local factors may be important to treatment
      of ascites.

PMID- 11211909
TI  - Induction of cytokine production and proliferation of memory lymphocytes by
      murine liver dendritic cell progenitors: role of these progenitors as immunogenic
      resident antigen-presenting cells in the liver.
AB  - BACKGROUND/AIMS: Many pathogenic organisms, including hepatotrophic viruses enter
      the liver and induce an immune response, but there is little information about
      the immunogenic resident antigen-presenting cells. The aim of this study was to
      determine whether dendritic cells in the liver are immunogenic antigen-presenting
      cells. METHODS: Liver dendritic cell progenitors were enriched from normal
      C57BL/6 mice by culturing non-parenchymal cells with granulocyte-macrophage
      colony stimulating factor for 7 days. Then the surface antigen (MHC class II,
      CD86) expression, endocytic capacity, ability to induce cytokines, and the
      proliferation of memory lymphocytes were investigated. RESULTS: Freshly enriched
      liver dendritic cell progenitors exhibited an immature phenotype and failed to
      stimulate allogenic T cells. However, the progenitors underwent maturation
      following exposure to antigens such as hepatitis B surface antigen and keyhole
      limpet hemocyanin. The progenitors then became strong stimulators of allogenic T
      cells, supported the production of interleukin-12 and interferon-gamma, and
      induced the proliferation of antigen-specific memory lymphocytes. CONCLUSIONS:
      Dendritic cell progenitors are immunogenic resident antigen-presenting cells in
      the liver. Simultaneous investigation of both tolerogenic and immunogenic
      resident antigen-presenting cells may provide insights into the pathogenesis of
      persistent infection and autoimmmune diseases of the liver.

PMID- 11211910
TI  - Human hepatocyte cell lines proliferating as cohesive spheroid colonies in
      alginate markedly upregulate both synthetic and detoxificatory liver function.
AB  - BACKGROUND/AIMS: Bio-artificial liver support systems for treatment of hepatic
      failure require maintained expression of hepatocyte function in vitro. We studied
      cultures of human hepatocyte cell-lines proliferating within alginate beads,
      investigating the hypothesis that 3-dimensional cohesive colonies of hepatocyte
      cell-lines would achieve polarity and cell-to-cell contact resulting in
      upregulation of function. METHODS: HepG2 and HHY41 human cell lines in alginate
      beads were cultured for >20 days. RESULTS: Proliferation was maintained for 20
      days. Production of albumin, prothrombin, fibrinogen, alpha-1-acid glycoprotein
      and alpha-1-antitrypsin was maintained throughout, maximal at days 8-10, when
      upregulation was 300-1100% compared with monolayer cultures at similar cell
      number per unit volume. Detoxificatory functions: ethoxyresorufin deethylase
      activity, androstenedione metabolism, and urea synthesis from arginine was also
      increased several-fold. Function returned to pre-freezing levels within 18 h of
      thawing after cryopreservation of cells in alginate. Electron microscopy revealed
      spherical colonies of cells of cuboidal shape, with cell-to-cell contact via
      desmosomes and junctional complexes, abundant microvilli, and cytoplasmic
      appearances suggesting transcriptionally active hepatocytes. CONCLUSION:
      Hepatocyte cell-lines, proliferating in alginate express a range of liver
      specific functions at levels approaching those found in vivo, relevant to their
      use in liver support systems.

PMID- 11211911
TI  - Expression of hepatocyte growth factor in human hepatocellular carcinoma.
AB  - BACKGROUND/AIMS: We have shown that hepatocyte growth factor, secreted by human
      liver myofibroblasts, promoted in vitro invasion of human hepatocellular
      carcinoma cell lines. The aim of this work was to measure hepatocyte growth
      factor expression in 29 human hepatocellular carcinomas and the corresponding
      peri-tumoral livers. METHODS: We used reverse transcription-polymerase chain
      reaction, in situ hybridization, ELISA and Western blot. RESULTS: Sixty-two of
      tested hepatocellular carcinomas were positive by reverse transcription
      polymerase chain reaction. With in situ hybridization, a signal was found in
      every sample. In many cases, the signal was localized in cells labeled with an
      anti-smooth muscle alpka-actin antibody, while hepatocytes were mostly non
      labeled. ELISA, performed in 15 pairs of hepatocellular carcinomas and
      surrounding livers, detected hepatocyte growth factor in every sample with wide
      variations. Hepatocellular carcinomas that had developed in non-cirrhotic livers
      contained essentially the same amount of hepatocyte growth factor as the matching
      non-tumoral liver. In cirrhotic livers, the hepatocyte growth factor content of
      the tumors was significantly lower than that of the surrounding cirrhotic livers.
      CONCLUSIONS: These data indicate that hepatocyte growth factor is expressed at
      significant levels in every hepatocellular carcinoma tested and that its
      expression takes place in the stromal myofibroblasts.

PMID- 11211912
TI  - Increased cancer risk after liver transplantation: a population-based study.
AB  - BACKGROUND/AIMS: Development of de novo malignancies emerges as a serious long
      term complication after liver transplantation. METHODS: We reviewed the medical
      records of 174 adult one-year survivors for de novo malignancies. The observed
      cancer rates were compared with the expected cancer rates in the Dutch
      population. RESULTS: Twenty-one of the 174 patients developed 23 malignancies
      (12%). Skin and lip cancer accounted for 12 of the 23 malignancies (52%). Only
      one patient had a B-cell lymphoma. The cumulative risk for de novo malignancy was
      6, 20, and 55% at 5, 10, and 15 years after transplantation, respectively. The
      overall relative risk (RR) as compared with the general population was 4.3 (95%
      confidence interval 2.4-7.1). Significantly increased RRs were observed for non
      melanoma skin cancer (RR 70.0), non-skin solid cancer (RR 2.7), renal cell cancer
      (RR 30.0), and colon cancer (RR 12.5). Multivariate analysis showed that an age >
      40 years and pretransplant use of immunosuppression were significant risk
      factors. CONCLUSIONS: An increased risk of cancer exists after liver
      transplantation, for both for skin/lip cancer, and other solid tumors. Older age
      and the use of immunosuppression are risk factors.

PMID- 11211914
TI  - Animal models of bronchial asthma.
AB  - Due to the continuous increase in prevalence and morbidity in asthma, there is an
      urgent need to improve present therapy by drugs with new modes of actions. In
      contrast to many human diseases, allergic asthma does not occur in the animal
      world. Therefore, we have to mimic some characteristic feature of asthma in
      animals. For this reason, a wide variety of animal models have been developed and
      are employed in the search for new chemical entities for asthma therapy. In the
      present paper, the experimental models of the most characteristic asthma symptoms
      are critically reviewed.

PMID- 11211913
TI  - Cost-benefit analysis of a nationwide infant immunization programme against
      hepatitis A in an area of intermediate endemicity.
AB  - BACKGROUND/AIMS: The availability of safe and effective Hepatitis A vaccines
      prompts an evaluation of a nationwide infant vaccination campaign to supplement
      strategies aimed at high-risk groups such as travellers and military personnel.
      METHODS: A spreadsheet model was used to estimate costs and benefits of a
      nationwide infant immunization programme against Hepatitis A for the period from
      1997-2014 in Israel. RESULTS: Immunizing all one year olds in Israel from 1997
      2014 would for a cost of $32.0 million to the health services and $42.1 million
      to society (including $10.1 million lost work and transport costs), reduce the
      number of cases of Hepatitis A during the next 45 years from 181,000 to 47,000.
      This would save $57.5 million in health service resources alone, $32.0 million in
      averted work absences and transport costs in addition to a further $17.0 million
      in averted premature mortality costs. The health service, resource and societal
      benefit:cost ratios are 1.80:1, 2.13:1 and 2.54:1, respectively. CONCLUSIONS: The
      recent adoption of a nationwide infant HAV immunisation policy in Israel is both
      medically and economically justifiable.

PMID- 11211915
TI  - Dexamethasone enhances P-selectin mRNA expression in hyperoxic rat lungs.
AB  - OBJECTIVE AND DESIGN: To test the hypothesis that glucocorticoid administration
      would diminish the lung expression of P-selectin mRNA in hyperoxia-exposed rats.
      ANIMALS: Adult male Sprague-Dawley rats were divided into 6 separate groups
      containing 10 to 13 animals per group. TREATMENT: Rats were dosed with 1 mg/kg of
      dexamethasone or vehicle only, ip. Immediately after dosing, animals were placed
      in > 95 % oxygen. Some animals were maintained in room air and are presented as 0
      h of exposure to hyperoxia. Another group of animals was dosed with 10 mg/kg
      lipopolysaccharide (LPS) ip immediately after dosing with either dexamethasone or
      vehicle as above. METHODS: At 24 or 48 h, lung samples were obtained, and lung
      weight to body weight ratios calculated. In the LPS studies, samples were
      obtained 4 h after LPS dosing. In a subset of animals, lung sections were
      hybridized for P-selectin mRNA. All data except for hybridizations were analyzed
      with three-way ANOVA, with subsequent post-hoc testing. P-selectin hybridizations
      were quantified by counting the number of positive vessels per high-powered
      field, and subsequently analyzed by unpaired Student's t-test.
      Immunohistochemical analyses for P-selectin expression were also performed to
      determine whether changes in P-selectin mRNA were associated with differences in
      protein expression. All data are expressed as means +/- SEM. RESULTS: Rats dosed
      with dexamethasone had higher lung/body weight ratios after 24 and 48 h of
      exposure to hyperoxia than did similarly exposed rats dosed only with vehicle (at
      48 h, 0.87 +/- 0.04 versus 0.65 +/- 0.06, respectively, P < 0.05). The higher
      ratios in hyperoxic animals dosed with dexamethasone were associated with much
      higher levels of lung expression for P-selectin mRNA than was observed in
      similarly exposed rats dosed with vehicle alone (at 48 h, 3.93 +/- 1.02, versus
      0.20 +/- 0.06, respectively, P < 0.01). In contrast dexamethasone dosing lead to
      lower lung P-selectin mRNA expression in animals exposed to LPS (1.23 +/- 1.08 in
      dexamethasone dosed animals versus 6.80 +/- 0.92 in vehicle only dosed animals).
      Consistent with the mRNA data, P-selectin immunoreactivity increased as a
      function of hyperoxia-exposure time in animals dosed with dexamethasone, while
      immunoreactivity decreased as a function of hyperoxia-exposure time in animals
      dosed with vehicle only. CONCLUSIONS: Increased P-selectin mRNA combined with
      increased P-selectin protein expression in animals exposed to hyperoxia and dosed
      with dexamethasone suggests that enhanced expression of P-selectin may contribute
      to the greater lung injury and inflammation caused by hyperoxia in rats treated
      with dexamethasone.

PMID- 11211916
TI  - Studies on the effects of adenosine A3 receptor stimulation on human eosinophils
      isolated from non-asthmatic or asthmatic donors.
AB  - OBJECTIVE: This study was designed to demonstrate the presence of adenosine A3
      receptors on human peripheral blood eosinophils, and to investigate the effect of
      A3 receptor stimulation on eosinophil function. MATERIAL: Eosinophils from either
      non-asthmatic or asthmatic donors. METHODS: Eosinophils were isolated from
      peripheral venous blood by discontinuous gradient centrifugation and negative
      immunoselection. Receptor localisation was investigated by immunoblotting and by
      immunocytochemistry using a novel antibody specific for the human A3 receptor.
      Two pharmacological responses were studied: elevation of intracellular calcium in
      single eosinophils, measured by microfluorimetry, and hydrogen peroxide
      generation in cell suspensions. RESULTS: The expression of A3 receptors by
      eosinophils was confirmed using the selective antibody. Addition of the A3
      receptor selective agonist, IB-MECA (100 nM), produced increases in intracellular
      calcium in less than 10% of the eosinophils isolated from non-asthmatic donors.
      These responses were only partially attenuated with the A3 receptor antagonist, I
      ABOPX. IB-MECA (0.001-1000 nM) did not stimulate hydrogen peroxide (H2O2)
      generation, nor did it enhance fMLP- or C5a-stimulated generation of H2O2. In
      fact high concentrations of IB-MECA inhibited the generation of H2O2 (when
      stimulated by fMLP or C5a), an effect probably mediated by A2 receptors. Similar
      results were obtained using eosinophils from asthmatic donors. CONCLUSIONS:
      Stimulation of adenosine A3 receptors does not appear to be a prime mechanism for
      free radical generation by human peripheral blood eosinophils.

PMID- 11211917
TI  - Neutrophil infiltration as a crucial step for monocyte chemoattractant protein
      (MCP)-1 to attract monocytes in lipopolysaccharide-induced arthritis in rabbits.
AB  - OBJECTIVE AND DESIGN: To evaluate the mechanism whereby monocyte chemoattractant
      protein (MCP)-1 attracts monocytes in vivo. SUBJECTS: New Zealand white rabbits
      (175 rabbits) were used. TREATMENT: LPS, MCP-1 or IL-8 was injected into knee
      joints. Antibodies against various cytokines or IL-1 receptor antagonist were
      injected to neutralize cytokine activities. METHODS: The numbers of leukocyte
      populations, levels of cytokines in joints were estimated. RESULTS: Partial
      inhibition of neutrophil influx with anti-IL-8 IgG (10 microg) suppressed LPS
      induced macrophage influx by 43 +/- 8.5% (p<0.05) without affecting the MCP-1
      level. Intraarticular injection of MCP-1 (1-30 microg) induced macrophage influx.
      The event was accompanied by a small number of neutrophils in an early phase. Co
      injection of IL-8 (1.0 microg) enhanced the MCP-1-induced macrophage infiltration
      (p < 0.01). In neutrophil-depleted rabbits, LPS failed to induce macrophage
      influx even though the MCP-1 level was maintained, and macrophage influx
      following exogenously administered MCP-1 was also dramatically inhibited.
      CONCLUSIONS: Early events associated with neutrophil infiltration appear to be
      important for MCP-1 to induce a later macrophage influx in LPS-arthritis.

PMID- 11211918
TI  - Retinoic acid enhances the effect of collagen on bone union, following induced
      non-union defect in guinea pig ulna.
AB  - OBJECTIVE AND DESIGN: The aim of the present study is to evaluate the involvement
      of retinoic acid and collagen in wound healing, by combining them in a
      therapeutic modality for treating a non-union bone defect in a guinea-pig ulnar
      bone model. METHODS: a 4-mm disc was excised from the guinea-pig's ulnar-bone,
      and the space formed between the two ulnar fragments was filled with either
      collagen solution, retinoic acid solution or a combination of both. The guinea
      pigs were sacrificed 2 or 6 weeks later, and the defected ulnar bones were
      studied by X-ray, by histology and by computerized histomorphometry. RESULTS:
      After 6 weeks, the long bone area fraction within the histological sections of
      the bone, was increased after treatment with this mixture by 180%, as compared to
      the untreated controls. The cartilage area in those sections was decreased by 44%
      after the combined treatment, as compared to increases of 133% and 182% following
      treatments with collagen alone. CONCLUSION: These findings demonstrate that
      addition of 500 IU of retinoic acid to collagen at a site of a bone defect, is
      superior to either agent in enhancing regeneration of new bone, achieving union
      across the defect and leading to its complete repair.

PMID- 11211919
TI  - FMLP-induced formation of F-actin in HL60 cells is dependent on PI3-K but not on
      intracellular Ca2+, PKC, ERK or p38 MAPK.
AB  - OBJECTIVE AND DESIGN: To further understand the mechanisms of signal transduction
      pathways for the formation of F-actin (polymerization of actin) and the
      activation of NADPH oxidase in phagocytic cells, the effects of various
      inhibitors on them were studied. MATERIALS AND METHODS: Differentiated HL60 cells
      were studied to examine their N-formyl-methionyl-leucyl-phenylalanine (fMLP)
      stimulated formation of F-actin and activation of NADPH oxidase following
      treatment with various inhibitors. These included a protein kinase C (PKC)
      inhibitor (GF 109203X), a phosphatidylinositide 3 kinase (PI3-K) inhibitor
      (wortmannin), an extracellular response kinase (ERK) inhibitor (PD 98059), a p38
      mitogen-activated protein kinase (MAPK) inhibitor (SB 203580) and an
      intracellular Ca2+ -chelator (BAPTA-AM). RESULTS: The treatment with wortmannin
      suppressed the formation of F-actin, with less suppression of the activation of
      NADPH oxidase. BAPTA-AM and GF 109203X did not attenuate the formation of F-actin
      but completely inhibited the activation of NADPH oxidase. PD 98059 and SB 203580
      partially inhibited the activation of NADPH oxidase without influence on the
      formation of F-actin. Furthermore, wortmannin but not BAPTA-AM and GF 109203X
      inhibited the fMLP-induced activation of Akt, which is known to regulate NADPH
      oxidase. CONCLUSIONS: These results suggest that the formation of F-actin is
      dependent on PI3-K and independent of PKC, ERK and p38 MAPK as well as the
      increase in intracellular Ca2+, whereas the activation of NADPH oxidase is partly
      dependent on ERK, p38 MAPK, Akt regulated by PI3-K, and strongly dependent on the
      activation of PKC and the increase in intracellular Ca2+.

PMID- 11211920
TI  - The in vitro and in vivo pharmacology of antisense oligonucleotides targeted to
      murine Stat6.
AB  - OBJECTIVE AND DESIGN: This study was designed to establish whether
      phosphorothioate (PS) antisense oligonucleotides (AS-ODN) targeted to Stat6 were
      active in vivo in a mouse model of active sensitisation. MATERIALS: Female Balb/c
      mice (6-8) per group were used for in vivo study. TREATMENT: Mice were treated
      with active PS AS-ODNs determined in initial in vitro studies. Compounds were
      dosed daily (3-30mg/kg i.v.) over the course of sensitisation to ovalbumin.
      METHODS: Stat6 mRNA and protein levels were determined in the spleen after
      treatment (quantitative northern and western analysis respectively), in addition
      to serum IgE (ELISA). ANOVA was used to determine any significant differences
      between groups. RESULTS: Both of the AS-ODNs tested in vivo, down regulated Stat6
      mRNA and protein levels in the spleen by 40-50% although there was no effect on
      serum IgE. These treatments also induced splenomegaly in vivo and caused
      splenocyte proliferation in vitro. CONCLUSIONS: The AS-ODNs used can down
      regulate Stat6 mRNA and protein although not sufficiently to influence IgE
      levels. These effects are likely to be complicated in vivo by the immune
      stimulation evident as splenomegaly.

PMID- 11211921
TI  - Reactive oxygen intermediates and eicosanoid production by kupffer cells and
      infiltrated macrophages in acute and chronic liver injury induced in rats by
      CCl4.
AB  - OBJECTIVE AND DESIGN: The aim of the present study was to characterize during
      acute and chronic liver injury induced by CCl4, macrophage phenotypes and whether
      a change in reactive oxygen intermediates (ROI) and eicosanoids production by
      Kupffer cells (KC) was observed. MATERIAL AND METHODS: Liver steato-necrosis and
      cirrhosis were induced in rats after 3 weeks and 9 weeks of CCl4 intoxication,
      respectively. Monocytes and tissue macrophages were identified by
      immunohistochemical study using monoclonal antibodies ED-1 and tissue macrophages
      using the antibody ED-2. The release of ROI and eicosanoids in response to the
      phorbol ester TPA (protein kinase activator) and to the calcium ionophore A23187
      was assessed in cultivated cells. RESULTS: As compared to healthy controls,
      livers of rats with steato-necrosis or cirrhosis exhibited a significant increase
      of ED-1 and ED-2 positive cells. Only KC from rats with liver steato-necrosis
      were found to have higher A23187, TPA + A23187 or opsonized zymosan induced ROI
      production than healthy controls (p < 0.01). After TPA + A23187 or opsonized
      zymosan stimulation, KC from both rats with steato-necrosis or cirrhosis produced
      more TxB2 and leukotrienes and less PGE2 as compared to healthy controls (p
      <0.05). CONCLUSIONS: These results suggest an influx of monocytes into the liver
      during acute and chronic injury induced by CCl4. Functional changes of this
      inflammatory infiltrate have been demonstrated with an increase of ROI production
      only in the early stage of liver injury whereas a rise in KC leukotriene
      production and an imbalance between cytoprotective and cytotoxic prostanoids were
      observed at all stages of liver disease.

PMID- 11211922
TI  - Mechanism underlying acute resident leukocyte disappearance induced by
      immunological and non-immunological stimuli in rats: evidence for a role for the
      coagulation system.
AB  - OBJECTIVE: To investigate the involvement of the fibrinogen-fibrin system in the
      acute reduction of the resident leukocyte population following pleural
      inflammation. METHODS: Sensitized and naive rats were injected intrapleurally
      (i.pl.) with antigen (ovalbumin) and platelet-activating factor (PAF) or
      bradykinin, respectively. Heparin (0.25 U/cavity), EDTA (80 microg/cavity) and
      hirudin (1 U/cavity) were injected locally 5 min before challenge, whereas
      fucoidin was injected intraperitoneally 30 min before stimulation. RESULTS:
      Antigen challenge led to a rapid reduction in the number of resident leukocytes
      30 min post-challenge (from 7.7 +/- 0.4 x 10(6) cells/cavity to 2.3 +/- 0.2 x 106
      cells/cavity, n = 6, p < 0.001). The pleural stimulation of naive rats with
      either PAF or bradykinin also led to a significant decrease in the pleural
      leukocyte population, which occurred in parallel with the formation of a fibrin
      meshwork containing captured cells, as attested by electron microscopy. Heparin
      prevented the drop in the total leukocyte numbers, without modifying either
      plasma leakage or histamine release at 30 min or the subsequent neutrophil and
      eosinophil infiltration noted 4 and 24 h post-challenge, respectively. Similarly,
      hirudin and EDTA prevented the antigen-induced leukocyte disappearance reaction.
      Heparin also impaired the drop in the pleural leukocyte numbers evoked by PAF and
      bradykinin. CONCLUSION: Our data show that the pleural resident cell
      disappearance phenomenon noted early after inflammatory provocation depends on
      the activation of the fibrinogen-fibrin system, and is not required for the
      subsequent leukocyte recruitment.

PMID- 11211923
TI  - Oral beta-stimulants can inhibit passive cutaneous anaphylaxis in rats through an
      indirect inhibitory mechanism: possible involvement of afferent and efferent
      nervous system via gastric beta2-adrenoceptor stimulation.
AB  - OBJECTIVE AND DESIGN: We previously demonstrated that oral l-ephedrine exerts an
      extremely rapid (within 20 s) inhibition of 48-h passive cutaneous anaphylaxis
      reaction (PCA) in rats by a possibly unidentified mode of action. In the present
      experiments, we elucidated the mechanism of the PCA inhibition by l-ephedrine
      using adrenoceptor agonists and antagonists. MATERIALS: Rat antiserum was
      prepared with dinitrophenylated Ascaris suum extract + Bordetella pertussis.
      TREATMENT: Passively skin-sensitised Wistar rats were mainly used. l-Ephedrine,
      and adrenoceptor agonists and antagonists were orally administered immediately
      before PCA provocation. Catecholamine depleting (6-hydroxydopamine, 6-OHDA),
      amine depleting (reserpine) or ganglion blocking (hexamethonium) agent was
      intraperitoneally or intravenously administered before the provocation. METHODS:
      The effects of the drugs on PCA were assessed by inhibition of the dye leakage.
      RESULTS: beta-(propranolol) and beta2-(butoxamine) blocking agents reduced the
      inhibition of PCA by l-ephedrine, while the inhibition was not altered by either
      an a-blocking agent (phentolamine) or a beta1-(atenolol) selective antagonist. On
      the other hand, beta-(isoproterenol) and beta2-selective (salbutamol) agonists
      showed extremely rapid inhibition of PCA. However, the beta-selective agonist
      (dobutamine) had no effect on the reaction. The pretreatment with hexamethonium,
      reserpine or 6-OH-DA substantially attenuated the inhibitory effect of l
      ephedrine on PCA. CONCLUSIONS: The results strongly suggest that beta2
      adrenoceptors locate in the stomach and that their receptor excitement finally
      may lead to the inhibition of PCA via the stimulation of the central and
      peripheral nervous systems.

PMID- 11211924
TI  - L-arginine modifies free radical production and the development of experimental
      allergic encephalomyelitis.
AB  - OBJECTIVES AND DESIGN: The present investigation examines the effects of
      increasing central nervous system (CNS) levels of nitric oxide (NO), via the
      administration of L-arginine, on the development of experimental allergic
      encephalomyelitis (EAE). SUBJECTS: EAE was induced in male Lewis rats (200-250
      g). TREATMENT: Normal rats were orally dosed with L-arginine (300 mg/kg body
      weight) once daily for 12 days. EAE-sensitised animals received L-arginine (300
      mg/kg body weight) once daily from day 1 to 12 post-inoculation. METHODS:
      Neurological and histological development of EAE were assessed. In addition, CNS
      cytosol levels of nitrite, superoxide and hydrogen peroxide were measured.
      Results were analysed using the Mann Whitney U-test and Chi-squared test.
      RESULTS: L-arginine administration significantly delayed disease onset (p < 0.05)
      and reduced the severity of neurological (p < 0.05) and histological (p < 0.001)
      signs of EAE. Treatment with L-arginine caused a significant elevation in CNS
      nitrite concentrations (p < 0.05) which in EAE-sensitised animals was associated
      with a concomitant and dramatic decrease in superoxide (p < 0.05) and hydrogen
      peroxide (p < 0.05) levels. CONCLUSIONS: The results suggest that NO may act as a
      protective molecule during the development of EAE possibly via the modulation of
      oxidant-mediated neuroinflammation.

PMID- 11211926
TI  - Neutrophil migration and aggregation induced by euphorbin, a lectin from the
      latex of Euphorbia milii, var. milii.
AB  - OBJECTIVE AND DESIGN: To study the neutrophil migration and aggregation induced
      by euphorbin, a D-galactose binding lectin from Euphorbia milii var. milli latex.
      MATERIALS AND METHODS: Euphorbin-induced neutrophil migration was evaluated in
      vivo and in vitro, in the absence or presence of soluble D-galactose. Neutrophil
      aggregation induced in vitro by euphorbin was determined by light microscopy.
      RESULTS: The neutrophil migration inducing activity of euphorbin was dose
      dependent and inhibited by soluble D-galactose. Neutrophil aggregation was
      rapidly reversed when provoked by 0.1 mg/ml euphorbin. In higher concentrations,
      euphorbin caused persistent and more extensive neutrophil aggregation.
      CONCLUSIONS: Euphorbin induced neutrophil migration through its sugar recognition
      property. The transitory neutrophil aggregation, induced by a euphorbin quantity
      similar to that able to cause maximal chemotactic response, is characteristic of
      homotypic neutrophil adhesion, whereas persistent aggregation, provoked by higher
      euphorbin quantities, corresponds to cell agglutination by a multivalent lectin.

PMID- 11211925
TI  - Urethane suppresses rat lung inducible cyclooxygenase and nitric oxide synthase
      mRNA levels.
AB  - OBJECTIVE AND DESIGN: The purpose of the present study was to evaluate the effect
      of urethane, pentobarbital sodium and ketamine-xylazine anesthesia upon
      constitutive and inducible cyclooxygenase (COX-1; COX-2) and nitric oxide
      synthase (eNOS; iNOS) mRNA levels in the lung. METHODS: mRNA levels were
      determined by the semiquantitative RT-PCR technique. TREATMENT: Urethane (1.1
      g/kg ip), Pentobarbital Sodium (40 mg/kg ip), and ketamine (85 mg/kg) - xylazine
      (15 mg/kg, im). Non-anesthetized animals served as controls. MATERIAL: Sprague
      Dawley rat lungs RESULTS: Urethane significantly decreased COX-1 and COX-2 mRNA
      levels to 30% of control values. This agent had no effect upon eNOS, but
      completely suppressed iNOS mRNA levels. Pentobarbital sodium and ketamine had no
      effect on the mRNA levels for COX-1 and COX-2 the lung. CONCLUSIONS: Urethane has
      a suppressive effect on COX and iNOS RNA message in the lung and for this reason
      it should be avoided as an anesthetic when lung inflammatory processes are
      experimentally evaluated in the rat.

PMID- 11211927
TI  - Assay of cyclooxygenase-1 and 2 in human monocytes.
AB  - OBJECTIVE AND DESIGN: There is frequently poor correlation between in vitro
      methods for calculated cyclooxygenase (COX)-1/COX-2 selectivities of inflammatory
      agents. Therefore, we have examined the use of a single stimulus in a single cell
      type containing both COX isoforms, for determining the selectivities of COX
      inhibitory agents. METHODS: Fresh human monocytes were stimulated with
      arachidonic acid (AA; 10 microM) for 15 min and prostaglandin E2 (PGE2) and
      thromboxane B2 (TXB2) production were used as a measure of COX-1 activity. To
      measure COX-2 activity, cells were transiently pre-treated with aspirin to
      irreversibly inhibit constitutive COX-1, treated with lipopolysaccharide (LPS) to
      induce COX-2 and then stimulated with AA. RESULTS: Eicosanoid production in
      resting monocytes was predominantly COX-1 derived since it was not inhibited by
      NS-398 and also, COX-2 was not detectable. In LPS treated monocytes pre-treated
      transiently with aspirin, neither the level of induced COX-2 nor the activity was
      affected. Using the mean of the results for PGE2 and TXB2 inhibition, the COX
      1/COX-2 ratios of the IC50 values for aspirin and NS-398 are < 0.1 and > 130,
      respectively. CONCLUSIONS: This study has provided a system for investigating
      inhibition of COX isotypes without the potentially confounding effects of using
      different cell types with different stimuli for each isotype as seen in other
      published systems. Dose responses to aspirin and NS-398 which are COX- and COX-2
      selective inhibitors respectively, confirmed the utility of this system.

PMID- 11211928
TI  - Characterization of chenodeoxycholic acid as an endogenous antagonist of the G
      coupled formyl peptide receptors.
AB  - OBJECTIVE AND DESIGN: To demonstrate the role of bile acids in immune modulation
      we examined the ability of select bile acids to inhibit leukocyte migration and
      chemoattractant receptor function. MATERIALS: To elucidate this mechanism, we
      employed primary human monocytes, neutrophils and cell lines transfected to
      express either the high affinity fMLP receptor (FPR) or the low affinity fMLP
      receptor like 1 (FPRL1). TREATMENT: Cells were treated with chenodeoxycholic acid
      (CDCA) and related bile acids in a 0-400 micromolar range. METHOD: Cell
      viability, chemotaxis and calcium flux analysis were preformed. RESULTS: We
      observed that pathophysiological levels (< or = 150 micromolar) of CDCA
      competitively inhibited 3H-fMLP binding to human monocytes, FPR and FPRL1
      transfected cells. Additionally, CDCA reduced both the chemotactic and calcium
      flux responses induced by fMLP or "W" peptide. Further, CDCA inhibited anti-FPR
      antibody binding to monocytes. CONCLUSIONS: CDCA selectively inhibited human
      leukocyte chemotaxis and calcium flux induced by fMLP, but not other
      chemoattractants, suggesting a mechanism for inhibition of inflammation and
      suppression of innate immune response.

PMID- 11211929
TI  - Killing tumour cells by alkylphosphocholines: evidence for involvement of CD95.
AB  - Many lipids act as cellular messengers and lead to a variety of different
      cellular responses. Out of the group of these compounds the ceramides are able to
      induce apoptosis, and some synthetic lipids can mimic this effect. Apoptosis is
      an important mechanism whereby chemotherapeutics exhibit their anti-oncogenic
      activity. Although, some lipid analogues were used in clinical trials, they exert
      severe side effects and their mechanism of action is widely unknown. We present
      here a new class of synthetic alkylphosphocholines (APC) that induce programmed
      cell death in leukaemia cells. The signs of apoptosis arise after 1 h of
      incubation with these compounds as shown by phosphatidylserine externalisation
      followed by caspase activation and DNA fragmentation. We demonstrate that the
      molecular target of these lipids is upstream of caspases and Bcl-2. Experiments
      with FADD dominant negative cells reveal that induction of apoptosis occurs on
      the level of CD95 and that these compounds can now be optimised for their
      capacity to activate the apoptosis-inducing receptor CD95.

PMID- 11211931
TI  - The effects of chelidonine on tubulin polymerisation, cell cycle progression and
      selected signal transmission pathways.
AB  - Chelidonine is a tertiary benzophenanthridine alkaloid known to cause mitotic
      arrest and to interact weakly with tubulin. Our interest in chelidonine began
      when we found it to be a major contaminant of Ukrain, which is a compound
      reported to be selectively toxic to malignant cells. The effects of chelidonine
      in two normal (monkey kidney and Hs27), two transformed (Vero and Graham 293) and
      two malignant (WHCO5 and HeLa) cell lines, were examined. Chelidonine proved to
      be a weak inhibitor of cell growth, but no evidence for selective cytotoxicity
      was found in this study. It was confirmed that chelidonine inhibits tubulin
      polymerisation (IC50 = 24 microM), explaining its ability to disrupt microtubular
      structure in cells. A G2/M arrest results, which is characterised by abnormal
      metaphase morphology, increased levels of cyclin B1 and enhanced cdc2 kinase
      activity. Exposure of all cell lines examined to chelidonine leads to activation
      of the stress-activated protein kinase/jun kinase pathway (SAPK/JNK).

PMID- 11211930
TI  - Heteromeric connexons formed by the lens connexins, connexin43 and connexin56.
AB  - In the eye lens, three connexins have been detected in epithelial cells and bow
      region/differentiating fiber cells, suggesting the possible formation of
      heteromeric gap junction channels. To study possible interactions between Cx56
      and Cx43, we stably transfected a normal rat kidney cell line (NRK) that
      expresses Cx43 with Cx56 (NRK-Cx56). Similar to the lens, several bands of Cx56
      corresponding to phosphorylated forms were detected by immunoblotting in NRK-Cx56
      cells. Immunofluorescence studies showed co-localization of Cx56 with Cx43 in the
      perinuclear region and at appositional membranes. Connexin hexamers in NRK-Cx56
      cells contained both Cx43 and Cx56 as demonstrated by sedimentation through
      sucrose gradients. Immunoprecipitation of Cx56 from sucrose gradient fractions
      resulted in co-precipitation of Cx43 from NRK-Cx56 cells suggesting the presence
      of relatively stable interactions between the two connexins. Double whole-cell
      patch-clamp experiments showed that the voltage-dependence of Gmin in NRK-Cx56
      cells differed from that in NRK cells. Moreover, stable interactions between Cx43
      and Cx56 were also demonstrated in the embryonic chicken lens by co-precipitation
      of Cx43 in Cx56 immunoprecipitates. These data suggest that Cx43 and Cx56 form
      heteromeric connexons in NRK-Cx56 cells as well as in the lens in vivo leading to
      differences in channel properties which might contribute to the variations in gap
      junctional intercellular communication observed in different regions of the lens.

PMID- 11211932
TI  - Supramolecular dynamics of gap junctions.
AB  - During the life cycle of a membrane protein its molecular structure may change
      and for aggregated proteins this process may be observed on the supramolecular
      level. Here we demonstrate that this is the case for gap junction channels which
      maintain cell-cell communication. Freshly synthesized connexins are integrated as
      hexamers (connexons) into the plasma membrane where they form plaques after
      pairing with connexons of an attached cell. We inhibited protein trafficking by
      applying the fungal metabolite brefeldin A (BFA), quantified cell-cell coupling
      by calcein transfer and fluorescence-activated flow cytometry, and examined the
      degradation and formation of gap junction plaques by indirect immunofluorescence
      and immunogold labeling. Under control conditions 50% of the detected plaques
      were ubiquitylated and less than 10% showed a two-dimensional crystalline
      packing. One hour after BFA reversal about 60% of the plaques were crystalline
      and ubiquitylation dropped to 14%. Label for ubiquitin was predominantly found on
      non-crystalline plaques. We, therefore, conclude that newly formed gap junction
      plaques are of crystalline morphology which changes to a pleomorphic structure
      when individual channels are modified during their aging process. This dynamic in
      plaque morphology correlates with channel inactivation and plaque ubiquitylation.

PMID- 11211933
TI  - Mycobacterial surface moieties are released from infected macrophages by a
      constitutive exocytic event.
AB  - Bacterial cell wall constituents are released from mycobacterial phagosomes and
      actively traffic within infected macrophages. Colocalization of fluorescently
      tagged bacterial moieties with endocytic tracers revealed the dynamic movement of
      released mycobacterial constituents into the endocytic network with accumulation
      in tubular lysosomal-like compartments. The released bacterial constituents not
      only penetrated the infected host cell but were also present in an extracellular
      microvesicular fraction. To identify the intracellular source of these exocytic
      compartments, released vesicular material was isolated from culture supernatants
      by differential ultracentrifugation and characterized by Western blot and
      electron microscopy analyses. The presence of lysosomal membrane proteins and
      lysosomal proteases suggested that labeled mycobacterial cell wall constituents
      access a constitutive lysosomal exocytic pathway. An abundance of multilamellar
      extracellular compartments morphologically reminiscent of MHC class II-enriched
      compartments (MIIC) implicated a MHC class II transport pathway in the
      extracellular release of bacterial constituents. Increases in intracellular free
      calcium have previously been shown to trigger lysosomal exocytosis by inducing
      fusion of lysosomes with the plasma membrane. To test if an increase in calcium
      would stimulate exocytosis with release of mycobacterial constituents, infected
      macrophages were exposed to the calcium ionophore A23187. The ionophore triggered
      the release of a microvesicular fraction containing labeled bacterial moieties,
      implicating calcium-regulated lysosomal exocytosis as a trafficking pathway by
      which mycobacterial products are released from infected macrophages.

PMID- 11211934
TI  - Synaptotagmin 13: structure and expression of a novel synaptotagmin.
AB  - Synaptotagmins represent a family of putative vesicular trafficking proteins.
      With synaptotagmin 13, we have now identified a novel synaptotagmin, making this
      one of the largest families of trafficking proteins. Similar to synaptotagmins 3,
      4, 6, 7, 9, and 11, synaptotagmin 13 is expressed at highest levels in brain but
      is also detectable at lower levels in non-neuronal tissues. Synaptotagmin 13 is
      composed of the canonical domains of synaptotagmins that include an N-terminal
      transmembrane region and two C-terminal cytoplasmic C2-domains (C2A- and C2B
      domain) and a connecting sequence between the transmembrane region and the C2
      domains. Different from most other synaptotagmins, however, synaptotagmin 13 does
      not have an N-terminal sequence preceding the transmembrane region, and features
      an unusually long connecting sequence that is proline-rich. Furthermore, the C2
      domains of synaptotagmin are degenerate and lack almost all of the residues
      involved in Ca2+ binding, suggesting that synaptotagmin 13 is not a Ca2+-binding
      protein unlike most other synaptotagmins. Our data demonstrate that
      synaptotagmins represent a larger and more complex gene family than previously
      envisioned.

PMID- 11211935
TI  - Distribution and localization of CMP-N-acetylneuraminic acid hydroxylase and N
      glycolylneuraminic acid-containing glycoconjugates in porcine lymph node and
      peripheral blood lymphocytes.
AB  - An immunohistochemical analysis was performed on paraplast-embedded sections of
      porcine lymph node with antibodies specific for CMP-N-acetylneuraminic acid
      hydroxylase (h-3 antibody) and glycoconjugate-bound N-glycolylneuraminic acid
      (Neu5Gc), which appears as a result of the hydroxylase reaction (a-Gc antibody).
      The observed localization of the enzyme in cells of the perifollicular zone,
      including lymphocytes, was reflected in a similar distribution of glycoconjugate
      bound Neu5Gc. This result confirms previous biochemical investigations on the
      role of the hydroxylase in regulating Neu5Gc biosynthesis in vitro on a
      histological level. An analysis of lymphocytes isolated from porcine thymus,
      spleen, lymph node and peripheral blood revealed differences in the amount of
      Neu5Gc in the various lymphocytes that correlated well with the activity of the
      hydroxylase determined in these cells. The largest amount of Neu5Gc and highest
      activity of the enzyme were detected in the peripheral blood lymphocytes (PBL).
      Immunohistochemical studies with a-Gc and h-3 antibodies on sections of paraplast
      embedded PBL showed that these antigens were located at the cell surface and in
      the cytosol, respectively. Ultrastructural immunocytochemistry with the h-3
      antibody and immunogold labelling was used to investigate the subcellular
      localization of the hydroxylase. The enzyme was detected in the cytosol in the
      vicinity of the nuclear membrane and the outer membrane of mitochondria, in
      particular those close to the nucleus. The antigen was also detected on
      cytoplasmic tubular structures. In addition, a weak labelling of the Golgi
      apparatus was also observed occasionally. The possibility that this localization
      may be related to the availability of the substrate CMP-Neu5Ac and the redox
      partner cytochrome b5 is discussed.

PMID- 11211936
TI  - Retinoic acid-induced blr1 expression requires RARalpha, RXR, and MAPK activation
      and uses ERK2 but not JNK/SAPK to accelerate cell differentiation.
AB  - Upstream signaling requirements of retinoic acid (RA)-induced blr1 expression and
      downstream signaling consequences of blr1 over-expression in a human myeloid
      leukemia cell line demonstrate that mitogen-activated protein kinase (MAPK)
      signaling complexes are involved in both avenues. RA-induced myeloid
      differentiation and G1/G0 growth arrest of HL-60 cells is known to require the
      activation of the RARalpha and RXR retinoid receptors, as well as activation of
      the MAPK, ERK2. Transcriptional activation of the Burkitt's lymphoma receptor 1
      (blr1) gene occurs early during RA-induced differentiation of HL-60 cells and
      requires these same three activating processes. The use of retinoid ligands that
      activate either the RARalpha or the RXR retinoid receptors revealed that blr1
      mRNA induction was detectable only when both RARalpha and RXR were activated.
      Neither the RARalpha nor RXR selective ligands alone induced expression of blr1,
      but the combination of the two ligands induced the expression of blr1 to the same
      extent as RA. The MAPKK (MEK) inhibitor, PD98059, was used to determine whether
      extracellular signal-regulated kinase (ERK2) activation was necessary for
      induction of blr1 mRNA. PD98059 inhibited induced blr1 mRNA expression, due to RA
      or activated RARalpha plus RXR ligands, indicating that ERK2 activation is
      necessary for blr1 mRNA expression. Previous studies showed that ectopic
      expression of blr1 also caused increased MAPK activation, in particular ERK2, and
      subsequently accelerated RA-induced differentiation and G1/G0 growth arrest.
      Inhibition of ERK2 activation inhibited differentiation of blr1 transfectants,
      suggesting that the accelerated differentiation reflected blr1-enhanced ERK2
      activation. The present data also demonstrate that ectopic expression of blr1
      increased JNK/SAPK activity, but JNK/ SAPK activation was not needed for
      accelerated RA-induced differentiation and growth arrest. The results show that
      the signals known to be required for HL-60 differentiation, activated RARalpha,
      RXR, and ERK2, are necessary for blr1 mRNA expression. Downstream consequences of
      blr1 overexpression include enhanced MAPK signaling.

PMID- 11211937
TI  - Collagen-induced proMMP-2 activation by MT1-MMP in human dermal fibroblasts and
      the possible role of alpha2beta1 integrins.
AB  - Culture of human dermal fibroblasts within a three-dimensional matrix composed of
      native type I collagen fibrils is widely used to study the cellular responses to
      the extracellular matrix. Upon contact with native type I collagen fibrils human
      skin fibroblasts activate latent 72-kDa type IV collagenase/ gelatinase (MMP-2)
      to its active 59- and 62-kDa forms. This activation did not occur when cells were
      cultured on plastic dishes coated with monomeric type I collagen or its denatured
      form, gelatin. Activation could be inhibited by antibodies against MT1-MMP, by
      the addition of TIMP-2 and by prevention of MT1-MMP processing. MT1-MMP protein
      was detected at low levels as active protein in fibroblasts cultured as
      monolayers. In collagen gel cultures, an increase of the active, 60-kDa MT1-MMP
      and an additional 63-kDa protein corresponding to inactive MT1-MMP was detected.
      Incubation of medium containing latent MMP-2 with cell membranes isolated from
      fibroblasts grown in collagen gels caused activation of the enzyme. Furthermore,
      regulation of MT1-MMP expression in collagen cultures seems to be mediated by
      alpha2beta1 integrins. These studies suggest that activation of the proMMP-2 is
      regulated at the cell surface by a mechanism which is sensitive to cell culture
      in contact with physiologically relevant matrices and which depends on the ratio
      of proenzyme and the specific inhibitor TIMP-2.

PMID- 11211938
TI  - Effects of prolonged exposure to hypoxia on morphological changes of endothelial
      cells plated on fibrin gel.
AB  - Since tissue oxygenation has a profound effect on capillary growth, the effect of
      pO2 on endothelial cell functions was studied. Under normoxic conditions,
      EA.hy926 endothelial cells and HUVEC plated onto fibrin gels in low-serum culture
      medium underwent rapid and profound morphological changes within 12 to 48 hours
      depending on the cell line used. Their characteristic cobblestone organisation
      was transformed into a network of cord-like or tube-like structures. We showed
      that when exposed to low oxygen concentrations for 3 days, HUVEC and EA.hy926
      have their ability to rearrange reduced to around 50 %. With EA.hy926 this effect
      was amplified by 79% after 9 days of hypoxia. The altered behaviour of hypoxia
      adapted cells was not caused by a loss in their fibrinolytic activity. In fact,
      the fibrin degradation rate and the generated fibrin fragments appeared identical
      in normoxia and hypoxia. Confocal microscopy and gel densitometry showed that in
      normoxia the remaining undegraded fibrin gel underwent a dynamic remodeling
      whereas in hypoxia it remained undisturbed. It is likely that hypoxia induces
      modification in the factors that integrate matrix information and cytoskeletal
      organisation in order to contract fibrin.

PMID- 11211939
TI  - Localization of protein kinase A and vitronectin in resting platelets and their
      translocation onto fibrin fibers during clot formation.
AB  - Physiological stimulation of platelets with thrombin brings about the release of
      protein kinase A (PKA) into the plasma. In human blood, this kinase singles out
      and phosphorylates vitronectin (Vn), a multifunctional regulatory protein, which
      was proposed to play an important role in the control of fibrinolysis. Here we
      present immuno-cytochemical evidence to show: (i) that intact platelets possess
      on their surface an ecto-PKA which can preferentially phosphorylate Vn; (ii) that
      in the resting platelet, both the catalytic and the regulatory subunits of PKA
      are present on the platelet surface, in the surface-connected canalicular system,
      and within the alpha-granules of the platelets; (iii) that the process initiated
      upon platelet activation, which leads to the formation of fibrin fibers and
      consequently forms the fibrin net, is accompanied by a translocation of PKA, of
      Vn, and of PAI-1 onto the fibrin fibers. We propose that the localization and the
      translocation of these proteins in the fibrin net, together with our finding that
      PKA phosphorylation of Vn reduces its grip of PAI-1, can unleash PAI-1 in its
      free form. The free PAI-1 can then assume its latent (non inhibitory)
      conformation, allow plasminogen activators to trigger the formation of active
      plasmin, and to initiate fibrinolysis.

PMID- 11211941
TI  - The production and clinical evaluation of macrophage colony-stimulating factor
      and macrophage chemoattractant protein-1 in human follicular fluids.
AB  - PROBLEM: In order to investigate the role of macrophage colony-stimulating factor
      (M-CSF) and macrophage chemoattractant protein-1 (MCP-1) in human ovulation, we
      measured the concentrations of M-CSF and MCP-1 in human follicular fluids (FFs)
      and correlated them with oocyte maturation. METHOD OF STUDY: The oocytes were
      obtained from the FFs of 46 women undergoing in vitro fertilization and embryo
      transfer (IVF ET). The concentrations of M-CSF and MCP-1 in the FFs were measured
      by enzyme-linked immunosorbent assay. In addition, granulosa cells obtained from
      the FFs of IVF patients were cultured and treated with forskolin and 12-O
      tetradecanoylphorbol 13-acetate (TPA) for 24 48 hr. RESULTS: Concentrations of M
      CSF and MCP-1 were significantly higher in the FFs than in the serum (P < 0.01).
      M-CSF concentrations tended to be higher, while MCP-1 concentrations were
      significantly higher in the FFs containing mature oocytes than in FFs containing
      immature oocytes (P < 0.05). The production of M-CSF was markedly increased over
      the basal level after treatment with forskolin (10 microM) for 24 (P < 0.02) and
      48 hr (P < 0.01); however, the production of MCP-1 was unchanged. CONCLUSIONS:
      Our data suggest that M-CSF and MCP-1 may play an important role in human
      preovulatory processes and that M-CSF, in particular, may be regulated by cyclic
      adenosine monophosphate. M-CSF and MCP-1 may also be valuable biochemical markers
      in the evaluation of oocyte maturation.

PMID- 11211940
TI  - Dendritic cells derived from peripheral monocytes express endothelial markers and
      in the presence of angiogenic growth factors differentiate into endothelial-like
      cells.
AB  - CD14-positive monocytes obtained from human peripheral blood were cultured with
      GM-CSF and IL-4. During the early culture phase immature dendritic cells (DCs)
      developed which not only expressed CD1a, HLA-DR and CD86, but also expressed the
      endothelial cell markers von Willebrand factor (vWF), VE-cadherin and VEGF
      receptors Flt-1 and Flt-4. Further maturation of DCs was achieved by prolonged
      cultivation with TNFalpha. These cells showed typical DC morphology and like
      professional antigen-presenting cells (APCs) expressed CD83 and high levels of
      HLA-DR and CD86. However, if immature DCs were grown with VEGF, bFGF and IGF-1 on
      fibronectin/vitronectin-coated culture dishes, a marked change in morphology into
      caudated or oval cells occurred. In the presence of these angiogenic growth
      factors the cultured cells developed into endothelial-like cells (ELCs),
      characterized by increased expression of vWF, KDR and Flt-4 and a disappearance
      of CD1a and CD83. Addition of IL-4 and Oncostatin M also increased VE-cadherin
      expression, and the loosely adherent cells formed clusters, cobblestones and
      network-like structures. vWF- expressing ELCs mainly originated from CD1a
      positive cells, and VEGF was responsible for the decrease in the expression of
      the DC markers CD1a and CD83. In mixed leukocyte cultures, mature DCs were more
      potent APCs than ELCs. Moreover, Ac-LDL uptake, and the formation of tubular
      structures on a plasma matrix was restricted to ELCs. These results suggest that
      in the presence of specific cytokines immature DCs have the potential to
      differentiate along different lineages, i.e. into a cell type resembling ELCs.

PMID- 11211942
TI  - Involvement of mu-calpain in human sperm capacitation for fertilization.
AB  - PROBLEM: The distribution and physiological role of calpains in human sperm were
      investigated. METHOD OF STUDY: Semen collected manually from healthy donors was
      liquefied then centrifuged by percoll gradient centrifugation. After exposure to
      different concentrations of Ca2+ ionophore A23187, the samples were used for
      immunostaining sodium dodecyl sulfate polyacrylamide gel electrophoresis, and
      western blot analysis. It was speculated from the results of the study using
      calpain-specific inhibitors that calpain contributes to the sperm motility and
      acrosome reaction. RESULTS: With the anti-pro mu-calpain antibody, sperm were
      immunostained, whereas all were negative for anti-pro mu-calpain antibody
      binding. Stained sperm were classified into four types according to the staining
      pattern: acrosome type, equatorial segment type, whole head type, and neck and
      tail segments type. Western blot analysis of sperm homogenate revealed a single
      80-kDa band using the anti-pro mu-calpain antibody, its dose-dependent reduction
      with Ca2+ ionophore A23187 suggesting activation by this treatment. In the
      presence of membrane permeable calpain inhibitors, sperm motility and acrosome
      reaction were significantly suppressed. CONCLUSION: These results indicate that
      mu-calpain may play pivotal roles in the process of fertilization of human sperm.

PMID- 11211943
TI  - Integrin pattern and effect on contraction in cultured testicular peritubular
      myoid cells.
AB  - PROBLEM: Neither the integrin pattern nor the biological functions of integrins
      have been extensively documented in human cultured testicular peritubular myoid
      cells (TPMC). The integrin pattern and the presence of some proteins of the
      immunoglobulin superfamily on human TPMC as well as the role of integrins in TPMC
      contraction were examined. METHOD OF STUDY: Integrin expression was evaluated by
      immunofluorescence and FACS analysis. To assess the role of integrin in TPMC
      contraction, human and rat cells were added to a collagen gel system and exposed
      to contractile stimuli. RESULTS: The immunofluorescence and cytofluorimetric
      analysis showed that human cultured TPMC express alpha1, alpha2, alpha3, alpha4,
      alpha5, alpha6, alphav, beta1, beta3, and beta4 integrin subunits, and
      significant amounts of intercellular adhesion molecule-1 (ICAM-1), whereas they
      do not present alpha4, beta2, beta7 subunits, nor intercellular adhesion molecule
      2 (ICAM-2) and neural cell adhesion molecule (NCAM). The preincubation of human
      cells with an anti-beta1 mAb and of rat cells with a polyclonal anti-beta1
      antibody inhibited TPMC contraction induced by different contractile stimuli.
      CONCLUSION: Our investigation documented a broad integrin pattern on human
      cultured TPMC as well as a role for integrins in human and rat TPMC contraction.

PMID- 11211944
TI  - Characterization of 80 kDa human sperm antigen responsible for immunoinfertility.
AB  - PROBLEM: An 80 kDa human sperm antigen (80 kDa HSA) has been identified by
      western blot technique using serum of an immunoinfertile woman as a probe. The 80
      kDa HSA has been subsequently purified from sperm extract and investigated for
      antifertility effects. METHOD OF STUDY: The purified 80 kDa HSA was used to
      immunize adult male and female rats. Rabbit anti 80 kDa HSA antibodies were used
      for immunofluorescent and immunohistochemical staining to demonstrate the
      presence of 80 kDa HSA on the sperm and to investigate its tissue distribution.
      The N-terminal sequence of native 80 kDa HSA and the peptides obtained by its
      endoproteinase Lys-C was determined. RESULTS: Active immunization of male and
      female rats with 80 kDa HSA caused infertility in all the immunized animals.
      Immunofluorescent staining showed its localization on the head region of the
      human and rat spermatozoa. While immunohistochemical studies showed its
      localization in the testes and epididymis but not in other somatic tissues.
      Partial amino-acid sequence analysis showed no sequence homology with any of the
      known protein in the database. CONCLUSIONS: 80 kDa HSA is a promising candidate
      antigen for immunocontraception as it is characterized and found to cause
      infertility upon active immunization. specific to spermatozoa and is conserved.

PMID- 11211945
TI  - The carriage of pro-inflammatory cytokine gene polymorphisms in recurrent
      pregnancy loss.
AB  - PROBLEM: Recurrent pregnancy loss (RPL) affects 2-4% of couples, and remains
      largely unexplained. Recent studies have examined the role of cytokines in the
      maintenance of normal pregnancy, which is linked with an increased expression of
      Th2 cytokines. Overexpression of Th1 cytokines is associated with RPL. Knowing
      that functional polymorphisms exist for certain cytokines, it has therefore been
      suggested that women with RPL may have a genetic predisposition to overexpress
      Th1 cytokines. METHOD OF STUDY: The genes for interleukin-1 beta (IL-1beta) and
      tumor necrosis factor alpha (TNF-alpha) carry functional gene polymorphisms. In
      both cases these are biallelic polymorphisms that can be detected by polymerase
      chain reaction followed by restriction fragment length polymorphism. The aim of
      this pilot study was to assess whether carriage of the rarer alleles (TNF*2 and
      IL-1B*2) could act as independent risk factors in recurrent miscarriage. RESULTS:
      We found an increased incidence in the carriage of TNF*2, more pronounced in
      those women with two or more miscarriages. Carriage of the IL-1B*2 either alone
      or in association with TNF*2 was not associated with recurrent miscarriage.
      CONCLUSION: There may be a role for these cytokine gene polymorphisms in RPL.

PMID- 11211946
TI  - TGFbeta2 in embryos with inborn anomalies: effect of maternal immunopotentiation.
AB  - PROBLEM: TGFbetas are among the main immunoregulatory molecules contributing to
      successful embryonic development. Besides, our and other studies revealed that
      maternal immunopotentiation has a potential to increase the resistance of the
      embryo to the teratogenic insult. This work was designed to evaluate: (1) whether
      the formation of teratogen-induced anomalies is accompanied by an altered pattern
      of TGFbeta2 expression in embryonic cells and (2) whether maternal
      immunopotentiation modifies the pattern of TGFbeta2 expression in embryos
      responding to the teratogenic insult. METHOD OF STUDY: Experiments were performed
      in embryos of ICR mice exposed to 15 and 40 mg/kg of a reference teratogen,
      cyclophosphamide (CP) on day 12 of gestation. A group of mice was
      immunopotentiated with xenogeneic rat splenocytes 21 hr before the beginning of
      mating. Embryos were examined for the occurrence of gross structural anomalies 24
      and 72 hr after CP treatment. Then, immunohistohemistry and in situ hybrydization
      assays were used to evaluate the expression of TGFbeta2 protein and mRNA in the
      brain, face, limbs and liver of these embryos. RESULTS: No external anomalies
      were observed in embryos examined 24 hr after CP treatment. Embryos examined 72
      hr after CP treatment at 40 mg/kg exhibited agnathia, micrognathia, kinky tail,
      phocomelia, but no signs of dismorphogenesis were observed in the liver at the
      organ level. A significant increase in the expression of TGFbeta2 mRNA was
      observed in cells, residing in the brain, face and limbs but not in the liver of
      CP-exposed embryos tested 24 hr after CP injection in both doses. The level of
      TGFbeta2 protein in these embryos did not differ from that of controls. In
      embryos tested 72 hr after CP injection in the high dose both TGFbeta2 protein
      and mRNA expression were found to be elevated. Maternal immunopotentiation while
      enhancing the embryo's resistance to CP practically abolished an elevated
      expression of the TGFbeta2 mRNA detected in tested organ structures of embryos of
      non-immunopotentiated CP treated mice 24 hr after CP injection in both the low
      and the high doses. Also, a significant decrease in the level of TGFbeta2 mRNA
      expression was observed in embryos of immunopotentiated mice examined 72 hr after
      CP treatment. CONCLUSIONS: The results of this work show a possible involvement
      of TGFbeta2 in the formation of teratogen-induced structural anomalies and
      suggest that the stimulation of the maternal immune system may realize its
      protective effect by normalizing the level of TGFbeta2 expression in teratogen
      targeted embryonic structures.

PMID- 11211947
TI  - Inhibition of murine sperm-oolemma binding by antibodies to an oocyte membrane
      (OM) antigen: implication in contraceptive vaccine development.
AB  - PROBLEM: The present study was conducted to investigate the oocyte membrane
      protein(s) that is involved in sperm binding in the mouse, and whether or not it
      can be used for the development of a contraceptive vaccine. METHOD OF STUDY: The
      zona-free oocytes were treated with Triton X-100 and the extract was analyzed for
      homogeneity in the sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis
      (PAGE) after staining with silver nitrate. The appropriate band of 50+/-4 kD,
      designated as OM antigen, was excised from the gel and used for the immunization.
      The female rabbits were immunized with the excised band per se and the female
      mice were immunized with the OM antigen after conjugation to keyhole limpet
      hemocyanin (KLH). The affinity-purified antibodies were analyzed in the enzyme
      linked immunosorbent assay (ELISA), immunoprecipitation procedure, western blot
      procedure, indirect immunofluorescence technique (IFT), and spermoolemma binding
      assay. Actively-immunized mice were analyzed for in vivo fertility. RESULTS: The
      Triton X-100 extract of zona-free oocytes predominantly showed a single protein
      band of 50+/-4 kD in the SDS-PAGE. Active immunization of female rabbits and of
      female mice with OM antigen raised high antibody titers (ELISA titer > 1:4096)
      that specifically recognized the OM antigen in the immunoprecipitation and
      Western blot procedures, and reacted with the oocyte in the IFT. These antibodies
      demonstrated a significant (P < 0.05) up to a complete block of sperm-oolemma
      binding in the in vitro binding assay. Binding of both the acrosome-intact and
      acrosome-reacted sperm was inhibited. Mice actively immunized with OM antigen
      also showed a significant reduction in vivo fertility as seen by the 9-day
      implants in uteri. Preliminary data indicate that the antibodies to OM antigen
      were tissue-specific and did not react with the specific band in any tissue
      extract in the western blot procedure. CONCLUSIONS: These results indicate that
      the OM antigen is involved in spermoolemma binding and constitute an attractive
      molecule that needs further investigation for examining its utility in the
      contraceptive vaccine development.

PMID- 11211948
TI  - TCRgammadelta + T lymphocytes in unexplained recurrent spontaneous abortions.
AB  - PROBLEM: It is generally accepted that the immune system and cellular immunity in
      particular are involved in the mechanisms affecting the outcome of gestation. In
      order to evaluate a putative role of lymphocytes in the immunological mechanisms
      of unexplained recurrent spontaneous abortions (URSA), we studied peripheral
      blood lymphocyte subpopulations in 244 women with URSA and 44 controls. METHOD OF
      STUDY: Direct immunofluorescence in whole blood with the appropriate combinations
      of monoclonal antibodies and flow cytometry was used. RESULTS: The study showed:
      a) a statistically significant increase of the mean CD4/CD8 ratio (2.12+/-0.84 vs
      1.85+/-0.63, P = 0,039); b) a statistically significant decrease of the mean
      value of the percentage of CD5+ CD19+ lymphocytes (0.4+/-0.6 vs 1.4+/-0.78, P <
      0.0001); and c) a statistically significant increase of the percentage of T
      lymphocytes expressing TCRgammadelta (4.68+/-3.19 vs 2.61+/-1.14, P < 0.0001). It
      should be noted that a statistically significant high number of women with URSA
      (72/195, 36.9%) showed an increased percentage of TCRgammadelta T cells (> or =
      5%, where 5 equals the mean value + 2 standard deviations (SD) of the mean value
      of controls), whereas such a high percentage was not found in any control
      subject. CONCLUSIONS: It seems that women who experienced URSA comprise a
      heterogeneous population, as far as immunological parameters are concerned. At
      least in a subgroup of them, TCRgammadelta + T cells could be considered to play
      a role in the immune pathogenesis of fetal loss.

PMID- 11211949
TI  - Vitamin D, physical performance and disability in the elderly.

PMID- 11211950
TI  - Gender differences in morbidity and mortality related to depression: a review of
      the literature.
AB  - In this review of the existing evidence regarding a gender-specific association
      of depression with major health outcomes in older adults, we were unable to
      confirm that relative risk of morbidity and/or mortality due to depression varies
      with respect to gender. Future researchers may wish to concentrate their efforts
      in the identification of possible biophysiologic mechanisms underlying the
      association between depression and a variety of health outcomes.

PMID- 11211951
TI  - Sleep disordered breathing in the elderly.
AB  - Sleep disordered breathing (SDB), i.e., obstructive, central or mixed sleep
      apneas, has been recognized as a common occurrence in the elderly. Aging is per
      se associated with a decrease in the quality of sleep; SDB may further disrupt
      the sleep architecture in older subjects. The prevalence of obstructive sleep
      apnea (OSA) increases with aging; available studies report prevalence rates of 11
      62%. Furthermore, OSA has been associated with increased mortality in older
      adults. Central apneas and periodic breathing occur with increased frequency
      either in subjects with neurological disorders such as infarction, tumor,
      sequelae of infection, diffuse encephalopathies, or in chronic heart failure.
      Patients with cerebrovascular disease (stroke, or transient ischemic attacks)
      have a markedly high prevalence of SDB, mainly OSA. In these patients, SDB is
      associated with a poorer functional prognosis at 3 and 12 months after the acute
      event, and a higher mortality. The clinical impact of SDB on cognitive function
      appears to be modest in patients without dementia, although there is a moderate
      increase in daytime sleepiness. In Alzheimer's disease (AD) however, SDB occurs
      more frequently than in non-demented older subjects, and its severity is
      correlated with the degree of cognitive impairment. The hypothesis of a causal
      relationship between AD and SDB remains a subject of controversy. The possibility
      of SDB should be considered in the elderly in the differential diagnosis of
      "reversible dementias", increased daytime sleepiness, or unexplained right-sided
      heart failure.

PMID- 11211952
TI  - Characteristics associated with inappropriate hospital use in elderly patients
      admitted to a general internal medicine service.
AB  - Our objective was to identify patient characteristics associated with
      inappropriate hospital days in a cohort of elderly medical inpatients. This
      prospective cohort study included a total of 196 patients aged 75 years and
      older, who were consecutively admitted over eight months to the internal medicine
      service of a regional, non-academic public hospital located in a rural area of
      Western Switzerland. Patients with severe cognitive impairment, terminal disease,
      or previously living in a nursing home were excluded. Data on demographics,
      medical, physical, social and mental status were collected at admission. A
      blinded hospitalization review was performed concurrently using a modified
      version of the Appropriateness Evaluation Protocol (AEP). Subjects' mean age was
      82.4 years; 63.3% were women. Median length of stay was 8 days. Overall, 68
      patients (34.7%) had at least one inappropriate day during their stay, including
      18 patients (9.2%) whose hospital admission and entire stay were considered
      inappropriate. Most inappropriate days were due to discharge delays (87.10%),
      primarily to nursing homes (59.30%). Univariate analysis showed that subjects
      with inappropriate days were more likely to be living alone (69.1 vs 48.4%,
      p=0.006), and receiving formal in-home help (48.5 vs 32.8%, p=0.031). In
      addition, they were more impaired in basic and instrumental activities of daily
      living (BADLs, and IADLs, p<0.001 and p=0.015, respectively), and more frequently
      had a depressed mood [29.4 vs 10.9%, p=0.001 with a score > 6 at the Geriatric
      Depression Scale (GDS), short form]. Using multivariate analysis, independent
      associations remained for patients living alone (OR 2.6, 95%CI 1.2-5.8, p=0.016),
      those with a depressed mood (OR 2.8, 95%CI 1.1-7.3, p=0.032), with BADL
      dependencies (OR 1.5, 95%CI 1.2-1.8, p=0.001), and IADL dependencies (OR 1.3,
      95%CI 1.0-1.6, p=0.032). Cardiovascular (OR 0.2, 95%CI 0.1-0.7, p=0.008) and
      pulmonary admission diagnoses (OR 0.1, 95%CI 0.0-0.7, p=0.022) were inversely
      associated with inappropriate hospital days. In conclusion, patients living
      alone, functionally impaired and showing depressive symptoms were at increased
      risk for inappropriate hospital days. These characteristics might permit better
      targeting for early discharge planning in these at-risk subjects, and contribute
      to avoiding premature discharge of other vulnerable elderly patients. Whether
      these interventions for at-risk patients will also result in prevention of
      hospitalization hazards, such as deconditioning and related functional decline,
      will require further study.

PMID- 11211953
TI  - Mini mental state examination in geriatric stroke patients. Validity, differences
      between subgroups of patients, and relationships to somatic and mental variables.
AB  - To study the validity of the Mini Mental State Examination (MMSE) in geriatric
      stroke patients, 116 patients were tested 2-8 weeks and 6 months post-stroke. A
      neuropsychological test battery consisting of five tests measuring memory,
      calculation and spatial ability was used for validation. Motor activity,
      depression, aphasia and activities of daily living were assessed. Confusion in
      the acute stage, Barthel Index, depression scores, level of motor activity, and
      most of the neuropsychological tests correlated to the MMSE. Logistic regression
      showed 4 independent variables which could predict the MMSE scores. A factor
      analysis showed 3 factors which could explain 53% of the variance. The
      sensitivity for detecting dementia was 56%, and increased to 68% if patients with
      isolated spatial dysfunction were excluded. The MMSE had acceptable validity in
      detecting cognitive dysfunction early poststroke in this old patient population.

PMID- 11211954
TI  - Age-related modifications in human unstimulated whole saliva: a biochemical
      study.
AB  - Human whole saliva contains a number of antimicrobial agents, and lysozyme,
      lactoferrin, secretory IgA and peroxidase are among the best known. Peroxidase
      catalyzes a reaction involved in the inhibition of bacterial growth and
      metabolism, and the prevention of hydrogen peroxide accumulation, thus protecting
      proteins from the action of oxygen and reactive oxygen species (ROS). To better
      understand the role played by the oxidative stress in the aging process, we
      studied the relationship between total protein content, peroxidase activity,
      malondialdehyde (MDA) and nitric oxide (NO) content of human unstimulated whole
      saliva in 169 healthy subjects subdivided into groups according to age. Our
      results show a significant decrease in peroxidase activity with age. Moreover,
      the increase in saliva lipid peroxide levels indicates an enhanced free radical
      production that may contribute to tissue damage. On the other hand, findings
      concerning human unstimulated whole saliva NO content showed a significant
      increase in elderly subjects, suggesting that an enhanced NO production might
      depend on a stimulation of leukocyte-inducible NO synthase (i-NOS) activity. Our
      results suggest that during aging the oral tissues may become more susceptible to
      environmental factors due to a modification in the balance between different
      antimicrobial agents.

PMID- 11211956
TI  - Muscle strength, functional mobility and vitamin D in older women.
AB  - Vitamin D deficiency may lead to loss of type II muscle fibres, and thereby to
      atrophy of proximal muscles with an increased risk of falling and bone fractures.
      The aim of the study was to determine if six months of vitamin D treatment (0.5
      microg alphacalcidol) could positively influence values for muscle strength and
      functional mobility in vitamin D-deficient older women. Twenty-seven women
      entered the study which took place at a teaching hospital outpatient department.
      Ten vitamin D-deficient (serum 25(OH)D3 <20 nmol/L) older (>70 years) women and
      13 age-matched female subjects with normal vitamin D levels (serum 25(OH)D3 >30
      nmol/L) completed the study. Preand post-treatment data were obtained for
      isometric knee extensor strength, handgrip strength and functional mobility
      (walking distance over 2 minutes and the timed i'Up & Go" test). Six months of
      treatment with alphacalcidol led to significant improvements (compared to the
      controls) in values of isometric knee extensor strength (left leg: 14.6% +/-
      5.7%. p=0.03; right leg: 11.5% +/- 5.0%, p=0.02) (mean +/- SEM). The achievements
      in the timed "Up & Go" test and 2-minute walking test did not improve in the
      alphacalcidol group compared to the controls after 6 months. However, within the
      vitamin D-deficient group, 6 months of alphacalcidol treatment led to a
      significant increase in the walking distance over 2 minutes (increase from 137.6
      +/- 12.6 to 151.3 +/- 11.2 meters, p=0.03). The controls, with normal vitamin D
      levels, did not exhibit improvements in performance of any of the tests over a
      period of 6 months. Summarized, alphacalcidol seems to improve muscle strength
      and walking distance over 2 minutes in vitamin D-deficient older women.

PMID- 11211955
TI  - Factors relating to place of death of Japanese people from a small town in a
      rural area.
AB  - The objective of our retrospective study was to clarify factors relating to place
      of death of Japanese people from a small town in a rural area who had been
      bedridden for at least one week before dying. The caregivers of subjects aged 40
      and above who died during a three-year period were surveyed by trained
      interviewers. Of 352 subjects who died, 312 caregivers responded and agreed to a
      face-to-face interview. A total of 213 subjects were considered as an eligible
      sample. The main outcome measures were odds ratios for death at home in relation
      to age, pain, cause of death, and home visit service. One hundred and two people
      died at home, while 112 people died in a hospital. Multivariate logistic
      regression analysis showed that the probability of home death increased with age
      of the bedridden, lack of pain during the bedridden period, not having cancer as
      a cause of death, having senility as a cause of death, and receiving regular home
      visits by a Public Health Nurse. In conclusion, expansion of the home visit
      programs by Public Health Nurses may enable people to die at home as they so
      desire. Further prospective research is needed to explore the association between
      the attitude toward terminal care and the place of death.

PMID- 11211957
TI  - A test of recently proposed BMI standards with respect to old age.
AB  - The purpose of this study was to investigate the effects of age on the
      relationship between BMI and multiple coronary risk factors, and to determine
      whether the BMI classification by NHLBI and WHO is applicable as a predictor of
      coronary risk factors in older (>65 years) as well as in younger (<65 years) men
      and women. Effects of age on ten coronary risk factors were examined. Sex
      differences in the slopes of BMI on risk factors were compared between younger
      and older subjects in order to examine the effects of age on these relationships.
      The frequency of risk factor abnormality in individual BMI groups (18.5-24.9,
      25.0-29.9, 30.0+) was examined for four age-sex groups. The significance of an
      age group-BMI interaction term was tested by the logistic regression model to see
      whether there is a significant difference in the relationship between BMI and the
      individual risk factor abnormalities between younger and older subjects. Older
      subjects had significantly higher values for most risk factors than younger
      subjects. The slopes of BMI on risk factors were different between younger and
      older subjects for fasting glucose, total, HDL- and LDL-cholesterol in men, and
      for diastolic blood pressure, total and LDL-cholesterol in women. The proportion
      of subjects with abnormal risk factor levels in each of the three BMI groups was
      higher in older than in younger subjects for most risk factors. There was
      generally a progressive worsening of the risk factor levels with increasing BMI
      in both age groups. There was no consistent age difference in the relationship
      between BMI groups and the frequency of risk factor abnormality. We conclude
      that, although age increases the frequency of most cardiovascular risk factor
      abnormalities, in general, it does not affect the trend of the relationship
      between the risk factors and the normal, overweight and obese BMI groups defined
      by NHLBI and WHO. Therefore, these BMI categories are applicable as predictors of
      risk factor levels in older as well as in younger men and women.

PMID- 11211958
TI  - Glutathione deficiency potentiates manganese-induced increases in compounds
      associated with high-energy phosphate degradation in discrete brain areas of
      young and aged rats.
AB  - Aging is a factor known to increase neuronal vulnerability to oxidative stress,
      which is widely accepted as a mechanism of manganese-induced neuronal damage. We
      previously showed that subchronic exposure to manganese induced greater energy
      impairment (as revealed by increases in hypoxanthine, xanthine and uric acid
      levels) in the striatum and brainstem of aged rats vs young rats. This study
      shows that inhibition of glutathione (GSH) synthesis, by means of buthionine (SR)
      sulfoximine, decreased GSH levels and increased the ascorbic acid oxidation
      status in the striatum and limbic forebrain of both young and aged rats. In
      addition, inhibition of GSH synthesis greatly potentiated the manganese-induced
      increase in inosine, hypoxanthine, xanthine and uric acid levels in both regions
      of aged rats; moreover, inhibition of GSH synthesis significantly increased
      inosine, hypoxanthine, xanthine and uric acid levels in both regions of young
      rats, compared with the manganese-treated group. These results suggest that an
      impairment in the neuronal antioxidant system renders young rats susceptible to
      manganese-induced energetic impairment, and further support the hypothesis that
      an impairment in this system plays a permissive role in the increase of neuronal
      vulnerability that occurs with aging.

PMID- 11211959
TI  - Changes in force by repeated stretches of skeletal muscle in young and old female
      Sprague Dawley rats.
AB  - We examined whether the decline in isometric force and peak stretch force during
      repeated stretches of activated plantar flexor muscles was larger in old (24
      months, N=5) compared with young (4 months, N=5) female Sprague Dawley rats.
      Thirty stretches were imposed on isometric contractions (stimulation time 1.9 s,
      rest periods 180 s) by ankle rotation from 90 degrees to 40 degrees at 50 degrees
      x s(-1). Even though muscle weights were similar [2094 +/- 54 (young) vs 2033 +/-
      73 mg (old) (mean +/- SE)], the isometric force (IF) at 90 degrees before stretch
      1 and peak stretch force (PSF) at 40 degrees for stretch 1 were lower in old rats
      [18.9 +/- 0.5 vs 15.5 +/- 1.4 N (p=0.024) and 25.8 +/- 1.3 vs 20.5 +/- 0.9 N
      (p=0.017)]. After the stretches, the IF deficit was similar [38.5 +/- 3.0%
      (young) vs 39.8 +/- 3.4% (old)] and did not recover after 1 hour of rest [35.1+/-
      4.1% (young) vs 36.9 +/- 4.3% (old)]. The decline in PSF was/also similar [36.0
      +/- 5.2% (young) vs 26.6 +/- 1.8% (old)]. Skeletal muscles of 24-month-old female
      Sprague Dawley rats were weaker than 4-month-old rats but had similar
      susceptibility to develop IF deficits after stretches of activated muscles.

PMID- 11211960
TI  - Parental imagery vividness: gender differences and relationships to emotional
      closeness.
AB  - This research was an investigation of the vividness with which individuals see
      their parents in different situations. In 3 studies, the Vividness of Visual
      Imagery for Parents Questionnaire (VVIPQ; S. J. McKelvie, 1998a) was completed by
      university undergraduates (201 women, 167 men). Visual imagery of mothers was
      reported to be more vivid than that of fathers, but only by the female students.
      For intact families, the female students also reported more imagery of mothers
      than of fathers, whereas the male students reported more vivid imagery of fathers
      than of mothers. However, for divorced or separated families in which individuals
      spent more time with their mothers, both men and women rated their mothers more
      vividly than their fathers. More vivid imagery was positively related to reported
      emotional closeness to parents and to more vivid imagery for general scenes.
      VVIPQ scores were associated with social desirability but were not related to
      measures of response leniency or general intelligence. Split-half reliability of
      the VVIPQ was very good, and both test-retest and alternate-format reliability
      were acceptable. The correlational evidence supports the construct validity of
      the VVIPQ, which is a promising tool for studying parental imagery.

PMID- 11211961
TI  - An operations model of psychosocial structure and function and of psychotherapy.
AB  - Currently, personality theory and clinical psychology have a fairly substantial
      tradition of promoting a strongly scientific basis for clinical work and
      theorizing. However, an appropriate foundation model has been difficult to
      identify and establish. A theory of human operations, here proposed, may provide
      such an elementary model. The theory is rooted in the organizational and
      industrial field known as operations, which is a highly systematic, precise,
      flexible, scientific approach to the understanding and management of human goal
      seeking action in the broadest sense. The proposed model includes the classical
      humanistic, clinical, and decision theoretic notions of values, cognition,
      emotions, ego, behavior, objectives, outcomes, feedback, and defenses. These
      notions are placed within an overall operations frame of reference and developed
      in such a manner that they can be used to assess human clinical problems and to
      design therapeutic interventions. The strengths and limitations of the model are
      discussed.

PMID- 11211962
TI  - Interpersonal conflict and sarcasm in the workplace.
AB  - Violence and aggression in the workplace are problems that most Americans
      confront on a daily basis. The present study is an exploration of the
      predisposition to conflict in a work environment in which personality traits
      responsible for increased sarcasm and increased anger in response to sarcasm are
      identified. Participants represented two subdepartments within a city general
      hospital. The Keirsey Temperament Sorter (D. Keirsey, 1998) test for departmental
      temperament and a sarcasm survey designed by the author were used to test for
      frequency of sarcasm and anger in relation to differing categories of sarcasm.
      Angry reactions were gauged in relation to sarcasm directed at job performance,
      personal life, behavior, and appearance. Conclusions from this study point to
      many variables as causes for workplace anger; these include influences from
      organizational culture, work environment, psychological defense mechanisms,
      leadership decisions, stress, task orientation, and personality differences.
      Sarcasm trigger points leading to anger may be predicted based on a work group's
      personality composition. A homogeneous personality composition within a work
      group may involve factors such as personality characteristics common to a
      particular profession, organizational demands, and hiring practices.

PMID- 11211963
TI  - Giant cell arteritis. Epidemiology, etiology and pathogenesis.
AB  - Giant cell arteritis (GCA) is a chronic inflammatory disorder targeting large and
      medium-sized arteries, which predominantly affects postmenopausal women. Its high
      incidence in populations with Scandinavian lineage, some familial accumulation,
      and the association with the HLA-DR4 haplotype indicate a genetic predisposition.
      Epidemiological observations, as well as the symptomatology, may indicate an
      infectious origin, but so far GCA has not been shown to be a truly infectious
      form of vasculitis. Immunological research indicates an antigen-driven disease
      with local T-cell and macrophage activation in the vessel wall. Morphologically,
      the inflammatory process appears to be initiated by a foreign-body giant-cell
      attack on calcified internal elastic membrane in arteries and on calcified
      atrophic parts of the aortic media. The ensuing diffuse chronic inflammation
      leads to vessel dilatation and extensive intimal thickening. The latter, which
      relates to the production of promoting factors by the inflammatory cells, causes
      arterial stenosis and ischemic complications. The possible role of female sex
      hormones in GCA requires further investigation. Mononuclear and giant cells in
      GCA display the cytoplasmic accumulation of estrogen receptor (ER) alpha.
      Cytoplasmic ER-alpha is also seen in media smooth-muscle cells in GCA and in non
      GCA controls, but nucleotide sequence analysis of the ER-alpha gene revealed no
      differences between GCA patients and controls. In the future, comprehensive
      morphological, cell biological and immunological research will be required for a
      better understanding of the complex etiology and pathogenesis of GCA.

PMID- 11211964
TI  - Retesting and follow-up of first-catch urines from men yield variable results
      with three Chlamydia trachomatis nucleic acid amplification tests.
AB  - First-catch urines from 276 asymptomatic male military recruits were screened by
      polymerase chain reaction for the detection of Chlamydia trachomatis. Eight
      initially positive specimens were retested by polymerase chain reaction, ligase
      chain reaction and transcription-mediated amplification. Urine specimens from six
      (2.2%) subjects were considered to contain C. trachomatis. However, retesting of
      serially collected urines from five of these six subjects using different nucleic
      acid amplification methods showed some discrepancy. This may have a major impact
      on the efficacy of screening programs for C. trachomatis in low prevalence
      populations.

PMID- 11211965
TI  - Buffy coat PCR for diagnosis of experimental pneumococcal pneumonia.
AB  - An immunocompetent murine model of pneumococcal pneumonia and bacteremia was used
      to evaluate a PCR assay based on amplification of the pneumolysin gene. Mice were
      treated with trovafloxacin to determine the decline in sensitivity of PCR as lung
      bacterial concentrations decreased and blood cultures became sterile. Forty-three
      mice were studied for up to 120 h after start of antibiotic treatment. PCR of
      buffy coat specimens was more sensitive than PCR of plasma. Only 21% of animals
      had a positive blood culture, whereas 77% of PCR buffy coat assays were positive.
      After 48 h of therapy all blood culture specimens were sterile, whereas buffy
      coat PCR was positive in 57.8% of specimens. PCR of buffy coat specimens was
      negative in all mice colonized nasally with Streptococcus pneumoniae and in
      rabbits with Escherichia coli bacteremia. Our results demonstrate that our PCR
      technique using buffy coat specimens is highly specific for invasive pneumococcal
      disease and remains positive in the majority of animals for at least 48 h after
      start of antibiotic therapy.

PMID- 11211966
TI  - Comparison of nasal swab culture, quantitative culture of nasal mucosal tissue
      and PCR in detecting Streptococcus pneumoniae carriage in rats.
AB  - It is not known how well nasopharyngeal swab culture represents pneumococcal
      carriage status. We tested this by comparing swab culture to quantitative culture
      and quantitative PCR of mucosal tissue in a rat model of pneumococcal carriage.
      Quantitative culture and quantitative PCR identified significantly more carriers
      compared to swab culture (differences 15% and 33%, 95% CI 1-28% and 16-47%,
      p=0.04 and 0.001, respectively). The sensitivity and specificity of swab culture
      was 75/92% and 63/100% compared to quantitative tissue culture and quantitative
      PCR, respectively. The quantitative estimates of culture and PCR were very
      similar (Pearson correlation coefficient 0.79, p<0.001). In conclusion, even a
      well-controlled swab sampling markedly underestimates pneumococcal carriage rate,
      and simultaneous use of quantitative culture and PCR increases the number of
      positive samples by about one third.

PMID- 11211967
TI  - Hepatitis C virus genotypes in Estonia.
AB  - Distribution of hepatitis C virus (HCV) geno(sub)types among 215 Estonian
      patients hospitalized with acute or chronic hepatitis and with HCV RNA-positive
      sera was investigated. For genotyping, both multiplex PCR with subtype-specific
      primers of the core region and RFLP analysis of cDNA of the 5' NCR region were
      used. These two methods permitted a correct characterization of genotypes, a more
      truthful characterization of mixed infections, and combined use of single-tube
      performances. They revealed, respectively, 200 and 202 (93.0% and 93.9%) HCV
      positive samples of sera, subtype 1a- 0.9% and 0.9%, 1b- 56.3% and 64.2%, 3a-
      13.9% and 22.3%, 2a- 6.5% and 5.6%, type 4 0.5% and 0%, mixed infections- 13.5%
      and 0%, and unidentified- 1.4% and 0.9%. In the majority of cases (84.7%) both
      methods gave completely or partially concordant results; in mixed infections, as
      determined by subtype-specific PCR, only one subtype was revealed by the RFLP
      method. In the remaining 15.3% of the cases (Ohno- 7.0%, RFLP- 8.3%) only one of
      the methods was positive. The epidemiological analysis of the dynamics of the
      subtypes' relative participation may indicate increasing 3a and decreasing 1b
      subtype infection during recent years.

PMID- 11211968
TI  - Expression and localisation of IGF-binding protein mRNAs in regenerating rat
      skeletal muscle.
AB  - The expression of the insulin-like growth factor-binding proteins (IGFBP) -3, -4,
      -5 and -6 was investigated in neonatal, in normal adult and in regenerating rat
      skeletal muscle. Semi-quantification was done by densitometric scannings of
      Northern blots. The expression of all investigated IGFBPs, with the exception of
      IGFBP-5, was higher in neonatal than in adult muscle. During postischaemic
      regeneration the expression of all IGFBPs increased, but with different time
      schedules. IGFBP-3 increased transiently during the early phase of regeneration,
      while IGFBP-4, -5 and -6 increased during the later phase of regeneration. In
      situ hybridisation on regenerating muscle showed that the expression of the
      various IGFBPs was cell specific; thus, IGFBP 3 was mainly expressed in
      macrophages, IGFBP-4 in connective tissue, IGFBP-5 in regenerating muscle cells,
      and IGFBP-6 in muscle cells, connective tissue and endothelium. Ligand blotting,
      using 125I-IGF-I as the ligand, showed a number of bands ranging between 24 and
      44 kDa. Samples from neonatal and regenerating muscle contained much higher
      levels of all IGFBPs than those from normal adult muscle. An ordered and cell
      specific expression of IGFBPs, allowing a strict regulation of IGF actions, is
      probably necessary to ensure an optimal regeneration process.

PMID- 11211969
TI  - p53 and Bcl-2 oncoprotein expression in placentas with hydropic changes and
      partial and complete moles.
AB  - Forty molar and non-molar placentas with hydropic changes (14 complete moles, 14
      partial moles, and 12 hydropic non-molar placentas) were examined
      immunohistochemically for expression of oncoproteins p53 and Bcl-2. The data were
      evaluated to determine if p53 and Bcl-2 expression could aid in differentiating
      molar from non-molar pregnancies on the one hand and complete mole from partial
      mole on the other. Thirteen out of fourteen complete moles showed p53 expression
      (93%), 8 of the 14 partial moles expressed p53 (57%), and none of the non-molar
      pregnancies expressed p53 in the extravillous intermediate trophoblasts.
      Regarding Bcl-2, the syncytiotrophoblasts of most molar and non-molar placentas
      showed strong and diffuse positivity. These results suggest that p53 expression
      can be used as a distinguishing parameter between complete moles and placentas
      with hydropic changes on the one hand and to a lesser extent between partial
      moles and placentas with hydropic changes on the other hand. Bcl-2 cannot be used
      in the same way as p53.

PMID- 11211970
TI  - Prevalence of EHEC O157:H7 in patients with diarrhoea in Lagos, Nigeria.
AB  - The prevalence of sorbitol-nonfermenting Escherichia coli O157:H7 (EHEC) was
      assessed in 100 patients with diarrhoea by stool culture on sorbitol MacConkey
      agar. The cytotoxicity of the EHEC strains was analysed by Vero cell assay and
      the antimicrobial susceptibility pattern of the isolates was determined.
      Detection rate of EHEC O157:H7 was 6%. Five of the six patients were males. Three
      of the isolates were from children and one was from a teenager. All strains
      induced cytotoxic effects in the Vero cell assay. All isolates were susceptible
      to most of the antimicrobials tested. The results showed that diarrhoea caused by
      EHEC O157:H7, a potentially life-threatening pathogen, has remained common
      particularly among the child population of Lagos during the past 10 years (5).
      There must therefore be adequate meat and food inspection to improve the general
      hygiene of local fast food restaurants, so-called 'bukkas', which are regarded as
      likely sources of infection.

PMID- 11211971
TI  - Autoantibody activity of the immunoglobulin secreted by a follicular B-cell
      lymphoma.
AB  - In patients with B-cell lymphoma, only in rare cases a secreted paraprotein is
      found, and in very few of them an associated autoantibody activity has been
      demonstrated. Here we report the case of a patient with a low-grade B-cell
      lymphoma with a serum biclonal paraprotein (G,M)lambda and severe
      erythroblastopenia. Indirect immunofluorescence studies of total serum revealed
      cytoplasmic (Hep-2 cells) and extracellular matrix (rat tissue sections)
      staining, suggestive of a new specificity. After gel filtration of serum samples,
      only the IgM-containing fraction showed the same pattern of staining. Tumor
      derived hybridomas expressed an unmutated V3-11 gene identical to that found in
      tumor samples and secreted an IgM immunoglobulin endowed with the same
      reactivity, which confirms the tumoral origin of the tissue-reactive protein. The
      results suggest a link between the autoimmune condition in this patient and the
      novel specificity displayed by the tumor-derived immunoglobulin.

PMID- 11211972
TI  - Distribution and sequence variations of selected virulence genes among group A
      streptococcal isolates from western Norway.
AB  - In order to compare the distribution of selected virulence genes among group A
      streptococci recovered from invasive disease and superficial infections, 42
      isolates were screened for mga, speB, speA, ssa and ska, by PCR. The isolates
      were predominantly of the sequence types emm1, emm3 and emm6, but also included a
      few of the types emm22, emm28, emm75 and emm78. The phage-mediated speA seemed to
      be prevalent in emm types 1 and 3, and its distribution was not related to
      disease severity. The other genes were present in all isolates. The mga, speB and
      speA were further studied by sequence analysis. Although allotypic associations
      with invasiveness were not found, allelic specificity to the emm sequence type
      was observed. In addition, the mga sequences indicated two lineages, related to
      opacity factor production. A possible recombination between these two main
      divergent mga genes was observed in isolates of the types emm22 and emm75. A
      logical nomenclature of the alleles of mga and speB is suggested.

PMID- 11211973
TI  - Structural evidence for counter-current flow in proximal tubules versus
      pertitubular capillaries in the rat kidney. Evaluation of the counter-current
      mechanism between the proximal convoluted tubules and the peritubular capillaries
      in the rat nephron.
AB  - BACKGROUND: In spite of the very high exchange of water and solutes between the
      proximal tubules and the peritubular capillaries, very little is known about flow
      directions in these two interrelated structures. We therefore developed a
      morphological technique suitable for the quantitative evaluation of a counter
      current system between the proximal convoluted tubules and the peritubular
      capillaries in rat renal cortex. METHODS: In male pentothal-anesthetized Wistar
      rats (body weight 200-250 g), India ink was injected into the aorta above the
      renal arteries, followed by instant freezing of the right kidney in isopentane at
      -165 degrees C, and subsequent freeze-substitution in alcohol. In microscopic
      slides from kidneys in which only 20-55% of the cortical peritubular capillary
      loops was filled with ink--representing the arterial end of the capillaries--and
      in which the proximal tubular segmentation could be identified in PAS-stained
      sections, the segments of the convoluted proximal tubules were quantitatively
      compared with regard to the presence of ink-stained and unstained peritubular
      capillaries in nephrons from the whole renal cortex. RESULTS: In the microscopic
      specimens of the five animals used both the loops from the first segment (P1) of
      the proximal convoluted tubule and those of the second segment (P2) were
      systematically packed closely together, the transitional segment (P1-2) being
      interposed between the groups. Around the loops of P1, 8%+/-2% of the capillaries
      was stained with India ink. In contrast, surrounding the P2 loops 67%+/-5% of the
      capillaries contained ink, significantly exceeding that for P1 (p<0.01).
      CONCLUSION: Throughout the rat renal cortex, the most proximal fraction of the
      peritubular capillaries surrounds the second segments of the proximal convoluted
      tubules, while the first tubular segments are surrounded by the more distal
      fraction of the peritubular capillaries. Consequently, the flows in the
      peritubular capillaries and in the proximal convoluted tubules in the rat renal
      cortex are systematically arranged as a counter-current system. This feature was
      previously identified only in superficial nephrons.

PMID- 11211975
TI  - Effects of electromagnetic radiation of the millimeter wavelength range on
      catecholamine metabolism in patients with arterial hypertension.

PMID- 11211974
TI  - Immunohistochemical localization of inducible and endothelial constitutive nitric
      oxide synthase in neoplastic and autoimmune thyroid disorders.
AB  - AIM: To investigate the distribution of nitric oxide synthase in tissues derived
      from patients with autoimmune or neoplastic disorders of the thyroid gland in
      order to test whether the expression of inducible nitric oxide synthase or
      endothelial constitutive nitric oxide synthase (two subtypes of EC 1.14.13.39)
      may be related to the inflammatory activity or degree of neoplasia. EXPERIMENTAL
      DESIGN: The expression of nitric oxide synthases was examined by
      immunohistochemistry in tissues from patients with either Hashimoto's thyroiditis
      (n=6), hyperplastic glands (Graves' disease) (n=7), adenomas (n=8), multinodular
      goitres (n=7), papillary carcinomas (n=4) or follicular carcinomas (n=5).
      RESULTS: Expression of inducible nitric oxide synthase was found in 22 of the
      tissues and was not specific for any of the examined thyroid disorders.
      Expression of endothelial constitutive nitric oxide synthase was found in some of
      the epithelial cells in all the tissues. There was no correlation between the
      intensity and distribution of the immunostaining and the thyroid disorders.
      CONCLUSION: Demonstration of nitric oxide synthase cannot be used for diagnostic
      purposes. The expression of endothelial constitutive nitric oxide synthase in all
      tissues indicates that the enzyme may be of importance for the function or growth
      of the thyroid epithelial cells.

PMID- 11211976
TI  - Rheocardiomonitoring systems.

PMID- 11211977
TI  - Clinical efficacy and immunoregulatory and neurohumoral effects of MM therapy in
      patients with atopic dermatitis.

PMID- 11211978
TI  - Laser clinical diagnostics as a promising trend of biomedical radio electronics.
AB  - This article outlines the up-to-date achievements of laser noninvasive clinical
      diagnostics. The outlook for its development and its close connection with the
      problems of physics, mathematics, and the electronic instrument-making industry
      are shown. The combined application of these disciplines in biology and medicine
      creates a novel integrated trend--medical physics.

PMID- 11211979
TI  - Prospects for applying fluorescence spectroscopy to diagnose the hard tissues of
      a tooth.
AB  - This article deals with the autofluorescence spectra from the hard tissues of a
      tooth, both in norm and pathology. An investigation was made on 30 extracted
      human teeth. The measurements were made both for the intact hard tissues of a
      tooth, such as enamel, dentine, cementum, and root canal, and for the tissues
      pathologically affected by a caries (superficial, intermediate, and deep) and by
      a dental calculus. It was found that the fluorescent spectra from enamel,
      dentine, cementum, and from the regions affected by a caries and dental calculus
      were identical in form. All the spectra revealed a maximum near 700 nm. However,
      the intact and affected hard tissues were greatly different in the integral
      fluorescent intensity. Dental calculus was found to produce the most pronounced
      fluorescent intensity, whereas the carious regions produced a slightly weaker
      fluorescent intensity. On the contrary, the intact hard tissues of a tooth
      exhibited the poorest fluorescent intensity.

PMID- 11211980
TI  - Fluorescence spectroscopy application in the express-evaluation of the
      gastrointestinal microflora.
AB  - Possible application is studied for fluorescence spectroscopy in the express
      evaluation of the gastrointestinal microflora. This diagnostic approach is
      feasible because of the difference in fluorescent spectra from different
      microorganisms, with anaerobic microorganisms exhibiting the most pronounced
      fluorescence. It was found that fluorescence strength raised with an increase in
      the bacteria Bacteroides and bifid bacteria, whereas it decreased with an
      increase in Escherichia coli. The bacteria Bacteroides and bifid bacteria are the
      most typical representatives of anaerobic bacteria, whereas the bacteria
      Escherichia coli are the typical representatives of aerobic bacteria. According
      to the literature, Bacteroides and bifid bacteria reveal an intense fluorescence.
      Bearing in mind that these genera of bacteria play an important role in the
      gastrointestinal microbiocenosis, fluorescence spectroscopy can be used as a
      diagnostic means for gastrointestinal dysbacteriosis.

PMID- 11211981
TI  - Features of electromagnetic radiation time-and-frequency fluctuation intensity
      distributions from human brain structures.
AB  - Time-and-frequency fluctuation intensity distributions' analysis is made of the
      electromagnetic radiation obtained from deep human brain structures. The role of
      monitoring the distribution changes due to various cerebral circulation disorders
      is explained.

PMID- 11211983
TI  - Millimeter radiation in the rehabilitation of oncological patients.

PMID- 11211982
TI  - The use of millimeter wavelength radiation to treat degenerative-dystrophic
      changes in articular cartilage in deforming osteoarthrosis.

PMID- 11211984
TI  - Functioning mechanisms of water biosensors of electromagnetic radiation.
AB  - The effect of microwaves on liquid water was investigated by using biosensors and
      physiochemical techniques, such as nuclear magnetic resonance (NMR) and
      spectrophotometry. The results obtained provided evidence for a nonthermal effect
      of microwaves on liquid water.

PMID- 11211985
TI  - Effects of millimeter wavelength electromagnetic radiation on neurons:
      electrophysiological study.

PMID- 11211986
TI  - Novel concepts of the causes of EHF-radiation-induced stimulating effects.
AB  - This article reviewed our investigations and the literature on the interaction of
      EHF radiation with biological objects. This allowed us to advance the general
      mechanism for the effect of millimetric waves on photosynthesizing organisms.

PMID- 11211987
TI  - Hydroxyapatite and their use as coatings in dental implants: a review.
AB  - At present, no standard manufacturing guideline exists for depositing
      hydroxyapatite (HA) on implant surfaces. Although animal and in vitro studies
      have reported on the benefits of using HA-coated implants as well as the risks of
      dissolution, these short-term studies did not demonstrate that the dissolution of
      the HA coating leads to a loss of implants. In addition, many in vivo and
      clinical studies did not include the chemical and structural characterization of
      the coatings, and thus comparisons between studies are difficult. In the clinics,
      the recommendation is that HA-coated screw implants be used for the anterior
      maxilla and posterior mandible where the bone depth exceeds 10 mm and when the
      cortical layer is thinner and spongiosia is less dense. In the posterior maxilla
      or when the cortical layer is very thin with low density, the use of HA-coated
      cylindrical implants is recommended. However, there are concerns for using HA
      coated implants. The clinician needs to take into consideration the enhanced
      bacterial susceptibility of HA coatings compared with titanium implants. In
      addition, the clinician needs to consider the possible failure of HA coatings as
      a result of coating-substrate interfacial fracture. Finally, besides the surgical
      skills, it is also important that the clinical investigators be well versed with
      the materials characterization needed for HA-coated implants, the problems
      associated with the current HA coatings, and the indications for use. In
      addition, the correlation between well characterized coatings and their effect on
      bone formation rate and long-term implant success, coating-implant interfacial
      strength, and alternative superior coating process need to be investigated
      further.

PMID- 11211988
TI  - The role of charge transport in the reception of electromagnetic radiation.

PMID- 11211989
TI  - Investigating the influence of electromagnetic radiation from millimeter ranges
      on the cardiovascular system in the hypertensive rat.

PMID- 11211990
TI  - Microprocessor systems for self-control of vital bodily functions.
AB  - This article presents a fundamentally novel approach to an urgent medico-social
      problem of providing the timely medical care. To maintain people's health and
      life in their everyday activities, a new concept of the medical instrument-making
      industry was put forward. This concept was developed in terms of the theory of
      functional systems, which revealed the universal rules of self-regulation of
      bodily functions. The practical realization of the above-mentioned concept
      involved the construction, patenting, and production of a number of original
      devices capable of warning the patient about disorders in basic bodily functions.
      These devices included a Heart Protection System, a Stress Doser, a Physiological
      Clock, a Ration Controller, and a Mother-Fetus Controller. They can all be
      regarded as informational household microprocessor-based instruments of the 21st
      century.

PMID- 11211991
TI  - Epigenetic mechanisms of chemical carcinogenesis.
AB  - Chemically induced cancer is a multi-step process involving damage to the genome
      initially followed by clonal expansion of the DNA damaged cell eventually leading
      to a neoplasm. Chemical carcinogens have been shown to impact at all of the
      stages of the tumorigenesis process. It has become apparent that chemical and
      physical agents that induce cancer may do so through several different cellular
      and molecular mechanisms. Epigenetic (nongenotoxic) chemical carcinogens are
      those agents that function to induce tumor formation by mechanisms exclusive of
      direct modification or damage to DNA. These agents appear to modulate cell growth
      and cell death and exhibit dose response relationships between exposure and tumor
      formation. The exact and/or exclusive mechanisms by which these agents function
      have not been established, however, changes in cell growth regulation and gene
      expression are important to tumor formation. This review focuses on several
      potential mechanisms and cellular processes that may be involved in nongenotoxic
      chemical carcinogenesis.

PMID- 11211992
TI  - Safety assessment for non-genotoxic rodent carcinogens: curves, low-dose
      extrapolations, and mechanisms in carcinogenesis.
AB  - The most frequent biologic events associated with multispecies multisite rodent
      non-genotoxic carcinogenesis include robust liver P450 enzyme induction without
      liver toxicity. This cancer process is not relevant for humans as exemplified by
      phenobarbital. A host of other pharmaceuticals, including loratidine and
      atorvastatin, with current sales in the billions of dollars attests to the lack
      of relevance of our rodent models acting via this specific process. Hopefully,
      the mechanism of phenobarbital will no longer draw research money in further
      probing the irrelevant in human carcinogenesis. The known human carcinogens not
      linked with genetic injury all perturb tissue growth/replication in humans as
      well as in rodent short-term tests at doses ultimately linked with cancer.
      Clearly identifying exposures perturbing growth/replication versus exposures not
      perturbing growth provides an effective tool for demonstrating the threshold for
      cancer risk in refining the risk assessment as capably described by Dr. Klaunig.
      Hopefully, we can begin to increasingly use data-based decisions in risk
      assessment versus hypothetical low- dose extrapolations and mathematical
      modeling, building on the wealth of current understanding in human and rodent
      cancer processes in arenas beyond pharmaceutics.

PMID- 11211993
TI  - Response to "Epigenetic mechanisms of chemical carcinogenesis" by James E.
      Klaunig, Lisa M. Kamendulis, and Xu Yong.

PMID- 11211994
TI  - Response to "Epigenetic mechanisms of carcinogenesis" by Klaunig JE, Kamendulis
      LM and Xu Y.
AB  - It is now quite clear that carcinogenesis involves more than mutagenesis and an
      increased focus on epigenetic events underlying the transformation of a normal
      cell into a frank malignancy is appropriate.

PMID- 11211995
TI  - A true threshold dose in chemical carcinogenesis cannot be defined for a
      population, irrespective of the mode of action.
AB  - Strongly sigmoidal (S-shaped) dose-cancer incidence relationships are often
      observed in animal bioassays for carcinogenicity. If a genotoxic contribution is
      not plausible, an epigenetic mode of carcinogen action is proposed and a
      thresholded low dose-response suggested. In a strict sense, a threshold implies a
      no-yes situation, i.e., no effect up to the threshold dose and an effect above
      the threshold dose. A convincing explanation of the discontinuity of the gradient
      of the dose-response curve at the threshold dose is not available to me. However,
      the existence of a threshold is accepted for an individual. The threshold dose is
      the dose required for the manifestation of the tumor in an individual exactly at
      the end of a defined period of observation (for instance, 2 years in an animal
      bioassay, 75 years in humans). Because of genetic and lifestyle-dependent
      susceptibility differences, each animal or human has his individual threshold
      dose. For a group, no single threshold dose can be defined, irrespective of the
      mode of carcinogen action. Furthermore, in view of the stochastic elements in the
      process of carcinogenesis, the exact threshold dose can only be defined after
      tumor incidence and cannot be predicted.

PMID- 11211996
TI  - Response to Klaunig J.E. et al.'s "Epigenetic mechanisms of chemical
      carcinogenesis".

PMID- 11211997
TI  - The composition of cigarette smoke: a retrospective, with emphasis on polycyclic
      components.
AB  - The difficulties encountered in extrapolating biological activity from cigarette
      smoke composition provide generally applicable lessons as they are representative
      of the problems encountered with other complex mixtures. Researchers attempting
      to assess risk are faced with attempting to interpret data from a number of areas
      including: tobacco science; smoke/aerosol chemistry specific to tobacco;
      sophisticated analytical chemistry applications and techniques for trapping,
      collecting, separating, and quantifying very specific compounds at nanogram to
      picogram levels; numerous biological testing methodologies; and animal models of
      tumors and carcinogenesis. Numerous hypotheses have been developed over the past
      five decades and tested with the technology of the day in attempts to interpret
      the biological activity of cigarette smoke in relation to the chemistry of this
      complex mixture. These hypotheses fall into several categories discussed in this
      review: mechanisms of pyrogenesis of polycyclic aromatic hydrocarbons (PAHs) in
      tobacco smoke; levels of PAHs in cigarette mainstream smoke (MS) and its
      tumorigenicity in mouse skin-painting experiments; control of PAH levels in MS;
      chemical indicators of cigarette smoke condensate (CSC) tumorigenicity; control
      of levels of MS components partitioned between the vapor phase and particulate
      phase of MS; tumorigenic threshold limits of CSC and many of its components;
      tumorigenic aza-arenes in tobacco smoke; MS components reported to be ciliastatic
      to smokers' respiratory tract cilia; anticarcinogenic tobacco-smoke components.
      Of 52 hypotheses reviewed in this paper, 15 have excellent data supporting the
      hypothesis based on today's technology. The remaining 37 hypotheses, although
      originally plausible, have since become insupportable in light of new and
      contradictory data generated over the years. Such data were generated sometimes
      by the original authors of the hypotheses and sometimes by other investigators.
      The hypotheses presented today are less likely to be supplanted because they are
      well conceived and have a strong mechanistic basis. The challenge for the future
      is the generation and interpretation of data relating the chemistry and
      biological activity associated with the dynamic and complex mixture of tobacco
      smoke.

PMID- 11211998
TI  - Gas phase reactions of NH2Cl with anionic nucleophiles: nucleophilic substitution
      at neutral nitrogen.
AB  - Reactions of chloramine, NH2Cl, with HO-, RO- (R = CH3, CH3CH2, CH3CH2CH2,
      C6H5CH2, CF3CH2), F- , HS- , and Cl- have been studied in the gas phase using the
      selected ion flow tube technique. Nucleophilic substitution (S(N)2) at nitrogen
      to form Cl- has been observed for all the nucleophiles. The reactions are faster
      than the corresponding S(N)2 reactions of methyl chloride; the chloramine
      reactions take place at nearly every collision when the reaction is exothermic.
      The thermoneutral identity S(N)2 reaction of NH2Cl with Cl-, which occurs
      approximately once in every 100 collisions, is more than two orders of magnitude
      faster than the analogous reaction of CH3Cl. The significantly enhanced S(N)2
      reactivity of NH2Cl is consistent with a previous theoretical prediction that the
      barrier height for the S(N)2 identity reaction at nitrogen is negative relative
      to the energy of the reactants, whereas this barrier height for reaction at
      carbon is positive. Competitive proton abstraction to form NHCl- has also been
      observed with more highly basic anions (HO-, CH3O-, and CH3CH2O-), and this is
      the major reaction channel for HO- and CH3O-. Acidity bracketing determines the
      heat of deprotonation of NH2Cl as 374.4 +/- 3.0 kcal mol(-1).

PMID- 11211999
TI  - Hydrogen bonds in gas-phase clusters between halide ions and olefins.
AB  - Gas-phase clustering reactions of halide ions (X- = F-, Cl-, Br-, and I-) with
      ethylene (C2H4) and propylene (C3H6) were studied with a pulsed electron beam
      mass spectrometer. Bonding energies of all cluster ions were found to be less
      than 10 kcal/mol, i.e., no anion-initiated polymerization of C2H4 and C3H6 took
      place. For the cluster F-(C2H4)n, a small gap in the binding energy is observed
      between n = 4 and 5 suggesting that the first shell is completed with n = 4. For
      larger halide ions, the bond energies for the clusters X-(C2H4)n were found to be
      nearly n independent. For Cl-(C3H6)n a steep decrease in binding energies was
      observed between n = 2 and 3 and n = 3 and 4. The structure of the cluster ions
      was investigated by ab initio calculations. X-(C2H4)n complexes were calculated
      to have hydrogen-bond geometries regardless of the identity of the halide ions,
      and bidentate (chelate) type geometries of X-(C3H6)1 were found.

PMID- 11212000
TI  - Ketalization of gaseous acylium ions.
AB  - A novel reaction of gaseous acylium ions: ketalization with diols and analogs,
      has been systematically studied via pentaquadrupole MS2 and MS3 experiments and
      ab initio calculations. A variety of alpha,beta-diols and their amino, thiol,
      ether, and thioether analogs have been tested for reactivity, mechanism
      evaluation, site selectivity, and for the effects of alpha- and beta
      interfunctional separation. As for condensed-phase ketalization of neutral
      carbonyl compounds followed by hydrolysis, gaseous acylium ions are chemically
      deactivated in the form of cyclic ionic ketals by ketalization, and are
      efficiently released via on-line collision-induced dissociation. Ketalization of
      acylium ions is shown to identify and structurally characterize alpha,beta-diols
      and their analogs, and to distinguish regioisomers. Diastereomers can also be
      distinguished, as illustrated for cis and trans 1,2-diaminocyclohexane. The MS2
      and MS3 data together with 18O-labeling and ab initio calculations establish for
      acylium ion ketalization a mechanism of anchimeric assistance with participation
      of the neighboring acyl group.

PMID- 11212001
TI  - Characterization of the product ions from the collision-induced dissociation of
      argentinated peptides.
AB  - Tandem mass spectrometry performed on a pool of 18 oligopeptides shows that the
      product ion spectra of argentinated peptides, the [bn + OH + Ag]+ ions and the
      [yn - H + Ag]+ ions bearing identical sequences are virtually identical. These
      observations suggest strongly that these ions have identical structures in the
      gas phase. The structures of argentinated glycine, glycylglycine, and
      glycylglycylglycine were calculated using density functional theory (DFT) at the
      B3LYP/DZVP level of theory; they were independently confirmed using HF/LANL2DZ.
      For argentinated glycylglycylglycine, the most stable structure is one in which
      Ag+ is tetracoordinate and attached to the amino nitrogen and the three carbonyl
      oxygen atoms. Mechanisms are proposed for the fragmentation of this structure to
      the [b2 + OH + Ag]+ and the [Y2 - H + Ag]+ ions that are consistent with all
      experimental observations and known calculated structures and energetics. The
      structures of the [b2 - H + Ag]+ and the [a2 - H + Ag]+ ions of
      glycylglycylglycine were also calculated using DFT. These results confirm earlier
      suggestions that the [b2 - H + Ag]+ ion is an argentinated oxazolone and the [a2 
      H + Ag]+ an argentinated immonium ion.

PMID- 11212002
TI  - Electron transfer vs. proton transfer within radical-cation clusters of guanosine
      and deoxyguanosine with substituted naphthalenes and sinapinic acid.
AB  - Guanosine (G) and deoxyguanosine (dG) radical cations can be generated in the gas
      phase by single electron transfer (SET) within nucleoside-dimethoxynaphthalenes
      (1-2) electron-bound heterodimers produced by fast atom bombardment in a four
      sector mass spectrometer. The nucleobase guanine is much more easily oxidized
      when it is linked to a ribose moiety. The radical cation dimers formed by G and
      dG with sinapinic acid behave as proton-bound heterodimers. The experiments mimic
      to some extent the migration of radical sites within stacking bases which causes
      DNA damaging through depurination processes.

PMID- 11212003
TI  - Metastable decay of negatively charged oligodeoxynucleotides analyzed with
      ultraviolet matrix-assisted laser desorption/ionization post-source decay and
      deuterium exchange.
AB  - In an effort to understand the initiating step in metastable-ion decay of UV
      matrix-assisted laser desorption/ionization (MALDI)-produced ions, we conducted
      experiments in which we exchanged all active protons for deuterons of tetrameric
      and hexameric oligodeoxynucleotides. We wish to address the controversial
      proposal that in the negative-ion mode, as in the positive-ion mode,
      fragmentation is driven by nucleobase protonation. The results show unambiguously
      that proton transfer, leading to zwitterion formation, charges a nucleobase prior
      to its elimination. The zwitterion formation directs fragmentation of both
      positive and negative oligodeoxynucleotide ions. Poly-T-rich oligodeoxynucleotide
      tetramers show surprising differences in the negative compared to the positive
      ion mode, as thymine is preferentially expelled, instead of a nucleobase with
      higher proton affinity. For the exceptional case of negatively charged poly-T
      rich oligodeoxynucleotide tetramers generated by MALDI, we propose that
      zwitterion formation with positive charging of a nucleobase leads to base
      stabilization in the negative-ion mode through an interaction of the positive
      nucleobase with the excess negative charge. Moreover, backbone cleavages
      (accompanied by H rearrangement) of a phosophodiester bond give first-generation
      products that can be traced back to this tripolar complex bearing one positive
      and two negative charges, all of which may be interacting.

PMID- 11212004
TI  - Fragmentation mechanisms of oligodeoxynucleotides studied by H/D exchange and
      electrospray ionization tandem mass spectrometry.
AB  - We used solution-phase hydrogen/deuterium (H/D) exchange and multistage tandem
      mass spectrometry (MS/MS) experiments in an electrospray ion-trap mass
      spectrometer operating in the negative-ion mode to investigate the consequences
      of the loss of a high proton-affinity (PA) base from T-rich tetra and
      hexadeoxynucleotides. The T-rich oligodeoxynucleotides containing one or two
      other nucleobases take advantage of the mass spectral inertness of T because
      fragmentation of a T-rich oligomer is simple, allowing a tight focus on those
      processes of interest. Furthermore, determination of T-rich oligodeoxynucleotides
      may be a starting point in the development of a mass spectrometric scheme to
      understand the mutagenicity of various types of DNA damage by UV radiation. For
      nine oligodeoxynucleotides, the nucleobases were charged by nearly exclusive D
      transfer and then expelled as neutral bases. Loss of the base located at the 3'
      end is preferred over that from the 5' terminus when the two bases are identical.
      The observation of partially exchanged fragments from a completely exchanged
      precursor ion proves intramolecular H/D exchange between hydrogen atoms that can
      exchange in water and those that cannot. The multiplicity of the product-ion
      peaks provides information on decomposition pathways and origins of the product
      ions and shows that the loss of base is the first step in all fragmentation of
      hexanucleotides, but is a competitive process for tetranucleotide fragmentation.

PMID- 11212005
TI  - A mechanistic study of electrospray mass spectrometry: charge gradients within
      electrospray droplets and their influence on ion response.
AB  - A model has been developed to account qualitatively for the effects of ion
      pairing, surface activity, and electrophoretic mobility in electrospray mass
      spectrometry. The model is tested with various salt and amino acid mixtures. The
      data suggest that the axial charge gradient arising from electrophoretic
      separation at droplet genesis may persist within the electrosprayed droplets at
      least until the first droplet fission, accounting for the field dependence of
      detected ion clustering of quaternary ammonium salts and for the relatively field
      invariant charge distribution of horse heart myoglobin samples.

PMID- 11212006
TI  - Protein identification by in-gel digestion, high-performance liquid
      chromatography, and mass spectrometry: peptide analysis by complementary
      ionization techniques.
AB  - A biologically active protein fraction was isolated from rabbit intestine,
      purified by one-dimensional SDS-PAGE and stained with Coomassie Brilliant Blue. A
      predominant band of approximately 110-130 kDa was excised and digested in-gel
      with trypsin. The resulting peptides were extracted then separated by microbore
      reversed-phase high-performance liquid chromatography (HPLC). Mass spectrometric
      data from one HPLC fraction obtained by two different ionization techniques
      proved to be complementary. Matrix-assisted laser desorption/ionization (MALDI)
      showed nine peptide masses, which by post source decay analysis and database
      searching were attributed to two proteins. Nanoflow electrospray analysis
      performed on a hybrid tandem mass spectrometer of quadrupole-quadrupole
      orthogonal acceleration time-of-flight (QqTOF) geometry detected six additional
      peptide components. On the basis of the additional peptides and superior quality
      collision-induced dissociation spectra typical of this instrument type, two
      further proteins were identified. The resolution afforded by the QqTOF instrument
      permitted charge state determination for the fragment ions while preserving the
      high detection sensitivity that was essential in obtaining the composition of
      this mixture of proteins.

PMID- 11212008
TI  - Similarity between condensed phase and gas phase chemistry: fragmentation of
      peptides containing oxidized cysteine residues and its implications for
      proteomics.
AB  - Amino acid residues containing thioethers are easily oxidized during protein
      purification, derivatization, and/or digestion. For instance, oxidation of
      methionine residues in proteins during SDS-PAGE is commonly observed. Under low
      energy collision induced dissociation this gives rise to a second series of
      fragment ion of lower abundance that are shifted by -64 Da when compared to the
      oxidized methionine-containing fragments. We report here that alkylated cysteine
      residues can be found in their oxidized form too, indicating that the oxidation
      of thioethers can occur during and following protein digestion and not only
      during SDS-PAGE or reduction and alkylation. Collision induced dissociation
      experiments on the singly- and multiply-charged species reveals that these
      peptides preferentially undergo elimination reactions that forms a dehydroalanine
      from the oxidized, alkylated cysteine residue. This contrasts to the less
      abundant elimination reaction of peptides containing oxidized methionines which
      cannot form an alpha,beta-unsaturated compound, but parallels the condensed
      phased chemistry of sulfoxides. The masses of both precursor and product ions are
      shifted such that these peptides cannot be identified in database searches with
      current algorithms. Incorporation of this fragmentation pattern is important for
      the isotope-coded affinity tag approach since this method is based on peptides
      containing cysteine residues.

PMID- 11212007
TI  - A new crosslinker for mass spectrometric analysis of the quaternary structure of
      protein complexes.
AB  - Mass spectrometric structural analysis of crosslinked peptides is a powerful
      method to elucidate the spatial arrangement of polypeptides in protein complexes.
      Our aim is to develop bifunctional crosslinkers that, after crosslinking protein
      complexes followed by proteolytic digestion, give rise to crosslinked peptides
      that can be readily tracked down by mass spectrometry. To this end we synthesized
      the crosslinker N-benzyliminodiacetoyloxysuccinimid (BID), which yields stable
      benzyl cation marker ions upon low-energy collision-induced dissociation (CID)
      tandem mass spectrometry. Sensitive detection of the marker ion upon low-energy
      CID is demonstrated with different BID-crosslinked peptide preparations. With BID
      it becomes possible to retrieve crosslinked and crosslinker-adducted peptides,
      without the necessity of purifying crosslinked peptides prior to identification.
      The basic design of this crosslinker can be varied upon, in order to meet
      specific crosslinking needs.

PMID- 11212009
TI  - Nonneurologic hand pain versus carpal tunnel syndrome: do psychological measures
      differentiate?
AB  - OBJECTIVE: To determine whether psychological measures would differentiate a
      group of patients with physician-diagnosed nonneurologic hand pain from patients
      with carpal tunnel syndrome (CTS). Many patients, who also displayed symptoms of
      psychological distress, were referred to an electrodiagnostic clinic with a
      diagnosis of possible CTS; they subsequently had normal nerve conduction studies.
      DESIGN: Sixty patients with hand pain were referred to either of two university
      clinics for electrophysiologic testing, were assigned to either the CTS or
      nonneurologic group, and were compared on a series of psychometric tests.
      RESULTS: The Beck Depression Inventory and McGill Pain Questionnaire showed that
      the physician-assigned nonneurologic patients have a greater degree of
      depression, use more affective adjectives, and choose more words on the McGill
      Pain Questionnaire than the physician-assigned CTS group. The nonneurologic group
      also scored higher on indices of self-reported disability on the Pain Disability
      Inventory in five of seven categories. Although the CTS group perceived more
      control over their pain, no differences were observed in the types of coping
      strategies used on the Coping Strategy Questionnaire. Finally, the nonneurologic
      group had more Workers' Compensation Board claims. CONCLUSION: Evidence of
      important psychological issues in some patients with hand pain suggests a need
      for greater awareness among treating physicians.

PMID- 11212010
TI  - Compound nerve action potential of common peroneal nerve recorded at fibular
      neck: its clinical usefulness.
AB  - OBJECTIVE: To determine the clinical usefulness of the compound nerve action
      potential of the common peroneal nerve recorded immediately distal to or at the
      fibular neck, at the same time stimulating the common peroneal nerve laterally at
      the posterior knee. DESIGN: For recording the compound nerve action potential of
      the common peroneal nerve, the active recording electrode was secured just distal
      to or at the fibular neck area, whereas the stimulating electrode was placed on
      the medial border of the lateral hamstring tendon at the level of the popliteal
      crease. To reduce shock artifacts, a biphasic stimulation was used. RESULTS: In
      35 adults (n = 19 men), 70 nerves were tested. The compound nerve action
      potential from each individual was recorded. The compound nerve action potential
      amplitude of a baseline-to-negative peak and conduction velocity were measured on
      both sides. For comparisons of the side-to-side amplitude and conduction
      velocity, Wilcoxon's signed-rank test was applied. CONCLUSION: This approach of
      recording the compound nerve action potential of the common peroneal nerve, in
      addition to conventional methods, may enhance the process of determining the
      precise localization of peroneal nerve lesion in the knee.

PMID- 11212011
TI  - Factor analysis of quality of life, dyspnea, and physiologic variables in
      patients with chronic obstructive pulmonary disease before and after
      rehabilitation.
AB  - OBJECTIVE: To identify the relationships between quality of life (QOL) and the
      clinical state using factor analysis pre- and postrehabilitation. Patients with
      chronic obstructive pulmonary disease (COPD) suffer from a significant
      physiologic impairment associated with an altered QOL. Comprehensive
      rehabilitative programs, including exercise training, have beneficial effects on
      exercise tolerance and QOL for these patients. DESIGN: Factor analysis (n = 6)
      was conducted using the data of 32 patients with COPD. Patients had been
      evaluated for QOL using the Nottingham Health Profile (NHP), spirometric values,
      dyspnea, and the variables assessed by an incremental exercise test at three
      levels of activity. All measurements were obtained pre- and postrehabilitation.
      RESULTS: Factor analysis showed that the following two factors characterize the
      pathophysiologic condition of patients with COPD: (1) the specific
      cardiorespiratory responses to incremental exercise test and the spirometric
      values; and (2) the QOL results. The factor analysis results differed with the
      testing time (pre, post) and the level of activity. CONCLUSIONS: QOL, as
      evaluated by a generic questionnaire and the clinical state of patients with
      COPD, was independent; this independence characterized the pathophysiologic
      condition of our patients. Our results reinforce the usefulness of different
      types of evaluation, especially pre- and postrehabilitation, because they reflect
      independent benefits used to understand the success and follow-up of
      rehabilitative programs.

PMID- 11212012
TI  - Influence of admission functional status on functional change after stroke
      rehabilitation.
AB  - OBJECTIVE: To determine whether the admission functional score influences the
      functional change after stroke rehabilitation. DESIGN: Two hundred forty-three
      patients who had received the Functional Independence Measure (FIM) assessment at
      admission and at discharge were enrolled in the study. The patients were
      stratified into three groups according to their FIM total scores at admission,
      i.e., < or =36, 37 to 72, and > or =73. RESULTS: The Scheffe's multiple
      comparison test showed that patients with FIM total scores of > or =73 at
      admission were significantly younger (58 +/- 11 [SD] yr) than those who had
      scores of 37 to 72 (64 +/- 11 yr) or < or =36 (66 +/- 12 yr). Patients with FIM
      total scores of 37 to 72 at admission showed significantly higher FIM gain (37 +/
      15) compared with those patients who had scores of > or =73 (20 +/- 10) or < or
      =36 (29 +/- 23). CONCLUSION: The functional levels of affected patients at
      admission stratified by the FIM scale roughly predict the degree of functional
      gain after rehabilitation in survivors with a first episode of ischemic stroke.
      Moderately affected patients will benefit from intensive rehabilitation. These
      findings may be useful for rehabilitation triage.

PMID- 11212013
TI  - Paravertebral venous plexus distention (Batson's): an inciting etiologic agent in
      lumbar radiculopathy as observed by venous angiography.
AB  - Can the paravertebral plexus of veins adjacent to the spinal nerve root within
      the narrow confines of the lateral neural canal be a collateral generator of
      radicular pain when no other evidence of spinal pathology is evident? A patient
      with complaints of intractable lumbar radiculopathy and an otherwise unremarkable
      clinical neuromusculoskeletal examination, as well as normal imaging and
      electrodiagnostic studies, is reviewed with special reference to symptomatic and
      paravertebral venous responses to both a Valsalva maneuver and dipyridamole
      infusion as imaged by magnetic venous angiography.

PMID- 11212014
TI  - Do endplate noise and spikes arise from normal motor endplates?
AB  - The concept that the endplate noise and endplate spike components of motor
      endplate potentials represent normal endplate potentials seems to be flawed. The
      morphology of the normal miniature endplate potentials described in the
      physiology literature is different from the morphology of the noise-like
      component of endplate potentials. This noise-like component is identified as
      normal in current electromyographic literature. There is strong experimental
      evidence that one source of the endplate noise component is grossly increased
      release (up to three orders of magnitude) of acetylcholine from the nerve
      terminal of that neuromuscular junction. The spikes can be accounted for by
      release of additional acetylcholine in response to mechanical stimulation by the
      electromyographic needle. Other possibilities exist.

PMID- 11212015
TI  - Measures of central tendency in rehabilitation research: what do they mean?
AB  - Measures of central tendency including the mean, median, and mode are commonly
      reported in rehabilitation research. It is believed that the relationship among
      the mean, median, and mode changes in a specific way when the distribution being
      analyzed is skewed. A number of widely used textbooks were reviewed to determine
      how the relationship among the mean, median, and mode is presented in the health
      sciences and rehabilitation literature. We report a potential misinterpretation
      of the relationship between measures of central tendency that was identified in
      several research and statistical textbooks on the subject of rehabilitation. The
      misinterpretation involves measures of central tendency derived from skewed
      unimodal sample distributions. The reviewed textbooks state or imply that in
      asymmetrical distributions, the median is always located between the mode and
      mean. An example is presented illustrating the fallacy of this assumption. The
      mean and median will always be to the right of the mode in a positively skewed
      unimodal distribution and to the left of the mode in a negatively skewed
      distribution; the order of the mean and median is impossible to predict or
      generalize. The assumption that the median always falls between the mode and mean
      in the calculation of coefficients of skewness has implications for the
      interpretation of exploratory and confirmatory data analysis in rehabilitation
      research.

PMID- 11212016
TI  - Defining the population, treatments, and outcomes of interest: reconciling the
      rules of biology with meaningfulness.
AB  - Population characteristics, treatment needs, therapeutic interventions, and
      outcomes are inextricably linked. To appreciate the treatment needs and outcomes
      of populations served by rehabilitation medicine, it is essential to understand
      how specific conditions impair mental and physical functioning, given the
      environments within which people choose to live. States of the mind and body
      combine with the characteristics of the man-made and natural world and the social
      infrastructure to yield disabilities and, thus, shape the demand for
      rehabilitation services. The 1997 draft of ICIDH-2: International Classification
      of Impairments, Activities, and Participation (ICIDH-2) is described as an
      approach to population definition and outcome assessment. A new and evolving
      model referred to as the spheres of human-environmental integration (HEI) is
      applied to expressing the nonlinear and overlapping relationships among the ICIDH
      2 dimensions. HEI is defined as the individual's potential for meaningful
      physical and mental activity as determined by physical and mental capabilities in
      relationship to the man-made and natural worlds, social expectations, and
      available resources. HEI can be expanded by reducing disabilities through medical
      and rehabilitation interventions and by eliminating environmental barriers. This
      dual approach implies a need to integrate rehabilitation sciences with the
      principles of independent living, which view disablement as a function of the
      environment. The ICIDH-2 dimensions combined with HEI are used to define
      populations and to study the mechanisms and effects of alternative treatments
      through various techniques of case-mix measurement, disability staging, and
      utility assessment.

PMID- 11212017
TI  - Identification of cervical radiculopathies: optimizing the electromyographic
      screen.
AB  - OBJECTIVE: To determine the optimal electromyography screening examination of the
      upper limb that ensures detection of those cervical radiculopathies, which can be
      electrodiagnostically confirmed, yet minimizes the number of muscles studied.
      DESIGN: A prospective multicenter study was conducted from May 1996 to September
      1997 at five institutions. Patients who were referred to participating
      electrodiagnostic laboratories with suspected cervical radiculopathy were
      recruited. A standard set of muscles were examined by needle electromyography.
      Patients with electrodiagnostically confirmed cervical radiculopathies, based on
      electromyography findings, were selected for analysis. Muscle screens were tested
      against this group to determine whether the screen identified the patients with
      radiculopathy. RESULTS: There were 101 patients with cervical radiculopathies
      representing all cervical root levels. When paraspinal muscles were one of the
      screening muscles, five muscle screens identified 90% to 98% of radiculopathies,
      six muscle screens identified 94% to 99%, and seven muscle screens identified 96%
      to 100%. When paraspinal muscles were not part of the screen, eight distal limb
      muscles recognized 92% to 95% of radiculopathies. CONCLUSION: This study
      demonstrated that six muscle screens including paraspinal muscles yielded
      consistently high identification rates. Studying additional muscles led to
      marginal increases in identification.

PMID- 11212018
TI  - Outcomes of cardiopulmonary arrest in an acute rehabilitation setting.
AB  - OBJECTIVE: Fifty consecutive cases of cardiopulmonary arrest with administration
      of cardiopulmonary resuscitation (CPR) during a 6-yr period at a freestanding
      academic acute rehabilitation hospital were identified. DESIGN: Medical records
      of 49 patients were available for review. Outcomes of survival of arrest,
      survival to 24 hr postarrest, survival to discharge from the hospital were
      determined, and chi2 or Fisher's exact tests were performed to investigate
      relationships between survival and admission functional status, age, gender, and
      medical comorbidities. RESULTS: Forty-three percent of patients survived the
      initial arrest, 37% survived to 24 hr post-CPR, and 18% survived to hospital
      discharge. We were unable to identify any statistically significant predictors of
      survival post-CPR. Six of the nine survivors returned to the acute rehabilitation
      setting after cardiopulmonary arrest, and five of these patients made significant
      functional gains. CONCLUSIONS: Outcomes after CPR in patients undergoing acute
      rehabilitation in one setting were not significantly different from those
      reported for patients in other healthcare settings. These data may be used by
      healthcare professionals to enhance discussions concerning advance healthcare
      planning (including resuscitation plans) with patients and families. Larger
      studies are needed to clarify the prognostic role of prior functional status in
      predicting CPR outcomes, particularly in the context of various diagnostic
      categories and age groups.

PMID- 11212019
TI  - In vitro pharmacologic effect of two endothelin-1 antagonists on equine colonic
      arteries and veins.
AB  - OBJECTIVE: To evaluate the effectiveness of 2 potential endothelin (ET)-1
      antagonists in blocking the contractile responses of equine colonic vessels to
      increasing concentrations of ET-1. SAMPLE POPULATION: Mesenteric vessels from 6
      clinically healthy horses. PROCEDURE: Colonic vessels (arterial and venous rings)
      were placed in organ baths with oxygenated Tyrode solution at 37 C. Each was
      attached to a force transducer interfaced with a polygraph, and 2 g of tension
      was applied and equilibrated for 45 minutes. Then, B-1 (PD 142893) and B-2 (PD
      145065) ET-1 antagonists were tested. One ring from each vessel type was used as
      a control for determining concentration-response relationships of ET-1 (10(-10)
      to 10(-6)M). Three rings of each vessel type were incubated with 3 concentrations
      of each antagonist (10(-7), 10(-6), and 10(-5) M) for 30 minutes before ET
      induced contractions were determined. The maximum contractile response and pA2
      values were determined. RESULTS: Vessels contracted in a concentration-dependent
      manner to ET-1. Arteries responded slowly but reached greater contractions. Veins
      responded immediately with sustained contractions. Both antagonists inhibited
      contractions in a concentration-dependent manner with significant differences at
      10(-6) and 10(-5)M for arteries and 10(-5) M for veins. Complete blockade of
      contractions was observed with B-2 (10(-5)M). The pA2 values for B-1 were 8.26
      and 6.82 for arteries and veins, respectively, whereas they were 8.25 and 7.21
      for B-2. CONCLUSION AND CLINICAL RELEVANCE: Both antagonists effectively blocked
      ET-1-induced contractions of equine colonic vessels. Because B-2 is water soluble
      and caused complete blockade at 10(-5) M, it appears to be the preferred
      antagonist.

PMID- 11212020
TI  - Effects of enrofloxacin and magnesium deficiency on matrix metabolism in equine
      articular cartilage.
AB  - OBJECTIVE: To investigate the effects of enrofloxacin and magnesium deficiency on
      explants of equine articular cartilage. SAMPLE POPULATION: Articular cartilage
      explants and cultured chondrocytes obtained from adult and neonatal horses.
      PROCEDURE: Full-thickness explants and cultured chondrocytes were incubated in
      complete or magnesium-deficient media containing enrofloxacin at concentrations
      of 0, 1, 5, 25, 100, and 500 microg/ml. Incorporation and release of sulfate 35S
      over 24 hours were used to assess glycosaminoglycan (GAG) synthesis and
      degradation. An assay that measured binding of dimethylmethylene blue dye was
      used to compare total GAG content between groups. Northern blots of RNA from
      cultured chondrocytes were probed with equine cDNA of aggrecan, type-II collagen,
      biglycan, decorin, link protein, matrix metalloproteinases 1, 3, and 13, and
      tissue inhibitor of metalloproteinase 1. RESULTS: A dose-dependent suppression of
      35S incorporation was observed. In cartilage of neonates, 35S incorporation was
      substantially decreased at enrofloxacin concentrations of 25 mg/ml. In cartilage
      of adult horses, 35S incorporation was decreased only at enrofloxacin
      concentrations of > or =100 microg/ml. Magnesium deficiency caused suppression of
      35S incorporation. Enrofloxacin or magnesium deficiency did not affect GAG
      degradation or endogenous GAG content. Specific effects of enrofloxacin on steady
      state mRNA for the various genes were not observed. CONCLUSION AND CLINICAL
      RELEVANCE: Enrofloxacin may have a detrimental effect on cartilage metabolism in
      horses, especially in neonates.

PMID- 11212021
TI  - Results of cystometry and urethral pressure profilometry in dogs sedated with
      medetomidine or xylazine.
AB  - OBJECTIVE: To compare effects of medetomidine and xylazine hydrochloride on
      results of cystometry and micturition reflexes in healthy dogs and results of
      urethral pressure profilometry (UPP) in sedated and conscious dogs. ANIMALS: 20
      dogs. PROCEDURES: Urodynamic testing was performed 6 times in each dog (3 times
      after administration of xylazine [1 mg/kg of body weight, IV] and 3 times after
      administration of medetomidine (30 microg/kg, IM). Before each episode of
      sedation, UPP was performed. Heart and respiratory rates and indirect blood
      pressures were recorded prior to and 5, 10, 20, and 30 minutes after injection of
      sedative. Cystometry measurements included threshold volume, threshold pressure,
      and tonus limb. The UPP measurements included maximal urethral closure pressure
      (MUCP), functional profile length, and, in male dogs, plateau pressure. RESULTS:
      Mean MUCP was decreased markedly in xylazine- and medetomidine-sedated dogs.
      Xylazine and medetomidine also decreased plateau pressure in male dogs. The MUCP
      measurements were consistent among days for conscious and xylazine-sedated dogs
      but were inconsistent for medetomidine-sedated female dogs. The proportion of
      valid cystometry measurements was greater for xylazine (39 of 60) than for
      medetomidine (27 of 60). Cystometry was considered invalid when bladder pressure
      reached 30 cm H2O without initiation of a micturition reflex. CONCLUSIONS AND
      CLINICAL RELEVANCE: Medetomidine and xylazine have similar effects on measurement
      of UPP and cystometry. Medetomidine was less consistent among days for UPP in
      female dogs and produced fewer valid cystometry tests, compared with xylazine.
      For urodynamic evaluations, medetomidine administered IM cannot be substituted
      for xylazine administered IV.

PMID- 11212022
TI  - Comparison of number of Streptococcus uberis calculated on a volume or weight
      basis in sand and sawdust bedding.
AB  - OBJECTIVE: To determine a method for comparing counts of Streptococcus uberis in
      sand and sawdust and account for the influence of weight or volume of the bedding
      material. SAMPLE POPULATION: 2 sources of kiln-dried sawdust and 2 sources of
      washed sand. PROCEDURES: Sterilized bedding material (100 ml) was weighed and
      uniformly distributed in an aluminum pan. Each sterilized bedding material was
      inoculated with a mean of 3.6 X 10(6) (experiment 1) or 2.4 X 10(7) (experiment
      2) colony-forming units (CFU) of S uberis/ml of bedding material. Without
      allowing time for replication of S uberis, inoculated bedding materials were
      washed with sterile saline (0.9% NaCl) solution. A 200-ml aliquot of wash
      solution was serially diluted up to 2,500 times with additional saline solution
      and inoculated on plates containing tryptose agar with 5% sheep blood. After
      incubation for 48 hours, number of CFU of S uberis was counted. This procedure
      was replicated 19 and 16 times for each bedding material in experiments 1 and 2,
      respectively. RESULTS: Evaluation of Bonferroni 95% confidence intervals revealed
      significant differences for counts of S uberis calculated on a weight basis
      between sand and sawdust. CONCLUSIONS AND CLINICAL RELEVANCE: Comparison of
      counts of S uberis determined on a volume basis for sand and sawdust accentuates
      to a lesser degree the weight difference of the bedding materials and ensures a
      more appropriate comparison of number of S uberis.

PMID- 11212023
TI  - Prevalence of Streptococcus iniae in tilapia, hybrid striped bass, and channel
      catfish on commercial fish farms in the United States.
AB  - OBJECTIVE: To determine the prevalence of Streptococcus iniae in tilapia
      (Oreochromis spp), hybrid striped bass (Morone chrysops X M saxatilis), and
      channel catfish (Ictalurus punctatus) on commercial fish farms in the United
      States. ANIMALS: 1,543 fish (970 tilapia, 415 hybrid striped bass, and 158
      channel catfish). PROCEDURES: The dry-swab technique was used for collection of
      specimens for streptococcal isolation. Specimens were shipped by overnight
      delivery and processed by use of standard bacteriologic techniques. RESULTS:
      Streptococcus iniae was not isolated from market-size channel catfish. Prevalence
      in tilapia and hybrid striped bass was 37 of 970 (3.81%) and 30 of 415 (7.23%),
      respectively. Prevalence by farm ranged from 0.0 to 27.4% for tilapia and 0.0 to
      21.6% for hybrid striped bass. In tilapia, prevalence was lowest in market-size
      and nursery fish (4 of 239 [1.67%] and 3 of 339 [0.88%], respectively), with an
      increase in prevalence for fish in the grow-out stage (30 of 337 [7.96%]). For
      hybrid striped bass, prevalence was lowest in nursery and market-size fish (3 of
      96 [3.12%] and 1 of 47 [2.12%], respectively) and highest in fish in the grow-out
      stage (26 of 272 [9.56%]). Prevalence in market-size tilapia and hybrid striped
      bass was 5 of 286 (1.75%). CONCLUSIONS AND CLINICAL RELEVANCE: Results of this
      study do not support the contention that S iniae is a serious public health
      threat associated with commercially raised fish; rather, it represents a limited
      risk for older or immunocompromised people who incur puncture wounds while
      handling and preparing fish.

PMID- 11212024
TI  - Electroacupuncture-induced neural activation detected by use of manganese
      enhanced functional magnetic resonance imaging in rabbits.
AB  - OBJECTIVE: To investigate the effects of acupuncture on neural activity detected
      by use of manganese-enhanced functional magnetic resonance imaging (fMRI) and
      elucidate the relationship between somatic acupoint stimulation and brain
      activation. ANIMALS: 40 New Zealand White rabbits. PROCEDURE: Manganese-enhanced
      fMRI was performed in anesthetized rabbits manipulated with electroacupuncture
      (EA) on Zusanli (ST-36) and Yanglingquan (GB-34) acupoints. Image acquisition was
      performed on a 1.5T superconductive clinical scanner with a circular polarized
      extremity coil. T1-weighted images were acquired sequentially as follows:
      baseline, after mannitol injection, after manganese infusion, and 5 and 20
      minutes after initiation of EA. RESULTS: Changes in focal neural activity were
      detected by use of manganese-enhanced fMRI. Stimulation on Zusanli (ST-36) for 5
      minutes resulted in activation of the hippocampus, whereas stimulation on
      Yanglingquan (GB-34) resulted in activation of the hypothalamus, insula, and
      motor cortex. Activation became less specific after 20 minutes of EA.
      Furthermore, stimulation on ipsilateral acupoints led to bilateral brain
      activation. CONCLUSIONS AND CLINICAL RELEVANCE: Each acupoint has a corresponding
      cerebral linkage, and stimulation on these points resulted in time-dependent
      neural activation. Understanding the linkage between peripheral acupoint
      stimulation and central neural pathways may provide a useful guide for clinical
      applications of acupuncture.

PMID- 11212025
TI  - Pharmacokinetics and adverse effects of butorphanol administered by single
      intravenous injection or continuous intravenous infusion in horses.
AB  - OBJECTIVE: To determine an infusion rate of butorphanol tartrate in horses that
      would maintain therapeutic plasma drug concentrations while minimizing
      development of adverse behavioral and gastrointestinal tract effects. ANIMALS: 10
      healthy adult horses. PROCEDURE: Plasma butorphanol concentrations were
      determined by use of high-performance liquid chromatography following
      administration of butorphanol by single IV injection (0.1 to 0.13 mg/kg of body
      weight) or continuous IV infusion (loading dose, 17.8 microg/kg; infusion dosage,
      23.7 microg/kg/h for 24 hours). Pharmacokinetic variables were calculated, and
      changes in physical examination data, gastrointestinal tract transit time, and
      behavior were determined over time. RESULTS: A single IV injection of butorphanol
      was associated with adverse behavioral and gastrointestinal tract effects
      including ataxia, decreased borborygmi, and decreased defecation. Elimination
      half-life of butorphanol was brief (44.37 minutes). Adverse gastrointestinal
      tract effects were less apparent during continuous 24-hour infusion of
      butorphanol at a dosage that resulted in a mean plasma concentration of 29 ng/ml,
      compared with effects after a single IV injection. No adverse behavioral effects
      were observed during or after continuous infusion. CONCLUSIONS AND CLINICAL
      RELEVANCE: Continuous IV infusion of butorphanol for 24 hours maintained plasma
      butorphanol concentrations within a range associated with analgesia. Adverse
      behavioral and gastrointestinal tract effects were minimized during infusion,
      compared with a single injection of butorphanol. Continuous infusion of
      butorphanol may be a useful treatment to induce analgesia in horses.

PMID- 11212026
TI  - Epidemiologic features of Campylobacter jejuni isolated from poultry broiler
      houses and surrounding environments as determined by use of molecular strain
      typing.
AB  - OBJECTIVE: To genetically type Campylobacter jejuni isolates from broiler houses
      or the external environment to identify the source of Campylobacter organisms in
      broiler chickens. SAMPLE POPULATION: Environmental samples associated with
      broiler chickens, in commercial grow-out houses. PROCEDURE: Polymerase chain
      reaction (PCR) was used to amplify flaB, and the amplicon was digested with Sau3A
      to create a restriction fragment length polymorphism assay; PCR was also used to
      detect a transcribed spacer region in the 23S rRNA gene. RESULTS: Isolates
      possessing a 23S spacer region were more prevalent outside broiler houses than
      inside. Houses that had previously contained chickens or lacked biosecurity
      procedures were more likely to contain isolates possessing the 23S spacer. One
      house contained only isolates possessing the spacer, whereas an adjacent house
      contained only isolates lacking the spacer. The flaB type detected in broiler
      houses was different from the type detected in the environment; however, many
      isolates within the broiler houses contained untypable flaB genotypes.
      CONCLUSIONS AND CLINICAL RELEVANCE: Most isolates from within houses were
      genetically distinct from isolates from outside houses that were examined by
      bacteriologic culture, suggesting an undetected source of C jejuni. Detection of
      isolates containing the 23S spacer appeared to be an indicator of environmental
      contamination of the houses. The observation of completely different C jejuni
      genetic types simultaneously within adjacent houses suggests that some types do
      not compete successfully during the grow-out period. In addition, the diversity
      of genotypes identified within broiler houses indicates the complexity of the
      ecologic features of C jejuni in the chicken environment.

PMID- 11212027
TI  - Evaluation of glycoprotein Ib expression on feline platelets.
AB  - OBJECTIVE: To determine whether platelets obtained from cats expressed
      glycoprotein Ib (GPIb). SAMPLE POPULATION: Platelets obtained from 11 specific
      pathogen-free cats. PROCEDURE: Platelets were analyzed by use of
      immunofluorescence microscopy, flow cytometry, sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, western immunoblot analysis, and
      immunoprecipitation. RESULTS: Immunofluorescence microscopy and flow cytometry
      revealed the protein on the surface of feline platelets. Biochemical studies
      (western immunoblot analysis and immunoprecipitation) revealed a 140-kd membrane
      glycoprotein. Additional biochemical studies revealed that feline GPIb was
      sensitive to proteolysis, because platelet cytoskeletons prepared with low
      concentrations of a calpain inhibitor (ie, leupeptin; 100 microg/ml) had
      substantial proteolysis, and there was an association of protein fragments with
      the actin cytoskeleton. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of these
      results indicate that feline platelets express a 140-kd membrane protein that is
      recognized by monoclonal antibodies developed against GPIb. Application of
      standardized ELISA to quantitate glycocalicin, the water-soluble fragment of
      GPIb, may provide important information on the production of microvesicles,
      increased platelet turnover, and abnormal proteolysis.

PMID- 11212028
TI  - Evaluation of effectiveness of a vaccination program against an infectious
      disease at the population level.
AB  - OBJECTIVE: To evaluate the application of a vaccine in a population of animals.
      SAMPLE POPULATION: Field-trial data from the literature. PROCEDURE: A spreadsheet
      simulation model was constructed to estimate the impact of a vaccination program,
      assuming various population sizes, transmission rates, and vaccine efficacies.
      RESULTS: Total effectiveness (proportion of affected animals [ie, cases] avoided)
      increased with the vaccinated proportion of the population. However, with a
      highly efficacious vaccine, this relationship discontinued after a sufficient
      vaccination proportion was reached, reflecting herd immunity. Evaluation of a
      case study indicated that what may be considered a poor vaccine on the basis of
      its low efficacy may protect a substantial portion of the population if the
      vaccine is administered to a sufficient number of susceptible animals. Further
      investigation of a case study of horses indicated that evaluating a vaccine based
      solely on its efficacy could greatly underestimate its value. CONCLUSIONS AND
      CLINICAL RELEVANCE: When evaluating a vaccine applied to a population, in
      addition to the vaccine efficacy, the vaccination rate, cost of the vaccine,
      potential disease transmission rate, and number and cost of cases avoided must
      also be considered. Efficacy may underestimate vaccine value in terms of the
      reduction of indirect cases typically avoided when vaccination is applied in a
      population.

PMID- 11212029
TI  - Locomotor characteristics of horses with navicular disease.
AB  - OBJECTIVE: To determine whether force-plate evaluation of horses with navicular
      disease would reveal an abnormal gait that persists despite loss of sensation to
      the palmar foot region, which may predispose such horses to navicular disease.
      ANIMALS: 17 clinically normal Thoroughbreds and 8 Thoroughbreds with navicular
      disease. PROCEDURE: Data on ground reaction forces were obtained in trotting
      horses, using a force plate. Force-time curve variables for clinically normal
      horses were derived from 4 points at the beginning and 4 points at the end of the
      vertical and craniocaudal horizontal plots. Principal component analysis was
      undertaken separately on beginning-of-stride and end-of-stride data, and the
      first 2 components were represented graphically. Rotation matrices were applied
      to equivalent data for horses with navicular disease before and after disruption
      of sensation by administration of a palmar digital nerve blockade. RESULTS: Prior
      to nerve block, horses with navicular disease differed significantly from normal
      horses for beginning-of-stance phase and end-of-stance phase variables. After
      nerve block, horses with navicular disease maintained the same significant
      differences from clinically normal horses only for variables at the beginning-of
      stance phase. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with navicular disease
      have abnormal limb-loading force patterns that are not altered by loss of
      sensation in the palmar region. These abnormal patterns were detected in a horse
      without navicular disease. Some horses are predisposed to navicular disease as a
      result of an inherent abnormal gait pattern. Analysis of gait patterns could be
      used for detection and appropriate management of horses susceptible to
      development of navicular disease.

PMID- 11212030
TI  - Quantitative assessment of mast cells and expression of IgE protein and mRNA for
      IgE and interleukin 4 in the gastrointestinal tract of healthy dogs and dogs with
      inflammatory bowel disease.
AB  - OBJECTIVE: To characterize the mucosal IgE network in dogs affected with
      inflammatory bowel disease (IBD) and compare it with that for healthy dogs.
      ANIMALS: 9 healthy dogs and 20 dogs with IBD. PROCEDURE: In situ hybridization of
      mRNA specific for IgE and interleukin 4 (IL-4) and immunohistochemical analysis
      for IgE protein and 2 markers of mast cells (ie, tryptase and chymase) were
      performed on tissue sections obtained from the gastrointestinal (GI) tract and
      lymph nodes of dogs. RESULTS: Dogs with IBD had significantly more cells positive
      for IgE protein and more mast cells in the GI mucosa than healthy dogs. Despite
      this significant increase in number of cells positive for IgE, cells positive for
      IgE mRNA were rarely detected in the GI mucosa; most cells positive for IgE mRNA
      were found in mesenteric lymph nodes. Signal pattern of IL-4 mRNA was similar to
      that of IgE mRNA. CONCLUSIONS AND CLINICAL RELEVANCE: The increased numbers of
      cells positive for IgE and mast cells in dogs with IBD suggest hypersensitivity
      such as hypersensitivity to bacterial or dietary-derived antigens in the
      intestinal lumen. Future studies need to elucidate whether this represents a
      cause of inflammation or is a result of the inflammatory process of IBD.

PMID- 11212031
TI  - Partial characterization of retroviruses from boid snakes with inclusion body
      disease.
AB  - OBJECTIVE: To characterize retroviruses isolated from boid snakes with inclusion
      body disease (IBD). ANIMALS: 2 boa constrictors with IBD and 1 boa exposed to an
      affected snake. PROCEDURE: Snakes were euthanatized, and tissue specimens and
      blood samples were submitted for virus isolation. Tissue specimens were cultured
      with or without commercially available viper heart cells and examined by use of
      transmission electron microscopy (TEM) for evidence of viral replication. Reverse
      transcriptase activ ty was determined in sucrose gradient-purified virus. Western
      blotting was performed, using polyclonal antibodies against 1 of the isolated
      viruses. Specificity of the rabbit anti-virus antibody was evaluated, using an
      immunogold-labeling TEM technique. RESULTS: 3 viruses (RV-1, RV-2, and RV-3) were
      isolated. The isolates were morphologically comparable to members of the
      Retroviridae family. Reverse transcriptase activity was high in sucrose gradient
      fractions that were rich in virus. Polyclonal antibody against RV-1 reacted with
      proteins of similar relative mobility in RV-1 and RV-2. By use of immunogold
      labeling, this antibody also recognized virions of both RV-1 and RV-2.
      CONCLUSIONS AND CLINICAL RELEVANCE: A retrovirus was isolated from boid snakes
      with IBD or exposed to IBD. Western blot analysis of viral proteins indicated
      that viruses isolated from the different snakes were similar. Whether this virus
      represents the causative agent of IBD is yet to be determined. The isolation of
      retroviruses from boid snakes with IBD is an important step n the process of
      identifying the causative agent of this disease.

PMID- 11212032
TI  - Effects of intraluminal distention and decompression on microvascular
      permeability and hemodynamics of the equine jejunum.
AB  - OBJECTIVE: To determine whether intraluminal distention and subsequent
      decompression of the equine jejunum affects intestinal blood flow, hemodynamics,
      and microvascular permeability. ANIMALS: 5 healthy adu t horses. PROCEDURES:
      Horses were anesthestized and underwent exploratory laparotomy. Two jejunal
      segments were identified as sham-operated or instrumented segments. After
      baseline values were obtained, intraluminal distention was created in the
      experimental segment to induce an ntraluminal pressure of 18 cm H2O. After 120
      minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric
      blood flow, oxygen delivery, oxygen consumption, microvascular permeability, wet
      weight-to-dry weight ratio, neutrophil infiltration, and vascular resistance were
      determined and comparisons made among control, sham-operated, and experimental
      segments. RESULTS: Mean jejunal blood flow was 21.4 ml/min per kg. There was a
      significant decrease in mesenteric bood flow to the distended intestine (13.4
      ml/min per kg). Blood flow increased significantly during the decompression
      period (340% of baseline blood flow). Intraluminal distention and subsequent
      decompression resulted in a significant increase in microvascular permeability,
      as determined by the osmotic reflection coefficient. Oxygen delivery and oxygen
      content decreased significantly during the distention period and increased during
      decompression. Morphologic evaluation revealed a significant increase in edema
      and neutrophil infiltration after distention and decompression, compared with
      results for the sham-operated or control segments. CONCLUSIONS AND CLINICAL
      RELEVANCE: Intraluminal distention and decompression of the equine jejunum
      results in low-flow ischemia and edema, which may contribute to adhesions and
      ileus in the postoperative period after surgery for obstructions of the small
      intestines.

PMID- 11212033
TI  - Ultrastructure of selected calcium oxalate-containing urinary calculi from dogs.
AB  - OBJECTIVE: To elucidate the ultrastructural details of calcium oxalate-containing
      urinary calculi from dogs. Sample Population-38 specimens selected from a
      collection of 8,297 oxalate-containing urinary calculi from dogs: 22 specimens
      composed of calcium oxalate (calcium oxalate monohydrate [COM], calcium oxalate
      dihydrate [COD], or COM and COD) and 16 specimens composed of calcium oxalate
      with amorphous calcium phosphate. PROCEDURE: Analyses of specimens included use
      of plain, reflected, and polarized light microscopy, X-ray diffractometry,
      scanning electron microscopy (SEM) with backscattered electron (BSE) imagery, and
      electron microprobe analysis. RESULTS: Four texture types were observed in
      calcium oxalate calculi; 4 texture types of calcium oxalate-calcium phosphate
      mixed calculi were recognized. Texture types were delineated through differences
      in calcium oxalate crystal sizes, which were affected by urine supersaturation
      and abundance of crystal nucleation sites. Segregation of calcium oxalate from
      calcium phosphate indicated they do not precipitate under the same conditions.
      Deposition of calcium phosphate between calcium oxalate crystals decreased the
      volume of pore spaces within calculi. Porosity was observed along boundaries
      between COM and COD. Minute pores increased the surface area of calculi exposed
      to urine, and this increase in liquid-solid interface promotes interaction of
      crystals with the surrounding urine. CONCLUSIONS AND CLINICAL RELEVANCE: Calcium
      oxalate urolithiasis is of major concern, because it is often a recurrent disease
      among dogs, principally treated by surgical removal of calculi, with few
      effective dissolution strategies. Understanding the ultrastructure and
      mineralogic content of calcium oxalate and its association with amorphous calcium
      phosphate is a step toward the solution of this increasingly important medical
      problem.

PMID- 11212034
TI  - Effects of changes in power setting of an ultrasonic aspirator on amount of
      damage to the cerebral cortex of healthy dogs.
AB  - OBJECTIVE: To determine the minimal ultrasonic aspirator pressure necessary to
      damage the cerebral cortex of healthy dogs. ANIMALS: 9 mixed-breed dogs.
      PROCEDURE: The study comprised 2 parts. In part A, 6 dogs were euthanatized
      immediately prior to the experiment. In part B, 3 dogs were anesthetized for
      recording of physiologic variables. In both parts, craniectomy and durotomy were
      performed to bilaterally expose the lateral aspect of the cerebral cortex. An
      ultrasonic aspirator was placed in contact with various areas of the cerebral
      cortex, and aspirator power was altered (10, 20, 30, and 40%). Duration of
      contact at each power was 5 and 10 seconds. Subsequently, gross morphologic and
      histologic damage was assessed in the cortex. RESULTS: Gross observations for all
      dogs were similar. At 10% power, visible or histologic damage was not evident in
      the cortex. At 20% power, the cortex was slightly indented from contact with the
      hand piece; however, cortical disruption was not evident. Cortical disruption was
      initially detectable at 30% power in some dogs and was consistently evident at
      40% power in both sets of dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonic
      aspirator power of < 20% created minimal acute morphologic damage to the cortex.
      Power settings between 20 and 30% may superficially damage the cerebral cortex in
      healthy dogs, whereas 40% power consistently damages the cerebral cortex.
      Knowledge of the degree of damage to cerebral cortex caused by various amounts of
      power for ultrasonic aspirators will allow surgeons to avoid damaging normal
      brain tissues during surgery.

PMID- 11212035
TI  - Experimental infection of European wild boars and domestic pigs with pseudorabies
      viruses with differing virulence.
AB  - OBJECTIVE: To determine susceptibility of European wild boars (Sus scrofa) to
      infection with pseudorabies virus (PrV) and to characterize the virulence of a
      wildboar PrV isolate for wild and domestic pigs. ANIMALS: 18 wild boars and 16
      domestic pigs. PROCEDURE: Three groups of 4 wild boars were inoculated with PrV
      Bartha, Kaplan, and a wild-boar isolate (BFW1) and housed with uninfected pigs.
      Two groups of domestic pigs (4 and 8 pigs/group, respectively) were inoculated
      with various doses of BFW1. Animals were observed daily for clinical signs, and
      samples were tested for PrV excretion and homologous antibodies. After
      reactivation of latent infection by induced immunosuppression, PrV was detected
      in tissues of necropsied animals, using cell culture and a polymerase chain
      reaction (PCR). RESULTS: Clinical signs depended on virulence of the PrV strain
      and dose of inoculum. Only infection with PrV Kaplan resulted in severe disease
      and death. Virus was isolated from nasal and genital swab specimens. Antibodies
      were first detected on day 7 after inoculation; a specific humoral immune
      response was delayed in BFW1-infected animals. Virus was isolated from various
      tissues of Kaplan-infected wild boars, whereas mainly viral DNA was detected in a
      few tissues of Bartha- and BFW1-infected animals, using PCR after
      immunosuppression. CONCLUSIONS AND CLINICAL RELEVANCE: European wild boars are
      susceptible to transmission of PrV infection from domestic pigs and vice-versa.
      The PrV isolate BFW1 is of low virulence and seems to be adapted to the wild boar
      population from which it was isolated.

PMID- 11212036
TI  - Comparative responses of bronchial rings to mediators of airway hyperreactivity
      in healthy horses and those affected with summer pasture-associated obstructive
      pulmonary disease.
AB  - OBJECTIVE: To compare responses of bronchial rings obtained from healthy horses
      and horses affected with summer pasture-associated obstructive pulmonary disease
      (SPAOPD) to selected mediators of airway hyperreactivity in vitro. SAMPLE
      POPULATION: Bronchial rings from 6 healthy horses and 6 horses affected with
      SPAOPD. PROCEDURE: Bronchial rings obtained from each group of horses were
      mounted in organ baths and attached to force transducers interfaced with a
      polygraph. After applying 2g of tension, each ring was allowed to equilibrate for
      45 minutes in Tyrode's solution at 37 C. Cumulative concentration-response
      relationships to graded concentrations of selected mediators (10(-8) to 10(-4) M)
      were determined and analyzed for significance at each concentration. RESULTS:
      Acetylcholine, histamine, 5-hydroxytryptamine, and leukotriene D4 induced
      concentration-dependent contractile responses in bronchial rings. Prostaglandin
      F2alpha induced weak and inconsistent contractile responses. The other 2 agents,
      norepinephrine and substance P, did not induce concentration-dependent responses.
      Considering the overall group-drug effect, acetylcholine, histamine, 5
      hydroxytryptamine, and leukotriene D4 were effective in inducing consistent
      concentration-dependent contractile responses in both groups. Only 5
      hydroxytryptamine and histamine induced significant responses in contractility
      between groups. The response of bronchial rings from horses with SPAOPD to 5
      hydroxytryptamine was significantly greater than those from control horses,
      whereas the response to histamine was significantly lower. Significant responses
      were evident at concentrations ranging from 10(-6) to 10(-4) M for both drugs.
      CONCLUSIONS AND CLINICAL RELEVANCE: Because the airways of horses with SPAOPD had
      increased responsiveness to 5-hydroxytryptamine in vitro, treatment modalities
      using 5-hydroxytryptamine antagonists should be investigated to address this
      phenomenon.

PMID- 11212037
TI  - Maternal expression of functional lipoprotein lipase and effects on body fat mass
      and body condition scores of mature cats with lipoprotein lipase deficiency.
AB  - OBJECTIVE: To assess effects of deficiency of lipoprotein lipase (LPL) on body
      condition scores and lean and fat body masses of adult cats. ANIMALS: 12 cats
      without LPL mutations and 23 cats that were heterozygous or homozygous carriers
      of the Gly412Arg LPL mutation. PROCEDURE: Lean and fat body masses were estimated
      by use of body condition scores and change in enrichment of serum after IV
      administration of deuterium oxide. Mass spectroscopy and infrared absorbance
      methods were used to determine deuterium enrichment. RESULTS: Fat body mass (mean
      +/- SD; 0.2 +/- 0.1 kg) and percentage body fat (6.2 +/- 1.4%) of homozygotes
      were significantly less than those of clinically normal cats and heterozygotes
      (0.7 +/- 0.1 kg, 18.2 +/- 1.6% and 0.5 +/- 0.1 kg, 15.6 +/- 1.7%, respectively).
      Homozygous offspring of homozygous dams had significantly less fat body mass (0.1
      +/- 0.1 kg) and percentage body fat (2.1 +/- 1.0%) than homozygous offspring of
      heterozygous dams (0.3 +/- 0.1 kg and 9.2 +/- 1.7%, respectively). Lean body mass
      did not differ significantly among groups. For all groups, percentage body fat
      was significantly correlated with body condition score (r= 0.65), and body
      condition scores supported findings for fat body mass. CONCLUSIONS AND CLINICAL
      RELEVANCE: Deficiency of LPL activity in cats diminishes stores of body fat. This
      is consistent with a low rate of de novo synthesis of fat. The effect of dam on
      body masses in mature LPL-deficient cats indicates nutrient programming of
      adipose formation during gestation or lactation.

PMID- 11212038
TI  - Use of long-term vaccination with a killed vaccine to prevent fecal shedding of
      Mycobacterium avium subsp paratuberculosis in dairy herds.
AB  - OBJECTIVES: To determine whether vaccination with a killed vaccine prevents fecal
      shedding of Mycobacterium avium subsp paratuberculosis, to compare effectiveness
      of a culture and cull program in vaccinated and nonvaccinated herds, and to
      compare paratuberculosis-related preventive management in vaccinated and
      nonvaccinated herds. SAMPLE POPULATION: 58 commercial Dutch dairy herds. DESIGN:
      Cross-sectional study (study A) in vaccinated (n = 25) and nonvaccinated (29)
      herds of dairy cows. Longitudinal study (study B) in vaccinated (n = 2) and
      nonvaccinated (2) herds of dairy cows. PROCEDURE: In study A, fecal samples were
      obtained from adult cows in herds with and without a history of vaccination with
      a killed vaccine. Management measures were evaluated. In study B, fecal samples
      were obtained 4 times at 6-month intervals from cows older than 6 months. Cows
      that had positive test results were removed from the herd directly after the
      outcome of the culture. RESULTS: In study A, differences were not detected among
      the 25 herds that were vaccinated; culture results were positive for M avium
      subsp paratuberculosis in 4.4% of herds. In 29 herds that had not been
      vaccinated, culture results were positive in 6.7%. In study B, the percentage of
      positive results on culture decreased from 10.9% and 5.7% to 3.5% and 0%,
      respectively in the 2 vaccinated herds. In the 2 nonvaccinated herds, percentages
      decreased from 6.1% and 16.5% to 0% and 2.3%, respectively. Management practices
      were different between herds that were vaccinated and herds that were not; owners
      of herds that were not vaccinated followed more preventive management procedures
      and practiced less feeding of raw milk to calves. CONCLUSIONS AND CLINICAL
      RELEVANCE: Vaccination of calves with a killed vaccine does not prevent
      transmission of M avium subsp paratuberculosis; therefore, hygienic practices
      remain essential in herd management.

PMID- 11212039
TI  - Dystonic reaction after anesthesia.

PMID- 11212040
TI  - On anesthesia services.

PMID- 11212041
TI  - Pancuronium added to intravenous regional anesthesia: systemic weakness after
      prolonged tourniquet inflation time.

PMID- 11212042
TI  - Subcutaneous tunnelling of interscalene catheters.

PMID- 11212043
TI  - What do outpatients value most in their anesthesia care?
AB  - PURPOSE: To determine what outpatients ranked highest in their anesthesia care
      and whether anesthesiologists could predict that ranking. METHODS: A 36 item mail
      back questionnaire was administered post-operatively to 45 surgical outpatients
      and to 15 expert anesthesiologists. Respondents were asked to rank the three
      highest items from each of four lists of nine items representing pre-operative,
      intra-operative, pre-discharge and post-discharge outpatient anesthesia care.
      RESULTS: Complete responses were obtained from 30 outpatients and all
      anesthesiologists. In each phase of their care (pre-operative, intra-operative,
      pre-discharge and post-discharge), outpatients ranked highest those elements
      representing information and communication. Physical conditions of care tend to
      be least valued. Although anesthesiologists were able to predict what patients
      valued in the pre and post-discharge phases of their anesthesia care (r = 0.85
      and 0.91), they undervalued the importance to patients of communication and
      information in pre-operative and intra-operative care (r = -0.09 and .65).
      CONCLUSIONS: Our results reinforce the value that patients place in adequate
      communication and provision of information in all phases of outpatient anesthesia
      care, a value that may be underappreciated by anesthesiologists.

PMID- 11212044
TI  - Remifentanil and controlled hypotension; comparison with nitroprusside or esmolol
      during tympanoplasty.
AB  - PURPOSE: To determine whether remifentanil, combined with propofol, could induce
      controlled hypotension, reduce middle ear blood flow (MEBF) measured by laser
      Doppler flowmetry, provide a "dry" operative field, and could be compared with
      nitroprusside or esmolol combined with alfentanil and propofol. METHODS: Thirty
      patients undergoing tympanoplasty and anesthetized with 2.5 mg x kg(-1) propofol
      iv followed by a constant infusion of 120 microg x kg(-1) x min(-1), were
      randomly assigned in three groups to receive either 1 microg x kg(-1)
      remifentanil iv followed by a continuous infusion of 0.25 to 0.50 microg x kg(-1)
      x min(-1), or nitroprusside iv, or esmolol iv combined for the latter two groups
      with alfentanil iv. RESULTS: Controlled hypotension was achieved at the target
      pressure of 80 mmHg within 107 +/- 16, 69 +/- 4.4, 53.3 +/- 4.4 sec for
      remifentanil, nitroprusside and esmolol respectively. MEBF decreased by 24 +/-
      0.3, 22 +/- 3.3, 37 +/- 3% and preceded the decrease in SABP, within 30 +/- 6.1,
      11.2 +/- 3.1, 15 +/- 2.8 sec for remifentanil, nitroprusside and esmolol
      respectively. Remifentanil, and nitroprusside decreased MEBF autoregulation less
      than esmolol (0.36 +/- 0.1, 0.19 +/- 0.2, -0.5 +/- 0.2). Controlled hypotension
      was sustained in all three groups throughout surgery, and the surgical field
      rating decreased in a range of 80% in all three groups. Nitroprusside decreased
      pH and increased PaCO2. There were no postoperative complications in any of the
      groups. CONCLUSIONS: Remifentanil combined with propofol enabled controlled
      hypotension, reduced middle ear blood flow and provided good surgical conditions
      for tympanoplasty with no need for additional use of a potent hypotensive agent.

PMID- 11212045
TI  - Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.
AB  - PURPOSE: To examine the effect of nicorandil, a K ATP channel agonist, on
      neuromuscular block caused by vecuronium in patients anesthetized with nitrous
      oxide, oxygen, isoflurane, and fentanyl. METHODS: Sixty adult patients were
      allocated to four groups of 15: nicorandil-post-tetanic count (N-PTC), nicorandil
      train-of-four (N-TOF), control-post-tetanic count (C-PTC) or control-train-of
      four (C-TOF) group. In the N-PTC and N-TOF groups, 0.1 mg kg nicorandil was given
      as a bolus followed by an infusion at 1 microg x kg(-1) x min(-1). Two minutes
      after the bolus, 0.1 mg x kg(-1) vecuronium was administered. In the C-PTC or C
      TOF group normal saline was given instead of nicorandil. PTC and TOF responses
      were measured mechanically using a force displacement transducer. RESULTS: Time
      from the administration of vecuronium to the onset of neuromuscular block in the
      N-PTC or N-TOF group did not differ from that in the C-PTC or C-TOF group (241 +/
      33 vs 225 +/- 32 sec, mean +/- SD). Times from vecuronium injection to the
      return of PTC in the N-PTC and C-PTC groups, and those of T1, T2, T3, and T4
      (first, second, third, and fourth stimulation of TOF) in the N-TOF and C-TOF
      groups did not differ. Recoveries of PTC in the N-PTC and C-PTC groups followed
      similar time course. T1/control twitch height and TOF ratio (T4/T1) in the N-TOF
      group were higher than those in the C-TOF group 80-120 min and 100-120 min after
      administration of vecuronium, respectively. CONCLUSION: Nicorandil accelerates
      recovery of neuromuscular block caused by vecuronium.

PMID- 11212046
TI  - High concentration sevoflurane induction of anesthesia accelerates onset of
      vecuronium neuromuscular blockade.
AB  - PURPOSE: To investigate neuromuscular block using accelography after
      administration of vecuronium under sevoflurane 8% induction and maintenance with
      sevoflurane 2% in adults. METHODS: Patients were allocated to three groups: (1)
      group I: anesthesia was induced and maintained with propofol and fentanyl (n=
      15), (2) group II: anesthesia was induced with propofol and maintained with
      N2O(66%)-O2-sevoflurane 2% (n = 15), (3) group III: anesthesia was induced with
      sevoflurane 8% using a vital capacity inhalation induction and maintained with
      N2O(66%)-O2-sevoflurane 2% (n = 15). 0.1 mg x kg(-1) vecuronium was used for
      paralysis three minutes after anesthetic induction and reversed using intravenous
      0.04 mg x kg(-1) neostigmine with 0.02 mg kg atropine when the train-of-four
      (TOF) ratio returned to 25%. RESULTS: The onset time from initial administration
      of vecuronium to maximal block in the group III was shorter than that in the
      groups I and II (139 +/- 35, 193 +/- 35 and 188 +/- 47s, respectively: P < 0.05).
      The clinical duration from maximal block to 25% recovery of TOF ratio in group II
      and III was longer than that in the group I (47 +/- 15, 48 +/- 14 and 36 +/- 10
      min, respectively: P < 0.05). The reversal times from administration of
      neostigmine to 75% of TOF ratio in groups II and III were longer than that in the
      group I (196 +/- 53, 208 +/- 64 and 136 +/- 28s, respectively: P < 0.05).
      CONCLUSIONS: Vital capacity inhalation induction of anesthesia with sevoflurane
      accelerates onset and prolongs duration of vecuronium neuromuscular block
      compared with propofol-fentanyl anesthesia.

PMID- 11212048
TI  - Anesthesia standards for facilities and equipment.
AB  - PURPOSE: This article will define standards, how they are developed and applied
      and how they impact on the day to day practice of clinicians. SOURCE: CSA
      International, International Electrotechnical Committee (IEC), Organization for
      International Standardization (ISO). PRINCIPAL FINDINGS: The safety record of the
      practice of anesthesia has improved over the past 20 yr. This has been brought
      about by the increase in the knowledge base of physiology and pharmacology,
      improvements in anesthetic drugs and other medications and through the use of
      better equipment. However, the introduction of new equipment and the building of
      new health care facilities has also introduced risks to patient safety. These
      risks have been created by oversights in design, mistakes in equipment
      manufacture or facility construction and the need to produce a usable product for
      the price the health care system can afford. After the anesthetic disasters of
      the 1960s and 1970s, the need for minimum standards for safety in the design and
      construction of healthcare facilities and medical equipment were recognized.
      Canadian anesthesiologists were at the forefront in the development of these
      standards, and still today members of the Canadian Anesthesiologist's Society are
      key contributors to the development of both National and International standards.
      CONCLUSION: Equipment and facility standards have helped improve patient safety
      over the past 20 yr. However, anesthesiologists need to encourage their
      governmental regulatory bodies to encourage manufacturer compliance with specific
      standards.

PMID- 11212047
TI  - Intraoperative decrease in pulse oximeter readings following injection of
      isosulfan blue.
AB  - PURPOSE: Sentinel lymph node mapping, involving injection of isosulfan blue dye
      around a tumour, is beginning to be used in patients with carcinoma of the
      breast. Absorption of the dye into the circulation may interfere with pulse
      oximetry, causing falsely low readings. This report describes changes in pulse
      oximeter readings following injection of isosulfan blue for sentinel lymph node
      mapping in a patient with carcinoma of the breast. CLINICAL FEATURES: An 83-yr
      old female patient underwent sentinel node biopsy of the axilla followed by
      partial mastectomy for carcinoma of the left breast. Isosulfan blue was injected
      in the area of the tumour in the left breast. The SpO2 began to decrease 15 min
      after dye injection, reaching a nadir of 89-90% 30 min after injection. Arterial
      blood gas analysis showed normal arterial partial pressure of oxygen. Pulse
      oximeter readings did not return to normal until more than six hours after dye
      injection. CONCLUSION: Review of the literature reveals a small number of case
      reports of similar occurrences of low pulse oximeter readings following injection
      of isosulfan blue or patent blue dye for lymphatic mapping. Data from these
      reports and the case described here suggest that the latency, magnitude and
      duration of effect on pulse oximeter readings following injection of these dyes
      is highly variable. It is important to rule out other causes of low pulse
      oximeter readings when this effect occurs; normal oxygenation can be verified
      with arterial blood gas analysis. Co-oximetry can be done to rule out
      methemoglobinemia as a cause of decreased SpO2.

PMID- 11212049
TI  - Lateral recumbent head-down posture for epidural catheter insertion reduces
      intravascular injection.
AB  - PURPOSE: The unintentional and unrecognized cannulation of an extradural vein is
      a potentially serious complication of an epidural anesthetic. The present study
      was undertaken to assess the incidence of blood vessel puncture related to
      epidural catheterization performed in three different body positions. METHODS:
      The study was conducted in 900 (three groups of 300) obstetric patients
      undergoing continuous epidural analgesia during their labour and who were
      randomly allocated to three groups. Epidural catheterization was performed with
      patients in the sitting, lateral recumbent horizontal, or lateral recumbent head
      down position. RESULTS: There was a lower incidence of vessel cannulation when
      this procedure was performed in the lateral recumbent head-down position (2%)
      than in the lateral recumbent horizontal (6%) and in the sitting position
      (10.7%). CONCLUSION: Adoption of the lateral recumbent head-down position for the
      performance of lumbar epidural blockade, in labour at term, reduces the incidence
      of lumbar epidural venous puncture.

PMID- 11212050
TI  - Epidural naloxone reduces intestinal hypomotility but not analgesia of epidural
      morphine.
AB  - PURPOSE: Epidural morphine is associated with decreased bowel motility and
      increased transit time. Low doses of intravenous naloxone reduce morphine-induced
      pruritus without reversing analgesia, but the effect of epidural naloxone on
      bowel motility has not been studied. Therefore we evaluated bowel motility and
      analgesia when naloxone was co-administered with morphine into the epidural
      space. METHODS: Forty-three patients having combined thoracic epidural and
      general anesthesia for subtotal gastrectomy were randomly assigned to one of two
      study groups. All received a bolus dose of 3 mg epidural morphine at the
      beginning of surgery, followed by a continuous epidural infusion containing 3 mg
      morphine in 100 ml bupivacaine 0.125% with either no naloxone (control group, n =
      18) or a calculated dose of 0.208 microg x kg(-1) x hr(-1) of naloxone
      (experimental group, n = 25) for 48 hr. We measured the time to the first
      postoperative passage of flatus and feces to evaluate the restoration of bowel
      function, and visual analog scales (VAS) for pain during rest and movement.
      Scores were assessed at 2, 4, 8, 16, 24, 36 and 48 hr postoperatively. RESULTS:
      The experimental group had a shorter time to the first postoperative passage of
      flatus (5 1.9 +/- 1 6.6 hr vs 87.0 +/- 19.5 hr, P < 0.001 ) and feces (95.3 +/-
      25.0 hr vs 132.9 +/- 29.4 hr, P < 0.001). No differences were found in either
      resting or active VAS between the two groups. CONCLUSION: Epidural naloxone
      reduces epidural morphine-induced intestinal hypomotility without reversing its
      analgesic effects.

PMID- 11212052
TI  - Improving quality of anesthesia care: opportunities for the new decade.

PMID- 11212051
TI  - Antinociceptive and cardiovascular properties of esmolol following formalin
      injection in rats.
AB  - PURPOSE: To assess the role of esmolol, a beta1 receptor blocker, in the
      modulation of pain in the absence of anesthesia. METHODS: Rats were chronically
      instrumented to record mean arterial blood pressure (MAP) and heart rate (HR).
      Animals were divided into three groups. Group 1 [esmolol high (EH) 150 mg x kg(
      1) x hr(-1); n = 9], Group 2 [esmolol low (EL) 40 mg x kg(-1) x hr(-1); n = 7]
      and Group 3 saline (n = 9). Formalin 5% was injected in the rat hind paw.
      Formalin-induced lifting, MAP and HR were recorded at five minute intervals for
      35 min after formalin injection. RESULTS: Formalin was associated with an early
      (Phase 1; 0-5 min) and late nociceptive response (Phase 2; 10-35 min). Esmolol
      did not affect Phase 1. Although low dose esmolol had minimum effects on
      nociceptive Phase 2, it was diminished with high dose esmolol. Formalin induced
      biphasic increases in MAP and HR. Although esmolol did not affect the initial
      increase in MAP, high dose esmolol blunted the secondary increase in MAP Both low
      and high doses of esmolol inhibited formalin-induced tachycardia during the first
      30 min. CONCLUSION: Our data suggest that esmolol leads to analgesia and
      reduction of cardiovascular responses to pain.

PMID- 11212053
TI  - Anterior mediastinal tumour identified by intraoperative transesophageal
      echocardiography.
AB  - PURPOSE: To report a child with anterior mediastinal tumour misdiagnosed as
      pericardial effusion who had been sent to the operating theatre for drainage.
      After induction of general anesthesia she developed cardio-respiratory collapse.
      The diagnosis was made with the aid of transesophageal echocardiography (TEE).
      CLINICAL FEATURES: A 14-yr-old girl suffered from cough and intermittent fever
      for one month before admission. Four days before admission, she became orthopneic
      and was admitted to the intensive care unit. Precordial echocardiography showed
      an anterior and posterior echolucent space between the pericardium and epicardium
      that was thought to be a pericardial effusion. She was sent to the operating room
      for emergency drainage. After induction of general anesthesia, breath sounds were
      not heard on the left side of the chest. The patient developed increasing
      hypoxemia and hypotension despite cardiocentesis. A TEE determined that an
      anterior mediastinal mass was the cause of her hypoxemia and hypotension. The
      tumour was debulked and the patient made an uneventful postoperative recovery.
      CONCLUSION: In this case, the correct diagnosis of an anterior mediastinal mass
      was made with TEE. The place of TEE may be indicated in patients with unexplained
      hypoxemia and hypotension.

PMID- 11212054
TI  - Neutrophilia and granulocyte colony-stimulating factor levels after
      cardiopulmonary bypass.
AB  - PURPOSE: The precise mechanism of neutrophilia after cardiac surgery is unknown.
      Granulocyte colony stimulating factor (G-CSF) can increase the number of
      leukocytes. The purpose of this study was to evaluate the relationship between
      serum G-CSF levels and peripheral blood leukocyte counts after cardiac surgery.
      METHODS: We prospectively studied 10 patients undergoing cardiac surgery
      (coronary artery bypass grafting) using cardiopulmonary bypass (CPB). Plasma G
      CSF levels and neutrophil count were measured before induction of anaesthesia, at
      the end of surgery, and on the first postoperative day. These changes were
      compared with those in patients undergoing non-cardiac major surgery (control
      group). RESULTS: At the end of surgery, G-CSF levels increased (P < 0.01) in both
      groups, but were higher in the control than in the cardiac group (3,250 +/- 690
      vs 194 +/- 29.5 pg ml(-1), respectively, mean +/- SEM, P < 0.01). On the first
      postoperative day, G-CSF levels were still high in both groups, and were still
      higher in the control (710 +/- 179 vs 122 +/- 19.9, respectively, P < 0.01).
      However, neutrophilia was greater in the cardiac group than in the control. G-CSF
      response correlated positively with neutrophilia in the control group (r = 0.656,
      P < 0.05) but not in the cardiac group. CONCLUSIONS: Our results indicate that
      changes in leukocyte count following cardiac surgery are unique to patients
      undergoing CPB. G-CSF plays an important role as the mediator of neutrophilia
      after non-cardiac surgery, but not after cardiac surgery with CPB.

PMID- 11212055
TI  - Increase of peak expiratory flow by atropine is dependent on circadian rhythm.
AB  - PURPOSE: To examine whether the bronchodilatory effect of atropine differs in the
      evening from the morning. METHODS: Thirteen adult healthy volunteers with no oral
      medication intake were studied. At 1600, peak expiratory flow (PEF) was measured
      three times, and the highest value recorded. Subsequently, the volunteer received
      0.01 mg(-1) x kg(-1) atropine im, and the PEF was measured every 30 min for 180
      min. On a different day, at 0400, the effect of atropine on the PEF was measured
      again in the same way. RESULTS: The PEF values before atropine at 1600 and 0400
      were 485 +/- 92 (350-730) and 458 +/- 76 (340-600) 1 min(-1),(P < 0.05). There
      was no difference in PEF values between the 1600 and 0400 time courses after
      atropine. The PEF value was increased only at 90 min at 1600 (P = 0.0012), but at
      30, 60, 90 and 120 min at 0400 (P = 0.0001). CONCLUSION: Atropine administration
      has a weak bronchodilatory effect in the evening, but a stronger effect in the
      morning. Airways are narrower in the morning than in the evening, and this change
      is inhibited by atropine such that the PEF values are restored to those observed
      in the evening.

PMID- 11212056
TI  - Amniotic fluid embolus: a review of the literature.
AB  - PURPOSE: To review the literature since 1979 to determine the natural history,
      etiology, diagnosis and potential treatment of amniotic fluid embolus (AFE).
      SOURCE: English language articles and books published between June 1976 and June
      1998 were identified by a computerized medline search using the title or text
      word amniotic fluid embolus. This same search strategy was repeated and updated
      to October 1999 by an independent individual using both Medline and Embase. The
      search was also expanded to include Science Citation Index listing Morgan's 1979
      review article. All relevant publications were retrieved and their bibliographies
      were scanned for additional sources. PRINCIPAL FINDINGS: Randomized controlled
      trials are not possible with amniotic fluid emboli. The majority of the
      literature consists of clinical reports combined with occasional limited reviews.
      Knowledge obtained from these reports suggests that amniotic fluid emboli present
      as a spectrum of disease that ranges from a subclinical entity to one that is
      rapidly fatal. Because cases are sporadic and the diagnosis is often unconfirmed,
      little progress has been made towards understanding its etiology or defining the
      risk factors. Present management is empirical and directed towards the
      maintenance of oxygenation, circulatory support and the correction of
      coagulopathy. CONCLUSION: Amniotic fluid embolus continues to be a life
      threatening but potentially reversible complication unique to pregnancy. It
      cannot be predicted nor prevented. Review of the literature reveals that there
      are no standardized investigational methods or protocols to confirm the diagnosis
      in suspected cases.

PMID- 11212057
TI  - Assessment of risks of hypertension and benefits of treatment--a difficult
      matter.

PMID- 11212058
TI  - Left ventricular hypertrophy is associated with an attenuated endothelium
      dependent vasodilation in hypertensive men.
AB  - To investigate the relationship between left ventricular hypertrophy (LVH) and
      endothelium-dependent vasodilation (EDV), 30 untreated hypertensive patients, 18
      treated hypertensives (53 +/- 7 years, all males) and 26 age-and sex-matched
      healthy normotensive controls, underwent evaluation of EDV and endothelium
      independent vasodilation (EIDV) in the forearm, by means of local intra-arterial
      infusions of methacholine (MCh, evaluating EDV) and sodium nitroprusside (SNP,
      evaluating EIDV). Forearm blood flow was measured by venous occlusion
      plethysmography and LVH was measured by echocardiography. The reduction in
      forearm vascular resistance during MCh infusion (4 microg/min) was significantly
      smaller in the hypertensive patients with LVH when compared to those without LVH,
      both in the untreated (-61 +/- 12%, n = 19 vs -72 +/- 4%, n = 11, p < 0.01) and
      in the treated group (-60 +/- 15%, n = 11 vs -75 +/- 5%, n = 7, p < 0.01).
      Thereby, EDV was significantly impaired only in the hypertensive patients with
      LVH when compared to controls (-77 +/- 7% at MCh 4 microg/min, p < 0.001). EIDV
      was not significantly different between patients with and without LVH and
      controls. In conclusion, the presence of LVH was related to endothelial
      dysfunction, both in untreated and treated hypertensive patients, suggesting
      either a role for endothelial function in the development of LVH, or that a
      dysfunctional endothelium and LVH are coexisting markers of a more severe
      hypertensive disease.

PMID- 11212059
TI  - Does hypertension or a previous myocardial infarction influence the blood
      pressure and heart rate responses to changes in body position? Results from a
      study with serial measurements in the supine and standing positions in 60-year
      old men.
AB  - An age-related attenuation of the normal increase in diastolic blood pressure and
      heart rate upon standing has previously been observed in man. Whether this is due
      to ageing as such, or a consequence of a higher prevalence of cardiovascular
      disease in older compared to younger subjects, is unclear. This population-based
      study was conducted to address this question. It was carried out in three groups
      of 60-year-old men: (i) with hypertension (n = 75), (ii) with a previous
      myocardial infarction (n = 39), and (iii) without any of these diseases, thus
      constituting a control group (n = 41). Blood pressure and heart rate were
      assessed during three 7-min periods (supine-standing-supine), using an unbiased
      non-invasive method. The cardiovascular responses were both qualitatively and
      quantitatively similar in all three groups, i.e. the increases in diastolic blood
      pressure and heart rate upon standing, and decreases upon laying down, were of a
      similar magnitude. In conclusion, 60-year-old men with hypertension or a previous
      myocardial infarction had blood pressure and heart rate responses similar to
      those of men of the same age who did not have these diseases. This indicates that
      the attenuated response previously reported in older compared to younger people
      is not explained by the higher prevalence of these cardiovascular diseases in the
      elderly, but is merely an age-dependent characteristic.

PMID- 11212060
TI  - How accurate are hypertension treatment decisions? Absolute risk assessment and
      prescribing for moderate hypertension--a study of Cambridge general
      practitioners.
AB  - OBJECTIVE: To determine the factors influencing general practitioners'
      prescribing for patients with moderate hypertension, and to investigate their
      ability to assess patients' absolute risk of cardiovascular disease. DESIGN:
      Decision-making was assessed by a postal questionnaire involving five
      standardised example patients, send to all general practitioners in the CB
      postcode area (Cambridge, UK). Patients varied in age, gender, diabetic and
      smoking status, blood pressure and total cholesterol, giving 5-year absolute
      risks ranging from less than 5% to greater than 20%. GP treatment decisions and
      risk factor influence, age bias, absolute risk calculations and cost-awareness
      were analysed with SPSS. Absolute risk was calculated using the New Zealand Core
      Services Committee (NZCSC) Guidelines, 1995. RESULTS: GP response rate was 66%.
      Sample demographics (mean age 42 years, 39% female) did not differ statistically
      from local health authority data. High blood pressure alone was the most common
      reason for instituting therapy (67%), independent of other risk factors. Drug
      choices did not differ statistically from Prescription Pricing Authority data.
      This supports the validity of the questionnaire. GP estimations of absolute risk
      were inconsistent, and there was a significant association between
      underestimation of elderly patient risk and overestimation of younger patient
      risk (p = 0.05). CONCLUSIONS: The Cambridge GPs more frequently based treatment
      decisions on patients' blood pressure level alone, rather than considering
      absolute risk as recommended by NZCSC and WHO guidelines. The relationship
      between patient age and risk estimations may indicate a "young age premium"
      influencing treatment. The data support the need for risk-based guidelines and
      education in treatment of hypertension.

PMID- 11212061
TI  - Self-reported side-effects of antihypertensive drugs: an epidemiological study on
      prevalence and impact on health-state utility.
AB  - The aim in this study was to assess the frequency and type of self-reported side
      effects among hypertensives in a general population, and to estimate the
      relationship between drug use and side-effects and health utility using the
      Rating Scale (RS) method. The study is based on a postal questionnaire that was
      sent to a random sample of 8000 inhabitants aged 20-84 years (response rate 68%)
      in Uppsala County, Sweden, in 1995. The results showed that nearly 20% of the
      users of antihypertensive drugs reported side-effects. Men and women reported
      side-effects to nearly the same extent. In the linear regression analyses, those
      with hypertension, with or without medication, rated lower health utilities (-6.0
      and -7.1 respectively) than did normotensives after controlling for age and sex.
      The lowest value, -8.7, was found among drug users who experienced side-effects.
      Side-effects causing impotence and emotional distress, i.e. insomnia, tiredness
      and depression had the strongest negative impact on health utility. To conclude,
      the study showed that side-effects among hypertensives are common. Both the
      disease and the drug treatment adversely affect the patient's well-being.
      However, drug treatment was of less importance than that found in prior studies.
      The findings here stress that side-effects should be taken into greater
      consideration when evaluating drug treatment.

PMID- 11212062
TI  - The placebo effect and white coat effect in isolated systolic hypertension and
      systo-diastolic hypertension.
AB  - It is well recognised from many clinical trials that there is a blood pressure
      lowering effect when placebo is administered to patients with essential
      hypertension ("placebo effect"). The reduction in blood pressure, however, may
      also be partly due to loss of the alerting response ("white coat effect") as a
      result of familiarisation with the clinical environment. To investigate the
      hypothesis that there may be a more marked placebo effect and white coat effect
      in isolated systolic hypertension (ISH) compared with systo-diastolic
      hypertension (SDH), we studied 78 patients with hypertension: 34 had ISH and 44
      patients had SDH. The 34 patients with ISH were older (68.7 vs 54.9 years), had a
      higher SBP (192.2 vs 169.6 mmHfg) and lower DBP (85.5 vs 102.0 mmHg) when
      compared to patients with SDH. Amongst the patients with ISH, there were no
      significant changes in mean blood pressures pre-placebo (paired t-test, p = NS).
      In the placebo period, there was a significant reduction in systolic blood
      pressures at all three points, and a significant reduction in diastolic blood
      pressures after 2 and 3 months placebo (paired t-test, p < 0.05). There was a
      mean reduction in mean systolic blood pressure at visit 1 by 5.2%, visit 2 by
      5.1% and visit 3 by 4.6%, when compared to mean pre-placebo systolic blood
      pressures (p < 0.05). The mean reduction in diastolic blood pressure was 5.8% at
      visit 2 and 3.5% at visit 3, when compared to mean pre-placebo diastolic blood
      pressure (p < 0.05). At the 4-week visit after receiving placebo, the mean
      systolic blood pressure decreased by 9.4 mmHg (p = 0.003) and mean diastolic
      blood pressure by 2.7 mmHg (p = NS) in the patients with ISH. In patients with
      SDH, there were no statistically significant changes in recorded BP readings
      following the introduction of placebo. We suggest blood pressures in some
      patients with ISH may settle with careful follow up and initiation of treatment
      in these patients could potentially be delayed for at least 3 months, as therapy
      may not prove necessary.

PMID- 11212063
TI  - Less difference between office and ambulatory blood pressure in women than in men
      both before and during antihypertensive treatment.
AB  - In 199 subjects (56% women) with a diastolic blood pressure (BP) of 95-115 mmHg,
      5 mg of either amlodipine or felodipine extended release (ER) was given for 4
      weeks following 4 weeks of placebo-treatment. BP was measured by conventional
      clinic BP technique and by 24-h ambulatory BP monitoring (Spacelab 90202/90207).
      Men and women had identical clinic BP at baseline and it was lowered equally much
      by 4 weeks of treatment (men: 158/101 and 147/93, women: 159/102 and 149/93 mmHg,
      respectively). However, ambulatory BP was higher in women than in men both before
      and after treatment (men: 145/91 and 134/85, women: 149/95 and 140/89 mmHg,
      respectively, p < 0.05 for both comparisons). The difference between clinic BP
      and daytime ambulatory BP was higher in men than in women (systolic men: 8.1 +/-
      14, women: 3.7 +/- 15 mmHg, respectively, p = 0.04; diastolic men: 5.5 +/- 8.0,
      women: 2.1 +/- 8.3 mmHg, p = 0.004). The correlation between the treatment effect
      measured by ambulatory and clinic BP was poor (systolic r = 0.26, p < 0.0001;
      diastolic r = 0.17, p = 0.03) and was unaffected by exclusion of subjects with
      normal ambulatory BP. The poor correlation between treatment effects measured as
      clinic and ambulatory BP is intriguing, and suggests that using ambulatory BP
      instead of clinic BP for monitoring the treatment of hypertension could affect
      the clinical outcome.

PMID- 11212064
TI  - Long-term renal and cardiovascular effects of antihypertensive treatment regimens
      based upon isradipine, perindopril and thiazide.
AB  - The aim of this study was to describe the renal function (renal hemodynamics,
      water and sodium handling) and its relation to cardiovascular structural changes
      in a population of essential hypertensive patients before and after
      antihypertensive treatment. Glomerular filtration rate and renal plasma flow were
      measured by a constant infusion technique. The reference substances used were
      [131I]iodohippurate (Hippuran) and [125I]iothalamate. The lithium clearance
      method was used for measuring renal water and sodium handling. Microalbuminuria
      was measured. A subcutaneous gluteal biopsy was taken and the media thickness to
      lumen diameter ratio of small resistance vessels was determined. Left ventricular
      mass index was determined by echocardiography. Thirty-seven patients with newly
      diagnosed or poorly controlled essential hypertension were randomized to
      treatment with regimens based upon either isradipine, perindopril or
      hydrochlorothiazide-amiloride. Atenolol and hydralazine were added as secondary
      and tertiary drugs, respectively, when needed for normalization of diastolic
      blood pressure. Investigations were performed before and after 9 months of
      normalization of blood pressure. Renal function in untreated hypertensive
      patients was characterized by increased renal vascular resistance, decreased
      renal blood flow, normal glomerular filtration fraction and normal serum
      creatinine. No association was found between peripheral resistance vessel
      structure in subcutaneous vessels and renal hemodynamic parameters. Patients with
      severe left ventricular hypertrophy (left ventricular mass >360 g) had lower
      glomerular filtration fraction, greater renal vascular resistance, lower renal
      blood flow and increased microalbuminuria in comparison with patients with less
      pronounced cardiac changes. After 1 year of treatment, which had a profound
      effect on heart and vessel structure, renal hemodynamics were unchanged in
      patients receiving antihypertensive treatment regimens based on the ACE inhibitor
      perindopril or the Ca-antagonist isradipine, whereas renal plasma flow was
      reduced, glomerular filtration rate preserved and filtration fraction
      significantly increased in those treated with a regimen based on diuretics. The
      serum creatinine concentration was decreased in the former group, whereas it was
      unchanged in the latter two. Significantly detrimental effect on uric acid
      homeostasis was only found in patients treated with a regimen based on diuretics.

PMID- 11212066
TI  - Treatment of hypertension in patients with type-2 diabetes mellitus.

PMID- 11212065
TI  - Comparative study of home and office blood pressure in hypertensive patients
      treated with enalapril/HCTZ 20/6 mg: the ESPADA study.
AB  - The introduction and generalization of 24-h ambulatory blood pressure (BP)
      monitoring has shown the clinical relevance of home BP. The aim of this study was
      to assess the validity of home-measured BP for monitoring and controlling
      patients with arterial hypertension while on a homogeneous treatment. An
      additional objective was to establish the degree of office BP control obtained.
      This was a prospective, longitudinal, observational and multicenter study in a
      cohort of 156 patients of both sexes, aged over 18 years and with essential
      hypertension. All of them received the fixed combination enalapril/HCTZ 20/6 mg
      as the only hypertensive agent for at least 4 weeks previously. Office BP was the
      average of three measurements. For home BP, a semi-automated device (OMRON HEM
      705 CP) was used. The patients measured their BP twice a day for 2 consecutive
      days. The average differences between the two measuring methods were low, but
      significant: 3.99 mmHg for systolic BP (SBP; p < 0.05), 2.02 mmHg for diastolic
      BP (DBP; p < 0.05). Pearson's regression coefficient between the office and home
      values was highly significant (p < 0.0001) for SBP, DBP and heart rate. Home BP
      measurement was highly reproducible as shown by the high within-class correlation
      coefficient for individual measurements on the first day compared with the
      second: 0.88 (95% confidence interval, CI 0.82-0.92; p < 0.00001) for SBP and
      0.89 for DBP (95% CI 0.83-0.93; p < 0.00001). The percentage of patients with
      strict office DBP and SBP control (< 140/90 mmHg) was 61.3% and with DBP control
      (<90 mmHg) 92%. In conclusion, in the ESPADA study, the application of home BP
      measurement is valid, reproducible and shows a high correlation with office BP.

PMID- 11212068
TI  - Endometriosis: candidate genes.
AB  - Endometriosis is generally regarded as a benign disease but it does exhibit some
      characteristics reminiscent of malignancy. This raises the possibility that, like
      malignant diseases, the development of endometriosis may involve the acquisition
      of somatic genetic alterations in genes that regulate cell growth and
      differentiation. Studies over the past few years have substantiated this view
      with the identification of a variety of genetic abnormalities usually only
      associated with malignancies. Our own studies have shown that genetic
      alterations, as shown by loss of heterozygosity, are relatively common in
      endometriosis implying that tumour suppressor gene inactivation is likely to be
      involved in the proliferation and maintenance of all endometriotic implants. We
      have also shown by DNA fingerprinting that endometriotic lesions found adjacent
      to ovarian cancers have a common lineage, reinforcing the compelling histological
      and epidemiological data that endometriosis is a precursor of endometrioid and
      clear cell ovarian cancers. It is now well accepted that susceptibility to
      endometriosis may also involve an inherited genetic component. Studies aimed at
      identifying the predisposing genes are still in their infancy but should
      eventually provide invaluable insights into the pathology and aetiology of
      endometriosis.

PMID- 11212067
TI  - The possible biological and reproductive functions of ubiquitin.
AB  - The protein ubiquitin (Ub) appears to be present in all eukaryotic cells. Its
      widespread presence and extremely conserved structure indicate that it may play a
      vital role in cell metabolism. The roles of Ub are mediated by its covalent
      attachment to target proteins, a process known as ubiquitylation, a form of
      protein modification which may lead to degradation of the modified protein. A
      number of proteins with similar structure to Ub but varying in function have been
      isolated. Recently, there has been much interest in the role of Ub and its
      related proteins in reproductive processes. Ub and Ub-related proteins may be
      involved in gametogenesis, modulation of steroid receptor concentrations,
      placental development and endometrial modification at the beginning of pregnancy.
      These wide-ranging effects have led to extensive research which will be reviewed
      in this article.

PMID- 11212069
TI  - Outcome and follow-up of children born after IVF-surrogacy.
AB  - This study addresses various outcomes and follow-up of children born after IVF
      surrogacy. Recent reports on perinatal outcome after IVF-surrogacy and on data
      generated by the Society of Assisted Reproductive Technology (SART) Registry
      between 1991 and 1995 were examined. A review of recently published perinatal
      outcomes of children born after IVF-surrogacy, including the developmental
      information of 110 children after the first 2 years of life, was undertaken. The
      birth weights for singleton pregnancies following IVF-surrogacy and IVF were
      similar, whereas the birth weights of twins and triplets born from the IVF
      surrogates were significantly heavier than those delivered from conventional IVF
      patients. Preterm delivery was increased in twin and triplet gestations in all
      segments analysed. The incidence of low birth weight was significantly lower in
      children born after IVF surrogacy than in those born after IVF, for all births
      recorded. The incidence of congenital abnormalities following IVF and IVF
      surrogacy was within the expected range for spontaneous conceptions. Speech
      delays were predominant in the multiple births, but neither speech nor motor
      delays persisted at 2 years of age in children born after IVF-surrogacy. These
      findings would imply that a gestational carrier would provide potential
      environmental benefits for the infant.

PMID- 11212070
TI  - Pregnancy and child outcome after oocyte donation.
AB  - During the last decade oocyte donation has been highly successful for treating
      women previously thought to be hopelessly infertile. The pregnancy rate after
      oocyte donation is among the highest reported for any fertility-enhancing
      procedure. Most investigators have noted an increased rate of obstetric
      complications in these pregnancies. In particular, pregnancy-induced hypertension
      appears to occur more often than expected, and the Caesarean section rate is
      high. However, the majority of oocyte recipients experience a favourable
      pregnancy and perinatal outcome. When perinatal complications occur they are
      usually related to multiple gestation. The high frequency of multiple pregnancy
      after oocyte donation, as well as in all other fields of assisted reproduction,
      deserves attention, and efforts to avoid multi-fetal gestation must be made.
      There are only a few studies on post-natal growth and development of young
      children born after oocyte donation. The health of these children appears to be
      within normal ranges. The psychological consequences of the treatment on the
      child require further investigation. Thus far, studies have shown normal socio
      emotional development in the child and a warm relationship between the parents
      and the child in oocyte donation families.

PMID- 11212071
TI  - Polycystic ovarian disease: heritability and heterogeneity.
AB  - The polycystic appearance of the ovary is the distinguishing characteristic of
      polycystic ovary syndrome (PCOS) but there is a wide range of other clinical and
      biochemical features, e.g. elevated serum concentrations of androgens, insulin,
      LH and decreased insulin sensitivity. The high prevalence of affected individuals
      and the wide range of related phenotypes can be explained by the interaction of a
      small number of key genes with environmental factors. Heritability of PCOS has
      been inferred from studies of the syndrome in various populations (ethnic groups,
      twins and PCOS families). The data suggest that the condition is passed down
      through either sex, according to an autosomal dominant model of genetic
      transmission. To date, specific gene mutations affecting androgen synthesis,
      insulin secretion and insulin activity explain most of the endocrine and
      metabolic symptoms, while environmental risk factors (either during prenatal or
      post-natal life), seem to convert an occult PCOS into a clinically manifest
      syndrome.

PMID- 11212073
TI  - Review: parent-child relationships and child development in donor insemination
      families.
AB  - The present article reviews the empirical research regarding the parent-child
      relationships and the development of children in donor insemination (DI)
      families. Over the years, follow-up studies have appeared sporadically and,
      despite the varying quality of the research methods, preliminary findings have
      emerged. Heterosexual DI parents were psychologically well adjusted and had
      stable marital relationships. DI parents showed a similar or higher quality of
      parent-child interaction and a greater emotional involvement with their children
      compared with naturally conceived families. The majority of studies which
      investigated several aspects of child development found that, overall, DI
      children were doing well. Findings with regard to emotional/behavioural
      development, however, were divergent in that some studies identified an increase
      of such problems while others did not. A steadily growing group within the DI
      population is lesbian mother families. More recently, follow-up studies have been
      carried out among DI children who were raised from birth by two mothers. Despite
      many concerns about the well-being of these children, no adverse effects of this
      alternative family structure on child development could be identified. As the DI
      children in all investigations were still young, our knowledge about the long
      term effects of DI remains incomplete.

PMID- 11212072
TI  - Follow-up studies of children born after frozen sperm donation.
AB  - The need to assess the health of children born after assisted reproductive
      technologies (ART) using frozen donor spermatozoa has been a major concern for
      the last decade. Most available published studies are confusing (since they are
      retrospective) and refer to small numbers of cases or involve a bias. Two
      prospective and large population-based studies have been published, one in France
      and the other in Australia. The general characteristics of children born after
      ART using frozen spermatozoa was unchanged in comparison with the general
      population (weight, prematurity, stillbirths, sex ratio). However, the rate of
      multiple pregnancy was increased, first in artificial insemination with donor
      semen (AID), where the use of hormonal treatment may be too heavily prescribed,
      and second in IVF with donor semen (IVF/D) where both the ovulation induction
      treatments and embryo transfer policy increase the rate of multiple pregnancies.
      As far as birth defects or chromosomal abnormalities are concerned, no difference
      has been observed from the general population. Finally, the use of frozen
      spermatozoa does not seem to affect the health of children conceived by AID or
      IVF/D. The psychosocial development of such infants is not as well known because
      of the confidentiality in many countries concerning sperm donation. However, the
      available information on the psychosocial development of these children up to the
      age of 8-10 years appears to be reassuring. Larger and longer studies are needed
      to answer such questions, particularly with regard to adulthood.

PMID- 11212074
TI  - Varicocele and male infertility: part I. Preface.

PMID- 11212075
TI  - Varicocele as a progressive lesion: positive effect of varicocele repair.
AB  - Varicoceles are the leading correctable cause of infertility in men who present
      to an infertility clinic for evaluation. Consequently, the surgical correction of
      a varicocele, known as a varicocelectomy, is the most commonly performed
      operation for the treatment of male infertility. The current data suggest that an
      individual with a varicocele, even with a previously normal semen analysis or
      documentation of previous fertility, is at risk for subsequent loss of testicular
      function and infertility. Many of these patients will need to be treated because
      there is convincing evidence that a varicocele may have a progressive toxic
      effect on the testes that may ultimately result in irreversible infertility if
      left untreated. Identifying those individuals with varicoceles that will
      ultimately cause fertility impairment is still beyond our current clinical
      capabilities. Current investigative modalities, e.g. semen analysis, testicular
      measurement, serum gonadotrophin determination, gonadotrophin-releasing hormone
      (GnRH) stimulation test, and testis biopsy analysis, may be employed to detect
      early changes in testicular physiology produced by a varicocele.

PMID- 11212076
TI  - Effects of varicocele on male fertility.
AB  - Varicoceles are vascular lesions of the pampiniform plexus and are the most
      common identifiable abnormality found in men being evaluated for infertility.
      Despite the long history associated with varicoceles, there remains much
      controversy regarding their diagnosis and management. The purpose of this
      manuscript is to address three of the most pressing controversies: (i) the
      association of varicoceles with male infertility, (ii) whether varicoceles exert
      a progressive deleterious effect and (iii) the relationship of varicocele size
      and outcome following varicocele repair. The current literature is reviewed in an
      effort to answer these questions. Based upon this analysis, conclusions can be
      drawn regarding the best management of varicoceles in subfertile men,
      adolescents, young fertile men and men with subclinical varicoceles. Although
      there remain many controversies due to a paucity of data, there appears to be a
      significant difference between adults and adolescents with respect to a
      progressive deterioration of semen parameters and it is clear that subclinical
      varicoceles do not play a major role in male infertility.

PMID- 11212077
TI  - Varicocele treatment in the light of evidence-based andrology.
AB  - Treatment of varicoceles became the most common treatment for male infertility
      merely on an empirical basis. However, in the age of evidence-based medicine it
      is surprising that only a few, and mainly recent, randomized controlled clinical
      trials with relevant outcome parameters have been published to allow adequate
      judgement of treatment effectiveness. Moreover, difficulties in study design
      could also be detected in most of these high-quality studies. Despite these
      difficulties and in contrast to the majority of uncontrolled studies on
      varicocelectomy, meta-analysis of these randomized controlled clinical studies
      involving 385 patients showed no significant treatment benefit and questions the
      common practice of varicocelectomy. Even the high-quality studies show
      conflicting results and therefore the topic of varicocele treatment will remain
      controversial and further randomized clinical trials should readdress this issue.
      For the time being, intervention by surgical or angiographic occlusion of the
      spermatic vein cannot be recommended.

PMID- 11212078
TI  - The varicocele dilemma.
AB  - There is probably no subject that is more controversial in the area of male
      infertility than varicocele. The overwhelming majority of non-urologist
      infertility specialists in the world are extremely sceptical of the role of
      varicocele or varicocelectomy in the treatment of male infertility. Directors of
      most assisted reproductive technologies (ART) programmes view the enthusiasm with
      which urologists approach varicocelectomy as a potential impediment to the couple
      that is getting older and do not have much time left to become pregnant using
      ART. There are many credible, well-controlled studies which show no effect of
      varicocelectomy on fertility. There are also a few 'controlled' studies that
      favour varicocelectomy, but all can be criticised on the basis of patient
      selection bias. Thus the great weight of evidence from controlled studies is
      against varicocelectomy and the reports supporting varicocelectomy are extremely
      weak. Finally, the reports that semen parameters are improved by varicocelectomy
      is flawed by uncontrolled observations and the failure to take into account the
      variability of semen analysis in infertile men and its regression toward the
      mean. Many control studies have demonstrated that, because of this variability,
      men with an initially low sperm count tend later to have higher sperm counts in
      the absence of any treatment whatsoever.

PMID- 11212079
TI  - The study of varicocele through the use of animal models.
AB  - The pathophysiology of the varicocele has received considerable study, both in
      humans and in animal models. Mechanistic information is difficult to obtain from
      human subjects because study designs must not be invasive and the subject
      population is variable in the status of the varicocele, patient age, fertility or
      other health-related issues. Because of these limitations, animal models of
      varicocele have been developed in several species, the most common being the rat.
      Surgery to establish the varicocele involves partial obstruction of the left
      renal vein, causing a varicosity of the left spermatic vein, including the
      pampiniform plexus. Studies using this model have shown that experimental left
      varicocele induces bilateral increases in testicular blood flow and temperature
      contemporaneous with decreases in intratesticular testosterone and testicular
      sperm output. Spermatic vein reflux is not related to the pathophysiological
      consequences of experimental varicocele. Many questions remain regarding the
      mechanism by which varicocele induces testicular dysfunction, chief among them
      being how the unilateral varicocele causes a bilateral testicular response in the
      first place.

PMID- 11212081
TI  - Haematopoietic stem cell transplantation and gene therapy in the fetus: ready for
      clinical use?
AB  - Allogeneic haematopoietic stem cell transplantation in utero has been
      successfully used for the prenatal treatment of severe combined immunodefiency
      syndrome. However, this treatment has not been successful in the therapy of other
      conditions in which the fetus is immunologically competent. The main obstacles to
      success are lack of competitive advantage of donor versus host stem cells,
      preventing stable engraftment and graft rejection. Several strategies are being
      explored to overcome these problems, and some of them have been successful in
      animal studies. Prenatal gene therapy, using ex-vivo transduced autologous
      haematopoietic cells or direct gene targeting in utero, is another potential
      approach in the treatment of immunocompetent fetal recipients. Although this has
      been shown to be feasible in animal models, safety concerns regarding
      transduction of fetal germ cells or maternal cells should be addressed in
      preclinical experiments prior to initiation of clinical trials.

PMID- 11212080
TI  - Leiomyomata: heritability and cytogenetic studies.
AB  - Leiomyomata represent the most common gynaecological tumour in women of
      reproductive age, and are the primary indication for hysterectomy in the USA.
      Cytogenetic and genetic studies have, in recent years, advanced our understanding
      of the aetiology of these tumours. Cytogenetic aberrations involving chromosomes
      6, 7, 12 and 14 constitute the major chromosomal abnormalities seen in
      leiomyomata, and suggest the possibility that disruption or dysregulation of the
      genes HMGIC and HMGIY may contribute to the development of these tumours. Based
      on the finding of a variety of chromosomal aberrations detected in fibroids,
      other genes with fundamental roles in the pathobiology of uterine leiomyomata
      await identification. Furthermore, the incidence of fibroids has been shown to be
      greater in African-American women than in Caucasian women. The existence of a
      heritability component of uterine leiomyomata has been further implicated by twin
      pair studies and the existence of familial forms of leiomyomata, both of which
      suggest an inherited diathesis for leiomyomata formation. This paper will review
      the cytogenetic aberrations and gene expression, with respect to their
      contributions to the pathogenesis of leiomyomata, and also summarize the current
      understanding of heritability of these tumours.

PMID- 11212082
TI  - Efficacy of nafarelin in assisted reproductive technology: a meta-analysis.
AB  - A systematic review identified nine randomized, controlled trials (both published
      and unpublished) which assessed the efficacy of nafarelin during IVF compared
      with other gonadotrophin-releasing hormone (GnRH) agonists. The trials included
      1,014 women (nafarelin n = 597) in protocols employing three different dosage
      regimens, long and short stimulation protocols, and three comparative GnRH
      agonists (buserelin n = 348; triptorelin n = 14, and leuprolide n = 55). The meta
      analysis of the data showed that pregnancy rates per embryo transfer with
      nafarelin were equivalent to those obtained with other GnRH agonists. Nafarelin
      and other agonists were also comparable in terms of several intermediate IVF
      outcomes, including fertilization rates, number of oocytes retrieved, peak
      oestradiol concentrations, and cycle cancellations. Women treated with nafarelin
      required fewer ampoules of human menopausal gonadotrophin (HMG)/FSH for ovarian
      stimulation and fewer days of stimulation. Safety results from both the meta
      analysis and a qualitative analysis of 12 additional reports suggested that
      adverse effects were within the accepted tolerance range; the most frequent
      adverse effects were hypo-oestrogenic symptoms. In conclusion, the overall
      efficacy of nafarelin was equivalent to that of other GnRH agonists. The
      possibility that the reduced gonadotrophin requirements in women taking nafarelin
      will translate into cost savings per IVF treatment cycle requires further study.

PMID- 11212083
TI  - Nuclear magnetic resonance (NMR) studies of homeopathic solutions.
AB  - The efficacy of homeopathy is controversial. Nuclear magnetic resonance (NMR) has
      been used to study homeopathic solutions, showing provocative results. We
      examined the reproducibility of one of the allegedly positive studies. 1H NMR
      spectra were recorded for Sulphur D4, diluted and succussed up to D30 (called
      potentization) at two different frequencies (300 and 500 MHz). The Sulphur
      solution had been potentiated according to homeopathic principles with deionized
      water and alcohol. Water proton T1 relaxation measurements were performed also at
      20 MHz for the different potentiated Sulphur solutions. Furthermore, the
      homeopathic remedy Betula alba 30c (birch pollen extract) and appropriate control
      solution (deionized water, unsuccussed solutions and placebo globules) were
      measured analogously, both with frequencies giving spectra and T1 relaxometry.
      The Sulphur remedies showed identical one dimensional proton spectra (1H NMR) at
      300 and 500 MHz, regardless of dilution/succussion stage, from D4 to D30.
      Furthermore, Betula 30c as a potentiated solution and its controls (ethanol
      dilutions and Betula diluted but not succussed) showed identical spectra. Nor
      were there any statistically significant differences in longitudinal (T1)
      relaxation times between deionized water and Sulphur D10 to D30 preparations. The
      shorter T1 of the Sulphur D4 preparation could be ascribed to the higher
      microviscosity within the sample matrix caused by the high concentration of
      dissolved material. Also, the T1 values of the Betula alba 30c preparation (in
      globular form) and control placebo globules were identical. In conclusion,
      published results from NMR research on homeopathy indicating differences between
      homeopathic solutions and control samples could not be reproduced.

PMID- 11212084
TI  - Nuclear magnetic resonance: let's consolidate the ground before getting excited!

PMID- 11212085
TI  - The efficacy and safety of a homeopathic gel in the treatment of acute low back
      pain: a multi-centre, randomised, double-blind comparative clinical trial.
AB  - Acute low back pain is a very common condition in Western industrialised
      countries. In most cases analgesics or topical medications are prescribed at
      first encounter with the general practitioner (GP). The aim of this study was to
      investigate whether the homeopathic gel Spiroflor SRL gel (SRL) is equally
      effective and better tolerated than Cremor Capsici Compositus FNA (CCC) in
      patients with acute low back pain. A multi-centre, randomised, double-blind,
      controlled clinical trial was conducted in the practices of 19 GPs in the
      districts of Bristol and Manchester, UK. One hundred and sixty-one subjects
      suffering from acute low back pain were treated for one week either with SRL or
      with CCC. Pain was scored on a 100 mm visual analogue scale (VAS). Main efficacy
      parameter VAS reduction was compared between treatments. Evaluation of safety was
      primarily based on the number of subjects with adverse events (AEs), withdrawals
      due to an AE and adverse drug reactions (ADRs). The mean difference between the
      VAS reduction in the SRL group and the CCC group adjusted for VAS at baseline and
      age was -0.6mm (90% CI = -6.5-5.3mm). Fewer subjects in the SRL group (11%)
      experienced an AE than in the CCC group (26%). The same applies to the number of
      subjects with an ADR (3/81 = 4% vs 18/74 = 24%) and the number of subjects
      withdrawn due to an ADR (0/81 = 0% vs 8/74 = 11%). In conclusion, SRL and CCC are
      equally effective in the treatment of acute low back pain, however, SRL has a
      better safety profile. Spiroflor SRL gel is preferable to Capsicum-based products
      for the topical treatment of low back pain, because of the lower risk of adverse
      effects.

PMID- 11212086
TI  - Clinical verification of symptom pictures of homeopathic medicines.
AB  - This invitation for co-operation is addressed to all interested groups. Its
      purpose is data collection for clinical verification of symptoms from homeopathic
      proving and collection of clinical symptoms not derived from homeopathic
      pathogenetic trials (provings). To date no consensus exists on this topic. The
      European Committee for Homoeopathy (ECH) research sub-committee has created a
      working group on this topic. This paper is the result of a review of papers on
      the topic, exchanges between members and a meeting.

PMID- 11212087
TI  - Cushing's disease: a new approach to therapy in equine and canine patients.
AB  - Forty-one cases of Cushing's Disease affecting both equine and canine patients
      were treated with an identical mixture of two homeopathically prepared remedies
      (ACTH 30c and Quercus robur 30c), and the clinical improvements seen in the cases
      assessed. Homeopathy has been described as a medicine that can only be prescribed
      on the basis of individual symptoms shown, fitting the remedy to the patient, not
      the disease. The aim of this study was to define whether a standardised approach,
      using homeopathically prepared remedies, was a valid system of therapy for this
      disease, and if so, whether results were repeatable between species. The overall
      success rate for the therapy was 80% and results were broadly similar between the
      two species, indicating that homeopathy lends itself to the treatment of
      Cushing's Disease, and also to both cohort studies and group medicine.

PMID- 11212088
TI  - Homeopathic remedies for the treatment of osteoarthritis: a systematic review.
AB  - Osteoarthritis is a common rheumatic disease. Limitations of conventional medical
      management of this condition indicate a real need for safe and effective
      treatment of osteoarthritic patients. The authors review the clinical evidence
      for and against the effectiveness of homeopathic medicines in the treatment of
      patients with osteoarthritis. A systematic review of all randomised controlled
      clinical trials of homeopathic treatment of patients with this condition is
      presented. A comprehensive search yielded four trials which are discussed in
      detail. The authors conclude that the small number of randomised clinical trials
      conducted to date, although favouring homeopathic treatment, do not allow a firm
      conclusion as to the effectiveness of homeopathic remedies in the treatment of
      patients with osteoarthritis. The clinical evidence appears promising, however,
      and more research into this area seems warranted.

PMID- 11212089
TI  - The widow spider Latrodectus tredecimguttatus: source of the remedy Tarentula
      hispanica?
AB  - The European wolf spider, Lycosa tarentula, said to have caused the historical
      phenomenon of 'tarantism', is the official medicinal source of the homeopathic
      remedy Tarentula hispanica. Yet, scientific evidence links the spider's venomous
      effects with mild necrotic and minor systemic effects that contrast with the
      proving symptoms of Tarentula hispanica which show a cerebral and neural
      component. A comparative investigation by use of toxicological, clinical
      findings, supported by modern and antique biological texts, as well as
      homeopathic materia medica, traces the source of the remedy Tarentula hispanica
      to the Mediterranean widow spider Latrodectus tredecimguttatus, thus warranting a
      re-evaluation of pharmacological preparation.

PMID- 11212090
TI  - On the investigation of homeopathic potencies using low resolution NMR T2
      relaxation times: an experimental and critical survey of the work of Roland Conte
      et al.
AB  - We have attempted to reproduce differences in low resolution nuclear magnetic
      resonance (NMR) T2 spin-spin relaxation times between homeopathically potentised
      and unpotentised Nitric acid (nit-ac) solutions previously reported by Conte, et
      al. Using similar instrumentation and experimental protocols, we have shown that
      it is likely that Conte's original results are attributable to experimental
      artifact originating in the glassware used for the manufacture of the NMR tubes.

PMID- 11212091
TI  - Synthesis of 4-alkoxy-2-phenylquinoline derivatives as potent antiplatelet
      agents.
AB  - In our continuing search for novel antiplatelet agents, 4-alkoxy derivatives of 2
      phenylquinoline as well as related compounds were prepared. Through biological
      screening, a preliminary structure antiplatelet activity relationship was
      established. Compounds 5-ethyl-4-methoxy-2-phenylquinoline (8), 4-ethoxy-5-ethyl
      2-phenylquinoline (9), 4-ethoxycarbonylmethoxy-5-ethyl-2-phenylquinoline (10), 4
      ethoxycarbonylbutoxy-5-ethyl-2-phenylquinoline (12) and 5-ethyl-4-(N
      ethylcarboxido)methoxy-2-phenylquinoline (17) all demonstrated potent
      antiplatelet activity. Among them, compound 8 was the most potent with an IC50
      value of 0.08 microM and was about 3-fold more active than indomethacin. The
      mechanism of antiplatelet action of 8 is possibly through its inhibition on
      cyclooxygenase or thromboxane synthetase.

PMID- 11212092
TI  - Synthesis and preliminary pharmacological evaluation of coumestans with different
      patterns of oxygenation.
AB  - Five coumestans with different patterns of oxygenation in rings A and D were
      synthesized from resorcinol and aromatic aldehydes, and screened for their
      antimyotoxic activity. The most potent compound (2b, IC50 = 1 microM) was
      selected for study of its pharmacological profile.

PMID- 11212093
TI  - Potent and selective bicyclic lactam inhibitors of thrombin. Part 4: transition
      state inhibitors.
AB  - Bicyclic piperazinone based thrombin inhibitors of general structure 2 were
      prepared and evaluated in vitro and in vivo. These inhibitors, having in common
      an electrophilic basic trans-cyclohexylamine P1 residue, displayed high thrombin
      affinity, high selectivity against trypsin and good in vivo efficacy in the rat
      arterial thrombosis model.

PMID- 11212094
TI  - Novel cytotoxic 7-iminomethyl and 7-aminomethyl derivatives of camptothecin.
AB  - A series of new 7-iminomethyl derivatives of camptothecin were obtained from
      camptothecin-7-aldehyde and aromatic, alicyclic and aliphatic amines. Their
      hydrogenation led to the corresponding amines. All the imines and the less polar
      amines showed a marked increase of the cytotoxic activity against H460 non-small
      lung carcinoma cell line, with respect to topotecan. The lipophilicity of the
      substituent in position 7 of camptothecin seems to play an important role for
      cytotoxic potency. The 7-phenyliminomethyl derivative showed efficacy comparable
      to topotecan in vivo against NSCLC H460 xenografted in athymic nude mice.

PMID- 11212095
TI  - General synthesis of alpha-substituted 3-bisaryloxy propionic acid derivatives as
      specific MMP inhibitors.
AB  - Modulations of alpha and aryl substitutions on 3-aryloxy propionic acid
      hydroxamates led to novel and potent inhibitors of MMP-2,3,9 and 13, and
      selectivity versus MMP-1.

PMID- 11212096
TI  - Antimycobacterial in vitro activity of cobalt(II) isonicotinoylhydrazone
      complexes. Part 10.
AB  - Octahedral cobalt(II) complexes of isonicotinoylhydrazones, which were obtained
      from the primary antituberculous agent isoniazid, have been synthesised and
      characterised. Their antimycobacterial in vitro activity has been evaluated
      against Mycobacterium tuberculosis H37Rv: they exhibit MIC values ranging from <
      0.1 to 0.39 microg/mL, showing them to be generally more active than previously
      reported analogous Cu(II) and Ni(II) complexes.

PMID- 11212097
TI  - Active site geometry of porcine pancreatic lipase: an interesting switchover from
      Jones' to Seebach's model.
AB  - Porcine pancreatic lipase (PPL)-catalyzed hydrolysis of cis 3-acetoxyethyl-1,4
      diphenyl and cis 3-acetoxyethyl-1-phenyl-4-(2-furyl) beta-lactams 1a and 1b
      proceeded with opposite stereoselectivity while the corresponding thienyl beta
      lactam 1c showed no selectivity at all. An explanation based upon the dominance
      of hydrophobic and polar pockets in governing the stereoselectivity has been
      proposed.

PMID- 11212098
TI  - Trifluoromethyl-containing 3-alkoxymethyl- and 3-aryloxymethyl-2-pyridinones are
      potent inhibitors of HIV-1 non-nucleoside reverse transcriptase.
AB  - 3-Alkoxymethyl- and 3-aryloxymethyl-2-pyridinones were synthesized and evaluated
      for activity as non-nucleoside reverse transcriptase inhibitors (NNRTIs) of HIV
      1. It was found that several compounds were potent inhibitors of HIV-1 with the
      most potent compound 24 exhibiting an IC90 = 32 nM. Compound 24 also possessed a
      potent resistance profile as demonstrated by submicromolar IC90s against several
      clinically meaningful mutant virus strains.

PMID- 11212099
TI  - Sulfonylated aminothiazoles as new small molecule inhibitors of protein
      phosphatases.
AB  - Based on a previously identified lead structure, SC-alphaalphadelta9, we have
      developed a versatile new chemical scaffold that can be readily modified to
      generate libraries of both Tyr and dual specificity phosphatase inhibitors with
      reduced molecular weight and lipophilicity. The most potent analogue identified
      to date, aminothiazole 8z, inhibits the dual specificity phosphatase Cdc25B with
      a Ki of 4.6+/-0.4 microM and a Hill coefficient of 2.

PMID- 11212100
TI  - The 5-HT3 antagonist tropisetron (ICS 205-930) is a potent and selective alpha7
      nicotinic receptor partial agonist.
AB  - The 5-HT3 receptor antagonist tropisetron (ICS 205-930) was found to be a potent
      and selective partial agonist at alpha7 nicotinic receptors. Two other 5-HT3
      receptor antagonists, ondansetron and LY-278,584, were found to lack high
      affinity at the alpha7 nicotinic receptor. Quinuclidine analogues (1 and 2) of
      tropisetron were also found to be potent and selective partial agonists at alpha7
      nicotinic receptors.

PMID- 11212101
TI  - Stereospecific synthesis of (2S)-2-methyl-3-(2',6'-dimethyl-4'-hydroxyphenyl)
      propionic acid (Mdp) and its incorporation into an opioid peptide.
AB  - To examine the effect of replacing the N-terminal amino group in opioid peptides
      with a methyl group on biological activity, a stereospecific synthesis of the
      tyrosine analogue (2S)-2-methyl-3-(2',6'-dimethyl-4'-hydroxyphenyl)-propionic
      acid (Mdp) was performed. The enkephalin analogue (2S)-Mdp-D-Ala-Gly-Phe-Leu-NH2
      turned out to be a quite potent delta opioid antagonist and a somewhat less
      potent mu antagonist, indicating that a positively charged N-terminal amino group
      is not a conditio sine qua non for the binding of opioid peptides to delta and mu
      receptors but may be required for signal transduction.

PMID- 11212102
TI  - Enkephalin analogues with 2',6'-dimethylphenylalanine replacing phenylalanine in
      position 4.
AB  - Four Leu-enkephalin (Enk) analogues containing 2',6'-dimethyphenylalanine (Dmp)
      in position 4 were prepared and tested for their receptor binding and biological
      activities. Among the analogues prepared, [2', 6'-dimethyltyrosine, D-Dmp4]Enk
      was found to be an antagonist toward mu and delta opioid receptors with pA2
      values of 6.90 and 5.57, respectively.

PMID- 11212103
TI  - The development of a potential single photon emission computed tomography (SPECT)
      imaging agent for the corticotropin-releasing hormone receptor type.
AB  - A high-affinity radioligand for CRHR1 has been prepared that can serve as a
      template for the development of SPECT imaging agents. The 5-chloro-N
      cyclopropylmethyl-N-(2,6-dichloro-4-iodophenyl)-2-methyl-N-propylpyrimidine-4,6
      diamine (6b, Ki = 14 nM), and the corresponding 4-bromophenyl analogue (6a, Ki =
      21 nM), were synthesized in four steps from compound 3.

PMID- 11212104
TI  - Specific binding of 2-amino-1,8-naphthyridine into a single guanine bulge as
      evidenced by photooxidation of GG doublet.
AB  - Photoirradiation of 2-amino-1,8-naphthyridines in the presence of duplex DNA
      containing the GG doublet opposite a single bulge was examined. After hot
      piperidine treatment, DNA cleavage was observed preferentially at the GG opposite
      a single bulge. The cleavage efficiency was highly dependent on the nature of
      bulged base. The G cleavage at the GG opposite a single G bulge was exceptionally
      weak, suggesting an intercalative binding of 2-amino-1,8-naphthyridine
      chromophore into the GG step.

PMID- 11212105
TI  - Design and synthesis of tricyclic derivatives as high density lipoprotein
      cholesterol enhancers.
AB  - A pharmacophore for increasing HDLC was proposed based on common structural
      features of non-thio-containing compounds with HDLC enhancing properties. A
      search of the compound database identified various series of these non-thio
      containing compounds, including a novel tricyclic imidazoisoquinolone.
      Preparation of 1-aryl-3-oxo-1,3-dihydro-2-benzofuran-1-carboxamides using a novel
      and widely applicable one-step process from 2-acyl benzoic acids is reported.
      Reaction of diamines with 1-aryl-3-oxo-1,3-dihydro-2-benzofuran-1-carboxamides
      and related aza-analogues proceeded with regio-control to furnish
      imidazoisoquinolones, pyrimidoisoquinolones, and imidazonaphthyridines. NMR
      studies and X-ray crystallography confirmed the regiochemistry of the products.
      Compounds of these series increased concentrations of HDLC in test animals
      following oral administration.

PMID- 11212106
TI  - Selective reaction to a flipping cytidine of the duplex DNA mediated by triple
      helix formation.
AB  - A new nucleoside derivative (2) with a butyl spacer between the sugar part and
      the 2-amino-6-vinylpurine motif has been synthesized. The triplex-forming
      oligodeoxynucleotide incorporating 2 has achieved strand- and cytidine-selective
      cross-linking reaction to the G-C target site mediated by triple helix formation.
      It has been suggested that 2 reacts with a flipping cytidine at the target site.

PMID- 11212107
TI  - Antifungal activity of octyl gallate: structural criteria and mode of action.
AB  - Octyl gallate (3,4,5-trihydroxybenzoate) was found to possess antifungal activity
      against Saccharomyces cerevisiae and Zygosaccharomyces bailii, in addition to its
      potent antioxidant activity. Catechol moiety is essential to elicit this
      activity. The primary fungicidal activity of octyl gallate comes from its ability
      to act as a nonionic surface-active agent (surfactant). The length of the alkyl
      chain is not a major contributor but plays an important role in eliciting the
      activity.

PMID- 11212108
TI  - Anthraquinone-peptides as inhibitors of AP-1 transcription factor.
AB  - Peptide-1-[N-[2-succinamidylethyl]amino]anthraquinones containing five seven
      amino acid residues including the KCR motif important in AP-1 protein binding to
      DNA have been synthesised as potential transcription factor inhibitors. These
      anthraquinone-peptides showed DNA intercalative binding and inhibition of AP-1
      protein binding to its DNA consensus sequence.

PMID- 11212109
TI  - The identification of alpha-ketoamides as potent inhibitors of hepatitis C virus
      NS3-4A proteinase.
AB  - Peptides based upon the non-prime side residues of the NS4A-4B cleavage site of
      hepatitis C virus (HCV) NS3-4A proteinase containing an alpha-ketoamide moiety in
      place of the scissile amide bond are potent inhibitors of this enzyme.

PMID- 11212111
TI  - Synthesis and photodynamic activity of a cationic zinc monoazaporphyrin bearing a
      nitrogen atom at the peripheral position.
AB  - A new cationic monoazaporphyrin, zinc 2-aza-8,12,13,17-tetraethyl-2,3,7,18
      tetramethylporphyrinium iodide 3 was synthesized. Photodynamic activity of 3 in
      degradation of 2',3'-isopropylideneguanosine 4 was compared with 2-aza-8,12,13,17
      tetraethyl-3,7,18-trimethylporphyrin 1, zinc 2-aza-8,12,13,17-tetraethyl-3,7,18
      trimethylporphyrin 2, and hematoporphyrin 5. The quarternary ammonium 3 showed a
      remarkable increase of photodynamic activity compared with 5, although no
      appreciable difference in the activity was observed between 1 and 5.

PMID- 11212110
TI  - Conformational study of a highly specific CXCR4 inhibitor, T140, disclosing the
      close proximity of its intrinsic pharmacophores associated with strong anti-HIV
      activity.
AB  - We report the solution structure of T140, a truncated polyphemusin peptide
      analogue that efficiently inhibits infection of target cells by T-cell line
      tropic strains of HIV-1 through its specific binding to a chemokine receptor,
      CXCR4. Nuclear magnetic resonance analysis and molecular dynamic calculations
      revealed that T140 has a rigidly structured conformation constituted by an
      antiparallel beta-sheet and a type II' beta-turn. A protuberance is formed on one
      side of the beta-sheet by the side-chain functional groups of the three amino
      acid residues (L-3-(2-naphthyl)alanine, Tyr5 and Arg14), each of which is
      indispensable for strong anti-HIV activity. These findings provide a rationale to
      dissect the structural basis for the ability of this compound to block the
      interaction between CXCR4 and envelope glycoproteins from T-tropic strains of HIV
      1.

PMID- 11212112
TI  - Serotonergic and dopaminergic activities of rigidified (R)-aporphine derivatives.
AB  - Novel rigidified (R)-aporphine derivatives were synthesized from (R)-1,11
      carbonylaporphine by ring expansion reactions. The structures of the novel
      analogues were assigned by NMR spectroscopy and X-ray crystallography. The
      compounds showed moderate affinities and selectivities at serotonin S-HT1A and 5
      HT7 and dopamine D2A receptors.

PMID- 11212113
TI  - Securiosides A and B, novel acylated triterpene bisdesmosides with selective
      cytotoxic activity against M-CSF-stimulated macrophages.
AB  - We report the discovery of securiosides A (1) and B (2), novel acylated
      triterpene bisdesmosides, isolated from the roots of Securidaca inappendiculata.
      Securiosides A and B showed potent selective cytotoxic activity against M-CSF
      stimulated macrophages and were suggested to have potential as new agents for the
      treatment of inflammatory diseases such as RA and atherosclerosis.

PMID- 11212114
TI  - Synthesis and biological activity of novel potent endothelin-converting enzyme-1
      inhibitors.
AB  - Through directed screening of metalloprotease inhibitors, CGS 30084 (1) has been
      identified as a potent endothelin-converting enzyme-1 (ECE-1) inhibitor in vitro
      (IC50 = 77 nM). Herein we report the syntheses and biological activities of
      analogues derived from this lead, based on modifications of the biphenyl moiety.
      Compound 10, the thioacetate methyl ester prodrug derivative of compound 6m, was
      found to be an orally active and potent inhibitor of ECE-1 activity in rats.

PMID- 11212115
TI  - Human beta3 adrenergic receptor agonists containing cyanoguanidine and
      nitroethylenediamine moieties.
AB  - Pyridineethanolamine derivatives containing cyanoguanidine or
      nitroethylenediamine moieties were examined as human beta3 adrenergic receptor
      (AR) agonists. Notably, indoline derivatives 6a and 11 were potent beta3 AR
      agonists (beta3 EC50 = 13 and 19 nM, respectively), which showed good selectivity
      over binding to and minimal activation of the beta1 and beta2 ARs.

PMID- 11212116
TI  - Solid-phase synthesis of oligonucleotides containing a bipyridine ligand at the
      3'-3' inversion of polarity site.
AB  - The preparation of a solid support useful for the synthesis of oligonucleotides
      with a 3'-3' inversion of polarity, via a linker containing a chelating molecule,
      namely 2,2'-bipyridine, is described.

PMID- 11212117
TI  - Solid-phase synthesis of pyrrolo[2,1-c][1,4]benzodiazepine-5,11-diones.
AB  - The solid-phase synthesis of biologically important pyrrolo[2,1
      c][1,4]benzodiazepine-5,11-diones using Wang resin through amide formation and
      reductive cyclization procedures is described. Further, N10-substituents have
      been introduced in the final products and these have been cleaved from the solid
      support in good yields.

PMID- 11212118
TI  - Bicyclic nucleoside inhibitors of Varicella-Zoster Virus (VZV): the effect of
      terminal unsaturation in the side chain.
AB  - Novel bicyclic nucleoside analogues bearing long alkyl side chains are prepared
      and tested as inhibitors of VZV. In particular, analogues with terminal
      unsaturation in the side chain are reported. Whilst terminal alkenyl derivatives
      are potent antivirals, the corresponding terminal alkynyls are poorly active.

PMID- 11212119
TI  - Synthesis and antifungal activities of novel 1,3-beta-D-glucan synthase
      inhibitors. Part 1.
AB  - Highly potent 1,3-beta-D-glucan synthase inhibitors 10, 11 and 13 have been
      identified by the chemical modification of the fungicidal macrocyclic
      lipopeptidolactone, RO-09-3655 (1), isolated from the cultured broth of
      Deuteromycotinia spp. D-Ornithine derivative (10) showed improved antifungal
      activity in the systemic candidiasis model in mice and reduced hepatotoxicity in
      vitro, as compared with 1.

PMID- 11212120
TI  - FR131535, a novel water-soluble echinocandin-like lipopeptide: synthesis and
      biological properties.
AB  - The synthesis and biological properties of a novel water-soluble echinocandin
      like lipopeptide, FR131535, are described. This compound displayed potent in
      vitro and in vivo antifungal activities. The hemolytic activity of FR901379 was
      reduced by replacing the acyl side chain. This compound showed good water
      solubility, comparable to the natural product FR901379.

PMID- 11212121
TI  - Anti-Helicobacter pylori agents endowed with H2-antagonist properties.
AB  - New anti-Helicobacter pylori (H. pylori) agents endowed with H2-antagonists
      properties were obtained by combining the lamtidine derived pharmacophoric group
      with the antibiotic calvatic acid. All the compounds were tested for their
      irreversible H2-antagonist properties and for their ability to inhibit 20 H.
      pylori strains, two of them metronidazole resistant. The most active derivative
      (compound 4) displayed antimicrobial activity similar to metronidazole.

PMID- 11212122
TI  - Orally active docetaxel analogue: synthesis of 10-deoxy-10-C-morpholinoethyl
      docetaxel analogues.
AB  - To improve cytotoxicity of 10-deoxy-10-C-morpholinoethyl docetaxel analogues
      against various tumor cell lines including resistant cells expressing P
      glycoprotein (P-gp), we modified the 7-hydroxyl group to hydrophobic groups
      (methoxy, deoxy, 6,7-olefin, alpha-F, 7-beta-8-beta-methano, fluoromethoxy).
      Among these analogues, the 7-methoxy analogue showed the strongest cytotoxicity.
      This analogue showed potent activity against B16 melanoma BL6 in vivo by oral
      administration.

PMID- 11212123
TI  - A model of photoprobe docking with beta1,4-galactosyltransferase identifies a
      possible carboxylate involved in glycosylation steps.
AB  - A molecular docking study has been performed on the interaction of beta1,4
      galactosyltransferase with an acceptor site photoprobe. This is based on an
      acceptor site peptide fragment which was recently identified by the use of a
      photoprobe. The present model strongly suggests that the carboxylate group of
      Asp318 could be involved in the activation of the acceptor sugar 4-OH for the
      efficient galactosyltransfer. The result also exemplified that the combination of
      photoaffinity labeling with crystallography is a powerful method for the detailed
      structural analysis of ligand protein complex.

PMID- 11212124
TI  - Nipecotic and iso-nipecotic amides as potent and selective somatostatin subtype-2
      receptor agonists.
AB  - N-Substituted nipecotic and iso-nipecotic amides of beta-methylTrpLys tert-butyl
      ester were found to be novel, selective and potent agonists of the somatostatin
      subtype-2 receptor in vitro. For example iso-nipecotic amide 8a showed high hsst2
      binding affinity (Ki = 0.5 nM) and good selectivity (h5/h2 = 832).

PMID- 11212125
TI  - Synthesis and transfecting properties of a glycosylated polycationic DNA vector.
AB  - A glycosylated analogue of dialkylamidoglycylcarboxyspermine was synthesized. The
      physico-chemical and transfecting properties of 11 were evaluated indicating that
      this cationic lipid forms stable particles at low charge ratio and is efficient
      for gene delivery.

PMID- 11212126
TI  - Structure-activity relationships of novel anti-malarial agents. Part 2: cinnamic
      acid derivatives.
AB  - We have described compound 1 as a lead structure for a novel class of anti
      malarial agents. Replacement of the 3-phenylpropionyl moiety of the lead
      structure 1 by a 4-propoxycinnamic acid residue resulted in a significant
      improvement in antimalarial activity. Compound 3q represents an important step in
      the development of lead structure 1 into an anti-malarial drug candidate.

PMID- 11212127
TI  - Non-peptidic, non-prenylic inhibitors of the prenyl protein-specific protease
      Rce1.
AB  - Several compounds designed as bisubstrate analogues of protein
      farnesyltransferase inhibited the prenyl protein-specific protease Rce1,
      qualifying them as lead structures for a novel class of non-peptidic, non
      prenylic inhibitors of this protease.

PMID- 11212128
TI  - Cytotoxic Michael-type amine adducts of alpha-methylene lactones alantolactone
      and isoalantolactone.
AB  - Two series of cytotoxic (IC50, K562 cell line, 1-24 microM) alpha-aminomethyl
      substituted lactones 3 and 4 were prepared by stereoselective Michael-type
      addition of amines to alantolactone (1) and isoalantolactone (2). The lactones 1
      and 2 and their amine adducts induce apoptosis and act as alkylating agents.

PMID- 11212129
TI  - Equilibrium and kinetics studies of transnitrosation between S-nitrosothiols and
      thiols.
AB  - Using UV-vis spectrometrical measurements, equilibrium constants for NO transfer
      between S-nitroso-N-acetyl-penicillamine (SNAP) and different thiols as well as
      kinetic data for NO transfer from S-nitroso bovine serum albumin (BSANO) to
      thiols have been obtained. NO transfer from SNAP to other primary/secondary
      thiols are thermodynamically favorable, whereas other S-nitrosothiols exhibit
      similar NO transfer potential. The obtained Gibbs free energy, enthalpy and
      entropy data indicated that NO transfer reactions from SNAP to four thiols are
      exothermic with entropy loss. The kinetic behavior of BSANO/RSH transfer can be
      related to both the acidity of sulfhydryl group and the electronic structure in
      thiol.

PMID- 11212131
TI  - Relationship between brain atrophy and disability: an 8-year follow-up study of
      multiple sclerosis patients.
AB  - Brain atrophy measurement can provide an estimate of the amount of tissue
      destruction due to the pathologic processes in multiple sclerosis. The potential
      usefulness of atrophy as a marker of disease progression depends upon the
      concurrent and predictive relationships between atrophy and disability. A follow
      up study was performed to measure atrophy and disability scores in patients from
      the Multiple Sclerosis Collaborative Research Group's phase III trial of IFNbeta
      1a (Avonex) in relapsing- remitting multiple sclerosis. New data were obtained on
      160 out of 172 eligible patients from the original trial were enrolled in the
      follow-up study approximately 8 years after randomization. The follow-up visit
      consisted of several tests and questionnaires including a clinical exam to
      determine Expanded Disability Status Score (EDSS) and Multiple Sclerosis
      Functional Composite (MSFC), and a magnetic resonance imaging exam to calculate
      the brain parenchymal fraction. Brain parenchymal fraction was correlated with
      both EDSS and MSFC at each of the four time points for which data were available
      (baseline 1, 2 and 8 years). Furthermore, the change in BPF was correlated with
      the changes in disability scores from the end of the phase III trial to the
      follow-up exam. These data suggest that brain atrophy may be a useful and
      clinically relevant marker of disease progression in relapsing--remitting MS.

PMID- 11212130
TI  - Brain atrophy in relapsing multiple sclerosis: relationship to relapses, EDSS,
      and treatment with interferon beta-1a.
AB  - Brain atrophy is a relevant surrogate marker of the disease process in multiple
      sclerosis (MS) because it represents the net effect of various pathological
      processes leading to brain tissue loss. There are various approaches to
      quantifying central nervous system atrophy in MS. We have focused on a normalized
      measure of whole brain atrophy, the brain parenchymal fraction (BPF). BPF is
      defined as the brain parenchymal volume, divided by the volume within the surface
      of the brain. We applied this method to an MRI data set generated during a phase
      III clinical trial of interferon beta-1a (AVONEX). The purpose of the current
      study is to further explore clinical and MRI correlates of the BPF, particularly
      as they relate to relapse rate and Kurtzke's Expanded Disability Status Score
      (EDSS); and to further explore the therapeutic effects observed in interferon
      beta-1a recipients. Of all demographic and disease measures in the clinical trial
      data base, T2 lesion volume most closely correlated with BPF in cross sectional
      studies, and was the baseline factor most closely correlated with progressive
      brain atrophy in the subsequent 2 years. We also observed that change in T2
      lesion volume was the disease measure most closely correlated with change in BPF
      during 2 years of observation. Of interest, relapse number and EDSS change during
      2 years were only weakly correlated with BPF change during the same period.
      Disability progression, defined as sustained worsening of at least 1.0 EDSS
      points from baseline, persisting at least 6 months, was associated with
      significantly greater brain atrophy progression. We observed a therapeutic effect
      of interferon beta-1a in the second year of the clinical trial, and this
      beneficial effect was not accounted for by change in gadolinium enhanced lesion
      volume, or by corticosteroid medication within 40 days of the final MRI scan. The
      BPF is an informative surrogate marker for destructive pathological processes in
      relaping MS patients, and is useful in demonstrating treatment effects in
      controlled clinical trials. The significance of progressive brain atrophy during
      relapsing MS will be assessed by measuring clinical and MRI changes in
      prospective follow up studies.

PMID- 11212132
TI  - Increase in serum levels of uric acid, an endogenous antioxidant, under treatment
      with glatiramer acetate for multiple sclerosis.
AB  - Free radicals including peroxynitrite are induced in Multiple Sclerosis (MS).
      Antioxidant and peroxynitrite inhibitor uric acid (UA), suppresses the MS animal
      model experimental autoimmune encephalomyelitis (EAE). MS patients have lower
      average serum UA than controls. An inverse relationship exists between MS and
      gout Glatiramer acetate (GA) suppresses EAE and is beneficial in relapsing MS. We
      investigated serum UA changes during open-label treatment of relapsing MS with
      GAA. Ten patients (six females, four males, aged 19 to 39 years, mean age 32
      years) completed 6 months of GAA (Copaxone 20 mg s.c daily). Of these, nine
      completed 12 months. After 6 months on GAA, serum UA (normal, 173359 micromol/ml
      for women, 258-491 micromol/ml for men) increased in nine and marginally
      decreased (302 to 300 micromol/ml) in a single patient. Mean UA significantly
      increased from 240 to 303 micromol/ml (P=0.0014). At 12 months, UA remained
      significantly higher than at start (P=0.006) decreasing in only one patient. In
      contrast, we found no significant UA changes after 6 and 12 months of treatment
      in 21 MS patients treated with interferon beta1-a (Avonex), or in 11 treated with
      interferon beta1-a (Rebif), or in five placebo-treated controls. Increasing UA, a
      natural inhibitor of free radicals, may represent a mechanism of action of
      glatiramer acetate in MS.

PMID- 11212133
TI  - Self-reported visual dysfunction in multiple sclerosis: results from the 25-Item
      National Eye Institute Visual Function Questionnaire (VFQ-25).
AB  - Visual impairment is one of the most common clinical manifestations of Multiple
      Sclerosis (MS), and is strongly related to overall health-related quality of life
      (HRQOL) in MS and other disorders. However, the assessment of vision-specific
      HRQOL in patients with MS has been limited. The purpose of this study was to
      examine self-reported visual dysfunction in a clinically heterogeneous MS cohort
      using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25).
      The VFQ-25 was administered by telephone interview to a subset of participants in
      a follow-up study to a phase III trial of interferon beta-1a for relapsing
      remitting MS. Mean VFQ-25 composite scores and selected sub-scale scores were
      significantly lower (worse) among patients in our MS cohort (n=35) compared with
      a published reference group of patients with no history of chronic eye disease
      (n= 118). These differences were observed despite a relatively younger age and
      tighter distribution of binocular visual acuities in the MS cohort Patients with
      MS in this study thus demonstrated a greater degree of self-reported visual
      dysfunction, as measured by the VFQ-25, compared with an eye disease-free
      reference group. The VFQ-25 is a potentially useful measure of vision-specific
      HRQOL in patients with MS.

PMID- 11212134
TI  - Olfactory dysfunction and extent of white matter abnormalities in multiple
      sclerosis: a clinical and MR study.
AB  - BACKGROUND: The relative contribution to the olfactory dysfunction of the lesions
      in the specific brain regions involved in olfaction compared with the lesions
      scattered all over the rest of the brain has not been fully clarified yet in
      patients with multiple sclerosis (MS). The concurrent use of Magnetic Resonance
      Imaging (MRI) and a standardized test of odor identification ability now permits
      to study the relation between smell loss and the extent of white matter
      abnormalities. METHODS: We tested the olfactory function of 40 patients with
      definite MS and of 40 age-sex- and smoking-habit-matched healthy controls by
      using the Cross Cultural Smell Identification Test. We measured also the lesion
      load on T2-weighted images in the inferior-frontal and temporal lobes and in the
      rest of the brain in MS patients. Therefore, we tried to correlate measures of
      lesion load and smell test scores. RESULTS: A robust correlation was demonstrated
      between MR measures of lesion load in the white matter of the olfactory brain
      region and smell loss (r=-0. 739, P<0.0001). A significant relationship has been
      found even after taking potential confounding factors, such as sex, age, disease
      duration, disability, anxiety and depression, into account (r=-0.90, P<0.0001).
      CONCLUSIONS: Our findings show, in MS patients with stable neurological
      impairment and no recent disease exacerbation, a correlation between smell loss
      and the lesion load in the regions of the brain involved in olfaction and support
      the theory that the extent and severity of MRI abnormalities in specific brain
      regions are related to the presence of selective neurologic and neuropsychologic
      impairment.

PMID- 11212135
TI  - Neuropsychological counseling improves social behavior in cognitively-impaired
      multiple sclerosis patients.
AB  - We studied the effectiveness of a newly-developed cognitive-behavioral
      intervention in 15 patients with marked cognitive impairment and behavior
      disorder. The design was a single-blind test of a neuropsychological
      intervention, with pre- and post-treatment assessments of personality and social
      behavior. MS patients underwent neurological examination and neuropsychological
      testing at baseline. The patients were then randomly assigned to
      neuropsychological counseling or standard, non-specific supportive psychotherapy.
      The active 12-week treatment emphasized enhancement of insight through education,
      social skills training, and behavior modification. All patients were re-examined
      within 2 weeks of the termination of treatment. Neuropsychological technicians
      were blind to treatment condition. Both groups showed evidence of cognitive
      impairment and personality/behavior disorder prior to treatment and were well
      matched on demographic, disability, and cognitive measures. Patients who
      underwent neuropsychological counseling showed significant positive response on
      measures of social behavior (e.g. excessive ego-centric speech) compared to those
      who underwent standard counseling. We conclude that these data support the use of
      non-pharmacological, neuropsychological counseling in patients with acquired, MS
      associated behavior disorder.

PMID- 11212136
TI  - Personality as a predictor of coping efforts in patients with multiple sclerosis.
AB  - The aim of the study was to explore personality traits as predictors of coping
      with disease-related distress in patients with multiple sclerosis (MS). All
      patients with clinically definite MS in a city with a population of approximately
      100000 were asked to complete the NEO Personality Inventory and a
      multidimensional coping inventory (COPE). There was an 83% response rate yielding
      49 patients for the study population and 49 controls, matched for age, gender and
      educational level to the MS-patients, were used as comparison. Only Neuroticism
      correlated significantly with emotion-focused coping in both groups. Extraversion
      and Openness to Experience were linked to task-oriented coping strategies in
      normal controls but not in the MS-group. Agreeableness was associated with
      avoidance-oriented coping strategies only in the MS-group. Thus, the relation of
      certain personality characteristics to the choice of strategies for coping with
      the disease-related distress appear to differ from coping with stressful problems
      in everyday life. As dispositional characteristics may interfere with adaptive
      coping responses, analysis of personality traits and coping strategies could
      contribute while attempting to relieve the consequences of chronic disease on
      everyday life.

PMID- 11212137
TI  - Neurological worsening due to infection from renal stones in a multiple sclerosis
      patient.
AB  - Symptomatic bladder dysfunction occurs in the majority of patients with multiple
      sclerosis (MS). Although guidelines have been established for diagnosis and
      management of bladder dysfunction in these patients, they are sometimes
      overlooked in the primary care setting, leading to severe, life threatening
      complications. A 64-year-old male with a 31-year history of spastic quadriparetic
      MS and neurogenic bladder dysfunction managed with an indwelling catheter,
      presented to the hospital with worsening neurological function. He had developed
      increased weakness and cognitive impairment several weeks after being treated for
      a urinary tract infection (UTI). He had become unable to perform any activities
      of daily living or drive his power wheelchair. After an extensive work-up, he was
      found to have a large (14 x 18 x 30 cm) retroperitoneal abscess and multiple
      renal stones, including a large obstructing calculus in the collecting system
      near the ureteropelvic junction, and he underwent nephrectomy and abscess
      drainage. Of note, he had been found to have multiple renal stones and
      hydronephrosis on renal ultrasound 3 years earlier, but he had received no
      treatment. Following drainage of the abscess, his upper extremity neurological
      function returned to baseline, his cognitive status improved, and he regained the
      ability to perform activities of daily living. Patients with paralysis from MS,
      much like those with traumatic spinal cord injuries, are at grave risk of
      mortality and morbidity from undiagnosed and under-treated urinary complications.
      This case demonstrates that evaluation and appropriate treatment for
      complications of neurogenic bladder should be part of routine care for patients
      with MS. Current recommendations for evaluation and management of bladder
      dysfunction in patients with MS will be reviewed.

PMID- 11212139
TI  - Establishment of two new Orthopteran cell lines.

PMID- 11212138
TI  - A novel in vitro model of tumor angiogenesis.

PMID- 11212140
TI  - Symmetry breaking in cultured mammalian cells.

PMID- 11212141
TI  - Establishment of a human hepatoma cell line, HLE/2E1, suitable for detection of
      p450 2E1-related cytotoxicity.
AB  - By transfection of an expression vector of human cytochrome P450 2E1 (CYP2E1)
      into a human hepatoma cell line (HLE), a new cell line (HLE/2E1) that stably
      expresses activity of CYP2E1 has been established. The HLE/2E1 cell line
      expressed a higher level of CYP2E1 messenger ribonucleic acid than did the mother
      HLE cell line. CYP2E1 enzyme activity determined by a p-nitrophenol oxidation
      assay was also higher in HLE/2E1 cells than in HLE cells. In addition, the enzyme
      activity of the HLE/2E1 cells was increased by ethanol treatment. Exposure to
      acetaminophen (APAP) or buthionine sulfoximine (BSO) caused a greater decrease in
      viability of the HLE/2E1 cells than that of the HLE cells, as determined by the 3
      [4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. The
      cytotoxicity of APAP or BSO to HLE/2EI cells was inhibited by the addition of
      ethanol or vitamin E. However, the cytotoxicity of both APAP and BSO was enhanced
      by 24-h preincubation of HLE/2E1 cells with ethanol. These results show that this
      cell line provides a useful model for studying catalytic properties of CYP2E1 and
      cytotoxic mechanisms of chemicals metabolized by CYP2E1.

PMID- 11212142
TI  - Novel cell culture medium for use in oxidation experiments provides insights into
      mechanisms of endothelial cell-mediated oxidation of LDL.
AB  - Though one prominent theory of atherogenesis involves free-radical oxidation of
      low-density lipoprotein (LDL) within the vessel wall by one of the vascular cell
      types, the mechanism for cell-mediated LDL oxidation remains unclear[sn1]. In
      these studies we examined the effects of media phenols, thiols, and metals on
      endothelial cell-mediated oxidation. We found that cell culture media such as
      Dulbecco modified Eagle medium and minimal essential medium are unable to support
      cell-mediated oxidation of LDL because they contain high concentrations of phenol
      red (PR) and tyrosine, both of which strongly inhibit cell-mediated oxidation.
      Ham's F-10, a commonly used medium for cell-mediated oxidation experiments, is
      also not entirely appropriate, as it contains both PR and cysteine. Cysteine is
      not critical for endothelial cell-mediated oxidation, but does increase oxidation
      of LDL in the absence of cells. Finally, of utmost importance to cell-mediated
      oxidation was the presence of either micromolar concentrations of Fe(II) or
      physiological concentrations of holo-ceruloplasmin, the protein which carries
      copper in plasma. An appropriate culture medium for use in cell-mediated
      oxidation experiments should thus contain either micromolar concentrations of
      Fe(II) or physiological concentrations of holo-ceruloplasmin, and should be
      prepared without PR, cysteine, or large concentrations of tyrosine, all of which
      are shown here to inhibit endothelial cell-mediated LDL oxidation. These results
      are consistent with a mechanism of cell-mediated oxidation involving Fenton-type
      chemistry and redox cycling of the metal.

PMID- 11212144
TI  - Roles of beta-catenin in somitogenesis in rat embryos.
AB  - We studied the roles of beta-catenin in somitogenesis using immunostaining and
      antisense experiments in rat embryos. High levels of beta-catenin appeared
      transiently in the developing rat somites. Initially, beta-catenin accumulation
      was observed in the core cells of presomitic cell aggregates and then in the
      lumen of epithelial vesicles. Subsequently, it was confined to the dermomyotomes
      and their lumen and then the myotomes. High levels of cyclin D1 were observed in
      the core cells, in the lumen of epithelial vesicles, in myotomes, and in
      mesenchymal sclerotomes. When embryos were cultured in medium supplemented with
      beta-catenin antisense oligodeoxynucleotide (ODN), the accumulation of beta
      catenin, but not of cyclin D1, in the nascent somites and dermomyotomes was
      suppressed, while the number of somites was the same as that observed in control
      embryos. The number of myosin-positive somites and the amount of myosin per
      somite in embryos treated with the antisense ODN were lower than those in
      controls. These results suggested that beta-catenin promotes development of
      myotomal cells during somitogenesis. The function of beta-catenin in the
      development of myotomes may not be correlated to cyclin D1.

PMID- 11212143
TI  - Mammary fibroblasts stimulate growth, alveolar morphogenesis, and functional
      differentiation of normal rat mammary epithelial cells.
AB  - Stromal-epithelial interactions play a profound role in regulating normal and
      tumor development in the mammary gland. The molecular details of these events,
      however, are incompletely understood. A novel serum-free transwell coculture
      system was developed to study the natural paracrine interactions between mammary
      epithelial cells (MEC) and mammary fibroblasts (MFC) isolated from normal rats
      during puberty. The MEC were cultured within a reconstituted basement membrane
      (RBM) in transwell inserts with or without MFC in the lower well. The presence of
      MFC stimulated epithelial cell growth, induced alveolar morphogenesis, and
      enhanced casein accumulation, a marker of the functional differentiation of MEC,
      but did not induce ductal morphogenesis. Potent mitogenic, morphogenic, and
      lactogenic effects were observed when the MFC were cultured either on plastic or
      within a layer of RBM. Although most MFC maintained on plastic died after 1 wk in
      serum-free medium, fibroblast survival was enhanced significantly when the MFC
      were cultured within the RBM. Taken together, this in vitro model effectively
      reconstitutes a physiologically relevant three-dimensional microenvironment for
      MEC and MFC, and seems ideal for studying the locally derived factors that
      regulate the developmental fate of the epithelial and fibroblast compartments of
      the mammary gland.

PMID- 11212145
TI  - Effects of collagen gel configuration on behavior of vascular smooth muscle cells
      in vitro: association with vascular morphogenesis.
AB  - The growth, behavior, and contractile protein expression of rabbit aortic smooth
      muscle cells (SMC) grown on, between layers, or within a collagen gel was
      investigated by confocal laser scanning fluorescence microscopy and Western
      analysis. SMC grown on collagen gel behaved similarly to those on conventional
      culture dishes. However, when a second layer of collagen was overlaid, cells
      underwent an elongated quiescent phase before onset of proliferation and a more
      than threefold lower logarithmic growth rate was observed. These cells self
      organized into a network with ring-like structures. With increasing culture time,
      some of the rings developed into funnel-like, incomplete or complete tubular
      structures. If a tubular template preexisted within the gel, the SMC established
      a cylinder-shaped tube with several circularly arranged muscular layers (similar
      to an artery wall). This behavior mimicked endothelial cells during angiogenesis
      in vitro. A similar phenomenon occurred in cultures in which SMC were randomly
      mixed in a collagen gel, but here their behavior and morphology varied with their
      position within the gel. Western blot analysis showed that the SMC
      differentiation marker, smooth muscle myosin heavy chain-2 (SM-2), rapidly
      decreased, disappearing by day 10 in SMC grown on collagen, but was still
      detectable until day 25 in cells cultured between or within the same gel. These
      findings indicate that like endothelial cells, vascular SMC can display blood
      vessel formation behavior in vitro when an appropriate three-dimensional matrix
      environment is provided to keep them in a relatively higher-differentiated and
      low-proliferative state.

PMID- 11212146
TI  - Comparative in vitro cytotoxicity of ethyl acrylate and tripropylene glycol
      diacrylate to normal human skin and lung cells.
AB  - The potential for occupational exposure to the esters of acrylic acid (acrylates)
      is considerable, and, thus, requires a greater understanding of the their
      toxicity. Confluent (70-90%) cultures of normal human epidermal keratinocytes
      (NHEK), dermal fibroblasts (NHDF). or bronchial epithelium (NHBE) were exposed to
      the monofunctional ethyl acrylate (EA), the multifunctional tripropylene glycol
      diacrylate (TPGDA), or TPGDA monomer in a radiation curable lacquer (Lacquer A)
      at equimolar dosages in order to determine human in vitro cytotoxicity. Viability
      of the cells after 2-24-h exposure to the representative monofunctional or
      multifunctional acrylate or solvent control was used to calculate an index of
      acute cytotoxicity (50% inhibitory dose; ID50) and to determine the shape of the
      dose-response curves. TPGDA, Lacquer A, and EA were equally cytotoxic (ID50 is
      approximately equal to 0.1 micromol/cm2) to NHEK at equimolar doses. TPGDA or
      Lacquer A were more cytotoxic (is approximately equal to 100X) to NHDF or NHBE
      than EA. Sequential exposure of UV(A) and TPGDA to NHEK indicate the potential
      for a synergistic cytotoxic response. These findings are consistent with observed
      decreases in free sulfhydryl groups (e.g., glutathione or cysteine) that parallel
      the dose-response-related decreases in viability. logether, these data suggest
      possible differences in toxicity between the monofunctional EA and
      multifunctional TPGDA to NHEK, NHDF. or NHBE, possibly due to the difference in
      the number of functional acrylate groups and/or physicochemical differences
      (e.g., vapor pressure) between the acrylates investigated.

PMID- 11212147
TI  - Comparison of differentiated dendritic cell infiltration of autoimmune and
      osteoarthritis synovial tissue.
AB  - OBJECTIVE: Infiltration of rheumatoid arthritis (RA) synovial tissue (ST) by
      differentiated dendritic cells (DC) is a consistent feature in patients with
      active disease. However, mononuclear cells (MNC), including DC, may be
      nonspecifically chemoattracted to inflammatory sites regardless of etiology.
      Therefore, to evaluate the specificity of ST infiltration by differentiated DC,
      synovial biopsies from patients with RA, spondylarthropathy (SpA), osteoarthritis
      (OA), and gout were examined. METHODS: Formalin-fixed ST sections were analyzed
      by double immunohistochemical staining for vascularity and infiltration by
      differentiated DC, lymphocytes, and macrophages. RESULTS: DC containing nuclear
      RelB were found in perivascular MNC aggregates from patients with all arthritides
      studied. Infiltration by differentiated DC was similar in RA and SpA ST, but
      reduced in OA ST. Differentiated DC were always observed in close association
      with lymphocytes, and the correlation between these variables suggested that the
      infiltration of inflammatory sites by DC and lymphocytes was associated.
      CONCLUSION: Perivascular infiltration by DC, lymphocytes, and macrophages is
      nonspecifically related to inflammation, but signals present in RA and SpA ST
      lead to more intense cellular infiltration and accumulation.

PMID- 11212149
TI  - Early degradation of type IX and type II collagen with the onset of experimental
      inflammatory arthritis.
AB  - OBJECTIVE: To determine whether following the onset of intraarticular
      inflammation, there is early damage to articular cartilage, specifically to types
      II and IX collagen, and the proteoglycan (PG) aggrecan, and whether measurement
      of the degradation products of these molecules in synovial fluid (SF) and serum
      may permit the detection of cartilage damage. METHODS: A rabbit model of
      rheumatoid arthritis, antigen (ovalbumin)-induced arthritis, was studied.
      Articular cartilage samples were analyzed by immunoassays for total type II
      collagen content, its denaturation and cleavage by collagenases, and for type IX
      collagen content. PG content was determined by colorimetric assay. In serum and
      SF, total PG content and collagenase-generated peptides of type II collagen were
      measured. RESULTS: After 6 days, both the PG content and the NC4 domain of type
      IX collagen were reduced in femoral and tibial cartilage, concomitant with the
      onset of arthritis. In only the tibial cartilage did this reduction in PG persist
      up to day 20. However, denatured type II collagen was increased in all cartilage
      samples, but only on day 20. In SF, the PG content was significantly reduced on
      day 20, and products of type II collagen cleavage by collagenase were
      significantly increased on both day 6 and day 20. CONCLUSION: This study, which
      is the first of its kind examining changes in both types II and IX collagen and
      PG content, reveals early damage to both types of collagen as well as to PG in
      articular cartilage samples following induction of joint inflammation. SF
      analyses reveal this early damage and may be of value in the study and treatment
      of inflammatory arthritic diseases such as rheumatoid arthritis.

PMID- 11212148
TI  - Dependence of interleukin-1-induced arthritis on granulocyte-macrophage colony
      stimulating factor.
AB  - OBJECTIVE: To determine whether granulocyte-macrophage colony-stimulating factor
      (GM-CSF) and macrophage CSF (M-CSF or CSF-1) are involved in the methylated
      bovine serum albumin/interleukin-1 (mBSA/IL-1)-induced arthritis model. METHODS:
      Following systemic injection, IL-1 has been shown to augment a weak inflammatory
      response to mBSA in murine joints and to induce an acute erosive arthritis. GM
      CSF and M-CSF have been implicated in inflammatory reactions, including those in
      joints, and have recently been shown to exacerbate murine arthritis. Since in
      vitro studies have found that IL-1 can enhance GM-CSF and M-CSF production, we
      reasoned that they might be playing a part in IL-1-mediated arthritis. GM-CSF
      deficient (GM-CSF-/-) and M-CSF-deficient (op/op) mice were injected
      intraarticularly with mBSA and subcutaneously with IL-1. Arthritis was monitored
      histologically on day 7. Normal mice were also treated intraperitoneally with
      blocking monoclonal antibodies to GM-CSF and M-CSF, and to the M-CSF receptor.
      Numbers of macrophages (Mac-2 and F4/80 staining) were monitored, as was the
      number of cycling (bromodeoxyuridine-positive) cells. RESULTS: GM-CSF-/- mice and
      normal mice treated with anti-GM-CSF antibody did not show IL-1-induced arthritis
      progression. There was a dramatic reduction in synovial cellularity, including
      reduced numbers of macrophages and cycling cells. The op/op mice did not develop
      mBSA/IL-1-induced disease, but blocking antibody to M-CSF or to the M-CSF
      receptor failed to diminish disease in normal mice. CONCLUSION: GM-CSF is
      involved in the IL-1-induced arthritis that follows mBSA injection; M-CSF
      involvement in the model is also suggested, since op/op mice did not develop
      arthritis. These studies provide the first in vivo evidence for a role of GM-CSF,
      and possibly M-CSF, in the proinflammatory actions of IL-1.

PMID- 11212150
TI  - Disease-modifying activity of SB 273005, an orally active, nonpeptide alphavbeta3
      (vitronectin receptor) antagonist, in rat adjuvant-induced arthritis.
AB  - OBJECTIVE: To evaluate the effects of SB 273005, a potent, orally active
      nonpeptide antagonist of the integrin avbeta3 vitronectin receptor, on joint
      integrity in rats with adjuvant-induced arthritis (AIA). METHODS: Male Lewis rats
      with AIA were orally dosed either prophylactically (days 0-20) or therapeutically
      (days 10-20) with SB 273005. Efficacy was determined by measurement of paw
      inflammation, assessment of bone mineral density using dual-energy x-ray
      absorptiometry (DEXA), magnetic resonance imaging (MRI), and histologic
      evaluation. RESULTS: SB 273005 is a potent antagonist of the closely related
      integrins, avbeta3 (Ki = 1.2 nM) and alphavbeta5 (Ki = 0.3 nM). When SB 273005
      was administered prophylactically to AIA rats twice per day, it inhibited paw
      edema at doses of 10, 30, and 60 mg/kg, by 40%, 50%, and 52%, respectively.
      Therapeutic administration twice daily was also effective, and a reduction in paw
      edema was observed at 30 mg/kg and 60 mg/kg of the antagonist (by 36% and 48%,
      respectively). SB 273005 was also effective when administered once per day, both
      prophylactically and therapeutically. Significant improvement in joint integrity
      in treated rats was shown using DEXA and MRI analyses. These findings were
      confirmed histologically, and significant protection of bone, cartilage, and soft
      tissue was observed within the joint. CONCLUSION: Symptoms of AIA in rats were
      significantly reduced by either prophylactic or therapeutic treatment with the
      alphavbeta3 antagonist, SB 273005. Measurements of paw inflammation and of bone,
      cartilage, and soft tissue structure indicated that this compound exerts a
      protective effect on joint integrity and thus appears to have disease-modifying
      properties.

PMID- 11212151
TI  - CD4+,CD28- T cells in rheumatoid arthritis patients combine features of the
      innate and adaptive immune systems.
AB  - OBJECTIVE: To determine whether CD4+,CD28- T cells, which are expanded in
      patients with rheumatoid arthritis (RA), express receptors that typically
      regulate the function of natural killer (NK) cells. METHODS: Expression of the NK
      cell surface molecules CD158, p70, CD94, CD161, and CD8alpha on T cell subsets
      was determined by multicolor flow cytometric analysis of peripheral blood
      mononuclear cells from 36 RA patients. Expression of CD161 on tissue-infiltrating
      CD4 T cells was determined by 2-color immunohistochemistry analysis of synovial
      tissue samples. RESULTS: Killer cell-inhibitory receptors (KIR) and killer cell
      activating receptors (KAR) were exclusively expressed on CD4+,CD28- T cells, with
      the CD158b molecule being the most frequently detected isoform. A coordinated
      mechanism inducing KIR/KAR expression was suggested by similarities in the
      expression of CD158b on CD4 and CD8 T cells. CD4+,CD28- T cells were also
      positive for CD8-alphaalpha homodimers, another characteristic shared with NK
      cells. Of the C-type lectin NK cell receptors (NK receptors), CD94 was
      consistently absent, but CD161 was found on a CD4 T cell population that is
      significantly expanded in RA patients (P = 0.01). Involvement in disease of NK
      receptor-expressing CD4 T cells was suggested by the presence of CD4+,CD161+ T
      cells in follicular microstructures typical of rheumatoid synovitis. CONCLUSION:
      Patients with RA have an expanded and unusual subset of CD4 T cells that
      infiltrates the tissue lesions and is characterized by a deficiency of CD28, the
      expression of CD8-alphaalpha homodimers, and the expression of several types of
      HLA class I-recognizing NK receptors. CD4 T cells bearing NK receptors can bridge
      functions of the innate and adaptive immune systems, such as responsiveness to
      specific antigen, rapid release of interferon-gamma, cytotoxicity, independence
      from classic costimulatory pathways, and integration of multiple activating and
      inhibitory signals to control effector functions.

PMID- 11212152
TI  - Induction of endothelial cell decay-accelerating factor by vascular endothelial
      growth factor: a mechanism for cytoprotection against complement-mediated injury
      during inflammatory angiogenesis.
AB  - OBJECTIVE: Decay-accelerating factor (DAF) is a widely expressed, multifunctional
      cell surface protein involved in complement regulation and cell signaling.
      Previous studies have demonstrated that endothelial cell (EC) DAF is up-regulated
      by tumor necrosis factor alpha and inhibits complement binding. Because vascular
      endothelial growth factor (VEGF) is cytoprotective to endothelium and is
      expressed at sites of chronic inflammation, we hypothesized that VEGF may induce
      DAF expression during inflammatory angiogenesis. METHODS: Human umbilical vein
      and dermal microvascular EC were isolated using routine procedures, and the
      regulation and function of DAF, as well as other complement-regulatory proteins
      (membrane cofactor protein and CD59), were analyzed following stimulation with
      VEGF. RESULTS: Incubation of large- or small-vessel EC with VEGF led to increased
      expression of DAF, with maximal expression after 48-72 hours of stimulation. This
      effect depended on the activation of protein kinase C (PKC) and required
      increased steady-state messenger RNA levels and de novo protein synthesis.
      Although VEGF-induced EC proliferation was inhibited by both p38 and p42/44
      mitogen-activated protein kinase (MAPK) antagonists, DAF up-regulation in
      response to VEGF was only sensitive to inhibition of p38 MAPK. VEGF-stimulated EC
      showed a 60% reduction in C3 deposition following complement activation, and this
      resulted in a marked reduction in complement-mediated EC lysis. These protective
      effects were abolished by anti-DAF monoclonal antibody 1H4. CONCLUSION: This
      study confirms the importance of PKC for the regulation of DAF expression by EC
      and reveals VEGF to be a physiologic agonist for this pathway. The up-regulation
      of DAF expression by VEGF may represent an important mechanism for the protection
      of EC from complement-mediated injury during angiogenesis in inflammatory
      rheumatic diseases.

PMID- 11212154
TI  - The MICA region determines the first modifier locus in familial Mediterranean
      fever.
AB  - OBJECTIVE: Familial Mediterranean fever (FMF) is a genetically recessive
      inflammatory disease caused by mutations in the MEFV gene. Most patients of non
      Ashkenazi Jewish ancestry or those who are homozygous for M694V manifest a severe
      disease course, but some express a mild form of the disease. We therefore
      searched for other genes which could possibly be implicated in the disease
      phenotype. We tested MICA (major histocompatibility complex class I chain-related
      gene A) because it has been associated with a number of other inflammatory
      disorders. METHODS: One hundred fifty FMF probands and their family members were
      evaluated. The MEFV gene was screened by a combination of denaturing gradient-gel
      electrophoresis, restriction fragment length polymorphism, and amplification
      refractory mutation system. The MICA transmembrane polymorphism in exon 5 was
      analyzed after biotin-labeled polymerase chain reaction products were loaded onto
      sequencing gels and subjected to autoradiography. RESULTS: The contribution of
      MICA to the FMF phenotype was confirmed after adjustment for the patient's
      ancestry and for the MEFV genotype. MEFV was individually the most important
      prognostic factor for the disease. However, the impact of M694V homozygosity on
      the age at disease onset (OR 2.3) was aggravated if patients also inherited MICA
      A9 (OR 6.3). In contrast, the frequency of attacks was found to be dramatically
      reduced (OR 0.16) in patients with MICA-A4. CONCLUSION: We have identified the
      first FMF modifier locus, MICA. FMF is the first model of a Mendelian disease
      associated with MICA. These results clarify, at least partly, the inconsistent
      phenotype-MEFV correlation in FMF.

PMID- 11212153
TI  - Insights from a novel three-dimensional in vitro model of lyme arthritis:
      standardized analysis of cellular and molecular interactions between Borrelia
      burgdorferi and synovial explants and fibroblasts.
AB  - OBJECTIVE: To develop a novel 3-dimensional (3-D) in vitro model of Lyme
      arthritis to use in the study of the interactions between Borrelia burgdorferi
      (Bb) and human synovial host cells with respect to phagocytosis and potential
      persistence of Bb as well as the induction of proinflammatory cytokines and
      chemokines. METHODS: Two distinct culture systems, consisting of synovial
      membrane explants or interactive synovial cells embedded in 3-D fibrin matrices,
      were chosen. Both systems were artificially infected with Bb, and the
      interactions between Bb and synovial tissue/cells were studied by histology,
      immunohistochemistry, and electron microscopy. Functional analyses included the
      induction/secretion of cytokines by Bb in the model system. RESULTS: Both culture
      systems proved to be stable and reproducible. The host cells and spirochetes
      showed high levels of viability and maintained their physiologic shape for >3
      weeks. Bb invaded the synovial tissue and the artifical matrix in a time
      dependent manner. Host cells were activated by Bb, as indicated by the induction
      of interleukin-1beta and tumor necrosis factor alpha. Electron microscopic
      analysis revealed Bb intracellularly within macrophages as well as synovial
      fibroblasts, suggesting that not only professional phagocytes, but also resident
      synovial cells are capable of phagocytosing Bb. Most interestingly, the uptake of
      the spirochetes appeared to cause severe damage of the synovial fibroblasts,
      since the majority of these cells displayed ultrastructural features of
      disintegration. CONCLUSION: A novel 3-D in vitro model has been established that
      allows the study of distinct aspects of Lyme arthritis under conditions that
      resemble the pathologic condition in humans. This reproducible, standardized
      model supplements animal studies and conventional 2-D cultures. The
      disintegration of synovial fibroblasts containing Bb or Bb fragments challenges
      the concept of an intracellular persistence of Bb and may instead reflect a
      mechanism that contributes to the inflammatory processes characteristic of Lyme
      arthritis.

PMID- 11212155
TI  - Clinical Images:Lupus erythematosus cells in the kidney and synovial fluid.

PMID- 11212156
TI  - Treatment of lupus-induced thrombocytopenia with recombinant human interleukin
      11.
AB  - Autoimmune thrombocytopenia can be a serious manifestation of systemic lupus
      erythematosus (SLE) which necessitates treatment with immunosuppressive agents
      and platelet transfusions. Interleukin-11 (IL-11) is a unique thrombopoietic
      growth factor which causes proliferation of megakaryocyte progenitors as well as
      induces megakaryocytic maturation. To our knowledge, this agent has not been used
      in the treatment of autoimmune thrombocytopenia, since theoretically there is a
      danger of IL-11 stimulating the immune system by up-regulating the lymphoid stem
      cells. We describe a 36-year-old splenectomized woman with known SLE who
      presented with pulmonary hemorrhage, acute renal failure, change in mental
      status, and severe thrombocytopenia (platelet count 2,000/mm3). Her pulmonary,
      renal, and central nervous system complications responded to intensive therapy
      with intravenous (IV) pulse methylprednisone and cyclophosphamide along with
      hemodialysis. The thrombocytopenia remained refractory to the above treatment
      plus daily multiple platelet transfusions and IV immunoglobulin. Treatment with
      recombinant human IL-11 (25 microg/kg/day subcutaneously) was initiated and
      continued for 5 days. Her platelet count improved to 25,000/mm3 within 48 hours,
      and she experienced no adverse effects.

PMID- 11212157
TI  - Genetic association between interleukin-10 promoter region polymorphisms and
      primary Sjogren's syndrome.
AB  - OBJECTIVE: To determine whether the haplotypes formed on the basis of single-base
      exchange polymorphisms at positions -1082, -819, or -592 of the interleukin-10
      (IL-10) gene predispose subjects to primary Sjogren's syndrome (SS). METHODS: The
      frequency of IL-10 polymorphisms was analyzed in 62 patients with primary SS and
      in 400 healthy subjects. These data were assessed for correlations with the
      concentration of IL-10 in the plasma. RESULTS: The frequency of the IL-10 GCC
      haplotype (G at position -1082, C at position -819, and C at position -592 of the
      IL-10 gene) was increased (P < 0.05, odds ratio [OR] 1.90, 95% confidence
      interval [95% CI] 0.955-3.62) and the frequency of the ACC haplotype decreased (P
      < 0.05, OR 0.443, 95% CI 0.257-0.764) in primary SS patients compared with
      healthy controls. Moreover, the frequency of the ATA haplotype was similar in
      primary SS patients and healthy controls, but the incidence of the GCC/ATA
      genotype was elevated in the primary SS patients (P < 0.05, OR 2.19, 95% CI 1.19
      4.03). The concentration of plasma IL-10 was significantly higher in patients
      carrying the GCC haplotype than in non-carriers of GCC. CONCLUSION: These results
      suggest that the presence of the GCC haplotype or the GCC/ATA genotype and the
      absence of the ACC haplotype of the IL-10 gene are associated with an increased
      susceptibility to primary SS. This effect is probably mediated by the increased
      capability to produce IL-10 among carriers of the GCC haplotype.

PMID- 11212158
TI  - Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of
      ankylosing spondylitis: a six-week controlled study with comparison against
      placebo and against a conventional nonsteroidal antiinflammatory drug.
AB  - OBJECTIVE: To evaluate the short-term efficacy of celecoxib, a cyclooxygenase 2
      specific inhibitor, in the treatment of ankylosing spondylitis (AS). METHODS: The
      study was a 6-week randomized, double-blind, placebo-controlled trial with 3
      treatment arms: placebo, ketoprofen 100 mg twice daily, and celecoxib 100 mg
      twice daily. Patients who had AS according to the modified New York criteria,
      without peripheral synovitis and with active disease (pain > or =40 mm on a 100
      mm visual analog scale [VAS] and an increase in pain of at least 30% after
      nonsteroidal antiinflammatory drug withdrawal) were eligible for study. Primary
      outcome measures were change in pain intensity (VAS) and change in functional
      impairment (Bath Ankylosing Spondylitis Functional Index [BASFI]). RESULTS: Of
      the 246 randomized patients, 76 were allocated to receive placebo, 90 ketoprofen,
      and 80 celecoxib. There were no statistically significant differences between
      treatment groups at study entry. During the 6 weeks of the study, the decrease in
      pain and functional impairment was greater in the active treatment groups than in
      the placebo group, with a trend in favor of celecoxib when the 2 active
      treatments were compared. The mean changes were -13 mm, -21 mm, and -27 mm (P =
      0.006) for pain and 1, -6, and -12 (P = 0.0008) for BASFI score in the placebo,
      ketoprofen, and celecoxib groups, respectively. During treatment, the number of
      patients reporting epigastric pain was 6 (8%), 13 (14%), and 10 (13%) in the
      placebo, ketoprofen, and celecoxib groups, respectively. CONCLUSION: The results
      of this study confirm the clinically relevant antiinflammatory effect of
      celecoxib at a 200-mg daily dosage, with significant improvement of both pain and
      function in patients with AS.

PMID- 11212159
TI  - Immunomodulatory effects of anti-tumor necrosis factor alpha therapy on synovium
      in spondylarthropathy: histologic findings in eight patients from an open-label
      pilot study.
AB  - OBJECTIVE: To assess the effects of treatment with anti-tumor necrosis factor
      alpha (anti-TNFalpha) on synovial histology in patients with spondylarthropathy
      (SpA) in order to confirm the effect on peripheral synovitis and to investigate
      the immunologic mechanisms involved in anti-TNFalpha therapy. METHODS: Patients
      with treatment-resistant SpA were treated with infliximab (5 mg/kg) at weeks 0,
      2, and 6 in an open-label pilot study. In 8 patients, synovial biopsy tissues
      obtained at baseline, week 2, and week 12 were used for histologic and
      immunohistochemical evaluation. RESULTS: In all 8 patients (3 with ankylosing
      spondylitis, 1 with undifferentiated SpA, and 4 with psoriatic arthritis), there
      was a clear clinical improvement in the peripheral arthritis after anti-TNFalpha
      therapy. Histologic analysis of the synovial biopsy tissues indicated that the
      synovial lining layer thickness tended to decrease, with a significant reduction
      of CD55+ synoviocytes, at week 12. In the sublining layer, vascularity was
      reduced at week 12, with a decreased endothelial expression of vascular cell
      adhesion molecule 1 but not intercellular adhesion molecule 1, platelet
      endothelial cell adhesion molecule 1, and E-selectin. Although at week 2 and week
      12, the number of neutrophils and CD68+ macrophages in the sublining layer was
      decreased, the overall degree of inflammatory infiltration remained unchanged.
      This could be related to the lymphocyte infiltration since at week 12, only CD4+
      cells (but not CD3+, CD45RO+, and CD8+ cells) tended to decrease, while CD20+
      lymphocytes and plasma cells were clearly increased. CONCLUSION: The reduction in
      lining layer thickness, vascularity, and infiltration with neutrophils and
      macrophages paralleled the beneficial effect of anti-TNFalpha therapy on
      peripheral synovitis in 8 patients with different subtypes of SpA. The adhesion
      molecule expression, T cell infiltration, and, most important, B cell
      infiltration seemed to contrast with previous observations in RA. Although these
      preliminary data need to be confirmed in a larger cohort, they suggest distinct
      immunomodulatory mechanisms of anti-TNFalpha in SpA.

PMID- 11212160
TI  - A functional polymorphic variant in the interleukin-6 gene promoter associated
      with low bone resorption in postmenopausal women.
AB  - OBJECTIVE: To examine functional interleukin-6 (IL-6) -174 G-->C allelic variants
      in relation to bone turnover and bone mineral density (BMD) in postmenopausal
      women. METHODS: Four hundred thirty-four healthy women living in the community
      (mean +/- SD age 71.7 +/- 5.7 years) were genotyped for the IL-6 -174 G-->C
      polymorphism. Serum levels of C-telopeptide of type I collagen (CTx), a marker of
      bone resorption, and osteocalcin (OC), a marker of bone formation, were
      determined. BMD at the hip and forearm was measured by dual-energy x-ray
      absorptiometry. RESULTS: CTx levels differed significantly (P = 0.006) among IL-6
      genotypes (mean +/- SEM 0.275 +/- 0.02 ng/ml, 0.325 +/- 0.01 ng/ml, and 0.356 +/-
      0.02 ng/ml in women with the CC genotype [n = 68], the GC genotype [n = 204], and
      the GG genotype [n = 162], respectively). Compared with the GG group, age
      adjusted odds ratios for high bone resorption were 0.65 (95% confidence interval
      [95% CI] 0.41-1.0, P = 0.06) and 0.37 (95% CI 0.18-0.73, P = 0.0047) in GC and CC
      subjects, respectively. In contrast, OC levels did not differ by genotype. BMD at
      the hip and forearm was 1.5-5% higher in CC subjects compared with GG subjects (P
      not significant). When the cohort was divided according to the median age (70.5
      years), BMD was significantly decreased in older compared with younger
      postmenopausal women with the GG and GC genotypes (-9.6% on average; P < 0.01),
      but not in those with the CC genotype (-5.1% on average; P not significant).
      CONCLUSION: Compared with the GC and GG IL-6 -174 G-->C genotypes, the CC
      genotype is associated with lower bone resorption and lesser decrease in bone
      mass in older postmenopausal women. These results suggest that IL-6 -174 G-->C
      alleles may be significant determinants of the risk for osteoporosis in elderly
      subjects.

PMID- 11212161
TI  - Two-year effects of alendronate on bone mineral density and vertebral fracture in
      patients receiving glucocorticoids: a randomized, double-blind, placebo
      controlled extension trial.
AB  - OBJECTIVE: To evaluate the continued efficacy and safety of alendronate (ALN) for
      up to 2 years in patients receiving glucocorticoids. METHODS: This is a 12-month
      extension of a previously completed 1-year trial of daily ALN, performed to
      evaluate the effects of ALN over a total of 2 years in 66 men and 142 women
      continuing to receive at least 7.5 mg of prednisone or equivalent daily. All
      patients received supplemental calcium and vitamin D. The primary end point was
      the mean percentage change in lumbar spine bone mineral density (BMD) from
      baseline to 24 months. Other outcomes included changes in hip and total body BMD,
      biochemical markers of bone turnover, radiographic joint damage of the hands, and
      vertebral fracture incidence. RESULTS: The mean (+/-SEM) lumbar spine BMD
      increased by 2.8 +/- 0.6%, 3.9 +/- 0.7%, and 3.7 +/- 0.6%, respectively, in the
      groups that received 5 mg, 10 mg, and 2.5/10 mg of ALN daily (P < or = 0.001) and
      decreased by -0.8 +/- 0.6% in the placebo group (P not significant) over 24
      months. In patients receiving any dose of ALN, BMD was increased at the
      trochanter (P < or = 0.05) and maintained at the femoral neck. Total body BMD was
      increased in patients receiving 5 or 10 mg ALN (P < or = 0.01). These 2 dose
      levels of ALN were more effective than placebo at all sites (P < or = 0.05). Bone
      turnover markers (N-telopeptides of type I collagen and bone-specific alkaline
      phosphatase) decreased 60% and 25%, respectively, during treatment with ALN (P <
      or = 0.05). There were fewer patients with new vertebral fractures in the ALN
      group versus the placebo group (0.7% versus 6.8%; P = 0.026). The safety profile
      was similar between treatment groups. CONCLUSION: Alendronate is an effective,
      well-tolerated therapy for the prevention and treatment of glucocorticoid-induced
      osteoporosis, with sustained treatment advantages for up to 2 years.

PMID- 11212162
TI  - Rheumatoid arthritis synovial macrophages express the Fas-associated death domain
      like interleukin-1beta-converting enzyme-inhibitory protein and are refractory to
      Fas-mediated apoptosis.
AB  - OBJECTIVE: The chronic inflammation and progressive joint destruction observed in
      rheumatoid arthritis (RA) are mediated in part by macrophages. A paucity of
      apoptosis has been observed in RA synovial tissues, yet the mechanism remains
      unknown. The present study sought to characterize the expression of Fas, Fas
      ligand (FasL), and Fas-associated death domain-like interleukin-1beta-converting
      enzyme-inhibitory protein (FLIP), and to quantify the apoptosis induced by
      agonistic anti-Fas antibody, using mononuclear cells (MNC) isolated from the
      peripheral blood (PB) and synovial fluid (SF) of RA patients. METHODS: The
      expression of Fas, FasL, and FLIP and apoptosis induced by agonistic anti-Fas
      antibody in MNC from the PB and SF of RA patients were determined by flow
      cytometry. Immunohistochemistry employing a monospecific anti-FLIP antibody was
      performed on RA and osteoarthritis (OA) synovial tissue. RESULTS: CD14-positive
      monocyte/macrophages from normal and RA PB and from RA SF expressed equivalent
      levels of Fas and FasL. Furthermore, unlike the CD14-positive PB monocytes, RA SF
      monocyte/macrophages were resistant to the addition of agonistic anti-Fas
      antibody. In contrast, both CD14-positive PB and SF monocyte/macrophages were
      sensitive to apoptosis mediated by a phosphatidylinositol 3-kinase inhibitor.
      Intracellular staining of the caspase 8 inhibitor, FLIP, in CD14-positive SF
      monocyte/macrophages revealed a significant up-regulation of FLIP compared with
      normal and RA PB monocytes. Immunohistochemical analysis of synovial tissue from
      RA and OA patients revealed increased FLIP expression in the RA synovial lining
      compared with the OA synovial lining. Furthermore, FLIP expression was observed
      in the CD68positive population in the RA synovial lining. Forced reduction of
      FLIP by a chemical inhibitor resulted in RA SF macrophage apoptosis that was
      enhanced by agonistic anti-Fas antibody, indicating that FLIP is necessary for SF
      macrophage survival. CONCLUSION: These data suggest that up-regulation of FLIP in
      RA macrophages may account for their persistence in the disease. Thus, the
      targeted suppression of FLIP may be a potential therapeutic strategy for the
      amelioration of RA.

PMID- 11212163
TI  - Arthritis prevalence and activity limitations in older adults.
AB  - OBJECTIVE: To evaluate the prevalence of arthritis and activity limitations among
      older Americans by assessing their demographic, ethnic, and economic
      characteristics. METHODS: Data from the Asset and Health Dynamic Survey Among the
      Oldest Old (AHEAD), a national probability sample of community-dwelling adults
      born before 1924, were analyzed cross-sectionally. Arthritis that resulted in a
      physician's visit or a joint replacement not associated with a hip fracture was
      ascertained by self-report. RESULTS: The prevalence of arthritis in older adults
      ranged from 25% in non-Hispanic whites to 40% in non-Hispanic blacks to 44% in
      Hispanics. A higher prevalence of arthritis was associated with less education as
      well as lower income and less wealth. The prevalence of limitations in activities
      of daily living (ADL) among non-Hispanic white, non-Hispanic black, and Hispanic
      adults who reported arthritis only was 29%, 30%, and 37%, respectively, and
      increased to 48%, 57%, and 56%, respectively, among those reporting arthritis
      plus other chronic conditions, after adjustment for age and sex. CONCLUSION: Non
      Hispanic black and Hispanic older adults reported having arthritis at a
      substantially higher frequency than did non-Hispanic whites. In addition,
      Hispanics reported higher rates of ADL limitations than did non-Hispanic whites
      with comparable disease burden. Further study is needed to confirm and elucidate
      the reasons for these racial and economic disparities in older populations.

PMID- 11212164
TI  - Alpha sleep characteristics in fibromyalgia.
AB  - OBJECTIVE: To characterize the patterns of alpha electroencephalographic sleep
      and their associations with pain and sleep in patients with fibromyalgia.
      METHODS: Pain and sleep symptoms of 40 female patients with fibromyalgia and 43
      healthy control subjects were studied before and after overnight polysomnography.
      Blinded analyses of alpha activity in non-rapid eye movement (non-REM) sleep were
      performed using time domain, frequency domain, and visual analysis techniques.
      RESULTS: Three distinct patterns of alpha sleep activity were detected in
      fibromyalgia: phasic alpha (simultaneous with delta activity) in 50% of patients,
      tonic alpha (continuous throughout non-REM sleep) in 20% of patients, and low
      alpha activity in the remaining 30% of patients. Low alpha activity was exhibited
      by 83.7% of control subjects (P < 0.01). All fibromyalgia patients who displayed
      phasic alpha sleep, activity reported worsening of pain after sleep, compared
      with 58.3% of patients with low alpha activity (P < 0.01) and 25.0% of patients
      with tonic alpha activity (P < 0.01). Postsleep increase in the number of tender
      points occurred in 90.0% of patients with phasic alpha activity, 41.7% of
      patients with low alpha activity, and 25.0% of patients with tonic alpha activity
      (P < 0.01). Self ratings of poor sleep were reported by all patients with phasic
      alpha activity, 58.3% of patients with low alpha activity (P < 0.01), and 12.5%
      of patients with tonic alpha activity (P < 0.01). Patients with phasic alpha
      activity reported longer duration of pain than patients in other subgroups (P <
      0.01). Additionally, patients with phasic alpha sleep activity exhibited less
      total sleep time than patients in other subgroups (P < 0.05), as well as lower
      sleep efficiency (P < 0.05) and less slow wave sleep (P < 0.05) than patients
      with a tonic alpha sleep pattern. CONCLUSION: Alpha intrusion during sleep can be
      of different patterns. Phasic alpha sleep activity was the pattern that
      correlated better with clinical manifestations of fibromyalgia.

PMID- 11212165
TI  - Efficacy and safety of desensitization to allopurinol following cutaneous
      reactions.
AB  - OBJECTIVE: To evaluate the long-term efficacy and safety of slow oral
      desensitization in the management of patients with hyperuricemia and allopurinol
      induced maculopapular eruptions. METHODS: A retrospective evaluation of an oral
      desensitization regimen using gradual dosage-escalation of allopurinol in 32
      patients (30 with gout and 2 with chronic lymphocytic leukemia) whose therapy was
      interrupted because of a pruritic cutaneous reaction to the drug. RESULTS: Twenty
      one men and 11 women with a mean age of 63 years (range 17-83 years), a mean
      serum urate level of 618 micromoles/liter (range 495-750) (or, mean 10.4 mg/dl
      [range 8.3-12.6]), and a mean serum creatinine level of 249 micromoles/liter
      (range 75-753) (or, mean 2.8 mg/dl [range 0.8-8.5]) were studied. Desensitization
      failed in 4 patients because of unmanageable recurrent rash. Twenty-eight
      patients completed the desensitization procedure to a target allopurinol dosage
      of 50-100 mg/day, 21 without deviation from the protocol for a mean of 30.5 days
      (range 21-56 days) and 7 requiring dosage adjustments because of a recurrent rash
      over 53.8 days (range 40-189 days). Seven of these 28 patients developed late
      cutaneous reactions 1-20 months postdesensitization, 4 responding to dosage
      modification and 3 discontinuing the drug. Twenty-five of the 32 patients (78%)
      continued to take allopurinol; their mean duration of followup was 32.6 months
      (range 3-92 months) and the mean postdesensitization serum urate level was 318
      micromoles/liter (range 187-452) (or, mean 5.3 mg/dl [range 3.0-7.5]).
      CONCLUSION: The study confirms the long-term efficacy and safety of slow oral
      desensitization to allopurinol in patients with maculopapular eruptions,
      particularly in those with gout, who cannot be treated with uricosurics or other
      urate-lowering drugs. Although pruritic skin eruptions may recur both during and
      after desensitization, most of these cutaneous reactions can be managed by
      temporary withdrawal of allopurinol and dosage adjustment.

PMID- 11212166
TI  - Evidence for linkage of the HLA-B locus in Behcet's disease, obtained using the
      transmission disequilibrium test.

PMID- 11212167
TI  - Beneficial effect of etanercept on rheumatoid lymphedema.

PMID- 11212168
TI  - Clinical images: Cervical spinal cord compression.

PMID- 11212169
TI  - Increase in the heart rate-corrected QT interval in children of anti-Ro-positive
      mothers, with a further increase in those with siblings with congenital heart
      block: comment on the article by Cimaz et al.

PMID- 11212170
TI  - Shrinking lung syndrome in patients without systemic lupus erythematosus: comment
      on the concise communication by Tavoni et al.

PMID- 11212171
TI  - Similar effects of pulse corticosteroid and tumor necrosis factor alpha blockade
      in rheumatoid arthritis: comment on the article by Taylor et al.

PMID- 11212172
TI  - Synergistic activity of interleukin-4 and interleukin-10 in suppression of
      inflammation and joint destruction in rheumatoid arthritis.

PMID- 11212173
TI  - Regulation of angiogenesis by the C-X-C chemokines interleukin-8 and epithelial
      neutrophil activating peptide 78 in the rheumatoid joint.
AB  - OBJECTIVE: Angiogenesis, the growth of new blood vessels, is vital to the ingress
      of inflammatory leukocytes in rheumatoid arthritis (RA) synovial tissue and to
      the growth and proliferation of RA pannus. The factors that mediate the growth of
      new blood vessels have not been completely defined. This study examined the
      ability of Glu-Leu-Arg (ELR)-containing chemokines to induce angiogenesis in the
      RA joint. METHODS: To reflect angiogenic activity in vivo, we selected a model
      using whole human synovial tissue rather than isolated cells. Tissues were
      examined by immunohistochemistry and enzyme-linked immunosorbent assay, and
      tissue homogenates were immunoneutralized and assayed for their ability to induce
      endothelial cell chemotaxis and rat corneal neovascularization. RESULTS: Cells
      expressing interleukin-8 (IL-8) and epithelial neutrophil activating peptide 78
      (ENA-78) were located in proximity to factor VIII-related antigen-immunopositive
      endothelial cells. RA homogenates produced more IL-8 and ENA-78 compared with
      normal synovial tissue homogenates. Moreover, homogenates from RA synovial tissue
      produced significantly more chemotactic activity for endothelial cells in vitro
      and angiogenic activity in the rat cornea in vivo than did normal synovial tissue
      homogenates. The effects of IL-8 and ENA-78 accounted for a significant
      proportion of the chemotactic activity of endothelial cells and angiogenic
      activity found in RA synovial tissue homogenates. CONCLUSION: These results
      indicate that the ELR-containing chemokines IL-8 and ENA-78 are important
      contributors to the angiogenic activity found in the inflamed RA joint. It is
      possible that efforts aimed at down-regulating these chemokines offer a novel
      targeted therapy for the treatment of RA.

PMID- 11212174
TI  - Secretion of anti-citrulline-containing peptide antibody by B lymphocytes in
      rheumatoid arthritis.
AB  - OBJECTIVE: To understand the regulation of anti-citrulline-containing peptide
      antibody (anti-CCP) production in rheumatoid arthritis (RA), production of anti
      CCP by B cells derived from peripheral blood (PB), bone marrow (BM), and synovial
      fluid (SF) was examined. METHODS: Purified PB and SF B cells were isolated by
      negative selection and then cultured in the absence or presence of L-CD40 ligand
      cells and interleukin-10 or anti-CD3-activated T cells. Total IgM and IgM-anti
      CCP were detected after 14 days of culture by enzyme-linked immunosorbent assay.
      Enzyme-linked immunospot assays were performed to analyze the frequency of cells
      that spontaneously produced IgM-anti-CCP in BM and SF B cells. RESULTS: IgM-anti
      CCP autoantibodies were induced in PB B cells from healthy controls and RA
      patients following coculture with activated T cells or application of the CD40
      activation system, whereas no production could be detected when PB B cells were
      cultured in the absence of a stimulus. SF and BM B cells from anti-CCP
      seropositive RA patients, but not anti-CCP-seronegative patients, actively
      produced IgM-anti-CCP without stimulation. The frequency of spontaneous
      production of IgM-anti-CCP among the IgM-secreting cells ranged from 2.2% to 25%.
      CONCLUSION: These results indicate the presence of B cell precursors for anti-CCP
      autoantibodies that are able to produce antibodies upon stimulation in the PB B
      cell repertoire of healthy controls and patients with RA. In contrast, B cells
      that actively secreted anti-CCP were specifically present in the BM and SF
      compartment of anti-CCP-seropositive RA patients. The local presence of anti-CCP
      secreting cells in the inflamed joints provides evidence for an antigen-driven
      maturation of CCP-specific B cells at the site of inflammation in RA.

PMID- 11212175
TI  - The influence of synovial fluid on adenovirus-mediated gene transfer to the
      synovial tissue.
AB  - OBJECTIVE: To determine the effect of synovial fluid (SF) from rheumatoid
      arthritis (RA) patients on adenovirus type 5 (Ad5)-mediated gene transfer to
      synoviocytes, and to explore new strategies for vector development based on the
      neutralization data obtained. METHODS: SF was derived from 63 randomly selected
      R4 patients. Ten samples were used to study the effect of SF on Ad5-mediated gene
      transfer in synoviocytes. IgG and <100-kd fractions were purified from these 10
      SF, and their effect on gene transfer was determined. Neutralizing activity
      against wild-type Ad5 (wt-Ad5), wt-Ad26, wt-Ad34, wt-Ad35, and wt-Ad48 was tested
      in the SF from the remaining 53 patients. RESULTS: Seven of 10 SF samples
      inhibited Ad5-mediated gene transfer. Purified antibodies exhibited inhibition
      patterns similar to those seen with unfractionated SF. In 5 of 10 SF samples, low
      molecular weight fractions inhibited gene transfer at low dilutions.
      Neutralization of wt-Ad35 by SF from RA patients was less frequent than
      neutralization of other wt-Ad tested (4% versus 42-72%; n = 53). CONCLUSION: SF
      from 70% of the RA patients contained neutralizing antibodies that hamper Ad5
      mediated gene transfer to synoviocytes. The activity of neutralizing antibodies
      may be circumvented in the majority of RA patients when vectors based on an Ad35
      backbone are used.

PMID- 11212176
TI  - Responsiveness of the self-assessed rheumatoid arthritis disease activity index
      to a flare of disease activity.
AB  - OBJECTIVE: To assess the responsiveness of the Rheumatoid Arthritis Disease
      Activity Index (RADAI) to increases in disease activity, using the occurrence of
      a flare of disease activity as an external standard. METHODS: A post hoc analysis
      was performed on data from a randomized, double-blind, controlled trial of
      methotrexate versus type II collagen in 92 patients with rheumatoid arthritis
      (RA). Responsiveness was analyzed by 1) correlating change in the RADAI score
      with change in the Disease Activity Score (DAS28), 2) determining the RADAI's
      ability to detect a disease flare by plotting a receiver operating characteristic
      (ROC) curve, and 3) using a responsiveness statistic, the standardized effect
      size (SES). The contribution of the single RADAI items to the change in total
      RADAI score was analyzed by the item score change in absolute value, the item
      responsiveness by the standardized response mean, and the correlation of item
      score change with total RADAI score change by Cronbach's alpha. RESULTS: Changes
      in the RADAI score correlated strongly with changes in the DAS28 (R2 = 0.70, P <
      0.0001). The area under the ROC curve for the RADAI was 0.88 (95% confidence
      interval 0.78-0.95), which was similar to that for the DAS28. The SES for the
      RADAI was 1.56, which was also similar to that for the DAS28. The RADAI items of
      past global disease activity and morning stiffness contributed least to the total
      score change. CONCLUSION: This study provides evidence that the RADAI is
      sensitive to relevant increases in disease activity in RA patients. The RADAI may
      complement clinical measures in clinical studies, or may be used as a proxy for
      disease activity in epidemiologic studies.

PMID- 11212177
TI  - Association between rheumatoid arthritis and polymorphism of tumor necrosis
      factor receptor II, but not tumor necrosis factor receptor I, in Caucasians.
AB  - OBJECTIVE: Tumor necrosis factor (TNF) is a powerful mediator of inflammation in
      rheumatoid arthritis (RA). In vivo, its acute effects are limited by binding to
      soluble receptors (TNFR), suggesting that TNFR genes could be important candidate
      risk factors. The present study was undertaken to investigate association of
      polymorphisms of TNFRI and TNFRII with RA in subjects in the UK. METHODS:
      Unrelated Caucasian RA patients (n = 291) and healthy Caucasian controls (n =
      143) were genotyped for A/G polymorphism in exon 1 of TNFRI. From this sample,
      240 of the patients and 137 controls were also typed for a single-nucleotide
      polymorphism (SNP) in exon 6 of the TNFRII gene. In followup studies, DNA samples
      from UK Caucasian RA patients with a positive family history (n = 149) and UK
      Caucasian patients with sporadic RA (n = 208) were also typed for the exon 6
      TNFRII polymorphism. RESULTS: TNFRI polymorphism was not associated with RA (odds
      ratio [OR] for GG genotype 0.93, 95% confidence interval [95% CI] 0.54-1.60). For
      TNFRII, in the initial study group, patients with RA were significantly more
      likely to be positive for both the G allele and GG genotype than were controls
      (OR for GG genotype 2.55, 95% CI 1.11-5.86). The association appeared to be
      confined to those with a family history of RA. This finding was replicated in an
      independent cohort of patients with familial RA. CONCLUSION: The results of this
      study provide evidence of association between an SNP in the TNFRII gene and RA,
      the strongest association being observed in patients with a family history. No
      evidence of association between RA and TNFRI was demonstrated.

PMID- 11212178
TI  - The clinical significance of amyloid fat deposits in rheumatoid arthritis: a
      systematic long-term followup study using abdominal fat aspiration.
AB  - OBJECTIVE: To analyze the prevalence of subclinical amyloid fat deposits in
      patients with rheumatoid arthritis (RA) and to evaluate its clinical
      significance. METHODS: A cohort of 313 adult RA patients were included in this
      prospective observational study. Systematic abdominal subcutaneous fat aspiration
      (ASFA) was performed on all patients at study entry. The prevalence of visceral
      amyloidosis at study entry and at the end of followup was analyzed for patients
      with a positive ASFA test result. Followup ranged from 1 to 14 years (mean +/- SD
      6.7 +/- 4.1 years). Patients with clinical and subclinical amyloidosis were
      compared with regard to clinical characteristics and the degree of amyloid
      deposits in abdominal fat. RESULTS: The first ASFA test found amyloid in the
      abdominal fat of 51 patients (16.3%), and subsequent ASFA tests found amyloid in
      the abdominal fat of 10 additional patients. At the time of the ASFA test,
      amyloidosis was subclinical in 45 of these 61 patients, 41 of whom were followed
      up. During followup, 11 of these 41 patients developed renal involvement, 5 due
      to amyloid nephropathy. Thus, amyloidosis remained subclinical in at least 30 of
      41 patients (73%) throughout followup. Marked amyloid fat deposits were found
      more frequently in patients with clinical amyloidosis than in those whose
      amyloidosis remained subclinical at the end of followup (57% versus 22%; P =
      0.04). CONCLUSION: Amyloid fat deposits are not uncommon in adult RA. In the
      majority of patients, the deposits do not indicate clinically evident organic
      dysfunction, even after several years of followup. Patients with more extensive
      fat deposits may have a higher risk of developing clinical amyloidosis.

PMID- 11212179
TI  - Hepatocyte growth factor induction of collagenase 3 production in human
      osteoarthritic cartilage: involvement of the stress-activated protein kinase/c
      Jun N-terminal kinase pathway and a sensitive p38 mitogen-activated protein
      kinase inhibitor cascade.
AB  - OBJECTIVE: Osteoarthritis (OA) involves both a decreased reparative process and
      an increased degradative phenomenon. Several cytokines and growth factors are
      known to facilitate the repair of articular cartilage defects. The hepatocyte
      growth factor (HGF) present in OA cartilage is suggested to be involved in the
      cartilage repair process as well as in matrix remodeling and chondrocyte
      migration, leading to partial reconstruction of articular cartilage. Since cell
      migration is often correlated with metalloprotease activity, the effect of HGF on
      collagenase 3 production was studied because of its possible implication in OA
      cartilage remodeling. METHODS: We examined HGF-stimulated collagenase 3
      production in human OA chondrocytes by Western and Northern blotting.
      Furthermore, we explored the intracellular signaling pathways through which HGF
      induced collagenase 3 production. RESULTS: This study showed that HGF stimulated
      collagenase 3 production in human OA chondrocytes at the transcriptional level,
      and this induction was mediated by activation of the stress-activated protein
      kinase (SAPK)/c-Jun N-terminal kinase (JNK) pathway, but not the p38 mitogen
      activated protein kinase (MAPK). The p44/42 MAPKs were also phosphorylated and
      the use of their specific inhibitor (PD 98059) did not affect HGF-induced
      collagenase 3 production in OA chondrocytes. Induced collagenase 3 production via
      the SAPK/JNK pathway was mediated, at least in part, by the TRE site in the
      promoter, and in the activator protein 1 complex, c-Jun, JunD, and Fra-1 were
      activated. Surprisingly, further experiments revealed that the specific p38 MAPK
      inhibitor SB 202190 also inhibited collagenase 3 production early in the HGF
      induced process. The 50% inhibitory concentration was as low as 50 nM, which is
      unlikely to be related to p38 MAPK inhibition (which is usually in the microM
      range), suggesting the involvement of another kinase sensitive to SB 202190.
      CONCLUSION: This is the first study to show that HGF has the ability to induce
      both the expression and synthesis of collagenase 3 in OA chondrocytes. The effect
      is mediated by kinase cascades involving SAPK/JNK and another, unidentified
      kinase. This study provides novel information implicating a role for HGF in the
      pathophysiology of OA through its effect on the production of collagenase 3,
      which is an enzyme that is possibly involved in OA cartilage remodeling.

PMID- 11212180
TI  - Human periosteum-derived cells maintain phenotypic stability and chondrogenic
      potential throughout expansion regardless of donor age.
AB  - OBJECTIVE: To assess the in vitro chondrogenic potential of adult human
      periosteum-derived cells (PDCs) with regard to the number of cell passages and
      the age of the donor. METHODS: Cells were enzymatically released from the
      periosteum of the proximal tibia obtained from adult human donors and expanded in
      monolayer. PDCs were harvested at multiple passages for total RNA extraction and
      semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) gene
      expression analysis. For the chondrogenesis assay, cells were plated in micromass
      and treated with transforming growth factor beta1 (TGFbeta1) in a chemically
      defined medium. At different time points, micromasses were either harvested for
      RT-PCR analysis for cartilage and bone markers or fixed, paraffin-embedded, and
      stained for cartilage matrix, and immunostained for type II collagen. RESULTS: At
      the first 2 passages, human PDCs from young donors formed chondrogenic nodules.
      This spontaneous chondrogenic activity was lost upon passaging, and it was not
      observed in donors older than 30 years. Using a panel of marker genes, PDCs were
      shown to be phenotypically stable during cell expansion. Regardless of donor age
      or cell passage, chondrogenesis could be induced consistently by combining
      micromass culture and TGFbeta1 treatment. Histochemical and immunohistochemical
      analyses demonstrated the hyaline-like cartilage phenotype of the tissue
      generated in vitro. Other TGFbeta superfamily members, such as growth
      differentiation factor 5/cartilage-derived morphogenetic protein 1, and bone
      morphogenetic proteins 2, 4, and 7, were poorly chondrogenic under the same
      culture conditions. CONCLUSION: Adult human PDCs have the potential to
      differentiate toward the chondrocytic lineage in vitro, retaining this property
      even after extensive subculture. Human PDCs are easily accessible, expandable,
      and maintain their chondrogenic potential, and are therefore promising progenitor
      cells for use in the repair of joint surface defects.

PMID- 11212182
TI  - Psychoanalysis, development, and the life cycle.

PMID- 11212183
TI  - The organized categories of infant, child, and adult attachment: flexible vs.
      inflexible attention under attachment-related stress.
AB  - From an evolutionary perspective, a central mechanism promoting infant survival
      is the maintenance of proximity to attachment figures. Consequently attachment
      figure(s) represent the infant's primary solution to experiences of fear. Aspects
      of the development of the field of attachment are outlined within this context,
      beginning with Bowlby's ethological/evolutionary theory, and proceeding to
      Ainsworth's early descriptions of infant-mother interaction in Uganda and
      Baltimore. Using a laboratory procedure called the strange situation, Ainsworth
      identified three organized patterns of infant response to separation from and
      reunion with the parent. Narratives derived from videotaped strange situation
      behavior of infants in each category (secure, avoidant, and resistant/ambivalent)
      are provided, together with a discussion of the prototypical sequelae of each
      category (e.g., school behavior, and separation-related narratives and drawings
      at age six). The Adult Attachment Interview (AAI) and the move to the level of
      representation are also described. AAI transcripts are presently analyzed
      according to the speaker's capacity to adhere to Grice's maxims of rational
      cooperative discourse, and three organized AAI categories, or states of mind with
      respect to attachment, have been identified (secure-autonomous, dismissing, and
      preoccupied). When the interview is administered to parents who have been seen
      with their infants in the strange situation, each AAI category has repeatedly
      been found to predict that infant's strange situation response to that parent.
      Illustrations of the discourse characteristic of each category are provided, and
      it is noted that individuals with apparently unfavorable life histories are found
      to have secure offspring, providing that their history is recounted coherently.
      Like infant strange situation behavior, differences in adult security as
      identified through discourse patterning are interpreted in terms of attentional
      flexibility or inflexibility under attachment-related stress.

PMID- 11212181
TI  - Nitric oxide regulates mitochondrial respiration and functions of articular
      chondrocytes.
AB  - OBJECTIVE: Biologic effects of nitric oxide (NO) have been shown to increase
      under hypoxic conditions. Because the oxygen tension in joint cavities of
      patients with arthritis is fairly low, biologic effects of NO would be expected
      to be significantly large in these compartments. This study was undertaken to
      investigate the effects of NO on the energy metabolism and functions of articular
      chondrocytes under different oxygen tension conditions. METHODS: Articular
      chondrocytes from rabbits were cultured under various oxygen concentrations in
      the presence or absence of NO and NOC18, an NO donor. Cellular respiration was
      measured using a Clark-type oxygen electrode. Levels of ATP in the cells were
      determined according to the luciferin-luciferase method. Cellular synthesis of
      proteoglycans was determined by measuring the incorporation of radioactivity
      (derived from 35S-labeled SO4) into glycosaminoglycans. Expression of stress
      related proteins was evaluated by Western blotting analysis using specific
      antibodies. RESULTS: Respiration and ATP synthesis of cultured chondrocytes were
      inhibited by NO, particularly under low oxygen concentrations. The presence of
      either NO or specific inhibitors of mitochondrial electron transport suppressed
      the synthesis of proteoglycans without affecting cell viability. When exposed to
      NO, cellular levels of heat-shock protein 70 (hsp70) and heme oxygenase 1 (HO-1)
      increased markedly. The presence of inhibitors of mitochondrial electron
      transport also increased cellular levels of hsp70 and HO-1. CONCLUSION: These
      results suggest that NO generated in the joint might inhibit energy metabolism
      and the synthesis of proteoglycans of chondrocytes, thereby modulating
      pathophysiologic processes occurring in patients with arthritis.

PMID- 11212184
TI  - Disorganized infant, child, and adult attachment: collapse in behavioral and
      attentional strategies.
AB  - This presentation focuses on the disorganized/disoriented (Group D) categories of
      infant, child, and adult attachment. The infant D category is assigned on the
      basis of interruptions and anomalies in organization and orientation observed
      during Ainsworth's strange situation procedure. In neurologically normal low-risk
      samples, D attachment is not substantially related to descriptions of infant
      temperament, and usually appears with respect to only one parent. At six, former
      D infants are often found to be role-inverting (D-Controlling) towards the
      parent, while drawings and separation-related narratives (D-Fearful) suggest
      continuing states of fear and disorganization. In adults, marked lapses in
      reasoning and discourse surrounding the discussion of loss or abuse during the
      Adult Attachment Interview (AAI) causes a transcript to be assigned to
      Unresolved/disorganized (U/d) adult attachment status, which predicts infant D
      attachment. Bowlby's theory is extended, with the proposal that certain forms of
      frightening parental behavior will arouse contradictory biologically channeled
      propensities to approach and to take flight from the parent. Maltreated infants
      are therefore highly likely to be disorganized. Also identified are subtler forms
      of frightening parental behavior (including dissociative behavior and anomalous
      forms of frightened behavior) that appear to lead to infant disorganization. This
      suggests that infant D attachment may at times represent a second-generation
      effect of the parent's own continuing unresolved responses to trauma. Infant D
      attachment predicts disruptive/aggressive and dissociative disorders in childhood
      and adolescence, while U/d adult attachment appears frequently in psychiatric and
      criminal populations. Clinical implications are discussed.

PMID- 11212185
TI  - Attachment and borderline personality disorder.
AB  - The author outlines his concept of reflective function or mentalization, which is
      defined as the capacity to think about mental states in oneself and in others. He
      presents evidence to suggest that the capacity for reflective awareness in a
      child's caregiver increases the likelihood of the child's secure attachment,
      which in turn facilitates the development of mentalization in the child. He
      proposes that a secure attachment relationship offers the child a chance to
      explore the mind of the caregiver, and in this way to learn about minds; he
      formulates this model of the birth of the psychological self as a variation on
      the Cartesian cogito: "My caregiver thinks of me as thinking and therefore I
      exist as a thinker." This model is then applied to provide insight into some
      personality-disordered individuals who were victims of childhood abuse. The
      author proposes (1) that individuals who experience early trauma may defensively
      inhibit their capacity to mentalize to avoid having to think about their
      caregiver's wish to harm them; and (2) that some characteristics of severe
      borderline personality disorder may be rooted in developmental pathology
      associated with this inhibition. He offers evidence for and some qualifications
      of this model, and argues that the therapeutic effect of psychoanalysis depends
      on its capacity to activate patients' ability to evolve an awareness of mental
      states and thus find meaning in their own and other people's behavior.

PMID- 11212186
TI  - The development and organization of attachment: implications for psychoanalysis.
AB  - As a result of John Bowlby's breach with the British Psychoanalytic Society
      nearly forty years ago, his work, specifically the development of attachment
      theory, was until recently largely expunged from the psychoanalytic record.
      However, thanks to developments in both psychoanalytic and attachment theories, a
      rapprochement has been forged, and a number of scholars are now seeking to
      integrate these two complementary perspectives. In this paper, the fundamental
      premises of attachment theory are discussed in light of their relation to
      psychoanalytic theory. In addition, their application to the clinical situation
      in both adult and child treatment is discussed.

PMID- 11212187
TI  - Clinical implications of current attachment theory. Panel report.

PMID- 11212188
TI  - Reapproaching Mahler: new perspectives on normal autism, symbiosis, splitting and
      libidinal object constancy from cognitive developmental theory.
AB  - Margaret Mahler's seminal work on the psychological birth of the infant has
      generated more critical discussion than most other psychoanalytic theories of
      early development. But while the empirically, theoretically, and methodologically
      based criticisms of Mahler's theory are generally justified, her critics fail at
      times to consider some of the intriguing and creative insights that her
      theoretical formulations tried to capture. This paper attempts to reformulate
      these insights using the new conceptual tools that current cognitive
      developmental theory provides. Mahler's stage of normal autism is reconsidered in
      the light of contingency detection theory as an initial phase of primary
      preoccupation with self-generated perfectly response-contingent stimulation. Her
      concept of normal symbiosis is recast with the help of attachment theory's views
      on homeostatic regulation and the social biofeedback model of affect-reflective
      mirroring interactions with parents. Finally, her ideas about the development of
      splitting and libidinal object constancy are reconsidered according to recent
      theories of early representational development and mentalization.

PMID- 11212189
TI  - On the vicissitudes of early primary surrogate mothering II: loss of the
      surrogate  mother and arrest of mourning.
AB  - Among the catastrophic events experienced by infants and young children, one of
      the most frequent is the loss of an early primary surrogate mother (EPSM).
      Usually permanent, the loss is often followed by the advent of a new,
      "replacement" caregiver. One aspect of the emotional environment is unique to
      this kind of caregiving situation: that parents are often unable to validate the
      true nature of their child's relationship with the EPSM or, ultimately, the
      trauma experienced by the child when the EPSM leaves. The marked discrepancy
      between the parent's and the infant or child's experience of the surrogate
      mothering leads to an arrest of the child's mourning process, with the potential
      for serious developmental consequences. Issues related to EPSM loss and its
      aftermath are examined in the light of two examples. Further exploration of the
      environment of this kind of caregiving directs attention to the critical need to
      nurture and protect the attachments of both the infant or child and the parent to
      the ESPM.

PMID- 11212190
TI  - A psychoanalytic perspective on attention-deficit/hyperactivity disorder.
AB  - Psychoanalysts have tended to view the diagnosis of AD/HD either with skepticism
      or as a contraindication to analytic treatment. The author reviews the history of
      this puzzling diagnostic entity, which is estimated to account for up to fifty
      percent of child referrals, and suggests that a psychoanalytic perspective on the
      underlying disturbance in ego functioning helps to clarify the nature of the
      symptom picture. Whatever the etiology, which may be compound, she suggests that
      psychoanalytic treatment, most often in conjunction with psychopharmacological
      therapy, can address the core disturbance in ego integration that creates the
      familiar triad of inattention, impulsivity, and hyperactivity.

PMID- 11212191
TI  - The Adam and Eve story as exemplar of an early-life variant of the oedipus
      complex.
AB  - The Adam and Eve story is construed as having an organizing function that
      facilitates the analytic understanding of certain patients. In this
      interpretation, the story epitomizes a psychodynamic in which progressive growth,
      with separation and individuation, of the young is experienced as perilous--not
      only to them, but also correspondingly to their procreators. In the myth, the
      increasing psychic and physical maturation of Adam and Eve produced a crisis. Not
      only was divine authority flouted, but also apprehensions were aroused that God
      might be humbled or diminished. This threatened him, evoking his wrath and
      leading to the punishment by abandonment of his youthful wards. It is suggested
      that the story depicts an emotional complex of widespread application and is an
      archaic version of the oedipus complex, continuous with the oedipus complex
      proper, but from an earlier stage of development. This archaic complex is
      delineated with clinical vignettes, and a clinical explication of its various
      components is provided. Clinical management is considered, particularly with
      reference to the challenge that a closed-system perspective (Fairbairn 1958)
      presents to a patient's development.

PMID- 11212192
TI  - Encopresis and anal masturbation.
AB  - Current pediatric and psychiatric studies on encopresis and its treatment are
      heavily influenced by mechanical, physiological, and behavioral considerations.
      Although psychodynamic treatment has generally been considered to be of little
      benefit, and its findings suspect, the authors suggest that a psychodynamic
      approach adds substantially to the understanding of some cases of encopresis;
      that the anal sensations and anal erotic feelings reported by a number of
      encopretic children are intense, and that the encopretic symptom, soiling, in
      these children is the result of a conscious form of anal masturbation in which
      the fecal mass is used for stimulation; and that any study of encopresis is
      incomplete that does not include what encopretic children, engaged in a sound
      therapeutic relationship, know and say about their soiling. The authors further
      suggest that physical treatments of those children whose encopresis is
      psychologically driven may be contraindicated. The presence of a large stool does
      not in itself substantiate a physical illness. Further research is needed to
      elucidate the prevalence of anal masturbation in encopretic children.

PMID- 11212193
TI  - Primary femininity: clinical advances and theoretical ambiguities.
AB  - This paper examines the use of the term "primary femininity" in current
      psychoanalytic thinking. The concept of primary femininity arose in reaction to
      early theories about female sexuality and development; based on a model of male
      development, these presented problems when applied to females. The author
      attempts to demonstrate the clinical advances that have resulted from the idea of
      primary femininity. At the same time she argues that the idea has been used to
      carry widely differing meanings, and has reflected many writers' differing frames
      of reference, which range from gender identity through biological traits, object
      relations, genital anxieties, and bisexuality. Like the terms it originally was
      intended to replace or augment, it has come to be used reductionistically or
      loosely. The author warns against its misuse and argues that primary femininity
      is not a unitary concept, but rather encompasses a related group of ideas about
      the female body and mind.

PMID- 11212194
TI  - Body ego and the preoedipal roots of feminine gender identity.
AB  - Traditionally, visual cues (that is, seeing the difference between one's own
      genitals and those of the opposite sex) and the fantasies that they prompt were
      thought to be the central determinants in the organization of gender identity.
      More recently attention has been focused on mother-infant interaction patterns,
      on the construction of the body itself, on its kinesthetic sensations, and on the
      fantasies that these evoke. These matters are now thought to be equal in
      importance to the traditional considerations. The resulting concept of a core
      gender identity has suggested the possibility of various forms of preoedipal
      genital anxiety. This paper discusses how two experiences common to childhood as
      well as adulthood--the tumescence of erectile tissue and the involuntary vaginal
      secretions of sexual arousal--may contribute to the organization of feminine
      gender identity. Case material, including a close examination of an analytic
      hour, is presented to show how this process may manifest itself in adult neurotic
      conflict.

PMID- 11212195
TI  - The feminization of the female oedipal complex, Part I: a reconsideration of the
      significance of separation issues.
AB  - Freud's insights about the oedipus complex have been universalized to include the
      psychology of the girl. The authors argue that this crucial developmental phase
      for girls has uniquely feminine characteristics that have not been fully
      recognized or cohesively incorporated into psychoanalytic theories. This paper
      addresses these differences, which are based on characteristic patterns of object
      relationships, typical defenses, and social considerations. The authors argue
      that "female oedipal" is an oxymoron, and propose that this constellation be
      named "the Persephone complex" after the Greek myth of Persephone, which seems to
      capture better the typical situation of the little girl. They focus on the issue
      of separation and its complicated and necessary role in the triangular situation
      of females. Using illustrations from clinical material, the authors argue that
      the frequent appearance of separation material linked to triangular heterosexual
      competitive fantasies can and should be differentiated from material in which
      ideas about separation stem from dyadic and earlier issues. Misunderstanding how
      these separation conflicts tie into triangular "oedipal" relationships can lead
      to a "preoedipalization" of the dynamics of girls and women.

PMID- 11212196
TI  - Barbie and the tree of life: the multiple functions of gender in development.
AB  - Gender identity is the lens through which people experience being boy or girl,
      man or woman. It is a complex compromise formation that is not separate from the
      wishes, fears, and intrapsychic conflicts of other domains. Over the course of
      development, gender identity becomes layered and reconfigured. This paper looks
      at one child's experience of gender over several phases in her development in
      order to learn how gender is integrated into identity. At different times, as
      different conflicts came to the fore, she used gender to shape and lend
      definition to these conflicts. Conversely, her experiences in other spheres
      influenced her experience of gender.

PMID- 11212197
TI  - Separation-individuation phenomena in adulthood: general concepts and the fifth
      individuation.
AB  - The elaboration of separation-individuation theory in the years beyond childhood
      has been a psychoanalytic focus for several decades. In this paper, the nature of
      separation-individuation phenomena in adulthood and the terminology and
      controversy surrounding the use of the terms third, fourth, and fifth
      individuation are considered first; a detailed elaboration of the concept of the
      fifth individuation in late adulthood follows.

PMID- 11212198
TI  - The overstimulated state of dyslexia: perception, knowledge, and learning.
AB  - Dyslexia is far more than a learning disorder; it has significant impact on
      personality organization. While dyslexia usually begins to manifest most clearly
      in early latency when the challenge of learning to read is at its height, often
      the dyslexic child's ego development and functioning has already been adversely
      affected. The literature from neuropsychology suggests that dyslexia is a subtle
      language-processing disorder that affects emotional, cognitive, and social
      development. The neuroanatomical literature also suggests a significant
      correlation between the neurodevelopmental basis for dyslexia, the caregiving
      environment, and psychological development. These two bodies of literature and
      analytic observations of a dyslexic patient suggest that the dyslexic individual
      may have a neurological deficit that increases vulnerability to overstimulation.
      The author hypothesizes that emotional and cognitive states result and reappear
      within the analytic encounter. This complicates clinical assessment and technical
      decisions. The author presents an analytic case and examines (1) the impact of
      deficit on the development of conflict; (2) the impact of the overwhelmed ego on
      the mastery of developmental tasks; and (3) the impact of dyslexia on dysgnosia,
      transference, and analytic process and technique.

PMID- 11212199
TI  - Countertransference enactments informed by cancer in an analyst's child.
AB  - The author's son was diagnosed with Hodgkin's lymphoma in the spring of 1997. She
      traces the impact of this trauma on her practice, with specific emphasis on her
      experience as both analyst and mother, and on the related countertransference
      feelings and enactments. The paper discusses in detail the analyst's effort to
      determine for each patient whether or not to disclose the fact of her son's
      illness, the internal conflict she experienced over those decisions, and the
      effects of her decisions on her patients. An extensive case discussion focuses on
      a patient who appeared to intuit in a dramatic fashion the traumatic events in
      the analyst's private life.

PMID- 11212200
TI  - Infertility in the age of technology.
AB  - Rapid advances in medical and biological technologies are changing the ways we
      are born, live, and die. Biotechnology is pushing us in our notion of what is
      possible, and tapping into our most primitive omnipotent fantasies. For the most
      part these new techniques have not yet been integrated into a shared social
      consciousness. This paper examines, in a case study of a woman who eventually got
      pregnant with a donor egg and in a shorter case vignette, how the new technology
      impacts upon the analytic process. Attention is focused on the permeability of
      the boundaries between analyst and patient and between fantasy and action. The
      study shows how analyst and patient, together and often for the first time, must
      face the difficult moral and ethical issues stimulated by such procedures, as
      well as the anxieties and underlying fantasies they evoke. It is the uniqueness
      and the intensity of this experience that permeates boundaries, stimulates
      emotion in patient and analyst alike, and has the potential to deepen the
      analytic bond. The study underlines the need for the analyst to be flexible,
      moving back and forth between interpreting and creating a needed holding
      environment. Finally, the paper points out the tension between the traditional
      roles of motherhood, fatherhood, and family and those being created in this high
      tech world.

PMID- 11212201
TI  - The older patient in psychoanalysis.
AB  - The demographic shift toward extended longevity has led to a commensurate
      increase in the length of the working and productive years, and with it an
      increase in the number of so-called "older" patients who come into psychoanalysis
      or psychoanalytic psychotherapy. This led the Psychoanalytic Research and
      Development Fund to support a four-year study by a small group of experienced
      psychoanalysts of "the older patient in psychoanalysis." Aging and old age are
      considered to be the final developmental crisis of the successive epigenetic
      phases of the life cycle. Eleven case presentations and various briefer clinical
      vignettes informed us that older and even old individuals, who seek treatment
      themselves or who are appropriately referred, respond in a positive and effective
      fashion to psychoanalysis and psychoanalytic psychotherapy. As do younger
      patients in analysis, such older people, motivated by the wish to make the most
      of what time is left, become interested in understanding their pasts with respect
      to the present and the future. The life stories of two older men who undertook
      analysis, and the courses and outcomes of their analyses, illustrate our findings
      and impressions. In both cases conflicts and difficulties from earlier
      developmental phases, extending back even as far as the oedipal and preoedipal
      years, were revived during their older years. And although these conflicts might
      have been beyond definitive resolution, what is salient is the extent to which
      they were ameliorated: sufficiently that they did not impede a satisfactory
      adaptive solution of the final crisis of the normative sequences of the life
      cycle.

PMID- 11212202
TI  - Treatment of the older adult: the impact on the psychoanalyst.
AB  - Work with the elderly challenges analysts in special ways. The author presents
      clinical material from her practice and from investigative interviews with nine
      treating analysts who report personal reactions and countertransferences to
      analytic work with twelve elderly patients. She concludes that the major
      challenges in work with the elderly come more from the analyst than from the
      patients. Issues arising from the analyst's unresolved feelings about aging,
      parents, loss, and death are revived in the treatment of the elderly in an
      especially intense form. In this paper many aspects of transference are
      considered, especially those relating to illness, loss, and the problems that
      flow from identifications of the older analyst with the patient. The affective
      reverberations in younger and older analysts with regard to the initiation of
      analytic treatment, the inevitability of moving in and out of real life crises,
      the sustaining of loss, and, particularly, the impending termination, are
      presented in the paper.

PMID- 11212203
TI  - The exclusion of child psychoanalysis.

PMID- 11212204
TI  - Electrophysiological and pharmacological properties of the human brain type IIA
      Na+ channel expressed in a stable mammalian cell line.
AB  - The human brain voltage-gated Na+ channel type IIA alpha subunit was cloned and
      stably expressed in Chinese hamster ovary cells and its biophysical and
      pharmacological properties were studied using whole-cell voltage-clamp. Fast,
      transient inward currents of up to -8,000 pA were elicited by membrane
      depolarization of the recombinant cells. Channels activated at -50 mV and reached
      maximal activation at -10 mV to 0 mV. The reversal potential was 62 +/- 2 mV
      which is close to the Na+ equilibrium potential. The half-maximal activation and
      inactivation voltages were -24 +/- 2 mV and -63 +/- 1 mV, respectively. Currents
      were reversibly blocked by tetrodotoxin with a half-maximal inhibition of 13 nM.
      The effects of four commonly used anti-convulsant drugs were examined for the
      first time on the cloned human type IIA channel. Lamotrigine and phenytoin
      produced concentration- and voltage-dependent inhibition of the type IIA
      currents, whereas, sodium valproate and gabapentin (up to 1 mM) had no effect.
      These results indicate that recombinant human type IIA Na+ channels conduct
      tetrodotoxin-sensitive Na+ currents with similar properties to those observed in
      recombinant rat brain type IIA and native rat brain Na+ channels. This stable
      cell line should provide a useful tool for more detailed characterization of
      therapeutic modulators of human Na+ channels.

PMID- 11212205
TI  - Respiratory effects of stimulation of cell bodies of the A5 region in the
      anaesthetised rat.
AB  - To assess the importance of the pontine A5 region in modulating respiratory
      activity, electric current or microinjections of glutamate (10-30 nl, 1-3 nmol)
      were used to stimulate discrete zones within this region in the spontaneously
      breathing, anaesthetised rat. These stimuli evoked an expiratory facilitatory
      response, consisting of a decrease in respiratory rate (P < 0.01 electrical, P <
      0.001 chemical) due to an increase of expiratory time (P < 0.01 in both cases) as
      measured from recordings of phrenic nerve activity. No changes were observed in
      inspiratory time. To avoid changes in PCO2, which could modulate the respiratory
      response, stimulation was also made during artificial ventilation. Under these
      conditions the expiratory facilitatory response elicited by glutamate was still
      present (P < 0.05), although its duration was reduced (P < 0.05), as was the
      magnitude of the phrenic burst (P < 0.05). At all the sites at which electrical
      stimulation and glutamate injection had evoked a respiratory response, electrical
      stimulation evoked a concomitant increase in both blood pressure and heart rate.
      Glutamate injection evoked a pressor response in 21 out of 30 animals. In eight
      animals the rise in blood pressure was followed by a fall in blood pressure and
      in one animal, a depressor response was observed. In all cases glutamate evoked
      an increase in heart rate. The expiratory facilitatory response was not evoked as
      a consequence of the increase of blood pressure since it was still present after
      the administration of guanethidine, which abolished the blood pressure changes.
      As glutamate is believed to excite perikarya rather than axons of passage these
      data indicate that expiratory facilitatory responses and the accompanying
      cardiovascular changes are the consequence of activating neurones located within
      the A5 region. The possible interactions between the A5 region and the medullary
      respiratory complex in eliciting these changes are discussed.

PMID- 11212206
TI  - Reorganisation of respiratory network activity after loss of glycinergic
      inhibition.
AB  - gamma-Aminobutyric acid (GABA)-ergic and glycinergic inhibition is believed to
      play a major role in the respiratory network. In the present study we tested
      whether specific blockade of glycinergic inhibition resulted in changes in
      respiratory network interaction and function. Using the working heart-brainstem
      preparation from adult mice, we recorded phrenic nerve activity and the activity
      of different types of respiratory neurones located in the ventrolateral medulla.
      Strychnine (0.03-0.3 microM) was given systemically to block glycine receptors
      (Gly-R). During exposure to strychnine, post-inspiratory (PI) neurones shifted
      their onset of discharge into the inspiratory phase. As a consequence, the post
      inspiratory phase failed and the rhythm changed from a three-phase cycle
      (inspiration, post-inspiration, expiration, with a frequency of about. 0.24 Hz)
      to a faster, two-phased cycle (inspiration expiration, frequency about 0.41 Hz).
      Inspiratory and expiratory neurones altered their augmenting membrane potential
      pattern to a rapidly peaking pattern. Smaller voltage oscillations at
      approximately 10 Hz and consisting of excitatory and inhibitory postsynaptic
      potential sequences occurred during the expiratory interval. Due to their high
      frequency and low amplitude, such oscillations would be inadequate for lung
      ventilation. We conclude that, under physiological conditions, glycinergic
      inhibition does indeed play a major role in the generation of a normal
      respiratory rhythm in adult mice. After failure of glycinergic inhibition a
      faster respiratory rhythm seems to operate through reciprocal GABAergic
      inhibition between inspiratory and expiratory neurones, while phase switching is
      organised by activation of intrinsic membrane properties.

PMID- 11212207
TI  - Erg1, erg2 and erg3 K channel subunits are able to form heteromultimers.
AB  - Clonal somato-mammotroph GH3/B6 cells and lactotroph MMQ cells express two (ergl,
      erg2) of the three cloned rat ether-a-go-go-related gene (erg) K channel
      subunits. To study whether the erg subunits form heteromultimers, dominant
      negative mutants of erg and erg2 were constructed by point mutation (erg1G630S,
      erg2G480S). After co-expression of these mutants with the wild-type erg1, erg2,
      or erg3 in Chinese hamster ovary (CHO) cells no erg currents could be detected.
      In contrast, in co-expression experiments with members of the other ether-a-go-go
      (EAG) subfamilies (eagl, elkl) the mutant erg1G630S had no effect. These results
      strongly suggest that erg channel subunits are able to form heteromultimers
      within the erg channel subfamily. Suppression of the endogenous E-4031-sensitive
      currents in GH3/B6 and MMQ cells by erg1G630S confirms that they are mediated by
      erg channels despite the differences in gating kinetics in these cells. Reduction
      of the erg current in GH3/B6 cells by erg2G480S indicates that erg
      heteromultimers can also be formed in these cells.

PMID- 11212208
TI  - Inhibitors of the Cl-/HCO3- exchanger activate an apical anion conductance with
      similar features in the epithelial cells of rabbit gallbladder: analysis in
      intact epithelium.
AB  - In the apical plasma membrane of rabbit gallbladder epithelium,
      hydrochlorothiazide (HCTZ), besides its inhibiting action on Na+-Cl- symport and
      some side-effects, opens a SITS-sensitive Cl- conductance (Gcl), resulting in
      depolarization of the membrane due to a cell-to-lumen Cl- backflux. Some previous
      indications suggest that GCl is someway related to the Cl-/HCO3- exchanger. Thus
      the actions on the apical membrane of HCTZ and two inhibitors of the exchanger
      mainly studied in erythrocytes, namely phlorizin and phenylglyoxal (PG), have
      been compared. The transapical Cl- influx was measured radiochemically and the
      anion exchange fraction identified. The apical and transepithelial membrane
      potentials (Vm, Vm), the apical/basolateral membrane resistance ratio (Rm/Rs) and
      the transepithelial resistance (Rep) were measured with conventional
      microelectrodes and the changes in apical electromotive force and conductance
      were calculated. It has been shown that: (1) 2.5 x 10(-4) mol/l HCTZ abolishes Cl
      /HCO3- exchange in a few seconds, (2) exchanger inhibition by HCTZ is direct and
      not mediated by carbonic anhydrase inhibition, (3) 2 mmol/l phlorizin and 4
      mmol/l PG also inhibit the exchanger in a few seconds or at least rapidly and in
      parallel activate a depolarization of 6-7 mV, like HCTZ, (4) dose/response curves
      of the three drugs for depolarization activation and anion exchange inhibition
      overlap, (5) depolarization time courses are similar for the three drugs, (6) a
      decrease in the Rm/Rs ratio occurs in the presence of the three drugs, with a
      significant change in apical electromotive force when the luminal Cl-
      concentration is reduced, all this indicating the appearance of a substantial,
      quantifiable GCl which is absent in the absence of incubation with the drugs, (7)
      GCl values are similar, regardless of the drug which generates them, (8) the
      effects of the three drugs are not additive, and (9) stilbenes and dipyridamole
      abolish GCl (but not DPC) as well as the basal intrinsic conductance of the
      exchanger. On this basis it is concluded that some inhibitors of the Cl-/HCO3-
      exchanger either turn it into an anion channel or, less probably, activate a
      parallel GCl, as a consequence of the exchanger inhibition.

PMID- 11212209
TI  - Inhibitors of the Cl-/HCO3- exchanger activate an anion channel with similar
      features in the epithelial cells of rabbit gallbladder: patch-clamp analysis.
AB  - The stilbene- and dipyridamole-sensitive Cl-conductance (GCl), non-additively
      activated by some inhibitors of the Cl-/HCO3- exchanger (hydrochlorothiazide,
      phlorizin, phenylglyoxal) after the exchanger inhibition in the apical plasma
      membrane of rabbit gallbladder epithelium, has been investigated by patch-clamp
      technique with cell-attached and inside-out configurations. No Cl- channels were
      observed under basal conditions or after treatment with 2.5 x 10(-4) mol/l 8-Br
      cAMP or hydrochlorothiazide (HCTZ) on the cytosolic side. Conversely, with 2.5 x
      10(-4) mol/l HCTZ or 2 mmol/l phlorizin in the pipette, a non-rectifying Cl-
      channel with about 5 pS conductance and 0.3-0.4 voltage-independent open
      probability was observed; it was inhibited by 10(-4) - 5 x 10(-4) mol/l SITS, 10(
      4) mol/l furosemide or 0.6 x 10(-4) mol/l dipyridamole; the effects of HCTZ and
      phlorizin were not additive. Open probability increased from 0 (after seal
      formation) to a maximum of 0.3-0.4 reached in 7-9 min. Similar results were
      obtained with both configurations. With the cell-attached configuration, HCTZ
      added to the bath did not activate Cl- channels in the patch. The channel was
      shown to exclude cations, to be selective for Cl-, but also conductive for
      gluconate (PGluc/PCl = 0.18). On this basis, it is concluded that: (1) GCl,
      activated either by HCTZ or phlorizin, has the same underlying anion channels,
      (2) the channels can be activated only on the external side of the membrane, also
      in the absence of cytoplasm, without cellular mediations or effects at a distance
      along the membrane, (3) the channels are inhibited by the same drugs which
      inhibit the very small intrinsic anion conductance of the exchanger, (4) they are
      either related to a slow conversion of inhibited exchangers into channels or,
      less probably, they are parallel to the exchanger and slowly activated by intra
      membrane (or membrane-bound) mediators in their turn activated by near, inhibited
      exchangers.

PMID- 11212210
TI  - Functional expression of angiotensin II receptors in type-I cells of the rat
      carotid body.
AB  - Angiotensin II increases afferent discharge from the carotid body in vitro. We
      hypothesized that angiotensin II receptors (AT receptors) are expressed
      functionally in the type-I cell of the carotid body. Cytosolic free [Ca2+]
      ([Ca2+]i) in type-I cells freshly dissociated from rat carotid bodies was
      measured spectrofluorimetrically. Angiotensin II (10-100 nM) concentration
      dependently increased [Ca2+]i in type-I cells. The [Ca2+]i response was blocked
      by pretreatment with losartan (1 microM), an AT1 receptor antagonist, but not by
      blockade of AT2 receptors with PD- 123319 (1 microM). Moreover, the gene
      expression of AT1 receptors was assessed by the reverse transcriptase polymerase
      chain reaction and gene transcripts of both AT1a and AT1b receptors were detected
      in the carotid body. In addition, immunohistochemical study revealed that AT1
      immunoreactivity was localized in lobules of type-I cells in the carotid body.
      Taken together, these results suggest that type-I cells in the rat carotid body
      express functional angiotensin II receptors. The binding of angiotensin II to the
      AT1 receptors increases [Ca2+]i, a key step of the intracellular signalling
      cascade following the activation of the receptors. It is concluded that
      angiotensin II modulates carotid body chemoreceptor function directly via AT1
      receptors in the type-I cell.

PMID- 11212211
TI  - Tissue distribution and functional expression of the human voltage-gated sodium
      channel beta3 subunit.
AB  - This study investigated the distribution of beta3 in human tissues and the
      functional effects of the human beta3 subunit on the gating properties of brain
      and skeletal muscle alpha subunits. Using RT-PCR of human cDNA panels, beta3
      message was detected in brain, heart, kidney, lung, pancreas and skeletal muscle.
      Both alphaIIA and SkM1 expressed in Xenopus oocytes inactivated with a time
      course described by two exponential components representing fast and slow gating
      modes, while co-expression of human beta3 with alphaIIA or SkM1 significantly
      increased the proportion of channels operating by the fast gating mode. In the
      presence of beta3 a greater proportion of alphaIIA or SkM1 current was described
      by the fast time constant for both inactivation and recovery from inactivation.
      beta3 caused a hyperpolarizing shift in the voltage dependence of inactivation of
      alphaIIIA and reduced the slope factor. The voltage dependence of inactivation of
      SkM1 was described by a double Boltzmann equation. However, SkM1 co-expressed
      with beta3 was described by a single Boltzmann equation similar to one of the
      Boltzmann components for SkM1 expressed alone, with a small positive shift in
      V1/2 value and reduced slope factor. This is the first study demonstrating that
      beta3 is expressed in adult mammalian skeletal muscle and can functionally couple
      to the skeletal muscle alpha subunit, SkM1.

PMID- 11212212
TI  - The properties of the secretagogue-evoked chloride current in mouse pancreatic
      acinar cells.
AB  - In this paper we describe the properties of the secretagogue-evoked chloride
      current from mouse pancreatic acinar cells. Single cells were patch-clamped in
      the whole-cell configuration with solutions that excluded cation currents and
      then stimulated with 1 mM carbachol (CCh). This resulted in a current that rose
      to a peak and then decayed to a plateau level. The current/voltage relationship
      of the peak current was linear whereas that of the plateau phase was rectified
      and showed time and voltage dependence. To determine if the CCh evoked current
      was strictly Ca2+ dependent, we compared the properties of the plateau current
      with those of currents evoked by directly raising cytosolic [Ca2+] The properties
      of the two currents were the same, with both currents showing outward
      rectification, development at depolarised potentials, similar time constants of
      activation, permeability sequences and sensitivity to the Cl- channel inhibitor
      4,4'-diisothiocyanatodihydrostilbene-2,2'-disulphonic acid (DIDS). We conclude
      that the agonist-evoked rise in Ca2+ is alone a sufficient signal to activate the
      CL- current.

PMID- 11212213
TI  - Weight loss reduces expression of SREBP1c/ADD1 and PPARgamma2 in adipose tissue
      of obese women.
AB  - Weight loss in obese patients, even if moderate, is clearly beneficial for health
      and implies a reduction in either adipocyte number or volume. This can be
      regulated by the key adipose transcription factors, sterol-regulatory-element
      binding protein-1c/adipocyte differentiation and determination factor-1
      (SREBP1c/ADD1), peroxisome proliferator-activated receptor-gamma2 (PPARgamma2)
      and CCAAT-enhancer binding protein-alpha (C/EBPalpha). which regulate the
      adipocyte metabolism and differentiation process. The present study was
      undertaken to obtain insights into the expression of these transcription factors
      during moderate weight loss in humans. In addition, the adipose depot-related
      differences and the relation to adipose lipoprotein lipase (LPL) expression and
      plasma lipids were studied. Using quantitative reverse transcription polymerase
      chain reaction (RT-PCR), the total amount of each adipose transcription factor
      messenger ribonucleic acid (mRNA) was determined in the subcutaneous or omental
      adipose tissue after a controlled, 2-month, bodyweight-reduction trial in 11
      obese middle-aged women and 17 comparable obese controls. Weight loss (6% of body
      weight) was associated with reduced serum insulin and plasma triacylglycerols.
      Adipose tissue PPARgamma2 and SREBP1c/ADD1 mRNA were lower in the weight-loss
      group than in controls (by 30% and 28%, respectively), whereas the C/EBPalpha
      mRNA level did not change. Moreover, PPARgamma2 mRNA was lower only in the
      subcutaneous adipose depot and was related to both adipose tissue lipoprotein
      lipase (LPL) mRNA and improvement in plasma triacylglycerols in the weight-loss
      group. Our results suggest a functional role for SREBP1c/ADD1 and PPARgamma2 in
      the control of energy metabolism in human adipose tissue.

PMID- 11212214
TI  - Non-uniform mapping of stress-induced, motility-related charge movement in the
      outer hair cell plasma membrane.
AB  - There is a growing consensus that outer hair cell (OHC) electromotility underlies
      the mammalian cochlear amplifier. This voltage-dependent motility is mirrored by
      a gating current, which along with motility can be altered by tension applied to
      the cell's plasma membrane. We used localized tension application along the
      length of the OHC to induce gating currents from membrane microdomains; with this
      information we mapped the distribution of the OHC's sensitivity to membrane
      stress before and after disrupting the cytoskeleton with intracellular Pronase.
      Mechanically induced gating currents, which were susceptible to salicylate,
      lanthanides and turgor pressure, evidenced a bell-shaped distribution that was
      restricted to the lateral membrane where the electromotile response resides.
      After Pronase treatment, gating currents remained intact and restricted. These
      results confirm that the molecular motors are intrinsically and bi-directionally
      susceptible to voltage and tension, and provide evidence for limited mobility of
      OHC motors within the cell's lateral membrane.

PMID- 11212215
TI  - Contribution of angiotensin II, endothelin 1 and the endothelium to the slow
      inotropic response to stretch in ferret papillary muscle.
AB  - We investigated the contribution of angiotensin II and endothelin I to the slow
      positive inotropic response observed following stretch of isolated ferret
      papillary muscle from 88% to 98% of the length at which maximum force is
      generated. Angiotensin antagonists losartan and saralasin did not affect the
      magnitude of the slow response in ferret papillary muscle. The ETA-selective
      antagonist BQ123 slightly reduced the magnitude of the slow response (P > 0.05).
      In the presence of PD145065 (an ETA and ETB antagonist), the magnitude of the
      slow response was reduced significantly by 50%. Removal of the endothelium with
      1% Triton X-100 reversed the slow response to stretch. We conclude that, in the
      ferret, endothelin I acting through ETA and ETB receptors, contributes to the
      slow response although it is not the sole mediator. Angiotensin II is not a
      prerequisite for the slow response to stretch. We have shown for the first time
      that the endocardial endothelium plays a pivotal role in this phenomenon in
      cardiac papillary muscle.

PMID- 11212216
TI  - Functional rescue of defective mutant connexons by pairing with wild-type
      connexons.
AB  - We have compared the functional and structural integrity of gap junction channels
      assembled from a Cx45 truncation mutant with those of gap junction channels
      assembled from wild-type (wt) Cx45 and Cx43. These channel-forming proteins are
      constitutively expressed in HeLa cells. The truncation mutant lacks the last 26
      amino acids of the COOH-terminus, including nine serine phosphorylation sites
      that are associated with regulatory processes of these channels. We determined
      the presence of gap junction plaques in these cells with the immunogold freeze
      fracture technique, which showed that plaque formation is similar in all the
      clones investigated. Junctional permeability was probed with calcein transfer and
      flow cytometry analyses and junctional conductance was measured in cell pairs
      with double whole-cell patch-clamp techniques. For homotypic pairing only the
      truncated mutant did not form permeable channels. However, coupling was restored
      for heterotypic channels (pairing wtCx45- or wtCx43- with mutant-connexons),
      whose junctional communication was not different from that of the homotypic
      channels. Our results indicate that the presence of gap junction plaques does not
      warrant functional coupling and that heterotypic trCx45/wtCx45 channels can be
      regulated by the intact wtCx45 connexons. This dominant-positive effect is also
      operative when wtCx43 are paired with trCx45 connexons.

PMID- 11212217
TI  - Identification of an organic anion transport system in the human colon carcinoma
      cell line HT29 clone 19A.
AB  - The human colon carcinoma cell line HT29 c1.19A was studied for organic anion
      transporter activity by determining intracellular fluo-3 and fura-red
      accumulation and by measuring fluo-3 efflux. Modulators of organic anion
      transport systems were used to identify the transporters that are involved in dye
      extrusion. Addition of probenecid to the dye-loading medium, containing 10 microM
      fluo-3/AM and fura-red/AM, resulted in a dose-dependent increase in fluo-3 and
      fura-red accumulation in the cells. The increase in fluo-3 accumulation in the
      cells in the presence of probenecid was explained by the inhibitory effect of
      this compound on fluo-3 efflux. Fluo-3 efflux from the cells was also inhibited
      by sulfinpyrazone, another inhibitor of organic anion transport. Substrates of
      renal probenecid-sensitive organic anion exchange mechanisms as well as
      modulators of multidrug resistance associated protein (MRP) activity did not
      influence fluo-3 extrusion rates. However, reducing intracellular ATP contents
      completely blocked fluo-3 extrusion. Moreover, MK571, an inhibitor of MRP,
      significantly stimulated dye accumulation, whereas inhibitors of the multidrug
      resistance gene (MDR1) product Pglycoprotein, cyclosporin A and verapamil, did
      not. As probenecid inhibits fluo-3 efflux across the apical membrane of cells
      grown on permeable supports, we conclude that a probenecid-sensitive organic
      anion transporter is present in the apical membrane of HT29 c1.19A cells. This
      organic anion transport system differs from MDRI and MRP2.

PMID- 11212218
TI  - The energy cost of walking in children.
AB  - Size, morphology and motor skills change dramatically during growth and this
      probably has an effect on the cost of locomotion. In this study, the effects of
      age and speed on the energy expended while walking were determined during growth.
      The rate of oxygen consumption and carbon dioxide production were measured in 3-
      to 12-year-old children and in adults while standing and walking at different
      speeds from 0.5 m x s(-1) to near their maximum aerobic walking speed. Standing
      energy expenditure rate decreases with age from 3.42 +/- 0.48 W x kg(-1) (mean +/
      SD, n = 6) in the 3- to 4-year-olds to 1.95 +/- 0.22 W x kg(-1) (n = 6) in young
      adults. At all ages the gross cost of transport has a minimum which decreases
      from 5.9 J x kg(-1) x m(-1) in 3- to 4-year-olds to 3.6 J x kg(-1) x m(-1) after
      10 years of age. The speed at which this minimum occurs increases from 1.2 m x s(
      1) to 1.5 m x s(-1) over the same age range. At low and intermediate walking
      speeds the net cost of transport is similar in children and adults (about 2 J x
      kg(-1) x m(-1)). In young children walking at their highest speeds the net cost
      of transport is 70% (3- to 4-year-olds) to 40% (5- to 6-year-olds) greater than
      in adults.

PMID- 11212219
TI  - Apamin interacts with all subtypes of cloned small-conductance Ca2+-activated K+
      channels.
AB  - The purpose of the present study was to examine how apamin interacts with the
      three cloned subtypes of small-conductance Ca2+-activated K+ channels (hSK1, rSK2
      and rSK3). Expression of the SK channel subtypes in Xenopus laevis oocytes
      resulted in large outward currents (0.5-5 microA) after direct injection of Ca2+.
      In all three cases the Ca2+-activated K+ currents could be totally inhibited by
      500 nM apamin. Dose-response curves revealed a subtype-specific affinity for the
      apamin-induced inhibition with IC50 values of 704 pM and 196 nM (biphasic) for
      hSK1, 27 pM for rSK2 and 4 nM for rSK3. Consistent with these results, membranes
      prepared from oocytes expressing the SK channel subtypes bound 125I-labelled
      apamin with distinct dissociation constants (Kd values) of approx. 390 pM for
      hSK1, 4 pM for rSK2 and 11 pM for rSK3. These results show that apamin binds to
      and blocks all three subtypes of cloned SK channels, and the distinct values for
      IC50 and Kd suggest that apamin may be useful for determining the expression
      pattern of SK channel subtypes in native tissue.

PMID- 11212220
TI  - Chloride conductance and volume-regulatory nonselective cation conductance in
      human red blood cell ghosts.
AB  - To identify the ion channels involved in erythrocyte volume regulation, whole
      cell currents from human red blood cells (RBCs) were recorded in isotonic,
      hypotonic and hypertonic media. In isotonic NaCl bath solution, whole-cell
      currents rectified outwardly with reversal potentials (Vrev) between the
      equilibrium potential of Cl- (ECl) and that of nonselective cations (NSC), ENSC.
      Replacement of bath Cl by gluconate decreased outward conductance (G outward) by
      43 +/- 6% (n = 5) and shifted Vrev with ECl indicating a high fractional Cl-
      conductance. Hypotonic cell swelling reversibly decreased G outward by 23 +/- 3%
      (n = 8) while hypertonic cell shrinkage reversibly increased G outward by 27 +/-
      8% (n = 5). These shrinkage-activated and swelling-inactivated current fractions
      rectified outwardly with Vrev at ENSC suggesting that both fractions are
      generated by the same type of NSC channel. The shrinkage-activated deltaG outward
      decreased from 4.7 +/- 1.2 nS (n = 3) to 1.4 +/- 0.4 nS (n = 5) and 0.5 +/- 0.4
      nS (n = 7) with the increase of pipette [Cl-] from 7 mM to 39 mM and 139 mM,
      respectively. Similarly, with this increase of pipette [Cl-], G outward under
      isotonic control conditions decreased from 8.2 +/- 1.4 nS (n = 5) to 7.4 +/- 1.0
      nS (n = 20) and 4.1 +/- 0.7 nS (n = 17), due to the differing activity of these
      NSC channels. In conclusion, human RBCs express, besides a high fractional Cl-
      conductance, NSC channels that are regulated by cell volume and the cytosolic [Cl
      ].

PMID- 11212222
TI  - New perspectives in breath-by-breath determination of alveolar gas exchange in
      humans.
AB  - Alveolar gas transfer over a given breath (i) was determined in ten subjects at
      rest and during steady-state cycling at 60, 90 or 120 W as the sum of volume of
      gas transferred at the mouth plus the changes of the alveolar gas stores. This is
      given by the gas fraction (FA) change at constant volume plus the volume change
      (deltaVAi) at constant fraction i.e. VAi-1(FAi-FAi-1)+FAi x deltaVAi, where VAi-1
      is the end-expiratory volume at the beginning of the breath. These quantities,
      except for VAi-1, can be measured on a single-breath (breath-by-breath) basis and
      VAi-1 set equal to the subject's functional residual capacity (FRC, Auchincloss
      model). Alternatively, the respiratory cycle can be defined as the interval
      elapsing between two equal expiratory gas fractions in two successive breaths
      (Gronlund model G). In this case, Ft1 = Ft2 and thus the term VAi-1 (FAi-FAi-1)
      vanishes. In the present study, average alveolar O2 uptake (VO2,A) and CO2 output
      (VCO2,A) were equal in both approaches whereby the mean signal-to-noise ratio
      (S/N) was 40% larger in G. Other approaches yield steady state S/N values equal
      to that obtained in G, although they are based on the questionable assumption
      that the inter-breath variability of alveolar gas transfer is minimal. It is
      concluded that the only promising approach for assessing "true" single-breath
      alveolar gas transfer is that originally proposed by Gronlund.

PMID- 11212221
TI  - Spermine increases the active and passive transport across the alveolar
      epithelium in situ: effect of thiol reagents.
AB  - An intact alveolar epithelial barrier is thought to be important for alveolar
      liquid absorption. However, polycations increase alveolar permeability without
      affecting alveolar liquid absorption (Saumon et al., Am J Physiol 1995: 269:L185
      L194). We have reconsidered this issue using polyamines. The polyamine spermine
      (10(-3) mol/l) produced a large (up to 20-fold), sustained increase in the
      permeability of the alveolar barrier to mannitol (PAMan) and in alveolar liquid
      absorption (Jw, twofold) in isolated rat lungs. These increases were inhibited by
      5 x 10(-3) mol/l putrescine and 2 x 10(-3) mol/l spermidine. Because spermine is
      known to affect the phosphoinositide/Ca2+ signalling pathway, we evaluated the
      effects of thiol reagents known to interfere with this pathway in different ways.
      Thimerosal, a thiol reagent which sensitizes the inositol 1,4,5-trisphosphate
      (IP3) receptor, inhibited the spermine-induced increase in PA(Man) and, to a
      lesser extent, that of Jw. Mersalyl, a thiol reagent which blocks IP3-gated Ca2+
      channels, enhanced spermine's effect, whereas N-ethylmaleimide, a non-specific
      thiol reagent, had no effect. These observations show that large increases in
      permeability may coexist with increases in Jw. They also suggest that the
      phosphoinositide/Ca2+ second messenger pathway is involved in modulating the
      tightness of the alveolar barrier and alveolar liquid absorption.

PMID- 11212223
TI  - Inducible nitric oxide synthase (iNOS) is expressed similarly in multiple
      aberrant crypt foci and colorectal tumors from the same patients.
AB  - Aberrant crypt foci (ACF) are the earliest identified neoplastic lesions in the
      colon. Aberrant expression of inducible nitric oxide synthase (iNOS or NOS2) has
      been documented in colorectal tumors, but expression of iNOS has not been
      reported in human ACF or multiple neoplastic lesions from the same patient.
      Immunohistochemical expression of iNOS was evaluated in 42 ACF, 14 adenomas, and
      25 carcinomas and their adjacent normal mucosa. iNOS was strongly expressed in
      the normal colonic epithelial cells of all patients; it was markedly reduced in
      21 of 42 (50%) ACF and in 14 of 25 (56%) carcinomas. The expression of iNOS was
      remarkably similar in multiple lesions from the same patient (P < 0.0001). These
      results suggest that the reduced expression of iNOS is a very early event in the
      development of some human colorectal tumors, and that host factors control the
      expression of iNOS similarly in premalignant and malignant colonic epithelial
      cells.

PMID- 11212224
TI  - Altered expression of androgen receptor in the malignant epithelium and adjacent
      stroma is associated with early relapse in prostate cancer.
AB  - The molecular basis of androgen-independent prostate cancer is unknown; however,
      functional androgen receptor (AR) signaling is maintained after the acquisition
      of hormone-refractory disease. Because normal and malignant prostate epithelial
      cell proliferation is regulated by androgen stimulation via both the AR-positive
      stroma and epithelium, we sought to evaluate patterns of AR expression in these
      cells and to determine any relationships with prostate cancer progression. AR
      expression in the malignant epithelium and associated periepithelial and
      nonperiepithelial stroma was measured in a cohort of 96 patients with clinically
      localized prostate cancer treated with radical prostatectomy. Data were evaluated
      for disease relapse using the Kaplan-Meier method and in a Cox proportional
      hazards model with other variables of known clinical relevance, including Gleason
      score, pathological stage, clinical stage, and pretreatment prostate-specific
      antigen concentration. Concurrent overexpression of AR (> or = 70% positive
      nuclei) in the malignant epithelium and loss of AR immunoreactivity in the
      adjacent periepithelial stroma (< or = 30%) was associated with higher clinical
      stage (P = 0.01), higher pretreatment prostate-specific antigen level (P = 0.03),
      and earlier relapse after radical prostatectomy (log-rank P = 0.009). These data
      identify a pattern of AR expression in malignant epithelium and adjacent stroma
      that is associated with a poor clinical outcome in prostate cancer. Equally
      important, they identify the need to further investigate the mechanistic basis of
      loss of AR expression in the malignant stroma and its potential role in
      deregulation of prostate epithelial cell proliferation.

PMID- 11212225
TI  - Persistent genetic instability in cancer cells induced by non-DNA-damaging stress
      exposures.
AB  - A hallmark of cancer cells is their pronounced genetic instability, which has
      been implicated in both tumor development and negative treatment outcomes.
      Recently, it has been reported that ionizing radiation may induce a persistent
      state of hypermutability in mammalian cells that lasts for many (>30) cell
      divisions. In this study, we examined whether other stress signals (both DNA
      damaging non-DNA-damaging) can initiate a similar process. We show that
      persistent genetic instability was induced by nongenotoxic stress exposures such
      as heat treatment, serum starvation, or the tumor microenvironment, as well as
      genotoxic stresses such as ionizing radiation and exposure to hydrogen peroxide.
      Progeny of 10-20% of surviving cells exhibited persistent and pronounced genetic
      instability at both an artificially transfected gene and a genomic minisatellite
      locus 23 cell divisions after the initial exposure. Stress-induced persistent
      genetic instability may be a general response of tumor cells to a wide range of
      genotoxic or nongenotoxic stress conditions.

PMID- 11212226
TI  - Assessment of tumor necrosis factor receptor and Fas signaling pathways by
      transcriptional profiling.
AB  - Apoptosis, or programmed cell death, is an important mechanism by which cells are
      eliminated during immune regulation and embryonic development. Aberrations in the
      signaling pathways leading to apoptosis may result in cancer, autoimmune
      diseases, or inflammatory disorders. In view of this, an understanding of the
      signaling capabilities of apoptosis-inducing or death receptors is essential to
      understanding their roles in biology and disease. We used cDNA microarrays to
      examine the downstream transcriptional effects of two members of the tumor
      necrosis factor (TNF) family of death receptor ligands. We compared the
      transcriptional responses of a model colon cancer cell line, HT29, to TNF-alpha
      and anti-Fas activating antibody. Both ligands induced a subset of genes
      characteristic of activation of the transcription factor nuclear factor-kappaB
      (NF-kappaB). Follow-up analyses demonstrated that, although TNF-alpha activated
      NF-kappaB through IkappaB-alpha degradation, alpha-Fas treatment led to NF-kappaB
      activation through a mechanism distinct from IkappaB-alpha degradation.

PMID- 11212227
TI  - A novel response of cancer cells to radiation involves autophagy and formation of
      acidic vesicles.
AB  - The mechanisms underlying neoplastic epithelial cell killing by ionizing
      radiation are largely unknown. We discovered a novel response to radiation
      manifested by autophagy and the development of acidic vesicular organelles (AVO).
      Acidification of AVO was mediated by the vacuolar H+-ATPase. Staining with the
      lysosomotropic agent acridine orange enabled us to quantify AVO accumulation and
      to demonstrate their time- and dose-dependent appearance. The appearance of AVO
      occurred in the presence of the pan-caspase inhibitor z-Val-Ala-Asp(Ome)
      fluoromethyl ketone, but was inhibited by 3-methyladenine, an inhibitor of
      autophagy. The accretion of AVO in surviving progenies of irradiated cells, and
      the increased incidence of clonogenic death after inhibition of vacuolar H+
      ATPase suggest that formation of acidic organelles represents a novel defense
      mechanism against radiation damage.

PMID- 11212228
TI  - Absence of endothelial cells, central necrosis, and fibrosis are associated with
      aggressive inflammatory breast cancer.
AB  - We recently established a new human inflammatory breast cancer (IBC) xenograft
      (WIBC-9) originating from a patient with IBC. The graft was transplantable in
      BALB/c nude and severe combined immunodeficient (SCID) mice. WIBC-9 was
      frequently accompanied by lung metastasis and exhibited erythema of the overlying
      skin, reflecting its human counterpart. Histological study of the original tumor
      and WIBC-9 revealed invasive ductal carcinoma with a hypervascular structure of
      solid nests and marked lymphatic permeation in the overlying dermis. In the
      central part of the solid nests, absence of endothelial cells, central necrosis,
      and fibrosis were observed. In vitro, WIBC-9 formed tube-like structures and
      loops, reflecting its in vivo feature and its human counterpart. WIBC-9 exhibited
      aneuploidy, ErbB-2 gene amplification, and an absence of estrogen receptor and
      progesterone receptor, which is consistent with IBC. Comparative studies of WIBC
      9, three established non-IBC xenografts, and a human breast cancer cell line (SK
      BR3) by reverse transcription-PCR, ELISA, and immunohistochemistry indicated that
      certain human genes (interleukin 8, vascular epidermal growth factor, basic
      fibroblast growth factor, angiopoietin 13, Flt-1, Tie-2, and Tie-1) and certain
      murine genes (integrin alpha(v)beta3, flt-1, tie-2, vascular epidermal growth
      factor, and CD31) were overexpressed in exposure to tumor cells. The molecular
      basis and these unique histological features may be associated with aggressive
      IBC on angiogenic and nonangiogenic pathways.

PMID- 11212229
TI  - Coexpression of CD40 and CD40 ligand in cutaneous T-cell lymphoma (mycosis
      fungoides).
AB  - Microarray analysis is a promising new approach for creating specific expression
      profiles of multiple genes simultaneously. We quantitatively analyzed
      differential gene expression patterns in mycosis fungoides-derived clonal T cells
      and autologous, identically cultured CD4+ lymphocytes using microarrays
      containing 588 cDNA segments from genes relevant to cell signaling,
      carcinogenesis, and apoptosis. Among other dissimilarities, neoplastic T cells
      showed coexpression of CD40 (Bp50) and CD40 ligand (gp39, CD154). These results
      could be corroborated by reverse transcription-PCR, immunohistochemistry, and two
      color immunofluorescence staining. Our data suggest that in cutaneous T-cell
      lymphoma, CD40/CD40 ligand interactions might represent a paracrine loop that is
      crucial not only in preventing apoptosis or positively regulating growth but also
      in homing of neoplastic cells to the skin.

PMID- 11212230
TI  - Cadmium-induced malignant transformation of human prostate epithelial cells.
AB  - Prostate cancer has become epidemic, and environmental factors such as cadmium
      may be partly responsible. This study reports malignant transformation of the
      nontumorigenic human prostatic epithelial cell line RWPE-1 by in vitro cadmium
      exposure. The cadmium-transformed cells exhibited a loss of contact inhibition in
      vitro and rapidly formed highly invasive and occasionally metastatic
      adenocarcinomas upon inoculation into mice. The transformed cells also showed
      increased secretion of MMP-2 and MMP-9, a phenomenon observed in human prostate
      tumors and linked to aggressive behavior. Cadmium-induced malignant
      transformation of human prostate epithelial cells strongly fortifies the evidence
      for a potential role of cadmium in prostate cancer.

PMID- 11212231
TI  - Antitumor immunity induced by laser immunotherapy and its adoptive transfer.
AB  - The ideal cancer treatment modality should not only cause tumor regression and
      eradication but also induce a systemic antitumor immunity, which is essential for
      control of metastatic tumors and for long-term tumor resistance. Laser
      immunotherapy using a laser, a laser-absorbing dye, and an immunoadjuvant has
      induced such long-term immunity in treatment of a mammary metastatic tumor. The
      successfully treated rats established total resistance to multiple subsequent
      tumor challenges. To further study the mechanisms of the antitumor immunity
      induced by this novel treatment modality, passive adoptive transfer was performed
      using splenocytes as immune cells. The spleen cells that were harvested from
      successfully treated tumor-bearing rats provided 100% immunity in the naive
      recipients. The passively protected first cohort rats were immune to tumor
      challenge with an increased tumor dose; their splenocytes also prevented the
      establishment of tumor in the second cohort of naive recipient rats. This
      immunity transfer was accomplished without the usually required T-cell
      suppression in recipients.

PMID- 11212232
TI  - RB2/p130 gene-enhanced expression down-regulates vascular endothelial growth
      factor expression and inhibits angiogenesis in vivo.
AB  - Angiogenesis is an essential step in the progression of tumor formation and
      development. The switch to an angiogenetic phenotype can occur as a distinct step
      before progression to a neoplastic phenotype and is linked to genetic changes
      such as mutations in key cell cycle regulatory genes. The pathogenesis of the
      angiogenetic phenotype may involve the inactivation of tumor suppressor genes
      such as the "guardian of the genome," p53, and the cyclin-dependent kinase
      inhibitor p16. Retinoblastoma family member RB2/p130 encodes a cell cycle
      regulatory protein and has been found mutated in different tumor types.
      Overexpression of RB2/p130 not only suppresses tumor formation in nude mice but
      also causes regression of established tumor grafts, suggesting that RB2/p130 may
      modulate the angiogenetic balance. We found that induction of RB2/p130 expression
      using a tetracycline-regulated gene expression system as well as retroviral and
      adenoviral-mediated gene delivery inhibited angiogenesis in vivo. This correlated
      with pRb2/p130-mediated down-regulation of vascular endothelial growth factor
      protein expression both in vitro and in vivo.

PMID- 11212233
TI  - Interferon gamma-dependent induction of thymidine phosphorylase/platelet-derived
      endothelial growth factor through gamma-activated sequence-like element in human
      macrophages.
AB  - Thymidine phosphorylase (TP), an enzyme involved in the reversible conversion of
      thymidine to thymine, is identical to platelet-derived endothelial cell growth
      factor. TP expression in cancer cells and/or infiltrated macrophages is
      associated with microvessel density and poor clinical prognosis in patients with
      various tumor types. However, how TP expression is up-regulated in human tumors
      is unclear. Of various inflammatory cytokines, such as tumor necrosis factor
      alpha (TNF-alpha), interleukin 1 alpha (IL-1alpha), and interferon gamma (IFN
      gamma), we observed that IFN-gamma most effectively increased the expression of
      TP in cultured human monocytic U937 cells. Transient transfection of the various
      deletion constructs of the TP promoter showed that the presence of the -474 to 
      355 sequence containing gamma-activated sequence-like element was essential for
      IFN-gamma-dependent activation of the TP gene. Furthermore, the IFN-gamma
      dependent transcriptional activity of the promoter construct containing mutations
      in the gamma-activated sequence-like element was significantly decreased. An
      electrophoretic mobility shift assay showed that IFN-gamma increased signal
      transducers and activators of transcription 1 binding to gamma-activated sequence
      like element in the TP promoter. IFN-gamma could be a mediator of TP expression
      in infiltrated monocyte/macrophages, and those monocyte/macrophages expressing TP
      might play an important role in malignancy and angiogenesis in various human
      tumors.

PMID- 11212234
TI  - Synthetic protein transduction domains: enhanced transduction potential in vitro
      and in vivo.
AB  - The protein transduction domain (PTD) embedded in the HIV TAT protein (amino
      acids 47-57) has been shown to successfully mediate the introduction of
      heterologous peptides and proteins in excess of Mr 100,000 into mammalian cells
      in vitro and in vivo. We report here that the modeled structure of the TAT PTD is
      a strong amphipathic helix. On the basis of this information, we synthesized a
      series of synthetic PTDs that strengthen the alpha-helical content and optimize
      the placement of arginine residues. Several PTD peptides possessed significantly
      enhanced protein transduction potential compared with TAT in vitro and in vivo.
      These optimized PTDs have the potential to deliver both existing and novel
      anticancer therapeutics.

PMID- 11212235
TI  - Soluble recombinant endostatin purified from Escherichia coli: antiangiogenic
      activity and antitumor effect.
AB  - Endostatin is a potent and specific antiangiogenic protein capable of inhibiting
      the growth of murine and xenotransplanted human tumors. Thus far, however,
      recombinant endostatin prepared from Escherichia coli is insoluble after
      purification and therefore inappropriate for clinical settings. A soluble form of
      endostatin is available from a yeast system with relatively low yield and high
      cost, which has made it difficult to produce endostatin in quantities sufficient
      for extensive clinical evaluation. In this study, we developed a protocol to
      generate soluble recombinant murine endostatin from E. coli at a yield of 150
      mg/liter-culture and 99% purity. The in vivo antiangiogenic and antitumor
      activities of the soluble recombinant endostatin are equally as potent as those
      of the previously published insoluble form. A similar protocol may be used to
      produce soluble human endostatin.

PMID- 11212236
TI  - Inhibiting mutations in the transforming growth factor beta type 2 receptor in
      recurrent human breast cancer.
AB  - Members of the transforming growth factor beta (TGF-beta) family are potent
      inhibitors of the growth of many epithelial cell types. Transmembrane signaling
      by TGF-beta occurs via a complex of the serine/threonine kinases TGF-beta type 1
      receptor and TGF-beta type 2 receptor (TGFBR2), and inactivating mutations in the
      latter have recently been detected in some primary tumors and in several types of
      tumor-derived cell lines. The most common mutations that have been identified in
      TGFBR2 are frameshifts in a repetitive polyadenine region in replication error
      positive colorectal carcinomas that result in a truncated protein and absence of
      receptor expression at the cell surface. A number of point mutations in the
      highly conserved serine/threonine kinase domain of TGFBR2 have also been
      reported, some of which have been correlated with either loss of trans
      phosphorylation of TGF-beta type 1 receptor or constitutive activation of trans
      phosphorylation. No TGFBR2 mutations have been reported in human breast tumors,
      but anomalous expression of TGF-beta in breast carcinomas suggests that TGF-beta
      signaling may be defective. We have therefore systematically examined unmatched
      sets of 17 primary and 17 recurrent breast tumor samples for mutations in TGFBR2,
      restricted to those regions of the gene in which mutations have previously been
      reported. None of the previously reported mutations was detected, but four novel
      mutations (V387M, N435S, V447A, and L452M) were found in the kinase domain in
      recurrent tumors. No mutations were detected in primary tumors. TGF-beta
      signaling was significantly inhibited by each of the N435S, V447A, and L452M
      mutations.

PMID- 11212237
TI  - p53 induction prevents accumulation of aberrant transcripts in cancer cells.
AB  - Loss of fidelity of the splicing process occurs during tumor progression and can
      have a deleterious effect on genes like tumor suppressor genes. It was reported
      recently that the presence of aberrant transcripts of the TSG101 gene in breast
      cancer cells was associated with the mutation of the p53 tumor suppressor gene.
      On the basis of this observation, we have analyzed TSG101 transcript patterns in
      p53-active and p53-inactive cells. Using several isogenic cellular models, we
      demonstrate that the induction of p53 in cancer cells leads to a significant
      decrease of aberrant transcripts levels. This indicates a novel implication of
      p53 in the regulation of the splicing process.

PMID- 11212238
TI  - Posttranslational truncation and inactivation of human E-cadherin distinguishes
      prostate cancer from matched normal prostate.
AB  - An essential event in the progression of adenocarcinoma is the loss of organized
      epithelial attachment (both to the basement membrane and to adjoining epithelial
      cells). The E-cadherin cell adhesion molecule has an established function in
      maintaining normal phenotype and tissue homeostasis, and loss of E-cadherin
      function has been implicated in tumorigenesis. Aberrations in E-cadherin are
      associated with prostate cancer progression; however, these aberrations are not
      simply a result of prodigious allelic loss. We have previously demonstrated a
      novel posttranslational truncation within the cytosolic domain of native Mr
      120,000 E-cadherin to a membrane-bound Mr 97,000 species. We hypothesize that
      truncation of E-cadherin is an inactivating event that is significantly increased
      in localized prostate tumors and that it represents a novel molecular event that
      may distinguish prostate cancer from adjacent normal tissue. E-cadherin was
      characterized by Western blot analysis in matched normal and cancer tissue from
      18 prostate cancer patients. Imaging and densitometry software were used to
      quantify the truncation of E-cadherin by measuring the ratio of Mr 97,000 E
      cadherin to Mr 120,000 E-cadherin, which was significantly increased in the tumor
      aspect of the prostate gland. Herein, we report the first experiment comparing
      case-matched human normal and cancerous prostate tissue in the context of E
      cadherin truncation.

PMID- 11212239
TI  - Oligoclonal T-cell receptor usage of melanocyte differentiation antigen-reactive
      T cells in stage IV melanoma patients.
AB  - Ex vivo ELISPOT analysis of peripheral blood lymphocytes obtained from stage IV
      melanoma patients demonstrated reactivity against peptides derived from MART-1
      and gp100. However, the number of reactive T cells was < 1% that of total
      lymphocytes as detected by flow cytometry using tetrameric MHC/peptide complexes.
      Despite this low frequency, we were able to directly isolate these populations ex
      vivo by means of magnetic beads coated with MHC/peptide complexes and to subject
      these cells to T-cell receptor clonotype mapping. This analysis revealed that the
      MART-1/A*0201- and gp100/A*0201-reactive T-cell populations are composed of
      oligoclonal T cells that engage several T-cell receptor beta chain families.
      Longitudinal studies using this approach may result in a better correlation
      between T-cell reactivity and the course of neoplastic disease.

PMID- 11212240
TI  - 15S-Hydroxyeicosatetraenoic acid activates peroxisome proliferator-activated
      receptor gamma and inhibits proliferation in PC3 prostate carcinoma cells.
AB  - 15-Lipoxygenase (15-LOX)-2 is expressed in benign prostate secretory cells and
      benign prostate produces 15S-hydroxyeicosatetraenoic acid (15S-HETE) from
      exogenous arachidonic acid (AA). In contrast, 15S-LOX-2 and 15S-HETE formation
      are reduced in prostate carcinoma (Pca). The mechanisms whereby reduced 15-LOX-2
      may contribute to Pca development or progression are not known. We investigated
      the expression of peroxisome proliferator-activated receptor (PPAR) gamma in
      benign and malignant prostate tissues and the ability of 15S-HETE to activate
      PPARgamma-dependent transcription and modulate proliferation of the Pca cell line
      PC3. In contrast to benign prostate and similar to most Pca tissues, 15-LOX-2
      mRNA was not detected in PC3 cells, and they did not produce detectable 15-HETE
      from [14C]AA. By reverse transcription-PCR, PPARgamma mRNA was present in 18 of
      18 benign and 9 of 9 tumor specimens. The PPARgamma ligand BRL 49653 and 15S-HETE
      caused a dose-dependent inhibition of PC3 proliferation in a 14-day soft agar
      colony-forming assay (IC50 of 3 and 30 microM, respectively). 15S-HETE (10
      microM) caused greater inhibition than 10 microM 15R-HETE. At 3 days, BRL 49653
      and 15S-HETE caused a slight increase in cells in G0-G1 and a corresponding
      decrease in cells in S phase. In PC3 cells transiently transfected with a
      luciferase reporter linked to a PPAR response element, 1 microM BRL 49653 and 10
      microM 15S-HETE caused approximately threefold and greater than twofold induction
      of PPAR-dependent transcription, respectively. By quantitative real-time reverse
      transcription-PCR and Northern analysis, 3-day treatment with BRL 49653 and 15S
      HETE caused a reduction of PPARgamma expression but a marked up-regulation of the
      PPAR response element containing adipocyte type fatty acid binding protein. These
      results support the hypothesis that 15-LOX-2-derived 15S-HETE may constitute an
      endogenous ligand for PPARgamma in the prostate and that loss of this pathway by
      reduced expression of 15-LOX-2 may contribute to increased proliferation and
      reduced differentiation in prostate carcinoma.

PMID- 11212241
TI  - Use of camptothecin-resistant mammalian cell lines to evaluate the role of
      topoisomerase I in the antiproliferative activity of the indolocarbazole, NB-506,
      and its topoisomerase I binding site.
AB  - NB-506 is a topoisomerase I (top1) inhibitor in clinical trials. In this study,
      we used a series of camptothecin (CPT)-resistant cell lines with known top1
      alterations. We show that three mutations in different domains of the top1 enzyme
      that confer CPT resistance also confer cross-resistance to NB-506. The CPT
      resistant cell lines and corresponding mutations were: human prostate carcinoma
      cells DU-145/RC1 (mutation R364H), Chinese hamster fibroblasts DC3F/C10 (mutation
      G503S), and human leukemia CEM/C2 cells (N722S). This result suggests that NB-506
      and CPT share a common binding site in the top1-DNA complex. We next used these
      three cell lines and their parental cells to study the relationship between top1
      poisoning by NB-506 and antiproliferative activity. We found that the CPT
      resistant cells were only 2-10-fold resistant to NB-506, which suggests that NB
      506 targets other cellular processes/pathways besides top1. This conclusion was
      further supported by the limited cross-resistance of top1-deficient murine
      leukemia P388/CPT45 cells (2-fold). Cross-resistance was also limited for J
      109,382, an isomer of NB-506 that does not intercalate into DNA, indicating that
      the non-top1-mediated antiproliferative activity of NB-506 is not attributable to
      DNA intercalation. Together, these data indicate that NB-506 and indolocarbazoles
      are promising agents to overcome CPT resistance.

PMID- 11212242
TI  - Frequent cytolytic T-cell responses to peptide MAGE-A10(254-262) in melanoma.
AB  - MAGE genes encode tumor-specific shared antigens that are among the most
      interesting candidates for cancer vaccines. Despite extensive studies, however,
      CD8+ T-cell responses to MAGE-derived epitopes have been detected only
      occasionally in cancer patients, even after vaccination. In contrast with these
      findings, we report here that HLA-A2 melanoma patients respond frequently to the
      recently identified peptide MAGE-A10(254-262). Indeed, as assessed by staining
      with fluorescent HLA-A2/peptide MAGE-A10(254-262) tetramers, CD8+ T cells
      directed against this peptide were readily detectable in a large proportion of
      HLA-A2+ melanoma patients. These results provide new insight into the
      immunogenicity of MAGE antigens and underline the potential usefulness of MAGE
      A10 peptide-based cancer vaccines.

PMID- 11212243
TI  - Loss of p53 but not ARF accelerates medulloblastoma in mice heterozygous for
      patched.
AB  - Brain malignancies represent the most common solid tumors in children, and they
      are responsible for significant mortality and morbidity. The molecular basis of
      the most common malignant pediatric brain tumor, medulloblastoma, is poorly
      understood. Mutations in several genes including the human homologue of the
      Drosophila segment polarity gene, patched (PTCH), the adenomatous polyposis coli
      gene (APC), beta-catenin, and p53 have been reported in subsets of hereditary and
      sporadic medulloblastoma. Inactivation of one Ptc allele in mice results in a 14%
      incidence of medulloblastoma. Here, we report a dramatic increase in the
      incidence (>95%) and accelerated development (prior to 12 weeks of age) of
      medulloblastoma in mice heterozygous for Ptc that lack p53. The acceleration of
      tumorigenesis in Ptc+/- mice is specific for loss of p53, because no change in
      tumor incidence was observed in Ptc+/- mice carrying a mutation in APC (Min+/-)
      or in Ptc+/- mice deficient in p19ARF. Thus, there is a specific interaction
      between p53 loss and heterozygosity of Ptc that results in medulloblastoma. This
      may be a consequence of increased genomic instability associated with loss of p53
      function that may enhance the rate of acquisition of secondary mutations. Ptc+/-
      p53-/- mice provide a useful model for investigation of the molecular bases of
      medulloblastoma and for evaluation of the efficacy of therapeutic intervention
      strategies in a spontaneously arising endogenous brain tumor.

PMID- 11212244
TI  - Antitumor synergy of CV787, a prostate cancer-specific adenovirus, and paclitaxel
      and docetaxel.
AB  - CV787, a PSA+ prostate cell-specific adenovirus variant, is currently in Phase
      I/II clinical trials for the treatment of prostate cancer. We have previously
      demonstrated that a single administration of CV787 at 1 x 10(11) particle/animal
      could eliminate established tumors within 6 weeks in nude mouse xenografts (Yu et
      al., Cancer Res., 59: 4200-4203, 1999). We now demonstrate that CV787-mediated
      replication-dependent cytotoxicity is synergistic with the chemotherapeutic
      agents paclitaxel (Taxol) or docetaxel (Taxotere) both in vitro and in vivo. In
      vitro, cells were pretreated with CV787 24 h before taxane, pretreated with
      taxane 24 h before CV787, or treated with both agents simultaneously. Cell
      viability was determined at various time points by 3-[4,5-dimethylthiazole-2-4]
      2,5-diphenyl-2H-tetrazolium bromide assay, and virus yield was examined by plaque
      assay. Addition of taxane to CV787 resulted in a synergistic increase of
      cytotoxicity toward the human prostate cancer cell line LNCaP, regardless of the
      timing of administration. There was no reduction in virus replication or
      specificity of CV787-based cytopathogenicity for prostate cancer cells
      (approximately 10,000 to 1) with the taxanes. p53 expression was significantly
      elevated in the cells treated with CV787 and taxane. In vivo, using the PSA+
      LNCaP xenograft model of prostate cancer, a single i.v. dose of 1 x 10(8)
      particles CV787 and docetaxel in combination eliminates large preexistent distant
      tumors. Toxicity studies do not show a synergistic increase of toxicity of CV787
      and taxane. These experiments demonstrate a synergistic antitumor efficacy for
      CV787 when combined with taxane and demonstrate an in vivo single-dose curative
      therapeutic index for CV787 of over 1000:1.

PMID- 11212245
TI  - Intratumoral administration of endostatin plasmid inhibits vascular growth and
      perfusion in MCa-4 murine mammary carcinomas.
AB  - Endostatin, a fragment of the COOH-terminal domain of mouse collagen XVIII is a
      recently demonstrated endogenous inhibitor of tumor angiogenesis and endothelial
      cell growth. Antiangiogenic therapy with endostatin in animals requires multiple
      and prolonged administration of the protein. Gene therapy could provide an
      alternative approach to continuous local delivery of this antiangiogenic factor
      in vivo. Established MCa-4 murine mammary carcinomas, grown in immunodeficient
      mice, were treated with intratumoral injection of endostatin plasmid at 7-day
      intervals. At the time of sacrifice, 14 days after the first injection,
      endostatin-treated tumor weights were 51% of controls (P < 0.01). Tumor growth
      inhibition was accompanied by a marked reduction in total vascular density.
      Specifically, computerized image analysis showed a 18-21% increase in the median
      distances between tumor cells and both the nearest anatomical (CD31-stained)
      vessel [48.1 +/- 3.8 versus 38.3 +/- 1.6 microm (P < 0.05)] and the nearest tumor
      specific (CD105-stained) vessel [48.5 +/- 1.5 versus 39.8 +/- 1.5 microm (P <
      0.01)]. An increased apoptotic index of tumor cells in endostatin-treated tumors
      [3.2 +/- 0.5% versus 1.9 +/- 0.3% (P < 0.05)] was observed in conjunction with a
      significant decrease in tumor perfused vessels (DiOC7 staining), and an increase
      in tumor cell hypoxia (EF5 staining). Hypoxia resulting from endostatin therapy
      most likely caused a compensatory increase of in situ vascular endothelial growth
      factor (VEGF) and VEGF receptor mRNA expression. Increased immunoreactivity of
      endostatin staining in endostatin-treated tumors was also associated with an
      increased thrombospondin-1 staining [1.12 +/- 0.16 versus 2.44 +/- 0.35]. Our
      data suggest that intratumoral delivery of the endostatin gene efficiently
      suppresses murine mammary carcinoma growth and support the potential utility of
      the endostatin gene for cancer therapy.

PMID- 11212246
TI  - Direct evidence of the importance of stromal urokinase plasminogen activator
      (uPA) in the growth of an experimental human breast cancer using a combined uPA
      gene-disrupted and immunodeficient xenograft model.
AB  - Several studies have indicated an interaction between tumor cells and
      infiltrating stromal cells regarding the urokinase plasminogen activation (uPA)
      system. By developing combined uPA gene-disrupted and immunodeficient mice, we
      have studied the role of stromal uPA for the growth of the MDA-MB-435 BAG human
      tumor xenograft. Subcutaneous tumor growth and lung metastasis were compared
      between wild-type immunodeficient mice and mice with the combined deficiencies.
      Tumor growth was evaluated by volume measurements and plasma beta-galactosidase
      activity and metastasis was evaluated by counting lung surface metastases.
      Although no differences appeared in primary tumor take between the two groups of
      mice, a significant difference was observed in primary tumor growth, with tumors
      in uPA-/- mice growing significantly more slowly. In addition, a nonsignificant
      trend toward fewer lung metastases in uPA-/- mice was observed. The present data
      points to a critical role of stromal-derived uPA in the primary tumor growth of
      MDA-MB-435 BAG xenografts, whereas only a trend toward fewer lung metastases in
      uPA gene-disrupted mice was found.

PMID- 11212247
TI  - Deregulated expression of c-mos in non-small cell lung carcinomas: relationship
      with p53 status, genomic instability, and tumor kinetics.
AB  - Little is known about the status of the mitogen-activating protein kinase
      pathways in lung cancer. One of the key molecules taking part in these pathways
      is the product of the c-mos proto-oncogene, which plays an important role in
      oocyte maturation. In vitro investigations in somatic cells have shown that c-mos
      expression has opposing effects on the cell cycle, which suggests that this proto
      oncogene may represent an important determinant of aberrant cell function
      (genomic instability and altered kinetics). A recent study suggests that these
      effects may be p53 dependent. In view of the apparent link between c-mos and p53,
      we investigated in a series of 56 non-small cell lung carcinomas: a) the status
      of c-mos; b) its relationship to genomic instability (aneuploidy) and two kinetic
      parameters of the tumors, proliferation and apoptotic indexes (AI); and c) its
      association with p53 alterations and their concomitant relationship with the
      above parameters. We found c-mos overexpression in 27% of the tumors. Expression
      was higher in stages II/III (34%) than in stage I (17%; P = 0.018). Complete
      concordance was observed between c-mos overexpression and elevated c-mos mRNA
      levels. Because c-mos gene amplification was not detected, its deregulated
      expression may be attributable to increased transcription. Of the c-mos positive
      [c-mos(P)] cases, 77% were associated with aneuploidy. Sequencing showed two
      silent mutations and one missense (R-->L) at codon 22, located in a region
      critical for c-mos stability. In contrast to the findings of some in vitro
      studies, c-mos(P) tumors had a lower mean AI score than the c-mos negative [c
      mos(N)] tumors had, implying that induction of apoptosis may have been defective.
      Indeed, 86% of the tumors overexpressing c-mos showed p53 alterations. The
      carcinomas with concomitant alterations of c-mos and p53 [c-mos(P)/p53 positive]
      had significantly lower AI values (P < 0.001) and were more frequently associated
      with aneuploidy (P = 0.015) than the c-mos(N)/p53 negative tumors but not the c
      mos(N)/p53 positive tumors, which suggests that p53 status is the main
      determinant of ploidy status and apoptosis in our series. This finding also
      strengthens the concept that wild-type p53 plays a "safeguard" role in preventing
      oncogene-mediated activation.

PMID- 11212248
TI  - Transforming growth factor-beta1 induces desmoplasia in an experimental model of
      human pancreatic carcinoma.
AB  - Proliferation of fibrotic tissue (desmoplasia) is one of the hallmarks of several
      epithelial tumors including pancreatic adenocarcinoma. This tissue reaction may
      be deleterious or advantageous to the host or tumor. In a systematic analysis, we
      identified two growth factors expressed by human pancreatic carcinoma cells that
      are positively correlated with the ability to induce fibroblast proliferation
      both in vitro and in vivo, i.e., transforming growth factor (TGF)-beta1 and
      fibroblast growth factor-2. Here we demonstrate that the overexpression of TGF
      beta1 induced up-regulation of matrix proteins and growth factors in the TGFbeta1
      transfected pancreatic tumor cells. Furthermore, transfection of PANC-1 cells
      induces the same change in fibroblasts in either cocultivation experiments or
      when they are grown in conditioned medium from TGF-beta1-transfected PANC-1
      cells. TGF-beta1-transfected pancreatic tumor cells induced a rich stroma after
      orthotopical transplantation in the nude mouse pancreas. The transfer of a single
      growth factor, TGF-beta1, conveys the ability to induce a fibroblast response
      similar to that seen in desmoplasia in human pancreatic adenocarcinoma. This
      effect cannot only be attributed to direct effects of TGF-beta1 but also results
      from the up-regulation of several other factors including collagen type I,
      connective tissue growth factor, and platelet-derived growth factor.

PMID- 11212249
TI  - Increased retinoic acid responsiveness in lung carcinoma cells that are
      nonresponsive despite the presence of endogenous retinoic acid receptor (RAR)
      beta by expression of exogenous retinoid receptors retinoid X receptor alpha, RAR
      alpha, and RAR gamma.
AB  - Nuclear retinoic acid receptors (RARs) and retinoid X receptors (RXRs) are
      thought to mediate most of the effects of retinoids on cell growth and
      differentiation. Despite expressing abundant levels of RAR beta mRNA, lung
      adenocarcinoma H1792 cells are resistant to the growth-inhibitory effects of all
      trans-retinoic acid, suggesting that they have a defect in retinoid signaling. To
      determine whether transfection of exogenous receptors can restore retinoid
      responsiveness, we transiently transfected into H1792 cells coexpression vectors
      containing cDNAs of cell surface antigen CD7 and either RAR alpha, RAR beta, RAR
      gamma, or RXR alpha. The cells were then treated with retinoids and incubated
      with 5'-bromo-2'-deoxyuridine. Cells that express exogenous receptor were
      identified using antibodies against CD7, and cells that synthesized DNA were
      identified with anti-5'-bromo-2'-deoxyuridine antibodies using secondary
      antibodies with red and green fluorescence, respectively. RXR alpha and RAR alpha
      enhanced growth inhibition by all-trans-retinoic acid or 9-cis-retinoic acid,
      whereas RAR gamma was less effective, and RAR beta was ineffective. The effects
      of the transfected receptors were associated with antagonism of activator protein
      1 (AP-1) activity. Studies with RXR alpha deletion and point mutants indicated
      that growth suppression is: (a) dependent on intact DNA-binding and ligand
      binding regions but not on the NH2-terminal region, which contains a ligand
      independent transactivation function; (b) dependent on RXR homodimer formation
      and transactivation of RXR response element; and (c) associated with AP-1
      antagonism. These results demonstrate that transfected receptors can restore
      responsiveness to retinoids by antagonizing AP-1 in H1792 cells.

PMID- 11212250
TI  - Targeted inactivation of the p21(WAF1/cip1) gene enhances Apc-initiated tumor
      formation and the tumor-promoting activity of a Western-style high-risk diet by
      altering cell maturation in the intestinal mucosal.
AB  - Elimination of both alleles of the gene that encodes the cyclin kinase inhibitor
      p21(WAF1/cip1) increases the frequency and size of intestinal tumors in Apc1638+/
      mice that inherit a mutant allele of the Apc gene, and intermediate effects are
      seen if a single p21 allele is inactivated. The increased tumor formation is
      associated with altered cell maturation in the intestinal mucosa of the p21
      deficient mice--increased cell proliferation, and decreased apoptosis, and goblet
      cell differentiation--that is also a function of p21 gene dosage. Moreover, a
      Western-style diet that mimics principal risk factors for colon cancer (high fat
      and phosphate, low calcium and vitamin D) accelerates tumor formation in
      Apc1638+/- mice, and the loss of a single or both p21 alleles is additive with
      the tumor-promoting effects of this diet, resulting in more and larger tumors,
      and a highly significant decrease in survival time. Thus, p21 normally suppresses
      Apc-initiated tumor formation and is haplo-insufficient in this regard. This is
      consistent with recent reports that Apc initiates tumor formation by up
      regulating c-myc expression through altered beta-catenin-Tcf signaling and that c
      myc then up-regulates cdk4, whose activity is inhibited by p21. Decreased
      expression of p21 is also a marker of poor prognosis in patients, and the data
      presented suggest that dietary alterations in patients undergoing treatment for
      colon cancer might be highly effective in improving outcome.

PMID- 11212251
TI  - The Sp family of transcription factors in the regulation of the human and mouse
      MUC2 gene promoters.
AB  - Modulation of mucin gene expression is an important component both in the early
      steps of colon cancer development and in later tumor progression. Previous work
      from our laboratory and others has suggested that the Sp family of transcription
      factors may play an important role in the regulation of the human MUC2 gene. To
      determine whether this was an essential element, we extended our work to the
      cloning and analysis of 3.5 kb of the 5'-flanking region of the mouse Muc2
      (mMuc2) gene. Comparative analysis between the mouse and human MUC2 promoter
      regions has identified a strong sequence homology between the mouse and human
      genes, including the presence of GC-rich boxes, the location and composition of
      which are maintained in the mouse and human genes. We show that these GC boxes
      are binding sites for Sp-family transcription factors and are functionally
      important since mithramycin, an inhibitor of Sp1/Sp3 binding, blocks MUC2 gene
      expression in HT29 cells. Furthermore, by a combination of gel shift analysis and
      site-directed mutagenesis, we have identified the relative contribution of
      individual GC boxes, and of the factors they bind, to the regulation of the mouse
      Muc2 promoter, which appears to be different in the mouse and human genes.
      Finally, we demonstrate by overexpressing Sp1 and Sp3 that the functional
      difference between the proximal promoter region of the MUC2 gene in the two
      species is not attributable to differential ability of this region to bind
      members of the Sp family of transcription factors, but rather to the different
      anatomy of the individual GC boxes in the mouse and human proximal promoters.

PMID- 11212252
TI  - Matrix metalloproteinase-7-mediated cleavage of Fas ligand protects tumor cells
      from chemotherapeutic drug cytotoxicity.
AB  - Recent evidence suggests that one mechanism whereby cytotoxic drugs, such as
      doxorubicin, kill tumors is the induction or up-regulation of Fas ligand (FasL)
      expression on the tumor cell surface. The ensuing engagement of Fas by FasL on
      adjacent cells leads to apoptosis. However, despite cytotoxic drug-induced FasL
      expression, Fas-sensitive tumors frequently resist chemotherapy, suggesting that
      they may possess a mechanism that prevents or inactivates Fas-FasL interactions.
      In the present work, we addressed the involvement of the FasL/Fas signaling
      pathway in doxorubicin-induced apoptosis and the ability of matrix
      metalloproteinases (MMPs) to proteolytically cleave FasL in tumor cells.
      Doxorubicin-induced apoptosis was inhibited by expression of soluble Fas or
      incubation of the tumor cells with MMP-7 but not with MMP-2 or MMP-9. Resistance
      to doxorubicin was also induced by expression in the tumor cells of
      constitutively active MMP-7 but not of a catalytically inactive mutant.
      Conversely, inhibition of MMP-7 expression in tumor cells by transfection of MMP
      7 cDNA in antisense orientation resulted in sensitization to doxorubicin. MMP-7
      efficiently cleaved recombinant FasL in vitro and reduced cell surface FasL
      expression. Our observations provide evidence that one mechanism whereby MMP-7
      may promote tumor survival and resistance to doxorubicin is by cleaving FasL and
      reducing its effectiveness in triggering Fas-mediated apoptosis.

PMID- 11212253
TI  - Overexpression of the G-protein inwardly rectifying potassium channel 1 (GIRK1)
      in primary breast carcinomas correlates with axillary lymph node metastasis.
AB  - The acquisition of genetic alterations in tumor cells is a hallmark of cancer
      progression. Genetic alterations, including chromosomal sequence alterations and
      abnormal gene expression, increase the malignant potential of tumors by affecting
      pathways that regulate cell growth, cell death, tumor angiogenesis, and
      invasion/metastasis. We used an expression profiling technique, representational
      difference analysis, to identify genes the expressions of which are aberrantly
      increased in invasive breast carcinomas as compared with adjacent normal breast
      tissue from the same individual. Among the genes we identified was GIRK1, which
      encodes a 501 amino acid, G-protein inwardly rectifying potassium channel
      protein. We then measured GIRK1 mRNA expression in benign breast tissues, primary
      invasive breast carcinomas, and metastatic breast carcinomas from axillary lymph
      nodes using quantitative TaqMan reverse transcription-PCR and correlated the
      results with clinical parameters. We found that GIRK1 overexpression correlated
      with lymph node metastasis (P < 0.0029), and overexpression was greatest in
      tumors with more than one positive lymph node. These results indicate that GIRK1
      may be useful as a biomarker for lymph node metastasis and possibly a
      pharmaceutical target.

PMID- 11212254
TI  - AKT activation up-regulates insulin-like growth factor I receptor expression and
      promotes invasiveness of human pancreatic cancer cells.
AB  - Insulin-like growth factor I receptor (IGF-IR) is frequently overexpressed in
      several types of human malignancy and is associated with invasion and metastasis
      of tumor cells. Recently, IGF-IR expression was reported to be up-regulated in
      the human pancreatic cancer cell line PANC-1 when cells were stably transfected
      with active Src. The downstream targets of Src that lead to the up-regulation of
      IGF-IR expression were previously unknown. We demonstrate here that AKT regulates
      IGF-IR expression in PANC-1 and AsPC-1 cells. Cells transfected with active Src
      exhibited significantly more IGF-IR protein compared with vector-transfected
      cells. Overexpression of wild-type or constitutively active AKT (i.e., AKT1 or
      AKT2) also resulted in elevated IGF-IR expression. IGF-IR protein levels were
      higher in cells transfected with constitutively active AKT than in cells
      transfected with active Src. In vitro kinase assays showed that AKT kinases are
      activated by active Src and inhibited by dominant negative Src or the tumor
      suppressor PTEN. Furthermore, AKT-induced IGF-IR expression was down-regulated by
      dominant-negative Src or PTEN. In addition, cells transfected with activated AKT
      in the presence of IGF-I were shown to have enhanced invasiveness compared with
      control cells. These data provide evidence for a link between AKT signaling and
      the regulation of IGF-IR expression and demonstrate that active AKT promotes the
      invasiveness of pancreatic cancer cells through the up-regulation of IGF-IR
      expression.

PMID- 11212255
TI  - Bcl-2 delays and alters hepatic carcinogenesis induced by transforming growth
      factor alpha.
AB  - Transgenic mice that overexpress transforming growth factor (TGF)-alpha develop
      liver tumors between 12 and 15 months of age. Tumor development is preceded by an
      overall increase in the rates of hepatocyte proliferation and cell death. To
      examine the role of apoptosis in the development of TGF-alpha-induced liver
      tumors, we generated TGF-alpha/Bcl-2 double transgenic mice by crossing TGF-alpha
      transgenic mice with Bcl-2 transgenic mice expressing a zinc-inducible Bcl-2
      transgene. Overexpression of the Bcl-2 transgene protected hepatocytes from Fas
      mediated apoptosis. We anticipated that hepatocytes in TGF-alpha/Bcl-2 double
      transgenic mice would be stimulated to proliferate but would fail to undergo
      apoptosis, leading to increased liver weights and accelerated tumorigenesis. At 4
      weeks of age, both TGF-alpha single transgenic and TGF-alpha/Bcl-2 double
      transgenic mice had elevated hepatocyte proliferation and increased liver:body
      weight ratios. However, by 8 months, the liver:body weight ratios had normalized
      in both TGF-alpha single transgenic and TGF-alpha/Bcl-2 double transgenic mice.
      Furthermore, Bcl-2 functioned as a tumor suppressor, significantly decreasing the
      frequency and delaying the development of TGF-alpha-induced liver tumors, despite
      having comparable levels of TGF-alpha transgene expression in both single and
      double transgenic mice. Between 11 and 12 months of age, >80% of the TGF-alpha
      single transgenic mice had developed tumors, whereas only 54% of the double
      transgenic mice had developed tumors after 13 months of age. The tumors that
      eventually developed in the TGF-alpha/Bcl-2 double transgenic mice were
      histologically distinct and smaller in size and had lower hepatocyte mitotic
      activity than tumors from TGF-alpha single transgenic mice. Furthermore, delaying
      Bcl-2 expression until 8.5 months of age was sufficient to inhibit TGF-alpha
      induced tumorigenesis. These results indicate that Bcl-2 inhibits tumor
      progression in the liver, possibly by interfering with hepatocyte proliferation.

PMID- 11212256
TI  - Raf-induced transformation requires an interleukin 1 autocrine loop.
AB  - The c-Raf-1 serine/threonine protein kinase plays a critical role in the
      proliferation of most cell types that have been examined. As such, the Raf proto
      oncogene is thought to play a central role in the development of human tumors.
      Although the c-raf-1 gene itself rarely appears to be mutated in human tumors,
      the kinase activity of Raf is frequently found to be more active in tumor cells,
      likely through constitutive activation of upstream activators of Raf. The
      downstream events triggered by Raf that are involved in transformation have been
      studied less extensively. We show in this study that Raf-induced transformation
      of NIH 3T3 cells requires the activation of the ubiquitously expressed
      transcription factor, nuclear factor-kappaB, by Raf. Furthermore, through the use
      of CrmA, interleukin 1 (IL-1) receptor antagonist, and a dominant-negative form
      of TRAF6, we demonstrate a requirement for IL-1 production and signaling from the
      IL-1 receptor as necessary components of Raf-induced transformation. These
      results indicate that IL-1 may be used as an autocrine growth factor by a number
      of tumors in which activation of Raf plays an important role in transformation
      and suggest that blockade of IL-1 signaling may be an approach to limiting the
      growth of certain tumors.

PMID- 11212257
TI  - p53 codon 72 polymorphism and various human papillomavirus 16 E6 genotypes are
      risk factors for cervical cancer development.
AB  - Risk factors other than human papillomavirus (HPV) infection per se for cervical
      cancer development have been investigated recently. It was suggested that HPV 16
      E6 variants and the p53 codon 72 arginine polymorphism could be progression
      markers. Indeed, it has been demonstrated that specific E6 variants and p53
      arginine were both enriched in cancer. However, especially with regard to the
      latter, divergent results have been reported. Our aim was thus to investigate
      whether p53 arginine is important for cervical carcinogenesis by scaling up
      samples of the two European cohorts, the initial results of which were reported
      previously. In addition, we have assessed the occurrence of p53 codon 72
      arginine, in combination with specific HPV 16 E6 genotypes. We found p53 arginine
      to be increased in cancer of both cohorts, consistent with our previous concept.
      Although specific E6 genotypes increased gradually with the severity of the
      lesion, p53 arginine was enriched in cancer only. Moreover, the frequency of the
      arginine allele was similar in groups with different E6 genotypes. It is
      concluded that p53 arginine is a risk factor for cervical cancer but probably
      acts independently of E6 variants.

PMID- 11212258
TI  - Tobacco smoke-induced DNA damage and an early age of smoking initiation induce
      chromosome loss at 3p21 in lung cancer.
AB  - The short arm of chromosome 3 is thought to harbor a novel oncogenic locus that
      is important in the genesis of lung cancer. The region at 3p21 is believed to
      contain a distinct locus that is sensitive to loss from the action of tobacco
      smoke carcinogens and has been reported to be specifically targeted for deletion
      in lung cancer. To investigate whether 3p21 alteration in lung cancer is
      associated with carcinogen exposure, PCR-based analysis was performed to detect
      loss of heterozygosity (LOH) on chromosome 3 at 3p21 in non-small cell lung
      carcinoma (NSCLC). We also measured instability at the BAT-26 locus, because the
      mismatch DNA repair gene, hMLH1, is found at 3p21. LOH at 3p21 was analyzed for
      association with the clinical features of NSCLC, p53 mutation status, polynuclear
      aromatic hydrocarbon-DNA adduct levels (measured using 32P-postlabeling) and
      carcinogen exposure information including cigarette smoking and asbestos
      exposure. Of 219 lung cancers, 150 cases (68.5%) were informative at the D3S1478
      locus, and 44.2% of squamous cell carcinoma cases and 30.2% of adenocarcinoma
      cases showed 3p21 LOH. None of the cancers showed BAT-26 instability. The
      prevalence of 3p21 LOH was higher in both current and former smokers compared
      with never smokers and was higher in p53 mutated cases. Among squamous cell
      carcinoma cases, there was a strong association of increased 3p21 LOH with
      increasing polynuclear aromatic hydrocarbon-DNA adducts levels (P = 0.03), as
      well as an increased prevalence LOH with earlier age of smoking initiation (P =
      0.02). Our results confirm that 3p21 LOH is strongly associated with measures of
      biologically effective dose of exposure to tobacco carcinogens. Our results also
      suggest that alterations of hMLH1 are not related to any of the reported
      associations, because there was no evidence of microsatellite instability.
      Finally, LOH in 3p21 may be an early molecular event in NSCLC, because it is
      significantly associated with a tendency to start smoking at a young age.

PMID- 11212260
TI  - Hypergastrinemia promotes adenoma progression in the APC(Min-/+) mouse model of
      familial adenomatous polyposis.
AB  - Serum hypergastrinemia promotes the growth of colorectal adenocarcinoma. Some
      colorectal adenomas express cholecystokinin B/gastrin receptor mRNA, and thus
      hypergastrinemia may increase progression through the adenoma-carcinoma sequence.
      This was investigated in the multiple intestinal neoplasia APC(Min-/+) mouse.
      Serum gastrin levels in APC(Min-/+) mice were elevated 5-6-fold by oral
      administration of omeprazole (75 mg/kg). Terminal tumor burden was monitored by
      onset of anemia. A labeling index was generated by immunohistochemical detection
      of bromodeoxyuridine incorporation. Serum gastrin was neutralized by antigastrin
      antibodies raised in situ by use of a gastrin immunogen, Gastrimmune.
      Hypergastrinemia resulted in reduced survival of the APC(Min-/+) mice from a
      median survival of 13 weeks in the controls to 10 weeks following omeprazole
      treatment (P < 0.00001, log-rank test). The labeling indices of adenomas from the
      small and large intestines of omeprazole-treated mice were increased 35 and 29%,
      respectively (P < 0.05 and P < 0.025, respectively). Gastrimmune immunization
      reversed both the survival effect and the increased proliferation resulting from
      serum hypergastrinemia. Hypergastrinemia may promote the progression of existing
      premalignant colonic lesions by increasing proliferation. Clinical investigations
      should determine whether this occurs in the human scenario, considering the
      widespread use of proton pump inhibitors.

PMID- 11212259
TI  - Human papillomavirus type 16 E6 inactivation of p53 in normal human mammary
      epithelial cells promotes tamoxifen-mediated apoptosis.
AB  - Aberrant p53 expression is frequently observed in mammary epithelial cells
      obtained from women at high risk for developing breast cancer and is a predictor
      for the subsequent development of malignancy. Tamoxifen has recently been shown
      to reduce the incidence of noninvasive breast cancer in high-risk women, but the
      molecular mechanism of tamoxifen chemoprevention in mammary epithelial tissue
      that does not overexpress the estrogen receptor is poorly understood. We
      suppressed p53 expression by retroviral-mediated expression of human
      papillomavirus type-16 E6 protein (HPV-16 E6) in human mammary epithelial cells
      (HMECs) to develop an in vitro model of tamoxifen chemoprevention in the context
      of p53 loss. Early passage p53(-) HMEC-E6-transduced cells treated with 1.0
      microM tamoxifen rapidly underwent apoptosis. In contrast, early passage p53(+)
      HMEC-LXSN vector controls treated with 1.0 microM tamoxifen underwent G1-G0-phase
      arrest but did not undergo apoptosis. p53(-) HMEC-E6 cells rapidly acquired
      resistance to tamoxifen-mediated apoptosis after 10 passages in culture (in the
      absence of tamoxifen). Both p53(+) and p53(-) HMECs exhibited a low level of
      estrogen receptor staining and minimal estrogen binding, characteristic of
      proliferating normal luminal mammary epithelial cells. Tamoxifen-mediated
      apoptosis in p53(-) HMEC-E6 cells was not blocked by inhibitors of transcription
      and protein synthesis. These data suggest that the acute loss of p53 function in
      HMECs by expression of HPV-16 E6 results in marked sensitivity to tamoxifen
      mediated apoptosis but that resistance to apoptosis rapidly develops within 10
      passages in vitro. Observations in our model system predict a critical role for
      the early institution of tamoxifen chemoprevention.

PMID- 11212261
TI  - Expression of estrogen receptor (ER) subtypes and ERbeta isoforms in colon
      cancer.
AB  - Colon cancer incidence and mortality rates are lower in females compared with
      males, and numerous epidemiological studies suggest that estrogen replacement
      therapy (ERT) reduces cancer risk in postmenopausal women. Two estrogen receptor
      (ER) subtypes, ERalpha and ERbeta, mediate genomic effects in target cells. The
      aim of this study was to determine the relative mRNA expression levels for ER
      subtypes and ERbeta isoforms in colon tumors, normal colonic mucosa, and colon
      cancer cell lines. ERalpha and ERbeta isoform mRNA levels were investigated in
      paired samples of colon tumors and normal mucosa from 26 patients using
      comparative reverse transcription-PCR and then Southern analyses. Constitutive
      steroid hormone receptor mRNA levels were determined for five colon
      adenocarcinoma cell lines using reverse transcription-PCR, and ERbeta levels were
      further studied in Caco-2 cells using Northern and Western analyses. ERbeta mRNA
      steady-state levels (relative to glyceraldehyde-3-phosphate dehydrogenase mRNA)
      were significantly decreased in colon tumors compared with normal mucosa in
      female patients. ERbeta1 and ERbeta2 isoform mRNA levels were significantly
      decreased in tumors from female patients, and ERbeta1 mRNA levels were also
      significantly lower in tumors from female patients compared with tumors from
      males. ERalpha mRNA levels were much lower than ERbeta levels and were similar
      between normal mucosa and tumor samples in both genders. ERbeta mRNA was detected
      in Caco-2, T84, and SW1116 cell lines and all lines were essentially negative for
      ERalpha mRNA. Caco-2 cells coexpressed ERbeta1, ERbeta2, and ERbeta5 mRNA, though
      a single protein transcript was observed. ERbeta protein was detected in normal
      colonic superficial epithelium, vascular smooth muscle and endothelium, and
      enteric neurons by immunohistochemistry. These data show that ERbeta is the
      predominant ER subtype in the human colon and that decreased levels of ERbeta1
      and ERbeta2 mRNA are associated with colonic tumorigenesis in females. This
      information suggests that activation of ERbeta-mediated processes in the
      superficial colonic epithelium may have a role in the preventive effects observed
      for female gender and ERT usage.

PMID- 11212262
TI  - Intranodal immunization with tumor lysate-pulsed dendritic cells enhances
      protective antitumor immunity.
AB  - We developed a technique for direct inguinal lymph node injection in mice to
      compare various routes of immunization with tumor lysate-pulsed dendritic cell
      (DC) vaccines. Syngeneic, bone marrow-derived, tumor lysate-pulsed DCs
      administered intranodally generated more potent protective antitumor immunity
      than s.c. or i.v. DC immunizations. Intranodal immunization with ovalbumin
      peptide-pulsed DCs induced significantly greater antigen-specific T-lymphocyte
      expansion in the spleen than either s.c. or i.v. immunization. Furthermore, a
      significantly more potent, antigen-specific TH1-type response to the ovalbumin
      peptide was induced by intranodal, compared with s.c. or i.v., immunization.
      Intranodal immunization, designed to enhance DC-T cell interaction in a lymphoid
      environment, optimizes induction of T lymphocyte-mediated protective antitumor
      immunity. These results support the use of intranodal immunization as a feasible
      and effective route of DC vaccine administration.

PMID- 11212263
TI  - Cyclin E is the only cyclin-dependent kinase 2-associated cyclin that predicts
      metastasis and survival in early stage non-small cell lung cancer.
AB  - Progression through G1-S transition and S phase of the cell cycle is mediated by
      cyclin-dependent kinase 2 (cdk2), which interacts with several cyclins. Two of
      these, cyclin E and cyclin A2 (also known as cyclin A), are overexpressed in many
      cancers. Cyclin E2 and cyclin A1 are recently discovered cdk2-interacting cyclins
      that are found in malignant tumor cell lines and in acute myeloid leukemia,
      respectively. Expression and prognostic role of these cyclins in solid tumors is
      unknown. Here, we have analyzed expression and prognostic relevance of the cdk2
      associated cyclins in non-small cell lung cancer (NSCLC). Fresh-frozen biopsies
      (n = 70) from completely resected tumors with stage I to IIIA NSCLC were studied.
      Gene expression was analyzed by quantitative real-time reverse transcription-PCR.
      Expression levels of cyclin E (P = 0.04) and cyclin A2 (P = 0.004) were
      significantly higher in the tumor samples than in normal controls. Cyclin A1,
      cyclin A2, and cyclin E2 expression levels did not have prognostic relevance for
      survival. The mean survival time associated with low and high levels of cyclin E
      was 69.4 and 47.2 months, respectively, which was statistically significant (P =
      0.03). Differences in survival were particularly pronounced in stages I and II.
      Cyclin E was also closely associated with the development of distant metastasis
      (P = 0.01). Finally, we confirmed by immunohistochemistry analyses that cyclin E
      mRNA expression was closely associated with cyclin E protein expression. In
      conclusion, cyclin E is a strong independent prognostic indicator in patients
      with early-stage NSCLC, whereas cyclin E2, cyclin A1, and cyclin A2 do not have a
      prognostic role in NSCLC.

PMID- 11212264
TI  - Glycophosphatidylinositol-anchored protein deficiency as a marker of mutator
      phenotypes in cancer.
AB  - Phosphatidylinositol glycan-A (PIGA) is a gene that encodes an element required
      for the first step in glycosylphosphatidylinositol (GPI) anchor assembly. Because
      PIGA is X-located, a single mutation is sufficient to abolish cell surface GPI
      anchored protein expression. In this study, we investigated whether mutation of
      the PIGA gene could be exploited to identify mutator (Mut) phenotypes in cancer.
      We examined eight Mut colon cancer lines and four non-Mut colon cancers as
      controls. In every case, flow cytometric analyses of cells sorted for low
      fluorescence after staining for GPI-linked CD59 and CD55 revealed negative peaks
      in the Mut lines but not in the controls. Single cell cloning of purged and
      sorted GPI-anchor- HCT116 cells and sequencing of the PIGA gene in each clone
      uniformly showed mutations. Pretreatment of the Mut lines with anti-CD55 or anti
      CD59 antibodies and complement or with the GPI-anchor-reactive bacterial toxin
      aerolysin enriched for the GPI-anchor- populations. Expansion of purged GPI
      anchor+ cells in the Mut lines and analyses using aerolysin in conjunction with
      flow cytometry yielded PIGA gene mutation frequencies of 10(-5) to 10(-4), values
      similar to the mutation frequencies of the hprt gene. This novel approach allows
      for the detection of as yet undescribed repair or replication defects and in
      addition to its considerably greater ease of use than existing techniques and in
      principle would not require the production of cell lines.

PMID- 11212266
TI  - Creation and characterization of 5-fluorodeoxyuridine-resistant Arg50 loop
      mutants of human thymidylate synthase.
AB  - Thymidylate synthase catalyzes the reductive methylation of dUMP to dTMP and is
      essential for the synthesis of DNA. Fluoropyrimidines, such as 5-fluorouracil (5
      FU), are used extensively in cancer therapy. In the cell, 5-FU is metabolized to
      5-fluoro-2'-deoxyuridine 5'-monophosphate, a tight binding covalent inhibitor of
      thymidylate synthase. Recent studies have identified 5-fluoro-2'-deoxyuridine (5
      FdUR) and antifolate-resistant mutants of human thymidylate synthase (TS) that
      contain single residue substitutions within the highly conserved Arg50-loop,
      which binds the pyrimidine substrate (Y. Tong et al., J. Biol. Chem. 273: 11611
      11618, 1998). We have used random sequence mutagenesis to gain structure-function
      information about the TS and to create novel drug-resistant mutants for gene
      therapy. A library of 1.5 million mutants of the Arg50-loop and the nearby
      residue Tyr 33 was selected to identify mutants of the human enzyme with the
      ability to complement a thymidylate synthase-deficient Escherichia coli strain
      and form colonies in the presence of 5-FdUR. E. coli-harboring plasmids that were
      encoding TS with single, double, and triple amino acid substitutions were
      identified that survive at dosages of 5-FdUR clearly lethal to E. coli harboring
      either wild-type thymidylate synthase or constructs encoding previously
      characterized drug resistant mutants. Four 5-FdUR-resistant mutants were purified
      to apparent homogeneity. Kinetic studies indicate that these enzymes are highly
      efficient. Inhibition constants (Ki) for the double mutant K47Q;D48E and the
      triple mutant D48E;T51S;G52C in the presence of 5-fluoro-2'-deoxyuridine 5'
      monophosphate were determined to be 75 to 100 times higher, respectively, than
      that of the wild-type enzyme. These mutant TSs, or others similarly created and
      selected, could be used to protect bone marrow cells from the cytotoxic side
      effects of 5-FU chemotherapy.

PMID- 11212265
TI  - Bax accelerates tumorigenesis in p53-deficient mice.
AB  - Bax is a Bcl-2 family member that promotes apoptosis and counters the protective
      effect of Bcl-2. Bax is a downstream effector of p53-induced apoptosis and is
      transcriptionally regulated by p53. Moreover, the introduction of Bax deficiency
      accelerates the onset of tumors in transgenic mice expressing truncated large T
      antigen. These results implicate Bax as a tumor suppressor. Consequently, we
      asked whether the levels of Bax expression would influence tumor development by
      comparing Bax-deficient and Bax transgenic mice in the presence or absence of
      p53. We found that Bax-deficient mice did not display an increased incidence of
      spontaneous cancers when followed for > 1.5 years. In addition, Bax-deficiency
      did not further accelerate oncogenesis in mice also deficient in p53. We
      generated Lck(pr)-Bax transgenic mice to examine the effects of overexpressed BAX
      on T-cell development and tumorigenesis. Lck(pr)-Bax mice show increased
      apoptosis consistent with the pro-apoptotic function of Bax. The introduction of
      p53-deficiency did not interfere with BAX-induced apoptosis; this is consistent
      with BAX operating downstream or independent of p53. However, we found that
      Lck(pr)-Bax/p53-deficient mice have an increased incidence of T-cell lymphomas
      when compared with p53-deficient mice. The Lck(pr)-Bax transgenic mice have an
      increased percentage of cells in cycle. These findings extend previous work
      suggesting that Bcl-2 family proteins regulate proliferation as well as cell
      death. We conclude that BAX-induced proliferation is synergistic with a defect in
      apoptosis contributed by p53-deficiency. Thus, the dual roles of BAX can either
      accelerate or inhibit tumorigenesis depending on the genetic context.

PMID- 11212268
TI  - Homozygous deletion of CDKN2A (p16INK4a/p14ARF) but not within 1p36 or at other
      tumor suppressor loci in neuroblastoma.
AB  - Loss of heterozygosity of several specific genomic regions is frequently observed
      in neuroblastoma tumors and cell lines, but homozygous deletion (HD) is rare, and
      no neuroblastoma tumor suppressor gene (TSG) has yet been identified. We
      performed a systematic search for HD, indicative of a disrupted TSG, in a panel
      of 46 neuroblastoma cell lines. An initial search focused on a well-characterized
      consensus region of hemizygous deletion at 1p36.3, which occurs in 35% of primary
      neuroblastomas. Each cell line was screened with 162 1p36 markers, for a
      resolution of 13 kb within the consensus 1p36.3 deletion region and 350 kb
      throughout the remainder of 1p36. No HDs were detected. This approach was
      expanded to survey 21 known TSGs, specifically targeting intragenic regions
      frequently inactivated in other malignancies. HD was detected only at the CDKN2A
      (p16INK4a/p14ARF) gene at 9p21 and was observed in 4 of 46 cell lines. The
      observed region of HD included all exons of both CDKN2A and the closely linked
      CDKN2B (p15INK4b) gene for cell lines LA-N-6 and CHLA-174, all exons of CDKN2A
      but none of CDKN2B for CHLA-179, and only 104 bp within CDKN2A exon 2 for CHLA
      101. All four deletions are predicted to inactivate the coding regions of both
      p16INK4a and p14ARF. HD was observed in corresponding primary tumor samples for
      CHLA-101 and CHLA-174 but was not present in constitutional samples. These
      results suggest that for neuroblastoma, large HDs do not occur within 1p36, most
      known TSGs are not homozygously deleted, and biallelic inactivation of CDKN2A may
      contribute to tumorigenicity in a subset of cases.

PMID- 11212267
TI  - Nuclear factor-kappaB-dependent expression of metastasis suppressor KAI1/CD82
      gene in lung cancer cell lines expressing mutant p53.
AB  - KAI1/CD82 has been shown to be a metastasis suppressor for several human cancers,
      and a recent study revealed that wild-type tumor suppressor p53 can directly
      activate KAI1/CD82 gene expression. However, the response of KAI1/CD82 expression
      in cancer cells to exogenous stimulants has not been investigated. The present
      study examined whether tumor necrosis factor (TNF), which mediates many of the
      cellular responses associated with inflammatory reactions or cancer progression,
      can affect the KAI1/CD82 expression in lung cancer cells and, if so, whether
      nuclear factor (NF)-kappaB, a key molecule in TNF-mediated gene expression, is
      involved in the mechanism of KAI1/CD82 induction. Our results demonstrated that
      expression of KAI1/CD82 in PC-14 cells expressing mutant p53 could be augmented
      by TNF-alpha, and that transfer of the gene for a specific inhibitor of NF
      kappaB, IkappaB alphaSR (mutant IkappaB alpha; NF-kappaB super-repressor), into
      PC-14 cells could inhibit this augmentation. The amount of NF-kappaB in the
      nucleus of PC-14/IkappaB alphaSR cells correlated well with KAI1/CD82 mRNA and
      protein expression. In addition, IkappaB alphaSR gene transfer inhibited the
      spontaneous expression of KAI1/CD82 protein in KAI1/CD82-high-expressing RERF-LC
      OK cells, which contain a mutant-type p53. These observations indicate that NF
      kappaB activation may play a role in the regulation of KAI1/CD82 expression in
      lung cancer cells independently of wild-type p53, and suggest that KAI1/CD82
      expression may be regulated by interaction with the host microenvironment.

PMID- 11212269
TI  - Glucagon-like peptide (GLP)-2 reduces chemotherapy-associated mortality and
      enhances cell survival in cells expressing a transfected GLP-2 receptor.
AB  - Chemotherapeutic agents produce cytotoxicity via induction of apoptosis and cell
      cycle arrest. Rapidly proliferating cells in the bone marrow and intestinal
      crypts are highly susceptible to chemotherapy, and damage to these cellular
      compartments may preclude maximally effective chemotherapy administration.
      Glucagon-like peptide (GLP)-2 is an enteroendocrine-derived regulatory peptide
      that inhibits crypt cell apoptosis after administration of agents that damage the
      intestinal epithelium. We report here that a human degradation-resistant GLP-2
      analogue, h[Gly2]-GLP-2 significantly improves survival, reduces bacteremia,
      attenuates epithelial injury, and inhibits crypt apoptosis in the murine
      gastrointestinal tract after administration of topoisomerase I inhibitor
      irinotecan hydrochloride or the antimetabolite 5-fluorouracil. h[Gly2]-GLP-2
      significantly improved survival and reduced weight loss but did not impair
      chemotherapy effectiveness in tumor-bearing mice treated with cyclical
      irinotecan. Furthermore, h[Gly2]-GLP-2 reduced chemotherapy-induced apoptosis,
      decreased activation of caspase-8 and -3, and inhibited poly(ADP-ribose)
      polymerase cleavage in heterologous cells transfected with the GLP-2 receptor.
      These observations demonstrate that the antiapoptotic effects of GLP-2 on
      intestinal crypt cells may be useful for the attenuation of chemotherapy-induced
      intestinal mucositis.

PMID- 11212270
TI  - Taxane-antibody conjugates afford potent cytotoxicity, enhanced solubility, and
      tumor target selectivity.
AB  - Paclitaxel (Taxol) is a chemotherapeutic agent that prevents disassembly of
      microtubular polymers, causing a growth arrest in the G2-M phase of the cell
      cycle and leading to apoptotic death. Paclitaxel has remarkable efficacy against
      fast-growing tumors but possesses major drawbacks, such as poor solubility and
      lack of tumor selectivity. Conversely, monoclonal antibodies usually have low
      therapeutic efficacy but are highly soluble and selectively target tumor markers
      overexpressed in cancer cells. Therefore, to improve the therapeutic index of
      taxanes as chemotherapeutics, the high toxicity of paclitaxel was combined with
      the high selectivity and solubility of monoclonal antibodies as targeting agents.
      We report the chemical coupling and characterization of paclitaxel-antibody
      conjugates for treatment of neuroectoderm-derived tumors. Paclitaxel-antibody
      conjugates afforded selective toxicity toward cells expressing the target marker
      and were more cytotoxic in vitro than equimolar concentrations of free paclitaxel
      or free paclitaxel plus free antibody. In an in vivo model of xenografted tumors,
      systemic administration of paclitaxel-antibody conjugates prevented tumor growth
      and prolonged survival of mice better than free drugs. In addition, paclitaxel
      antibody conjugates were highly soluble in water and stable at -20 degrees C for
      at least 3 months. These studies may lead to an increase or an improvement of the
      armamentarium and selectivity of cytotoxic agents.

PMID- 11212271
TI  - Granulocytic differentiation of human NB4 promyelocytic leukemia cells induced by
      all-trans retinoic acid metabolites.
AB  - The metabolism of all-trans retinoic acid (ATRA) has been reported to be partly
      responsible for the in vivo resistance to ATRA seen in the treatment of human
      acute promyelocytic leukemia (APL). However, ATRA metabolism appears to be
      involved in the growth inhibition of several cancer cell lines in vitro. The
      purpose of this study was to evaluate the in vitro activity of the principal
      metabolites of ATRA [4-hydroxy-retinoic acid (4-OH-RA), 18-hydroxy-retinoic acid
      (18-OH-RA), 4-oxo-retinoic acid (4-oxo-RA), and 5,6-epoxy-retinoic acid (5,6
      epoxy-RA)] in NB4, a human promyelocytic leukemia cell line that exhibits the APL
      diagnostic t(15;17) chromosomal translocation and expresses the PML-RAR alpha
      fusion protein. We established that the four ATRA metabolites were indeed formed
      by the NB4 cells in vitro. NB4 cell growth was inhibited (69-78% at 120 h) and
      cell cycle progression in the G1 phase (82-85% at 120 h) was blocked by ATRA and
      all of the metabolites at 1 microM concentration. ATRA and its metabolites could
      induce NB4 cells differentiation with similar activity, as evaluated by cell
      morphology, by the nitroblue tetrazolium reduction test (82-88% at 120 h) or by
      the expression of the maturation specific cell surface marker CD11c. In addition,
      nuclear body reorganization to macropunctated structures, as well as the
      degradation of PML-RAR alpha, was found to be similar for ATRA and all of its
      metabolites. Comparison of the relative potency of the retinoids using the
      nitroblue tetrazolium reduction test showed effective concentrations required to
      differentiate 50% of cells in 72 h as follows: ATRA, 15.8 +/- 1.7 nM; 4-oxo-RA,
      38.3 +/- 1.3 nM; 18-OH-RA, 55.5 +/- 1.8 nM; 4-OH-RA, 79.8 +/- 1.8 nM; and 5,6
      epoxy-RA, 99.5 +/- 1.5 nM. The ATRA metabolites were found to exert their
      differentiation effects via the RAR alpha nuclear receptors, because the RAR
      alpha-specific antagonist BMS614 blocked metabolite-induced CD11c expression in
      NB4 cells. These data demonstrate that the principal ATRA Phase 1 metabolites can
      elicit leukemia cell growth inhibition and differentiation in vitro through the
      RAR alpha signaling pathway, and they suggest that these metabolites may play a
      role in ATRA antileukemic activity in vivo.

PMID- 11212272
TI  - Intratesticular transplantation of testicular cells from leukemic rats causes
      transmission of leukemia.
AB  - A rat T-cell leukemia model was used to study the safety of germ cell
      transplantation as a mean of preventing infertility in males undergoing
      gonadotoxic cancer treatment. Donor germ cells were harvested from the testes of
      terminally ill leukemic rats and were either used directly or cryopreserved and
      thawed before transplantation by rete testis microinjection. All rats
      transplanted with testicular cells from leukemic donors developed signs of
      terminal rat T-cell leukemia, whereas control animals remained healthy.
      Cryopreservation of the donor germ cells caused a 3- to 6-day delay in the
      terminal phase of leukemia. When a known number of leukemic cells were mixed with
      germ cells and microinjected into the testis, the rate of appearance of terminal
      leukemia was directly related to the number of transferred leukemic lymphoblasts.
      As few as 20 leukemic cells were able to cause a cancer relapse resulting in
      terminal leukemia 21 days after transplantation in three of five transplanted
      animals. Our results demonstrate that germ cell transplantation with the
      presently used techniques is not safe enough for clinical use. Improved methods
      for purging testicular specimens of cancer cells or totally new approaches with
      transient xenogenetic host models to detect contamination of malignant cells must
      be developed before this technique can be offered to patients without fear of
      disease relapse.

PMID- 11212273
TI  - Targeted delivery of tissue factor to the ED-B domain of fibronectin, a marker of
      angiogenesis, mediates the infarction of solid tumors in mice.
AB  - The selective thrombosis of tumor blood vessels, leading to the starvation and
      subsequent death of tumor cells, is an attractive anticancer strategy. Here we
      report that a fusion protein, consisting of an antibody fragment specific for the
      oncofoetal ED-B domain of fibronectin fused to the extracellular domain of tissue
      factor, selectively targets tumor blood vessels in vivo. Furthermore, this fusion
      protein mediates the complete and selective infarction of three different types
      of solid tumors in mice. At the highest doses administered, complete tumor
      eradication was observed in 30% of the mice treated without apparent side
      effects. These results are of therapeutic relevance because the ED-B domain of
      fibronectin, a naturally occurring marker of angiogenesis identical in mouse and
      man, is expressed in the majority of aggressive solid tumors but is undetectable
      in normal vessels and tissues.

PMID- 11212274
TI  - A photobiological and photophysical-based study of phototoxicity of two chlorins.
AB  - To understand the fundamental determinants of phototoxic efficacy and absorbed
      photodynamic dose, the triplet state and photobleaching quantum yields in living
      cells, cellular uptake, intracellular localization, and correlation with cell
      viability were studied for the two purpurins tin ethyl etiopurpurin 1 (SnET2) and
      tin octaethylbenzochlorin (SnOEBC) in ovarian cancer cells (OVCAR5). Although the
      triplet yields of these two photosensitizers were not significantly affected by
      cellular incorporation, the photobleaching yields were shown to be 3 orders of
      magnitude higher for cellular-bound sensitizer than for free or albumin-bound
      photosensitizer and higher for SnET2 than for SnOEBC for all of the cases. The
      intracellular concentration of SnOEBC was half that of SnET2 after 3 h- and 24 h
      incubation times for both 0.1 microM and 1.0 microM incubation concentrations.
      Despite the lower concentrations of SnOEBC, the phototoxicity of the two
      photosensitizers was comparable at 1-microM incubation concentration and was up
      to 10-fold higher for SnOEBC at the lower concentration. The subcellular
      localization established using confocal microscopy and molecular probes showed
      that both photosensitizers were primarily lysosomally localized. SnOEBC, however,
      had an extra-lysosomal, mitochondrial localization component. The photophysical
      measurements allowed calculation of the intracellular singlet oxygen production,
      which indicated that the photosensitizer-light dose reciprocity was limited by
      photobleaching for SnET2 but only minimally for SnOEBC, and this was confirmed
      through cell-survival studies. Taken together, these data indicate that the
      critical determinant of differences in phototoxicity between the two molecules
      was their relative rates of photobleaching and their subcellular localization.
      The study points to the importance of combining photosensitizer uptake and
      localization with photophysical measurements in the relevant biological milieu to
      reasonably interpret and/or predict photosensitization efficacies.

PMID- 11212275
TI  - Antiproliferative effects of S-allylmercaptocysteine on colon cancer cells when
      tested alone or in combination with sulindac sulfide.
AB  - Epidemiological studies link increased garlic (Allium sativum) consumption with a
      reduced incidence of colon cancer in various human populations. Experimental
      carcinogenesis studies in animal models and in cell culture systems indicate that
      several allium-derived compounds exhibit inhibitory effects and that the
      underlying mechanisms may involve both the initiation and promotion phases of
      carcinogenesis. To provide a better understanding of the effects of allium
      derivatives on the prevention of colon cancer, we examined two water-soluble
      derivatives of garlic, S-allylcysteine (SAC) and S-allylmercaptocysteine (SAMC),
      for their effects on proliferation and cell cycle progression in two human colon
      cancer cell lines, SW-480 and HT-29. For comparison, we included the compound
      sulindac sulfide (SS), because sulindac compounds are well-established colon
      cancer chemopreventive agents. We found that SAMC, but not SAC, inhibited the
      growth of both cell lines at doses similar to that of SS. SAMC also induced
      apoptosis, and this was associated with an increase in caspase3-like activity.
      These affects of SAMC were accompanied by induction of jun kinase activity and a
      marked increase in endogenous levels of reduced glutathione. Although SS caused
      inhibition of cell cycle progression from G1 to S, SAMC inhibited progression at
      G2-M, and a fraction of the SW-480 and HT-29 cells were specifically arrested in
      mitosis. Coadministration of SS with SAMC enhanced the growth inhibitory and
      apoptotic effects of SS. These findings suggest that SAMC may be useful in colon
      cancer prevention when used alone or in combination with SS or other
      chemopreventive agents.

PMID- 11212276
TI  - Differential p53-dependent mechanism of radiosensitization in vitro and in vivo
      by the protein kinase C-specific inhibitor PKC412.
AB  - The cellular response to ionizing radiation is governed by the DNA-damage
      recognition process but is also modulated by cytoplasmic signal transduction
      cascades that are part of the cellular stress response. Growth-promoting protein
      kinase C activity antagonizes irradiation-induced cell death, and, therefore,
      protein kinase C inhibitors might be potent radiosensitizers. The
      antiproliferative and radiosensitizing effect of the novel N-benzoylated
      staurosporine analogue PKC412 was tested in vitro against genetically defined p53
      wild type (+/+) and p53-deficient (-/-) murine fibrosarcoma cells and in vivo
      against radioresistant p53-/- murine fibrosarcoma and human colon adenocarcinoma
      tumor xenograft (SW480, p53-mutated). PKC412 sensitized both p53+/+ and p53-/-
      tumor cells in vitro and in vivo for treatment with ionizing radiation but with a
      different mechanism of radiosensitization depending on the p53 status. In p53+/+,
      cells combined treatment with PKC412 and ionizing radiation drastically induced
      apoptotic cell death, whereas no apoptosis induction could be observed in p53
      deficient cells in vitro and in histological tumor sections. Combined treatment
      resulted in an increased G2 cell cycle distribution in p53-/- cells at PKC412
      concentrations that did not alter cell cycle distribution when applied alone. In
      vivo, a minimal treatment regimen during 4 consecutive days of PKC412 (4 x 100
      mg/kg) in combination with ionizing radiation (4 x 3 Gy) exerted a substantial
      tumor growth delay for both p53-disfunctional tumor xenografts and showed that
      the clinically relevant protein kinase C inhibitor PKC412 is a promising new
      radiosensitizer with a potentially broad therapeutic window.

PMID- 11212277
TI  - The HER tyrosine kinase inhibitor CI1033 enhances cytotoxicity of 7-ethyl-10
      hydroxycamptothecin and topotecan by inhibiting breast cancer resistance protein
      mediated drug efflux.
AB  - Because the activities of HER family members are elevated and/or aberrant in a
      variety of human neoplasms, these cell surface receptors are receiving increasing
      attention as potential therapeutic targets. In the present study, we examined the
      effect of combining the HER family tyrosine kinase inhibitor CI1033 (PD 183805)
      with the topoisomerase (topo) I poison 7-ethyl-10-hydroxycamptothecin (SN-38),
      the active metabolite of irinotecan, in a number of different cell lines. Colony
      forming assays revealed that the antiproliferative effects of simultaneous
      treatment with CI1033 and SN-38 were synergistic in T98G glioblastoma cells and
      HCT8 colorectal carcinoma cells, whereas sequential treatments were additive at
      best. In additional studies examining the mechanistic basis for these findings in
      T98G cells, immunoblotting revealed that the inhibitory effects of CI1033 on
      epidermal growth factor receptor autophosphorylation were unaffected by SN-38.
      Likewise, CI1033 had no effect on topo I polypeptide levels, localization, or
      activity. Nonetheless, CI1033 markedly enhanced the number of covalent topo I-DNA
      complexes stabilized by SN-38 or the related agent topotecan (TPT). Analysis of
      intracellular SN-38 levels by high-performance liquid chromatography and
      intracellular TPT levels by flow microfluorometry revealed that CI1033 increased
      the steady-state accumulation of SN-38 and TPT by 9.4 +/- 1.9- and 1.8 +/- 0.2
      fold, respectively. Further evaluation revealed that the initial rate of TPT
      uptake was unaffected by CI1033, whereas the rate of efflux was markedly
      diminished. Additional studies demonstrated that T98G and HCT8 cells express the
      breast cancer resistance protein (BCRP), a recently cloned ATP binding cassette
      transporter. Moreover, CI1033 enhanced the uptake and cytotoxicity of SN-38 and
      TPT in cells transfected with BCRP but not empty vector. Conversely, CI1033
      accumulation was diminished in cells expressing BCRP, suggesting that CI1033 is a
      substrate for this efflux pump. These results indicate that CI1033 can modulate
      the accumulation and subsequent cytotoxicity of two widely used topo I poisons in
      cells that have no history of previous exposure to these agents.

PMID- 11212278
TI  - In vitro and in vivo reversal of P-glycoprotein-mediated multidrug resistance by
      a novel potent modulator, XR9576.
AB  - The overexpression of P-glycoprotein (P-gp) on the surface of tumor cells causes
      multidrug resistance (MDR). This protein acts as an energy-dependent drug efflux
      pump reducing the intracellular concentration of structurally unrelated drugs.
      Modulators of P-gp function can restore the sensitivity of MDR cells to such
      drugs. XR9576 is a novel anthranilic acid derivative developed as a potent and
      specific inhibitor of P-gp, and in this study we evaluate the in vitro and in
      vivo modulatory activity of this compound. The in vitro activity of XR9576 was
      evaluated using a panel of human (H69/LX4, 2780AD) and murine (EMT6 AR1.0, MC26)
      MDR cell lines. XR9576 potentiated the cytotoxicity of several drugs including
      doxorubicin, paclitaxel, etoposide, and vincristine; complete reversal of
      resistance was achieved in the presence of 25-80 nM XR9576. Direct comparative
      studies with other modulators indicated that XR9576 was one of the most potent
      modulators described to date. Accumulation and efflux studies with the P-gp
      substrates, [3H]daunorubicin and rhodamine 123, demonstrated that XR9576
      inhibited P-gp-mediated drug efflux. The inhibition of P-gp function was
      reversible, but the effects persisted for >22 h after removal of the modulator
      from the incubation medium. This is in contrast to P-gp substrates such as
      cyclosporin A and verapamil, which lose their activity within 60 min, suggesting
      that XR9576 is not transported by P-gp. Also, XR9576 was a potent inhibitor of
      photoaffinity labeling of P-gp by [3H]azidopine implying a direct interaction
      with the protein. In mice bearing the intrinsically resistant MC26 colon tumors,
      coadministration of XR9576 potentiated the antitumor activity of doxorubicin
      without a significant increase in toxicity; maximum potentiation was observed at
      2.5-4.0 mg/kg dosed either i.v. or p.o. In addition, coadministration of XR9576
      (6-12 mg/kg p.o.) fully restored the antitumor activity of paclitaxel, etoposide,
      and vincristine against two highly resistant MDR human tumor xenografts (2780AD,
      H69/LX4) in nude mice. Importantly all of the efficacious combination schedules
      appeared to be well tolerated. Furthermore, i.v. coadministration of XR9576 did
      not alter the plasma pharmacokinetics of paclitaxel. These results demonstrate
      that XR9576 is an extremely potent, selective, and effective modulator with a
      long duration of action. It exhibits potent i.v. and p.o. activity without
      apparently enhancing the plasma pharmacokinetics of paclitaxel or the toxicity of
      coadministered drugs. Hence, XR9576 holds great promise for the treatment of P-gp
      mediated MDR cancers.

PMID- 11212279
TI  - Pretreatment with paclitaxel enhances apo-2 ligand/tumor necrosis factor-related
      apoptosis-inducing ligand-induced apoptosis of prostate cancer cells by inducing
      death receptors 4 and 5 protein levels.
AB  - We have demonstrated that Apo-2 ligand (Apo-2L)/tumor necrosis factor-related
      apoptosis-inducing ligand (TRAIL) induces apoptosis of human prostate cancer PC
      3, DU145, and LNCaP cells in a dose-dependent manner, with PC-3 cells displaying
      the greatest sensitivity to Apo-2L/TRAIL. Susceptibility of the prostate cancer
      cell types to Apo-2L/TRAIL-induced apoptosis did not appear to correlate with the
      levels of the Apo-2L/TRAIL receptors death receptor (DR) 4 (TRAIL receptor 1) or
      DR5 (TRAIL receptor 2), decoy receptor (DcR) 1 and DcR2, Flame-1, or the
      inhibitors of apoptosis proteins family of proteins. Apo-2L/TRAIL-induced
      apoptosis of PC-3 cells was associated with the processing of caspase-8, caspase
      10, and the proapoptotic Bid protein, resulting in the cytosolic accumulation of
      cytochrome c as well as the processing of procaspase-9 and procaspase-3.
      Cotreatment with the caspase-8 inhibitor z-IETD-fmk or DR4:Fc significantly
      inhibited Apo-2L/TRAIL-induced apoptosis. Treatment with paclitaxel or taxotere
      increased DR4 and/or DR5 protein levels (up to 8-fold) without affecting the
      protein levels of DcR1 and DcR2, Apo-2L/TRAIL, Fas, or Fas ligand. Up-regulation
      of DR4 and DR5 was not preceded by the induction of their mRNA levels but was
      inhibited by cotreatment with cycloheximide. Importantly, sequential treatment of
      PC-3, DU145, and LNCaP cells with paclitaxel followed by Apo-2L/TRAIL induced
      significantly more apoptosis than Apo-2L/TRAIL treatment alone (P < 0.01). This
      was also associated with greater processing of procaspase-8 and Bid, as well as
      greater cytosolic accumulation of cytochrome c and the processing of caspase-3.
      These findings indicate that up-regulation of DR4 and DR5 protein levels by
      treatment with paclitaxel enhances subsequent Apo-2L/TRAIL-induced apoptosis of
      human prostate cancer cells.

PMID- 11212280
TI  - A truncated human xeroderma pigmentosum complementation group A protein expressed
      from an adenovirus sensitizes human tumor cells to ultraviolet light and
      cisplatin.
AB  - Individuals with the genetic disease xeroderma pigmentosum (XP) have impaired
      nucleotide excision repair (NER). Group A XP cells are defective in the XPA
      protein essential for NER and serve, together with other NER proteins, as a
      nucleation factor for the demarcation of bulky DNA damage. Because XPA cells are
      extremely sensitive to UV and drugs that cause bulky DNA damage, the XPA protein
      is an attractive target for manipulating cellular sensitivity to certain cancer
      therapeutics, a concept that perhaps can be applied toward developing more
      effective cancer treatments. We have made a replication-defective adenovirus,
      AdCMV-FlagXPA(59-114), that expresses a truncated form of XPA encompassing amino
      acids 59-114 sufficient for binding to the excision repair cross-complementing
      protein 1 (ERCC1)/xeroderma pigmentosum complementation group F (XPF) nuclease
      essential for making an incision 5' of the damage. On the basis of previous work,
      it was expected that this truncated XPA protein would work as a decoy and impair
      NER and, thus, sensitize cells to UV and drugs that produce bulky DNA lesions.
      Because the truncated XPA protein is "tagged" with the Flag epitope, an anti-Flag
      antibody can be used to detect protein expression and to isolate proteins
      associated with the XPA complex. We show that relatively large quantities of
      truncated XPA protein are present in infected human lung carcinoma A549 cells 2-4
      days postinfection. Moreover, in a pull-down assay using anti-Flag antibody, we
      show that ERCC1 is present in the FlagXPA complex but not in a complex isolated
      from cells infected with a control virus. Most importantly, cells infected with
      AdCMV-FlagXPA(59-114) are significantly more sensitive than control cells to UV
      induced damage as determined by host-cell reactivation of UV-irradiated AdLacZ
      adenovirus and in a cytotoxicity assay that appears to be the result of aberrant
      processing of 6-4 photoproducts. Infected cells were also more sensitive to
      treatment with cisplatin, an important cancer drug. These results suggest that
      NER, and the XPA protein in particular, can be a direct target for sensitizing
      tumor cells to UV and cisplatin and perhaps also certain other clinically
      important drugs.

PMID- 11212281
TI  - Cumulative and irreversible cardiac mitochondrial dysfunction induced by
      doxorubicin.
AB  - Interference with mitochondrial calcium regulation is proposed to be a primary
      causative event in the mechanism of doxorubicin-induced cardiotoxicity. We
      previously reported disruption of mitochondrial calcium homeostasis after chronic
      doxorubicin administration (Solen et al. Toxicol. Appl. Pharmacol, 129: 214-222,
      1994). The present study was designed to characterize the dose-dependent and
      cumulative interference with mitochondrial calcium regulation and to assess the
      reversibility of this functional lesion. Sprague Dawley rats were treated with 2
      mg/kg/week doxorubicin s.c. for 4-8 weeks. With succinate as substrate, cardiac
      mitochondria isolated from rats after 4 weeks of treatment with doxorubicin
      expressed a lower calcium loading capacity compared with control. This
      suppression of calcium loading capacity increased with successive doses to 8
      weeks of treatment (P < 0.05) and persisted for 5 weeks after the last
      doxorubicin injection, and was corroborated by dose-dependent and irreversible
      histopathological changes. Preincubation of mitochondria with tamoxifen, DTT, or
      monobromobimane did not reverse the diminished calcium loading capacity caused by
      doxorubicin. In contrast, incubation with cyclosporin A abolished any discernible
      difference in mitochondrial calcium loading capacity between doxorubicin-treated
      and saline-treated rats. The decrease in cardiac mitochondrial calcium loading
      capacity was not attributable to bioenergetic changes in the electron transport
      chain, because the mitochondrial coupling efficiency was not altered by
      doxorubicin treatment. However, the ADP/ATP translocase content was significantly
      lower in mitochondria from rats that received 8 weeks of doxorubicin treatment.
      These data indicate that doxorubicin treatment in vivo causes a dose-dependent
      and irreversible decrease in mitochondrial calcium loading capacity. Suppression
      of adenine nucleotide translocase content may be a key factor altering the
      calcium-dependent regulation of the mitochondrial permeability transition pore,
      which may account for the cumulative and irreversible loss of myocardial function
      in patients receiving doxorubicin chemotherapy.

PMID- 11212282
TI  - Nitrated and oxidized plasma proteins in smokers and lung cancer patients.
AB  - Cigarette smoking is a cause of lung cancer and other respiratory diseases.
      Oxidants either present in cigarette smoke and/or formed in the lung of smokers
      may trigger oxidative and nitrative damage to DNA and cellular components,
      contributing to carcinogenesis. We have used immunodot and Western blot analyses
      to measure nitrated (nitrotyrosine-containing) and oxidized (carbonyl-containing)
      proteins in plasma samples collected from 52 lung cancer patients and 43 control
      subjects (heavy and light smokers, nonsmokers with or without exposure to
      environmental tobacco smoke). The levels of nitrated proteins were significantly
      higher in lung cancer patients than in controls (P = 0.003). On the other hand,
      the levels of oxidized proteins were significantly higher in smokers than in
      nonsmokers (P < 0.001). Western-blot analyses showed the presence of two to five
      nitrated proteins and one oxidized protein. Using immunoprecipitation and Western
      blot analyses with eight different antibodies against human plasma proteins, we
      identified fibrinogen, transferrin, plasminogen, and ceruloplasmin as nitrated
      proteins and fibrinogen as the only oxidized protein present in human plasma of
      lung cancer patients and smokers. Our results indicate that cigarette smoking
      increases oxidative stress and that during lung cancer development, formation of
      reactive nitrogen species results in nitration and oxidation of plasma proteins.

PMID- 11212283
TI  - Building a multigenic model of breast cancer susceptibility: CYP17 and HSD17B1
      are two important candidates.
AB  - We conducted a nested case-control study to evaluate whether polymorphisms in two
      genes involved in estrogen metabolism, CYP17 and HSD17B1, were useful in
      developing a breast cancer risk model that could help discriminate women who are
      at higher risk of breast cancer. If polymorphisms in these genes affect the level
      of circulating estrogens, they may directly influence breast cancer risk. The
      base population for this study is a multiethnic cohort study that includes
      African-American, Non-Latina White, Japanese, Latina, and Native Hawaiian women.
      For this analysis, 1508 randomly selected controls and 850 incident breast cancer
      cases of the first four ethnic groups who agreed to provide a blood specimen were
      included (76 and 80% response rates, respectively). The CYP17 A2 allele and the
      HSD17B1 A allele were considered "high-risk" alleles. Subjects were then
      classified according to number of high-risk alleles. After adjusting for age,
      weight, and ethnicity, we found that carrying one or more high-risk alleles
      increases the risk of advanced breast cancer in a dose-response fashion. The risk
      among women carrying four high-risk alleles was 2.21 [95% confidence interval
      (CI), 0.98-5.00; P for trend = 0.03] compared with those who carried none. This
      risk was largely limited to women who were not taking hormone replacement therapy
      (relative risk, 2.60; 95% CI, 0.95-7.14) and was most pronounced among those
      weighing 170 pounds or less (RR, 3.05; 95% CI, 1.29-7.25). These findings suggest
      that breast cancer risk has a strong genetic component and supports the theory
      that the underlying mechanism of "complex traits" can be understood using a
      multigenic model of candidate genes.

PMID- 11212284
TI  - Cyclohexane as an alternative vapor of carbon tetrachloride for the assessment of
      gas removing capacities of gas masks.
AB  - An alternative vapor was explored to replace carbon tetrachloride (CCl4) for
      testing breakthrough times of cartridges and canisters of gas masks in the
      National Approval Test of Respirators. Cyclohexane was single out as a candidate
      for the alternative vapor out of six vapors: trichloroethylene, n-pentane, n
      hexane, n-heptane, toluene and cyclohexane from the viewpoints of similarity of
      vapor pressure and water-solubility to CCl4, lower toxicity than CCl4, and
      technical feasibility in generating an airflow of 30 L/min containing the vapor
      ranging from 300 to 5000 ppm. Breakthrough times of cartridges and canisters were
      examined by generating cyclohexane vapor in a test airflow of 30 L/min in
      comparison with CCl4 vapor under various test conditions with different vapor
      concentrations and relative humidities (RH). As the results, the breakthrough
      times of the cartridges and canisters for cyclohexane were found to almost
      coincide with those for CCl4 under all examined range of concentrations and RH.
      By an increase of humidity from 50% RH to 80% RH, the cartridges showed
      significant shortening of breakthrough times for both of CCl4 and cyclohexane,
      but the susceptibility of the breakthrough time of cyclohexane to humidity was
      also similar to that of CCl4. It was, therefore, concluded that cyclohexane can
      be recommended as the alternative vapor of CCl4 for testing the breakthrough
      times of gas mask cartridges and canisters in the National Approval Test.

PMID- 11212285
TI  - Hematocrit and risk for hypertension in middle-aged Japanese male office workers.
AB  - The association of hematocrit with development of hypertension over 9 years was
      studied in 784 hypertension-free Japanese men aged 40 to 59 years. The age
      adjusted relative risk for hypertension above the borderline level and definite
      hypertension increased in a dose-dependent manner as hematocrit level increased
      (P for trend: 0.007 and 0.001, respectively). After controls for other potential
      factors of hypertension, the test for trend across increasing categories of
      hematocrit level remained as statistical significance for definite hypertension
      (P=0.015). The multivariate-adjusted relative risk for definite hypertension
      compared with less than 43.8% of hematocrit level was 1.29 [95% confidence
      interval (CI): 0.62-2.67] for 43.8 to 45.2% hematocrit level, 1.35 (95% CI: 0.62
      2.95) for 45.3 to 46.3% hematocrit level, 1.96 (95% CI: 0.97-3.97) for 46.4 to
      48.1% hematocrit level, and 2.06 (95% CI: 1.02-4.15) for 48.2% or more hematocrit
      level. These results suggest that hematocrit is closely associated with
      development of hypertension in middle-aged Japanese men.

PMID- 11212286
TI  - Effect of platinum coordination complex (PtCx) on citrate uptake by rat renal
      brush border membrane vesicles (BBMV): direct effect of carboplatin.
AB  - Inhalation of platinum, as soluble salts, is known to cause respiratory distress
      and severe dermatitis in workers. Platinum coordination complexes are widely used
      in the treatment of a variety of solid tumors. However, the clinical use of
      cisplatin (CDDP) (the most useful agent) is limited by the development of
      nephrotoxicity. High dose accidental exposure to soluble platinum in platinum
      refineries and pharmaceutical factories could induce occupational nephrotoxicity.
      Carboplatin (CBDCA), a second-generation platinum coordination complex, is highly
      effective against a variety of malignancies at doses five- to ten-times higher
      than CDDP. At therapeutic doses, CBDCA is less nephrotoxic than CDDP.
      Additionally, urinary citrate is freely filtered at the glomerulus, and its
      reabsorption in the proximal tubule is the major determinant of the rate of renal
      excretion. In our previous study, the preincubation of rat renal brush border
      membrane vesicles (BBMV) with 5 mM cisplatin for 4 and 8 hours significantly
      inhibited the citrate uptake compared with that of the control BBMV. In this
      study, we exposed BBMV to 100 mM carboplatin (twenty-times higher concentration
      than cisplatin) and examined the citrate uptake characteristics to clarify the
      toxic mechanism of platinum coordination complexes. The preincubation of BBMV
      with 100 mM carboplatin for 8 hours also significantly inhibited the citrate
      uptake compared with that of the control BBMV, but the alterations were not as
      severe as those with 5 mM cisplatin.

PMID- 11212287
TI  - Association of alcohol consumption with increase in aortic stiffness: a 9-year
      longitudinal study in middle-aged Japanese men.
AB  - A 9-year longitudinal study was performed to prospectively examine the
      association of alcohol consumption with development of aortic stiffness in 1121
      aortic stiffness-free [aortic pulse wave velocity (PWV) of less than 8.0 m/sec]
      Japanese men aged 35 to 59 years without definite hypertension,
      hypercholesterolemia, or diabetes. 274 men developed aortic stiffness (aortic PWV
      of 8.0 m/sec or more) during 8872 person-years follow-up. After controlling for
      potential predictors of aortic stiffness, the relative risk for increased aortic
      stiffness compared with non-drinkers was 1.01 [95% confidence interval (CI): 0.62
      1.64] for those who drank 0.1 to 22.9 g/day of ethanol, 1.71 (95% CI: 1.12-2.60)
      for those who drank 23.0 to 45.9 g/day of ethanol, 1.79 (95% CI: 1.18-2.71) for
      those who drank 46.0 to 68.9 g/day of ethanol, and 2.09 (95% CI: 1.35-3.26) for
      those who drank 69.0 or more g/day of ethanol (P for trend < 0.001). These
      results suggest that alcohol consumption is closely associated with development
      of aortic stiffness.

PMID- 11212288
TI  - Lymphocyte metallothionein-mRNA as a sensitive biomarker of cadmium exposure.
AB  - Human peripheral blood lymphocytes (PBLs) produce metallothioneins (MTs) in
      response to a variety of heavy metal ions. MTs could therefore be a candidate for
      a marker that represents the biological effect of heavy metals. Since it is
      practically difficult to measure MT protein levels in PBLs, we examined if MT
      mRNA could serve as a biomarker of heavy metal exposure. It is difficult to
      obtain RNA from PBLs without degradation, but we found that intact RNA can be
      prepared by the acid guanidinium thiocyanate-phenol-chloroform extraction method
      which minimizes nuclease digestion of RNA during purification steps. By Northern
      blot analysis of RNA isolated by this method from PBLs cultured with or without
      CdSO4, we demonstrated that MT-mRNA is induced by 0.1 to 0.5 microM CdSO4 in a
      dose-dependent manner. The blood cadmium levels of exposed humans have been
      reported to be up to 0.5 microM. This suggests that our assay is able to detect
      quantitative changes in the PBL MT-mRNA level resulting from in vivo cadmium
      exposure. Thus, PBL MT-mRNA could be used as a sensitive biomarker reflecting
      exposure to cadmium, and probably to several other MT-inducing heavy metals.

PMID- 11212289
TI  - Causal relationship between a case of severe hepatic dysfunction and low exposure
      concentrations of N,N-dimethylformamide in the synthetics industry.
AB  - A 19-year-old man suffered hepatic dysfunction after 5 months of exposure to N,N
      dimethylformamide (DMF) at his job in the synthetic resins industry. Laboratory
      data revealed elevated levels of AST (578 IU/l), ALT (1193 IU/l), and gamma-GTP
      (107 IU/l), no viral infection with HAV, HBV, or HCV, and no history or evidence
      of hepatic injury, although he did have a slight abdominal abnormality and
      swelling which was detected by palpation. His urinary N-methylformamide level, as
      a biological exposure index of DMF, was 42.8 mg/l, indicating 10-30 ppm of DMF
      exposure. After 2 months he was reinstated in two workplaces, the former where he
      worked in the morning and the other in the afternoon where environmental DMF
      concentrations were less than those in the former workplace. On the 18th day
      after his reinstatement, his liver function became exasperated again. After the
      second period of medication and one month of rest from work, he had fully
      recovered and was reinstated, but to a workshop without DMF exposure.

PMID- 11212290
TI  - Lung lesions induced by intratracheal instillation of vanadium pentoxide powder
      in rats.
AB  - To clarify acute toxicity and histopathological changes in the lung after
      exposure to V2O5 powder, rats (SD, male, n=66) were observed for 4 weeks after an
      intratracheal administration of V2O5 powder (geometric mean diameter 0.31 microm,
      geomertic standard deviation sigmag=2.19) at three doses (0.88, 3.0, 13.0 mg/kg
      body weight). The histopathological lung lesions were developed dose-dependently,
      and characterized by exudative inflammation, injury of alveolar macrophages, and
      swelling and mucous degeneration in the broncho-bronchiolar epithelia. Growth
      rate of the V2O5 powder-instilled rat was also retarded dose-dependently. The
      V2O5 powder used was composed of not coagulated but well dispersed particles
      consisting of vanadium pentoxide of more than 99.8% (w/w) with vanadium
      tetraoxide of less than 0.2%. The V2O5 powder was found to be 8 times more
      soluble in an artificial biological fluid "Gamble's solution" than in a pure
      water. From the present findings as well as those from the related literature, it
      was inferred that the histopathological lesions induced by the intratracheally
      instilled V2O5 powder are caused not only by the V2O5 particles per se but also
      by vanadium ions dissolved from the particles into the lung fluid.

PMID- 11212291
TI  - Hepatocyte growth factor in renal disease: cause or cure?
AB  - Hepatocyte growth factor (HGF) is an injury-released growth factor with diverse
      effects on epithelial and endothelial cells. These effects include proliferation,
      migration, extracellular matrix production and tubulogenesis. These activities
      allow HGF to function as an organizer of repair processes that bring about
      restoration of tubular function following renal injury. However, while HGF has
      been demonstrated to accelerate recovery of renal function after an acute insult,
      prolonged exposure to elevated levels of HGF can reduce renal function and may
      contribute to progressive renal disease. This review will describe the cellular
      activities of HGF, how they pertain to renal repair and the therapeutic
      application of regulating HGF activity in acute versus chronic renal disease.

PMID- 11212292
TI  - Bacterial suicide through stress.
AB  - Outside of the laboratory, bacterial cells are constantly exposed to stressful
      conditions, and an ability to resist those stresses is essential to their
      survival. However, the degree of stress required to bring about cell death varies
      with growth phase, amongst other parameters. Exponential phase cells are
      significantly more sensitive to stress than stationary phase ones, and a novel
      hypothesis has recently been advanced to explain this difference in sensitivity,
      the suicide response. Essentially, the suicide response predicts that rapidly
      growing and respiring bacterial cells will suffer growth arrest when subjected to
      relatively mild stresses, but their metabolism will continue: a burst of free
      radical production results from this uncoupling of growth from metabolism, and it
      is this free-radical burst that is lethal to the cells, rather than the stress
      per se. The suicide response hypothesis unifies a variety of previously unrelated
      empirical observations, for instance induction of superoxide dismutase by heat
      shock, alkyl-hydroperoxide reductase by osmotic shock and catalase by ethanol
      shock. The suicide response also has major implications for current [food]
      processing methods.

PMID- 11212293
TI  - Modulation of phospholipase A2 activity generated by molecular evolution.
AB  - Snake venom oligomeric neurotoxins offer several unique examples of modulation of
      phospholipase A2 (PLA2) activity generated by molecular evolution. This
      phenomenon was found in evolutionary younger snakes and is probably common for
      representatives of the genus Vipera. At present, the best-studied example is the
      heterodimeric neurotoxin vipoxin from the venom of the southeast European snake
      Vipera ammodytes meridionalis. It is a complex between a basic strongly toxic
      PLA2 and an acidic and catalytically inactive PLA2-like component (Inh). This is
      the first reported example of a high degree of structural homology (62%) between
      an enzyme and its natural protein inhibitor. The inhibitor is a product of the
      divergent evolution of the unstable PLA2 in order to stabilize it and to preserve
      the pharmacological activity/toxicity for a long time. Inh reduces both the
      catalytic activity and toxicity of PLA2. Vipoxin also illustrates evolution of
      the catalytic into a inhibitory function. Vipoxin analogues have been found in
      the venom of viperid snakes inhabiting diverse regions of the world. An attempt
      is made to explain modulation of the toxic function by the three-dimensional
      structure of vipoxin.

PMID- 11212294
TI  - Cryo-bioorganic chemistry: molecular interactions at low temperature.
AB  - Freezing of aqueous or organic solutions plays a pivotal role in enhancement of
      rate and/or yield of biomolecular reactions. The smooth conditions of the frozen
      state at low temperature can also suppress racemization and side-product
      formation of the reactions. Molecular interactions in liquid undercooled
      solutions, on the other hand, offer the possibility to study enzyme activity
      mechanisms in vitro and a chance for survival of organisms in vivo. This review
      illustrates the differences between frozen and liquid conditions on several small
      and large biomolecules, together with the synthetic use of freezing. In relation
      to the freezing effect on enzyme activity, a peculiar phenomenon is discussed:
      'cryo-oscillations' are temporal motions of trypsin activity in frozen solution
      in the presence of Mn2+ ion. The molecular basis of cold adaptation is also
      discussed, which points to mechanisms evolved by organisms living at subzero
      temperatures. The factors involved in the freezing effect are shown; i.e. the
      role of freeze-concentration and frozen solvent surface is demonstrated and
      elucidated using several examples.

PMID- 11212295
TI  - Molecular mechanism of heme signaling in yeast: the transcriptional activator
      Hap1 serves as the key mediator.
AB  - Heme is a key molecule in mediating the effects of oxygen on various molecular
      and cellular processes in many living organisms. In the yeast Saccharomyces
      cerevisiae, heme serves as a secondary signal for oxygen; intracellular heme
      synthesis directly correlates with oxygen tension in the environment. In yeast,
      oxygen sensing and heme signaling are primarily mediated by the heme activator
      protein Hap1, which, in response to heme, activates the transcription of genes
      required for respiration and for controlling oxidative damage. Heme regulation of
      many genes required for anaerobic growth is mediated by the aerobic repressor
      Rox1, whose expression is controlled by heme. In this review, we summarize recent
      knowledge about (i) how heme synthesis may be controlled by oxygen tension, (ii)
      how heme precisely and stringently controls Hap1 activity and (iii) whether other
      transcriptional activators can also mediate heme action.

PMID- 11212296
TI  - Integrin antagonists.
AB  - Integrins are a family of cell surface glycoproteins that mediate numerous cell
      cell and cell-matrix interactions and are involved in biological processes such
      as tissue morphogenesis, leukocyte recirculation and migration, wound healing,
      blood clotting and immune response. Aberrant cell adhesion has been implicated in
      the pathogenesis of several diseases, including a number of inflammatory
      disorders such as rheumatoid arthritis, inflammatory bowel disease and asthma, as
      well as cancer and coronary heart disease. As such integrins are seen as
      excellent targets for the development of therapeutic agents. This report begins
      with an examination of the structure of integrin molecules and their ligands and
      then goes on to review the current state of development of antiintegrin
      antagonists.

PMID- 11212297
TI  - Laminins during muscle development and in muscular dystrophies.
AB  - Cellular interactions with the extracellular matrix during muscle formation and
      in muscular dystrophy have received increased interest during the past years.
      Laminins constitute a growing family of proteins with complex expression patterns
      in forming basement membranes during muscle development. In skeletal muscle,
      laminins constitute major ligands for cell surface receptors involved in the
      transmission of force from the cell interior, but laminins might also influence
      signal transmission events during muscle formation and in muscle regeneration.
      During myogenesis the laminin alpha1 chain is present around the epithelial
      somite; but later, in forming muscle, the laminin alpha1 chain is restricted to
      the myotendinous junction. The laminin alpha2, alpha4 and alpha5 chains are major
      laminin chains in the muscle basement membrane during muscle formation, but
      laminin alpha4 and alpha5 chains are absent in adult muscle. The importance of
      laminins for muscle integrity is manifested in congenital muscular dystrophies
      with defects in the laminin alpha2 chain. There is no good evidence for the
      presence of laminin alpha1 chain in dystrophic muscle, but some other fetal
      muscle laminins can be detected in dystrophic muscle. Characterization of laminin
      expression patterns in muscular dystrophies might be of diagnostic and
      therapeutic value. In this paper, we review the recent publications on the
      biological functions of muscle laminins and discuss their roles in skeletal
      muscle.

PMID- 11212298
TI  - Roles of postsynaptic density-95/synapse-associated protein 90 and its
      interacting proteins in the organization of synapses.
AB  - Synapses are central stages for neurotransmission. Neurotransmitters are released
      from the presynaptic membrane of one neuron, and bind to the receptors
      accumulated at the postsynaptic membrane, followed by the activation of the other
      neuron. The strength of a synapse is modified depending on the history of the
      previous neurotransmissions. This property is called synaptic plasticity and is
      implicated in learning and memory. Synapses contain not only the components
      essential for neurotransmission but also the signalling molecules involved in
      synaptic plasticity. The elucidation of the molecular structures of synapses is
      one of the key steps to understand the mechanism of learning and memory. Recent
      studies have revealed postsynaptic density (PSD)-95/synapse-associated protein
      (SAP) 90 as a core component in the architecture of synapses. In this review, we
      summarize up-to-date information about PSD-95/SAP90 and its interacting proteins,
      and the organization of synapses orchestrated

PMID- 11212299
TI  - The hypocretins/orexins: novel hypothalamic neuropeptides involved in different
      physiological systems.
AB  - The hypothalamus regulates diverse physiological functions, including the control
      of energy metabolism, circadian rhythms, stress and anxiety, sexual and
      reproductive behaviors. An overview of the most prevalent hypothalamus-enriched
      mRNAs revealed that this area of the brain specializes in producing intercellular
      signaling molecules. Two new secreted peptides derived from a single neuropeptide
      precursor, named hypocretins and orexins by two different groups, are synthesized
      in a small set of neurons in the perifornical area of the hypothalamus.
      Intracerebroventricular injection of the hypocretins/orexins increases food
      consumption in rats. Here we review recent progress in identifying the role of
      the hypocretins/orexins in the control of energy balance and in other
      physiological systems.

PMID- 11212300
TI  - Chemotherapy and immunotherapy of malignant glioma: molecular mechanisms and
      clinical perspectives.
AB  - Despite the considerable progress in modern tumor therapy, the prognosis for
      patients with glioblastoma, the most frequent malignant brain tumor, has not been
      substantially improved. Although cytoreductive surgery and radiotherapy are the
      mainstays of treatment for malignant glioma at present, novel cytotoxic drugs and
      immunotherapeutic approaches hold great promise as effective weapons against
      these malignancies. Thus, great efforts are being made to enhance antitumoral
      efficacy by combining various cytotoxic agents, by novel routes of drug
      administration, or by combining anticancer drugs and immune modulators.
      Immunotherapeutic approaches include cytotoxic cytokines, targeted antibodies,
      and vaccination strategies. However, the success of most of these experimental
      therapies is prevented by the marked molecular resistance of glioma cells to
      diverse cytotoxic agents or by glioma-associated immunosuppression. One promising
      experimental strategy to target glioma is the employment of death ligands such as
      CD95 (Fas/Apo1) ligand or Apo2 ligand (TRAIL). Specific proapoptotic approaches
      may overcome many of the obvious obstacles to a satisfactory management of
      malignant brain tumors.

PMID- 11212301
TI  - Carbamoyl phosphate synthetase: an amazing biochemical odyssey from substrate to
      product.
AB  - Carbamoyl phosphate synthetase (CPS) catalyzes one of the most remarkable
      reactions ever described in biological chemistry, in which carbamoyl phosphate is
      produced from one molecule of bicarbonate, two molecules of Mg2+ ATP, and one
      molecule of either glutamine or ammonia. The carbamoyl phosphate so produced is
      utilized in the synthesis of arginine and pyrimidine nucleotides. It is also
      employed in the urea cycle in most terrestrial vertebrates. Due to its large
      size, its important metabolic role, and the fact that it is highly regulated, CPS
      has been the focus of intensive investigation for nearly 40 years. Numerous
      enzymological, biochemical, and biophysical studies by a variety of investigators
      have led to a quite detailed understanding of CPS. Perhaps one of the most
      significant advances on this topic within the last 2 years has been the
      successful X-ray crystallographic analysis of CPS from Escherichia coli. Quite
      unexpectedly, this structural investigation revealed that the three active sites
      on the protein are widely separated from one another. Furthermore, these active
      sites are connected by a molecular tunnel with a total length of approximately
      100 A, suggesting that CPS utilizes this channel to facilitate the translocation
      of reaction intermediates from one site to another. In this review, we highlight
      the recent biochemical and X-ray crystallographic results that have led to a more
      complete understanding of this finely tuned instrument of catalysis.

PMID- 11212302
TI  - Signaling through beta-catenin and Lef/Tcf.
AB  - Beta-catenin plays a structural role in cell adhesion by binding to cadherins at
      the intracellular surface of the plasma membrane and a signaling role in the
      cytoplasm as the penultimate downstream mediator of the wnt signaling pathway.
      The ultimate mediator of this pathway is a nuclear complex of beta-catenin acting
      as a coactivtor with lymphoid enhancer factor/T cell factor (Lef/Tcf)
      transcription factors to stimulate transcription of a variety of target genes.
      Signaling through beta-catenin is regulated by modulating its degradation and
      nuclear translocation. In the absence of an activating signal, phosphorylation of
      beta-catenin by glycogen synthase kinase 3 (GSK3) acting in conjunction with
      adenomatous polyposis coli and axin/conductin causes beta-catenin to interact
      with the beta-transducin repeat-containing protein which results in its
      ubiquitination and degradation. Signaling from the wnt pathway activates
      dishevelled which, in an as yet undefined manner, inhibits the activity of GSK3
      resulting in an increase in the cytoplasmic free pool of beta-catenin, and
      translocation into the nucleus. The integrin-linked kinase (ILK) pathway also
      activates beta-catenin-Lef/Tcf signaling. ILK phosphorylates GSK3 to inhibit its
      activity and translocates beta-catenin into the nucleus. In addition, ILK
      downregulates the expression of E-cadherin and upregulates Lef-1 expression. In
      the final step of the beta-catenin-Lef/Tcf signaling pathway, nuclear beta
      catenin binds pontin52-TATA binding protein and displaces Groucho-related gene or
      CREB-binding protein corepressors from Lef/Tcf resulting in stimulation of
      transcription. During development, beta-catenin-Lef/Tcf signaling is involved in
      the formation of dorsal mesoderm and dorsal axis. Furthermore, defects in the
      beta-catenin-Lef/Tcf pathway are involved in the development of several types of
      cancers.

PMID- 11212303
TI  - Role of pathways for signal transducers and activators of transcription, and
      mitogen-activated protein kinase in adipocyte differentiation.
AB  - Members of the signal transducer and activator of transcription (STAT) family and
      the mitogen-activated protein kinase (MAPK) cascade play a major role in the
      regulation of cell growth and differentiation. This review concentrates on the
      role played by these pathways in the development of adipose cells. STATs are
      activated by both positive and negative modulators of adipocyte differentiation
      leading to the hypothesis that the STAT pathway may function in adipogenesis. The
      role of the p42/p44 MAPK pathway in adipocyte differentiation has recently been
      the subject of contradictory reports. Several molecular mechanisms are proposed
      to explain the opposing effects of MAPK activation in the programme of adipose
      cell differentiation.

PMID- 11212304
TI  - The in vitro antiapoptotic effect of dehydroepiandrosterone sulfate in mouse
      thymocytes and its relation to caspase-3/caspase-6.
AB  - The effects of dehydroepiandrosterone sulfate (DHEAS) on thymocyte apoptosis
      induced by dexamethasone (DEX) were investigated. Apoptosis was measured by using
      agarose gel electrophoresis of DNA, the terminal deoxynucleotidyltransferase
      (TdT)-mediated dUTP nick end labeling (TUNEL) assay and flow cytometry. Our
      results showed that preincubation with 1 x 10(-4) M DHEAS protected thymocytes
      from DEX-induced apoptosis in vitro. Moreover, we found no blocking effect on the
      DEX-induced activation of caspase-3 and caspase-6 by the preincubation of
      thymocytes with DHEAS. This may be interpreted to mean that the antagonism of
      DHEAS to DEX-induced apoptosis is not related to the activation of these down
      stream caspases which play a critical role in the execution of apoptosis.

PMID- 11212305
TI  - Nitric oxide and cellular respiration.
AB  - The role of nitric oxide (NO) as a signalling molecule involved in many
      pathophysiological processes (e.g., smooth muscle relaxation, inflammation,
      neurotransmission, apoptosis) has been elaborated during the last decade. Since
      NO has also been found to inhibit cellular respiration, we review here the
      available information on the interactions of NO with cytochrome c oxidase (COX),
      the terminal enzyme of the respiratory chain. The effect of NO on cellular
      respiration is first summarized to present essential evidence for the fact that
      NO is a potent reversible inhibitor of in vivo O2 consumption. This information
      is then correlated with available experimental evidence on the reactions of NO
      with purified COX. Finally, since COX has been proposed to catalyze the
      degradation of NO into either nitrous oxide (N2O) or nitrite, we consider the
      putative role of this enzyme in the catabolism of NO in vivo.

PMID- 11212306
TI  - Kainate receptor pharmacology and physiology.
AB  - Glutamate is the primary neurotransmitter in the central nervous system. One of
      the classes of ionotropic glutamate receptors is kainate receptors. Recent
      developments in the pharmacology of kainate receptors have resulted in the
      emergence of several selective agonists and antagonists. These compounds have
      allowed scientists to begin to probe the functional properties of these receptors
      in neurons and gain a better understanding of the role of these receptors in the
      nervous system.

PMID- 11212308
TI  - Scaffolding proteins and their role in viral assembly.
AB  - Scaffolding proteins are proteins that are required to catalyse, regulate or
      modulate some step in the assembly of a macromolecular complex. They associate
      specifically with the nascent protein complex during assembly, but are
      subsequently removed, and are absent from the mature structure. Scaffolding
      proteins have been described primarily from viral systems, in particular from the
      double-stranded DNA bacteriophages, but most likely play a more general role in
      macromolecular assembly, a fundamental process in all biological systems.
      Scaffolding proteins may act in a specific fashion, by actively encouraging the
      formation of correct protein-protein interactions, or more generally by
      nucleating and promoting assembly. They may also work to ensure the fidelity of
      the assembly process by preventing the formation of improper interactions, in
      many ways similar to the role of molecular chaperones in protein folding. In
      viruses, scaffolding proteins are found both in the form of internal cores and
      external bracing, and may form elaborate and complex structures. This review will
      focus on the viral scaffolding proteins, for which an increasing amount of
      structural and functional information has recently become available.

PMID- 11212307
TI  - The polycystins: a novel class of membrane-associated proteins involved in renal
      cystic disease.
AB  - Polycystin-1, polycystin-2 and polycystin-L are the predicted protein products of
      the PKD1, PKD2 and PKDL genes, respectively. Mutations in PKD1 and PKD2 are
      responsible for almost all cases of autosomal dominant polycystic kidney disease
      (ADPKD). This condition is one of the commonest mendelian disorders of man with a
      prevalence of 1:800 and is responsible for nearly 10% of cases of end-stage renal
      failure in adults. The cloning of PKD1 and PKD2 in recent years has provided the
      initial steps in defining the mechanisms underlying renal cyst formation in this
      condition, with the aim of defining pharmacological and genetic interventions
      that may ameliorate the diverse and often serious clinical manifestations of this
      disease. The PKD genes share regions of sequence similarity, and all
      predictintegral membrane proteins. Whilst the predicted protein domain structure
      of polycystin-1 suggests it is involved in cell-cell or cell-matrix interactions,
      the similarity of polycystin-2 and polycystin-L to the pore-forming domains of
      some cation channels suggests that they all form subunits of a large plasma
      membrane ion channel. In the few years since the cloning of the PKD genes, a
      consensus that defines the range of mutations, expression pattern, interactions
      and functional domains of these genes and their protein products is emerging.
      This review will therefore attempt to summarise these data and provide an insight
      in to the key areas in which polycystin research is unravelling the mechanisms
      involved in renal cyst formation.

PMID- 11212309
TI  - Nickel-binding proteins.
AB  - Nickel enzymes are a relatively new class of metalloenzymes. The seven known
      nickel enzymes are urease, hydrogenase, CO-dehydrogenase, methyl-coenzyme M
      reductase, Ni-superoxide dismutase, glyoxalase I and cis-trans isomerase. The
      requirement for nickel implies the presence of a nickel-processing system, since
      free transition metals are harmful to the cell. A nickel-processing system
      involves the recognition and transport of nickel into the cell and the handling
      of the nickel once it enters the cell until it is inserted into the nickel
      enzyme. Several mechanisms for nickel transport have been identified and will be
      reviewed here. Accessory proteins required for the biosynthesis of the nickel
      active site have been identified. Accessory proteins bind the nickel when it
      enters the cell and are proposed to assist with the insertion of nickel into the
      enzyme. The function of the characterized nickel-processing proteins is
      described, and models for nickel insertion into the nickel enzymes are presented.

PMID- 11212310
TI  - Diagnostic and therapeutic applications of azulenyl nitrone spin traps.
AB  - Azulenyl nitrones have been recently demonstrated to constitute a new class of
      nitrone-based spin traps with the unprecedented capacity to tag free radicals by
      yielding characteristically colored and highly visible diamagnetic (and
      paramagnetic) spin adducts. In addition, a comparison of the oxidation potentials
      of azulenyl nitrones such as 1 and congeners to those of conventional nitrone
      spin traps previously investigated as potential antioxidant therapeutics such as
      N-tert-butyl-alpha-phenylnitrone and its related ortho-sodium sulfonate reveals
      that the azulene-derived spin traps are far more readily oxidized. These special
      features render azulenyl nitrones of interest with regard to both their distinct
      ability to engender the convenient use of colorimetric detection to monitor free
      radical-mediated oxidative stress in biological systems, and to their potentially
      enhanced efficacy as neuroprotective antioxidants vs. those conventional nitrone
      spin traps earlier examined as such. Herein is reported an overview of recent
      developments pertaining to the use of azulenyl nitrones in the detection of
      oxidative stress in animal models of amyotrophic lateral sclerosis and stroke,
      and to their neuroprotective activity in animal models of Parkinson's disease,
      stroke and neurodegeneration within the retina.

PMID- 11212311
TI  - Sexual behavior mutants revisited: molecular and cellular basis of Drosophila
      mating.
AB  - The study of Drosophila melanogaster by a combination of forward genetics with
      specific mutants, and reverse genetics, in which a given gene is expressed in an
      appropriate brain area to test its effect on behavior, provides a unique
      opportunity to explore the causal relationship between a particular gene, its
      function in the cell and the behavioral outcome at the organismic level. Enhanced
      male-to-male courtship has been shown to occur as a result of mutations in
      several different genes. For example, the Voila mutant exhibits intense GAL4
      reporter expression in the tarsal gustatory sensilla, suggesting the importance
      of tapping by a male on the female abdomen with his forelegs. Feminization of
      parts of the antennal lobe and mushroom body by targeted expression of a female
      determining gene transformer+ (tra+) drives the male to court other males.
      Mutations in the tra target gene fruitless (fru), which is expressed in the
      antennal lobe as well as the suboesophageal ganglion (the gustatory inputs are
      processed here), also induce homosexual courtship in males. These results suggest
      that sensory inputs mediated and/or processed by the tarsal receptors,
      suboesophageal ganglion, antennal lobe and mushroom body contribute to the
      regulation of male-female courtship. Mosaic analysis localized the neural center
      for male courtship behavior to the posterior dorsal brain, in which the sensory
      information processed by the aforementioned neural structures may be integrated.
      Another mosaic study mapped the neural center for female sexual behavior, as
      measured by her receptiveness to copulation, to the anterior dorsal brain. The
      issue as to how the mutations that reduce female sexual receptiveness, e.g.
      dissatisfaction (dsf), spinster (spin) and chaste (cht), affect the structure
      and/or function of this neural center deserves to be addressed urgently.

PMID- 11212312
TI  - Vertebrate odorant receptors.
AB  - Olfactory transduction begins with the binding of an odorous molecule to a
      protein receptor--odorant receptor--on the cell surface of olfactory neuron.
      Odorant receptors are encoded by a large gene family belonging to the superfamily
      of G-protein-coupled, seven-transmembrane-domain receptors. Since the
      identification of the receptor gene family in 1991, a considerable amount of
      progress has been made in the study of odorant receptors, including aspects of
      spatial and temporal expression pattern, the genomic organization of the receptor
      genes, regulation of expression, and receptor function. These studies are of
      critical importance in understanding how the olfactory system recognizes and
      distinguishes thousands of odors.

PMID- 11212313
TI  - Three for T: molecular analysis of the low voltage-activated calcium channel
      family.
AB  - Despite the wealth of information on voltage-gated calcium channels, little is
      known about low voltage-activated, T-type channels. The ability of the
      antihypertensive drug mibefradil to selectively block T-type channels has
      generated much interest in their structure, physiology and pharmacology. This
      review covers the cloning of a new family of calcium channels, their putative
      structure, the electrophysiological evidence that demonstrated that these
      complementary DNAs encoded low voltage-activated, T-type channels, the tissue
      expression of these genes, and concludes with a discussion of their possible
      physiological roles.

PMID- 11212314
TI  - Hyaluronan synthases: fascinating glycosyltransferases from vertebrates,
      bacterial pathogens, and algal viruses.
AB  - Hyaluronan (or hyaluronic acid or hyaluronate; HA) is a polysaccharide found in
      the extracellular matrix of vertebrate tissues and in the surface coating of
      certain Streptococcus and Pasteurella bacterial pathogens. At least one algal
      virus directs its host to produce HA on the cell surface early in infection. HA
      synthases (HASs) are the enzymes that polymerize HA using uridine diphospho-sugar
      precursors. In all known cases, HA is secreted out of the cell; therefore, HASs
      are normally found in the outer membranes of the organism. In the last 6 years,
      the HASs have been molecularly cloned from all the above sources. They were the
      first class of glycosyltransferases identified in which a single polypeptide
      species catalyzes the transfer of two different monosaccharides; this finding is
      in contrast to the usual 'single enzyme, single sugar' dogma of glycobiology.
      There appear to be two distinct classes of HASs based on differences in amino
      acid sequence, topology in the membrane, and reaction mechanism. This review
      discusses the current state of knowledge surrounding the molecular details of HA
      biosynthesis and summarizes the possible evolutionary history of the HASs.

PMID- 11212315
TI  - Intrathalamic sensory connections mediated by the thalamic reticular nucleus.
AB  - The thalamus and cerebral cortex are linked together to form a vast network of
      interconnections. Different modes of interactions among the cells in this network
      underlie different states of consciousness, such as wakefulness and sleep.
      Interposed between the dorsal thalamus and cortex are the GABAergic neurons of
      the thalamic reticular nucleus (TRN), which play a pivotal role not only in
      switching between the awake and sleep states but also in sensory processing
      during the awake state. The visual, somatosensory, and auditory sectors of TRN
      share many of the same organizational features. Each of these sectors contains
      maps, which are related to its inputs and outputs, and organizational components
      called 'slabs.' It is proposed that, during wakefulness, TRN is crucially
      involved in resetting the activity levels in sensory nuclei of the dorsal
      thalamus, which allows the cortex to actively and periodically compare its
      ongoing sensory processing with the available sensory information.

PMID- 11212316
TI  - Polymorphism in the regulatory sequence of the human hsp70-1 gene does not affect
      heat shock factor binding or heat shock protein synthesis.
AB  - A bi-allelic polymorphism found in the regulatory region of the human heat shock
      (HS) protein (HSP) hsp70-1 gene, which comprises an A-->C transversion, 3 bp
      upstream of the HS element (HSE), has been associated with extended HLA
      haplotypes. In view of the chaperoning and protective functions of Hsp70, we
      investigated whether this hsp70-1 bi-allelic polymorphism could modulate the
      stress response, which may relate to enhanced resistance or susceptibility to
      certain diseases. We compared the basal and HS-induced HS factor (HSF)-binding
      activity of the two polymorphic HSEs, hsp70-1 mRNA accumulation and HSP
      expression in two human Epstein Barr virus (EBV)-transformed B cell lines typed
      for hsp70-1 promoter alleles. Our results suggest that hsp70-1 promoter
      polymorphism does not influence HSF-binding activity, hsp70 mRNA accumulation or
      synthesis in human EBV-transformed B cell lines.

PMID- 11212317
TI  - A C-terminally elongated form of PHI from porcine intestine.
AB  - A C-terminally elongated form of peptide histidine isoleucine amide (PHI) was
      isolated from porcine intestine based on its effect on cAMP production in IMR-32
      cells. The structure was determined by amino acid sequence analysis of tryptic
      fragments and by mass spectrometry. The peptide has 42 amino acid residues like
      those described from human, rat and mouse, but the amino acid sequence of the C
      terminal extension of pig PHI is unique. Unlike the other peptides, it has a C
      terminal Ala and it differs at five positions from the human form and at six
      positions from the rat form, while the human and the rat forms differ by only two
      substitutions. To avoid confusion arising from different C-terminal residues, a
      unifying nomenclature is proposed: PHI-27 for the hormone and PHI-42 for the
      elongated product.

PMID- 11212318
TI  - Xenoreactive natural antibodies.
AB  - Shortages of human organs for transplantation have made it necessary to examine
      the possibility of using nonhuman organs for xenotransplantation the
      transplantation of tissues between different species. Pigs are now regarded as
      the most likely species to serve as donors for clinical xenotransplantation.
      However, rejection of pig tissues and organs, mediated by the host's immune
      system, remains a major barrier to successful xenotransplantation. The primary
      immunological hurdle to overcome is rejection mediated by antibodies in the host
      that recognize antigens present on xenogeneic tissues. Since these antibodies are
      produced naturally in the host without immunization, they are termed natural
      antibodies. Here, we review the nature of xenoreactive natural antibodies
      directed toward pig tissues, and summarize recent progress in the field of
      xenotransplantation directed at overcoming humoral rejection of porcine
      xenografts.

PMID- 11212319
TI  - Beyond blood pressure: new roles for angiotensin II.
AB  - Since the discovery 100 years ago by Tigerstedt and Bergman of renin, an acid
      protease generating angiotensin peptide, numerous discoveries have advanced our
      understanding of the renin-angiotensin system (RAS). The recent cloning of
      angiotensin receptors and the availability of specific receptor ligands have
      allowed characterization of angiotensin-receptor-mediated actions, and an
      increasing number of studies using biochemical, pharmacological and molecular
      biological methods has focused on the many different physiological actions of the
      RAS in various tissues. Angiotensin II, the main effector peptide of the RAS,
      exerts most of its known actions in blood pressure control and body fluid
      homeostasis via the AT, receptor. AT, receptors not only play a role in growth
      control and cell differentiation but have been implicated in apoptosis and tissue
      regeneration. This review focuses on the extrarenal functions of angiotensin,
      especially in neuronal cells and the nervous system, and on recent advances in
      angiotensin receptor research.

PMID- 11212321
TI  - The role of adapter proteins in T cell activation.
AB  - Engagement of antigen receptors on lymphocytes leads to a myriad of complex
      signal transduction cascades. Recently, work from several laboratories has led to
      the identification and characterization of novel adapter molecules, proteins with
      no intrinsic enzymatic activity but which integrate signal transduction pathways
      by mediating protein-protein interactions. Interestingly, it appears that many of
      these adapter proteins play as critical a role as the effector enzymes themselves
      in both lymphocyte development and activation. This review describes some of the
      biochemical and molecular features of several of these newly identified
      hematopoietic cell-specific adapter molecules highlighting their importance in
      regulating (both positively and negatively) signal transduction mediated by the T
      cell antigen receptor.

PMID- 11212320
TI  - Are elicitins cryptograms in plant-Oomycete communications?
AB  - Stimulation of plant natural defenses is an important challenge in
      phytoprotection prospects. In that context, elicitins, which are small proteins
      secreted by Phytophthora and Pythium species, have been shown to induce a
      hypersensitive-like reaction in tobacco plants. Moreover, these plants become
      resistant to their pathogens, and thus this interaction constitutes an excellent
      model to investigate the signaling pathways leading to plant resistance. However,
      most plants are not reactive to elicitins, although they possess the functional
      signaling pathways involved in tobacco responses to elicitin. The understanding
      of factors involved in this reactivity is needed to develop agronomic
      applications. In this review, it is proposed that elicitins could interact with
      regulating cell wall proteins before they reach the plasma membrane.
      Consequently, the plant reactivity or nonreactivity status could result from the
      equilibrium reached during this interaction. The possibility of overexpressing
      the elicitins directly from genomic DNA in Pichia pastoris allows site-directed
      mutagenesis experiments and structure/function studies. The recent discovery of
      the sterol carrier activity of elicitins brings a new insight on their molecular
      activity. This constitutes a crucial property, since the formation of a sterol
      elicitin complex is required to trigger the biological responses of tobacco cells
      and plants. Only the elicitins loaded with a sterol are able to bind to their
      plasmalemma receptor, which is assumed to be an allosteric calcium channel.
      Moreover, Phytophthora and Pythium do not synthesize the sterols required for
      their growth and their fructification, and elicitins may act as shuttles trapping
      the sterols from the host plants. Sequence analysis of elicitin genes from
      several Phytophthora species sheds unexpected light on the phylogenetic
      relationships among the genus, and suggests that the expression of elicitins is
      under tight regulatory control. Finally, general involvement of these lipid
      transfer proteins in the biology of Pythiaceae, and in plant defense responses,
      is discussed. A possible scheme for the coevolution between Phytophthora and
      tobacco plants is approached.

PMID- 11212322
TI  - Permeability of rat heart myocytes to cytochrome c.
AB  - Rat heart myocytes undergoing progressive damage demonstrate morphological
      changes of shortening and swelling followed by the formation of intracellular
      vacuoles and plasma membrane blebbing. The damaged myocytes displayed impaired
      N,N'-tetramethyl-p-phenyldiamine (TMPD) ascorbate-stimulated respiratory activity
      which was restored by the addition of reduced cytochrome c to the cell culture
      medium. To clarify the role played by cytochrome c in the impairment of cell
      respiration, polarographic, spectrophotometric and fluorescence as well as
      electron microscopy imaging experiments were performed. TMPD/ascorbate-stimulated
      respiratory activity returned to control levels, at approximately 20 microM
      cytochrome c, establishing the threshold below which the turnover rate by
      cytochrome c oxidase in the cell depends on cytochrome concentration. Mildly
      damaged cardiac myocytes, as indicated by cell shortening, retention of visible
      striations and free-fluorescein exclusion, together with the absence of lactate
      dehydrogenase leakage and exclusion of trypan blue, were able to oxidize
      exogenous cytochrome c and were permeable to fluorescein-conjugated cytochrome c.
      The results, while consistent with an early cytochrome c release observed at the
      beginning of cell death, elucidate the role played by cytochrome c in the kinetic
      control of mitochondrial electron transfer under pathological conditions,
      particularly those involving the terminal part of the respiratory chain. These
      data are the first to demonstrate that the sarcolemma of cardiac myocytes,
      damaged but still viable, is permeable to cytochrome c.

PMID- 11212323
TI  - Whatever happened to SRY?
AB  - The mammalian sex-determining gene, SRY, was identified by positional cloning
      approximately 10 years ago. Since its discovery, intense research into this gene
      has been directed on two main fronts: elucidation of its function in development
      of the testis and examination of its singular evolutionary history. The role or
      SRY as the testis-determining factor (TDF) places it at a crucial point in the
      highly conserved morphogenetic process of vertebrate gonadogenesis. None of the
      genes that directly activate SRY nor any of its immediate downstream targets have
      yet been positively identified. Several genes, however, such as SF1, DAX1, and
      SOX9, whose spatial and temporal expression profiles overlap with that of SRY,
      are strongly implicated as co-regulators of gonadogenesis. Molecular genetic
      manipulation of these genes in mice has shown that they are indispensable to
      sexual development. Remarkably, its key position in this cascade of gene action
      has not protected SRY from strong yet poorly understood selective forces that
      have caused it to evolve rapidly in mammals. The evolution of SRY has been
      characterized not only by rapid sequence divergence within mammals, but also by
      structural changes such as intron insertion, gene amplification, and deletion.

PMID- 11212324
TI  - Cathepsin A/protective protein: an unusual lysosomal multifunctional protein.
AB  - Cathepsin A/protective protein [3.4.16.5], carboxypeptidase A, is a lysosomal
      serine protease with structural homology to yeast (Saccharomyces cerevisiae)
      carboxypeptidase Y. Cathepsin A is a member of the alpha/beta hydrolase fold
      family and has been suggested to share a common ancestral relationship with other
      alpha/beta hydrolase fold enzymes, such as cholinesterases. Several lines of
      evidence indicate that cathepsin A is a multicatalytic enzyme with deamidase and
      esterase in addition to carboxypeptidase activities. Cathepsin A was recently
      identified in human platelets as deamidase. In vitro, it hydrolyzes a variety of
      bioactive peptide hormones including tachykinins, suggesting that extralysosomal
      cathepsin A plays a role in regulation of bioactive peptide functions. Recent
      reports emphasize the lysosomal protective function of cathepsin A rather than
      its protease function. The protective function of cathepsin A is distinct from
      its catalytic function. Human lysosomal beta-galactosidase and neuraminidase
      exist as a high molecular weight enzyme complex, in which there is a 54-kDa
      glycoprotein termed 'lysosomal protective protein'. Based on cell culture
      studies, protective protein was found to protect both beta-galactosidase and
      neuraminidase from intralysosomal proteolysis by forming a multienzyme complex
      and was shown to be deficient in patients with galactosialidosis, a combined
      deficiency of beta-galactosidase and neuraminidase. Molecular cloning and gene
      expression studies have disclosed that protective protein is cathepsin A. The
      cathepsin A precursor has the potential to restore both beta-galactosidase and
      neuraminidase activities in fibroblasts from patients with galactosialidosis.
      Cathepsin A knockout mice showed a phenotype similar to human galactosialidosis
      and the deficient phenotype found in the mutant mice was corrected by
      transplanting erythroid precursor cells overexpressing cathepsin A. Collectively,
      these findings demonstrate the significance of cathepsin A as a key molecule in
      the onset of galactosialidosis and also highlight the therapeutic potential of
      the cathepsin A precursor for patients with galactosialidosis.

PMID- 11212325
TI  - Proteasomes in apoptosis: villains or guardians?
AB  - The proteasome (multicatalytic proteinase complex, prosome) is a major
      cytoplasmic proteolytic enzyme, responsible for degradation of the vast majority
      of intracellular proteins. Proteins degraded by the proteasome are usually tagged
      with multiple ubiquitin moieties, conjugated to the substrates by a complicated
      cascade of enzymes. Over the last years, evidence has accumulated that changes in
      the expression and activity of the different components of the ubiquitin
      proteasome system occur during apoptosis. Proteasome inhibitors have been used to
      induce apoptosis in various cell types, whereas in others, these compounds were
      able to prevent apoptosis induced by different stimuli. The proteasome mediated
      step(s) in apoptosis is located upstream of mitochondrial changes and caspase
      activation, and can involve in different systems Bcl-2, Jun N-terminal kinase,
      heat shock proteins, Myc, p53, polyamines and other factors.

PMID- 11212326
TI  - Plant mitochondrial carriers: an overview.
AB  - In the two last decades, biochemical studies using mitochondrial swelling
      experiments or direct solute uptake in isolated mitochondria have lead to the
      identification of different transport systems at the level of the plant
      mitochondrial inner membrane. Although most of them have been found to have
      similar features to those identified in animal mitochondria, some differences
      have been observed between plant and animal transporters. More recently,
      molecular biology studies have revealed that most of the mitochondrial exchanges
      are performed by nuclear encoded proteins, which form a superfamily. Members of
      this family have been reported in animals, yeast as well as plants. This review
      attempts to give an overview of the present knowledge concerning the biochemical
      and molecular characterisation of plant members of the mitochondrial carrier
      family and, when possible, a comparison with carriers from other organisms.

PMID- 11212327
TI  - Signalling via caveolin: involvement in the cross-talk between
      phosphoinositolglycans and insulin.
AB  - In recent years, a number of cross-talk systems have been identified which feed
      into the insulin signalling cascade at the level of insulin receptor substrate
      (IRS) tyrosine phosphorylation, e.g., receptor and non-receptor tyrosine kinases
      and G-protein-coupled receptors. At the molecular level, a number of negative
      modulator and feedback systems somehow interacting with the beta-subunit
      (catecholamine-, phorbolester-, or tumor necrosis factor-alpha-induced
      serine/threonine phosphorylation, carboxy-terminal trimming by a thiol-dependent
      protease, association of inhibitory/regulatory proteins such as RAD, PC1, PED,
      alpha2-HS-glycoprotein) have been identified as candidate mechanisms for the
      impairment of insulin receptor function by elevations in the activity and/or
      amount of the corresponding modification enzymes/inhibitors. Both decreased
      responsiveness and sensitivity of the insulin receptor beta-subunit for insulin
      induced tyrosine autophosphorylation have been demonstrated in several cellular
      and animal models of metabolic insulin resistance as well as in the adipose
      tissue and skeletal muscle of diabetic patients and obese Pima Indians compared
      to non-obese subjects. Therefore, induction of the insulin signalling cascade by
      bypassing the defective insulin receptor kinase may be useful for the therapy of
      non-insulin dependent diabetes mellitus. During the past two decades,
      phosphoinositolglycans (PIGs) of various origin have been demonstrated to exert
      potent insulin-mimetic metabolic effects upon incubation with cultured or
      isolated muscle and adipose cells. However, it remained to be elucidated whether
      these compounds actually manage to trigger insulin signalling and if so at which
      level of hierarchy within the signalling cascade the site of interference is
      located. Recent studies using isolated rat adipocytes and chemically synthesized
      PIG compounds point to IRS1/3 tyrosine phosphorylation by p59Lyn kinase as the
      site of cross-talk, the negative regulation of which by interaction with caveolin
      is apparently abrogated by PIG. This putative mechanism is thus compatible with
      the recently formulated caveolin signalling hypothesis, the supporting data for
      which are reviewed here. Though we have not obtained experimental evidence for
      the involvement of PIG in physiological insulin action, the potential cross-talk
      between insulin and PIG signalling, including the caveolae/detergent-insoluble
      glycolipid-enriched rafts as the compartments where the corresponding signalling
      components are concentrated, thus represent novel targets for signal transduction
      therapy.

PMID- 11212328
TI  - Pathophysiology of mitochondrial cell death control.
AB  - Mitochondria have been recently recognized to play a major role in the control of
      apoptosis or programmed cell death. Permeabilization of mitochondrial membranes,
      a decisive feature of early cell death, is regulated by members of the Bcl-2
      family which interact with the permeability transition pore complex (PTPC). Thus,
      the cytoprotective oncoprotein Bcl-2 stabilizes the mitochondrial membrane
      barrier function, whereas the tumor suppressor protein Bax permeabilizes
      mitochondrial membranes. The regulation of membrane permeabilization is
      intertwined with that of the bioenergetic and redox functions of mitochondria.
      The implications of alterations in the composition of the PTPC and in
      mitochondrial function for the pathophysiology of cancer (reduced apoptosis) and
      neurodegeneration (enhanced apoptosis) are discussed.

PMID- 11212329
TI  - Insights from von Willebrand disease animal models.
AB  - von Willebrand disease is a genetic bleeding disorder that arises from
      abnormalities in von Willebrand factor, an adhesive glycoprotein involved in both
      primary hemostasis and coagulation. It is the most common inherited bleeding
      disorder in humans, and over the years several animal species have also been
      described as suffering from this disease whether through a spontaneous mutation
      (pigs, dogs) or a genetically engineered one (mouse). These different animal
      models are extremely useful in exploring the characteristics of von Willebrand
      disease and in testing new treatments. This review provides an update of the
      various von Willebrand disease models and the contribution that these models can
      make to a better understanding of human von Willebrand disease.

PMID- 11212330
TI  - The active role of astrocytes in synaptic transmission.
AB  - In the central nervous system, astrocytes form an intimately connected network
      with neurons, and their processes closely enwrap synapses. The critical role of
      these cells in metabolic and trophic support to neurons, ion buffering and
      clearance of neurotransmitters is well established. However, recent accumulating
      evidence suggests that astrocytes are active partners of neurons in additional
      and more complex functions. In particular, astrocytes express a repertoire of
      neurotransmitter receptors mirroring that of neighbouring synapses. Such
      receptors are stimulated during synaptic activity and start calcium signalling
      into the astrocyte network. Intracellular oscillations and intercellular calcium
      waves represent the astrocyte's own form of excitability, as they trigger release
      of transmitter (i.e. glutamate) via a novel process sensitive to blockers of
      exocytosis and involving cyclooxygenase eicosanoids. Astrocyte-released glutamate
      activates receptors on the surrounding neurons and modifies their electrical and
      intracellular calcium ([Ca2+]i) state. These exciting new findings reveal an
      active participation of astrocytes in synaptic transmission and the involvement
      of neuronastrocyte circuits in the processing of information in the brain.

PMID- 11212331
TI  - Evolution of bacterial pathogenesis.
AB  - The evolution of bacteria is associated with continuous generation of novel
      genetic variants. The major driving forces in this process are point mutations,
      genetic rearrangements, and horizontal gene transfer. A large number of human and
      animal bacterial pathogens have evolved the capacity to produce virulence factors
      that are directly involved in infection and disease. Additionally, many bacteria
      express resistance traits against antibiotics. Both virulence factors and
      resistance determinants are subject to intrastrain genetic and phenotypic
      variation. They are often encoded on unstable DNA regions. Thus, they can be
      readily transferred to bacteria of the same species or even to non-related
      prokaryotes. This review article focuses on the main mechanisms of bacterial
      microevolution responsible for the rapid emergence of variants with novel
      virulence and resistance properties. In addition, processes of macroevolution are
      described with special emphasis on gene transfer and fixation of adaptive
      mutations in the genome of pathogens.

PMID- 11212332
TI  - Short sequence repeats in microbial pathogenesis and evolution.
AB  - Repetitive DNA is ubiquitous in microbial genomes. Different classes of short
      sequence repeats (SSRs) have been identified and demonstrated to be generally
      heterogeneous in a locus-dependent manner, reflected in variation in the number
      of repeat units present at a given genomic site or by sequence heterogeneity
      among individual units. Both types of variability can be used to assess intra
      species genetic diversity. Repeat variability often affects the coding potential
      of the region in which the repetitive element is located. This implies that
      determination of the primary structure of variable numbers of tandem repeats can
      be used for epidemiological identification purposes, and also for the analysis of
      gene function. Precise assessment of SSR structure can also generate insight into
      the regulation of gene expression. Together, DNA repeat analysis in microbial
      species provides information on both functional and evolutionary aspects of
      genetic diversity among microbial isolates.

PMID- 11212333
TI  - Evolution of virulence factors in Shiga-toxin-producing Escherichia coli.
AB  - The major demonstrated or putative virulence factors of Shiga-toxin-producing
      Escherichia coli (STEC) are the Shiga toxins, products of the locus of enterocyte
      effacement, and products encoded by the EHEC-hemolysin plasmid. Molecular
      analysis shows that STEC acquired the majority of these virulence factors by
      horizontal transfer of genetic material. In the case of Shiga toxins, the phages
      encoding them are probably responsible for this transfer. For the locus of
      enterocyte effacement, however, it is not clear how often this transfer took
      place and which parts of the locus were involved in this transfer. The large EHEC
      hemolysin plasmid is clearly a mosaic structure, which arose from multiple
      recombination events with foreign DNA. Two lineages of this plasmid can be
      distinguished, one of which is associated with chromosomally encoded virulence
      factors. Despite the wealth of information available, further comparative studies
      are needed to decipher definitively the evolution of virulence in STEC.

PMID- 11212334
TI  - Antibiotic resistance in microbes.
AB  - The treatment of infectious disease is compromised by the development of
      antibiotic-resistant strains of microbial pathogens. A variety of biochemical
      processes are involved that may keep antibiotics out of the cell, alter the
      target of the drug, or disable the antibiotic. Studies have shown that resistance
      determinants arise by either of two genetic mechanisms: mutation and acquisition.
      Antibiotic resistance genes can be disseminated among bacterial populations by
      several processes, but principally by conjugation. Thus the overall problem of
      antibiotic resistance is one of genetic ecology and a better understanding of the
      contributing parameters is necessary to devise rational approaches to reduce the
      development and spread of antibiotic resistance and so avoid a critical situation
      in therapy--a return to a pre-antibiotic era.

PMID- 11212335
TI  - Spread of antibiotic resistance with food-borne pathogens.
AB  - This short review summarizes data on antibiotic resistance profiles of common
      food-borne pathogens like Salmonella sp., Escherichia coli, Campylobacter sp.,
      Listeria monocytogenes, Clostridium perfringens, Staphylococcus aureus, and
      coagulase-negative staphylococci. As a flashlight on the literature of the last
      few years, it provides ample evidence that antibiotic resistance traits have
      entered the microflora of farm animals and the food produced from them. Molecular
      analysis of the resistance genes, where available, shows that the food microflora
      is not separated from its human counterpart and conjugative transfer of
      resistance genes has been demonstrated in vitro and in a few cases in vivo. For
      example, for Salmonella typhimurium, resistance towards tetracyclines has
      increased from zero in 1948 to a 98% level in certain epidemic populations of S.
      typhimurium DT104 in 1998. The high incidence of food-borne pathogens in raw meat
      and milk together with a high level of therapeutic, prophylactic and nutritional
      application of antibiotics in agriculture reveals an antibiotic resistance
      problem of global dimensions. The resistance problem in human medicine will not
      be solved if there is a constant influx of resistance genes into the human
      microflora via the food chain.

PMID- 11212336
TI  - Genetic basis of methicillin resistance in Staphylococcus aureus.
AB  - Methicillin resistance in staphylococci is due to the acquisition of the mecA
      gene encoding a new penicillin-binding protein (PBP2', PBP2a) that has a lower
      affinity to methicillin than the endogenous PBPs. PBP2' is involved in the
      assembly of the cell wall peptidoglycan in the presence of high concentrations of
      beta-lactams that otherwise inhibit the endogenous PBPs. The production of PBP2'
      is under dual control by its own mecR1-mecI- and the penicillinase blaR1-blaI
      encoded regulatory elements. Resistance to high levels of methicillin depends, in
      addition to PBP2', on chromosomally encoded factors that are involved in the
      synthesis and degradation of the peptidoglycan. Any mutations that reduce
      peptidoglycan precursor formation or change the chemical composition of the
      muropeptide precursor result in lowered resistance.

PMID- 11212337
TI  - Bacterial antibiotic efflux systems of medical importance.
AB  - Multidrug efflux systems endow on bacterial cells the ability to limit the access
      of antimicrobial agents to their targets. By actively pumping out antibiotic
      molecules, these systems prevent the intracellular accumulation necessary for
      antibiotics to exert their lethal activity. Drug efflux appears to be one of the
      most widespread antibiotic resistance mechanisms among microorganisms, since it
      has been demonstrated to occur in many Gram-positive and Gram-negative bacteria
      including medically important species like staphylococci, streptococci,
      enterobacteria and opportunistic pathogens like Pseudomonas aeruginosa. Efflux
      pumps can be specific for only one substrate or accommodate a more or less wide
      range of noxious products. Export of structurally unrelated compounds confers a
      multidrug-resistance phenotype on bacterial cells. Therapeutically critical
      levels of resistance can be achieved by overexpression of efflux systems,
      especially in those species such as P. aeruginosa which possess a low outer
      membrane permeability. It is suspected that the dual physiological function of
      active efflux systems is both the secretion of intracellular metabolites and the
      protection against a variety of harmful substances that the microorganism may
      encounter in its natural environment.

PMID- 11212338
TI  - Bacterial targets and antibiotics: genome-based drug discovery.
AB  - The requirement for novel classes of antibiotics to combat the emergence of
      resistant and multi-resistant bacteria has coincided with the completion
      sequencing of a number of bacterial genomes. The in silico analysis of these
      genomes coupled with innovative genetic manipulation has already led to the
      identification of conserved essential (either in vitro or in vivo, depending on
      the methodology) genes that are potential targets for antibacterial research. New
      technologies, made possible by access to the genomic sequences, are capable of
      simultaneously quantifying almost the entire complement of gene products
      synthesised by bacterial cells. These technologies are opening up the way for the
      analysis of expression patterns elicited in cells in response to changes in their
      environment. The integration of these technologies into the drug discovery
      process is still in its infancy and the potential wealth of information, some of
      it already available, has yet to be fully realised.

PMID- 11212339
TI  - Phosphorylation-dependent prolyl isomerization: a novel signaling regulatory
      mechanism.
AB  - Protein phosphorylation on serine or threonine residues preceding proline
      (Ser/Thr-Pro) plays an essential role for regulating various cellular processes,
      including cell cycle progression. Although phosphorylation has been proposed to
      regulate the function of a protein by inducing conformational changes, much less
      is known about what phosphate additions actually do and how the functions of
      phosphoproteins are coordinated. Proline is important for determining protein
      structure because it exists in cis or trans conformation and can put kinks into a
      polypeptide chain. We have shown that phosphorylation on Ser/Thr-Pro motifs
      reduces the cis/trans isomerization rate of Ser/Thr-Pro bonds. At the same time,
      proteins containing phosphorylated Ser/Thr-Pro motifs are substrates for the
      prolyl isomerase Pin1. The WW domain of Pin1 acts as a phosphoserine/threonine
      binding module binding a defined subset of mitosis-specific phosphoproteins, such
      as Cdc25 and tau. These interactions target the enzymatic activity of Pin1 close
      to its substrates. In contrast to other prolyl isomerases (peptidyl-prolyl
      isomerases, PPlases), Pin1 has an extremely high degree of substrate specificity,
      specifically isomerizing phosphorylated Ser/Thr-Pro bonds. Therefore, Pin1 binds
      and regulates the function of a defined subset of phosphoproteins. Furthermore,
      inhibiting Pin1 function is lethal for dividing cells. Interestingly, Pin1, which
      can restore the biological function of phosphorylated tau, is sequestered in the
      neurofibrillary tangles in Alzheimer's brains. Thus, we have proposed a novel
      signaling regulatory mechanism, where protein phosphorylation creates binding
      sites for Pin1, which can then latch on to and isomerize the phosphorylated
      Ser/Thr-Pro peptide bond. In turn, this may change the shape of the protein,
      regulating its activity, dephosphorylation, degradation or location in the cell.
      This new post-phosphorylation regulatory mechanism appears to play an important
      role in normal cell function, such as mitotic progression, and in the
      pathogenesis of some human pathologies, such as Alzheimer's disease.

PMID- 11212340
TI  - Yeast aging research: recent advances and medical relevance.
AB  - The molecular mechanisms of aging are most fully understood for the budding yeast
      Saccharomyces cerevisiae. Recent advances in our understanding of aging in this
      organism have enabled researchers to answer some fundamental questions about the
      aging process. Is aging due to a multitude of 'mechanisms' or can there be a key
      few? Can we design single-gene mutations that will prolong life? Can we prolong
      life whilst maintaining health and fecundity? The various contributing factors to
      yeast longevity, uncovered thus far, fall into three classes: DNA metabolism,
      heterochromatin, and metabolic activity. However, these separate classes may
      actually represent different aspects of the same aging mechanism based on genome
      stability. This review examines the recent advances in our understanding of yeast
      aging and discusses their relevance, if any, to the human condition.

PMID- 11212341
TI  - The preprotein translocase of the outer mitochondrial membrane: receptors and a
      general import pore.
AB  - Cytosol-synthesized preproteins destined for the mitochondria are transported
      across the outer membrane by the translocase of the mitochondrial outer membrane
      (TOM complex). This dynamic transport machinery can be divided into receptors
      that recognize preprotein targeting signals and components of the general import
      pore complex that mediate preprotein transport across the outer membrane. This
      review focuses on recent studies dealing with the central questions regarding the
      pore-forming subunits, and architecture and gating of the translocation channel
      of the outer membrane.

PMID- 11212342
TI  - ATP-dependent proteases controlling mitochondrial function in the yeast
      Saccharomyces cerevisiae.
AB  - Regulated protein degradation by ATP-dependent proteases plays a fundamental role
      in the biogenesis of mitochondria. Membrane-bound and soluble ATP-dependent
      proteases have been identified in various subcompartments of this organelle.
      Subunits composing these proteases are evolutionarily conserved from yeast to
      humans and, in support of an endosymbiotic origin of mitochondria, evolved from
      prokaryotic ancestors: the PIM1/Lon protease is active in the matrix of
      mitochondria, while the i-AAA protease and the m-AAA protease mediate the
      turnover of inner membrane proteins. Most of the knowledge concerning the
      biogenesis and the physiological role of ATP-dependent proteases comes from
      studies in the yeast Saccharomyces cerevisiae. Proteases were found to be
      required for mitochondrial stasis, for the maintenance of the morphology of the
      organelle and for mitochondrial genome integrity. ATP-dependent proteolysis is
      crucial for the expression of mitochondrially encoded subunits of respiratory
      chain complexes and for the assembly of these complexes. Hence, mitochondrial ATP
      dependent proteases exert multiple roles which are essential for the maintenance
      of cellular respiratory competence.

PMID- 11212343
TI  - Glycine: a new anti-inflammatory immunonutrient.
AB  - The mechanism of the immunosuppressive effects of glycine and its
      pathophysiological applications are discussed in this review. Glycine has been
      well characterized in spinal cord as an inhibitory neurotransmitter which
      activates a glycine-gated chloride channel (GlyR) expressed in postsynaptic
      membranes. Activation of the channel allows the influx of chloride, preventing
      depolarization of the plasma membrane and the potentiation of excitatory signals
      along the axon. Glycine has recently been shown to have similar inhibitory
      effects on several white blood cells, including hepatic and alveolar macrophages,
      neutrophils, and lymphocytes. Pharmacological analysis using a GlyR antagonist
      strychnine, chloride-free buffer, and radiolabeled chloride has provided
      convincing evidence to support the hypothesis that many white blood cells contain
      a glycine-gated chloride channel with properties similar to the spinal cord GlyR.
      Molecular analysis using reverse transcription-polymerase chain reaction and
      Western blotting has identified the mRNA and protein for the beta subunit of the
      GlyR in total RNA and purified membrane protein from rat Kupffer cells. Dietary
      glycine is protective in rat models against endotoxemia, liver ischemia
      reperfusion, and liver transplantation, most likely by inactivating the Kupffer
      cell via this newly identified glycine-gated chloride channel. Glycine also
      prevents the growth of B 16 melanomas cell in vivo. Moreover, dietary glycine is
      protective in the kidney against cyclosporin A toxicity and ischemia-reperfusion
      injury. Glycine may be useful clinically for the treatment of sepsis, adult
      respiratory distress syndrome, arthritis, and other diseases with an inflammatory
      component.

PMID- 11212344
TI  - Cell surface heparan sulfate proteoglycans and lipoprotein metabolism.
AB  - Cell surface heparan sulfate proteoglycans are involved in several aspects of the
      lipoprotein metabolism. Most of the biological activities of these proteoglycans
      are mediated via interactions of their heparan sulfate moieties with various
      protein ligands, including lipoproteins and lipases. The binding of lipoproteins
      to heparan sulfate is largely determined by their apoprotein composition, and
      apoproteins B and E display the highest affinity for heparan sulfate.
      Interactions of lipoproteins with heparan sulfate are important for the cellular
      uptake and turnover of lipoproteins, in part by enhancing the accessibility of
      lipoproteins to lipoprotein receptors and lipases. Apoprotein B may interact with
      receptors without involving heparan sulfate. Heparan sulfate has been further
      implicated in presentation and stabilization of lipoprotein lipase and hepatic
      lipase on cell surfaces and in the transport of lipoprotein lipase from
      extravascular cells to the luminal surface of the endothelia. In atherosclerosis,
      heparan sulfate is intimately involved in several events important to the
      pathophysiology of the disease. Heparan sulfate thus binds and regulates the
      activity of growth factors, cytokines, superoxide dismutase and antithrombin,
      which contribute to aberrant cell proliferation, migration and matrix production,
      scavenging of reactive oxygen radicals and thrombosis. In this review we discuss
      the various roles of heparan sulfate proteoglycans in vascular biology, with
      emphasis on interactions of heparan sulfate with lipoproteins and lipases and the
      molecular basis of such interactions.

PMID- 11212345
TI  - The rat beta (b miny)-globin promoter: nuclear protein factors and erythroid
      specific induction of transcription.
AB  - We show that the rat adult beta (b miny)-globin gene is transcriptionally active.
      The - 100-bp promoter region contains control elements that are important for the
      induction of transcription in rat erythroleukemia (REL) cells. By using DNaseI
      footprinting and gel mobility shift assays, we have shown that the CCAAT box, a
      regulatory element from an analyzed promoter region, binds NF-Y and GATA-1
      transcription factors. Another regulatory element from this region, betaDRE,
      binds erythroid-specific and ubiquitous factors from REL cells. Although both the
      CCAAT box region and betaDRE element bind the same protein factors before and
      after induction of REL cells, we show by South-Western blot analysis that the
      concentrations of 150-kDa, 70-kDa and 60-kDa factors binding to the betaDRE are
      increased in DMSO-induced REL cells.

PMID- 11212346
TI  - The diversity of molecular motors: an overview.
AB  - Rapid progress has recently been made in the identification and characterization
      of a large number of kinesin and myosin motor proteins. Recent work has uncovered
      roles for these motors in processes such as vesicle trafficking, cytoskeletal
      organization, and chromosome movements, to name a few. A series of reviews
      describing some of the significant advances in our understanding of the structure
      and function of myosins and kinesins is presented.

PMID- 11212347
TI  - Three-dimensional structure of motor molecules.
AB  - Images, calculated from electron micrographs, show the three-dimensional
      structures of microtubules and tubulin sheets decorated stoichiometrically with
      motor protein molecules. Dimeric motor domains (heads) of kinesin and ncd, the
      kinesin-related protein that moves in the reverse direction, each appeared to
      bind to tubulin in the same way, by one of their two heads. The second heads show
      an interesting difference in position that seems to be related to the directions
      of movement of the two motors. X-ray crystallographic results showing the
      structures of kinesin and ncd to be very similar at atomic resolution, and
      homologous also to myosin, suggest that the two motor families may use mechanisms
      that have much in common. Nevertheless, myosins and kinesins differ kinetically.
      Also, whereas conformational changes in the myosin catalytic domain are amplified
      by a long lever arm that connects it to the stalk domain, kinesin and ncd do not
      appear to possess a structure with a similar function but may rely on biased
      diffusion in order to move along microtubules.

PMID- 11212348
TI  - Kinesins in the nervous system.
AB  - Both the development and the maintenance of neurons require a great deal of
      active cytoplasmic transport. Much of this transport is driven by microtubule
      motor proteins. Membranous organelles and other macromolecular assemblies bind
      motor proteins that then use cycles of adenosine 5'-triphosphate hydrolysis to
      move these 'cargoes' along microtubules. Different sets of cargoes are
      transported to distinct locations in the cell. The resulting differential
      distribution of materials almost certainly plays an important part in generating
      polarized neuronal morphologies and in maintaining their vectorial signalling
      activities. A number of different microtubule motor proteins function in neurons;
      presumably they are specialized for accomplishing different transport tasks.
      Questions about specific motor functions and the functional relationships between
      different motors present a great challenge. The answers will provide a much
      deeper understanding of fundamental transport mechanisms, as well as how these
      mechanisms are used to generate and sustain cellular asymmetries.

PMID- 11212349
TI  - Kinesin-II, the heteromeric kinesin.
AB  - The kinesins constitute a large family of motor proteins which are responsible
      for the distribution of numerous organelles, vesicles and macromolecular
      complexes throughout the cell. One class of these molecular motors, kinesin-II,
      is unique in that these proteins are typically found as heterotrimeric complexes
      containing two different, though related, kinesin-like motor subunits, and a
      single nonmotor subunit. The heteromeric nature of these kinesins appears to have
      resulted in a class of combinatorial kinesins which can 'mix and match' different
      motor subunits. Another novel feature of these motors is that the activities of
      several kinesin-II representatives are essential in the assembly of motile and
      nonmotile cilia, a role not attributed to any other kinesin. This review presents
      a brief overview of the structure and biological functions of kinesin-II, the
      heteromeric kinesin.

PMID- 11212350
TI  - Myosins from plants.
AB  - Molecular cloning and sequence analysis of myosin genes from Arabidopsis thaliana
      and electron microscopic observation of a myosin from characean alga have
      revealed that overall structure of plant unconventional myosins is similar to
      that of the class V myosins. These plant unconventional myosins have two heads, a
      coiled-coil tail of varied length and a globular tail piece at the end. The tail
      piece is probably a site for membrane interaction. Characean myosin is of special
      interest because it can translocate actin filaments at a velocity several times
      faster than muscle myosin, which must have evolved to support the quick movement
      of animals in the struggle for their lives.

PMID- 11212351
TI  - Myosin-V: head to tail.
AB  - The myosin-V family is the most extensively studied of the unconventional myosin
      families. Most organisms examined have at least one member of the myosin-V
      family: many have multiple members. The wide range of species in which myosin-V
      has been identified suggests that myosin-V is a fundamental component of
      organelle transport in all higher eukaryotes. Possible cargoes for myosin-V range
      from melanosomes and synaptic vesicles in mammals to vacuoles and messenger RNA
      in yeast. In this review, we discuss the current state of research on the
      cellular function of myosin-V as described by the actions of the head, neck and
      tail domains.

PMID- 11212352
TI  - Tails of unconventional myosins.
AB  - In addition to the conventional myosins (class II) required for processes such as
      muscle contraction and cytokinesis, the myosin superfamily of actin-based motor
      proteins includes at least 14 'unconventional' classes. These unconventional
      myosins are defined by myosin-like head (motor) domains attached to class
      specific tail domains that differ greatly from those of myosin-II. The
      unconventional myosins account for almost two-thirds of the 28 or more myosin
      genes currently believed to be expressed in humans and 80-90% of the
      approximately 10 or more myosin genes expressed in a typical nonmuscle cell.
      Although these members of the myosin superfamily have not been as intensively
      investigated as the conventional myosins, unconventional myosins are known or
      believed to power many forms of actin-based motility and organelle trafficking.
      The presence of signaling domains such as kinase domains, SH3 domains, PH domains
      or GTPase-activating domains in the tails of unconventional myosins indicates
      that these proteins can also be components of signal transduction pathways. Since
      several classes of the myosin superfamily have been found only in lower
      eukaryotes or plants (VIII, XI, XIII and XIV), in this review we will focus on
      the structures and properties of the unconventional myosins found in
      multicellular animals (excluding classes I and V, which have been reviewed
      elsewhere recently). Special attention will be focused on the three classes of
      unconventional myosins that can cause deafness in mouse or humans when mutated.
      In addition, we discuss the discovery of a pair of intriguing domains, the Myosin
      Tail Homology 4 (MyTH4) and FERM (band 4.1, Ezrin, Radixin, Moesin) domains, that
      are present in the tails of otherwise very different myosins as well as a plant
      kinesin-like protein. Recent progress in the identification of novel
      unconventional myosins will also be summarized.

PMID- 11212353
TI  - Molecular genetics of Usher syndrome.
AB  - The Usher syndrome, an autosomal recessive deafness and blindness, is genetically
      and clinically heterogeneous. In the past 4 years, genes mutated in Usher
      syndrome type Ib and type IIa have been described. The Usher Ib gene encodes the
      motor protein myosin VIIa and was identified as the human homolog of the mouse
      shaker-1 gene. The Usher type IIa gene was identified by positional cloning and
      encodes a protein with homology to extracellular matrix proteins and cell
      adhesion molecules. This review summarizes the current knowledge regarding both
      the genetic and molecular aspects of Usher syndrome in the context of recent
      scientific advances in the areas of sensorineural deafness and retinitis
      pigmentosa.

PMID- 11212354
TI  - Molecular pathogenesis of apolipoprotein E-mediated amyloidosis in late-onset
      Alzheimer's disease.
AB  - Apolipoprotein E (apoE) epsilon4 allele is a genetic risk factor for late-onset
      familial and sporadic Alzheimer's disease (AD). In the central nervous system,
      apoE is secreted mainly by astrocytes as a constituent of high-density
      lipoproteins. A recent study using apoE knockout mice provided strong evidence
      that apoE promotes cerebral deposition of amyloid beta protein (Abeta). However,
      no clear explanation of the pathogenesis of apoE-induced AD has been provided.
      Here we discuss two possible mechanisms by which apoE might enhance Abeta
      deposition. One is the intracellular pathway in which apoE is internalized by
      neurons and induces lysosomal accumulation of Abeta and amyloidogenic APP
      (amyloid precursor protein) fragments, leading to neuronal death. The other is
      the extracellular pathway in which apoE-containing lipoproteins are trapped by
      Abeta1-42 deposits mobilizing soluble Abeta peptides and consequently enlarge
      amyloid plaques. These two mechanisms may operate at different stages of AD
      pathogenesis and suggest a chaperone-like function for the apoE molecule

PMID- 11212355
TI  - Oxazolidinones: a novel class of antibiotics.
AB  - Oxazolidinones are a novel class of synthetic antimicrobial agents which have now
      entered phase III clinical trials. The most promising feature of these compounds
      is their oral activity against multidrug-resistant Gram-positive bacteria which
      have created tremendous therapeutic problems in recent years. In addition,
      development of resistance in vitro has so far remained below detectable levels.
      Different from many antibacterial agents used in the treatment of human
      infections, oxazolidinones do not block bacterial protein synthesis at the level
      of polypeptide chain elongation but rather seem to interfere with initiation of
      translation. Both binding of formylmethionine-transfer RNA to initiation
      complexes as well as release of formylmethioninepuromycin from initiation
      complexes have been reported to be targets for oxazolidinones. The major binding
      sites of oxazolidinones are the large (50S) ribosomal subunits.

PMID- 11212356
TI  - Immunoglobulin-binding proteins in ticks: new target for vaccine development
      against a blood-feeding parasite.
AB  - Humans have a long history of trying to control ticks. At first, attempts focused
      on modifying the habitat, whereas later efforts relied heavily on the use of
      chemicals. Current research is directed at finding a vaccine against ticks. A
      strategy of targeting 'concealed antigens' succeeded with the first
      commercialised vaccine against the cattle tick Boophilus microplus. However,
      vaccine development against other tick species appears unsatisfactory to date.
      Vaccination depends on a specific antibody-mediated immunoreaction that damages
      the parasite. Immunoglobulin molecules of vertebrate hosts can pass through gut
      barriers into the haemolymph of ectoparasites while retaining antibody activity.
      Research on the ixodid tick Rhipicephalus appendiculatus revealed that host
      immunoglobulin-G in the parasite was excreted via salivation, during feeding.
      Immunoglobulin-binding proteins in tick haemolymph and salivary glands are
      thought to be responsible for such excretion. The discovery of an immunoglobulin
      excretion system in ticks indicates that they have a highly developed mechanism
      to protect themselves from their host's antibody attack. Such a mechanism
      questions whether immunization strategies will be effective against ticks, unless
      they circumvent or disable the ticks' immunoglobulin excretion system.

PMID- 11212357
TI  - Role of the inositol 1,4,5-trisphosphate receptor in early embryonic development.
AB  - There is now considerable literature on the importance of phosphatidylinositol
      cycle activation in transducing information of various types across the plasma
      membrane. Though much of the data derives from studies on somatic cells, there is
      increasing evidence for crucial events related to development, including
      fertilization, cell cycle progression and dorsoventral axis formation. In this
      review, focus is directed mainly to the molecular basis of the inositol 1,4,5
      triphosphate receptor expressed in oocytes and early embryos of Xenopus. Recent
      progress in studies concerning the role of this receptor in early embryonic
      development is discussed.

PMID- 11212358
TI  - The pleiotropic functions of aspirin: mechanisms of action.
AB  - Recent studies have suggested that aspirin and aspirin-like compounds have a
      variety of actions in addition to their well-studied ability to inhibit
      cyclooxygenases. These actions include inhibition of the uncoupling of oxidative
      phosphorylation, decreases in adenosine triphosphate stores. increases in
      extracellular adenosine, downregulation of the expression and activity of
      inducible nitric oxide synthetase, inhibition and/or stimulation of various
      mitogen-activated protein kinase activities and inhibition of nuclear factor
      binding kappaB site (NF-kappaB) activation. Moreover, aspirin-like compounds have
      recently been shown to have previously unappreciated clinical and biological
      effects, some apparently independent of cyclooxygenase. In this review we discuss
      the various mechanisms of action of aspirin-like compounds and their relevance to
      clinical disease and therapy.

PMID- 11212359
TI  - Geminivirus DNA replication.
AB  - Geminiviruses are DNA viruses which infect plants. They have a small genome and
      encode only a few proteins. Therefore, their DNA replication cycle relies largely
      on the use of cellular DNA replication proteins. The strategy used by
      geminiviruses to replicate their single-stranded DNA (ssDNA) genome consists of a
      first stage of conversion of ssDNA into double-stranded DNA (dsDNA) intermediates
      and, then, the use of dsDNA as a template to amplify viral dsDNA and to produce
      mature ssDNA genomes by a rolling-circle replication mechanism. In addition, the
      accumulating evidence indicates that viral DNA replication is somehow coupled to
      the cell cycle regulatory network of the infected cell. For these reasons,
      geminiviruses are excellent model systems to understand the regulation of DNA
      replication and cell cycle in plant cells. Recent years have witnessed
      significant progress in the identification of cis-acting signals and their
      interaction with trans-acting factors that contribute to geminivirus origin
      function. These and other aspects of the geminivirus DNA replication cycle will
      be reviewed.

PMID- 11212360
TI  - Chlorophyll breakdown in higher plants and algae.
AB  - Leaf senescence is accompanied by the metabolism of chlorophyll (Chl) to
      nonfluorescent catabolites (NCCs). The pathway of Chl degradation comprises
      several reactions and includes the occurrence of intermediary catabolites. After
      removal of phytol and the central Mg atom from Chl by chlorophyllase and Mg
      dechelatase, respectively, the porphyrin macrocycle of pheophorbide (Pheide) a is
      cleaved. This two-step reaction is catalyzed by Pheide a oxygenase and RCC
      reductase and yields a primary fluorescent catabolite (pFCC). After hydroxylation
      and additional species-specific modifications, FCCs are tautomerized
      nonenzymically to NCCs inside the vacuole. Different subcellular compartments
      participate in Chl catabolism and, thus, transport processes across membranes are
      required. This review focuses on the catabolites and the individual reactions of
      Chl breakdown in higher plants. In addition, the pathway is compared to Chl
      conversion to red catabolites in an alga, Chlorella protothecoides. Finally, the
      significance and regulation of Chl degradation are discussed.

PMID- 11212361
TI  - Picroliv modulates the expression of insulin-like growth factor (IGF)-I, IGF-II
      and IGF-I receptor during hypoxia in rats.
AB  - The insulin-like growth factors (IGFs), IGF-I and IGF-II, play important roles in
      normal growth and differentiation. In recent studies, IGFs have been implicated
      in tissue repair and regeneration after hypoxicischemic injury. The growth
      effects of these genes are exerted primarily through IGF-I receptor (IGF-IR). We
      have earlier shown that picroliv, obtained from the roots of Picrorhiza kurrooa,
      reduces cellular damage caused by hypoxia in vitro. We have now studied the
      modulation of IGF-I, IGF-II and IGF-IR in hypoxia and the ability of picroliv to
      modify their expression in vivo. Male Sprague-Dawley rats, placed in 10% oxygen
      for 4 days, were sacrificed, and the expression of IGF-I, IGF-II and IGF-IR was
      determined by immunohistochemistry, in situ hybridization and reverse
      transcriptase polymerase chain reaction (RT-PCR) in brain, liver and lung. One
      group of animals was pretreated with picroliv and the other served as control.
      IGF-I and IGF-IR were expressed in distinct regions of the brain but not in liver
      or lung. IGF-I was mainly expressed in the hippocampus and cerebellum, whereas
      IGF-IR expression was also observed in the cortex. A significant reduction in the
      messenger RNA (mRNA) level of these genes was observed in response to hypoxia.
      Pretreatment with picroliv not only prevented such downregulation but more
      importantly resulted in increased levels of IGF-I and IGF-IR. These observations
      correlated with reduced neuronal cell death observed in these animals. The mRNA
      of IGF-II was constitutively expressed and was not altered by hypoxia. Modulation
      of IGF-I and IGF-II expression by picroliv, a novel pharmacological agent, could
      benefit in similar clinical settings such as myocardial ischemia and certain
      cerebral injuries.

PMID- 11212363
TI  - In vivo effect of sodium valproate on mouse liver.
AB  - The in vivo effect of sodium valproate (SV) on the activity of uridine
      diphosphate glucuronosyltransferase (UDP-GT) and hepatotoxicity in the mouse
      liver was studied. Mice were injected intraperitoneally (IP) with SV at doses
      varying from 50 to 800 mg/kg per day, for six consecutive days (dose-response
      group) or at a standard dose of 300 mg/g per day for 2-10 days (time-response
      group), whereas the controls were injected with normal saline. Valproic acid
      levels had a positive correlation to the dose (P < 0.001) and duration of drug
      administration (P = 0.006). A gradual increase in UDP-GT activity was observed in
      doses of up to approximately 400 mg/kg per day, whereas in higher doses the
      enzyme activity gradually decreased. The time course of UDP-GT activity at the
      standard dose of 300 mg/kg per day increased progressively, with a maximum up to
      the sixth day and then had a gradual reduction. Hepatic necrosis (which was
      unrelated to the dose or the duration of drug administration) was found in 13% of
      the SV-treated animals and in none of the controls. We conclude that at an
      optimal dose (300-400 mg/kg per day) and at a time course of 6 days, SV causes
      liver UDP-GT induction, whereas in higher doses and longer duration of
      administration, UDP-GT activity is gradually reduced. SV also causes
      hepatotoxicity unrelated to dose and time course.

PMID- 11212362
TI  - Detection of HLA-E and -G DNA alleles for population and disease studies.
AB  - HLA-E and -G genes show a restricted polymorphism encoding for molecules whose
      variability is limited at the peptide binding site. Fourteen alleles that give
      rise to only three productive proteins for HLA-G (*0101, *0103 and *0104) and
      five alleles with three different proteins for HLA-E (*0101, *0102 and *0103)
      have been described. Expression of these molecules is low and found in many
      tissues for HLA-E: HLA-G protein is expressed in extravillous trophoblast cells
      and thymic epithelium. Molecular studies have shown how HLA-G and HLA-E bind to
      natural killer (NK) cells immunoglobulin and lectin-type inhibitory receptors.
      HLA-E may act as a sentinel of the cell; if classical class I and HLA-G are being
      expressed, HLA-E molecules may reach the cell surface and inhibit the lysis by NK
      cells. Most findings are consistent with the hypothesis that HLA-E and -G
      proteins may be tolerogenic molecules at either the T-cell receptor (TcR)
      (inflammation, graft rejection) or NK level, switching off cells which usually
      attack foreign (including foetus) or self (autoimmune) antigens. A low HLA-E and 
      G polymorphism is observed in humans, and their allele frequencies are mostly
      homogeneous in the populations tested so far. Many studies to detect these
      alleles are now being performed in isolated populations and also in pregnancy
      associated pathologies. In the present paper, standard and detailed techniques to
      detect HLA-E and -G DNA polymorphism are reported and discussed.

PMID- 11212364
TI  - Reconstruction of MR images from data acquired on a general nonregular grid by
      pseudoinverse calculation.
AB  - A minimum-norm least-squares image-reconstruction method for the reconstruction
      of magnetic resonance images from non-Cartesian sampled data is proposed. The
      method is based on a general formalism for continuous-to-discrete mapping and
      pseudoinverse calculation. It does not involve any regridding or interpolation of
      the data and therefore the methodology differs fundamentally from existing
      regridding-based methods. Moreover, the method uses a continuous representation
      of objects in the image domain instead of a discretized representation.
      Simulations and experiments show the possibilities of the method in both radial
      and spiral imaging. Simulations revealed that minimum-norm least-squares image
      reconstruction can result in a drastic decrease of artifacts compared with
      regridding-based reconstruction. Besides, both in vivo and phantom experiments
      showed that minimum-norm least-squares image reconstruction leads to contrast
      improvement and increased signal-to-noise ratio compared with image
      reconstruction based on regridding. As an appendix, an analytical calculation of
      the raw data corresponding to the well-known Shepp and Logan software head
      phantom is presented.

PMID- 11212365
TI  - Optimal k-space sampling in MRSI for images with a limited region of support.
AB  - Magnetic resonance spectroscopic imaging requires a great deal of time to gather
      the data necessary to achieve satisfactory resolution. When the image has a
      limited region of support (ROS), it is possible to reconstruct the image from a
      subset of k-space samples. Therefore, we desire to choose the best possible
      combination of a small number of k-space samples to guarantee the quality of the
      reconstructed image. Sequential forward selection (SFS) is appealing as an
      optimization method because the previously selected sample can be observed while
      the next sample is selected. However, when the number of selected k-space samples
      is less than the number of unknowns at the beginning of the selection process,
      the optimality criterion is undefined and the resulting SFS algorithm cannot be
      used. In this paper, we present a modified form of the criterion that overcomes
      this problem and develop an SFS algorithm for the new criterion. Then we develop
      an efficient computational strategy for this algorithm as well as for the
      standard SFS algorithm. The combined algorithm efficiently selects a reduced set
      of k-space samples from which the ROS can be reconstructed with minimal noise
      amplification.

PMID- 11212366
TI  - Brain tissue classification of magnetic resonance images using partial volume
      modeling.
AB  - This paper presents a fully automatic three-dimensional classification of brain
      tissues for Magnetic Resonance (MR) images. An MR image volume may be composed of
      a mixture of several tissue types due to partial volume effects. Therefore, we
      consider that in a brain dataset there are not only the three main types of brain
      tissue: gray matter, white matter, and cerebro spinal fluid, called pure classes,
      but also mixtures, called mixclasses. A statistical model of the mixtures is
      proposed and studied by means of simulations. It is shown that it can be
      approximated by a Gaussian function under some conditions. The D'Agostino-Pearson
      normality test is used to assess the risk alpha of the approximation. In order to
      classify a brain into three types of brain tissue and deal with the problem of
      partial volume effects, the proposed algorithm uses two steps: 1) segmentation of
      the brain into pure and mixclasses using the mixture model; 2) reclassification
      of the mixclasses into the pure classes using knowledge about the obtained pure
      classes. Both steps use Markov random field (MRF) models. The multifractal
      dimension, describing the topology of the brain, is added to the MRFs to improve
      discrimination of the mixclasses. The algorithm is evaluated using both simulated
      images and real MR images with different T1-weighted acquisition sequences.

PMID- 11212367
TI  - Modeling the haemodynamic response in fMRI using smooth FIR filters.
AB  - Modeling the haemodynamic response in functional magnetic resonance (fMRI)
      experiments is an important aspect of the analysis of functional neuroimages.
      This has been done in the past using parametric response function, from a limited
      family. In this contribution, we adopt a semi-parametric approach based on finite
      impulse response (FIR) filters. In order to cope with the increase in the number
      of degrees of freedom, we introduce a Gaussian process prior on the filter
      parameters. We show how to carry on the analysis by incorporating prior knowledge
      on the filters, optimizing hyper-parameters using the evidence framework, or
      sampling using a Markov Chain Monte Carlo (MCMC) approach. We present a
      comparison of our model with standard haemodynamic response kernels on simulated
      data, and perform a full analysis of data acquired during an experiment involving
      visual stimulation.

PMID- 11212368
TI  - An active contour model for measuring the area of leg ulcers.
AB  - Leg ulcers are chronic skin wounds that affect many people and take a long time
      to heal. The progress of wound healing and the effect of clinical treatments can
      be monitored partly by measuring the area of the wound. Measurements taken via
      manually based methods, such as using a computer pointing device to delineate the
      wound boundary in a digitized image, suffer from variations due to manual
      dexterity and differences of opinion between observers. An active contour model
      is presented that models the contour using piecewise B-spline arcs and uses the
      minimax principle to adaptively regularize the contour according to the local
      conditions in the wound image. The model makes use of the existing manual
      delineation process in order to initialize the solution and is shown to reduce
      the effect of the inherent variations upon the repeatability and consistency of
      area measurements in many cases.

PMID- 11212369
TI  - Edge-guided boundary delineation in prostate ultrasound images.
AB  - Accurate detection of prostate boundaries is required in many diagnostic and
      treatment procedures for prostate disease. In this paper, a new paradigm for
      guided edge delineation is described, which involves presenting automatically
      detected prostate edges as a visual guide to the observer, followed by manual
      editing. This approach enables robust delineation of the prostate boundaries,
      making it suitable for routine clinical use. The edge-detection algorithm is
      comprised of three stages. An algorithm called sticks is used to enhance contrast
      and at the same time reduce speckle in the transrectal ultrasound prostate image.
      The resulting image is further smoothed using an anisotropic diffusion filter. In
      the third stage, some basic prior knowledge of the prostate, such as shape and
      echo pattern, is used to detect the most probable edges describing the prostate.
      Finally, patient-specific anatomic information is integrated during manual
      linking of the detected edges. The algorithm was tested on 125 images from 16
      patients. The performance of the algorithm was statistically evaluated by
      employing five expert observers. Based on this study, we found that consistency
      in prostate delineation increases when automatically detected edges are used as
      visual guide during outlining, while the accuracy of the detected edges was found
      to be at least as good as those of the human observers. The use of edge guidance
      for boundary delineation can also be extended to other applications in medical
      imaging where poor contrast in the images and the complexity in the anatomy limit
      the clinical usability of fully automatic edge-detection techniques.

PMID- 11212370
TI  - A novel approach to extract colon lumen from CT images for virtual colonoscopy.
AB  - An automatic method has been developed for segmentation of abdominal computed
      tomography (CT) images for virtual colonoscopy obtained after a bowel preparation
      of a low-residue diet with ingested contrast solutions to enhance the image
      intensities of residual colonic materials. Removal of the enhanced materials was
      performed electronically by a computer algorithm. The method is a multistage
      approach that employs a modified self-adaptive on-line vector quantization
      technique for a low-level image classification and utilizes a region-growing
      strategy for a high-level feature extraction. The low-level classification labels
      each voxel based on statistical analysis of its three-dimensional intensity
      vectors consisting of nearby voxels. The high-level processing extracts the
      labeled stool, fluid and air voxels within the colon, and eliminates bone and
      lung voxels which have similar image intensities as the enhanced materials and
      air, but are physically separated from the colon. This method was evaluated by
      volunteer studies based on both objective and subjective criteria. The validation
      demonstrated that the method has a high reproducibility and repeatability and a
      small error due to partial volume effect. As a result of this electronic colon
      cleansing, routine physical bowel cleansing prior to virtual colonoscopy may not
      be necessary.

PMID- 11212371
TI  - Rapid 3-D cone-beam reconstruction with the simultaneous algebraic reconstruction
      technique (SART) using 2-D texture mapping hardware.
AB  - Algebraic reconstruction methods, such as the algebraic reconstruction technique
      (ART) and the related simultaneous ART (SART). reconstruct a two-dimensional (2
      D) or three-dimensional (3-D) object from its X-ray projections. The algebraic
      methods have, in certain scenarios, many advantages over the more popular
      Filtered Backprojection approaches and have also recently been shown to perform
      well for 3-D cone-beam reconstruction. However, so far the slow speed of these
      iterative methods have prohibited their routine use in clinical applications. In
      this paper, we address this shortcoming and investigate the utility of widely
      available 2-D texture mapping graphics hardware for the purpose of accelerating
      the 3-D algebraic reconstruction. We find that this hardware allows 3-D cone-beam
      reconstructions to be obtained at almost interactive speeds, with speed-ups of
      over 50 with respect to implementations that only use general-purpose CPUs.
      However, we also find that the reconstruction quality is rather sensitive to the
      resolution of the framebuffer, and to address this critical issue we propose a
      scheme that extends the precision of a given framebuffer by 4 bits, using the
      color channels. With this extension, a 12-bit framebuffer delivers useful
      reconstructions for 0.5% tissue contrast, while an 8-bit framebuffer requires 4%.
      Since graphics hardware generates an entire image for each volume projection, it
      is most appropriately used with an algebraic reconstruction method that performs
      volume correction at that granularity as well, such as SART or SIRT. We chose
      SART for its faster convergence properties.

PMID- 11212372
TI  - X-ray CT metal artifact reduction using wavelets: an application for imaging
      total hip prostheses.
AB  - Traditional computed tomography (CT) reconstructions of total joint prostheses
      are limited by metal artifacts from corrupted projection data. Published metal
      artifact reduction methods are based on the assumption that severe attenuation of
      X-rays by prostheses renders corresponding portions of projection data
      unavailable, hence the "missing" data are either avoided (in iterative
      reconstruction) or interpolated (in filtered backprojection with data completion;
      typically, with filling data "gaps" via linear functions). In this paper, we
      propose a wavelet-based multiresolution analysis method for metal artifact
      reduction, in which information is extracted from corrupted projection data. The
      wavelet method improves image quality by a successive interpolation in the
      wavelet domain. Theoretical analysis and experimental results demonstrate that
      the metal artifacts due to both photon starving and beam hardening can be
      effectively suppressed using our method. As compared to the filtered
      backprojection after linear interpolation, the wavelet-based reconstruction is
      significantly more accurate for depiction of anatomical structures, especially in
      the immediate neighborhood of the prostheses. This superior imaging precision is
      highly advantageous in geometric modeling for fitting hip prostheses.

PMID- 11212373
TI  - A perspective on needle artifacts in MRI: an electromagnetic model for
      experimentally separating susceptibility effects.
AB  - A thorough understanding of artifacts caused by metallic instruments is essential
      for the guidance of interventional procedures by magnetic resonance imaging
      (MRI), because the accurate localization of each instrument is mandatory for
      this. In the past, this problem has been addressed by several groups, using
      theoretical, as well as experimental approaches. The artifacts associated with
      MRI are caused by geometry distortion and intravoxel dephasing. Usually, both
      effects mingle in the image, and depending on the pulse sequences and its
      parameters used for data acquisition, these effects are reflected in the image
      with different magnitude. In this paper we shortly present the well-known
      mathematical background of the two underlying effects. Mathematically, both can
      be treated separately. Here, we propose a new electromagnetic model which also
      allows to experimentally separate the effects better than by comparing spin-echo
      and gradient-echo images of the same object. With this new model, both effects
      geometry distortion and intravoxel dephasing-are demonstrated separately using
      the same gradient-echo pulse sequence for all scans and adjusting the fields of
      the model properly. Furthermore, as this model allows to adjust both effects
      independently, it is used to study different weightings of both effects when they
      appear simultaneously in the image.

PMID- 11212374
TI  - AM-FM texture segmentation in electron microscopic muscle imaging.
AB  - This paper describes the application of an amplitude modulation-frequency
      modulation (AM-FM) image representation in segmenting electron micrographs of
      skeletal muscle for the recognition of: 1) normal sarcomere ultrastructural
      pattern and 2) abnormal regions that occur in sarcomeres in various myopathies. A
      total of 26 electron micrographs from different myopathies were used for this
      study. It is shown that the AM-FM image representation can identify normal
      repetitive structures and sarcomeres, with a good degree of accuracy. This system
      can also detect abnormalities in sarcomeres which alter the normal regular
      pattern, as seen in muscle pathology, with a recognition accuracy of 75%-84% as
      compared to a human expert.

PMID- 11212375
TI  - A Jini service to reconstruct tomographic data.
AB  - Distributed computing that uses dynamic networks will change the way we work and
      communicate thanks to the interaction of devices and services, that are
      automatically added and removed from the network as needed. The Jini technology,
      which is built atop the Java programming language, provides a homogenous view of
      the network and extends the ability of code to migrate in Java. This software
      design model simplifies the configuration and access to hardware devices and
      software services in a network. Thus, it becomes possible to execute new services
      without pre-installing software on client machines. This new programming paradigm
      is especially important in medical applications, where the reliable transmission
      of information is essential. This paper demonstrates how single photon emission
      computerized tomography data can be iteratively reconstructed using a Jini
      service.

PMID- 11212376
TI  - Evaluation of the adaptive speckle suppression filter for coronary optical
      coherence tomography imaging.
AB  - During the last few years, optical coherence tomography (OCT) has demonstrated
      considerable promise as a method of high-resolution intravascular imaging. The
      goal of this study was to apply and to test the applicability of the rotating
      kernel transformation (RKT) technique to the speckle reduction and enhancement of
      OCT images. The technique is locally adaptive. It is based on sequential
      application of directional masks and selection of the maximum of all outputs.
      This method enhances the image features by emphasizing thin edges while
      suppressing a noisy background. Qualitatively, the RKT algorithm provides
      noticeable improvement over the original image. All processed images are smoother
      and have better-defined borders of media, intima, and plaque. The quantitative
      evaluation of RKT performance showed that in terms of average contrast-to-noise
      ratio, there is a significant improvement in image quality between original and
      enhanced images. The RKT image enhancement technique shows great promise in
      improving OCT images for superior boundary identification.

PMID- 11212377
TI  - Estimating the keratoconus index from ultrasound images of the human cornea.
AB  - The keratoconus index (KI) is a new biometric parameter to make diagnosis and to
      follow the development of the keratoconus in human eyes. Using images from an
      ultrasound biomicroscope, we show a semi-automatic method to speed up the
      computation of the KI.

PMID- 11212379
TI  - Polymorphism of the D12S66 system in the Japanese population and its detection
      using degraded DNA.
AB  - The short tandem repeat (STR) polymorphism of the locus D12S66 was amplified by
      PCR and analyzed by denaturing polyacrylamide gel electrophoresis followed by
      silver staining. Among 190 DNA samples from the Japanese population, six alleles
      were observed. The genotypic distribution meets Hardy-Weinberg expectations, and
      the heterozygosity was 52.7%. When sequences of the allelic products were
      compared, each allelic segment was 153-173 bp in size, and contained 9 to 14 GATA
      tetranucleotide repeat motifs. Amplification of the locus using 27 tooth and
      blood stain samples as sources of degraded DNA resulted in low backgrounds and
      reproducible patterns, suggesting the usefulness of the application of this locus
      for material examination.

PMID- 11212378
TI  - Characteristics of event related potentials elicited by trains of teeth clenching
      in humans.
AB  - Event related potentials were recorded on the human scalp during a foot pedal
      task, a hand gripping task, and a teeth clenching task. These were carried by
      targeting four trains of clicks, each at an interval of 1 sec, which were
      repeated 20 times at random frequencies. The brain potentials were recorded from
      midline-frontal (Fz), -central (Cz) and -parietal (Pz) sites using surface
      electrodes. Positive potentials like P3 were elicited predominantly at the
      frontal site (Fz); those for the clenching task were slower and smaller. The
      magnitudes of the P3 potentials showed rough facilitation with trains of movement
      of the tasks. If it is assumed that the observed potentials involve an inhibition
      or reset of motor neurons referring to the tasks, the facilitation might be
      expedient for the neurons to recover the potential condition more quickly, which
      is important in preparing for the next action.

PMID- 11212380
TI  - Primary insertion of implants in the zygomatic bone following subtotal
      maxillectomy.
AB  - A case of maxillary carcinoma treated with primary insertion of Branemark
      implants into the zygomatic bone following subtotal maxillectomy is reported.
      This method has several advantages. First, early detection of postoperative
      recurrence is easier than with closing the flap. Second, when the implant is
      inserted into the midfacial region, zygomatic bone can be useful because of
      thickness. In addition, applying a maxillary prosthesis in the early stages
      avoids contracture of facial soft tissue. This primary reconstructive method is
      effective in cases of preserved zygoma after total maxillectomy.

PMID- 11212381
TI  - Assessing the image quality of a CCD-based digital intraoral radiography system:
      application of perceptibility curve test.
AB  - The perceptibility curve test is a method for evaluating the psychophysical
      properties of radiographic systems. The concept of the perceptibility curve is
      based on the minimum perceptible exposure differences that are recorded by a
      particular imaging system. The perceptibility curve test was applied to a Charge
      Coupled Device (CCD)-based digital intraoral radiography system in this study. A
      test object was made of a square aluminum block, 28 mm in both height and length
      and 10 mm in thickness. The test object had ten contrast details in the form of
      round holes with diameters of 1.5 mm. The depths of the holes ranged from 0.05 mm
      to 0.5 mm in steps of 0.05 +/- 0.01 mm. An X-ray unit was used that operated in
      the range of 60 to 90 kVp. Test radiographs were shown to observers in random
      order. Six observers were asked to rate them regarding the number of spots
      representing holes that they could perceive. The smallest perceptible difference
      in gray level on the computer monitor, a 15-inch cathode-ray tube (CRT), was then
      found. The minimum difference in gray level between a perceptible detail and the
      background was determined. Dose response functions were employed to determine
      exposures corresponding to these gray levels. For each case, delta logE as a
      function of the number of object details was calculated. Finally the reciprocal
      of all values of (delta logE)min were calculated. The number of details which the
      observers perceived decreased linearly with decreasing delta logE values. The
      maximum number of details that observers perceived was eight or nine. The
      perceptibility curves showed that their peaks shifted slightly with a change of
      the kVp but that their shapes were similar at different kVp settings.

PMID- 11212382
TI  - Apical microsurgery for failed endodontics.
AB  - The operating microscope allows the surgeon unparalleled visualization of the
      root end structures for periapical surgery. The ultrasonic root end preparation
      tips enable debridement of the resected root end 2 to 4 mm in the long axis of
      the root. These advances have allowed periapical surgery to be performed at a new
      level of excellence with, we believe, more predictable healing.

PMID- 11212383
TI  - Necrotizing fasciitis and mediastinitis.
AB  - Necrotizing fasciitis and mediastinitis are two rare but grave complications of
      orofacial infections. The clinical presentation, diagnostic modalities, anatomic
      pathways, microbiologic make-up, surgical management, and the use of adjuvant HBO
      therapy for both entities have been discussed.

PMID- 11212384
TI  - Infections of the jaws, including infected fractures, osteomyelitis, and
      osteoradionecrosis.

PMID- 11212385
TI  - Surgical treatment of periodontal infections.

PMID- 11212386
TI  - Peri-implant infections.
AB  - The most judicious way to address peri-implant disease is to take steps to avoid
      it from the beginning of each implant restoration case. This involves treatment
      planning with a priority placed on biomechanically overengineering the case,
      using sound surgical techniques, enhancing keratinized tissue prior to placing
      the implants when appropriate, and placing an emphasis on rigorous follow-up and
      hygiene instruction. In the long run, the benefits of adhering to such methods
      outweigh the disadvantages. Careful attention to these guidelines leads to a less
      stressful practice and fewer cases of peri-implantitis. It should also increase
      our dental implant success rates and predictability of outcome even further.

PMID- 11212387
TI  - Team approach for closure of oroantral and oronasal fistulae.
AB  - Oroantral and oronasal fistulas present with a broad range of causation, size,
      duration, and extent of infection involving the nose and paranasal sinuses.
      Accurate diagnosis of the extent of the disease with appropriate radiographic
      evaluation will guide the surgeon to select an approach that addresses all of the
      infected sites. When significant sinus disease is found, an endoscopic approach
      to restoring drainage in all of the involved sinuses can promote predictably
      successful closure of oroantral and oronasal fistulas. The multispecialty team
      approach to this disease, with the concomitant management of the sinusitis and
      fistula closure, is a significant advance in the successful management of this
      chronic condition.

PMID- 11212388
TI  - Surgical management of orofacial infections.
AB  - This overview of the surgical management of orofacial odontogenic infections is
      designed as a practical guide for the oral and maxillofacial surgeon.
      Fortunately, the incidence of serious odontogenic infections is decreasing. This
      decreased frequency, however, necessitates diligent study and mental preparation
      in advance of the emergent situations in which such cases present.

PMID- 11212389
TI  - The fifth commandment: honor your father and your mother.

PMID- 11212390
TI  - Juggling hats.

PMID- 11212391
TI  - Difficult parents, desperate children.

PMID- 11212392
TI  - Another look at long-term care insurance.

PMID- 11212393
TI  - [Cytotoxic and cytostatic effect of avermectines on tumor cells in vitro].
AB  - Effect of natural avermectin complex (aversectin C) and separate avermectins A1,
      A2, B1 and B2 in the cell culture of murine myeloma Ns/o, Erlich carcinoma
      ascites and human larynx carcinoma Hep-2 was investigated. It was shown that
      aversectin C within the concentrations of 0.1 to 1.0 mcg/ml inhibited
      proliferation of tumor cells and induced their death. Proliferation inhibition
      was due to the delay of the cells cycle start (lag-phase prolongation) and
      blocking of mitotic cycle. Ns/o cells death had apoptosis signs: chromatin
      condensation and fragmentation, DNA fragmentation. It was demonstrated that only
      avermectin A1 has cytotoxic activity within the concentrations used, avermectins
      A2 and B2 had cytostatic activity, avermectin B1 showed no activity under the
      experimental conditions.

PMID- 11212394
TI  - [Microbiological evaluation of antibiotics for empirical therapy of community
      acquired infections of the lower respiratory tract].
AB  - During first 3 days after patient hospitalization with pneumonia or chronic
      obstruction pulmonary disease (COPD) pathogens in sputum were studied according
      NCCLS standards (for 1999 year). Among 93 pathogens isolated in pneumonia the
      most frequent were S. pneumoniae (41.9%), H. influenzae (21.5%). Among 232
      pathogens isolated in COPD the most frequent were S. pneumoniae (35.5%), H.
      influenzae (16.8%). Other pathogens were staphylococci, moraxella, gram-negative
      bacteria. No penicillin-resistant S. pneumoniae, were isolated, the strains with
      moderate penicillin resistance were less than 3% in both groups. Among H.
      influenzae isolated from patients with pneumonia 25% were beta-lactamase
      producers, from COPD patients 21% strains produced beta-lactamase. Totally among
      all studied pathogens only 58% were sensitive to ampicillin in pneumonia groups
      and 48% in COPD groups, for azithromycin 70.7% and 71% respectively, for
      cefuroxime 84.5% and 85% respectively. Ampicillin efficacy for empirical
      treatment of community-acquired low respiratory tract infections was
      substantially less than that of modern antibiotics.

PMID- 11212395
TI  - [Fluorine level in the bone and cartilage in children treated with ciprofloxacin
      (data obtained from the femur distal part].
AB  - Comparative data on the content of fluorine in various sections of the left femur
      distal part, i.e. spongy bone, process zone and articular cartilage are
      presented. The examination was performed on postmortem sections from 10 pediatric
      cases (the average age of 9.5 years) with mucoviscidosis or aplastic anemia
      treated before the death for up to 12 months with ciprofloxacin in a dose of 20
      to 40 mg/kg body weight. The control postmortem sections were from 10 practically
      healthy children (the average age of 10.4 years) killed in a car accident. The
      sections were subjected to 2-stage dry ashing with ionometric determination of
      the fluorine ions. The results were treated according to the V.Yu. Urbach
      procedure. It was shown that the content of fluorine in the sponge bone and
      process zone in both the groups did not significantly differ. A comparatively
      high content of fluorine was detected only in the postmortem sections of the
      articular cartilage from the children of the main group who however had no
      chondrotoxic symptoms while alive. That means that the difference is
      statistically and clinically insignificant.

PMID- 11212397
TI  - [Azithromycin (sumamed)--basic properties and therapy of community-acquired
      pneumonia].

PMID- 11212396
TI  - [Disruption of microbiocenosis of the large intestine and the immune and
      interferon status in children with bacterial complications of acute viral
      infections of the respiratory tract and their correction by high doses of
      bifidumbacterin forte].
AB  - One hundred and twenty-nine children with acute viral and bacterial infection of
      the respiratory tract were examined and disturbance of the large intestine
      microflora was detected. It was characterized by significant reduction of
      lactobacilli, moderate growth of opportunistic bacteria and higher contents of
      Candida. Changes in T- and especially B-cellular immunity were observed in 35 per
      cent of the patients. In patients with decreased avidity of the immunoglobulins G
      in the peripheral blood the changes were observed in 82-100 per cent of the
      cases. In the majority of the patients the capacity for interferon genesis was
      suppressed. A shorten course (5 days) of the bifidumbacterin forte therapy in a
      dose of not less than 10(9) CFU/ml. normalized the intestinal microflora,
      improved the indices of the B- and T-cellular immunity (including the
      subpopulation of the T-helper cells but not the T-suppressor cells), stimulated
      NK and improved the ability to induce alfa- and gamma-interferons of the
      peripheral blood leukocytes. The experience with using high doses of
      bifidumbacterin forte was evident of its good tolerance and possible value in
      increasing the patient resistance to infection.

PMID- 11212398
TI  - [Prospects of development of drugs for therapy of gram-positive bacterial
      infections].

PMID- 11212400
TI  - [Biosynthesis of the non-polyene antibiotic imbricin in the medium containing the
      producer culture filtrate].
AB  - Imbricin (macrolide nonpolyen antibiotic) biosynthesis conditions was
      investigated in the medium containing culture filtrate of its producer-
      Streptomyces imbricatus. It was demonstrated that filtrate contains some
      regulator substance affecting the antibiotic biosynthesis and metabolism
      processes of actinomycetes S. imbricatus. Maximum of regulator accumulation
      coincides with maximum of antibiotic biosynthesis, and amount of synthesized
      imbricin is proportional to the amount of the culture filtrate added to the
      medium. When low active mutant of S. imbricatus was grown in the medium with
      added regulator its activity achieved the control level. It was shown that
      stimulating activity of the producer's culture filtrate is not connected with pH
      changes or with supplement with some additional nutritional substrates.

PMID- 11212399
TI  - [General trends in design of drugs for chemotherapy of AIDS].

PMID- 11212402
TI  - [Prolonged hypothermia refractory to active warming with air convection].

PMID- 11212401
TI  - [Locoregional anesthesia for external ear surgery and postoperative analgesia].
AB  - OBJECTIVES: To evaluate a change in the classical technique for local-regional
      anesthesia (periauricular "V" infiltration) for surgery on the outer ear,
      specifically adding a new infiltration of the osteocartilaginous juncture of the
      external acoustic meatus and the auditory foramen, as an alternative to general
      anesthesia in adults, including assessment of postoperative analgesia. PATIENTS
      AND METHODS: The new technique was used in 45 operations on 23 patients. We
      analyzed pain during and after surgery on a simple verbal scale. RESULTS: After
      modifying the technique it was possible to perform surgery on the outer ear
      without causing pain, patients reporting "0" pain on a scale of 0 to 10. Eight
      patients reported "0" for postoperative pain, while one assessed pain as "4" and
      one as "2". No signs of emesis or cardiac events were observed. CONCLUSIONS: The
      described local-regional blockade of the outer ear used as the only anesthetic
      method, is indicated for both cosmetic surgery and repair of outer ear injuries,
      given its excellent analgesia during and after surgery. The characteristics of
      this type of block of the pavilion make it ideal for major outpatient surgery and
      a valid alternative to general anesthesia in adults.

PMID- 11212403
TI  - [Eisenmenger syndrome in a patient with persistent ductus arteriosus and septic
      shock].

PMID- 11212404
TI  - [Combined subarachnoid-epidural anesthesia technique using a double catheter in
      lower limb revascularization surgery].

PMID- 11212405
TI  - [Early detection of hyperkalemia caused by reperfusion during liver
      transplantation using neuromuscular block monitoring].

PMID- 11212406
TI  - [Anesthesia considerations in West syndrome].

PMID- 11212407
TI  - Blurred relationship between periodontist and the general practitioner.

PMID- 11212408
TI  - Smile-maxilla, maxilla in the mouth, and other interdisciplinary design
      guidelines: helpful hints for the esthetic dental team.

PMID- 11212409
TI  - Advantages and limitations of nonsurgical periodontal therapy in the management
      of chronic periodontitis.

PMID- 11212410
TI  - Initial preparation: anti-infective therapy.
AB  - The primary aim of anti-infective therapy is to eliminate or reduce the
      subgingival plaque and to arrest tissue breakdown associated with chronic or
      progressive periodontitis. Four to six weeks following anti-infective therapy,
      initial healing is usually complete, and the clinical status should be re
      evaluated. After assessing the reduction in probing depths, bleeding on probing
      and clinical attachment levels, the clinician must decide whether the anti
      infective therapy has arrested the disease. If it is determined that maximum
      healing has occurred, the initial phase of therapy is complete, and the patient
      is placed into the maintenance program. In sites that remain > or = 6 mm
      following anti-infective therapy, surgical debridement may be indicated to
      increase visualization of the roots for deposit removal because the evidence
      points to better calculus removal in an open versus closed environment. During
      surgical root preparation, fine diamonds or finishing burs produce the smoothest
      root surface followed by manual and power-driven scalers. Endoscopic cameras that
      enable the clinician to see subgingival calculus without benefit of surgical
      access may prove to be a valuable diagnostic tool for sites that do not respond
      to therapy. Diamond-coated ultrasonic inserts are available from some
      manufacturers and have been shown to be efficient and effective in surgical root
      preparation. New designs and finer grits may enable clinicians to use these
      instruments in nonsurgical applications in the future. Finally, new evidence from
      one group in Belgium has shown that significantly more attachment gain and
      probing depth reduction is achieved when scaling and root planing is done in one
      or two visits within 24 hours compared with the traditional method of scaling
      quadrant by quadrant over four visits. These preliminary results need to be
      confirmed by others but hold a great deal of promise for improving the outcomes
      from nonsurgical root preparation in the future.

PMID- 11212411
TI  - Regenerative materials: an overview.
AB  - Periodontal reconstructive therapies have demonstrated the ability to reverse the
      destruction due to periodontitis provided that they are implemented according to
      their individual indications. By properly evaluating a site, one can employ an
      evidence-based approach to effectively and predictably treat intrabony defects
      and furcation involvements. It also should be emphasized that a thorough
      evaluation of the therapeutic outcome should be continuously performed on all
      sites in order to determine treatment success and the possible need for further
      intervention. This is based on the long-term follow-up of cases treated with
      regenerative therapies, which have shown maintenance of results if the patient
      had good oral hygiene and was enrolled in a proper maintenance program. With
      respect to the preceding discussion: 1. The main periodontal reconstructive
      therapies employed by periodontists are GTR, bone replacement grafts and biologic
      mediators. 2. It is possible to achieve regeneration when using barriers,
      autografts, allografts, bovine-derived xenografts and EMDs. 3. Currently,
      regenerative techniques can be used for the treatment of intrabony defects and
      furcation involvements given the proper evaluation of each individual site. 4.
      Various regenerative materials are capable of achieving similar results in
      intrabony defects and are very predictable when employing evidence-based
      treatment. 5. A combination of regenerative materials such as barriers and grafts
      in intrabony defects has not demonstrated any improvement over their use alone.
      6. A combination of regenerative materials such as barriers and grafts in
      mandibular class II furcations has demonstrated improvement over the use of the
      graft or barrier alone. 7. A combination of regenerative materials such as
      barriers and grafts in maxillary class II furcations has some limited evidence to
      support improvement over the use of the graft or barrier alone, but the
      predictability should not be considered high. 8. A combination of regenerative
      materials such as barriers and grafts in class III furcations has very limited
      evidence to support improvement over the use of the graft or barrier alone and
      should not be considered predictable. 9. Beyond the initial healing phase
      postsurgically, maintenance and oral hygiene play the largest role in long-term
      therapeutic success.

PMID- 11212412
TI  - Worldwide advancement of anesthesia in dentistry.

PMID- 11212414
TI  - Simulation technology in anesthesiology.

PMID- 11212413
TI  - Sevoflurane and isoflurane reduce oxygen saturation in infants.
AB  - Volatile anesthetics are generally known to exert several influences on the
      respiratory system, but their direct effect on oxygen saturation as measured by
      pulse oximetry (SpO2) in infants remains unknown. In this study, 70 infants under
      2 years of age who received general anesthesia were examined to determine the
      effects of several volatile anesthetics and nitrous oxide on SpO2. After
      endotracheal intubation, the subjects were ventilated using a Jackson-Rees
      circuit with oxygen, nitrous oxide, and either sevoflurane, enflurane, or
      isoflurane adjusted to twice the adult minimum alveolar concentration (MAC) for
      the agents when used in combination with 67% nitrous oxide. In all cases, the end
      tidal carbon dioxide tension (PetCO2) was maintained within the same range (28-35
      mm Hg). Significantly lower SpO2 values (paired t test, P < .05) were observed
      when the subjects were ventilated with oxygen, 67% nitrous oxide, and sevoflurane
      or isoflurane--but not with oxygen, 67% nitrous oxide, and enflurane--than when
      they were administered oxygen, 50% nitrous oxide, and the original concentration
      of each volatile anesthetic. These results suggest that sevoflurane and
      isoflurane have different effects from enflurane on gas exchange systems.

PMID- 11212415
TI  - "Read and understand" vs. "a competency-based approach" to designing, evaluating,
      and validating SOP training.

PMID- 11212416
TI  - Comparative hemolytic activity of undiluted organic water-miscible solvents for
      intravenous and intra-arterial injection.
AB  - In humans, nonaqueous solvents are administered intravascularly in two kinds of
      situations. They have been used in subcutaneous or intramuscular pharmaceutical
      formulations to dissolve water-insoluble drugs. The need for these vehicles had
      increased in recent years, since the drug development process has yielded many
      poorly water-soluble drugs. The use of water-miscible nonaqueous solvents in
      therefore one of the approaches for administering these products as reference
      solutions useful in formulation bioequivalence studies. The intravascular use of
      organic solvents has also gained importance owing to a new approach for the
      treatment of cerebral malformations using precipitating polymers dissolved in
      water-miscible organic solvents. At present, the solvent most commonly used for
      the liquid embolics to solubilize the polymers is dimethyl sulfoxide, which
      exhibits some local and hemodynamic toxicities. In order to find new, less toxic
      vehicles for pharmaceutical formulations for the intravenous and intra-arterial
      routes and for embolic materials, 13 water-miscible organic solvents currently
      used (diluted with water) for pharmaceutical applications, were evaluated in this
      study. Their hemolytic activity and the morphological changes induced when mixed
      with blood (1:99, 5:95, 10:90 solvent:blood) were estimated in vitro. From these
      data, the selected organic solvents could be subdivided into four groups
      depending on their hemolytic activity: very highly hemolytic solvents (ethyl
      lactate, dimethyl sulfoxide), highly hemolytic solvents (polyethylene glycol 200,
      acetone), moderately hemolytic solvents (tetrahydrofurfuryl alcohol, N-methyl-2
      pyrrolidone, glycerol formal, ethanol, Solketal, glycofurol) and solvents with
      low hemolytic activity (propylene glycol, dimethyl isosorbide, diglyme).

PMID- 11212417
TI  - Chemical sterilization with peracetic acid: permeation risks inside parenteral
      infusion fluid.

PMID- 11212418
TI  - One-way distribution system for water for injection: process management,
      microbiological quality control, and meeting regulatory requirements.
AB  - The specifications for pharmaceutical water, the qualification and validation of
      water preparation facilities, strategies to prevent contamination by water-borne
      bacteria and lastly, the monitoring of microbiological purity are the topics of
      frequent seminars on Pharma Water Total Quality Management. The same subdivisions
      are used in the following paper on the process management and microbiological
      control of a one-way distribution system for Water for Injection. Since 1990,
      such a system has been in use in the production department of Pharma Hameln GmbH,
      a contract manufacturer of parenterals. Using this system as an example, the twin
      needs for flawless microbiological process control and for suitable measures to
      monitor water quality are discussed, which, together with extensive documentation
      of the qualification of the production and distribution system, ultimately led to
      acceptance of the system by regulatory authorities.

PMID- 11212420
TI  - A validated calibration method for hydrogen peroxide vapour sensors.
AB  - A method of calibrating hydrogen peroxide vapour sensors is described which is
      based on the well-defined saturated vapour pressures of hydrogen peroxide over
      its aqueous solutions at fixed temperatures. The calibration technique was
      developed for use with amperometric gas sensors but could be applied to other
      sensor types. The method can be used over the entire range of vapour pressures
      that are likely to be of practical interest in the context of isolator
      sterilisation and has been reliably validated by quantitative volumetric
      analysis. The method depends not only on the well understood underlying
      principles but also on the solution of practical problems associated with
      ensuring full saturation of the carrier gas stream and, simultaneously, the
      elimination of aerosol droplets which might otherwise interfere with the
      calibration.

PMID- 11212419
TI  - Activities of the USP Microbiology Subcommittee of Revision during the 1995-2000
      revision cycle.
AB  - This article is a comprehensive review of the published activities of the
      Microbiology Subcommittee of the USP Committee of Revision for the 1995-2000
      revision cycle. The activities of this revision cycle were designed to position
      USP activities in microbiology that will be useful as technology advances. In
      addition to reviewing the changes accomplished, this article discusses the
      rationale for many of the changes and some background information on new
      initiatives underway. Where appropriate, changes in the USP that did not fall
      under the direct purview of the MCB Subcommittee but of interest to the
      microbiology community are also discussed.

PMID- 11212422
TI  - Case report: successful use of rectally administered levodopa-carbidopa.

PMID- 11212423
TI  - National Family Medicine Resident Survey. Part 1: Learning environment, debt, and
      practice location.

PMID- 11212421
TI  - Diagnosing and managing delirium in the elderly.
AB  - OBJECTIVE: To outline current approaches to diagnosing and managing delirium in
      the elderly. QUALITY OF EVIDENCE: A literature review was based on a MEDLINE
      search (1966 to 1998). Selected articles were reviewed and used as the basis for
      discussion of diagnosis and etiology. We planned to include all published
      randomized controlled trials regarding management but found only two.
      Consequently, we also used review articles and recent practice guidelines for
      delirium published by the American Psychiatric Association. MAIN FINDINGS:
      Clinical diagnosis of delirium can be aided by using DSM-IV criteria, the
      Delirium Symptom Interview, or the confusion assessment method. Management must
      include investigation and treatment of underlying causes and general supportive
      measures. Providing optimal levels of stimulation, reorienting patients,
      education, and supporting families are important. Pharmacologic management of
      delirium should be considered only for specific symptoms or behaviours, e.g.,
      aggression, severe agitation, or psychosis. Only one randomized controlled trial
      of tranquilizer use for delirium in medically ill people has been published.
      Findings support the current belief that neuroleptics are superior to
      benzodiazepines in most cases of delirium. Most authorities still consider
      haloperidol the neuroleptic of choice. Controlled trials of the new atypical
      neuroleptics for treating delirium are not yet available. Benzodiazepines with
      relatively short half-lives, such as lorazepam, are the drugs of choice for
      withdrawal symptoms. CONCLUSION: Delirium is frequently underdiagnosed in
      clinical practice. It should be suspected with acute changes in behaviour.
      Careful investigation of the underlying cause permits appropriate management.

PMID- 11212424
TI  - Drug interactions with St John's wort.

PMID- 11212425
TI  - Hypothesis: the Research Page. Welcome to the Research Page.

PMID- 11212426
TI  - Primary care and population health promotion. Collaboration between family
      physicians and public health units in Ontario.

PMID- 11212427
TI  - Drug information needs clarification.

PMID- 11212428
TI  - Time to fess up, authors!

PMID- 11212429
TI  - Josee and Richard.

PMID- 11212430
TI  - Cancer chemotherapy during pregnancy. Consortium of cancer in pregnancy evidence.
AB  - QUESTION: I have an 8-weeks' pregnant patient who was diagnosed with stage III
      Hodgkin's disease last week. The oncologist suggests delaying chemotherapy until
      the second trimester. What are the effects of chemotherapy on a fetus after the
      first trimester? Where can I find reliable information on the subject? ANSWER:
      Available data suggest that exposure to chemotherapy during the first trimester
      of pregnancy is associated with increased risk of major malformations. Exposure
      during the second and third trimesters does not result in major malformations,
      but could have nonteratogenic effects, such as low birth weight. The brain
      develops throughout pregnancy, and it could be affected later in pregnancy.

PMID- 11212431
TI  - Deep vein thrombosis.

PMID- 11212432
TI  - Forced treatment.

PMID- 11212433
TI  - Pharmacologic management of refractory depression.

PMID- 11212434
TI  - Good-quality medical advice on the Internet.

PMID- 11212435
TI  - Canadians without regular medical doctors. Who are they?
AB  - OBJECTIVE: Because having a regular medical doctor is associated with positive
      outcomes, this study attempted to determine the characteristics of Canadians
      without regular doctors so that alternative methods of delivering care to people
      with those characteristics can be studied. DESIGN: Secondary data analysis of the
      National Population Health Survey using bivariate analyses and logistic
      regression. PARTICIPANTS: A total of 15,777 respondents older than 20 years. MAIN
      OUTCOME MEASURES: Responses to the question "Do you have a regular medical
      doctor?" and analysis of 11 variables covering demographics, health status, and
      lifestyle factors. RESULTS: One in seven respondents did not have a regular
      doctor. Younger respondents, men, single people, poorer respondents, respondents
      who perceived themselves in better health, recent immigrants, those without
      confidants, and smokers were more likely not to have regular doctors. Comparing
      provinces, participants from Quebec were least likely to have regular doctors.
      CONCLUSION: Primary care reform might need to consider alternative ways of
      providing care to certain people. Future primary care programs could be targeted
      to improve coverage of relatively underserviced people, particularly men, people
      on low incomes, those without confidants, and recent immigrants.

PMID- 11212436
TI  - Does having regular care by a family physician improve preventive care?
AB  - OBJECTIVE: To assess whether regular care from a family physician is associated
      with receiving preventive services. DESIGN: Secondary analysis of the 1994
      National Population Health Survey. SETTING: Cross-sectional sample of the
      Canadian population. PARTICIPANTS: A total of 15,731 non-institutionalized
      adults. MAIN OUTCOME MEASURES: Reported visits to general practitioners and
      specialists in the previous year and reports of having had blood pressure
      measurements, mammography, and Pap smears. RESULTS: A graded relationship was
      observed between level of regular care by a family physician in the previous year
      (none, some, regular) and receiving preventive services. Those without regular
      doctors and those reporting only some care by a family physician were less likely
      to have ever had their blood pressure checked than adults receiving ongoing care
      from a regular family physician. Women reporting some or no care were less likely
      to have had mammography within 2 years or to have ever had Pap smears.
      CONCLUSION: Adults who receive regular care from a family physician are more
      likely to receive recommended preventive services.

PMID- 11212437
TI  - Vitamin B12 injections versus oral supplements. How much money could be saved by
      switching from injections to pills?
AB  - OBJECTIVE: To estimate savings, using a third-party payer perspective, if all
      elderly patients currently receiving vitamin B12 (cobalamin) injections were
      switched to high-dose oral therapy. DESIGN: We modeled high-dose oral B12
      supplement costs to include drugs, pharmacists' fees, and one-time conversion
      costs consisting of two physician visits and laboratory monitoring. The number of
      vitamin-injection visits avoided by switching to oral therapy was predicted using
      a multivariate model that considered covariates for overall patient illness.
      SETTING: Ontario family physicians' and internists' practices. PARTICIPANTS:
      Population-based administrative databases for Ontario were used to identify all
      people between 65 and 100 years who received parenteral vitamin B12 during 1995
      and 1996. MAIN OUTCOME MEASURES: The cost of parenteral vitamin B12 for each
      patient, including drugs, injections, pharmacists' fees, and injection-associated
      physician visits, was measured directly from the databases. RESULTS: The annual
      cost of parenteral vitamin B12 therapy averaged $145.88 per person and totaled a
      maximum $25 million over 5 years. Converting all patients to high-dose oral B12
      and treating them for 5 years would cost $7.4 million. Depending on how many
      vitamin-injection visits are avoided by switching to oral therapy, between $2.9
      million and $17.6 million would be saved. Switching to oral B12 administration
      saved costs as long as 16.3% of injection-associated visits were avoided.
      CONCLUSION: Switching all patients from B12 injections to oral cobalamin therapy
      could result in substantial savings.

PMID- 11212438
TI  - Andropause. Testosterone replacement therapy for aging men.
AB  - OBJECTIVE: To review the rationale for treating symptomatic aging men whose
      testosterone levels are mildly reduced or low-normal with testosterone
      replacement therapy. QUALITY OF EVIDENCE: Large-scale multicentre prospective
      studies on the value of treating andropausal men with hormone therapy do not
      exist because the whole area of hormone therapy is barely 10 years old. Evidence
      presented is based on physiologic studies, particularly studies in which
      treatment has been assessed. These were largely uncontrolled open studies.
      Studies to date report positive responses to testosterone treatment with very few
      serious side effects. MAIN MESSAGE: Physicians should consider hypoandrogenism if
      male patients complain of loss of libido, erectile dysfunction, weakness,
      fatigue, lethargy, loss of motivation, or mood swings. Less obvious associations
      with reduced levels of testosterone are anemia and osteoporosis. The main cause
      of reduced testosterone production is primary gonadal insufficiency, but
      secondary causes, such as hypothalamic-pituitary disease, should be considered.
      Evidence shows that most men treated with testosterone will feel better about
      themselves and their lives. CONCLUSION: Andropause is a term of convenience
      describing a complex of symptoms in aging men who have low testosterone levels.
      Physicians should be aware of its existence, should consider ordering tests for
      men who have symptoms, and should treat carefully selected patients whose serum
      testosterone levels are low.

PMID- 11212439
TI  - Hunterian Lecture. What can we learn about mechanisms of mutation from a study of
      craniosynostosis?
AB  - Mutation may be defined simply as structural change affecting the genetic
      material. The generation of genetic variety by spontaneous mutational events has
      been the driving force behind evolution--without such mutation our complex human
      genome could not have evolved. However, as doctors, we more frequently encounter
      mutation in the context of human disease, whether in somatic cells as a cause of
      cancer, or in the germline as a cause of inheritable disease. In these contexts,
      the processes of mutagenesis are relevant to every field of medicine. Scientific
      study of mutational mechanisms has logically been founded in the relatively
      simple genetic systems of the prokaryotes and such lowly eukaryotes as the fruit
      fly. The study of human clinical genetics approaches the problem from quite the
      opposite direction--from that of the most highly evolved genetic system. Whilst
      this approach may be dependent less on logical progression and more on
      phenomenology, it nevertheless provides a complementary avenue for the
      observation and study of mutational mechanisms. The genetic research described in
      this article is firmly rooted in such phenomenology, based as it is on rare
      craniosynostosis syndromes. Over the past decade, there has been a deluge of
      molecular discoveries in the field of craniosynostosis. This promises
      improvements in classification, prognostication, pre-natal diagnosis, and perhaps
      ultimately for potential avenues for cure. However, exciting as these clinical
      prospects are, the research presented here has a different focus: it investigates
      the mechanistic basis underlying the craniosynostosis mutations, in the hope that
      such study may lead to insights applicable generally to the field of mutagenesis.

PMID- 11212441
TI  - A simple, effective and safe method for central venous catheter replacement.
AB  - With the possible exception of pulmonary artery catheters, central venous
      catheters (CVCs) have the highest rates of infection of all intravascular
      catheters, accounting for up to 90% of all vascular catheter-related bloodstream
      infections. The frequency of CVC-related infections is between 10-30%.

PMID- 11212440
TI  - Contrast-enhanced helical computerised tomography in the investigation of
      thoracic aortic injury.
AB  - Aortic angiography is widely considered the 'gold standard' for the diagnosis of
      traumatic thoracic aortic injury. Unfortunately, thoracic aortic angiography has
      many disadvantages: the technique is invasive but, more importantly, it is not
      routinely available in all hospitals, necessitating transfer of critically ill
      patients. Contrast-enhancement helical computerised tomography (CEHCT) of the
      thorax is rapidly becoming available, especially in more district general
      hospitals, and has been shown to be as sensitive and specific in detecting aortic
      trauma as angiography. This technique has the advantage of being non-invasive and
      is able to demonstrate injuries other than thoracic aortic disruption. We present
      four cases of traumatic thoracic disruption initially diagnosed using CEHCT in
      whom surgical repair was performed on the basis of the CEHCT findings. The
      surgical findings of aortic injury were correlated with CEHCT features.

PMID- 11212442
TI  - A stratified response system for the emergency management of the severely
      injured.
AB  - A decade ago, there were justifiable criticisms of the delivery of emergency care
      for injured patients in accident and emergency departments in the UK. To address
      this, a trauma management system was developed in 1991 at Alder Hey Hospital,
      Liverpool. This includes a trauma team, communication system, management
      guidelines and quality assurance. On admission to the accident and emergency
      department, injured patients are triaged to one of three levels of injury
      severity, and a multidisciplinary team lead by a paediatric surgeon or senior
      accident and emergency department physician is activated. The level of injury
      severity determines the composition of the trauma team. A care pathway based on
      ATLS/APLS principles has been developed. The response process as well patient
      management are documented and reviewed at a monthly audit meeting. Currently,
      more than 80% of eligible patients are managed using the trauma system, with an
      over-triage rate of about 25%. Regular modifications to the trauma system since
      its inception in 1991 have resulted in an efficient and effective management
      structure. Stratification of the trauma response has minimised unnecessary use of
      the multidisciplinary trauma team and ensures that mobilisation and use of
      hospital staff and resources are tailored to the needs of the injured patient.
      Although developed in a specialist children's hospital, the system could be
      adapted for any acute hospital.

PMID- 11212444
TI  - All basic surgical trainees should rotate through an accident and emergency post.
AB  - A 6-month post in accident and emergency is no longer compulsory for basic
      surgical training. Meanwhile, trauma teams have emerged in many UK hospitals to
      receive seriously injured patients, often with no involvement of basic surgical
      trainees (BSTs). This may lead to the appointment of surgical specialist
      registrars (SpRs) who have had little exposure to the initial management of
      seriously injured patients. This study documents the experience of a senior house
      officer undertaking a 6-month post in the accident and emergency department of a
      district general hospital. METHODS: Data concerning the nature of cases seen were
      collected retrospectively from all patient record cards signed by the author
      during the placement. RESULTS: During the period studied, the author was present
      in the resuscitation room on 41 occasions, of which 10 episodes involved the
      management of a multiply injured patient. A total of 159 fractures and
      significant soft tissue injuries in the upper limb and 122 such cases in the
      lower limb were seen. There were 25 head injuries, 17 spinal injuries, 5
      significant cases of chest trauma, 4 of abdominal trauma and 5 significant
      urinary tract injuries. Some 86 practical procedures were carried out during the
      placement. DISCUSSION: The 6-month post in accident and emergency provided the
      BST with significant exposure to the care of seriously injured patients. Such a
      post should be compulsory to ensure that SpRs on appointment have already
      received exposure to managing the seriously injured. The post provided additional
      benefit in terms of performing practical procedures and exposure to other acute
      surgical conditions.

PMID- 11212443
TI  - The impact of trauma teams on basic surgical training.
AB  - An analysis of the number of trauma teams and the extent of involvement of basic
      surgical trainees in these teams in the South-West region is presented.

PMID- 11212445
TI  - Patients with acute skin loss: are they best managed on a burns unit?
AB  - Patients who are critically ill and have large areas of skin loss or breakdown
      present a difficult management problem. They require the combination of intensive
      therapy facilities to support failing organs and specialized skin care, sometimes
      including extensive debridement and reconstruction. The expertise required for
      both aspects of treatment are found uniquely on a burns unit. We present five
      patients with large areas of cutaneous loss or damage secondary to a variety of
      non-burn aetiologies who were managed on a burns unit. We suggest that a burns
      unit may be the most appropriate place for such patients to be treated during
      both the acute phase of their illness and the later stages of surgical
      reconstruction and physical rehabilitation.

PMID- 11212446
TI  - Oesophagogastric cancer and surgical subspecialisation: how much work?
AB  - The aim of this study was to assess the volume of work generated by one
      consultant (out of a surgical unit of seven) managing all the upper
      gastrointestinal malignancy in a district general hospital serving a population
      of 480,000. A 3-year period was prospectively audited and the volume of out
      patient and in-patient workload assessed with particular reference to resource
      management and levels of surgical staffing. Oesophagogastric cancer accounted for
      a mean of 61 new cases per year, representing 5.3% of new patient referrals.
      Assuming that a complex major operation for an oesophagogastric cancer equates to
      four intermediate equivalent values (IEVs), then this translated to a mean
      operative workload of 186 IEVs per year, representing 16.7% of the total elective
      operative workload of 1140 IEVs per year. Thus, all the oesophagogastric cancer
      was managed by a single firm as a speciality in a district general hospital over
      this 3-year period, though a relatively small proportion of new patients with
      oesophagogastric cancer translated into a significantly greater burden on the
      resources of consultant manpower and operating theatre time.

PMID- 11212447
TI  - Arthroscopy of the elbow for loose bodies.
AB  - This retrospective study confirms the benefit of arthroscopic removal of loose
      bodies from the elbow, and documents the accuracy of history and plain
      radiographs. In contrast to previous reports, patients with a diagnosis of
      osteoarthritis had a similar outcome to those with an alternative diagnosis.

PMID- 11212448
TI  - A study of waiting time for surgery in elderly patients with hip fracture and
      subsequent in-patient hospital stay.
AB  - OBJECTIVE: To establish whether increased waiting time to operation in elderly
      patients with hip fracture significantly affects postoperative time to discharge.
      METHODS: Combined prospective and retrospective analysis of theatre logbooks and
      in-patient data to determine the type, time and date of operation and subsequent
      in-patient stay. SETTING: A busy district general hospital in the South East
      Thames Valley area with changing availability of a dedicated trauma list.
      PATIENTS: 441 elderly patients undergoing hip surgery between May 1995 and March
      1997. MAIN OUTCOME MEASURES: Waiting time from booking of operation to surgery
      and length of postoperative hospital stay. RESULTS: Increased pre-operative wait
      for emergency hip surgery in elderly patients significantly increases
      postoperative stay. Roughly doubling pre-operative wait increases postoperative
      stay by 19% (P < 0.01).

PMID- 11212449
TI  - Small bowel obstruction due to postoperative adhesions: treatment patterns and
      associated costs in 110 hospital admissions.
AB  - The workload and costs of the emergency admissions and treatment of adhesive
      small bowel obstruction (ASBO) are unclear. This review details and costs the
      admission workload of ASBO. All admissions over a 2-year period for ASBO at two
      district general hospitals were identified through ICD10 diagnostic codes.
      Diagnostic investigations, treatment patterns, ward stay and outcome information
      for admissions were detailed from clinical records to develop mean cost estimates
      and assess the associated workload. Of the 298 admissions identified, 188 were
      not due to ASBO and were excluded from analysis. Of the 110 admissions detailed,
      41 (37%) were treated surgically and 69 (63%) conservatively. Most admissions
      occurred through general practitioner referral (86.4%) to accident and emergency
      (90.0%). Mean (SD) length of stay was 16.3 days (11.0 days) for surgical
      treatment and 7.0 days (4.6 days) for conservative treatment. In-patient
      mortality was 9.8% for the surgical group and 7.2% for the conservative group.
      Costs were based on the mean values from both centres for surgical and
      conservative admissions and detailed according to the cost of referral and follow
      up (100.98 Pounds surgical versus 102.61 Pounds conservative), hospital ward and
      ICU stay (3,327.48 Pounds versus 1,267.92 Pounds), theatre time (832.32 Pounds
      surgical only), investigations (282.73 Pounds versus 207.33 Pounds) and drug
      costs (133.90 Pounds versus 28.29 Pounds). Total treatment cost per admission for
      ASBO was 4,677.41 Pounds for surgically treated admissions and 1,606.15 Pounds
      for conservatively treated admissions. The impact of admissions for ASBO is
      considerable in terms of both costs and workload. Bed stay for these admissions
      represents the equivalent of almost one surgical bed per year and at least 2 days
      theatre time, impacting on surgical capacity and waiting lists. Adhesion
      prevention strategies may reduce the workload associated with ASBO. The review
      provides useful information for planning resource allocation.

PMID- 11212450
TI  - Ecthyma gangraenosum--a trap for the unwary.
AB  - Neutropaenic patients are at particular risk of developing a pseudomonal
      fasciitis known as ecthyma gangraenosum. Despite the similarities with
      necrotising fasciitis, Fournier's gangrene has a very different aetiology and
      management.

PMID- 11212451
TI  - Help of the fire brigade in a case of a strangulated penis.

PMID- 11212452
TI  - Is transurethral resection of the prostate safe and effective in the over 80-year
      old?
AB  - OBJECTIVE: To assess the safety and effectiveness of transurethral resection of
      the prostate (TURP) in patients over 80 years old. PATIENTS AND METHODS: The
      records of all patients over 80 years old undergoing TURP at one institution over
      a 3.5-year period were studied retrospectively. RESULTS: 31% of patients
      underwent TURP for symptoms and 68% for urinary retention. The early complication
      rate was 41%. The late complication rate was 22%. There were no deaths within 30
      days of surgery. Of all patients, 80% were satisfied with the outcome of their
      operation. Of all patients with retention, 80% were able to void with small
      residual volumes by 6 weeks after operation. CONCLUSIONS: Although TURP in the
      over 80-year-old male is associated with significant morbidity, it is an
      effective treatment for urinary symptoms or retention. The majority of patients
      are able to void afterwards and are satisfied with the outcome of their surgery.

PMID- 11212453
TI  - Paediatric day-case surgery in a district general hospital: a safe option in a
      dedicated unit.
AB  - Currently, there is a trend towards the centralisation of paediatric surgery in
      specialist regional units. This study reports the results of 4 years' experience
      of paediatric day-case surgery in a dedicated unit within a district general
      hospital. Since its inception in 1993, data have been collected on all
      individuals undergoing surgery. Between 1993-1997, 804 operations were performed
      with 80% of procedures being undertaken by a consultant. There were 7 (< 1%)
      known complications and 7 (< 1%) patients required admission postoperatively.
      These results compare favourably with those of specialist institutions.

PMID- 11212454
TI  - Audit of referral practice to a fast-access breast clinic before the guaranteed 2
      week wait.
AB  - Currently in the fast-access breast clinic at Eastbourne District General
      Hospital, the specialist determines the level of urgency of a referral. With the
      new '2-week wait' imposed by the Government since 1 April 1999, the determination
      of urgency has transferred to the general practitioner. Therefore, we decided to
      audit the current situation to see whether the guidelines were adequate for this
      change of emphasis. A total of 100 consecutive patients referred to the fast
      access breast clinic were evaluated to assess the quality of referrals and the
      effectiveness of the clinic. Only 80% of the referrals adhered to the guidelines;
      73% of the referrals were deemed by the specialist to be urgent and seen within
      the 2-week time period. All patients who were subsequently diagnosed as having
      breast cancer were seen within 2 weeks. The audit indicates that further specific
      changes could be made to the guidelines to improve the referral practice.

PMID- 11212456
TI  - The CRABEL score--a method for auditing medical records.
AB  - Medical record keeping has become increasingly important particularly for
      research, audit and medico-legal purposes. The authors present a protocol, the
      CRABEL score, that is quick and easy to use for the assessment of the quality of
      medical record keeping with the purpose of standardizing the audit of medical
      records and improving their quality.

PMID- 11212455
TI  - An audit of general dental practitioners' referral practice following the
      distribution of third molar guidelines.
AB  - Oral and maxillofacial surgery waiting lists are amongst the longest of any
      surgical specialty. The majority of patients on these waiting lists have been
      referred for removal of their third molars (wisdom teeth). With increasing
      pressure to reduce the size of both out-patient and surgical waiting lists, it is
      important to ensure that only those patients with a recognised clinical need are
      referred and accepted for treatment. In April 1998, local general dental
      practitioners were issued guidelines for the management of patients with impacted
      third molars. This paper describes an audit that assessed the impact of this
      intervention. The results suggest that referral guidelines are an effective means
      of changing general dental practitioners' referral practice and that, used along
      with other strategies, could be effective in reducing oral and maxillofacial
      surgery out-patient and surgical waiting lists.

PMID- 11212457
TI  - The assessment of surgical skills and a simple knot-tying exercise.
AB  - Basic surgical skills courses are mandatory for all surgical trainees taking the
      MRCS examination. An important aspect of these courses is the level of practical
      skill achieved by junior surgeons attending them. We present a simple knot-tying
      exercise, which may be used to assess the baseline skill level of trainees at the
      outset of the course and against which their progress can be judged after tuition
      and practice.

PMID- 11212458
TI  - A short history of the dispensary movement in London from 1675 to 1948.

PMID- 11212459
TI  - Measles, mumps, rubella vaccine: through a glass, darkly.

PMID- 11212460
TI  - Genetic polymorphism and outcomes with azathioprine and 6-mercaptopurine.

PMID- 11212462
TI  - Accreditation: a two-edged sword.

PMID- 11212461
TI  - Profile of hospital admissions following acute poisoning--experiences from a
      major teaching hospital in south India.
AB  - This study was conducted to determine the incidence of hospital admissions
      following acute poisoning, nature of agents involved and change in pattern of
      poisoning over a 5-year period. Data from hospital records of all admissions to
      emergency department following acute poisoning collected prospectively were
      analysed for the period January 1993 to January 1998. A steady increase in
      deliberate poisoning using pesticides, particularly among young adults, was
      noted. Kerosene (paraffin) was the commonest poison in children and plant poisons
      were also common. There were 52 deaths (3.3%) among the 1584 admissions. The
      majority of deaths were due to pesticides. Poisoning and mortality followed
      ingestion of readily-available and commonly used agents. Measures to increase
      public education, counselling and awareness could prevent a number of these
      admissions.

PMID- 11212463
TI  - Visual hallucinations: a prevalence study among hospice inpatients.
AB  - The aim of the study was to determine the prevalence of visual hallucinations
      among hospice inpatients, and the prevalence of a number of possible associated
      risk factors. One hundred consecutive admissions to St. John's Hospice in Wirral
      were screened for visual hallucinations in a semi-structured interview. The
      prevalence of opioid administration, other drugs known to cause hallucinations,
      brain tumours, liver metastases, bone metastases, lung metastases, known renal
      failure, eye disease, Alzheimer's disease, Parkinson's disease, other
      neurodegenerative disorder, psychiatric disorder and epilepsy were also recorded.
      Subjects were screened for cognitive function using the Folstein mini-mental
      state examination (MMSE). Survival times from assessment to death were
      calculated. The results were analysed using arithmetical means with 95%
      confidence intervals (CI) and odds ratios with 95% confidence intervals. Almost
      half (47%) the patients had experienced visual hallucinations within the previous
      month. Hypnagogic or hypnopompic hallucinations of a person standing by the
      bedside were the commonest type. Median survival time for hallucinators was 15
      days (range 0-50 days) and for non-hallucinators was 11 days (range 0-89 days).
      There was no significant difference in cognitive scores between hallucinators and
      non-hallucinators. Hallucinations were associated with multiple possible risk
      factors in every case. Hallucinators were more likely to be taking opioids,
      although the association was not strong (odds ratio 4.48, 95% CI = 1.6-12.19),
      and were taking larger numbers of potentially hallucinogenic drugs. It is not
      clear why some patients on opioids hallucinate and others do not. Data on the
      prevalence of various possible risk factors yielded ample material for the
      planning of future studies.

PMID- 11212464
TI  - Retrospective study of the use of hydromorphone in palliative care patients with
      normal and abnormal urea and creatinine.
AB  - An uncontrolled retrospective study was conducted looking at the use of oral
      controlled-release hydromorphone in palliative care patients. Over a 2-year
      period 55 patients were switched to hydromorphone therapy, and the efficacy and
      outcomes were assessed. Urea and electrolyte measurements were also recorded at
      the time of opioid switch and renal impairment defined as urea > 10.5 mmol/l
      and/or creatinine > or = 101 mmol/l. This group of 29 patients with abnormal urea
      and/or creatinine (Group 1) was compared with the remaining 26 patients (Group 2)
      who had normal urea and creatinine. The major reasons for change to hydromorphone
      were side-effects (cognitive/drowsiness/nausea) on previous therapy. Following a
      switch to hydromorphone these side-effects improved in over 80% of patients (n =
      55). Comparison between Group 1 and 2 demonstrated a significant difference in
      renal function but no significant differences in reasons for change, dose of
      opioids or response to change (over 80% improvement following opioid switch). We
      conclude that hydromorphone is a flexible second-line alternative to morphine
      that is particularly useful when intolerable side-effects are experienced with
      other opioids. In renal impairment (including two patients with end-stage renal
      failure) we found hydromorphone to be safe and effective. Further clinical and
      pharmacokinetic studies are required.

PMID- 11212465
TI  - A prospective survey of the use of dexamethasone on a palliative care unit.
AB  - One hundred and six consecutive patients started on glucocorticosteroids
      (steroids) according to a defined prescription policy were surveyed each week to
      document the indications for use, any beneficial effect, any toxicity incurred
      and the reason for stopping. All patients had advanced malignant disease and
      survived for a median of 40.5 days (range 1-398+ days) from the start of steroid
      treatment. Fifty-seven per cent of patients completed three or more assessments.
      The most common specific indications for starting steroids were spinal cord
      compression, cerebral metastases, lymphangitis carcinomatosa and intestinal
      obstruction. The most common non-specific indications were anorexia, nausea, low
      mood, pain and vomiting. The median duration of steroid use was 21.5 days (range
      1-89 days). The most common reason for the discontinuation of steroids was death
      or deteriorating condition. Symptom scores improved at some stage for the
      majority of patients started on steroids for anorexia, nausea, pain, low mood,
      vomiting and weakness but not in patients complaining of dyspnoea or poor
      mobility. The most common side-effects that were most probably attributable to
      steroid therapy were oral candidosis and proximal myopathy. The benefits of
      steroids when used according to defined guidelines were thought to outweigh
      toxicity.

PMID- 11212466
TI  - Diagnosis disclosure in a Portuguese oncological centre.
AB  - The disclosure of a diagnosis of cancer to patients is a controversial matter.
      There have been major differences in practice concerning this issue through time
      and between cultures. A questionnaire was sent to the doctors of the Oporto
      Centre of the Portuguese Institute of Oncology in order to assess their
      attitudes. We received 45 responses (40%) from the 113 questionnaires sent. Of
      these, 32 (71%) said that they disclose the diagnosis as a general policy or at
      the patients' request, and 13 (29%) disclose it rarely or not at all. The most
      frequent reason indicated by these 13 physicians was that the disclosure might
      damage the patients psychologically. Forty-four (98%) doctors inform the family
      of the diagnosis. Thirty-nine (87%) think that patients are satisfied with the
      information provided. This study was carried out in one oncological centre only,
      so it is inappropriate to conclude that this is what happens throughout Portugal.
      As far as we know, this is the first study in Portugal addressing this area of
      practice. This subject is a very important topic of research both in Portugal and
      in other countries, as many published recommendations are not research based.

PMID- 11212467
TI  - Palliative care and nursing homes: where next?
AB  - Specialist palliative care providers are seeking to transfer the principles of
      palliative care to more general care settings in order to meet the needs of
      people with diseases other than cancer. To prepare nursing home staff to provide
      palliative care increasing numbers of educational initiatives are now being
      offered. This paper explores some of the assumptions that underpin these
      initiatives. Recommendations are made that recognize the expertise already held
      within nursing homes and propose a collaborative approach to promote the
      appropriate integration of palliative care with nursing home practice.

PMID- 11212468
TI  - Is videotaping of consultations acceptable to patients attending a hospice day
      centre?
AB  - The use of a videotape recorder to analyse consultations in UK general practice
      is accepted, well established and has been extensively researched. The technique
      has potential in palliative medicine for training and the continuing assessment
      of communication skills as part of peer review. However, there have been no
      published studies on whether or not videotaping of consultations would be
      acceptable to a hospice population. Using a semi-structured questionnaire, we
      interviewed 31 patients who had agreed to have their consultation with a doctor
      videotaped. Although 30 (97%) did not regret having given permission and would
      'definitely' or 'possibly' agree to another recording in the future, three (10%)
      felt that the procedure had been inadequately explained to them, six (19%) felt
      that they were 'possibly' or 'definitely' not given sufficient notice of the
      recording and one patient felt under pressure to agree to the recording. These
      findings suggest that if videotaping of consultations in the hospice setting is
      to be undertaken, more advanced notice than that usually given in general
      practice is required and strict safeguards should be in place to protect
      vulnerable patients.

PMID- 11212469
TI  - Determining the decision-making capacity of a patient who refused food and water.
AB  - A terminal patient expressed the wish to hasten her death and refused nutrition.
      The psychiatrist asked to render an opinion relevant to her competence employed
      questions in a semi-structured interview derived from a new instrument originally
      designed to determine competence to create 'Advance Directives'. Although the
      patient ultimately demonstrated her resolve by totally ceasing fluid intake, the
      complexity of the case--including the question of the stability of her choice-
      illustrates the need for specific patient safeguards.

PMID- 11212470
TI  - Can euthanasia be safely legalized?

PMID- 11212471
TI  - Interdisciplinary working: a Greek perspective.

PMID- 11212472
TI  - Describing the subjects in a study.

PMID- 11212473
TI  - Syringe driver drug compatibility database and patient information leaflets on
      the Internet.

PMID- 11212474
TI  - Use of a subcutaneous syringe driver in epidermolysis bullosa.

PMID- 11212475
TI  - The prevalence of episodic pain in cancer: a survey of hospice patients on
      admission.
AB  - Pain that varies with time, referred to here as episodic pain, is a commonly
      encountered but under-investigated clinical problem. Previous studies of cancer
      patients have found that a significant proportion of their pains are episodic. To
      establish the prevalence and characteristics of episodic pains in hospice in
      patients we assessed 245 consecutive admissions to four hospices in Yorkshire.
      The admitting doctor completed a questionnaire, detailing the characteristics of
      all pains experienced by the patient in the previous 24 h. Two hundred and forty
      two questionnaires were entered into the study. One hundred and thirty-two
      patients reported pain in the preceding 24 h, of these 93% had at least one
      episodic pain. In total, 228 pains were described, of which 211 were episodic
      with a wide variation in their temporal characteristics, intensities and
      limitation. One hundred and fifty-two episodic pains had a precipitating factor;
      movement and weight bearing being the most frequent precipitants. One hundred and
      sixty-eight episodic pains had a relieving factor, medication improving 54%.
      Ninety-five pains were related to the malignancy and 47 to concurrent illness.
      The study confirms that episodic pain is extremely common in cancer patients
      referred for in-patient hospice care and highlights the need for further
      evaluation of its management.

PMID- 11212476
TI  - Transplantation of fibula with vascular pedicle for fusion of ankle in leprotic
      drop-foot.
AB  - Devascularized bone grafts are pieces of dead bone and they simply serve as
      scaffolds for new bone to grow and fill the gap, taking a long time when they
      succeed in doing so. In contrast, vascularized grafts being living tissues have
      short healing time, great vitality and strong infection-resisting capacity. We
      report here the successful use of vascularized grafts of the lower end of fibula
      for fusing the ankle in five leprosy patients.

PMID- 11212477
TI  - Assessment of viability by normal mouse foot-pad and bacillary ATP
      bioluminescence assay in multibacillary cases treated with an MDT regimen using
      conventional as well as newer drugs like minocycline and ofloxacin.
AB  - The therapeutic effect of a drug regimen of conventional drugs as well as newer
      drugs like ofloxacin and minocycline in smear-positive multibacillary (MB)
      leprosy cases was assessed by mouse foot-pad and ATP bioluminiscence methods.
      Biopsies were taken before starting treatment and after one year of treatment.
      They were processed for viability assessment by normal mouse foot-pad inoculation
      and bacillary ATP assay techniques. The test regimen was quite effective in its
      anti-bacterial effect as it was found to result in loss of bacillary viability in
      all the cases, as assessed by both methods.

PMID- 11212478
TI  - Bacteriological study of pus isolates from neuropathic plantar ulcers associated
      with acute inflammatory phase.
AB  - In this retrospective study, sensitivity of organisms cultured from ulcers of
      leprosy patients without and with diabetes mellitus, diabetic patients without
      leprosy and patients with ulcers from other causes was examined. The profile of
      organisms grown from these groups of patients did not differ significantly.
      However, there was a high prevalence of organisms like Proteus, E. coli and
      Enterococcus in the ulcers of leprosy patients indicating faecal contamination of
      the ulcers. Co-trimaxazole and tetracycline were of little value in the treatment
      of these ulcers. We therefore recommend that in situations where there is no
      culture facility, the patients be started on a course of penicillin and
      gentamycin. If these antibiotics fail, it would be necessary to use more advanced
      antibiotics like norfloxacin, amikacin and ciprofloxacin.

PMID- 11212480
TI  - The use of pentoxifylline in the treatment of type 2 reactional episodes in
      leprosy.
AB  - It has been suggested that erythma nodosum leprosum (ENL) is associated with
      enhanced production of TNF-alpha resulting in increased inflammation of the skin
      and nerve function impairment. Thalidomide and steroids are the major drugs used
      in the treatment of ENL, but due to the serious problems associated with their
      use, alternative therapeutic interventions are being considered. In the present
      retrospective study, the authors report their clinical observations on the effect
      of pentoxifylline (PTX) in the treatment of ENL. Parameters, such as the clinical
      involution of reactional lesions, the regression of the inflammatory symptoms
      associated with the lesions, and the impact on the systemic symptoms common to
      ENL were assessed at regular intervals during PTX therapy. It was found that PTX
      therapy led to total elimination of systemic symptoms within the first week of
      treatment. This improvement was maintained until the end of the study (60 days of
      treatment). Moreover, the evolution of nodular lesions showed a 100% improvement
      within the first 14 days of treatment. However, by the 60th day, worsening of the
      lesions was noted in 20% of the cases. The impression is that PTX is well
      tolerated, and it may be used for improving patient's clinical condition during
      ENL reaction. Nevertheless, a randomized, double blind, controlled trial to
      compare the effects of the widely-accepted thalidomide and the yet untested
      pentoxifylline for treatment of type 2 reaction is still necessary.

PMID- 11212479
TI  - Intranasal administration of fusidic acid cream in leprosy.
AB  - The effect of local treatment of nostrils with fusidic acid cream was
      investigated in 30 previously untreated lepromatous leprosy patients. The cream
      was applied in the nostrils after flushing the nostrils with normal saline, twice
      a day for a period of four weeks. It was found that 20 mg/gm of sodium fusidate
      was effective in reducing the morphological index of the nose-blow smear to zero
      in two weeks in majority of the patients. No untoward side effect was seen in any
      of the patients. Such nasal treatment along with multidrug therapy may help in
      reducing the patient's level of infectiousness to their contacts, since the nose
      is recognized to be an important portal of exit of M. leprae.

PMID- 11212481
TI  - Status of long absentees among multibacillary leprosy patients admitted to a
      controlled clinical study.
AB  - Of 210 multibacillary leprosy patients who were admitted to a trial of two drug
      regimens, fifty-seven were excluded from efficacy analysis at 120 months for
      various reasons. Thirty-three of these patients were identified as long
      absentees. Efforts were made to contact these patients through letters and home
      visits to assess their clinical and bacteriological status and to find out the
      reasons for default. Twenty-one patients were thus retrieved. Only one patient
      was found to be having active disease requiring treatment; the rest were
      clinically inactive and bacteriologically negative.

PMID- 11212482
TI  - Multidrug therapy--the pathway for global leprosy elimination.
AB  - Introduction of dapsone therapy paved the way for better and more humanitarian
      way of dealing with the leprosy victims who, prior to 1943, were simply rejected
      and segregated from society. Emergence of dapsone-resistant M. leprae and
      mycobacterial persistence provoked our quest for another solution. More drugs
      were discovered for treatment of leprosy. But the real breakthrough was the
      recommendation of regimens of multidrug therapy (MDT) for the treatment of
      leprosy by the WHO Study Group on Chemotherapy of Leprosy in October 1981.
      Subsequent world wide development of leprosy control activities was phenomenal.
      The impact of MDT has led to the cure of over eight million leprosy sufferers and
      the saving of one million patients from becoming crippled. Leprosy prevalence has
      decreased by 80% in ten years. By the end of May 1999 the leprosy burden remained
      concentrated in only 12 countries of the world. These achievements are mainly
      attributed to the development and worldwide adoption of the MDT programme.

PMID- 11212483
TI  - Histoid leprosy--an unusual presentation.

PMID- 11212484
TI  - Lepromatous leprosy masquerading as molluscum contagiosum.

PMID- 11212485
TI  - Primary penile tuberculoid leprosy.

PMID- 11212486
TI  - [Problems in clinical use of immunomodulators in surgery].

PMID- 11212487
TI  - [Trends in adjuvant pathogenetic therapy of infectious and autoimmune diseases].

PMID- 11212488
TI  - [Autoimmune disorders in pregnant women with mixed urogenital infections.
      Interferon therapy in prophylaxis of obstetric and perinatal complications].

PMID- 11212489
TI  - [Pathogenetic therapy in newborn from mothers with autoimmune disorders and mixed
      urogenital infections].

PMID- 11212490
TI  - [Recombinant human erythropoietin--blood transfusion alternative].

PMID- 11212491
TI  - [Modern concepts of stimulation of anti-infectious immunity with
      immunomodulators].

PMID- 11212492
TI  - [Immunity in candidosis and immune correction].

PMID- 11212493
TI  - [Cephalosporins of the third generation in therapy of children with severe
      infections].

PMID- 11212494
TI  - [Therapeutic efficacy of the new drug Pharingal in acute inflammations of pharynx
      and tonsils in children].

PMID- 11212495
TI  - [Clinical and laboratory efficacy of the novel difluoroquinolone Sparflo
      (sparfloxacin) in therapy of skin and soft tissue infections].
AB  - Results of clinical trial of new difluoroquinolone--Sparflo (sparfloxacin, Dr.
      Reddy's Laboratories Ltd) are presented. Sparfloxacin was used in the treatment
      of 24 patients at the Department of Wounds and Wounds infections (11 patients)
      and at the Department of burn wounds (13 patients) of the A.V. Vishnevsky
      Institute of Surgery. After the treatment with sparfloxacin pathogen eradication
      was stated in 18 patients, eradication with superinfection--in 13 patients,
      persistence--in 3 patients. Thus bacteriological efficacy amounted to 87.5 per
      cent. Pharmacokinetic data demonstrates long-term sparfloxacin circulation in the
      organism of patients with burns--elimination half-life amounted to 20 hours.
      Overall after the sparfloxacin use the favourable clinical effect was stated in
      100 per cent patients--18 patients (75%) had clinical cure and 6 (25%)--clinical
      improvement. The drug tolerance was good. It is concluded that clinical and
      laboratory investigation demonstrated high efficacy of sparfloxacin (Sparflo, Dr.
      Reddy's Laboratories Ltd) in the treatment of patients with skin and tissue
      wounds of different localization and genesis, complicated with infections.

PMID- 11212496
TI  - [Discussions on problems in chemotherapy at the VII National Russian Congress
      "Man and Drug"].

PMID- 11212497
TI  - [Origin and evolution of mammalian sex chromosomes].
AB  - Mammals present an XX/XY system of chromosomal sex determination, males being the
      heterogametic sex. Comparative studies of the gene content of sex chromosomes
      from the major groups of mammals reveal that most Y genes have X-linked
      homologues and that X and Y share homologous pseudoautosomal regions. These
      observations, together with the presence of the two homologous regions
      (pseudoautosomal regions) at the tips of the sex chromosomes, suggest that these
      chromosomes began as an ordinary pair of homologous autosomes. Birds present a
      ZW/ZZ system of chromosomal sex determination where females are the heterogametic
      sex. In this case, avian sex chromosomes are derived from different pairs of
      autosomes than mammals. The evolutionary pathway from the autosomal homomorphic
      departure to the present-day heteromorphic sex chromosomes in mammals includes
      suppression of X-Y recombination, differentiation of the nascent non-recombining
      regions, and progressive autosomal addition and attrition of the sex chromosomes.
      Recent results indicate that the event marking the beginning of the
      differentiation between the extant X and Y chromosomes occurred about 300 million
      years ago.

PMID- 11212499
TI  - Post-translational modifications of the regulatory subunits of cAMP-dependent
      protein kinases during G1/S progression.
AB  - During the G1/S transition of the cell cycle variations in the labelling by 8-N3
      [32P]cAMP of the protein kinase A regulatory subunits RI and RII, used as a probe
      to monitor post-translational modifications that may regulate cAMP binding, were
      observed in synchronized HeLa cells. A decrease in 8-N3-[32P]cAMP labelling of
      RI, RII and RII phosphorylated by the catalytic subunit of PKA was correlated
      with the increased percentage of cells in phases G1. An increase in 8-N3
      [32P]cAMP incorporated into the 54-kDa RII subunit during progression from G1 to
      S was correlated with an increase in intracellular cAMP. A transient increase in
      Mn-SOD activity was detected in cells arrested at the G1/S transition using two
      different techniques, suggesting that oxidative modulation of regulatory subunits
      by free radicals may modify cAMP binding sites during the cell cycle. Decreased
      photoaffinity labelling by 8-N3-[32P]cAMP of RI, RII and autophosphorylated RII
      subunits was found to be an inherent characteristic of PKA in the G1/S
      transition.

PMID- 11212498
TI  - [Transition metals and nitric oxide production in human endothelial cells].
AB  - The bioavailability of endothelial nitric oxide (NO) is regulated by transition
      metals but their mechanisms of action on NO synthesis and degradation are not
      clearly understood. Using differential pulse amperometry and NO microelectrodes,
      local NO concentration was measured at the surface of cultured human umbilical
      vein endothelial cells (HUVECs) stimulated by histamine or thrombin in the
      presence of transition metal chelators. The agonist-activated NO release required
      both extracellular Ca2+ and transition metals. In the presence of 1 mM external
      Ca2+, a low concentration of EGTA (5 microM) inhibited by 40% the NO release from
      stimulated HUVECs. In the presence of extracellular L-arginine, the inhibitory
      effect of EGTA was even more marked and, in its absence, it was suppressed by
      adding exogenous superoxide dismutase. The decrease in NO release induced by the
      copper chelators, cuprizone and DETC, suggests that extracellular traces of Cu2+
      could regulate NO availability.

PMID- 11212500
TI  - Noradrenergic modulation of tactile responses in rat cortex. Current source
      density and unit analyses.
AB  - This study describes the noradrenergic modulation of tactile afferent information
      in the sensorimotor cortex of urethane-anesthetized rats. Synaptic and spike
      responses to a mechanical stimulation of the hand palm were evaluated by means of
      current source-density analysis and unit activity recording in all cortical
      layers. Results showed that activation of the locus coeruleus decreased and
      shortened afferent synaptic excitation in supragranular, but not in deep layers.
      On the average, unit responses exhibited facilitated latency, moderately
      increased amplitude, enhanced postexcitatory inhibition and synchronization of
      responses across layers. The apparent paradox of this global phasic facilitation
      correlated with a decrease in input synaptic currents was discussed according to
      hypotheses which might explain its functional significance.

PMID- 11212501
TI  - [Skeletal configurations of cervical column during rest to motion transition:
      generalization that underlie the motor repertoire in rodents].
AB  - During forward locomotion, guinea pigs adopted a posture which, although
      different, was as stereotyped as at rest. The whole extent of the vertebral
      column was extended, parallel to the earth-horizontal plane. This result supports
      the hypothesis that, in mammals, gaze and postural control by the central nervous
      system would be simplified by the adoption of a limited number of skeletal
      configurations. They would be optimized for energy saving, biomechanical efficacy
      and limitation of the number of degrees of freedom of the skeletal apparatus.
      Transition between rest and forward locomotion displayed two prominent
      characteristics: the head was stabilized versus space throughout the whole
      transition and the modifications of the skeletal geometry were confined to the
      median plane and to two major articular regions. Such an organization revealed a
      fourth characteristic of the guinea pig postural control: the skeletal
      configurations retained by evolution would ensure that smooth transitions take
      place between rest and the various activities of its motor repertoire. Finally,
      our purely descriptive data shed new light on the architecture of the neuronal
      network which underlies the vestibular control of gaze and posture.

PMID- 11212502
TI  - Productivity and carbon isotope discrimination in durum wheat organs under a
      Mediterranean climate.
AB  - For durum wheat, we promote the use of carbon isotope discrimination (delta) as
      an indirect selection criterion for transpiration efficiency and grain yield
      (GY), and we identify the most effective organ for characterising delta genotypic
      variation. A field experiment was conducted in the South of France on 144
      accessions, with a drought period occurring from February to June. Harvest index
      (HI), GY and delta (delta L, flag leaf; delta A, awn, delta G grain) were
      measured. Significant positive genetic correlations were noted between delta and
      both GY and HI. A larger genotypic variation and a higher broad-sense
      heritability were noted for delta G compared to delta L and delta A. delta G
      correlated better with GY and HI than delta L and delta A, showing that delta G
      could provide a better assessment of genotypic behaviours under drought during
      grain filling. Moreover, the indirect selection based on delta G (even when
      evaluated with one replicate) appeared more efficient than the direct selection
      for grain yield. This result emphasised the potential value of grain carbon
      isotope discrimination as a criterion for grain yield improvement under stressed
      Mediterranean conditions.

PMID- 11212504
TI  - Evidence from DNA that the mysterious 'linh duong' (Pseudonovibos spiralis) is
      not a new bovid.
AB  - In 1993, several horns of an unknown mammal were collected in the south of
      Vietnam. Due to the unusual characteristics of its horns, the 'linh duong', as
      named by Vietnamese hunters, was quickly described as belonging to a new
      monospecific genus of bovid, i.e. Pseudonovibos spiralis Peter & Feiler, 1994.
      The taxonomic status of Pseudonovibos was a highly controversial subject, and it
      has been suggested that this enigmatic species may be related to three different
      groups of Bovidae: Antilopini (gazelles), Bovini (cattle, bisons, buffaloes), and
      Caprini sensu lato (goats, sheep and allies). To assess the phylogenetic
      relationships of the linh duong within the family Bovidae, two different DNA
      markers, the nuclear lactoferrin and the mitochondrial cytochrome b genes, were
      sequenced from bone samples of four trophies collected during 1925 in Indochina.
      Results show that the mysterious horns of linh duong belong to domestic cattle
      (Bos taurus). Thus, the linh duong is not a new mammal and the scientific name
      Pseudonovibos spiralis should be abandoned.

PMID- 11212503
TI  - [Humus functioning types in evergreen coniferous forests of the French Inner
      Alps].
AB  - Three humus forms that are widespread in the Inner Alps, a dysmull below Pinus
      sylvestris, an oligomull below Abies alba and a mor below Pinus cembra, were
      studied by following mineral nitrogen production and uptake and by a
      characterization of the pedofauna. Due to the production and uptake of nitrogen,
      mainly as nitrates and also due to the dominance of Lumbricids versus Arthropods,
      the oligomull was the sole humus form that functioned as a mull. Nevertheless
      relatively weak mineral nitrogen production and the dominance of endogeic soil
      dwelling earthworms versus anecic earthworms demonstrated the moderate activity
      of this mull, which is representative of humus forms of old growth forests and
      cold climates. There was a discrepancy between the very low biological activity
      of the dysmull and its status of mull, while an observed bifunctioning between
      the different layers of this humus also differentiated it from the mor.

PMID- 11212505
TI  - The enigmatic new Indochinese bovid, Pseudonovibos spiralis: an extraordinary
      forgery.
AB  - In 1993, the discovery of several pairs of lyre-shaped horns with corrugations
      was recorded in Vietnam and regarded as evidence for a new, large bovid, later
      referred to as Pseudonovibos spiralis Peter & Feiler, 1994. Despite numerous
      field investigations made since 1994 in Vietnam and Cambodia, no new anatomical
      evidence has ever been found, except for two frontlets with their horn cores and
      horn sheaths. A new investigation has been carried out on six frontlets and based
      on a histological analysis of the keratin. It shows that the horns of P. spiralis
      are merely a skillful forgery made by carving and distorting ordinary cow horns.
      The horns of Pseudonovibos spiralis were, in some cases, positioned back onto the
      corresponding horn cores of domestic cow frontlets. The name Pseudonovibos
      spiralis is thus a junior synonym of Bos taurus, yet it remains valid and
      available.

PMID- 11212506
TI  - [Heterochronia via procrustean superimposition: application to the skulls of
      Homonidae primates].
AB  - The procrustes superimposition method is well adapted to heterochronic studies in
      the field of evolutionary biology. 1) The procrustes method gives a precise and
      mathematical definition of two of the three heterochronic variables: size and
      shape. 2) It allows us to describe complex anatomical structures and thus to
      analyse the whole structure and not just to proceed trait by trait. 3) The
      approach is statistical and the different hypotheses and results may be
      statistically tested. 4) When applied to heterochronies the method allows us to
      test if there is a common shape change related to allometry. In the present study
      of three species of Hominoid primates, the procrustes superimposition reveals
      that various heterochronic processes are simultaneously present. Size-age-shape
      dissociations between species, already present in the first ontogenetic stage,
      are amplified with growth until adult stage. As compared with that of the
      chimpanzee, the growth of the gorilla skull is accelerated in terms of size-shape
      covariation and size alone. The growth of the human skull is neotenic as compared
      with that of the apes.

PMID- 11212507
TI  - [Lateralisation of the brain injury in female Wistar rats determines the immune
      and neurological status in offspring].
AB  - The T-cell immune deficiency was found to be more obvious in offspring of rats
      with a right-side brain injury. The EMG pattern changed in accordance with the
      brain injury lateralisation in the muscles responsible for posture asymmetry. The
      offspring EMG disorders were more obvious in cases of a right-side brain injury
      in mothers. The right-side brain injury in mothers led to a higher negative
      emotionality and a diminished tentative-research behaviour in "open-field" tests
      in 30-day old offspring.

PMID- 11212509
TI  - [Cardiac pump function in rats of different ages during muscle training and
      hypokinesia].

PMID- 11212508
TI  - [Comparative characteristics of myogenic responses in pial arterioles in
      normotensive and spontaneously hypertensive rats].
AB  - In acute experiments on SHR and WKY rats, the pial arterioles' myogenic responses
      to a drop in systemic blood pressure (SBP) were studied. The SHR seem to be more
      capable of keeping the myogenic activity in low SBP. It might depend on
      structural changes in the vascular wall under these conditions wall in the SHR.

PMID- 11212510
TI  - [Effect of the body antiorthostatic posture on various circulation and
      respiration parameters in anesthetised cats].
AB  - In anaesthetised cats, antiorthostatic posture of the body with an inclination
      angle of 30 degrees increased pressure in the vena cava superior and in jugular
      vein. The rest of the cardio-respiratory parameters were changed insignificantly.
      Physical and physiological mechanisms of the blood regional redistribution in
      alteration of the body gravitation orientation, are discussed.

PMID- 11212511
TI  - [Involvement of nitrogen oxide in the cerebral vasoconstriction during
      respiration with high pressure oxygen].
AB  - High pressure oxygen evokes a cerebral vasoconstriction and diminishes cerebral
      blood flow with the aid of mechanisms which are not yet sufficiently studied. We
      were checking a hypothesis that the hyperbaric oxygen (HBO2) inactivates cerebral
      nitrogen oxide (NO), interrupts its basal relaxing effect, and evokes a
      vasoconstriction. In our experiments, HBO2 decreased cerebral blood flow
      depending on the pressure. Inhibiting the NO-synthase weakened basal
      vasorelaxation in breathing with atmosphere air and eliminated the
      vasoconstriction in exposure to the HBO2. Inactivation of O2 prevented the HBO2
      induced vasoconstriction. The data obtained reveal that diminishing of cerebral
      blood flow in HBO is related to the NO inactivation and weakening of its basal
      vasorelaxing effect. Possible mechanisms of the NO inactivation may involve its
      reaction with oxygen and superoxide anion which lead to diminishing of the tissue
      NO concentration and weakening of its vasorelaxing effect.

PMID- 11212512
TI  - [Time correlation of the cardiac electric field on the body surface and
      depolarization sequences in the pigeon heart ventricle epicardium].
AB  - Multifocal depolarisation of the pigeon ventricle's epicardium was revealed. A
      time inversion correlation was found between cardiac electrical field's positive
      and negative areas on the body surface and the multifocal depolarisation of the
      ventricle epicardium, during the period of initial ventricular activity.

PMID- 11212514
TI  - [Effect of cooling rate and intensity on the immune response and corticosterone
      blood level in rats].
AB  - Changes in the rat antigen-induced immune activity were shown to depend on
      cooling depth: slight cooling activated the immune response whereas deep cooling
      inhibited it. Involvement of the skin cold receptors' dynamic activity in
      responses to rapid cooling attenuated the effect of cold exposure on the immune
      response as well as the corticosterone elevation in plasma.

PMID- 11212513
TI  - [Changes in the venous vessels capacitance in the cat forepaw in response to
      neurohumoral stimuli].
AB  - The trend in changes of the cat forepaw vessels' capacity was found to
      practically not differ from the trend in shifts in the vena cava anterior basin's
      capacity: in both areas the capacity decreases in response to pressor neurogenic
      stimuli and decreases or increases under the effects of pressor and depressor
      humoral stimuli. The data obtained suggest that the trend in shifts of the vena
      cava anterior basin's capacity under the effects of pressor humoral stimuli
      mainly depends on the skin-muscular area's vessels, whereas the trend in shifts
      of the vena cava anterior basin's capacity under the effects of depressor humoral
      stimuli depends, apparently, on the shifts in the brain vessels' capacity
      function.

PMID- 11212515
TI  - [Functional activity and mechanical properties of blood leukocytes during heating
      in rats].
AB  - Different phasic changes induced by exogenous hyperthermia in leukocytes
      correlated with the latter adhesion and resistance properties as well as osmotic
      factors. The changes seem to be related to unspecific reactions. Phagocytes' and
      migratory activity increased along with the time of heating exposure. Activation
      of protective reactions seems to be caused by humoral factors the amount of which
      increases in the blood along with the heating temperature.

PMID- 11212516
TI  - [Effect of cross-fostering on various physiological and behavioral features in
      Wistar and genetically cataleptic rats].
AB  - In the GC rats reared by their natural mothers the plasma corticosterone
      concentration and open field locomotion were lower than in Wistar rats whereas
      the startle-reflex amplitude was higher. Cross-fostering did not affect the
      plasma corticosterone concentration or the startle-reflex amplitude. A negative
      correlation between these parameters was found. An open field test yielded lower
      results in Wistar rats reared by foster mothers belonging to the GC strain
      whereas the reverse cross-fostering did not affect the locomotion in GC rats. The
      data suggest that fostering affects the open field behaviour whereas cross
      fostering effects depend on the genotype of fostered litter.

PMID- 11212517
TI  - [Changes in the hormonal function of the hypophysis-adrenal system by
      administration of cortisol in 'fixed' phases of the postnatal ontogenesis in
      rats].
AB  - Administration of cortisol on the 13th, 15th, and 17th days of postnatal
      ontogenesis was shown to exert a long-lasting modifying effect upon the
      hypophysis-adrenal system's (HAS) stress reactivity in the rat litter. The effect
      involved a longer duration of hormonal response to immobilisation stress: a
      longer-lasting elevation of the corticosterone level in the blood plasma
      suggesting a diminished sensitivity of the HAS to feed-back signal. In
      hippocampus, frontal cortex and hypothalamus of the experimental rats, a decrease
      in receptor binding of labeled corticosterone was revealed.

PMID- 11212518
TI  - [Delay inhibition of the active avoidance reflex and intertrial responses in rats
      in the shuttle box].
AB  - A diminished probability of avoidance response in early phases of a warning
      signal was revealed with salient signals given after short intertrial intervals.
      The inhibition of the delay in avoidance response is due to an interaction of the
      safety state conditioning and the excitation elicited by onset of warning signal.

PMID- 11212519
TI  - [Electrophysiological pacemaking properties of the ureter peribladder area in
      cats and rats].
AB  - The rhythm generated by the peribladder area was found to be slower than that
      generated by the basis perirenal pacemaker in cats and rats. The antiperistaltic
      waves' frequency of the peribladder area was the lowest within the range of all
      the recorded rhythms.

PMID- 11212520
TI  - [Hydrolases in the large intestine in rats with various experimental
      pathologies].
AB  - In the colon mucous membrane, activity of a wide range of membrane and mainly
      intracellular enzymes was studied in the organism at different conditions. The
      data obtained suggest participation of digestive hydrolases in the colon not only
      on postdigestive processes but, in certain states of the organism, in digestive
      processes too.

PMID- 11212522
TI  - [Long-term potentiation of glutamatergic transmission and epileptiform activity
      induced by short-term episodes of anoxia in the CA1 field of the rat hippocampal
      slices].

PMID- 11212521
TI  - [Effects of acetylcholine and histamine on leukocyte and neutrophil numbers in
      the endometrium of rats in various phases of the estrous cycle (by imprints)].
AB  - Administration of the acetylcholine esterase antagonist aminostigmin increased
      the number of neutrophils in the estrus phase and the number of lymphocytes in
      the diestrus phase in rats. Histamine decreased both the neutrophils and
      lymphocytes at all stages of the estrus cycle in the uterus endometrium.

PMID- 11212523
TI  - [Effect of physical load on glucocorticoid binding in the fatty tissue cytosol].

PMID- 11212524
TI  - [Effect of pH on the osmotic water flow stimulated by arginine vasopressin added
      to the solution at the bladder mucosa from the frog Rana temporaria].

PMID- 11212525
TI  - [Lev Germanovich Leibson (1900-1996) (on his 100th birthday)].

PMID- 11212526
TI  - [Centennial of the birth of Lev Germanovich Leibson].

PMID- 11212527
TI  - [Hypothesis of the key coordinating role of adenylate cyclase signal mechanism
      and cAMP in regulatory effect of insulin superfamily peptides on fundamental
      cellular processes: cell growth, apoptosis, metabolism (Development of the L. G.
      Leibson's works)].

PMID- 11212528
TI  - [STAT pathway of the intracellular signaling].

PMID- 11212529
TI  - [Progress in studies on effect of leptin on the hypothalamus neurons].

PMID- 11212530
TI  - [Hormonal regulation of metabolism and exotrophy in fishes. Polyfunctionality and
      polypotentiality].

PMID- 11212531
TI  - [Internal symmetry of the mirror type in the primary structure of proteins:
      identification and the functional role].

PMID- 11212532
TI  - [Ontogenesis of human islets of Langerhans. Review of light and electron
      microscopic data, immunohistochemical and functional data on fetal development of
      the endocrine pancreas].

PMID- 11212533
TI  - [Binding of insulin-like growth factor I (IGF-1) in skeletal muscles of Lampetra
      fluviatilis dominates over insulin binding and increases during spawning
      migration].

PMID- 11212534
TI  - [Primary structure of insulin from the Black Sea Scorpaena porcus].

PMID- 11212535
TI  - [Adenylate cyclase signaling mechanism of the relaxin function].

PMID- 11212536
TI  - [The role of mitogen-activated protein kinases in stimulation of the smooth
      muscle cell migration by urokinase].

PMID- 11212537
TI  - [Tyrosine hydroxylase and/or aromatic L-amino acid decarboxylase-expressing
      neurons in the mediobasal hypothalamus of Wistar rats in ontogenesis: topographic
      interrelations and axonal projections to the medial eminence].

PMID- 11212538
TI  - [Interaction of distant mechanoreceptor systems during presentation of the
      interspecies acoustic signals to intact and allatectomized male crickets Gryllus
      bimaculatus].

PMID- 11212539
TI  - [Intestinal regulatory systems in invertebrates and their evolution in
      multicellular animals].

PMID- 11212540
TI  - [Some elements of a portrait of Lev Germanovich Leibson].

PMID- 11212541
TI  - [History of science in works of L. G. Leibson].

PMID- 11212542
TI  - Contamination of animal feed and food from animal origin with mineral oil
      hydrocarbons.
AB  - Oils and fats used for the production of animal feed can become contaminated with
      mineral oil material originating from gas oils (C18-C35) or synthetic oils (poly
      alpha olefins, C25 to beyond C45). An important cause is assumed to be the
      discharge of waste oils, such as motor oil and hydraulic oils. Mineral oil
      material was analysed by on-line LC-GC-FID directly in the fat or in a raw
      extract from animal feed or foodstuffs. In Switzerland in summer/autumn 1999
      concentrations in oils and fats for feed production were often found to be
      between 100 and 1000 mg/kg. In the feeds, the average concentration was around
      100 mg/kg with values ranging up to a maximum of 1000 mg/kg; few samples were
      free of contamination. In animal body fat, the average concentration determined
      in summer 1999 was 25 mg/kg, with a maximum of 150 mg/kg, although in samples
      from December 1999, contamination was substantially lower. In the fat phase of
      eggs, the average concentration was 30 mg/kg, with a maximum of 80 mg/kg.
      Paraffin oil is used for feed production, which may account for part of the
      contamination problem (e.g. eggs).

PMID- 11212543
TI  - Development of an ELISA for sulfachlorpyridazine and investigation of matrix
      effects from different sample extraction procedures.
AB  - The development of an enzyme-linked immunosorbent assay (ELISA) for the detection
      of residues of sulfachlorpyridazine (SCP) is described for the first time. The
      assay is highly specific for SCP, is simple to perform and has a lower detection
      limit of 0.65 ng/ml in assay buffer. In potential application of the assay to
      detect residues of SCP at the 0.1 mg/kg level in eggs, milk, beef, lamb, pork,
      chicken, turkey, porcine kidney, porcine liver and pig feedstuffs is discussed
      with regard to the effects of sample extracts on the standard curves. The
      antibody exhibits a rare stability in assay buffers containing up to 30%
      methanol. It is concluded that the ELISA for SCP has the appropriate
      characteristics for development into a robust method for the detection of this
      sulphonamide in agri-food materials.

PMID- 11212544
TI  - A comparison of techniques for preparing fish fillet for ICP-AES multielemental
      analysis and the microwave digestion of whole fish.
AB  - Four catfish fillet homogenate treatments before multielemental metal analysis by
      simultaneous inductively coupled plasma/atomic emission spectroscopy were
      compared in triplicate. These treatments were: nitric acid wet-ashing by Parr
      bomb digestion; nitric acid wet-ashing by microwave digestion;
      tetramethylammonium hydroxide/nitric acid wet digestion; and dry-ashing. The
      tetramethylammonium hydroxide/nitric acid method was imprecise (coefficients of
      variation > 20%). The dry-ashing method was fast and sensitive but had low
      recoveries of 50% for spiked Pb and Al and was not as precise as the Parr bomb or
      microwave treatments. The Parr bomb method was the most precise method but was
      less sensitive than the microwave method which had nearly the same precision. The
      microwave method was then adapted to homogenates of small whole fish < or = 3 cm
      in length. The whole fish homogenate required more vigorous digestion conditions,
      and addition of more acid after the evaporative step because of the presence of
      less oxidizable and acid-soluble components than fillet. The whole fish
      homogenate was also more heterogeneous than catfish fillet. A quality assurance
      protocol to demonstrate homogenate uniformity is essential. The use of a non
      specialized microwave oven system allowed precise results for fillet and whole
      fish homogenates.

PMID- 11212545
TI  - Copper, zinc, tin and lead in canned evaporated milk, produced in Lithuania: the
      initial content and its change at storage.
AB  - The study has been carried out to elucidate what contents of heavy metals were
      typical for canned milk products--evaporated (TS 25.5-28.5%) sterilized milk and
      condensed sweetened milk, produced in Lithuania in the period 1983-1997. The
      influence of storage time upon the level of Sn, Pb, Cu and Zn in the products has
      also been determined. The results show that the most considerable changes
      occurred in Cu concentration, which gradually decreased from the maximum level in
      1983-1985 (2.23 +/- 0.18 mg/kg) to the minimum level in the latest years (0.44 +/
      0.01 mg/kg). Such variation of copper content in canned milks can be closely
      connected with its changes in raw milk. Zinc content in canned milk products also
      was in good agreement with raw milk. The content of tin and lead in the canned
      products many times exceeded their concentration in raw milk and ranged from 28
      +/- 2 and 0.093 +/- 0.005 to 114 +/- 4 and 0.29 +/- 0.01 mg/kg, respectively. It
      has been determined that the dependence of the concentration of tin and lead on
      the storage time of concentrated (or evaporated) sterilized milk is nearest to
      the parabolic, and in sweetened condensed milk to the exponential function,
      whereas the small increase of copper and zinc concentrations can be described by
      straight-line function. The functional dependence obtained enables one to predict
      the Sn and Pb level in canned evaporated milk products after storage and to
      foresee the safe initial concentration of these metals in freshly produced
      evaporated milk, assigned for storage.

PMID- 11212546
TI  - A survey of zearalenone in corn using Romer Mycosep 224 column and high
      performance liquid chromatography.
AB  - A survey of zearalenone (ZEA) in corn from various regions of Brazil was carried
      out by the analysis of 380 corn samples, of which 30 samples (7.8%) were found to
      be contaminated in the range of 46.7-719 micrograms/kg. ZEA was extracted with
      acetonitrile-water (84:16, v/v), cleaned-up on a Romer Mycosep 224 column,
      separated, detected and quantified by high performance liquid chromatography
      (HPLC). The in-house method characteristics of linearity, accuracy, precision,
      and detection limit were defined by means of recovery tests with spiked corn
      samples in the range of 35.8-716 micrograms/kg and the analysis of a naturally
      contaminated sample (n = 7). The mean recovery for ZEA was 99.4% and the relative
      standard deviation (RSD) varied from 0.7 to 26.6% in the range studied. The
      method has been shown to be accurate, quick and reliable for determination of
      zearalenone in corn.

PMID- 11212547
TI  - Absorption, distribution and excretion of aflatoxin-derived ammoniation products
      in lactating cows.
AB  - Peanut meal naturally contaminated with 3.5 mg/kg aflatoxin B1 (AFB1) was spiked
      with radiolabelled AFB1 (meal 14C-I0) and decontaminated by a small-scale copy of
      an industrial ammoniation process (meal 14C-I1). During the process 15% of the
      radioactivity was lost, whereas 90% of the remaining radiolabel could not be
      extracted from the meal. In the extractable part, AFB1 accounted for 10% of the
      radiolabel, consistent with a total AFB1 reduction of more than 99%. No
      degradation products were observed in the extracts. Four lactating cows were fed
      with a diet containing 15% of either meal 14C-I0 or 14C-I1 for 10 days. On day 9
      of this treatment, respectively 23 and 67% of the radiolabel was excreted in the
      urine and faeces of cows fed meal 14C-I0, as compared with 2 and 101% in the case
      of cows fed meal 14C-I1. Milk contained respectively 1.35 (meal 14C-I0) and 0.25%
      (meal 14C-I1) of the radiolabel. Milk samples taken during the equilibrium stage
      contained respectively 5 and 0.5 ng/ml of AFB1-derived compounds. Aflatoxin M1
      (AFM1) accounted for 50-80% of these compounds in the case of milk from cows fed
      14C-I0, as compared with 6-20% in the case of 14C-I1. AFB1 to AFM1 carry-over
      rates for 14C-I0 or 14C-I1 were estimated to be respectively 0.5 and 5.9%. Only
      liver and kidney samples contained detectable levels of the radiolabel, being
      respectively 260 and 37 micrograms/kg for cows fed meal 14C-I0, and 10 and 3
      micrograms/kg for those fed meal 14C-I1. In the latter case, more than 55% of the
      radiolabel in the liver could not be extracted, as compared with 90% in the group
      fed meal 14C-I1. A small part of the extractable radiolabel in the livers of cows
      fed meal 14C-I0 could be attributed to AFB1 and AFM1 (less than 1% of total
      radioactivity). In the case of the animals fed 14C-I1 there were indications for
      the presence of AFB1 and AFM1 (6% of total radioactivity). Decontamination of the
      highly contaminated (non-radiolabelled) peanut meal by two different industrial
      ammoniation processes, resulted in a similar reduction of the initial AFB1 levels
      of 3.5 mg/kg to 15 micrograms/kg. Feeding of diets containing 15% of the non
      treated and two treated peanut meals to cows for a period of 10 days, resulted in
      AFM1 levels in milk of respectively 2.1, 0.04 and 0.07 ng/ml. AFB1 to AFM1 carry
      over rates were calculated to be respectively 0.5, 2.0, and 3.6%. It is concluded
      that the efficient reduction of aflatoxin levels by ammoniation of contaminated
      peanut meal results in a strong reduction of aflatoxin-related residues in milk
      and meat of cows, most likely caused by a decreased bioavailability of the
      degradation products.

PMID- 11212548
TI  - Comparison of different extraction and clean-up procedures for the determination
      of fumonisins in maize and maize-based food products.
AB  - In order to optimize the analytical method for the determination of fumonisin B1
      (FB1) and fumonisin B2 (FB2) in different maize products, five materials (maize
      flour, corn flakes, extruded maize, muffins and infant formula) were investigated
      under a variety of experimental conditions organized in a ruggedness test
      according to a factorial design. The influence of five factors (extraction
      solvent, extraction mode, volume of extraction solvent, test sample size and
      clean-up) on method performances was tested by four laboratories using spiked
      materials (0.5 microgram/g and 1.5 micrograms/g FB1 + FB2) and naturally
      contaminated materials (ca 1.5 micrograms/g with FB1 + FB2). The end
      determination step was performed by high-performance liquid chromatography
      analysis of the o-phthaldialdehyde derivatized extracts. The ruggedness test
      permitted identification of two critical factors in the analysis of fumonisins in
      the above products, namely 'extraction solvent' and 'clean-up procedure'. In
      particular, the use of acetonitrile (ACN)-water (1 + 1, v + v) as extraction
      solvent and immunoaffinity column for clean-up provided better recovery of
      fumonisins and chromatographic resolution as compared with methanol (MeOH)-water
      (3 + 1, v + v) and strong anion exchange (SAX), respectively. However, phase
      separation occurring after extraction with ACN-water may have given incorrect
      results. Based on the information obtained with the present study it was possible
      to develop a new method horizontally applicable to all the above mentioned maize
      based food matrices.

PMID- 11212549
TI  - Determination of bisphenol A in canned vegetables and fruit by high performance
      liquid chromatography.
AB  - A high performance liquid chromatography (HPLC) method was developed for the
      determination of bisphenol A (BPA) that had migrated into canned fruit and
      vegetables. BPA was extracted with acetonitrile from the solid portion of canned
      food, and with an OASIS HLB cartridge from the aqueous portion, respectively.
      Both extracts were cleaned up on a Florisil cartridge. The HPLC separation was
      carried out on a Wakosil II 3C18 RS column (4.6 x 150 mm) with acetonitrile-water
      (40:60, v/v) as a mobile phase with a flow rate of 0.8 ml/min. BPA was detectable
      by UV detector at 228 nm and determined with the similarity of chromatographic
      peak spectrum by multiwavelength detector (similarity index was 0.99 or above).
      The quantification limits were 10 ng/g for the solid portion and 5 ng/ml for the
      aqueous portion, respectively. BPA was mainly detected in the solid portion of
      canned food and found at the maximum level of 11 micrograms per can. To verify
      migration into the solid portion of canned food, a partitioning experiment was
      carried out.

PMID- 11212550
TI  - Investigation of migration from paper and board into food--development of methods
      for rapid testing.
AB  - A range of paper and board materials including carton board, corrugated board,
      napkins and paper towels intended for contact with food have been solvent
      extracted and substances present at the highest levels identified and quantified
      by GC/MS. Dibutyl phthalate, and diisopropylnaphthalene (DIPN) were selected to
      study migration to food and potential food simulants with the aim of developing a
      simple quick test that will give an equivalent or higher result. Tenax was found
      to be a suitable food simulant for dry foods and dry 'fatty foods' such as pastry
      and cake and was also found to be a suitable simulant for pizza base tested at
      higher temperatures for short contact times. The percentage migration values from
      corrugated and carton boards were generally in the range 15-40%, with the highest
      percentage being 49% for rice using conditions representing ambient storage.
      Quick tests were developed using Tenax under accelerated conditions of 4 h at 80
      degrees C to cover room temperature storage with dry foods and fatty dry foods.
      These tests are suitable for compliance testing of paperboard samples if
      migration limits are applied in future legislation. Migration from tissues,
      napkins and paper towels was found to be at very low or not detectable levels,
      even when the levels of DIPN and DBP were significant. It is strongly suspected
      that this finding is due to a combination of short contact time, low grammage and
      the fact that the tissues absorb fat and moisture from foods, thus minimizing
      extraction from the paper. In all cases, the results from migration experiments
      into food and Tenax indicate that for the substances found at highest
      concentrations in the paper, currently accepted safety limits were not exceeded
      where they exist in EU legislation or in working documents applying to plastics.

PMID- 11212552
TI  - Esthetic analysis of the cervicofacial region.
AB  - For many patients the primary motivating factor for orthognathic surgery is
      improvement of their facial appearance. In order to achieve a satisfactory
      esthetic result and satisfy the patients' concerns, a systematic, thorough
      evaluation should be performed. Because the face is a complex anatomic unit, it
      is best to evaluate each distinct region of the face separately, taking care to
      relate the various parts to the whole. During this examination it is important
      that the patient be in natural head position with the lips in repose and the
      teeth lightly touching in a centric relationship. Direct measurements from the
      patient are always more accurate than those obtained from photographs or
      radiographs. The surgeon should keep in mind that the proper relationships
      between the various regions of the face are more important than specific angles
      or numbers.

PMID- 11212551
TI  - Volatile and non-volatile compounds in irradiated semi-rigid crystalline
      poly(ethylene terephthalate) polymers.
AB  - In this study two different semi-rigid crystalline and oriented polyethylene
      terephthalate materials were used and were irradiated at 25-kGy dose at room
      temperature by using a caesium137 radiator. Volatile and non-volatile compounds
      present in the irradiated materials were identified and quantified. The
      qualitative results obtained from HS/GC/TCD/FID analysis at room temperature
      showed volatiles could not be identified. The HS/GC/MSD analysis performed at 106
      degrees C showed that the irradiation generated 668-742 micrograms/kg formic
      acid, 868-922 micrograms/kg acetic acid, 17-32 micrograms/kg 1,3-dioxolane, and
      47-71 micrograms/kg 2-methyl-1, 3-dioxolane based on PET weight. The results
      obtained from the thermal desorption and GC/MSD performed at 200 degrees C showed
      that 10-12 mg/kg acetaldehyde, 479-975 micrograms/kg 1,3-dioxolane, and 6.6-11.2
      mg/kg methyl-1, 3-dioxolane were detected after irradiation. The concentrations
      of the two dioxolanes found from thermal desorption were much higher than those
      observed in the HS, although formic and acetic acids were not detected. It is
      possible that the formic and acetic acids produced by irradiation underwent
      further reactions with ethylene glycol during thermal desorption to form the
      dioxolanes. The soluble solid extracted from various PET specimens before and
      after irradiation were in a range of 0.67-0.78%. PET cyclic trimer is the major
      component and is present at 0.41-0.50%, accounting for more than 50% of the
      percent total solid in PET. Statistically, irradiation did not increase the
      soluble solid and cyclic trimer. The overall results suggest that 25-kGy
      irradiation had a significant effect on increasing the volatile but not the non
      volatile compounds detected in the PET specimens.

PMID- 11212553
TI  - Considerations for esthetic facial surgery in the African-American patient.
AB  - Due to the diverse ethnic nature of most communities, the perception of beauty is
      not homogeneous. Beauty is a perception of good balance, symmetry, harmony, and
      features that are pleasing to the eye. It is not possible to quantitate beauty.
      Many attempts have been made to standardize what is and is not beautiful by
      establishing the ethnic norms. Surgeons commonly attempt to achieve these ideal
      norms, but they may not necessarily be considered beautiful by the individual
      patient. Therefore, it is imperative for the surgeon to completely understand the
      patients' goals for surgery, which may not fit the ideal norms published in
      studies for that specific ethnic community. It also has become essential for
      patients to be made aware of the limitations of surgery, especially if their
      goals are unrealistic, to avert future distress and medicolegal problems. Thus,
      what is "normal" is not necessarily beautiful, and perhaps it would be better to
      strive for what is considered beautiful to the individual patient, rather than
      normal. Within the African-American population, the concept of what is beautiful
      can be extremely diverse. The number of African Americans who seek cosmetic or
      esthetic facial surgery is limited. As the number of esthetic procedures
      performed in the African-American population increases, however, the more
      educated this population will become regarding these procedures, and the more
      comfortable the surgeon will become regarding his or her own sense of "African
      American beauty" and specific esthetic facial considerations for this population.
      It should be mentioned that as the number of African-American surgeons increases,
      their influence within the African-American population regarding the availability
      of esthetic procedures will also be felt.

PMID- 11212554
TI  - Alloplastic augmentation of the face.
AB  - The previously presented facial augmentation techniques can be used in
      conjunction with orthognathic procedures or may be performed as separate
      procedures. When performed properly, they can enhance facial esthetics and
      improve patient satisfaction. Alloplastic augmentation, when properly planned and
      performed, is predictable, stable, and generally accepted by the patient.

PMID- 11212556
TI  - The influence of maxillary osteotomy design on esthetic outcome.

PMID- 11212555
TI  - Soft tissue changes associated with orthognathic surgery.

PMID- 11212557
TI  - Techniques to control nasal features.

PMID- 11212558
TI  - Techniques to preserve or modify lip form during orthognathic surgery.

PMID- 11212559
TI  - Adjunctive cervicofacial liposuction.
AB  - Submental liposuction is an adjunctive surgical procedure that allows for the
      relatively predictable soft tissue recontouring of the cervicofacial region
      (Figs. 13 to 17). It may be performed independently as an outpatient procedure
      under intravenous sedation or as an adjunctive procedure during orthognathic
      surgery. Surgical complications are rare and are usually preventable with
      appropriate patient selection and surgical technique. Submental liposuction is a
      useful tool for enhancing the esthetic benefits of orthognathic surgery.

PMID- 11212560
TI  - Adjunctive rhinoplasty.

PMID- 11212561
TI  - Our magnificent obsession.

PMID- 11212562
TI  - Reflections on the astonishing 20th century.

PMID- 11212564
TI  - Periodontal prosthesis: a 50-year perspective.

PMID- 11212563
TI  - Discoveries of importance in restorative dentistry over the past 40 years.
AB  - The advancements in restorative dentistry over the past several decades have been
      impressive. It is now possible to prevent dental caries on a predictable basis.
      If prevention is not carried out in early life and teeth are lost, it is now
      possible to restore mutilated or missing teeth with high efficiency and
      effectiveness. The future for restorative dentistry is extremely bright and has
      never been better in its history.

PMID- 11212565
TI  - Children's dental health: the past is the present and the gateway to the future.

PMID- 11212566
TI  - Oral and maxillofacial surgery: a century of progress.

PMID- 11212567
TI  - Endodontics: controversial past, exciting present, incredible future.

PMID- 11212568
TI  - Evolution of orthodontic bracket design.

PMID- 11212569
TI  - Retrospective look at notable advances in periodontics in the 20th century.

PMID- 11212570
TI  - Alveolar ridge augmentation using mandibular block grafts: clinical update.

PMID- 11212571
TI  - Cosmetic and functional aspects of orthognathic surgery: a primer for dentists.

PMID- 11212572
TI  - Bone grafting the jaws in the 21st century: the use of platelet-rich plasma and
      bone morphogenetic protein.
AB  - The use of PRP and rhBMP-2 in facial skeletal reconstruction is supported by
      theoretical and practical human and animal data that represent exciting prospects
      for the 21st century. Although the use of PRP in conjunction with autogenous
      grafting of the maxillofacial complex increases the already impressive
      predictability of this technique, it is possible that improvement of the clinical
      use of rhBMP-2 may one day obviate the need for a donor site harvest of bone.

PMID- 11212573
TI  - Surgical removal of wisdom teeth and associated pathology.

PMID- 11212574
TI  - Cosmetic soft-tissue enhancement for dental implants.

PMID- 11212575
TI  - Evaluation and treatment of temporomandibular disorders: considerations for the
      general dentist.
AB  - Temporomandibular disorders are only one of a host of different conditions that
      may result in orofacial pain. Hence, due to this multifactorial etiology, it is
      imperative to adopt a multidisciplinary approach when treating these patients.
      Listed in Table 3 are some of the conditions that must be considered when a
      dentist faces the dilemma of orofacial pain of unknown etiology in clinical
      practice.

PMID- 11212577
TI  - A small-conductance Ca(2+)-activated K+ current and Cl- current in rat dental
      pulp cells.
AB  - We characterized a voltage-dependent ionic current in dental pulp cells on dental
      pulp slices using a nystatin perforated-patch recording configuration. The
      outward currents in dental pulp cells were inhibited by the following channel
      blockers: 1) Ca(2+)-free extracellular solution containing 10 mM Ba2+, 2)
      extracellular 400 nM apamin and 3) extracellular 300 nM 4,4'
      diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS). On the other hand, 15 mM
      tetraethylammonium (TEA) did not inhibit the outward currents. The inhibitory
      effects of Ca(2+)-free extracellular solution, apamin and DIDS had voltage
      dependency. These results indicated that dental pulp cells expressed a small
      conductance Ca(2+)-activated K+ current (SK current) and a DIDS-sensitive Cl-
      current. The functional significance of these channels is discussed.

PMID- 11212576
TI  - Angiotensin II-induced depolarizations in hamster submandibular ganglion neurons.
AB  - Angiotensin II acts as an excitatory neurotransmitter of the sympathetic ganglia.
      In the parasympathetic neurons, however, angiotensin II (angio II)-induced
      responses have not been recorded. In this study, we investigated the effects of
      angio II in the hamster submandibular ganglion (SMG) neurons using a
      intracellular recording technique. Approximately 70% of these ganglion cells
      responded with persistent depolarization (3-6 mV, 5-9 min) at a concentration of
      10 microM. The angio II-induced depolarizations were caused by the combination of
      an increase in Na+ conductance and a decrease in K+ conductance. An involvement
      of K+ channels such as M channels and SK channels in the electrogenesis mechanism
      was suggested by an inhibitory effect of Ba2+ ion on the component of the
      increased membrane input resistance during the angio II-induced depolarization.
      In addition, the angio II-induced depolarizations were mediated through angio II
      type I (AT1) receptors. Thus angio II is probably a neurotransmitter that
      increases their excitability in most of the neurons in parasympathetic ganglia.

PMID- 11212578
TI  - Effect of Er:YAG laser irradiation on acid resistance to bovine dentin in vitro.
AB  - Resin bond strength to Er:YAG laser irradiated dentin has been reported to be
      lower than that of unlased dentin. The reasons have been much discussed, but not
      clarified. One hypothetical cause has been discussed that lased dentin is acid
      resistant, therefore, the etching effect of acid conditions decreases. The
      purpose of this study was to evaluate the acid resistance of laser-irradiated
      dentin and compare it with the dissolved mineral of Er:YAG laser irradiated
      dentin and unlased dentin. This experiment was a pilot study to assess the
      etching effect of pre-conditioner for resin bonding to lased dentin. Bovine
      dentin was irradiated by Er:YAG laser and immersed in 0.1 M lactic buffer
      solution (pH 4.0). The dissolved Ca and P in the solution were then both
      measured. Dissolved Ca from lased dentin was not significantly different from
      that coming from unlased dentin (p > 0.05). The molar ratio of Ca/P did not
      differ significantly between lased and unlased dentin, either (p > 0.05). Under
      FE-SEM view before immersion, the dentin surface was covered with a smear layer
      in unlased dentin, but this layer was not clearly observed in lased dentin. These
      results suggested that the lased dentin had little or no resistance to lactic
      buffer solution.

PMID- 11212579
TI  - Influence of finishing on the electrochemical properties of dental alloys.
AB  - Dental alloy surface finishing procedures of may influence their electrochemical
      behavior, which is used to evaluate their corrosion resistance. We examined the
      polarization resistance and potentiodynamic polarization profile of the precious
      metal alloys, Type 4 gold alloy and silver-palladium alloy, and the base-metal
      alloys, nickel-chromium alloy, cobalt-chromium alloy, and CP-titanium. Three
      types of finishing procedure were examined: mirror-finishing using 0.05 micron
      alumina particles, polishing using #600 abrasive paper and sandblasting.
      Dissolution of the alloy elements in 0.9% NaCl solution was also measured and
      compared with the electrochemical evaluation. The corrosion resistance of the
      dental alloys was found to relate to finishing as follows: The polarization
      resistance and potentiodynamic polarization behavior revealed that the corrosion
      resistance improved in the order of sandblasting, #600-abrasive-paper polishing,
      and mirror-finishing. While the corrosion potential, critical current density and
      passive current density varied depending on the type of finishing, the
      transpassive potential remained unchanged. The influence of finishing on the
      corrosion resistance of precious-metal alloys was less significant than on that
      of base-metal alloys. A mirror-finishing specimen was recommended for use in
      evaluation of the corrosion resistance of various dental alloys.

PMID- 11212580
TI  - Influence on myoelectric discharges of anteroposterior displacement of the
      mandibular position near the tapping point.
AB  - The purpose of this study was to examine the influence that the anteroposterior
      mandibular displacement near the tapping point exerts on the myoelectric activity
      of masseter and temporal muscles at a specific occluding force and to clarify the
      possibility of judging the mandibular position by measuring the amount of
      myoelectric discharge. Eight dentulous subjects were selected for the study.
      Surface electrodes were placed over the anterior, middle and posterior regions of
      the masseter muscle and over the anterior, middle and posterior bundles of the
      temporal muscle. Independently of the measurement region, the changes in the
      masseter and temporal muscle myoelectric activity which accompanied the
      anteroposterior mandibular displacement, were low. Moreover, when the mandible
      was displaced anteroposteriorly, the total amount of the myoelectrical discharge
      from all the recorded places, as well as the amounts of myoelectrical discharge
      over the middle part of the masseter muscle and the anterior bundle of the
      temporal muscle reached their lowest values in those mandibular positions which
      included the tapping point in less than half of the subjects. Therefore, this
      study indicates that the possibility of judging anteroposterior mandibular
      displacement by masseter and temporal muscle electromyography is quite low.

PMID- 11212581
TI  - Surgical simulation of Class III edentulous patient using a 3D craniofacial
      model: report of a case.
AB  - A case of edentulous prognathism in a 46-year-old Japanese male is presented. We
      described the outcome of the patient who underwent simultaneous sagittal
      splitting ramus osteotomy of the edentulous mandible, interpositional bone graft
      of severely atrophic edentulous jaws, and delayed placement of titanium implants
      for reconstruction. We highly recommend performing a surgical simulation using a
      craniofacial model of the patient's anatomy created using CT image data. The
      procedure provides almost ideal maxillary and mandibular contours.

PMID- 11212582
TI  - Significance of detection of Porphyromonas gingivalis, Bacteroides forsythus and
      Treponema denticola in periodontal pockets.
AB  - The relationship between the detection of Porphyromonas gingivalis, Bacteroides
      forsythus and Treponema denticola in subgingival plaque samples of periodontal
      pockets and periodontal status was evaluated using the polymerase chain reaction
      (PCR). A total of 165 sites in 60 periodontitis patients were examined, and the
      relationships between the detection of each of the three bacterial species and
      the pocket depth and bleeding on probing (BOP) were analyzed. The detection
      ratios of P. gingivalis, B. forsythus, and T. denticola in samples from adult
      periodontitis lesions were 75.5%, 69.8%, and 72.6%, respectively. It was found
      that all sites where all three microorganisms were detected were BOP positive and
      had greater pocket depths than those where only one or two species were found.
      The detection rate of B. forsythus and T. denticola decreased with age in the
      sites in which PD was less than 4 mm. The present study indicates that detection
      of a mixed infection by P. gingivalis, B. forsythus, and T. denticola strongly
      correlated with adult periodontitis.

PMID- 11212583
TI  - Histological study of masseter muscle in a mouse muscular dystrophy model (mdx
      mouse).
AB  - Histological changes in the masseter muscle were observed over time in mdx mice,
      a muscular dystrophy model. It was found that marked necrosis occurs about the
      time of weaning at around 4 weeks of age; then the tissue actively regenerates at
      8 weeks and stabilizes as regenerated muscle with centronuclei at 15 weeks old.
      This study examined the centronucleus in regenerated muscle. The process from
      necrosis to regeneration in muscle fibers occurs a little later in the masseter
      muscle than in other limbic muscles. Regenerated muscles observed around 15 weeks
      after birth showed a moth-eaten appearance. Transmission Electron Microscope
      (TEM) observation of transverse sections of muscle fibers revealed that
      myofibrils surrounded lost regions in the area showing a moth-eaten appearance.
      Thus, some defensive mechanism may affect the ability of muscle fibers to
      maintain a function close to normal in mdx mice even though the muscle fibers
      develop muscular dystrophy. The function of the masseter muscle drastically
      changes from sucking to mastication behavior at around 4 weeks, and this was
      considered to influence the morphological changes in the muscle tissue. The moth
      eaten appearance seen at 15 weeks may represent an appropriate myofibril
      reconstruction preventing invasion of the lost regions.

PMID- 11212585
TI  - Survey of dental treatments for pediatric patients referred to the pediatric
      dental clinic of a dental school hospital.
AB  - This survey was conducted to clarify which dental treatments in children are
      regarded as difficult by general dentistry practitioners. The subjects were 615
      children who first visited Tokyo Dental College Chiba Hospital from January 1995
      to August 1999 with reference letters. There were 615 children in the study; 571
      (92.8%) came from Chiba City where our hospital is located and the 11 regions
      surrounding Chiba City. The prime reasons for referral in the order of frequency
      were treatments of dental caries, malalignment/malocclusion, traumatized teeth,
      supernumerary teeth, retarded eruption/impacted teeth, abnormal direction of
      erupted teeth, congenitally missing teeth, prolonged retention of deciduous
      teeth, and abnormal frenulum. Patients with dental caries or traumatized teeth in
      the deciduous dentition period and those with malalignment/malocclusion,
      supernumerary teeth, or retarded eruption/impacted teeth in the mixed dentition
      period were often referred to medical organizations specializing in pediatric
      dentistry because of the difficulties in controlling the patients' behavior and
      in providing adequate treatment. The information about pediatric dental
      treatments considered difficult by general dentists revealed by this survey
      appears to be useful and needs to be incorporated in the programs for clinical
      training of undergraduate students and education of postgraduate students.

PMID- 11212584
TI  - Adsorption of oral bacteria to porous type calcium carbonate.
AB  - The purpose of this study was to investigate the adsorption of [3H]-thymidine
      labeled oral microorganisms to porous type calcium carbonate (PCC) beads in a
      buffer containing human parotid saliva and to PCC combined chewing gum sheets.
      Adsorption rates of Streptococcus sobrinus B13 and 6715, Streptococcus mutans
      MT8148R and Actinomyces naeslundii T14V with PCC were significantly higher than
      those with calcium carbonate (CC) beads (p < 0.01). Adsorption rates of S.
      sobrinus, S. mutans and A. naeslundii with PCC combined chewing gum were
      significantly higher than those with CC combined chewing gum (p < 0.01). The
      present results suggested that the chewing gum containing PCC may be able to
      exclude oral bacteria, including cariogenic and periodontopathic bacteria, for
      prevention of dental caries and periodontal disease.

PMID- 11212586
TI  - Differences in TNF-alpha producing activity from murine peritoneal macrophages
      induced by lipopolysaccharides of Prevotella heparinolytica and Porphyromonas
      gingivalis.
AB  - We compared the effects of LPSs from P. gingivalis and P. heparinolytica on the
      induction of tumor necrosis factor-alpha (TNF-alpha) production by murine
      peritoneal macrophages. The lipopolysaccharide (LPS) preparation from P.
      gingivalis showed a typical ladder pattern in SDS-PAGE, whereas that from P.
      heparinolytica formed several stained bands without a ladder pattern. When the
      macrophages from C3H/HeJ mice were incubated with P. gingivalis LPS, the level of
      TNF-alpha released in the culture supernatants was significantly higher than that
      with P. heparinolytica. All tested reagents except genistein strongly inhibited
      the production of TNF-alpha by the macrophages after induction by either LPS.
      These results suggested the following possibilities, i) the induction level of
      TNF-alpha by P. heparinolytica is similar to that of Salmonella minnesota, ii)
      tyrosine phosphorylation is not the only pathway for the TNF-alpha production
      induced by these LPSs, iii) different regulatory mechanisms are involved in TNF
      alpha production in P. gingivalis LPS stimulated and P. heparinolytica LPS
      stimulated cells.

PMID- 11212587
TI  - Contrast-enhanced conventional CT in patients after surgery for malignant tumors:
      evaluation of the optimal method of the administration of the contrast medium.
AB  - Patients after ablative surgery for malignant tumors require computed tomography
      (CT) examination of a wide area on the head and neck to follow-up for recurrence
      and lymph metastasis. The aim of this study was to determine a more effective
      method for the infusion of the contrast medium into post-operative patients
      undergoing conventional CT, based on the relationship between the method of
      administering the contrast medium and the contrast-enhancing effect in the
      internal jugular vein. First eleven images were selected from the existing
      contrast-enhanced and plain CT images in a manner such that the CT values of the
      internal jugular vein were distributed evenly in a range of 50-180. Seven
      experienced observers evaluated the contrast-enhancing effect of each image set
      at a window value of 40 and window widths of 120, 200, and 280. Secondly, the CT
      values of the right internal jugular vein were measured in a total of 10 CT
      images from the thyroid to maxillary sinus level from each of 60 post-operative
      patients. The injection needles and contrast-enhancing techniques used in the 60
      patients were drip infusion using an 18G injection needle in 20, drip infusion
      using a 21G injection needle with bolus intravenous injection immediately before
      scanning in 20, and drip infusion using a 23G injection needle with bolus
      intravenous injection immediately before scanning in 20. A CT value of 100 or
      above, preferably 120 or above, in the internal jugular vein was needed for the
      contrast-enhancing effect of a CT image to be judged as clinically significant.
      Our results found that, when a conventional CT was used in patients after surgery
      for malignant tumors, drip infusion using a 21G or 23G injection needle should be
      combined with bolus injections immediately before the beginning of scanning, and
      at the glottis or submandibular gland level during the scanning. A sufficient
      contrast-enhancing effect can also be obtained by drip infusion using an 18G
      injection needle without bolus injection.

PMID- 11212588
TI  - Antidepressant use during pregnancy.

PMID- 11212589
TI  - Antidepressants as analgesics: an introduction.

PMID- 11212590
TI  - Antidepressants as analgesics: an overview of central and peripheral mechanisms
      of action.
AB  - Antidepressants, given systemically, are widely used for the treatment of various
      chronic and neuropathic pain conditions in humans. In animal studies,
      antidepressants exhibit analgesic properties in nociceptive, inflammatory and
      neuropathic test systems, with outcomes depending on the specific agent, the
      particular test, the route of administration and the treatment method used.
      Although early studies focused on central (i.e., supraspinal, spinal) actions,
      more recent studies have demonstrated a local peripheral analgesic effect of
      antidepressants. These peripheral actions raise the possibility that topical
      formulations of antidepressants may be a useful alternative drug delivery system
      for analgesia. Antidepressants exhibit a number of pharmacological actions: they
      block reuptake of noradrenaline and 5-hydroxytryptamine, have direct and indirect
      actions on opioid receptors, inhibit histamine, cholinergic, 5-hydroxytryptamine
      and N-methyl-D-aspartate receptors, inhibit ion channel activity, and block
      adenosine uptake. The involvement of these mechanisms in both central and
      peripheral analgesia produced by antidepressants is considered. Data illustrating
      the preclinical peripheral analgesic actions of antidepressants are presented, as
      are some aspects of the mechanisms by which these actions occur.

PMID- 11212592
TI  - Putative mechanisms of action of antidepressant drugs in affective and anxiety
      disorders and pain.
AB  - An enhancement of neurotransmission of serotonin (5-HT), noradrenaline, or both,
      underlies the antidepressant response associated with most agents presently
      available to treat major depression. With respect to the 5-HT system,
      antidepressant drugs exert immediate effects on some neuronal elements
      controlling overall transmission, but it is the gradual changes in neuronal
      responses to such treatments that are ultimately responsible for producing their
      therapeutic benefits. In major depression, an increase in 5-HT1A transmission is
      thought to be a crucial determinant of the antidepressant response, whereas an
      enhancement of 5-HT2 transmission in the orbitofrontal cortex may mediate the
      therapeutic effect of 5-HT reuptake inhibitors in obsessive-compulsive disorder
      (OCD). The doses of medication and the durations of treatment necessary to obtain
      these alterations in 5-HT transmission in various brain structures of laboratory
      animals are fully consistent with the conditions in the clinic necessary to
      attenuate symptoms in depression and OCD. It is also possible that the relief of
      chronic pain produced by some antidepressants may be mediated, in part, by the
      blockade of peripheral 5-HT2A receptors. These observations emphasize the notion
      that the 5-HT system is endowed with different adaptive properties in various
      parts of the body, which, in addition to the multiplicity of 5-HT receptors,
      makes this chemospecific network important in many disorders.

PMID- 11212591
TI  - Antidepressants as analgesics: a review of randomized controlled trials.
AB  - This review provides an overview of 59 randomized placebo-controlled trials that
      examined the analgesic effect of antidepressants. To summarize, there is
      significant evidence that the tricyclic group of antidepressants is analgesic and
      that trazodone is not; the data regarding selective serotonin reuptake inhibitors
      are conflicting. To date, there are no randomized controlled trials examining the
      potential analgesic action of nefazodone or venlafaxine, but on the basis of
      initial clinical reports and its structural similarity to other analgesics,
      venlafaxine shows promise as an analgesic.

PMID- 11212593
TI  - Abrupt discontinuation of psychotropic drugs during pregnancy: fear of
      teratogenic risk and impact of counselling.
AB  - OBJECTIVE: To assess the consequences to mother and baby of abruptly
      discontinuing antidepressant or benzodiazepine medication during pregnancy and to
      assess the impact of our counselling. PARTICIPANTS: All women who consulted the
      Motherisk Program between November 1996 and December 1997 and who stopped taking
      antidepressant or benzodiazepine medication when pregnancy was confirmed agreed
      to participate in the study. DESIGN AND INTERVENTIONS: Subjects were interviewed,
      received counselling, and completed a questionnaire 1 month after their initial
      call and after the birth of their baby. RESULTS: Of 36 women who completed the
      study, 34 discontinued their medication abruptly for fear of harming the fetus,
      28 on the advice of their physician; 26 (70.3%) women reported physical and
      psychological adverse effects, 11 reported psychological effects only, and 11
      reported suicidal ideation (4 were admitted to hospital). After counselling, 22
      of 36 (61.1%) women resumed taking their medication, and 4 found that they no
      longer required it. One woman had a therapeutic abortion and 2 experienced
      spontaneous abortions; there were therefore 35 healthy babies (including 2 sets
      of twins) born to 33 women; 14 of 21 mothers breast-fed their babies while taking
      their psychotropic medication, with no adverse effects reported. CONCLUSIONS:
      When assessing the risks and benefits of taking psychotropic medication during
      pregnancy, women and their physicians should be aware that the abrupt
      discontinuation of psychotropic drugs can lead to serious adverse effects.
      Counselling is effective in reassuring women to adhere to therapy.

PMID- 11212594
TI  - Does sex influence the relation between symptoms and neurocognitive functions in
      schizophrenia?
AB  - OBJECTIVE: A secondary analysis of our data to investigate if sex influences the
      specificity of the relationship between each of the 3 clinical syndromes (i.e.,
      reality distortion, disorganization and psychomotor poverty) in schizophrenia and
      the neurocognitive functions that are thought to represent regional brain
      functions. PATIENTS AND DESIGN: Fifty-seven male and 30 female patients with a
      DSM-III-R diagnosis of schizophrenia were rated on the Scale for Assessment of
      Negative Symptoms and the Scale for Assessment of Positive Symptoms to derive
      scores for psychomotor poverty, disorganization, and reality distortion
      syndromes. All subjects completed a battery of neuropsychological tests purported
      to assess functioning of left temporal, right temporal, left basal frontal, right
      basal frontal, and dorsolateral prefrontal cortex. RESULTS: Correlation
      coefficients between syndrome scores and neuropsychological measures showed only
      word fluency (left frontal functioning) to have a statistically significant
      association with psychomotor poverty in women (p < 0.01). This relation was
      specific to psychomotor poverty syndrome. No relations between neurocognitive
      measures and symptoms were seen in men. CONCLUSIONS: The lack of specific
      relations between symptom dimensions in schizophrenia may be influenced by the
      fact that the neuronal circuitry associated with particular symptom dimensions
      may differ in men and women.

PMID- 11212595
TI  - Quetiapine and obsessive-compulsive symptoms (OCS): case report and review of
      atypical antipsychotic-induced OCS.
AB  - The atypical antipsychotics have advanced the treatment of schizophrenia and have
      proved to be effective agents in treating other disorders with or without
      psychotic features. We review the literature concerning an increasingly reported
      and interesting adverse effect, atypical antipsychotic-induced obsessive
      compulsive symptoms (OCS). The first known report of quetiapine exacerbating OCS
      in a 43-year-old man with obsessive-compulsive disorder (OCD), trichotillomania,
      delusional disorder and bipolar II disorder is presented. Mechanisms, including 5
      HT2A and 5-HT2C antagonism, serotonergic regulation of dopamine systems and
      putative dopaminergic subtypes of OCS and OCD, are discussed. Given the
      paradoxical efficacy of the atypical antipsychotics in pure OCD, the neurobiology
      and comorbidity of OCD and schizophrenia, as well as the increasing use of
      atypical antipsychotics, a cautious and rational pharmacotherapeutic treatment
      approach is recommended.

PMID- 11212596
TI  - Hallucinations and the cerebral hemispheres.

PMID- 11212597
TI  - What is the best approach to treating interferon-induced depression in people
      with multiple sclerosis?

PMID- 11212598
TI  - Distribution and characterization of proliferative cells in the rat mandibular
      condyle during growth.
AB  - Distribution of proliferative cells and localization of types I and II collagen
      were examined in the rat mandibular condylar cartilage of 36 long-Evans/Turku
      strain rats during normal postnatal growth using an immunohistochemical method
      combined with histomorphometry. There were considerable differences in the
      thickness of the proliferative cell layer in the condylar head, with most mitoses
      occurring in the postero-superior area. It was found that the extracellular
      matrix of the proliferative cells does not stain for type II collagen in 20-day
      old and older rats, and that besides the subchondral bone, the strongest
      intensity for type I collagen stain was always localized in the articular surface
      of the condylar head. Statistically significant overlapping of the proliferative
      cell layer and the one secreting type II collagen occurred during the earlier
      stages of development, particularly in the postero-superior area of the condylar
      head. As type II collagen is considered to be a marker for identification of
      typical cartilage cells, the findings indicate that, in addition to
      undifferentiated cells, a portion of the proliferative cells can be characterized
      as chondroblasts during the early postnatal period in rats, but not in the later
      stages of development. The developmental phase of the condylar cartilage should
      therefore be taken into consideration when the effect of various biomechanical
      and humoral/hormonal factors on growth of the condylar cartilage is examined.

PMID- 11212599
TI  - Proliferative response of cells of the dentogingival junction to mechanical
      stimulation.
AB  - The aim of this research was to study the proliferative response of junctional
      epithelium (JE) and gingival connective tissue (GCT) to mechanical stimulation in
      vivo with regard to the potential occurrence of apical migration of JE and loss
      of GCT attachment during orthodontic tooth movement. Elastic bands were inserted
      between the maxillary first and second molars of male rats aged 8 weeks, which
      were pulse-labelled with 3H-thymidine and subsequently killed in groups, together
      with labelled control animals (a total of 98 rats) after periods of 1-168 hours.
      Autoradiographs were prepared from plastic mesiodistal sections, and parameters
      of cell proliferation for JE and GCT of the papilla between the second and third
      molars were determined. Although the distance between the apical limit of JE and
      the most coronal periodontal ligament (PDL) fibres decreased on the pressure and
      increased on the tension sides of mechanically stimulated animals, the total
      cross-sectional area of JE remained unchanged compared with controls. In the
      basal and suprabasal layers of JE, cell proliferation was reduced on the pressure
      side and showed no change on the tension side. In the apical JE compartments on
      both sides, mechanical stressing resulted in lower proliferative activity. Cell
      proliferation in GCT adjacent to JE in stimulated animals did not differ from the
      corresponding controls. JE rapidly adapted to mechanical stimulation by means of
      differential local adjustments of cell proliferation without an occurrence of
      apical migration or hyperplasia. GCT cells in the vicinity of JE maintained their
      steady-state proliferative activity. These results do not support the concept
      that orthodontic tooth movement might per se have detrimental effects on the
      stability of the dentogingival junction.

PMID- 11212600
TI  - Computer tomographic and radiographic changes in the temporomandibular joints of
      two young adults with occlusal asymmetry, treated with the Herbst appliance.
AB  - Two young patients, one female and one male, with asymmetric occlusal deviation
      and extreme Angle Class II division 1 malocclusions were treated with the Herbst
      appliance after cessation of endochondral growth (union of the radius epiphysis).
      During treatment, computer tomographic (CT) scanning and orthopantomograms of the
      temporomandibular joints (TMJs) revealed, as a result of bone modelling,
      asymmetrical new bone formation as a double contour on the distocranial part of
      the condyles. The treatment results were followed for more than 2 years and the
      new bone was found to be stable.

PMID- 11212601
TI  - Root resorption after orthodontic treatment in high- and low-risk patients:
      analysis of allergy as a possible predisposing factor.
AB  - The development of excessive root resorption during orthodontic tooth movement is
      an adverse side-effect, which is of great concern. The aim of this investigation
      was to analyse factors that might be associated with orthodontically induced root
      resorption. After buccal movement of maxillary premolars in 96 adolescents, the
      experimental teeth were extracted and subjected to histological analysis and
      measurement of resorbed root area. Fifty individuals, 18 boys and 32 girls, mean
      age 13.4 years, were selected and divided into two equal groups: the high-risk
      group based on measurements of the most severe root resorptions, and the low-risk
      group on measurements of mild or no root resorptions. After a preliminary
      screening of possible risk factors regarding root resorption, i.e. root
      morphology, gingivitis, allergy, nail-biting, medication, etc., only those
      subjects with allergy showed an increased risk of root resorption, but this was
      not statistically significant.

PMID- 11212602
TI  - A radiographic comparison of apical root resorption after orthodontic treatment
      with a standard edgewise and a straight-wire edgewise technique.
AB  - The purpose of this study was to compare the severity of apical root resorption
      occurring in patients treated with a standard edgewise and a straight-wire
      edgewise technique, and to assess the influence of known risk factors on root
      resorption incident to orthodontic treatment. The sample consisted of 80 patients
      with Angle Class II division 1 malocclusions, treated with extraction of at least
      two maxillary first premolars. Variables recorded for each patient included
      gender, age, ANB angle, overjet, overbite, trauma, habits, invagination,
      agenesis, tooth shedding, treatment duration, use of Class II elastics, body
      build, general factors, impacted canines, and root form deviation. Forty patients
      were treated with a standard edgewise and 40 with a straight-wire edgewise
      technique, both with 0.018-inch slot brackets. Crown and root lengths of the
      maxillary incisors were measured on pre- and post-treatment periapical
      radiographs corrected for image distortion. Percentage of root shortening and
      root length loss in millimetres were then calculated. There was significantly
      more apical root resorption (P < 0.05) of both central incisors in the standard
      than in the straight-wire edgewise group. No significant difference was found for
      the lateral incisors. Root shortening of the lateral incisors was significantly
      associated with age, agenesis, duration of contraction period (distalization of
      incisors), and invagination, while root shortening of the central incisors was
      related to treatment group and trauma.

PMID- 11212603
TI  - Dental follicle cell-conditioned medium enhances the formation of osteoclast-like
      multinucleated cells.
AB  - An influx of mononuclear cells and the subsequent increase of osteoclasts around
      tooth germs suggests that the dental follicle (DF) regulates or influences bone
      resorption required for tooth eruption. In order to study the effects of DF cell
      products on osteoclast formation during tooth eruption, a conditioned medium (CM)
      was created in which DF cells were added to mouse bone marrow cultures. Tartrate
      resistant acid phosphatase (TRAP)-positive osteoclast-like multinucleated cells
      were formed in the presence of 10 nM 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. The
      CM, dose-dependently, stimulated the formation of TRAP-positive cells in the
      presence of 1,25(OH)2D3 for 14 days culture. The number of these cells decreased
      due to degradation in the control culture. A semi-solid methylcellulose assay in
      the presence of CM showed little expression of colony-stimulating activity. These
      results suggest that the DF cells of a developing tooth produce factor(s) that
      enhance osteoclast formation and bone resorption necessary for tooth eruption.

PMID- 11212604
TI  - A comparative analysis of distal maxillary molar movement produced by a new
      lingual intra-arch Ni-Ti coil appliance and a magnetic appliance.
AB  - The aim of the study was to evaluate cephalometrically the dental and skeletal
      treatment effects of a new lingual intra-arch Ni-Ti coil appliance for molar
      distalization and to compare these with those of an established intra-arch
      appliance that uses repelling magnets for distal molar movement. Two groups of 21
      adolescents, all girls, participated in this retrospective study. One group was
      treated with the new lingual Ni-Ti coil appliance for 6.5 months and the other
      with the magnetic appliance for 5.8 months. The treatment effects were analysed
      by measurements on lateral head radiographs at the start of treatment and after
      the molar distalization was completed. The mean amount of distal molar movement
      was 2.5 mm (SD 0.69) in the lingual coil group and 2.6 mm (SD 0.51) in the magnet
      group. A significantly higher degree of distal molar tipping was found in the
      magnet group, -8.8 degrees, compared with -2.2 degrees for the lingual coil
      group. Due to anchorage loss, the maxillary incisors moved forwards, and the
      overjet was increased by an average of 1.2 mm in the lingual coil group and 1.7
      mm in the magnet group. The results indicate that the new lingual Ni-Ti coil
      appliance was better choice than the magnet appliance for distal bodily movement
      of maxillary molars. The benefits of the new Ni-Ti appliance were due to the
      design preventing molar tipping and its single activation.

PMID- 11212606
TI  - Open bite: stability after bimaxillary surgery--2-year treatment outcomes in 58
      patients.
AB  - Stability after bimaxillary surgery to correct open bite malocclusion and
      mandibular retrognathism was evaluated on lateral cephalograms before surgery, 8
      weeks post-operatively, and after 2 years. The 58 consecutive patients were
      treated to a normal occlusion and good facial aesthetics. Treatment included the
      orthodontic alignment of teeth by maxillary and mandibular fixed appliances, Le
      Fort I osteotomy, and bilateral sagittal split ramus osteotomy. Twenty-six
      patients also had a genioplasty. Intra-osseous wires or bicortical screws were
      used for fixation. Twenty-three patients had maxillo-mandibular fixation (MMF)
      for 8 weeks or more, six for 4-7 weeks, 14 for 1-3 weeks, and 15 had no fixation.
      At follow-up 2 years later, the maxilla remained unchanged and the mandible had
      rotated on average 1.4 degrees posteriorly. Seventeen patients had an open bite.
      Among them, eight patients had undergone segmental osteotomies. The relapse was
      mainly due to incisor proclination. The most stabile overbite was found in the
      group with no MMF after surgery.

PMID- 11212605
TI  - The congenitally missing upper lateral incisor. A retrospective study of
      orthodontic space closure versus restorative treatment.
AB  - Orthodontic treatment for patients with uni- or bilateral congenitally missing
      lateral incisors is a challenge to effective treatment planning. The two major
      alternatives, orthodontic space closure or space opening for prosthetic
      replacements, can both compromise aesthetics, periodontal health, and function.
      The aim of this retrospective study was to examine treated patients who had
      congenitally missing lateral incisors and to compare their opinion of the
      aesthetic result with the dentists' opinions of occlusal function and periodontal
      health. In this sample, 50 patients were identified. Thirty had been treated with
      orthodontic space closure, and 20 by space opening and a prosthesis (porcelain
      bonded to gold and resin bonded bridges). The patient's opinion of the aesthetic
      result was evaluated using the Eastman Esthetic Index questionnaire and during a
      structured interview. The functional status, dental contact patterns, periodontal
      condition, and quality of the prosthetic replacement was evaluated. In general,
      subjects treated with orthodontic space closure were more satisfied with the
      appearance of their teeth than those who had a prosthesis. No significant
      differences in the prevalence of signs and symptoms of temporomandibular
      dysfunction (TMD) were found. However, patients with prosthetic replacements had
      impaired periodontal health with accumulation of plaque and gingivitis. The
      conclusion of this study is that orthodontic space closure produces results that
      are well accepted by patients, does not impair temporomandibular joint (TMJ)
      function, and encourages periodontal health in comparison with prosthetic
      replacements.

PMID- 11212607
TI  - Tensile bond strength of a light-cured glass ionomer cement when used for bracket
      bonding under different conditions: an in vitro study.
AB  - The purpose of this study was to investigate the tensile bond strength of a new
      light-cured resin reinforced glass ionomer cement (Fuji Ortho LC), following the
      bonding of stainless steel brackets to 40 extracted human premolar teeth under
      four different enamel surface conditions: (1) non-etched, moistened with water;
      (2) etched, moistened with water; (3) etched, moistened with human saliva; and
      (4) etched, moistened with human plasma. The etched surface produced a higher
      bond strength than the non-etched surface when contaminated with distilled water.
      Contamination with human saliva resulted in a further increase in bond strength
      whilst plasma contamination produced an even higher strength. However, one-way
      analysis of variance showed no statistically significant difference between the
      various groups. After debonding, enamel and bracket base surfaces were examined
      for residual adhesive. The location of the adhesive also indicated improved
      bonding to etched enamel. This investigation shows that regardless of enamel
      surface pretreatment or environment, Fuji Ortho LC provides an adequate strength
      for bonding of orthodontic brackets.

PMID- 11212608
TI  - Public relations: it starts with you.

PMID- 11212609
TI  - The roots of EMS (getting back to your roots).

PMID- 11212610
TI  - Leveling the playing field for EMS services.
AB  - Pinellas County's emergency medical services system is a public utility model EMS
      system where as the purchaser of services, the EMS Authority can achieve the
      highest-quality, most cost-effective and most reliable EMS services. Pinellas
      County's use of an absolute level-playing-field, non-political bidding process
      that isolated quality and pricing issues has raised the bar for government
      purchasing. The entire EMS industry has seen how contract services can be
      evaluated fairly, in a non-political atmosphere, for the betterment of the
      citizens of the community. Our EMS Authority voted to award the contract to the
      best overall proposal based on fact and merit. The new agreement allows us to
      provide significantly improved paramedic ambulance services to our citizens at a
      substantial cost reduction to the county.

PMID- 11212611
TI  - How to conduct a DUI reenactment.

PMID- 11212614
TI  - [Morphological and karyotypic analysis of five blackfly species of the genus
      Cnetha (Diptera: Simulidae): description of the novel species from the
      Dzhrvezhskii canyon in Armenia].
AB  - Morphological and karyotypical features of a new blackfly species Cnetha akopi
      sp. n. from Armenia are described. Comparative analysis of the new species and
      four closely related endemic species from Caucasus is performed. Photographic
      maps of polythene chromosomes are provided.

PMID- 11212613
TI  - [Seasonal dynamics of population of the feather mite Monojoubertia microphylla
      (Astigmata: Analgoidea: Proctophyllodidae) in the chaffinch Fringilla coelebs].
AB  - The seasonal dynamics of the Monojoubertia microphylla micropopulations in
      different sex and age groups of the chaffinch Fringilla coelebs (Passeriformes:
      Fringillidae) have been studied during the nest and migration periods in the
      North-West of Russia. Three bird groups were determined within the chaffinch
      population during the study: adult males, adult females, immature chaffinches.
      Total number of bird specimens examined--353. In all chaffinch groups, the mean
      mite numbers and age structure of mite micropopulations were similar during the
      spring migration. The number of mites gradually increased from April to May.
      During the nest and autumn migration periods the seasonal dynamics of M.
      microphylla micropopulations were quite different on adult males and females of
      the chaffinch, because of different roles of male and female in the process of
      infestation the young bird generation. On the adult chaffinch males, the mite
      number continued to increase during the breeding period (June) and began to
      decrease significantly in July because of the postbreeding plumage moult. The
      mite number slowly decreased in the end of summer and the autumn migration. On
      the adult chaffinch females, the mite number decreased abruptly during the nest
      period. During this period, the chaffinch female sits together with nestlings for
      a long time, and the great number of its mites (about 60% of mite
      micropopulation) moves from the female onto the nestlings. The mite
      micropopulation migrated onto nestling is represented mainly by males, females
      (about 25% each) and tritonymphs (38%). Total mite number on the chaffinch
      females continued to decrease in July under the influence of postbreeding moult
      and slightly increased up to the autumn migration only. On the young chaffinches,
      the number of M. microphylla quickly increased during the second part of summer.
      It is the result of the great quota of mite instars being ready for the
      reproduction (imago, tritonymphs) within the micropopulation migrated from the
      chaffinch female onto the nestlings. The decrease of the M. microphylla
      micropopulation on the young birds was observed in the autumn only. In the end
      autumn migration (October), the mean numbers of mites on all chaffinch groups
      became approximately similar, but did not reach the mean rate observed in the
      beginning of the spring migration. During both migration periods, the imago and
      all preimaginal instars of M. microphylla were active, the diapause was not
      observed. In the beginning of spring migration and the end of autumn migration
      the main part of the mite micropopulations was represented by females, while in
      all other periods of chaffinch's stay in the North-West of Russia the immature
      instars predominated.

PMID- 11212615
TI  - [A catalog of mosquito species (Culicidae family) from the Asian region of
      Russia].
AB  - A new checklist of mosquitoes (Culicidae) recorded in the Asian part of Russia
      includes 79 species. The checklist is provided with taxonomic comments and
      compared with ones compiled by previous authors. In a comparison to the checklist
      of Kukharchuk (1980) including 73 species, 10 species are added into the present
      checklist and 6 species mentioned by this author are excluded, as far they were
      not actually found in Asian part of Russia. The names of 9 species are chanced
      according to the International Code of Zoological Nomenclature (1966). In the
      checklist of Stojanovich and Scott (1995) including 64 species, 5 species were
      included erraneously and 21 species were missed. The classification and valid
      species names are listed according to the Catalog of the Mosquitoes of the World
      (Knight, Stone, 1977) and its supplements (Knight, 1978; Ward, 1984, 1992;
      Gaffigan, Ward, 1985), except 5 species. These species (Aedes implicatus, Ae.
      esoensis, Ae. rossicus, Ae. albescens, Ae. subdiversus) are considered in the
      comments to the checklist.

PMID- 11212616
TI  - [Genetic heterogeneity in natural populations of Microphallus piriformes and M.
      pygmaeus parthenites (Trematoda: Microphallidae)].
AB  - The random amplified polymorphic DNA (RAPD) technique was applied for the studies
      of genetic heterogeny between several natural populations of trematodes belonging
      to the Microphallida family. Initially, the metacercariae from the daughter
      sporocysts infestating Littorina saxatilis and Littorina littorea periwinkles
      were used. Comparison of the banding patterns obtained for the different
      metacercariae within one sporocyst gave an unpredicted results. For two of three
      studied species (M. pygmaeus and M. pseudopygmaeus), the considerable differences
      in RAPD patterning was detected. According to the classical point of view, the
      process of cercariae (metacercariae in case of the "pygmaeus" group of
      microphallides) formation does not include DNA recombination. Because of that,
      all metacercariae within one single sporocyst should be genetically identical.
      However, data obtained clearly shows that at least in some cases it is not so. We
      can hardly believe that such result could be a methodological artifact, for not
      single difference in a RAPD patterns was recorded between the metacercariae
      within sporocysts of M. piriformes. Moreover, even the 100 fold dilution of the
      total DNA used for PCR amplification does not change the banding patterns. Hence,
      our results can not be explained by slight fluctuations in the DNA concentrations
      between the samples. The most evident conclusion is that we came across yet
      strange, but real phenomenon--some degree of genetic difference within the
      progeny of each of the sporocysts--metacercariae. However, the detailed study is
      needed to understand and interpret these observations correctly. Amplification of
      the total DNA extracted from the whole sporocysts (containing metacercariae)
      never showed any differences in RAPD patterns between the parasites been derived
      from one infestated snail (local parasite hemipopulation). That allowed us to
      compare different parasite populations referring the RAPD pattern of one
      sporocyst from a snail to as a representative of one local hemipopulation.
      Analysis of the RAPD-loci frequencies showed a considerable genetic differences
      between the subpopulations of M. piriformes, infestating different paraxenic
      intermediate hosts--L. saxatilis and L. obtusata. This phenomenon was
      statistically significant for 2 localities of 3 studied. No heterogeny within
      populations was recorded for M. pygmaeus. Both M. piriformes and M. pygmaeus are
      characterized by the genetic differentiation in the microgeographic scale (within
      the Chupa bay of the White sea, the longest distance between the analyzed
      localities is 20 km). According to the frequencies of the RAPD-loci, parasites
      from the sheltered locality differ significantly from the parasites of other two
      localities exposed to the open sea. For both species the degree of genetic
      similarity between the populations correlates positively with the distance
      between the localities. We can suppose that the population structure of
      microphallids depended mainly upon the population structures of their
      intermediate hosts, definitive hosts and geographical structure of the areal.
      However, taking into consideration the low motility of snails, we believe that
      the distribution, migration and species composition of the definitive hosts play
      the key role in the genetic structuring of M. pygmaeus and M. piriformes
      hemipopulations. As an addition, the RAPD analysis of the parasite populations
      from the Barents Sea (East cost of Murman peninsula) and North Sea (Western cost
      of Sweden) revealed no significant genetic differences between the worms from
      those places and from the White Sea. However in case of this macrogeographic
      comparison, insufficient number of samples does not allow us to draw any final
      conclusions.

PMID- 11212618
TI  - [Structure of the epithelium of the parasitic turbellaria Notenera ivanovi
      (Turbellaria: Fecampiida)].
AB  - The ultrastructure of the epithelium in Notentera ivanovi (Turbellaria,
      Fecampiida) has been studied. Notentera ivanovi lacks the digestive system but
      has a pad of the epidermal cells on the dorsal side of the body, which seems to
      be similar to the digestive epidermis on LM. Both the ventral and dorsal
      epithelium are cellular, ciliated and not insunk (fig. 1, a). The ultrastructure
      of the ventral and dorsal epithelium is similar in essential features. The cells
      bear abundant microvilli, cilia and are very rich in mitochondria, but the
      cytoplasm does not contain lysosomes and shows no other indications of phago- or
      pinocytosis. The basal membrane of epithelial cells forms deep invaginations
      (fig. 1, [symbol: see text]), partly with dilations (fig. 1, a; 2, a) containing
      the lamellated material (3, [symbol: see text]). In the basal part of the cells
      the numerous Golgi apparatus and rare cysternae of the smooth endoplasmic
      reticulum were observed (fig. 2, a, [symbol: see text]). The epithelium consists
      of several types of cells, which differ in the structure of secretory granules.
      The most abundant type of cells contains the granules with the rough-fibrillated
      content (fig. 1, a; 2, [symbol: see text]; 3, a). The cells of this type cover
      most part of the body. In some cells the content of such granules becomes
      condensed and electron-dense granules appear (fig. 3, a, [symbol: see text]).
      Another type of cells contains the giant granules with the rough-fibrillated
      content (fig. 3, [symbol: see text]). Third type of the secret is the granules
      with the finely fibrillated content which is ejected by exocytosis. The cells of
      the second and third types form a separate areas of the epithelium of the dorsal
      side of the body but occasionally were observed in the ventral epithelium too.
      The epithelium of N. ivanovi differs from that in Kronborgia by the abundance and
      diversity of secretory contents. The role of the epithelium in the digestion
      remains conjectural. It seems to be mainly the suckering tissue transporting the
      low molecular nutrients.

PMID- 11212617
TI  - [Comparative morphofunctional analysis of the gastropod-trematode interactions].
AB  - A morphofunctional aspect of pathogenesis in various mollusc--trematode
      combinations is very different. To evaluate the level of antagonism between the
      host and parasite, it is reasonable to use a summarized parameter of general
      physiological state of infected individuals. The somatic growth of the host could
      be used for that purpose. Analysis of original and reference data has shown, that
      the gastropod growth response to the trematode infection depends on the longevity
      of molluscs. The growth acceleration (gigantism) in infected individuals is
      common for snails with the intermediate longevity (3-4 yr), such as Hydrobia,
      Onobia and Bithynia (Prosobranchia: Rissoacea). As an exception, the gigantism is
      observed in the short-living species, which do not change the growth rate when
      they are parasitized: Biomphalaria, Bulinus, Helisoma and Lymnaea (Pulmonata:
      Basomathophora). Earlier, it was assumed that the single trend manifested in the
      infected long-living species (6-27 yr), such as Littorina (Prosobranchia:
      Littorinacea) and Cerithidea (Prosobranchia: Cerithiacea), in the decrease of the
      growth rate. The only case of the growth acceleration within the long-living
      molluscs was detected in the Littorina littorea from the White Sea infected with
      low pathogenic partenits of Cryptocotyle lingua (Heterophyidae). Based on the
      groups of snails with different longevity and being phylogenetically distant from
      each other, we can presume that the growth response to the infection correlates
      with the morphological peculiarities of hosts. The morphofunctional distinction
      in the system formed by trematodes and molluscs of different taxa are expressed
      in the parthenit localization in the host body and in the degree of digestive
      gland and/or gonad destriction. From the viewpoint of general physiological
      status of the host organism, the results of disfunctions in these organs are not
      similar. The destruction of digestive system ("energy power station" of
      organisms) is more fatal for infected individuals than a parasitic castration.
      Therefore, the localization of parasites in the mollusc gonad can be recognized
      as a parasitic adaptation to decrease the probability of a premature host's death
      and respectively to prevent the elimination of parasites. Phylogenetically
      distant gastropods with different life cycles use a diverse reproduction
      strategy, which implies a different proportion of gonad and digestive gland
      volume. Thus, snail species from different taxa are not similar in relation to
      the life space, which could be "granted" to the parasite without any risk to
      reduce a viability of the host. The space lack forces the parthenits parasitizing
      in the molluscs with the longer life span to occupy the digestive gland tissues,
      that increases their pathogenicity and decreases the host's growth rate.

PMID- 11212619
TI  - [Distribution of coccidians (Sporozoa: Coccidiida) in various systematic groups
      of fishes].
AB  - There are about 250 coccidian species associated with fishes. They belong to 8
      genera (Calyptospora, Cryptosporidium, Crystallospora, Eimeria, Epieimeria,
      Goussia, Isospora, Octosporella) and 3 families (Calyptosporidae,
      Cryptosporidiidae, Eimeriidae). Two genera are represented by great number of
      species associated with fishes: Eimeria--157 and Goussia--69 species. Most
      diverse fauna of coccidians was found in fishes of the class Actinopterigii;
      fishes of the class Elasmobranchii have significantly less number of coccidians.
      These parasites have never been recorded on the class Holocephali. Coccidian have
      been recorded in 55 orders of fishes. Within the Actinopterigii, the richest
      coccidian fauna is recorded from Cypriniformes and Perciformes. Accumulated data
      on host associations proves that coccidian species have mainly a restricted hosts
      specificity.

PMID- 11212620
TI  - [First record of the mite genus Neharpyrhyncuhus (Acari: Harpirhynchidae) in the
      Russian fauna].
AB  - The mites of genus Neharpyrhynchus Fain, 1972 (Acari: Harpirhynchidae) are
      recorded from Rissia for first time. Two species, N. hippolae sp. n. from
      Hippolais icterina (Passeriformes: Sylviidae) and N. plumaris (Fritsch) from
      Fringilla coelebs (Passeroformes: Fringillidae) from N. W. Russia was found. N.
      hippolae sp. n., female holotype (all measurements in mkm, abbreviations--see
      Fain e.a., 1999): L 517, W 382, LS 179, WS 325, PA 27, thicker than PI 49 and PE
      24, pts smooth, vi, ve [symbol: see text] sci are subequal, about 94, l5 247;
      propodosomal shield not divided; anterior region of pronotum with rounded
      verrucosites; venter without scales; legs I-II with 2 free segments and strongly
      developed lobes at their bases; legs III-IV with one segment, bears 4 and 5 setae
      respectively (in paratypes number of these setae is variable, 4-5). Male: L 227
      254, W 210-219, LS 129-134, WS 170-183, pts are smooth, ve 78-87, sci 83-90, sce
      89-95, h 90-110; penis 49-56 long; legs III with 2 free segments, basal segment
      bears seta, apical segment with 5-6 setae; legs IV with one free segment, it
      bears 4-5 setae. The new species is closely related to N. pilirostris (Berlese et
      Trouessart, 1889) and distinguished by characters as follows. N. hippolae sp. n.
      (female): the setae PI about 2 times are longer than PA and PE; the apical
      segment of legs III-IV bears 4-5 setae. N. pilirostris: setae PA, PI [symbol: see
      text] PE are subequal; the apical segment of legs III-IV bears 4 setae only. N.
      plumaris differs from closely related species N. novoplumaris Moss e.a., 1968 by
      characters as follows. In female of N. plumaris, the setae PA are subequal to PE
      and 1.6-1.8 times shorter than PI. In N. novoplumaris, the setae PA shorter than
      PI and PE.

PMID- 11212622
TI  - A global perspective on statutory Social Security programs for the sick.
AB  - Statutory sickness benefit programs have been adopted in 129 countries. Most have
      an employment-based strategy, social insurance, that restricts coverage to those
      in paid formal employment. The cash entitlements provided are predominantly
      earnings-related. Funding comes overwhelmingly from employer and employee
      contributions, with only a minority of countries providing government subsidies.
      A comparative-evaluative assessment methodology is used to assess national
      statutory intentions with respect to statutory social security provision for the
      sick. The best-designed statutory program is found in Sweden followed closely by
      France and then Australia, Austria and Germany. Algeria clearly leads the African
      rankings, as does Peru in Latin America, Iraq in the Middle East, and Nauru in
      the Pacific Islands. Turkmenistan has the best-designed statutory program in
      Asia, by a very small margin. In North America, Canada is well ahead of the
      United States.

PMID- 11212621
TI  - Difficulty or dependency? Effects of measurement scales on disability prevalence
      among older Americans.
AB  - This study examines how the prevalence of disability among subgroups of older
      persons is influenced by the activity of daily living (ADL) scale selected. Using
      the 1993 Survey of Asset and Income Dynamics of the Oldest Old, we construct four
      disability scales, ranging from difficulty performing an ADL to receiving help
      with an ADL, or dependency. In all instances, the difficulty scales produce
      substantially higher estimates of disability than the dependency scales. Larger
      percentages of women, Blacks, and less educated persons are classified disabled
      under all scales compared with men, Whites, and more educated persons. Specific
      subgroups are more sensitive to the scale used. The policy implications of using
      ADL scales to establish program eligibility are discussed.

PMID- 11212623
TI  - Quality, CQI, and reengineering in health services organizations.
AB  - Quality in health care is defined with a focus on satisfying customer needs. The
      contemporary management philosophies of continuous quality improvement (CQI) and
      reengineering are defined; attributes and applications of each are described.
      Criticism of reengineering appearing in the literature is presented. It is likely
      that CQI will remain a predominate management philosophy in health services,
      while reengineering may not endure in its form of radical change.

PMID- 11212624
TI  - Family health: an emerging paradigm for social workers.
AB  - The profession of social work has, since its inception, stressed the importance
      of the family system in social treatment. Even though the family has always been
      central to effective social work intervention, the framing of the family system
      from a family health perspective is new to the field. The goal of this paper is
      to present the empirical grounding of family health and the implications of this
      emerging paradigm for social policy. Family health is built on the
      biopsychosocial model and emphasizes the importance of the role of the family
      system in the social functioning of individuals. Family health is defined
      (Pardeck and Yuen, 1999, p. 1) "as a state of holistic well-being of the family
      system. Family health is manifested by the development of, and continuous
      interaction among, the physical, mental, emotional, social, economic, cultural
      and spiritual dimensions of the family which results in the holistic well-being
      of the family and its members."

PMID- 11212625
TI  - The Morton-Massaro law of information integration: implications for models of
      perception.
AB  - Information integration may be studied by analyzing the effect of 2 or more
      sources (e.g., auditory and visual) on participants' responses. Experiments show
      that ratios of response probabilities often factorize into components selectively
      influenced by only 1 source (e.g., 1 component affected by the acoustic source
      and another 1 affected by the visual source). This is called the Morton-Massaro
      law (MML). This article identifies conditions in which the law is optimal and
      notes that it reflects an implicit assumption about the statistics of the
      environment. Adherence to the MML can be used to assess whether the assumption is
      being made, and analyses of natural stimuli can be used to determine whether the
      assumption is reasonable. Feed-forward and interactive models subject to a
      channel separability constraint are consistent with the law.

PMID- 11212626
TI  - Perception and preference in short-term word priming.
AB  - Responding optimally with unknown sources of evidence (ROUSE) is a theory of
      short-term priming applied to associative, orthographic-phonemic, and repetition
      priming. In our studies, perceptual identification is measured with two
      alternative forced-choice testing. ROUSE assumes features activated by primes are
      confused with those activated by the target. A near-optimal decision discounts
      evidence arising from such shared features. Too little discounting explains the
      finding that primed words were preferred after passive viewing of primes. Too
      much discounting explains the findings of reverse preference after active
      processing of primes. These preference changes highlight the need to use
      paradigms (like the present ones) capable of separating preferential and
      perceptual components of priming. Evidence of enhanced perception was found only
      with associative priming and was very small in magnitude compared with preference
      effects.

PMID- 11212627
TI  - Signal-detection analysis of group decision making.
AB  - How effectively can groups of people make yes-or-no decisions? To answer this
      question, we used signal-detection theory to model the behavior of groups of
      human participants in a visual detection task. The detection model specifies how
      performance depends on the group's size, the competence of the members, the
      correlation among members' judgments, the constraints on member interaction, and
      the group's decision rule. The model also allows specification of performance
      efficiency, which is a measure of how closely a group's performance matches the
      statistically optimal group. The performance of our groups was consistent with
      the theoretical predictions, but efficiency decreased as group size increased.
      This result was attributable to a decrease in the effort that members gave to
      their individual tasks rather than to an inefficiency in combining the
      information in the members' judgments.

PMID- 11212628
TI  - DRC: a dual route cascaded model of visual word recognition and reading aloud.
AB  - This article describes the Dual Route Cascaded (DRC) model, a computational model
      of visual word recognition and reading aloud. The DRC is a computational
      realization of the dual-route theory of reading, and is the only computational
      model of reading that can perform the 2 tasks most commonly used to study
      reading: lexical decision and reading aloud. For both tasks, the authors show
      that a wide variety of variables that influence human latencies influence the DRC
      model's latencies in exactly the same way. The DRC model simulates a number of
      such effects that other computational models of reading do not, but there appear
      to be no effects that any other current computational model of reading can
      simulate but that the DRC model cannot. The authors conclude that the DRC model
      is the most successful of the existing computational models of reading.

PMID- 11212629
TI  - A Bayesian model for implicit effects in perceptual identification.
AB  - Retrieving effectively from memory (REM; R. M. Shiffrin & M. Steyvers, 1997), an
      episodic model of memory, is extended to implicit memory phenomena, namely the
      perceptual identification studies reported in R. Ratcliff and G. McKoon (1997).
      In those studies, the influence of prior study was greatest when words were
      presented most briefly and when forced-choice targets and foils were most
      similar. R. Ratcliff and G. McKoon use these data to argue against models in
      which prior study changes a word's representation. A model in which prior study
      changes a word's representation by adding context information is fit to their
      data; at test, the model uses a Bayesian decision process to compare the
      perceptual and context features associated with the test flash to stored traces.
      The effects of prior study are due to matching extra context information and are
      larger when alternatives share many features, thereby reducing noise that
      attenuates these effects.

PMID- 11212630
TI  - Is it time to pull the plug on the hostile versus instrumental aggression
      dichotomy?
AB  - Psychologists have often categorized human aggression as hostile or instrumental.
      Hostile aggression is "hot," impulsive behavior that is motivated by a desire to
      hurt someone; instrumental aggression is "cold," premeditated behavior used as a
      means to some other end. This dichotomy was useful to the early development of
      aggression theories and continues to capture important features of nonhuman
      aggression, but it has outlived its usefulness as a descriptor of fundamentally
      different kinds of human aggression. It is confounded with the automatic
      controlled information-processing dichotomy, and it fails to consider aggressive
      acts with multiple motives. Knowledge structure models of aggression easily
      handle these problems. Taking extreme measures to preserve the hostile
      instrumental dichotomy will delay further advances in understanding and
      controlling human aggression. Therefore, this seems a proper time to "pull the
      plug" and allow the hostile-instrumental aggression dichotomy a dignified death.

PMID- 11212631
TI  - Cognitive emissions of 1/f noise.
AB  - The residual fluctuations that naturally arise in experimental inquiry are
      analyzed in terms of their time histories. Although these fluctuations are
      generally relegated to a statistical purgatory known as unexplained variance,
      this article shows that they may harbor a long-term memory process known as 1/f
      noise. This type of noise has been encountered in a number of biological and
      physical systems and is theorized to be a signature of dynamic complexity. Its
      presence in psychological data appears to be associated with the most elementary
      aspect of cognitive process, the formation of representations.

PMID- 11212632
TI  - A modern learning theory perspective on the etiology of panic disorder.
AB  - Several theories of the development of panic disorder (PD) with or without
      agoraphobia have emerged in the last 2 decades. Early theories that proposed a
      role for classical conditioning were criticized on several grounds. However, each
      criticism can be met and rejected when one considers current perspectives on
      conditioning and associative learning. The authors propose that PD develops
      because exposure to panic attacks causes the conditioning of anxiety (and
      sometimes panic) to exteroceptive and interoceptive cues. This process is
      reflected in a variety of cognitive and behavioral phenomena but fundamentally
      involves emotional learning that is best accounted for by conditioning
      principles. Anxiety, an anticipatory emotional state that functions to prepare
      the individual for the next panic, is different from panic, an emotional state
      designed to deal with a traumatic event that is already in progress. However, the
      presence of conditioned anxiety potentiates the next panic, which begins the
      individual's spiral into PD. Several biological and psychological factors create
      vulnerabilities by influencing the individual's susceptibility to conditioning.
      The relationship between the present view and other views, particularly those
      that emphasize the role of catastrophic misinterpretation of somatic sensations,
      is discussed.

PMID- 11212633
TI  - Time scales in motor learning and development.
AB  - A theoretical framework based on the concepts and tools of nonlinear dynamical
      systems is advanced to account for both the persistent and transitory changes
      traditionally shown for the learning and development of motor skills. The
      multiple time scales of change in task outcome over time are interpreted as
      originating from the system's trajectory on an evolving attractor landscape.
      Different bifurcations between attractor organizations and transient phenomena
      can lead to exponential, power law, or S-shaped learning curves. This unified
      dynamical account of the functions and time scales in motor learning and
      development offers several new hypotheses for future research on the nature of
      change in learning theory.

PMID- 11212634
TI  - Do infant rats cry?
AB  - In the current revival of interest in the emotional and mental lives of animals,
      many investigators have focused attention on mammalian infants that emit distress
      vocalizations when separated from the home environment. Perhaps the most
      intensively studied distress vocalization is the ultrasonic vocalization of
      infant rats. Since its discovery, this vocalization has been interpreted both as
      a communicatory signal for the elicitation of maternal retrieval and as the
      manifestation of emotional distress. In contrast, the authors examined the
      cardiovascular causes and consequences of the vocalization, and on the basis of
      this work, they hypothesized that the vocalization is the acoustic by-product of
      the abdominal compression reaction (ACR), a maneuver that results in increased
      venous return to the heart. Therefore, the vocalization may be analogous to a
      sneeze, serving a physiological function while incidentally producing sound.

PMID- 11212635
TI  - Hyperbolic value addition and general models of animal choice.
AB  - Three mathematical models of choice--the contextual-choice model (R. Grace,
      1994), delay-reduction theory (N. Squires & E. Fantino, 1971), and a new model
      called the hyperbolic value-added model--were compared in their ability to
      predict the results from a wide variety of experiments with animal subjects. When
      supplied with 2 or 3 free parameters, all 3 models made fairly accurate
      predictions for a large set of experiments that used concurrent-chain procedures.
      One advantage of the hyperbolic value-added model is that it is derived from a
      simpler model that makes accurate predictions for many experiments using discrete
      trial adjusting-delay procedures. Some results favor the hyperbolic value-added
      model and delay-reduction theory over the contextual-choice model, but more data
      are needed from choice situations for which the models make distinctly different
      predictions.

PMID- 11212636
TI  - Making more by working less.

PMID- 11212637
TI  - Your career guide. Solving the midcareer puzzle. Make your practice more
      profitable.

PMID- 11212638
TI  - My other career: how the military enriches my practice.

PMID- 11212639
TI  - Your career guide. Solving the midcareer puzzle. Do you have the right stuff to
      go solo?

PMID- 11212640
TI  - "We've proved that David can compete with Goliath".

PMID- 11212641
TI  - Your career guide. Solving the midcareer puzzle. Knowing when it's time to move
      on.

PMID- 11212642
TI  - Your career guide. Surveying the landscape. Where the jobs are.

PMID- 11212643
TI  - Your career guide. Surveying the landscape. What they're paying.

PMID- 11212644
TI  - Your career guide. Surveying the landscape. Are you cut out to be a country doc?

PMID- 11212645
TI  - The big step: starting a small-town practice.

PMID- 11212646
TI  - Your career guide. Surveying the landscape. Knowing who you are and what you
      want.

PMID- 11212647
TI  - At your service.

PMID- 11212648
TI  - Your career guide. Landing the job you want. Job search strategies that really
      work.

PMID- 11212649
TI  - The frantic job search of an IMG.

PMID- 11212650
TI  - Your career guide. Landing the job you want. Shape a contract you'll be glad you
      signed.

PMID- 11212651
TI  - Your career guide. Solving the midcareer puzzle. Can you find happiness where you
      are?

PMID- 11212652
TI  - My cure for burnout: job sharing.

PMID- 11212653
TI  - [BLNK deficiency].

PMID- 11212654
TI  - [Surrogate light chain deficiency].

PMID- 11212655
TI  - [Primary combined immunodeficiency due to a defect in interleukin 2 production].

PMID- 11212656
TI  - [Primary CD4 deficiency].

PMID- 11212657
TI  - [Primary CD7 deficiency].

PMID- 11212658
TI  - [Primary immunodeficiency associated with defective signal transduction in T
      cells].

PMID- 11212659
TI  - [Primary combined immunodeficiency due to defective transcription of multiple T
      cell cytokine genes].

PMID- 11212660
TI  - [CD8 deficiency].

PMID- 11212661
TI  - [Idiopathic CD4+ T lymphocytopenia].

PMID- 11212662
TI  - [DiGeorge anomaly (DiGeorge syndrome)].

PMID- 11212663
TI  - [Wiskott-Aldrich syndrome].

PMID- 11212664
TI  - [Ataxia-telangiectasia(AT), Louis-Bar syndrome].

PMID- 11212665
TI  - [Chediak-Higashi syndrome].

PMID- 11212666
TI  - [Kostmann syndrome, hereditary neutropenia].

PMID- 11212667
TI  - [Pelger-Huet anomaly].

PMID- 11212668
TI  - [Shwachman syndrome].

PMID- 11212669
TI  - [Deficiency of leukocyte glutathione reductase, deficiency of leukocyte
      glutathione peroxidase].

PMID- 11212670
TI  - [Neutrophil cytoskeletal disease].

PMID- 11212672
TI  - [Neutrophil glucose-6-phosphate dehydrogenase deficiency].

PMID- 11212671
TI  - [MHC class I deficiency].

PMID- 11212673
TI  - [Tuftsin deficiency].

PMID- 11212674
TI  - [Chronic benign neutropenia(CBN)].

PMID- 11212675
TI  - [Chronic idiopathic neutropenia].

PMID- 11212676
TI  - [Cyclic neutropenia].

PMID- 11212677
TI  - [Lazy-leukocyte syndrome].

PMID- 11212678
TI  - [Neutrophil secondary granule deficiency].

PMID- 11212679
TI  - [Leukocyte adhesion deficiency, type I].

PMID- 11212680
TI  - [Leukocyte adhesion deficiency, type II].

PMID- 11212681
TI  - [Neutrophil pyruvate kinase deficiency].

PMID- 11212683
TI  - [MHC class II deficiency (CIITA/RFX deficiency)].

PMID- 11212682
TI  - [Chronic granulomatous disease].

PMID- 11212684
TI  - [Myeloperoxidase deficiency].

PMID- 11212685
TI  - [C1q deficiency].

PMID- 11212686
TI  - [C1r/C1s deficiency].

PMID- 11212687
TI  - [C2 deficiency].

PMID- 11212688
TI  - [C3 deficiency].

PMID- 11212689
TI  - [C4 deficiency].

PMID- 11212690
TI  - [C5 deficiency/dysfunction].

PMID- 11212691
TI  - [C6 deficiency].

PMID- 11212692
TI  - [C7 deficiency].

PMID- 11212693
TI  - [Nezelof's syndrome].

PMID- 11212694
TI  - [C8 alpha-gamma chain/beta chain deficiency].

PMID- 11212695
TI  - [C9 deficiency].

PMID- 11212696
TI  - [C1 inhibitor deficiency].

PMID- 11212697
TI  - [Factor H deficiency].

PMID- 11212698
TI  - [Factor D deficiency].

PMID- 11212699
TI  - [Properdin deficiency].

PMID- 11212700
TI  - [C4 binding protein deficiency].

PMID- 11212701
TI  - [HRF20(CD59, MACIF) deficiency].

PMID- 11212702
TI  - [Omenn syndrome].

PMID- 11212703
TI  - [CR1 deficiency].

PMID- 11212704
TI  - [CR3/4 deficiency].

PMID- 11212705
TI  - [Paroxysmal nocturnal hemoglobinuria].

PMID- 11212706
TI  - [CD46 deficiency].

PMID- 11212707
TI  - [C5a inhibitor deficiency].

PMID- 11212708
TI  - [Mannose-binding lectin(MBL) deficiency].

PMID- 11212709
TI  - [Factor I deficiency].

PMID- 11212710
TI  - [Diseases associated with C1q abnormalities].

PMID- 11212711
TI  - [Bloom syndrome].

PMID- 11212712
TI  - [Fanconi anemia].

PMID- 11212713
TI  - [ICF syndrome].

PMID- 11212714
TI  - [T cell activation defects].

PMID- 11212715
TI  - [Nijmegen breakage syndrome].

PMID- 11212716
TI  - [Seckel syndrome].

PMID- 11212717
TI  - [Down's syndrome].

PMID- 11212718
TI  - [Turner syndrome].

PMID- 11212719
TI  - [Xeroderma pigmentosum].

PMID- 11212720
TI  - [Abnormal condensation of the heterochromatin of chromosomes 1, 9 and 16].

PMID- 11212721
TI  - [Deletions and rings of chromosome 18].

PMID- 11212722
TI  - [Dubowitz syndrome].

PMID- 11212723
TI  - [Familial intestinal polyatresia(FIPA)].

PMID- 11212724
TI  - [Immunodeficiency and partial albinism, Griscelli syndrome].

PMID- 11212725
TI  - [Asplenia syndrome(Ivemark syndrome)].

PMID- 11212726
TI  - [Netherton syndrome].

PMID- 11212727
TI  - [Papillon-Lefevre syndrome].

PMID- 11212728
TI  - [Schimke immuno-osseous dysplasia].

PMID- 11212729
TI  - [Hutchinson-Gilford progeria syndrome].

PMID- 11212730
TI  - [Adenosine deaminase deficiency].

PMID- 11212731
TI  - [Dyskeratosis congenita].

PMID- 11212732
TI  - [Short-limb skeletal dysplasia with immunodeficiency].

PMID- 11212733
TI  - [Acrodermatitis enteropathica].

PMID- 11212734
TI  - [Short-limbed dwarfism with immunodeficiency, cartilage-hair hypoplasia,
      metaphyseal chondrodysplasia, Gutti-Lux syndrome].

PMID- 11212735
TI  - [Dysgenesis of the corpus callosum].

PMID- 11212736
TI  - [Growth retardation, facial anomalies and immunodeficiency].

PMID- 11212737
TI  - [Anhidrotic ectodermal dysplasia].

PMID- 11212738
TI  - [Mannosidosis].

PMID- 11212740
TI  - [Hereditary transcobalamin II deficiency].

PMID- 11212739
TI  - [Hereditary orotic aciduria].

PMID- 11212741
TI  - [Glycogen storage disease type Ib].

PMID- 11212742
TI  - [Reticular dysgenesis].

PMID- 11212743
TI  - [Biotin-responsive multiple carboxylase deficiency].

PMID- 11212744
TI  - [Methylmalonic acidemia].

PMID- 11212745
TI  - [Hyper IgE syndrome].

PMID- 11212746
TI  - [Familial hypercatabolic hypoproteinemia].

PMID- 11212747
TI  - [Myotonic dystrophy].

PMID- 11212748
TI  - [Intestinal lymphangiectasia].

PMID- 11212749
TI  - [Chronic mucocutaneous candidiasis (CMCC)].

PMID- 11212750
TI  - [HIV infection and AIDS].

PMID- 11212751
TI  - [Severe combined immunodeficiency].

PMID- 11212752
TI  - [Extrahepatic manifestations of viral hepatitis].

PMID- 11212753
TI  - [Immunologic disorders associated with herpesvirus infection].

PMID- 11212754
TI  - [Immunologic disorders associated with virus infections].

PMID- 11212755
TI  - [Brill-Zinsser disease].

PMID- 11212756
TI  - [Spirochetal infection].

PMID- 11212757
TI  - [Protozoan diseases].

PMID- 11212758
TI  - [Helminth infection and immunodepression].

PMID- 11212759
TI  - [Malignant lymphoma].

PMID- 11212760
TI  - [Acute myelogenous leukemia].

PMID- 11212761
TI  - [Multiple myeloma].

PMID- 11212762
TI  - [Chronic myelogenous leukemia].

PMID- 11212763
TI  - [Acute lymphoblastic leukemia and chronic lymphocytic leukemia].

PMID- 11212764
TI  - [Myelofibrosis].

PMID- 11212765
TI  - [Immunodeficiency in autoimmune diseases].

PMID- 11212766
TI  - [Purine nucleoside phosphorylase deficiency].

PMID- 11212767
TI  - [Immunodeficiency induced by antineoplastic agents].

PMID- 11212768
TI  - [Drug induced immunodeficiency].

PMID- 11212769
TI  - [Immunodeficiency induced by immunosuppressive agents].

PMID- 11212770
TI  - [D-penicillamine-induced immune deficiency].

PMID- 11212771
TI  - [Cushing's syndrome].

PMID- 11212772
TI  - [Febrile neutropenia].

PMID- 11212774
TI  - [Altered immunity in patients with alcoholism].

PMID- 11212773
TI  - [Werner syndrome].

PMID- 11212775
TI  - [Common variable immunodeficiency(CVID)].

PMID- 11212776
TI  - [Malnutrition, essential trace element deficiency, vitamin deficiency].

PMID- 11212777
TI  - [Post-thymectomy syndrome].

PMID- 11212778
TI  - [Post-splenectomy syndrome].

PMID- 11212779
TI  - [Stress].

PMID- 11212780
TI  - [Autoimmune disorders in diabetes mellitus].

PMID- 11212781
TI  - [Nephrotic syndrome].

PMID- 11212782
TI  - [Immunological response to severe burn].

PMID- 11212783
TI  - [Good syndrome, immunodeficiency with thymoma].

PMID- 11212784
TI  - [Radiation injury].

PMID- 11212785
TI  - [Chronic renal failure, uremia].

PMID- 11212786
TI  - [Acquired disorders of the complement system].

PMID- 11212787
TI  - [Antibody-mediated thrombosis].

PMID- 11212788
TI  - [Castleman's disease].

PMID- 11212789
TI  - [Ankylosing spondylitis].

PMID- 11212790
TI  - [Reactive arthritis(Reiter's syndrome)].

PMID- 11212791
TI  - [Psoriatic arthritis].

PMID- 11212792
TI  - [Arthropathies of inflammatory bowel diseases].

PMID- 11212793
TI  - [HTLV-I associated arthropathy (HAAP)--a review].

PMID- 11212794
TI  - [X-linked lymphoproliferative syndrome (XLP)].

PMID- 11212795
TI  - [Hermans syndrome].

PMID- 11212796
TI  - [Chronic fatigue syndrome].

PMID- 11212797
TI  - [Secondary neutrophil dysfunction].

PMID- 11212798
TI  - [Compromised host syndrome].

PMID- 11212799
TI  - [Histiocytic necrotizing lymphadenitis].

PMID- 11212800
TI  - [Inflammatory abdominal aortic aneurysm].

PMID- 11212802
TI  - [Kimura's disease(eosinophilic lymphfolliculoid granuloma].

PMID- 11212801
TI  - [Granular lymphocyte-proliferative disorders, lymphoproliferative disease of
      granular lymphocytes].

PMID- 11212803
TI  - [Familial hemophagocytic lymphohistiocytosis(FHL)].

PMID- 11212804
TI  - [Malignant tumor-associated hemophagocytic syndrome(MAHS)].

PMID- 11212805
TI  - [Hyper IgM syndrome].

PMID- 11212806
TI  - [Virus-associated hemophagocytic syndrome(VAHS)].

PMID- 11212807
TI  - [Bacteria-associated hemophagocytic syndrome(BAHS)].

PMID- 11212808
TI  - [Autoimmune-associated hemophagocytic syndrome(AAHS)].

PMID- 11212809
TI  - [Postmyocardial infarction syndrome].

PMID- 11212810
TI  - [Postcardiotomy syndrome].

PMID- 11212811
TI  - [Idiopathic myocarditis and pericarditis].

PMID- 11212812
TI  - [Kawasaki vasculitis].

PMID- 11212813
TI  - [X-linked agammaglobulinemia].

PMID- 11212814
TI  - [Langerhans cell histiocytosis(LCH)].

PMID- 11212815
TI  - [Crow-Fukase (POEMS) syndrome].

PMID- 11212816
TI  - [Monoclonal gammopathy of undetermined significance(MGUS)].

PMID- 11212817
TI  - [Disseminated eosinophilic collagen disease].

PMID- 11212818
TI  - [Mastocytosis].

PMID- 11212819
TI  - [Orbital myositis].

PMID- 11212820
TI  - [Immunoblastic lymphadenopathy].

PMID- 11212821
TI  - [Alloimmune disease].

PMID- 11212822
TI  - [Tuberculosis and Legionella infection on immunocompromised host].

PMID- 11212823
TI  - [Fungal infection in immunocompromised hosts].

PMID- 11212824
TI  - [Autosomal recessive agammaglobulinemia].

PMID- 11212826
TI  - [X-linked hypogammaglobulinemia with growth hormone deficiency].

PMID- 11212825
TI  - [Antibody deficiency with normal(or elevated) immunoglobulins].

PMID- 11212827
TI  - [Transient hypogammaglobulinemia of infancy].

PMID- 11212828
TI  - [Ig heavy-chain gene deletions].

PMID- 11212829
TI  - [Selective deficiency of IgA subclass].

PMID- 11212830
TI  - [Deficiency of secretory IgA].

PMID- 11212831
TI  - [Selective IgA deficiency].

PMID- 11212832
TI  - [Selective IgG deficiency].

PMID- 11212833
TI  - [IgG subclass deficiency].

PMID- 11212834
TI  - [CD3 subunit deficiencies].

PMID- 11212836
TI  - [Isolated IgE deficiency].

PMID- 11212835
TI  - [Selective IgM deficiency].

PMID- 11212837
TI  - [IgA-IgM deficiency].

PMID- 11212838
TI  - [Light-chain deficiency(kappa-chain deficiency, lambda-chain deficiency].

PMID- 11212839
TI  - Characterization of glyoxalase I (E. coli)-inhibitor interactions by electrospray
      time-of-flight mass spectrometry and enzyme kinetic analysis.
AB  - Potential inhibitors of the enzyme glyoxalase I from Escherichia coli have been
      evaluated using a combination of electrospray mass spectrometry and conventional
      kinetic analysis. An 11-membered library of potential inhibitors included a
      glutathione analogue resembling the transition-state intermediate in the
      glyoxalase I catalysis, several alkyl-glutathione, and one flavonoid. The E. coli
      glyoxalase I quaternary structure was found to be predominantly dimeric, as is
      the homologous human glyoxalase I. Binding studies by electrospray revealed that
      inhibitors bind exclusively to the dimeric form of glyoxalase I. Two specific
      binding sites were observed per dimer. The transition-state analogue was found to
      have the highest binding affinity, followed by a newly identified inhibitor; S-(2
      [3-(hexyloxy)benzoyl]-vinyl)glutathione. Kinetic analysis confirmed that the
      order of affinity established by mass spectrometry could be correlated to
      inhibitory effects on the enzymatic reaction. This study shows that selective
      inhibitors may exist for the E. coli homologue of the glyoxalase I enzyme.

PMID- 11212840
TI  - Microscopic analysis of polymerization and fragmentation of individual actin
      filaments.

PMID- 11212842
TI  - Murine retroviral vector producer cells survival and toxicity in the dog liver.
AB  - To develop a safe method to target gene delivery into intrahepatic tumors, we
      examined the toxicity of intrahepatic (IH) injection of retroviral vector
      producer cells (VPC) into the canine liver. VPC have been demonstrated to
      effectively transfer genes in vivo. To evaluate for adverse effects form
      xenogeneic cell transplantation, mongrel dogs were injected IH with 1 x 10(9)
      murine LTKOSN.2 VPC divided into three aliquots. The animals were then monitored
      for acute toxicity induced by the VPC. The intraoperative IH injections of the
      cells were tolerated without difficulty. Starting 7 days after IH injection, the
      dogs then received intravenous ganciclovir (GCV) twice daily (5 mg/kg) for 7
      days. GCV treatment did not cause significant toxicities. Dogs underwent serial
      blood tests to evaluate bone marrow, renal, liver and immunological function.
      Complete blood counts, electrolytes, liver function and renal function tests
      remained normal except for mild elevations of alkaline phosphatase. Histologic
      examination of liver tissues from the IH injection site revealed no apparent
      normal tissue destruction induced by the VPC. Two of the four treated dogs
      underwent liver biopsy on day 3. These biopsy specimens were cultured and
      persistent, viable VPC were recovered. The dogs mounted an antibody response to
      the murine VPC that was first demonstrated 5 days post injection. PCR analysis
      demonstrated low level gene transfer into dog liver tissue. Overall, our results
      demonstrate that IH xenogeneic VPC injections are not accompanied by significant
      adverse effects over a 1 month period following administration into the canine
      liver. These data support the safety aspects of using murine VPC in Phase I
      clinical trials.

PMID- 11212841
TI  - Murine retroviral vector producer cells survival and toxicity in the peritoneal
      cavity of dogs.
AB  - Retroviral vector producer cells (VPC) can effectively transfer genes in vivo. To
      develop a safe method to target gene delivery into intraperitoneal tumors, we
      have examined the toxicity of intraperitoneal (i.p.) infusion of retroviral VPC
      in a xenogeneic canine model. Mongrel dogs were injected intraperitoneally (i.p.)
      with 2 x 10(9) murine LTKOSN.2 VPC. The animals did not demonstrate acute
      toxicity and tolerated the i.p. infusion of the cells without difficulty.
      Starting 7 days after i.p. injection, the dogs received intravenous injections of
      ganciclovir (GCV) twice daily (5 mg/kg) for 7 days. The treatment dogs underwent
      peritoneal washings on days 3, 7 and 14 after their initial infusion of cells to
      study the persistence of the VPC. GCV treatment did not cause significant
      toxicities. Dogs underwent serial blood tests to evaluate bone marrow, renal,
      liver and immunological function. Complete blood counts, electrolytes and renal
      function remained normal throughout the study. Although, transient mild
      elevations occurred of serum alkaline phosphate, the remaining hepatic enzymes
      remained normal. Histologic examination of tissues from animals sacrificed after
      the i.p. administration of the VPC revealed no tissue destruction of the normal
      peritoneal lining. The dogs mounted an antibody response to the murine VPC that
      was first observed 7 days post injection. PCR analysis of selected tissues after
      GCV administration did not reveal persistent vector sequences. These results
      demonstrated that the injection of xenogeneic VPC is not accompanied by
      significant adverse effects over a 1 month period following administration into
      the canine peritoneal cavity. These data support the potential clinical
      application of the VPC in Phase I clinical trials in humans.

PMID- 11212843
TI  - Prognostic significance of matrix metalloproteinase expression in colorectal
      carcinomas.
AB  - The matrix metalloproteinases (MMPs) are a family of enzymes that degrade the
      extracellular matrix (ECM) and are considered to be important in neoplastic cell
      invasion and metastasis. Structural changes in the extracellular matrix are
      necessary for cell migration during tissue remodeling and neoplastic cell
      invasion. Histochemical expression of MMP-2, -3, -9, -10, and -13 was observed in
      19 human colorectal carcinomas (CCs) employing an indirect alkaline phosphatase
      (AP) conjugated antigen detection technique. Evaluation of the results was based
      on (a) the percent of neoplastically transformed cells that reacted positively
      and (b) a measure of staining intensity [graded from A (highest) to D]. The two
      forms of stromelysin (SL), types 1 (MMP-3) and 2 (MMP-10), share 82% sequence
      homology, but exhibit differences in cellular synthesis and inducibility by
      cytokines and growth factors in vitro. Strong overall expression of MMP-3 and -10
      was found in all CC cases observed, especially in the ECM adjacent to blood
      vessels. Positive immunoreactivity could be seen for these two MMPs in the ECM
      surrounding over 90% of the neoplastically transformed cells, and the staining
      intensity was also the strongest possible (A,B). Weak (surrounding anywhere
      between 10% and 90% of the neoplastically transformed cells, and of strong A,B
      intensity) expression of MMP-2 (gelatinase A) and MMP-9 (gelatinase B), two
      cytokine-induced MMPs, was also observed in CCs. Expression of collagenase-3 (MMP
      13), an endopeptidase characterized by a potent degrading activity against a wide
      spectrum of substrates, was not defined in the CCs cases observed by us. It is
      clear that the activation of MMPs and their inhibitors occurs in a very well
      orchestrated manner. The necessity of these same enzymes for the extravasation
      and infiltration of lymphocytes into regions of chronic local inflammation, as
      associated with neoplastically transformed masses of cells, may aid the
      transformed cells which have already acquired a metastatic immunophenotype to
      enter the peripheral circulation. Further characterization of the expression and
      utilization of MMPs and their inhibitors in the progression of solid human
      neoplasms should lead to the development of novel anti-cancer therapies.

PMID- 11212844
TI  - Matrix metalloproteinase expression in childhood medulloblastomas/primitive
      neuroectodermal tumors.
AB  - The matrix metalloproteinases (MMPs) are a family of enzymes that degrade the
      extracellular matrix (ECM) and are considered to be important in neoplastic cell
      invasion and metastasis. Structural changes in the extracellular matrix are
      necessary for cell migration during tissue remodeling and neoplastic invasion.
      Expression of MMP-2, -3, -9, -10, and -13 was investigated in human childhood
      medulloblastomas (MEDs)/primitive neuroectodermal tumors (PNETs) employing an
      indirect alkaline phosphatase conjugated immunohistochemical antigen detection
      technique. Evaluation of the results was based on (a) the percent of
      neoplastically transformed tissue that reacted positively and (b) a measure of
      immunoreactivity or staining intensity [graded from A (highest) to D (negative)].
      Strong overall expression of MMP-3 and -10 was found in MEDs/PNETs, especially in
      the ECM adjacent to blood vessels. Positive immunoreactivity was identified for
      these two MMPs in the ECM surrounding over 90% of the neoplastically transformed
      cells with the staining intensity being also the strongest possible (A,B). These
      two forms of stromelysin (SL), types 1 (MMP-3) and 2 (MMP-10), share 82% sequence
      homology, but exhibit differences in cellular synthesis and inducibility by
      cytokines and growth factors in vitro. Focal (surrounding less than 10% of the
      neoplastically transformed cells) but strong (A,B) immunoreactivity was
      determined for collagenase-3 (MMP-13), an endopeptidase characterized by a potent
      degrading activity against a wide spectrum of substrates. Weak (surrounding
      anywhere between 10% and 90% of the neoplastically transformed cells, and of B
      and B,C intensity) expression of MMP-2 (gelatinase A) and MMP-9 (gelatinase B),
      two cytokine-induced MMPs, was also observed. It is clear that the activation of
      MMPs and their inhibitors occurs in a very well orchestrated manner. The
      necessity of these same enzymes for the extravasation and infiltration of
      lymphocytes into regions of chronic local inflammation, as associated with
      neoplastically transformed masses of cells, may aid the transformed cells which
      have already acquired a more aggressive, metastatic immunophenotype (IP) to enter
      the peripheral circulation. Further characterization of the expression and
      utilization of MMPs and their inhibitors in the progression of solid human
      malignancies should lead to the development of novel anti-cancer therapies.

PMID- 11212846
TI  - 1st International Workshop on Coronary MR and CT Angiography. Lyon, France, 1-3
      October 2000. Abstracts.

PMID- 11212845
TI  - Significant differences in the matrix metalloproteinase expression profiles of
      spontaneous medulloblastomas/primitive neuroectodermal tumors as compared with
      their xenografted, established tumor cell line derived counterparts.
AB  - Matrix metalloproteinases (MMP) are a family of zinc-dependent enzymes which
      degrade various components of the extracellular matrix (ECM) and play an
      important role in facilitating neoplastic cell invasion and metastasis.
      Structural changes in the extracellular matrix are necessary for cell migration
      during tissue remodeling and tumor invasion. Expression of MMP-2, -3, -9, -10,
      and -13 was investigated in both spontaneous and xenografted (cells derived from
      an established cell-line [DAOY#3]) childhood medulloblastomas (MEDs)/primitive
      neuroectodermal tumors (PNETs) employing an indirect alkaline phosphatase
      conjugated immunocytochemical technique. Evaluation of the results was based on
      (a) the percent of neoplastically transformed tissue that reacted positively and
      (b) a measure of staining intensity [graded from A (highest) to D]. The two forms
      of stromelysin (SL), types 1 (MMP-3) and 2 (MMP-10), share 82% sequence homology,
      but exhibit differences in cellular synthesis and inducibility by cytokines and
      growth factors in vitro. Strong overall expression of MMP-3 and -10 was found
      only in the spontaneous MEDs/PNETs, especially in the ECM adjacent to blood
      vessels. Positive immunoreactivity could be seen for these two MMPs in the ECM
      surrounding over 90% of the neoplastically transformed cells in the spontaneous
      cases, and the staining intensity was also the strongest possible (A,B). Focal
      (surrounding less than 10% of the neoplastically transformed cells) but strong
      (A,B) immunoreactivity for collagenase-3 (MMP-13) was also only detected in
      spontaneous MEDs/PNETs, an endopeptidase characterized by a potent degrading
      activity against a wide spectrum of substrates. Weak (surrounding anywhere
      between 10% and 90% of the neoplastically transformed cells, and of B and B,C
      intensity) expression of MMP-2 (gelatinase A) and MMP-9 (gelatinase B), two
      cytokine-induced MMPs, was also observed in the spontaneous cases. Staining for
      MMP-2 was negative in the xenografted MEDs/PNETs. The only positive
      immunoreactivity in the xenografted MEDs/PNETs was observed in the case of MMP-9,
      with expression of strong intensity in the ECM surrounding over 90% of the
      neoplastically transformed xenografted MED/PNET cells (++++; A,B). It is clear
      that the activation of MMPs and their inhibitors occurs in a very well
      orchestrated manner. The data presented here suggest that there are significant
      differences in the pathophysiology of spontaneous and xenografted human
      neoplasms, which further establishes the already detected limitations of such
      models in preclinical cancer research.

PMID- 11212847
TI  - Review of publications.

PMID- 11212848
TI  - [Reverse transcriptase polymerase chain reaction and immunocytochemistry of bone
      marrow aspiration specimen and peripheral blood for detection of
      microdisseminated prostatic carcinoma. A comparative analysis].
AB  - Reverse transcriptase-polymerase chain reaction (RT-PCR) assay for prostate
      specific antigen and immunocytochemistry for cytokeratin-18 (CK-18) are tests for
      the detection of microdisseminated carcinoma of the prostate. Bone marrow
      aspirates and peripheral venous blood from 50 patients with clinically organ
      confined prostate cancer were examined. The rate of positive results was
      independent of the pT stage, serum PSA, and previous antiandrogen treatment. RT
      PCR and immunocytochemistry have to be tested under standardized conditions in
      prospective trials, and the results have to be compared to the serum PSA follow
      up.

PMID- 11212849
TI  - [Surgical procedures for patients with hyperparathyroidism].

PMID- 11212850
TI  - [Survey on attitudes of sentinel clinicians in Yokohama about infectious diseases
      surveillance system].

PMID- 11212852
TI  - [Symptomatic cluster headache. Expression of multiple sclerosis relapse with
      magnetic resonance tomography detection of pontomedullary lesion in the
      ipsilateral trigeminal nucleus area].
AB  - We describe a 25-year-old male who developed, in the course of an acute
      exacerbation of his multiple sclerosis, cluster headache-like attacks which
      responded to oxygen therapy. Magnetic resonance imaging revealed a lesion in the
      area of the ipsilateral pontomedullary trigeminal nuclei. This symptomatic case
      and other published cases are most probably explained by an activation of the
      trigeminovascular system as it is assumed for primary headache syndromes.

PMID- 11212851
TI  - Correlates of self-efficacy in diabetes self-care among Hispanic adults with
      diabetes.
AB  - PURPOSE: The purpose of this study was to examine factors associated with
      increased diabetes self-efficacy among insulin-requiring Hispanic adults with
      diabetes. METHODS: A cross-sectional survey design was used to obtain self
      reported data on a nonrandom sample of 97 insulin-requiring Hispanic adults with
      diabetes. The Insulin Management Diabetes Self-Efficacy Scale (IMDSES) was
      translated into Spanish and administered with a demographic questionnaire by
      trained bilingual/bicultural interviewers in each respondent's own home. Factor
      analysis of the IMDSES revealed 4 subscales that corresponded with major diabetes
      self-care management behaviors. RESULTS: Respondents gave low to average self
      efficacy ratings on their ability to manage all aspects of their disease.
      Behaviors that required problem solving in changing circumstances received the
      lowest scores. Attending diabetes classes and having home nursing visits were
      associated with an increased sense of self-efficacy, particularly as it related
      to diet and insulin. English-speaking ability was associated with a general sense
      of self-efficacy in managing diabetes care. CONCLUSIONS: The model tested was
      able to explain modest levels of self-efficacy, particularly in 2 of the most
      important diabetes management areas, insulin and diet management.

PMID- 11212853
TI  - Congress close to finalizing Medicare relief package for SNFs, other providers.

PMID- 11212854
TI  - New perspectives in the treatment of breast cancer. Introduction.

PMID- 11212855
TI  - What's all this talk about randomized, double blind, clinical trials?

PMID- 11212856
TI  - Prophylaxis against fungal infections and cytomegalovirus disease after bone
      marrow transplantation.
AB  - Among the serious complications associated with bone marrow transplantation are
      invasive fungal infections caused by organisms such as Candida and Aspergillus
      species and end-organ disease caused by cytomegalovirus (CMV). Successful
      prevention of these complications can have a significant impact on morbidity and
      mortality. The primary option for prophylaxis against fungal infections is
      fluconazole (Diflucan). Low doses of intravenous amphotericin B may be useful
      where there is a higher rate of aspergillosis. Itraconazole (Sporanox) and nasal
      amphotericin B are other options that have been less well studied. The
      development of fluconazole-resistant candidiasis may become problematic.
      Ganciclovir (Cytovene) is useful for the prevention of end-organ disease caused
      by CMV but carries a significant risk for neutropenia. New techniques for the
      early detection of CMV infection should allow prophylaxis to be targeted to
      patients at highest risk of developing CMV disease. It is critical to clearly
      define the risk factors for fungal and CMV disease in the individual patient in
      order to minimize adverse effects and provide the optimal prophylactic benefit.

PMID- 11212857
TI  - Spontaneous neoplastic regression: the significance of apoptosis.
AB  - In mammalian cells, neoplastic transformation has a direct relationship with the
      expression of oncogenes, the production of certain growth factors and with the
      mutation, loss or simple inactivation of the function of tumor suppressor genes.
      Genes for suppression of the development of the malignant immunophenotype, as
      well as inhibitory growth factors have regulatory functions within the normal
      processes of cell division and differentiation. Telomerase (a ribonucleoprotein
      polymerase) activation is frequently observed in various types of neoplastic cell
      transformation. Telomerase activation is regarded as essential for cell
      immortalization and its inhibition may result in spontaneous regression (SR) of
      neoplasms. SR of neoplasms occurs when the malignant tumor mass partially or
      completely disappears without any treatment or as a result of a therapy
      considered inadequate to influence systemic neoplastic disease. This definition
      makes it clear that the term SR applies to neoplasms in which the malignant
      disease is not necessarily cured, and to cases where the regression may not be
      complete or permanent. A number of possible mechanisms of SR are reviewed, with
      the understanding that no single mechanism can completely account for this
      phenomenon. The application of the newest immunological, molecular biological and
      genetic insights for more individualized anticancer immunotherapy (biotherapy) is
      also discussed. In conclusion, of all the possible mechanisms of SR of neoplasms,
      programmed cell death (PCD) or apoptosis is involved in each. The immunological
      mechanism is probably the main effector mechanism of SR in human neoplasms with
      its trigger being apoptosis. The treatments of the tumor, such as with various
      anti-neoplastic drugs or radiation or immunotherapy, all include the basic
      mechanism of programmed cell death or apoptosis. Without apoptosis, there is
      practically no tumor regression, none of any kind.

PMID- 11212858
TI  - Systolic heart failure: practical implementation of standard guidelines.
AB  - Congestive heart failure (CHF) is being described as an epidemic of the next
      decade. Despite significant advances in the treatment of systolic heart failure,
      community mortality remains high, which is partly due to a failure to implement
      standard guidelines. The purpose of this article is to describe the scope of the
      problem, advances in pathophysiology, common clinical scenarios, and practical
      implementation of standard therapies for CHF.

PMID- 11212859
TI  - Rickets on the rise.

PMID- 11212860
TI  - Zona thinning with noncontact diode laser in patients aged < or = 37 years with
      no previous failure of implantation: a prospective randomized study.
AB  - PURPOSE: Zona thinning (ZT) is a technique used to improve pregnancy rates among
      patients > or = 38 years old and/or patients presenting previous implantation
      failure. The objective of the study was to determine whether ZT has a beneficial
      effect on patients younger than 37 years who are undergoing the first ICSI
      attempt. METHODS: A total of 103 patients submitted to ICSI for the first time
      and those aged < or = 37 years were divided in a prospective and randomized
      manner into two groups: group I, patients submitted to ZT (n = 51) (a laser diode
      with 1.48-micron wavelength (Fertilaser) was used for the procedure); group II,
      patients with no ZT (n = 52). In both groups, embryo transfer was performed on
      the second day. RESULTS: The age of group I patients (31.8 +/- 3.6) did not
      differ (P = 0.53) from that of group II patients (31.4 +/- 3.6). The number of
      metaphase II oocytes was similar (P = 0.76) for the two groups (group I = 9.12 +/
      5.27; group II = 8.67 +/- 5.02). The average number of embryos available per
      transfer of group I (6.14 +/- 4.02) did not differ (P = 0.69) from that of group
      II (5.75 +/- 3.83). The number of embryos transferred was similar (P = 0.61) for
      the two groups (group I = 2.76 +/- 0.9; group II = 2.87 +/- 0.79). The thickness
      of the zona pellucida of group I embryos (16.6 +/- 2.2 microns) did not differ (P
      = 0.08) from that of group II embryos (17.1 +/- 1.7 microns). The rate of embryo
      implantation (20.8%) and the rate of clinical pregnancy per embryo transfer
      (40.3%) were higher for group II than for group I (17.7% and 33.3%,
      respectively), but the difference was not significant (P = 0.55 and P = 0.54).
      CONCLUSIONS: These results suggest that ZT in the population aged < or = 37 years
      and with no previous failure of implantation may have no impact on
      intracytoplasmic sperm injection success rates.

PMID- 11212861
TI  - [GM2-activator protein and vesicular transport in the connecting cells of kidney
      collecting tubules].

PMID- 11212862
TI  - [In memoriam Professor Dr. Hans Gunter Goslar, 1918-2000].

PMID- 11212863
TI  - Expression of neural cell adhesion molecule in spinal cords following a complete
      transection.
AB  - Neural cell adhesion molecule (NCAM) regulates tissue organization during
      development and in the adult. NCAM upregulation occurs after an injury to brains
      and sciatic nerves. However, little is known about NCAM expression after spinal
      cord injury (SCI). By using a complete spinal cord transection with a 5 mm tissue
      removal, an increase in the NCAM level is detected in spinal cord stumps proximal
      and distal to the transection site at 1 d and 3 d post injury, while its
      expression at 8 d is declined to a lower level than that observed in sham
      operated spinal cords. The strong NCAM expression is present in motor neurons at
      3 d post transection whereas the intensive NCAM immunostaining is localized in
      dorsal sensory and corticospinal fiber tracts at 8 d following injury.
      Collectively, NCAM level is elevated and strongly expressed in dorsal fiber
      tracts after SCI, implying that the endogenous process for spinal cord
      regeneration may take place after SCI.

PMID- 11212865
TI  - Intracerebroventricular injection of streptozotocin in rats produces both
      oxidative stress in the brain and cognitive impairment.
AB  - Recent reports suggest the involvement of free radicals in the pathophysiology of
      Alzheimer's disease [AD]. Streptozotocin [STZ] injection in the brain is known to
      cause cognitive impairment in rats and is likened to sporadic AD in humans.
      Though STZ is known to cause impairment in glucose and energy metabolism, it is
      not known whether this is associated with free radical generation. The present
      study was designed to investigate if the changes in learning and memory by
      intracerebroventricular administration of STZ are associated with changes in the
      markers of oxidative stress. Adult male Wistar rats [330-340 g] were injected
      with intracerebroventricular STZ [3 mg/kg] bilaterally stereotaxically under
      ketamine anesthesia [70 mg/kg]. The rats were treated with STZ twice, on day 1
      and on day 3. The learning and memory behavior was analyzed using passive
      avoidance paradigms, elevated plus maze and the closed field activity test while
      the parameters of oxidative stress assessed were malondialdehyde [MDA] and
      glutathione. The behavioral tests were performed on day 17, 18 and 19. The rats
      developed significant deficits in learning, memory and cognitive behavior,
      indicated by deficits in passive avoidance paradigm and elevated plus maze as
      compared to sham rats. On day 21, the rats were sacrificed under ether anesthesia
      and the brains were analyzed for biochemical studies. There was a development of
      oxidative stress in the brain as indicated by significant elevations in
      malondialdehyde [MDA] levels and decreased levels of glutathione. The study
      demonstrates that intracerebroventricular STZ may be appropriate model for
      investigations of antioxidants as potential treatment in Alzheimer's dementia.

PMID- 11212864
TI  - Role of endogenous opioid peptides in protection of ischemic preconditioning in
      rat small intestine.
AB  - This study investigated the protective effects of ischemic preconditioning on
      intestinal ischemic injury and the role of endogenous opioid peptides (EOP) in
      these effects. Ischemia-reperfusion (I/R) induced by 30-min of ischemia and 60
      min of reperfusion significantly increased the levels of malondialdehyde (MDA)
      and lactate dehydrogenase (LDH) and resulted in serious intestinal edema (wet
      weight/dry weight). The ischemic preconditioning (PC) elicited by three 8-min
      occlusion periods interspersed with 10-min reperfusion markedly attenuated
      intestinal injury caused by ischemia-reperfusion. Pretreatment with morphine (300
      microg x kg(-1), i.v.) 10-min before ischemia and reperfusion mimicked the
      protection produced by PC. Naloxone (3 mg x kg(-1), i.v.) abolished the
      protection of morphine-induced preconditioning and ischemic preconditioning in
      rat intestine. However, there were no changes between naloxone alone and control
      groups. Treatment with naloxone before ischemia-reperfusion had no effect on
      animals compared with the I/R group. In addition, we also measured the content of
      endogenous opioid peptides (Leu-enkephalin) in the effluent which was collected
      before and during preconditioning. It was shown that the release of leu
      enkephalin was markedly increased during preconditioning. These results suggested
      that EOP might play an important role in PC in rat small intestine.

PMID- 11212867
TI  - Increase in hypoxanthine-guanine phosphoribosyl transferase gene mutations by
      exposure to electric field.
AB  - Previously, we reported that exposure to extremely low frequency magnetic field
      (400 mT) increased in hypoxanthine-guanine phosphoribosyl transferase (HPRT) gene
      mutations. However, it is unclear these mutations were induced by magnetic field
      (MF), electric field (EF), or both. To explore this question, a new exposure
      apparatus for EF was manufactured. We observed an increase in HPRT gene mutations
      in Chinese hamster ovary (CHO) cells after exposure to EF (10 V/m, 60 Hz) for 10
      h. The mutant frequency by EF-exposure was an approximate 2-fold of that by sham
      exposure. Our data suggest that the mutations induced by exposure of cells to the
      variable magnetic field at 400 mT may be, in part, due to the induced EF.

PMID- 11212866
TI  - The localization of dopamine D2 receptor mRNA in the human placenta and the anti
      angiogenic effect of apomorphine in the chorioallantoic membrane.
AB  - While there are some reports indicating that dopamine (DA) and D2-like receptors
      (Rc) are detected in human placenta, there is little evidence available regarding
      the function of DA or the precise localization of its receptors in this organ. In
      the present study, we confirmed the placental expression of DA D2 Rc transcripts
      by Northern blot analysis. Using in situ hybridization, we also first revealed
      that DA D2 Rc mRNA was expressed in cytotrophoblasts, syncytial trophoblasts,
      vascular endothelial cells, Hafbauer cells, and fibroblasts in the chorionic
      villi of the human placenta. The expression sites of DA D2 Rc mRNA led us to
      suspect other functions of DA in the placenta besides the regulation of human
      placental lactogen. Since the cells expressing DA D2 Rc mRNA are related to
      proliferation and remodeling of placental tissue, we tried to evaluate a possible
      involvement of DA in the regulation of placental angiogenesis. To this end, we
      used the chicken chorioallantoic membrane (CAM) assay. In CAM assay, apomorphine,
      a potent nonselective agonist of DA, has an anti-angiogenic effect. These results
      suggest that DA may regulate the vascularization of human placenta through its
      receptors present in the chorionic villi.

PMID- 11212868
TI  - Effect of ovarian hormones on intestinal mast cell reactivity to substance P.
AB  - Evidence exists to support the concept that ovarian hormones influence mast cell
      functioning and related events. Here, we evaluated the constitutive gender
      difference and the influence of ovarian status on rat mast cell (MC) distribution
      in jejunum and colon, histamine synthesis and/or its release elicited by
      Substance P (SP). Higher mast cell (MC) number and histamine release were found
      in female compared with male. In female rats, hormonal status did not affect the
      density of resident MC neither in the jejunum nor in the colon. Interestingly,
      histamine levels released after SP stimulation of jejunal segment was reduced in
      ovariectomized (OVX) compared with sham OVX rats, and restored in OVX female
      receiving progesterone. In the colon, OVX resulted in a significant increase in
      histamine levels released after SP stimulation and a treatment with progesterone
      did not restore basal histamine levels. Thus, ovarian steroid hormones do not
      affect jejunal and colonic mast cell number. However, the hormonal status
      differently influences jejunal and colonic MC sensitivity to SP.

PMID- 11212869
TI  - Vasomotion in rat mesentery during hemorrhagic hypotension.
AB  - Although vasomotion has been considered a feature of the microvascular bed under
      physiological conditions, it has also been observed following hypotension in
      several tissues. In this work, 158 mesenteric microvessels of 36 rats were
      investigated quantitatively in normovolemic and hemorrhaged animals, focussing on
      diameter changes, particularly vasomotion incidence and characteristics. The
      femoral arteries of Wistar rats (body weight BW = 188 +/- 23 g, mean +/- SD)
      anesthetized with pentobarbital were cannulated for arterial pressure (AP)
      monitoring and blood withdrawal. The protocol consisted of 15 min control and 30
      min of hemorrhagic hypotension (AP = 52 +/- 5 mmHg, hemorrhaged vol. = 17 +/- 4
      ml/kg BW). During control normovolemic conditions, analysis of mesenteric
      microcirculation using intravital videomicroscopy revealed neither arteriolar nor
      venular vasomotion. During hemorrhagic hypotension (HH) microvascular blood flow
      reduced to 25% of control. While venules did not show diameter changes during HH,
      arterioles contracted to 85 +/- 20% of control and arteriolar vasomotion appeared
      in 42% of the animals and 27% of the arterioles. The amplitude of arteriolar
      diameter change during HH relative to mean diameter and to control diameter
      averaged 65 +/- 24% (range: 32-129%) and 41 +/- 10% (range: 25-62%),
      respectively. Vasomotion analysis showed two major frequency components: 1.7 +/-
      0.8 and 7.0 +/- 5.2 cycles/min. Arterioles showing vasomotion had a mean control
      diameter larger than the remaining arterioles and showed the largest constriction
      during HH. We conclude that hemorrhagic hypotension does not change venular
      diameter but induces arteriolar constriction and vasomotion in rat mesentery.
      This activity is expressed as slow waves with high amplitude and fast waves with
      low amplitude, and is dependent on vessel size.

PMID- 11212870
TI  - Regulation of bronchoalveolar lavage fluids cell function by the immunomodulatory
      agents from Cordyceps sinensis.
AB  - Cordyceps sinensis (C. sinensis) is one of the well known fungi used in
      traditional Chinese medicine for treatment asthma and bronchial and lung
      inflammation. In this study, effects of C. sinensis methanolic extracts on
      bronchoalveolar lavage fluids (BALF) cells proliferation, inflammatory cytokines
      production, and genes expression were evaluated. The proliferative response of
      BALF cells to lipopolysaccharide (LPS) was determined by the tritiated thymidine
      uptake method. The cell-free supernatants were harvested then tested for
      interlukin-1beta (IL-1beta), interlukin-6 (IL-6), tumor necrosis factor-alpha
      (TNF-alpha), interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-12 (IL
      12), and interferon-gamma (IFN-gamma) by the enzyme immunoassay. The results
      indicated that the CS-19-22 fraction dose dependently suppressed BALF cells
      proliferation activated by LPS. The CS-19-22 fraction also reduced IL-1beta, IL
      6, IL-8, IL-10 and TNF-alpha production in LPS activated BALF cell cultures.
      Furthermore, the IL-12 and IFN-gamma production in activated BALF cells were
      enhanced by CS-19-22 treatment. The CS-19-22 fraction did not affect IL-1beta, IL
      6, TNF-alpha, and IL-8 mRNAs expression in BALF cells detected by reverse
      transcription-polymerase chain reaction (RT-PCR). By contrast, the CS-19-22
      fraction increased IL-12 and IFN-gamma mRNAs expression and decreased IL-10 mRNA
      expression in the BALF cells activated with LPS. These results indicated the CS
      19-22 fraction suppressed IL-1beta, IL-6, TNF-alpha, and IL-8 cytokines
      production in BALF cells through other than inhibition of mRNAs expression
      pathway. These results also demonstrate that the therapeutic activity of C.
      sinensis in Chinese medicine may be related to modulation of TH1 and TH2 cells
      functions in bronchial airway.

PMID- 11212871
TI  - The effect of ketamine hydrochloride anesthesia on basal and N-methyl-D,L
      aspartate induced plasma prolactin secretion in the adult male rhesus monkey.
AB  - The excitatory amino acids (EAAs), glutamate and aspartate, acting predominantly
      on N-methyl-D-aspartate (NMDA) receptor, have been shown to be involved in the
      central regulation of the secretion of several anterior pituitary hormones
      including prolactin (PRL), whereas ketamine hydrochloride (KH), a widely used
      anesthetic, has been reported to antagonize a variety of NMDA receptor mediated
      actions of these EAAs. In the present study, the effect of KH on basal PRL levels
      as well as on N-methyl-D,L-aspartate (NMA), an agonist of NMDA receptor, induced
      plasma PRL secretion was investigated in the adult male rhesus monkey. The values
      were compared to those obtained from the same animals restrained in primate
      chairs. The plasma PRL concentrations were higher in animals receiving KH
      administered either intramuscularly (2.5 mg/kg BW at 30 min intervals) or
      intravenously (10 mg/kg BW) as compared to those observed in the unanesthetized
      chair-restrained monkeys. NMA induced an unequivocal increase in plasma PRL
      concentrations in both conscious chair-restrained and KH anesthetized monkeys,
      but the response was greater in anesthetized animals than the conscious monkeys.
      The present findings suggest that KH has stimulatory effects on both basal and
      NMA induced plasma PRL secretion.

PMID- 11212872
TI  - Significance of glutamate and dopamine neurons in the ventral pallidum in the
      expression of behavioral sensitization to amphetamine.
AB  - To explore the significance of ventral pallidum (VP) during the amphetamine
      sensitization, we first investigated if there are neurochemical alterations in
      the VP during amphetamine withdrawal period. Chronic amphetamine-treated (5 mg/kg
      x 14 days) rats displayed an apparent locomotion sensitization as compared with
      saline controls when challenged with 2 mg/kg amphetamine at withdrawal days 10
      14. A microdialysis analysis revealed that output of the dopamine metabolites,
      3,4-dihydroxyphenylacetic acid and homovanillic acid, in the VP of amphetamine
      sensitized rats increased approximately two-fold as compared to controls at both
      pre- and post-amphetamine challenge period. On the other hand, the in vivo
      glutamate output in the VP increased upon amphetamine challenge in the
      behaviorally sensitized rats, but not in the controls. To evaluate if drug
      manipulation in the VP would affect the behavioral sensitization, we treated both
      groups of rats with NMDA receptor antagonist, MK-801 (5 microg/microl for 5 days;
      bilateral) in the VP during withdrawal days 6-10. Animals were challenged with 2
      mg/kg amphetamine at withdrawal day 11. The behavioral profile exhibited that MK
      801 pre-treatment significantly blocked the locomotion hyperactivity in
      amphetamine-sensitized rats. Taken together, the current results suggest that the
      excitatory amino acid in the VP plays a significant role during the expression of
      behavioral sensitization to amphetamine.

PMID- 11212873
TI  - Viral neuroinvasion as a marker for BBB integrity following exposure to
      cholinesterase inhibitors.
AB  - Exposure to the nerve agent soman, an irreversible cholinesterase (ChE)
      inhibitor, results in changes in blood-brain barrier permeability attributed to
      its seizure-induced activity. However, smaller BBB changes may be independent of
      convulsions. Such minor injury may escape detection. A nonneuroinvasive
      neurovirulent Sindbis virus strain (SVN) was used as a marker for BBB
      permeability. Peripheral inoculation of mice with 2 x 10(3) plaque forming units
      (PFU) caused up to 10(5) PFU/ml viremia after 24 hours with no signs of central
      nervous system (CNS) infection and with no virus detected in brain tissue. Intra
      cerebral injection of as low as 1-5 PFU of the same virus caused CNS infection,
      exhibited 5-7 days later as hind limb paralysis and death. Soman (0.1-0.7 of the
      LD50) was administered at peak viremia (1 day following peripheral inoculation).
      Sublethal soman exposure at as low as 0.1 LD50 resulted in CNS infection 6-8 days
      following inoculation in 30-40% of the mice. High virus titer were recorded in
      brain tissue of sick mice while no virus was detected in healthy mice subjected
      to the same treatment. No changes in the level of viremia or changes in viral
      traits were observed in the infected mice. The reversible anticholinesterases
      physostigmine (0.2 mg/kg, s.c.) and pyridostigmine (0.4 mg/kg, i.m.) injected at
      a dose equal to 0.1 LD50, induced similar results. Thus, both central and
      peripheral anticholinesterases (anti-ChEs) induce changes in BBB permeability
      sufficient to allow, at least in some of the mice, the invasion of this otherwise
      noninvasive but highly neurovirulent virus. This BBB change is probably due to
      the presence of cholinesterases in the capillary wall. SVN brain invasion served
      here as a highly sensitive and reliable marker for BBB integrity.

PMID- 11212874
TI  - Generation of polyclonal antiserum against the growth hormone secretagogue
      receptor (GHS-R): evidence that the GHS-R exists in the hypothalamus, pituitary
      and stomach of rats.
AB  - Growth hormone (GH) secretagogues (GHSs), which stimulate GH secretion, are
      synthetic compounds that act through the GHS receptor (GHS-R) which has been
      recently cloned. We raised an antiserum in a rabbit against a synthetic peptide
      corresponding to amino acid residues 248-260 of the third intracellular loop of
      the rat GHS-R. A competitive immunoassay showed that the antiserum had a specific
      affinity for the target peptide. To confirm the specificity of the antiserum, the
      GHS-R cDNA was stably expressed in COS-7 cells. In Western blot analysis, the
      band was detected at 44 kDa in the extracts from COS-7 cells expressing GHS-R
      (COS-7/tf3-2) but not in those from wild-type COS-7 cells. Furthermore, while COS
      7/tf3-2 cells were strongly immunostained for GHS-R, no GHS-R-like
      immunoreactivity was observed in wild-type COS-7 cells. Immunoreactive bands were
      also observed at approximately 46 kDa in the extracts from rat hypothalamus,
      pituitary and stomach by Western blot analysis. These studies are the first to
      show the existence of GHS-R protein in the stomach. The antiserum for the GHS-R
      is sensitive and specific, and it would be useful for clarifying the roles of
      GHS/ghrelin.

PMID- 11212875
TI  - Linoleamide, a brain lipid that induces sleep, increases cytosolic Ca2+ levels in
      MDCK renal tubular cells.
AB  - Linoleamide is an endogenous lipid that has been shown to induce sleep in cats,
      rats and humans. However, its physiological function remains unclear. In this
      study the effect of linoleamide on cytosolic free Ca2+ concentrations ([Ca2+]i)
      in Madin Darby canine kidney (MDCK) tubular cells was examined, by using fura-2
      as a Ca2+ probe. In a concentration-dependent manner, linoleamide induced
      increases in [Ca2+]i between 10-500 microM with an EC50 of 20 microM. The signal
      comprised a slow rise and a persistent phase, and was a result of internal Ca2+
      release and external Ca2+ influx because it was partly inhibited by external Ca2+
      removal. In Ca2+-free medium, depletion of the endoplasmic reticulum Ca2+ store
      with 1 microM thapsigargin abolished 100 microM linoleamide-induced internal Ca2+
      release, and conversely, pretreatment with linoleamide prevented thapsigargin
      from releasing internal Ca2+. This demonstrates that the internal source of
      linoleamide-induced [Ca2+]i increase is located in the endoplasmic reticulum.
      This discharge of internal Ca2+ caused capacitative Ca2+ entry because after
      incubation with 100 microM linoleamide in Ca2+-free medium for 8 min readmission
      of 3 mM CaCl2 induced increases in [Ca2+]i. After the formation of inositol-1,4,5
      trisphosphate (IP3) was blocked by the phospholipase C inhibitor U73122 (1
      microM), linoleamide still induced an increase in [Ca2+]i but the shape of the
      increase was altered. Similar results were found for another sleep-inducing lipid
      9,10-octadecenoamide. Together, the present study shows that the endogenous sleep
      inducing lipid linoleamide was able to cause significant increases in [Ca2+]i in
      renal tubular cells, by releasing the endoplasmic reticulum Ca2+ store and
      triggering capacitative Ca2+ entry in a manner independent of IP3.

PMID- 11212876
TI  - Hyperthermia in oncology.
AB  - The purpose of this article is to provide an overview on the current clinical
      application of hyperthermia combined with conventional treatment modalities (e.g.
      ionizing radiation, chemotherapy) in the treatment of malignant disease. The
      clinical application of hyperthermia with increase of tissue temperatures (range
      40-44 degrees C) has been integrated in multimodal anti-cancer strategies. This
      review describes selected phase I or II (n = 17) and phase III trials (n = 16)
      investigating the effect of hyperthermia combined with radiotherapy (n = 10
      trials), chemotherapy (n = 15 trials), or both (n = 8 trials) in a total of more
      than 2200 patients. The trials were performed in a variety of solid tumours (e.g.
      melanoma, head and neck cancer, breast cancer, cancer of the gastrointestinal or
      urogenital tract, glioblastoma, sarcoma) in paediatric or adult patients.
      Profound research has produced a scientific basis for the simultaneous
      application of hyperthermia in combination with ionizing radiation and/or
      systemic chemotherapy. Hyperthermia is becoming more accepted clinically, due to
      the substantial technical improvements made in achieving selected increase of
      temperatures in superficial and deep-seated tumours. At present, the combination
      of hyperthermia and chemotherapy or radiochemotherapy is further tested within
      clinical protocols (phase II/III) in order to improve local tumour control and
      relapse-free survival in patients with high-risk or advanced tumours of different
      entities.

PMID- 11212877
TI  - Whole-body hyperthermia with water-filtered infrared radiation: technical
      physical aspects and clinical experiences.
AB  - Among the different methods of whole-body hyperthermia (WBH), the energy transfer
      with infrared radiation seems to have established itself as a relatively simple
      procedure. The infrared systems differ with regard to the used spectrum of
      radiation. In the case of water-filtered infrared radiation, infrared A (760-1400
      nm) is the focal point of heat radiation. This radiation penetrates deep into the
      skin up to the capillary area of the corium. Eighty treatments of patients in an
      advanced stage of cancer (40 male, 40 female, April 1998-April 1999) were
      performed with a WBH device with water-filtered infrared radiation, IRATHERM
      2000. Extreme WBH was combined with induced hyperglycaemia and relative
      hyperoxaemia, and for 83% of the patients with chemotherapy as well. The body
      core temperature was measured rectally (85%) or vesically. The objectives of the
      thermal control were a low rate of side-effects and a quick rise of the body-core
      temperature with regard to the condition of the patient's skin. The mean duration
      of the rising phase (37.5-41.5 degrees C) was 87 +/- 19 min. A correlation
      between lamp power and rising time (r = 0.08) was not found. Moreover, no
      correlation could be found between the appearance of thermal lesions > or = WHO
      2nd degree and the lamp power. Thermal lesions according to WHO 1st, 2nd and 3rd
      degrees appeared in the case of 20, 15 and one treatment, respectively. Their
      area amounted in 2nd-degree cases to 0.08% of the body surface, on average. The
      highest mean temperature over 60 min (T60) was 42.1 +/- 0.1 degrees C, and the
      mean of maximum temperature (Tmax) was 42.3 +/- 0.1 degrees C. The mean thermal
      isoeffect dose EM43 was 35.8 +/- 6.3 min. WBH with water-filtered infrared
      radiation in combination with induced hyperglycaemia and relative hyperoxaemia
      (procedure of systemic Cancer Multistep Therapy) is a safe and practicable
      procedure with good tolerability in the case of experienced application. It
      permits a rapid rise of body-core temperature and a high thermal constancy in the
      plateau phase. An all-around access to the patient is possible in all therapy
      phases.

PMID- 11212878
TI  - Feasibility and patient tolerance of a novel transrectal ultrasound hyperthermia
      system for treatment of prostate cancer.
AB  - This report describes patient tolerance and toxicity of a transrectal ultrasound
      hyperthermia system used with external beam radiation therapy in treatment of
      locally advanced prostate cancer. Nine patients with clinical T2B-T3B (4th
      edition AJCC criteria) disease received external beam radiation therapy, with two
      hyperthermia treatments scheduled at least 1 week apart during the first 4 weeks
      of radiation. Five patients also received hormonal therapy. Interstitial and
      anterior rectal wall thermometry were performed. Median temperature for each
      treatment (T50) was 40.8 degrees C and mean CEM T90 = 43 degrees C was 3.4 min.
      Rectal wall temperature was maintained at < or = 40 degrees C. Treatment duration
      was limited in three of 17 sessions due to positional discomfort which was
      alleviated with light IV sedation and use of a 'New Life' mattress (Comfortex,
      Inc. Winoba, MN, USA). Acute toxicity was limited to NCI common toxicity criteria
      grade 1 and no excess toxicity was noted with full course radiation therapy +/-
      hormonal therapy. These findings are consistent with those reported in a previous
      phase I trial assessing this device. Given the favourable toxicity profile
      demonstrated to date, modification of treatment parameters for this ongoing phase
      II study have been instituted that should further the efficacy of transrectal
      ultrasound hyperthermia for treatment of prostate cancer.

PMID- 11212879
TI  - Adenoviral p53 gene therapy promotes heat-induced apoptosis in a nasopharyngeal
      carcinoma cell line.
AB  - BACKGROUND: It has previously been demonstrated that Ad5CMV-p53 gene transfer,
      either used alone or delivered concomitantly with ionizing radiation, resulted in
      cytotoxicity mediated by apoptosis in nasopharyngeal carcinoma (NPC) cell lines.
      In this study, a novel approach was evaluated of combining Ad5CMV-p53 gene
      therapy with hyperthermia (HT), in the CNE-1 NPC cell line, which harbours a
      mutation in codon 249 of the p53 gene. MATERIALS AND METHODS: CNE-1 cells were
      infected using either Ad5CMV-p53 or Ad5CMV-B-gal, followed, 24 h later, by HT (43
      degrees C x 0-2 h). Protein was extracted for Western blot analysis, and
      apoptosis was evaluated using acridine-orange ethidium bromide staining, followed
      immediately by fluorescent microscopy examination for the proportion of cells
      displaying morphologic features of apoptosis. RESULTS: Ad5CMV-p53 gene therapy
      combined with HT resulted in a dose-dependent cytotoxicity with less than 1%
      clonogenic survival when 10 pfu/cell of Ad5CMV-p53 was combined with 2 h heating
      at 43 degrees C. Western blotting demonstrated that treatment with Ad5CMV-p53
      resulted in the rapid expression of p53, which was minimally affected by HT. The
      inducible form of hsp70 was maximally expressed at 48 h post-HT, with minimal
      effect when cells were additionally treated with Ad5CMV-p53. Clonogenic
      cytotoxicity was associated with the development of apoptosis, with up to 70% of
      CNE-1 cells displaying morphologic features of apoptosis after the combination
      treatments. CONCLUSION: Based on the shapes of the clonogenic survival curves,
      Ad5CMV-p53 gene therapy and HT appear to interact in an additive manner,
      suggesting the therapeutic potential of this combined treatment approach for
      patients with NPC.

PMID- 11212880
TI  - Dosimetry and techniques for simultaneous hyperthermia and external beam
      radiation therapy.
AB  - An increased biological effect is realized when hyperthermia and radiation
      therapy are combined simultaneously. To take advantage of this effect, techniques
      have been developed that combine existing hyperthermia devices with a linear
      accelerator. This allows concomitant delivery of either ultrasound or microwave
      hyperthermia with photon radiation therapy. Two techniques have been used
      clinically: the orthogonal technique, in which the microwave or ultrasound beam
      and the radiation beam are orthogonal to one another, and the en face technique,
      in which the ultrasound or microwave beam and the radiation beam travel into the
      tumour through the same treatment window. The en face technique has necessitated
      the development of special attachments so that the hyperthermia device can be
      mounted to the linear accelerator and so that non-uniform portions of the
      hyperthermia device can be removed from the radiation beam. For microwave
      therapy, applicators are mounted onto the linear accelerator using the
      compensating filter tray holder. For ultrasound, special reflector devices are
      mounted to a frame that is mounted onto the compensating filter tray holder of
      the linear accelerator. Because the linear accelerator is an isocentric device,
      the height of the radiation source is fixed, and this has necessitated specially
      designed devices so that the ultrasound support system is compatible with the
      linear accelerator. The treatment setups for both the en face technique and the
      orthogonal technique require the interaction of both hyperthermia and radiation
      therapy personnel and equipment. The dosimetry and day-to-day operations for each
      technique are unique. The simulation for the en face technique is much different
      from the simulation of a normal radiation treatment and requires the presence of
      a hyperthermia physicist. Also, for the en face technique, the attenuation of the
      microwave applicator and the thickness and attenuation of the ultrasound
      reflector system are taken into account for radiation dosimetry. This paper
      presents details of the dosimetry and logistics of the techniques for
      simultaneous thermoradiotherapy based on 7 years of experience treating more than
      50 patients.

PMID- 11212881
TI  - RF hyperthermia array modelling; validation by means of measured EM-field
      distributions.
AB  - The accuracy of a hyperthermia treatment simulation determines its role in
      prospective treatment planning and dosimetry for the individual patient. Of
      importance are (1) the accuracy of the numerical simulation method, and (2) the
      numerical description of the hyperthermia treatment system. The accuracy of the
      numerical method is generally determined by analysis of a problem that is
      analytically solvable. The validity of the description of the hyperthermia system
      is to be investigated by comparison of the simulated and measured EM-field
      amplitude and phase of the clinical operational hyperthermia system. In this
      paper, the numerical description of the AMC-4 waveguide phased array for which
      treatment planning is performed by the Weak Form of the Conjugate Gradient FFT
      method is investigated. The accuracy of the description is analysed for four set
      ups, varying the bolus size and the number of waveguides attached to a phantom.
      The comparison of experimental and numerical data has demonstrated the ability of
      the Weak Formulation of the Conjugate Gradient FFT method to predict the EM-field
      of the AMC-4 waveguide array hyperthermia system, including effects due to bolus
      size variations. However, based on the comparison of the measured EM-field
      distributions and those obtained from simulations, the accuracy of the planning
      system is found to be insufficient for quantitative SAR dosimetry for individual
      patients. Qualitative SAR dosimetry can be applied in cases where the accuracy is
      of minor importance, e.g. for the retrospective analysis of problematic
      hyperthermia treatments. Prospective applications of the treatment planning
      system include the (qualitative) determination/simulation of a set of starting
      points giving a 'close to optimal' amplitude and phase setting, the prediction of
      possible problem areas and the analysis of the performance of new/improved
      hyperthermia devices.

PMID- 11212882
TI  - Theoretical comparison of the SAR distributions from arrays of modified current
      sheet applicators with that of lucite cone applicators using Gaussian beam
      modelling.
AB  - The technical comparison of Current Sheet Applicator (CSA) and Lucite Cone
      Applicator (LCA) arrays covering an area of approximately 20 x 20 cm2 is
      investigated based on Gaussian beam (GB) predicted SAR distributions. The
      comparison is made in muscle equivalent tissue at 1 cm depth (maximum SAR
      normalized to 100%) and over a volume of 3 cm depth under the aperture of the
      antennae. The planar SAR distribution is tested on field sizes (FSx: area
      covering x% SAR), penetration depth (PD) and homogeneity coefficient (HC =
      FS75/FS25). From the SAR volume, a SAR-Volume histogram (volume enclosing y%
      SAR/total volume) is calculated as well as the volumetric HC. First, the
      prototype CSA (aperture 58 x 67 mm2, FS50 = 21 cm2) is technically modified to
      assure clinical safety and load independence. The modified CSA, the D-CSA, has an
      aperture of 66 x 75 mm2 with an FS50 = 28 cm2 and a PD of 10 mm, the LCA
      (aperture 105 x 105 mm2) has an FS50 = 76 cm2 and PD = 12 mm. The HC equals 0.21
      (D-CSA), respectively 0.22 (LCA). Secondly, a 3 x 3 D-CSA array is compared with
      a 2 x 2 LCA array. The FS50s equals 72% (D-CSA), respectively 75% (LCA). The SAR
      volume histograms, planar and volumetric HC show no significant difference;
      however, the planar HCs for D-CSA and LCA increase from 0.2-0.3, indicating that
      incoherently powered arrays from these antennae build SAR distributions
      constructively.

PMID- 11212883
TI  - Demystified...adhesion molecule deficiencies.
AB  - The basic physiology of leucocyte emigration from the intravascular space into
      the tissues is now known to be dependent on a class of cell surface molecules
      that have come to be known as adhesion molecules. Many cell-cell interactions are
      dependent on adhesion and signal transduction via the various adhesion molecules,
      particularly the integrins. The study of the functions of these molecules has
      been enhanced by the development of blocking and activating monoclonal
      antibodies, knockout mice, and by the rare "experiments of nature" in the human
      population, in whom there is absence or dysfunction of one of the adhesion
      molecules. This review describes these leucocyte adhesion defects and discusses
      how they have provided important insights into the function of these molecules.

PMID- 11212884
TI  - Correlation between apoptosis microarray gene expression profiling and
      histopathological lymph node lesions.
AB  - AIMS: Microarray technology has recently led to the identification of molecular
      prognostic subgroups in non-Hodgkin's lymphomas. To determine the usefulness of
      ready made macroarrays as routine diagnostic tools in haematopathology, lymph
      node biopsies were analysed using a cDNA macroarray containing genes involved in
      apoptosis, including caspases. METHODS: Nine biopsy specimens were analysed using
      total frozen tissues: four samples of B cell follicular lymphoma, two of B cell
      diffuse large cell lymphoma, and three of non-neoplastic lymph nodes from benign
      lymphadenitis. Nine cell populations were sorted from fresh tissues: malignant B
      cells from two patients with follicular lymphoma and two with diffuse large cell
      lymphoma, reactive B cells from two benign lymph nodes, reactive T cells from one
      benign lymph node, and virgin (mantle zone) B cells and germinal centre B cells
      from benign tonsils. Immunohistochemistry (IHC) on paraffin wax sections was
      performed for the localisation of caspases 2, 3, 4, 7, 8, and 9. RESULTS: In the
      clustered array data, sorted cells from samples sharing common histological
      lesions were grouped together, whereas the array/histology correlation was less
      satisfactory for tissues. The expression profiles of both the array and IHC
      methods correlated for most caspases and samples. CONCLUSIONS: Variations in
      array profiles of sorted cell populations can be associated with specific
      histological features, suggesting a possible diagnostic application of ready made
      apoptosis macroarrays in haematopathology.

PMID- 11212885
TI  - Rapid real time PCR to distinguish between high risk human papillomavirus types
      16 and 18.
AB  - AIMS: To assess the validity and practicality of real time polymerase chain
      reaction (PCR) for human papillomavirus (HPV) testing in combination with liquid
      based cytology samples for cervical screening. METHODS: Real time PCR using
      consensus (GPS+/6+) and type specific primers was developed to detect genital HPV
      types. This provides rapid, efficient amplification followed by denaturation of
      the product and computer analysis of the kinetics data that are generated. Liquid
      based cytology samples were obtained from patients attending routine cervical
      screening clinics. DNA was extracted from the residual cellular suspension after
      cytology using spin columns. RESULTS: Real time PCR successfully distinguished
      between HPV-16 and HPV-18 on the basis of amplification with consensus primers
      followed by DNA melting temperature (Tm) analysis. Sensitivities of one to 10
      copies of HPV-16 (mean Tm = 79.4 degrees C; 2 SD, 0.8) and four to 40 copies of
      HPV-18 (mean Tm = 80.4 degrees C; 2 SD, 0.4) were obtained. In a mixed population
      of SiHa and HeLa cells containing known copy numbers of HPV-16 and HPV-18
      genomes, HPV-16 and HPV-18 products were clearly separated by Tm analysis in
      mixtures varying from equivalence to 111000. Together with detailed melt
      analysis, type specific primers from the same region of the L1 gene confirmed the
      differential ability of this system. The method was applied to 100 liquid based
      cytology samples where HPV status using conventional GP5+/6+ PCR was already
      known. There was 95% agreement between the methods, with 55 positives detected by
      conventional PCR and 59 with real time PCR. The method was then tested on 200
      routine liquid based cytology samples. Approximately 10% were positive by real
      time PCR, most of which were classified as HPV-16 by detailed melt analysis.
      Thirteen (6.8%) HPV positives were identified in 189 samples showing no evidence
      of cervical cytological abnormality. CONCLUSIONS: Real time PCR is a rapid,
      efficient method for the detection of HPV with the separation of HPV-16 and HPV
      18 on the basis of differential Tm. Preliminary results suggest it could prove

PMID- 11212886
TI  - Insulin-like growth factors I and II induce cell death in Wilms's tumour cells.
AB  - AIM: To study the effects of insulin-like growth factors (IGFs) on the growth
      phenotype of a Wilms's tumour cell line (WCCS-1). METHODS: WCCS-1 cells were
      cultured in vitro and exposed to IGF-I and IGF-II, as well as their antagonists,
      IGF binding protein 2 and the type I receptor blocking antibody IGF-IRalpha. The
      effects on proliferation and cell cycle parameters were assayed by assessing cell
      numbers, autoradiography after labelling with tritiated thymidine, and flow
      cytometry after double staining with fluorescein isothiocyanate (FITC) labelled
      annexin V and propidium iodide. RESULTS: The addition of IGF-I as well as IGF-II
      in physiological doses induced cell death in Wilms's tumour cells. Cell numbers
      decreased most dramatically on the fifth to sixth day after growth factor
      addition. The occurrence of apoptosis as well as necrosis was confirmed by
      annexin-V staining of cell cultures. S-phase indices were comparable,
      irrespective of whether the cells were exposed to IGFs or not, which suggests
      that WCCS-1 cells undergo cell death at random during the cell cycle rather that
      from the prereplicative phase. To exclude any influences of the IGF binding
      proteins (IGFBPs), all results were repeated with Des(1-3)IGF-I, which is unable
      to bind to any of the IGFBPs. However, this peptide was equally potent in
      inducing cell death. Finally, the addition of IGFBP-2 or the type 1 receptor
      blocking antibody IGF-IRalpha partly abrogated the death inducing effects of IGF
      I and IGF-II. CONCLUSIONS: Insulin like growth factors induce cell death-
      apoptosis as well as necrosis--in cultured Wilms's tumour cells. Furthermore, it
      is proposed that this effect is mediated by the type 1 receptor.

PMID- 11212887
TI  - The University of Halle through the centuries.

PMID- 11212888
TI  - Microarrays under the microscope.
AB  - Microarray technology is a rapidly advancing area, which is gaining popularity in
      many biological disciplines from drug target identification to predictive
      toxicology. Over the past few years, there has been a dramatic increase in the
      number of methods and techniques available for carrying out this form of gene
      expression analysis. The techniques and associated peripherals, such as slide
      types, deposition methods, robotics, and scanning equipment, are undergoing
      constant improvement, helping to drive the technology forward in terms of
      robustness and ease of use. These rapid developments, combined with the number of
      options available and the associated hyperbole, can prove daunting for the new
      user. This review aims to guide the researcher through the various steps of
      conducting microarray experiments, from initial strategy to analysing the data,
      with critical examination of the benefits and disadvantages along the way.

PMID- 11212889
TI  - Meeting report: Dictyostelium 2000: a conference on the cell and developmental
      biology of a social amoeba, Dundee, Scotland, July 30-August 4, 2000.

PMID- 11212890
TI  - Meeting report: XIIIth meeting of the International Society for Evolutionary
      Protistology, Ceske Budejovice, Czech Republic, July 31-August 4, 2000.

PMID- 11212891
TI  - Opinion: long branch attraction and protist phylogeny.

PMID- 11212892
TI  - Bacterial orthologues indicate the malarial plastid gene ycf24 is essential.
AB  - ycf24 is a well conserved gene found in all major groups of bacteria, as well as
      on red algal plastid genomes and the vestigal plastid genome of apicomplexan
      pathogens like the malaria parasite Plasmodium falciparum (ORF470). Some database
      annotations describe Ycf24 as an ABC transporter subunit, but we find the level
      of significance is low. To investigate ycf24's function we disrupted it in the
      cyanobacterium Synechocystis sp., strain PCC6803 which has a multi-copy genome.
      This showed ycf24 is essential, partial loss producing a terminal phenotype of
      chlorosis, reduced cell size, loss of DNA, and a striking arrest in cytokinesis.
      Attempts to disrupt the single copy of ycf24 in E. coli failed to give stable
      transformants. When Ycf24 was over-expressed in E. coli as a soluble fusion
      protein, it localized mostly as a band on either side of the nucleoid and
      nucleoid partitioning was aberrant. We propose the relict plastid organelle of
      apicomplexans retains its capacity for protein synthesis because Ycf24 is
      essential.

PMID- 11212893
TI  - Molecular phylogeny of Besnoitia and the genetic relationships among Besnoitia of
      cattle, wildebeest and goats.
AB  - Knowledge on parasites of the genus Besnoitia is sparse, which are classified in
      the subfamily Toxoplasmatinae of the phylum Apicomplexa. This arrangement
      hypotheses that Besnoitia represents the sister group to species such as
      Toxoplasma gondii and Hammondia hammondi. In order to test this hypothesis,
      phylogenetic analyses of 18S ribosomal DNA (rDNA) from Besnoitia, Hammondia,
      Isospora, Frenkelia, Eimeria, Neospora, Sarcocystis and Toxoplasma were
      performed. The 18S rDNA of Besnoitia besnoiti, Besnoitia jellisoni and Eimeria
      alabamensis were amplified by PCR and sequenced. Phylogenetic analyses by
      parsimony and maximum-likelihood methods showed Besnoitia to be reproducibly the
      sister group to a clade containing Hammondia, Neospora and Toxoplasma.
      Furthermore, Besnoitia of cattle, wildebeest and goats had identical ITS1 rDNA
      sequences, which questions the use of the taxon Besnoitia caprae to describe the
      Besnoitia found in goats.

PMID- 11212894
TI  - Phylogenetic position of Cryothecomonas inferred from nuclear-encoded small
      subunit ribosomal RNA.
AB  - The systematic position of the genus Cryothecomonas has been determined from an
      analysis of the nuclear-encoded small subunit ribosomal RNA gene of
      Cryothecomonas longipes and two strains of Cryothecomonas aestivalis. Our
      phylogenetic trees inferred from maximum likelihood, distance and maximum
      parsimony methods robustly show that the genus Cryothecomonas clusters within the
      phylum Cercozoa, and is related to the sarcomonad flagellate Heteromita globosa.
      Morphological data supporting the taxonomic placement of Cryothecomonas near the
      sarcomonad flagellates has been compiled from the literature. The high number of
      nucleotide substitutions found between two morphologically indistinguishable
      strains of Cryothecomonas aestivalis suggests the possibility of cryptic species
      within Cryothecomonas aestivalis.

PMID- 11212895
TI  - Complete gene map of the plastid genome of the nonphotosynthetic euglenoid
      flagellate Astasia longa.
AB  - Astasia longa is a colourless heterotrophic flagellate closely related to the
      photoautotrophic Euglena gracilis. A circular 73 kb plastid DNA (ptDNA) has been
      isolated from A. longa that is about half the size of the chloroplast DNA of E.
      gracilis (143 kb). We have determined the complete sequence of the ptDNA of A.
      longa and established a complete gene map. All chloroplast genes for
      photosynthesis-related proteins are completely absent from the A. longa plastid
      DNA except for rbcL, the gene for the ribulose-1,5-bisphosphate carboxylase large
      subunit. Identified genes encode components of the plastid transcriptional and
      translational machinery: genes for three subunits of a chloroplast RNA
      polymerase, 20 chloroplast ribosomal protein genes, a gene for a plastid
      elongation factor Tu, 27 plastidic tRNA genes and three tandemly arranged repeats
      of 16S, 23S and 5S rDNA. Transcripts of a number of genes were detected by
      Northern hybridisation. The ribulose-1,5-bisphosphate carboxylase large subunit
      protein has been identified by immunoblotting.

PMID- 11212896
TI  - A problem cannot be solved unless one sees it (F. Schmitz 1883). Lothar geitler
      (1899-1990) and the endosymbionts: revolutionary as a twen, conservative till
      ripe old age.

PMID- 11212897
TI  - Frequent loss of heterozygosity at the 19p13.3 locus without LKB1/STK11 mutations
      in human carcinoma metastases to the brain.
AB  - Inactivating germline mutations of the novel putative tumor-suppressor gene
      LKB1/STK11 at 19p13.3 have been shown to cause Peutz-Jeghers syndrome (PJS), an
      autosomal dominantly inherited disease characterized by a predisposition to
      mucocutaneous pigmentations, as well as various benign and malignant neoplasms.
      To elucidate the role of LKB1/STK11 in the carcinogenesis of primary and
      secondary human brain tumors, a total of 309 tumors were analyzed for loss of
      heterozygosity (LOH) at microsatellite loci D19S886, DI9S878, and D19S565. Low
      LOH rates were observed for glioma (17.3%, n = 139), meningioma (5.3%, n = 57),
      schwannoma (0%, n = 21), pituitary adenoma (18.8%, n = 16), primary CNS lymphoma,
      neuroblastoma, plasmocytoma, medulloblastoma, germinoma, and papilloma of the
      choroid plexus (6.6%, n = 15). In contrast, brain metastases exhibited a mean LOH
      frequency of 42.6% (n = 61), with breast (56.3%) and lung cancer metastases
      (58.3%) being most frequently affected. Genomic DNA sequencing of the complete
      coding region of LKB1/STK11 was performed in all brain metastases exhibiting LOH
      (n = 26); no mutation was revealed, but we did find a germline mutation in a PJS
      patient. Despite high LOH fiequencies at the 19p13.3 locus in carcinoma
      metastases to the brain and occasional mutations reported for certain primary
      carcinomas, there are no mutations in LKB1/STK11. This fact suggests that
      alterations of LKB1/STK11 occur relatively early in tumorigenesis and are rarely
      involved in the development of carcinoma metastases. Based on these findings, the
      genes adjacent to LKB1/STK11 may be relevant for the development of metastases to
      the brain from certain carcinomas.

PMID- 11212898
TI  - Analysis of mdm2 and p53 gene alterations in glioblastomas and its correlation
      with clinical factors.
AB  - Malignant gliomas are the most frequent primary brain tumors. Recent studies
      defined several genetic markers, which might characterize molecular-biological
      subsets of glioblastomas with probably prognostic implications. To elucidate the
      involvement of murine-double-minute (mdm)2 gene amplifications and mutations of
      the tumor suppressor gene p53 in the tumorigenesis of malignant gliomas we
      analyzed a series of 75 glioblastomas. The p53 mutations occur in one-third of
      glioblastomas, mdm2 amplifications were found in 13% of cases. Our analysis
      revealed a hot spot in the p53 gene locus in codon 156, the same point mutation
      was detected in 4 tumor samples. None of the mdm2 amplified tumors had p53
      mutations, supporting the hypothesis, that mdm2 amplifications are alternative
      mechanisms for p53 inactivation. Patients with p53 mutated tumors were
      significantly younger characterized by a mean age of 44 years. Additionally
      association with longer overall survival could be detected for this subgroup of
      patients. In our study, survival estimation revealed a significant correlation of
      mdm2 gene amplification with shorter survival time, and support the hypothesis,
      that mdm2 oncogene activation appears to occur late in tumor progression and may
      be characteristic as negative prognostic marker.

PMID- 11212899
TI  - Cranial nerve root entry zone primary cerebellopontine angle gliomas: a rare and
      poorly recognized subset of extraparenchymal tumors.
AB  - With the exception of patients with neurofibromatosis type II, pediatric
      extraparenchymal cerebellopontine angle (CPA) tumors of any sort are extremely
      rare. Most gliomas encountered in the CPA in either children or adults involve
      the CPA as exophytic extensions of primary brain stem and/or cerebellar tumors.
      We encountered an unusual case of a giant CPA pilocytic astrocytoma arising from
      the proximal trigeminal nerve, completely separate from the brain stem. A nine
      year-old girl with no evidence for any neurocutaneous syndrome, presented with
      headaches, mild obstructive hydrocephalus, trigeminal hypesthesia and a subtle
      peripheral facial paresis. Pre-operative neuroimaging suggested a petroclival
      meningioma. The tumor was completely resected via a right pre-sigmoid, retro
      labyrinthine, subtemporal, transtentorial ('petrosal') approach, using
      intraoperative neurophysiological monitoring, with minimal morbidity. This
      appears to be the first reported case of a pediatric primary CPA glioma and the
      seventh reported case of primary CPA glioma, overall. It represents the second
      reported case of a primary CPA pilocytic astrocytoma. Given the findings in this
      case and the six other cases of primary CPA gliomas reported in the literature,
      as well as the results of histological studies of normal cranial nerves, we
      hypothesize that the point of origin of these rare and unusual tumors is the root
      entry zone of the involved cranial nerves. The differential diagnosis of primary
      CPA tumors should be expanded to include cranial nerve root entry zone primary
      CPA gliomas.

PMID- 11212900
TI  - A phase II study of nimustine hydrochloride, cisplatin, and etoposide combination
      chemotherapy for supratentorial malignant gliomas.
AB  - Twenty-eight patients who were previously treated by aggressive surgery and
      radiation and were diagnosed with supratentorial malignant gliomas received a
      combination of nimustine hydrochloride; 1-(4-amino-2-methyl-5-pyrimidinyl) methyl
      3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU), cisplatin and etoposide
      (ACE therapy) as primary treatment. Cisplatin and etoposide were given at doses
      of 20 and 60 mg/m2/day for 5 days, respectively, ACNU doses 80 mg/m2/day on the
      first day. Treatment was repeated at 4-week intervals for up to 3 cycles.
      Seventeen patients (60.7%) complained of nausea. Grade 3 or 4 hematological
      toxicity occurred in 11 patients (39.3%), and grade 3 or 4 renal toxicity
      occurred in 2 patients. The percentage of patients who showed complete or partial
      response was 28.6% (8/28). The median time of tumor progression was 40 weeks, and
      the median survival time was 146 weeks. There were some long-surviving patients
      who may have benefited from ACE combination. This study demonstrated the effects
      of ACE combination in patients with supratentorial malignant gliomas.

PMID- 11212902
TI  - Treosulfan chemotherapy for recurrent malignant glioma.
AB  - Treosulfan is a bifunctional alkylating prodrug with activity against various
      solid tumors. To improve the outcome for patients with recurrent malignant
      glioma, we assessed the efficacy of intravenous treosulfan (6-10 g/m2 4-weekly)
      as salvage therapy for patients with recurrent or progressive glioblastoma (GB, n
      = 14) or anaplastic astrocytoma (AA, n = 2). All patients had prior involved
      field radiotherapy and adjuvant nitrosourea-based chemotherapy. A total of 56
      cycles were administered. Tumor responses were assessed radiologically and
      clinically prior to each cycle. All patients were assessable for toxicity,
      response and survival. There were no complete or partial responses (CR, PR). Two
      patients progressed after the first cycle, 14 patients had initially stable
      disease (SD). Median progression-free survival was 3.25 months for the GB
      patients. Five patients were progression-free at 6 months (30%), including the 2
      AA patients. The 2 AA patients are stable at 22 months. Myelosuppression was the
      dose-limiting toxicity in this cohort of nitrosourea-pretreated patients.
      Treosulfan has modest activity in patients with recurrent malignant glioma.
      Further evaluation of treosulfan in chemonaive malignant glioma patients is
      warranted.

PMID- 11212901
TI  - Angiolipomas of the central nervous system.
AB  - Angiolipomas are neoplasms composed of mature adipocytes admixed with abnormal
      vascular elements. They are most commonly found in the subcutaneous tissue of the
      trunk and extremities, but other sites have been reported. The craniospinal axis
      is an uncommon but significant site. An extensive review of the literature is
      conducted. We summarize 94 cases of angiolipomas in the central nervous system
      (CNS) in 92 patients, including five in our own series, to highlight the most
      prominent features of these tumors. The increasing number of cases of CNS
      angiolipoma in the era of magnetic resonance imaging raises the question of the
      rarity of these lesions.

PMID- 11212903
TI  - Allocentric visuospatial processing in patients with cerebral gliomas: a
      neurocognitive assessment.
AB  - Visuospatial function is a central neuropsychological domain which has been
      neglected in brain tumor studies. This study examined visuospatial function in 4
      groups of brain tumor patients. The investigation involved 27 adult tumor
      subjects, 25 of whom had undergone resection and radiotherapy. Ten normal adults
      acted as controls. The 4 tumor groups were based on neuroanatomic locus - focal
      lesions were localized to clearly defined visuospatial areas in the left or right
      posterior parietal cortex or prefrontal cortex. Neuroanatomic and visuospatial
      assessment parameters were specified: only allocentric ('mental' or 'conceptual')
      operations were examined. A theoretical framework outlined the role of the
      posterior parietal and prefrontal cortices in allocentric spatial processing. Six
      visuospatial tests involving allocentric operations were applied to patients in
      whom tumors involved these cortical areas. In numerous analyses, the 4 tumor
      groups showed no significant differences with the control group on the
      allocentric tests. Between-group comparisons were also not significant. Analyses
      by gender revealed significant differences on shape rotation and line orientation
      tests, especially in the right hemisphere and parietal groups. Comparisons
      between focal radiation subgroups and 'nonradiation' subgroups produced unclear
      results. The main conclusions are that despite the presence of frontal or
      parietal tumors, (1) allocentric processing is hardly compromised, and (2)
      females show lower spatial performance than males due to tumor-related effects on
      a pre-existing pattern of cerebral lateralization. The study emphasizes the need
      to address visuospatial function in the neuropsychological study of brain tumor
      patients, particularly the role of intact spatial processing in this patient
      group.

PMID- 11212904
TI  - Intracranial low-grade chondrosarcoma with hyperostosis of the skull: a case
      report.
AB  - We describe a case of intracranial chondrosarcoma in a 46-year-old woman. The
      preoperative diagnosis was meningioma as plain radiography and computed
      tomography of the head revealed a tumor with discrete calcifications
      predominantly in the right frontoparietal region and hyperostosis of the inner
      table of the skull overlying the tumor. However, the tumor was histologically
      composed of cartilaginous tissue without meningiomatous differentiation and the
      final diagnosis was a low-grade chondrosarcoma based on its histological
      appearance and size, together with the radiologic images. Intracranial
      chondrosarcoma occurring above the skull base is extremely rare and 19 cases were
      found in our literature review. Intracranial chondrosarcoma showing hyperostosis
      of the skull has not been reported in the cases. The discussion includes its
      differential diagnosis, origin, and clinical behavior.

PMID- 11212905
TI  - A randomized phase II and pharmacokinetic study of dacarbazine in patients with
      recurrent glioma.
AB  - We conducted a randomized phase II study to determine the efficacy of dacarbazine
      (DTIC) in recurrent gliomas. Patients were randomly assigned to receive either
      DTIC 750 mg/m2 IV day 1 every 28 days (Arm A) or DTIC 200 mg/m2 IV days 1-5 every
      28 days (Arm B). Pharmacokinetics were studied in 6 patients on each arm using
      HPLC analysis. Thirty-nine patients (30 male, 9 female), ages 27-67 years (median
      53) were entered on the study (20 on Arm A, 19 on Arm B). No objective responses
      were seen. Median time to progression was 3 months. Median survival was 8 months.
      Treatment was generally well tolerated. Major toxicities were grade 1-2 nausea
      (33%). lethargy (28%), diarrhea (15%), alopecia (15%), and grade 3 neutropenia
      (8%). Four patients on Arm A had mild self-limited episodes of intravascular
      hemolysis occurring immediately after drug infusion, the mechanism of which is
      unknown. Mean AUC for DTIC, HMMTIC (5-[3-hydroxymethyl-3-methyl-1-triazeno]
      imidazole-4-carboxamide), and MTIC (5-[3-methyl-1-triazenol imidazole-4
      carboxamide), in Arm A were 14.8, 0.17, and 1.15 mM min, respectively.
      Corresponding values for Arm B (on day 1 of 5) were 1.7, 0.06, and 0.29 mM min,
      respectively. The predicted HMMTIC and MTIC exposure over 5 days for Arm B, based
      on the day 1 data, is higher than with Arm A. We conclude that DTIC is well
      tolerated but does not have activity in patients with recurrent gliomas. The 5
      day schedule appears less toxic, and pharmacokinetic studies show that it
      provides greater exposure to MTIC and HMMTIC compared to the one-day schedule.

PMID- 11212906
TI  - Evidence of therapeutic efficacy of CCNU in recurrent choroid plexus papilloma.
AB  - A pregnant 33-year old woman developed nystagmus and cerebellar ataxia. A tumor
      in the roof of the fourth ventricle was diagnosed. The tumor was subtotally
      removed using microneurosurgical techniques. The histopathological diagnosis was
      choroid plexus papilloma (CPP). Twenty-one months later, the tumor recurred and
      was reoperated. Histologically the tumor displayed now increased mitotic activity
      and pleomorphism. Radiation therapy of the neuroaxis was performed. Within 59
      months, the CPP recurred 3 more times with neuroradiological evidence of
      extensive spinal seeding. After several palliative irradiations, including 2
      gamma-knife boosts, the patient was referred to chemotherapy. She was treated
      with CCNU (Lomustin) 100 mg/m2 orally (12 cycles, cumulative dosis 1440 mg/m2).
      Within 42 months, there was no new local recurrence and spinal seeding showed
      significant regression. Clinically the patient improved and stabilized, but needs
      continuous support because of persisting severe gait ataxia. The course of
      disease in our patient provides evidence for therapeutic efficacy of CCNU in
      recurrent CPP.

PMID- 11212907
TI  - Functional complementation between mutations at two distant positions in
      Escherichia coli RNA polymerase as revealed by second-site suppression.
AB  - Subunit-subunit interactions are critical for the assembly of the core of
      Escherichia coli RNA polymerase. The mutant alpha-subunit C131A is unable to
      complement the temperature-sensitive alpha-R45C mutant strain, which is defective
      for binding of the beta-subunit. In vitro reconstitution experiments, however,
      indicate that the alpha-C131A variant is able to form the intermediate
      alpha2beta, but is defective in contacting the beta'-subunit. We used this alpha
      C131A mutant to isolate a suppressor mutation in the beta'-subunit. Genetic and
      biochemical characterization of the beta' suppressor indicates the allele
      specific nature of its effect. Sequence analysis of the suppressor revealed a
      single substitution of Gly at position 333, an evolutionarily conserved position
      in the conserved region C of the beta'-subunit, by Asp. However, the crystal
      structure of the bacterial RNA polymerase indicates that the primary mutation
      (alpha-C131A) and its suppressor lie far apart. Thus, we propose that long-range
      interactions, as in this case, may play an important role in the functional
      assembly of E. coli RNA polymerase.

PMID- 11212908
TI  - The complete DNA sequence of the mitochondrial genome of Physarum polycephalum.
AB  - The complete sequence of the mitochondrial DNA (mtDNA) of the true slime mold
      Physarun polycephalum has been determined. The mtDNA is a circular 62,862-bp
      molecule with an A+T content of 74.1%. A search with the program BLAST X
      identified the protein-coding regions. The mitochondrial genome of P.
      polycephalum was predicted to contain genes coding for 12 known proteins [for
      three cytochrome c oxidase subunits, apocytochrome b, two F1Fo-ATPase subunits,
      five NADH dehydrogenase (nad) subunits, and one ribosomal protein], two rRNA
      genes, and five tRNA genes. However, the predicted ORFs are not all in the same
      frame, because mitochondrial RNA in P. polycephalum undergoes RNA editing to
      produce functional RNAs. The nucleotide sequence of an nad7 cDNA showed that 51
      nucleotides were inserted at 46 sites in the mRNA. No guide RNA-like sequences
      were observed in the mtDNA of P. polycephalum. Comparison with reported Physarum
      mtDNA sequences suggested that sites of RNA editing vary among strains. In the
      Physarum mtDNA, 20 ORFs of over 300 nucleotides were found and ORFs 14 19 are
      transcribed.

PMID- 11212910
TI  - The Rhizobium leguminosarum glnB gene is down-regulated during symbiosis.
AB  - Symbiotic nitrogen fixation involves the development, on the legume plant root,
      of specialised organs called nodules, within which plant photosynthates are
      exchanged for combined nitrogen of bacterial origin. The glnB gene encodes a
      signal transduction protein (P(II)) which is a component of the bacterial
      nitrogen regulation (Ntr) system and an essential regulator of ammonium
      assimilation. We demonstrate that in Rhizobium leguminosarum the glnB promoter is
      strongly regulated by nitrogen and NtrC, but still shows a significant level of
      activity in conditions of nitrogen excess. Expression of genes involved in
      nitrogen assimilation has been shown to be absent in nitrogen-fixing bacteroids,
      and, in agreement with this, we find that the glnB promoter is down-regulated
      during bacteroid differentiation at a time coincident with the arrest of
      bacterial division in the nodule. This pattern is common to other bacterial genes
      involved in nitrogen assimilation and it is noteworthy that the zone where the
      glnB promoter is active is coincident with the region in which NtrC is expressed.

PMID- 11212909
TI  - The Aspergillus nidulans bncA1 mutation causes defects in the cell division
      cycle, nuclear movement and developmental morphogenesis.
AB  - Wild-type Aspergillus nidulans conidia are uninucleate. The mutation bncA1
      (binucleated conidia) was first described as a single mutation located on
      chromosome IV that caused formation of approximately 25% binucleate and 1%
      trinucleate conidia. In this study, we show that bncA1 conidia exit G1 arrest
      earlier than the wild type. Germlings have hyphal elements with abnormal
      morphology, elevated numbers of randomly distributed nuclei and an irregular
      septation pattern. Older hyphal elements undergo mitotic catastrophe, suggesting
      the nuclear division cycle of internal (nonterminal) elements is not arrested.
      The bncA1 mutation also causes aberrant morphogenesis of the asexual reproductive
      structure, the conidiophore. Metulae and phialides are elongated and have
      incorrect numbers of nuclei. Phialides also have internal septation that appears
      to delineate hyphal-like elements. Heterokaryon analysis using strains with
      contrasting auxotrophic markers showed that the bncA1 mutation resulted in a
      higher frequency of diploid and multinucleated prototrophic conidia than control
      heterokaryons. These results suggest that in bncA1 strains multiple nuclei can
      move from the conidiophore vesicle to the metulae and/or from the phialide to the
      conidium. The bncA1 mutant also showed hypersensitivity to the anti-microtubule
      drugs thiabendazole and nocodazole, which is consistent with the defects in cell
      cycle regulation and nuclear movement. We propose that bncA has an important role
      in correctly regulating both the cell division cycle and nuclear movement.

PMID- 11212911
TI  - Comparative analyses of the distribution of various transposable elements in
      Pyricularia and their activity during and after the sexual cycle.
AB  - We examined the distribution and activity of six transposable elements found in
      the blast fungus, Pyricularia spp. Sixty-eight isolates from various gramineous
      plants were used for the survey, and the elements were plotted on a dendrogram
      constructed on the basis of their rDNA-ITS2 sequences. MGR586 and Pot2 (Class II
      elements), Mg-SINE (SINE-like element) and MGR583 (LINE-like retrotransposon)
      were widely distributed among the Pyricularia isolates, suggesting that they are
      old elements which arose in, or invaded, the Pyricularia population at very early
      stages in its evolution. By contrast, the distribution of the LTR
      retrotransposons MAGGY and Grasshopper was limited or sporadic, suggesting that
      they are relatively new elements which recently invaded the Pyricularia
      population by means of horizontal transfer events. The activity of these elements
      was evaluated by Southern analysis in progenies derived from a cross between a
      Setaria isolate and a Triticum isolate. Many new MAGGY signals were observed,
      which were absent in the parental isolates, at various stages of the sexual cycle
      and following vegetative growth. In contrast, the other elements yielded few, if
      any, such signals. Analysis of the sequences flanking the new MAGGY insertions
      revealed that they were each associated with a 5-bp target-site duplication at
      both ends of the insertion. These data suggested that MAGGY was the most active
      of the elements tested for transposition in Pyricularia.

PMID- 11212912
TI  - A study of protein-protein interactions in living cells using luminescence
      resonance energy transfer (LRET) from Renilla luciferase to Aequorea GFP.
AB  - We have previously reported that Escherichia coli and mammalian cells containing
      a fusion protein consisting of the Renilla luciferase linked to Aequorea GFP
      exhibited luminescence resonance energy transfer (LRET) from luciferase to GFP in
      the presence of coelenterazine. In this paper, we describe the construction of
      two gene fusions in which the cDNA for insulin-like growth factor II (IGF-II) is
      connected to the cDNA for a "humanized" GFP, and the cDNA for insulin-like growth
      factor binding protein 6 (IGFBP-6) is linked to a cDNA encoding the Renilla
      luciferase (RUC). The expression of the fusion gene constructs in CHO cells
      resulted in single polypeptides with the molecular weights expected for IGF-II
      GFP and IGFBP-6-RUC, respectively, based on the use of antibodies against GFP and
      Renilla luciferase. The secretion of IGF-II-GFP from CHO cells was verified by
      fluorescence microscopy and the presence of IGFBP-6-RUC in the culture medium was
      confirmed by luminometry. The interaction between the two known binding partners,
      IGF-II and IGFBP-6, was monitored by measuring LRET from the IGFBP-6-RUC protein
      to IGF-II-GFP in the presence of coelenterazine, using a low-light imaging system
      and spectrofluorometry. Based on these data, luciferase-to-GFP LRET holds great
      promise for the study of protein-protein interactions in eukaryotic cells in real
      time.

PMID- 11212913
TI  - The endogenous Drosophila melanogaster retrovirus gypsy can propagate in
      Drosophila hydei cells.
AB  - The endogenous Drosophila melanogaster retrovirus gypsy (mdg4) forms virus-like
      particles (VLPs) which are found as extracellular particles in the medium used to
      culture D. melanogaster cells. The D. hydei somatic cell line DH14, which does
      not harbour gypsy sequences, was exposed to D. melanogaster VLPs. Subsequent PCR
      and Southern analysis revealed that gypsy elements had penetrated into the D.
      hydei cells, suggesting interspecific transmission of the retrovirus. A D. hydei
      cell line containing gypsy sequences was established and grown in a mixed culture
      together with the G418-resistant D. hydei cell line DH33, and gypsy was shown to
      be transmitted from cell to cell. The proportion of cells carrying gypsy
      increased with time. The rate of gypsy invasion of the lines DH14 and DH33 was
      10(-3) and 10(-2) per cell per generation, respectively. The results demonstrate
      the possibility of interspecific horizontal transfer of gypsy in the form of its
      VLPs.

PMID- 11212914
TI  - Variation in sequence and RNA editing within core domains of mitochondrial group
      II introns among plants.
AB  - The 3' regions of several group II introns within the mitochondrial genes nad1
      and nad7 show unexpected sequence divergence among flowering plants, and the core
      domains 5 and 6 are predicted to have weaker helical structure than those in self
      splicing group II introns. To assess whether RNA editing improves helical
      stability by the conversion of A-C mispairs to A-U pairs, we sequenced RT-PCR
      amplification products derived from excised intron RNAs or partially spliced
      precursors. Only in some cases was editing observed to strengthen the predicted
      helices. Moreover, the editing status within nad1 intron 1 and nad7 intron 4 was
      seen to differ among plant species, so that homologous intron sequences shared
      lower similarity at the RNA level than at the DNA level. Plant-specific variation
      was also seen in the length of the linker joining domains 5 and 6 of nad7 intron
      3; it ranged from 4 nt in wheat to 11 nt in soybean, in contrast to the 2-4 nt
      length typical of classical group II introns. However, this intron is excised as
      a lariat structure with a domain 6 branchpoint adenosine. Our observations
      suggest that the core structures and sequences of these plant mitochondrial
      introns are subject to less stringent evolutionary constraints than conventional
      group II introns.

PMID- 11212915
TI  - Molecular control of copper homeostasis in filamentous fungi: increased
      expression of a metallothionein gene during aging of Podospora anserina.
AB  - The lifespan of the ascomycete Podospora anserina was previously demonstrated to
      be significantly increased in a copper-uptake mutant, suggesting that copper is a
      potential stressor involved in degenerative processes. In order to determine
      whether changes in copper stress occur in the cells during normal aging of
      cultures, we cloned and characterized a gene coding for a component of the
      molecular machinery involved in the control of copper homeostasis. This gene,
      PaMt1, is a single-copy gene that encodes a metallothionein of 26 amino acids.
      The coding sequence of PaMt1 is interrupted by a single intron. The deduced amino
      acid sequence shows a high degree of sequence identity to metallothioneins of the
      filamentous ascomycete Neurospora crassa and the basidiomycete Agaricus bisporus,
      and to the N-terminal portion of mammalian metallothioneins. Levels of PaMt1
      transcript increase in response to elevated amounts of copper in the growth
      medium and during aging of wild-type cultures. In contrast, in the long-lived
      mutant grisea, transcript levels first increase but then decrease again. The
      ability of wild-type cultures to respond to exogenous copper stress via the
      induction of PaMt1 transcription is not affected as they grow older.

PMID- 11212917
TI  - RpoN of Rhizobium leguminosarum bv. viciae strain VF39SM plays a central role in
      FnrN-dependent microaerobic regulation of genes involved in nitrogen fixation.
AB  - The rpoN gene, which codes for the alternative transcription factor sigma54, was
      cloned and sequenced from Rhizobium leguminosarum strain VF39SM. Construction of
      a rpoN mutant allowed analysis of the role of RpoN as a transcriptional regulator
      of genes carrying lacZ reporter fusions. Analysis of a rpoN::lacZ transcriptional
      fusion in the rpoN background revealed that this gene was negatively
      autoregulated. Site-directed mutagenesis was used to demonstrate that this
      autoregulation was dependent on a reverse complement RpoN binding site located
      upstream of the rpoN gene. rpoN was shown to be required for full microaerobic
      expression of both copies of fixGHIS, as well as of fixNOQP, despite the absence
      of apparent rpoN binding sites upstream of fixG. Moreover, rpoN was found to be
      required for full microaerobic expression of fnrN, which in turn is absolutely
      required for microaerobic induction of fixGHIS. This suggests that the reduced
      fixG::lacZ expression seen in the rpoN background is due to the dependence of
      fnrN expression on RpoN.

PMID- 11212916
TI  - Transcriptional regulation of the Saccharomyces cerevisiae amino acid permease
      gene BAP2.
AB  - Uptake of branched-chain amino acids by Saccharomyces cerevisiae from media
      containing a preferred nitrogen source is mediated by the permeases encoded by
      BAP2, BAP3, and VAP1/TAT1. The transcriptional activity of the BAP2 promoter is
      affected by a number of genes, including SSY1, which encodes an amino acid
      permease homologue that is necessary for transcription of BAP2. Other genes that
      control BAP2 encode known (Leu3p, Tup1p) and putative (Stp1p, Stp2p)
      transcription factors. We present evidence that the zinc-finger proteins Stp1p
      and Stp2p bind directly to the BAP2 promoter. Binding of Stplp to the BAP2
      promoter in vivo and in vitro indicates that the STP gene family indeed encodes
      transcription factors. The presence of a Leu3p binding site in the BAP2 promoter
      is required for full promoter activity on synthetic complete medium. The capacity
      of Leu3p to activate BAP2 transcription correlates with conditions that affect
      the level of alpha-isopropyl malate. The effect of a tup1 deletion on BAP2
      transcription depends on SSY1. In an ssy1 strain, the phenotype of tup1 conforms
      to the well-established role of Tup1p as part of a repressor complex, but in the
      SSY1 strain deletion of TUP1 causes a decrease in transcription, indicating that
      Tup1p may also have an activating role at the BAP2 promoter. Our results thus
      suggest a complex interplay between several transcription factors in the
      expression of BAP2.

PMID- 11212918
TI  - Integrated structures of the linear plasmid SCP1 in two bidirectional donor
      strains of Streptomyces coelicolor A3(2).
AB  - The linear plasmid SCP1 is integrated into the central region of the chromosome
      of Streptomyces coelicolor A3(2). The integrated structures of SCP1 in two
      bidirectional donor strains, 2612 and A634, were analyzed by cloning and
      sequencing of the junctions between the SCP1 DNA and the chromosomal DNA. In the
      NF (normal fertility) strain 2612, SCP1 is integrated in a right-handed direction
      into ORF-X at the left end of the IS cluster in AseI fragment E. An almost intact
      left end of SCP1 is retained, while the right terminal inverted repeat (TIR-R) of
      SCP1 and a 33-kb chromosomal DNA segment including the IS cluster are deleted. In
      the NF-like strain A634, SCPI is also integrated into AseI fragment E in a left
      handed direction. The left junction is composed of IS466 with complete deletion
      of TIR-R of SCP1, and the right junction is located at the left end of IS468A*
      with half of TIR-L being deleted. During the integration event, a 5.4-kb
      chromosomal DNA segment including IS468A, IS468B, IS469 and IS466A was duplicated
      so that this sequence is now present on both sides of SCP1. Since 2612 and A634
      exhibit a similar bidirectional gradient of gene transfer, it is surprising that
      their chromosomal structures are so different.

PMID- 11212919
TI  - Multiple isoforms of the Drosophila Spatzle protein are encoded by alternatively
      spliced maternal mRNAs in the precellular blastoderm embryo.
AB  - The spatzle gene is required for proper specification of positional information
      along the dorsal-ventral axis of the Drosophila embryo and for induction of the
      innate immune response to fungal infection. It has been shown to encode a
      precursor of a Nerve Growth Factor-like ligand which is also a member of the
      cysknot protein superfamily. In dorsal-ventral patterning, the most widely
      accepted model of the pathway places Spatzle at the end of a ventrally restricted
      protease cascade that results in the proteolytic processing of the precursor form
      of Spatzle to an active ligand which is thought to bind to the Toll receptor.
      Here we show that the spatzle gene encodes at least ten different protein
      isoforms as a result of complex alternative splicing in precellular blastoderm
      embryos. Multiple transcripts are clearly present up until the time of
      cellularization, at which point most transcripts can no longer be detected. Nine
      isoforms were expressed and at least five are efficiently secreted in a
      heterologous protein expression system. RNA microinjection experiments
      demonstrate that three isoforms completely rescue embryos from spatzle null
      mothers, while most of the others rescue to a lesser extent. The phenotypic
      rescue activities of several isoforms and the relevance of these isoforms to the
      generation of the ventralizing signal are discussed.

PMID- 11212920
TI  - Transposition of the maize transposable element Ac in barley (Hordeum vulgare
      L.).
AB  - Transposition of the maize autonomous element Ac (Activator) was investigated in
      barley (Hordeum vulgare L.) with the aim of developing a transposon tagging
      system for the latter. The Ac element was introduced into meristematic tissue of
      barley by microprojectile bombardment. Transposon activity was then examined in
      the resulting transgenic plants. Multiple excision events were detected in leaf
      tissue of all plant lines. The mobile elements generated empty donor sites with
      small DNA sequence alterations, similar to those found in maize. Reintegration of
      Ac at independent genomic loci in somatic tissue was demonstrated by isolation of
      new element-flanking regions by AIMS-PCR (amplification of insertion-mutagenized
      sites). In addition, transmission of transposed Ac elements to progeny plants was
      confirmed. The results indicate that the introduced Ac element is able to
      transpose in barley. This is a first step towards the establishment of a
      transposon tagging system in this economically important crop.

PMID- 11212921
TI  - Molecular characterization of co-transcribed genes from Streptomyces tendae Tu901
      involved in the biosynthesis of the peptidyl moiety and assembly of the peptidyl
      nucleoside antibiotic nikkomycin.
AB  - Six genes (nikP1, nikP2, nikS, nikT, nikU, and nikV) from Streptomyces tendae
      Tu901 were identified by analysis of the nucleotide sequence of the nikkomycin
      gene cluster. These genes, together with the previously described nikQ and nikR,
      span 9.39 kb and are transcribed as a polycistronic mRNA in a growth-phase
      dependent manner. The nikP1 gene encodes a non-ribosomal peptide synthase
      consisting of an adenylation domain, a thiolation domain, and an N-terminal 70
      residue segment of unknown function. The amino acid sequence encoded by the nikP2
      gene displays similarity to the sequences of thioesterases, and the nikS product
      belongs to a superfamily of proteins characterized by a specific ATP-binding
      fold. The N-terminal 70 amino acids of the predicted nikT gene product show
      significant sequence similarity to acyl carrier proteins, and the C-terminal 330
      amino acids to aminotransferases. The sequences of the deduced proteins NikU and
      NikV exhibit similarity to components S and E, respectively, of glutamate mutase
      from Clostridium. Disruption of the nikP1, nikS, nikT, or nikV gene by insertion
      of a kanamycin resistance cassette abolished formation of nikkomycins I, J, X,
      and Z, all of which contain hydroxypyridylhomothreonine as the peptidyl moiety.
      The nikP1 mutants, and the nikS and nikT mutants accumulated the nucleoside
      moieties nikkomycin Cz, and nikkomycins Cx and Cz, respectively. The nikV mutants
      formed nikkomycins Ox and Oz, which contain 2-amino-4-hydroxy-4-(3'-hydroxy-6'
      pyridyl) butanoic acid as the peptidyl moiety. The nikP2 mutants synthesized
      nikkomycins I, J, X, and Z, but amounts of nikkomycins I and X, which contain
      formylimidazolone as the base, were lower. Feeding formylimidazolone to nikP2
      mutants restored the ability to form nikkomycins I and X. Our results indicate
      that nikU and nikV are required for the synthesis of hydroxypyridylhomothreonine,
      the genes nikP1, nikP2 and nikS are required for the assembly of nikkomycins, and
      nikT is required for both pathways. The putative activities of each of their
      products are discussed.

PMID- 11212922
TI  - Two novel genes encoding SNF-1 related protein kinases from Arabidopsis thaliana:
      differential accumulation of AtSR1 and AtSR2 transcripts in response to
      cytokinins and sugars, and phosphorylation of sucrose synthase by AtSR2.
AB  - We searched for genes encoding members of the group-3 SNF1-related protein kinase
      (SnRK3) family in the Arabidopsis thaliana database, and seven independent
      sequences were identified. Transcripts of two of them were found to accumulate
      differentially upon treatment with light, cytokinins and sugars. Full-length
      cDNAs were isolated and designated as AtSR1 and AtSR2; they encode polypeptides
      of 442 and 429 amino acids with relative molecular masses of 50.3 kDa and 48.2
      kDa, respectively. In etiolated seedlings, no transcripts of either gene were
      observed. However, upon exposure to light or cytokinins, transcripts of AtSR1 but
      not AtSR2 began to accumulate. The induction with light was greatly reduced in
      the presence of a cytokinin antagonist, suggesting that cytokinins are involved
      in light-signaling pathways. In contrast, transcription of AtSR2, but not of
      AtSR1, was greatly increased by sucrose, as well as glucose and fructose. AtSR2
      expressed in E. coli efficiently phosphorylated sucrose synthase in the presence
      of manganese ions. These results suggest that, although SnRK3 proteins may
      generally be involved in sugar metabolism, expression of AtSR1 and AtSR2 is
      differentially and distinctly regulated by various external signals, and AtSR2
      may function in the regulation of sucrose synthase by specific phosphorylation.

PMID- 11212923
TI  - Comparison of psbK operon organization and group III intron content in
      chloroplast genomes of 12 Euglenoid species.
AB  - A novel mixed operon has been identified in the photosynthetic protist E.
      gracilis. The genes for psbK, ycf12, psaM, and trnR are co-transcribed. The
      resulting tetracistronic transcripts are processed through endonucleolytic
      cleavage of the intergenic spacers and intron splicing to form three mature
      monocistronic mRNAs and a tRNA. A group III twintron and a group III intron are
      located in psbK. Another group III intron is found in ycf12. The psbK operon has
      been cloned by PCR amplification from nine related Euglenoid species. In each
      species, the gene order and content of the psbK operon is conserved. The psbK
      operons contain phylogenetically conserved eubacterial promoter, translational,
      and 3' processing elements. Intron content varies significantly from species to
      species. Based on a comparison of the intron content with the results of
      phylogenetic analysis, group III intron evolution within the Euglenoid lineage is
      much more complex than previously believed.

PMID- 11212924
TI  - DNA circle formation in Neisseria gonorrhoeae: a possible intermediate in diverse
      genomic recombination processes.
AB  - An important attribute that contributes to the virulence of Neisseria gonorrhoeae
      is its phenotypic variability, which is based on recombination within complex
      gene families in the genome. In this study we report on the in vivo amplification
      of large segments of the genome and the existence of circular DNA intermediates
      in the cell, which might help to explain the evolution of these gene families and
      provide possible clues as to how genetic variability is maintained. Using an
      inserted chromosomal marker (cat) in the N. gonorrhoeae MS11 genome that confers
      low-level resistance to chloramphenicol (Cm), we isolated variants that express
      resistance to high levels of Cm. Genetic analysis revealed that virtually all
      variants harboured single or multiple tandem amplifications of the respective
      genome segments carrying the cat insert. This process occurred independently of
      both the location of the cat insertion site and of the presence of a functional
      recA gene. Analysis of the genetically well characterised pilC region revealed a
      head-to-tail orientation of the amplified segments, with the junctions being
      located within direct repeats. Identical junctions were detected in extra
      chromosomal circular DNA molecules isolated from non-selected wild-type and recA
      strains, suggesting that both types of structure arise by related processes. The
      existence of DNA circles was shown by their banding behaviour in caesium
      chloride/ethidium bromide density centrifugation and their resistance to
      digestion by exonuclease. The possible roles of such circles in processes such as
      pilin gene recombination, chromosomal gene amplification and genetic
      transformation are discussed.

PMID- 11212925
TI  - Involvement of SGS1 in DNA damage-induced heteroallelic recombination that
      requires RAD52 in Saccharomyces cerevisiae.
AB  - The SGS1 gene of Saccharomyces cerevisiae is homologous to the genes that are
      mutated in Bloom's syndrome and Werner's syndrome in humans. Disruption of SGS1
      results in high sensitivity to methyl methanesulfonate (MMS), poor sporulation,
      and a hyper-recombination phenotype including recombination between
      heteroalleles. In this study, we found that SGS1 forms part of the RAD52
      epistasis group when cells are exposed to MMS. Exposure to DNA-damaging agents
      causes a striking, Rad52-dependent, increase in heteroallelic recombination in
      wild-type cells, but not in sgs1 disruptants. However, in the absence of DNA
      damage, the frequency of heteroallelic recombination in sgs1 disruptants was
      several-fold higher than in wild-type cells, as described previously. These
      results imply a function for Sgs1: it acts to suppress spontaneous heteroallelic
      recombination, and to promote DNA damage-induced heteroallelic recombination.

PMID- 11212926
TI  - An Aspergillus nidulans uvsC null mutant is deficient in homologous DNA
      integration.
AB  - The Aspergillus nidulans uvsC gene was identified as a homolog of RAD51 and recA
      of Saccharomyces cerevisiae and Escherichia coli, respectively, whose role in
      genetic recombination and recombinational repair has been extensively studied.
      Like many other filamentous fungi, A. nidulans shows no bias towards either
      homologous or ectopic integration of exogenous DNA. Therefore it is a unique and
      useful organism for the study of the mechanisms of DNA integration. Homologous
      integration of a 1.7-kb argB gene was not detected in 50 transformants obtained
      from a uvsC null mutant. In contrast, the frequency of homologous integration in
      uvsC+ control strains varied from 41 to 86%. Another feature observed with the
      uvsC null mutant was that an increased number of transformants had undergone
      ectopic integrations at multiple sites in the genome. These results are
      consistent with the established function of Rad51/RecA, and further indicate the
      involvement of redundant pathways in integration of exogenous DNA. This study
      provides direct evidence for the involvement of uvsC in exogenous DNA integration
      and should contribute to the improvement of genetic manipulations in general, but
      particularly in fungi.

PMID- 11212927
TI  - Growth and recombination of phage lambda in the presence of exonuclease V from
      Bacillus subtilis.
AB  - When expressed in Escherichia coli, the AddAB exonuclease/recombinase from
      Bacillus subtilis blocks the growth of phage lambda. Mutants of lambda that are
      deleted for ea47, a gene of unknown function which is expressed early in the
      lytic cycle, are not blocked for growth. The blocked-growth phenotype of lambda
      ea47+ in the presence of AddAB is expressed only when phage DNA replication is
      permitted.

PMID- 11212928
TI  - Transposition of autonomous and engineered impala transposons in Fusarium
      oxysporum and a related species.
AB  - The impala transposon of Fusarium oxysporum is an active element. We demonstrated
      that the imp160 copy, transposed into the gene encoding nitrate reductase, is an
      autonomous element, since it excises from this gene and reinserts at a new
      genomic position in backgrounds free of active elements. An element in which the
      transposase gene was replaced by a hygromycin B resistance gene was used (1) to
      demonstrate the absence of endogenous transposase in several F. oxysporum strains
      and (2) to check the ability of different genomic copies of impala to
      transactivate this defective element. This two-component system allowed the
      identification of autonomous elements in two impala subfamilies and revealed that
      transactivation can occur between highly divergent elements. We also demonstrate
      that the autonomous copy transposes in a closely related species complex, F.
      moniliforme, in a fashion similar to that observed in F. oxysporium. The ability
      of impala to function as a two-component system and to transpose in a
      heterologous host promises further advances in our understanding of the factors
      that modulate transposition efficiency and demonstrates the potential of impala
      as a means of establishing a transposon tagging system for a wide range of fungal
      species.

PMID- 11212929
TI  - A brief historical review of research achievements by the OVI during the 20th
      century against the background of socioeconomic and political developments in
      South Africa.

PMID- 11212930
TI  - Bone, blood and faecal response to an acidogenic lick for range cattle using
      different concentrations of ammonium chloride.
AB  - Thirty Brahman-Angus cross heifers at breeding age on extensive grazing were used
      to test the effectiveness of NH4Cl as an acidogenic agent at 15,18, 21 and 26 %
      of a dicalcium phosphate lick (A+), compared to a lick of 5 parts dicalcium
      phosphate and 3 parts salt (A-). Blood and faecal phosphorus (P), faecal calcium
      (Ca) and faecal magnesium (Mg) were significantly (P<0.05) higher in A+ compared
      to A-animals at different stages of the experiment. Bone P did not increase in
      response to NH4Cl but bone Ca was significantly (P<0.05) higher in A+ animals
      offered 18% NH4Cl and significantly (P<0.05) lower at 15 and 26%. Bone Mg in A+
      animals was significantly (P<0.05) higher at 15 and 18% NH4Cl and lower at 26%
      NH4Cl compared to A- animals. Percentage ash in bone increased linearly from 62.5
      to 64.9% in A+ animals as NH4Cl was increased in the lick from 15 to 21% and then
      decreased to 63.3% but was significantly (P<0.05) greater than the percentage ash
      in A-animals when the NH4Cl was increased to 26%. Bone mineral status was only
      marginally improved by adding NH4Cl to the lick in this study but blood P was
      significantly (P<0.05) improved in A+ compared to A- animals when the lick
      contained 15, 21 and 26% NH4Cl. Based on bone mineral results reported here, it
      is recommended that, when NH4Cl is used as an acidogenic agent in licks for range
      cattle, the amount in the lick should not exceed 21%.

PMID- 11212931
TI  - Control of immature stages of the flea Ctenocephalides felis (Bouche) in carpets
      exposed to cats treated with imidacloprid.
AB  - Fleas cause allergic dermatitis in cats and dogs and therefore warrant control.
      It has been demonstrated previously that there is marked inhibition of the
      development of the immature stages of the cat flea Ctenocephalides felis on
      fleece blankets exposed to cats treated with imidacloprid. This study reports on
      the efficacy of imidacloprid in suppressing adult flea emergence in carpet
      exposed to treated cats. Circular discs of carpet pre-seeded with flea eggs and
      larvae were exposed to 6 untreated control and 6 topically treated (imidacloprid
      10% m/v) cats 1 to 2 days after treatment and subsequently fortnightly for 6
      weeks. Exposure times on alternate days were either 1 or 6 hours. Adult flea
      yield from carpets was determined 35 days after exposure. Differences between
      flea yield on control carpets and those exposed for 1 hour were significant only
      for days +1 and +14. For the 6-hour exposure, differences were significant at all
      times except on Day +43. The ability of imidacloprid to suppress the yield of
      adult fleas on carpets (6-hour exposure) steadily declined from 82 % (Day +2) to
      12% (Day +43). For the 1-hour exposure it varied inconsistently between 0 and 83%
      over the 6-week study period.

PMID- 11212932
TI  - A survey of feline babesiosis in South Africa.
AB  - South Africa appears to be the only country where feline babesiosis is a
      significant clinical entity in domestic cats. Little is known about its
      epidemiology or the clinical challenges facing practitioners. A questionnaire
      posted to 1760 South African veterinarians was returned by 16%, representing
      approximately 40% of practices. Just over half reported seeing feline babesiosis,
      with most cases occurring in the coastal areas of the Western Cape, Eastern Cape
      and KwaZulu-Natal Provinces. Overall incidence is highest in summer, but
      seasonality is less pronounced in non-seasonal and winter rainfall areas. No age,
      breed or sex predisposition was identified. Weight loss, weakness, anaemia, fever
      and icterus are common clinical findings. Complications include hepatopathy,
      renal failure, pulmonary oedema, cerebral signs, immune-mediated haemolytic
      anaemia and concurrent infections. The antibabesial drug of choice is primaquine
      phosphate. Response to therapy is generally good, but recurrence and chronic
      infections were identified as problems. The average mortality rate was 15%.
      Approximately 3000 cases are seen annually by the respondents, at an estimated
      cost of R750 000 to the owners. Feline babesiosis is a significant problem in
      South Africa, and further investigations of taxonomic status, concurrent
      infections, chemotherapy, complications and management of refractory cases are
      warranted.

PMID- 11212933
TI  - Effects of xylazine on acid-base balance and arterial blood-gas tensions in goats
      under different environmental temperature and humidity conditions.
AB  - The effects of acute exposure to 3 different temperature and humidity conditions
      on arterial blood-gas and acid-base balance in goats were investigated after
      intravenous bolus administration of xylazine at a dose of 0.1 mg/kg. Significant
      (P<0.05) changes in the variables occurred under all 3 environmental conditions.
      Decreases in pH, partial pressure of oxygen and oxyhaemoglobin saturation were
      observed, and the minimum values for oxygen tension and oxyhaemoglobin saturation
      were observed within 5 min of xylazine administration. The pH decreased to its
      minimum values between 5 and 15 min. Thereafter, the variables started to return
      towards baseline, but did not reach baseline values at the end of the 60 min
      observation period. Increases in the partial pressure of carbon dioxide, total
      carbon dioxide content, bicarbonate ion concentration, and the actual base excess
      were observed. The maximum increase in the carbon dioxide tension occurred within
      5 min of xylazine administration. The increase in the actual base excess only
      became significant after 30 min in all 3 environments, and maximal increases were
      observed at 60 min. There were no significant differences between the variables
      in the 3 different environments. It was concluded that intravenous xylazine
      administration in goats resulted in significant changes in arterial blood-gas and
      acid-base balance that were associated with hypoxaemia and respiratory acidosis,
      followed by metabolic alkalosis that continued for the duration of the
      observation period. Acute exposure to different environmental temperature and
      humidity conditions after xylazine administration did not influence the changes
      in arterial blood-gas and acid-base balance.

PMID- 11212934
TI  - Acute pancreatitis: a newly recognised potential complication of canine
      babesiosis.
AB  - This retrospective study describes 4 cases of canine babesiosis with
      histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis
      are reported with serum amylase (>3500 U/l) and/or lipase (>650 U/l) activity
      elevations of a magnitude that would support a diagnosis of probable acute
      pancreatitis, although extra-pancreatic sources of the enzymes could not be
      excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post
      admission, with primarily young (median age 3 years), sexually intact dogs
      affected. The development of pancreatitis was unrelated to the degree of anaemia
      at time of admission. In addition to pancreatitis, 80% of cases suffered from
      other babesial complications, namely icterus (13), acute respiratory distress
      syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3),
      haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress
      syndrome, renal failure and cerebral syndrome were associated with a poor
      prognosis, with 4 of the 5 dogs included in the overall 26% mortality rate having
      at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion
      injury to the pancreas is proposed as a possible primary pathophysiological
      mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic
      anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis
      may also be involved. The previously postulated pro-inflammatory cytokine milieu
      of complicated babesiosis may underlie the progression, if not the primary
      initiation, of pancreatic pathology. Acute pancreatitis may represent the
      previously reported 'gut' form of babesiosis.

PMID- 11212935
TI  - The use of herbal preparations for tick control in western Ethiopia.
AB  - Information on the traditional tick control methods used in Keffa, Illubabor and
      Wellega Provinces in western Ethiopia was obtained from 86 veterinary clinics and
      865 peasant farmers through a questionnaire survey. Latexes of Euphorbia
      obovalifolia and Ficus brachypoda, juice of crushed leaves of Phytolaca
      dodecandra and Vernonia amygdalina, fruit juice of Solanum incanum, crushed seeds
      of Lepidium sativum mixed with fresh cattle faeces, juice of crushed leaves and
      bark of Calpurnea aurea and commercially available spice of Capsicum spp. mixed
      with butter, were used by peasant farmers to control ticks. Preliminary in vitro
      efficacy tests of these plant preparations were performed on engorged female
      Boophilus decoloratus. Preparations of Capsicum spp., E. obovalifolia, S. incanum
      and F. brachypoda were found to have 30-100% killing effects. Subsequently, in
      vivo treatment trials of these preparations were conducted using indigenous Bos
      indicus cattle naturally infested with ticks. Results indicate that treatments at
      the rate of once per day for 5 consecutive days with the latexes of E.
      obovalifolia and F. brachypoda can reduce tick burdens by up to 70% on cattle.

PMID- 11212936
TI  - Effect of dietary concentrate level on body immune response in calves fed a wheat
      straw-based diet.
AB  - Twenty 9-month-old crossbred calves were divided into 2 equal groups (A and B; n
      = 10). The feeding trial was conducted for 119 days to study the effect of
      concentrate supplementation on body immune response and blood metabolites in
      calves. The concentrate and roughage (wheat straw) ratio in the diet of Groups A
      and B was 60:40 and 30:70, respectively. Daily dry matter intake was
      significantly (P<0.01) higher in Group A than in Group B, which also resulted in
      significantly higher (P<0.01) total body weight gain in the former group.
      Protein, albumin, globulin, total and differential leukocyte count in blood were
      similar in the 2 groups but blood glucose level was higher (P<0.05) in the calves
      of Group A. There was no difference in body immune response between the groups,
      which indicated that body immune response of animals is not significantly
      influenced by restricted concentrate feeding.

PMID- 11212937
TI  - Isoflurane anaesthesia in an African wild dog, Lycaon pictus.
AB  - Anaesthesia was required in a captive female African wild dog (Lycaon pictus) for
      surgical wound treatment. After it was immobilised with a medetomidine-ketamine
      combination, bradycardia, hypothermia, systolic hypertension and metabolic
      acidosis were observed. Surgical anaesthesia was maintained with a 1% end-tidal
      isoflurane concentration. A decrease in the arterial blood pressure, rectal
      temperature and pH occurred during maintenance of anaesthesia.

PMID- 11212938
TI  - Helminth parasites of indigenous chickens in Oodi, Kgatleng District, Botswana.
AB  - Thirteen adult indigenous chickens from Oodi, Kgatleng district, Botswana, were
      examined for helminth parasites. Two species of nematodes, Ascaridia galli and
      Heterakis gallinarum, and species of the cestode genus Raillietina, were
      recovered. A. galli and H. gallinarum were the most commonly seen parasites. The
      nematode A. galli occurred concurrently with Raillietina spp.

PMID- 11212939
TI  - Parasites of domestic pigeons (Columba livia domestica) in Sebele, Gaborone,
      Botswana.
AB  - The following parasites were found in apparently healthy pigeons kept in Sebele:
      a haemoprotozoan, Haemoproteus columbae (80%); endoparasite metazoan nematodes,
      Ascaridia columbae (30%) and Dispharynx spiralis (10%); a cestode, Raillietina
      sp. (80%) and coccidian oocysts (40%); 2 ectoparasites, namely the pigeon fly,
      Pseudolynchia canariensis (50%) and the louse, Columbicola columbae (30%). The
      pigeons also had highantibody titres, (1:256) to the protozoan parasite
      Toxoplasma gondii (100%). The latter infection in these domestic pigeons has
      public health implications.

PMID- 11212940
TI  - Gastric Ollulanus tricuspis infection identified in captive cheetahs (Acinonyx
      jubatus) with chronic vomiting.
AB  - Gastritis, vomition and weight loss are common in captive cheetahs (Acinonyx
      jubatus). Gastric spiral bacteria (Helicobacter spp.) and the very small,
      viviparous nematode Ollulanus tricuspis, a stomach worm of cats, are believed to
      be important causes. Three sibling cheetahs at Wellington Zoo, New Zealand,
      developed chronic vomiting, diarrhoea and debility. Their parents were both South
      African-born. Response to antibacterial treatment was poor. Endoscopic
      examinations revealed chronic lymphoplasmacytic gastritis and Ollulanus
      infection. Treatment with oxfendazole and pyrantel embonate resulted in clinical
      improvement; however, 1 cheetah, which died 7 months later as a result of a
      ruptured liver due to hepatic amyloidosis, still had Ollulanus worms present in
      her stomach. Ollulanus tricuspis is a significant cause of gastritis and vomiting
      in captive cheetahs, lions and tigers, as well as wild cougars and tigers. The
      parasite has not yet been found in sub-Saharan Africa. Because of the unusual
      characteristics of this parasite, the literature on its life history and
      techniques for diagnosis is reviewed.

PMID- 11212941
TI  - Vulvovaginectomy and neo-urethrostomy for treatment of haemangiosarcoma of the
      vulva and vagina.
AB  - Vulvovaginectomy and neo-urethrostomy were performed in a 9-year-old German
      shepherd dog following a diagnosis of infiltrative vulvar and vestibulovaginal
      haemangiosarcoma. The dog was presented for intermittent vulvar haemorrhage over
      a 3-month period. On examination the vulva and vestibulovagina were distended and
      firm. Vaginal discharge and fine needle aspiration cytology detected anaplastic
      cells. Haemangiosarcoma was diagnosed on biopsy. A new urethral opening was
      created in the floor of the vagina allowing resection of the vulva and caudal
      vestibulovagina. Urinary continence was preserved and healing was without
      complications.

PMID- 11212942
TI  - Molecular structure-based prediction of human abdominal skin permeability
      coefficients for several organic compounds.
AB  - Mechanistically based predictions of skin permeability coefficients (Kp) derived
      solely on the basis of molecular structure information of organic compounds have
      not been reported previously. The objective of the present study was to predict
      the human abdominal Kp of structurally unrelated organic compounds using a
      mechanistic equation that takes into account compound-specific and species
      specific determinants of Kp and relates the compound-specific determinants
      directly to molecular structure information. The method consisted of obtaining
      predictions based on a modified form of the conventional equation used to
      describe Kp (= P x D/L, where P, D, and L represent the stratum corneum:water
      partition coefficient, diffusion coefficient, and path length of diffusion). The
      value of P was predicted from the n-octanol:water partition coefficient (Po:w)
      computed from molecular structure information as well as the lipid, protein, and
      water contents in stratum corneum. The value of D was predicted according to the
      conventional Einstein-Stoke equation using the molar volume (Vmolar) of compounds
      computed from molecular structure information as well as data on viscosity of the
      stratum corneum components. Finally, the value of L was estimated in accordance
      with the characteristics of the diffusion pathways in the stratum corneum (i.e.,
      transcellular and intercellular pathways). The average ratio of predicted Kp to
      the corresponding mean experimental values obtained from the literature was 1.25
      (SD = 0.68, r = .95) for 47 structurally unrelated organic compounds (volatile
      organics and drugs), which were characterized by the presence of less than 2
      hydrogen bonding groups and Vmolar < 231 cm3/mol. The present study is the first
      initiative that permits prediction of the human Kp of organic compounds by using
      molecular structure information as the sole chemical-specific input in a
      mechanistic equation.

PMID- 11212943
TI  - Correlation of blood cholinesterase levels with toxicity of sarin in rats.
AB  - The dose-mortality response curve for sarin when administered to pregnant rats is
      extremely steep. The pregnant animal either died during the treatment or survived
      with no observable fetal toxicity. Animals that died displayed many symptoms
      characteristic of anticholinesterase toxicity. The present study was conducted to
      determine whether the maternal deaths, clinical observations, and/or weight loss
      could be correlated with baseline blood cholinesterase levels in individual
      animals. Cholinesterase levels (plasma and erythrocyte) were obtained prior to,
      during, and following treatment of nonpregnant rats by gavage with 380
      microg/kg/d sarin for 10 d. After the first dose, there was a drop in the plasma
      cholinesterase levels, which then remained low throughout the dosing period.
      There was a statistically significant correlation between body weight loss and
      plasma cholinesterase levels of the sarin dosed animals. The surviving animals
      also had lower plasma cholinesterase levels and lower body weights, both of which
      recovered on the cessation of dosing. The erythrocyte cholinesterase levels were
      not different between treated and nontreated rats. Neither plasma or erythrocyte
      baseline cholinesterase levels nor relative or absolute cholinesterase decline
      values could be used as predictors of mortality from sarin administration in
      rats.

PMID- 11212944
TI  - Quantitative modeling of suppression of IgG1, IgG2a, IL-2, and IL-4 responses to
      antigen in mice treated with exogenous corticosterone or restraint stress.
AB  - Exposure to toxic chemicals often induces a neuroendocrine stress response
      leading to increased concentrations of a variety of potentially immunomodulatory
      mediators. Corticosterone is a major stress-induced mediator that can be
      immunosuppressive. However, the quantity of corticosterone exposure required to
      produce particular decrements in particular immunological parameters is not
      known. Mice treated with various dosages of exogenous corticosterone were
      compared to mice exposed to a psychogenic stressor (restraint). Cumulative
      corticosterone exposure in these mice, expressed as the area under the curve
      (AUC) of corticosterone concentration versus time, was used to develop
      quantitative models of the effects of corticosterone on the immunoglobulin (Ig)
      G1 and IgG2a responses to keyhole limpet hemocyanin (KLH) and sheep erythrocytes
      (sRBC). The production of interleukin (IL)-2 and IL-4 by splenocytes stimulated
      with KLH in culture was also evaluated. Linear regression models were derived
      that describe the relationship between the IgG1 and IgG2a responses to KLH.
      Restraint had a greater effect (at equivalent corticosterone AUC values) than
      exogenous corticosterone, suggesting that mediators in addition to corticosterone
      are important in suppression of the IgG1 and IgG2a response to KLH. The
      production of IL-2 and IL-4 by cultured splenocytes was mostly, but not always,
      consistent with the changes in IgG1 or IgG2a. For example, the regression lines
      for IgG2a (a Th1-driven response) and IL-2 (a Th1 cytokine) were not
      significantly different. The relationships between corticosterone AUC and the
      IgG1 and IgG2a responses to sRBC were nonlinear and characterized by enhanced
      responses at low to moderate AUC values. The quantitative models developed here
      have implications for risk assessment in immunotoxicology.

PMID- 11212945
TI  - Effects of PCB 126 on thymocyte surface marker expression and immune organ
      development in chicken embryos.
AB  - Previous studies have shown that chicken (Gallus domesticus) embryos are
      sensitive to the immunotoxic effects of Ah receptor agonists. These chemicals
      cause atrophy of the thymus gland and bursa of Fabricius, the sites of T- and B
      lymphocyte maturation, respectively. The objectives of this study were (1) to
      evaluate the effects of 3,3,4,4',5-pentachlorobiphenyl (PCB 126) on thymocyte
      phenotypes (CD4-CD8-, CD4+CD8+, CD4+CD8-, CD4-CD8+, TCRalphabeta+, and
      TCRgammadelta) in chicken embryos, and (2) to compare phenotype alterations with
      masses and cellularity of lymphoid organs. To simulate exposure in wild avian
      embryos, chicken eggs were injected with PCB 126 (sunflower oil carrier) into the
      air cell before incubation. Doses ranged from 0.051 to 0.8 ng/g egg with carrier
      injected and noninjected control groups. The thymus and bursa were removed,
      weighed, and homogenized on d 20 of egg incubation (1 d before hatch). Thymocyte
      phenotypes were quantified by flow cytometry using monoclonal antibodies for CD4,
      CD8, TCRalphabeta (Vbeta1), and TCRgammadelta. Right thymus mass declined with
      dose, decreasing significantly between 0.32 and 0.8 ng/g to a size 28% lower than
      controls. Live lymphoid cell numbers in the right thymus dropped markedly (21%
      lower than controls) between 0.051 and 0.13 ng/g, with a further decrease (35%
      lower than controls) at higher doses. There was no significant change in the
      percentage of thymocytes expressing TCRalphabeta. The total number of
      TCRalphabeta+ thymocytes decreased with dose as a function of the declines in
      TCRalphabeta+ percentages and total thymocyte numbers. The percentages of all
      other measured phenotypes were unaltered by PCB 126. The total number of CD4+CD8+
      cells, and to a lesser degree CD4-CD8+ cells, decreased in a dose-dependent
      manner following the pattern of total live thymocytes. The number of viable
      lymphoid cells in the bursa decreased to 45% lower than controls at 0.13 ng/g and
      fell to 76% lower than controls at 0.8 ng/g. Lymphoid atrophy occurred at doses
      that were 8- to 12-fold lower with full-term incubation as compared to exposure
      only during later stages of incubation, and the lymphoid atrophy was associated
      with decreased TCRalphabeta+ thymocytes at higher doses. These immunological
      effects were observed at concentrations of PCB 126 comparable to those found in
      Great Lakes herring gull eggs, after correcting for interspecies differences in
      sensitivity to PCB 126.

PMID- 11212946
TI  - Effects of sodium diethyldithiocarbamate on type II pulmonary epithelial cells in
      vitro.
AB  - Dithiocarbamates (DDTC) are chemicals widely used in the form of pesticides,
      therapeutic and chelating agents, and scavengers. Since DDTC interfere with SH,
      Cu, and Zn enzymes due to chelating properties, it was of interest to clarify, in
      primary culture of type II alveolar pneumocytes, the effect of this compound upon
      enzymes of glutathione cycle, Cu, Zn-superoxide dismutase, and the membrane
      structure of cells. DDTC significantly inhibited the activity of superoxide
      dismutase and the activity of gamma-glutamyl transpeptidase, glutathione
      reductase, and alkaline phosphatase, whereas an increase in the activity of
      glutathione peroxidase was found. The membranes of pneumocytes type II were
      injured. Data show that DDTC adversely affected type II pneumocyte function and
      structure.

PMID- 11212947
TI  - Numerical simulation and experimental validation of blood flow in arteries with
      structured-tree outflow conditions.
AB  - Blood flow in the large systemic arteries is modeled using one-dimensional
      equations derived from the axisymmetric Navier-Stokes equations for flow in
      compliant and tapering vessels. The arterial tree is truncated after the first
      few generations of large arteries with the remaining small arteries and
      arterioles providing outflow boundary conditions for the large arteries. By
      modeling the small arteries and arterioles as a structured tree, a semi
      analytical approach based on a linearized version of the governing equations can
      be used to derive an expression for the root impedance of the structured tree in
      the frequency domain. In the time domain, this provides the proper outflow
      boundary condition. The structured tree is a binary asymmetric tree in which the
      radii of the daughter vessels are scaled linearly with the radius of the parent
      vessel. Blood flow and pressure in the large vessels are computed as functions of
      time and axial distance within each of the arteries. Comparison between the
      simulations and magnetic resonance measurements in the ascending aorta and nine
      peripheral locations in one individual shows excellent agreement between the two.

PMID- 11212948
TI  - Method for assessing the need for case-specific hemodynamics: application to the
      distribution of vascular permeability.
AB  - A common approach to understanding the role of hemodynamics in atherogenesis is
      to seek relationships between parameters of the hemodynamic environment, and the
      distribution of tissue variables thought to be indicative of early disease. An
      important question arising in such investigations is whether the distributions of
      tissue variables are sufficiently similar among cases to permit them to be
      described by an ensemble average distribution. If they are, the hemodynamic
      environment needs be determined only once, for a nominal representative geometry;
      if not, the hemodynamic environment must be obtained for each case. A method for
      classifying distributions from multiple cases to answer this question is proposed
      and applied to the distributions of the uptake of Evans blue dye labeled albumin
      by the external iliac arteries of swine in response to a step increase in flow.
      It is found that the uptake patterns in the proximal segment of the arteries,
      between the aortic trifurcation and the ostium of the circumflex iliac artery,
      show considerable case-to-case variability. In the distal segment, extending to
      the deep femoral ostium, many cases show very little spatial variation, and the
      patterns in those that do are similar among the cases. Thus the response of the
      distal segment may be understood with fewer simulations, but the proximal segment
      has more information to offer.

PMID- 11212949
TI  - Finite element modeling of diffusion and partitioning in biological systems: the
      infinite composite medium problem.
AB  - Four methods are proposed for modeling diffusion in heterogeneous media where
      diffusion and partition coefficients take on differing values in each subregion.
      The exercise was conducted to validate finite element modeling (FEM) procedures
      in anticipation of modeling drug diffusion with regional partitioning into ocular
      tissue, though the approach can be useful for other organs, or for modeling
      diffusion in laminate devices. Partitioning creates a discontinuous value in the
      dependent variable (concentration) at an intertissue boundary that is not easily
      handled by available general-purpose FEM codes, which allow for only one value at
      each node. The discontinuity is handled using a transformation on the dependent
      variable based upon the region-specific partition coefficient. Methods were
      evaluated by their ability to reproduce a known exact result, for the problem of
      the infinite composite medium (Crank, J. The Mathematics of Diffusion, 2nd ed.
      New York: Oxford University Press, 1975, pp. 38-39.). The most physically
      intuitive method is based upon the concept of chemical potential, which is
      continuous across an interphase boundary (method III). This method makes the
      equation of the dependent variable highly nonlinear. This can be linearized
      easily by a change of variables (method IV). Results are also given for a one
      dimensional problem simulating bolus injection into the vitreous, predicting time
      disposition of drug in vitreous and retina.

PMID- 11212950
TI  - Delayed activation and retrograde propagation in cardiac muscle: implication of
      virtual electrode effects.
AB  - Point cathodal stimulation of cardiac tissue was shown previously to produce both
      a dog-bone shaped virtual cathode transverse to the muscle fibers and two
      longitudinal virtual anodes. We hypothesize that virtual anodes can cause a
      region of delayed activation, separating two regions of early activation caused
      by the virtual cathode. Using a high-density electrode array in 42 superfused
      epicardial slices from 14 canine left ventricles, we observed regions of early
      and delayed activation and different pathways of retrograde propagation
      corresponding to the earlier patterns. Retrograde propagation was seen from the
      transversely located early activation area through areas of delayed activation
      toward the cathode, and from the early activation area toward the cathode
      directly. These pathways caused a wide dispersion in the direction of retrograde
      propagation (2 degrees +/- 31 degrees, n = 179, relative to the fast axis of
      threshold activation; radial velocity: 0.5 +/- 0.2 m/s, n = 95, in 12 slices from
      8 hearts with stimuli of 330 micros, 0.8-30 mA). Delayed activations were
      observed 0 degrees +/- 6 degrees (n = 32) from the axis in 23 maps (at differing
      stimulation strengths) recorded in 13 slices from 10 hearts. We conclude that
      point cathodal stimulation induce delayed activation along the fiber axis and
      retrograde propagation both along and transverse to the axis.

PMID- 11212951
TI  - Anisotropic mechanisms for multiphasic unipolar electrograms: simulation studies
      and experimental recordings.
AB  - The origin of the multiple, complex morphologies observed in unipolar epicardial
      electrograms, and their relationships with myocardial architecture, have not been
      fully elucidated. To clarify this problem we simulated electrograms (EGs) with a
      model representing the heart as an anisotropic bidomain with unequal anisotropy
      ratio, ellipsoidal ventricular geometry, transmural fiber rotation, epi
      endocardial obliqueness of fiber direction and a simplified Purkinje network. The
      EGs were compared with those directly recorded from isolated dog hearts immersed
      in a conducting medium during ventricular excitation initiated by epicardial
      stimulation. The simulated EGs share the same multiphasic character of the
      recorded EGs. The origin of the multiple waves, especially those appearing in the
      EGs for sites reached by excitation wave fronts spreading across fibers, can be
      better understood after splitting the current sources, the potential
      distributions and the EGs into an axial and a conormal component and after taking
      also into account the effect of the reference or drift component. The split model
      provides an explanation of humps and spikes that appear in the QRS (the initial
      part of the ventricular EG) wave forms, in terms of the interaction between the
      geometry and direction of propagation of the wave front and the architecture of
      the fibers through which excitation is spreading.

PMID- 11212953
TI  - Relations between components of impedance cardiogram analyzed by means of finite
      element model and sensitivity theorem.
AB  - The main aim of the study is to establish a relation between different sources of
      Impedance cardiogram (ICG) as function of spatial distribution of conductivity. A
      three-dimensional model of a human thorax using the finite element method has
      been constructed. The model includes 35 horizontal layers consisting of up to 519
      pentahedral elements that are automatically divided into tetrahedral ones before
      calculating the potential distribution. Electrode array configuration proposed by
      Kubicek et al. (Aerosp. Med. 37: 1208-1212, 1996) has been studied. A
      relationship proposed by Geselowitz (IEEE Trans. Biomed. Eng. 18: 38-41, 1971)
      has been used to calculate the sensitivity of the examined electrode array to
      conductivity changes inside the thorax. This relationship has allowed for the
      calculation of the contributions to ICG from spatially separated sources when
      modeling all changes in conductivity simultaneously. It has been confirmed that
      the main contributions to ICG signal come from ventricles, atria, aorta, and
      lungs. The relations between these components have been found to be dependent
      nonlinearly on spatial conductivity distribution. As a result, reliable and
      reproducible measurements of stroke volume (SV) using ICG are impossible.
      Nevertheless, ICG can be used to monitor relative changes of SV in all cases
      where the spatial distribution of conductivity and geometry of the subject,
      during the examination, is preserved. However, it does not mean that the accuracy
      of SV measurement will be the same in all these cases.

PMID- 11212952
TI  - Ectopic activity in ventricular cells induced by early afterdepolarizations
      developed in Purkinje cells.
AB  - The development of early afterdepolarizations (EADs) in Purkinje fibers and their
      propagation to ventricular muscle cells are studied by computer modeling. The
      Purkinje-ventricular system has been simulated by a two-dimensional model of a
      Purkinje fiber (PF) connected to a thin sheet of ventricular muscle tissue (VMT).
      EADs are induced in the PF by enhancing the fast second inward current, iCa,f,
      and blocking the delayed K+ current, iK, while the VMT is kept under
      physiological conditions. Different phenomena are observed depending on the EAD
      conditions applied. For 70% iK blockade and iCa,f enhancement greater than 60%, a
      single phase 3 EAD developed in the PF propagates to the VMT generating an
      ectopic beat. For 80% iK blockade and iCa,f enhancement in the range from 0% to
      70%, multiple ectopic beats appear in the VMT. However, for iK blockades over
      80%, action potentials in PF cells do not repolarize and the ectopic activity in
      the VMT disappears. In our simulations, the ionic mechanism underlying phase 3
      EAD development is the reactivation of the fast sodium current in the PF. Our
      results demonstrate that there exists a critical range of EAD conditions that
      favor the development of EADs in the PF and their propagation to the VMT as
      ectopic activity. This phenomenon could underlie the genesis of some triggered
      arrhythmias.

PMID- 11212954
TI  - EEG spike detection with a Kohonen feature map.
AB  - Artificial neural networks are widely used for pattern recognition tasks. For
      spike detection in electroencephalography (EEG), feedforward networks trained by
      the backpropagation algorithm are preferred by most authors. Opposed to this, we
      examined the off-line spike detection abilities of a Kohonen feature map (KFM),
      which is different from feedforward networks in certain aspects. The EEG data for
      the training set were obtained from patients with intractable partial epilepsies
      of mesiotemporal (n=2) or extratemporal (n=2) origin. For each patient the
      training set for the KFM included the same patterns of background activity and
      artifacts as well as the typical individual spike patterns. Three different-sized
      networks were examined (15 x 15 cells, 25 x 25 cells, and 60 x 60 cells in the
      Kohonen layer). To investigate the quality of spike detection the results
      obtained with the KFM were compared with the findings of two board-certified
      electroencephalographers. Application of a threshold based on the partial
      invariance of spike recognition against translation of the EEG provided an
      average sensitivity and selectivity of 80.2% at crossover threshold (71%-86%)
      depending on the networksize and noise. Multichannel EEG processing in real time
      will be available soon. In conclusion, pattern-based automated spike detection
      with a KFM is a promising approach in clinical epileptology and seems to be at
      least as accurate as other more-established methods of spike detection.

PMID- 11212955
TI  - Effect of supraglottic mechanoreceptors on spatial mapping of respiratory related
      evoked responses using wavelet and Laplacian methods.
AB  - Respiratory related evoked potentials (RREPs) were recorded from eight normal
      subjects in response to brief pressure pulses of -10 cm H2O with a duration of
      200 ms to identify the contribution of supralaryngeal mechanoreceptors to the
      evoked responses by constraining application of the stimulus to the larynx and
      sublaryngeal regions through insertion of a laryngeal mask airway (LMA). Wavelet
      decomposition of RREP responses from 30 electrodes on the right side of the scalp
      was performed for eight frequency scales in time. The RREPs at each wavelet scale
      were enhanced by eliminating the wavelet coefficients due to artifacts and noise.
      After denoising, the third (125-150 Hz), fourth (62.5-125 Hz), fifth (31.25-62.5
      Hz) and sixth (13.62-31.25 Hz) wavelet scales were used for estimation of the
      Laplacian. In addition, the global field power was calculated to quantify the
      wavelet-filtered RREP activity and to extract features for statistical analysis.
      Our results show that estimates of the global field power at the fourth and fifth
      wavelet scales are more significantly decreased after the insertion of the LMA
      than was true for scales 3 and 6. Further, after the LMA was inserted, the
      Laplacian showed reduced activity in the posterior-lateral region in four
      subjects and reductions in other places in the rest.

PMID- 11212956
TI  - A spherical rotation coordinate system for the description of three-dimensional
      joint rotations.
AB  - Three-dimensional joint rotations in human movement analysis have been mainly
      described by Euler/Cardan angles. Due to sequence dependence, each combination of
      three Euler/Cardan angles defines a single pattern of joint rotation. When the
      rotation pattern is unknown, it needs to be considered using a particular
      sequence of Euler/Cardan angles to represent joint rotations. In this paper a
      spherical rotation coordinate system is developed for describing three
      dimensional joint rotations using a method of rotation involving two steps: a
      long axis rotation and a pure axial rotation. Two angles of the classical
      spherical coordinate system--longitude and latitude--are used to describe long
      axis rotations in this newly proposed coordinate system. The spherical rotation
      coordinate system uses a radial rotation angle to describe pure axial rotation of
      a limb segment whereas the classical spherical coordinate system uses a radial
      displacement to describe motion of a point. An application of the spherical
      rotation coordinate system is given to define three-dimensional rotations of the
      glenohumeral joint. A mathematical proof shows that the long axis rotation and
      axial rotation are sequence independent. Two numerical examples are investigated
      which demonstrate that the spherical rotation angles can be uniquely determined
      in both forward and inverse kinematics without considering sequences rotations.

PMID- 11212957
TI  - Comparison of particle image velocimetry and laser Doppler anemometry
      measurements in turbulent fluid flow.

PMID- 11212958
TI  - Arterial hypertension and cardiac arrhythmias.
AB  - PURPOSE AND DATA IDENTIFICATION: One of the main clinical problems of patients
      with arterial hypertension is the presence of arrhythmias, especially if left
      ventricular hypertrophy exists. Recent results from our group and all data
      available via Med-Line-search have been analysed. The analysis was focused on
      atrial and ventricular arrhythmias and arrhythmic risk prediction, using non
      invasive markers. RESULTS OF ANALYSIS AND CONCLUSION: Arterial hypertension is a
      major cause of non-rheumatic atrial fibrillation and other supraventricular
      arrhythmias. The prevalence of ventricular arrhythmias is increased in
      hypertensive patients without left ventricular hypertrophy, compared to
      normotensives. If left ventricular hypertrophy is present, the risk for
      ventricular tachycardias is quadrupled. The presence of left ventricular
      hypertrophy is associated with an increase in all-cause mortality by a factor of
      seven in men and nine in women. In particular, patients with hypertrophy,
      increased rate of ventricular extrasystoles up to non-sustained ventricular
      tachycardia and ST-depression in long-term ECG are threatened by sudden cardiac
      death. At present, it is not possible to safely identify patients with increased
      risk. Regression of hypertrophy exists along with a decreased rate of ventricular
      extrasystoles. We hypothesize that by the regression of hypertrophy, the
      prevalence of sustained ventricular tachycardia decreases and therefore the
      prognosis of those patients can be improved, although controlled studies are not
      yet available.

PMID- 11212959
TI  - Usefulness of home blood pressure measurements in assessing the effect of
      treatment in a single-blind placebo-controlled open trial.
AB  - OBJECTIVES: Reproducibility of home blood pressure measurements (HBP), and the
      placebo effect on HBP, were examined to establish the number of subjects required
      in order to observe a significant antihypertensive effect of a drug for a
      comparative study between placebo and active treatment. METHODS: Reproducibility
      of HBP (n = 172 for systolic blood pressure and n = 137 for diastolic blood
      pressure) and the placebo effect on HBP (n = 35 for systolic and n = 42 for
      diastolic blood pressure) were examined using a semi-automatic electronic device
      on untreated hypertensive subjects during 21 consecutive days of measurements.
      From these two studies, the number of subjects required in order to observe a
      significant antihypertensive drug effect was assessed. In both studies,
      measurements from the first 3 days were excluded from the analysis. RESULTS:
      Reproducibility, defined as the difference between the initial 5 day average
      (days 4-8) and the last 5 day average (days 17-21) was -1.9 +/- 7.0/-1.4 +/- 4.8
      mmHg (mean +/- SD), indicating high reproducibility with a minimal regression to
      the mean effect. A placebo was administered after the 8 day run-in period. The
      difference between the initial 5 day average (days 4-8) and the last 5 day
      average (days 17-21) was compared. The mean difference was 1.1 +/- 6.2/0.2 +/-
      5.7 mmHg, suggesting that there was a minimal, if any, placebo effect. As
      determined by the power calculations, based on the standard deviations of the
      tests for reproducibility and the placebo effect, nine of 13 subjects are
      required to show that a 9/5 mmHg decrease in systolic HBP/diastolic HBP (50% of
      estimated effective decrease in systolic HBP/diastolic HBP according to the
      guidelines for clinical trials in Japan) is statistically significant
      CONCLUSIONS: The results suggest that the HBP measurement is highly reproducible
      and that there is a minimal, if any, placebo effect. These characteristics of HBP
      contribute to minimizing the number of subjects necessary for assessment of
      antihypertensive drug effects in comparative studies between an active treatment
      and placebo.

PMID- 11212960
TI  - Risks of smoking in treated and untreated older Chinese patients with isolated
      systolic hypertension.
AB  - OBJECTIVES: To examine the health risks associated with smoking and blood
      pressure in Chinese hypertensive patients and to compare the benefit of
      antihypertensive drug treatment with the risk attributable to smoking. METHODS:
      We used multiple Cox regression to correlate outcome with blood pressure and
      smoking status in 2284 older (aged > or = 60 years) patients enrolled in the
      Systolic Hypertension in China (Syst-China) Trial (systolic/diastolic blood
      pressure > or = 160/< 95 mmHg). RESULTS: Median follow-up was 3.0 years. After
      adjustment for sex, age, active antihypertensive treatment and various entry
      characteristics, the relative hazard rates associated with smoking more than 20
      cigarettes per day were 2.04 (P = 0.04), 4.66 (P < 0.001) and 4.74 (P = 0.002)
      for all-cause, noncardiovascular and cancer mortality, respectively. With similar
      adjustments applied, the relative hazard rates for total (fatal and non-fatal)
      stroke associated with smoking 10-20 and more than 20 cigarettes per day were
      1.78 (P = 0.04) and 2.23 (P = 0.03), respectively. Furthermore, both smoking and
      systolic blood pressure were associated with higher risk of stroke. Compared with
      the overall risk in the whole group, treating 1,000 patients for 5 years
      prevented 40 [95% confidence interval (CI), 5-75] strokes in smokers as well as
      never smokers. Prognosis in never smokers and past smokers was similar. Quitting
      smoking had the potential to prevent 51 (95% CI, -21 to 122) strokes in untreated
      hypertensive patients and to prevent 45 (95% CI, - 14 to 104) additional strokes
      in treated patients, over and above the effects of antihypertensive treatment.
      If, in addition to stroke, non-cardiovascular mortality was also accounted for,
      the estimated absolute benefit of quitting smoking increased to 69 (95% CI, -18
      to 155) and 97 (95% CI, 23-171) events in the untreated and the treated group,
      respectively. CONCLUSIONS: In elderly Chinese patients, smoking was a risk factor
      for all-cause, non-cardiovascular and cancer mortality, as well as fatal and non
      fatal stroke. The potential benefits of antihypertensive treatment and quitting
      smoking were approximately similar. In our view, these findings are important in
      terms of public health policies and health economics.

PMID- 11212961
TI  - Involvement of erythropoietin-induced cytosolic free calcium mobilization in
      activation of mitogen-activated protein kinase and DNA synthesis in vascular
      smooth muscle cells.
AB  - BACKGROUND/OBJECTIVE: Human recombinant erythropoietin (rHuEPO) induces cytosolic
      free calcium ([Ca2+]i) mobilization, an activation of mitogen-activated protein
      (MAP) kinase and DNA synthesis in several tissues. We explored the mechanism of
      rHuEPO-induced [Ca2+]i mobilization and its role in the activation of MAP kinase
      and DNA synthesis in vascular smooth muscle cells (VSMC). METHODS: [Ca2+]i
      concentrations were measured by fura-2. MAP kinase activation was analyzed using
      an immunocomplex kinase assay and Western blotting. DNA synthesis was measured as
      an incorporation of 5-bromo-2'-deoxyuridine. RESULTS: Although addition of rHuEPO
      significantly increased [Ca2+]i, either in the presence or absence of
      extracellular Ca2+, the peak level and sustained elevation of [Ca2+]i were
      significantly reduced in the absence of extracellular Ca2+. Pretreatment with
      genistein completely blocked the elevation of [Ca2+]i in both conditions.
      Calphostin C and staurosporine did not completely block the elevation of [Ca2+]i.
      Staurosporine reduced its peak level in a dose-dependent manner, whereas
      calphostin C reduced its peak level at concentrations over 1 nmol/l in the
      presence of extracellular Ca2+. Similar results to those with staurosporine were
      observed with nifedipine. In the absence of extracellular Ca2+, their dose
      dependent effects disappeared even though rHuEPO increased [Ca2+]i. rHuEPO
      activated MAP kinase and DNA synthesis, both of which were significantly
      suppressed by the chelation of intracellular Ca2+. CONCLUSION: These findings
      suggest that rHuEPO increases [Ca2+]i by both Ca2+ influx and Ca2+ release from
      intracellular stores. Tyrosine phosphorylation is critical in the regulation of
      [Ca2+]i, but protein kinase C activation is important only in the regulation of
      Ca2+ influx. Dihydropyridine-sensitive L-type Ca2+ channels seem to be involved
      in rHuEPO-induced Ca2+ influx. In addition, increase of [Ca2+]i by rHuEPO
      stimulates MAP kinase activation and DNA synthesis in VSMC.

PMID- 11212962
TI  - Inhibition of vascular smooth muscle cell proliferation by DNA-RNA chimeric
      hammerhead ribozyme targeting to rat platelet-derived growth factor A-chain mRNA.
AB  - BACKGROUND: Spontaneously hypertensive rats (SHR)-derived vascular smooth muscle
      cells (VSMC) show exaggerated growth and increasingly express platelet-derived
      growth factor (PDGF) A-chain mRNA compared to VSMC from normotensive Wistar-Kyoto
      (WKY) rats. OBJECTIVE: To investigate the effects of designed DNA-RNA chimeric
      hammerhead ribozyme to rat PDGF A-chain on exaggerated growth of VSMC from SHR.
      DESIGN AND METHODS: We designed and synthesized a 38-base DNA-RNA chimeric
      hammerhead ribozyme with two phosphorothioate linkages at the 3' terminal to
      cleave rat PDGF A-chain mRNA at the GUC sequence at nucleotide 921. We confirmed
      the cleavage activity of designed ribozyme by in vitro cleavage reaction and by
      lipofectin-mediated transfection of ribozyme into VSMC. RESULTS: Doses of 0.1 and
      1 micromol/l DNA-RNA chimeric ribozyme dose-dependently inhibited basal DNA
      synthesis in VSMC from SHR. A dose of 1 micromol/l DNA-RNA chimeric ribozyme time
      dependently inhibited basal DNA synthesis in VSMC from SHR. However, the same
      doses of all-RNA ribozyme had no effects on DNA synthesis in VSMC from SHR.
      Fluorescein isothiocyanate-labeled DNA-RNA chimeric ribozyme was recognized in
      cytosol at 30 min, and in nucleus at 60 min after lipofectin transfection. A dose
      of 1 micromol/l DNA-RNA chimeric ribozyme significantly inhibited expressions of
      both PDGF A-chain mRNA and PDGF-AA protein in VSMC from SHR, but not from WKY
      rats. CONCLUSION: These results indicated that the designed DNA-RNA chimeric
      ribozyme to PDGF A-chain mRNA effectively and specifically inhibited the
      exaggerated growth of VSMC from SHR at low concentrations, which were mediated by
      the reduction of PDGF A-chain mRNA and PDGF-AA protein expressions.

PMID- 11212963
TI  - Peripheral arterial vascular function at altitude: sea-level natives versus
      Himalayan high-altitude natives.
AB  - OBJECTIVES: Regulation of the vascular system may limit physical performance and
      contribute to adaptation to high altitude. We evaluated vascular function in 10
      Himalayan high-altitude natives and 10 recently acclimatized sea-level natives at
      an altitude of 5,050 m. METHODS: We registered electrocardiogram, blood flow
      velocity in the common femoral artery, and blood pressure in the radial artery
      using non-invasive methods under baseline conditions, and during maximal
      vasodilation after 2 min leg occlusion. Vascular mechanics were characterized by
      estimating pulse wave velocity and input impedance. RESULTS: Pulse wave velocity
      and parameters of input impedance did not differ between groups under baseline
      conditions. In the post-ischemic period, the ratio between maximal hyperemic and
      baseline blood flow velocity was significantly higher in the high-altitude than
      in the sea-level natives (5.7 +/- 2.5 versus 3.8 +/- 1.2, P < 0.05). The leg
      vascular resistance decreased in the post-occlusive period without differences
      between groups. Characteristic impedance decreased in the post-ischemic period by
      about one third of the baseline level without differences between groups. The
      post-ischemic decrease of input impedance modulus was more marked in the high
      altitude than in the sea-level natives at low frequencies (28 +/- 12 versus 6.4
      +/- 20% at 2 Hz, P < 0.01). CONCLUSIONS: Our results demonstrate a superior
      ability to increase blood flow velocity as a response to muscular ischemia in
      high-altitude natives compared to sea-level natives. This phenomenon may be
      associated with a more effective coupling between blood pressure and blood flow
      which is probably caused by differences in conduit vessel function.

PMID- 11212964
TI  - Angiotensin converting enzyme protects acetylcholine-induced relaxation from its
      attenuation by formyl-methionyl-leucyl-phenylalanine in rat aorta.
AB  - OBJECTIVE: A chemotactic tripeptide formyl-methionyl-leucyl-phenylalanine (fMLP)
      attenuated acetylcholine (ACh)-induced relaxation. Because angiotensin converting
      enzyme (ACE), which inactivates fMLP, is rich in vascular endothelial cells, we
      examined whether endothelial cell ACE inhibits the attenuating effect of fMLP on
      ACh-induced relaxation. DESIGN AND METHODS: ACh-induced relaxation was evaluated
      in aortic rings from 9-week-old Sprague-Dawley rats. We examined the effects of
      ACE, the ACE inhibitor captopril and/or fMLP on ACh-induced relaxation in aortas
      from rats with or without dexamethasone treatment, which enhances ACE activity.
      RESULTS: Pre-treatment with ACE did not alter ACh-induced relaxation in control
      aortas but abolished the inhibitory effect of fMLP on ACh-induced relaxation
      [maximal relaxation (Emax): 95.4 +/- 1.2 versus 75.5 +/- 1.9%, P < 0.05].
      Conversely, captopril enhanced the attenuation of ACh-induced relaxation by fMLP
      (Emax: 62.5 +/- 3.3 versus 74.0 +/- 2.2%, P < 0.05), although captopril did not
      affect ACh-induced relaxation in control aortas. In addition, fMLP did not
      attenuate ACh-induced relaxation in aortas from dexamethasone-treated rats (Emax:
      89.7 +/- 3.7 versus 85.2 +/- 3.8%, NS), which enhanced ACE activity of aortas
      (3.37 +/- 0.25 versus 2.70 +/- 0.20 IU/mg protein, P < 0.05). CONCLUSION:
      Endothelial-cell ACE attenuates the effect of fMLP on ACh-induced relaxation,
      possibly by its cleavage.

PMID- 11212965
TI  - Identification of endogenous ouabain in culture supernatant of PC12 cells.
AB  - OBJECTIVE: Ouabain-like factor (OLF), assayed as ouabain-like immunoreactivity
      (OLI), is thought to represent an endogenous digitalis-like factor. We found
      increased plasma OLI during the surgical removal of a pheochromocytoma. The
      elution volume of the OLI extracted from plasma and the pheochromocytoma tissue
      was the same as that for authentic ouabain, using reverse phase high-performance
      liquid chromatography. The present study was performed to characterize OLF from
      the culture supernatant of a rat pheochromocytoma cell line, PC12 cells. DESIGN:
      OLI from culture supernatant and chromatographic fractions were assayed by a
      sensitive enzyme-linked immunosorbent assay for ouabain. PC12 cells, subcultured
      in RPMI 1640 with 10% horse serum and 5% fetal bovine serum, were washed, and
      then cultured in Iscove's modified Dulbecco's medium (Life Technologies,
      Rockville, Maryland, USA) with 0.4% bovine serum albumin (without serum).
      Progesterone was added to augment the production or secretion of OLI. The
      conditioned medium was acidified to dissociate the binding protein, and OLI was
      purified by five steps of octadecylsilane (ODS) column chromatography. The
      structural identity of this OLI was determined by liquid chromatography and mass
      spectrometry (LC/MS). RESULTS: OLI in the culture medium increased after addition
      of progesterone in a dose-dependent manner. The concentration in the culture
      medium was approximately double of that in homogenized PC12 cells. After five
      rounds of ODS column chromatography, approximately 100 ng of OLI was purified
      from 21 of culture supernatant, without fetal calf serum, in the presence of
      progesterone. The molecular size of purified OLI was found to be identical to
      authentic ouabain, based on analysis by LC/ MS. CONCLUSION: Mammalian cells
      originating from a rat pheochromocytoma cell line were found to produce and/or
      secrete OLF by the addition of progesterone.

PMID- 11212966
TI  - A novel assay for determination of diadenosine polyphosphates in human platelets:
      studies in normotensive subjects and in patients with essential hypertension.
AB  - OBJECTIVE: Diadenosine polyphosphates (APnAs, n = 3-6) are a family of endogenous
      vasoactive purine dinucleotides which have been isolated from thrombocytes.
      Diadenosine pentaphosphate (AP5A) and diadenosine hexaphosphate (AP6A) are more
      potent than diadenosine tetraphosphate (AP4A) and diadenosine triphosphate (AP3A)
      and cause skeletal muscle vasoconstriction in rats. Little is known about their
      physiological and pathophysiological significance in humans. The aims of the
      present study were to compare thrombocyte APnA concentrations in patients with
      essential hypertension (HYP) and in healthy normotensive humans (CON) using a
      novel quantitative assay and to assess a possible relationship between
      thrombocyte APnA concentrations and skeletal muscle vascular resistance. DESIGN
      AND METHODS: We describe a novel assay for quantification of APnAs in human
      platelets, involving platelet isolation from human blood, a solid-phase
      extracting procedure with a derivatized resin, desalting and quantitative
      determination of the substances with an ion-pair reversed-phase high-performance
      liquid chromatography (HPLC) system. The structural integrity of the isolated
      APnAs was confirmed by mixed assisted laser desorption ionization-time of flight
      mass spectrometry (MALDI-TOF) measurements and co-elution with added standards.
      The detection threshold for all four APnAs was 1 pmol/l and the inter-assay
      coefficients of variation were < 11% (n = 12). After venous blood sampling, mean
      arterial blood pressure (MAP) and forearm blood flow (FBF, using venous occlusion
      plethysmography) were measured in HYP and CON. Forearm vascular resistance (FVR)
      was calculated as MAP/FBF. significantly differ in platelet AP3A and AP4A
      content, but HYP had significantly higher thrombocyte concentrations of AP5A (56
      +/- 7 versus 32 +/- 3 ng/microg beta-thromboglobulin, P = 0.003) and AP6A (10 +/-
      1 versus 6 +/- 1 ng/microg beta-thromboglobulin, P = 0.015) than CON. HYP had
      significantly elevated FVR (50 +/- 6 versus 33 +/- 2 arbitrary units, P = 0.01)
      compared to CON. Significant correlations were found between AP5A and FVR (p =
      0.38, P = 0.04) as well as between AP6A and FVR (p = 0.42, P = 0.02). In
      contrast, there were no significant correlations between APnAs and MAP.
      CONCLUSIONS: The study shows that thrombocyte concentrations of AP5A and AP6A are
      elevated in patients with essential hypertension. Vasoconstriction caused by
      release of AP5A and AP6A from thrombocytes may contribute to the increase of
      vascular resistance in hypertensive patients.

PMID- 11212967
TI  - Relative deficiency of nitric oxide-dependent vasodilation in salt-hypertensive
      Dahl rats: the possible role of superoxide anions.
AB  - OBJECTIVE: The contribution of major vasoactive systems (renin-angiotensin
      system, sympathetic nervous system and nitric oxide) to blood pressure
      maintenance and the possible involvement of superoxide anions in the reduced
      efficiency of nitric oxide (NO)-dependent vasodilation to counterbalance
      sympathetic vasoconstriction were studied in salt-hypertensive Dahl rats. DESIGN
      AND METHODS: We used Dahl salt-sensitive (SS/Jr) and salt-resistant (SR/Jr)
      female rats kept on a low-salt (0.3% NaCl) or high-salt diet (8% NaCl) for 6
      weeks since weaning. Mean arterial pressure (MAP) was measured in conscious
      animals subjected to acute consecutive blockade of the renin-angiotensin system
      (RAS) [captopril, 10 mg/kg intravenously (i.v.)], the sympathetic nervous system
      (SNS) (pentolinium, 5 mg/kg i.v.) and NO synthase (Nomega-nitro-L-arginine methyl
      ester (L-NAME), 30 mg/kg i.v.). Before the consecutive blockade of vasoactive
      systems one-half of the animals in each experimental group was pre-treated with a
      stable membrane-permeable mimetic of superoxide dismutase (tempol, 25 mg/kg i.v.)
      which functions as a superoxide scavenger. RESULTS: Compared to normotensive
      SR/Jr animals, salt-hypertensive SS/Jr rats were characterized by an enhanced
      blood pressure (BP) fall after ganglionic blockade (-104 +/- 8 versus -62 +/- 5
      mm Hg, P < 0.001) and by higher residual blood pressure recorded after the
      blockade of both RAS and SNS (70 +/- 3 versus 43 +/- 3 mmHg, P < 0.01), but there
      was only a borderline elevation of their BP response to acute NO synthase
      inhibition (67 +/- 6 versus 49 +/- 4 mmHg, P < 0.05). The acute tempol pre
      treatment elicited the most pronounced reduction of basal BP (-13 +/- 1 mmHg, P <
      0.001) in the salt-hypertensive SS/Jr group in which the BP rise after L-NAME
      administration was augmented by about 50%. On the contrary, tempol pre-treatment
      did not affect norepinephrine- or angiotensin II-dependent vasoconstriction.
      CONCLUSIONS: The NO system is not able to counterbalance effectively the
      hyperactivity of the sympathetic nervous system in salt-hypertensive Dahl rats.
      The predominance of sympathetic vasoconstriction over NO-dependent vasodilation
      could be explained partially by enhanced NO inactivation due to augmented
      superoxide anion formation in hypertensive animals.

PMID- 11212968
TI  - Differential expression and synthesis of natriuretic peptides determines
      natriuretic peptide receptor expression in primary cultures of human proximal
      tubular cells.
AB  - INTRODUCTION: The natriuretic peptides and natriuretic peptide receptors may play
      a beneficial role in hypertension and heart failure and possibly in opposing
      associated detrimental cellular changes in the heart, vasculature and kidney.
      These responses may be, in part, modulated by the natriuretic peptide clearance
      receptor rather than the natriuretic peptide receptors (NPR-A or NPR-B).
      OBJECTIVE: To investigate the expression of the natriuretic peptide receptors
      (NPR-A,-B,-C) and the natriuretic peptides (ANP, BNP, CNP) in primary cultures of
      human proximal tubular cells and the role played by endogenously released
      natriuretic peptides in natriuretic peptide receptor expression. RESULTS:
      Northern analysis demonstrated that freshly isolated human proximal tubular cells
      express the NPR-C only. However, at confluence mRNA transcripts for both the NPR
      A and -B were expressed, accompanied by a significant cyclic guanosine
      monophosphate (cGMP) response to ANP and CNP, indicating the development of
      functionally active receptors. A significant increase in immunoreactive ANP, BNP
      and CNP in the cell supernatant accompanied the appearance of these receptors.
      Incubation of freshly isolated cells with exogenous ANP, BNP, CNP or with the NPR
      C specific ligand C(4.23)ANF induced similar changes in receptor expression,
      suggesting that these changes were mediated via the NPR-C rather than the NPR-A
      or -B. CONCLUSIONS: Significant changes in peptide and receptor expression occur
      during cell culture and may be integrally linked, with functionally active NPR-A
      and -B occurring in response to an increase in the expression of the natriuretic
      peptides possibly acting at the NPR-C.

PMID- 11212969
TI  - Effects of oral L-arginine on plasma nitrate and blood pressure in cortisol
      treated humans.
AB  - OBJECTIVE: The aim of this study was to determine whether cortisol-induced
      hypertension can be reversed by co-administration of oral L-arginine. STUDY
      DESIGN: Three studies were undertaken in healthy male human subjects. The first
      study addressed the effect of oral L-arginine loading on plasma arginine
      concentration. Study 2 addressed the effect of co-administration of cortisol with
      L-arginine on plasma L-arginine concentrations. Study 3 was a randomized placebo
      crossover control comparing the effects of cortisol 80 mg/day co-administered
      with a placebo to cortisol 80 mg/day co-administered with L-arginine 21 g/day.
      METHODS: Blood pressure was measured by a random Hawksley sphygmomanometer.
      Plasma nitrate/nitrite concentrations were measured by a modified Greiss
      reaction. Plasma arginine and citrulline concentrations were measured by an
      automated amino acid analyser. RESULTS: Plasma arginine concentrations were
      doubled by oral doses of 15 g/day and 21 g/day of L-arginine (study 1). Co
      administration of cortisol did not alter plasma arginine concentrations in
      subjects taking 21 g of L-arginine per day (study 2). Co-administration of L
      arginine 21 g/day with cortisol 80 mg/day did not prevent cortisol-induced
      increases in blood pressure or cortisol-induced falls in plasma nitrate/nitrite
      concentrations. CONCLUSION: Cortisol-induced hypertension is accompanied by a
      fall in plasma nitrate/nitrite concentrations. Oral L-arginine administration
      does not prevent cortisol-induced falls in plasma nitrate/nitrite concentrations
      or increases in blood pressure. We propose that cortisol-induced reductions in
      nitrate/nitrite production occur at a point distal to L-arginine availability in
      the nitric oxide synthase pathway.

PMID- 11212970
TI  - Hormone replacement improves hemodynamic profile and left ventricular geometry in
      hypertensive and normotensive postmenopausal women.
AB  - BACKGROUND: Postmenopausal estrogen replacement, with or without progestins, has
      been related to lower cardiovascular risks. OBJECTIVE: We investigated whether
      the actions of estrogen on vascular resistance contribute to this
      cardioprotective effect. DESIGN AND METHODS: In a 6-month double-blind study, pre
      and post-treatment blood pressure, cardiac index, total vascular resistance
      index and plasma catecholamine responses during baseline and mental stressors
      were compared in 69 women (including 19 with mild hypertension but no history of
      heart disease). Women were randomized to receive either conjugated estrogens
      alone, estrogens plus medroxyprogesterone, or placebo. RESULTS: Both groups on
      active hormone replacement showed similar decreases in vascular resistance and
      modest blood pressure reductions, which differed from the unchanged responses of
      those on placebo (P< 0.05) after 3 and 6 months of treatment. Hypertensive women
      showed greater reductions in vascular resistance than normotensives (P< 0.05) and
      their blood pressure reductions tended to be larger. Women receiving hormone
      replacement showed increased stroke volume and cardiac index at 6 months,
      particularly among hypertensives and those receiving medroxyprogesterone (P <
      0.05). Hormone replacement was also related to decreases in plasma
      norepinephrine. Finally, in 33 women receiving hormone replacement, significant 5
      and 3% decreases in echocardiographic measures of left ventricular mass index and
      relative wall thickness were evident at 6 months (P < 0.05), while 20 placebo
      treated women showed no reliable echocardiographic improvements (P= NS).
      CONCLUSIONS: These findings suggest that estrogen-mediated reductions in
      hemodynamic load on the heart may contribute to the reduced risk of
      cardiovascular events in relatively healthy postmenopausal women who use hormone
      replacement.

PMID- 11212972
TI  - Left ventricular hypertrophy and nocturnal hypoxemia in hemodialysis patients.
AB  - OBJECTIVE: Nocturnal hypoxemia has recently been proposed as a cardiovascular
      risk factor in patients with chronic renal failure. In this study we have tested
      the hypothesis that this disturbance is associated with left ventricular
      hypertrophy (LVH) in dialysis patients. METHODS: During a mid-week non-dialysis
      day, 38 hemodialysis patients underwent continuous monitoring of arterial O2
      saturation (SaO2) during night-time as well as 24 h ambulatory blood pressure
      monitoring and echocardiography. RESULTS: Eighteen patients had one or more
      episodes of O2 desaturation during night-time (average: 21 episodes; range 1 to
      120) while the other 20 had no episode. Neither day-time arterial pressure nor
      heart rate were significantly associated with nocturnal hypoxemia. However there
      was a significant correlation between the night/day systolic ratio and the
      severity of hypoxemia during night-time (r = 0.36, P = 0.03). On multivariate
      analysis, nocturnal hypoxemia proved to be the stronger independent predictor of
      relative wall thickness, mean wall thickness and left ventricular mass index,
      suggesting that nocturnal O2 desaturation is linked to concentric hypertrophy and
      to concentric geometry of the left ventricle. Accordingly, the proportion of
      patients with such geometric alteration was higher (chi2 = 4.1, P = 0.04) in
      patients with a pulse oximetry severity score > 50th percentile [15 of 19 (79%)]
      than in those below this threshold [nine of 19 (47%)]. CONCLUSIONS: Nocturnal
      hypoxemia is an important correlate of LVH in hemodialysis patients. Such an
      association is largely independent of arterial pressure. These data further
      underscore the importance of disturbed respiratory control as a cardiovascular
      risk factor in dialysis patients.

PMID- 11212971
TI  - Comparative effects of mibefradil and nifedipine gastrointestinal transport
      system on autonomic function in patients with mild to moderate essential
      hypertension.
AB  - BACKGROUND: L-type dihydropyridine calcium channel blockers (CCBs) have been
      implicated in increased cardiovascular events in patients with hypertension,
      perhaps due to adverse effects on autonomic nervous system (ANS) function.
      Blockade of T-type calcium channels may limit ANS dysfunction by inhibition of T
      channel-mediated neuroendocrine effects. OBJECTIVE AND DESIGN: This double-blind,
      parallel group study compared the effect of nifedipine gastrointestinal transport
      system (GITS) (L-type CCB) versus mibefradil (T-type CCB) on ANS function in
      patients with mild-moderate essential hypertension. METHODS: Sixteen patients (10
      male, 6 female; age 57.2 +/- 2.3 years), diastolic blood pressure (DBP) < 95 mmHg
      were randomized to nifedipine 30 mg daily or mibefradil 50 mg daily (2 weeks),
      then nifedipine 60 mg daily or mibefradil 100 mg daily (4 weeks). Sympathetic
      nervous system activity (SNSA) was assessed using norepinephrine kinetics.
      Parasympathetic nervous system activity (PSNA) was assessed from 24 h Holter
      recordings of heart rate variability (HRV). Non-invasive baroreflex sensitivity
      (BRS) provided integrated assessment of ANS. RESULTS: Patient groups were well
      matched at baseline. Achieved DBP was lower in patients treated with mibefradil
      compared with nifedipine, (83.4 +/- 1.7 versus 95.25 +/- 3.3 mmHg). There were no
      significant differences in SNSA and BRS between groups, however the root mean
      square of successive differences and high frequency power (HFP) were increased in
      mibefradil compared with nifedipine-treated patients [(+ 1.07 +/- 1.6 versus 
      3.36 +/- 1.2 ms, P < 0.05) and (+ 0.28 +/- 0.1 versus -0.23 +/- 0.1 ms2, P <
      0.01), respectively]. Furthermore, Ln HFP/Ln total power was increased from week
      0 to week 6 in the mibefradil-treated group, (0.71 +/- 0.02 versus 0.74 +/- 0.03,
      P = 0.046). CONCLUSION: No differences existed between effect of L- and T-type
      CCBs on SNSA and BRS. However, T-type CCBs increased PSNA, independent of
      achieved changes in heart rate.

PMID- 11212973
TI  - Increased incidence of myocardial infarction and stroke in hypertensive men with
      reduced lung function.
AB  - BACKGROUND AND OBJECTIVE: Although hypertension is associated with increased
      cardiovascular risk, many individuals remain free from disease. This study is
      aimed to investigate whether this variation in individual susceptibility is
      associated with lung function. DESIGN: Population-based prospective cohort study.
      PARTICIPANTS: 'Men born in 1914', Malmo, Sweden. Subjects (n = 639) were examined
      and considered free from prevalent cardiovascular disease at age 55 years. MAIN
      OUTCOME MEASURES: Mortality, fatal and non-fatal stroke and cardiac events (fatal
      or non-fatal myocardial infarction) during 28-years follow-up. RESULTS: Of the
      men, 467 had normal blood pressure and 172 (27%) had hypertension (> or = 160/95
      mmHg or treatment for hypertension). Hypertensive men with height-adjusted forced
      expiratory volume during 1 s (FEV1.0) below median had significantly higher rates
      of stroke (13.4 versus 5.8/1,000 person-years), cardiac events (27.1 versus
      12.8/1,000 person-years) and all cause mortality (52.5 versus 28.6/1,000 person
      years) than hypertensive men with high FEV1.0. These differences remained
      statistically significant after adjustment for potential confounders. Men with
      normal blood pressure and FEV1.0 below median had higher rates of stroke (5.4
      versus 4.2/1,000 person-years), cardiac events (13.3 versus 11.6/1,000 person
      years) and all cause mortality (29.9 versus 21.2/1,000 person-years) than men
      with normal blood pressure and high FEV1.0. After adjustments for potential
      confounders, FEV1.0 was significantly associated with mortality among men with
      normal blood pressure, whereas the associations with stroke and cardiac events
      did not reach significance. CONCLUSION: The incidence of cardiovascular disease
      and death associated with hypertension is increased among men with reduced lung
      function. The synergistic interaction between hypertension and lung function was
      independent of smoking and other potential confounders.

PMID- 11212975
TI  - Left ventricular mass is not related to insulin sensitivity in never-treated
      primary hypertension.
AB  - OBJECTIVE: Insulin has been suggested to promote myocardial cell growth and the
      development of left ventricular (LV) hypertrophy. This study examines the
      possible relationship between LV mass and insulin sensitivity. DESIGN: Previously
      untreated non-diabetic hypertensive patients. PATIENTS: Fifty-one patients with
      mean age 51 +/- 8 years, body mass index (BMI) 25.9 +/- 3.2 kg/m2 and blood
      pressure 158/102 mmHg were included. LV mass was determined by echocardiography.
      Glucose metabolism was assessed by an euglycemic insulin clamp (40 mU/m2 body
      surface area/min). RESULTS: Insulin sensitivity index (MI) and insulin clearance
      were inversely related to LV mass (r = -0.37, P < 0.01 and -0.33, P < 0.05,
      respectively) and LV mass indexed to height (r = -0.33, P < 0.05 and -0.29, P <
      0.05, respectively). C-peptide and fasting insulin were related to LV mass (r =
      0.33, P < 0.05 and r = 0.36, P < 0.01, respectively) and LV mass indexed to
      height (r = 0.30, P < 0.05 and r = 0.34, P < 0.05, respectively). In contrast,
      when LV mass was indexed by body surface area there was no longer a relation to
      MI, insulin clearance, C-peptide or fasting insulin. When adjusting for BMI in a
      multiple regression analysis, MI and LV mass no longer showed a relation. Indeed,
      MI, insulin clearance, C-peptide and insulin were all strongly related to weight
      and BMI. CONCLUSION: Insulin sensitivity is related to body size in untreated
      hypertension. However, insulin sensitivity is not related to LV mass, if
      adjusting for body size. This does not support a direct growth-promoting effect
      of insulin on the myocardium. Insulin does not appear to be strongly involved in
      development of hypertensive LV hypertrophy.

PMID- 11212974
TI  - Long-term effects of amlodipine and lisinopril on left ventricular mass and
      diastolic function in elderly, previously untreated hypertensive patients: the
      ELVERA trial.
AB  - OBJECTIVE: To compare the effects of a calcium antagonist (amlodipine) and an
      angiotensin converting enzyme inhibitor (lisinopril) on left ventricular mass and
      diastolic function in elderly, previously untreated hypertensives. DESIGN: A
      double-blind randomized parallel group trial. Effects of amlodipine and
      lisinopril on left ventricular mass and diastolic function (E/A Ratio) (The
      ELVERA trial). SETTING: Rural northern Netherlands: population screening new
      diagnosed hypertensive subjects. PATIENTS: The study population comprised 166
      newly diagnosed hypertensive (aged 60-75) with diastolic blood pressure between
      95-115 mmHg and/or systolic blood pressure between 160-220 mmHg. INTERVENTION:
      Patients were randomly allocated to receive 5-10 mg amlodipine or 10-20 mg
      lisinopril for 2 years. MAIN OUTCOME MEASURES: Prior and after 1 and 2 years of
      treatment left ventricular mass, indexed by body surface (LVMI) was estimated by
      2-D mode echocardiography according to Devereux with use of Penn convention.
      Early to atrial filling ratio (E/A) was assessed by transmitral flow. Change from
      baseline of LVMI and E/A ratio was evaluated by repeated measurement analysis of
      the treatment effect in an intention-to-treat analysis. RESULTS: Both amlodipine
      and lisinopril led to equivalent reduction in systolic and diastolic blood
      pressure. At the end of the study the amlodipine group led to LVMI decrease by
      21.8 g/m < or = [95% confidence interval (CI), 18.3-25.3] and E/A ratio increased
      by 0.08 (95% CI, 0.05-0.11). In the lisinopril group LVMI decreased by 22.4 g/m <
      or = (95%, CI, 19.0-25.8) and E/A ratio increased by 0.07 (95% CI, 0.04-0.10). No
      statistically significant differences were found in changes in LVMI and E/A ratio
      between amlodipine and lisinopril. CONCLUSION: A long-term study, the ELVERA
      trial proves that amlodipine and lisinopril reduce left ventricular mass and
      improve diastolic function to a similar extent in elderly newly diagnosed
      hypertensive patients.

PMID- 11212976
TI  - Frequency and determinants of microalbuminuria in mild hypertension: a primary
      care-based study.
AB  - OBJECTIVE: To evaluate the frequency of microalbuminuria and its relationship
      with several risk factors and left ventricular mass in a population of mildly
      hypertensive subjects attended in a primary-care setting. DESIGN: Cross-sectional
      study. SETTING: Eight primary-care centres. PATIENTS: Two hundred and twenty
      three non-diabetic patients recently diagnosed with mild hypertension were
      included in the study. None of them had clinical evidence of target-organ damage
      or had received prior antihypertensive treatment. INTERVENTIONS: Subjects
      included in the study underwent clinical interview, measurement of blood pressure
      (BP) on three visits, blood analysis, measurement of albumin by
      immunonephelometry in three overnight urine collections, 24 h BP monitoring and M
      mode and Doppler echocardiography. MAIN OUTCOME MEASURES: Tobacco habit, clinic
      BP, body mass index, serum lipids and uric acid, glycaemia, urinary albumin
      excretion (UAE), ambulatory BP and left ventricular mass index. RESULTS: The
      frequency of microalbuminuria was 7.2%. Microalbuminuric patients were more
      likely to be men and to be characterized by higher ambulatory BP, body mass index
      and uric acid levels. Regression analysis demonstrated that male sex and 24 h
      systolic BP were determinants of UAE. Patients with white-coat hypertension
      showed lower UAE than did subjects with sustained hypertension. Although a
      certain relationship between UAE and left ventricular mass index was found, these
      variables were not significantly correlated. CONCLUSIONS: A low proportion of
      mildly hypertensive patients attended in a primary care setting are
      microalbuminuric. In this population, UAE is an expression of BP values over 24 h
      and correlates with several risk factors.

PMID- 11212977
TI  - Glomerular hypertension and hyperfiltration in adrenocorticotrophin-induced
      hypertension in rats: the role of nitric oxide.
AB  - OBJECTIVE: To determine the effects on pre- and post-glomerular vascular
      resistance of adrenocorticotrophin (ACTH)-induced hypertension in rats, before
      and after blockade of nitric oxide formation. DESIGN: Four groups of Sprague
      Dawley rats were studied. Measurements were made in ACTH- (Synacthen Depot, 0.25
      mg/kg twice daily for 8 days) and sham-treated anaesthetized rats, before and
      after either Nomega-nitro-L-arginine (L-NNA, 6 mg/kg) or vehicle. METHODS: Whole
      kidney and single-nephron haemodynamics and function were measured. Glomerular
      capillary pressure was estimated from tubular stop-flow pressure measurements.
      RESULTS: Blood pressure (P < 0.001), renal blood flow (RBF, P < 0.05) and
      glomerular filtration rate (P < 0.01) were increased following ACTH treatment
      compared with sham. There were no differences in either total renal, or pre- or
      post-glomerular vascular resistances, but stop-flow-estimated glomerular
      capillary pressure was elevated (P < 0.001) as was single-nephron glomerular
      filtration rate (SNGFR) (P < 0.001) and single-nephron blood flow (P < 0.01 ) in
      the ACTH- compared to the sham-treated rats. L-NNA treatment increased blood
      pressure by a similar extent in both ACTH- and sham-treated rats, but reduced RBF
      (P < 0.05) and glomerular filtration rate (GFR) (P < 0.05) more in the ACTH
      group; similar changes were seen in single-nephron values. L-NNA increased pre-
      and post-glomerular resistances to a greater extent in the ACTH group.
      CONCLUSIONS: ACTH-induced hypertension produced glomerular hypertension and
      hyperfiltration, which may be due to nitric oxide-related vasodilatation of the
      renal vasculature.

PMID- 11212978
TI  - Electronic compliance monitoring in resistant hypertension: the basis for
      rational therapeutic decisions.
AB  - OBJECTIVE: Incomplete compliance is one of several possible causes of
      uncontrolled hypertension. Yet, non-compliance remains largely unrecognized and
      is falsely interpreted as treatment resistance, because it is difficult to
      confirm or exclude objectively. The goal of this study was to evaluate the
      potential benefits of electronic monitoring of drug compliance in the management
      of patients with resistant hypertension. METHODS: Forty-one hypertensive patients
      resistant to a three-drug regimen (average blood pressure 156/ 106 +/- 23/11
      mmHg, mean +/- SD) were studied prospectively. They were informed that for the
      next 2 months, their presently prescribed drugs would be provided in electronic
      monitors, without any change in treatment, so as to provide the treating
      physician with a measure of their compliance. Thereafter, patients were offered
      the possibility of prolonging the monitoring of compliance for another 2 month
      period, during which treatment was adapted if necessary. RESULTS: Monitoring of
      compliance alone was associated with a significant improvement of blood pressure
      at 2 months (145/97 +/- 20/15 mmHg, P < 0.01). During monitoring, blood pressure
      was normalized (systolic < 140 mmHg or diastolic < 90 mmHg) in one-third of the
      patients and insufficient compliance was unmasked in another 20%. When analysed
      according to tertiles of compliance, patients with the lowest compliance
      exhibited significantly higher achieved diastolic blood pressures (P = 0.04). In
      30 patients, compliance was monitored up to 4 months and drug therapy was adapted
      whenever necessary. In these patients, a further significant decrease in blood
      pressure was obtained (from 150/100 +/- 18/15 to 143/94 +/- 22/11 mmHg, P =
      0.04/0.02). CONCLUSIONS: These results suggest that objective monitoring of
      compliance using electronic devices may be a useful step in the management of
      patients with refractory hypertension, as it enables physicians to take rational
      decisions based on reliable and objective data of drug compliance and hence to
      improve blood pressure control.

PMID- 11212979
TI  - A comparison of indapamide SR 1.5 mg with both amlodipine 5 mg and
      hydrochlorothiazide 25 mg in elderly hypertensive patients: a randomized double
      blind controlled study.
AB  - OBJECTIVE: To analyse the efficacy of indapamide sustained-release (SR) 1.5 mg in
      reducing blood pressure versus amlodipine 5 mg and hydrochlorothiazide 25 mg, in
      elderly hypertensive patients. DESIGN: Double-blind, randomized, 12 week study
      using three parallel groups. SETTING: European teaching hospitals and general
      practices. PATIENTS: Randomized patients, (n = 524) including 128 patients with
      isolated systolic hypertension (ISH); mean age: 72.4 years; mean
      systolic/diastolic blood pressures (SBP/DBP): 174.5/97.9 mmHg. MAIN OUTCOME
      MEASURES: Clinic systolic and diastolic blood pressure variations. RESULTS:
      Indapamide SR 1.5 mg demonstrates a similar efficacy to that of amlodipine 5 mg,
      as well as to that of hydrochlorothiazide 25 mg (equivalence P < 0.001); the mean
      decreases in SBP/DBP were -22.7/-11.8 mmHg, -22.2/-10.7 mmHg and -19.4/-10.8
      mmHg, respectively. In the ISH subgroup, indapamide SR 1.5 mg tends to have
      greater efficacy than hydrochlorothiazide 25 mg in reducing the SBP (-24.7 versus
      -18.5 mmHg, respectively; equivalence P = 0.117), while similar results are
      obtained with amlodipine 5 mg (-23 mmHg, equivalence P < 0.001). The
      normalization rate was relatively high for indapamide SR 1.5 mg (75.3%), when
      compared with amlodipine (66.9%) and hydrochlorothiazide (67.3%), especially in
      the subgroup of isolated systolic hypertensive patients: 84.2 versus 80.0% for
      amlodipine, and versus 71.4% for hydrochlorothiazide. CONCLUSIONS: Indapamide SR
      1.5 mg shows similar antihypertensive efficacy to amlodipine 5 mg and
      hydrochlorothiazide 25 mg in elderly hypertensive patients, while in patients
      with isolated systolic hypertension, indapamide SR 1.5 mg shows a similar
      efficacy to amlodipine 5 mg but a greater efficacy than hydrochlorothiazide 25
      mg.

PMID- 11212980
TI  - Assessment of arterial and cardiopulmonary baroreflex gains from simultaneous
      recordings of spontaneous cardiovascular and respiratory variability.

PMID- 11212981
TI  - Epidural analgesia for labour and instrumental vaginal delivery: an anaesthetic
      problem with an obstetric solution?

PMID- 11212982
TI  - The frequency of significant pathology in women attending a general
      gynaecological service for postcoital bleeding.
AB  - OBJECTIVES: To document the frequency of pathology in women who complain of
      postcoital bleeding. To determine whether negative cervical cytology excludes
      serious pathology in women with postcoital bleeding. To determine whether
      postcoital bleeding increases the risk of serious pathology in women with an
      abnormal smear. DESIGN: A retrospective study. SETTING: A university teaching
      hospital. POPULATION: 314 women with postcoital bleeding seen in the gynaecology
      service from first January 1988 to 31 December 1994. METHODS: Women were
      identified from the computerised records of the colposcopy service and copies of
      correspondence, which was routinely retained on computer. The latter was searched
      for the text strings coital and intercourse. MAIN OUTCOME MEASURE:
      Histopathological diagnosis. RESULTS: Twelve women (4%) had invasive cancer: 10
      were cervical or vaginal cancers and two endometrial cancers. Eight of the 10
      cervical or vaginal cancers were clinically apparent. Four women of these 10 had
      had a normal smear before being referred for further investigation of postcoital
      bleeding. Two of these cancers were visible only with the aid of the colposcope.
      Thus, 0.6% of women attending a gynaecology service with postcoital bleeding, a
      normal looking cervix and a normal smear had invasive cancer of the cervix.
      Cervical intraepithelial neoplasia were found in 54 women (17.%) and 15 women
      (5%) had cervical polyps. Nineteen of the 63 women (30%) with significant
      pathology had a normal or inflammatory cervical smear. No explanation for the
      postcoital bleeding was found in 155 women (49 %). CONCLUSIONS: Although invasive
      cancer is rare in women with postcoital bleeding, it is much commoner than in the
      general population. It seems likely that cervical intraepithelial neoplasia is
      also associated with postcoital bleeding, perhaps because the fragile cervical
      epithelium becomes detached during intercourse. Postcoital bleeding should
      continue to be regarded as an indication of high risk for invasive cervical
      cancer and for cervical intraepithelial neoplasia. Prompt referral to a
      colposcopy clinic is indicated, but most women with postcoital bleeding will have
      no serious abnormality.

PMID- 11212983
TI  - Evaluating ambulatory urodynamics: a prospective study in asymptomatic women.
AB  - OBJECTIVE: To identify abnormal detrusor contractions in asymptomatic women
      undergoing ambulatory urodynamics, to standardise the investigation technique for
      women with urinary symptoms for clinical practice. DESIGN: Prospective
      observational study. SETTING: Two tertiary referral urogynaecology units: one in
      London, UK and one in Varese, Italy. METHODS: Women without urinary symptoms were
      recruited into the study. Ambulatory urodynamics was performed according to the
      King's College Hospital protocol. All the traces were analysed in four different
      ways: 1. without the second bladder transducer measurements displayed on the
      screen and without the diary; 2. as in 1. but with the diary; 3. with the second
      bladder sensor displayed on the screen but without the diary; 4. as in 3. but
      with the diary. The diary was always interpreted at the end of the test with the
      woman present. For each method we reported the total number of detrusor
      contractions and whether the woman would have been diagnosed as having abnormal
      detrusor contraction. Cochran's Q test was used for statistical analysis.
      RESULTS: Twenty-six women (mean age 31.7 years) were recruited. Ambulatory
      urodynamic testing lasted an average of 3.57 hour. The diagnosis of abnormal
      detrusor contraction varied by 65.4% depending on the method of analysis used.
      The diary and the women's symptoms during the test were the most discriminating
      factors. A significant difference between the diagnoses was obtained when
      comparing the four different ways of analysis. According to our protocol only
      three women (11.5%) had abnormal detrusor contractions. CONCLUSIONS: Using our
      protocol almost 90% of asymptomatic women have a stable bladder on ambulatory
      urodynamics. This is similar to the results of labouratory urodynamic testing of
      asymptomatic women but is in contrast to previous reports of ambulatory
      urodynamics of asymptomatic women. The technique used during ambulatory
      urodynamics determines the tests ability to detect detrusor instability with an
      accurate symptom diary being the most important.

PMID- 11212984
TI  - Non-surgical treatment of uterovaginal prolapse using double vaginal rings.
AB  - A new technique of using double vaginal ring pessaries to treat uterovaginal
      prolapse in a group of elderly women is described. Eighteen women with a mean age
      of 82 years and advanced Stage III or IV uterovaginal prolapse had double vaginal
      rings inserted. All of them previously had used single vaginal ring pessaries or
      had undergone pelvic floor repair surgery. Double ring pessaries were successful
      in 13 of the 18 women. They are a useful treatment of advanced prolapse in women
      unsuitable for surgery.

PMID- 11212985
TI  - Medical education with the Internet: a pilot training programme in reproductive
      medicine.
AB  - Following a detailed information technology survey in the South West Deanery, an
      Internet educational programme in reproductive medicine was constructed,
      delivered and assessed. The course followed a problem-based approach using case
      studies, using an education website and electronic mail (e-mail) to communicate
      between trainees and trainers. Independent evaluation revealed a high level of
      satisfaction for both trainees and trainers with an increase in trainees'
      confidence to deal with patients following the course. This study suggests that
      the Internet may be used effectively to deliver postgraduate medical education,
      if the training programme is designed appropriately to computer infrastructure
      and the computer literacy of the users.

PMID- 11212986
TI  - Conservative anterior exenteration with preservation of fertility potential and
      continent urinary diversion.

PMID- 11212987
TI  - Malignant rhabdoid tumour of the uterine cervix.

PMID- 11212988
TI  - Ureteric obstruction with mucocoele of the appendix due to endometriosis.

PMID- 11212989
TI  - Association of cerebral perfusion pressure with headache in women with pre
      eclampsia.

PMID- 11212991
TI  - Can diagnostic laparoscopy be avoided in routine investigation for infertility?

PMID- 11212990
TI  - Puerperal sepsis: a disease of the past?

PMID- 11212992
TI  - Randomised comparison of Burch colposuspension versus anterior colporrhaphy for
      patients with stress urinary incontinence.

PMID- 11212993
TI  - Guidelines in gynaecology: in menorrhagia and in urinary incontinence.

PMID- 11212994
TI  - Fertility following radical, conservative-surgical or medical treatment for tubal
      pregnancy: a population-based study.

PMID- 11212995
TI  - Decision to delivery for assisted vaginal vertex delivery.

PMID- 11212996
TI  - Decision to delivery for assisted vaginal vertex delivery.

PMID- 11212997
TI  - Fibroid embolisation: a technique not without significant complications.

PMID- 11212998
TI  - Collaboration in maternity care: a randomised controlled trial comparing
      community-based continuity of care with standard hospital care.
AB  - OBJECTIVE: To test whether a new community-based model of continuity of care
      provided by midwives and obstetricians improved maternal clinical outcomes, in
      particular a reduced caesarean section rate. DESIGN: Randomised controlled trial.
      SETTING: A public teaching hospital in metropolitan Sydney, Australia. Sample
      1089 women randomised to either the community-based model (n = 550) or standard
      hospital-based care (n = 539) prior to their first antenatal booking visit at an
      Australian metropolitan public hospital. MAIN OUTCOME MEASURES: Data were
      collected on onset and outcomes of labour, antenatal, intrapartum and postnatal
      complications, antenatal admissions to hospital and neonatal mortality and
      morbidity. RESULTS: There was a significant difference in the caesarean section
      rate between the groups, 13.3% (73/550) in the community-based group and 17.8% in
      the control group (96/539). This difference was maintained after controlling for
      known contributing factors to caesarean section (OR = 0.6, 95% CI 0.4-0.9, P =
      0.02). There were no other significant differences in the events during labour
      and birth. Eighty babies (14.5%) from the community-based group and 102 (18.9%)
      from the control group were admitted to the special care nursery, but this
      difference was not significant (OR 0.75, 95% CI 0.5-1.1, P = 0.12). Eight infants
      died during the perinatal period (four from each group), for an overall perinatal
      mortality rate of 7.3 per 1000 births. CONCLUSION: Community-based continuity of
      maternity care provided by midwives and obstetricians resulted in a significantly
      reduced caesarean section rate. There were no other differences in clinical
      outcomes.

PMID- 11212999
TI  - A comparison of oral and vaginal misoprostol for induction of labour at term: a
      randomised trial.
AB  - OBJECTIVE: To compare the efficacy of oral with vaginal misoprostol for induction
      of labour at term. DESIGN: Randomised trial. SETTING: Tertiary Care hospital.
      PARTICIPANTS: One hundred and sixty-seven women requiring induction of labour.
      METHODS: The women were randomised to receive 50 microg of misoprostol orally or
      vaginally every 6 h until the cervix was favourable for amniotomy, spontaneous
      rupture of membranes, or active labour occurred. Sample size was calculated with
      a two-tailed alpha of 0.05 and a power of 95% to detect a 5 h difference in
      induction-to-delivery time. Student's t test was used for comparison of normally
      distributed continuous variables and the Mann-Whitney U test was used for non
      Gaussian distributed continuous variables. Fisher' s exact and chi2 tests were
      used for comparison of categorical variables. The main outcome measure was
      induction to delivery time. RESULTS: The median induction to delivery time was
      significantly shorter with vaginal misoprostol (15.7 h range 4.3-55.7), compared
      with oral misoprostol (23.0 h range 3.2-141.7, P = 0.0013). The median number of
      doses was also significantly less in the vaginal misoprostol group, 1 (range 1
      3), compared with the oral group, 2 (range 1-8), (P < 0.0001). The significant
      differences in outcome held true when nulliparous and multiparous women were
      analysed separately. There were no differences between the two routes of
      administration with respect to rates of hyperstimulation or neonatal asphyxia.
      There were more caesarean sections in the vaginal misoprostol group, but the
      difference was not statistically significant. CONCLUSIONS: Compared with oral
      misoprostol, vaginal misoprostol for induction of labour at term results in a
      shorter induction-to-delivery time, with fewer doses required per patient.
      Vaginal misoprostol may be associated with higher rates of caesarean section than
      oral misoprostol.

PMID- 11213000
TI  - A randomised controlled trial of epidural compared with non-epidural analgesia in
      labour.
AB  - OBJECTIVES: To investigate possible short and long term side effects of epidural
      analgesia, compared with non-epidural analgesia for pain relief in labour.
      DESIGN: Randomised controlled study, with long term follow up by questionnaire.
      Analysis by intention-to-treat. SETTING: Busy maternity unit within a district
      general hospital in England. PARTICIPANTS: Three hundred and sixty nine
      primigravid women in labour were included (randomised allocation: epidural n =
      184, non-epidural n = 185). MAIN OUTCOME MEASURES: Backache at three and twelve
      months after delivery, instrumental delivery rates and maternal opinion of pain
      relief in labour. RESULTS: No significant differences were found in the reported
      incidence of backache between the groups at three months: middle backache [22% vs
      20%, chi2 = 0.057, P = 0.81; odds ratio (95% CI) 1.4(0.9-2.3)]; low backache [35%
      vs 34%, chi2 = 0.009, P = 0.92; odds ratio (95% CI) 1.0(0.6-1.6)]. Nor were there
      significant differences at 12 months: [middle backache 16% vs 16%, chi2 = 0.013,
      P = 0.91; odds ratio (95% CI) 1.0(0.5-1.8)]; or low backache [35% vs 27%, chi2 =
      1.91, P = 0.17; odds ratio (95% CI) 1.4(0.9-2.3)]. The incidence of instrumental
      delivery was somewhat higher in the epidural group [30% vs 19%, odds ratio (95%
      CI) 1.77(1.09-2.86)]. Maternal satisfaction was not significantly different
      between the groups. CONCLUSIONS: This study provided no evidence to support the
      suggestion of a direct association between the use of epidural anaesthesia in
      labour and the incidence of long term backache. Despite a significant proportion
      of women in each group not receiving their allocated analgesia, a significant
      difference in terms of instrumental delivery rates remained. Satisfaction in both
      groups of women was high.

PMID- 11213001
TI  - The long-acting progestogen-only contraceptive injections: an update.

PMID- 11213002
TI  - The Ipswich childbirth study: one year follow up of alternative methods used in
      perineal repair.
AB  - OBJECTIVE: To assess the long term implications of four alternative approaches to
      postpartum perineal repair. DESIGN: A stratified randomised controlled trial
      using a 2x2 factorial design. SETTING: Original recruitment at the Maternity Unit
      at Ipswich Hospital NHS Trust, a district general hospital, between 1992 and
      1994. SAMPLE: Seven hundred and ninety three women who had participated in the
      Ipswich Childbirth Study--a trial among women who had required repair of
      episiotomy or first or second degree tears--at least one year previously.
      METHODS: Self-completed postal follow up at least one year after recruitment to
      trial comparing 1. two-stage repair leaving the skin unsutured with standard
      three-stage repair, and 2. polyglactin 910 with chromic catgut as suture material
      for the repair. MAIN OUTCOME MEASURES: Failure to resume pain-free intercourse;
      persistent perineal pain; perineum feeling different; resuturing; time to resume
      pain-free intercourse; and dyspareunia. RESULTS: Fewer women allocated two-stage
      repair reported that the perineum felt different (30% versus 40%; RR 0.75; 95% CI
      0.61 to 0.91; 2P < 0.01); otherwise there were no clear differences between the
      two methods. Women allocated polyglactin 910 were less likely to have dyspareunia
      (8% versus 13%; RR 0.59, 95% CI 0.39 to 0.91; 2P = 0.02) and less likely to fail
      to resume pain-free intercourse (8% versus 14%; RR 0.57, 95% CI 0.38 to 0.87; 2P
      < 0.01). CONCLUSION: Two-stage repair of perineal trauma leaving the skin
      unsutured appears to reduce the likelihood of the perineum feeling different from
      before delivery, in addition to less pain and dyspareunia initially; there were
      no apparent disadvantages. Polyglactin 910 reduces dyspareunia long term,
      indicating that the short term benefits of this material over chromic catgut
      persist.

PMID- 11213003
TI  - Postpartum intrauterine pressure studies of the uterotonic effect of oral
      misoprostol and intramuscular syntometrine.
AB  - OBJECTIVES: To investigate the effect of oral misoprostol in dosages varying from
      200 microg to 800 microg on postpartum uterine contractility and to establish
      their side effects. DESIGN: A prospective descriptive study. PARTICIPANTS: Fifty
      seven women who delivered vaginally after spontaneous labours not requiring
      augmentation. METHODS: Within 5 minutes of delivery of the placenta, a calibrated
      Gaeltec catheter with an intrauterine pressure transducer at its tip was inserted
      transcervically into the uterine cavity. Cumulative uterine activity was recorded
      for 30 minutes in each woman before administering the oral misoprostol tablets
      and continued for a further 90 minutes after its administration. Thus each woman
      acted as her own control regarding changes in uterine contractility. Uterine
      activity was recorded on a Sonicaid Meridian fetal monitor, which measures active
      contraction area automatically. The incidence of side effects was also recorded.
      RESULTS: There was no statistical difference (P = 0.887) in the adjusted mean
      difference in cumulative uterine activity following all the doses of oral
      misoprostol, compared with intramuscular syntometrine, the largest difference
      being seen in oral misoprostol 200 microg (adjusted mean difference -2282 kPas s,
      95% CI -7954 to 3390 kPas s). The mean onset of action of oral misoprostol (6.1,
      SD 2.1 min) was significantly slower than that of intramuscular syntometrine
      (3.2, SD 1.5 min; P = 0.002), but their durations of action were similar (P =
      0.637). In the misoprostol group the commonest side effects were shivering (36%)
      and a rise in body temperature above 38 degrees C (40%). In the syntometrine
      group, the most commonly observed side effect was moderate uterine pain (nine out
      of ten women) and a rise in diastolic blood pressure of 20 mmHg (two out of ten
      women). CONCLUSION: The results of this study show that oral misoprostol has a
      definite uterotonic effect on the postpartum uterus. At doses of 200 microg to
      400 microg, oral misoprostol has a similar uterotonic effect to intramuscular
      syntometrine. Higher doses of oral misoprostol are associated with significantly
      more side effects.

PMID- 11213004
TI  - Trends in risk factors for caesarean sections in France between 1981 and 1995:
      lessons for reducing the rates in the future.
AB  - OBJECTIVE: To assess the effects of the characteristics of mothers, fetuses and
      maternity units on the trends in caesarean section use, especially for
      primiparae. DESIGN: Cross sectional surveys. SETTING: Maternity units.
      POPULATION: Two representative national samples of births including 5410 newborns
      in 1981 and 13318 in 1995. METHOD: Univariate analysis and logistic regression
      analysis. RESULTS: The overall rate of caesarean section rose from 10.7% in 1981
      to 15.3% in 1995. This trend is mainly attributable to the increases in the
      proportion of previously sectioned women (from 4.1% to 8.2%) and in caesarean
      sections for primiparae (from 12.6% to 17.8%). Among primiparae several maternal
      risk factors such as late childbearing and obesity before pregnancy were more
      frequent in 1995 than in 1981. The increase in caesarean sections affected both
      the high risk group (25.4% to 32.4%) and the low risk group (8.1% to 12.0%).
      CONCLUSION: A significant reduction in the overall rate cannot be achieved
      without regulating caesarean section use for primiparae. Strategies to change
      delivery patterns should be aimed at both high and low risk women.

PMID- 11213005
TI  - Venous thromboembolism in pregnancy and the puerperium: incidence and additional
      risk factors from a London perinatal database.
AB  - OBJECTIVE: To determine the incidence of venous thromboembolism in pregnancy and
      the puerperium and to identify risk factors for pregnancy-related venous
      thromboembolism. DESIGN: Cohort study and case-control study. SETTING: London,
      UK. POPULATION: 395,335 women with live births or pregnancies of 24 or more weeks
      of gestation between 1988 and 1997. METHODS: Data extraction from the St Mary's
      Maternity Information System database. Random sample of 5% for case-control
      study. MAIN OUTCOME MEASURES: Incidence of venous thromboembolism; odds ratios
      for variables associated with venous thromboembolism. RESULTS: The incidence of
      venous thromboembolism was 85/100,000 maternities. There were approximately twice
      as many postpartum as antepartum events. Blood group A, multiple pregnancy,
      caesarean section, cardiac disease, delivery at gestational age of < 36 weeks, a
      body mass index of > or = 25, or more and maternal age of 35 or over were all
      found to increase incidence of venous thromboembolism. CONCLUSIONS: Although
      venous thromboembolism is the leading cause of maternal deaths in the UK, it is
      still a rare event. Most of these events are deep vein thromboses occurring in
      the postpartum period. Antenatally multiple birth is an important risk factor.
      Postnatally women who have had a caesarean section, premature delivery or history
      of cardiac disease should be assessed carefully for venous thromboembolism.

PMID- 11213006
TI  - Is maternal underweight really a risk factor for adverse pregnancy outcome? A
      population-based study in London.
AB  - OBJECTIVE: To determine the maternal and fetal risk of adverse outcome during
      pregnancy in relation to low maternal body mass index in an unselected
      population. DESIGN: Retrospective analysis. METHODS: Information for the years
      between 1988 and 1997 was extracted from a validated maternity database,
      including all but one of the maternity units in the North West Thames Region;
      215,105 completed singleton pregnancies were studied. Comparison of pregnancy
      outcome was made on the basis of maternal body mass index at booking. There were
      176,923 with a normal weight body mass index ( = 20 < 25). There were 38,182 with
      an underweight body mass index (< 20). Comparisons included antenatal
      complications (e.g. gestational diabetes, pre-eclampsia); intervention in labour,
      maternal morbidities (e.g. infection, postpartum haemorrhage, pulmonary
      thromboembolism); and neonatal outcome (admitted to special care baby unit at 24
      hour of age, gestation at delivery, birthweight, stillbirth). Data are presented
      as percentages of outcomes in the normal and underweight groups with adjusted
      odds ratios and confidence intervals according to body mass index group. RESULTS:
      In the underweight group only antenatal anaemia, preterm delivery and birthweight
      below the 5th centile were more frequent than in women of normal body mass index.
      The prevalence of certain complications, including development of gestational
      diabetes mellitus, pre-eclampsia, obstetric intervention and postpartum
      haemorrhage, were significantly lower in those with low body mass index.
      CONCLUSION: Low maternal body mass index is associated with increased prevalence
      of some pregnancy complications, notably preterm delivery and low birthweight,
      but overall the outcome is favourable and several adverse outcomes are less
      common in this group of women.

PMID- 11213007
TI  - Effects at age nine of maternal smoking in pregnancy: experimental and
      observational findings.
AB  - OBJECTIVES: To compare long term outcomes of a randomised controlled trial of
      anti-smoking education in pregnancy and to examine the same outcomes according to
      maternal pregnancy smoking behaviour. DESIGN: Follow up of the population
      included in the randomised controlled trial nine years later and of ex-smokers
      and non-smokers within the same hospital population. SETTING: A maternity
      hospital in Birmingham with follow up of children in schools and mothers at home.
      POPULATION: 1218 smokers recruited to the trial; also 191 ex-smokers at booking
      and 414 non-smokers throughout pregnancy. METHODS: Children were assessed
      individually by psychologists in schools, and mothers interviewed at home to
      obtain additional information relevant to cognitive development and growth.
      Information on smoking during pregnancy was obtained from mothers and obstetric
      data from computerised case-notes, both recorded immediately following delivery.
      MAIN OUTCOME MEASURES: Height, weight, IQ and neurological soft signs at 9.4
      years. RESULTS: Differences in birthweight and length between the intervention
      and control groups were confirmed but no intervention-control differences were
      found at age 9.4 for weight, height, IQ or neurological soft signs. Differences
      were found for height and IQ according to mothers pregnancy smoking behaviour,
      but smoking did not remain an independent predictor after taking account of
      confounding factors. Alternative classifications of smoking behaviour, taking
      account of the gestation at stopping and mean cigarette consumption throughout
      pregnancy likewise showed no effect. CONCLUSIONS: The well established early
      hazards of smoking during pregnancy seem to be resolved by later childhood, with
      no evidence of direct long term effects on growth or cognitive functioning.

PMID- 11213008
TI  - The effectiveness of the levonorgestrel-releasing intrauterine system in
      menorrhagia: a systematic review.
AB  - OBJECTIVE: To determine whether the levonorgestrel-releasing intrauterine device
      (LNG-IUS), licensed at present for contraceptive use, may reduce menstrual blood
      loss with few side effects. If effective, surgery could be avoided with
      consequent resource savings. METHODS: A systematic review addressing the
      effectiveness and cost effectiveness of the LNG-IUS for menorrhagia was
      undertaken. RESULTS: Five controlled trials and five case series were found which
      measured menstrual blood loss. Nine studies recorded statistically significant
      average menstrual blood loss reductions with LNG-IUS (range 74%-97%). Another
      showed reduction in menstrual disturbance score. The LNG-IUS was more effective
      than tranexamic acid, but slightly less effective than endometrial resection at
      reducing menstrual blood loss. In one study, 64% of women cancelled surgery at
      six months, compared with 14% of control group women. In another, 82% were taken
      off surgical waiting lists at one year. No cost effectiveness studies were found.
      DISCUSSION: Small studies of moderate quality indicate the LNG-IUS is an
      effective treatment for menorrhagia. Costs may be less than for tranexamic acid
      in primary and secondary care. Although its use may reduce surgical waiting
      lists, cost effectiveness assessment requires longer follow up. CONCLUSION:
      Effectiveness and cost effectiveness relative to other treatments and the effect
      on surgical waiting lists can only be established in larger trials measuring
      patient-centred outcomes in women with menorrhagia.

PMID- 11213009
TI  - The effect of an intrauterine application of two percent lignocaine gel on pain
      perception during Vabra endometrial sampling: a randomised double-blind, placebo
      controlled trial.
AB  - OBJECTIVE: To determine whether two percent lignocaine gel can reduce the
      perception of pain during Vabra endometrial aspiration. DESIGN: Randomised,
      double-blind placebo-controlled trial. SETTING: Women's Health Directorate,
      Warrington Hospital NHS Trust. POPULATION: Women were referred to the endometrial
      sampling clinic for the investigation of pre and postmenopausal vaginal bleeding.
      METHODS: Randomisation to either pre-sampling intrauterine two percent lignocaine
      gel or an inert gel. Patients, recruiters and assessors were blinded to the gel
      used. MAIN OUTCOME MEASURES: The difference between the study groups in the
      proportion of women who, after Vabra sampling, recorded a pain score of > or = 6
      out of 10 on a visual analogue scale. RESULTS: Three hundred and eight women were
      randomised, 284 (92%) completed a pain scale before and immediately after the
      procedure. After the procedure, 84 women (30%) recorded a pain score of > or = 6,
      38 (26%) received anaesthetic and 46 (33%) an inert gel. The difference in the
      proportion of women recording a pain score of 6 or above between the two study
      groups was not significant (relative risk (RR) for the anaesthetic gel = 0.79 95%
      CI, 0.55, 1.14). CONCLUSIONS: Intrauterine application of 2% lignocaine gel did
      not significantly reduce the frequency with which women experienced unacceptable
      levels of pain or anxiety during endometrial aspiration compared with placebo.

PMID- 11213010
TI  - Randomised, double-blind, placebo-controlled trial of corticosteroids for the
      treatment of hyperemesis gravidarum.
AB  - OBJECTIVE: To assess the efficacy of corticosteroids in the treatment of severe
      hyperemesis gravidarum refractory to conventional management. DESIGN:
      Multicentre, double-blind, randomised, placebo-controlled trial. SETTING:
      Inpatient gynaecology wards in eight collaborating centres. POPULATION: Twenty
      five women with severe hyperemesis of which 24 completed the one- week study
      period. METHODS: Twenty-five women were randomised to receive either 40 mg
      prednisolone daily in two divided oral doses, or equivalent placebo tablets. If,
      after three days, a woman was still vomiting, medication was changed to the
      equivalent intravenous alternative (hydrocortisone 100 mg twice daily or normal
      saline injections) MAIN OUTCOME MEASURES: Frequency of vomiting and the
      dependence on intravenous fluid replacement therapy after one week of treatment.
      RESULTS: There was a non-significant trend towards improved nausea and vomiting
      and reduced dependence on intravenous fluids. However, steroid therapy led to an
      improved sense of wellbeing (P = 0.021), improved appetite (P = 0.039) and
      increased weight gain (P = 0.025) compared with placebo. There was no difference
      in pregnancy outcome between the treatment and placebo groups. CONCLUSIONS: This
      study supports a beneficial role for steroids in severe hyperemesis, but did not
      validate the hypothesis that they lead to rapid and complete remission of
      symptoms. The study was not large enough to demonstrate a significant improvement
      in the primary outcome measures.

PMID- 11213011
TI  - Excision of mature teratoma using culdotomy, with and without laparoscopy: a
      prospective randomised trial.
AB  - OBJECTIVE: To compare the results of removing mature teratoma with laparoscopy or
      without laparoscopy. DESIGN: A prospective, randomised trial. SETTING: Medical
      centre. PARTICIPANTS: Seventy-nine women with mature teratomas identified using
      results of ultrasound examinations and biochemical markers. INTERVENTION:
      Cystectomy with laparoscopic approach or without laparoscopic approach through a
      culdotomy. METHODS: Patients were randomly assigned to have their cysts removed
      via vaginal cystectomy without laparoscopy (n = 37, Group A) or laparoscopic
      cystectomy via culdotomy opening (n = 42, Group B). Inclusion criteria were
      history of vaginal delivery, no previous abdominal surgery, no history of pelvic
      inflammatory disease, no medical illness, and no presenting symptoms. Eight women
      randomised to Group A withdrew before surgery. The laparoscopically resected
      tumours were each put into a cellulose bag, and tumours without laparoscopic
      assistance were removed directly via the vagina. RESULTS: Blood loss in Group A
      (88 +/- 37 ml) was significantly more than that in Group B (64 +/- 20 ml, P =
      0.000). The post-operative recovery times were 20 and 17 hours, respectively (P =
      0.030). The rates of successful surgery were 58.6 and 97.6%, respectively (P =
      0.002). The spillage rates were 44.8% and 19.0%, respectively (P = 0.006). There
      were no significant differences in tumour size, patient age, and operative time
      between groups. CONCLUSION: Cystectomy without assistance of laparoscopy could be
      applied to manage mature teratoma of the ovary; however, because of the
      difficulty of this technique, we had high percentages of tumour spillage and more
      blood loss during operation and a high percentage of patients who required
      conversion to laparotomy compared with laparoscopic cystectomy. We favoured
      laparoscopically assisted cystectomy to manage mature teratoma.

PMID- 11213012
TI  - Oestrogen deficiency causes DNA damage in uterine leiomyoma cells: a possible
      mechanism for shrinkage of fibroids by GnRH agonists.
AB  - OBJECTIVE: To examine whether gonadotrophin-releasing hormone agonist or
      oestradiol can directly affect DNA in leiomyoma cells. DESIGN: In vitro explant
      culture of leiomyoma cells. SETTING: University research group. SAMPLE: Leiomyoma
      cells were cultured from the specimens of four premenopausal women at myomectomy.
      METHODS: The presence of gonadotrophin-releasing hormone receptor in leiomyoma
      cells was determined by reverse transcriptase-olymerase chain reaction. Leiomyoma
      cells were treated with gonadotrophin-releasing hormone agonist or cultured in
      different concentrations of oestrogen, progesterone or fetal calf serum for one,
      four or seven days. MAIN OUTCOME MEASURES: Cell number, expression of
      proliferating cell nuclear antigen, and DNA damage after one, four or seven days
      of treatment. RESULTS: Gonadotrophin-releasing hormone receptor messenger
      ribonucleic acid was detected on cultured leiomyoma cells. Leiomyoma cell growth
      was not affected by the addition of gonadotrophin-releasing hormone agonist or
      progesterone, but increased with oestrogen or fetal calf serum supplementation.
      Overexpression of proliferating cell nuclear antigen was prevented in cultures
      added with oestrogen or fetal calf serum, but not related to gonadotrophin
      releasing hormone agonist treatment. Significant decreases in DNA damage as
      indicated by decreased comet number were found in the leiomyoma cultures treated
      with oestrogen or fetal calf serum for four and seven days but not with
      gonadotrophin-releasing hormone agonist or progesterone. Furthermore, 5% fetal
      calf serum supplementation was more growth supporting and more significantly
      reduced the comet number than 250 pM 17 beta-oestradiol. CONCLUSION: Cell growth,
      proliferating cell nuclear antigen expression and DNA damage are dependent on
      oestrogen or fetal calf serum, but independent of gonadotrophin-releasing hormone
      agonist or progesterone. Our findings suggest that gonadotrophin-releasing
      hormone agonist-induced leiomyoma shrinkage may be due in part to a mechanism
      involving DNA damage, and support the hypothesis that gonadotrophin-releasing
      hormone agonist exerts its action indirectly through oestrogen action on the
      tumour level.

PMID- 11213013
TI  - Involvement of specific chromosomes in radiation-induced rearrangements detected
      by fluorescence in situ hybridization (FISH).
AB  - We investigated the involvement of chromosomes in dicentrics and translocations
      in human peripheral blood lymphocytes exposed to X-rays in vitro. Chromosomes 2,
      4, 8, 13, 15, 16, and 22 were analyzed in three cocktails of different
      combinations using whole chromosome probes (WCP) with the fluorescence in situ
      hybridization (FISH)-painting technique. The results showed overexpression of
      chromosomes 2, 8, and 22 in translocation, the majority being of the complete
      type. Chromosome 4 was underrepresented in translocation formation in both
      combinations, that is, 2 + 4 + 8 in cocktail I and 4 + 13 + 22 in cocktail II.
      Its participation in dicentric production was in good agreement with its DNA
      content in association with 2, 4, and 8, whereas it was underexpressed in the
      combination of 4 + 13 + 22. DNA-proportional involvement was noticed with
      chromosomes 13 and 16 in all exchange aberrations. Underexpression of chromosome
      15 was observed in translocation, which is contradictory to its overexpression in
      dicentric formation. The participation of chromosome 22 was predominant for both
      translocations and dicentrics, compared with its DNA content. The overall
      observation of our study supports the assumption of DNA-proportional distribution
      of Lucas et al. However, more data are required for chromosomes 4, 8, 15, and 22
      in combination with other chromosomes.

PMID- 11213014
TI  - Role of antioxidant enzymes in radiosensitivity of human blood cells.
AB  - The marked variability in radiation response among individuals of the same age
      group prompted us to investigate the role of antioxidative enzyme activity.
      Micronuclei (MN) and enzyme assays were performed on blood samples of healthy
      male volunteers. The procedure consisted of micronucleus analysis and measurement
      of the superoxide dismutase (SOD) activity in harvested blood samples irradiated
      in vitro with 2 Gy gamma-rays and in unirradiated control samples for each
      individual. We found that the yield of radiation-induced micronuclei was in the
      range of 112 to 378 micronuclei per 1000 binucleated cells. The activity of
      cytosol superoxide dismutase (CuZnSOD) was reduced, whereas the activity of
      manganese superoxide dismutase (MnSOD) was markedly elevated in the blood samples
      harvested in lymphocyte cultures after irradiation. The analysis of our results
      showed that MnSOD plays the most important role in radiation-induced cellular
      damage. The results of this investigation showed that measurement of micronuclei
      and the activities of SOD in harvested human blood cells can serve as a rapid
      predictive assay of radiosensitivity in a clinical setting.

PMID- 11213015
TI  - Nontoxic, mutagenic, and clastogenic activities of Mate-Chimarrao (Ilex
      paraguariensis).
AB  - Aqueous extracts of Ilex paraguarariensis (mate-chimarrao), a species that
      belongs to the Aquifoliaceae family, were analyzed for the presence of genotoxic,
      mutagenic, and clastogenic activities through bacterial trials based on the
      induction of the SOS functions, as well as in human lymphocytes in vitro and in
      mammalian cells in vivo. The extracts of mate-chimarrao were genotoxic, as
      assessed by lysogenic induction in Escherichia coli, and they also induced
      mutagenesis in Salmonella typhimurium. They addition of S9 microsomal fraction,
      catalase, thiourea, or dipyridyl counteracted the genotoxic activity of mate
      chimarrao, suggesting that oxygen reactive species play an essential role in the
      genotoxicity of mate-chimarrao extracts. The extracts were not clastogenic in
      vivo (bone marrow cells of rats) in our experimental conditions, but we have
      observed an increased frequency of chromosomal aberrations in mate-chimarrao
      treated human peripheral lymphocytes. Our results suggest that a high consumption
      of mate-chimarrao can potentiate carcinogenesis in the human oropharynx and
      esophagus.

PMID- 11213016
TI  - Cytogenetic toxicity of vincristine.
AB  - The anticancer drugs vincristine sulphate (VCR) and cyclophosphamide (CTX) were
      tested for their cytogenetic effects in the bone marrow cells of Swiss mice. The
      end points investigated were chromosomal aberrations and mitotic index at 24
      hours posttreatment and micronuclei (MN) at 30 hours posttreatment in bone marrow
      cells of male and female mice after a single intraperitoneal exposure. The doses
      tested were VCR 0.25, 0.5, and 1.0 mg/kg and CTX 40 mg/kg b.w. of mice.
      Significant percentages of chromosomal aberrations and significant numbers of
      micronuclei per thousand polychromatic erythrocytes (PCEs) that were induced were
      recorded from bone marrow of each of the VCR-treated groups of mice. There were
      no significant differences between the percentages of dividing cells in the VCR
      treated group and the vehicle control groups of mice. Peculiarly, in the
      chromosomal aberration study, the male mice were found to be more responsive to
      VCR than the females, and the aberrations per hundred metaphases were found to be
      decreased when the dose of VCR was increased. The percentage of dividing cells
      was also higher with the lowest dose of VCR tested. However, there was a dose
      dependent, but nonlinear, increase in MN per thousand PCEs. The results were
      compared with the already available fragmentary and self-contradictory data on
      the genotoxicity of VCR in mice and in other mammalian test systems.

PMID- 11213017
TI  - Toxicity of aflatoxin: effects on spermatozoa, oocytes, and in vitro
      fertilization.
AB  - Aflatoxin B1 has been reported to have a deleterious effect on the reproductive
      capacity of laboratory and domestic animals. We wanted to elucidate the
      mechanistic aspect of this phenomenon by determining the toxic potential of
      aflatoxin B1 on the in vitro fertilizing ability of oocytes and epididymal sperm
      in albino rats. In vitro fertilization medium (IVFM) containing aflatoxin B1 at
      concentrations of 2.0, 4.0, 8.0, and 16.0 ppb was cultured with oocytes obtained
      from superovulated healthy fertile female rats and exposed to sperm cells.
      Epididymal sperm capacitated in IVFM, with or without aflatoxin B1, were exposed
      to oocytes, and the rates of fertilization in the two experiments were assessed.
      Aflatoxin B1 significantly reduced the mean number of ova fertilized, even at the
      lowest concentration. Exposure to aflatoxin caused a significant reduction in the
      motility of sperm cells. These results demonstrate the adverse effects of
      aflatoxin B1 on oocytes, spermatozoa, and in vitro fertilization.

PMID- 11213018
TI  - Morphometric analysis of rat testis following chronic exposure to cigarette
      smoke.
AB  - PURPOSE: To assess the effect of chronic exposure to cigarette smoke on
      spermatogenesis in Sprague-Dawley rats. MATERIALS AND METHODS: Twenty 5-day-old
      Sprague-Dawley rats were exposed daily to cigarette smoke by the Walton smoking
      machine for a period of 15, 30, and 45 days. Age-matched Sprague-Dawley rats
      exposed to room air with the smoking machine served as controls. Rats were
      sacrificed from each group at 15, 30, and 45 days and the testes were removed.
      Fifty seminiferous tubules were assessed in each group. Morphometric and
      histopathologic analyses of the testes were carried out. The following parameters
      were studied: (1) Number of germ cells (step 7 spermatids), (2) seminiferous
      tubule diameter, (3) height of germinal epithelium, (4) presence of degenerating
      or sloughed cells, (5) failure of release of spermatids into the tubular lumen,
      and (6) degeneration of Leydig cells. Statistical analysis was performed using
      ANOVA followed by the t test. RESULTS: There was a significant decrease in the
      germ cell count (step 7 spermatids) in the rats exposed to cigarette smoke for 30
      days (93.19 versus 98.15 step 7 spermatids in the control animals (p < 0.001).
      This decrease persisted in the rats exposed to cigarette smoke for 45 days (82.47
      versus 103.01 step 7 spermatids in control animals, p < 0.001). The mean
      seminiferous tubule diameter was significantly reduced only in the rats exposed
      to cigarette smoke for 45 days (0.283 microm versus 0.299 microm in the control
      animals, p < 0.001). There was no significant difference in the height of the
      germinal epithelium, and no degenerating cells were noted in either group.
      CONCLUSIONS: Cigarette smoke adversely affects spermatogenesis in pubertal
      Sprague-Dawley rats.

PMID- 11213019
TI  - Chronic cigarette smoking induces an oxidantantioxidant imbalance in the testis.
AB  - OBJECTIVES: We have previously demonstrated the harmful effect of chronic
      inhalation of cigarette smoke on the testis in Sprague-Dawley rats. The aim of
      the present study was to investigate the role of free oxygen radicals and
      reactive oxygen species in inducing testicular damage in Sprague-Dawley rats
      following exposure to cigarette smoke. MATERIALS AND METHODS: Sprague-Dawley
      rats, 25 days old, were exposed daily to cigarette smoke by the Walton smoking
      machine for a period of 15, 30, and 45 days. Age-matched Sprague-Dawley rats were
      exposed to room air with the smoking machine and served as controls. Rats were
      sacrificed from each group at 15, 30, and 45 days and the testes were removed.
      The testicular tissue levels of glutathione and lipid peroxidation product
      malonaldehyde (MDA) were measured colorimetrically using the Bioxytech GSH-400
      and LPO-586 kits, respectively. The activity of glutathione peroxidase was
      assessed colorimetrically using the Bioxytech GPx-340 kit. Statistical analysis
      was performed using ANOVA followed by the t test. RESULTS: There was a 47.8%
      increase in the MDA in the treated rat testis compared with the control rat after
      45 days of exposure to cigarette smoke or air, respectively (p < 0.05). This was
      associated with a parallel significant decrease in the level of glutathione and
      glutathione peroxidase activity in the treated rat testis, 38.2% and 29.1%,
      respectively, after 45 days of cigarette smoke exposure (p < 0.05). No
      significant difference was noted in the levels of glutathione, glutathione
      peroxidase, and lipid peroxidation end products after 15 and 30 days of
      treatment. CONCLUSIONS: Chronic cigarette smoke inhalation is associated with an
      increase in the level of oxidants and a simultaneous decrease in the level of
      antioxidants in the rat testis. This abnormality of the oxidant-antioxidant
      balance may be one of the mechanisms leading to testicular tissue damage and
      abnormal spermatogenesis in the rat testis following chronic inhalation of
      cigarette smoke.

PMID- 11213020
TI  - Potentiation of docetaxel antitumor activity by batimastat against mouse
      forestomach carcinoma.
AB  - Docetaxel is a chemical compound belonging to the taxoid class of anticancer
      agents. Batimastat (BB-94) is the first matrix metalloproteinase inhibitor
      entering clinical trials. To improve the treatment of tumors, we studied the
      combined effects of docetaxel and batimastat on mouse forestomach carcinoma
      (MFC), and compared them with doxorubicin. In vitro growth curve analysis, MTT
      assay, and clonogenic assay were used to determine the cytotoxic effect of
      docetaxel or/and BB-94 on MFC. They showed that docetaxel, but not BB-94, had a
      significant cytotoxicity and that the effect of docetaxel was not enhanced by BB
      94. In an early stage MFC tumor model, an obvious antitumor effect of docetaxel
      or doxorubicin given iv at maximum tolerated dose (MTD) was observed. Tumor
      growth inhibition was greater for docetaxel + BB-94 (96.0%) than for doxorubicin
      + BB-94 (88.0%), docetaxel (89.0%), doxorubicin (68.0%), and BB-94 (33.0%).
      Docetaxel showed activity against advanced stage MFC tumor in a dose-dependent
      manner and was more effective at MTD than doxorubicin, with 4/5 regression, 46.5
      days tumor growth delay, and 2.8 log10 tumor-cell kill. Our results suggest that
      docetaxel is an effective new cytotoxic drug against MFC tumor and that BB-94
      enhances the antitumor activity of docetaxel in the dose and schedule used.

PMID- 11213021
TI  - Effects of nitric oxide donors on energy metabolism of rat erythrocytes.
AB  - It is known that nitric oxide (NO) influences the activities of glycolytic
      enzymes, resulting in alteration of glycolysis rate. We investigated the effect
      of NO donors on the energy metabolism of rat erythrocytes. Rat erythrocyterich
      blood suspensions were aerobically incubated for 2 hours (1) as controls or (2)
      with different concentrations of NO donors: nitroglycerin (NTG), isosorbide
      dinitrate (ISDN), molsidomine (MO), and sodium nitroprusside (SNP). NTG, ISDN,
      MO, and SNP significantly (p < 0.05) increased glucose consumption and lactate
      accumulation in rat erythrocytes in a dose-dependent manner, indicating
      stimulation of glycolysis. The increased rate of glycolysis was accompanied by
      elevation of energy production (p < 0.05), but no changes in ATP levels were
      observed. The dose-dependent increase of glycolytic ATP production and the
      unaltered levels of ATP resulted in considerably shortened ATP-turnover time with
      the maximal experimental doses of NO donors used, indicating the stimulation of
      the ATP-consuming process in rat erythrocytes. The metabolic effects of NTG,
      ISDN, MO, and SNP were not mimicked by exogenous 8-Br-cGMP, NaNO2, or NaNO3,
      suggesting that the NO donor-induced stimulation of glycolysis and abbreviation
      of ATP-turnover time in rat erythrocytes was mediated by NO as an effector
      molecule, irrespective of the irreversible scavenger effect of hemoglobin. The
      implications of the NO effect on energy metabolism of erythrocytes is discussed.

PMID- 11213022
TI  - In vivo experimental model for silicosis.
AB  - The selection of an experimental model for silicosis requires a thorough
      understanding of many pulmonary parameters specific to the experimental animal
      (e.g., clearance time, penetration curves, anatomical differences), as well as
      the strain's sensitivity to different conditions. The pulmonary response of three
      rat strains (i.e., Fischer 344, Sprague-Dawley, and Wistar) to silica dust was
      compared using two methods of exposure: intratracheal injection and inhalation.
      The test period lasted 3 months for injection and 6 and 12 months for inhalation.
      The histological study of the lung revealed a distinct nodular reaction in
      Sprague-Dawley and Wistar strains. Intratracheal injections led to the
      development of fibrotic nodules in Wistar rats, whereas such silicotic nodules
      were infrequent in injected Fischer 344 rats, and almost absent when exposure was
      by inhalation. Sprague-Dawley and Fischer 344 rats showed frequent thickening and
      metaplasia of the alveolar walls near the terminal bronchioles. This tendency was
      particularly pronounced in rats exposed by inhalation (especially Fischer 344
      rats). Macroscopic examination (wet lung weight) and biochemical dosing (lung
      silica, hydroxyproline, and lipid content) revealed an increase in the various
      parameters examined in Sprague-Dawley rats relative to the other two strains,
      regardless of the type of exposure. The histological examination, however, leads
      us to conclude that the Wistar rats offer the best experimental model for
      silicosis, because their pulmonary reaction is more characteristic of the human
      condition than that of the other two strains.

PMID- 11213023
TI  - Antimutagenesis studies of magnesium and calcium salts.
AB  - Magnesium is a microelement that is essential for biological functions and
      particularly for cellular metabolism. It has a central role in protein, lipid,
      carbohydrate, and nucleic acid synthesis, and it is important for muscular
      physiology and nerve excitability. Magnesium has an important role in the
      stability of biological membranes, it controls immune phenomena, and it activates
      over 300 enzymes. However, the mechanism of action of magnesium salts has not
      been well investigated and, in particular, its antimutagenesis properties and its
      effects in the detoxification of free radicals need further study. We
      investigated the effect of magnesium chloride, sulphate, carbonate, and oxide on
      the yeast Saccharomyces cerevisiae D7 strain, to evaluate their ability to
      protect against genotoxic damage. We found that magnesium salts induced
      antimutagenic effects in the cells harvested in the logarithmic phase by
      decreasing the induction of hydrogen peroxide. This, however, did not occur in
      the stationary phase. We also studied calcium salts of the type corresponding to
      those of magnesium and their protective role against the oxidative damage of free
      radicals and enzymatic activities, such as catalase, glutathione peroxidase, and
      superoxide dismutase, which are involved in antioxidative defenses.

PMID- 11213025
TI  - The effects of short-term blood pressure variability and nighttime blood pressure
      levels on cognitive function.
AB  - We investigated the relationship between 24-h blood pressure (BP) and cognitive
      function. We performed the Hasegawa Dementia Scale Revised (HDSR), the Mini
      Mental State Examination (MMSE), and the Raven's Coloured Progressive Matrices
      Test (RCPM) in 88 subjects (71+/-9 years) with no history of stroke. Ambulatory
      BP was non-invasively measured using a TM2421 for 24 h in all patients. Whereas
      90% of the scores converged into a narrow range between 25 and 30 points in the
      HDSR and the MMSE tests, the RCPM score was widely distributed, ranging from 9 to
      36 points. The subjects were therefore divided into three groups of > or =25, 26
      30, and 31-36 according to their RCPM scores. Subjects with lower scores were
      significantly associated with increased short-term BP variability during the
      daytime (p<0.05) and had a tendency toward higher nighttime SBP (p=0.05) compared
      with those with higher scores. Increased short-term variability of daytime BP and
      high nighttime systolic BP were associated with cognitive impairment as assessed
      by the RCPM. The RCPM, which can assess the capacity for judgment through visual
      information processing, may detect earlier stages of cognitive impairment related
      to high BP. To prevent a deterioration of cognitive function, strict control of
      nighttime BP and suppression of short-term BP variability are thus necessary.

PMID- 11213024
TI  - Clinical usefulness of duplex ultrasonography for the assessment of renal
      arteriosclerosis in essential hypertensive patients.
AB  - The present study was carried out to investigate whether the renal resistive
      index (RRI), obtained by ultrasonic duplex scanning, is useful for the evaluation
      of renal arteriosclerosis in essential hypertensive patients. We also studied the
      relationships between RRI and other kinds of hypertensive target-organ damage,
      including carotid atherosclerosis. One hundred and two patients (56.4+/-9.4
      years) with untreated mild or moderate essential hypertension were examined. The
      normal range of RRI was determined for 12 normal age-matched volunteers (55.0+/
      6.6 years). Hypertensive organ damage was evaluated by funduscopy,
      electrocardiograms, and carotid B-mode imaging. Based on the mean and
      distribution of RRI in normal volunteers (0.60+/-0.05), the normal upper limit of
      RRI was found to be 0.7. RRI was correlated with creatinine clearance (CCr) (r=
      0.61, p<0.05), and blood urea nitrogen (r=0.46, p<0.05), but not with serum
      creatinine. In addition, the incidence of abnormal RRI (>0.7) was higher in
      patients with left ventricular hypertrophy and in those with advanced carotid
      atherosclerosis (p<0.01, respectively). Thus, RRI appears to be more strongly
      associated with CCr than with serum creatinine, and it increases in patients with
      hypertensive end-organ damage. The assessment of RRI may be useful for the
      evaluation of early renal damage in essential hypertension.

PMID- 11213026
TI  - Influence of night shift work on psychologic state and cardiovascular and
      neuroendocrine responses in healthy nurses.
AB  - Night shift work has often been associated with increasing degree and frequency
      of various psychologic complaints. The study examined whether psychologic states
      after night work are related to adaptive alterations of the cardiovascular and
      neuroendocrine systems. We studied 18 healthy nurses (age 29+/-2 years) engaged
      in a modified rapid shift rotation system (day work, 8:15-17:15; evening work,
      16:00-22:00; night work, 21:30-8:30). Blood pressure, heart rate, RR interval
      variability (L/H and HF power spectrum for sympathetic and vagal activities), and
      physical activity were measured using a multibiomedical recorder for 24 h from
      the start of work during the night and day shifts. Plasma ACTH and cortisol
      concentrations were measured at the end of each shift and at 8:30 AM on a day of
      rest. Each subject's psychologic state was assessed using a validated
      questionnaire. Among the parameters measured, scores for confusion, depression,
      anger-hostility, fatigue and tension-anxiety were highest, and scores for vigor
      lowest, after a night shift. Systolic blood pressure and heart rate during work
      were lower during night shift than during day shift (119+/-2 vs. 123+/-1 mmHg,
      p<0.05 and 75+/-1 vs. 84+/-2 bpm, p<0.001, respectively). Both parameters were
      lower still (p<0.005 and p<0.05) when measured outside of the hospital under
      waking conditions following a night shift than following a day shift, even though
      the levels of physical activity were similar. The HF power spectrum of RR
      interval variability was greater not only during work (24.2+/-2.1 vs. 18.5+/-1.8
      ms, p<0.005) but also during the awake period (29.1+/-2.5 vs. 24.4+/-2.6 ms,
      p<0.005) after the night shift compared with the day shift. Plasma ACTH and
      cortisol concentrations were lower after night work than in the day of rest
      (7.3+/-1.2 vs. 11.5+/-2.3 pg/ml, p<0.1 and 11.1+/-1.1 vs. 14.4+/-1.1 mg/dl, p<
      0.05). Systolic and diastolic blood pressures during night shift work and the
      subsequent awake period correlated positively with scores for vigor and
      negatively with scores for confusion (p<0.05). Plasma ACTH and cortisol
      concentrations did not correlate with any psychologic scores. We conclude that
      psychologic disturbances after night work were associated with altered
      cardiovascular and endocrine responses in healthy nurses. Some of the psychologic
      complaints may be attributable to lower waking blood pressure.

PMID- 11213027
TI  - Risk factors and predictors of coronary arterial lesions in Japanese hypertensive
      patients.
AB  - The morbidity rate of coronary artery disease has recently increased in Japan.
      This is attributable to changes from traditional to more westernized lifestyles.
      In this study, we therefore examined the risk factors and predictors of coronary
      arterial lesions in Japanese patients with essential hypertension. Coronary
      angiography was performed in 109 consecutive essential hypertension patients (57
      men and 52 women; 66 +/- 8.0 years of age) with either angina pectoris or
      atypical chest pain, who were chosen from 485 consecutive hypertensive patients
      in a hypertension clinic in Sendai, Japan. Coronary arterial stenosis of greater
      than 50% was defined as significant and used as a dependent variable for the
      multiple regression analysis. Risk factors were defined as factors confirmed to
      have a causal relationship with coronary arterial lesions, whereas
      arteriosclerotic complications and hypertensive target organ damage were defined
      as predictors. Multiple logistic regression analysis was performed using these
      parameters as independent variables. Of 109 patients, 25 had a coronary arterial
      stenosis greater than 50%. A smoking habit (odds ratio (OR): 4.48; 95% confidence
      interval (CI): 1.13-17.82; p<0.05), hypercholesterolemia (OR: 5.34; 95% CI: 1.52
      18.73; p<0.05), and 24-h diastolic blood pressure (OR: 2.33; 95% CI: 1.06-5.16;
      p<0.05) were significant risk factors, whereas carotid intima-media thickness
      (OR: 5.85; 95% CI: 1.48-23.2; p<0.05) was a significant predictor of coronary
      arterial lesion. When two of the major risk factors (a smoking habit,
      hypercholesterolemia, or impaired glucose tolerance including diabetes mellitus)
      were clustered in addition to the hypertension, the risk of coronary arterial
      lesions increased by 6.7 to 10.1 times. These findings indicate that the major
      risk factors established in Caucasians, i.e., a smoking habit,
      hypercholesterolemia and blood pressure level, are also risk factors for coronary
      arterial lesions in Japanese with essential hypertension. The presence of two or
      more risk factors increases the risk of coronary arterial lesions synergistically
      in the presence of hypertension.

PMID- 11213028
TI  - 11beta-hydroxysteroid dehydrogenase activity in human aortic smooth muscle cells.
AB  - 11beta-Hydroxysteroid dehydrogenases (11beta-HSD) interconvert cortisol, the
      physiological glucocorticoid, and its inactive metabolite cortisone in humans.
      There are two isoforms. The type 1 isoform (11beta-HSD1) catalyzes both 11beta
      dehydrogenation (cortisol to cortisone) and the reverse oxoreduction (cortisone
      to cortisol), but the type 2 isoform (11beta-HSD2) catalyzes only 11beta
      dehydrogenation. The diminished dehydrogenase activity has been demonstrated in
      resistance vessels of genetically hypertensive rats. However, the isoform(s) that
      plays a significant role in conferring the dehydrogenase activity on vasculature
      has not been determined. We investigated 11beta-HSD activities in human vascular
      smooth muscle cells by manipulating 11beta-HSD expressions with antisense
      oligonucleotides. The results showed that 11beta-HSD2 dominates functioning in
      the dehydrogenase mode in these cells. This indicates that impairment of 11beta
      HSD2 activity in vascular wall may be related to the pathogenesis of
      hypertension.

PMID- 11213029
TI  - Role of the central nervous system in the development of hypertension produced by
      chronic nitric oxide blockade in rats.
AB  - We examined the role of the central nervous system, and particularly the renin
      angiotensin (RA) system, in the development of hypertension produced by chronic
      inhibition of NO synthesis. In experiment 1, Wistar rats drank either nitro-L
      arginine-methyl ester (L-NAME) or tap water. Before L-NAME treatment rats were
      divided into 6 groups. Four of them were administered either losartan or
      artificial cerebroventricular fluid (a-CSF) intracerebroventricularly (i.c.v.)
      for 1 week using an osmotic mini pump. The other two groups were administered the
      same amount of losartan intravenously (i.v.). In experiment 2, cardiovascular
      responses to acute i.c.v. losartan and muscimol, a GABA(A) agonist, were examined
      in conscious L-NAME-treated rats. Finally, in experiment 3, effects of ablation
      of the AV3V (anteroventral third ventricle) area, known to be one of the centers
      of cardiovascular control, were tested in the development of L-NAME hypertension.
      The development of hypertension by L-NAME treatment was attenuated with chronic
      i.c.v. losartan in a dose-dependent manner, while i.v. losartan had no effect.
      One week after cessation of i.c.v. losartan, blood pressure was elevated to the
      same level as in a-CSF-infused, L-NAME-treated rats. Acute i.c.v. losartan
      produced no cardiovascular changes in either L-NAME-treated or control rats. On
      the other hand, although i.c.v. muscimol elicited depressor effects in both
      groups, these responses were significantly larger in L-NAME-treated rats.
      Cardiovascular responses to i.v. hexamethonium were similar in both groups. The
      existence of prior lesions in the AV3V area significantly attenuated the
      development of L-NAME-induced hypertension. These results indicate that the
      central RA system plays an important role in the development of hypertension
      produced by chronic inhibition of NO synthase. Moreover, disorder of the central
      GABA system, rather than that of the RA system, might be important in the
      maintenance of hypertension in this model.

PMID- 11213030
TI  - Hypothermia on NO-mediated neurogenic relaxation and on hypoxic inhibition in the
      response of canine cerebral arteries.
AB  - Cerebral arteries are innervated by nitric oxide (NO)-mediated vasodilator
      nerves, and hypoxia has been shown to attenuate neurogenic vasorelaxation. The
      present study examines the effects of hypothermia on neurogenic vasorelaxation
      and on the hypoxia-induced inhibition of the neurogenic vasorelaxation response.
      In isolated canine cerebral arteries, relaxant responses to transmural electrical
      stimulation (5 Hz for 40 s), mediated via NO synthesized from L-arginine, were
      not influenced by lowering the bathing media temperature from 37 degrees C to 30
      degrees C but were attenuated at 25 degrees C. On the other hand, relaxations
      caused by nicotine and exogenous NO were not significantly attenuated but were
      prolonged by cooling to 25 degrees C. The responses associated with nerve
      stimulation by electrical pulses or nicotine were depressed by hypoxia (from
      about 500 mmHg of partial O2 pressure to about 45 mmHg) under normothermia.
      However, hypothermia at 25 degrees C prevented the inhibition by hypoxia of the
      neurogenic relaxation. It is concluded that the hypothermia-induced inhibition in
      the response to electrical nerve stimulation is not associated with a decreased
      synthesis and release of NO in vasodilator nerves nor with a reduced ability of
      smooth muscle to relax in response to NO. Interference with the propagation of
      action potentials might be involved in the inhibition via a fall of temperature.
      The fact that the hypoxia-induced impairment of vasodilator nerve function was
      prevented by cooling may partially explain the efficacy of hypothermia in
      protecting against ischemic neuronal injury in the brain.

PMID- 11213031
TI  - Effects of TCV-116 on endothelin-1 and PDGF A-chain expression in angiotensin II
      induced hypertensive rats.
AB  - Angiotensin II (Ang II) has been shown to stimulate cardiac growth and collagen
      synthesis in cultured vascular smooth muscle cells and to increase fibroblast
      proliferation. Chronic infusion with Ang II increases blood pressure and
      activates growth mechanisms to produce hypertrophy of the heart. This study
      investigated the effects of an Ang II type 1 receptor antagonist, TCV-116, on
      preproendothelin-1 (preproET-1), ETA receptor and platelet-derived growth factor
      (PDGF) A-chain expression in the left ventricle of Wistar-Kyoto rats treated for
      2 weeks with Ang II (200 ng x kg(-1) x min(-1)), and the relation of these
      effects to myocardial remodeling. Rats given Ang II alone (ANGII-V) were compared
      with rats also receiving TCV-116 (ANGII-TCV). In both groups, blood pressure was
      similar and significantly higher than in control rats. The preproET-1, ET(A)
      receptor and PDGF A-chain expressions in the left ventricle were significantly
      increased in ANGII-V compared with control rats, and were significantly
      suppressed in ANGII-TCV compared with ANGII-V rats. ANGII-V rats showed a
      significant increase of the type I collagen expression, wall-to-lumen ratio,
      perivascular fibrosis, and myocardial fibrosis, with all these parameters being
      significantly improved by TCV-116. Myocardial remodeling in Ang II-induced
      hypertensive rats was significantly ameliorated by a subdepressor dose of TCV
      116, which may have been due to a decrease in ET-1 and PDGF A-chain expression in
      the left ventricle.

PMID- 11213032
TI  - Acute effects of E-3174, a human active metabolite of losartan, on the
      cardiovascular system in tachycardia-induced canine heart failure.
AB  - The aim of this study was to evaluate the acute effects of E-3174, a human active
      metabolite of the AT1 receptor antagonist, losartan, on hemodynamic functions in
      dogs with severe heart failure (HF). In dogs, insignificant plasma levels of E
      3174 are present following administration of losartan, and therefore, the effects
      of these two drugs can be studied independently in the dog. HF was established by
      rapid pacing of the right ventricle (250-270 beats/min) for 4 weeks. We examined
      changes in cardiovascular functions after acute intravenous administration of
      losartan (1 mg/kg) and E-3174 (0.3 and 1 mg/kg), as well as an ACE inhibitor,
      enalapril (0.3 and 1 mg/kg), under condition of HF. The HF before treatment was
      characterized by increases in pre- and after-load of the left ventricle (LV),
      consequent low cardiac output, and LV dilatation. E-3174 at 0.3 and 1 mg/kg
      reduced pulmonary artery pressure (-13+/-6% and -22+/-3% from baseline,
      respectively, p<0.05), pulmonary capillary wedge pressure (-18+/-4% and -36+/
      10%, p<0.05) and mean arterial pressure (-24+/-2% and -36+/-7%, p<0.05),
      increased stroke volume (SV: +12+/-7% p>0.05; +36 +/-19%, p<0.05), and reduced
      peripheral resistance (-23+/-5% and -41+/-9%, p<0.05), but had no effect on the
      first derivative of left ventricular pressure (dP/dt/P) or the time constant for
      relaxation. Effects of losartan at 1 mg/kg were similar to those of 0.3 mg/kg of
      E-3174. Enalapril at 1 mg/kg caused changes comparable to those seen after E-3174
      administration (1 mg/kg), except that the increase in SV (+16+/-8%, p<0.05) with
      enalapril was not as great as that with E-3174. Both losartan at 1 mg/kg and E
      3174 at 0.3 and 1 mg/kg increased fractional shortening to a similar extent (FS:
      +52+/-12%, +47+/-8% and +56+/-8%), while enalapril at 0.3 and 1 mg/kg had no
      significant effects on FS. Reflex elevation of plasma renin activity induced by 1
      mg/kg of E-3174 was similar to that caused by 1 mg/kg of enalapril, suggesting
      that the two drugs achieved similar inhibition of the endogenous renin
      angiotensin system. Our study demonstrated that acute blockade of the AT1
      receptor with E-3174 reduced elevated pre- and after-load and consequently
      increased stroke volume in a canine HF model. With the exception of changes in
      stroke volume, these effects of E-3174 were comparable to those produced by
      enalapril, and were 3 times stronger than those by losartan.

PMID- 11213033
TI  - Coronary capillary remodeling in non-insulin-dependent diabetic rats:
      amelioration by inhibition of angiotensin converting enzyme and its potential
      clinical implications.
AB  - Using Otsuka Long Evans Tokushima Fatty (OLETF) rats, a model of human non
      insulin-dependent diabetes mellitus (NIDDM) that exhibits hypertension, obesity,
      hyperglycemia and hyperlipidemia, the role of local angiotensin II in
      cardiovascular complications at early stages of NIDDM was characterized. OLETF
      rats were given an angiotensin converting enzyme (ACE) inhibitor, cilazapril (10
      mg/kg/day) or vehicle from the age of 5 weeks to 20 weeks. Arteriolar,
      intermediate and venular capillary proportions were determined by the double
      staining method and levels of collagen and non-collagenous proteins were
      determined by the selective dye-binding method in heart tissues. In OLETF rats at
      20 weeks of age, capillary network remodeling (i.e., an increase in arteriolar
      portions and a decrease in venular portions) and an increase in collagen content
      were detected. Cilazapril not only exerted favorable effects on markers of
      diabetes, but also prevented capillary network remodeling and ameliorated the
      increase in collagen content. These results suggest that 1) capillary network
      remodeling and increase in extracellular matrix protein levels precede the onset
      of overt NIDDM in OLETF rats, and 2) angiotensin II may be involved in the
      pathogenesis of cardiac complications in the early stages of NIDDM.

PMID- 11213034
TI  - A case of renovascular hypertension due to bilateral renal artery microaneurysm
      who succeeded in baby delivery.
AB  - We report the case of a young pregnant woman with bilateral renovascular
      hypertension due to renal microaneurysms from an unknown cause, who had a
      successful delivery. Pregnancy did not affect the disease activity even in the
      postpartum period. Her blood pressure was maintained within the normal range by
      administration of labetalol. Although the angiographic appearance of the
      symmetrical aneurysms in both renal artery beds from the interlobular to arcuate
      artery levels suggested polyarteritis nodosa of multiple microaneurysms in the
      bilateral interlobular arteries, the clinical features suggested other causes of
      renovascular hypertension, such as fibromuscular dysplasia and/or congenital
      microaneurysms. We were thus unable to reach a definitive diagnosis.

PMID- 11213035
TI  - Endoscopic subtotal thyroidectomy for patients with Graves' disease.
AB  - Endoscopic thyroidectomy performed via the precordial approach leaves no scarring
      of the neck, and thus provided excellent results from a cosmetic viewpoint. We
      applied this technique to perform subtotal thyroidectomy in 12 patients with
      Graves' disease. Three trocars were inserted in the precordial region, and
      endoscopic surgery was performed with carbon dioxide insufflation. Vessel
      management and thyroidectomy were carried out using ultrasonic coagulation
      devices. The mean operative time was 259.8 min, and the mean blood loss was
      90.2ml. There were no postoperative complications such as subcutaneous emphysema
      or hemorrhage, although hypoparathyroidism and recurrent laryngeal nerve
      paralysis occurred in one patient. Cosmetically esthetic results were achieved in
      all patients. These findings indicate that this surgical technique represents an
      effective method of treating Graves' disease that provides excellent cosmetic
      results.

PMID- 11213036
TI  - Pneumatic stabilization for flail chest injury: an 11-year study.
AB  - The use of prolonged mechanical ventilation in the treatment of flail chest
      injury may increase the incidence of pulmonary morbidity. The aim of this study
      was to examine the results of performing internal pneumatic stabilization in our
      hospital. A retrospective review of the medical records of 59 patients with flail
      chest injury who presented within an 11-year period was conducted. During the
      second half of the period examined, we routinely adopted three characteristic
      procedures in the treatment of flail chest injury, namely, pressure support on
      spontaneous breathing, continuous positive airway pressure via a mask, and
      respiratory physical therapy by physical therapists. We compared the background,
      prognosis, and methods of treatment for flail chest injury before and after the
      introduction of these three procedures. A marked decline in the duration of
      endotracheal intubation and controlled mechanical ventilation, and in the
      frequency of pulmonary morbidity, was evident following the introduction of the
      above procedures.

PMID- 11213038
TI  - Annuloaortic repair in the treatment of aortic regurgitation and aortic root
      pathology.
AB  - We developed a new technique of aortic root repair which may be able to eliminate
      the potential problem of leaflet damage, resulting from the direct contact of the
      aortic leaflets with synthetic vascular grafts during systole. This report
      describes our technique of annuloaortic repair and the operative results. Between
      February 1995 and October 1998, 13 patients underwent annuloaortic repair. The
      patients included 8 males and 5 females (mean age 50 years). Four patients had
      grade IV/IV aortic regurgitation (AR), 5 had III/IV AR, 2 had II/IV AR, and 1 had
      no AR preoperatively. Regarding the preoperative functional status, 1 patient was
      classified as New York Heart Association class IV, 5 were class III, 6 class II,
      and 1 class I. Concomitant cardiovascular procedures were performed in 12 cases.
      Aortic valvuloplasty or annuloplasty was performed in 7 patients. Both operative
      and short-term postoperative results with pre- and postoperative
      echocardiographic findings were studied retrospectively. The mean total
      cardiopulmonary bypass time was 212 min. The mean aortic cross-clamp time was 130
      min. Circulatory arrest was induced in 5 patients. Postoperatively, 7 patients
      had no AR. Three patients had grade I/IV AR and 3 had grade II/IV AR.
      Perioperative changes in aortic annulus, mid-sinus portion, and sinotubular
      junction diameters were determined echocardiographically in 5 patients. The
      preoperative diameters were 2.7 +/- 0.4, 5.4 +/- 0.5, and 4.7 +/- 1.0 cm,
      respectively. The postoperative diameters were 2.3 +/- 0.5, 4.2 +/- 0.5, and 3.5
      +/- 0.5cm, respectively. Ten patients were class I and 2 were class II. This
      technique of annuloaortic repair with or without aortic valvuloplasty is
      applicable to a certain subset of patients with aortic root disease and AR. Both
      the indications for this procedure and the long-term results should be confirmed.

PMID- 11213037
TI  - Treatment for aortic graft infection.
AB  - Nine patients with an aortic graft infection presented after undergoing aortic
      grafting. Seven of 9 patients underwent an initial aortic reconstruction in our
      hospital. The incidence of aortic graft infection was 1.5% (7/456). There were 6
      cases of paraprosthetic infection and 3 cases of aortointestinal fistulas. The
      treatments consisted of a complete graft excision and an axillofemoral bypass in
      6 patients, a complete graft excision alone, a partial graft excision and a
      femorofemoral bypass, and the preservation of the graft with omental wrapping and
      irrigation in 1 each. Broad-spectrum antibiotics were intravenously administered
      to all patients and were then replaced by selective antibiotics for the
      responsible organisms. All surviving patients received antibiotics orally for 3-6
      months. The early postoperative mortality rate was 11.1%. Aortoduodenal fistula
      occurred in 1 patient with graft excision alone. Graft thrombosis occurred in 2
      patients with an axillofemoral bypass. No late graft infection or stump blowout
      occurred in any patient. We believe that a complete excision of the infected
      graft as well as the maintenance of distal tissue perfusion is necessary.
      However, based on the condition of the patient, the appearance of the operating
      field, and the difficulty of a repeat operation, we would like to stress the
      importance of selecting the best and safest treatment plan for each case.

PMID- 11213039
TI  - Penetrating atherosclerotic ulcer.
AB  - The pathogenesis of penetrating atherosclerotic ulcer (PAU) in aortic disease
      remains controversial. Between January 1995 and April 1999, five patients
      underwent treatment for a PAU in our hospital. All were men, ranging in age from
      46 to 74 years, with a mean age of 66.2 years. The PAU was located on the
      thoracic descending aorta in three patients and on the abdominal aorta in two.
      Preoperative diagnosis was established by contrast-enhanced computed tomographic
      scan and aortogram. Surgery was performed in four patients, as graft replacement
      in three, and patch plasty in one. The remaining patient is being carefully
      observed on antihypertensive therapy. No connective tissue disorder, trauma,
      dissection, or infection was seen in any of the patients who underwent surgery,
      all of whom had uneventful postoperative courses with no perioperative
      complications or enlargement of the aorta. We conclude that surgical treatment
      should be performed for patients with PAU to prevent an aortic catastrophe caused
      by rapid development of the lesion. This report might provide further evidence of
      the importance of PAU.

PMID- 11213040
TI  - Management of esophageal perforation.
AB  - Despite recent advances in thoracic surgery, the management of esophageal
      perforation remains problematical and controversial. Thirty-one patients were
      treated for an esophageal perforation between 1986 and 1998. The esophageal
      perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and
      caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10
      cervical, 19 thoracic, and 2 abdominal perforations. The interval from
      perforation to operation was less than 24h in 12 patients and more than 24h in 19
      patients. The surgical procedures included a primary repair in 12 patients, a
      resection in 8, and conservative treatment with minor surgical approaches in 11.
      The mortality rate was 20% (4/20 patients) in the surgical treatment group and
      45.5% (5/11 patients) in the conservative treatment with minor surgery group. The
      overall mortality was 29% (9/31 patients). The prognosis is thus concluded to
      depend on the cause and location of the perforation, the presence of underlying
      esophageal diseases, and the surgical procedure chosen.

PMID- 11213041
TI  - A new procedure of percutaneous microwave coagulation therapy under artificial
      hydrothorax for patients with liver tumors in the hepatic dome.
AB  - Percutaneous microwave coagulation therapy (PMCT) has been widely used as an
      effective minimal invasive therapy for small liver tumors. The occurrence of a
      sonographic masked space due to the presence of the lung, however, has become a
      major obstacle to visualizing the whole tumor in the hepatic dome. To facilitate
      the use of PMCT for liver tumors in the hepatic dome, we developed PMCT in
      combination with the artificial hydrothorax method (percutaneous
      transdiaphragmatic MCT: PTD-MCT). Our new approach for PMCT to the hepatic tumors
      located in Couinaud's segments VIII or VII just under the diaphragm resulted in a
      successful treatment. The separation of the lung from the diaphragm by the
      infusion of saline into the pleural cavity enabled us not only to visualize the
      whole tumor in the hepatic dome to accurately target the tumor, but also helped
      us to avoid injuring the lung. PTD-MCT is therefore strongly recommended for the
      treatment of liver tumors in the hepatic dome.

PMID- 11213042
TI  - The role of endoscopic procedures in the management of postcholecystectomy and
      posttraumatic biliary leak.
AB  - Endoscopic retrograde cholangiopancreatography (ERCP) is an important tool in the
      evaluation of the biliary system. It not only diagnoses the site of biliary leak
      following bile duct injury, but it also acts as a therapeutic modality to allow
      interventional procedures such as sphincterotomy, nasobiliary drainage, or stent
      placement to be performed. The present study was carried out to evaluate the role
      of endoscopic management of biliary leak, following either liver trauma or
      cholecystectomy. Of a total 21 patients with bile leak following liver trauma and
      biliary surgery, 20 were managed by various endoscopic procedures. In the
      postcholecystectomy group, ERCP revealed a cystic duct leak in 9 patients and
      common bile duct injury in 6 patients. These complications were managed by
      sphincterotomy alone in 2 patients, by nasobiliary drainage alone in 4 patients,
      by sphincterotomy and nasobiliary drainage in 8 patients, and by sphincterotomy
      and stent placement in 1 patient. Posttraumatic biliary fistula was successfully
      managed by performing sphincterotomy followed by the placement of nasobiliary
      drainage in all of five patients who had suffered trauma injury.

PMID- 11213043
TI  - Diaphragmatic injuries in childhood.
AB  - The early detection and surgical repair of diaphragmatic injury is vital for
      saving the life of symptomatic children suffering from trauma. Furthermore, an
      accurate diagnosis may be difficult, particularly in right-sided diaphragmatic
      injuries. Fifteen children with diaphragmatic injury treated at our department
      between 1977 and 1998 were evaluated retrospectively. They included 9 boys and 6
      girls, and consisted of 8 left- and 6 right-sided injuries, and 1 midline
      retrosternal injury, due to a blunt (n = 13) or penetrating (n = 2) trauma. The
      most frequent symptoms were dyspnea (86.6%), and abdominal pain and vomiting
      (13.4%). The diagnosis was confirmed preoperatively in 13 patients based on chest
      X-ray (n = 7), gastrointestinal series (n = 3), barium enema (n = 1), and
      computed tomography and/or ultrasonography findings (n = 2). Among these, a
      diagnostic delay occurred in 3 patients with right-sided injuries. A primary
      repair was performed through a laparotomy (n = 14) or thoracotomy (n = 1).
      Postoperative intussusception was the most frequent complication (n = 2).
      Diaphragmatic injury must be considered in any child who has sustained a
      thoracoabdominal trauma. Serial chest X-rays should be taken especially in right
      sided injuries in which a considerable diagnostic delay may occur. Further
      radiological methods may be necessary to confirm the diagnosis. In addition,
      postoperative intussusception may be encountered following diaphragmatic repair.

PMID- 11213045
TI  - Successful surgical removal of an intrapulmonary aberrant needle under
      fluoroscopic guidance: report of a case.
AB  - We describe herein the successful surgical removal of an intrapulmonary aberrant
      needle. An asymptomatic 47-year-old woman underwent a routine chest X-ray which
      revealed a needle located in the right S8 area. We first tried to extract the
      needle; however, fluoroscopic examination confirmed that it had broken into two
      pieces and therefore, partial resection of the right S8 was performed. To avoid
      rethoracotomy, the operation was done under fluoroscopic guidance. An
      intrathoracic aberrant needle should always be removed surgically as soon as
      possible, even if the patient is asymptomatic, due to the possibility of its
      migration into the vessels and the development of lung abscess or pyothorax.

PMID- 11213044
TI  - Intrathoracic aneurysm of the innominate and right subclavian arteries: report of
      a case.
AB  - Aneurysms of the innominate and subclavian arteries are uncommon but associated
      with high mortality rates. We report herein the case of a 45-year-old man who
      presented with facial anhidrosis that developed several years after blunt
      thoracic trauma, in whom an aneurysm involving the innominate and subclavian
      arteries was revealed by preoperative examinations. Resection of the aneurysm and
      reconstruction from the ascending aorta to both the subclavian and common carotid
      arteries using a bifurcated graft was successfully performed without brain
      perfusion. Although the left posterior cerebral artery, which was not manipulated
      during surgery, became occluded, it was recanalized by thrombolysis. The patient
      was discharged in good health and has remained well since.

PMID- 11213046
TI  - Laryngotracheo-esophageal cleft in a neonate with esophageal atresia and tracheo
      esophageal fistula: report of a case.
AB  - Laryngotracheo-esophageal cleft (LTEC) is a congenital anomaly, rarely found in
      neonates with esophageal atresia (EA) and tracheo-esophageal fistula (TEF), that
      poses diagnostic and treatment dilemmas for the attending surgeon. In most cases
      previously reported, the diagnosis of this association was made either at surgery
      or at autopsy. We present herein the case of a neonate with EA and distal pouch
      (type C) TEF who was also found to have a LTEC (Evans type III) at the time of
      surgery. The salient clinical and radiological features of this association are
      highlighted to increase awareness of the possibility of this rare association and
      to help promote its early detection.

PMID- 11213047
TI  - Complete cure of malignant lymphoma of the stomach with a huge adrenal lesion
      achieved by preoperative chemotherapy and surgery: report of a case.
AB  - We report herein the case of a 53-year-old woman with malignant lymphoma of the
      stomach who was successfully treated by preoperative chemotherapy and surgery.
      The patient consulted our hospital with the chief complaint of upper abdominal
      pain. Endoscopy demonstrated a protruding lesion at the antral posterior wall of
      the stomach, and a post-biopsy pathological diagnosis of diffuse large cell type
      B-cell lymphoma was established. Moreover, abdominal ultrasonography, computed
      tomography, and magnetic resonance imaging demonstrated a tumor measuring
      approximately 10cm in diameter in the left adrenal gland. A total of three
      courses of chemotherapy using the CHOP regimen were given preoperatively. The
      CHOP regimen consisted of 100mg of prednisolone administered for 8 days together
      with 1.9mg of vincristine, 1,000mg of cyclophosphamide, and 60mg of epirubicin
      administered intravenously on the first day. This resulted in tumor shrinkage,
      and a distal gastrectomy, lymph node dissection, and left adrenalectomy were
      subsequently performed. Since the pathological findings of the resected tissue
      specimen demonstrated complete elimination of the malignant lymphoma, this
      combination of procedures was defined as having resulted in a complete response.
      The postoperative course of this patient was uneventful. She is still alive
      without any sign of tumor recurrence 6 years after her operation, and is being
      followed up at the outpatient clinic.

PMID- 11213048
TI  - Penetration of the duodenum by an ingested needle with migration to the pancreas:
      report of a case.
AB  - A case of a penetration of the duodenum by a needle with migration to the
      pancreas in a 50-year-old man is reported herein. The patient was referred to us
      with a chief complaint of diarrhea. An abdominal plain roentgenogram showed a
      needle in the upper abdominal area. An abdominal computed tomography scan and
      contrast X-ray revealed the foreign body to be located outside of the duodenum
      and in the head of the pancreas. An emergency operation was therefore performed
      on the first day and the needle in the head of the pancreas was thus extirpated
      safely. A perforation of the gastrointestinal tract by an ingested foreign body
      is difficult to accurately and quickly diagnose when no peritonitis or abscess
      formation is observed. Therefore, the use of contrast X-ray is considered to be
      useful in the diagnosis of such a perforation.

PMID- 11213049
TI  - Cystic duplication of the cecum with segmental dilatation of the ileum: report of
      a case.
AB  - Duplication cyst and segmental dilatation are rare congenital anomalies of the
      gastrointestinal tract, both of which are known to result in intestinal
      obstruction. We describe herein a case of intestinal obstruction in a neonate,
      caused by a duplication cyst in the cecum. A small dilated segment of ileum was
      also present at the site where Meckel's diverticulum would be expected, which was
      not causing obstruction to the luminal contents. Although it is well known that
      either of these conditions may coexist with a number of congenital malformations,
      their concurrent occurrence has never been reported before.

PMID- 11213050
TI  - Pneumoperitoneum following the spontaneous rupture of a gas-containing pyogenic
      liver abscess: report of a case.
AB  - We report herein the case of a ruptured liver abscess that resulted in
      pneumoperitoneum. A patient with diabetes mellitus presented with symptoms of
      acute abdomen. The plain abdominal radiograph and computed tomography findings
      revealed abdominal free air and a gas-containing liver abscess, whereby a
      diagnosis of a ruptured liver abscess was made. An emergency operation was
      performed, and the abscess was drained followed by peritoneal lavage and the
      administration of appropriate antibiotics. To the best of our knowledge, very few
      cases of spontaneous pneumoperitoneum occurring secondary to the rupture of a gas
      containing liver abscess have been encountered in Japan.

PMID- 11213051
TI  - Malignant pheochromocytoma with hepatic metastasis diagnosed 10 years after a
      resection of the primary incidentaloma adrenal lesion: report of a case.
AB  - A 40-year-old woman developed hepatic tumors 10 years after a resection of
      pheochromocytoma of the left adrenal gland. Computed tomography showed a round
      tumor measuring about 35mm in diameter at segment V of the liver (Couinaud's
      classification), and magnetic resonance imaging showed another tumor measuring
      about 5mm at segment V-VIII of the liver. The results of the endoscopic
      examination of her upper gastrointestinal tract and barium enema were normal.
      Owing to a suspected hepatic metastasis of malignant pheochromocytoma, a right
      lobectomy of the liver was performed. Postoperatively,
      [131I]metaiodobenzylguanidine scintigram and computed tomography showed no other
      residual tumors nor metastasis. The present case suggests that a long-term follow
      up only by endocrinological examinations is insufficient to find newly developed
      metastatic foci, while routine diagnostic imaging at frequent intervals is
      necessary in cases of pheochromocytoma.

PMID- 11213052
TI  - Ruptured dissecting aneurysm in bilateral iliac arteries caused by Ehlers-Danlos
      syndrome type IV: report of a case.
AB  - Ehlers-Danlos syndrome (EDS) is an inherited disorder of connective tissue
      characterized by hyperextensible skin, hypermobile joints, and abnormalities of
      the cardiovascular system. Ten types and several subtypes of EDS have so far been
      recognized based on genetic, clinical, and biochemical characteristics. The
      spectrum of the disorder varies from mild to life-threatening vascular
      complications. EDS type IV is a particularly dangerous form with a lethal
      spontaneous rupture of the major arteries and aneurysmal formation. We present
      herein a case of a ruptured dissecting aneurysm in the bilateral iliac arteries
      caused by EDS type IV. A previously healthy 33-year-old man without any physical
      features of this connective tissue disorder experienced a metachronous vascular
      rupture two times. Successful synthetic bypass grafting was performed with great
      difficulty. The diagnosis of EDS type IV was made afterwards based on an
      electrophoresis analysis of a skin biopsy specimen which revealed a lack of type
      III collagen. Surgical intervention in cases of arterial complications in EDS
      type IV patients have been reported to be both difficult and frequently
      unsuccessful. The early clinical recognition of this syndrome is therefore of
      great importance due to the hazards of such surgical therapies.

PMID- 11213053
TI  - Billroth I gastrectomy using a circular stapler to treat gastric cancer.
AB  - We describe herein our technique of performing gastrectomy followed by side-to
      end gastroduodenostomy. Because the clamp is removed at the resection line of the
      greater curvature, there is no need to perform an additional gastrotomy for
      insertion of the instrument. This feature differentiates our technique from
      previous methods of anastomosis using the circular stapler. We believe that our
      technique is superior in simplicity and security to the traditional hand-sewn
      anastomosis. Moreover, it allows for a shorter operative time. This technique is
      recommended for practical surgery over conventional techniques.

PMID- 11213054
TI  - Laparoscopic right hemicolectomy with radical lymph node dissection using the no
      touch isolation technique for advanced colon cancer.
AB  - The treatment of advanced right-sided colon cancer presents numerous challenges
      for the surgeon who must aim to minimize the invasiveness of surgery, achieve
      curative resection, and prevent port-site recurrences. To overcome these issues,
      we performed a totally intra-abdominal laparoscopic right hemicolectomy with
      radical lymph node dissection based on a no-touch isolation technique. To perform
      this no-touch technique, we initially dissected the lymph nodes along the
      surgical trunk, then transected the transverse colon, terminal ileum, and
      mesentery without tumor manipulation. Finally, the right side of the colon was
      freed retroperitoneally. We performed this surgical technique on three patients
      and no intraoperative complications were encountered. Curative resection was
      achieved in all three patients, as curability A according to the Japanese
      Classification of Colorectal Carcinoma, and their postoperative courses were
      uneventful. Therefore, this novel technique proved to be both feasible and safe.
      Furthermore, it enabled us to minimize the invasiveness of surgery, while
      providing clear access to resect the right-sided advanced colon cancer.

PMID- 11213055
TI  - Could inducible nitric oxide synthase inhibitors improve the survival and long
      term function of intraportal islet grafts?

PMID- 11213056
TI  - Prevention of early islet graft failure by selective inducible nitric oxide
      synthase inhibitors after pig to nude rat intraportal islet transplantation.
AB  - BACKGROUND: Clinical and experimental data indicate that early failure of
      intraportally grafted islets is caused by inflammation including secretion of
      cytokines and nitric oxide. Direct inducible nitric oxide synthase suppression
      may avoid detrimental effects associated with steroid administration. We compared
      the efficiency of selective and unselective inducible nitric oxide synthase
      inhibitors with dexamethasone to suppress nitric oxide generation after
      intraportal islet xenotransplantation into nude rats. METHODS: Nonfasting serum
      glucose levels were daily evaluated after intraportal transplantation of 4000
      freshly isolated pig islets into diabetic nude rats (85 mg/kg streptozotocin)
      either sham-treated with saline (n=21) or continuously infused for 7 days with L
      NG-monomethyl-arginine (n=7), S-methyl-isothiourea (n=15), or S-(2-aminoethyl)
      isothiourea (n=19) in a dosage of 240, 100, or 50 mg/kg/day, respectively.
      Dexamethasone was injected i.p. twice as a daily bolus of 20 mg/kg (n=10)
      starting 1 day pretransplant. The nitrate/nitrite serum level was quantified
      colorimetrically 0, 24, and 48 hr posttransplant. RESULTS: Saline treatment
      partially resulted in graft function (4/21) throughout the observation period (21
      days). L-NG-monomethyl-arginine-treated rats showed sustained hyperglycemia (0/7)
      not different from diabetic controls. Normoglycemia was observed after treatment
      with dexamethasone (6/10, P<0.05 versus saline and L-NG-monomethyl-arginine), S
      methyl-isothiourea (10/15, P<0.01), or S-(2-aminoethyl)-isothiourea (15/19,
      P<0.001). Graft function was associated with complete suppression of nitric oxide
      generation after S-methyl-isothiourea and S-(2-aminoethyl)-isothiourea treatment
      (P<0.001 versus saline) and partial suppression after dexamethasone treatment
      (P<0.05). CONCLUSIONS: Our observation of long-term function of xenogeneic islets
      in an inflammatory environment without interference of reactive T cells revealed
      the potency of highly selective isothioureas to completely suppress inducible
      nitric oxide synthase making reduction of islet-toxic immunosuppression feasible.

PMID- 11213057
TI  - Protection against gas exchange abnormalities by pre-aerosolized PGE1, iloprost
      and nitroprusside in lung ischemia-reperfusion.
AB  - BACKGROUND: Development of severe gas exchange abnormalities and respiratory
      failure is a major threat in lung transplantation. METHODS: We used a model of
      ischemia-reperfusion injury in buffer-perfused rabbit lungs, with gas exchange
      conditions being analyzed in detail by the multiple inert gas elimination
      technique. A total of 150 min of warm ischemia was performed, and anoxic
      ventilation and a positive intravascular pressure were maintained throughout the
      ischemic period. RESULTS: Reperfusion provoked a transient, mostly precapillary
      pulmonary artery pressure elevation and progressive lung edema formation
      attributable to increased capillary permeability. Severe ventilation-perfusion
      mismatch with predominance of shunt flow became apparent within minutes after
      onset of reperfusion. 5 min-aerosolization maneuvers for alveolar deposition of
      prostaglandin E1, the long-acting prostacyclin analogue iloprost or the nitric
      oxide donor agent sodium nitroprusside were undertaken at the onset of ischemia.
      All preaerosolized vasodilator agents markedly reduced the pulmonary artery
      pressure elevation and the leakage response upon reperfusion. Most impressively,
      maintenance of physiological ventilation-perfusion matching was achieved by these
      maneuvers, and the development of shunt flow was largely suppressed. CONCLUSIONS:
      Preischemic alveolar deposition of PGE1, iloprost, and sodium nitroprusside by
      aerosol technique is highly effective in conserving normal pulmonary
      hemodynamics, microvascular integrity, and physiological gas exchange conditions
      upon reperfusion. This approach may offer as new strategy for maintenace of
      pulmonary function in lung transplantation.

PMID- 11213058
TI  - V-PYRRO/NO: an hepato-selective nitric oxide donor improves porcine liver
      hemodynamics and function after ischemia reperfusion.
AB  - BACKGROUND: The role of nitric oxide (NO) in ischemia reperfusion (I/R) injury is
      controversial as both beneficial and harmful effects have been reported. We
      explored the potential role of a pharmacological agent recently shown to generate
      NO metabolically in the liver in an animal model of transplantation. METHODS: The
      effect of a selective hepatic NO donor, O2-vinyl 1-(pyrrolidin-1-yl)diazen-1-ium
      1,2-diolate (V-PYRRO/NO), on hepatic hemodynamics and biliary function was
      evaluated in both the in situ and I/R pig liver. RESULTS: V-PYRRO/NO
      significantly reduced in situ hepatic vascular resistance (HVR) without altering
      systolic blood pressure. Portal vein flow was essentially unchanged during in
      situ infusions while hepatic artery flow nearly doubled (P=0.03). After I/R, V
      PYRRO/NO infusions significantly reduced both portal vein pressure (PVP) and HVR
      (P=0.04). Also, serum bile acid clearance increased from 15% when taurocholate
      (TC) was infused alone to 46% (P=0.007) when infused simultaneously with V
      PYRRO/NO. Aqueous bile production tripled with TC and V-PYRRO/NO as compared to
      TC alone (P=0.04). Analysis of bile outputs revealed a significant increase in
      biliary cholesterol, biliary phospholipid, and biliary bile acid (P<0.05) with V
      PYRRO/NO infusion. CONCLUSIONS: The hepato-selective nitric oxide donor, V
      PYRRO/NO, reduced hepatic resistance parameters of the pig liver both before and
      after I/R and improved the plasma clearance of bile acid and biliary outputs of
      bile acid-dependent compounds. The augmented function observed after I/R may be
      due to improvements in hepatic blood flow secondary to altered hepatic
      hemodynamics.

PMID- 11213059
TI  - Transplantation of infantile bladder in rats: an alternative procedure for
      bladder augmentation.
AB  - BACKGROUND: Our purpose was to evaluate whether bladder transplantation (BTx) can
      be used for bladder augmentation (BA). METHODS: Bladders from infantile Brown
      Norway rats (less than 21 days old) were excised and each transplanted into a
      pouch created in the distal omentum of a 6-week-old Lewis rat (fully allogeneic
      BTx). No immunosuppressant was used in group I (n=12). Intramuscular FK506 was
      used daily from the day of BTx in group II (n=16; 0.2 mg/kg), group III (n=22;
      0.6 mg/kg), and group IV (n=16; 1.2 mg/kg) until harvesting 3, 4, 5, or 6 weeks
      after BTx. FK506 was used for only 2 weeks in group V (n=12; 0.6 mg/kg/day) and
      group VI (n=12; 1.2 mg/kg/day). Syngeneic bladder transplants acted as controls
      (n=16). Hematoxylin and eosin staining was used to examine all grafts. In six
      rats from group III, BA was performed by anastomosing the graft to the recipient
      bladder 10 days after BTx. RESULTS: Each successfully transplanted graft appeared
      macroscopically as a thin-walled cyst. Rejection was seen in all grafts from
      groups I, II, V, and VI, and was minimal or absent in groups III and IV. On
      medium to long-term follow-up the only side effect of FK506 observed was reduced
      weight gain. Graft survival in the control group was 100%. BA was successful in
      all six cases, and the mucosa was normal throughout each augmented bladder.
      CONCLUSIONS: This is the first report of the successful transplantation of
      infantile tissue without vascular anastomosis. Because of the efficient, safe
      immunosuppression possible with FK506, our BTx technique could find clinical
      application for creating viable vesical tissue that could be used for BA.

PMID- 11213060
TI  - Islets in alginate macrobeads reverse diabetes despite minimal acute insulin
      secretory responses.
AB  - BACKGROUND: Encapsulation of islets has been widely investigated as a treatment
      for diabetes. The characteristics and dynamics of insulin secretion by
      encapsulated islets in response to glucose and other secretagogues are not well
      understood. METHODS: In our study, macroencapsulated syngeneic islets at 3-4 wk
      after transplantation were studied for insulin release in response to i.v.
      glucose (hyperglycemic clamps at 250 or 350 mg/dl plasma glucose), arginine (i.v.
      bolus, 100 mg/kg), glucagon-like peptide-1 (i.v. infusion for 20 min, 2.2
      pmol/kg/min), and meal challenge. Syngeneic islets (6000 islets) were
      encapsulated in alginate macrobeads (2-3 mm diameter) with or without poly-L
      lysine coating and transplanted into the peritoneal cavity of STZ-diabetic Lewis
      rats. Normal (nontransplanted) and diabetic Lewis rats transplanted with "naked"
      islets under the kidney capsule served as controls. RESULTS: Animals transplanted
      with macrobeads displayed subnormal insulin responses to glucose, arginine, and
      glucagon-like peptide-1 despite achieving normoglycemia faster than animals with
      renal subcapsular islet transplants. Plasma insulin responses to meal challenges
      were blunted in animals with macrobeads resulting in increased plasma glucose
      excursions. CONCLUSIONS: We conclude that, after transplantation into diabetic
      Lewis rats, macroencapsulated islets have significantly impaired insulin
      secretion despite achieving normal fed glycemic levels.

PMID- 11213061
TI  - The use of the endothelin receptor antagonist, tezosentan, before or after renal
      ischemia protects renal function.
AB  - BACKGROUND: Utilization of organs subjected to ischemia/reperfusion (I/R) injury
      could expand the donor pool. Endothelin (ET) is implicated in renal I/R injury.
      Therefore, our study compared the effectiveness of pre- and postischemic
      administration of the ET receptor antagonist, Tezosentan, in preserving renal
      function. METHODS: In a rat model, a kidney was subjected to 45 min of ischemia
      along with a contralateral nephrectomy. After 24 hr of reperfusion, renal
      function was assessed by serum creatinine (Scr), inulin clearance (glomerular
      filtration rate; GFR), and histology. ET-1 peptide expression was localized using
      immunohistochemistry. Three groups were studied: I/R untreated (n=17), I/R
      pretreated (n=11), and I/R posttreated (n=13) with Tezosentan (15 mg/kg, i.v.).
      RESULTS: Tezosentan significantly decreased (P<0.05) the rise in Scr from I/R
      injury (2.0+/-0.4 mg/dl, before and 2.9+/-0.4 mg/dl, after treatment) compared
      with untreated animals (4.2+/-0.4 mg/dl). GFR was significantly increased
      (P<0.05) from 0.13+/-0.03 ml/min (untreated animals) to 0.74+/-0.16 and 0.47+/
      0.14 ml/min (pre- and posttreated animals). Untreated animals had significant
      cortical acute tubular necrosis, which was almost completely prevented by
      pretreatment with Tezosentan and markedly reduced by posttreatment. Increased ET
      1 peptide expression was noted in the renal vasculature and in the cortical
      tubular epithelium of kidneys exposed to I/R. CONCLUSIONS: The purpose of this
      study was to optimize the function of kidneys exposed to I/R injury. Pretreatment
      as well as posttreatment with Tezosentan successfully decreased Scr, increased
      GFR, and maintained renal architecture in kidneys after ischemia. Therefore, ET
      receptor antagonists may be useful to preserve renal function in the
      transplantation setting.

PMID- 11213062
TI  - Heart and liver xenotransplantation under low-dose tacrolimus: graft survival
      after withdrawal of immunosuppression.
AB  - BACKGROUND: The hamster-to-rat xenotransplantation model is a useful model to
      investigate the features of extended host response to long-surviving xenografts.
      Early xenoantibody responses are T-cell independent and resistant to tacrolimus.
      Treatment with the combination of mofetil mycophenolate plus FK506 avoids acute
      xenograft rejection completely, but after withdrawal of immunosuppression hamster
      grafts are rejected by a process called late xenograft rejection (LXR). METHODS:
      Hamster hearts and livers were transplanted into Lewis rats. Grafted rats were
      treated with mofetil mycophenolate (25 mg/kg/day) for 8 days and FK506 (0.2
      mg/kg/day) for 31 days. Serum IgM and IgG levels were determined by flow
      cytometry and interferon-gamma levels by ELISA. IgM, IgG, and C3 deposits were
      measured in tissue by immunofluorescence, and leukocyte infiltration was measured
      by immunoperoxidase staining. Results. Survival of heart and liver xenografts in
      the rats was 48+/-4 days and 63+/-8 days, respectively. After cessation of all
      immunosuppression, hearts were rejected in 18+/-4 days and livers in 33+/-8 days.
      Production sequences of xenoantibodies in the two organs differed substantially,
      especially 7 days after transplantation and at the moment of rejection.
      Quantification of interferon-gamma levels indicated that there were no
      significant changes after transplantation. Histological and immunohistochemical
      studies showed signs of humoral mechanism of LXR in rats undergoing heart
      transplantation and cellular mechanism of LXR in those that received a liver
      transplant. Conclusions. These observations suggest that rejection in the hamster
      to-rat heart xenotransplantation model is mediated by a T cell-independent B-cell
      response to which a T cell-dependent B-cell response is added in LXR. In the
      liver xenotransplantation model, our hypothesis is that LXR is mediated by a
      mixed cell mechanism, involving lymphocytes CD4+ CD45RC+, macrophages, and
      cytotoxic T lymphocytes. In summary, we have demonstrated and compared the
      peculiar features of LXR in two different organs.

PMID- 11213064
TI  - Ethnic differences in clinical response to corticosteroid treatment of acute
      renal allograft rejection.
AB  - BACKGROUND: Limited in vitro data suggest that African-Americans exhibit greater
      resistance to corticosteroids than do non-African-American transplant recipients.
      However, ethnic differences in clinical response to corticosteroids for treatment
      of acute rejection have not been investigated previously. The purpose of this
      study was to evaluate the clinical response to corticosteroid treatment for acute
      rejection in both African-American and non-African-American renal allograft
      recipients. METHODS: We retrospectively reviewed the medical records of 497
      consecutive renal allograft recipients to identify patients who had received
      corticosteroids as initial treatment of acute rejection. One hundred and twenty
      patients who received corticosteroids for treatment of acute rejection were
      evaluated in this analysis. The study population was divided into two groups: the
      African-American group (n=73) and non-African-American group (n=47). All acute
      rejection episodes were documented by biopsy and were classified as mild-moderate
      histologically. Corticosteroid therapy consisted of either methylprednisolone,
      500 mg intravenously for 3 days, or oral prednisone, 2 mg/kg/day rapidly tapered
      over 3 weeks. RESULTS: Twenty-six percent (26%) of African-Americans were
      considered corticosteroid treatment failures compared to an 8.0% failure rate
      among non-African-Americans (P<0.05). One-year graft survival was 78% in African
      American versus 96% in non-African-American (P<0.05). Among African-American and
      non-African-American recipients, 1-year patient survival rates were 97% and 100,
      respectively (P=NS). CONCLUSIONS: African-American patients exhibit higher
      failure rates with corticosteroid treatment of acute rejection. Alternative anti
      rejection therapies may need to be considered for this "high-risk" patient
      population to improve long-term graft survival.

PMID- 11213063
TI  - Use of mycophenolate mofetil as rescue therapy after pediatric liver
      transplantation.
AB  - BACKGROUND: Mycophenolate mofetil (MMF) has been increasingly used after liver
      transplantation (LT) in adults. We report our preliminary experience with MMF as
      rescue therapy after pediatric LT. METHODS: A total of 19 children received MMF
      for 21 indications. Median age at LT was 30 months (range 7-149). The median
      initial oral dose of MMF was 23 mg/kg/day (range 12-43) orally. Median follow-up
      after initiation of MMF therapy was 642 days (range 229-1606). RESULTS: 1)
      EFFICACY: MMF was indicated for rejection or insufficient immunosuppression in 16
      cases, with normalization of both liver function tests and liver histology in 10
      (62%). MMF was successfully used in one patient with post-LT immmune hepatitis
      and one patient with corticodependence. In three patients with renal function
      impairment, MMF allowed reduction of cyclosporine A or tacrolimus blood levels,
      without subsequent rejection. 2) Tolerance: Six patients (32%) experienced eight
      side effects, mainly gastrointestinal and hematological, which resolved after
      cessation of MMF in five cases and dose reduction in three. One case of
      posttransplant lymphoproliferative disease (PTLD) occurred under MMF therapy
      (5.2%). Four patients had EBV primary infection, while under MMF therapy, without
      subsequent PTLD. Three patients had CMV primary infection, and five CMV
      reactivation, under MMF therapy. Seven remained asymptomatic, and one presented
      with CMV enteritis. CONCLUSIONS: These preliminary results suggest that MMF is an
      effective and safe immunosuppressant in pediatric LT recipients. Its use is
      hampered by frequent gastrointestinal and hematological side-effects. MMF does
      not seem to increase the risk of PTLD nor CMV disease.

PMID- 11213065
TI  - Live donor renal allograft in end-stage renal failure patients from
      immunoglobulin A nephropathy.
AB  - BACKGROUND: The purpose of this study was to attempt to resolve two important
      issues, i.e. to determine (1) whether the course of recurrent immunoglobulin A
      nephropathy (IgAN) is benign, and (2) whether it is advisable to use a related
      donor. METHODS: We evaluated the long-term outcome, in terms of recurrence and
      graft survival, after live related or unrelated donor renal transplantation, and
      assessed the validity of the use of related donors in 90 grafts in 89 IgAN
      patients. RESULTS: Ten-year graft survival for IgAN patients was 66%, compared
      with 84% for 107 reference recipients who had other kinds of glomerulonephritis
      (GN), and with 69% in 90 other recipients who had non-GN renal failure (P=0.27).
      In 43 grafts, 54 event graft biopsies were performed, documenting the presence of
      mesangial IgA deposits in 19 of those grafts. In eight grafts, lesions were
      accompanied by chronic rejection (CR). Ten-year cumulative recurrence was 44%.
      Ten grafts were lost: by CR (n=3) or acute rejection (n=1) in 24 recurrence-free
      recipients, by CR (n=2) or recurrence (n=2) in 19 recurrent patients, and by
      patient death (n=2) in 46 patients devoid of graft biopsy. We found no difference
      in 10-year graft survival between the recurrent and recurrence-free patients (63%
      vs. 74%, P=0.98), or the proportion of related donors (68% vs. 83%, P=0.25). The
      presence or matching of HLA B12, B35, or DR4 did not affect the recurrence.
      CONCLUSIONS: Recurrence increased to 44% with longer follow-up, but this did not
      limit the graft outcome. Recurrence was not affected by the kind of live donor.
      We conclude that live related or unrelated kidneys should be offered to IgAN
      patients.

PMID- 11213066
TI  - Herbal supplements: a potential for drug interactions in transplant recipients.
AB  - BACKGROUND: Herbal dietary supplements represent a potential and possibly an
      overlooked cause for drug interactions in transplant recipients. METHODS: Two
      patients are reported which suggest that St. John's Wort (SJW) may induce
      cytochrome P-450 3A4 activity and/or P-glycoprotein expression. Both of these
      mechanisms are significantly involved in the metabolism and absorption of
      cyclosporine (CSA) and other immunosuppressants. RESULTS: After two renal
      transplant recipients started self-medicating with SJW, their CSA concentrations
      were consistently documented to be subtherapeutic. While on SJW, one patient
      developed acute graft rejection due to low CSA concentrations. In both patients,
      termination of SJW returned their CSA concentrations to therapeutic values.
      CONCLUSIONS: Patients taking SJW concomitantly with CSA or other medications
      whose absorption and metabolism are mediated by cytochrome P-450 and/or P
      glycoprotein should require close monitoring. Potential herb-prescription drug
      interactions are not just limited to SJW. Inquiries regarding the usage of herbal
      supplements should be an integral component of a transplant recipient's
      medication history.

PMID- 11213067
TI  - Hypogammaglobulinemia in lung transplant recipients.
AB  - BACKGROUND: Infectious complications continue to represent a significant source
      of morbidity and mortality in lung transplant recipients. Identifying specific,
      remediable immune defects is of potential value. After one lung transplant
      patient with recurrent infections was noted to be severely hypogammaglobulinemic,
      a screening program for humoral immune defects was instituted. The objectives
      were to define the prevalence of hypogammaglobulinemia in lung transplant
      recipients, assess levels of antibody to specific pathogens, and correlate
      infectious disease outcomes and survival with immunoglobulin levels. METHODS: All
      lung transplant recipients followed at a single center between October 1996 and
      June 1999 underwent a posttransplant humoral immune status survey as part of
      routine posttransplant follow-up. This survey consists of total immunoglobulin
      levels (IgG, IgM, IgA), IgG subclasses (IgG1-4), and antibody titers to
      Pneumococcus, diphtheria, and tetanus. Since February 1997, this survey has been
      incorporated into the pretransplant evaluation as well. Humoral survey results
      for October 1996 through July 1999 were recorded, and clinical information on
      major infectious disease outcomes was obtained from chart reviews, discharge
      summaries, the Cleveland Clinic Unified Transplant Database, and review of all
      microbiological studies and pathology results for each patient. RESULTS: Of 67
      patients with humoral immune surveys drawn posttransplant, 47 (70%) had IgG
      levels less than 600 mg/dl (normal 717-1410 mg/dl), of which 25 (37%) had IgG
      levels less than 400 mg/dl ("lowest IgG group") and 22 (33%) had IgG levels
      between 400 and 600 mg/dl ("moderately low IgG group"). A total of 20 patients
      (30%) had IgG levels of more than 600 mg/dl ("normal IgG group"). Infections that
      were significantly more common in the lowest IgG group, and more common in the
      moderately low IgG group than the normal IgG group, included: number of
      pneumonias (P=0.0006), bacteremias (P=0.02), total bacterial infections
      (P=0.002), tissue-invasive cytomegalovirus (P=0.01), invasive aspergillosis
      (P=0.001), total fungal infections (P=0.001), and total infections (P=0.006).
      Median hospital days per posttransplant year was significantly different in the
      three groups (11.0 vs. 7.4 vs. 2.8 days, P=0.0003.) Invasive aspergillosis
      occurred in 44% of the lowest IgG group, 9% of the moderately low IgG group, and
      0% of the normal IgG group (P<0.001). Survival was poorest in the lowest IgG
      group and intermediate in the moderately low IgG group. IgG subclass deficiencies
      occurred in a variety of patterns. Hypogammaglobulinemic patients lacked
      protective responses to Pneumococcus in 14/47 (30%), diphtheria in 15%, and
      tetanus in 19%. In a group of 48 patients screened pretransplant, 90% had normal
      immunoglobulin levels. CONCLUSIONS: Hypogammaglobulinemia in lung transplant
      recipients is more common than has been previously recognized. An IgG level of
      less than 400 mg/dl identifies a group at extremely high risk of bacterial and
      fungal infections, tissue-invasive cytomegalovirus, and poorer survival.
      Immunoglobulin monitoring may offer an opportunity for intensive surveillance,
      tapering of immunosuppression, and preemptive therapy for infection.

PMID- 11213068
TI  - The effect of aprotinin on renal function in orthotopic liver transplantation.
AB  - BACKGROUND: In the European Multicenter Study on the Use of Aprotinin in Liver
      Transplantation (EMSALT), a randomized, double-blind, placebo-controlled,
      prospective study, we demonstrated that aprotinin significantly reduces
      intraoperative blood loss during orthotopic liver transplantation (OLT).
      Aprotinin is metabolized in the kidney and potentially nephrotoxic at high
      concentrations. Renal insufficiency is a common and serious complication after
      OLT. It is unknown whether aprotinin increases the risk of renal failure after
      OLT. METHODS: We analyzed intraoperative urine output, need for postoperative
      dialysis, perioperative serum creatinine levels, and creatinine clearance in 93
      patients enrolled in EMSALT, receiving a high dose of aprotinin, a regular dose,
      or placebo. RESULTS: Peak increase in serum creatinine exceeding 0.5 mg/dl during
      one of the postoperative days occurred in 11 (35%) patients in the placebo group,
      in 11 (34%) patients in the high-dose group, but only in 1 (3%) patient in the
      regular-dose group (P=0.007). Furthermore, a perioperative decrease in creatinine
      clearance was seen in the placebo group (-23.9+/-10.1 ml/min) but not in both
      high-dose (-1.6+/-13.3 ml/min) and regular-dose (9.7+/-10.3 ml/min) groups
      (P<0.02 comparing regular-dose and placebo group). CONCLUSIONS: Despite its
      potential nephrotoxicity, the use of aprotinin for reducing blood loss during OLT
      does not lead to a higher incidence of postoperative renal insufficiency. In
      combination with the observed reduction in blood loss, these findings support the
      prophylactic use of regular-dose aprotinin during OLT.

PMID- 11213069
TI  - Posttransplant diabetes mellitus in pediatric thoracic organ recipients receiving
      tacrolimus-based immunosuppression.
AB  - BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is a well-known
      complication of tacrolimus-based immunosuppression in both adult and pediatric
      solid organ recipients. The "natural history" of diabetes in the pediatric
      thoracic transplant population has not yet been described. METHODS: We identified
      all pediatric thoracic transplant patients receiving tacrolimus-based
      immunosuppression who developed PTDM. Medical records were reviewed, with a
      particular focus on the clinical course of PTDM and its relationship to drug
      weaning. RESULTS: Diabetes developed in 24 of 143 (17%) 30-day survivors of heart
      (12/96, 13%) and heart-lung/lung (12/ 47, 26%) transplantation. In 17 (71%)
      patients, the immunosuppressive regimen at the onset of PTDM also included
      maintenance corticosteroids. Seventeen patients demonstrated glucose intolerance
      before the onset of diabetes. Nine patients (38%) developed diabetes during
      pulsed corticosteroid therapy. Median time of onset after transplantation was 9.0
      months. All patients required s.c. insulin for glucose control. The median follow
      up from transplant was 49.9 months. There was a significant decrease in mean
      tacrolimus dosage (P<0.01), tacrolimus level (P<0.04), and steroid dosage
      (P<0.02) from onset of PTDM to most recent follow-up. Despite this significant
      reduction in immunosuppression, only 3/24 (13%) patients were successfully weaned
      off insulin. CONCLUSIONS: Diabetes mellitus is a common complication in pediatric
      thoracic transplant patients receiving tacrolimus-based immunosuppression.
      Insulin dependence in our population rarely resolved, even after lowering
      tacrolimus and steroid doses. Discontinuation of steroids did not guarantee
      resolution of diabetes.

PMID- 11213070
TI  - Evaluation of renal function in potential living kidney donors.
AB  - BACKGROUND: Most transplant centers in the United States, including our own, use
      creatinine clearance (Ccr) to estimate glomerular filtration rate (GFR) in
      potential living kidney donors. The purpose of this study was to evaluate our
      experience with estimation of donor GFR by Ccr and to explore other potential
      strategies for evaluation of renal function in donors. METHODS: Potential donors
      performed one to three outpatient urine collections for Ccr measurement. Those
      with low or inconsistent results underwent measurement of GFR by a radionuclide
      method not dependent upon urine collection (rGFR). The ability to determine
      adequacy of urine volume by creatinine excretion rate (UVcr) was examined. GFR
      was also predicted from serum creatinine (Scr) by using two prediction equations
      [Cockcroft-Gault and that from the Modification of Diet in Renal Disease Study
      (MDRD)]. The effect of indexing GFR by height, as opposed to body surface area
      (BSA) was explored. RESULTS: Over a 5-year period, 22 potential donors
      (approximately 10% of total evaluated) had inconsistent or low Ccr. Most had
      normal rGFR and, presumably, undercollected their urine. However, several female
      donors had truly low GFR by rGFR. The accuracy of Ccr (compared with rGFR) was
      not predicted by UVcr in a clinically useful way. The prediction equations did
      not have sufficient accuracy or precision to replace rGFR in this population.
      Indexing GFR estimates by BSA introduced a bias toward lower values in females;
      this was largely overcome by indexing GFR by height. CONCLUSIONS: Evaluation of
      GFR in potential living donors by Ccr is not very useful. A more promising
      strategy could be developed predicting GFR from Scr and indexing the results by
      height rather than BSA. The optimum method for evaluation of renal function in
      kidney donors deserves further study.

PMID- 11213071
TI  - Daily interferon therapy for hepatitis C virus infection in liver transplant
      recipients.
AB  - BACKGROUND: Hepatitis C virus infection persists after liver transplantation and
      causes recurrent liver injury in the majority of patients. Standard dose
      interferon therapy has been largely unsuccessful for hepatitis C in transplant
      recipients. METHODS: Twelve patients, at least 7 months posttransplant, with
      detectable hepatitis C virus RNA in serum and features of hepatitis C on liver
      biopsy were randomized to interferon-alpha2a, 3 mU daily for 12 months (n=8) or
      no treatment (n=4). The tolerability of daily interferon dosing in liver
      transplant recipients was evaluated and effects on hepatitis C virus RNA level,
      quasispecies evolution, and liver histology were studied. RESULTS: Treated
      patients had an improvement in histological activity index at the end of therapy
      relative to controls (median reduction of 2 versus median increase of 1.5)
      (P=0.04). Four treated patients had a virological response (all bDNA negative,
      one qualitative polymerase chain reaction negative) compared with none of the
      untreated patients. Only two of six treated patients tested had evidence of
      quasispecies diversification on therapy. Seven of eight patients in the treatment
      group required dose reduction for fatigue and/or depression. They tolerated 1.5
      mU of interferon-alpha2a daily. Two treated patients developed graft dysfunction,
      one of who had histological evidence of rejection and subsequent graft loss.
      CONCLUSIONS: Low daily doses of interferon were tolerated by liver transplant
      recipients and provided histological benefit without associated quasispecies
      diversification in most cases. These findings provide a rationale to study low
      dose daily or pegylated interferon maintenance therapy for the management of
      hepatitis C posttransplant.

PMID- 11213072
TI  - Kidney transplantation for end-stage renal failure in liver transplant recipients
      with hepatitis C viral infection.
AB  - BACKGROUND: End-stage renal failure after successful liver transplantation (LTx)
      has been described in up to 5% of patients. Kidney transplantation (KTx) has been
      the treatment of choice in these cases. However, in recipients infected with
      hepatitis C virus (HCV), the augmentation of immunosuppression after KTx may
      result in an increased viral load. This, in turn, may adversely affect the liver
      allograft. METHOD: The present study retrospectively examined the outcome in 17
      patients (3 females and 14 males, mean age 51.1+/-11.3 years) who received KTx
      after LTx. The mean interval from LTx to KTx was 57.6+/-32.1 months. The mean
      follow-up was 41.7+/-20.5 months after KTx, and 99.6+/-37.7 months after LTx.
      Sixteen of the 17 patients received tacrolimus-based immunosuppression at the
      time of KTx. RESULTS: During the follow-up period, one patient underwent combined
      liver and kidney retransplantation 3.7 years after KTx and 12.7 years after LTx.
      She subsequently died secondary to primary nonfunction. Four other patients died,
      two of lung cancer, one of pancreatitis/sepsis, and one of severe depression
      leading to noncompliance. A total of 29 episodes of biopsy-proven acute renal
      allograft rejection (1.7 episodes/ patient) were encountered and treated with
      steroids. Seven patients experienced a rise in liver function tests during the
      period of increased steroid dosage. Four patients received no treatment, and
      their liver function returned to baseline. The remaining three were treated with
      interferon. Overall 1- and 3-year actuarial patient and liver allograft survival
      was 88% and 71% (after renal transplantation); corresponding 1- and 3-year
      actuarial graft survival was 88% and 61%. Twelve patients are alive with normal
      liver function. One patient is on dialysis, because of renal allograft loss to
      noncompliance. CONCLUSION: In this series, LTx recipients with HCV infection were
      able to undergo KTx with a reasonable degree of success. KTx should be offered
      for end-stage renal failure after LTx, even in the presence of HCV infection, to
      individuals with stable liver function and no signs of liver failure.

PMID- 11213073
TI  - A worldwide, phase III, randomized, controlled, safety and efficacy study of a
      sirolimus/cyclosporine regimen for prevention of acute rejection in recipients of
      primary mismatched renal allografts.
AB  - BACKGROUND: Despite the various immunosuppressive regimens presently in use,
      acute rejection in the early postoperative period continues to occur in 20 to 40%
      of renal transplant patients. In a double-blind, multicentred study, we
      investigated the ability of two different doses of sirolimus (rapamycin,
      RAPAMUNE), a new class of immunosuppressant that blocks cell cycle progression,
      to prevent acute rejection in recipients of primary mismatched renal allografts
      when added to a regimen of cyclosporine (cyclosporin A, CsA) and corticosteroids.
      METHODS: Between October 1996 and September 1997, 576 recipients of primary
      mismatched cadaveric or living donor renal allografts were randomly assigned in a
      2:2:1 ratio (before the transplant operation) to receive an initial loading dose
      of either 6 or 15 mg of orally administered sirolimus, followed by a daily dose
      of either 2 or 5 mg/day, or to receive a matched placebo. All groups received
      cyclosporine (microemulsion formula, CsA) and corticosteroids. The primary
      endpoint was a composite of first occurrence of biopsy-confirmed acute rejection,
      graft loss, or death during the first 6 months after transplantation. Safety data
      were monitored by an independent drug safety monitoring board. RESULTS: Based on
      an intention-to-treat analysis of 576 patients, there were no significant
      differences in patient demographic or baseline characteristics among treatment
      groups. The overall rate of the primary composite endpoint for the 6-month period
      after transplantation was 30.0% (68/227) in the 2 mg/day sirolimus group and
      25.6% (56/219) in the 5 mg/day sirolimus group, significantly lower than the
      47.7% (62/130) in the placebo group (P=0.002, P<0.001, respectively). During this
      period, the incidence of biopsy-confirmed acute rejection was 24.7% (56/227) in
      the 2 mg/day sirolimus group and 19.2% (42/219) in the 5 mg/day sirolimus group,
      compared with 41.5% (54/130) in the placebo group (P=0.003, P<0.001,
      respectively), representing a significant reduction in acute rejection of 40.5
      and 53.7%, respectively. The need for antibody therapy to treat the first episode
      of biopsy-confirmed acute rejection was significantly reduced in the 5 mg/ day
      sirolimus group (3.2%) compared to the placebo group (8.5%; P=0.044). The results
      1 year after transplantation were similar for the efficacy parameters studied.
      Adverse events and infections occurred in all groups. CONCLUSIONS: The addition
      of either 2 mg/day sirolimus or 5 mg/day sirolimus to CsA/corticosteroid therapy
      significantly reduces the incidence of acute rejection episodes in primary
      mismatched renal allograft recipients, without an increase in immunosuppressant
      related side effects, including infections and malignancy, at 6 months and at 1
      year after transplantation.

PMID- 11213074
TI  - U.S. nephrologists' attitudes towards renal transplantation: results from a
      national survey.
AB  - BACKGROUND: Renal transplantation is the optimal treatment for persons with end
      stage renal disease (ESRD). A shortage of kidneys in the U.S. has focused
      increasing attention on the process by which kidneys are allocated. A national
      survey was undertaken to determine the relative importance of both clinical and
      nonclinical factors in the recommendation for renal transplantation by U.S.
      nephrologists. METHODS: We conducted a national random survey of 271 U.S.
      nephrologists using hypothetical patient scenarios to determine their
      recommendation for renal transplantation based on demographic, clinical, and
      social factors. Specifically, eight unique patient scenarios were randomly
      distributed to each survey respondent. RESULTS: According to responding
      nephrologists (response rate 53%), females were less likely than males to be
      recommended for renal transplantation [adjusted odds ratio (OR)=0.41; confidence
      interval (CI) 0.21, 0.79; for whites]. Asian males were less likely than white
      males to be recommended for transplantation (OR=0.46, CI 0.24, 0.91). Black-white
      differences in rates of recommendation were not found. Other factors associated
      with low rates of recommendation for renal transplantation included history of
      noncompliance (OR=0.17, CI 0.13, 0.23), <25% cardiac ejection fraction (OR=0.15,
      CI 0.10, 0.21), HIV infection (OR=0.01, CI 0.00, 0.01), and being >200 lbs
      (OR=0.73, CI 0.56, 0.95). CONCLUSIONS: Female gender, and Asian but not black
      race, were associated with a decreased likelihood that nephrologists would
      recommend renal transplantation for patients with end stage renal disease. The
      well-documented black-white disparities in use of renal transplantation may be
      due to unaccounted for factors or may arise at a subsequent step in the
      transplantation process.

PMID- 11213075
TI  - Fatal primary infection due to human herpesvirus 6 variant A in a renal
      transplant recipient.
AB  - We describe a fatal primary human herpesvirus 6 (HHV-6) variant A infection in a
      kidney transplanted adult woman. On day 20 post transplantation (TX), after
      rejection therapy, the patient presented an acute hemophagocytic syndrome with
      hepatitis and central nervous system involvement. HHV-6 IgG and IgM antibodies
      seroconversion was demonstrated. HHV-6 variant A was the sole pathogen detected
      by nested PCR and/or culture in blood, bone marrow aspiration, liver biopsy,
      cerebrospinal fluid and bronchoalveolar lavage. The graft was HHV-6 seropositive
      and the patient was not transfused before day 28 post TX, suggesting that the
      virus was transmitted by the graft. Despite immunoglobulins, ganciclovir and
      foscarnet therapy, the HHV-6 infection progressed and led to severe aplasia. The
      patient developed Aspergillus fumigatus pneumonia and died from fulminant
      candidemia. This case demonstrated for the first time that HHV-6 variant A
      primary infection can cause life-threatening disseminated infection in
      immunosuppressed patients.

PMID- 11213076
TI  - Transforming growth factor-beta inhibits lymphokine activated killer cytotoxicity
      of bone marrow cells: implications for the graft-versus-leukemia effect in
      irradiation allogeneic bone marrow chimeras.
AB  - BACKGROUND: We have previously shown that allogeneic bone marrow (BM) chimeras
      preconditioned with total lymphoid irradiation and low-dose total body
      irradiation (TLI/TBI) develop a stronger graft-versus-leukemia (GVL) effect than
      chimeras preconditioned with high-dose total body irradiation only (TBI). Here,
      we report on the possible role of cytokines in the mechanism underlying this GVL
      effect. METHODS: Splenic mRNA levels of the cytokines interleukin (IL)-1, IL-2,
      IL-4, IL-6, IL-7, IL-10, IL-12, IL-15, interferon-gamma, tumor necrosis factor
      alpha, and transforming growth factor-beta (TGF-beta), and of inducible nitric
      oxide synthetase were determined by reverse transcription-polymerase chain
      reaction in TLI/TBI- or TBI-conditioned C3H/AKR BM chimeras challenged with AKR
      type BW5147.3 leukemia cells. Ex vivo TGF-beta protein production by splenocytes
      was determined using ELISA. The possibility that cytokines influence the GVL
      effect by modulating the activity of IL-2-activated lymphocytes (LAK cells) was
      investigated by in vitro assays on donor-type BM cells. RESULTS: Of all cytokine
      mRNA levels studied, those of TGF-beta and IL-7 were different between groups;
      both were significantly more elevated in TBI- than in TLI/ TBI-conditioned or
      normal mice. Differences were apparent after conditioning and were not influenced
      by additionally injected BM or leukemia cells. Cultured splenocytes of TBI
      conditioned animals produced significantly more TGF-beta protein than those of
      TLI/TBI-conditioned ones or normal controls. r-TGF-beta but not r-IL-7 suppressed
      in vitro LAK activity of donor-type BM cells against BW5147.3 cells in a dose
      dependent way. CONCLUSIONS: High-dose TBI-induced, host-derived splenic TGF-beta
      may inhibit generation of LAK cells from subsequently transplanted donor BM
      cells, suppressing their capacity to generate cytotoxicity upon injection of
      leukemia cells. The cytokine profile, induced by irradiation in host
      hematopoietic organs, can significantly modify posttransplant immunological
      processes such as the GVL effect and graft-versus-host disease (GVHD).

PMID- 11213077
TI  - Lung preconditioning with N-acetyl-L-cysteine prevents reperfusion injury after
      liver no flow-reflow: a dose-response study.
AB  - BACKGROUND: Circulating xanthine oxidase activity and the generated oxidants have
      been linked to lung reperfusion injury from no flow-reflow conditions in other
      organs after organ transplantation or surgery. N-acetyl-1-cysteine (NAC), an
      oxidant scavenger, promotes glutathione in its reduced form (GSH) that is
      depleted during ischemia. We have recently demonstrated its efficacy in
      protecting lungs from reperfusion injury if administered during reperfusion of
      postischemic liver. We now investigated whether preconditioning of lungs with NAC
      could attenuate lung respiratory or vascular derangement after no flow-reflow
      (ischemia-reperfusion, IR) and if this depends on lung GSH levels. METHODS: Rat
      isolated livers were stabilized and perfused with modified Krebs-Henseleit
      solution (KH) (control, n=12) or made ischemic (no flow, IR-0, n=12) for 2 hr.
      Meanwhile, lungs were isolated, ventilated, and stabilized (KH+bovine albumin
      5%). Serial perfusion (15 min) of liver+lung pairs took place followed by lung
      only recirculation (45 min) with the accumulated solution. Another three controls
      and three ischemic groups included lungs treated during stabilization with NAC at
      100 mg x kg(-1), 150 or 225 mg x kg(-1) (in 2.5, 3.7 or 5.5 mmol solutions,
      respectively). Results. Ischemic liver damage, expressed by circulating
      hepatocellular constituents, was associated with pulmonary artery and ventilatory
      pressure increases by 70-100% of baseline, abnormal wet-to-dry weight ratio, and
      abnormal bronchoalveolar lavage volume and content in the IR-0 (nontreated) and
      the IR-100 and IR-225 pretreated lungs. NAC-150 pretreatment afforded
      preservation for most parameters. GSH content in the IR-150 lung tissue was only
      11% higher than that of IR-225, but 2-fold that in IR-0 and IR-100 GSH lungs.
      CONCLUSION: Lung preconditioning with NAC prevents reperfusion injury but not in
      a dose-related manner. Although enhanced GSH tissue content explains lung
      protection, GSH-independent NAC activity is another possibility.

PMID- 11213078
TI  - Tubulitis after renal transplantation: demonstration of an association between
      CD103+ T cells, transforming growth factor beta1 expression and rejection grade.
AB  - BACKGROUND: Tubulitis is a defining feature for the diagnosis and management of
      acute renal allograft rejection. Lymphocytes extracted from rejecting renal
      tissue are known to express the alphaEbeta7-integrin (CD103), a receptor for E
      cadherin expressed on epithelial cells. In this study, expression of CD103 was
      examined in situ in tubulitis associated with acute rejection. METHODS: Immuno
      labeling detected CD8+ and CD103+ lymphocytes and E-cadherin on epithelial cells
      in cryostat sections from 34 diagnostic biopsy specimens and a limited number of
      transplant nephrectomies. CD8+ and CD103+ intratubular cells were enumerated as
      mean numbers per tubular crosssection and median values were compared between
      rejection grades as were median ratios of CD103+ to CD8+ cells. Active
      transforming growth factor (TGF) beta1 was quantified in paraffin sections by
      immunofluorescence and confocal microscopical analysis. A parallel in vitro study
      quantified CD103+ T cells after allospecific activation with and without
      exogenous TGFbeta1. RESULTS: CD8+ T cells were present in tubules and tubular
      interstitium in acute rejection. CD103+ T cells were restricted exclusively to
      the tubules. The numbers of intratubular CD8+ and CD103+ cells and the ratio of
      intratubular CD103+ to CD8+ cells increased significantly with tubulitis score (P
      values 0.005, 0.009, and 0.02, respectively). TGFbeta1 expression was wide-spread
      in tubules also increasing significantly with tubulitis score (P=0.034). In
      chronic rejection, CD103+ T cells and TGFbeta1 were present within both tubules
      and interstitial cell populations. The in vitro study demonstrated that addition
      of TGFbeta1 to activated, alloantigen-specific T cells increased the proportion
      of CD8+ cells that also expressed CD103. CONCLUSIONS: These data indicate that
      specific upregulation of the alphaEbeta7-integrin by activated, intratubular T
      cells in acute renal allograft rejection could be a consequence of exposure to
      high local concentrations of TGFbeta1. The capacity of CD103+ T cells to bind E
      cadherin on tubular epithelial cells may be an important factor in the
      pathogenesis of specific tissue damage observed in acute renal allograft
      rejection.

PMID- 11213079
TI  - Antigen expression in xenotransplantation: how low must it go?
AB  - BACKGROUND: Acute vascular rejection (AVR) is an important immunological barrier
      to xenotransplantation. Thought to be initiated by xenoreactive antibodies, acute
      vascular rejection might, in principle, be avoided by engineering animals to
      express low levels of antigen. The extent to which antigen expression would have
      to be decreased to achieve such a goal is unknown. METHODS: We estimated the
      decrease in expression of a xenogeneic antigen, Galalpha1-3Gal, which might be
      needed to avert acute vascular rejection of xenotransplants based on the decrease
      in antibody binding to endothelium that would prevent tissue damage. RESULTS: The
      level of decrease needed in Galalpha1-3Gal expression needed to avoid acute
      vascular rejection was estimated to exceed 96% of baseline. The extent of the
      decrease needed reflected, in part, a substantial "excess" of Galalpha1-3Gal on
      porcine endothelial cell surfaces. CONCLUSIONS: Although the change in antigen
      expression required to avoid acute vascular rejection might be conditioned by
      various factors, the very large magnitude of this change necessitates application
      of highly efficient approaches to antigen modification.

PMID- 11213080
TI  - Rat xenograft survival in mice treated with donor-specific transfusion and anti
      CD154 antibody is enhanced by elimination of host CD4+ cells.
AB  - BACKGROUND: Treatment with a donor-specific transfusion (DST) and a brief course
      of anti-mouse CD154 (anti-CD40-ligand) monoclonal antibody (mAb) prolongs the
      survival of both allografts and rat xenografts in mice. The mechanism by which
      allograft survival is prolonged is incompletely understood, but depends in part
      on the presence of CD4+ cells and the deletion of alloreactive CD8+ T cells. Less
      is known about the mechanism by which this protocol prolongs xenograft survival.
      METHODS: We measured rat islet and skin xenograft survival in euthymic and
      thymectomized mice treated with combinations of DST, anti-CD154 mAb, anti-CD4
      mAb, and anti-CD8 mAb. Recipients included C57BL/6, C57BL/6-scid, C57BL/6
      CD4null, and C57BL/6-CD8null mice. RESULTS: Pretreatment with a depleting anti
      CD4 mAb markedly prolonged the survival of both skin and islet xenografts in mice
      given DST plus anti-CD154 mAb. Comparable prolongation of xenograft survival was
      obtained in C57BL/6-CD4null recipients treated with DST and anti-CD154 mAb. In
      contrast, anti-CD8 mAb did not prolong the survival of either islet or skin
      xenografts in mice treated with DST and anti-CD154 mAb. Thymectomy did not
      influence xenograft survival in any treatment group. Adoptive transfer of
      splenocytes from C57BL/6-CD4null recipients treated with DST and anti-CD154 mAb
      and bearing long-term skin xenografts revealed the presence of residual
      xenoreactive cells. CONCLUSIONS: These data suggest that treatment with DST and
      anti-CD154 mAb induces a state of "functional" transplantation tolerance. They
      also support the hypothesis that both the induction and maintenance of graft
      survival based on this protocol depend on different cellular mechanisms in
      allogeneic and xenogeneic model systems.

PMID- 11213081
TI  - Simplified technique of orthotopic liver transplantation in pigs.
AB  - BACKGROUND: Pig models have become common in transplantation immunological
      research. However, in pigs, clamping of the venous splanchnic system during
      orthotopic liver transplantation (OLT) is responsible for high morbidity and
      mortality rates; therefore, the use of venovenous bypass (VVB) is advocated.
      Because venous bypass can also cause specific complications, a simplified method
      for OLT in pigs has been developed and evaluated in terms of morbidity and
      mortality. METHODS: Twenty-three OLTs were performed between pairs of inbred
      miniature swine. Donor and recipient pairs (weighing 20-35 kg) were selected at 3
      6 months of age. In the donor, the portal vein, infrahepatic vena cava, and
      suprahepatic vena cava were dissected, whereas the hepatic artery was preserved
      in continuity with the coeliac trunk and the abdominal aorta up to the iliac
      bifurcation. In situ cold perfusion was then performed. The recipient was
      prepared simultaneously by another surgical team. After total hepatectomy and
      complete portal and caval clamping, the suprahepatic vena cava and portal vein
      were sutured; VVB was not used. After completion of both venous sutures, the
      liver graft was reperfused. The infrahepatic vena cava was then anastomosed and
      unclamped. The donor aorta conduit was implanted end-to-side to the recipient
      infrarenal aorta, and the biliary reconstruction consisted of a
      cholecystojejunostomy with a Roux-Y loop. RESULTS: Twenty of 23 (87%) animals
      survived more than 1 week (7-483 days). The mean anhepatic time was 29.6+/-4.12
      min. Although severe hypotension was noted during the anhepatic phase, the
      hemodynamic status rapidly recovered and stabilized after graft reperfusion.
      CONCLUSION: Simplified technique without VVB is appropriate for successfully
      achieving OLT in pigs.

PMID- 11213082
TI  - Vitamin E inhibits renal mRNA expression of COX II, HO I, TGFbeta, and
      osteopontin in the rat model of cyclosporine nephrotoxicity.
AB  - BACKGROUND: In a rat model of cyclosporine (CsA) nephrotoxicity, vitamin E
      preserves renal function and reduces free radicals, vasoconstrictive
      thromboxanes, and tubulointerstitial fibrosis. We examined the effect of vitamin
      E on tubule gene expression in this model. METHODS: In two of three groups, rats
      were treated with either CsA, or CsA plus vitamin E, whereas the control group
      received vehicles. We pooled purified tubules or whole kidney tissue in a novel
      manner to represent each treatment group, harvested RNA, and performed rigorously
      controlled qualitative reverse transcription-polymerase chain reaction. RESULTS:
      Cyclooxygenase (COX) I mRNA was detectable in control animals, was increased by
      CsA, but was unchanged by vitamin E. COX II mRNA was detected in controls, was
      inhibited in the CsA group, and was further inhibited with vitamin E.
      Hemeoxygenase I and TGF-beta and osteopontin mRNA were increased in the CsA
      treated group and were inhibited by vitamin E. CONCLUSIONS: Our data support the
      involvement of free radicals, COX pathways, and pro-fibrotic genes in
      cyclosporine nephrotoxicity and suggest that the salutary effect of vitamin E
      involves the suppression of some of these genes.

PMID- 11213083
TI  - Chronic diarrhea as a result of intestinal microsposidiosis in a liver transplant
      recipient.
AB  - BACKGROUND: Microsporidia are common pathogens among patients infected with human
      immunodeficiency virus. They account for a substantial proportion of chronic
      diarrhea and malabsorption in acquired immune deficiency syndrome, but their
      appearance after solid organ transplantation has only rarely been reported.
      Methods. We report what we believe is the first case of documented Enterocytozoon
      bieneusi infection in a liver transplant recipient. Results. Our patient
      presented with chronic diarrhea and colicky abdominal pain. Although symptoms
      were severe, only mild microscopical mucosal changes were found in the intestinal
      tract. A modified trichrome stain of stool specimens revealed microsporidial
      spores, and species differentiation by restriction fragment length polymorphism
      polymerase chain reaction identified Enterocytozoon bieneusi. Albendazole therapy
      brought symptomatic relief but no microbiological clearance. CONCLUSIONS:
      Enterocytozoon bieneusi may cause chronic diarrhea not only in immunosuppression
      as a result of human immunodeficiency virus infection but also among patients
      with therapeutic immunosuppression after organ transplantation. Therefore,
      microsporidial infection should be considered in immunosuppressed patients with
      otherwise unexplained diarrhea.

PMID- 11213084
TI  - Primary fibroblast cell cultures from transbronchial biopsies of lung transplant
      recipients.
AB  - BACKGROUND: Survival after lung transplantation is limited by the development of
      bronchiolitis obliterans (BO) that is a fibroproliferative process and regarded
      as the histological marker of chronic rejection. To study further the
      pathogenesis of BO we attempted to establish primary fibroblast cell cultures
      from transbronchial lung biopsies (TBBs)of lung transplant recipients. METHODS:
      One to two TBB samples from each patient were collected in sterile phosphate
      buffered saline. Biopsies were cut into small pieces and placed onto 25-cm2
      culture flasks for cell culture and kept under standard cell culture conditions
      (21% O2, 5% CO2, 37 degrees C). Culture medium consisted of RPMI 1640, 10% fetal
      calf serum, L-glutamine, HEPES, and antibiotics. After reaching confluence,
      fibroblasts were passaged into 75-cm2 flasks. RESULTS: The success rate of
      establishing fibroblast cultures from transbronchial lung biopsies was 54%
      (27/50). Cell growth was independent of patient age, transplant type, underlying
      lung disease, indication for transbronchial lung biopsies, grade, or type of re
      jection and infection. CONCLUSIONS: We have established a novel method of
      culturing fibroblasts from lung transplant recipients. We consider this method as
      an unique human in vitro model to study the pathogenetic mechanisms leading to
      BO.

PMID- 11213085
TI  - Retention of organs after necropsy.

PMID- 11213086
TI  - Role of antibody response in outcome of antibiotic-associated diarrhoea.

PMID- 11213087
TI  - Prospects for improving staging of ovarian cancers.

PMID- 11213088
TI  - Anticipation of epileptic seizures from standard electro-encephalographic
      recordings.

PMID- 11213089
TI  - Regulation of the cholesterol efflux gene, ABCA1.

PMID- 11213090
TI  - Effects of volcanic air pollution on health.

PMID- 11213091
TI  - Review of first 5 years of screening for familial hypercholesterolaemia in the
      Netherlands.
AB  - BACKGROUND: Familial hypercholesterolaemia is a common lipid disorder that
      predisposes for premature cardiovascular disease (CVD). We set up a screening
      programme in the Netherlands in 1994 to: establish the feasibility of active
      family screening supported by DNA diagnostics; assess whether or not active
      identification of these patients with familial hypercholesterolaemia would lead
      to more cholesterol-lowering treatment; and compare diagnosis by DNA analysis
      with that by cholesterol measurement. METHODS: Both DNA analysis and measurement
      of cholesterol concentrations were used to screen families in which a functional
      mutation in the LDL-receptor gene had been detected. FINDINGS: In the first 5
      years, 5442 relatives of 237 people with familial hypercholesterolaemia were
      screened; 2039 individuals were identified as heterozygous by LDL-receptor gene
      mutation analysis. At the time of examination, 667 of these adults with familial
      hypercholesterolaemia (39%) received some form of lipid-lowering treatment; 1
      year later, this percentage had increased to 93%. In addition, laboratory
      analysis showed that for carriers as well as non-carriers 18% would have been
      misdiagnosed by cholesterol measurement alone, with sex-specific and age-specific
      90th percentiles of the general Dutch population as diagnostic criteria.
      INTERPRETATION: Targeted family screening with DNA analysis proved to be highly
      effective in identifying patients with hypercholesterolaemia. Most of the
      identified patients sought treatment and were successfully started on cholesterol
      lowering treatment to lower the risk of premature CVD. Our findings could have
      wider relevance for the screening of other prevalent genetic disorders in the
      population at large.

PMID- 11213092
TI  - Clinical picture: paravertebral abscess.

PMID- 11213093
TI  - Pathological correlates of late-onset dementia in a multicentre, community-based
      population in England and Wales. Neuropathology Group of the Medical Research
      Council Cognitive Function and Ageing Study (MRC CFAS).
AB  - BACKGROUND: We have undertaken a large unselected, community-based neuropathology
      study in an elderly (70-103 years) UK population in relation to prospectively
      evaluated dementia status. The study tests the assumption that dementing
      disorders as defined by current diagnostic protocols underlie this syndrome in
      the community at large. METHODS: Respondents in the Medical Research Council
      Cognitive Function and Ageing Study were approached for consent to examine the
      brain at necropsy. Dementia status was assigned by use of the automated geriatric
      examination for computer-assisted taxonomy algorithm. Neuropathological features
      were standardised by use of the protocol of the Consortium to Establish a
      Registry of Alzheimer's Disease, which assesses the severity and distribution of
      Alzheimer-type pathology, vascular lesions, and other potential causes of
      dementia. A statistical model of dementia risk related predominantly to Alzheimer
      type and vascular pathology was developed by multivariate logistic regression.
      FINDINGS: We report on the first 209 individuals who have come to necropsy. The
      median age at death was 85 years for men, and 86 years for women. Cerebrovascular
      (78%) and Alzheimer-type (70%) pathology were common. Dementia was present in 100
      (48%), of whom 64% had features indicating probable or definite Alzheimer's
      disease. However, 33% of the 109 non-demented people had equivalent densities of
      neocortical neuritic plaques. Some degree of neocortical neurofibrillary
      pathology was found in 61% of demented and 34% of non-demented individuals.
      Vascular lesions were equally common in both groups, although the proportion with
      multiple vascular pathology was higher in the demented group (46% vs 33%).
      INTERPRETATION: Alzheimer-type and vascular pathology were the major pathological
      correlates of cognitive decline in this elderly sample, as expected, but most
      patients had mixed disease. There were no clear thresholds of these features that
      predicted dementia status. The findings therefore challenge conventional dementia
      diagnostic criteria in this setting. Additional factors must determine whether
      moderate burdens of cerebral Alzheimer-type pathology and vascular lesions are
      associated with cognitive failure.

PMID- 11213094
TI  - Prognostic importance of degree of differentiation and cyst rupture in stage I
      invasive epithelial ovarian carcinoma.
AB  - BACKGROUND: Previous studies on prognostic factors in stage I invasive epithelial
      ovarian carcinoma have been too small for robust conclusions to be reached. We
      undertook a retrospective study in a large international database to identify the
      most important prognostic variables. METHODS: 1545 patients with invasive
      epithelial ovarian cancer (International Federation of Gynaecology and Obstetrics
      [FIGO] stage I) were included. The records of these patients were examined and
      data extracted for univariate and multivariate analysis of disease-free survival
      in relation to various clinical and pathological variables. FINDINGS: The
      multivariate analyses identified degree of differentiation as the most powerful
      prognostic indicator of disease-free survival (moderately vs well differentiated
      hazard ratio 3.13 [95% CI 1.68-5.85], poorly vs well differentiated 8.89 [4.96
      15.9]), followed by rupture before surgery (2.65 [1.53-4.56]), rupture during
      surgery (1.64 [1.07-2.51]), FIGO 1973 stage Ib vs Ia 1.70 [1.01-2.85]) and age
      (per year 1.02 [1.00-1.03]). When the effects of these factors were accounted
      for, none of the following were of prognostic value: histological type, dense
      adhesions, extracapsular growth, ascites, FIGO stage 1988, and size of tumour.
      INTERPRETATION: Degree of differentiation, the most powerful prognostic indicator
      in stage I ovarian cancer, should be used in decisions on therapy in clinical
      practice and in the FIGO classification of stage I ovarian cancer. Rupture should
      be avoided during primary surgery of malignant ovarian tumours confined to the
      ovaries.

PMID- 11213095
TI  - Anticipation of epileptic seizures from standard EEG recordings.
AB  - BACKGROUND: New methods derived from non-linear analysis of intracranial
      recordings permit the anticipation of an epileptic seizure several minutes before
      the seizure. Nevertheless, anticipation of seizures based on standard scalp
      electroencephalographical (EEG) signals has not been reported yet. The
      accessibility to preictal changes from standard EEGs is essential for expanding
      the clinical applicability of these methods. METHODS: We analysed 26 scalp
      EEG/video recordings, from 60 min before a seizure, in 23 patients with temporal
      lobe epilepsy. For five patients, simultaneous scalp and intracranial EEG
      recordings were assessed. Long-term changes before seizure onset were identified
      by a measure of non-linear similarity, which is very robust in spite of large
      artifacts and runs in real-time. FINDINGS: In 25 of 26 recordings, measurement of
      non-linear changes in EEG signals allowed the anticipation of a seizure several
      minutes before it occurred (mean 7 min). These preictal changes in the scalp EEG
      correspond well with concurrent changes in depth recordings. INTERPRETATION:
      Scalp-EEG recordings retain sufficient dynamical information which can be used
      for the analysis of preictal changes leading to seizures. Seizure anticipation
      strategies in real-time can now be envisaged for diverse clinical applications,
      such as devices for patient warning, for efficacy of ictal-single photon emission
      computed tomography procedures, and eventual treatment interventions for
      preventing seizures.

PMID- 11213096
TI  - Association between antibody response to toxin A and protection against recurrent
      Clostridium difficile diarrhoea.
AB  - BACKGROUND: We have reported that symptom-free carriers of Clostridium difficile
      have a systemic anamnestic immune response to toxin A. The aim of this study was
      to determine whether an acquired immune response to toxin A, during an episode of
      C. difficile diarrhoea, influences risk of recurrence. METHODS: We prospectively
      studied 63 patients with nosocomial C. difficile diarrhoea. Serial serum IgA,
      IgG, and IgM concentrations against C. difficile toxin A, toxin B, or non-toxin
      antigens were measured by ELISA. Individuals were followed for 60 days. FINDINGS:
      19 patients died (30%). Of the 44 who survived, 22 had recurrent C. difficile
      diarrhoea. Patients with a single episode of C. difficile diarrhoea (n=22) had
      higher concentrations of serum IgM against toxin A on day 3 of their first
      episode of diarrhoea than those with recurrent diarrhoea (n=22, p=0.004). On day
      12, serum IgG values against toxin A were higher in patients who had a single
      episode of diarrhoea (n=7) than in those who subsequently had recurrent diarrhoea
      (n=9, p=0.009). The odds ratio for recurrence associated with a low concentration
      of serum IgG against toxin A, measured 12 days after onset of C. difficile
      diarrhoea, was 48.0 (95% CI 3.5-663). INTERPRETATION: A serum antibody response
      to toxin A, during an initial episode of C. difficile diarrhoea, is associated
      with protection against recurrence.

PMID- 11213097
TI  - Emphysematous pyelonephritis: a rare cause of pneumaturia.

PMID- 11213098
TI  - Efficacy of meningococcal serogroup C conjugate vaccine in teenagers and toddlers
      in England.
AB  - The UK was the first country to use meningococcal serogroup C conjugate (MCC)
      vaccines, which were licensed on the basis of immunogenicity and safety data but
      without a formal efficacy study. Increased surveillance during the first 9 months
      since introduction has shown that short-term efficacy of the MCC vaccine in
      England was 97% (95% CI 77-99) for teenagers and 92% (65-98) for toddlers. These
      early results confirm the superiority of MCC over plain C polysaccharide
      vaccines, which are ineffective in young children.

PMID- 11213099
TI  - Prevention of hepatocellular carcinoma in patients with chronic active hepatitis
      C and cirrhosis.
AB  - In a prospective randomised controlled study, 90 patients with chronic active
      hepatitis C and compensated cirrhosis were assigned symptomatic treatment or
      interferon alfa (IFN-alpha). We report data on decompensation, detection of
      hepatocellular carcinoma, and mortality rates. IFN-alpha gave a sustained
      response in only a small proportion of patients, but worsening of compensated
      cirrhosis was prevented and development of hepatocellular carcinoma was
      inhibited, increasing the survival rate. The risk ratio of IFN-alpha versus
      symptomatic treatment decreased by 0.250 for progression to Child-Pugh grade B,
      0.256 for detection of hepatocellular carcinoma, and 0.135 for a fatal outcome.

PMID- 11213101
TI  - Eclipse burns: a prospective study of solar retinopathy following the 1999 solar
      eclipse.
AB  - Looking at the sun can cause focal burns to the retina. We prospectively followed
      up all patients who presented to Eye Casualty of Leicester Royal Infirmary having
      observed the solar eclipse of August, 1999. 45 patients attended, of whom 20 had
      visual symptoms and five had visible changes in the retina; four patients were
      still symptomatic after 7 months.

PMID- 11213100
TI  - The evolution of human group B rotaviruses.
AB  - The largest reported rotavirus epidemic affected well over a million people in
      China during 1982-83 and was caused by the adult diarrhoea rotavirus (ADRV), a
      serogroup B rotavirus. However, ADRV has not been reported outside China since
      the last recorded small outbreak there in 1987. Here we present evidence that
      offers an explanation for the sudden appearance and disappearance of the epidemic
      ADRV strain.

PMID- 11213102
TI  - NATO doctors question "Balkan war syndrome".

PMID- 11213103
TI  - New vaccines for mycobacterial infections "desperately needed".

PMID- 11213104
TI  - Making new connections--preventing the brain drain.

PMID- 11213105
TI  - Good health news spares UK government from media onslaught.

PMID- 11213106
TI  - Child activist's critical condition is wake-up call for nation.

PMID- 11213107
TI  - Family-practice doctors seek to reawaken US health-care debate.

PMID- 11213108
TI  - Germany's Health and Agriculture ministers resign over handling of BSE.

PMID- 11213109
TI  - UN sanctions imposed against Afghanistan while thousands flee.

PMID- 11213110
TI  - Primary, secondary, and tertiary prevention of pre-eclampsia.
AB  - Pre-eclampsia remains one of the major obstetrical problems in less-developed
      countries. The causes of this condition are still unknown, thus effective primary
      prevention is not possible at this stage. Research in the past decade has
      identified some major risk factors for pre-eclampsia, and manipulation of these
      factors might result in a decrease in its frequency. In the early 1990s aspirin
      was thought to be the wonder drug in secondary prevention of pre-eclampsia.
      Results of large trials have shown that this is not the case: if there is an
      indication for using aspirin it is in the patient at a very high risk of
      developing severe early-onset disease. The calcium story followed a more or less
      similar pattern, with the difference that existing evidence shows that women with
      a low dietary calcium intake are likely to benefit from calcium supplementation.
      Proper antenatal care and timed delivery are of utmost importance in tertiary
      prevention of pre-eclampsia. There is evidence to suggest that the intrinsic
      direct effect of moderate degrees of maternal hypertension is beneficial to the
      fetus. Severe hypertension needs treatment. If antihypertensive is indicated,
      there is no clear choice of a drug. Hydralazine should no longer be thought of as
      the primary drug, most studies show a preference for calcium channel blockers.

PMID- 11213111
TI  - Neuropsychological effects of epilepsy and antiepileptic drugs.
AB  - Epilepsy and its treatment can have deleterious cognitive and behavioural
      consequences. Affected individuals have a higher prevalence of neuropsychological
      dysfunction than the general population because of complex interactions among
      several multifaceted and overlapping influences--for example, underlying
      neuropathologies, ictal and interictal neuronal discharges, a plethora of
      antiepileptic drugs, and numerous psychosocial issues. Research into the clinical
      relevance of these factors has been dogged by a range of methodological pitfalls
      including lack of standardisation of neuropsychological tests, small numbers and
      multiple testing, and statistical failure to appreciate differential effects of
      interactive elements in individual patients. Although antiepileptic drugs can
      impair neuropsychological functioning, their positive effect on seizure control
      might improve cognition and behaviour. Each person should be assessed
      individually with respect to factors unique to his or her seizure disorder and
      its treatment.

PMID- 11213112
TI  - What can be achieved with an HIV vaccine?

PMID- 11213113
TI  - Term breech trial.

PMID- 11213114
TI  - Term breech trial.

PMID- 11213115
TI  - Term breech trial.

PMID- 11213116
TI  - Term breech trial.

PMID- 11213117
TI  - Term breech trial.

PMID- 11213118
TI  - Term breech trial.

PMID- 11213119
TI  - Term breech trial.

PMID- 11213120
TI  - Term breech trial.

PMID- 11213121
TI  - Syndrome X in testicular-cancer survivors.

PMID- 11213122
TI  - Follicle-stimulating-hormone receptor and twinning.

PMID- 11213123
TI  - Follicle-stimulating-hormone receptor and twinning.

PMID- 11213124
TI  - Follicle-stimulating-hormone receptor and twinning.

PMID- 11213125
TI  - HIV-1 infection and malaria parasitaemia.

PMID- 11213126
TI  - HIV-1 infection and malaria parasitaemia.

PMID- 11213127
TI  - HIV-1 infection and malaria parasitaemia.

PMID- 11213128
TI  - Heparin and aspirin in stroke.

PMID- 11213129
TI  - The gender gap in autoimmune disease.

PMID- 11213130
TI  - Wound botulism in the UK.

PMID- 11213131
TI  - African malaria vectors in European aircraft.

PMID- 11213133
TI  - Drug development for tuberculosis: the missing ingredient.

PMID- 11213132
TI  - African malaria vectors in European aircraft.

PMID- 11213134
TI  - Declaration of Helsinki.

PMID- 11213135
TI  - Tip-of-the-tongue experiences.

PMID- 11213136
TI  - A clinical trial.

PMID- 11213137
TI  - Sourdough, homoeopathy, and evidence-based medicine.

PMID- 11213138
TI  - A relative risk-based, disease-specific definition of sexual abstinence failure
      rates.
AB  - Sexual abstinence programs have the potential to reduce the incidence of
      unplanned pregnancies and sexually transmitted diseases (STDs) among adolescents.
      Effectiveness measures are needed to help researchers assess the impact of sexual
      abstinence promotion programs on STD and pregnancy rates and to enable
      comparisons of abstinence effectiveness with other contraception and STD
      prevention methods. Abstinence "failure rates" have been proposed as one measure
      of program effectiveness. However, the concept of abstinence failure rates has
      not been adequately operationalized. The present study examines a novel
      mathematical framework for estimating abstinence failure rates, both
      theoretically and empirically. Examples are provided, and the advantages and
      disadvantages associated with the mathematical model-based approach are
      discussed.

PMID- 11213139
TI  - Disease-specific sexual abstinence user rates: the role of science in policy
      making.

PMID- 11213140
TI  - Factors associated with Army obstetricians-gynecologists' practice of HIV
      prevention education during routine gynecologic care.
AB  - The authors evaluate obstetricians-gynecologists' (OB-GYNs') anxiety about
      clinical uncertainty and patient, physician, and organizational factors
      associated with their selection of HIV-related educational activities for high
      risk and low-risk written case simulations. A total of 117 U.S. Army OB-GYNs
      completed a mailed, anonymous questionnaire. Overall, informants were much less
      likely to educate in response to the low-risk simulation; however, more
      informants who were anxious about uncertainty were more likely to do so in a
      model that included supportive institutional policies, willingness to educate
      despite patient barriers, and comfort with the topic. OB-GYNs were more likely to
      educate in response to the high-risk simulation given greater willingness to
      discuss HIV despite organizational barriers, supportive policies, and comfort.
      Findings suggest a need to better understand the role that anxiety about
      uncertainty plays in HIV prevention and the need to promote organizational
      policies that support and remove barriers to clinically based education.

PMID- 11213141
TI  - Sources influencing patients in their HIV medication decisions.
AB  - The authors surveyed 202 patients (54.5% male; 62.4% African American) enrolled
      at St. Louis HIV clinics to identify the importance of various sources of
      influence in their HIV medication decisions. Physicians were the most important
      source for 122 (60.4%) respondents, whereas prayer was most important for 24
      respondents (11.9%). In multivariate tests controlling for CD4 counts, Caucasian
      men were more likely than Caucasian women and African Americans of both genders
      to select a physician as the most important source. African Americans were more
      likely than Caucasians to mention prayer as the most important source. Caucasians
      and those rating physicians as the most important source were more likely to be
      using antiretroviral medications. Respondents identified multiple important
      influences-hence the potential for conflicting messages about HIV medications.
      These findings have implications for health education practices and behavioral
      research in the medical setting.

PMID- 11213143
TI  - Hispanic cultural norms for health-seeking behaviors in the face of symptoms.
AB  - This study examines factors that contribute to the delayed use of medical care
      among Hispanics when chronic disease-related symptoms (warning signs) occur. As
      an adjunct to a larger project funded by the National Cancer Institute, this
      study accessed a population of primarily Hispanic, mostly male employees at
      public work sites in two Arizona counties. Through focus groups and a survey of
      employees, a model describing the factors underlying health care use was tested.
      Seriousness of symptoms has the most effect on visits to doctor, with more
      serious symptoms leading to prompter visits. Faith in God and seriousness of
      symptoms both are related to the search for a doctor one can trust. Also, a
      cluster of variables describing past bad experiences, practical barriers, and
      emotional avoidance are related to the desire to get advice or medical help from
      someone who is close; these influence the search for a trusted doctor, which in
      turn leads to prompter visits to doctor.

PMID- 11213142
TI  - Selected ethical issues in research and publication: perceptions of health
      education faculty.
AB  - A national random sample of 195 university health education faculty at graduate
      degree-granting programs completed a 31-item survey with regard to their
      perceptions of ethical issues in research and publishing. Most respondents were
      male (57%), tenured (75%), had graduate faculty status (92%), had presented
      original research at conferences (85%), and had published articles in health
      education journals (89%). Faculty members were requested to assess whether 21
      scenarios dealing with ethical issues in research and publishing were ethical,
      unethical, questionable, or not an ethical issue. Of the scenarios, 3 were
      considered ethical and 7 unethical by the majority of respondents. The
      perceptions of how ethical the remaining 11 scenarios were varied considerably.
      Perceptions of the ethical scenarios did not differ among respondents by sex,
      academic rank, years taught as a faculty member, whether the department taught
      units/classes on research ethics, or whether the respondents were from doctoral
      level versus master's-level programs.

PMID- 11213144
TI  - When the perpetrator gets killed: effects of observing the death of a handgun
      user in a televised public service announcement.
AB  - This study evaluates the cognitive effects of an anti-handgun violence public
      service announcement (PSA) on sixth-, seventh-, and eighth-grade students (N =
      294). Participants were randomly assigned to a treatment group, which viewed a
      PSA depicting the death of an aggressive handgun user, or a comparison group,
      which viewed identical content except that the PSA showed no negative consequence
      for the handgun user. Logistic regression analysis, adjusting for race and
      gender, revealed that the treatment group was more likely to report negative
      expected outcomes for aggressively using a handgun and lower behavioral
      intentions to aggressively use a handgun compared with the comparison group.
      These findings suggest that observing handgun violence on television that depicts
      death as a negative physical consequence for the perpetrator may produce lower
      handgun-encouraging beliefs compared with observing no consequence for the
      perpetrator--the norm for most televised violence today.

PMID- 11213145
TI  - Peer and parent influences on smoking and drinking among early adolescents.
AB  - Social influences can promote or discourage adolescent substance use. The authors
      surveyed 4,263 sixth- to eighth-grade students to assess the effect of peer and
      parent influences on adolescent substance use. The authors conducted separate
      multiple logistic regression analyses for smoking and drinking, controlling for
      grade, sex, and race. Positive independent associations with smoking and drinking
      were found for direct peer pressure and associating with problem-behaving
      friends. Independent negative associations with smoking and drinking were also
      found for parent involvement, parent expectations, and parent regard. In an
      analysis of interactions, peer pressure was positively associated with drinking
      for girls but not for boys and problem-behaving friends was positively associated
      with drinking for both boys and girls. The findings are consistent with the
      hypothesis that associating with deviant peers promotes and that authoritative
      parenting protects against smoking and drinking.

PMID- 11213146
TI  - Hydatid disease--continuing serious public health problem: introduction.

PMID- 11213147
TI  - Laboratory diagnosis of cystic hydatic disease.
AB  - The main purpose of this article is to answer the questions about which test to
      perform for hydatic diagnosis and when. Several techniques for biologic diagnosis
      and follow-up of human cystic hydatidosis are reviewed. The specificity and
      sensitivity of immunologic reactions are reported. The differential diagnosis
      between Echinococcus granulosus and E. multilocularis is examined. The
      characteristics of the immunologic diagnosis according to the stage and the
      treatment of hydatidosis disease is discussed. Laboratory diagnosis of cystic
      hydatic disease is complementary to the clinical data. A judicious association of
      the usual techniques (indirect immunofluorescence assay, indirect
      hemagglutination assay, immunoelectrophoresis, co-electrophoresis with antigen 5
      identification) confirms the diagnosis in 80% to 94% of hepatic hydatidosis cases
      and in 65% of pulmonary hydatidosis cases. Special techniques (enzyme-linked
      immunosorbent assay, Western blot, polymerase chain reaction) must be used for
      other localizations or when cysts are calcified. A serologic survey is necessary
      for the follow-up of operated medically treated patients. Despite poor
      standardization, purified antigens can distinguish between E. granulosus and E.
      multilocularis infections, although false-positive results are observed during
      other helminthiases, such as cysticerocosis.

PMID- 11213148
TI  - Fiberoptic bronchoscopy of intubated patients with life-threatening hemoptysis.
AB  - Bleeding in the tracheobronchial tree in intubated patients on an intensive care
      unit is a potentially life-threatening incident. The antecedent state of disease
      and frequent respiratory failure require immediate and effective therapeutic
      measures to avoid further respiratory and cardiocirculatory depression. We
      present our bronchoscopic management of endobronchial bleeding. Cardiorespiratory
      function must be maintained by modification of the mechanical ventilation and
      drug therapy owing to the patient's condition. Seven consecutive patients with
      acute endobronchial bleeding were treated with fiberoptic bronchoscopy and
      instillation of cold epinephrine-saline solution (1:10,000-100,000) during the
      period of July 1997 to December 1997. Control of bleeding was achieved after 1 to
      20 (mean +/- SEM: 5.86 +/- 0.93) bronchoscopic interventions during a period of
      0.5 hours to 10 days. One control bronchoscopy was performed additionally in
      every patient. Cardiocirculatory instability was observed in five patients. Six
      patients survived; one patient died of uncontrolled bleeding caused by severe
      pulmonary aspergillosis. Fiberoptic endobronchial epinephrine instillation is an
      effective therapy for life-threatening hemoptysis in critically ill patients.
      Widespread use of flexible bronchoscopy makes this procedure immediately
      applicable in critical situations. Intubated and mechanically ventilated patients
      with life-threatening hemoptysis especially benefit from this rapidly feasible
      procedure.

PMID- 11213149
TI  - Determining which patients require evaluation for blunt cardiac injury following
      blunt chest trauma.
AB  - The objective of this study was to determine prospectively which risk factors
      require cardiac monitoring for blunt cardiac injury (BCI) following blunt chest
      trauma. All patients who sustained blunt chest trauma had an electrocardiogram
      (ECG) on admission to our urban level I trauma center. Those with ST segment
      changes, dysrhythmias, hemodynamic instability, history of cardiac disease, age >
      55 years, or a need for general anesthesia within 24 hours (group 1) were
      admitted to the intensive care unit (ICU) for 24 hours where they were subjected
      to serial ECGs, creatinine phosphokinase (CPK) assays, and echocardiography
      (ECHO). Those with only mechanism for BCI, i.e., none of the above risk factors
      (group 2), were admitted to a nonmonitored bed and had a follow-up ECG 24 hours
      later. A series of 315 patients were admitted with blunt chest trauma during a 17
      month period; 144 patients were in group 1 and 171 in group 2. Overall, 22
      patients were diagnosed as BCI (+BCI), defined as evolving ST segment changes,
      dysrhythmias, a CPK-MB index of > 2.5, or hemodynamic instability. Of the 18 +BCI
      patients in group 1, all were symptomatic (i.e., none was included solely for a
      cardiac history, age, or need for general anesthesia). Six of these patients
      required treatment for dysrhythmias, hypotension, or pulmonary edema; one of whom
      died. Four patients with +BCI were in group 2 and had ECG changes at 24 hours;
      none of these four had any sequelae from their +BCI. None of the ECHOs
      demonstrated abnormal wall motion. Patients who sustain blunt chest trauma with a
      normal ECG, normal blood pressure, and no dysrhythmias on admission require no
      further intervention for BCI. Patients with ST segment changes, dysrhythmias, or
      hypotension following blunt chest trauma should be monitored for 24 hours, as
      this subgroup occasionally requires further treatment for complications of BCI.
      ECHO adds nothing as a screening test.

PMID- 11213150
TI  - Teaching hospital perspective of the quality of trauma care in Lagos, Nigeria.
AB  - Information including respiratory rate, blood pressure, Glasgow Coma Scale, and
      anatomic injuries were obtained for all injured patients consecutively admitted
      to the Lagos University Teaching Hospital (LUTH) during the 9-month period from
      September 1995 to May 1996. The data were analyzed using the UK Major Trauma
      Outcome Study (MTOS) methodology. The Revised Trauma Score (RTS), the Injury
      Severity Score (ISS), and the Probability of Survival (Ps) were calculated for
      each patient. In addition, the "M," "z," and "w" scores were calculated for blunt
      injuries. Of the 253 patients (median age 28 years; male/female ratio 4:1)
      studied, 85% suffered blunt trauma, 75% of which were due to RTA. About 60% of
      RTA victims were pedestrians. Only 8% of nonpedestrian victims wore protective
      devices. The mean ISS was 10, the mean RTS 6.98, and the mean Ps 0.96. The "m"
      statistic for blunt trauma was 0.91, and there were 122 survivors compared to the
      163 predicted. The "z" and "w" scores were -18.49 and -24.55, respectively.
      Altogether, 42.7% of patients with ISS > 15 and 40.7% with RTS < 7.5 died.
      According to these results, the severity of injuries encountered in Lagos is
      comparable to those reported from the United Kingdom and the United States, but
      the death rate is higher.

PMID- 11213151
TI  - Medical treatment of liver hydatidosis.
AB  - There are currently three treatment options for liver hydatidosis: urgery, which
      remains the mainstay of radical treatment; ultrasound-guided aspiration
      (puncture/aspiration/injection/reaspiration--PAIR); and chemotherapy with
      benzimidazole compounds (albendazole and mebendazole). Chemotherapy is a
      noninvasive treatment and is less limited by the patient's status than surgery or
      PAIR but is not ideal when used alone. Albendazole, the drug most often used,
      appears to have the greatest efficacy of any agent used so far; nevertheless,
      apparent cure (shrinkage or disappearance of cysts) ranges only between 20% and
      30% of cases. The possible contribution of perioperative chemotherapy offers the
      prospect of preventing recurrent disease, but it requires more clinical trials to
      establish that pre- or postoperative chemotherapy does prevent recurrence. The
      main adverse events are related to changes in liver enzyme levels and bone marrow
      suppression. About 10% to 20% of patients develop self-limited, reversible rises
      in transaminase levels; clinically severe pancytopenia or agranulocytosis is
      exceptional. Alopecia is observed during long-term treatment with albendazole. In
      all cases these events disappear once treatment is interrupted. According to the
      World Health Organization guidelines, chemotherapy is the preferred treatment
      when the disease is inoperable, when surgery or PAIR is not available, or when
      the cysts are too numerous. Another important indication for chemotherapy is the
      prevention of secondary echinococcosis. There is not yet formal consensus, as the
      efficacy and safety of some of the methods require further evaluation before we
      can establish comprehensive guidelines for the medical treatment of hydatidosis.

PMID- 11213152
TI  - Diagnosis and treatment of uncomplicated hydatid cyst of the liver.
AB  - Hydatid disease of the liver is still endemic in certain parts of the world. The
      diagnosis of noncomplicated hydatid cyst of the liver depends on clinical
      suspicion. Ultrasonography and computed tomography, the most important diagnostic
      tools, are helpful for determining the complications and planning treatment. The
      modern treatment of hydatid cyst of the liver varies from surgical intervention
      to percutaneous drainage or medical therapy. Surgery is still the treatment of
      choice and can be performed by the conventional or laparoscopic approach.
      Percutaneous drainage and treatment of the cyst with hypertonic saline or alcohol
      seems to be a good alternative to surgery in selected cases. Currently, we treat
      types I and II by ultrasound-guided percutaneous drainage and types IV and V
      (excluding totally calcified cysts) surgically. Type III cysts can be managed
      either way depending on the presence of drainable content. We believe that the
      laparoscopic approach should be limited to noncomplicated cysts.

PMID- 11213153
TI  - Management of liver hydatid cysts with a large biliocystic fistula: multicenter
      retrospective study. Tunisian Surgical Association.
AB  - The large biliocystic fistula (> 5 mm) encountered with hydatic cyst of the liver
      produces clinical manifestations only when it allows the hydatic cyst content to
      pass into the common bile duct. Various therapeutic problems occur. The aim of
      this study was to evaluate the results of the therapeutic methods used by 14
      Tunisian centers to treat this specific aspect of the hydatic cyst of the liver
      associated with a large biliocystic fistula. This study concerned a period of 5
      years between January 1988 and December 1992, and it included 244 cases
      associated with hydatic content in the common bile duct (158 cases) and with
      cholelithiasis and choledocholithiasis (2 cases); 127 patients underwent an
      emergency operation (52%). The surgical procedures performed consisted in radical
      procedures (24 cases, 9.8%) and conservative procedures (220 cases, 90.2%). The
      latter included 52 cases of internal transfistulary drainage, 140 unroofing
      procedures associated in 20 cases with the fistula, in 93 cases with suture of
      the fistula, and in 27 cases with direct fistulization. In the 28 remaining
      cases, through the choledoctomy evacuation of the parasite was performed. The
      common bile duct was approached in 180 cases (73.7%). The postoperative course
      was uneventful in 57% of the cases and complicated in 38.5% others. The mortality
      rate was 4.5%. In conclusion, the presence (or not) of hydatic material in the
      common bile duct did not seem to be a determinant of the surgical procedure
      choice and did not influence the results. The only difficulty with treatment was
      the large biliocystic fistula itself. The internal transfistulary drainage on one
      part, and the unroofing procedure associated with suturing healthy fistula tissue
      and to omentoplasty or capitonnage of the remaining cavity on the other part,
      were easily performed and constituted efficient methods. Radical methods
      constituted operations that had excellent results, but they were feasible in only
      10% of the cases.

PMID- 11213154
TI  - Hydatidosis: dynamics of transmission.
AB  - Hydatidosis is a widespread zoonosis infecting a large number of animals and
      humans. Echinococcus granulosus has the smallest taenia adult of the cestodes but
      with the largest larva. Its morphologic and biologic features were identified
      with DNA analysis. Different strains were separated according to the intermediate
      hosts: sheep, cattle, pigs, horses, camels. Definitive host are canids, mostly
      dogs, where the worm grows to adulthood in several months. The eggs are scattered
      in the pasture by wind and water and are ingested by various hosts. The larvae
      migrate through the intestinal wall and penetrate the organs, mostly liver and
      lungs. The eggs survive several days outside, depending on the temperature, but
      numerous eggs die in nature because they cannot resist desiccation and extreme
      temperatures. Dissemination is accomplished by dogs. In Turkana (Kenya) the
      incidence of hydatidosis is high because of the close relationship between the
      population and dogs and the habit of leaving their dead bodies in the grasslands.
      In rural areas, the custom of slaughtering sheep at home, among the dogs, is an
      important dissemination factor. The circumstances of transmission vary according
      to the country. In Europe the natural life cycle of E. granulosus granulosus
      involves dogs as the definitive host and sheep as the intermediate host. In
      northern Europe E. granulosus borealis infects the canids and deer. E. granulosus
      canadensis infects wolves and reindeer, but there are no human cases. In the
      endemic Mediterranean area, sheep and dromedaries are the intermediate hosts. In
      South America, the life cycle of E. granulosus develops among several definitive
      and intermediate hosts. Hence the dynamics of transmission vary according to the
      countries with different hosts.

PMID- 11213155
TI  - Hydatid disease of the liver with thoracic involvement.
AB  - Hydatidosis, caused by Echinococcus granulosus, is an endemic parasitic disease
      in Mediterranean countries. The most frequent anatomic locations are liver and
      lung. Intrathoracic rupture of hydatid cysts situated in the hepatic dome is a
      serious complication resulting in damage to the pleura, pulmonary parenchyma, and
      bronchi. From January 1984 to December 1997 we operated on 40 patients with
      intrathoracic rupture of a hepatic hydatid cyst. Chest roentgenograms showed a
      shadow of varying size at the base of the hemithorax. Hepatic and thoracic
      ultrasonography was performed in all cases. The diagnosis of intrathoracic
      rupture of a liver cyst was confirmed preoperatively in 30 of the 40 cases.
      Posterolateral thoracotomy was performed in all patients. This transthoracic
      approach allowed adhesiolysis and treatment of the pleural lesions, pulmonary
      lesions, and hepatic cyst. Treatment of the diaphragmatic gap is easily done. We
      performed 15 lobectomies, 10 wedge resections, 16 decortications, and in one
      patient simple drainage of a voluminous pleuropulmonary and hepatic purulent
      hydatic collection. The postoperative course was uneventful in 26 cases, but 14
      patients had complications, from which 3 patients died. The therapeutic approach
      depends on ultrasonographic findings. We believe ultrasonography to be the best
      examination for assessing biliary, hepatic, diaphragmatic, and pleuropulmonary
      lesions. When an intrathoracic collection is present, thoracotomy must be
      performed and is sufficient if the biliary tract is safe. An abdominal approach
      is necessary when biliary duct drainage is required, and it may be sufficient in
      cases of direct rupture into the bronchi.

PMID- 11213156
TI  - Hydatid cyst of the lung: diagnosis and treatment.
AB  - Hydatid infestation of the lung can be primary or secondary. In three of four
      cases the cyst is a single one. Hydatidosis of a different location, particularly
      the liver, may be associated. The period of initial growth of primary hydatidosis
      is frequently asymptomatic. Bronchial fistulization is an important event in the
      evolution of the cyst. Intrapleural rupture constitutes a rare eventuality, but
      it is often as characteristic as it is severe. Secondary, metastatic hydatidosis,
      due to breaking of a primary visceral cyst in a vein or heart, is rare. A special
      form is so-called multiple malignant pulmonary hydatidosis, which causes
      progressive respiratory deficiency and right ventricular failure. There are a
      variety of radiographic images. Ultrasonography, computed tomography, and
      magnetic resonance imaging can recognize certain details of the lesions and
      discover others that are not visible by conventional radiography. For a specific
      serologic diagnosis, our experience favors the immunoglobulin G enzyme-linked
      immunosorbent assay and immunoelectrophoresis. Treatment is essentially surgical.
      In general, chemotherapy is used as a complement to operative treatment to avoid
      recurrence. Surgery has two objectives: to remove the parasite and to treat the
      bronchipericyst pathology and other associated lesions. The prognosis has changed
      during the last few years, and results are now commonly satisfactory. The most
      frequent complications are pleural infection and prolonged air leakage. Operative
      mortality does not exceed 1% to 2%. Despite the low mortality and the limited
      recurrence rate, it is necessary to remember the invading character of pulmonary
      hydatid disease, which sometimes makes therapy difficult and questionable.
      Prophylaxis is essential to eradicate the disease completely.

PMID- 11213157
TI  - Cardiopericardial hydatid cysts.
AB  - Cardiac hydatic cyst is a rare parasitic disease. We reported 45 patients with
      cardiac hydatid cysts; 33 of the 45 had a primitive, unique cardiac cyst.
      Altogether, 18 patients of our series were asymptomatic, and 27 patients
      complained of symptoms (dyspnea, chest pain, palpitations). In 11 cases the cyst
      was revealed by an acute complication; 3 of the 11 had pulmonary metastatic
      hydatidosis. The diagnosis was based on a series of test results in which hydatid
      serology and imaging (echocardiography, computed tomography, magnetic resonance
      imaging) played a predominant role. Cystopericystectomy is the gold standard
      procedure but is sometimes unsuitable for particular sites. In that case, a
      conservative approach (partial pericystectomy) is mandatory to preserve organ
      function. The operative mortality rate is 5.5%. Two pericardial recurrences were
      reported during follow-up.

PMID- 11213158
TI  - Hydatid cyst of the kidney: diagnosis and treatment.
AB  - Renal echinococcosis is relatively uncommon compared to liver and lung
      localizations. Kidney involvement represents 4% of confirmed cases of hydatid
      disease. We reviewed the clinical findings of a personal series of renal
      hydatidosis with emphasis on diagnostic and therapeutic issues. A total of 178
      renal cysts were collected over a period of 33 years from 1963 to 1996. Clinical,
      radiologic and laboratory data are analyzed. Radiologic exploration has had an
      interesting evolution, with the appearance of ultrasonography and computed
      tomography. Diagnostic accuracy has been greater since the availability of
      ultrasonography and immunologic studies. Their contribution to the diagnosis of
      renal hydatid disease is important. We try, with our experience of
      ultrasonography in the matter of renal hydatid cysts, to underline the role of
      this exploration. The treatment of hydatid cyst of the kidney is surgical. Renal
      sparing surgery, cystectomy plus pericystectomy, is possible in most cases (75%).
      Nephrectomy (25% of cases) must be reserved for destroyed kidneys resulting from
      aged cysts opening into the excretory cavities and complicated by renal
      infection. Whether conservative or radical, the first surgery performed is
      cystectomy, with germinate membrane removal after controlled evacuation and
      opening of the cyst, making the subsequent steps of surgery easier.

PMID- 11213159
TI  - Hydatid cyst of bone: diagnosis and treatment.
AB  - Osseous hydatidosis is a rare occurrence of hydatid disease. Anatomoclinical
      changes are, however, peculiar to this localization. From the anatomopathologic
      standpoint, this localization marks the torpid, insidious progression of the
      parasite into bone tissue, leading to an immediate diffuse, extensive, invasion
      process, so complete surgical eradication is rarely possible. From the clinical
      standpoint, whatever the localization may be, we are surprised by the latency of
      this affection, the patient being treated at an advanced stage, when radiologic
      lesions are already extensive, and the complications, especially in the spinal
      area, are severe. Owing to the poor biologic findings, the diagnosis of osseous
      hydatidosis is still primarily based on roentgenographic findings. Sometimes,
      however, the diagnosis is established only after surgery. Treatment of osseous
      hydatidosis is closer to oncologic therapy than to the usual surgical treatment
      of visceral hydatid cysts. Because of the poor results with medical treatment,
      osseous hydatidosis must be treated by a radical operation with wide excision,
      adapted to each localization. In the main, the prognosis of osseous hydatidosis
      remains poor, especially with spinal and pelvic localizations, which are the most
      frequent ones. The prognosis and treatment of osseous hydatidosis belong in the
      same category as a locally malignant lesion.

PMID- 11213160
TI  - Recurrence of hydatid disease.
AB  - Surgical management of hepatic hydatid disease has been associated with an
      overall local recurrence rate of approximately 10%. Local recurrence is rarely
      seen following complete resection of an intact cyst and is usually the result of
      spillage of live parasites or leaving a residual cyst wall containing germinal
      epithelium, daughter cysts, or protoscolices during surgery. Recurrence is
      frequently asymptomatic, so the diagnosis depends on dedicated follow-up of
      treated patients with serology and either ultrasonography or computed tomography.
      The management of locally recurrent disease should include administration of
      albendazole followed by the appropriate application of interventional
      radiotherapy or operation. As with the treatment of primary disease, the
      preservation of liver function and minimizing the risk to the patient remain the
      guiding principles of therapy of local recurrence.

PMID- 11213161
TI  - Evolution of surgery for liver hydatidosis from 1950 to today: analysis of a
      personal experience.
AB  - Hydatid disease (echinococcosis) remains a complex worldwide problem in rural
      areas. Medical treatment does not definitively cure hydatid cysts, and surgical
      management aims to eliminate the parasite, favoring rapid disappearance of the
      residual cavity, preventing complications and recurrence, and shortening the
      hospital stay. In this consecutive series, 298 patients with liver hydatidosis
      were treated surgically by the authors from 1950 to 1987 in various hospitals in
      Rome, Italy. Surgery comprised conservative methods (marsupialization and partial
      cystopericystectomy) and radical methods (total pericystectomy and liver
      resection). Liver resection was used only if unavoidable. Complications were
      exudate from the residual cystic cavity, cholerrhagia, and nonspecific incisional
      fistula. In the entire series, morbidity was 8.7% of which 12.6% was seen with
      conservative methods and 5.5% with radical methods (p < 0.05); mortality was
      3.6%, of which 5.9% was seen with conservative methods and 1.8% with radical
      methods (p = NS). Over the 37 years, as medical science and complementary
      therapies progressed, the use of conservative operations diminished and radical
      treatments increased. Long-term follow-up showed that hydatid disease relapsed
      more frequently in patients who underwent conservative or subtotally radical
      treatment than in those who underwent radical surgery: eight patients (11.2%)
      versus one (0.9%) (p < 0.01). Hence surgical treatment that removes all of the
      pericyst and preservation of the nonpathologic liver are important.

PMID- 11213162
TI  - Evaluation of S-100b as a specific marker for neuronal damage due to minor head
      trauma.
AB  - Management of patients with minor head trauma (MHT) continues to be debated in
      the literature. Measurement of S-100b in serum has been introduced into the
      discussion as an additional screening tool for intracerebral injuries because
      routine cranial computed tomography (CCT) of a large number of patients causes
      logistic difficulties, and the neurologic examination is often impaired by a high
      frequency of coincidental intoxication. The aim of our study was to determine the
      diagnostic value of measuring S-100b in the serum of MHT patients to identify
      risk groups. Additional validity should be aquired by a comparison with plasma
      levels of polymorphonuclear neutrophil (PMN) elastase an established general
      trauma marker. A series of 52 patients with MHT were included in the prospective
      study. At admission the patients underwent a routine CCT scan to detect
      intracerebral lesions, and blood samples were drawn to investigate circulating
      levels of S-100b and PMN elastase. For comparison, data for a positive control
      group of 10 severe head trauma patients (initial Glasgow Coma Scale score < 8)
      and for a negative control group with 20 healthy volunteers were obtained. The
      interval between MHT and admission to our hospital was 73.4 +/- 47.0 minutes. The
      initial S-100b serum levels of MHT patients were 0.470 +/- 0.099 ng/ml, those of
      the positive control group were 7.16 +/- 3.77 ng/ml, and those of the negative
      control group were 0.05 +/- 0.01 ng/ml. Relevant pathologic CCT scans were
      detected in 28.8% of MHT patients; one patient of that group was subjected to
      immediate surgical intervention (1.9%). At a cut-off point of 0.1 ng/ml, the
      sensitivity of positive S-100b levels reached 100% and the specificity 40.5%.
      Plasma levels of PMN elastase reached 60.52 +/- 10.75 ng/ml in the MHT group,
      66.4 +/- 14.92 ng/ml in the severely head-injured group, and 23.26 +/- 1.53 ng/ml
      in the negative control group. Serum levels of S-100b seem to be a highly
      sensitive but not very specific marker for isolated neurotrauma. Measurement of
      this parameter may be helpful as an additional screening tool to identify high
      risk groups in the cohort of MHT patients.

PMID- 11213163
TI  - Indicators of fatigue and of prolonged weaning from mechanical ventilation in
      surgical patients.
AB  - Indicators of weaning success have been tested primarily in patients who have
      been ventilated for short periods of time, and they may not be as accurate in
      cases where support has been required for longer than a few days. In patients
      requiring longer periods of support it is difficult to estimate the likelihood of
      successful liberation. Therefore we evaluated established weaning indices for
      their accuracy in surgical patients who required > or = 72 hours of mechanical
      ventilation. Surgical patients who required mechanical ventilation for > or = 72
      hours were prospectively followed (over 6 months). We obtained standard indices
      of ventilatory function daily once patients were ready to wean. These indices
      included the respiratory rate/tidal volume ratio (RSBI), the maximal inspiratory
      pressure, and the minute ventilation. The duration of weaning and explicitly
      defined episodes of fatigue were the outcomes of interest. Statistical analyses
      evaluated the multiple factors that might influence the duration of weaning.
      Ninety-five patients (66% trauma; 34% surgery) survived to begin weaning, and 93%
      were liberated. The median duration of mechanical ventilation prior to weaning
      was 4 days (range 3-16 days), and the median duration of weaning was 3 days
      (range 0-56 days). Fatigue occurred in 36 patients and was not reliably predicted
      by any of the weaning measurements. However, a RSBI of > 105 on the first day of
      weaning was associated with prolonged weaning. By multivariate analysis, an RSBI
      of > 105 on the first day of weaning predicted prolonged weaning (hazard ratio
      1.9; p = 0.03). After 72 hours of mechanical ventilation, clinical fatigue and
      successful liberation are not reliably predicted by standard indices of
      respiratory muscle strength and reserve. However, an RSBI of >105 observed once
      the patient is ready to wean is associated with prolonged weaning.

PMID- 11213164
TI  - Contents of minerals in green leafy vegetables cultivated in soil fortified with
      different chemical fertilizers.
AB  - Content of selected minerals in spinach (Spinacea oleracea) and ambat chuka
      (Rumex vesicarius) cultivated in soil fortified with different chemical
      fertilizers was determined in a pot experiment. Addition of NPK (Nitrogen,
      Phosphorus and Potassium) fertilizer along with micronutrients, iron and zinc,
      enhanced the concentration of zinc, iron and magnesium in selected green leafy
      vegetables markedly (p < 0.05), while the concentration of copper was not altered
      significantly (p > 0.05). Potassium content in the green leafy vegetables was not
      affected (p > 0.05) by the addition of chemical fertilizers to soil. Spinach and
      ambat chuka differed remarkably in their mineral contents. Contents of potassium,
      zinc and copper were significantly high in spinach, while the contents of
      magnesium and iron were markedly high in ambat chuka (p < 0.05).

PMID- 11213166
TI  - Survey of fura production in some northern states of Nigeria.
AB  - The objective of this research was to conduct a survey related to the production
      process for fura. Fura is a staple food for the Fulanis and Hausas. The single
      most important cereal grain for fura production is millet. A significant
      difference exists among respondents on the variety of millet chosen for fura
      production. A significantly (p = 0.05) greater proportion indicated that 'gero'
      is the variety in common use. Spices are indispensable as an ingredient in fura
      production with ginger being the single most important spice (p = 0.01). The
      traditional pounding method for processing millet into flour is still very much
      used. The implication of this is highlighted and a possible solution of
      optimizing the fura production process is recommended. Strictly speaking, fura is
      distributed with a minimum of packaging. The choice of suitable packaging
      provided protection during a generally short shelf-life and for local
      distribution. With increasing influence of advertising upon customers, small food
      processing enterprises making fura will have to improve the packaging and
      preservation of their products if they are to survive the competition.

PMID- 11213165
TI  - Effect of dietary fiber on the activity of intestinal and fecal beta
      glucuronidase activity during 1,2-dimethylhydrazine induced colon carcinogenesis.
AB  - The effects of fiber isolated from black gram (Phaseolus mungo) and coconut
      (Cocos nucifera) kernel on the metabolic activity of intestinal and fecal beta
      glucuronidase activity during 1,2-dimethylhydrazine induced colon carcinogenesis
      were studied. The results indicated that the inclusion of fiber from black gram
      and coconut kernel generally supported lower specific activities and less fecal
      output of beta-glucuronidase than did the fiber free diet. This study suggests
      that the fibers isolated from coconut or black gram may potentially play a role
      in preventing the formation of colon tumors induced by the carcinogen 1,2
      dimethylhydrazine by reducing the activity of the intestinal as well as fecal
      beta-glucuronidase.

PMID- 11213167
TI  - Biological evaluation for protein quality of supplementary foods based on popped
      cereals and legumes suitable for feeding rural mothers and children in India.
AB  - Eight different formulations of supplementary foods (FS) based on popped cereals
      (wheat, ragi, bajra and sorghum) and legumes (soy and bengalgram) were prepared.
      Four of the FS were produced with cereals, soy flour (SF) and bengalgram (BG)
      dhal and the other four were prepared with combinations of cereals and SF. These
      blends were evaluated for food efficiency ratio (FER), protein efficiency ratio
      (PER) and net protein utilization (NPU) using growing albino rats. Skim milk
      powder (SMP, standard reference protein) was used in the control diet. In general
      the FER (0.28 to 0.34), PER (2.7 to 2.9) and NPU (62 to 68) results of the FS
      were not significantly (p > 0.05) different among the FS groups or compared with
      FER (0.36), PER (3.0) and NPU (73.5) of the control SMP. It is evident from the
      results that all eight FS were nutritionally and biologically as good as SMP with
      regard to proximate composition, PER and NPU.

PMID- 11213168
TI  - Serum and liver lipids in rats fed diets containing corn oil, cottonseed oil, or
      a mixture of corn and cottonseed oils.
AB  - Previous research has demonstrated that the total replacement of corn oil (CO)
      with cottonseed oil (CSO) in the diets of growing male rats results in a lowering
      of the total cholesterol (TC) concentration in the serum. It is not, however,
      known if a partial replacement of dietary CO with CSO would be sufficient to
      lower TC levels, nor is the effect of replacing dietary CO with CSO on other
      indices of cholesterol status (e.g., the levels of high-density lipoprotein
      cholesterol [HDL-C], non-HDL-C [i.e., very-low and low-density lipoprotein
      cholesterol], or the TC/HDL-C ratio). Growing male rats were fed diets having CO,
      CSO, or a CO/CSO (1:1, w/w) oil mixture (OM) as the source of dietary oil (diet
      groups CO, CSO, and OM, respectively). There were no differences between CO and
      OM groups for TC, HDL-C, non-HDL-C, or the TC/HDL-C ratio. However, TC was
      significantly lower (p < or = 0.05) for the CSO group than the CO group (2.85 vs.
      3.23 mmol/l, or 110 vs. 125 mg/dl, respectively) as was HDL-C (1.83 vs. 2.13
      mmol/l, or 71 vs. 82 mg/dl, respectively), but there were no differences between
      these groups for non-HDL-C or the TC/HDL-C ratio. Diet had no effect on serum
      triglycerides (TGs) or on total liver content of either cholesterol or TGs. Thus,
      partial (50%) replacement of CO with CSO was without effect on any of these serum
      indices of cholesterol status, but total replacement resulted in lower TC and HDL
      C, without affecting non-HDL-C or the TC/HDL-C ratio. Because, relative to CO,
      CSO has higher levels of saturated fatty acids but lower levels of
      monounsaturated and polyunsaturated fatty acids, the cholesterol-lowering effect
      of CSO appears to be unrelated to its fatty acid composition, and may be caused
      by a component of its nonsaponifiable fraction.

PMID- 11213169
TI  - Evaluation of selected food attributes of four advanced lines of ungerminated and
      germinated Nigerian cowpea (Vigna unguiculata (L.) Walp.).
AB  - The chemical composition and functional properties of ungerminated and germinated
      seeds of four advanced lines of cowpeas (IT81D-699, IT82E-18, IT84S-2246-4 and
      TVx 3236) were investigated. Ungerminated seeds contained 20.1 to 25.8% crude
      protein, 2.0 to 2.2% lipid, 115.1 to 210.0 mg phytic acid/100 g and 8.9 to 9.6 mg
      iron/100 g. The polyphenol contents of the brown- and cream-colored beans were
      similar (192.0 to 196.0 mg/100 g) but were significantly (p < 0.05) higher than
      the amount (99.8 mg/100 g) found in the white beans. Germination increased the
      crude protein content, total phosphorus content, nitrogen solubility, fat
      absorption capacity and foam capacity but decreased ether extract, polyphenol and
      phytic acid contents, water absorption capacity, bulk density and foam stability
      of all cowpea lines. Incorporation of up to 0.2 M NaCl improved foam volume.
      Ungerminated seeds had high water (2.3-3.2 g/g) absorption capacities, while
      germinated seeds had high fat (3.1-3.6 g/g) absorption capacities. TVx 3236 and
      IT81D-699 might be selected for combining such characteristics as high crude
      protein, low phytic acid content and good foaming properties into a single cowpea
      line through breeding.

PMID- 11213170
TI  - Diplazium sammatii: Athyraceae ('Nyama idim'): age-related nutritional and
      antinutritional analysis.
AB  - Tender and mature leaflets and leaves of Diplazium sammatii ('Nyama idim'), were
      separately investigated for their nutritional and antinutritional properties.
      Results showed little difference in proximate nutritional contents between tender
      and mature leaves, except for crude fat, which was present in levels 1.5 times
      higher in younger than in older leaves. Crude fiber levels were low. Zinc (Zn)
      and copper (Cu) were higher in younger leaves (6.8 and 3.5 mg/100 g dry matter,
      respectively, compared to 4.5 and 2.5 mg/100 g dry matter, respectively in older
      leaves). Older leaves contained higher levels of iron (Fe): 6.7 mg/100 g dry
      matter, in comparison to 4.3 mg/100 g dry matter, in young leaves. Oxalate levels
      were slightly higher in younger than older leaves. However, the reverse was true
      for tannin content. Both antinutritional compounds were present in levels which
      should be safe.

PMID- 11213171
TI  - Chemical composition of walnuts (Juglans regia L.) grown in New Zealand.
AB  - Walnuts (Juglans regia L.) were collected during the 1997 harvest from 12
      different cultivars of trees grown in a replicated trial in an experimental
      orchard at Lincoln University. Two US commercial cultivars (Tehama and Vina),
      three European commercial cultivars (Esterhazy, G139, G120) and eight New Zealand
      selections (Rex, Dublin's Glory, Meyric, Stanley, 150, 151, 153) were evaluated.
      The total oil content ranged from 62.6 to 70.3% while the crude protein ranged
      from 13.6 to 18.1%. Dietary fiber ranged from 4.2 to 5.2% while the starch
      content made up no more than 2.8% of the remaining portion of the kernel. The
      amino acid content of the walnuts was similar between cultivars and the patterns
      of essential amino acids were characteristic of a high quality protein.

PMID- 11213172
TI  - Bioavailability trials of beta-carotene from fresh and dehydrated drumstick
      leaves (Moringa oleifera) in a rat model.
AB  - Male albino rats (Charles Foster, n = 40) were fed a synthetic diet deficient in
      vitamin A for 4 weeks. Six rats died during the depletion period. Of the 34
      surviving, 5 rats were continued on the vitamin A deficient diet for 4 more weeks
      and 24 were repleted with vitamin A (4000 IU/kg diet) in the form of vitamin A
      acetate (group A, n = 8), fresh drumstick leaves (group B, n = 8) or dehydrated
      drumstick leaves (group C, n = 8) for 4 weeks. The remaining 10 rats were
      continued on the vitamin A adequate diet for 4 (n = 5) and 8 weeks, respectively
      (n = 5). A marked reduction in food intake, body weight, accompanied by clinical
      signs of vitamin A deficiency and a decline in serum vitamin A (29.2 to 19.1
      microg/dL) and liver vitamin A (3.7 to 2.0 microg/dL) were seen at the end of 4
      weeks of feeding a vitamin A deficient diet. On repletion significant
      improvements in clinical signs, food intake and body weights were noted in the
      three groups compared to the baseline (n = 5) and at the end of 4 weeks of
      depletion. The gain in body weight was highest for the group repleted with
      dehydrated drumstick leaves. Among the repleted groups, the serum vitamin A was
      highest for group A (34.7 microg/dL) given synthetic vitamin A, compared to group
      B (25.8 microg/dL) and group C (28.2 microg/dL) given drumstick leaves. All these
      were significantly higher than the serum vitamin A values seen at the end of 4
      weeks of depletion (19.1 microg/dL). A significant improvement was also observed
      in the liver retinol levels on repletion for 4 weeks in the three groups,
      compared to the vitamin A depleted rats. These results imply that beta-carotene
      from drumstick leaves was effective in overcoming vitamin A deficiency although
      serum vitamin A levels remained somewhat lower compared to the group repleted
      with vitamin A acetate. In terms of growth parameters, the fresh and dehydrated
      drumstick leaves were better than the synthetic vitamin A. It is therefore
      concluded that in the developing countries like India, sources of vitamin A such
      as drumstick leaves are valuable in overcoming the problem of vitamin A
      deficiency.

PMID- 11213173
TI  - Harmonisation and quality assurance in pre-analytical steps of soil contamination
      studies--conclusions and recommendations of the CEEM Soil project.
AB  - The paper summarises the project's results and consequences including expert's
      statements. Based on sampling strategies and methodological details which have
      been recognised to be critical for the comparability of the results of soil
      contamination studies, recommendations are given towards harmonisation of soil
      sampling guidelines, improvement of quality assurance of pre-analytical steps and
      inclusion of soil sampling into accreditation systems. Recommended approaches to
      improve QA and QC in soil sampling are: harmonised guidelines; specified SOPs;
      written sampling (strategy) plans; defined qualification and experience of
      sampling personnel; sampling records; regular interlaboratory comparisons
      (proficency tests) for sampling; and inclusion of sampling and sample preparation
      into accreditation procedures. Needs for further research in the field of pre
      analytical phases of soil contamination studies are outlined and further R&D
      projects are encouraged.

PMID- 11213174
TI  - Quantifying uncertainty of the reference sampling procedure used at Dornach under
      different soil conditions.
AB  - The reference sampling procedure, used in the CEEM soil project on a single test
      area at Dornach, had been applied under different soil conditions in a sampling
      proficiency test and in the Swiss national soil-monitoring network related to
      pollution (NABO). Methods of analysis of variance (ANOVA) were used to quantify
      sampling and analytical uncertainty. The soil sampling procedure and the chemical
      analysis were considered as two parts of the same measurement process and the so
      called 'top-down' approach was used to quantify their combined contribution to
      the uncertainty. By this approach a systematic error of one sampler or of one
      laboratory becomes a random error when assessed as part of a multi-sampler or
      multi-laboratory comparison.

PMID- 11213175
TI  - Of the necessity of knowledge of the natural pedo-geochemical background content
      in the evaluation of the contamination of soils by trace elements.
AB  - In order to evaluate the contamination of the Dornach (Switzerland) site within
      the framework of the CEEM-Soil project, each participating team was allowed to
      take a maximum of 15 samples. The French team's sampling was organized in such a
      way as to answer the following questions: (i) what is the natural concentration
      of the soils at this site (local pedo-geochemical background content)?; (ii) what
      are the levels of Cd, Cu, Pb and Zn contamination of the soil?; (iii) what is the
      depth reached by the surface contamination that is derived from atmospheric
      fallout?; (iv) how is the contamination spread along the longest axis of the area
      under study? The relationships between total Fe and the trace metals have allowed
      local variations in the natural pedo-geochemical background content to be
      detected and thus permitted the anthropogenic contamination to be estimated.
      There would appear to be a low level of Pb contamination over all the site
      investigated (an increase of the order of 5-10 mg kg(-1) on the background
      level), limited to the surface humus-bearing layers. There is also a significant
      contamination by Cu over all of the site (an increase of the order of 30-40 mg
      kg(-1)). This contamination has remained in the surface horizons (0-20 cm). Very
      high Zn and Cd concentrations have been found in the four surface (0-4 cm) and
      deep horizons (15-70 cm) taken under the forest and very much lower values in the
      samples taken from cultivated soils. The most likely explanation is an unequal
      inheritance between the upper part of the site (wooded with thinner very clayey
      soils) and the lower cultivated part of the site (with thicker less clayey soils
      developed in a loamy material). For various reasons, it seems unlikely that a
      contamination of the wooded part should be so much higher than the cultivated
      part due to the interception of atmospheric dust by the trees. The local pedo
      geochemical background Cd and Zn content of the upper wooded part proved to be
      clearly higher than that which would be encountered in most soils of Switzerland
      and France. Given this evaluation of the background content, it seems that only
      the surface horizons have been affected by Zn contamination (an addition of
      approx. 60-100 mg kg(-1)). In the case of Cd, the increase in concentrations is
      only 0.5-1 mg kg(-1) for the ploughed horizons, as well as the for the A
      horizons.

PMID- 11213176
TI  - A soil sampling strategy for mapping trace element concentrations in a test area.
AB  - A sampling strategy, based on previous knowledge of a test area, was compared
      with a Reference Sampling in the frame of the EU-funded CEEM project. The aim was
      a comparison of sampling strategies for the drafting of concentration maps for a
      set of trace elements (Cd, Pb, Cu and Zn), with three-dimension information that
      can be used for risk assessment. The main constraint was that only 15 soil
      samples were to be analysed. The test area (in Dornach, Switzerland) included
      different soil types and land uses (forest, arable land and permanent
      grasslands). The sampling strategy proposed defined strata on the basis of land
      use, then applying a systematic regular sampling within each stratum. A composite
      sample was formed from each individual sample. In forests, H and Ah horizons were
      taken separately. In arable lands, a depth within the ploughed layer (0-15 cm)
      was analysed. In grasslands, samples were taken at two depths (0-10 and 10-20 cm)
      to provide information on the vertical variability. The comparison of the results
      obtained with those derived from the Reference Sampling allowed us to estimate if
      the information obtained from the proposed sampling strategy was sufficiently
      representative for an assessment of the level of elements considered. It was
      concluded that recommendations on sampling strategy depend on the interaction
      pattern of the element. In this case, for mobile trace elements, such as Cd, the
      information derived from sampling of two soil layers was not as important as that
      for the rest of metals studied that accumulated in the upper layer. If the H
      horizons in forests was not considered this led to unreliable predictions of the
      concentration levels, since the concentrations in H and Ah horizons differed
      irrespective of whether they were expressed in mg kg(-1) (the H horizon was
      enriched in those trace elements, except for Cd) and in mg m(-2) (the low bulk
      density of the H horizon led to a lower trace element level than in Ah horizon).
      Finally, in undisturbed systems such as grasslands, sampling 0-10 cm instead of 0
      20 cm is recommended to prevent dilution of the concentration of trace elements.

PMID- 11213178
TI  - Sampling and pre-treatment--some observations from the United Kingdom.
AB  - This paper arises from the current discussion in the United Kingdom to develop,
      under the auspices of the British Standards Institution a 'code of practice for
      investigation of potentially contaminated sites'. Within this code of practice a
      key element in the analysis is the sampling strategy for the collection of
      samples and characterisation of the site. The paper briefly summarises the
      current status of the development of the ideas on the sampling and pre-treatment
      of potentially contaminated sites, and emphasises the importance which must be
      attached to the sampling phase of any investigation if the outcomes are to be
      valid. A brief reference is made to other studies which have addressed the
      problem of sampling contaminated sites. These studies have considered both the
      design of the sampling scheme and the number of samples to be taken in relation
      to the costs of sampling, the nature of the potential hazard, the potential risks
      involved and the statistical requirements if samples are to be used to predict
      within given confidence limits.

PMID- 11213177
TI  - A flexible methodology for the characterisation of soils: a case study of the
      heavy metal status of a site at Dornach.
AB  - The sampling scheme devised to study the site at Dornach was successful in
      identifying most of the features and element distributions in the site using only
      15 composite samples. The scheme was based on dividing the area into six
      individual sampling units each of which represented a different combination of
      land use and soil type. The three-dimensional information was obtained by taking
      samples at different depths, either on a fixed depth basis for cultivated soils
      or according to soil horizons for undisturbed soils. In each sampling unit the
      composite samples were bulked from 12 individual samples. The sampling point for
      each individual sample was chosen according to a stratified random plan. Key
      features of the scheme were the flexibility which required the use of experienced
      personnel and the fact that the sole task of the sampling exercise was to
      characterise the site with no preconceptions of possible outcomes. The results
      showed that the high concentrations of Cd in the soil probably resulted from the
      high concentrations of Cd in the underlying limestone and not primarily from
      atmospheric inputs. Higher levels of copper were found in soils close to fruit
      trees probably as a result of using sprays on the trees. The concentrations of Pb
      and Zn were relatively uniform throughout the site although there was some
      evidence of increased Zn concentrations with depth analogous to the Cd
      distributions. The fact that these findings were in agreement with the known
      characteristics of the site indicates the successful application of the chosen
      methodology in this study.

PMID- 11213179
TI  - An overview of the present state of standardization of soil sampling in Spain.
AB  - There are no national standard soil sampling guidelines at present in Spain,
      although a strong need for standardization of sampling activities is evident.
      Some relevant publications dealing with sampling subjects are cited, and common
      practices in sampling and sample pre-treatment carried out in Spain for basic
      soil maps, soil fertility and soil contamination are briefly described. The need
      to standardize sampling protocols and guidelines in Spain and to harmonize them
      with those of the EU countries is emphasized.

PMID- 11213180
TI  - Description of the test area and reference sampling at Dornach.
AB  - The selected test area for the comparative evaluation of European methods on
      sampling and sample preparation of soils (CEEM Soil) at Dornach near Basel
      (Switzerland) is located at approximately 400 m a.S.l. on the north-west rolling
      footslope of the Jura mountain chain that has a temperate climate. The area is
      known to be airborne polluted by emissions of a non-ferrous metal recycling
      plant. The geology is dominated by Jurassic limestone and (decarbonated) loess
      loam. The land use is deciduous forest (beech, oak) in the upper part and
      traditional cherry orchards with permanent grassland which have mostly been
      converted into arable land. The detailed soil survey distinguishes four different
      soil mapping units in the test area of 0.61 ha. The reference sampling was
      performed in a 190-m-long and 20-40 m large transect area following four devices:
      (1) composite samples (0-10 cm and 0-20 cm), each from 25 stratified single
      samples of 61 squares of 10 x 10 m; (2) hypotheses and soil horizon-based
      composite samples at nine locations; (3) horizon-related samples from the four
      described soil profiles representing the mapping units; and (4) three soil cores
      with 5-cm interval samples taken in the major land use units. Altogether 301
      reference soil samples were taken.

PMID- 11213181
TI  - The Austrian soil sampling procedure tested in a field study (CEEM-project).
AB  - The Austrian soil sampling procedure requires sampling from representative,
      uniform areas. For chemical analyses a composite sampling procedure is proposed
      in which 15-25 single samples should be distributed evenly over the area.
      Sampling depth for top soils varies between 5 and 30 cm depending on land use. In
      a field experiment, the suitability and reliability of this sampling method for
      the determination of trace elements in soil was tested. A high degree of
      accordance with the results of the extensive and systematic CEEM-Reference
      Sampling Method was found; therefore the Austrian sampling procedure is
      recognized as a simple but valid method which can be also proposed as a basis for
      corresponding ISO- or CEN-Standards.

PMID- 11213182
TI  - Comparative evaluation of European methods for sampling and sample preparation of
      soils--the Portuguese contribution.
AB  - The main purpose of this work was to prepare a Portuguese sampling strategy,
      according to the existing Portuguese recommendations, for the soil sampling
      exercise at Dornach in the framework of the CEEM soil project of the SMT
      Programme of the EU. Within this project, the results obtained from the Dornach
      study were compared with the results obtained by other European participants and
      also with the reference sampling. The objective of this comparison was to
      validate the method used and to evaluate possible factors of uncertainty that may
      arise from the application of our national guideline as well as possible
      advantages. Another objective, also important, was to provide information
      regarding the need for a harmonised procedure within the European Union related
      to soil sampling and sample preparation of soils. The results obtained were
      consistent with the results obtained by other participants, however, in the
      Portuguese recommendations there is a general lack of specific information that
      may complicate its application to polluted scenarios. In fact, those guidelines
      are valuable to detect the average contamination of the soil, but they are not
      useful to identify hot spots or the edge influence in a contaminated land. As a
      conclusion, the results obtained by the CEEM soil project helped to evaluate the
      Portuguese sampling plan. This may provide a basis for further standardisation of
      soil sampling for specific purposes, e.g. contaminated land, and to establish a
      technical support for criteria used in the accreditation of laboratories for soil
      sampling.

PMID- 11213183
TI  - Guidelines for sampling in Flanders (Belgium).
AB  - In Flanders, sampling guidelines for investigations on contamination of soils are
      in development. One detailed sampling guideline is currently available with
      respect to the prospective investigation in the frame of the decree related to
      soil sanitation. Four strategies for sampling may be followed as a function of
      available information about pollution sources. Guidelines indicate what has to be
      sampled (top soil, deeper soil, soil water), how sampling points must be
      determined, how the number of samples and analyses is determined and what
      parameters need to be analysed. The example given shows that sampling guidelines
      will strongly depend on the ultimate goal of a particular sampling. A sampling
      procedure should be developed with close consideration of practical aspects and
      limitations, in order to be practical, realistic and cost-effective.

PMID- 11213184
TI  - Requirements for soil sampling in the context of ecosystem research.
AB  - Soils are important compartments of ecosystems which are characterized by self
      regulation within specific limits and different spatial and temporal
      heterogeneities. Soil sampling has to take into account the sampling strategy,
      pre-analytical sample processing, extraction and analysis and the interpretation
      of data as well as quality controls. Some examples from different investigations
      illustrate special sampling problems under different circumstances.

PMID- 11213185
TI  - Accreditation and recognition of soil sampling evidence of competence for testing
      laboratories in Germany.
AB  - Quality assurance is an essential requirement in many areas of soil testing. Soil
      sampling plays an important role in soil investigation. One important quality
      assurance measure is evidence of the competence of institutions offering sampling
      services (testing laboratories) to carry out appropriate sampling. A special
      quality assurance procedure has been developed in the course of the investigation
      and assessment of suspected and contaminated sites on federal property. Testing
      laboratories are granted official recognition by an independent competent
      institution, based on well-defined criteria with regard to testing methodology
      and the qualifications held by the personnel. A prerequisite for such recognition
      is an effective accreditation procedure. Currently only testing laboratories with
      recognised status are commissioned for work on contaminated sites on federal
      property.

PMID- 11213186
TI  - Analytical aspects of the CEEM soil project.
AB  - In the past, exercises aiming at an assessment of data uncertainty in
      environmental analysis were usually restricted to the analysis step, while
      sampling and pre-analytical sample treatment was largely ignored. Collaborative
      studies on the quantification of sampling errors require, besides a suitable and
      well characterized test site, the availability of a reference laboratory for the
      analysis of all of the samples taken in the context of the study by all
      participants and also test methods which do not contribute large and variable
      uncertainties due to long and complex analytical methodologies. Here we summarize
      the major analytical aspects of a European project on the identification and
      quantification of sampling influences on the determination of lead, cadmium,
      copper and zinc in soil. The participant group included the leading soil analysis
      laboratories in Europe; the test site at Dornach (CH) was well suited for the
      purpose and showed high metal gradients and differentiated land use. The
      analytical methods (wavelength-dispersive X-ray fluorescence spectrometry and
      solid-state Zeeman AAS) used in the study showed stable performance
      characteristics within the confidence interval of the certified reference
      materials used for the measurement quality control over the entire project
      period. Additionally, double-blind tests on split samples showed agreement of
      data in very narrow limits thus demonstrating the reliability of the reference
      database.

PMID- 11213187
TI  - Objectives, concept and design of the CEEM soil project.
AB  - Within the member countries of the European Union, different strategies and
      guidelines for the sampling and the preparation of soils are used to investigate
      soil contamination. As a consequence, there is reasonable doubt that the results
      gained by applying these different strategies and methods are comparable. In
      general, the relative contribution of sampling and sample preparation to the
      total uncertainty in soil contamination studies is a subject of speculation than
      of knowledge. For this purpose, the first European soil sampling inter-comparison
      test was organised as a project under the Standards, Measurement and Testing
      Programme of the European Commission. The aim of this project was to analyse and
      to compare the existing guidelines, the degree and the state of standardisation
      in this field in the European countries, and to compare their results when
      applied on the same test area under comparable conditions by representative
      sampling teams. The results of the project in general demonstrate that sampling
      and sample preparation errors reach about the same order of magnitude as errors
      caused in the chemical analysis. However, there are great differences depending
      on the elements investigated and their concentration ranges, as well as on
      pedological and land-use conditions in the test area. Consequently, sampling and
      sample preparation require the same attentiveness and equivalent measures for
      quality assurance (QA) and quality control (QC) as the chemical analysis, which
      has not been the case up to now. Insufficient comparability of the results is
      illustrated by the fact that different participants arrive at different
      conclusions for up to 61% of tested soil quality criteria (e.g. threshold
      levels). The methods and results of the project are presented in detail in the
      six following papers within this volume. The following 13 papers present some key
      studies and specific contributions of the participants, as well as synoptical
      papers of the invited experts in standardisation and accreditation.

PMID- 11213188
TI  - European soil sampling guidelines for soil pollution studies.
AB  - The soil sampling guidelines used in European countries (ESSG), as kindly
      provided by the national institutions which participated in the project, have
      been recorded, studied, evaluated and presented in this paper. The aim has been
      to ascertain what soil sampling guidelines exist in Europe; to detect
      similarities and differences (comparable results), advantages and deficiencies;
      to identify incompatible strategies and evaluate how methodologies might affect
      data quality; to investigate sources of deviations or uncertainties; to improve
      comparability and representativeness of soil sampling; to investigate the need
      for harmonised sampling guidelines; and to develop suggestions for standard
      operating procedures (SOP). Soil sampling guidelines throughout Europe differ as
      to whether they are applied by law, or used throughout the country. In some
      countries these are ISO/DIS related or based (ISO 10381-1, 1995; ISO 10381-2,
      1995), or are produced by a scientific society or a standardisation body. As far
      as sampling strategy is concerned, not all sampling guidelines clearly describe
      the sampling scale, the specifications for contamination risk precautions, the
      sampling plan and protocol structure and the pre-analysis treatment of the soil
      samples. The purpose for sampling, in descending order of frequency, is soil
      pollution, soil fertilisation, general soil monitoring, background risk
      assessment, or else it is not specified. The majority of countries do not sample
      the top organic matter separately. Sampling depth is either related to the
      morphogenetic horizon or to ad hoc sampling depth, which is not specified in all
      cases. They suggest mass- and volume-related soil sampling, while the sampling
      pattern is not presented in all national guidelines. The criteria for area, site,
      unit, sub-unit, and point selection are mainly based on pedology and land use,
      following the history and pre-screening information or geology, or is site
      related. Some guidelines suggest the division of sampling units into sub-units.
      The sampling pattern is mainly grid sampling, grid and random sampling, or not
      mentioned. Sampling density inside the sampling unit either varies greatly or it
      is not mentioned, while the size of the sampling unit varies widely. Most
      guidelines require the collection of composite instead of simple samples, while
      some prefer sampling soil profiles. In the European SSG many technical details
      and steps are either not defined or vary, while in the pre-analysis treatment
      quality assurance (QA) and quality control (QC) approaches are used either both
      in the lab and in the field, or only in the field, or are not mentioned. The
      common points and the points in which harmonisation could be started or achieved
      are discussed.

PMID- 11213189
TI  - Comparative soil sampling in the Dornach site (Switzerland) for soil three
      dimensional pollution description.
AB  - Fifteen institutions from 13 European countries and Switzerland participated in a
      comparative test sampling at the Dornach site, near Basel in Switzerland. They
      received the site description and were asked to develop their own sampling plans,
      based on their national guidelines for a three-dimensional description of the Pb,
      Zn, Cu and Cd pollution, with a maximum of 15 samples. The comparative sampling
      test took place in late August 1997. The sampling plans and records, provided by
      the participants, were compared and evaluated in terms of sampling strategy
      throughout the site, the sampling strategy inside the sampling unit, strategy at
      the sampling point and last minute alteration of the sampling plans in the field.
      The object of this was to define the similarities and the differences in the
      sampling plans and identify the crucial steps inducing error or uncertainty which
      should be harmonized throughout Europe. The number of the total composite samples
      varied from 4 to 16, while the number of sampling points varied from 4 to 224 and
      the sampling density varied from 0.25 to 16 single samples per 100 m2. The number
      of 10 x 10 m2 quadrats from which samples were taken varied from 3 to 56, out of
      the total 61. The number of sampling units varied between 3 and 12. The criteria
      in descending order of frequency were: both land use and pedology, land use,
      pedology. The majority of the national participants divided the sampling units
      into two or three sub-units, while seven participants collected replicate
      composite samples from the same sampling unit. Only one sampled from the existing
      profiles, eight national representatives ignored the plough depth. The sampling
      pattern inside the sampling unit was in descending order of frequency: random,
      point sampling, regular, 'W' and 'X' shaped sampling. The number of single
      samples in the composite varied from 1 to 20. Most of the national participants
      sampled to pre-defined (ad-hoc) sampling depths, while others sampled soil
      horizons and others both. The maximum soil depth sampled also varied from 20 to
      117 cm. Most participants mixed in the top organic matter horizon while others
      sampled it separately. Most sampled separately the top Ah horizon in the forest
      while the rest mixed it with the underlying soil horizon. The last-minute
      sampling plan alterations were in: the sampling depth (nine), the movement of
      sampling points (five), the reduction of sub-samples in the composite sample
      (four), changes in the number of sampling units (three), ignoring the bottom
      sample (three), not sampling the L/H layer (three) although this was planned,
      unplanned sampling of the L/H layer (two) and changing the number of planned
      samples (two). This study has highlighted the need for soil sampling
      harmonization throughout Europe for pollution and soil quality determination.

PMID- 11213190
TI  - Quantitative evaluation of the CEEM soil sampling intercomparison.
AB  - The aim of the CEEM soil project was to compare and to test the soil sampling and
      sample preparation guidelines used in the member states of the European Union and
      Switzerland for investigations of background and large-scale contamination of
      soils, soil monitoring and environmental risk assessments. The results of the
      comparative evaluation of the sampling guidelines demonstrated that, in soil
      contamination studies carried out with different sampling strategies and methods,
      comparable results can hardly be expected. Therefore, a reference database (RDB)
      was established by the organisers, which acted as a basis for the quantitative
      comparison of the participants' results. The detected deviations were related to
      the methodological details of the individual strategies. The comparative
      evaluation concept consisted of three steps: The first step was a comparison of
      the participants' samples (which were both centrally and individually analysed)
      between each other, as well as with the reference data base (RDB) and some given
      soil quality standards on the level of concentrations present. The comparison was
      made using the example of the metals cadmium, copper, lead and zinc. As a second
      step, the absolute and relative deviations between the reference database and the
      participants' results (both centrally analysed under repeatability conditions)
      were calculated. The comparability of the samples with the RDB was categorised on
      four levels. Methods of exploratory statistical analysis were applied to estimate
      the differential method bias among the participants. The levels of error caused
      by sampling and sample preparation were compared with those caused by the
      analytical procedures. As a third step, the methodological profiles of the
      participants were compiled to concisely describe the different procedures used.
      They were related to the results to find out the main factors leading to their
      incomparability. The outcome of this evaluation process was a list of strategies
      and methods, which are problematic with respect to comparability, and should be
      standardised and/or specified in order to arrive at representative and comparable
      results in soil contamination studies throughout Europe. Pre-normative
      recommendations for harmonising European soil sampling guidelines and standard
      operating procedures have been outlined in Wagner G, Desules A, Muntau H,
      Theocharopoulos S. Comparative Evaluation of European Methods for Sampling and
      Sample Preparation of Soils for Inorganic Analysis (CEEM Soil). Final Report of
      the Contract SMT4-CT96-2085, Sci Total Environ 2001;264:181-186. Wagner G,
      Desaules A, Munatu H. Theocharopolous S, Quevauvaller Ph. Suggestions for
      harmonising sampling and sample pre-treatment procedures and improving quality
      assurance in pre-analytical steps of soil contamination studies. Paper 1.7 Sci
      Total Environ 2001b;264:103-118.

PMID- 11213191
TI  - Application of waste ashes to agricultural land--effect of incineration
      temperature on chemical characteristics.
AB  - Incineration is one of the most important methods of municipal waste disposal.
      During incineration, various reactions of composition and decomposition may
      occur; the physical and chemical properties of municipal wastes may change to a
      great extent. In the present study, 15 samples, including food scraps (FS),
      animal wastes (AW) and sewage sludges (SS) were collected from various places in
      Japan, incineration treatments at 500 degrees C, 850 degrees C and 1000 degrees C
      were conducted in laboratory, and pH, EC, P content, various P forms, anions and
      soluble metals were determined. The results indicated that average pH increased
      by 1.09, 1.84, 2.27 and EC decreased by 4.6, 4.6, 5.6 ds m(-1) at 500 degrees C,
      850 degrees C, 1000 degrees C, respectively, pH increased in the sequence of AM >
      SS > FS, and the decrease rate of EC was in the order of FS > SS > AM. Compared
      with no treatment (NT), water-soluble P decreased greatly at all three
      temperatures; available P increased at 500 degrees C, but decreased to the
      original level at 850 degrees C and 1000 degrees C; the amount of Ca-P, Fe-P and
      Al-P decreased and residual insoluble P increased greatly at 850 degrees C and
      1000 degrees C; no significant change of total P was found at all three
      temperatures. However, water-soluble HPO4(2-) and Cl- decreased greatly, the
      decrease ratio of Cl- was in the sequence of SS > FS > AM at 500 degrees C, and
      FS > SS > AM at 850 degrees C and 1000 degrees C; no significant difference was
      found for HPO4(2-) among all three treatment temperatures; water-soluble SO4(2-)
      decreased at 1000 degrees C, but there was no significant change at 500 degrees C
      and 850 degrees C. Moreover, water-soluble Na, Mg, K, Ti, Mn, Fe, Ga, Cd, Zn, Ba,
      Pb, Sr, W and 0.1 M HNO3 soluble Al, K, Cr, Mn, Fe, Zn, Sr, Ba, Pb, Be, Ga, Rb,
      Cd, Sn, Sb, Ta, Tl, Bi, Na, Co, Ni, Sc, Cs decreased, but water-soluble Ca, Cr,
      Co, Ni and 0.1 M HNO3 soluble Cu, Ca, V, Mo, W, Th, U, Hf increased at 500
      degrees C, 850 degrees C or 1000 degrees C.

PMID- 11213192
TI  - Paleonutritional analysis of the pre-Hispanic population from Fuerteventura
      (Canary Islands).
AB  - In this study, from histological and chemical perspectives, we analyse the human
      remains belonging to the pre-Hispanic inhabitants from Fuerteventura (one of the
      Canary Islands) and compare the results with those obtained on a sample of pre
      Hispanic inhabitants from Gran Canaria (Canary Islands). We observe that
      trabecular bone mass was normal in the samples from Fuerteventura except for an
      elderly woman; this result is in sharp contrast with the decreased bone mass
      observed in the population from Gran Canaria. The pre-Hispanic population from
      Fuerteventura showed lower bone strontium, Sr/Ca ratio, and bone barium, but
      slightly higher bone copper, than that from Gran Canaria. All these data indicate
      a greater consumption of marine products by the population of Fuerteventura. The
      high prevalence of osteoporosis observed in the population from Gran Canaria may
      be interpreted as a consequence of protein-calorie malnutrition, a condition
      which seemed to be not so prevalent in the population of Fuerteventura.

PMID- 11213193
TI  - Further evidence for a marine dinoflagellate cyst as an indicator of
      eutrophication in Yokohama Port, Tokyo Bay, Japan. Comments on a discussion by B.
      Dale.

PMID- 11213194
TI  - Marine dinoflagellate cysts as indicators of eutrophication and industrial
      pollution: a discussion.
AB  - The results from an investigation of dinoflagellate cysts as indicators of
      eutrophication in Tokyo Bay, Japan, by Matsuoka [Sci Total Environ 231 (1999) 17]
      are discussed with reference to other pertinent literature not discussed in the
      original article. Both the Japanese study and previous work from Norwegian fjords
      show that pollution (including cultural eutrophication) may produce changes in
      the phytoplankton reflected by a shift from more autotrophic--to more
      heterotrophic--dominance of cyst assemblages. However, this is a proportional
      change that seems likely to result from reduced autotrophic production rather
      than the increased heterotrophic production suggested by Matsuoka. This is not
      unequivocal evidence of eutrophication, since Tokyo Bay is impacted also by heavy
      industrial pollution, the possible effects of which cannot be distinguished, and
      the quantitative method used for estimating changes in cyst productivity is
      flawed.

PMID- 11213195
TI  - A model for determination of motor vehicle emission factors from on-road
      measurements with a focus on submicrometer particles.
AB  - The multiplicity of parameters that influence traffic-related emissions and that
      are often very difficult to measure or predict, makes the assessment of traffic
      emissions a very complicated process, strongly dependent on local conditions and
      usually associated with a high degree of error. The aim of this paper was to
      develop, calibrate and test a simple model for 'on-road' measurements of traffic
      emission factors as part of a major program focussed on the assessment of traffic
      contribution to fine and ultrafine emissions to the whole air shed and to local
      areas in south-east Queensland, Australia. A mathematical model developed was
      based on the mass balance concept for on-road assessment of traffic-related
      emission rates. The model requires fewer experimental data points as input and is
      more applicable to the common on-road testing situation, when no more than two
      monitors of a specific pollutant can be used. The model was tested and calibrated
      using experimental data on particle number concentration collected at a road
      monitoring site using the scanning mobility particle sizer, and was applied to
      assess the emission factors of submicrometer particles emitted by traffic. The
      average emission factor obtained using the box model and the experimental data
      from road measurements was 1.75 x 10(14) particles km(-1) vehicle(-1), with a
      standard error of 67.6%. While the emission factor obtained was comparable with
      some results obtained from dynamometer studies and applied to the vehicle mix at
      the sampling site, they were significantly higher than the factors reported by
      other studies.

PMID- 11213196
TI  - Occupational exposure to trihalomethanes in indoor swimming pools.
AB  - The study evaluated occupational exposure to trihalomethanes (THMs) in indoor
      swimming pools. Thirty-two subjects, representing the whole workforce employed in
      the five public indoor swimming pools in the city of Modena (Northern Italy) were
      enrolled. Both environmental and biological monitoring of THMs exposure were
      performed. Environmental concentrations of THMs in different areas inside the
      swimming pools (at the poolside, in the reception area and in the engine-room)
      were measured as external exposure index, while individual exposure of swimming
      pool employees was estimated by THMs concentration in alveolar air. The levels of
      THMs observed in swimming pool water ranged from 17.8 to 70.8 microg/l; the mean
      levels of THMs in ambient air were 25.6+/-24.5 microg/m3 in the engine room,
      26.1+/-24.3 microg/m3 in the reception area and 58.0+/-22.1 microg/m3 at the
      poolside. Among THMs, only chloroform and bromodichloromethane were always
      measured in ambient air, while dibromochloromethane was detected in ambient air
      rarely and bromoform only once. Biological monitoring results showed a THMs mean
      value of 20.9+/-15.6 microg/m3. Statistically significant differences were
      observed according to the main job activity: in pool attendants, THMs alveolar
      air were approximately double those observed in employees working in other areas
      of the swimming pools (25.1+/-16.5 microg/m3 vs. 14.8+/-12.3 microg/m3, P <
      0.01). THMs in alveolar air samples were significantly correlated with THMs
      concentrations in ambient air (r = 0.57; P < 0.001). Indoor swimming pool
      employees are exposed to THMs at ambient air levels higher than the general
      population. The different environmental exposure inside the swimming pool can
      induce a different internal dose in exposed workers. The correlation found
      between ambient and alveolar air samples confirms that breath analysis is a good
      biological index of occupational exposure to these substances at low
      environmental levels.

PMID- 11213197
TI  - Concentrations and patterns of organochlorine contaminants in white whales
      (Delphinapterus leucas) from Svalbard, Norway.
AB  - Blubber was collected from live-captured, adult male white whales (Delphinapterus
      leucas) from Svalbard, Norway, and analysed for levels and patterns of
      organochlorine (OC) contaminants. The OC compounds analysed were HCB, dieldrin,
      sigmaHCH (alpha-HCH, beta-HCH and gamma-HCH), sigmaChl (heptachlor epoxide,
      oxychlordane, cis-chlordane, trans-nonachlor, and cis-nonachlor), sigmaDDT (pp'
      DDT, pp'-DDE and pp'-DDD) and sigmaPCB (27 PCB congeners). The major OC compounds
      detected in the blubber were sigmaPCB (5103+/-1874 ng/g l.w.) and sigmaDDT
      (5108+/-1089 ng/g l.w.), which made up 70% of the sigmaOC. These compounds were
      followed in prevalence by sigmaChl (2872+/-1177 ng/g l.w.), which contributed 20%
      of the sigmaOC burden. SigmaHCH, HCB and dieldrin were present, but at low
      concentrations. This OC pattern is typical of top predators in Arctic marine food
      chains. OC levels in white whales from Svalbard are lower than white whales from
      the St Lawrence River in Canada and are generally similar to values reported
      previously for other Arctic white whale stocks. Some geographic patterns in
      relative prevalence of various OC compounds appear to be quite consistent among
      various marine mammal species in the Arctic. PCB and DDT concentrations in
      Svalbard's white whales are below the levels that are thought to have negative
      effects on reproduction or the immune system.

PMID- 11213198
TI  - Airborne emission of enriched uranium at Tokai-mura, Japan.
AB  - A new strategy for characterisation of airborne uranium contamination based on
      elemental/isotopic analysis of tree bark is described. Bark samples collected at
      Tokai-mura (Japan) were subjected to high sensitivity ICP mass spectrometric
      analysis; for control purposes, samples from the remote Yakushima island
      (Southern Japan) and central Tokyo were also analysed. The uranium contents of
      tree bark for Tokyo and Yakushima were of similar magnitude to that at Tokai-mura
      (U, 0.01-1.0 microg/g - all samples), however, there were marked differences in
      isotope ratio values between the sites. Whereas natural uranium isotope ratio
      values (235U/238U, 0.0072) were observed for Yakushima and Tokyo, non-natural and
      natural signatures (235U/238U, 0.00697-0.01448) were realised at Tokai-mura.
      These findings are consistent with the release of enriched uranium at Tokai-mura.

PMID- 11213199
TI  - A review of the family Enenteridae Yamaguti, 1958 (Digenea), with descriptions of
      species from Australian waters, including Koseiria huxleyi n. sp.
AB  - The family Enenteridae is reviewed, with keys to the genera and species and
      diagnoses of the family and genera, based on a cladistic analysis utilising 44
      characters. Subfamilies are not recognised. Descriptions of the following taxa
      from Australian marine teleosts are given: Enenterum mannarense from Kyphosus
      sydneyanus, SW Australia, E. elongatum from Kyphosus sydneyanus, SW Australia
      (these two species are distinguished by the number of oral lobes and the ovary to
      anterior testis distance), Koseiria huxleyi n. sp. from Chaetodontoplus
      meredithi, Great Barrier Reef (this new species is distinguished by the
      vitellarium reaching into the forebody, the infundibuliform terminal oral sucker,
      the unlobed ovary and the distinct post-oral ring), Koseiria xishaense from
      Kyphosus cinerascens and K. vaigiensis, Great Barrier Reef, Cadenatella isuzumi
      from Kyphosus cinerascens and K. vaigiensis, Great Barrier Reef, and C. pacifica
      (Yamaguti, 1970) n. comb. [was Jeancadenatia] from Kyphosus cinerascens and K.
      vaigiensis, Great Barrier Reef. The genus Jeancadenatia is considered a synonym
      of Cadenatella, and the new combination C. dollfusi (Hafeezullah, 1980) is
      formed. Members of the family are parasitic mainly in herbivorous fishes with a
      few genera and species from non-herbivorous fishes.

PMID- 11213200
TI  - A technique for preserving pigmentation in some capsalid monogeneans for
      taxonomic purposes.
AB  - A technique is described to preserve the pigment found in the bodies and the
      intestine of some brightly coloured and darkly pigmented benedeniine capsalid
      monogeneans. Previous studies of these pigmented capsalids have proven difficult
      because the pigmentation usually disappears when the worms are fixed using
      preservatives containing concentrations of formalin over 5% and/or ethanol,
      acetic acid, chromic acid, picric acid and mercuric chloride. The technique
      developed here uses a fixative comprising glycerol, acetone and formalin (GAF).
      After fixation under light coverslip compression for three minutes, specimens are
      transferred to absolute acetone for three minutes and cleared in a mixture of
      nine parts cedar wood oil and one part absolute acetone before mounting in Canada
      balsam. Processing must be carried out quickly, as these chemicals will cause the
      pigments to fade if the specimens are exposed to them for too long. Pigmented
      benedeniines processed using this technique retain the distribution, intensity
      and colour observed in live worms. The colour and distribution of pigmentation in
      monogeneans may be of taxonomic importance and this technique aids preparation of
      whole-mounts suitable for registration as type-material.

PMID- 11213201
TI  - Allassogonoporus callosciuri n. sp. (Digenea: Allassogonoporidae) from the
      plantain squirrel Callosciurus notatus (Boddaert) (Rodentia: Sciuridae) in
      Borneo.
AB  - A new digenean, Allassogonoporus callosciuri n. sp. from the plantain squirrel
      Callosciurus notatus from the Malaysian state of Sarawak, Borneo, is described.
      The new species differs from: A. amphoraeformis by the size of the ventral sucker
      and the position of the vitellarium and uterus; and from A. marginalis by the
      smaller oral sucker, the position of the testes and vitellarium; from A.
      vespertilionis by the position of the vitellarium, testes and ovary; from A.
      asymmetrica by the position of the testes and uterus. Gilford's (1955) and
      Dubois' (1963) opinions on the synonymy of Allassogonoporus and Myotitrema is
      supported. No representatives of the family Allassogonoporidae have been reported
      previously from sciurids or South-East Asia.

PMID- 11213202
TI  - Salsuginus neotropicalis n. sp. (Monogenea: Ancyrocephalinae) from the pike
      killifish Belonesox belizanus (Atheriniformes: Poeciliidae) from southeastern
      Mexico.
AB  - Salsuginus neotropicalis n. sp. is described from the gills of Belonesox
      belizanus (Kner), the pike killifish (Poeciliidae), from the southeastern Mexico.
      S. neotropicalis is distinguished from all other congeners by the morphology of
      the haptoral sclerites, especially by the presence of a ventral bar with notably
      enlarged ends, and by possessing overlapping gonads. The diagnosis of Salsuginus
      is amended based on the position of gonads in this species. This is the first
      known Salsuginus species occurring in a freshwater fish from the Neotropical
      Region.

PMID- 11213203
TI  - A new species of Isospora Schneider, 1881 (Apicomplexa: Eimeriidae) from the Bali
      (Rothschild's) mynah Leucopsar rothschildi (Passeriformes: Sturnidae), and
      comments concerning the genera Atoxoplasma Garnham, 1950 and Isospora.
AB  - A new species of isosporan (Apicomplexa: Eimeriidae) is reported from the Bali
      mynah Leucopsar rothschildi (Passeriformes: Sturnidae). Oocysts of Isospora
      rothschildi n. sp. are spherical to subspherical, 22.3 x 21.6 (20-26 x 19-23)
      microm, with a shape index (length/width) of 1.03 (1.00-1.15). A micropyle and
      oocyst residuum are absent, but one to many polar granules are present.
      Sporocysts are ovoidal, 15.9 x 10.6 (15-18 x 9.5-11) microm, with Stieda and
      substieda bodies and a shape index of 1.50 (1.39-1.65). Each sporocyst contains
      an ellipsoidal sporocyst residuum, 8.0 x 5.8 (6-11 x 5-8), and each sporozoite
      contains two refractile bodies. No correlation was found between the presence of
      coccidian oocysts in the faeces of some of the birds and Atoxoplasma in blood
      smears.

PMID- 11213204
TI  - Pterospora floridiensis, a new species of acephaline gregarine (Apicomplexa) from
      the maldanid polychaete Axiothella mucosa in St. Andrew Bay, Florida.
AB  - Pterospora floridiensis, a new species of acephaline gregarine from the body
      cavity of the bamboo worm Axiothella mucosa (Polychaeta: Maldanidae), is
      described. The gamont stage is distinctive and possesses a central cytoplasmic
      mass and two elongate trunks that bifurcate repeatedly and comprise approximately
      60% of the total cell length. The gamont averages 198 (50-545) x 71 (25-180)
      microm (N= 45, 43) from the tip of the trunks to the anterior (the junctional
      site with the other gamont in syzygy). Gametocysts average 402 (297-545) x 304
      (149-495) microm (N = 37). The oocysts measure 22.5 (20.5-23.5) x 8.3 (7.0-10.0)
      microm (N = 30) and possess an internal capsule (average length = 13.9 microm, N
      = 30) containing the sporozoites and aliform wings on the epispore.

PMID- 11213205
TI  - Polystoma macrocnemis n. sp. (Monogenea: Polystomatidae) from the Iranian
      longlegged wood frog Rana macrocnemis (Ranidae) in Turkey.
AB  - Polystoma macrocnemis n. sp. (Polystomatidae) is described from the urinary
      bladder of Rana macrocnemis (Ranidae) in Turkey. Its general morphology is
      similar to that of other members of the genus, but it is distinguished from
      closely related species by numerical parameters of the hamuli and also by its
      host species and geographical range.

PMID- 11213206
TI  - Monogenea of Chinese marine fishes. XIV. Two new species of Microcotylidae from
      fishes of the South China Sea.
AB  - Two new species of microcotylid monogeneans are described. Solostamenides
      platyorchis n. sp. was obtained from the gills of Mugil cephalus (Mugilidae) and
      Polylabroides guangdongensis n. sp. from the gills of Sparus macrocephalus, S.
      berda and Acanthopagrus latus (Sparidae). Solostamenides platyorchis is
      morphologically similar to S. mugilis (Vogt, 1878) Unnithan, 1971 and S.
      pseudomugilis (Hargis, 1956) Unnithan, 1971 in the structure of the copulatory
      organ, but differs from them in the number, arrangement and shape of the testes.
      Features of P. guangdongensis distinguishing it from other species of the genus
      include a copulatory organ lacking small spines and an extremely long polar
      filament on the egg. In view of this species, we suggest omitting the presence of
      small spines on the copulatory organ as a diagnostic character of the genus
      Polylabroides Mamaev & Parukhin, 1976.

PMID- 11213207
TI  - Argulus izintwala n. sp. (Crustacea: Branchiura) from Lake St Lucia, South
      Africa.
AB  - During surveys of the fish parasites of Lake St Lucia on the coast of northern
      KwaZulu-Natal, specimens of an hitherto undescribed argulid were found on the
      skin of the kelee shad Hilsa kelee (Cuvier). This, only the fourth argulid
      species to be found in South African coastal waters, is here described as Argulus
      izintwala n. sp.

PMID- 11213208
TI  - A pattern correlation model of vestibulo-ocular reflex habituation.
AB  - Through the process of habituation, the response of the vestibulo-ocular reflex
      (VOR) is decreased by prolonged, sinusoidal stimulation at lower frequencies (<
      or =0.1 Hz). Research on goldfish has uncovered frequency-specific and nonlinear
      behaviors associated with habituation of the goldfish VOR, which include
      phenomena that cannot be explained using dynamic linear and static nonlinear
      models. The unexplained phenomena are abrupt decreases at peak response, gain
      decreases far in excess of linear predictions based on phase, and violation of
      superposition. Their existence was attributed to a hypothetical switch that
      closed in the appropriate context. The pattern correlation model provides a new
      perspective on the process of VOR habituation. Rather than treat the stimulus as
      a continuous sinusoid, the pattern correlation model breaks it up into a number
      of discontinuous patterns. The pattern most closely correlated with the current
      stimulus then decreases the VOR response by the amount of that correlation times
      a pre-assigned weight. The pattern correlation model explains how the frequency
      specific and the nonlinear behaviors may be related, and how the apparent
      switching phenomena may occur.

PMID- 11213209
TI  - A synthesis procedure for associative memories based on space-varying cellular
      neural networks.
AB  - In this paper, we consider the problem of realizing associative memories via
      space-varying CNNs (cellular neural networks). Based on some known results and a
      newly derived theorem for the CNN model, we propose a synthesis procedure for
      obtaining a space-varying CNN that can store given bipolar vectors with certain
      desirable properties. The major part of our synthesis procedure consists of
      solving generalized eigenvalue problems and/or linear matrix inequality problems,
      which can be efficiently solved by recently developed interior point methods. The
      validity of the proposed approach is illustrated by a design example.

PMID- 11213210
TI  - The Bifurcating Neuron network 1.
AB  - The Bifurcating Neuron (BN), a chaotic integrate-and-fire neuron, is a model of a
      neuron augmented by coherent modulation from its environment. The BN is
      mathematically equivalent to the sine-circle map, and this equivalence
      relationship allowed us to apply the mathematics of one-dimensional maps to the
      design of BN networks. The study of symmetry in the BN revealed that the BN can
      be configured to exhibit bistability that is controlled by attractor-merging
      crisis. Also, the symmetry of the bistability can be controlled by the
      introduction of a sinusoidal fluctuation to the threshold level of the BN. These
      two observations led us to the design of the BN Network 1 (BNN-1), a chaotic
      pulse-coupled neural network exhibiting associative memory. In numerical
      simulations, the BNN-1 showed a better performance than the continuous-time
      Hopfield network, as far as the spurious-minima problem is concerned and
      exhibited many biologically plausible characteristics.

PMID- 11213211
TI  - Optimal control by least squares support vector machines.
AB  - Support vector machines have been very successful in pattern recognition and
      function estimation problems. In this paper we introduce the use of least squares
      support vector machines (LS-SVM's) for the optimal control of nonlinear systems.
      Linear and neural full static state feedback controllers are considered. The
      problem is formulated in such a way that it incorporates the N-stage optimal
      control problem as well as a least squares support vector machine approach for
      mapping the state space into the action space. The solution is characterized by a
      set of nonlinear equations. An alternative formulation as a constrained nonlinear
      optimization problem in less unknowns is given, together with a method for
      imposing local stability in the LS-SVM control scheme. The results are discussed
      for support vector machines with radial basis function kernel. Advantages of LS
      SVM control are that no number of hidden units has to be determined for the
      controller and that no centers have to be specified for the Gaussian kernels when
      applying Mercer's condition. The curse of dimensionality is avoided in comparison
      with defining a regular grid for the centers in classical radial basis function
      networks. This is at the expense of taking the trajectory of state variables as
      additional unknowns in the optimization problem, while classical neural network
      approaches typically lead to parametric optimization problems. In the SVM
      methodology the number of unknowns equals the number of training data, while in
      the primal space the number of unknowns can be infinite dimensional. The method
      is illustrated both on stabilization and tracking problems including examples on
      swinging up an inverted pendulum with local stabilization at the endpoint and a
      tracking problem for a ball and beam system.

PMID- 11213212
TI  - Signal estimation and denoising using VC-theory.
AB  - Signal denoising is closely related to function estimation from noisy samples.
      The same problem is also addressed in statistics (non-linear regression) and
      neural network learning. Vapnik-Chervonenkis (VC) theory has recently emerged as
      a general theory for estimation of dependencies from finite samples. This theory
      emphasizes model complexity control according to Structural Risk Minimization
      (SRM) inductive principle, which considers a nested set of models of increasing
      complexity (called a structure), and then selects an optimal model complexity
      providing minimum error for future samples. This paper applies the framework of
      VC-theory to signal estimation/denoising. There are three factors important for
      accurate signal estimation from finite samples: (1) the type of (orthogonal)
      basis functions used (i.e. Fourier basis, wavelets etc.). (2) The choice of a
      structure, i.e. ordering of the basis functions according to their 'importance'
      for accurate signal estimation. This corresponds to the choice of a 'structure'
      under SRM formulation. (3) Selecting an optimal number of terms (basis functions)
      from the ordered sequence of basis functions (2), aka model selection or
      complexity control (in statistics). We propose a methodology for specifying
      appropriate orderings (2) and an analytic expression for model selection (3) for
      signal processing applications. We also present empirical comparisons between the
      proposed methodology and current state-of-the-art wavelet thresholding methods
      for univariate signals. These comparisons suggest that the prudent choice of a
      structure (2) and the use of VC-based model selection (3) are critical for
      accurate signal estimation with finite samples.

PMID- 11213213
TI  - Incremental projection learning for optimal generalization.
AB  - In many practical situations in neural network learning, it is often expected to
      further improve the generalization capability after the learning process has been
      completed. One of the common approaches is to add training data to the neural
      network. In view of the learning methods of human beings, it seems natural to
      build posterior learning results upon prior results, which is generally referred
      to as incremental learning. Many incremental learning methods have been devised
      so far. However, they provide poor generalization capability compared with batch
      learning methods. In this paper, a method of incremental projection learning in
      the presence of noise is presented, which provides exactly the same learning
      result as that obtained by batch projection learning. The effectiveness of the
      presented method is demonstrated through computer simulations.

PMID- 11213214
TI  - Properties of incremental projection learning.
AB  - We proposed a method of incremental projection learning which provides exactly
      the same generalization capability as that obtained by batch projection learning
      in the previous paper. However, properties of the method have not yet been
      investigated. In this paper, we analyze its properties from the following
      aspects: First, it is shown that some of the training data which is regarded as
      redundant in most incremental learning methods have potential effectiveness, i.e.
      they will contribute to better generalization capability in the future learning
      process. Based on this fact, an improved criterion for redundancy of additional
      training data is derived. Second, the relationship between prior and posterior
      learning results is investigated where effective training data is classified into
      two categories from the viewpoint of improving generalization capability.
      Finally, a simpler representation of incremental projection learning under
      certain conditions is given. The size of memory required for storing prior
      results in the representation is fixed and independent of the total number of
      training data.

PMID- 11213215
TI  - Error correcting memorization learning for noisy training examples.
AB  - In order to avoid overfitting, we propose error correcting memorization learning.
      This method is derived from minimization of error between outputs of a trained
      neural network and correct values for noisy training examples, although the
      correct values are unknown. We show that noise is adequately suppressed by error
      correcting memorization learning. The noise suppression mechanism is
      theoretically clarified. It is found that redundancy plays an essential role for
      noise suppression and depends on a set of training inputs. We give the condition
      for the training inputs to provide the redundancy. Moreover, by clarifying the
      relationships between the proposed method and the weighted least squares
      estimation with the Mahalanobis norm, we reveal effectiveness of the weighted
      least squares estimation on noise suppression.

PMID- 11213216
TI  - A real-coded genetic algorithm for training recurrent neural networks.
AB  - The use of Recurrent Neural Networks is not as extensive as Feedforward Neural
      Networks. Training algorithms for Recurrent Neural Networks, based on the error
      gradient, are very unstable in their search for a minimum and require much
      computational time when the number of neurons is high. The problems surrounding
      the application of these methods have driven us to develop new training tools. In
      this paper, we present a Real-Coded Genetic Algorithm that uses the appropriate
      operators for this encoding type to train Recurrent Neural Networks. We describe
      the algorithm and we also experimentally compare our Genetic Algorithm with the
      Real-Time Recurrent Learning algorithm to perform the fuzzy grammatical
      inference.

PMID- 11213217
TI  - A review of molecular recognition technologies for detection of biological threat
      agents.
AB  - The present review summarizes the state of the art in molecular recognition of
      biowarfare agents and other pathogens and emphasizes the advantages of using
      particular types of reagents for a given target (e.g. detection of bacteria using
      antibodies versus nucleic acid probes). It is difficult to draw firm conclusions
      as to type of biorecognition molecule to use for a given analyte. However, the
      detection method and reagents are generally target-driven and the user must
      decide on what level (genetic versus phenotypic) the detection should be
      performed. In general, nucleic acid-based detection is more specific and
      sensitive than immunological-based detection, while the latter is faster and more
      robust. This review also points out the challenges faced by military and civilian
      defense components in the rapid and accurate detection and identification of
      harmful agents in the field. Although new and improved sensors will continue to
      be developed, the more crucial need in any biosensor may be the molecular
      recognition component (e.g. antibody, aptamer, enzyme, nucleic acid, receptor,
      etc.). Improvements in the affinity, specificity and mass production of the
      molecular recognition components may ultimately dictate the success or failure of
      detection technologies in both a technical and commercial sense. Achieving the
      ultimate goal of giving the individual soldier on the battlefield or civilian
      responders to an urban biological attack or epidemic, a miniature, sensitive and
      accurate biosensor may depend as much on molecular biology and molecular
      engineering as on hardware engineering. Fortunately, as this review illustrates,
      a great deal of scientific attention has and is currently being given to the area
      of molecular recognition components. Highly sensitive and specific detection of
      pathogenic bacteria and viruses has increased with the proliferation of nucleic
      acid and immuno-based detection technologies. If recent scientific progress is a
      fair indicator, the future promises remarkable new developments in molecular
      recognition elements for use in biosensors with a vast array of applications.

PMID- 11213218
TI  - Simultaneous detection of six biohazardous agents using a planar waveguide array
      biosensor.
AB  - Recently, we demonstrated that an array biosensor could be used with cocktails of
      fluorescent antibodies to perform three assays simultaneously on a single
      substrate, and that multiple samples could be analyzed in parallel. We extend
      this technology to demonstrate the simultaneous analysis of six samples for six
      different hazardous analytes, including both bacteria and protein toxins. The
      level of antibody cross-reactivity is explored, revealing a possible common
      epitope in two of the toxins. A panel of environmental interferents was added to
      the samples; these interferents neither prevented the detection of the analytes
      nor caused false-positive responses.

PMID- 11213219
TI  - Single-pad scheme for integrated optical fluorescence sensing.
AB  - A new scheme for integrated optical fluorescence sensing is presented. The
      principle is based on a planar waveguide containing multiple sensing units, each
      consisting of a single-pad grating coupler structure. Single-pad means that all
      the following functions are incorporated in one single pad: laser light input,
      excitation of the labeled analyte molecules, efficient collection of the emitted
      fluorescent light into the waveguide, background suppression, and coupling the
      guided wave out to the detector. The results demonstrate a high efficiency of the
      fluorescence light excitation and collection, as well as a good suppression of
      the volume background.

PMID- 11213220
TI  - Optical chip immunoassay for hCG in human whole blood.
AB  - We report on the development of an integrated optic chip sensor for performing
      rapid and sensitive immunoassays with human whole blood using human chorionic
      gonadotropin (hCG) as the model system. The optical chip is based on the Hartman
      interferometer, which uses a single planar lightbeam to address multiple
      interferometers, each comprising a signal/reference pair of sensing regions. The
      binding of antigen to specific capture antibodies on the signal sensing region
      causes a change in the refractive index of the surface layer, which is detectable
      by its effect on the evanescent field of the guided lightbeam. The reference
      sensing region is coated with an irrelevant antibody, which optically cancels a
      large fraction of the non-specific adsorption that occurs on the specific-sensing
      region when the sensor is tested with clinical specimens. This work extends
      previous experiments with buffer and human serum to measurements in undiluted
      whole human blood. Optical chips were stored dry after surface functionalization,
      and rehydrated with blood. Colloidal gold nanoparticles conjugated to a second
      anti-hCG monoclonal antibody were used to provide signal amplification, thereby
      enhancing assay sensitivity, in a one-step procedure with the gold conjugate
      added to the test sample immediately prior to measurement. Background signals due
      to non-specific binding (NSB) in blood were found to be higher than those
      previously reported with human serum. In addition, a high level of background
      signal was found with the gold conjugate, which had not been observed in
      experiments with either buffer or serum. Nevertheless, hCG could be detected at
      0.5 ng/ml within 10 min of sample application. The sensor response was linear
      over the concentration range 0.5-5 ng/ml hCG, as compared with the clinically
      relevant range 0.3-1.5 ng/ml. Detection at higher concentrations was affected by
      scattering from large amounts of bound gold nanoparticles. However, initial
      binding rate measurements could be used to maintain assay quantitation.

PMID- 11213221
TI  - Comparison of surface plasmon resonance and quartz crystal microbalance in the
      study of whole blood and plasma coagulation.
AB  - The coagulation of blood plasma and whole blood was studied with a surface
      plasmon resonance (SPR) based device and a quartz crystal microbalance instrument
      with energy dissipation detection (QCM-D). The SPR and QCM-D response signals
      were similar in shape but differing in time scales, reflecting differences in
      detection mechanisms. The QCM-D response time was longer than SPR, as a physical
      coupling of the sample to the substrate is required for molecules to be detected
      by the QCM-method. Change of sample properties within the evanescent field is
      sufficient for detection with SPR. Both the SPR signals and the QCM-D frequency
      and dissipation shifts showed dependency on concentrations of coagulation
      activator and sensitivity to heparin additions. The ratio of dissipation to
      frequency shifts, commonly considered to reflect viscoelastic properties of the
      sample, varied with the concentration of activator in blood plasma but not in
      whole blood. Additions of heparin to the thromboplastin activated whole blood
      sample, however, made the ratio variation reoccur. Implications of these
      observations for the understanding of the blood coagulation processes as well as
      the potential of the two methods in the clinic and in research are discussed.

PMID- 11213222
TI  - Evaluation of antibody immobilization methods for piezoelectric biosensor
      application.
AB  - The immobilization of anti-Salmonella antibodies by two methods were studied and
      evaluated for their potential use in a piezoelectric biosensor. The optimum
      temperature-time combinations for the highest immobilization yields were
      determined for both methods. Protein A binding was found to be 67.4+/-3.8% on the
      gold surface which then allowed an immobilization of 42.1+/-2.09% antibody. The
      degree of antibody immobilization via surface aldehyde groups of glutaraldehyde
      (GA) on a precoated quartz crystal with polyethylenimine (PEI) was 31.6+/-0.3%. A
      piezoelectric probe was designed and used in dry assays to observe the frequency
      change due to addition of mass by the immobilization layers. The frequency
      changes recorded showed a better reproducibility and less added mass for the
      Protein A method. The frequency decrease due to microg of added antibodies was
      compared to frequency decrease calculated by the Sauerbrey equation. The
      experimental data was found to be only approximately 8% of theoretical data. The
      functionality of the immobilized antibodies with the Protein A method was tested
      with S. typhimurium in a wet chamber and the frequency decrease was compared to
      results of a similar system activated with PEI-GA immobilization. The frequency
      decreases with S. typhimurium concentration of approximately 1.5 x 10(9) CFU/ml
      were 50+/-2 Hz and 44+/-3 Hz for the Protein A method and PEI-GA method,
      respectively. It was concluded that although both methods resulted in comparable
      activities in terms of % immobilized protein and frequency decreases due to
      Salmonella binding, the Protein A method was favorable due to stability and
      better reproducibility of the immobilization layers.

PMID- 11213223
TI  - Preparation of spatially ordered multilayer thin films of antibody and their
      binding properties.
AB  - Spatially ordered multilayer thin films containing anti-fluoresceinisothiocyanate
      (anti-FITC) were prepared on the surface of a quartz slide to study the binding
      properties of the multilayer films. A quartz slide was treated in solutions of
      avidin and biotin-labeled anti-FITC alternately and repeatedly to form multilayer
      thin films through a strong affinity between avidin and biotin. A
      spectrophotometric study revealed explicitly that the thin films thus prepared
      consisted of alternate monomolecular layers of avidin and biotin-labeled anti
      FITC. The antibody retained its binding activity to antigen in the multilayer
      thin film, though the antigen could not access the antibody embedded deep in the
      multilayer film. Only the outermost four or five layers of antibody were involved
      in the binding of antigen.

PMID- 11213224
TI  - Piezoelectric quartz crystal based label-free analysis for allergy disease.
AB  - This work presents a piezoelectric (Pz) quartz crystal based label-free
      quantification of total IgE and allergen-specific IgE in human sera for allergy
      testing. An evaluation of the different brands of crystals was first initiated
      with respect to variability in mass sensitivity, frequency measurement
      reliability and stability, and surface roughness. Thereafter, for total IgE
      quantification. a direct assay format was adopted. By means of thioctic acid (TA)
      and coupling reagents, anti-human IgE antibodies were immobilized on AT-cut Pz
      crystals (10 MHz). The modified crystals could detect serum IgE directly
      corresponding to a downward frequency shift. The results showed that silver
      coated crystals as compared with their gold-coated counterparts provided
      approximately 1.5 times higher mass detection sensitivity for total IgE in the
      range of 5-300 IU/ml with a linear regression line, y = 1.8957 x + 1.5603, R2 =
      0.995. For the detection of allergen-specific IgE, a sandwiched assay format was
      used. As the allergen-modified sensor surface captured various classes of
      associated antibodies (IgE, IgG, etc) and interfering serum proteins as well, the
      initial frequency shift downwards caused by sera sample incubation would not be
      proportional to specific IgE levels. Thus, following sample incubation, a second
      incubation step with secondary anti-human IgE was added to recognize IgE from
      other bound substances. The frequency shift after secondary antibody binding
      reflected the amount of allergen-specific IgE proportionally. Compared with 10
      MHz crystals, the 20 MHz counterparts provided approximately four times higher
      mass detection sensitivity for allergen specific IgE in the range of 0.15-17.5
      IU/ml with a linear regression line, y = 50.525 x + 107.777, R2 = 0.954. Total
      IgE and allergen specific IgE assay results of real patients' sera using the Pz
      sensors agreed well with those obtained by commercially available test kits with
      correlation coefficient 0.96-0.98. The possibility of regenerating the quartz
      crystals for further re-use was also dealt with.

PMID- 11213225
TI  - A comparison of protocols for the optimisation of detection of bacteria using a
      surface acoustic wave (SAW) biosensor.
AB  - A dual channel surface acoustic wave (SAW) device has been used as a biosensor to
      detect two different microorganisms, Legionella and Escherichia coli,
      simultaneously. A series of experiments was conducted to optimise the use of the
      SAW for bacterial detection using a novel protocol of coating bacteria on the
      sensor surface prior to addition of the antibody. Results were compared with an
      experiment in which a conventional protocol was utilised, where antibody was
      coated on the sensor surface prior to exposure to bacteria. The concentration of
      bacteria that attached to the surface of the SAW device was related to the
      antibody that specifically bound to it and therefore to frequency in a dose
      dependent fashion. Unlike conventional microbiological techniques quantitative
      results can be obtained for Legionella and E. coli down to 10(6) cells per ml
      within 3 h. In addition E. coli was detected down to 10(5) cells per ml in a
      modified protocol using sheep IgG as a blocking agent.

PMID- 11213226
TI  - Analyte-receptor binding and dissociation kinetics for biosensor applications: a
      fractal analysis.
AB  - A fractal analysis of confirmative nature only is presented for analyte-receptor
      binding and dissociation kinetics for biosensor applications. Data taken from the
      literature may be modeled, in the case of binding using a single-fractal analysis
      or a dual-fractal analysis. The dual-fractal analysis represents a change in the
      binding mechanism as the reaction progresses on the surface. Relationships are
      presented for the binding and dissociation rate coefficients as a function of
      their corresponding fractal dimension, Df or the degree of heterogeneity that
      exists on the surface. When analyte-receptor binding or dissociation is involved,
      an increase in the heterogeneity on the surface (increase in Df) leads to an
      increase in the binding and in the dissociation rate coefficient. It is suggested
      that an increase in the degree of heterogeneity on the surface leads to an
      increase in the turbulence on the surface owing to the irregularities on the
      surface. This turbulence promotes mixing, minimizes diffusional limitations, and
      leads subsequently to an increase in the binding and in the dissociation rate
      coefficient (Martin S.J., Granstaff, V.E., Frye, G.C., Anal. Chem., 65, (1991)
      2910). The binding and the dissociation rate coefficient are rather sensitive to
      the degree of heterogeneity, Df,bind and Df,diss respectively, that exists on the
      biosensor surface. For example, the order of dependence on Df,bind is 19.2 for
      the binding rate coefficient, kbind for the binding of 0.03-1.0 microM SH-2Ld in
      solution to 2C TCR immobilized on a surface plasmon resonance (SPR) biosensor
      (Corr, M., Salnetz, A.E., Boyd, L.F., Jelonek, M.T., Khilko, S., Al-Ramadi, B.K.,
      Kim, Y.S., Maher, S.E., Bothwell, A.L.M., Margulies, D.H., Science, 265, (1994)
      946). The order of dependence on Df,diss is -6.22 for the dissociation rate
      coefficient, kdiss for the dissociation of 250-1000 nM Sophora japonica
      agglutinin (SJA)-lactose complex from the SPR surface. In general, the technique
      is applicable to other reactions occurring on different types of surfaces, such
      as cell-surface reactions.

PMID- 11213227
TI  - Silver electrodeposition catalyzed by colloidal gold on carbon paste electrode:
      application to biotin-streptavidin interaction monitoring.
AB  - A new electrochemical method to monitor biotin-streptavidin interaction on carbon
      paste electrode, based on silver electrodeposition catalyzed by colloidal gold,
      was investigated. Silver reduction potential changed when colloidal gold was
      attached to an electrode surface through the biotin-streptavidin interaction.
      Thus, the direct reduction of silver ions on the electrode surface could be
      avoided and therefore, they were only reduced to metallic silver on the colloidal
      gold particle surface, forming a shell around these particles. When an anodic
      scan was performed, this shell of silver was oxidized and an oxidation process at
      + 0.08 V was recorded in NH3 1.0 M. Biotinylated albumin was adsorbed on the
      pretreated electrode surface. This modified electrode was immersed in colloidal
      gold-streptavidin labeled solutions. The carbon paste electrode was then
      activated in adequate medium (NaOH 0.1 M and H2SO4 0.1 M) to remove proteins from
      the electrode surface while colloidal gold particles remained adsorbed on it.
      Then, a silver electrodeposition at -0.18 V for 2 min and anodic stripping
      voltammetry were carried out in NH3 1.0 M containing 2.0 x 10(-5) M of silver
      lactate. An electrode surface preparation was carried out to obtain a good
      reproducibility of the analytical signal (5.3%), using a new electrode for each
      experiment. In addition, a sequential competitive assay was carried out to
      determine streptavidin. A linear relationship between peak current and logarithm
      of streptavidin concentration from 2.25 x 10(-15) to 2.24 x 10(-12) M and a limit
      of detection of 2.0 x 10(15) M were obtained.

PMID- 11213228
TI  - An integrated NAD+-dependent enzyme-functionalized field-effect transistor
      (ENFET) system: development of a lactate biosensor.
AB  - An integrated NAD+-dependent enzyme field-effect transistor (ENFET) device for
      the biosensing of lactate is described. The aminosiloxane-functionalized gate
      interface is modified with pyrroloquinoline quinone (PQQ) that acts as a catalyst
      for the oxidation of NADH. Synthetic amino-derivative of NAD+ is covalently
      linked to the PQQ monolayer. An affinity complex formed between the NAD+/PQQ
      assembly and the NAD+-cofactor-dependent lactate dehydrogenase (LDH) is
      crosslinked and yields an integrated biosensor ENFET-device for the analysis of
      lactate. Biocatalyzed oxidation of lactate generates NADH that is oxidized by PQQ
      in the presence of Ca2+-ions. The reduced catalyst, PQQH2, is oxidized by O2 in a
      process that constantly regenerates PQQ at the gate interface. The biocatalyzed
      formation of NADH and the O2-stimulated regeneration of PQQ yield a steady-state
      pH gradient between the gate interface and the bulk solution. The changes in the
      pH of the solution near the gate interface and, consequently, the gate potential
      are controlled by the substrate (lactate) concentration in the solution. The
      device reveals the detection limit of 1 x 10(-4) M for lactate and the
      sensitivity of 24+/-2 mV dec(-1). The response time of the device is as low as 15
      s.

PMID- 11213229
TI  - Inhibitive determination of mercury and other metal ions by potentiometric urea
      biosensor.
AB  - The biosensor with urease entrapped in PVC layer at the surface of pH-sensitive
      iridium oxide electrode was applied for testing of mercury and other metal ions
      inhibition on enzymatic reaction. The calculation of inhibition effect was based
      on the measurement of initial rate of decrease of biosensor potential
      (proportional to the initial rate of enzymatic reaction) after addition of
      substrate after inhibition step. Some differences of inhibition extent were
      observed for various mercury forms (Hg(NO3)2, HgCl2, PhHgCl and Hg2(NO3)2) as
      well as for other heavy metal ions investigated as potential interferents.
      Because the method was not specific, it was applied for the determination of
      total inhibition effect caused by heavy metal ions in water samples. In the case
      of most cations tested the total recovery of enzyme activity was possible using
      Tris buffer solution with EDTA and thioacetamide after less than 10 min
      regeneration time.

PMID- 11213230
TI  - Society for Vascular Medicine and Biology: a vision for the future.

PMID- 11213231
TI  - Basis and implications of change in arterial pressure with age.

PMID- 11213232
TI  - Non-invasively determined ambulatory venous pressure.
AB  - In view of the resemblance of exercise-induced plethysmographic changes with
      those obtained by direct venous pressure measurement, we decided to use a
      combination of photoplethysmography (PPG) and hydrostatic pressure calibration to
      determine the PPG/pressure relationship. A standard foot dorsiflexion exercise
      involving stepwise position changing was performed which induced hydrostatic
      pressure changes that were recorded as the heart-probe distance. A logarithmic
      PPG/pressure relationship was identified and the resulting ambulatory venous
      pressure (AVP) was obtained from the PPG/pressure curve. Simultaneous direct AVP
      was recorded in 14 patients scheduled for venous surgery. 'Non-invasive AVP only'
      was determined in 24 normal control subjects with a mean value of 19.24 mmHg (+/
      8.79 SD). In the patient group, the direct AVP values were 40.00 mmHg (+/-10.83
      SD) compared with the PPG values of 33.07 mmHg (+/-12.94 SD). The resulting
      correlation was r = 0.8850. By utilizing stepwise leg elevation, a reliable
      PPG/pressure curve can be established which, in turn, permits AVP determination.
      It is suggested that this non-invasive AVP determination may serve as a screening
      test to evaluate non-invasively venous hemodynamics.

PMID- 11213233
TI  - Therapy of unstable angina with the low molecular weight heparins.
AB  - Unstable angina is in most cases caused by partial or complete coronary artery
      occlusion due to the disruption of an atherosclerotic plaque and to thrombus
      formation. An immediate antithrombotic approach is essential to prevent fatal and
      non-fatal myocardial infarction, and the combination of aspirin and
      unfractionated heparin has played a pivotal role in the past years. Low molecular
      weight heparins have improved pharmacokinetic and pharmacodynamic properties over
      unfractionated heparin that have resulted in greater efficacy and safety in the
      field of venous thromboembolism. Low molecular weight heparins can be
      administered by once or twice daily subcutaneous injections at fixed, weight
      adjusted doses without the need for monitoring. Because of their potential, many
      recent clinical trials have evaluated their efficacy and safety in the management
      of patients with unstable angina. Three low molecular weight heparins have so far
      been tested: nadroparin, dalteparin and enoxaparin. The results of the published
      trials confirm that the newer compounds are at least as safe and effective as
      unfractionated heparin, and offer considerable therapeutic advantages.
      Nevertheless, the different properties of the three compounds and perhaps the
      different designs of the clinical trials have led to not entirely comparable
      findings.

PMID- 11213234
TI  - Multiple skeletal muscle mitochondrial DNA deletions in patients with unilateral
      peripheral arterial disease.
AB  - Peripheral arterial disease (PAD) is associated with metabolic derangements and
      accumulation of the common 4977 bp mitochondrial DNA (mtDNA) deletion mutation.
      The current study was undertaken to test the hypothesis that PAD is associated
      with multiple mtDNA deletions. Gastrocnemius biopsies were obtained from nine
      patients with unilateral PAD. DNA extracted from the biopsies was analyzed for
      mtDNA deletions using a primer-shift PCR strategy. Multiple primers and strict,
      prospective criteria were used to identify deletions. PAD was associated with
      multiple mtDNA deletions (average of 8.2 distinct deletions in muscle from the
      hemodynamically affected limb). mtDNA injury was present in both the worse- and
      less-affected limbs of the unilateral PAD patients, and the estimated degree of
      mtDNA injury was strongly correlated in the two limbs on an intra-subject basis.
      The 4977 bp deletion was frequently identified, but was not always the deletion
      of highest frequency in individual samples. The estimated relative frequency of
      the 4977 bp deletion was correlated with the overall mtDNA injury in the
      biopsies. In summary, PAD is associated with mtDNA injury as reflected by
      multiple deletion mutations. As the mutations are not limited to the ischemic
      limb in unilateral patients, they are unlikely to contribute to the
      pathophysiology of claudication.

PMID- 11213235
TI  - Trial of a novel prostacyclin analog, UT-15, in patients with severe intermittent
      claudication.
AB  - Prostacyclin is an endothelially derived vasodilator and inhibitor of platelet
      aggregation. Despite its therapeutic potential for peripheral arterial disease,
      the short half-life and chemical instability are barriers to routine therapy.
      Accordingly, prostacyclin analogs are being evaluated in patients with peripheral
      arterial disease. State-of-the-art non-invasive ultrasonography allows for serial
      testing of the hemodynamic effects of vasoactive drugs. The safety, efficacy and
      hemodynamic effects of UT-15, a novel, long-acting prostacyclin analog, were
      studied in patients with severe intermittent claudication. A total of eight
      patients with stable severe intermittent claudication, Fontaine classes IIb-III,
      were admitted to the hospital for intravenous infusion of UT-15. A symptom
      limited, dose-escalation protocol was instituted, beginning with placebo and then
      with increasing dosage at 60-min intervals, followed by a 2-h period of
      maintenance dose at the maximum well-tolerated infusion rate. The hemodynamic
      response in the lower limbs was assessed with serial ultrasonography, segmental
      arterial pressures and pulse volumes. Blood flow in the common femoral artery
      increased 29% (p = 0.003) by the end of the maintenance period and remained above
      baseline throughout the washout period (p = 0.044). Blood velocity in the lower
      limb increased in most of the peripheral arteries. These increases achieved
      statistical significance in the common femoral artery (p = 0.025) and anterior
      tibial artery (p = 0.019), and approached significance in the popliteal artery (p
      = 0.062). In two of four patients in whom blood flow was undetectable before the
      infusion, arterial blood flow at the ankle level became apparent on
      ultrasonography during maintenance infusion. UT-15 infusion improved the pulse
      volume recording (p = 0.016) but the ankle/brachial index did not change
      significantly. Common side effects at peak dose included headache and nausea.
      There were no serious adverse events attributable to UT-15 treatment. In most
      patients, the optimal infusion rate was 10-20 ng/kg per min. In conclusion,
      ultrasonography is a novel approach for assessing the hemodynamic response to
      vasoactive agents. UT-15 is well tolerated when given for up to 2 h and increases
      arterial blood flow and velocity in patients with severe intermittent
      claudication.

PMID- 11213236
TI  - Hirudin therapy during thrombolysis for venous thrombosis in heparin-induced
      thrombocytopenia.
AB  - Heparin-induced thrombocytopenia (HIT) is the most common drug-related
      thrombocytopenia. Thromboembolic complications occur in approximately 50% of
      patients with HIT and result in limb amputation and death in up to 20% and 30%
      respectively. Because patients with a history of HIT may require future
      intravenous anticoagulation but have a high-risk of thromboembolism if re
      challenged with heparin, alternative therapies are necessary when further
      anticoagulation is indicated. The use of direct thrombin inhibitors in HIT
      patients who also require thrombolytic therapy offers unique challenges to
      anticoagulant monitoring and safety. We present a case of progressive ileofemoral
      deep venous thrombosis in a patient with a history of HIT in order to review the
      combined use of hirudin and thrombolysis in this setting.

PMID- 11213238
TI  - Low molecular weight heparins for arterial thrombosis.
AB  - The use of low molecular weight heparin (LMWH) for the prevention and treatment
      of venous thromboembolism has been validated by numerous clinical trials and meta
      analyses over the past 25 years. More recently, the possibility of extending
      treatment with LMWH to the arterial disease where thrombosis is a prominent
      feature has led to the planning of many clinical trials, several of which have
      been already published. LMWH has been tested in settings such as acute coronary
      syndromes, including myocardial infarction, surgery or percutaneous
      revascularization for coronary and peripheral arteries, and stroke. In most
      indications, LMWH has proved to be superior to or at least as effective as
      unfractionated heparin and it is also easier to administer.

PMID- 11213237
TI  - Adenosine and chronic ischemia of the lower limbs.
AB  - Adenosine is an endogenous nucleoside with multiple biological properties which
      plays a central role in the pathophysiology of tissue ischemia. Adenosine signals
      an imbalance between oxygen demand and supply, and it initiates responses to
      redress such a discrepancy. Besides its vasodilating properties, adenosine
      possesses anti-platelet and anti-neutrophil activities and provides
      cytoprotection. Adenosine is presumably the main mediator of the preconditioning
      phenomenon. During ischemia of the lower limbs, adenosine plays a physiological
      role by inducing vasodilatation and by preventing microcirculatory failure.
      Exercise training prolongs claudication distance possibly by inducing pulse
      increases of adenosine and consequently skeletal muscle preconditioning.
      Moreover, the adenosine increase which follows the administration of some drugs,
      such as buflomedil and propionylcarnitine, opens new perspectives in the
      management of leg ischemia. In fact, the concept arises of an ischemic (exercise
      dependent) or pharmacologic preconditioning in the treatment of patients with
      claudication.

PMID- 11213239
TI  - Images in vascular medicine. Mycotic aneurysm.

PMID- 11213240
TI  - Images in vascular medicine. Elephantiasis nostras verrucosa.

PMID- 11213242
TI  - Efficacy of adjunctive cricopharyngeus myotomy in supraglottic laryngectomy.
AB  - This study investigates prospectively the effect of concurrent cricopharyngeus
      myotomy (CPM) on swallowing following horizontal supraglottic laryngectomy (SL)
      using fiberoptic, radiographic, and manometric evaluations and suggests possible
      mechanisms regarding the role of CPM following SL. Six patients undergoing
      horizontal SL between 1995 and 1997 were enrolled in a prospective evaluation
      with a followup of 0.5-2.25 years. Three patients underwent concurrent CPM and
      three did not. Fiberoptic, radiographic. and manometric assessments were
      performed postoperatively. Although mean resting pressures at the upper
      esophageal sphincter were reduced significantly by myotomy (12 mm Hg) compared
      with nonmyotomized patients (57 mm Hg), p < 0.01, no rehabilitative advantage was
      observed in the former group. In fact, of the myotomized patients, two required
      feeding gastrostomy tubes with resumption of an oral diet in one year and in two
      months, respectively, while the nonmyotomized patients were all capable of
      resuming a full oral diet within four weeks. It appears that CPM provides no
      rehabilitative advantage in patients undergoing SL.

PMID- 11213241
TI  - Accuracy of bedside clinical methods compared with fiberoptic endoscopic
      examination of swallowing (FEES) in determining the risk of aspiration in acute
      stroke patients.
AB  - This prospective study was undertaken to determine the accuracy of bedside
      clinical methods compared with fiberoptic endoscopic examination of swallowing
      (FEES) for detecting aspiration in acute stroke patients. Fifty patients
      underwent an examination of their ability to swallow 50 ml of water in 10-ml
      aliquots. Later their oxygen saturation levels before and after swallowing 10 ml
      of water were measured using a pulse oximeter. Oxygen desaturation of more than
      2%, was considered to be clinically significant. All patients then underwent a
      FEES assessment by a speech therapist and were followed up during their inpatient
      stay for evidence of aspiration pneumonia. The oxygen desaturation test had a
      sensitivity of 76.9% and specificity of 83.3% (chi2 = 18.154, p = 0.00002), while
      the 50-ml water swallow test had a sensitivity of 84.6% and specificity of 75.0%
      (chi2 = 18.001, p = 0.00002). However, when these two tests were combined into
      one test called "bedside aspiration," the sensitivity rose to 100% with a
      specificity of 70.8% (chi2 = 27.9, p = 0.000001). Five (10%) patients developed
      pneumonia during their inpatient stay. The relative risk (RR) of developing
      pneumonia, if there was evidence of aspiration on FEES, was 1.24 (1.03 < RR <
      1.49). We conclude that the oxygen desaturation test combined with the 50-ml
      water swallow test is suitable as a screening test to identify all acute stroke
      patients at risk of aspiration for further evaluation and management.

PMID- 11213243
TI  - Oropharyngeal dysphagia in esophageal cancer before and after transhiatal
      esophagectomy.
AB  - Although dysphagia is the predominant symptom of esophageal cancer, the nature of
      the swallowing deficit remains unclear, particularly regarding an oropharyngeal
      motor component. The present study examined the oropharyngeal swallow in patients
      with esophageal cancer before and following transhiatal esophagectomy.
      Videofluoroscopic data were obtained from ten patients with esophageal cancer
      before and following transhiatal esophagectomy as they swallowed 2-, 5-, and 10
      cc aliquots of liquid and puree, and 0.5 and 1 tsp of solid. Each swallow was
      rated on 36 parameters by three independent judges. Swallow-related hyoid bone
      movement, computed from digitized segments of the videofluoroscopic data, was
      compared pre- and postsurgically. All patients showed at least mild abnormality
      of the oropharyngeal swallow preoperatively. Abnormalities involved all stages of
      swallowing in nine of the ten patients; however, the oral preparatory/oral stage
      was relatively more impaired than the pharyngeal stage in the majority of
      patients. Postsurgically, all patients exhibited at least a mild oropharyngeal
      swallowing impairment. New or increased postoperative deficits involved the
      pharyngeal stage of swallowing, whereas oral stage abnormalities were generally
      improved or unchanged following surgery. Swallow-related hyoid kinematics were
      highly variable both before and following surgery. Anterior hyoid bone excursion
      was significantly reduced postoperatively in one patient and significantly
      increased in one patient. Patients with esophageal cancer exhibit oropharyngeal
      dysphagia, with different profiles of abnormality before and following
      esophagectomy.

PMID- 11213244
TI  - Teaching speech pathology students  the interpretation of videofluoroscopic
      swallowing studies.
AB  - This article examines a teaching package that was designed to cover the
      progression of skills agreed to by clinicians and educators as being pertinent to
      interpreting Videofluoroscopy Swallowing Studies (VFSSs). Sessions taught
      included knowledge of anatomy and physiology of swallowing, examination and
      identification of structures and landmarks from radiographs, and the use of an
      assessment scale such as the Bethlehem Assessment Scale (BAS) to interpret VFSSs.
      The ability to interpret eight VFSSs using the BAS was used as the final
      assessment. ANOVA for repeated measures and post hoc tests using Tukey's HSD
      statistic revealed that there was a statistically significant correlation between
      students' knowledge of anatomy and physiology and their knowledge of radiographic
      anatomy. There was a statistically significant correlation between their
      knowledge of radiographic anatomy and their ability to interpret
      videofluoroscopic examinations, as assessed using the BAS. There was also a
      statistically significant correlation between their knowledge of anatomy and
      physiology and their ability to interpret videofluoroscopic examinations using
      the BAS.

PMID- 11213245
TI  - Voluntary and reflex influences on the initiation of swallowing reflex in man.
AB  - The electrophysiological features of voluntarily induced and
      reflexive/spontaneous swallows were investigated. In normal subjects, swallows
      were elicited by infusing water either into the mouth (1-3 ml) or directly into
      the oropharyngeal region through a nasopharyngeal cannula (0.3-1 ml). For water
      infused orally, subjects were either requested to swallow voluntarily or
      instructed to resist swallowing and maintain the horizontal head position until
      swallowing occurred reflexively. Spontaneous saliva swallowing was investigated
      in patients with severe dysphagia who had a prominent clinical picture of
      suprabulbar palsy. Comparisons between different swallowing types were made by
      measuring the time interval between the onset of submental electromyographic
      activity (SM-EMG) and the onset of the upward movement of the larynx recorded by
      a movement sensor. This interval was less than 100 ms, even frequently less than
      50 ms, in reflexive/spontaneous swallows, while in voluntarily induced swallows
      it was substantially longer. The rising time of submental muscle's excitation was
      also shorter in reflexive/spontaneous swallows. It was suggested that the
      triggering of voluntarily induced swallows commences more than 100 ms before the
      onset of swallowing reflex and that this mechanism is under the control of
      corticobulbar-pyramidal pathways. If the swallowing reflex is triggered within
      such a short period of time following the onset of SM-EMG, the central control by
      the bulbar swallowing center should be effective until the end of oropharyngeal
      swallowing.

PMID- 11213246
TI  - Effects of age, gender, disease, and multisystem involvement on oxygen saturation
      levels in dysphagic persons.
AB  - The purpose of this study was to examine the effects of age, gender, disease, and
      multisystem involvement on SpO2 levels of 104 dysphagic patients and 77
      nondysphagic persons. Results indicated that solid aspirators had lower SpO2
      levels than liquid aspirators, penetrators, and nondysphagics. In addition, SpO2
      levels varied by age, with older persons having lower levels than younger persons
      among dysphagics but not among nondysphagics. Patients with COPD had lower SpO2
      levels than dysphagics with other disorders. Significant interactions were found
      among age, gender, and disease. Multisystem involvement was found not to be a
      factor in SpO2 levels. It was concluded that although normal aging processes
      reduce swallowing and pulmonary functioning, it became a significant factor only
      when combined with an assault to the system, such as CVA or COPD.

PMID- 11213247
TI  - Quantitative evaluation of infant's nonnutritive and nutritive sucking.
AB  - Two important aspects of the clinical feeding evaluation of infants are the
      assessment of their nonnutritive and nutritive sucking skills. Nonnutritive
      sucking is monitored routinely by using a gloved finger and nutritive sucking by
      observing infants' sucking while bottle feeding. This approach, however. provides
      only a subjective and descriptive evaluation. In this study, we developed a
      finger pressure device that allows for quantification of specific measures of
      nonnutritive sucking. We are proposing that its use, in combination with the
      nipple/bottle system developed for the monitoring of nutritive sucking. will
      allow therapists to conduct objective and quantitative evaluations of infants'
      nonnutritive and nutritive sucking. The suction and expression components of
      sucking are monitored via two catheters placed at the tip of the index finger of
      a disposable glove and at the tip of a bottle nipple. The observations made from
      the standard clinical feeding evaluation and from these two instruments were
      compared. In addition to providing quantitative measures of sucking, the latter
      techniques allowed the review/reassessment of data, the monitoring of the
      maturation of oral motor skills over time, and the comparison of these measures
      between infants. It is proposed that the concurrent use of these devices will
      allow therapists to conduct more objective and detailed evaluations of infants'
      feeding skills than can be obtained at present.

PMID- 11213248
TI  - Foreign body ingestion in children with severe developmental disabilities: a case
      study.
AB  - Dysphagia is common in children with severe developmental disabilities. The
      nature of these difficulties can predispose them to foreign body ingestion. This
      article presents a case that highlights the need for vigilance in diagnosing
      dysphagia in children with multiple and complex developmental disabilities where
      severe cognitive impairment and an inability to communicate may mask the presence
      of underlying problems.

PMID- 11213249
TI  - Screening for dysphagia and aspiration in acute stroke: a systematic review.
AB  - Stroke is a common problem, producing a variety of neurological problems that
      affect eating. Dysphagia is a particular concern because of its potential for
      airway obstruction, malnutrition, and aspiration pneumonia. With chest infection
      reported in up to 32% of stroke patients, this is a major clinical issue. The
      following research questions are raised: (1) What are the incidence and outcomes
      of dysphagia and aspiration in acute stroke? (2) What screening interventions are
      available to detect dysphagia in patients with acute stroke and what effect have
      they on patient outcomes? A systematic review was carried out using methods and
      quality criteria of the NHS Centre for Reviews and Dissemination (1996), focusing
      on studies of adults with acute stroke. Data were extracted, collated, and
      presented descriptively. Two hundred forty-eight articles were retrieved with 26
      meeting inclusion and quality criteria. Clinical dysphagia is common, associated
      with a range of deleterious outcomes and clearly linked to development of chest
      infection. Interpretation of aspiration on videofluoroscopy is not as
      straightforward but probably also confers additional risk. Further work is
      required on the relationship between aspiration and pneumonia, and pneumonia
      prevention. This will include exploration of the effects of screening, and the
      further development and validation of screening methods. While studies indicate
      current "best practice," in this important area of patient care further work is
      urgently required.

PMID- 11213250
TI  - Case management challenges in pediatric dysphagia.

PMID- 11213251
TI  - Why are there so many sensory brain maps?

PMID- 11213252
TI  - The plasminogen activator system: biology and regulation.
AB  - The regulation of plasminogen activation involves genes for two plasminogen
      activators (tissue type and urokinase type), two specific inhibitors (type 1 and
      type 2), and a membrane-anchored urokinase-type plasminogen-activator-specific
      receptor. This system plays an important role in various biological processes
      involving extracellular proteolysis. Recent studies have revealed that the
      system, through interplay with integrins and the extracellular matrix protein
      vitronectin, is also involved in the regulation of cell migration and
      proliferation in a manner independent of proteolytic activity. The genes are
      expressed in many different cell types and their expression is under the control
      of diverse extracellular signals. Gene expression reflects the levels of the
      corresponding mRNA, which should be the net result of synthesis and degradation.
      Thus, modulation of mRNA stability is an important factor in overall regulation.
      This review summarizes current understanding of the biology and regulation of
      genes involved in plasminogen activation at different levels.

PMID- 11213253
TI  - A structural view of microtubule dynamics.
AB  - The essential microtubule property of dynamic instability is based on the
      binding, hydrolysis and exchange of GTP in each tubulin dimer. The recent high
      resolution structures of tubulin and the microtubule have given us the first view
      at atomic level of properties such as nucleotide exchangeability, the linkage
      between polymerization and nucleotide hydrolysis. and the origin of microtubule
      destabilization, as well as the mode of action of antimitotic agents such as
      taxol.

PMID- 11213254
TI  - Dual Valpha T cells.
AB  - The assumption that T cells can only express a single receptor for antigen has in
      recent years been shown to be incorrect. However, the finding that a substantial
      number of T cells express two distinct antigen receptors at the cell surface
      raises a number of questions. In particular, it has been suggested that cells
      expressing low levels of a self-reactive T cell receptor may escape self
      tolerance mechanisms and in certain situations trigger the onset of autoimmune
      disease. Such a hypothesis in turn raises questions central to the understanding
      of the nature of T cell recognition and the process of thymocyte maturation.

PMID- 11213255
TI  - Regulation of plant ferritin synthesis: how and why.
AB  - Plant ferritins are key iron-storage proteins that share important structural and
      functional similarities with animal ferritins. However, specific features
      characterize plant ferritins, among which are plastid cellular localization and
      transcriptional regulation by iron. Ferritin synthesis is developmentally and
      environmentally controlled, in part through the differential expression of the
      various members of a small gene family. Furthermore, a strict requirement for
      plant ferritin synthesis regulation is attested to by alterations of the
      photosynthetic apparatus and of iron homeostasis in transgenic tobaccos
      overexpressing these proteins. Plant ferritin gene regulation appears to consist
      of a complex interplay of transcriptional and posttranscriptional mechanisms,
      involving cellular relays such as plant hormones, oxidative steps and Ser/Thr
      phosphatase.

PMID- 11213256
TI  - Arachidonic acid release by ionomycin and phorbol ester is similar in C127
      epithelial cells expressing wild-type or mutated (delta F508) cystic fibrosis
      transmembrane conductance regulator.
AB  - The Ca2+ ionophore ionomycin induced cytosolic [Ca2+ ]i elevation as well as
      strong activation of Cl- efflux in mouse mammary epithelial cell lines expressing
      wild-type or mutated (deletion of phenylalaline 508) cystic fibrosis
      transmembrane conductance regulator (CFTR) or vector. Ionomycin-induced Cl-
      efflux was abolished by the intracellular Ca2+ chelator 1,2-bis(2
      aminophenoxy)ethane-N,N,N',N'-tetraacetic acid, whereas both activators and
      inhibitors of phospholipase A2 had no effect, indicating the involvement of Ca2+
      dependent Cl- channels. Stimulation of arachidonic acid release by ionomycin and
      phorbol ester was not significantly different between wild-type or mutated cell
      lines, whereas vector-transfected cells exhibited a significant higher release,
      which was shown to be due to larger amount of immunoreactive cytosolic
      phospholipase A2. These results indicate that phospholipase A2 activity of C127
      cells was not influenced by the presence of wild-type or mutated CFTR.

PMID- 11213257
TI  - Spleen antibacterial peptides: high levels of PR-39 and presence of two forms of
      NK-lysin.
AB  - Antibacterial peptides were isolated from porcine spleen by acetic acid
      extraction, ion exchange chromatography and reverse-phase high-performance liquid
      chromatography. C-terminal ladder sequence analysis of a bioactive peptide with
      matrix-assisted laser desorption/ionization mass spectrometry after digestion
      with carboxypeptidases P and Y showed that it is identical to the antibacterial
      proline/arginine-rich intestinal peptide PR-39. It is present at high levels in
      granulocytes of the spleen, and peptides with C-terminal proline amide and
      internal adjacent Pro residues can be analyzed with this method. In addition, two
      forms of NK-lysin (NKL) were found. One, NKLi, is identical to that isolated from
      pig intestine, and the other, NKLbw, to a mature peptide deduced from a clone
      from a porcine bone marrow cDNA library.

PMID- 11213258
TI  - Small nucleolar RNAs.
AB  - Many small RNA species associate with the nucleolar structure. Some of these
      small nucleolar RNAs (snoRNAs) are required for cleavage processing of ribosomal
      RNA precursors. There are many pseudouridine residues and methylated riboses in
      mature ribosomal RNA. For most, if not all, of these modifications, each site is
      selected by base pairing with a specific snoRNA species. Some snoRNAs are needed
      for the 2'-O-ribose methylation of at least one spliceosomal small nuclear RNA.
      Many snoRNAs, particularly in yeast, are generated from independent transcription
      units. Most vertebrate snoRNAs are produced by processing of introns from protein
      coding transcripts. Some snoRNAs are made by processing of introns from non
      protein-coding transcripts.

PMID- 11213259
TI  - Epithelial antimicrobial peptides: innate local host response elements.
AB  - Multicellular organisms have to survive in an environment laden with numerous
      microorganisms, which represent a potential hazard to life. Different strategies
      have been developed to ward off infections by preventing microorganisms from
      entering surfaces and by preventing the attack of microorganisms that have
      already entered the epithelia. Therefore, it is not surprising that epithelia are
      equipped with various antimicrobial substances that act rapidly to kill a broad
      range of microorganisms. This review summarizes our present knowledge about
      epithelial peptide antibiotics produced in plants, invertebrates, and vertebrates
      including humans. There is now strong evidence that in addition to constitutively
      secreted peptide antibiotics, others are induced upon contact with microorganisms
      or by proinflammatory cytokines. beta-Defensins represent one family of
      vertebrate antimicrobial peptides, members of which are inducible and have
      recently been identified in humans. The defensin-characteristic local expression
      pattern may indicate that specialized surfaces express a characteristic surface
      antimicrobial peptide pattern that might define the characteristic microflora as
      well as the density of microorganisms present on the surface.

PMID- 11213260
TI  - Botulinum toxin as a carrier for oral vaccines.
AB  - Botulinum toxin is an unusually potent substance that acts on the nervous system
      to produce the clinical outcome of flaccid paralysis. To produce this effect, the
      toxin ordinarily proceeds through two separate but essential sequences of events.
      During the first, the toxin is ingested, it traverses a portion of the
      gastrointestinal system and then it is transcytosed from the lumen of the gut to
      the general circulation. During the second, circulating toxin binds to peripheral
      cholinergic nerve endings, it is endocytosed and then it acts as a
      metalloendoprotease to cleave polypeptides that are essential for exocytosis.
      Although botulinum toxin is antigenic, it ordinarily does not evoke an immune
      response during or after cases of oral poisoning. This is due to the fact that
      the dose of toxin that produces flaccid paralysis-and potentially death-is less
      than the dose needed to evoke an antibody response. In the recent past, the
      techniques of molecular biology have been used to generate an expression product
      of botulinum toxin that retains the ability to escape the gut and reach the
      general circulation, retains the ability to evoke an immune response, but has
      lost the ability to produce neurotoxicity. This modified toxin may have two
      clinical applications. The expression product itself may have utility as an oral
      vaccine against botulism. Beyond this, the modified toxin, or a truncation mutant
      of the toxin, may have utility as a carrier in the construction of other oral
      vaccines. Both potential applications could lead to the expression of oral
      vaccines in common foods.

PMID- 11213261
TI  - Antigen-specific T cells in autoimmune diseases with a focus on multiple
      sclerosis and experimental allergic encephalomyelitis.
AB  - Although the pathogenesis of autoimmune diseases remains poorly understood, the
      current view is that autoaggresive antigen-specific T cells play a central role
      in the cascade of events leading to most autoimmune diseases. A major event in
      the development of autoimmune diseases is the activation of antigen-specific T
      cells-how, when and where does this activation take place? This review addresses
      questions concerning the occurrence of unique autoantigens triggering autoimmune
      diseases, the factors influencing the balance between self-tolerance and
      autoaggresive immunity, and the mechanisms by which dendritic cells mediate
      immunity and tolerance to antigen-specific T cells. Knowledge of how antigen
      specific T cells are activated is now being used to develop therapeutic
      approaches to control autoimmune diseases. We discuss tolerance to antigen
      specific T cells and tolerance induction as treatment of T-cell-mediated
      autoimmune diseases. Therapeutic modalities have been established which
      selectively target the pathogenic T cells. leaving the remainder of the immune
      system intact.

PMID- 11213262
TI  - Netrins and netrin receptors.
AB  - The formation of precise connections between neurons and their targets during
      development is dependent on extracellular guidance cues that allow growing axons
      to navigate to their targets. One family of such guidance molecules. conserved
      across all species examined, is that of the netrin/UNC-6 proteins. Netrins act to
      both attract and repel the growing axons of a broad range of neuronal cell types
      during development and are also involved in controling neuronal cell migration.
      These actions are mediated by specific receptor complexes containing either the
      colorectal cancer (DCC) or neogenin protein, in the case of the attractive
      receptor, or UNC-5-related proteins, in the case of the repellent receptor.
      Recent work has identified a key role for intracellular cyclic nucleotide levels
      in regulating the nature of the response of the growing axon to netrins as either
      attractive or repulsive. Netrin-DCC signaling has also been shown to regulate
      cell death in epithelial cells in vitro, raising the interesting possibility that
      netrins may also regulate cell death in the developing nervous system.

PMID- 11213263
TI  - Memory T lymphocytes.
AB  - Immunological memory protects organisms from recurrent challenge by pathogens.
      The persistence of a heightened reactive state initiated by antigenic challenge
      is mediated by long-lived memory lymphocytes. The survival of memory T cells is
      thought to require stimulation through the T cell receptor (TCR), sometimes by
      persistent antigen. However, memory T cells can survive in the absence of
      antigen, in which case TCR stimulation provided by cell surface self-peptide/
      major histocompatibility complex (MHC) molecules and cytokines are required to
      sustain memory T cells. Recent work using mouse models has provided insights into
      the origin of memory T cells. Understanding the mechanisms that underlie the
      differentiation and persistence of memory T cells may improve the effectiveness
      of vaccines through the induction of T cell memory.

PMID- 11213264
TI  - alpha-Endosulfine, a new entity in the control of insulin secretion.
AB  - ATP-dependent potassium (K ATP) channels occupy a key position in the control of
      insulin release from the pancreatic beta cell since they couple cell polarity to
      metabolism. These channels close when more ATP is produced via glucose
      metabolism. They are also controlled by sulfonylureas, a class of drugs used in
      type 2 diabetic patients for triggering insulin secretion from beta cells that
      have lost part of their sensitivity to glucose. We have demonstrated the
      existence of endogenous counterparts to sulfonylureas which we have called
      'endosulfines.' In this review, we describe the discovery, isolation, cloning,
      and biological features of the high-molecular-mass form, alpha-endosulfine, and
      discuss its possible role in the physiology of the beta cell as well as in
      pathology.

PMID- 11213265
TI  - Evolution of the genetic code, protein synthesis and nucleic acid replication.
AB  - A better definition of the structural and thermodynamic determinants of the
      interaction of nucleic acids with proteins is shedding light on the origin of the
      genetic code, protein synthesis, and nucleic acid replication. This is also
      allowing to show a consistent biochemical framework for the appearance of these
      fundamental synthetic mechanisms. This article reviews recent significant
      developments in the field, and discusses an integrated model for a biochemically
      plausible evolution of these fundamental mechanisms of synthesis. This model is
      based on sequence-specific interactions between abiotically synthesized
      polynucleotides and polypeptides, and can account for a coordinate evolution of
      the genetic code, protein synthesis, and nucleic acid replication in living
      cells.

PMID- 11213266
TI  - Evolutionary diversification of the mammalian defensins.
AB  - Defensins are cysteine-rich cationic peptides that function in antimicrobial
      defense in both invertebrates and vertebrates. Three main groups of animal
      defensins are known: insect defensins; mammalian alpha-defensins and vertebrate
      beta-defensins. It has been difficult to determine whether these molecules are
      homologous or have independently evolved similar features, but overall the
      evidence favors a distant relationship. The best evidence of this relationship is
      structural, particularly from their overall three-dimensional structure and from
      the spacing of half-cystine residues involved in intra-chain disulfide bonds.
      Some evidence favors a closer relationship between vertebrate beta-defensins and
      insect defensins than between the two groups of vertebrate defensins. Examination
      of nucleotide substitutions between recently duplicated mammalian defensin genes
      shows that the rate of nonsynonymous (amino-acid-altering) substitution exceeds
      that of synonymous substitution in the region of the gene encoding the mature
      defensin. This highly unusual pattern of nucleotide substitution is evidence that
      natural selection has acted to diversify defensins at the amino acid level. The
      resulting rapid evolution explains why it is difficult to reconstruct the
      evolutionary history of these molecules.

PMID- 11213267
TI  - Interpretation, design, and analysis of gene array expression experiments.
AB  - Experiments using arrays of cDNA targets to compare patterns of gene expression
      are beginning to play a prominent role in biogerontology, but drawing reliable
      conclusions from the resulting data sets requires careful application of
      statistical methods that discriminate chance events from those likely to reflect
      real differences among the samples under study. This essay discusses flaws in the
      logic of studies that base their conclusions on ratio calculations alone, reviews
      the multiple comparison traps inherent in high throughput systems that test a
      very large number of mRNAs simultaneously, and advocates a two-stage design in
      which significance testing applied to exploratory data is used to guide a second
      round of hypothesis-testing experiments conducted in a separate set of
      experimental samples.

PMID- 11213268
TI  - Age, fatigue, and excitation-contraction coupling in masseter muscles of rats.
AB  - The purpose of this study was to determine if masseter muscle endurance changes
      with increasing age and, if so, to examine mechanisms of fatigue. Characteristics
      of fatigue were measured under isometric conditions using high-frequency
      stimulation of anterior deep masseter (ADM) muscles of male Fischer 344 rats, 5
      to 24 months old, and fed a hard (HD) or a soft (SD) diet. Potentiating effects
      of caffeine on ADM muscle performance in vitro were also examined. Fatigability
      increased by 48% with age in muscles of HD rats. Muscles of SD rats were highly
      fatigable at all ages. Increased HD fatigability was associated with
      significantly decreased concentrations of Na+/K+-adenosine triphosphatase (22%)
      and decreased responsiveness to caffeine postfatigue (29%). The pH levels
      decreased similarly in fatigued muscles of all groups. We conclude that the age
      related increase in fatigability is associated with alterations in excitation
      contraction coupling mechanisms. However, differences between SD and HD on ADM
      muscles represent possible fiber-type transitions.

PMID- 11213269
TI  - Age-related differences in hippocampal extracellular fluid glucose concentration
      during behavioral testing and following systemic glucose administration.
AB  - Recent evidence indicates that the level of glucose in the brain's extracellular
      fluid (ECF) is not constant, as traditionally thought, but fluctuates. We
      determined the effect of aging on hippocampal ECF glucose before, during, and
      after spatial memory testing. Fischer-344 rats (24 months old) showed a greater
      decrease in ECF glucose than 3-month-old rats (48% vs 12%); the decrease seen in
      24-month-old rats persisted for much longer following testing. These changes were
      associated with an age-related deficit in spontaneous alternation performance.
      Following systemic glucose administration, the decrease in ECF glucose was
      reversed in both aged and young rats, and performance in aged versus young rats
      following glucose administration did not differ. These findings suggest that
      increased susceptibility to depletion of ECF glucose in aged rats may contribute
      to age-related deficits in learning and memory and that administration of glucose
      may enhance memory by providing additional glucose to the brain at times of
      increased cognitive demand.

PMID- 11213270
TI  - Array-based expression analysis of mouse liver genes: effect of age and of the
      longevity mutant Prop1df.
AB  - Ames dwarf mice, homozygous for the df allele at the Prop1 locus, live 40% to 70%
      longer than nonmutant siblings and represent the first single-gene mutant that
      extends life span in a mammal. To gain insight into the basis for the longevity
      of the Ames dwarf mouse, we measured liver mRNA levels for 265 genes in a group
      of 11 df/df mice, (three to four mice per age group), at ages 5, 13, and 22
      months, and in 13 age- and sex-matched control mice. The analysis showed seven
      genes where the effects of age reach p < .01 in normal mice and six others with
      possible age effects in dwarf mice, but none of these met Bonferroni-adjusted
      significance thresholds. Thirteen genes showed possible effects of the df/df
      genotype at p < .01. One of these, insulin-like growth factor 1 (IGF-1), was
      statistically significant even after adjustment for multiple comparisons; and
      genes for two IGF-binding proteins, a cyclin, a heat shock protein, p38 mitogen
      activated protein kinase, and an inducible cytochrome P450 were among those
      implicated by the survey. In young control mice, half of the expressed genes
      showed SDs that were more than 58% of the mean, and a simulation study showed
      that genes with this degree of interanimal variation would often produce false
      positive findings when conclusions were based on ratio calculations alone (i.e.,
      without formal significance testing). Many genes in our data set showed apparent
      young-to-old or normal-to-dwarf ratios above 2, but the large majority of these
      proved to be genes where high interanimal variation could create high ratios by
      chance alone, and only a few of the genes with large ratios achieved p < .05. The
      proportion of genes showing relatively large changes between 5 and 13 months, or
      from 13 to 22 months of age, was not diminished by the df/df genotype, providing
      no support for the idea that the dwarf mutation leads to global delay or
      deceleration of the pace of age-dependent changes in gene expression. These
      survey data provide the foundation for replication studies that should provide
      convincing proof for age- and genotype-specific effects on gene expression and
      thus reveal key similarities among the growing number of mouse models of
      decelerated aging.

PMID- 11213271
TI  - Interleukin-6 production does not increase with age.
AB  - Investigators have reported an increase, decrease, or no effect of age on
      interleukin-6 (IL-6) production. Differences in experimental conditions and the
      health status of subjects may explain these contradicting results. Because the
      subjects used in most of the previous studies were not carefully screened for
      health, we investigated the effect of age on IL-6 production in healthy young and
      elderly subjects. Twenty young (aged 20-30 years) and 26 elderly (>65 years) men
      completed the study. Each subject was screened for good health, undergoing
      physical examinations and laboratory tests. Circulating IL-6 levels were not
      significantly different between young and elderly subjects. A subgroup of
      subjects representing both young and elderly volunteers had high (>1000 pg/ml)
      circulating levels of IL-6. However, circulating IL-6 levels were low (<100
      pg/ml) in the majority of subjects in both age groups. Peripheral blood
      mononuclear cells (PBMC) were cultured for IL-6 production in the presence or
      absence of phytohemagglutinin (PHA) or concanavalin (Con)A for 48 hours.
      Unstimulated secretion of IL-6 by PBMC cultured in autologous plasma (AP) or
      fetal bovine serum (FBS) was detectable in the majority of cultures. Age did not
      influence this spontaneous secretion of IL-6. PBMC stimulation with PHA or ConA
      significantly increased IL-6 production, but age did not affect the ability of
      PBMC to secrete IL-6 after stimulation when cultured in FBS. IL-6 production by
      PBMC cultured in AP and stimulated with PHA was not affected by age. However,
      when stimulated with ConA, PBMC from the elderly subjects produced less IL-6 than
      PBMC from the young subjects. Because IL-6 has been suggested to contribute to
      the age-related increase in prostaglandin (PG)E2 and nitric oxide (NO)
      production, we investigated the effect of age on the production of IL-6 by murine
      peritoneal macrophages (Mphi) as well as the effect of IL-6 on the production of
      other Mphi inflammatory products. Similar to the findings in humans, mouse age
      did not influence the level of IL-6 produced by Mphi. These data suggest that in
      healthy subjects, increased production of IL-6 is not a normal consequence of
      aging. Previously reported higher IL-6 levels in elderly subjects might reflect
      an underlying, undiagnosed disease state. PGE2 and NO production were not
      affected by the addition of IL-6 to Mphi from young mice or anti-IL-6 antibody to
      Mphi from old mice. Thus, IL-6 does not appear to influence the Mphi production
      of selected inflammatory molecules.

PMID- 11213273
TI  - The effects of a collaborative model of primary care on the mortality and
      hospital use of community-dwelling older adults.
AB  - BACKGROUND: This study evaluates the ability of a model of collaborative primary
      care practice to reduce mortality and hospital use in community-dwelling elderly
      persons. METHODS: Four rural and four urban clinic sites in east central Illinois
      were randomized to form treatment and comparison clinics from which patients were
      enrolled and followed prospectively for 2 years. Patients from the practices of
      participating physicians were eligible if they were aged 65 and older, were
      living in the community, and had at least one risk factor as determined prior to
      the study. Medicare hospital data were obtained from the Health Care Financing
      Administration. Demographic and health status measures were obtained by telephone
      interview every 12 months throughout the study. RESULTS: The treatment group
      experienced a 49% reduction in all-cause mortality during the second year of the
      study (odds ratio, 0.51, 95% confidence interval, 0.29-0.91, p = .02). There were
      no significant differences between treatment and comparison patients in
      percentage of persons hospitalized, hospital length of stay, or Medicare
      payments. Although measures of health status indicated that the treatment group
      was significantly sicker at baseline at the end of 1 year, these differences
      disappeared by the end of 2 years. CONCLUSIONS: The collaborative primary care
      model evaluated in this study significantly reduced mortality in the second year,
      without increasing hospital use. These findings suggest that a collaborative
      primary care team that enhances primary care practice can result in better
      patient outcomes.

PMID- 11213272
TI  - Female sensitivity to diet and irradiation treatments underlies sex-mortality
      differentials in the Mediterranean fruit fly.
AB  - Large-scale experiments on medflies that were subjected to sterilizing doses of
      ionizing radiation (plus intact controls) and maintained on either sugar-only or
      full, protein-enriched diets revealed that, whereas the mortality trajectories of
      both intact and irradiated male cohorts maintained on both diets are similar, the
      mortality patterns of females are highly variable. Mean mortality rates at 35
      days in male cohorts ranged from 0.2 to 0.3 but in female cohorts ranged from
      0.09 to 0.35, depending on treatment. The study reports three main influences:
      (a) qualitative differences exist in the sex-mortality response of medflies
      subjected to dietary manipulations and irradiation; (b) the female mortality
      response is linked to increased vulnerability due to the nutritional demands of
      reproduction; and (c) female sensitivity to environmental changes underlies the
      dynamics of the sex-mortality differential.

PMID- 11213274
TI  - Sildenafil citrate (VIAGRA) improves erectile function in elderly patients with
      erectile dysfunction: a subgroup analysis.
AB  - BACKGROUND: The prevalence of erectile dysfunction (ED) increases with advancing
      age, with a particularly high prevalence of ED in elderly patients with diabetes.
      In the United States it is estimated that approximately 45% of men aged 65 to 69
      years have moderate or complete ED. The efficacy and safety of oral sildenafil
      (VIAGRA) for treating ED in elderly men (aged > or = 65 years or older) were
      assessed. METHODS: We analyzed data obtained from five double-blind, placebo
      controlled studies of the efficacy and tolerability of oral sildenafil taken as
      required (but not more than once daily) over a 12-week to 6-month period. Two
      subgroups were evaluated: (i) elderly patients with ED of broad-spectrum etiology
      (n = 411), and (ii) elderly patients with ED and diabetes (n = 71). Efficacy was
      assessed using a global efficacy question, questions 3 and 4 of the International
      Index of Erectile Function (IIEF). and the five sexual function domains of the
      IIEF. RESULTS: All efficacy assessments indicated that sildenafil significantly
      improved erectile function both in elderly patients with ED of broad-spectrum
      etiology and in elderly patients with ED and diabetes. The most common adverse
      events were mild-to-moderate headache, flushing, and dyspepsia. The rates of
      discontinuation due to adverse events were low and were comparable to the rates
      with placebo. CONCLUSIONS: Sildenafil is an efficacious and well-tolerated
      treatment for ED in elderly men.

PMID- 11213275
TI  - Infections in nursing homes: assessing quality of care.
AB  - BACKGROUND: Each year more than 25% of nursing home patients are taken to the
      hospital emergency room or hospitalized for the evaluation and treatment of
      infections. These transfers may have an adverse impact on the quality and the
      cost of patient care. METHODS: Using both Medicare and Medicaid records from a
      sample of dually eligible elderly people in Ohio, we identified patients
      receiving antibiotic prescriptions in the nursing home and measured the frequency
      of nursing home physician visits and the hospital transfer rate. RESULTS: Among
      the study sample (N = 1306), two thirds experienced a total of 3685 episodes of
      infections. Just under 5% of the sample were hospitalized as a result of the
      infection. In one third of the episodes, physicians saw the resident in person
      within 5 days (before or after) of the initiation of the medication. The hospital
      transfer rate was slightly higher (7% vs 3.5%) for those patients directly
      evaluated by a physician before receiving the prescription. CONCLUSIONS: A
      majority of prescriptions were written without direct physician examination,
      raising key questions about practice patterns and the effect on patient care and
      costs.

PMID- 11213276
TI  - Aging-related growth hormone (GH) decrease is a selective hypothalamic GH
      releasing hormone pulse amplitude mediated phenomenon.
AB  - BACKGROUND: Aging is accompanied by declining growth hormone (GH) and insulin
      like growth factor-I (IGF-I) levels. The neuroendocrine mechanisms of this
      decline have been studied previously, but the interpretation of the data was
      confounded by the imprecision in GH measurements and by the intervening variables
      of altered body composition and decreased gonadal steroid milieu in the elderly
      subjects of both sexes. METHODS: To study the contribution of aging per se, we
      evaluated discrete parameters of GH pulsatility in young (n = 8 women, n = 8 men)
      and elderly (n = 11 women, in 10 men) subjects closely matched for body mass
      index. Blood samples for GH were obtained every 10 minutes for 24 hours. Plasma
      GH was measured by a sensitive chemiluminescent assay. GH pulsatility was
      assessed using cluster analysis. RESULTS: The elderly subjects had plasma IGF-I
      levels and integrated GH concentrations that were 32% to -56% of their sex
      matched younger counterparts. The age-associated attenuation in GH was due to a
      decrease in GH pulse amplitude, whereas pulse frequency and nadir levels were
      unchanged. The majority of the young subjects (81%) reached their peak GH during
      the "lights off" period, whereas the majority of the elderly subjects (62%)
      peaked during the "lights on" period (p = .01). CONCLUSIONS: We conclude that
      aging in both sexes is accompanied by profound decreases in GH output and in
      plasma IGF-I concentrations. This effect is separate from the alterations in body
      mass index that accompany the normal aging process. Attenuation of GH output
      associated with aging is related solely to the lower GH and, by inference, GH
      releasing hormone (GHRH) pulse amplitude.

PMID- 11213277
TI  - Genetic and phenotypic markers among centenarians.

PMID- 11213278
TI  - What do the serum proteins tell us about our elderly patients?

PMID- 11213279
TI  - Longevity and the epsilon2 allele of apolipoprotein E: the Finnish Centenarians
      Study.
AB  - BACKGROUND: Whether and which genetic factors affect human longevity is unclear.
      This study assesses the association between the epsilon2 allele of apolipoprotein
      E (APOE), a putative longevity gene, and extremely old age. METHODS: This study
      is based on all centenarians living in Finland in 1991. Subjects were 179 persons
      (28 men and 151 women) aged 100 years and older (response rate, 97%). RESULTS:
      The percentages of epsilon2-allele carriers in persons aged 100 to 101, 102 to
      103, and 104 years and older were 9% (10/117), 21% (9/42), and 25% (5/20; gender
      adjusted p for trend = .01), respectively. The effect was particularly strong in
      women: 8% (8/100), 18% (6/33), and 28% (5/18; p for trend = .01) by age group,
      respectively. Low cell numbers prevented clear conclusions being drawn for men.
      Seventeen percent (30/179) of the adult Finnish population were carriers of the
      epsilon4 allele, a figure lower than expected, and stable by age group.
      CONCLUSIONS: Carriers of the epsilon2 allele of APOE might be predisposed to
      reach extremely old age.

PMID- 11213280
TI  - Serum insulin-like growth factor-1 in centenarians: implications of IGF-1 as a
      rapid turnover protein.
AB  - BACKGROUND: It is well documented that serum insulin-like growth factor 1 (IGF-1)
      levels as well as growth hormone secretion decline with advancing age. Low levels
      of IGF-1 are shown to be associated with low activity of growth hormone, low lean
      mass, and high body fat mass; however, in the elderly, the relationship has not
      been confirmed. METHODS: We studied serum IGF-1 levels in 49 centenarians, who
      are at the ultimate stage of physiological senescence, and investigated the
      possible relationship between IGF-1 and body mass index, lipid parameters,
      nutritional indices, physical and cognitive function, and frequency of hip
      fracture. As nutritional indices, serum levels of albumin, prealbumin,
      transferrin, and retinol binding protein were measured. Cognitive function of the
      centenarians was assessed by clinical dementia rating. RESULTS: In the
      centenarians, the mean levels of IGF-1 were relatively low, indicating that there
      is an age-associated decline in IGF-1 even in the extremely old age. We
      demonstrated a strong association of IGF-1 with prealbumin and retinol binding
      protein (r2 = .192, .195, respectively); however, there was no association with
      albumin, transferrin, or body mass index. Interestingly, centenarians with lower
      IGF-1 levels had a higher prevalence of definitive dementia. CONCLUSIONS: These
      data suggest that serum IGF-1 levels in the centenarians appeared to reflect
      their short-term nutritional status as a rapid turnover protein. It is also
      suggested that low levels of serum IGF-1 may be involved in the progression of
      dementia in the oldest old.

PMID- 11213281
TI  - Searching for human longevity genes: the future history of gerontology in the
      post-genomic era.
AB  - Over the last 30 years, a number of genetic and environmental factors that lead
      to decreased length of life have been identified. Unfortunately, much less
      progress has been achieved in identifying genes associated with longevity that
      protect from common diseases or slow the aging process. Recent compelling
      evidence supports a role for important genetic and environmental interactions on
      longevity in lower organisms. Although less is known in humans, commonality in
      molecular and biological processes, evolutionary arguments, and epidemiological
      data would strongly suggest that similar mechanisms also apply. The completion of
      the Human Genome Project and the rapid innovations in technology will make
      possible the identification of human longevity-assurance genes. This article
      reviews such evidence, its implications for the identification of human longevity
      assurance genes, and the significance of finding longevity genes to human health
      and disease.

PMID- 11213282
TI  - Heart failure in the 21st century: a cardiogeriatric syndrome.
AB  - Chronic heart failure (CHF) is principally a cardiogeriatric syndrome, and it has
      become a major public health problem in the 21st century due largely to the aging
      population. Age-related changes throughout the cardiovascular system in
      combination with the high prevalence of cardiovascular diseases at older age
      predispose older adults to the development of CHF. Features that distinguish CHF
      at advanced age from CHF occurring during middle age include an increasing
      proportion of women, a shift from coronary heart disease to hypertension as the
      most common etiology, and the high percentage of cases that occur in the setting
      of preserved left ventricular systolic function. Although the pharmacotherapy of
      CHF is similar in older and younger patients, the presence of multiple
      comorbidities in older patients mandates a multidisciplinary approach to care.
      Manifest CHF is associated with a poor prognosis, especially in elderly persons,
      and there is an urgent need to develop more effective strategies for the
      prevention and treatment of this increasingly common disorder to reduce the
      individual and societal burden of this devastating illness in the decades ahead.

PMID- 11213283
TI  - Effects of housing relocation on immunocompetence and psychosocial functioning in
      older adults.
AB  - BACKGROUND: The psychological and physical response to moderate life stressors
      among older adults has not been well characterized. This research examines
      effects of voluntary housing relocation on distress and immune function in
      healthy older adults as a model for studying the effects of moderate life stress.
      METHODS: Thirty older adults moving to congregate living facilities were assessed
      1 month premove, 2 weeks postmove, and 3 months postmove. Twenty-eight nonmoving
      control subjects were assessed at similar time points. Subjects completed
      psychosocial questionnaires and had early morning blood draws in their homes.
      Blood samples were assayed for natural killer cell cytotoxicity (NKCC),
      interleukin-6 (IL-6), and IgG antibody titers to the Epstein Barr virus (EBV)
      viral capsid antigen. RESULTS: Movers demonstrated decreased vigor and elevated
      thought intrusion 1 month premove and 2 weeks postmove. By the 3-month follow-up,
      vigor increased, and intrusion decreased to levels commensurate with the
      controls. Averaged across all time points, movers showed lower NKCC than
      controls; however, post-hoc analyses indicate that by the 3-month follow-up time
      point, these differences were no longer significant. There were no differences
      between groups in IL-6 or in EBV antibody titers. Independent of the effects of
      group, higher levels of vigor were associated with greater NKCC at all
      assessments and with lower EBV titers at 2 weeks postmove. CONCLUSIONS: Findings
      suggest that in general, healthy older adults recover well psychologically from
      moderate. temporary life stressors such as moving. Whereas movers showed
      generally lower NKCC than controls, IL-6 and EBV antibody titers appeared not to
      be strongly affected by the stress of moving.

PMID- 11213285
TI  - Quinolactacins A, B and C: novel quinolone compounds from Penicillium sp. EPF-6.
      II. Physico-chemical properties and structure elucidation.
AB  - Three novel quinolone compounds, quinolactacins A (1), B (2) and C (3), have been
      found from the fermentation broth of Penicillium sp. EPF-6, a fungus isolated
      from the larvae of mulberry pyralid (Margaronia pyloalis Welker). The molecular
      formulas of 1, 2 and 3 were determined to be C16H18N2O2, C15H16N2O2 and
      C16H18N2O3, respectively by FAB-MS and NMR spectral analyses. The structures of
      these compounds have a novel quinolone skeleton with a gamma-lactam ring
      consisting of C12H8N2O2 as the common chromophore.

PMID- 11213284
TI  - Quinolactacins A, B and C: novel quinolone compounds from Penicillium sp. EPF-6.
      I. Taxonomy, production, isolation and biological properties.
AB  - Quinolactacins A (1), B (2) and C (3), novel quinolone antibiotics have been
      found from the cultured broth of a fungal strain isolated from the larvae of the
      mulberry pyralid Margaronia pyloalis Welker). The fungal strain, EPF-6 was
      identified as Penicillium sp. from its morphological characteristics.
      Quinolactacins were obtained from the culture medium by solvent extraction and
      chromatographic purification. Compound 1 showed inhibitory activity against tumor
      necrosis factor (TNF) production induced by murine peritoneal macrophages and
      macrophage-like J774.1 cells stimulated with lipopolysaccharide (LPS).

PMID- 11213286
TI  - Biosynthetic intermediates of the tetradehydro cyclic dipeptide albonoursin
      produced by Streptomyces albulus KO-23.
AB  - The cell-free extract of an albonoursin-producing strain Streptomyces albulus KO
      23 catalyzes the conversion of cyclo(L-Leu-L-Phe) (1) to albonoursin (2). At the
      early stage of this conversion, two compounds were newly formed prior to
      albonoursin synthesis in the reaction mixture. These compounds were isolated and
      identified as (Z)-3-benzylidene-6-isobutyl-2,5-piperazinedione (4) and (Z)-3
      benzyl-6-isobutylidene-2,5-piperazinedione (3). The cell-free extract also
      catalyzed the conversion of compound 3 or 4 to albonoursin. From these results,
      albonoursin was found to be biosynthesized via these compounds from cyclo(L-Leu-L
      Phe). These didehydro diketopiperazines exhibited no inhibitory activity toward
      the first cleavage of sea urchin embryo in contrast to the higher cytotoxicity
      for albonoursin, indicating that dehydrogenation at alpha,beta-positions of both
      amino acid residues in diketopiperazines is required for cytotoxicity.

PMID- 11213287
TI  - Blasticidin A as an inhibitor of aflatoxin production by Aspergillus parasiticus.
AB  - Blasticidin A, an antibiotic, showed strong inhibitory activity toward aflatoxin
      production by Aspergillus parasiticus. Its structure was characterized by NMR and
      chemical degradation experiments as 1, which is a tetramic acid derivative with a
      highly oxygenated long alkyl chain similar to aflastatin A (2). Absolute
      configurations of the eight chiral centers at C-4, 6, 31, 32, 33, 34, 35 and 37
      of 1 were chemically determined. Blasticidin A almost completely inhibited
      aflatoxin production at 0.5 microM.

PMID- 11213288
TI  - Discovery of RWJ-54428 (MC-02,479), a new cephalosporin active against resistant
      gram-positive bacteria.
AB  - The discovery of RWJ-54428 (MC-02,479), a new cephalosporin displaying promising
      activity against sensitive and resistant Gram-positive bacteria, is described.
      Progressive structural modification from the previously reported 3
      phenylthiocephem MC-02,331 afforded an overall increase in potency against MRSA
      while retaining other key properties such as acceptable solubility and serum
      binding. Evaluation of the in vitro potency and in vivo efficacy of a series of
      closely related compounds resulted in selection of RWJ-54428 (MC-02,479) for
      further studies.

PMID- 11213289
TI  - Synthesis and activity of analogues of SB-219383: novel potent inhibitors of
      bacterial tyrosyl tRNA synthetase.
AB  - SB-219383 is a naturally occurring antibiotic, which acts by inhibition of
      tyrosyl tRNA synthetase. Semi-synthetic derivatives of SB-219383 were prepared
      with the objective of elucidating the key features required for inhibition of
      tyrosyl tRNA synthetase in order to improve the antibacterial activity. Some
      ester and amide derivatives as well as monocyclic analogues exhibited sub
      nanomolar inhibitory activity against tyrosyl tRNA synthetase.

PMID- 11213290
TI  - Aureoquinone, a new protease inhibitor from Aureobasidium sp.

PMID- 11213291
TI  - Waol B, a new trihydrofuran derivative with cytocidal activity, isolated from
      Myceliophthora lutea.

PMID- 11213292
TI  - Biosynthesis of the fungal polyketide antibiotics TMC-151s: origin of the carbon
      skeleton.

PMID- 11213293
TI  - Synthesis and antibacterial activities of novel C(3)-aminopyrimidinyl substituted
      cephalosporins.

PMID- 11213295
TI  - Laccaridiones A and B, new protease inhibitors from Laccaria amethystea.

PMID- 11213294
TI  - Reblastatin, a novel benzenoid ansamycin-type cell cycle inhibitor.

PMID- 11213296
TI  - Argimicin A, a novel anti-cyanobacterial compound produced by an algae-lysing
      bacterium.

PMID- 11213297
TI  - Adolf Windaus--Nobel Prize for research on sterols.

PMID- 11213298
TI  - Reducing the health burden of tobacco use: what's the doctor's role?

PMID- 11213299
TI  - Residential (inpatient) treatment compared with outpatient treatment for nicotine
      dependence.
AB  - OBJECTIVE: To compare smoking abstinence outcomes between smokers treated in a
      residential (inpatient) program and those treated in an outpatient program to
      determine if residential treatment was superior to outpatient treatment in
      smokers with moderate to severe nicotine dependence. PATIENTS AND METHODS:
      Patients treated in the residential nicotine dependence program at the Mayo
      Clinic, Rochester, Minn., between May 1, 1992, and January 31, 1996, were
      selected for this study. Each patient in the residential treatment group (n=146)
      was matched to 2 patients who received an outpatient nicotine dependence
      consultation by a trained counselor (n=292). Each patient was matched on age,
      sex, year seen, number of cigarettes smoked per day, longest previous abstinence,
      education, and marital status. Abstinence at 6 and 12 months was determined by
      self-report. For the purposes of analysis, each patient with missing outcome data
      was considered to be smoking. RESULTS: The 6-month abstinence rates for the
      residential group compared with the outpatient group were 45% and 26%,
      respectively (P<.001), and the 12-month abstinence rates were 45% and 23%,
      respectively (P<.001). After adjusting for matching variables that were not
      exactly matched (age, baseline number of cigarettes smoked per day, and longest
      previous abstinence) and the baseline variables, including education, age when
      started smoking, and degree of nicotine dependence, there was a significant
      effect of residential treatment on 6- and 12-month abstinence rates (P<.001).
      Odds ratio of 6-month abstinence in the residential group was 2.74 (95%
      confidence interval, 1.60-4.71; P<.001) and at 12 months was 3.03 (95% confidence
      interval, 1.74-5.27; P<.001). CONCLUSION: Residential treatment for tobacco
      dependence is superior to outpatient treatment in some smokers who are moderately
      to severely nicotine dependent.

PMID- 11213300
TI  - Attitudes of Olmsted County, Minnesota, residents about tobacco smoke in
      restaurants and bars.
AB  - OBJECTIVE: To determine the attitudes of Olmsted County, Minnesota, adults about
      environmental tobacco smoke in restaurants, bars, and nightclubs. SUBJECTS AND
      METHODS: In this population survey,2014 adults were contacted by random digit
      dial methods between February 28 and May 5, 2000, and asked to participate in a
      telephone survey; 1224 (61%) consented. RESULTS: For the 57% (95% confidence
      interval [CI], 54%-60%) of the study population that reported exposure to
      environmental tobacco smoke, the most frequently reported sites of exposure were
      restaurants (44% [95% CI, 41%-48%]), work (21% [95% CI, 18%-24%]), and bars (19%
      [95% CI, 16%-22%]). Seventy-two percent (95% CI, 69%-74%) of respondents said
      that they would select a smoke-free restaurant over one where smoking is
      permitted, and 70% (95% CI, 67%-72%) said that they would select a smoke-free bar
      over one where smoking is permitted. The majority of respondents said that they
      would not dine out or visit bars or nightclubs more often or less often if all
      restaurants, bars, and nightclubs were smoke-free. CONCLUSIONS: Olmsted County
      residents prefer smoke-free restaurants, bars, and nightclubs.

PMID- 11213301
TI  - Patient satisfaction and discussion of smoking cessation during clinical visits.
AB  - OBJECTIVE: To learn whether patients who smoke and who receive smoking cessation
      information during medical office visits were less likely to be satisfied with
      the smoking cessation help they received than patients who smoke but who did not
      receive such information. PATIENTS AND METHODS: A total of 3703 current cigarette
      smokers were identified by a mailing in November 1998 to 163,596 members of 2
      Minnesota health plans, and 2714 (77.3%) responses to a 44-item questionnaire
      were available for analysis. Using hierarchical analysis to control confounding
      variables, we assessed the relationship between patient-reported smoking
      cessation support actions at the last physician visit and satisfaction "with the
      help received from your doctor about quitting smoking." RESULTS: Smokers were
      very satisfied (12.0%), satisfied (25.3%), neutral (48.6%), and dissatisfied or
      very dissatisfied (13.5%) with physician help. After controlling for other
      characteristics, the 1898 patients who reported that they had been asked about
      tobacco use or advised to quit during the latest visit had 10 percentage point
      greater satisfaction ratings and 5 percentage point less dissatisfaction than
      those not reporting such discussions (P<.001). Smokers reporting no interest in
      quitting at the time of the latest visit also demonstrated greater satisfaction
      in association with these actions. CONCLUSION: Smoking cessation interventions
      during physician visits were associated with increased patient satisfaction with
      their care among those who smoke. This information should reduce concerns of
      physicians or nurses about providing tobacco cessation assistance to patients
      during office visits.

PMID- 11213302
TI  - A free smoking intervention clinic initiated by medical students.
AB  - OBJECTIVE: To describe a medical student-run smoking intervention clinic, report
      initial outcomes, and assess medical student competence in smoking intervention
      counseling. PATIENTS AND METHODS: Volunteer medical students of Mayo Medical
      School in Rochester, Minn, staffed a free smoking intervention clinic in
      conjunction with the Salvation Army Free Acute Care Clinic between December 1997
      and January 1999. Patients received a comprehensive intervention for smoking that
      comprised counseling, frequent follow-up contact, and pharmacologic therapy,
      including bupropion and nicotine replacement. Eighty-eight patients seen during
      the first 13 months of the clinic's operation and 30 medical student volunteer
      counselors were included in the study. Patients were contacted via telephone to
      assess 6-month self-reported smoking abstinence. Medical student counselors
      completed a self-assessment questionnaire surveying competence before and after
      working in the clinic. RESULTS: The 6-month self-reported smoking abstinence rate
      was 18% (95% confidence interval, 11%-28%). Twelve of 14 medical students
      completing the survey reported improved competence in smoking intervention
      counseling. CONCLUSIONS: A comprehensive smoking intervention program provided by
      medical students yielded smoking abstinence rates comparable to other treatment
      programs. Medical students believed they improved their smoking cessation
      counseling skills.

PMID- 11213303
TI  - Doppler hemodynamics of 51 clinically and echocardiographically normal pulmonary
      valve prostheses.
AB  - OBJECTIVE: To determine the normal Doppler hemodynamics of various pulmonary
      valve prostheses (PVPs). PATIENTS AND METHODS: We retrospectively analyzed
      comprehensive Doppler echocardiographic examinations of 51 patients (mean age,
      27.8 years; range, 1-59 years) with PVPs that were normal on clinical and 2
      dimensional echocardiographic examinations to establish the normal hemodynamics
      of various types and sizes of PVPs. The earliest complete postoperative
      transthoracic echocardiogram was identified for each patient. Doppler
      examinations were analyzed for peak instantaneous velocity, right ventricular
      outflow tract velocity, and peak and mean systolic gradient. The frequency of
      prosthetic regurgitation was also noted. RESULTS: The average +/- SD peak
      instantaneous velocity for all PVPs was 2.24+/-0.6 m/s, with an average peak
      systolic gradient of 20.4+/-10.4 mm Hg and an average mean systolic gradient of
      11.0+/-5.1 mm Hg. The mean right ventricular outflow tract velocity was 1.0+/-0.2
      m/s. Pulmonary homografts were found to have significantly lower peak velocities
      (average, 1.8+/-0.6 m/s) than all heterografts combined (average, 2.4+/-0.5 m/s;
      P=.002). Prosthetic regurgitation was more common in pulmonary homografts (88%)
      than in heterografts combined (29%; P<.001). CONCLUSION: This study establishes
      the normal range for Doppler hemodynamics of various PVPs, specifically
      homografts and heterografts, in both pediatric and adult patients.

PMID- 11213304
TI  - Adrenal hemorrhage: a 25-year experience at the Mayo Clinic.
AB  - OBJECTIVE: To characterize the clinical course of adrenal hemorrhage (AH) by
      using a systematic review of the presentation, associated conditions, and
      outcomes in patients with AH seen at our institution between 1972 and 1997 (a 25
      year period). PATIENTS AND METHODS: A computer search of recorded dismissal
      diagnoses identified 204 patients with a diagnosis of AH, but only 141 fulfilled
      our study criteria. Their records were analyzed systematically by presentation,
      bilateral or unilateral hemorrhage, corticosteroid treatment, and survival.
      RESULTS: AH is a heterogeneous entity that occurs in the postoperative period, in
      the antiphospholipid-antibody syndrome, in heparin-associated thrombocytopenia,
      or in the setting of severe physical stress and multiorgan failure. Standard
      laboratory evaluation is not helpful in establishing the diagnosis. Of the 141
      cases of AH, 78 were bilateral, and 63 were unilateral. Corticosteroid treatment
      in situations of severe stress or sepsis had little effect on outcome (9% vs. 6%
      survival with and without corticosteroid treatment, respectively). This is in
      sharp contrast to AH occurring postoperatively (100% vs. 17% survival with or
      without treatment, respectively) or in the antiphospholipid-antibody syndrome
      (73% vs. 0% survival, respectively). CONCLUSIONS: A high index of suspicion is
      required to make a timely diagnosis of AH. Fever and hypotension in the
      appropriate clinical setting necessitate further investigation. Although the
      diagnosis of AH is infrequently made while the patient is alive, appropriate
      imaging techniques are useful for establishing a timely diagnosis. In severe
      physical stress or sepsis, AH may be a marker of severe, preterminal physiologic
      stress and poor outcome.

PMID- 11213305
TI  - Characteristics of patients with upper respiratory tract infection presenting to
      a walk-in clinic.
AB  - OBJECTIVE: To profile patients with upper respiratory tract infection (URI)
      presenting to a walk-in clinic, to quantify their perspectives on the need for
      antibiotic therapy, and to find out their predictions of future behavior for
      similar illnesses. PATIENTS AND METHODS: In the spring of 1998, previsit and
      postvisit questionnaires were distributed at the clinic to patients 18 years of
      age or older with URI symptoms. RESULTS: Based on 210 completed previsit
      questionnaires, 161 respondents (77%) had been ill 5 or more days, 200 (95%) had
      cough, 177 (84%) had phlegm, 132 (63%) had sinus pain, and 79 (38%) had fever.
      Additionally, 54 patients (26%) reported a history of chronic obstructive
      pulmonary disease, asthma, or chronic sinusitis, and 37 (18%) were smokers. Most
      patients were between 18 and 40 years of age. The 210 patients were categorized
      into 2 groups: those who believed that antibiotics were necessary (157 [75%]) and
      those who believed antibiotics were unnecessary (53 [25%]). The only
      statistically significant difference between the 2 groups was in patients with
      sinus pain: 109 (69%) wanted antibiotics compared with 23 (43%) who did not
      (P<.001). Of the 210 patients, 130 completed postvisit questionnaires, 129 (99%)
      of whom reported satisfaction with the clinic visit. All patients who either
      desired or received antibiotics indicated they would likely seek medical care for
      future URIs. CONCLUSIONS: The majority of patients with presumed URI presenting
      to this walk-in clinic expect to receive treatment with antibiotics. Of our 130
      study patients, 83 (64%) received antibiotics regardless of their desire for
      antibiotic treatment. Satisfaction with the office visit was independent of
      patients' initial beliefs about antibiotics and whether antibiotics were
      prescribed.

PMID- 11213306
TI  - Acute and chronic seizures in patients older than 60 years.
AB  - As the number of older adults continues to increase, the population at risk for
      neurologic illnesses also rises. Acute and chronic seizures are commonly seen in
      adults older than 60 years; however, no consensus exists on the best way to
      diagnose and treat seizures and epilepsy in this age group. Several new medical
      and surgical therapies are now available for all epilepsy patients, some of which
      may be especially helpful for older patients. This article reviews the current
      literature on the diagnosis and management of seizures in older adults. Unique
      aspects of the epidemiology, etiology, diagnosis, and medical and surgical
      treatments of acute and chronic seizures in patients older than 60 years are
      discussed.

PMID- 11213307
TI  - Narcolepsy: new understanding of irresistible sleep.
AB  - Recently, low levels of a newly identified neuropeptide, hypocretin 1, were
      described in the cerebrospinal fluid of patients with narcolepsy. This
      neurochemical finding furthers our understanding of this enigmatic sleep disorder
      typically characterized by excessive daytime sleepiness, cataplexy, sleep
      paralysis, and hypnagogic hallucinations. Narcolepsy appears to be fundamentally
      related to abnormally regulated rapid eye movement sleep. The diagnosis of this
      disorder remains challenging because of multiple other conditions that can cause
      daytime sleepiness and the difficulties in recognizing cataplexy based on patient
      report. The role of hypocretins in narcolepsy is unclear but intriguing because
      the cell bodies are restricted to the lateral hypothalamus, a brain region long
      associated with sleep regulation, with neuronal widespread projections to areas
      including the locus ceruleus, ventral tegmental area, amygdala, and dorsal raphe.
      Hypocretins potentially modulate the activity of monoamines and acetylcholine,
      and therefore their absence leads to the multiple symptoms of narcolepsy. This
      article reviews the current understanding of the diagnosis and treatment of
      narcolepsy and discusses the possible implications of the hypocretin discovery.

PMID- 11213309
TI  - 87-year-old man with macrocytic anemia.

PMID- 11213308
TI  - Primary esophageal motility disorders.
AB  - Esophageal motility disorders often manifest with chest pain and dysphagia.
      Achalasia is a disorder of the lower esophageal sphincter and the smooth
      musculature of the esophageal body. In achalasia the lower esophageal sphincter
      typically fails to relax with swallowing, and the esophageal body fails to
      undergo peristalsis. In contrast to spastic disorders of the esophagus, achalasia
      can be progressive and cause pronounced morbidity. Pseudoachalasia mimics
      achalasia in terms of symptoms but can be caused by infectious disorders or
      malignancy. Treatment for achalasia is nonstandardized and includes medical,
      endoscopic, and surgical options. Spastic disorders of the esophagus, such as
      diffuse esophageal spasm and nutcracker esophagus, and nonspecific esophageal
      motility disorder are benign and nonprogressive, with similar findings on
      esophageal manometry. Although the exact cause remains unknown, these disorders
      may represent a manifestation of gastroesophageal reflux disease. Treatment of
      spastic disorders includes medical and surgical approaches and is aimed at
      symptomatic relief.

PMID- 11213310
TI  - Metastatic carcinoma of the breast resembling early gastric carcinoma.
AB  - We describe a case of gastric metastasis from a lobular carcinoma of the breast
      in a 45-year-old woman who had undergone a left mastectomy with axillary
      dissection 7 years earlier. At the current presentation, she had been
      experiencing progressive epigastric discomfort for 3 months. The initial
      diagnosis was early gastric carcinoma, diffuse type, based on gastric biopsy
      findings and ultrasonographic endoscopy. A definitive diagnosis of metastatic
      breast cancer was confirmed after subtotal gastrectomy of a presumed primary
      early gastric carcinoma. Although gastrointestinal metastases from breast cancer
      are not rare, the early stage of the gastric lesion and the absence of further
      disease dissemination make this case unusual. The onset of gastrointestinal
      symptoms in a patient with a history of breast carcinoma should prompt the
      physician to rule out the possibility of gastric metastases.

PMID- 11213311
TI  - Pulmonary Langerhans cell histiocytosis presenting as a solitary nodule.
AB  - Solitary pulmonary nodules are an uncommon manifestation of pulmonary Langerhans
      cell histiocytosis (PLCH). We describe a 45-year-old male cigarette smoker who
      presented with an asymptomatic solitary pulmonary nodule that showed histologic
      and immunophenotypic characteristics of PLCH. Twenty-one years after excision of
      the nodule, at the age of 66 years, he is asymptomatic with a new contralateral
      lung nodule but no evidence of interstitial disease. The new nodule has remained
      unchanged after 36 months of observation. This case affirms that PLCH can
      occasionally cause solitary lesions, which should not be interpreted as a
      harbinger of interstitial lung disease. Isolated PLCH should be included in the
      differential diagnosis of unusual solitary pulmonary nodules.

PMID- 11213312
TI  - Acute renal vein thrombosis, oral contraceptive use, and hyperhomocysteinemia.
AB  - Oral contraceptive use and hyperhomocysteinemia are considered to be relatively
      weak risk factors for venous thromboembolism. We report a case of acute renal
      vein thrombosis, a rare and aggressive form of thromboembolism, that occurred in
      a 21-year-old woman taking oral contraceptives, who was subsequently found to
      have marked hyperhomocysteinemia. This case suggests that the oral contraceptive
      and hyperhomocysteinemia may interact in a synergistic manner in the pathogenesis
      of thrombosis. In oral contraceptive users who develop venous thrombosis in the
      absence of other risk factors, clinicians should consider investigations for an
      underlying prothrombotic biochemical disorder.

PMID- 11213313
TI  - Reversible galactorrhea and prolactin elevation related to fluoxetine use.
AB  - Fluoxetine, an antidepressant of the selective serotonin reuptake inhibitor
      class, may stimulate prolactin release by pituitary lactotrophs. A 71-year-old
      woman taking estrogen replacement therapy developed galactorrhea after initiation
      of fluoxetine for depression and was found to have an elevated prolactin level.
      Fluoxetine was discontinued with resolution of the patient's galactorrhea and
      normalization of her prolactin level.

PMID- 11213314
TI  - Endoscopic and histologic diagnosis of Barrett esophagus.
AB  - Endoscopy plays an important role in the identification, diagnosis, and treatment
      of Barrett esophagus. Short-segment (<2-3 cm) and traditional long-segment (>2-3
      cm) Barrett esophagus are distinguished solely on the length of metaplastic
      tissue above the esophagogastric junction. The histologic hallmark of intestinal
      metaplasia is required to confirm diagnosis. Biopsy specimens obtained from
      tissue of presumed Barrett esophagus or an irregular Z line confirm metaplastic
      glandular mucosa and permit evaluation of dysplastic or neoplastic changes. In
      the appropriate clinical setting, the use of adjunctive diagnostic techniques may
      facilitate the diagnosis of Barrett esophagus and sequelae such as dysplasia.
      Chromoendoscopy with high-resolution or magnified endoscopy is simple, safe, and
      desirable for surveillance but requires additional procedural time. The use of
      light-induced fluorescence endoscopy and light-scattering spectroscopy (i.e.,
      optical biopsy) is appealing for the diagnosis and characterization of suspicious
      lesions. Adjunctive endoscopic techniques and adherence to a protocol for
      performing biopsies facilitate the early detection and subsequent surveillance of
      Barrett esophagus.

PMID- 11213315
TI  - Pathogenesis of gastroesophageal reflux and Barrett esophagus.
AB  - Barrett esophagus is a metaplastic condition that affects the lower esophagus and
      is a complication of gastroesophageal reflux disease (GERD). Under normal
      circumstances, the reflux of gastric contents into the esophagus is prevented by
      a complex barrier at the esophagogastric junction. Dysfunction of the lower
      esophageal sphincter and the presence of a hiatal hernia lead to failure of this
      barrier. Esophageal mucosal damage results from the chronic exposure of the
      esophageal mucosa to gastroduodenal contents and the lack of an effective mucosal
      defense. This article is an overview of the dysfunction of the esophagogastric
      junction that leads to GERD. The role of the contents of the reflux and that of
      Helicobacter pylori infection in the pathogenesis of Barrett esophagus are also
      summarized.

PMID- 11213316
TI  - Single subject research designs for disability research.
AB  - PURPOSE: The objective of this article is to offer an overview of single subject
      designs and provide clinicians with information regarding the components of
      single subject designs and how they can be used in clinical and other
      rehabilitation environments. METHOD/RESULT: Three basic designs in single subject
      research are presented, with corresponding examples illustrating each design. A
      review of visual and statistical analysis techniques commonly used in single
      subject designs is provided, and the advantages and limitations of each are
      noted. CONCLUSION: Single subject designs are ideally suited for research in the
      rehabilitation practice environment. If properly applied, these designs can help
      establish the efficacy of rehabilitation practice and contribute to
      rehabilitation science.

PMID- 11213317
TI  - The paradox of changing the service delivery system in the field of
      rehabilitation.

PMID- 11213318
TI  - Commentary on: Community-based service delivery in rehabilitation: the promise
      and the paradox.

PMID- 11213319
TI  - Community based service delivery: power and pathology: or, social rehabilitation
      is still a 'commie plot'.
AB  - Service delivery in the broad field of rehabilitation has been declining in
      quantity and quality for people with disabilities, the dispossessed, and others.
      The context, that is, our communities, has similarly been weakened. Meanwhile,
      the world's resources and wealth and talent flow freely up the hierarchies to the
      powers-that-be, the wealthy and the elite. In turn, these powerful people regard
      social action efforts to redress the underlying social, economic, and political
      imbalances as a 'Commie plot'. More, not less, social rehabilitation is needed to
      make human communities fit again.

PMID- 11213320
TI  - Commentary on 'community based service delivery in rehabilitation: the promise
      and the paradox' by Kendall, Buys and Larner.

PMID- 11213321
TI  - Every solution has a problem.

PMID- 11213322
TI  - Stroke rehabilitation: application and analysis of the modified Barthel index in
      an Arab community.
AB  - PURPOSE: The primary aim was to provide experience with a functional evaluation
      instrument (modified Barthel index MBI) that assures the quality of work and
      identify its deficiencies, familiarize our staff with the feasibility of its
      application on our local inpatients and educate our personnel in the field of
      stroke rehabilitation. The secondary aim was to collect data that are measurable
      and reproducible, identify specific local factors that adversely affect outcomes
      and serve as a feedback system to our national organizations. METHODS: In this
      prospective/retrospective study we evaluated 80 hemiplegic patients with
      completed stroke, admitted to hospital during the year 1989 1990. They were
      assessed by a neurologist, physiatrist and physiotherapist on admission and
      discharge using the MBI. All patients received comprehensive inpatient
      rehabilitation. The study was interrupted at the beginning of the Gulf crisis.
      However, the data were revived and retrospectively studied in the year 1994-1995.
      RESULTS: The MBI proved to be fully acceptable and easily applicable in our
      community. The rehabilitation staff became rapidly familiarized with its
      application and the reproduction of its data. The goals of rehabilitation were
      achieved through the reduction in the number of individuals in the more severe
      MBI scores and the increase in the number of individuals in the less severe ones.
      Significant improvements occurred in dressing of the upper and lower body,
      washing, grooming, care of perineum, transfer chair, toilet and walking on a
      level of 50 yards (p < or = 0.0005). CONCLUSIONS: We conclude that MBI is simple,
      convenient, efficient, gives exact and accurate information about daily
      activities and ambulation and could be used in inpatient follow up sittings, in
      the Arab and culturally similar Middle East countries.

PMID- 11213323
TI  - Disability awareness training for disability professionals.
AB  - PURPOSE: This article describes work at the Virginia School of the Deaf and Blind
      in Hampton, Virginia, USA. Disability sensitivity training in businesses and
      government organizations has become a more important activity in the United
      States since the Americans with Disability Act (ADA) of 1992 was published. That
      act of the US Congress required organizations to hire and make reasonable
      accommodations for the disabled. ISSUE: Lack of sensitivity or awareness of the
      plight of the disabled in business and government continues to be a distinct
      problem requiring attitude changes and training, but this problem can become
      acute even for professionals in organizations dedicated to the care and education
      of the disabled. CONCLUSION: Professionals tend to become inured to the hardships
      of others and lose sight of the need for both verbal and non-verbal sensitivity
      in the workplace.

PMID- 11213324
TI  - Work profile and functional capacity of formwork carpenters at construction
      sites.
AB  - PURPOSE: This study established a work profile and functional capacity for
      formwork carpenters (FCs) working at construction sites. METHOD: Thirty male FCs
      aged 19-45 were recruited by convenient sampling from the construction training
      centres. All FCs participated in an interview/questionnaire and a standardized
      functional capacity evaluation (FCE) using the Baltimore Therapeutic Equipment
      Primus (BTE Primus) and Valpar Component Work Sample (VALPAR19). Thirty male
      adults (office workers) aged 19-45 participated in the exact FCE for comparison.
      RESULTS: The results of the questionnaire indicated that the job demands of
      formwork carpenters were frequent lifting (46.7%), carrying (50.0%) and handling
      (60.0%). Significantly higher lifting and carrying capacities were revealed among
      the FCs, but not in their isometric strengths and the endurance of the upper
      limbs (chi2 = 6.48, df = 2, p < 0.05). CONCLUSIONS: The dynamic and repetitive
      sub-maximal nature of the work of formwork carpentry induced an elevation of job
      specific lifting and carrying capacities among the FCs. The job and functional
      capacity profiles would be useful for formulating guidelines for the
      rehabilitation of injured workers and the training of new workers in the trade.

PMID- 11213326
TI  - Vive la difference.

PMID- 11213325
TI  - Heart of the matter.

PMID- 11213327
TI  - Women in dentistry.

PMID- 11213328
TI  - Dental strategy.

PMID- 11213329
TI  - Routine check-ups.

PMID- 11213331
TI  - Cartoon cover.

PMID- 11213330
TI  - Oral cancer knowledge.

PMID- 11213332
TI  - Tooth notations.

PMID- 11213333
TI  - Special care dentistry.

PMID- 11213334
TI  - Oral temazepam.

PMID- 11213335
TI  - Antibiotic cover.

PMID- 11213336
TI  - Dentists register on the Internet.

PMID- 11213337
TI  - Factors associated with oral health: a multivariate analysis of results from the
      1998 Adult Dental Health survey.

PMID- 11213338
TI  - Clasp design.

PMID- 11213339
TI  - Introducing safety syringes into a UK dental school--a controlled study.
AB  - AIM: How an appropriate safety syringe was chosen, how the change-over to it was
      achieved and what outcome measures were used to measure the effectiveness of this
      change. INTRODUCTION: One third of all reported sharps injuries in dental
      practice are due to the use of non disposable dental syringes with most injuries
      being sustained during removal and disposal of the disposable needle from the non
      disposable syringe. METHOD: After evaluation of all available disposable safety
      syringes they were introduced into a dental school after appropriate education of
      all staff and students. Risk management provided data on all reported needle
      stick injuries in the dental school and a control unit using non disposable
      syringes for a period of two years. RESULTS: Avoidable needle stick injuries
      reduced from an average of 11.8 to 0 injuries per 1,000,000 hours worked per year
      as compared with a control unit who reduced their frequency from 26 to 20
      injuries per 1,000,000 hours worked. The cost of safety syringes is comparable to
      non-disposable syringes but the reduction in cost of management of needle stick
      injuries including the psychological effects are significant. CONCLUSION:
      Education plays a vitally important role in the effective implementation of the
      change to safety syringes which is advocated for all dentists.

PMID- 11213340
TI  - The provision of dental implants in the National Health Service Hospital dental
      services--a national questionnaire.
AB  - OBJECTIVE: To assess the activity of consultants in restorative dentistry in the
      United Kingdom in the provision of osseointegrated dental implants within the
      National Health Service Hospital service and to evaluate their attitudes
      concerning the relevant medical and oral factors considered in patient selection
      for implant treatment. DESIGN/SETTING: Anonymous postal questionnaire in the
      United Kingdom. SUBJECTS: Consultants in restorative dentistry. RESULTS: Out of
      the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54
      of the 109 consultants (49.5%) are involved in the provision of osseointegrated
      implant treatment, treating an average of 29 cases/year (range 2-150). However,
      over one third of the respondents treated 10 or less cases/year. 89% worked with
      oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as
      their main system. The majority of consultants felt that smoking, psychoses and
      previous irradiation were the most important medical factors that contra
      indicated implant retained restorations whilst untreated periodontitis, poor oral
      hygiene and uncontrolled caries were the most important oral contra-indications.
      Many centres were experiencing significant problems with the funding of implant
      treatment with one centre receiving no funding. The implications for patient care
      and specialist training are discussed. CONCLUSIONS: There is a marked variation
      in the number of patients treated with endosseous dental implants within the
      United Kingdom National Health Service hospitals. Many consultants treat 10 or
      fewer patients each year. In the main, there is agreement about the factors that
      contra-indicate implant treatment; these are in line with national guidelines.

PMID- 11213342
TI  - The in vitro colony assay: a predictor of clinical outcome.
AB  - PURPOSE: To determine the predictive power of an in vitro colony assay on the
      clinical normal-tissue complication rate. MATERIAL AND METHODS: Primary skin
      fibroblasts from 88 individuals were generated from the skin biopsies of patients
      who received a standardized radiotherapy. Tissue was cultured for three to six
      passages, irradiated with doses between 1 and 8 Gy under defined conditions,
      seeded and finally the colonies were stained and counted after 10-14 days. The
      survival curves were fitted by the L-Q model and the SF2, alpha/beta and plating
      efficiency were calculated. RESULTS: The parameters SF2 and plating efficiency
      were stable throughout the 4-year test period. Intra-individual differences
      between repeated experiments were significantly lower than inter-individual test
      results. For the observed acute skin and late normal-tissue reactions other than
      skin the in vitro parameter SF2 correlated significantly (p<0.005). For late skin
      reactions this correlation was not found. DISCUSSION: In contrast to other
      publications, a clear correlation was found between the in vitro test results and
      clinically observed early reactions. The lack of correlation for late skin
      reactions suggests that the combination of intrinsic radiation sensitivity and
      exogenous factors may alter the clinically observed reaction of certain tissues
      to a different extent.

PMID- 11213341
TI  - Radiation sensitivity and apoptosis in human lymphoma cells.
AB  - PURPOSE: The impact ofapoptosis on radiation-induced eradication of clonogenic
      tumour cells is uncertain. The aim was to analyse the relationship of different
      functional stages during the apoptotic process to cell death and clonogenic cell
      eradication. MATERIALS AND METHODS: Apoptosis in Jurkat T-cells was studied by
      morphology, light scatter and caspase activation. Mitochondrial integrity was
      determined by the mitochondrial membrane potential (delta(phi)m). Cell death was
      quantified using propidium iodide exclusion. Clonogenic cell death was determined
      using a dilution survival assay. The influence of Bcl-2 was tested using a Bcl-2
      transfected Jurkat clone. RESULTS: Irradiation induced profound apoptosis within
      48 h associated with caspase activation and breakdown of delta(phi)m. Inhibition
      of caspases abrogated the apoptotic morphology with no influence on breakdown of
      delta(phi)m and survival. Over-expression of Bcl-2 abrogated all hallmarks of
      apoptosis; delayed cell death, however, had no influence on clonogenic survival
      after irradiation. CONCLUSION: Based on Bcl-2 as a positional marker, radiation
      induced apoptosis can be divided into two stages: the initiation/decision phase,
      characterized by a breakdown of the mitochondrial membrane potential, and the
      execution phase, characterized by caspase activation. The execution phase had no
      influence on survival, whereas the initiation/decision phase controls immediate
      survival. However, abrogation of both phases did not influence radiation
      sensitivity.

PMID- 11213343
TI  - A cluster of childhood leukaemias near two neighbouring nuclear installations in
      Northern Germany: prevalence of chromosomal aberrations in peripheral blood
      lymphocytes.
AB  - PURPOSE: Between 1990 and 1991 a leukaemia cluster was observed in children
      living close to the combined site of a nuclear power plant and a nuclear research
      facility in Elbmarsch, a region in Lower Saxony (Germany). We aim to investigate
      the prevalence of presumably radiation-induced chromosomal aberrations in
      peripheral blood lymphocytes of children in Elbmarsch and children of a control
      region in order to find out whether there was an uncontrolled release of
      radioactive material which resulted in a substantial exposure. MATERIALS AND
      METHODS: The frequency of dicentric and ring chromosomes in lymphocytes of the
      peripheral blood in 42 children in Elbmarsch and 30 children in Plon was
      investigated. Children in both groups had been permanent residents of the study
      area. RESULTS: The mean frequency of dicentric and ring chromosomes in Elbmarsch
      was 14/32580 cells (=0.430 x 10(-3); 95% CI 0.24-0.70 x 10(-3) cells), and in
      Plon it was 17/24065 cells (=0.706 x 10(-3); 95% CI 0.42-1.10 x 10(-3) cells).
      CONCLUSIONS: No difference in the frequency of dicentric and ring chromosomes was
      observed between children in Elbmarsch living close to a combined site of a
      nuclear power plant and a nuclear research facility and children living in the
      control area Plon. The power of the study to detect a threefold or higher
      increase in the aberration frequency was at least 0.86.

PMID- 11213344
TI  - Physical heights of children with prolonged low dose-rate gamma-radiation
      exposure in radiocontaminated buildings.
AB  - PURPOSE: To evaluate low dose-rate radiation effects on the physical heights of
      children staying in apartments with 60Co-contaminated steel construction.
      MATERIALS AND METHODS: Children who once resided in radiocontaminated apartments
      since early 1983 were examined for height and body weight status from age 1 month
      to 18 years and before they moved out of the apartments. The physical heights and
      body weights of 21 898 age- and sex-matched non-exposed children from a
      nationwide school surveillance in 1997-98 were taken as controls. The physical
      height data were shown as height percentiles (HP) compared with reference
      children and age-specific relative height differences (RHD). RESULTS: HP and RHD
      in 48 exposed boys and 37 girls were analysed using generalized estimating
      equations (GEE), which accounted for multiple measurements and correlation
      between these measurements in the same individuals during this period. After
      adjusting for effects from parental heights and body mass index (BMI), clear dose
      related decreases in HP and RHD were observed in the exposed boys with a
      cumulative exposure > 60 mSv. CONCLUSIONS: Prolonged low dose-rate y-radiation
      exposure was associated with adverse effects on the physical heights of growing
      boys, but were less apparent in the exposed girls.

PMID- 11213345
TI  - Cellular effects of high-intensity focused continuous wave ultrasound alone and
      in combination with X-rays.
AB  - PURPOSE: To investigate the cellular effects of 1.1 MHz high-intensity focused
      continuous wave (CW) ultrasound alone and in combination with X-rays. MATERIALS
      AND METHODS: V79 cells were exposed to ultrasound of different intensities for
      30s (non-hyperthermic conditions). In the combined treatments, cells were exposed
      to ultrasound (63 W/cm2) either before or after 2 Gy X-irradiation. Cellular
      effects studied were clonogenic survival, DNA strand breaks (pulsed-field gel
      electrophoresis, DNA precipitation assay) and membrane integrity (morphological
      analysis). RESULTS: With increasing ultrasound intensity, cell survival decreased
      in a dose-dependent manner as the induction of DNA strand breaks, the fraction of
      cells with lost membrane integrity and cell lysis increased. In the treatments
      with combined exposures, the regimen with X-rays before ultrasound had a nearly
      additive effect on cell kill, whereas the reverse regimen with ultrasound
      exposure before X-irradiation resulted in a synergistic effect (p<0.012).
      CONCLUSIONS: High-intensity focused CW ultrasound induces an intensity-dependent
      reduction in clonogenic survival in V79 cells, which seems to depend on both DNA
      and membrane damage. Combined exposures of ultrasound and X-rays resulted in a
      synergistic reduction in cell survival when cells were exposed to ultrasound
      before X-rays but not for the reverse regimen. Thus, a larger fraction of the
      repairable sublethal cell damage induced by an initial ultrasound exposure was
      rendered non-repairable by a subsequent X-ray exposure than if the reverse
      treatment order was used.

PMID- 11213346
TI  - Threshold effect for teratogenic risk of radiation depends on dose-rate and p53
      dependent apoptosis.
AB  - PURPOSE: To obtain evidence that the p53 gene is indispensable for reduction of
      high teratogenic risk of radiation at a high dose-rate to zero risk by lowering
      the dose-rate. MATERIALS AND METHODS: Wild-type p53(+/+), heterozygous p53(+/-)
      and null p53(-/-) mice were exposed to gamma-rays at high or low dose-rates
      during days 9.5-10.5 of gestation. The incidence of malformations and prenatal
      deaths was studied. Frequencies of cells dying by apoptosis were measured during
      or after protracted irradiation. RESULTS: After irradiation with 2 Gy, the
      frequency of apoptotic cells increased to 20% for p53(+/+) mice and did not
      increase at all for p53(-/-) mice. For p53(+/+) mice, 2 Gy y-rays induced 70%
      malformations when given at 1.06 Gy/min, but no malformations above the control
      when given at 1.2 mGy/min. In contrast, after irradiation of p53(-/-) foetuses
      with 2 Gy at 1.2mGy/min, the incidence of malformations increased 12% above
      control levels. CONCLUSION: Foetal irradiation with 2 Gy at 1.2 mGy/min was not
      teratogenic for p53(+/+) mice but teratogenic for p53(-/-) mice. This indicates
      that the p53 gene is indispensable for a threshold effect in the risk of
      radiation at low doses or dose-rates.

PMID- 11213347
TI  - Susceptibility to radiation-induced leukaemia/lymphoma is genetically separable
      from sensitivity to radiation-induced genomic instability.
AB  - PURPOSE: To determine whether there is a relationship between the genetics
      underlying the susceptibility to radiation-induced leukaemia in CBA/H (acute
      myeloid leukaemia, AML) and C57BL/6 (thymic lymphoma, TL) mice, and the genetics
      underlying the sensitivity of CBA/H (sensitive) and C57BL/6 (resistant) mice to
      radiation-induced chromosomal instability. MATERIALS AND METHODS: CBA/H, (CBA/H x
      C57BL/6)F1, F1 x CBA/H, F1 x C57BL/6 and F1 x F1 mice were exposed to a single
      acute dose of 3.0 Gy X-rays. AML and TL were diagnosed over the subsequent 30
      months. RESULTS: There was no statistically significant difference in the
      incidence of AML in F1, F1 x F1, F1 x CBA/H and F1 x C57BL/6 mice, which was
      approximately 50% that in CBA/H mice. AML susceptibility is therefore a dominant
      polygenic trait, and both susceptibility and resistance (variable penetrance)
      CBA/H and C57BL/6 loci are involved. The incidence of TL in the FM and F1 x CBA/H
      mice was negligible, indicating that TL susceptibility is a recessive trait. As
      the TL incidence in the F1 x C57BL/6 mice was about half that in C57BL/6 mice,
      one recessive locus is probably involved. CONCLUSIONS: AML susceptibility in
      CBA/H mice is a dominant trait in contrast to the recessive inheritance of CBA/H
      sensitivity to radiation-induced chromosomal instability. TL-susceptibility in
      C57BL/6 is a recessive trait in contrast to the dominant inheritance of C57BL/6
      resistance to radiation-induced chromosomal instability.

PMID- 11213348
TI  - Oncoprotein expression in human breast epithelial cells transformed by high-LET
      radiation.
AB  - PURPOSE: The aim of the present work was to analyze the expression of
      oncoproteins that are frequently altered in breast cancer with specific
      phenotypic stages in the neoplastic process. MATERIALS AND METHODS: Expression of
      c-myc, c-jun, c-Ha-ras and the tumor suppressor gene p53 oncoproteins were
      examined by immunohistochemical staining coupled with confocal microscopy in
      transformed and tumorigenic human breast epithelial cells induced by high-LET
      alpha-particles (150 kcV/microm). RESULTS: MCF-10F cells, irradiated with single
      and double doses of 60 cGy alpha-particles and subsequently treated with
      cstrogen, showed gradual phenotypic changes including altered morphology,
      increased cell proliferation relative to control, anchorage-independent growth,
      invasive capabilities and tumorigenicity in nude mice. MCF-10F cells irradiated
      with a second dose of 60 cGy alpha-particles after estrogen treatment (60 cGy+
      E/60 cGy+E) showed tumorigenicity both in SCII) and nude mice. Alterations in the
      protein expression of several oncogenes including c-myc, c-jun, c-Ha-ras and the
      tumor suppressor gene p53 were detected in alpha-particle-irradiated cells and in
      those cells subsequently cultured in the presence of estrogen. The expression
      level of these oncoproteins correlated with the progressive nature of the
      neoplastic process. CONCLUSION: These studies suggest that overexpression of
      several oncoproteins is important in the neoplastic transformation of human
      breast epithelial cells induced by high-LET radiation. In addition, use of
      endocrine factors such as estrogen allows the examination of various aspects of
      protein expression providing the basis for understanding the complex interactions
      of hormones and genes.

PMID- 11213350
TI  - Mutagenic effects of 5-formyluracil on a plasmid vector during replication in
      Escherichia coli.
AB  - PURPOSE: 5-Formyluracil (5-foU) is a major derivative of thymine produced in DNA
      by ionizing radiation and various chemical oxidants. It has been previously shown
      that 5-foU in template DNA directs misincorporation of nucleotides by DNA
      polymerases during in vitro DNA synthesis. The present experiments were designed
      to understand the biological effects of5-foU in vivo. MATERIALS AND METHODS: The
      modified base was incorporated site-specifically into the recognition site of
      restriction endonuclease SalI (5'-GTCGAC) or AflII (5'-CTTAAG) in vector plasmid
      pSVK3 and introduced the plasmid into Escherichia coli. RESULTS: When the
      plasmids were replicated in E. coli, 5-foU caused mutations at the target sites.
      The induced mutation frequencies were 0.038-0.049%. Sequence analysis revealed
      that 5-foU preferentially caused T:A-->C:G and T:A-->A:T base substitutions and 
      1 deletions at the 5-foU site. 5-FoU also caused mutations at sites near the 5
      foU. The alkA mutation did not affect the frequency of mutations in 5-foU
      containing plasmids. CONCLUSIONS: The present experiments demonstrated that 5
      formyluracil in DNA caused mutations in E. coli.

PMID- 11213349
TI  - Induction of osteosarcoma and acute myeloid leukaemia in CBA/H mice by the alpha
      emitting nuclides, uranium-233, plutonium-239 and amercium-241.
AB  - PURPOSE: To compare tumour induction in CBA/H mice, principally osteosarcoma and
      acute myeloid leukaemia, resulting from exposure to the alpha-emitting nuclides,
      uranium-233, plutonium-239 and americium-241, and to relate differences between
      the three nuclides to the pattern of dose delivery within tissues. MATERIALS AND
      METHODS: Each nuclide was administered intraperitoneally in citrate solution to
      three groups of adult male CBA/H mice at levels of activity which gave estimated
      life-time average skeletal doses of about 0.25-0.3 Gy, 0.5-1 Gy and 1-2 Gy.
      Animals were carefully monitored and sacrificed as soon as they showed signs of
      ill health; tumours were identified by standard histopathological techniques.
      RESULTS: Statistical modelling by Cox regression showed that, considering all
      three nuclides together, there was a highly significant increase in risk of death
      from osteosarcoma or myeloid leukaemia with increasing dose rate. For
      osteosarcoma, the effect was significantly greater for 239Pu than 241Am, while
      separate analysis for 233U showed no significant increase with increasing dose
      rate. For example, the increase in relative risk of death from osteosarcoma for
      an increase in life-time average dose rate to bone of 1 mGyd(-1) was 4.2 (2.7
      6.5) for 239Pu, 2.3 (1.4-3.4) for 241Am and 1.1 (0.4-3.1) for 233U. For myeloid
      leukaemia, there was no significant difference between 239Pu and 241Am in the
      effect of dose rate. The increase in relative risk from myeloid leukaemia for an
      increase in average dose rate of 1 mGyd(-1) was 1.8 (1.1-2.8) for 239Pu, 2.0 (1.4
      2.9) for 241Am and 1.5 (0.8-2.7) for 233U. Significant increases in renal and
      hepatic carcinomas were also recorded in animals exposed to 233U and 241Am,
      respectively. Studies of the distribution of the nuclides within the skeleton,
      published separately, have shown differences in their retention in individual
      bones and within bone. The proportions of decays occurring near to endosteal bone
      surfaces and throughout bone marrow were in the order: 239Pu> 241Am>233U.
      CONCLUSIONS: For osteosarcoma, the relative effectiveness of the nuclides in
      terms of average bone dose, in the order 239Pu>241Am>233U, is consistent with the
      proportion of dose delivered near to endosteal surfaces. For myeloid leukaemia,
      the greater effectiveness of 239Pu and 241Am than 233U is consistent with their
      accumulation in marrow.

PMID- 11213351
TI  - Analysis of Ar-ion and X-ray-induced chromatin breakage and repair in V79 plateau
      phase cells by the premature chromosome condensation technique.
AB  - PURPOSE: The premature chromosome condensation technique has been used to compare
      chromatin breakage and repair in noncycling V79 cells following high and low LET
      radiation. MATERIALS AND METHODS: Plateau-phase V79 cells were exposed to graded
      doses of low energy Ar ions (LET 1233 keV/microm) and X-rays. Cells were fused to
      mitotic V79 cells immediately after exposure to examine initial chromatin
      breakage or after various time intervals of post-irradiation incubation to
      investigate the kinetics of chromatin break rejoining as well as the fraction of
      unrejoined fragments. RESULTS AND CONCLUSIONS: For both radiation qualities an
      average initial number of about 2.4 excess PCC fragments per cell per Gy was
      found increasing linearly with dose. The distributions of PCC chromosomes plus
      excess fragments among cells followed Poisson statistics after X-ray irradiation,
      while an overdispersion of the frequencies was observed after Ar-irradiation
      indicating that a single particle traversal through a cell nucleus can produce
      multiple chromatin lesions. Moreover, for both radiation types the rejoining of
      excess fragments has been examined. Both data sets could be fitted well to first
      order kinetics with a single component. Despite similar rates of rejoining
      cellular repair was noticeably less effective for Ar ions than for X-rays. While
      after 10 h of post-irradiation incubation 60% of Ar ion induced excess fragments
      remained unrejoined, only 14% of X-ray-induced lesions were not rejoined.
      Furthermore, comparison of the residual number of excess PCC fragments with
      recently published data on the yield of chromosome aberrations in first post
      irradiation metaphases shows that for both radiation types more aberrations are
      detected in interphase than in metaphase cells. Yet, for comparable doses this
      difference is more pronounced for Ar ions indicating that scoring of high LET
      induced aberrations in metaphase cells might result in a significant
      underestimation of the produced damage.

PMID- 11213352
TI  - In utero radiation-induced apoptosis and p53 gene expression in the developing
      rat brain.
AB  - PURPOSE: This study addressed the question of the role of the p53 gene in
      prenatal low-dose radiation-induced apoptosis in the neuroepithelium, in an
      effort to elucidate molecular mechanisms involved in the extreme radiosensitivity
      of the developing brain. MATERIALS AND METHODS: Pregnant Wistar rats were exposed
      to a single dose of 10, 20 or 40 cGy of X-rays on day 15 or 17 of gestation.
      Animals were sacrificed 4 or 24h after exposure. Apoptosis was studied by gel
      electrophoresis of isolated DNA and in situ by the TUNEL reaction. Expression of
      the p53 gene was studied by immunocytochemistry and Western analysis, as well as
      Northern analysis, for the detection of the protein and mRNA respectively.
      RESULTS: In utero low-dose irradiation led to apoptosis and an increase of p53
      gene expression in the developing rat brain. Apoptotic as well as p53
      immunopositive cells were detected among proliferating, migratory and post
      mitotic neurones in the developing neuroepithelium following prenatal
      irradiation, even after only l0 cGy. In addition to the p53 protein, p53 mRNA
      brain levels were also increased following prenatal irradiation. CONCLUSIONS: Low
      dose prenatal irradiation of the developing brain led to p53 induction and cell
      death by apoptosis.

PMID- 11213353
TI  - In utero radiation-induced changes in growth factor levels in the developing rat
      brain.
AB  - PURPOSE: To investigate the role of growth factors in the compensatory response
      to radiation injury during development of the brain. Levels of gene expression in
      the embryonic rat brain were assessed for IGF-I, IGF-II, BDNF and NT-3. MATERIALS
      AND METHODS: Pregnant Wistar rats were exposed to a single dose of 10, 20 or 40
      cGy X-rays on day 15 or 17 of gestation. Animals were sacrificed 4 or 24 h after
      exposure. IGF-I, BDNF and NT-3 proteins were detected by immunocytochemistry,
      while IGF-I and IGF-II mRNA by in situ hybridization, and Northern analysis
      respectively. RESULTS: In utero low dose X-irradiation led to a decrease in IGF-I
      gene expression and a compensatory increase in the expression of IGF-II, BDNF and
      NT-3 in the developing rat brain. IGF-I, BDNF and NT-3 immunopositive cells were
      detected among proliferating, migratory and post-mitotic neurones in the
      developing neuroepithelium. CONCLUSIONS: Low dose prenatal irradiation of the
      developing brain results in down-regulation of IGF-I, which could lead to cell
      death by apoptosis. On the other hand, IGF-II, BDNF and NT-3 gene expression is
      increased following irradiation, possibly as a compensatory mechanism.

PMID- 11213354
TI  - Inflammatory response to abdominal irradiation stimulates hemopoiesis.
AB  - PURPOSE: The connection between inflammation and hemopoiesis was studied in the
      context of abdominal irradiation. MATERIALS AND METHODS: Male C57BL6/J mice
      received localized irradiation of 20 Gy either to 70% of the liver or to the
      intestine (most of ileum and caecum). RESULTS: Irradiation of liver induced a
      rapid increase in intercellular adhesion molecule-1 mRNA expression in the liver.
      In serum/plasma, an increase in positive acute phase proteins (serum amyloid-P
      and fibrinogen) and a decrease in albumin occurred during the second and third
      week following liver irradiation. Similarly, intestinal irradiation induced an
      increase in plasma fibrinogen level. A transient elevation in neutrophil and
      platelet counts was observed that was maximal during the second and third week
      with similar kinetics for intestinal and liver irradiation. Moreover, intestinal
      irradiation enhanced hemopoietic progenitors in bone marrow. IL-6, which is known
      to be an agonist in the regulation of acute phase protein expression as well as
      hemopoietic cell production, was increased in plasma from intestinal- and liver
      irradiated mice. Administration of an anti-IL-6 mAb to intestinal-irradiated mice
      abrogated the elevation of fibrinogen and the increase in hemopoietic
      progenitors. CONCLUSIONS: Abdominal irradiation provokes an inflammatory response
      which in turn stimulates hemopoiesis. IL-6 may play a major role in controlling
      these events.

PMID- 11213355
TI  - The inhibitory effects of lead on steroidogenesis in MA-10 mouse Leydig tumor
      cells.
AB  - Lead is an environmental and occupational pollutant. It has been reported that
      lead affects the male reproductive system in humans and animals. However, the
      cellular mechanism of the adverse effect of lead on Leydig cell steroidogenesis
      remains unknown. To clarify whether lead has a direct effect on Leydig cells and
      how lead affects Leydig cells, MA-10 cells, a mouse Leydig tumor cell line, were
      exploited in this study. Lead acetate significantly inhibited hCG- and dbcAMP
      stimulated progesterone production in MA-10 cells at 2 h. Steroid production
      stimulated by hCG or dbcAMP were reduced by lead. The mechanism of lead in
      reducing MA-10 cell steroidogenesis was further investigated. The expression of
      Steroidogenic Acute Regulatory (StAR) protein and the activities of P450 side
      chain cleavage (P450scc) and 3beta-hydroxysteroid dehydrogenase (3beta-HSD)
      enzymes were detected. Cells were treated with dbcAMP, 22R-hydroxycholesterol or
      pregnenolone alone or in combination with lead acetate ranging from 10(-8) to 10(
      5) M for 2 h. The expression of StAR protein stimulated by dbcAMP was suppressed
      by lead at about 50%. Progesterone productions treated with 22R
      hydroxycholesterol or pregnenolone were reduced 30-40% in lead-treated MA-10
      cells. These data suggest that lead directly inhibited steroidogenesis by
      decreasing StAR protein expression and the activities of P450scc and 3beta-HSD
      enzymes with a dose-response trend in MA-10 cells. Moreover, cadmium, a calcium
      channel blocker, abolished inhibitory effect of lead on MA-10 cell steroid
      production. This indicates that lead might act on calcium channel to regulate MA
      10 cell steroidogenesis.

PMID- 11213356
TI  - Human chorionic gonadotropin beta-core fragment is directly produced by cancer
      cells.
AB  - The present study was undertaken to investigate whether hCG beta-core fragment
      (hCGbeta cf) was directly produced by cancer cells. Fifteen cell lines, including
      four choriocarcinoma and five ovarian cancer cell lines, were tested, and
      immunoreactivity of hCGbeta cf was present in the culture media of five of the
      cell lines. It was also present in the culture media of Chinese hamster ovary
      (CHO) cells transfected with hCGbeta gene. In addition to hCGbeta cf, gel
      chromatography and Western blot analysis of the culture media showed the presence
      of an hCGbeta cf immunoreactive material with a molecular weight of approximately
      40 kDa. In an in vivo study, hCGbeta cf immunoreactivity was detected in the sera
      of the mice transplanted with NaUCC-3 choriocarcinoma cells, although the ratios
      of hCGbeta cf/hCG and hCGbeta cf/free hCGbeta were lower than those in the
      culture medium. Incubation experiments of purified hCGbeta cf in the serum showed
      no substantial decrease in its values, ruling out the possibility that formation
      of a macromolecule with serum components may mask hCGbeta cf immunoreactivity in
      the serum. Taken together, these results indicate that hCGbeta cf immunoreactive
      materials are directly produced by cancer cells and hCGbeta cf is not a urinary
      metabolite of hCG or hCGbeta alone. Also, reduced levels of hCGbeta cf in the
      serum compared with that of intact hCG or free hCGbeta are likely due to its
      short half-life.

PMID- 11213357
TI  - Modulation of serotonin transporter function by interleukin-4.
AB  - Serotonin (5-HT) is an important mediator of interactions between the nervous and
      immune systems. 5-HT signaling is regulated by the 5-HT transporter (5-HTT),
      which determines the magnitude and duration of serotonergic responses. Due to
      this important role, regulation of the 5-HTT by cytokines has been the focus of
      recent interest. A number of proinflammatory cytokines, including interleukin
      1beta, tumor necrosis factor-alpha, and interferon-gamma, have been shown to
      upregulate the 5-HTT. In the present study we investigated the influence of
      interleukin-4 (IL-4), which acts as an anti-inflammatory cytokine in the central
      nervous system, on the 5-HTT. As a model system we used immortalized B
      lymphocytes, which not only express the 5-HTT, but also allow testing the co
      modulatory influence of a recently described polymorphism in the 5-HTT gene
      promoter (5-HTTLPR) that is associated with anxiety- and depression-related
      behavioral traits. The results show that IL-4 induces a dose-dependent reduction
      of 5-HT uptake. This effect is preferentially seen in cell lines homozygous for
      the long, high-activity allele of the 5-HTTLPR. In conclusion, a picture of
      differential modulation of the 5-HTT by proinflammatory and anti-inflammatory
      cytokines is emerging, which may represent a fine-tuned mechanism to communicate
      the state of an immune response to the central nervous system.

PMID- 11213358
TI  - Influence of estradiol and progesterone on the sensitivity of rat thoracic aorta
      to noradrenaline.
AB  - The aim of this study was to investigate the effects of low and high doses of
      estradiol, and of progesterone on the response to noradrenaline in rat thoracic
      aorta. Two weeks after bilateral ovariectomy, female rats received a s.c.
      injection of vehicle (corn oil, 0.1 mL/day), estradiol (10 microg/kg/day or 4
      mg/kg/day) and/or progesterone (20 mg/kg/day), for eight days. On the ninth day,
      the rats were sacrificed and aortic rings, with or without endothelium, were used
      to generate concentration-response curves to noradrenaline. Aortic rings with
      intact endothelium from the high-dose (4 mg/kg/day) estradiol group were
      supersensitive to noradrenaline compared to the vehicle or low-dose (10
      microg/kg/day) estradiol groups (pD2 values = 7.86+/-0.09, 7.30+/-0.11 and 7.35+/
      0.04, respectively). Endothelium-intact aortic rings from high-estradiol rats
      were supersensitive to noradrenaline when compared to vehicle-, progesterone- and
      progesterone + high-estradiol-treated rats (pD2 values = 7.77+/-0.12, 7.21+/
      0.13, 6.93+/-0.04 and 7.22+/-0.18, respectively). There were no significant
      differences among the pD2 values for noradrenaline in aortic rings without
      endothelium. In conclusion, at high but not low doses, estradiol increased the
      sensitivity to noradrenaline and this was prevented by progesterone. Both of
      these effects were endothelium-dependent.

PMID- 11213359
TI  - Effects by doxorubicin on the myocardium are mediated by oxygen free radicals.
AB  - We hypothesized that doxorubicin (DOX) induces cardiotoxicity of myocardium via
      oxygen radicals. The present study is aimed at examining the membrane alterations
      by oxygen radicals generated by DOX in adult rats and cultured neonatal myocytes.
      Our results showed that DOX 1) decreased beta-adrenoceptor (BAR) density in the
      cell membrane, 2) increased the membrane permeability of cultured neonatal rat
      myocytes and 3) altered the ultrastructure of myofibrils and subplasmalemmal
      actin networks. These effects were reproducible by exogenous hydrogen peroxide.
      The antioxidant melatonin (MLT) inhibited enzyme leakage and peroxidation in a
      concentration-dependent manner. It is concluded that DOX induces cardiotoxicity
      through lipid peroxidation and melatonin is an effective antioxidant against the
      reactive oxygen intermediates generated by DOX.

PMID- 11213360
TI  - Magnesium tanshinoate B (MTB) inhibits low density lipoprotein oxidation.
AB  - Danshen, a Chinese herbal medicine has been widely used for the treatment of
      cardiovascular diseases. Magnesium tanshinoate B (MTB) is an active compound
      purified from Danshen. The objective of this study was to investigate the effect
      of MTB on the susceptibility of low density lipoproteins (LDL) to oxidative
      modification as well as on the accumulation of lipids in THP-1 derived
      macrophages. Aliquots of LDL were incubated with copper sulfate in the absence or
      presence of MTB. The degrees of oxidative modification of LDL were assessed by
      examining the relative gel electrophoretic mobility, by measuring the amount of
      thiobarbituric acid reactive substances (TBARS), and by continuous monitoring of
      the formation of conjugated dienes upon the increase in absorbency at 234 nm. MTB
      at concentrations of 1-10 microM significantly inhibited oxidative modification
      of LDL. Such inhibitory effect resulted in a decrease in the uptake of LDL by THP
      1 derived macrophages. Taken together, these results clearly demonstrate that MTB
      inhibits oxidative modification of LDL and hence prevents the uptake of LDL by
      cultured macrophages. Such effect may be therapeutically relevant in protecting
      cells from lipid peroxidation in vascular disorders.

PMID- 11213361
TI  - Effects of nitric oxide on matrix metalloproteinase-2 production by rheumatoid
      synovial cells.
AB  - Nitric oxide (NO) is a multifunctional messenger molecule generated from L
      arginine by a family of enzymes, including nitric oxide synthase (NOS). This
      study was performed to examine whether NO modulates the production of matrix
      metalloproteinases (MMPs), which degrade all components of extracellular matrix
      (ECM), in rheumatoid synovial cells. We investigated the effects of exogenously
      generated NO by a NO donor, S-nitroso-N-acetyl-DL-penicillamine (SNAP), on the
      MMPs production by rheumatoid synovial cells. Culture media conditioned by SNAP
      treated synovial cells were examined by gelatin zymography and immunoblot
      analysis. Incubation of synovial cells with SNAP resulted in gelatinase A
      production in a dose-dependent fashion. Furthermore, RT-PCR analysis demonstrated
      that MMP-2 mRNA expression was induced in SNAP-treated synovial cells. In
      contrast, SNAP did not influence the production of TIMP-1 and TIMP-2, which
      preferentially inhibit MMP-2, by rheumatoid synovial cells. Our data indicate
      that NO could modulate MMP production by rheumatoid synovial cells and therefore
      contribute to ECM degradation of articular components in RA.

PMID- 11213362
TI  - Inhibition of inducible nitric oxide synthase and cyclooxygenase-2 expression by
      flavonoids in macrophage J774A.1.
AB  - The present study focuses on the effect of various naturally occurring flavonoids
      (apigenin, galangin, morin, naringenin, quercetin, and silymarin) on nitric oxide
      (NO) and prostaglandin E2 (PGE2) production induced by lipopolysaccharide (LPS)
      in the macrophage cell line J774A.1. Moreover, we evaluated flavonoid modulation
      of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) enzyme
      expression by western blot analysis. Apigenin and quercetin (0.5-50 microM) were
      the most potent inhibitors of NO production and this effect was concentration
      dependent and significant at 5 and 50 microM. These data were consistent with the
      modulation of iNOS enzyme expression. A similar pattern was observed considering
      the inhibitory effect of flavonoids on LPS-induced PGE2 release and COX-2
      expression. Quercetin, galangin, apigenin, and naringenin markedly decreased PGE2
      release and COX-2 expression in a concentration-dependent manner. This study
      suggests that inhibition of iNOS and COX-2 expression by flavonoids may be one of
      the mechanisms responsible for their anti-inflammatory effects.

PMID- 11213363
TI  - Uptake by vascular smooth muscle cells plays an important role in targeting of
      lipid microspheres incorporating prostaglandin E1 into a thickened intima.
AB  - A study was done to determine how lipid microspheres (LM) containing
      prostaglandin E1 (lipo PGE1) accumulate in injured arterial tissue. After
      administration of lipo PGE1 labeled with a fluorescence probe, 1,1'-dioctadecyl
      3, 3, 3',3'-tetramethyl-indocarbocyanine perchlorate (DiI-lipo PGE1) to rats 14
      of days after balloon injury of the carotid artery, localization into the injured
      site was examined using a fluorescence confocal laser scanning microscope (CLSM).
      In contrast with the normal carotid artery, DiI-lipo PGE1 accumulated remarkably
      in neointima of the injured site which was occupied mainly by the migration of
      the proliferating and quiescent vascular smooth muscle cells (SMC). In vitro
      cellular uptake of DiI-lipo PGE1 was semi-quantitatively measured using CLSM,
      regarding differentiated and proliferative phenotypes of human vascular SMC,
      compared with the human endothelial cells (EC) and mouse fibroblasts. The
      differentiated SMC incorporated DiI-lipo PGE1 to equal or a higher level of the
      proliferative phenotype, and was significantly higher than EC and fibroblasts.
      The uptake of DiI-lipo PGE1 by both SMC and EC was inhibited at 4 degrees C, by
      dansylcadaverine and excessive LM, but was unaffected by cytochalasin B. These
      results suggest that the uptake of DiI-lipo PGE1 by SMC plays an important role
      in localization of DiI-lipo PGE1 at the injured site, and that the uptake seems
      to be a receptor mediated endocytosis.

PMID- 11213364
TI  - Effects of melatonin, morphine and diazepam on formalin-induced nociception in
      mice.
AB  - The possible analgesic effect of melatonin was investigated in young male ICR
      mice. The formalin test which elicits typically 2 phases of pain response, the
      acute (first) phase and tonic (second) phase, was used. The test was performed in
      the late light period when the mice have been reported to be more sensitive to
      pain. Compared to control mice, no significant difference in nociceptive response
      was observed when melatonin was injected intraperitoneally at doses of 0.1, 5,
      and 20, mg/kg body weight. The combined effects of melatonin with diazepam and/or
      morphine, were also investigated. Melatonin, injected at 20 mg/kg 15 min before
      formalin test, significantly increased the antinociceptive response of diazepam
      (1 mg/kg) or morphine (5 mg/kg) in the second phase. In addition, when melatonin
      was given at 20 mg/kg together with diazepam and morphine, antinociceptive
      responses in both the first and second phase were increased. These data indicate
      the synergistic analgesia effect of melatonin with morphine and diazepam and
      suggest the possible involvement of melatonin as an adjunct medicine for pain
      patients.

PMID- 11213365
TI  - Endothelium-independent vasorelaxation by leonurine, a plant alkaloid purified
      from Chinese motherwort.
AB  - Leonurine, a plant alkaloid present in Chinese motherwort, induced concentration-
      dependent and endothelium-independent relaxation of phenylephrine (PE)-
      pretreated rat aortic arterial rings. The IC50 values for leonurine were 86.4+/
      10.4 and 85.9+/-17.2 microM in the presence and absence of endothelium
      respectively. It inhibited the responses of aortic smooth muscle to PE in Ca2+
      free medium containing 100 microM EGTA, suggesting a possible action on the
      release of intracellular Ca2+. Leonurine is not a specific alpha-adrenoceptor
      blocker, since it also caused a concentration-dependent inhibition of vascular
      contractile responses to KCl with an IC50 value of 96.4+/-13.4 microM, suggesting
      that leonurine also blocks the L-type Ca2+-channel. In addition, leonurine
      relaxed the aortic contraction induced by prostaglandin F2alpha (PGF2alpha).
      These inhibitory effects of leonurine were reversible and did not affect the
      resting tension. In conclusion, these findings suggest that leonurine is an
      effective inhibitor of vascular smooth tone, probably acting by inhibiting the
      Ca2+ influx and the release of intracellular Ca2+.

PMID- 11213366
TI  - Angelica sinensis modulates migration and proliferation of gastric epithelial
      cells.
AB  - A crude extract from Angelica sinensis (ASCE), which mainly consists of
      polysaccharides, prevents ethanol- or indomethacin-induced gastric mucosal damage
      and promotes ulcer healing. The aim of this study was to test the hypothesis that
      ASCE has a direct stimulating effect on gastric epithelial cells for wound
      healing. We found that ASCE significantly promoted the migration of epithelial
      cells over an artificial wound on the surface of an RGM-1 monolayer. The extract
      also stimulated DNA synthesis in a dose-dependent manner and concomitantly
      increased EGF mRNA expression. Co-incubation of ASCE with anti-EGF antibody
      reduced the speed of migration and the DNA synthesis, which however were still
      higher than the control without ASCE. These results strongly suggest that ASCE
      has a direct wound healing effect on gastric mucosa, and this is acting partially
      through an EGF-mediated pathway.

PMID- 11213367
TI  - Biological properties of Phe(o)-opioid peptide analogues.
AB  - Biological properties of new analogues, which represent Phe(o)-propeptides of a
      variety of opioid peptides, are described. All Phe(o)-opioid analogues expressed
      both receptor binding affinities and in vitro biological activities at least at
      the level of the primary opioid peptides. Surprisingly, some of the propeptides
      expressed slightly higher activity than the primary opioid peptides.
      Nevertheless, no significant shift in receptor selectivity was observed, which
      indicate that these Phe(o)-analogues undoubtedly are propeptides. The possible
      role of membrane proteolytic enzymes associated with opioid receptors in
      transformation of propeptides is discussed.

PMID- 11213368
TI  - Marketplace. With workers' compensation outlays set to rise there's renewed
      interest in how to contain costs.

PMID- 11213369
TI  - Perspectives. Burgeoning technology will strain Medicare more than previously
      admitted, says panel.

PMID- 11213370
TI  - Current practice in assessment and treatment of bronchial asthma in young males
      in Italy.
AB  - The aim of the study was to evaluate, in a sample of young asthmatics in Italy,
      the current practice in assessment and treatment of asthma after the publication
      of guidelines. Young soldiers who declared bronchial asthma at the beginning of
      the compulsory military service were evaluated. One-hundred and thirty-eight
      subjects with confirmed asthma were selected. Sixty-seven subjects (48.5%) had
      had at last one spirometry, and only one subject had underwent peak flow
      monitoring at home; most of the subjects (96.8%) had had prick tests. More of the
      50% of the subjects with bronchial obstruction or with severe bronchial
      hyperresponsiveness, with clinical moderate or severe asthma, had used only
      bronchodilators or no therapy at all in the preceding year. In this sample of
      young asthmatics, the lung function tests were still underutilized for the
      diagnosis and follow-up of bronchial asthma; moreover, the inhaled anti
      inflammatory drugs were still underutilized.

PMID- 11213371
TI  - Perception of methacholine-induced airway obstruction in asthmatics.
AB  - The main objective of this study was to examine the perception of the first
      symptom during methacholine bronchoconstriction as soon as it occurred, and in
      the second instance to quantify the intensity of the breathlessness by means of
      the Borg Scale performed at the end of challenge so to not determine any
      difficulties for identification of the first symptom. A methacholine challenge
      test was carried out in 139 symptom-free asthmatics with a normal pulmonary
      function. When the first symptom was reported by the subject, the forced
      expiratory volume in one second (FEV1) was measured immediately. FEV1 was
      expressed as a percentage of the best personal value (FEV1%BPV). The intensity of
      the breathlessness was rated using a modified Borg Scale at the end of the
      challenge test so as not to confuse the patient. Seven subjects felt nothing
      during challenge. The first symptoms varied: constriction behind the breastbone
      (49%), inspiratory shortness (16.5%), coughing (10%), wheezing, throat
      constriction, general chest tightness, pain behind the sternum, and a sensation
      of rheum behind the sternum. FEV1%BPV at the first symptom was 80.5 +/- 10 (range
      41-99). No symptom was perceived by 42% of the subjects within the 80-100 range
      of FEV1%BPV. FEV1%BPV at the first symptom was related to the log of the
      provocative dose causing a 20% fall in FEV1 (r = 0.2, p < 0.05). An inverse
      correlation between Borg Score and final FEV1%BPV (r = -0.25, p < 0.01) was found
      at the end of challenge. A subgroup of 39 subjects with similar final FEV1%BPV
      values (68-72) showed a correlation between the Borg Score at end of challenge
      and FEV1%BPV at the first symptom (r = 0.59, p < 0.001). The first symptom of the
      methacholine-induced bronchoconstriction varies in asthmatics and may be
      atypical, the bronchoconstriction level at which it is felt also varies among
      individuals, highly methacholine-responsive subjects perceive the
      bronchoconstriction later, while late perceivers of the first symptom show less
      intense breathlessness at the end of challenge. The measurement of the patient's
      ability to perceive asthmatic symptoms during the methacholine challenge test
      could be used to single out poor perceivers.

PMID- 11213372
TI  - Accuracy of indirect estimation of oxyhaemoglobin saturation in patients with
      respiratory failure.
AB  - The indirect estimate of oxyhaemoglobin saturation (Sa,O2) is largely used in the
      management of patients with respiratory failure. The aim of this study was to
      evaluate the accuracy of the Sa,O2 values calculated by using both the Siggaard
      Andersen (SA) and the Severinghaus (SE) equation, in comparison with the real
      Sa,O2 values measured by a co-oximeter. A total of 558 arterial blood samples
      were analysed. On average, only a slight overestimation was found for Sa,O2
      estimated by the SA (2.35 +/- 5.75%) and the SE (2.37 +/- 5.65%) equations in
      comparison with the real values. However, a difference higher than 5% between
      estimated and real Sa,O2 values was demonstrated in more than 20% of the blood
      samples evaluated. This difference was higher than 10% in 9% of the samples, with
      similar results obtained with the two equations. The discrepancy between real and
      estimated values, probably due, at least in part, to errors in measurement of
      arterial oxygen tension (Pa,O2) and pH, was maximally evident for Sa,O2 values
      lower than 70%. An indirect estimate of Sa,O2 is not homogeneously accurate, and
      the clinical consequence of this finding might be especially dangerous in
      monitoring patients with severe respiratory failure.

PMID- 11213373
TI  - Bronchial atresia with mucocele in an adolescent girl: an uncommon cause of lobar
      emphysema.
AB  - Congenital bronchial atresia (CBA) is a congenital anomaly but is seldom
      diagnosed in children. They are usually asymptomatic and are found during
      screening chest radiographs in young adults. The characteristic chest radiographs
      of CBA consist of a hyperlucent lung, central branching but contrast non
      enhancing mass and air-fluid lesion. Most of the cases reported in the past were
      managed surgically. The present study reported an 11-yr-old presenting with chest
      pains, exercise intolerance, and refractory wheezing. It is of utmost importance
      to consider the possibility of CBA in children with lobar emphysema in order to
      achieve early diagnosis and avoid unnecessary exploratory surgery.

PMID- 11213374
TI  - Sarcoidosis in a patient with 5q-myelodysplasia. A possible pathogenetic link
      between the two diseases.
AB  - This study describes the occurrence of sarcoidosis with lung and skin
      involvements in a 56-yr-old woman who suffered from 5q-myelodysplastic syndrome
      since the age of 50. The 5q-myelodysplastic syndrome is marked by deletion of the
      long arm of chromosome 5, which carries the genes coding for T-helper cell 2
      cytokines, such as interleukins-3, -4 and -5, and granulocyte-macrophage colony
      stimulating factor. Although the aetiology of sarcoidosis remains unclear,
      sarcoid granulomatous inflammation is marked by predominant expression of T
      helper cell 1 cytokines, with reduced expression of T-helper cell 2 cytokines.
      The authors suggest that 5q-abnormality may have predisposed to sarcoidosis
      through an imbalance in the cytokine network, caused by the deletion of genes
      coding for T-helper cell 2 cytokines.

PMID- 11213375
TI  - Mycobacterium tuberculosis and HIV co-infection in the lung: synergic immune
      dysregulation leading to disease progression.
AB  - There is evidence that Mycobacterium tuberculosis (Mtb) impacts on human
      immunodeficiency virus (HIV) infection and that HIV promotes mycobacterial
      diseases. Epidemiological and clinical studies demonstrate the detrimental effect
      of tuberculosis (TB) on the progression of HIV infection, that is an increased
      risk of death among Mtb-HIV co-infected patients. Pulmonary TB may occur very
      early during HIV infection, whereas extrapulmonary or atypical manifestations are
      associated with more profound immunodeficiency, showing features like
      mycobacteraemia and multi-drug resistance, much more severe than in
      immunocompetent hosts. During the last decade, many efforts have been focused on
      the immunological aspects of Mtb-HIV co-infection. The host protective response
      to TB is mediated by cell immunity, which, mainly supported by interleukin (IL)
      12 and interferon (IFN)-gamma production, leads to granuloma formation.
      Perturbations in the cytokine expression, that is a reduced type-1-like response,
      have been suggested in HIV-infected patients to contribute to their
      susceptibility to TB. Indeed, an impaired balance between pro-inflammatory and
      anti-inflammatory cytokines and apoptosis-induced depletion of immune effector
      cells account for the dissemination of both the pathogens and for a poor
      granulomatous reaction in Mtb-HIV co-infected patients. However, the recently
      elucidated role of chemokines and their receptors in immune regulation opens new
      questions on the pathogenesis of Mtb-HIV co-infection.

PMID- 11213376
TI  - New therapeutic approach to persistent asthma.
AB  - The goal of asthma treatment has moved from achieving symptom relief alone to
      overall disease control. The latest guidelines propose that first-line treatment
      of mild persistent asthma requires the introduction of anti-inflammatory agents,
      preferably inhaled corticosteroids at low dose. In patients in whom control of
      disease is not achieved with this treatment, it was demonstrated that addition of
      a long-acting beta 2-agonist is more effective than increasing the dose of
      inhaled corticosteroid. Addition of a long-acting beta 2-agonist to an inhaled
      corticosteroid not only improves symptoms and lung function but also reduces the
      risk of asthma exacerbations, suggesting complementary therapeutic activity.
      Therefore, use of long-acting bronchodilators with inhaled corticosteroids is a
      prerequisite for optimal management of the disease. For this reason, the logical
      development in asthma management would be a combination of these two classes of
      drug in a single inhaled formulation. Fixed combinations of the long-acting beta
      2-agonist salmeterol and the inhaled corticosteroid fluticasone propionate were
      launched recently. Results from recent clinical trials have demonstrated that the
      combination of salmeterol and fluticasone propionate improves control of asthma
      in the majority of patients with moderate-to-severe asthma and enhances
      compliance by virtue of both drugs being in the one inhaler. The possibility to
      treat asthma of differing severity is provided by the flexibility to choose
      between three different doses of fluticasone propionate in the fixed combination
      devices. Another obvious advantage of the combination is cost savings, as the
      fixed combination inhaler is cheaper than giving the two drugs separately. The
      introduction of combination preparations is an important step forward in asthma
      management, which is expected to be a popular choice with both patients and
      physicians.

PMID- 11213377
TI  - What is liquid breathing and ventilation?
AB  - Liquid ventilation is a rapidly growing ventilation technique. In spite of the
      large number of scientific and technical papers on the argument, the general
      concepts, particularly useful for the non-specialist physician, are not easy to
      acquire. The scope of this simple review is to explain the present general
      aspects and uses of liquid ventilation, analysing their chronological
      development.

PMID- 11213378
TI  - Contribution of upper airway reflexes to apnoea reversal, arousal, and
      resuscitation.
AB  - Cardiorespiratory decompensation or even death may result from dysfunction of
      upper airway reflexes during sleep. This could manifest, for example, as a lack
      of pharyngeal dilation in obstructive sleep apnoea or failure of
      autoresuscitation by gasping in sudden infant death syndrome. Data obtained from
      experiments in anaesthetized cats suggest several clinicophysiological
      applications for upper airway reflexes possessing important pathogenetic and
      therapeutic potentials. Such reflex effects include: 1. Pharyngeal dilation as
      additional treatment in obstructive sleep apnoea. 2. Bronchodilation after deep
      nasal breathing in asthmatic attacks. 3. Oesophageal sphincter relaxation
      alleviating gastro-oesophageal reflux. 4. Provocation of sniff- and gasp-like
      aspiration for reversal of central apnoea. 5. Arousal from sleep increasing the
      general reactivity. 6. Increase in muscle tone underlying behavioural defence
      reactions. 7. Increase in sympathetic activity contributing to powerful
      cardiopulmonary-cerebral resuscitation. 8. Adrenergic reaction mediated by
      catecholamine secretion.

PMID- 11213379
TI  - Sleep apnoea syndrome: the health economics point of view.
AB  - This review analyses the available literature on the economic aspects of
      obstructive sleep apnoea, including the indirect medical costs, the indirect
      nonmedical costs, the direct costs of diagnosing and treating the disease, and
      the utilities as perceived by patients. The philosophical context of health
      economics is also considered. The literature available on the economic aspects of
      obstructive sleep apnoea is scarce, and frequently incomplete, so that only
      tentative conclusions can be reached. Obstructive sleep apnoea seems to lead to
      measurable (about two-fold) increases in indirect medical costs. Moreover, this
      excess cost seems to be reduced in the first years following the institution of
      treatment with nasal continuous positive airway pressure (nCPAP). There are also
      indirect nonmedical costs linked to the disease, for example traffic, domestic
      and workplace accidents. The exact extent of these costs is, however, impossible
      to ascertion from the available literature. Cost/utility analysis has shown full
      night polysomnography to be the diagnostic approach with the higher cost/utility
      ratio, because diagnostic errors (greater with other approaches) carry a
      disproportionate weight. The cost of treating the disease has not been thoroughly
      assessed but appears as quite reasonable, and certainly not excessive. Finally,
      one study has shown in patients with severe sleep apnoea that treatment with
      nCPAP has a favourable effect when measured as quality adjusted life years. It is
      concluded that obstructive sleep apnoea leads to an excess in health-related
      expenditure, that treatment with nasal continuous positive airway pressure
      reduces this excess cost and thus makes sense in economic terms, and that
      patients believe nasal continuous positive airway pressure treatment to be worth
      considering for economic reasons. It is further concluded that medical decisions
      should be guided by medical (not economic) considerations, even if it is
      acknowledged that, for the time being, economic analysis is necessary to to
      convince health managers that obstructive sleep apnoea is also worth considering
      from the economic point of view.

PMID- 11213380
TI  - Potential usefulness of inhibiting neural mechanisms in asthma.
AB  - The airway innervation consists of a cholinergic system, an adrenergic system,
      and a non-adrenergic, non-cholinergic (NANC) system. Anticholinergic drugs have
      long since been used in the treatment of asthma and chronic obstructive pulmonary
      disease (COPD). The new anticholinergic drug, tiotropium bromide, causes long
      lasting bronchodilatation (> or = 24 h) in patients with COPD. The sensory airway
      neuropeptides, substance P (SP) and neurokinin A (NKA), are potent contractors of
      smooth muscle, vasodilators and have important proinflammatory effects. Their
      airway effects are mediated by tachykinin NK1 and NK2 receptors. Antagonists for
      these receptors are currently being developed as a possible treatment of
      obstructive airway diseases.

PMID- 11213381
TI  - Acute exacerbations in chronic obstructive pulmonary disease (COPD)--microbial
      patterns and risk factors.
AB  - Around 25% of patients with stable chronic obstructive pulmonary disease (COPD)
      show some evidence of tracheobronchial colonization. It is, however, probable
      that the vast majority of patients become colonized at some time during the
      course of the disease. A variety of factors including current smoking and viral
      infections predispose to bacterial colonization and subsequently acute
      exacerbations. In fact, infectious aetiologies account for around 50-75% of acute
      COPD exacerbations. Bacterial pathogens are present in around 50% of patients,
      Haemophilus influenzae and Streptococcus pneumoniae being the most frequently
      encountered pathogens. Pseudomonas aeruginosa and probably also Gram-negative
      enteric bacilli are more frequently found in patients with more severe airflow
      limitation. Viral infections are present in around 10-20%, with Influenzavirus
      representing the most frequent viral pathogen. Only recently, evidence for
      infection by Chlamydia pneumoniae has been found in 5-20% of patients. Predictors
      of distinct aetiologies have only infrequently been studied so far. Thus, it
      currently remains difficult to make adequate predictions on clinical grounds in
      the individual patient. Nevertheless, we would advocate to tentatively stratify
      the initial antimicrobial treatment according to the severity of the acute
      exacerbation episode and the presence of individual risk factors. The validation
      of such an approach may result in significant progress in our understanding of
      the role of infection and infectious agents in different subgroups of patients
      with acute exacerbations.

PMID- 11213382
TI  - Complementary investigations in bronchiectasis in children.
AB  - The different modalities suitable for image-guided diagnosis of bronchiectasis in
      children are described. Plain chest radiography is still the most important
      imaging method of respiratory disease in children, but when it comes to
      ascertaining the diagnosis of bronchiectasis, high-resolution computed tomography
      (CT) is currently the method of choice. Ultrafast computed tomography and
      multislice computed tomography have increased the value of computed tomography as
      a diagnostic tool by reducing the need for sedation or anaesthesia. Bronchography
      is as a rule no longer necessary to perform on this indication alone. If modern,
      high-quality computed tomography is not readily available, however, bronchography
      may still be necessary preoperatively.

PMID- 11213383
TI  - Tidal breathing at all ages.
AB  - Measurement of lung function during tidal breathing may be performed regardless
      of the age and respiratory state of the patient. This is particularly
      advantageous in young children in whom forced respiratory manoeuvres cannot be
      performed, but has also been found useful in adults with various chest diseases.
      The most frequently reported tidal breathing parameters are mathematical
      expressions of the shape of the tidal flow/volume (TFV) loop or tidal flow/time
      traces, as the ratio of the time or volume taken to reach peak expiratory flow to
      total expiratory time or volume (tPTEF/tE or VPTEF/VE, respectively). However,
      new parameters have been suggested, focusing on the shape of the latter portion
      of the curve. Standardization of measurements is important, and more studies are
      required to settle some of the issues regarding, for instance, how many curves to
      evaluate, which parameter to report and how to perform challenge or reversibility
      tests. Intra-individual variation should be kept to a minimum, preferably
      performing measurements under the same conditions on each occasion. The issue of
      whether to sedate is a subject of debate. However, with experience, reproducible
      TFV measurements may be obtained in most subjects in the awake state, regardless
      of age, provided the setting is friendly and calm. TFV measurements have provided
      important information in research as well as clinical settings. Reduced tPTEF/tE
      has been demonstrated in newborn term and premature babies born to smoking
      mothers, and is a risk factor for recurrent wheeze within the first 3 yrs of
      life. Also, tPTEF/tE is clearly reduced in subjects with acute bronchial
      obstruction (BO) (such as occur in bronchiolitis), but also in asymptomatic
      children with BO for other reasons, such as asthma. Significant response to
      histamine and methacholine as well as to bronchodilator has been demonstrated in
      preschool children, adults and animals (horses, dogs and cats). The present paper
      discusses various practical issues concerning and possible uses of tidal
      flow/volume measurements. In conclusion, tidal flow/volume measurements may be
      important supplementary tools in the investigation of respiratory disease in both
      research and clinical work in subjects who for any reason cannot cooperate with
      more conventional lung function measurements.

PMID- 11213384
TI  - [Quality control in hemodialysis: quality assurance process].
AB  - The development of a quality assurance step in hemodialysis replies to the needs
      of the accreditation process defined in the hospital reform and the related
      ordinances edited in April 1996. This global concept is set to continuously
      improve the quality care and the outcomes of the hemodialysis patients. The
      thought behind this work has two objectives: provide guidelines to guaranty
      quality and adequacy of hemodialysis treatment schedule in ESRD patients;
      anticipate standard rules edited by regulatory authorities for quality indices
      and control process in hemodialysis. The final aim of this work is also to
      demonstrate that the quality assurance process in hemodialysis should not be
      perceived as an extra administrative burden but rather as a new opportunity to
      establish good medical practice rules in the peculiar domain of renal replacement
      therapy.

PMID- 11213385
TI  - [Renal osteodystrophy (3); its treatment in dialysis patients].
AB  - The prevalence and the clinical gravity of the various histopathological
      varieties of renal osteodystrophy in dialysis patients depends on the severity of
      both the aluminium intoxication and that of hyperparathyroidism. The prevalence
      of bone pains, fractures and hypercalcemias are the highest in adynamic bone
      diseases (ABD) with severe aluminium intoxication, then in osteitis fibrosa and
      mixed osteopathy, in the ABD with moderate aluminium intoxication and rare in the
      mild lesion in spite of similar moderate aluminium intoxication. In the absence
      of aluminium intoxication, hypercalcemia and hyperphosphatemia prevalence is
      higher only when intact PTH is more that 4 times the upper limit of normal. When
      PTH is between 1 and 2 folds the ULN this prevalence is null and bone mineral
      density is the highest. 2. The low turnover aluminic bone diseases (osteomalacic
      or adynamic) will be cured by long term deferoxamine treatment. The hazards of
      such treatment justify the performance of a bone biopsy to ensure the diagnosis.
      Their prevention relies on adequate treatment of tapwater and definitive
      exclusion of long term administration of aluminum phosphate binders. 3. Non
      aluminic osteomalacia will be treated according to the same guidelines given for
      the uremic patients before dialysis. 4. Non aluminic adynamic bone disease will
      be cured by means aiming at stimulating PTH secretion as discontinuing 1 alpha
      hydroxylated vitamin D derivatives, and, if there is no hyperphosphatemia by
      discontinuation of calcium supplement. In case of hyperphosphatemia in dialysis
      patients CaCO3 doses have to be nevertheless increased after the dialysate
      calcium concentration (DCa) has been decreased in order to induce a negative
      perdialytic calcium balance for PTH secretion stimulation. In the near future
      substitution of CaCO3 by non calcemic non aluminic phosphate binders will
      suffice. 5. Osteitis fibrosa due to hyperparathyroidism will be treated first by
      securing an optimal vitamin D repletion (bringing plasma 25OH vitamin D around 30
      and 60 ng/ml or 75-150 nmol/l) and by correcting hypocalcemia and
      hyperphosphatemia by CaCO3 at high doses (3-12 g/day) taken with the meals. In
      case of hypercalcemia dialysate calcium concentration will be decreased to
      correct it or, in a near future, CaCO3 will be decreased to 3 g/day and
      hyperphosphatemia will be controlled by non calcemic, non aluminic phosphate
      binders. When hyperphosphatemia is controlled whereas plasma calcium is normal or
      low, 1 alpha hydroxylated vitamin D derivatives can be administered. 6.
      Instrumental parathyroidectomy should be considered when plasma levels of intact
      PTH remain above 7 folds the upper limit of normal whereas hyperphosphatemia
      persists and hypercalcemia occurs in order to prevent thining of the corticals
      and subsequent fracture risk. In case of previous exposition to aluminum, a
      deferoxamine test and/or a bone biopsy will be performed to decide a long term
      DFO treatment before the parathyroidectomy in order to prevent the transformation
      of a mixed osteopathy into an aluminic adynamic bone disease. 7. The difficulty
      of hyperparathyroidism control in dialysis patients is due to poor compliance to
      phosphate binders and to irreversible parathyroid hyperplasia with occured before
      the dialysis stage. This stress the primary importance if its early prevention
      without iatrogenia by first CaCO3 and vitamin D repletion, as soon as the
      creatinine clearance decreases below 60 ml/min/1.73 m2.

PMID- 11213386
TI  - [Selective inhibitors of type 2 cyclooxygenase: less renal effects than the
      classical non-steroidal anti-inflammatory agents].
AB  - Prostaglandins play an important role in the regulation of renal hemodynamics and
      sodium excretion. Thus, the administration of non-steroidal anti-inflammatory
      drugs (NSAIDs) induces a renal vasoconstriction and sodium and potassium
      retention. In some high risk patients, this may lead to acute renal failure. The
      anti-inflammatory and renal effects of conventional NSAIDs are mediated by the
      non-selective inhibition of two cyclo-oxygenases, COX-1 and COX-2. Recently,
      highly selective COX-2 inhibitors have been developed such as celecoxib
      (Celebrex) and rofecoxib (Vioxx). These drugs were designed to preserve the
      analgesic and anti-inflammatory properties of NSAIDs while reducing their gastro
      intestinal and renal side effects. Selective COX-2 inhibitors have indeed less
      gastro-intestinal side-effects. However, their renal profile is comparable to
      that of non-selective inhibitors as they induce a decrease in glomerular
      filtration rate and a sodium and potassium retention. Thus, despite the good
      gastro-intestinal safety profile of selective COX-2, one should be careful with
      the use of these agents in high risk patients as they may induce similar renal
      complications as non-selective NSAIDs.

PMID- 11213387
TI  - [Value of an end-stage renal failure registry. Experience of the Champagne
      Ardenne region].
AB  - Since 1992, a registry gathering all the patients with end-stage renal failure is
      established in Champagne-Ardenne. It is based upon demographic data and
      allocation of dialysis treatment. It is supported by regional nephrologists. It
      is exhaustive and has been validated by the regional health administration. It is
      the only data base considered for the regional scheme of sanitary organization.
      In 1999 the incidence of terminal renal failure was 119 pmp and, at 1 January
      2000, prevalence of uremic patients treated with supportive therapy, except
      transplantation, was 426 pmp. Our registry may be used as a regional registry
      awaiting to participate into built the national program project REIN (Renal
      Epidemiology and Information Network) and to help better health care policy and
      costs containment.

PMID- 11213389
TI  - [The "Ana Rosa syndrome" in scientific literature].

PMID- 11213388
TI  - [Diffuse colitis associated with mycophenolate mofetil treatment: apropos of 1
      case].
AB  - Mycophenolate mofetil (MMF) or Cellcept is a potent immunosuppressor that
      inhibits purin synthesis used to prevent human allograft rejection. The most
      important secondary effects include haematological and intestinal disorders.
      Among them, diarrhea is the most common. It is dose-dependant and appears
      commonly during the first 2 months of treatment. Its physiopathology remains
      unclear. We reported a case of colitis, 6 months after a kidney transplantation.
      The patient was treated since day 2 with 2 grams per day of MMF. Morphological
      analysis showed a diffuse colitis from the coecum to the rectum. Histological
      samples confirmed a colitis with atrophic crypts but with mucosal secretions and
      some cryptic abscesses. No granuloma or CMV inclusion was founded. Histochemical
      immunostaining for CMV was negative. Finally, symptoms regressed within 5 days
      after tapering down MMF dose in association with metronidazole treatment. The
      role of MMF in inducing colitis is discussed.

PMID- 11213390
TI  - [Recovery of circumcision as medical practice in Miguel Servet's literature].

PMID- 11213391
TI  - [Analysis of 83 urethroplasties for urethral stenosis].
AB  - OBJECTIVE: To determine the appropriate technique for each case of urethral
      stricture, according to its length, depth, localization, etiology and age of the
      patient. METHODS: 83 urethroplasties for urethral stricture performed from 1992
      1998 were reviewed. The strictures involved different levels of the urethra. The
      techniques utilized were analyzed (substitution urethroplasty with pedicle skin
      graft and free grafts using buccal mucosa and extragenital skin, excision and
      anastomotic repair, regeneration techniques with internal urethrotomy and
      placement of intraluminal prosthesis, and two-stage repair procedures). RESULTS:
      The overall functional results were good in 93% of the cases (78 good, 5 poor),
      but the morphological results demonstrated by the radiological findings were not
      as good in 24% of the cases, which corresponded to those that had received
      preputial pedicle grafts and buccal mucosa free grafts. CONCLUSION: Using the
      appropriate urethroplasty technique is essential to achieve good functional
      results. The substitution techniques require well-vascularized grafts and/or
      recipient sites. The foregoing must be taken into account in the selection of the
      appropriate graft and deciding on the stricture length and localization.

PMID- 11213392
TI  - [Immunotherapy in superficial bladder carcinoma].
AB  - OBJECTIVE: To review the current status of superficial bladder cancer treatment
      with several immune response modifiers. METHODS: A review of the advances in the
      treatment of superficial bladder cancer with BCG, interferon, interleukin-2,
      bropirimine and keyhole-limpet hemocyanin was performed. RESULTS: Treatment with
      BCG has been demonstrated to be superior to intravesical chemotherapy and other
      immune response modifiers in the trials reviewed. BCG therapy, however, carries a
      higher toxicity. Several trials have demonstrated that in low and medium risk
      patients, it is better to administer low BCG doses to reduce the toxicity.
      Furthermore, the trials confirm the utility of maintenance schedules with BCG.
      CONCLUSION: The Calmette-Guerin Bacillus is the most effective adjuvant treatment
      in superficial bladder cancer, especially in the high risk patients. The other
      immune response modifiers are an alternative to this treatment.

PMID- 11213394
TI  - [Characteristics of prostatic cancer undetected in the first assessment of a
      screening program. Quality control].
AB  - OBJECTIVE: To study the results of the second round in the subjects with negative
      tests in the first round of a prostate cancer screening program and to analyze
      the characteristics of the tumors that were not detected in the first round.
      METHODS: Of 5188 males evaluated in a prostate cancer screening program, 976 with
      negative tests in the first round (804 with PSA < or = 4 ng/ml; 172 with PSA > 4
      ng/ml and a negative biopsy) accepted to undergo subsequent tests. During the
      second round, 163 biopsies were indicated. The biopsy results and the
      characteristics of the tumors detected were analyzed. RESULTS: The biopsy yield
      was higher (but not significantly) in the first round (80 cancers/481 biopsies;
      16.6%) than in the second round (13 cancers/115 biopsies; 11.3%). Of the 163
      biopsies indicated in the second round, 115 were performed and 13 cancers were
      detected (10 of these patients had a high PSA in the first round). The univariate
      analysis showed no differences for age, PSA, PSA density, prostate volume,
      transrectal US findings, or Gleason score in the cases diagnosed in the first
      round and those detected in the second round. However, there was a higher
      proportion of tumors with abnormal DRE in the cancers detected in the first round
      than in the second round, (31.3% vs 7.7%, respectively; p = 0.02). There was a
      higher proportion of tumors clinically detected in the second round than in the
      first round (100% vs 75%, respectively; p = 0.043). The multivariate analysis
      only showed differences for the DRE findings (p = 0.045). CONCLUSION: A
      significant number of tumors are undetected in prostate cancer screening
      programs. Although the biopsy yield may be slightly lower in subsequent rounds,
      there is a strong trend of detecting more localized tumors (and therefore
      potentially curable). We have found no correlation between a greater prostate
      volume and tumors that were undetected in the first round.

PMID- 11213395
TI  - [Laparoscopic approach through optic trocars].
AB  - OBJECTIVE: Laparoscopy has not reached the same levels of development in Urology
      as it has in other surgical specialties. Consequently, the average urologist is
      not sufficiently accustomed to using laparoscopic trocars, a difficulty which
      becomes even more noteworthy since treatment is occasionally preferably by the
      extraperitoneal approach (preperitoneoscopy and retroperitoneoscopy). Our
      experience with different visualizing trocars is presented. METHODS: We reviewed
      our experience with different visualizing trocars. The advantages and
      inconveniences of each type, utilized in different approaches, are discussed.
      RESULTS: Active visualizing trocars are preferred because they are safe and
      permit pre and retroperitoneal blunt dissection without difficulty. However, cost
      is the major disadvantage of these instruments because they are not reusable.
      CONCLUSION: Lately, we are more inclined to utilize the reusable visualizing
      trocars with the helicoidal cannula, which are very safe for the transperitoneal
      and perhaps slightly less for the extraperitoneal approach. These instruments
      cause less injury when they go through the abdominal wall and, furthermore, they
      cost less.

PMID- 11213393
TI  - [Studer-type orthotopic urinary bladder: our experience].
AB  - OBJECTIVE: To analyze the outcome, complications and functional results in
      patients undergoing bladder substitution with the Studer continent urinary pouch.
      METHODS: The clinical records of 6 male patients who underwent radical cystectomy
      for invasive bladder cancer and bladder substitution with the Studer reservoir at
      our hospital from January 1996 to February 2000 were reviewed. Patient mean age
      was 54.2 years and mean follow-up was 14 months. Follow-up evaluation included
      abdominopelvic CT, chest x-ray, urinalysis, blood biochemistry, venous gasometry
      and ultrasonography with evaluation of postvoid residual urine. RESULTS:
      Transitional cell carcinoma was found to be the most frequent histopathological
      type. Distribution by grade and pathological stage showed they were all high
      grade infiltrating tumors localized to the bladder. Four patients are free of
      disease, one died from metastatic disease and one patient with tumor progression
      and multiple lung metastases at two months' follow-up is currently on
      chemotherapy. The mean operating time was significantly longer for this procedure
      than for the non-continent Bricker urinary diversion (mean 7.2 hours vs 3.5
      hours, respectively). The immediate postoperative complications were: ileus (> 7
      days) in two patients, diarrhea (> 3 days) in two, occlusive ileus due to
      fecaloma in one, metabolic acidosis in one, wound seroma in one, and wound
      infection in two patients. The early and late postoperative complications were:
      incontinence for up to one month after removing the urethral catheter in three
      patients (two of these patients are still incontinent at two months' follow-up),
      wound infection in two and impotence in 6 patients. CONCLUSION: Reservoir
      function in the medium-term is good; spontaneous urethral micturition and
      continence are maintained. To achieve good results, patients should be followed
      carefully and should be given detailed information about postoperative care and
      management.

PMID- 11213396
TI  - [Diagnosis and therapeutic options for prolonged erection and priapism: up-date
      review].
AB  - OBJECTIVE: To review the pathophysiology, diagnostic methods and treatments of
      priapism, with special reference to alternative treatment options. METHODS: The
      different surgical options are presented and discussed, with special emphasis on
      the oral drugs and intracavernous therapy for priapism. The advantages and
      inconveniences of the different agents and surgical techniques are discussed. The
      publications in MEDLINE 1980-2000, our experience and the results of our studies
      previously reported in the literature were reviewed. RESULTS/CONCLUSIONS:
      Complete detumescence and recovery of normal arterial blood flow can be achieved
      in a majority of the cases by systematic and standardized management. Sedatives,
      alpha-adrenergic agents or oral ketamine hydrochlorate can be utilized. However,
      due to the importance of the time factor, intracavernosal therapy should be the
      priority for persistent erection, using alpha-adrenergic agonists or other
      alternatives, such as methylene blue, which do not have the well-recognized risks
      of the conventional agents. The etiology of the priapism should be clearly
      established by metabolic and hemodynamic studies, since treatment will be based
      on the underlying disorder. In veno-occlusive low flow priapism, surgical
      shunting should be performed if aspiration of intracavernosal blood and other
      treatments are not successful. Arterial embolization and surgical ligation should
      be performed for high flow persistent priapism.

PMID- 11213397
TI  - [Low-flow priapism associated with systemic lupus erythematosus and nephrotic
      syndrome].
AB  - OBJECTIVE: To present a case of priapism associated with systemic lupus
      erythematosus and nephrotic syndrome. METHODS: A 29-year-old male patient with a
      history of multiple pathologies consulted at the emergency services with painful
      priapism of 12 hours' duration. The intracavernosal aspirated blood had a venous
      appearance. Among the risk factors analyzed, systemic lupus erythematosus and
      nephrotic syndrome are recognized to cause hypercoagulability, a condition that
      can lead to low flow priapism. RESULTS: There was no response to lavage
      aspiration or intracorporeal administration of an alpha-adrenergic agonist. The
      high surgical risk of the patient advised against surgery. The priapism gradually
      diminished until complete remission on the sixth day. The patient has remained
      without spontaneous erection. CONCLUSION: Systemic lupus erythematosus and
      nephrotic syndrome can cause low flow priapism. The best treatment is by
      prevention with adequate antithrombotic prophylaxis.

PMID- 11213398
TI  - [Isolated primary hyperaldosteronism caused by adrenocortical carcinoma].
AB  - OBJECTIVE: To report a case of adrenocortical carcinoma and primary aldosteronism
      as the sole endocrine manifestation. METHODS/RESULTS: A 39-year-old male with
      adrenocortical carcinoma and primary aldosteronism is presented. Following
      complete hormonal and radiological evaluation, right adrenalectomy and
      nephrectomy were performed (pT2pN0M0, stage II). Blood pressure, serum potassium
      and aldosterone levels returned to normal. The patient received adjuvant therapy
      with carboplatin and etoposide. After 15 months' disease-free interval, lung
      metastasis was diagnosed, without evidence of local recurrence until 5 months
      later, when hypertension and primary hyperaldosteronism reappeared. There were no
      other endocrine disorders. Treatment with spironolactone, 5-FU and adriamycin was
      instituted with no tumor response and the patient died 3 years later from
      complications of endobronchial metastasis. CONCLUSION: Adrenocortical carcinoma
      with isolated primary hyperaldosteronism is uncommon and consequently there is no
      wide experience in regard to its diagnosis and treatment. Although randomized
      studies are not available, adjuvant therapy using other agents instead of
      mitotane (o,p-DDD), such as the combination of cisplatin and etoposide (VP-16),
      seems reasonable in the locally advanced stages. Mitotane may be useful when
      hypercortisolism is present, but its efficacy as an antitumor agent has been
      controversial.

PMID- 11213399
TI  - [Leiomyoma of the bladder].
AB  - OBJECTIVE: To report a case of leiomyoma of the bladder, a benign tumor that
      accounts for 0.43% of bladder tumors. The literature is briefly reviewed.
      METHODS/RESULTS: A 64-year-old male with prostatic syndrome is described. The
      preoperative evaluation showed bladder lithiasis and signs compatible with
      prostatic hypertrophy, but no evidence of a bladder tumor. Endoscopic evaluation,
      however, revealed a tumor in the bladder neck. Transurethral resection of the
      tumor, prostate and endoscopic lithotripsy of the bladder were performed. The
      anatomopathological findings showed leiomyoma of the bladder. The postoperative
      course was unremarkable. CONCLUSION: Leiomyoma of the bladder does not present
      specific symptoms and is frequently an incidental finding. The diagnosis is based
      on the results of the anatomopathological analysis of the specimen.

PMID- 11213400
TI  - [Epidermoid carcinoma of the scrotum].
AB  - OBJECTIVE: To analyze the therapeutic approach in epidermoid or squamous cell
      carcinoma of the scrotum, a rare tumor that is of interest for clinical and
      historical reasons. METHODS/RESULTS: A case of epidermoid carcinoma of the
      scrotum is described. The patient had undergone urethroplasty in 1972, using
      preputial free graft, according to the technique of Ben Johnson. Right
      scrotectomy and orchidectomy were performed and partial urethrectomy with
      inguinal lymphadenectomy 6 weeks later. At 24 months' follow-up, the patient has
      no tumor recurrence. CONCLUSION: Malignant tumors of the scrotum are rare.
      Squamous cell carcinoma is the most frequent tumor type. Radical surgery with
      inguinal lymphadenectomy is the treatment of choice. It must be distinguished
      from verrucous carcinoma, a tumor that requires a different therapeutic approach
      and for which radical surgery is not indicated.

PMID- 11213401
TI  - [Giant fibroepithelial polyp of the ureter].
AB  - OBJECTIVE: To report a case of giant fibroepithelial polyp of the ureter and
      review the literature with special reference to the diagnosis and treatment of
      this benign condition. METHODS: A young male patient with a nonfunctioning left
      kidney caused by a giant fibroepithelial polyp of the ureter is presented. The
      diagnostic methods and treatment options are discussed. RESULTS: Following the
      diagnosis of obstructive uropathy with loss of left renal unit function, a left
      nephroureterectomy was performed which revealed a giant polypoid mass.
      CONCLUSION: Fibroepithelial polyp of the ureter is a benign condition that is
      difficult to diagnose with current endoscopic techniques. Endoscopy should be the
      first therapeutic option if loss of renal function is not irreversible.

PMID- 11213402
TI  - [Leiomyoma of the bladder].
AB  - OBJECTIVE: To present an additional case of leiomyoma of the bladder, a rare
      tumor that is frequently discovered incidentally, and to review the few cases
      reported in the Spanish literature, with special reference to the clinical
      aspects, complementary tests and treatment. METHODS: A case of leiomyoma of the
      bladder in a patient who had come to deliver after a full-term pregnancy is
      presented. Routine physical examination on admission revealed a tumor in the
      anterior aspect of the vagina. Ultrasound, radiological and endoscopic studies
      were performed. The Spanish literature is reviewed with special reference to the
      clinical aspects, complementary tests and treatment. RESULTS: After the diagnosis
      of a bladder tumor had been confirmed and the effects on the adjacent structures
      determined, TUR biopsy was performed. The anatomopathological analysis
      demonstrated leiomyoma of the bladder. CONCLUSION: The ultrasound and
      radiological images of leiomyoma localized to the bladder are sufficient to
      suspect the nature of the lesion, but the definitive diagnosis is based on the
      anatomopathological findings. The choice of the type of surgery, open or
      endoscopic, is based on tumor localization and size.

PMID- 11213403
TI  - Intraoperative penile erection.
AB  - OBJECTIVE: Penile erection following epidural anesthesia is an infrequent
      occurrence of unclear etioogy. It is very troublesome to perform the procedure
      during penile erection and attempting it leads to various complications. Three
      such cases are reported herein. The literature on the pathophysiology and
      management of intraoperative penile erection is discussed. METHODS: Eighteen
      hundred patients who received epidural anesthesia for various transurethral
      procedures like cystoscopy, ureterorenoscopy, transurethral resection of prostate
      and bladder tumors form the clinical material. RESULTS: Out of 1800 cases, we
      have encountered penile erection only in three cases. Two cases were managed with
      local application of cold saline and cold sponging followed by terbutaline. The
      third case could be managed with local application of cold saline and cold
      sponging of scrotum and penis. Afterwards the procedure could be performed
      safely. CONCLUSION: The pathophysiology and management of intraoperative penile
      erection is poorly understood. With the onset of erection during an operative
      procedure, the anesthesiologist must quickly initiate the therapy, as duration of
      erection is the critical factor in the detumescence of the penis.

PMID- 11213404
TI  - Equivocal mammographic findings. A pictorial essay.

PMID- 11213405
TI  - [Some thoughts about the ethics of radioprotection].

PMID- 11213406
TI  - [CT findings in fire arm injuries of the pelvis. Personal experience].
AB  - PURPOSE: We investigated the yield of CT in firearms wounds with pelvis
      involvement by evaluating the CT features of pelvis, bone walls, and associated
      injuries, if any. CT plays a major role, while conventional radiography remains
      an important integration in the workup of pelvis bone injuries. MATERIAL AND
      METHODS: We report a retrospective series of pelvis gunshot wounds studied with
      CT in a 5-year period; the patients were all men, with a mean age of 38 years
      (range 18-56). When only the pelvis was involved, CT was performed from the
      transverse umbilical plane to the pubis, in order to include the continuous
      abdomen. We used an intravenous contrast agent to study the aorta and its iliac
      branches, pelvic vessels, active hemorrhagic effusions and bladder filling.
      RESULTS: Penetrating firearms wounds were found in 21 cases and perforating ones
      in 7. In the penetrating wounds, the bullet course was most frequently (75%)
      stopped by the pelvic bones, with retention and CT visualization within muscular
      and bone structures. The incidence of bone injuries, especially crash wounds, was
      high, with 18 cases (64%). In both types of wounds with anterior course, we
      demonstrated bladder perforation in 2 cases, vascular damage in 2 and perforation
      of intestinal loops in 6. DISCUSSION AND CONCLUSION: Paradoxically, pelvic bone
      fractures may be "protective" for the pelvic content; however the involvement of
      large arteries and veins and multiple perforations of intestinal loops are no
      less dangerous than the upper abdominal wounds. CT is an important diagnostic
      tool that permits accurate and prompt evaluation of pelvic organs such as
      intestine, bladder and bone structures. Thus, CT permits prompt assessment of
      pelvic structures involvement by firearms wounds, which provides the clinician
      with useful imaging findings of bullet damage.

PMID- 11213407
TI  - [The current state of the diagnostics of breast diseases in Lombardy].
AB  - PURPOSE: The SIRM study group for senology in Lombardy set the following goals:
      to quantify the number of radiologist working in public radiology centers and in
      private credited hospitals in Lombardy; to quantify the number of radiologists
      working in diagnostic senology and the mean time they devote to this field; to
      survey the diagnostic equipment used for senology purposes and check its
      adequacy. MATERIAL AND METHODS: We considered 58 centers of senology diagnostic
      imaging in the radiology departments of general hospitals in 8 Lombardy
      provinces. First we evaluated the screening programs for early breast cancer
      detection carried out with clinical mammography. All data were evaluated with
      reference to female residents aged 40 to 69, to the average adherence rates
      reported in the literature, to the protocols adopted in different centers
      relative to the examination frequency. Mammography was always associated with a
      physical examination and then the patient was submitted to radiological
      investigations to make the final diagnosis. The form we used for data report is
      summarized in Table I. RESULTS: In the centers for diagnostic senology we
      surveyed in 1998, in all 182,724 mammograms, 58,686 breast US examinations and
      7,097 needle biopsies for cytology or microhistology were performed; 35.5% of the
      female population which should have been screened actually underwent the
      examination and 32.6% of them was also submitted to breast US, while 3.88%
      underwent FNAB. Sixty-three mammographic units and 62 US units were operated by
      152 radiologists. An average 2,900 radiographic investigations per mammographic
      unit were performed yearly. Each radiologist reported an average 1,202 mammograms
      a year. Refer to the tables for detailed data reporting by province. Thirty-six
      per cent of radiologists presently reads more than 1,500 breast examinations a
      year. The radiologists working in diagnostic imaging in senology devote an
      average 20% of their working time to this field. As for the technical adequacy of
      mammographic and US equipment relative to some reference levels reported in
      detail in the paper, only 42% of the former and 48% of the latter were up to
      standards. DISCUSSION AND CONCLUSIONS: Despite the massive work done in the field
      of senology, the estimated needs of the female population have not been met yet,
      given the increased demand for senologic examinations and women's growing
      awareness of the need of early breast cancer diagnosis. The answer to this
      problem lies in a political health care policy that should promote the current
      clinical programs increasing both instrumental and human resources. Alternatively
      screening programs could be planned on a regional basis, with the pro of reaching
      a larger female population and that of a more homogeneous methodological
      approach. Our data indicate that breast cancer detection is best achieved with
      clinical and screening tools: the former can be easily promoted in a short time
      and could thus make our first goal, while the latter, which is more complex,
      could be implemented later. Thus, a growing clinical activity could make a very
      good basis for high quality breast screening programs. Finally, it is necessary
      to guarantee high quality standards for equipment, methods and training of
      medical and nonmedical staff.

PMID- 11213408
TI  - [Radiologic analysis of interval cancers in the screening program called Florence
      Woman Project].
AB  - PURPOSE: The aim of the present study was to provide data on interval cancer
      incidence after the first round of the screening program in the city of Florence,
      and to provide and discuss the results of the review of previous screening
      mammograms. MATERIAL AND METHODS: The screening program "Progetto Firenze Donna"
      involves all women age 50 to 69 years resident in the city of Florence. In the
      interval from the end of the first and the start of the second screening round 51
      interval cancers were identified, of which 41 were available for radiological
      review. Films were reviewed by expert screening radiologists, not involved in the
      program and blinded to the final diagnosis, according to the review criteria
      recommended by the UK Guidelines for radiologists (blind and informed review).
      RESULTS: Sensitivity (screening errors/total) was different among blind reviewers
      (reader A = 7.3%, reader B = 14.6%), as well as specificity which shows an
      inverse pattern (reader A = 98.4%, reader B = 97.6%). Informed review classified
      5 cases as "screening error" (12.2%), 11 as "minimal sign" (26.8%) and 25 as
      "occult" (61%). Informed review classified a higher proportion of cases as
      "minimal sign" (minimal abnormalities are better perceived with the knowledge of
      the site and the pattern of subsequent cancer). DISCUSSION AND CONCLUSIONS:
      Analysis of interval cancers is fundamental for the quality control of a
      screening program. According to this experience, informed review tends to
      overestimate "minimal signs" in the cancer site and should not be used (or
      "minimal signs" should be anyhow assumed as negative). Identification of interval
      cases as "minimal signs" may be influenced by individual variability. Standard
      criteria should be adopted to identify and review/classify interval cancers to
      allow comparisons between different programs.

PMID- 11213409
TI  - [Pleural and parenchymal lung diseases from asbestos exposure. CT diagnosis].
AB  - INTRODUCTION: We report the CT findings of parenchymal and pleural diseases in a
      group of patients with a history of asbestos exposure, excluding lung cancer
      (which is not typical in this subjects) and asbestosis (which is a parenchymal
      fibrosis). MATERIAL AND METHODS: We retrospectively reviewed a series of CT
      examinations (conventional, helical and high resolution scans) of 21 patients
      examined from 1995 to 1999. They had pleural plaques (10), round atelectasis (2)
      and malignant pleural mesothelioma (9). All patients had a history of direct or
      indirect asbestos exposure, except one with malignant pleural mesothelioma. We
      evaluated the following CT findings: nodular, plaque or uniform pleural
      thickening; pleural calcifications; pleural thickening less or greater than 1 cm;
      pleural margins (regular, polycyclic, spiculated); localization (uni/bilateral
      hemithorax); distribution (upper, medium or lower region); pulmonary, mediastinal
      and diaphragmatic involvement; fissural involvement; pleural effusion; lymph node
      enlargement; lung mass with the comet-tail sign; lung volume (normal, reduced,
      increased). RESULTS: Pleural plaques were always bilateral and less than 1 cm
      thick, with calcifications in 80% of the cases. Margins were always regular,
      polycyclic in 40% of the patients and never irregular. The pulmonary pleura in
      the mid-chest was involved in cell cases the diaphragmatic pleura in the 50% of
      the cases and the upper and lower regions in 60% and 80% of the patients,
      respectively. Round atelectasis (3 cases in 2 patients) was always shown as a
      parenchymal mass in the lower lobes, posteriorly or posteromedially, with
      adjacent pleural thickening; its diameter ranged 4.4-6 cm and there was the comet
      tail sign. In malignant pleural mesothelioma we always found pleural effusion,
      with unilateral pleural effusion being the only sign in 2 patients. Other
      findings were pleural nodules (77.7%), with spiculated (22.2%) and polycyclic
      (77.7%) margins, more than 1 cm in diameter. The disease was always unilateral.
      The parenchymal pleural was involved in 77.7% of the cases while the mediastinal
      and diaphagmatic pleura were involved in 44.4% of the patients. Fissural
      involvement was demonstrated in 66.6% of the patients. Lymph nodes were enlarged
      in 66.6% of the cases. The volume of the affected hemithorax was increased
      (22.2%), decreased (44.4%) or normal (33.3%). DISCUSSION AND CONCLUSIONS: The
      presence of pleural plaques is a specific sign of asbestos exposure. Round
      atelectasis may also indicate asbestos exposure, but it can be found in many
      diseases with pleural inflammation, such as tuberculous effusion, trauma,
      pulmonary infarct, congestive heart failure, coronary artery bypass. The CT
      patterns of these two diseases are typical and no other finding is necessary to
      confirm the diagnosis. CT-guided needle biopsy is needed only if the round
      atelectasis has an atypical appearance on CT images, that is without the comet
      tail sign. Malignant pleural mesothelioma is strongly associated with previous
      occupational exposure and presents typical CT findings only in an advanced stage
      (irregular and nodular pleural thickening, pleural effusion, mediastinal and
      pulmonary contraction for tumor encasement, parenchymal and lymph node
      metastases), but the differential diagnosis with pleural metastatic disease can
      be difficult. CT plays an important role in tumor assessment but biopsy is
      necessary for lesion characterization.

PMID- 11213410
TI  - [Radionuclide imaging in oral implantations. Personal experience in   maxillary
      sinus elevation].
AB  - PURPOSE: Presently nuclear medicine techniques are not very popular in oral
      implantology, but they can play an interesting role in this surgical field too.
      In particular bone scan with 99mTc-MDP allows to evaluate the function of oral
      implants and the survival of bone grafts. We report our experience with skull
      bone scan in maxillary sinus lifting. MATERIAL AND METHODS: We performed a three
      year follow-up on 13 patients treated with inlay-one stage uni- or bilateral
      sinus lifting with a mixture composed of 90% bovine bone powder and of 10% small
      bone splinters and autogenous fibrin glue. We performed imaging studies and
      quantitated implant MDP uptake from the mean values at the surgical site to the
      5th neck vertebral ratio (M/V index). The M/V index was also statistically
      compared with the one measured in 13 patients with severe resorption of distal
      upper dental arches (bone height less than 0.5 cm) and in 63 patients with normal
      dental status. Scintigraphic data were interpreted in the light of clinical,
      radiological and histologic findings. RESULTS: All oral implants appeared to be
      fixed and radiographs showed good positioning and bone adhesion; bone height
      exceeded 1 cm. Peri implant biopsy material was formed by normal mature bone
      tissue without bovine bone granules, necrotic areas and inflammatory cells. The
      highest bone activity (M/V index: 1.54-2.57) was observed 1-4 months after sinus
      lifting. Then MDP uptake decreases and 18 months after surgery radionuclide
      uptake in maxillary arches is homogeneous, with M/V values of 0.81-0.88. The
      average M/V value in the 18 surgical sites was clearly higher than in the
      resorbed (1.44 vs 0.64; Kruskall-Wallis ANOVA test; Dunn's method; p < 0.05) and
      normal (1.44 vs 0.73; p < 0.05) maxillary arches. DISCUSSION AND CONCLUSIONS:
      99mTc-MDP can show the transformation of newformed into mature bone and then
      allows in vivo visualization of implant osteointegration. The importance of our
      work lies in the use of radionuclide imaging to assess both the function of oral
      implants inserted by a complex surgical technique and the expected bioactive
      properties of the filling mixture. Nevertheless the strong active autogenous
      compounds do not permit to detect the real agent of local bone induction. An
      interesting finding is that implant stability is biologically gained 18 months
      after intervention and that the uptake index facilitates comparison of sequential
      scans and confirmation of local bone growth. Therefore high MDP uptake by the
      implant 2-3 years after surgery can suggest mechanical or septic bone injury
      which can lead to implant failure if not treated promptly. In conclusion we
      believe that quantitative bone scan is a valid diagnostic tool in the follow-up
      of oral implants inserted with sinus lifting, though our experience needs
      confirmation on larger series and new research is warranted to understand the
      real mechanisms of assisted bone regeneration.

PMID- 11213411
TI  - [Abdominal pain and bowel dysfunction: the diagnostic role of ultrasonography].
AB  - PURPOSE: To evaluate the role of intestinal ultrasound (US) in differentiating
      organic from functional bowel disease. MATERIAL AND METHODS: We examined with
      abdominal and intestinal US 313 consecutive outpatients presenting abdominal pain
      and bowel dysfunction, lasting more than 3 months, with no symptoms or signs of
      alarm and with no previous diagnosis of organic disease. Our population consisted
      of 191 women and 122 men, with average age at diagnosis of 36.5 years; 236 of
      these patients had irritable bowel syndrome, 61 Crohn's disease, and 16
      ulcerative colitis. Intestinal wall thickness exceeding 7 mm was considered
      diagnostic for inflammatory bowel diseases. We compared US findings with the
      diagnosis made with the conventional diagnostic workup of radiological and
      endoscopic examinations. RESULTS: Sensitivity of intestinal US for diagnosis of
      inflammatory bowel diseases was 74% and specificity 98% (respectively 84% and 98%
      for the diagnosis of Crohn's disease and 38% and 98% for ulcerative colitis), and
      positive and negative predictive values were both 92%; efficacy was also 92%. The
      likelihood ratio was 35 if US was positive for inflammatory bowel diseases and
      0.26 if bowel wall thickness was less than 7 mm. Diagnostic efficacy was 95% for
      Crohn's disease and 94% for ulcerative colitis. DISCUSSION: Intestinal US proved
      to be a valuable tool in diagnosing Crohn's disease. As the first step
      examination US can show the disease site and suggest further instrumental tests.
      CONCLUSIONS: In our experience intestinal US is an important diagnostic
      examination for the approach to young patients without symptoms or signs
      suggestive of organic diseases and can help avoid invasive instrumental
      examinations.

PMID- 11213413
TI  - [Radiologic investigation of external rectal prolapse. Assessment in 48 patients
      with defecography, seven of them also with dynamic CT of the pelvis].
AB  - PURPOSE: To report our personal experience in 48 patients with external rectal
      prolapse examined with defecography, evaluating radiological signs and the
      indications for surgical treatment. We also report the results of 7 patients with
      severe prolapse submitted to dynamic CT of pelvis. MATERIAL AND METHODS: The
      findings relative to 48 patients suffering from external prolapse, 27 women and
      21 men, (mean age 58 years), were retrospectively reviewed. In our study protocol
      the patient is made to sit on a defecographic commode with the pelvis in lateral
      projection and radiographic images are acquired at rest, on contraction and on
      evacuation. Dynamic CT of pelvis with axial and coronal scans of the pelvic floor
      was carried out in 7 patients with severe prolapses. Twenty-six of 48 patients
      underwent rectopexy. RESULTS: The main symptoms were anorectal and perineal
      weight sensation (93%), perineal disturbance in the sitting position (91%) and
      anorectal pain extended to sacral area (83%). Manometry, which was performed in
      36 cases, showed a rectoanal inhibitory reflex evokable at high volumes of air,
      especially in incontinent subjects. Defecography demonstrated external rectal
      prolapse in all cases; rectal intussusception in 32, mucosal prolapse in 30,
      abnormal widening of the anorectal angle in 24 (16 of them were incontinent),
      rectocele in 22 and perineal descent syndrome in 16 cases. DISCUSSION AND
      CONCLUSIONS: External rectal prolapse is sometimes a dynamic progression of a
      rectal intussusception. In anorectal intussusceptions, the invaginatum involves
      the anal canal, thus causing the external prolapse. Defecography clearly shows
      the continuation of invagination out of the anus, with the formation of prolapse.
      Dynamic CT proved accurate in detecting the rectum morphology, but added no
      further information to defecography, except for the diastasis of anosphincterial
      muscles. Therefore, we conclude that defecography is the method of choice, though
      complementary to other instrumental techniques such as manometry,
      electromyography and endoscopy, in the diagnostic workup of these patients.
      Moreover, it can recognize other alterations, such as incontinence and rectocele,
      which can be submitted to surgical correction with rectopexy.

PMID- 11213412
TI  - [Gastric tumors with fatty components. CT findings and differential diagnosis].
AB  - PURPOSE: To assess the role of CT in diagnosing and characterizing gastric fatty
      tumors. MATERIAL AND METHODS: We reviewed the CT scans of 16 patients (8 men, 8
      women, mean age 52 years) with gastric fatty tumors (11 lipomas, 3 liposarcomas,
      1 angiolipoma, 1 teratoma) examined from 1990 to 1999. The differential diagnosis
      considered primary and secondary lipomatosis, carcinoma engulfing the
      perivisceral fat and thus mimicking a liposarcoma, mesenchymal gastric and
      primary peritoneal tumors. RESULTS: Lipomas involved the fundus (7/11), the body
      (3/11), the antrum (1/11). Multifocality was found in one case. Lesions size
      ranged 25 to 65 mm (mean 35 mm). All the lipomas showed homogeneous structure
      with negative (-30 -100) HU values. A pseudocapsule was demonstrated in 7/11
      cases. No infiltrative growth was demonstrated. The angiolipoma located in the
      fundus showed a vascular component with strong contrast enhancement. All the
      liposarcomas were bigger than 10 cm and there was a strong correlation between
      pathologic specimen and CT findings. The differentiated liposarcomas showed the
      classic heterogeneous fatty density; on the contrary the myxoid and the
      pleomorphic types showed an aspecific structure with necrotic/cystic changes,
      mostly demonstrated in the myxoid type. The teratoma was a solid mass with fatty,
      solid, necrotic and calcified components. CONCLUSION: CT allows the diagnosis and
      characterization of gastric fatty tumors. The preoperative diagnosis of lipomas
      plays a major clinical role because it often makes surgery unnecessary.

PMID- 11213414
TI  - [Nonobstructive residual mucocele of the cystic duct. Reassessment of 
      complications in our 13 years' experience with liver transplantation].
AB  - PURPOSE: We reassessed the incidence of mucocele of the residual cystic duct in
      our series of orthotopic liver transplantation (OLT) patients. MATERIAL AND
      METHODS: We examined a series of 283 liver transplants with end-to-end choledocho
      choledocal anastomosis (263 patients, 163 men and 80 women, 24-65 years old),
      performed at the II Surgical Department of the University of Bologna from May
      1986 to April 1999 and subsequently followed-up in our Institute. All patients
      were examined with gray-scale and color Doppler US and some also underwent CT and
      CT cholangiography. RESULTS: An anechoic ovoidal structure just before the portal
      vein and in proximity of the main bile duct was found in 13 patients. US and CT
      findings, the latter when available, led us to make a diagnosis of nonobstructive
      mucocele of the cystic duct. The radiological diagnosis was eventually confirmed
      by clinical and surgical findings. DISCUSSION AND CONCLUSIONS: In our series the
      incidence of this complication was 4.5%, a slightly higher value than those
      reported in the literature. Cystic duct mucocele cannot be considered an uncommon
      complication and should thus be more carefully searched for by operators. In our
      experience this complication never required reoperation for cholestasis.

PMID- 11213415
TI  - [Renal arteriovenous fistulas after renal biopsy. Percutaneous embolization].
AB  - PURPOSE: We report our experience relative to transcatheter percutaneous
      embolization of post-biopsy renal intraparenchymal arteriovenous fistulas in
      patients with chronic renal insufficiency. MATERIAL AND METHODS: We observed 5
      patients affected with post-bioptic fistulas for possible embolization. In three
      cases the symptoms were represented by intermittent macro-microhematuria; one
      patient had hypertension of nephrovascular origin and one patient was
      asymptomatic. In all cases we performed angiography and it was possible to
      catheterize the peripheral afferent branch of the fistula with a superselective
      technique using a hydrophilic guide of 0.035 F and a hydrophilic Cobra catheter
      of 4-5 F. The occlusion was obtained by the positioning of Granturco metal coils:
      in 1 case we adapted a coil of 3 mm diameter and 1 cm length; in 3 cases 2 coils
      of 3 mm and in 1 case 2 coils of 3 mm and 1 coil of 5 mm diameter and 1 cm length
      were necessary. The success of the procedure was always checked with an immediate
      angiogram and color Doppler US after 48 hrs. RESULTS: The diagnosis of
      arteriovenous fistulas was always confirmed by a preliminary angiography that
      demonstrated the normal anatomic disposition of the renal arteries except in one
      case in which the fistula was fed by a peripheral branch originating from an
      inferior polar artery. All the lesions were localized in the inferior pole, the
      site of biopsy, and ranged from 3 mm to 2.5 cm in diameter. We never had any
      difficulties in the positioning and placement of the coils. The arterial
      occlusion and exclusion of the fistula was accomplished in all cases. The induced
      parenchymal loss ranged from 10 to 30% of the renal volume. There was a complete
      disappearance of symptoms in 3 of the patients, with hematuria without any
      modification of the blood pressure values in the patient with hypertension.
      Considering the patient status renal function did not worsen after the
      embolization. Each patient was followed-up with color Doppler US every two
      months. CONCLUSIONS: The intrarenal arteriovenous fistula represents a relative
      frequent complication of renal needle biopsy in patients with arterial
      hypertension and nephroangiosclerosis as risk factors. Embolization is a valid
      alternative therapeutic option to surgical treatments. The use of small size
      catheters permits the successful embolization also of peripheral lesions,
      reducing the induced parenchymal ischemia. We believe that among the embolization
      material available metal coils represent a valid solution as they are easily
      positioned and permit definitive occlusion without any risks of systemic venous
      microembolization.

PMID- 11213416
TI  - Correlation between pretreatment prognostic factors and lymph node metastases in
      endometrial adenocarcinoma. Clinical application.
AB  - PURPOSE: To evaluate the prognosis of stage I endometrial adenocarcinoma, which
      differs by various prognostic factors. Some of them (tumor grading, histotype,
      myometrial infiltration, the latter evaluated with Magnetic Resonance Imaging)
      can be assessed before surgery. These prognostic factors correlate with patient
      survival and the presence of lymph node metastases. MATERIAL AND METHODS: We used
      tumor grading, histotype, myometrial infiltration for the preoperative and
      prospective classification into a low- and a high-risk group of 80 patients with
      endometrial adenocarcinomas stage I. Low-risk patient [group A: G1-G2, pure
      adenocarcinoma involving the inner portion of the myometrium (M0-M1)] underwent
      surgery without lymph node resection, while high-risk patients [group B: G3, pure
      adenocarcinoma with deep infiltration of the myometrium (M2) and/or clear cell,
      serous papillary, adenosquamous carcinomas] had pelvic and lumboaortic
      lymphadenectomy. The minimum 36 months' follow-up (median: 61 months) was
      requested for all patients. RESULTS: Histotype evaluated by dilatation and
      curettage and hysteroscopic and/or office biopsy, had 100% agreement with tumor
      histotype. Tumor grading was in agreement in 72/80 patients (81%). The grade of
      myometrial infiltration was confirmed in 72/80 cases (81%). Eight misdiagnoses
      were divided in over--(4 cases) and under--(4 cases) estimated infiltration. All
      16 mistakes resulted in 10 inclusion in the wrong risk group (8 in the low-risk
      and two in the high-risk group). Surgical-pathological staging did not change the
      prognosis but only staging in 6 preoperatively high-risk group. CONCLUSIONS: This
      initial study confirms the importance of prognostic factors in the treatment of
      endometrial adenocarcinoma, as well as that of the different surgical choices
      which can be made after correct pretreatment prognosis.

PMID- 11213417
TI  - [Optimization of lymphoscintigraphy in sentinel node biopsy in the staging of
      malignant melanoma].
AB  - PURPOSE: To optimize the lymphoscintigraphic procedure in the staging of
      malignant cutaneous melanoma. MATERIAL AND METHODS: Fifty-five patients (21 men
      and 34 women) were enrolled. Breslow thickness of the lesions ranged 0.75-1 mm
      (Clark III-IV) to 1-4 mm. Lymphoscintigraphy was performed with a large-view
      gamma camera equipped with a low-energy general purpose collimator, two weeks
      after melanoma excision. A single perilesional dose of 30-50 MBq nanocoll-Tc99m
      (volume 0.2-0.3 mL) was injected 18 hours before surgery (6 hours in head
      localizations). After injection a gentle local massage was applied. A planar
      static scintigraphy (matrix 512 x 512, pre-set time 5 min) in anterior and/or
      oblique view(s) was obtained 5-10 min after radiotracer injection. The skin
      projection of the first node was stained with an external radioactive marker.
      Fifteen minutes before surgery a blue-vital dye was injected around the lesion. A
      radioguided biopsy of the sentinel node was performed. RESULTS: The site of the
      sentinel node was typical in 80% of patients. Two or three nodes were identified
      in 20% of patients. An unexpected node site was detected in 9% of patients. The
      total rate of micrometastasis to the sentinel node was 14.7% but significant
      differences were observed relative to the melanoma thickness. CONCLUSIONS:
      Preoperative scintigraphy increases the accuracy of sentinel node identification
      in unusual lymphatic drainage pathways, in unexpected sites and in fast lymphatic
      drainage. Radioguided biopsy reduces surgical time, requires only local
      anesthesia and permits shorter hospitalization.

PMID- 11213418
TI  - [A method for quantitative evaluation of the physical quality of radiologic
      devices].
AB  - INTRODUCTION: The evaluation of the quality of a radiological device depends on
      both clinical judgement about diagnostic imaging and physical judgement about
      technical performance. The latter is the final result of a set of measurements of
      several physical quantities. The aim of the present paper is to make a synthesis
      of such measurements through a parameter whose comparison with a threshold value
      would allow to establish whether a given radiological machine is acceptable from
      the point of view of physical quality. MATERIAL AND METHODS: The parameter, which
      we called quality index, was obtained by considering, for each operating
      condition, the values of physical quantities which exceed their limits and by
      giving them a different weight, depending on their influence on image quality,
      patient dose, or both. Further analysis led to assign a gravity index to such
      quantities as a function of the extent of the discrepancies with respect to their
      limits. RESULTS AND DISCUSSION: The method was illustrated through the example of
      a simple radiological equipment with two separate hypothetical cases
      corresponding to different degrees of fault gravity. The method gave very
      different values of quality index, according to the extent of discrepancies found
      in the two cases. We gave suggestions about the way to follow in order to
      determine a proper threshold value for each kind of equipment. The invariance of
      the method with respect to the choice of the physical quantities and their limits
      was also shown. CONCLUSIONS: The proposed method appears to be useful because it
      makes a synthesis, through a single parameter, of a series of measurements of
      several physical quantities and allows to discriminate, through direct comparison
      with a threshold value, about the physical quality of a radiological device; in
      addition, it may be easily implemented into programs for the automated analysis
      of quality controls. The quality index may contribute, together with some other
      parameters to be defined in a forthcoming paper, in establishing a quantitative
      criterion in order to define equipment replacement priorities within the context
      of the technological improvement requested by the laws currently in force.

PMID- 11213419
TI  - [Unusual location of villonodular tenosynovitis. Three case reports and review of
      the literature].

PMID- 11213420
TI  - [Ossifying pleural metastases from osteosarcoma. CT evidence in two cases].

PMID- 11213421
TI  - [Comprehensive imaging of hepatic adenoma simulating focal nodular hyperplasia. A
      case report].

PMID- 11213422
TI  - [Renal adenocarcinoma in childhood. A case report].

PMID- 11213423
TI  - [Idiopathic retroperitoneal fibrosis diagnosed with color Doppler echography and
      ultrasonography-guided fine needle biopsy, a case report].

PMID- 11213424
TI  - [Thyroid gland involvement in acute leukemia. Ultrasonographic aspects of a
      case].

PMID- 11213425
TI  - [Lymphoma of the breast: contrast agent transit time in color-Doppler
      ultrasonography. A case report].

PMID- 11213426
TI  - Comparative in vitro evaluation of nimesulide-containing preparations on the
      Italian market.
AB  - Nimesulide is a quite popular non-steroidal anti-inflammatory drug (NSAID), which
      has been demonstrated to preferentially inhibit cycloxygenase-2 (COX-2), thus
      exerting milder gastrointestinal and renal side effects. Apart from the original
      products (Aulin and Mesulid), several copy and generic nimesulide-containing
      preparations are presently available on the Italian market. Generics are defined
      by the World Health Organization (WHO) as interchangeable multi-source
      pharmaceutical products and, according to international regulatory issues, their
      bioequivalence to an already marketed reference product has to be proven. Due to
      its physico-chemical properties, and in particular to the low solubility,
      nimesulide appears to be a critical molecule from a biopharmaceutical point of
      view. On the basis of these premises, the aim of the present work was to perform
      a comparative evaluation of tablets in vitro behaviour for the best-selling copy
      (Sulidamor) and generic (Nimesulide Dorom) in reference to the original products.
      The results provided by the dissolution test pointed out statistically
      significant differences in the in vitro behaviour displayed by the original
      products on one hand and by the copy as well as generic preparations in exam on
      the other.

PMID- 11213427
TI  - Effect of dissolution fluid and presence of hog intestinal barrier on the
      dissolution of theophylline from bioadhesive granules.
AB  - The effect of dissolution fluid and the presence of a natural barrier (hog
      intestine) on the release of theophylline from some bioadhesive granules is
      presented. A higher quantity of the drug was released in simulated intestinal
      fluid (SIF) than O. IN HCl. When a hog intestine was used as the diffusion
      barrier, the availability of the drug through the barrier into the sink solution
      was low, ranging from 20-35%.

PMID- 11213429
TI  - The compliance of the community and private pharmacies' patients.
AB  - This issue is an attempt to expose the extent of compliance, respectively of non
      compliance among the patients of the community and private pharmacies in Sofia.
      The authors make an attempt to elucidate the factors that influence upon the non
      compliance of the patients in order to increase the rate of compliance among
      them. The results of the analysis of the received data show that the level of the
      compliance is 69% among the studied patients. Despite the presented adequate
      level of compliance among the patients, there are possibilities for the
      individualisation of the treatment, for supply with more information and for
      improvement of the patient-physician and patient-pharmacist interrelations.

PMID- 11213428
TI  - The absorption of protein hormones through rabbit rhinal mucosa.
AB  - The absorptions through rabbit rhinal mucosa of the following hormones with a
      protein-peptide structure: thyrotropin-releasing hormone, insulin, and prolactin,
      were compared. A very high negative correlation between the molecular weight of
      the hormones and the total amount of the hormones molecular weight of hormones
      absorbed through the rhinal mucosa (r = 0.973) was found. Within 2 hours of the
      experiment, 33.94% TRH, 23.96% INS, and only 11.01% PRL, were absorbed from the
      administered dose.

PMID- 11213430
TI  - A comparative study of modified starches in direct compression of a water soluble
      drug-chloroquine phosphate.
AB  - Some in vitro properties of chloroquine phosphate tablets formulated with four
      modified starches were investigated. The drug was formulated as tablets
      containing 250 mg of chloroquine phosphate and produced by the direct compression
      technique. The starches were isolated from maize, zea mays, rice, Oryza sativa,
      cassava, Manihot esculenta and cocoyam, Zanthosoma sagittifolium. They were
      modified through physicochemical process, Sta-Rx 1500, a directly compressible
      starch was used as basis for comparison. The hardness of the chloroquine tablets
      generally decreased to a minimum with all the modified starches at concentration
      level of 40% and with maximum hardness obtained when their concentrations were
      increased to 80%. The least hardness values were obtained with modified cocoa yam
      starch while the highest hardness values were obtained with modified rice starch.
      Modified rice and cassava starches produced chloroquine tablets that exhibited
      higher mechanical properties than those of modified maize starch, cocoayam starch
      and Sta-Rx 1500. On the basis of dissolution profile of chloroquine phosphate
      tablets, the modified starch samples were ranked in order of increasing
      dissolution as modified cocoayam maize Sta-Rx 1500 cassava rice starch sample.
      The release rate of chloroquine was found to be dependent on the physico-chemical
      properties of the individual modified starch granules such as particle size and
      degree of gelatinization.

PMID- 11213431
TI  - Assay of fluoxetine hydrochloride by titrimetric and HPLC methods.
AB  - Two alternative methods were proposed to assay Fluoxetine Hydrochloride: a
      titrimetric method and another by HPLC using as mobile phase water pH 3.5:
      acetonitrile (65:35). These methods were applied to the determination of
      Fluoxetine as such or in formulations (capsules). The titrimetric method is an
      alternative for pharmacies and small industries. Both methods showed accuracy and
      precision and are an alternative to the official methods.

PMID- 11213432
TI  - Chromatographic detection of cimetidine and famotidine using chloranilic acid as
      a spray reagent.
AB  - Qualitative determination of cimetidine and famotidine by TLC using chloranilic
      acid as the detecting spray reagent was carried out in different elution systems.
      On spraying, coloured spots corresponding to the drugs were formed which were
      stable for over three hours. In a particular solvent system, a commercial sample
      gave the same Rf value as its corresponding pure reference sample without any
      interference from the excipient.

PMID- 11213433
TI  - Synthesis and biological activity of 6-substituted-3-[2-(5-substituted-2
      furfurylidenehydrazino)-4-thiazolyl] coumarins.
AB  - A series of coumarin-derivatives (5) were synthesized by the reaction of 5
      substituted-2-furfuraldehyde thiosemicarbazones with 3-bromoacetyl-6-substituted
      coumarins. The structures of newly synthesized compounds were confirmed on the
      basis of their elemental analysis, NMR and mass spectral data. Some selected
      compounds were screened for their antibacterial activity employing disc diffusion
      technique.

PMID- 11213434
TI  - Lipid peroxidation in human blood platelets during unstable angina and myocardial
      infarction.
AB  - A comparative study on the levels of lipid peroxidation in human platelets has
      been undertaken in patients of unstable angina and reperfused acute myocardial
      infarction and matched healthy individuals. Lipid peroxidation increases in these
      patients, most marked increase were in the patients of reperfused myocardial
      infarction.

PMID- 11213435
TI  - A comparative study of aminophylline and acepifylline on reversal phenomenon of
      anticonvulsant drug efficacy in electroshock model of seizures in rats.
AB  - The study was designed to compare the proconvulsive activity of two theophylline
      containing bronchodilating agents, aminophylline and acepifylline and their
      antagonistic effects to diazepam, phenytoin, MK-801 and carbamazepine in
      electroshock seizure model in rats. Graded intensity (30-150 mA for 0.2 s) of
      electroshock was applied to different groups of rats pretreated either with
      normal saline (0.5 ml, i.p.), graded doses (25-150 mgkg-1, i.p.) of
      aminophylline, graded doses (70-560 mgkg-1, i.p.) of acepifylline, graded doses
      of the antiseizure drugs or to rats pretreated with aminophylline (25 mgkg-1,
      i.p.) + antiseizure drugs or acepifylline (70 mgkg-1, i.p.) + antiseizure drugs.
      CI 50 +/- s.e.m. value was 88.41 +/- 2.14 mA in saline treated rats. In
      aminophylline pretreated rats the values were 84.14 +/- 2.03, 68.06 +/- 1.24,
      54.28 +/- 1.96 and 39.58 +/- 2.31 mA at 25 mgkg-1 (0.06 mmolekg-1), 50 mgkg-1
      (0.12 mmolekg-1), 100 mgkg-1 (0.24 mmolekg-1) and 150 mgkg-1 (0.36 mmolekg-1),
      i.p. doses respectively. The values were 85.73 +/- 1.09, 64.86 +/- 2.37, 61.58 +/
      1.37 and 60.62 +/- 2.41 mA at 70 mgkg-1 (0.125 mmolekg-1), 140 mgkg-1 (0.25
      mmolekg-1), 280 mgkg-1 (0.50 mmolekg-1) and 560 mgkg-1 (1.0 mmolekg-1), i.p.
      doses respectively for the acepifylline pretreated groups of rats. Diazepam, MK
      801, phenytoin and carbamazepine significantly antagonized electroshock-induced
      seizure in a dose-dependent manner. Subsensitizing dose of aminophylline (25 mgkg
      1, i.p.) but not that of acepifylline (70 mgkg-1, i.p.) pretreatment
      significantly antagonized the efficacy of all the antiseizure drugs. The study
      highlighted that acepifylline might be safely used in epileptic patients well
      controlled on antiepileptic drugs. Aminophylline, on the other hand, should be
      avoided since it might produce breakthrough seizure attacks due to its greater
      proconvulsive and anti-antiseizure drug effects.

PMID- 11213436
TI  - Investigation of antimicrobial activity of essential oils of several Macedonian
      Thymus L. species (Lamiaceae).
AB  - Antimicrobial activity of twenty specimens of essential oils of eleven Thymus
      species, naturally occurring in the Macedonian flora, was investigated by agar
      diffusion and broth dilution methods. Inhibition of growth and microbicidal
      action was examined on three Gram positive bacteria (Staphylococcus aureus,
      Streptococcus pyogenes and Streptococcus pneumoniae). In spite of wide
      variability in essential oil composition, ranging from traces of thymol to the
      amount of about 50% thymol in oils, all examined samples of Thymus essential oil
      possessed strong antibacterial activity. Zones of inhibition of growth (for 25%
      dilution of oils) was from 10-54 mm in diameters. MICs ranging from 0.012-0.1%
      while MMCs were from 0.025-0.4% for essential oils that contained large amounts
      of phenols and 0.2-1.6% for those which contained traces of phenols and large
      amounts of geraniol, linalool and (Z + E)-citral.

PMID- 11213437
TI  - Some emulsifying and suspending properties of the mucilage extracted from kernels
      of Irvingia gabonensis.
AB  - The mucilage extracted from the kernels of Irvingia gabonensis was evaluated for
      use as suspending and emulsifying agent. The rheological behaviour of the
      mucilage was studied and compared to that of tragacanth. As a suspending agent,
      Irvingia mucilage was compared to tragacanth at various concentrations (0.5, 1.0,
      1.5 and 2.0% w/v) in the formulation of sulphanilamide suspensions. At all
      concentrations the formulated suspensions with Irvingia mucilage gave higher Hu
      (final sedimentation height) and F (sedimentation volume) values. As an
      emulsifying agent, the properties of Irvingia mucilage was compared to tragacanth
      and acacia gum. The emulsions prepared with 0.6, 1.0, and 1.5% tragacanth and
      Irvingia 'cracked' within six days while that with 12.5% w/v acacia started
      showing signs of creaming at the tenth day. The emulsion prepared with 2.0% w/v
      Irvingia mucilage was however stable throughout the six weeks of study. The
      results indicate that Irvingia mucilage performed better than acacia and
      tragacanth even at lower concentrations in the formulation of emulsions and
      suspensions.

PMID- 11213438
TI  - Eudragit matrices for sustained release of ketorolac tromethamine: formulation
      and kinetics of release.
AB  - Matrix type formulations with dicalcium phosphate dihydrate (DCPD) using a
      polymeric binder (Eudragit RSPM) to obtain controlled release of Ketorolac
      tromethamine (KT) has been investigated. The drug, DCPD and Eudragit RSPM were
      granulated using isopropyl alcohol with and without a plasticizer (Diethyl
      phthalate, DEP). Addition of Eudragit appear to affect the release profile.
      However, addition of a plasticizer had a significant effect on the rate of
      release. The release appears to follow first order kinetics and the rate constant
      decreased linearly with increasing DEP concentration. A directly compressible
      mixture was also formulated by coating DCPD particles with DEP with and without
      Eudragit RSPM.

PMID- 11213439
TI  - [Production and characterization of an atenolol-reticulated povodone tablet].
AB  - The production of polymeric complexes in many active drugs with reticulated
      povidone increased dissolved component percentage. In this work made use a
      coevaporation technique. Complex formation has been tested by X Ray
      Diffractometry and Differential Scanning Calorimetry. The percentage of
      dissolution was determined to the USP XXIII Edition methodology. As can be seen
      from the results, the Atenolol-reticulated Povidone complexes has greater
      solubility than the Atenolol mixed with Lactose as excipient.

PMID- 11213440
TI  - Synthesis of some new phenylthiocarbamoyl 2-pyrazolin-5-ones of pharmaceutical
      interest.
AB  - Thiocarbamoylation reaction of 3-methyl-2-pyrazolin-5-one (1a) with two
      equivalents of PhNCS, resulted in the formation of 1,4-di(alpha
      phenylthiocarbamoyl)-3-methylpyrazolone 3, which underwent cleavage of the
      thiocarbamoyl group at position 4 when coupled with aromatic diazonium salts
      affording 4-arylhydrazono-1-phenylthiocarbamoylpyrazolone (4a-j). Reactions of 4a
      with chloroacetyl chloride, benzenesulphonyl chloride, piperidine and hydrazine
      hydrate, resulted in the formation of 8.

PMID- 11213441
TI  - Syntheses of new 5,6,7,8-tetrahydropyrrolo [2,3-d]azepine ring system.
AB  - A first synthesis of pyrrolo[2,3-d]azepine ring system starting from pyrrole and
      perhydroazepine derivatives was reported. In addition, Lansbury's reaction is
      developed through the use of para-toluene sulphonic acid (p-TsOH) as a new
      catalyst for this reaction.

PMID- 11213442
TI  - Distribution and pharmacokinetics of the gonadotrophin releasing hormone analogue
      (Gn-RH analogue) dalarelin in rats.
AB  - The dynamics of concentration changes for dalarelin in the blood as well as in
      organs and tissues at different times from its administration to female rats as a
      single subcutaneous injection, was observed. Also, the basic pharmacokinetic
      parrameters were determined. The maximum concentration of dalarelin in the blood
      (Cmax), which was 261.5 pg/cm3, was observed at the maximum time (tmax) 30 min,
      after its subcutaneous administration. The simplest equation describing the
      observed concentration changes for dalarelin in the blood is a tri-exponential
      equation of an open two-compartment model. The obtained results indicate that
      dalarelin is selectively captured by the pituitary as well as by the non-specific
      organs: heart, brain and uterus. It allows us to conclude that it has a wider
      spectrum of activity.

PMID- 11213443
TI  - In vitro anti-mycotic activity of some medicinal plants containing flavonoids.
AB  - Aqueous, ethanolic and petroleum ether extracts of Citrus sinensis L. (Osbeck),
      Euphrasia officinalis L., Glycyrrhiza glabra L., Matricaria recutita L., Rosa
      canina L. and Ruta graveolens L. have been studied. The antimycotic activity was
      evaluated "in vitro" on strains of Candida albicans isolated from clinical
      samples obtained in the course of acute vaginitis.

PMID- 11213444
TI  - Investigation of alkylating, antineoplastic and anti-HIV potentials of the
      chalcones: 2-(3-arylpropenoyl)benzimidazole and their corresponding N1-methyl
      derivatives.
AB  - A series of 2-(3-Arylpropenoyl)benzimidazole, 3a-d, and their corresponding N1
      methyl analogues, 3e-h, were synthesized from p-substituted benzaldehyde and 2
      acetylbenzimidazole or 2-acetyl-1-methylbenzimidazole, respectively. The in vitro
      alkylating activities of these alpha-beta-unsaturated ketones were investigated
      using L-cysteine as a model of cellular thioles at pH 7.4 and 37 degrees C. No
      significant difference between the alkylating activities of 3a-d and 3e-h as
      expressed from the pseudo first-order rate constants of the reactions of these
      derivatives with L-cysteine monitored by HPLC. However, significant variations in
      the rates of alkylation among these derivatives relative to the p-substituted
      group on the aryl moiety were observed, which is attributable to the electronic
      parameters of the substituted groups. The in vitro cytotoxic activity provided
      that the p-nitro derivative; 3d has some selectivity for cell lines of leukemia,
      renal cancer and breast cancer. The compounds were completely inactive as anti
      HIV agents. Molecular modeling for all derivatives was undertaken.

PMID- 11213445
TI  - [Scientific cooperation in the area of criminologic techniques in Europe].
AB  - Due to an increased trend toward professionalism on the part of criminals and the
      globalization of crime the demands on forensic science have increased. These
      demands can only be met by international co-operation. A priori all areas of
      forensic science can be recommended as fields where working together is adequate.
      Co-operation--depending for example on the amount of work required for planned
      research and development, on the need for harmonization of methods and techniques
      or on the complexity of the task--is certainly necessary to a varying extent. In
      institutionalizing co-operation it is not so much a mere increase in the relevant
      activities that is offered but much more variety of (new) ideas. In doing this,
      as will be shown in a couple of examples, the use of new information and
      communication technology in particular should be increased.

PMID- 11213446
TI  - [Combined suicide by drinking acetic acid with subsequent hanging].
AB  - Three late emigrants of German origin from Russia (1 man, 2 women) drank 70- and
      86% acetic acid respectively before hanging themselves. In one of the suicides
      the hanging noose was running across the face. None of the cases presented showed
      any perioral chemical burns. At autopsy an intense odor of acetic acid was
      noticeable. The mucosa of the upper digestive tract showed a whitish, grey, brown
      or black discoloration and was partially detached. In two cases intravascular
      clotting of blood was discernible in the area affected by the acid; in one case
      the vessels were imbibed with haemoglobin due to haemolysis. Highly concentrated
      acetic acid is generally available in the successor states of the former USSR and
      its use in suicides is thus not uncommon. The legal regulations applying in
      Germany to the sale of acetic acid and the toxicological data are briefly
      described.

PMID- 11213447
TI  - [Criminal and suicidal death with bolt gunshot weapons. An experimental and case
      contribution].
AB  - Authors report on two cases of homicide and another case of suicide, all
      committed with captive-bolt livestock-stunners. The investigation of skull caps
      revealed roundish holes at the entry sites which were beveled-out in a paraboloid
      like manner on the inner aspect. These defects were reproducible in test shots
      with various strengths of ammunition and different materials as targets.

PMID- 11213448
TI  - [Discovery of externally unremarkable case of homicide of an infant].
AB  - The court-ordered autopsy of an infant who had died 26 days after delivery
      unexpectedly revealed a fatal head injury. As external inspection of the body had
      not shown any traces of violence sudden infant death had at first been assumed.
      At autopsy a linear fracture of the skull and a subdural haematoma was found.
      Subsequent investigations showed that the father had thrown the baby into the air
      while playing with it, that he had failed to catch it and that it had fallen
      downwards heavily hitting the wooden armrest of a couch with the parietal region.
      As an example of a manslaughter without any external signs of trauma the case
      illustrates the importance of forensic autopsies in all cases of unexpected
      death.

PMID- 11213450
TI  - Culture of the bacterium responsible for Whipple's disease.

PMID- 11213449
TI  - [Misinterpretation of fetal high voltage and lightning accidents].
AB  - From medicolegal practice it is known that in deaths caused by low voltage,
      electric marks may be absent or inconspicuous so that they may remain undetected
      during the scene examination. That this may happen even in fatal high-voltage
      accidents is demonstrated by 4 examples from our own autopsy material. The cases
      reported shared the following features: The decedents were found outdoors under a
      high-voltage line with a several metres long conductive object being in the
      immediate vicinity of the body; no extensive burns as those seen after the impact
      of an electric arc; inconspicuous electric marks on the hands; clearly visible
      electrothermal skin lesions limited to body regions covered by clothing
      (especially soles of the feet). Another case report demonstrates that even fatal
      lightning accidents are not always recognized correctly.

PMID- 11213451
TI  - [History of oxygen therapy].

PMID- 11213452
TI  - [Biliary epithelium, hepatocytes and oval cells].
AB  - Two types of epithelial cells derived from a unique embryonic stem cell coexist
      in the liver: hepatocytes, which form the liver parenchyma, and cholangiocytes
      which line intrahepatic bile ducts. Both cell types represent more than 70% and
      around 3% of hepatic cells, respectively. Initially secreted in the canalicular
      space formed by the apical domain of hepatocytes, bile is subsequently collected
      and modified in bile ducts. Both types of epithelia can regenerate as a result of
      differentiated cell proliferation. However, massive or chronic injury may induce
      the emergence and proliferation of oval cells, a heterogeneous population of
      small cells expressing embryonic markers that may subsequently differentiate into
      hepatocytes or cholangiocytes. Oval cells may also give rise to hepatocellular or
      cholangiocellular carcinomas. They may derive not only from hepatic cells
      (including hepatocytes and cholangiocytes themselves), but also from extrahepatic
      haematopoietic stem cells.

PMID- 11213453
TI  - [Epidemiology and natural history of cholelithiasis].
AB  - Gallstone disease is relatively common, affecting approximately 15% of the
      population in Europe and North America, but it is benign since its natural
      history remains asymptomatic in nearly 80% of cases. The stones are predominantly
      cholesterol derived in 80% and pigmentary in 20% of cases. Recent epidemiologic
      studies using ultrasound examination have determined the factors favouring
      lithogenesis, in addition to those that are already wellknown, such as age,
      obesity, female gender, high blood triglyceride levels and multiparity, the risk
      is correlated with high, frequent variations in weight, with intake of certain
      drugs and with alimentary habits. In addition, physical exercise plays a
      protective role against the development of symptomatic gallstone disease.

PMID- 11213454
TI  - [Gallstones and their complications].
AB  - Gallbladder stones are present in more than 10% of the population in Europe,
      particularly in women. Most patients are and will remain asymptomatic. No
      treatment is required. Patients with gallstones and biliary colics should have
      elective laparoscopic cholecystectomy which can be performed in almost every
      case. Acute gall-stone cholecystitis is the most severe complication. It should
      prompt urgent cholecystecomy that can be done by laparoscopy. Other complications
      such as biliobiliary fistulas have become unfrequent.

PMID- 11213455
TI  - [Common bile duct stones and their complications].
AB  - At the time of cholecystectomy for symptomatic cholelithiasis, 7-20% of patients
      have common bile duct stones. Nearly one third of them are asymptomatic. Routine
      cholangiography during cholecystectomy allows the diagnosis and treatment of
      common bile duct stones during the same operation. Selective indication for the
      diagnosis of common bile duct stones based on the positive predictive value of
      indicators limits treatment to symptomatic cases. No single indicator is however
      completely accurate in predicting common bile duct stones and the natural history
      of asymptomatic cases is uncertain. Endoscopic stone extraction preceding
      cholecystectomy is not superior to one-stage surgical treatment. Diagnosis and
      treatment of common bile duct stones are feasible laparoscopically. Complications
      of common bile duct stones are cholangitis and acute pancreatitis; if severe,
      they require specific therapeutic approaches.

PMID- 11213456
TI  - [Biliary tract cancers].
AB  - Biliary tract cancer is the second most common primary hepatobiliary cancer,
      after hepatocellular carcinoma. The most frequent localisation is the
      gallbladder. Mean age of diagnosis is 65 years. The exact cause remains unknown
      despite well documented risk factors. The majority of these tumours are
      adenocarcinomas. Symptoms, frequently non specific, are occasionally typical
      including jaundice, right upper quadrant mass or fatigue and weight loss.
      Magnetic resonance imaging is becoming the main diagnostic tool, replacing
      retrograde or transhepatic cholangiography. Surgical resection remains the only
      treatment that may allow long term survival. However, it is possible in only one
      third of patients.

PMID- 11213457
TI  - [Cystic dilatation of the biliary tract].
AB  - Cystic dilatations of the biliary tree are defined by cysts which communicate
      with the biliary channels. Caroli's disease is characterized by macroscopic
      dilatations of segmental bile ducts (who drain the segments of the liver). It is
      not familial. Kidneys are usually normal. The main symptom is cholangitis.
      Complications are intrahepatic stones and cholangiocarcinoma. Treatment of
      cholangitis is antibiotics. In resistant cases, partial hepatectomy (if cysts are
      localized in one part of the liver) or hepatic transplantation (if cysts are
      diffuse) should be considered. Congenital hepatic fibrosis is characterized by
      microscopic dilatations of interlobular bile ducts and portal fibrosis. It is an
      autosomal recessive disease associated with renal abnormalities. The major
      clinical manifestation is digestive haemorrhage due to portal hypertension.
      Caroli's syndrome is the association of Caroli's disease and congenital hepatic
      fibrosis. Choledocal cyst is characterized by a cystic dilatation of the common
      bile duct or hepatic duct. The main manifestations are jaundice and cholangitis.
      Cholangiocarcinoma may occur. Treatment is surgical resection.

PMID- 11213458
TI  - [Congenital disorders of the biliary ducts].
AB  - Congenital disorders of the bile ducts manifesting as neonatal cholestasis, are:
      biliary atresia, Alagille syndrome and neonatal sclerosing cholangitis. Biliary
      atresia must be considered as a neonatal surgical emergency: diagnosis and
      therapeutic intervention should be completed before one month of age. Survival at
      10 years is about 70%, 14% without and 56% with liver transplantation. The cause
      of the disease is unknown. Alagille syndrome is defined by the association of
      bile duct paucity, pulmonary stenosis, butterfly-like vertebrae, peculiar facies
      and posterior embryotoxon. JAGGEDI gene mutations have been identified allowing
      prenatal diagnosis. The diagnosis of neonatal sclerosing cholangitis can only be
      performed by cholangiography.

PMID- 11213459
TI  - [Primary sclerosing cholangitis].
AB  - Primary sclerosing cholangitis is an uncommon disease, characterized by the
      progressive destruction of intra and extrahepatic bile ducts. The disease mainly
      affects males below 40 years of age. Main consequences of the disease are
      cholestasis, cholangitis, intrahepatic lithiasis, and secondary biliary
      cirrhosis. In 5-10% of the patients, cholangiocellular carcinoma develops.
      Diagnosis is based on retrograde cholangiography. There is no specific medical
      treatment. Liver transplantation must be considered in the end-stage of the
      disease.

PMID- 11213460
TI  - [Quantifying quality: the patient's perspective].

PMID- 11213461
TI  - [Epithelial skin cancers. Epidemiology, etiology, anatomic pathology, diagnosis,
      treatment principles].

PMID- 11213462
TI  - [Diffuse goiter and thyroid nodule].

PMID- 11213463
TI  - [Workplace accidents and occupational diseases. Definitions].

PMID- 11213464
TI  - [Mumps. Epidemiology, diagnosis, etiology, prevention].

PMID- 11213465
TI  - [T cells and cellular immunity; T receptors (structure, diversity, repertory);
      differentiation antigens (CD4, CD8); activation; auxillary T cells and
      immunoregulation; lymphokines (interferons, TNF, IL-1, IL-2, IL-4) and
      cytotoxicity; concept of cellular immunity deficit].

PMID- 11213466
TI  - [Manic syndrome. Diagnostic approach and treatment principles].

PMID- 11213467
TI  - Evolution of thioredoxin and redox signaling research: viewpoint.

PMID- 11213468
TI  - Effect of cAMP on inducible nitric oxide synthase gene expression: its dual and
      cell-specific functions.
AB  - The effects of some cAMP-elevating agents on the induction of nitric oxide
      synthase II (NOS II) were investigated for a macrophage-derived cell line,
      RAW264.7, stimulated with lipopolysaccharide (LPS) or interferon-gamma (IFN
      gamma) and the results were compared for the case of vascular smooth muscle cells
      (VSMC) stimulated with interleukin-1 beta (IL-1 beta). Forskolin, dibutyryl cAMP,
      and a phosphodiesterase inhibitor, 3-isobutyl-1-methyl xanthine, resulted in an
      elevated production of nitrite and nitrate, NOS II activities, NOS II mRNA
      accumulation, and the protein level in RAW264.7 cells stimulated with LPS or IFN
      gamma. However, the addition of combinations of these reagents decreased these
      levels in RAW264.7 cells, but enhanced them in VSMC that had been stimulated with
      IL-1 beta. When intracellular cAMP levels in VSMC were measured, they were
      elevated by about 100 times more in the forskolin-treated cells, compared to the
      untreated cells. Stimulated RAW264.7 cells, on the other hand, produced much
      lower levels of cAMP than VSMC. It is likely that cAMP functions in two opposing
      directions in terms of NOS II gene induction in RAW264.7 cells in a dose
      dependent manner. The effects of cAMP-elevating agents on promoter activities of
      the 5'-flanking region of the mouse NOS II gene were then examined. The promoter
      activities were enhanced in RAW264.7 cells, even in the presence of all three
      cAMP-elevating agents. Although the binding of NF-kappa B to responsive elements
      is essential for the induction of the NOS II gene, cAMP-elevating agents had no
      effect on NF-kappa B binding to the element, thus eliminating the involvement of
      NF-kappa B in the suppression of the NOS II gene by high concentrations of cAMP.
      These data suggest that a putative responsive element to high levels of cAMP is
      present outside of the region examined in this study. The inhibitory effects of
      cAMP in RAW264.7 cells would be due to the presence of a negative regulatory
      factor that is absent in VSMC.

PMID- 11213469
TI  - Efficiency of selenocysteine incorporation in human thioredoxin reductase.
AB  - Thioredoxin reductase (TR) is a flavoenzyme, containing one selenocysteine (Sec)
      residue at the penultimate carboxyl-terminus, that catalyzes the NADPH-dependent
      reduction of oxidized thioredoxin. Sec is encoded by the UGA stop codon in the
      open reading frame of the mRNA, and the conserved stem-loop structure in 3'
      untranslated regions functions as the determinant of Sec incorporation instead of
      termination of translation. The efficiency of Sec incorporation in Sec-containing
      enzymes in physiological or selenium (Se)-deficient condition remains unclear. To
      clarify this, we have developed monoclonal antibodies to human TR, and
      established a sandwich enzyme-linked immunosorbent assay to determine TR protein
      content. We observed that the specific activity of cytosolic TR in NCI-H441 cells
      increased with increasing concentrations of Se in a serum-free medium. The
      specific activity of TR purified from each cytosol was essentially equal to the
      calculated specific activity of each cytosolic TR. The Se content of TR increased
      with increasing concentration of Se in the medium, from 0.32 mol/mol of TR
      subunit (no SE) to 0.98 mol/mol of TR subunit (500 nM Se), and was directly
      correlated with the specific activity of TR. When calculated from the cytosolic
      TR specific activity of human peripheral mononuclear cell, the theoretical
      efficiency of Sec incorporation in physiological conditions is assumed to be 87%.

PMID- 11213470
TI  - Immunohistochemical localization of thioredoxin and glutaredoxin in mouse embryos
      and fetuses.
AB  - Although oxygen is essential for promoting energy metabolism and for enhancing
      cell proliferation, early mouse embryos are very sensitive to high oxygen
      concentration. Because the tissue-specificity and sequential changes of the
      expression of antioxidative enzymes in rodent embryos have not been investigated
      systematically, we examined the ontogenesis of thioredoxin (TRX) and glutaredoxin
      (GRX) in mouse embryos and fetuses by using immunohistochemical methods. These
      compounds were found to be localized in most tissues examined, with some tissue
      specificity and temporal sequence. In many tissues, both TRX and GRX began to be
      expressed at embryonic day 11 (E11) or E13 and appeared to increase later in
      development, but the heart and great vessels of E8.5 embryos were already
      positive for their immunoreactivity. The stage at which the antioxidative enzymes
      begin to be expressed seems to coincide with the stage at which rodent embryos
      acquire the capacity of aerobic energy metabolism. Although TRX and GRX were co
      localized in many tissues and showed similar sequential changes of expression,
      their expression patterns were different in the fetal cartilage, suggesting that
      they may play different roles in endochondral ossification. Their
      immunoreactivity was not homogeneous in the liver and the epithelium of
      uriniferous tubules, probably because their expression is associated with the
      proliferating and metabolic activities of the cell, as suggested by previous
      investigators. These results suggest that TRX and GRX play some tissue-specific
      roles in mammalian morphogenesis as well as general roles as antioxidant enzymes.

PMID- 11213471
TI  - Molecular cloning and expression of human xCT, the light chain of amino acid
      transport system xc-.
AB  - Transport of system xc- is an exchange agency with high specificity for anionic
      form of cystine and glutamate. The protein mediating this transport is a
      disulfide-linked heterodimer of a light chain named xCT and a heavy chain
      previously known as 4F2hc. We have isolated two cDNAs encoding xCT from the human
      cDNA library. One clone coded for a protein of 501 amino acids with 12 putative
      transmembrane domains. When functionally expressed in Xenopus oocytes together
      with the human 4F2hc, human xCT induced the transport activity whose
      characteristics are similar to those of system xc-. Another clone seemed to
      contain a partial human xCT and a long 3' untranslated region. The human xCT gene
      was localized at chromosome 4q28-31. Analysis of the 5'-flanking region of the
      human xCT gene revealed several sites for potentially binding of transcriptional
      factors, including NF-E2 and AP-1. Transport of cystine via system xc- has been
      known as a regulatory factor for the intracellular glutathione level, and its
      transport activity is induced in response to the oxygen tension in culture.
      Northern blot analysis demonstrated that the expression of both xCT and 4F2hc was
      significantly enhanced by oxygen. The results suggest that oxygen regulates the
      activity of system xc- by modulating the expression of both xCT and 4F2hc mRNAs.

PMID- 11213472
TI  - Nitric oxide induces a decrease in the mitochondrial membrane potential of
      peripheral blood lymphocytes, especially in natural killer cells.
AB  - Increased levels of nitric oxide (NO) at an inflammatory site may affect the
      biological activity of lymphoid cells. To investigate the effects of NO on the
      immune system, we measured the mitochondrial membrane potential (delta psi m) of
      the peripheral blood lymphocytes (PBL) cultured with a chemical NO donor. PBL
      from healthy volunteers were cultured with NOC18, a NO-generating compound, at
      various concentrations. The delta psi m of the PBL was measured by flow-cytometry
      using 3,3-dihexyloxacarbocyanine iodide (DiOC6(3)). NOC18 induced a decrease in
      the delta psi m of the PBL in a dose-dependent fashion, induced an increase in
      the levels of reactive oxygen species (ROS), and caused these cells to undergo
      apoptosis. Dual-color staining of the delta psi m and lymphocyte surface markers
      demonstrated that CD3-CD56+ natural killer (NK) cells were responsive to NO.
      Trolox, a vitamin E analog, partially reversed the NO-induced decrease in the
      delta psi m of the PBL. We showed that the delta psi m of peripheral NK cells
      were decreased by NO, which suggests that abundant NO at an inflammatory site may
      impair NK cell function.

PMID- 11213473
TI  - Serum 4-hydroxy-2-nonenal-modified albumin is elevated in patients with type 2
      diabetes mellitus.
AB  - 4-Hydroxy-2-nonenal (HNE) is one of the major lipid peroxidation products with
      cytotoxic and mutagenic activity. It further reacts with protein residues such as
      histidine to generate stable Michael adducts. To evaluate the status of oxidative
      stress in the serum of type 2 diabetes mellitus, we constructed a sandwich enzyme
      linked immunosorbent assay to measure serum HNE-modified albumin by the use of a
      specific monoclonal antibody (HNEJ-2) against HNE-histidine adducts as well as an
      antibody against human serum albumin. Serum of type 2 diabetes outpatients
      revealed significantly higher levels of HNE-modified albumin (736.1 +/- 34.2
      pmol/ml, n = 54) than the matched nondiabetics (611.4 +/- 39.1 pmol/ml, n = 30;
      means +/- SEM; p = 0.018). However, no significant correlation was observed in
      diabetic outpatients between the levels of HNE-modified albumin and clinical
      parameters such as fasted blood glucose, HbA1c, diabetes duration, or
      complications. Our data demonstrated the increased formation of serum HNE
      modified albumin in type 2 diabetic outpatients in the milieu between liver and
      vascular lumina, indicating the presence of oxidative stress.

PMID- 11213474
TI  - Thioredoxin levels in the sera of untreated viral hepatitis patients and those
      treated with glycyrrhizin or ursodeoxycholic acid.
AB  - Thioredoxin (TRX), a thiol-containing protein, is induced by various oxidative
      stresses. Serum TRX levels were measured with a sandwich enzyme-linked
      immunosorbent assay kit in 210 hepatitis C virus (HCV)-infected patients, 39
      hepatitis B virus (HBV)-infected patients, and 17 healthy volunteers. The effects
      of hepatoprotective drugs on TRX levels were also examined. The median TRX levels
      were significantly higher in HCV-infected patients than in controls (34.2 vs.
      23.5 ng/ml, respectively; p < 0.005), but were not elevated in HBV-infected
      patients (26.7 ng/ml). The TRX levels were significantly correlated with serum
      lipid peroxide levels and indocyanine green exclusion test values, and were
      markedly decreased following treatment with Stronger Neo-Minophagen C or
      ursodeoxycholic acid. In conclusion serum TRX levels, a marker of oxidative
      stress, were higher in patients with HCV infection than those with HBV infection
      and healthy controls. The therapeutic efficacy of hepatoprotective drugs may be
      connected with the decrease in oxidative stress in hepatitis patients.

PMID- 11213475
TI  - Secretion of thioredoxin enhances cellular resistance to cis
      diamminedichloroplatinum (II).
AB  - Thioredoxin (TRX) is a redox-active protein induced by a variety of stress and
      secreted from cells. Collecting evidence revealed that extracellular TRX shows
      cytokine- and chemokine-like activities. In the present study, we studied the
      role of secreted TRX on cellular resistance to cis-diamminedichloroplatinum (II)
      (CDDP). The CDDP-resistant variants of HeLa cells not only have enhanced
      expression of intracellular TRX, but also show increased secretion of TRX into
      the culture medium, compared to the parental cells. The CDDP-resistant cells also
      exhibit an enhanced L-cystine uptake capability, which results in a significant
      increase in the intracellular sulfhydryl content, including glutathione (GSH).
      Exogenous administration of recombinant TRX (rTRX) increases cellular resistance
      to CDDP and augments the L-cystine uptake in the parental HeLa cells. Moreover,
      depletion of L-cystine from the culture medium or combined treatment with L
      cystine uptake inhibitors increases cellular sensitivity to CDDP in the CDDP
      resistant cells. These findings suggest that secreted TRX may play an important
      role in the acquisition of cellular CDDP resistance through enhancement of the L
      cystine uptake activity, and that the L-cystine transport system, as well as the
      TRX system, may be a novel therapeutic target in CDDP-resistant cancer cells.

PMID- 11213476
TI  - Thioredoxin blood level increases after severe burn injury.
AB  - We have investigated the thioredoxin (TRX) levels in severely burned patients and
      the possible origin of TRX, based on the recent understanding that TRX is a
      potent antioxidant with cytoprotective functions. Serum and plasma samples from
      burns patients and healthy blood donors were collected during the first 10 post
      burn days and analyzed in a sandwich TRX enzyme-linked immunosorbent assay
      (ELISA). The TRX levels found were correlated to a panel of blood tests. The
      presence of TRX in platelets was investigated by immunoelectron microscopy and
      Western blotting. TRX serum levels of the severely burned patients showed a
      significant increase, with a mean serum TRX concentration on the day of injury of
      76.5 +/- 19.5 ng/ml (mean +/- SD) and on post-burn day one 122.6 +/- 66.9 ng/ml,
      compared to control blood donor levels of 22.7 +/- 12.2 ng/ml (p = 0.0041 and
      0.0117, respectively). A second peak of increase was found on post-burn days 7 to
      9 with a four- to five-fold rise in concentration compared to controls. TRX
      elevation correlated well with increased platelet (p = 0.007) and leukocyte
      counts (p = 0.002). We also demonstrated by immunoelectron microscopy and Western
      blotting the presence of TRX in platelets. In conclusion, our demonstration of
      TRX release in burn injuries indicates that the TRX system is involved in a rapid
      antioxidant defense, coagulation processes, cell growth, and control of the
      extracellular peroxide tone intimately linked to cytoprotection and wound healing
      in burns. One of the cell types that delivers TRX promptly and efficiently into
      the blood may be the platelet.

PMID- 11213477
TI  - Secretion of 10-kDa and 12-kDa thioredoxin species from blood monocytes and
      transformed leukocytes.
AB  - Thioredoxins (TRX) are ubiquitous, small redox-active proteins with multiple
      functions, including antioxidant, cytoprotective, and chemoattractant activities.
      In addition to a 12-kDa intracellular form, extracellular 10-kDa and 12-kDa TRX
      have been defined. The biological activities of the 10-kDa TRX were previously
      measured as eosinophil cytotoxicity enhancing activity or B-cell stimulatory
      activity. Cytotrophoblastic cell lines also release a 10-kDa TRX form. To study
      the biological role of 10-kDa TRX, we established two highly sensitive enzyme
      linked immuno-spot assays (ELISPOT), which detect secreted truncated 10-kDa and
      full-length 12-kDa TRX at the single cell level. TRX secretion was investigated
      in several cell lines including the T-helper cell hybridoma MP6, the Jurkat T
      cell leukemia, the U-937 myelomonocytic leukemia, and the 3B6, EBV-transformed,
      lymphoblastoid B-cell line. The highest number of secreting cells was found in
      3B6 cultures, median = 34 (quartiles, 27-39) per well (10(5) cells). Peripheral
      blood monocytes isolated from healthy donors secreted significantly more TRX
      after stimulation with ionomycin, phorbol myristate acetate (PMA), fMLP, and
      lipopolysaccharide (LPS), compared to unstimulated cells. Oxidative stress
      induced by thioloxidant diamide also induced the secretion of both truncated and
      full-length TRX measured in ELISPOT (p = 0.047 and p = 0.031, respectively). The
      biological activity of the truncated and full-length forms was tested in a cell
      migration assay. Truncated TRX was devoid of protein disulfide reductase
      activity, but retained strong chemoattractant activity for human monocytes, in
      the same range as full-length TRX, as previously reported (Bertini et al., 1999).

PMID- 11213478
TI  - Enhanced invasion of Tax-expressing fibroblasts into the basement membrane is
      repressed by phosphorylated ascorbate with simultaneous decreases in
      intracellular oxidative stress and NF-kappa B activation.
AB  - Invasion of rat fibroblastic cells Rat-1 through Matrigel was shown to be
      promoted by transfection with tax gene of human T-cell leukemia virus type 1. We
      found that an oxidation-resistant type of vitamin C (Asc), Asc-2-O-phosphate
      (Asc2P), inhibited the invasion of the tax-transfected Rat-1 cells (W4 cells).
      Intracellular Asc (Ascin), after enzymatic dephosphorylation of administered
      Asc2P, was more abundant in W4 cells than in Rat-1 cells, and the ratio of
      dehydroascorbic acid versus Asc was increased in W4 cells but scarcely in Rat-1
      cells, according to the enhanced level of intracellular reactive oxygen species
      (ROSin) in W4 cells. Asc2P notably repressed the increases in both ROSin and
      secretion of matrix metalloproteases (MMPs), but did not affect Tax protein
      expression in tax-transfectants. NF-kappa B activation, as evidenced by its
      translocation to the nucleus in W4 cells, was also repressed by Asc2P. Thus, the
      tax-promoted invasion together with the enhanced production of MMPs occurred with
      NF-kappa B activation and the increase in ROSin, both of which were effectively
      reduced by Asc2P. These findings indicate the therapeutic efficacy of Ascin
      enriching agents for the prevention against tumor invasion in which ROSin plays a
      major role.

PMID- 11213479
TI  - Role for copper in transient oxidation and nuclear translocation of MTF-1, but
      not of NF-kappa B, by the heme-hemopexin transport system.
AB  - Heme-hemopexin (2-10 microM) is used as a model for intravenous heme released in
      trauma, stroke, and ischemia-reperfusion. A transient increase in cellular
      protein oxidation occurs during receptor-mediated heme transport from hemopexin
      which is inhibited by the nonpermeable Cu(I) chelator, bathocuproinedisulfonate.
      Thus, participation of surface redox process involving Cu(I) generation are
      proposed to be linked to the induction of the protective proteins heme oxygenase
      1 (HO-1) and metallothionein-1 (MT-1) by heme-hemopexin. The region (-153 to -42)
      in the proximal promoter of the mouse MT-1 gene responds to heme- and CoPP
      hemopexin in transient transfection assays and contains metal-responsive elements
      for MTF-1 and an antioxidant-responsive element (ARE) overlapping a GC-rich E-box
      to which USF-1 and -2 bind. No decreases in DNA binding of the diamide-oxidation
      sensitive USF-1 and -2 occur upon exposure of cells to heme-hemopexin. MTF-1 and
      the ARE-binding proteins are relatively resistant to diamide oxidation and are
      induced approximately eight- and two-fold, respectively, by heme-hemopexin. BCDS
      prevents the nuclear translocation of MTF-1 by both heme- and CoPP-hemopexin
      complexes as well as MT-1 mRNA induction by CoPP-hemopexin. Thus, copper is
      needed for the surface oxidation events and yet the nuclear translocation of MTF
      1 in response to hemopexin occurs via copper, probably Cu(I),-dependent signaling
      cascades from the hemopexin receptor rather than the oxidation per se.

PMID- 11213480
TI  - Cell-surface events for metallothionein-1 and heme oxygenase-1 regulation by the
      hemopexin-heme transport system.
AB  - A model has been developed for the hemopexin receptor-mediated heme transport
      system based on iron uptake in yeast. Two steps are required: reduction followed
      by oxidation by a multi-copper-oxidase. Furthermore, in the hemopexin system, the
      surface redox events have been linked with gene regulation. The impermeable Cu(I)
      chelator bathocuproinedisulfonate (BCDS) is shown here to abrogate heme oxygenase
      1 (HO-1) mRNA induction by heme-hemopexin. A role for Cu(I) in the regulation of
      HO-1 and MT-1 (Sung et al., 1999) by hemopexin supports the participation of
      electron transport processes at the cell surface as does competition by the
      reductase activator, ferric citrate, which inhibits the induction of MT-1 and HO
      1 mRNA by heme-hemopexin. There is a key role for the hemopexin receptor because
      neither ferric citrate nor iron-transferrin alone regulates MT-1 or HO-1. Cell
      surface copper is the first molecule to link the concomitant regulation of HO-1
      and MT-1 by the hemopexin receptor. In addition, cytochrome b5 and cytochrome b5
      reductase are implicated here in the response of cells to heme-hemopexin.
      Reduction of one or more electron donors of the reductase and oxidation of the
      electron acceptor, b5 heme, leads to gene regulation, but only when heme
      hemopexin is bound to its receptor. Protein kinase cascades, including JNK, are
      activated by the hemopexin receptor itself upon ligand binding but are modulated
      by a Cu(I)-dependent process likely to be heme uptake.

PMID- 11213482
TI  - Evidence for a NADH/NADPH oxidase in human umbilical vein endothelial cells using
      electron spin resonance.
AB  - A growing body of evidence has suggested that a membrane-bound NADH/NADPH oxidase
      is the predominant source of reactive oxygen species (ROS) in vascular cells.
      Prior studies have used indirect assessments of superoxide including lucigenin
      enhanced chemiluminescence, cytochrome c, and fluorescent dye techniques. The
      present study was performed to determine if NADH/NADPH oxidase function could be
      detected human endothelial cells using electron spin resonance. Human umbilical
      vein endothelial cells (HUVEC) were homogenized and fractionated into cytosolic
      and membrane components. Cell fractions were incubated in buffer containing
      either NADH or NADPH (100 microM for each) and the spin trap 5
      (diethoxyphosphoryl)-5-methyl-1-pyrroline N-oxide (DEPMPO). EPR signals were
      obtained in a Bruker EMX spectrometer. Cytoplasmic fractions were devoid of
      activity. In contrast, incubation of membrane fractions with NADH produced a
      signal with a total peak intensity of 1,038 +/- 64, which was significantly
      greater than that observed with NADPH (540 +/- 101). The signal was completely
      inhibited by either manganese superoxide dismutase (MnSOD, 100 U/ml) or the
      flavoprotein inhibitor diphenylene iodinium (DPI, 100 microM). Rotenone (100
      microM) did not significantly alter the signal intensity, (833 +/- 88). These
      data demonstrate direct evidence for a functional NADH/NADPH oxidase in human
      endothelial cells and show that electron spin resonance is a useful tool for
      study of this enzyme system.

PMID- 11213481
TI  - Glutathione-dependent regulation of nitric oxide production in isolated rat
      hepatocyte suspensions.
AB  - Freshly isolated suspensions of rat parenchymal liver cells (hepatocytes)
      spontaneously produce large amounts of nitrite following collagenase isolation.
      Our previous studies indicate that nitrite production is associated with the
      expression of inducible nitric oxide synthase (iNOS) and reflects NO production.
      Depletion of glutathione (GSH) with diethylmaleate (DEM) inhibited nitrite
      production, and this inhibition was time-dependent. DEM was more effective in
      blocking nitrite production if it was added within the first 1 hr of the start of
      the incubation. The reducing agent dithiothreitol (DTT) and the alkylating agent
      ethyl methanesulfonate (EMS) also inhibited hepatocyte nitrite production, and
      this inhibition was also greatest if they were added within 1 hr of initiating
      the incubation. However, EMS added at 3 hr still reduced 6-hr nitrite production
      by about 70%. This reduction in nitrite production by EMS added at 3 hr may be
      due to the direct modification of thiol groups on the iNOS protein because we
      have determined that iNOS activity is inhibited by the sulfhydryl modifying
      reagent N-ethylmaleimide (NEM). Western blots also indicate that the iNOS protein
      is expressed when EMS is added at 3 hr. The addition of DEM, DTT, or EMS at 0
      time greatly reduced the levels of cellular iNOS mRNA relative to controls as
      determined by quantitative RT-PCR. Based on our results with mRNA levels, both
      DTT and depletion of cellular GSH appear to inhibit the early signaling events
      leading to iNOS expression and suggest that the control of iNOS induction in
      hepatocytes is sensitive to the thiol redox status of the cell.

PMID- 11213483
TI  - Anethole dithiolethione regulates oxidant-induced tyrosine kinase activation in
      endothelial cells.
AB  - Interaction between neutrophils and endothelial cells is one of the first steps
      in the functional response of polymorphonuclear neutrophils (PMN), and is
      necessary for their migration toward damaged tissues. PMN activation, leading to
      their adhesion to and migration between endothelial cells, is part of a complex
      phenomenon that can be altered in pathological situations such as the ischemia
      reperfusion syndrome, in which large numbers of PMN are recruited to the tissue
      and release reactive oxygen species (ROS) near the vessel wall. ROS have been
      implicated in the pathogenesis of various inflammatory diseases. The increased
      adhesion of PMN to ROS-stimulated endothelial cells involves an increase in
      tyrosine phosphorylation of a tyrosine kinase focal adhesion kinase (p125FAK) and
      several cytoskeleton proteins, including paxillin and p130 cas. We examined the
      role of glutathione (GSH) in the regulation of this adhesion phenomenon and in
      the increased tyrosine phosphorylation induced by ROS. For this purpose we used
      anethole dithiolthione (ADT), which increases the glutathione synthesis by
      activating gamma-glutamyl-cysteine synthetase. We found that ADT reduced both PMN
      adhesion to ROS-stimulated human umbilical vein endothelial cells (HUVEC) and
      tyrosine phosphorylation of p125FAK and paxillin. ADT increased redox status by
      increasing intracellular GSH content in oxidized cells. These results show that
      GSH can reverse the effect of oxidation on tyrosine kinase activation and
      phosphorylation, and thus plays an important role in cell signaling. They also
      confirm the antioxidant activity of ADT.

PMID- 11213484
TI  - The mitochondrial thioredoxin system.
AB  - Eukaryotic organisms from yeast to human possess a mitochondrial thioredoxin
      system composed of thioredoxin and thioredoxin reductase, similar to the
      cytosolic thioredoxin system that exists in the same cells. Yeast and mammalian
      mitochondrial thioredoxins are monomers of approximately 12 kDa and contain the
      typical conserved active site WCGPC. However, there are important differences
      between yeast and mammalian mitochondrial thioredoxin reductases that resemble
      the differences between their cytosolic counterparts. Mammalian mitochondrial
      thioredoxin reductase is a selenoprotein that forms a homodimer of 55
      kDa/subunit; while yeast mitochondrial thioredoxin reductase is a homodimer of 37
      kDa/subunit and does not contain selenocysteine. A function of the mitochondrial
      thioredoxin system is as electron donor for a mitochondrial peroxiredoxin, an
      enzyme that detoxifies the hydrogen peroxide generated by the mitochondrial
      metabolism. Experiments with yeast mutants lacking both the mitochondrial
      thioredoxin system as well as the mitochondrial peroxiredoxin system suggest an
      important role for mitochondrial thioredoxin, thioredoxin reductase, and
      peroxiredoxin in the protection against oxidative stress.

PMID- 11213485
TI  - Antioxidant function of thioredoxin and glutaredoxin systems.
AB  - Selenium is an essential trace element with known antioxidant properties.
      Cytosolic thioredoxin reductase from mammalian cells is a dimeric flavin enzyme
      comprising a glutathione reductase-like equivalent elongated with 16 residues
      including the conserved carboxy-terminal sequence, Gly-Cys-SeCys-Gly, where SeCys
      is selenocysteine. Replacement of the SeCys residue by Cys in rat cytosolic
      thioredoxin reductase using site-directed mutagenesis and expression in
      Escherichia coli resulted in a functional mutant enzyme having about one percent
      activity with thioredoxin as a substrate through a major loss of Kcat and a shift
      in the pH optimum from 7 to 9. The truncated enzyme expected in selenium
      deficiency by the UGA mRNA codon for SeCys acting as a stop codon was also
      expressed. This enzyme lacking the carboxy-terminal SeCys-Gly dipeptide contained
      FAD but was inactive because the SeCys selenol is in the active site. These
      results show that selenium is essential for the activity of thioredoxin
      reductase, explaining why this trace element is required for cell proliferation
      by effects on thioredoxin-dependent control of the intracellular redox state,
      ribonucleotide reductase production of deoxyribonucleotides, or activation of
      transcription factors. The selenazol drug ebselen (2-phenyl-1,2 benzisoselenazol
      3 (2H)-one) is a known glutathione (GSH) peroxidase mimic with antioxidant
      properties. The hydrogen peroxide reductase activity of human thioredoxin
      reductase was stimulated 15-fold by 2 microM ebselen. Glutaredoxins protect
      against oxidative stress by catalyzing reduction of protein mixed disulfides with
      GSH. The mechanism of glutaredoxins as efficient general GSH-mixed disulfide
      oxidoreductases may protect proteins from inactivation as well as play a major
      role in general redox signaling.

PMID- 11213486
TI  - Vitamin E and leukocyte-endothelial cell interactions.
AB  - Leukocyte-endothelial cell interactions are mediated by adhesion molecules,
      expression of which is modulated by cytokines and chemical mediators in the early
      phase of inflammatory and immunologic reactions, including the development of
      atherosclerosis. Vitamin E is a lipid-soluble antioxidant that is present in all
      cell membranes at a low concentration and is reported to be an anti-atherogenic
      agent. Recently, it was reported that vitamin E inhibits the activation of
      protein kinase C and nuclear factor-kappa B (NF-kappa B). We demonstrated that
      vitamin E can prevent leukocyte-endothelial cell adhesion by inhibiting signal
      transduction involved in the surface expression of adhesion molecules by
      leukocytes and endothelial cells. These results suggest that vitamin E may have a
      protective effect against the progression of inflammation and atherosclerosis.

PMID- 11213487
TI  - Molecular views of redox regulation: three-dimensional structures of redox
      regulatory proteins and protein complexes.
AB  - The last decade has witnessed the explosion of research on redox-controlled
      cellular and biochemical processes. Whereas the vast majority of these studies
      have centered on clinical, genetic, and biochemical aspects of redox signaling
      and regulation inside and outside the cell, a significant number of nuclear
      magnetic resonance (NMR) and crystallographic studies have been undertaken to
      obtain an atomic-level understanding of the mechanisms of the redox regulation.
      This review highlights the recent progress of three-dimensional structure
      determination of key proteins and protein complexes involved in redox regulation.
      An increased list of such class of protein structures and their complexes with
      ligands will provide invaluable insight into the molecular basis of redox
      regulatory processes and may be useful for the future development of therapeutic
      agents for redox-related diseases.

PMID- 11213489
TI  - Redox control of protein degradation.
AB  - This review summarizes evidence that most of cell protein degradation is
      maintained by pathways transferring energy from glucose to reduction of enzymic
      and nonenzymic proteins (redox-responsive). In contrast, a major subcomponent of
      proteolysis is simultaneously independent of the cell redox network (redox
      unresponsive). Thus far, direct and indirect redox-responsive proteolytic
      effector mechanisms characterized by various investigators include: several
      classes of proteases, some peptide protease inhibitors, substrate conjugation
      systems, substrate redox and folding status, cytoskeletal-membrane kinesis, metal
      homeostasis, and others. The present focus involves redox control of sulfhydryl
      proteases and proteolytic pathways of mammalian muscle; however, other
      mechanisms, cell types, and species are also surveyed. The diversity of redox
      responsive catabolic mechanisms reveals that the machinery of protein turnover
      evolved with fundamental dependencies upon the cell redox network, as observed in
      many species. The net redox status of a reversible proteolytic effector mechanism
      represents the balance between combined oxidative inactivating influences versus
      reductive activating influences. Similar to other proteins, redox-responsive
      proteolytic effectors appear to be oxidized by mixed disulfide formation,
      nitrosation, reactive oxygen species, and associations or reactions with metal
      ions and various pro-oxidative metabolites. Systems reducing the proteolytic
      machinery include major redox enzyme chains, such as thioredoxins or
      glutaredoxins, and perhaps various reductive metabolites, including glutathione
      and dihydrolipoic acid. Much of mammalian intracellular protein degradation is
      reversibly responsive to noninjurious experimental intervention in the reductive
      energy supply-demand balance. Proteolysis is reversibly inhibited by diamide or
      dehydroascorbic acid; and such antiproteolytic actions are strongly dependent on
      the cell glucose supply. However, gross redox-responsive proteolysis is not
      accompanied by ATP depletion or vice versa. Redox-responsive proteolysis includes
      Golgi-endoplasmic reticulum degradation, lysosomal degradation, and some amount
      of extravesicular degradation, all comprising more than half of total cell
      proteolysis. Speculatively, redox-dependent proteolysis exhibits features
      expected of a controlling influence coordinating distinct proteolytic processes
      under some intracellular conditions.

PMID- 11213490
TI  - Detection and imaging of endogenously produced nitric oxide with electron
      paramagnetic resonance spectroscopy.
AB  - Nitric oxide (NO) represents a new paradigm for second messengers in regulation.
      Despite the numerous physiological and pathophysiological functions of NO, its
      importance as an endogenous second messenger and a cytostatic and/or cytotoxic
      agent was unknown until 1987. Recent developments in detection methods for
      endogenous NO produced directly or indirectly from NO synthases (NOSs) have
      enabled major advances in our understanding of the role of NO in biological
      systems. The spin-trapping technique combined with electron paramagnetic
      resonance (EPR) spectroscopy is a method for analyzing NO production directly
      both in vivo and in vitro. Iron complexes with dithiocarbamate derivatives are
      noteworthy among the spin-trapping reagents for NO because NO has a high affinity
      for iron complexes. The resultant stable nitrosyl iron complexes exhibit an
      intense three-line signal at room temperature and an axial signal at low
      temperature. Besides the facility and wide applicability of this method, its
      outstanding feature is that noninvasive in vivo measurements are available by
      using a low-frequency EPR spectrometer. In this article, we review on previous
      and recent developments of in vitro, in vivo, and ex vivo EPR detection and
      imaging of endogenously produced NO.

PMID- 11213488
TI  - Molecular mechanism of activation and superactivation of Ret tyrosine kinases by
      ultraviolet light irradiation.
AB  - The catalytic activities of Ret tyrosine kinases as the products of oncogene RET
      with multiple endocrine neoplasia type 2A (Ret-MEN2A) or 2B (Ret-MEN2B) mutations
      and the hybrid gene from c-RET and RFP (Rfp-Ret) were higher than those of c-Ret.
      We demonstrated that ultraviolet light (UV) irradiation induced activation of c
      Ret and superactivation of genetically mutated, and thereby constitutively
      activated, Ret-MEN2A, Ret-MEN2B, and Rfp-Ret. We found that small proportions of
      c-Ret and Ret-MEN2B and a large proportion of MEN2A were dimerized due to
      disulfide bonds and that high kinase activity resided in these fractions. The UV
      induced activation of c-Ret and superactivation of Ret-MEN2A and Ret-MEN2B were
      then shown to be closely associated with promotion of the disulfide bond-mediated
      dimerization of the Ret proteins. Furthermore, we showed that a large proportion
      of Rfp-Ret was dimerized or polymerized and that almost all kinase activities
      resided in the highly polymerized but not dimerized fraction. The UV-induced
      superactivation of Rfp-Ret was also found to be closely associated with promotion
      of polymerization but not with dimerization of Rfp-Ret. Further experiments
      revealed that UV induced intracellular dimerization and activation of the
      extracellular domain-deleted mutant Ret (Ret-PTC-1). Most importantly, the levels
      of basal kinase activity and dimerization of Ret-TPC-1-C376A, in which cysteine
      376 in the tyrosine kinase domain of Ret-TPC-1 was replaced with alanine, were
      low and were not increased by UV irradiation. These results suggest that the
      cysteine at this position works as the primary target of dimerization of Ret
      proteins inside the cell for both the maintenance of the basal kinase activity
      and its promotion by UV, possibly in co-operation with the cysteine(s) in the
      extracellular domain of Ret-MEN2A and Rfp-Ret, which is the target of
      dimerization and polymerization outside the cell. The potential biological
      significance of the UV-mediated superactivation of mutant Ret through the newly
      proposed mechanism in oncogenesis is discussed.

PMID- 11213491
TI  - Oxidants and antioxidants in breast cancer.
AB  - Although a number of risk factors have been identified for breast cancer,
      mechanisms by which they increase risk of the disease are not clear. Breast
      cancer etiology could, in part, be related to oxidative stress. Recognized risk
      factors for breast cancer include a family history of the disease. BRCA1 is
      needed for post-transcriptional repair of oxidative damage, indicating that
      oxidative stress may be an important risk factor for women with a family history
      of the disease. Reproductive and hormonal factors that result in greater exposure
      to circulating estrogens also increase risk, and steroid hormones are metabolized
      to reactive quinones and hydroquinones, which can directly damage DNA. Alcohol
      consumption is associated with increased risk, and the metabolism of alcohol
      results in production of DNA-damaging reactive oxygen species (ROS). Finally, the
      inverse relationship noted with consumption of fruits and vegetables could be
      related to their being a source of antioxidant vitamins. Endogenous factors may
      play an equally important role in the effects of oxidative stress on breast
      carcinogenesis. Genetic variability in enzymes that result in increased
      production of ROS and those that protect the cell from oxidative stress could
      also have an impact for risk of the disease. In this review, a rationale is given
      for linking breast cancer risk factors to oxidative stress. The possible role of
      genetic polymorphisms in a number of enzymes that may be important in affecting
      levels of ROS to which the cell is exposed, as well as those that protect the
      cell from oxidative stress, is discussed.

PMID- 11213492
TI  - Redox control of vascular nitric oxide bioavailability.
AB  - NO is an important component of vascular homeostasis and abnormal NO bioactivity
      has been implicated in number of disease states with important public health
      implications. One clear mechanism of impaired NO bioactivity and vascular disease
      is excess vascular oxidative stress. There is now a wealth of developing data
      that manipulation of vascular antioxidant stress is the considerable influence of
      the biologic activity of endothelium-derived NO. It remains to be seen if this
      influence can be exploited in a manner that truly alters the course of human
      disease.

PMID- 11213493
TI  - Antioxidants and redox signaling: Internet resources.

PMID- 11213494
TI  - Hospital not responsible for physician's death. Campo v. St. Luke's Hospital.

PMID- 11213495
TI  - Home health nurses may be paid on a "per visit" basis and still be exempt.
      Fazekas v. the Cleveland Clinic Foundation Health Care Ventures, Inc.

PMID- 11213496
TI  - Immunity provisions: they must be read carefully. Ironside v. Simi Valley
      Hospital.

PMID- 11213497
TI  - Usefulness of intraoperative cytology for the diagnosis of primary pancreatic
      lymphoma.

PMID- 11213498
TI  - Adult rhabdomyosarcoma with skin metastases: diagnosis by fine needle aspiration
      biopsy.

PMID- 11213499
TI  - Characterizing subpopulations of neoplastic cells in serous effusions. The role
      of immunocytochemistry.
AB  - OBJECTIVE: To analyze the role of immunochemistry in serous effusions. STUDY
      DESIGN: We analyzed cell blocks of 18 pleural and 18 peritoneal effusions
      diagnosed as malignant (18), benign (14) and suspicious (4). They were
      immunostained by the avidin-biotin complex method with a panel of four monoclonal
      antibodies--CEA, Ber-EP4, LeuM1 (CD15) and p53--and, for lectins (Ulex europaeus)
      UEA-l, ConA and ConBr. RESULTS: Seventeen of the 18 cases of adenocarcinoma were
      positive for CEA (95%), 12 (66.6%) for Ber-EP4, 11 (61%) for CD15 and 11 (61%)
      for p53. Twelve of the 18 (66.6%) were positive for UEA-1, CEA, Ber-EP4 and CD15.
      UEA-1 did not react with mesothelial cells. p53 Gave a positive reaction in only
      one case, reactive mesothelial cells. ConA and ConBr reacted indiscriminately
      with benign and malignant cells; thus, it was not useful in distinguishing
      between these cells. CONCLUSION: In this context no antibody used alone is
      reliable for corroborating a diagnosis, but the selective use of a small panel of
      three markers (CEA, Ber-EP4 and LeuM1) can be very useful in solving diagnostic
      difficulties in the cytodiagnosis of serous effusions.

PMID- 11213500
TI  - Repeat cervical cytology at the time of colposcopy. Is there an added benefit?
AB  - OBJECTIVE: To determine if repeating the Pap smear (PS) at colposcopy offers
      added benefit in the detection of cervical squamous intraepithelial lesions
      (SILs). STUDY DESIGN: Eight hundred fifty-two women were subjects of this study.
      Patients with cervical SIL were defined as women with SIL on the repeat PS, or
      SIL on the colposcopic cervical biopsy (bx) or a negative repeat PS and bx but
      confirmed SIL on both the previous and follow-up PS or bx. The sensitivities of
      repeat PS and bx in detecting SIL were calculated. The chi 2 test was used to
      assess statistical significance. The total cost of repeating the PS was
      calculated by multiplying the total number of patients (852) by the estimated
      cost of a single PS ($25). RESULTS: The sensitivities of repeat PS, bx and PS/bx
      combined were .89, .69 and .92 for low grade SIL (LSIL) and .74, .77 and .98 for
      high grade SIL (HSIL), respectively (P < .0001). Sixteen percent of the HSIL and
      28% of the LSIL cases were diagnosed on repeat PS only (negative bx). If repeat
      PS was omitted, $21,300 would have been saved.

PMID- 11213501
TI  - Cost analysis of PAPNET-assisted vs. conventional Pap smear evaluation in primary
      screening of cervical smears.
AB  - OBJECTIVE: To assess the difference in costs between PAPNET-assisted and
      conventional microscopy of cervical smears when used as a primary screening tool.
      STUDY DESIGN: We performed time measurements of the initial screening of smears
      by four cytotechnologists in one laboratory. Time was measured in 816
      conventionally screened smears and in 614 smears with PAPNET-assisted screening.
      Data were collected on the components of initial screening, clerical activities
      and other activities in the total work time of cytotechnologists in the routine
      situation and on resource requirements for both techniques. RESULTS: PAPNET saved
      an average of 22% on initial screening time per smear. Due to costs of processing
      and additional equipment, the costs of PAPNET-assisted screening were estimated
      to be $2.85 (and at least $1.79) higher per smear than conventional microscopy.
      The difference in costs is sensitive to the rate of time saving, the possibility
      of saving on quality control procedures and the component of the initial
      screening time in the total work time of cytotechnologists. CONCLUSION: Although
      PAPNET is time saving as compared with conventional microscopy, the associated
      reduction in personnel costs is outweighed by the costs of scanning the slides
      and additional equipment. This conclusion holds under a variety of assumptions.
      Using PAPNET instead of conventional microscopy as a primary screening tool will
      make cervical cancer screening less cost-effective unless the costs of PAPNET are
      considerably reduced and its sensitivity and/or specificity are considerably
      improved.

PMID- 11213502
TI  - Molecular biomarker-based screening for early detection of cervical cancer.
AB  - OBJECTIVE: To evaluate the effectiveness of a molecular biomarker-based screening
      method for early detection of cervical cancer. STUDY DESIGN: Fluorescent
      immunochemical labeling was used to classify cervical cytology specimens as
      probably normal or probably abnormal. These specimens were then Papanicolaou
      stained and evaluated twice by a cytotechnologist and by a pathologist when
      appropriate. The first evaluation was performed as conventional Pap screening to
      assign a reference per-specimen diagnosis. The second evaluation assigned a
      cytologic diagnosis to each cell in the specimen. The fluorescence results were
      correlated with those from each of the two morphologic evaluations to determine
      the sensitivity and specificity of the method on a per-specimen and a per-cell
      basis. Where available, in cases of positive morphologic analysis, biopsy was
      compared to fluorescence results. RESULTS: The per-specimen sensitivity and
      specificity were 87.5% and 81.8%, respectively, when using atypical squamous
      cells of undetermined significance and "above" as the decision threshold. For the
      same specimens evaluated on a cell-by-cell basis, the corresponding sensitivity
      and specificity were 71.4% and 66.3% when the same threshold was used. The per
      specimen sensitivity for high grade squamous intraepithelial lesions was 100%
      under these conditions. CONCLUSION: This method appears to be a robust and
      reliable means of detecting cervical dysplasia and is now being evaluated in
      additional clinical studies.

PMID- 11213503
TI  - Nuclear grooves. How specific are they?
AB  - OBJECTIVE: To study the significance of nuclear grooves in thyroid and
      extrathyroid benign and malignant lesions. STUDY DESIGN: In this retrospective
      study, 26 cases were selected randomly, consisting of papillary carcinoma of the
      thyroid (7), papillary adenocarcinoma (9), normal cervical smear (5) and benign
      bronchioalveolar lavage (BAL) (5). In all cases hematoxylin and eosin- and
      Papanicolaou-stained smears were studied for nuclear grooves. RESULTS: Except for
      one case of papillary adenocarcinoma, nuclear grooves were discernible in all
      cases. The highest number of nuclear grooves was seen in normal cervical smears,
      followed by papillary carcinoma of the thyroid, papillary adenocarcinoma and BAL
      smears. CONCLUSION: The number of grooves did not correlate with either benign or
      malignant conditions. These findings cast serious doubt about the diagnostic
      significance of nuclear grooves. Probably nuclear grooves are nonspecific
      findings and should be considered only in association with other diagnostic
      features.

PMID- 11213504
TI  - Benign cellular changes in Pap smears. Causes and significance.
AB  - OBJECTIVE: We reviewed consecutive cases classified as benign cellular changes
      (BCC) over a four-month period. STUDY DESIGN: Cases classified as BCC were
      retrieved from the cytology files. A search was carried out to identify the
      previous Pap smears and concomitant cervical biopsies. RESULTS: One thousand one
      hundred three cases (23% of our gynecologic smears) were classified as BCC.
      Ninety-two patients (8.3%) underwent concurrent cervical biopsies. Specific
      infections accounted for 8% of BCC cases; reactive changes accounted for 92%. Of
      the biopsy specimens, 8.3% had no significant pathologic change. The most common
      biopsy diagnoses were cervicitis (31.5%), immature squamous metaplasia (16.3%)
      and reserve cell hyperplasia (10.8%). Miscellaneous benign diagnoses accounted
      for 21.7%. Cervical intraepithelial neoplasia (CIN) 1/human papillomavirus (HPV)
      was present in 14% of cases. All patients with biopsy diagnoses of CIN 1 had at
      least two previous abnormal Pap smears. Previous biopsy reports were available
      for review in 127 (12%) of the 1,103 patients. Of these 127 cases, 53.5% had a
      previous diagnosis of CIN/HPV; 9.4% had invasive carcinoma. A benign diagnosis
      was reported in 36.5%. CONCLUSION: The majority of BCC cases are due to reactive
      and inflammatory processes. In patients with a previous history of CIN, BCC may
      be of some significance. In patients with no significant prior cervical
      abnormalities, a Pap smear classified as BCC represents a reactive process.

PMID- 11213505
TI  - Cerebrospinal fluid cytologic findings in multiple sclerosis. A comparison
      between patient subgroups.
AB  - OBJECTIVE: To compare cytologic findings in cerebrospinal fluid (CSF) in various
      subgroups of multiple sclerosis (MS) patients. STUDY DESIGN: CSF from 77 patients
      with clinically definitive or probable MS was examined by means of qualitative
      cytology. After the cell count was determined in a Fuchs-Rosenthal chamber,
      slides were prepared by the cytosedimentation method and stained with May
      Grunwald-Giemsa stain and oil red O and, whenever possible, with Papanicolaou
      stain and toluidine blue. In addition to the differential cell count, the
      lymphocyte/monocyte ratio, percentage of activated forms in the lymphocytic and
      monocytic series, presence and percentage of lymphoplasmacytes and mature plasma
      cells, presence of lipophages, lymphophages and presence of mitotic figures were
      evaluated. RESULTS: The following statistically significant differences were
      found between the various MS subgroups: (1) higher prevalence of mitotic figures
      in the primary progressive MS subgroup; (2) higher prevalence of foam cells and
      lymphophages and lower prevalence of CSF pleocytosis in more severely disabled
      patients; (3) lower cell count, lower prevalence of CSF pleocytosis, lower
      lymphocyte/monocyte ratio and lower prevalence of lymphoplasmacytes in treated
      patients; and (4) higher prevalence of mature plasma cells and lipophages in MS
      patients with disease of longer duration. CONCLUSION: The differences observed in
      the various MS subgroups may reflect certain aspects of MS pathogenesis.
      Qualitative CSF cytology may therefore be useful for both clinicians and
      neuroimmunologists. Qualitative cytology of CSF is an important diagnostic method
      that should never be omitted from an examination of CSF from patients with MS.

PMID- 11213506
TI  - Routine air drying of all smears prepared during fine needle aspiration and
      intraoperative cytology studies. An opportunity to practice a unified protocol
      offering the flexibility of choosing a variety of staining methods.
AB  - OBJECTIVE: To evaluate the possibility of routine use of air-dried smears (ADS)
      instead of wet-fixed smears (WFS). STUDY DESIGN: Intraoperative cytology (IC)
      smears from 293 specimens and fine needle aspiration cytology (FNAC) smears from
      118 cases were studied. Cytomorphology of ADS processed with our protocol for
      hematoxylin-eosin (HE) and Papanicolaou (PAP) staining after saline rehydration
      and postfixation in 95% ethanol with 5% acetic acid were compared with
      respectively stained WFS. Additional ADS were stored up to 72 hours at room
      temperature prior to HE, PAP and Diff-Quik (DQ) staining to evaluate the effects
      of postponing rehydration and postfixation. Special stains for fungi were also
      studied in four cases. RESULTS: ADS were easy to prepare without air-drying
      artifact in the final HE- and PAP-stained smears. ADS were more cellular than
      WFS. Erythrocyte interference was frequent in WFS. HE and PAP staining of ADS
      stored up to 72 hours showed cytomorphology comparable to that of the similarly
      stained fresh smears. However, DQ staining was better if ADS were processed
      before 24 hours. ADS stained with special stain for fungi showed good morphology,
      similar to that in WFS. CONCLUSION: All ADS showed results comparable to or
      better than WFS. ADS could be stored up to 72 hours before staining with HE and
      PAP. ADS offers the flexibility of selecting a variety of staining methods and is
      a practical alternative to WFS.

PMID- 11213507
TI  - Infantile cartilaginous hamartoma of the rib. A case report.
AB  - BACKGROUND: Infantile cartilaginous hamartoma of the rib is a rare condition
      occurring in newborn infants, with an incidence of 1 in 3,000 (0.03%) among
      primary bone tumor cases. Reports of this condition so far have presented the
      clinical, radiologic and histopathologic features. To the best of our knowledge,
      reports of the cytopathologic features have not been documented. In the present
      case report, clinical, radiologic and cytopathologic features and differential
      diagnosis are enumerated. CASE: A 1-month-old, male infant presented with a chest
      wall mass with a clinical diagnosis of osteochondroma. On fine needle aspiration
      cytology, a diagnosis of infantile cartilaginous hamartoma of the rib was
      suggested; it was supplemented by the clinical history and radiologic findings.
      CONCLUSION: Although rare, this condition ought to be kept in mind while dealing
      with infantile chest wall masses to avoid an erroneous diagnosis of malignancy,
      owing to its ominous cytopathologic features.

PMID- 11213508
TI  - Cytologic features of pleural effusion in apocrine sweat gland carcinoma. A case
      report.
AB  - BACKGROUND: Carcinoma arising in the apocrine sweat glands is very rare, and
      there are few reports of the cytologic features. We encountered a case of
      metastatic apocrine carcinoma in a pleural effusion. CASE: A 46-year-old male had
      a dark reddish nodule in the right axillary region that was diagnosed as apocrine
      carcinoma of skin appendage origin. Three years after wide resection and
      chemotherapy, widespread metastases developed with a massive pleural effusion.
      Needle aspiration fluid cytology contained clusters of adenocarcinoma. Some tumor
      cells had abundant cytoplasm or periodic acid-Schiff-positive, coarse granules.
      Decapitation secretion was occasionally found on the cell surface.
      Immunohistochemically, the tumor cells were often positive for BRST-2 and BRST-3.
      CONCLUSION: Cytologic features of metastatic apocrine sweat gland carcinoma show
      some characteristics of adenocarcinoma. Moreover, its definitive diagnosis in a
      pleural effusion can be made because of retaining the characteristics of apocrine
      sweat gland.

PMID- 11213509
TI  - Paracoccidioides brasiliensis in a postpartum Pap smear. A case report.
AB  - BACKGROUND: There are several reported cases that describe female genital tract
      infections with opportunistic fungi, such as Blastomyces dermatitidis,
      Coccidioides immitis, Aspergillus flavus, Cryptococcus neoformans and Mucor. We
      describe a case of paracoccidiodomycosis limited to the uterine cervix. To the
      best of our knowledge, no such case has been described before in the English
      language literature. CASE: A 27-year-old, healthy female, gravida 3, para 2,
      abortion 1, presented for a routine gynecologic examination at six weeks'
      postpartum. Her past medical history was unremarkable. A routine
      cervical/endocervical smear revealed the presence of multiple fungal forms at
      different stages of development with a characteristic "pilot's wheel" appearance
      consistent with Paracoccidioides brasiliensis. Detailed medical examination of
      the patient did not reveal the presence of the primary infection in any other
      system. Cultures of the endometrium revealed no growth of the fungal organisms.
      The patient was asymptomatic, and therefore no therapy was initiated. Repeat
      Papanicolaou smears were negative for organisms. CONCLUSION:
      Paracoccidioidomycosis can present as a limited form, involving the cervix only.
      Identification and recognition of the infection are important in cytopathology.

PMID- 11213510
TI  - Intraabdominal desmoplastic small cell tumor mimicking adenocarcinoma. A case
      report.
AB  - BACKGROUND: Fine needle aspirates and washings from intraabdominal desmoplastic
      small cell tumors (IADSCTs) are rarely encountered by pathologists.
      Immunocytochemical examination of histologic material is usually necessary for a
      definitive diagnosis. CASE: A 23-year-old man presented with abdominal pain,
      ascites and bilateral pleural effusion. Examination of ascitic fluid suggested
      adenocarcinoma, but histologic and immunocytochemical examination of surgically
      resected tissue showed features of an IADSCT. CONCLUSION: This case is a reminder
      that IADSCT should be included in the differential diagnosis of intraabdominal
      neoplasms and that its diagnosis in cytologic preparations requires a high index
      of suspicion. In particular, this case appears to be the first reported example
      of IADSCT mimicking adenocarcinoma.

PMID- 11213511
TI  - Fine needle aspiration cytology of soft tissue chondroma. A case report.
AB  - BACKGROUND: Soft tissue chondroma, though rare, is well known to
      histopathologists and radiologists. Cytologic features of soft tissue chondroma
      mimic those of its malignant counterpart to a considerable extent. To our
      knowledge, this is the first case in which the aspiration cytology of soft tissue
      chondroma is described as an aid to definitive diagnosis. CASE: A 54-year-old
      male presented with a 6 x 5-cm swelling on his right forearm that had existed for
      20 years. Its extraskeletal location was confirmed. Aspiration cytology showed
      myxofibrillary material and pleomorphic cells. CONCLUSION: The clinical,
      radiologic and cytologic triad is important for the correct cytologic diagnosis
      of soft tissue chondroma despite worrisome cell atypia.

PMID- 11213512
TI  - Peritoneal effusion in a dog secondary to visceral mast cell tumor. A case
      report.
AB  - BACKGROUND: Mast cell tumor, one of the most common skin tumors in dogs, may also
      be found in visceral sites (mainly spleen and liver). When a visceral mast cell
      tumor is present, neoplastic mast cells may be found in any effusion secondary to
      the tumor. Therefore, the diagnosis may be made by cytologic analysis of the
      effusion. CASE: An 8-year-old, spayed, female Siberian husky presented with a
      peritoneal effusion secondary to a visceral mast cell tumor. Seven months
      earlier, the dog had presented with a cutaneous nodule diagnosed as a well
      differentiated mast cell tumor. The peritoneal fluid was classified as a
      transudate. Numerous neoplastic mast cells were found in the effusion. Although
      the mast cell tumor presented with characteristics of the well-differentiated
      tumor, its biologic behavior was that of a malignant tumor. CONCLUSION: Care
      should be taken to evaluate the prognosis of mast cell tumors in dogs since their
      biologic behavior is extremely variable.

PMID- 11213513
TI  - Fine needle aspiration of gastrointestinal stromal tumors.
AB  - OBJECTIVE: Gastrointestinal stromal tumors (GISTs) are uncommon mesenchymal
      tumors of the gastrointestinal tract. Fine needle aspiration (FNA) is one option
      for diagnosing GISTs before surgery. This study was designed to evaluate the
      clinical utility of FNA in the diagnosis of GISTs. STUDY DESIGN: FNAs from 19
      GISTs originating in the stomach, small bowel and colon obtained from 1988 to
      1998 were studied. Immunocytochemistry was performed on 12 cases. The GISTs were
      classified as benign, borderline and malignant, according to location, size,
      mitotic activity and clinical outcome. RESULTS: Benign (three) and borderline
      (five) GISTs were all spindle cell type; malignant GISTs included five spindle
      cell type and six epithelioid type. Most smears contained abundant cellular
      material. Benign and borderline GISTs of spindle cell type tended to have cells
      arranged in tightly cohesive clusters, while malignant GISTs were more likely to
      exhibit loosely cohesive groups with many single cells, occasional nuclear
      pleomorphism, hyperchromasia and irregular nuclear contours. Epithelioid-type
      GISTs mimicked adenocarcinoma. Mitoses were seldom observed in either type. CD117
      (KIT protein product) was demonstrated by immunocytochemistry in 9 cases, CD34 in
      11, desmin in 3, S-100 protein in 2 and smooth muscle actin in 6 cases.
      CONCLUSION: FNA can be used to diagnose GISTs as spindle cell and epithelioid
      types, but cytomorphology alone cannot be used to assess malignant potential.
      Immunocytochemical staining for CD117 is helpful in confirming the diagnosis.
      Care must be taken to differentiate epithelioid-type GISTs from adenocarcinoma.

PMID- 11213514
TI  - Spindle cell lipoma of the oral cavity. Report of a rare intramuscular case with
      fine needle aspiration findings.
AB  - BACKGROUND: Spindle cell lipoma (SCL) is a benign neoplasm characterized by a
      mixture of mature fat, bland spindle cells and wiry collagen in a variably myxoid
      background. Oral SCLs are rare, and only four cases of intramuscular SCL exist in
      the literature. We report the first case of intramuscular SCL of the oral cavity
      with fine needle aspiration (FNA) findings. CASE: A 61-year-old woman presented
      with a 3-cm mass in the right gingivobuccal sulcus. Papanicolaoustained FNA
      smears were hypocellular and contained loose collections of spindle cells in a
      myxoid background, numerous mast cells, rare capillary fragments and portions of
      skeletal muscle. The spindle cells had mild nuclear enlargement, focal nuclear
      irregularities, rare intranuclear inclusions and occasional small nucleoli. No
      lipoblasts or mitoses were identified. There was intermingling of the spindle
      cells with the skeletal muscle fragments. CONCLUSION: Intraoral SCL is a rare
      lesion but should be considered in the differential for a benign spindle cell
      neoplasm in the oral cavity. Clues to diagnosis on cytology include mature fat,
      bland spindle cells, a myxoid background and mast cells.

PMID- 11213516
TI  - Adolescent medicine: a resident's perspective.

PMID- 11213515
TI  - Understanding the adolescent with developmental disabilities.

PMID- 11213517
TI  - The pediatrician's adolescent children.

PMID- 11213518
TI  - The resilient adolescent: implications for the pediatrician.

PMID- 11213519
TI  - Treating the adolescent who might be "out of control".

PMID- 11213520
TI  - How many more Columbines? What can pediatricians do about school and media
      violence?

PMID- 11213521
TI  - Why today's adolescents behave differently from those of earlier generations.

PMID- 11213522
TI  - Cervicogenic headache (CEH): notes on some burning issues.

PMID- 11213523
TI  - R3 nociceptive reflex in multiple sclerosis patients with paroxysmal symptoms
      treated with gabapentin.
AB  - Gabapentin (GBP) is a new, well-tolerated antiepileptic drug found to be
      effective for painful paroxysmal symptoms (PS) in multiple sclerosis (MS). The
      aim of this study was to obtain a neurophysiological evaluation of the effects of
      GBP on the nociceptive system of MS patients suffering PS. We studied 10 MS
      patients, 6 males, 4 females (mean age 47.3 years), suffering PS (3 had
      trigeminal neuralgia, 1 painful tonic spasms and 6 dysesthetic or paresthetic
      symptoms). Three patients were, at the same time, also being treated with
      carbamazepine. Pain was evaluated by means of the Visual Faces Scale. R3
      nociceptive reflex was recorded after 2 weeks' treatment. R3 thresholds and
      latencies were evaluated and a statistical analysis was performed. A significant
      variation was found in R3 thresholds between the values recorded before and
      during GBP treatment; no significant variation was observed in R3 latencies.

PMID- 11213524
TI  - Abnormal H-Tfam in a patient harboring a single mtDNA deletion.
AB  - We report on a patient suffering from a progressive mitochondrial disorder
      characterized by ocular myopathy, exercise intolerance, and muscle wasting.
      Morphological examination of muscle biopsy showed increased variability in fiber
      size and scattered ragged-red fibers. Analysis of muscle mitochondrial DNA by
      Southern blot and PCR revealed a heteroplasmic single deletion of 4100 base
      pairs, located between nucleotide positions 8300 and 12,400. Western blot
      analysis showed high levels of the human mitochondrial transcription factor A
      (Tfam). Interestingly, we also detected an additional Tfam product, of
      approximately 22 kDa. This is the first case in which a qualitatively abnormal
      Tfam has been found to be associated with a mitochondrial disorder in humans.

PMID- 11213525
TI  - Case-control study on the epidemiology of cluster headache. II: Anthropometric
      data and personality profile.
AB  - Several papers have been published on the possible risk factors and conditions
      associated with CH which may provide clues to its underlying etiopathogenesis,
      including a typical physical appearance and peculiar psychological
      characteristics. The aim of the present study was to evaluate the presence of
      peculiar somatic and psychological features in CH patients by means of a case
      control study. One hundred and twenty CH patients and as many gender- and age
      matched controls completed the Minnesota Multiphasic Personality Inventory and
      underwent 20 cranial and body measurements. The photographs of 71 male subjects
      (38 cases and 33 controls) were examined by two experienced neurologists who had
      to decide which subjects were affected by CH. Both cases and controls showed
      normal personality profiles, without any significant difference emerging between
      them. None of the head, facial or body measurements differed between cases and
      controls, except for midface height. The sensitivity and specificity of the
      patients' pictures for the diagnosis of CH were found by examiner 1 to be 0.71
      and 0.67 respectively, and by examiner 2 to be 0.63 and 0.58 respectively. CH
      patients do not seem to have a peculiar personality profile. While their
      physiques do not seem to differ substantially from those of the general
      population, certain skull and/or skin characteristics could lend some patients a
      typical face appearance.

PMID- 11213526
TI  - Mechanism of cell death in experimental models of Parkinson's disease.

PMID- 11213528
TI  - Possible cellular mechanism accounting for the cell type-specific vulnerability
      in Huntington's disease.

PMID- 11213527
TI  - Animal models of Huntington's disease: from basic research on neuronal death to
      assessment of new therapeutic strategies.

PMID- 11213529
TI  - Animal models of dystonia.

PMID- 11213530
TI  - Mapping neuronal activity of the basal ganglia in experimental models of
      Parkinson's disease: contributions of the [14C]2-deoxyglucose method.

PMID- 11213531
TI  - Risk factors for the development of diabetes.

PMID- 11213532
TI  - Factors related to the development of diabetes during a 20-year follow-up. A
      prospective study in a homogeneous group of middle-aged men.
AB  - BACKGROUND AND AIMS: To investigate factors associated with the development of
      type 2 diabetes mellitus (DM) during a 20-year follow-up in a homogeneous group
      of initially healthy middle-aged men with similar socioeconomic status. METHODS
      AND RESULTS: We studied 1802 executives and businessmen, born 1919-34, without
      type 2 DM at baseline and with coronary heart disease (CHD) risk factor
      measurements in 1974-75. Diagnosis of type 2 DM during the follow-up was based on
      entitlement to re-imbursement for type 2 DM medication during 1975-1995,
      retrieved from national registers, self-report of type 2 DM or fasting blood
      glucose (> or = 6.7 mmol/L) in 1985-1986 (72% of the initial cohort re
      evaluated). During the follow-up (up to 1995) type 2 DM was diagnosed using the
      above criteria in 94 men (5.2%). At baseline, men who later developed type 2 DM
      smoked more (p = 0.01), and had significantly higher body mass index (BMI),
      systolic and diastolic blood pressure, pulse pressure, serum triglycerides, and
      fasting and one-hour blood glucose. In a subset of high-risk men, those who
      developed type 2 DM also showed signs of white-coat effect on blood pressure (p =
      0.008). Already at baseline, the CHD risk score was 23% higher in future type 2
      DM subjects (p = 0.008). Re-evaluation in 1985-1986 showed essentially similar
      results for risk factors, but in addition, LDL cholesterol without lipid lowering
      drugs was significantly lower (p = 0.0018) in type 2 DM subjects. During the
      follow-up, 23.4% of the men with type 2 DM developed CHD as compared to 13.4% of
      those without (p = 0.008). CONCLUSIONS: During a 20-year follow-up, several
      cardiovascular risk factors, including smoking, pulse pressure and the white-coat
      effect, predicted the development of type 2 DM in initially healthy middle-aged
      men. However, despite the higher incidence of CHD, development of type 2 DM was
      associated with lowered LDL cholesterol.

PMID- 11213533
TI  - L-carnitine reduces plasma lipoprotein(a) levels in patients with hyper Lp(a).
AB  - BACKGROUND AND AIMS: Elevated Lp(a) levels are a significant cardiovascular risk
      factor, particularly for young individuals and for subjects with concomitant high
      LDL cholesterol. Increased Lp(a) is believed to be linked to an enhanced
      production of the lipoprotein, controlled by genetic factors; it can be reduced
      by agents such as nicotinic acid, lowering free fatty acid inflow to the liver.
      METHODS AND RESULTS: L-carnitine, a natural compound stimulating fatty acid
      oxidation at the mitochondrial level, was tested in a double blind study in 36
      subjects with Lp(a) levels ranging between 40-80 mg/dL, in most with concomitant
      LDL cholesterol and triglyceride elevations. L-carnitine (2 g/day) significantly
      reduced Lp(a) levels (-7.7% vs baseline and -11.7% vs placebo treatment), the
      reduction being more dramatic in the subjects with the more marked elevations. In
      particular, in the L-carnitine group, 14 out of 18 subjects (77.8%) had a
      significant reduction of Lp(a) vs only 7 out of 18 (38.9%) in the placebo group
      (chi 2 = 4.11, p = 0.0452). In a significant number of subjects the reduction of
      Lp(a) resulted in a return of this major cardiovascular risk parameter to the
      normal range. CONCLUSIONS: L-carnitine offers a potentially useful therapeutic
      agent for atherogenic conditions characterized by high Lp(a) levels, also in view
      of the excellent tolerability and essential lack of major side effects.

PMID- 11213534
TI  - Lipid-altering efficacy and safety of simvastatin 80 mg/day: worldwide long-term
      experience in patients with hypercholesterolemia.
AB  - BACKGROUND AND AIM: Clinical data suggesting that larger decreases in low density
      lipoprotein cholesterol (LDL-C) result in greater reductions in coronary heart
      disease events have led to the establishment of aggressive LDL-C targets for the
      treatment of hypercholesterolemia. In view of this, the efficacy and safety of a
      new maximum dose of simvastatin, 80 mg, were evaluated in 9 studies involving
      2819 hypercholesterolemic patients. This report focuses on the combined results
      from the 4 main or Pivotal studies in which a total of 1936 patients received
      simvastatin 40 or 80 mg for 36 to 48 weeks. METHODS AND RESULTS: The Pivotal
      studies had similar randomized, multicenter, controlled, double-blind, parallel
      group designs. Their combined results demonstrated a significant advantage in the
      LDL-C-lowering effect for the 80 mg dose. At week 24, the mean percentage
      reductions (95% confidence intervals) from baseline in LDL-C for the 40 and 80 mg
      groups were -39.8% (-40.9, -38.7) and -45.7% (-46.5, -45.0) respectively (p <
      0.001, between groups), and larger reductions in total cholesterol and
      triglycerides were also observed in the 80 mg group. Both doses were well
      tolerated. No new or unexpected adverse events were observed and the overall
      clinical event profiles were similar in the two groups. Clinically significant
      hepatic transaminase increases (> 3 times the upper limit of normal/ULN) and
      myopathy (muscle symptoms plus creatine kinase increase > 10 times ULN) occurred
      infrequently with both doses. Simvastatin 80 mg had a comparable efficacy and
      safety profile in women and men as well as in non-elderly and elderly patients.
      CONCLUSIONS: Simvastatin 80 mg provides additional LDL-C and triglyceride
      reductions compared to the 40 mg dose and has an excellent safety and
      tolerability profile.

PMID- 11213535
TI  - Helicobacter pylori infection in type 2 diabetic patients.
AB  - BACKGROUND AND AIM: A high prevalence of Helicobacter pylori (Hp) infection in
      diabetic patients has been described in recent years. This study investigates its
      prevalence in type 2 diabetics and its correlation with the degree of metabolic
      control and the presence of chronic complications. METHODS AND RESULTS: Forty-one
      consecutive type 2 diabetics (21 males, 20 females aged 46-78, mean 62) and 31
      age-matched controls participated. Hp infection was assessed by means of the 13C
      urea breath test. Fasting glucose and glycated haemoglobin (HbA1c) levels were
      measured to evaluate metabolic control. Chronic complications were assessed by
      means of albumin excretion rate (AER), fundoscopy, vibratory perception threshold
      (VPT), ECG, clinical history of coronary, cerebral or peripheral arteriopathy,
      foot examination and cardiovascular autonomic function tests. A higher prevalence
      of Hp infection was found in diabetic than in control women (80% vs 37.5%; p <
      0.05), whereas there was no difference between males. A higher prevalence
      correlated with macroangiopathy and neuropathy and higher BMI, blood pressure,
      fasting glucose and HbA1c values. By contrast, microangiopathy was significantly
      more prevalent (p < 0.05) in Hp negative (85%) than in Hp positive patients
      (48%). CONCLUSIONS: There is a high prevalence of Hp infection in type 2 diabetic
      women. The absence of microangiopathy may be a predisposing factor: microvascular
      changes in the gastric mucosa may create an unfavourable environment for the
      establishment or survival of Hp.

PMID- 11213536
TI  - Prevention of coronary heart disease in post-menopausal women.

PMID- 11213538
TI  - Obesity hypertension, salt sensitivity and insulin resistance.
AB  - AIM: To review human and animal data describing the complex interrelation between
      obesity hypertension, salt-sensitivity and insulin resistance. DATA SYNTHESIS:
      The first part of the article reviews the information available in the literature
      defining obesity hypertension as a salt sensitive form of hypertension and that
      links obesity hypertension to the presence of insulin. The second part reviews
      the four factors frequently cited as possible causes for this sodium retention:
      insulin resistance, alteration in the renin-angiotensin system, altered vascular
      responsiveness and alterations in the sympathetic nervous system. Special
      emphasis is given in an attempt to explain how each of these four factors can
      change pressure-natriuresis. CONCLUSIONS: There is clearly a strong relationship
      between obesity hypertension, sodium sensitivity and insulin resistance. The
      exact mechanism responsible for linking these three conditions is still unknown.
      However, there is ample evidence to suggest that insulin resistance, altered
      vascular responsiveness, altered function of the renin-angiotensin aldosterone
      system and altered function of the sympathetic nervous system are important in
      these three conditions. Further investigation is warranted to completely
      elucidate the complex relationship between insulin resistance, obesity
      hypertension and sodium sensitivity.

PMID- 11213537
TI  - Insulin resistance in essential hypertension: a psychophysiological approach to
      the "chicken and egg" question.
AB  - AIMS: High levels of plasma insulin have frequently been found in patients with
      high blood pressure. The causal role of insulin resistance in essential
      hypertension, however, is still debated. Epidemiological and clinical studies
      have not provided complete responses to the original pathophysiological
      speculations, while the suggestion that enhanced sympathetic tone may induce both
      insulin resistance and hypertension is gaining ground. DATA SYNTHESIS: Many
      studies indicate that the high sympathetic drive in hypertensive patients
      originates within the brain, while other studies show that insulin resistance is
      associated with reduced vasodilatory capacity and increased vasoconstrictive
      functional responses ascribed to endothelial impairment. The sympathetic
      overdrive and enhanced cardiovascular reactivity, detectable since the earliest
      stages of hypertension lead to endothelial damage and, hence, impair the
      vasodilatory response, peripheral blood flow and flow-dependent metabolism. Thus,
      the link between hyperinsulinemia and high blood pressure might lie in the
      vascular abnormalities secondary to elevated sympathetic tone and exaggerated
      hemodynamic stress response. CONCLUSIONS: Examination of the literature and the
      results of recent pilot studies of the stress systemic and regional hemodynamic
      reactivity in the present paper suggests that behavioral characteristics and
      cardiovascular stress responses play a pivotal role in determining the
      hyperinsulinemic state in hypertensive patients. High sympathetic tone, with
      consequent vascular impairment and altered functional responses, may be the
      primary event causing hyperinsulinemia and start very early in patients with high
      blood pressure. In turn, hyperinsulinemia further contributes to vascular damage
      and aggravates the metabolic and hypertensive disease.

PMID- 11213539
TI  - [Behavior of the pulp after dental trauma: diagnosis, sequelae, therapy].

PMID- 11213540
TI  - [Early and late intraoral sequelae after radiotherapy].

PMID- 11213541
TI  - [Severe sepsis, inflammation and coagulation: a close connection  between
      physiological anticoagulants and improved prognosis]  .

PMID- 11213542
TI  - [Antithrombin III concentrates in the treatmetn of sepsis and  septic shock:
      indictions, limits and future prospects]  .
AB  - Sepsis and septic shock are the most frequent cause of mortality in non
      cardiologic intensive care units. Mortality of the severe form is still elevated
      in spite of the progress in the antibiotic therapy and in the hemodynamic and
      respiratory support. The most frequent cause of death is the Multi Organ
      Dysfunction Syndrome (MODS). The excessive inflammatory reaction and the damage
      of the microvascular bed secondary to the inflammation and to the disseminated
      intravascular coagulation (DIC) are important pathogenetic factors. In the sepsis
      a complex system of cellular activation initiates the release and the interaction
      of activators and inhibitors of the inflammation (cytokines), the activation of
      the enzymatic cascade systems (coagulation, fibrinolytic and complement systems)
      and the synthesis of proteases and anti proteases. The activation of the
      coagulation system, uncontrolled by the fibrinolytic system with formation of
      fibrin in the micro vascular bed, has an important role in the MODS. Experimental
      data and clinical observations suggest a possible therapeutic role of
      antithrombin III (AT) in sepsis; its plasma concentration is constantly decreased
      in patients with sepsis or septic shock and the entity of the decrease is
      correlated with the severity of the clinical picture and the outcome. At has a
      double function: regulation of the coagulation system and anti inflammatory
      properties. The anti inflammatory properties depend in part on the binding to the
      glycosaminoglycans of the endothelial cells and the consequent release of
      prostacyclin (PGI2). The anti inflammatory effect is independent from the
      anticoagulant one. The preliminary studies on the clinical use of AT were carried
      out in small groups of patients with DIC associated with pathologies of different
      etiology and often in very critical conditions. In general the evaluation
      criteria were the improvement or the normalization of the laboratory data. The
      interpretation of the therapeutic effect of AT is difficult because the
      dysomogeneity of these studies. The effect on mortality is controversial.
      Recently three prospective, randomized, double blind studies have been published
      in patients with severe sepsis and septic shock. The results of the single
      studies are inconclusive but the limited number of patients included in each
      study may explain the results. A meta-analysis of the data referring to the
      patients with severe sepsis and septic shock evidenced an odd ratio (OR) of 0.43
      with 95% confidential interval of 0.20-0.92 (p = 0.029). The preliminary analysis
      of the results of a phase III study is unconclusive. Time, dosage and duration of
      treatment are still open to question. In perspective AT may be used in other
      clinical conditions associated with activation of the hemostatic system (cardiac
      surgery, stem cell transplantation, burns) even though the preliminary results
      must be confirmed by prospective studies. All these data suggest severe sepsis
      and septic shock as main criteria for treatment.

PMID- 11213543
TI  - Measuring neuropathic pain.

PMID- 11213544
TI  - What about primary and secondary ARDS.

PMID- 11213545
TI  - [Sufentanyl in balanced anesthesia for neurosurgery. Comparative  study with
      fentanyl]  .
AB  - BACKGROUND: The aim of this study was to evaluate the effects of sufentanil in
      comparison with those of fentanyl during balanced anesthesia in patients
      undergoing neurosurgery. METHODS:  EXPERIMENTAL DESIGN: prospective randomized
      study. SETTING: operating room in a neurosurgery University department. PATIENTS:
      50 patients, ASA I and II with age ranging from 18 to 77 years were divided in
      two groups randomly. INTERVENTIONS: 25 patients received sufentanil as single
      bolus dose of 0.2 microgram/kg i.v. as premedication and supplemental bolus doses
      of 0.15 microgram/kg during the maintenance of anesthesia while the remainders
      received fentanyl 2.0 micrograms/kg as premedication and supplemental boluses of
      1.5 micrograms/kg. All patients were induced with propofol 2.5 mg/kg, were
      intubated after cisatracurium 0.15 mg/kg for muscle relaxation, then were
      ventilated with sevoflurane and O2:N2O (1:1). MEASUREMENTS: heart rate, SAP, DAP
      and MAP were recorded at different times and ECG, ETCO2 and pulsoximetry were
      monitored continuously. Furthermore postoperative analgesia by VAS, recovery time
      and inspiratory concentrations of the volatile anesthetic were evaluated.
      Statistical analysis was carried out using ANOVA for repeated measures and
      Bonferroni "t"-test; a value of p < 0.05 was considered to be significant.
      RESULTS: Significant changes in MAP (at IOT and 1 and 2 min after IOT), in HR (at
      IOT) and in RPP (at IOT and 1, 2 and 3 min after IOT) were recorded in group F.
      Recovery time was shorter in group S than in group F and postoperative analgesia
      was more prolonged in group S. Inspiratory concentrations of volatile agent were
      lower in patients treated with sufentanil than in those treated with fentanyl.
      CONCLUSIONS: In patients treated with sufentanil a better cardiocirculatory
      stability was achieved with lower inspiratory concentrations of volatile agent
      and a well relaxed brain. Sufentanil can be considered a valid alternative to
      fentanyl as analgesic agent in balanced anesthesia for neurosurgery.

PMID- 11213547
TI  - [Anesthesiologic considerations in Cornelia de Lange syndrome].
AB  - BACKGROUND: Retrospective study in pediatric patients with Cornelia de Lange
      syndrome undergoing different surgical operations, in order to critically
      evaluate the anesthesiologic aspects of this syndrome. METHODS: Between January
      1997 and December 1998, 42 patients undergoing diagnostic examinations
      (esophagogastroscopy, oculistic visit) or surgery (total exodontia, fundoplicatio
      for esophageal reflux, correction of labiopalatoschisis) have been studied. The
      anaesthesiologic technique has been similar for all the cases. RESULTS: Any
      particular difficulty or inconvenience in comparison with patients with the same
      range of age, or particular intraoperative difficulties have been observed. In
      only one patient the McCoy laryngoscope was used due to difficult intubation
      (Cormack and Lehane III). CONCLUSIONS: Short neck, ogive palatum, cleft palate,
      micrognatia, urogenital and gastroenteric anomalies, esophageal reflux, together
      with heart defects (15% of cases), can complicate the peri and postoperative
      period in these patients. A careful preoperative evaluation and a careful
      perioperative management, may decrease anesthetic complications in Cornelia de
      Lange syndrome to the same range of normal patients.

PMID- 11213546
TI  - [The effects of remifentanil on hemodynamic response to  intubation. A
      comparative study with fentanyl]  .
AB  - BACKGROUND: The aim of this study was to evaluate the effects of remifentanil in
      comparison with those of fentanyl on the hemodynamic response to orotracheal
      intubation. METHODS:  EXPERIMENTAL DESIGN: prospective comparative and randomized
      study. SETTING: operating room in a neurosurgery department at University.
      PATIENTS: 50 patients, ASA I or II with age ranging from 32 to 64 years were
      divided in two groups randomly. INTERVENTIONS: 25 patients received fentanyl as
      single bolus dose of 2.0 micrograms/kg and atropine 0.01 mg/kg i.v. as
      premedication while the remainders received atropine 0.01 mg/kg i.v. and
      remifentanil 0.2 microgram/kg/min as infusion. All patients were induced with
      propofol 2.0 mg/kg and cisatracurium 0.15 mg/kg for muscle relaxation and were
      intubated 4 min after induction of anesthesia. MEASUREMENTS: Heart rate, SAP,
      DAP, MAP and RPP were recorded at different times: baseline, induction,
      intubation, 1, 2, 3 and 4 min after intubation; ECG and pulsoximetry were
      monitored continuously. Statistical analysis was carried out using ANOVA for
      repeated measures and Bonferroni t-test a value of p < 0.05 was considered to be
      significant. RESULTS: Significant increases in PAS were recorded, at intubation
      and at 1 min after in patients treated with fentanyl; in the remifentanil group
      significant decreases in SAP at induction and at 4 min after intubation were
      recorded. HR increased significantly at intubation and at 1, 2 and 3 min after in
      the fentanyl group. RPP showed a significant decrease at induction in the
      remifentanil group and significant increases at intubation and at 1, 2 and 3 min
      after in patients treated with fentanyl. CONCLUSION: In conclusion remifentanil
      was found to properly control the hemodynamic response to intubation in
      comparison with fentanyl.

PMID- 11213548
TI  - [Anesthesia with sevoflurane and orotracheal intubation for  pediatric ophthalmic
      surgery of medium length in day hospital]  .
AB  - BACKGROUND: The aim of this study was to evaluate the discharge rate of children
      undergoing ophthalmic surgery of medium length (69-120') in a day-hospital regime
      under general anesthesia with orotracheal intubation and using Sevoflurane as the
      only anesthetic agent. METHODS:  EXPERIMENTAL PROTOCOL: prospective study.
      SETTING: the study was carried out in the operating theatre of the Ophthalmic
      Clinic at Florence University. PATIENTS: 58 pediatric patients aged 2-10 years,
      ASA I-II, 13-34 kg. OPERATIONS: correction of strabismus, cataract, glaucoma,
      palpebral ptosis and intubation of lacrimal tracts. Parameters measure: Any signs
      of reactivity in the airways to Sevoflurane on induction or reawakening (cough,
      bronchospasm, laryngospasm and psychomotor agitation), hemodynamic variables
      (heart rate and NIBP); reawakening time (from turning off the vaporiser to
      extubation), discharge time from recovery room (SatO2 > or = 97% in ambient
      atmosphere), discharge time from hospital (stable vital signs, response to simple
      and complex commands). RESULTS: The mean reawakening time was 7 min, discharge
      time from the recovery room was 20 min, discharge time from the hospital 80%
      after four hours, 100% after six hours. No respiratory and/or cardiovascular
      complications were reported nor psychomotor agitation. CONCLUSIONS: General
      anesthesia with Sevoflurane and Atracurium was found to be a realistic and
      reliable technique in pediatric ophthalmic surgery of medium length performed in
      day hospital.

PMID- 11213550
TI  - Cost analysis of an Italian ICU.
AB  - BACKGROUND: Cost reduction is an important issue in medicine today, especially
      when considering ICUs, since they account for a large percentage of all hospital
      expenditure. Through a retrospective analysis of the data regarding the expenses
      incurred during the years 1996-97, we have been able to evaluate the total costs
      of our ICU and the influence that each component had on the final costs, thus
      gathering the necessary information for the improvement of the unit itself.
      METHODS: Retrospective analysis of a 5-bedded multidisciplinary ICU activity over
      a two-year period (1996-1997). Cost-related data have been supplied by the
      Hospital Administration as to wages, infrastructures, equipment buying and
      maintenance; by Hospital Pharmacy as to drugs and devices supplies; and by
      Laboratory and Radiology as to diagnostic investigations. RESULTS: According to
      our experience, physicians and non-medical staff account for more than 50% of the
      total expenditure--the latter slightly prevailing. Furthermore, we have assessed
      that the cost distribution is hardly comparable to that reported by other
      authors. CONCLUSIONS: It is useful to analyse the total distribution and to
      evaluate their nature only to gain the necessary data that will lead to a more
      effective management of the unit. Nevertheless, this methodology is valid within
      the cost analysis of our ICUs but the ICUs of other countries show great
      differences in the way they are structured and some of the use more reliable
      activity-based costing methodology.

PMID- 11213549
TI  - Italian experience with the cuffed oropharyngeal airway (COPA). A prospective,
      observational study.
AB  - BACKGROUND: The cuffed oropharyngeal airway (COPA) has been recently introduced
      into the market, but few is known about its clinical use in Italy. We therefore
      conducted a prospective, observational investigation to evaluate the use of this
      new extra-tracheal airway in clinical practice. METHODS: Anesthesiologists
      participating in the study received a simple questionnaire where data concerning
      anthropometric variables, surgical procedure, type and doses of drugs used to
      induce and maintain general anesthesia, type of ventilation during the procedure,
      and occurrence of untoward events during either COPA placement, general
      anesthesia maintenance, or postoperative period were prospectively recorded. The
      number of previously placed COPA, and the adequacy of airway control (subjective
      four point scale: excellent, good, fair, and poor) were also assessed. RESULTS: A
      total of 210 patients (139 female and 71 male) were prospectively studied.
      General anesthesia was induced with propofol in 204 patients (98%), sodium
      thiopental in 3 patients (1.5%), and midazolam in 1 patient (0.5%); while only
      one patient received muscle relaxants (0.5%); 126 patients (64%) were
      spontaneously breathing while 71 patients (36%) received positive pressure
      mechanical ventilation. No differences in the incidence of untoward events was
      reported between spontaneously breathing and mechanically ventilated patients. No
      differences in the incidence of untoward events were reported according to the
      number of previously placed COPA. Difficulties in COPA placement were reported in
      7 patients with normal dentiture (5%) and 9 patients (39%) with dental prosthesis
      (p = 0.003), (Odds Ratio: 5.1; Cl95%: 3.0-8.7). Furthermore, airway obstruction
      was more frequently reported in patients with dental prosthesis (8% vs 0%; p =
      0.002). The seal pressure was higher in mechanically ventilated (17 +/- 10 cm
      H2O) than spontaneously breathing patients (10 +/- 8 cm H2O), (p = 0.0005), while
      a sealing pressure higher than 12 cm H2O was associated with an increased risk
      for postoperative sore throat (Odds ratio: 4.3; Cl95%: 2.6-7.1; p = 0.002).
      Airway control was graded as excellent in 61.4% of cases by physician previously
      placing more than 50 COPA, compared with only 26.5% when less than 50 COPA had
      been previously placed (p = 0.0005). CONCLUSIONS: COPA provided as safe and
      effective airway management in mechanically ventilated patients as that observed
      during spontaneous breathing. Experience with COPA placement had no effects on
      the placement success rate or incidence of untoward events, but improved the
      quality of airway control.

PMID- 11213551
TI  - SCS in intractable angina.
AB  - Despite a wide range of therapeutic choice in the treatment of angina pectoris,
      there is a small but increasing population of patients that doesn't benefit of
      conventional therapy and whose life is invalidated by frequent attack of anginal
      pain. For this population, nonresponders to drug therapy not suitable for
      revascularization (coronary bypass surgery, angioplasty), neurostimulation of
      dorsal column has been described as an effective and safe therapy. The mechanism
      of action is not completely known, but is safety is sufficiently established. It
      may become a useful choice in the treatment of patients with intractable angina.

PMID- 11213552
TI  - [Bioethical interpretation of intensive care]  .
AB  - The bioethical interpretation concerns both those receiving intensive care (IC)
      and the nature of the treatment itself. The principle of autonomy expressed in
      the doctor-patient relationship is achieved through the use of informed consent
      and may also be used in the unique context of patients in IC. Organ-function
      replacement treatment raises the ethical question of the definition and
      management of the limit to treatment. The appropriateness of IC can be defined by
      clinical and ethical criteria and aims to avoid inappropriately excessive
      treatment. In order to improve the decision-making process involving bioethical
      questions, the authors outline a number of working approaches: the use of
      informed consent even in IC, the possible role of Advanced Directives in IC,
      epidemiological studies, operator training.

PMID- 11213553
TI  - Total intravenous anaesthesia without muscle relaxants in a child with diagnosed
      Duchenne muscular dystrophy.
AB  - The case of a 3 year old child, affected by Duchenne muscular dystrophy, who
      underwent adenoidectomy and bilateral myringotomy, is reported. Total intravenous
      anaesthesia (propofol 1% infusion (160 micrograms kg-1min-1) and remifentanil
      (0.55 microgram kg-1min-1) without any muscle relaxants was used. The
      postoperative period was uneventful.

PMID- 11213554
TI  - [Italian version of "The Neuropathic Pain Scale"]  .

PMID- 11213555
TI  - Histochemistry and cytochemistry of nuclear receptors.
AB  - Receptors of steroid hormones, thyroid hormones and several kinds of vitamins
      have been shown to act as nuclear transcription factors and to form a nuclear
      receptor (NR) family. Histochemical techniques including autoradiography using
      radio-labeled ligands, immunohistochemistry and in situ hybridization
      histochemistry, have displayed that target cells of these receptors are
      distributed not only in the classical target organs but also widely in a variety
      of tissues; these techniques can demonstrate the presence of receptor proteins
      and mRNAs, even though they are expressed in a small cell population of tissues.
      On the other hand, many studies have been performed to demonstrate the
      interaction between NRs and nuclear and cytoplasmic proteins, and to clarify the
      mechanism of transcriptional regulation through NRs in artificial conditions
      which are created in gene transfer experiments or under cell-free conditions.
      Some data coincide with those obtained from histochemical techniques, however,
      some histochemical data do not support the results of studies in vitro. This
      review focuses on the following topics: histochemical methodologies to detect
      NRs, the distribution and function of NRs in the tissues, the intracellular and
      intranuclear localization of NRs, roles of gonadal steroid receptors and their
      ligands on developing tissues including cell communications such as mesenchymal
      stromal interaction, and the interaction between other cellular components and
      NRs. In addition, the agreement and disagreement between the results of
      histochemical studies and those from the experiments in the model systems or in
      vitro are discussed.

PMID- 11213558
TI  - [Index 1857-2000 on cd-rom; Dutch Journal of Medicine may be ordered on its own
      web page].

PMID- 11213556
TI  - [Congenital infection: diagnostic serology of the mother not always definitive].
AB  - In 2 infants, a girl and a boy, congenital viral infection was diagnosed in the
      neonatal period. The prenatal examination (serologic investigation for Toxoplasma
      gondii, rubella virus, cytomegalovirus, herpes simplex virus and syphilis
      (TORCHES)) was negative. In both cases prenatal ultrasonography was abnormal and
      suggested intrauterine infection. The infants were born with typical symptoms of
      multisystem disease, known as symptomatic congenital cytomegalovirus infection
      (jaundice, petechiae, hepatosplenomegaly, intrauterine growth retardation,
      microcephaly and cerebral calcifications) and congenital rubella syndrome
      (intrauterine growth retardation, congenital heart disease, cataract,
      hepatosplenomegaly and cerebral calcifications), respectively. Both had severe
      cerebral damage. To diagnose severe congenital infection in the first trimester
      of pregnancy in presence of congenital anomalies in utero there are other
      possible methods than TORCHES investigation, such as polymerase chain reaction
      and virus culture in amniotic fluid or in foetal blood obtained by cord puncture.

PMID- 11213559
TI  - [Roaming through methodology. XXX. The capture-recapture method].
AB  - The capture-recapture method is useful for the estimation of the incidence and
      prevalence of a disease if there exist multiple lists that can be linked. Some
      assumptions have to be fulfilled for the estimate to be adequate. For example,
      for every list every individual should have the same probability to be on the
      list, and the lists should be independent. In case of two lists one has to assume
      that these are independent in order to get an estimate. When three or more lists
      are available this strong assumption may be mitigated.

PMID- 11213560
TI  - [Roaming through methodology. XXXI. Estimating partially hidden populations:
      heroin addicts in Amsterdan].
AB  - To estimate the size of a partly hidden population the capture-recapture method
      can be used. The estimation is based on analysis of the overlap between several
      samples of the population of interest. The quality of this capture-recapture
      estimation highly depends on whether the assumptions of the method are or are not
      met: samples should be independent, the population should be closed, the overlap
      should be recognised, and samples should contain only individuals originating
      from the population of interest. Violation of these assumptions may lead to a
      serious underestimation or (more often) overestimation. The number of problematic
      heroin addicted people in Amsterdam was estimated on the basis of registered
      numbers in the easily accessible methadone programme of the municipal health
      organisation, in the police station methadone treatment programme, and in the
      hospital registration in the first quarter of 1997: 4130 (95% confidence
      interval: 3750-4570).

PMID- 11213561
TI  - [Drug treatment of erection disorders in patients with cardiovascular disease].
AB  - Erectile dysfunction is a frequent condition in cardiovascular patients. Since
      the arrival of oral erection-supporting medication, patients want to know how
      safe sexual activity is in cardiovascular disease in general and during use of
      erection-supporting medication in particular. Sexual intercourse with a steady
      partner causes no more cardiovascular risk than normal daily activities such as
      ironing, 2 kilometers of walking without climbing, paperhanging, playing golf or
      gardening. The relative risk of myocardial infarction during sexual activity is
      not significantly higher than for healthy persons. The incidence of
      cardiovascular morbidity and mortality is not higher among users of sildenafil.
      Sildenafil is contraindicated in patients using long-acting nitrates or who may
      need to use short-acting nitrates, because the combination may cause a sharp fall
      of the blood pressure. No interactions have been observed with beta-receptor
      blockers, calcium antagonists, thiazide and loop diuretics and ACE inhibitors.
      Before prescribing a symptomatic (pharmaceutical) treatment for patients with an
      erection disorder, attention should be given tot the sexological, psychological
      and medical backgrounds of the disorder. Secondary prevention of atherosclerotic
      risk factors is also important: regulation of blood pressure and blood sugar
      level, hyperlipidaemia and obesity, as well as a change of lifestyle (giving up
      smoking, adapting of diet and more physical exertion). Patients with a very low
      cardiac capacity should be advised to refrain from treatment of the erection
      disorder.

PMID- 11213562
TI  - [Diagnostic image (22). Partial torsion of ovarian tumor].
AB  - In a 28-year-old woman recurrent abdominal pain was caused by a partially torded
      cystic teratoma of the ovary.

PMID- 11213563
TI  - [From gene to disease; from polycystines to polycystic kidney disease].
AB  - Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease that
      results in multiple cysts in the kidneys and other organs and leads to endstage
      renal failure relatively late in life. The disease results from mutations in one
      of two independently segregating genes that under normal conditions produce
      polycystines. Polycystines are membrane proteins that form a complex involved in
      signal transduction in epithelial cells. Genetic heterogeneity explains in part
      the various ADPKD phenotypes.

PMID- 11213564
TI  - [Considerable underreporting of malaria in the Netherlands; a capture-recapture
      analysis].
AB  - OBJECTIVE: To estimate the completeness of notification of malaria by physicians
      and laboratories in the Netherlands. METHOD: Capture-recapture analysis was
      applied to three incomplete, partially overlapping registers of malaria cases in
      1995 and 1996: a laboratory survey, the Notification Office and the hospital
      admission registration. RESULTS: The average response of the 107 laboratories
      approached was 83.6% over both years. In 1995 and 1996 581 and 535 malaria cases
      respectively were microscopically diagnosed. In each year physicians officially
      notified 311 patients. 350 and 330 patients respectively were admitted to
      hospital. Capture-recapture analysis estimated the total number of new malaria
      cases at 933 (95% confidence interval: 849-1072) in 1995 and at 774 cases (740
      821) in 1996. The estimated completeness of notification in 1995 and 1996 was
      therefore 33.3% and 40.2% for physicians and 62.3% and 69.1% for the
      laboratories. CONCLUSION: Laboratory-based notification, introduced in the
      Infectious Diseases Act, can considerably increase the number of officially
      reported malaria cases as compared with notification by physicians. However,
      approximately one-third of the estimated number of cases may still go unreported.

PMID- 11213565
TI  - [Diagnostic value of prenatal MRI in fetus with intracranial anomalies diagnosed
      by ultrasonography].
AB  - OBJECTIVE: To determine the value of prenatal MRI in the third trimester in the
      foetus with intracranial lesions established by ultrasonography. DESIGN:
      Descriptive. METHOD: During a period of one year, prenatal MRI was performed in
      12 patients after ultrasonography had revealed intracranial lesions in the
      foetus. Postnatally, ultrasonography, MRI or postmortem examination of the brain
      was performed in 11 children. The MRI examination was carried out in a 1.5 Tesla
      field. Rapid, T2-weighted images were obtained. To immobilize the child, the
      pregnant women were sedated. RESULTS: In 5 cases, prenatal ultrasonography and
      prenatal MRI resulted in the same diagnosis. In seven cases, MRI provided more
      information. Postnatal examination confirmed the prenatal diagnosis in 10 of the
      11 cases. In one case, maceration rendered supplementary examination impossible.
      CONCLUSION: MRI may be regarded as a valuable alternative diagnostic aid if
      prenatal ultrasonography is incomplete or the findings are uncertain or limited.

PMID- 11213566
TI  - [Fever and chills due to leptospirosis after travel to Thailand].
AB  - Two weeks after rafting on a river in Thailand a Dutch 54-year-old male
      experienced chills and high fever. While rafting he had wounded his hand. Because
      of the history (water contact, the wound, high fever with chills), of the
      findings at examination (fever, conjunctivitis) and of the laboratory findings
      (leukocytosis, albuminuria, disturbance of liver enzymes), a clinical diagnosis
      of 'leptospirosis' was made. This was confirmed by serological tests and
      culturing of Leptospirae from the blood. Leptospirosis is a zoonosis, in man
      associated with certain occupations, water sports and inundations. The clinical
      picture varies from a mild febrile disease (sometimes pyrexia of unknown origin)
      to a severe condition with kidney and liver failure, bleeding tendency, lung
      oedema (Weil's syndrome). In travellers with fever, water contact, leukocytosis
      and neutrophilia, leptospirosis must be considered and specific diagnostic tests
      applied.

PMID- 11213567
TI  - [Clinical thinking and decision-making in practice. A pregnant Turkish woman with
      a liver tumor].

PMID- 11213568
TI  - [Stereotaxic irradiation of vestibular schwannoma (acoustic neurinoma)].

PMID- 11213569
TI  - [Diagnostic imaging in vascular diagnosis].
AB  - Previously, vascular imaging was done exclusively using angiography (X-ray
      projectional imaging of vessels opacified by iodinated contrast media). Recently
      angiography especially is used in combination with angioplasty (percutaneous
      enlargement of a closed or stenotic vessel). There has been a change from
      invasive to non invasive procedures. New developments in computed tomography
      (CT), magnetic resonance imaging (MR) and ultrasound have reduced the indications
      for the invasive digital subtraction angiography (DSA). Further improvement
      especially im MR-angiography and colour-coded dopplersonography will cover all
      primary diagnostic vascular examinations.

PMID- 11213570
TI  - [Treatment of peripheral arterial occlusive disease].
AB  - The choice of therapy for peripheral artery occlusive disease depends on
      functional stage, site and extent of vascular lesion, pathogenesis, and the
      individual needs of the patients. In stage I (according to Fontaine) the risk
      factors are sought and treated. In stage II walking exercise is the main pillar
      besides vasoactive drugs and secondary drug prevention. Transluminal angioplasty
      is recommended if vascular lesions are suitable (short stenoses or occlusions in
      iliac a/o femoro-popliteal arteries). Surgery may be performed in aorto-iliac
      arteries but only exceptionally in femoro-popliteal disease. In stage III/IV or
      chronic critical ischemia every possibility for revascularisation must be
      considered. In acute stages immediate therapy is necessary. In our hands catheter
      techniques (thrombolysis a/o aspiration) are the first line approach on the
      femoro-popliteal level while occlusions on aorto-iliac level are left to surgery.

PMID- 11213572
TI  - [Comment on Hermann Feldmeier: West Nile virus ante portas].

PMID- 11213573
TI  - [Risk factors for arteriosclerosis].
AB  - The arteriosclerotic damage of the arterial endothelium is initiated by risk
      factors like dyslipidemia, hypertension, diabetes mellitus, and smoking, which
      account for the majority of vascular morbidity and mortality. Interventional
      studies confirmed the causative role of hyperlipidemia, particularly of the
      modified LDL-cholesterol. A large number of epidemiological and interventional
      studies identified hypertension as another risk factor and showed the correlation
      between lowering blood pressure and the reduction in micro- and macrovascular
      complications. Diabetes mellitus decreases the life expectancy on average by 10
      years, mainly due to cardiovascular disease. However, intensive control of blood
      glucose and blood pressure achieved a significant and clinically important
      reduction in death and complications related to diabetes. Smoking is a main risk
      factor for peripheral arterial disease and causes advanced arterial lesions in
      the younger people. Novel risk factors have been identified and contribute to the
      elucidation of the atherogenic process.

PMID- 11213571
TI  - [Surgical therapy of acute and chronic arterial occlusions below the inguinal
      ligament].
AB  - The history and physical examination are extremely important in the management of
      vascular surgical patients because a correct diagnosis can usually be made on the
      basis of information obtained from these two modalities. The severity of the
      chronic occlusive process leads to characteristic symptoms in the extremity:
      claudication, rest pain, skin ulcerations and gangrene. Chronic progressive
      lesions permit enlargement of collateral blood supply which, for a time,
      minimizes the severity of symptoms. Milde degrees of arterial insufficiency
      (claudication) can be treated conservatively. Unreconstructed chronic critical
      ischemia predicts a poor outcome in terms of survival and limb salvage. The
      outlook with arterial reconstructive surgery is by far better. Arteriography ist
      the most reliable diagnostic test for occlusive lesions. It ist essential for the
      operative planning. Vein-bypass procedures are, if feasible, very effective in
      most cases. Acute embolic occlusion: Sudden occlusion of a previously patent
      artery is usually a dramatic event producing severe ischemia of the distal
      tissue. The characteristic symptoms and signs are the 5 P's: pallor, pain,
      paresthesia, paralysis, pulselessness. Emergent restoration of blood flow by
      operation may be essential to prevent limb loss. Milder forms of ischemia (acute
      thrombosis--acute or chronic disease) can be treated initially with intravenous
      heparin if the extremity is not threatened (minimal sensory loss, no muscle
      weakness). Elective surgery at a later date is highly successful.

PMID- 11213574
TI  - [Diagnosis of arterial occlusive disease: what does angiology have to offer?].
AB  - Peripheral arterial disease is common in the elderly patient. The clinical
      symptoms are varied from claudication to the acute ischemic syndrome. The
      diagnosis can be suspected from history and clinical examination. Additional
      investigations like leg pressure measurements, oscillography and duplex
      sonography confirm the diagnosis. These investigations further quantify the
      extent and the localisation of the occlusive disease and are needed to choose the
      treatment. Treatment modalities are conservative, interventional by catheters and
      surgical. Further angiographic examinations are rarely needed. The
      interdisciplinary approach together with surgeons and radiologists is most
      important.

PMID- 11213575
TI  - [Some comments about hemochromatosis].

PMID- 11213576
TI  - [Prevalence of hereditary hemochromatosis among healthy workers. Diagnostic value
      of transferrin saturation assay].
AB  - AIM: Hereditary hemochromatosis is the most common inherited disorder in white
      population (2-8 cases per 1000 habitants). Hemochromatosis is characterized by
      increased intestinal absorption of iron leading to its deposition into multiple
      organs. An early diagnosis and proper management with frequent phlebotomies are
      known to improve life expectancy and quality of life. Diagnosis is suggested by
      an elevated Transferrin saturation (TS) (more than 60%). METHOD: Prospective
      study of the level of TS among 1131 healthy workers, who came to the Security and
      Hygiene Official Centre for their annual revision had been undertaken. RESULTS:
      Twenty-wo workers had high TS; in 10 of them the increase of TS was confirmed on
      repeated determinations. Liver biopsy was performed in six (and refused by the
      other four), eventually a diagnosis of hemochromatosis was confirmed in three (in
      group prevalence of 2.6 per 1000 people). CONCLUSIONS: In our experience, TS is
      the most appropriate initial screening test for detecting hereditary
      hemochromatosis in a normal population.

PMID- 11213577
TI  - [Correlation between mantoux and tuberculin's fraction from delayed
      hypersensitivity skin test, in a cohort from HIV-1 positive patients, in function
      of immunodeficiency level, and active tuberculosis incidence].
AB  - OBJECTIVES: The aim of this work was to assess cellular immunity using the
      multitest CMI and relate its results with lymphocyte CD4 counts, and the risk to
      developed active tuberculosis if the multi-test's tuberculosis papula was
      positive. METHODS: Prospective longitudinal follow-up of 342 IDU patients, 210
      infected with HIV-1 and seronegative 132 patients. The cohort study was 165 IDU
      HIV-1 positive patients (128 men, 37 female). Ages was 18 to 45 years. Study time
      were 25 months (8-25). Tuberculin skin tests and multitest IMC were performed at
      baseline and each three months, and screening from active tuberculosis were
      performed all study when necessary was considered. RESULTS: Actived tuberculosis
      developed in 9.25 cases per one hundred persons and year from follow-up in the
      ranges with better immunologic status (Score from PHR > 10 mm). There are an
      significative correlation between tuberculosis skin test diameter and PHR
      tuberculin fraction papula. CONCLUSIONS: PHR performed with Multitest IMC is an
      useful test to evaluate cellular immune system, and HIV-1 positive patients with
      energy in this test or positive tuberculine fraction must be considered to
      isoniazid (9 months) prophylaxis.

PMID- 11213578
TI  - [Extrapulmonary tuberculosis in our area. Forms of presentation].
AB  - OBJECTIVE: To analyse the distribution of the extrapulmonary forms of
      presentation of tuberculosis (EFP) in our health district. MATERIALS AND METHODS:
      The medical records of patients diagnosed with extrapulmonary tuberculosis
      attending the Tuberculosis Prevention and Control Unit of the Santiago Health
      District were reviewed over a three years period. The classification of EFP was:
      extrapulmonary forms (EF), disease outside the lung; mixed forms (MF), the
      presence of both pulmonary and extrapulmonary tuberculosis; disseminated forms
      (DF), the presence of two or more extrapulmonary locations; and miliary TB, which
      was defined by a diffuse pulmonary radiographic pattern or diagnosis was
      undertaken by necropsy. RESULTS: A total of 921 tuberculosis infected patients
      were observed, of which 370 (40.2%) were extrapulmonary forms; of these, 199 were
      men and 171 women (mean age was 36.9 years, range 19-68). The distribution of EFP
      was: 307 EF (83%) of which 140 (45.6%) were pleural, 87 (28.3%) ganglionary, 16
      (5.2%) intestinal, 14 (4.5%) bone and joint, 11 (3.6%) genitourinary, 11 (3.6%)
      cutaneous, 10 (3.3%) meningeal, and other locations 18 (5.9); MF 38 cases
      (10.3%); DF 8 cases (2.1%) and miliary TB 1 cases (4.6%). In HIV infected
      patients 17 EF (77.3%), which were mainly ganglionary (64.7%); 4 DF (18.2%); and
      1 miliary TB (4.5%) cases were observed. CONCLUSIONS: Our findings confirm the
      high incidence of extrapulmonary TB, similar to the number of pulmonary forms.
      Our experience shows a significant modification to the classical presentation of
      the disease, and thus the need for sensitivity in locating the disease.

PMID- 11213579
TI  - [Value of the detection of serum thyroglobin and I-131 scintigraphy in the follow
      up of differentiated thyroid cancer].
AB  - OBJECTIVES: The objective of this work has been to know the sensitivity of serum
      thyroglobulin and I-131 scintigraphy in the detection of thyroid remnants or
      metastases, and to evaluate the predictive value of serum thyroglobulin in the
      follow-up of differentiated thyroid cancer patients. METHODS: We have carried out
      a retrospective study of 218 patients with differentiated thyroid cancer, with
      detection of serum thyroglobulin levels and I-131 scintigraphy in clinical status
      of hypothyroidism, after to perform thyroidectomy and between six and nine months
      later. We have rejected 16 and 14 patients who have had presented high serum
      levels of thyroglobulin, or an incomplete follow-up. RESULTS: Our results showed
      a good correlation of both parameters (92%). The sensitivity of TG and I-131 scan
      was 85% and 90% respectively, and superior to 90% for both procedures in the
      diagnosis of the osseous and lung metastases. The sensitivity of I-131 scan and
      TG was 100% and less to 70% in the detection of thyroid remnants and regional
      lymphatic nodes. The positive and negative value of TG was 99% and 91%,
      respectively, with a total of 24 false negative results. CONCLUSIONS: Considering
      this study, we believe that both techniques are complementary, with a lower
      sensitivity of serum TG in the detection of thyroid remnants and regional
      lymphatic involvement, and a negative predictive value that does not permit to
      accomplish the follow-up of differentiated thyroid cancer patients, considering
      exclusively the results of this tumoral marker.

PMID- 11213580
TI  - [Cytomegalovirus diarrhea as a diagnostic index for AIDS].
AB  - We report a case of a male 49 years old, without clinical history, excepting rape
      in 1996, that was admitted to the Emergency Room of HGUGM because of diarrhea 6
      months duration, plus fever (39 degrees C) in the last 2 months. He was diagnosed
      of infection by the Human Immunodeficiency Virus (HIV), with serum antigenemia
      (70 cells), and colonic biopsy positives for Cytomegalovirus, and a normal
      colonoscopy. Cytomegalovirus colitis is the major etiologic infectious agent in
      patients with AIDS-associated diarrhea, although it can be the diagnostic index
      for AIDS in a few cases.

PMID- 11213581
TI  - [Listeriosis: an infrequent infection in patients with HIV].
AB  - Although resistance to Listeria monocytogenes infection requires intact T-cell
      mediated immunity, listeriosis is an infrequent problem in patients with HIV
      infection and only about 50 patients have been reported to date. Only two
      patients with HIV and L. monocytogenes have been attended in our hospital since
      the beginning of aids epidemic in 1981. Case 1: a man with HIV and 364 CD4+
      cells/mm3 presented fever and occipital headache. The cerebral scan was normal
      and L. monocytogenes grew in licuor culture. He was outcome after treatment with
      ampicillin and tobramycin. Case 2: a 47 years old man with HIV, 44 CD4+ cells/mm3
      and hepatic virus C cirrhosis was admitted to the hospital because fever and
      abdominal distension. He was on menstrual pentamidine prophylaxis for
      Pneumocystis carinii pneumonia (PCP). Bacterial peritonitis was diagnosed and the
      patient begun treatment with ceftriaxone. The patient dead 72 hours later with
      hepatic encepholopathy. Postmortem L. monocytogenes grew. Listeriosis is an
      infrequent disease in patients with HIV that causes difficult diagnostic
      problems, principally in patients without prophylaxis with cotrimoxazole for PCP.

PMID- 11213582
TI  - [Repeated hemoptysis for foreign body bronchial aspiration: presentation of a
      case and review of literature].
AB  - The foreign body aspiration is more frequent in children. The most usual etiology
      is the foreign bodies of vegetable nature, which can not be observed in the chest
      radiograph. The clinic signs are varied, including shortness of breath, cough and
      wheezing. Hemoptysis is a rare symptom, whose arising is generally connected with
      the existence of bronchiectasis. We present the case of a child who showed
      repeated hemoptysis and focal neumonitis due to Eikenelle corrodens three years
      after the aspiration of a spike. The diagnosis of the bronchial aspiration
      obtained after The most unusual in this case is the clinic manifestation of
      repeated hemoptysis, together with the long connected to the existence of foreign
      body inside the bronchus.

PMID- 11213583
TI  - [Spontaneous pneumomediastinum and idiopathic pulmonary fibrosis].
AB  - The association between pulmonary fibrosis and pneumomediastinum is infrequent.
      Computed tomography is the suited method for the detection of small
      pneumomediastinum, which is difficult to detect by chest radiography. A case of
      idiopathic pulmonary fibrosis, with frequent and violent cough, with
      pneumomediastinum and cervical subcutaneous emphysema, without pneumothorax,
      probably caused by rupture of bullae is presented. The outcome was favourable
      with symptomatic treatment.

PMID- 11213584
TI  - [Pyogenic liver abscess as a complication of Crohn's disease].
AB  - Pyogenic liver abscess in patients with Crohn's disease is not common, but the
      mortality has been reported to be high if diagnosis and treatment is delayed.
      Intra-abdominal abscesses, fistulous disease, and steroid therapy have all been
      reported to be important predisposing factors in the pathogenesis of this entity.
      We present a patient with Crohn's disease in whom multiple abscesses were
      encountered in the right lobe of the liver. The diagnosis of liver abscess was
      established by abdominal computed tomography and the patient was treated by
      percutaneous catheter drainage. Awareness of this rare complication is important
      because diagnosis is difficult to make and a high index of suspicion is required.
      Once suspected, aggressive diagnostic workup and treatment is indicated. Most
      patients with liver abscess can be successfully managed by percutaneous catheter
      drainage combined with antibiotic therapy if it is diagnosed before extensive
      necrosis has occurred.

PMID- 11213585
TI  - [Evidence-based medicine tratment of chronic viral hepatitis B and C].
AB  - Worldwide, viral hepatitis is the most common cause of jaundice, chronic liver
      disease, cirrhosis and hepatocellular carcinoma. Although mayor advances have
      been made in the field of treatment and prevention, there is not a totally
      satisfactory treatment for each of both diseases. They account for a high
      percentage of the etiology of viral hepatitis and have a tendency towards
      chronicity and developing cirrhosis, resulting in a tremendous waste of medical
      resources. On the other hand, their treatments are long-term ones and the drugs,
      which are employed, are expensive. Thus, it is necessary to make an evidence
      based medicine approach in this particular kind of illness to obtain the best
      benefit/cost ratio. In this current review, we analyzed the different drugs and
      therapeutic schedules, which are used in the chronic viral hepatitis B and C, and
      as well as their obtained response.

PMID- 11213586
TI  - [Monoclonal gammapathy IgG kappa in patients with Sjogren syndrome. Apropos of a
      case].

PMID- 11213587
TI  - [Alteromona putrefaciens pleural empyema].

PMID- 11213588
TI  - [Hypovolemic shock by aortoenteric fistula].

PMID- 11213589
TI  - [Patient with HIV infection and acromegaly].

PMID- 11213590
TI  - [Myasthenia gravis after tetrazepam treatment].

PMID- 11213591
TI  - [Pulmonary embolism in the Internal Medicine Service (1992-97)].

PMID- 11213592
TI  - [Severe thrombocytopenia related to granulocyte-macrophage colony-stimulating
      factor (rHU-GM-CSF)].

PMID- 11213593
TI  - [Pneumocystis carinii pneumonia in patients with HIV infection. Review of 70
      cases].

PMID- 11213594
TI  - Multiple risk factor intervention in type 2 diabetes: an opportunity not to be
      missed.

PMID- 11213595
TI  - Clustering of cardiovascular risk factors in type 2 diabetes mellitus: prognostic
      significance and tracking.
AB  - AIM: Little attention has been paid to the prognostic significance and tracking
      effect of risk factor clusters characteristic of type 2 diabetes mellitus. We
      studied the clustering of eight cardiovascular risk factors (smoking, high body
      mass index, elevated systolic blood pressure, high serum, low density lipoprotein
      (LDL) cholesterol, high serum LDL triglycerides, low serum, high density
      lipoprotein (HDL) cholesterol, high fasting blood glucose and high plasma insulin
      concentration) and their effect on the prognosis and the tracking effect.
      METHODS: This study is a population-based prospective follow-up of newly
      diagnosed type 2 diabetic subjects (n = 133, aged 45-64 years) in Eastern
      Finland. The following end points were used: all-cause mortality, cardiovascular
      mortality, and incidences of first myocardial infarction and first stroke.
      Furthermore, we studied the 'tracking effect' of the risk factor clusters during
      the 10-year follow-up period. RESULTS: When the clustering of risk factors
      typical of type 2 diabetes mellitus was taken into account, all-cause mortality
      increased from 28.6% to 50.0% (p < 0.05) and cardiovascular disease mortality
      increased from 14.3% to 50.0% (p < 0.01) depending on the number of risk factors
      present. The incidence of first myocardial infarction increased from 0% to 40.0%
      (p < 0.05) as the number of risk factors increased from 0 to 5. In survivors, the
      proportion of individuals with no risk factors decreased and the proportion on
      individuals with three to four risk factors increased during the 10-year follow
      up period despite the high mortality among the group with many risk factors.
      CONCLUSIONS: The risk factor clusters among type 2 diabetic subjects are of great
      predictive value and when not aggressively treated, show a relentless increase
      despite selective mortality.

PMID- 11213596
TI  - Impaired glucose metabolism and obesity in Swedish patients with borderline
      isolated systolic hypertension: Skaraborg Hypertension and Diabetes Project.
AB  - AIM: To assess the prevalence of borderline isolated systolic hypertension
      (borderline ISH), and to examine its association with other cardiovascular risk
      factors. METHODS: A cross-sectional community-based study was carried out in 1993
      1994 in Skara, Sweden, including 1109 randomly chosen subjects > or = 40 years
      old. Normotension (NT) was defined as systolic blood pressure (SBP) < 140 and
      diastolic blood pressure (DBP) < 90 mmHg, borderline ISH as SBP 140-159 and DBP <
      90 mmHg and hypertension (HT) as SBP > or = 160 or DBP > or = 90 mmHg or ongoing
      treatment. RESULTS: The prevalence of borderline ISH (n = 203) by age was 4% in
      ages 40-49 years, 15% in ages 50-59 years, 28% in ages 60-69 years and 25% in
      ages 70-79 years. With borderline ISH as reference, normotensive subjects less
      often had fasting blood glucose > 5.5 mmol/l (odds ratio (OR): 0.4, 95% CI: 0.26
      0.75), BMI > 27 kg/m2 (OR: 0.6, 95% confidence intervals (CI): 0.42-0.85) and
      known diabetes (OR: 0.4, 95% CI: 0.16-0.95). Hypertensive subjects more often had
      high density lipoprotein (HDL) cholesterol < 1.0 mmol/l (OR: 2.0, 95% CI: 1.35
      2.99), a history of previous cardiovascular disease (CVD) (OR: 1.7, 95% CI: 1.01
      2.72), known diabetes (OR: 2.4, 95% CI: 1.29-4.58) and microalbuminuria (men)
      (OR: 1.9, 95% CI: 1.15-3.11). CONCLUSION: Borderline ISH is a common condition.
      It is associated with a more unfavourable risk factor profile than that of
      normotensive subjects concerning primarily glucose metabolism and obesity. The
      prevalence of known diabetes increased with the degree of hypertension.

PMID- 11213598
TI  - Dyslipidaemia in African Americans, Hispanics and whites with type 2 diabetes
      mellitus and hypertension.
AB  - AIM: To study the pattern of dyslipidaemia in African American, Hispanic, and
      White patients with type 2 diabetes mellitus and/or hypertension. METHODS: The
      data were collected retrospectively on 6450 patients followed in the Harris
      County Hospital District Community Clinics. The information collected from review
      of the charts included each patient's age, sex, race, body mass index (b.m.i.),
      duration of type 2 diabetes mellitus and hypertension, medications, fasting
      plasma glucose, haemoglobin A1c, and fasting lipid profile. Mean lipid and
      haemoglobin A1c levels in the three ethnic groups were compared. The risk of
      abnormal cholesterol and triglyceride levels was assessed with logistic
      regression analysis. RESULTS: The results show that in patients with type 2
      diabetes mellitus after correcting for age, sex and b.m.i., African Americans
      have the lowest serum triglyceride concentrations and Whites have the highest
      values. This trend holds true even in patients with hypertension and in patients
      with both hypertension and type 2 diabetes mellitus. The risk of having abnormal
      triglycerides is 74% lower in African Americans, and 42% lower in Hispanics than
      Whites based on logistic regression model. Despite better glycaemic control,
      Whites have a greater increase in serum triglyceride concentrations than
      Hispanics and African Americans. CONCLUSIONS: Although African Americans are
      known to be at higher risk for cardiovascular complications than Whites or
      Hispanics, they appear to have lower triglyceride concentrations than Whites or
      Hispanics in the presence of type 2 diabetes mellitus. This suggests that an
      increased prevalence of other adverse factors must contribute to their heightened
      cardiovascular risk.

PMID- 11213597
TI  - Effect of treatment with acarbose and insulin in patients with non-insulin
      dependent diabetes mellitus associated with non-alcoholic liver cirrhosis.
AB  - AIM: Non-insulin-dependent diabetes mellitus (type 2 diabetes) not responding to
      dietary treatment alone in patients with non-alcoholic liver cirrhosis is
      characterized by high postprandial hyperglycaemia. The control of postprandial
      hyperglycaemia in such patients, is generally achieved by the means of
      progressively higher doses of insulin, with an increasing risk of hypoglycaemia
      in the late postprandial period. The aim of this study was to evaluate the use of
      acarbose for the control of postprandial hyperglycaemia in 100 patients with well
      compensated liver cirrhosis and type 2 diabetes treated with insulin. METHODS:
      The study was double blind with randomization of treatments into acarbose (52
      patients) vs. placebo (48 patients) with parallel branches over a period of 28
      weeks. RESULTS: All patients tolerated the treatments well and no significant
      variations in liver function tests were observed (< 5% vs. pretreatment). A
      significant reduction of several parameters was observed only after acarbose
      treatment: fasting glycaemia (173 +/- 28 vs. 146 +/- 19 mg/dl; p < 0.01),
      postprandial glycaemia (230 +/- 24 vs. 148 +/- 20 mg/dl; p < 0.01), mean
      glycaemia (206 +/- 20 vs. 136 +/- 13 mg/dl; p < 0.01), mean variation (180 +/- 14
      vs. 51 +/- 10 mg/dl; p < 0.01), HbA1c (8.9 +/- 0.8 vs. 7.2 +/- 0.5; p < 0.05), C
      peptide 2 h after a standard meal (4.5 +/- 1.9 vs. 2.8 +/- 1.7 ng/ml; p < 0.05),
      whereas the parameters did not change significantly after the placebo. After
      acarbose treatment a significant increase of intestinal voiding/week (+116% vs.
      +10%; p < 0.01) and a parallel reduction of blood ammonia levels (-52 +/- 9% vs. 
      9 +/- 5%; P < 0.01) were observed. CONCLUSIONS: The results clearly document the
      good tolerability and the absence of toxic effects of acarbose on liver, due to
      the lack of both intestinal absorption and hepatic metabolism of the drug at
      doses in the therapeutic range. In fact, acarbose increases the peristalsis
      movements of the gut, stimulates the proliferation of the saccarolytic bacteria
      and simultaneously reduces the proliferation of proteolytic bacteria, thus
      resulting active in the reduction of blood ammonia levels. These effects of
      acarbose may be advantageously exploited in the treatment of type 2 diabetic
      patients with well-compensated non-alcholic liver cirrhosis.

PMID- 11213599
TI  - Beta 3-adrenergic receptor gene polymorphism and type 2 diabetes in a Caucasian
      population.
AB  - AIM: The beta 3-adrenergic receptor (beta 3-AR) is suspected to play a key role
      in the regulation of energy balance by increasing lipolysis and thermogenesis. A
      mutation in the beta 3-AR gene (Trp64Arg) has been associated with the capacity
      of weight gain and with early onset of noninsulin dependent diabetes mellitus
      (type 2 diabetes). In this study we investigated the prevalence of the two beta 3
      AR alleles in a Caucasian population and studied the association between the beta
      3-AR genotype and metabolic disorders (obesity and type 2 diabetes). METHODS:
      Genomic DNA extracted from peripheral blood leucocytes of 200 Caucasian subjects
      (137 subjects with and 63 subjects without type 2 diabetes). The MvaI
      polymorphism of beta 3-AR, which detects the Trp64Arg mutation, was determined by
      polymerase chain reaction (PCR). We studied the correlation between the Trp64Arg
      mutation and the body mass index (b.m.i. kg/m2). RESULTS: There was no
      significant difference between the patients with type 2 diabetes and control
      subjects in the frequency of the Arg64 allele (5.5% and 4.8%, respectively).
      Within the group of type 2 diabetes patients were 14 subjects with the Trp64Arg
      mutation (b.m.i., mean +/- s.d.: 31 +/- 8.5 kg/m2) and 123 without the mutation
      (b.m.i. 29 +/- 4.8). There was no association between the beta 3-AR gene
      polymorphism and sex, obesity, blood pressure, glycohaemoglobin concentration,
      proteinuria. CONCLUSION: Our results suggest that the Trp64Arg mutation is not a
      major determinant of metabolic disorders (type 2 diabetes, obesity) and chronic
      complications of type 2 diabetes in a Dutch population.

PMID- 11213600
TI  - Recent developments and future prospects in pancreatic and islet transplantation.

PMID- 11213602
TI  - Spinal cord injuries.

PMID- 11213603
TI  - Latex-allergy concerns.

PMID- 11213605
TI  - Patient puzzle. Use systematic assessment to detect & correct patient conditions.
AB  - Medic 27 responds to a report of a fall victim at 27 West Pinnacle Lane. En
      route, the crew learns from dispatch that the patient fell approximately 25 feet
      from the roof of a three-story structure onto the roof of an adjacent garage. The
      caller reports the patient "going in and out of consciousness." The EMS crew
      requests the dispatch of a rescue unit and ladder company to assist on scene and
      the placement of a medical helicopter on standby. On scene, the patient's wife
      reports her husband accidentally disturbed a hornets' nest as he secured a
      weather vane to the top of the family home. She says the hornets stung her
      husband repeatedly. In his attempt to avoid the stings, his movements jarred the
      ladder, causing him to fall to the roof below. As you walk to the side of the
      patient's home, his wife adds that her husband has a cardiac condition and now
      complains of chest pain and trouble breathing. You wonder what you'll find when
      you reach the victim. Is he a medical patient with traumatic injuries or a trauma
      patient with medical complications?

PMID- 11213604
TI  - As the stomach turns....

PMID- 11213607
TI  - JEMS 2001 resource directory. Need-to-know info at your fingertips.

PMID- 11213606
TI  - On the write track. 21 strategies to prepare clear & accurate documentation.

PMID- 11213608
TI  - HIPAA: where do providers stand? Roundtable discussion.

PMID- 11213609
TI  - PKI (public key infrastructure)--how and why it works.

PMID- 11213610
TI  - Beyond the buy-it button.

PMID- 11213611
TI  - Reducing medication errors.

PMID- 11213612
TI  - Making the leap to avoid medication errors.

PMID- 11213613
TI  - Mobile computing.

PMID- 11213615
TI  - Power plays and protection.

PMID- 11213614
TI  - Calling for a higher standard of service.

PMID- 11213617
TI  - ASPs (application service providers): a better tool.

PMID- 11213616
TI  - GIS technology helps pinpoint patients.

PMID- 11213618
TI  - What works. Calling all caregivers.

PMID- 11213619
TI  - What works. Documents on demand.

PMID- 11213620
TI  - Put a lock on security.

PMID- 11213622
TI  - Consultants hotlist.

PMID- 11213621
TI  - Backing up business.

PMID- 11213623
TI  - HIPAA to accelerate change in healthcare landscape.

PMID- 11213624
TI  - [Influence of tumor drug resistance phenotype on the dynamics of cisplatin
      induced changes of rat peripheral lymphocyte chromatin structure in Guerin's
      carcinoma].
AB  - The correlation between the tumor drug sensitivity and the degree of lymphocyte
      interphase nuclei chromatin damages induced by cisplatin in rats was found using
      sensitive and resistant to cisplatin variants of Guerin's carcinoma. Increased
      optical density of lymphocyte chromatin in first minutes after cisplatin
      injection both in rats without Guerin's carcinoma and with sensitive to cisplatin
      variants of this tumor was observed. Lymphocyte chromatin structure remains
      unchanged in rats with cisplatin resistant carcinoma. Normal blood cells are
      suppose to change their sensitiveness to cisplatin under the humoral influence of
      the growing tumor in according with its phenotype.

PMID- 11213626
TI  - [Population genetics research in the Lerik region of Azerbaijan].
AB  - The results of populational, clinic-genealogical and genetic-demographic research
      for six villages in Lerik region of Azerbaijan Republic are presented. The
      frequency of consanguineous marriages according to pedigrees was 62.3% with 32.4%
      of marriages between cousins. Inbreeding coefficient F = 0.0486 is considerably
      higher that the mean value for population of the Republic (F = 0.0063). The
      register of patients with congenital and inherited pathologies in the population
      of the studied villages has been set up. Genetic screening of glucose-6
      phosphatedehydrogenase erythrocyte enzyme deficiency in schoolchildren revealed
      high frequency of pathologic gene (36.4%) previously unregistered for the
      population of the Republic.

PMID- 11213625
TI  - [Distribution of the 32 base pair deletion of the CCR5 chemokine receptor gene in
      different regions of Ukraine].
AB  - The results of the analysis of 32 b.p. deletion in the CCR5 macrophage chemokine
      receptor gene in regional populations of Ukraine are presented. The frequency of
      this mutation ranged from 9.1% to 11% in the Slavs populations but in the
      population of Crimea Tartars the frequency of mutation was only 5%.

PMID- 11213627
TI  - [Comparison of the possibilities of micronuclear and chromosomal aberration tests
      for evaluation of the effects of radiation of different intensities].
AB  - The comparative evaluation of sensitivity and specificity of the micronucleus and
      chromosome aberration tests for human lymphocytes at the delayed terms after
      acute exposure to high-dose as well as during constant exposure to low-dose gamma
      radiation has been done. Accordance between these tests registered only in the
      cases of acute radiation sickness of second and third degrees of severity
      (irradiation doses above 200 cGy). Unspecificity of micronucleus test for
      estimation of the radiation load under constant low-intensity irradiation was
      found.

PMID- 11213628
TI  - [Phylogeny of Finnish-Ugric populations].
AB  - Genetic distances of 18 Finnish-Ugric and other populations of Europe, Asia and
      America by 28 alleles of 12 loci of proteins, enzymes and blood groups were
      calculated. The data of matrix of genetic distances and dendrogramme constructed
      by paired clusterisation method suggested that there was the relationship of
      Finnish-Ugric populations and some Caucasoids and North Mongoloid populations.
      These data give new approaches to the problem of Finnish-Ugric phylogenesis.

PMID- 11213629
TI  - [Creation of maize lines inducing maternal haploids with high frequency].
AB  - The new inducers of maternal haploids have been created. The results on their
      inducing capacity in crossing with MK01u and A619 lines and MK01u x A619 hybrid
      are presented. Pollination with pollen of the new inducers allowed to obtain in
      average 6.5% of haploids among the three maternal genotypes. The ZMS and KMS
      initial lines induced 2.3% and 2.0% of haploids respectively. The frequency of
      haploids was studied in different parts of ears. It was found that in the higher
      part of an ear where the egg cells are the youngest during flowering the
      frequency of haploids was almost three times higher than in the lower part of an
      ear and more than twice higher than in the middle part of an ear. It was assumed
      that early pollination may increase frequency of obtaining haploids.

PMID- 11213630
TI  - [Development of Triticale and soft wheat forms with substituted wheat and rye
      chromosomes].
AB  - During hybridization between winter forms of hexaploid (6x) triticale and soft
      wheat varieties the intergenomic substitution of alian chromosomes occurs. As a
      result of these crosses the forms of 6x-triticale with D(R)-substitution of
      chromosomes in R-rye genome by wheat ones of D-genome and wheat revertants with
      rye chromosomes replacing the wheat ones are originated. This is the simplest and
      the most effective technique for developing of selected lines of triticale and
      soft wheat with alien substituted chromosomes and valuable genes transfer.

PMID- 11213631
TI  - [Mutagenic effect of the herbicide Titus in maize].
AB  - Mutagenic effect of the new herbicide titus has been studied by the tests of
      chromosome aberration and gene mutations in maize. It has been shown that the
      preparation in question possesses a definite mutagenic activity, which sometimes
      5-7 times exceeded the level of spontaneous mutating. Therefore, when
      recommending it for application in agriculture it is necessary strict following
      recommended doses, because even slight excess may result in considerable genetic
      consequences. It is also of great importance to apply this herbicide during the
      recommended stage. The application of titus for maize in hybridization plots as
      well as in nurseries for reproduction of elite and super elite lines is not
      recommended.

PMID- 11213632
TI  - [Genetic diversity of isoenzymes in mountain pine (Pinus mugo Turra) in natural
      populations in the Ukrainian Carpathian mountains].
AB  - Electrophoretic spectra of GOT, GDH, DIA, MDH, SOD, FDH, ADH, ACP, IDH enzymes in
      the megagametophytes of seeds of 69 mountain pine (Pinus mugo Turra) trees from
      natural populations of the Ukrainian Carpathian mountains have been described. 19
      loci products had efficient electrophoretic separation. The analysis of alleles
      segregation of the heterozygous trees on the whole confirms monogenic inheritance
      of the discovered variants.

PMID- 11213633
TI  - [Morpho-functional characteristics of hemoglobinopathies].
AB  - The approaches to the problems of primary diagnostics of the hereditary
      hematoglobinopathias caused by unbalanced synthesis of alpha and beta chains, as
      well as modern state of screening of hereditary thalassemic hematoglobinopathias
      are considered. The result of the available information analysis takes into
      account numerous peculiarities of this problem, including economic ones.
      Experience of an estimation of the displays of unbalanced synthesis of globin
      chains concerning the morphology of red blood cells is presented in the
      generalized form. The latter is a very important for preliminary diagnostics the
      hematoglobinopathias because, for the first, it may be realized at primary units
      of public health system service, for the second, it allows to narrow to an
      acceptable level the group of persons whose blood requires more complex and
      expensive researches.

PMID- 11213634
TI  - [Structure and function of thyroid hormone receptors].
AB  - The new data concerning the structure of nuclear receptor of thyroid hormone and
      peculiarities of its functioning as a ligand-dependent transcriptional factor are
      reviewed. Considerable attention is concentrated on the analysis of mechanisms of
      receptor interactions with specifical DNA regions which mediate iodothyronine
      influence on the gene expression and factors that participate in regulation of
      these mechanisms.

PMID- 11213635
TI  - Physician practices. Slowing the flow of red ink.

PMID- 11213636
TI  - Nurse shortage. An eBay for RNs.

PMID- 11213637
TI  - Suicide prevention. Death-defying acts.

PMID- 11213638
TI  - Medical schools. Changing course.

PMID- 11213639
TI  - Hopkins HealthCare. Home-grown TPAs.

PMID- 11213641
TI  - Back to basics.

PMID- 11213642
TI  - Wired & waiting.
AB  - Disease management was supposed to be the next big thing in health care, thanks
      largely to the breathtaking pace of advances in technology. But so far reports of
      a disease management revolution have been premature. While technology vendors
      promise that their devices can save millions and keep patients healthier longer,
      providers have been reluctant to make the large investments necessary until they
      have proof of a payoff. Formal studies and reliable statistics to provide such
      proof are sorely lacking, although anecdotal evidence appears to signal high
      hopes for the future.

PMID- 11213644
TI  - Short supply.

PMID- 11213645
TI  - [Organ donation, retrieval, and transplantation in Italy, in 1994-98].
AB  - Organ donation and transplantation activity in Italy have been always
      characterised by two contrasting features: first the constant positive trend in
      the improvement of the number of organ donors and transplants which allowed the
      country to exceed the value of 12 donors per million population in 1998; second
      the difficult situation in southern regions, so that the national distribution of
      the activity is highly and steadily non homogeneous. Herein we report the data
      regarding donation, retrievals and transplant activity in Italy in the years 1994
      98, focusing on the activity of each region and the three interregional centres
      which encompass the majority of the national territory.

PMID- 11213646
TI  - [Organ transplantation: results and perspectives].
AB  - Nowadays organ transplantation is a life-saving procedure, or anyhow it can
      considerably improve the life quality of patients suffering from irreversible
      organ impairment. Monitoring transplantation outcome is the last step of a long
      process that starts with cadaver donor identification, selection and clinical
      management, and continues with organ allocation, patient evaluation, surgical
      operation and clinical follow-up. The National Transplantation Committee has been
      discussing many of these items and, in 1995, it set up two protocols, one on
      liver exchange for urgent patients and the other on transplantation in the
      pediatric patient. The protocols application has met many difficulties, mainly
      due to the uneven behaviours of the different inter-regional organizations. In
      this paper we comment on the two main aspects to be submitted to the next
      National Committee: organ allocation and transplantation outcome. As far as the
      last point is concerned, the enclosed data are based on the experience of the
      North Italy Transplant program (NITp), and on that of the major international
      registries. Without any doubt these data demontrate that organ transplantation is
      to be ascribed among the successes of medicine in the just closed century.

PMID- 11213647
TI  - [Transplantation collaborative networks].
AB  - The collaborative networks in Italy are described, with their objectives and the
      geographical areas covered. Their main features are: function of the reference
      centres, waiting lists, criteria for organ assignment, common programmes for some
      patients, services offered to the network members, organ procurement activity.
      The analysis of the activities performed included organ exchanges within and
      outside the network, common activities for tasks that could not be satisfactorily
      attained by a single centre or region, the collaborative studies. Finally, the
      role of the networks and of a national coordination, in order to better develop
      transplants nationwide, is discussed.

PMID- 11213648
TI  - [Planning of transplantation centers].
AB  - Health policies are correlated with the economics resources invested in each
      specific field. The planning of organ transplant centres depends on the
      relationship between health demand and health offer. The health demand is due to
      the number of the patients which are waiting for a transplant, while the health
      offer is represented by all the specific resources: number of cadaver donors and
      transplant centres. The analysis of transplant activity performed in Italy during
      the period 1996-1998 suggests that it is not necessary to increase the number of
      transplant centres but that of organ donors.

PMID- 11213649
TI  - [Tissue-typing laboratories for organ transplantation].
AB  - The tissue typing laboratory performs genetic analysis: the safety and the
      reproducibility of results are mandatory, because HLA typing can be crucial both
      in donor-recipient compatibility assessment for organ transplantation and for the
      diagnosis of immune related disease. The HLA laboratory should perform analysis,
      as quickly as possible, in order to define donor-recipient matching and to assess
      the presence of anti-donor specific antibodies in recipient's serum to prevent
      iperacute rejection. The aim of this report is to define the guidelines that
      should be followed in all laboratories for each specific transplantation in order
      to acquire national and international accreditation, and to obtain the best
      clinical results.

PMID- 11213650
TI  - [Statistical bases and models for the selection of kidney transplant recipients].
AB  - The thesis of this study is that the use of discrete simulations is the most
      appropriate instrument to support the definition of a kidney allocation
      procedure. We first furnished a general description of what it means to run a
      simulation to solve the problems related to the study of the statistical
      characteristics of any population. In the second part of the paper we
      mathematically formalized the subject of our study: the statistical properties of
      waiting lists, allocation algorithm and transplants. The third part reported the
      results of several simulations we have done with the aim to show the potential of
      these methods at assessing the most appropriate adjustments for the optimization
      of any allocation scheme.

PMID- 11213652
TI  - [Italian patients who received transplants from foreign countries].
AB  - The article analyzes the procedures for patient transferal to foreign countries
      presently adopted in Italy, with a particular insight in organ transplantation.
      All the legal and sanitary regulations that, from 1970 on, have regulated this
      issue for the European Community (now European Community) and extracommunitary
      countries are reviewed. The present legislation is reported and the guidelines
      for transferal to foreign countries is illustrated. The role of the specialistic
      regional referral centers in the concession of the authorization is examined in
      detail. The few available official sources have been reviewed to illustrate the
      migratory fluxes of transplant candidates in the recent years. Finally, the
      procedures that could make the system more efficient and uniform on the whole
      territory are reported.

PMID- 11213651
TI  - [The national program of pediatric transplantation].
AB  - The national programme for paediatric transplants currently implemented at the
      Istituto Superiore di Sanita is one of the first results of the efforts devoted
      to the definition of an efficient co-ordination policy of the transplantation
      activity in Italy. Since 1997 the programme has allowed all transplant centres
      throughout Italy to share unified waiting lists for kidney, heart, lung and
      liver, which gives paediatric patients a much better possibility than with local
      waiting lists. We present the regulations, criteria and operative solutions
      adopted to make the programme work, and the analysis of the data collected in
      these three years. The analysis gives statistical information on the composition
      and evolution of waiting lists and transplants done, which may be useful in the
      continuous process of revision and improvement of the criteria for recipient
      selection.

PMID- 11213653
TI  - [Waiting lists for transplantation in Italy].
AB  - To plan health services it is essential to gauge the needs. In transplant field
      in Italy, the first suitable data for waiting lists were collected in 1998. The
      data collected by Istituto Superiore di Sanita gave us a shot of patients field
      in waiting list at that time. We here analyse more significant data about heart,
      liver and kidney waiting lists. The situation is very different among north,
      centre and south of Italy: in South, where transplant activity is low, we found
      rare transplant centres, and most of patients prefer north centres. In kidney
      waiting list we found 1100 patients living in southern regions but registered in
      the waiting list of a different region. These data can help in planning
      development lines in Italy.

PMID- 11213654
TI  - [Psychological assistance in organ transplantation].
AB  - The aim of this report is introducing with a series of psychological, psychiatric
      and psychosocial problems, that can arise, at every point, in the procedure of
      organ transplantations. Different areas of intervention are considered: the
      assistance to the patients and their families during the pre- and post-operative
      periods; the evaluation of transplant recipients' quality of life; ethical and
      psychological problems of living kidney donation; psychosocial support to donors'
      families; the training of the intensive therapy units to entertain relationships
      with donors' relatives; the delicate psychological aspects of transplantation
      during childhood. The sense of awareness about these matters is growing in Italy
      too, and many initiatives of psychological and psychiatric help are being
      developed in collaboration with several transplantation centres.

PMID- 11213655
TI  - [The transplant coordinator].
AB  - Spain was the first European country adopting a strategy of organ procurement
      based on a specific health professional named transplant coordinator, who was
      first established in Catalunya in the middle eighties. In principle, the
      transplant coordinator is a doctor with hospital experience who is involved full
      time in organ procurement. The transplant coordination activity is available
      without interruption, due to a team work. Transplant coordination is based on
      four main functions: clinical, research, training and communication, management.
      The principles of transplant coordination according to the Spanish model are
      reported in the recently approved Italian law on transplantation (law 91/1999),
      indicating the coordinator's specific functions: a) communication to the regional
      reference centre of the data concerning the possible organ donors, b) preparation
      of the documents needed, c) relationship with the donors' family, d) information
      and education of the population on transplantation issues.

PMID- 11213656
TI  - Endoscopic retrograde cholangiopancreatography: what role does it have in primary
      care?
AB  - Endoscopic retrograde cholangiopancreatography (ERCP) is a unique specialty tool
      used for the diagnosis and treatment of biliary and pancreatic disease. The
      procedure is much more available now and can be used in place of surgery or in
      conjunction with surgery. This article reviews the indications, applications, and
      personal experiences with the procedure in a rural referral hospital. Discussion
      includes the risks and complications of ERCP. Also included are explanations of
      therapeutic interventions. After reading this article, primary care physicians
      should have greater familiarity with the utility of this endoscopic tool.

PMID- 11213657
TI  - A primary care approach to pediatric gastroesophageal reflux.
AB  - Gastroesophageal reflux is a common problem that occurs in the pediatric
      population. Gastroesophageal reflux refers to the retrograde passage of gastric
      contents into the esophagus. Current thinking implicates transient lower
      esophageal sphincter relaxations as a major cause for reflux. Infants generally
      present with symptoms of regurgitation, whereas symptoms of esophagitis are more
      common in older children. When there are dangerous consequences secondary to
      gastroesophageal reflux, it is termed gastroesophageal reflux disease (GERD).
      GERD has been shown to manifest with respiratory symptoms and a pathologic
      process. A variety of diagnostic procedures are available for the assessment of
      GERD which include barium swallow, pH probe, scintigraphy, and endoscopy with
      esophageal biopsy. Medical management of GERD primarily involves prokinetic
      agents and acid suppression therapy. Surgical therapy, albeit less common, now
      still has its role in the treatment of GERD.

PMID- 11213658
TI  - Acute gastrointestinal bleeding: clinical essentials for the initial evaluation
      and risk assessment by the primary care physician.
AB  - Acute gastrointestinal bleeding is a common medical emergency that frequently
      results in hospitalization. Rapid initial assessment of clinical parameters such
      as estimated volume of blood lost, appearance of expelled blood, hypotension,
      mental status changes, and coagulopathy should all be evaluated as part of the
      outcomes prediction equation. For upper gastrointestinal bleeding, early
      endoscopy of the upper gastrointestinal tract will also provide important
      information to aid in efforts to predict risk. Endoscopic evidence of ongoing
      rapid bleeding or the presence of a "visible vessel" or adherent clot on the
      ulcer base are findings that are associated with a high likelihood of continued
      bleeding or recurrent bleeding. Endoscopic therapy can reduce the rates of
      recurrent bleeding, surgery, and length of hospital stay in patient with these
      "stigmata of recent bleeding." Other endoscopic ulcer appearances such as brown
      or black pigment in the ulcer base or a clean ulcer base do not require
      endoscopic therapy, as rates of recurrent bleeding are very low for these
      lesions. Use of these clinical and endoscopic outcome predictors can also be
      useful in refining triage decisions as to which patients need to be in the
      intensive care unit, which need to be admitted to the hospital, and which can
      have early oral feeding and expedited hospital discharge or outpatient care.

PMID- 11213659
TI  - Sleep-related gastroesophageal reflux.
AB  - Although we spend approximately one third of our lives sleeping, rarely do we
      consider that sleep may contribute to medical conditions. For gastroesophageal
      reflux, sleep or physiologic changes associated with the sleep state often
      promote or increase the likelihood of reflux and aspiration. These changes
      include the assumption of the supine position, a decrease in the arousal
      threshold, mechanical effects of the abdomen, and disorders associated with
      sleep. Of the sleep disorders, obstructive sleep apnea is associated with a high
      frequency of gastroesophageal reflux, probably due to the generation of negative
      intrathoracic pressures and obesity associated with the disease. Obstructive
      sleep apnea in patients with gastroesophageal reflux can lead to difficult-to
      treat or refractory gastroesophageal reflux, predominantly nocturnal or early
      morning symptoms, and unusual or uncommon manifestations that do not appear to
      reflect the underlying pathologic process. Under most circumstances, aggressive
      treatment regimens must be instituted for both disorders in order to effectively
      control symptoms. This article reviews the major information that is currently
      available on the relationship between obstructive sleep apnea and
      gastroesophageal reflux.

PMID- 11213660
TI  - Fair hearing/peer review: truth or oxymoron?

PMID- 11213661
TI  - Time for Medicare reform is now.

PMID- 11213662
TI  - Questioning of OCF should rouse osteopathic response.

PMID- 11213663
TI  - Hardship deferment saves residents' money.

PMID- 11213664
TI  - Spirituality in medicine.

PMID- 11213666
TI  - Minor depression in primary care.
AB  - Minor depression is defined as a mood disturbance of at least 2 weeks' duration,
      with between two and five symptoms of depression, including depressed mood,
      diminished interest, weight change, sleep disturbance, psychomotor changes,
      fatigue, feelings of worthlessness, poor concentration, and recurrent thoughts of
      death. Patients with this condition may have fewer vegetative symptoms (appetite,
      diurnal mood variation) and more subjective symptoms (self-blame, worry,
      irritability, lethargy). Minor depressive disorder is more prevalent in primary
      care than major depressive disorder. Failure to adequately treat this condition
      may have far-reaching impact on the health, functional status, quality of life,
      and cost of care for patients who have it. The notion that minor depression
      requires minor treatment is misleading. Cognitive-behavioral modes of therapy and
      selective serotonin reuptake inhibitor antidepressants have demonstrated efficacy
      for primary care patients who have minor depression.

PMID- 11213665
TI  - Benefits of osteopathic manipulative treatment for hospitalized elderly patients
      with pneumonia.
AB  - While osteopathic manipulative treatment (OMT) is thought to be beneficial for
      patients with pneumonia, there have been few clinical trials--especially in the
      elderly. The authors' pilot study suggested that duration of intravenous
      antibiotic use and length of hospital stay were promising measures of outcome.
      Therefore, a larger randomized controlled study was conducted. Elderly patients
      hospitalized with acute pneumonia were recruited and randomly placed into two
      groups: 28 in the treatment group and 30 in the control group. The treatment
      group received a standardized OMT protocol, while the control group received a
      light touch protocol. There was no statistical difference between groups for age,
      sex, or simplified acute physiology scores. The treatment group had a
      significantly shorter duration of intravenous antibiotic treatment and a shorter
      hospital stay.

PMID- 11213667
TI  - Re-expansion pulmonary edema following puncture of a giant bulla.
AB  - Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated
      after a period of collapse. The syndrome of re-expansion pulmonary edema is
      associated with variable degrees of hypotension and hypoxemia. In its extreme
      form, it may result in cardiac arrest and death. The initial cause of uninflated
      pulmonary parenchyma described with re-expansion pulmonary edema has typically
      been either a large undrained pleural effusion or a pneumothorax. The authors
      describe a patient in whom re-expansion pulmonary edema developed when
      inadvertent puncture of large emphysematous bullae released previously
      atelectatic lung.

PMID- 11213668
TI  - Collaboration between pharmacy and osteopathic medicine to teach via the
      Internet.
AB  - This article describes the results of a survey from graduate pharmacy students
      who completed a neurology/psychiatry course taught by a pharmacist and an
      osteopathic physician via the Internet. Seventeen practicing pharmacists
      completed the 11-week course, and thirteen students completed the survey provided
      at the end of the course. Results indicated that students were pleased with the
      course. Mean evaluation scores ranged from 4.31 to 4.77 on a five-point scale.
      Additionally, students indicated that the collaboration of medicine and pharmacy
      provided an educational model that should be duplicated for future courses.

PMID- 11213669
TI  - Government control of medicine.

PMID- 11213670
TI  - Plasma exchange in myasthenia gravis and multiple sclerosis.
AB  - During the last twenty-year period therapeutic plasma exchange (TPE) was used in
      the treatment of 68 patients with myasthenia gravis and 61 patients with multiple
      sclerosis. The therapeutic effects were evaluated on the basis of neurologic
      deficit changes, electrophysiological findings, necessary laboratory analyses and
      patient's general conditions. It was shown that the therapeutic effects mosty
      depended on the nature and stage of the basic disease, adequate selection of the
      patients and timely applied therapeutic procedure. Significant positive effects
      of the TPE treatment applied with the anti-inflammatory and immunosuppressive
      therapy were observed in patients with myasthenia gravis and multiple sclerosis
      upon clinical findings and some paraclinical tests.

PMID- 11213671
TI  - [Blood transfusion therapy at the Military Medicine Academy--present
      possibilities].
AB  - Blood component therapy refers to the transfusion of the specific part of blood
      that a patient needs, as opposed to the routine transfusion of whole blood (WB)
      in the past. This not only maintains blood resources, but also provides the
      optimal method of transfusing patients who require large amounts of a specific
      blood component. Since this concept have been accepted, the Institute of
      Transfusiology of Military Medical Academy (MMA) possess appropriate equipment
      for blood collection and processing of WB in components. Mainly, all kind (except
      frozen) of packed red cells (RBCs), platelet concentrates (random-donor buffy
      coat or apheresis donation), single-donor (apheresis) or random-donor (buffy
      coats) granulocytes, fresh frozen plasma (FFP), single-donor cryoprecipitate are
      prepared. Recently, fibrin glue (obtained by recycled cryoprecipitation from
      single-donor or autologous plasma), and some of new generation of blood
      components: hematopoietic stem and progenitor cells (fresh or cryopreserved),
      collected from bone marrow or harvested from peripheral blood after mobilization
      and donor-specific mononuclear cells for cell therapy, i.e. immunomodulation
      during relapse of leukemia after bone marrow transplantation, have become the
      routine. Analysis of blood component therapy done at the MMA during the past 11
      years (1989-1999) showed that: a) participation of WB transfusion in the group of
      surgical clinics was permanently decreased (from 59.60% in 1989 to 0.37% in
      1999); b) WB transfusion (in the last few years) practically was not used in the
      group of internal medicine clinics (0.82% in 1993 and 0.45% in 1999); c) overall
      WB transfusion in MMA is extremely rare (0.37%).

PMID- 11213672
TI  - [Biochemical changes in thrombocyte concentrates stored for 5 days].
AB  - The purpose was to evaluate biochemical and functional changes in platelet
      concentrates prepared from buffy-coat (PC-BC), stored up to five days at
      temperature of 20 +/- 2 degrees C. Forty-two PC-BC units from random blood donors
      were examined. In order to determine the biochemical changes we studied the
      release of lactate dehidrogenase (LDH), changes in pH value, pCO2, pO2, glucose
      and lactate concentrations. In addition, the aggregation of platelets with
      adenosine diphosphate (ADP), and hypotonic shock response were examined. The
      concentration of LDH markedly increased from 138.8 IU/l (day 1st) up to 234 IU/l
      (day 5th). The lactate concentration increased significantly (p < 0.001) from 2.1
      to 8.6 mmol/l, and consequently pH decrease was observed (from 7.31 to 7.13). The
      level of glucose decreased gradually from 22.8 to 19.4 mmol/l. The pCO2 decreased
      progressively from 36.8 mmHg to 24 mmHg during first two days of storage and
      after that gradually to 20 mmHg. In contrast, pO2 fluctuated between 108 and 133
      mmHg during five day of storage. Recovery of hypotonic shock response was 70% on
      day 1st and 35.7% on day 5th, respectively (p < 0.001). Platelet aggregation
      using ADP showed significant increase from 6.6 sec (day 1st), to 11.2 sec (day
      4th) and 14.6 sec (day 5th), too. Significant differences in biochemical
      parameters and platelet functions, with confirmed relationship between changes
      obtained during five days stored PC-BC did not affect the efficacy of applied
      platelets.

PMID- 11213674
TI  - [Advantages of polyethylene glycol in comparison to bovine serum albumin in the
      indirect antiglobulin test in pregnant women].
AB  - Results of indirect antiglobulin test (IAT) adding polyethylene glycol (PEG) were
      compared with conventional IAT performed using bovine serume albumin (BSA) with
      the aim of prenatal protection of Rh(D) negative pregnant women. Investigation
      enrolled 986 samples of pregnant women sera and confirmed that the use of PEG-IAT
      increased the degree of detection of clinically significant antierythrocyte
      antibodies. Above all, form the Rhesus blood groups system (using exclusively PEG
      IAT) was detected by one antibody of anti-D, anti-C, anti-e and two anti-E),
      while by using BSA, anti-e was not detected at all. Besides, the need for
      additional serologic techniques has been reduced (treating of erythrocytes by
      enzymes) and the work of laboratories for prenatal protection has been
      alleviated, and at the same time the quality of analyses was not diminished,
      which gave the preference to PEG-IAT compared to BSA-IAT in prenatal testing.

PMID- 11213673
TI  - [Significance of blood transfusion in the development of cytotoxic antibodies in
      patients on hemodialysis].
AB  - The aim was to evaluate the influence of red blood cells (RBC) transfusion on the
      development of cytotoxic antibodies (C-Ab) in patients subjected to hemodialyses
      (HD) and planned for the kidney transplantation. The group of 71 HD patients, of
      mean age 42 years (19-65), 48 males and 23 females, planned for the kidney
      information was examined. Out of 71 HD patients, only 42 (59.19%) HD patients
      (group I) received subcutaneously recombinant human erythropoietin--rhuEPO (Eprex
      -epoetin-alpha or Recormon SE--epoetin-beta in dosage of 4,000 IU during every
      HD; i.e. one to three times a week) and they were not treated by RBC transfusion.
      The other 29 (40.85%) HD patients (group II) received RBC transfusion: 18
      (62.07%) HD patients received < 10 units 18 of RBC, 8 (27.59%) HD patients
      received 10-20 units of RBC; 3 (10.35%) HD patients received > 20 units of RBC.
      Testing of C-Ab was done in all patients every three months by standard
      lymphocytotoxicity test on the panel from 20 different lymphocyte donors with
      definite class I phenotype of antigen HLA. C-Ab was not found in HD patients who
      were not treated by RBC transfusion. Out of 18 HD patients who received < 10
      units of RBC only 3 (16.67%) HD patients developed C-Ab; out of 8 HD patients who
      received 10-20 units of RBC, in 4 (50%) patients was proved C-Ab; and C-Ab was
      proved in all 3 HD patients who received > 20 units of RBC. RhuEPO administration
      is very important for the transfusiologic treatment of HD patients; especially
      those who are planned for the kidney transplantation. Development of C-Ab is in
      direct correlation with the number of transfunded units of RBC. HD patients who
      received 10 or more units of RBC were at great risk to develop C-Ab.

PMID- 11213675
TI  - [Detection of anti-HCV antibodies in patients on long-term hemodialysis].
AB  - Hepatitis C virus (HCV) infection is highly prevalent among chronic dialysis
      patients and is the most common cause of chronic liver disease. Ninety six
      patients on chronic hemodialysis in our institute of transfusiology at the
      Military Medical Academy were evaluated for the presence of HCV infection. There
      was a significant relationship between presence of anti-HCV antibodies and number
      of blood transfusion received by examined patients. We concluded that hepatitis C
      is a common problem among patients on chronic hemodialysis in our institution:
      HCV infection is proved in about 48.95% of all patients on hemodialysis.

PMID- 11213676
TI  - [Aspects of transfusion-infusion therapy during war conditions].

PMID- 11213677
TI  - [Treatment of Hodgkin's disease with high-dose chemotherapy and autologous stem
      cell transplantation].
AB  - High dose chemotherapy (HDC) with autologous stem cell transplantation (SCT) was
      applied for the treatment of 13 patients (pts) with Hodgkin's disease (HD) (10
      with relapsed form and 3 with conventional chemotherapy resistant form) in the
      Clinic for Hematology, Military Medical Academy, from May 1997 to October 1999.
      After the initial treatment for the reduction of tumor, burden stem cells were
      mobilized by cyclophosphamide 2.5-7.0 g/m2 with G-CSF 5-12 micrograms/kg body
      mass (BM). The average number of colected mobilized mononuclear cells (MNC) was
      2.99 (1.66-5.9) x 10(8)/kg BM by the apheresis large volume from peripheral
      blood. All patients received BEAM (BCNU, etoposide, Cyto-Ara, and melfalan)
      conditioning regimen with adequate supportive therapy. Good engraftment (100%)
      was observed at postransplantation period: number of polymorphonuclear cells was
      > 0.5 x 10(9)/l, on day 13th (10-21) and number of platelets > 20 x 10(9)/l, on
      day 17th (11-28). One patient (7.6%) died due to infective complications at day
      98th after transplantation, 9 (69.2%) patients achieved complete and 3 (23.1%)
      patients partial remission of the disease. Out of three patients with partial
      remission, one relapsed, seven months after autologous SCT, with conventional
      chemotherapy resistant form and two, after the applied conventional locoregional
      radiotherapy reached remission. One patient (7.6%) developed secondary malignancy
      of acute myeloid leukemia form with threelinage displasy 27 months after
      autologous SCT. HDC with autologous SCT contributes to more successful treatment
      of early relapsed and standard chemotherapy resistant forms of HD and gives the
      opportunity for successful quality of living for those patients.

PMID- 11213678
TI  - [Cytomegalovirus infection in patients with kidney diseases].
AB  - Cytomegalovirus (CMV) has a prominent position as the cause of severe
      cytomegalovirus infection (CMVI) in immunocompromised persons, such as: patients
      with primary or secondary immunodeficiency (risk group), blood/hemoproducts
      recipients, especially recipients of tissue and organ transplants, which have
      implications for difficult providing of CMV-seronegative (safe) blood. However,
      CMV-disease is manifested in the minority of immunocompetent persons. Sera of
      patients from the Center for Hemodialysis of the Clinic of Nephrology of the
      Military Medical Academy (MMA) were tested on the presence of CMVI markers. All
      patients belonged to the risk group considering the chronicity of the main
      disease, receiving of the large quantities of blood and as the possible potential
      recipients of kidney transplants. Testing was performed by commercial serologic
      enzyme-immune tests (Abott--USA, Behring--Germany) for CMV antibodies of IgG and
      IgM classes by which was determined serologic state of patients. Test results:
      out of 106 tested sera samples, 100 (99.33%) were CMV-seropositive (CMV-IgG), 27
      (25.47%) were positive on recent CMVI (CMV-IgM), 99 (93.39%) received the blood
      previously, the majority of patients were with the diagnosis of primary
      glomerulopathy--68 (64.15%) and tubulointerstitial nephropathy--32 (30.18). Such
      results indicate the potentional possibility of reactivation of latent CMV and
      development of CMVI, and in transplant recipients--its rejection. It can occur if
      appropriate measures of prevention from CMVI are not timely undertaken, which
      includes the providing of CMV-seronegative-safe blood/hemoproducts, as well as
      the appropriate application of combined medicamentous therapy by chemical agents
      and immunomodulators-specific hyperimmune anti-CMV immunoglobulins.

PMID- 11213679
TI  - [Therapeutic use of blood products and their recombinant analogs in patients with
      disorders of hemostasis].

PMID- 11213680
TI  - [Flow cytometry in quality control of the new generation of blood products
      prepared for use in stem cell transplantation].

PMID- 11213681
TI  - Donor leukocyte infusion--the effect of mutual reactivity of donor's and
      recipient's peripheral blood mononuclear cells on hematopoietic progenitor cells
      growth.
AB  - Donor leukocyte infusions are an effective therapy for patients who relapse with
      leukemia after bone marrow transplantation. We report the case of 14-year-old boy
      who relapsed 34 months after sibling donor bone marrow transplant for
      Philadelphia-positive chronic myeloid leukemia. Subsequently, he received three
      infusions of donor mononuclear cells (DMNC) harvested in steady state
      hematopoiesis and one G-CSF mobilized-peripheral blood mononuclear cells (PBMC)
      infusion. Simultaneously, test named as--"Test of Mixed Progenitors" (TMP) was
      performed for the assessment whether the outcome of donor leukocyte infusion
      treatment could be predicted. Prior to DMNC infusions, the CFU-GM and BFU-E
      colony assays were performed for donor's and recipient's PBMC individually, as
      well as for the mixture of these cells at 1:1 ratio. The cells were plated either
      directly in the semisolid medium or after 24 h preincubation treatment.
      Significantly lower values for CFU-GM derived colonies were determined in TMP in
      comparison to the CFU-GM values obtained for the recipient's cells. The reduced
      number of CFU-GM was determined both in TMP performed without preincubation
      treatment, app. 80% and after the 24 h preincubation, app. 55%. The reduced
      number of BFU-E derived colonies (app. 44%) was observed only related to
      recipient's cells and after the preincubation treatment of the cells. The patient
      did not develop GVHD and currently (40 months after the first infusion). He
      remained well in complete hematological, cytogenetic, molecular and clinical
      remission, which was the most direct evidence of the GVL effect. The novel in
      vitro TMP test in which the specific contribution of donor's leukocytes to the
      growth of recipient's hematopoietic precursor cell growth was determined,
      correlated with the clinical outcome.

PMID- 11213682
TI  - [Second allogenic bone marrow transplantation after late graft rejection in a
      patient with severe aplastic anemia].
AB  - Allogeneic bone marrow transplantation (BMT) is the treatment of choice in young
      patients (pts) with severe aplastic anemia (SAA) who have an HLA identical
      sibling donor. Late graft rejection to following allogeneic BMT for SAA is a
      significant clinical problem and is associated with a high risk of mortality. The
      optimal treatment strategy for patients with late graft rejection after first BMT
      is still an open question. We report 12-year-old patient with acquired SAA who
      underwent BMT from his HLA identical sister. BMT was first-line treatment within
      3 months of diagnosis. Preparative therapy was Cyclophosphamide (Cy) 200 mg/kg
      body mass (BM) during 4 days. Graft versus host disease (GVHD) was prevented with
      Methotrexate (MTX), Methylprednisolone (MPDN) and Cyclosporin A (CsA). After 17
      months, during which patient was with normal blood counts and full donor
      chimaerism, graft rejection occurred. The patient was re-engrafted from the same
      donor after conditioning with Cy 200 mg/kg BM plus horse antithymocyte globulin
      (ATG)--2 vials (a 25 mg)/10 kg BM over 4 days. Before the collection, donor's
      bone marrow was activated with low dose rhGM-CSF (3 micrograms/kg one day).
      Following a secondary BMT engraftment has sustained. The patient is alive with
      full donor chimaerism 26 months from secondary transplantation, without acute or
      chronic GVHD.

PMID- 11213683
TI  - [Secondary myelodysplastic syndrome after autologous transplantation of
      hematopoietic stem cells in a female patient with Hodgkin's disease].
AB  - Secondary acute myeloid leukemia with threelineage displasy (sAML/MDS) has been
      described as a complication of therapeutic approach with high-dose chemotherapy
      and autologous stem cell transplantation (SCT) in the patients with Hodgkin's
      disease (HD). It is not yet clear whether the sAML/MDS is a consequence of a
      standard therapeutic regimen, applied before transplantation, or a high-dose
      chemotherapy. In a female patient with initially resistant form of HD at III-B-b
      clinical stadium (bulky disease in neck and mediastinum) after the initial
      treatment (MOPPx4; ABVDx3; BEA-COPPx2), high-dose chemotherapy has been applied
      according to BEAM protocol with autologous SCT. In a period after
      transplantation, radiotherapy (RT) has been applied at initial region of the
      disease and a patient reached complete remission (CR), which lasted for a 27
      months. After that period sAML/MDS has been observed. Application of more
      standard therapeutic cycles and characteristic cytogenetic findings are the facts
      that support the opinion that sAML/MDS is a consequence of standard treatment
      before transplantation, rather than high-dose chemotherapy. That finding implies
      the need for correct choice of the HD patients suitable for early SCT therapeutic
      approach.

PMID- 11213684
TI  - Managing in the whitespace.
AB  - The assumption today is that new value in a company can be created only when
      people shed their suits, don khakis and Hawaiian shirts, and think and act like
      the most passionate entrepreneurs. The problem is, they're rarely told when it
      makes sense to do those things--or how to do them. With help from a team of
      ethnographers and senior organization specialists, authors Mark Maletz and Nitin
      Nohria recently conducted a unique research project that attempted to full those
      gaps. Their project focused on whitespace: the large but mostly unoccupied
      territory in every company where rules are vague, authority is fuzzy, budgets are
      nonexistent, and strategy is unclear--and where entrepreneurial activity that
      helps reinvent and renew an organization most often takes place. The researchers
      shadowed entrepreneurial managers operating in the whitespace and met with top
      managers about their efforts to oversee whitespace activities. Using examples
      from the financial services, computer, and e-commerce industries, the authors
      explain when it's imperative to operate in the whitespace--and when it's wiser to
      stay in the traditional blackspace. They describe how effective whitespace
      managers subtly and resourcefully lead successful efforts, and how senior
      executives nurture whitespace projects by putting aside their traditional
      planning, organizing, and controlling techniques. Finally, they examine the
      ultimate issue for any successful whitespace project: should it be moved into the
      blackspace, kept in the whitespace indefinitely--or, despite its apparent
      success, killed off? If companies leave this valuable territory to the
      scattershot whims and talents of individual managers, the authors say, they are
      likely to miss out on many of the opportunities that come from exploring the next
      frontier.

PMID- 11213685
TI  - The business against case revolution. An interview with Nestle's Peter Brabeck.
      Interview by Sue Wetlaufer.
AB  - One of the world's most enduring companies, Nestle epitomizes everything that
      today's high-flying, headline-grabbing companies are not. It respects technology
      but doesn't consider it central to strategy. It values growth but prefers it
      controlled. It seeks talented professionals but wants only those who are modest
      in word and deed. Nestle CEO Peter Brabeck is skeptical of the relentless push
      for radical transformation heard from every quarter. He believes, instead, in
      continuous improvement through slow and steady change. Big, dramatic change is
      fine for a crisis, Brabeck says, but not every company is in crisis all the time.
      Many companies are like Nestle--performing well, growing and innovating, without
      frenzy, without bloodshed. While he acknowledges that every company must change
      in order to compete in today's turbulent marketplace, Brabeck makes the focus of
      his work identifying and strengthening those aspects of Nestle that should stay
      the same. For example, Nestle eschews the noise and energy swirling around
      technology. Many companies make technology the focal point of strategy, Brabeck
      says, but Nestle is about people, products, and brands. The company uses
      technology to create better products but keeps it in its right place--the
      background. Brabeck also talks candidly about how to fight complacency in a
      successful company, how to institutionalize collaboration in a decentralized
      organization, and how to resist pressure from analysts and money managers and
      focus on long-term, sustainable and profitable growth--in short, how to win the
      war without the revolution.

PMID- 11213686
TI  - Price smarter on the Net.
AB  - Companies generally have set prices on the Internet in two ways. Many start-ups
      have offered untenably low prices in a rush to capture first-mover advantage.
      Many incumbents have simply charged the same prices on-line as they do off-line.
      Either way, companies are missing a big opportunity. The fundamental value of the
      Internet lies not in lowering prices or making them consistent but in optimizing
      them. After all, if it's easy for customers to compare prices on the Internet,
      it's also easy for companies to track customers' behavior and adjust prices
      accordingly. The Net lets companies optimize prices in three ways. First, it lets
      them set and announce prices with greater precision. Different prices can be
      tested easily, and customers' responses can be collected instantly. Companies can
      set the most profitable prices, and they can tap into previously hidden customer
      demand. Second, because it's so easy to change prices on the Internet, companies
      can adjust prices in response to even small fluctuations in market conditions,
      customer demand, or competitors' behavior. Third, companies can use the
      clickstream data and purchase histories that it collects through the Internet to
      segment customers quickly. Then it can offer segment-specific prices or
      promotions immediately. By taking full advantage of the unique possibilities
      afforded by the Internet to set prices with precision, adapt to changing
      circumstances quickly, and segment customers accurately, companies can get their
      pricing right. It's one of the ultimate drivers of e-business success.

PMID- 11213687
TI  - Are the strategic stars aligned for your corporate brand?
AB  - In recent years, companies have increasingly seen the benefits of creating a
      corporate brand. Rather than spend marketing dollars on branding individual
      products, giants like Disney and Microsoft promote a single umbrella image that
      casts one glow over all their products. A company must align three interdependent
      elements--call them strategic stars--to create a strong corporate brand: vision,
      culture, and image. Aligning the stars takes concentrated managerial skill and
      will, the authors say, because each element is driven by a different
      constituency: management, employees, or stakeholders. To effectively build a
      corporate brand, executives must identify where their strategic stars fall out of
      line. The authors offer a series of diagnostic questions designed to reveal
      misalignments in corporate vision, culture, and image. The first set of questions
      looks for gaps between vision and culture; for example, when management
      establishes a vision that is too ambitious for the organization to implement. The
      second set addresses culture and image, uncovering possible gaps between the
      attitudes of employees and the perceptions of the outside world. The last set of
      questions explores the vision-image gap--is management taking the company in a
      direction that its stake-holders support? The authors discuss the benefits of a
      corporate brand, such as reducing marketing costs and building a sense of
      community among customers. But they also point to cases in which a corporate
      brand doesn't make sense--for instance, if you are a product incubator, if you've
      recently experienced M&A activity, or if you are expecting fallout from risky
      ventures.

PMID- 11213688
TI  - Retention through redemption.
AB  - Corporate America and the U.S. Navy share one big problem: employee retention.
      Today's knowledge workers hop from start-up to start-up. And 40% of the navy's
      new recruits leave the service before their four-year tours of duty are up. D.
      Michael Abrashoff came face to face with the navy's retention problem when he
      took command of the USS Benfold. Before he became captain, sailors couldn't get
      away from the ship fast enough. Today the vessel is the pride of the Pacific
      fleet, and sailors from other ships are clamoring to join its crew. In this
      firsthand account, Abrashoff explains how he got the ship and its crew back on
      course by breaking bad habits--personal and professional ones--and jettisoning
      old attitudes. During his 21 months aboard the Benfold, Abrashoff came to realize
      that in today's technology-intensive U.S. Navy, the traditional command-and
      control style wouldn't work. And it hadn't--the Benfold's 310 sailors had cheered
      derisively when Abrashoff's predecessor had left the ship. So he defied 225 years
      of navy tradition in his quest to engage the sailors in their work, increase
      their performance, and keep them around for their entire tours of duty. He
      retained his crew by redeeming them--showing them how to be not just better
      sailors but better people, too. That meant breaking them down when they were at
      their worst and then building them up to reach their best. It also meant personal
      redemption for Abrashoff; he resolved to really listen to what his sailors were
      saying. The result? Cost-saving ideas for the entire navy and surging confidence
      and commitment among crew members.

PMID- 11213689
TI  - Will disruptive innovations cure health care?

PMID- 11213690
TI  - Will disruptive innovations cure health care?

PMID- 11213691
TI  - Will disruptive innovations cure health care?

PMID- 11213692
TI  - Cheetah teams.
AB  - Your crucial new product is on the fast track, when suddenly a problem develops
      that threatens to derail it. Time to bring in the cheetah team.

PMID- 11213693
TI  - A better way to manage risk.
AB  - Through an innovative new policy forged with a single insurer, Honeywell is
      consolidating risks as diverse as fire protection and currency fluctuations--and
      saving a bundle.

PMID- 11213694
TI  - The law of the pack.
AB  - The value of the Internet lies in its connections, but some connections are more
      valuable than others. Which matter most? Reed's Law can tell you.

PMID- 11213695
TI  - Competing for supply.
AB  - The Internet was supposed to make it possible for anybody anywhere to get
      anything anytime. Instead, it's magnified suppliers' miscalculations into global
      shortages. But if the Net caused these supply chain woes, it's also the solution,
      says the CEO of a supply-chain software manufacturer.

PMID- 11213696
TI  - Marketing rules.
AB  - New research shows that the top-performing dot-coms aren't necessarily the ones
      with the best business models--they're the ones with the quickest, most
      responsive marketing.

PMID- 11213697
TI  - How we built a strong company in a weak industry.
AB  - When Roger Brown and Linda Mason decided to start a child care and early
      education company 15 years ago, they knew about the challenges inherent in the
      industry: no barriers to entry, low margins, few economies of scale, heavy
      regulatory oversight--to name just a few. But that didn't stop them. They
      eventually built Bright Horizons Family Solutions, a company that now has more
      than 340 high-quality child care centers, serving 40,000 children and employing
      12,000 people. How did they do it? Sheer determination helped. But even more
      important, they developed a business model that took advantage of industry
      weaknesses. When the couple sat down to hash out a plan for the company, they
      realized that the key to achieving profitability and creating barriers to entry
      was to partner with companies. They could achieve higher returns by having those
      companies build and outfit the centers and, at the same time, boost customer
      loyalty. Indeed, Bright Horizon's corporate clients came to see the state-of-the
      art centers as a way to distinguish themselves in the eyes of current and
      prospective employees. The high-quality child care attracted the best employees
      and raised retention rates. Brown's first-person account describes the
      difficulties the couple and their company faced along the way, including the
      struggle for funding and a board that questioned Bright Horizons' business model
      and basic philosophy of good child care. But, Brown says, the commitment to a
      singular business model and the determination to make strengths out of weaknesses
      made the impossible possible.

PMID- 11213698
TI  - When to trust your gut.
AB  - Many top executives say they routinely make big decisions without relying on any
      logical analysis. Instead, they call upon their "intuition," "gut instinct,"
      "hunches," or "inner voice"--but they can't describe the process much more than
      that. What exactly is gut instinct? In this article, author Alden Hayashi
      interviews top executives from companies such as America Online and Johnson and
      Johnson to find out how they make decisions. Hayashi also presents the research
      of leading scientists who suggest that our emotions and feelings might not only
      be important in our intuitive ability to make good decisions but may actually be
      essential. Specifically, one theory contends that our emotions help us filter
      various options quickly, even if we're not consciously aware of the screening.
      Other research suggests that professional judgment can often be reduced to
      patterns and rules; indeed, truly inspired decisions seem to require an ability
      to see similar patterns across disparate fields. A CEO who possesses that ability
      can craft a perfect strategy by detecting patterns that others either overlook or
      mistake for random noise. But various traits of human nature can easily cloud our
      intuitive decision making. One potential pitfall is our tendency to see patterns
      where none exist. Thus, continual self-checking and feedback are crucial, and
      some organizations have made these processes part of their corporate culture.

PMID- 11213699
TI  - Enlightened experimentation. The new imperative for innovation.
AB  - The high cost of experimentation has long put a damper on companies' attempts to
      create great new products. But new technologies are making it easier than ever to
      conduct complex experiments quickly and cheaply. Companies now have an
      opportunity to take innovation to a whole new level--if they're willing to
      rethink their R&D from the ground up.

PMID- 11213700
TI  - Finally, a way to put your Internet portfolio in order.
AB  - Eager to capitalize on the Internet's potential, many companies have allowed
      scores of on-line projects to bubble up throughout their organizations. The
      result? More harm than good, as companies find themselves confusing customers,
      aggravating employees, and wasting bushels of money. In this article, consultant
      Anthony Tjan explains how companies can do better. By adapting classical
      portfolio strategy to the digital age, executives can coordinate their Internet
      initiatives to avoid the needless headaches and spending, he says. Much of the
      market and industry data that underpin traditional portfolio analysis is
      unavailable for the Internet space, so Tjan replaces the two criteria used in
      traditional portfolio analysis--market position and industry attractiveness--with
      business viability and business fit. Viability captures the available
      quantitative data about an investment's likely payoff. Fit is qualitative; it
      measures the degree to which an investment dovetails with a company's existing
      processes, capabilities, and culture. Using viability and fit to assess their
      online initiatives, companies can then plot these efforts onto a simple matrix,
      called an Internet portfolio map. Their location on the matrix will suggest
      whether each initiative should be invested in, redesigned, sold or spun out, or
      killed. As Tjan notes, the process of organizing and evaluating new investment
      options against coherent, meaningful criteria isn't new. In the digital era, what
      is new are the tools you use. Internet portfolio planning is one such tool.

PMID- 11213701
TI  - Breakthrough bargaining.
AB  - Unspoken, subtle parts of a bargaining process--also known as the shadow
      negotiation--can set the tone for a successful negotiation. Deborah Kolb and
      Judith Williams, whose book The Shadow Negotiation was the starting point for
      this article, say there are three strategies businesspeople can use to guide
      these hidden interactions. Power moves are used when two negotiating parties hold
      unequal power--for instance, subordinates and bosses; new and existing employees;
      and people of different races, ages, or genders. These strategies, such as
      casting the status quo in an unfavorable light, can help parties realize that
      they must negotiate: they will be better off if they do and worse off if they
      don't. Process moves affect how negotiation issues are received by both sides in
      the process, even though they do not address substantive issues. Working outside
      of the actual bargaining process, one party can suggest ideas or marshal support
      that can shape the agenda and influence how others view the negotiation.
      Appreciative moves alter the tone or atmosphere so that a more collaborative
      exchange is possible. They shift the dynamics of the shadow negotiation away from
      the adversarial--helping parties to save face--and thus build trust and encourage
      dialogue. These strategic moves don't guarantee that all bargainers will walk
      away winners, but they help to get stalled negotiations moving--out of the dark
      of unspoken power plays and into the light of true dialogue.

PMID- 11213702
TI  - [Honestly--did you read the Helsinki declaration? A new version of the
      fundamental basis of medical research ethics].

PMID- 11213703
TI  - [Routine use of placebos is questioned. Clear standpoint in the Helsinki
      declaration].

PMID- 11213704
TI  - [Still a small problem with the mad cow disease? Creutzfeldt-Jakob disease and
      other prion diseases: current status].
AB  - This review is based on recent published research on the BSE/CJD/vCJD problem
      mainly from UK, Germany and France. The situation in Sweden seems to be fortunate
      for several reasons. The use of meat and bonemeal as animal fodder was forbidden
      in this country 13 years ago. Sweden has not had any sheep with scrapie for many
      years. No animals with BSE have so far been found in our country. The incidence
      of sporadic CJD in this country followed retrospectively from 1985 to 1996 and
      prospectively from 1997 to 1999 has been around 1.2 per million per year with no
      significant increase. Only few cases of familial CJD are known. No patient with
      iatrogenic CJD has ever been found. The use of growth hormone derived from human
      pituitary glands was abandoned in 1985 when recombinant human growth hormone
      became available. So far there is no indication that any of the CJD cases
      diagnosed in Sweden has been of the vCJD type, the one linked to BSE. However, as
      the incubation period for prion diseases is very long and the Swedes are frequent
      travellers there is a risk that people from our country could have contracted
      vCJD through consuming meat products in countries with BSE. As a precaution the
      consumption of brain, spinal cord, lymphatic tissue, lungs, and gastrointestinal
      tract should be avoided. Human pituitary derived growth hormone is still
      available in some countries and might be illegally imported into Sweden.

PMID- 11213705
TI  - [Patient based care registries as a tool to follow up services].
AB  - The Federation of Swedish County Councils and six medical specialties are working
      together in a project aiming to support and stimulate the development of patient
      based case registers as a tool to follow up, evaluate, develop and manage medical
      units. The project is based on participation on the part of the medical
      professions in a process-oriented way. Each case register shall be based on the
      individual patient, and will integrate inpatient and outpatient care, all medical
      professions and important procedures. In hematology the project also seeks to
      merge case costing data with the patient based case registers in order to
      facilitate more comprehensive cost analysis and comparison. This episodic
      perspective is useful for providers per se as well as in discussions between
      purchasers and providers as a method for understanding and analyzing medical
      services. The six specialties are hematology, obstetrics and gynecology,
      ophthalmology, otorhinolaryngology, dermatology and sexually transmitted
      diseases, and lastly psychiatry.

PMID- 11213706
TI  - [Family therapy appropriate even in somatic care. Study review of medically
      oriented family therapy].
AB  - By observing and analyzing the influence of the therapist on the family as well
      as interactions between family members, the encounter with a family in a medical
      setting can serve to improve the health of its members, by improving their
      ability to use their own resources. This method of focusing on the interaction
      between individuals in a family or other systems has been a valuable addition to
      medical treatment of chronic disease. Family therapy has been shown to
      effectively improve treatment of diabetes, asthma and obesity. A review of the
      literature is presented.

PMID- 11213707
TI  - [How Hippocrates became the father of medicine].

PMID- 11213708
TI  - [Meniere and lemology--comments and a reply].

PMID- 11213709
TI  - [Difficult heart-questions: pacemaker, prolapse and downgrade].

PMID- 11213710
TI  - [Craig Venter: higher intelligence is not always related to bigger genome].

PMID- 11213711
TI  - [Role of the genetic code for public disease and behavior].

PMID- 11213712
TI  - [Laughter is nothing to joke about. A quality of value for survival].

PMID- 11213713
TI  - [Comment to the opinion-based campaign against neuropsychiatry].

PMID- 11213714
TI  - [Urgent with an interdisciplinary conference on DAMP/ADHD].

PMID- 11213715
TI  - [Scrutinize and diagnose the public environment of children, also].

PMID- 11213716
TI  - [Seven criteria for clinical research ethics. Useful when used with love for
      medicine and patients].

PMID- 11213717
TI  - [An appeal to support Christopher Gillberg's research and fight for children with
      neuropsychiatric disabilities].

PMID- 11213718
TI  - [Physicians and psychiatrists in school health services in Stockholm: we know how
      important a correct diagnosis is for children with neuropsychiatric problems ].

PMID- 11213719
TI  - [Shortage of psychotherapeutic methods in neuropsychiatric functional disorder].

PMID- 11213721
TI  - [The myth about water].

PMID- 11213720
TI  - [The National Board of Health and Welfare: 25 percent of general practitioners in
      other specialties].

PMID- 11213722
TI  - Delaware's medicolegal investigation of death. Part 1.
AB  - In 1194, the coroner system was formally established in England with the original
      interest in death to protect the financial interest of the crown. This coroner
      system was brought to the United States during the early 1600s where the first
      recorded autopsy was performed in Massachusetts in 1647. Significant changes were
      made to improve upon the coroner system. In 1877, the first medical examiner
      system was established in the state of Massachusetts requiring that the coroner
      be supplanted by a physician known as a medical examiner. Using the system
      established in Massachusetts as a model, New York City developed an improved
      medical examiner system in 1915. The improvements made by New York City, under
      the leadership of men such as Drs. Charles Norris and Alex Gettler, essentially
      laid down the foundation for medical examiner systems and forensic toxicology
      throughout the country. Part II of this series will begin in Maryland. Maryland
      soon followed in New York City's footsteps and in 1939 developed the first
      statewide medical examiner system in the U.S. Influenced by systems such as
      Maryland's and New York City's, Delaware established a medical examiner system in
      1955 to work alongside of the pre-existing coroner system. It was not until about
      a decade later in 1964 that the system became successful under the leadership of
      Dr. All Z. Hamell. In 1970, after 15 years of uphill battles with supporters of
      the antiquated coroner system, it was abolished, resulting in a statewide medical
      examiner system. Today, Delaware's medical examiner system has one of the best
      medicolegal investigative facilities in the country, complete with its own
      forensic sciences laboratory under the jurisdiction of a Chief Medical Examiner.
      Delaware's Office of Chief Medical Examiner will try to continue its tradition to
      serve as a model for other states and possibly other countries to follow.

PMID- 11213723
TI  - Litigation run amuck.

PMID- 11213724
TI  - Voluntary Initiative Program II.

PMID- 11213725
TI  - [Ultrastructure and elemental composition of frog bladder granular epithelial
      cells in normal state and upon stimulation of water transport].
AB  - Changes in the frog urinary bladder granular cell ultrastructure were analysed in
      parallel with those in element composition of these cells after induction of
      water transport across the urinary bladder wall. Two ultrastructural (ultrathin
      section and freeze-fracture) methods were used in addition to two methods of
      object preparation for electron microprobe analysis--freeze-drying and freeze
      substitution. It has been shown that arginin-vasotocin stimulation of osmotic
      water flow across the urinary bladder wall causes certain morphological changes
      in the granular cells: decrease in electron density of the cytoplasm,
      depolymerization of the apical submembrane layer of actin microfilaments,
      increase in the number of sites of specific granules and apical membrane fusion,
      emergency of intramembrane particle aggregates in the apical membrane P-face. The
      quantitative electron microprobe analysis made it possible to reveal a
      statistically significant increase in sodium and calcium concentration and fall
      in that of potassium and chlorine in granular cells after water transport
      stimulation. A concentration gradient of sodium and potassium ions was seen to
      appear along the apical-basal axis in the cytoplasm of granular cells. Possible
      association between the obvious morphological transformations in granular cells
      and changes in their elemental composition has been discussed, in addition to
      some regulatory significance of calcium concentration increase in granular cells
      after arginin-vasotocin-induced osmotic water transport.

PMID- 11213726
TI  - [Stereologic analysis of vacuolization of the T-system of frog muscle fibers,
      detected using confocal fluorescence microscopy].
AB  - The confocal fluorescence microscopy has been used for quantitative evaluation of
      the T-system reversible vacuoles produced by efflux of 80-120 mM glycerol from
      frog skeletal muscle fibers. The fibers were stained by membrane probe RH414 and
      by water-soluble dye fluorescein dextran that marks the vacuolar lumen. Using
      morphometrical and stereological methods the volume and surface densities of
      vacuoles were measured on single optical sections and Z-series during a 30 min
      glycerol efflux. Various methods of measurements (three-dimensional
      reconstruction of vacuoles, computer morphometry, point counting method) applied
      to the same Z-series provide similar results. The vacuolar membranes stained by
      RH414 look like bright rings 0.3-0.4 micron in width. It is concluded that the
      real position of vacuolar membrane corresponds to the middle of the vacuolar
      envelope. The measurements of the external dimensions of the envelope
      overestimate the stereological parameters up to 50%. The volume density of
      vacuoles reaches 10% within 20-30 min of glycerol efflux. It means that the
      volume of the T-system may increase by 25-30 times compared to the control value
      (0.3-0.4%). The surface density of vacuoles during reversible vacuolation is
      equal to 0.20-0.35 micron-1 and does not exceed the surface density of normal T
      system. The sufficiency of membrane material for the T-system reversible
      vacuolation is discussed in addition to the role of geometrical factor in this
      phenomenon.

PMID- 11213727
TI  - [Electrophoretic forms of glucose-6-phosphate dehydrogenase, acid phosphatase and
      esterase in Amoeba species amoebas].
AB  - Glucose-6-phosphate dehydrogenase (G6PD), acid phosphatase and esterases in free
      living amoebae of 7 Amoeba species were investigated with the use of disc
      electrophoresis in polyacrylamide gel. The evidence provided is suggestive that
      the electrophoretic isoenzyme patterns of acid phosphatase and esterases (and
      G6PD in some cases), in addition to a few morphological characters, can serve as
      a taxonomic criterion for species identification within this genus, as well as
      for revealing erroneously classified species and strains. It is suggested that A.
      indica is an independent species whose preliminary diagnosis has been given in
      this paper. It is concluded that A. discoides and A. lescherae are strains of A.
      proteus, rather than two independent species. A and As-102 amoebian strains, kept
      in the collection of protozoan strains and species of the Institute of Cytology
      RAS and referred to as strains of A. proteus, belong in reality to another Amoeba
      species and even to another genus within the family Amoebidae. This conclusion
      has been documented by results of our analysis of electrophoretic patterns of
      acid phosphatase and esterases in these strains.

PMID- 11213728
TI  - [Effect of cytomedins on development of organotypic culture of various tissues
      from the internal organs of rats].
AB  - Some natural peptides, referred to as cytomedines, were isolated from different
      organs: cortexin and epithalamin (both from the brain), cordialin (heart),
      hepalin (liver) and thymalin (thymus),--to test their stimulating effects on the
      growth in organotypic culture of different tissue explants taken from 3 day old
      rats. It has been found that these peptides exerted their obvious stimulating
      effects on the growth of the cultured explants, compared to the control, if taken
      in the respective concentrations: 100, 50, 50, 100 and 5 ng/ml. Thus, these
      cytomedins can be used in the clinical practice for stimulating reparative
      processes in the appropriate tissues.

PMID- 11213729
TI  - [Function of an inhibitor of cyclin-dependent kinase p27/Kip in cells transformed
      by E1A + E1B19 kDa + E1A + cHa-Ras, differing in their ability to realize a G1
      block during serum starvation].
AB  - We studied the capability of E1A + cHa-ras and E1A + E1B19kDa transformants to
      undergo the G1/S arrest of the cell cycle following depletion of serum growth
      factors. It has been shown that serum starvation induced the G1/S arrest both in
      normal rat embryo fibroblasts (REF) and in E1A + E1B19kDa transformants, whereas
      E1A + cHa-ras transformed cells lost this feature. To analyse the mechanisms
      underlying these differences, we studied the expression of p27/KIP, its
      intracellular distribution and association with E1A oncoproducts. The content of
      the p27/KIP inhibitor of cyclin-dependent kinases was found to change a little
      upon transformation by two complementary oncogene pairs. However, serum
      starvation for 24 h led to a significant increase in the content of p27/KIP in
      E1A + E1B19kDa transformants, while E1A + cHa-ras cells accumulated p27/KIP less
      markedly. According to the immunofluorescence study, the p27/KIP inhibitor is
      located in the nucleus of both normal and transformed cells. Moreover, serum
      starvation did not lead to its inhibition due to redistribution to the cytoplasm
      in both cell lines. Also, we were unable to detect association of p27/KIP with
      E1A oncoproducts in immunoprecipitated complexes. The obtained data indicate
      that, in contrast to E1A + cHa-ras transformants, in E1A + E1B19kDa cells the
      p27/KIP inhibitor is functional and it is capable of inducing the G1/S block
      after serum starvation.

PMID- 11213731
TI  - [Disruption of male meiosis in transgenic line tobacco res91].
AB  - The course of meiosis in male-sterile trasgenic tobacco line res91 has been
      analysed. Cytological analysis included visualization of the spindle and
      phragmoplast. Abnormal meiosis was characterized with 1) cytomixis; 2)
      deformation of nuclei at prophase 2 in part of the cells, and lack of spindle
      formation in such cells at M2; 3) desorientation of spindles in meiosis 2. This
      set of abnormalities allows to suppose certain disturbancies of cytoskeleton
      during male meiosis in res91.

PMID- 11213730
TI  - [Both alpha1- and beta-adrenergic receptors participate in generation of a Ca2+
      response to noradrenaline in murine brown preadipocytes].
AB  - It has been shown that in Ca(2+)-signal generation, at the addition of
      norepinephrine (NE) to a suspension of freshly isolated brown preadipocytes, beta
      receptors participate alongside with alpha 1-adrenoreceptors. The amplitude of
      cell response to 10(-5)-10(-8) M NE is approximately equal to the sum of effects
      of alpha 1-specific agonists (oxymetazoline or cirazoline) and beta-selective
      agonist isoproterenol. beta-Selective antagonist nadolol practically completely
      prevented the effect of NE on the intracellular Ca2+ level, while phentolamine,
      an antagonist of alpha-receptors, caused only a approximately 25% inhibition of
      the cellular response.

PMID- 11213732
TI  - [Effect of age on frequency of heteroploidy in human oocytes].
AB  - Human oocytes that failed to be fertilized in vitro were fixed for cytogenetic
      analysis. Successful karyotyping was achieved in 157 oocytes. Among women aged 23
      35 years, 34% of oocytes were aneuploid and 8.6% diploid, while for women aged 36
      39 years, these values exceeded 41 and 11.8%, respectively. The proportion of
      aneuploid and diploid oocytes increased significantly as the maternal age
      advanced. The rate of chromosomal abnormalities with age was analysed using
      methods of mathematical modelling.

PMID- 11213733
TI  - Vascular hamartoma of the orbit.
AB  - The aim of this presentation is to report a combined form of vascular
      malformation of the orbit. A 2-year-old girl had a four-month history of severe
      proptosis in the right eye. The patient had intermittent proptosis in association
      with a common cold. The globe was displaced downward and extraocular motility was
      markedly limited. Multiple intraconal and some extraconal cysts were removed with
      transcutaneous transseptal anterior orbitotomy. Histological examination showed
      several characteristics of vascular anomaly. There were malformatively dilated
      veins intermingled with dilated lymphatic channels, focal cavernous and capillary
      hemangiomatous features. This combined form of vascular anomaly can be presented
      as a venous lymphatic malformation associated with hemangiomatous features.

PMID- 11213734
TI  - Two cases of orbital infarction syndrome.
AB  - Orbital infarction syndrome is defined as ischemia of all intraorbital and
      intraocular structures. It is a rare disease caused by rich anastomotic
      vascularization of the orbit. It can occur secondary to different conditions,
      such as, acute perfusion failure, systemic vasculitis, orbital cellulitis and
      vasculitis. It results in orbital and ocular pain, total ophthalmoplegia,
      anterior and posterior segment ischemia, and acute blindness. We report here upon
      two cases of orbital infarction with similar presentations but with different
      causes, namely, mucormycosis and as a postoperative complication of intracranial
      aneurysm, discuss the possible mechanisms of orbital infarction, and present a
      review of the literature on the topic. The prompt recognition of clinical
      pictures and rapid diagnosis is essential for the early treatment of orbital
      infarction, since its progression is very rapid and it can be even fatal.

PMID- 11213735
TI  - Effect of zinc on the visual sensitivity of the bullfrog's eye.
AB  - There is a high concentration of zinc in ocular tissue, especially the
      retinachoroids, and the presence of physiological levels of zinc in these tissues
      seems essential for their normal function. The purpose of our study was to
      clarify this point using electroretinogram (ERG) recordings and spectrophotometer
      measurements before and after zinc treatment in a bullfrog's eye. The optimal
      zinc concentration used in this experiment was 1 microM ZnCl2, 100 microliters/6
      ml ringer solution, with the result that the total zinc concentration in the
      ringer solution was 16.4 nM. To determine the effects of zinc on the retinal
      function, the changes of ERG parameters, such as threshold, a-, b- and c-waves
      and absorption spectra were observed before and after zinc treatment. It is
      noteworthy that high concentrations of zinc are present in the retina and the
      retinal pigment epithelium. Our results indicate that zinc treatment elevated the
      dark-adapted ERG threshold, all of the peak amplitudes of ERG were increased and
      rhodopsin regeneration was accelerated during visual adaptation. In spectral
      scans, absorbance increment due to zinc treatment was shown over the whole range
      of spectral scanning (300 nm-750 nm). We believe that zinc, which is abundant in
      the retina and the retinal pigment epithelium particularly, is an essential
      factor for the visual process and may be required to improve visual sensitivity
      during visual adaptation.

PMID- 11213736
TI  - Feeder vessel laser photocoagulation of subfoveal choroidal neovascularization.
AB  - We performed laser photocoagulation for extrafoveal feeder vessels in a series of
      10 eyes with subfoveal choroidal neovascular membranes (CNVMs) in which feeder
      vessels could be detected by means of indocyanine green angiography using
      scanning laser ophthalmoscope. On the follow up indocyanine green angiograms
      performed within one week after treatment, successful occlusion of the feeder
      vessels with nonperfusion of the corresponding CNVMs was observed in 8 eyes
      (80%). Four eyes showed improved visual acuities with resolution of the exudative
      manifestation. But within 3 months, recanalization of the feeder vessels or
      further proliferation of the CNVMs developed in 7 eyes. We confirmed the
      possibility of infarction and regression of the CNVM by feeder vessel
      photocoagulation, which could improve the visual acuity. But it was rarely
      possible to maintain them.

PMID- 11213737
TI  - Axial length in branch retinal vein occlusion.
AB  - To determine the effects of axial length on the development of branch retinal
      vein occlusion (BRVO), determination of the affected eye, development of surgical
      complications, and visual prognosis, axial length was measured in 27 eyes each in
      surgical, non-surgical and control group and in 54 eyes each in occlusion
      (surgical + non-surgical group), non-affected eye (non-affected eyes of occlusion
      group), and non-occlusion group (both eyes of the control group). The average
      axial length was 22.61 mm in surgical, 22.48 mm in non-surgical, 23.09 mm in
      control, 22.55 mm in occlusion, 22.56 mm in non-affected eye, and 23.11 mm in non
      occlusion group. The axial length showed a statistically significant difference
      between surgical and control group (p = 0.018), between non-surgical and control
      group (p = 0.002), and between occlusion and non-occlusion group (p < 0.001);
      however, no statistically significant difference was seen between surgical and
      non-surgical group, between non-affected eyes of surgical and non-surgical group,
      and between occlusion and non-affected eye group. Also, in such as BRVO groups as
      surgical, non-surgical, and occlusion groups, no correlation was present between
      axial length and degree of visual acuity recovery and final visual acuity.
      Although the possibility of developing BRVO is higher in those with short axial
      length, the axial length may have no relationship with the determination of the
      affected eye, visual prognosis and development of surgical complications.

PMID- 11213738
TI  - Biomicroscopic vitreous observation using a 3 CCD video camera and a personal
      computer for image capture and archiving.
AB  - The purpose of this study is to evaluate the clinical usefulness of a newly
      developed biomicroscopic vitreous observation system. Vitreous observation was
      performed in 300 eyes with age- or disease-related vitreous changes using a 3 CCD
      video camera mounted on a slit-lamp biomicroscope and connected to a personal
      computer for real-time observation and especially for the capture and archiving
      of images. Various types of fundus lenses were used to scan the vitreous status
      systemically from the posterior pole to the vitreous base. This system allowed us
      to obtain and immediately review the images of the vitreoretinal relationship.
      The image quality was sufficient for clinical evaluation of the vitreous status.
      We were able to identify some variations of posterior vitreous detachments and
      clarify the changes of the vitreoretinal interface in the study eyes. This system
      is very useful for the dynamic observation and documentation of vitreous images
      in order to determine the role of vitreous in many vitreoretinal disorders.
      Furthermore it is more convenient and affordable than previous methods.

PMID- 11213739
TI  - Management of posteriorly dislocated intraocular lens using pars plana
      vitrectomy.
AB  - In order to evaluate the results of pars plana vitrectomy (PPV) for the treatment
      of posteriorly dislocated intraocular lens (PC-IOL), we retrospectively examined
      and analyzed the hospital records of patients who had undergone PPV to exchange
      or reposition a PC-IOL dislocated into the vitreous cavity. Of 20 eyes in 20
      patients, IOL exchange was performed in 6 eyes, and IOL repositioning in 14 eyes.
      Posteriorly dislocated IOL occurred in 14 eyes during or within 2 days, and in 6
      eyes 6 months after the IOL implantation. Thirteen eyes were surgically treated
      early after the occurrence, within 3 days, while 7 eyes were treated later,
      between 5 to 7 days. Compared with preoperative best-corrected visual acuity, the
      final visual acuity improved more than 2 lines in 12 eyes. With no significant
      difference on the statistics, earlier visual rehabilitation seemed to be shown in
      late-treated patients than in early-treated. Accordingly, a posterior dislocation
      of IOL can be successfully treated with PPV, and barring any serious
      complications such as retinal detachment, there is no need for surgery
      immediately following the occurrence.

PMID- 11213740
TI  - Telomerase activity in pterygeal and normal conjunctival epithelium.
AB  - All pterygia have similar histologic features of solar degeneration seen in the
      skin such as acanthosis, keratosis, or hyperkeratosis. Although the pathogenesis
      of pterygia is still unclear, an association with solar exposure, in particular
      with UV radiation, has been reported. Telomerase activity has been found to be
      higher in some degenerative, precancerous, and cancerous skin lesions. We
      investigated telomerase activity in the epithelium and the stromal tissues of the
      pterygium. Pterygeal tissues were obtained from 30 patients. Telomerase activity
      was measured with TRAPeze-ELISA kit. Three of the 28 (10.7%) pterygeal stromal
      tissues demonstrated positive telomerase activity. Fourteen of the 27 (51.9%)
      epithelial tissues were positive in telomerase activity, whereas telomerase
      activity was positive in only 3 of 9 normal epithelia (33.3%). Telomerase
      activity in the pterygium-covered epithelium was increased as compared with that
      seen in the normal epithelium, but the increase was not statistically
      significant. In conclusion, telomerase activity was somewhat increased in
      pterygeal tissues. Telomerase activity may be involved in the pathogenesis of
      pterygium.

PMID- 11213741
TI  - Congenital nasolacrimal duct obstruction: irrigation or probing?
AB  - The authors investigated the efficacy of antibiotic irrigation as the therapeutic
      option in congenital nasolacrimal duct obstruction. We retrospectively reviewed
      the medical record of 76 patients' eyes in whom congenital nasolacrimal duct
      obstruction had been diagnosed. In 50 of these patients, the colonizing
      microorganism was identified and, irrigation through canaliculi was performed
      using antibiotics of suitable sensitivity. Nasolacrimal system probing was
      performed on 26 patients as the control group. Treatment was regarded successful
      when over a 4 week period epiphora or mucous discharge disappeared and when
      saline passed without resistance on irrigation. 96.0% of patients in the
      irrigation group and 84.6% of patients in probing group were treated
      successfully. There was no statistical difference in the success rate between the
      two groups (P = 0.173). The recovery period based on culture results was 3.22 +/-
      0.37 months in the group in which microorganisms were isolated and 2.39 +/- 0.35
      months in the group in which no organisms were isolated. There were no
      statistically significant differences in the success rates between the group in
      which there was growth and the group in which there was no growth (P = 0.1308).
      Thus a similar result was obtained using nasolacrimal probing and canaliculus
      antibiotic irrigation in congenital nasolacrimal duct obstruction. Antibiotic
      irrigation is a safe and simple therapeutic option in congenital nasolacrimal
      duct obstruction.

PMID- 11213742
TI  - Hepatocellular carcinoma metastatic to the orbit.
AB  - Orbital metastases of hepatocellular carcinoma are rare. The authors report a
      case of hepatocellular carcinoma metastatic to the orbit. A 56-year-old woman
      with hepatitis B infection as confirmed serologic test for hepatitis B surface
      antigen (HBsAg) demonstrated superior displacement of the left eyeball. The
      clinical appearance of the patient demonstrated an inferior displacement of the
      right eye. MRI disclosed an orbital mass that extended toward the lower eyelid
      and into the temporal fossa with destruction of the lateral orbital wall. Upon
      subsequent abdominal computed tomographic scans, the primary tumor was found in
      the liver. A biopsy specimen of the orbit showed trabecular structures with
      eosinophilic cytoplasm. Bile canaliculi and sinusoids were also seen. The tumor
      cells showed vesicular nuclei with mitoses. Immunohistochemical markers such as
      high-molecular-weight keratin and alpha-fetoprotein showed a positive response.
      However, immunohistochemical markers such as low-molecular-weight keratin and
      polyclonal carcinoembryonic antigen showed as negative. We diagnosed the tumor as
      a hepatocellular carcinoma metastatic to the orbit. A review of the pertinent
      literature disclosed relatively few occurrences of hepatocellular carcinoma
      metastasizing to the orbit.

PMID- 11213743
TI  - Web sites, portals, and channels: e-strategies for consumer relationship
      management.

PMID- 11213744
TI  - A realistic outlook for Web strategy.

PMID- 11213745
TI  - Ten Internet strategies for connecting with health consumers.

PMID- 11213746
TI  - Retaining good employees in tough times. Part II: Six strategies for retention.

PMID- 11213747
TI  - Aggressive nutrition intervention. Staff training is key to ensuring positive
      outcomes.

PMID- 11213748
TI  - Assessment of patients (PE).

PMID- 11213749
TI  - Enhancing working conditions and patient safety.

PMID- 11213750
TI  - CDC looks to update HIV guidelines.

PMID- 11213751
TI  - Conflict to cooperation: integrating social work into your CM model.
AB  - Ann Marie Distasio, RN, BSN, MSA, became acutely aware of the turf battle between
      RN case managers and social workers when she began work as the director of case
      management at Memorial-Hermann Memorial City Hospital in Houston. She saw a real
      fear in her social workers that their importance to the department was
      compromised. But a common goal among hospitals is a revised approach to case
      management that negates the fear. It enforces a sharing philosophy, making sure
      that each discipline's expertise is used most appropriately to advance the best
      patient management.

PMID- 11213752
TI  - Reclaim your denials to help save bottom line.
AB  - Johns Hopkins Hospital in Baltimore provides an excellent real-life example of
      how to manage claims denials for increased reimbursement. Hopkins gained more
      than $2 million when it revised its policies and procedures regarding claims
      denials. Jon Mayer, RN, FNP, MBA, a management consultant with Chicago-based
      Milliman and Robertson Inc., suggests getting case management involved early, at
      the contract negotiation stage.

PMID- 11213753
TI  - Cultural competence is a must for all hospitals.
AB  - It makes sense to move your facility to an attitude of cultural competency, not
      only because there are certain minimum requirements from the Joint Commission on
      Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, and other
      watchdogs, but also because it's the right thing to do, according to Beth Remus,
      an expert in the field of cultural awareness and competency in health care.

PMID- 11213754
TI  - Pathway achieves first steps toward improvement.
AB  - In 1999, Pomona Valley Hospital in Claremont, CA, saw a real need to revise its
      treatment of community-acquired pneumonia. After a thorough chart review and
      development of a new pathway, the case management team has taken an important
      step toward a standard of care.

PMID- 11213755
TI  - Higher risk of re-admits when patient can't read.

PMID- 11213756
TI  - Hiring how-to: use the Internet as supplement.
AB  - Although the Internet generally is the first place people look for job
      opportunities these days, Elaine Cohen, EdD, RN, director of case management at
      the University of Colorado Health Services Center in Denver, does not see a real
      need to go on-line for qualified case manager candidates. However, Cohen
      acknowledges that the Internet is a good tool to contact and interact with
      potential employees.

PMID- 11213757
TI  - Special report: building a successful CM career. Directory of the top 12 CM
      credentials.

PMID- 11213758
TI  - A preliminary functional brain study on amputees.
AB  - The purpose of this study was to verify whether brain activation could be used to
      modulate the movements of an artificial limb. This approach was begun 20 years
      ago with the fitting of prostheses immediately following lower-limb amputations.
      We studied 9 unilateral amputees and 9 control participants using functional MRI,
      electroneuromyography, gait laboratory, and neuropsychological assessments. The
      results demonstrated that brain activation is analogous when participants in the
      control group are asked to mentally move a foot, compared with amputees who are
      asked to move a nonexistent foot. The brain has not been damaged and maintains
      its areas of command. This can be applied in rehabilitation.

PMID- 11213759
TI  - Multiple imputation and posterior simulation for multivariate missing data in
      longitudinal studies.
AB  - This paper outlines a multiple imputation method for handling missing data in
      designed longitudinal studies. A random coefficients model is developed to
      accommodate incomplete multivariate continuous longitudinal data. Multivariate
      repeated measures are jointly modeled; specifically, an i.i.d. normal model is
      assumed for time-independent variables and a hierarchical random coefficients
      model is assumed for time-dependent variables in a regression model conditional
      on the time-independent variables and time, with heterogeneous error variances
      across variables and time points. Gibbs sampling is used to draw model parameters
      and for imputations of missing observations. An application to data from a study
      of startle reactions illustrates the model. A simulation study compares the
      multiple imputation procedure to the weighting approach of Robins, Rotnitzky, and
      Zhao (1995, Journal of the American Statistical Association 90, 106-121) that can
      be used to address similar data structures.

PMID- 11213760
TI  - Symmetrically dependent models arising in visual assessment data.
AB  - Given data from bilateral visual assessments on N subjects at k occasions, we
      consider inference for contralateral correlations (C) between fellow eyes and
      lateral correlations (L) among p different assessments of the same eye. Under
      permutation symmetric dependence structure between observations from fellow eyes
      and among observations from the same eye, we obtain maximum likelihood estimates
      of L, C, and L-C. Based on the large-sample estimates of the corresponding
      covariance structures, we test the hypothesis that the association between fellow
      eyes is constant across time and the hypothesis that lateral and contralateral
      associations between any two occasions are the same.

PMID- 11213762
TI  - OIG to target ineligible SNF stays, duplicative payments in fiscal 2001.

PMID- 11213761
TI  - A diagnostic for Cox regression with discrete failure-time models.
AB  - Changes in maximum likelihood parameter estimates due to deletion of individual
      observations are useful statistics, both for regression diagnostics and for
      computing robust estimates of covariance. For many likelihoods, including those
      in the exponential family, these delete-one statistics can be approximated
      analytically from a one-step Newton-Raphson iteration on the full maximum
      likelihood solution. But for general conditional likelihoods and the related Cox
      partial likelihood, the one-step method does not reduce to an analytic solution.
      For these likelihoods, an alternative analytic approximation that relies on an
      appropriately augmented design matrix has been proposed. In this paper, we extend
      the augmentation approach to explicitly deal with discrete failure-time models.
      In these models, an individual subject may contribute information at several time
      points, thereby appearing in multiple risk sets before eventually experiencing a
      failure or being censored. Our extension also allows the covariates to be time
      dependent. The new augmentation requires no additional computational resources
      while improving results.

PMID- 11213763
TI  - Paying the piper: HCFA guidance on survey revisits raises concerns about
      continuation of penalties.

PMID- 11213764
TI  - What to do when Medicare asks for its money back. Part I: The top reasons for
      post-payment denials.

PMID- 11213765
TI  - Small employers give coverage a big boost.

PMID- 11213766
TI  - Who'll get soaked if Medicare covers drugs?

PMID- 11213767
TI  - E-health, your workforce and you.

PMID- 11213768
TI  - Retiree benefits just fading away.

PMID- 11213769
TI  - Union Pacific ... on the right track.

PMID- 11213771
TI  - DataWatch. Premiums rise while employee share drops.

PMID- 11213770
TI  - Blocked laws and bad language.

PMID- 11213772
TI  - Words for the wise. To make your message heard, it's best to paint a verbal
      picture.

PMID- 11213773
TI  - The fear factor.

PMID- 11213774
TI  - Synthesis of new pyridoquinoxalines, thienopyridoquinoxalines and
      pyrimidothienopyridoquinoxalines.
AB  - Synthesis of 3-chloro-2-cyanoquinoxaline (1) and its reactions with sodium azide,
      guanidine hydrochloride, semicarbazide and thioheterocycles have been
      investigated (2-7). Also, the reaction of the chloro compound 1 with
      cyanoacetamide or cyanothioacetamide gave the pyrido[2,3-b]quinoxaline
      derivatives 8, 9. Compound 9 was used as a key intermediate to produce the more
      polyheterocyclic systems 10-18.

PMID- 11213775
TI  - Perceived need for and use of mental health services by women living with or at
      risk of human immunodeficiency virus infection.
AB  - OBJECTIVES: To determine prevalence of and factors associated with perceived need
      for and use of mental health services and use of psychotherapeutic medications
      among women in the Human Immunodeficiency Virus Epidemiology Research Study
      (HERS). METHODS: We interviewed 871 HIV-seropositive and 439 demographically and
      behaviorally similar seronegative women at baseline regarding demographics,
      psychosocial measures, substance use, medical history, and use of health care
      services and medications. RESULTS: Thirty-eight percent of HIV-seropositive women
      and 35% of seronegative women (p = 0.33) reported needing mental health services
      in the prior six months. Women who were older, were white or Latina (compared
      with African American), had some college education, had less social support, and
      reported recent negative life events or had CES-D scores higher than 15
      (suggesting depression) were more likely to report needing mental health
      services. Sixty-seven percent of seropositive and 65% of seronegative women who
      reported needing services (p = 0.69) reported obtaining services. Women who were
      white (compared with Latina or African American) and had more education, more
      social support, and health insurance were more likely to obtain services.
      Eighteen percent of seropositive and 13% of seronegative women (p = 0.006)
      reported current use of psychotherapeutic medications, especially antidepressants
      and antianxiety medications. Women who reported use of medications were more
      likely to report recent negative life events; were older, white, or Latina; had
      more education, less social support, CES-D scores higher than 15, and health
      insurance. CONCLUSION: Women both living with or at risk of HIV perceived a need
      for and used mental health services in association with negative life events,
      social isolation, and depressive symptoms. Need for and use of services differed
      by race/ethnicity, education, and availability of social support.

PMID- 11213776
TI  - Use of cyclosporin A as a steroid sparing agent in cystic fibrosis.

PMID- 11213777
TI  - Survey of criteria used to diagnose allergic bronchopulmonary aspergillosis in
      cystic fibrosis.

PMID- 11213778
TI  - Subnormal growth in children with Helicobacter pylori infection.

PMID- 11213779
TI  - Growth monitoring.

PMID- 11213780
TI  - Detecting outbreaks of E coli O157 infection in nurseries.

PMID- 11213781
TI  - Meningococcal disease due to W135: fresh public health concerns.

PMID- 11213782
TI  - Prevention and treatment of cow's milk allergy.

PMID- 11213783
TI  - Pyridoxine dependent and pyridoxine responsive seizures.

PMID- 11213784
TI  - Are sleep studies worth doing?

PMID- 11213785
TI  - Data presented do not justify pessimistic conclusions.

PMID- 11213786
TI  - Spacers and holding chambers: not the last word, we hope.

PMID- 11213787
TI  - The Collaborative Longitudinal Personality Disorders Study: reliability of axis I
      and II diagnoses.
AB  - Both the interrater and test-retest-retest reliability of axis I and axis II
      disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I
      Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders
      (DIPD-IV). Fair-good median interrater kappa (.40-.75) were found for all axis II
      disorders diagnosed five times or more, except antisocial personality disorder
      (1.0). All of the test-retest kappa for axis II disorders, except for
      narcissistic personality disorder (1.0) and paranoid personality disorder (.39),
      were also found to be fair-good. Interrater and test-retest dimensional
      reliability figures for axis II were generally higher than those for their
      categorical counterparts; most were in the excellent range (> .75). In terms of
      axis I, excellent median interrater kappa were found for six of the 10 disorders
      diagnosed five times or more, whereas fair-good median interrater kappa were
      found for the other four axis I disorders. In general, test-retest reliability
      figures for axis I disorders were somewhat lower than the interrater reliability
      figures. Three test-retest kappa were in the excellent range, six were in the
      fair-good range, and one (for dysthymia) was in the poor range (.35). Taken
      together, the results of this study suggest that both axis I and axis II
      disorders can be diagnosed reliably when using appropriate semistructured
      interviews. They also suggest that the reliability of axis II disorders is
      roughly equivalent to that reliability found for most axis I disorders.

PMID- 11213789
TI  - [Secondary hyperparathyroidism].

PMID- 11213788
TI  - The Collaborative Longitudinal Personality Disorders Study: development, aims,
      design, and sample characteristics.
AB  - This paper describes the aims, background, design, and methods used in a
      collaborative longitudinal study of Axis II personality disorders (PDs). This
      study examines the putative stability of selected PD diagnoses and criteria, what
      factors affect their course, and whether their stability and course distinguishes
      them from a representative Axis I disorder. This article also describes the
      acquisition and demographics of the sample on whom the study is being done. A
      prospective, repeated measures investigation of the stability of PDs is now
      underway at multiple clinical settings in four collaborating urban sites in
      Boston. New Haven, New York, and Providence. Diagnostic assignments are based on
      semistructured interview assessments (by clinically trained raters) and confirmed
      by at least one additional contrasting diagnostic method. The sample consists of
      668 treatment seeking and reliably diagnosed adults recruited from a broad range
      of clinical sites. By design, patients in the sample met standards for one of
      five diagnostic subgroups: (a) schizotypal (N = 86); (b) borderline (N = 175);
      (c) avoidant (N = 157); (d) obsessive-compulsive (N = 153) personality disorders
      or a control group having (e) major depressive disorder without personality
      disorder (N = 97).

PMID- 11213791
TI  - Preformulation experiences and in vitro model studies with spironolactone
      containing suppositories.
AB  - The optimal suppository base for the formulation of rectal suppositories
      containing diuretic spironolactone was selected experimentally. Model studies
      were carried out about the effect of solubility-increasing additives on the
      release of the drug from the suppositories. During the in vitro examinations
      acceptor phases of different pH values were used, and both diffusion time and the
      number of samplings were changed. Among the lipophilic and hydrophilic
      suppository bases studied the hydrophilic Macrogolum 1540 was found to be
      optimal. The release and diffusion of spironolactone was the most favourable from
      these suppositories. During storage these suppositories remained stable and the
      values of release did not decrease significantly (p < 0.05).

PMID- 11213790
TI  - Tobacco use among high school students in Buenos Aires, Argentina.
AB  - OBJECTIVES: This study assessed the prevalence and correlates of tobacco use
      among high school students in Buenos Aires, Argentina. METHODS: Anonymous, self
      administered questionnaires were given to 3909 8th and 11th graders in a
      stratified random sample of 49 public and private schools. The instrument
      included items from American surveys, translated and validated among Argentinean
      teens. Multiple logistic regression analysis was used to estimate possible
      effects on smoking behavior of environment, students' personal characteristics,
      and their knowledge, beliefs, and attitudes regarding smoking. RESULTS: Of 8th
      and 11th graders, 20% and 43%, respectively, were classified as current smokers.
      Overall, 29% of males and 32% of females were current smokers. Students attending
      public schools were more likely to smoke than those in private schools (P < .05).
      Current smoking was associated with having a best friend who smokes, reporting
      that more than 50% of friends of the same sex smoke, having positive attitudes
      and beliefs toward smoking, and having a positive intention to smoke within the
      next year (all P < .001). CONCLUSIONS: Over 20% of the 8th graders in our sample
      were current smokers; prevention efforts must therefore start early.

PMID- 11213792
TI  - Influence of curing tip distance on composite Knoop hardness values.
AB  - The purpose of this paper was to study the influence of curing tip distance on
      Knoop hardness values, at different depths, of two composites, Z100 and Silux
      Plus. Specimens (5 mm in diameter and 2.5 mm in height) were prepared in a copper
      mold, covered with mylar strip and polymerized for 40 s, at 3 tip-to-composite
      surface distances: 0 mm (surface contact), 6 and 12 mm, utilizing an XL 3000
      curing unit, with 750 mW/cm2 power. The specimens were then stored at 37 degrees
      C for 24 h. Knoop hardness values were measured using a microhardness tester,
      with a load of 50 g for 30 s for each indentation. Four specimens were made for
      each distance and composite and eighteen indentations were made of each specimen.
      The results were submitted to analysis of variance and Tukey test at 5%
      significance level. The results indicated that 1) composite Z100: the larger the
      curing tip distance in relation to the composite, the lower the Knoop hardness
      values; 2) Silux Plus: increasing the curing tip distance did not produce a
      statistically significant difference in the Knoop hardness values; however, at 6
      and 12 mm, the deeper layers showed lower Knoop hardness values in relation to
      the surface; 3) Z100: statistically superior in relation to Silux Plus at all
      three curing tip distances and at all depths (P < 0.05).

PMID- 11213793
TI  - A clinical evaluation of materials for interocclusal registration in centric
      relation.
AB  - Four techniques for interocclusal registrations of centric relation based on
      materials or combinations of materials usually utilized were tested by means of
      mounting of casts for a patient with partial lower edentulousness, without a free
      end saddle. To ensure the correct position of centric relation a Lucia jig was
      utilized. The following conditions for the record of posterior section were
      tested: registrations with wax, wax plus zinc oxide-eugenol paste, wax plus
      Duralay acrylic resin, and condensation silicone (putty). The evaluation was made
      by the measure of vertical distance between reference points in the base of the
      casts and calculation of variations occurring with each material. The
      combinations of wax plus zinc oxide-eugenol paste and wax plus Duralay acrylic
      resin showed the smallest variations in centric relation position.

PMID- 11213794
TI  - Tooth wear and loss: symptomatological and rehabilitating treatments.
AB  - The authors report a clinical case that presented tooth wear and absence, with
      painful muscular and articular symptomatology, and also alteration in
      deglutition, mastication and speech. The clinical procedures used were re
      establishment of vertical dimension of occlusion, mandibular centric relations,
      and occlusal contacts through therapeutic removable partial dentures. The condyle
      position was analyzed in habitual occlusion and in occlusion with dentures,
      through transcranial radiographs of the temporomandibular joints. Oral
      rehabilitation was achieved with dental restoration and removable partial
      dentures.

PMID- 11213795
TI  - Wiskott-Aldrich syndrome protein and platelets.
AB  - Wiskott-Aldrich syndrome (WAS) and X-linked thrombocy topenia (XLT) are caused by
      mutations of the WAS protein (WASP) gene. The manifestations of the classic WAS
      phenotype consist of immunodeficiency, eczema and thrombocytopenia. However,
      thrombocytopenia and small platelets are the only consistent features of WAS and
      XLT. The exact mechanisms of the development of thrombocytopenia in patients with
      WAS or XLT are unknown. To date, platelets are the only primary cells in which
      inducible tyrosine phosphorylation of WASP has been consistently demonstrated.
      This review focuses on the recent progress in dissecting the causes of
      thrombocytopenia and the emerging understanding of WASP phosphorylation.

PMID- 11213796
TI  - The Wiskott-Aldrich syndrome: disordered actin dynamics in haematopoietic cells.
AB  - The Wiskott-Aldrich syndrome protein (WASp) is a member of a unique family whose
      members share similar domain structures and are responsible for the transduction
      of signals from the cell membrane to the actin cytoskeleton. For WASp, the
      interactions with Rho family GTPases and the cytoskeletal organising complex
      Arp2/3 are critical to these functions, which when disturbed translate into
      abnormalities of haematopoietic cell signaling, polarisation, migration and
      phagocytosis. This review discusses the evidence for regulation of highly dynamic
      cytoskeletal structures by WASp and the consequences of disturbed function on
      some of these processes.

PMID- 11213797
TI  - Human interferon-gamma-mediated immunity is a genetically controlled continuous
      trait that determines the outcome of mycobacterial invasion.
AB  - Individuals with inherited disorders of interferon gamma (IFN-gamma)-mediated
      immunity appear to be specifically vulnerable to mycobacterial infections. The
      severity of clinical features of affected individuals differs between cases. Some
      patients die of mycobacterial infection in early childhood, whereas others have
      long asymptomatic periods in childhood and as adults. This rare syndrome also
      shows high allelic and non-allelic genetic heterogeneity. Mutations in IL12B,
      encoding the interleukin (IL)-12 p40 subunit, and in IL12RB1, encoding the beta1
      chain of the IL-12 receptor, result in impaired IFN-gamma production. Mutations
      in IFNGR1 and IFNGR2, encoding the two IFN-gamma receptor chains, and mutations
      in STAT1, encoding an essential signaling component, result in impaired cellular
      responses to IFN gamma. Different types of mutation define two types of complete
      and two types of partial IFNgammaR1 deficiency. Complete and partial IFNgammaR2
      deficiency have also been described. We herein compare the genotypes, cellular
      phenotypes, and clinical phenotypes of healthy individuals and patients with the
      seven known genetic disorders impairing cellular responses to IFN-gamma. Patients
      with defective IFN-gamma production were not considered in this study. The
      mutations and clinical features of patients with IFNgammaR1, IFNgammaR2, and STAT
      1 deficiency are reviewed. Selected cell lines from each of the eight groups were
      tested for their response to IFN-gamma. We find that individuals may be
      classified into four broad groups based on genotype, cellular phenotype, and
      clinical phenotype (normal individuals and patients with mild, intermediate, or
      severe disease). This correlation suggests that IFN-gamma-mediated cell
      activation is a genetically controlled quantitative trait and that it determines
      the outcome of mycobacterial invasion in man.

PMID- 11213798
TI  - Gene therapy of severe combined immunodeficiencies.
AB  - Primary immunodeficiency diseases (PID) are attractive candi dates for a gene
      therapy approach because many of these disorders convey a poor prognosis while a
      number of the genes mutated in these conditions have been identified. Gene
      transfer into hematopoietic stem cells (HSC) should, in theory, lead to a cure of
      the disease. There are, however, a number of limitations mostly related to the
      failure of clinically available vectors to enable transgene integration into HSC.
      Nevertheless PID due to a gene defect leading to failure of cell development
      could be amenable to gene therapy given the selective advantage conferred to
      transgene expression in progenitor cells. Terminally differentiated cells are,
      however, long lived, as is the case for T lymphocytes. This concept led to the
      first gene therapy trials for adenosine deaminase (ADA) deficiency several years
      ago. Results were in part disappointing mostly because of the concomitant
      substitutive treatment by polyethylene glycol-ADA. However, recent application to
      X-linked severe combined immunodeficiency (gamma(c) deficiency) turned out to be
      efficient at least on a relatively short term basis (i.e. one year so far). These
      results demonstrate that this concept is valid and can be the basis for the
      treatment of other forms of severe T-cell immunodeficiencies. Obviously,
      development of vectors (lentiviruses) able to efficiently target HSC could in the
      future considerably enlarge the field of PID treatable by gene transfer.

PMID- 11213799
TI  - Leukocyte adhesion deficiency II-from A to almost Z.
AB  - Leukocyte adhesion deficiency (LAD) type II is the second human disorder
      identified which involves the adhesion cascade. While in LAD I the integrin
      family is defective, in LAD II the selectin system is involved. The syndrome has
      been described in only five patients and is transmitted as an autosomal recessive
      trait. The infectious episodes and the severity are much milder than those
      observed in LAD I, and the only persistent clinical symptom is chronic severe
      periodontitis. Delay separation of the umbilical cord, which is a hallmark for
      LAD I, was not observed in any of the LAD II patients. The exact defect in the
      system is absence of the SLeX, which is an important ligand for the selectin on
      the leukocyte lead ing to a profound defect in leukocyte rolling, the first step
      in the adhesion cascade. This causes a marked decrease in chemotaxis accompanied
      by pronounced neutrophilia. Apart from the leukocyte defect, these patients
      suffer from severe growth and mental retardation and exhibit the rare Bombay
      blood group type. The primary defect in the syndrome is in fucose metabolism,
      with the absence of all fucosylated glycans on cell surface membranes. Recently,
      it is was found that the defect is in a specific transporter of GDP fucose into
      the Golgi apparatus, and thus no fucosylation process takes place, and no surface
      expression can be detected. The exact genetic defect in the transporter is still
      unknown. Four of the patients were of Arabic origin while the fifth was of
      Turkish origin. It seems that the primary defect is somewhat different and,
      therefore, fucose administration was effective in the Turkish child, but did not
      show any beneficial results in the patients of Arabic origin.

PMID- 11213800
TI  - Lessons from the bare lymphocyte syndrome: molecular mechanisms regulating MHC
      class II expression.
AB  - Major histocompatibility complex class II (MHCII) molecules drive the
      development, activation and homeostasis of CD4* T-helper cells. They play a
      central role in key processes of the adaptive immune system, such as the
      generation of T-cell-mediated immune responses, the regulation of antibody
      production and the development and maintenance of tol erance. It is thus not
      surprising that the absence of MHCII expression results in a severe primary
      immunodeficiency disease (the bare lymphocyte syndrome (BLS)). The genetic
      defects responsible for BLS do not lie within the MHCII locus, but in genes
      encoding transcription factors required for MHCII expression. A great deal of our
      current knowledge about the mechanisms regulating expression of MHCII genes has
      been derived from the study of BLS. Four different MHCII regulatory genes have
      been identified. These genes encode RFXANK, RFXS, RFXAP and CIITA. The first
      three are subunits of RFX, a ubiquitously expressed factor that binds to the
      promoters of all MHCII genes. RFX binds co-operatively with other factors to form
      a highly stable multiprotein complex referred to as the MHCII enhanceosome. This
      enhanceosome serves as a landing pad for the co-activator CIITA, which is
      recruited via protein-protein interactions CIITA is the master control factor for
      MHCII expression. The highly regulated expression pattern of CIITA ultimately
      dictates the cell type specificity, induction and level of MHCII expression.

PMID- 11213801
TI  - Complement: a critical test of its biological importance.
AB  - The biological activities of the more than 30 proteins that comprise the
      complement system have been elucidated in parallel lines of investigation that
      resulted in the purification of the proteins and studies of their function in
      vitro. Twenty years ago, the first complement cDNA clones were generated.
      Subsequently the structure and chromosomal localization of the complement genes
      and the primary sequences of their gene products were revealed. For some, even
      their higher order structure was solved. This work, coupled with studies of
      complement gene expression, biosynthesis, post-synthetic processing and
      secretion, contributed to an analysis of the relatively rare naturally occurring
      genetic deficiencies of complement proteins discovered fortuitously in humans
      sand experimental animals. Not until the past 5 years, with the application of
      methods for manipulating genes in vivo (targeted deletion and overexpression),
      has it been possible to definitively assign specific functions to complement
      proteins and to assess their importance in the intact organism. These relatively
      recent studies have confirmed the in vitro work or revealed unexpected roles for
      complement effector and regulatory proteins in host defenses, specific immunity,
      immunopathology, metabolism and reproductive biology This work is reviewed and
      the implications for understanding human diseases and the design of novel
      pharmaceutical agents are discussed. The promise of this line of investigation is
      certain but the context imposed by gender, developmental stage, other genes and
      environment must be taken into account before the practical implications of this
      deeper understanding of complement biology are fully realized.

PMID- 11213802
TI  - Novel immunodeficiency data servers.
AB  - The Internet contains scientific information in increasing amounts. It is
      possible to obtain the latest information, and Web services can easily be
      maintained and updated. We have set up three Internet services on
      immunodeficiencies. Immunodeficiency-related mutation infor mation is available
      in immunodeficiency mutation databases (IDbases). Currently 14 registries are
      distributed, including information about Bloom syndrome (BLMbase), X-linked
      agammaglobulinemia (BTKbase), X-linked and autosomal recessive chronic
      granulomatous diseases (CYBBbase for X-linked CGD, CYBAbase for p22(phox)
      deficiency, NCF1base for p47(phox) deficiency, NCF2base for p67(phox)
      deficiency), CD3gamma and CD3epsilon deficiencies (CD3Gbase, CD3Ebase), X-linked
      hyper-IgM syndrome (CD40Lbase), T-B+ severe combined immunodeficiency (JAK3base),
      V(D)J recombination defects (RAG1base, RAG2base), X-linked lymphoproliferative
      syndrome (SH2D1Abase), and ZAP-70 deficiency (ZAP70base). Information on
      laboratories analysing the genetic defects is collected to IDdiagnostics
      registry. Due to the rareness of immunodeficiencies there are very few
      laboratories performing genetic diagnostics. Such laboratories are listed in
      IDdiagnostics and physicians can use the registry to find a suitable laboratory
      for their diagnostic needs. Immunodeficiency Resource (IDR) is a comprehensive
      integrated knowledge base for all the information on immunode ficiencies,
      including clinical, biochemical, genetic, structural and computational data and
      analyses. All three services are available at http: //www.uta.fi/imt/bioinfo/.

PMID- 11213803
TI  - X-linked lymphoproliferative disease is caused by deficiency of a novel SH2
      domain-containing signal transduction adaptor protein.
AB  - X-linked lymphoproliferative disease (XLP) is an inherited immunodeficiency,
      involving primarily T and natural killer (NK) cells, which in the majority of
      cases exacerbates following exposure to Epstein-Barr virus (EBV). Prior to EBV
      infection, most boys with the defective XLP gene appear to be clinically healthy
      EBV infection in males with the defective XLP gene leads to three main
      phenotypes: severe and mostly fatal infectious mononucleosis (58%),
      lymphoproliferative disorders mostly of B-cell origin (30%) and/or
      dysgammaglobulinemia (31%). Later in life, dysgammaglobulinemia and malignant
      lymphoma may also develop in about 53% and 56% of EBV-negative XLP males,
      respectively This fact suggests that EBV may only act as a potent trigger of the
      earliest and most serious clinical phenotype of XLP, i.e. fatal infectious
      mononucleosis. XLP has an unfavorable prognosis. Successful transplanta tion of
      hematopoietic stem cells can cure this immunodeficiency In the future, gene
      therapy may eventually become an additional option to prevent XLP. The gene
      responsible for XLP, SH2-domain containing gene 1A (SH2D1A) has recently been
      identified and sequenced. SH2D1A encodes a polypeptide of 128 amino acids
      containing a single SH2 domain. Until now, 45 different SH2D1A gene mutations
      have been identified in patients with XLP SH2D1A is thought to play an important
      role in signal transduction in T and NK cells. In vitro, SH2D1A has been shown to
      interact as an adaptor protein with the signaling pathways through SLAM, a T-cell
      co-stimulatory molecule, and 2B4, an NK-cell-activating receptor. Further
      functional studies of the SH2D1A protein will probably provide new insights into
      the pathogenesis of severe infectious mononucleosis, malignant lymphomas and
      immunodeficiency in patients with XLP.

PMID- 11213804
TI  - Hematopoietic stem cell gene therapy: towards clinically significant gene
      transfer efficiency.
AB  - Early clinical gene therapy and gene marking trials using retroviral vectors to
      transduce hematopoietic stem cells (HSC) revealed two major shortcomings of this
      new treatment modality. One was insufficient expression or even silencing of the
      integrated vector sequences, and the second was the low gene transfer efficiency
      achieved to in vivo repopulating cells. It became clear that neither rodent
      models nor human in vitro surrogate assays for stem cells were predictive of in
      vivo transgene levels in human target cells. Using the rhesus monkey model we
      have focused on improving gene transfer efficiency into HSC. Immune rejection of
      trans duced cells has been shown to occur in mature peripheral target cells such
      as lymphocytes or myocytes. Our studies and those from other investiga tors
      suggest that transgenes introduced via HSC induces immunologic tolerance towards
      the foreign product. In vivo priming of target cells, i.e. mobilization of HSC
      into the circulation with granulocyte colony stimulating factor and stem cell
      factor, as well as optimization of the in vitro transduction conditions, now
      allow a stable in vivo gene transfer efficiency of up to 10-15% in both lymphoid
      and myeloid circulating cells in non-human primates, levels that would be
      adequate for many clinical applications.

PMID- 11213805
TI  - Of genes and phenotypes: the immunological and molecular spectrum of combined
      immune deficiency. Defects of the gamma(c)-JAK3 signaling pathway as a model.
AB  - Cytokines play a major role in lymphoid development. Defects of the common gamma
      chain (gamma(c)) or of the JAK3 protein in humans have been shown to result in a
      severe combined immune deficiency (SCID), with a profound defect in T and natural
      killer (NK)-cell development, whereas B-cell generation is apparently unaffected
      (T-B+NK-SCID). While extensive molecular and biochemical analysis of these
      patients has been instrumental in understanding better the biological properties
      of the gamma(c) and JAK3 protein, an unexpected phenotypic heterogeneity of
      gamma(c) and JAK3 deficiency has emerged, indicating the need for appropriate and
      extensive investigations even in patients with atypical presentations. At the
      same time, characterization of the defects has been instrumental in the
      development of novel therapeutic approaches, from in utero hematopoietic stem
      cell transplantation to gene therapy.

PMID- 11213806
TI  - The cellular phenotype conditions Btk for cell survival or apoptosis signaling.
AB  - Bruton's agammaglobulinemia tyrosine kinase (Btk) was identified as the gene
      mutated in X-linked agammaglobulinemia. Btk is involved in B-cell receptor
      signaling and B cell ontogeny as the disease is characterized by a block in B
      cell development. Cell proliferation and apoptosis are integral parts of B-cell
      development. We have demonstrated that overexpression of Btk in HeLa cells led to
      apoptosis, whereas in B cells, en dogenous levels of Btk protected the cells from
      apoptosis. We suggest a dual role for Btk in apoptosis and cell survival. We
      further propose that the phenotype of the cell may direct Btk for either cell
      survival or apoptosis. Our model is in line with the general feature of mammalian
      cells that have the inherent property to die unless the survival signals are
      triggered. The interplay between survival and apoptotic signaling is regulated by
      cell sur face receptors, cytoplasmic and nuclear regulatory molecules. These regu
      latory molecules may be simple unidirectional regulators or bidirectional
      regulators such as Btk. The different molecules involved in these pathways bring
      about an orchestrated signal depending on the phenotype of the cell, and a cell
      type-specific biological response is achieved that decides the fate of the cell.

PMID- 11213807
TI  - Experiments of nature: primary immune defects deciphered and defeated.

PMID- 11213808
TI  - The genetic and biochemical basis of Omenn syndrome.
AB  - Omenn syndrome (OS) is a peculiar, autosomal recessive severe combined
      immunodeficiency (SCID) associated with early-onset, generalized, exudative
      erythrodermia; lymphoadenopathy; hepato- and splenomegaly; hypereosinophilia;
      elevated serum IgE; and normal to high activated, yet non-functional, oligoclonal
      T cells. Recent investigations have shown that the primum movens of all these
      puzzling features lies in a defect of the lymphoid-specific V(D)J recombination
      process. Abnormalities in both alleles of either Rag-1 or -2 genes are found in
      all OS patients. At variance with T B- SCID, whose Rag mutations represent null
      alleles, OS mutations maintain a residual recombination activity, allowing
      limited T-cell receptor gene rearrangements to occur in the thymus. The gene
      rearrangements are subsequently expanded in the periphery after environmental
      antigen exposure. Missense mutations detected in OS have been examined in a
      number of biochemical assays and have contributed to dissect the various
      functional domains of both Rag-1 and Rag-2 proteins. The examination of a set of
      mutations occurring in the Rag-1 N-terminal portion has demonstrated that this
      region plays a fundamental role in vivo. The elucidation of the molecular basis
      of OS has allowed us to perform early prenatal diagnosis and could be the basis
      for trials of in utero bone marrow transplantation or gene therapy approaches.

PMID- 11213809
TI  - Defects in early B-cell development: comparing the consequences of abnormalities
      in pre-BCR signaling in the human and the mouse.
AB  - Patients with genetic defects in B-cell development provide an unusual
      opportunity to dissect the requirements for normal B-cell maturation. It is
      striking that all of the known genetic defects that result in a failure of B-cell
      development involve signaling through the pre-B-cell receptor (pre-BCR).
      Approximately 85% of affected patients are males with mutations in the X
      chromosome-encoded cytoplasmic tyrosine kinase Btk. Preliminary experiments using
      stem cell transplants and retroviral-mediated gene therapy in Btk-deficient mice
      suggest that it may be relatively easy to correct serum immunoglobulins but
      harder to correct antibody production to T-cell-independent antigens in this
      disorder. About 3-6% of patients with defects in B-cell development have
      deletions or critical base pair substitutions in the mu constant region gene.
      Patients with defects in Igalpha, lambda5 and B-cell linker protein (BLNK) have
      also been described. All of these patients have a block at the pro-B to pre-B
      cell transition. Defects in Btk, lambda5 and BLNK result in a more severe
      phenotype in the human compared to the mouse. These findings suggest that
      requirements for signaling through the pre-BCR are more stringent in the human
      compared to the mouse. Possible explanations for this observation are discussed.

PMID- 11213810
TI  - A brief history of immunodeficiency disease.

PMID- 11213812
TI  - Molecular basis of IgG subclass deficiency.
AB  - IgG subclass deficiency was recognized as a separate disease entity in the early
      seventies and was shown to be associated with an increased susceptibility to
      infections. Although deletions of the corresponding gamma genes have been
      demonstrated in a few cases, a majority of patients suffer from a regulatory
      dysfunction, and the deficiencies are most often relative rather than absolute.
      Some of the molecular mechanisms underlying the disorder have been unraveled
      recently. In this review we will touch upon the deletions described within the
      IGHC locus but mainly concentrate on the regulatory aberrations involved in IgG
      subclass deficiency.

PMID- 11213811
TI  - Autosomal primary immunodeficiencies affecting human bone marrow B-cell
      differentiation.
AB  - Since the initial report of X-linked agammaglobulinemia by Bruton, numerous
      autosomal primary immune deficiencies affecting early B-cell differentiation have
      been described in humans. The identification of these autosomal mutations has
      been facilitated by phenotype comparison with knockout mice. In mice, defects in
      B-cell development have been observed after disruption of genes encoding
      transcription factors, the interleukin-7 pathways as well as structural or
      signaling components of the pre-B-cell receptor. In general, the phenotypes of
      primary immune deficiencies in humans correlate with those observed in mutant
      mice, validating the use of the mouse model approach. In addition, we report a
      follow-up analysis of an autosomal primary deficiency in a young female patient
      born from consanguinous parents and characterized by the absence of pre-B and B
      cell compartments. The patient's gene defect was identified as a cytosine
      insertion at the beginning of the CH1 exon of the Ig(mu) gene, resulting in a
      stop codon at position 48 and the absence of Ig(mu) chain expression. The precise
      phenotype of this patient is compared to other autosomal primary
      immunodeficiencies affecting humans and mice.

PMID- 11213813
TI  - Abnormal levels of urokinase plasminogen activator protein and tissue plasminogen
      activator activity in human aortic aneurysms.
AB  - OBJECTIVE: To measure the concentrations and activities of plasminogen activators
      and plasminogen activator inhibitors in human abdominal aneurysms. DESIGN:
      Laboratory study. SETTING: University hospital, Sweden. MATERIAL: Biopsy
      specimens from 12 abdominal aortic aneurysms and 8 normal aortas (controls).
      INTRERVENTIONS: Tissues were homogenised and eluted. The supernatants were
      assayed for antigens of tissue and urokinase plasminogen activator and
      plasminogen activator inhibitor 1 and 2. The activities of tissue plasminogen
      activator and plasminogen activator inhibitor-1 were assayed by ELISA. Frozen
      sections were immunostained for tissue and urokinase plasminogen activators and
      for plasminogen activator inhibitor-1. MAIN OUTCOME MEASURES: Concentrations and
      activities of these activators and inhibitors. RESULTS: The concentration of
      urokinase plasminogen activator antigen was higher in aneurysmal walls than in
      normal aortas; it was detected immunohistochemically in aneurysmal but not in
      normal aortas. The concentration (and the detection immunohistochemically) of
      tissue plasminogen activator was equal in aneurysmal and normal aortas, but its
      activity was reduced in the aneurysmal wall. Plasminogen activator inhibitor-1
      did not differ significantly between the groups. CONCLUSIONS: Urokinase
      plasminogen activator may be responsible for the digestion of the media of the
      aorta and the development of an aneurysm. Reduced activity of tissue plasminogen
      activator may be responsible for thrombosis in the aneurysm.

PMID- 11213814
TI  - Advanced breast biopsy instrumentation for the evaluation of impalpable lesions:
      a reliable diagnostic tool with little therapeutic potential.
AB  - OBJECTIVE: To assess the potential of advanced breast biopsy instrumentation
      (ABBI) to clarify the diagnosis of impalpable mammographic lesions and to remove
      the entire malignant lesions with clear margins. DESIGN: Prospective assessment
      in a consecutive series of patients. SETTING: University hospital, Basel,
      Switzerland. SUBJECTS: 139 patients presenting with 144 impalpable
      microcalcifications or solid nodular densities evident on screening and follow-up
      mammograms that were suspicious of malignancy. MAIN OUTCOME MEASURES:
      Feasibility, sensitivity, efficiency in obtaining definitive diagnoses in an
      outpatient clinic under local anaesthesia, feasibility of complete removal of a
      primary malignancy, and intervention-related morbidity. RESULTS: The ABBI
      procedure was successful in 135/144 (94%); an accurate diagnosis was made in
      129/130 patients followed up (99%), sensitivity for malignant lesions was 31/32
      (97%) and there were 2 complications (2%). Margins of the biopsy cylinder
      contained a malignant lesion in 26/31 (84%). CONCLUSIONS: Excisional biopsy using
      the ABBI system is a reliable diagnostic tool with a low morbidity. As in other
      published series margins were often not clear of tumour and therefore the
      therapeutic use of the ABBI procedure is limited.

PMID- 11213815
TI  - Endoscopic sentinel node detection with a gamma probe combined with minimally
      invasive axillary lymph node dissection: a preliminary study.
AB  - OBJECTIVE: To investigate the efficacy of videoendoscopic axillary lymph node
      dissection combined with endoscopic sentinel node detection by gamma probe and
      preoperative sentinel node imaging. DESIGN: Open study. SETTING: University
      hospital, Germany. SUBJECTS: Four patients with breast cancer. INTERVENTION:
      Injection of 99mTc-nanocolloid around the tumour. RESULTS: In three patients
      axillary sentinel nodes were detected both before and after operation. In the
      remaining one it was not found. In two patients the minimally invasive approach
      had to be converted to conventional open surgery because of anatomical
      restrictions. CONCLUSION: We describe a new approach that uses a minimally
      invasive technique and endoscopic radioguided sentinel node biopsy in patients
      with breast cancer. The results of this preliminary study warrant further
      investigation.

PMID- 11213816
TI  - Clinical and quality of life outcomes of laparoscopic and open splenectomy for
      haematological diseases.
AB  - OBJECTIVE: To study the outcome of open and laparoscopic splenectomy for
      haematological diseases in terms of quality of life and haematological measures.
      DESIGN: Prospective non-randomised study. SETTING: Tertiary care hospital, USA.
      PARTICIPANTS: 44 patients, 27 treated laparoscopically and 17 by open
      splenectomy. MAIN OUTCOME MEASURES: Quality of life judged by the SF-36 and
      adequacy of control of the haematological disease. RESULTS: Both quality of life
      and haematological disease were significantly improved by operation;
      laparoscopically treated patients had less pain. CONCLUSION: In properly selected
      patients laparoscopic splenectomy is preferable to open splenectomy.

PMID- 11213817
TI  - Use of absorbable mesh in the treatment of parenchymal liver injuries during
      orthotopic liver transplantation.
AB  - OBJECTIVE: To find out whether packing or wrapping with polyglactin 910 mesh was
      more effective in stopping bleeding in livers that had been damaged during
      transplantation. DESIGN: Retrospective study. SETTING: University hospital,
      Austria. SUBJECTS AND INTERVENTIONS: 15 of 27 livers that had been damaged during
      transplantation bled sufficiently to warrant either packing (n = 6) or wrapping
      (n = 9). MAIN OUTCOME MEASURES: Arrest of bleeding; other complications. RESULTS:
      Both packing and wrapping succeeded in stopping the bleeding, and neither caused
      infections. Packing may theoretically cause an increase in intra-abdominal
      pressure and impair organ function. CONCLUSION: It is preferable to wrap rather
      than pack a bleeding liver that has been damaged during transplantation.

PMID- 11213818
TI  - Operative treatment of acute complications of diverticular disease: primary or
      secondary anastomosis after sigmoid resection.
AB  - OBJECTIVE: To assess the comparative effects of two surgical regimens on the
      outcome of acute complicated diverticular disease. DESIGN: Retrospective study.
      SETTING: Teaching hospital, The Netherlands. SUBJECTS: 60 patients who presented
      with acute complicated diverticular disease. INTERVENTIONS: 28 patient were
      treated by sigmoid resection and a Hartmann operation, and 32 by resection with
      primary anastomosis and defunctioning stoma. MAIN OUTCOME MEASURES: Morbidity and
      mortality. RESULTS: The severity of peritonitis and the amount of faecal
      contamination were similar in the 2 groups. 12 patients died (7 in the Hartmann
      group and 5 in the primary anastomosis group). There were 3 radiological leaks
      with no clinical implications in the primary anastomosis group. 6 patients in the
      Hartmann group and 5 in the primary anastomosis group required reoperations for
      intra-abdominal abscess or infection. 7 and 3 patients, respectively, developed
      dysfunction of their stomas, and 9/21 and 3/27, respectively, required a
      permanent stoma (p = 0.02, 95% confidence interval of difference 0.07 to 0.56). 3
      patients in the Hartmann group developed anastomotic leaks after closure of their
      stomas, 1 of whom required reoperation but died. No patient developed an
      anastomotic leak after closure of the stoma in the primary anastomosis group.
      CONCLUSION: Both regimens are accepted treatments for patients with acute
      complicated diverticular disease, but because of the higher morbidity after the
      Hartmann procedure we prefer primary anastomosis with covering stoma.

PMID- 11213819
TI  - Production of free radicals measured by spin trapping during operations for
      stenosis of the carotid artery.
AB  - OBJECTIVES: To analyse production of free radicals during operations for stenosis
      of the internal carotid artery. SETTING: University hospital, Sweden. SUBJECTS:
      10 patients operated on for carotid artery stenosis. INTERVENTIONS: Blood samples
      were repeatedly drawn from the sigmoid sinus through a catheter in the internal
      jugular vein on the same side, before, during, and after clamping of the internal
      carotid artery. OXANOH was added to the blood samples in vitro and the radical
      production calculated from the amount oxidised to OXANO as electron spin
      resonance. MAIN OUTCOME MEASURES: The relation between radical production and
      certain clinical variables investigated by partial least squares regression
      analysis. RESULTS: There were several significant relations. High systolic blood
      pressure and advanced age were associated with low, and severe degree of stenosis
      with increased, free radical production. Certain anaesthetic drugs as well as
      blood variables also influenced the production of radicals. CONCLUSIONS: The
      technique used seems to offer the possibility to find and study methods to reduce
      free radical production during this kind of operation.

PMID- 11213820
TI  - Morbidity and functional outcome after restorative proctocolectomy for ulcerative
      colitis.
AB  - OBJECTIVE: To find out whether a threefold increase in follow up (median 108
      compared with 36 months) influenced major morbidity and functional outcome
      between the first 32 and the last 32 patients consecutively operated on with J
      pouch ileoanal anastomosis for ulcerative colitis from 1984 to 1997. DESIGN:
      Retrospective and prospective study. SETTING: University hospital, Norway.
      PATIENTS: 64 patients with ulcerative colitis who had proctocolectomy and ileal
      pouch-anal anastomoses. INTERVENTIONS: The pouches were mainly hand anastomosed
      (n = 61) to the dentate line after mucosectomy or anastomosed by double stapling
      technique without mucosectomy (n = 3). The 58 patients who still had their
      pouches responded to a questionnaire on functional outcome and satisfaction. MAIN
      OUTCOME MEASURES: Morbidity, functional outcome, and patients' satisfaction.
      RESULTS: Major morbidity in these 64 patients comprised pelvic sepsis in 3 (5%),
      operation for intestinal obstruction in 5 (8%), pouchitis in 12 (19%), fistulas
      in 7 (11%) and pouch excision in 6 (9%). Thirteen patients (20%) had 35
      reoperations and 11 patients (17%) had 22 re-laparotomies. There were more
      complications among the first 32 patients with the longest follow up than among
      the last 32 patients, but this difference was significant only concerning the
      rate of reoperations (31% compared with 9%) because of the higher number of pouch
      excisions (5 compared with 1) in this group. There were no significant
      differences in the functional outcome and degree of patient satisfaction between
      the first 29 and the last 29 patients. Respective values for 24 hour median stool
      freqency were 7.0 and 6.3, leakage of stool 48% and 38%, ability to defer
      defaecation 86% and 97%, perineal irritation 59% and 48%, use of antidiarrhoeal
      medication 55% and 52%, and wearing of pad 28% and 38%. Sexual life (n = 57) was
      improved in 11 (19%) and reduced in 7 (12%). Potency was reduced in 5 (15%) and
      ejaculation in 4 (12%), one of whom (3%) had retrograde ejaculation. Three (5%)
      received disability pensions and five (9%) had reduced workload. After the pouch
      operation 48 (91%) felt better and 3 (6%) felt worse because of frequent bowel
      emptying, perineal eczema, or pouch fistula. CONCLUSION: Continence-preserving
      proctocolectomy carries considerable morbidity, but the long term functional
      outcome is satisfactory and does not seem to deteriorate substantially.

PMID- 11213822
TI  - Monitoring of p53 autoantibodies after resection of colorectal cancer:
      relationship to operative curability.
AB  - OBJECTIVE: To investigate the clinical use of p53 autoantibodies as a marker in
      the postoperative monitoring of colorectal cancer. DESIGN: Retrospective study.
      SETTING: Teaching hospital, Japan. SUBJECTS: 40 patients with colorectal cancer
      who had p53 autoantibodies in their serum preoperatively. INTERVENTIONS: Serial
      assay of p53 autoantibodies by ELISA before and after resection. MAIN OUTCOME
      MEASURES: Interpretation by a qualitative analysis. RESULTS: A significant
      correlation was observed between curability by surgical resection and
      postoperative disappearance of p53 autoantibodies. Twenty-seven (96%) of 28
      patients, who had p53 autoantibodies and whose cancer was completely removed, had
      no such antibodies after resection and no recurrence after 7 to 26 months.
      CONCLUSIONS: Postoperative assays of p53 autoantibodies are potentially useful
      for predicting recurrence of colorectal cancer in patients who have p53
      autoantibodies preoperatively.

PMID- 11213821
TI  - Trimethoprim-sulphamethoxazole and metronidazole as prophylaxis in colorectal
      surgery: a study of bioavailability after an oral single dose.
AB  - OBJECTIVE: To evaluate oral single dose prophylaxis in colorectal surgery.
      DESIGN: Prospective study. SETTING: University hospital, Sweden. SUBJECTS: 24
      patients (13 women; 11 men; mean age 57 years, range 27-81) listed for elective
      colorectal operations. INTERVENTION: At 0630 on the day of the operation all
      patients were given an oral dose of trimethoprim-sulphamethoxazole (TMP 160 mg
      and SMZ 800 mg) and metronidazole (2 g). The serum concentrations of TMP and SMZ
      were analysed in venous samples taken at the start and end of each operation.
      RESULTS: The earliest operation started at 0830 and the last finished at 1700.
      The median (range) serum concentrations of TMP were 1.4 (0.7-2.6) mg/L (start)
      and 1.3 (1.0-2.8) mg/L (end), and of SMZ 35 (15-65) mg/L (start) and 33 mg (13
      70) mg/L (end). The individual values were above or equal to the minimal
      inhibitory concentration (TMP 0.8 mg/L; SMZ 15.2 mg/L) for relevant gram-negative
      species. CONCLUSION: Oral TMP/SMZ in the morning gives satisfactory serum
      concentrations independently of when the operation is done during the day. The
      regimen is simple and has the potential for being an effective alternative to
      intravenous prophylaxis.

PMID- 11213823
TI  - Somatostatin blockade improves the proliferative response but not intestinal
      morphological growth after small bowel resection in rats.
AB  - OBJECTIVE: To find out whether or not blockade of somatostatin improves
      intestinal adaptation after small bowel resection. DESIGN: Laboratory experiment.
      SETTING: Teaching hospital, Spain. SUBJECTS: Eighty adult Wistar rats.
      INTERVENTIONS: Animals underwent intestinal resection or sham operation (n = 40
      each) and were treated with a somatostatin antagonist either intermittently or
      continuously in three different doses (n = 8 each). MAIN OUTCOME MEASURES: Bowel
      mucosal thickness, proliferation and concentrations of cAMP, somatostatin,
      insulin-like growth factor 1. RESULTS: Intestinal resection induced a
      proliferative and morphometric increase of the mucosa; however, the antagonist
      increased proliferation only in those animals given the highest dose.
      Intermittent doses induced a proliferative effect that was stronger than that in
      the three continuous groups. There was no relationship between trophic stimulus
      and insulin-like growth factor 1 or cAMP, but somatostatin concentrations
      increased after the intermittent course. CONCLUSIONS: Somatostatin receptor
      blockade with an antagonist does not cause in normal rats an intestinal
      morphological adaptation process or increase it after resection; however, it did
      promote a proliferative stimulus in the crypts.

PMID- 11213824
TI  - Mass closure technique: an experimental study on separation of wound edge.
AB  - OBJECTIVE: To study separation of wound edges in midline laparotomy incisions
      closed with either a mass stitch or a stitch incorporating only aponeurosis.
      DESIGN: Experimental study in pig. SETTING: University hospital, Norway. ANIMALS:
      8 domestic pigs. METHODS: Steel sutures were used and metallic clips were placed
      in the aponeurosis. After increasing the intra-abdominal pressure the distance
      between the lateral edge of stitches and between pairs of clips was measured on
      sequential radiographs. RESULTS: After three hours with raised intra-abdominal
      pressure the lateral edge of stitches became separated by a mean (SD) of 5.6
      (1.3) mm with a mass stitch and by 0.5 (0.6) mm with stitches placed only in the
      aponeurosis (p < 0.001). Corresponding figures for separation of clips was 3.6
      (1.5) mm and 0.1 (0.3) mm (p < 0.001). The suture cut through the muscle by more
      than 3mm in 25 out of 36 mass stitches. Muscle and peritoneum included in the
      mass stitch was compressed, darkly discoloured, and there were signs of
      haemorrhage. CONCLUSIONS: Wound edges become separated with a mass stitch but not
      with stitches placed only in the aponeurosis when the intra-abdominal pressure is
      raised after closure of midline laparotomy incisions. This results from sutures
      compressing or cutting through subcuticular fat, muscle, and peritoneum enclosed
      in a mass stitch.

PMID- 11213825
TI  - Internal jugular vein invasion by thyroid carcinoma.

PMID- 11213826
TI  - Surgical management of pancreatic sarcoid.

PMID- 11213828
TI  - Umbilical herniorrhaphy in cirrhotic patients: a safe approach.

PMID- 11213827
TI  - Splenic salvage by superselective embolisation after blunt abdominal trauma.

PMID- 11213829
TI  - Laparoscopic management of common bile duct stones.

PMID- 11213830
TI  - Gastrointestinal stromal tumors--definition, clinical, histological,
      immunohistochemical, and molecular genetic features and differential diagnosis.
AB  - Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of
      the gastrointestinal (GI) tract. They are defined here as KIT (CD117, stem cell
      factor receptor)-positive mesenchymal spindle cell or epithelioid neoplasms
      primary in the GI tract, omentum, and mesentery. GISTs typically present in older
      individuals and are most common in the stomach (60-70%), followed by small
      intestine (20-25%), colon and rectum (5%), and esophagus (<5%). Benign tumors
      outnumber the malignant ones by a wide margin. Approximately 70% of GISTs are
      positive for CD34, 20-30% are positive for smooth muscle actin (SMA), 10% are
      positive for S100 protein and <5% are positive for desmin. The expression of CD34
      and SMA is often reciprocal. GISTs commonly have activating mutations in exon 11
      (or rarely exon 9 and exon 13) of the KIT gene that encodes a tyrosine kinase
      receptor for the growth factor named stem cell factor or mast cell growth factor.
      Ligand-independent activation of KIT appears to be a strong candidate for
      molecular pathogenesis of GISTs, and it may be a target for future treatment for
      such tumors. Other genetic changes in GISTs discovered using comparative genomic
      hybridization include losses in 14q and 22q in both benign and malignant GISTs
      and occurrence in various gains predominantly in malignant GISTs. GISTs have
      phenotypic similarities with the interstitial cells of Cajal and, therefore, a
      histogenetic origin from these cells has been suggested. An alternative
      possibility, origin of pluripotential stem cells, is also possible; this is
      supported by the same origin of Cajal cells and smooth muscle and by the common
      SMA expression in GISTs. GISTs differ clinically and pathogenetically from true
      leiomyosarcomas (very rare in the GI tract) and leiomyomas. The latter occur in
      the GI tract, predominantly in the esophagus (intramural tumors) and the colon
      and rectum (muscularis mucosae tumors). They also differ from schwannomas that
      are benign S100-positive spindle cell tumors usually presenting in the stomach.
      GI autonomic nerve tumors (GANTs) are probably a subset of GIST. Other
      mesenchymal tumors that have to be separated from GISTs include inflammatory
      myofibroblastic tumors in children, desmoid, and dedifferentiated liposarcoma.
      Angiosarcomas and metastatic melanomas, both of which are often KIT-positive,
      should not be confused with GISTs.

PMID- 11213831
TI  - The association between tumour progression and vascularity in myxofibrosarcoma
      and myxoid/round cell liposarcoma.
AB  - Angiogenesis is an important factor in the morphological progression and
      metastasis of many solid tumours. We studied two homogeneous series of
      myxofibrosarcoma (MFS) and myxoid/round liposarcoma (MRLS), characterised by
      distinct vascular patterns and correlated the intratumoral microvessel density
      (IMD) with morphologic progression in both types of sarcoma. In our study, 43
      cases of MFS and 42 cases of MRLS were graded according to established diagnostic
      criteria. For evaluation of IMD, representative sections were stained
      immunohistochemically for CD31. After selection of "neovascular hot spots", IMD
      was calculated by measuring the endothelial surface within twenty 200x fields in
      relation to the total analysed area. In addition to the correlation of IMD with
      histological grades of malignancy, a correlation of IMD with the inflammatory
      infiltrate in MFS was done. To determine whether vascular endothelial growth
      factor (VEGF) and its receptors, KDR and flt-1, may play a role in the
      progression of both types of sarcomas, we used mRNA in situ hybridisation (ISH)
      to study VEGF, KDR and flt-1 expression in selected cases. In addition, the
      expression of thrombospondin-1, which has been reported to inhibit angiogenesis,
      and of collagen type I was studied using mRNA ISH. Cases of MFS varied
      histologically from hypocellular, mainly myxoid, neoplasms (low-grade malignant,
      18 cases) to intermediate-grade malignant lesions with increased cellularity and
      mitotic activity (13 cases), and high-grade malignant cases with marked
      pleomorphism, high proliferative activity and areas of necrosis in many cases (12
      cases). Cases of purely low-grade myxoid liposarcoma (16 cases) were
      characterised by low-cellularity, mucin pooling and plexiform vasculature. In
      combined MRLS, these hypocellular areas were admixed with hypercellular, round
      cell areas (5-80% of the analysed tumour area; 23 cases), and in round cell
      liposarcoma (three cases) rounded tumour cells predominated (>80% of the analysed
      tumour area). The average IMD in intermediate and high-grade malignant MFS (4.03
      and 4.09, respectively) was significantly higher than in low-grade malignant MFS
      (2.73). Correlation of vascularity with the inflammatory infiltrate in MFS showed
      increased IMD only in cases with abundant neutrophils; most of these cases were
      high-grade malignant neoplasms. In contrast, no statistical correlation between
      morphological progression and IMD was seen in myxoid liposarcoma (6.08), MRLS
      (6.57) and round cell liposarcoma (4.07). VEGF mRNA was expressed by tumour cells
      in all histological grades of MFS and MRLS. VEGF receptor mRNA was weakly
      expressed by endothelia of newly formed blood vessels in both entities.
      Interestingly, tumour cells of all analysed cases of MFS strongly expressed
      collagen type I and thrombospondin-1, while these proteins were not detected in
      tumour cells of MRLS. In conclusion, morphologic tumour progression in MFS is
      associated with increased IMD, whereas, in MRLS, no such correlation is seen.
      Whereas VEGF and VEGF receptor mRNA were expressed in both entities, a
      characteristic expression profile of collagen type I and thrombospondin-1 in MFS
      emerged. Further studies are necessary to correlate vascularity and clinical
      course in MFS and MRLS.

PMID- 11213832
TI  - Expression of cadherins and their undercoat proteins (alpha-, beta-, and gamma
      catenins and p120) and accumulation of beta-catenin with no gene mutations in
      synovial sarcoma.
AB  - E-cadherin, the major intercellular adhesion molecule of epithelial cells, is
      important in determining the architecture of sarcomas, especially those showing
      epithelioid features. In addition to its role in cell adhesion, beta-catenin, a
      cadherin undercoat protein, has been shown to function as a downstream
      transcriptional activator of the Wnt/Wingless signaling pathway. In order to
      evaluate the significance of the cadherin cell adhesion system and the
      Wnt/Wingless signaling pathway in the morphogenesis and/or tumorigenesis of
      synovial sarcoma (a major type of sarcoma with epithelioid features),
      immunoreactivity for pan-cadherin, E-cadherin, and their undercoat proteins
      (alpha-, beta-,and gamma-catenins and p120) was evaluated in 15 synovial
      sarcomas. Immunoreactivity for pan-cadherin, E-cadherin, alpha-catenin, beta
      catenin, and p120 was observed in all 15 specimens. Immunoreactivity for pan
      cadherin was stronger than that for E-cadherin. Expression of gamma-catenin was
      detected in ten specimens. Although beta-catenin was observed only at the cell
      cell boundaries in four specimens, it was present in the nucleus and cytoplasm
      and at the cell-cell boundaries in the other 11, suggesting constitutional
      activation of the Wnt/Wingless signaling pathway in synovial sarcoma. Direct
      sequencing for exon 3 of the beta-catenin gene, however, revealed no mutations in
      any of the 15 specimens. In conclusion, other types of cadherin besides E
      cadherin, together with cadherin undercoat proteins, may play a role in cell
      adhesion in synovial sarcoma. Furthermore, mechanisms other than mutation of exon
      3 of the beta-catenin gene may activate the Wnt/Wingless signaling pathway in
      this type of tumor.

PMID- 11213833
TI  - Evidence for two modes of allelic loss: multifocal analysis on both early and
      advanced gastric carcinomas.
AB  - To assess the extent and the timing of allelic loss required for the progression
      of gastric carcinoma, the intratumoral distribution of loss of heterozygosity
      (LOH) was compared in early and advanced tumors: early loss is uniformly observed
      in all tumor areas and late loss is localized in parts of tumor tissue. Tumor
      sites (167 sites) obtained from 42 gastric carcinoma tissues (26 advanced cancers
      and 16 early cancers) were examined for LOH on chromosomes 5q, 9p, 13q, 17p, and
      18q. By using two or three microsatellite markers for each chromosome arm, it was
      shown that of 29 tumors showing LOH in at least one tumor site, 15 (51.7%, 12
      advanced and three early cancers) harbored multiple losses on three or more
      chromosome arms, and 89.4% (84 of 94) of these losses was uniformly found in all
      tumor sites tested. In the remaining 14 tumors (48.3%, eight advanced and six
      early tumors) with sporadic losses on one or two chromosome arms, 44% (11 of 25)
      of the losses were commonly shared among the sites tested. Such marked difference
      (P<0.001, Fisher's exact test) in the intratumoral distribution of multiple and
      sporadic LOH patterns proposes two distinct LOH subtypes: multiple losses (high
      LOH), occurring at an early stage with a few additional losses, and sporadic
      losses (low LOH), taking place relatively late during tumor progression. The
      multifocal LOH findings imply that, rather than being gradual, the allelic losses
      take place in two manners that are already determined at an early stage.

PMID- 11213834
TI  - Immunohistochemical pattern of hMSH2/hMLH1 in familial and sporadic colorectal,
      gastric, endometrial and ovarian carcinomas with instability in microsatellite
      sequences.
AB  - Alterations of DNA mismatch repair (MMR) genes are involved in carcinogenesis of
      sporadic and inherited human cancers characterised by instability of DNA
      microsatellite sequences (MSI). MSI tumours are usually identified using
      molecular analysis. In the present investigation, hMLH1 and hMSH2
      immunohistochemistry was tested in order to evaluate the utility of this method
      in predicting MMR deficiency. Colorectal (72), gastric (68), endometrial (44) and
      ovarian (17) carcinomas were independently evaluated for familial history,
      histological type of tumour, MSI status and immunohistochemical results. Loss of
      expression of either hMLH1 or hMSH2 was observed in 51 of 55 (92.8%) MSI tumours,
      while 145 of 146 microsatellite stable (MSS) tumours expressed both the hMLH1 and
      hMSH2 gene products. Independently of tumour site, an overall agreement between
      immunohistochemical and molecular results was observed in 15 hereditary non
      polyposis colorectal cancer-related tumours. Among sporadic tumours, only 2 of 60
      colorectal and 2 of 66 gastric carcinomas, displaying MSI, expressed both hMLH1
      and hMSH2 gene products. All 39 endometrial and 16 ovarian tumours presented a
      concordant molecular and immunohistochemical profile. These data show that
      immunohistochemistry is an accurate and rapid method to predict the presence of
      defective DNA MMR genes and to identify both sporadic and familial MSI tumours.

PMID- 11213835
TI  - Time-dependent expression of intestinal phenotype in signet ring cell carcinomas
      of the human stomach.
AB  - Signet ring cell carcinomas of the stomach are thought to arise from the proper
      gastric mucosa without intestinal metaplasia. It was recently reported that
      intestinal phenotypes appear along with tumor progression. In this study, we
      performed several experiments to reconsider the significance of this
      intestinalization in the growth of signet ring cell carcinoma. We applied mucin
      histochemistry with monoclonal antibodies MUC2 (Ccp58) and M1 (45M1), and
      paradoxical concanavalin A staining for class III mucin [PCS(III)] reaction to 29
      intramucosal and 25 deeply invasive carcinomas of this type and correlated the
      phenotypic expression with the size of the mucosal spread and the depth of tumor
      invasion. It was found that the larger the size of the mucosal lesion, the more
      frequently the intestinal phenotypes were demonstrated. There was no significant
      increase in the expression of the intestinal phenotype as the tumor invaded the
      deeper part of the mucosa or as the intestinal metaplasia increased in the
      background mucosa. The intestinal expression appeared to be suppressed in the
      earlier phase of deep invasion. In the mucosal part of the tumor, the intestinal
      phenotype was often expressed regionally and incompletely, coexisting with
      gastric phenotypes at the cellular and the tissue levels. These findings indicate
      that the expression of the intestinal phenotype is a time-dependent and unstable
      phenomenon probably based on the accumulation of genetic changes and plays a
      neutral role in progression of signet ring cell carcinomas.

PMID- 11213836
TI  - Gains of 12q13-14 and overexpression of mdm2 are frequent findings in intimal
      sarcomas of the pulmonary artery.
AB  - The characterization of clinical, histopathological, immunohistochemical, and
      genetic features of intimal sarcomas arising in the pulmonary artery is presented
      in this study. Four resected lungs, one endarterectomy specimen and three
      biopsies from eight patients (four males and four females; median age 41 years)
      suffering from intimal sarcomas of the pulmonary artery using conventional
      stains, immunohistochemistry, and comparative genomic hybridization (CGH) were
      analyzed. The predominant clinical presentation was dyspnea (all eight patients)
      and febrile pulmonary disease (six of eight). Signs of embolic lung disease were
      present in all patients. One patient died postoperatively, six patients died of
      disease 8-35 months after presentation, and one patient was alive 6 months after
      surgery. Histopathological examination of the submitted material showed spindle
      cell, partially myxoid and pleomorphic sarcomas. Metastases were histologically
      confirmed in three patients (lung, pleura, and skull). Immunohistochemically,
      vimentin was strongly expressed in all tumors. Focal positivity was observed for
      alpha smooth muscle actin, CD117, CD68, p53, and bcl2. No reaction could be
      obtained for endothelial markers. The proliferation index Ki-67 was between 5%
      and 80%. Six examined tumors were positive for mdm2. In the CGH analysis, gains
      and amplifications in the 12q13-14 region were found in six of eight tumors
      (75%). Other, less consistent alterations, were losses on 3p, 3q, 4q, 9p, 11q,
      13q, Xp, and Xq, gains on 7p, 17p, and 17q, and amplifications on 4q, 5p, 6p, and
      11q. Intimal sarcomas of the pulmonary artery are tumors with an unfavorable
      prognosis and poorly differentiated morphology. A majority of tumors show a
      consistent genetic alteration (gains and amplifications in the 12q13-14 region)
      and overexpression of mdm2, implicating the mdm2/p53 pathway as a possible
      mechanism in the tumor pathogenesis.

PMID- 11213837
TI  - Angiomyxolipoma shares cytogenetic changes with lipoma, spindle cell/pleomorphic
      lipoma and myxoma.
AB  - Angiomyxolipoma is a rare variant of lipoma, two cases of which have recently
      been described. We report on the hitherto unreported clonal chromosomal changes
      of a third case of angiomyxolipoma. The karyotype showed a
      46,XX,t(7;13)(p15;q14),t(8;12)(q13;p13)[17]/46,XX[3]. The involvement of 13q14,
      12p13, and 8q13 supports a relationship with other types of benign lipomatous and
      myxoid tumors.

PMID- 11213838
TI  - Expression of monocyte chemoattractant protein-1 in peritoneal endometriotic
      cells.
AB  - It is well known that the number of peritoneal macrophages is increased in
      patients with pelvic endometriosis. We measured the concentration of monocyte
      chemoattractant protein-1 (MCP-1) using an enzyme-linked immunosorbent assay
      (ELISA) in the peritoneal fluid of women with and without endometriosis. The
      expression of MCP-1 in pelvic endometriotic lesions obtained from the peritoneum
      was also examined using immunohistochemistry and nonradioactive in situ
      hybridization. The mean concentration of MCP-1 in the peritoneal fluid was
      significantly higher in the patients with endometriosis (P<0.05). The most
      significant elevation, compared with non-endometriosis patients, was found in
      stage I of the disease (P<0.05). However, no statistically significant difference
      was found among endometriosis stages I, II, III, and IV. Immunohistochemical
      staining revealed that MCP-1-positive cells were localized in the glandular
      epithelium of the endometriotic lesions and in the stromal macrophages
      distributed in those lesions, but normal peritoneal cells were negative. The in
      situ hybridization method demonstrated expression of MCP-1 mRNA on the
      endometriotic glandular epithelium and stromal macrophages. These findings
      suggest that MCP-1 may be involved in the histogenesis and early development of
      peritoneal endometriosis.

PMID- 11213839
TI  - Alteration of CD44 and cadherins expression: possible association with augmented
      aggressiveness and invasiveness of endometrial carcinoma.
AB  - Cadherins and CD44 isoforms are transmembrane glycoproteins with diverse
      functions in cell-cell and cell-matrix interactions and may be a determinant of
      invasive and metastatic behavior in carcinomas. The immunohistochemical
      expression of cadherins and CD44 in tissue samples from 15 normal endometrium and
      33 endometrial adenocarcinomas were examined. The immunohistochemical analysis
      was performed using the monoclonal antibody HECD-1 against E-cadherin and the
      polyclonal antibody against N-cadherin. In addition, the monoclonal antibodies
      2C5, which binds to CD44s and all of the variants encoded by exons 3-10; 3G5,
      which is specific for CD44v3; and 2F10, which is specific for CD44v6 were used. E
      cadherin (P=0.0001) and N-cadherin (P<0.001) expressions were statistically lower
      in endometrial adenocarcinoma than in normal endometrium. In contrast, an
      overexpression of CD44 isoforms (P<0.01) and CD44v3 (P<0.01) expressions was
      found in endometrial adenocarcinomas compared with normal endometrium. No
      difference was noted for CD44v6. An association was found between a decrease in E
      cadherin expression and the occurrence of local recurrent and nodal metastasis.
      An association was found between CD44 overexpression, lymph space involvement,
      and myometrial invasion. Our results suggest that cadherin and CD44 expressions
      in endometrial carcinomas may have a prognostic value. Alteration of CD44 seems
      to be related to local invasion, while alteration of E-cadherin seems to be
      associated with dissemination of the disease.

PMID- 11213840
TI  - Immunohistochemical analysis of the proliferative activity of neuroendocrine
      tumors from various organs. Are there indications for a neuroendocrine tumor
      carcinoma sequence?
AB  - Small-cell neuroendocrine carcinomas (NECs) of the prostate are believed not to
      derive from benign orthotopic NE epithelial cells. Instead, an origin from a
      putative stem cell is actually the most favored concept. Whether this concept can
      also be applied to neuroendocrine tumors (NETs) of other organs, especially
      whether there are indications for well-differentiated NET-NEC sequence, is
      subject of the present study. A double-labeling technique for the proliferation
      marker MIB-1 and the NE markers chromogranin A (ChrA) and synaptophysin (SNP) was
      used for the immunohistochemical analysis of 45 well-differentiated NETs, 16 well
      differentiated (low-grade) NECs, and 63 high-grade NECs of the esophagus,
      stomach, small intestine, appendix, colon, lung, prostate, and urinary bladder.
      The lowest proliferative activity was found in NETs (0.85% of tumor cells), and
      the highest activity was found in high-grade NECs (72.5%). The expression of ChrA
      was highest in NETs and lowest in high-grade NECs. None of the NETs and only
      sporadic cells in low-grade NECs showed double labeling (up to 0.05%). Up to 50%
      of the tumor cells in high-grade NECs were positive for MIB-1 and SNP. The
      percentage of double-labeled cells ranged between 0.9 and 39.6 (mean 9.7). No
      double-labeled cells were found in the normal epithelium adjacent to the tumors.
      Transitions from NET to NEC could not be observed. NETs and low-grade NECs differ
      in their proliferative activity from high-grade NECs, suggesting that they may
      arise from different precursor cell populations.

PMID- 11213841
TI  - Volume-weighted mean nuclear volume and numerical nuclear density in the
      cardiomyocyte following enalapril and verapamil treatment.
AB  - The estimation of the volume-weighted mean nuclear volume, nu(nu), and the
      numerical nuclear density in the plane, N(A), was used to analyze cardiomyocyte
      nuclei in the condition of cardiac hypertrophy caused by nitric oxide (NO)
      synthesis blockade and simultaneous antihypertensive treatment for 40 days (four
      groups of ten rats each: control, L-NAME, L-NAME+enalapril, L-NAME+verapamil).
      The blood pressure (BP) increased 71% in the L-NAME group. In the L
      NAME+enalapril and L-NAME+verapamil groups, the BP did not show any alteration
      when compared with the respective controls. In comparison with the control group,
      nu(nu) was 250% greater, and the N(A) was 25% smaller in the L-NAME animals,
      while no difference occurred in the other two groups. With respect to
      cardiomyocyte nuclear size, the present results suggest a beneficial effect of
      the angiotensin-converting enzyme inhibitor enalapril and the calcium channel
      blocker verapamil when NO synthesis is blockaded.

PMID- 11213842
TI  - Personality disorders in the community: a report from the Australian National
      Survey of Mental Health and Wellbeing.
AB  - BACKGROUND: The first set of aims of the present study was to determine the
      prevalence of personality disorders (PDs) in a nation, and gender differences in
      the types and numbers of PDs endorsed. The second set of aims was to establish
      the relationship of PD to other, non-PD disorders, physical conditions, and
      disability. METHOD: Data were obtained from the Australian National Survey of
      Mental Health and Wellbeing, conducted between May and August 1997. A stratified
      random sample of households was generated, from which all those aged 18 or over
      were considered potential interviewees. There were 10,641 respondents to the
      survey, and this represented a response rate of 78%. Each interviewee was asked
      59 questions indexing specific ICD-10 PD criteria. RESULTS: Of the total survey
      sample, 704 persons had at least one PD. Using weighted replicate weights, it was
      estimated that approximately 6.5% of the adult population of Australia have one
      or more PDs (lifetime prevalence). Persons with PD were more likely to be
      younger, male, and not married, and to have an anxiety disorder, an affective
      disorder, a substance use disorder, or a physical condition. They were also more
      likely to have greater disability than those without PD. CONCLUSION: The study is
      the first nationwide survey of mental disorders conducted within Australia. It
      provides an estimate of the prevalence of the various types of PD. The survey has
      considerable limitations, however, and these are discussed.

PMID- 11213843
TI  - Prevalence of alcohol consumption, abuse and dependence in a country with high
      per capita consumption: findings from the German TACOS study. Transitions in
      Alcohol Consumption and Smoking.
AB  - BACKGROUND: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS)
      project is to investigate substance use and use disorders in the adult general
      population in a region of the under-researched north of Germany, focussing on
      smoking and alcohol consumption. In this study, the design and quality assurance
      provisions of the baseline cross-section of the longitudinal project are
      described. Prevalence rates of alcohol use disorders, consumption pattern, and
      the nature of their association are also analysed with regard to preventive
      strategies. METHOD: A random sample of 4075 participants, aged 18 to 64 and drawn
      from residents registration office files, was interviewed with a DSM-IV adapted
      version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an
      unbiased database with regard to demographic characteristics. RESULTS: Low
      lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and
      hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to
      southern regions of Germany and US American data. In contrast, we found a
      comparatively high percentage of moderate alcohol uses. Male subjects are more
      affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2;
      dependence OR 4.3, 95% CI 2.8-6.4). The association between alcohol use disorders
      and alcohol consumption pattern revealed a weaker relation for alcohol abuse
      compared to dependence. CONCLUSION: National and regional drinking habits and
      norms have to be considered as a significant source of variance, supporting the
      need for European epidemiological research on substance use in addition to US
      American activities, and emphasising the advantages of community-based preventive
      measures. An evaluation of public recommendations for safe limits of alcohol
      consumption and prevention targets referring to average consumption is indicated.
      There is also a need for a clear distinction between alcohol abuse and
      dependence.

PMID- 11213844
TI  - Al Ain Community Survey of Psychiatric Morbidity III. The natural history of
      psychopathology and the utilization rate of psychiatric services in Al Ain.
AB  - BACKGROUND: We evaluated the natural history of psychopathology in a stratified
      sample (n = 245) comprising subjects with no DSM-III-R psychiatric disorder,
      subthreshold disorder and threshold (DSM-III-R) psychiatric disorder,
      respectively, over a 12-months period, using the Structured Clinical Interview
      for DSM-III-R mental disorders (SCID) as an assessment tool. METHODS: A
      representative sample categorized 1 year earlier into DSM-III-R psychiatric
      disorder, subthreshold disorder and no DSM-III-R psychiatric disorder were
      reassessed with SCID 1 year on. The incidence, recovery rates and the percentage
      of subthreshold disorders which become DSM-III-R disorders were calculated. The
      utilization rate of psychiatric services was also assessed. RESULTS: The
      incidence rate of new cases was 10.4%. The recovery (remission) rate was 41.5%,
      and approximately 20% of subthreshold disorders became definitive disorders (DSM
      III-R) after 1 year. Anxiety disorders tend to have a higher magnitude of
      temporal stability in comparison with depressive disorders. Male sex and contact
      with psychiatric services were found to affect the recovery rate. Approximately
      13% of the sample had made contact with psychiatric services with no gender
      differences, but men were significantly more often hospitalized than women.
      CONCLUSION: Our findings indicate that mental disorders are relatively common.
      The high incidence rate found in this study is attributed in part to the high
      negative rate at baseline assessment. Approximately 60% of psychiatric disorders
      in the community are persistent, and patients with emotional disorder under
      utilize existing services.

PMID- 11213845
TI  - Continuity of contact with psychiatric services: immigrant and Australian-born
      patients.
AB  - BACKGROUND: Under-representation of ethnic minority groups in psychiatric
      services has been widely reported in Western nations. The present study examined
      whether there were differences between immigrant and Australian-born patients in
      their maintenance of contact with a statewide psychiatric service system.
      METHODS: Groups were selected on the empirical grounds that they are differently
      represented in this service system. Employing a form of case-control design, four
      groups of patients were compared: those born in Australia, the United Kingdom,
      Southern Europe, and South East/East Asia respectively (n = 79 for each). Groups
      were identically matched on sex, age, diagnosis (either schizophrenia or bipolar
      illness) and locality of service. The groups did not differ as to the timing of
      their first appearance in the 3-year period in which their psychiatric contact
      was examined. RESULTS: Despite their different representation in the psychiatric
      service system, the four groups did not differ on measures of continuity of
      contact. Measures included number of contacts with mental health community
      services, number of admissions to inpatient wards, length of stay in hospital and
      the longest interval between any two successive service contacts. CONCLUSIONS:
      The commonly reported underrepresentation of immigrant groups in the psychiatric
      service system does not appear to be due to greater discontinuation of contact
      with services. If the assumption of equal community prevalence of disorder is
      made, then the observed under-representation may be due to differential rates of
      access to (that is, initial contact with) psychiatric services.

PMID- 11213846
TI  - Increasing use of Dutch mental health care: an investigation.
AB  - BACKGROUND: In the Netherlands, a previous study has shown an increase in the 1
      year prevalence of patients in mental health care during the 1990s. Though the
      number of inpatients decreased, this decrease was far outweighed by a large
      increase of patients in community care, causing an increase in total year
      prevalence. The current study aimed at an explanation. METHODS: The Groningen
      psychiatric case register was used to determine treated incidence and prevalence
      over a 9-year period for different age groups. RESULTS: Incidence rates proved
      fairly stable. The increased prevalence was primarily caused by the growing
      number of existing cases. People had their first encounter with mental health
      care at an earlier age and remained in care for a larger part of their life.
      CONCLUSIONS: Results indicate that the accessibility of Dutch mental health care
      was increased by the implementation of community care. In contrast to other
      countries, Dutch community care lowered the threshold for mental health care
      utilization without broadening the target group of mental health services.

PMID- 11213847
TI  - A trans-cultural comparison of four psychiatric case-finding instruments in a
      Welsh community.
AB  - BACKGROUND: Case-finding instruments have been developed for different purposes
      and in different cultural settings. Four instruments designed to detect
      psychiatric morbidity in community-based populations were studied in order to
      compare the performance of instruments from differing sources in a common
      setting. METHODS: The study was undertaken in a Welsh primary care setting. The
      Revised Clinical Interview Schedule (CIS-R) was used to define caseness. The
      instruments studied were the General Health Questionnaire (GHQ), the Mental
      Health Index (MHI), the Self Reporting Questionnaire (SRQ), and the Shona Symptom
      Questionnaire (SSQ). Performance was assessed by standard test indices, kappa
      values, and receiver operating curve analysis. The content of the four
      instruments was also compared. RESULTS: Sixty-nine adults completed the study.
      The prevalence of CIS-R caseness in this sample was 45%. No significant
      differences in case-recognition were found and all instruments had
      misclassification rates of 10% or less. The instruments showed wide variation in
      content. Half the items were unique to a single instrument and only three items
      (sleep, unhappiness and decision making) were shared by three instruments. The
      most frequent symptom within the total sample, and among cases, was the
      Zimbabwean concept of 'thinking too much'. CONCLUSIONS: Etic instruments (SRQ and
      SSQ) performed as well as emic ones (GHQ and MHI) in this setting, despite the
      wide variation in instrument structure.

PMID- 11213848
TI  - Interrelationships among mortality rates, drug costs, total cost of care, and
      length of stay in United States hospitals: summary and recommendations for
      clinical pharmacy services and staffing.
AB  - We evaluated interrelationships and associations among mortality rates, drug
      costs, total cost of care, and length of stay in United States hospitals.
      Relationships between these variables and the presence of clinical pharmacy
      services and pharmacy staffing also were explored. A database was constructed
      from the 1992 American Hospital Association's Abridged Guide to the Health Care
      Field, the 1992 National Clinical Pharmacy Services database, and 1992 Health
      Care Finance Administration mortality data. A severity of illness-adjusted
      multiple regression analysis was employed to determine relationships and
      associations. Study populations ranged from 934-1029 hospitals (all hospitals for
      which variables could be matched). The only pharmacy variable associated with
      positive outcomes with all four health care outcome measures was the number of
      clinical pharmacists/occupied bed. That figure tended to have the greatest
      association (slope) with reductions in mortality rate, drug costs, and length of
      stay. As clinical pharmacist staffing levels increased from the tenth percentile
      (0.34/100 occupied beds) to the ninetieth percentile (3.23/100 occupied beds),
      hospital deaths declined from 113/1000 to 64/1000 admissions (43% decline). This
      resulted in a reduction of 395 deaths/hospital/year when clinical pharmacist
      staffing went from the tenth to the ninetieth percentile. This translated into a
      reduction of 1.09 deaths/day/hospital having clinical pharmacy staffing between
      these staffing levels, or 320 dollars of pharmacist salary cost/death averted.
      Three hospital pharmacy variables were associated with reduced length of stay in
      1024 hospitals: drug protocol management (slope -1.30, p=0.008), pharmacist
      participation on medical rounds (slope -1.71, p<0.001), and number of clinical
      pharmacists/occupied bed (slope -26.59, p<0.001). As drug costs/occupied bed/year
      increased, severity of illness-adjusted mortality rates decreased (slope 
      38609852, R(2) 8.2%, p<0.0001). As the total cost of care/occupied bed/year
      increased, those same mortality rates decreased (slope -5846720642, R(2) 14.9%,
      p<0.0001). Seventeen clinical pharmacy services were associated with improvements
      in the four variables.

PMID- 11213849
TI  - Epidemiology, resistance, and outcomes of Acinetobacter baumannii bacteremia
      treated with imipenem-cilastatin or ampicillin-sulbactam.
AB  - STUDY OBJECTIVE: To evaluate epidemiology, resistance, and treatment outcomes of
      Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin
      sulbactam for 72 hours or longer. DESIGN: Retrospective analysis. SETTING:
      University teaching hospital. PATIENTS: Forty-eight patients with A. baumannii
      bacteremia. INTERVENTION: Evaluation of susceptibility and clinical data from 48
      patients treated with either ampicillin-sulbactam or imipenem-cilastatin from
      1987-1999. MEASUREMENTS AND MAIN RESULTS: Comparing ampicillin-sulbactam and
      imipenem-cilastatin, there were no differences between days of bacteremia (4 vs 2
      days, p=0.05), days to resolution of temperature or white blood cell count,
      success or failure during or at end of treatment, or intensive care unit total or
      antibiotic-related length of stay (13 vs 10 days, p=0.05). Patients treated with
      ampicillin-sulbactam had significantly decreased antibiotic treatment costs (1500
      dollars vs 500 dollars, p=0.004). CONCLUSION: Ampicillin-sulbactam is at least as
      effective as imipenem-cilastatin based on clinical response at days 2, 7, and end
      of treatment and is a cost-effective alternative for treatment of A. baumannii
      infections.

PMID- 11213850
TI  - Influence of coadministration of fluoxetine on cisapride pharmacokinetics and QTc
      intervals in healthy volunteers.
AB  - STUDY OBJECTIVE: To evaluate the effect of fluoxetine on the pharmacokinetics and
      cardiovascular safety of cisapride at steady state in healthy men. DESIGN: Open
      label, three-phase, sequential study. SETTING: Clinical research center.
      SUBJECTS: Twelve healthy male volunteers. INTERVENTIONS: Each subject was treated
      according to the following sequence: baseline; phase 1 (days 1-6): cisapride 10
      mg 4 times/day; washout (days 7-13); phase 2 (days 14-44): fluoxetine 20 mg/day;
      and phase 3 (days 45-52): cisapride 10 mg 4 times/day (days 45-51) plus
      fluoxetine 20 mg/day (days 45-52). MEASUREMENTS AND MAIN RESULTS: Blood samples
      were drawn and 12-lead electrocardiograms performed at specified time points
      after the last morning dose of cisapride in phases 1 and 3. Blood samples also
      were taken before morning doses on the 3rd, 4th, and 5th days of phases 1 and 3.
      Electrocardiograms were done at baseline and on the last day of the washout
      period and phase 2. Coadministration of fluoxetine significantly decreased
      cisapride plasma concentrations. There were no clinically significant changes in
      corrected QT intervals during administration of cisapride alone or with
      fluoxetine. Cisapride was well tolerated when administered alone or with
      fluoxetine. CONCLUSION: Cisapride can be administered safely to patients
      receiving low therapeutic dosages of fluoxetine.

PMID- 11213851
TI  - Relative bioavailability of lamotrigine chewable dispersible tablets administered
      rectally.
AB  - STUDY OBJECTIVE: To determine the relative bioavailability of lamotrigine (LTG)
      chewable dispersible tablets after rectal administration. DESIGN: Two-period,
      crossover study with a 2-week washout between dosing periods. SETTING: Clinical
      research center. PATIENTS: Twelve healthy adult volunteers. INTERVENTION: One
      hundred milligrams of a LTG chewable dispersible tablet was administered by oral
      and rectal routes. MEASUREMENTS AND MAIN RESULTS: Plasma samples were collected
      before and up to 120 hours after drug administration. The samples were analyzed
      for LTG by high-performance liquid chromatography, and the relative
      bioavailability was determined. Drug concentrations were lower after rectal than
      after oral administration. The relative bioavailability (F =
      AUC(rectal)/AUC(oral)) was 0.52 +/- 0.23 (SD). CONCLUSION: Drug prepared from LTG
      chewable dispersible tablets is absorbed rectally, although not to the same
      extent as when given orally. Rectal administration of suspension of these tablets
      can be an acceptable route of administration.

PMID- 11213852
TI  - Lack of effect of a single dose of ketoconazole on the pharmacokinetics of
      citalopram.
AB  - STUDY OBJECTIVE: To determine whether the pharmacokinetics of the antidepressant
      citalopram are affected by ketoconazole, a potent inhibitor of cytochrome P450
      (CYP) 3A4. DESIGN: Single-center, double-blind, randomized, three-way crossover
      trial. SETTING: Research facility. PARTICIPANTS: Eighteen healthy male and female
      volunteers. INTERVENTION: Subjects received three treatments with a 14-day
      washout period: single dose of ketoconazole 200 mg plus placebo, single dose of
      citalopram 40 mg plus placebo, and single dose of ketoconazole 200 mg plus single
      dose of citalopram 40 mg. MEASUREMENTS AND MAIN RESULTS: Pharmacokinetic
      parameters were determined after each treatment. The pharmacokinetic profile of
      citalopram administered alone was essentially identical to that when administered
      with ketoconazole. Similarly, the pharmacokinetics of the metabolite
      desmethylcitalopram were unaltered by ketoconazole. CONCLUSION: No changes in
      pharmacokinetics of citalopram were observed after coadministration of
      ketoconazole, suggesting that ketoconazole and other CYP3A4 inhibitors may be
      administered safely with citalopram. Furthermore, no adjustment of citalopram
      dosage should be necessary in most patients who receive the drug in combination
      with a CYP3A4 inhibitor.

PMID- 11213853
TI  - The pharmacokinetics of subcutaneous enoxaparin in end-stage renal disease.
AB  - STUDY OBJECTIVE: To evaluate the pharmacokinetics of enoxaparin in end-stage
      renal disease (ESRD), and determine if dosage reduction is necessary to maintain
      antifactor Xa activity concentrations within the therapeutic range. DESIGN:
      Prospective, single-dose pharmacokinetic study. SETTING: University-affiliated
      general clinical research center. PATIENTS: Eight nonthrombosed patients with
      ESRD requiring hemodialysis. INTERVENTION: All subjects received a single dose of
      enoxaparin sodium 1 mg/kg subcutaneously and had serial plasma antifactor Xa
      activity concentrations measured over 24 hours. MEASUREMENTS AND MAIN RESULTS:
      The pharmacokinetics of enoxaparin were determined from plasma antifactor Xa
      activity concentrations, and various multiple-dose regimens were simulated. After
      administration of the drug, total body clearance was 14.6 ml/minute and there was
      a 2-fold prolongation in antifactor Xa activity half-life compared with values
      reported in healthy subjects. All other pharmacokinetic parameters were similar
      to those in healthy subjects and patients with chronic renal insufficiency. An
      accumulation ratio of 1.6 was estimated for a dosing interval of every 12 hours
      based on single-dose pharmacokinetics. When various therapeutic regimens were
      simulated to predict average steady-state antifactor Xa activity, standard
      enoxaparin dosages of 1 mg/kg subcutaneously every 12 hours and 1.5 mg/kg every
      24 hours resulted in average steady-state concentrations within the therapeutic
      range. CONCLUSIONS: Based on antifactor Xa activity, ESRD has little effect on
      the pharmacokinetics of enoxaparin, and dosing adjustments are unnecessary.

PMID- 11213854
TI  - Evaluation and survey of intravenous vitamin K1 for treatment of coagulopathy in
      critically ill patients.
AB  - STUDY OBJECTIVES: To determine patient factors associated with coagulopathy, to
      assess variables affecting response to vitamin K1, to describe vitamin K1
      associated adverse reactions, and to survey Canadian tertiary care hospitals
      about vitamin K1 practice patterns in their intensive care units (ICUs). DESIGN:
      Retrospective chart audit and prospective survey. SETTING: Medical-surgical ICU
      with a 23-bed complement in a tertiary care, university-affiliated hospital, and
      47 Canadian tertiary care hospitals. PATIENTS: Forty-eight critically ill
      patients with nonconsumptive coagulopathies. INTERVENTION: Intravenous vitamin K1
      utilization over 4 months. MEASUREMENTS AND MAIN RESULTS: The only independent
      risk factor for elevated baseline international normalized ratios (INRs) was
      Acute Physiologic and Chronic Health Evaluation (APACHE) II score (r2 = 0.51,
      p<0.05). The INR values decreased after two doses of vitamin K1 10 mg for
      patients grouped as a whole (2.14 +/- 0.96 to 1.61 +/- 0.62, p<0.0001) and when
      patients were stratified according to APACHE II scores below 23 (1.83 +/- 0.44 to
      1.34 +/- 0.18, p<0.05). The INRs were not significantly reduced for patients with
      APACHE II scores of 23 or greater (2.44 +/- 1.23 to 1.82 +/- 0.66). No variables
      were associated with response, and adverse events were not observed. Of 47
      Canadian tertiary care hospitals surveyed, 27 (55%) responded. Twenty-four (89%)
      indicated that vitamin K1 was administered intravenously, and no adverse events
      resembling anaphylaxis were reported. CONCLUSION: Administration of two doses of
      intravenous vitamin K1 10 mg was associated with reversal of coagulopathies, but
      variable responses may be expected for patients with high APACHE II scores.
      Randomized, placebo-controlled studies are necessary to confirm the effectiveness
      of vitamin K1.

PMID- 11213855
TI  - Factors associated with the risk of liver enzyme elevation in patients with type
      2 diabetes treated with a thiazolidinedione.
AB  - STUDY OBJECTIVE: To characterize frequency of liver enzyme elevation in patients
      with type 2 diabetes mellitus receiving troglitazone. DESIGN: Retrospective
      study. SETTING: Hospital-affiliated medical center. PATIENTS: Two hundred ninety
      one patients with type 2 diabetes mellitus. INTERVENTION: Data from patients with
      an average troglitazone exposure of 412.7 +/- 255.6 days were studied.
      MEASUREMENTS AND MAIN RESULTS: Enzyme elevations more than 1.5 times the upper
      limit of normal (ULN) occurred in 17 patients (5.8%) and more than 3-fold
      elevations in 6 (2.1%). The relationship among enzyme elevation events,
      demographic factors, duration of troglitazone exposure, frequency of monitoring,
      and concurrent drugs (limited to glucose and lipid-lowering agents) was assessed
      by multiple logistic regression. Age was an independent predictor of risk
      (p=0.009), and concurrent insulin therapy approached statistical significance
      (p=0.051) for 1.5-fold ULN elevation in liver enzymes. Age and concurrent therapy
      with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors were the only
      significant predictors of 3-fold ULN elevations (p=0.03 and p=0.04,
      respectively). CONCLUSION: Several factors appear to increase the risk of enzyme
      elevation events in patients treated with troglitazone.

PMID- 11213856
TI  - Improved health-related quality of life with SSRIs and other antidepressants.
AB  - STUDY OBJECTIVE: To document the health-related quality of life (HRQOL) of
      depressed patients receiving antidepressant drugs. DESIGN: Cross-sectional study.
      SETTING: Community pharmacy-based setting. PATIENTS: Fifty-seven depressed
      patients. INTERVENTION: Independent pharmacist members of the Community
      Pharmacists Research Network in Georgia administered the Medical Outcomes Study
      36-Item Short-Form Health Survey (SF-36) to subjects. MEASUREMENTS AND MAIN
      RESULTS: Sixty-one percent of patients were treated with a selective serotonin
      reuptake inhibitor (SSRI) and 38.6% were treated with a non-SSRI. Those receiving
      SSRIs scored higher on the mean physical (PCS) and mental (MCS) health summary
      scores of the SF-36 than those not receiving the drugs. No significant
      differences were seen in PCS or MCS scores of men and women. CONCLUSION:
      Community pharmacists documented better HRQOL in patients receiving SSRIs than in
      those given other antidepressants.

PMID- 11213857
TI  - A review of budesonide inhalation suspension in the treatment of pediatric
      asthma.
AB  - Asthma is recognized as an inflammatory disease, and inhaled corticosteroids are
      the mainstay of treatment in patients with persistent disease. Until recently, no
      inhaled corticosteroid was approved in the United States for children aged 4
      years and younger, and no practical dosage form was available for infants and
      young children unable to use metered-dose inhalers effectively. Budesonide
      inhalation suspension (BIS) is a glucocorticoid with high topical and low
      systemic activity. In children aged 12 months-8 years, BIS improves asthma
      symptoms and lung function and decreases the need for breakthrough
      bronchodilators. Long-term follow-up studies in children concluded that BIS is
      well tolerated, with little or no effect on growth and hypothalamic-pituitary
      adrenal axis function. Thus it is a valuable therapeutic alternative to systemic
      corticosteroid therapy in infants and young children.

PMID- 11213858
TI  - A review of available fibrin-specific thrombolytic agents used in acute
      myocardial infarction.
AB  - Thrombolytic agents are a first-line therapeutic option for establishing coronary
      artery patency in acute myocardial infarction. Three fibrin-specific
      thrombolytics--alteplase, reteplase, and tenecteplase--are available in the
      United States and have undergone preliminary patency trials and large randomized,
      comparative, survival studies. Patency rates differ among them, although overall
      mortality benefit is similar. Because of this fact and the economic impact of the
      drugs, competition in this market is significant. Distinguishing features of the
      drugs will likely influence selection. Reteplase and tenecteplase offer ease of
      administration with bolus dosing. Increased fibrin specificity appears to play a
      significant role in separating them. Tenecteplase, the most highly fibrin
      specific, is associated with decreased risk of noncerebral bleeding and reduced
      need for blood transfusions in all patients, as well as longer survival in those
      with late presentation acute myocardial infarction. Current trials will reveal
      the role of these agents in combination with glycoprotein lIb-IIIa receptor
      antagonists.

PMID- 11213859
TI  - Dosing and monitoring of low-molecular-weight heparins in special populations.
AB  - As a result of numerous clinical trials and meta-analyses supporting the superior
      efficacy and relative safety of low-molecular-weight heparins (LMWHs) compared
      with unfractionated heparin (UFH), LMWHs are emerging as the antithrombotic
      agents of choice for the prevention and treatment of deep vein thrombosis and
      pulmonary embolism. In addition, data indicate that enoxaparin given with low
      dosage aspirin is more effective than UFH in treating acute coronary syndromes.
      Anti-Xa activity can be used as a biologic marker of LMWH activity. Because of
      the more predictable anticoagulant response to subcutaneous administration of
      LMWHs compared with UFH, routine monitoring of anti-Xa activity in clinically
      stable adults with uncomplicated disease is not recommended. Because the optimal
      dosage of LMWHs has not been established for patients with renal insufficiency or
      extremes of body weight, during pregnancy, or for children, anti-Xa activity
      monitoring may be warranted in these subsets.

PMID- 11213860
TI  - Implications of cytochrome P450 2C9 polymorphism on warfarin metabolism and
      dosing.
AB  - Warfarin is an anticoagulant available as a racemic mixture. The R- and S-isomers
      differ with respect to relative plasma concentrations, clearance, potency, sites
      of metabolism, and cytochrome P450 (CYP) isoenzymes responsible for metabolism. S
      Warfarin, the more potent isomer, is metabolized primarily by CYP2C9. Genetic
      polymorphisms resulting from single amino acid substitutions reduce the metabolic
      capability of 2C9. A reduction in warfarin metabolism due to genetic polymorphism
      may explain the increased warfarin response and bleeding episodes in some
      patients. Clinical studies showed an increased plasma level of S-warfarin,
      decreased clearance of S-warfarin, increased frequency of bleeding, and
      prolongation of hospitalization in patients with variant CYP2C9 alleles. Adverse
      outcomes associated with warfarin possibly could be avoided by identifying
      patients with variant alleles before therapy and starting therapy at low dosages.

PMID- 11213861
TI  - Results of a community pharmacy-based breast cancer risk-assessment and education
      program.
AB  - We tested the hypothesis that an education program addressing breast cancer
      screening schedules and modalities coupled with a breast cancer risk assessment
      provided by community pharmacists can increase women's confidence in performing
      screening practices endorsed by the American Cancer Society (ACS). This
      randomized, paired, pre-post study was conducted in six community pharmacies and
      two health-screening fairs; subjects were 140 women over 18 years of age. The
      pharmacist-administered program used the Breast Cancer Risk-Assessment Tool (Gail
      model) software provided by the National Cancer Institute of the National
      Institutes of Health. In addition, pharmacists provided education and training on
      breast self-examination (BSE), clinical breast examination (CBE), and
      mammography. Adherence to ACS guidelines for monthly BSE increased from 31% to
      56% (p<0.001) for all women 6 months after the program. Performance of monthly
      BSE by women considered at high risk for developing breast cancer increased from
      20% to 60% (p<0.005). The mean number of BSEs performed over 6 months increased
      from 2.69 to 4.09 (p<0.001). Women's confidence performing correct BSE improved
      from 6.41 to 7.04 (p<0.001) on a scale of 0-10. Adherence to ACS guidelines for
      CBE and mammography did not reveal statistically significant improvements except
      for better adherence to CBE in women aged 40-49 years (81% to 97%, p<0.025). The
      strength of the pharmacists' intervention may not appear as manipulation of high
      risk patients' behavior but as improvement of self-directed behaviors, such as
      BSE, across all age groups.

PMID- 11213862
TI  - Successful management of prolonged gamma-hydroxybutyrate and alcohol withdrawal.
AB  - A 27-year-old man was admitted with tremulousness, diaphoresis, tachypnea (28
      breaths/min), full-body rigidity, irritability, paranoia, and auditory and visual
      hallucinations 2 days after stopping long-term gamma-hydroxybutyrate (GHB) and 8
      hours after stopping alcohol intake. He received intravenous fluids and tapering
      dosages of lorazepam to control agitation and rigidity, and recovered with no
      significant sequelae after 8 days. Abrupt cessation of GHB after high-dosage
      abuse can precipitate a clinically significant withdrawal syndrome. Lorazepam
      should be considered for treatment of GHB withdrawal. Concomitant alcohol abuse
      may mask early GHB withdrawal symptoms and exacerbate withdrawal.

PMID- 11213863
TI  - Photosensitivity associated with fluorouracil, prochlorperazine, and topical
      tretinoin.
AB  - A woman newly diagnosed with colon cancer began chemotherapy with fluorouracil
      and leucovorin. Chemotherapy was given daily for 5 days with prochlorperazine
      premedication and was well tolerated. The patient continued her previous drug
      regimen during and after chemotherapy, which consisted of hormone replacement
      therapy, chloroquine, insulin, multivitamin, and tretinoin topical cream. Several
      days after the end of the first cycle of chemotherapy she experienced a dramatic
      photosensitivity reaction. Tretinoin application was discontinued, and she
      recovered. All other drugs remained unchanged. The patient was treated with five
      additional cycles of chemotherapy. She did not experience the reaction with any
      potentially photosensitizing agents again; only when the specific sequence and
      drug combination was administered in the first cycle.

PMID- 11213864
TI  - Aspirin therapy in diabetes is underutilized.

PMID- 11213865
TI  - Aspirin use among adults with diabetes: estimates from the Third National Health
      and Nutrition Examination Survey.
AB  - OBJECTIVE: Since 1997, the American Diabetes Association has recommended that
      aspirin therapy be considered for adults with diabetes who have cardiovascular
      disease (CVD) or CVD risk factors. We examined the prevalence of regular aspirin
      use among adults in the U.S. with diagnosed diabetes. RESEARCH DESIGN AND
      METHODS: The Third National Health and Nutrition Examination Survey (1988-1994)
      used a probability sample of the U.S. population and included an interview,
      physical examination, and laboratory studies. Among the survey participants were
      1,503 adults (age > or =21 years) with self-reported diabetes. We defined regular
      aspirin use as reported having taken aspirin > or = 15 times in the previous
      month. CVD conditions were self-reported heart attack and stroke and symptoms of
      angina and claudication. CVD risk factors included smoking, hypertension,
      obesity, albuminuria, lipid abnormalities, and family history of heart attack.
      RESULTS: An estimated 27% of adults with diabetes had CVD, and an additional 71%
      had one or more CVD risk factors. Aspirin was used regularly by 37% of those with
      CVD and by 13% of those with risk factors only Adjusted odds of regular aspirin
      use were significantly greater for individuals with CVD than for those with one
      CVD risk factor (odds ratio [OR] = 4.3); for non-Hispanic whites than for blacks,
      Mexican-Americans, and others (OR = 2.5); and for individuals age 40-59 years
      than for those <40 years (OR = 33.3). CONCLUSIONS: Nearly every adult in the U.S.
      with diabetes has at least one risk factor for CVD and thus may be considered a
      potential candidate for aspirin therapy. During 1988-1994, only 20% (95% CI 16
      23) took aspirin regularly Major efforts are needed to increase aspirin use.

PMID- 11213866
TI  - Impact of automated calls with nurse follow-up on diabetes treatment outcomes in
      a Department of Veterans Affairs Health Care System: a randomized controlled
      trial.
AB  - OBJECTIVE: We evaluated automated telephone disease management (ATDM) with
      telephone nurse follow-up as a strategy for improving diabetes treatment
      processes and outcomes in Department of Veterans Affairs (VA) clinics. We also
      compared the results with those of a prior ATDM trial conducted in a county
      health care system. RESEARCH DESIGN AND METHODS: A total of 272 VA patients with
      diabetes using hypoglycemic medications were randomized. During the 1-year study
      period, intervention patients received biweekly ATDM health assessment and self
      care education calls, and a nurse educator followed up with patients based on
      their ATDM assessment reports. Telephone surveys were used to measure patients'
      self-care, symptoms, and satisfaction with care. Outpatient service use was
      evaluated using electronic databases and self-reports, and glycemic control was
      measured by HbA1c and serum glucose testing. RESULTS: At 12 months, intervention
      patients reported more frequent glucose self-monitoring and foot inspections than
      patients receiving usual care and were more likely to be seen in podiatry and
      diabetes specialty clinics. Intervention patients also were more likely than
      control patients to have had a cholesterol test. Among patients with baseline
      HbA1c levels > or =8%, mean end-point values were lower among intervention
      patients than control patients (8.7 vs. 9.2%, respectively; P = 0.04). Among
      intervention and control patients with baseline values > or =9%, mean end-point
      values were 9.1 and 10.2%, respectively (P = 0.04). At follow-up, intervention
      patients reported fewer symptoms of poor glycemic control than control patients
      and greater satisfaction with their health care. CONCLUSIONS: This intervention
      improved the quality of VA diabetes care. Intervention effects for most end
      points replicated findings from the prior county clinic trial, although
      intervention-control differences in the current study were smaller because of the
      relatively good self-care and health status among the current study's enrollees.

PMID- 11213867
TI  - The potentially poor response to outpatient diabetes care in urban African
      Americans.
AB  - OBJECTIVE: HbA1c levels can be reduced in populations of diabetic patients, but
      some individuals may exhibit little improvement. To search for reasons underlying
      differences in HbA1c outcome, we analyzed patients managed in an outpatient
      diabetes clinic. RESEARCH DESIGN AND METHODS: African-Americans with type 2
      diabetes were categorized as responders, intermediate responders or poor
      responders according to their HbA1c level after 1 year of care. Logistical
      regression was used to determine baseline characteristics that distinguished poor
      responders from responders. Therapeutic strategies were examined for each of the
      response categories. RESULTS: The 447 patients had a mean age and disease
      duration of 58 and 5 years, respectively, and BMI of 32 kg/m2. Overall, the mean
      HbA1c level fell from 9.6 to 8.1% after 12 months. Mean HbA1c levels improved
      from 8.8 to 6.2% in responders, and from 9.5 to 7.9% in intermediate responders.
      In poor responders, the average HbA1c level was 10.8% on presentation and 10.9%
      at 1 year. The odds of being a poor responder were significantly increased with
      longer disease duration, higher initial HbA1c level, and greater BMI. Although
      doses of oral agents and insulin were significantly higher among poor responders
      at most visits, the acceleration of insulin therapy did not occur until late in
      the follow-up period. CONCLUSIONS: Clinical diabetes programs need to devise
      methods to identify patients who are at risk for persistent hyperglycemia.
      Whereas patient characteristics explain some heterogeneity of HbA1c outcome (and
      may aid in earlier identification of patients who potentially may not respond to
      conventional treatment), insufficient intensification of therapy may also be a
      component underlying the failure to achieve glycemic goals.

PMID- 11213868
TI  - A foot care program for diabetic unilateral lower-limb amputees.
AB  - OBJECTIVE: To assess the efficacy of a specialist foot care program designed to
      prevent a second amputation and to assess peripheral vascular disease (PVD) and
      peripheral neuropathy in diabetic unilateral lower-limb amputees. RESEARCH DESIGN
      AND METHODS: Investigations were carried out in 143 diabetic lower-limb
      unilateral amputees referred to a subregional rehabilitation center for
      prosthetic care from a catchment area of approximately 3 million people.
      Peripheral vascular and nerve assessment, education, and podiatry were provided
      for each patient. RESULTS: For the patients referred to the foot care program,
      there were no baseline differences between the patients who proceeded to a
      bilateral amputation (n = 22) and those who remained as unilateral amputees (n =
      121) in their level of foot care knowledge and mean neuropathy scores. Mean ankle
      brachial pressure index was significantly lower for the bilateral amputees (0.75
      +/- 0.04) compared with the unilateral amputees (0.90 +/- 0.03, mean +/- SEM, P <
      0.05), but there was no difference in the level of oxygen in the skin. However,
      the level of carbon dioxide was significantly lower in patients with bilateral
      amputation (24.21 +/- 2.16 vs. 31.20 +/- 0.85 mmHg, P < 0.03). Overall, the
      establishment of a specialist foot care program made no impact on contralateral
      limb amputation (22 of 143, 15.4%) compared with matched patients without the
      program (21 of 148, 14%) over a 2-year outcome period for each patient.
      CONCLUSIONS: PVD is more closely associated with diabetic bilateral amputation
      than neuropathy or level of foot care knowledge. Preventative foot care programs
      for diabetic unilateral amputees should therefore place greater emphasis on
      peripheral vascular assessment to identify patients at risk and on the
      development of timely intervention strategies.

PMID- 11213869
TI  - Teaching subjects with type 2 diabetes how to incorporate sugar choices into
      their daily meal plan promotes dietary compliance and does not deteriorate
      metabolic profile.
AB  - OBJECTIVE: To determine whether teaching free-living subjects with type 2
      diabetes how to incorporate added sugars or sweets into their daily meal plan
      results in a greater consumption of calories (fat or sugar) and deteriorates
      their glycemic or lipid profiles but improves their perceived quality of life.
      RESEARCH DESIGN AND METHODS: In an 8-month randomized controlled trial, 48 free
      living subjects with type 2 diabetes were taught either a conventional (C) meal
      plan (no concentrated sweets) or one permitting as much as 10% of total energy as
      added sugars or sweets (S). Mean individual nutrient intake was determined using
      the average of six 24-h telephone recalls per 4 months. Metabolic control and
      quality of life were evaluated every 2 months. Quality of life was assessed using
      the Medical Outcome Survey and the Diabetes Quality of Life questionnaire.
      RESULTS: The S group did not consume more calories (fat or sugar) and in fact ate
      significantly less carbohydrate (-15 vs. 10 g) and less starch (-7 vs. 8 g) and
      had a tendency to eat fewer calories (-77 vs. 81 kcal) than the C group. Weight
      remained stable, and there was no evidence that consuming more sugar worsened
      metabolic profile or improved their perceived quality of life. CONCLUSIONS:
      Giving individuals with type 2 diabetes the freedom to include sugar in their
      daily meal plan had no negative impact on dietary habits or metabolic control.
      Health professionals can be reassured and encouraged to teach the new "sugar
      guidelines," because doing so may result in a more conscientious carbohydrate
      consumption.

PMID- 11213870
TI  - Beneficial effects of a soy-based dietary supplement on lipid levels and
      cardiovascular risk markers in type 2 diabetic subjects.
AB  - OBJECTIVE: Consumption of soy protein has recently been shown to improve the
      blood lipid levels in nondiabetic subjects. The purpose of this study was to
      evaluate if a dietary supplement of soy protein, isoflavones, and cotyledon fiber
      (Abalon) affects cardiovascular risk markers, blood glucose, and insulin levels
      in type 2 diabetic subjects. RESEARCH DESIGN AND METHODS: Twenty type 2 diabetic
      subjects participated in a crossover trial. They were randomized to double-blind
      supplementation for 6 weeks with Abalon (soy protein [50 g/day] with high levels
      of isoflavones [minimum 165 mg/day] and cotyledon fiber [20 g/day]) or placebo
      (casein [50 g/day] and cellulose [20 g/day]), separated by a 3-week wash-out
      period. RESULTS: The results are expressed as means +/- SD. The percentage mean
      treatment difference between Abalon and placebo demonstrated significantly lower
      mean values after Abalon for LDL cholesterol (10 +/- 15%, P < 0.05), LDL/UHDL
      ratio (12 +/- 18%, P < 0.05), apolipoprotein (apo) B100 (30 +/- 38%, P < 0.01),
      triglycerides (22 +/- 10%, P < 0.05), and homocysteine (14 +/- 21%, P < 0.01),
      whereas the total cholesterol value tended to be less significant but still lower
      (8 +/- 15%, P < 0.08). No change occurred in HDL cholesterol, apo B100/apo A1
      ratio, plasminogen activator inhibitor 1, factor VIIc, von Willebrand factor,
      fibrinogen, lipoprotein(a), glucose, HbA1c, or 24-h blood pressure. CONCLUSIONS:
      These results indicate beneficial effects of dietary supplementation with Abalon
      on cardiovascular risk markers in type 2 diabetic subjects. This improvement is
      seen even in individuals with near-normal lipid values.

PMID- 11213871
TI  - Comparison of single-mother and two-parent families on metabolic control of
      children with diabetes.
AB  - OBJECTIVE: To understand the impact of family structure on the metabolic control
      of children with diabetes, we posed two research questions: 1) what are the
      differences in sociodemographic, family, and community factors between single
      mother and two-parent families of diabetic children? and 2) to what extent do
      these psychosocial factors predict metabolic control among diabetic children from
      single-mother and two-parent families? RESEARCH DESIGN AND METHODS: This cross
      sectional study included 155 diabetic children and their mothers or other female
      caregivers. The children were recruited if they had been diagnosed with diabetes
      for at least 1 year, had no other comorbid chronic illnesses, and were younger
      than 18 years of age. Interviews and self-report questionnaires were used to
      assess individual, family, and community variables. RESULTS: The findings
      indicate that diabetic children from single-mother families have poorer metabolic
      control than do children from two-parent families. Regression models of
      children's metabolic control from single-mother families indicate that age and
      missed clinic appointments predicted HbA1c levels; however, among two-parent
      families, children's ethnicity and adherence to their medication regimen
      significantly predicted metabolic control. CONCLUSIONS: This study suggests that
      children from single-mother families are at risk of poorer metabolic control and
      that these families have more challenges to face when raising a child with a
      chronic illness. Implications point to a need for developing strategies sensitive
      to the challenges of single mothers.

PMID- 11213872
TI  - Factors influencing glycemic control in young people with type 1 diabetes in
      Scotland: a population-based study (DIABAUD2).
AB  - OBJECTIVE: To evaluate differences in HbA1c concentrations between centers and to
      assess the factors associated with glycemic control in young people with type 1
      diabetes in Scotland. RESEARCH DESIGN AND METHODS: Data on 1,755 patients (94% of
      those registered) were collected from 18 centers providing care to children <15
      years of age. At every clinic visit, a duplicate HbA1c sample was measured in a
      reference laboratory, and clinical information was collected prospectively.
      RESULTS: Average HbA1c concentration was 9.1% (range 5.0-15.0). The following
      significant associations with HbA1c level were identified: age, insulin regimen,
      BMI, season, social circumstances, and family history. HbA1c concentrations were
      significantly worse in older children (age 10-15 years 9.5% vs. other ages 8.8%,
      P < 0.001), those using two injections per day (2/day 9.1% vs. 3/day 8.8%, P <
      0.01), children without both parents at home (9.4 vs. 9.0%, P < 0.001), a sibling
      with diabetes (9.7% vs. no family history 9.1%, P < 0.001). HbA1c concentration
      ranged from 8.1 to 10.2% between centers, after adjustment for factors associated
      with poor HbA1c (P < 0.001). CONCLUSIONS: The overall glycemic control of
      diabetic young people in Scotland is equivalent to a Diabetes Control and
      Complications Trial HbA1c concentration of 8.7%, placing the majority at a high
      risk of the complications of diabetes in adulthood. Although factors were
      significantly associated with poor HbA1c adjustment for these did not explain the
      differences between centers. We suggest that factors not analyzed in DIABAUD2
      (e.g., deployment of resources, organization of the clinical structure,
      strategies of care, and clinic philosophy) are the determinants of HbA1c. We
      speculate that the style of utilization of optimum resources is the key to
      achieving good glycemic control.

PMID- 11213873
TI  - Limited value of the homeostasis model assessment to predict insulin resistance
      in older men with impaired glucose tolerance.
AB  - OBJECTIVE: Insulin resistance (IR) in older individuals is associated with risk
      factors for coronary artery disease. The glucose clamp measures IR directly, but
      the homeostasis model assessment (HOMA) of IR, referred to here as HOMA-IR, is
      based on fasting glucose and insulin and is less invasive and labor intensive.
      This method requires validation in the elderly. RESEARCH DESIGN AND METHODS: We
      assessed the validity of HOMA-IR as an index of IR by comparing it to glucose
      infusion rates (GIRs) measured by a glucose clamp (600 pmol x m(-2) x min(-1)) in
      45 obese men (61 +/- 8 years of age, mean +/- SD) with normal glucose tolerance
      (NGT) (n = 21) or impaired glucose tolerance (IGT) (n = 24). We also evaluated
      relationships between body composition, exercise capacity, and IR. RESULTS:
      Subjects with NGT had lower BMI (28 +/- 3 vs. 31 +/- 3 kg/m2), waist
      circumference (97 +/- 9 vs. 105 +/- 9 cm), waist-to-hip ratio (WHR) (0.93 +/-
      0.06 vs. 0.97 +/- 0.05), and percent body fat (25 +/- 6 vs. 30 +/- 6) than
      subjects with IGT. Subjects with NGT also had lower areas above basal during the
      2-h oral glucose tolerance test for glucose (274 +/- 95 vs. 419 +/- 124 mmol x
      min/l) and insulin (38,142 +/- 18,206 vs. 58,383 +/- 34,408 pmol x min/l) and
      lower HOMA-IR values (2.2 +/- 0.8 vs. 4.2 +/- 2.6) than subjects with IGT. GIR
      (micromol x kg(-1) FFM x min(-1)) was higher in subjects with NGT than in
      subjects with IGT (53 +/- 11 vs. 43 +/- 14). HOMA-IR correlated with GIR in
      subjects with NGT (r = -0.59), but not in subjects with IGT (r = -0.13). GIR
      correlated with VO2max in subjects with NGT (r = 0.58) and IGT (r = 0.42), but
      with WHR only in subjects with NGT (r = -0.53). HOMA-IR correlated with VO2max (r
      = -0.57) and waist circumference (r = 0.54) in subjects with NGT, but with
      percent body fat in subjects with IGT (r = 0.54). CONCLUSIONS: These findings
      indicate that HOMA-IR should not be used as an index of IR in older individuals
      who may be at risk for IGT, and suggest that lifestyle changes that increase
      VO2max and decrease body fat may reduce IR in older people.

PMID- 11213874
TI  - Simple screening tests for peripheral neuropathy in the diabetes clinic.
AB  - OBJECTIVE: The utility of rapid and reliable sensory tests appropriate for the
      diagnosis of neuropathy in the diabetes clinic, rather than as prognostic tools
      for the prediction of foot complications, has been unclear because of limitations
      inherent in previous studies. Although clinical practice guidelines recommend
      annual screening for neuropathy, they are unable to support specific
      recommendations for screening maneuvers because of a lack of evidence for the
      validity of screening tests in the medical literature. The objective of this
      study was to assess the operating characteristics of four simple sensory
      screening maneuvers as compared with standardized electrophysiological tests in
      the diagnosis of distal symmetrical polyneuropathy. RESEARCH DESIGN AND METHODS:
      We assessed four simple tests (the 10-g Semmes-Weinstein monofilament examination
      [SWME], superficial pain sensation, vibration testing by the on-off method, and
      vibration testing by the timed method) in 478 subjects with independent blinded
      evaluations compared against the criterion standard of nerve conduction studies.
      We present receiver-operating characteristic (ROC) curves, positive and negative
      likelihood ratios, and sensitivity and specificity values for each test. RESULTS:
      The four simple screening maneuvers reveal similar operating characteristics.
      Cutoff points by ROC curve analyses reveal that a positive or abnormal test is
      represented by five incorrect responses of eight stimuli applied. A negative or
      normal test is represented by one or fewer incorrect responses of eight stimuli
      applied. By these criteria, the point estimates of the positive likelihood ratios
      for vibration testing by the on-off method, vibration testing by the timed
      method, the SWME, and superficial pain sensation test are 26.6, 18.5, 10.2, and
      9.2, respectively. The point estimates of the negative likelihood ratios are
      0.33, 0.51, 0.34, and 0.50, respectively The screening tests showed comparable
      sensitivity and specificity results. The 10-g SWME, superficial pain test, and
      vibration testing by the on-off method are rapid, each requiring approximately 60
      s to administer. The timed vibration test takes longer, and the interpretation is
      more complicated. The combination of two simple tests (e.g., the 10-g SWME and
      vibration testing by the on-off method) does not add value to each individual
      screening test. CONCLUSIONS: Annual screening for diabetic neuropathy should be
      conducted using superficial pain sensation testing, SWME, or vibration testing by
      the on-off method. The reported operating characteristics for each sensory
      modality can be applied to positive findings on the physical examination of
      individual patients to predict the likelihood of neuropathy.

PMID- 11213875
TI  - Productivity losses associated with diabetes in the US.
AB  - OBJECTIVE: The objective of this study was to estimate the cost of productivity
      losses in the U.S. attributable to diabetes, with regard to specific demographic
      and disease-related characteristics in the U.S.. RESEARCH DESIGN AND METHODS: We
      used the 1989 National Health Interview Survey, a random survey of individuals in
      the U.S. that included a diabetes supplement. Data on individuals were obtained
      for labor force participation, hours of work, demographic and occupational
      characteristics, self-reported health status, and several variables that
      indicated the presence, duration, and severity (complications) of diabetes. Using
      multivariate regression analyses, we estimated the association of independent
      variables (e.g., demographics, health, and diabetes status) with labor force
      participation, hours of work lost, and the economic value of lost work
      attributable to diabetes and its complications and duration. RESULTS: In general,
      the presence of diabetes and complications were found to be related to workforce
      participation variables. The magnitude of the lost-productivity costs depended on
      personal characteristics and on the presence and status of diabetes. In general,
      the loss of yearly earnings amounted to about a one-third reduction in earnings
      and ranged from $3,700 to $8,700 per annum. CONCLUSIONS: Diabetes has a
      considerable net effect on earnings, and the complications and duration of
      diabetes have compound effects. Our findings have implications for the cost
      effectiveness of diabetes control; the presence of complicating factors is the
      single most important predictive factor in lost productivity costs attributable
      to diabetes, and thus the avoidance or retardation of complications will have an
      impact on indirect health-related costs.

PMID- 11213876
TI  - The Oregon Health Plan: predictors of office-based diabetic quality of care.
AB  - OBJECTIVE: In 1994, the Oregon Health Plan (OHP) expanded basic Medicaid
      insurance to residents under the federal poverty limit, adopted a prioritized
      limited benefits package, and converted to managed care. The quality of care in
      predominantly Medicaid populations with diabetes has not been previously
      described. In OHP enrollees, we examined predictors of diabetes care based on
      American Diabetes Association guidelines and described OHP diabetes care compared
      with national benchmarks. RESEARCH DESIGN AND METHODS: Chart abstraction and
      Medicaid data for 1995-1996 yielded 996 nonpregnant diabetic patients who were 18
      64 years of age. Using HbA1c, lipid panel, and urine protein/microalbumin
      documentation ordered during the study year, we constructed a standard care (SC)
      index: SC for all three tests, mixed care (MC) for one to two tests, or no tests
      documented (NTD). RESULTS: Our sample was predominantly white, 48 +/- 11 years of
      age, 63% women, with 8 +/- 5 provider visits. Providers ordered HbA1c (70%),
      urine microalbumin/protein (57%), and lipid panel (41%) tests. Patients
      distributed into SC (22%), MC (62%), or NTD (16%). Thirteen variables predicted
      SC. Patients had a higher likelihood of SC if they were 18-24 years of age, had
      more clinic visits, were on insulin daily, were in several comorbid groups, were
      enrolled in salaried or capitated health plans, or lived in counties with more
      hospital beds. Four studies were used as comparable national benchmarks.
      CONCLUSIONS: Care provided to OHP patients with diabetes compares favorably with
      national benchmarks. Yet, most OHP patients with diabetes are still not achieving
      optimal care. Examining predictors of SC may play an important role in further
      policy development.

PMID- 11213877
TI  - Barriers to providing diabetes care in community health centers.
AB  - OBJECTIVE: We aimed to identify barriers to improving care for individuals with
      diabetes in community health centers. These findings are important because many
      such patients, as in most other practice settings, receive care that does not
      meet evidence-based standards. RESEARCH DESIGN AND METHODS: In 42 Midwestern
      health centers, we surveyed 389 health providers and administrators about the
      barriers they faced delivering diabetes care. We report on home blood glucose
      monitoring, HbA1c tests, dilated eye examinations, foot examinations, diet, and
      exercise, all of which are a subset of the larger clinical practice
      recommendations of the American Diabetes Association (ADA). RESULTS: Among the
      279 (72%) respondents, providers perceived that patients were significantly less
      likely than providers to believe that key processes of care were important
      (overall mean on 30-point scale: providers 26.8, patients 18.2, P = 0.0001).
      Providers were more confident in their ability to instruct patients on diet and
      exercise than on their ability to help them make changes in these areas. Ratings
      of the importance of access to care and finances as barriers varied widely;
      however, >25% of the providers and administrators agreed that significant
      barriers included affordability of home blood glucose monitoring, HbA1c testing,
      dilated eye examination, and special diets; nonproximity of ophthalmologist;
      forgetting to order eye examinations and to examine patients' feet; time required
      to teach home blood glucose monitoring; and language or cultural barriers.
      CONCLUSIONS: Providers in health centers indicate a need to enhance behavioral
      change in diabetic patients. In addition, better health care delivery systems and
      reforms that improve the affordability, accessibility, and efficiency of care are
      also likely to help health centers meet ADA standards of care.

PMID- 11213878
TI  - The metabolic syndrome in the West Bank population: an urban-rural comparison.
AB  - OBJECTIVE: To compare the prevalence of components of the metabolic syndrome,
      including hypertension, abnormal glucose metabolism, dyslipidemia, central
      obesity, and overall obesity, between a rural and an urban Palestinian West Bank
      community. RESEARCH DESIGN AND METHODS: A total of 500 rural and 492 urban men
      and women aged 30-65 years participated in a community-based cross-sectional
      survey Diabetes and impaired glucose tolerance were diagnosed using the oral
      glucose tolerance test. BMI, waist-to-hip ratio, and blood pressure were
      measured, and blood samples were taken from each subject. Sociodemographic
      characteristics were investigated using a questionnaire. RESULTS:
      Hypertriglyceridemia, low HDL cholesterol, overall obesity, and smoking were
      significantly more prevalent in the urban population, whereas central obesity was
      more prevalent in the rural population. Prevalence of hypertension was not
      significantly different between the rural and urban populations (25.4 and 21.5%,
      respectively; P = 0.15). The age-adjusted prevalences of diabetes were high:
      11.3% (8.5-14.1 95% CI) and 13.9% (10.8-17.0) in the rural and urban populations,
      respectively, but not significantly different. In each community, the age
      adjusted prevalence of the metabolic syndrome as defined by the World Health
      Organization was 17%. CONCLUSIONS: Although no significant differences were found
      in the prevalences of hypertension and diabetes between the two populations,
      other components of the metabolic syndrome, namely elevated triglycerides, low
      HDL cholesterol, and overall obesity, were more prevalent in the urban
      population. Given the rapid urbanization of the Palestinian population, the
      implications for a rise in noncommunicable diseases should be a major public
      health concern.

PMID- 11213879
TI  - African-American women have higher initial HbA1c levels in diabetic pregnancy.
AB  - OBJECTIVE: African-American women with diabetes are at greater risk for poor
      glycemic control outside of pregnancy. We evaluated the effect of race on
      glycemic control in a racially mixed population of women with diabetes entering
      prenatal care. RESEARCH DESIGN AND METHODS: HbA1c levels along with demographic
      data were collected at the first prenatal visit from a group of 234 women with
      preexisting diabetes. We applied logistic multivariate analysis to identify
      factors associated with HbA1c levels above the median for the group. RESULTS: The
      median HbA1c level for the group was 8%. HbA1c levels were 8.7 +/- 2.0% in
      African-Americans and 7.7 +/- 1.5% in Caucasians (P < 0.001). African-American
      racial designation was significantly and independently associated with high HbA1c
      when controlled for maternal age, parity, White classification, diabetes type,
      education, marital status, obesity, insurance type, and first trimester entry
      into care. The effect of race was confined to the nonobese patients, for whom the
      adjusted odds ratio for African-American race as a predictor of high HbA1c was
      8.15 with a 95% CI of 2.41-27.58 (P = 0.001). CONCLUSIONS: We found a clear
      racial disparity in glycemic control among women entering prenatal care with
      preexisting diabetes. This study demonstrates that there generally is need for
      better glycemic control among reproductive-age women with diabetes, but
      especially among those who are African-American.

PMID- 11213880
TI  - Markers of insulin resistance are strong risk factors for retinopathy incidence
      in type 1 diabetes.
AB  - OBJECTIVE: To determine the incidence of retinopathy and the relative importance
      of its risk factors in type 1 diabetes. RESEARCH DESIGN AND METHODS: This is a
      7.3-year follow-up of 764 of 1,215 (63%) people with type 1 diabetes across
      Europe, aged 15-60 years at baseline with no retinopathy (the EURODIAB
      Prospective Complications Study). Retinal photographs were taken at baseline and
      follow-up and risk factors were assessed to a standard protocol. RESULTS:
      Retinopathy incidence was 56% (429/764, 95% CI 52-59%). Key risk factors included
      diabetes duration and glycemic control. We found no evidence of a threshold
      effect for HbA1c on retinopathy incidence. Univariate associations were observed
      between incidence and albumin excretion rate, cholesterol, triglyceride,
      fibrinogen, von Willebrand factor, gamma-glutamyltransferase, waist-to-hip ratio,
      and insulin dose. No associations were observed for blood pressure,
      cardiovascular disease, or smoking. Independent risk factors, as assessed by
      standardized regression effects, were HbA1C (1.93, P = 0.0001), duration (1.32, P
      = 0.008), waist-to-hip ratio (1.32, P = 0.01), and fasting triglyceride (1.24, P
      = 0.04). CONCLUSIONS: Retinopathy incidence in type 1 diabetes remains high. Key
      risk factors include diabetes duration and glycemic control, with no evidence of
      a threshold for the latter. Other independent risk factors, such as waist-to-hip
      ratio and triglyceride levels, both markers of insulin resistance, were strongly
      related to incidence.

PMID- 11213881
TI  - Graftskin, a human skin equivalent, is effective in the management of noninfected
      neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical
      trial.
AB  - OBJECTIVE: We assessed in a randomized prospective trial the effectiveness of
      Graftskin, a living skin equivalent, in treating noninfected nonischemic chronic
      plantar diabetic foot ulcers. RESEARCH DESIGN AND METHODS: In 24 centers in the
      U.S., 208 patients were randomly assigned to ulcer treatment either with
      Graftskin (112 patients) or saline-moistened gauze (96 patients, control group).
      Standard state-of-the-art adjunctive therapy, which included extensive surgical
      debridement and adequate foot off-loading, was provided in both groups. Graftskin
      was applied at the beginning of the study and weekly thereafter for a maximum of
      4 weeks (maximum of five applications) or earlier if complete healing occurred.
      The major outcome of complete wound healing was assessed by intention to treat at
      the 12-week follow-up visit. RESULTS: At the 12-week follow-up visit, 63 (56%)
      Graftskin-treated patients achieved complete wound healing compared with 36 (38%)
      in the control group (P = 0.0042). The Kaplan-Meier median time to complete
      closure was 65 days for Graftskin, significantly lower than the 90 days observed
      in the control group (P = 0.0026). The odds ratio for complete healing for a
      Graftskin-treated ulcer compared with a control-treated ulcer was 2.14 (95% CI
      1.23-3.74). The rate of adverse reactions was similar between the two groups with
      the exception of osteomyelitis and lower-limb amputations, both of which were
      less frequent in the Graftskin group. CONCLUSIONS: Application of Graftskin for a
      maximum of 4 weeks results in a higher healing rate when compared with state-of
      the-art currently available treatment and is not associated with any significant
      side effects. Graftskin may be a very useful adjunct for the management of
      diabetic foot ulcers that are resistant to the currently available standard of
      care.

PMID- 11213882
TI  - Comparison of the soluble basal insulin analog insulin detemir with NPH insulin:
      a randomized open crossover trial in type 1 diabetic subjects on basal-bolus
      therapy.
AB  - OBJECTIVE: Insulin detemir (NN304) is a soluble basal insulin analog developed to
      cover basal insulin requirements. This trial aimed to compare the blood glucose
      lowering effect of insulin detemir with that of NPH insulin (NPH) and to evaluate
      the two treatments with regard to intrasubject variation of fasting blood
      glucose, incidence of hypoglycemia, dose requirements, and safety. RESEARCH
      DESIGN AND METHODS: This multicenter open randomized crossover trial in 59 type 1
      diabetic subjects comprised a 2-week run-in period on a basal-bolus regimen with
      NPH insulin once daily, followed by two 6-week periods of optimized basal-bolus
      therapy with either once-daily insulin detemir or NPH insulin. RESULTS: The area
      under the curve, in the time interval 23:00-8:00, derived from 24-h serum glucose
      profiles, was not statistically significantly different for the two treatment
      periods (insulin detemir:NPH ratio 89.2:83.5, P = 0.59). The intrasubject
      variation in fasting blood glucose during the last 4 days of treatment was lower
      for insulin detemir compared with NPH (P < 0.001). Mean dose requirements of
      insulin detemir were 2.35 times higher (95% CI 2.22-2.48) compared with NPH.
      During the last week of treatment, fewer subjects experienced hypoglycemic
      episodes on insulin detemir (60%) compared with NPH treatment (77%) (P = 0.049).
      CONCLUSIONS: Insulin detemir was as effective as NPH in maintaining glycemic
      control when administered at a higher molar dose. The results indicate that
      insulin detemir may provide more predictable fasting blood glucose with lower
      intrasubject variation and reduced risk of hypoglycemia compared with NPH.

PMID- 11213883
TI  - Macrophage activation in type 1 diabetic patients with catheter obstruction
      during peritoneal insulin delivery with an implantable pump.
AB  - OBJECTIVE: The purpose of this study was to evaluate the activation of
      macrophages in type 1 diabetic patients during peritoneal insulin delivery with
      an implantable pump against two types of insulin: that which was collected from
      the pump reservoir and that which came straight fromn the bottle (i.e., vial
      insltlin). Macrophage activation was studied in patients with and without
      cathcter obstruction and compared with activation in healthy subjects. RESEARCH
      DESIGN AND METHODS: Human insulin (21 PH, 400 U/ml; Hoescht) was collected from
      the pump reservoir (Minimed) of diabetic patients with (n = 3) or without (n = 7)
      catheter obstruction, as assessed by histological examination of the catheter
      tip. Monocytes were obtained from venous blood samples from both kinds of
      diabetic patients and from healthy subjects (n = 5) and were differentiated into
      monocyte-derived macrophages in culture. Their chemotaxis and tumor necrosis
      factor-alpha (TNF-alpha) release were studied with respect to both types of
      insulin, as previously stated. Formyl-methionyl-leucyl-phenylalanine (fMLP) and
      lipopolysaccharide (LPS) were used as controls. RESULTS: Neither insulin
      recovered from the pump reservoir nor vial insulin proved chemotactic to
      macrophages from either healthy subjects or those diabetic patients with and
      without catheter obstruction. The migration toward fMLP of macrophages from
      patients presenting a catheter obstruction was significantly higher than that
      observed with macrophages from either diabetic patients without obstruction or
      healthy subjects, the chemotactic index (mean +/- SD) was 3.81 +/- 0.36 vs. 2.30
      +/- 0.89 and 2.60 +/- 0.80, respectively (P < 0.05). LPS significantly stimulated
      the TNF-alpha secretion of macrophages from diabetic subjects with a catheter
      obstruction, whereas both native and reservoir-recovered insulin had no effect on
      this release (144.83 +/- 67.25 vs. 5.15 +/- 2.93 and 5.27 +/- 2.43 pg/ml, P <
      0.001). CONCLUSIONS: The human insulin used in implantable pumps, regardless of
      how long it had remained in the pump reservoir, did not induce macrophage
      activation in diabetic patients treated through intraperitoneal insulin delivery.
      In some of these diabetic patients, catheter obstruction could be explained by
      their high capacity of macrophage chemotaxis.

PMID- 11213884
TI  - Once- and twice-daily dosing with rosiglitazone improves glycemic control in
      patients with type 2 diabetes.
AB  - OBJECTIVE: To determine the efficacy of rosiglitazone compared with placebo in
      reducing hyperglycemia. RESEARCH DESIGN AND METHODS: After a 4-week placebo run
      in period, 959 patients were randomized to placebo or rosiglitazone (total daily
      dose 4 or 8 mg) for 26 weeks. The primary measure of efficacy was change in the
      HbA1c concentration. RESULTS: Rosiglitazone produced dosage-dependent reductions
      in HbA1c of 0.8, 0.9, 1.1, and 1.5% in the 4 mg o.d., 2 mg b.i.d., 8 mg o.d., and
      4 mg b.i.d. groups, respectively, compared with placebo. Clinically significant
      decreases from baseline in HbA1c were observed in drug-naive patients at all
      rosiglitazone doses and in patients previously treated with oral monotherapy at
      rosiglitazone 8 mg o.d. and 4 mg b.i.d. Clinically significant decreases from
      baseline in HbA1c were also observed with rosiglitazone 4 mg b.i.d. in patients
      previously treated with combination oral therapy. Approximately 33% of drug-naive
      patients treated with rosiglitazone achieved HbA1c < or =7% at study end. The
      proportions of patients with at least one adverse event were comparable among the
      rosiglitazone and placebo groups. There was no evidence of hepatotoxicity in any
      treatment group. There were statistically significant increases in weight and
      serum lipids in all rosiglitazone treatment groups compared with placebo. For LDL
      and HDL cholesterol, the observed increase appeared to be dose related.
      CONCLUSIONS: Rosiglitazone at total daily doses of 4 and 8 mg significantly
      improved glycemic control in patients with type 2 diabetes and was well
      tolerated.

PMID- 11213885
TI  - Relationship between plasma sialic acid concentration and microvascular and
      macrovascular complications in type 1 diabetes: the EURODIAB Complications Study.
AB  - OBJECTIVE: To test the hypothesis that an increased plasma concentration of
      sialic acid, a marker of the acute-phase response, is related to the presence of
      diabetic micro- and macrovascular complications in type 1 diabetes. RESEARCH
      DESIGN AND METHODS: We investigated the relationship between plasma sialic acid
      concentration and nephropathy, retinopathy, neuropathy, and coronary heart
      disease (CHD) in a cross-sectional survey of 1,369 people with type 1 diabetes.
      Subjects were participants in the EURODIAB IDDM Complications Study, which
      involved 31 centers in 16 European countries. RESULTS: There was a significantly
      increasing trend of plasma sialic acid with severity of retinopathy (P < 0.001 in
      men) and with degree of urinary albumin excretion (P < 0.001 men, P < 0.01
      women). Plasma sialic acid correlated with increasing plasma creatinine
      concentration (P < 0.009 men, P < 0.0002 women), and men with neuropathy had a
      higher plasma sialic acid concentration than those without (P < 0.006). There was
      no significant correlation between plasma sialic acid and CHD in either sex.
      Elevated plasma sialic acid concentrations were also associated with several risk
      factors for diabetic vascular disease: diabetes duration, HbA1c, plasma
      triglyceride and cholesterol concentrations, waist-to-hip ratio, hypertension and
      smoking (in men), and low physical exercise (in women). In multiple logistic
      regression analysis, plasma sialic acid was independently related to
      proliferative retinopathy and urinary albumin excretion rate in men. CONCLUSIONS:
      We conclude that an elevated plasma sialic concentration is strongly related to
      the presence of microvascular complications in type 1 diabetes, especially
      retinopathy and nephropathy. Further study of acute-phase response markers and
      mediators as indicators or predictors of diabetic microvascular complications is
      therefore justified.

PMID- 11213886
TI  - Plasma levels of cellular fibronectin in diabetes.
AB  - OBJECTIVE: Cellular fibronectin is an endothelium-derived protein involved in
      subendothelial matrix assembly. Elevated plasma levels of cellular fibronectin
      therefore reflect loss of endothelial cell polarization or injury to blood
      vessels. Consequently, elevated plasma levels of circulating cellular fibronectin
      have been described in clinical syndromes with vascular damage, although not in
      diabetes or atherosclerosis. RESEARCH DESIGN AND METHODS: We determined
      fibronectin levels in 52 patients with type 1 diabetes, 50 patients with type 2
      diabetes, 54 patients with a history of ischemic stroke, 23 patients with renal
      artery stenosis, and 64 healthy subjects. RESULTS: Circulating cellular
      fibronectin was significantly elevated in patients with diabetes (4.3 +/- 2.8
      microg/ml) compared with patients with ischemic stroke (2.0 +/- 0.9 microg/ml),
      patients with renovascular hypertension (1.7 +/- 1.1 microg/ml), and healthy
      subjects (1.4 +/- 0.6 microg/ml). Patients with diabetes and at least one
      cardiovascular risk factor had an almost 2.5-fold increase in cellular
      fibronectin compared with diabetic subjects without such a risk factor. In
      multivariate regression analysis, higher triglycerides, current or past cigarette
      smoking, and higher urinary albumin excretion were independently associated with
      an increase in circulating cellular fibronectin in diabetes. CONCLUSIONS: These
      results suggest that circulating cellular fibronectin may be a marker protein for
      endothelial cell activation, especially in diabetes. Prospective studies are
      needed to explore this possibility

PMID- 11213887
TI  - Plasma levels of tumor necrosis factor-alpha, angiotensin II, growth hormone, and
      IGF-I are not elevated in insulin-resistant obese individuals with impaired
      glucose tolerance.
AB  - OBJECTIVE: To investigate the relationship between insulin resistance and plasma
      concentrations of free fatty acids (FFAs), leptin, and potential agonists of the
      insulin receptor substrate (IRS) system, including tumor necrosis factor-alpha
      (TNF-alpha), IGF-I, growth hormone (GH), and angiotensin II in individuals with
      impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: Because glucose
      toxicity per se leads to insulin resistance, the determination of the primary
      metabolic alterations leading to insulin resistance is best accomplished in
      individuals who are at an increased risk to develop type 2 diabetes. Therefore,
      48 subjects with IGT and insulin resistance (IR), characterized by
      hyperinsulinemic-euglycemic clamps, were compared with 52 healthy insulin
      sensitive (IS) control subjects with respect to the relationship between the
      plasma levels of TNF-alpha, IGF-I, GH, angiotensin II, FFA, leptin, and insulin
      resistance. RESULTS: Between the IR and the IS groups, there were no significant
      differences in the plasma concentrations of TNF-alpha, GH, angiotensin II, IGF-I,
      and leptin. However, plasma FFA levels were significantly elevated in the IR
      group compared with the IS group after matching for BMI. CONCLUSIONS: The plasma
      concentrations of FFA, but not TNF-alpha, IGF-I, GH, and angiotensin II, are
      elevated in patients at an early stage of insulin resistance, suggesting that
      FFAs, but not the other modulators of the IRS system, may be a primary metabolic
      abnormality leading to insulin resistance.

PMID- 11213888
TI  - Increased prevalence of significant coronary artery calcification in patients
      with diabetes.
AB  - OBJECTIVE: Coronary artery disease is the major cause of morbidity and mortality
      in patients with diabetes. Detection of coronary artery disease before the first
      myocardial infarction and before anginal symptoms will allow for strategies
      designed to reduce the cardiovascular event rate in this group of patients.
      Electron beam-computed tomography (EBCT) is a noninvasive technology for
      evaluating the extent of coronary artery atherosclerosis that relies on the
      detection of coronary artery calcium (CAC). We used EBCT to detect significant
      coronary artery atherosclerosis in diabetic patients without symptoms of heart
      disease. RESEARCH DESIGN AND METHODS: We used EBCT to evaluate calcium in the
      coronary arteries of 139 consecutive diabetic patients scanned over a 20-month
      period. The CAC scores in this group were compared with a randomly selected
      nondiabetic control group and a control group that was selected to match a number
      of established cardiovascular risk factors. RESULTS: Patients with diabetes had a
      significant increase in the prevalence of CAC scores > or =400 (25.9%) compared
      with the randomly selected (7.2%) and matched (14.4%) nondiabetic control groups.
      Scores in this range have been reported to be highly predictive for abnormal
      stress myocardial perfusion tomography and subsequent coronary events.
      CONCLUSIONS: Our results, therefore, indicate a substantial prevalence of
      significant coronary artery disease in an asymptomatic diabetic patient
      population compared with nondiabetic control subjects. They also suggest that
      EBCT may be a useful approach for selecting a group of diabetic subjects who
      would benefit most from additional evaluation for subclinical coronary artery
      disease.

PMID- 11213889
TI  - Predictive value of cardiac autonomic neuropathy in diabetic patients with or
      without silent myocardial ischemia.
AB  - OBJECTIVE: The aim of this study was to determine the predictive value of silent
      myocardial ischemia (SMI) and cardiac autonomic neuropathy (CAN) in asymptomatic
      diabetic patients. RESEARCH DESIGN AND METHODS: We recruited 120 diabetic
      patients with no history of myocardial infarction or angina, a normal 12-lead
      electrocardiogram (ECG), and two or more additional risk factors. SMI assessment
      was carried out by means of an ECG stress test, a thallium-201 myocardial
      scintigraphy with dipyridamole, and 48-h ECG monitoring. CAN was searched for by
      standardized tests evaluating heart rate variations. Accurate follow-up
      information for 3-7 years (mean 4.5) was obtained in 107 patients. RESULTS: There
      was evidence of SMI in 33 patients (30.7%). CAN was detected in 33 of the 75
      patients (38.9%) who were tested, and a major cardiac event occurred in 11 of
      them. Among these 75 patients, the proportion of major cardiac events in the SMI+
      patients was not significantly higher than that in the SMI- patients (6 of 25 vs.
      5 of 50 patients), whereas it was significantly higher in the CAN+ patients than
      in the CAN- patients (8 of 33 vs. 3 of 42 patients; P = 0.04), with a relative
      risk of 4.16 (95% CI 1.01-17.19) and was the highest in the patients with both
      SMI and CAN (5 of 10 patients). After adjusting for SMI, there was a significant
      association between CAN and major cardiac events (P = 0.04). CONCLUSIONS: In
      asymptomatic diabetic patients, CAN appears to be a better predictor of major
      cardiac events than SMI. The risk linked to CAN appears to be independent of SMI
      and is the highest when CAN is associated with SMI.

PMID- 11213890
TI  - Contribution of nerve-axon reflex-related vasodilation to the total skin
      vasodilation in diabetic patients with and without neuropathy.
AB  - OBJECTIVE: To examine the contribution of nerve-axon reflex-related vasodilation
      to total acetylcholine-induced vasodilation in the skin of normal and diabetic
      subjects. RESEARCH DESIGN AND METHODS: The skin microcirculation was evaluated at
      the forearm level in 69 healthy subjects and 42 nonneuropathic diabetic patients
      and at the foot level in 27 healthy subjects and 101 diabetic patients (33 with
      neuropathy, 23 with Charcot arthropathy, 32 with peripheral vascular disease and
      neuropathy, and 13 without complications). Two single-point laser probes were
      used to measure total and neurovascular vasodilation response to the
      iontophoresis of 1% acetylcholine, 1% sodium nitroprusside, and deionized water.
      RESULTS: The neurovascular response to acetylcholine was significantly higher
      than the response to sodium nitroprusside and deionized water (P < 0.01). At the
      forearm level, the contribution of neurovascular response to the total response
      to acetylcholine was 35% in diabetic patients and 31% in control subjects. At the
      foot level, the contribution was 29% in diabetic patients without neuropathy and
      36% in control subjects, while it was significantly diminished in the three
      neuropathic groups. A significantly lower nonspecific nerve-axon-related
      vasodilation was observed during the iontophoresis of sodium nitroprusside, which
      does not specifically stimulate the C nociceptive fibers. CONCLUSIONS:
      Neurovascular vasodilation accounts for approximately one-third of the total
      acetylcholine-induced vasodilation at both the forearm and foot levels. The
      presence of diabetic neuropathy results in reduction of both the total
      vasodilatory response to acetylcholine and the percentage contribution of
      neurovascular vasodilation to the total response. Acetylcholine and sodium
      nitroprusside cause vasodilation in the skin microcirculation through different
      pathways.

PMID- 11213891
TI  - Differential influence of LDL cholesterol and triglycerides on lipoprotein(a)
      concentrations in diabetic patients.
AB  - OBJECTIVE: To evaluate the relationship between plasma lipid profiles and
      lipoprotein(a) [Lp(a)] concentrations in diabetic patients, taking into account
      the Lp(a) phenotype. RESEARCH DESIGN AND METHODS: We included 191 consecutive
      diabetic outpatients (69 type 1 and 122 type 2 diabetic patients) in a cross
      sectional study Serum Lp(a) was determined by enzyme-linked immunosorbent assay,
      and Lp(a) phenotypes were assessed by SDS-PAGE followed by immunoblotting. The
      statistical methods included a stepwise multiple regression analysis using the
      Lp(a) serum concentration as the dependent variable. The lipid profile consisted
      of total cholesterol, HDL cholesterol, LDL cholesterol, corrected LDL
      cholesterol, triglycerides, and apolipoproteins AI and B. RESULTS: In the
      multiple regression analysis, LDL cholesterol (positively) and triglycerides
      (negatively) were independently related to the Lp(a) concentration, and they
      explained the 6.6 and 7.8% of the Lp(a) variation, respectively. After correcting
      LDL cholesterol, the two variables explained 3.8 and 6.4% of the Lp(a) variation,
      respectively. In addition, we observed that serum Lp(a) concentrations were
      significantly lower in patients with type IV hyperlipidemia (mean 1.0 mg/dl
      [range 0.5-17], n = 16) than in normolipidemic patients (6.5 mg/dl [0.5-33.5], n
      = 117) and in type II hyperlipidemic patients (IIa 15.5 mg/dl [3.5-75], n = 13;
      IIb 9 mg/dl [1-80], n = 45); P < 0.001 by analysis of variance. CONCLUSIONS:
      Lp(a) concentrations were directly correlated with LDL cholesterol and negatively
      correlated with triglyceride levels in diabetic patients. Therefore, our results
      suggest that the treatment of diabetic dyslipemia may indirectly affect Lp(a)
      concentrations.

PMID- 11213892
TI  - Renin-angiotensin system gene polymorphisms, blood pressure, dyslipidemia, and
      diabetes in Hong Kong Chinese: a significant association of tne ACE
      insertion/deletion polymorphism with type 2 diabetes.
AB  - OBJECTIVE: In Chinese populations, hypertension is common and is a major risk
      factor for cerebrovascular and coronary heart disease, particularly when
      associated with diabetes. The clustering of these disorders and dyslipidemia and
      obesity is termed the metabolic syndrome and is increasing in prevalence in the
      populations of modernizing Asian nations. The renin-angiotensin system (RAS)
      helps maintain blood pressure and salt homeostasis and may play a role in the
      pathogenesis of aspects of the metabolic syndrome. We investigated three RAS gene
      polymorphisms--the ACE insertion/deletion (I/D), angiotensinogen (AGT) M235T, and
      angiotensin II type 1 receptor (AT1R) A1166C polymorphisms--for a possible role
      in modulating these disorders in 853 Chinese subjects with varying components of
      the metabolic syndrome. RESEARCH DESIGN AND METHODS: The three gene polymorphisms
      of this cross-sectional study were detected using polymerase chain reaction-based
      protocols. The genotype frequencies were compared between the controls (n = 119)
      and both overlapping and nonoverlapping groups of patients with type 2 diabetes,
      hypertension, and dyslipidemia using chi2 test. Differences in levels of the
      biochemical parameters between the genotypes were determined using analysis of
      variance. RESULTS: No significant relationship was identified between these
      polymorphisms and blood pressure in this population. Although the AT1RA1166C
      polymorphism was not associated with any aspect of the metabolic syndrome
      examined, there was limited evidence to suggest that the AGT M235T polymorphism
      may be associated with cholesterol levels. The ACE I allele was significantly
      more frequent in each group comprising subjects with type 2 diabetes/glucose
      intolerance (GIT), and the I allele was associated with higher fasting plasma
      glucose levels. CONCLUSIONS: These findings suggest that these polymorphisms are
      unlikely to be involved in the pathogenesis of hypertension. The ACE I/D
      polymorphism was associated with the metabolic syndrome, having a higher
      frequency of I allele-containing genotypes in those groups, but this appeared to
      result predominantly from the relationship with type 2 diabetes/GIT in this
      population of Chinese subjects.

PMID- 11213893
TI  - Homeostasis model assessment is a reliable indicator of insulin resistance during
      follow-up of patients with type 2 diabetes.
AB  - OBJECTIVE: To investigate the usefulness of the homeostasis model assessment as
      an index of insulin resistance (HOMA-IR) for evaluating the clinical course of
      patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: The usefulness of
      HOMA-IR and its relationship with insulin resistance assessed by the
      hyperinsulinemic-euglycemic clamp study (clamp IR) were evaluated in 55 Japanese
      patients with type 2 diabetes before and after treatment. The patients were
      subjected to diet (approximately 1,440-1,720 kcal/day) and exercise therapy
      (walking 10,000 steps daily) for 6 weeks during their hospitalization. RESULTS:
      Univariate regression analysis disclosed a significant correlation between log
      transformed HOMA-IR and log-transformed clamp IR before (r = -0.613, P < 0.0001)
      and after ( = -0.734, P < 0.0001) treatment. Neither the slopes (-0.71 +/- 0.12
      vs. -0.79 +/- 0.09, F = 0.25, P = 0.61) nor the intercepts (y-intercept = 1.67
      vs. 1.70, x-intercept = 2.36 vs. 2.15, F = 0.02, P = 0.88) of the regression
      lines between HOMA-IR and clamp IR were significantly different before and after
      treatment. There was a significant correlation between the decrease in log
      transformed HOMA-IR and the increase in clamp IR during treatment (r = -0.617, P
      < 0.0001). CONCLUSIONS: HOMA-IR may constitute a useful method not only for
      diagnosing insulin resistance, but also for follow-up during the treatment of
      patients with type 2 diabetes.

PMID- 11213894
TI  - Changes in cognitive abilities over a 4-year period are unfavorably affected in
      elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study.
AB  - OBJECTIVE: To compare 4-year changes in cognitive performance among elderly
      subjects according to category of fasting blood glucose (FBG) using American
      Diabetes Association criteria. RESEARCH DESIGN AND METHODS: Subjects without any
      detectable cognitive dysfunction were selected from the Epidemiology of Vascular
      Aging (EVA) Study, a cohort of community-dlwelling people aged 59-71 years at
      baseline. They were classified into glucose categories (normal, impaired fasting
      glucose [IFG], or diabetic) based on FBG values or known diabetes. Their
      cognitive abilities were assessed by a global test (Mini Mental Status
      Examination [MMSE]) and eight domain-specific tests, and they were reassessed 4
      years later. Serious cognitive worsening was defined as a score evolution into
      the worst 15% of the sample's distribution of score differences (4-year score
      minus baseline score) for each test. RESULTS: At baseline, age-, sex-, and
      education-adjusted scores for all cognitive tests except one were similar across
      glucose categories. After 4 years, diabetic subjects had a lower performance on
      all tests except the MMSE, with differences reaching statistical significance on
      four tests. Adjusted odds ratios for serious worsening over 4 years in diabetic
      subjects, with reference to normal subjects, were >2 for four tests (P < 0.05)
      and bordering this value for two others (P < 0.09). Further adjustment for blood
      pressure or potential cognition-affecting substances (alcohol, tobacco, and
      medications) did not modify these results. CONCLUSIONS: Despite similar high
      initial cognitive function, diabetic subjects tended to have an unfavorable
      evolution of cognitive performance over 4 years compared with subjects who had
      normal glucose or IFG.

PMID- 11213895
TI  - Relationships of upper gastrointestinal motor and sensory function with glycemic
      control.
AB  - Acute changes in the blood glucose concentration have a major reversible effect
      on esophageal, gastric, intestinal, gallbladder, and anorectal motility in both
      healthy subjects and diabetic patients. For example, gastric emptying is slower
      during hyperglycemia than euglycemia and accelerated during hypoglycemia. Acute
      hyperglycemia also affects perceptions arising from the gastrointestinal tract
      and may accordingly, be important in the etiology of gastrointestinal symptoms in
      diabetes. Elevations in blood glucose that are within the normal postprandial
      range also affect gastrointestinal motor and sensory function. Upper
      gastrointestinal motor function is a critical determinant of postprandial blood
      glucose concentrations by influencing the absorption of ingested nutrients.
      Interventions that reduce postprandial hyperglycemia, by modulating the rate of
      gastric emptying, have the potential to become mainstream therapies in the
      treatment of diabetes.

PMID- 11213896
TI  - Renal gluconeogenesis: its importance in human glucose homeostasis.
AB  - Studies conducted over the last 60 years in animals and in vitro have provided
      considerable evidence that the mammalian kidney can make glucose and release it
      under various conditions. Until quite recently however, it was generally believed
      that the human kidney was not an important source of glucose except during
      acidosis and after prolonged fasting. This review will summarize early work in
      animals and humans, discuss methodological problems in assessing renal glucose
      release in vivo, and present results of recent human studies that provide
      evidence that the kidney may play a significant role in carbohydrate metabolism
      under both physiological and pathological conditions.

PMID- 11213897
TI  - Control of vascular cell proliferation and migration by PPAR-gamma: a new
      approach to the macrovascular complications of diabetes.
AB  - Compared with nondiabetic subjects, type 2 diabetic individuals are at an
      increased risk for coronary artery disease and coronary restenosis after
      angioplasty or stenting. Increased proliferation and migration of vascular smooth
      muscle cells (VSMCs) contribute importantly to the formation of both
      atherosclerotic and restenotic lesions. Therefore, pharmaceutical interventions
      targeting proteins that regulate VSMC growth or movement are a promising new
      approach to treat diabetes-associated cardiovascular disease. Peroxisome
      proliferator-activated receptor-gamma (PPAR-gamma) is a member of the nuclear
      receptor superfamily that, when activated by thiazolidinedione (TZD) insulin
      sensitizers, regulates a host of target genes. All of the major cells in the
      vasculature express PPAR-gamma, including endothelial cells, VSMCs, and
      monocytes/macrophages. PPAR-gamma is present in intimal macrophages and VSMCs in
      early human atheromas. In an animal model of vascular injury; PPAR-gamma levels
      are substantially elevated in the neointima that forms after mechanical injury of
      the endothelium. Recent experimental studies provide evidence that PPAR-gamma may
      function to protect the vasculature from injury. Cell culture studies have shown
      that TZD PPAR-gamma ligands inhibit both the proliferation and migration of
      VSMCs. These antiatherogenic activities of PPAR-gamma may also occur in vivo,
      because TZDs inhibit lesion formation in several animal models. PPAR-gamma
      ligands may also protect the vasculature indirectly by normalizing metabolic
      abnormalities of the diabetic milieu that increase cardiovascular risk.
      Activation of PPAR-gamma, newly defined in vascular cells, may be a useful
      approach to protect the vasculature in diabetes.

PMID- 11213898
TI  - Proposed guidelines on screening for risk of type 1 diabetes.

PMID- 11213899
TI  - American Diabetes Association 60th Scientific Sessions, 2000: cardiovascular
      disease in diabetes.

PMID- 11213900
TI  - Reduction in foot ulcer incidence: relation to compliance with a prophylactic
      foot care program.

PMID- 11213901
TI  - Depression among African-Americans with diabetes: a dearth of studies.

PMID- 11213902
TI  - Evidence of autoimmunity in male twins with neonatal diabetes.

PMID- 11213903
TI  - Does pioglitazone, like troglitazone, increase serum levels of lipoprotein(a) in
      diabetic patients?

PMID- 11213904
TI  - Efficacy of oral sildenafil in the treatment of erectile dysfunction in diabetic
      men with positive response to intracavernosal injection of alprostadil.

PMID- 11213905
TI  - Treatment with human analog (GlyA21, ArgB31, ArgB32) insulin glargine (HOE901)
      resolves a generalized allergy to human insulin in type 1 diabetes.

PMID- 11213906
TI  - The continuing increase of diabetes in the US.

PMID- 11213907
TI  - Cost-free prevention to asymptomatic bacteriuria in diabetic women: two hands,
      two towels.

PMID- 11213908
TI  - Catch-22.

PMID- 11213910
TI  - Studies on the biological effects of ozone: 11. Release of factors from human
      endothelial cells.
AB  - BACKGROUND: Empirical observations have shown that ozonated autohemotherapy
      markedly improves the symptoms of chronic limb ischemia (muscular pain at rest,
      intermittent claudication, etc) in atherosclerotic patients, but mechanisms of
      action remain unclear. AIMS: Human endothelial cells (HUVECs) are known to
      release nitrogen monoxide (NO) and we investigated the biological effects of
      human ozonated serum on HUVECs in culture. METHODS: We assessed the relevance of
      peroxidation, the release of NO as nitrite and of three classical cytokines.
      RESULTS: The treatment of HUVECs with ozonated serum yields a dose dependent
      increase of thiobarbituric acid reactive substances (TBARS) and of hydrogen
      peroxide (H2O2) and a decrease of protein thiol groups (PTG). Concomitantly, in
      comparison to either the control or the oxygenated sample, there is a significant
      and steady increase of nitric oxide (NO) production; this is markedly enhanced by
      the addition of L-arginine (20 microM) and inhibited in the presence of the NO
      inhibitor, L-NAME (20 mM). The main mediator of ozone action is H2O2 as it has
      been shown either after its direct measurement or by the addition of 20, 40 and
      100 microM. Moreover, during 24 hours incubation we have investigated the
      production of endothelin 1 (ET-1), E-selectin and Interleukin 8 (IL-8) and it
      appears that ozonation enhances IL-8, inhibits E-selectin and hardly modifies ET
      1 production. CONCLUSIONS: It appears that reinfusion of ozonated blood, by
      enhancing release of NO, may induce vasodilation in ischemic areas and reduce
      hypoxia.

PMID- 11213909
TI  - Role of cytokines and nitric oxide in the induction of tuberculostatic macrophage
      functions.
AB  - The aim of this study was to determine phenotypic differences when BCG invades
      macrophages. Bacilli prepared from the same BCG primary seed, but produced in
      different culture media, were analysed with respect to the ability to stimulate
      macrophages and the susceptibility to treatment with cytokines and nitric oxide
      (NO). Tumour necrosis factor (TNF) activity was assayed by measuring its
      cytotoxic activity on L-929 cells, interleukin-6 (IL-6) and interferon-gamma (IFN
      gamma) were assayed by enzyme-linked immunosorbent assay (ELISA), whereas NO
      levels were detected by Griess colorimetric reactions in the culture supernatant
      of macrophages incubated with IFN-gamma, TNF or NO and subsequently exposed to
      either BCG-I or BCG-S. We found that BCG-I and BCG-S bacilli showed different
      ability to simulate peritoneal macrophages. Similar levels of IL-6 were detected
      in stimulated macrophages with lysate from two BCG samples. The highest levels of
      TNF and IFN-gamma were observed in macrophages treated with BCG-S and BCG-I,
      respectively. The highest levels of NO were observed in cultures stimulated for
      48 h with BCG-S. We also found a different susceptibility of the bacilli to
      exogenous treatment with IFN-gamma and TNF which were capable of killing 60 and
      70% of both bacilli, whereas NO was capable of killing about 98 and 47% of BCG-I
      and BCG-S, respectively. The amount of bacilli proportionally decreased with IFN
      gamma and TNF, suggesting a cytokine-related cytotoxic effect. Moreover, NO also
      decreased the viable number of bacilli. Interestingly, NO levels of peritoneal
      macrophages were significantly increased after cytokine treatment. This indicates
      that the treatment of macrophages with cytokines markedly reduced bacilli number
      and presented effects on NO production. The results obtained here emphasize the
      importance of adequate stimulation for guaranteeing efficient killing of bacilli.
      In this particular case, the IFN-gamma and TNF were involved in the activation of
      macrophage bactericidal activity.

PMID- 11213911
TI  - ATP induced MUC5AC release from human airways in vitro.
AB  - BACKGROUND: Chronic airway diseases are often associated with marked mucus
      production, however, little is known about the regulation of secretory activity
      by locally released endogenous mediators. AIM: This investigation was performed
      to determine the release of MUC5AC mucin from human bronchial preparations using
      the purinergic agonists adenosine 5'-triphosphate (ATP) and uridine 5'
      triphosphate (UTP). METHODS: Immunohistochemical and immunoradiometric assays
      (IRMA) were used to detect the MUC5AC mucin. Immunohistochemical analysis were
      performed using individual 1-13 M1 and 21 M1 MAbs recognizing a recombinant M1
      mucin partially encoded by the MUC5AC gene. IRMA measurments were performed using
      a mixture of eight anti-M1 mucin MAbs (PM8), which included both 1-13 M1 and 21
      M1 MAbs. Lysozyme and protein were also measured in the biological fluids derived
      from human bronchial preparations obtained from patients who had undergone
      surgery for lung carcinoma. RESULTS: The anti-M1 monoclonal antibodies labelled
      epithelial goblet cells. After challenge of human bronchial preparations with
      ATP, the goblet cells exhibited less staining. In contrast, UTP did not alter the
      immunolabelling of goblet cells. MUC5AC mucin in the bronchial fluids derived
      from ATP-challenged preparations was increased while UTP had no effect on
      release. ATP did not alter either the quantities of lysozyme or protein detected
      in the biological fluids. CONCLUSION: These results suggest that ATP may regulate
      epithelial goblet cell secretion of MUC5AC mucin from human airways in vitro.

PMID- 11213912
TI  - Sera from patients with sepsis induce nitric oxide production in vascular smooth
      muscle cells.
AB  - BACKGROUND: Nitric oxide (NO) is an important physiological mediator of vascular
      tone and is involved in pathophysiology of septic shock. Although plasma nitrite
      is a stable end product of NO oxidation derived from endogenous NO, the plasma
      nitrite level is also easily affected by the intake of various foods, bacterial
      products and renal functional status. AIMS: We propose an excellent alternative
      assay technique for measuring endogenous NO production. METHODS: We measured the
      nitrite level in cultured vascular smooth muscle cells (SMC) treated with serum
      obtained from patients with sepsis (4 patients), by means of a chemiluminescence
      detector. RESULTS: The nitrite concentrations in such cells were significantly
      higher as compared to those in the cells treated with normal serum. Moreover, the
      increased nitrite levels in the SMC treated with the sera obtained from patients
      with sepsis were completely inhibited by L-nitroarginine (1 mmol/L), a nitric
      oxide synthase inhibitor. CONCLUSION: These data suggest that this assay method
      enable us to know the ability of endogenous NO production in each patient.

PMID- 11213914
TI  - Diagnostic ultrasound should be performed without upper intensity limits.

PMID- 11213913
TI  - IL-12, IL-6 and IFN-gamma production by lymphocytes of pregnant women with
      rheumatoid arthritis remission during pregnancy.
AB  - BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with progressive
      activity. The RA remission was observed in women during pregnancy, but the
      mechanism responsible for remission is hypothetical only and concerns mechanisms
      of immune regulation such as lymphocyte subpopulations and interleukin
      production. AIMS: The lymphocyte subpopulations and interleukin production in
      vitro in a group of healthy non-pregnant women, healthy pregnant women and
      pregnant women suffering from RA may help towards a better understanding of
      regulation of the immune processes. METHODS: The investigations were performed in
      trimester III--2 days after delivery and 6 weeks after delivery. Peripheral blood
      lymphocytes were isolated on Gradisol gradient and analysed immediately or after
      having been cultured for 72 hours in RPMI medium supplemented with 10% FCS. The
      cultures were terminated after 72 h, supernatants stored at -72 degrees C for
      interleukin evaluation. The concentrations of IFN-gamma, IL-2, IL-6, IL-12, TNF
      alpha and its soluble receptors R-I, R-II were estimated in non-stimulated and
      PHA (Sigma, 5 microg/ml) stimulated culture supernatants using ELISA Endogen kits
      according to the manufacturer's instructions. RESULTS: The general pattern of T
      cell subpopulation distribution was similar in all analysed groups. Decreased IFN
      gamma, IL-12 and increased IL-6 production by lymphocytes after PHA stimulation
      was found in trimester III in pregnant women with RA as compared to healthy
      pregnant woman. CONCLUSION: The obtained results suggest that in pregnant women
      with RA the TH1 cell response predominates, contrary to healthy pregnant women
      with TH2 type functional response. These phenomena were not observed after
      delivery.

PMID- 11213915
TI  - Control of interstitial thermal coagulation: comparative evaluation of microwave
      and ultrasound applicators.
AB  - This study presents a comparative evaluation of the control of heating and
      thermal coagulation with microwave (MW) and ultrasound (US) interstitial
      applicators. Helical coil MW antennas (17 mm and 25 mm length radiating antennae)
      were tested using an external implant catheter (2.2 mm o.d.) with water-cooling.
      US applicators with tubular transducers (2.2 and 2.5 mm o.d., 10 mm length,
      single-element and 3-element) were utilized with a direct-coupled configuration
      and internal water-cooling. Measurements of E-field distributions (for MW) and
      acoustic beam distributions (for US) were used to characterize the applicator
      energy output. Thermal performance was evaluated through multiple heating trials
      in vitro (bovine liver) and in vivo (porcine thigh muscle and liver) at varied
      levels of applied power (20-40 W for microwave, 15-35 W for ultrasound) and
      heating times (0.5-5 min). Axial temperature distributions in the tissue were
      recorded during heating, and dimensions of the resulting lesions of thermal
      coagulation were measured. Both MW and US applicators produced large volumes of
      tissue coagulation ranging from 8 to 20 cm3 with singular heating times of 5 min.
      Radial depth of lesions for both MW and US applicators increased with heating
      duration and power levels, though US produced notably larger lesion diameters (30
      42 mm for US vs 18-26 mm for MW, 5 min heating). Characteristic differences
      between the applicators were observed in axial energy distribution, tissue
      temperatures, and thermal lesion shapes. MW lesions increased significantly in
      axial dimensions (beyond the active applicator length) as applied power level
      and/or heating duration was increased, and lesion shapes were generally not
      uniform. US provided greater control and uniformity of heating, with energy
      deposition and axial extent of thermal lesions corresponding to the length of the
      active transducer(s). The improved ability to control the extent of thermal
      coagulation demonstrated by the US applicators provides greater potential to
      target a specific region of tissue.

PMID- 11213916
TI  - Threshold contrast detail detectability measurement of the fluoroscopic image
      quality of a dynamic solid-state digital x-ray image detector.
AB  - Solid-state digital x-ray imaging detectors of flat-panel construction will play
      an increasingly important role in future medical imaging facilities. Solid-state
      detectors that will support both dynamic (including fluoroscopic) and
      radiographic image recording are under active development. The image quality of
      an experimental solid-state digital x-ray image detector operating in a
      continuous fluoroscopy mode has been investigated. The threshold contrast detail
      detectability (TCDD) technique was used to compare the fluoroscopic imaging
      performance of an experimental dynamic solid-state digital x-ray image detector
      with that of a reference image intensifier television (IITV) fluoroscopy system.
      The reference system incorporated Plumbicon TV. Results were presented as a
      threshold detection index, or H(T)(A), curves. Measurements were made over a
      range of mean entrance air kerma (EAK) rates typically used in conventional IITV
      fluoroscopy. At the upper and mid EAK rate range (440 and 220 nGy/s) the solid
      state detector outperformed the reference IITV fluoroscopy system as measured by
      TCDD performance. At the lowest measured EAK rate (104 nGy/s), the solid-state
      detector produces slightly inferior TCDD performance compared with the reference
      system. Although not statistically significant at this EAK rate, the difference
      will increase as EAK is lowered further. Overall the TCDD results and early
      clinical experiences support the proposition that a current design of dynamic
      solid-state detector produces image quality competitive with that of modern IITV
      fluoroscopy systems. These findings encourage the development of compact and
      versatile universal x-ray imaging systems based upon solid-state detector
      technology to support R & F and vascular/interventional applications.

PMID- 11213917
TI  - Comparison of in-phantom dose distributions for coronary angiography using an x
      ray machine and synchrotron radiation.
AB  - Coronary cineangiography using synchrotron radiation is anticipated, owing to the
      high intensity and availability of monoenergy. To investigate allowable dose
      levels in clinical application, absorbed dose distribution in a tissue substitute
      phantom for a conventional x-ray machine was measured with thermoluminescent
      dosimeters at the University of Tsukuba under the practical conditions used for
      digital angiography. The dose rate at a 0.5-cm depth was 0.145 Gy/s, and the dose
      per frame was 0.725 mGy for the irradiation period of 5 ms per frame. For
      synchrotron radiation, the dose distribution measurement was made at a 5-GeV AR
      (Accumulation Ring) of the High Energy Accelerator Research Organization, in
      which a polymethylmethacrylate (PMMA) phantom was irradiated with the strongest
      beam available at the facility, which was 33.32 keV, 5.2 x 6.2 cm2 beam. Using
      this beam, a 1-mm-diameter coronary artery has been visualized at 1% iodine
      concentration at the AR. Nonhomogeneous strength distribution in the beam was
      observed in the vertical direction. The maximum dose rate was 0.556 Gy/s, and it
      attenuated to 1/3000 at a 30-cm depth in the beam center. At the deep positions,
      the doses were influenced by the high harmonics, which was confirmed with an EGS4
      Monte Carlo calculation. Outside the beam, beam contamination on both sides of
      the main beam affected the doses. For comparison to the x-ray machine, the
      measured dose was analytically converted to that needed for a 5.2 x 16 cm2 beam
      that is used for clinical application. The dose rate at 0.5-cm depth was found to
      be 0.215 Gy/s, which is 1.48 times larger than that for x-rays. Moreover, the
      attenuation rate in the phantom was significantly greater than that of the x-ray
      machine, because of the difference of the energy spectra between the x-rays and
      synchrotron radiation used.

PMID- 11213918
TI  - Processing of medical images using real-time optical Fourier processing.
AB  - Optical image processing techniques are inherently fast in view of parallel
      processing. A self-adaptive optical Fourier processing system using photoinduced
      dichroism in a bacteriorhodopsin film was experimentally demonstrated for medical
      image processing. Application of this powerful analog all-optical interactive
      technique for cancer diagnostics is illustrated with two mammograms and a Pap
      smear. Microcalcification clusters buried in surrounding tissue showed up clearly
      in the processed image. By playing with one knob, which rotates the analyzer in
      the optical system, either the microcalcification clusters or the surrounding
      dense tissue can be selectively displayed. Bacteriorhodopsin films are stable up
      to 140 degrees C and environmentally friendly. As no interference is involved in
      the experiments, vibration isolation and even a coherent light source are not
      required. It may be possible to develop a low-cost rugged battery operated
      portable signal-enhancing magnifier.

PMID- 11213919
TI  - Fast acceleration-encoded magnetic resonance imaging.
AB  - Direct acceleration imaging with high spatial resolution was implemented and
      tested. The well-known principle of phase encoding motion components was applied.
      Suitable gradient switching provides a signal phase shift proportional to the
      acceleration perpendicular to the slice in the first scan of the sequences. An
      additional scan serving as a reference was recorded for compensation of phase
      effects due to magnetic field inhomogeneities. The first scan compensated for
      phase shifts from undesired first- and second-order motions; the second scan was
      completely insensitive to velocity and acceleration in all directions. Advantages
      of the proposed two-step technique compared to former approaches with Fourier
      acceleration encoding (with several phase encoding steps) are relatively short
      echo times and short total measuring times. On the other hand, the new approach
      does not allow us to assess the velocity or acceleration spectrum simultaneously.
      The capabilities of the sequences were tested on a modern 1.5 T whole body MR
      unit providing relatively high gradient amplitudes (25 mT/m) and short rise times
      (600 micros to maximum amplitude). The results from a mechanical acceleration
      phantom showed a standard deviation of 0.3 m/s2 in sequences with an acceleration
      range between -12 and 12 m/s2. This range covers the expected maximum
      acceleration in the human aorta of 10 m/s2. Further tests were performed on a
      stenosis phantom with a variable volume flow rate to assess the flow
      characteristics and possible displacement artifacts of the sequences. Preliminary
      examinations of volunteers demonstrate the potential applicability of the
      technique in vivo.

PMID- 11213920
TI  - Device-dependent activity estimation and decay correction of radionuclide
      mixtures with application to Tc-94m PET studies.
AB  - Multi-instrument activity estimation and decay correction techniques were
      developed for radionuclide mixtures, motivated by the desire for accurate
      quantitation of Tc-94m positron emission tomography (PET) studies. Tc-94m and
      byproduct Tc isotopes were produced by proton irradiation of enriched Mo-94 and
      natural Mo targets. Mixture activities at the end of bombardment were determined
      with a calibrated high purity germanium detector. The activity fractions of the
      greatest mixture impurities relative to 100% for Tc-94m averaged 10.0% (Tc-94g)
      and 3.3% (Tc-93) for enriched targets and 10.1% (Tc-94g), 11.0% (Tc-95), 255.8%
      (Tc-96m), and 7.2% (Tc-99m) for natural targets. These radioisotopes have
      different half-lives (e.g., 52.5 min for Tc-94m, 293 min for Tc-94g), positron
      branching ratios (e.g., 0.72 for Tc-94m, 0.11 for Tc-94g) and gamma ray emissions
      for themselves and their short-lived, excited Mo daughters. This complicates
      estimation of injected activity with a dose calibrator, in vivo activity with PET
      and blood sample activity with a gamma counter. Decay correction using only the
      Tc-94m half-life overestimates activity and is inadequate. For this reason
      analytic formulas for activity estimation and decay correction of radionuclide
      mixtures were developed. Isotope-dependent sensitivity factors for a PET scanner,
      dose calibrator, and gamma counter were determined using theoretical sensitivity
      models and fits of experimental decay curves to sums of exponentials with fixed
      decay rates. For up to 8 h after the end of bombardment with activity from
      enriched and natural Mo targets, decay-corrected activities were within 3% of the
      mean for three PET studies of a uniform cylinder, within 3% of the mean for six
      dose calibrator decay studies, and within 6% of the mean for four gamma counter
      decay studies. Activity estimation and decay correction for Tc-94m mixtures
      enable routine use of Tc-94m in quantitative PET, as illustrated by application
      to a canine Tc-94m sestamibi study.

PMID- 11213921
TI  - Scanning microwave-induced thermoacoustic tomography: signal, resolution, and
      contrast.
AB  - Scanning thermoacoustic tomography was explored in the microwave region of the
      electromagnetic spectrum. Short microwave pulses were used to induce acoustic
      waves by thermoelastic expansion in biological tissues. Cross sections of tissue
      samples were imaged by a linear scan of the samples while a focused ultrasonic
      transducer detected the time-resolved thermoacoustic signals. Based on the
      microwave-absorption properties of normal and cancerous breast tissues, the
      piezoelectric signals in response to the thermoacoustic contrast were
      investigated over a wide range of electromagnetic frequencies and depths of tumor
      locations. The axial resolution is related to the temporal profile of the
      microwave pulses and to the impulse response of the ultrasonic transducer. The
      lateral resolution is related to the numerical aperture of the ultrasonic
      transducer as well as to the frequency spectra of the piezoelectric signals in
      the time window corresponding to the axial resolution. Gain compensation,
      counteracting the microwave attenuation, was applied to enhance the image
      contrast.

PMID- 11213922
TI  - Reference dosimetry in clinical high-energy photon beams: comparison of the AAPM
      TG-51 and AAPM TG-21 dosimetry protocols.
AB  - Task Group 51 (TG-51) of the Radiation Therapy Committee of the American
      Association of Physicists in Medicine (AAPM) has recently developed a new
      protocol for the calibration of high-energy photon and electron beams used in
      radiation therapy. The formalism and the dosimetry procedures recommended in this
      protocol are based on the use of an ionization chamber calibrated in terms of
      absorbed dose-to-water in a standards laboratory's 60Co gamma ray beam. This is
      different from the recommendations given in the AAPM TG-21 protocol, which are
      based on an exposure calibration factor of an ionization chamber in a 60Co beam.
      The purpose of this work is to compare the determination of absorbed dose-to
      water in reference conditions in high-energy photon beams following the
      recommendations given in the two dosimetry protocols. This is realized by
      performing calibrations of photon beams with nominal accelerating potential of 6,
      18 and 25 MV, generated by an Elekta MLCi and SL25 series linear accelerator. Two
      widely used Farmer-type ionization chambers having different composition, PTW
      30001 (PMMA wall) and NE 2571 (graphite wall), were used for this study. Ratios
      of AAPM TG-51 to AAPM TG-21 doses to water are found to be 1.008, 1.007 and 1.009
      at 6, 18 and 25 MV, respectively when the PTW chamber is used. The corresponding
      results for the NE chamber are 1.009, 1.010 and 1.013. The uncertainties for the
      ratios of the absorbed dose determined by the two protocols are estimated to be
      about 1.5%. A detailed analysis of the reasons for the discrepancies is made
      which includes comparing the formalisms, correction factors and quantities in the
      two protocols, as well as the influence of the implementation of the different
      standards for chamber calibration. The latter has been found to have a
      considerable influence on the differences in clinical dosimetry, even larger than
      the adoption of the new data and recommended procedures, as most intrinsic
      differences cancel out due to the adoption of the new formalism.

PMID- 11213923
TI  - Modeling the extrafocal radiation and monitor chamber backscatter for photon beam
      dose calculation.
AB  - A simple analytical approach has been developed to model extrafocal radiation and
      monitor chamber backscatter for clinical photon beams. Model parameters for both
      the extrafocal source and monitor chamber backscatter are determined
      simultaneously using conventional measured data, i.e., in-air output factors for
      square and rectangular fields defined by the photon jaws. The model has been
      applied to 6 MV and 15 MV photon beams produced by a Varian Clinac 2300C/D
      accelerator. Contributions to the in-air output factor from the extrafocal
      radiation and monitor chamber backscatter, as predicted by the model, are in good
      agreement with the measurements. The model can be used to calculate the in-air
      output factors analytically, with an accuracy of 0.2% for symmetric or asymmetric
      rectangular fields defined by jaws when the calculation point is at the isocenter
      and 0.5% when the calculation point is at an extended SSD. For MLC-defined
      fields, with the jaws at the recommended positions, calculated in-air output
      factors agree with the measured data to within 0.3% at the isocenter and 0.7% at
      off-axis positions. The model has been incorporated into a Monte Carlo dose
      algorithm to calculate the absolute dose distributions in patients or phantoms.
      For three MLC-defined irregular fields (triangle shape, C-shape, and L-shape),
      the calculations agree with the measurements to about 1% even for points at off
      axis positions. The model will be particularly useful for IMRT dose calculations
      because it accurately predicts beam output and penumbra dose.

PMID- 11213924
TI  - Leaf position error during conformal dynamic arc and intensity modulated arc
      treatments.
AB  - Conformal dynamic arc (CD-ARC) and intensity modulated arc treatments (IMAT) are
      both treatment modalities where the multileaf collimator (MLC) can change leaf
      position dynamically during gantry rotation. These treatment techniques can be
      used to generate complex isodose distributions, similar to those used in fix
      gantry intensity modulation. However, a beam-hold delay cannot be used during CD
      ARC or IMAT treatments to reduce spatial error. Consequently, a certain amount of
      leaf position error will have to be accepted in order to make the treatment
      deliverable. Measurements of leaf position accuracy were taken with leaf
      velocities ranging from 0.3 to 3.0 cm/s. The average and maximum leaf position
      errors were measured, and a least-squares linear regression analysis was
      performed on the measured data to determine the MLC velocity error coefficient.
      The average position errors range from 0.03 to 0.21 cm, with the largest
      deviations occurring at the maximum achievable leaf velocity (3.0 cm/s). The
      measured MLC velocity error coefficient was 0.0674 s for a collimator rotation of
      0 degrees and 0.0681 s for a collimator rotation of 90 degrees. The distribution
      in leaf position error between the 0 degrees and 90 degrees collimator rotations
      was within statistical uncertainty. A simple formula was developed based on these
      results for estimating the velocity-dependent dosimetric error. Using this
      technique, a dosimetric error index for plan evaluation can be calculated from
      the treatment time and the dynamic MLC leaf controller file.

PMID- 11213925
TI  - Experimental validation of dose calculation algorithms for the GliaSite RTS, a
      novel 125I liquid-filled balloon brachytherapy applicator.
AB  - This paper compares experimentally measured and calculated dose-rate
      distributions for a novel 125I liquid-filled brachytherapy balloon applicator
      (the GliaSite RTS), designed for the treatment of malignant brain-tumor resection
      cavity margins. This work is intended to comply with the American Association of
      Physicists in Medicine (AAPM) Radiation Therapy Committee's recommendations [Med.
      Phys. 25, 2269-2270 (1998)] for dosimetric characterization of low-energy photon
      interstitial brachytherapy sources. Absolute low dose-rate radiochromic film
      (RCF) dosimetry measurements were performed in coronal planes about the
      applicator. The applicator was placed in a solid water phantom, machined to
      conform to the inflated applicator's surface. The results were used to validate
      the accuracy of Monte Carlo photon transport (MCPT) simulations and a point
      source dose-kernel algorithm in predicting dose to water. The absolute activity
      of the 125I solution was determined by intercomparing a National Institute of
      Standards and Technology (NIST) 125I standard with a known mass of radiotherapy
      solution (Iotrex) in an identical vial and geometry. For the two films not in
      contact with applicator, the average agreement between RCF and MCPT (specified as
      the mean absolute deviation in successive 4 mm rings) was found to be within +/
      5% at distances 0.2-25 mm from the film centers. For the two films touching the
      catheter, the mean agreement was +/-14.5% and 7.5% near the balloon surface but
      improving to 7.5% and 6% by 3.5 mm from the surface. These errors, as large as
      20% in isolated pixels, are likely due to trim damage, 125I contamination, and
      poor conformance with the balloon. At larger distances where the radiation doses
      were very low, the observed discrepancies were significantly larger than
      expected. We hypothesize that they are due to a dose-rate dependence of the RCF
      response. A 1%-10% average difference between a simple one-dimensional path
      length semiempirical dose-kernel model and the MCPT calculations was observed
      over clinically relevant distances.

PMID- 11213926
TI  - Dose rate constant and energy spectrum of interstitial brachytherapy sources.
AB  - In the past two years, several new manufacturers have begun to market low-energy
      interstitial brachytherapy seeds containing 125I and 103Pd. Parallel to this
      development, the National Institute of Standards and Technology (NIST) has
      implemented a modification to the air-kerma strength (S(K)) standard for 125I
      seeds and has also established an S(K) standard for 103Pd seeds. These events
      have generated a considerable number of investigations on the determination of
      the dose rate constants (inverted V) of interstitial brachytherapy seeds. The aim
      of this work is to study the general properties underlying the determination of
      dose rate constant and to develop a simple method for a quick and accurate
      estimation of dose rate constant. As the dose rate constant of clinical seeds is
      defined at a fixed reference point, we postulated that dose rate constant may be
      calculated by treating the seed as an effective point source when the seed's
      source strength is specified in S(K) and its source characteristics are specified
      by the photon energy spectrum measured in air at the reference point. Using a
      semi-analytic approach, an analytic expression for dose rate constant was derived
      for point sources with known photon energy spectra. This approach enabled a
      systematic study of dose rate constant as a function of energy. Using the
      measured energy spectra, the calculated dose rate constant for 125I model 6711
      and 6702 seeds and for 192Ir seed agreed with the AAPM recommended values within
      +/-1%. For the 103Pd model 200 seed, the agreement was 5% with a recently
      measured value (within the +/-7% experimental uncertainty) and was within 1% with
      the Monte Carlo simulations. The analytic expression for dose rate constant
      proposed here can be evaluated using a programmable calculator or a simple
      spreadsheet and it provides an efficient method for checking the measured dose
      rate constant for any interstitial brachytherapy seed once the energy spectrum of
      the seed is known.

PMID- 11213927
TI  - A dose texture plot in a moving frame as a new planning tool for single-plane
      implants in HDR brachytherapy.
AB  - A dose-texture plot is a print of dose values on the points of interest in a
      super-plane. The super-plane is a moving frame across the treatment depth
      surface(s) with a fixed distance from surgical bed. The moving frame has an axis
      tangent to the midline of two neighboring catheters and the other axis
      perpendicular to the midline. By setting the scales of the two axes in units of
      the dwell step-size and the local distance between the two catheters, we can
      easily locate the basal-dose points with pairs of integers. A dose-texture plot
      on the basal-dose points in the super-plane provides the dose and location
      information in one picture. Such a picture can concisely represent the dose
      distribution in the treatment depth and allows us to quickly and quantitatively
      evaluate the effect of the source-dwell times and positions. This treatment
      planning-evaluation tool has been used for development of an iteration
      optimization algorithm. The results of the iteration optimization on clinical
      cases demonstrated significant improvements over the optimization algorithms used
      in a commercial planning system.

PMID- 11213928
TI  - The nontoxic tripeptide glycyl-prolyl-glycine amide inhibits the replication of
      human immunodeficiency virus type 1.
AB  - OBJECTIVE: To determine whether short peptides corresponding to the RGPGR motif
      of the V3 loop of gp 120 have anti-human immunodeficiency virus type 1 (anti-HIV
      1) activity. DESIGN/METHODS: Short peptides were tested against the HIV-1
      laboratory strains and clinical isolates. RESULTS: The tripeptide glycyl-prolyl
      glycine amide (GPG-NH2) inhibited the replication of both laboratory strains and
      47 clinical isolates, including 19 strains that were resistant to other drugs or
      that were from patients with failing therapy. The 50% inhibitory concentrations
      values were 2.7 to 37 microM. Phenotypic change of two isolates from nonsyncytia
      inducing to syncytia-inducing did not change their sensitivity to GPG-NH2. The
      tripeptide added to the antiviral effect of both zidovudine and ritonavir.
      CONCLUSIONS: The tripeptide GPG-NH2 is a nontoxic compound that inhibits the
      replication of HIV-1 by an apparently new mode of action. Glycyl-prolyl-glycine
      NH2 might prove useful by itself or as a lead compound for the treatment of drug
      resistant HIV-1. Glycyl-prolyl-glycine-NH2 is currently undergoing phase I/II
      human clinical trials in Sweden.

PMID- 11213929
TI  - Differences in perinatal transmission among human immunodeficiency virus type 1
      genotypes.
AB  - OBJECTIVE: To determine whether genotypes from human immunodeficiency virus type
      1 (HIV-1) subtypes A, C, or D or intersubtype recombinants have the same
      probability of being transmitted from mother to child. METHODS: We determined the
      HIV-1 genetic subtype and maternal risk factors of 51 matched transmitting and
      nontransmitting mothers from Tanzania. The HIV-1 gag (p24-p7) and env (C2-C5)
      nucleotide sequences were used for genotype classification, and matched logistic
      regression analysis was used to assess differences among genotypes. RESULTS:
      Mothers infected with HIV-1 subtype A (odds ratio, 3.8; 95% CI, 0.8-24.7%), HIV-1
      subtype C (odds ratio, 5.1; 95% CI, 1.3-30.8%), or HIV-1 intersubtype recombinant
      viruses (odds ratio, 5.3; 95% CI, 1.2-33.4%) were more likely to transmit HIV-1
      to their infants than mothers infected with HIV-1 subtype D. Lower CD4 cell
      counts at enrollment were associated with transmission, but CD4 cell counts
      within each genotype did not explain differences in transmission among HIV-1
      genotypes. CONCLUSION: We have shown that HIV-1 genotypes might be associated
      with differential risk for vertical transmission. These findings provide the
      first evidence that HIV-1 genetic subtypes may play a role in rates of vertical
      transmission in an African setting.

PMID- 11213930
TI  - The product of human cytomegalovirus UL73 is a new polymorphic structural
      glycoprotein (gpUL73).
AB  - OBJECTIVES: This work focuses on human cytomegalovirus (HCMV) UL73, which encodes
      for a putative transmembrane glycoprotein that is highly conserved among
      herpesviruses. STUDY DESIGN: pUL73 expression was analyzed both in transiently
      transfected and in HCMV-infected cells using a pUL73-specific antiserum by
      immunoblot and immunofluorescence. Sequencing analysis from several clinical
      isolates and laboratory-adapted strains was also performed. RESULTS: pUL73
      expressed in transiently transfected cells consists in a polypeptide of the
      expected size (15-18 kd) with cytoplasmic localization. In infected cells, pUL73
      is expressed with true-late kinetics and localizes both in perinuclear granular
      formations and on the cell surface. A broad band (39-53 kd), sensitive to O
      glycosidase digestion was detected in purified virus. In addition, sequence
      analysis showed that the N-terminal portion of pUL73 from clinical isolates is
      highly polymorphic. CONCLUSIONS: UL73 encodes for a new structural glycoprotein
      (gpUL73) expressed on the cell surface of infected cells and highly polymorphic
      among clinical isolates.

PMID- 11213931
TI  - Prevalence of drug resistance mutations in B, non-B subtypes, and recombinant
      forms of human immunodeficiency virus type 1 in infected individuals in Spain
      (Galicia).

PMID- 11213932
TI  - Human immunodeficiency virus (HIV)-specific immune responses are generated with
      the simultaneous vaccination of a gp120-depleted, whole-killed HIV-1 immunogen
      with cytosine-phosphorothioate-guanine dinucleotide immunostimulatory sequences
      of DNA.
AB  - OBJECTIVES: We compared the effect of priming with a synthetic
      oligodeoxynucleotide (ODN) immunostimulatory DNA sequence followed by vaccination
      with human immunodeficiency virus type 1 (HIV-1) in incomplete Freund's adjuvant
      (IFA) or HIV-1 antigen alone to the simultaneous administration of
      immunostimulatory sequences (ISS) with HIV-1 in IFA. METHODS: We examined immune
      function involving interferon-gamma (IFN-gamma) production, RANTES (regulated
      upon activation, normal T cell expressed and secreted) production, and lymphocyte
      proliferation, all of which appear to be augmented in HIV-1-exposed, but
      uninfected, individuals. RESULTS: We demonstrate that similar levels of antigen
      specific IFN-gamma were produced from lymph node cells of the animals immunized
      with HIV-1 antigen in IFA containing the CpG ODN 1826 (ISS; mean +/- SE = 450.8
      +/- 224.3 pg/mL) and the group of animals primed with the ODN before injection
      with the HIV-1 in IFA (mean +/- SE = 377.7 +/- 294.8 pg/mL) or HIV-1 antigen
      alone (IFN-gamma = 0 pg/mL). However, the group that received the HIV-1 in IFA
      plus ISS mounted a stronger lymphocyte proliferation (mean net +/- SE = 29,180 +/
      1,932 cpm) compared to the group primed with the ODN before injection with HIV-1
      in IFA (mean net +/- SE = 8,575 +/- 2,978 cpm). Furthermore, the group that
      received the HIV-1 in IFA plus ISS also mounted stronger beta-chemokine
      production measured as RANTES (mean +/- SE = 1,217 +/- 267.4 pg/mL) compared to
      the group that received the ODN before injection with HIV-1 in IFA (mean +/- SE =
      129.1 +/- 48.5 pg/mL). Antibody responses from the group that received the HIV-1
      in IFA plus ISS also showed a higher p24-specific response that was predominantly
      of the immunoglobulin G IgG2b isotype. CONCLUSION: These results suggest that the
      simultaneous administration of the ISS in the HIV-1 in IFA emulsion may be a
      condidate for testing in non-human primates and in human studies as a therapeutic
      and preventative vaccine.

PMID- 11213933
TI  - A bereavement support group intervention affects plasma burden of human
      immunodeficiency virus type 1. Report of a randomized controlled trial.
AB  - OBJECTIVES: This study investigates the potential impact of a bereavement support
      group on plasma viral load. METHODS: A randomly selected subsample of human
      immunodeficiency virus type 1 (HIV-1)-positive homosexual men participating in a
      controlled clinical trial of a bereavement support group intervention was
      studied. The intervention consisted of one 90-minute group session per week for
      10 weeks. The plasma HIV-1 RNA copy number was measured at baseline and after
      intervention (10 weeks) by the Roche AMPLICOR assay. RESULTS: There was a
      significant effect of the intervention on the change on the plasma HIV-1 RNA copy
      number (limited control model, beta = -0.49, p = 0.02; extended control model,
      beta = -0.37, p = 0.01), independent of antiretroviral therapies; prophylactic
      therapies against potentially lethal HIV-1 associated conditions; CD4 cell count;
      viral load; and Centers for Disease Control and Prevention clinical disease stage
      at baseline. CONCLUSIONS: Bereavement support group interventions may prove to be
      not only a primary therapy for psychologic distress after bereavement but also an
      adjunctive therapy for sustained control of plasma viral load in conjunction with
      highly active antiretroviral therapy in this population.

PMID- 11213934
TI  - The tripeptide glycyl-prolyl-glycine amide does not affect the early steps of the
      human immunodeficiency virus type 1 replication.
AB  - OBJECTIVE: To determine whether the peptide glycyl-prolyl-glycine amide (GPG-NH2)
      corresponding to a conserved motif in the tip of the third hypervariable region
      of gp120 affected the early events in the human immunodeficiency virus type 1
      (HIV-1) replication. DESIGN/METHODS: Glycyl-prolyl-glycine amide was tested for
      its effect on HIV-1 adsorption, co-receptor usage, proviral DNA synthesis,
      messenger RNA (mRNA) synthesis and splicing, translation, tat/TAR
      transactivation, and virus protease activity. RESULTS: Glycyl-prolyl-glycine
      amide did not appear to affect the early events of the virus replication. HIV-1
      having glycine-leucine-glycine instead of GPG in the V3 loop and the mutants
      deleted of the GPG motif were still inhibited by the peptide. Glycyl-prolyl
      glycine-NH2 had no discernible effect on any of the other steps in the virus
      replication cycle tested. The only effect observed was an increased sodium
      dodecyl sulfate polyacrylamide amide gel electrophoresis mobility of gp160/120 at
      high concentrations of GPG-NH2. CONCLUSIONS: The tripeptide GPG-NH2 is a nontoxic
      compound that inhibits the replication of HIV-1 by an apparently new mode of
      action.

PMID- 11213935
TI  - Generic substitution: issues for problematic drugs.
AB  - The methodology and criteria for bioequivalence testing have been firmly
      established by the Food and Drug Administration (FDA). For certain drugs with a
      narrow therapeutic index (e.g., digoxin, levothyroxine, warfarin), generic
      substitution may not be advisable or even allowable, depending on the
      substitution laws of individual states. Digoxin and levothyroxine tablets are
      examples of drugs for which no New Drug Applications (NDAs) currently exist.
      However, commercially available generic products for both of these drugs have not
      been determined by the FDA to be therapeutically equivalent to the innovator
      products. Generic versions of warfarin have been approved by the FDA as being
      therapeutically equivalent to the innovator products, as have generic versions of
      the rescue inhaler albuterol. Yet, misinformation and myths persist regarding the
      adequacy and proven reliability of the FDA's determination of bioequivalence for
      these products.

PMID- 11213936
TI  - Psoas abscess: a primer for the internist.
AB  - Psoas abscess is a rare condition with vague clinical presentation. In this
      article, its epidemiology, etiology, bacteriology, diagnosis, and treatment are
      discussed. Common diseases that may be erroneously diagnosed in patients with
      psoas abscess are presented.

PMID- 11213937
TI  - Information about age-related macular degeneration on the Internet.
AB  - BACKGROUND: A great deal of health information has become available on the
      Internet over the past several years. Some of this information is inaccurate or
      misleading to patients. We attempted to determine the accuracy of information on
      the Internet concerning age-related macular degeneration (ARMD). METHODS: The
      term "macular degeneration" was entered in each of seven Internet search engines,
      and the subsequent links were followed and categorized. The number of sites that
      discussed treatment inconsistent with the peer-reviewed standard of care for ARMD
      was tabulated. RESULTS: Of the 80 unique sites regarding ARMD that we identified,
      17 (21%) featured nonconventional information. CONCLUSIONS: Many Internet sites
      feature unproven and costly nonconventional information about ARMD. Each
      physician should be prepared to address these sites and to suggest reliable sites
      concerning health information on the Internet.

PMID- 11213938
TI  - Evolutionary approach to medicine.
AB  - A new discipline in the medical field, called Darwinian (or evolutionary)
      Medicine, has arisen to study how natural selection could shape a machine as
      complex as the human body without eliminating its vulnerability to diseases. It
      asserts that systems and organs that form our bodies result from millions of
      years of evolutionary advances and are designed to survive in order to reproduce.
      According to this principle, Nature does not strive for complexity or perfection
      it is blind and random. Using the scientific knowledge that has revolutionized
      biology, Darwinian Medicine seeks to provide an explanation for diseases based on
      the evolutionary process. This new discipline, in short, can undoubtedly help
      physicians in their medical practice, though further research is necessary to
      improve understanding of the range of its clinical application.

PMID- 11213939
TI  - 'It was the best of times, it was the worst of times...'.

PMID- 11213940
TI  - Multicenter trial of prolonged infusions of rocuronium bromide in critically ill
      patients: effects of multiple organ failure.
AB  - BACKGROUND: This study was done to determine the safety, efficacy, dosing
      requirements, and spontaneous recovery profiles of prolonged infusions of
      rocuronium bromide in the critically ill. METHODS: This multicenter, prospective,
      nonrandomized, open label trial enrolled 32 patients at two university-based
      medical centers. Patients who were determined to require neuromuscular blockade
      for at least 24 hours received a bolus of 0.6 mg/kg of rocuronium. After
      subsequent recovery of two responses (T2) to the TOF stimulation, an infusion of
      rocuronium was begun at 10 microg/kg/min and continued for 24 to 120 hours as
      required by the patients' clinical status. RESULTS: Patients were divided into
      multiple organ failure (MOF) and non-multiple organ failure (non-MOF) groups on
      enrollment. The mean infusion rates for the MOF and non-MOF groups were 0.2 and
      0.5 mg/kg/hour, respectively. CONCLUSION: The mean infusion rate of rocuronium
      that provides approximately 90% blockade is less for critically ill patients with
      MOF. Spontaneous recovery was prolonged in patients with MOF.

PMID- 11213941
TI  - Early experience with laparoscopic antireflux surgery in the rural setting.
AB  - BACKGROUND: Gastroesophageal reflux (GERD) affects a significant portion of the
      population, and refractory or untreated disease can have serious long-term
      complications. Antireflux procedures are now done more frequently because of
      advances in laparoscopic technique. It has been reported in the literature that
      the quality of care is better in larger urban hospitals than in smaller
      facilities. We report our experience with laparoscopic antireflux surgery in a 35
      bed rural county hospital. METHODS: We reviewed the charts of 26 patients who had
      a laparoscopic antireflux procedure in our facility during a 2-year period. Data
      from the preoperative evaluation, the operative procedure, and the postoperative
      period were recorded. The patients had office follow-up after the procedure and
      also were contacted at the time of the study to evaluate their outcome. RESULTS:
      Ninety-five percent of the patients had excellent symptomatic relief from
      heartburn and required no medication at follow-up. There was no mortality. Our
      complication rate was 7%, and the conversion rate to laparotomy was 7%. Most
      patients were discharged on the day after the procedure. CONCLUSION: Laparoscopic
      antireflux procedures can effectively relieve symptoms of GERD with minimal
      morbidity and mortality. The outcome of our initial experience in a small rural
      facility is analogous to results previously published in the literature.

PMID- 11213942
TI  - Sexually transmitted diseases during pregnancy: screening, diagnostic, and
      treatment practices among prenatal care providers in Georgia.
AB  - BACKGROUND: Sexually transmitted diseases (STD) during pregnancy are associated
      with adverse outcomes. We conducted a prenatal care provider survey to determine
      STD screening, diagnosis, and treatment practices. METHODS: Standard
      questionnaires were mailed to Georgia-licensed obstetrician/ gynecologists,
      family practitioners, and nurse-midwives (N = 3,082) in 1998. RESULTS: Of the
      1,300 care providers who returned the survey, 565 (44%) provided prenatal care,
      390 (57%) were male, and 396 (70%) were obstetrician/ gynecologists. Overall, 553
      prenatal care providers (98%) reported screening all pregnant patients for
      syphilis, 551 (98%) for hepatitis B, 501 (89%) for trichomonas, 474 (84%) for
      human immunodeficiency virus (HIV), 401 (71%) for gonorrhea, 403 (71%) for
      chlamydia, 475 (84%) for group B streptococci, and 130 (23%) for bacterial
      vaginosis (BV) (high risk). Less than 10% used amplification tests for chlamydia
      or gonorrhea. Most providers used appropriate regimens to treat STD in pregnant
      women. A written office policy on testing for BV or HIV was associated with
      increased screening. CONCLUSIONS: Provider education is needed about diagnosis
      and treatment of STD during pregnancy.

PMID- 11213943
TI  - Ultrasound detection of free intraperitoneal fluid associated with hepatic and
      splenic injuries.
AB  - BACKGROUND: The objective of this study was to compare the sensitivity and
      specificity of 5 abdominal views for detecting free intraperitoneal fluid in
      trauma patients later diagnosed with hepatic or splenic injuries. METHODS: This
      retrospective study conducted over a 17-month period enrolled patients with
      trauma. A Focused Abdominal Sonogram for Trauma (FAST) examination was done using
      5 abdominal views. Exploratory laparotomy or computed tomography (CT) confirmed
      the presence of intraperitoneal fluid and associated injuries. The sensitivity
      and specificity were determined. RESULTS: Of the 245 study patients, 29 had
      injuries to the liver or spleen or both. The 5-view FAST examination's
      sensitivity for detecting free intraperitoneal fluid associated with hepatic,
      splenic, or combined injuries was 77%, 90%, and 100%, respectively. The
      sensitivity of the single Morison's pouch view in detecting free intraperitoneal
      fluid associated with hepatic, splenic, or combined injuries was 38%, 20%, and
      67%, respectively. CONCLUSION: For identifying free intraperitoneal fluid
      associated with hepatic or splenic injuries, no single view of the FAST
      examination could match the sensitivity provided by the 5-view technique.

PMID- 11213944
TI  - Vitamin D: balancing cutaneous and systemic considerations.
AB  - BACKGROUND: Vitamin D insufficiency may lead to various health problems. By
      encouraging sun protection to prevent skin cancer, physicians may be limiting a
      major source of vitamin D for many individuals. METHODS: We did a literature
      review on issues related to vitamin D inadequacy, particularly those relevant to
      various racial/ethnic groups. RESULTS: Vitamin D is an important hormone with
      many physiologic roles beyond those related to bones, including blood pressure
      regulation and acting as a tumor suppressant. The recommended amount of vitamin D
      has recently increased for adults over age 50. Moreover, some researchers are
      urging higher doses for the entire population to prevent osteoporotic fractures.
      CONCLUSIONS: Previous studies that have found serum levels of vitamin D in their
      sun-protected subjects to be in the normal range may need to be reevaluated. In
      concert with counseling sun protection, physicians should consider discussing
      vitamin D intake, typically in the form of supplements.

PMID- 11213945
TI  - Ventriculitis due to Cryptococcus uniguttulatus.
AB  - Infections due to non-neoformans cryptococci are rare. We report the first case
      of a human infection caused by Cryptococcus uniguttulatus. Ventriculitis caused
      by this organism developed in a 65-year-old woman who had had repair of an
      internal carotid aneurysm. In vitro sensitivity testing showed the Cryptococcus
      species sensitive to amphotericin B and itraconazole. Treatment with amphotericin
      led to resolution of the infection.

PMID- 11213946
TI  - Influenza A pneumonia with rhabdomyolysis.
AB  - Influenza A pneumonia accounts for a significant number of the community-acquired
      pneumonias in the United States. While myalgia is a common complaint in influenza
      A infection, few cases of rhabdomyolysis associated with this virus have been
      described. Although it has been recently recognized that rhabdomyolysis
      complicating certain bacterial pneumonias has important prognostic implications,
      rhabdomyolysis in the setting of influenza A pneumonia does not appear to carry
      the same prognostic significance.

PMID- 11213947
TI  - Chemoprevention of breast cancer.
AB  - We critically examined the literature regarding tamoxifen and raloxifene for
      breast cancer chemoprevention, a controversial topic of interest to all providers
      of health care services for women. The National Surgical Adjuvant Breast and
      Bowel Project showed that tamoxifen decreased the incidence of breast cancer in
      women at increased risk. Two European studies did not confirm this benefit.
      Although well-tolerated, tamoxifen chemoprevention continues to be associated
      with an increased risk of endometrial cancer. Raloxifene is a promising agent
      that has not been established to reduce the incidence of breast cancer in women
      at increased risk and currently should not be considered an alternative to
      tamoxifen outside of clinical trials. Tamoxifen results in a decreased risk of
      causing breast cancer in women at increased risk for having the disease. Women at
      increased risk are encouraged to participate in the ongoing clinical trial
      comparing tamoxifen and raloxifene for breast cancer prevention.

PMID- 11213948
TI  - Echolalia as a novel manifestation of neuropsychiatric systemic lupus
      erythematosus.
AB  - "That tongue of yours, by which I have been tricked, shall have its power
      curtailed and enjoy the briefest use of speech." With these words, Hera, of Greek
      mythology, deprived the nymph Echo of spontaneous speech, constraining her
      instead to merely repeating the words of others. Echolalia, which derives from
      the word "echo," is disordered speech in which an individual persistently repeats
      what is heard. Echolalia has been described in patients with a number of
      neuropsychiatric illnesses including autism and Tourette's syndrome.
      Neuropsychiatric systemic lupus erythematosus (NPSLE) is a heterogeneous disease
      with protean manifestations that may occur in approximately 25% to 50% of
      patients with systemic lupus erythematosus (SLE). Although the most common
      manifestations include cognitive dysfunction (50%) and seizures (20%), NPSLE may
      also present as peripheral neuropathy (15%), psychosis (10%), or other central
      nervous system abnormalities. We report the case of a 57-year-old woman with SLE
      and echolalia.

PMID- 11213949
TI  - Transvaginal ultrasonographic identification of appendicitis in a setting of
      chronic pelvic pain and endometriosis.
AB  - Our patient had a history of chronic endometriosis and pelvic pain and complained
      of recent onset of right-sided abdominal pain, nausea, and vomiting. Transvaginal
      ultrasonography revealed a thick-walled mass superior and medial to the right
      ovary, which was thought to be an inflamed appendix. The woman was not pregnant,
      and the structure appeared to be anatomically separate from the uterus.
      Subsequent laparoscopy confirmed the diagnosis of acute appendicitis;
      uncomplicated laparoscopic appendectomy followed. In the setting of chronic
      endometriosis, other nongynecologic sources of acute pelvic pain must be
      considered. Surgical intervention is appropriate whenever clinical suspicion for
      an acute abdomen is high, and the a priori diagnosis of endometriosis should not
      result in operative delay.

PMID- 11213950
TI  - Sarcoidosis and opportunistic infections.
AB  - Two patients receiving steroid therapy for sarcoidosis had a potentially fatal
      opportunistic infection that was difficult to differentiate from the underlying
      illness, but was successfully treated after the diagnosis was made. The effects
      of sarcoidosis on the immune system and the additional effects of steroid therapy
      on cell-mediated immunity seem to be of real clinical significance, rather than
      being of theoretical interest alone, because of the risk of infection with
      intracellular infecting organisms, even if such infections occur relatively
      infrequently.

PMID- 11213951
TI  - Pancreatitis due to Ascaris lumbricoides: second occurrence after 2 years.
AB  - Pancreatitis is a common disease in the United States, with the most likely
      etiologies being biliary tract disease and alcohol use. Infections with parasites
      such as Ascaris lumbricoides comprise a small percentage of pancreatitis cases in
      the United States, but they are a common etiology in developing countries. In the
      United States, the incidence of pancreatic and biliary ascariasis has been
      increasing because of the migration of people from endemic countries, as well as
      increased travel by Americans to such countries. Patients treated for this
      roundworm can have reinvasion for the same reasons. We report the case of a
      patient with two episodes of pancreatitis due to A. lumbricoides 2 years apart.

PMID- 11213952
TI  - Strangulated obturator hernia: still deadly.
AB  - The case of an elderly, emaciated female patient with recurrent lower abdominal
      and hip pain associated with nausea and vomiting due to an incarcerated obturator
      hernia is described. The presence of a Howship-Romberg sign and a tender mass on
      digital rectal examination in this thin, elderly woman with a small bowel
      obstruction led to the rapid diagnosis of an obturator hernia by computed
      tomography (CT). The high mortality rate associated with this most lethal of all
      abdominal hernias requires a high index of suspicion to facilitate rapid
      diagnosis and surgical intervention if the survival rate is to be improved.

PMID- 11213953
TI  - Physicians, firearm counseling, and legal liability.
AB  - To explore the potential legal consequences to physicians of counseling their
      patients about gun violence, I consider the question: If a patient divests
      herself of a firearm upon the advice of her physician and is subsequently the
      victim of a rape, robbery, aggravated assault, or homicide, could she or her
      survivors argue convincingly that her physician was negligent? In attempting to
      answer this question, the four elements that a patient must establish to prevail
      in a malpractice action against a physician are discussed, and possible
      strategies for establishing them in the hypothetical case are explored. I
      conclude that plausible arguments can be made against the hypothetical physician
      engaged in firearm counseling as described. Conversely, physicians not engaging
      in discussions of gun safety face substantially lower liability risks.

PMID- 11213954
TI  - Cerebrospinal fluid shunt infection: a prospective study of risk factors.
AB  - OBJECT: Hydrocephalus is a common condition of childhood that usually requires
      insertion of a cerebrospinal fluid (CSF) shunt. Infection is one of the most
      devastating complications that may arise from the presence of CSF shunts. In this
      study, the authors prospectively analyzed perioperative risk factors for CSF
      shunt infection in a cohort of children. METHODS: Between 1996 and 1999, 299
      eligible patients underwent CSF shunt operations (insertions and revisions) that
      were observed by a research nurse at a tertiary care pediatric hospital. Several
      perioperative variables were recorded. All cases were followed postoperatively
      for 6 months to note any development of CSF shunt infection. A Cox proportional
      hazards model was used to analyze the relationship between the variables and the
      development of shunt infection. Thirty-one patients (10.4%) experienced shunt
      infection. Three perioperative variables were significantly associated with an
      increased risk of shunt infection: 1) the presence of a postoperative CSF leak
      (hazard ratio [HR] 19.16, 95% confidence interval [CI] 6.96-52.91); 2) patient
      prematurity (< 40 weeks' gestation at the time of shunt surgery: HR 4.72, 95% CI
      1.71-13.06), and 3) the number of times the shunt system was inadvertently
      exposed to breached surgical gloves (HR 1.07, 95% CI 1.02-1.12). CONCLUSIONS:
      Three variables associated with an increased incidence of shunt infection have
      been identified. Changes in clinical practice should address these variables, as
      follows. 1) Great care should be taken intraoperatively to avoid a postoperative
      CSF leak. 2) Alternatives to placement of a CSF shunt in premature infants should
      be studied. 3) Surgeons should minimize manual contact with the shunt system and
      consider the use of double gloves.

PMID- 11213955
TI  - Predicting shunt failure on the basis of clinical symptoms and signs in children.
AB  - OBJECT: In evaluating pediatric patients for shunt malfunction, predictive values
      for symptoms and signs are important in deciding which patients should undergo an
      imaging study, whereas determining clinical findings that correlate with a low
      probability of shunt failure could simplify management. METHODS: Data obtained
      during the recently completed Pediatric Shunt Design Trial (PSDT) were analyzed.
      Predictive values were calculated for symptoms and signs of shunt failure. To
      refine predictive capability, a shunt score based on a cluster of signs and
      symptoms was derived and validated using multivariate methods. Four hundred
      thirty-one patient encounters after recent shunt insertions were analyzed. For
      encounters that took place within 5 months after shunt insertion (early
      encounters), predictive values for symptoms and signs included the following:
      nausea and vomiting (positive predictive value [PPV] 79%, likelihood ratio [LR]
      10.4), irritability (PPV 78%, LR 9.8), decreased level of consciousness (LOC)
      (PPV 100%), erythema (PPV 100%), and bulging fontanelle (PPV 92%, LR 33.1).
      Between 9 months and 2 years after shunt insertion (late encounters), only loss
      of developmental milestones (PPV 83%, LR 36.7) and decreased LOC (PPV 100%) were
      strongly associated with shunt failure. However, the absence of a symptom or sign
      still left a 15 to 29% (early encounter group) or 9 to 13% (late encounter group)
      chance of shunt failure. Using the shunt score developed for early encounters,
      which sums from 1 to 3 points according to the specific symptoms or signs
      present, patients with scores of 0, 1, 2, and 3 or greater had shunt failure
      rates of 4%, 50%, 75%, and 100%, respectively. Using the shunt score derived from
      late encounters, patients with scores of 0, 1, and 2 or greater had shunt failure
      rates of 8%, 38%, and 100%, respectively. CONCLUSIONS: In children, certain
      symptoms and signs that occur during the first several months following shunt
      insertion are strongly associated with shunt failure; however, the individual
      absence of these symptoms and signs offers the clinician only a limited ability
      to rule out a shunt malfunction. Combining them in a weighted scoring system
      improves the ability to predict shunt failure based on clinical findings.

PMID- 11213956
TI  - Patient-assessed outcomes after excision of acoustic neuroma: postoperative
      symptoms and quality of life.
AB  - OBJECT: The aim of this study was to assess whether outcomes from excision of
      acoustic neuroma vary among patients and have a material impact on their quality
      of life (QOL). METHODS: A questionnaire concerning postoperative symptoms and the
      Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who
      had undergone acoustic neuroma surgery via the translabyrinthine approach. The
      survey response rate was 78% and the symptomatology was consistent with other
      reports, supporting the representativeness of the sample. The respondents' QOL
      was rated significantly below published norms and their work capacity was
      reportedly reduced. Specifically, the following SF-36 dimensions were reduced:
      physical functioning and role-physical, together with vitality, general health,
      and social functioning. Greater numbers of postoperative symptoms and larger
      tumors were associated with a worse rating of physical functioning. More severe
      balance problems were associated with lower ratings of social functioning. The
      disparity between the patient's self-estimate and self-measurement and the
      clinician's assessment of the patient's facial functioning raises doubts about
      the validity of subjective reports and assessment. CONCLUSIONS: The present study
      supports the use of generic QOL measures to assess outcome and to draw
      comparisons between different populations.

PMID- 11213957
TI  - Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size
      and surgical approach on incidence and response to treatment.
AB  - OBJECT: The aims of this study were to review the incidence of cerebrospinal
      fluid (CSF) leakage complicating the removal of acoustic neuroma and to identify
      factors that influence its occurrence and treatment. METHODS: Prospective
      information on consecutive patients who underwent operation for acoustic neuroma
      was supplemented by a retrospective review of the medical records in which
      patients with CSF leaks complicating tumor removal were identified. This paper
      represents a continuation of a previously published series and thus compiles the
      authors' continuous experience over the last 24 years of practice. In 624 cases
      of acoustic neuroma the authors observed an overall incidence of 10.7% for CSF
      leak. The rate of leakage was significantly lower in the last 9 years compared
      with the first 15, most likely because of the abandonment of the combined
      translabyrinthine (TL)-middle fossa exposure. There was no difference in the
      leakage rate between TL and retrosigmoid (RS) approaches, although there were
      differences in the site of the leak (wound leaks occurred more frequently after a
      TL and otorrhea after an RS approach, respectively). Tumor size (maximum
      extracanalicular diameter) had a significant effect on the leakage rate overall
      and for RS but not for TL procedures. The majority of leaks ceased with
      nonsurgical treatments (18% with expectant management and 49% with lumbar CSF
      drainage). However, TL leaks (especially rhinorrhea) required surgical repair
      significantly more often than RS leaks. This has not been reported previously.
      CONCLUSIONS: The rate of CSF leakage after TL and RS procedures has remained
      stable. Factors influencing its occurrence include tumor size but not surgical
      approach. The TL-related leaks had a significantly higher surgical repair rate
      than RS-related leaks, an additional factor to consider when choosing an
      approach. The problem of CSF leakage becomes increasingly important as
      nonsurgical treatments for acoustic neuroma are developed.

PMID- 11213958
TI  - Basal ganglia hematomas in severely head injured patients: clinicoradiological
      analysis of 37 cases.
AB  - OBJECT: The authors analyzed the clinicoradiological presentation of traumatic
      basal ganglia hematomas (TBGHs) in severely head injured (SHI) patients. METHODS:
      The records of 37 patients (28 male and nine female patients with a mean age of
      28 years) in whom computerized tomography (CT) scans revealed TBGHs 2 ml or more
      in volume were retrospectively reviewed. These cases represented 2.4% of the
      total series of 1526 SHI patients admitted to the authors' institution between
      1979 and 1998. Thirty-five patients (94%) were involved in traffic accidents and
      only two exhibited a period of lucidity. Associated extracranial injuries were
      seen in 21 patients (57%) and coagulation disorders in 32 (86%). Skull fracture
      was present in 10 (43%) of the 23 patients in whom skull x-ray films were
      obtained. Computerized tomography findings indicated diffuse axonal injury in 27
      patients (73%), intraventricular hemorrhage in 22 patients (59%), and
      subarachnoid hemorrhage in 16 patients (43%). In all but two patients, the TBGHs
      were visible on the initial CT scan, and in 28 cases (76%) these hematomas were
      contralateral to the side of impact. Hematoma enlargement over the first few
      posttraumatic days was noted in 65% of the patients in whom control CT scans had
      been obtained (22 of 34 patients). Four patients (11%) underwent surgery to
      remove their TBGHs. Final outcomes were poor: 22 patients (59%) died, two (5%)
      became vegetative, seven (19%) experienced severe disabilities, and only six
      patients (16%) made a favorable recovery. CONCLUSIONS: Traumatic basal ganglia
      hematomas are dynamic lesions that tend to enlarge during the acute posttraumatic
      period. The overall prognosis in this series was poor. Patients in whom the
      volume of the hematoma was larger than 25 ml and those in whom hematoma volume
      enlargement or raised intracranial pressure occurred had the worst outcomes,
      perhaps indicating the need for a more aggressive surgical treatment.

PMID- 11213959
TI  - High-field magnetic resonance imaging in patients with moyamoya disease.
AB  - OBJECT: The purpose of this study was to assess the utility of high-field
      magnetic resonance (MR) imaging as a quantitative tool for estimating cerebral
      circulation in patients with moyamoya disease. METHODS: Eighteen patients with
      moyamoya disease who were scheduled to undergo revascularization surgery and 100
      healthy volunteers were examined using T2-reversed MR imaging performed using a 3
      tesla system. Ten of the 18 patients underwent a second study between 1 year and
      3 years after revascularization. Magnetic resonance images obtained in the
      patients with moyamoya disease were statistically analyzed and compared with
      those obtained in healthy volunteers. The MR imaging findings were also
      correlated with results of single-photon emission computerized tomography and
      conventional cerebral angiography studies. Transverse lines in the white matter
      (medullary streaks) were observed in almost all persons. In healthy volunteers,
      the diameter sizes of the medullary streaks increased significantly with age (p <
      0.001). Multiple logistic regression analysis revealed that age-adjusted
      medullary streak diameters were significantly larger in patients with moyamoya
      disease (p < 0.001). Diameter sizes also increased significantly with the
      increased severity of cerebral hypoperfusion (p < 0.001) and a higher
      angiographically determined stage of the disease (p < 0.001). Diameter sizes
      decreased significantly after surgery (p < 0.001). CONCLUSIONS: The increases in
      medullary streak diameters observed in patients with moyamoya disease appear to
      represent vessels dilated due to cerebral hypoperfusion. High-field T2-reversed
      MR imaging is useful in estimating cerebral circulation in patients with moyamoya
      disease.

PMID- 11213960
TI  - Rupture of intracranial aneurysms during treatment with Guglielmi detachable
      coils: incidence, outcome, and risk factors.
AB  - OBJECT: The aim of this study was to assess the incidence and outcome of
      procedure-related rupture of intracranial aneurysms in patients treated with
      Guglielmi detachable coils (GDCs) and to identify risk factors for this
      complication. METHODS: Procedure-related rupture occurred in seven of 264 treated
      aneurysms in 239 consecutive patients. Aneurysm size, history of previous
      subarachnoid hemorrhage (SAH) caused by the treated aneurysm, timing of treatment
      after SAH, and the use of a temporary occlusion balloon in the seven procedures
      in which rupture occurred were compared with the remaining 257 procedures, and
      these findings were correlated with data from 13 studies in the literature, in
      which results of 2030 aneurysm treatments were reported. CONCLUSIONS: Procedure
      related rupture of intracranial aneurysms during GDC treatment occurs in 2.5% of
      cases and is responsible for 1% of treatment-related deaths. Risk factors are as
      follows: small aneurysm size, previous SAH, and probably the use of a temporary
      occlusion balloon.

PMID- 11213961
TI  - Health-related quality of life after aneurysmal subarachnoid hemorrhage: impacts
      of bleeding severity, computerized tomography findings, surgery, vasospasm, and
      neurological grade.
AB  - OBJECT: Based on the results of earlier studies it is agreed that the
      significance of aneurysm location and surgery for neuropsychological impairments
      after subarachnoid hemorrhage (SAH) is secondary to the effects of the bleeding
      itself. Therefore, the present study was performed to evaluate whether bleeding,
      acute clinical course, and surgery have persistent effects on health-related
      quality of life (QOL) after SAH. METHODS: A series of 116 patients was examined
      for 4 to 5 years (mean 52.2 months) after aneurysmal SAH by means of a QOL
      questionnaire. Eighty-six patients (74.1%) had undergone surgery early (< or = 72
      hours post-SAH). There were 77 women (66.4%) and 39 men (33.6%) in the study
      group, and the mean age of the patients was 50.3+/-13.3 years (range 30-69
      years). Patients who had undergone surgery for a left-sided middle cerebral
      artery (MCA) aneurysm complained of significantly more impairments in social
      contact, communication, and cognition than those treated for a right-sided MCA
      aneurysm. No other effects of aneurysm location (including the anterior
      communicating artery) emerged. Multiple aneurysms, intraoperative aneurysm
      rupture, and partial resection of the gyrus rectus had no adverse effects on
      later daily life. Only temporary clipping was associated with increased
      complaints in some QOL areas. Disturbances of the circulation of cerebrospinal
      fluid and the presence of intraventricular hemorrhage led to more impairments in
      daily life. Specific effects of the anatomical pattern of the bleeding could be
      identified, but no adverse effects of vasospasm were found. Multivariate analyses
      revealed, in particular, that patient age and admission neurological status (Hunt
      and Hess grade) are substantial predictors of the psychosocial sequelae of SAH.
      CONCLUSIONS: In contrast to the mild effects of aneurysm surgery, patient's age,
      initial neurological state on admission, and the bleeding pattern substantially
      influence late QOL after SAH.

PMID- 11213962
TI  - Increase and uncoupling of adrenomedullin from the natriuretic peptide system in
      aneurysmal subarachnoid hemorrhage.
AB  - OBJECT: Natriuresis is a common systemic manifestation of aneurysmal subarachnoid
      hemorrhage (SAH). Natriuresis and its accompanying hypovolemia may be a major
      contributing factor in the pathophysiology of symptomatic cerebral vasospasm.
      METHODS: The authors studied 14 consecutive patients with aneurysmal SAH and
      compared levels of adrenomedullin (ADM), a novel endogenous natriuretic peptide
      that possesses additional profound vasodilatory properties, with the natriuretic
      peptide system by using radioimmunoassay. The mean ADM values on admission were
      24.8 pg/ml, a twofold increase over control values, but no correlation was found
      with atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C
      natriuretic peptide (CNP) from the natriuretic peptide system. At Day 5 post-SAH,
      ADM levels were significantly elevated in patients with vasospasm documented
      angiographically or on transcranial Doppler studies as compared with those who
      suffered no vasospasm (mean 61.9 pg/ml compared with 15.3 pg/ml, p < 0.01).
      CONCLUSIONS: The authors conclude that an elevation of ADM in plasma may indicate
      a physiological regulatory attempt to induce cerebral vasodilation. The
      regulation of ADM is uncoupled from ANP, BNP, and CNP.

PMID- 11213964
TI  - Cerebral blood flow alterations in progressive communicating hydrocephalus:
      transcranial Doppler ultrasonography assessment in an experimental model.
AB  - OBJECT: In many cases communicating hydrocephalus is the result of impairments in
      cerebrospinal fluid absorption in the arachnoid villi at the cranial convexity.
      Reported methods of creating experimental hydrocephalus have not sought to
      produce an arachnoidal adhesion in the cranial convexity. In this study the
      authors investigate alterations in cerebral blood flow (CBF) in experimental
      communicating hydrocephalus induced by the injection of kaolin into the
      subarachnoid space at the convexity in neonatal rats. METHODS: In neonatal rats,
      kaolin was injected into the subarachnoid space at the cranial convexity.
      Assessment of CBF alterations was performed using transcranial Doppler
      ultrasonography preinjection and at 10 days, 4 weeks, and 8 weeks postinjection.
      Light microscopy examination was also performed at 4 weeks and 8 weeks
      postinjection. Conspicuous lateral ventricle enlargements of different dimensions
      were observed in kaolin-injected rats at 4 to 8 weeks postinjection. The third
      and fourth ventricles were dilated to a lesser extent. Resistance to CBF and
      increased mean CBF velocity were apparent 8 weeks after kaolin injection.
      Further, destruction and even loss of ependymal layers were more prominent at the
      chronic stage. CONCLUSIONS: The present model may be considered a progressive
      communicating hydrocephalus because of marked changes in blood flow dynamics and
      destruction of the ependymal layer at the chronic stage.

PMID- 11213963
TI  - Transcerebellomedullary fissure approach with special reference to methods of
      dissecting the fissure.
AB  - OBJECT: The purpose of the present study was to refine the
      transcerebellomedullary fissure approach to the fourth ventricle and to clarify
      the optimal method of dissecting the fissure to obtain an appropriate operative
      view without splitting the inferior vermis. METHODS: The authors studied the
      microsurgical anatomy by using formalin-fixed specimens to determine the most
      appropriate method of dissecting the cerebellomedullary fissure. While dissecting
      the spaces around the tonsils and making incisions in the ventricle roof, the
      procedures used to expose each ventricle wall were studied. Based on their
      findings, the authors adopted the best approach for use in 19 cases of fourth
      ventricle tumor. The fissure was further separated into two slit spaces on each
      side: namely the uvulotonsillar and medullotonsillar spaces. The floor of the
      fissure was composed of the tela choroidea, inferior medullary velum, and lateral
      recess, which form the ventricle roof. In this approach, the authors first
      dissected the spaces around the tonsils and then incised the taenia with or
      without the posterior margin of the lateral recess. These precise dissections
      allowed for easy retraction of the tonsil(s) and uvula and provided a sufficient
      view of the ventricle wall such that the deep aqueductal region and the lateral
      region around the lateral recess could be seen without splitting the vermis. The
      dissecting method could be divided into three different types, including
      extensive (aqueduct), lateral wall, and lateral recess, depending on the location
      of the ventricle wall and the extent of surgical exposure required. CONCLUSIONS:
      When the fissure is appropriately and completely opened, the approach provides a
      sufficient operative view without splitting the vermis. Two key principles of
      this opening method are sufficient dissection of the spaces around the tonsil(s)
      and an incision of the appropriate portions of the ventricle roof. The taenia(e)
      with or without the posterior margin of the lateral recess(es) should be incised.

PMID- 11213965
TI  - Anticonvulsant effects of gamma surgery in a model of chronic spontaneous limbic
      epilepsy in rats.
AB  - OBJECT: The management of intractable epilepsy remains a challenge, despite
      advances in its surgical and nonsurgical treatment. The identification of low
      risk, low-cost therapeutic strategies that lead to improved outcome is therefore
      an important ongoing goal of basic and clinical research. Single-dose focal
      ionizing beam radiation delivered at necrosis-inducing and subnecrotic levels was
      investigated for its effects on seizure activity by using an established model of
      chronic recurrent spontaneous limbic seizures in rats. METHODS: A single 90
      minute period of repetitive electrical stimulation (inducing stimulus) of the
      hippocampus in rats elicited a single episode of status epilepticus, followed by
      a 2- to 4-week seizure-free period. Spontaneous recurrent seizures developed
      subsequently and persisted for the duration of monitoring (2-10 months).
      Simultaneous computerized electroencephalography and video recording were used to
      monitor the animals. After the establishment of spontaneous recurrent seizures,
      bilateral radiation centered in the ventral hippocampal formation was
      administered with the Leksell gamma knife, aided by a stereotactic device custom
      made for small animals. A center dose of 10, 20, or 40 Gy was administered using
      a 4-mm collimator. Control animals were subjected to the same seizure-inducing
      stimulus but underwent a sham treatment instead of gamma irradiation. In a second
      experiment, the authors examined the effects of gamma irradiation on the
      proclivity of hippocampal neurons to display epileptiform discharges. Naive
      animals were irradiated with a single 40-Gy dose, as already described. Slices of
      the hippocampus were prepared from animals killed between 1 and 178 days
      postirradiation. Sensitivity to penicillin-induced epileptiform spiking was
      examined in vitro in slices prepared from control and irradiated rat brains.
      CONCLUSIONS: In the first experiment, single doses of 20 or 40 Gy (but not 10 Gy)
      reduced substantially, and in some cases eliminated, behaviorally and
      electrographically recognized seizures. Significant reductions in both the
      frequency and duration of spontaneous seizures were observed during a follow-up
      period of up to 10 months postradiation. Histological examination of the targeted
      region did not reveal signs of necrosis. These findings indicate that single-dose
      focal ionizing beam irradiation at subnecrotic dosages reduces or eliminates
      repetitive spontaneous seizures in a rat model of temporal lobe epilepsy. In the
      second experiment, synaptically driven neuronal firing was shown to be intact in
      hippocampal neurons subjected to 40-Gy doses. However, the susceptibility to
      penicillin-induced epileptiform activity was reduced in the brain slices of
      animals receiving 40-Gy doses, compared with those from control rats that were
      not irradiated. The results provide rational support for the utility of
      subnecrotic gamma irradiation as a therapeutic strategy for treating epilepsy.
      These findings also provide evidence that a functional increase in the seizure
      threshold of hippocampal neurons contributes to the anticonvulsant influence of
      subnecrotic gamma irradiation.

PMID- 11213966
TI  - Augmentation of endothelial function by endothelin antagonism in human saphenous
      vein conduits.
AB  - OBJECT: Cerebral revascularization with saphenous vein (SV) conduits is used in
      the management of hard-to-treat lesions that require deliberate arterial
      occlusion and in selected patients with occlusive vascular disease. Endothelial
      dysfunction is thought to contribute to acute perioperative vasospasm and chronic
      graft atherosclerosis. In the present study the authors examined the contribution
      of the potent vasoconstrictor endothelin-1 (ET-1) to endothelial dysfunction in
      human SVs. METHODS: The effects of an ET(A/B) receptor antagonist (bosentan), an
      ET(A) receptor antagonist (BQ-123), and an ET(B) receptor antagonist (BQ-788) on
      in vitro endothelium-dependent and -independent responses were studied in human
      SVs. Vascular segments were obtained in 34 patients who had undergone
      revascularization procedures, and isometric dose-response curves (DRCs) were
      constructed using the isolated tissue bath procedure as follows: 1) cumulative
      DRCs to norepinephrine; and 2) DRCs to acetylcholine (ACh) and sodium
      nitroprusside in the absence and presence of bosentan, BQ-123, or BQ-788. Maximal
      vasodilatory responses and sensitivity were compared between groups. In the
      presence of bosentan (Experiment 1) and BQ-123 or BQ-788 (Experiment 2), ACh
      responses were significantly augmented (percent maximum relaxation values: 7+/-2
      [control] compared with 17+/-3 [bosentan], p < 0.002 [Experiment 1]; and 12+/-2
      [control] compared with 29+/-2 [BQ-123] and 25+/-2 [BQ-788], p < 0.003 and p <
      0.002, respectively [Experiment 2]). The sensitivity of SVs to ACh was unaffected
      by treatment. These beneficial effects were specific for the endothelium.
      CONCLUSIONS: Blockade of ET receptors significantly improves endothelial function
      in SVs. Furthermore, these effects appear to be independently and maximally
      mediated by antagonism of either ET(A) or ET(B) receptors. Interventions aimed at
      improving endothelial function may serve to counter perioperative vasospasm and
      impede atherosclerosis in SVs used for revascularization procedures.

PMID- 11213967
TI  - Immunogene therapy with interleukin-2-secreting fibroblasts for intracerebrally
      metastasizing breast cancer in mice.
AB  - OBJECT: Breast cancer is the second leading cause of cancer-related death in
      American women. Brain metastases occur in 15 to 30% of patients with breast
      cancer, and this usually results in death. Despite the availability of surgery,
      radiotherapy, and chemotherapy, the prognosis for patients with breast cancer
      that has metastasized to the intracerebral region remains poor. This study was
      designed to determine if an intracerebrally metastasizing breast tumor could be
      treated successfully with a cellular vaccine consisting of allogeneic fibroblasts
      (H-2K) modified to secrete interleukin (IL)-2. METHODS: The authors used EO771
      breast cancer cells, derived from a spontaneously arising breast-cancer tumor in
      C57BL/6 mice. The authors first determined the length of survival of C57BL/6 mice
      that had been injected with varying numbers of EO771 cells into the right frontal
      lobes and found that 100% of those animals that received a dose of 10(4) cells
      died within 41 days, whereas 100% of the group that received 10(3) cells died
      within 23 days. Based on these results, 5 x 10(4) EO771 cells were injected into
      the right frontal lobe of C57BL/6 mice and the animals were treated
      intracerebrally with a single intratumoral injection of 10(6) allogeneic
      fibroblasts genetically engineered to secrete IL-2. The allogeneic fibroblasts
      transfected with the IL-2 gene formed large quantities of IL-2 as measured by an
      enzyme-linked immunosorbent assay. Control groups of animals were treated with
      either allogeneic fibroblasts transfected with the retroviral vector, but not the
      IL-2 gene, or with media. The effects of this treatment on the animal's survival
      and the tumor's histopathological characteristics were investigated. The results
      indicate a significant prolongation (p < 0.005) of survival in animals with
      intracerebrally metastasizing breast cancer treated only with IL-2-secreting
      allogeneic fibroblasts. Tumor did not develop in four of 10 animals in the IL-2
      treated group, and these animals were rechallenged at 90 days by intracerebral
      injection of tumor, but no treatment cells, and compared with four naive animals
      receiving intracerebral tumor. Again, animals that previously had been treated
      with IL-2-secreting fibroblasts had a markedly prolonged survival (p < 0.05)
      compared with control animals following a second challenge with tumor cells.
      Histopathological examination revealed smaller tumors associated with lymphocytic
      infiltrations in the treated animals. CONCLUSIONS: This work represents a new
      treatment for breast cancer that has metastasized to the brain in which a
      cellular vaccine consisting of allogeneic fibroblasts genetically engineered to
      secrete cytokines is used as a novel means for delivery of immunogene therapy and
      demonstrates the induction of long-term immunity against tumor.

PMID- 11213968
TI  - Evidence for mitogen-associated protein kinase activation and transduction of
      mitogenic signals by platelet-derived growth factor in human meningioma cells.
AB  - OBJECT: Coexpression of platelet-derived growth factor (PDGF)-BB and activated
      PDGF-beta receptor in meningioma cells indicates that this cytokine may act as an
      autocrine or paracrine stimulant of meningioma growth. The intracellular events
      transducing signals from PDGF-beta receptor tyrosine kinases are unknown. In this
      study the authors evaluated whether or not mitogen-activated protein kinases
      (MAPKs) are expressed in meningiomas, regulate their growth, and transduce
      mitogenic signals of PDGF-BB. METHODS: Ten human meningioma tumors as well as
      cells cultured from two normal leptomeninges and 10 additional human meningiomas
      were evaluated using Western blot analysis to determine the presence of MAPK and
      phosphorylated (activated) MAPK. The effects of PD098059, a selective inhibitor
      of MAPK phosphorylation/activation, on proliferation of meningioma cells
      stimulated with 10% fetal bovine serum was also evaluated. Last, the authors
      evaluated whether PDGF-BB stimulation of meningioma cells was associated with
      activation of MAPK. Western blots of lysates from meningiomas and from cultured
      leptomeningeal and meningioma cells demonstrated MAPK and phosphorylated MAPK.
      Treatment with PD098059 produced a 52 to 84% (x = 69.8) loss in [3H]thymidine
      incorporation, which was associated with a partial or complete loss of
      phosphorylated MAPK after 3 days of treatment. The PDGF-BB produced a significant
      increase in [3H]thymidine incorporation and phosphorylation of MAPK at 1 and 3
      days. Coadministration of PD098059 completely blocked PDGF-BB's stimulation of
      [3H]thymidine incorporation and cell proliferation concomitant with reduced MAPK
      phosphorylation. CONCLUSIONS: The findings indicate that MAPK is constitutively
      expressed in leptomeningeal and meningioma cells and transduces mitogenic signals
      of PDGF, contributing to the growth of human meningiomas.

PMID- 11213970
TI  - Delayed onset of hemidystonia and hemiballismus following head injury: a
      clinicopathological correlation. Case report.
AB  - The authors report the case of a young man who suffered multiple injuries in a
      motor vehicle accident, the most significant of which arose in the brain,
      creating an unusual clinical syndrome. After experiencing an initial coma for
      several days, the patient was found to have a right-sided homonymous hemianopsia
      and a right hemiparesis, which was more marked at the shoulder and was
      accompanied by preservation of finger movement. Dystonic movements appeared 2
      months later and progressed, along with increased spasticity on volition, to
      severe uncontrolled arm movements at 2 years postinjury. This motor disorder
      continued to worsen during the following 6 years prior to the patient's death. At
      autopsy, the left side of the brain was observed to have marked atrophy of the
      optic tract, a partial lesion of the posterior portion of the medial segment of
      the globus pallidus (GP), and a reduction in the size of the internal capsule at
      the level of the GP, suggesting impaired circulation to these areas at the time
      of injury. The isolated lesion of the internal segment of the GP was the presumed
      cause of the dystonia, acting through an alteration in thalamic inhibition. The
      atrophic subthalamic nucleus was the probable cause of the hemiballismus. The
      authors speculate that this and other delayed and progressive features of this
      case were the result of an active, but disordered, adaptive process that failed
      to compensate and, instead, caused even greater problems than the original
      injury.

PMID- 11213969
TI  - Establishment and characterization of a novel malignant astrocytoma cell line
      derived from a tumor removed in a patient with neurofibromatosis type 1.
AB  - OBJECT: Patients with neurofibromatosis Type 1 (NF1) have a predisposition to
      development of a variety of benign and malignant tumors including neurofibromas,
      astrocytomas, pheochromocytomas, and malignant peripheral nerve sheath tumors.
      The availability of an astrocytoma cell line derived from NF1 would be useful in
      studies in which sporadic astrocytomas could be compared with NF1-derived
      astrocytomas. In this article the authors describe a novel astrocytoma cell line,
      TM-31, that they established from a tumor removed in a 42-year-old woman with
      NF1. METHODS: The TM-31 cell line was prepared from a surgical specimen of
      malignant astrocytoma and was serially subcultured over 250 times throughout a 6
      year period without showing any sign of cell senescence. Immunocytochemical
      analyses demonstrated that TM-31 cells are negative for glial fibrillary acidic
      protein but positive for vimentin and S-100 protein. The TM-31 cells display
      little neurofibromin expression when subjected to immunoblotting, indicating that
      there is an NF1 gene mutation. Polymerase chain reaction-single-strand
      conformational polymorphism analysis revealed that TM-31 cells harbor a p53 point
      mutation in exon 7, codon 238. Chemosensitivity testing of TM-31 cells revealed a
      resistance to 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3
      nitrosourea, although they are sensitive to cisplatin and etoposide. In addition,
      TM-31 cells displayed no morphological differentiation after all-transretinoic
      acid and dibutyryl cyclic adenosine monophosphate treatments. Pharmacological
      inhibition of farnesyltransferase of the Ras oncoprotein led to decreased
      proliferative activity and inhibition of anchorage-independent growth of TM-31
      cells in soft agar. CONCLUSIONS: The TM-31 cell line is an immortalized
      astrocytoma cell line derived from a tumor obtained in a patient with NF1. Ras
      activation may be the major event of proliferative activity and of the
      transformed phenotype of TM-31 cells, and the farnesyltransferase inhibitor may
      be potentially important as a novel antiproliferative therapy for NF1-derived
      astrocytomas.

PMID- 11213971
TI  - Experience with the high occipital transcortical approach in the treatment of
      intraventricular hemorrhage. Report of two cases.
AB  - Two patients with intraventricular hemorrhage (IVH) were treated by direct
      removal of their intraventricular hematomas via a high occipital transcortical
      approach with successful results. This approach lies between the parietooccipital
      transcortical approach and the occipital transcortical approach. The patients
      were a 90-year-old woman with idiopathic IVH and a 60-year-old man with
      hemorrhage caused by bleeding in the thalamus. In both cases, the hematoma was
      tightly packed in the lateral ventricle. In the former case, the inferior horn of
      the lateral ventricle was extremely swollen, and the patient was at risk for
      development of uncal herniation. With the goals of complete elimination of the
      hematoma in the inferior horn and identification of the source of bleeding, a
      high occipital transcortical approach was applied, and the hematoma was removed
      under direct vision. With the patient in the lateral position, a minor craniotomy
      of approximately 3 cm was performed around the puncture site of the posterior
      horn (8 cm craniad from the inion and 3 cm lateral from the midline). A 1-cm
      cortical incision was made and the posterior horn was reached. First, the portion
      of hematoma at this site was removed, and then the remainder was completely
      removed from the interior horn and corpus. Using this method, the entire region
      of the lateral ventricle, including the inferior horn, corpus, and posterior
      horn, can be covered in a single operative field, and it is also possible to have
      sufficient working space for the operation.

PMID- 11213972
TI  - Cerebral dissection from syringomyelia demonstrated using cine magnetic resonance
      imaging. Case report.
AB  - A 16-year-old boy presented at the authors' emergency department with a sudden
      deterioration of respiration. He had been paraparetic for 3 years and had become
      quadriplegic 2 days previously. Magnetic resonance images revealed a Chiari I
      malformation and a hydromyelic cavity extending from C-1 to T-11. Rostrally, a
      small cylindrically shaped lesion extended from the cervicomedullary junction to
      the left semioval center. The patient made a dramatic neurological recovery
      following suboccipital craniectomy and upper cervical laminectomies with
      augmentation duraplasties followed by placement of a syringoperitoneal shunt.

PMID- 11213973
TI  - Symptomatic solitary xanthogranuloma occupying the cavernous sinus. Case report.
AB  - The authors report the first case of a solitary xanthogranuloma of the cavernous
      sinus without systemic manifestation. A 43-year-old woman experienced decreased
      visual acuity on the right side in association with papilledema and a visual
      field defect. She was alert and no other neurological sign was observed. She had
      no family history of hyperlipoproteinemia and no cutaneous and/or systemic
      xanthomatous lesions. Skull x-ray films showed an enlarged right superior orbital
      fissure. Computerized tomography revealed a low-density oval mass 2 x 3 cm in
      diameter in the right cavernous region that was compressing the right optic nerve
      in the lateral to medial direction. This mass exhibited isointensity on T1
      weighted and mixed-pattern hyperintensity on T2-weighted magnetic resonance
      images with diffuse contrast enhancement. Cerebral angiography demonstrated fine
      staining in the margin, originating from the right middle meningeal artery. These
      neuroimaging findings closely mimicked those associated with trigeminal neuroma.
      The lesion was partially removed via a right-sided zygomatic approach, and her
      symptoms improved. Clinical characteristics and histopathological features of
      this rare case are discussed.

PMID- 11213974
TI  - Gamma knife surgery for treatment of central neurocytomas. Report of four cases.
AB  - The authors investigated the use of gamma knife surgery (GKS) in the treatment of
      central neurocytoma, a usually benign primary brain tumor of the lateral and
      third ventricles. Four patients with subtotally resected or recurrent central
      neurocytomas were retrospectively studied. The prescription isodose was 9 to 13
      Gy to the 30 to 50% peripheral isodose line. Pre- and postoperative magnetic
      resonance (MR) images were compared to determine the volume reduction following
      GKS. Follow-up review included annual MR imaging and clinical evaluation by a
      neurosurgeon. Follow-up periods ranged from 12 to 99 months. Marked reduction in
      tumor size was seen in all four patients; the decrease in tumor volume for each
      was 48%, 72%, 81%, and 77%, respectively, at the last follow-up review. None of
      the four patients required additional treatment and none experienced a decline in
      neurological function during the follow-up period. No complications have been
      noted in any of these patients to date. Even though there have been few
      observations and follow-up time has been limited, because of the consistency of
      the response and the lack of observed side effects, GKS may be the treatment of
      choice for subtotally resected and recurrent central neurocytomas.

PMID- 11213975
TI  - Giant chondroma arising from the dura mater of the convexity. Case report and
      review of the literature.
AB  - Chondromas arising from the dura mater are rare intracranial tumors. The authors
      present a case of intracranial giant chondroma originating from the dura mater of
      the convexity. Neuroimaging and surgical findings are described. The diagnostic
      clues are discussed and similar cases from the literature are reviewed.

PMID- 11213976
TI  - Secondary abscess formation in pituitary adenoma after tooth extraction. Case
      report.
AB  - The presence of an abscess in a pituitary tumor is a very rare finding. The
      authors report the case of a 69-year-old man with a pituitary adenoma confirmed
      by neuroimaging results, in whom a high fever, meningismus, and left-sided
      ophthalmoplegia developed 4 days after tooth extraction. The results of serial
      cranial magnetic resonance imaging were highly indicative of an abscess formation
      within the pituitary adenoma. During surgery the tumor was approached
      transsphenoidally and removed. Histological examination confirmed the presence of
      an abscess formation within the pituitary adenoma. It is most likely that the
      tooth extraction caused a bacteremia, which led to an inflammation with abscess
      formation within the pituitary adenoma. The authors conclude that invasive dental
      procedures should be avoided before planned resection of a pituitary adenoma.

PMID- 11213977
TI  - Supracerebellar transtentorial approach to posterior temporomedial structures.
AB  - The supracerebellar transtentorial (SCTT) approach, a modification of the
      infratentorial supracerebellar approach, facilitates simple and minimally
      invasive access to posterior temporomedial structures without requiring
      retraction of the temporal or occipital lobe. The SCTT approach was used in 16
      patients over a 3-year period. Eleven patients harbored tumors confined to, or
      located mainly within, the posterior hippocampal formation, three patients
      harbored aneurysms (one ruptured posterior cerebral artery [PCA] aneurysm at the
      P2-P3 junction, one ruptured giant PCA [P2] aneurysm, and one giant basilar
      artery-superior cerebellar artery aneurysm), one patient had juvenile-type
      moyamoya disease, and one patient suffered from medically intractable epilepsy.
      In these patients, the SCTT approach enabled tumor removal, aneurysm clipping,
      and vascular bypass procedures. The authors' experience suggests that this
      approach can be used routinely in treating lesions in the posterior temporomedial
      region.

PMID- 11213978
TI  - Astrocytoma cell line.

PMID- 11213979
TI  - Closing the gender gap.

PMID- 11213980
TI  - A prospective electromyographic and computer-aided thermal sensitivity assessment
      of nerve lesions after sagittal split osteotomy and Le Fort I osteotomy.
AB  - PURPOSE: The purpose of this study was to determine the incidence of temporary
      and permanent sensory disturbance of the inferior alveolar nerve (IAN) after
      bilateral sagittal split osteotomy (BSSO) of the mandible and of the infraorbital
      nerve (ION) after Le Fort I osteotomy, as well as the rate of recovery of sensory
      function using subjective and objective measures. PATIENTS AND METHODS:
      Preoperatively and after 1 week, and 1, 3, 6, and 12 months postoperatively,
      sensibility in the distribution of 36 IONs after Le Fort I osteotomy and 24 IANs
      after BSSO in 19 patients were investigated by using sharp-blunt testing, 2-point
      discrimination, electromyographic recording, and thermal sensitivity (Pain and
      Thermal Sensitivity Test Device [PATH]) tests of the Adelta and C nerve fibers.
      RESULTS: With conventional clinical sharp-blunt and 2-point discrimination tests,
      the incidence of temporary impairment was 81% for the ION (29 of 36) and 83% for
      the IAN (20 of 24). The rate of permanent sensibility disturbance with
      conventional clinical testing was 6% for the ION and 15% for the IAN. Obvious
      recovery was found after 1 to 3 months for the ION, but it took 6 to 12 months
      for the IAN. In contrast, electromyography (EMG) testing showed lower rates of
      temporary sensory disturbance, namely, 54% (13 of 24) for the ION and 68% (15 of
      22) for the IAN. Permanent sensory losses were not found. The results of the EMG
      test was confirmed by the PATH test. CONCLUSIONS: Objective tests for sensory
      disturbances show lower rates than the conventional tests. For quality control,
      preoperative and postoperative measurement and documentation of postoperative
      recovery of sensation is recommended.

PMID- 11213981
TI  - Vascularized free fibular flap for mandibular reconstruction: a report of 26
      cases.
AB  - PURPOSE: Mandibular reconstruction represents a challenge to the oral and
      maxillofacial surgeon and has been revolutionized by the modern microvascular
      techniques. Rehabilitation using techniques such as reconstruction plates
      frequently produce a functional and cosmetic defect. The primary objective of the
      current study was to evaluate the usefulness of the osteomuscular free fibular
      flap for this purpose. PATIENTS AND METHODS: The results of 26 vascularized free
      fibula flaps with or without a skin paddle that were used for mandibular
      reconstruction is presented. The "double barrel" technique was used in 6 cases.
      The donor site was closed directly in 2 cases and with an abdominal full
      thickness skin graft in 24 cases. RESULTS: All flaps except 1 were viable. There
      was partial necrosis of the skin island in 1 patient. The average length of the
      fibula graft was 10.96 cm, and the number of osteotomies ranged from 0 to 3. In
      the donor site, the most significant problem was unsatisfactory scarring related
      to the use of a skin graft. There were no long-term functional complications in
      the lower leg. Two patients have been secondarily rehabilitated with
      osseointegrated implants. CONCLUSION: The fibula flap provides a successful bone
      graft for mandibular restoration with an acceptably low complication rate. This
      method meets most of the requirements for oral and mandibular replacement.

PMID- 11213982
TI  - Thermographic imaging of postoperative inflammation modified by anti-inflammatory
      pretreatment.
AB  - PURPOSE: The aim of this study was to assess the usefulness of thermography in
      detecting the postoperative inflammatory reaction after third molar removal.
      PATIENTS AND METHODS: Thermographic images (NovaTherm; Novamedix Ltd, Hampshire,
      England) of both cheeks were obtained on the first and seventh postoperative days
      after removal of impacted mandibular third molars under local anesthesia in 30
      patients (15 men, 15 women). The unoperated contralateral side served as a
      control. One of the following pretreatments was given immediately before the
      operation: diclofenac (Voltaren; Novartis, Espoo, Finland) 150 mg orally (rapid
      release 50 mg and prolonged-release 100 mg, n = 15), diclofenac 100 mg orally
      (prolonged-release) and 50 mg intramuscularly (n = 11), or placebo (n = 4).
      RESULTS: The postoperative skin surface temperature on the operated side was
      significantly higher than that on the unoperated side. The thermal difference was
      0.9 degrees C +/- 0.1 degrees C on the first postoperative day and declined
      significantly by the seventh day to 0.3 degrees C +/- 0.1 degrees C (both P <
      .001). The thermal difference in patients receiving diclofenac preoperatively was
      significantly smaller (0.8 degrees C +/- 0.1 degrees C at day 1 and 0.2 degrees C
      +/- 0.1 degrees C at day 7) than in patients receiving placebo (1.6 degrees C +/-
      0.1 degrees C at day 1 and 0.8 degrees C +/- 0.3 degrees C at day 7, P < .001).
      However, with equal doses of diclofenac, the combination of rapid-release and
      prolonged-release tablets orally was more effective in reducing skin temperature
      than an orally administered prolonged-release tablet combined with intramuscular
      injection (P < .001). CONCLUSION: Thermography is a suitable method to measure
      the inflammatory reaction related to third molar removal. Thermal changes are
      significant and are decreased by the nonsteroidal anti-inflammatory drug
      diclofenac.

PMID- 11213983
TI  - Soft tissue changes of the upper lip associated with maxillary advancement in
      obstructive sleep apnea patients.
AB  - PURPOSE: This retrospective study evaluated the horizontal and vertical soft
      tissue changes that occur with maxillary advancement surgery with a Le Fort I
      osteotomy with concomitant anatomic reorientation of the nasolabial musculature.
      SUBJECTS AND METHODS: Fifteen OSA patients who underwent maxillary advancement
      with a Le Fort I osteotomy without adjunctive nasal soft tissue procedures were
      studied after a minimum of 8 months of follow-up. The V-Y technique was used to
      close the maxillary vestibular incision. Only cases with minimal vertical
      movement (< 3.5 mm) in which no orthodontics were used were included. The average
      maxillary advancement was 8.0 +/- 2.5 mm, measured at the upper incisor (UPI) and
      the average vertical movement was 0.7 +/- 1.8 mm. The horizontal and vertical
      soft tissue change in subnasale (SN), labrale superiorus (LS), superior stomion
      (SS), nasal tip (NT), nasolabial angle (NLA), and lip length were measured in
      each patient and correlated with hard tissue measurements at anterior nasal spine
      (ANS) and UPI. The effect of lip thickness on these soft tissue changes also was
      evaluated. RESULTS: Using mean data, the horizontal soft-to-hard-tissue ratio for
      LS to UPI was 0.80:1, with a concomitant vertical (superior) soft tissue change
      to hard tissue advancement of 0.16:1. Lip length did not change significantly.
      All patients except 1 showed a slight decrease in nasolabial angle. The average
      decrease was 5 (range, -10 to +7 ). There was no statistically significant
      correlation between the degree of change in NLA and the amount of maxillary
      advancement. CONCLUSION: This study showed that advancement of the maxilla when
      controlling vertical movement resulted in the a hard-to-soft-tissue ratio of
      LS:UPI of 0.80:1. NLA did not change significantly.

PMID- 11213984
TI  - Craniofacial fibrous dysplasia of the fronto-orbital region: a case series and
      literature review.
AB  - PURPOSE: Craniofacial fibrous dysplais (CFD), involving the fronto-orbital region
      often is challenging to treat because of the proximity of neurovascular and
      ocular structures. This article presents the surgical experience with 6 patients.
      PATIENTS AND METHODS: Six patients ranging in age from 7 to 23 years, who had
      undergone surgery for CFD of the orbital region, were retrospectively reviewed.
      All patients had progressive complaints of deformity, pain, paresthesia or visual
      disturbances. Surgery generally involved extensive tumor excision and immediate
      orbital reconstruction with autogenous bone grafts. Two patients also were
      reconstructed with resected and treated autogenous bone, which then was
      immediately reimplanted, using rigid fixation. Three patients also had
      intracranial microsurgical optic canal decompression. All patients received
      perioperative corticosteroids. RESULTS: Five patients experienced partial relief
      of their sensory and visual disturbances. These patients also felt that there had
      been improvement in facial appearance. One patient with very extensive
      circumferential optic canal involvement, and who underwent 2-wall decompression,
      suffered visual loss. CONCLUSION: Early surgery to address progressive sensory
      disturbances is recommended so as to avoid the hazards of late-stage
      decompression. The risks of surgery must be weighed against the benefits of
      achieving a more functional and aesthetic result. Long-term neuro-ophthalmologic
      monitoring is essential.

PMID- 11213985
TI  - Tissue-engineered mucosa graft for reconstruction of the intraoral lining after
      freeing of the tongue: a clinical and immunohistologic study.
AB  - PURPOSE: This article describes the use of tissue-engineered mucosal grafts
      instead of split-thickness skin grafts after freeing of the tongue in patients
      who had previous resection of an oral squamous cell carcinoma and initial primary
      wound closure. PATIENTS AND METHODS: Tissue-engineered mucosal grafts, up to 75
      cm2 in size, were cultured from biopsy specimens of the hard palate in 6
      patients, starting 3 to 4 weeks before the operation. After freeing of the
      tongue, the engineered mucosa was implanted on the wound surface by using
      vaseline gauze as carrier and fixed with an intraoral gauze wound dressing.
      RESULTS: A good glossoalveolar sulcus was formed in 5 patients, resulting in good
      mobility of the tongue and a satisfactory denture-bearing surface. In 1 patient,
      there was a disturbance of wound healing, leading to severe shrinkage of the
      glossoalveolar sulcus and very limited improvement in tongue mobility.
      Preoperative bromodeoxyuridine (BrdU) labeling of the graft and postoperative
      immunohistochemical staining of biopsy specimens from the grafted areas with anti
      BrdU showed that the cultured cells are integrated into the newly formed mucosal
      epithelium. Postoperative histologic investigations showed a differentiation
      process in the grafted mucosal epithelium, with a change in the expression of
      cytokeratins. At 6 months postoperatively, the typical pattern of normal
      nongrafted mucosa was regained. CONCLUSIONS: This investigation provides evidence
      that tissue-engineered mucosal cells can serve as a graft for large intraoral
      wounds. Complete intraoral lining is quickly reestablished, and normal epithelial
      differentiation is seen in the graft area within a 6-month postoperative period.

PMID- 11213986
TI  - The course of the temporal branch of the facial nerve in the periorbital region.
AB  - PURPOSE: This study identified the terminal temporal and zygomatic branches of
      the facial nerve as they enter the orbicularis oculi muscle and related these
      branches to identifiable surface markings. MATERIALS AND METHODS: The temporal
      and zygomatic branches of the facial nerve were dissected from 5 preserved
      cadavers (10 sides). The most superior temporal branch entering the orbicularis
      oculi muscle was identified and related to the lateral canthus of the eye. A
      vertical line was passed through this point so that the line was equidistant from
      the nasal tip and chin point. A line perpendicular to the vertical line through
      the lateral canthus served as the horizontal scale. Vertical and horizontal lines
      through the lateral canthus were used to establish the anatomic relationship
      between the lateral canthus and the branch of the temporal nerve entering the
      orbicularis oculi muscle. RESULTS: The temporal branch was an average of 2.85 +/-
      0.69 cm superior to the lateral canthus and an average of 2.54 +/- 0.43 cm
      lateral to the lateral canthus as it courses into the orbicularis oculi muscle.
      At the lateral border of the orbicularis oculi muscle, where the temporal and
      zygomatic nerves insert into the muscle, the mean vertical distance between the
      temporal and zygomatic nerves was 1.72 +/- 0.62 cm. CONCLUSION: Incisions
      superior or inferior and parallel to the course of the facial nerve, can provide
      access to the fronto zygomatic suture and the superior and lateral orbit without
      damaging its branches.

PMID- 11213987
TI  - Tissue-engineered composites of bone and cartilage for mandible condylar
      reconstruction.
AB  - PURPOSE: This study evaluated the feasibility of creating a tissue-engineered
      adult human mandible condyle composite of bone and cartilage. MATERIALS AND
      METHODS: A polymer template composed of polyglycolic acid (PGA) and polylactic
      acid (PIA), and formed in the shape of the human mandible condyle, was seeded
      with osteoblasts isolated from a bovine periosteum suspended in calcium alginate.
      Chondrocytes isolated from the same calf suspended in 30% pluronic were then
      "painted" onto the articular surface of the scaffold, and it was then implanted
      into subcutaneous pockets on the dorsum of athymic mice. Animals were divided
      into 3 groups: group I (n = 6) received a PGA/PLA scaffold saturated with
      hydrogels not containing cells; group II (n = 6) received scaffolds seeded with
      both cell types suspended in saline rather than hydrogels; and group III (n = 6)
      received scaffolds seeded with both cell types suspended in hydrogel composites.
      Constructs were harvested after 12 weeks and evaluated grossly and
      microscopically by using histologic stains. RESULTS: In group I, the constructs
      formed a small mass without evidence of new bone or cartilage. In group II, the
      constructs were small and irregular. Microscopically they contained scattered
      islands of bone and cartilage. All specimens in group III retained their original
      condylar shape and were quite firm. Microscopic evaluation indicated trabecular
      bone interfacing with hyaline cartilage on the articulating surface. CONCLUSION:
      These findings show that the composites of bone and cartilage can be engineered
      to serve as condylar substitutes. The interdigitation of bone and cartilage at
      their interface is similar to the normal interface of these composite tissues
      seen in articulating joints.

PMID- 11213988
TI  - Preliminary investigation of the biomechanics of internal fixation of sagittal
      split osteotomies with miniplates using a newly designed in vitro testing model.
AB  - PURPOSE: This article reports a preliminary study undertaken to investigate the
      biomechanics of internal fixation systems for sagittal split ramus osteotomy of
      the mandible with advancement, using a newly designed 3-point bovine rib testing
      model. MATERIALS AND METHODS: After 1 of 5 different miniplates internal fixation
      systems was placed, a vertical load was applied just below the superior border of
      sagittal split osteotomy gaps in bovine ribs positioned in a custom-made cradle
      using a compound cantilered bar device. Load/displacement data were gathered, and
      the mean elastic limits of the 5 miniplate designs were compared by using a 1-way
      analysis of variance (ANOVA) with Tukey multiple comparisons. RESULTS: The
      elastic limit of the rigid fixation system was higher when using a curved plate
      design than with a straight plate design. CONCLUSION: The 3-point bovine rib
      model used in this study is an inexpensive, discriminating, and reproducible
      method for testing internal fixation systems on sagittal ramus osteotomies under
      conditions that more accurately represent the human mandible in function.

PMID- 11213989
TI  - Maxillary sinusitis after augmentation of the maxillary sinus floor: a report of
      2 cases.

PMID- 11213990
TI  - An unusual postextraction hemorrhage associated with Klippel-Trenaunay-Weber
      syndrome.

PMID- 11213991
TI  - Intramuscular hemangioma of the temporalis muscle.

PMID- 11213992
TI  - Gastric mucosal choristoma of the tongue and floor of the mouth.

PMID- 11213993
TI  - Interface analysis of titanium implants in a human vascularized fibula bone
      graft.

PMID- 11213994
TI  - Treatment of obstructive sleep apnea syndrome by mandibular elongation using
      osseous distraction followed by a Le Fort I advancement osteotomy: case report.

PMID- 11213995
TI  - Treatment of mandibular malignant fibrous histiocytoma during pregnancy.

PMID- 11213996
TI  - Ganglion of the temporomandibular joint: case report.

PMID- 11213998
TI  - Castleman disease (giant lymph node hyperplasia) in the maxillofacial region: a
      report of 3 cases.

PMID- 11213999
TI  - Solitary intraosseous neurofibroma of the inferior alveolar nerve: report of a
      case.

PMID- 11214000
TI  - Use of bone rongeur to aid in splitting the ascending ramus during mandibular
      sagittal split ramus osteotomy.

PMID- 11214001
TI  - A modified mandibular ramus osteotomy for orthognathic surgery.

PMID- 11214002
TI  - "Insuring" against allegations of discrimination.

PMID- 11214003
TI  - Management of the paranasal sinus mucocele.

PMID- 11214004
TI  - The heart of the matter--new insights into the genetics of cardiomyopathy.

PMID- 11214005
TI  - S100-B in blood: a marker of brain damage or simply a covariate?

PMID- 11214006
TI  - Neurologic injury in cardiac surgery: aortic atherosclerosis emerges as the
      single most important risk factor.
AB  - With older and sicker patients undergoing cardiac surgery, neurologic injury has
      emerged as an increasingly important cause of rising costs, morbidity and
      mortality. Several studies investigating the relationship between atherosclerotic
      aortic disease and subsequent adverse clinical outcomes have demonstrated that
      the single most important risk factor for neurologic injury following cardiac
      surgery is the presence of aortic atheromatous disease. The results of these
      studies suggest that atheroemboli are correlated with neurologic injury following
      cardiac surgery. Surgical techniques to avoid and prevent particulate debris
      during cardiac surgery may be a major step in preventing severe neurologic
      injury.

PMID- 11214007
TI  - A novel missense mutation, Leu390Val, in the cardiac beta-myosin heavy chain
      associated with pronounced septal hypertrophy in two families with hypertrophic
      cardiomyopathy.
AB  - OBJECTIVE: An examination of the genetic background and phenotypic presentation
      of familial hypertrophic cardiomyopathy (FHC) with respect to specific mutations
      in the MYH7-gene encoding the cardiac beta-myosin heavy chain. SETTINGS: Two
      families (n = 22) from a cohort of 67 families with FHC were studied at the
      National University Hospital, Rigshospitalet, Copenhagen. METHODS: Clinical, non
      invasive examinations of all included family members followed by molecular
      genetic analysis including PCR-single strand conformation
      polymorphism/heteroduplex (SSCP/HD) analysis and sequencing of exon 3-23 of the
      MYH7-gene. RESULTS: We found FHC associated with a missense mutation in two
      families, i.e. a C > G transversion at position g10124 and a G > T transversion
      at position g10126 causing the change of a leucine residue at codon 390 to a
      valine residue. The mutation is located in the actin-binding region of the beta
      myosin heavy chain. The leucine residue is evolutionarily conserved in vertebrate
      myosins. In the two families, the phenotypic presentations in the clinically
      affected were characterized by asymmetric septal hypertrophy (septum diameter
      18.8 (5.0) mm (mean (SD)) with only minor involvement of the left ventricular
      free wall (posterior wall diameter 11.0 (2.2) mm). Furthermore, the left
      ventricular systolic and diastolic functions were well preserved, even at a high
      age. The symptomatic status of the clinically affected patients depended on the
      presence or absence of a concomitant left ventricular outflow tract gradient.
      CONCLUSIONS: We report a novel missense mutation associated with FHC caused by a
      double nucleotide transversion. The penetrance of the mutation was not complete,
      but in clinically affected patients the mutation gives rise to an
      echocardiographic phenotype, predominantly characterized by pronounced septal
      hypertrophy.

PMID- 11214008
TI  - Outcome of septal myectomy in patients with hypertrophic obstructive
      cardiomyopathy.
AB  - OBJECTIVES: To study the outcome of septal myectomy in patients with hypertrophic
      obstructive cardiomyopathy. DESIGN: Septal myectomy in patients with hypertrophic
      cardiomyopathy with obstruction of the left ventricular outflow tract (HOCM) is
      symptomatically effective, and complication rates have been found to be low in
      large centres performing the procedure routinely. Representing a small centre we
      studied the outcome after septal myectomy in 11 consecutive patients, aged 44 +/-
      21 (mean +/- SD) years with HOCM myectomized at our institution from 1991 to
      1998. The patients were evaluated preoperatively using echocardiography and left
      sided heart catheterization. RESULTS: Eight patients were operated on after
      medical treatment had failed and three after sudden deterioration of cardiac
      function. A Morrow myectomy was performed in 10 patients and a modified Konno
      procedure in one. Significant reductions were observed in left ventricular
      outflow tract gradients (77 +/- 29 to 10 +/- 7 mmHg, p < 0.01; n = 11), the
      degree of mitral valve regurgitation (grades 0-3) (1.7 +/- 1.0 to 0.8 +/- 0.7, p
      < 0.01; n = 11), NYHA functional classification score (2.4 +/- 1.0 to 1.5 +/-
      0.7, p < 0.01; n = 11) and all five patients with angina preoperatively had an
      improved CCS angina classification score. There were no operative or early
      postoperative (30 days) deaths. One patient operated on with the modified Konno
      procedure was reoperated for a septal patch suture leak. During follow-up (43 +/-
      24 months, range 11-83), the linearized mortality rate was 3.6% per year. One
      patient died from a pancreas cancer, one probably from coronary artery disease
      and one suddenly of unknown cause. CONCLUSION: We conclude that septal myectomy
      efficiently relieves symptoms in HOCM patients, possibly reflecting the direct as
      well as secondary effects of left ventricular outflow tract gradient reduction.
      The present results, obtained at a smaller centre for this procedure, should be
      considered when choosing from available therapeutic alternatives when medical
      therapy fails: dual chamber pacemaker implantation, percutaneous transluminal
      septal myocardial ablation or myectomy.

PMID- 11214009
TI  - Serum S-100beta protein predicts brain injury after hypothermic circulatory
      arrest in pigs.
AB  - OBJECTIVE: Serum S-100beta protein is suggested to be a neurobiochemical marker
      of brain injury after cardiac and aortic arch surgery. The aim of the present
      study was to investigate the predictive value of S-100beta protein with respect
      to histopathological analysis of the brain after a prolonged period of
      hypothermic circulatory arrest (HCA). METHODS: Eighteen pigs (21 to 31 kg)
      underwent a 75 min period of HCA at 20 degrees C. Serum concentrations of S
      100beta were assayed in mixed venous blood before and 2, 4, 7 and 20 h after HCA.
      A semiquantitative post-mortem histopathological analysis scoring all main
      regions of the brain was carried out in every animal. RESULTS: All animals were
      stable during and after cardiopulmonary bypass (CPB) and survived at least to the
      first postoperative day. Ten of the 18 animals survived 7 days after surgery and
      were electively sacrificed. Animals with severe histopathological injury showed
      higher serum S-100beta protein levels at every time point after HCA. The
      strongest correlation between the total histopathologic score and serum S-100beta
      levels was found at 7 h after HCA (tau = 0.422 and p = 0.023). CONCLUSION: Serum
      S-100beta protein levels correlate with histopathological injury after a
      prolonged period of HCA in pigs. This finding supports the results of previous
      studies suggesting the potential accuracy of S-100beta in the prediction of brain
      injury after cardiac surgery.

PMID- 11214010
TI  - Bundle branch block and acute myocardial infarction. Treatment and outcome.
AB  - OBJECTIVE: To study early diagnosis, treatment and outcome in patients with
      bundle branch block and clinically suspected acute myocardial infarction. DESIGN:
      A prospective multicenter study including 14 Swedish coronary care units. The
      study included 257 consecutive patients with bundle branch block and clinical
      suspicion of acute myocardial infarction. RESULTS: Left bundle branch block was
      present in 62% of patients and right bundle branch block in 38%. Thrombolytic
      treatment of acute myocardial infarction in the left and right bundle branch
      block was 16% and 36%, respectively. Of those undergoing thrombolytic therapy,
      20% of patients with left and 13% with right bundle branch block did not develop
      an acute myocardial infarction. Patients with left bundle branch block had higher
      mortality rates than those with right bundle branch block. After one year there
      was no difference in mortality rates between patients with and those without
      acute myocardial infarction on admission. CONCLUSION: Patients with bundle branch
      block and suspected acute myocardial infarction receive suboptimal treatment.
      Thus better diagnostic regimes are needed to identify those patients with bundle
      branch block and acute myocardial infarction who are suitable for thrombolytic
      treatment.

PMID- 11214011
TI  - Depression after coronary heart disease events.
AB  - OBJECTIVE: To study the prevalence of depression at least 6 months after various
      coronary heart disease (CHD) events (bypass grafting, coronary angioplasty,
      myocardial infarction, myocardial ischaemia without infarction) and the
      associations between depression and clinical variables. DESIGN: In the course of
      the study 414 (284 males, 130 females) patients younger than 71 years (mean age
      for men 60.9 years and for women 63.6 years) were interviewed and examined.
      Smoking habits, body mass index, lipid levels and diabetic status were recorded.
      The New York Heart Association (NYHA) class was assessed. Depression was screened
      using a self-rated depression scale. RESULTS: In the four diagnostic categories,
      one-sixth of the patients (14-19%) suffered from depression. Depression was
      associated with smoking (OR 1.7, 95% CI 1.2; 2.4) and poor NYHA class (OR 1.9,
      95% CI 1.4; 2.6). CONCLUSION: Depression is common after CHD events, and is
      associated with smoking and poor NYHA class. The identification and treatment of
      depression should be one of the elements in the rehabilitation of cardiac
      patients.

PMID- 11214012
TI  - Inverse association between birth weight, birth length and serum total
      cholesterol in adulthood.
AB  - OBJECTIVES: To investigate whether impaired fetal growth, measured by low birth
      weight and short birth length, is linked with raised levels of serum lipids and
      increased risk and mortality of coronary heart disease. DESIGN: The association
      between birth length, birth weight, Ponderal Index and total serum cholesterol
      was examined in 545 Danish men and women aged 31 to 51 years who participated in
      the Ebeltoft Health Promotion Project in Denmark. RESULTS: No associations were
      found in women. For men, a negative association was found between birth weight
      and serum total cholesterol, with a fall in mean serum total cholesterol from
      6.03 mmol/l at birth weight below 3300 g to 5.64 mmol/l at birth weight above
      4000. A similar association was found between birth length and serum cholesterol,
      with a mean value of 6.23 mmol/l at birth length below 51 cm and a mean value of
      5.56 mmol/l at birth length above 54 cm. No associations were found for Ponderal
      Index. Between 3% and 8% of the variance in serum total cholesterol could be
      explained by the statistical models used in this study. CONCLUSION: Our findings
      support the hypothesis of a negative association between birth weight, birth
      length and elevated serum cholesterol in adult life, but only in men.

PMID- 11214013
TI  - Influence of glutaraldehyde fixation on the detection of SLA-I and II antigens
      and calcification tendency in porcine cardiac tissue.
AB  - OBJECTIVE: Immunological effects have been addressed as key factors for the long
      term results of biological porcine aortic prostheses. In this study we
      investigated the influence of glutaraldehyde fixation on the expression of SLA
      (swine leucocyte antigens) and the calcification of porcine cardiac tissue.
      DESIGN: Deparaffinized sections obtained from porcine aortic tissue were fixed in
      a buffered glutaraldehyde solution for 1, 2, 3, 24 and 72 hours, respectively,
      and finally immunostained with monoclonal anti-SLA class I antibody 2.27-3a and
      anti-SLA-II antibody MSA3. Sixteen samples from fixed porcine cardiac tissue and,
      for comparison, 8 samples from leaflets of Toronto-SPV and Freestyle valves were
      implanted subcutaneously in 10 Wistar rats for 12 weeks and their calcium content
      was measured by atomic absorption spectrophotometry. RESULTS: SLA-I epitopes were
      no longer detectable using anti-SLA-I antibodies after fixation for 3 h. The SLA
      II antigens remained detectable after longer fixation period. Short-time fixation
      resulted in marked calcification of the porcine cardiac tissue and to destruction
      of the SLA-I epitopes, whereas, even after longer fixation time, the epitopes of
      the SLA-II antigen remain unaffected. CONCLUSION: Chelate formation due to
      glutaraldehyde treatment provides protection against calcification. Short-time
      fixed porcine cardiac tissue has a tendency towards a greater degree of
      calcification than longer fixation periods. Based on the present results, it is
      pointless to set the length of fixation to switch off the immunogenicity.

PMID- 11214014
TI  - Effect of allopurinol on myocardial oxygen free radical production in coronary
      bypass surgery.
AB  - OBJECTIVES: Allopurinol protects the heart from reperfusion injury. The aim of
      this study was to investigate myocardial free radical production during
      reperfusion with and without allopurinol treatment in coronary artery bypass
      grafting patients randomized into allopurinol (n = 14) or placebo (n = 13)
      groups. DESIGN: Allopurinol (1 g) was given blind prior to cardiopulmonary bypass
      and prior to opening the aorta. Oxygen free radicals were measured before
      anesthesia in arterial blood, before cross-clamping and 1 and 10 min after
      reperfusion in arterial and coronary sinus blood. Levels were measured as
      relative concentrations by the electron spin resonance method. RESULTS: One
      minute after reperfusion the level of spin-trapped radicals in arterial blood was
      elevated significantly (p = 0.016) in the allopurinol group, from 7.7 (SE: 0.8)
      to 8.6 (1.4) and non-significantly (p = 0.074) in the placebo group, from 7.3
      (0.7) to 8.3 (0.8). Ten minutes after reperfusion the arterial values were 8.6
      (1.5) in the allopurinol and 7.6 (0.7) in the placebo group, the sinus values
      being 7.6 (1.3) and 8.3 (0.8), respectively. Myocardial free radical production
      was -0.94 (1.21) in the allopurinol and +0.79 (0.96) in the placebo group after
      10 min reperfusion, the difference being significant (p = 0.043). CONCLUSIONS:
      All patients in both groups had an increasing tendency to free radical production
      during early reperfusion. Patients treated with allopurinol showed less
      myocardial production of free radicals, indicating that its protective effect may
      be due to its antioxidative properties.

PMID- 11214015
TI  - Middle cerebral artery circulation during carotid surgery. A transcranial Doppler
      study.
AB  - OBJECTIVE: Perioperative carotid cross-clamping might induce low stump pressures
      as well as hypoperfusion of the middle cerebral artery. In this study blood flow
      velocities in the middle cerebral artery were compared with intraoperative
      measurements of the poststenotic carotid blood pressure. DESIGN: Forty-one
      patients with internal carotid artery stenosis were operated on without shunting,
      under general anesthesia. Poststenotic carotid pressures and middle cerebral
      artery flow velocities were measured before and during cross-clamping. The
      hemodynamic responses to preoperative carotid compressions and intraoperative
      cross-clamping were evaluated. RESULTS: In seven patients the poststenotic
      carotid blood pressure decreased on clamping despite unchanged or even increased
      middle cerebral artery blood flow velocities. In all other patients, pressure
      changes were significantly correlated to the decrease in middle cerebral artery
      blood flow velocities. Autoregulatory blood flow velocity responses after
      preoperative common carotid artery compression were not reproducible by cross
      clamping. CONCLUSIONS: Stump blood pressure measurements may not reflect middle
      cerebral artery perfusion in about 20% of thrombendarterectomies performed under
      general anesthesia. A possible explanation might be dimished cerebral
      autoregulation and changes in collateral flow distributions.

PMID- 11214016
TI  - Aggressive surgical treatment of multiple primary lung cancers.
AB  - A case of triple primary lung cancers--squamous cell carcinoma, adenocarcinoma
      and large-cell carcinoma--is presented. Surgical treatment comprised,
      respectively, left pneumonectomy, partial resection of the right upper lobe and
      completion right upper lobectomy. The postoperative courses were uneventful and
      the patient remains well, with no sign of recurrence, 20 months after the third
      operation.

PMID- 11214017
TI  - Primary lymphoma of the heart.
AB  - Primary tumors of the heart are rare. Most patients have very few clinical
      manifestations and present with uncharacteristic symptoms, often misdiagnosed as
      heart failure. As investigation techniques such as echocardiography, computed
      tomography and magnetic resonance imaging become more widespread, the clinician
      will be confronted with the diagnosing of cardiac masses. Early identification is
      essential for optimum treatment. We present a case of malignant lymphoma of the
      heart, where treatment led to remission from cardiac growth of the tumor.

PMID- 11214018
TI  - Implications and refinements of the establishing operation concept.
AB  - In this paper I discuss (a) three steps in the development of establishing
      operation (EO) terminology, (b) my early neglect of its possible relevance to
      applied behavior analysis, (c) the importance of functional analysis methodology
      for increasing awareness of EO issues, and (d) three comprehensive reviews that
      clarify the role of EOs in applied work. I then review and further analyze seven
      topics that require further clarification or that have been raised since my 1982
      and 1993 articles: the EO evocative effect, deprivation and satiation, problem
      behavior maintained by attention, decreasing behavior evoked by a transitive
      conditioned establishing operation, EOs in the context of escape and avoidance,
      academic demand, and decreasing behavior evoked by a reflexive conditioned
      establishing operation.

PMID- 11214019
TI  - Current research on the influence of establishing operations on behavior in
      applied settings.
AB  - This article provides commentary on research published in the special section of
      the Journal of Applied Behavior Analysis devoted to establishing operations
      (EOs). Three major themes are highlighted: (a) identification of the influence of
      EOs on behavior in applied settings, (b) the use of EO manipulation as an
      assessment tool, and (c) the development of interventions based on the alteration
      of EO influences. Methodological issues pertaining to research on EOs are
      addressed, and suggestions for future investigation are provided.

PMID- 11214020
TI  - A method for identifying satiation versus extinction effects under noncontingent
      reinforcement schedules.
AB  - We evaluated one method for determining whether response suppression under
      noncontingent reinforcement (NCR) is a function of satiation or extinction. Three
      individuals with developmental disabilities who engaged in self-injurious
      behavior (SIB) or aggression participated. Results of functional analyses
      indicated that their problem behavior was maintained by social-positive
      reinforcement. NCR procedures, individualized for each participant, were
      implemented in a multiple baseline across subjects design and were associated
      with decreases in all participants' problem behavior. Identification of the
      mechanism by which NCR produced these effects was based on examination of
      cumulative records showing response patterns during and immediately following
      each NCR session. Satiation during NCR should lead to a temporary increase in
      responding during the post-NCR (extinction) period due to a transition from the
      availability to the unavailability of reinforcement (satiation to deprivation).
      Alternatively, extinction during NCR should reveal no increase in responding
      during the extinction period because the contingency for the problem behavior
      would remain unchanged and the transition from satiation to deprivation
      conditions would be irrelevant. Results suggested that the operative mechanisms
      of NCR were idiosyncratic across the 3 participants and appeared to change during
      treatment for 1 of the participants.

PMID- 11214021
TI  - Effects of noncontingent reinforcement on problem behavior and stimulus
      engagement: the role of satiation, extinction, and alternative reinforcement.
AB  - This study examined the effects of noncontingent reinforcement (NCR) with and
      without extinction on problem behavior and stimulus engagement (consumption of
      reinforcement) of 4 participants. Reductions in problem behavior using NCR have
      frequently been attributed to both satiation of the reinforcer and extinction. In
      the current study, aspects of the NCR treatment effects were difficult to explain
      based solely on either a satiation or an extinction account. Specifically, it was
      found that stimulus engagement remained high throughout the NCR treatment
      analysis, and that problem behavior was reduced to near-zero levels during NCR
      without extinction. The implications of these findings are discussed with respect
      to the satiation and extinction hypotheses frequently described in the applied
      literature. Findings from basic studies examining the effects of response
      independent schedules are presented, and are used as the basis for a matching
      theory account of NCR-related effects. It is proposed that reductions in problem
      behavior observed during NCR interventions may be a function of the availability
      of alternative sources of reinforcement.

PMID- 11214022
TI  - Relative influences of establishing operations and reinforcement contingencies on
      self-injurious behavior during functional analyses.
AB  - In the typical functional analysis in which the antecedent and consequent events
      associated with problem behavior are manipulated, the control condition involves
      elimination of both the relevant establishing operation (EO) and its associated
      contingency through a schedule of noncontingent reinforcement (usually fixed-time
      [FT] 30 s). In some functional analyses, however, antecedent events are
      manipulated in the absence of differential consequences, and a common test
      condition in such analyses also involves the delivery of reinforcement on an FT
      30-s schedule. Thus, the same schedule of reinforcement (FT 30 s) is not
      considered to be an EO in the former type of analysis but is considered to be an
      EO in the latter. We examined the relative influences of EOs and reinforcement
      contingencies on problem behavior by exposing 6 individuals who engaged in self
      injurious behavior (SIB) to four combinations of functional analysis conditions:
      EO present/contingency present, EO absent/contingency present, EO
      present/contingency absent, and EO absent/contingency absent. Results indicated
      that the only condition in which high rates of SIB were observed consistently was
      one in which the EO and the reinforcement contingency were both present.
      Implications of these results for the design of functional analysis test and
      control conditions are discussed.

PMID- 11214024
TI  - Escape behavior during academic tasks: a preliminary analysis of idiosyncratic
      establishing operations.
AB  - The presence or absence of idiosyncratic stimuli has been demonstrated to
      predictably alter the occurrence of problem behavior. By specifying stimuli
      related to negatively reinforced behavior during academic tasks, it may be
      possible to identify methods of instruction that decrease the occurrence of
      problem behavior. The current study used a four-step procedure that involved a
      functional analysis, descriptive assessment, establishing operations (EO)
      analysis, and follow-up evaluation (a) to identify the operant function of
      destructive behavior and (b) to evaluate the effects of idiosyncratic features of
      academic task demands and related methods of instruction on the occurrence of
      negatively reinforced destructive behavior of 3 boys with developmental
      disabilities and autism in a classroom setting. The data suggest that the four
      step procedure was effective in identifying methods of instruction that decreased
      the likelihood of destructive behavior without disrupting the maintaining
      contingencies for destructive behavior. Results are discussed in terms of
      establishing operations for negatively reinforced destructive behavior during
      academic tasks and related methods of instruction in classroom settings.

PMID- 11214023
TI  - The effects of presession exposure to attention on the results of assessments of
      attention as a reinforcer.
AB  - The effects of presession exposure to attention on responding during subsequent
      assessments of attention as a reinforcer were evaluated across three behavioral
      assessments. In Experiment 1, a contingent attention assessment condition was
      preceded by either a noncontingent attention condition (free play) or a
      contingent escape condition. In Experiment 2, a diverted attention with
      extinction condition was preceded by either an alone or a free-play condition. In
      Experiment 3, a two-choice preference assessment was preceded by either 10 min of
      free play or 10 min of playing alone. In each experiment, the participant
      responded differentially within the test condition according to the presence or
      absence of dense schedules of attention immediately prior to that condition. The
      results of this study show that events occurring immediately prior to an
      assessment condition can influence behavior within the assessment.

PMID- 11214025
TI  - Effects of deprivation on engagement in preferred activities by persons with
      developmental disabilities.
AB  - This study examined the effects of deprivation on engagement in activities for 3
      adult men with developmental disabilities. First, an assessment was conducted to
      identify a high- and a low-preference activity for each participant. Second, the
      high-preference activity was made available following three amounts of
      deprivation of the activity (15 min, 2 hr, and 1 to 4 days); the low-preference
      activity was made available following the schedule of deprivation that produced
      the highest level of engagement by each participant in the high-preference
      activity. The results were that 1 to 4 days of deprivation produced the highest
      average amounts of engagement in the high-preference activity for each
      participant; this amount of deprivation did not produce high engagement in the
      low-preference activities. Third, the deprivation procedures and results were
      replicated when high-preference activities were presented by teachers during the
      participants' daily activities when their engagement had been quite low.

PMID- 11214026
TI  - "Transitional objects" as establishing operations for thumb sucking: a case
      study.
AB  - This study examines the effects of a "transitional object" (surgical cloth) on
      the thumb sucking of a 3-year-old boy in two conditions: while sitting in the lap
      of his physical therapist and while alone in his crib. Sucking occurred when the
      cloth was present and did not occur when it was absent, regardless of condition.
      These results are discussed in terms of establishing operations, object
      attachment, and application.

PMID- 11214027
TI  - Assessment of the influence of background noise on escape-maintained problem
      behavior and pain behavior in a child with Williams syndrome.
AB  - We examined the influence of background noise on levels of problem behavior and
      pain behavior under functional analysis conditions for a child with a diagnosis
      of Williams syndrome and hyperacusis. Background noise was associated with
      increases in escape-maintained problem behavior and increases in pain behavior
      such as clasping ears and crying. When the child was fitted with earplugs, there
      were substantial reductions in both problem and pain behavior under the
      background noise condition.

PMID- 11214028
TI  - Recombinative generalization of within-syllable units in prereading children.
AB  - This study demonstrates recombinative generalization of within-syllable units in
      prereading children. Three kindergarten children learned to select printed
      consonant-vowel-consonant words upon hearing the corresponding spoken words. The
      words were taught in sets; there were six sets, presented consecutively. Within
      sets, the four words that were taught had overlapping letters, for example, sat,
      mat, sop, and sug. Tests for recombinative generalization determined whether the
      children selected novel words with the same components as the trained words
      (e.g., mop and mug). Two children demonstrated recombinative generalization after
      one training set, and the 3rd demonstrated it after two training sets. In
      contrast, 2 other children, who received tests but no training, showed low
      accuracy across six sets. The 3 experimental children then demonstrated highly
      accurate printed-word-to-picture matching, and named the majority of the printed
      words. These findings are a promising step in the development of a computerized
      instructional technology for reading.

PMID- 11214029
TI  - Preference for unreliable reinforcement in children with mental retardation: the
      role of conditioned reinforcement.
AB  - We examined the effects of conditioned reinforcement on children's choice between
      reliable (100%) and unreliable (50%) reinforcement under various stimulus
      conditions in a concurrent-chains procedure. The study was conducted across three
      experiments. Experiments 1 and 2 were conducted under conditions similar to basic
      laboratory work and consisted of participants selecting from one of two black
      boxes (placed on a table) that were correlated with different reinforcement
      schedules. In Experiment 3, we assessed a participant's preference for unreliable
      reinforcement during conditions in which the target responses were aggression and
      mands. Results of the three experiments showed that the participants preferred
      unreliable reinforcement under certain conditions. Findings are discussed
      regarding the role of specific stimuli (i.e., items correlated with a
      reinforcement schedule, adult reactions) as conditioned reinforcers and how they
      may influence children's preference for a response (e.g., aggression, self
      injury) that produces reinforcement on a leaner schedule than a socially
      desirable response (e.g., mands).

PMID- 11214030
TI  - Variable-time reinforcement schedules in the treatment of socially maintained
      problem behavior.
AB  - Noncontingent reinforcement (NCR) consists of delivering a reinforcer on a time
      based schedule, independent of responding. Studies evaluating the effectiveness
      of NCR as treatment for problem behavior have used fixed-time (FT) schedules of
      reinforcement. In this study, the efficacy of NCR with variable-time (VT)
      schedules was evaluated by comparing the effects of VT and FT reinforcement
      schedules with 2 individuals who engaged in problem behavior maintained by
      positive reinforcement. Both FT and VT schedules were effective in reducing
      problem behavior. These findings suggest that VT schedules can be used to treat
      problem behavior maintained by social consequences.

PMID- 11214031
TI  - Analyzing the multiple functions of stereotypical behavior for students with
      autism: implications for assessment and treatment.
AB  - We studied behavioral functions associated with stereotypical responses for
      students with autism. In Study 1, analogue functional analyses (attention,
      demand, no-attention, and recreation conditions) were conducted for 5 students.
      Results suggested that stereotypy was multiply determined or occurred across all
      assessment conditions. For 2 students, stereotypy was associated with positive
      and negative reinforcement and the absence of environmental stimulation. For 2
      other students, stereotypy occurred at high levels across all experimental
      conditions. For the 5th student, stereotypy was associated with negative
      reinforcement and the absence of environmental stimulation. In Study 2, the
      stereotypy of 1 student was further analyzed on a function-by-function basis.
      Within a concurrent-schedules procedure, alternative responses were taught to the
      student using functional communication training. The results of Study 2 showed
      that similar topographies of stereotypy, based on qualitatively different
      reinforcers, were reduced only when differential reinforcement contingencies for
      alternative forms of communication were implemented for specific response
      reinforcer relations. Our results suggest that the causes of stereotypy for
      students with autism are complex and that the presumed association between
      response topography and behavioral function may be less important than previously
      realized.

PMID- 11214032
TI  - Effects of methylphenidate on sensitivity to reinforcement in children diagnosed
      with attention deficit hyperactivity disorder: an application of the matching
      law.
AB  - The behavior of children diagnosed with attention deficit hyperactivity disorder
      (ADHD) has been hypothesized to be the result of decreased sensitivity to
      consequences compared to typical children. The present study examined sensitivity
      to reinforcement in 2 boys diagnosed with ADHD using the matching law to provide
      more precise and quantitative measurement of this construct. This experiment also
      evaluated the effects of methylphenidate (MPH) on sensitivity to reinforcement of
      children with ADHD. Subjects completed math problems to earn tokens under four
      different variable-interval (VI) schedules of reinforcement presented in random
      order under both medicated and nonmedicated conditions. Results showed that, in
      the medicated condition, the matching functions for both subjects resulted in
      higher asymptotic values, indicating an overall elevation of behavior rate under
      these conditions. The variance accounted for by the matching law was also higher
      under the medicated conditions, suggesting that their behavior more closely
      tracked the changing rates of reinforcement while taking MPH compared to placebo.
      Under medicated conditions, the reinforcing efficacy of response-contingent
      tokens decreased. Results are discussed with respect to quantifying behavioral
      changes and the extent to which the drug interacts with prevailing contingencies
      (i.e., schedule values) to influence behavioral variability.

PMID- 11214033
TI  - Testing the ability of children with attention deficit hyperactivity disorder to
      accurately report the effects of medication on their behavior.
AB  - Children with attention deficit hyperactivity disorder (ADHD) are often treated
      with central nervous system stimulants, making the evaluation of medication
      effects an important topic for applied behavior analysts. Because assessment
      protocols emphasize informant reports and direct observations of child behavior,
      little is known about the extent to which children themselves can accurately
      report medication effects. Double-blind placebo-controlled procedures were used
      to examine whether 6 children with ADHD could recognize the effects of their
      medication. The children were given math worksheets to complete for 15 min during
      each of 14 sessions while on medication and placebo. Children completed a self
      evaluation form at the end of each session, and ratings were compared to observed
      behavior and academic performance. Results indicated that 3 children were able to
      accurately report their medication status at levels greater than chance, whereas
      the accuracy of reports by all children was related to dosage level, differences
      in behavior, and the presence of adverse effects. The implications of these
      results for placebo-controlled research, self-monitoring of dosage levels, and
      accuracy training are discussed.

PMID- 11214034
TI  - Teaching self-control to small groups of dually diagnosed adults.
AB  - The present study examined the use of a progressive delay procedure to teach self
      control to two groups of dually diagnosed adults. When given a choice between an
      immediate smaller reinforcer and a larger delayed reinforcer, both groups chose
      the smaller reinforcer during baseline. During treatment, progressive increases
      in work requirements for gaining access to a larger reinforcer resulted in both
      groups selecting larger delayed reinforcers. The results are discussed with
      respect to increasing cooperative work behavior and self-control.

PMID- 11214035
TI  - Treatment of covert food stealing in an individual with Prader-Willi syndrome.
AB  - Covert food stealing is common among individuals with Prader-Willi syndrome. We
      found that verbal reprimands, delivered contingent upon eating prohibited foods,
      were sufficient to decrease the food stealing of a girl with Prader-Willi
      syndrome. Warning stimuli were then used to help her discriminate between
      permitted and prohibited foods during sessions in which food stealing was not
      directly observed. This procedure resulted in decreases in food stealing from
      containers labeled with the warning stimuli.

PMID- 11214036
TI  - The effects of a vitamin supplement on the pica of a child with severe mental
      retardation.
AB  - The effects of a common multiple vitamin on the pica of a child with severe
      mental retardation and anemia were evaluated. A BAB design revealed that pica was
      decreased by the vitamin. The results suggest that pica can be effectively
      treated by implementation of a simple nutritional or biological intervention.
      Further research investigating the generality of this finding and the effects of
      combining biological and behavioral interventions are discussed.

PMID- 11214037
TI  - The effects of noncontingent access to single- versus multiple-stimulus sets on
      self-injurious behavior.
AB  - The automatically reinforced self-injury of a girl with autism was treated by
      providing noncontingent access to a single set of preferred toys during 30-min
      sessions. The reductive effects of the intervention waned as the session
      progressed. Rotating toy sets after 10 min or providing access to multiple toy
      sets resulted in reductions that lasted the entire 30 min.

PMID- 11214038
TI  - Teaching children with autism to ask questions about hidden objects.
AB  - We taught 2 4-year-old children with autism to ask questions of an adult who held
      a closed box with a toy inside. The treatment package (modeling, prompting, and
      reinforcement) was evaluated with a multiple baseline design across the three
      question forms during training, generalization, and follow-up evaluations. The
      first question form ("What's that?") produced the name of the hidden item. The
      second form ("Can I see it?") produced sight of it, and the third form ("Can I
      have it?") produced the item itself. Both children learned to ask questions about
      hidden objects.

PMID- 11214039
TI  - Partial remediation of speaker and listener behaviors in people with severe
      dementia.
AB  - We investigated the effects of contingent reinforcement (Intervention 1) and
      contingent reinforcement with modeling (Intervention 2) on speaker and listener
      behaviors in 5 people with severe dementia. Intervention 1 generally increased
      listener behavior; there was no clear effect on tacting, but echoic behavior
      increased in the one case investigated. Given the weak baseline repertoires of
      these clients and the paucity of other effective interventions, even the small
      increases in verbal behaviors found here are important. Further gains may be
      achieved, for example, if reinforcement opportunity per trial type were to be
      increased from one to several per day or if participants were trained to echo the
      listener stimulus in mand compliance tasks.

PMID- 11214040
TI  - Motivating signage prompts safety belt use among drivers exiting senior
      communities.
AB  - Senior drivers are vulnerable to automobile crashes and subsequent injury and
      death. Safety belts reduce health risks associated with auto crashes. Therefore,
      it is important to encourage senior drivers to wear safety belts while driving.
      Using an AB design, replicated five times, we evaluated the short- and long-term
      effects of a sign with the message "BUCKLE UP, STAY SAFE" attached to a stop sign
      at the exits of five different senior communities. Safety belt use was stable
      during two pretreatment assessments averaged across the five sites and 250
      drivers (72% and 68% usage), but significantly increased following installation
      of these signs (94% usage). Six months after installation of the signs, the
      effect persisted (88% usage). Use of such signs may be a cost-effective way of
      promoting safety belt use.

PMID- 11214041
TI  - Embedded evaluation of preferences sampled from person-centered plans for people
      with profound multiple disabilities.
AB  - We investigated a brief, embedded assessment for evaluating preferences sampled
      from person-centered plans. After developing person-centered plans for
      individuals with multiple disabilities, systematic assessments were conducted
      with preferences sampled from the plans. An assessment of sampled preferences was
      then embedded within the participants' daily routines. The two assessments
      identified similar preferences based on participant approach responses. Both
      assessments also indicated inconsistencies with reported preferences in the
      person-centered plans. Overall, results suggested the embedded assessment may be
      an alternative means of evaluating some preferences reported through person
      centered planning.

PMID- 11214043
TI  - Palatal fistulas: rare with the two-flap palatoplasty repair.
AB  - The purpose of this study was to examine the palatal fistula rate after repair
      with the two-flap palatoplasty technique. This is a retrospective review of 119
      consecutive cleft-palate repairs performed over a 5-year interval by a single
      surgeon. The two-flap palatoplasty technique was used to provide tension-free,
      multilayer repairs. The age of these children at the time of repair ranged from 7
      to 84 months (mode, 9 months). The initial follow-up visit occurred 2 to 12 weeks
      after the repair operation (mean, 4 weeks). The postoperative follow-up duration
      ranged from 7 to 48 months. This review of 119 cleft-palate repairs revealed a
      fistula rate of 3.4 percent (four fistulas in 119 repairs). This experience
      demonstrates the lowest reported palatal fistula complication rate with use of
      the two-flap palatoplasty technique.

PMID- 11214042
TI  - Repair of bilateral complete cleft lip: intraoperative nasolabial anthropometry.
AB  - Synchronous repair of bilateral complete cleft lip and nasal deformity requires
      conception of three-dimensional form and fourth-dimensional changes with growth,
      as distorted by the malformation. The aim is to obviate typical postoperative
      nasolabial stigmata. The strategy is to construct fast-growing features on a
      smaller scale and slow-growing features on a normal or slightly larger scale. In
      this study, intraoperative alterations in nasolabial dimensions were documented
      by anthropometry in 46 consecutive infants with bilateral complete cleft lip.
      These values were averaged and compared with measures from normal Caucasian
      infants at ages 0 to 5 months and 6 to 12 months. Nasal height (n-sn) and nasal
      width (al-al), both fast-growing features, were set smaller (88 percent and 96
      percent, respectively) than those of age-matched normal infants. In contrast, the
      slow-growing features, nasal protrusion (sn-prn) and columellar length, were
      constructed longer than normal (130 percent and 167 percent, respectively).
      Because all labial features grow rapidly, they were made diminutive in this
      study, with the exception of central vermilion-mucosal height (median tubercle),
      which was purposively made full. These maneuvers resulted in a normal, average
      overall upper-lip height (sn-sto). Two technical refinements also are described:
      (1) construction of deepithelialized bands flanking the philtral flap to improve
      surface contour; and (2) positioning and fixation of the dislocated alar
      cartilages, performed entirely through superiomedial nostril rim incisions.

PMID- 11214044
TI  - The thersites complex in plastic surgical patients.
AB  - Body dysmorphic disorder describes the preoccupation with an imagined defect of
      appearance. A subgroup of patients suffer from the so-called Thersites complex,
      in which a minimal physical deformity causes excessive psychological disturbances
      and distress. Patients with body dysmorphic disorder tend primarily to visit a
      plastic surgeon for relief with distinct plans for surgical correction of their
      "deformity." Psychotherapy is generally refused or ineffective. The plastic
      surgeon should be familiar with this mental disorder and recognize these patients
      during consultation. Most of these patients should be excluded from surgery;
      however, patients of the Thersites complex category might be candidates for
      plastic surgical correction after careful selection. Only the experienced plastic
      surgeon should make the decision to operate in this situation. A successful
      treatment can relieve the patient from his or her distress and improve the
      quality of life substantially. A surgical result that is not accepted by the
      patient can end in a tragedy for either the patient or the doctor.

PMID- 11214045
TI  - Type A botulinum toxin for the treatment of hypertrophy of the masseter and
      temporal muscles: an alternative treatment.
AB  - The treatment of hypertrophy of the masseter and temporal muscles has to date
      been dominated by conservative and surgical measures. Local therapy with type A
      botulinum toxin permits an alternative method of treatment. After targeted,
      sometimes electromyographically controlled, intramuscular injection of the
      affected muscles, marked inactivity atrophy occurred in the muscles of seven
      patients over the course of 3 to 8 weeks. This atrophy remained constant over a
      follow-up period of up to 25 months, and no side effects were observed. Because
      of its minimal invasiveness, this technique seems to have an advantage over
      conventional surgical therapy. Consequently, treatment with type A botulinum
      toxin can be regarded as a sensible alternative to surgery in cases of
      hypertrophy of the masseter and/or temporal muscles.

PMID- 11214046
TI  - Endoscopic correction of pectus excavatum.
AB  - Endoscopic surgery is minimally invasive and can be used to achieve superior
      cosmetic results. Conventional correction of pectus excavatum results in a long
      scar. Correction by use of endoscopic surgery involves a smaller skin incision.
      In this study, endoscopic correction of pectus excavatum was performed in 20
      cases. A small transverse skin incision was made above the xyphoid process. A
      wide area beneath the pectoralis major muscle was dissected under endoscopic
      visualization. Subperichondrial resection was performed under direct
      visualization when possible. Subperichondrial resection of the third or fourth
      rib was performed under endoscopic visualization. Ravitch's chondrotomy of the
      second or third rib was performed under endoscopic visualization. Endoscopy was
      also useful for sternal elevation, with minimal risk of pleural perforation.
      Kirschner wire was inserted percutaneously under the sternum to prevent
      postoperative paradoxical respiration. In all cases, the postoperative course was
      uneventful. The advantages of endoscopic pectus excavatum correction are a short
      scar, control of bleeding, safe dissection of the pleura from the sternum without
      the risk of pleural perforation, and ease of sternal elevation without injury to
      the intramammary vessels. However, the endoscopic operation is long and is not
      useful in adults because subperichondrial resection in adults is difficult to
      perform.

PMID- 11214047
TI  - Postoperative morphine requirements of free TRAM and DIEP flaps.
AB  - In a review of the charts of 158 patients who had undergone breast reconstruction
      with free transverse rectus abdominis musculocutaneous (TRAM) or deep inferior
      epigastric perforator (DIEP) flaps and who were treated for postoperative pain
      with morphine administered by a patient-controlled analgesia pump, the total dose
      of morphine administered during hospitalization for the flap transfer was
      measured. Patients whose treatment was supplemented by other intravenous
      narcotics were excluded from the study. The mean amount of morphine per kilogram
      required by patients who had reconstruction with DIEP flaps (0.74 mg/kg, n = 26)
      was found to be significantly less than the amount required by patients who had
      reconstruction with TRAM flaps (1.65 mg/kg; n = 132; p < 0.001). DIEP flap
      patients also remained in the hospital less time (mean, 4.73 days) than did free
      TRAM flap patients (mean, 5.21 days; p = 0.026), but the difference was less than
      one full hospital day. It was concluded that the use of the DIEP flap does reduce
      the patient requirement for postoperative pain medication and therefore
      presumably reduces postoperative pain. It may also slightly shorten hospital
      stay.

PMID- 11214048
TI  - Complications of postmastectomy breast reconstructions in smokers, ex-smokers,
      and nonsmokers.
AB  - Smoking results in impaired wound healing and poor surgical results. In this
      retrospective study, we compared outcomes in 155 smokers, 76 ex-smokers, and 517
      nonsmokers who received postmastectomy breast reconstructions during a 10-year
      period. Ex-smokers were defined as those who had quit smoking at least 3 weeks
      before surgery. Transverse rectus abdominis musculocutaneous (TRAM) flap surgery
      was performed significantly less often in smokers (24.5 percent) than in ex
      smokers (30.3 percent) or nonsmokers (39.1 percent) (p < 0.001). Tissue expansion
      followed by implant was performed in 112 smokers (72.3 percent), 50 (65.8
      percent) ex-smokers, and 304 nonsmokers (58.8 percent) (p = 0.002). The overall
      complication rate in smokers was 39.4 percent, compared with 25 percent in ex
      smokers and 25.9 percent in nonsmokers, which is statistically significant (p =
      0.002). Mastectomy flap necrosis developed in 12 smokers (7.7 percent), 2 ex
      smokers (2.6 percent), and 8 nonsmokers (1.5 percent) (p < 0.001). Among patients
      receiving TR4AM flaps, fat necrosis developed in 10 smokers (26.3 percent), 2 ex
      smokers (8.7 percent), and 17 nonsmokers (8.4 percent). Abdominal wall necrosis
      was more common in smokers (7.9 percent) than in ex-smokers (4.3 percent) or
      nonsmokers (1.0 percent). In this large series, tissue expansion was performed
      more often in smokers than was autogenous reconstruction. Complications were
      significantly more frequent in smokers. Mastectomy flap necrosis was
      significantly more frequent in smokers, regardless of the type of reconstruction.
      Breast reconstruction should be done with caution in smokers. Ex-smokers had
      complication rates similar to those of nonsmokers. Smokers undergoing
      reconstruction should be strongly urged to stop smoking at least 3 weeks before
      their surgery.

PMID- 11214049
TI  - Incidence of hematoma associated with ketorolac after TRAM flap breast
      reconstruction.
AB  - Ketorolac is frequently used as an adjunct for postoperative pain relief,
      especially by anesthesiologists during the immediate postoperative period. It can
      be used alone as an analgesic but is more often used to potentiate the actions of
      narcotics such as morphine or meperidine in an attempt to reduce the total dose
      and side effects of those drugs. The manufacturer of ketorolac cautions against
      its use in patients who have a high risk of postoperative bleeding, for fear of
      increasing the risk of hematoma, but the risk in transverse rectus abdominis
      musculocutaneous (TRAM) flap patients has never been reported. In a study of 215
      patients who had undergone TRAM flap breast reconstruction, it was determined
      that patients who received intravenous ketorolac (n = 65) as an adjunct to their
      treatment with morphine administered by use of a patient-controlled analgesia
      device required less morphine (mean cumulative dose, 1.39 mg/kg) than did
      patients who did not receive ketorolac (n = 150; mean cumulative dose, 1.75
      mg/kg; p = 0.02). There was no increase in the incidence of hematoma in patients
      who were treated with ketorolac. The data presented in this study suggest that
      the use of intravenous ketorolac does reduce the need for narcotics
      administration in patients undergoing TRAM flap breast reconstruction, without
      significantly increasing the risk of hematoma.

PMID- 11214050
TI  - Calcification properties of saline-filled breast implants.
AB  - Three patients requested explantation of their saline-filled breast implants.
      Bilateral calcification had occurred in all six implants. Four of the implants
      were manufactured by McGhan Corporation (Santa Barbara, Calif.), and two, by the
      Simaplast Company (Toulon, France). All implants had been inserted in the
      subglandular plane and had been in place for 7 to 23 years. At the time of
      explantation, patients were 32, 34, and 44 years old. Calcification on the
      surface of the implants and capsules was analyzed. Implant surface calcification
      was clinically evident on all six implants, appearing as ivory-colored,
      tenaciously adherent deposits, only on the anterior surface of the implant.
      Capsular calcification, which was observed only microscopically, was
      characterized by poorly organized, irregularly shaped, calcified agglomerates;
      this calcification also occurred only on the anterior surface of the capsule,
      adjacent to the area of calcification on the implant. Ultrastructural analysis of
      scrapings from the implant surface showed large, electron-dense aggregates of
      crystals, with individual crystals measuring approximately 40 x 10 x 10 nm. In
      contrast, capsular calcification was characterized by two patterns of deposition,
      spherulitic aggregates of needle-shaped crystals and areas of metaplastic bone.
      The individual crystals were approximately 40 x 10 x 10 nm. Energy-dispersive x
      ray spectroscopy of specimens from the areas of calcification on the implant and
      capsule surfaces demonstrated calcium and phosphorus. Electron diffraction of
      crystals from the implant and capsule surfaces demonstrated the D-spacings
      characteristic of calcium apatite. There were many differences between the
      calcification properties of these six saline implants and those of silicone gel
      implants. For example, mineralization has not been observed on the surface of gel
      implants, but in these saline implants it occurred primarily on the implant
      surface. Also, capsular calcification has been observed clinically in gel
      implants across the surface of the capsule (except at the site of attachment of a
      Dacron patch), but in this study it was observed only microscopically and was
      located on the anterior surface of the capsule, adjacent to the area of
      calcification on the implant. In addition, crystals 100 times larger than those
      observed on the six saline implant capsules have been observed on the surface of
      gel implant capsules. A model is presented to explain the mechanism of
      calcification associated with breast implants and to explain the observed
      differences between saline-filled and gel-filled implants.

PMID- 11214051
TI  - The use of muscle flaps to treat left ventricular assist device infections.
AB  - Left ventricular assist devices have become an important adjunct in the
      therapeutic armamentarium for patients with end-stage heart failure. Although
      they may provide a bridge to transplantation, they are prone to certain problems,
      expecially infection. Because these are life-sustaining devices, changing the
      device or simple explantation may be a risky, if not impossible, option.
      Therefore, we evaluated the effectiveness of a surgical alternative, namely,
      coverage of infected devices with muscle or myocutaneous flaps. Eighty-two
      consecutive patients who underwent the insertion of 88 left ventricular assist
      devices at our institution over a 6.5-year period were evaluated. Follow-up was
      provided for all patients and ranged from 1 to 7.5 years. The duration of
      ventricular support ranged from 0 to 434 days. All patients who demonstrated
      clinical evidence of infection were identified. Overall, 54 patients (66 percent)
      had infections locally at the device site, at distant sites, or systemically
      during support. Cultured organisms included gram-positive and -negative bacteria,
      fungi, and viruses. Of the 56 infections in these 54 patients, 21 (38 percent)
      were device-related, i.e., in the pocket created by the device, in the device
      itself, or from the driveline. Thus, 24 percent (21 of 88) of all ventricular
      support devices inserted demonstrated device infection during use. Therapeutic
      modalities used to combat device-related infection included both nonsurgical
      management with antibiotics alone and surgical procedures such as device change
      or relocation, device explant, and flap coverage. Eight of the 20 patients in
      whom the 21 device-related infections occurred underwent surgical intervention.
      Four of these eight patients undenwent local flap coverage of their infected left
      ventricular assist devices. All four patients also had evidence of systemic
      infection, or "device endocarditis." Coverage was successfully achieved in all
      cases with pedicled rectus abdominis flaps. There were no perioperative
      complications. Two patients later underwent successful transplantation; the other
      two died from causes unrelated to the flap. In conclusion, the treatment of
      infected left ventricular assist devices currently includes both nonsurgical and
      surgical alternatives. Of the latter, muscle flaps should be considered a first
      line intervention to assist in eradicating infection by providing well
      vascularized tissue. Although there were no perioperative complications, the 50
      percent mortality rate is consistent with that reported for patients with "device
      endocarditis." It may be that flap coverage of infected ventricular assist
      devices, if instituted at an earlier stage in the therapeutic process, could help
      prevent systemic infection in these patients and, therefore, improve their
      overall outcome.

PMID- 11214052
TI  - The thin latissimus dorsi perforator-based free flap for resurfacing.
AB  - The authors present their experience with "thin" latissimus dorsi perforator
      based free flaps for resurfacing defects. Perforator-based free flaps have been
      used for various kinds of reconstruction by presenting important donor
      structures. The thin latissimus dorsi perforatorbased free flap included only the
      skin and superficial adipose layer to reduce its bulkiness by dissection through
      the superficial fascial plane. This flap was used in 12 clinical cases, without
      flap necrosis or other serious postoperative complications. All of the patients
      were examined by preoperative power Doppler ultrasound in the spectral Doppler
      mode to search for the most reliable perforator. This noninvasive ultrasound
      technique determines the exact location and course of and ensures the reliable
      flow of the perforators; therefore, it greatly assists microsurgeons in saving
      operation time and in selecting the most suitable design for perforator flap
      reconstruction. We used perforators that were identified several centimeters from
      the lateral border of the latissimus dorsi muscle. The thin flap dimensions could
      be safely designed for flaps measuring up to 20 cm in length and 8 cm in width
      for primary closure of the donor site. Generally, a long pedicle is not required
      for resurfacing reconstructions, where small recipient arteries in the bed are
      acceptable for anastomosis with pedicles. However, pedicle dissection to the
      proximal vessels through the latissimus dorsi muscle was required when it was
      necessary to match the recipient vein for anastomosis. The authors conclude that
      this thin latissimus dorsi perforator-based free flap has great potential for
      resurfacing because of its constant thickness, easy elevation with the help of
      power Doppler ultrasound information, and proper flap size for moderate defects
      caused by scar contracture release, superficial tumor ablation, and so on.

PMID- 11214053
TI  - Comparative study of two series of distally based fasciocutaneous flaps for
      coverage of the lower one-fourth of the leg, the ankle, and the foot.
AB  - Skin defects over the lower one-fourth of the leg and over the foot are difficult
      to cover. Two types of pedicled fasciocutaneous flaps used to cover such defects
      were studied: the lateral supramalleolar flap and the distally based sural
      neurocutaneous flap. The series consisted of 27 and 36 cases, respectively. The
      lateral supramalleolar flap was used 27 times: for skin defects over the ankle
      (4), foot (16), and leg (7). The distally based sural neurocutaneous flap was
      used 42 times: over the foot (24), ankle (13), and leg (5). Fourteen of these
      patients were 65 years of age or older, and local vascularity was diminished in
      16 cases. The flaps were evaluated clinically twice: in the immediate
      postoperative period for survival or for partial or total flap necrosis, and
      again to determine the presence of pain at the donor or recipient sites and the
      cosmetic appearance. Thirty-nine patients (62 percent) were reviewed
      subsequently, with a mean follow-up of 5 years for the supramalleolar flap and 2
      years for the sural neurocutaneous flap. The results were evaluated for the
      presence or absence of pain, the appearance of the flap, the disability due to
      the insensate nature of the flap, and the presence or absence of secondary
      ulceration. Painful neuromata were noted in three cases with the sural
      neurocutaneous flap, whereas complete necrosis of the supramalleolar artery flap
      occurred in three patients. The distally based sural neurocutaneous island flap
      is very reliable, even in debilitated patients. Though the lateral supramalleolar
      artery flap offers the possibility of covering the same areas as the sural
      neurocutaneous flap, it is much less reliable in the presence of diminished local
      vascularity (18.5 percent failure rate as compared with 4.8 percent for the sural
      neurocutaneous flap). Because the procedure can cover extensive defects and is
      easy to perform, the distally based sural neurocutaneous flap was the method of
      choice for covering skin defects over the foot, heel, ankle, and the lower one
      fourth of the leg. The lateral supramalleolar artery flap is indicated only when
      the sural neurocutaneous flap is contraindicated.

PMID- 11214054
TI  - Do not use epinephrine in digital blocks: myth or truth?
AB  - The purpose of this study was to examine the role for epinephrine augmentation of
      digital block anesthesia by safely prolonging its duration of action and
      providing a temporary hemostatic effect. After obtaining approval from the review
      board of the authors' institution, 60 digital block procedures were performed in
      a prospective randomized double-blinded study. The digital blocks were performed
      using the dorsal approach. All anesthetics were delivered to treat either
      posttraumatic injuries or elective conditions. Of the 60 digital block
      procedures, 31 were randomized to lidocaine with epinephrine and 29 to plain
      lidocaine. Of the procedures performed using lidocaine with epinephrine, one
      patient required an additional injection versus five of the patients who were
      given plain lidocaine (p = 0.098). The need for control of bleeding required
      digital tourniquet use in 20 of 29 block procedures with plain lidocaine and in 9
      of 31 procedures using lidocaine with epinephrine (p < 0.002). Two patients
      experienced complications after plain lidocaine blocks, while no complications
      occurred after lidocaine with epinephrine blocks (p = 0.23). By prolonging
      lidocaine's duration of action, epinephrine may prevent the need for an
      additional injection and prolong post-procedure pain relief. This study
      demonstrated that the temporary hemostatic effect of epinephrine decreased the
      need for, and thus the potential risk of, using a digital tourniquet (p < 0.002).
      As the temporary vasoconstrictor effect is reversible, the threat of complication
      from vasoconstrictor-induced ischemia is theoretical.

PMID- 11214055
TI  - Salvage of ischemic digits using a lateral arm fascial flap.
AB  - Four patients underwent microvascular transfer of a lateral arm fascial flap to
      salvage severely ischemic digits by means of induction of neovascularization. The
      cause of the digital ischemia was direct trauma (crush injury) in one patient and
      chronic embolic phenomena (proximal arterial occlusion) in three patients. None
      of the patients had responded to traditional therapy, including treatment with
      one or more of the following: anticoagulation, lytic therapy, oral vasodilators,
      digital sympathectomy, and vein bypass grafting. Each patient underwent
      noninvasive (Doppler ultrasound, digital pressures, digital temperatures,
      vascular refill) and invasive (angiogram) vascular assessment preoperatively.
      After microvascular transfer of the lateral arm fascial flap, all patients
      reported symptomatic relief, and objective improvements were documented by both
      noninvasive and invasive assessment criteria. One patient developed a seroma at
      the donor site; another experienced a late complication of thrombosis of the flap
      after his wound dehisced. A 6-month follow-up evaluation demonstrated neovascular
      collateralization and stable improvement without regression in the remaining
      patients. The authors present their clinical experience and propose a treatment
      algorithm for patients with chronic digital ischemia.

PMID- 11214056
TI  - A phase II trial of intraluminal irrigation with recombinant human tissue factor
      pathway inhibitor to prevent thrombosis in free flap surgery.
AB  - A multicenter, multinational, blinded, randomized, parallel-group, phase II study
      was conducted to investigate the use of recombinant human tissue factor pathway
      inhibitor (rhTFPI; SC-59735) as an antithrombotic additive to the intraluminal
      irrigating solution during microvascular anastomosis in free flap reconstructive
      surgery. A total of 622 patients undergoing free flap reconstruction were
      randomly assigned to three groups. For each group, a different intraluminal
      irrigating solution was administered at completion of the microvascular arterial
      and venous anastomoses and before blood flow to the flap was reestablished:
      rhTFPI at a concentration of 0.05 or 0.15 mg/ml (low-dose or high-dose group,
      respectively) or heparin at a concentration of 100 U/ml (current-standard-of
      practice group). There were no other differences in treatment among the groups.
      Patient characteristics, risk factors, and surgical techniques used were similar
      among all three groups. Flap failure was lower (2 percent) in the low-dose rhTFPI
      group than in the high-dose rhTFPI (6 percent) and heparin (5 percent) groups,
      but this difference was not statistically significant (p = 0.069). There were no
      significant differences in the rate of intraoperative revisions of vessel
      anastomoses (11 percent, 12 percent, and 13 percent) or postoperative thrombosis
      (8 percent, 8 percent, and 7 percent) among the low-dose rhTFPI, high-dose
      rhTFPI, and heparin groups, respectively. The rate of postoperative wound
      hematoma was significantly lower in the low-dose rhTFPI group (3 percent) than in
      the high-dose rhTFPI (8 percent) and heparin (9 percent) groups (p = 0.040).
      There were no differences in blood chemistry or coagulation values among the
      three study groups. Other than hematomas, there were no differences in the
      incidence or severity of adverse reactions among the three groups. It is
      concluded that use of rhTFPI as an intraluminal irrigant during free flap
      reconstruction is safe, well tolerated, and as efficacious as use of heparin for
      preventing thrombotic complications during and after the operation. Furthermore,
      the lower dose of rhTFPI (0.05 mg/ml) may reduce the occurrence of postoperative
      hematoma and help prevent flap failure.

PMID- 11214057
TI  - Reconstruction of the nose damaged by cocaine.
AB  - Nasal snorting of cocaine crystals causes destruction of the septal and nasal
      mucosa, which eventually provides exposure of the septal cartilage and nasal
      bones. This exposure eventually leads to septal chrondritis and nasal bone
      osteomyelitis. As this process continues, the severe loss of cartilage and bone
      allows gradual to total collapse of the nose. Correction of this deformity is
      best achieved by supplying new lining; this is possible by turning nasolabial
      flaps into the nasal vestibule to replace the lost and released lining. Once this
      has been accomplished, costal cartilage grafts can be inserted along the bridge
      and alae to maintain the structural integrity of the reconstruction.

PMID- 11214058
TI  - Inhibition of apoptosis: a potential mechanism for syndromic craniosynostosis.
AB  - The biologic pathogenesis of syndromic craniosynostosis remains unknown. The
      purpose of this investigation was to determine whether specific biologic
      differences exist between normal calvarial osteoblasts and osteoblasts derived
      from patients with syndromic craniosynostosis. This study (1) examined the
      apoptotic rate and cell cycle of osteoblasts derived from patients with syndromic
      craniosynostosis, and (2) investigated for the presence of soluble factors
      released from syndrome-derived osteoblasts. Osteoblast cell lines were
      established from calvarial specimens of patients with clinically diagnosed
      syndromic synostosis and from normal controls. A co-culture technique was used to
      investigate for the presence of elaborated soluble factors. Apoptotic rate and
      cell cycle analyses were performed by using flow cytometry after staining with
      annexin V-fluorescein isothiocyanate and propidiumiodide, respectively. The
      apoptotic rate was significantly reduced in syndrome-derived osteoblasts as
      compared with control osteoblasts. Control osteoblasts co-cultured with syndromic
      osteoblasts demonstrated a dramatic reduction in their apoptotic rate as compared
      with those co-cultured with control osteoblasts. These results indicate that
      osteoblasts derived from patients with syndromic craniosynostosis display a lower
      apoptotic rate, a normal DNA synthetic rate, and the capability to reduce the
      apoptotic rate in normal calvarial osteoblasts through the elaboration of soluble
      factors.

PMID- 11214059
TI  - In vitro redifferentiation of culture-expanded rabbit and human auricular
      chondrocytes for cartilage reconstruction.
AB  - To construct an autologous cartilage graft using tissue engineering, cells must
      be multiplied in vitro; they then lose their cartilage-specific phenotype. The
      objective of this study was to assess the capacity of multiplied ear chondrocytes
      to re-express their cartilage phenotype using various culture conditions. Cells
      were isolated from the cartilage of the ears of three young and three adult
      rabbits and, after multiplication in monolayer culture, they were seeded in
      alginate and cultured for 3 weeks in serum-free medium with insulin-like growth
      factor 1 (IGF-1) and transforming growth factor-beta2 (TGF-beta2) in three
      different dose combinations. As a control, cells were cultured in 10% fetal calf
      serum, which was demonstrated in previous experiments to be unable to induce
      redifferentiation. Chondrocytes from the ears of young, but not adult, rabbits,
      synthesized significantly more glycosaminoglycan when serum was replaced by
      insulin-like growth factor-1 and transforming growth factor-beta2. The number of
      collagen type II-positive cells was increased from 10 percent to 97 percent in
      young cells and to 33 percent in adult cells. Using human ear cells from 12
      patients (aged 7 to 60 years), glycosaminoglycan synthesis could also be
      stimulated by replacing serum with insulin-like growth factor and transforming
      growth factor-beta. Although the number of collagen type II-positive cells could
      be increased under these conditions, it never reached above 10 percent. Data from
      five patients showed that further optimization of the culture conditions by
      adding ITS+ and cortisol significantly increased (doubled or tripled) both
      glycosaminoglycan synthesis and collagen type II expression. In conclusion, this
      study demonstrates a method to regain cartilage phenotype in multiplied ear
      cartilage cells. This improves the chances of generating human cartilage grafts
      for the reconstruction of external ears or the repair of defects of the nasal
      septum.

PMID- 11214060
TI  - Rat mandibular distraction osteogenesis: part III. Gradual distraction versus
      acute lengthening.
AB  - Distraction osteogenesis is a well-established method of endogenous tissue
      engineering. This technique has significantly augmented our armamentarium of
      reconstructive craniofacial procedures. Although the histologic and
      ultrastructural changes associated with distraction osteogenesis have been
      extensively described, the molecular mechanisms governing successful membranous
      distraction remain unknown. Using an established rat model, the molecular
      differences between successful (i.e., osseous union with gradual distraction) and
      ineffective (i.e., fibrous union with acute lengthening) membranous bone
      lengthening was analyzed. Herein, the first insight into the molecular mechanisms
      of successful membranous bone distraction is provided. In addition, these data
      provide the foundation for future targeted therapeutic manipulations designed to
      improve osseous regeneration. Vertical mandibular osteotomies were created in 52
      adult male Sprague-Dawley rats, and the animals were fitted with customized
      distraction devices. Twenty-six animals underwent immediate acute lengthening (3
      mm; a length previously shown to result in fibrous union) and 26 animals were
      gradually distracted (after a 3-day latency period, animals were distracted 0.25
      mm twice daily for 6 days; total = 3 mm). Four mandibular regenerates were
      harvested from each group for RNA analysis on 5, 7, 9, 23, and 37 days
      postoperatively (n = 40). Two mandibular regenerates were also harvested from
      each group and prepared for immunohistochemistry on postoperative days 5, 7, and
      37 (n = 12). In addition to the 52 experimental animals, 4 control rats underwent
      sham operations (skin incision only) and mandibular RNA was immediately
      collected. Control and experimental specimens were analyzed for collagen I,
      osteocalcin, tissue inhibitor of metalloproteinase-1, and vascular endothelial
      growth factor mRNA and protein expression. In this study, marked elevation of
      critical extracellular matrix molecules (osteocalcin and collagen I) during the
      consolidation phase of gradual distraction compared with acute lengthening is
      demonstrated. In addition, the expression of an inhibitor of extracellular matrix
      turnover, tissue inhibitor of metalloproteinase-1, remained strikingly elevated
      in gradually distracted animals. Finally, this study demonstrated that neither
      gradual distraction nor acute lengthening appreciably alters vascular endothelial
      growth factor expression. These results suggest that gradual distraction
      osteogenesis promotes successful osseous bone repair by regulating the expression
      of bone-specific extracellular matrix molecules. In contrast, decreased
      production or increased turnover of bone scaffolding proteins (i.e., collagen) or
      regulators of mineralization (i.e., osteocalcin) may lead to fibrous union during
      acute lengthening.

PMID- 11214061
TI  - Effect of isolation of periosteum and dura on the healing of rabbit calvarial
      inlay bone grafts.
AB  - Little is understood about the role of the recipient site in the
      revascularization and incorporation of autogenous inlay bone grafts in the
      craniofacial skeleton. Clinical experience demonstrates that secondary complex
      cranial vault reconstruction performed with scarred avascular dura or poor soft
      tissue coverage may undergo significant resorption, thus compromising the
      aesthetic outcome. This study was designed to determine the effect of isolating
      autogenous orthotopic inlay calvarial bone grafts from the surrounding dura
      and/or periosteum on graft revascularization, healing, and volume maintenance in
      the adult rabbit. Adult rabbits were randomized into four groups (n = 10 per
      group); in each rabbit, the authors created a circular, 15-mm in diameter, full
      thickness cranial defect followed by reconstruction with an autogenous calvarial
      bone graft, which was replaced orthotopically and held with microplate fixation.
      Silicone sheeting (0.5 mm thickness) was used to isolate the dura (group II), the
      periosteum (group II), or both dura and periosteum (group IV) from the graft
      interface. No silicone was placed in group I. Animals were killed 10 weeks
      postoperatively, and calvaria were harvested to assess graft surface area,
      morphology, quantitative histology, fluorochrome staining, and revascularization.
      Grafts isolated from both the dura and periosteum exhibited significant decreases
      in total bone (cortical and trabecular) surface area, blood vessel count, and
      interface healing compared with nonisolated control grafts. Isolation of either
      the dura or periosteum significantly (p < 0.05) decreased blood vessel count but
      had no significant effect on interface healing. Isolation of the dura alone was
      associated with a significant (p < 0.05) decrease in graft cross-sectional
      surface area and dural cortical thickness compared with nonisolated control
      grafts, but this effect was not observed when the periosteum alone was isolated.
      Quantitative histology performed 10 weeks after surgery indicated that graft
      isolation was associated with increased marrow fibrosis and necrosis compared
      with nonisolated controls; it also demonstrated evidence of increased activity in
      bone remodeling (osteoblast and osteocyte count, new trabecular bone, and surface
      resorption). Triple fluorochrome staining suggested increased bone turnover in
      the nonisolated grafts compared with isolated grafts at 1 and 5 weeks
      postoperatively. This study demonstrates that isolating a rabbit calvarial inlay
      autogenous bone graft from the dura and/or periosteum results in significantly (p
      < 0.05) decreased revascularization, interface healing, and cross-sectional areas
      of amount of mature bone compared with nonisolated control grafts 10 weeks after
      surgery. At this time point, histologic examination demonstrates a paradoxical
      increase in bone remodeling in isolated bone grafts compared with controls. It is
      possible that the inhibition of revascularization results in a delayed onset of
      the remodeling phase of graft incorporation. However, in the model studied, it is
      not known whether the quantitative histologic and morphometric parameters
      measured in these isolated grafts exhibit a "catch-up" phenomenon at time points
      beyond 10 weeks after surgery. The results of this study emphasize the importance
      of a healthy recipient site in the healing and incorporation of calvarial bone
      grafts but stress the need for further investigation at later time points.

PMID- 11214062
TI  - Eversion with four sutures: an easy, fast, and reliable technique for
      microvascular anastomosis.
AB  - In this study, a microvascular anastomosing technique called "eversion with four
      sutures" is introduced. For microvascular anastomosis, this technique requires
      fishmouth incisions at both vessel ends and the completion of four sutures. In
      120 Wistar-Albino rats, 120 eversion and 120 conventional anastomoses were done
      in 240 femoral arteries. Each rat received both treatments. Operating time,
      bleeding time, number of sutures used, patency rates, and pseudoaneurysm
      formation were analyzed statistically; healing was evaluated with both light and
      electron microscopy. When compared with the conventional technique using nine
      sutures, the eversion with four sutures technique was found to be a faster and
      easier method of anastomosis and as reliable as the conventional technique.
      Without compromising patency rates, bleeding time, or rates of pseudoaneurysm
      formation, anastomosis time and amount of suture material exposed to the lumen
      were significantly reduced when using this technique. In conclusion, the authors
      think that eversion with four sutures is a reliable alternative to the
      conventional suturing technique, especially for emergency cases that require
      multiple microvascular anastomoses.

PMID- 11214064
TI  - Dynamic rectus abdominis muscle sphincter for stoma continence: an acute
      functional study in a dog model.
AB  - Fecal stomal incontinence is a problem that continues to defy surgical treatment.
      Previous attempts to create continent stomas using dynamic myoplasty have had
      limited success due to denervation atrophy of the muscle flap used in the
      creation of the sphincter and because of muscle fatigue resulting from continuous
      electrical stimulation. To address the problem of denervation atrophy, a stomal
      sphincter was designed using the most caudal segment of the rectus abdominis
      muscle, preserving its intercostal innervation as well as its vascular supply.
      The purpose of the present study was to determine whether this rectus abdominis
      muscle island flap sphincter design could maintain stomal continence acutely. In
      this experiment, six dogs were used to create eight rectus abdominis island flap
      stoma sphincters around a segment of distal ileum. Initially, the intraluminal
      stomal pressures generated by the sphincter using different stimulation
      frequencies were determined. The ability of this stomal sphincter to generate
      continence at different intraluminal bowel pressures was then assessed. In all
      cases, the rectus abdominis muscle sphincter generated peak pressures well above
      those needed to maintain stomal continence (60 mmHg). In addition, each sphincter
      was able to maintain stomal continence at all intraluminal bowel pressures
      tested.

PMID- 11214063
TI  - Vanadate ingestion increases the gain in wound breaking strength and leads to
      better organized collagen fibers in rats during healing.
AB  - Repair of incision wounds closed by suturing is evaluated by the progressive gain
      in wound breaking strength. Previously the closure of open wounds in rats
      ingesting vanadate, an inhibitor of tyrosine phosphate phosphatases, was shown to
      occur with deposition of more uniformly organized collagen fiber bundles. The
      hypothesis of this study was that deposition of more uniformly organized collagen
      fibers would enhance the gain in wound breaking strength of incisional wounds.
      Six adult rats received vanadate-supplemented saline drinking water for 1 week
      before placement of two 6-cm, parallel, suture-closed wounds on their backs. Six
      control rats received identical wounds and were given saline drinking water. The
      drinking water regimen was continued for 1 week after wounding, and then wound
      strength was tested with a tensiometer and tissue samples were obtained for
      histologic evaluation. Wound breaking strength doubled in vanadate-treated rats
      compared with controls. Bright-field and polarized light microscopy showed that
      the connective tissue matrix of granulation tissue from control rats was oriented
      perpendicular to the surface of the skin. In contrast, the connective tissue
      matrix of granulation tissue from vanadate-treated rats was oriented parallel to
      the skin surface. The gap in granulation tissue between the edges of the wounds
      in the vanadate-treated rats was greater than that in controls. Electron
      microscopy showed that wounds in the vanadate-treated contained uniform collagen
      fibers that were 20 percent greater in diameter and more evenly spaced than they
      were in controls. It is proposed that these changes in the organization of
      collagen fibers within incisional wounds were responsible for the increased wound
      breaking strength observed in rats ingesting vanadate.

PMID- 11214066
TI  - Heterotopic brain tissue in the scalp.

PMID- 11214065
TI  - Tissue engineering of peripheral nerves: A comparison of venous and acellular
      muscle grafts with cultured Schwann cells.
AB  - Bioengineering is considered to be the laboratory-based alternative to human
      autografts and allografts. It ought to provide "custom-made organs" cultured from
      patient's material. Venous grafts and acellular muscle grafts support axonal
      regeneration only to a certain extent because of the lack of viable Schwann cells
      in the graft. We created a biologic nerve graft in the rat sciatic nerve model by
      implanting cultured Schwann cells into veins and acellular gracilis muscles,
      respectively. Autologous nerve grafts and veins and acellular muscle grafts
      without Schwann cells served as controls. After 6 and 12 weeks, regeneration was
      assessed clinically, histologically, and morphometrically. The polymerase chain
      reaction analvsis showed that the implanted Schwann cells remained within all the
      grafts. The best regeneration was seen in the control; after 12 weeks the number
      of axons was increased significantly compared with the other grafts. A good
      regeneration was noted in the muscle-Schwann cell group, whereas regeneration in
      both of the venous grafts and the muscle grafts without Schwann cells was
      impaired. The muscle-Schwann cell graft showed a systematic and organized
      regeneration including a proper orientation of regenerated fibers. The venous
      grafts with Schwann cells showed less fibrous tissue and disorganization than the
      veins without Schwann cells, but failed to show an excellent regeneration. This
      might be attributed to the lack of endoneural-tube-like components serving as
      scaffold for the sprouting axon. Although the conventional nerve graft remains
      the gold standard, the implantation of Schwann cells into an acellular muscle
      provides a biologic graft with basal lamina tubes as pathways for regenerating
      axons and the positive effects of Schwann cells producing neurotrophic and
      neurotropic factors, and thus, supporting axonal regeneration.

PMID- 11214067
TI  - Computer-Assisted sensorimotor testing documents neural regeneration after ulnar
      nerve repair at the wrist.

PMID- 11214068
TI  - Bipedicled fronto-occipital flap for reconstruction of postoncologic defects of
      the lateral scalp.
AB  - Presented here are two clinical cases of extensive defects of the scalp secondary
      to surgical resection of invasive basal cell carcinoma on the parietal region,
      successfully treated by means of very large, bipedicled fronto-occipital flaps,
      based anteriorly on the supratrochlear-supraorbital vessels and posteriorly on
      the occipital and posterior auricular vessels. Considering both the location and
      the large size of the scalp defects, different surgical techniques are discussed
      and the potential use of bipedicled scalp flaps is considered, designed either
      sagittally or coronally as fronto-occipital or temporo-temporal flaps. The
      bipedicled fronto-occipital scalp flap is believed to represent a simple, secure,
      and useful reconstructive procedure for cutaneous coverage of extensive defects
      located on the lateral scalp.

PMID- 11214069
TI  - A contemporary correction of inverted nipples.

PMID- 11214070
TI  - Distal arteriovenous fistula to maintain patency of the venous drainage of a
      latissimus dorsi flap following subclavian vein repair.
AB  - Successful reconstructive surgery with muscle flaps depends on adequate arterial
      supply and undisturbed venous drainage. Combining such surgery with
      reconstructive vascular surgery of a large-caliber vein that is responsible for
      the venous drainage of the flap poses an additional challenge--the repaired
      vein's susceptibility to thrombosis. Every attempt must be made to prevent venous
      outflow obstruction following muscle flap surgery. Data from the vascular surgery
      literature demonstrate a low success rate for subclavian vein repair. The success
      rate with venous reconstructive surgery has been greater when a distal
      arteriovenous fistula accompanied the repair. The present case described the use
      of a temporary distal cephalic-brachial arteriovenous fistula to maintain the
      patency of the venous drainage of a pedicled latissimus dorsi muscle flap,
      following subclavian vein repair, for one-stage coverage of a large chest wall
      defect.

PMID- 11214071
TI  - The leech pond: a translation and commentary on the notes of Professor Luigi
      Zersi.

PMID- 11214072
TI  - New developments in cranial suture research.

PMID- 11214073
TI  - Breast cancer: advances in surgical management.
AB  - The surgical management of breast cancer has changed dramatically from a
      deforming ablative procedure to an approach that for the majority of breast
      cancer patients can preserve the breast and axillary anatomy. The current
      approach to the diagnosis of breast cancer and the evolution of the more limited
      approach to surgical resection are discussed. The technique of sentinel lymph
      node biopsy, originally developed for melanoma patients, has now been adopted for
      use in the treatment of breast cancer. The methodology and advantages of this
      approach to the axillary lymph nodes in both tumor recognition and reduced risk
      to the patient are detailed.

PMID- 11214074
TI  - A lifelong journey and passion: maintaining clinical competence in plastic
      surgery.

PMID- 11214075
TI  - AlloDerm for dorsal nasal irregularities.
AB  - After nasal surgery, thinning of the nasal skin, bony irregularities, or
      adhesions of dorsal skin to underlying bone can all occur. These problems can be
      solved by using either alloplastic materials or various autogenous tissues. In
      this study, AlloDerm, a dermal replacement derived from cadaveric skin, has been
      used to cover the osseocartilaginous framework of the nose in an attempt to
      achieve a smooth contour and a natural feel in secondary rhinoplasties. Fifteen
      patients were treated and observed for a minimum of 24 months. Clinically
      palpable or visible bony irregularities were successfully covered, and adhesions
      of dorsal skin to nasal bones were diminished. Prolonged but not socially
      unacceptable dorsal nasal swelling, which resolved during the first 4 months,
      seemed to be the only problem related to its use. With this limited experience,
      AlloDerm was found to be useful in secondary nasal surgery to cover
      osseocartilaginous irregularities, to eliminate the adhesions between nasal bones
      and overlying skin, and to create a smooth nasal dorsum.

PMID- 11214076
TI  - The use of alloderm for the correction of nasal contour deformities.
AB  - What rhinoplasty surgeon has not been frustrated by unmet expectations from
      unreliable graft materials? The quest for an ideal graft continues. Septal
      cartilage is not always adequate in amount or substance. Ear cartilage may cause
      unsightly irregularities over time. Cranial bone or rib harvest sites add to the
      complexity of the procedure and can be intimidating for many operators. This
      article describes the authors' successful experience with AlloDerm onlay grafts
      for the correction of nasal contour deformities in 58 primary and secondary
      rhinoplasty cases by means of the open and endonasal approaches. Forty-two
      patients received an open-approach procedure; the remaining 16 received grafting
      through an endonasal or closed approach. Thirty-seven of the patients were
      secondary rhinoplasty patients, and some underwent multiple nasal corrections.
      The indications, intraoperative surgical technique of graft placement, and
      representative results will be discussed. Long-term follow-up showed good
      results, though partial graft resorption occurred in some patients. Overall, this
      experience with AlloDerm for nasal augmentation was encouraging.

PMID- 11214077
TI  - The sit-up position in breast surgery.
AB  - Breast shape is best evaluated while the patient is in an upright position.
      However, many surgeons are reluctant to have a patient sit upright during surgery
      because of concerns over the patient's hemodynamic instability. Therefore, the
      purpose of this study was to prospectively measure cardiovascular parameters,
      including heart rate and mean arterial pressure, in a series of 30 patients who
      were placed upright during various aesthetic and reconstructive breast
      procedures. Data regarding the number of times the patient was placed upright and
      the amount of time spent in the upright position were also recorded. Measurements
      were obtained immediately before and after elevating the head of the bed to 80 to
      90 degrees during the procedure. The average supine mean arterial pressure was 73
      +/- 3 mmHg and that for an upright position was 70 +/- 3 mmHg. The average supine
      heart rate was 73 +/- 4 beats per minute and that for an upright position was 76
      +/- 4 beats per minute. Although the difference between these results is
      statistically significant (p < 0.05), there was no clinical significance to
      placing patients in an upright seated position in this study, and no patient had
      to be laid back down because of hemodynamic instability. Therefore, the upright
      seated position is strongly advocated for intraoperative evaluation of breast
      shape, and a safe and effective method to accomplish this is described.

PMID- 11214078
TI  - The "Nordstrom suture" to enhance scalp reductions.
AB  - The authors compared the results of 10 scalp reductions using the "Nordstrom
      suture" with the earlier published results of scalp reductions without a device
      to prevent stretch-back and of reductions with extenders. At 1 month
      postoperatively, the Nordstrom suture eliminated the stretch-back of 8.3 mm seen
      in earlier studies and, in fact, it shrank the bald area. The average shrinking
      achieved with the Nordstrom suture was 16.9 mm (i.e., 143 percent improvement
      over scalp reductions alone). Scalp extenders shrank the bald area, but the
      Nordstrom suture shrank the area about three times more than extenders at 1 month
      postoperatively.

PMID- 11214079
TI  - Combined erbium:YAG laser resurfacing and face lifting.
AB  - Facial aging occurs secondary to gravity-induced tissue ptosis and photoaging.
      Combined face lifting and carbon dioxide laser resurfacing provides a
      comprehensive one-stage approach to facial rejuvenation but is condemned by many
      plastic surgeons due to the nonspecific thermal effects of the laser and risk of
      skin necrosis. Newer high-energy erbium:YAG lasers allow precise tissue ablation
      with minimal thermal effect. In this study, various facial rejuvenation
      techniques were combined with simultaneous erbium:YAG laser resurfacing to assess
      results and complications. A total of 257 patients from Florida, Melbourne,
      Australia, and Tel Aviv, Israel, underwent combined erbium:YAG laser resurfacing
      and surgical facial rejuvenation. Various face-lift methods were used, including
      endoscopic, deep plane, and subcutaneous. Simultaneous, full-facial laser
      resurfacing was performed using a variety of erbium:YAG lasers. It was found that
      combined laser resurfacing and face lifting was successful in greater than 95
      percent of patients with minimal morbidity. Two patients (1 percent) (both heavy
      smokers) developed small areas of skin necrosis that healed with minor pigment
      changes. Five patients (2 percent) developed synechia that was treated with no
      residual effect. Two additional patients (1 percent) developed temporary
      ectropion. There were no other cases of scarring, infection, or cosmetically
      obvious hypopigmentation. Although larger studies are necessary, it seems that
      the lack of thermal injury from the erbium:YAG laser makes it possible to safely
      perform laser resurfacing with surgical facial rejuvenation in nonsmokers.
      However, the authors caution that familiarity with the nuances of erbium:YAG
      laser resurfacing be obtained before performing combined laser resurfacing and
      face lifting.

PMID- 11214080
TI  - A novel device for the simple and efficient refinement of liposuctioned tissue.
AB  - In short, our device allows a surgeon who is harvesting adipose tissue for
      autologous fat transplantation to immediately, easily, efficiently, and sterilely
      isolate adipose tissue from the unwanted waste components that are associated
      with primary liposuction effluent. It does so by "trapping" the fat tissue
      contained within raw liposuction effluent. Once the tissue fraction has been
      separated, the device design then allows for direct implantation or subsequent
      washing/rinsing of the tissue with saline/buffer of choice in preparation for
      tissue reimplantation.

PMID- 11214081
TI  - A lesson from the high-tech economic boom: use the competitive advantage of
      plastic surgery.

PMID- 11214082
TI  - Corrugator supercilii resection through blepharoplasty incision.

PMID- 11214083
TI  - Sucking fat: an 18-year statistical and personal retrospective.

PMID- 11214084
TI  - Coblation: an emerging technology and new technique for soft-tissue surgery.

PMID- 11214085
TI  - Progressive tension sutures to reduce complications in abdominoplasty.

PMID- 11214086
TI  - Technique for isolating ruptured extensor pollicis longus tendon.

PMID- 11214087
TI  - The distally based dermo-adipofascial flap.

PMID- 11214088
TI  - Aspirin and elective surgery.

PMID- 11214089
TI  - A missed opportunity?

PMID- 11214090
TI  - Amnion tube for nerve regeneration.

PMID- 11214091
TI  - External device for adipose tissue.

PMID- 11214092
TI  - Tail bone in the rat.

PMID- 11214093
TI  - In-vivo sensitivity of Plasmodium vivax isolates from Rond nia (western Amazon
      region, Brazil) to regimens including chloroquine and primaquine.
AB  - Seventy-nine adults with Plasmodium vivax malaria, from the Porto Velho area of
      Rond nia (western Amazon region, Brazil), gave informed consent to participate in
      a blind, clinical study of two regimens of treatment with chloroquine (CQ) and
      primaquine. The effectiveness of the 'classical' regimen (CQ for 3 days, followed
      by primaquine for 14 days) was compared with that of a 'short' regimen in which
      the two drugs were given simultaneously for 5 days. There were no cases of
      recrudescence indicative of CQ resistance (i.e. within 30 days of the first
      treatment dose) among the 73 patients who each completed a full, supervised
      course of treatment. However, 10 cases of apparent relapse were observed (all >
      60 days after first treatment dose), representing 6.5% (2/31) of the patients who
      completed 60 days of follow-up after the classical treatment and 26.7% (8/30) of
      the short-regimen patients who completed the same period of follow-up. PCR-based
      comparison of parasitic DNA collected pre- and post-treatment was successful for
      eight of the 10 cases of apparent relapse and indicated that two such cases, both
      given the short regimen of treatment, were, in fact, probable cases of re
      infection rather than of relapse. The results indicate that the classical
      schedule of treatment with chloroquine and primaquine was more effective at
      preventing relapses than the short regimen. However, since prolonged treatment
      with primaquine often produces side-effects that are severe enough to reduce
      compliance, the short schedule could be a useful alternative for malaria control
      in endemic areas of the Amazon region.

PMID- 11214094
TI  - Chloroquine prophylaxis, iron/folic-acid supplementation or case management of
      malaria attacks in primigravidae in western Uganda: effects on congenital malaria
      and infant haemoglobin concentrations.
AB  - A randomized, double-blind, placebo-controlled trial, which compared the effects
      of three interventions (weekly chloroquine prophylaxis, daily iron and weekly
      folic-acid supplementation, and case management of malaria) on congenital
      malaria, maternal haemoglobin (Hb) and foetal outcome, was conducted among
      primigravidae resident in Hoima district, Uganda. Among 473 babies examined at
      birth or within 7 days of birth, 198 (42%) were parasitaemic, the level of
      parasitaemia in an infant being strongly correlated with those of placental (P<
      0.01) and maternal, peripheral parasitaemia (P < 0.01). However, 33 (17%) of the
      parasitaemic babies were born to mothers who had placental but not peripheral
      parasitaemia, 22 (11%) to mothers who had peripheral but not placental
      parasitaemia, and 12 (6%) to mothers with neither peripheral nor placental
      parasitaemia. Overall, 163 babies were each examined for malarial parasites at
      birth and 1 month later. Of the 76 (47%) found to have parasitaemia at birth, 37
      (23%) appeared aparasitaemic at the 1-month follow-up but 28 (17%) were still
      parasitaemic at that time. Among the babies born to the mothers who only received
      case management of malaria during pregnancy, parasitaemia at birth was associated
      with infant anaemia at birth (i.e. < 140 g Hb/litre; P = 0.03). Infants found to
      be parasitaemic at the 1-month follow-up had lower mean concentrations of Hb at
      that time than their aparasitaemic counterparts (P= 0.03). Parasitaemia at birth
      was not significantly associated with low birthweight, in any of three
      intervention groups. The intervention given to the mother had no significant
      effect on the parasitaemia of her baby, either at birth or at the age of 1 month.
      Congenital malaria per se may have little influence on birthweight but may have
      an impact on infant anaemia. In conclusion, congenital parasitaemia was not
      associated with birthweight, but was related to anaemia at birth in infants born
      to women who had only received active case management during their pregnancies.

PMID- 11214095
TI  - Incidence and management of malaria in two communities of different socio
      economic level, in Accra, Ghana.
AB  - Two adjacent communities of differing socio-economic levels were selected, in
      Accra, Ghana, for the study of the home management of malaria. The youngest child
      in each selected household, each of which had a child aged < 5 years, was
      recruited for weekly follow-up, following informed consent. Malaria was the most
      common condition reported by the 'caregivers' (mothers of the subjects and others
      caring for the subjects) in each community, with 2.0 episodes of clinical
      malaria/child during the 9-month study. Most (89%) of the caregivers in the
      better-off community had been educated beyond primary-school level, but 55% of
      the caregivers in the poorer community had either received no formal education or
      only primary-school education. This difference was also reflected by the
      educational facilities provided to the children studied: 52% of the those in the
      better-off community attended nurseries, kindergartens or creches, compared with
      8% of the children investigated in the poorer community. The proportion of
      caregivers who purchased drugs without prescription or used left-over drugs to
      treat clinical malaria in the children was higher in the poorer community (82% v.
      53%), and a child from the poorer community was less likely to have been taken to
      a clinic or hospital to be treated for malaria than a child from the better-off
      community (27% v. 42%). During the follow-up period two children died, one from
      each community. Treatment of malaria in young children is likely to be less
      effective in the poorer community, where a lack of economic access to health
      services was demonstrated.

PMID- 11214096
TI  - Cutaneous leishmaniasis in Guatemala: people's knowledge, concepts and practices.
AB  - Ten rural communities in the northern area of Guatemala where cutaneous
      leishmaniasis (CL) is endemic were investigated to determine the residents'
      knowledge of the disease, their related concepts and practices, and their
      treatment preferences, and to identify the communication channels they use to
      acquire information. Of 425 heads of household interviewed, 96.7% could
      accurately describe a typical CL lesion. CL was found to be the fourth most
      frequently mentioned disease (in studies based on a free list format) and to be
      considered the sixth most serious (in studies based on paired comparisons). A
      series of three-way comparisons, used to analyse the subjects' concepts about the
      similarities of various discases, indicated that CL was considered to be most
      closely related to skin problems and to be different from any other group of
      diseases. All interviewees believed that it was necessary to receive treatment
      for CL, because without treatment the disease would progress, reach the bone, and
      take years to heal. More than half (55%) of the respondents knew about meglumine
      antimonate (Glucantime), the most commonly prescribed drug for treating CL in
      Guatemala. Only a few communication channels that were used by respondents to
      receive information were identified; the use of radio broadcasts and direct
      communication via the community leaders appeared to be the most effective.

PMID- 11214097
TI  - Effects of itraconazole and terbinafine on Leishmania major lesions in BALB/c
      mice.
AB  - The effects of two antifungal compounds, the azole itraconazole and the
      allylamine terbinafine, on Leishmania major infections in mice are reported.
      Sixty BALB/c mice were each inoculated subcutaneously with metacyclic
      promastigotes of L. major at the base of the tail. From 4 weeks post-inoculation,
      40 of the mice were treated for 4 weeks (20 with itraconazole and 20 with
      terbinafine) and the rest were left untreated. Lesion sizes were estimated weekly
      for 10 weeks post-infection. Both drugs appeared effective in treating the
      cutaneous lesions but response to itraconazole was faster and, at the end of the
      experiment, the mean size of the lesions on the mice treated with itraconazole
      was smaller than that of the lesions on the terbinafine-treated mice.

PMID- 11214098
TI  - Clinical and parasitological aspects of itching caused by onchocerciasis in
      Morogoro, Tanzania.
AB  - A clinical and parasitological assessment of onchodermatitis was conducted in a
      rural area of Morogoro district, Tanzania. The study population consisted of
      1,005 individuals aged > or = 5 years: 749 from a hyper-endemic community and 256
      from a hypo-endemic. The prevalence of troublesome itching was 67.0% in the hyper
      endemic community but only 5% (13/256) in the hypo-endemic. The corresponding
      prevalences of nodules among the adult male subjects were 77.7% (171/220) and
      2.3% (2/86). The most common onchocercal skin lesion in the hyper-endemic
      community was chronic papular onchodermatitis (CPOD) manifested by itching, which
      was often very severe. There was a strong association between skin itching and
      endemicity (r = 0.75; P < 0.001). The prevalence of CPOD in the hyper-endemic
      community was significantly higher in males than females (P< 0.001). CPOD was
      only observed in subjects aged > or = 7 years. Many of the subjects were checked
      for microfilaridermia, by skin-snipping. The prevalence of microfilaridermia
      [58.2% (393/675) v. 6.2% (3/48)] and its geometric mean intensity (8.9 v. 1.0
      microfilariae/mg skin snip) were both higher in the hyper-endemic community than
      the hypo-endemic. Itching appears to be related to reactive onchodermatitis.

PMID- 11214099
TI  - Antibiotics and Wolbachia in filarial nematodes: antifilarial activity of
      rifampicin, oxytetracycline and chloramphenicol against Onchocerca gutturosa,
      Onchocerca lienalis and Brugia pahangi.
AB  - The activity against filarial parasites of the antibiotics rifampicin,
      oxytetracycline and chloramphenicol was examined. In addition, transmission
      electron microscopy was used to study the effects of rifampicin and
      oxytetracycline on filarial tissues and on the endosymbiont bacterium, Wolbachia.
      When tested in vitro at a concentration of 50.0 microM, each of the three
      antibiotics significantly reduced the motility levels of male Onchocerca
      gutturosa. Rifampicin, however, was the most active, virtually immobilizing the
      parasite by the end of the 40-day trial and producing an 84% reduction in
      viability (as measured by formazan-based colorimetry). In tests against O.
      lienalis microfilariae (mff) in CBA mice, the numbers of mff recovered after
      treatment with oxytetracycline at 100, 25 or 6.5 mg/kg daily, for 15 days, were
      56% (P < or = 0.03), 38% (P> 0.05) and 45% (P = 0.05) less than that recovered
      from the untreated controls, respectively. In another trial in mice, rifampicin
      (100 mg/kg daily for 15 days) was found to be the most active (causing a 74%
      reduction in the number of mff recovered--approximately equal to that achieved
      with the positive control of a single dose of ivermectin at 2 microg/kg), with
      chloramphenicol also showing significant activity (39% reduction). In further, in
      vivo trials, at three dose levels (100, 25 or 6.25 mg/kg daily, for 15 days), all
      three antibiotics were tested against adult Brugia pahangi in the peritoneal
      cavities of jirds. None of the antibiotics produced a significant reduction in
      the numbers of live worms recovered, although a marginal effect was observed in
      eight of the nine antibiotic-treated groups. A further extended trial with
      rifampicin and oxytetracycline resulted in 43% and 38% reductions in worm
      recoveries, respectively (not statistically significant but consistent with a
      marginal effect); some of these worms appeared less motile and qualitatively in
      poor condition compared with those recovered from untreated jirds.
      Ultrastructural studies of these treated worms revealed that virtually all of the
      endosymbiont bacteria had been cleared from the parasite tissues. The tissues of
      the adult worms appeared to be largely intact but with a granulomatous response
      of host cells adhering to some specimens. However, developing uterine forms
      appeared to be abnormal and extensively damaged, showing an abrogation of
      embryogenesis. In contrast, worms recovered from control animals contained large
      numbers of Wolbachia, had no adherent host cells, and showed normal
      ultrastructure; the female worms exhibited a full range of intra-uterine
      developing stages from eggs to stretched mff. It is likely that the activity of
      these antibiotics against the endosymbiont Wolbachia causes the observed
      antifilarial activity, although some direct effect of each drug on filarial
      viability cannot be ruled out.

PMID- 11214100
TI  - Morbidity and mortality among Egyptian neonates and infants: rates and associated
      factors.
AB  - Among 2,128 women residing in two Egyptian governorates with differing socio
      economic backgrounds, who were interviewed after giving birth between 1994 and
      1996, 181 experienced an early foetal death, 34 had stillbirths, and 1,908 each
      had a live birth. Among the live births, there were 35 neonatal deaths and 42
      post-neonatal deaths. A high percentage of the women sought prenatal care,
      beginning early in pregnancy, from both government health facilities (GHF) and
      private physicians. Problem-based care was typically directed to private
      physicians whereas routine care was largely directed to GHF. Diagnostic
      procedures were not routinely performed at GHF. The women recognized symptoms
      which may be associated with adverse outcomes, but health-seeking based on this
      recognition was inconsistent. Most deliveries were conducted by Egyptian
      traditional birth attendants, in homes. Anaesthesia and medications to accelerate
      labour were commonly administered by all types of practitioners in home
      deliveries. Perinatal mortality was mid-range by global standards, with most
      deaths occurring at home rather than in hospitals. Although care was sought for
      most infants with diarrhoea, respiratory infections and fever, neonates with
      these symptoms were rarely given oral rehydration therapy or antibiotics.

PMID- 11214101
TI  - Clinical and biological evolution of human trypanosomiasis in C te d'Ivoire.

PMID- 11214102
TI  - Human infections with Moniliformis moniliformis (Bremser 1811) Travassos 1915 in
      south-eastern Nigeria.

PMID- 11214104
TI  - International training of doctors in maritime health.

PMID- 11214103
TI  - The present state and prospects of development of maritime medicine in Ukraine.
AB  - In this article the present situation, tasks, and prospects of development of
      maritime in Ukraine are reviewed. Some information about morbidity and mortality
      among seafarers is also provided.

PMID- 11214105
TI  - The seafarers' opinions on the increasing influence of their administrative work
      on ship safety.

PMID- 11214106
TI  - Maritime health services in the Ivory Coast.

PMID- 11214107
TI  - Deaths due to disease of seafarers on board Singapore ships.
AB  - Based on records kept in the Singapore Mercantile Marine Office, the paper
      presents the results of a study on deaths due to disease of seafarers on board
      Singapore ships. Out of a total of 373 deaths, altogether 69 fatalities were
      attributed to diseases. More than 65% (n=45) of theses deaths were due to
      circulatory diseases commonly associated with life-style factors, but only 24
      cases had a specific and 9 cases had an unspecific diagnosis confirmed by a
      medical, practitioner. A total of 32 seafarers (46.4%) died of a sudden death and
      were found dead by their shipmates whereas 17 seafarers (24.6%) died on board
      after a short illness. In only two cases was it reported that Radio Medical
      advice had been sought indicating either a lack of interest of the ship's
      management or a lack of knowledge or information on the availability of such
      services. Eight of the fatalities who died on board had seen a doctor and been
      declared fit to stay on board, pointing to deficiencies in the port medical
      services or pressures on port doctors to avoid a costly repatriation. The mean
      annual mortality rate for deaths due to all causes was 26.5 per 10,000 seafarers
      and due to disease was 4.9 per 10,000 seafarers.

PMID- 11214108
TI  - Liver injury in the course of malaria.
AB  - 121 malaria cases treated in the Ward of Tropical Diseases of the Clinic of the
      Institute of Maritime and Tropical Medicine in Gdynia in the years 1993-1999 were
      analysed. About 37% of the patients showed symptoms of parenchymal liver injury
      manifested by increased bilirubin concentration, elevated transaminase, alkaline
      phosphatase and GGTP levels. Histopathological examination of the liver revealed
      the activation of cells of mononuclear phagocyte system, Kupffer's cells in
      particular, with the presence of granules of browny-black ,,malarial" pigment and
      iron deposits. In one fatal tropical malaria case, symptoms of disseminated
      intravascular coagulation were found along with a few lymphocytic infiltrations
      in portal spaces, and focal necrosis of hepatocytes. In some patients with the so
      called ,,untypical" secondary liver lesions present in the histopathological
      examination, the toxic effect of antimalarial drugs should be taken into account.
      A liver biopsy is justified in patients manifesting multiple courses of malaria.
      It is indispensable in cases of suspected polyetiological changes in the liver
      and in cases of recompensation payment claims.

PMID- 11214110
TI  - Travel medicine in Poland an overview.

PMID- 11214109
TI  - Evaluation of methods of sewage treatment on board of vessels on the basis of
      surveys in 1994-1999.
AB  - The purpose of the present study was to show in what degree the ships of the
      Polish merchant fleet observe the obligations provided for Poland by acts of good
      will of nations, i.e. International Convention for the Prevention of Pollution
      from Ships -MARPOL 73/78 - Annex IV, and the Helsinki Convention. The
      examinations involved ships equipped with sewage treatment and disinfection
      plants, the surveys were performed during their normal operation. The tests were
      made in accordance with the resolution MEPC-2(VII) and encompassed: determination
      of residual available chlorine (on board vessel, immediately after sampling),
      determination of faecal coli index and suspended solids, determination of
      biochemical oxygen demand (in laboratory conditions). Results of the tests were
      evaluated according to the above mentioned Resolution. From 1994 to 1999, the
      total of 245 surveys were made, 177 sewage treatment plants were evaluated, 173
      certificates were issued (in that number 125 permanent and 48 temporary). It was
      stated that Polish ships were properly equipped and well prepared to comply with
      the obligations provided by international conventions. A conclusion was
      formulated that the curriculum of higher maritime schools should be broadened in
      respect of environment protection issues.

PMID- 11214111
TI  - Diagnosing and treatment of skin filariases based on own observations.
AB  - 7 cases of Mansonella perstans filariasis and 9 of Loa loa invasion were
      diagnosed and treated in the clinic of the Institute of Maritime and Tropical
      Medicine in Gdynia in the years 1993-1999. The study group comprised 7 women aged
      15-45 and 19 men aged 32-49. The most frequently occurring symptoms and signs of
      the disease, results of laboratory tests, diagnostic methods, ways of treatment
      and their efficacy were discussed. The diagnosis was made on the basis of the
      presence of filaria larvae in peripheral blood and, in part, on positive
      serological reactions. The most frequently reported and observed in our patients
      were Calabar swellings, allergic lesions of the skin and general symptoms. In the
      laboratory tests the most characteristic were elevated white blood cells counts
      with marked eosinophilia and a rise in immunoglobulin E during the active phase
      of the disease. In doubtful cases, Mazzotti's test was applied. In spite of the
      treatment with DEC lasting for 3-4 weeks and a combined therapy with levamisole
      and albendazole, relapses occurred in 5 cases in the period from 2 months to 2
      years after the completion of the therapy. In 3 patients treated with ivermectin
      the period of observation was still too short (2 and 5 months) to draw
      conclusions as to the efficacy of such treatment.

PMID- 11214112
TI  - Diseases, accidents and injuries among travelers in Poland.
AB  - A survey was conducted among a group of people who traveled from Poland abroad,
      and who were insured before leaving the country, and in case of illness or injury
      claimed the costs of treatment providing medical documentation. The risk of
      disease and injury among these travelers was estimated. Among 336,254 travelers,
      there were 2,411 cases of disease and 789 cases of injury, during their mean
      period of travels and stay abroad of about 3 weeks (20,63 days). In the surveyed
      group, there were 24 cases of fatal disease and 7 cases of fatal injuries
      recorded. The incidence per 100,000 was calculated.

PMID- 11214113
TI  - Drowning among Polish boat and cutter fishermen as a specific cause of death at
      sea.

PMID- 11214114
TI  - Recreational diving--an overview of selected medical aspects.
AB  - Recreational diving has become very popular in Croatia. Selected medical aspects
      of it are reviewed in this article.

PMID- 11214115
TI  - Health examinations of seafarers--whose interests are we taking care of?

PMID- 11214116
TI  - The International Radio Medical Centre (C.I.R.M.): an organization providing free
      medical assistance to seafarers of any nationality world wide.
AB  - The International Radio Medical Centre (Centro Internazionale Radio Medico,
      C.I.R.M.) was founded in 1935 with the purpose of giving radio medical advice to
      ships on any nationality navigating on all seas of the world. The Centre has its
      headquarters in Rome, and its medical services are completely free of charge.
      They also include arrangements for the transfer, if necessary, of a patient to a
      ship with a doctor on board or if the distance allows it, to evacuate the patient
      for hospitalization. Requests for medical advice reaching C.I.R.M. are handled by
      doctors on continuos duty at the C.I.R.M. headquarters. These doctors advice on
      the appropriate treatment and keep in contact with every ship that has asked for
      assistance, following up the progress of the patient until his recovery or
      evacuation to the hospital on shore.

PMID- 11214117
TI  - Health care for seafarers in Indonesia.

PMID- 11214118
TI  - The Research Unit of Maritime Medicine Esbjerg, Denmark.

PMID- 11214119
TI  - World trade rules and cheaper drugs.

PMID- 11214120
TI  - Toxicity of depleted uranium.

PMID- 11214121
TI  - Relation between colitis and colon cancer.

PMID- 11214122
TI  - Glusoamine for osteoarthritis: dawn of a new era?

PMID- 11214123
TI  - Hyperplastic callus and osteogenesis imperfecta.

PMID- 11214124
TI  - Towards a genomic-based diagnosis.

PMID- 11214125
TI  - To blow or not to blow?

PMID- 11214126
TI  - Long-term effects of glucosamine sulphate on osteoarthritis progression: a
      randomised, placebo-controlled clinical trial.
AB  - BACKGROUND: Treatment of osteoarthritis is usually limited to short-term symptom
      control. We assessed the effects of the specific drug glucosamine sulphate on the
      long-term progression of osteoarthritis joint structure changes and symptoms.
      METHODS: We did a randomised, double-blind placebo controlled trial, in which 212
      patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral
      glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior
      radiographs of each knee in full extension were taken at enrolment and after 1
      and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral
      joint was assessed by digital image analysis, whereas minimum joint-space width-
      ie, at the narrowest point--was measured by visual inspection with a magnifying
      lens. Symptoms were scored by the Western Ontario and McMaster Universities
      (WOMAC) osteoarthritis index. FINDINGS: The 106 patients on placebo had a
      progressive joint-space narrowing, with a mean joint-space loss after 3 years of 
      0.31 mm (95% CI -0.48 to -0.13). There was no significant joint-space loss in the
      106 patients on glucosamine sulphate: -0.06 mm (-0.22 to 0.09). Similar results
      were reported with minimum joint-space narrowing. As assessed by WOMAC scores,
      symptoms worsened slightly in patients on placebo compared with the improvement
      observed after treatment with glucosamine sulphate. There were no differences in
      safety or reasons for early withdrawal between the treatment and placebo groups.
      INTERPRETATION: The long-term combined structure-modifying and symptom-modifying
      effects of gluosamine sulphate suggest that it could be a disease modifying agent
      in osteoarthritis.

PMID- 11214127
TI  - Comparison of formoterol and terbutaline for as-needed treatment of asthma: a
      randomised trial.
AB  - BACKGROUND: Asthma guidelines recommend that long-acting inhaled beta-agonists
      should be used as maintenance therapy for patients with asthma inadequately
      controlled on an inhaled corticosteroid. We studied the safety and efficacy of
      the long-acting beta-agonist formoterol compared with terbutaline, each taken as
      needed, in patients with moderate to severe asthma. METHODS: Patients were taking
      an inhaled corticosteroid (mean dose 870 microg daily) and had a forced
      expiratory volume in 1 s (FEV1) of at least 50% predicted (mean 74%). Those
      requiring an inhaled beta-agonist three to eight times a day during the study run
      in period (362 of 621 who started) were randomly assigned formoterol 4.5 microg
      or terbutaline 0.5 mg as needed by Turbuhaler in daily doses up to 54 microg and
      6 mg, respectively, for 12 weeks in a double-blind, parallel-group study.
      Analyses were by intention to treat. FINDINGS: The 362 randomised patients (157
      men, 205 women) had a mean age of 47 years. Patients taking formoterol had a
      longer time to their first severe asthma exacerbation (relative-risk ratio 0.55
      [95% CI 0.34-0.89]), took fewer inhalations of study drug, and had larger
      increases in FEV1 (5%) and morning and evening peak expiratory flow (mean
      difference in increase 11 L/min and 8 L/min) than those taking terbutaline. No
      safety issues were identified. INTERPRETATION: When taken as needed, formoterol
      4.5 microg provided better asthma control than terbutaline 0.5 mg in patients
      requiring moderate doses of relief medication despite inhaled corticosteroid
      treatment. Safety studies should be extended to a wider population of patients
      with asthma.

PMID- 11214128
TI  - Colorectal cancer rates among first-degree relatives of patients with
      inflammatory bowel disease: a population-based cohort study.
AB  - BACKGROUND: Inflammatory bowel disease (IBD) and colorectal cancer might share a
      common cause and, therefore, relatives of patients with IBD could be at increased
      risk of this malignant disease. We aimed to assess cancer rates among first
      degree relatives of patients with IBD to try to determine whether an association
      between the two diseases exists. METHODS: In a population-based study, we
      identified 114,102 first-degree relatives by registry linkage and followed them
      up for cancer occurrence. We used standardised incidence ratio (SIR) of cancer as
      relative risk. FINDINGS: 560 colorectal cancers were identified among relatives.
      First-degree relatives of patients with Crohn's disease or ulcerative colitis
      were not at increased risk of cancer (SIR 0.90, 95% CI 0.82-0.97). The relative
      risk was 0.96 (0.87-1.06, n=379) for colon cancer and 0.78 (0.68-0.91, 181) for
      rectal cancer. The SIRs were not affected by age, relation to patient, or type or
      extent of IBD in the patient. Relatives of patients with both IBD and colorectal
      cancer had an 80% increased risk of colorectal cancer. INTERPRETATION: Our
      results do not endorse a common cause of IBD and colorectal cancer. The slightly
      decreased relative risk for colorectal cancer among relatives could indicate the
      proportion of all colorectal cancer cases attributable to IBD.

PMID- 11214129
TI  - Clinical picture: thrombus in the left atrial appendage.

PMID- 11214130
TI  - Charcot-Marie-Tooth disease and sleep apnoea syndrome: a family study.
AB  - BACKGROUND: Charcot-Marie-Tooth (CMT) disease is a genetically heterogeneous
      group of hereditary motor and sensory polyneuropathies in which sleep apnoea has
      rarely been reported and no causal relation shown. We looked for an association
      between the most common subtype of CMT disease (CMT1A) and sleep apnoea syndrome.
      METHODS: Having diagnosed sleep apnoea and CMT in one family member (index case),
      we prospectively investigated 13 further members not previously suspected of
      having neuropathy or apnoeas. All had a neurological examination,
      electroneuromyography, polysomnography, and genetic testing for CMT disease.
      FINDINGS: 11 of the 14 family members had the autosomal dominant demyelinating
      form of CMT disease with PMP22 gene duplication on chromosome 17. Whatever their
      neurological disability, all 11 individuals had sleep apnoea syndrome with a mean
      (SD) apnoea-hypopnoea index of 46.6/h (28.5) of sleep (normal value <15/h). The
      remaining three family members were free from neuropathy and sleep apnoea
      syndrome. Sleep apnoea and neuropathy severity were highly correlated; the
      compound muscle action potential (CMAP) amplitude of the median nerve was
      inversely correlated with the apnoea-hypopnoea index (r=-0.69, p=0.029). The
      severity of neuropathy and sleep apnoea were higher in male CMT individuals and
      were correlated with age and body mass index. No wake or sleep diaphragmatic
      dysfunction was shown. INTERPRETATION: We think that sleep apnoea syndrome is
      related to a pharyngeal neuropathy. Upper airway dysfunction, previously
      described in the CMT2C subtype, might be a clinical expression of the CMT1A
      subtype, to which familial susceptibility could predispose.

PMID- 11214131
TI  - Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine
      system versus hysterectomy for treatment of menorrhagia: a randomised trial.
AB  - BACKGROUND: Heavy menstrual blood loss is a common reason for women to seek
      medical care. The levonorgestrel-releasing intrauterine system (IUS) is an
      effective medical treatment for menorrhagia. We report a randomised comparison of
      this approach with hysterectomy in terms of the quality of life of women with
      menorrhagia and cost-effectiveness. METHODS: Of 598 women referred with
      menorrhagia to five university hospitals in Finland, 236 were eligible and agreed
      to take part. They were randomly assigned treatment with the levonorgestrel
      releasing IUS (n=119) or hysterectomy (n=117). The amount of menstrual blood loss
      was objectively measured. The primary outcome measure was health-related quality
      of life at 12-month follow-up. Analyses were by intention to treat. FINDINGS: In
      the group assigned the levonorgestrel-releasing IUS, 24 (20%) women had had
      hysterectomy and 81 (68%) continued to use the system at 12 months. Of the women
      assigned to the hysterectomy group, 107 underwent the operation. Health-related
      quality of life improved significantly in both the IUS and hysterectomy groups
      (change 0.10 [95% CI 0.06-0.14] in both groups) as did other indices of
      psychological wellbeing. There were no significant differences between the
      treatment groups except that women with hysterectomy suffered less pain. Overall
      costs were about three times higher for the hysterectomy group than for the IUS
      group. INTERPRETATION: The significant improvement in health-related quality of
      life highlights the importance of treating menorrhagia. During the first year the
      levonorgestrel-releasing IUS was a cost-effective alternative to hysterectomy in
      treatment of this disorder.

PMID- 11214132
TI  - A confused uraemic woman.

PMID- 11214133
TI  - Myoblast transplantation for heart failure.
AB  - Intramyocardial skeletal muscle transplantation has been shown experimentally to
      improve heart function after infarction. We report success with this procedure in
      a patient with severe ischaemic heart failure. We implanted autologous skeletal
      myoblasts into the postinfarction scar during coronary artery bypass grafting of
      remote myocardial areas. 5 months later, there was evidence of contraction and
      viability in the grafted scar on echocardiography and positron emission
      tomography. Although this result is encouraging, it requires validation by
      additional studies.

PMID- 11214135
TI  - Hyponatraemia as a complication of colonoscopy.
AB  - A case of colonoscopy-induced hyponatraemic encephalopathy led us to study the
      risk of hyponatraemia after gastrointestinal endoscopy. We assessed 40 patients
      before and after colonoscopy. 20 gastroscopy patients served as controls. Our
      findings show a high incidence (7.5%) of hyponatraemia after colonoscopy, in
      association with raised serum concentrations of arginine vasopressin. Physicians
      should be aware of this complication, since it may contribute to psychological
      and neurological symptoms after colonoscopy.

PMID- 11214134
TI  - Increased mitochondrial toxicity with ribavirin in HIV/HCV coinfection.
AB  - In two of 15 patients coinfected with HIV and hepatitis C virus who received
      interferon-alpha plus ribavirin in addition to HAART, we observed multiorgan
      dysfunction and lactic acidaemia. As ribavirin is a nucleoside analogue, an
      increased risk of mitochondrial toxicity can be induced in HIV-infected patients
      already treated with nucleoside analogues, leading to clinical deterioration in
      some cases.

PMID- 11214136
TI  - Oral mature teratoma containing epididymal tissue in a female neonate.
AB  - We describe a female neonate with an oral teratoma showing bone, teeth, and
      epidermis, but also epididymal (male) tissue. PCR amplification of Y-chromosomal
      DNA clearly showed male DNA from paraffin-embedded tumour tissue. The girl had a
      normal female karyotype without abnormalities of the genital organs. There are at
      least three hypotheses for the origin of teratomas: parthenogenesis, incomplete
      twinning, and totipotent somatic-cell origin. This case supports the hypothesis
      of an included dizygotic twin, and might contribute to the elucidation of the
      pathogenesis of extragonadal teratomas.

PMID- 11214137
TI  - Biocomplexity: look at the whole, not the parts.

PMID- 11214138
TI  - The doctor who broke rules of engagement with Pyongyang.

PMID- 11214139
TI  - Prevention fails to halt South Africa's well-treated cholera epidemic.

PMID- 11214140
TI  - UK starts campaign to reassure parents about MMR-vaccine safety.

PMID- 11214141
TI  - UK government overhauls nationwide cancer health care.

PMID- 11214142
TI  - FDA wants more disclosure of gene-therapy and xenotransplantation risks.

PMID- 11214143
TI  - Uterine fibroids.
AB  - Uterine leiomyomas (fibroids or myomas), benign tumours of the human uterus, are
      the single most common indication for hysterectomy. They are clinically apparent
      in up to 25% of women and cause significant morbidity, including prolonged or
      heavy menstrual bleeding, pelvic pressure or pain, and, in rare cases,
      reproductive dysfunction. Thus, both the economic cost and the effect on quality
      of life are substantial. Surgery has been the mainstay of fibroid treatment, and
      various minimally invasive procedures have been developed in addition to
      hysterectomy and abdominal myomectomy. Formation of new leiomyomas after these
      conservative therapies remains a substantial problem. Although medications that
      manipulate concentrations of steroid hormones are effective, side-effects limit
      long-term use. A better approach may be manipulation of the steroid-hormone
      environment with specific hormone antagonists. There has been little evidence
      based evaluation of therapy. New research into the basic biology of these
      neoplasms may add new treatment options for the future as the role of growth
      factors and genetic mutations in these tumours are better understood.

PMID- 11214144
TI  - The fourth disease, 1900-2000.
AB  - Measles and scarlet fever were differentiated from one another in the 17th
      century. Rubella was accepted as the third distinct paediatric exanthem in 1881.
      Nil Filatow in 1885 and Clement Dukes in 1894 described two distinct forms of
      rubella, and in 1900 Dukes proposed that one of these forms of rubella was a
      separate entity which he called the fourth disease. For the past five decades,
      fourth disease has been considered a non-entity, perhaps a mild form of scarlet
      fever, but certainly not a distinct disease. In 1979 Keith Powell resurrected the
      idea of the fourth disease and argued that it was caused by exotoxin-producing
      Staphylococcus aureus. We present additional arguments for the existence of
      fourth disease, as well as information to link the disease to S. aureus.

PMID- 11214145
TI  - Japan's "comfort women".

PMID- 11214146
TI  - Supporting local efforts to document human-rights violations in armed conflict.

PMID- 11214147
TI  - Responding to rape.

PMID- 11214148
TI  - Sexual violence in Sierra Leone.

PMID- 11214149
TI  - Breast-conserving surgery.

PMID- 11214150
TI  - Acute radiation proctitis.

PMID- 11214151
TI  - Acute radiation proctitis.

PMID- 11214152
TI  - Human herpesvirus as a sexually transmitted agent.

PMID- 11214153
TI  - Use of medication in Zanzibar.

PMID- 11214154
TI  - Adult growth-hormone deficiency.

PMID- 11214155
TI  - Rats and risk.

PMID- 11214156
TI  - Prenatal identification of fetal genetic traits.

PMID- 11214157
TI  - Cause of otitis media.

PMID- 11214158
TI  - Choroidal abnormalities and mental retardation in neurofibromatosis type 1.

PMID- 11214159
TI  - Pre-eclampsia.

PMID- 11214160
TI  - Pre-eclampsia.

PMID- 11214161
TI  - Care after cure in leprosy.

PMID- 11214162
TI  - Risk of asthma.

PMID- 11214163
TI  - Catalase deficiency, diabetes, and mitochondrial function.

PMID- 11214164
TI  - Changes in trial parameters.

PMID- 11214165
TI  - Does lung cancer need a lapel ribbon?

PMID- 11214166
TI  - Does lung cancer need a lapel ribbon?

PMID- 11214167
TI  - The Joy of health.

PMID- 11214168
TI  - The Joy of health.

PMID- 11214169
TI  - The Joy of health.

PMID- 11214170
TI  - Keats's notebook.

PMID- 11214171
TI  - Viewing the ribosome and visiting the nucleolus at Lake Tahoe.

PMID- 11214172
TI  - Tethered-function analysis reveals that elF4E can recruit ribosomes independent
      of its binding to the cap structure.
AB  - The cap-binding complex elF4F is involved in ribosome recruitment during the
      initiation phase of translation and is composed of three subunits: elF4E, -4G,
      and -4A. The m7GpppN cap-binding subunit eIF4E binds the N-terminal region of
      eIF4G, which in turn contacts eIF4A through its central and C-terminal regions.
      We have previously shown, through a tethered-function approach in transfected
      HeLa cells, that the binding of eIF4G to an mRNA is sufficient to drive
      productive translation (De Gregorio et al., EMBO J, 1999, 18:4865-4874). Here we
      exploit this approach to assess which of the other subunits of elF4F can exert
      this function. eIF4AI or mutant forms of eIF4E were fused to the RNA-binding
      domain of the lambda phage antiterminator protein N to generate the chimeric
      proteins lambda4A, lambda4E-102 (abolished cap binding), and lambda4E-73-102
      (impaired binding to both, the cap and eIF4G). The fusion proteins were directed
      to a bicistronic reporter mRNA by means of interaction with a specific lambda-N
      binding site (boxB) in the intercistronic space. We show that lambda4E-102, but
      neither the double mutant lambda4E-73-102 nor lambda4A, suffices to promote
      translation of the downstream gene in this assay. Coimmunoprecipitation analyses
      confirmed that all lambda-fusion proteins are capable of interacting with the
      appropriate endogenous eIF4F subunits. These results reveal that eIF4E, as well
      as eIF4G, can drive ribosome recruitment independent of a physical link to the
      cap structure. In spite of its interaction with endogenous eIF4G, lambda4A does
      not display this property. eIF4A thus appears to supply an essential auxiliary
      function to eIF4F that may require its ability to cycle into and out of this
      complex.

PMID- 11214174
TI  - The stem-loop binding protein forms a highly stable and specific complex with the
      3' stem-loop of histone mRNAs.
AB  - Replication-dependent histone mRNAs end in a highly conserved 26-nt stem-loop
      structure. The stem-loop binding protein (SLBP), an evolutionarily conserved
      protein with no known homologs, interacts with the stem-loop in both the nucleus
      and cytoplasm and mediates nuclear-cytoplasmic transport as well as 3'-end
      processing of the pre-mRNA by the U7 snRNP. Here, we examined the affinity and
      specificity of the SLBP-RNA interaction. Nitrocellulose filter-binding
      experiments showed that the apparent equilibrium dissociation constant (Kd)
      between purified SLBP and the stem-loop RNA is 1.5 nM. Binding studies with a
      series of stem-loop variants demonstrated that conserved residues in the stem and
      loop, as well as the 5' and 3' flanking regions, are required for efficient
      protein recognition. Deletion analysis showed that 3 nt 5' of the stem and 1 nt
      3' of the stem contribute to the binding energy. These data reveal that the high
      affinity complex between SLBP and the RNA involves sequence-specific contacts to
      the loop and the top of the stem, as well the base of the stem and its immediate
      flanking sequences. Together, these results suggest a novel mode of protein-RNA
      recognition that forms the core of a ribonucleoprotein complex central to the
      regulation of histone gene expression.

PMID- 11214173
TI  - A novel protein-RNA binding assay: functional interactions of the foot-and-mouth
      disease virus internal ribosome entry site with cellular proteins.
AB  - Translation initiation on foot-and-mouth disease virus (FMDV) RNA occurs by a cap
      independent mechanism directed by a highly structured element (approximately 435
      nt) termed an internal ribosome entry site (IRES). A functional assay to identify
      proteins that bind to the FMDV IRES and are necessary for FMDV IRES-mediated
      translation initiation has been developed. In vitro-transcribed polyadenylated
      RNAs corresponding to the whole or part of the FMDV IRES were immobilized on
      oligo-dT Dynabeads and used to deplete rabbit reticulocyte lysate (RRL) of IRES
      binding proteins. Translation initiation factors eIF4G, eIF4A, and eIF4B bound to
      the 3' domain of the FMDV IRES. Depletion of eIF4G from RRL by this region of the
      FMDV IRES correlated with the loss of translational capacity of the RRL for
      capped, uncapped, and FMDV IRES-dependent mRNAs. However, this depleted RRL still
      supported hepatitis C virus IRES-directed translation. Poly (rC) binding protein
      2 bound to the central domain of the FMDV IRES, but depletion of RRL with this
      IRES domain had no effect on FMDV IRES-directed translation initiation.

PMID- 11214175
TI  - Yeast U1 snRNP-pre-mRNA complex formation without U1snRNA-pre-mRNA base pairing.
AB  - Base pairing between the 5' end of U1 snRNA and the conserved 5' splice site of
      pre-mRNA is important for commitment complex formation in vitro. However, the
      biochemical mechanisms by which pre-mRNA is initially recognized by the splicing
      machinery is not well understood. To evaluate the role of this base pairing
      interaction, we truncated U1 snRNA to eliminate the RNA-RNA interaction and
      surprisingly found that U1 snRNP can still form a nearly normal RNA-protein
      complex and maintain sequence specificity. We propose that some feature of U1
      snRNP, perhaps one or more protein factors, is more important than the base
      pairing for initial 5' splice site recognition. In addition, at least five sets
      of interactions contribute to complex formation or stability. Only one of these
      is base pairing between the 5' splice site and the 5' end of U1 snRNA, without
      which the U1 snRNP-pre-mRNA complex is less stable and has a somewhat altered
      conformation.

PMID- 11214176
TI  - Two alternating structures of the HIV-1 leader RNA.
AB  - In this study we demonstrate that the HIV-1 leader RNA exists in two alternative
      conformations, a branched structure consisting of several well-known hairpin
      motifs and a more stable structure that is formed by extensive long-distance base
      pairing. The latter conformation was first identified as a compactly folded RNA
      that migrates unusually fast in nondenaturing gels. The minimally required
      domains for formation of this conformer were determined by mutational analysis.
      The poly(A) and DIS regions of the leader are the major determinants of this RNA
      conformation. Further biochemical characterization of this conformer revealed
      that both hairpins are disrupted to allow extensive long-distance base pairing.
      As the DIS hairpin is known to be instrumental for formation of the HIV-1 RNA
      dimer, the interplay between formation of the conformer and dimerization was
      addressed. Formation of the conformer and the RNA dimer are mutually exclusive.
      Consequently, the conformer must rearrange into a branched structure that exposes
      the dimer initiation signal (DIS) hairpin, thus triggering formation of the RNA
      dimer. This structural rearrangement is facilitated by the viral nucleocapsid
      protein NC. We propose that this structural polymorphism of the HIV-1 leader RNA
      acts as a molecular switch in the viral replication cycle.

PMID- 11214177
TI  - Replicating satellite RNA induces sequence-specific DNA methylation and truncated
      transcripts in plants.
AB  - Tobacco plants were transformed with a chimeric transgene comprising sequences
      encoding beta-glucuronidase (GUS) and the satellite RNA (satRNA) of cereal yellow
      dwarf luteovirus. When transgenic plants were infected with potato leafroll
      luteovirus (PLRV), which replicated the transgene-derived satRNA to a high level,
      the satellite sequence of the GUS:Sat transgene became densely methylated. Within
      the satellite region, all 86 cytosines in the upper strand and 73 of the 75
      cytosines in the lower strand were either partially or fully methylated. In
      contrast, very low levels of DNA methylation were detected in the satellite
      sequence of the transgene in uninfected plants and in the flanking nonsatellite
      sequences in both infected and uninfected plants. Substantial amounts of
      truncated GUS:Sat RNA accumulated in the satRNA-replicating plants, and most of
      the molecules terminated at nucleotides within the first 60 bp of the satellite
      sequence. Whereas this RNA truncation was associated with high levels of satRNA
      replication, it appeared to be independent of the levels of DNA methylation in
      the satellite sequence, suggesting that it is not caused by methylation. All the
      sequenced GUS:Sat DNA molecules were hypermethylated in plants with replicating
      satRNA despite the phloem restriction of the helper PLRV. Also, small, sense and
      antisense approximately 22 nt RNAs, derived from the satRNA, were associated with
      the replicating satellite. These results suggest that the sequence-specific DNA
      methylation spread into cells in which no satRNA replication occurred and that
      this was mediated by the spread of unamplified satRNA and/or its associated 22 nt
      RNA molecules.

PMID- 11214178
TI  - A ribozyme selected from variants of U6 snRNA promotes 2',5'-branch formation.
AB  - In vitro selection was used to sample SnRNA-related sequences for ribozyme
      activities, and several 2',5'-branch-forming ribozymes were isolated. One such
      ribozyme is highly dependent upon an 11-nt motif that contains a conserved U6
      snRNA sequence (ACAGAGA-box) known to be important for pre-mRNA splicing. The
      ribozyme reaction is similar to the first step of splicing in that an internal 2'
      hydroxyl of an unpaired adenosine attacks at the 5'-phosphate of a guanosine. It
      differs in that the leaving group is diphosphate rather than a 5' exon. The
      finding that lariat formation can be accomplished by a small RNA with sequences
      related to U6 snRNA indicates that the RNA available in the spliceosome may be
      involved in RNA-catalyzed branch formation.

PMID- 11214179
TI  - Thermodynamics of 2'-ribose substitutions in UUCG tetraloops.
AB  - The ribose 2'-hydroxyl group confers upon RNA many unique molecular properties.
      To better appreciate its contribution to structure and stability and to monitor
      how substitutions of the 2' hydroxyl can alter an RNA molecule, each loop
      pyrimidine ribonucleotide in the UUCG tetraloop was substituted with a nucleotide
      containing either a fluorine (2'-F), hydrogen (2'-H), amino (2'-NH2), or methoxy
      (2'-OCH3) group, in the context of both the C:G and G:C loop-closing base pair.
      The thermodynamic parameters of these tetraloop variants have been determined and
      NMR experiments used to monitor the structural changes resulting from the
      substitutions. The modified riboses are better tolerated in the G[UUCG]C
      tetraloop, which may be due to its increased loop flexibility relative to the
      C[UUCG]G loop. Even for these simple substitutions, the free-energy change
      reflects a complex interplay of hydrogen bonding, solvation effects, and
      intrinsic pucker preferences of the nucleotides.

PMID- 11214180
TI  - Evidence that phosphorylation of human Upfl protein varies with intracellular
      location and is mediated by a wortmannin-sensitive and rapamycin-sensitive PI 3
      kinase-related kinase signaling pathway.
AB  - Human Upf1 protein (p), a group 1 RNA helicase, has recently been shown to
      function in nonsense-mediated mRNA decay (NMD) in mammalian cells. Here, we
      demonstrate that the estimated 3 x 10(6) copies of hUpf1 p per exponentially
      growing HeLa cell are essentially equally distributed among polysomal,
      subpolysomal, and ribosome-free fractions. We also demonstrate that hUpf1p binds
      RNA and is a phosphoprotein harboring phosphoserine and phosphothreonine. hUpf1p
      is phosphorylated to the highest extent when polysome-associated and to the
      lowest extent when ribosome free. We find that serum-induced phosphorylation of
      hUpf1p is inhibited by wortmannin at a concentration that selectively inhibits PI
      3-kinase related kinases and, to a lesser extent, by rapamycin. These and other
      data suggest that phosphorylation is mediated by a wortmannin-sensitive and
      rapamycin-sensitive PI 3-kinase-related kinase signaling pathway. Comparisons are
      made of hUpf1p to Upf1p and SMG-2, which are the orthologs to hUpf1p in
      Saccharomyces cerevisiae and Caenorhabditis elegans, respectively.

PMID- 11214181
TI  - Interactions between 23S rRNA and tRNA in the ribosomal E site.
AB  - Interactions between tRNA or its analogs and 23S rRNA in the large ribosomal
      subunit were analyzed by RNA footprinting and by modification-interference
      selection. In the E site, tRNA protected bases G2112, A2392, and C2394 of 23S
      rRNA. Truncated tRNA, lacking the anticodon stem-loop, protected A2392 and C2394,
      but not G2112, and tRNA derivatives with a shortened 3' end protected only G2112,
      but not A2392 or C2394. Modification interference revealed C2394 as the only
      accessible nucleotide in 23S rRNA whose modification interferes with binding of
      tRNA in the large ribosomal subunit E site. The results suggest a direct contact
      between A76 of tRNA A76 and C2394 of 23S rRNA. Protections at G2112 may reflect
      interaction of this 23S rRNA region with the tRNA central fold.

PMID- 11214182
TI  - Functional mapping of ribosome-contact sites in the ribosome recycling factor: a
      structural view from a tRNA mimic.
AB  - Ribosome recycling factor (RRF) is required for disassembly of the
      posttermination complex of the ribosome after release of polypeptides. The
      crystal structure of RRF resembles a tRNA shape, with an architecturally
      different flexibility compared with tRNA, but its structure-and-function
      relationships are unknown. We here found that an RRF variant defective in
      ribosome binding regains the binding capacity through 20 independent secondary
      changes occurring in three topologically distinct regions of RRF. Because two of
      these regions are equivalent to the tip of the anticodon stem and the upper
      surface of the acceptor stem of tRNA, RRF may interact with the ribosome in a way
      similar to tRNA, spanning 30S and 50S subunits, to exert its action for splitting
      the ribosome.

PMID- 11214183
TI  - Arrangement of the central pseudoknot region of 16S rRNA in the 30S ribosomal
      subunit determined by site-directed 4-thiouridine crosslinking.
AB  - The 16S rRNA central pseudoknot region in the 30S ribosomal subunit has been
      investigated by photocrosslinking from 4-thiouridine (s4U) located in the first
      20 nt of the 16S rRNA. RNA fragments (nt 1-20) were made by in vitro
      transcription to incorporate s4U at every uridine position or were made by
      chemical synthesis to incorporate s4U into one of the uridine positions at +5,
      +14, +17, or +20. These were ligated to RNA containing nt 21-1542 of the 16S rRNA
      sequence and, after gel purification, the ligated RNA was reconstituted into 30S
      subunits. Long-range intramolecular crosslinks were produced by near-UV
      irradiation; these were separated by gel electrophoresis and analyzed by reverse
      transcription reactions. A number of crosslinks are made in each of the
      constructs, which must reflect the structural flexibility or conformational
      heterogeneity in this part of the 30S subunit. All of the constructs show
      crosslinking to the 559-562, 570-571, and 1080-1082 regions; however, other sites
      are crosslinked specifically from each s4U position. The most distinctive
      crosslinking sites are: 341-343 and 911-917 for s4U(+5); 903-904 (very strong),
      1390-1397, and 1492 for s4U(+14); and 903-904 (moderate) for s4U(+17); in the
      1070-1170 region in which there are different patterns for each s4U position.
      These results indicate that part of the central pseudoknot is in close contact
      with the decoding region, with helix 27 in the 885-912 interval and with part of
      domain III RNA. Crosslinking between s4U(+14) and 1395-1397 is consistent with
      base pairing at U14-A1398.

PMID- 11214184
TI  - The mechanism of RNA binding to TRAP: initiation and cooperative interactions.
AB  - The trp RNA-binding Attenuation Protein (TRAP) from Bacillus subtilis is an 11
      subunit protein that binds a series of 11 GAG and UAG repeats separated by two to
      three-spacer nucleosides in trp leader mRNA. The structure of TRAP bound to an
      RNA containing 11 GAG repeats shows that the RNA wraps around the outside of the
      protein ring with each GAG interacting with the protein in nearly identical
      fashion. The only direct hydrogen bond interactions between the protein and the
      RNA backbone are to the 2'-hydroxyl groups on the third G of each repeat.
      Replacing all 11 of these guanosines with deoxyriboguanosine eliminates
      measurable binding to TRAP. In contrast, a single riboguanosine in an otherwise
      entirely DNA oligonucleotide dramatically stabilizes TRAP binding, and
      facilitates the interaction of the remaining all-DNA portion with the protein.
      Studies of TRAP binding to RNAs with between 2 and 11 GAGs, UAGs, AAGs, or CAGs
      showed that the stability of a TRAP-RNA complex is not directly proportional to
      the number of repeats in the RNA. These studies also showed that the effect of
      the identity of the residue in the first position of the triplet, with regard to
      binding to TRAP, is dependent on the number of repeats in the RNA. Together these
      data support a model in which TRAP binds to RNA by first forming an initial
      complex with a small subset of the repeats followed by a cooperative interaction
      with the remaining triplets.

PMID- 11214185
TI  - The intramolecular stem-loop structure of U6 snRNA can functionally replace the
      U6atac snRNA stem-loop.
AB  - The U6 spliceosomal snRNA forms an intramolecular stem-loop structure during
      spliceosome assembly that is required for splicing and is proposed to be at or
      near the catalytic center of the spliceosome. U6atac snRNA, the analog of U6
      snRNA used in the U12-dependent splicing of the minor class of spliceosomal
      introns, contains a similar stem-loop whose structure but not sequence is
      conserved between humans and plants. To determine if the U6 and U6atac stem-loops
      are functionally analogous, the stem-loops from human and budding yeast U6 snRNAs
      were substituted for the U6atac snRNA structure and tested in an in vivo genetic
      suppression assay. Both chimeric U6/U6atac snRNA constructs were active for
      splicing in vivo. In contrast, several mutations of the native U6atac stem-loop
      that either delete putatively unpaired residues or disrupt the putative stem
      regions were inactive for splicing. Compensatory mutations that are expected to
      restore base pairing within the stem regions restored splicing activity. However,
      other mutants that retained base pairing potential were inactive, suggesting that
      functional groups within the stem regions may contribute to function. These
      results show that the U6atac snRNA stem-loop structure is required for in vivo
      splicing within the U12-dependent spliceosome and that its role is likely to be
      similar to that of the U6 snRNA intramolecular stem-loop.

PMID- 11214186
TI  - Old and new targets of antibacterial therapy.
AB  - Currently available antibiotics target bacterial cell wall synthesis, protein
      synthesis, or DNA replication. Antibiotics that are structurally unrelated
      sometimes have common targets. Mutations in these common targets frequently give
      rise to bacteria that are resistant to multiple antibiotics. The impact of these
      bacteria in clinical situations is increasing whereas development of effective
      antibiotics for their treatment is not keeping pace. This emerging crisis in
      clinical care has led to intense efforts in new antibiotic development. Both
      improvements in currently available classes of antibiotics as well as discovery
      of completely novel ones are being aggressively sought. In this review, the
      mechanisms of action of available antibiotics will be discussed with emphasis on
      newly developed drugs. Also, some of the potential new targets of antibiotic
      therapy in the future will be highlighted.

PMID- 11214187
TI  - Optimizing clinical outcomes by the use of pharmokinetic and pharmacodynamic
      principles.
AB  - Since the advent of antimicrobial chemotherapy, considerable controversy has
      existed as to the most appropriate method to administer antibiotics to maximize
      the killing of microorganisms, while minimizing toxicity to the patient. Over the
      past decade, data gained from animal models of infection, in vitro
      pharmacodynamic studies, volunteer studies and human clinical trials have enabled
      us to establish the best mode of drug administration to achieve these goals. The
      clinician should be aware that appropriate antibiotic selection and dosing
      depends on pharmacodynamic concepts where there is an integration of the drug's
      microbiological activity, pharmacokinetic properties and mode of bacterial
      killing.

PMID- 11214188
TI  - Mechanisms of bacterial resistance to antimicrobial agents.
AB  - The 20th century has been considered the antimicrobial era--whereas the 21st
      century may well represent the post-antimicrobial era. The reason for this
      dramatic change, should it come to pass, is the development of bacterial
      resistance to antimicrobial agents. This emerging resistance is now challenging
      the clinical utility of many antimicrobial agents such that the chemotherapy of
      hospitalized patients with serious infections has been compromised. If the
      problem with resistance is to be successfully dealt with by clinicians, the
      mechanisms of such resistance must be known and understood. This paper thus
      reviews the most important mechanisms of resistance as well as some of the most
      important pathogens having these mechanisms. An understanding of these important
      microbial resistance mechanisms will help the clinician identify circumstances in
      which resistance may be a problem as well as evaluating the potential usefulness
      of an alternate antimicrobial agent against resistant microbes.

PMID- 11214189
TI  - Available laboratory tests to guide antimicrobial therapy.
AB  - Physicians are encountering more difficulties in treating and managing patients
      with infectious diseases due to the continued emergence of single and multi-drug
      resistant organisms. This emphasizes the need of laboratory tests that are of
      help in predicting or monitoring response to therapy. Several conventional,
      special, automated and molecular antimicrobial susceptibility tests are available
      including the disk diffusion test, determination of the minimal inhibitory
      concentration, the E test, serum bactericidal titers, and determination of
      antimicrobial levels in blood. This article addresses these and other
      antimicrobial tests to update and enlighten the physicians in selecting the most
      relevant test(s) that will help guiding the therapy of infections caused by
      different bacterial etiologic agents.

PMID- 11214190
TI  - Molecular diagnosis of antimicrobial resistance.
AB  - Advances in molecular technology have helped in better understanding of
      mechanisms and diagnosis of diseases in many medical fields. Several molecular
      techniques are available for determining the genotypic drug-resistance and
      monitoring epidemic spread of a particular antimicrobial resistance gene in a
      hospital or patient population. The molecular (genotypic) testing has several
      advantages over conventional (phenotypic) testing in being faster and
      unambiguous, more accurate, able to detect masked resistance and can serve as a
      "gold" or "reference" test for detecting antibiotic resistance genes. This
      article addresses these molecular tests with their application and limitations
      and provide examples of their use especially in Mycobacterium tuberculosis and
      methicillin resistant Staphylococcus aureus.

PMID- 11214191
TI  - Common bacteria whose susceptibility to antimicrobials is no longer predictable.
AB  - The widespread use of antibiotics has been responsible for the development of
      numerous problems including the emergence of multidrug resistant bacteria,
      increased number of nosocomial- and community-acquired infections, less than
      optimal patient outcome, and increased health care costs. Of equal concern is the
      emergence of resistance in clinical isolates to antibiotics that were once
      considered "standard" with predictable in vitro susceptibility patterns. Such
      resistance has been especially notable in organisms that are commonly encountered
      in a variety of infections including, Streptococcus pneumoniae, Staphylococcus
      aureus. Enterococci, Klebsiella pneumoniae, and Escherichia coli. It is important
      for the clinical microbiology laboratory to provide the practicing clinician with
      accurate and timely antimicrobial susceptibility information which requires the
      application of standardized and approved in vitro testing methods. The laboratory
      also serves as a sentinel by maintaining an active monitoring and surveillance
      program in which current in vitro susceptibility patterns can be compared with
      local, regional, and national data bases.

PMID- 11214192
TI  - The impact of antimicrobial resistance on empiric antibiotic selection and
      antimicrobial use in clinical practice.
AB  - The prevalence of antimicrobial resistance may vary dramatically between
      countries and regions and even among different patient populations and between
      hospitals in the same community. In light of these variations, physicians in
      practice must make a clinical judgment about the likely pathogen(s) involved in
      the infectious process. They should have access to up-to-date data on the
      antimicrobial resistance pattern of commonly encountered pathogens. Such data
      should be subdivided and analyzed for isolates from community as opposed to
      hospitalized patients. The data on intensive care units patients and from special
      groups of patients, such as those undergoing dialysis, organ transplant
      recipients, or cancer patients receiving chemotherapy, should also be made
      available to practicing physicians. When antimicrobial resistance is considered
      to be probable or highly likely, or if empirical therapy has failed, a concerted
      effort should be made to make a microbiologic diagnosis which will ultimately
      reduce the cost, simplify therapy and improve the outcome over treatment that is
      solely empirically based.

PMID- 11214193
TI  - Current status and changing trends of antimicrobial resistance in Lebanon.
AB  - Antimicrobial resistance among microorganisms has been on the rise worldwide
      including Lebanon. Several surveillance programs have been initiated to monitor
      the patterns of resistance due to the deleterious consequences on patients
      management. Thus, knowledge about the local antimicrobial resistance patterns is
      essential for epidemiologic aspects as well as clinical practice. In this
      context, the current status and changing trends of antimicrobial resistance in
      Lebanon are addressed covering the most relevant bacterial, mycobacterial and
      fungal pathogens.

PMID- 11214194
TI  - Current status and changing trends of antimicrobial resistance in Saudi Arabia.
AB  - Due to modern travel and ease of spread of infections, it is desirable to widen
      knowledge of susceptibility of common bacterial isolates from different parts of
      the world for optimal clinical management and control programs. Over the past
      decades, antimicrobial resistance has emerged in all kinds of micro-organisms
      worldwide including Saudi Arabia. This phenomenon is primarily due to increasing
      antibiotic use and misuse in humans, animals and agriculture. Additionally, the
      presence of a large expatriate population and a significant number of visitors to
      the Kingdom annually for pilgrimage and/or work from all over the world may have
      also facilitated the importation to Saudi Arabia of drug resistant micro
      organisms from other countries. Saudi Arabia has witnessed an increase of drug
      resistant Mycobacterium tuberculosis, Streptococcus pneumoniae, Staphylococcus
      aureus and some Enterobacteriaceae in the last decade. We describe the status of
      antimicrobial resistance in Saudi Arabia which is an important focus of
      antimicrobial resistance for the Gulf Region.

PMID- 11214195
TI  - Transitional (intravenous to oral) antibiotic therapy.
AB  - Most clinicians feel the best clinical outcome occurs when patients are treated
      for serious infections with injections for the entire illness. Unfortunately,
      this type of prescribing style results in considerable indirect costs such as
      those involved in increased labor (nursing, pharmacy, intravenous technician
      time), supplies (needles, syringes, intravenous solutions, administration sets,
      infusion pumps) and nosocomial bacteremia. It now appears from pharmacodynamic
      and pharmacoeconomic information that this traditional prescribing behavior
      should change in the management of many infectious diseases, particularly in
      those clinically stable patients who can ingest or digest a medication. With the
      presence of numerous antibiotics with high bioavailability, many infections in
      such patients can now be successfully treated with an oral agent. This review
      provides examples of common infections (such as community- and hospital-acquired
      pneumonias, intra-abdominal infections, urinary tract infections, and skin, soft
      tissue, and bone infections) in which oral therapy can replace parenteral agents.

PMID- 11214196
TI  - Antibiotic prophylaxis.
AB  - The use of antibiotic prophylaxis has long been established to prevent the
      development of invasive infections. In many settings, it is currently considered
      to be the standard of care to administer antibiotics prior to surgical
      procedures. The aim is to decrease the load of organisms at the site of
      manipulation and therefore minimize the appearance of local as well as distant
      infection. With the increasing number of antimicrobial agents available on the
      market, physicians are often faced with a dilemma when trying to decide which
      agent to use. This review addresses the current recommendations of antimicrobial
      prophylaxis in surgical procedures, in the prevention of infective endocarditis,
      as well as the prophylaxis required following exposure to highly infective
      bacteria.

PMID- 11214197
TI  - Mycobacteria: treatment approaches and mechanisms of resistance.
AB  - First-line drugs for tuberculosis treatment include isoniazid, rifampin,
      ethambutol, streptomycin, and pyrazinamide. Molecular mechanisms for resistance
      to each of these drugs have been elucidated. In every case, resistance is
      conferred by mutations in existing genes, not by the acquisition of new genetic
      material. Drug resistance is a major problem worldwide, but the rates vary widely
      among countries and within countries. Acquired resistance in previously-treated
      patients is much more common than primary resistance in patients with no previous
      treatment. High rates of acquired resistance have been reported from referral
      centers in Saudi Arabia and Lebanon. Successful TB treatment requires prolonged
      therapy with at least two active drugs. Directly-observed therapy (DOT) improves
      success rates and reduces the risk of acquired resistance. TB due to susceptible
      strains can be cured in over 95% of cases.

PMID- 11214198
TI  - Treatment of human brucellosis.
AB  - Human brucellosis is a multisystem disease that may present with a broad spectrum
      of clinical manifestations. The primary goals of therapy for brucellosis are to
      improve the symptoms, reduce complications and prevent relapses. The choice of a
      regimen and duration of antimicrobial therapy should be based on the location of
      the disease and the underlying conditions. The regimen of choice is a combination
      therapy with doxycycline for 45 days and streptomycin for 14 days. A second
      choice consists of a combination of doxycycline and rifampin for 45 days.
      Children under 8 years old and pregnant women should not be treated with
      tetracyclines. In children under 8 years old, the preferred regimen is rifampin
      with cotrimoxazole or gentamicin. Rifampin (900 mg once daily for 6 weeks) is
      considered the drug of choice for treating brucellosis in pregnant women. Surgery
      should be considered for patients with endocarditis, cerebral, epidural or
      splenic abscess or other abscesses, which are resistant to antibiotics.

PMID- 11214199
TI  - Community-acquired respiratory infections: spectrum of organisms and treatment.
AB  - The respiratory infections addressed in this paper include otitis media,
      sinusitis, and community-acquired pneumonia. The morbidity and mortality of
      respiratory infections are assessed from the American standpoint ; their
      worldwide significance is even greater. The emphasis is on specific diagnosis.
      Treatment options vary from country to country. Therapeutic decisions are usually
      easy once a specific etiologic organism is isolated. Since in many of these
      common respiratory infections a specific microorganism is not documented and
      empiric therapy is designed based on past clinical studies, resistance patterns
      need to be known for each country.

PMID- 11214200
TI  - Infectious diarrhea: pathogens and treatment.
AB  - Infectious diarrhea is the most common infectious disease syndrome worldwide
      resulting in more than five million deaths annually. The greatest morbidity and
      mortality is seen among children younger than two years of age. A variety of
      bacterial, viral and parasitic pathogens are responsible for the various
      syndromes. A combination of host susceptibility and organism virulence factors is
      responsible for disease. Most episodes of gastroenteritis are self-limited. The
      hallmark of patient management is strict attention to fluid and electrolyte
      disturbances. Antimotility agents should be used with caution if at all in
      children, but may be helpful in adults with travelers' diarrhea. Antimicrobial
      therapy may shorten the duration of diarrhea in some illnesses, but use is
      restricted due to emergence of resistance or due to lack of availability in some
      countries. Newer strategies for prevention include vaccine development.

PMID- 11214201
TI  - Management of urinary tract infections.
AB  - Urinary tract infections (UTIs) are commonly encountered in medical practice and
      range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae
      with E. coli being the most prevalent, are responsible for most commonly acquired
      uncomplicated UTIs and usually respond promptly to oral antibiotics. In
      contradistinction, more resistant pathogens cause nosocomially acquired
      infections which often require parenteral antibiotic therapy. Patients with acute
      bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender
      prostate gland and respond promptly to antibiotic therapy. Chronic bacterial
      prostatitis on the other hand, is a subacute infection characterized by recurrent
      episodes of bacterial UTI where the patient presents with vague symptoms of
      pelvic pain and voiding problems. Treatment is protracted and may be frustrating.
      Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms
      similar to those of chronic bacterial prostatitis. Treatment is not well defined
      due to their uncertain etiologies. Most episodes of catheter associated
      bacteruria are asymptomatic, where less than 5% will be complicated by
      bacteremia. The use of systemic antibiotics for treatment or prevention of
      bacteruria is not recommended, particularly in the geriatric age group, since it
      helps select for resistant organisms. Prevention thus remains the best option to
      control it. Few patients without catheters who have asymptomatic bacteruria
      develop serious complications and therefore routine antimicrobial therapy is not
      justified with only two exceptions : before urologic surgery and during
      pregnancy.

PMID- 11214202
TI  - Loneliness and fear of intimacy among adolescents who were taught not to trust
      strangers during childhood.
AB  - This study explored feelings of loneliness and fear of intimacy among adolescents
      as a function of whether they were taught not to trust strangers during
      childhood. Eighty college students and their parents completed the Revised UCLA
      Loneliness Scale, both versions of the Fear of Intimacy Scale (FIS-D and FIS-F),
      and a background information questionnaire. It was found that students whose
      parents taught them not to trust strangers during childhood had greater fear of
      intimacy. Further, females who were taught to distrust strangers also experienced
      more loneliness than did their male counterparts, as well as females and males
      who were not taught to distrust strangers.

PMID- 11214203
TI  - High-risk behavior among gay adolescents: implications for treatment and support.
AB  - This article contrasts the experiences of most adolescents during social and
      psychological development with the special challenges faced by those developing
      an awareness of their homosexuality. Emphasis is placed upon the interplay
      between societal prejudices and discrimination toward homosexuality and personal
      development and risk-taking behavior in gay adolescents. The implications of
      these life stressors for gay adolescents are also discussed in terms of their
      consequences for mental health policy and treatment.

PMID- 11214204
TI  - Revisiting the imaginary audience and personal fable constructs of adolescent
      egocentrism: a conceptual review.
AB  - Adolescents are thought to believe that others are always watching and evaluating
      them, and that they are special and unique, labeled the imaginary audience and
      the personal fable, respectively. These two constructs have been fixtures in
      textbooks on adolescent development, and have been offered as explanations for
      self-consciousness and risk-taking. However, their characterization of adolescent
      social cognition as biased has not been supported empirically, the measures used
      to assess them lack construct validity, and alternative explanations for both
      ideation patterns have not been explored. Despite these issues, the imaginary
      audience and personal fable constructs continue to be considered prototypical
      representations of social cognitive processes during adolescence. This paper (1)
      reviews theoretical models of the imaginary audience and the personal fable, and
      the empirical data pertaining to each model, (2) highlights problems surrounding
      the two most commonly used measures, and (3) outlines directions for future
      research, so that a better understanding of the imaginary audience and personal
      fable, and their roles in adolescent development, may be achieved.

PMID- 11214205
TI  - Angry adolescents who worry about becoming violent.
AB  - In the present study, 31 of 89 adolescents responded affirmatively to the
      following statement: "Sometimes I get so angry that I worry I will become
      violent." These adolescents (the anger group) were compared with the nonanger
      group, and several differences were found. The anger group (1) reported less
      intimacy with parents, received less support from them, and was less close to
      siblings; (2) had more opposite-sex friends, dated more frequently, and more
      frequently had a boyfriend or girlfriend; (3) had a lower grade point average;
      (4) were more depressed; and (5) used marijuana more frequently. Results of a
      regression analysis revealed that depression and dating were the only significant
      predictors of anger, explaining 17% of the variance.

PMID- 11214206
TI  - Adolescent victimization and associated suicidal and violent behaviors.
AB  - This study examined the relationship between victimization and both suicidal and
      violent behaviors among 1,569 public high school students in New York State
      (excluding New York City). They had participated in the 1997 Youth Risk Behavior
      Survey and, based on their responses, were divided into four groups: no suicidal
      or violent behavior, suicidal behavior only, violent behavior only, and both
      suicidal and violent behaviors. Males reported significantly more victimization,
      less suicidal behavior, and more violent behavior compared with females. Logistic
      regression analyses indicated that all categories of suicidal/violent behaviors
      were more frequent among those who had been victimized compared with the
      nonvictimized, for both males and females. In addition, victimized males were
      over two times more likely than victimized females to report violent behavior
      only. Gender differences were not significant for victimized students in two
      groups, suicidal behavior only and both suicidal and violent behaviors, although
      the results were in the hypothesized direction for suicidal behavior (e.g.,
      females were more prone to suicidal behavior only). It was concluded that
      identifying and treating the victims of violence should be an integral component
      of suicide prevention programs and interventions aimed at reducing interpersonal
      violence in schools.

PMID- 11214207
TI  - Punishments adolescents find justified: an examination of altitudes toward
      delinquency.
AB  - The purpose of this study was to examine adolescents' attitudes toward
      delinquency, specifically the degree to which they find norm violations
      acceptable in various circumstances. A total of 1,914 Dutch youths participated:
      1,046 reported having committed no crimes in the past year, 578 reported having
      committed only nonviolent offenses, and 290 reported having committed both
      violent and nonviolent offenses. It was hypothesized that, in general,
      delinquents would prescribe less severe punishments for deviant behavior,
      irrespective of the circumstances. This hypothesis was rejected. It was found,
      however, that violent delinquents were significantly more tolerant of violent
      behavior as compared with nondelinquents, with one important exception: when
      injury was inflicted on someone they knew, they were as little inclined to excuse
      the perpetrator as were nondelinquents. Violent delinquents discriminated most
      strongly between friends and strangers as both victims and perpetrators.

PMID- 11214208
TI  - The relationship between barriers to birth control use and actual birth control
      use among Mexican-American adolescents.
AB  - This study examined the relationship between barriers to using birth control and
      actual use of birth control among a national sample of Mexican-American
      adolescents. Participants were either over age 15 or sexually active (regardless
      of age). They responded to survey items on birth control use. Chi-square analysis
      and t tests were used to investigate whether barriers to using birth control were
      related to actual use during first intercourse and most recent sexual
      intercourse. It was found that nonusers had significantly higher barrier scores
      compared with users of birth control. The results indicate that attitudes toward
      birth control are associated with actual birth control use among Mexican-American
      adolescents. Additionally, males and females may have distinct barriers to using
      birth control. It was concluded that a better understanding of the sexual
      attitudes and beliefs associated with birth control is needed in order to improve
      programs seeking to increase the use of birth control among this rapidly
      expanding, high-risk population.

PMID- 11214209
TI  - Knowledge about the deleterious effects of smoking and its relationship to
      smoking cessation among pregnant adolescents.
AB  - Smoking cessation among pregnant adolescents remains a complex and unresolved
      issue. The purpose of this study was to examine adolescents' knowledge of the
      detrimental effects of smoking on pregnant women and fetuses and its relationship
      to efforts to quit smoking. The sample consisted of 71 pregnant adolescents, and
      a three-group randomized intervention design-Teen FreshStart (TFS), Teen
      FreshStart with buddy (TFSB), and usual care control (UCC)-was used. Instruments
      included a demographic questionnaire, a smoking history questionnaire, and an 11
      item scale measuring knowledge of the effects of smoking during pregnancy. For
      the entire sample, knowledge scores increased significantly (p = .000) from T1
      (preintervention) to T2 (postintervention), and the adolescents who quit smoking
      had significantly higher knowledge at T2 (p = .028) and greater increases (T1 to
      T2) in their knowledge (p = .019) than did those who did not quit. Together, the
      TFS and TFSB groups had significantly higher knowledge at T2 (p = .017) and a
      significantly greater increase in knowledge from T1 to T2 (p = .005) than did the
      UCC group. This also held true when the TFS and TFSB groups were examined
      individually. Each had significantly higher knowledge at T2 (TFS, p = .029; TFSB,
      p = .008) and a significantly greater increase in knowledge from T1 to T2 (TFS, p
      = .007; TFSB, p = .009) than did the UCC group. Furthermore, despite the small
      sample sizes, within-group comparisons showed (a) no significant differences
      between quitters and nonquitters in the UCC group, (b) significantly higher
      knowledge at T2 (p = .052) and a trend indicating greater increases in knowledge
      from T1 to T2 (p = .092) for the quitters compared with the nonquitters in the
      TFS group, and (c) a trend for adolescents in the TFSB group who quit smoking to
      have greater increases in knowledge compared with those who did not quit (p =
      .158). These results indicate the need for continued inquiry into the
      relationship between pregnant teenagers' health knowledge and decisions to stop
      smoking.

PMID- 11214210
TI  - "You have to have somebody watching your back, and if thats God, then thats
      mighty big": the church's role in the resilience of inner-city youth.
AB  - This study was designed to explore Freeman's (1986) finding that the institution
      that made the greatest contribution to male African-American youths'
      socioeconomic success was the church. Thirty-two African-American, Haitian
      American, and Latino male and female teenagers--16 drawn from inner-city
      Protestant churches and 16 comparison teenagers from the same communities-were
      interviewed. The interviews revealed that churched teenagers were less stressed
      and less likely to have psychological problems than were teenagers in the
      comparison group. They also appeared more likely to be living with both
      biological parents, less likely to have a family member on welfare, and more
      likely to have a job when compared with the other teenagers. They described the
      church as being central to their lives and as having multiple functions, many of
      which have been identified in the resilience literature as contributing to
      positive developmental outcomes. Results are interpreted in light of the
      transactional model, and recommendations are made, such as expanding the role of
      the church within these ethnic communities.

PMID- 11214211
TI  - Fathering and children's sex role orientation in Korea.
AB  - The purpose of this exploratory study was to examine variation in aspects of
      contemporary Korean fathering, such as warmth and involvement (frequency and task
      share), and its relationship to children's sex role development. One hundred and
      twenty-nine Korean families (fathers, mothers, and their 11- to 13-year-old
      children) completed standardized questionnaires addressing child-rearing
      practices, parental involvement, spousal support, and sex role orientations.
      Statistical analyses of the data revealed that warmth of fathering and father
      involvement (frequency and task share) were not significantly associated with
      children's sex role orientations. However, girls' femininity was significantly
      related to fathers' masculinity.

PMID- 11214212
TI  - Fitting in: exploring the emotional dimension of adolescent peer pressure.
AB  - The general public and academic researchers alike have long recognized the
      importance of peer relations in the lives of young people. However, three issues
      are notably absent from the dominant models of peer influence. First, these
      models neglect the affective dimension of a youth's experiences. Second, the
      models tend to ascribe a passive role to the youth, a stance also reflected
      methodologically by the absence of the youth's voice. Third, the motivational
      component remains unspecified; that is, why does a youth conform to peer
      influence? Using a framework drawn from recent social psychological work on shame
      and related feelings, the present study collected qualitative data from twelve
      college students. The findings indicate that negative emotions play a role in
      peer influence, particularly feelings of inadequacy and isolation, as well as
      feeling ridiculed, all of which may be indicative of shame. Thus, shame-related
      feelings may be instrumental in motivating individuals to conform. A variety of
      directions for future research are suggested.

PMID- 11214213
TI  - What every professional who works with adolescents needs to know about
      firesetters.
AB  - The number of adolescent firesetters has been growing each year, along with the
      psychological and financial damage they create. It is therefore essential that
      mental health professionals who work with adolescents be aware of the
      characteristics of firesetters. This study describes the individual and
      environmental factors that relate to the etiology and levels of firesetting.
      Specifically, it discusses different types of firesetters and their aggressive
      tendencies, internalizing problems, family dynamics, and sociability. Further, it
      explores the treatment of adolescent firesetters.

PMID- 11214214
TI  - Interpersonal relationship quality in young adulthood: a gender analysis.
AB  - This study explored gender differences in the degree to which parent-child dyads
      and family system variables are associated with relationship quality in late
      adolescence and early adulthood. It was hypothesized that the quality of mother
      child and father-child relationships, as well as family adaptability and family
      cohesion, would be positively correlated with the quality of intimate
      relationships in late adolescence and young adulthood. Further, it was
      hypothesized that correlations would vary according to gender. The sample was
      composed of 50 males and 48 females between the ages of 18 and 24. The results
      indicated that the relationship of family factors to the intimate relationships
      of young adults was similar for males and females. Specifically, a positive
      relationship with mother and greater adaptability in the family system during
      adolescence were related to more positive intimate relationships in young
      adulthood.

PMID- 11214215
TI  - Understanding dysfunctional and functional family behaviors for the at-risk
      adolescent.
AB  - At-risk adolescents and their impact on families and society, as well as
      characteristics of both healthy and maladaptive families, are discussed.
      Cognitive distortions of dysfunctional adolescents and their effect on family
      members, along with methods for intervention and creating more healthy
      environments, are delineated from a systemic viewpoint.

PMID- 11214216
TI  - Moderate involvement in sports is related to lower depression levels among
      adolescents.
AB  - Sports involvement has been found to be related to social and psychological well
      being in Icelandic adolescents. The present study investigated whether similar
      relationships exist for American adolescents. A group of 89 high school seniors
      completed a questionnaire that gathered data on sports involvement, depression,
      intimacy with parents and friends, and grade point average. It was found that the
      moderate sports involvement group (3 to 6 hours per week) had lower depression
      scores than did the low sports involvement group (2 hours or less per week). The
      findings are discussed.

PMID- 11214217
TI  - Adolescent sex and mass media: a developmental approach.
AB  - Media critics point to adolescents' exposure to "sexy" television and popular
      music. Developmental transitions lead to increased information seeking, and
      developmental tasks force adolescents to find information sources other than
      their parents, implying a link between sexy media and adolescent development.
      Media research informed by knowledge of adolescent development may be able to
      clarify this connection, and model development is discussed here.

PMID- 11214218
TI  - Elevated plasma factor VIII levels--a novel risk factor for venous
      thromboembolism.
AB  - An association between elevated plasma levels of FVIII:C and arterial thrombosis
      was first described 20 years ago. More recently a growing literature has centered
      on the potential role for elevated FVIII:C in venous thromboembolic disease. 25%
      of patients have plasma FVIII:C levels greater than 1500 IU/l six months
      following venous thrombosis. This increased FVIII:C appears unrelated to any
      ongoing acute phase reaction, and reflects a true increase in circulating FVIII
      protein. Furthermore the increase in FVIII:C is sustained in the vast majority of
      subjects for years following the thrombotic episode. Multivariate analysis of the
      Leiden thrombophilia study has demonstrated that increased FVIII is an
      independent risk factor for venous thromboembolism. Individuals with FVIII:C
      exceeding 1500 IU/l had a six-fold increased risk, compared to those with FVIII:C
      levels less than 1000 IU/l. Also, prospective follow-up has shown that patients
      with high FVIII:C levels are at increased risk for episodes of recurrent venous
      thrombosis. These findings support the theory that increased plasma levels of
      FVIII:C represent a constitutional prothrombotic tendency. However the mechanism
      underlying the elevation in FVIII remains unknown.

PMID- 11214219
TI  - Recombinant single chain cardiac troponin I-C polypeptides: superior calibration
      and control materials for cardiac troponin I immunoassays.
AB  - There has been a need to create stable and reproducible calibration and control
      materials for cardiac troponin I assays. Free troponin I, native or recombinant,
      has been known to be unstable, while troponin CI complex can be easily
      dissociated in low concentrations or in the presence of chelating agents. In
      order to overcome these difficulties, two single chain troponin I-C polypeptides
      have been engineered and expressed separately in Escherichia coli. One consists
      of a full-length of human cardiac troponin I and C, termed as ScTnI-C and the
      other consists of a stable fragment (aa28-110) of human cardiac troponin I and a
      full-length troponin C, termed as ScTnI-C-2. Both ScTnI-C and ScTnI-C-2 were
      purified to homogeneity by affinity chromatography using anti-cTnI monoclonal
      antibodies. ScTnI-C and ScTnI-C-2 have apparent molecular weights of 45 kD and 30
      kD by SDS-PAGE, respectively. Stability studies by Stratus showed that ScTn I-C
      and ScTnI-C-2 were stable for 4 months at 2-8 degrees C and at least one year at 
      20 degrees C. When incubated in human serum at 37 degrees C, ScTnI-C-2 was more
      resistant to proteolysis than ScTnI-C. ScTnI-C can be recognized by all
      commercial TnI immunoassays with excellent activity. ScTnI-C-2 can be recognized
      by all immunoassays that target the stable region of cardiac troponin I. Judging
      by their performances, ScTnI-C and ScTnI-C-2 are both superior materials to be
      used as calibrators and controls in clinical laboratories.

PMID- 11214220
TI  - B-type natriuretic peptide (BNP)--validation of an immediate response assay.
AB  - B-type natriuretic peptide, a proteohormone secreted by the left ventricle in
      response to wall-tension, is a promising laboratory parameter for the detection
      and follow-up of heart failure. In this report analytical validation data of a
      non-isotopic point-of-care testing system for the quantitative determination of
      BNP (Triage BNP, Biosite, USA) are given. Despite a very short turn-around time
      of about 10 minutes the assay proved to be reproducible (interassay coefficient
      of variation (n=10) of 8.4% and 8.0% at concentrations of 19.3 ng/l and 392 ng/l,
      respectively), linear (r=0.998, from 5 ng/l to 818 ng/l), and rugged with respect
      to common interferents; compared to the widely used SHIONORIA BNP assay (CIS,
      France) higher results were found (Triage-BNP = 1.52 x SHIONORIA BNP - 7.0 ng/l;
      n=70) with a relatively close correlation of the results (r=0.935). It is
      concluded that the Triage BNP assay meets the analytical requirements for further
      clinical validation and may allow a more widespread clinical use of BNP
      determination in contrast to competing assays with long turn-around times.

PMID- 11214221
TI  - Evaluation of the Dade Behring Dimension RxL clinical chemistry analyzer.
AB  - The performance of the Dade Behring Dimension RxL clinical chemistry analyzer was
      evaluated according to the guidelines of the European Committee for Clinical
      Laboratory Standards. The following analytes were tested: glucose, urea,
      creatinine, albumin, phosphorus, cholesterol, triglyceride, uric acid, magnesium,
      sodium, potassium, chloride, calcium, iron and total bilirubin. The Dade Behring
      Dimension RxL was compared with the Hitachi 704, Bayer RA-1000, Ektachem 250 and
      Chiron 865 depending on available tests on these analyzers. Coefficients of
      correlation showed high correlation between compared analyzers. Other
      performances (intra- and inter-assay variation, carry-over and interferences) of
      the analyzer were satisfactory.

PMID- 11214222
TI  - Serodiagnosis of Lyme borreliosis using detection of different immunoglobulin
      (sub)classes by enzyme-linked immunosorbent assay and Western blotting.
AB  - To improve the performance of enzyme-linked immunosorbent assays for the
      serodiagnosis of Lyme borreliosis, the prevalence of several immunoglobulin
      classes and subclasses against various antigens of Borrelia burgdorferi was
      investigated by Western blotting. The sera of 40 early Lyme borreliosis patients
      (ELB), 27 late Lyme borreliosis patients (LLB), 62 healthy controls and 140 non
      Lyme borreliosis patients were used. Detection of IgG1 versus total IgG was found
      to be more sensitive in detecting Borrelia burgdorferi antigens, especially
      flagellin (41 kD) protein, but did not improve the performance of Western
      blotting. The use of IgG1 detection showed an increase in sensitivity and
      specificity for the early Lyme borreliosis patient group compared to the standard
      IgG and IgM detection method by enzyme immunoassays using purified Borrelia
      burgdorferi flagellum. However, in an enzyme immunoassay using a total sonicate,
      sensitivity in detecting early Lyme borreliosis and late Lyme borreliosis with
      IgG1 remained lower compared to the detection of early Lyme borreliosis by IgM
      antibodies and late Lyme borreliosis by total IgG antibodies.

PMID- 11214223
TI  - Hepatitis B--an important public health issue.
AB  - Hepatitis B is one of the most common infectious diseases in the world. It has
      been estimated that 350 million people worldwide are chronic hepatitis B virus
      (HBV) carriers. The global prevalence of chronic HBV infection varies widely,
      from high ( > 8%, e.g., Africa, Asia and the Western Pacific) to intermediate (2
      7% e.g., Southern and Eastern Europe) and low (< 2%, e.g., Western Europe, North
      America and Australia). The predominant routes of transmission vary according to
      the endemicity of the HBV infection. In areas of high endemicity, perinatal
      transmission is the main route of transmission, whereas in areas of low
      endemicity, sexual contact amongst high-risk adults is predominant. Between one
      third and one-quarter of people infected chronically with HBV are expected to
      develop progressive liver disease (including cirrhosis and primary liver cancer).
      Although mass vaccination programs have begun to control the spread of HBV
      infection, therapeutic intervention is the only option for those with established
      chronic HBV-associated liver disease. Until recently, the only treatment for
      chronic hepatitis B was the immune modulator, interferon (IFN) alpha. However,
      IFN alpha treatment has several disadvantages; it is expensive, it must be
      administered by injection, there are side-effects, and IFN alpha is poorly
      tolerated. Lamivudine, a nucleoside analogue, is the first effective, and well
      tolerated, oral treatment for chronic hepatitis B. In conclusion, although we are
      still some way from eradicating or curing chronic hepatitis B, the advent of
      lamivudine allows new populations to benefit from therapy and helps to address
      the global public health problem of hepatitis B.

PMID- 11214224
TI  - Changing clinicians' laboratory test requesting behaviour: can the poacher turn
      gamekeeper?
AB  - A major reason for the dramatic increase in laboratory costs is the increased
      number of laboratory investigations, many of which are perceived to be a waste of
      time and money. In consequence, several strategies, reviewed below, for
      curtailing clinicians' laboratory usage have been proposed but none has been
      universally successful. It is clear, however, that a combination of several
      strategies is likely to be more successful than any single approach. There may be
      several reasons why no single strategy has been widely adopted in routine
      practice. We suggest that modern computers have the ability to overcome these
      obstacles. We propose, therefore, that expert systems at the clinical-laboratory
      interface utilising a multifactorial approach within a framework of commitment
      from clinicians and laboratorians offer the best prospect for reducing
      inappropriate laboratory usage.

PMID- 11214225
TI  - Hypercalcemia of malignancy--new insights into an old syndrome.
AB  - Hypercalcemia is a common paraneoplastic syndrome. Tumors induce hypercalcemia by
      a local mechanism associated with the tumor's production of various cytokines
      increasing bone osteolysis. In addition, many tumors release humoral factors,
      mainly parathyroid hormone (PTH)-related protein (PTHrP), which stimulates bone
      resorption and/or tubular calcium reabsorption leading to hypercalcemia.
      Interaction of PTHrP with other tumor-elaborated cytokines might explain some
      nonPTH-like features associated with the hypercalcemia of malignancy syndrome.
      Using assays recognizing various PTHrP epitopes, the majority of hypercalcemic
      cancer patients have higher immunoreactive PTHrP levels in either plasma or urine
      than normal subjects. Present data support the concept that PTHrP might also be a
      factor which promotes tumor growth and also the development of osteolytic
      metastasis. A variety of therapeutic approaches are available to lower serum
      calcium in hypercalcemic cancer patients. The pathophysiological mechanisms of
      hypercalcemia appear to be a determinant of the efficacy of different
      antihypercalcemic treatments.

PMID- 11214226
TI  - Reference ranges for analytes in extravascular body fluids.
AB  - Interpreting analytes measured in extravascular body fluids can be problematic as
      the only suitable literature reference, the Geigy Scientific Tables (1), is
      almost 20 years old, dating back to the year 1981. It is not always possible to
      apply the values indicated therein to modern analytical procedures since many of
      these determinations were developed in the 1940es, 1950es and 1960es and measured
      with methods that have since lost their significance. We therefore did some
      extensive literature searches to compile an updated list for the most essential
      extravascular body fluids. The number of analytes featured in the list has been
      limited to the most relevant substances. A critical examination of the published
      data revealed that only 10-20% of the papers could actually be used because of
      insufficient statistical data, too small number of test subjects, or a lack of
      plausibility.

PMID- 11214227
TI  - The DSL analog free testosterone assay: serum levels are not related to sex
      hormone-binding globulin in normative data throughout childhood and adolescence.
AB  - In this study we tested the performance of easy-to-use and rapid, commercially
      available immunoassays to measure free testosterone (fT) and sex hormone-binding
      globulin (SHBG). We asked whether fT and SHBG serum levels are age-dependent and
      whether or not there is a gender dependence of fT and SHBG in this age group.
      Finally, by measuring fT and SHBG in sera of a cohort of healthy children and
      adolescents using commercially available immunoassays, we established normative
      data for fT and SHBG in this age group: in boys fT levels increased significantly
      (r=0.83, p<0.0001) from 0.63 pmol/l (median) in the age group below 5 years to
      56.9 pmol/l in the age group 16-20 years. In girls fT levels also increased with
      age (r=0.66, p<0.0001): from 0.72 pmol/l (median) in the age group below 5 years
      to 3.34 pmol/l in the age group 16-20 years. In contrast, SHBG serum
      concentrations significantly decreased with age in boys (r=-0.62, p<0.0001) but
      remained constant in girls (r=0.04, n.s.). Importantly, fT values were
      independent of SHBG levels as determined by our methods. In conclusion, fT can be
      measured in an acceptable quality using the DSL analog tracer-based immunoassay
      and normative data are now available. In addition, SHBG levels in healthy
      children and adolescents are also given and may permit for studies of
      pathophysiologic states in this age group.

PMID- 11214228
TI  - Improved methods for the quantification of free and linked spacer in conjugate
      vaccine process.
AB  - In polysaccharide (PS)-protein conjugate vaccine process, indirect coupling via
      derivatization of the antigenic PS by diamino spacer molecules is widely used.
      Such a conjugation technology requires the accurate determination of both the
      degree of PS-amino substitution (linked spacer) and the removal of residual
      unlinked (free) diamino spacer. We report two methods for the microdetermination
      of the spacer primary amino groups, based on their fluorescent labelling. In the
      first developed assay, activated PS is derivatized with 6-aminoquinolyl-N
      hydroxysuccinimidyl carbamate (AQC) and the free spacer is separated and detected
      as its AQC derivative by RP-HPLC with fluorescence detection (lambda(Ex,Em)
      246/396 nm). In the second assay, activated PS is derivatized with 3-(2
      furoyl)quinoline-2-carboxaldehyde (FQ) and its FQ derivative is separated by
      capillary zone electrophoresis (CZE) with laser-induced-fluorescence (LIF)
      detection (lambda(Ex/Em) 488/590 nm). Compared to the traditional gel filtration
      and colorimetric assays, these two methods show major advances in terms of
      sensitivity, reduced analysis time and small sample requirements.

PMID- 11214229
TI  - Simultaneous evaluation of molecular size and antigenic stability of PNEUMOVAX
      23, a multivalent pneumococcal polysaccharide vaccine.
AB  - A technique using high performance size exclusion chromatography (HPSEC) with
      rate nephelometry (RN) detection has been developed to simultaneously measure the
      relative molecular size and antigenicity of the bacterial polysaccharide
      components in a multivalent pneumococcal vaccine, PNEUMOVAX 23. This assay was
      used to establish stability profiles for each of the 23 pneumococcal
      polysaccharide serotypes in this vaccine formulation, based on concurrent
      analyses of vaccine lots up to nine years of age. The exceptional inter-assay
      precision (<1% RSD) permitted detailed analysis of the data and a more accurate
      measure of the stability of this product that heretofore has not been available.
      While 21 of the 23 serotypes in the vaccine show essentially no change in
      molecular size over several years, serotypes 19A and 19F show changes in relative
      molecular size of approximately 2% per year. Similar decreases in relative
      molecular size for serotypes 19A and 19F stored in aqueous formulation have also
      been observed in other commercially available pneumococcal vaccine products.
      Additionally, stability profiles of relative antigenicity for nine of the 23
      serotypes are reported based on information that is simultaneously obtained in
      the HPSEC/RN analysis. Of the nine serotypes examined, only serotypes 1, 9V and
      18C demonstrate antigenic lability over time, in each case showing a decrease in
      antigenicity on the order of 5% to 10% per year. Overall, this method is a
      precise and efficient means of providing data on relative molecular size and
      relative antigenicity for each polysaccharide component of a multivalent vaccine
      product. Application of this method in stability studies of such vaccines
      provides critical information for evaluating time-dependent changes in these
      products.

PMID- 11214230
TI  - Characterization of multivalent pneumococcal conjugate vaccines.
AB  - A new heptavalent pneumococcal conjugate vaccine, designed to protect against
      disease due to serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F, was formulated with
      aluminium phosphate adjuvant and analysed before testing in infants. Analyses
      were complicated by the presence of the adjuvant, and by the low level of each
      antigen; for example, all serotypes were formulated at 2 microg of saccharide
      /dose (except 6B which was formulated at 4 microg). Type specific analyses were
      performed on the formulated vaccine, and included determination of immunogenicity
      and antigenicity; the former was measured by ELISA following immunization of
      rabbits, the latter was measured by rate nephelometry. Non serotype specific
      information was also collected, and included total and adsorbed saccharide (by
      Anthrone assay), and total and adsorbed protein (by Lowry assay). These
      preclinical data supported the use of the vaccine in infants in a large
      randomized double-blinded clinical trial in a multiethnic population. The results
      of this trial show that the vaccine is safe and efficacious. Collectively, the
      data will be used to support licensure of the heptavalent vaccine, and documents
      successful scale-up of the formulation process to manufacturing level.

PMID- 11214231
TI  - Spectroscopic studies of the structure and stability of glycoconjugate vaccines.

PMID- 11214232
TI  - Monitoring stability of meningococcal group C conjugate vaccines; correlation of
      physico-chemical methods and immunogenicity assays.
AB  - Two meningococcal C-CRM197 conjugates differing in oligosaccharide chain length,
      number of conjugation sites, conjugation chemistry and process were monitored for
      stability at various temperatures or after repeated freeze-thawing by physico
      chemical assays. The results were compared with assessment of immunogenicity in
      mice, previously shown to correlate with performance of the vaccine in clinical
      trials. The structural stability of the oligosaccharide chains and the protein
      carrier varied between the two types of conjugates. Neither was adversely
      affected by repeated freeze-thawing but one developed conformational changes in
      the protein carrier, detected by optical (CD, fluorescence) and NMR spectroscopy,
      when incubated at 23 degrees C or above, although integrity of the
      oligosaccharide structure was maintained. This was not associated with any
      reduction in primary IgM or IgG antibody responses to meningococcal C
      polysaccharide. Exposure to more extreme conditions resulting in release of a
      substantial proportion of free saccharide from the other conjugate sample was
      accompanied by significant reduction in both IgG and IgM antibody responses. In
      conclusion, FPLC-SEC, HPAEC-PAD and NMR spectroscopy were found useful for
      monitoring the stability of meningococcal C-CRM197 conjugates. Although optical
      spectroscopy was a sensitive method for detecting modification of the protein
      carrier, the results did not correlate with reduced immunogenicity.

PMID- 11214233
TI  - Structure activity studies on group C meningococcal polysaccharide-protein
      conjugate vaccines: effect of O-acetylation on the nature of the protective
      epitope.
AB  - A series of group C meningococcal polysaccharide-tetanus toxoid (GCMP-TT)
      conjugates were prepared as vaccines with varying percentages of O-acetylation at
      the C-7 and C-8 positions of sialic acid residues in the polysaccharide (PS). The
      immune response in mice was highly dependent on the degree of O-acetylation. Less
      O-acetylation resulted in higher serum bactericidal activity (SBA) towards the O
      acetylated (OA) meningococcal strain, C11. In addition, since an unconjugated de
      O-acetylated (dOA) GCMP vaccine was previously shown to be highly immunogenic in
      humans, we had chosen this dOA form to couple with TT by reductive amination for
      clinical evaluation. This conjugate vaccine was shown to be well-tolerated and
      highly immunogenic in adults, children, and infants in the UK. To understand the
      nature of the GCMP protective epitope, a series of spectroscopic and serological
      studies were conducted, using high resolution H-NMR spectroscopy at 500 MHz and
      competitive inhibition SBA assays. The dOA GCMP was 10-1000 times better at
      inhibiting the SBA for an OA strain than the OA GCMP, suggesting that the GCMP
      based protective epitope on the bacterium exists in a dOA form. In addition, SBA
      for an OA strain is highly correlated with dOA GCMP-specific IgG. NMR data on
      freshly isolated GCMP indicated that, on the surface of the organism, most of the
      O-acetylation exists at position C-8, with some regions containing dOA or OA C-7
      sialic acid. After extraction of PS and storage in solution, most of the O-acetyl
      groups migrate to C-7, leaving an epitope that is conformationally related, but
      not quite identical (due to the presence of the O-acetyl group), to the one
      contained in the dOA PS. We speculate that the role of the O-acetyl group at the
      C-8 position of the PS on the organism is to form less immunogenic epitopes, or
      mask the protective epitope, and thus escape immune surveillance. The dOA form of
      the vaccine may therefore provide better protection against group C meningococcal
      disease than the OA form by eliciting a greater proportion of functional
      antibodies that are directly aimed at the protective epitope.

PMID- 11214234
TI  - Characterization of a recombinant outer surface protein A (OspA) vaccine against
      Lyme disease.
AB  - Lyme disease, the most prevalent tick-borne disease in the United States, results
      from infection with Borrelia burgdorferi sensu stricto. Early studies of Borrelia
      burgdorferi sensu stricto identified outer surface protein A (OspA), a
      lipoprotein on the surface of spirochetes that could be the target of protective
      antibodies to this agent. Pasteur Merieux Connaught has developed a Lyme vaccine,
      ImuLyme, using recombinant OspA protein (rOspA). Methods were developed to
      routinely assess the identity, quantity, structure, purity, biological activity,
      heterogeneity, stability, and potency of rOspA. In addition, several methods were
      performed on a series of lots to support the routine testing methods and further
      our understanding of the physicochemical characteristics of rOspA. These tests
      were electrospray mass spectrometry, circular dichroism, two-dimensional gel
      electrophoresis, amino acid analysis, peptide mapping with peptide sequencing,
      and the application of proteomic methodology to identify trace contaminant host
      cell proteins. The results of these methods indicate that the rOspA lots are
      composed of highly purified and properly processed and folded rOspA with trace
      amounts of E. coli host cell proteins.

PMID- 11214235
TI  - Physicochemical characterisation of the pertussis vaccine.
AB  - The characterisation of an acellular pertussis vaccine composed of a genetically
      modified pertussis toxin, filamentous haemagglutinin and pertactin is described.
      The three antigens are submitted to a mild treatment with formaldehyde in the
      presence of lysine before their use in vaccine formulation. Characterisation is
      performed by amino acid analysis, SDS-PAGE, analytical size exclusion
      chromatography and, in the case of pertactin, isoelectrofocusing. The effect of
      some variables on pertactin formaldehyde treatment has been studied by means of
      isoelectrofocusing and mouse immunogenicity.

PMID- 11214236
TI  - Biophysical validation of Epaxal Berna, a hepatitis A vaccine adjuvanted with
      immunopotentiating reconstituted influenza virosomes (IRIV).
AB  - Inactivated vaccines usually contain an adjuvant which potentiates the immune
      response to the antigen. During the last 70 years aluminium salts have been the
      only adjuvant licensed for human use. The adjuvanting activity is based on their
      serving as an antigen depot and inducing a localized inflammatory response. Our
      efforts to develop a potent and well tolerated adjuvant has focussed on the use
      of immunopotentiating reconstituted influenza virosomes (IRIV). The IRIV base is
      a liposome with a mean diameter of 150 nm, comprising phosphatidylcholine (PC)
      and phosphatidylethanolamine (PE). These mammalian phospholipids are virtually
      non-immunogenic and have enjoyed a long history of use in human pharmaceutical
      preparations. The haemagglutinin (HA) and trace quantities of viral neuraminidase
      and phospholipids from the A/Singapore 6/86 virus strain are intercalated within
      the phospholipid bilayer. The presence of the HA is necessary to enhance the
      immunopotentiating effect to antigen associated with IRIV The excellent
      characteristics of IRIVs as adjuvants have been demonstrated in several systems.
      IRIVs as alternative adjuvant system for human use are registered by most
      European, Asian and American countries in commercial hepatitis A and influenza
      vaccines. IRIVs were first used in the manufacture of a hepatitis A vaccine. This
      contains formalin-inactivated and highly purified hepatitis A virus (HAV) of
      strain RG-SB, cultured in human diploid cells, which is coupled to the IRIV
      vesicle. For a new influenza vaccine the surface spikes (HA and NA) of three
      currently circulating influenza strains were jointly inserted into the vesicle
      membrane of the IRIVs and successfully tested clinically. In Epaxal Berna, the
      first commercially available liposomal vaccine is expected to be the inactivated
      hepatitis A virus adsorbed to IRIV particles. In the virosomal hepatitis A
      vaccine, the antigen is believed to be attached to the IRIV by interacting with
      phospholipids which are considered to correspond to its natural receptor on
      hepatocytes. The present investigation includes data based on light scattering
      measurements which show the binding of the virions to vesicles.

PMID- 11214237
TI  - Properties of recombinant HtrA: an otitis media vaccine candidate antigen from
      non-typeable Haemophilus influenzae.
AB  - Non-encapsulated or non-typable Haemophilus influenzae (NTHi) is a major cause of
      middle ear infections in young children. HtrA has been identified as a vaccine
      candidate antigen from NTHi; therefore physicochemical characterization of this
      antigen is important for vaccine development. Recombinant NTHi HtrA has been
      expressed in E. coli and shown to have serine protease activity. Several mutant,
      recombinant HtrA proteins were expressed and purified to obtain suitable vaccine
      antigens lacking protease activity. Two mutants with alterations at the putative
      active site His91 and Ser197, designated H91A and S197A were examined by circular
      dichroic spectropolarimetry (CD) to evaluate secondary structure. The S197A
      mutant had a more random secondary structure compared to wild-type rHtrA or H91A.
      It is likely that improper folding of S197A accounts for its lack of
      immunoprotective properties in a chinchilla model of otitis media.

PMID- 11214238
TI  - Physicochemical analysis of purified diphtheria toxoids: is toxoided then
      purified the same as purified then toxoided?
AB  - Diphtheria toxin can be converted into a highly immunogenic and irreversibly
      detoxified vaccine either using the conventional process in which the crude toxin
      is formalinised and subsequently purified (DTxd(conv)) or by detoxification of
      the highly purified toxin (DTxd(new)). In this study, both DTxd(new) and
      DTxd(conv) were evaluated by use of physico-chemical methods. For some methods,
      results were also compared to those obtained for cross-reacting material
      (CRM197), which is a non-toxic mutant of diphtheria toxin. DTxd(new) was assayed
      to have a specific purity of at least 2300 LF/mg protein N, thereby exceeding
      Pharm. Eur. requirements by up to 35%. Superior purity of DTxd(new) could also be
      demonstrated by size exclusion HPLC experiments and by amino acid composition
      studies. Far-UV circular dichroism spectroscopy revealed that the secondary
      structure of DTxd(new) almost resembled that of CRM197, suggesting only minor
      molecular changes during detoxification. This study worked out differences
      between purified diphtheria toxoids. Physico-chemical means revealed the
      advantages of DTxd(new) being the purer and more defined product, thus making it
      highly efficient for its use as a vaccine carrier as well as a component of
      vaccine combinations.

PMID- 11214239
TI  - Characterization of aluminium-containing adjuvants.
AB  - The approved aluminium-containing vaccine adjuvants have been shown to be poorly
      crystalline aluminium oxyhydroxide (AIO(OH)) and amorphous aluminium
      hydroxyphosphate of varying phosphate content. Adsorption of the antigen by the
      adjuvant is implied in many proposed mechanisms of antibody production
      enhancement caused by the adjuvants. The World Health Organization recommends
      adsorption of 80% or more of tetanus and diphtheria toxoid by the aluminium
      containing adjuvants. Thus, one objective in the preparation of vaccines
      containing these adjuvants is to optimize adsorption of the antigen on the
      adjuvant. Production of a consistent adjuvant effect in vaccines would be
      facilitated by the thorough characterization of aluminium-containing adjuvants
      with reference to properties that affect adsorption and other colloidal
      behaviour. Such properties include surface area, surface charge, chemical
      composition, structure, and morphology. Techniques and measurements such as X-ray
      diffraction, infrared spectroscopy, transmission electron microscopy, energy
      dispersive spectrometry, Doppler electrophoretic light scattering analysis,
      dissolution rates, and adsorption isotherms provide a basis for understanding and
      predicting interactions and behaviour in monovalent as well as multivalent
      vaccines. Such characterization would be crucial in vaccine standardization and
      quality control.

PMID- 11214240
TI  - Synthesis and characterization of respiratory syncytial virus protein G related
      peptides containing two disulphide bridges.
AB  - Respiratory Syncytial Virus (RSV) is the most important cause of bronchiolitis
      and viral pneumoniae in infants and young children. Approximately 100,000
      children are hospitalized in the USA each year as a result of RSV infections.
      During the research and development of subunit human RSV vaccines, we have
      produced numerous synthetic peptides and recombinant proteins containing the four
      cysteines of the highly conserved central region of the G attachment protein. For
      several of these disulphide bridges containing peptides, all possible oxidizing
      isomers were synthesized using various oxidising conditions, resulting in
      different ratios of isomers. Each isolated isomer was fully characterized by RP
      HPLC, FZCE and ES-MS after purification by preparative RP-HPLC. The different
      cysteine pairings were unambiguously established after enzymatic digestion, LC-MS
      analysis and peptide microsequencing. These synthetic and analytical methods were
      developed for the characterization of recombinant fusion protein BBG2Na which is
      currently investigated in clinical phase II and seems to be as a very promising
      vaccine candidate, and for peptides which were synthesized to be evaluated as
      conjugate vaccines or as immunochemical tools, after covalent coupling to carrier
      proteins. Furthermore, these studies allowed us to determine which of the
      different possible isomers was the most stable and probably the preferred form in
      native conditions. Finally, the different oxidising and analysis conditions,
      should be useful for disulphide pairing studies of other peptides and proteins
      having the same "xCxxCxxxxxCxxxCx" framework, such as G proteins of non-human RSV
      strains, developed for example as veterinary vaccine candidates.

PMID- 11214241
TI  - Direct biophysical characterization of protein antigens in ISCOM formulations.

PMID- 11214242
TI  - Absolute molecular-size and molar-mass analysis of meningococcal and pneumococcal
      conjugates and polysaccharide intermediates by size-exclusion chromatography with
      detection by multiangle light-scattering photometry and differential
      refractometry.

PMID- 11214243
TI  - Measurement of kinetic binding constants of pneumococcal polysaccharide
      antibodies using plasmon surface resonance.

PMID- 11214244
TI  - Physico-chemical characterization and immunogenicity studies of peptide and
      polysaccharide conjugate vaccines based on a promising new carrier protein, the
      recombinant Klebsiella pneumoniae OmpA.

PMID- 11214245
TI  - Capillary electrophoretic analysis of meningococcal polysaccharide-diphtheria
      toxoid conjugate vaccines.
AB  - Protein-polysaccharide conjugate vaccines are large, complex molecules that
      present challenges in terms of characterization. Free solution capillary
      electrophoresis using alkaline (pH 9-10) borate or glycine/NaOH buffers permitted
      electrophoresis of diphtheria toxoid (Dt) or meningococcal polysaccharide-Dt
      conjugates as well-formed, relatively broad peaks. Resolution was observed
      between the conjugate and the Dt peaks for some serotypes; however, overlap
      between Dt and one or more conjugate peaks was observed with both buffers.
      Inclusion of SDS in the separation buffer at a level above the critical micelle
      concentration allowed separation of Dt and Dt-conjugates of meningococcal
      serotypes A, C, Y and W135. Using borate/SDS, a linear relationship between peak
      area and Dt concentration was observed between approximately 2 mg/ml and 20
      microg/ml. A linear relationship between Dt peak area and injection times from 10
      to 50 seconds was also observed. Capillary electrophoresis may therefore be a
      useful method for quantifying free protein level in meningococcal-Dt conjugate
      vaccines.

PMID- 11214246
TI  - Quantification of free polysaccharide in meningococcal polysaccharide-diphtheria
      toxoid conjugate vaccines.
AB  - A precipitation method using deoxycholate/HCI has been applied successfully to
      separate unconjugated free polysaccharide from carrier protein-bound material in
      meningococcal polysaccharide-diphtheria toxoid conjugate vaccines. The method
      effectively separated free and bound polysaccharide in conjugate vaccines
      prepared from Neisseria meningitidis serotypes A, C, W135 and Y. Free
      polysaccharide remained in the supernatant after deoxycholate treatment while
      protein-bound polysaccharide was fully precipitated. Testing by both colorimetric
      assay and high performance anion exchange chromatography with pulsed amperometric
      detection (HPAEC-PAD) has confirmed the selective loss of protein-bound
      polysaccharide in samples of conjugate vaccine or conjugate vaccine mixed with
      known amounts of free polysaccharide. This rapid separation method requires
      minimum sample handling and is specific, reproducible, and allows assessment of
      free polysaccharide levels in vaccines at final container concentration.

PMID- 11214247
TI  - Preliminary physical and chemical characterisation of Salmonella typhi VI
      polysaccharide.

PMID- 11214248
TI  - Physical and chemical parameters for the characterisation of the group C
      polysaccharide of the Cuban meningococcal BC vaccine.

PMID- 11214249
TI  - Determination of C-polysaccharide in pneumococcal polysaccharides using 1H and
      31P NMR.

PMID- 11214250
TI  - Quantification of C-polysaccharide in Streptococcus pneumoniae polysaccharides by
      high-performance anion-exchange chromatography with pulsed amperometric
      detection.
AB  - A sensitive method, using high-performance anion-exchange chromatography with
      pulsed amperometric detection (HPAEC-PAD) has been developed for measurement of
      the C-polysaccharide contamination in Streptococcus pneumoniae capsular
      polysaccharides, which are part of the polysaccharides based vaccines for the
      prevention of pneumococcal infections. This method, based on the quantification
      by HPAEC-PAD of the ribitol released by aqueous hydrofluoric acid (HF) followed
      by trifluoro acid hydrolysis (TFA) of the pneumococcal polysaccharides is simple
      and provides both a qualitative and quantitative method for control of the
      polysaccharides.

PMID- 11214251
TI  - Physico-chemical characterization of polysaccharide vaccines.
AB  - An increasing number of sophisticated analytical techniques, including NMR
      spectroscopy, are currently being applied to the quality control of
      polysaccharide and polysaccharide-based vaccines. These methodologies are
      providing more precise and more detailed profiles of these vaccines. NMR
      spectroscopy also provides a convenient and powerful technique to monitor
      alterations of the polysaccharide in the production of protein conjugate
      vaccines.

PMID- 11214252
TI  - Physicochemical characterisation of the oligosaccharide component of vaccines.
AB  - Glycoconjugate vaccines are being developed against Haemophilus influenzae (Hib)
      and meningococcal Type A and C micro-organisms; they consist of oligosaccharides
      of intermediate chain length conjugated to the carrier protein CRM (a non-toxic
      diphtheria toxin mutant). The oligosaccharides can be quantified using specific
      composition analyses and their structure and identity (and pattern of
      acetylation) evaluated by use of NMR spectroscopy. The average molecular-size
      (degree of polymerisation) can be determined using colorimetric assays, qualified
      by analysis of authentic standards. The molecular-size distribution of these
      anionic oligosaccharides can be achieved using ion exchange chromatography or
      application of the rapid and sensitive analytical HPAEC-PAD system (high
      performance anion-exchange chromatography with pulsed amperometric detection).
      Preparative ion exchange chromatography permits the isolation of purified
      oligomers, which can be well-characterised using the methods described above.
      Molecular size can be confirmed by use of mass spectrometry. These vaccines are
      semi-synthetic products and therefore their preparation involves several steps of
      chemical reaction, the detailed physicochemical characterisation of the
      oligosaccharide-components permits the consistent production of these well
      defined glycoconjugate vaccines.

PMID- 11214253
TI  - Monitoring of diphtheria, pertussis and tetanus toxoids by circular dichroism,
      fluorescence spectroscopy and size-exclusion chromatography.
AB  - A combination of spectroscopic and chromatographic methods has been used to
      monitor the quality and integrity of diphtheria, pertussis and tetanus toxoids
      (DTxd, PTxd and TTxd) which have been prepared from the toxins by formaldehyde
      treatment. Different processes for detoxifying all three toxins have yielded
      toxoids varying in their molecular size, including oligomers (associated
      monomers) and aggregates (high molecular weight complexes of non-specifically
      associated monomers). Changes in the intrinsic fluorescence spectra of the
      polypeptides have been observed in some sized fractions of DTxd and PTxd. Some
      physico-chemical changes have been observed to correlate with a loss of
      antigenicity. Spectroscopic and chromatographic methods are useful not only in
      monitoring the stability and consistency of vaccine starting materials, but can
      also be used to dissect heterogeneous toxoid preparations.

PMID- 11214254
TI  - Characterization of post-translationally modified recombinant protein using
      liquid chromatography/mass spectrometry.
AB  - Post-translational modification plays an important role in the biological
      functions of many proteins. Characterization of such modifications is crucial in
      the development of recombinant protein-based vaccines. Liquid Chromatography
      coupled with Mass Spectrometry (LC/MS) provides a powerful tool with high
      resolution and accuracy to characterize proteins and their post-translational
      modifications. The technique was applied to characterization of a Lyme vaccine
      protein rOspA (recombinant Outer surface protein A). The results demonstrate that
      LC/MS could be used to resolve and characterize various forms of post
      translational lipidation of the protein. It was this detailed structural
      information that made it possible to validate a method for quantitative
      determination of the lipidation forms of rOspA.

PMID- 11214255
TI  - Binding measurements as surrogate biological assays: surface plasmon resonance
      biosensors for characterizing vaccine components.
AB  - There is considerable interest in the possibility of using surrogate physico
      chemical assays for the quality control of vaccine components. Since biological
      activity always depends on a first binding step, the primary criterion for
      assessing biological activity is the ability of a vaccine component to bind
      specifically in a binding assay. Biosensor instruments that measure binding
      kinetics with considerable ease and precision are used increasingly to assess the
      quality of antigens intended for vaccination as well as the binding affinity of
      antibodies elicited by vaccination. The most widely used biosensor instrument is
      the BIACORE and its mode of operation is briefly described. The use of biosensors
      for measuring the active concentration of biomolecules and for assessing the
      probable effectiveness of vaccine-induced antibodies is described.

PMID- 11214256
TI  - Selection of putative immunogenic peptides by molecular modelling of the urease
      of Helicobacter pylori.
AB  - Computational methods such as molecular modelling are becoming an increasingly
      useful means of rationalising experimental data and creating a hypothesis that
      can suggest new experiments. In this report we discuss the application of
      molecular modelling methods to aid the selection of feasible peptide epitopes of
      the urease enzyme from Helicobacter pylori, an important vaccine candidate.
      Surface exposure was chosen as a criterion for the selection of three peptides
      which each had different levels of accessibility according to the 3D model.
      Antibodies raised against these peptides were analysed for their immunoreactivity
      with the holo enzyme. Only one anti-peptide antibody showed good reactivity with
      the urease. Our findings emphasise that surface exposure of peptide is not the
      only important criterion for the selection of immunogenic peptides.

PMID- 11214257
TI  - Mining genomes and mapping proteomes: identification and characterization of
      protein subunit vaccines.
AB  - Currently, there is an extensive and unprecedented effort to obtain the complete
      nucleotide sequence of the complex genomes of many micro-organisms. In this post
      genomic era, based on the availability of the entire genome sequence of an
      organism, three new disciplines of molecular biology have emerged: genomics,
      transcriptional profiling and proteomics. All these technologies have the
      potential to accelerate the process of identifying protective protein antigens as
      subunit vaccine targets as well as validating and extending the range of
      available candidate antigens. The progress of these technologies has led to the
      origination of the science of bioinformatics for management and critical
      evaluation of the large amount of information generated. Although genomics,
      transcriptional profiling and proteomics are each based on different principles,
      there is considerable synergy between them. Appropriate application of any one,
      or a combination of two or more of these approaches, coupled with bioinformatics,
      would allow identification of a short-list of vaccine candidates from the entire
      list of several hundreds to thousands of proteins encoded by the genome. These
      candidates would then require usual channelling through the subsequent process
      involving recombinant expression, purification and testing for immunogenicity and
      protective efficacy.

PMID- 11214259
TI  - On becoming a virtual editor.

PMID- 11214258
TI  - Characterization of saccharide-CRM197 conjugate vaccines.
AB  - A seven-valent pneumococcal conjugate and a Group C Meningococcal conjugate are
      at the late stage of development. Clinical studies have demonstrated the efficacy
      and safety of these vaccines and licensure of these vaccines will be approved in
      the near future. Several new techniques have been proposed for characterizing
      polysaccharide-protein conjugates and their production intermediates. We are
      evaluating some of these new techniques, particularly NMR and MALLS, to determine
      whether or not they provide useful information for conjugate production. In the
      production of polysaccharide protein conjugates, the degree of saccharide
      activation, location of activation site, and the molecular weight of activated
      saccharides may typically be determined. In our evaluation, techniques such as
      NMR and MALLS may have a limited applicability for testing polysaccharides and
      activated saccharides.

PMID- 11214260
TI  - Continuous cardiac output monitoring system.
AB  - A continuous cardiac output monitoring system has been developed in the
      laboratory to allow the real-time measurement of the cardiac output. This form of
      continuous cardiac output measurement allows the doctor to view the beat-to-beat
      cardiac output and can be employed to measure artery constrictions as well. The
      sensor comprises a laser Doppler velocimeter and an impedance measurement unit.
      The laser Doppler velocimeter is capable of measuring bi-directional blood flow
      within the vessel while the impedance measurement unit determines the cross
      sectional area of the vessel. In laboratory tests, it was demonstrated on a heart
      lung machine that the product of the two parameters measured is proportional to
      the actual flow volume of up to 6 lmin(-1) with a mean percentage error of 12.4%
      and a mean square error of 0.09 (using the lmin(-1) scale) were obtained. This is
      significantly more accurate than the measurement made using the thermodilution
      cathether.

PMID- 11214261
TI  - A knowledge-based technique for automated detection of ischaemic episodes in long
      duration electrocardiograms.
AB  - A novel method for the detection of ischaemic episodes in long duration ECGs is
      proposed. It includes noise handling, feature extraction, rule-based beat
      classification, sliding window classification and ischaemic episode
      identification, all integrated in a four-stage procedure. It can be executed in
      real time and is able to provide explanations for the diagnostic decisions
      obtained. The method was tested on the ESC ST-T database and high scores were
      obtained for both sensitivity and positive predictive accuracy (93.8% and 78.5%
      respectively using aggregate gross statistics, and 90.7% and 80.7% using
      aggregate average statistics).

PMID- 11214262
TI  - Circadian rhythm changes in heart rate variability during chronic sound stress.
AB  - To study the circadian rhythm changes of the heart rate variability (HRV) during
      chronic sound stress, Wistar rats were implanted with telemetry transmitters and
      exposed to chronic ultrasound stress for 14 days. The heart rate, mean R-R
      intervals (mean R-R) and body temperature were monitored hourly. The spectra of
      five-minute heart rate variability were plotted on a log-log scale of frequency
      versus power spectral density, and the spectral exponent beta of the regression
      line of this plot was calculated. The exponent beta, heart rate (HR) and body
      temperature recorded hourly were plotted and fitted to sine curves to observe the
      circadian rhythm of these parameters. The correlation coefficient of the fitted
      sine curves in beta decreased from 0.644 in the control period to 0.105 in the
      stress period, indicating that the rhythm of beta deceased during stress. This
      did not occur in the other two parameters, demonstrating that the HRV exponent
      can assess chronic stress.

PMID- 11214263
TI  - Compact long-term recorder for the transabdominal foetal and maternal
      electrocardiogram.
AB  - Foetal heart rate (FHR) monitoring is a proven means of assessing foetal health
      during the antenatal period. Currently, the only widely available instrumentation
      for producing these data is based on Doppler ultrasound, a technology that is
      unsuitable for long-term use. For nearly a century, it has been known that the
      foetal electrocardiogram (FECG) can be detected using electrodes placed on the
      maternal abdomen. Although these signals suggest an alternative means of FHR
      derivation, their use has been limited owing to problems of poor signal-to-noise
      ratio. However, the eminent suitability of the transabdominal FECG for long-term
      FHR monitoring has suggested that perseverance with the technique would be
      worthwhile. The paper describes the design, construction and use of a compact,
      long-term recorder of three channels of 24 h antenatal transabdominal data.
      Preliminary use of the recorder in around 400 short recording sessions
      demonstrates that FHR records of equivalent quality to those from Doppler
      ultrasound-based instruments can be extracted from such data. The success of FHR
      derivation is, on average, around 65% of the recording period from around 20
      weeks gestation (although this figure is reduced from around 28-32 weeks, and the
      success rates exhibit a wide range when individual subjects are considered).
      These results demonstrate that the technique offers, not only a means of
      acquiring long-term FHR data that are problematic to obtain by other means, but
      also a more patient-friendly alternative to the Doppler ultrasound technique.

PMID- 11214264
TI  - Temperature and perfusion responses of muscle and lung tissue during chronic
      heating in vivo.
AB  - For the first time, both temperature and perfusion responses have been obtained
      from in vivo studies of chronically heated lung and muscle tissue of calves. In
      each tissue, the spatial temperature distribution was measured by thermistors
      placed in needles at several distances from an implanted heated disc. A perfusion
      parameter was defined for a bioheat transfer model that describes temperature
      dynamics with distance from the heated disc. Estimates of perfusion were obtained
      by a least-squares fit of the model output to a step change in heat flux. Except
      for short transient experiments several times a week, a constant heat flux of
      0.04, 0.06 or 0.08 Wcm(-2) was maintained at the disc surface for up to seven
      weeks. At the higher heat fluxes, the steady-state tissue temperature decreased
      with heating duration. Also, the characteristic time constants of the tissues
      decreased with heating duration. Muscle perfusion showed a statistically
      significant increase during chronic heating. Tissue adapts to chronic heating
      above 42 degrees C by allowing more capillary blood flow that increases heat loss
      to reduce tissue temperature.

PMID- 11214265
TI  - Otoacoustic emissions and improved pass/fail separation using wavelet analysis
      and time windowing.
AB  - A new method is presented for the purpose of improving pass/fail separation
      during transient evoked otoacoustic emission (TEOAE) hearing screening. The
      method combines signal decomposition in scales using the discrete wavelet
      transform, non-linear denoising and scale-dependent time windowing. The cross
      correlation coefficient between two subaveraged, processed TEOAE signals is used
      as a pass/fail criterion and assessed in relation to the pure-tone, mean hearing
      level. The performance is presented in terms of receiver operating
      characteristics for a database of 5,214 individuals. The results show that the
      specificity improves from 68% to 83% at a sensitivity of 90% when compared with
      the conventional wave reproducibility parameter.

PMID- 11214266
TI  - Microprocessor-based gait analysis system to retrain Trendelenburg gait.
AB  - A microprocessor-based gait analysis system is described that uses two
      electromyogram (EMG) amplifiers, two foot switches and an audio feedback device
      to allow the retraining of one type of improper gait, where the hip abductors
      (gluteus medius muscles) are weak on one side of the body, causing the opposite
      hip to drop during the swing phase of gait (Trendelenburg gait). As the
      abnormality is strictly on one side of the body in most people, the circuitry is
      minimised, as gait can be analysed by only comparing muscle activity in the
      affected gluteus medius muscle with that in the unaffected gluteus medius muscle,
      through the EMG. Two foot contact switches are used to help assess timing of the
      step cycle. If gait is different on the two sides of the body, an audio cue
      directs the patient to correct the abnormality by increasing activity on the
      affected side. The device is tested on five patients. Trendelenburg gait is
      reduced by an average of 29 degrees through the use of the device. The average
      stride length at the beginning of the study is 0.32 +/- 0.3 m. By the end of the
      study, the stride length is increased to 0.45 +/- 0.2 m for the entire group of
      five subjects. The speed of gait has increased from 1.6 +/- 0.4 kmh(-1) to 3.1 +/
      0.5km h(-1).

PMID- 11214267
TI  - Electric current generated by ultrasonically induced Lorentz force in biological
      media.
AB  - The ions of solutions exposed to the propagation of ultrasound in the presence of
      a magnetic field experience Lorentz force. Their movement gives rise to a local
      electric current density, which is proportional to the electric conductivity of
      the medium. In vitro assessment of this current is performed using simple models
      of biological media. A constant magnetic field of 0.35 T and 500 kHz pulsed
      ultrasound are used. The sensing electrodes are exposed to neither the pressure
      wave nor the magnetic field, thus ensuring that the signal is not due to any
      undesirable electrode effect. The experimental results confirm that the current
      is proportional to the electrical conductivity of the medium. The changes in the
      measured current against the width of the measurement chamber show that the
      electrodes only collect a fraction of the current created within the medium. The
      magnitude of the measured current is 50nA in a saline solution of 0.5 S/m
      conductivity. The technique enabled the determination of the conductivity of a
      porcine blood sample against haematocrit. It is concluded that this type of
      measurement has the potential to allow the electrical conductivity of a medium to
      be determined using ultrasound.

PMID- 11214268
TI  - Image analysis of quick phase eye movements in nystagmus with high-speed video
      system.
AB  - There are several methods of measuring horizontal, vertical and torsional
      nystagmus for the diagnosis of vertigo. Using Frentzel glasses,
      electronystagmography (ENG) and video-oculography (VOG) are common methods for
      observing nystagmus. In this study, a high-speed video camera is used to analyse
      high-speed eye movements, including three components of nystagmus, in order to
      monitor precisely the amplitude and velocity of the quick phase of nystagmus. To
      confirm the accuracy of the analysis, images of optokinetic nystagmus (OKN)
      evoked by a stimulating device were analysed. We obtained a high linearity with
      regard to the relation between the horizontal nystagmus amplitude detected with
      the high-speed video system and ENG (R2= 0.99). On comparison of the maximum
      velocities detected with 30Hz and with 250 Hz at each amplitude, the velocities
      calculated at 30Hz were smaller than those calculated at 250 Hz. At an amplitude
      of 5 degrees , the 30 Hz velocity decreased by 50%, while a decrease of 35% was
      observed at 15 degrees. The vertical nystagmus data obtained using high-speed VOG
      was different in appearance to that obtained using ENG. The torsional component
      of nystagmus was also measured, and was recorded in the form of a large number of
      sampling points.

PMID- 11214269
TI  - A method for detecting myocardial abnormality by using a total current-vector
      calculated from ST-segment deviation of a magnetocardiogram signal.
AB  - A simple method to determine the state of ischaemia or fibrosis of myocardial
      cells has been developed. This method uses the ST wave of 64-channel
      magnetocardiogram (MCG) signals to calculate three parameters from the current
      arrow map of the normal component signal of the MCG. One parameter is a total
      current vector that is obtained through summation of all current arrows. Another
      is a variance current vector calculated from the differential vector of two total
      current vectors at different times. The third is a flatness factor between the
      magnitude of the total current vector and the variance current vector. The three
      parameters are independent of the distance between the heart and the
      gradiometers. We measured the MCG signals of 29 healthy subjects, twenty patients
      with coronary artery disease (ten with previous myocardial infarction (MI) and
      ten with angina pectoris (AP)), and eight patients with cardiomyopathy (four with
      hypertrophic cardiomyopathy (HCM), three with dilated cardiomyopathy (DCM), and
      one with restrictive cardiomyopathy (RCM)). With our method, none of the healthy
      subjects tested positive for myocardial abnormalities, while 80% of the MI
      patients, 50% of the AP patients, and 100% of the cardiomyopathy patients tested
      positive. Although further testing is needed, we feel this simple technique
      enables easy diagnosis of myocardial damage.

PMID- 11214270
TI  - A method for detecting myocardial abnormality by using a current-ratio map
      calculated from an exercise-induced magnetocardiogram.
AB  - A method for making a current-ratio map to determine the ischaemic area of angina
      pectoris (AP) patients has been developed. This method uses a current-arrow map
      calculated using a ORS wave from 64-channel magnetocardiogram (MCG) signals. The
      current-ratio map can be calculated from the ratio of an exercise-induced current
      vector to an at-rest current vector. The MCG signals of eight patients with
      angina pectoris (AP) (six patients with effort AP and two patients with variant
      AP) and four healthy volunteers were measured before and after a two-step
      exercise test. The current-ratio maps of the six patients with effort AP showed
      three distinct patterns: a left-circumflex-artery (LCX) pattern; a right-coronary
      artery (RCA) pattern; and a left-anterior-descending (LAD) pattern. The maximum
      current ratios of these three patterns differed from those of normal patterns.
      The patterns of two patients with variant AP were similar to normal patterns.
      Furthermore, a comparison of the current-ratio map before and after percutaneous
      transluminal-coronary-angioplasty (PTCA) treatment indicated that the cardiac
      ischaemia was reduced in all patients. An appropriate criterion to diagnose
      abnormality in a patient with an ischaemic myocardial area seems to be a maximum
      current ratio exceeding 0.4 to 0.5. Based on these preliminary results, it is
      believed that the location of an ischaemic area (the coronary artery part) can be
      estimated by using the ischaemic current-ratio map pattern.

PMID- 11214272
TI  - Modelling the sampling volume for skin blood oxygenation measurements.
AB  - The absolute quantified measurement of haemoglobin skin blood saturation from
      collected reflectance spectra of the skin is complicated by the fact that the
      blood content of tissues can vary both in the spatial distribution and in the
      amount. These measurements require an understanding of which vascular bed is
      primarily responsible for the detected signal. Knowing the spatial detector depth
      sensitivity makes it possible to find the best range of different probe
      geometries for the measurements of signal from the required zones and group of
      vessels inside the skin. To facilitate this, a Monte Carlo simulation has been
      developed to estimate the sampling volume offered by fibre-optic probes with a
      small source-detector spacing (in the current report 250 microm, 400 microm and
      800 microm). The optical properties of the modelled medium are taken to be the
      optical properties of the Caucasian type of skin tissue in the visible range of
      the spectrum. It is shown that, for a small source-detector separation (800
      microm and smaller), rough boundaries between layers of different refractive
      index can play a significant role in skin optics. Wavy layer interfaces produce a
      deeper and more homogeneous distribution of photons within the skin and tend to
      suppress the direct channelling of photons from source to detector. The model
      predicts that a probe spacing of 250 microm samples primarily epidermal layers
      and papillary dermis, whereas spacings of 400-800 microm sample upper blood net
      dermis and dermis.

PMID- 11214271
TI  - Volume conductor effects on the spatial resolution of magnetic fields and
      electric potentials from gastrointestinal electrical activity.
AB  - An analysis of the relative capabilities of methods for magnetic and electric
      detection of gastrointestinal electrical activity is presented. The model
      employed is the first volume conductor model for magnetic fields from GEA to
      appear in the literature. A mathematical model is introduced for the electric
      potential and magnetic field from intestinal electrical activity in terms of the
      spatial filters that relate the bioelectric sources with the external magnetic
      fields and potentials. The forward spatial filters are low-pass functions of
      spatial frequency, so more superficial external fields and potentials contain
      less spatial information than fields and potentials near the source. Inverse
      spatial filters, which are reciprocals of the forward filters, are high-pass
      functions and must be regularised by windowing. Because of the conductivity
      discontinuities introduced by low-conductivity fat layers in the abdomen, the
      electric potentials recorded outside these layers required more regularisation
      than the magnetic fields, and thus, the spatial resolution of the magnetic fields
      from intestinal electrical activity is higher than the spatial resolution of the
      external potentials. In this study, two smooth muscle sources separated by 5cm
      were adequately resolved magnetically, but not resolved electrically. Thus,
      sources are more accurately localized and imaged using magnetic measurements than
      using measurements of electric potential.

PMID- 11214273
TI  - Evaluation of the ability to make non-invasive estimation of muscle contractile
      properties on the basis of the muscle belly response.
AB  - The histochemical and biomechanical relationships of limb muscles are examined in
      two groups of 15 men aged between 17 and 40 years. Seven muscles are chosen:
      biceps brachii, triceps brachii (TB), flexor digitorum superficialis, extensor
      digitorum, biceps femoris, tibialis anterior and gastrocnemius caput mediale
      (GCM). The aim of the preliminary study is to evaluate an alternative method
      based on a tensiomyographic (TMG) non-invasive measurement technique. The
      percentage of type I muscle fibres obtained with the histochemical method is 2.2
      times higher for the slowest measured muscle (GCM) than for the fastest (TB). The
      contraction time of a muscle belly twitch response measured by TMG is 1.9 times
      higher for GCM than for TB. Statistical analysis of the data obtained by
      tensiomyographic and histochemical techniques shows a significant correlation
      between the contraction time of muscle response measured by TMG and the
      percentage of type I muscle fibres (correlation coefficient equals 0.93). Results
      of the study suggest using the TMG measuring technique as a basis for the
      estimation of the percentage of type I muscle fibres.

PMID- 11214274
TI  - Systematic methodology for the design of a flexible keel for energy-storing
      prosthetic feet.
AB  - An effective design method is suggested for a flexible keel design for energy
      storing prosthetic feet (ESPF). The basic, two-dimensional shape of the keel is
      based on anthropometric data and normal gait analysis available in the
      literature. Cost function is defined for the performance evaluation of the keel.
      Five factors and five levels of their effect on the performance of the keel are
      established. By use of an orthogonal array table, 25 trials of dynamic
      simulations of prosthetic walking are designed, from among 3,125 possible
      combinations, dramatically reducing the number of total simulations needed to
      examine sufficiently the contribution of each factor to cost function. A
      prosthetic walking model is built, and a dynamic simulation of prosthetic walking
      is performed using the finite element method. The contribution of each factor to
      cost function is investigated by an analysis of variance (ANOVA), and the average
      main effects of factors for cost function are calculated. The optimum combination
      of factor levels is obtained by minimisation of cost function. To examine the
      structural safety of the keel, the deformation and stress distribution of the
      keel are investigated by static analysis, and failure indices are calculated by
      three failure criteria. Finally, the optimum flexible keel is designed with
      increased energy storage capacity, without failure, and suitable for more active
      prosthetic walking; the recoverable strain energy stored in the optimum ESPF keel
      is 25.8J.

PMID- 11214275
TI  - Automatic recognition of vertebral landmarks in fluoroscopic sequences for
      analysis of intervertebral kinematics.
AB  - Intervertebral kinematics closely relates to the functionality of the spinal
      segments. Direct measurement of the intervertebral kinematics in vivo is very
      problematic. The use of a fluoroscopic device can provide continuous screening of
      the lumbar tract during patient spontaneous motion, with an acceptable, low X-ray
      dose. The kinematic analysis is intended to be limited to planar motion.
      Kinematic parameters are computed from vertebral landmarks on each frame of the
      image sequence. Landmarks are normally selected manually in spite of the fact
      that this is subjective, tedious to perform and regarded as one of the major
      contributors to errors in the computed kinematic parameters. The aim of this work
      is to present an innovative method for the automatic recognition of vertebral
      landmarks throughout a fluoroscopic image sequence to provide an objective and
      more precise quantification of intervertebral kinematics. The recognition
      procedure is based upon comparing vertebral features in two adjacent frames by
      means of a cross-correlation index, which is also robust despite the low signal
      to-noise ratio of the lumbar fluoroscopic images. To provide a quantitative
      assessment of this method a calibration model was used which consisted of two
      lumbar vertebrae linked by a universal joint. The reliability and accuracy of the
      kinematic measurements have been investigated. The errors are of the order of a
      millimetre for the localisation of the intervertebral centre of rotation and
      tenths of a degree for the intervertebral angle. Error analysis suggests that
      this method improves the accuracy of the intervertebral kinematic calculations
      and has the potential to automate the selection of anatomical landmarks.

PMID- 11214276
TI  - A fast method for calibrating video-based motion analysers using only a rigid
      bar.
AB  - Video-camera systems are widely used in biomechanics and clinical fields to
      measure the 3D kinematic measurements of human motion. To be used, they need to
      be calibrated, that is the parameters which geometrically define the cameras have
      to be determined. It is shown here how this can be achieved by surveying a rigid
      bar in motion inside the working volume, and in a very short time: less than 15 s
      on a Pentium III. The exterior parameters are estimated through the coplanarity
      constraint, the camera focal lengths through the properties of epipolar geometry
      and the principal points with a fast evolutionary optimisation which guarantees
      convergence when the initial principal points cannot be adequately estimated. The
      method has been widely tested on simulated and real data. Results show that its
      accuracy is comparable with that obtained using methods based on points of known
      3D coordinates (DLT): 0.37 mm RMS error over a volume with a diagonal
      approximately 1.5 m. A preferential absolute reference system is obtained from
      the same bar motion data and is used to guide an intelligent decimation of the
      data. Finally, the role that the principal points play in achieving a high
      accuracy, which is questioned in the computer vision domain, is assessed through
      simulations.

PMID- 11214277
TI  - Automatic segmentation algorithm for the extraction of lumen region and boundary
      from endoscopic images.
AB  - A new segmentation algorithm for lumen region detection and boundary extraction
      from gastro-intestinal (GI) images is presented. The proposed algorithm consists
      of two steps. First, a preliminary region of interest (ROI) representing the GI
      lumen is segmented by an adaptive progressive thresholding (APT) technique. Then,
      an adaptive filter, the Iris filter, is applied to the ROI to determine the
      actual region. It has been observed that the combined APT-Iris filter technique
      can enhance and detect the unclear boundaries in the lumen region of GI images
      and thus produces a more accurate lumen region, compared with the existing
      techniques. Experiments are carried out to determine the maximum error on the
      extracted boundary with respect to an expert-annotated boundary technique.
      Investigations show that, based on the experimental results obtained from 50
      endoscopic images, the maximum error is reduced by up to 72 pixels for a 256 x
      256 image representation compared with other existing techniques. In addition, a
      new boundary extraction algorithm, based on a heuristic search on the
      neighbourhood pixels, is employed to obtain a connected single pixel width outer
      boundary using two preferential sequence windows. Experimental results are also
      presented to justify the effectiveness of the proposed algorithm.

PMID- 11214278
TI  - A new approach to mechanical simulation of lung behaviour: pressure-controlled
      and time-related piston movement.
AB  - A mechanical lung simulator is described (an extension of a previous mechanical
      simulator) which simulates normal breathing and artificial ventilation in
      patients. The extended integration of hardware and software offers many new
      possibilities and advantages over the former simulator. The properties of
      components which simulate elastance and airway resistance of the lung are defined
      in software rather than by the mechanical properties of the components alone.
      Therefore, a more flexible simulation of non-linear behaviour and the cross-over
      effects of lung properties is obtained. Furthermore, the range of lung compliance
      is extended to simulate patients with emphysema. The dependency of airway
      resistance on lung recoil pressure and transmural pressure of the airways can
      also be simulated. The new approach enables one to incorporate time-related
      mechanics such as the influence of lung viscosity or cardiac oscillation. The
      different relations defined in the software can be changed from breath to breath.
      Three simulations are presented: (1) computer-controlled expiration in the
      artificially ventilated lung; (2) simulation of normal breathing; and (3)
      simulation of viscoelastance and cardiac influences during artificial
      ventilation. The mechanical simulator provides a reproducible and flexible
      environment for testing new software and equipment in the lung function
      laboratory and in intensive care, and can be used for instruction and training.

PMID- 11214280
TI  - Greece should abandon a short-sighted policy.

PMID- 11214281
TI  - Post-genomic cultures.

PMID- 11214282
TI  - Ethics watchdog to oversee drugs trials in Third World.

PMID- 11214279
TI  - Neural morphological effects of long-term implantation of the self-sizing spiral
      cuff nerve electrode.
AB  - The paper reports on the histological effects of chronic implantation of self
      sizing spiral cuff nerve electrodes on the cat sciatic nerve. The implantation
      period is about 4.4 months. Four different experimental conditions are evaluated:
      control, sham, bare cuff (cuffs without contacts and leads) and full cuff. The
      total number of axons in the nerves of the control group is compared with the
      three other groups. The surface occupied by collagen fibres in the nerve section,
      perineurium thickness, fibre diameter and myelin thickness are also measured. The
      average number of axons in the control nerves is found to be 16,416 (+/- 1,509)
      and does not differ significantly from the three other groups (p > 0.1). Collagen
      measurements show an extrafascicular epineurial fibrosis in the two implanted
      groups that is found to be significantly different (p < 0.05). No differences are
      encountered in the perineurium thickness analysis. Fibre diameter distributions
      show a regular bimodal pattern for all groups. Centrality (mean and Pm) and
      dispersion statistics (P25 and P75) extracted from fibre diameter distributions
      do not reveal significant differences. Myelin thickness distributions are also
      similar for all groups, as well as centrality and dispersion statistics. The
      present morphometrical results suggest that the effects produced by a chronic
      spiral cuff implant on this animal model are negligible.

PMID- 11214284
TI  - Weapons labs escape FBI action.

PMID- 11214283
TI  - Hughes Institute will put down roots to develop research tools.

PMID- 11214285
TI  - Journal will publish accused scientist's work.

PMID- 11214286
TI  - Canada pours funds into health research.

PMID- 11214287
TI  - BSE crisis sinks German public biotech programme.

PMID- 11214288
TI  - Poor coordination 'wastes US research into global change'.

PMID- 11214289
TI  - Bank raids malaria centre in dispute over landlord's debt.

PMID- 11214290
TI  - Designer rice to combat diet deficiencies makes its debut.

PMID- 11214291
TI  - Commercial sector scores success with whole rice genome.

PMID- 11214292
TI  - Bill Gates provides funding boost to AIDS vaccine.

PMID- 11214294
TI  - Informatics. Digital history.

PMID- 11214293
TI  - Hazard management. Taming Africa's killer lake.

PMID- 11214295
TI  - Changing patent laws could be a healthy move to combat resistance.

PMID- 11214296
TI  - We need both computer models and experiments.

PMID- 11214298
TI  - Back to the future from 1888.

PMID- 11214297
TI  - Why Pauling didn't solve the structure of DNA.

PMID- 11214299
TI  - A never-ending story.

PMID- 11214301
TI  - Fluid dynamics. That sinking feeling.

PMID- 11214300
TI  - Fusion needs more than SNAREs.

PMID- 11214303
TI  - A laser that turns down the heat.

PMID- 11214302
TI  - Functional genomics. Silent genes given voice.

PMID- 11214304
TI  - Structural biology. Pumping DNA.

PMID- 11214305
TI  - Ultrafast colour displays.

PMID- 11214306
TI  - Oceanography. The Rossby rototiller.

PMID- 11214307
TI  - Vascular biology. Targeted delivery of nitric oxide.

PMID- 11214308
TI  - A fern that hyperaccumulates arsenic.

PMID- 11214309
TI  - Neuroperception. Superior auditory spatial tuning in conductors.

PMID- 11214310
TI  - Trans-complex formation by proteolipid channels in the terminal phase of membrane
      fusion.
AB  - SNAREs (soluble N-ethylmaleimide-sensitive factor attachment protein receptors)
      and Rab-GTPases, together with their cofactors, mediate the attachment step in
      the membrane fusion of vesicles. But how bilayer mixing--the subsequent core
      process of fusion--is catalysed remains unclear. Ca2+/calmodulin controls this
      terminal process in many intracellular fusion events. Here we identify V0, the
      membrane-integral sector of the vacuolar H+-ATPase, as a target of calmodulin on
      yeast vacuoles. Between docking and bilayer fusion, V0 sectors from opposing
      membranes form complexes. V0 trans-complex formation occurs downstream from trans
      SNARE pairing, and depends on both the Rab-GTPase Ypt7 and calmodulin. The
      maintenance of existing complexes and completion of fusion are independent of
      trans-SNARE pairs. Reconstituted proteolipids form sealed channels, which can
      expand to form aqueous pores in a Ca2+/calmodulin-dependent fashion. V0 trans
      complexes may therefore form a continuous, proteolipid-lined channel at the
      fusion site. We propose that radial expansion of such a protein pore may be a
      mechanism for intracellular membrane fusion.

PMID- 11214311
TI  - Rapid collisional evolution of comets during the formation of the Oort cloud.
AB  - The Oort cloud of comets was formed by the ejection of icy planetesimals from the
      region of giant planets--Jupiter, Saturn, Uranus and Neptune--during their
      formation. Dynamical simulations have previously shown that comets reach the Oort
      cloud only after being perturbed into eccentric orbits that result in close
      encounters with the giant planets, which then eject them to distant orbits about
      10(4) to 10(5) AU from the Sun (1 AU is the average Earth-Sun distance). All of
      the Oort cloud models constructed until now simulate its formation using only
      gravitational effects; these include the influence of the Sun, the planets and
      external perturbers such as passing stars and Galactic tides. Here we show that
      physical collisions between comets and small debris play a fundamental and
      hitherto unexplored role throughout most of the ejection process. For standard
      models of the protosolar nebula (starting with a minimum-mass nebula) we find
      that collisional evolution of comets is so severe that their erosional lifetimes
      are much shorter than the timescale for dynamical ejection. It therefore appears
      that collisions will prevent most comets escaping from most locations in the
      region of the giant planets until the disk mass there declines sufficiently that
      the dynamical ejection timescale is shorter than the collisional lifetime. One
      consequence is that the total mass of comets in the Oort cloud may be less than
      currently believed.

PMID- 11214312
TI  - Two coexisting vortex phases in the peak effect regime in a superconductor.
AB  - The critical current in the vortex phase of a type-II superconductor such as
      NbSe2 displays a striking anomaly in the vicinity of the superconductor-to-normal
      metal transition. Instead of going to zero smoothly, it rebounds to a sharp and
      pronounced maximum, just before vanishing at the transition. This counter
      intuitive phenomenon, known as the peak effect, has remained an unsolved problem
      for 40 years. Here we use a scanning a.c. Hall microscope to visualize the real
      space distribution of the critical current in NbSe2. We show that in the peak
      effect regime two distinct vortex-matter phases with intrinsically different
      pinning strengths coexist on a macroscopic scale. The composition of the two
      phase mixture and the transformation of one phase into another are responsible
      for the history effects and anomalous voltage response commonly seen when
      external parameters such as temperature, magnetic field or transport current are
      varied. We argue that the observed phase coexistence is, in fact, the hallmark of
      a disorder-driven non-thermal phase transition.

PMID- 11214313
TI  - An effective gravitational temperature for sedimentation.
AB  - The slow sedimentation of suspensions of solid particles in a fluid results in
      complex phenomena that are poorly understood. For a low volume fraction (phi) of
      particles, long-range hydrodynamic interactions result in surprising spatial
      correlations in the velocity fluctuations; these are reminiscent of turbulence,
      even though the Reynolds number is very low. At higher values of phi, the
      behaviour of sedimentation remains unclear; the upward back-flow of fluid becomes
      increasingly important, while collisions and crowding further complicate inter
      particle interactions. Concepts from equilibrium statistical mechanics could in
      principle be used to describe the fluctuations and thereby provide a unified
      picture of sedimentation, but one essential ingredient--an effective temperature
      that provides a mechanism for thermalization--is missing. Here we show that the
      gravitational energy of fluctuations in particle number can act as an effective
      temperature. Moreover, we demonstrate that the high-phi behaviour is in fact
      identical to that at low phi, provided that the suspension viscosity and
      sedimentation velocity are scaled appropriately, and that the effects of particle
      packing are included.

PMID- 11214314
TI  - Pumping of nutrients to ocean surface waters by the action of propagating
      planetary waves.
AB  - Primary productivity in the oceans is limited by the lack of nutrients in surface
      waters. These nutrients are mostly supplied from nutrient-rich subsurface waters
      through upwelling and vertical mixing, but in the ocean gyres these mechanisms do
      not fully account for the observed productivity. Recently, the upward pumping of
      nutrients, through the action of eddies, has been shown to account for the
      remainder of the primary productivity; however, these were regional studies which
      focused on mesoscale (100-km-scale) eddies. Here we analyse remotely sensed
      chlorophyll and sea-surface-height data collected over two years and show that
      1,000-km-scale planetary waves, which propagate in a westward direction in the
      oceans, are associated with about 5 to 20% of the observed variability in
      chlorophyll concentration (after low-frequency and large-scale variations are
      removed from the data). Enhanced primary production is the likely explanation for
      this observation, and if that is the case, propagating disturbances introduce
      nutrients to surface waters on a global scale--similar to the nutrient pumping
      that occurs within distinct eddies.

PMID- 11214315
TI  - Aerogeophysical measurements of collapse-prone hydrothermally altered zones at
      Mount Rainier volcano.
AB  - Hydrothermally altered rocks can weaken volcanoes, increasing the potential for
      catastrophic sector collapses that can lead to destructive debris flows.
      Evaluating the hazards associated with such alteration is difficult because
      alteration has been mapped on few active volcanoes and the distribution and
      severity of subsurface alteration is largely unknown on any active volcano. At
      Mount Rainier volcano (Washington, USA), collapses of hydrothermally altered
      edifice flanks have generated numerous extensive debris flows and future
      collapses could threaten areas that are now densely populated. Preliminary
      geological mapping and remote-sensing data indicated that exposed alteration is
      contained in a dyke-controlled belt trending east-west that passes through the
      volcano's summit. But here we present helicopter-borne electromagnetic and
      magnetic data, combined with detailed geological mapping, to show that
      appreciable thicknesses of mostly buried hydrothermally altered rock lie mainly
      in the upper west flank of Mount Rainier. We identify this as the likely source
      for future large debris flows. But as negligible amounts of highly altered rock
      lie in the volcano's core, this might impede collapse retrogression and so limit
      the volumes and inundation areas of future debris flows. Our results demonstrate
      that high-resolution geophysical and geological observations can yield
      unprecedented views of the three-dimensional distribution of altered rock.

PMID- 11214316
TI  - Unexpected diversity of small eukaryotes in deep-sea Antarctic plankton.
AB  - Phylogenetic information from ribosomal RNA genes directly amplified from the
      environment changed our view of the biosphere, revealing an extraordinary
      diversity of previously undetected prokaryotic lineages. Using ribosomal RNA
      genes from marine picoplankton, several new groups of bacteria and archaea have
      been identified, some of which are abundant. Little is known, however, about the
      diversity of the smallest planktonic eukaryotes, and available information in
      general concerns the phytoplankton of the euphotic region. Here we recover
      eukaryotes in the size fraction 0.2-5 microm from the aphotic zone (250-3,000 m
      deep) in the Antarctic polar front. The most diverse and relatively abundant were
      two new groups of alveolate sequences, related to dinoflagellates that are found
      at all studied depths. These may be important components of the microbial
      community in the deep ocean. Their phylogenetic position suggests a radiation
      early in the evolution of alveolates.

PMID- 11214317
TI  - Oceanic 18S rDNA sequences from picoplankton reveal unsuspected eukaryotic
      diversity.
AB  - Picoplankton--cells with a diameter of less than 3 microm--are the dominant
      contributors to both primary production and biomass in open oceanic regions.
      However, compared with the prokaryotes, the eukaryotic component of picoplankton
      is still poorly known. Recent discoveries of new eukaryotic algal taxa based on
      picoplankton cultures suggest the existence of many undiscovered taxa.
      Conventional approaches based on phenotypic criteria have limitations in
      depicting picoplankton composition due to their tiny size and lack of distinctive
      taxonomic characters. Here we analyse, using an approach that has been very
      successful for prokaryotes but has so far seldom been applied to eukaryotes, 35
      full sequences of the small-subunit (18S) ribosomal RNA gene derived from a
      picoplanktonic assemblage collected at a depth of 75 m in the equatorial Pacific
      Ocean, and show that there is a high diversity of picoeukaryotes. Most of the
      sequences were previously unknown but could still be assigned to important marine
      phyla including prasinophytes, haptophytes, dinoflagellates, stramenopiles,
      choanoflagellates and acantharians. We also found a novel lineage, closely
      related to dinoflagellates and not previously described.

PMID- 11214318
TI  - Parallel adaptive radiations in two major clades of placental mammals.
AB  - Higher level relationships among placental mammals, as well as the historical
      biogeography and morphological diversification of this group, remain unclear.
      Here we analyse independent molecular data sets, having aligned lengths of DNA of
      5,708 and 2,947 base pairs, respectively, for all orders of placental mammals.
      Phylogenetic analyses resolve placental orders into four groups: Xenarthra,
      Afrotheria, Laurasiatheria, and Euarchonta plus Glires. The first three groups
      are consistently monophyletic with different methods of analysis. Euarchonta plus
      Glires is monophyletic or paraphyletic depending on the phylogenetic method. A
      unique nine-base-pair deletion in exon 11 of the BRCA1 gene provides additional
      support for the monophyly of Afrotheria, which includes proboscideans, sirenians,
      hyracoids, tubulidentates, macroscelideans, chrysochlorids and tenrecids.
      Laurasiatheria contains cetartiodactyls, perissodactyls, carnivores, pangolins,
      bats and eulipotyphlan insectivores. Parallel adaptive radiations have occurred
      within Laurasiatheria and Afrotheria. In each group, there are aquatic, ungulate
      and insectivore-like forms.

PMID- 11214319
TI  - Molecular phylogenetics and the origins of placental mammals.
AB  - The precise hierarchy of ancient divergence events that led to the present
      assemblage of modern placental mammals has been an area of controversy among
      morphologists, palaeontologists and molecular evolutionists. Here we address the
      potential weaknesses of limited character and taxon sampling in a comprehensive
      molecular phylogenetic analysis of 64 species sampled across all extant orders of
      placental mammals. We examined sequence variation in 18 homologous gene segments
      (including nearly 10,000 base pairs) that were selected for maximal phylogenetic
      informativeness in resolving the hierarchy of early mammalian divergence.
      Phylogenetic analyses identify four primary superordinal clades: (I) Afrotheria
      (elephants, manatees, hyraxes, tenrecs, aardvark and elephant shrews); (II)
      Xenarthra (sloths, anteaters and armadillos); (III) Glires (rodents and
      lagomorphs), as a sister taxon to primates, flying lemurs and tree shrews; and
      (IV) the remaining orders of placental mammals (cetaceans, artiodactyls,
      perissodactyls, carnivores, pangolins, bats and core insectivores). Our results
      provide new insight into the pattern of the early placental mammal radiation.

PMID- 11214320
TI  - Horsetails and ferns are a monophyletic group and the closest living relatives to
      seed plants.
AB  - Most of the 470-million-year history of plants on land belongs to bryophytes,
      pteridophytes and gymnosperms, which eventually yielded to the ecological
      dominance by angiosperms 90 Myr ago. Our knowledge of angiosperm phylogeny,
      particularly the branching order of the earliest lineages, has recently been
      increased by the concurrence of multigene sequence analyses. However,
      reconstructing relationships for all the main lineages of vascular plants that
      diverged since the Devonian period has remained a challenge. Here we report
      phylogenetic analyses of combined data--from morphology and from four genes--for
      35 representatives from all the main lineages of land plants. We show that there
      are three monophyletic groups of extant vascular plants: (1) lycophytes, (2) seed
      plants and (3) a clade including equisetophytes (horsetails), psilotophytes
      (whisk ferns) and all eusporangiate and leptosporangiate ferns. Our maximum
      likelihood analysis shows unambiguously that horsetails and ferns together are
      the closest relatives to seed plants. This refutes the prevailing view that
      horsetails and ferns are transitional evolutionary grades between bryophytes and
      seed plants, and has important implications for our understanding of the
      development and evolution of plants.

PMID- 11214321
TI  - Export by red blood cells of nitric oxide bioactivity.
AB  - Previous studies support a model in which the physiological O2 gradient is
      transduced by haemoglobin into the coordinate release from red blood cells of O2
      and nitric oxide (NO)-derived vasoactivity to optimize oxygen delivery in the
      arterial periphery. But whereas both O2 and NO diffuse into red blood cells, only
      O2 can diffuse out. Thus, for the dilation of blood vessels by red blood cells,
      there must be a mechanism to export NO-related vasoactivity, and current models
      of NO-mediated intercellular communication should be revised. Here we show that
      in human erythrocytes haemoglobin-derived S-nitrosothiol (SNO), generated from
      imported NO, is associated predominantly with the red blood cell membrane, and
      principally with cysteine residues in the haemoglobin-binding cytoplasmic domain
      of the anion exchanger AE1. Interaction with AE1 promotes the deoxygenated
      structure in SNO-haemoglobin, which subserves NO group transfer to the membrane.
      Furthermore, we show that vasodilatory activity is released from this membrane
      precinct by deoxygenation. Thus, the oxygen-regulated cellular mechanism that
      couples the synthesis and export of haemoglobin-derived NO bioactivity operates,
      at least in part, through formation of AE1-SNO at the membrane-cytosol interface.

PMID- 11214322
TI  - Scabrous complexes with Notch to mediate boundary formation.
AB  - The mechanisms that establish and sharpen pattern across epithelia are poorly
      understood. In the developing nervous system, the first pattern elements appear
      as 'proneural clusters' In the morphogenetic furrow of the immature Drosophila
      retina proneural clusters emerge in a wave as a patterned array of 6-10-cell
      groups, which are recognizable by expression of Atonal, a basic helix-loop-helix
      transcription factor that is required to establish and pattern the first cell
      fate. The establishment and subsequent patterning of Atonal expression requires
      activity of the signalling transmembrane receptor Notch. Here we present in vivo
      and biochemical evidence that the secreted protein Scabrous associates with
      Notch, and can stabilize Notch protein at the surface. The result is a regulation
      of Notch activity that sharpens proneural cluster boundaries and ensures
      establishment of single pioneer neurons.

PMID- 11214323
TI  - Polarity controls forces governing asymmetric spindle positioning in the
      Caenorhabditis elegans embryo.
AB  - Cell divisions that create daughter cells of different sizes are crucial for the
      generation of cell diversity during animal development. In such asymmetric
      divisions, the mitotic spindle must be asymmetrically positioned at the end of
      anaphase. The mechanisms by which cell polarity translates to asymmetric spindle
      positioning remain unclear. Here we examine the nature of the forces governing
      asymmetric spindle positioning in the single-cell-stage Caenorhabditis elegans
      embryo. To reveal the forces that act on each spindle pole, we removed the
      central spindle in living embryos either physically with an ultraviolet laser
      microbeam, or genetically by RNA-mediated interference of a kinesin. We show that
      pulling forces external to the spindle act on the two spindle poles. A stronger
      net force acts on the posterior pole, thereby explaining the overall posterior
      displacement seen in wild-type embryos. We also show that the net force acting on
      each spindle pole is under control of the par genes that are required for cell
      polarity along the anterior-posterior embryonic axis. Finally, we discuss simple
      mathematical models that describe the main features of spindle pole behaviour.
      Our work suggests a mechanism for generating asymmetry in spindle positioning by
      varying the net pulling force that acts on each spindle pole, thus allowing for
      the generation of daughter cells with different sizes.

PMID- 11214324
TI  - Normal human mammary epithelial cells spontaneously escape senescence and acquire
      genomic changes.
AB  - Senescence and genomic integrity are thought to be important barriers in the
      development of malignant lesions. Human fibroblasts undergo a limited number of
      cell divisions before entering an irreversible arrest, called senescence. Here we
      show that human mammary epithelial cells (HMECs) do not conform to this paradigm
      of senescence. In contrast to fibroblasts, HMECs exhibit an initial growth phase
      that is followed by a transient growth plateau (termed selection or M0; refs 3
      5), from which proliferative cells emerge to undergo further population doublings
      (approximately 20-70), before entering a second growth plateau (previously termed
      senescence or M1; refs 4-6). We find that the first growth plateau exhibits
      characteristics of senescence but is not an insurmountable barrier to further
      growth. HMECs emerge from senescence, exhibit eroding telomeric sequences and
      ultimately enter telomere-based crisis to generate the types of chromosomal
      abnormalities seen in the earliest lesions of breast cancer. Growth past
      senescent barriers may be a pivotal event in the earliest steps of
      carcinogenesis, providing many genetic changes that predicate oncogenic
      evolution. The differences between epithelial cells and fibroblasts provide new
      insights into the mechanistic basis of neoplastic transformation.

PMID- 11214325
TI  - The bacterial conjugation protein TrwB resembles ring helicases and F1-ATPase.
AB  - The transfer of DNA across membranes and between cells is a central biological
      process; however, its molecular mechanism remains unknown. In prokaryotes, trans
      membrane passage by bacterial conjugation, is the main route for horizontal gene
      transfer. It is the means for rapid acquisition of new genetic information,
      including antibiotic resistance by pathogens. Trans-kingdom gene transfer from
      bacteria to plants or fungi and even bacterial sporulation are special cases of
      conjugation. An integral membrane DNA-binding protein, called TrwB in the
      Escherichia coli R388 conjugative system, is essential for the conjugation
      process. This large multimeric protein is responsible for recruiting the
      relaxosome DNA-protein complex, and participates in the transfer of a single DNA
      strand during cell mating. Here we report the three-dimensional structure of a
      soluble variant of TrwB. The molecule consists of two domains: a nucleotide
      binding domain of alpha/beta topology, reminiscent of RecA and DNA ring
      helicases, and an all-alpha domain. Six equivalent protein monomers associate to
      form an almost spherical quaternary structure that is strikingly similar to F1
      ATPase. A central channel, 20 A in width, traverses the hexamer.

PMID- 11214326
TI  - Three key residues form a critical contact network in a protein folding
      transition state.
AB  - Determining how a protein folds is a central problem in structural biology. The
      rate of folding of many proteins is determined by the transition state, so that a
      knowledge of its structure is essential for understanding the protein folding
      reaction. Here we use mutation measurements--which determine the role of
      individual residues in stabilizing the transition state--as restraints in a Monte
      Carlo sampling procedure to determine the ensemble of structures that make up the
      transition state. We apply this approach to the experimental data for the 98
      residue protein acylphosphatase, and obtain a transition-state ensemble with the
      native-state topology and an average root-mean-square deviation of 6 A from the
      native structure. Although about 20 residues with small positional fluctuations
      form the structural core of this transition state, the native-like contact
      network of only three of these residues is sufficient to determine the overall
      fold of the protein. This result reveals how a nucleation mechanism involving a
      small number of key residues can lead to folding of a polypeptide chain to its
      unique native-state structure.

PMID- 11214327
TI  - Molecular characterization of the Smyth chicken sublines and their parental
      controls by RFLP and DNA fingerprint analysis.
AB  - The Smyth line (SL) chicken, a model for autoimmune human vitiligo, is
      characterized by a spontaneous posthatch epidermal pigment loss (vitiligo). Even
      though the immunological and morphological changes accompanying the vitiligo
      process have been well studied, the genetics of this phenomenon remains elusive.
      The SL lines have been maintained by nonpedigreed matings since their inception,
      and therefore, the inbreeding status is unknown. The present study was designed
      to provide an estimate of the inbreeding coefficients and the molecular genetic
      profiles of the SL sublines, each homozygous for a different MHC haplotype and
      their MHC-matched parental control (BL) sublines. The DNA fingerprint analysis
      revealed that there is a moderate level of inbreeding within the SL and BL
      parental sublines. Of the two SL sublines studied, SL101 had the highest level of
      inbreeding (0.948). Similarly, its parental control line (BL101) was more inbred
      than the parental subline of SL102 (BL102). The very high level of similarity
      between the SL sublines and their respective parental control lines is shown
      further by the similarity index (SI) estimates (SI between SL101 and BL101 was
      0.949 and that between SL102 and BL102 was 0.932). Restriction fragment length
      polymorphism (RFLP) analysis of the endogenous viral genes (avian leukosis virus
      subgroup E, ALVE) showed that five ALVE-related BamH1 fragments were present in
      the SL101 and four in SL102 sublines, whereas the parental BL101 and BL102
      sublines had five and six fragments, respectively. SL101 and SL102 shared two
      fragments, but the frequencies were different. Similarly, BL101 and BL102 shared
      two fragments. SL101 and BL101 shared three fragments, and SL102 and BL102 also
      shared three fragments.

PMID- 11214328
TI  - Acceptance of fresh chicken meat presented under three light sources.
AB  - The effect of using incandescent (INC), fluorescent (FL), and metal halide (MH)
      light sources on consumer preference of three different chicken cuts was
      investigated. For whole chicken and skinless thigh meat, INC was the preferred
      light source (P < 0.05). For the skinless breast meat, FL light was significantly
      preferred over MH but not over INC. Panelists indicated that they would buy thigh
      meat presented under INC and MH light but not under FL. Light reflectance data
      indicated that the reason was a lack of red light in the bulb output of FL light.

PMID- 11214329
TI  - Formation of cholesterol oxides in irradiated raw and cooked chicken meat during
      storage.
AB  - The objective of this study was to determine the effect of electron-beam
      irradiation on the oxidation of cholesterol in raw and cooked chicken meats with
      different packaging and storage times. Patties were prepared with skinless
      chicken breasts and legs. Half of the patties were used for raw meat study and
      the other half for cooked meat work. For cooked samples, patties were cooked in
      an electric oven to an internal temperature of 70 C. Raw and cooked meat patties
      were either aerobically or vacuum-packaged before irradiation. Irradiated patties
      were stored at 4 C up to 2 wk, and the amounts of cholesterol oxides in the
      patties were analyzed at 0, 7, and 14 d of storage. In raw chicken meat with
      vacuum packaging, 7beta-hydroxycholesterol and beta-epoxide were the only two
      cholesterol oxides present in significant amounts. In raw chicken meat with
      aerobic packaging, 7alpha-hydroxycholesterol and 7-keiocholesterol, which were
      not detected in vacuum-packaged raw chicken meat, were found. 7beta
      Hydroxycholesterol in raw chicken meat was increased by irradiation and storage
      time, regardless of packaging. The kinds of cholesterol oxides found in cooked
      meat were basically the same as those found in raw chicken, but the levels in
      cooked meats at all storage time were higher than those of the raw meats. With
      vacuum packaging, irradiation had no consistent effect on the amount of beta
      epoxide, 7alpha-hydroxycholesterol, or 7-ketocholesterol, but storage
      significantly influenced the amount of 7-ketocholesterol, 7beta
      hydroxycholesterol, and total cholesterol oxides in cooked chicken meat. With
      aerobic packaging, irradiation significantly increased the formation of 7alpha
      hydroxycholesterol, 7beta-hydroxycholesterol, and 7-ketocholesterol in cooked
      meat stored for 0 and 7 d. After 14 d of storage, however, irradiation had minor
      effects on the formation of cholesterol oxides in aerobically packaged cooked
      chicken.

PMID- 11214330
TI  - Effect of deboning time, muscle tensioning, and calcium chloride marination on
      texture characteristics of chicken breast meat.
AB  - Tenderness is the most important organoleptic characteristic of meat, and various
      methods have been developed to improve it. The purpose of this experiment was to
      evaluate the effect of different conditioning treatments of broiler carcasses on
      pH, cooking losses, shear values, R-values, and sensory tenderness of breast
      meat. All measurements were collected for breast muscle as follows: after 24 h of
      carcass aging (T1); after 24 h of carcass aging with muscle tensioning (T2);
      after 24 h of carcass aging with muscle tensioning, followed by muscle collection
      and marination in CaCl2 (T3); after hot-boning 15 min following slaughter (T4);
      after hot-boning 15 min following slaughter and marination in CaCl2 (T5). pH
      values in meat treated with CaCl2 were significantly lower than those in
      untreated meat from the aged carcass group (T3) or the hot-boning group (T5).
      Breasts from carcasses aged for 24 h (T1, T2, and T3) showed lower cooking loss
      than breasts harvested immediately after slaughter (T4 and T5). CaCl2 marination
      produced meats with cooking losses significantly higher than those observed for
      untreated meats. Regardless of muscle tensioning or marination treatments, aging
      of the carcass for 24 h (T1, T2, and T3) produced meats with lower shear values
      than those from hot-boned carcasses (T4 and T5). Hot-boned breasts treated with
      CaCl2 (T5) were judged less tender by panelists than breasts aged under muscle
      tensioning (T2 and T3).

PMID- 11214331
TI  - Evaluation of between-line variation for within-line selection against ascites in
      broilers.
AB  - Within-line opportunities for selection against ascites were studied in a data
      set comprising a 10-line comparison. The study attempted to reveal whether
      contrasts between lines provide reliable candidate traits for within-line
      selection. Mortality was chosen as the reference trait. As no pedigree
      information was available, a trait was required that related mortality to the
      nonmortality data. By principal component analysis, such a trait (ASC_INDIC =
      ascites indicator) was developed from pathology data. The composite trait
      ASC_INDIC ranked lines well for their mortality figures (r = 0.96), from which it
      was concluded that ASC_INDIC represents an underlying continuous ascites trait.
      Between lines, blood gas traits seemed to be the most promising traits. Within
      lines, performance traits appeared to be highly correlated to ascites. Comparison
      of within-line variation to between-line contrasts revealed considerable
      differences. The high correlation of the blood gas traits with mortality was not
      present within lines. However, although the magnitude was considerably reduced,
      the nature of the blood gas traits in their relationship to ascites was similar
      within and between lines. The study primarily demonstrates that contrasts between
      lines carry systematic but limited information for within-line coherence.
      Therefore, line contrasts must be interpreted with care when aiming to study
      genetic variation and coherence within lines.

PMID- 11214332
TI  - DNA microsatellites linked to quantitative trait loci affecting antibody response
      and survival rate in meat-type chickens.
AB  - Selection for immune response parameters may lead to improved general disease
      resistance. Because disease resistance and immune response are hard-to-measure
      quantitative traits with low to moderate heritability, they may respond more
      efficiently to marker-assisted selection (MAS) than to phenotypic selection. To
      detect DNA markers linked to quantitative trait loci (QTL) associated with immune
      response, a resource half-sib family of 160 backcross (BC1) and intercross (F2)
      birds was derived from a cross between two meat-type lines divergently selected
      for high or low antibody (Ab) response to Escherichia coli. By using 25
      microsatellite DNA markers covering approximately 25% of the chicken genome,
      initial genotyping of 40% of the resource family was followed by complete
      genotyping of the entire family with four suggestive markers. Three of these
      markers exhibited significant association with immune response: (1) ADL0146 on
      Chromosome 2 associated with Ab to SRBC and Newcastle disease virus (NDV), (2)
      ADL0290 on linkage group 31 affecting Ab to NDV, and (3) ADL0298 on linkage group
      34 associated with Ab to E. coli and survival. The family was also genotyped with
      five linked markers from two of the suggested regions, and interval mapping was
      applied. The results confirmed the significant effects, suggested the location of
      the QTL, and confirmed the genetic association between immune responses and
      disease resistance. These findings support the idea of improving poultry
      immunocompetence by MAS.

PMID- 11214333
TI  - Early age thermal conditioning and a dual feeding program for male broilers
      challenged by heat stress.
AB  - The effects of early age thermal conditioning (TC) and dual feeding on responses
      of male broilers to a thermal challenge at 34 d of age are reported. Three
      hundred chicks were randomly divided into two equal groups. One group was exposed
      to thermal conditioning (38 C, 42% relative humidity for 24 h) at the age of 5 d,
      and the other group was not exposed. From 11 to 41 d of age, temperature was
      diurnally cyclic: 26 C (1600 to 0900 h) and 30 C (0900 to 1600 h). From Day 19, a
      factorial (2 x 2, TC x diet) experiment was conducted using eight pens of six
      broilers per treatment. Diets were control diet and dual feeding of a high
      protein fraction (1600 to 0900 h) and an energy-rich fraction (0900 to 1600 h).
      Growth and feed efficiency were slightly enhanced (+4%) by thermal conditioning
      and slightly reduced (-4%) by dual feeding. Mortality during thermal challenge
      was reduced by both factors. [In not conditioned chicks (N), 31 fed a control
      grower diet (NG) and 12 on a dual feeding program (NDF) died; in thermal
      conditioned chicks (T), 18 fed a control grower diet (TG) and 11 on a dual
      feeding program (TDF) died.] Before the thermal challenge period, body
      temperature (Tb) was consistently reduced in T. During the thermal challenge
      period, Tb was reduced by thermal conditioning and dual feeding. Measured at the
      age of 32 d, Tb gave an estimation of the ability of the chickens to cope with
      heat stress 2 d later. Pectoral mass was increased in TG, whereas the liver and
      the gizzard were significantly heavier in TDF and NDF. These results suggest that
      thermal conditioning at 5 d of age induces a consistent metabolic change in
      broiler males. The dual feeding program might have induced transitory effects on
      heat production during the heat stress.

PMID- 11214334
TI  - Carcass traits, ovarian morphology and egg laying characteristics in early versus
      late maturing strains of commercial egg-type hens.
AB  - Three hundred commercial Single Comb While Leghorn (SCWL) pullets of two strains
      differing in age at first oviposition (early maturing = EARLY; later maturing =
      LATE) were reared and photostimulated at 18 wk. Selected birds of each strain
      were killed at weekly intervals from 17 to 23 wk, at sexual maturity, or at 68 wk
      of age for the study of carcass and reproductive organ traits. Egg production was
      recorded for surviving hens to 68 wk of age. The two strains differed in age at
      sexual maturity (EARLY, 137.5 d; LATE, 142.1 d). The EARLY strain birds appeared
      to allocate a greater proportion of nutrients to reproductive development
      (oviduct) from 19 to 22 wk of age than did the LATE group, which showed greater
      breast muscle development during this same period. The LATE strain hens were
      significantly heavier than the EARLY hens at sexual maturity, and this difference
      in BW persisted to the end of the laying period. Although total egg production
      did not differ between strains, the LATE strain hens had a longer prime egg
      laying sequence length (LATE, 70.2 d; EARLY, 52.6 d) as well as a longer mean
      sequence length (LATE, 12.8 d; EARLY, 8.7 d). Egg weight did not differ between
      strains. These data suggest that LATE lines of egg-type hens offer equivalent
      production efficiency due to improved rates of lay, albeit starting later.

PMID- 11214335
TI  - Effects of photostimulatory light intensity on ovarian morphology and carcass
      traits at sexual maturity in modern and antique egg-type pullets.
AB  - The effects of light intensity during sexual maturation on ovarian and carcass
      morphology at first oviposition [sexual maturity (SM)] were examined in two
      Single Comb White Leghorn (SCWL) strains. A modern commercial layer strain (COMM;
      Shaver Starcross 288) and an antique randombred control strain (ANT) were used to
      compare the effects of changes in laying stock on their response to varying light
      intensities from photostimulation (PS) until SM. Two hundred pullets from each
      strain were reared following COMM breeder guidelines. At 18 wk of age, 32 COMM
      and 32 ANT pullets were individually caged in individually lit cages and
      photostimulated with light intensities of 1, 5, 50, and 500 lx. Each bird was
      processed when it reached SM, and carcass and ovarian morphology were assessed.
      The ANT birds came into production 9.1 d later than the COMM birds, on average.
      The ANT pullets consumed 7.0% more feed per day than COMM pullets but gained at a
      slower rate (ANT = 12.9 g/d; COMM = 15.0 g/d). The ANT birds reached SM at a
      greater weight and with a smaller ovary than did COMM birds. Although the number
      of large yellow follicles (LYF) was similar between strains (mean = 6.72), both
      LYF weight and first egg weight were lower in ANT birds than in COMM birds. The
      COMM layer strain was more growth efficient and had a greater emphasis on ovary
      maintenance. Light intensity had no effect on the timing of SM or on BW at SM,
      indicating that all intensities used were effectively able to stimulate the
      sexual maturation process. However, ovary weight and number of LYF exhibited an
      increasing dose response to light intensity, particularly in the COMM birds.
      Overall, the birds photostimulated with 1 lx of light had reduced ovary
      development and were heavier than their counterparts exposed to 50 and 500 lx.
      Within the ANT strain, LYF numbers were not significantly affected by light
      intensities, whereas, within the COMM strain, LYF numbers were 4.88, 6.63, 7.88,
      and 8.13 for the 1-, 5-, 50-, and 500-lx intensity groups, respectively. Although
      light intensity did not affect the rate of sexual maturation, it altered ovarian
      morphology and carcass lipid stores. A light intensity of 1 lx was limiting to
      ovarian follicle formation and caused increased carcass weight compared with
      birds on higher light intensity treatments. The COMM birds were more negatively
      affected by low light intensity than were the ANT birds, indicating that light
      intensity may be a more critical environmental factor with modern, highly
      efficient SCWL strains than has previously been thought. Light intensity can
      affect the reproductive development and likely the associated egg production
      potential of modern layer stocks.

PMID- 11214336
TI  - Recovery and characterization of by-products from egg processing plant wastewater
      using coagulants.
AB  - The effectiveness of precipitation or coagulation technology to treat commercial
      egg processing plant wastewater, using such coagulants as lignosulfonate,
      bentonite, carboxymethylcellulose, and ferric chloride, was evaluated. For
      simulated and industrial waste-water, chemical oxygen demand, turbidity, and
      total solids were reduced over 90, 97, and 95%, respectively, for all coagulants
      tested. Protein and fat recoveries were over 95% for all coagulants. The optimal
      coagulant concentration for maximum by-product recovery depended on initial
      wastewater concentrations of protein, total solids, and fat. The dried by
      products contained high concentrations of protein (30 to 50%) and fat (30 to 40%)
      and had similar essential amino acid profiles as standard proteins from the
      United Nations Food and Agricultural Organization (FAO). The relative protein
      digestibilities of each recovered solid (carboxymethycellulose, lignosulfonate,
      bentonite, and ferric chloride) and corn meal relative to a liquid whole egg
      standard were approximately 80, 90, 60, 30, and 56%, respectively. These
      compositional and in vitro digestibility studies suggest that the recovered by
      products could be useful as livestock feed ingredients or for other applications.

PMID- 11214337
TI  - Screening for highly heterozygous chickens in outbred commercial broiler lines to
      increase detection power for mapping quantitative trait loci.
AB  - Two commercial broiler lines were used in an experiment to map quantitative trait
      loci (QTL) affecting disease resistance. Chickens from these lines were genotyped
      with 27 microsatellite markers to estimate heterozygosity and polymorphism
      information content (PIC), the probability that one parent is heterozygous at a
      marker locus and the other has a different genotype. Heterozygosity estimated
      from allelic frequencies was 0.52 for the two lines; however, heterozygosity
      calculated from actual counts of heterozygous loci was much lower (0.36) than the
      estimated heterozygosity. The PIC was 0.45 in these lines, and average allele
      number per marker locus was about 3.5. Twenty-five males produced from a cross
      between these two lines were screened with the DNA markers to select birds with
      high heterozygosity at marker loci. Mating simulation showed that uninformative
      matings could be reduced by about 5% if 12 pairs of males and females with the
      highest heterozygosity at marker loci were selected, which was about a 25%
      reduction in total uninformative matings. This experiment demonstrated that the
      heterozygosity and PIC in commercial broiler lines were low and selection for the
      birds with high heterozygosity at marker loci could increase informative content
      in chickens used in the experiments of QTL mapping, thus increasing detection
      power for QTL mapping.

PMID- 11214338
TI  - Farm and management variables linked to fecal shedding of Campylobacter and
      Salmonella in commercial squab production.
AB  - A cross-sectional study was performed to determine the relationship of farm
      variables and management practices to fecal shedding of Campylobacter or
      Salmonella on commercial squab (young pigeon) farms. A detailed survey provided
      information on biosecurity, cleaning and disinfection, bird health, vector
      control, and loft and pen. Twenty pigeons on each of 12 farms were cultured
      before and after the producers completed a voluntary quality assurance training
      program (QAP), based on principles of hazard analysis critical control point
      (HACCP). The prevalence of positive samples for Salmonella and C. jejuni was
      1/480 (0.21%) and 19/480 (3.96%), respectively. Campylobacter was present on one
      farm during both visits; three farms during the first visit, and three farms
      during the second visit. Analysis by fixed-effects logistic regression showed the
      probability of having a positive C. jejuni culture was increased by not using dry
      manure in the nesting material, not cleaning shipping crates, cleaning landing
      boards, and by increased frequency of chemical disinfection of water. Having a
      positive parent and higher numbers of squab per pen (density) were also
      associated with higher odds of being positive for C. jejuni. Factors not
      associated with a positive C. jejuni culture included, other avian species on the
      farm, type of shipping crate, covered drinkers, fly problems, bird age, level of
      nest box within the loft, and QAP training. Prevalence of food safety pathogens
      was extremely low on the squab facilities tested as compared with reports from
      commercial broiler or turkey flocks. This observation suggests that one or more
      farm variables or management practices were effectively reducing infection, or
      possibly a species-related difference existed in carriage rates and shedding of
      pathogens. These results emphasize critical control points for food safety
      pathogens may vary widely, and the formulation of effective QAP programs are
      dependent on science-based knowledge of diverse animal production systems.

PMID- 11214339
TI  - Dietary fatty acid profile modifies abdominal fat deposition in broiler chickens.
AB  - An experiment was conducted to study the effect of different dietary fatty acid
      profiles on abdominal fat deposition in broilers. Diets with four types of fats
      (tallow, olive oil, sunflower oil, and linseed oil), at two levels of fat
      inclusion (either 6 or 10%), were administered to males from 21 to 42 d and to
      females from 21 to 49 d of age. The sexes were studied separately. Performance
      parameters, abdominal fat, muscle fat and cholesterol, and fatty acid profile of
      thigh, breast, and abdominal fat were determined. Broilers fed sunflower and
      linseed oils presented better values of feed efficiency. Abdominal fat and
      cholesterol content of thigh muscle were significantly lower in animals fed
      sunflower and linseed oils than in those fed tallow or olive oil (P < 0.001). In
      females, abdominal fat increased with level of fat inclusion only in birds fed
      tallow or olive oil, whereas it remained constant in birds fed sunflower or
      linseed oil. Muscle fat content was lower for birds fed tallow or olive oil but
      not significantly. The fatty acid profile of the different tissues reflected
      dietary fatty acid profile. Monounsaturated fatty acids were higher in abdominal
      fat, whereas polyunsaturated fatty acids were higher in muscle fat. These results
      suggest that polyunsaturated fatty acids produce lower abdominal fat deposition
      than saturated or monounsaturated fatty acids.

PMID- 11214340
TI  - Indicators of nutritional value of hydrolyzed feather meal.
AB  - Processing pressure and time were evaluated for their effects on feather meal
      protein quality. Feathers were collected from a commercial broiler plant and
      hydrolyzed with saturated steam in an experimental batch hydrolyzer. A constant
      time series (36 min) was completed to evaluate the effect of increasing pressure
      (207 to 517 kPa) on nutritional value. Feather meal processed at the lowest
      pressure had the highest nutritional value, and vice versa. True amino acid
      availability determined with force-fed White Leghorn cockerels demonstrated that
      increasing pressure decreased true available (TA) cystine (P < 0.05) more than
      any other amino acid. Sulfur content and acid detergent fiber were positively
      correlated with TA sulfur amino acid content; bulk density, 0.2% pepsin
      digestible protein, and acid detergent soluble protein were negatively correlated
      with TA sulfur amino acid content. Increased steam pressure also resulted in
      decreased, undegraded intake protein. Various combinations of time (106 to 4.5
      min) and pressure (207 to 724 kPa) were used to prepare a constant density series
      (483 kg/m3). In this series, feather meals were similar in nutritional value.
      There was no indication that high hydrolysis pressure was detrimental to feather
      meal quality, if the appropriate time was used. These results suggest that sulfur
      content and bulk density can be used to monitor feather meal quality.

PMID- 11214341
TI  - Zinc bioavailability in tetrabasic zinc chloride and the dietary zinc requirement
      of young chicks fed a soy concentrate diet.
AB  - Three chick assays were conducted to determine a bioavailable Zn requirement and
      to establish a Zn relative bioavailability (RBV) value for tetrabasic Zn chloride
      [TBZC, i.e., Zn5Cl2(OH)8]. In Assay 1, 8-d-old chicks were fed a Zn-deficient soy
      concentrate diet (8.8 mg/kg bioavailable Zn) supplemented with 0, 5.81, 10.81,
      15.10, and 20.25 mg Zn/kg from ZnSO4.7H2O for 14 d to establish a linear response
      range and estimate a bioavailable Zn requirement. Weight gain of chicks increased
      linearly (P < 0.01; r2 = 0.99) when the first three levels of Zn were fed. Broken
      line analysis of the weight gain data indicated a bioavailable Zn requirement of
      22.4 mg/kg. In Assay 2, RBV of Zn in TBZC was determined by multiple-linear
      regression slope-ratio methodology. The Zn-deficient basal diet was supplemented
      with 0, 5.81, and 10.81 mg Zn/kg from ZnSO4.7H2O to produce a linear growth
      response as determined in Assay 1. The same basal diet was supplemented with 5.38
      and 10.81 mg Zn/kg from TBZC. The RBV of Zn in TBZC was found to be 102%, which
      was not different (P > 0.10) from 100%. A third assay was conducted as described
      for Assay 2, and the RBV of Zn in TBZC was 111%, which was not different from
      100%. In summary, the RBV of Zn in TBZC was not different from that of
      ZnSO4.7H2O, and the minimal bioavailable Zn requirement for chicks 1 to 3 wk of
      age fed a soy concentrate diet was estimated at 22.4 mg/kg.

PMID- 11214342
TI  - The influence of drinking water containing sodium chloride on performance and
      eggshell quality of a modern, colored layer strain.
AB  - Hubbard ISA IsaBrown pullets were purchased from a commercial supplier at 16 wk
      of age and kept at a constant 18 C or a constant 30 C in temperature-controlled
      rooms. The purpose of our experiment was to determine the effect of ambient
      temperature on the eggshell quality responses of laying hens receiving saline
      drinking water with or without simultaneous supplementation of the diet with
      ascorbic acid or Zn methionine. Four treatments were investigated: 1) a basal
      layer diet (C) and local drinking water, 2) diet C and local drinking water
      containing 2 g NaCl/L, 3) diet C containing 200 mg ascorbic acid/kg and local
      drinking water containing 2 g NaCl/L, and 4) diet C with 360 mg Zinpro 100 (Zn
      methionine)/kg and local drinking water containing 2 g NaCl/L. The local drinking
      water contained <1 mmol Cl/ L. The pullets received a continuous daily
      photoperiod of 16 h from fluorescent lighting, and production measures were made
      between 20 and 60 wk of age. Production and eggshell quality were significantly
      reduced at 30 C compared with 18 C but were not significantly affected by the
      dietary and water treatments. The results indicated that the IsaBrown hens were
      relatively insensitive to intakes of NaCl from the drinking water at
      concentrations of 2 g/L. This lack of sensitivity in eggshell quality contrasts
      with the majority of published reports, including earlier work with local
      Australian layer strains. It is suggested that this contrasting sensitivity may
      relate to the concentration of dietary NaCl used during the selection of layer
      genotypes.

PMID- 11214343
TI  - Temporal characteristics and incidence of photorefractoriness in turkey hens.
AB  - We conducted experiments to determine the incidence and temporal components of
      photorefractoriness (PR) in first-year turkey breeder hens after
      photostimulation. In turkey hens, PR may be defined as a lack of responsiveness
      to photoperiods that previously induced or maintained egg production and is
      characterized by a spontaneous cessation of lay, usually followed by molt, as
      well as an absence of nesting behavior. In one experiment, groups of hens were
      photostimulated with 18 h of light (L):6 h darkness (D) for 12, 16, 19, or 22 wk
      and then were exposed to 13L:11D photoperiods to induce a change in egg laying
      that allowed an evaluation of the photoresponsive state of each group of hens. In
      two other experiments individual hens were photostimulated continuously with
      16L:8D for 24 or 45 wk, and the onset of PR was evaluated by the spontaneous
      cessation of lay. Data were collected for time to onset of PR, percentage
      incidence, duration of PR, and the time required for the transition from the
      photosensitive to the PR state. The earliest onset of PR occurred 7 wk after
      photostimulation, and the mean onset occurred at about 18 wk of photostimulation.
      Hens that expressed PR did so within an 18-wk period ending at 25 wk of
      photostimulation, but not all of these first-year hens expressed PR. Incidence of
      PR was variable at 59 and 89% in Experiments 2 and 3, respectively. The
      transition from a photosensitive state to an overt PR state, and therefore a
      laying to nonlaying state, occurred abruptly within a 2-wk period.
      Photorefractoriness was permanent during 45 wk of photostimulation for 11% of the
      PR hens. In the remaining 89% of hens, PR persisted for at least 14 wk (mean of
      20.0+/-0.9) but it was not permanent, because they subsequently spontaneously
      recrudesced. That is, they spontaneously terminated PR. It was concluded that
      most, but not all, first-year turkey hens become PR and that the incidence is
      highly variable; PR may be relative or absolute, and absolute PR occurs abruptly
      but with a highly variable onset time. In most hens, PR is not permanent.

PMID- 11214344
TI  - HIPAA special report: final privacy rules affect all of health care.

PMID- 11214345
TI  - Survey shows medical errors, malpractice now leading public quality indicators.

PMID- 11214346
TI  - Spatial and temporal performance of the miniface (free air CO2 enrichment) system
      on Bog Ecosystems in northern and Central Europe.
AB  - The Bog Ecosystem Research Initiative (BERI) project was initiated to
      investigate, at five climatically different sites across Europe, the effects of
      elevated CO2 and N deposition on the net exchange of CO2 and CH4 between bogs and
      the atmosphere, and to study the effects of elevated CO2 and N deposition on the
      plant biodiversity of bog communities. A major challenge to investigate the
      effects of elevated CO2 on vegetation and ecosystems is to apply elevated CO2
      concentrations to growing vegetation without changing the physical conditions
      like climate and radiation. Most available CO2 enrichment methods disturb the
      natural conditions to some degree, for instance closed chambers or open top
      chambers. Free Air CO2 Enrichment (FACE) systems have proven to be suitable to
      expose plants to elevated CO2 concentrations with minimal disturbance of their
      natural environment. The size and spatial scale of the vegetation studied within
      the BERI project allowed the use of a modified version of a small FACE system
      called MiniFACE. This paper describes the BERI MiniFACE design as well as its
      temporal and spatial performance at the five BERI field locations. The temporal
      performance of the MiniFACE system largely met the quality criteria defined by
      the FACE Protocol. One minute average CO2 concentrations measured at the centre
      of the ring stayed within 20% of the pre-set target for more than 95% of the
      time. Increased wind speeds were found to improve the MiniFACE system's temporal
      performance. Spatial analyses showed no apparent CO2 gradients across a ring
      during a 4 day period and the mean differences between each sampling point and
      the centre of the ring did not exceed 10%. Observations made during a windy day,
      causing a CO2 concentration gradient, and observations made during a calm day
      indicated that short term gradients tend to average out over longer periods of
      time. On a day with unidirectional strong winds, CO2 concentrations at the upwind
      side of the ring centre were higher than those made at the centre and at the
      downwind side of the ring centre, but the bell-shaped distribution was found
      basically the same for the centre and the four surrounding measurement points,
      implying that the short term (1 sec) variability of CO2 concentrations across the
      MiniFACE ring is almost the same at any point in the ring. Based on gas
      dispersion simulations and measured CO2 concentration profiles, the possible
      interference between CO2-enriched and control rings was found to be negligible
      beyond a centre-to-centre ring distance of 6 m.

PMID- 11214347
TI  - The importance of leaching from litter collected in litterfall traps.
AB  - Litterfall (LF) is usually collected by means of open traps. However, this litter
      will be subject to leaching by the throughfall which passes through the
      accumulated litter in the traps. The nutrients lost during this leaching are not
      taken into account in the calculation of LF nutrient fluxes. We report the
      results from a 2-month (August-September) study carried out in 8 northern
      coniferous forest stands to assess the possible importance of leaching from
      litter in LF traps. Compared to throughfall (TF), the litterfall leachate
      (LFLgross), which includes a throughfall component, had significantly (p < 0.05)
      higher concentrations and fluxes of Ca, Mg, Na and S. The average net LFL (i.e.,
      LFLnet = LFLgross - TF) fluxes were 21 (Ca), 7 (Mg), 57 (K), 10 (Na), 10 (N), and
      19 (S) mg m-2 mo-1. LFLnet accounted for 42%, 37% and 50% of the LFLgross flux,
      and for 91%, 51% and 49% of the total litterfall flux (i.e., LF + LFLnet) of Na,
      S and K, respectively. For Ca, Mg and N, the LFLnet flux accounted for 64%, 58%
      and 29% of the LFLgross flux, and for < 14% of the total litterfall flux.
      Compared to TF, LF was the dominant return pathway for Ca, Mg and N to the forest
      floor regardless of whether LFLnet was included or not. However, for K and S,
      taking LFLnet into account determined whether TF or LF was the dominant pathway.
      TF remained the dominant pathway for Na even when LFLnet was included.

PMID- 11214348
TI  - Distribution of heavy metals in surface sediments from an Antarctic marine
      ecosystem.
AB  - The concentrations of lead, cadmium, copper, chromium, iron, manganese and zinc
      in surface sediments collected from Potter Cove, in the 25 de Mayo Island (King
      George Island), Antarctica, and its drainage basin, were measured by atomic
      absorption spectroscopy. The obtained results were use to determine the areal and
      vertical distribution of the metals of in the Cove and potential sources of these
      metals to this environment. The geochemical data suggest that most of the metals
      found in Potter Cove constitute a redistribution of autochthonous materials
      within the ecosystem. Therefore, the metal concentrations can be considered to be
      present at natural background levels in surface sediments.

PMID- 11214349
TI  - A watershed-based cumulative risk impact analysis: environmental vulnerability
      and impact criteria.
AB  - Swine Concentrated Animal Feeding Operations (CAFOs) have received much attention
      in recent years. As a result, a watershed-based screening tool, the Cumulative
      Risk Index Analysis (CRIA), was developed to assess the cumulative impacts of
      multiple CAFO facilities in a watershed subunit. The CRIA formula calculates an
      index number based on: 1) the area of one or more facilities compared to the area
      of the watershed subunit, 2) the average of the environmental vulnerability
      criteria, and 3) the average of the industry-specific impact criteria. Each
      vulnerability or impact criterion is ranked on a 1 to 5 scale, with a low rank
      indicating low environmental vulnerability or impact and a high rank indicating
      high environmental vulnerability or impact. The individual criterion ranks, as
      well as the total CRIA score, can be used to focus the environmental analysis and
      facilitate discussions with industry, public, and other stakeholders in the
      Agency decision-making process.

PMID- 11214350
TI  - Assessment of water pollution and suitability to fish life in six Italian rivers.
AB  - This paper reports the results of a monitoring programme of six rivers (Serchio,
      Cecina, Cascina, ERa, Elsa and Pavone) that drain north-west Tuscany (Italy). In
      this area, agricultural, industrial and urbanization pressures affect water
      quality, also in terms of suitability for the survival of aquatic organisms. The
      river waters were monitored for several physico-chemical parameters (temperature,
      dissolved oxygen, suspended solids, total ammonia, nitrites, Cu, Cd, Cr, Ni and
      Pb) in order to assess the anthropogenic impact on the environmental conditions
      of these watercourses and their suitability for fish life. Statistical data
      handling was performed for each river and the percentage of physico-chemical
      parameters that, according to the E.C. law, were over the limits that must not be
      exceeded to protect fish life, was calculated and a classification was made of
      the six rivers in this sense. Concerning the metals, inter-element relationships
      (between chromium and nichel, lead and copper, nichel and lead and copper, copper
      and lead) were found which allow some remarks on the origins of the anthropogenic
      impacts, and comparisons were made with two metal-polluted watercourses in
      northern Italy, the Po and Lambro rivers. From the comparison, the Tuscan rivers
      showed generally lower metal contamination, especially with respect to the
      Lambro.

PMID- 11214351
TI  - Plasma and breast milk vitamin A as indicators of vitamin A status in pregnant
      women.
AB  - Breast milk vitamin A is not well characterized as an indicator of vitamin A
      status in women with infections. A controlled trial of vitamin A, 3 mg retinol
      equivalent/day, was conducted among 697 pregnant women with human
      immunodeficiency virus (HIV) infection in Malawi which allowed comparison of
      plasma versus breast milk vitamin A as indicators of vitamin A status. Retinol
      concentrations were measured in plasma at baseline (18-28 weeks) and 38 weeks
      gestation and breast milk at 6 weeks post-partum. Plasma alpha 1-acid
      glycoprotein (AGP) and C-reactive protein (CRP) were measured at baseline. Plasma
      retinol (geometric mean, SD) at 38 weeks was 0.72 (0.44, 1.18) and 0.61 (0.38,
      0.98) mumol/L (P < 0.0002) and breast milk retinol was 1.32 (0.71, 2.43) and 0.95
      (0.49, 1.82) mumol/L (P < 0.0001) in vitamin A and placebo groups, respectively.
      Women with elevated acute phase protein (AGP > 1 gm/L and/or CRP > 5 mg/L) at
      baseline who received vitamin A had significantly higher plasma and breast milk
      vitamin A at follow-up compared with placebo. Elevated acute phase proteins did
      not distinguish women with low body stores of vitamin A. Breast milk retinol
      appears to be a better indicator of vitamin A status than plasma retinol in women
      with infections.

PMID- 11214352
TI  - Effects of supplemental vitamin A on retinoic acid concentrations in the plasma
      of preruminant calves.
AB  - Neonatal calves are fed frequently milk replacers with vitamin A concentrations
      exceeding those recommended by the National Research Council. The vitamin A
      metabolite, retinoic acid (RA), affects profoundly cellular differentiation and
      homeostasis. For this reason, effects of dietary vitamin A on plasma
      concentrations of RA isomers in milk replacer-fed calves were examined. Male,
      Holstein calves (n = 24) were fed colostrum within 12 hours after birth and,
      thereafter, a custom-formulated low vitamin A milk replacer providing 0, 1700
      [National Research Council (NRC) daily requirement for young growing calves]
      (controls), 34,000 (industry standard in the United States) or 68,000 IU of
      vitamin A daily. Concentrations of retinol and RA isomers in plasma samples
      collected from birth to 27 days of age were determined by HPLC. Retinol was
      affected by dietary vitamin A with higher concentrations occurring in calves
      supplemented with > or = 34,000 IU of vitamin A/day than in control (1700 IU of
      vitamin daily) and unsupplemented calves. Relative to controls, concentrations of
      all isomers of RA were higher in calves supplemented with > or = 34,000 of
      vitamin A daily during the experimental period. The predominant isomer in all
      calves was 9,13-dicis-RA. In control calves, 9,13-dicis-RA and 9-cis-RA were
      maximal at 1 to 6 days of age and then decreased progressively. In calves fed >
      or = 34,000 IU of vitamin A daily, concentrations of these isomers were markedly
      higher at 6 days of age, relative to controls, and remained elevated for the
      duration of the study. In all calves, retinol was correlated positively with 9,13
      dicis- and 9-cis-RA from 9 to 27 days of age. 9,13-cis-Retinoic acid was
      correlated positively with 9-cis- and 13-cis-RA from 13 to 27 days of age. It is
      concluded that supplementing milk replacer-fed calves with vitamin A at levels
      exceeding current NRC recommendations by > or = 20-fold causes an elevation in
      plasma concentrations of retinol and retinoic acids. 9,13-dicis- and 9-cis
      Retinoic acids were most affected by supplemental vitamin A. Physiologic
      consequences of increased plasma RA concentrations induced by high dietary levels
      of vitamin A warrant investigation.

PMID- 11214353
TI  - Serum parathyroid hormone in healthy Japanese women in relation to serum 25
      hydroxyvitamin D.
AB  - The aim of this work was to clarify levels of serum parathyroid hormone (PTH) in
      healthy adult women and to study the relationship between PTH and 25
      hydroxyvitamin D [25(OH)D]. One hundred sixty-nine healthy women aged 40 years or
      older in a community were studied. The average age of the subjects was 65.3 years
      (SD 8.2). All subjects had normal serum creatinine levels. Serum intact PTH and
      25(OH)D were measured in these subjects. The mean intact PTH concentration was
      2.19 pmol/l (SD 1.02). High intact PTH levels above the reference range were
      observed in four women (2.4%), all of whom were aged 70 years or older. Intact
      PTH increased with age with a correlation coefficient of 0.192 (p = 0.013).
      However, there was no correlation (r = -0.125, p = 0.105) between intact PTH and
      25(OH)D whose concentrations were more than 37.5 nmol/l. In conclusion, PTH
      levels of healthy adult Japanese women are lower than previous reports from
      Western countries, which may be due to the high 25(OH)D levels of the present
      subjects and/or an ethnic difference. In addition, there is no association
      between serum 25(OH)D and PTH levels in this Japanese population, supporting a
      cutoff level of 25(OH)D less than 37.5 nmol/l for the elevated PTH level.

PMID- 11214354
TI  - Vitamin E deficiency fails to affect myocardial performance during in vivo
      ischemia-reperfusion.
AB  - Vitamin E content of cardiac tissue has been proposed to play a major role in the
      damage caused by myocardial ischemia-reperfusion (I-R). Previous studies using in
      vitro models have examined vitamin E deficiency and I-R-induced myocardial damage
      with equivocal results. The purpose of this study was to use an in vivo model of
      myocardial I-R to determine the effects of vitamin E deficiency on myocardial I-R
      induced damage. Female Sprague-Dawley rats (4-mo old) were assigned to either: 1)
      control diet (CON), or 2) vitamin E deficient diet (VE-DEF). The CON diet was
      prepared to meet AIN-93M standards, which contains 75 IU vitamin E/kg diet. The
      VE-DEF diet was the AIN-93M diet prepared with tocopherol stripped corn oil and
      no vitamin E. Following a 14-week feeding period, significant differences (p <
      0.05) existed in mean myocardial VE levels between groups (mean values +/- SEM:
      CON = 48.2 +/- 3.5; VE-DEF = 12.4 +/- 1.4 micrograms VE/g wet weight). Animals
      from both experimental groups were subjected to an in vivo I-R protocol
      consisting of 25 minutes of left coronary artery occlusion followed by 10 minutes
      of reperfusion. No group differences (p > 0.05) existed in cardiac performance
      (peak arterial pressure or ventricular work) or the incidence of ventricular
      arrhythmias during the I-R protocol. VE-DEF animals had significantly higher (p <
      0.05) levels of myocardial lipid peroxidation and lower (p < 0.05) protein thiols
      following I-R compared to the CON animals. These data suggest that although
      vitamin E deficiency increases oxidative damage resulting from myocardial I-R, it
      does not affect cardiac performance during the insult.

PMID- 11214355
TI  - Comparative effects of vitamin K2 and estradiol on experimental arteriosclerosis
      with diabetes mellitus.
AB  - In order to further investigate the radical scavenging and anti-arteriosclerotic
      activities of vitamin K2 and estradiol, the comparative effects of vitamin K2 and
      estradiol on aortic calcium (Ca) and inorganic phosphorus (P) levels in the aorta
      and the elastin fraction (fr.) were investigated in male rats after experimental
      arteriosclerosis with diabetes mellitus was induced by vitamin D2 and radical
      producing substance, streptozotocin (STZ). Pharmacological dose of vitamin K2
      (100 mg/kg b.w.) and medical dose of estradiol (83 micrograms/kg b.w.) suppressed
      the increased serum glucose, and vitamin K2 and estradiol increased the decrease
      in serum insulin. Moreover, vitamin K2 and estradiol inhibited the increase of Ca
      and P in the aorta and the elastin fr. Vitamin K2 and estradiol decreased the
      increase in serum lipid peroxide (LPO). It is suggested that both the
      pharmacological dose of vitamin K2 and medical dose of estradiol suppressed the
      development of arteriosclerosis associated with diabetes mellitus, owing to
      radical scavenging activity of vitamin K2 and estradiol.

PMID- 11214356
TI  - Beta-carotene, retinol and alpha-tocopherol status in calves fed the first
      colostrum at 0-2, 6-7, 12-13 or 24-25 hours after birth.
AB  - Effects on beta-carotene, retinol and alpha-tocopherol status of feeding 1st
      colostrum at 0-2, 6-7, 12-13 and 24-25 h after birth were studied in calves. beta
      carotene, retinol and alpha-tocopherol concentrations decreased in colostrum
      during the first 2.5 d of lactation. Plasma beta-carotene, retinol and alpha
      tocopherol concentrations in newborn calves were very low. Plasma beta-carotene
      concentrations increased up to d 3 after the 1st meal and during the 1st month
      were higher in calves fed 1st colostrum at < 6-7 h than at > 12-13 h after birth.
      Plasma retinol concentrations increased up to d 5 after the 1st meal and were
      higher during the 1st month in calves fed 1st colostrum at < 12-13 h than at > 24
      25 h after birth, whereas hepatic concentrations increased up to d 5 independent
      of time of 1st colostrum feeding. Plasma alpha-tocopherol concentrations
      increased after the 1st meal except in calves fed 1st colostrum at 24-25 h after
      birth and were higher during the 1st month in calves fed the 1st colostrum at 6-7
      h than at 24-25 h after birth. In conclusion, delaying 1st colostrum intake by
      more than 12-13 h after birth impaired the plasma beta-carotene, retinol and
      alpha-tocopherol status during the 1st month of life, but did not negatively
      influence hepatic retinol concentrations.

PMID- 11214357
TI  - Bioavailability of water- and lipid-soluble thiamin compounds in broiler
      chickens.
AB  - The bioavailability of thiamin mononitrate, thiamin chloride-hydrochloride and
      benfotiamin was compared in broiler chickens. A thiamin-deficient diet was
      supplemented with either 1.8 and 1.5 mg/kg thiamin equivalent as water-soluble
      salts, or with 1.5 and 1.2 mg/kg thiamin equivalent as benfotiamin, respectively,
      and fed to 3 replicate groups/treatment for 21 days. Weight gain, feed
      consumption and feed conversion rate were not significantly affected by
      solubility or dietary level of thiamin. Likewise, using biochemical indices of
      thiamin status (erythrocyte transketolase activation coefficient, and thiamin
      concentrations in blood and liver), no differences were found between the water
      soluble thiamin salts, indicating that they have identical potency. In contrast,
      biochemical indices of thiamin status showed a significantly higher
      bioavailability for benfotiamin than for the water-soluble sources.

PMID- 11214358
TI  - Thiamin status of gravidas treated for gestational diabetes mellitus compared to
      their neonates at parturition.
AB  - Since thiamin plays a role in glucose metabolism we wanted to know if blood
      thiamin influx from gravida to neonate was influenced by treatment of gravidas
      having gestational diabetes mellitus (GDM). In this study we found thiamin
      hypovitaminemia in 19% of the 77 pregnancies despite vitamin supplementation and
      treatment for GDM; neonates born to mothers with hypovitaminemia were also
      thiamin hypovitaminemic. All neonatal blood had significantly higher thiamin
      concentration than gravidas. Indeed, cord blood from neonates born to mothers
      treated with insulin for GDM had significantly higher thiamin concentration than
      other neonates in the study. A significant weight depression was noted in
      neonates born to treated GDM mothers. Healthy gravidas giving birth to macrosomia
      neonates, had significant thiamin hypovitaminosis, but only macrosomic neonates
      of treated diabetic mothers had significantly depressed blood thiamin
      concentrations. We noted that subclinical thiamin hypovitaminemia is prominent
      during pregnancy despite vitamin supplementation. Perhaps increased thiamin
      supplementation during pregnancy seems warranted to avoid metabolic stress in
      mother and fetus due to thiamin hypovitaminemia.

PMID- 11214359
TI  - Lipid peroxidation in nicotinamide-deficient and nicotinamide-supplemented rats.
AB  - Supplementation or deficiency of nicotinamide in rats may interfere with the
      oxidative balance, with excess leading to greater lipid peroxidation, measured by
      TBARS, and deficiency causing a greater consumption of antioxidants such as
      vitamin E and glutathione. Urinary N-methylnicotinamide excretion was much more
      marked in the supplemented group, whereas the difference between deficient and
      control animals was nonsignificant.

PMID- 11214360
TI  - [Strength training in patients after myocardial infarct].
AB  - The objective of the work was to evaluate the suitability and safety of
      resistance training in patients after myocardial infarction (IM), in older
      patients and to assess the suitable time for including resistance exercise into
      the rehabilitation programme. The group comprises a total of 74 patients after IM
      aged 27-76 years (57 +/- 9). The group included 65 men and 9 women. The authors
      divided the whole group into two sub-groups by age. The first group is formed by
      patients under 65 years and the second one by those aged > 65 years. The authors
      included resistance training from the third week of the rehabilitation programme.
      During the resistance exercise none of the patients suffered from impaired rhythm
      or stenocardia. The total muscular strength during the initial tests was in the
      first group (< 65 years) 105 +/- 26 kg and 93 +/- 26 kg in the group of older
      patients. At the end of the rehabilitation programme in both groups a
      statistically significant increase of the total strength was recorded. In the
      first group it was 120 +/- 20 kg and in the older patients 108 +/- 23 kg, i.e. an
      increase by 14 and 16%. The mean value of the ejection fraction (EF) was at the
      onset of rehabilitation 58 +/- 7% and did not differ substantially in the two
      groups. The mean EF value at the end of rehabilitation was 59 +/- 9% in the first
      group and 58 +/- 10% in the second group (n.s.). The body weight expressed as the
      body mass index was initially significantly lower in the older patients (25.5 +/-
      2.6 kg/m2 vs. 27.4 +/- 3.3 kg/m2, p < 0.01). During the rehabilitation programme
      in both groups a slight but statistically significant decline of body weight was
      recorded. In the first group (< 65 years) to 27.0 +/- 3.2 kg/m2 and in the group
      of older patients to 25.2 +/- 2.4 kg/m2 (p < 0.01). It can be concluded that the
      application of resistance exercise as a supplement of classical aerobic training
      is a suitable, beneficial and safe extension of the regabilitation programme. The
      use of resistance exercise is suitable even in older patients, it is well
      tolerated and is not associated with cardiovascular complications. Resistance
      exercise can be applied already after two weeks of the aerobic programme.

PMID- 11214361
TI  - [Dehydrdoepiandrosterone, dehydroepiandrosteron-sulfate and insulin in acute
      myocardial infarct].
AB  - The authors discuss the relationship between dehydroepiandsoterone, its sulphate
      conjugate and insulin and ischaemic heart disease in patients with acute
      myocardial infarction. In the examined group of patients they found lower values
      of dehydroepiandosterone and its sulphate in men, lower values of
      dehydroepiandosterone in women as compared with mean values with regard to age
      and a close inverse correlation of insulin and dehydroepiandrosterone and insulin
      and dehydroepiandrosterone sulphate. Whether dehydroepiandosterone is the
      "missing link" of hyperinsulinaemia and arterosclerosis is so far only a
      theoretical issue.

PMID- 11214362
TI  - [Helicobacter pylori and nonspecific intestinal inflammation].
AB  - In 50 subjects with non-specific inflammations of the gut the total prevalence of
      Helicobacter pylori positive antibodies was 28%, while in the control group of
      blood donors its was 54% Patients with ulcerative colitis had lower antibodies-
      18%, in Crohn's disease the serum positivity was 33%. The lowest value of
      antibodies was found in patients taking Sulfasalazine--11%. The serum positivity
      was substantially higher in inactive ulcerative colitis and Crohn's disease--35%
      than in patients with signs of high activity--13%. In 28 patients with non
      specific inflammations of the gut endoscopy was performed, in 60% with a
      pathological outcome. Histologically confirmed gastritis was in the majority
      Helicobacter pylori negative. It may be stated that in patients with non-specific
      inflammations of the gut there is a lower incidence of Helicobacter pylori than
      in the general population, in particular those subjects who were or are treated
      with Sulfasalazine. The explanation of this fact is however only speculative.

PMID- 11214363
TI  - [The role of ergometric testing in diagnosis of latent long QT syndrome].
AB  - BACKGROUND: The long QT syndrome is a genetically determined disease based on
      mutations of ion membrane channel genes. The resulting prolongation of
      repolarization increases a risk of malignant ventricular arrhythmias and sudden
      death. The diagnosis is problematic in individuals with borderline or even normal
      corrected QT interval value. Ventricular arrhythmias in this syndrome are often
      provoked by exercise, therefore exercise testing is considered as a useful
      differential diagnostic method. METHODS: In a 24-member family an occurrence of
      the long QT syndrome was established clinically in 7 patients. In other 3 members
      borderline corrected QT interval values were found (0.44-0.46 s). In these
      individuals a stress testing by bicycle ergometry was performed. RESULTS: During
      exercise in a 28-year old man (patient III/6) the corrected QT interval prolonged
      to 0.53 s, in a 27-year old man (patient III/2) and in a 20-year old woman
      (patient III/9) physiological QT interval shortenings were observed (0.4 s during
      peak exercise). The diagnosis was confirmed by molecular genetic investigation.
      In patient III/6 (along with other symptomatic family members) a mutation in exon
      7 of KCNQ1 (previously called KVLQT1) gene was found. In patients III/2 and III/9
      no signs of KCNQ1 gene pathology were present. CONCLUSIONS: In families with
      clinically established diagnosis of long QT syndrome occurrence the exercise
      testing reveals previously asymptomatic individuals, at least in LQT1 type (which
      is the most common). In general stress testing and measurement of QT interval
      dynamics is a necessary part of arrhythmological investigation especially in
      young individuals with history of syncope.

PMID- 11214364
TI  - [Echocardiography and sonography of the carotid arteries in diabetics with
      cerebrovascular stroke].
AB  - The incidence of cerebrovascular attacks (CVA) in diabetics is 2-3 times higher
      as compared with the non-diabetic population. The objective of the present work
      was to evaluate etiological factors by means of echocardiography and sonography
      of the carotid arteries. The authors evaluated retrospectively findings of these
      examinations in 253 patients with CVA in a group of diabetic and non-diabetic
      patients as well as in a group of patients with atrial fibrillations or sinus
      rhythm. In patients with a sinus rhythm the presence of diabetes was associated
      with a more frequent finding of atherosclerotic changes, significant stenoses of
      the carotid vessels (2% as compared with 8%, p < 0.05) as well as thickness of
      the intima in the carotid bulbus (0.78 as compared with 0.96 mm, p < 0.05).
      Conversely when evaluating signs of thromboembolic risk, i.e. the size of the
      left ventricle (42 vs. 40 mm, n.s.) and ejection fraction of the left ventricle
      (55% vs. 50%, n.s.) no statistical significance in the difference of parameters
      was found. In the sub-group of patients with atrial fibrillation, who accounted
      for 28% of the group, the authors did not find when comparing diabetic and non
      diabetic patients, any difference as regards the presence of significant stenoses
      in the carotid arteries nor in the thickness of the intima. There was no
      statistically significant difference in the size of the left atrium and left
      ventricular function. The findings suggest the possibility that the increased
      risk of ischaemic CVA in diabetic patients is caused by the atherosclerotic
      process in the carotid vessels and not a higher risk of embolism of cardiac
      origin.

PMID- 11214365
TI  - [Catheter therapy in patients with stable angina pectoris. Results of 662
      coronary angioplasties].
AB  - Coronary angioplasty supplemented by implantation of a stent has become a
      standard therapeutic method in patients with stable angina pectoris. The authors
      analyzed the spectrum of patients indicated for this treatment, its
      successfulness and complications of catheterizations. In the course of a two-year
      period the authors implemented 662 catheterizations in 602 patients with stable
      angina. 58% patients indicated for coronary angioplasty on account of stable
      angina had a history of myocardial Q infarction, 93% had angina grade II or III
      according to CCS. Affection of one artery was diagnosed in 56% patients, complete
      revascularization was achieved in 59% of the operations. The clinical rate of
      success of catheterization was 97% in stenoses of the coronary arteries and 61%
      in coronary occlusions. In 57% of the treated lesions a coronary stent was
      implanted. Serious clinical complications developed in 1% of the interventions,
      none of the patients died. Catheterization treatment of stable angina is very
      successful and safe.

PMID- 11214366
TI  - [Experimental study of resveratrol and flavonoids in red wine with regard to
      their possible hypolipemic effects].
AB  - Resveratrol (trans-3,5,4'-trihydroxystilben) is a polyphenol (phytoalexin)
      naturally found in wine and different therapeutic plants. It is a substance with
      an antioxidant and estrogenic effect and the ability to inhibit the growth of
      some tumours. Some studies mention its possible antiaggregation, neuroprotective
      and antiallergic effect. In the submitted pilot study the authors investigated
      the effect of resveratrol and flavonoids (anthocyanins, catechins) on serum lipid
      levels, in particular total cholesterol and liver enzymes in the laboratory rat.
      In the experiments healthy animals were used (fed a standard diet) as well as
      hypercholesterolemic animals (fed a special sugar diet) and treated animals. The
      investigated parameters were total cholesterol, HDL-cholesterol, aminotransferase
      aspartate (AST) and alanine aminotransferase (ALT). The conclusions of the
      investigation indicate that resveratrol and flavonoids (anthocyanins, catechins)
      found in red wine significantly reduce the total cholesterol level in the
      hypercholesterolemic rat. The resultant effect of resveratrol and flavonoids on
      liver enzymes in our experiment is not unequivocal.

PMID- 11214367
TI  - [Therapy of vasovagal syncope (nonpharmacologic therapy and pharmacotherapy)].
AB  - Recurrent vasovagal syncope is a frequent clinical problem. Provisions regarding
      the regimen, non-pharmacological treatment and pharmacotherapy are the basic
      principles of management of patients with vasovagal syncope. Regimen provisions
      involve avoidance of predisposing factors and immediate horizontalization during
      initial presyncopal manifestations. Endurance training, tilt training, autogenous
      training and increased intake of salt and fluids are possible ways of non
      pharmacological treatment. According to the relatively extensive number of
      published reports on pharmacological treatment of vasovagal syncope four
      preparations proved effective in randomized placebo controlled trials--atenolol,
      midodrin, paroxetin and enalapril. The author gives an account of non
      pharmacological and pharmacological treatment of vasovagal syncope, whereby he
      concentrates on the validity and clinical importance of different trials.

PMID- 11214368
TI  - [Therapy of vasovagal syncoope (cardiostimulation therapy)].
AB  - Cardiostimulation in used less frequently than pharmacotherapy in the treatment
      of vasovagal syncope. It proves useful in treatment of vasovagal associated with
      bradycardia. Cardiostimulation of both cavities is more effective than of one
      cavity. The optimal cardiostimulation algorithm for treatment of vasovagal
      syncope which ensures and adequate start of cardiostimulation and has an optimal
      effect on haemodynamic parameters is still sought. The rate drop response
      algorithm seems promising. The algorithm was used so far only in one randomized
      study which was to verify the effect of cardiostimulation in the treatment of
      vasovagal syncope--Vasovagal Pacemaker Study. The study proved a marked risk
      reduction of relapses of syncope in highly bradycardia during the tilt test. The
      Vasovagal Pacemaker Study II with is under way at present compares the effect
      cardiostimulation and placebo and the effect of cardiostimulation with the rate
      drop response algorithm.

PMID- 11214369
TI  - [Clinical characteristics of pulmonary embolism].
AB  - Pulmonary embolism is nearly always a complication of deep venous thrombosis. The
      evaluation of risk factors for venous thromboembolism not only aids diagnosis but
      also guides decisions about the intensity of prophylactic measures. As both the
      extent and chronicity of pulmonary vascular obstruction vary widely, pulmonary
      embolism can produce widely differing clinical pictures. From the clinical,
      pathophysiological and therapeutical point of view, it is convenient to classify
      pulmonary embolism into four types: acute minor embolism (dyspnoea with or
      without pleuritic pain or haemoptysis), acute massive embolism (hemodynamic
      instability), subacute massive embolism (mimicking heart failure or indolent
      pneumonia), and chronic thromboembolic pulmonary hypertension (slowly progressing
      dyspnoea). This classification is of importance not only for the rational
      diagnosis and differential diagnosis, but also for the institution of adequate
      therapy. Because the disease has many nonspecific manifestations but no
      pathognomonic symptoms or signs, it is impossible to prove the diagnosis of
      pulmonary embolism alone on the basis of clinical presentation.

PMID- 11214370
TI  - [Diagnosis of pulmonary embolism].
AB  - Accurate diagnosis of pulmonary embolism is essential to minimize morbidity and
      mortality caused by failure to treat when necessary or by inappropriate
      treatment. Because clinical symptoms and signs are nonspecific, it is impossible
      to prove the diagnosis solely on clinical grounds. The diagnosis requires high
      level of suspicion, estimation of the pretest clinical likelihood of embolism,
      and judicious use of objective investigations (scintigraphy, computed tomography,
      or angiography) to confirm or refute the suspicion. The choice of tests depends
      on the availability of these tests, the hemodynamic state of the patient, and the
      presence of other cardiopulmonary diseases. Despite the availability of most
      accurate tests, pulmonary embolism will continue to be missed if not first
      considered by the physician.

PMID- 11214371
TI  - [Adrenomyeloneuropathy as the cause of Addison's disease].
AB  - The authors describe adrenoleukodystrophy and adrenomyeloneuropathy found in one
      family. This disease is a less frequent cause of Addison's disease, but it is
      very serious from the prognostic aspect. The authors recommend therefore to
      examine very long chain fatty acid plasma levels in patients with adrenal
      insufficiency.

PMID- 11214372
TI  - Canada's first-ministers' conference: health care without strings.

PMID- 11214373
TI  - Perilous partnerships: the UN's corporate outreach program.

PMID- 11214374
TI  - Health inequities in the United States: prospects and solutions.
AB  - An overview of the role that social determinants of health play in influencing
      health is provided. Emphasis is on the impact of economic inequality in creating
      health inequities among Americans. Economic inequality is seen as impacting
      health in three ways: increasing economic inequality weakens population health by
      creating poverty; weakening communal social structures that support health such
      as social and health services; and decreasing social cohesion and civil
      commitment. Documentation is provided of the growing degree of economic
      inequality in the USA and complicating issues of racial segregation are
      considered. Specific recommendations for addressing economic inequality, from
      USA, British, and Canadian sources, are presented. These recommendations indicate
      the need to move from epidemiologic research to public health action, from
      demonstrating the major impact of economic inequality on community health to the
      development and implementation of specific policies and programs to reverse the
      continuing increase in economic inequality.

PMID- 11214375
TI  - Using social indicators to inform community drug and alcohol prevention policy.
AB  - In recent years, the federal government has begun to require state agencies to
      allocate drug prevention resources according to the needs of local communities.
      The methods by which this is to be accomplished have not been described, and most
      published social indicator studies in the field of drug abuse research have used
      county-level data which are too insensitive to local needs to be of use in
      resource allocation decisions. The present study describes a needs assessment in
      drug abuse prevention in the state of New Jersey using municipal-level social
      indicator data. In addition, it examines the extent to which the resource
      allocation of one state prevention agency can be predicted by the municipal-level
      social indicators. Thirty-six social indicators pertaining to 508 municipalities
      were used in the study, and data were analyzed using principal component analysis
      and hierarchical regression analysis. Five factors were extracted from the
      principal component analysis, two of which clearly describe "high risk"
      municipalities and one of which clearly describes "low risk" municipalities. The
      regression analysis showed that these factors explained very little of the
      variance in the state agency's drug prevention spending. The study shows that
      social indicators can be used to distinguish between different levels of need for
      drug prevention services at a municipal level, and that these data can be used to
      inform decisions concerning resource allocation.

PMID- 11214376
TI  - The ethics of alternative medicine therapies.
AB  - It is estimated that 42% of the American public is using some form of alternative
      medicine, which reflects the changing needs and values in our society.
      Unfortunately, Western medicine has failed to see alternative medicine as
      complementary and integrative with conventional medicine. This is due to the fact
      that there is very little scientific data available regarding the safety,
      efficacy, optimal dosage and side-effects or interactions of these alternative
      medicine therapies. Many physicians dismiss a patient's questions concerning
      alternative medicine because the physician believes it is "quackery," without any
      proof to support this claim. This violates the patient's right to full disclosure
      of all possible treatment options and encourages patients to use these therapies
      without their physician's knowledge. As a result, it is estimated that 46% of
      those using alternative medicine do so without the supervision of their primary
      care physicians or alternative medicine practitioners. At the present time there
      is no regulatory process to ensure the safety and efficacy of these alternative
      medicine therapies. Manufacturers do not have to prove that their product works,
      but they must ensure that their product is not harmful. The combination of
      failure to inform physicians of usage and the possibility of adverse reactions
      with prescription drugs is placing the lives of many Americans in jeopardy.
      Ethically, consumers have the right to use alternative medicine therapies as a
      matter of autonomy, but they also have the duty not to harm themselves. To ensure
      their safety, alternative medicine therapies must be evaluated in regards to
      safety and efficacy so that they can be integrated into conventional medicine.
      The Federal Drug Administration has the ethical responsibility to take the lead
      in this area. To protect the common good, there is a need to know not only what
      alternative medicine can do for us but what it can do to us.

PMID- 11214377
TI  - The greening of engineers: a cross-cultural experience.
AB  - Experience with a group of mechanical engineering seniors at the University of
      Colorado led to an informal experiment with engineering students in India. An
      attempt was made to qualitatively gauge the students' ability to appreciate a
      worldview different from the standard engineering worldview--that of a mechanical
      universe. Qualitative differences between organic and mechanical systems were
      used as a point of discussion. Both groups were found to exhibit distinct thought
      and behavior patterns which provide important clues for sensitizing engineers to
      environmental issues in future educational initiatives. Cross-cultural and global
      dimensions of these initiatives are discussed.

PMID- 11214378
TI  - "Nature and human values" at the Colorado School of Mines.

PMID- 11214379
TI  - Engineering education for sustainability: reflections on "the greening of
      engineers".

PMID- 11214380
TI  - Overcoming the barriers of insularity. Commentary on: "the greening of engineers:
      a cross-cultural experience".

PMID- 11214381
TI  - "Sherry's secret". Case study and commentary on research ethics.

PMID- 11214382
TI  - Transforming animal species: the case of 'oncomouse'.
AB  - In this paper I deal with ethical implications arising from animal biotechnology.
      I analyse some general questions surrounding the production of transgenic animals
      through a specific case study: the oncomouse. In particular, I explore ethical
      factors involved in the production of oncomice. This is because biologists
      genetically modify animals' germ cells and refuse to modify human germ cells. I
      will underline how the international community has thus far justified this
      'ethical difference'.

PMID- 11214384
TI  - Genes in court.

PMID- 11214383
TI  - DNA patents and scientific discovery and innovation: assessing benefits and
      risks.
AB  - This paper focuses on the question of whether DNA patents help or hinder
      scientific discovery and innovation. While DNA patents create a wide variety of
      possible benefits and harms for science and technology, the evidence we have at
      this point in time supports the conclusion that they will probably promote rather
      than hamper scientific discovery and innovation. However, since DNA patenting is
      a relatively recent phenomena and the biotechnology industry is in its infancy,
      we should continue to gather evidence about the effects of DNA patenting on
      scientific innovation and discovery as well the economic, social, and legal
      conditions relating to intellectual property in biotechnology. We should give the
      free market, the courts, researchers, and patent offices a chance to settle
      issues related to innovation and discovery, before we seek legislative remedies,
      since new laws proposed at this point would lack adequate foresight and could do
      more harm than good. However, we should be open to new laws or regulations on DNA
      patents if they are required to in order to deal with some of the biases and
      limitations of the free market.

PMID- 11214386
TI  - Research practices in need of examination and improvement.

PMID- 11214385
TI  - The 'redefinition of death' debate: western concepts and western bioethics.
AB  - Biomedicine is a global enterprise constructed upon the belief in the
      universality of scientific truths. However, despite huge scientific advances over
      recent decades it has not been able to formulate a specific and universal
      definition of death: In fact, in its attempt to redefine death, the concept of
      death appears to have become immersed in ever increasing vagueness and ambiguity.
      Even more worrisome is that bioethics, in the form of principlism, is also
      endeavouring to become a global enterprise by claiming neutrality. It appears
      that the discourse within both disciplines have similarly manipulated the
      boundaries of death to include the "dying". This paper argues that the
      redefinition of death debate in biomedicine reveals a concept of personhood which
      is profoundly western in origin and which is in accordance to the concept adhered
      to within principlism. Biomedicine and bioethics do not appear to acknowledge the
      limitations of their own world view and hence lack an understanding of their
      applicability and appropriateness in diverse social and cultural contexts; a
      situation which adds credence to claims as to the hegemonic and imperialistic
      nature of all such global enterprises.

PMID- 11214387
TI  - Suppression of scientific research: bahramdipity and nulltiple scientific
      discoveries.
AB  - The fairy tale The Three Princes of Serendip can be taken to be allegorical of
      not only chance discovery (serendipity) but of other aspects of scientific
      discovery as well. Just as Horace Walpole coined serendipity, so can the term
      bahramdipity be derived from the tale and defined as the cruel suppression of a
      serendipitous discovery. Suppressed, unpublished discoveries are designated
      nulltiples. Several examples are presented to make the case that bahramdipity is
      an existent aspect of scientific discovery. Other examples of non-ideal
      scientific research and discovery are provided in order to contrast and clarify
      the meaning and use of bahramdipity. Additional allegories of scientific
      discovery are taken from the tale and a hope for the strengthening of scientific
      integrity is expressed.

PMID- 11214388
TI  - Current trends in the management of deep venous thrombosis and postthrombotic
      syndrome.

PMID- 11214389
TI  - Compliance programs.

PMID- 11214390
TI  - Pediatrics. 1915.

PMID- 11214391
TI  - AMA agrees in principle with privacy effort; cautions that "the devil is in the
      details".

PMID- 11214392
TI  - Principles of observation medicine.
AB  - The defining characteristic of emergency medicine is "time," or the acuity of
      disease presentation. Observation, like resuscitation, involves the management of
      time-sensitive conditions. In the ED there is a continuum of time-sensitive
      conditions. This continuum extends from resuscitation on one end to observation
      on the other. When performed well, observation services have been shown to
      improve diagnostic accuracy, improve treatment outcomes, decrease costs, and
      improve patient satisfaction. For the subset of ED patients who would have been
      inappropriately discharged or unnecessarily admitted, the OU has become a safety
      net of the ED itself. Like EDs, OUs have progressed from being poorly managed
      areas of the hospital to the cutting edge of acute health care. The principles
      developed through past experience and research provide a framework for future
      developments in emergency medicine.

PMID- 11214393
TI  - Management of patients with syncope and cardiac arrhythmias in an emergency
      department observation unit.
AB  - Syncope is an ideal condition for the emergency observation setting because of
      its difficulty in diagnosis, many causes, high liability, and variable diagnostic
      approaches. Hospital admissions can be averted with appropriate patient selection
      for a short-term observation period. Atrial fibrillation is a common presenting
      condition in the emergency department. With aggressive management, the
      appropriately selected patient can have restoration of sinus rhythm and be safely
      discharged home.

PMID- 11214394
TI  - Abdominal pain and emergency department evaluation.
AB  - By approaching the abdominal pain patient in a systematic fashion, the physician
      can improve his or her performance in evaluating the patient in a safe and
      efficient manner without extensive or redundant tests.

PMID- 11214395
TI  - Management of traumatically injured patients in the emergency department
      observation unit.
AB  - An EDOU may be an ideal setting for the short-term monitoring and treatment of
      certain acutely injured patients. The patients choosen for observation, and the
      diagnostic studies used, will be specific to a particular institution's
      availability and expertise. Pathways should be developed in conjunction with all
      services caring for these patients.

PMID- 11214396
TI  - Emergency department observation for toxicologic exposures.
AB  - Most toxicologic exposures resolve within 24 hours, yet catastrophic outcomes may
      occur if patients are directly discharged from the emergency department (ED).
      These cases are, perhaps, the ideal candidates for observation unit (OU)
      management. This article reviews the criteria for admission and discharge as well
      as clinical management strategies in the OU for the most common toxicologic
      exposures. Special attention is given to the multidisciplinary interactions among
      the ED physician, the medical toxicologist, the physiatrist, and the specialty
      laboratory.

PMID- 11214397
TI  - Asthma therapy in the observation unit.
AB  - The management of asthma is a commonly encountered clinical problem. There have
      been major advances in the treatment of asthma, including an increase in the
      drugs available for treatment, as well as in knowledge of the pathophysiology of
      the disease. Despite these advances, however, the prevalence, morbidity, and
      mortality for asthma have shown a disturbing upward trend over the past few
      decades. Experience with the OU management of asthma has shown many advantages:
      decreased inpatient hospitalization, better quality of life for patients, higher
      patient satisfaction, cost-effectiveness, and effective patient care. It is
      estimated that 60% to 70% of asthmatic patients could be treated in an ED
      observation unit instead of in an inpatient hospital ward. There is a tremendous
      opportunity for the OU management of asthma to improve patient care, as well as
      decrease costs, thereby reducing asthma morbidity and mortality.

PMID- 11214398
TI  - Management of patients with infectious diseases in an emergency department
      observation unit.
AB  - Pneumonia, cellulitis, and pyelonephritis are discussed in this review because
      they are the most common infections requiring hospital care, and they all have
      significant death or complication rates and broad differential diagnoses. They
      also demonstrate many of the considerations that could be applied to other
      infections appropriate for OU care. Table 11 lists additional infections that are
      good candidates for OU care. A key to successful OU management of infection is
      early consultation with the primary care physicians and appropriate specialists
      when one is setting up the unit, designing its guidelines, and when treating
      specific patients. Because individual patient outcomes are not predictable,
      increasing the absolute numbers treated and successfully discharged from
      observation can necessarily increase the percentage of OU patients that are
      hospitalized. In essence, a group who would be hospitalized from the ED is
      transferred to observation status, where most avoid hospital admission. Because
      some patients fail to respond, develop complications, or demonstrate alternative
      diagnoses, many troubles can be avoided when the primary care and specialist
      physicians have collaborated in the observation treatment decisions. These
      guidelines have been presented as a starting point. It is clear that more
      research targeted at this group of patients is required to refine current
      practice. As for everything else in medicine, there is no doubt that many of the
      specific recommendations made here will become obsolete in no time.

PMID- 11214399
TI  - Economic issues in observation unit medicine.
AB  - Emergency department observation units are the rational choice for improving the
      utilization of health care resources and at the same time improving the quality
      of patient care. Potential pitfalls can be avoided by flexibility on both the
      part of the observation unit and the hospital administration staff. The continued
      growth of observation medicine throughout the country is evidence that most have
      been successful in designing creative solutions to accommodate this new health
      service.

PMID- 11214400
TI  - Observation unit management of heart failure.
AB  - The acute exacerbation of HF can be treated successfully in the OU. There are
      significant benefits, such as admission avoidance, decreased 90-day readmissions,
      and decreased costs. HF requires a comprehensive management program with
      extensive involvement from a multidisciplinary team committed to improving care
      for this population, however.

PMID- 11214401
TI  - Extended emergency care for painful conditions.
AB  - Painful conditions are a common cause for visits to emergency departments.
      Appropriate therapy often consists of sedating medications followed by a period
      of observation that is beneficial in assessing their effect. The cause of
      abdominal pain is frequently elusive, requiring prolonged testing and re
      examination. Observation is particularly beneficial in assessing this condition,
      while certain other painful conditions are not suitable for emergency observation
      because of the need for prolonged treatment.

PMID- 11214402
TI  - Pediatric observation medicine.
AB  - Observing pediatric patients in an OU (whether a pediatric or combined or hybrid
      unit) has many advantages: better patient care, a decrease in missed diagnoses
      and acuity, better risk management, decreased malpractice liability, cost
      effectiveness, increased patient and family satisfaction, and psychosocial
      benefits. Key principles of observation medicine (purpose, time frame, general
      patient inclusion and exclusion criteria, administration, CQI, and so forth) are
      equivalent for pediatric and adult observation patients, but there are important
      differences. Unique characteristics of pediatric observation patients include
      specific diagnosis, decreased length of stay, less need for cardiac monitoring, a
      highly variable admission rate, and a decreased percentage or admission rate to
      the OU from the ED. Whereas the adult OU is primarily a cardiac-monitoring unit,
      the pediatric OU is a respiratory and infectious disease unit with a frequent
      need for an i.v. therapy and hydration. Types of pediatric patients commonly
      treated in an OU include respiratory illnesses (asthma, croup, bronchiolitis,
      pneumonia), gastrointestinal disorders (gastroenteritis, abdominal pain),
      dehydration, infections (fever, cellulitis, lymphangitis, pyelonephritis or UTI),
      overdoses or poisonings, and seizures.

PMID- 11214403
TI  - Identification of chest pain patients appropriate for an emergency department
      observation unit.
AB  - There are no perfect tests or algorithms to exclude ACI. Because acute coronary
      occlusion often occurs in patients with low-grade coronary stenosis, the
      diagnostic goal of a chest pain diagnostic protocol is not to identify patients
      with CAD, but rather to identify patients who may be safely discharged home
      without the development of complications such as MI, unstable angina, death,
      shock, or CHF over the next 1 to 6 months. There is an advantage to evaluating
      patients at the time of their symptoms. Patients who have a small plaque that is
      ruptured, leading to intracoronary thrombosis and ischemia, will manifest
      ischemia on diagnostic testing that could missed in routine outpatient testing
      when their plaque were stable. The diagnosis and risk stratification of acute
      coronary ischemia in the ED depends on a careful history and interpretation of
      the ECG. Multiple regression models using readily available data (e.g., history,
      physical examination, and ECG) provide the best tools for risk stratification. If
      one is deciding how to select patients for an EDOU chest pain evaluation,
      diagnostic tools that have previously been tested and validated in this setting
      are preferable. These include the Multicenter Chest Pain Study derived tools
      (i.e., Goldman, Lee), the ACI and ACI-TIPI tools, and sestamibi risk
      stratification tools. This is not to say that other tools may not play a role at
      individual institutions. It is probably better to select a consistent approach
      and evaluate its performance, rather than to allow random variation to dictate
      practice. The future direction probably will involve standardization of the ED
      chest pain population. This allows outcome and cost-effectiveness comparative
      research of various strategies for patients with normal or nondiagnostic ECGs and
      normal biomarkers. Although this approach allows more precise stratification, the
      risk will never be zero, meaning that there will never be a substitute for good
      clinical judgment and close follow-up care.

PMID- 11214404
TI  - Cardiac markers protocols in a chest pain observation unit.
AB  - The use of cardiac markers to identify high-risk patients in the observation unit
      is undeniable. As the literature reviewed here reveals, the history and ECG miss
      a significant portion of patients with acute cardiac ischemia. It appears that
      acute MI and some high-risk "unstable angina" observation unit patients can be
      identified within 6 hours of hospital presentation using a combination of cardiac
      markers. Testing these patients soon after symptom onset or on arrival in the ED
      for myoglobin, CK-MB subforms, or CK-MB delta appears to provide the best
      diagnostic usefulness. For testing later in the clinical course, CK-MB troponin
      I, or troponin T are of clear diagnostic and prognostic value. The markers
      currently used are unable to identify the significant subset of patients with
      "non-AMI" coronary syndromes, however. These patients require further testing
      with appropriate noninvasive or invasive diagnostic studies.

PMID- 11214405
TI  - Stress testing for risk stratification of patients with low to moderate
      probability of acute cardiac ischemia.
AB  - In summary, this article focused on the use of stress testing to risk-stratify
      patients at the conclusion of their emergency evaluation for ACI. As discussed,
      those patients in the probably not ACI category require additional risk
      stratification prior to discharge. It should be kept in mind that patients in
      this category are heterogeneous, containing subgroups at both higher and lower
      risk of ACI and cardiac events. The patients with lower pretest probability for
      ACI may only need exercise testing in the ED. Patients with higher pretest
      probability should undergo myocardial perfusion or echocardiographic stress
      testing to maximize diagnostic and prognostic information. Prognostic information
      is the key to provocative testing in the ED. Prognostic information is the
      component that will help emergency physicians identify the patients who may be
      discharged home safely without having to worry about a 6% annual cardiac death
      rate and a 10% overall death rate over the next 30 months. Stress testing
      provides this key prognostic data, and it can be obtained in short-stay chest
      pain observation units in a safe, timely, and cost-effective fashion.

PMID- 11214406
TI  - Psychiatric school consultation. An organizing framework and empowering
      techniques.
AB  - As the myriad biopsychosocial factors contributing to school success become
      better understood, opportunities will expand for child psychiatrists to
      contribute to schools. More collaborative roles with school staff will improve
      both the individual student's success and also the redefinition of schools as
      they better address the future needs of their students. Psychiatric consultation,
      including techniques that empower school staff, will become increasingly
      valuable.

PMID- 11214408
TI  - School-based prevention of problem behaviors.
AB  - Sex and violence are the major sources of morbidity and mortality among American
      youth. Problem-behavior prevention programs based in schools have been found to
      be feasible, acceptable, and desirable to school personnel, parents, and students
      for improving students' health status and educational outcomes.

PMID- 11214407
TI  - High school consultation.
AB  - High schools painstakingly plan their academic standards, curricula,
      instructional approaches, technology, and facilities. Also essential to the
      vision is a systematic plan for developmental guidance, prevention, at-risk
      services, intervention, crisis responding, and postvention. The consultant,
      working in partnership with a caring school staff, can promote safety and well
      being and reduce risk-taking behaviors so that adolescents can get the most
      benefit from school experiences. Several protocols have been described that may
      guide a consultant in helping school personnel.

PMID- 11214409
TI  - Consultation about violent students.
AB  - Violence in the schools is a growing problem. Psychiatrists consulting to schools
      can play an important role in helping school-based professionals with early
      identification, diagnostic evaluations, program planning, and prevention. They
      can also serve as educators and child advocates and help to coordinate and to
      organize a team approach.

PMID- 11214410
TI  - Emerging models.
AB  - In all these models, the potential of child psychiatrists and other mental health
      professionals in decreasing student barriers to learning is promising. While
      expanding the traditional client service model, child psychiatrists can serve as
      advocates for identifying student's unmet mental health needs, encourage schools
      to build capacity for effective responses, be vigilant for quality assurance,
      develop and initiate new programs that systematically respond to needs of the
      school community, and provide training opportunities that demystify the
      psychiatric concepts that can help administrators and teachers. Relatively few
      child psychiatrists are active in the school setting or have developed a presence
      in the national movement to provide mental health services in schools. In
      recognition of the fact that traditional models of psychiatric care such as
      outpatient clinics and hospital-based programs do not reach many children and
      adolescents, it is hoped that child psychiatrists will be more motivated to have
      a more active and rewarding presence in the school setting. Even with the variety
      of responses to the need for increasing mental health services to children, there
      are a lot of unanswered questions. With only 8000 child psychiatrists in the
      United States and 80,000 schools, it is clear that we need to be strategic about
      how best to utilize our resources. The big question is whether there are
      predictable and alterable characteristics, mechanisms, and interactive processes
      that enable high-risk students to attain educational and personal success,
      despite seemingly poor odds. Emerging models have the potential to begin
      answering this question.

PMID- 11214411
TI  - Consultation and therapy in the boarding high school setting.
AB  - The tasks of a psychiatric consultant in the boarding high school setting are
      complex and require a particular set of tools. A thorough familiarity and comfort
      with the psychology and psychopathology of adolescence are necessities. In my
      view a psychodynamic point of view is most helpful. I have emphasized that
      students attending boarding schools are different from all other high school
      students in that they are experiencing a radical and more or less permanent
      separation from their homes a full developmental epoch earlier than their
      nonboarding peers. Whether this separation is helpful and growth promoting or
      traumatic and disruptive needs to be evaluated for each individual whose family
      seeks psychiatric opinion about such matters. Broad generalization is not
      possible. What is required is a careful evaluation of the developmental state of
      the particular teenager and an assessment of the psychologic meaning of the
      experience in terms of that child's psychic reality. To this formulation I add
      that a knowledge of the particular boarding schools under consideration, their
      cultures, mores, personnel, and administrative and academic styles can be of
      great additional help in making a decision. In addition to their radical and
      early separation from home, boarding students find themselves integrated into
      tightly knit school communities, each with its own unique group and institutional
      dynamics. The best consultation work will include an understanding of what is
      occurring at the interface between individual and school community. These
      interactions can be as critical in determining the fate of a boarding student as
      can be the interactions between a student living at home and interacting with his
      or her family. Separated from home and emotionally hungry for new objects to
      replace the ones left behind, the boarding student may have passionate and
      intense interactions with the institutions and members of the school community.
      In this article I have provided a recent example (Ted) of such an intense
      interaction, albeit one with a terrible and tragic outcome. Such anatomies of
      suicides as the one I have tried to reconstruct in this case can provide a
      realistic basis for optimism that a future recurrence can be prevented. Another
      case (Bob, discussed first) illustrated the potential for profound and far
      reaching positive results of the consultation and treatment processes.

PMID- 11214412
TI  - Developing school mental health in a rural state. The New Mexico School Mental
      Health Initiative.
AB  - Enhancing the effectiveness of intervention in addressing barriers to development
      and learning requires collaboration among agencies, schools, families, and
      communities. Inadequate policy support related to any of these matters decreases
      the likelihood of enhancing intervention effectiveness on a large scale.

PMID- 11214413
TI  - Psychiatric consultation to schools on remote islands.
AB  - This article describes psychiatric consultation to schools with a diverse
      cultural group of youngsters in a geographically unique area. Collaborative
      aspects among the child psychiatrist, the sponsoring agency, and other community
      agencies are described.

PMID- 11214414
TI  - Consultation in the classroom.
AB  - The advantages of classroom, playground, and hallway observation are that the
      diagnosing child and adolescent psychiatrist can directly observe the
      difficulties the child is having. When the psychiatrist is an employee of the
      school district, there can be easier access and quicker help for challenging
      students.

PMID- 11214415
TI  - Opportunities within a large metropolitan school district.
AB  - As a school district employee, the child psychiatrist can offer valuable school
      consultations at multiple levels as an "insider." The access to teamwork within
      the district system is particularly empowering and advantageous. This article
      outlines the richness and variety of school consultative opportunities within the
      school district.

PMID- 11214416
TI  - Consultation to administrators.
AB  - Mental health specialists can contribute to improvements in children's school
      experience when they work with administrators to incorporate up-to-date mental
      health knowledge into educational practice. Effective consultation is not simply
      a knowledge dissemination exercise. The impact of the consultant's input is
      determined by how responsive the consultation process is to the needs and assets
      of faculty, students, and the broader community.

PMID- 11214417
TI  - The benefits of a clinician consulting in schools of education.
AB  - A psychiatric clinician was available to lecture and discuss behavior of children
      and adolescents. Faculty in four schools of education in Los Angeles requested
      this service. These were (1) a university graduate school teacher training
      program; (2) a school psychologist training program; (3) an undergraduate
      education program; and (4) an administrator training program. In the last
      program, experiences providing mental health consultation to administrators were
      presented. In the first program, an evaluation was conducted. It emerged that the
      teachers-in-training were able to feel more permission to see their role as
      counselor as an appropriate part of the teacher role. Their increased knowledge
      and understanding of psychopathologic behavior, especially in adolescents, seemed
      to increase their comfort and ability to handle these behaviors.

PMID- 11214418
TI  - A retrospective view of school mental health consultation.
AB  - General principles of mental health consultation as written about by Coleman and
      Maddux are enumerated. Historically, the refinement of these principles for
      school consultation was described in detail in the literature by Gerald Caplan
      and Irving Berlin. Common methods define the consultees' problems as work
      problems; the consultant views the consultees' difficulties as due to
      intrapsychic conflicts. Resolution of the consultees' difficulties requires the
      consultant to use methods that enhance the consultee's self-esteem and indirectly
      provide the consultee insight into the genesis of his or her problems. Thus,
      consultees are gradually better able to help the client with his or her
      difficulties. Training of child psychiatry residents in school consultation
      historically occurred in three divisions of child psychiatry. Training methods
      were quite similar. The history of consultation to school administrators at
      various levels, the issues that emerged, and methods of helping administrators to
      deal with these problems are elucidated. Special problems in dealing with school
      consultation on two American Indian reservations, especially that of gaining
      entrance into the school, are discussed.

PMID- 11214419
TI  - Mental health consultations in the preschool daycare center.
AB  - This article explores some of the challenges to children's emotional and social
      development inherent in the all-day childcare programs for children aged 3 to 5
      years. The psychoanalytically oriented child development community has offered
      ongoing assistance, information, and support to teachers, parents, and children
      in preschools and preschool daycare sites in a number of communities across the
      country. The process and results of a long-term preschool daycare consultation
      are presented.

PMID- 11214420
TI  - School crisis consultation.
AB  - School crisis consultations are services necessary to assist school communities
      recover from disruptions that interfere with a learning environment. Child and
      adolescent psychiatrists are ideal participants in such consultations owing to
      their knowledge of child development, familiarity with school systems, family
      dynamics, stress reactions in children, and crisis intervention skills. The
      exciting challenge is to tailor a consultation based on a needs assessment,
      degree of impact of event, and other resources. Every consultation is a unique
      and stimulating learning experience. Those who develop expertise in this area
      will be poised to lead future consultation efforts. These consultations are now
      informed by an increasing body of research on children's stress reactions and
      various types of interventions.

PMID- 11214421
TI  - Consultation interactions between special education teachers and child
      psychiatrists.
AB  - Characteristics were investigated for 169 special education students referred to
      a child psychiatrist consultant. There was a common occurrence of learning or
      language disorders, predominance of attention deficit/hyperactivity disorder,
      severity and complexity of psychopathology, and undertreatment. The teachers
      especially asked about diagnosis, behavioral management, and medication and also
      about issues involving learning and language disorders.

PMID- 11214422
TI  - Training programs in school consultation.
AB  - The need to train psychiatrists in school consultation is important to approach
      mental health and psychosocial concerns from the broad perspective of addressing
      barriers to learning and promoting healthy development. There is a major national
      impetus to improve academic achievement and literacy, which can be amplified by
      addressing the social, emotional, and mental health needs of children and youth.
      Training in school consultation allows the psychiatrist to better understand a
      critical institution in each child's life and also provides technical assistance
      and training to school personnel, which facilitates networking between programs
      and individuals involved in or interested in school mental health. Each of the
      described programs approaches consultation from a specific focus that varies in
      time commitment, placement options, and frequency and order of didactic
      presentations. There is no conclusive available evidence as to which program is
      most effective, since such evaluation depends on the overall goals of the
      consultation program itself.

PMID- 11214423
TI  - Evaluations of outcome in mental health consultation in schools.
AB  - Outcome evaluation should be a part of every consultation with before-and-after
      measurements and a control group, if possible. Unfortunately, these are not often
      available. Eight examples of outcome evaluations are described, for behavioral
      (child-centered), consultee-centered, and administrative consultations.
      Evaluation can be statistical or verbal. Behavioral consultations often can have
      systemic influences. Comparison is made with outcome in a SBHC.

PMID- 11214424
TI  - Quantification of venous reflux by means of some duplex scanner and light
      reflection rheography parameters and its correlation with chronic venous
      insufficiency symptoms.
AB  - BACKGROUND: The quantification of venous reflux is rarely made but it is valuable
      for studying the natural history of CVI, its prognostic implications and the
      therapy effectiveness. We have evaluated some parameters of chronic venous
      insufficiency, caused by valvular incompetence, by means of duplex scanner and
      light reflection rheography searching for a better correlation with the clinical
      stages of vein disease. METHODS: We have examined 107 patients (35 males, 72
      females; aged 22-78, mean 61.5 +/- 14.3) with long saphenous insufficiency in
      different clinical stages and measured the venous reflux, the reflux duration,
      the reflux grade, the vein diameter near the saphenofemoral junction with the
      duplex scanner and the refilling time with the light reflection rheography. The
      reproducibility of the studied techniques has been determined by examining 20
      legs four times each in the same day or on different days. Statistical analysis
      of the data was performed by means of the variance analysis followed by the
      Waller-Duncan test. RESULTS: The venous reflux, the venous diameter and the
      refilling time can easily range between mild and severe insufficiency: reflux is
      6.3 +/- 2.5 ml/sec at stage I; 27.5 +/- 10.1 at stage III; venous diameter is
      6.04 +/- 1.4 at stage I; 10.6 +/- 2.2 at stage III; refilling time is 23.6 +/-
      9.6 at stage I; 5.4 +/- 2.4 at stage III. The reflux time and reflux grade are
      unable to separate the various CVI stages. CONCLUSIONS: The measurement of venous
      reflux, venous diameter and refilling time is simple, quick, reproducible; these
      indices are able to differentiate mild from severe CVI but unable to separate
      patients at the second stage of the venous disease from those at the third stage
      and then ineffective in the ulcer risk assessment but the reflux is highly
      predictable. The ulcer risk is practically absent for reflux < 12 ml/sec; highly
      probable for reflux > 15 ml/sec (20/46 cases; 43.4%).

PMID- 11214425
TI  - Elective coronary and valve surgery without blood transfusion in patients treated
      with recombinant human erythropoietin (epoetin-alpha).
AB  - BACKGROUND: This study evaluates the real effectiveness of epoetin-alpha
      associated with ferrous sulphate, in reducing blood transfusion in patients
      undergoing elective open heart surgery not treated with autologous donation.
      METHODS: Sixty patients had been divided into 2 groups: group A (30 patients)
      treated with 525 mg ferrous sulphate three time a day per os for 3 weeks; group B
      (30 patients) treated with epoetin-alpha 10,000 UI twice a week and 525 mg
      ferrous sulphate 3 times a day. Grouping of patients has been randomized. In both
      groups hemoglobin, hematocrit, reticulocytes, iron values, ferritine,
      transferrine, and serological values, have been evaluated sequentially before
      treatment, before surgery, day of operation, 1st, 2nd, 3rd, 7th postoperative
      days and at discharge. RESULTS: In group A 86% patients needed blood transfusion
      (26 out of 30); in group B only 3% of patients needed blood transfusion (1
      patient). One year follow up didn't show side effects related to epoetin-alpha.
      CONCLUSIONS: This study confirms the real effectiveness of epoetin-alpha in
      reducing the postoperative need for homologous blood transfusion. No side effects
      due to epoetin-alpha treatment have been proved. The conclusion is drawn that
      epoetin-alpha can be used as an alternative to blood transfusion or in
      association with predeposit and in the treatment of basal anemia.

PMID- 11214427
TI  - [Type "A" aortic dissection. Surgical technique, caseload, and follow-up].
AB  - BACKGROUND: The authors analyse the indications for the various surgical
      strategies through a retrospective study of the morbility and mortality rates in
      their own series of cases and during follow-up. METHODS: 107 patients were
      operated for type A aortic dissection between 1978 and 1998: 69 using a technique
      performed under moderate hypothermia (Group A) and 38 in deep hypothermia (Group
      B). All patients who survived from 1978 to 1994 underwent an accurate follow-up.
      RESULTS: The mortality rate in Group A was 21.7% and 26.3% in Group B. 61.9%
      patients in Group B presented thrombosis of the false lumen, compared to 30.6% in
      Group A. Patients with a false perfused lumen underwent re-do surgery in 9.5%
      compared to 3.5% in those with thrombosed false lumen, and 16.6% showed an aortic
      dilatation rate of over 5 cm compared to 7.1%. CONCLUSIONS: From an analysis of
      these data, and in line with the data reported in the literature, although it is
      impossible lo indicate an ideal surgical strategy for this severe pathology, it
      is extremely important to achieve thrombosis of the false lumen.

PMID- 11214426
TI  - Prognostic significance of markers of thrombin generation in the acute and
      chronic phases of non cardioembolic ischemic stroke.
AB  - BACKGROUND: Previous studies have shown there is activation of the hemostatic
      system, with thrombin generation, in the acute phase of stroke. Such an
      activation has unfavourable effects. It is still not known whether there is also
      a persistent hypercoagulability state in these patients as well as in subjects
      affected by acute coronary syndromes. METHODS: To know more about the issue, we
      measured plasma levels of the prothrombin fragment 1 + 2 (F1 + 2) and the
      thrombin-antithrombin III complex (TAT) in 40 consecutive patients with first
      ischemic non-cardioembolic stroke; 16 matched involutive cardiomyopathy patients
      served as the control group. TATs and F1 + 2 were also assessed six months after
      the onset of stroke symptoms. RESULTS: At baseline stroke patients had higher
      values than controls of both F1 + 2 and TAT (F1 + 2: 2.38 +/- 2.30 nmol/l vs 1.20
      +/- 0.50; p < 0.03; TAT 16.11 +/- 19.60 ng/ml vs 5.51 +/- 4.29; p < 0.05) and
      these measurements were not related to the typical acute phase reactants. After 6
      months F1 + 2 levels in stroke patients were still higher than controls (F1 + 2:
      1.68 +/- 0.80 nmol/l vs 1.20 +/- 0.50; p < 0.05), but there were no differences
      from the baseline levels of F1 + 2 and TAT. According to survival curves
      mortality was significantly higher in patients with hypercoagulability (defined
      as F:1 + 2 and TAT levels more than two standard deviations above the mean).
      CONCLUSIONS: These data confirm that for stroke patients there is sustained
      activation of the blood coagulation system like in unstable angina and myocardial
      infarction these abnormalites may have unfavourable prognostic significance.

PMID- 11214428
TI  - Primary pulmonary hypertension.
AB  - Primary Pulmonary Hypertension (PPH) is a rare disease that progressively
      increases pulmonary arterial pressure and pulmonary vascular resistance to the
      point of right heart failure, in the absence of secondary causes of the disease.
      The following specific risk factors that can trigger PPH have been identified and
      examined: appetite depressant drugs, oral contraceptives and hyperuricaemia.
      Familial PPH transmitted by an incomplete penetrance dominant autosomic mechanism
      is responsible for about 6% of PPH cases. Recent research groups have identified
      the gene responsible for familial PPH. Since pulmonary vasoconstriction is the
      prime cause of PPH, vasodilation of the pulmonary arterial circulation system
      (using prostacyclin in the form of epoprostenol or iloprost) is the main aim of
      treatment.

PMID- 11214429
TI  - Cardiovascular diseases and nitric oxide in humans.
AB  - The production of nitric oxide is impaired in patients with clinical and
      instrumental signs of arteriosclerosis (chronic coronary heart disease, stable
      and unstable angina, myocardial infarction); the NO deficiency is assessed
      through the vascular response to the infusion of stimulating (acetycholine) or
      inhibiting (N-mono-methylarginine) substances upon NO synthesis. Also in
      hypertensive subjects a weak endothelium-dependent vascular relaxation was
      documented, but this phenomenon is not constant and is still to be confirmed. In
      hypercholesterolemic patients a hyporesponsive endothelium-dependent vasodilation
      has been well documented, lipid lowering agents (drugs, apheresis) improve
      endothelium function. In heart failure low NO levels are found proportionally to
      the severity of disease: the expression of No is depressed, but cytokine mediated
      i NOS expression is enhanced, causing exaggerated amounts of NO and producing
      myocyte damage or death. Interesting findings indicated NO inhalation as a useful
      tool for reducing pulmonary hypertension and congestive heart failure.

PMID- 11214430
TI  - Digital necrosis in a woman over eighty.
AB  - Chronic vascular disorders of the upper limbs are not frequently encountered in
      women; in addition, advanced age of onset tends to suggest the presence of common
      diseases such as arteriosclerosis or microembolization. Nonetheless, diagnosis is
      not always straightforward and in some cases both-laboratory and instrumental
      findings can do no more than arouse a diagnostic suspicion. We present a case of
      acro-localized disorder, which proved difficult to diagnose and which we believe
      may be attributed to a slowly progressing form of scleroderma of the extremities
      which, in our case, determined positivity of anticentromere autoantibodies.

PMID- 11214431
TI  - Different impact of carvedilol and transdermal scopolamine on cardiovascular
      performance of mild-moderate chronic heart failure patients: evidence of useful
      effects of scopolamine on tolerance to work load.
AB  - OBJECTIVES: To verify and compare the effects respectively exercised in chronic
      heart failure patients by transdermal, slow release scopolamine patch and by the
      beta and alfa adrenoreceptor blocker carvedilol upon the main indexes derived
      from maximal cardiopulmonary stress test, as well as from analysis of heart rate
      variability. METHODS: In each of 14 patients suffering from NYHA class II chronic
      heart failure, admitted to study, the maximal cardiopulmonary test and heart
      period power spectrum assessment were performed, firstly during usual therapy,
      then after 7 days of continuous adjunctive treatment with scopolamine patch, and,
      finally after 3 months of regular administration of oral carvedilol, added to the
      basal therapy. The need of time enough to the adaptation of the cardiovascular
      system against the carvedilol pharmacodynamics, together with the need of slow,
      progressive dose titration, caused that the onset of therapy with carvedilol was
      separated from assessment of its effects on ergometric and spectral parameters by
      an interval period of 3 months. RESULTS: During administration of low doses of
      scopolamine, the values of VO2max, exercise time and double product were
      respectively 24 +/- 5.3 ml/kg/min, 12 +/- 3 min and 23630 +/- 3760, and resulted
      significantly higher than basal (p < 0.05 in all cases) and carvedilol-related
      readings (p < 0.01 by comparisons with VO2max and double product; p < 0.05 by
      comparison with exercise time). Again during scopolamine, the total variance, LF
      and HF powers exhibited the values reported as follows: 1255 msec2 and,
      respectively, 430 and 250 msec2, thus exceeding significantly the basal levels (p
      < 0.05 from comparison with total power, p < 0.01 from comparisons with LF and HF
      bands) as well as the levels reached during adrenergic blockade with carvedilol
      (LF scopolamine vs LF carvedilol: p < 0.01; total power and HF scopolamine vs
      corrispective carvedilol values p < 0.05). Compared to the basal findings, the
      carvedilol induced a significant reduction in VO2max (p < 0.05), double product
      (p < 0.01), peack of heart rate (p < 0.05) and LF power (p < 0.05), and elicited
      no significant decreases in exercise time; similarly a weak, not significant
      surge was product by carvedilol in total and HF powers. CONCLUSIONS: Therefore,
      in patients with left ventricle asymptomatic dysfunction, the low doses of
      scopolamine potentiate simultaneously the spontaneous heart rare variability and
      cardiopulmonary maximal testing; whereas, the carvedilol acts upon LF oscillatory
      component only, the effects upon total variance and HF band being negligible;
      moreover, this drug depress the myocardial functional capability; in fact, the
      carvedilol has been demonstrated to produce a remarkable fall in VO2max, this
      significant reduction in O2 maximal uptake involving the poor rise in cardiac
      output during the effort or less effective O2 removal from capillary beds or
      both.

PMID- 11214432
TI  - Sonographic assessment of hepatic transplants.
AB  - Liver transplantation has become a standard treatment for end-stage liver
      disease, with survival rates for liver transplant patients increasing steadily.
      Several imaging techniques are used to evaluate patients for possible
      complications of liver transplantation. This article focuses on the role of
      ultrasound and color flow and spectral Doppler in evaluating complications such
      as fluid collections and vascular or biliary obstructions.

PMID- 11214433
TI  - Doctorally prepared R.T.s: a professional profile.
AB  - Registered radiologic technologists holding doctoral degrees were surveyed to
      establish demographic and professional profiles. In addition, the scholarly
      production of this unique group was quantified by self-reports. A majority of
      respondents (67%) were not employed in the radiologic sciences and most had not
      authored journal articles, books or submitted grant proposals. Doctorally
      prepared technologists reported several professional and personal benefits in
      earning the degree, including self-fulfillment, respect and advanced occupational
      opportunities.

PMID- 11214434
TI  - Nuclear medicine infection imaging.
AB  - This Directed Reading introduces the reader to basic immunological processes
      related to infection scintigraphy and describes the radiopharmaceuticals used in
      this type of imaging. Following a discussion of radiation safety and infection
      control, the article explains various applications of nuclear medicine for
      detecting and assessing infection.

PMID- 11214435
TI  - Benign breast disease.
AB  - When faced with a suspicious clinical or mammographic finding, patients may be
      anxious about the possibility of breast cancer. Because many of these findings
      are benign, clinicians attempt to make a rapid and accurate diagnosis to
      definitively rule out carcinoma. Imaging plays a key role in diagnostic
      strategies. This article addresses some of the more common benign breast diseases
      and their differential diagnosis from malignant breast disease.

PMID- 11214436
TI  - How computers will change education.

PMID- 11214437
TI  - Acute epiglottitis.

PMID- 11214438
TI  - Double take.

PMID- 11214439
TI  - Expanding boundaries.

PMID- 11214440
TI  - Electronic medical records.

PMID- 11214441
TI  - Eco-toxicology: traditional and post-normal interpretations of the Great Lakes
      Water Quality Agreement.
AB  - Eco-toxicology is a potentially useful fusing of the two distinct disciplines of
      ecology and environmental toxicology. However, in applying an ambiguous
      "ecosystem approach," since the late 1970s, to the implementation of the Great
      Lakes Water Quality Agreement, there have been difficulties in delimiting the
      Great Lakes issues to be addressed under the Agreement and in ensuring that
      general biological resource management and conservation issues are dealt with
      separately under other existing mandates. There is a priority need for managers
      involved in the implementation of the Great Lakes Water Quality Agreement to
      decide whether the purpose remains one of maintaining and restoring Great Lakes
      water quality or whether it has already been transformed into a broad program to
      maintain and restore ecosystem integrity throughout the entire Great Lakes basin.
      Parts of this ambiguity may have arisen as a result of this fusing of ecology and
      environmental toxicology.

PMID- 11214442
TI  - Field research for the authorisation of pesticides.
AB  - On request of the Dutch government a committee of the Health Council of the
      Netherlands has reviewed the role that results of field research in its broadest
      sense (i.e., including multi-species toxicity tests in the laboratory, research
      on model ecosystems et cetera) can play in ecotoxicological risk assessment for
      the authorisation of pesticides. The Committee believes that field research can
      provide valuable additional data about the exposure of non-target organisms and
      the resultant effects at population, community and ecosystem level. However, it
      frequently is unclear how these data might be used in reaching a decision about
      authorisation. To solve this problem, it is necessary to specify what is
      understood by "unacceptable damage". Both more clearly formulated protection
      goals of the government and a better understanding of the ecological significance
      of effects are needed to clarify this. Furthermore, the Committee points out that
      the statistical power of field trials must be sufficient to allow for the
      detection of changes that might be regarded as ecologically relevant. Finally, it
      recommends keeping a finger on the pulse in relation to authorised pesticides by
      monitoring their presence in environmental compartments and by investigating
      their role in suddenly occurring mortality among conspicuous animal species, such
      as birds, fish and honeybees. This kind of research forms a safety net for
      substances that have been wrongly authorised.

PMID- 11214443
TI  - Effects of endocrine disruptors on prosobranch snails (Mollusca: Gastropoda) in
      the laboratory. Part I: Bisphenol A and octylphenol as xeno-estrogens.
AB  - The effects of suspected endocrine disrupting chemicals on freshwater and marine
      prosobranch species were analysed in laboratory experiments. In this first
      publication, the responses of the freshwater snail Marisa cornuarietis and of the
      marine prosobranch Nucella lapillus to the xeno-estrogenic model compounds
      bisphenol A (BPA) and octylphenol (OP) are presented at nominal concentration
      ranges between 1 and 100 micrograms/L. Marisa was exposed during 5 months using
      adult specimens and in a complete life-cycle test for 12 months. In both
      experiments, the xeno-estrogens induced a complex syndrome of alterations in
      female Marisa referred to as "superfemales" at the lowest concentrations.
      Affected specimens were characterised by the formation of additional female
      organs, an enlargement of the accessory pallial sex glands, gross malformations
      of the pallial oviduct section resulting in an increased female mortality, and a
      massive stimulation of oocyte and spawning mass production. The effects of BPA
      and OP were comparable at the same nominal concentrations. An exposure to OP
      resulted in inverted U-type concentration response relationships for egg and
      spawning mass production. Adult Nucella from the field were tested for three
      months in the laboratory. As in Marisa, superfemales with enlarged accessory
      pallial sex glands and an enhancement of oocyte production were observed. No
      oviduct malformations were found probably due to species differences in the gross
      anatomical structure of the pallial oviduct. A lower percentage of exposed
      specimens had ripe sperm stored in their vesicula seminalis and additionally male
      Nucella exhibited a reduced length of penis and prostate gland when compared to
      the control. Because statistically significant effects were observed at the
      lowest nominal test concentrations (1 microgram BPA or OP/L), it can be assumed
      that even lower concentrations may have a negative impact on the snails. The
      results show that prosobranchs are sensitive to endocrine disruption at
      environmentally relevant concentrations and that especially M. cornuarietis is a
      promising candidate for a future organismic invertebrate model to identify
      endocrine-mimetic test compounds.

PMID- 11214445
TI  - Metals, boron, and selenium in Neosho Madtom habitats in the Neosho River in
      Kansas, U.S.A.
AB  - In 1991 and 1992 we determined the levels of metals, arsenic, boron, and selenium
      in the Neosho River drainage in southeastern Kansas, the primary habitat for the
      threatened Neosho madtom (Noturus placidus). We evaluated concentrations in
      sediments, mussels (Quadrula pustulosa and Q. metanevra), and fish (Percina
      phoxocephala, Cyprinus carpio, and Ictiobus bubalus) from three sites on the
      Neosho River and one site on the Cottonwood River. We also evaluated contaminant
      concentrations in C. carpio composite samples collected by the Kansas Department
      of Health and Environment (KDHE) at two additional locations on the Neosho River
      in 1990-92. Sediments were contaminated by lead. Concentrations of selenium,
      boron, and most metals in mussels were low to normal for biota. Arsenic levels in
      mussels and fish suggest low-level contamination of biota. Aluminum, barium,
      manganese and strontium concentrations were much higher in mussels than in fish.
      Five fish composite samples had cadmium concentrations that indicate chronic
      deleterious effects on biota. Lead concentrations in six fish samples were
      elevated. Mercury concentrations in most large fish composites exceeded
      concentration for protection of animals that might consume them. We believe that
      reductions in cadmium, lead, and mercury contamination, in particular, would
      benefit aquatic life in the river.

PMID- 11214444
TI  - Effects of endocrine disruptors on prosobranch snails (Mollusca: Gastropoda) in
      the laboratory. Part II: Triphenyltin as a xeno-androgen.
AB  - In laboratory experiments the effects of suspected endocrine disrupting chemicals
      on freshwater and marine prosobranch species were analysed. In this second of
      three publications the responses of the freshwater ramshorn snail Marisa
      cornuarietis and of two marine prosobranchs (the dogwhelk Nucella lapillus and
      the netted whelk Hinia reticulata) to the xeno-androgenic model compound
      triphenyltin (TPT) are presented. Marisa and Nucella were exposed via water
      (nominal concentrations 5-500 ng TPT-Sn/L) and Hinia via sediments (nominal
      concentrations 50-500 micrograms TPT-Sn/kg dry wt.) for up to 4 months. Female
      ramshorn snails but not the two marine species developed imposex in a time and
      concentration dependent manner (EC10 4 months: 12.3 ng TPT-Sn/L) with a
      comparable intensity as described for tributyltin. TPT reduced furthermore the
      fecundity of Marisa at lower concentrations (EC10 4 months: 5.59 ng TPT-Sn/L)
      with a complete inhibition of spawning at nominal concentrations > or = 250 ng
      TPT-Sn/L (mean measured +/- SD: > or = 163 +/- 97.0 ng TPT-Sn/L). The extension
      of the pallial sex organs (penis with accessory structures and prostate gland) of
      male ramshorn snails and dogwhelks were reduced by up to 25% compared to the
      control but not in netted whelks. Histopathological analyses for M. cornuarietis
      and H. reticulata provide evidence for a marked impairment of spermatogenesis
      (both species) and oogenesis (only netted whelks). The test compound induced a
      highly significant and concentration independent increase in the incidence of
      hyperplasia on gills, osphradia and other organs in the mantle cavity of N.
      lapillus indicating a carcinogenic potential of TPT. The results show that
      prosobranchs are sensitive to endocrine disruption at environmentally relevant
      concentrations of TPT. Also, M. cornuarietis is a promising candidate for a
      future organismic invertebrate system to identify endocrine-mimetic test
      compounds.

PMID- 11214446
TI  - On developing bioindicators for human and ecological health.
AB  - Risk assessors and risk managers generally either examine ecological health
      (using bioindicators) or human health (using biomarkers of exposure or effect).
      In this paper we suggest that it is possible and advantageous to develop
      bioindicators that can be used to assess exposure and effect for both human and
      non-human receptors. We describe the characteristics of suitable bioindicators
      for both human and ecological health, using mourning doves (Zenaida macroura),
      raccoons (Procyon lotor), and bluefish (Pomatomus saltatrix) as examples, and
      list the general characteristics of other species that would make them useful
      indicators for assessing both human and ecological health. Bioindicators can be
      used cross-sectionally to assess the status of ecosystems and risk as well as
      longitudinally for monitoring changes or evaluating remediation. For both human
      and ecological risk assessment, there are three sets of characteristics to
      consider when selecting bioindicators: biological relevance, methodological
      relevance, and societal relevance. An indicator which fails to fulfill these is
      not likely to be considered cost-effective and is likely to be abandoned. The
      indicator should be readily measured and must measure an important range of
      impacts. For long-term support of a bioindicator, the indicator should be easily
      understood, and be cost effective. We suggest that bioindicators that can also be
      used for both ecological and human health risk assessment are optimal.

PMID- 11214447
TI  - Precipitation and aerosol studies in India.
AB  - In India, rain water and atmospheric aerosols are observed to be alkaline in
      nature due to the influence of soil-derived particles which are rich in
      components like Ca and Mg. These components increase the neutralization potential
      of rain water and have a greater influence at rural site compared to urban site.
      However, if there are continuous rains, the concentration of crustal components
      becomes lower resulting in lower pH of rain water. Unlike the characteristics of
      rain water on continent, the pH of rain water has been observed to be acidic in
      all the events over the Indian Ocean during Pre-campaigns of Indian Ocean
      Experiment (INDOEX). The possible reason for acidic rains over Indian Ocean could
      be the anthropogenic contribution from continent transported by NE winds coming
      towards the ocean during this period.

PMID- 11214448
TI  - Ambient air quality monitoring network design for assessing human health impacts
      from exposures to airborne contaminants.
AB  - Existing methods of establishing ambient air quality monitoring networks
      typically evaluate only parameters related to ambient concentrations of the
      contaminant(s) of interest such as emission source characteristics, atmospheric
      transport and dispersion, secondary reactions, deposition characteristics, and
      local topography. However, adverse health risks from exposures to airborne
      contaminants are a function of the contaminant and the anatomic and physiologic
      characteristics of the exposed population. Thus, ambient air quality monitoring
      networks designed for the protection of public health or for epidemiological
      studies evaluating adverse health impacts from exposures to ambient air
      contaminants should account for both contaminant characteristics and human health
      parameters. A methodology has been established which optimizes ambient air
      quality monitoring networks for assessments of adverse human health impacts from
      exposures to airborne contaminants by incorporating human health risk assessment
      techniques. The use of risk assessment techniques as the basis for designing
      ambient air quality monitoring networks will help to target limited financial and
      human resources to evaluate human health risks from exposures to airborne
      contaminants.

PMID- 11214449
TI  - Spatio-temporal variations of sulphur dioxide patterns with wind conditions in
      central Taiwan.
AB  - Sulphur dioxide (SO2) is one of the main atmospheric pollutants in central
      Taiwan. This article analyses the SO2 concentration seasonal variations and
      spatial distribution using data obtained from ten air quality monitoring stations
      and the Taiwan Weather Bureau. It reveals that SO2 concentration is high in
      winter and low in summer and that high concentration centers are located south of
      the Taichung coal-fired power plant, the main source of SO2 emissions in the
      region. The location of high concentration centers changes with different
      prevailing winds. SO2 variations due to wind direction are not unique. During
      short periods, when meteorological conditions are constant, variation in the
      pollution sources cause variations in the spatial distribution. This has been
      deduced by appreciation of 'Intervention analysis' to time series of hourly data.

PMID- 11214450
TI  - Is private health insurance in trouble?

PMID- 11214451
TI  - Hospital managers of the future--what are their needs?
AB  - In the course of conducting a review of the international Hospital Management MA
      course at the Nuffield Institute for Health, Leeds University, the reviewers
      conducted a survey of international health care trends, especially in developing
      countries, and considered their implications for hospital and health managers.
      The demands on managers are becoming more complex and require new expertise in
      working autonomously, financial planning, organisation development, risk
      management in physical resource use, and quality of clinical care. The course has
      been restructured to take account of the identified needs. This article discusses
      the development needs of hospital managers in the context of changing
      international health trends, and how they can be met. It arises from a review of
      the Hospital Management course at Leeds University, which has been restructured
      to enable managers to meet these challenges. The account may interest not only
      health management development practitioners, but also hospital managers worldwide
      who reflect on their working environment, and how to respond to it.

PMID- 11214452
TI  - [Risk management in hospitals: update and prospect].
AB  - Recently introduced in Europe, the concept of risk management is now recognised
      in hospitals. The end of the 90s was noted in particular for the social emergence
      of nosocomial risks. Tolerated or accepted in the past as just bad luck, they are
      no longer acceptable today: hospitals must be safe. If hospitals cannot guarantee
      the total safety of health care, they must manage as far as possible the risks
      incurred by the patients within the hospital. Risk management is the insurer's
      job. It is also a new hospital profession and a future concern to meet tomorrow's
      ever increasing patient demands for safe health care.

PMID- 11214453
TI  - A quality approach for conducting training needs assessments in the Ministry of
      Health, State of Bahrain.
AB  - In health care organizations around the world, Training Needs Assessments (TNAs)
      have generally followed a professions-based approach. For example, the training
      needs of doctors, nurses, each allied health profession, and distinct support
      staff have been analyzed separately--individualized TNAs conducted for each
      speciality and functional area. Although a professions-based TNA model can
      provide useful information to human resource development (HRD) professionals,
      there are two major drawbacks: (1) it is possible that important training needs
      might be overlooked because of lack of information sharing among professions and
      (2) such an approach does not encourage an interdisciplinary, team orientation to
      service provision. This paper proposes an improved method of conceptualizing
      TNAs, using an approach that builds on the quality management literature (TQM,
      CQI, etc.) which stresses the importance of customer- and service-orientations to
      organizing and measuring organizational and individual performance.

PMID- 11214454
TI  - [Accreditation: the outcome is worth the time and money].
AB  - When the Canadian Council on Health Services Accreditation adopted the Client
      centered Accreditation Program (CCAP), we had to assess our methods and results
      and encourage the staff at all levels and the users to be involved. A complete
      change, considerable benefits: improved staff knowledge of the organisation,
      support and understanding within the teams, improved training through team
      meetings, more room for the patients and their families. Is accreditation costly?
      One cannot put a price on the degree of satisfaction experienced by the staff
      within a team who listens to their opinions and strives to make the daily routine
      as rewarding as possible.

PMID- 11214456
TI  - Children in hospital: a design question.
AB  - Holistic medicine is the global trend in medical care. It involves not only the
      highest possible standard of diagnosis and treatment, but also designing the
      whole experience of being ill and that of hospitalization. In such a frame,
      planning and designing for children has to be considered in such a way that a
      child will be helped to withstand the effects of illness, the separation from
      home and family and the entrance into an unusual, unfamiliar and strange world.
      Although the wellbeing and happiness of children in hospital is the concern of
      the nursing staff and of the parents, many other factors have to be satisfied
      also. A young ill child who has to be treated in hospital has to adjust to a
      number of environmental and treatment conditions which may be upsetting and may
      have far-reaching effects. Because of all these, much effort has been made, over
      the last fifty years, to develop planning and design aspects, which will make a
      child's life in hospital less unnatural. Furthermore, it will reduce the
      unavoidable and inevitable discomfort, disease, pain and misery experienced by
      children. These aspects include avoidance of admission of children into hospital
      whenever possible, operations on a daily basis, unrestricted visits, encouraging
      of parents to visit or to stay with their children, the provision of suitable
      playing facilities, materials, equipment etc. This paper will seek to explore and
      develop: a change in philosophy in child care, its influence on the various types
      of facilities, the importance of the family, the psychological needs as design
      factors such as security, social contacts, personal space, movement, comfort,
      independence, outdoor spaces and others. Factors relating to design parameters
      and standards will also be explored. The meaning and importance of scale is
      highlighted since it is felt that children are not miniature adults, but
      individuals with their own particular capacities.

PMID- 11214457
TI  - Health care systems: the emperor has no clothes.
AB  - Stand-alone hospitals are becoming something of a rarity on the American
      landscape. While hospital boards have repeatedly voted to form systems in the
      last 10 to 20 years, they have been just as likely to neglect to identify
      specific, measurable benefits that a merger would bring to their institution. An
      even if they did, they frequently discontinued evaluating whether system
      formation brought the hoped-for benefits, thereby justifying ongoing system
      participation. It is an incumbent fiduciary obligation to continually ask the
      question: Does continued participation make sense; that is, are we appropriately
      exercising stewardship over the hospitals' or system's assets by participating in
      this system? In a sense, boards are in danger of becoming like the emperor in the
      children's fairy tale, believing they have done the right thing without taking a
      hard look at today's reality.

PMID- 11214459
TI  - Learning lessons.

PMID- 11214458
TI  - Creating knowledge structures in the pharmaceutical industry: the increasing
      significance of virtual organisation.
AB  - This paper explores the specific trend and challenges facing the pharmaceutical
      industry regarding the exploitation of Internet e-commerce technology and virtual
      organisation to develop and maintain competitive advantage. There are two
      important facets of the current trend. One is the rapid development of a complex
      network of alliances between the established pharmaceutical companies and the
      specialised biotechnology company start-ups. The other is the rapid growth of
      internet e-commerce companies dedicated to developing specialised technological
      platforms for acquiring and selling genetic and biochemical knowledge. The
      underlying challenge is how big pharmaceutical companies can emulate some of the
      innovation processes of smaller biotechnology company start-ups, and how they can
      appropriate and applied new technological knowledge on the development of new
      drugs. Pharmaceutical companies in order to retain competitive advantage need to
      continuously monitor all aspects of knowledge management with regard to the R&D
      and manufacturing process (as well as customer management and marketing).
      Technological change and organisational restructuring should be aimed at boosting
      the capacity of large firms to innovate rapidly.

PMID- 11214460
TI  - Managing technology in developing countries.

PMID- 11214461
TI  - A clear view of structural glazing.
AB  - An ideal building skin, which has simplicity, flexibility and planarity, bolted
      systems provide an efficient barrier against weather ingress and can be designed
      to be aesthetically pleasing structures. It is an ideal system for roof or wall
      glazing, since drainage and cleaning is made easy by the totally flush exterior.
      Many innovative applications of bolted systems can be glazed at only 3-4 degrees
      from the horizontal, making it a multi-purpose facade solution for building
      designers. Working together, architect, fenestration engineer, structural
      engineers and glass manufacturer, make up the facade team and each skill is
      highly specialised. As our knowledge of facade technology develops with every new
      building challenge, the most complicated external walls can now be constructed
      with confidence.

PMID- 11214462
TI  - Sustainable construction: the next 40 years.

PMID- 11214463
TI  - Managers and nurses. Going to the devil.

PMID- 11214464
TI  - Managers and nurses. Level crossings.

PMID- 11214465
TI  - Managers and nurses. Without prejudice.

PMID- 11214466
TI  - Care to talk?

PMID- 11214467
TI  - Fractal self-organization of the molluscan (Mizuhopecten yessoensis) hemolymph
      cells capable of aggregation in vitro.

PMID- 11214468
TI  - Soliton-like mode in two-dimensional excitable medium: echo effects induced by
      collision of excitation waves with local nonconductive medium elements.

PMID- 11214469
TI  - Low-frequency oscillations of bacteriochlorophyll and coherent dynamics of nuclei
      in the primary processes of photosynthesis.

PMID- 11214470
TI  - Spontaneous mobility of a lipid layer in a system composed of three immiscible
      liquids.

PMID- 11214471
TI  - Ascorbic acid and nitric oxide production in Escherichia coli.

PMID- 11214472
TI  - Phenotypic dissociation in an Escherichia coli population.

PMID- 11214473
TI  - Picosecond absorption spectroscopy of cytochrome c oxidase: excited states and
      relaxation processes in heme groups of cytochromes a and a3.

PMID- 11214474
TI  - Mechanisms of vibrational mobility of lipid layer in a thermomechanical
      oscillator composed of three immiscible liquids.

PMID- 11214475
TI  - The role of peroxyredoxin in the antioxidant system of respiratory organs.

PMID- 11214476
TI  - Linkage disequilibrium in MNSs blood group system in population of south Backa.
AB  - Linkage disequilibrium is a characteristic of MNSs blood group system which
      performs more frequent association of linked alleles than it is expected in
      comparison with their allelic frequencies. Measure of linkage disequilibrium is
      the difference between expected and actual genotypic frequencies which is stated
      in coefficient of linkage disequilibrium. The purpose of this study was to
      fortify existence of linkage disequilibrium phenomenon inside MNSs blood group
      system in population of South Backa in comparison with calculated allelic
      frequencies. Blood group typing in MNSs system included 1,000 healthy nonrelated
      persons where allelic frequencies, expected and actual genotype frequencies had
      been calculated, as well as the differences between them. Results of
      investigation showed that allele has the highest allelic frequency (0.672), S
      allele has the lowest frequency (0.33), the highest expected frequencies are
      calculated for Ms/Ns (Ms/NS) (0.218) and Ms/Ns (0.2235) genotypes, while the
      actual frequencies are highest for MS/NS (Ms/NS) (0.184), Ms/Ns (0.193) and Ns/Ns
      (0.153) genotypes. Statistically significant difference between expected and
      actual genotypic frequencies occurs for Ms/MS and Ns/Ns genotypes, which means
      that S and M and N and s alleles are more frequently associated and prove the
      existence of linkage disequilibrium phenomenon in population of South Backa.

PMID- 11214478
TI  - [Arrhythmogenic right ventricular dysplasia].
AB  - INTRODUCTION: Arrhythmogenic right ventricular dysplasia (ARVD), disease of
      uncertain etiology, is characterized by fibrofatty collections in the right
      ventricular myocardium, premature ventricular complexes with left bundle branch
      block (LBBB) morphology, ventricular tachycardia and fibrillation. GOALS: To
      point out diagnostic methods for this progressive disease and to analyze
      differential diagnosis and significance of arrhythmogenic right ventricular
      dysplasia in young, active athletes. RESULTS: Arrhythmogenic right ventricular
      disease can be asymptomatic or manifested (syncope). It is not uncommon that the
      first evidence of the disease is ventricular tachycardia/fibrillation or sudden
      cardiac death. Results of electrocardiography, echocardiography, invasive and
      other methods can, even after few years, be negative for ARVD. The most
      significant ECG features are inverese T wave in precordial V1-V3 leads and
      widened QRS complex (> 120 ms) in V1 lead. Significant echocardiographic features
      and data obtained by invasive hemodynamic examinations are: dilated right
      ventricle, left and right ventricular end-diastolic diameter ratio less then 0.5,
      hypokinetic/akinetic areas involving the wall of the right ventricle,
      predominantly inferobasal, apical and wall of the left ventricular outflow tract.
      Findings may also include deep fissures among hypertrophied trabeculae. Biopsy
      may reveal fibrofatty tissue in hypo/akinetic regions of the right ventricular
      myocardium. DISCUSSION AND CONCLUSION: Since arrhythmogenic right ventricular
      dysplasia is diagnosed in predominantly young population, not uncommonly
      athletes, and since it may be cause of sudden cardiac death, there must be a high
      degree of suspicion in cases with activity related VT/VF and positive family
      history (it is proposed that it is a hereditary disease).

PMID- 11214479
TI  - [The modern approach to wound treatment].
AB  - INTRODUCTION: Wound healing is a complex process involving interactions among a
      variety of different cell types. The normal wound repair process consists of
      three phases--inflammation, proliferation, and remodeling that occur in a
      predictable series of cellular and biochemical events. Wounds are classified
      according to various criteria: etiology, lasting, morphological characteristics,
      communications with solid or hollow organs, the degree of contamination. In the
      last few years many authors use the Color Code Concept, which classifies wounds
      as red, yellow and black wounds. This paper presents conventional methods of
      local wound treatment (mechanical cleansing, disinfection with antiseptic
      solutions, wound debridement--surgical, biological and autolytic; wound closure,
      topical antibiotic treatment, dressing), as well as general measures (sedation,
      antitetanous and antibiotic protection, preoperative evaluation and correction of
      malnutrition, vasoconstriction, hyperglycemia and steroid use, appropriate
      surgical technique, and postoperative prevention of vasoconstriction through pain
      relief, warming and adequate volume resuscitation). THE ROLE OF PHYSIOLOGICAL
      FACTORS AND ANTIMICROBIAL AGENTS IN WOUND HEALING: Growth factors play a role in
      cell division, migration, differentiation, protein expression, enzyme production
      and have a potential ability to heal wounds by stimulating angiogenesis and
      cellular proliferation, affecting the production and the degradation of the
      extracellular matrix, and by being chemotactic for inflammatory cells and
      fibroblasts. There are seven major families of growth factors: epidermal growth
      factor (EGF), transforming growth factor-beta (TGF-beta), insulin-like growth
      factor (IGF), platelet-derived growth factor (PDGF), fibroblast growth factor
      (FGF), interleukins (ILs), and colony-stimulating factor (CSF). Acute wounds
      contain many growth factors that play a crucial role in the initial phases of
      wound healing. The events of early wound healing reflect a finely balanced
      environment leading to uncomplicated and rapid wound healing. Chronic wounds, for
      many reasons, have lost this fine balance. Multiple studies have evaluated the
      effect that exogenously applied growth factors have on the healing of chronic
      wounds. In the study conducted by Knighton and colleagues, topical application of
      mixture of various growth factors (PDGF, TGF-beta, PDAF, PF4, PDEGF) demonstrated
      increased wound healing over controls. Brown and associates demonstrated a
      decrease in skin graft donor site healing time of 1 day using topically applied
      EGF. Herndon and ass. used systemic growth hormone in burned children and
      reduction in healing time made a significant clinical difference by allowing
      earlier wound coverage and decreasing the duration of hospitalization. The TGF
      family of growth factors is believed to be primarily responsible for excessive
      scar formation, especially the beta 1 and beta 2 isoforms. TGF-beta 3 isoform has
      recently been described and may have an inhibitory function on scar formation by
      being a natural antagonist to the TGF-beta 1 and TGF-beta 2 isoforms. Cytokines,
      especially interferon-alpha (INF-alpha), INF-alpha, and INF-alpha 2b, may also
      reduce scar formation. These cytokines decrease the proliferation rate of
      fibroblasts and reduce the rate of collagen and fibronectin synthesis by reducing
      the production of mRNA. Expression of nitric oxide synthase (NOS) and heat shock
      proteins (HSP) have an important role in wound healing, as well as trace elements
      (zinc, copper, manganese). Applications of some drugs (antioxidants-
      asiaticoside, vitamin E and ascorbic acid; calcium D-pantothenate, exogenous
      fibronectin; antileprosy drugs--oil of hydnocarpus; alcoholic extract of yeast)
      accelerate wound healing. Thymic peptide thymosin beta 4 (T beta 4R) topically
      applicated, increases collagen deposition and angiogenesis and stimulates
      keratinocyte migration. Thymosin alpha 1 (T alpha 1R), peptide isolated from the
      thymus, is a potent chemoattractant which accelerates angiogenesis and wound
      healing. On the contrary, steroid drugs, hemorrhage and denervation of wounds
      have negative effect on the healing process.

PMID- 11214477
TI  - [Therapeutic approach and results in the treatment of subglottic tracheal
      stenosis].
AB  - INTRODUCTION: We had the opportunity to treat upper respiratory tract stenosis,
      so the aim of this paper was to present results of treatment of subglottic and
      upper tracheal stenosis in our clinical material. MATERIAL AND METHODS:
      Retrospective study included a period of 5 years (1990-1995), and evaluated
      results of treating 11 patients with subglottic laryngeal stenosis--with stenosis
      of proximal tracheal part. There were 6 females and 5 males ranging from 2-65
      years of age. Nine patients had postintubational stenosis, one patient had
      corrosive injury, and one had congenital stenosis which occurred in older age.
      Apart from two patients, the rest were already treated in other institutions in
      our country (1-6 times) where they underwent laser (6 patients) or open surgical
      resection (3 patients). Diagnosis of stenosis was based on laryngotracheoscopy,
      laryngotracheal tomography, and CT. RESULTS: The patient with congenital
      subglottic stenosis underwent resection with laryngomicroscopy. Two weeks later,
      she was decannulated, having good breathing and voice. Two youngest patients,
      aged 2 and 10 years, underwent dilatation of upper tracheal part and subglottic
      stenosis, followed by Montgomery T tube placement. The two-years-old boy had the
      tube for 26 months. During that period, his tube was once replaced with wider
      one, and after that, he was decannulated. He has a good voice with preserved
      mobility of vocal cords, but he still has stenosed subglottic level, which partly
      narrows the lumen, so his tracheotomy is still present. We successfully
      decannulated a 10-year-old boy, who had the tube for 18 months after stenosis
      dilatation. In eight patients stenosis of proximal tracheal part and subglottic
      part of larynx was diagnosed. It was 2.5 to 4 cm long. In three patients we
      diagnosed tracheal malacia, and in one of them also cricoid malacia with luxation
      of one arytenoid and ankylosis of the other. In all patients we performed
      resection of proximal tracheal part with excision of half of cricoid ring. What
      was left of laryngeal stenosis was cut out and covered with distal tracheal
      mucosa or Thiersch grafting. In two patients after resection of proximal part of
      the trachea and part of cricoid ring, end-to-end anastomosis was performed
      without tube placing, with excellent results. In six patients Montgomery T tube
      was placed, and in four of them it stayed for 6 to 12 months. These four patients
      were later decannulated with good functional results. In the rest of two
      patients, we did not resolve the stenosis of proximal part of trachea and
      subglottic space of the larynx. DISCUSSION: In etiology of chronic subglottic
      stenosis postintubational stenoses are dominate. Methods we used were successful
      in solving high tracheal and subglottic stenosis if the stenotic part was at
      cricoid level. In higher subglottic stenosis, other techniques are to be used.
      CONCLUSION: We presented cases of 11 patients with high tracheal and/or
      subglottic laryngeal stenosis. In one patient stenosis was solved by
      laryngomicroscopy, in two with subglottic stenosis dilatation. Eight patients
      were operated using segmental resection of proximal tracheal part and part of
      cricoid ring, using end-to-end method. In our opinion this method gives good
      results in stenosis which does not spread higher than upper cricoid cartilage.
      Some patients can be operated without tracheotomy. For higher stenoses, this
      method is not recommended.

PMID- 11214480
TI  - [What do we know today about diaminodiphenylsulfone?].
AB  - INTRODUCTION: Diaminodiphenylsulfone or dapsone is a chemical analogue of
      sulfapyridine, synthesized in 1908. Dapsone is a bacteriostatic agent that proved
      to be efficient in treating leprosy and malaria, but today it is used in treating
      dermatologic noninfectious inflammatory diseases. PHARMACOLOGY: Dapsone is orally
      used in a dose of 50-400 mg per day in treatment of dermatologic diseases, and
      also in a dose of 50-100 mg per day in leprosy treatment. Dapsone is mainly
      eliminated from the body by urine and smaller part by faeces. Pharmacological
      interaction was reported when it is used with rifampicin and probenecid.
      MECHANISM OF ACTION: The bacteriostatic effect of dapsone is well known. It
      involves inhibition of folic acid synthesis in susceptible organisms. The anti
      inflammatory effect of dapsone, which proves to be efficient in treating
      noninfectious inflammatory diseases, has not been explained completely yet. There
      are some pieces of evidence that anti-inflammatory action is not connected with
      its antibacteriological action. CLINICAL USE: Based on previous studies about
      therapy efficiency of dapsone in treating some diseases, there are two groups of
      diseases: the group responding well to dapsone (leprosy, malaria, DH, linear IgA
      dermatosis, erythema elevatum diutinum, bullous systemic lupus erythematosus) and
      a group responding with average good response to dapsone (pyoderma gangrenosum,
      bullous and cicatricial pemphigoid, acne conglobata, discoid cutaneous lupus
      erythematosus, subcorneal pustulosis dermatosis, granuloma faciale, rheumatoid
      arthritis, polychondritis, leucocytoclastic vasculitis). ADVERSE EFFECTS: Adverse
      effects depend on the dose and they rarely occur at doses less than 100 mg per
      day. They are mainly shown on skin, nervous system, digestive system,
      hepatobiliary system, and kidney and hematologic system. The most important
      adverse effects are hemolytic anaemia and methemoglobinemia. Hemolysis usually
      occurs at doses of 200 mg and more per day. In patients with glucose-6-phosphate
      dehydrogenase deficiency, hemolysis may be provoked by a dose less than 50 mg per
      day. For prevention, before using dapsone in therapy, clinical examination with
      history, blood parameters, liver and renal parameters and determination of
      glucose-6-phosphate dehydrogenase level are recommended. CONCLUSION: The use of
      dapsone is absolutely indicated in DH treatment and erythema elevatum diutinum.
      Because of anti-inflammatory effects, dapsone can also be used in treating other
      inflammatory noninfectious dermatoses when one should take care about "therapy
      efficiency/adverse effect" balance using the correct dose, monitoring relevant
      clinical and laboratory parameters and educating patients.

PMID- 11214481
TI  - [Late results of myocardial revascularization in patients with coronary artery
      endarterectomy].
AB  - INTRODUCTION: The aim of this study was to evaluate long-term results after
      myocardial revascularization in patients with diffuse and distal coronary
      disease, and to compare this procedure with the classical approach--indirect
      myocardial revascularization (revascularization without endarterectomy). MATERIAL
      AND METHODS: This retrospective study was done in the period of three years, and
      includes patients operated between January 1, 1985 and December 31, 1990 at the
      University Clinic of Cardiovascular Surgery, Novi Sad. 500 patients were included
      and two groups were made. The investigated group consisted of 251 patients with
      endarterectomy and control group of 249 patients without endarterectomy. Other
      parameters (age, gender, preoperative hemodynamic parameters etc.) were
      practically the same. RESULTS: Postoperative mortality (PM) during immediate 30
      postoperative days was 4.64% in the investigated group, and 1.97% in the control
      group (total PM = 2.66%). The main causes of death were cardiac (3.74%), and the
      rest of them were respiratory, renal and cerebral. The highest postoperative
      mortality according to the localization of endarterectomy was left artery
      descendent (LAD) in the position of the first septal artery (36.36%). The follow
      up study included 500 operated patients. The mean follow-up period was 9 years (0
      13 years). Cumulative survival curve and postoperative myocardial infarction
      curve made by Wilcocxon (Gehan) and Kaplan-Meier methods showed no statistically
      significant difference between groups after 13 years of follow up. Lower incident
      of new angina was found in the investigated group (p < 0.01). Most of patients
      show good physical condition, well toleration of the stress test (Bruce protocol)
      and no significant impairment of ejection fraction. DISCUSSION: Despite its long
      history and development, endarterectomy of coronary arteries is one of the most
      controversial methods in cardiac surgery. Application of this method was very
      restrictive mostly because its complexity and very controversial results from one
      institution to another. Endarterectomy of the first septal artery has the highest
      operative risk, but it is the method of choice in full revascularization of this
      region. Despite higher operative mortality, the immediate and long term results
      of this study show that endarterectomy of the coronary arteries is a method with
      very acceptable operative risk. CONCLUSION: Endarterectomy is a good and
      effective method for direct myocardial revascularization in cases with diffuse
      coronary disease. It is the best procedure for revascularization of the septum.
      The number of endarterectomies and low ejection fraction are independent
      predictors for early and long-term mortality. Endarterectomy is also a method of
      choice in patients with low ejection fraction and poor coronary bed. Frequent and
      repeated application of angioplasty, higher incidence of diffuse and distal
      coronary disease and no available donors for heart transplantation will increase
      the application of this method. In the future we expect further improvement and
      complete affirmation of endartrectomy of coronary arteries.

PMID- 11214482
TI  - [Premalignant and malignant lesions of the uterine cervix--personal experience].
AB  - INTRODUCTION: Cervical pathology represents the most frequent cause of mortality
      and morbidity in regard to female genital diseases in Serbia. The aim of this
      study was to establish the occurrence and grade of histopathologic lesions by
      examination of cervical biopsy specimens taking into consideration the patient's
      age and knife conization as a diagnostic-therapeutic procedure. The study
      included a period of 1993-1997 at the Department of Gynecology and Obstetrics of
      the Health Center in Sremska Mitrovica. MATERIAL AND METHODS: Criteria for biopsy
      were: colposcopic or naked eye evaluation of lesions and Papanicolaou smear grade
      III or higher. Conization was not performed in cases with: low grade squamous
      intra-epithelial lesion (L-SIL) with HPV (human papillomavirus) and high grade
      squamous intra-epithelial lesion (H-SIL) or microinvasive Ca (< 5 mm without
      distribution by lymph or blood). None of the patients had undergone biopsy
      before. RESULTS AND DISCUSSION: Our results show high occurrence of malignancy,
      mainly of invasive type. In elder patients all grades of pathologic lesions were
      established, whereas knife conization showed high efficacy. Although patients
      might be exposed to risk factors predominantly in their older age, it is evident
      that public knowledge is poor, while physician-patient relationship is
      unsatisfactory. CONCLUSION: In accordance with reported, it can be concluded that
      there is a great need for public health education as well as improvement of
      secondary health care in the long run.

PMID- 11214483
TI  - [Cardiovascular disease risk factors in product quality control workers at the AD
      Neoplant facility in Novi Sad].
AB  - INTRODUCTION: Monitoring the health status of the employed in the meat industry
      "Neoplanta", a high prevalence of cardiovascular risk factors was observed. It
      was also observed that workers employed in the meat industry have specific
      dietary habits as a result of working practice. Their hypercaloric diet is with
      high dietary animal fat and protein intake. This particularly refers to the group
      of workers in charge of the quality control of meat products who, besides regular
      hot meal and frequent business lunches, consume certain quantities of these
      products on a daily basis. A common characteristic shared by members of this
      group is that they very seldom or never have preventive medical examination.
      OBJECTIVE: The objective of this paper was to determine cardiovascular risk
      factors in this group of workers and to evaluate educational program effects on
      the prevalence of risk factors. MATERIAL AND METHODS: Cardiovascular risk factors
      were examined in 39 workers (28 men and 11 women) involved in the daily control
      of meat products and performing executive jobs of different complexity levels in
      the meat industry "Neoplanta". Cardiovascular risks and lipid status were
      examined before and after a nine-month-long educational program. Occurrence of
      increased risks and lipid status elements were tested, p < 0.05. RESULTS:
      According to obtained results hypercholesterolemia is present in 94.87%, obesity
      in 82.05%, positive family cardiovascular anamnesis in 74.48%, physical
      inactivity in 69.33%, continuous alcohol consumption in 69.23%, excessive
      consumption of black coffee in 61.54%, hypertension in 51.28%, "stress
      alleviation" with food in 46.15%, hypertriglyceridemia in 46.15% and cigarette
      smoking in 46.15% of examinees. Cigarette smoking, chi 2 = 1.85, alcohol
      consumption, chi 2 = 0.26, black coffee drinking, chi 2 = 0.22, preparation of
      the meals on the fat, chi 2 = 0.10 has remained unchanged after educational
      program. The number of patients "alleviating" stress with food, chi 2 = 5.26 and
      physically inactive patients, chi 2 = 1.06 has significantly increased. Body
      mass, chi 2 = 0.06 and hypertension, chi 2 = 1.42, has not reduced,
      hyperholesterolemia has remained unchanged, chi 2 = 2.22, LDL-cholesterol has
      decreased insignificantly, chi 2 = 0.60, while HDL-cholesterol has decreased
      significantly, chi 2 = 4.27. Atherosclerosis index has increased significantly,
      chi 2 = 4.47. Thus, poor effects of the educational program can be attributed to
      unchanged lifestyle habits of the examined workers. CONCLUSION: It can be
      concluded that cardiovascular risk factors as well as lipid status elements have
      not decreased in this group of workers after educational program and therefore
      continuous medical educational program is suggested with purpose to increase the
      motivation of workers.

PMID- 11214484
TI  - [The CO2 laser and verruca vulgaris].
AB  - INTRODUCTION: Verruca vulgaris, or a common wart, is a benign epithelial
      contagious tumour. It is usually flesh-coloured hyperkeratotic papule of a small
      size (few millimetres in diameter) although sometimes it may reach up to 2 cm in
      diameter. Milder, more conservative chemical therapy often requires weeks or
      months and is often unsuccessful. More aggressive therapy (e.g.
      electrodesiccation and curettage) may result in significant morbidity, tissue
      damage, and scarring. Plantar warts are particularly problematic. CO2 laser has
      numerous applications in dermatology and dermatologic surgery. It is versatile,
      being either a vaporising tool or a light scalpel. CO2 laser is an excellent
      modality for treating problematic or recurrent warts. In our experience it has
      now become the method of choice for warts. The aim of the present investigation
      was to evaluate the efficacy of the laser treatment in comparison to more
      conventional forms of treatment. MATERIAL AND METHODS: Surgical laser was used at
      15 W power at superpulsating, pulsating and continuous beam. The wavelength was
      10,600 nm and the laser was used at infrared spectrum. Active substance was CO2
      in combination with nitrogen and helium at following proportion: CO2:N2:He =
      4.5%:13.5%:82%. It was used under the pressure of 20-80 mbars. Lesions are
      treated with laser in a focused mode at low to medium-power density in a series
      of brief pulses (0.05-0.1 sec). Treatment was carried out under magnified vision
      (2.5x magnifying loupes) in order to see all small satellite warts and to judge
      more precisely when all wart tissue has been vaporized. All interventions were
      performed under local anaesthesia with either carticaine-chloride or 2% lidocaine
      chloride. All interventions were performed between 1992-1996 in an outpatient
      clinic. Warts were excised with a combination of vaporization and resection of
      the wart root. RESULTS: The laser beam promptly sterilized the operative field
      more efficiently than any other commonly used disinfectant. Healing was by
      granulation and the post-operative period was relatively painless for the
      patient. Healing resulted in either no scar or a supple flexible scar which was
      asymptomatic. DISCUSSION: Verruca vulgaris most often occurs on fingers and hands
      of children and teenagers (most commonly between ages 18 to 20). Resistance to
      therapy is common, and recurrences are frequent. Carbon dioxide laser is a high
      precision, bloodless light scalpel used for incising and excising tissues with
      sealing of small blood vessels. It is the treatment of choice for local
      destruction of intraephithelial neoplastic lesions. The carbon dioxide beam may
      be used to remove tissue in one of two ways. First, the lesion may be vaporized
      until a bed of healthy tissue is reached. The second and better technique is to
      use the beam as a scalpel to excise a lesion with appropriate margins. Post
      operative morbidity and complications are low, and long-term results appear to be
      excellent. CONCLUSION: Laser therapy of common warts is a novel form of treatment
      of these papillomavirus-induced skin tumours. Our results show that this method
      has numerous advantages over more conventional forms of treatment.

PMID- 11214485
TI  - [Postpartum anemia--incidence and etiology].
AB  - INTRODUCTION: Anemia is the most common puerperal complication which increases
      the risk of maternal morbidity in postpartal period with incidence of up to 56%
      of women. In 90% cases the etiology of postpartal anemia is decreased serum iron
      level. Postpartal hemorrhage (loss of blood more than 0.5 L during labor) is the
      cause of anemia in 5-10% of women. MATERIAL AND METHODS: This prospective study
      included 4009 postpartal women with normal pregnancy and delivery who gave birth
      during the year 1997 at our Department. There were 3305 women with vaginal
      delivery and 704 women who had cesarean section. Anemia was diagnosed when the
      hemoglobin serum concentrations were less than 100 g/L (6.21 mmol/L) and
      hematocrit less than 0.31. RESULTS AND DISCUSSION: Although about three quarters
      of pregnant women had 8 and more obstetrical controls and 3 and more ultrasound
      examinations during pregnancy, only half of them had blood count control 3 or
      more times. Blood count was checked 3 or more times during pregnancy in 54.98%
      women and 32.9% of all women took iron medication during pregnancy but no longer
      than 12 weeks. Before pregnancy 0.6% of women had anemia, and after the delivery
      that number increased to 25.41% with no significant differences between those who
      had vaginal delivery and those with cesarean section. The incidence of newborns
      with anemia was 5.11% in both groups. These results show that anemia of mother
      has no influence on anemia of the newborn who has its own mechanisms of
      compensation. The etiology of puerperal anemia was in 79.18% women caused by low
      serum iron levels with no differences between both groups, but infection caused
      anemia was more frequent in women with cesarean section (11.8%) than in women
      with vaginal delivery (0.36%). CONCLUSION: Although one third of pregnant women
      take iron medication during pregnancy, every third woman has anemia after
      delivery, both vaginal delivery and cesarean section. Women who had cesarean
      section had anemia more frequently caused by infection. Anemia is 5 times more
      frequent in the mother than in her newborn. Prophylactic iron medications during
      pregnancy are not recommended, but more frequent control of blood count during
      pregnancy is required, as well as adequate therapy of anemia.

PMID- 11214486
TI  - [Acute meningococcemia in a 4-month-old infant].
AB  - INTRODUCTION: What causes meningococcial diseases (MD) is a Gramm-negative
      diplococcus Neisseria meningitidis (meningococcus). Most frequently it manifests
      itself in the form of meningitis and meningococcemia. The mortality rate of those
      suffering from MD has not significantly changed for three decades and ranges from
      7% to 19%, and for meningococcemia from 18% to 53%. According to the data
      presented by domestic authors, of the total of the diseased with bacterial
      meningitis 75% are children with mortality rate from 6% to 15%. Severe forms of
      meningococcemia sometimes have extremely rapid development and lethal outcome
      within a few hours. Key elements for establishing the diagnosis of
      meningococcemia are presence of hemorrhagic rash with high fever, loss of
      interest in the environment, loss of consciousness and paleness. CASE REPORT: The
      boy was admitted to hospital as an emergency case on 29 December 1988 at 11:45.
      The disease manifested abruptly the day before. He burst into tears easily, would
      take very little food and in the evening his temperature rose T degree 40.8
      degrees C. Before midnight, in the village he was given injections of: lincomycin
      300 mg and lasdol 250 i.m. During admittance the infant was agitated, kept
      moaning. His skin was pail gray with dot-like and spot-like hematoma which were
      more numerous and intense on the left ear, lower part of the body, scrotum and
      legs. The infant breathed heavily and fast (FR: 100/min) Cardiologist's finding
      showed: tahicardia over 200/min, buffled tones, gallop rhythm, pulsating neck
      veins and edema point to acute heart failure. Large fontanelles remained swollen
      even after lumbar puncture (LP) and extraction of 15 ml of clear cerebro-spinal
      fluid. Soon after admittance the boy stopped moaning but didn't cry when pricked
      and slipped deeper into coma. During the third hour of treatment generalized
      convulsions began which lasted approximately 10 minutes and stopped after i.v.
      administered diazepam. The boy remained in coma the second day in lethargy and
      with swollen fontanelles on the third day, so the first subdural puncture was
      then performed bilaterally. On that occasion only from the right side 8 ml of
      reddish liquid was obtained. Right after he was admitted we began permanent
      transfusion, which lasted 17 days. On the first day he received fresh blood
      transfusion. He was administered benzinpenicilline, chloramphenicol-succinate,
      lanatoside, human albumins, dexamethasone.... Blood oxygenation was carried out
      in the first few days of illness during the exhibited cardio-respiratory failure.
      DISCUSSION: Among risk factors, which contribute to occurrence of
      meningococcemia, is also artificial infant food. The reported boy was incorrectly
      fed with overdiluted cow milk. That and apparent hemostasis brake-down only
      worsened anemia and increased susceptibility to infections. Although LP was
      performed when the boy was admitted and the nutritious foundation was soaked with
      cerebro-spinal fluid, no bacteria were isolated or their presence confirmed in
      cerebro-spinal fluid colored after Gramm's method, because the child was given
      linkomycin the previous night. CONCLUSION: On the basis of clinical findings,
      hemorrhagic rush, convulsions, coma and acute heart failure as well as the
      laboratory findings it was concluded that it was a case of severe
      meningococcemia, meningitis and subdural effusion. Listed therapy and six
      subdural punctures led to full recovery of the patient. Further examination by a
      pediatrician and a psychologist eliminated the possibility of mental deficiency.
      The boy is now a good fifth grade elementary school pupil.

PMID- 11214487
TI  - [Importance of self-assessment of functional and communication abilities on the
      outcome of rehabilitation in patients with hemiplegia after cerebrovascular
      stroke].
AB  - INTRODUCTION: Cerebrovascular insult causes focal damage of the central nervous
      system structures consequently causing loss or disturbance of their functions.
      Motor deficit is often associated with personality alterations generally
      speaking, as well as changes in behavior and loss of numerous neuropsychological
      functions. Rehabilitation of such patients should be defined by all members of
      the team, including the patient himself and members of his family. MATERIAL AND
      METHODS: This is a case report on a male patient 49 years of age with rightsided
      paralysis accompanied by aphasia. Thirty days after cerebrovascular insult he was
      transferred from the Clinic of Neurology in Novi Sad to the Clinic of Medical
      Rehabilitation. Functional disability assessment was made using Barthel Index,
      whereas communication was assessed by Boston Diagnostic Aphasia Examination. The
      rehabilitation program included, apart from the usual team, the patient himself
      and members of his family. The patient became the center of the team and was
      informed about the disease. Personal assessment of the patient on his functional
      and communication abilities and their importance for further progress was used to
      set the objectives of the rehabilitation program. The rehabilitation program was
      performed by a speech therapist and a psychologist, including kinesis, work
      activities, occupational therapy, individual and group therapy. RESULTS: The
      outcome of the rehabilitation program in this patient was significantly better
      than expected. DISCUSSION AND CONCLUSION: This case report shows that being the
      center of the rehabilitation team the patient takes an active part in setting
      objectives of the rehabilitation program, whereas involvement of the family,
      knowledge on necessary medical issues about the disease, contribute to better
      motivation and better outcome of the rehabilitation program in patients with
      hemiplegia caused by cerebrovascular insult.

PMID- 11214488
TI  - [Simultaneous extracranial and intracranial otogenic complications].
AB  - INTRODUCTION: Chronic otitis media is the most common cause of otologic
      complications. A simultaneous occurrence of extracranial and intracranial
      otologic complications is rare in clinical practice. In this paper, we are
      presenting a patient with exacerbation of chronic otitis media and associated
      otologic complications: peripheral facial nerve palsy and subdural cerebral
      abscess. CASE REPORT: A patient aged 56 who has suffered from chronic otitis
      media during the past 37 years, was admitted at the Clinic of Otorhinolaryngology
      due to worsening of the underlying disease. The clinical examination revealed
      chronic otitis media with granulation in the external auditory canal, pulsatile
      discharge and extracranial otologic complication--facial nerve paralysis. The
      preoperative diagnostic procedure included: cochleovestibular investigations
      (hearing disorder of mixed type on the left side with normal labyrinthine
      function), temporal bone radiography (sclerotic cell alteration of mastoid on the
      left), topodiagnosis of facial nerve). The laboratory finding confirmed increased
      number of leukocytes (21.7 x 10(9)/l), increased erythrocyte sedimentation rate
      (25/58 mm/h), increased fibrinogen (5.0 g/l) and presence of protein in urine.
      Chest and heart X-ray findings were normal. Staphylococcus aureus was isolated
      from ear discharge by microbiological investigation. Signs of meningitis were
      negative, the liquor was colorless, slightly stirred up with total number of
      cells 384 x 10(6)/l, sugar 2.7 mmol/l and total proteins from 0.82 g/l.
      Bacteriological liquor culture was negative. The ophthalmologic examination
      confirmed normal finding of the eye fundus and absence of increased cranial
      pressure. For further diagnostics CT (computerized tomography) and MRI of head
      (magnetic resonance imaging) were performed. The findings confirmed subdural
      abscess and suspected encephalitic foci of the left cerebral lobe. According to
      findings, surgery involving radical trepanation of the temporal bone,
      decompression of facial nerve, denudation of sigmoid sinus dural sinus and angle
      area and incision of dura mater of the cranial fossa posterior with drainage of
      subdural abscess (meningitis surgery) was performed. CONCLUSION: A simultaneous
      occurrence of extracranial and intracranial otologic complications accompanied by
      subdural abscess is rare in clinical practice. The mechanism of development and
      spreading of subdural abscess is very interesting. In this case, subdural abscess
      caused the reaction of dura mater, which has prevented spreading of the disease
      by cerebrospinal liquid at the onset. However, there is a possibility of its
      further spreading by blood vessels into the brain white substance, where
      encephalitic foci may develop and later brain tissue abscesses as well. The
      clinical course of subdural abscess may be atypical, without headache and
      increased cranial pressure. This kind of disease demands a complex diagnostic
      procedure, sufficient otosurgical and neurosurgical interventions, cooperation
      with infectologist and administration of antibiotic therapy.

PMID- 11214489
TI  - Smallpox vaccination in Senta County in the early 19th century.
AB  - The objective of this paper was to report data on vaccination against smallpox in
      the first decades of the 19th century in the documentation of the historical
      archives of Senta. The most important documents regulating smallpox vaccination,
      its control and way of conducting it are presented in complete. One of the most
      important documents is a poster proclamation from 1814 by which vaccination of
      children against smallpox was requested. Another document from 1817 was found and
      it certifies, with great certainty that at that time (or since that time)
      vaccination against smallpox was present at the territory of Senta. Authors
      consider that these documents are of utmost importance and that they represent
      documents enriching history of medicine in our regions.

PMID- 11214490
TI  - [News in oral therapy of diabetes mellitus].
AB  - INTRODUCTION: Recent interest in regard to therapy of diabetes mellitus has
      focused on novelties in the field of insulin and other kinds of therapies
      disregarding the contemporary achievements in oral therapy. DIETARY PLANT FIBER:
      Dietary habits and food preferences in developed countries reveal lack of dietary
      plant fiber associated with the epidemiologic expansion of widespread
      noninfectious diseases (metabolic, cardiovascular and some malignant neoplasms).
      INHIBITORS OF INTESTINAL ALPHA-GLYCOSIDASES: These are substances which
      competatively and reversibly inhibit the intestinal alpha-glycosidases. The best
      known among them is acarbose, already in clinical usage for some time. Its wide
      application has been limited due to fairly distressing side effects. NEW ORAL
      HYPOGLYCEMIC AGENTS: Although metformin is not a new agent, it deserves attention
      because it is a novelty in our country. It is extremely useful in therapy of
      obese diabetics with insulin resistance and hyperinsulinemia. Furthermore,
      glimepiride--a new sulphonyluretic agent is also at disposal, being better than
      the previous due to not inhibiting vasodilatory reaction and so it can be used in
      treatment of some heart diseases. A completely new group of oral hypoglycemics is
      represented by thiazolidine agents which represent the so-called insulin
      sensitisers. Apart from that, they have a favourable effect on some lipid
      fractions and arterial blood pressure. SOME OTHER HYPOGLYCEMIC AGENTS: Among
      numerous substances with hypoglycemic effect it seems that in the future
      sulphonyluretic agents might be replaced by benzoic acid preparations.

PMID- 11214491
TI  - Superstition vs science. More sinned against than sinning.

PMID- 11214492
TI  - The origins and nature of the cognitive paradigm: an overview.
AB  - Although cognitive science, the 'science of mind' is generally regarded as of
      relatively recent vintage, its origins can actually be traced back to ideas from
      the 1930s. The purpose of this paper is to offer a view of the essential nature
      of what has come to be called the cognitive paradigm--the framework around which
      cognitive science has come to be constructed--and about its origins and
      development. Of particular note is the interdisciplinarity of the field, with its
      strong links to psychology, linguistics, neurobiology, computer science and
      philosophy. As will be explained below, this interdisciplinary character is
      rooted in the historical development of the science itself, and can only be
      understood in such a context. Thus, the present article is strongly historical in
      spirit and content.

PMID- 11214493
TI  - Cardiovascular responses to head-down-body-up postural exercise (Sarvangasana).
AB  - Sarvangasana (SVGN) is a head-down-body-up postural exercise in a 'negative g'
      condition. Though highly recommended as one of the three best of all the asanas
      it has not yet been studied for its very obvious effects on the cardiovascular
      (CV) functions. This paper reports the results of the first systematic
      investigation on SVGN employing echocardiographic analysis in eight healthy male
      subjects before and after a practice of this asana twice daily for two weeks. The
      resting heart rate (HR) and left ventricular end-diastolic volume (LVEDV) were
      significantly reduced (P < 0.02, P < 0.01 respectively) after practising this
      asana. A tendency toward a mild regression of the left ventricular mass was
      noticed, though it was not statistically significant. The CV responses to acute
      45 degrees head-down tilt (HDT) in a tilt table was not altered after practising
      this asana. Also there was no orthostatic intolerance during the 3-5 min period
      of 70 degrees head-up tilt (HUT). These results strongly indicate that further
      studies of this asana performed for a longer period is most likely to yield very
      significant observations of applied value.

PMID- 11214494
TI  - Effects of exogenous vitamin C on ethanol toxicity in rats.
AB  - The effect of a mega dose of ascorbic acid (200 mg/100 g body wt.) on alcohol
      induced toxicity in rats was evaluated. In rats administered alcohol and ascorbic
      acid, malondialdehyde (MDA), hydroperoxide and conjugated dienes decreased in
      comparison with that given alcohol alone. The reduced activities of scavenging
      enzymes, e.g. superoxide dismutase (SOD) and catalase, in ethanol-administered
      rats were also enhanced by the co-administration of ascorbic acid and ethanol. Co
      administration of ethanol and ascorbic acid reduced phospholipids and MDA levels
      of the erythrocyte membrane in comparison with that of the ethanol fed rats. The
      reduction in the activities of glutamic oxaloacetic transaminase (GOT), glutamic
      pyruvic transaminase (GPT), gamaglutamyl transpeptidase (GGT) and the decrease in
      triglycerides levels also clearly showed the protective action of ascorbic acid
      in reducing ethanol induced toxicity.

PMID- 11214495
TI  - Comparative profiles of sodium valproate and ethosuximide on electro-behavioural
      correlates in gamma-hydroxybutyrate and pentylenetetrazol induced absence
      seizures in rats.
AB  - Sodium valproate (VPA) and ethosuximide (ESM) were compared on behavioural and
      EEG changes in gamma-hydroxybutyrate (GHB) and pentylenetetrazole (PTZ) rat
      models of Absence Seizures (AS). Both GHB, 100 mg/kg i.p. and PTZ, 20 mg/kg i.p.,
      produced repetitive episodes of staring and immobility with concomitant 6 to 9 Hz
      spike and wave discharges (SWDs) in the EEG. The parameters used for drug
      evaluation were the number and duration of SWDs/hour. Though the number of
      SWDs/hour produced by GHB and PTZ were not significantly different, the duration
      of SWDs was significantly longer in GHB treated rats (P < 0.001) VPA and ESM, at
      200 mg/kg i.p., reduced SWD number and duration in GHB pretreated rats, whereas
      ESM, 50 mg/kg i.p., was four times more effective than VPA, 200 mg/kg i.p., in
      the PTZ model. Phenytoin (PHY) 20 and Carbamazepine (CBZ) 10 mg/kg i.p., worsened
      AS, a feature which has also been reported clinically. Both rat models of
      experimental AS can be used to defect potential anti-absence activity in new
      chemical entities.

PMID- 11214496
TI  - Lipid peroxidation and antioxidant enzyme levels of intestinal renal and muscle
      tissues after a 60 minutes exercise in trained mice.
AB  - To investigate the effect of blood perfusion difference on oxidant status, mice
      were trained by a 7-week running program. Two days after the last training
      session, mice were exercised for 60 minutes at the same training intensity.
      Changes in the concentration of thiobarbituric acid reactive substance (TBARS),
      as an index of lipid peroxidation, in intestine, kidney and muscle, were studied
      in trained mice immediately (0 h), 3 h and 24 h after the running exercise and in
      unexercised control group. The activities of superoxide dismutase (SOD),
      glutathione peroxidase (GPx) and xanthine oxidase (XO) were determined in these
      tissues. Tissue SOD activities were unaffected by the exercise. Muscle GPx
      activity increased after exercise (0 h and 3 h group, P < 0.01) and returned to
      control levels at 24 h, but there was not any significant difference in
      intestinal and renal tissues. Renal tissue XO activity could not be determined.
      There was not any significant difference among groups in intestinal tissue XO
      activity. The activity of XO was decreased only in skeletal muscle at 0 h (P <
      0.05). TBARS levels of exercised groups were higher than control in muscle (P <
      0.01). Intestinal TBARS levels decreased at 0 h (P < 0.05), than reached to
      control level. Renal TBARS levels of 0 h and 24 h group was higher than control
      (P < 0.01, P < 0.01 respectively). The results show that a long distance running
      exercise may cause lipid peroxidation damage in skeletal muscle and kidney.

PMID- 11214497
TI  - The effect of delta sleep-inducing peptide on the EEG and power spectra in rat.
AB  - The effects of delta sleep-inducing peptide (DSIP) on the EEG and power spectra
      of adult male Wistar rats (b.w. 180-220 g) were studied by power spectra analyses
      of EEG wave forms recorded continuously for 12 h after DSIP administration. The
      animals were given DSIP i.p. (1 mg/kg). Saline-injected rats served as the
      corresponding control. Recorded bursts of high amplitude EEG in the 1-9 Hz range
      (delta and theta) were found to be more frequent in DSIP-treated animals, while
      power spectra and (delta) wave activity were enhanced in comparison with the
      control and a statistically significant increase was registered in all
      experimental points after DSIP (2 h P < 0.05; 4 h P < 0.05; 5 h P < 0.05; 6 h P <
      0.05; 7 h P < 0.01; 11 h P < 0.05). In addition, DSIP significantly elevated both
      the EEG output in the (delta) range and sleep activity. These results suggest
      that DSIP should be considered as a potential agent for the treatment of sleep
      disturbances in human medicine.

PMID- 11214498
TI  - Experimental evaluation of Bocopa monniera on rat gastric ulceration and
      secretion.
AB  - The anti-ulcerogenic effect of fresh juice from the whole plant of Bocapa
      monniera Wettst. (BMJ) commonly known as Brahmi in Hindi was examined using
      gastric ulcer models induced by ethanol, aspirin, 2 h cold restraint stress and 4
      h pylorus ligation. Bocapa monniera juice (BMJ) at doses of 100 and 300 mg/kg and
      sucralfate at a dose of 250 mg/kg were given orally, twice daily for 5 days. BMJ
      100-300 mg/kg produced significant antiulcer activity in all the experimental
      gastric ulcer models except in case of ethanol-induced ulcers where 100 mg/kg was
      not found to decrease it significantly. BMJ (100-300 mg/kg) was found to have
      little or no effect on the offensive acid-pepsin secretion, while cell shedding
      (microgram DNA/mg of protein) and mucin secretion in terms of total
      carbohydrates:protein ration (TC:P), the two important parameters of defensive
      factors were significantly decreased and increased respectively indicating
      enhancement of protective mucosal factors. Both BMJ (300 mg/kg) and SF showed
      tendency to increase the mucosal glycoproteins in terms of TC:P, though
      individual carbohydrates and total carbohydrates were either increased or showed
      a tendency to increase. Thus, ulcer protective effect of BMJ may be due to its
      effect on mucosal defensive factors like enhanced mucin secretion, mucosal
      glycoprotein and decreased cell shedding rather than on offensive factors such as
      acid and pepsin.

PMID- 11214499
TI  - Status of pulmonary function tests in adolescent females of Delhi.
AB  - Progesterone is known to cause hyperventilation and hypercapnia in the luteal
      phase of a normal menstrual cycle. Viewing this fact lung functions were measured
      in 71 girls with a mean age of 14.5 years during their follicular and luteal
      phase of menstrual cycle. Subjects were grouped into I, II and III depending on
      the age range. Respiratory functions comprising of FVC, FIVC, TLC, RV/TLC, FEV1,
      FEV1/FVC, FRC, PEFR, FEF 25%, FEF 50%, FEF 75%, PIFR, RAW and KST respectively
      were performed using Spiro 232 of PK Morgan under standardized laboratory
      settings. The anthropometric parameters such as height, weight and arm span were
      also recorded. The majority of pulmonary functions reflect better values in
      luteal phase as compared with follicular phase however, a statistically
      significant higher results of FVC, FIVC, FEV1, and TLC were noticed in group I
      and group III. These observations suggest a possible role in increased level of
      progesterone in luteal phase on respiratory system.

PMID- 11214500
TI  - Effect of nimodipine on male reproductive functions in rats.
AB  - Nimodipine, a dihydropyridine calcium channel blocker, was administered orally
      using two different doses (40 mg and 60 mg/kg/day) to rats. Both short term (2
      weeks) and long term (6 weeks) effects of the drug were observed. The drug
      administration resulted in a marked decrease in sperm density, sperm motility and
      acrozomal reaction. Zona-pellucida penetration by the sperm obtained from drug
      treated animals was significantly lower when compared with sperm from normal
      animals. Nimodipine stimulated Ca2+ ATPase activity in isolated plasma membrane
      of rate spermatozoa. In conclusion, short term and long term administration of
      nimodipine has deleterious effect on male reproductive functions in rats.

PMID- 11214501
TI  - Relationship of seminal plasma transferrin with seminal parameters in male
      infertility.
AB  - This study was undertaken to investigate whether there is relationship between
      seminal plasma transferrin and seminal parameters which included sperm count,
      motility and morphology. The study included 100 male subjects in the age group of
      23-41 yrs including 7 proven fertility, 6 post-vasectomised and 87 subjects were
      of idiopathic infertility. Estimation of seminal plasma transferrin concentration
      was done by using Mancini's single radial immunodiffusion technique. Study of the
      seminal parameters (Sperm count, Motility and Morphology) was done by using
      guidelines of WHO Manual. Mean seminal plasma transferrin concentration in proven
      fertility subject was 5.35 mg/dl (+/- 2.07) and in normozoospermic subject was
      4.63 mg/dl (+/- 2.50) which was significantly higher (P < 0.001) than those of
      oligozoospermic, azoospermic and post-vasectomised subjects. Coefficient of
      correlation between seminal plasma transferrin concentration and sperm count was
      statistically significant (r = 0.3087, P < 0.001). The seminal plasma transferrin
      concentration was correlated with the percentage of motile sperms and was
      statistically significant. However no correlation could be demonstrated with
      various grades of motility. Statistically significant correlation was not found
      between transferrin and sperm morphology. The present study demonstrates that
      seminal plasma transferrin concentration is correlated with sperm count and
      percent motile sperms. Thus sertoli cell secretion-transferin has a positive
      influence over spermatogenesis and can be used as a marker of testicular
      function.

PMID- 11214502
TI  - Event related evoked potential responses in epileptic patients.
AB  - The effect of epilepsy on cognitive functions has been investigated in this
      study. The P300 auditory event related potentials (AERP), Wechsler Adult
      Performance Intelligence Scale (WAPIS--Indian Adaptation) & Digit Span Test (DST)
      have been used to assess the cognitive status. Twenty primary generalised
      epilepsy patients and 20 normal controls were subjected to WAPIS & DST testing
      and their AERP recorded. On comparative statistical analysis, epileptic subjects
      were found to have significantly higher N2 & P300 latencies and lower P300
      amplitude, WAPIS-IQ scores & DST scores. These findings suggest that there is a
      general decline of cognitive functions in epileptics especially the memory,
      attention, concentration and speed of mental processing and as also corroborated
      by P300 and that P300 can be used as an additional sensitive parameter to assess
      the cognitive status.

PMID- 11214503
TI  - Effect of head-up tilt on cardiovascular responses in normal young volunteers.
AB  - Since the cardiovascular effects of tilting are influenced by degree as well as
      duration of the tilt, we planned to study the time course of blood pressure and
      heart rate (HR) responses during 30 degrees, 60 degrees, 80 degrees head up tilt
      (HUT). The study was conducted on 20 volunteers aged 18-20 y who were tilted on a
      tilting table. Blood pressure was determined by sphygmomanometer and HR was
      calculated from R-R interval of ECG. 30 degrees HUT produced an insignificant
      decrease in systolic pressure (SP) and pulse pressure (PP) while diastolic
      pressure (DP), mean pressure (MP) and rate-pressure-product (RPP) registered an
      insignificant rise. The changes produced by 60 degrees and 80 degrees HUT were
      more marked than those produced by 30 degrees HUT. While SP and PP decreased
      significantly, HR and RPP increased significantly. In conclusion, 30 degrees HUT
      produces insignificant changes while 60 degrees and 80 degrees HUT produce
      significant changes in SP, PP and RPP.

PMID- 11214504
TI  - Long-term effects of postnatal aluminium exposure on acetylcholinesterase
      activity and biogenic amine neurotransmitters in rat brain.
AB  - The long-term effects of early postnatal exposure to aluminium on acetyl choline
      esterase (AChE) activity and on biogenic amines were studied in different brain
      regions. The subjects were eight days old male Wistar rat pups. They were grouped
      into normal control and aluminium exposed groups. For aluminium exposure, the
      pups were gastric intubated with aluminium chloride (40 mg/Kg body weight) for
      two weeks. Control rats were given equal volumes of distilled water. After the
      treatment, they were rehabilitated for forty days. On the sixtieth day, the rats
      from both the groups were sacrificed and AChE activity, levels of dopamine,
      noradrenaline and serotonin were estimated in the cerebral cortex, hippocampus,
      septum, brainstem and striatum. In the aluminium exposed group: the AChE activity
      was significantly decreased in the hippocampus, septum, striatum and brainstem;
      serotonin levels were reduced by 20% in the cortex, hippocampus, septum and
      striatum; in brain stem, the serotonin level was decreased by 40%. A 60%
      reduction in noradrenaline levels was observed in the striatum whereas it was
      reduced by 25% in other regions except in hippocampus. Though dopamine levels
      were not altered in the cortex, septum and brainstem, they were reduced by 40% in
      the striatum. The study documents the long-term consequences of exposure to
      aluminium during the developmental periods.

PMID- 11214505
TI  - Minimum muscular fitness in school children.
AB  - Two hundred and fifty school boys from Lonavla were randomly selected and tested
      with Kraus-Weber tests for their minimum muscular fitness. The results revealed
      that 20.8 per cent boys failed in the tests. Multiple failures were 4.8 percent
      while flexibility failures alone were 11.6 percent. Boys at the age of 15 years
      failed more in flexibility test. Boys at the age of 10 years had the maximum
      percentage of failures to the extent of 38.5. Inclusion of Yogasanas in the
      programme of physical activities of the school is suggested for the improvement
      of the status of the failures.

PMID- 11214506
TI  - Changes in fibrinolytic activity of blood after prostatectomy.
AB  - After prostatectomy, hypofibrinogenemia and bleeding were reported earlier. The
      objective of present study is to find out, of blood, after prostatectomy. Blood
      samples of patients posted for operations were studied by following tests before
      and after operation along with controls. 1. Euglobulin lysis time. 2. Plasminogen
      assay. 3. Fibrinogen estimation. The results showed clearly that there is
      decrease in euglobulin lysis time indicating increased plasminogen activator
      level, increased plasminogen level and decreased fibrinogen level after the
      operation. This suggests that there is significant increase in fibrinolytic
      activity of blood after prostatectomy leading to hypofibrinogenemia and clotting
      defects.

PMID- 11214507
TI  - Some biochemical changes in heme synthesis in iron deficiency.
AB  - Some enzymes and intermediates of heme synthesis were determined in blood and
      urine of 26 women with severe iron deficiency anemia (IDA). Erythrocyte free
      protoporphyrin was almost doubled and delta-aminolevulinate dehydrase
      significantly raised. But urinary excretion of delta-aminolevulinic acid and
      reticulocyte ferrochelatase were significantly reduced in iron deficiency anemia.
      Hence these could serve as useful indices of iron deficiency and consequent
      anemia.

PMID- 11214508
TI  - Effect of alcohol dependence on the levels of duodenal disaccharidases in human
      subjects.
AB  - BACKGROUND: The aim of the study was to detect the duodenal enzyme activity in
      patients of alcohol dependence and to compare with non-alcoholic patients of non
      ulcer dyspepsia. METHODS: Disaccharidases (lactase, sucrase, maltase) were
      estimated in 20 non alcoholic patients of non-ulcer dyspepsia and 20 alcoholics
      admitted to the drug de-addiction and treatment centre of PGIMER, Chandigarh,
      India. RESULTS: No significant influence of alcohol on enzyme levels in patients
      of alcohol dependence when compared to patients of non-ulcer dyspepsia was
      observed. However, a significant decrease in lactase level was noted in patients
      consuming more than 125 gm/day of alcohol. CONCLUSION: Amount of consumption of
      alcohol showed decrease in lactase enzyme, but not in maltase and sucrase. There
      was no effect of duration of alcohol consumption on dissacharidases in the two
      groups.

PMID- 11214509
TI  - Increase in circulating products of lipid peroxidation (malonaldehyed) in
      streptozocin induced diabetic mice.

PMID- 11214510
TI  - Unipolar depression and serum electrolytes.

PMID- 11214511
TI  - Effect of examination stress on some metabolic parameters.

PMID- 11214512
TI  - Antidepressant activity of some phenylaceticacid hydrazones and 2-chlorophenyl
      semicarbazones.

PMID- 11214513
TI  - PEFR in relation to phases of pregnancy.

PMID- 11214514
TI  - Infertility and psychosexual disorders: relationship in infertile couples.
AB  - 175 consecutive infertile couples were interviewed together and individually in
      accordance with a 25 point questionnaire. Amongst the males, premature
      ejaculations 66% was most common problem followed by erectile dysfunction 15%,
      decreased libido 11% and orgasmic failure 8%. Amongst females dyspareunia 58%,
      decreased libido 28% and orgasmic failure 14% were most common problems. Various
      type of misconceptions were also observed in the infertile couples. Lack of
      sexual awareness and education formed an important part of observations.
      Psychosexual dysfunction and infertility was found to occur, in a large number of
      couples, together in association. Most common cause for this problem seems to be
      ignorance and lack of sex education.

PMID- 11214515
TI  - Foreign body in injury--an important evidence.
AB  - In the present paper, a complete case is discussed, that is from the crime upto
      judgement in the court of law, from the Forensic point of view. The postmortem
      examination was conducted by the author in which a metallic fragment of size of a
      mustard seed was found in a incised wound. On chemical analyzers examination, the
      metal fragment matched with the suspected weapon, in respect of spectrochemical
      contents. This evidence became an important part in the investigation for
      conviction of the accused in the court of law. This indicates that when-ever any
      foreign body, whatever it may be or of whatever size, should not be neglected
      while examining the injury before death of after death, since it can become an
      important piece of evidence.

PMID- 11214516
TI  - Transient asceptic arthritis of knees in a patient with melioidosis.
AB  - Osteomyelitis and septic arthritis are known manifestations of melioidosis.
      Whether reactive arthritis can occur as a sequele to B. pseudomallei infection,
      is yet to be seen. As more and more cases of melioidosis will be reported in
      future, this aspect has to be kept in mind.

PMID- 11214517
TI  - Levels of lactic acid, normal level & its relation to food, glucose, cholesterol,
      raised blood urea and phenformin therapy.
AB  - 1. The level of lactic acid was found to be 25 mg percent in 95 percent of 186
      normal Indians. There was no difference due to sex and age. 2. Level of lactic
      acid was estimated in blood of normal persons and diabetics Type II patients to
      observe the effects of food and glucose. There was no change except the level of
      lactic acid was in higher but in normal range. 3. Hyperglycemia of over 300 mg
      raised the blood lactic acid in 25 percent of patients. 4. Lactic acid was not
      affected by hypercholesteremia but was raised in 60 percent of cases with raised
      blood urea. 5. Lactic acid was found to remain within normal limits in 48 type II
      diabetics treated with phenformin dose varying from 50 mg to 225 mg per day. The
      duration of treatment varied from one year to seven years.

PMID- 11214518
TI  - Memory 'photographed' for the first time.

PMID- 11214519
TI  - Leprosy elimination moves a step nearer.

PMID- 11214521
TI  - Hyperkalemia.

PMID- 11214520
TI  - Adolescent's sexual and reproductive health, behavioural change and the
      application of psychosocial theories.

PMID- 11214522
TI  - EMS under the new Medicare fee schedule.

PMID- 11214523
TI  - Enhancing patient care during interhospital transport.

PMID- 11214524
TI  - A is for airway: needle techniques to the neck.
AB  - The purpose of this article is only to introduce these procedures. More extensive
      review of the procedures and instruction by a qualified professional are
      mandatory before proceeding further. The three procedures are very similar, using
      the same anatomic location and many of the same techniques. They allow you to
      establish a secure airway rapidly; however, the skills needed to do them must be
      practiced on a regular basis and performed by people who are familiar with ACLS
      procedures, are intimately aware of airway anatomy and are skilled at doing
      endotracheal intubation. Since these techniques are probably used infrequently, a
      regular training schedule should be established, along with competency testing.
      Whichever procedure is used will enable appropriately trained and competent
      personnel to get a patient through a life-threatening situation quickly.

PMID- 11214525
TI  - EMS for the masses. Preplanning your EMS response to a major event.

PMID- 11214526
TI  - When leaders lead ... employees commit.

PMID- 11214527
TI  - Making the money match.

PMID- 11214528
TI  - 21st century EMS: are you ready for the challenge?

PMID- 11214529
TI  - Disease transmission by mouth-to-mouth resuscitation.

PMID- 11214530
TI  - Stats & facts. Growth of ambulatory surgery centers continues.

PMID- 11214531
TI  - Thinking through e-health care return on investment.

PMID- 11214532
TI  - Revisiting the "ideal" health care system: what happened to the Rochester model?

PMID- 11214533
TI  - Health care resource evaluation.

PMID- 11214534
TI  - Selection criteria and external validity.

PMID- 11214535
TI  - In search of ... connectivity.

PMID- 11214536
TI  - The management of hypercholesterolemia revisited.
AB  - Coronary artery disease (CAD) is the major cause of death in the United States.
      This disease places a large economic burden on society stemming from both loss of
      productivity and use of health care resources. The primary factor that has been
      extensively correlated with risk for CAD is elevated cholesterol levels. The lack
      of efficacy with dietary restriction alone and the limitations, adverse effects,
      and drug interactions associated with current lipid-lowering therapies have
      caused health care providers to search for safer and more efficacious agents.

PMID- 11214537
TI  - Effect of sumatriptan on health care resource use among patients with migraine.
AB  - Previous investigations examining health care resource utilization in patient
      populations have shown patients with migraine to consume significantly higher
      health care resources compared with individuals without migraine. The purpose of
      this study was to compare health care resource and narcotic use in migraineurs
      prescribed sumatriptan (oral, subcutaneous, or nasal) with those not prescribed
      sumatriptan.

PMID- 11214538
TI  - The board's role in diagnosing organizational performance.

PMID- 11214539
TI  - Being a good environmental neighbor.

PMID- 11214540
TI  - Executive coaching: a new demand.

PMID- 11214541
TI  - Benchmarking in HR: ask the right questions.

PMID- 11214542
TI  - From the assembly line to the emergency room: GM enhances quality improvement in
      the health care industry.

PMID- 11214543
TI  - The lean team.

PMID- 11214544
TI  - Two become one through collaboration.

PMID- 11214545
TI  - Contract management: management's tool for better operating results.

PMID- 11214546
TI  - Medical malpractice coverage: a look back and a look forward.

PMID- 11214547
TI  - We cannot get there from here.

PMID- 11214549
TI  - Michigan hospitals exceedingly efficient.

PMID- 11214548
TI  - Sustaining our calling and cause.

PMID- 11214551
TI  - Revisions to Medicare coverage appeals procedures issued.

PMID- 11214550
TI  - Optimizing performance is no longer an option.

PMID- 11214552
TI  - Getting the most from receivable-support vendor agreements.

PMID- 11214553
TI  - [Teleradiology. The experience in Panama].
AB  - The technological advances have brought today procedures, that were not possible
      a few years ago. Telemedicine is one of them. Teleradiology in particular is one
      of the specialty where this application has been more important.

PMID- 11214554
TI  - [Myasthenia gravis in Santo Tomas Hospital 1990-1997].
AB  - Myasthenia Gravis is an infrequent disease. Diagnosis and treatment must be done
      early to avoid high morbidity that can compromise patients lives. Nine cases were
      identified during the eight year 1990-1997 at the Santo Tomas Hospital of Panama
      city but one had to be excluded because he refused treatment. Most of the
      patients (7/8) had symptoms for more than 3 months. The diagnosis of Myasthenia
      Gravis requires a high index of suspicion and the clinical impression must be
      confirmed by various diagnostic studies that include the edrophonium test, the
      repetitive stimulation test, the therapeutic test with pyridostigmine, the
      determination of acetylcholine anti-receptor antibodies and a CT Scan of the
      thorax. Medical treatment consists mainly of anticholinesterase agents and
      surgical treatment consists of thymectomy by means of an extended transternal
      ablation. Operative results were excellent, seven out of eight improved.

PMID- 11214555
TI  - [Psychosomatic medicine and gastroenterology].
AB  - The possible relationship between psychosomatic medicine and gastroenterology is
      described and more specifically in the question of peptic ulcer which gave rise
      to the psychosomatic theory, prevalent in 1950-85. The infectious theory (H.
      pylori), that arose within the last decade, was discussed and the question was
      posed in the direction that one theory was not exclusive of the other but in fact
      were probably complementary of each other.

PMID- 11214556
TI  - [Correlation between myocardial perfusion and coronary angiography].
AB  - Determining the severity of coronary heart disease is of great importance to the
      cardiologist. There is a very good correlation between the severity of coronary
      heart disease and perfusion abnormalities to the myocardium as determined by
      radioisotope studies. We present our experience with forty (40) cases of ischemic
      heart disease diagnosed with sestamibi and its correlation with the obstruction
      of the coronary arteries by angiography. There is good correlation between the
      sestamibi findings and the coronary artery angiography obstructions and our
      findings concur with those published in the literature, which is between 75-85%.

PMID- 11214557
TI  - [Importance of Mycoplasma pneumoniae and Chlamydia pneumoniae in children with
      community-acquired pneumonia].
AB  - OBJECTIVES: To determine the importance of Mycoplasma pneumoniae and Chlamydia
      pneumoniae in community-acquired pneumonia (CAP) of children from different
      latitudes and to compare clinical outcome using azithromycin (AZM) versus either
      amoxicillin-clavulanate (A-C) or erythromycin estolate (EE). METHODS: Ambulatory
      patients with CAP were identified at either the Children's Medical Center of
      Dallas, Texas or the Hospital del Nino of Panama City, Panama. Children 6 months
      to 15 years of age were enrolled and randomized to receive either AZM for 5 days
      or a 10 day course of either A-C or EE, for those younger or older than 5 years
      of age, respectively. Mycoplasma pneumoniae and C. pneumoniae were identified by
      measuring acute and convalescent serum antibody titers and by performing
      nasopharyngeal (NP) and oropharyngeal (OP) swabs for culture and polymerase chain
      reaction (PCR) testing. RESULTS: Overall 335 patients (168 in Dallas and 167 in
      Panama) were evaluated from February 1996 through December 1997. Acute M.
      pneumoniae infection was detected in 12 (7%) patients each in Dallas and Panama.
      Acute C. pneumoniae infection was observed in 10 (6%) children at each site.
      Infection caused by these "atypical" microorganisms occurred more frequently in
      children older than 5 years of age (23% vs 9%, P = 0.001, RR 2.5, 95% CI 1.4
      4.3). No distinctive pattern of clinical or radiologic abnormalities was seen in
      relation to etiology. Clinical cure was achieved in 43 of 44 children infected by
      these bacteria regardless of treatment assignment. CONCLUSION: Mycoplasma
      pneumoniae and C. pneumoniae are common etiologic agents of CAP in older children
      from different latitudes. Children with CAP present with similar clinical and
      radiologic findings to those caused by other etiologic agents. Outcome was
      excellent for the three treatment regimens studied.

PMID- 11214558
TI  - [Comparative study in postmenopausal women with osteoporosis (sodium alendronate,
      calcium and HRT vs sodium alendronate and calcium].
AB  - In 1995 Alendronate was approved by the FDA for the treatment of Post-Menopause
      Osteoporosis. Their use for the preventive treatment on Osteopenic patients is
      approved in 1996. Calcium is a very important element in the treatment of
      Osteoporosis, because it is the only one that acts in the mineralization phase.
      It is well known that the first line to stop the loss of DMO in Post-Menopausic
      women are Estrogens. If we add TRH to the therapy, the effects of Alendronate
      will raise significantly. The first group (A) of 32 patients received
      Alendronate, Calcium and TRH. In the second group (B), there were 35 patients and
      they received Alendronate and Calcium. The groups were statistically compared and
      selected. In both groups the lumbar column was more affected than the hips. The
      use of TRH associated with Alendronate for the lumbar column significantly raised
      the percentage of change of DMO in 24 months. The change percentage was of 9% of
      DMO for group A and 5.25% for group B, giving a significant difference of 3.75%
      of DMO. For the hips the use of TRH associated with Alendronate did not have any
      difference in raise between both groups. In the next twelve months there was a
      change of 3.2% of DMO more in group A than in group B. In 24 months the change of
      DMO in the hips was of 7.95% in group A and 4.75% for group B. The TRH decrease
      the vasomotor symptoms, and improves the hormonal levels (FSH and Estradiol)
      keeping their benefits effective (Cardioprotectors, Neuroprotectors, etc.) but it
      potentiates the decrease of the bone reabsorption shown by the Alendronate. This
      significantly increases the change of percentage of DMO, obtaining densiometrics
      and clinical improvements in less time than using only Alendronate and Calcium.
      Also decreases the price of the treatment and the risk of fracture in less time,
      offering in that way a better quality of life to our patients.

PMID- 11214559
TI  - [Cardiac insufficiency and B-blockers].
AB  - This article summarise our experience with the Beta-Blocker in the management of
      congestive heart failure, which did not respond to the usual medical treatment.

PMID- 11214560
TI  - EBRI research highlights: retirement and health data.

PMID- 11214561
TI  - [Sensitivity and specificity of physical examination].

PMID- 11214562
TI  - [The circulatory system].

PMID- 11214563
TI  - [The cranial nerve system].

PMID- 11214564
TI  - [The digestive system].

PMID- 11214565
TI  - [The respiratory system].

PMID- 11214566
TI  - [The endocrine system].

PMID- 11214567
TI  - [Collagen diseases].

PMID- 11214568
TI  - [Infections].

PMID- 11214569
TI  - [Kidney and urologic system].

PMID- 11214570
TI  - [Breast and lymph nodes].

PMID- 11214571
TI  - [Fundus oculi].

PMID- 11214572
TI  - [Examination of patients in coma].

PMID- 11214573
TI  - [Needs and importance of physical examination: discussion].

PMID- 11214574
TI  - [Secondary amyloidosis and crescentic glomerulonephritis in a patient with
      rheumatoid arthritis].

PMID- 11214575
TI  - [Familial tumor forming chronic pancreatitis of juvenile onset].

PMID- 11214576
TI  - [Protein-losing gastroenteropathy effectively treated by prednisolone].

PMID- 11214577
TI  - [Type I homocystinuria associated with megaloblastic anemia].

PMID- 11214578
TI  - [An autopsy case of polyarteritis nodosa with myeloperoxydase-antineutrophil
      cytoplasmic antibody (P-ANCA) and clinical features of microscopic polyangiitis].

PMID- 11214579
TI  - [Current status of the treatment of Alzheimer's disease].

PMID- 11214580
TI  - [The forefront of arrhythmia therapy: progress in the management of atrial
      fibrillation].

PMID- 11214582
TI  - The Parasitological Society of Southern Africa 26th Annual Scientific Meeting. 9
      11 September 1998. Mont-aux-Sources, South Africa. Abstracts.

PMID- 11214581
TI  - [Muscular dystrophy: recent progress].

PMID- 11214583
TI  - Selected topics from Food Micro '99. 17th International Conference of the
      International Committee on Food Microbiology and Hygiene. September 13-17, 1999.
      Veldhoven, The Netherlands.

PMID- 11214584
TI  - Proceedings of the 2nd International Symposium on the Developmental Aspects of
      Androgen Excess Disorders. Toronto, Canada, June 20, 2000.

PMID- 11214585
TI  - Professor Andre Delmas.

PMID- 11214586
TI  - B1 Lymphocytes in B Cell Neoplasia. Proceedings of the 16th Workshop on the
      Mechanisms of B Cell Neoplasia. Bethesda, Maryland, USA. October 28-29, 1999.

PMID- 11214587
TI  - Brain Energy Metabolism: Relationship to Development and Disease. Proceedings of
      the 4th International Conference on Brain Energy Metabolism. Oxford, United
      Kingdom, August 14-18, 1999.

PMID- 11214588
TI  - Peritoneal dialysis catheter infections and peritonitis in children: a report of
      the North American Pediatric Renal Transplant Cooperative Study.
AB  - Peritonitis and catheter-related infections remain the two most-common causes of
      peritoneal dialysis (PD) treatment failure. To define the frequency and risks
      associated with exit site/tunnel infections (ESI/TI), as well as peritonitis, in
      pediatric patients on PD, we undertook a retrospective cohort study of patients
      initiated on PD in the North American Pediatric Renal Transplant Cooperative
      Study (NAPRTCS). We examined demographic data and PD catheter characteristics of
      1,258 patients, aged < or = 21 years, initiated on PD from 1992 to 1997. We
      examined the frequency and complications of ESI/TI occurring within 30 days, 6
      months, and 1 year of follow-up. For peritonitis episodes, we examined patient
      risk factors for peritonitis. Almost 11% of patients had an ESI/TI at 30 days,
      26% between 30 days and 6 months, and 30% between 6 months and 1 year of follow
      up. There was no increased risk of ESI/TI associated with patient age, race, or
      catheter characteristics. Peritonitis occurred in dialysis patients at a rate of
      1 episode per 13.2 patient months. Proportional hazards regression analysis
      demonstrated that black race, single-cuffed catheters, and upward pointing exit
      sites were independent risk factors for peritonitis in the pediatric PD
      population. Patients with ESI/TI had twice the risk of those without these
      infections of developing peritonitis or needing access revision, and an almost
      threefold increased risk of hospitalization for access complications/malfunction.
      ESI/TI occurs commonly in pediatric PD patients. These infections cause
      significant morbidity, through risk of peritonitis, access revision, and
      hospitalization for catheter complications. Further study of potentially
      modifiable risk factors for ESI/TI in pediatric end-stage renal disease patients
      is warranted.

PMID- 11214589
TI  - Apoptosis parallels ceramide content in the developing rat kidney.
AB  - Ceramide is emerging as an important hydrophobic sphingolipid involved in cell
      differentiation and apoptosis. Since apoptosis plays a significant role in
      cellular remodeling during renal morphogenesis, we measured ceramide content and
      apoptosis in the fetal (18 days gestation), neonatal (3, 7, and 14 days
      postnatal), and adult rat kidney. In addition, to determine whether developmental
      changes in ceramide content are tissue-specific, we compared renal ceramide
      content with that in lung and liver. Ceramide was measured by the diacylglycerol
      kinase assay, and apoptosis was determined by the TUNEL technique. Renal ceramide
      content fell over 100-fold from the fetus to the 7th postnatal day. Renal
      apoptosis paralleled ceramide content, with a greater than 300-fold decrease in
      apoptosis from fetal to adult life. Ceramide content of the lung and liver was
      significantly less than that of the kidney, and changed less with maturation. We
      conclude that maturational changes in ceramide content are tissue-specific, and
      that the high rate of apoptosis in the developing kidney may be related to the
      elevated ceramide content.

PMID- 11214590
TI  - [Proceedings of the Joint Congress of the SIAPEC-IAP. Italian Society of
      Pathologic Anatomy and Diagnostic Cytology. Bolzano, Italy, 24-27 May 2000.
      Abstracts].

PMID- 11214591
TI  - The Healthy Home Summit: The Significance of Cleanliness and Disinfection in the
      Home and its Link to Infection Control. Proceedings of a conference. New York,
      New York, USA. November 6, 1999.

PMID- 11214592
TI  - Alterations in the proliferative response of peripheral lymphocytes in tick-borne
      encephalitis.

PMID- 11214593
TI  - Reversed sequence of repolarization in the rabbit ventricular epicardium under
      hypothermia.

PMID- 11214594
TI  - Functional state of the circulatory and external respiratory systems under
      hyperbaric oxygenation.

PMID- 11214595
TI  - Growth and survival of cyanobacteria in water from blooming and nonblooming ponds
      under experimental conditions.

PMID- 11214597
TI  - Role of the ecdysteroid system in the regulation of Drosophila reproduction under
      environmental stress.

PMID- 11214596
TI  - The role of p-aminobenzoic acid in DNA protection against oxidants.

PMID- 11214598
TI  - Cadaverine as a signal of heat shock in plants.

PMID- 11214599
TI  - A 55-year-old man with right-sided weakness.

PMID- 11214600
TI  - Protein kinase C suppresses spontaneous, transient, outwards K+ currents through
      modulation of the Na/Ca exchanger in guinea-pig gastric myocytes.
AB  - The effect of protein kinase C (PKC) on the Ca2+-activated K+ current (IK,Ca) in
      guinea-pig gastric myocytes was studied using the whole-cell voltage-clamp
      technique. At a holding potential of 0 mV, IK,Ca, recorded as spontaneous,
      transient, outwards currents (STOCs), was markedly inhibited, both in mean
      amplitude (54 +/- 5%) and frequency (60 +/- 8%) by 1 microM phorbol 12, 13
      dibutyrate (PDBu, n = 6). These effects were antagonized by pretreatment with 10
      nM bisindolylmaleimide I (n = 5), a selective inhibitor of PKC. The possibility
      that the inhibition of STOCs was due to direct channel inhibition by PKC was
      addressed using inside-out or open-cell-attached patch-clamp techniques, the
      latter established using beta-escin. PDBu did not alter the conductance or open
      probability of the KCa channel in any mode, suggesting that PKC does not inhibit
      the KCa channel directly. To study the involvement of the Na/Ca exchanger in the
      inhibition of STOCs by PDBu, its operation was prevented by replacing Na+ in the
      internal solution by tris(hydroxymethyl)aminomethane (TRIS) and external Na+ by
      equimolar K+ and Ca2+-activated inwards K+ currents recorded at a holding
      potential of 0 mV. Neither the mean amplitude (96 +/- 8%) nor the frequency of
      these currents was inhibited significantly by 1 microM PDBu (n = 5). Like PDBu, 5
      microM 2-(2-[4-(4-nitrobenzyloxy)phenyl]ethyl) isothiourea methanesulphonate (KB
      R7943), a selective inhibitor of the reverse mode Na/Ca exchanger, also inhibited
      the mean amplitude (45 +/- 6%) and frequency (26 +/- 2%) of STOCs at the holding
      potential of 0 mV (n=6). The results suggest that the suppression of STOCs by PKC
      is mediated by inhibition of the Na/Ca exchanger.

PMID- 11214602
TI  - Dr Hanns Pacy. From turmoil to tea gardens.

PMID- 11214601
TI  - Symptom profiles in children with ADHD: effects of comorbidity and gender.
AB  - OBJECTIVE: To examine ratings and objective measures of attention
      deficit/hyperactivity disorder (ADHD) symptoms to assess whether ADHD children
      with and without comorbid conditions have equally high levels of core symptoms
      and whether symptom profiles differ as a function of comorbidity and gender.
      METHOD: Four hundred ninety-eight children from the NIMH Collaborative Multisite
      Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity
      Disorder (MTA) were divided into comorbid groups based on the parent Diagnostic
      Interview Schedule for Children and assessed via parents' and teachers' Swanson,
      Nolan, and Pelham (SNAP) ratings and a continuous performance test (CPT).
      Comorbidity and gender effects were examined using analyses of covariance
      controlled for age and site. RESULTS: CPT inattention, impulsivity, and
      dyscontrol errors were high in all ADHD groups. Children with ADHD + oppositional
      defiant or conduct disorder were rated as more impulsive than inattentive, while
      children with ADHD + anxiety disorders (ANX) were relatively more inattentive
      than impulsive. Girls were less impaired than boys on most ratings and several
      CPT indices, particularly impulsivity, and girls with ADHD + ANX made fewer CPT
      impulsivity errors than girls with ADHD-only. CONCLUSIONS: Children with ADHD
      have high levels of core symptoms as measured by rating scales and CPT,
      irrespective of comorbidity. However, there are important differences in
      symptomatology as a function of comorbidity and gender.

PMID- 11214603
TI  - [Locoregional neuraxial anesthesia and vascular surgery: the benefits].
AB  - PURPOSE: To assess the advantages of neuraxial blockade (NB) during and after
      vascular surgery and to confront them with the risk of epidural or spinal
      hematoma. MAIN FINDINGS: NB may reduce the risk of thrombotic occlusion following
      lower extremity vascular reconstruction. This effect of NB may be attributed to
      reduced hypercoagulability, decreased peripheral resistance and increased graft
      flow. In patients under general anesthesia, only those authors using an
      aggressive perioperative management (pulmonary artery catheter monitoring,
      intensive care unit admission) were able to report grafts patency rates similar
      to those obtained with NB. NB facilitates the modulation of the hemodynamic and
      hormonal stress responses during the perioperative period. It also produces
      superior postoperative analgesia. Still, the impact of NB on cardiac morbidity
      following aortic reconstructive surgery remains open to debate. Only very few
      cases of epidural hematomas associated to NB following vascular surgery have been
      reported. They implicated patients who received either fibrinolytic medication,
      continuous heparin infusion, or both. Low molecular weight heparins may increase
      the risk or epidural hematoma and, should their administration become more
      frequent during vascular surgery, the safety of NB would then have to be
      reassessed. CONCLUSION: NB during vascular surgery is a safe and well-established
      practice. It offers many theoretical and demonstrated advantages. NB is
      particularly beneficial and economical for lower extremity vascular
      reconstruction. Still, NB may not be the best approach if the administration of
      fibrinolityc medication or prolonged heparin infusion is contemplated.

PMID- 11214604
TI  - [Locoregional neuraxial anesthesia as used in vascular surgery].
AB  - OBJECTIVES: Neuraxial blockade (spinal or epidural anesthesia) is still widely
      used in patients undergoing vascular surgery. However, the combined
      administration of anticoagulants and antiplatelet agents may compromise the
      safety of this technique with regards to the potential occurrence of a spinal or
      of an epidural hematoma. We review the benefits and risks of neuraxial blockade
      in light of the evolution of anticoagulation for vascular surgery. MAIN FINDINGS:
      Vascular surgery generally requires a high level of intraoperative
      anticoagulation. An increasing number of patients are also treated pre and post
      operatively with antiplatelet agents. Their administration cannot be interrupted
      without serious risks to the patients' cardiovascular system and, further their
      continued use during surgery may improve graft permeability. Recent reports have
      emphasized the danger of neuraxial anesthesia in patients receiving low dose
      anticoagulation. So, high doses of heparins should carry an ever higher risk of
      serious complications in patients undergoing neuraxial blockade. Furthermore, no
      published data has ever demonstrated convincingly the benefit of either epidural
      or spinal anesthesia over general anesthesia. No differences have ever been
      documented in terms of cardio-vascular morbidity, graft patency, and mortality.
      CONCLUSION: Routine neuraxial blockade cannot be recommended in patients
      undergoing vascular surgery. The decision to perform a neuraxial block in such a
      patient may only be taken on a case by case basis, after careful consideration of
      expected benefits and potential risks.

PMID- 11214605
TI  - Global challenges of cervical cancer prevention.

PMID- 11214606
TI  - Is there a place for molecular biology markers and other prognostic factors in
      staging gynaecological tumours?

PMID- 11214607
TI  - The making of a gynecologic oncologist.

PMID- 11214608
TI  - Evolution in cervical pathology and cytology: a historical perspective.

PMID- 11214609
TI  - Third generation aromatase inhibitors in metastatic breast cancer patients
      failing tamoxifen. Randomized comparisons with megestrol acetate: a critical
      review.

PMID- 11214610
TI  - Perioperative development of a thrombogenic risk profile in patients with
      carcinomas of the breast: a cause of increased thrombosis.
AB  - Within the context of a prospective study we investigated the influence of
      malignant and benign breast disease on the coagulation systems both prior to and
      after surgery. In addition we also investigated to what extent individual risk
      factors aid the formation of a thrombophiliac risk profile. Altogether 50
      patients with carcinomas of the breast and 12 patients with benign breast disease
      were included in the study. The coagulation investigations took place prior to
      surgery and on the 1st, 3rd, 7th and 10th day following the operation. The
      results have already revealed that prior to surgery a clear activation of the
      haemostasis takes place among patients with a carcinoma of the breast. When
      compared to patients with benign breast conditions there was a far greater plasma
      level of factor VIII vWF, fibrinogen, thrombin-antithrombin III complex, D-dimer
      fibrin degradation products, tissue-type plasminogen activator and the activity
      and the antigen of plasminogen activator inhibitor 1. Also during the
      postoperative period the malignant tumour was a stimulus for additional increased
      activity of blood coagulation and fibrinolysis. Individual risk factors such as
      age, menopausal status, obesity and smoking lead to a thrombogenic risk profile
      which could provide a possible explanation for the observed increased incidence
      of thrombosis in breast cancer patients. For the clinical work there is a need
      for intensive pre- and postoperative monitoring in the cases of patients with
      malignant tumours including angiological examinations, intensive physiotherapy
      and a risk-adapted prophylactic anticoagulation.

PMID- 11214611
TI  - Combined prognostic importance of CA 125, histopathologic grade and DNA-index in
      advanced ovarian cancer.
AB  - PURPOSE: To analyse the possible prognostic importance of a combination of serum
      CA 125 levels, tumor cell DNA distribution and histopathologic grade in patients
      with epithelial ovarian cancer. METHOD: The study included 41 patients with
      ovarian cancer stages II-IV. CA 125 was measured before the start of chemotherapy
      and after every course. The DNA distribution was analysed by flow cytometry in
      biopsy specimens from the primary tumour. The histopathologic grading was
      performed according to WHO criteria. RESULTS: The CA 125 level was of major
      prognostic significance. All patients with an abnormal value (> 35 U/ml) after
      three courses died within 16 months. The DNA distribution did not add significant
      prognostic information, but the histopathologic grade was of significant
      prognostic importance as investigated by Cox analysis. CONCLUSION: CA 125 is an
      important prognostic marker in epithelial ovarian cancer. The value after three
      courses of chemotherapy is significant. The histopathologic grade adds further
      prognostic information.

PMID- 11214612
TI  - Comparison of endometrial carcinoma coexisting with and without endometrial
      hyperplasia.
AB  - OBJECTIVE: It has been reported that endometrial carcinoma has two pathogenic
      types; one with and the other without endometrial hyperplasia. The present study
      was done to clarify whether this was true in our series of a large number of
      Japanese patients. METHODS: Three hundred and twenty-eight patients with
      endometrial carcinoma were classified into two groups, one coexisting endometrial
      hyperplasia (group 1; 182 cases) and the other having normal endometrium without
      endometrial hyperplasia (group 2; 107 cases). The clinical and pathological
      observations of the two groups were compared. RESULTS: The ages of the patients
      were significantly lower in group 1 (30-83; mean 50.7) than in group 2 (34-81;
      mean, 57.2). The incidence of the carcinoma with invasion limited to less than
      1/3 of the myometrium, with surgical stage I, lower grade endometrioid type and
      higher levels of progesterone receptor, and without lymph node metastasis were
      significantly higher in group 1 than in group 2. The cumulative survival rate for
      stage I was also significantly higher in group 1 patients. CONCLUSION: A
      significant difference was found between groups 1 and 2 in age distribution,
      degree of progress and pathological observations. Stage I patients in the former
      group had a better prognostic than the latter.

PMID- 11214613
TI  - Primary carcinoma of the fallopian tube. A report of 19 cases with literature
      review.
AB  - Primary carcinoma of the fallopian tube is the rarest cancer of the female
      genital tract with an incidence of 0.5% of all gynecologic tumors. Since the
      first report in 1847 about 1,500 cases have been published. Due to similarity of
      the clinical presentation the staging and therapeutic management have been
      adapted to that of ovarian cancer. We retrospectively evaluated all the 19
      patients who had been diagnosed with primary carcinoma of the fallopian tube at
      the Department of Obstetrics and Gynecology of the University of Zurich between
      1977 and 1998. All lesions were staged according to the rules of FIGO adopted in
      1991. At the time of diagnosis the median age was 62 (46-87) years. Twelve (63%)
      women revealed FIGO stage III-IV, whereas four (21%) and three (16%) patients
      were diagnosed in stage I and stage II, respectively. Eight (42%) women were
      nullipara. Histology showed serous-papillary carcinoma, in ten (53%) cases. The 5
      year survival rate was 22% for all FIGO stages and 80% for stage I. None of the
      patients with stage III and IV survived 5 years. Ovarian cancer and primary
      carcinoma of the fallopian tube are similar in many aspects. Both carcinomas have
      a similar age distribution, show an increase among nulliparous women, are often
      of serous papillary histology, have a poor prognosis with stage and residual
      tumor size as important prognostic factors, and respond initially well to
      platinum-based chemotherapy. Nevertheless, there appears to be a difference
      between the two diseases: primary carcinoma of the fallopian tube is more often
      diagnosed in an earlier stage. This many be due to lower abdominal pain resulting
      from tubal dilatation and to abnormal bloody-watery discharge.

PMID- 11214614
TI  - Artificial neural networks and survival prediction in ovarian carcinoma.
AB  - The standard use of known survival predictors for ovarian cancer in clinical
      practice are primarily based on disease stage. This does not permit a real
      individualization of a patient's potential outcome. This study assessed the value
      of neural networks to refine the prediction of survival based only on information
      gleaned at primary surgery. The possibility exists that such methods may permit
      further elucidation of outcome and influence management.

PMID- 11214615
TI  - Usefulness of PCR in situ hybridization as a technique for morphological
      detection of human papillomavirus in uterine cervical neoplasia.
AB  - This study was designed in order to devise fitting conditions in polymerase chain
      reaction (PCR)-in situ hybridization (ISH) for observing human papillomavirus
      (HPV) infection morphologically in uterine cervical neoplasias and to compare the
      detection rates of HPV by PCR-ISH and solution phase PCR (S-PCR) as well as
      fluorescence ISH (FISH). Tissues were obtained from 23 patients with cervical
      intraepithelial neoplasia 3, who visited our hospital between 1994 and 1997. To
      detect HPV-16, a HPVpF forward primer and a HPVp 16 reverse primer were used.
      Compared with the traditional methods, the PCR-ISH technique performed in this
      study was contrived as follows. To prevent detachment, the specimens were
      attached to silane-coated slides at 90 degrees C and successively left at room
      temperature for 36 hours. In proteopepsis, pepsin was used. PCR products were
      fixed with 4% paraformaldehyde. PCR-ISH, S-PCR, and FISH showed HPV-16 positivity
      in 52.2%, 56.5% and 21.7%, respectively. The positive rate of HPV-16 detected by
      PCR-ISH as well as S-PCR was significantly higher than that by FISH (p<0.01,
      respectively). There was no significant difference between the positive rates of
      HPV-16 detected by PCR-ISH and S-PCR. HPV-16 was detected by S-PCR in all 12
      specimens in which HPV-16 expression was judged as positive using PCR-ISH.
      Similarly, HPV-16 was found by PCR-ISH in all five specimens in which HPV-16
      expression was regarded as positive using FISH. While the FISH technique detected
      HPV-16 signals only in the superficial and middle layers of squamous cells, the
      PCR-ISH technique demonstrated them in all the layers including the parabasal and
      basal layers. The PCR-ISH technique contrived in this study has a high
      sensitivity to HPV-16 equal to that of S-PCR. The difference in detection rate
      and distribution of HPV DNA between PCR-ISH and FISH might suggest that HPV does
      not infect the superficial layer but rather the parabasal layer.

PMID- 11214616
TI  - Malignant fibrous histiocytoma of the uterus.
AB  - A 56-year-old menopausal woman was admitted to hospital because of vaginal
      spotting of several months duration. The patient underwent total abdominal
      hysterectomy with bilateral salpingo-oophorectomy and omentectomy. On divalving,
      the uterus showed an ulcerated nodule 8 cm in diameter, protruding into the
      uterine cavity from the posterior wall. Histologically the tumor had a typical
      morphology of malignant fibrous histiocytoma (MFH). Multinucleated giant cells
      were strongly positive for CD 68 alpha antichymotripsin and alpha antitrypsin.
      Mononuclear cells also showed the same immunohistochemical pattern though less
      intensive than the giant cells. The cells were uniformly negative for S-100
      protein, myoD1, myogenin desmin and actin. Electron microscopical investigation
      disclosed ultrastructural features compatible with the histiocytic nature of the
      tumor. Thirty-three months later the patient was free of disease.

PMID- 11214617
TI  - Differential diagnosis of breast lesions by use of biomagnetic activity and non
      linear analysis.
AB  - PURPOSE: Breast cancer mortality rates have not changed during the past 60 years
      despite significant advances in screening methods. It is tempting therefore to
      use novel technology in order to better understand breast oncology. In this study
      we investigated the biomagnetic activity obtained in benign and malignant breast
      lesions using a single channel biomagnetometer SQUID (Superconducting Quantum
      Interference Device) in order to assess the method's efficacy in the differential
      diagnosis of these two types of lesions and its establishment as a screening
      technique. METHOD: Magnetic recordings were obtained from 21 patients with
      palpable breast lumps. Of these 11 were invasive carcinomas and 10 were benign
      breast lesions. We used non-linear analysis to investigate whether there is any
      biological differentiation in the dynamics in these two types of lesions.
      RESULTS: High amplitudes characterized the waveform of a malignant breast lesion
      whereas in benign breast lesions the corresponding amplitudes were low. Using the
      application of non-linear analysis we observed a clear saturation value for the
      dimension of malignant breast lesions and no saturation for benign ones.
      DISCUSSION: Biomagnetic measurements with the SQUID and the application of non
      linear analysis are promising procedures in assessing and differentiating breast
      tumors.

PMID- 11214618
TI  - Invasive condylomatous vulvar carcinoma associated with multifocal low genital
      tract neoplasia. A case report.
AB  - Squamous cell carcinoma is a morphologically heterogenous neoplasm of specific
      histologic entities involved in human papillomavirus infection. The condylomatous
      types of squamous cell vulvar carcinoma, caused by HPV-16, most often manifest as
      exophytic papillary tumors mimicking condylomas.

PMID- 11214619
TI  - Correlations of serum CA125 level and computerized tomography (CT) imaging with
      laparotomic findings following intraperitoneal chemotherapy in patients with
      ovarian cancer.
AB  - The aim of this study was to evaluate the role of serum CA125 levels and
      computerized tomography (CT) scans in predicting pathologic response of
      intraperitoneal chemotherapy in patients with ovarian cancer. We prospectively
      analyzed serum CA125 levels and abdominopelvic CT scans obtained after the
      completion of intraperitoneal chemotherapy in 52 patients with ovarian cancer and
      compared the results with subsequent laparotomic findings, which served as the
      gold standard for statistical analysis. Laparatomy revealed either microscopic or
      macroscopic residual disease in 20 patients, while 32 patients were completely
      tumor-free. CA125 levels correlated significantly with laparotomic findings
      (p=0.003, u=1405). Median CA125 values in patients with residual tumors and in
      tumor-free patients following intraperitoneal chemotherapy were 14.6 (1-775) and
      7.2 (1-37) U/ml, respectively. Although CT-imaging and CA 125 levels had a high
      specificity (100% and 96.9%, respectively), they showed a low sensitivity rate
      (50% and 40%, respectively). Similarly, despite high positive predictive values
      (100% and 88.9%, respectively), the negative predictive values were 76.2% and
      72.1%, respectively. CONCLUSION: Although highly specific, CT scans and CA125
      levels do not accurately indicate the presence of disease. Due to a high false
      negative rate, a normal CT scan or a normal CA125 value is not sufficient to
      replace a laparotomy.

PMID- 11214620
TI  - A rare case of angiosarcoma of the breast in a man: case report.
AB  - This is a case report of a 57-year-old man who had primary angiosarcoma of the
      left breast. Five months after detecting a mass in his breast, he underwent
      mastectomy with biopsy of the ipsilateral axillary lymph nodes. Three years
      later, he is still alive without any recurrence. Angiosarcoma of the female
      breast is rare and exceptional in males. It is a condition with a poor prognosis
      and there are as yet no established chemotherapeutic regimens.

PMID- 11214621
TI  - Conservative surgical management of malignant ovarian germ cell tumors: the
      experience of the Gynecologic Oncology Unit at Ain Shams University.
AB  - PURPOSE: To evaluate the role of extended surgical staging in patients with
      malignant ovarian germ cell tumors in the presence of cisplatinum-based
      combination chemotherapy. MATERIALS & METHODS: 16 patients aged between 13 and 40
      years (mean 20.5) diagnosed and treated for malignant ovarian germ cell tumors at
      the Gynecologic Oncology Unit. Ain Shams University, during the period from May
      1994 to October 1999. RESULTS: Six patients were diagnosed with dysgerminoma, six
      with immature teratoma and four with endodermal sinus tumor. Only seven cases
      were primarily managed at the unit and were subjected to proper surgical staging
      as required by FIGO (two in each of the stages IC, IIC and IIIA and one in stage
      IV). However, the remaining nine cases were referred to the unit, six after
      having unilateral salpingo-oophorectomy and no surgical staging, one patient
      after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO),
      and one with recurrent dysgerminoma in the retroperitoneum and mediastinum
      following suboptimal treatment. None of these cases were surgically re-explored
      and all including the first six cases were given the standard BEP chemotherapy
      for 4-6 courses (mean 5.8). Follow-up ranged from 7-72 months (mean 30.5). All
      patients are alive without any evidence of disease recurrence except for one
      patient with a stage IIIA immature teratoma who had a local and distant
      recurrence and is undergoing second-line chemotherapy. All patients have their
      menstrual function preserved except for three patients; one having 46,XX pure
      gonadal dysgenesis with a preoperative FSH level of 120 U/l and the eldest two
      patients having a TAH+BSO as they had completed their families. Three patients
      are currently pregnant. CONCLUSION: In view of the high chemosensitivity and
      curability of ovarian germ cell tumors and their occurrence in young patients,
      every effort should be made to preserve one ovary and the uterus for future
      reproduction even in advanced cases. The role of revisional surgical staging, in
      particular retroperitoneal lymphadenectomy in light of these data and those of
      others should be redefined in the future.

PMID- 11214622
TI  - Phase II study of high-dose paclitaxel in platinum-refractory epithelial ovarian
      cancer.
AB  - The purposes of this study were to determine the efficacy of paclitaxel, using a
      dose of 200 mg/m2 intravenous continuous infusion over 24 hours every three weeks
      in the treatement of platinum-refractory epithelial ovarian cancer (EOC) and to
      evaluate the toxicities. Eligibility criteria included: histologically proven
      EOC, platinum resistance, measurable disease, Zubrod performance status grade 0
      2, expected survival of > 3 months and adequate hematological function. Response
      was assessed at three-cycle intervals or earlier if required. Twenty-one patients
      were recruited in this study. The response rate was 52% (2 CR, 9 PR) with a
      median duration of response of six months. The median progression-free interval
      was eight months and the median survival was 12 months. Leukopenia was the
      predominant toxic effect. Eighty-six percent of patients required granulocyte
      colony stimulation factor (G-CSF). All patients had alopecia grade 3. In
      conclusion, high-dose paclitaxel is active in platinum-refractory EOC with
      manageable toxicities.

PMID- 11214623
TI  - Comparison of granulocyte-colony, stimulating factor and granulocyte macrophage
      colony stimulating factor in the treatment of chemotherapy extravasation ulcers.
AB  - The results of perilesional granulocyte macrophage-colony stimulating factor and
      granulocyte-colony stimulating factor application in a patient with chemotherapy
      extravasation ulcers are reported. A 64-year-old patient with recurrent ovarian
      carcinoma was admitted to our department in February 1999. In June 1998, six
      cycles of chemotherapy were applied to the patient after surgery. At the first
      cycle, two ulcers appeared on both lower arms related to doxorubicin
      extravasation despite all interventions. When the patient was admitted to in our
      department, we observed an ulcer on the distal part of the right lower arm with a
      dimension of 1.5x2 cm and another on the proximal portion of the left lower arm
      with a dimension of 2.5x3 cm. Of those ulcers, the bigger and deeper one on the
      left was treated with weekly 400 mcg granulocyte macrophage-colony stimulating
      factor subcutaneously for three weeks. The lesion completely disappeared in the
      fourth week. The other ulcer that was left for control on the right arm was
      treated with weekly 48 M.U. granulocyte-colony stimulating factor for four weeks.
      This ulcer did not reduce in size. As a result granulocyte-colony stimulating
      factor did not affect the healing of chemotherapy extravasation ulcers, as did
      granulocyte macrophage-stimulating factor.

PMID- 11214624
TI  - Primary malignant lymphoma of the ovary: an unusual presentation of a rare
      disease.
AB  - Because the outcome of patients with primary ovarian non-Hodgkin's lymphoma (NHL)
      is controversial, we present the incidental finding of a primary malignant
      lymphoma of the ovary in a 50-year-old patient. Three and a half years following
      ablative surgery and adjuvant chemotherapy, the patient is alive and disease
      free. Ovarian lymphoma is a disease of reportedly poor prognosis. However, many
      previously reported cases of ovarian lymphoma actually represented ovarian
      involvement by a more diffuse lymphomatous process. If stringent criteria are
      used for case selection, true primary ovarian lymphoma is a very rare disease and
      usually carries a favorable prognosis.

PMID- 11214625
TI  - Thalamic astrocytomas: surgical anatomy and results of a pilot series using
      maximum microsurgical removal.
AB  - Deep-seated astrocytomas within the basal ganglia and the thalamus are considered
      unfavourable for microsurgical removal since the circumferential neighbourhood of
      critical structures limits radical resection. On closer assessment, the thalamus
      has a unique configuration within the basal ganglia. Its tetrahedric shape has 3
      free surfaces and only the ventrolateral border is in contact with vital and
      critical functional structures, e.g. the subthalamic nuclei and the internal
      capsule. The purpose of the present study was to investigate the feasibility of
      maximum microsurgical removal in a series of intrinsic thalamic astrocytomas. 14
      patients with intrathalamic astrocytomas grades I to 4 as diagnosed by previous
      stereotactic biopsy or intra-operative frozen section were selected for maximum
      microsurgical removal. The infratentorial supracerebellar approach from the
      contralateral side was used for 4 limited neoplasms of the pulvinar. For the
      other 10 larger and more extensive processes a parieto-occipital transventricular
      approach was chosen. Final histology gave the result of astrocytoma grade 1 or 2
      in 4 patients, and of astrocytoma grade 3 or 4 in 10 patients. Postoperative MRI
      confirmed reduction of the tumor mass by 80 to 100% in 11 of 14 cases. Regional
      ancillary radiotherapy with 60 Gy was administered postoperatively for
      astrocytomas grades 3 and 4. Two patients operated on via the posterior
      transventricular approach had new postoperative partial hemianopia. Five of the
      14 patients finally needed a ventriculo-peritoneal shunt. During the follow-up
      time of 6 to 52 months, tumor progression/recurrence was observed in 6 of the 10
      high grade and none of the low grade neoplasms. The present pilot series
      demonstrates the feasibility of the microsurgical concept. Comparison with other
      treatment modalities, such as brachytherapy, requires future consideration.

PMID- 11214626
TI  - Multiple pituitary hormone gradients from cavernous sinus sampling in patients
      with Cushing's disease.
AB  - OBJECTIVE: Cavernous sinus sampling in patients with adreno-corticotropic-hormone
      (ACTH) secreting pituitary adenomas has been used to identify directly ACTH
      hypersecretion from the pituitary and to predict the lateralization of a
      microadenoma. In our previous series, cavernous sinus sampling provided a
      sufficient central/peripheral (c/p) ratio of ACTH and the correct laterality of
      the pituitary lesion in all microadenomas situated in the lateral wing. To
      clarify the diagnostic value of other anterior pituitary hormones in relation to
      ACTH gradients, we evaluated multiple pituitary hormone gradients between a
      cavernous sinus and a peripheral vein and between both cavernous sinuses in
      patients with Cushing's disease. METHODS: Cavernous sinus sampling was done in 11
      patients with clinical and biochemical features of ACTH-dependent Cushing's
      syndrome. In 9, pituitary adenoma was detected during trans-sphenoidal surgery
      and histologically confirmed, while 2 others were suspected of having ectopic
      lesions. Serum ACTH, prolactin (PRL), thyroid stimulating hormone (TSH), growth
      hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH)
      from catheters in both cavernous sinuses and from a peripheral vein were
      measured. The c/p ratios of each hormone and the intercavernous gradients were
      evaluated. RESULTS: The c/p ratio of ACTH indicated the presense of pituitary
      lesions in all 9 patients with ACTH-secreting microadenomas. In addition, the
      intercavernous gradients of ACTH indicated the correct localization of
      microadenomas in all 6 patients with lateralized lesions. As for other hormones,
      the c/p ratios of GH, PRL, TSH and LH were significantly high in number 7, 6, 6
      and 3 patients, respectively. In contrast, the significant step up of FSH was
      observed only in one patient. The intercavernous gradients of GH and PRL were
      significantly high in number 5 and 4 patients, respectively. CONCLUSIONS: The
      intercavernous gradients of GH and PRL tend to indicate the lateralization of a
      microadenoma. The measurement of GH and PRL during cavernous sinus sampling may
      provide additional information, in the lateralization of ACTH-secreting
      microadenomas.

PMID- 11214627
TI  - Proliferation, vascular endothelial growth factor expression and cavernous sinus
      invasion in growth hormone secreting pituitary adenomas.
AB  - Surgical cure of growth hormone producing pituitary adenomas (GHomas) becomes
      difficult when they invade the cavernous sinus (CS). Tumour proliferative
      activity and angiogenesis are thought to be required for tumour growth and
      invasion, and vascular endothelial growth factor (VEGF) activates
      neovascularization around tumours. In this study, the mechanism and clinical
      significance of CS invasion is analysed. In 25 surgically treated GHomas, the
      extent of CS invasion was classified as high (Knosp's grade 3 and 4), and low
      (grade 0, 1 and 2) MR grades, and the MR grades were compared with tumour
      proliferative potential (Ki-67 expression), angiogenetic demand (VEGF
      expression), volume of adenomas and serum hormone levels. The Ki-67 index of high
      MR grade adenomas (1.17 +/- 0.62%) was significantly higher than that of low MR
      grade adenomas (0.55 +/- 0.42%, p = 0.027), whereas VEGF expression showed no
      significant correlation with MR grades (p > 0.999). Tumour volume also showed a
      significant correlation with MR grade (p = 0.002). VEGF expression was not
      correlated with serum hormone level and volume, but was correlated with tumour
      proliferative potential. Proliferative potential and tumour volume were two
      independent factors related to CS invasion. Although VEGF expression was not a
      direct factor related to CS invasion, it may indirectly play a role in activation
      of tumour aggressiveness, which is required in CS invasion. Our results show that
      high MR grade adenomas have higher proliferative ability. In order to improve the
      surgical outcome, preoperative medical debulking is indicated, particularly, in
      such adenomas.

PMID- 11214628
TI  - Closure of recurrent frontal skull base defects with vascularized flaps -- a
      technical case report.
AB  - Techniques for vascularized reconstruction of the anterior cranial fossa floor
      defects causing recurrent cerebrospinal fluid fistula are discussed in this
      report. The closure employs the use of local random- or axial-pattern
      vascularized flaps in simple cases. In complicated cases (for instance, status
      after repeated exploration) the tissue of the cranial base is severely
      compromised and shows low potential for healing. Non-vascularized grafts only add
      avital scars to the already present ones leading to recurrent fistulas. Free
      vascularized flaps show more mechanical strength and less scar contraction,
      resistance to infections and survive better in a compromised surrounding, thus
      leading to long term sealing in such cases. The technical issues of vascularized
      closure of defects of the frontal skull base are discussed in this report.

PMID- 11214629
TI  - Surgical treatment of glossopharyngeal neuralgia as vascular compression syndrome
      via transcondylar fossa (supracondylar transjugular tubercle) approach.
AB  - OBJECTIVE: These are the first reported cases in whom the transcondylar fossa
      approach was applied for the treatment of glossopharyngeal neuralgia (GPN) as a
      vascular compression syndrome. CASES PRESENTATION: All three cases presented with
      severe paroxysmal pharyngeal pain which could not be controlled by medical
      treatment. The patients all underwent microvascular decompression surgery (MVD)
      via transcondylar fossa approach. The posterior inferior cerebellar artery or the
      anterior inferior cerebellar artery was clearly verified to be compressing the
      glossopharyngeal nerve and then was safely and completely moved and fixed to the
      dura mater by the sling retraction technique to effect decompression. No patient
      has since experienced any further pain or permanent neurological deficit after
      surgery. TECHNICAL ADVANTAGE: The transcondylar fossa approach is one of the
      lateral approaches which is different from the transcondylar approach. In this
      approach, the posterior part of the jugular tubercle is extradurally removed
      without injuring the atlanto-occipital joint. The entire course of the cisternal
      portion of the glossopharyngeal nerve can be sufficiently seen with gentle
      retraction of the cerebellar hemisphere, when using this approach. CONCLUSION:
      This approach makes the MVD for GPN both effective and safe.

PMID- 11214630
TI  - Haemorrhagic complication following percutaneous transluminal angioplasty for
      carotid stenosis.
AB  - We report 2 cases with haemorrhagic complications following percutaneous
      transluminal angioplasty (PTA) for carotid stenosis. Computed tomography (CT)
      scanning of these cases demonstrated diffuse subarachnoid haemorrhage in 1 case,
      and intracerebral haemorrhage in the other case on the next day after PTA. In the
      latter case, we measured cerebral blood flow velocity and mean transit time with
      transcranial doppler (TCD) and dynamic CT scan, which demonstrated remarkable
      increases in the blood flow velocity and peak height, respectively. From these
      results, postoperative hyperperfusion was suggested to have caused haemorrhagic
      complications.

PMID- 11214631
TI  - Central lumbar disc herniation.
AB  - A follow-up study which describes the experience of the Department of
      Neurosurgery in Berne in the treatment of patients with central lumbar disc
      herniation (CLDH). BACKGROUND DATA: The anatomical position of lumbar disc
      herniation, in general, does not seem to affect postoperative outcome. However,
      according to other studies a subgroup of patients with central lumbar disc
      herniations appears to have poorer results. OBJECTIVES: The aim of the present
      study was to assess clinical outcome in a recent cohort of patients, to
      investigate whether there is a difference in outcome with regard to the surgical
      approach (unilateral vs bilateral) and to compare the postoperative results
      between the subcategories of CLDH: central massprolaps (CMP) and central
      contained disc herniation (CCDH). METHODS: Between 1990 and 1997, 40 out of 3150
      patients operated on for lumbar disc herniation were diagnosed with CLDH (1.2%).
      The patients were operated on through unilateral or bilateral fenestrations with
      microdiscectomy. Recent follow-up studies were obtained by standardized
      questionnaires. The retrospective investigation was performed by an unbiased
      observer. RESULTS: Long-term follow-up was available for 34 of the 40 patients
      (85%) at a mean of 3.3 years. Eight patients had an excellent result (24%), 15
      patients a good result (44%), 8 patients a fair (24%) and 3 patients had a poor
      result (9%). Overall, the operation was considered successful in 68% of patients.
      There was no statistically significant difference in outcome in patients with CMP
      as compared with those with CCDH (75% versus 64%). There was also no significant
      difference for better outcome between bilateral as compared with unilateral
      approaches. CONCLUSIONS: Postoperative outcome of central lumbar disc herniation
      (CLDH) is poorer as compared with other types of lumbar disc herniation. The
      reason seems to be the anatomical position of the disc herniation with a peculiar
      derangement of the disc architecture. The surgical approach itself or the
      subcategories of CLDH appear to have only minor impact on postoperative outcome.
      Interlaminar fenestrations, in general, are appropriate for removal of the disc
      fragments.

PMID- 11214632
TI  - External ventricular drainage catheters: effect of surface heparinization on
      bacterial colonization and infection.
AB  - Surface heparinization of central venous catheters has earlier been shown to
      reduce the frequency of bacterial colonization and septicaemia. The present study
      was undertaken to investigate the benefit of surface heparinization of external
      ventricular drainage (EVD) catheters in relation to bacterial colonization, as
      measured by bacterial growth and examination by a 16S-rRNA PCR assay, of
      catheters and of samples of cerebrospinal fluid (CSF). Ninety-eight heparinized
      and one hundred unheparinized EVD catheters from the same batch of catheters were
      used. Twenty point five percent of the heparinized and 22.8% (p = 0.63) of the
      unheparinized EVD catheters were colonized with bacteria. Culture of CSF, which
      is the definition of clinical infection in this study, yielded growth in 10.3% of
      patients with heparinized and in 6.3% (p = 0.18) of those with unheparinized
      catheters. PCR examination yielded positive signal in 31.3% of patients with
      heparinized catheters and in 37.7% (p = 0.061) of patients without (CSF and
      catheters). In the subgroup of patients with subarachnoid haemorrhages, there was
      a tendency, though not statistically significant, towards a lowered frequency of
      colonization with 23.1% for heparinized and 33.3% (p = 0.31) for unheparinized
      catheters. PCR examination did not contribute any further to the diagnostic
      procedure in the patients concerned. The EVD catheters are skin-penetrating
      devices and contamination from the skin flora is common. Skin cultures, obtained
      after skin disinfection and insertion of catheters, showed growth of bacteria in
      62% of the patients.

PMID- 11214633
TI  - Virtual pointer projection of the central sulcus to the outside of the skull
      using frameless neuronavigation -- accuracy and applications.
AB  - BACKGROUND: The purpose of this prospective study was to localize the central
      sulcus by frameless neuronavigation and to project this anatomical structure to
      the outside of the skull on the skin. This method was analyzed in respect to its
      practicability, accuracy, and potential applications. METHOD: In 27 patients
      investigated (28 unaffected hemispheres), the central sulcus was virtually
      projected to the outside of the skull using frameless neuronavigation and a
      virtual pointer elongation of 15 or 20 mm. The following parameters were measured
      on the scalp: 1. the distance between the bregma and the midline junction of the
      central sulcus, and 2. the angle between the central sulcus and the midline.
      These dada were compared with measurements based on the original axial MR images
      of these patients. Finally, a laboratory phantom study was designed in analogy to
      a patient's examination for estimation of the overall accuracy of the
      neuronavigation system in the experimental setup used in this study. FINDINGS:
      Virtual pointer projection of the central sulcus to the outside of the skull
      using frameless neuronavigation was found to be easily possible. The distance
      between the bregma and the midline junction of the central sulcus amounted to a
      mean of 55 mm on the left and 56 mm on the right. The angle between the central
      sulcus and the midline reached a mean of 63 degrees on the left and 60 degrees on
      the right. These data confirmed results of other studies with no frameless
      neuronavigation devices. The phantom study revealed a mean overall inaccuracy of
      0.9 mm at a virtual pointer elongation of 15 mm. At a virtual pointer elongation
      of 20 mm, the mean overall inaccuracy of our study was 1.1 mm. These results
      correspond to the inaccuracy of frame based stereotaxy. INTERPRETATION: It is
      easily possible, valid, and reliable to virtually project the central sulcus to
      the outside of the skull with an acceptably low inaccuracy using frameless
      neuronavigation. This is important for research studies that correlate and
      integrate different functional imaging methods with the aid of frameless
      neuronavigation.

PMID- 11214634
TI  - From anaesthesia for neurosurgery to neuroanaesthesia: a historical note.

PMID- 11214635
TI  - Scanning electron microscopic evaluation of nonocclusive excimer laser-assisted
      anastomosis in rabbits.
AB  - BACKGROUND: The nonocclusive Excimer laser-assisted bypass technique has been
      described in previous studies and proved to be a promising bypass operation in
      vascular brain surgery. Little is known about the morphological regeneration
      process of the laser-assisted anastomosis in time. By way of a scanning electron
      microscopic study we examined the way in which the anastomosis site created by
      the nonocclusive Excimer laser-assisted anastomosis technique becomes
      endothelialized. METHODS: In 14 rabbits the internal jugular vein was placed in a
      loop on the abdominal aorta. The distal anastomosis was made using the
      nonocclusive Excimer laser-assisted technique. The proximal anastomosis was made
      either laser-assisted or conventional end-to-side. After clipping of the aorta
      between the two anastomoses sites the vein served as a bypass. To evaluate the
      endothelialization at the laser-assisted anastomosis site in time, a scanning
      electron microscopic study was performed. RESULTS: In the first hours after the
      bypass operation a new intimal surface is formed by fibrin and activated
      platelets. Some leukocytes are seen during the first days. The endothelialization
      process of the laser-assisted anastomosis site begins one day after the
      operation. The gradual endothelialization process evolved along two lines. First,
      endothelial cells grow from the side of the aorta to the bypass. Second, after
      one day solitary (blood-borne) endothelial cells deposit on the laser edge and
      the sutures, covering the platelet aggregates. CONCLUSIONS: The
      endothelialization of the Excimer laser-assisted anastomosis is more or less
      completed 9 days after the operation. The edge created by the laser becomes
      smoother after a few days and is gone for the most part after 9 days.

PMID- 11214636
TI  - Endothelin-1 initiates the development of vasospasm after subarachnoid
      haemorrhage through protein kinase C activation, but does not contribute to
      prolonged vasospasm.
AB  - Endothelium plays a role in the regulation of vascular tone. Endothelin is a
      family of potent vasoconstrictive peptides, and endothelin-1 (ET-1) produced in
      the endothelium induces a tonic contraction via specific receptor ET(A). ET-1 has
      been postulated as an important factor in the development of vasospasm after
      subarachnoid haemorrhage (SAH). We have previously shown that protein kinase C
      (PKC) of the cerebral artery plays a pivotal role in the pathogenesis of
      vasospasm. The purpose of this study is to clarify the relationship between ET-1
      and PKC in the development and maintenance of vasospasm. Using a "two
      haemorrhage" canine model, chronological changes of angiographic progression of
      vasospasm, PKC activation, and ET-1 level of the basilar artery were assessed. In
      an isometric tension study with a control artery, the effects of ET(A)- and
      ET(A)/ET(B)-antagonists on the tonic contraction induced by ET-1 were examined.
      The effects of ET-1, ET-1 and an ET(A)-antagonist, and ET-1 and an ET(A)/ET(B)
      antagonist on PKC activation were also evaluated. ET-1 level temporarily
      increased, then decreased to the control level in a later stage of vasospasm. ET
      1 induced a tonic contraction and enhancement of PKC activation, but both were
      inhibited either by an ET(A)- or an ET(A)/ET(B)-antagonist. These results
      indicate that ET-1 initiates the development of vasospasm through PKC activation,
      but does not contribute to prolonged vasospasm.

PMID- 11214637
TI  - Central neurocytoma: 2 case reports and review of the literature.
AB  - Central neurocytoma is a rare benign tumor of the central nervous system occuring
      in young adults and typically located in the ventricles. The tumor is composed of
      small round cells with neuronal differentiation and has a favourable prognosis.
      We report two cases of giant central neurocytomas with a triventricular extension
      in two young women. The first case concerned a 26 years old righthanded woman in
      whom an intraventricular mass was discovered, after a car accident with head
      trauma. Skull radiography showed an enlargment of the sella turcica. A CT scan
      performed in order to examine the pituitary gland revealed a voluminous and
      heterogenous intraventricular tumor with calcification. The second case concerned
      a 26 years old righthanded woman, presenting with a 4 Glasgow Coma Scale Score
      preceded by an acute onset of headache with projectile vomiting. A CT scan
      performed in emergency revealed a voluminous intraventricular mass with
      significant hydrocephalus. We review the different pathological and topographical
      patterns of previously published neurocytomas and discuss surgical management,
      effectiveness of radiation therapy and biological behavior.

PMID- 11214638
TI  - Haemorrhagic nonsecreting pituitary adenoma associated with persistent primitive
      trigeminal artery.

PMID- 11214639
TI  - Ruptured intracranial aneurysms in infancy. Diagnostic difficulties and overall
      reflections associated with the surgical treatment and the treatment of
      vasospasm.

PMID- 11214640
TI  - Growth of a meningioma induced by implantation of a foreign body into an
      arachnoid cyst.

PMID- 11214641
TI  - Research, publication and ethics.

PMID- 11214642
TI  - Leptomeningeal contrast enhancement in moyamoya: its potential role in
      postoperative assessment of circulation through the bypass.
AB  - Leptomeningeal contrast enhancement (LMCE) is one of the MRI features of
      moyamoya. Its clinical significance, however, is not elucidated. Our purpose was
      to characterise LMCE on MRI and to evaluate its role in the assessment of
      circulation through a surgically established bypass in moyamoya. We studied 16
      patients with idiopathic moyamoya (seven males, nine females, includingt four
      children, aged 7 to 54 years, mean 24 years) who underwent T1-weighted MRI before
      and after intravenous contrast medium. The presence of LMCE, its intensity and
      anatomical distribution, catheter angiographic findings, and relation of LMCE to
      the bypass surgery were assessed. More LMCE was seen in the cerebrum in most
      patients with moyamoya than in normal controls. LMCE in the brain stem and
      cerebellum was minimal, similar to that seen in the controls. LMCE was less
      prominent following surgery than before operation or in patients who did not
      undergo surgery. In three patients examined both before and after operation LMCE
      became less prominent following bypass surgery. As LMCE becomes less prominent
      after "effective" bypass surgery, this may be used for evaluation of
      effectiveness of surgery in moyamoya.

PMID- 11214643
TI  - Continuous administration of contrast medium for transcranial colour-coded
      sonography.
AB  - Since the introduction of contrast media, transcranial colour-coded sonography
      (TCCS) has become increasingly important for examination of the intracranial
      vessels. However, the widely practised bolus injection of these agents leads to
      initial blooming artefacts and thereafter the level of contrast enhancement
      decreases rapidly, reducing the effective time of enhancement. It was our aim to
      investigate the effect of continuous administration of contrast medium at a
      defined infusion rate. We performed 28 TCCS examinations of the intracranial
      vessels in 26 patients using a 2.25 MHz phased-array transducer during
      administration of 4 g Levovist (Schering, Berlin, Germany) 300 mg/ml with a
      constant infusion rate of 60 ml/h into an antecubital vein. The degree of
      enhancement was graded over time in a subjective analysis by two independent
      observers. During continuous administration, a constant level of contrast
      enhancement was reached after 60.1+/-26.2 s and this lasted 663.4+/-55.8 s as
      assessed by the first observer (66.6+/-26.2 s and 664.3+/-55.9 s according to the
      second observer). The limits of inter-observer agreement ranged from -10.1% to
      9.9%. No major blooming effect was seen in the initial phase of the examination.

PMID- 11214644
TI  - Primary central nervous system lymphoma in AIDS: a wider spectrum of CT and MRI
      findings.
AB  - Diagnosis of primary central nervous system lymphoma (PCNSL) in patients with
      AIDS based on radiological findings is still a challenging problem. Our purpose
      was to review the CT and MRI findings in PCNSL in our patients with AIDS and
      compare them with those reported in the literature. CT and MRI of 28 patients
      with AIDS and pathologically confirmed PCNSL were analysed retrospectively for
      the number of lesions, their site, size, density, signal intensity, contrast
      enhancement, oedema and mass effect. We found 82 lesions. On CT 45 lesions were
      found in 22 patients, whereas MRI revealed 66 in 20 patients. The lymphoma was
      solitary in 20 patients (29 %) and multiple in 20 (71%). Spontaneous haemorrhage
      was seen in 7 patients. Contrast-enhanced MRI showed no enhancement in 27.3 %
      (18/66) of the lesions. In one patient diffuse signal abnormalities in the white
      matter were seen on T2-weighted images. Our findings suggest that the previously
      described spectrum imaging characteristics of PCNSL has widened.
      Neuroradiologists should be aware of the variable appearance in patients with
      AIDS. Spontaneous haemorrhage, a non-enhancing lesion, or diffuse white matter
      changes do not exclude lymphoma in an immunocompromised patient.

PMID- 11214645
TI  - Primary brain lymphoma presenting as Parkinson's disease.
AB  - Neoplasm is an uncommon cause of a parkinsonian syndrome. We report a woman with
      primary brain B-cell lymphoma presenting as Parkinson's disease. After 1 year of
      the illness, CT and MRI showed lesions without mass effect in the basal ganglia
      and corpus callosum. The patient did not respond to levodopa and right cerebellar
      and brain-stem signs appeared, which prompted further neuroimaging, showing an
      increase in size of the lesions and a right cerebellar and pontine mass.
      Stereotactic biopsy of the basal ganglia showed high-grade B-cell lymphoma.
      Despite the basal ganglia frequently being involved in lymphoma of the brain,
      presentation with typical or atypical parkinsonism is exceptional.

PMID- 11214646
TI  - Traumatic atlanto-occipital dislocation: MRI and CT.
AB  - CT and MRI were employed to help characterize an atlanto-occipital dislocation
      injury, providing useful information for planning surgical stabilization and
      directing rehabilitation.

PMID- 11214648
TI  - Cyst of the ligamentum flavum.
AB  - We report the case of a patient with sciatica resulting from a cyst of the
      ligamentum flavum.

PMID- 11214647
TI  - Trans-sphenoidal encephalocele in association with Dandy-Walker complex and
      cardiovascular anomalies.
AB  - We present a case of trans-sphenoidal encephalomeningocele in association with a
      posterior cranial fossa malformation which fulfils the criteria for the Dandy
      Walker complex [1]. Congenital cardiovascular defects were also present. An
      abnormality of neural crest development may be responsible for the combined
      occurrence of these anomalies.

PMID- 11214649
TI  - MRI of unusual lesions in the internal auditory canal.
AB  - We report the MRI findings of six unusual lesions of the internal auditory canal:
      three haemangiomas, one lipoma, one metastasis and one traumatic neuroma. We
      compare the findings to those of 20 intracanalicular schwannomas. We noted the
      site and size of the tumour, its signal intensity, borders and the homogeneity of
      enhancement were studied on T1-weighted images before and after intravenous
      contrast medium and T2-weighted images. Most schwannomas were homogeneous
      lesions, isointense on T1- and T2-weighted images, and strongly enhancing.
      Spontaneous high signal on T1-weighted images, heterogeneous contrast enhancement
      and extranodular enhancement were helpful for recognising lesions other then
      schwannomas; site, size and signal on T2-weighted images were not. All the
      haemangiomas had a specific pattern of contrast enhancement, with an anterior
      core intensely enhancing portion and a posterior portion which enhanced
      moderately or not at all.

PMID- 11214650
TI  - MRI and CT of adenomatous tumours of the middle ear.
AB  - We report three adenomatous middle-ear tumours, an adenoma, an adenocarcinoma and
      a semimalignant adenomatous tumour, with special attention to CT and MRI
      findings. In all cases we found small intratympanic masses in which the ossicles
      were embedded. All showed contrast enhancement and similar signal intensity as
      brain tissue on T1- and T2-weighted images. The biological nature of the tumours
      was not reflected by the imaging or operative findings.

PMID- 11214651
TI  - 1H MR spectroscopy evidence for the varied nature of asymptomatic focal brain
      lesions in neurofibromatosis type 1.
AB  - We present the MRI and 1H MR spectroscopy findings in six patients with
      neurofibromatosis type 1 (NF1) and asymptomatic focal brain lesions. Variations
      in imaging appearances were seen, including regression of a previously identified
      lesion. MR spectra for the lesions and corresponding areas of normal brain show
      significant differences. The lesions could be separated into two groups, one
      demonstrating only slight metabolite ratio changes relative to normal brain and
      the other group showing significant increase in choline and decrease in N-acetyl
      aspartate. The lesion which regressed fell into the second group. These findings
      are not in agreement with those previously reported and provide evidence for the
      varied and possibly transient nature of these asymptomatic lesions. The
      spectroscopy findings suggest that metabolite changes may be present without
      visible changes on MRI.

PMID- 11214652
TI  - Fetal germinal matrix and intraventricular haemorrhage diagnosed by MRI.
AB  - Subependymal germinal matrix haemorrhage and intraventricular haemorrhage (GMIVH)
      is a common complication of delivery in preterm neonates but has rarely been
      observed in the fetus. We report two cases of GMIVH in fetuses of 36 weeks
      gestation, clearly demonstrated by antenatal MRI. In both cases progressive
      ventriculomegaly was observed, and ventriculoperitoneal shunts were placed at 19
      and 6 months of age, respectively. Prenatal GMIVH may be a cause of congenital
      hydrocephalus, for which no aetiology has yet been found.

PMID- 11214653
TI  - Monitoring cerebral perfusion after subarachnoid hemorrhage using CT.
AB  - The aim of this prospective study was to assess the feasibility and diagnostic
      relevance of repetitive dynamic (contrast-enhanced) CT measurements of cerebral
      blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) in the
      first 3 weeks after aneurysmal subarachnoid hemorrhage (SAH). In 15 patients with
      SAH, 59 dynamic CT studies including 944 regions of interest (ROI) were analyzed.
      The results were correlated with the clinical course and time after the event and
      the occurrence of vasospasm. Values for the entire series were 33.8+/-19.3 ml/100
      g/min (CBF), 3.3+/-1.3 ml/100 g (CBV), and 7.3+/-3.9 s (MTT). Significant
      differences in CBF and CBV were found between ROI in grey and white matter, with
      time after the event, between patients with significant and absent or minor
      vasospasm, and between patients with and without a presumed vasospasm-related
      infarct.

PMID- 11214654
TI  - Dysembryoplastic neuroepithelial tumour and cerebellar atrophy: case report.
AB  - Dysembryoplastic neuroepithelial tumours (DNET) are mainly benign cortical
      lesions. DNET in the caudate nucleus, thalamus, hypothalamus, pons and cerebellar
      hemispheres has also been reported. We describe a fronto-temporo-parietal DNET
      extending to the ipsilateral thalamus and internal capsule, associated with
      cerebellar lobe atrophy. Involvement of the internal capsule and complication of
      DNET with cerebellar atrophy have not been reported previously. We emphasise the
      importance of early diagnosis and treatment of this rare condition.

PMID- 11214655
TI  - The mechanism of thallium-201 accumulation.

PMID- 11214656
TI  - Guidelines for the diagnosis of dementia and Alzheimer's disease. The Dementia
      Study Group of the Italian Neurological Society.

PMID- 11214657
TI  - Transesophageal echocardiography for identifying potential cardiac sources of
      embolism in patients with stroke.
AB  - Pathologies of cerebral circulation are one of the most frequent causes of
      mortality and morbidity among the populations of Western countries. The incidence
      of ischemic events presumed to have a cardioembolic origin varies from 13% to 34%
      in the largest international multi-center studies. However, some authors have
      reported an incidence of general cardiogenic stroke ranging from 23% to 36% in
      younger patients. Transesophageal echocardiography (TEE) is a useful
      investigation for identifying cardiac sources of embolism in patients without
      vascular alterations involving the carotid and vertebral districts. This study
      comprised 73 patients with unexplained stroke who were investigated by both
      transthoracic echocardiography (TTE) and TEE. Vascular echocolor sonography had
      been performed in all of them with negative results. TEE demonstrated: atrial or
      ventricular thrombosis in 6 patients (8%), intracavitary neoplasm in 2 (2%),
      spontaneous echocontrast in 11 (13%), valve strands in 6 (7%), complex aortic
      plaque in 10 (11%), patency of the foramen ovale in 17 (19%), atrial septal
      aneurysm in 9 (11%), dystrophy and mitral calcifications in 9 (11%). In the other
      18 patients, TEE did not reveal any anomalies. Definite sources of stroke (clots
      and tumors) were identified in 14% of all the lesions; however, the majority
      (86%) were potential sources. A comparison of the two echocardiographic
      techniques demonstrated a greater sensitivity and specificity of TEE. Although
      TEE was superior to TTE for identifying and evaluating potential embolic sources,
      we found both methods to be useful and would advise performing TTE before TEE.
      While TTE is not capable of identifying the majority of anomalies, it does
      provide useful information to guide subsequent transesophageal investigations.

PMID- 11214658
TI  - Conventional external radiotherapy in the management of clivus chordomas with
      overt residual disease.
AB  - Cranial chordomas are uncommon tumors accounting for less than 1% of all
      intracranial neoplasms. Although they are slowly growing, rarely metastasizing
      tumors, cranial chordomas are challenging to treat due to their critical
      location, invasive nature and aggressive recurrence. The aim of this
      retrospective study was to evaluate the role of conventional irradiation in the
      treatment of clival chordomas with overt residual disease after incomplete
      surgery. Between January 1979 and December 1997, 18 patients with histologically
      confirmed clival chordoma were treated with radiotherapy. Median age at the time
      of diagnosis was 32 years. The mean duration of the symptoms before diagnosis was
      33.9 months. Median tumor diameter at initial presentation was 5 cm (range, 3-7
      cm). The type of surgical procedure was subtotal excision in 11 patients and
      biopsy in 7. Radiation treatment was delivered with megavoltage units, and total
      doses between 50 Gy and 64 Gy (median, 60 Gy) were administered with conventional
      daily fractions. One patient received additional 12.50 Gy with linear accelerator
      based stereotactic radiosurgery after subtotal excision and external irradiation.
      The mean follow-up time was 43.2 months. Overall survival at 5 years was 35%.
      Eleven patients showed progression after radiotherapy. The median time to
      progression after radiotherapy was 40.8 months (38.4-43.2) with a 5-year
      progression-free survival of 23%. Five patients (29.4%) showed symptomatic relief
      after radiotherapy while persistent symptoms were recorded for 6 patients.
      Incomplete surgery and conventional external radiotherapy with a dose of around
      60 Gy seem to be inadequate in the treatment of clival chordomas.

PMID- 11214659
TI  - Leucopenia induced by low dose clozapine in Parkinson's disease recedes shortly
      after drug withdrawal. Clinical case descriptions with commentary on switch-over
      to olanzapine.
AB  - Four patients affected by severe Parkinson's disease developed leucopenia (900
      1200 WBC) during treatment of psychosis (3) or untreatable insomnia (1) with
      clozapine (37.5-75 mg/day). Clozapine withdrawal was followed by recovery of
      leucopenia (4000-6000 WBC) in two weeks with no need for the administration of
      leucokines. After 1-6 months olanzapine was administered (increasing the dose
      from 2.5 to 10 mg/day) to treat persisting disturbances, but the drug induced
      severe worsening of parkinsonism and also this drug had to be withdrawn.

PMID- 11214660
TI  - EDSS correlated analysis of median nerve somatosensory evoked potentials in
      multiple sclerosis.
AB  - Median nerve somatosensory evoked potentials (SEP) were recorded in 30 patients
      with multiple sclerosis. The examined patients had an expanded disability status
      scale (EDSS) between 0 and 6. The primary cortical potential N20, the subcortical
      potentials P14, N13b, N13a and the peripheral potential P9 were recorded
      simultaneously. In 5 patients normal SEP were observed (group 1), and in 6
      patients there were consecutive disturbances of the somatosensory pathway (group
      3). In 19 patients subcortical potentials were abnormal or absent while the
      following potentials were normal or identified which pattern corresponds to
      amplification within CNS structures (group 2). The EDSS of groups 1 and 2 were
      similar and lower than the EDSS of group 3, which indicates that amplification
      mechanisms could represent a positive prognostic factor in SEP diagnosis of
      multiple sclerosis.

PMID- 11214661
TI  - Length of hospitalization of patients with transient ischemic attacks.
AB  - OBJECTIVE: To investigate factors that influence length of stay (LOS) in patients
      hospitalized for transient ischemic attacks (TIAs). This may help to reduce
      unnecessary days of hospitalization. DESIGN: Retrospective study. SETTING: A
      large, non-academic general hospital. PATIENTS: All patients hospitalized for
      TIAs during the years 1996-1998 were retrospectively studied. We analyzed the
      relationship between demographic, clinical and management features and LOS.
      RESULTS: We studied 157 patients. Median LOS was 8 days (range, 1 to 21 days).
      Statistical analysis showed that female sex, being hospitalized in 1996,
      hospitalization from Wednesday through Saturday, and second-level cardiological,
      neuroradiological and miscellaneous investigations significantly increased LOS.
      CONCLUSIONS: The LOS of patients with TIAs may be reduced through measures that
      accelerate the diagnostic work-up and by scheduling the admission to the first
      days of the week, when this is possibile.

PMID- 11214662
TI  - Guillain-Barre syndrome: an Italian multicentre case-control study. Guillain
      Barre Syndrome Study Group.
AB  - Various diseases are described as antecedents of Guillain-Barre syndrome (GBS),
      particularly gastroenteritis and respiratory infectious diseases, but
      epidemiological surveys are rare. This paper details a multicentre matched case
      control study carried out within a well-defined Italian population. For each GBS
      case fulfilling the Asbury and Cornblath criteria, one control was recruited from
      a neurological (NC) ward and another from a non-neurological (NNC) ward, matched
      for age, sex, season of disease onset and area of residence. All cases and
      controls were administered a semistructured questionnaire. The OR was calculated
      according to the Mantel-Haenszel equation for triplets. Between 1 October 1996
      and 30 September 1998, 75 triplets were included in the case-control study. The
      OR for flu-like syndrome was 7.14 (CI 95%, 3.28-15.52) and for gastroenteritis
      3.57 (CI 95%, 1.31-9.72); no other factor reached significance. Our results,
      based on the clinical and anamnestic features of triplets of patients, support
      the possible role as risk factors for GBS of infectious diseases, particularly
      flu-like syndrome and gastroenteritis.

PMID- 11214663
TI  - Plasma levels of coagulation and fibrinolysis markers in acute ischemic stroke
      patients with lone atrial fibrillation.
AB  - Atrial fibrillation (AF) is a well-defined risk factor for ischemic stroke.
      Patients with lone AF represent a subgroup of AF patients with the lowest
      lifelong stroke risk. Nonvalvular atrial fibrillation (NVAF) confers a
      hypercoagulable state resulting in an increased risk of thromboembolism. This
      study was performed to determine the contributory role of alteration in the
      hemostatic markers of thrombin generation and fibrinolysis in patients with lone
      AF during acute ischemic stroke episode. We studied thrombin-antithrombin
      complexes (TAT), prothrombin fragments 1+2 (F1+2), tissue-type plasminogen
      activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1) concentrations
      in patients with acute middle cerebral artery ischemic stroke due to
      atherosclerotic large artery disease (n=50), lone AF (n=24) and cardioembolism
      (n=21). The values were compared with those of age-matched control subjects with
      lone AF and sinus rhythm (n=21 and 15, respectively). The mean F1+2 concentration
      was higher in the control subjects with lone AF in comparison with those without
      AF (p=0.014). Patients with stroke due to possible cardioembolism, from lone AF
      or other causes, had higher TAT (and marginally higher F1+2) concentrations than
      those with atherosclerotic stroke (p<0.001). tPA concentrations were not
      different among groups (p=0.89). PAI-I levels were marginally higher in stroke
      patients with lone AF and atherothrombotic large artery disease compared to the
      controls without AF (p=0.05). These results suggest that in the acute period of
      ischemic stroke secondary to lone AF, enhancement of the coagulatory activity
      occurs as a result of increased thrombin generation, similar to other possible
      sources of cardioembolism. Observed hemostatic alterations in acute ischemic
      stroke associated with lone AF may indicate some therapeutic and prognostic
      implications.

PMID- 11214664
TI  - Brachial plexus neuropathy as unusual onset of diffuse neurolymphomatosis.
AB  - We present a patient with a large B cell gastric lymphoma in total remission who,
      after 4 months, developed a fatal progressive peripheral neuropathy with an
      unusual early involvement of the right brachial plexus. No evidence of lymphoma
      was found at whole body computed tomography, magnetic resonance imaging of the
      head, cervical spine and right brachial plexus, bone marrow biopsy or repeated
      lumbar punctures. The diagnosis of neurolymphomatosis was made only at postmortem
      examination.

PMID- 11214665
TI  - Eyelid myoclonia with absences in three subjects with mental retardation.
AB  - Eyelid myoclonia with absences is a rare epileptic syndrome, characterized by
      eyelid myoclonia, absences, and photosensitivity. On the basis of its clinical
      and EEG features, this syndrome has been classified as a specific new entity
      among the idiopathic generalized epilepsies. We report three subjects, aged 4,
      16, and 31 years, respectively, with eyelid myoclonia, and absences, mental
      retardation and other abnormalities of the central nervous system. Our findings
      suggest that, at least in some cases, eyelid myoclonia and absences can represent
      a peculiar phenomenon of symptomatic epilepsies.

PMID- 11214666
TI  - The insomnia plague: a Gabriel Garcia Marquez story.
AB  - "All the great writers have good eyes" is a sentence by V. Nabokov that is very
      suitable for G.G. Marquez and his One Hundred Years of Solitude. The novel,
      published in 1967, introduces among many others, the character of little Rebeca,
      whose frailness and greenish skin revealed hunger "that was older than she was".
      The girl, because of a pica syndrome, only liked to eat earth and the cake of
      whitewash. But her fate appears to be determined by the lethal insomnia plague,
      whose most fearsome part was not the impossibility of sleeping but its inexorable
      evolution toward a loss of memory in which the sick person "sinks into a kind of
      idiocy that had no past". Rebeca's lethal insomnia looks quite similar to the
      "peculiar, fatal disorder of sleep" originally described by Lugaresi et al. in
      1986. One Hundred Years (of Solitude shows that G.G. Marquez was gifted not only
      with good eyes, but has the seductive power of changing reality into fantasy,
      while transforming his visions into reality.

PMID- 11214667
TI  - Biochemical characterization of Mycoplasma bovirhinis, Mycoplasma dispar and
      recent bovine isolates of Mycoplasma canis.
AB  - The pattern and kinetics of substrate utilization by the type strains of
      Mycoplasma canis, M. bovirhinis and M. dispar and ten recent M. canis isolates
      from cattle were determined. Metabolism of a range of sugars and organic acids by
      M. dispar was detectable by measurement of oxygen uptake. Organic acids were not
      utilized by M. bovirhinis or M. canis, and there was no oxygen uptake during
      metabolism of glucose or other sugars, as monitored by a pH-change method. The M.
      canis strains varied in their ability to metabolize sugars; seven of the isolates
      from cattle had the distinctive ability to metabolize sucrose, and one isolate,
      plus the type strain (from a dog), metabolized N-acetylglucosamine. The M.
      bovirhinis strain metabolized maltose. However, all the test strains oxidized
      glycerol at high rates and with a high affinity. Oxidation of glycerol has been
      reported for other mycoplasmas from the bovine respiratory tract and leads to the
      production of hydrogen peroxide, a potential virulence factor.

PMID- 11214669
TI  - Reduction in serum lecithin:cholesterol acyltransferase activity in natural cases
      of pneumonia in calves.
AB  - In experimental calf pneumonia induced by inoculations of Pasteurella haemolytica
      or bovine herpesvirus-1, lipoprotein lipid concentrations and
      lecithin:cholesterol acyltransferase (LCAT) activity decrease. The purpose of
      this study was to examine whether similar changes in lipoproteins occur in
      natural cases of calf pneumonia. When monitored in a time-course study, the
      activity of LCAT, and the concentrations of free cholesterol, cholesteryl esters,
      phospholipids and triglycerides were steadily decreased. No significant decreases
      in LCAT activity or lipid concentrations were detected in sera from cows with
      mastitis. These results, coupled with the previous findings on experimental calf
      pneumonia, indicate that, while decreases in LCAT activity and the LCAT-related
      lipid concentrations are involved in the pathogenesis of calf pneumonia, this is
      not the case for all inflammatory diseases.

PMID- 11214668
TI  - Occurrence and characterization of Escherichia coli O157 isolated from cattle in
      Norway.
AB  - Faecal samples from 504 imported beef cattle were screened to investigate the
      occurrence of Escherichia coli O157. The results were compared with those from a
      previous screening of Norwegian dairy cattle, and the occurrence was found to be
      higher in the imported beef cattle. The E. coli O157 isolates from the previous
      and present studies were characterized for the genes encoding for shigatoxin 1
      (stx1), shigatoxin 2 (stx2), the intimin protein (eae) and the flagellar protein
      H7 (fliC) using PCR analysis, pulsed-field gel electrophoresis (PFGE) with the
      restriction enzyme XbaI, and bacteriophage lambda RFLP analysis using the PvuII
      restriction enzyme. The isolates from the dairy and beef cattle could be
      distinguished by the profiles of the toxin genes and by PFGE patterns. Whether
      the importation of animals in itself should be regarded as a risk factor for the
      occurrence of E. coli O157, or whether other management factors contribute to the
      differences in carrier rates compared to the previous study on domestic cattle,
      is discussed.

PMID- 11214670
TI  - Glycoconjugate histochemistry in the duodenum of fetal and adult fallow deer.
AB  - This work aimed to characterize the complex carbohydrates in the duodenum of
      fetal and adult fallow deer. The proximal parts of the duodenum were removed from
      the intestine of 12- and 16-week-old fetuses and of adult fallow deer. Sections
      were assessed by conventional carbohydrate histochemistry combined with
      glycosidase digestions and treatment with KOH. During development, there was an
      increase in the acid carboxylated components of the glycoconjugates in goblet
      cells, while the duodenal glands expressed high quantities of sulphated
      glycoconjugates at the beginning of development but, in the adult. mainly
      secreted neutral and carboxylated glycoconjugates containing sialic acid.
      Sulphated components, probably represented by chondroitin sulphate B-like and
      heparan sulphate-like glycosaminoglycans may play a role in the morphofunctional
      differentiation of the duodenum.

PMID- 11214671
TI  - Antibody response in sheep following immunization with Streptococcus bovis in
      different adjuvants.
AB  - Recent studies have shown that immunization with Streptococcus bovis using
      Freund's complete adjuvant (FCA) may confer protection against lactic acidosis in
      sheep. The major objective of this study was to compare the antibody responses to
      S. bovis in a practically acceptable adjuvant (Freund's incomplete adjuvant
      (FIA); QuilA; dextran sulphate (Dex); Imject Alum; or Gerbu) and in FCA. Thirty
      five sheep were randomly allocated to 7 treatment groups. Six groups were
      immunized with S. bovis in an adjuvant; the other group served as the non
      immunization control. The primary immunization was administered intramuscularly
      on day 0. followed by a booster injection on day 28. Immunization with FCA
      induced the highest saliva and serum antibody responses. The saliva antibody
      concentrations in the FIA and QuilA groups were significantly higher than those
      in the Alum, Dex and Gerbu groups (p < 0.01). The serum antibody concentration in
      the FIA group was significantly higher than those in the QuilA, Alum. Dex and
      Gerbu groups (p < 0.01). Immunization enhanced the antibody level in faeces (p <
      0.05), but there was no significant difference between the different adjuvant
      groups (p > 0.05). Seven and 14 days following booster immunization, the saliva
      antibody levels induced by QuilA and/or FIA were comparable with the level
      stimulated by FCA (p > 0.05). There was a strongly positive correlation (R2 =
      0.770, p < 0.01) between the antibody concentrations in salival and serum.
      Compared with the controls, a higher faecal dry matter content was observed in
      the animals immunized with either FCA or QuilA. The change in faecal dry matter
      content was positively associated with the faecal antibody concentration (R2 =
      0.441, p < 0.05). These results indicate that FIA and QuilA were effective at
      inducing high levels of antibody responses to S. bovis, and suggest that either
      Freund's incomplete adjuvant or QuilA may be useful for preparing a practically
      acceptable vaccine against lactic acidosis.

PMID- 11214672
TI  - Enhanced lipid peroxide levels in the erythrocytes of calves with
      haemoglobinuria.
AB  - Eight 6-9 month old calves, showing clinical signs of intermittent
      haemoglobinuria, even after treatment with an antipiroplasmal drug (4,4
      diamidinodiazaminobenzene diaceturate), were examined for oxidative damage to
      their erythrocytes and the presence of hemoprotozoa in blood smears. Four calves
      without signs of haemoglobinuria served as controls. The blood smears from three
      of the eight calves contained piroplasms for Theileria annulata. Irrespective of
      the presence of piroplasms in their blood smears, the calves with haemoglobinuria
      had significantly (p < 0.01) lower haemoglobin concentrations (Hb) and packed
      cell volumes (PCV). The lipid peroxide level in the erythrocytes, but not in the
      plasma, of calves with red urine was significantly (p <0.05) higher than that for
      the controls. It is concluded that haemoglobinuria, irrespective of the presence
      of piroplasms in blood smears, is associated with oxidative stress to
      erythrocytes and peroxidation of polyunsaturated fatty acids of cell membrane.

PMID- 11214673
TI  - A preliminary study on the anthelmintic activity of Calotropis procera latex
      against Haemonchus contortus infection in Najdi sheep.
AB  - The anthelmintic activity of Calotropis procera latex was investigated in sheep
      that had been infected with single oral doses of 12000 infective Haemonchus
      contortus larvae. Inappetence, dullness, erosive abomasitis, decreased
      haemoglobin concentration and increased eosinophils were the main features of
      haemonchosis in the sheep. In the sheep treated with single oral doses of 0.01 ml
      or 0.02 ml/kg body weight of C. procera latex, egg production was significantly
      reduced, but not completely suppressed, and fewer adult Haemonchus worms were
      found in the abomasum. Although the appetite improved, the haemoglobin
      concentration and serum copper, iron and zinc levels were still reduced after
      therapy with Calotropis latex. Calotropis latex showed a concentration-dependent
      larvicidal activity in vitro within 20 min of application.

PMID- 11214674
TI  - Ethnoveterinary medicine in the Northern Provinces of Cameroon.

PMID- 11214675
TI  - Detection and differentiation of CAV-1 and CAV-2 by polymerase chain reaction.
AB  - Canine adenovirus type 1 (CAV-1) and type 2 (CAV-2) can be categorized in the
      laboratory by haemagglutination and neutralization tests, but they are difficult
      to differentiate from each other in specimens, especially when infection occurs
      in the digestive tract. The object of this study was to develop a simple method
      of detecting and differentiating them. One pair of common primers was designed
      and synthesized according to the sequences of the E3 and flanking regions and a
      polymerase chain reaction (PCR) assay was established using these two primers to
      amplify the virus-specific DNA fragment from clinical specimens as well as from
      cell cultures. After elecctrophoresis, under the same amplification conditions,
      508 bp and 1030 bp PCR products were observed for CAV-1 and CAV-2, respectively.
      These were further shown to be adenovirus specific by dot hybridization and
      sequencing. As only one pair of primers was involved in the PCR procedure, it was
      faster and easier to perform than any of the other assays used for detecting
      canine adenovirus, making it applicable in the rapid confirmation of diagnosis
      and differentiation of the two types of canine adenoviruses.

PMID- 11214676
TI  - Hepatic veno-occlusive disease in children undergoing bone-marrow
      transplantation: usefulness of sonographic findings.
AB  - BACKGROUND: Reports of the usefulness of ultrasonography in the diagnosis of
      hepatic veno-occlusive disease (HVOD) have presented conflicting results.
      OBJECTIVE: To determine the usefulness of gray-scale or Doppler ultrasonographic
      measurements in the diagnosis of HVOD in pediatric patients undergoing BMT.
      MATERIALS AND METHODS: We prospectively obtained 202 serial sonograms on 48
      patients and examined the association between the clinical diagnosis of HVOD
      (McDonald criteria) and eight ultrasound parameters, including the hepatic artery
      resistive index (HARI), direction and velocity of portal venous flow, and
      thickness of the gall bladder wall. RESULTS: HVOD developed in 29 of the 48
      patients. The portal venous velocity increased after BMT in the group without
      HVOD and decreased in the group with HVOD; this difference was significant (P =
      0.01). However, there was a great deal of variability in velocity measurements
      for individual patients. The mean HARI was 0.64 in the group with HVOD and 0.63
      in the group without HVOD, and there was no difference between the two groups in
      the pattern of change in HARI relative to the day of BMT (P = 0.4). There was
      also no significant difference in thickness of the gallbladder wall between the
      two groups (P = 0.6). CONCLUSION: No ultrasound parameter studied was as useful
      as the McDonald criteria for diagnosing HVOD.

PMID- 11214677
TI  - Imaging diagnosis of retroperitoneal ganglioneuroma in childhood.
AB  - PURPOSE: To demonstrate the typical appearance of retroperitoneal ganglioneuromas
      on CT and MRI. MATERIALS AND METHODS: Retrospective analysis of diagnostic
      imaging (five CT scans, three MRI scans) in five children aged 3-15 years with
      the histological diagnosis of ganglioneuroma. RESULTS: The scans showed large
      (maximum 11 cm diameter), round or oval tumours with sharply defined margins.
      Intraspinal tumour involvement occurred in two cases. Comparing CTwith MRI, MRI
      was more accurate in defining the intraspinal involvement. The ganglioneuromas
      were hypodense on unenhanced CT and showed moderate enhancement with
      administration of contrast medium. In three patients, CT demonstrated tumour
      calcification with a disseminated speckled pattern. On T1-weighted MRI the
      tumours were homogeneous and hypointense, showing marked enhancement after
      gadolinium administration. On T2-weighted scans the tumours were hyperintense.
      CONCLUSION: At the time of diagnosis, retroperitoneal ganglioneuromas are
      generally large tumours that can be shown well by CT and MRI. The appearance on
      CT more readily suggests the diagnosis, but MRI is superior for documenting local
      or intraspinal tumour extension and lacks radiation load.

PMID- 11214678
TI  - Symptomatic splenic hamartoma with renal, cutaneous, and hematological
      abnormalities.
AB  - BACKGROUND: There is a rare association between splenic hamartomas and
      hematological abnormalities with, to our knowledge, only 24 reported cases in the
      English literature. PATIENTS AND METHODS: We report a case of a splenic hamartoma
      in a 14-year-old boy associated with membranoproliferative glomerulonephritis,
      multiple lobular capillary hemangiomas of the skin, hypertension, and anemia.
      Following imaging with ultrasonography, MRI, and nuclear scans, a hamartoma was
      suspected, but malignancy could not be excluded. The lesion was removed by
      partial splenectomy, and pathological examination confirmed the presence of a red
      pulp splenic hamartoma. RESULTS: The renal, hematological, and dermatological
      abnormalities resolved following removal of the splenic hamartoma. This is the
      first reported case of a splenic hamartoma associated with renal, cutaneous, and
      hematological abnormalities and only the second reported case of a symptomatic
      splenic hamartoma treated by partial splenectomy.

PMID- 11214679
TI  - Mucormycosis resulting in a pseudoaneurysm in the spleen.
AB  - Mucormycosis is an uncommon and frequently fatal fungal infection. It
      characteristically affects patients with diabetes mellitus or patients with
      severe immunosuppression. The hallmark of mucormycosis infection is tissue
      infarction and vascular invasion. We present clinical data and imaging studies of
      a 16 year-old child with acute lymphoblastic leukemia complicated by disseminated
      mucormycosis resulting in a pseudoaneurysm of the spleen. This was successfully
      managed by a combination of systemic antifungal therapy (Amphotericin B) and
      surgery (splenectomy). This entity has not been described in the literature.

PMID- 11214680
TI  - Peripheral primitive neuroectodermal tumour of the kidney: CT findings.
AB  - Peripheral primitive neuroectodermal tumour in the kidney is a rare entity with
      high malignant potential. The distinctive demographic, clinical and radiological
      findings, as described in the present case, should suggest this aggressive tumour
      in the differential diagnosis of renal neoplasms in adolescents.

PMID- 11214682
TI  - Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome.
AB  - A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is
      described. She was diagnosed after acute neurological deterioration by MRI and
      angiography. Recombinant tissue plasminogen activator (r-TPA) was injected
      locally to recanalise the thrombus. The patient's condition significantly
      improved and she was discharged. After 2 years of follow-up the child remains
      asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be
      overlooked as a cause of acute neurological deterioration in a child with Down's
      syndrome. MRA appears to be a safe and accurate alternative to traditional
      angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA
      is the treatment of choice for cerebral venous thrombosis due to its safety and
      efficacy.

PMID- 11214681
TI  - Extrinsic ureteropelvic junction obstruction from a crossing renal vessel:
      demography and imaging.
AB  - BACKGROUND: The increase in the use of prenatal ultrasound has revolutionized the
      detection of hydronephrosis and has had an unanticipated consequence. OBJECTIVE:
      To describe the new demographics of symptomatic ureteropelvic junction (UPJ)
      obstruction and the characteristic imaging findings, when the obstruction is
      extrinsic, from a crossing renal vessel. MATERIALS AND METHODS: From a
      uroradiology database (1994 through 1999) we identified children with surgically
      corrected UPJ obstruction from intrinsic and extrinsic causes. RESULTS: One
      hundred children had symptomatic UPJ obstruction treated by surgery. In 51 (49
      %), obstruction was due to a crossing vessel. One hundred and one had UPJ
      obstruction detected by prenatal sonography. Only 11 (11%) were due to a vessel.
      Two clinical and imaging findings were strongly suggestive of obstruction from a
      vessel: (1) in 5 of the 100 children the symptoms (pain, nausea, and vomiting)
      were intermittent. Only when symptoms were present were there hydronephrosis and
      obstruction; (2) in 51 of the 100 children a short segment of ureter, just below
      the UPJ, was filled with contrast or urine (on renal sonography, intravenous
      urography, or retrograde/antegrade ureterography). CONCLUSIONS: Extrinsic UPJ
      obstruction caused by a vessel is an uncommon cause of obstruction when all
      patients are considered. However, in symptomatic older patients whose
      hydronephrosis was not first identified on prenatal sonography, a vessel was the
      cause of obstruction in one half.

PMID- 11214684
TI  - Additional cases of pseudotumoral eosinophilic cystitis.

PMID- 11214683
TI  - Asymptomatic intraventricular lipid leak from a primary pineal teratoma.
AB  - We present a case of pineal teratoma in a symptomatically stable 6-year-old child
      in which MRI revealed intraventricular lipid accumulation in the absence of any
      primary tumour growth, metastatic disease or tumour degeneration.

PMID- 11214685
TI  - Internal jugular vein phlebectasia and duplication: case report with magnetic
      resonance angiography features.

PMID- 11214686
TI  - Three-dimensional MR microscopy of a transgenic mouse model of dilated
      cardiomyopathy.
AB  - BACKGROUND: Scientists are now able to alter the genetics of vertebrate embryos
      routinely to produce animal models of human developmental diseases. However, our
      understanding of structural changes in these animal models is limited by current
      methodologies. Histological techniques, although providing great anatomic detail,
      display only "static" data (one time point only) in two dimensions. Ultrasound
      may be used to generate continuous time course data, but is limited by
      interobserver variation, limited acoustic windows, and relatively low resolution.
      OBJECTIVE: To apply the high resolution, non-destructive, and three-dimensional
      acquisition capabilities of magnetic resonance (MR) microscopy to compare the
      hearts of normal mice versus an established transgenic mouse model of dilated
      cardiomyopathy. MATERIALS AND METHODS: Transgenic mice exhibiting dilated
      cardiomyopathy were developed via the introduction of a mutated, heart-specific
      gene (myosin light chain). Postmortem cardiac imaging was performed on the
      transgenic mice and normal controls. MR imaging was performed on a Bruker 3T
      imaging magnet using a custom radiofrequency coil following contrast perfusion of
      the atrial and ventricular chambers. Image resolution was 156 microm isotropic
      voxels. MR images were compared to gross pathologic specimens. Imaging data were
      post-processed using custom software to calculate the volumes of the atria and
      ventricles and to display the three-dimensional morphology of the chambers and
      myocardium. RESULTS: Of the seven mice scanned, four exhibited normal right
      atrial (average = 14.8 microl +/- 1.4), left atrial (average = 8.5 microl +/
      0.3), right ventricular (average = 12.9 microl +/-2.7), and left ventricular
      (average 3.3 microl +/-0.5) volumes. Three mice exhibited dilatation of the right
      and left cardiac chambers (RA average = 23.9 microl +/-5.6; LA average = 15.9
      microl +/-4.8; RV average = 32.5 microl +/- 6.8; LV average 24.0 microl +/-1.4).
      The gross morphology was verified upon autopsy of the animals and correlated with
      the animal's genotype. The differences in volumes between the normal and dilated
      cardiomyopathy mice were statistically significant (P values ranged from 0.001 to
      0.024 for the different chambers). CONCLUSION: MR microscopy is a potentially
      useful tool for developmental biology research. The imaging of mouse hearts is
      feasible, and these methods provide quantitative and qualitative morphologic data
      of a mouse model of dilated cardiomyopathy not available using traditional
      methods.

PMID- 11214687
TI  - Complications of limb-sparing procedures using endoprosthetic replacements about
      the knee for pediatric skeletal sarcomas.
AB  - Ninety-five percent of bone tumors are now managed with limb-sparing techniques.
      For pediatric patients with bone cancer, such limb reconstruction techniques
      often involve the placement of large endoprosthetic devices with the goal of
      improving survivors' quality of life. Nevertheless, few radiologic publications
      discuss the use of these techniques in children and adolescents. This pictorial
      essay describes the imaging characteristics of the complications associated with
      endoprosthetic devices and discusses the conditions that may simulate them.

PMID- 11214688
TI  - Vertebral osteoid osteoma masquerading as a malignant bone or soft-tissue tumor
      on MRI.
AB  - PURPOSE: Four pediatric patients were sent to our institution with the diagnosis
      of soft-tissue/malignant bone tumor. In all cases an MRI was the initial study
      performed for neck or back pain. All were surgically proven to have an osteoid
      osteoma/osteoblastoma (OO) as a final diagnosis. The MRI findings are reviewed.
      METHODS: Four patients, three boys and one girl, ranging in age from 5 to 17
      years, presented with symptoms of neck or back pain for 2 months to 2 years. Two
      had neurological findings. All patients underwent MRI. RESULTS: All MRIs
      demonstrated decreased T1 signal and increased T2 signal in the soft tissues and
      bone surrounding the lesions consistent with edema. Enhancement was observed in
      the adjacent soft tissues and in the lesion nidus retrospectively. CONCLUSION:
      Investigating neck or back pain with an initial MRI may lead to misleading
      diagnoses unless the radiologist is aware of the typical MRI appearance of
      vertebral osteoid osteoma.

PMID- 11214689
TI  - Spondylar dysplasia in type X collagenopathy.
AB  - BACKGROUND: The type X collagen gene (COL10A1) is currently known as the disease
      causing gene of metaphyseal dysplasia type Schmid (MDS), whereas a mutation of
      COL10A1 has been reported to cosegregate with a disease phenotype of mild
      spondylometaphyseal dysplasia (SMD) in a Japanese family. OBJECTIVE: To elucidate
      whether or not spondylar dysplasia is common in patients with mutations of
      COL10A1. MATERIALS AND METHODS: We re-evaluated the radiological manifestations
      in six patients with mutations of COL10A1, who had been previously reported as
      having MDS. RESULTS: Two of six patients showed mild platyspondyly in infancy and
      early childhood. In both patients, the spondylar dysplasia tended to normalize
      with age, but mild alterations of the vertebral bodies persisted, even into late
      childhood. The other radiological manifestations of both patients were identical
      to those of MDS. CONCLUSION: Our observation suggests that mild spondylar
      dysplasia may not be uncommon in MDS.

PMID- 11214690
TI  - Patterson-Lowry rhizomelic dysplasia: a potentially lethal bone dysplasia?
AB  - We report a Japanese boy, who is considered as having Patterson-Lowry rhizomelic
      dysplasia, a rare, as yet undefined, skeletal dysplasia. The diagnosis was
      warranted by the constellation of skeletal abnormalities - mild platyspondyly,
      hypoplastic ilia, broad proximal femora with prominent lesser trochanters, mild
      brachymetacarpalia and, most importantly, rhizomelic shortening of the upper
      limbs with lateral bowing, medial cortical thickening, and medial metaphyseal
      notching of the humeri. Our patient, unlike previously reported patients, had
      respiratory distress and died suddenly of unknown cause in late infancy. Our
      experience may imply the heterogeneity or phenotypic variability of Patterson
      Lowry rhizomelic dysplasia.

PMID- 11214691
TI  - CT findings of descending necrotising mediastinitis via the carotid space
      ('Lincoln Highway').
AB  - A 3-year-old girl with fever and neck swelling showed widening of the superior
      mediastinum on chest radiographs. Contrast-enhanced CT of the neck revealed ill
      defined low-attenuation areas with a thick, enhanced rim adjacent to the
      hypertrophied palatine tonsil. The abscess extended inferiorly within the carotid
      sheath between the carotid artery and the internal jugular vein into the anterior
      mediastinum. The carotid space is considered an important conduit of descending
      necrotising mediastinitis and is called the 'Lincoln Highway' as previously
      suggested.

PMID- 11214692
TI  - The significance of recurrent lung opacities in neonates on surfactant treatment
      for respiratory distress syndrome.
AB  - PURPOSE: To determine the significance of recurrent opacities in chest
      radiographs of neonates on surfactant therapy for respiratory distress syndrome
      (RDS) after an initial period of improvement. MATERIALS AND METHODS: Serial pre
      and post-surfactant chest radiographs on 94 preterm infants with RDS were
      analyzed and the pattern of chest radiographic response was classified as (a)
      clear, (b) recurrent opacities, and (c) no response. Their clinical
      characteristics were also recorded. RESULTS: In 34 infants the RDS changes
      cleared within 3 days. 31 infants developed lung opacities within 10 days after
      an initial period of improvement. Twenty-nine infants failed to respond to the
      surfactant. The corresponding mean birth weights for the three groups were 1.74,
      1.19, and 0.76 kg and the mean gestation ages 32.6, 27.7, and 25.4 weeks. The
      incidence of bronchopulmonary dysplasia (BPD) was highest among the slumping
      infants (72% vs. 50% in no responders, P<0.001) CONCLUSIONS: The pattern of chest
      radiographic response is primarily affected by gestation age and birth weight.
      Recurrent lung opacity after an initial positive response to surfactant therapy
      may be caused by such factors as edema from barotrauma and patent ductus
      arteriosus. Infants with intraventricular hemorrhage may demonstrate neurogenic
      edema. Other contributory factors include pneumonia and abnormal consumption of
      surfactant. Recurrent lung opacities after surfactant may be a predictor of
      chronic lung disease in the preterm infant.

PMID- 11214693
TI  - MRCP in the evaluation of pancreaticobiliary disease in children.
AB  - BACKGROUND: Radiologic assessment of pancreaticobiliary ductal disease (PBDD) in
      children currently consists of physiologic tests (radionuclide examinations) or
      invasive anatomic studies (ERCP and PTC). An accurate noninvasive and
      reproducible examination that can direct the subsequent need for more invasive
      studies would be helpful in this patient group. OBJECTIVE: To determine the
      effectiveness of MRCP as a screening tool for PBBD in the pediatric population.
      MATERIALS AND METHODS: Over the last year, 33 patients ranging from 7 months to
      20 years of age were prospectively evaluated with MRCP on a 1.5 T magnet. One
      patient was examined twice, several months apart. Thirteen patients had liver
      transplants. Coronal SPGR and heavily T-2W FSE cross-sectional images were
      obtained. Standard and oblique 2- to 6-cm-thick slab SSFSE (single-shot fast spin
      echo) acquisition and 3D MIP reconstruction of 2D FSE images were obtained in the
      planes of the CBD and pancreatic duct. Nine studies were performed with the
      patient under sedation with chloral hydrate or nembutal and fentanyl with quiet
      respiration, and the non-sedated patients were assessed with single breath hold
      or quiet respiration. Three patients received secretin. MRCP results were
      correlated with ERCP (9), PTC (7), liver biopsy (13), clinical information (6),
      surgery (3), and autopsy (2). RESULTS: All 34 studies performed were considered
      diagnostic. Periportal fluid, proximal bowel fluid, and gallbladder distention
      did not significantly diminish the diagnostic information in any cases. Motion
      artifact did not cause serious degradation in image quality. MRCP depicted
      abnormalities including stones, stricture, intraductal tumor, and extrinsic
      compression, all of which were confirmed at ERCP, PTC ( two unsuccessful in
      patients with non-dilated ducts by MRCP), surgery, liver biopsy, and autopsy.
      There were no false-negative examinations. Normal pancreatic studies performed to
      exclude pancreas divisum were followed without additional clinical or laboratory
      evidence of pancreatitis. Secretin administration increased the conspicuity of
      the pancreatic duct in two of three patients. CONCLUSION: MRCP is a fast non
      invasive method of evaluating the pancreatic duct and biliary tree in children. A
      normal MRCP may obviate the need for PTC or ERCP. Abnormalities detected on MRCP
      can direct the type of intervention.

PMID- 11214694
TI  - Treatment of oesophageal strictures in children: a comparison of fluoroscopically
      guided balloon dilatation with surgical bouginage.
AB  - PURPOSE: To compare the technical feasibility and procedural complications of
      fluoroscopically guided balloon dilatation with conventional surgical bouginage
      for the treatment of oesophageal strictures in children. MATERIALS AND METHODS: A
      retrospective analysis of 125 balloon dilatations in 37 children with oesophageal
      strictures of varying aetiology. Twenty-four of the 37 children also underwent 88
      procedures of surgical bouginage and comparison was made between the methods.
      RESULTS: Fluoroscopic balloon dilatation had fewer technical failures (0/125 vs.
      4/88, P<0.02) and fewer iatrogenic perforations (2/125 vs. 5/88 P = 0.1) than
      surgical bouginage. CONCLUSION: Fluoroscopically guided balloon dilatation is
      safer and has fewer technical failures than surgical bouginage and should be
      considered the first line of treatment for oesophageal strictures in children.

PMID- 11214695
TI  - The relationship between wine consumption and cardiovascular risk: from
      epidemiological evidence to biological plausibility.
AB  - Epidemiological studies have suggested that cardiovascular disease morbidity and
      mortality can be decreased by moderate alcohol consumption. Several recent
      studies have also separately assessed the relative risk associated with different
      types of alcoholic beverages. The evidence obtained strongly suggests, although
      does not prove, that there is a major beneficial effect from drinking a low
      moderate amount of wine. A meta-analysis has recently been performed on 19 of
      these studies, selected on the basis of the availability of specific information
      on the relative risk associated with wine consumption. The results indicate a
      negative association of moderate (up to 300 ml per day) wine consumption with the
      risk of cardiovascular events. Although some cardioprotective effects of
      alcoholic beverages are probably due to ethanol-induced elevation of HDL
      cholesterol, lowering of fibrinogen plasma levels and, perhaps, of platelet
      aggregation, it is reasonable to speculate that the cardiovascular protective
      effects of wine, observed in French and in other populations, may be attributed
      in part to the antioxidant, vasorelaxant, and antithrombotic properties of its
      polyphenolic components.

PMID- 11214696
TI  - Echo-Doppler evaluation of left ventricular diastolic dysfunction during acute
      myocardial infarction: methodological, clinical and prognostic implications.
AB  - Left ventricular (LV) diastolic dysfunction has been reported in the subacute and
      late phase after myocardial infarction and it is becoming increasingly clear that
      abnormalities of diastolic function during acute myocardial infarction (AMI) have
      a major role in affecting the prognosis. However, until recent years the study of
      patients with diastolic dysfunction has suffered from the substantial
      difficulties inherent in diagnosing, measuring, quantitating and in following it
      over time. Moreover, the complexity of events encompassed by diastole, which are
      often difficult to control in the clinical arena, and the lack of data available
      to guide therapy, have hampered the widespread application of diastology in the
      clinical setting of AMI. The advent of Doppler echocardiography and its
      complementary techniques have provided a bedside tool which yields reliable and
      useful measures of diastolic performance during AMI, placing such an assessment
      well within the grasp of every clinical echocardiographic laboratory.
      Determination of the pattern of LV filling by Doppler echocardiography provides
      important information about LV diastolic function in AMI patients. Clinical data
      gathered so far demonstrate that Doppler-derived LV filling, specifically the
      restrictive filling pattern, is a powerful independent predictor of late LV
      dilation and, most importantly, of cardiac death in patients with AMI and clearly
      indicate the need for evaluating and monitoring LV diastolic function in these
      patients. Large scale studies, utilizing simple and easy to measure Doppler
      indexes of LV filling are needed to assess the efficacy of medical therapy in
      patients with acute LV diastolic dysfunction during AMI.

PMID- 11214697
TI  - Surgical and percutaneous myocardial angiogenesis induction. Part II-
      neoangiogenesis.
AB  - Coronary artery bypass surgery and angioplasty provide symptomatic relief in
      patients with ischemic heart disease, but despite advancement in technique and
      devices, these methods are not applicable to a subset of patients with angina
      refractory to medical treatment. Bypass surgery might not be feasible because of
      lack of suitable conduits, diffuse coronary disease or poor distal run-off, and
      coronary angioplasty is sometimes not applicable due to chronic total occlusion,
      diffuse disease or extreme tortuosity. We have previously reviewed the available
      experience with laser-induced direct myocardial revascularization, one of the new
      potential treatment modalities for this patient subset. One of the potential
      mechanisms of action for laser treatment is the induction of neoangiogenesis. In
      the second part of our article we review the available experience with the
      induction of myocardial angiogenesis using different growth factors or the genes
      encoding for them.

PMID- 11214698
TI  - Spinal cord stimulation in patients with refractory anginal pain and normal
      coronary arteries.
AB  - BACKGROUND: Spinal cord stimulation (SCS) has been shown to be effective in
      patients with refractory angina and coronary artery disease. No previous study
      assessed the clinical effects of SCS in patients with refractory angina who
      present angiographically normal coronary arteries. METHODS: SCS was performed in
      7 patients (4 men, 3 women, mean age 59.3 +/- 11 years) with refractory angina
      and normal coronary arteries. Clinical status was assessed 1 month after SCS
      device implantation and at a mean follow-up of 11 months (range 2-17 months) by:
      1) an estimate of the number of anginal attacks and nitrate consumption in the 2
      weeks prior to implantation and to follow-up visits; 2) a score of quality of
      life by a visual analogic scale; 3) a five-item questionnaire assessing effort
      angina and satisfaction with treatment; 4) treadmill exercise testing. RESULTS:
      At the last follow-up the number of anginal episodes (p < 0.001) and nitrate
      consumption (p < 0.004) were both reduced by SCS. Visual analogic scale score
      improved from 2.1 +/- 0.98 to 9.0 +/- 0.9 (p < 0.001) at 1 month and to 6.4 +/-
      2.3 (p < 0.01) at the last follow-up. Questionnaire analysis showed that mild (p
      = 0.006) and moderate (p = 0.000) physical activity, as well as patient
      satisfaction with anginal status (p = 0.000) and with current treatment (p =
      0.000) all improved by SCS. Finally, time to 1 mm ST segment depression, time to
      angina, and exercise duration were all prolonged by SCS. CONCLUSIONS: Our data
      point out that SCS may considerably improve anginal symptoms and exercise
      tolerance in a significant number of patients with refractory angina and normal
      coronary arteries and therefore it should be considered as a valuable treatment
      option in this group of patients.

PMID- 11214699
TI  - Effect of intermittent subdiastolic pressure in thigh cuffs on human arterial
      baroreflex.
AB  - BACKGROUND: We investigated the effects of subdiastolic variations of the
      pressure inside the thigh cuffs on cardiovascular oscillations and arterial
      baroreflex sensitivity in humans. METHODS: During 10 min of controlled breathing
      at low (0.1 Hz) and high (0.25 Hz) frequencies, 30 healthy subjects underwent
      variations of the pressure inside the thigh cuffs (from 0 to 40 mmHg) at 0.25 and
      0.1 Hz respectively; the periods of controlled breathing without cuff pressure
      modulation were used as a control. The frequency responses of cardiovascular
      signals were assessed using spectral analysis, and baroreflex sensitivity by the
      sequence method. RESULTS: Cuff pressure modulation at 0.25 Hz did not affect the
      RR interval, arterial pressure, or baroreflex sensitivity; at 0.1 Hz it did not
      change the RR interval and arterial pressure, but engaged (0.76 +/- 0.2 of
      coherence) and increased the low frequency oscillations of the RR interval (from
      5.6 +/- 1 to 6.1 +/- 0.9 ln ms2, p < 0.05) and improved baroreflex sensitivity by
      25% (from 14.2 +/- 9 to 17.7 +/- 10 ms/mmHg, p < 0.01). CONCLUSIONS: Subdiastolic
      thigh cuff pressure modulation at 0.1 Hz improved the low frequency oscillations
      of heart rate and baroreflex sensitivity. This approach represents a new and
      simple non-pharmacological strategy for acutely improving baroreflex sensitivity
      in humans.

PMID- 11214700
TI  - Prevalence and correlates of syncope-related traumatic injuries in tilt-induced
      vasovagal syncope.
AB  - BACKGROUND: Vasovagal syncope represents the most common form of syncope in the
      general population and is usually considered as a benign affection. However,
      syncope-related traumatic injuries may represent a major complication of such a
      condition in a relevant percentage of cases. The aim of this study was to assess
      the prevalence and clinical correlates of syncope-related trauma in a cohort of
      consecutive patients with recurrent vasovagal syncope. METHODS: Three hundred and
      forty-six consecutive patients were studied in whom a diagnosis of vasovagal
      syncope was established. All subjects were interviewed with a standard
      questionnaire in order to collect all possible information about their clinical
      history and the occurrence of trauma during syncopal spells. RESULTS: Ninety-four
      of the 346 patients (27.2%) reported at least one syncope-related traumatic
      injury. In 31/346 cases (8.9%) the severity of trauma had determined hospital
      admission and surgical treatment. When compared to the rest of the study
      population, patients with syncope-related trauma showed a higher prevalence of
      male gender (p < 0.01), a higher absolute number (p < 0.01) and frequency (p <
      0.01) of syncopal episodes in their history. Patients with trauma also reported a
      shorter duration of warning symptoms preceding syncope (p < 0.01), while showing
      a higher prevalence of positive cardioinhibitory response to tilt table testing
      (p < 0.01). Moreover, the number of syncope-related injuries was found to
      correlate significantly with the number of syncopal spells (r = 0.64, p < 0.01).
      CONCLUSIONS: Most practicing physicians consider vasovagal syncope as simply a
      benign affection in young people. However, such a clinical view should be
      partially revised, as recurrent vasovagal syncope is associated with significant
      trauma-related morbidity.

PMID- 11214701
TI  - Gated blood pool tomography for the evaluation of global and regional left
      ventricular function in comparison to planar techniques and echocardiography.
AB  - BACKGROUND: Multigated radionuclide ventriculography (MUGA) is a simple and
      reliable tool for the assessment of global systolic and diastolic function and in
      several studies it is still considered a standard for the assessment of left
      ventricular ejection fraction. However the evaluation of regional wall motion by
      MUGA is critical due to two-dimensional imaging and its clinical use is
      progressively declining in favor of echocardiography. Tomographic MUGA (T-MUGA)
      is not widely adopted in clinical practice. The aim of this study was to compare
      T-MUGA to planar MUGA (P-MUGA) for the assessment of global ejection fraction and
      to transthoracic echocardiography for the evaluation of regional wall motion.
      METHODS: A 16-segment model was adopted for the comparison with echo regional
      wall motion. For each one of the 16 segments the normal range of T-MUGA ejection
      fraction was quantified and a normal data file was defined; the average value 
      2.5 SD was used as the lower threshold to identify abnormal segments. In
      addition, amplitude images from Fourier analysis were quantified and considered
      abnormal according to three different thresholds (25, 50 and 75% of the maximum).
      RESULTS: In a study group of 33 consecutive patients the ejection fraction values
      of T-MUGA highly correlated with those of P-MUGA (r = 0.93). The regional
      ejection fraction (according to the normal database) and the amplitude analysis
      (50% threshold) allowed for the correct identification of 203/226 and 167/226
      asynergic segments by echocardiography, and of 269/302 and 244/302 normal
      segments, respectively. Therefore sensitivity, specificity and overall accuracy
      to detect regional wall motion abnormalities were 90, 89, 89% and 74, 81, 79% for
      regional ejection fraction and amplitude analysis, respectively. CONCLUSIONS: T
      MUGA is a reliable tool for regional wall motion evaluation, well correlated with
      echocardiography, less subjective and able to provide quantitative data.

PMID- 11214703
TI  - Healing of acute myocarditis with left ventricular assist device: morphological
      recovery and evolution to the aspecific features of dilated cardiomyopathy.
AB  - Dilated cardiomyopathy may result from an acute myocarditis. Little is reported
      in vivo documenting the progression from the acute inflammatory disease to the
      healing phase. We describe the consecutive light and electron microscopy studies
      performed on five myocardial sample series in a 47-year-old female patient who
      was referred to our hospital with acute myocarditis. She was sustained with left
      ventricular assist device (LVAD) for 63 days, and then she died of cerebral
      hemorrhage. The first three consecutive endomyocardial biopsies (days 2, 4, 36
      from onset) documented the acute and early healing phase of the inflammatory
      disease. In the last two biopsies (days 50 and 64 from onset) active inflammation
      and myocyte necrosis were absent. The histopathological features were those
      commonly observed in most patients diagnosed with dilated cardiomyopathy, namely
      myocyte hypertrophy, nuclear size and shape irregularities, and interstitial
      fibrosis. Overall, the myocyte morphology significantly improved and LVAD support
      likely contributed to the structural recovery. The major conclusions to be drawn
      from this case are: 1) the aspecific pathologic findings of dilated
      cardiomyopathy patients may result from an acute myocardial inflammation; 2)
      immediate endomyocardial biopsy in patients with clinically diagnosed myocarditis
      minimizes the risk of missing the diagnosis of inflammatory disease; to this aim
      a precise definition of "early onset" is especially needed; 3) LVAD support may
      contribute to the morphological recovery of severely damaged myocytes.

PMID- 11214702
TI  - Estrogen derivative relaxes rabbit aorta via the endothelial receptor system.
AB  - BACKGROUND: It is well known that sexual hormones, in particular estrogens, may
      influence the cardiovascular system. Experimental and clinical studies have shown
      that estrogen directly or indirectly modulates the reactivity of vascular smooth
      muscle but at present the mechanism of action of this hormone has yet to be
      clarified. The aim of this study was to evaluate the vascular effects of a
      synthetic non-steroid estrogen, diethylstilbestrol, and the possible involvement
      of endothelial function. METHODS: We investigated, on aortic strips of a female
      rabbit, the inhibitory effects of diethylstilbestrol on the contractions induced
      by different spasmogenic agents, noradrenaline (10(-6) M), angiotensin II (10(-6)
      M), serotonin (10(-6) M), and KCl (10(-1) M). Some experiments were performed in
      high K+, Ca++-free solution. In some experiments endothelial function was
      abolished by mechanical ablation. Another series of experiments was incubated (30
      min) with N(G)-monomethyl-L-arginine, which inhibits nitric oxide synthase or
      with tamoxifen, a specific antagonist of estrogen receptors. RESULTS: At doses
      from 10(-6) M to 10(-4) M, diethylstilbestrol showed an evident spasmolytic
      action on contractions induced by noradrenaline, angiotensin II and serotonin but
      no significant effect was observed on KCl spasm. The inhibitory response of
      diethylstilbestrol to increased vascular tone induced by noradrenaline
      disappeared when the endothelial function, validated by the acetylcholine test,
      was abolished by mechanical ablation. When tested in high K+, Ca++-free solution,
      diethylstilbestrol did not significantly shift the cumulative dose-response curve
      of calcium. In the experiments performed with N(G)-monomethyl-L-arginine,
      diethylstilbestrol failed to induce vasodilation suggesting that its action may
      be related to synthesis of nitric oxide. Moreover, in the presence of tamoxifen,
      diethylstilbestrol was unable to induce vasodilation. CONCLUSIONS: The early
      occurrence of vasodilation is in favor of a direct effect and seems to exclude a
      regulation of gene expression. These results suggest that estrogens may directly
      regulate vascular tone interacting with its specific endothelial cell receptors
      through the release of nitric oxide.

PMID- 11214704
TI  - Dynamic left ventricular outflow tract obstruction: an unusual mechanism
      mimicking anterior myocardial infarction with cardiogenic shock.
AB  - Cardiogenic shock is a frequent and threatening complication in the course of
      acute myocardial infarction. Besides the well known causes (left ventricular
      failure, acquired interventricular defect, papillary muscle rupture, free wall
      rupture) other less frequent mechanisms recognize a functional substrate. The
      recognition of such mechanisms makes us to revert to the treatments with
      completely different prognostic implications. In our Coronary Care Unit we
      encountered, in a period of 12 months, 4 patients who presented clinical,
      electrocardiographic and/or echographic signs and symptoms of acute myocardial
      infarction, with different degrees of heart failure up to cardiogenic shock. Only
      1 patient showed a severe stenosis of the left anterior descending coronary
      artery and a significant creatine kinase reduction. Left ventriculography,
      performed at admission, was unable to disclose the true mechanism of clinical
      presentation. Only a thorough echographic examination disclosed the presence of a
      dynamic left ventricular outflow tract obstruction as the cause of heart failure
      culminating in cardiogenic shock. Once recognized, pathophysiological treatment
      (administration of beta-blockers and withdrawal of vasodilators, inotropic drugs
      and intra-aortic balloon pump) led to a dramatic improvement, with an almost
      complete left ventricular function recovery. Left ventricular outflow tract
      obstruction is a mechanism that can lead to severe heart failure as a
      complication of an acute myocardial infarction. Conversely such a mechanism can
      be precipitated by other causes (hypotension, hypovolemia, especially in
      hypertensive patients) and can mimic an acute myocardial infarction. Its
      incidence is not negligible: in our Coronary Care Unit it accounted for about 15%
      of all cases of myocardial infarction requiring inotropic support. An accurate
      echocardiographic examination is mandatory even after coronary angiography, and
      always permits the physician to select the appropriate therapy.

PMID- 11214705
TI  - Images in cardiovascular medicine. Double is better: type IV dual left anterior
      descending coronary artery and superimposed atherosclerosis.

PMID- 11214706
TI  - Images in cardiovascular medicine. An unusual case of in-stent restenosis.

PMID- 11214707
TI  - Development of heart failure in bradycardic sick sinus syndrome.
AB  - Mounting evidence shows that elevated resting sinus rate is an independent
      predictor of cardiovascular morbidity and mortality in the general population, in
      elderly subjects, and in patients with myocardial infarction or hypertension.
      Therefore, a rather slow sinus rate appears to be a protecting factor acting
      through several mechanisms. The present contribution focuses on the relationship
      between sinus rate and heart failure. Its major objectives are to discuss whether
      in patients with heart failure a rather slow heart rate is advisable and whether
      a sinus bradycardia secondary to sinus node dysfunction can facilitate the
      development of heart failure. It has been reported that among patients with left
      ventricular dysfunction, increased sinus rate was a predictor of cardiovascular
      death at univariate analysis; however, a multivariate analysis to verify whether
      sinus rate was an independent predictor of mortality was not performed.
      Randomized trials carried out by utilizing beta-blockers or amiodarone in
      patients with heart failure showed that heart rate reduction by these drugs was a
      marker of their ability to reduce mortality. However, beta-blockers and
      amiodarone have additional pharmacological effects which interfere with the
      disease substrate. So, at present, though the results of these trials show that a
      rather slow sinus rate is advisable, we do not know whether in patients with
      heart failure sinus rate represents an independent predictor of mortality as in
      patients with myocardial infarction or hypertension and whether the reduction of
      sinus rate per se is beneficial. The results of the recent randomized THEOPACE
      trial showed, for the first time, that in a patient population with symptomatic
      sinus bradycardia (sinus rate < 50 b/min), an increase in heart rate, induced by
      DDD pacing or oral theophylline, reduced the incidence of overt heart failure.
      Therefore, sinus bradycardia seems to play a role in the genesis of heart
      failure. In a post-hoc analysis of the results of this trial it emerged that in
      the control (not treated) group, the subjects with sinus bradycardia more prone
      to develop heart failure were those of old age, about 80 years, with organic
      heart disease and severe chronotropic incompetence. However, this conclusion
      needs further validation.

PMID- 11214708
TI  - Regulation of von willebrand factor of human endothelial cells exposed to laminar
      flows: an in vitro study.
AB  - The effect of laminar flow on the regulation of von Willebrand Factor (vWF) of
      cultured human umbilical vein endothelial cells (HUVECs) was studied. Confluent
      endothelial monolayers were exposed to shear stresses (0.2 and 1.0 Pa) from 2 to
      24 h. vWF was labelled with indirect immunofluorescence method and observed with
      3D fluorescence microscopy. The distribution of vWF and the cytoskeleton
      organization were observed simultaneously by double fluorescence labelling. More
      actin stress fibers and an increased release of vWF appeared in the cells exposed
      to flow at the same time. The qualitative and quantitative results showed that
      there was not only a shear-dependent regulation but also a time-dependent
      modification. For a short-time shear stimulation, both 0.2 Pa and 1.0 Pa shear
      stresses induced a release of vWF from the endothelial cells. In contrast, after
      24 h exposure to 1.0 Pa shear flow, vWFs were much more in the cells than that in
      the cells exposed to 0.2 Pa for 24 h (p < 0.01) or that in the control cells (p <
      0.05). TNF-alpha caused a decrease of vWF and Weibel-Palade bodies in the cells.

PMID- 11214709
TI  - Exposure of human erythrocytes to oxygen radicals causes loss of deformability,
      increased osmotic fragility, lipid peroxidation and protein degradation.
AB  - The effects of two oxygen radical generating systems (H2O2 and ascorbate/Fe+2) on
      erythrocyte deformability, osmotic fragility, lipid peroxidation and protein
      degradation were studied. Incubation of erythrocytes with different
      concentrations of H202 (5-20 mM) or ascorbate/Fe+2 (10/0.1-40/0.4 mM) caused a
      loss of deformability and increased osmotic fragility. The loss of deformability
      has occurred in a dose-dependent fashion and was proportional to the extent of
      malonyldialdehyde (an indicator of lipid peroxidation) and alanine production (an
      indicator of protein degradation). Prior exposure of the erythrocytes to carbon
      monoxide (known to inhibit heme-protein degradation) prevented almost completely
      the loss in deformability caused by H2O2, indicating that the loss in
      deformability was due mainly to protein degradation rather than to lipid
      peroxidation. Erythrocytes incubated with either of the two systems have also
      shown morphologic changes characterized by a dose-dependent increase in
      echinocyte formation. The results indicate the importance of oxidatively damaged
      proteins in compromising the rheologic behaviour of the erythrocytes,
      particularly when the free radicals are involved.

PMID- 11214710
TI  - Evaluation of different methods used to measure malonyldialdehyde in human
      erythrocytes.
AB  - Malonyldialdehyde (MDA), a secondary product of lipid peroxidation is widely used
      as an indicator of lipid peroxidation. Eight of the most frequently used methods
      for measuring MDA have been evaluated with regard to their sensitivity and
      reproducibility. The sensitivity of these methods for pure MDA solution was in
      the order: Satoh's > Stocks and Dormandy's >> Buege and Aust's > Dresel's >>
      Slater's > Yoshioka's et al. > Yagi's > Jain's method. Whereas the sensitivity of
      the first four methods for erythrocyte MDA was in the order: Stocks and
      Dormandy's >> Buege and Aust's > Satoh's > Dresel's method. The reproducibility
      (expressed as coefficient of variation) of these four methods for erythrocyte MDA
      were: 3.5%, 17.9%, 31.5% and 16.1%, respectively. These results indicate that
      Stocks and Dormandy's method has the highest sensitivity and an excellent
      reproducibility for erythrocyte MDA. Also, it was found to be simple and many
      samples can be treated in a relatively short time. When standard MDA (0.1-15
      nmol/ml) was incubated with erythrocytes, the percentage recovery of MDA (using
      Stocks and Dormandy's method) has ranged from 50-85%. This result indicates that
      a considerable amount of MDA formed in erythrocytes probably reacts with other
      cell components and becomes undetectable. Despite this, the determination of MDA
      level remains a useful indicator of lipid peroxidation and correlates well with
      the degree of oxidative stress.

PMID- 11214711
TI  - Validation of a test of the red cell membrane osmotic resistance.
AB  - The aim of the present work was to validate a new technique for the measurement
      of resistance of the red blood cell membrane using an automated apparatus called
      a Fragilimeter. Its principle lies in the measurement of the extinction of a
      laser beam projected through a red blood cell suspension subjected, by diffusion,
      to a variation of salinity from an isotonic equilibrium (154 mM NaCl) to, a
      hypotonic one, 25 mM NaCl. The variation of osmotic pressure induces on the cells
      a progressive lysis and a modification of the extinction of the transmitted
      light. The validation of the method was based on the comparison between results
      obtained with the Fragilimeter and those obtained using the reference DACIE
      technique. Analyses were based on blood samples from healthy donors. The
      determination of the initial, the 50% and the full haemolysis thresholds allowed
      observation of the fragility of the cell, through its membrane resistance. The
      physical phenomenon measured in these cells when subjected to various ionic
      strengths is discussed on the basis of observations realised by means of an
      optical microscope.

PMID- 11214713
TI  - Influence of neuraminidase on the characteristics of microrheology of red blood
      cells.
AB  - Surface charge was removed from RBC (erythrocyte) membrane to different degrees
      with biochemical methods, i.e., treatment of RBCs with neuraminidase, either
      using different doses for the same incubation time (1 hour) or using the same
      dose (75 milli-unit) for different incubation time. Several rheological
      properties of the RBCs with surface charge removal were observed, including the
      deformation index DI (using traditional ektacytometry) orientation index (DI)or
      and small deformation index (Dl)d (using new ektacytometry), the viscosity at low
      and high shear rates (using a cone-plate rotating viscosimeter). In addition,
      photographs of RBCs aggregation under a microscope and the histograms of RBC
      aggregate size after treatment with neuraminidase were obtained. It is found from
      these experiments that the decrease of the surface charge of RBCs leads to the
      decrease in the deformation and orientation indices as well as the increase in
      blood viscosity.

PMID- 11214714
TI  - Hemorheology in asymptomatic HIV-infected patients.
AB  - Although cardiac and vascular complications have been recognized among patients
      infected with the Human Immunodeficiency Virus-1 (HIV-1), their vascular biology
      and rheology have not been studied. Rheology of red blood cells (RBC) was
      assessed with an erythroaggregometer in 22 HIV-1 infected asymptomatic patients
      (pts) and 17 healthy HIV negative controls (C). All participants were
      normotensive, nondiabetics, had normal lipid levels and had an hematocrit ranging
      from 37 to 44% and hemoglobin levels > or = 12 g/100 ml. Patients had a shorter
      RBC aggregation characteristic time than controls (1.49 +/- 0.17 vs. 2.04 +/-
      0.41 s, p = 0.001) and an increased disaggregation shear rate (166 +/- 34.9 vs.
      122 +/- 25.4 s(-1), p = 0.001). This hyperaggregation tendancy was associated
      with increased gamma-globulin (18.3 +/- 3.3 vs. 13.7 +/- 1.9 g/l, p = 0.01) and
      fibrinogen (3.52 +/- 0.57 vs 3.03 +/- 0.48 g/l, p = 0.003) levels and with an
      increased erythrocyte sedimentation rate (ESR) (25 +/- 14.3 vs. 12.3 +/- 7.5 mm,
      p = 0.02). Even in patients with ESRs ranging within normal values (< or = 20
      mm), the aggregation characteristic time was found lower in patients than in
      controls (p = 0.004). There was no correlation between these rheological changes
      and the CD4+ T-cell count. The 17 patients receiving an antiviral therapy had
      lower CD4+ T-cell counts than their 5 untreated counterparts (244.7 +/- 167 vs.
      410 +/- 106/mm3, p = 0.025), and a higher disaggregation shear rate (177.4 +/-
      38.2 vs. 127 +/- 25.4, p = 0.01). Thus, an impairment of rheological
      characteristics is observed in asymptomatic HIV-I infected patients in
      association with changes in plasma proteins.

PMID- 11214712
TI  - Importance of measurement temperature in detecting the alterations of red blood
      cell aggregation and deformability studied by ektacytometry: a study on
      experimental sepsis in rats.
AB  - It is well known that RBC rheological parameters are affected by temperature.
      Usually, the measurement temperature of these parameters is kept constant
      throughout a given study, however it can be seen that different temperatures are
      used by different groups, during the measurement of a given parameter. It is
      assumed that the data should not be qualitatively different when measured at
      different temperatures, although significant quantitative differences exist. This
      study revealed that the selected temperature for RBC elongation index
      measurements by ektacytometry is important in detecting a given impairment in RBC
      deformability induced by experimental sepsis. RBC elongation indexes were found
      to be significantly different in septic and normal rats, only if measured at 37
      degrees C. The differences in RBC aggregation parameters for septic and normal
      rats were also affected by the measurement temperature, however statistically
      significant differences were present in a wider range of temperatures between 25
      37 degrees C. Therefore, it is strongly recommended that the measurement of RBC
      deformability and aggregation be performed using a controlled-temperature device,
      set to 37 degrees C.

PMID- 11214715
TI  - High and low molecular weight heparins do not modify red blood cell aggregability
      in vitro.
AB  - The usefulness of heparins as anticoagulants has been demonstrated, but their
      effects on hemorheological parameters, such as erythrocyte aggregability, are
      under discussion. If the heparins had adverse effect on erythrocyte
      aggregability, its use would be especially undesirable in patients with
      pathologies involving red blood cell hyperaggregability as is the case of cardiac
      disease. In the present study we examine the in vitro effect of unfractionated
      and fractionated heparins on red blood cell aggregability. The results show that
      heparins do not increase this rheological parameter but show a slight tendency to
      lower it.

PMID- 11214716
TI  - Students with disabilities: a national survey of participation in school
      activities.
AB  - INTRODUCTION: The policies of integration and full inclusion in school activities
      have been enacted to promote the independence and social participation of
      students with disabilities. This study examined the nature and extent of
      participation in schools by students with disabilities in the context of the
      physical, social and psychological features of the school environment. METHOD: A
      national survey was completed by 1180 teachers of students with disabilities in
      the US describing student participation in school activities encompassing
      involvement in social activities, sports, academic and artistic/creative
      endeavours. RESULTS/CONCLUSIONS: Multivariate analysis revealed that school life
      in elementary, middle and high school could be defined by six distinct factors
      describing individual and group roles. Structural equation modelling yielded a
      second order latent variable that captured the complex and multi-dimensional
      aspect of participation, accounting for availability, eligibility, student
      characteristics/status, and student choice within a larger framework of
      participation.

PMID- 11214717
TI  - Evaluation of the quality of life in Brazilian women with fibromyalgia, through
      the medical outcome survey 36 item short-form study.
AB  - PURPOSE: The purpose of this study is to assess the impact of Fibromyalgia (FM)
      on the female patient's quality of life who attended the Rheumatology Outpatient
      Unit of Sorocaba Hospital Complex and compare it to the quality of life of
      healthy control group, through the Medical Outcome Study Short-form 36 item
      Survey (SF36). SUBJECTS: 32 women who fitted the American College of Rheumatology
      Classification Criteria for Fibromyalgia and 28 healthy women. MATERIALS AND
      METHODS: The groups were submitted to 'Medical Outcome Study 36 Item Short-form
      Survey' (SF36). This questionnaire is composed of 8 scales about several aspects
      of the quality of life. RESULTS: The SF36 scales in the Fibromyalgia group
      presented the following results: general health--43.3; functional ability--39.4;
      bodily pain--26.5; physical functioning--14.8 (0-75); vitality--38.5 (5-85);
      emotional functioning--32.2; mental health--44.2; social functioning--45.1. The
      SF36 scales in the control group presented the following results: general health-
      73.2; functional ability--86.6; bodily pain--68.9; physical functioning--82.4;
      vitality--59.6; emotional functioning--78.5; mental health--67.4; social
      functioning--77.9. Significant statistics variations in all evaluated scales were
      presented by the survey group. CONCLUSION: Fibromyalgia has had a negative impact
      on the quality of life.

PMID- 11214718
TI  - Development of an ADL instrument targeting elderly persons with age-related
      macular degeneration.
AB  - BACKGROUND: In order to estimate the needs of early intervention in a health
      education program, an ADL instrument measuring feelings of (in)security was
      needed. The instrument was intended to detect early signs of decline and to
      evaluate ADL performance among persons with AMD. An evaluative instrument must
      have a high level of responsiveness, which is the ability to detect true changes
      over time but must also show a high level of intra-individual agreement in a test
      retest assessment. PURPOSE: The purpose of this study was to develop an ADL
      instrument for evaluative purposes and to establish the reliability and the
      responsiveness of the instrument. METHOD: The target group comprised all persons
      referred by an ophthalmologist for low vision rehabilitation, 65 years and older,
      living at home, with aged-related macular degeneration as the primary diagnosis
      and with distance visual acuity of the better eye with best correction not lower
      than 0.1. A non-parametric statistical method that is developed for paired
      ordered parametrical data was applied in order to measure the systematic and
      occasional intra-rater disagreement separately and to measure the responsiveness.
      CONCLUSION: The test-retest study showed that the ADL-instrument had a high level
      of test-retest stability, which is a condition for responsiveness. The instrument
      was found to be responsive. It could therefore detect true longitudinal changes
      and be used for evaluative purposes targeting elderly with AMD.

PMID- 11214719
TI  - Non-traumatic lower limb older amputees: a database survey from a geriatric
      centre.
AB  - PURPOSE: The purpose of this survey was to examine the characteristic of a
      geriatric population admitted for amputation of a lower limb and to explore some
      of the factors that may affect the course of their hospital stay. METHOD: The
      study took place in the geriatric division of a tertiary general hospital and
      included a close geriatric-orthopaedic liaison. Two-hundred and forty-one
      patients were included in the final analysis. RESULTS: Many above knee
      amputations were performed, which correlated with advanced age. Rates of in
      hospital mortality and systemic complications were 16% and 19%, respectively.
      Thirty-three percent of the patients were discharged back home, and only 6% were
      supplied with an artificial limb. The general condition of most patients remained
      poor. CONCLUSION: We conclude that despite a team approach to the care of the
      geriatric amputee a poor functional result was obtained. By encouraging earlier
      referrals from the community it is postulated that a reduction in the costly
      provision of antibiotics would be beneficial and that perhaps lower levels of
      amputation could be performed thereby enhancing the possibilities for ambulation.

PMID- 11214720
TI  - An investigation into the predictive ability of rehabilitation clinicians.
AB  - PURPOSE: There is increasing pressure by providers, purchasers and recipients of
      service within the United Kingdom for a more accurate prediction of
      rehabilitation outcomes. The purpose of this research was to investigate how
      accurately clinicians were predicting rehabilitation outcomes. METHOD: The study
      was carried out among 47 patients admitted to a general rehabilitation unit. The
      Functional Independence Measure and Functional Assessment Measure (FAM) were used
      as the outcome measure. RESULTS: The results showed a statistically significant
      positive correlation between goal scores and discharge scores as a total
      population using Spearmans correlation co-efficient. When breaking the sample
      into an orthopaedic and CVA population, the predictive ability for the
      orthopaedic population was consistently higher than for the CVA population.
      CONCLUSIONS: The results of this study suggest that the predictive ability of
      clinicians is good for the rehabilitation population although the prediction is
      consistently better with the orthopaedic population than the CVA population.

PMID- 11214721
TI  - Rehabilitation of a quadruple amputee subsequent to electrical burns sustained
      whilst hang gliding.
AB  - PURPOSE: The purpose of this article is to describe the management, difficulties
      encountered and level of independence achieved during the initial stage of a
      quadruple amputee's rehabilitation. METHOD: This is a case study of the
      rehabilitation of the first known person losing all four limbs due to
      electrocution whilst hang gliding. RESULTS: The patient became a successful upper
      limb prosthetic user and returned to work six hours a day. Full independence in
      activities of daily living was not achieved nor considered practical. Independent
      walking was accomplished in physiotherapy. however an electric wheelchair remains
      the only functional means of mobility. CONCLUSION: The rehabilitation is
      described in detail to assist those managing such a rare and complex case.

PMID- 11214723
TI  - Variation in molecular species of polar lipids from thermoplasma acidophilum
      depends on growth temperature.
AB  - Five types of molecular species of C40 isoprenoid chains, having different
      numbers of cyclopentane rings, were detected in the ether core lipid of
      Thermoplasma acidophilum. The average cyclization number of the hydrocarbon
      chains in the lipids increased with increasing growth temperatures.

PMID- 11214722
TI  - Effect of a low-fat diet enriched with oleic acid on postprandial lipemia in
      patients with type 2 diabetes mellitus.
AB  - The aim of the present study was to compare the effects of a low-fat diet
      enriched with oleic acid to those of a low-fat diet enriched with linoleic acid
      on fasting lipids, postprandial lipemia, and oxidative susceptibility of low
      density lipoprotein (LDL) in patients with type 2 diabetes mellitus (DM). In a 3
      wk randomized crossover study, eight patients with type 2 DM were given an
      experimental low-fat diet enriched with either oleic acid or linoleic acid. The
      oleic-acid-enriched diet contained 5, 15, and 5%, energy from saturated,
      monounsaturated, and polyunsaturated fatty acids, and the linoleic-acid-enriched
      diet contained 5, 5, and 15% energy from saturated, monounsaturated, and
      polyunsaturated fatty acids, respectively. In addition to evaluating the fasting
      lipids and oxidative susceptibility of LDL, we evaluated postprandial lipemia
      using an oral fat load at the end of each 3-wk dietary phase. There were no
      significant differences in fasting lipid profile or lag time of LDL oxidation
      between the two experimental dietary phases. The average and maximal increments
      of remnant-like particle (RLP) cholesterol levels during oral fat load were
      significantly higher after the oleic-acid-enriched dietary phase than after the
      linoleic-acid-enriched dietary phase. The area under the curve of RLP cholesterol
      was also significantly larger after the oleic-acid-enriched dietary phase than
      after the linoleic-acid-enriched dietary phase. These results suggest that the
      oleic-acid-enriched diet was associated with increased formation of postprandial
      chylomicron remnants compared with the linoleic-acid-enriched diet.

PMID- 11214724
TI  - The composition of saturated fatty acids in plasma phospholipids changes in a way
      to counteract changes in the mean melting point during pregnancy.
AB  - It has been demonstrated that in pathological conditions with an increase in the
      calculated mean melting point (MMP) of phospholipid (PL) fatty acids (FA) there
      are changes in the composition of the saturated FA (SFA), which partially
      counteract this effect: shorter-chain SFA with lower melting points are
      increased, while longer-chain less fluid SFA are suppressed. The aim of this
      study was to determine whether there are differences in MMP during pregnancy and
      in the newborn and, if so, whether similar adaptive changes occur in the
      composition of the SFA. The FA composition of plasma PL was determined in healthy
      women (n = 16) twice during pregnancy (15-24 wk and 29-36 wk) and at delivery and
      in umbilical venous blood obtained at birth. The MMP of maternal PL was
      significantly higher at delivery compared to mid-gestation, due to a loss of
      highly unsaturated FA (HUFA) which were replaced by SFA. In addition, changes in
      the SFA occurred: 16:0 with lower melting point was higher while 18:0 with higher
      melting point was lower at delivery. MMP of PL FA in umbilical plasma was lower
      than in maternal plasma at delivery, which was due to higher HUFA content. In
      contrast to maternal plasma, 16:0 was lower while 18:0, 20:0, and 24:0 were
      higher in umbilical plasma resulting in a higher MMP of SFA, tending to raise the
      overall MMP. It can be concluded that, during pregnancy and in the newborn, the
      FA composition of SFA changes in a way to counteract changes in MMP induced by
      reduced and increased HUFA, respectively.

PMID- 11214725
TI  - Influence of fatty alcohol and other fatty acid derivatives on fatty acid uptake
      into rat intestinal epithelial cells.
AB  - We investigated the influence of various substrates on the uptake of long-chain
      fatty acid into IEC-6, rat intestinal epithelial cell line. The uptake of
      [3H]oleic acid into IEC-6 cells was a saturable function of the oleic acid
      concentration. Long-chain fatty acids significantly inhibited the oleic acid
      uptake into IEC-6 cells and shorter-chain fatty acids had little or no effect.
      Various fatty acid esters suppressed the oleic acid uptake into IEC-6. Fatty
      alcohols also inhibited oleic acid uptake into IEC-6 and the length of the carbon
      chain played an important role. These results suggest that long-chain fatty acid
      uptake was inhibited by the substrates which had a structure similar to long
      chain fatty acids, especially those with a long carbon chain. At least two
      molecules, fatty acid translocase and fatty acid transport protein type 4, which
      are considered to be involved in the long-chain fatty acid transport into the
      cell, were expressed on IEC-6 cells, supporting the existence of the carrier
      mediated system of long-chain fatty acid transport on IEC-6 cells.

PMID- 11214726
TI  - Modulation of apolipoprotein E-mediated plasma clearance and cell uptake of
      emulsion particles by cholesteryl ester.
AB  - Cholesteryl ester, along with triglyceride (TG), is the major core component of
      plasma lipoproteins. We investigated the effect of core composition on the
      physical state and metabolic behavior of lipid emulsions, as model particles of
      lipoproteins. Fluorescence studies using 1,6-diphenylhexatriene analogs showed
      that although cholesteryl oleate (CO) significantly decreased core mobility, the
      surface rigidity of phosphatidylcholine (PC) monolayers was independent of core
      composition. When intravenously injected into rats, the increased amount of core
      CO tended to retard TG emulsion removal from plasma, and the initial clearance
      rate was correlated with the amount of apolipoprotein E (apoE) bound from plasma.
      In addition, PC liposomes with a similar emulsion particle size showed negligible
      binding of apoE and were cleared at a slower rate compared to all emulsions.
      Furthermore, the effect of CO on the binding behavior of apoE to the emulsion
      surface and the emulsion uptake by hepatocytes was assessed in vitro. Replacing
      core TG with CO was found to decrease the apoE binding capacity to emulsions
      markedly without changing the binding affinity and thereby to reduce the cell
      uptake of emulsion particles by HepG2 cells. These results indicate that the
      physical state of core lipids, which can be modulated by CO content, plays a role
      in emulsion metabolism through the alteration in apoE binding.

PMID- 11214727
TI  - In vitro behavior of marine lipid-based liposomes. Influence of pH, temperature,
      bile salts, and phospholipase A2.
AB  - To deliver polyunsaturated fatty acids (PUFA) by the oral route, liposomes based
      on a natural mixture of marine lipids were prepared by filtration and
      characterized in media that mimic gastrointestinal fluids. First the influence of
      large pH variations from 1.5-2.5 (stomach) to 7.4 (intestine) at the
      physiological temperature (37 degrees C) was investigated. Acidification of
      liposome suspensions induced instantaneous vesicle aggregation, which was
      partially reversible when the external medium was further neutralized.
      Simultaneously, complex morphological bilayer rearrangements occurred, leading to
      the formation of small aggregates. These pH- and temperature-dependent structural
      changes were interpreted in terms of osmotic shock and lipid chemical
      alterations, i.e., oxidation and hydrolysis, especially in the first hours of
      storage. Besides, oxidative stability was closely related to the state of
      liposome aggregation and the supramolecular organization (vesicles or mixed
      micelles). The effects of bile salts and phospholipase A2 (PLA2) on the liposome
      structures were also studied. Membrane solubilization by bile salts was favored
      by preliminary liposome incubation in acid conditions. PLA2 showed a better
      activity on liposome structures than on the corresponding mixed lipid-bile salt
      micelles. As a whole, in spite of slight morphological modifications, vesicle
      structures were preserved after an acid stress and no lipid oxidation products
      were detected during the first 5 h of incubation. Thus, marine lipids constituted
      an attractive material for the development of liposomes as potential oral PUFA
      supplements.

PMID- 11214728
TI  - Alpha- and gamma-tocotrienols are metabolized to carboxyethyl-hydroxychroman
      derivatives and excreted in human urine.
AB  - Limited information is available regarding metabolism of vitamin E forms,
      especially the tocotrienols. Carboxyethyl-hydroxychromans (alpha- and gamma-CEHC)
      are human urinary metabolites of alpha- and gamma-tocopherols, respectively. To
      evaluate whether tocotrienols are also metabolized and excreted as urinary CEHC,
      urine was monitored following tocotrienol supplementation. Complete (24 h) urine
      collections were obtained for 2 d prior to (baseline), the day of, and 2 d after
      human subjects (n = 6) ingested tocotrienol supplements. The subjects consumed
      125 mg gamma-tocotrienyl acetate the first week, then the next week 500 mg; then
      125 mg alpha-tocotrienyl acetate was administered the third week, followed by 500
      mg the fourth week. Urinary alpha- and gamma-CEHC were measured by high
      performance liquid chromatography with electrochemical detection. Urinary gamma
      CEHC levels rose about four- to sixfold in response to the two doses of gamma
      tocotrienol and then returned to baseline the following day. Significant (P <
      0.0001) increases in urinary alpha-CEHC were observed only following ingestion of
      500 mg alpha-tocotrienyl acetate. Typically, 1-2% of alpha-tocotrienyl acetates
      or 4-6% of gamma-tocotrienyl acetates were recovered as their respective urinary
      CEHC metabolites. A gamma-CEHC excretion time course showed an increase in
      urinary gamma-CEHC at 6 h and a peak at 9 h following ingestion of 125 mg gamma
      tocotrienyl acetate. In summary, tocotrienols, like tocopherols, are metabolized
      to CEHC; however, the quantities excreted in human urine are small in relation to
      dose size.

PMID- 11214729
TI  - Mechanisms of dimer and trimer formation from ultraviolet-irradiated alpha
      tocopherol.
AB  - Alpha-Tocopherol (alpha-TH) undergoes ultraviolet (UV)-induced photooxidation on
      the surface of mouse skin to produce a dihydroxydimer, a spirodimer, and trimers
      as the major products. To study the photochemistry involved, we UV-irradiated
      alpha-TH in a thin film on a glass petri dish. Photooxidation yielded a mixture
      of dihydroxydimer, spirodimer, and trimers. In the time-course studies, the
      dihydroxydimer accumulated and then was further oxidized, whereas the spirodimer
      and trimers accumulated more gradually. Reaction of two tocopheroxyl radicals
      forms the dihydroxydimer, whereas the spirodimer may be formed either by
      photooxidation of alpha-TH to an orthoquinone methide (o-QM) followed by a Diels
      Alder reaction or by photooxidation of alpha-TH to the dihydroxydimer, followed
      by two-electron oxidation. Irradiation of a mixture of d10-labeled and unlabeled
      (d0) dihydroxydimer produced a mixture of labeled and unlabeled spirodimers as
      detected by positive atmospheric pressure chemical ionization-mass spectrometry.
      The absence of mixed label spirodimers among products indicated that direct
      oxidation of the dihydroxydimer is a facile route to the spirodimer and is
      probably the major spirodimer-forming reaction in alpha-TH photooxidations.
      Trimer formation from the dihydroxydimer and the spirodimer was observed,
      however, and requires an o-QM intermediate. Photooxidation of dl0-labeled and
      unlabeled (d0) dihydroxydimers yielded mixed isotopomers of the trimer products,
      thus demonstrating that the dihydroxydimer and spirodimers underwent conversion
      to o-QM intermediates. Photochemical conversion of alpha-TH to UV-absorbing dimer
      and trimer products may contribute to photoprotection by topically applied alpha
      TH.

PMID- 11214730
TI  - Effects of ascorbate on membrane phospholipids and tocopherols of intact
      erythrocytes during peroxidation by t-butylhydroperoxide: comparison with effects
      of dithiothreitol.
AB  - Peroxidation of intact human erythrocytes by t-butylhydroperoxide (tBHP)) was
      studied. By incubation of the erythrocytes with 1 mM tBHP, reduced glutathione
      (GSH) was exhausted within 1 min, and tocopherols (Toc) and phospholipids (PL)
      decreased to nearly their lowest levels (in this study) within 5 min. The rate of
      decrease of alpha-Toc was faster than that of gamma-Toc, but alpha-Toc was never
      exhausted. The rates of decrease of Toc were faster than that of PL.
      Malondialdehyde increased slowly to reach a maximal value at 30 min.
      Methemoglobin (metHB) reached a maximum at 15 min. The maximal levels of these
      substances were maintained until 90 min incubation, which indicated that the
      peroxidation by tBHP had stopped spontaneously until at least 90 min. By the
      incubation with tBHP for 30 min, phosphatidylethanolamine (PE) and alpha-Toc
      decreased to about 70 and 30% of control levels, respectively, and gamma-Toc and
      GSH were almost exhausted. Ascorbate (0.1 mM) afforded protection of 92% to PE,
      50% to alpha-Toc, and 65% to gamma-Toc against peroxidation, but ascorbate had no
      preventive effect at all on the formation of metHB and the decrease of GSH. These
      results may indicate that ascorbate-mediated protection of the membrane PL
      against the peroxidation depends primarily on Toc. On the other hand,
      dithiothreitol (DTT) (5 mM) almost completely prevented the formation of metHB,
      and DTT completely protected the PL and Toc against peroxidation, indicating the
      importance of sulfhydryl groups in erythrocytes.

PMID- 11214731
TI  - Cacao liquor polyphenols reduce oxidative stress without maintaining alpha
      tocopherol levels in rats fed a vitamin E-deficient diet.
AB  - The effect of crude polyphenols (CLP) from cacao liquor on vitamin E-deficient
      rats was examined. The CLP fraction contained 49.8% antioxidative polyphenols
      such as catechins and their oligomers. Supplementation of the vitamin E-deficient
      diet with CLP for 7 wk did not prevent the decrease in alpha-tocopherol levels in
      the liver, kidney, heart, brain, and plasma. The lipid peroxide levels in these
      tissues increased in the group fed the vitamin E-deficient diet compared with the
      control group. However, these changes were inhibited in a dose-dependent manner
      as a result of supplementation of the vitamin E-deficient diet with 0.25, 0.5, or
      1.0% CLP. The lipid peroxide levels in plasma increased in the group fed the
      vitamin E-deficient diet. This change tended to be suppressed as a result of
      supplementation of the diet with CLP, but the difference was not significant.
      There was no evidence of absorption and distribution of CLP to the tissues;
      however, CLP intake resulted in a decrease in oxidative stress without
      maintaining vitamin E levels in the plasma and the tissues.

PMID- 11214732
TI  - A long-term seal- and cod-liver-oil supplementation in hypercholesterolemic
      subjects.
AB  - In this long-term study, we wanted to explore the effect of dietary
      supplementation of seal oil (SO) as compared cod-liver oil (CLO) on subjects with
      moderate hypercholesterolemia. The test parameters included fatty acid
      composition in serum, blood lipids, platelet aggregation, and the activity of
      blood monocytes. After a run-in period of 6 mon, 120 clinically healthy
      hypercholesterolemic (7.0-9.5 mmol/L; 270-366 mg/dL) subjects were randomly
      selected to consume either 15 mL of SO or CLO daily for 14 mon followed by a 4
      mon wash-out period. A third group was not given any dietary supplement
      (control). Consumption of marine oils (SO and CLO) changed the fatty acid
      composition of serum significantly. Maximal levels were achieved after 10 mon. No
      further changes were seen after 14 mon. A wash-out period of 4 mon hardly altered
      the level of n-3 fatty acids in serum. Addition of SO gave 30% higher level of
      eicosapentaenoic acid, as compared to CLO. Subjects taking SO or CLO had lower
      whole-blood platelet aggregation than the control group. Neither SO nor CLO had
      any effects on the levels of serum total cholesterol, high-density lipoprotein
      cholesterol, postprandial triacylglycerol, apolipoproteins Al and B100,
      lipoprotein (a), monocyte function expressed as monocyte-derived tissue factor
      expression, and tumor necrosis factor.

PMID- 11214734
TI  - Biosynthesis of eicosapentaenoic acid in the sea urchin Psammechinus miliaris.
AB  - The sea urchin Psammechinus miliaris (Gmelin) (Echinodermata: Echinoidea) was
      shown by using a deuterated tracer (D5-18:3n-3) and quantitation by negative
      chemical ionization gas chromatography-mass spectrometry to convert 18:3n-3 to
      20:5n-3. The rate of conversion was very slow, corresponding to 0.09 microg/g
      tissue/mg 18:3n-3 eaten over 14 d. Deuterated arachidonic acid (D8-20:4n-6) was
      also included in the diet to give a measure of the relative amounts of diet eaten
      by the different animals. The recovery of this fatty acid in tissue lipids was
      33.7% compared with only 0.95% recovery of D5-18:3n-3 and its anabolites,
      indicating that the majority of the D5-tracer was catabolized. Considerable
      elongation of D5-18:3n-3 into 20:3n-3 and a trace of 22:3n-3 was found, and these
      were accompanied by minor amounts of the intermediates 18:4n-3 and 20:4n-3. No
      deuterated 22:6n-3 was found.

PMID- 11214733
TI  - Removal of fat from cow's milk decreases the vitamin E contents of the resulting
      dairy products.
AB  - The present study was undertaken to determine whether decreases in fat contents
      result in lower vitamin E contents. Milk samples of varying fat contents (half
      and half, whole milk, reduced-fat milk, low-fat milk, and nonfat milk) were
      obtained from a local dairy on six different occasions. alpha-Tocopherol was the
      major form of vitamin E (>85%); gamma-tocopherol and alpha-tocotrienol were
      present to a lesser extent. As the fat contents of milk products decreased from
      11 to 0.3%, the vitamin E contents decreased. For example, raw milk as compared
      to nonfat milk had both higher (-tocopherol contents (45.5 +/- 4.6 vs. 4.5 +/-
      0.5 microg/100 g; P < or = 0.0001) and higher total lipids (3.46 +/- 0.49 vs.
      0.30 +/- 0.07 g/100 g; P < or = 0.0001). Vitamin E, cholesterol, and total lipids
      increased as cream was added back to nonfat milk during production. For every 1
      mg cholesterol increase, there was an increase of approximately 4 microg of alpha
      tocopherol; for every 1 g total lipids increase, the alpha-tocopherol content
      increased by 17 microg. These data demonstrate that removal of milk fat markedly
      decreases the vitamin E content of various milk products.

PMID- 11214735
TI  - The first naturally occurring alpha-methoxylated branched-chain fatty acids from
      the phospholipids of Amphimedon complanata.
AB  - The phospholipid fatty acid composition of the sponge Amphimedon complanata was
      reinvestigated, and the 2-methoxy-13-methyltetradecanoic acid, 2-methoxy-14
      methylpentadecanoic acid, and 2-methoxy-13-methylpentadecanoic acid were
      identified for the first time in nature. Structure characterization was
      accomplished by means of gas chromatographic retention times and gas
      chromatography-mass spectrometry. These acids could have originated from bacteria
      in symbiosis with the sponge.

PMID- 11214736
TI  - A fast and reliable spectroscopic method for the determination of membrane--water
      partition coefficients of organic compounds.
AB  - Partition coefficients (Kp) between egg yolk phosphatidylcholine multilamellar
      vesicles and water were determined for two nonsteroidal anti-inflammatory drugs
      (indomethacin and acemetacin) using two independent methodologies: derivative
      spectrophotometry and variation of the experimental acidity constant in the
      presence of increasing vesicle concentration. Second-derivative spectrophotometry
      allowed for total elimination of background signal effects arising from lipid
      vesicles, without the need for separation techniques that may disturb equilibrium
      states. By using a model based on a simple partition, the values of K(T)p can be
      obtained directly; furthermore, by performing determinations at two different pH
      values it is possible to calculate partition coefficients for the neutral and
      negatively charged forms of the drugs (K(AH)p and K(A)p). In the other
      methodology, values of apparent acidity constants (K(app)) were determined by
      spectrophotometry at different pH values and different lipid concentrations, and
      an increase in K(app) with decreasing lipid concentration was observed for both
      drugs, and from this dependence it was possible to calculate K(AH)p and K(A-)p
      for each drug. These values were used as a check for those obtained by derivative
      spectroscopy, which has proven to be a reliable and more expeditious method to
      obtain K(AH)p and K(A-)p .

PMID- 11214737
TI  - A novel assay method for glycosphingolipid deacylase by enzyme-linked
      immunochemical detection of lysoglycosphingolipid.
AB  - Lysoglycosphingolipids consist of a sphingoid long-chain base and monosaccharide
      or complex sugar, and they lack the fatty acyl group present in native
      glycosphingolipids. Less than 1 pmol of lyso-Forssman glycolipid and
      lysoganglioside GM1 were detected on a thin-layer chromatogram by an enzyme
      linked immunochemical coloration method with anti-Forssman glycolipid antibody
      (FOM-1) and cholera toxin B subunit, respectively. Each spot between 1 and 100
      pmol lyso-Forssman glycolipid was immunostained as densely as that of the same
      amount of native Forssman glycolipid. The density of the lyso-Forssman glycolipid
      spots increased proportionally with increment in the amount of lysoglycolipid.
      The density of spots of 0.2-100 pmol lysoganglioside GM1 was also proportional to
      the amount of each lyso-GM1 spot. These results indicated that less than 1 to 100
      pmol of deacylated glycosphingolipid was quantifiable by the immunochemical
      coloration method with sugar chain-specific antibodies. Glycosphingolipid
      deacylase, which cleaved an amide bond between the sphingoid long-chain base and
      fatty acyl chain in ceramide of glycosphingolipid, was assayed by detecting the
      lyso-Forssman glycolipid produced. Lipophilic compounds, recovered from an
      aliquot of the reaction mixture of Forssman glycolipid and crude enzyme at
      appropriate times, were analyzed by thin-layer chromatography. It was found that
      lyso-Forssman glycolipid was produced in the first 1-2 h by the enzyme and
      production increased with incubation time. This coloration method is more
      sensitive and specific than the visualization method with a nonspecific reagent
      such as orcinol-sulfuric acid reagent.

PMID- 11214738
TI  - End organ protection by calcium-channel blockers.
AB  - In recent years, much attention has been given to end organ protection by
      antihypertensive, anti-heart failure, and anti-ischemic medications. This review
      describes the available information on end organ protection by calcium-channel
      blockers (CCBs). In normotensive patients and patients with hypertension treated
      with long-acting dihydropyridines, medial thickness was thinner than in patients
      treated with atenolol or in untreated hypertensive patients. Long-term treatment
      was associated with significant reduction in left ventricular mass. Calcium
      channel blockers also improved endothelial-dependent relaxation and reversed the
      vasoconstrictive response to nitric oxide inhibitors. In diabetic patients, CCBs
      were effective in preserving kidney function and microalbuminurea. The
      combination of angiotensin-converting enzyme (ACE) inhibitors and CCBs was more
      effective than ACE inhibitors alone in preserving kidney function. In animal
      experiments, CCBs prevented development of coronary atheroschlerosis; however, in
      humans only limited data are available on their antiatherogenic effect. Some
      studies suggest that CCBs exert antiplatelets properties and may therefore be
      beneficial in patients with coronary artery disease.

PMID- 11214739
TI  - Prognosis following acute myocardial infarction in patients with ST-T
      abnormalities on electrocardiograms obtained before myocardial infarction.
AB  - BACKGROUND: Many studies have examined the relationship between prognosis after
      myocardial infarction (MI) and electrocardiographic (ECG) findings at the time of
      or after the onset of MI. However, little work has been done concerning the
      association between ECG findings obtained before the onset of MI (pre-MI) and the
      prognosis after MI. HYPOTHESIS: The study was undertaken to determine whether ST
      T segment and T-wave morphology on pre-MI ECGs provides useful information for
      prognosis after acute MI. METHODS: Pre-MI ECGs of 212 patients recorded within
      the 6-month period before MI were studied for the presence of high-voltage R
      waves, ST-segment depression, and negative T waves. The Kaplan-Meier method and
      multivariate analysis were used to determine the relationship between these ECG
      findings and in-hospital cardiac death. RESULTS: In-hospital cardiac death
      occurred in 32 (15.1%) patients. The in-hospital mortality rate was 38.5% (5/13)
      for the patients with high-voltage R waves, 54.5% (6/11) for patients with ST
      segment depression, and 45.6% (15/33) for patients with negative T waves. The in
      hospital mortality rate was 13.6% (27/199) for patients without high-voltage R
      waves, 12.9% (26/201) for patients without ST-segment depression, and 9.5%
      (17/179) for those without negative T waves. Multivariate analysis identified age
      and negative T waves as independent risk factors for cardiac death, with a hazard
      ratio for negative T waves of 3.1. CONCLUSION: Negative T waves on pre-MI ECGs
      represent an independent predictor of in-hospital cardiac death in patients with
      MI.

PMID- 11214740
TI  - Intervention to improve adherence to ACC/AHA recommended adjunctive medications
      for the management of patients with an acute myocardial infarction.
AB  - BACKGROUND: The most recent published guidelines regarding management of patients
      surviving an acute myocardial infarction (AMI) advocate the administration of
      aspirin (ASA), beta blockers (BB), and angiotensin-converting enzyme inhibitors
      (ACEi) and discourages the use of calcium-channel blockers (CCB). Previous data
      collected in our region from the National Registry (NR) showed a dismal
      compliance with these guidelines. In an attempt to increase physician awareness
      and to optimize implementation of recommended guidelines, a cardiac and pharmacy
      steering committee was created. METHODS: The pharmacist assigned to the project
      identified all patients admitted with an AMI using troponin-I and creatine kinase
      MB (CK-MB) reports. The pharmacist then contacted physicians to make
      recommendations if an adjunctive medication was not prescribed for a patient with
      no apparent contraindications. Administration rates for ASA, BB, ACEi, and CCB
      were then assessed and compared with the previously obtained baseline data from
      the NR. RESULTS: At admission, the use of ASA increased from 70 to 72%, BB from
      45 to 72%, and ACEi from 12 to 44%. In terms of medications at discharge, ASA use
      increased from 74 to 88%, BB from 55 to 76%, and ACEi from 30 to 40%. In
      addition, the prescription rates for CCB at discharge decreased from 36 to 21%.
      CONCLUSIONS: An interdisciplinary approach for disease management is an effective
      method for improving adherence to treatment guidelines simply with pharmacy
      intervention. The percentage of patients receiving the recommended adjunctive
      medications increased significantly. We propose that these guidelines should be
      periodically inserviced to physicians. Furthermore, patient counseling sessions
      should also be instituted to help reinforce the importance of compliance with the
      medications after discharge, as well as lipid management and smoking cessation.

PMID- 11214741
TI  - Reduced incidence of clinical restenosis with newer generation stents, stent
      oversizing, and high-pressure deployment: single-operator experience.
AB  - BACKGROUND: Over the last 4 years, several newer generation stents have become
      available, promising to change the scenery of coronary angioplasty (PTCA) with
      its attendant restenosis rate. HYPOTHESIS: The aim of this study was to review
      prospectively the results of a single operator adopting a uniform approach with
      approximately 0.5 mm stent oversizing and high-pressure (> or = 12-16 bar)
      deployment and compare them with conventional PTCA in a series of 244 consecutive
      patients. METHODS: The study included 203 men and 41 women, aged 59 +/- 11 years,
      who presented with stable angina and/or positive exercise testing (n = 75),
      unstable angina (n = 161), or acute myocardial infarction (n = 8). Dilated
      vessels included the left anterior descending artery (n = 139), the right
      coronary artery (n = 86), the left circumflex artery (n = 47), the ramus branch
      (n = 4), or venous grafts (n = 2). Stents were implanted for dissection,
      suboptimal PTCA result, and electively. Two groups were compared: 83 patients who
      underwent balloon PTCA alone and 161 patients who also received stent(s).
      RESULTS: The two groups had similar demographics, age (58 +/- 10 vs. 59 +/- 11
      years), initial vessel stenosis (92 +/- 7 vs. 93 +/- 6%), and left ventricular
      ejection fraction (51 +/- 9 vs. 51 +/- 8%). Procedural success was also similar
      (97.6 vs. 99.4%), but as expected the residual stenosis was much lower in the
      stent group (< or = 0 vs. 17%). The following stents were employed: J & J (n =
      1), NIR (n = 117), ACS (n = 59), AVE (n = 9), Inflow GoldFlex (n = 9), Crossflex
      (n = 5), Wictor (n = 1), Jostent (n = 16), R stent (n = 9), Seaquence (n = 2) and
      Wallstent (n = 1). Single stents were used in 118 patients, two stents in 31
      patients, three in 6 patients, and four in 6 patients. There was one in-hospital
      death at 3 days unrelated to the procedure. There were no events of subacute
      stent thrombosis; all patients in the stent group received combined therapy with
      aspirin and ticlopidine, the latter for 1 month. During 18 +/- 14 months, the
      clinical restenosis rate was significantly lower in the stent group (6.9%) than
      in the PTCA group (28.4%) (p = 0.001). CONCLUSION: In a series of 244 consecutive
      patients, newer generation stents and a consistent approach of stent oversizing
      and high-pressure stent deployment by a single operator resulted in high
      procedural success (99%), lack of stent thrombosis (0%), and a very low clinical
      restenosis rate (7%).

PMID- 11214742
TI  - Angioplasty decreases prolonged QT dispersion in patients with angina pectoris
      but not in patients with prior myocardial infarction.
AB  - BACKGROUND AND HYPOTHESIS: Prolonged QT dispersion (QTd) is shortened by
      successful percutaneous transluminal coronary angioplasty (PTCA) in patients with
      ischemic heart disease. Particularly, QTd plays an important role in the
      prognostication in patients with prior myocardial infarction (MI). However,
      whether the effect of PTCA on QTd differs in patients with and without prior MI
      is not clear, and this study sought to clarify this question. METHODS: In 41
      consecutive patients with ischemic heart disease, we measured QTd from a routine
      12-lead electrocardiogram taken at 72 h before and after successful PTCA.
      Patients were divided into two groups based on the presence or absence of prior
      MI: Group 1 consisted of 24 patients with angina (61 +/- 11 years old) without
      prior MI and Group 2 was comprised of 17 patients (69 +/- 10 years old) with
      prior MI. QTd was calculated as the difference between the maximum and minimum QT
      and QT corrected for heart rate (QTc), using Bazett's formula for calculating
      QTcd. All measurements were obtained manually and blindly. RESULTS: In Group 1,
      15 of 24 patients (63%) demonstrated multivessel disease and 16 of 24 (67%)
      patients had high QTd > 60 ms. Percutaneous transluminal coronary angioplasty
      decreased QTd and QTcd in Group 1 (QTd, from 83 +/- 35 to 57 +/- 19 ms, p < 0.05
      ; QTcd, from 89 +/- 37 to 63 +/- 33 ms, p < 0.05), whereas no changes were
      observed in Group 2 (QTd, from 73 +/- 25 to 69 +/- 22 ms, NS; QTcd, from 80 +/-
      30 to 79 +/- 28 ms, NS). QTd is more sensitive to decrease by successful PTCA in
      patients with angina than in patients with prior MI. CONCLUSIONS: The effect of
      successful PTCA on inhomogeneity of ventricular repolarization reflected by QTd
      in patients with prior MI is different from that in patients without prior MI.

PMID- 11214744
TI  - Accelerated dobutamine stress testing: safety and feasibility in patients with
      known or suspected coronary artery disease.
AB  - BACKGROUND: Dobutamine pharmodynamics require approximately 10 min to reach
      steady state. Despite this, standard dobutamine stress echo typically uses 3-min
      stages of advancing dobutamine doses because of safety concerns. HYPOTHESIS: In
      patients with a high pretest probability of coronary artery disease (CAD), a
      continuous infusion of high-dose dobutamine is a feasible and safe method for
      performing a dobutamine stress test. METHODS: Forty-seven consecutive patients
      (mean age 64 +/- 11 years) with 3.0 +/- 1.4 cardiac risk factors underwent
      dobutamine stress testing utilizing a single, high-dose (40 mcg/kg/min),
      continuous dobutamine infusion. The 40 mcg/kg/min infusion was continued for up
      to 10 min or until a test endpoint had been reached. If a test endpoint was not
      achieved, atropine (up to 1.0 mg) was added. RESULTS: Heart rate rose from 71 +/-
      12 to 137 +/- 18 beats/min at peak (p<0.0001) with a concomitant change in
      systolic blood pressure (143 +/- 35 vs. 167 +/- 38 mmHg; p = 0.001) but no change
      in diastolic blood pressure (74 +/- 19 vs. 75 +/- 18 mmHg; p = NS). Target heart
      rate was achieved in 20 of 47 (43%) patients with accelerated dobutamine alone
      and in 34 of 47 (72%) with the addition of atropine. An average of 11.6 +/- 3.7
      min was required to obtain target heart rate. Subjective sensations from the
      dobutamine occurred in 49% of patients (palpitations 21%, nausea 6%, chest pain
      6%, headache 6%, dizziness 13%), mild arrhythmia in 48% of patients (ventricular
      premature beats 38%, supraventricular tachycardia 10%), and one patient had
      nonsustained ventricular tachycardia. CONCLUSION: A single, high-dose (40
      mcg/kg/min) dobutamine-atropine protocol provides an efficient means of
      performing dobutamine stress echocardiography with a similar symptom profile as
      conventional dobutamine infusion protocols in patients with a high pretest
      probability of CAD. Randomized, controlled studies will be necessary to assess
      the sensitivity and specificity of this accelerated dobutamine echo protocol.

PMID- 11214743
TI  - Clinical characteristics of acute pulmonary thromboembolism in Japan: results of
      a multicenter registry in the Japanese Society of Pulmonary Embolism Research.
AB  - BACKGROUND: Although the incidence of acute pulmonary thromboembolism (APTE) has
      been increasing in Japan, patient characteristics, management strategies, and
      outcome have not yet been assessed in large series. HYPOTHESIS: The present study
      was designed to investigate the current status of APTE in Japan. METHODS: Of a
      total of 533 registry patients with pulmonary thromboembolism, 309 with APTE were
      analyzed with respect to clinical symptoms and signs, predisposing factors,
      diagnostic procedures, estimation of deep venous thrombosis, treatment, and
      clinical course. RESULTS: Main risk factors were recent major surgery, cancer,
      prolonged immobilization, and obesity; only a few patients had coagulopathy and
      36% were in cardiogenic shock at presentation. The majority of registry patients
      underwent lung scans or pulmonary angiography; 30% were diagnosed only by lung
      scanning. Venous ultrasonography was used in only 34 patients, while 188 patients
      underwent at least one diagnostic procedure for deep venous thrombosis.
      Thrombolysis was more frequently performed in patients with cardiogenic shock,
      and only a few patients received thromboembolectomy. In-hospital mortality rate
      was 14%. In patients with cardiogenic shock, the mortality rate was reduced by
      thrombolysis. The predictors of in-hospital mortality were male gender,
      cardiogenic shock, cancer, and prolonged immobilization. CONCLUSIONS: The
      patients in this registry had almost the same findings as those in Western
      patients, except for some points that had the possibility of demonstrating a
      difference between Westerners and Japanese in the development of APTE. These
      results can prove especially helpful in planning prospective, randomized trials
      that will clarify the impact of widely used treatment modalities on the outcome
      of patients with APTE.

PMID- 11214745
TI  - Sleep-Disordered breathing in patients referred for angina evaluation-
      association with left ventricular dysfunction.
AB  - BACKGROUND: Clinical observations have linked sleep-disordered breathing to
      cardiovascular morbidity and mortality, and especially to coronary artery
      disease. HYPOTHESIS: The study was undertaken to determine the prevalence of
      sleep-disordered breathing in consecutive patients referred for angina
      evaluation, and analyzed the parameters influencing the severity of sleep
      disordered breathing. METHODS: In all, 68 consecutive patients (53 men, 15 women,
      aged 63.4 +/- 10.0 years) referred for angina evaluation were studied. Coronary
      angiography, selective left ventriculography, and a polygraphic study with a
      validated six-channel monitoring device were performed. Full-night
      polysomnography was used to reevaluate patients with an apnea/hypopnea index > or
      = 10/h. RESULTS: Sleep-disordered breathing as defined by an apnea/hypopnea index
      > or = 10/h was found in 30.9% of patients; its prevalence was not increased in
      patients with and without coronary artery disease (26.5 vs. 42.1%). Multiple
      stepwise linear regression analysis revealed that the severity of sleep
      disordered breathing was significantly and independently associated with left
      ventricular ejection fraction (r = -0.38; p = 0.002), but not with age, body mass
      index, gender, diabetes mellitus, hypertension, hyperuricemia,
      hypercholesterolemia, smoking habits, or coronary artery disease. In this group
      of patients, multiple logistic regression analysis could not demonstrate sleep
      disordered breathing to be an independent predictor of coronary artery disease.
      CONCLUSIONS: Sleep-disordered breathing is common in patients referred for angina
      evaluation. The degree of sleep-disordered breathing is mainly determined by the
      extent of left ventricular dysfunction.

PMID- 11214746
TI  - Effects of stent coating on platelets and endothelial cells after intracoronary
      stent implantation.
AB  - BACKGROUND: Adhesion molecules are known to be important in the regulation of
      endothelial cell and platelet functions. Increased platelets P-selectin
      expression is a marker of stent thrombosis after uncoated stent placement.
      HYPOTHESIS: The aim of this study was to compare the effects of intracoronary
      placement of phosphorylcholine (PC)-coated, versus heparin-coated, versus
      uncoated stents on platelets and endothelial activity. METHODS: Thirty patients
      (age 55 +/- 10, 27 men) with significant proximal left anterior descending
      coronary artery stenoses were randomized to elective implantation of PC-coated,
      versus heparin-coated, versus uncoated stents. Following stent placement,
      intravenous heparin and aspirin plus ticlopidine were administered. Venous plasma
      soluble E-selectin, sP-selectin, and intercellular adhesion molecule-l levels
      were measured before the procedure and 24 and 48 h thereafter as markers of
      platelet and endothelial cell activation. Patients were excluded if they had a
      disease known to influence platelet and endothelial cell function. RESULTS:
      Plasma sP-selectin levels decreased significantly after implantation of PC- and
      heparin-coated stents (p = 0.04), but remained unchanged in patients randomized
      to uncoated stents. Plasma sE-selectin levels increased significantly after
      uncoated stent placement (p = 0.04) and remained unchanged after coated stent
      implantation. CONCLUSION: In patients treated with combined antiplatelet therapy,
      implantation of PC- and heparin-coated stents decreased platelet activity without
      activating endothelial cells, whereas placement of uncoated stents led to
      endothelial activation without changing platelet activity. These results suggest
      that PC-coated and heparin-coated stents may be advantageous in limiting
      thrombotic complications.

PMID- 11214747
TI  - Electrocardiographic changes of acute cervical spinal cord trauma.

PMID- 11214748
TI  - Native aortic valve tissue systemic embolization complicating bacterial
      endocarditis.
AB  - Systemic embolic events are known complications of bacterial endocarditis.
      Embolization of prosthetic valves has previously been reported in the literature.
      We report a case of embolization of native aortic valve tissue to the popliteal
      artery as the presenting event in a patient with subacute bacterial endocarditis.
      To our knowledge, this rare complication has not been previously reported.

PMID- 11214749
TI  - Profiles in cardiology. Sir Leonard Erskine Hill.

PMID- 11214750
TI  - Determining prognosis after acute myocardial infarction.

PMID- 11214751
TI  - Peptide and protein PEGylation: a review of problems and solutions.
AB  - The paper discusses general problems in using PEG for conjugation to high or low
      molecular weight molecules. Methods of binding PEG to different functional groups
      in macromolecules is reported together with their eventual limitations. Problems
      encountered in conjugation, such as the evaluation of the number of PEG chains
      bound, the localisation of the site of conjugation in polypeptides and the
      procedure to direct PEGylation to the desired site in the molecule are discussed.
      Finally, the paper reports on more specific methods regarding reversible
      PEGylation, cross-linking reagents with PEG arms, PEG for enzyme solubilization
      in organic solvent and new polymers as alternative to PEG.

PMID- 11214752
TI  - Nuclear magnetic imaging of an osmotic water uptake and delivery process.
AB  - The water absorption of NH4F-doped silicone cylinders was studied by spin-echo
      Fourier nuclear magnetic resonance imaging, in conjunction with gravimetric (mass
      uptake) and ionic concentration (release of NH4F) measurements. The addition of
      NH4F greatly increases the water uptake as the inclusions are surrounded by
      droplets of water when wetted by water diffusing in the polymer. These droplets
      then expand due to the osmotic pressure difference between the internal droplet
      and external solution; this expansion is opposed by an elastic restraining force.
      The rate of ingress into the polymer will depend on the relative chemical
      potential of water associated with the polymer and the droplet, as well as the
      diffusion coefficient. Later stages of the absorption process are dominated by
      the droplets. The dilution of the droplets (from water diffusing into the
      droplets) slowly reduces the chemical potential driving the process. Hence, the
      later stages occur without any notable concentration gradient but a slight
      chemical potential gradient. If the droplet expansion exceeds that which can be
      restrained by the material, failure around the droplet occurs resulting in the
      release of the salt and the solution within the droplet.

PMID- 11214753
TI  - Human preadipocytes seeded on freeze-dried collagen scaffolds investigated in
      vitro and in vivo.
AB  - Currently, there is no adequate implant material for the correction of soft
      tissue defects such as after extensive deep burns, after tumor resection and in
      hereditary and congenital defects (e.g. Romberg's disease, Poland syndrome). The
      autologous transplantation of mature adipose tissue has poor results. In this
      study human preadipocytes of young adults were isolated and cultured. 10(6)
      preadipocytes were seeded onto collagen sponges with uniform 40 microm pore size
      and regular lamellar structure and implanted into immunodeficient mice. Collagen
      sponges without preadipocytes were used in the controls. Macroscopical
      impression, weight, thickness, histology, immunohistochemistry (scaffold
      structure, cellularity, penetration depth of the seeded cells) and ultrastructure
      were assessed after 24 h in vitro and after explantation at 3 and 8 weeks.
      Preadipocytes penetrated the scaffolds 24 h after seeding at a depth of 299+/-55
      microm before implantation. Macroscopically after 3 and 8 weeks in vivo layers of
      adipose tissue accompanied by new vessels were found on all preadipocyte/collagen
      grafts. The control grafts appeared unchanged without vessel ingrowth. There was
      a significant weight loss of all grafts between 24 h in vitro and 3 weeks in vivo
      (p < 0.05), whereas there was only a slight weight reduction from week 3 to 8.
      The thickness decreased in the first 3 weeks (p < 0.05) in all grafts. The
      preadipocyte/collagen grafts were thinner but had a higher weight than the
      controls at this point in time. The histology showed adipose tissue and a rich
      vascularisation adherent to the scaffolds under a capsule. The control sponges
      contained only few cells and a capsule but no adipose tissue. Human-vimentin
      positive cells were found in all preadipocyte/collagen grafts but not in the
      controls, penetrating 1188+/-498 microm (3 weeks) and 1433+/-685 microm (8
      weeks). Ultrastructural analysis showed complete in vivo differentiation of
      viable adipocytes in the sponge seeded with preadipocytes. Formation of
      extracellular matrix was more pronounced in the preadipocyte/collagen grafts. The
      transplantation of isolated and cultured preadipocytes within a standardised
      collagen matrix resulted in well-vascularised adipose-like tissue. It is assumed
      that a pore size greater than 40 microm is required, as preadipocytes enlarge
      during differentiation due to incorporation of lipids.

PMID- 11214754
TI  - Tethered-TGF-beta increases extracellular matrix production of vascular smooth
      muscle cells.
AB  - Biomaterials developed for tissue engineering and wound healing applications need
      to support robust cell adhesion, yet also need to be replaced by new tissue
      synthesized by those cells. In order to maintain mechanical integrity of the
      tissue, the cells must generate sufficient extracellular matrix before the
      scaffold is degraded. We have previously shown that materials containing cell
      adhesive ligands to promote or improve cell adhesion can decrease extracellular
      matrix production (Mann et al., Modification of surfaces with cell adhesion
      peptides alters extracellular matrix deposition. Biomaterials 1999;20:2281-6).
      Such decreased matrix production by cells in tissue engineering scaffolds may
      result in tissue failure. However, we have found that TGF-beta1 can be used in
      scaffolds to dramatically increase matrix production. Matrix production by
      vascular smooth muscle cells grown on adhesive ligand-modified glass surfaces and
      in PEG hydrogels containing covalently bound adhesive ligands was increased in
      the presence of 0.04 pmol/ml (1 ng/ml) TGF-beta1. TGF-beta1 can counteract the
      effect of these adhesive ligands on matrix production; matrix production could be
      increased even above that observed in the absence of adhesive peptides. Further,
      TGF-beta1 covalently immobilized to PEG retained its ability to increase matrix
      production. Tethering TGF-beta1 to the polymer scaffold resulted in a significant
      increase in matrix production over the same amount of soluble TGF-beta1.

PMID- 11214755
TI  - Synthetic polymers alter the structure of cervical mucus.
AB  - Mucosal sites have an innate defense system--which includes immune cells,
      antibodies, and mucus--to protect the body from opportunistic pathogens. Some
      sexually transmitted diseases (STDs), such as HIV, utilize host defense
      mechanisms to evade detection by infecting motile immune cells present at the
      site. The infected cells migrate through the mucus layer and penetrate the
      epithelium undetected. A new strategy for preventing STDs could involve
      inhibiting cell migration through the mucus. One method for inhibiting migration
      is to alter the barrier property of mucus by modifying its gel structure. Mucin,
      the structural component of mucus, is a high molecular weight anionic molecule,
      which forms an entangled fiber network through non-covalent interactions. The
      addition of nonionic or cationic polymers, such as poly(ethylene glycol) (PEG) or
      poly(vinyl pyridine) (PVP), altered the overall gel structure as revealed by
      scanning electron microscopy (SEM), while anionic poly(acrylic acid) had little
      effect on the structure. Acid residues on mucin associate with PEG through
      hydrogen bonds to form regions of coalesced fibers within the mucus. PVP,
      however, interacts with mucin via electrostatic bonds, forming a gel that had
      areas of aggregated fibers adjacent to regions with virtually no fibers. These
      results suggest that addition of small amounts of certain synthetic polymers will
      modify mucus structure; these changes should alter the barrier properties of
      mucus.

PMID- 11214756
TI  - Triggered release of calcium from lipid vesicles: a bioinspired strategy for
      rapid gelation of polysaccharide and protein hydrogels.
AB  - The bioinspired strategy of triggered release of Ca2+ from liposomal compartments
      was used to induce rapid gelation of polysaccharide and protein-based hydrogels.
      Thermally triggerable liposomes were designed by entrapping CaCl2 within
      liposomes constructed of 90% dipalmitoylphosphatidylcholine and 10%
      dimyristoylphosphatidylcholine. These liposomes released greater than 90% of
      entrapped Ca2+ when heated to 37 degrees C. A precursor fluid containing
      liposomes suspended in aqueous sodium alginate remained fluid for several days at
      room temperature but gelled rapidly when heated to 37 degrees C, as a result of
      Ca2+ release and formation of crosslinked Ca-alginate. Alternatively, thermally
      triggered Ca2+ release from liposomes was used to activate enzyme-catalyzed
      crosslinking of proteins to form hydrogels. A mixture of Ca-loaded liposomes,
      fibrinogen, and a Ca2+-dependent transglutaminase enzyme (either human
      recombinant FXIII or guinea pig liver transglutaminase) remained fluid
      indefinitely when stored at room temperature, but gelled rapidly when heated to
      37 degrees C. SDS-PAGE of the reaction mixture revealed that gelation was due to
      enzymatic crosslinking of the alpha and gamma chains of fibrinogen, and
      oscillating rheometry revealed gel formation within 10 min of heating to 37
      degrees C. This new approach may be useful for developing rapidly gelling
      injectable biomaterials that can be stored at room temperature and injected in a
      minimally invasive manner into a body tissue or cavity, upon which rapid
      solidification would occur. This versatile bioinspired strategy could be utilized
      for the delivery of biomaterials for tissue repair and reconstruction, and local
      site-directed drug delivery.

PMID- 11214757
TI  - Coating of Dacron vascular grafts with an ionic polyurethane: a novel sealant
      with protein binding properties.
AB  - The purpose of this study was to develop a novel sealant that would seal
      prosthetic vascular graft interstices and be accessible for protein binding.
      Crimped knitted Dacron vascular grafts were cleaned (CNTRL) and hydrolyzed in
      boiling sodium hydroxide (HYD). These HYD grafts were sealed using an 11% solids
      solution of a polyether-based urethane with carboxylic acid groups (PEU-D) via a
      novel technique that employs both trans-wall and luminal perfusion. Carboxylic
      acid content, determined via methylene blue dye uptake, was 2.3- and 4.2-fold
      greater in PEU-D segments (1.0+/-0.27 nmol/mg) as compared to HYD and CNTRL
      segments, respectively. Water permeation through PEU-D graft (1.1+/-2 ml/cm2 min(
      1)) was comparable to collagen-impregnated Dacron (9.8+/-10 ml/cm2 min(-1)). Non
      specific 125I-albumin (125I-Alb) binding to PEU-D segments (18+/-3 ng/mg) was
      significantly lower than HYD and CNTRL segments. 125I-Alb linkage to PEU-D using
      the crosslinker EDC resulted in 5.7-fold greater binding (103+/-2 ng/mg) than non
      specific PEU-D controls. However, covalent linkage of 125I-Alb to PEU-D was 4.9-
      and 5.9-fold less than CNTRL and HYD segments with EDC, respectively. Thus, ionic
      polyurethane can be applied to a pre-formed vascular graft, seal the interstices
      and create "anchor" sites for protein attachment.

PMID- 11214758
TI  - Poly(ethylenimine)-mediated gene delivery affects endothelial cell function and
      viability.
AB  - Poly(ethylenimine) (PEI) was used to transfect the endothelial cell line EA.hy
      926, and the secreted levels of three gene products, tissue-type plasminogen
      activator (tPA), plasminogen activator inhibitor type 1 (PAI-1), and von
      Willebrand Factor (vWF), were assessed via ELISA. We found that the levels of
      these gene products in cell supernatants increased by factors up to 16.3 (tPA),
      8.3 (PAI-1), or 6.7 (vWF) times the levels recorded for untreated cells, and
      roughly correlated with the percentage of cells that expressed the reporter
      plasmid. Transfections carried out using promotorless constructs of the same
      reporter plasmid also yielded increases in tPA, PAI-1, and vWF to similar
      extents. Additionally, data regarding cell viability were gathered and found to
      inversely relate to both the effectiveness of the PEI used for transfection and
      the secreted levels of the three mentioned products. There appeared to be two
      distinct types of cell death, resulting from the use of either free PEI (which
      acts within 2 h) or PEI/DNA complexes (which cause death 7-9 h after
      transfection). Cells were also transfected by poly(L-lysine) and liposomal
      carriers, and increases in secreted tPA similar to those seen with PEI-mediated
      transfection were observed for positively transfected cells. The results of these
      investigations indicate that non-viral gene delivery can induce a state of
      endothelial cell dysfunction, and that PEI-mediated transfection can lead to two
      distinct types of cell death.

PMID- 11214759
TI  - Surface characteristics and in vitro biofilm formation on glass ionomer and
      composite resin.
AB  - In the initial stages of dental plaque formation, early colonizing bacteria bind
      to receptor structures in the pellicle, a proteinaceous film formed instantly
      after cleaning of the tooth surface. Dental restorative materials with surface
      characteristics different from the tooth might affect pellicle formation and the
      ability of bacteria to colonize the oral cavity. In this study (i) roughness and
      chemical composition of glass ionomer and composite resin surfaces before and
      after polishing, and (ii) the adsorption of salivary proteins and bacterial
      adherence to the pellicle-coated surfaces were examined. Compared with unpolished
      composite resin, unpolished glass ionomer had higher surface roughness, contained
      more inorganic, positively charged components, collected more proteins, and
      promoted better bacterial adherence. Polishing had the most pronounced effect on
      the composite resin, giving an enlarged and a rougher surface with a more
      inorganic character. Polishing the composite resin also led to increased biofilm
      formation.

PMID- 11214761
TI  - Investigation of thermal parameters and crytallisation in a ternary CaO-Na2O-P2O5
      based glass system.
AB  - This paper presents the results of a study of the thermal properties of a range
      of phosphate-based glasses in the system CaO-Na2O-P2O5. The glasses had a fixed
      P2O5 content of 45 mol% and the CaO:Na2O ratio was varied. The glasses were
      produced and ground and their thermal properties measured using a Setaram
      differential thermal analyser (DTA). Initial data showed that for the high Na2O
      containing glass, NaPO3 forms and a second unidentified phase that is probably
      calcium rich. In the middle compositional region, multiple phases precipitated
      out and were identified as NaPO3 and Na4Ca(PO3)6. For the high CaO content
      glasses, Na4Ca(PO3)6 was the only phase formed. Further studies were carried out
      to examine whether the phases were bulk or surface nucleating, by grinding the
      samples to different particle sizes. From this data, it is evident that the NaPO3
      forms via a bulk nucleation mechanism and that Na4Ca(PO3)6 forms via surface
      nucleation. The factors controlling this precipitation process are discussed and
      ionic radius as a controlling factor is hypothesised.

PMID- 11214760
TI  - Treatment of tooth fracture by medium-energy CO2 laser and DP-bioactive glass
      paste: the interaction of enamel and DP-bioactive glass paste during irradiation
      by CO2 laser.
AB  - Acute trauma or trauma associated with occlusal disturbance can produce tooth
      crack or fracture. Although several methods are proposed to treat the defect,
      however, the prognosis is generally poor. If the fusion of a tooth fracture by
      laser is possible, it will offer an alternative to extraction or at least serve
      as an adjunctive treatment in the reconstruction. We have tried to use a
      continuous-wave CO2 laser and a newly developed DP-bioactive glass paste (DPGP)
      to fuse or bridge tooth crack or fracture lines. Both the DP-bioactive glass
      paste and tooth enamel have strong absorption bands at the wavelength of 10.6
      microm. Therefore, under CO2 laser, DPGP and enamel should have an effective
      absorption and melt together. The interface between DPGP and enamel could be
      regarded as a mixture of DPGP and enamel (DPG-E). The study focused on the phase
      transformation, microstructure, functional group and thermal behavior of DPG-E
      with or without CO2 laser irradiation, by the analytical techniques of XRD, FTIR,
      DTA/TGA, and SEM. The results of XRD showed that the main crystal phase in the
      DPG-E was dicalcium phosphate dihydrate (CaHPO4.2H2O). It changed into CaHPO4,
      gamma-Ca2P2O7, beta-Ca2P2O7 and finally alpha-Ca2P2O7 with increasing
      temperature. In the FTIR analysis, the 720 cm(-1) absorption band ascribed to the
      P-O-P linkage in pyrophosphate rose up and the intensities of the OH- bands
      reduced after laser irradiation. In regard to the results of DTA/TGA after
      irradiation, the weight loss decreased due to the removal of part of absorption
      water and crystallization water by the CO2 laser. SEM micrographs revealed that
      the melted masses and the plate-like crystals formed a tight chemical bond
      between the enamel and DPGP. We expect that DPGP with the help of CO2 laser can
      be an alternative to the treatment of tooth crack or fracture.

PMID- 11214762
TI  - Prevention of surface encrustation of urological implants by coating with
      inhibitors.
AB  - The encrustation of materials used for urological implants is as yet an
      unresolved problem. The crystallisation-inhibiting effect of the
      glycosaminoglycan heparin was used to reduce encrustation. Heparin was covalently
      bound to the surface of slotted-tube stents of tantalum and stainless steel using
      a spacer molecule. To verify the inhibition of crystallisation processes,
      reproducible in vitro tests and in vivo tests using the rat as animal model were
      carried out. The in vitro and in vivo experiments showed that the heparin coating
      has a significant influence on the encrustation of the surface. After 7 days in
      vitro and 120 days in vivo, heparin coated stents were free of encrustation,
      whereas the uncoated reference stents were extensively covered.

PMID- 11214763
TI  - A review of factors affecting fat absorption in hot chips.
AB  - Consumption of hot chips is a convenience food in most countries. Unfortunately,
      these are high in fat and contribute to fat-related diseases in societies with a
      high fat consumption. There is substantial scope through best-practice deep
      frying techniques for producing lower fat, high-quality chips. From a review of
      the literature, the main factors associated with a lower-fat content of chips are
      thick (>12 mm), straight cut chips; cryogenic freezing methods; low moisture
      content of potatoes (specific gravity >1.1); frying fat: chip volume ratio of
      6:1; frying at optimal temperature (180 to 185 degrees C) during cooking and
      turning the temperature down (approximately 140 degrees C) and covering the vats
      during slack periods; vigorously shaking the basket and hanging it over the deep
      fryer to drain after frying; maintaining the quality of the frying fat by
      regularly skimming the cracklings, filtering the fat, and topping up the fryer
      with fresh fat; keeping the fat turnover <5 days; regular cleaning of frying
      equipment. It is important that all deep frying operators are adequately trained
      in these techniques. It is also important that the frying medium is low in
      saturated and trans fatty acids (<20%) because of their effects on blood lipids
      and low in linolenic acid (<3%) because it is readily degraded. The widespread
      implementation of best-practice deep-frying would reduce fat content of hot chips
      and thus lower overall fat consumption.

PMID- 11214764
TI  - A review on grain and nut deterioration and design of the dryers for safe storage
      with special reference to Turkish hazelnuts.
AB  - Turkey produces about 80% of the total hazelnut crop of the world. About 75% of
      the production are exported. In Turkey hazelnuts are traditionally sun dried, and
      may be subject to mold growth and subsequent mycotoxin formation due to prolonged
      drying time under humid and rainy weather conditions. Drying hazelnuts in a
      reasonable time after harvest is necessary for mycotoxin-free, high-quality
      products. In general, nuts and cereals contaminated by the toxins pose a
      potential hazard not only to the people of the producer countries, but also to
      people of the importing countries, if they should be regarded as safe by
      inefficient sampling plans, therefore preventing toxin formation actually
      benefits very large populations. Deterioration and health hazards associated with
      toxin contaminated hazelnuts and other nuts and cereals have similar causes and
      consequences; therefore, deterioration of the nuts and cereals in storage has
      been reviewed by considering as many grains and nuts as possible, then special
      reference was made to hazelnuts. Proper preharvest practices followed by proper
      drying and safe storage reduces the hazards associated with contamination by the
      toxins. This article reviews the pre- and post-harvest practices, and the grain-
      and nut-drying systems required for toxin-free products. Because drying is the
      major unit operation involving this process, the drying systems and the
      mathematical models required for their design is also discussed.

PMID- 11214765
TI  - Interaction between angiotensin-converting enzyme inhibitors and aspirin: a
      review.
AB  - Aspirin and angiotensin-converting enzyme inhibitors (ACEIs) are often associated
      for the treatment of coronary disease and/or chronic heart failure, but
      conclusions of some prospective and retrospective studies show a possible
      negative interaction between aspirin and ACEIs. ACEIs inhibit the conversion of
      angiotensin I to angiotensin II and also the catabolism of bradykinin, which
      results in increased synthesis of vasodilatory agents [prostaglandins and nitric
      oxide (NO)], whereas aspirin inhibits prostaglandin synthesis. Thus, a potential
      interaction from the opposing effects of aspirin and ACEIs could affect the
      metabolism of bradykinin. We conducted an extensive Medline search, as well as a
      manual search, of published literature including pharmacodynamic studies and
      clinical trials concerning the impact of aspirin on the effect of ACEIs in
      hypertension, coronary disease and chronic heart failure. A review of this
      literature shows five studies in hypertension (all prospective and using blood
      pressure as the main criterion of assessment), five in coronary disease (three
      retrospective and two prospective trials, four of which use mortality as the
      criterion of assessment) and 13 in chronic heart failure (eight using
      haemodynamic measurements of which seven are prospective--one prospective study
      using pulmonary tests, four using clinical events including mortality as
      criterion of assessment of which two are prospective). The counteraction of ACEI
      efficacy by aspirin is demonstrated in one out of five studies in hypertension,
      one out of four of studies in coronary disease and nine out of thirteen in
      chronic heart failure. This counteraction is more often observed with high
      dosages of aspirin (greater than 250 mg/day, four out of six studies) and less
      often with lower dosages (less than or equal to 250 mg/day, three out of 11
      studies). These studies are retrospective analyses or use haemodynamic end
      points, so there is as yet no methodological argument strong enough to
      contraindicate the aspirin-ACEI association or to prove the clinical relevance of
      this interaction. In conclusion, prospective studies using mortality as a
      criterion of assessment are needed to offer the practitioner the answer to the
      question of ACEI-aspirin association.

PMID- 11214766
TI  - Inhibition of puerperal lactation with 2-mercaptopropionyl-glycine.
AB  - OBJECTIVES: Thiols (sulfydryl compounds) have a prolactin-lowering effect in
      animals. The purpose of our study was to evaluate the effects of orally
      administered N-2-mercaptopropionyl-glycine (tiopronin) on suppression of
      lactation and plasma prolactin (PRL) levels in a group of women in the
      puerperium. METHODS: One hundred women aged 17-37 years were studied. We divided
      our population in four groups (25 patients in each group). In group I, no
      medication was administered but only conservative measures were taken
      (restriction of fluid intake, ice-bags applied on the breasts, tight breast
      binders). Subjects in group II received tiopronin (200 mg/day) for 14 days. In
      group III, tiopronin (500 mg/day) was administered for 14 days. Subjects in group
      IV, took bromocriptine (5 mg/day) for 14 days. Assessment of suppression of
      lactation was performed clinically and laboratory determinations were obtained
      before and after 1, 2, 3, 4, and 14 days of treatment. Furthermore, in seven
      healthy women plasma PRL responses to thyrotropin-releasing hormone (TRH) before
      and after one week of tiopronin therapy (500 mg/day) were studied. RESULTS:
      Statistically significant higher percentages of success of lactation suppression
      were obtained with tiopronin (84% and 88%) and bromocriptine (96%) compared to
      conservative treatment (60%). In the four groups a significant decrease of PRL
      was observed. However, in women who received tiopronin and bromocriptine, the
      levels of PRL after 14 days of therapy were lower compared to the conservative
      treatment group. Moreover, in the tiopronin groups and the bromocriptine group,
      lactation was stopped earlier. In the first group (conservative measures) the
      lactation was suppressed after 13.3+/-5.4 days of treatment. In the groups who
      received tiopronin (200 mg/day and 500 mg/ day) lactation was suppressed after
      4.4+/-1.7 and 4.3+/-1.6 days of treatment. In the bromocriptine group the
      lactation was stopped after 1.2+/-0.4 days. Bromocriptine treatment was
      associated with more frequent side effects than the tiopronin. CONCLUSION:
      Administration of tiopronin in low to moderate doses is effective in suppression
      of puerperal lactation.

PMID- 11214767
TI  - Assessment of the systemic effects of beclomethasone dipropionate inhaled via
      Easyhaler or via Diskhaler in healthy male volunteers.
AB  - OBJECTIVE: The objective of this study was to compare the systemic effects of a
      moderate dose (800 microg/day) with the highest recommended dose (1600
      microg/day) of beclomethasone dipropionate (BDP) inhaled via either Easyhaler or
      Diskhaler in 15 healthy adult male volunteers. METHODS: This was an open, placebo
      controlled, randomised study conducted according to a crossover design and
      consisting of a 1-week baseline period and five 1-week treatment periods, each
      separated by a 1-week washout period. Subjects received in randomised order 800
      microg/day BDP via Easyhaler, 1600 microg/day BDP via Easyhaler, placebo via
      Easyhaler, 800 microg/day BDP via Diskhaler and 1600 microg/day BDP via
      Diskhaler. Subjects inhaled BDP twice daily at 0800 hours and 2000 hours. The
      last dose of each period was inhaled at the study site. Venous blood samples were
      drawn prior to and at 2-hour intervals for 20 h after the last dose. Serum
      cortisol area under the curve (AUC0-20) and morning serum cortisol values were
      determined using radioimmunoassay. Urine for analysis of urine
      cortisol/creatinine ratios (UCC) was collected over a 12-h period after the last
      dose of each treatment period. RESULTS: According to serum cortisol values, no
      systemic effects were detected with BDP 800 microg/day inhaled via Easyhaler. The
      mean (+/-SD) change in serum cortisol AUC0-20 was +118.3+/-1391 nmol h/l compared
      with placebo. Mean (SD) changes from placebo in serum cortisol AUC0-20 values
      after BDP 1600 microg/day were--546.3+/-1004 nmol h/l with Easyhaler and -769.3+/
      596 nmol h/l with Diskhaler. However, there were no statistically significant
      differences in systemic bioactivity between the active treatments. Morning serum
      cortisol levels and UCC ratios were consistent with the serum cortisol AUC0-20
      data. CONCLUSIONS: In conclusion, BDP 800 microg/day inhaled via Easyhaler did
      not reduce serum cortisol AUC0-20 compared with placebo. Although the decrease in
      hypothalamic pituitary-adrenal (HPA) axis function after BDP 1600 microg/day was
      statistically significant compared with placebo, the reduction was small and
      similar with both devices.

PMID- 11214768
TI  - Efficacy of combination of atorvastatin and micronised fenofibrate in the
      treatment of severe mixed hyperlipidemia.
AB  - OBJECTIVES: In patients with mixed lipid disorders, monotherapy may not
      effectively control all lipid abnormalities. We undertook this study to assess
      the efficacy of fenofibrate in combination with atorvastatin in patients with
      severe mixed dyslipidemia. METHODS: This was an 18-week, open-label study
      conducted in our lipid clinic. After a 6-week dietary baseline phase, patients
      received 200 mg/day micronised fenofibrate for 6 weeks. At the end of this period
      the subjects discontinued this treatment and received 40 mg/day atorvastatin for
      6 weeks. Finally 200 mg/day of micronised fenofibrate was added to the statin
      therapy. RESULTS: Administration of micronised fenofibrate reduced serum
      triglycerides (P < 0.01) and total cholesterol and low-density lipoprotein (LDL)
      cholesterol (P < 0.05 for both parameters), while it evoked a significant
      increase in serum high-density lipoprotein (HDL) cholesterol levels (P < 0.05).
      Atorvastatin monotherapy induced a more pronounced decrease of total and LDL
      cholesterol. However, plasma triglycerides, although significantly lower than
      baseline values (P < 0.05), were higher than the values observed during treatment
      with fenofibrate. Moreover, serum HDL cholesterol concentrations were higher
      during fibrate therapy than during the statin one. During the combination
      therapy, the decrease in triglycerides was greater than that observed with
      fenofibrate alone, while the decrease in LDL cholesterol was more pronounced than
      that observed with atorvastatin alone. CONCLUSION: The combination of
      atorvastatin with micronised fenofibrate in patients with severe mixed
      dyslipidemia may have a favourable effect on some major coronary artery disease
      risk factors.

PMID- 11214769
TI  - Blood pressure responses to whole-body cold exposure: effect of carvedilol.
AB  - OBJECTIVE: The aim of this study was to test the effects of carvedilol on blood
      pressure (BP) and heart rate (HR) during whole-body cold exposure in hypertensive
      and normotensive subjects. METHODS: Ten hypertensive and twelve normotensive
      subjects were exposed to cold (-15 degrees C, wind 3.5 m/s) three times for 15
      min with a 1-week interval between the exposures. The study design was made
      according to a randomised double-blind, crossover method. Before the cold
      exposures the subjects ingested carvedilol or placebo once a day (carvedilol 12.5
      mg/day for 2 days and then 25 mg/day for 5 days) for 1 week. The systolic (SBP)
      and diastolic (DBP) blood pressure and HR were measured every 3 min during the
      test procedures using an indirect ambulatory blood pressure monitor device (ABPM
      02, Meditech Co.). RESULTS: In the hypertensive group, the cold exposure
      increased SBP/DBP from 119/75 mmHg to 143/96 mmHg during carvedilol treatment
      (P<0.001) and from 132/85 mmHg to 159/106 mmHg during placebo (P<0.001). In the
      normotensive group the cold exposure increased SBP/DBP from 112/72 mmHg to 142/93
      mmHg during carvedilol treatment (P<0.001) and from 121/75 mmHg to 147/98 mmHg
      during placebo (P<0.001). In the hypertensive group, the levels of SBP, DBP and
      MAP (mean arterial pressure) were significantly lower with carvedilol than with
      placebo during the cold exposure although carvedilol did not affect the cold
      induced rise of the BP. The BPs were lower also with carvedilol in the
      normotensive group than the placebo during the cold exposure, but the differences
      were smaller than in the hypertensive group. Carvedilol decreased the BP more the
      higher the initial mean SBP/DBP was with placebo during the cold exposure.
      CONCLUSION: Carvedilol reduced the BP during the cold exposure, especially in the
      hypertensive subjects but also in normotensive ones, without effect on the cold
      induced rise of the BP.

PMID- 11214770
TI  - Effects of grapefruit juice on the stereoselective disposition of nicardipine in
      humans: evidence for dominant presystemic elimination at the gut site.
AB  - OBJECTIVES: To assess relative roles of the intestinal and hepatic
      stereoselective metabolism of nicardipine in an oral first-pass disposal with and
      without grapefruit juice intake. METHODS: The kinetic profiles of (+)- and (-)
      nicardipine were studied in the six normal healthy male volunteers who received
      oral (40 mg) and intravenous (2 mg) racemic nicardipine, first with water and
      second with grapefruit juice. Both the enantiomers were determined by the
      stereoselective high-performance liquid chromatographic method, and hemodynamic
      parameters (arterial blood pressure, heart rate, and electrocardiogram) were
      assessed when each blood sample was taken. RESULTS: Grapefruit juice compared
      with water intake caused a significant (P < 0.05) increase in the mean oral (+)-
      and (-)-nicardipine bioavailability (Fobs) (48.6+/-5.0% and 105.6+/-7.8%) and
      dose-absorbed (Fabs) available fraction unmetabolized at the gut (Fg) (48.2+/
      5.6% and 110.9+/-8.8%, respectively) with no significant change in the hepatic
      first-pass effect. However, all of the mean kinetic parameters of both the
      enantiomers after the intravenous dosing of racemic nicardipine did not differ
      between the grapefruit juice- and water-intake trial phases. The mean percentage
      changes in oral AUC (43.1+/-3.4% in [+]-nicardipine and 90.9 6.4% in [-]
      nicardipine, or Fobs) and Fabs Fg by grapefruit juice tended to be greater for (
      )-nicardipine than for (+)-nicardipine and the mean oral (+)/(-)-nicardipine AUC
      ratio was significantly reduced by grapefruit juice (from 2.25+/-0.37 to 1.75+/
      0.28) (P < 0.05). Except for heart rates, which were greater with grapefruit
      juice (P < 0.05) at 1 and 2 h after the oral dose of nicardipine, the mean
      hemodynamic variables did not differ between the two trial phases. CONCLUSION: We
      conclude that the gut is the major presystemic disposal site of racemic
      nicardipine in humans. Grapefruit juice appears to affect this metabolic disposal
      of (-)-nicardipine to a somewhat greater extent compared with that of (+)
      nicardipine, with an early postdose transient tachycardia after the oral dosing
      of racemic nicardipine.

PMID- 11214771
TI  - In-vivo indices of CYP2D6 activity: comparison of dextromethorphan metabolic
      ratios in 4-h urine and 3-h plasma.
AB  - OBJECTIVES: Dextromethorpan (DM) is widely used as a probe drug to assess in vivo
      the activity of the cytochrome P450 2D6 (CYP2D6). The aim of the study was to
      compare metabolic ratios (MRs) of DM to dextrorphan (DEX) in plasma and urine. We
      examined, separately in urine and plasma, the relationships between the MRs which
      are based on DEX and those involving the sum of DEX and a secondary metabolite
      hydroxymorphinan (HM). Furthermore, we compared the MRs in plasma obtained with
      and without hydrolysis of DEX glucuronides. METHODS: Concentrations of DM and
      metabolites in urine and plasma were determined by HPLC after a single oral dose
      of 30 mg DM hydrobromide to 101 healthy Caucasian subjects. Urine was collected
      over the time interval 0-4 h after the dose and plasma was obtained from 95
      subjects 3 h after administration. RESULTS: Six subjects (5.9%) were of poor
      metaboliser (PM) phenotype (urinary DM:DEX ratio >0.3). A good correlation (r2 =
      0.777, P < 0.00001) was observed between the metabolic ratios of DM:DEX in plasma
      and urine. There was an excellent correlation, both in plasma and urine, between
      the log-transformed ratios of DM:DEX and of DM to the sum of molar concentrations
      of DEX and HM (r2 > 0.996, P < 0.00001). Plasma samples of 89 subjects (83 EM and
      6 PM) were analyzed without deconjugation of DEX glucuronide also. The
      correlation between the plasma ratios of DM:DEX based on unconjugated DEX and
      those involving glucuronide (r2 = 0.793, P < 0.00001) was comparable to that
      reported by other authors on urine. CONCLUSION: In healthy Caucasian subjects,
      the MRs of DM to DEX in plasma obtained at 3 h correlated reasonably well with
      those in urine collected over the time interval 0-4 h after the dose.
      Nevertheless, repeatability of this plasma index should be determined before its
      wide use can be recommended. Finally, the interindividual variation in DEX
      metabolism to HM (catalyzed by CYP3A) contributes only minimally to the
      interindividual variability of the MRs.

PMID- 11214773
TI  - Pharmacokinetics of esomeprazole after oral and intravenous administration of
      single and repeated doses to healthy subjects.
AB  - OBJECTIVE: To study the pharmacokinetics of esomeprazole, one of the optical
      isomers of omeprazole, after 20 mg or 40 mg single and repeated oral and
      intravenous administration to healthy subjects. The main metabolites of
      esomeprazole were also assessed after the 40-mg oral dose. METHODS: In two
      separate studies, 16 healthy male subjects and 16 healthy male and female
      subjects received intravenous doses of 20 mg and 40 mg esomeprazole,
      respectively, on the first investigation day. After a washout period of 5-14
      days, the same doses (20 mg as a solution and 40 mg as a capsule) were given
      orally for 5 days and then again intravenously on day 6. Blood samples for
      determination of esomeprazole and its metabolites were collected 12 h or 24 h
      post-dose and were analysed using normal-phase liquid chromatography with
      ultraviolet (UV) detection. Pharmacokinetic parameters of esomeprazole and its
      metabolites were estimated using non-compartmental analysis. Geometric means and
      ratios of the geometric means together with 95% confidence intervals (CI) of the
      pharmacokinetic parameters were calculated using analysis of variance (ANOVA).
      RESULTS: Plasma clearance (CL) of esomeprazole decreased from 22 l/h to 16 l/h
      and from 17 l/h to 9 l/h following repeated dosing of 20 mg and 40 mg,
      respectively. Total area under the plasma concentration-time curve (AUC)
      increased (from 1.34 micromol x h/l to 2.55 micromol x h/l) with absolute
      bioavailability (F) being 50% on day 1 and 68% on day 5 after the 20-mg oral
      dose. AUC increased (from 4.32 micromol x h/l to 11.21 micromol x h/l) with F
      being 64% on day 1 and 89% on day 5 after the 40-mg oral dose. The plasma levels
      for esomeprazole sulphone were substantially higher on day 5 than on day 1, while
      those for 5-hydroxy esomeprazole were marginally higher on day 5 than on day 1
      following repeated oral dosing of 40 mg esomeprazole. No side effects
      attributable to esomeprazole were noticed. CONCLUSION: The increased AUC of
      esomeprazole with repeated dosing is probably due to a combination of a decreased
      first-pass elimination and a decreased systemic clearance.

PMID- 11214772
TI  - Mycophenolic acid glucuronidation and its inhibition by non-steroidal anti
      inflammatory drugs in human liver and kidney.
AB  - OBJECTIVE: The aims of this investigation were to study the glucuronidation of
      mycophenolic acid (MPA) in human liver and kidney and to search for a compound
      that inhibits MPA glucuronidation among the non-steroidal anti-inflammatory drugs
      (NSAIDs). METHODS: A sensitive and reproducible radiometric assay was developed
      to measure the rate of MPA glucuronidation in human liver and kidney microsomes.
      The assay employed uridine 5'-diphosphate-[U-14C]-glucuronic acid (UDPGA) and MPA
      glucuronide was isolated by TLC. The final concentrations of UDPGA and MPA
      necessary were 1 mM (liver), and MPA concentration was 0.5 mM (kidney). The
      inhibition of MPA glucuronidation was studied with 18 NSAIDs and tacrolimus.
      RESULTS: Glucuronosyl transferase activity followed Michaelis-Menten kinetics and
      the Km (mean +/- SD; mM) was 0.31+/-0.06 (liver; n = 5) and 0.28+/-0.07 (kidney;
      n = 5; P = 0.555); the Vmax (mean SD; nmol/mg per minute) was 5.2+/-1.4 (liver; n
      = 5) and 10.5+/-1.2 (kidney; n = 5; P = 0.0005). The MPA glucuronidation rates
      (mean +/- SD; nmol/min/mg) were 3.3+/-0.9 (liver; n = 10) and 7.8+/-1.5 (kidney;
      n = 10; P = 0.0002). The rate of MPA glucuronidation ranged between 2.0 and 5.1
      nmol/ mg per minute with a 2.5-fold variation (liver) and between 5.7 and 9.8
      nmol/mg per minute with a 1.7-fold variation (kidney). The inhibition study was
      performed in liver and revealed that the percentage of control ranged from 8%+/
      3% (niflumic acid) to 119%+/-16% (Ketoralac). The inhibition curves for MPA
      glucuronidation rate were determined with the four most effective inhibitors:
      niflumic acid, flufenamic acid, mefenamic acid and diflunisal. Their IC50
      estimates (microM) were 8+/-1, 19+/-9, 63+/-8 and 109+/-15, respectively (liver),
      and 8+/-2, 13+/-2, 49+/-4 and 122+/-18, respectively (kidney). The IC50 estimate
      for niflumic acid was eightfold lower than the peak plasma levels after a single
      oral dose of 250 mg of this drug. CONCLUSION: The human liver and kidney are
      important sites of MPA glucuronidation. MPA glucuronidation was inhibited to
      various extents by different NSAIDs and the four most effective inhibitors were
      niflumic acid, flufenamic acid, mefenamic acid and diflunisal. These drugs have
      similar molecular structures consisting of two aromatic rings bearing a
      carboxylic group.

PMID- 11214774
TI  - Influence of continuous veno-venous haemodiafiltration and continuous veno-venous
      haemofiltration on the pharmacokinetics of fluconazole.
AB  - OBJECTIVE: To compare the elimination of fluconazole by continuous veno-venous
      haemodiafiltration (CVVHD) and continuous veno-venous haemofiltration (CVVH) at
      different dosages. INTERVENTION: Patients received doses of 400 mg (n=3), 600 mg
      (n=1) or 800 mg (n=2) fluconazole as a short-time infusion once a day. Patients
      underwent CVVHD the first day and CVVH the second day. CVVHD and CVVH were
      performed using an acrylonitrile hollow-fibre filter at a constant blood flow of
      90 ml/min and a substitution flow of 1000 ml/h (predilution). During CVVHD, the
      dialysate flow was 1000 ml/h. Ultrafiltration rates were 1158+/-90.5 ml/h during
      CVVHD and 1167+/-81.6 ml/h. Serum and ultrafiltrate/dialysate concentrations of
      fluconazole were determined on nine occasions over 24 h. PARTICIPANTS: Six
      critically ill patients with acute renal failure (ARF) and serious fungal
      infection. RESULTS: Extracorporeal clearance (CVVHD 30.5+/-6.0 ml/min, CVVH
      17.5+/-4.0 ml/min) and total clearance of fluconazole (CVVHD 37.9+/-4.4 ml/min,
      CVVH 25.3+/-6.5 ml/min) were significantly higher during CVVHD (P < 0.05). During
      CVVHD, the sieving coefficient (S(CVVHD)) was 0.88 (range 0.54-1) and the
      elimination half-life (t1/2) was 14.8-35.1 h. During CVVH, the S(CVVH) was 0.96
      (range 0.56-1.02) and t1/2 was 24.0-51.6 h. CONCLUSIONS: A daily dosage of 400
      800 mg fluconazole is recommended in the treatment of life-threatening fungal
      infections in critically ill patients undergoing CVVHD since the clearance of
      CVVHD may considerably exceed the clearance in patients with normal renal
      function, which is about 20 ml/min. Drug monitoring is highly recommended for
      these patients.

PMID- 11214776
TI  - Consideration of endogenous backgrounds in pharmacokinetic analyses: a simulation
      study.
AB  - OBJECTIVE: The pharmacokinetic analysis of biologic compounds is frequently
      disturbed by the presence of endogenous levels, which cannot be discerned from
      exogenous levels. The frequently used method of subtracting baseline levels from
      subsequent measurements was compared to a fully adjusted regression model in a
      simulation study. METHODS: Simulations (5,000 each) were carried out for a
      standard one-compartment model with rich (n = 10) and poor (n = 6) postdose
      sampling, using unweighted as well as two-weighted types of non-linear
      regression. RESULTS: Whereas the fully adjusted model performed properly across
      various scenarios, the subtraction method showed a noteworthy bias (up to 14%)
      for area under the curve (AUC) and elimination half-life with weighted non-linear
      regression. For estimation of the Cmax parameter using any weighting scheme, and
      of any parameter using unweighted non-linear regression, the two methods
      performed equally well. As expected, poor in contrast to rich sampling resulted
      in larger coefficients of variation, but also in increasing failures (4.4%) of
      the regression algorithm (failure to converge, negative Cmax or half-life) for
      the subtraction method when it was combined with the weighting scheme giving
      highest weight to small concentrations. CONCLUSION: The risk of biased results
      may result from the subtraction method, which may also affect the analysis of
      dose linearity, bioequivalence and population kinetic studies with biologic
      compounds. When background endogenous levels are not negligible, a fully adjusted
      model is recommended.

PMID- 11214775
TI  - CYP2D6 genotype and antipsychotic-induced extrapyramidal side effects in
      schizophrenic patients.
AB  - OBJECTIVE: In order to evaluate whether poor metabolizers (PM) of debrisoquine
      are overrepresented among patients with acute dystonic reactions and chronic
      movement disorders associated with the administration of antipsychotic drugs, the
      CYP2D6 genotype was determined in schizophrenic patients. METHODS: Allele status
      for CYP2D6*3, CYP2D6*4, CYP2D6*5, and CYP2D6*6 as well as gene duplication was
      determined by allele-specific PCR, long-PCR and restriction fragment length
      polymorphism analysis (RFLP) in 119 schizophrenic patients (99 males and 20
      females). All subjects were treated with antipsychotics metabolized, at least
      partially, by this isozyme. Sixty-three of the patients (52.9%) had a history of
      extrapyramidal side effects (EPS), while 56 (47.1%) had not experienced such
      problems (controls). RESULTS: Sixty-five patients (54.6%) were homozygous for a
      functional CYP2D6*1 allele, 44 (37.0%) were heterozygous for detrimental alleles,
      and 4 (3.4%), who carried two detrimental alleles, were classified as PM. In six
      patients (5.0%) duplication of a functional CYP2D6 gene was found, and they were
      consequently classified as ultrarapid metabolizers (UM). Homo- and heterozygous
      extensive metabolizers (EM) as well as UM were equally distributed between
      patients with and without EPS, whereas all the PM had a history of EPS. No
      significant differences in allele frequencies between the two groups were found.
      CONCLUSION: Although the results cannot be considered conclusive due to the small
      number of PM patients in our study, the PM genotype may be a predisposing factor
      for antipsychotic-induced EPS. Knowledge of the CYP2D6 genotype, before starting
      antipsychotic therapy, might be useful in identifying subjects at risk of
      developing EPS.

PMID- 11214777
TI  - Correlation between acetylation phenotype and genotype in Chinese women.
AB  - OBJECTIVE: The acetylation polymorphism is a common inherited variation in human
      drug and carcinogen metabolism. Because N-acetyltransferase (NAT2) is important
      for the detoxification and/or bioactivation of drugs and carcinogens, this
      polymorphism has important implications in therapeutics and cancer
      susceptibility. A high correlation between acetylation phenotype and genotype has
      been demonstrated in several studies. However, no such data exist for Chinese
      females. The aim of the present study was to compare acetylation phenotype with
      NAT2 genotype in a population of primarily non-smoking Chinese females. METHODS:
      In the present study, the correlation between N-acetyltransferase activity and
      NAT2 genotype was evaluated in 103 unrelated Chinese female controls derived from
      a hospital-based case-control study of lung cancer in Singapore. Acetylation
      phenotype and genotype were respectively determined using caffeine and an allele
      specific polymerase chain reaction (PCR). RESULTS: The proportions of rapid and
      slow phenotypes were 78% and 22%, respectively, while the distribution of rapid
      (heterozygotes and homozygotes combined) and slow acetylator genotypes was 76%
      and 24%, respectively. The distribution of the various NAT2 genotypes did not
      differ significantly (chi2 = 1.45, P > 0.05) from that predicted by the Hardy
      Weinberg Law. All slow acetylators were accurately predicted (100%), whereas 2 of
      80 rapid acetylators were erroneously predicted as slow (2.5%). The overall
      prediction rate of the PCR-based test for the acetylation phenotype was at 98.1%
      in our Chinese population. CONCLUSION: Our results suggest that genotyping with
      PCR may well become the preferred method for the determination of acetylation
      polymorphism in epidemiological studies in this Asian population.

PMID- 11214778
TI  - Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil
      enantiomers in healthy volunteers.
AB  - OBJECTIVES: To determine the effect of grapefruit juice on the pharmacokinetics
      and pharmacodynamics of S- and R-verapamil (given as racemates) at steady state.
      METHODS: Nine healthy male volunteers followed a randomised cross-over study
      comprising two treatment periods. Pretreatments of 200 ml orange juice (control)
      or grapefruit juice twice daily for 5 days and 120 mg verapamil (orally) twice
      daily for 3 days were given. On the study day, the subjects received the morning
      dose of verapamil with either orange juice (control) or grapefruit juice. Plasma
      and urine samples were collected for measurement of S- and R-verapamil and the
      metabolites S- and R-norverapamil. Blood pressure (BP), heart rate (HR) and PR
      interval were monitored. RESULTS: During the grapefruit juice period, the steady
      state peak and trough concentrations of S-verapamil were moderately increased
      (peak 41+/-25 ng ml(-1) versus 26+/-13 ng ml(-1), trough 14+/-7 ng ml(-1) versus
      12+/-6 ng ml(-1), P=0.08). Grapefruit juice significantly increased the area
      under the plasma concentration-time curve during the 12-h dose interval (AUC0-12
      h) of S-verapamil by 36% (292+/-146 ng h ml(-1) versus 215+/-102 ng h ml(-1),
      P=0.04). Similar results were obtained for peak and trough concentrations of R
      verapamil. The AUC0-12 h of R-verapamil was increased by 28% (1022+/-412 ng h ml(
      1) versus 800+/-316 ng h ml(-1), P=0.04). Elimination half-life and renal
      clearance of both S- and R-verapamil were not affected. Considerable inter
      subject variability in interaction was shown. There were no significant
      differences in the pharmacodynamic parameters (BP, HR and PR-interval).
      CONCLUSIONS: The present study has demonstrated an interaction between verapamil
      and grapefruit juice, which is likely due to an inhibition of intestinal
      metabolism resulting in increased oral bioavailability.

PMID- 11214779
TI  - Citalopram pharmacokinetics in patients with chronic renal failure and the effect
      of haemodialysis.
AB  - OBJECTIVE: To study the effects of severe renal failure and haemodialysis on the
      pharmacokinetics of citalopram. METHODS: Four patients with renal failure
      undergoing haemodialysis and eight healthy controls were given a single dose of
      citalopram. The concentrations of citalopram and its metabolites
      desmethylcitalopram and didesmethylcitalopram were measured in serum and urine.
      On a different day, the four patients undergoing haemodialysis were given another
      single dose of citalopram, and the drug concentrations were measured in serum
      from the artery leading to the dialyser and in the dialysate. In addition, one
      anuric patient treated with citalopram on a regular basis was included in the
      study. RESULTS: There were no significant differences between the two groups in
      any of the pharmacokinetic parameters with the exception of the renal clearance
      of citalopram, which was significantly lower in the renal failure group than in
      the control group (1.70 ml/min versus 66.2 ml/min, P<0.001). Oral clearance of
      citalopram was almost identical in the two groups (452 ml/min versus 456 ml/min).
      The process of haemodialysis cleared about 1% of the dose as citalopram and 1% as
      desmethylcitalopram only. CONCLUSION: Severe renal failure does not affect the
      pharmacokinetics of citalopram and modification of the usual citalopram dose does
      thus not seem to be necessary. The contribution of haemodialysis to the total
      elimination of citalopram is negligible.

PMID- 11214780
TI  - Pharmacokinetic and pharmacodynamic interactions between the novel calcium
      sensitiser levosimendan and warfarin.
AB  - OBJECTIVE: To study the effects of possible interactions between levosimendan and
      warfarin on pharmacokinetics and pharmacodynamics. Furthermore, the effects of
      levosimendan on blood coagulation were investigated. METHODS: Open, randomised
      cross-over design with two treatment phases was used. During one phase,
      levosimendan (0.5 mg four times daily) was given orally to ten healthy subjects
      for 9 days. On the fourth treatment day with levosimendan, a single oral dose of
      warfarin (25 mg) was given. Pharmacokinetic parameters of levosimendan from the
      third and fourth treatment days were compared with each other. During the other
      treatment phase the subjects received only a single dose of warfarin.
      Pharmacokinetic parameters of warfarin alone were compared with those determined
      after concomitant administration of levosimendan. Changes in blood coagulation
      parameters were evaluated after levosimendan and warfarin alone and after
      concomitant administration. RESULTS: Warfarin did not change the pharmacokinetics
      of levosimendan. The distribution volume of warfarin was higher and elimination
      half-life shorter after concomitant levosimendan administration than after
      warfarin alone. However, concomitant levosimendan administration did not
      potentiate the effects of warfarin on blood coagulation assessed using activated
      partial thromboplastin time (APTT) and thromboplastin time (TT-SPA). Levosimendan
      alone for 3 days did not change APTT or TT-SPA values. There were no changes in
      the protein binding of levosimendan or warfarin upon concomitant administration.
      Continuous treatment with oral levosimendan caused headache, which was probably
      due to cerebral vasodilation. CONCLUSIONS: Concomitant levosimendan
      administration did not potentiate the effect of warfarin on blood coagulation
      after a single dose. Levosimendan itself had no effects on blood coagulation.

PMID- 11214781
TI  - Effects and pharmacokinetics of oral glibenclamide and glipizide in Caucasian and
      Chinese patients with type-2 diabetes.
AB  - The effects and kinetics of oral glibenclamide (Gb) and glipizide (Gz) were
      studied in Caucasian and Chinese patients (ten in each group) with type-2
      diabetes. In randomised order, 2.5 mg Gb, 2.5 mg Gz or placebo was given orally
      before the administration of 75 g oral glucose. Concentrations of insulin and
      proinsulin were determined using radioimmunoassay (RIA) without cross
      reactivities, and sulphonylurea concentrations were determined using high
      performance liquid chromatography (HPLC). There were no significant interethnic
      differences in Gb or Gz effects whether on glucose, insulin or proinsulin/insulin
      ratio at any time point. Following Gz, however, Chinese patients had greater
      increments of serum proinsulin at 10-30 min compared with Caucasians. Apart from
      the maximum plasma concentration (Cmax) and area under the plasma concentration
      time curve (AUC) of Gz being higher among the Chinese, no significant interethnic
      differences in pharmacokinetics were found. It appears that the same dosage
      principles could be used for Caucasian and Chinese patients with type-2 diabetes
      when Gb or Gz are prescribed.

PMID- 11214782
TI  - Steady-state dispositions of valproate and diflunisal alone and coadministered to
      healthy volunteers.
AB  - OBJECTIVE: The effects of coadministration of the non-steroidal anti-inflammatory
      drug diflunisal (DF) on glucuronidation and beta-oxidation of the antiepileptic
      agent valproic acid (VPA), and of VPA on DF glucuronidation, were studied in
      human volunteers. METHODS: Seven healthy male volunteers received sodium
      valproate (NaVPA, 200 mg) orally twice daily for 7 days, after which all drug
      intake ceased for 1 month. The volunteers then took DF (250 mg) orally twice
      daily for 7 days. Both drugs were then taken (at the same doses as previously)
      twice daily for 7 days. On day 7 of each dosing phase, serial blood samples and
      all urine passed over the 12-h inter-dosing interval were collected. VPA, DF and
      selected metabolites were analysed using validated methods. Statistical
      comparisons of pharmacokinetic parameters were made using paired Student's t
      tests. RESULTS: Mean plasma concentrations of total VPA were lower and apparent
      plasma clearances significantly higher during DF coadministration. This was
      associated with a significant 20% increase in the unbound fraction of VPA (from
      6.6+/-1.3% to 7.9+/-1.8%). The apparent clearance of unbound VPA was not
      different. There was no evidence of any significant effect of DF coadministration
      on VPA metabolism: urinary recoveries of and formation clearances to urinary VPA
      glucuronide, E-2-en-VPA, 3-oxo-VPA and 4-en-VPA were not significantly altered.
      However, there was a highly significant 35% increase in the area under the plasma
      concentration-time curve from 0-12 h (AUC0-12h) of 3-oxo-VPA and its renal
      clearance was lower, though not significantly so. VPA coadministration had no
      effect on DF pharmacokinetics or formation clearances of DF to its acyl
      glucuronide (DAG), phenolic glucuronide (DPG) or sulfate (DS) conjugates.
      However, plasma AUC0-12h values of the glucuronides were significantly lower and
      their renal clearances higher (though significantly so only in the case of DPG)
      during VPA coadministration. CONCLUSIONS: Steady-state coadministration of VPA
      and DF leads to a significant displacement of VPA from plasma protein binding
      sites. There was no evidence of competition for glucuronidation capacity or other
      metabolic interactions. Rather, the interactions detected appeared to be renal in
      nature, with renal clearance of 3-oxo-VPA being reduced by DF coadministration,
      and renal clearance of DPG and perhaps DAG being increased by VPA
      coadministration.

PMID- 11214783
TI  - Different versions of the anatomical therapeutic chemical classification system
      and the defined daily dose--are drug utilisation data comparable?
AB  - OBJECTIVE: To investigate whether published drug utilisation studies contain
      satisfactory references to the ATC/DDD version applied and thus are usable for
      comparative purposes. METHODS AND RESULTS: A literature survey of drug
      utilisation studies was made. Seventy-three articles were identified by two
      Medline searches, one in 1996 and another in 1998. The articles were classified
      into four different groups. Groups 1 and 2 give proper references to the defined
      daily doses (DDDs) used in the studies, either by full reference to the version
      of the ATC Index with DDDs or by listing the actual DDDs used. The articles in
      groups 1 and 2 represent 46% of the articles in the survey. The articles
      classified in groups 3 and 4 give references only to general articles about the
      anatomical therapeutic chemical classification (ATC)/DDD system or no references
      at all. Fifty-four percent of the articles in the survey were classified in these
      groups. In these articles it is not possible to identify which DDDs have been
      used in the presentation of drug consumption data. CONCLUSIONS: According to the
      results from our literature survey, it is not common practice to include the ATC
      codes and the DDD values used or to make reference to the versions of the ATC/DDD
      index used when results from drug utilisation studies are published. One possible
      reason for this might be little or no knowledge about the ATC/DDD system as a
      dynamic system in which alterations are made annually. The lack of references to
      the actual DDDs used in the studies make comparisons between different data sets
      difficult and misleading.

PMID- 11214784
TI  - Attitudes to reporting adverse drug reactions in northern Sweden.
AB  - OBJECTIVES: This study was designed to investigate attitudes of general
      practitioners (GPs) and hospital physicians in Sweden towards spontaneous
      reporting of adverse drug reactions (ADRs). METHOD: Two areas in the northern
      region of Sweden were selected for the study. A knowledge and attitude
      questionnaire followed by a reminder letter 2 weeks later was addressed to all
      GPs and hospital physicians in the study areas. RESULT: The total response rate
      from the study areas was 748 of the 1274 questionnaires sent out (58.7%). Of
      those who responded, 236 were GPs, 433 were hospital physicians and 79 had other
      positions. Of the responders, 252 stated that they had never reported any ADR and
      488 that they had reported at least once in their career. Issues that came out as
      important in the decision to report or not to report were whether the reaction
      was considered well-known or not, the severity of the reaction, hesitance to
      report only on suspicion, lack of knowledge of existing rules, giving priority to
      other matters and lack of time to report ADRs. Only minor differences in these
      regards were observed between male and female physicians. CONCLUSION: Our
      investigation shows that the physicians in northern Sweden have a fairly good
      knowledge about the existing rules for reporting ADRs in Sweden. However, the
      attitudes leave room for considerable under-reporting due to matters related
      mainly to the medical impact of the reaction and of reporting it, but also to the
      scientific "paradox" of reporting only on suspicion and of course due to lack of
      time in the health care setting.

PMID- 11214785
TI  - Detecting drug-drug interactions using a database for spontaneous adverse drug
      reactions: an example with diuretics and non-steroidal anti-inflammatory drugs.
AB  - OBJECTIVE: Drug-drug interactions are relatively rarely reported to spontaneous
      reporting systems (SRSs) for adverse drug reactions. For this reason, the
      traditional approach for analysing SRS has major limitations for the detection of
      drug-drug interactions. We developed a method that may enable signalling of these
      possible interactions, which are often not explicitly reported, utilising reports
      of adverse drug reactions in data sets of SRS. As an example, the influence of
      concomitant use of diuretics and non-steroidal anti-inflammatory drugs (NSAIDs)
      on symptoms indicating a decreased efficacy of diuretics was examined using
      reports received by the Netherlands Pharmacovigilance Foundation Lareb. METHODS:
      Reports received between 1 January 1990 and 1 January 1999 of patients older than
      50 years were included in the study. Cases were defined as reports with symptoms
      indicating a decreased efficacy of diuretics, non-cases as all other reports.
      Exposure categories were the use of NSAIDs or diuretics versus the use of neither
      of these drugs. The influence of the combined use of both drugs was examined
      using logistic regression analysis. RESULTS: The odds ratio of the statistical
      interaction term of the combined use of both drugs was increased [adjusted odds
      ratio 2.0, 95% confidence interval (CI) 1.1-3.7], which may indicate an enhanced
      effect of concomitant drug use. CONCLUSION: The findings illustrate that
      spontaneous reporting systems have a potential for signal detection and the
      analysis of possible drug-drug interactions. The method described may enable a
      more active approach in the detection of drug-drug interactions after marketing.

PMID- 11214786
TI  - Predictors for prophylactic antithrombotic prescribing in ischaemic heart disease
      and the impact of national guidelines.
AB  - OBJECTIVES: Assessment of predictors for initiating prophylactic antithrombotic
      prescribing for patients newly diagnosed with ischaemic heart disease (IHD) and
      the impact of the introduction of national guidelines. DESIGN AND SETTING: A
      retrospective case-control study was performed using pharmacy prescription data
      from 120,000 Dutch patients over a 5-year period. IHD patients were identified
      using as a marker multiple nitrate prescriptions [anatomical-chemical-therapeutic
      (ATC) code CO1D] indicating chronic use. Initiation of antithrombotic therapy was
      likewise identified using ATC codes B01AA and B01AC (oral anticoagulants and
      thrombocyte aggregation inhibitors), prescribed within 6 months following the
      first nitrate prescription. Statistically significant (P<0.05) predictors were
      assessed using multivariable analysis considering patient, prescriber and
      medication characteristics. RESULTS: Of the 2598 patients who met specified
      inclusion criteria for newly diagnosed IHD, approximately 35% was not prescribed
      any type of antithrombotic therapy. Male patients [odds ratio (OR) 2.4, 95%
      confidence interval (CI) 2.0-2.9], patients with cardiovascular (other than IHD)
      and diabetic co-morbidity (OR 6.4, 95% CI 4.8-7.9 and OR 1.6, 95% CI 1.1-2.1,
      respectively) and patients using isosorbide mononitrate rather than isosorbide
      dinitrate as anti-ischaemic main therapy (OR 2.1, 95% CI 1.3-2.5) were most
      likely to be prescribed antithrombotic therapy. Furthermore, initiating
      antithrombotic prescribing was more likely after the introduction of national
      guidelines (OR 1.4, 95% CI 1.1-1.7). CONCLUSIONS: Initiating antithrombotic
      prescribing in newly diagnosed IHD patients can be predicted by patient gender,
      certain co-morbidity and main type of nitrate therapy. The introduction of
      national guidelines has resulted in an increase of prophylactic antithrombotic
      prescribing in accordance with their contents.

PMID- 11214787
TI  - Influence of physician's education, drug information and medical-care settings on
      the quality of drugs prescribed.
AB  - OBJECTIVE: To identify factors associated with low prescription quality in
      primary care. METHODS: We carried out a cross-sectional study on a sample of 405
      primary care physicians in Galicia (Northwest Spain). The following independent
      variables were collected through a mail questionnaire survey: physician's
      education and speciality, physician's perception of the quality of available drug
      information sources, type of practice and number of patients. We constructed
      multiple regression models using as dependent variables four indicators of the
      quality of drugs prescribed. RESULTS: The response rate was 75.2%. The quality of
      drugs prescribed was found to be associated with regulated physician training (P
      = 0.001), perceived credibility of information sources (P = 0.013) and
      environmental characteristics of the practice (reform model and number of
      patients' cards). CONCLUSION: Study results suggest that in order to improve the
      quality of drugs prescribed, physician education and training must be improved
      and the role of pharmaceutical companies in physician training should be limited,
      emphasising more objective sources of information, such as therapeutic
      guidelines. Our results also underline the need to complete the reform of our
      primary care system and promote better relationships among physicians and between
      physicians and patients.

PMID- 11214788
TI  - A study of drug utilisation and cost of treatment in patients hospitalised with
      unstable angina.
AB  - OBJECTIVE: The current study was designed to investigate drug utilisation in the
      management of unstable angina in India and to calculate the costs incurred by
      patients in the treatment of a single episode of unstable angina. METHODS: We
      conducted a prescription survey to examine the use of antianginal drugs in
      patients with unstable angina in a tertiary care Indian hospital. The use of
      concurrent medications such as antidiabetic, antihypertensive and lipid-lowering
      agents was also examined. Data on the cost of treatment, investigations, income,
      and family size were collected from the case histories or direct interviews with
      the patients/relatives. RESULTS: A total of 336 consecutive prescriptions were
      evaluated. Aspirin was the most frequently prescribed drug (98%) followed by
      nitroglycerin infusion (90%) and enoxaparin (52%). One of the heparins was used
      by 89% of all patients and beta-blockers by up to 62% of the patients. Besides
      antianginals, antihypertensive (49%) and antidiabetic (16%) drugs were commonly
      coadministered. The mean (+/- SD) cost of treatment of a single episode of
      unstable angina in the hospital was US $494 (+/- 271) against an annual per
      capita income of US $245. The mean (+/- SD) cost incurred by the patients due to
      drugs alone during the hospital stay was US $70 (+/- 18) and enoxaparin accounted
      for 60% of the expenditure due to drugs. CONCLUSIONS: The results of our study
      show that low-molecular-weight heparin, enoxaparin, is replacing unfractionated
      heparin in the treatment of unstable angina. In view of the use of costly new
      drugs, there is an urgent need for carrying out pharmacoeconomic analysis in
      developing countries as the treatment of a single episode of unstable angina
      imparts a considerable economic burden on the patient.

PMID- 11214789
TI  - Agranulocytosis associated with calcium dobesilate clinical course and risk
      estimation with the case-control and the case-population approaches.
AB  - OBJECTIVE: Calcium dobesilate is used in the treatment of diabetic retinopathy,
      chronic venous insufficiency, haemorrhoids and other ill-defined vascular
      conditions. It has been associated with agranulocytosis in anecdotal reports. We
      describe the clinical course of a series of patients who developed
      agranulocytosis while taking this drug, and we estimate the risk by means of both
      a case-control and a case-population strategy. METHODS: All cases of
      agranulocytosis meeting strict predefined diagnostic criteria in an area of 3.3
      to 3.9 x 106 inhabitants in the period 1980-1998 were identified. Cases and age-,
      gender- and hospital-matched controls were interviewed with a structured
      questionnaire including a detailed drug history. Each case was reviewed and
      confirmed by a haematologist, who was blind with respect to drug exposures.
      Consumption data were used to estimate the risk of agranulocytosis associated
      with calcium dobesilate using a case-population approach in which the incidence
      of agranulocytosis among users of calcium dobesilate was compared with that among
      the non-exposed population. RESULTS: After a follow up of 68.55 x 10(6) person
      years, 345 cases of agranulocytosis (242 community cases) were assembled.
      Reliable information was obtained from 216 cases. Two patients exhibited positive
      rechallenge. Twelve cases (5.6%) and 5 of 1380 controls (0.4%) had taken calcium
      dobesilate in the week before. With the case-control approach, the odds ratio was
      23.66 [95% confidence interval (CI), 7.54-74.24], the attributable risk was 5.3%
      (95% CI, 3.0-9.4), and the number of cases attributable to dobesilate in the
      study area during the study period was 12.8. The case-population estimates were
      an incidence of 121.03 cases per 10(6) patient-years, a relative risk of 39.55
      (95% CI, 17.96-77.49), an attributable risk of 6.73% (CI 3.4-12.9), and 16.30
      cases attributable to dobesilate in the study area during the study period.
      DISCUSSION: This study adds to evidence indicating that the case-population
      method is adequate for the study of rare type B adverse drug reactions. An
      additional advantage of this approach is that the incidence of the disease of
      interest among those exposed to the drug can be estimated. The risk of
      agranulocytosis associated with calcium dobesilate should be considered in
      relation to poor evidence of its clinical efficacy.

PMID- 11214790
TI  - Candesartan and acute liver injury.

PMID- 11214792
TI  - Microbiology of the 'G-bacteria' in activated sludge.
AB  - This review discusses a group of bacteria, the 'G-bacteria', which have a
      distinctive morphology of cocci in tetrads, sheets or clusters, that are seen in
      large numbers in many activated sludge biomass samples. Isolates of 'G-bacteria'
      that have been grown axenically are phylogenetically diverse. The Gram-negative
      members include several alpha- and beta-proteobacteria, among which is the genus
      Amaricoccus, while the Gram-positive 'G-bacteria' contain several members of the
      actinobacteria. It is probable that other, as yet uncharacterized, 'G-bacteria'
      exist in activated sludge. The hypothesis that these 'G-bacteria' are detrimental
      to the process of enhanced biological phosphate removal by competing for
      substrates anaerobically with the phosphate-accumulating bacteria in such
      systems, based as it is largely on mixed-culture studies, receives little support
      from studies using those available in pure culture. The evidence on which these
      conclusions are founded is discussed, as are the arguments used to explain why
      these 'G-bacteria' all appear to thrive under conditions found in certain
      activated sludge systems.

PMID- 11214791
TI  - Prolonged sedation due to an accumulation of midazolam in an intensive care
      patient with hypothyroidism.

PMID- 11214793
TI  - Population genetics of Escherichia coli in a natural population of native
      Australian rats.
AB  - Escherichia coli, a normal inhabitant of the intestinal tract of mammals and
      birds, is a diverse species. Most studies on E. coli populations involve
      organisms from humans or human-associated animals. In this study, we undertook a
      survey of E. coli from native Australian mammals, predominantly Rattus tunneyi,
      living in a relatively pristine environment in the Bundjalung National Park. The
      genetic diversity was assessed and compared by multilocus enzyme electrophoresis
      (MLEE), sequence analysis of the mdh (malate dehydrogenase) gene and biotyping
      using seven sugars. Ninety-nine electrophoretic types were identified from the
      242 isolates analysed by MLEE and 15 sequences from the mdh genes sequenced from
      21 representative strains. The Bundjalung isolates extend the diversity
      represented by the E. coli reference (ECOR) set, with new MLEE alleles found in
      six out of 10 loci. Many of the Bundjalung isolates fell into a discrete group in
      MLEE. Other Bundjalung strains fell into the recognized E. coli ECOR set groups,
      but tended to be at the base of both the MLEE and mdh gene trees, implying that
      these strains are derived independently from ancestral forms of the ECOR groups
      and that ECOR strains represent only a subset of E. coli adapted to humans and
      human-associated animals. Linkage disequilibrium analysis showed that the
      Bundjalung population has an 'epidemic' population structure. The Bundjalung
      isolates were able to utilize more sugars than the ECOR strains, suggesting that
      diet plays a prominent role in adaptation of E. coli.

PMID- 11214794
TI  - Isolation and characterization of a chromium-reducing bacterium from a chromated
      copper arsenate-contaminated site.
AB  - A Gram-negative bacterium (CRB5) was isolated from a chromium-contaminated site
      that was capable of reducing hexavalent chromium to an insoluble precipitate,
      thereby removing this toxic chromium species from solution. Analysis of the 16S
      rRNA from the isolate revealed that it was a pseudomonad with high similarity to
      Pseudomaonas synxantha. CRB5 was tolerant to high concentrations of chromate (500
      mg l(-1)) and can reduce Cr(VI) under aerobic and anaerobic conditions. It also
      exhibited a broad range of reduction efficiencies under minimal nutrient
      conditions at temperatures between 4 degrees C and 37 degrees C and at pH levels
      from 4 to 9. As reduction increased, so did total cellular protein, indicating
      that cell growth was a requirement for reduction. Under low nutrient conditions
      with CRB5 or when using non-sterile contaminated groundwater from the site,
      reduction of Cr(VI) was followed by a increase in solution turbidity as a result
      of the formation of fine-grained Cr(III) precipitates, most probably chromium
      hydroxide mineral phases such as Cr(OH)3. Chromium adsorption and precipitation,
      as observed by transmission electron microscopy coupled with energy dispersive X
      ray spectroscopy (TEM/EDS), revealed that the surfaces of the cells were
      uniformly stained with bound Cr(III) and amorphous precipitates (as determined by
      selected area electron diffraction; SAED). A mass balance of chromium in a batch
      bioreactor revealed that up to 30% of the total Cr was as settable precipitates
      or bound to cells.

PMID- 11214795
TI  - Variations in antibiotic resistance profile in Enterobacteriaceae isolated from
      wild Australian mammals.
AB  - We carried out a retrospective analysis of 946 strains of Enterobacteriaceae
      isolated from wild Australian mammals between 1993 and 1997. The prevalence of
      resistance to fixed concentrations of 32 antimicrobial agents was determined, and
      the respective roles that taxonomic family of the host, state of origin and
      bacterial species play in defining prevalence and range of resistance were
      investigated. Our results demonstrated a low but widespread prevalence of
      antimicrobial resistance in wild isolates. Only amikacin, ciprofloxacin,
      meropenem and gentamicin inhibited growth in all 946 samples. There was extensive
      variation in the combination of antibiotics to which isolates were resistant, and
      multiple antibiotic resistance was common. Geographical location and host group
      significantly influenced the antibiotic resistance profile of an isolate, whereas
      bacterial species influenced both the resistance profile of an isolate and the
      number of antibiotics it was resistant to. The role of these factors in
      determining observed antibiotic resistance profiles suggests that any study
      measuring resistance in wild isolates should include the broadest possible range
      of bacterial species, host species and sampling locations. As such, this study
      provides an important new baseline for future measurements of antibiotic
      resistance in the Australian environment.

PMID- 11214796
TI  - Comparison of microbial populations in model and natural rumens using 16S
      ribosomal RNA-targeted probes.
AB  - A model rumen system, dual-flow continuous culture fermenters, was evaluated by
      two comparative criteria in two experiments using ribosomal (r)RNA-targeted DNA
      probes to compare key microbial groups in samples. The initial experiment
      measured temporal changes in population structure during adaptation of ruminal
      microbial populations in fermenters over 240 h. The fermenter inoculum contained
      34.9% Bacteria, 60.1% Eukarya and 6.8% Archaea measured as a fraction of total
      small subunit (SSU) rRNA quantified using a universal probe. The cellulolytic
      bacterial genus Fibrobacter comprised 9.5% of total SSU rRNA in the inoculum.
      After 240 h of fermenter operation, the average abundance was 80.9% Bacteria,
      6.1% Eukarya, 5.1% Archaea and Fibrobacter genus accounted for 6.6% of the total
      SSU rRNA. Divergence between ruminal and fermenter population structure was
      evaluated in the second experiment and samples were classified as ruminal,
      inoculum or fermenter (96, 120, 144 and 168 h of fermenter operation). Fermenter
      samples had higher relative abundances of Bacteria (84.5%) and Archaea (2.1%) and
      lower relative abundances of Eukarya (1.8%) than ruminal samples (average 48.0%
      Bacteria, 1.3% Archaea and 61.5% Eukarya). The relative abundance of Fibrobacter
      was similar in all samples, averaging 2.5%. The ruminal and fermenter samples had
      similar proportions of F. succinogenes and F. succinogenes subgroup 3 (as a
      percentage of Fibrobacter SSU rRNA). Fibrobacter succinogenes subgroup 1 and F.
      intestinalis proportions of Fibrobacter were lower in fermenter samples (8.2% and
      0.7% respectively) than in ruminal samples (28.4% and 2.2% respectively).
      Fermenters were able to maintain a core prokaryotic community structure similar
      to the native microbial community in the rumen. Although protozoa populations
      were lost, maintenance of Fibrobacter and archaeal populations indicated that the
      model system supported a functional community structure similar to the rumen.
      This model rumen system may serve as a suitable tool for studying aspects of
      ruminal microbial ecology and may resolve some of the relationships between
      microbial community structure and function by providing control of experimental
      conditions.

PMID- 11214797
TI  - Novel forms of ring-hydroxylating dioxygenases are widespread in pristine and
      contaminated soils.
AB  - Ring-hydroxylating dioxygenases (RHDs) are of central importance to bacterial
      recycling of aromatic hydrocarbons, including anthropogenic pollutants. The
      database of presently characterized RHDs is biased towards those from organisms
      readily isolated on anthropogenic substrates. To investigate the extent to which
      RHDs from extant organisms reflect the natural diversity of these enzymes, we
      developed a polymerase chain reaction (PCR) method for retrieval of RHD gene
      fragments from environmental samples. Gene libraries from two contaminated and
      two pristine soil samples were constructed. None of the inferred peptides from
      clones examined were identical to previously described RHDs; however, all showed
      significant sequence homology and contained key catalytic residues. On the basis
      of sequence identity, the environmental clones clustered into six distinct
      groups, only one of which included known RHDs. One of the new sequence groupings
      was particularly widespread, being recovered from all soil samples tested.
      Comparison of inferred peptide sequences of the environmental clones and known
      RHDs showed the former to have greater sequence variation at sites thought to
      influence accessibility of the active site than that seen between currently known
      RHDs. We conclude that presently characterized RHDs do not adequately represent
      the diversity of function found in in situ forms.

PMID- 11214798
TI  - Bacterial chromosomal painting for in situ monitoring of cultured marine
      bacteria.
AB  - We previously described a new method, bacterial chromosomal painting (BCP), for
      the in situ identification of bacterial cells. Here, we describe the application
      of this technique to study the ecology and physiology of cultured marine pelagic
      bacteria from the western Sargasso Sea (WSS). A total of 86 bacteria were
      isolated from seawater collected from near the surface, at a depth of 250 m and
      from nutrient-amended seawater incubations. The 10 bacterial isolates that were
      best represented in environmental genomic DNA from the WSS were selected using
      reverse genome probing. BCP hybridization cell counts were used to determine the
      depth-specific distribution of one of the alpha proteobacterial isolates, B5-6,
      in the WSS during two thermal stratification regimes: stratified and partially
      mixed. The maximum cell count measured for B5-6 at the summer deep chlorophyll
      maximum was approximately 4% of the total cell count. This study is the first
      application of BCP to natural environments.

PMID- 11214799
TI  - Effects of O2 and CH4 on presence and activity of the indigenous methanotrophic
      community in rice field soil.
AB  - The activity and distribution of methanotrophs in soil depend on the availability
      of CH4 and O2. Therefore, we investigated the activity and structure of the
      methanotrophic community in rice field soil under four factorial combinations of
      high and low CH4 and O2 concentrations. The methanotrophic population structure
      was resolved by denaturant gradient gel electrophoresis (DGGE) with different PCR
      primer sets targeting the 16S rRNA gene, and two functional genes coding for key
      enzymes in methanotrophs, i.e. the particulate methane monooxygenase (pmoA) and
      the methanol dehydrogenase (mxaF). Changes in the biomass of type I and II
      methanotrophic bacteria in the rice soil were determined by analysis of
      phospholipid-ester-linked fatty acid (PLFA) biomarkers. The relative contribution
      of type I and II methanotrophs to the measured methane oxidation activity was
      determined by labelling of soil samples with 14CH4 followed by analysis of [14C]
      PLFAs. CH4 oxidation was repressed by high O2 (20.5%), and enhanced by low O2
      (1%). Depending on the CH4 and O2 mixing ratios, different methanotrophic
      communities developed with a higher diversity at low than at high CH4
      concentration as revealed by PCR-DGGE. However, a prevalence of type I or II
      populations was not detected. The [14C]-PLFA fingerprints, on the other hand,
      revealed that CH4 oxidation activity was dominated by type I methanotrophs in
      incubations with low CH4 mixing ratios (1000 p.p.m.v.) and during initiation of
      CH4 consumption regardless of O2 or CH4 mixing ratio. At high methane mixing
      ratios (10 000 p.p.m.v.), type I and II methanotrophs contributed equally to the
      measured CH4 metabolism. Collectively, type I methanotrophs responded fast and
      with pronounced shifts in population structure and dominated the activity under
      all four gas mixtures. Type II methanotrophs, on the other hand, although
      apparently more abundant, always present and showing a largely stable population
      structure, became active later and contributed to CH4 oxidation activity mainly
      under high CH4 mixing ratios.

PMID- 11214800
TI  - Microenvironments and distribution of nitrifying bacteria in a membrane-bound
      biofilm.
AB  - The distribution of nitrifying bacteria of the genera Nitrosomonas, Nitrosospira,
      Nitrobacter and Nitrospira was investigated in a membrane-bound biofilm system
      with opposed supply of oxygen and ammonium. Gradients of oxygen, pH, nitrite and
      nitrate were determined by means of microsensors while the nitrifying populations
      along these gradients were identified and quantified using fluorescence in situ
      hybridization (FISH) in combination with confocal laser scanning microscopy. The
      oxic part of the biofilm which was subjected to high ammonium and nitrite
      concentrations was dominated by Nitrosomonas europaea-like ammonia oxidizers and
      by members of the genus Nitrobacter. Cell numbers of Nitrosospira sp. were 1-2
      orders of magnitude lower than those of N. europaea. Nitrospira sp. were
      virtually absent in this part of the biofilm, whereas they were most abundant at
      the oxic-anoxic interface. In the totally anoxic part of the biofilm, cell
      numbers of all nitrifiers were relatively low. These observations support the
      hypothesis that N. europaea and Nitrobacter sp. can out-compete Nitrosospira and
      Nitrospira spp. at high substrate and oxygen concentrations. Additionally, they
      suggest microaerophilic behaviour of yet uncultured Nitrospira sp. as a factor of
      its environmental competitiveness.

PMID- 11214802
TI  - Antigen 43 facilitates formation of multispecies biofilms.
AB  - Antigen 43 (Ag43) is a surface-displayed autotransporter protein of Escherichia
      coli. By virtue of its self-association characteristics, this protein is able to
      mediate autoaggregation of E. coli cells in static cultures. Here, we show that
      Ag43 can be expressed in a functional form on the surface of Pseudomonas
      fluorescens. Ag43 expression dramatically enhances the biofilm-forming potential
      of both E. coli and P. fluorescens to abiotic surfaces in simple microtitre well
      assays and in flow chambers. Importantly, Ag43-expressing E. coli and P.
      fluorescens cells tagged with Gfp and Rfp were shown to form interwoven biofilms
      in flow chambers. The three-dimensional structures of the biofilms were analysed
      by laser-confocal microscopy. Heterogeneous expression of Ag43 induced
      interspecies cell-to-cell contact that generated multispecies biofilm formation.
      Our data indicate that this versatile molecular tool can be used for the rational
      design of multispecies biofilms. More specifically, this novel technology offers
      opportunities for the design of multispecies consortia in which the concerted
      action of several bacterial species is required, e.g. waste treatment and
      degradation of pollutants.

PMID- 11214801
TI  - Enhancing desulphurization by engineering a flavin reductase-encoding gene
      cassette in recombinant biocatalysts.
AB  - Biological desulphurization of petroleum feedstocks and products may offer an
      attractive alternative to reduce sulphur oxide emissions that cause serious
      environmental pollution. Dibenzothiophene (DBT) desulphurization via the Dsz
      pathway of Rhodococcus erythropolis IGTS8 is an energetically expensive process
      that consumes reducing equivalents. We have shown in this work that the HpaC
      oxidoreductase from Escherichia coli W is able to supply the required FMNH2 to
      the Dsz monooxygenases. The cloning and expression of the hpaC gene in
      Pseudomonas strains bearing the dszABC gene cluster significantly enhanced DBT
      desulphurization efficacy of the recombinant biocatalysts in a resting-cell
      process, thus indicating that overexpression of a heterologous flavin reductase
      in the host cell is critical for a high rate of sulphur removal in vivo. The hpaC
      and dszABC genes have been engineered as a single transcription unit under
      control of broadhost-range regulatory signals in a mobilizable DNA cassette that
      can be used to confer a DBT desulphurization phenotype to a wide variety of
      bacteria regardless of the expression of putative housekeeping flavin reductases
      within the host cells. This cassette will be very useful in exploring the
      biotechnological potential of novel biocatalysts for developing an efficient
      desulphurization process.

PMID- 11214803
TI  - Monitoring of Desulfitobacterium frappieri PCP-1 in pentachlorophenol-degrading
      anaerobic soil slurry reactors.
AB  - Anaerobic biodegradation of pentachlorophenol (PCP) was studied in rotative
      bioreactors containing 200 g of PCP-contaminated soil and 250 ml of liquid
      medium. Reactors were bioaugmented with cells of Desulfitobacterium frappieri
      strain PCP-1, a bacterium able to dehalogenate PCP to 3-chlorophenol. Cells of
      strain PCP-1 were detected by quantitative PCR for at least 21 days in reactors
      containing 500 mg of PCP per kg of soil but disappeared after 21 days in reactors
      with 750 mg of PCP per kg of soil. Generally, PCP was completely removed in less
      than 9 days in soils contaminated with 189 mg of PCP per kg of soil. Sorption of
      PCP to soil organic matter reduced its toxicity and enhanced the survival of
      strain PCP-1. In some non-inoculated reactors, the indigenous microorganisms of
      some soils were also able to degrade PCP. These results suggest that anaerobic
      dechlorination of PCP in soils by indigenous PCP-degrading bacteria, or after
      augmentation with D. frappieri PCP-1, should be possible in situ and ex situ when
      the conditions are favourable for the survival of the degrading microorganisms.

PMID- 11214804
TI  - Web alert. Thermophilic bacteria.

PMID- 11214805
TI  - Sample selection bias, is misleading.

PMID- 11214806
TI  - Treatment practices for childhood posttraumatic stress disorder.
AB  - OBJECTIVE: This study surveyed practices in treating childhood PTSD among child
      psychiatrists and non-M.D. therapists with self-identified interest in treating
      traumatized children. METHOD: An anonymous survey was mailed to 207 child
      psychiatrists ("medical") and 460 nonphysician ("non-medical") therapists
      inquiring about current interventions used to treat children with PTSD. RESULTS:
      Two hundred and forty-seven responses were received: of 77 medical and 82
      nonmedical respondents who currently treat children with PTSD, a wide variety of
      modalities are used. Most preferred modalities among medical responders were
      pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred
      modalities among nonmedical respondents were cognitive-behavioral, family, and
      nondirective play therapy. Ninety-five percent of medical respondents used
      pharmacotherapy for this disorder; most preferred medications to treat childhood
      PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists.
      Several significant differences between medical and nonmedical practices were
      identified. CONCLUSIONS: There is little clinical consensus regarding the
      effectiveness of the many modalities used to treat traumatized children who have
      PTSD symptoms; empirical research is particularly needed to evaluate the efficacy
      of pharmacotherapy and EMDR.

PMID- 11214807
TI  - Play and social skills in maltreated and non-maltreated preschoolers during peer
      interactions.
AB  - OBJECTIVE: The goal of the study was to investigate whether maltreated children
      differ from nonmaltreated children with regard to their social skills and play
      behaviors. METHOD: The social skills and free-play behaviors of 30 3- to 5-year
      old maltreated and nonmaltreated children were compared. Fifteen children with a
      range of maltreatment experiences drawn from a hospital-based therapeutic nursery
      treatment program and 15 demographically similar children drawn from a home-based
      Head Start program participated in the study. All children were of low
      socioeconomic status. Children's free-play peer interactions were videotaped
      during the first 3 months of attendance in either program and analyzed along
      social and cognitive dimensions. Teachers and therapists rated children's social
      skills in peer interactions. RESULTS: Maltreated children were found to have
      significantly poorer skill in initiating interactions with peers and maintaining
      self-control, as well as a greater number of problem behaviors. Significant
      differences were not found between groups with regard to social participation or
      cognitive level of play. Significant correlations of moderate strength were found
      between social participation in play and social skills for the sample as a whole:
      total social skills score was positively related to interactive play, and
      negatively related to solitary play. CONCLUSION: The results suggest that the
      experience of maltreatment has a negative impact on children's developing
      interpersonal skills above and beyond the influence of factors associated with
      low socioeconomic status and other environmental stressors.

PMID- 11214808
TI  - Childhood sexual abuse, adolescent sexual coercion and sexually transmitted
      infection acquisition among homeless female adolescents.
AB  - OBJECTIVE: To examine the relationship between childhood experiences of sexual
      abuse, sexual coercion during adolescence, and the acquisition of sexually
      transmitted infections (STIs) in a population of homeless adolescents. METHOD:
      Homeless adolescent females (N = 216) from a northwestern United States city were
      recruited by street outreach workers for a longitudinal study of STI
      epidemiology. Baseline data on childhood abuse and recent history of sexual
      coercion were used to predict physiologically confirmed STI acquisition over the
      subsequent 6 months. RESULTS: About 38% of all girls reported a history of
      childhood sexual abuse (CSA). Girls with a history of CSA were more likely to
      report recent sexual coercion. In turn, sexual coercion in the last three months
      was significantly associated with a higher number of sexual partners (but not
      with a greater frequency of intercourse or with lower rates of condom use).
      Number of sexual partners significantly predicted the future acquisition of an
      STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors
      in homeless adolescent females may need to consider the impact of CSA,
      particularly on the number of sexual partners during adolescence. However, it
      also should be noted that engagement in intercourse often results from coercion
      and is not voluntary in this population.

PMID- 11214809
TI  - Examining child sexual abuse evaluations: the types of information affecting
      expert judgment.
AB  - OBJECTIVE: There were two aims: First, to determine to what extent four
      variables, disclosure, doll play, affect and collateral information, affect the
      decision-making processes of child sexual abuse experts and lay persons when
      confronted with an abuse allegation, and second, to see how these two groups of
      raters might differ from one another. METHOD: A randomized block partially
      confounded factorial design was used. Participants made abuse likelihood and
      confidence ratings in response to six hypothetical cases of child sexual abuse,
      four of which had varying combinations of the four types of information and two
      of which were constant across all raters. Participants also completed attitudes
      and knowledge questionnaires. RESULTS: Disclosure and collateral information both
      had large effects on both rater groups. Doll play and affect had little or no
      effect on the decisions of either group. Experts were slightly more conservative
      in their judgments over all than students were. Experts also displayed more
      knowledge of the sexual abuse literature and more child-believing attitudes than
      their student counterparts. CONCLUSION: Concrete information such as disclosure
      statements and collateral information affected abuse decisions while inferential
      data such as doll play and affect did not. The goal of these evaluations may be
      the clarification of such concrete information and the inferential data may be
      used only to guide one's inquiry. This conclusion argues against the concern that
      experts might jump to conclusions of abuse merely based upon suggestive, symbolic
      material.

PMID- 11214810
TI  - Factors predicting PTSD, depression, and dissociative severity in female
      treatment-seeking childhood sexual abuse survivors.
AB  - OBJECTIVE: Two main questions were asked: (1) what abuse characteristics relate
      to PTSD, depressive, and dissociative severity in adult survivors of child sexual
      abuse (CSA); and (2) what abuse characteristics influence the severity of
      dissociation during CSA. METHOD: 89 female CSA survivors' current symptoms of
      PTSD, depression, and dissociation were assessed with standardized measures.
      Additionally, abuse characteristics (e.g., age of onset, peritraumatic
      dissociation) were assessed with a structured interview. RESULTS: Correlational
      analyses indicated that peritraumatic dissociation was most strongly related to
      all three types of symptom severity. Additional posthoc correlational analyses
      revealed that women who experienced penile penetration, believed someone/thing
      else would be killed, and/or were injured as a result of the abuse exhibited more
      severe peritraumatic dissociation. Regression analyses indicated that
      peritraumatic dissociation was the only variable to significantly predict symptom
      severity across symptom type or disorder. Furthermore, different abuse
      characteristics predicted adult symptom severity and peritraumatic dissociation.
      CONCLUSIONS: The relation between peritraumatic dissociation and adult
      symptomatology was most intriguing and has two main clinical implications: (1)
      teaching engagement strategies to some CSA survivors in hopes of containing
      dissociative symptoms immediately following the abuse and (2) the inclusion of
      exposure-based interventions in the treatment of some adult CSA survivors where
      indicated.

PMID- 11214811
TI  - Perceived and actual academic competence in maltreated children.
AB  - OBJECTIVE: The aims were twofold: 1) to determine whether maltreated and
      nonmaltreated children differed in the accuracy of their self-assessments of
      academic achievement; and 2) to determine whether discrepancies between perceived
      and actual academic competence were related to perceptions of social support from
      mothers, teachers, and peers. METHOD: A sample of 195 maltreated children known
      to a state protective service agency was compared to a control group of 179
      nonmaltreated children. The groups were matched on child's gender, age,
      ethnicity, and birth order; socioeconomic ranking of neighborhood; and family
      structure. RESULTS: Although maltreated children had significantly lower
      achievement scores than did nonmal-treated children, the two groups did not
      differ on perceived academic competence. With regard to discrepancies between
      perceived and actual competence, maltreated children were more likely than
      nonmaltreated children to overestimate their level of competence, particularly
      for reading and arithmetic. Overall, children who reported low maternal support
      were more likely to overestimate reading competence than were those who reported
      average or high maternal support. When maltreatment status was considered,
      maltreated children with low support seemed likely to overestimate abilities,
      whereas nonmaltreated children with low support seemed likely to underestimate
      competence. CONCLUSIONS: Maltreated children may overestimate their academic
      abilities in order to compensate for self-perceptions of low self-worth. Efforts
      to improve academic performance in maltreated children should focus not only on
      increasing academic skills but also on enhancing self-esteem.

PMID- 11214812
TI  - Parental features and quality of life in the decision to remove children at risk
      from home.
AB  - OBJECTIVES: The study examined the associations between the decisions of child
      protection officers to remove children at risk from home and a) the features of
      the children's parents and b) the quality of life the parents make it possible
      for their children to have. METHOD: 194 child protection workers completed a
      parental features questionnaire, child injury questionnaire, and Shye's Systemic
      Quality of Life Questionnaire on two children, one removed from home, the other
      remained. RESULTS: Parental cooperation with the worker, relationship with the
      child, addiction, and cleanliness were related to both the decision and the
      assessment of enabling quality of life. Parents' poverty, criminality,
      psychological problems, and cognitive impairment were related only to the workers
      assessment of parents enabling quality of life. Family status was related only to
      the decision. While injury to the child was associated with the decision, it
      added virtually nothing to the explanation of the decision beyond parental
      features and enabling. CONCLUSIONS: The variables related to the workers'
      assessment of the parents' enabling overlapped only partially with those related
      to the decision. The parents' features and enabling made only a modest
      contribution to explaining the workers' decisions. The findings suggest that the
      quality of life measure used in this study encompasses injury.

PMID- 11214813
TI  - Patterns of interactions in multidisciplinary child protection teams in New
      Jersey.
AB  - OBJECTIVE: The objective of this study was to gain an understanding of how
      multidisciplinary team members in child protection worked together within the
      team, meeting to provide assessments of, and services to, children and families.
      METHOD: Fifteen multidisciplinary child-protection teams in New Jersey were
      observed during one meeting of each team. The interaction among team members was
      recorded and analyzed using a structured observation method, Bales' Interaction
      Process Analysis. RESULTS: There was a wide variation in participation among team
      members, with some contributing nothing to the meeting and others contributing a
      great deal. In some teams, participation by members was more equal than others.
      Some professional groups and agencies contributed very little to any meeting
      while others contributed a great deal to many meetings. CONCLUSIONS:
      Professionals are members of multidisciplinary teams because they are expected to
      contribute to the investigation of child maltreatment cases and to the planning
      for further work with cases. However, the findings from this study suggest that
      there is a considerable degree of inequality in levels of participation in
      multidisciplinary meetings. It is particularly noticeable that staff from the
      prosecutor's offices participate in every meeting and either the agency as a
      whole or individual members of it dominate many of the meetings.

PMID- 11214814
TI  - Sample selection bias and racial differences in child abuse reporting: once
      again.

PMID- 11214815
TI  - Child abuse reporting: teachers' perceived deterrents.
AB  - OBJECTIVE: There are three general objectives: First, to determine the number of
      reports of abuse made by teachers, their knowledge of child abuse laws and
      reporting procedures, and their perceived deterrents in reporting abuse; second,
      to determine if there were gender or ethnic differences in reporting; and third,
      to evaluate teachers responses to case vignettes. METHOD: A survey of 197
      teachers was conducted. They were given a questionnaire that included demographic
      information, knowledge of child abuse laws and procedures, and two scenarios of
      legally reportable child abuse. RESULTS: Seventy-three percent of this sample
      reported that they had never made a report of child abuse, while those who had
      made reports made an average of one report. Only 11% of teachers reported that
      there were instances in which they believed abuse may have occurred, but failed
      to report. Additionally, these teachers felt that their pre- and post-service
      training did not adequately prepare them for abuse reporting. The most common
      reasons cited for not reporting abuse were fear of making an inaccurate report,
      feeling as though child protective services do not help families, and no apparent
      physical signs of abuse. There were no gender differences in reporting. The
      teachers' responses to the case vignettes were not consistent with their previous
      reports. CONCLUSIONS: In general, most teachers reported having never made a
      child abuse report. Although only a small percentage of teachers reported failing
      to report abuse, when presented with legally reportable case vignettes, many
      failed to report. The majority of teachers report receiving inadequate training
      in child abuse signs, symptoms, and reporting procedure. There is an obvious need
      for more education for teachers that addresses their perceived deterrents and
      aids them in feeling more confident in making reports of child abuse.

PMID- 11214816
TI  - Childhood physical abuse, early social support, and risk for maltreatment:
      current social support as a mediator of risk for child physical abuse.
AB  - OBJECTIVE: The study investigated whether perceptions of social support in
      adulthood partially mediated the associations between childhood experiences
      (i.e., receipt of physical abuse and levels of early social support) and adult
      risk for child physical abuse. METHOD: Participants included 598 general
      population adults who completed self-report measures designed to assess childhood
      physical abuse, perceptions of early and current social support, and risk factors
      for child physical abuse. Structural equation modeling was used to test and cross
      validate a model that included the direct effects of child physical abuse and
      early social support on child physical abuse risk, as well as mediated effects
      through an influence on adult perceptions of social support. RESULTS: Childhood
      physical abuse and early social support covaried, such that receipt of physical
      abuse was associated with lower levels of perceived early social support. Early
      support, but not child physical abuse, had an indirect effect (i.e., through
      current support) on child physical abuse risk. More specifically, levels of early
      support were directly related to adult perceptions of support, and adult
      perceptions of support were inversely associated with child physical abuse risk.
      Childhood physical abuse was directly related to child physical abuse risk.
      CONCLUSIONS: Low levels of early support may impact risk for child physical abuse
      by affecting perceptions of others as supportive in adulthood. The receipt of
      physical abuse in childhood, however, does not appear to impact perceptions of
      support in adulthood. Research is needed to identify additional factors that may
      explain the association between receipt of physical abuse in childhood and
      increased risk of child physical abuse in adulthood.

PMID- 11214817
TI  - Sexual behavioural risks of married men in Oyo State, Nigeria.

PMID- 11214818
TI  - SM5-1: a new monoclonal antibody which is highly sensitive and specific for
      melanocytic lesions.
AB  - Antibodies such as HMB-45 and anti-S100 protein have been widely used as markers
      of malignant melanoma despite evidence that HMB-45 has a sensitivity of only 67
      93% and S100 is nonspecific for melanoma. Using a subtractive immunization
      protocol in a mouse model of human melanoma, we have generated several monoclonal
      antibodies with putative specificity for melanoma. After initial screenings, the
      antibody SM5-1 was chosen because of its intriguing reactivity with melanocytic
      tumors in both frozen and paraffin sections. The immunohistochemical staining of
      SM5-1 was studied in paraffin-embedded specimens of 401 melanomas (n = 401; 250
      primary melanomas, 151 metastases), melanocytic nevi of the skin (n = 16),
      nonmelanocytic neoplasms (n = 84). The results were compared with HMB-45 and anti
      S100 staining. All antibodies reacted with nevi and 97-99% with primary
      melanomas. Whereas both SM5-1 and anti-S100 stained 96% (146/151) of melanoma
      metastases, HMB-45 correctly identified only 83% (126/151). All HMB-45-negative
      metastases were positive for SM5-1. Whereas neither SM5-1 nor HMB-45 stained any
      of 84 specimens from 40 different nonmelanocytic neoplasms, anti-S100 was
      positive in 21/84 (25%). While the staining pattern of SM5-1 was mostly
      homogeneous, small tumor areas in some metastases remained unstained. Staining
      with SM5-1 was also observed in perivascular dendritic cells, in plasma cells,
      some myofibroblasts and the secretion of eccrine sweat glands. Nonactivated
      epidermal melanocytes, keratinocytes, endothelial cells, smooth muscle cells and
      peripheral nerves were all negative for SM5-1. These results suggest that SM5-1
      is highly specific, as well as sensitive, for melanocytic lesions and is useful
      in the immunohistochemical evaluation of melanoma.

PMID- 11214819
TI  - Involvement of insulin-like growth factor-I in psoriasis as a paracrine growth
      factor: dermal fibroblasts play a regulatory role in developing psoriatic
      lesions.
AB  - To investigate the contribution of dermal fibroblasts to the development of
      psoriasis, we examined the expression of mRNA for insulin-like growth factor-I
      (IGF-I) and its regulator IGF-I binding proteins (IGFBPs) in psoriatic
      fibroblasts by RT-PCR. We also studied the effect of inflammatory cytokines
      including interferon gamma (IFN-gamma), tumor necrosis factor alfa (TNF-alpha),
      and IFN-alpha on the expression of IGF-I and IGFBPs in the fibroblasts.
      Semiquantitative analysis revealed that IGF-I mRNA expression in psoriatic
      fibroblasts (PF) was significantly higher than in control fibroblasts (CF).
      However, no significant difference in IGF-I mRNA was shown between nonlesional
      psoriatic fibroblasts (NF) and CF. Treatment with IFN-alpha in vitro upregulated
      IGF-I mRNA in PF and in CF. TNF-alpha appeared to downregulate IGF-I mRNA in PF
      but had no effect on CF. IFN-gamma did not show a significant effect on IGF-I
      mRNA levels in any type of fibroblast. IGFBP-3 mRNA was expressed equally in PF
      and CF, and was not affected by cytokines. The expression of IGFBP-5 mRNA in PF
      was downregulated by IFN-gamma and TNF-alpha. Taken together, these results
      indicate that dermal fibroblasts may contribute to the epidermal hyperplasia of
      psoriasis by promoting keratinocyte proliferation through IGF-I, whose secretion
      could be modulated by inflammatory cytokines.

PMID- 11214820
TI  - Role of androgens in female-pattern androgenetic alopecia, either alone or
      associated with other symptoms of hyperandrogenism.
AB  - The roles of androgen hypersecretion, in situ enzyme activity, and androgen
      receptors in androgenetic alopecia in women are still a matter of debate. We
      studied 187 women with alopecia, which we graded I, II, or III, according to
      Ludwig's classification, and 21 healthy control women. All participants were
      subjected to full basal and 1 h post-beta-1-24 corticotropin stimulation
      endocrine profiles. Abnormal hormone profiles were observed in 67% of the
      patients with alopecia alone (group A, n = 110) and in 84% of the patients with
      alopecia plus other symptoms of hyperandrogenism including acne, hirsutism, and
      menstrual cycle disturbances (group B, n = 77). Mean serum 5alpha-androstane
      3alpha,17beta-diol glucuronide (3alpha-AdiolG) levels in all three patient groups
      (6.50+/-4.10, 8.90+/-5.80, and 14.70+/-8.90 nmol/l, respectively) correlated with
      the grade of alopecia (I-III) and were significantly higher than in the control
      group (4.80+/-2.05 nmol/l, P < 0.005). Mean serum sex hormone-binding globulin
      (SHBG) levels were inversely correlated with the grade of alopecia (I-III) and
      were significantly lower in all three patient groups (50.55+/-23.50, 40.00+/
      17.65, and 38.80+/-14.10 nmol/l, respectively) than in the control group (61.15+/
      17.65 nmol/l, P < 0.05). Mean serum levels of delta4-androstenedione,
      dehydroepiandrosterone, dehydroepiandrosterone sulfate, and 3alpha-AdiolG were
      higher in group B than in group A, and higher in group A than in the control
      group. The significant correlations found between adrenal secretion - either
      positive (with 3alpha-AdiolG levels and the body mass index) or negative (with
      SHBG levels) - might reflect the important contribution of secretory and
      metabolic components in the development of alopecia, the severity of which has
      been shown to be very closely related to observed levels of two of these
      parameters (3alpha-AdiolG and SHBG).

PMID- 11214821
TI  - Functional analysis of the stratum corneum of scalp skin: studies in patients
      with alopecia areata and androgenetic alopecia.
AB  - Because of the presence of thick long hairs on the scalp, little information is
      available concerning the functional characteristics of the stratum corneum (SC)
      of scalp skin. We therefore conducted a functional study of the SC of lesional
      scalp skin of patients with alopecia areata and of patients with androgenetic
      alopecia. We compared the scalp with the cheek and the flexor surface of the
      forearm (volar forearm). The water barrier function of the scalp SC of both
      patient groups, in terms of transepidermal water loss (TEWL), was almost
      comparable to that of the volar forearm, and was far better than that of facial
      skin. However, hydration of the scalp skin surface, as evaluated by measurement
      of high-frequency conductance, was markedly higher than that of facial skin, and
      showed significantly higher values than the volar forearm. These characteristics
      seem to be dependent, at least to some extent, on the amount of sebum-derived
      skin surface lipids because these were abundant on the scalp skin. Moreover,
      removal of skin surface lipids led to a significant decrease in skin surface
      hydration. The superficial corneocytes, the size of which reflects the
      proliferative activity of the epidermis, were substantially smaller on the scalp
      than on the volar forearm but significantly larger than on the cheek. These
      findings suggest that the rate of turnover of the scalp epidermis is intermediate
      between that of the facial and volar forearm epidermis. We conclude that the SC
      of the scalp skin in humans is functionally distinct from that of the face and
      extremities.

PMID- 11214822
TI  - Biological effects and metabolism of 9-cis-retinoic acid and its metabolite 9,13
      di-cis-retinoic acid in HaCaT keratinocytes in vitro: comparison with all-trans
      retinoic acid.
AB  - 9-cis-Retinoic acid (9cRA), a geometric isomer of all-trans-retinoic acid (atRA),
      is an endogenous high-affinity ligand for retinoid X receptors and retinoic acid
      receptors activating them with high potency. 9,13-di-cis-Retinoic acid (9,13dcRA)
      has been described as a major plasma metabolite of 9cRA. In this study, the
      biological activity and the metabolism of 9cRA and 9,13dcRA were investigated and
      compared with those of atRA in a retinol-free culture system of HaCaT
      keratinocytes. 9cRA exhibited a slightly weaker activity overall than atRA in
      inhibiting cell proliferation, inducing cellular retinoic acid binding protein II
      (CRABP II) mRNA levels and upregulating cytokeratin 19 expression. 9,13dcRA
      regulated HaCaT keratinocyte activity only at the highest concentration tested
      (10(-6) M). In cultures of HaCaT keratinocytes with atRA and 9cRA, rapid
      intracellular accumulation of atRA was observed within 2 h, and atRA levels were
      higher with atRA treatment than with 9cRA treatment. 9,13dcRA remained relatively
      stable in the medium with intracellular 9,13dcRA levels below the level of
      detection. Taken together, 9cRA seems to be slightly less potent than atRA in
      regulating the biological activity of HaCaT keratinocytes, while its metabolite
      9,13dcRA is effectively inactive at biologically relevant concentrations. Our
      data suggest a prodrug/drug relationship between 9cRA and atRA in human
      keratinocytes. 9,13dcRA seems to be a weaker prodrug of atRA or an inactive
      metabolic derivative.

PMID- 11214823
TI  - N-acetylcysteine downregulates vascular endothelial growth factor production by
      human keratinocytes in vitro.
AB  - The present study was designed to evaluate the action of various antioxidants
      including N-acetylcysteine (NAC) and the flavonoids resveratrol and quercetin on
      the production of VEGF by human keratinocytes (HKC). NAC, resveratrol, and
      quercetin dose-dependently suppressed the incorporation of 3H-thymidine into HKC.
      Values of median inhibitory concentration for NAC, resveratrol, and quercetin
      were 10 mM, 55 microM, and 15 microM, respectively (P < 0.01). RT-PCR
      demonstrated VEGF 121 and VEGF 206 expression in all HKC samples. HKC showed
      baseline expression and a progressive gradual time-dependent increase in VEGF
      secretion (510+/-75 pg/ml at 24 h), and EGF (2.5-100 ng/ml) enhanced the
      secretion of VEGF in a dose-dependent fashion. HKC were incubated with NAC (2.5
      20 mM) for 2 h prior to the addition of EGF (5 ng/ml) or PMA (10 ng/ml), and a
      significant decrease (P < 0.01) was found after 24 h of incubation with 2.5 mM
      NAC. However, neither resveratrol nor quercetin reduced the synthesis of this
      cytokine. In summary we conclude that NAC and the flavonoid antioxidants
      resveratrol and quercetin inhibit HKC proliferation regardless of the stage of
      differentiation and that NAC significantly inhibits VEGF secretion in basal and
      EGF- or PMA-treated HKC.

PMID- 11214824
TI  - The patterns of late deterioration in patients with transitional
      lipomyelomeningocele.
AB  - INTRODUCTION: Tethering is assumed to be the primary cause of deterioration seen
      in children with transitional lipomyelomeningocele as they age. The inevitability
      of deterioration has led to recommendations for prophylactic interventions to
      stabilize or prevent further clinical deterioration. OBJECTIVE: Determine the
      frequency and patterns of functional deterioration observed after successful
      untethering in patients with transitional lipomyelomeningocele and compare
      functional outcomes with what is known regarding untreated patients. METHODS:
      Fifty patients having transitional LMMC, treated at a single institution and
      followed in a multidisciplinary clinic were retrospectively reviewed to determine
      their clinical status prior to untethering, and the time to development of new
      symptoms or signs following untethering. RESULTS: 82% of patients were diagnosed
      and 78% underwent untethering prior to one year of age. All patients had a
      cutaneous lumbosacral lipoma, 22 patients were considered normal at presentation
      and 28 showed abnormalities on clinical examination. Forty-nine patients were
      untethered successfully and all were available for follow-up ranging from 2 to
      138 months (mean 39 months). Acute morbidity was limited to transient neurogenic
      bladder dysfunction and minor wound complications. Late clinical deterioration
      occurred in the majority of patients. Orthopedic and neurological deterioration
      occurred over the first 60 months following untethering and urological
      deterioration occurred thereafter. CONCLUSIONS: Functional loss after untethering
      is common and the pattern of loss is likely a reflection of the ability to detect
      abnormalities in this infant population. Untethering does not usually result in
      permanent acute morbidity, and does not prevent longer-term functional
      deterioration. The ratio of asymptomatic to symptomatic patients at follow-up in
      this operative series is similar to age-matched historical series of untreated
      patients.

PMID- 11214825
TI  - Prevalence of the Chiari/hydrosyringomyelia complex in adults with spina bifida:
      preliminary results.
AB  - AIM: To establish the prevalence of Chiari malformations and hydrocephalus (HS)
      in adults with spina bifida (SB). INTRODUCTION: Adults with SB have recently been
      shown to be at risk from significant deterioration arising from the C/HS complex.
      Little is known about the prevalence of these malformations in adulthood, their
      natural history, risk factors for deterioration and optimum management. MATERIALS
      AND METHODS: Patients are recruited from a clinic for adults with SB and
      hydrocephalus, routinely questioned about recent changes in neurological symptoms
      and a full neurological examination performed. Functional assessments include:
      Barthel Index; Nottingham EADL; Nine Hole Peg Test; 10 metre timed walk test.
      Sagittal T1 and TSE (turbo spin-echo) magnetic resonance images (MRI) of the
      cranio-cervical junction and spinal cord are obtained using a 1.0-T MRI system
      with a phased-array surface coil. Scans are reported blindly. RESULTS: 76
      patients have been assessed, 40 female, 36 male, mean age 27.5 years. Of these,
      48 (63.2%) have symptoms +/- signs compatible with C/HS, but only 18 (23.7%) have
      reported new, potentially relevant, neurological symptoms over the previous 12
      months. Of 25 patients undergoing MRI so far, 19 (76%) have had Chiari
      malformations and 12 (48%) have had HS. None of those with a negative scan have
      had signs/symptoms suggestive of the C/HS complex but a negative clinical
      evaluation has been unable to exclude such pathology. CONCLUSIONS: These early
      results suggest that the prevalence of the C/HS complex is high in adults with SB
      and cannot be predicted by neurological examination alone. Given past experience,
      the need for continued neurological follow up in a large proportion of the SB
      population throughout adulthood is likely to be essential.

PMID- 11214826
TI  - Can prognostic indicators be identified in a fetus with an encephalocele?
AB  - Encephaloceles, like other congenital malformations of the brain diagnosable in
      utero, can be either complicated (there being an associated chromosomal
      abnormality, abnormalities in the remainder of the central nervous system (CNS)
      and/or other organs), or isolated (no abnormalities in the chromosomes, the
      remainder of the CNS or other organs). Complicated cases invariably have a poor
      prognosis but amongst those with isolated lesions the outcome is variable with
      some affected children having poor mental and physical development but others who
      are only mildly or moderately disabled. To be able to make an informed decision
      about how to manage their pregnancy parents need to know what the prognosis is
      likely to be for their fetus with an encephalocele. To see if the necessary
      information could be reliably gathered by prenatal assessment of affected
      fetuses, a review was carried out of the medical records and ultrasound scans of
      31 fetuses with encephaloceles referred to the Fetal Management Unit at St.
      Mary's Hospital in Manchester between January 1991 and December 1997. Eighteen of
      the cohort were classified as having a complicated encephalocele. Thirteen of the
      pregnancies were terminated; there were three intrauterine deaths, and one
      neonatal death. There is only one surviving child who is severely disabled.
      Thirteen fetuses were classified as having isolated encephaloceles, six had a
      mass of neural tissue in the encephalocele sac and were terminated, one died in
      utero and six had a cystic lesion or only a nubbin and have survived with few or
      no abnormalities. This study has shown that it is possible to identify fetuses
      with an encephalocele with a favourable outcome.

PMID- 11214827
TI  - Day-care ultrasound avoids urodynamics.
AB  - BACKGROUND: Post-voiding residual urine is a common problem underlying urinary
      symptoms in many children often associated with infection. Tertiary referral is
      often made to exclude a neurological aetiology. This review reports the
      experience of clinician-performed ultrasound examinations in the Day-Care Unit on
      50 children during a 9-month period, with various aetiologies of urinary
      incontinence avoiding urodynamic studies in 34. METHODS: From March 1999 tertiary
      referral patients with urinary incontinence with or without infection and
      secondary referrals not responding to 'standard' management regimes, underwent
      clinician-performed bladder ultrasound scans in the day-care ward. A standard
      renal tract ultrasound examination had been reported as normal in 19 patients. In
      general referral had been made to exclude a neuropathic aetiology. In addition 5
      patients were studied who were known to have a neurogenic bladder, 3 with an
      anorectal anomaly, 3 were post cystoplasty and 2 had undergone surgery for
      ureteric reflux. RESULTS: In 34 patients it was considered that a urodynamic
      study had been avoided, while in one results from a urodynamic study were
      refuted. By means of directly visualising the bladder on real time scanning, 12
      children and families achieved a significantly better understanding of the
      relevance of residual urine in relation to symptoms, or were shown to have normal
      detrusor function (7), excluding a neuropathic aetiology. The three who had
      undergone cystoplasty were shown to have adequate bladder volumes in spite of
      persisting wetness. CONCLUSION: Real-time ultrasound examination of the bladder
      performed by a clinician in a patient-friendly environment (day-care ward) can
      provide significant information regarding detrusor function, often avoiding
      urodynamic studies. The test does not replace formal scanning for anomalies but
      may provide information that is masked by the more rigid environment of a
      radiology department, sometimes correcting results from standard urodynamic
      studies.

PMID- 11214828
TI  - Decision-making for a successful bowel continence program.
AB  - Bowel continence is one of the most difficult challenges for patients with spina
      bifida. Incontinence acts as a social stigma for children and a barrier for
      adults seeking employment. We present an algorithm for stepwise decision-making
      in construction of personalized continence programs for greater likelihood of
      success. The protocol contains 13 assessment points including; stool consistency,
      frequency and amount; mobility; level of paraplegia: diet; medication;
      anal/rectal canal tone; prior programs attempted; family routines; age;
      accessibility; and learning issues. Based on outcomes of these assessments, an
      individualized bowel program is constructed. The algorithm helps the practitioner
      and patient decide on components and indicators of a successful continence
      program. The recommended program might include timed toileting, suppository,
      continence enema, and ACE procedure, or a combination. Evaluation and patient
      education address adequate fluid/fiber, appropriate toileting equipment, and use
      of stool softeners/laxatives. Descriptions are available. Key elements in
      monitoring a continuing plan for continence include: the degree of constipation
      and its etiology; changing age; family availability for assistance until
      interdependence is optimal; wheelchair accessibility of the toilet; and ability
      to transfer to and from the toilet. Use of the algorithm allows for careful
      decision-making based on information from the patient and family. This has led to
      greater success in bowel continence in children with spina bifida.

PMID- 11214829
TI  - Why do adults with spina bifida and hydrocephalus die? A clinic-based study.
AB  - AIM: To establish the death rate and factors contributing to death among
      attenders at a clinic for adults with spina bifida and hydrocephalus (CASBAH).
      INTRODUCTION: Due to improvements in medical care in the past 40 years,
      increasing numbers of spina bifida patients go on to prosper in adult life.
      Despite this, levels of morbidity are high and services for such patients are
      uneven and unpredictable. MATERIALS AND METHODS: Since 1990 there has been a
      CASBAH service in Belfast operating on a regional basis. Led by a consultant in
      rehabilitation medicine, it provides a multidisciplinary approach to patient
      care. Between 1990 and 1999 there have been 280 referrals to the clinic. Charts
      were reviewed regarding current health status and mode of death where relevant.
      RESULTS: There have been 18 deaths during the term of the clinic (6.4%). There
      were four deaths due to renal failure and two due to cardiac failure. Two deaths
      occurred following surgery for a Chiari/hydrosyringomyelia complex and one
      patient died due to shunt malfunction. Three deaths were presumed related to
      infection. Two deaths were attributable to malignancy (carcinoma of a renal
      conduit and transitional cell carcinoma of the kidney) and other terminal events
      in one patient each were: basilar artery aneurysm rupture, post-partum pulmonary
      embolism, peptic ulcer disease, myocardial infarction and status epilepticus.
      CONCLUSIONS: Although certain deaths were unpredictable during the period of
      review and not directly attributable to spina bifida, the majority reflect many
      of the related secondary health issues of the condition and indicate the need for
      organised, medically co-ordinated follow-up of adult patients.

PMID- 11214830
TI  - Longevity of patients born with myelomeningocele.
AB  - There are limited data concerning the life expectancy for individuals born with
      myelomeningocele (MM), with and without hydrocephalus. To ascertain such data was
      our first purpose. We have selected all patients with MM in our computer
      database, The Patient Data Management System (PDMS/fx). Data were transferred to
      Excel for primary and SPSS/PC for final analysis by Kaplan-Meier life survival
      curves. Of the 1,054 patients with MM in the Birth Defects Clinic and the
      University of Washington Medical Center (UWMC) of Seattle, 505 are now over the
      age of 21 (391) or have died (114). Follow-up information was available since
      1994 for 132, 62% of whom we have had contact within the past 2 years. The second
      purpose was to identify potential health factors associated with long-term
      outcome of patients with MM. Patient variables chosen as relevant to survival
      included hydrocephalus, treatment before or after 1975, and health maintenance
      determined by outcome for those receiving care within the last 5 years or those
      last seen before. Age at last appointment and reason for visit were determined in
      order to identify age-specific health care needs of the adult population.
      Survival and medical needs were obtained from the UWMC's computer database,
      Mindscape, and by telephone survey for adult patients not seen in the last 2
      years. Death is more frequent earlier in life for those MM patients with
      hydrocephalus. Ordinary degenerative disorders affect MM patients earlier in life
      than normals. Our data extend life expectancy for patients with MM and
      hydrocephalus to age 40 years with some reliability for those treated from 1957
      to 1974, but only 24 years for those treated with modern techniques after 1974.
      More data is needed to determine long-term survival.

PMID- 11214831
TI  - Beyond multidisciplinary care: a new conceptual model for spina bifida services.
AB  - Medical care for people who are born with spina bifida (myelodysplasia) is
      complex and challenging, but the goal of such care is to optimize health and
      function for people with this condition. Despite years of expert agreement that
      multidisciplinary care is the medical standard for individuals with spina bifida,
      this model does not seem to go far enough towards accomplishing the goal of
      improved function as well as health for all people with spina bifida. Advances in
      the medical and surgical management of people with spina bifida and society's
      increased desire to include those with disabilities in family and community life
      has heightened our expectations for functional/participatory improvement for
      people with this condition. Some large spina bifida programs have added a
      separate rehabilitation component to the comprehensive package of services
      offered to people with spina bifida. The problem with adding further services to
      the traditional multidisciplinary spina bifida program is the increased
      complexity and potential for fragmentation that it presents, particularly for the
      patient and family. We performed a MEDLINE literature search to find information
      on integrating these services. Although several articles address the importance
      of either the multidisciplinary spina bifida clinic or a rehabilitation approach,
      there is little information about integration of medical and rehabilitation
      services. We propose a new model for spina bifida services throughout the
      lifespan that integrates the medical and functional/rehabilitative perspectives.
      Our model for conceptualizing spina bifida services builds on the WHO framework
      for coding disability (ICIDH-2). This framework includes not only health and
      functional perspectives, but a participation dimension as well. Furthermore, our
      new model emphasizes the importance of anticipatory guidance and transitional
      planning as an integrating dimension applicable across the lifespan. The model is
      based on three main conceptual dimensions--comprehensiveness, coordination and
      longitudinality. We are using the model to create standards of care, integrate
      services and improve their efficiency, and to develop policies regarding spina
      bifida services. Through this effort we hope to provide better medical and
      rehabilitation services to those with spina bifida and meet the complex challenge
      the condition presents throughout the lifespan.

PMID- 11214832
TI  - Possible role of CSF in a developmental abnormality associated with early-onset
      hydrocephalus.

PMID- 11214833
TI  - Early management of meningomyelocele.

PMID- 11214834
TI  - Suggested goals for intrauterine surgery for the repair of myelomeningoceles.

PMID- 11214835
TI  - Effect of folic acid fortification in Chile: preliminary results.

PMID- 11214836
TI  - Infections after cerebrospinal fluid shunting.

PMID- 11214837
TI  - Growth factor modulation of CSF formation by isolated choroid plexus: FGF-2 vs.
      TGF-beta1.

PMID- 11214838
TI  - Percutaneous endoscopic recanalization of catheter.

PMID- 11214839
TI  - Visual evoked potentials and brainstem auditory evoked potentials in experimental
      hydrocephalus.

PMID- 11214840
TI  - Search for the peptide mimics of the antigen produced in ventriculo-peritoneal
      (VP) shunt infection.

PMID- 11214841
TI  - The antegrade continence enema (ACE) surgical procedure: patient selection,
      outcomes, long-term patient management.

PMID- 11214842
TI  - 44 years experience with management of myelomeningocele: presidential address,
      Society for Research into Hydrocephalus and Spina Bifida.

PMID- 11214843
TI  - The ACE procedure--problems behind the success.

PMID- 11214844
TI  - Self-care skills in young children with myelomeningoceles.

PMID- 11214845
TI  - The ASPINE study: preliminary results on sex education, relationships and sexual
      functioning of Dutch adolescents with spina bifida.

PMID- 11214846
TI  - A community-based model for serving persons with spinal cord disabilities.

PMID- 11214847
TI  - The study of neural tube defects after the Human Genome Project and folic acid
      fortification of foods.
AB  - The implementation of folic acid fortification will eliminate a proportion of
      neural tube defects (NTD). As a result, the etiologic and clinical profiles of
      the developmental disorder may both change. In the assessment of NTD as it
      evolves, the bioinformatics structure and content of the Human Genome Project
      will find vital application. One important development will be an enhanced
      understanding of the role of folic acid in global regulation of gene expression
      through epigenetic processes. In addition, bioinformatics will facilitate
      coordination of research in the basic sciences with clinical investigations to
      better define remaining etiologic factors.

PMID- 11214848
TI  - Service-learning: isn't that what nursing education has always been?

PMID- 11214849
TI  - Teaching undergraduate nursing research: a narrative review of evaluation studies
      and a typology for further research.
AB  - Before knowledge about strategies for teaching undergraduate nursing research can
      be synthesized, it must be demonstrated that studies evaluating teaching outcomes
      are valid. A narrative review using Cook and Campbell's validity framework for
      experimental and quasi-experimental studies was done to appraise the validity of
      the eight studies in which teaching strategies for undergraduate research have
      been evaluated. Although the studies sampled had evidence of uncontrolled threats
      to validity, the research reports emphasized the teaching strategy's "contextual
      validity" rather than the study's internal or external validity. This insight
      stimulated questions about the appropriateness of a traditional perspective on
      validity for research designed to evaluate teaching strategies. Accordingly, a
      "typology for research on strategies for teaching research," loosely based on
      Beer and Bloomer's schema for evaluation research, was proposed. The typology
      consists of four categories of evaluation studies that vary according to purpose,
      methodological assumptions, types of validity emphasized, and student sample
      size. The four categories, which are minimally represented in the current
      literature, are complementary approaches for further evaluation studies of
      teaching strategies in undergraduate nursing research.

PMID- 11214850
TI  - The effects of the problem-based Alcohol Early-Intervention Education Package on
      the knowledge and attitudes of students of nursing.
AB  - The profession of nursing is seeking to establish its unique professional
      identity by developing discipline-focused research and clinical practice
      supported by university education. However, according to refereed literature,
      educating undergraduate nurses in alcohol-related problems is lacking. The
      literature reveals that nurses in general lack the necessary knowledge,
      attitudes, and skills to work with problem drinkers. Alcohol early intervention
      is advocated as a strategy compatible with contemporary nursing practice. This
      paper reports a study that commenced with the development of a problem-based,
      five-week Alcohol Early Intervention Education Package (AEIEP). This package
      became an intervention around which the knowledge and attitudes of a sample of
      212 students of nursing were evaluated. A comprehensive instrument was developed
      to measure the respondent's knowledge and attitude regarding alcohol-related
      problems in general and specifically in early intervention. The effects of the
      education intervention on the different strata of students, were examined in a
      quasi-experimental, pre-post test design. The findings demonstrated it had a
      significant effect on the knowledge and attitudes of students enrolled in an
      integrated bachelor of nursing curriculum.

PMID- 11214851
TI  - A new module in caring for older adults: problem-based learning and practice
      portfolios.
AB  - It is not often that educators have the chance to design a new educational
      program on the basis of up-to-date and locally relevant research findings. We
      describe the process by which we designed a new module, aimed at registered
      nurses who care for older adults in the community. The content of the new module
      was derived from an analysis of educational needs of the potential student
      population. The mode of delivery was strongly student-centered, using problem
      based learning. Assessment was through the building up by students of a practice
      portfolio. This paper focuses on a description of the new module and how it
      relates to the findings of the educational needs analysis. The National Board for
      Nursing, Midwifery and Health Visiting for Scotland put out a tender in 1995 for
      a community research project on "Educational Provision for Evolving Roles in
      Community Health Care" (Nursing Times, June, 9, 1995) with the aim of piloting
      and evaluating an "innovative program which meets changing needs in community
      health care." A joint bid by Napier University and the University of Glasgow not
      only proposed to pilot and evaluate the educational program, but also first to
      develop the content of the program itself through an educational needs analysis.
      In this paper, we will first provide an outline of the research that underpinned
      the educational program. Then, we will describe how the results of the needs
      analysis were implemented into an innovative educational module. Finally, we will
      give a brief summary of the new module.

PMID- 11214852
TI  - Assessing the value of the follow-through family project for students and
      families.
AB  - Although not a new teaching strategy, the follow-through family assignment is
      receiving renewed attention from maternity nursing faculty in light of shorter
      hospital stays and increased competition for clinical sites. The purpose of this
      evaluation study was to assess the project's value as a learning experience for
      students and to determine its benefits for participating families. The findings
      indicate that students enjoyed establishing therapeutic relationships with their
      families and helping child-bearing families answer health care questions.
      Students developed primary care skills, increased their self-confidence, and
      developed an appreciation of childbearing as a transition event for the family.
      Families appreciated students' educational support and individualized assistance.
      Families also enjoyed feeling that they had helped their student nurses learn.
      Overall, the benefits of the follow-through family project appear to outweigh the
      costs for both students and families.

PMID- 11214853
TI  - Effects of a modified version of Feeley's Campus Wellness Vacation on
      baccalaureate registered nurse students' knowledge of and attitudes toward older
      adults.

PMID- 11214854
TI  - Using popular culture to teach nursing leadership.

PMID- 11214855
TI  - Using personal accounts of mental illness as a teaching tool.

PMID- 11214856
TI  - The role of flow cytometry in the study of cell growth in the rat anterior
      pituitary gland.
AB  - Flow cytometry is a suitable technique for studying in vivo and in vitro the cell
      cycle kinetics of different animal and human tissues, both in normal and tumoral
      conditions. The rat anterior pituitary gland is a model to investigate cell
      growth and replication of differentiated, neuroendocrine cells, and we report
      current evidence on its cell cycle kinetics as well as on the role played by flow
      cytometry in this type of study. The proliferation potential of normal anterior
      pituitary cells is related to a number of different conditions, including
      heterogeneity of cell types, age and sex of donors, and circadian influences. In
      addition, the trend of cell proliferation in both in vivo and in vitro studies is
      similar, suggesting that cultured anterior pituitary elements may, at least in
      part, retain growth features analogous to those of the intact gland. Sorting of
      selective cell types and analysis of the relation between proliferating anterior
      pituitary cells and the light-dark cycle have shown that flow cytometry may be
      useful to investigate the replication process of the gland. By using a
      combination of flow cytometry, light microscopic immunocytochemistry and
      morphometry, we have reported a peculiar trend of proliferation in primary
      monolayer cultures of rat anterior pituitary gland, characterized by a non-linear
      reduction in their proliferation rate with advancing age, primarily dependent on
      a reduced transition of cells from the G0/G1- to the early S-phase pool. These
      studies indicate that flow cytometry offers insights into cell cycle check points
      of anterior pituitary cells, and suggest that it might be applied to the study of
      growth of selective pituitary elements, both in normal and tumoral conditions.

PMID- 11214857
TI  - Characterization of leptin intracellular trafficking.
AB  - Leptin is produced by adipose tissue, and its concentration in plasma is related
      to the amount of fat in the body. The leptin receptor (OBR) is a member of the
      class I cytokine receptor family and several different isoforms, produced by
      alternative mRNA splicing are found in many tissues, including the hypothalamus.
      The two predominant isoforms includes a long form (OBR) with an intracellular
      domain of 303 amino acids and a shorter form (OBR) with an intracellular domain
      of 34 amino acids. Since OBR, is mainly expressed in the hypotalamus, it has been
      suggested to be the main signalling form. The peripheral production of leptin by
      adipocyte tissue and its effects as a signal of satiety in the central nervous
      system imply that leptin gains access to regions of the brain regulating in
      energy balance by crossing the blood-brain barrier. In an attempt to characterize
      the intracellular transport of leptin, we have followed binding internalization
      and degradation of leptin in HEK293 cells. We have also monitored the
      intracellular transport pathway of fluorescent conjugated leptin in HEK293 cells.
      Phenylarsine oxide, a general inhibitor of endocytosis, as well as incubation at
      mild hypertonic conditions, prevented the uptake of leptin, confirming a receptor
      mediated internalization process. When internalized, 125I-leptin was rapidly
      accumulated inside the cells and reached a maximum after 10 min. After 70 minutes
      about 40-50% of total counts in each time point were found in the medium as TCA
      soluble material. Leptin sorting, at the level of early endosomes, did not seem
      to involve recycling endosomes, since FITC-leptin was sorted from Cy3-transferrin
      containing compartments at 37 degrees C. At 45 minutes of continuos
      internalization, FITC-leptin appeared mainly accumulated in late endocytic
      structures colocalizing with internalized rhodamine coupled epidermial growth
      factor (EGF) and the lysosomal marker protein lamp-1. The transport of leptin was
      also shown to engage a monensin and bafilomycin sensitive degradation process in
      lysosomes. Together, our results provide novel data concerning the uptake,
      intracellular localization and transport of leptin.

PMID- 11214858
TI  - Different patterns of collagen-proteoglycan interaction: a scanning electron
      microscopy and atomic force microscopy study.
AB  - The extracellular matrix of unfixed, unstained rat corneal stroma, visualized
      with high-resolution scanning electron microscopy and atomic force microscopy
      after minimal preliminary treatment, appears composed of straight, parallel,
      uniform collagen fibrils regularly spaced by a three-dimensional, irregular
      network of thin, delicate proteoglycan filaments. Rat tail tendon, observed under
      identical conditions, appears instead made of heterogeneous, closely packed
      fibrils interwoven with orthogonal proteoglycan filaments. Pre-treatment with
      cupromeronic blue just thickens the filaments without affecting their spatial
      layout. Digestion with chondroitinase ABC rids the tendon matrix of all its
      interconnecting filaments while the corneal stroma architecture remains virtually
      unaffected, its fibrils always being separated by an evident interfibrillar
      spacing which is never observed in tendon. Our observations indicate that matrix
      proteoglycans are responsible for both the highly regular interfibrillar spacing
      which is distinctive of corneal stroma, and the strong interfibrillar binding
      observed in tendon. These opposite interaction patterns appear to be distinctive
      of different proteoglycan species. The molecular details of proteoglycan
      interactions are still incompletely understood and are the subject of ongoing
      research.

PMID- 11214859
TI  - The role of the Golgi apparatus during terminal differentiation of mouse
      urothelial surface cells.
AB  - The development of the Golgi apparatus in the surface cells of mouse urinary
      bladder during embryonic development was investigated by electronmicroscopic
      cytochemistry. The distributions of NADPase and TPPase activities were studied in
      the urinary bladder during day 15 to day 18 of gestation. At the early embryonic
      stage, the products of the NADPase and TPPase reactions were visible exclusively
      in 1 to 2 medial and/or trans Golgi saccules. The strongest increment of NADPase
      and TPPase positive Golgi cisternae was detected at day 17 when the activity of
      the urothelial cells was very prominent. At this age, NADPase activity was
      detected also in lysosomes and on the apical surface of the urothelial cells. The
      highest distribution pattern of NADPase and TPPase activities observed at this
      stage rapidly decreases at day 18 of fetal life. The results suggest that the
      organization of the Golgi apparatus reflected the intensity of the processes
      occuring in the urothelial cells during gestation.

PMID- 11214860
TI  - Immunohistochemical observation of actin filaments in epithelial cells encircling
      the taste pore cavity of rat fungiform papillae.
AB  - Epithelial cells are connected to each other around taste pores in rat fungiform
      papillae. Cytoskeletal components are responsible for the maintenance of
      intracellular adhesion, and we investigated the identification and localization
      of actin filaments around taste pores. On the basis of observations made by
      immunohistochemical transmission electron microscopy comparing with confocal
      laser scanning microscopy using actin-lectin double staining, actin filaments
      were found to be localized, encircling the squeezed taste pore cavity, in
      epithelial cells a few micrometers below the papilla surface. In addition, these
      observations suggest that the organization of actin filaments around taste pores
      might be involved in the constriction of taste pores.

PMID- 11214861
TI  - Expression of Tn, sialosyl-Tn and T antigens in human foetal large intestine.
AB  - Tn, sialosyl-Tn and T antigens are simple mucin-type carbohydrate antigens that
      may be expressed in human neoplasies due to alteration of the glycoprotein
      biosynthetic pathway. Utilising specific monoclonal antibodies (HB-Tn1, HB-STn1
      and HB-T1), we have investigated the expression of these simple mucin-type
      carbohydrate antigens in large intestine of 8 human foetuses at early gestational
      age (9-10 weeks), obtained after therapeutic abortion. In all cases the
      expression of Tn antigen was mainly localised as a thin rim at the cell membrane
      and occasionally in the supranuclear region of epithelial cells, while sialosyl
      Tn antigen was documented in some goblet cell vacuoles and occasionally in the
      cytoplasm of columnar cells. T antigen was not expressed in any case. These
      results indicate that Tn and sialosyl-Tn antigens are expressed as early as nine
      weeks of gestation, further supporting the notion that they may be considered as
      oncodevelopmental cancer-associated antigens in the large intestine.

PMID- 11214862
TI  - Cytology of large neurons in the guinea pig dorsal cochlear nucleus contacting
      the inferior colliculus.
AB  - Large neurons in the dorsal cochlear nucleus of the guinea pig which project to
      the inferior colliculus were identified after injections of the neural tracer WGA
      HRP. Retrograde labelled cells (pyramidal and giant neurons) in the dorsal
      cochlear nucleus were glycine and GABA immunonegative and showed a similar
      ultrastructure. Between 30 and 60% of their perimeter was covered by axo-somatic
      boutons, most of which (>50%) contained pleomorphic synaptic vesicles. Other
      boutons (about 40% of total) contained flat vesicles and few (5-6%) contained
      round vesicles, a characteristic of the excitatory cells innervating the inferior
      colliculus. Immunogold-cytochemistry, coupled to silver intensification, showed
      that more than 50% of axo-somatic pleomorphic boutons and over 90% of boutons
      containing flat and pleomorphic vesicles store glycine. Rare WGA-HRP labelled axo
      somatic boutons containing flat-pleomorphic vesicles were seen on pyramidal and
      giant neurons. This suggests that a few inhibitory collicular terminals contact
      the excitatory large neurons in the dorsal cochlear nucleus.

PMID- 11214863
TI  - Expression of peptidergic and nitrergic structures in dorsal root ganglia of the
      rabbit.
AB  - In this study we have demonstrated the presence of neuropeptide substance P
      (SP)and nonpeptide neurotransmiter NO (nitric oxide) in the dorsal root ganglia
      (DRG) of rabbits. NADPH-diaphorase histochemical staining was used for detection
      of NO and an immunohistochemical method for detection of substance P. A number of
      DRG cells were stained by SP- and NADPH-d reactions. The presence of SP and NADPH
      diaphorase positive cells varied depending upon the spinal level of the DRG.
      Positively stained neurons were only small and intermediate in size. Cells of
      large diameter profiles showed no staining. Substance P immunoreactive cells were
      of brown and dark brown colour, the intensity of NADPH-d staining varied from
      light to very dark blue. In some DRG cells, there was very significant neuronal
      co-localization of immunoreactivity for SP and reactivity for NADPH-d. In
      summary, DRG cells appear to express diaphorase and substance P activity, and
      some of them show the presence of both neurotransmitters. Recent studies on the
      participation of NO in the regulation of SP release in the spinal cord suggest,
      that also in the DRG neurons there may be a close interaction between NO and SP.

PMID- 11214864
TI  - Immunohistochemical evidence of seasonal changes of gonadotropes in male ruin
      lizard (Podarcis sicula campestris De Betta).
AB  - The pars distalis from the pituitary gland of adult male ruin lizards (Podarcis
      sicula campestris De Betta), captured during the five periods of the annual
      sexual cycle (emergence from hibernation, reproductive period, summer regression,
      autumnal recrudescence, winter arrest), was studied immunohistochemically using
      specific antibodies against hFSHbeta, hLHbeta, oFSHbeta, and oLHbeta with the
      avidin-biotin complex (ABC) procedure to monitor the seasonal changes in shape,
      size and percentage area taken up from gonadotropes. FSH containing cells were
      specifically identified with anti-hFSHbeta and anti-oFSHbeta sera, whereas the LH
      cells were localized by anti-hLHbeta. The anti-oLHbeta serum showed cross
      reactivity with the cells immunostained by the three above antisera (anti
      hFSHbeta, anti-oFSHbeta, and anti-hLHbeta). None of the cells contained both
      gonadotropic hormones as shown by the double-immunostaining procedure. Generally,
      FSH cells were larger and more numerous than LH cells. FSH cells were elongated
      or pyriform in shape from spring to autumn, whereas they were round or oval
      during the winter stasis and until the emergence from hibernation. The size and
      the percentage area occupied by FSH cells showed an annual pattern with two
      distinct peaks in the reproductive and in the autumnal recrudescence periods. LH
      cells did not show seasonal changes in shape, being round or oval throughout the
      reproductive cycle, whereas their size and the area they occupied underwent
      seasonal variations. The LH cells reached the largest size during the
      reproductive period and the smallest size during the summer regression. The
      percentage area occupied by LH cells in the pars distalis peaked at the emergence
      from hibernation and during the summer refractory period, when FSH cells
      displayed their lowest values.

PMID- 11214865
TI  - Immunohistochemical detection of ACTH and MSH cells in the hypophysis of the
      hermaphroditic teleost, Diplodus sargus.
AB  - Hypophyseal ACTH and MSH cells were immunohistochemically characterised in the
      teleost fish, Diplodus sargus, using anti-ACTH (1-24) and anti alpha-MSH
      polyclonal antisera. ACTH cells were found both in the pars distalis and in the
      pars intermedia. In the former region, they appeared small, round-shaped and
      clustered; in the latter, they were either small or large and elongated.
      Moreover, a few ACTH-immunoreactive cells resembling microglia were present in
      the neurohypophysis. Conversely, MSH cells were found only in the pars
      intermedia, and were similar to the larger ACTH cells of the same region. In the
      pars intermedia, co-localisation of ACTH and MSH immunoreactivity in the same
      cell was revealed by double immunostaining, though the two hormones were also
      observed in distinct cell types. The distribution of ACTH cells appeared quite
      uniform, without any marked difference between the specimens tested. Conversely,
      MSH cell amount varied according to the stage of the sexual cycle of this teleost
      fish, which is characterised by protandrous hermaphroditism. In fact, a lower
      amount of MSH cells were observed in females, whereas no significant difference
      was found between immature and male specimens.

PMID- 11214866
TI  - Expression of N-CAM-180 and N-cadherin during development in two South-American
      anuran species (Bufo arenarum and Hyla nana).
AB  - Cadherins and N-CAM are Ca++-dependent and Ca++-independent cell adhesion
      molecules respectively. These molecules play a key role in morphogenesis and
      histogenesis. We determined the spatiotemporal pattern of N-cadherin and N-CAM
      180 kDa expression by immunohistochemistry during development in two South
      American anuran species (Bufo arenarum, toad and Hyla nana, frog). Both N
      cadherin and N-CAM were not detectable during early developmental stages.
      Expression of N-cadherin appeared between the inner and the outer ectoderm layers
      at stages 19-20. At stages 24-25, N-cadherin was expressed in the neural tube and
      the heart. In early tadpoles, N-cadherin expression increased along with the
      central nervous system (CNS) morphogenesis, and reached its maximum level at
      metamorphic climax stage. N-Cadherin expression was not uniformly distributed. At
      stage 42, olfactory placodes and retina expressed N-cadherin. Contrary to N-CAM,
      the strongly myelinated cranial nerves were not labeled. N-Cadherin was present
      in several mesoderm derivatives such as the notochord, heart and skeletal muscle.
      The non-neural ectoderm and the endoderm were always negative. Expression of N
      CAM appeared first in the neural tube at stages 24-25 and the level of expression
      became uniform from pre-metamorphic to metamorphic climax tadpoles. At this
      latter stage, a clear N-CAM immunolabeling appeared in the nerve terminals of
      pharynx and heart. N-Cadherin and N-CAM were found mainly co-expressed in the CNS
      from early tadpole to metamorphic climax tadpole. Our results show that the
      expression of N-CAM and N-cadherin is evolutionary conserved. Their increased
      expression during late developmental stages suggests that N-CAM and N-cadherin
      are involved in cell contact stabilization during tissue formation.

PMID- 11214867
TI  - Wavelength dependence of the time course of fluorescence enhancement and
      photobleaching during irradiation of ethidium bromide-stained nuclei.
AB  - The variation of fluorescence during irradiation of ethidium bromide-stained
      nuclei with the 458 nm argon laser line was measured at different wavelengths
      throughout the emission spectrum. When glycerol was used as a mountant,
      photoenhancement of fluorescence was observed at all wavelengths, but was greater
      at the shorter wavelengths. Fluorescence increased by almost one order of
      magnitude at 500 nm after 40 s of irradiation, compared with only about 10% at
      wavelengths longer than 600 nm after 2-3 s. In nuclei mounted in phosphate
      buffer, an initial photoenhancement of fluorescence was detected only at the
      shorter wavelengths, while continuous photobleaching was observed in the rest of
      the emission spectrum. When the spectra are normalized to maximum, so as to
      eliminate the effect of the concurrent photobleaching, it appears that the
      difference between the time course of fluorescence variation in buffer and
      glycerol depends largely on the lower photobleaching rate in glycerol. The
      photoenhancement of fluorescence at shorter wavelengths was found to consist of a
      band peaking at 485-491 nm in glycerol and at 495-496 nm in buffer. Attenuation
      of the inner-filter effect contributes minimally to the enhancement of
      fluorescence at shorter wavelengths. Since the dimer is known to be non
      fluorescent, the light-induced disaggregation of dimers to monomers cannot be an
      explanation for the large increase of fluorescence at the shorter wavelengths.
      The same laser beam that was used to excite the fluorescence of stained nuclei
      was also used for monitoring the concomitant variation of transmitted light, from
      which the variation of absorptance during irradiation was computed. While the
      expected decrease of absorptance was observed in glycerol, reflecting the
      photodestruction of the fluorophore, in buffer solution an unexpected initial
      increase was found, which may reflect the accumulation of an absorbing
      photoproduct.

PMID- 11214868
TI  - Sorption characteristics of zinc(II) by calcareous soil-radiotracer study.
AB  - 65Zn was used as a radiotracer to study the sorption characteristics of zinc by
      two calcareous soils from Gansu Province (China). The sorption and desorption
      isotherms of Zn on two untreated calcareous soils and on two soils treated to
      remove CaCO3 were determined at 20 +/- 2 degrees C, pH 7.8 +/- 0.2 in the
      presence of 0.001 mol/l CaCl2. The contribution of CaCO3 to the Zn sorption by
      the two calcareous soils was approximately 70% of the total amount sorbed and the
      sorption-desorption hysteresis was definitely demonstrated, thus the CaCO3 in
      calcareous soil is undoubtedly the most significant sink for zinc at high pH
      range.

PMID- 11214870
TI  - Purification of recovered tellurium dioxide for re-use in iodine radioisotope
      production.
AB  - In the production of radioiodine via charged particle activation of isotopically
      enriched TeO2 and subsequent heating of the irradiated target, some TeO2 is lost.
      Again, use of recovered TeO2 for radioiodine production showed that impurities
      are present, which prevent complete volatilization of radioiodine from the heated
      target. An effective purification procedure for recovered TeO2 has been
      developed, resulting in a yield of 95-97%. The procedure developed may also be
      used to purify Te metal.

PMID- 11214869
TI  - Matrix effects during potassium and calcium determinations in rice saplings using
      X-ray spectrometery.
AB  - For selectively excited calcium K X-rays in rice saplings, the relations alpha =
      N(KR)[1 + A gamma + B beta/(1 + alpha)] and 1/N(Ca) = alpha/beta + b + c beta are
      found to support the enhancement of potassium K X-rays and N(Ca) calcium K X-ray
      counts during potassium and calcium determinations, respectively. Here alpha,
      beta and gamma are weight fractions of potassium, calcium and the matrix
      substrate, respectively, N(KR) is the relative potassium K X-ray counts of the
      sample to that of pure potassium and A, B, a, b and c are constants. Tests of
      these relations, using eight known mixtures of CaCO3, KNO3 and Na2B4O7 10H2O
      (borax), have further supported the findings.

PMID- 11214871
TI  - Lyoluminescence characteristics of trehalose dihydrate.
AB  - Lyoluminescence (LL) of trehalose dihydrate showed a linear gamma ray sensitivity
      in the dose range 0.1-5 x 10(2) Gy. At increased sample weight dissolved, the
      LL/mg showed a reduction when the microcontroller based integrated measurement
      system was used. The LL/mg was found to be independent of the sample weight when
      the instantaneous peak output observed by the electrometer amplifier on
      dissolution of the phosphor was taken as a measure of LL yield. The LL spectral
      measurement of trehalose dihydrate in luminol solution (LL sensitizer) confirms
      an energy transfer from the radiation induced free radicals to luminol molecule
      to produce light.

PMID- 11214872
TI  - Radiological impacts of the amang processing industry on neighbouring residents.
AB  - The processing of amang (one of a number of tin-tailing products) for its
      valuable minerals has associated with the radiological and environmental
      problems. The processing and stockpiling of amang and ilmenite in open-air
      spaces, subject as it is to environmental influences, gives rise to a potential
      for affecting residents in adjacent area. A case study was carried out in a
      residential area neighbouring a typical amang plant to investigate the
      radiological impact to the residents. The average Effective Dose rates,
      calculated based on the contributions of Effective Dose rates from inhaled
      suspended radioactive dust, radon-thoron and their progeny, and external gamma
      radiation, were determined for selected houses. Results show that the occupants
      of those houses received Effective Dose rate, which cannot be differentiated from
      background. The major contributor to the average Effective Dose rate came from
      external radiation sources. Inhaled radon and its progeny was the second major
      contributor.

PMID- 11214873
TI  - Direct radiolabeling of monoclonal antibodies with rhenium-188 for
      radioimmunotherapy of solid tumors--a review of radiolabeling characteristics,
      quality control and in vitro stability studies.
AB  - 188Re is one of the radioisotopes expected to emerge as useful for therapy.
      Development of new radiopharmaceuticals based on 188Re depends on the
      radiolabeling methods used, which would give stable complexes having predefined
      radiochemical properties and in vitro and in vivo stability. This paper has
      attempted to provide a perspective of 188Re-labeled monoclonal antibodies, their
      radiolabeling characteristics, methods for quality control of
      radioimmunoconjugates and in vitro stability for radioimmunotherapy of solid
      tumors. The direct method of 188Re radiolabeling of antibodies by reductive
      attachment of 188Re in which free sulfhydryl groups have been generated by
      reduction of the intramolecular S-S disulfide bonds has been shown to be a
      promising approach in particular. Moreover, excellent methods have been developed
      to test the radionuclide, radiochemical purity and stability of 188Re
      radioimmunoconjugates using high performance liquid chromatography (HPLC) and
      paper chromatography.

PMID- 11214874
TI  - Synthesis of a [18F]labeled chelidonine derivative as a possible antitumor agent.
AB  - [(+/-)-[5bRS-(5b alpha, 6beta, 12b alpha)]-5b,6,7,12b,13,14-hexahydro-13
      methyl[1,3]benzodioxolo[5,6-c]-1,3-dioxolo[4,5-1] phenanthridin-6-yl]-4
      [18F]fluorobenzoate (6b) an aromatic ester of chelidonine was prepared as a
      possible PET radiotracer. Compound (6b) was prepared in no-carrier-added (n.c.a)
      form from the 4-N,N,N-trimethylanilinium triflate derivative (5) in one step. The
      best results were obtained using Kryptofix(2.2.2)/[18F] and DMSO as the solvent
      at 90 degrees C. Column chromatography afforded the desired compound in overall
      radiochemical yield of 65-70% (EOS) with a specific activity of about 3000
      Ci/mmole and radiochemical purity greater than 95% in 15 min.

PMID- 11214876
TI  - Automation of the synthesis of highly concentrated 188Re-MAG3 for intracoronary
      radiation therapy.
AB  - We have developed an efficient method and an automated synthetic system for the
      preparation of highly concentrated 188Re-MAG3. Routine production of 188Re-MAG3
      for use in intracoronary radiation therapy was performed by compressed air driven
      semi-automated shielded system. 188Re-MAG3 was prepared with a commercial kit and
      reducing agents, purified and concentrated by C18 Sep-Pak cartridges to desired
      radioactivity and volume. Using this automated system, reproducible radiolabeling
      yields of 80-85% were obtained.

PMID- 11214875
TI  - Uptake of the 188Re(V)-DMSA complex by cervical carcinoma cells in nude mice:
      pharmacokinetics and dosimetry.
AB  - The uptake of the rhenium-188 (188Re(V)-DMSA) complex of dimercaptosuccinic acid
      by cervical carcinoma cells in nude mice was evaluated. The pharmacokinetics and
      dosimetry calculations in normal rats were also evaluated. The images obtained in
      mice did not show significant accumulation in metabolic organs and the
      biodistribution studies showed that 3.52 +/- 0.76% of the injected activity per
      gram (n = 4) was taken up by the tumor. This percentage produces a cumulated
      activity of 35.63 +/- 8.40 MBq h and an equivalent dose per injected activity of
      260 +/- 8.91 mSv/MBq. Pharmacokinetics and dosimetry of the 1887e(V)-DMSA complex
      indicate that this radiopharmaceutical could be evaluated in patients with soft
      tissue tumors, since the risk of radiation damage to the kidney or red bone
      marrow could not be an obstacle for its application in therapeutic nuclear
      medicine.

PMID- 11214877
TI  - Synthesis, characterization and biological evaluation of a novel "3 + 1" mixed
      ligand 99mTc complex having an aliphatic thiol as coligand.
AB  - A novel "3 + 1" mixed ligand 99mTc complex with N,N-bis(2-mercaptoethyl)-N'N'
      diethyl-ethilenediamine as ligand and 1-octanethiol as coligand was prepared and
      evaluated as potential brain radiopharmaceutical. Preparation at tracer level was
      accomplished by substitution, using 99mTc-glucoheptonate as precursor and a
      coligand/ligand ratio of 5. Under these conditions the labeling yield was over
      80% and a major product with radiochemical purity >80% was isolated by HPLC
      methods and used for biological evaluation. Chemical characterization at carrier
      level was developed using the corresponding rhenium and 99gTc complexes. Results
      were consistent with the expected "3 + 1" structure and X-ray diffraction study
      demonstrated that the complex adopted a distorted trigonal bipyramidal geometry.
      All sulphur atoms underwent ionization leading to the formation of a neutral
      compound. Biodistribution in mice demonstrated early brain uptake, fast blood
      clearance and excretion through hepatobiliary system. Although brain/blood ratio
      increased significantly with time, this novel 99mTc complex did not exhibit ideal
      properties as brain perfusion radiopharmaceutical since brain uptake was too low.

PMID- 11214878
TI  - Labelling of Re-ABP with 188Re for bone pain palliation.
AB  - Etidronate and medronate have been labelled with technetium-99m (99mTc-HEDP,
      99mTc-MDP) for bone scanning and, with rhenium-188 (188Re-HEDP) to palliate the
      pain resulting from bone metastases. The objective of this study was to label
      alendronate, ABP, a new bisphosphonate, with SnF2-reduced-188Re. The reagents for
      the 5 mg ABP kit were SnF2, KReO4 and gentisic acid at acid pH. The chemical,
      spectroscopic and microscopic characteristics, quality control, rat bone uptake
      of [188Re]Re-ABP and similarities with 99mTc-ABP are presented. We conclude that
      this is a promising new radiopharmaceutical for bone metastases pain palliation.

PMID- 11214879
TI  - Measurement of the gamma-ray probability per decay of 42K.
AB  - In the present work, the gamma-ray emission probabilities per decay of 42K
      transitions have been measured. The activity measurement was carried out in a 4pi
      (PC)beta-gamma coincidence system. The gamma-ray measurements were performed in a
      HPGe system. All the uncertainties involved were treated rigorously, by means of
      covariance analysis. The value of the 1524 keV gamma-ray intensity per decay of
      42K obtained in the present work was (0.1813+/-0.0014). This result is compared
      to the data from other authors.

PMID- 11214880
TI  - Free parameter, figure of merit and ionization quench in liquid scintillation
      counting.
AB  - A statistical study of the detection process demonstrates that the free parameter
      is essential to compute the counting efficiency in both CIEMAT/NIST and TDCR
      methods. An analysis of the computed counting efficiencies shows the uselessness
      of old definition of the figure of merit. A new definition is required and we
      adopt the idea of taking quantities related with the output of the
      photomultiplier. In addition, we justify the application of the chemical
      quenching simulation with the electronic variation of the photomultiplier gain.
      Finally, we describe a new procedure to determine the figure of merit and the
      optimum ionization-quenching factor from the pulse spectrum of different
      radionuclides. The robustness of the new procedure is tested with three different
      sets of stopping power for low-energy electrons.

PMID- 11214881
TI  - Total L-shell X-ray production cross sections by 400-700 keV proton impact for
      elements with 34 < or = Z < or = 53.
AB  - Total L-shell X-ray production cross sections induced by protons with energies
      between 400 and 700 keV were measured for elements with atomic number Z between
      34 and 53. The ECPSSR theory describes appropriately the results. This model
      modifies the plane wave born approximation by considering projectile energy loss
      (E), Coulomb deflection of the incoming ion (C), polarization and change in
      electron binding energies through a perturbed stationary states method (PSS) and
      relativistic values of target electron mass (R). A comparison is given with
      previously published data for proton energies below 1 MeV and 26 < or = Z < or =
      53, based on a scaling obtained from a reduced velocity parameter zeta(L)R. The
      results show that the scaling for these atomic numbers and energy ranges is
      adequate and a semi-empirical expression to calculate those cross sections is
      proposed.

PMID- 11214882
TI  - Dose distributions at extreme irradiation depths of gamma knife radiosurgery:
      EGS4 Monte Carlo calculations.
AB  - The accuracy of the dose planning system (Leksell GammaPlan), used in Gamma Knife
      (type B) radiosurgery at extreme irradiation depths, was verified using the Monte
      Carlo technique. EGS4 Monte Carlo calculations were employed to calculate the
      dose distribution along the x, y and z axes for an irradiation relatively shallow
      in a spherical bony cavity water phantom. Two different sizes of the collimator
      helmets, 8 and 18 mm, of the Leksell Gamma Knife Unit were studied. The results
      of GammaPlan showed good consistency with the Monte Carlo results. Furthermore,
      small dose enhancements were observed in the skull bone where accurate dose
      measurements are difficult due to the presence of the air-phantom interface.
      Therefore, the results of this project can promote confidence to all Gamma Knife
      centres in the world when using the Leksell GammaPlan.

PMID- 11214883
TI  - Determination of 222Rn emanation fraction and diffusion coefficient in concrete
      using accumulation chambers and the influence of humidity and radium
      distribution.
AB  - In this paper we present a laboratory method for the determination of diffusion
      coefficient, D, as well as the 222Rn emanation fraction, f, in concrete core
      samples. It is based either on the analyses of the growth curves of the radon in
      the air volume surrounding a sample enclosed in an accumulation chamber (Lucas
      cell or RADIM device) or using the charcoal adsorption method. Samples used have
      a special geometry allowing the assumption of a one-dimensional diffusion of
      radon in material. Radium was enhanced in the concrete samples by adding radium
      bromide solution or uranium ore. A strong dependence of the emanation fraction on
      the enhancing method was observed. For the sample enhanced with uranium ore the
      specific exhalation rate was about ten times smaller. A marked dependence of
      radon exhalation on the water content was also observed.

PMID- 11214884
TI  - Application of concentrated TiO2 sols for gamma-ray radiation dosimetry.
AB  - Upon exposure to gamma-radiation, a concentrated TiO2 sol changes from colorless
      to deep blue with an absorption maximum at 540 nm. The absorption has been
      assigned to trapped electrons or Ti3+ states in the solid matrix based on its
      spectroscopic similarity to the samples irradiated with UV light. Unlike the
      conduction-band electrons generated from direct excitation by UV radiation, the
      origin of the trapped electrons during gamma-ray irradiation may be traced to a
      series of reducing species produced by the high energy electrons, which in turn,
      are the direct result of gamma-irradiation. As the absorption intensity is
      linearly related to the duration of exposure to gamma-radiation, it may have an
      application in gamma-ray dosimetry. The sensitivity of its dosage response has
      been found to be influenced by the semiconductor particle concentration and the
      dispersing solvent.

PMID- 11214885
TI  - Absolute measurements of photon emission probabilities of 169Yb.
AB  - A solution of 169Yb was absolutely standardized by the 4pi(EC,X)-gamma
      coincidence counting method and the result was used to obtain direct measurements
      of gamma-ray emission probabilities with a coaxial HPGe detector. The empirical
      relation proposed by (Vano, F., Gonzalez, L., Gaeta R., Gonzalez, J.A., 1975. An
      empirical function which relates the slope of the Ge efficiency curves and the
      active volume Nucl. Instr. Meth. 123, 573) was tested using the gamma spectral
      response above 200 keV. The half-life of 169Yb was also measured with a 4pi gamma
      ionization chamber.

PMID- 11214887
TI  - Evaluation of airborne gamma-ray spectrometric data for the Missikat uranium
      deposit, Eastern Desert, Egypt.
AB  - The examination of gamma-ray spectrometric data of the Missikat area was found to
      be useful in locating areas worth exploring for uranium occurrence. The
      statistical treatment of these data shows that the uranium threshold level is 13
      ppm. Such a value represents indirectly the presence of uranium mineralization
      and identifies anomalous areas on the eU contour map in the northern border of
      the Missikat-Ria El Gerra granitic plutons. This area should be of prime concern
      in uranium exploration of these plutons. The interpretation of the variation in
      the eU/eTh ratio with eU and eTh suggests that uranium redistribution has
      occurred within the Missikat-Ria El Gerra granitic plutons. Uranium may be
      reconcentrated in silicification, sericitization and kaolinization alterations
      which are geologically evident. eU, eTh and their ratio eU/eTh for the Missikat
      Ria El Gerra granites exhibit a lognormal distribution which is in agreement with
      the general distribution of trace elements, whereas the K content tends towards a
      normal distribution.

PMID- 11214886
TI  - Intercomparison of 131I and 99mTc activity measurements in Brazilian nuclear
      medicine services.
AB  - This work outlines the quality assurance program for the activity measurements of
      the most used radionuclides at Brazilian Nuclear Medicine Services (NMS). The
      program aims to guarantee that the patient is given the correct prescribed amount
      of activity in diagnostic or therapeutic applications. This accurate
      administration depends upon proper use and calibration of the activity meters by
      the NMS. Underestimation of administered activity in diagnostic practices could
      delay correct diagnosis disturbing the value of the investigation. On the other
      hand, the overestimation would be worse, mainly in therapeutic applications,
      because an unnecessarily high absorbed dose would be delivered to the patient.
      The preliminary results of intercomparison for 131I and 99mTc showed that many
      activity meters used at NMS's present problems giving results up to 41% greater
      than the reference values determined at the National Metrology Laboratory for
      Ionizing Radiation (LNMRI) which is recognized as the Brazilian authorized
      metrology laboratory for ionizing radiation. These results have demonstrated that
      the NMS should improve the accuracy of the activity measurements of the
      radionuclides administered to the patients and establish the traceability to the
      national standards of measurements. These standards are based on a pressurized
      well-type ionization chamber installed at LNMRI and calibrated with reference
      sources standardized by absolute methods. The protocol of the intercomparison and
      recommendations made in order to minimize errors in measuring procedures are
      described and results are discussed.

PMID- 11214888
TI  - The effect of heterogeneity in gamma-ray albedo analysis of mineral raw
      materials.
AB  - The influence of heterogeneity on the results of a gamma-ray albedo analysis of
      heterogeneous raw materials has been considered. The heterogeneity error
      components, caused by dispersing the defined element in the bulk under study and
      by the direct influence of the particles dimension (grain size) on the intensity
      of the scattered gamma-rays, have been determined. Mathematical models to
      describe the dependence of the error on the chemical composition of the raw
      material under study, the component densities, the particles dimensions and the
      primary gamma-radiation energy have been suggested.

PMID- 11214889
TI  - Application of PGNAA for bulk coal samples in a 4pi geometry.
AB  - A 4pi geometry bulk coal analyser using the Prompt gamma neutron activation
      analysis (PGNAA) technique was tested in the laboratory. The volume of the bulk
      samples was 270 litres. A 1.5 microg 252Cf neutron source and a 75 mm x 35 mm dia
      BGO detector were used for the measurements. The ash, Fe, Si and Al content of
      coal were determined with good accuracy.

PMID- 11214890
TI  - The subsoil gamma-ray intensity distribution in the Oriental Region of the
      Republic of Paraguay.
AB  - Subsoil gamma-ray intensity measurements are used in uranium prospecting and in
      the classification of lithologies. This work charts the subsoil gamma-ray
      intensity distribution in the Oriental Region of the Republic of Paraguay, a
      centrally located country in South America. Gamma-ray count rates were obtained
      at depths of 5, 10, 50, and 100 m in 158 wells and count rate contour maps were
      generated for each of the depths. Three regions of gamma-ray anomalies were
      identified.

PMID- 11214891
TI  - Cluster analysis of radionuclide concentrations in beach sand.
AB  - This paper presents a method in which natural radionuclide concentrations of
      beach sand minerals are traced along a stretch of coast by cluster analysis. This
      analysis yields two groups of mineral deposit with different origins. The method
      deviates from standard methods of following dispersal of radionuclides in the
      environment, which are usually based on the construction of lines of equal
      concentrations. The paper focuses on the methodology of quantitatively
      correlating activity concentrations of natural radionuclides in two groups of
      minerals. The methodology is widely applicable, but is demonstrated for natural
      radioactivity in beach sands along the coast of South West Australia.

PMID- 11214892
TI  - Geophysical natural gamma-ray well logging and spectrometric signatures of south
      AL-Abter phosphatic deposits in Syria.
AB  - A combination of several exploration techniques was carried out in AL-Abter
      region, aiming at outlining the main characteristics of the phosphatic layers in
      this region. The techniques used in this research are natural 7-ray well logging,
      gamma and alpha-spectrometry. It is shown that uranium concentrations in the
      samples taken from the wells studied vary between 42.8 and 112.5 ppm with a
      standard deviation of 15.2 ppm. The P2O5 content varies between 20.5% and 28.31%
      with a standard deviation of 3.11% and the radioactive intensities vary between
      150 and 275 counts per second (cps) with a standard deviation of 31 cps. The
      ratio of 234U/238U in the analyzed samples indicates that the study region is in
      radioactive equilibrium. The affinity of uranium and P2O5 to some trace elements,
      such as V, Sr, Cu and Ni has been verified through studying the correlation
      matrix of these elements.

PMID- 11214893
TI  - Elemental analysis of two Egyptian iron ores and produced industrial iron samples
      by neutron activation analysis.
AB  - Elemental analysis of two iron ores and initial industrial iron production
      prepared by the Egyptian Iron and Steel Company of Helwan near Cairo were
      performed by the instrumental neutron activation analysis technique. Five samples
      of each type were irradiated for 48 h in a thermal neutron flux of 4 x 10(12)
      n/cm2 s in the first Egyptian research reactor ET-RR-1. Also, the Pneumatic
      Irradiation Rabbit System (PIRS), attached to the reactor ET-RR-1 in Inshass, was
      used to measure short-life elements. The gamma-ray spectra were obtained with a
      hyper pure germanium detection system. The concentration percentage values of
      major, minor and trace elements are presented. Implications of the elemental
      concentration values obtained are presented.

PMID- 11214894
TI  - Determining soil contamination profiles from intensities of capture-gamma rays
      using above-surface neutron sources.
AB  - Four methods are presented to estimate contaminant concentration profiles in soil
      from the intensities of neutron-induced capture-gamma photon intensities measured
      at the soil surface. In particular, the method of linear regularization with and
      without an iterative positivity constraint, the Backus-Gilbert method, and the
      maximum entropy method are applied to the soil contamination problem. Example
      results obtained with the four methods are given for photon intensities
      calculated for idealized test contaminant profiles in soil irradiated by neutron
      sources above the surface.

PMID- 11214895
TI  - Cognitive performance and muscle activation in workers with chronic shoulder
      myalgia.
AB  - The present study determined whether workers with chronic shoulder myalgia
      exhibit impaired cognitive performance and elevated muscle activation. Ten
      workers with and 10 without shoulder myalgia performed three sessions, each
      consisting of three different cognitive tasks. Subjective pain was reported on
      visual analogue scales (VAS). Surface electromyography was recorded bilaterally
      from the trapezius and forearm extensor muscles. Speed and error rates of the
      cognitive work were almost the same in the two groups, but the myalgia subjects
      reported more stress during the work. In two of the cognitive tasks, both groups
      increased their speed of performance to the same extent from the first to the
      third session, despite pain increase in the myalgia subjects. In the
      biomechanically demanding task, the speed fell from the first to the third
      session in both groups. Muscle activation was equal in the two groups and
      constant throughout the protocol despite changes in speed of performance and
      pain. It is concluded that localized chronic muscle pain does not significantly
      alter cognitive performance, or muscle activation level during cognitive work.
      However, the perceived burden of work is larger, as indicated by the higher
      stress reported during cognitive work in the myalgia subjects compared with their
      pain-free controls.

PMID- 11214896
TI  - Pattern recognition for road traffic accident severity in Korea.
AB  - An increasing number of road traffic accidents (RTA) in Korea has emerged as
      being harmful both for the economy and for safety. An accurately estimated
      classification model for several severity types of RTA as a function of related
      factors provides crucial information for the prevention of potential accidents.
      Here, three data-mining techniques (neural network, logistic regression, decision
      tree) are used to select a set of influential factors and to build up
      classification models for accident severity. The three approaches are then
      compared in terms of classification accuracy. The finding is that accuracy does
      not differ significantly for each model and that the protective device is the
      most important factor in the accident severity variation.

PMID- 11214897
TI  - Theories of musculoskeletal injury causation.
AB  - Based on the scientific evidence in published literature about precipitation of
      musculoskeletal injuries in the workplace, four theories have been proposed to
      explain these afflictions. Central to all theories is the presupposition that all
      occupational musculoskeletal injuries are biomechanical in nature. Disruption of
      mechanical order of a biological system is dependent on the individual components
      and their mechanical properties. These common denominators will be causally
      affected by the individual's genetic endowment, morphological characteristics and
      psychosocial makeup, and by the occupational biomechanical hazards. This
      phenomenon is explained by the Multivariate Interaction Theory. Differential
      Fatigue Theory accounts for unbalanced and asymmetric occupational activities
      creating differential fatigue and thereby a kinetic and kinematic imbalance
      resulting in injury precipitation. Cumulative Load Theory suggests a threshold
      range of load and repetition product beyond which injury precipitates, as all
      material substances have a finite life. Finally, Overexertion Theory claims that
      exertion exceeding the tolerance limit precipitates occupational musculoskeletal
      injury. It is also suggested that while these theories may explain the immediate
      mechanism of precipitation of injuries, they all operate simultaneously and
      interact to modulate injuries to varying degrees in different cases.

PMID- 11214898
TI  - Can accelerometry accurately predict the energy cost of uphill/downhill walking?
AB  - To evaluate whether an activity monitor based on body acceleration measurement
      can accurately assess the energy cost of the human locomotion, 12 subjects walked
      a combination of three different speeds (preferred speed +/- 1 km/h) and seven
      slopes (-15 to +15% by steps of 5%) on a treadmill. Body accelerations were
      recorded using a triaxial accelerometer attached to the low back. The mean of the
      integral of the vector magnitude (norm) of the accelerations (mIAN) was
      calculated. VO2 was measured using continuous indirect calorimetry. When the
      results were separately analysed for each incline, mIAN was correlated to VO2
      (average r = 0.87, p<0.001, n = 36). VO2 was not significantly correlated to mIAN
      when data were globally analysed (n = 252). Large relative errors occurred when
      predicted VO2 (estimated from data of level walking) was compared with measured
      VO2 for different inclines (-53% at +15% incline, to +55% at -15% incline). It is
      concluded that without an external measurement of the slope, the standard method
      of analysis of body accelerations cannot accurately predict the energy cost of
      uphill or downhill walking.

PMID- 11214899
TI  - Change in pattern of absenteeism as a result of workplace intervention for
      personnel support.
AB  - The aim was to investigate whether a preventive intervention carried out in a
      predominantly female workplace, that of hospital cleaners (consisting of a group
      of 97 women), had any effect on patterns of absenteeism. As a background, a model
      for analysing complex patterns of absenteeism, including sickness absences, was
      also developed. A further aim was to study the interactions between different
      forms of absenteeism. Comparison was made with a reference group consisting of
      employees in the same job category who only received the customary personnel
      support. For individuals in the intervention group who were < 42 years of age,
      total absence due to sickness decreased. In a multiple regression analysis, the
      contribution from the intervention to the decrease was significant at the 5%
      level. This change was particularly obvious in those who had a previous history
      of high absence due to sickness. No clear relationship was shown between short
      term absenteeism and the interventions applied. For those who were > 42 years,
      short-term absence decreased for those who had been in the same jobs for a long
      time. The combination of increased age and experience showed a tendency to
      enhance this decline in short-term absenteeism due to sickness. For those > 42
      years, and who at the same time have a previous history of high absenteeism, long
      term absenteeism due to sickness seemed to be increasing. Increased experience
      tended to reduce this increase in long-term sickness absence. This combination of
      different effects possibly indicated the presence of a process of selection which
      determined who remained in the job as opposed to those who did not. An important
      conclusion is that different forms of absenteeism need to be looked at in
      parallel, and at the same time multivariate statistical analysis needs to be
      carried out to determine the different interactions between the factors.

PMID- 11214900
TI  - Vigilance on the civil flight deck: incidence of sleepiness and sleep during long
      haul flights and associated changes in physiological parameters.
AB  - The study investigated sleepiness and sleep in aircrew during long-haul flights.
      The objectives were to identify loss of alertness and to recommend a practical
      approach to the design of an alerting system to be used by aircrew to prevent
      involuntary sleep. The flights were between London and Miami, covering both day-
      and night-time sectors, each with a duration of approximately 9 h. The subjects
      were 12 British Airways pilots. Various physiological variables were measured
      that could potentially be used to indicate the presence of drowsiness and
      involuntary sleep: brain electrical activity (electroencephalogram, EEG), eye
      movements via the electro-oculogram (EOG), wrist activity, head movements and
      galvanic skin resistance. The EEG and EOG identified sleepiness and sleep, as
      well as being potential measures on which to base an alarm system. Ten pilots
      either slept or showed evidence of sleepiness as assessed by the EEG and EOG.
      Many of the episodes of sleepiness lasted < 20 s, which could mean that the
      subjects were unaware of their occurrence and of the potential consequences on
      performance and vigilance. All physiological parameters showed changes during
      sleep, although only the EEG and EOG were modified by sleepiness. During sleep,
      skin resistance was increased, and wrist activity and head movements were absent
      for long periods. The study indicated that the measurement of eye movements
      (either alone or in combination with the EEG), wrist activity or head movement
      may be used as the basis of an alarm system to prevent involuntary sleep. Skin
      resistance is considered to be unsuitable, however, being related in a more
      general way to fatigue rather than to sleep episodes. The optimal way to monitor
      the onset of sleep would be to measure eye movements; however, this is not
      feasible in the flight deck environment at the present time due to the intrusive
      nature of the recording methodology. Wrist activity is therefore recommended as
      the basis of an alertness alarm. Such a device would alert the pilot after
      approximately 4-5 min of wrist inactivity, since this duration has been shown by
      the present study to be associated with sleep. The possibility that sleep inertia
      (reduced alertness immediately after awakening from sleep) could follow periods
      of sleep lasting 5 min needs to be considered. The findings reported here might
      be applicable to other occupational environments where fatigue and sleepiness are
      known to occur.

PMID- 11214901
TI  - The human olfactory subgenome: from sequence to structure and evolution.
AB  - Olfactory receptors (ORs) constitute the largest multigene family in
      multicellular organisms. Their evolutionary proliferation has been driven by the
      need to provide recognition capacity for millions of potential odorants with
      arbitrary chemical configurations. Human genome sequencing has provided a highly
      informative picture of the "olfactory subgenome", the repertoire of OR genes. We
      describe here an analysis of 224 human OR genes, a much larger number than
      hitherto systematically analyzed. These are derived by literature survey, data
      mining at 14 genomic clusters, and by an OR-targeted experimental sequencing
      strategy. The presented set contains at least 53% pseudogenes and is minimally
      divided into 11 gene families. One of these (no. 7) has undergone a particularly
      extensive expansion in primates. The analysis of this collection leads to insight
      into the origin of OR genes, suggesting a graded expansion through mammalian
      evolution. It also allows us to delineate a structural map of the respective
      proteins. A sequence database and analysis package is provided
      (http://bioinformatics.weizmann.ac.il/HORDE), which will be useful for analyzing
      human OR sequences genome-wide.

PMID- 11214902
TI  - A silent mutation induces exon skipping in the phenylalanine hydroxylase gene in
      phenylketonuria.
AB  - An A-->T substitution in cDNA nucleotide 1197 (c.1197A/T) of the human
      phenylalanine hydroxylase (PAH) gene has been regarded as a silent mutation,
      because both the wild-type (GUA) and the mutant (GUU) alleles encode a valine
      residue at codon 399 (V399 V). The nucleotide c.1197 is located at the 3'-end of
      exon 11at position -3 of the exon-intron junction. To explore whether the
      substitution exerts any effects on the processing of the PAH mRNA, illegitimate
      PAH transcripts from lymphoblast cultures of a phenylketonuria (PKU) patient
      heterozygous for c.1197A/T were analyzed by the polymerase chain reaction
      following reverse-transcription (RT-PCR). mRNAs with an exon 11 deletion were
      revealed. Furthermore, by using an R408 W mutation in the paternal allele as a
      marker, sequence analysis of the RT-PCR products indicates that virtually all PAH
      transcripts from the maternal allele with the c. 1197A/T substitution do not
      contain exon 11. To address whether this substitution is the main determinant for
      exon skipping, PAH minigenes with or without the substitution were constructed
      and transfected to a human hepatoma cell line. Analysis of the transcription
      products by S1 nuclease mapping clearly indicated that such exon 11 skipping was
      directly associated with the c.1197A/T substitution. Thus, this study
      demonstrates that the c.1197A/T substitution in the PAH gene is not just a
      neutral polymorphism but a mutation that induces post-transcriptional skipping of
      exon 11 leading to a PKU phenotype.

PMID- 11214903
TI  - Patterns of haplotype diversity within the serpin gene cluster at 14q32.1:
      insights into the natural history of the alpha1-antitrypsin polymorphism.
AB  - The levels of haplotype diversity associated with different alpha1-antitrypsin
      (PI) alleles were assessed by the analysis of three microsatellites located
      within or close to corticosteroid-binding globulin (CBG), alpha1-antitrypsin [PI
      (TG)n] and protein C inhibitor [PCI-(TG)n] loci in three populations with
      different historic backgrounds: Portugal, the Basque Country and Sao Tome
      Principe (Gulf of Guinea). Unlike the more distant PCI-(TG)n repeat, allelic
      variation at PI-(TG)n reflected distinct phases of mutational recovery of
      microsatellite diversity around different founder alleles and showed a
      considerable differentiation between alpha1-antitrypsin protein variants. In
      accordance with population history, the Basque sample presented overall reduced
      levels of microsatellite variation. The African sample, although presenting the
      highest PCI-(TG)n diversity, showed a lineage-specific reduction in PI-(TG)n
      heterozygosity within the oldest M1Ala213 variant that could have been caused by
      (1) selection at a closely linked locus or (2) biases in the microsatellite
      mutation process leading to a stable equilibrium distribution. Age estimates of
      alpha1-antitrypsin variants based on microsatellite variation suggest that the Z
      deficiency allele appeared 107-135 generations ago and could have been spread in
      Neolithic times. The S mutation has an older 279- to 470-generation age,
      indicating that its high frequencies in Iberia did not result from a recent
      bottleneck and that PI*S could have originated in this region. M2 and M3 types
      had lower age estimates than would be expected from their wide geographical
      distributions, suggesting that their dispersion in Europe might have been
      preceded by important bottlenecks.

PMID- 11214904
TI  - Transmission ratio distortion in offspring of heterozygous female carriers of
      Robertsonian translocations.
AB  - Robertsonian translocations are the most common structural rearrangements of
      human chromosomes. Although segregation of Robertsonian chromosomes has been
      examined in many families, there is little consensus on whether inheritance in
      the balanced progeny conforms to Mendelian ratios. To address this question, we
      have compiled previously reported segregation data, by sex of parent, for 677
      balanced offspring of Robertsonian carriers from 82 informative families and from
      a prenatal diagnosis study on the risk of unbalanced offspring in carriers of
      chromosome rearrangements. Care was taken to avoid any source of ascertainment
      bias. Our analysis supports the following conclusions: (1) the transmission ratio
      is not independent of the sex of the carrier; (2) the transmission ratio
      distortion is observed consistently only among the offspring of carrier females;
      (3) the transmission ratio distortion does not appear to be dependent on the
      presence of a specific acrocentric chromosome in the rearrangement. The sex-of
      parent-specific origin of the non-Mendelian inheritance, the finding that the
      rearranged ("mutant") chromosomes are recovered at significantly higher frequency
      than the acrocentric ("normal") chromosomes, and the similarities between these
      observations and the segregation of analogous rearrangements through female
      meiosis in other vertebrates strongly support the hypothesis that the
      transmission ratio distortion in favor of Robertsonian translocations in the
      human results from the preferential segregation of chromosomes during the first
      meiotic division. This non-Mendelian inheritance will result in increased overall
      risk of aneuploidies in the families of Robertsonian translocation carriers,
      independently of the origin of the transmission ratio distortion.

PMID- 11214905
TI  - Human type I hair keratin pseudogene phihHaA has functional orthologs in the
      chimpanzee and gorilla: evidence for recent inactivation of the human gene after
      the Pan-Homo divergence.
AB  - In addition to nine functional genes, the human type I hair keratin gene cluster
      contains a pseudogene, phihHaA (KRTHAP1), which is thought to have been
      inactivated by a single base-pair substitution that introduced a premature TGA
      termination codon into exon 4. Large-scale genotyping of human, chimpanzee, and
      gorilla DNAs revealed the homozygous presence of the phihHaA nonsense mutation in
      humans of different ethnic backgrounds, but its absence in the functional
      orthologous chimpanzee (cHaA) and gorilla (gHaA) genes. Expression analyses of
      the encoded cHaA and gHaA hair keratins served to highlight dramatic differences
      between the hair keratin phenotypes of contemporary humans and the great apes.
      The relative numbers of synonymous and non-synonymous substitutions in the
      phihHaA and cHaA genes, as inferred by using the gHaA gene as an outgroup,
      suggest that the human hHaA gene was inactivated only recently, viz., less than
      240,000 years ago. This implies that the hair keratin phenotype of hominids prior
      to this date, and after the Pan-Homo divergence some 5.5 million years ago, could
      have been identical to that of the great apes. In addition, the homozygous
      presence of the phihHaA exon 4 nonsense mutation in some of the earliest
      branching lineages among extant human populations lends strong support to the
      "single African origin" hypothesis of modern humans.

PMID- 11214906
TI  - A detailed analysis of the MECP2 gene: prevalence of recurrent mutations and
      gross DNA rearrangements in Rett syndrome patients.
AB  - Mutations in the X-linked methyl-CpG-binding protein 2 gene (MECP2) have been
      found to be a cause of Rett syndrome (RTT). In order to provide further insights
      into the distribution and the spectrum of mutations, we investigated, in addition
      to the whole coding sequence, a phylogenetically conserved sequence within the 3'
      untranslated region (3' UTR) of the MECP2 gene for 55 sporadic RTT, including 47
      typical and 8 nonclassical cases. We have developed an approach based on
      conformation-sensitive gel electrophoresis, sequence analysis and, for the first
      time, Southern blot analysis. Mutation detection, including unreported gross DNA
      rearrangements, was achieved in 79% of classical RTT and 25% of nonclassical RTT
      patients. The high prevalence of recurrent mutations allows us to propose a
      molecular diagnosis strategy for RTT.

PMID- 11214907
TI  - Diverse prevalence of large deletions within the OA1 gene in ocular albinism type
      1 patients from Europe and North America.
AB  - Ocular albinism type 1 (OA1) is an X-linked disorder mainly characterized by
      congenital nystagmus and photodysphoria, moderate to severe reduction of visual
      acuity, hypopigmentation of the retina, and the presence of macromelanosomes in
      the skin and eyes. We have previously isolated the gene for OA1 and characterized
      its protein product as melanosomal membrane glycoprotein displaying structural
      and functional features of G protein-coupled receptors. We and others have
      identified mutations of various types within the OA1 gene in patients with this
      disorder, including deletions and splice site, frameshift, nonsense, and missense
      mutations. However, different prevalences of large intragenic deletions have been
      reported, ranging from 10% to 50% in independent studies. To determine whether
      these differences might be related to the geographic origin of the OA1 families
      tested, we performed a further extensive mutation analysis study leading to the
      identification of pathogenic mutations in 30 unrelated OA1 patients mainly from
      Europe and North America. These results, together with our earlier mutation
      reports on OA1, allow us to resolve the apparent discrepancies between previous
      studies and point to a substantial difference in the frequency of large
      intragenic deletions in European (<10%) compared with North American (>50%) OA1
      families. These observations and our overall refinement of point mutation
      distribution within the OA1 gene have important implications for the molecular
      diagnosis of OA1 and for the establishment of any mutation detection program for
      this disorder.

PMID- 11214908
TI  - The relationship between Y chromosome DNA haplotypes and Y chromosome deletions
      leading to male infertility.
AB  - Microdeletions on the short arm of the Y chromosome have defined three non
      overlapping regions (AZFa, b, c) recurrently deleted among infertile males. These
      regions contain several genes or gene families involved in male germ-cell
      development and maintenance. Even though a meiotic origin for these
      microdeletions is assumed, the mechanisms and causes leading to microdeletion
      formation are largely unknown. In order to assess whether some Y chromosome
      groups (or haplogroups) are predisposed to, or protected against, deletion
      formation during male meiosis, we have defined and compared Y chromosome
      haplogroup distribution in a group of infertile/subfertile males harbouring Yq
      deletions and in a relevant Northwestern European control population. Our
      analyses suggest that Y chromosome deletion formation is, at least in the study
      populations, a stochastic event independent of the Y chromosome background on
      which they arise and may be caused by other genetic and/or environmental factors.

PMID- 11214909
TI  - AFLP fingerprinting of the human genome.
AB  - Elucidation of the genetic basis of complex traits and diseases in humans
      includes the use of genome-wide association studies that depend on the analysis
      of a large number of diallelic markers. We describe the application of the
      amplified fragment length polymorphism (AFLP) technique as an efficient approach
      for rapidly identifying and scoring multiple variants in the human genome. Using
      a commercially available kit, we found that AFLP yields reproducible DNA
      fingerprints consisting of 42-132 fragments, 8% of which show variability between
      individuals. These variant markers appear to be from different chromosomes, and
      the majority of them is diallelic. Based on the information obtained in this
      study, it is possible to approximate the minimum number of selective AFLP primer
      combinations needed to approach a desired coverage density of all chromosomes. To
      our knowledge, this is the first study showing the general applicability of AFLP
      in humans and providing a constructive guide for the design of genomic studies in
      Homo sapiens with this robust methodology.

PMID- 11214910
TI  - Novel missense mutations outside the allosteric domain of glutamate dehydrogenase
      are prevalent in European patients with the congenital hyperinsulinism
      hyperammonemia syndrome.
AB  - The hyperinsulinism-hyperammonemia syndrome (HHS) has been shown to result from
      'gain-of-function' mutations of the glutamate dehydrogenase (GlDH) gene, GLUD1.
      In the original report, all mutations were found in a narrow range of 27 base
      pairs within exons 11 and 12 which predicted an effect on the presumed allosteric
      domain of the enzyme and all these mutations were associated by a diminished
      inhibitory effect of guanosine triphosphate (GTP) on GlDH activity. We have
      investigated 14 patients from seven European families with mild hyperinsulinism.
      In four families, more than one member was affected. In eight cases
      hyperammonemia was documented, and eight cases had signs of significant leucine
      sensitivity. In one of the families, a novel heterozygous missense mutation in
      exon 6 [c.833C>T (R221C)] was detected, and in all other cases from six unrelated
      families the novel heterozygous missense mutation c.978G>A (R269H) was found in
      exon 7. When GIDH activity was measured in lymphocytes isolated from affected
      patients, both mutations were shown to result in a normal basal activity but a
      diminished sensitivity to GTP. It is the first time that this effect is reported
      for mutations located in the presumed catalytic site and outside the GTP
      allosteric domain of the enzyme. The observation of the high prevalence of the
      exon 7 mutation both in familial and sporadic cases of HHS suggests a mutation
      hot spot and justifies a mutation screening for this novel mutation by mismatch
      PCR-based restriction enzyme digestion in patients with hyperinsulinism.

PMID- 11214911
TI  - The Frequency of Inherited Disorders Database.

PMID- 11214912
TI  - A transgenic model of a familial prion disease.
AB  - We have generated lines of transgenic mice that express a mutant prion protein
      containing 14 octapeptide repeats whose human homologue is associated with an
      inherited prion dementia. These mice develop an ataxic illness that begins at 65
      days of age when the transgene array is homozygous, and results in death by 115
      138 days. Starting from birth, mutant PrP is converted into a protease-resistant
      and detergent-insoluble form that resembles PrP(Sc), and this form accumulates
      dramatically in many brain regions throughout the lifetime of the mice. As PrP
      accumulates, there is massive apoptosis of cerebellar granule cells, as well as
      astrocytosis and deposition of PrP in a punctate pattern. These results establish
      a new transgenic animal model of an inherited human prion disease, and provide
      important insights into the molecular pathogenesis of these disorders.

PMID- 11214913
TI  - Transgenic models of prion disease.
AB  - There is growing concern that bovine spongiform encephalopathy (BSE) may have
      passed from cattle to humans, resulting in approximately 70 cases of an atypical,
      variant CJD (vCJD) in teenagers and young adults. We report here that transgenic
      (Tg) mice expressing full-length bovine (Bo) PrP serially propagate BSE prions
      and that there is no species barrier for transmission from cattle to Tg(BoPrP)
      mice. Surprisingly, these same mice were also highly susceptible to vCJD and
      natural sheep scrapie. The incubation times (approximately 250 d),
      neuropathology, and PrP(Sc) isoforms in Tg(BoPrP) mice inoculated with vCJD and
      BSE brain extracts were indistinguishable and differed dramatically from those
      seen in these mice injected with natural scrapie. In efforts to identify PrP
      sequences required for prion formation, we found that a redacted prion protein of
      only 106 amino acids (PrP106) containing two large deletions supported prion
      propagation. In Tg(PrP106) mice, an artificial transmission barrier for the
      passage of full-length mouse prions was diminished by the coexpression of full
      length wt MoPrP(C), suggesting that wt MoPrP acts in trans to accelerate the
      replication of "miniprions" containing PrP(Sc)106. Following a single passage
      (approximately 300 d) in Tg(PrP106) mice, the miniprions efficiently transmitted
      disease to Tg(PrP106) mice after only approximately 66 days. Our findings with
      Tg(BoPrP) mice provide compelling evidence that prions from cattle with BSE have
      infected humans and caused fatal neurodegeneration, the unique features of
      miniprions offer new insights into the mechanism of prion replication, and the
      trans-acting effects of full-length PrP coexpression suggest a new approach to
      the development of even more efficient animal models for prion diseases.

PMID- 11214914
TI  - Surveillance of BSE.
AB  - The current method used to identify suspect BSE cases is based on reporting
      cattle displaying clinical signs compatible with BSE. The reporting of such cases
      is dependent on the ability of farmers and veterinarians to recognise the disease
      symptoms and on the willingness to report such cases. Furthermore, it depends on
      the stage of the disease, because early clinical signs of BSE are not always
      typical. Histology and immunohistochemistry are established and reliable to
      confirm BSE in cattle, but the procedure is cumbersome, time consuming and
      therefore not suited for mass testing of animals. A targeted surveillance system
      using the Prionics-Western-Blot Test was initiated in Switzerland in 1999.
      Prionics-positive results are confirmed by histology or immunohistochemistry by
      the BSE-reference laboratory. This surveillance scheme has confirmed fallen stock
      and cows subjected to emergency slaughter as the major risk groups. Currently all
      cattle from these two categories are tested. As a further measure a random sample
      of cows from regular slaughtering is tested. This enables to determine the BSE
      status independent of the inaccuracies of a clinical case reporting system. This
      approach may be helpful to reliably assess the BSE situation in countries with
      low incidence in order to verify their BSE status and in countries which want to
      prove their BSE-free status.

PMID- 11214915
TI  - Follicular dendritic cells in scrapie pathogenesis.
AB  - Scrapie pathogenesis was studied in chimaeric mice that carried the prion protein
      (PrP) gene only in particular cells of the immune system. These mice were
      produced by grafting bone marrow from PrP expressing donors into PrP deficient
      recipients and vice versa. As follicular dendritic cells are not replaced
      significantly from the bone marrow in adult mice, this procedure resulted in a
      mismatch in PrP genotype between these cells and bone marrow derived cells such
      as lymphocytes. Using these models we obtained strong evidence that follicular
      dendritic cells produced high levels of the normal form of PrP in uninfected
      mice. Furthermore, the replication of a mouse-passaged scrapie strain in the
      spleen depended only on the presence of PrP expressing follicular dendritic
      cells. PrP expression by lymphocytes or other bone marrow derived cells had no
      influence on replication in spleen or on neuroinvasion in these models. These
      results indicate that the follicular dendritic cell is a potential target for
      prophylactic or therapeutic intervention in transmissible spongiform
      encephalopathies.

PMID- 11214916
TI  - Histopathology and immunohistochemistry of human transmissible spongiform
      encephalopathies (TSEs).
AB  - Neuropathological examination has remained the most important tool to give a
      definite diagnosis of human transmissible spongiform encephalopathies (TSEs). In
      recent years, immunohistochemistry (IHC) for the disease-associated prion protein
      (PrP) has emerged as an indispensable adjunct to the neuropathological
      confirmation of TSEs, especially in cases with equivocal histopathological
      changes. The clinico-pathological phenotype including histopathology and IHC for
      PrP depends upon PrPres fragment size and codon 129 genotype in the PrP gene,
      PRNP. However, some TSEs have little or no spongiform change or detectable PrP,
      such as fatal familial insomnia (FFI). IHC for PrP requires appropriate
      technique, has some pitfalls and thus should be interpreted by experienced
      observers. The amount and distribution of PrP deposits do not always correlate
      with type and severity of local tissue damage. PrP deposition occurs only where
      neuronal parenchyma is present; in pre-existing tissue lesions such as scarred
      infarctions with prominent gliosis, PrP does not accumulate. Most recently, new
      patterns of granular ganglionic and tiny adaxonal PrP deposits were described in
      the peripheral nervous system in rare human TSE cases and experimental scrapie.
      There is early, severe and selective loss of a peculiar parvalbumin-expressing
      subset of inhibitory GABAergic neurons both in human and experimental TSEs.

PMID- 11214917
TI  - Pathology of variant Creutzfeldt-Jakob disease.
AB  - Variant Creutzfeldt-Jakob disease (vCJD) is a novel prion disease in man which
      was first described in 1996 in the UK. There is substantial evidence to indicate
      that vCJD represents the effects of the bovine spongiform encephalopathy (BSE)
      agent in man. The neuropathology of vCJD is characterised by the florid plaque,
      composed of a central amyloid core with a fibrillary periphery, surrounded by a
      rim of spongiform change in an intact neuropil. Unique patterns of PrP
      accumulation in vCJD are revealed by immunocytochemistry in the cerebral and
      cerebellar cortices, the basal ganglia, thalamus and brainstem. The
      neuropathology of the thalamus and midbrain is also characterised by severe
      neuronal loss and gliosis. vCJD is distinct from other human prion diseases in
      that disease-associated PrP accumulates within follicular dendritic cells in
      lymphoid tissue, and consistently in peripheral sensory ganglia. All vCJD
      patients so far have been methionine homozygotes at codon 129 in the PrP gene.
      There is no evidence to indicate that cases of BSE infection have occurred in
      individuals in the UK who are MV or VV at codon 129 in the PrP gene. It is
      conceivable that BSE incubation periods in these groups may be longer than in
      methionine homozygotes, hence the precise numbers of future cases of vCJD are
      difficult to estimate at present.

PMID- 11214918
TI  - Clinical and differential diagnosis of Creutzfeldt-Jakob disease.
AB  - Until recently, the clinical diagnosis of CJD relied mainly on three criteria.
      These include patient history (rapidly progressive dementia), neurological
      findings (ataxia, pyramidal/extrapyramidal signs, myoclonus, akinetic mutism) and
      typical electroencephalographic (EEG) findings. These criteria are fulfilled in
      typical cases. The occurrence or increase of certain proteins in cerebrospinal
      fluid (CSF; 14-3-3, neuron-specific enolase) now provide important adjuncts in
      recognizing variant forms. Although these proteins can be detected in other
      neurological diseases accompanied with substantial brain damage such as
      encephalitis, they are also characterized by their high sensitivity and
      specificity with regard to other dementing processes (Alzheimer and vascular
      dementia). The increase in the number of positive cases during the last years in
      Germany reflects an improved case ascertainment rather than the appearance of the
      variant CJD (vCJD). Although several recent cases with a long duration of the
      disease were actually recognized, they did not reveal the typical florid plaques
      at autopsy. They were revealed as a rare variant of sporadic CJD, which is
      characterized by homocygosity for valine at codon 129 and PrP(Sc) type 1. This
      variant is positive for the 14-3-3 protein in CSF. Further subtypes described by
      Parchi et al. can also be characterized by a certain pattern of clinical
      symptomatology, EEG- and 14-3-3-findings. In addition, differential diagnosis
      revealed some treatable dementias among the most common diseases (Alzheimer and
      vascular dementia) such as herpes encephalitis, multiple sclerosis and Hashimoto
      encephalitis, particularly in the younger age group.

PMID- 11214919
TI  - Putting prions into focus: application of single molecule detection to the
      diagnosis of prion diseases.
AB  - Prion diseases are characterized by the cerebral deposition of an aggregated
      pathological isoform of the prion protein (PrP(Sc)) which constitutes the
      principal component of the transmissible agent termed prion. In order to develop
      a highly sensitive method for the detection of PrP(Sc) aggregates in biological
      samples such as cerebrospinal fluid (CSF), we used a method based on Fluorescence
      Correlation Spectroscopy (FCS), a technique which allows detection of single
      fluorescently labeled molecules in solution. Within the FCS setup, fluorescent
      photons emitted by molecules passing an open volume element defined by the beam
      of an excitation laser focussed into a diffraction-limited spot are imaged
      confocally onto a single photon counting detector. Aggregates of PrP(Sc) could be
      labeled by co-aggregation of probe molecules such as monomeric recombinant PrP or
      PrP-specific antibodies tagged with a fluorescent dye. In addition to slow
      diffusion, labeled aggregates are characterized by high fluorescence intensity,
      which allows detection and quantification by analysis of fluorescence intensity
      distribution. To improve detection of rare target particles, the accessible
      volume element was increased by scanning for intensely fluorescent targets
      (SIFT). To further improve sensitivity and specificity, two different probes were
      used simultaneously in a two-color setup. In a diagnostic model system of CSF
      spiked with purified prion rods, dual-color SIFT was more sensitive than Western
      blot analysis. In addition, a PrP(Sc)-specific signal was also detected in a
      number of CSF samples derived from CJD patients but not in controls.

PMID- 11214920
TI  - Detection of PrP(Sc) in subclinical BSE with the paraffin-embedded tissue (PET)
      blot.
AB  - The appearance of a new variant of CJD (vCJD) in young patients has caused
      considerable public concern and there is evidence that this novel disease is
      caused by the same agent as BSE. BSE is a prion disease that became epidemic in
      the UK, with a peak incidence in January 1993. New test systems should aim to
      identify BSE-infected cattle early in the incubation period. We compared the
      established histological and immunohistochemical methods and the Western blot
      method used by Prionics with the PET blot method that detects prion PrP(Sc)
      deposits in formalin-fixed and paraffin-embedded tissue. Investigating the obex
      region with the PET blot, all BSE cases were detectable and no false positive
      cases occurred. From the Swiss culling program, five clinically healthy cattle
      out of 1761 were identified as incubating BSE. With the PET blot method four of
      them showed the same PrP(Sc) deposition pattern that was seen in clinical BSE,
      though less conspicuous. In one of the five cases, PrP(Sc) was restricted to two
      brain stem nuclei, a pattern that was reported to be the first manifestation of
      PrP(Sc) deposits in the brain after peripheral infection and one that occurs
      after half of the incubation time. In this case, histology and Western blot were
      negative.

PMID- 11214921
TI  - Sheep and goats: natural and experimental TSEs and factors influencing incidence
      of disease.
AB  - The major factor influencing incidence of disease following challenge with
      transmissible spongiform encephalopathies (TSEs) in sheep is the allotype at
      amino acid numbers 136, 154 and 171 of the PrP protein. There are at least two
      groups of TSEs, one which targets the amino acid encoded at position 136 and the
      other which is more influenced by the amino acid at codon 171. Within these
      groups of TSE types, there may additionally be sub-types, as resistance to some,
      but not all, "136-type" TSEs can also be affected by the amino acid at codon 154.
      In goats, there are also PrP polymorphisms which apparently influence incubation
      period of TSE disease, however, this has not found to be true for cattle and BSE
      incidence. Sheep PrP amino acid codons 136, 154 and 171 do not explain everything
      about, for example, natural scrapie occurrence in sheep flocks, and attention is
      now turning to the flanking regions of the PrP gene looking for sequence
      differences in gene expression control motifs which may also have an influence on
      disease development. The sheep PrP gene produces two mRNAs in peripheral tissues,
      the result of alternative polyadenylation in the 3' untranslated region of the
      gene. Results from transfection assays of murine neuroblastoma cells with
      constructs expressing different regions of ovine PrP mRNA have revealed the
      presence of sequences in the 3' untranslated region that modulate protein
      synthesis and have therefore the potential to affect disease progression.

PMID- 11214922
TI  - Application of Prionics Western blotting procedure to screen for BSE in cattle
      regularly slaughtered at Swiss abattoirs.
AB  - Disease-specific PrP (PrP(Sc)) is at least part of the infectious particle
      (prion) causing bovine spongiform encephalopathy (BSE) or scrapie in sheep.
      Digestion with protease allows a distinction between normal PrP (PrP(C)) and
      PrP(Sc) i.e. PrP(C) is completely digested while PrP(Sc) is cleaved at the N
      terminus leading to a fragment of reduced molecular weight (PrP 27-30). Detection
      of this fragment by Western blotting has been described more than a decade ago
      for rodent PrP. We have now optimized the technique in order to allow rapid
      analysis of hundreds of samples per day. Here we report the application of this
      technique to the analysis of 3000 regularly slaughtered cattle from Swiss
      abattoirs. For comparison all the animals were subsequently examined by classical
      methods (i.e. histology and immunohistochemistry). All but one animal were
      negative for BSE by all methods. The Western blot positive animal was confirmed
      to be a BSE case and the carcass was removed from the food chain. We conclude
      that it is feasible to examine slaughtered cattle on a routine basis without
      causing delays to the meat processing industry.

PMID- 11214923
TI  - Specific determination of the proteinase K-resistant form of the prion protein
      using two-site immunometric assays. Application to the post-mortem diagnosis of
      BSE.
AB  - The aim of this work was to establish an immunological test suitable for
      specifically detecting PrPres in tissues from animals or humans developing TSEs.
      We chose to use as detection method a conventional two-site immunometric assay
      (sandwich immunoassay) because over the last 20 years this technique has clearly
      been shown to be more sensitive and specific than other tests. We have
      established numerous two-site immunometric assays based on the use of monoclonal
      antibodies and suitable for measurement of PrPsen in various mammalian species
      (human, bovine, ovine, mouse and hamster). A detection limit below 100 pg/ml was
      estimated from standard curves established using ovine recombinant PrP. PrPres
      was selectively detected by processing samples (currently brain homogenates) to
      enable specific purification and concentration of PrPres, which was finally
      solubilized by a strong denaturing treatment. This sample-processing procedure
      can be achieved within 30 minutes. The capacity of this test to detect bovine
      PrPres was estimated in the framework of an evaluation study organized by the
      Directorate-General XXIV of the European Commission during May 1999. On this
      occasion, a blind test on 1400 brain stem samples taken from either healthy
      (1000) or BSE-infected (300) cows demonstrated 100% sensitivity and specificity.
      In addition, dilution experiments showed that the test can significantly detect
      PrPres in homogenates diluted 1/300 and was at least as sensitive as a
      conventional bioassay performed on mice.

PMID- 11214925
TI  - Characterization of BSE and scrapie strains/isolates.
AB  - Following the BSE epidemic in cattle and the emergence of a variant form of
      Creutzfeldt-Jakob disease in humans, the question was raised whether BSE has been
      transmitted to small ruminants by the inadvertent feeding of infectious meat and
      bone meal. Such infections could easily be concealed in countries where scrapie
      is endemic. To address this issue by immuno-chemically analyzing the PrP(Sc)
      fragments, we have developed two lines of research. Firstly we have focused on
      the development of criteria for the differential characterization of experimental
      BSE and scrapie strains/isolates in rodents. To date, three criteria have been
      identified: quantification of the relative banding intensities of PrP(Sc)
      glycotypes using a photoimaging technique; the non-uniform kinetic of proteinase
      K degradation of PrP(Sc); and differences in the molecular masses of their non
      glycosylated PrP(Sc) fragments after PK cleavage in immunoblot. The second line
      of research focused on the implementation of the criteria described above to
      representative samples from scrapie diseased Irish sheep. Using these three
      criteria, no evidence was found for the presence of a BSE infection in these
      animals. However, the final conclusion must take into account the results of
      mouse incubation time and mouse lesion profile data which are currently being
      generated.

PMID- 11214924
TI  - PrP(Sc) typing by N-terminal sequencing and mass spectrometry.
AB  - The heterogeneity of the clinicopathological phenotype in human prion diseases is
      associated with the presence of the different forms of the abnormal prion
      protein, PrP(Sc). We have previously shown that PrP(Sc) in FFI and a subtype of
      familial CJD linked to the D178N mutation can be distinguished by their
      difference in gel mobility following proteinase K (PK) treatment. To further
      characterize the structural difference of PrP(Sc) in familial prion diseases, N
      terminal sequencing and mass spectrometry were used to identify the protease
      cleavage sites in PrP(Sc) extracted from affected brains. We found that the main
      PK cleavage sites of PrP(Sc) are located at residue 97 in FFI, and residue 82 in
      both CJD178 and a GSS subtype linked to the P102L mutation. The differential
      accessibility to protease in the native PrP(Sc) suggests that PrP(Sc) exist as
      distinct conformers in different disease states.

PMID- 11214926
TI  - Quantitative traits of prion strains are enciphered in the conformation of the
      prion protein.
AB  - Variations in prions, which cause different disease phenotypes, are often
      referred to as strains. Strains replicate with a high degree of fidelity, which
      demands a mechanism that can account for this phenomenon. Prion strains differ by
      qualitative characteristics such as clinical symptoms, brain pathology, topology
      of accumulated PrP(Sc), and Western blot patterns of glycosylated or
      deglycosylated PrP(Sc). Since none of these qualitative features can directly
      explain quantitative strain traits such as incubation time or dose response, we
      analyzed conformational parameters of PrP(Sc) and the rate of accumulation in
      different prion strains. Using the conformation-dependent immunoassay (CDI), we
      were able to discriminate among PrP(Sc) molecules from eight different prion
      strains propagated in Syrian hamsters. CDI quantifies PrP isoforms by
      simultaneously following antibody binding to both the denatured and native forms
      of a protein. In a plot of the ratio of antibody binding to denatured/native PrP
      graphed as a function of the concentration of PrP(Sc), each strain occupied a
      unique position, indicating that each strain accumulated different concentrations
      of particular PrP(Sc) conformers. This conclusion was supported by a unique
      pattern of equilibrium unfolding of PrP(Sc) found within each strain. By
      comparing the PrP(Sc) levels before and after limited proteinase K digestion, we
      found that each strain produces a substantial fraction of protease-sensitive
      PrP(Sc). We asked whether this fraction of PrP(Sc) might reflect those PrP(Sc)
      molecules that are most readily cleared by cellular proteases. When the protease
      sensitive PrP(Sc) fraction was plotted as a function of the incubation time, a
      linear relationship was found with an excellent correlation coefficient (r =
      0.94). Combined with the data on time courses of prion infection in Tg(MHu2M) and
      Tg(SHaPrP) mice, the results argue that different incubation times of various
      prion strains may arise predominantly from distinct rates of PrP(Sc) clearance
      rather than from different rates of PrP(Sc) formation.

PMID- 11214927
TI  - Cellular and sub-cellular localisation of PrP in the lymphoreticular system of
      mice and sheep.
AB  - Using immunocytochemistry or immunogold electron microscopy, abnormal PrP
      accumulation was found in lymphoreticular tissues of Suffolk sheep naturally
      exposed to scrapie and in the spleens of ME7 infected C57 BL mice at 70 days
      after infection and at the terminal stage of disease at 170 days. Clinically
      diseased scrapie affected sheep show widespread PrP accumulation within tingible
      body macrophages (TBMs) and follicular dendritic cells (FDCs) of secondary
      lymphoid follicles. Serial tonsillar biopsies taken from 171 ARQ/ARQ sheep at 4
      months of age did not contain abnormal PrP accumulations but 80% of biopsies were
      positive by 14 months. In contrast, whole body necropsies of sheep not previously
      biopsied failed to detect PrP in the tonsil of sheep at 4, 8, 12 or 16 months of
      age. These findings suggest that the biopsy procedure of susceptible sheep but
      not resistant sheep may induce tonsillar infection. In spleen of mice both at 70
      and 170 dpi, accumulations of PrP were found within lysosomes of TBMs and also at
      the plasma-lemma of FDCs. In the light zone of follicles of terminally diseased
      mice, all FDC dendrites were arranged in the form of highly reactive or
      hyperplastic labrynthine glomerular complexes. PrP was consistently seen between
      FDC dendrites in association with abundant electron dense antigen-antibody
      complexes. At 70 days after challenge, labrynthine complexes were rare and
      invariably labelled for PrP. However, sparse PrP labelling was also seen on
      simple FDC dendrites at this stage. These observations suggests that scrapie
      infected FDCs continually release PrP from the cell surface where it accumulates
      in excess in association with trapped immune complexes and dendritic extension.
      It is likely that TBMs acquire lysosomal PrP following phagocytosis of effete FDC
      processes or from the extracellular space. We suggest that the normal function of
      PrP may involve cell process extension or immune complex trapping.

PMID- 11214928
TI  - Function of PrP(C) as a copper-binding protein at the synapse.
AB  - The prion protein (PrP(C)) shows cooperative copper binding of the N-terminal
      octarepeat (PHGGGWGO) x4. In brain homogenates, PrP(C) is found in highest
      concentration in synaptosomal fractions. Mice devoid of PrP(C) (Prnp0/0 mice)
      show synaptosomal copper concentrations diminished by 50% as compared to normal
      mice. PrP(C) in the synaptic cleft may serve as a copper buffer. Alternatively it
      may play a role in the re-uptake of copper into the presynapse or may be of
      structural importance for the N-terminus and thus may influence binding of PrP(C)
      to other proteins.

PMID- 11214929
TI  - The prion protein globular domain and disease-related mutants studied by
      molecular dynamics simulations.
AB  - In humans, familial forms of transmissible spongiform encephalopathies (TSE;
      "prion diseases") have been shown to segregate with the exchange of individual
      amino acids in the prion protein (PrP) sequence. We used the NMR structure of the
      globular domain of mouse PrP in the cellular form (PrP(C)) as a starting point
      for investigations by long-time molecular dynamics (MD) simulations at ambient
      temperature of likely impacts of such mutations on the PrP(C) structure, making
      use of the fact that species-related amino acid replacements between mouse PrP
      and human PrP are spatially well separated from the disease-related mutations in
      human PrP. In the MD simulations these amino acid substitutions were found to
      have a variety of different effects on the protein structure, with some species
      showing altered packing of regular secondary structure elements, while other
      mutants showed no or only strictly localized changes of the structure near the
      variant amino acid. The fact that some of the disease-related amino acid
      exchanges cause no measurable change of the PrP(C) structure indicates that their
      influence on the conformational transition to the scrapie form of PrP may be due
      to modified intermolecular interactions during the aggregation process.

PMID- 11214930
TI  - Neurotoxicity but not infectivity of prion proteins can be induced reversibly in
      vitro.
AB  - Prion diseases include Creutzfeldt-Jakob disease in humans, scrapie in sheep and
      bovine spongiform encephalopathy. The hallmark of prion diseases is the
      accumulation of an abnormal isoform (PrP(Sc)) of the cellular prion protein
      accompanied by neuronal cell death and astroglial proliferation. To characterize
      the correlation between PrP secondary and quarternary structure and their
      biological effects we assayed soluble and aggregated forms of PrP 27-30, the N
      terminal truncated form of PrP(Sc), as well as the corresponding recombinant
      PrP(90-231) for their neurotoxicity and infectivity. PrP was kept soluble in 0.2%
      SDS and subsequently re-aggregated either by diluting the SDS or by adding
      acetonitril. The neurotoxicity of the re-aggregated states were comparable to
      that of prion rods (PrP 27-30) whereas the soluble forms had no neurotoxic
      effects. The solubilized PrP 27-30 showed no significant infection upon re
      aggregation as determined by bioassays in Syrian golden hamsters. The recombinant
      PrP did not exhibit infectivity in any state.

PMID- 11214932
TI  - The use of monoclonal antibody epitopes for tagging PrP in conversion
      experiments.
AB  - The key event in the pathogenesis of spongiform encephalopathies is a
      conformational transition of a normal cellular protein, PrPsen, to its
      pathological isoform, PrPres. The mechanism of PrPres formation is unknown but is
      likely to involve a direct interaction between PrPsen and PrPres. The molecular
      basis of PrPres formation has been studied extensively using transgenic mice and
      scrapie-infected tissue cultures that express heterologous PrP molecules.
      However, these experiments are dependant on the discrimination of endogenous host
      PrP and exogenous PrP molecules. Here we give a short review on the PrP-specific
      epitopes that have been used for tagging exogenous PrP molecules and present a
      novel PrP-specific epitope that is well suitable for in vivo and in vitro
      conversion experiments.

PMID- 11214931
TI  - Inhibition of formation of protease-resistant prion protein by Trypan Blue,
      Sirius Red and other Congo Red analogs.
AB  - Five compounds related to Congo Red were found to inhibit generation of protease
      resistant prion protein in a cell-free system. In this assay Trypan Blue, Evans
      Blue, Sirius Red F3B, Primuline and Thioflavin-S were all more inhibitory than
      Congo Red itself. In scrapie-infected mouse neuroblastoma cells one compound,
      Sirius Red F3B, was capable of blocking the formation of protease-resistant prion
      protein to a similar extent as Congo Red; however, the other four compounds were
      less effective. Some of these compounds should be considered for testing in TSE
      disease models in live animals.

PMID- 11214933
TI  - Prions: from neurografts to neuroinvasion.
AB  - Spongiform encephalopathies are infectious neurodegenerative diseases caused by
      pathogens that seem to be devoid of any informational nucleic acids.
      Histopathologically, these diseases are characterized by spongiform degeneration
      of the central nervous system. Although the main pathological changes during the
      course of the disease occur in the brain, the infectious agent accumulates early
      in lymphoid tissue. The consecutive development of clinical disease depends on
      the presence of an intact immune system including mature B-cells and follicular
      dendritic cells. In this article we review the state of knowledge on the routes
      of neuroinvasion used by the infectious agent in order to gain access to the
      central nervous system upon entry into extracerebral sites.

PMID- 11214935
TI  - Pathogenesis of natural scrapie in sheep.
AB  - Although scrapie has been known for a long time as a natural disease of sheep and
      goats, the pathogenesis in its natural host still remains unclear. To study the
      pathogenesis of natural scrapie, we used immunohistochemistry to monitor the
      deposition of PrP(Sc) in various tissues, collected during a natural scrapie
      infection from sheep with the PrP(VRQ)/PrP(VRQ) genotype which were purposely
      bred for their short incubation period for natural scrapie. PrP(Sc) was present
      in the lymphoid tissues of all animals from the age of 5 months onwards. At this
      age, PrP(Sc) was detected in the neural tissues only in the enteric nervous
      system (ENS) at the level of the duodenum and ileum. At the age of 10 months,
      PrP(Sc) was not only found in the ENS but also in the ganglion mesentericum
      cranialis/coeliacum, the dorsal motor nucleus of the vagus, and the
      intermediolateral column of the thoracic segments T8-T10. PrP(Sc) was detected
      for the first time in the nucleus tractus solitarius and ganglion nodosus at 17
      months of age and in the ganglion trigeminale and several spinal ganglia at 21
      months of age. Since the scrapie agent consists largely, if not entirely of
      PrP(Sc), these results indicate that the ENS acts as a portal of entry to the
      neural tissues for the scrapie agent followed by centripetal and retrograde
      spread through sympathetic and parasympathetic efferent fibers of the autonomic
      nervous system to the spinal cord and medulla oblongata respectively. PrP(Sc)
      accumulation in sensory ganglia occurs after infection of the CNS and is
      therefore probably due to centrifugal and anterograde spread of the scrapie agent
      from the CNS through afferent nerve fibers.

PMID- 11214934
TI  - Pharmacological manipulation of early PrPres accumulation in the spleen of
      scrapie-infected mice.
AB  - In most experimental models of scrapie and in some naturally infected species,
      the lymphoreticular system and the spleen in particular play a major role in the
      pathogenesis of the disease. Previous studies demonstrated scrapie infectivity in
      peripheral organs from the day of infection up to the terminal stage. The
      discovery of the abnormal prion protein, PrPres, as a specific molecular hallmark
      of scrapie should permit enhanced study of scrapie pathogenesis and has some
      pharmacological applications. In this study, PrPres accumulation was followed day
      by day in peripheral organs. Four different phases were identified: the
      circulation of scrapie inoculum, a clearance phase, the peripheral accumulation
      of PrPres and a plateau phase. This kinetics was then pharmacologically modified
      (i) by applying the macrophage "suicide" technique to unveil the cellular types
      involved in scrapie pathogenesis and (ii) with anti-scrapie drugs such as polyene
      antibiotics, polyanions and Congo red to investigate their mode and site of
      action.

PMID- 11214936
TI  - Detection of cattle-derived BSE prions using transgenic mice overexpressing
      bovine PrP(C).
AB  - In interspecies transmissions of transmissible spongiform encephalopathies, the
      agent has to overcome a species barrier that is largely influenced by the rate of
      homology between the prion proteins (PrP(C)) of the two involved species.
      Generating transgenic mice expressing PrP(C) of a foreign species is an approach
      to develop TSE models that are at least partly devoid of a species barrier. The
      availability of such animals would enable the detection of low doses of
      infectivity in tissues or bodily fluids derived from other species. We generated
      transgenic mice that overexpress bovine PrP(C) (Tgbov XV mice) for the
      development of an improved detection assay for cattle derived BSE prions. These
      mice succumbed to the disease 250 days after inoculation with a brain homogenate
      from BSE diseased cattle. Diagnosis of BSE in transgenic mice was confirmed using
      Western blot, as well as histological and immunohistochemical methods. In
      contrast, transgenic mice overexpressing murine PrP(C) (tga20 mice) did not
      display shorter incubation times than nontransgenic RIII mice infected with the
      same inoculum. The expression of a chimaeric PrP of murine and bovine sequences
      rendered such mice partly, if not entirely resistant to an infection with the BSE
      agent.

PMID- 11214937
TI  - Analyzing the influence of PrP primary structure on prion pathogenesis in
      transgenic mice.
AB  - Expression of prion protein (PrP) genes in transgenic (Tg) mice has been an
      extremely effective means of studying human and animal prion diseases. Indeed,
      much of what we currently understand about the molecular basis of prion
      pathogenesis derives from such studies. Despite these advances, the emergence of
      a new variant of Creutzfeldt-Jakob disease (vCJD), apparently the human
      manifestation of bovine spongiform encephalopathy (BSE), demonstrates that our
      understanding of the factors controlling prion transmission is far from complete.
      We review studies in Tg mice that have addressed issues of prion strains and
      species barriers and have provided insights into mechanisms of prion propagation.
      The goal of future investigation will be to determine the interplay between PrP
      primary structure and conformation in determining prion transmission barriers and
      we discuss some ongoing transgenic studies designed to address these issues.

PMID- 11214938
TI  - A single amino acid alteration in murine PrP dramatically alters TSE incubation
      time.
AB  - In order to investigate mutations linked to human TSEs, we have used the
      technique of gene targeting to introduce specific mutations into the endogenous
      murine PrP gene which resulted in a P101L substitution (Prnp(a101L)) in the
      murine PrP gene. This mutation is equivalent to the 102L mutation in the human
      PrP gene which is associated with Gerstmann-Straussler syndrome. Since the
      mutated gene is in the correct chromosomal location and control of the mutant
      gene expression is identical to that of the wild type murine PrP gene, the
      precise effect of the 101L mutation in the uninfected and TSE infected mouse can
      be investigated in this transgenic model. Mice homozygous for this mutation
      (101LL) while showing no spontaneous TSE disease were more susceptible to TSE
      disease than wild type mice following inoculation with GSS infectivity. Disease
      was transmitted from these mice to mice both with and without the Prnp(a101L)
      allele. The 101L mutation does not therefore produce spontaneous genetic disease
      in mice but does dramatically alter incubation periods following TSE infection.
      Additionally, a rapid TSE transmission was demonstrated associated with extremely
      low amounts of PrP(Sc).

PMID- 11214939
TI  - Homocysteine and human reproduction.
AB  - Homocysteine is an amino acid that is capable of disturbing the proper growth of
      cells. Hyperhomocysteinemia can lead to a non-closure of the neural tube. The
      underlying basis is a derangement of homocysteine metabolism due to a missense
      mutation of the MTHFR enzyme that has to catalyze the folate metabolic cycle
      furnishing sufficient methyl groups for DNA and tRNA synthesis. Folate can
      overcome the dysfunction of the mutation and the decreased activity of the
      thermolabile MTHFR. Homocysteine is also recognized as an independent risk factor
      for obstetrical vascular disease that can manifest itself in maternal veins
      (thrombosis), arteries (preeclampsia) or spiral arteries supplying the placenta
      (placental abruption). Low vitamin status (folic acid, vitamin B6 and B12),
      hyperhomocysteinemia, the MTHFR gene mutation C677T, and thrombotic factors like
      Protein C, Protein S. antithrombin III, factor V Leiden and Activated Protein C,
      are alone or in combination high risk factors for obstetrical vascular disease.
      Their values can be modulated by B-vitamin status and could be able to prevent
      disease from occurring or recurring. Placebo-randomized trials have been done in
      neural tube defects but are urgently needed in the vascular area. The common
      denominator of the effect of homocysteine on the embryo and the blood vessels
      (endothelium) could be sited in the process of proliferation of cells that need
      proper methyl groups for proper function.

PMID- 11214940
TI  - The presence of small uterine fibroids not distorting the endometrial cavity does
      not adversely affect conception outcome following embryo transfer in older
      recipients.
AB  - PURPOSE: To determine if uterine fibroids have a negative impact in older
      patients having embryo transfer (ET). METHODS: Comparison of clinical and viable
      pregnancy rates, implantation rates, and spontaneous abortion rates in older
      (>35) oocyte or embryo recipients with uterine leiomyomata compared to comparable
      patients without fibroids. RESULTS: The clinical pregnancy rate per transfer was
      56% in the fibroid group vs 64% for the controls. Implantation rates were also
      very similar (33 vs 32%7). There were no spontaneous abortion or preterm
      deliveries <32 weeks in the fibroid group and the average term of pregnancies was
      also similar. CONCLUSION: Small fibroids not distorting the uterine cavity do not
      seem to negatively affect conception outcome even in older women.

PMID- 11214941
TI  - Successful pregnancy despite advanced age and elevated serum follicle stimulating
      hormone levels--a case report.
AB  - PURPOSE: To determine if a woman over age 45 with elevated serum follicle
      stimulating hormone (FSH) levels in the early follicular phase could still
      successfully conceive. METHODS: Female partner was treated with guaifenesin to
      improve cervical mucus quality and vaginal progesterone in the luteal phase.
      Careful monitoring of follicular maturation was performed. RESULTS: A successful
      pregnancy after 14 months of progesterone therapy was achieved. CONCLUSIONS: It
      is possible for a 46-year-old infertile woman with elevated serum FSH to achieve
      a pregnancy even when the male partner is taking calcium channel blockers for
      heart problems.

PMID- 11214942
TI  - Comparable implantation rates with fresh vs frozen embryo transfer suggests that
      controlled ovarian hyperstimulation has an adverse effect on conception outcome.
AB  - PURPOSE: A retrospective comparison of fresh vs frozen embryo pregnancy rates.
      METHODS: All frozen embryos transferred used in the analysis including deselected
      embryos from the oocyte retrieval cycle, and twice-frozen embryos. RESULTS:
      Pregnancy and implantation rates following fresh or frozen embryo transfers were
      similar. CONCLUSION: The similar outcomes despite the obvious disadvantages for
      the frozen-thawed embryo suggests that some other factor reduces the chance of
      embryo implantation on oocyte-retrieval cycles. An adverse affect of controlled
      ovarian hyperstimulation on the uterine environment is a strong possibility.

PMID- 11214943
TI  - A morphologic and morphometric study of the vesical mucosa and urethra of
      castrated female rats following estrogen and/or progestogen replacement.
AB  - PURPOSE: The aim of this study was to analyze the morphologic and morphometric
      changes in the urethra and vesical mucosa following hormonal replacement METHODS:
      We analyzed the changes in the urethra and vesical mucosa of 35 castrated adult
      female rats that had been subjected to estrogen and/or progestogen replacement.
      RESULTS: Estrogen replacement, whether or not accompanied with progestogen
      replacement, provoked metaplasia, hyperplasia and an increased occurrence of
      stratified epithelia. In the proximal urethra hypoestrogenism caused a higher
      occurrence of pseudo-stratified and transition epithelia, whereas in the urethral
      vesical junction it caused a higher frequency of pseudo-stratified epithelia. The
      thickness of the epithelium increased following estrogen replacement whereas only
      a trend towards an increase of the propria lamina thickness was identified.
      Nuclear volume was only altered in the bladder epithelium. CONCLUSION: Estrogen
      replacement acted both morphometrically and morphologically on the lower urinary
      tract.

PMID- 11214944
TI  - Additive antioxidative effect of hormone replacement therapy combined with a
      statin.
AB  - In treating postmenopausal women both statins and estrogens have been shown to
      elicit favourable effects on lipids and lipoproteins. In addition direct
      beneficial effects of these substances on the vascular wall are discussed.
      However, progestin addition to estrogen replacement therapy, which is mandatory
      in women with an intact uterus. is thought to deteriorate at least partly
      estradiol-induced direct effects on the vasculature. Oxidation of LDL, which
      mainly takes place in the vessel wall, seems to be a crucial step in the
      development of atherosclerosis. Therefore, for the first time, the effect of a
      statin and an estrogen/progestin combination on the in vitro oxidation of human
      LDL was investigated comparing the monosubstances fluvastatin. 17beta-estradiol
      and norethisterone acetate (NETA) as well as the effect of the combination. LDL
      was isolated from human female serum and oxidation was initiated by copper(II)
      chloride. The progression of LDL oxidation was monitored spectrometrically at 234
      nm for 300 min. Fluvastatin significantly delayed the onset of LDL oxidation
      (controls = 85 min) by 21 min at 1 microM, by 99 min and by 210 min at 5 and 10
      microM. respectively. 17beta-estradiol significantly reduced the onset by 73 min
      at 1 microM and by more than 300 min at 5 and 10 microM. NETA had no significant
      effect. The combination of I microM 17beta-estradiol and 1 microM fluvastatin
      with 1, 5 and 10 microM NETA showed an additive antioxidative effect of estradiol
      and fluvastatin and no deterioration by the addition of NETA even at high
      dosages. It can be concluded that treatment of postmenopausal women with
      fluvastatin and a combination of 17beta-estradiol with NETA may have not only
      beneficial effects on lipid disorders but may also elicit a direct potent
      antiatherosclerotic action on the vasculature.

PMID- 11214945
TI  - Adrenalin versus terlipressin: blood loss and cardiovascular side-effects in the
      vaginal part of laparoscopically-assisted vaginal hysterectomy or vaginal
      hysterectomy.
AB  - The purpose of the study was to compare blood loss and cardiovascular side
      effects in the course of the vaginal part of laparoscopically-assisted vaginal
      hysterectomy (LAVH) or single vaginal hysterectomy (VH) [1]. Blood loss was
      evaluated in relation to local application of two haemostatic agents, e.g.
      adrenalin as a gold standard versus terlipressin. The investigation was designed
      as a prospective randomised study. A prospective group of 40 patients selected
      for LAVH or VH was randomised into two groups, e.g. 20 patients in each group. In
      both of these groups, the blindly selected haemostatic agent was applied locally
      immediately before circular colpotomy, the surgeon not being aware which agent
      was being used. Because of the claimed delayed effect of terlipressin a third
      group of another 20 patients was randomly selected. For comparison in this group
      terlipressin was locally already applied before the laparoscopic part of LAVH,
      e.g. 20-25 minutes before performing circular colpotomy. Thus, this particular
      group could not be made blind to the surgeon. The study confirmed a significantly
      superior haemostatic effect of adrenalin. On the other hand after the adrenalin
      application a higher frequency of hypertensive reactions and mild arrythmias were
      observed but without any clinical seguelae.

PMID- 11214946
TI  - At term pregnancies in transfusion-dependent beta-thalassemic women.
AB  - The health background management and outcome of five pregnancies in women
      affected by Cooley Disease are described and the preconceptual guidance and care
      are considered. The patients were selected from a group of 103 thalassemic women
      divided into three subgroups according to their first and successive menstruation
      characteristics. Only one woman needed induction of ovulation. A precise and
      detailed pre-pregnancy assessment was done before each conception. All the women
      were in labour at 38 weeks' gestation, and five healthy babies were born at term,
      weighing between 2,600 and 3,200 g. The improvement in current treatments will
      result in a continuous increase in pregnancies in thalassemic women, making
      pregnancy a real eventuality for them. Furthermore, we are studying the
      possibility of collecting foetus umbilical cord blood after delivery, with the
      aim of obtaining complete marrow reconstitution in an attempt at heterologous
      transplantation to the mother.

PMID- 11214947
TI  - Homocysteinaemia during pregnancy and placental disease.
AB  - OBJECTIVE: Hyperhomocysteinaemia, due to enzymatic defects or to the lack of some
      vitamin cofactors (vit. B6, vit. B12, folic acid), could be associated with
      obstetric disease. The aim of this study was to investigate placental disease in
      women with mild-moderate hyperhomocysteinaemia. MATERIALS AND METHODS: Blood
      samples of seven pregnant women with severe early onset preeclampsia were
      assessed for hyperhomocysteinaemia. The obtained values were compared with those
      of a control group. In all cases, tissue samples obtained from the placenta,
      umbilical cord and membranes were studied. One of the patients was treated
      empirically with folic acid during a subsequent pregnancy. RESULTS: Patient
      homocysteine plasma levels were higher than in the control group. In all cases
      several placental abnormalities were found. The patient treated with folic acid
      had a good pregnancy outcome. CONCLUSION: Hyperhomocysteinaemia during pregnancy
      could be responsible for placental abnormalities. Treatment with folic acid could
      improve pregnancy outcome in women with homocysteine metabolism abnormalities.

PMID- 11214948
TI  - Infertility treatment by in vitro fertilization in patients with minimal or mild
      endometriosis.
AB  - PURPOSE: To estimate the clinical effectiveness of in vitro fertilization
      treatment in patients with minimal or mild endometriosis (stages I and II) in
      comparison to the patients with tubal infertility in terms of fertilization,
      pregnancy and livebirth rates. METHODS: Retrospective analysis of the outcome of
      IVF-ET in 612 cycles of the patients with endometriosis (389 stimulated with
      HMG/HCG and 223 co-treated with GnRH-a) and in 7,339 cycles of the patients with
      tubal infertility (5,520 stimulated with HMG/HCG and 1,819 co-treated with GnRH
      a). RESULLTS: Regardless of the type of ovarian stimulation, the fertilization
      rate per treated cycle was practically the same in both groups (endometriosis
      81.4% vs tubal infertility 84.2%; p = 0.07). However, in the endometriosis group
      the pregnancy rate was higher (25.3% vs 18.9%; p = 0.000), and so was the
      livebirth rate (19.0% vs 14.2%; p = 0.003). Considering the type of ovarian
      stimulation, the fertilization rate in the endometriosis group was almost the
      same in the HMG/HCG (81.2%) and in the GnRH-a co-treated cycles (81.6%), and did
      not differ from that in the tubal infertility group (83.6% in the HMG/HCG vs
      85.9% in the GnRH-a cycles). In the GnRH-a co-treated cycles the pregnancy rate
      and the livebirth rate were not significantly higher in the endometriosis group
      than in the tubal infertility group (27% and 20.2% vs 22.2% and 17.5%). In the
      HMG/HCG stimulated cycles the pregnancy rate was significantly higher in the
      endometriosis than in the tubal infertility group (24.3% vs 17.7%; p = 0.004),
      and so was the livebirth rate (18.4% vs 13.0%; p = 0.008). CONCLUSION: In
      patients with minimal or mild endometriosis the IVF-ET procedure is at least as
      effective as in patients with tubal infertility.

PMID- 11214949
TI  - Multiple ovarian biopsy in the treatment of women with polycystic ovary syndrome
      (PCOS).
AB  - BACKGROUND: Ovarian electrocautery has been used with success in the treatment of
      PCOS women. However, unipolar coagulation carries the risk of serious injuries to
      pelvic organs. In an effort to avoid this potential risk, the efficacy of
      multiple ovarian biopsy was evaluated in our study. METHODS: Eleven PCOS patients
      were enrolled to the study. Four to eight biopsies were taken from both ovaries.
      The levels of LH, FSH, androgens and the reactivity of ACTH test were evaluated
      at standard intervals. The occurrence of ovulation was determined by ultrasound.
      RESULTS: Laparoscopy was followed by non-significant changes of endocrine
      parameters only. The ovulatory cycle was restored in only three women of the
      whole group. CONCLUSIONS: Our study did not prove the efficacy of multiple
      ovarian biopsy in the treatment of PCOS women. The procedure caused only minor
      changes in endocrine parameters and rarely restored ovulation.

PMID- 11214950
TI  - The emergency department gynaecologist and emergency postcoital contraception.
AB  - The emergency department gynaecologist is often faced with requests for emergency
      postcoital contraception. The physician on duty is usually very busy and does not
      always have enough time to perform a complete evaluation of the woman's state of
      health. The emergency gynaecologist who prescribes postcoital contraception also
      has a number of other problems to cope with in regard to the pharmacological
      preparations on the market, the efficacy of various methods, the monitoring of
      side-effects which are not, always, tolerated by all patients and the outcome of
      his therapeutic prescription. All these aspects should be emphasized in the
      "first aid" counselling offered to the patients. In conclusion, we consider that
      any women who decides to use postcoital contraception should have the right to
      receive assistance of guaranteed quality throughout the period that elapses
      between taking the drug and the subsequent menstrual cycle. This is not strictly
      guaranteed by an emergency gynaecological service.

PMID- 11214951
TI  - Ureteral drainage by double-J-catheters during pregnancy.
AB  - PURPOSE: To access the safety and effectiveness of Double-J-stents in treating
      symptomatic hydronephrosis during pregnancy. MATERIAL AND METHODS: From 1994 to
      1999, 21 women were hospitalized in the Urology Clinic at the University Hospital
      of Crete. Fourteen patients presented acute pyelonephritis, six painful
      hydronephrosis and one spontaneous renal rupture. In four cases the
      hydronephrosis was caused by calculus in the upper 3rd quadrant of the ureters.
      In 13 out of 14 cases of urinary febrile infection and one with spontaneous renal
      rupture, the dilatation resulted from direct compression of the ureters by the
      gravid uterus. Using ultrasound guidance, 21 ureteral stents were successfully
      placed under local ane- sthesia. RESULTS: In 14 out of 21 patients with urinary
      infection, we observed remission of fever during the first 24 hours after the
      placement of the ureteral stents. In the patient with spontaneous renal rupture
      the remission of symptoms was observed a few hours after the ureteral drainage.
      Complications were reported in six cases, such as, voiding symptoms and
      discomfort. CONCLUSION: Double-J-ureteral stenting is an effective, simple and
      safe method in treating symptomatic hydronephrosis during pregnancy.

PMID- 11214952
TI  - A comparative study of a gonadotropin-releasing hormone agonist and finasteride
      on idiopathic hirsutism.
AB  - OBJECTIVE: To compare the efficacy of finasteride and GnRH agonist in the
      treatment of idiopathic hirsutism. METHODS: Sixty women with hirsutism were
      randomly assigned to receive either 5 mg of finasteride or long-acting GnRH
      agonist (depot leuprolide 3.75 mg) intramuscularly monthly for six months. MAIN
      OUTCOME MEASURES: Hirsutism scores were measured according to the Ferriman
      Gallway scoring system, and side-effects were monitored for six months of
      treatment. Blood samples were taken at each visit for assessment of endocrine
      (FSH, LH, estradiol, progesterone, total and free testosterone, androstenedione,
      DHEAS-S, 17-OH-P. SHBG), biochemical, and hematologic para- meters. RESULTS: All
      of the patients treated with finasteride or GnRH agonist showed neither menstrual
      abnormalities nor side-effects. The mean percent change (+/- SD) in hirsutism
      scores in the GnRH and finasteride groups was 36% +/- 14% and 14% +/- 11% at six
      months, respectively. Serum total testosterone, free testosterone, androstenedion
      and DHEA-S showed a meaningful decrease in patients treated with GnRH agonist. On
      the other hand, only serum total testosterone and free testosterone levels
      decreased with finasteride treatment (p < 0.05 and p < 0.0001, respectively).

PMID- 11214953
TI  - The evaluation of misoprostol-related tachysystole in normal and high risk
      pregnancies.
AB  - OBJECTIVE: To determine whether misoprostol-related tachysystole is due to the
      cumulative effect of the drug. METHODS: A group of preeclamptic patients were
      chosen and data were compared to non-preeclamptic patients to prove the
      hypothesis. Among 90 patients evaluated, 45 were preeclamptic while 45 were non
      preeclamptic. Six out of 43 preeclamptic patients were diagnosed as having HELLP
      syndrome. All patients were induced by 50 microg of misoprostol applied to the
      posterior vaginal fornix with 4-hour intervals for a maximum of three times.
      RESULTS: Two patients from both groups were left out of the study leaving 86
      patients to evaluate. The number of misoprostol tablets used in the preeclamptic
      group was significantly higher (2.32 +/- 0.64 preeclamptic vs 1.81 +/- 0.76
      tablets non-preeclamptic group; [p = 0.001]) while the number of women giving
      birth after only one tablet of misoprostol was significantly lower (2/24
      preeclamptic vs. 14/32 non-preeclamptic group [p = 0.006, OR 0.116; 95% CI 0.02
      0.58]). Although the frequency of tachysytolic patterns observed was different
      between the two groups, (35% preeclamptic vs 16% non-preeclamptic) this
      difference was not statistically significant (p = 0.082). It is important to note
      that an increase of only one case having tachysystole in the preeclamptic group
      would have converted this difference to significant. CONCLUSION: Relatively hard
      induction of labor in preeclamptic patients leads to an increase in the amount of
      misoprostol used and hence to an increased incidence of tachysystole secondary to
      the cumulative effect of the drug. These findings seem to support our hypothesis
      and prove the presence of the cumulative effect of misoprostol.

PMID- 11214954
TI  - Changes of glucose tolerance after delivery in women with gestational diabetes.
AB  - We investigated glucose tolerance after cesarean section in 24 women with
      gestational-onset diabetes (group A), in 18 women with an adverse pregnancy
      outcome (group B), and in 19 healthy pregnant women (group C). Glucose tolerance
      was performed within six days as well as six weeks after delivery. Eleven (45.8%)
      women in group A, five (27.8%) in group B and one (5.2%) in group C showed
      glucose intolerance immediately after delivery. Six weeks after delivery, 18
      (75%) women in group. A showed normal glucose tolerance (NGT), four (16.6%)
      impaired glucose tolerance (IGT) and two (8.3%) diabetes according to WHO
      criteria. NGT showed 16 (88.8%) women in group B, and 19 (100%) in group C, while
      two (11.1%) women in group B presented with IGT. We conclude that a glucose
      tolerance test both immediately and six weeks after delivery is useful not only
      in women who have gestational diabetes but also in women with an adverse
      pregnancy outcome.

PMID- 11214955
TI  - Pseudoxanthoma elasticum and pregnancy: a case report.
AB  - BACKGROUND: Pseudoxanthoma elasticum (PXE) is a rare hereditary disease
      characterised by systemic degeneration of elastic tissue. Calcification of
      elastic fibres seen histologically is pathognomonic for the disorder. Most
      pseudoxanthoma elasticum patients show no serious complications during pregnancy.
      CASE: We report a case of a 29-year-old white woman with pseudoxanthoma
      elasticum, who delivered a healthy infant at the 35th week by cesarean section
      after an uneventful pregnancy. Sonographic and histological placental findings
      are described. CONCLUSION: Pregnancy in a patient with pseudoxanthoma elasticum
      presents some problems such as the evolution of the disease in the soon to be
      mother and the influence of the disease on the pregnancy. In our case there were
      no fetal-maternal complications related to the disease except skin lesion
      aggravation.

PMID- 11214956
TI  - Effects of unilateral uterine artery ligation on skin development.
AB  - BACKGROUND: It has been previously demonstrated that intrauterine growth
      retardation (IUGR) due to vascular insufficiency in humans results in newborn
      infants with marked loss of subcutaneous fat and decreased content of
      differentiation-specific epidermal structural proteins. OBJECTIVE: In this study,
      the teratogenic effects of impaired maternal blood flow were investigated
      histologically on rat skin. MATERIALS & METHODS: Twenty Spraque-Dawley female
      rats were separated into two groups (n = 10), a control (sham-operated) and an
      experimental group. The experimental group of fetal rats were subjected to IUGR
      by unilateral ligation of the maternal uterine artery on the 18th day of
      pregnancy. The maternal rats were subjected to cesarean hysterectomy on the 21st
      day of pregnancy and a skin biopsy was taken from the respective litters of both
      groups. RESULTS: In histopathological examination, normal epidermis and dermis
      were observed in the control group of litters and littermate rats from the
      opposite uterine horn (non-ligated side). A statistically significant reduced
      body weight and height were noted in the ligated side of the litters. CONCLUSION:
      Our findings give further evidence to the concept that normal maternal blood flow
      is essential for fetal growth and decreased maternal blood flow may create an
      impairment in skin development.

PMID- 11214957
TI  - Misoprostol in uterine atony: a report of 2 cases.

PMID- 11214958
TI  - Eighteen years of maternity care in a new teaching hospital.
AB  - A new maternity hospital was inaugurated in Trinidad in 1981 to provide access
      for pregnant women to specialist antenatal care and to trained attendants during
      childbirth. As an academic tertiary-care institution, it also became a referral
      centre for high-risk pregnancies and obstetric emergencies. The efficacy of the
      services provided since inception was evaluated by measurement of mortality
      statistics, which are the most sensitive indices of maternal care. Over a period
      of 18 years, there were almost 100,000 births. Although the caesarean section
      rate was low, the perinatal and maternal mortality rates suggest that there is
      still a wide gap in obstetric standards between the developed world and this
      country. Improved vigilance for high-risk groups is required to identify
      potentially preventable deaths.

PMID- 11214959
TI  - Fetal echocardiography: a comparison of different techniques.
AB  - There is great availability on the market of echocardiographic instruments that
      have innovative technological systems which use second harmonic imaging. The true
      usefulness and applicability of these instruments in fetal echocardiography have
      yet to be verified. The objective of the present study was to verify the impact
      of this echographic technology in the diagnostic evaluation of the fetal
      cardiovascular system. Thus, an Acuson Sequoia echograph which uses native tissue
      harmonic imaging (NTHI) was used to examine 30 pregnant women between the 28th
      and 32nd week of gestation. The b-mode and m-mode images were acquired and
      recorded by the conventional method and by the second harmonic imaging method
      without contrast medium. Two experts in the field analyzed and compared the
      images recorded by the two methods and made diagnostic and qualitative
      judgements. The 30 cases examined were unanimously determined to have no visible
      echo pathologies. The morpho-biometric evaluation obtained by the two methods did
      not show any significant differences and the quality of the images obtained by
      the traditional method was found on average to be higher. In conclusion we
      believe that the use of second harmonic imaging for studies of the fetal heart
      does not seem to offer any advantages with respect to the conventional method.

PMID- 11214960
TI  - Hepatic and renal effects of azidothymidine and acyclovir on pregnant rats.
AB  - The antiviral effect of azidothymidine (AZT) can be potentiated by acyclovir
      (ACV), and this drug association has been used in the management of HIV-infected
      patients. In the present study we examined the effects of this association on the
      livers and kidneys of both pregnant rats and their concepts. Previous data from
      this laboratory suggested that the deleterious effects of ACV on rat pregnancy
      are due to its extraplacental actions and these are, at least in part,
      counteracted by concomitant treatment with AZT. Kidneys and livers of pregnant
      rats were noticed to be much more sensitive to the toxic action of the drugs than
      those of their concepts, ACV eliciting much more evident morphological
      alterations than did AZT. Contrary to what was expected, in the group of rats
      treated with both drugs AZT was not able to diminish the severity of the
      alterations evoked by ACV. The proposed "protective" action of AZT against the
      abortive effect of ACV on rat pregnancy does not seem to be exerted through a
      renal or hepatic pathway.

PMID- 11214961
TI  - The effects of sialoadenectomy & flutamide on skin development.
AB  - BACKGROUND: Epidermal growth factor is a low molecular weight polypeptide with 53
      amino acids and is known to stimulate cell proliferation and differentiation in a
      wide range of tissues. The submandibulary gland in the mouse is a rich source of
      epidermal growth factor and decreased plasma epidermal growth factor levels have
      been observed after sialoadenectomy (removal of the submandibular glands).
      Furthermore. there is evidence that epidermal growth factor stimulates
      spermatogenesis and reverses antiandrogen induced cryptorchidism. OBJECTIVE: In
      the present study, the teratogenic effects of sialoadenectomy and antiandrogen
      (flutamide) administration on rat skin were investigated histologically.
      MATERIALS & METHODS: Thirty Spraque-Dawley female rats were separated into three
      groups (n = 10), a control (sham-operated) and two experimental groups. The first
      experimental group of rats were subjected to sialoadenectomy in order to create
      maternal EGF deficiency one month before copulation. The second experimental
      group of rats were given flutamide (10 mg/100 g) for ten days during pregnancy.
      Three months after birth, a penile skin biopsy was taken from respective
      offspring in all groups. RESULTS: A statistically significant reduced body weight
      and length were noted in the first group of litters (maternal EGF deficient) and
      in the flutamide administered group when compared to the control group. Atrophic
      epidermis and dermal adnexa were observed histologically as the teratogenic
      effects of sialoadenectomy and flutamide administration on rat skin development.
      CONCLUSION: Epidermal growth factor is a key hormone for skin development and
      antiandrogen administration may insult this process by interfering with epidermal
      growth factor metabolism.

PMID- 11214962
TI  - Teratogenic effects of propineb on rat skin.
AB  - The dithiocarbamates are known to cause dermatitis, conjunctivitis, rhinitis,
      pharyngitis and bronchitis in humans. The experimental group received Propineb
      (obtained from Bayer) concentrations of 400 ppm in distilled water five days a
      week (treatment time three weeks) administered orally by gasric pit. Acute oral
      LD50 for male rats has been found to be 8,500 mg/kg (Worthing, 1983). The control
      group (n = 10) received only distilled water. At ultrasonographical examination,
      there were no resorbed fetuses or stillborns during or after propineb
      administration. It can be clearly seen that the body weights of the experimental
      group of litters are lower than those of the control group (p < 0.001). However,
      the mean length of the experimental litters was identical to the control group of
      litters (p > 0.05). Under microscopical examination, increased keratinization and
      hyperplasia were observed in the epidermal cells.

PMID- 11214963
TI  - Effects of clomiphene citrate on neonatal rat skin.
AB  - BACKGROUND: Clomiphene citrate is chemically related to non-steroidal estrogens,
      and has antiestrogenic properties. It is used in the treatment of anovulatory
      female infertility and its therapeutic effect mainly depends on inhibiting the
      negative feedback effects of endogenous estrogen by stimulating the gonadotropin
      releasing hormone. Today, it is also used in the treatment of male infertility.
      OBJECTIVES: In this study the effects of clomiphene citrate on skin maturation in
      neonatal rats were investigated. METHODS: Forty Spraque-Dawley female newborn
      rats were separated into two control and two experimental groups (n = 10). One
      day after birth. experimental newborn rats were given clomphene citrate
      subcutaneously in a dosage of 100 mg/kg/day for five days. The first experimental
      group of rats were anesthetised at 21 days whereas the second experimental group
      of rats were then anestetised on day 28. Biopsies were taken immediately from the
      perineal skin. Histopathological assessments were made and compared with their
      control groups. RESULTS: In both the experimental groups of newborn rats,
      increased keratinization and irregular hypertrophy were observed in the epidermal
      cells. Disorganization of the basal layer cells and hyperplasia were found to be
      more prominent in the first experimental group and dermal fibrosis and
      lymphohistiocytic inflammatory cell infiltration were especially prominent around
      the sebaceous glands in the second experimental group. CONCLUSION: The
      administration of clomiphene citrate in newborn rats showed impaired skin
      maturation.

PMID- 11214964
TI  - Teratogenic effects of nicotine on rat skin.
AB  - BACKGROUND: Nicotine is a well-known toxic alkaloid substance with several
      teratogenic effects. In animal studies it has been observed that nicotine led to
      intrauterine growth retardation and intrauterine growth abnormalities including
      anancephaly, neonatal death and low birth weight. However, the teratogenic
      effects of nicotine have not previously been observed on skin. OBJECTIVE: We
      performed a study in order to observe histologically the teratogenic effects of
      nicotine on rat skin. MATERIALS & METHODS: Ten female Wistar-albino rats were
      separated into two groups, a control and an experimental group (n = 5). After the
      first week of pregnancy, the experimental group of rats were given nicotine
      intraperitoneally in a dosage of 2 mg/kg for two weeks. RESULTS: Striking
      teratogenic effects were observed in the experimental group of neonatal rats.
      Increased mitotic activity was noticed in the basal cells and hypertrophic
      epithelial cells were prominent in the epidermis. Chronic inflammatory cell
      infiltrate, fibrosis and extravasation of the erythrocytes were found in the
      dermis and hair follicles. CONCLUSION: Considerable teratogenic effects of
      nicotine were observed histologically on newborn rat skin.

PMID- 11214965
TI  - The effect of abdominal surgery on serum CA-125 levels.

PMID- 11214966
TI  - The size and sequence organization of the centromeric region of arabidopsis
      thaliana chromosome 5.
AB  - We have determined the size of the centromeric region of Arabidopsis thaliana
      chromosome 5, which corresponds to the genetically defined centromere by
      Copenhaver et al. (Science, 286, 2468-2474, 1999) on the basis of restriction
      analysis. As a large clone gap was present in the previously constructed contig
      map of the centromeric region, the restriction map of this region was constructed
      using Asc I, Not I, Apa I and Pme I and genomic DNA from a hypomethylated strain.
      The size of the centromeric region finally estimated by combination with the
      sequence data of cloned regions at both sides was 4.35 megabases (Mb). This value
      is over 2 Mb longer than those estimated in our previous work and also by
      Copenhaver et al. Combing this centromeric region with the physical map
      previously constructed, the entire length of chromosome 5 becomes 31 Mb. Although
      the internal moiety of the centromeric region has not been sequenced yet because
      of extremely high repetition, the result of sequence analysis from both sides
      toward the inside strongly suggests that the centromeric region is composed of
      the central 2.9-Mb domain consisting of mainly 180-bp repeats and Athila
      retrotransposons and flanking regions containing various types of transposons. On
      the basis of these observations, a structural model for the centromeric region is
      discussed.

PMID- 11214967
TI  - Complete structure of the chloroplast genome of a legume, Lotus japonicus.
AB  - The nucleotide sequence of the entire chloroplast genome (150,519 bp) of a
      legume, Lotus japonicus, has been determined. The circular double-stranded DNA
      contains a pair of inverted repeats of 25,156 bp which are separated by a small
      and a large single copy region of 18,271 bp and 81,936 bp, respectively. A total
      of 84 predicted protein-coding genes including 7 genes duplicated in the inverted
      repeat regions, 4 ribosomal RNA genes and 37 tRNA genes (30 gene species)
      representing 20 amino acids species were assigned on the genome based on
      similarity to genes previously identified in other chloroplasts. All the
      predicted genes were conserved among dicot plants except that rpl22, a gene
      encoding chloroplast ribosomal protein CL22, was missing in L. japonicus.
      Inversion of a 51-kb segment spanning rbcL to rpsl6 (positions 5161-56,176) in
      the large single copy region was observed in the chloroplast genome of L.
      japonicus. The sequence data and gene information are available on our World Wide
      Web database at http://www.kazusa.or.jp/en/plant/database.html.

PMID- 11214968
TI  - Complete genome structure of the nitrogen-fixing symbiotic bacterium
      Mesorhizobium loti.
AB  - The complete nucleotide sequence of the genome of a symbiotic bacterium
      Mesorhizobium loti strain MAFF303099 was determined. The genome of M. loti
      consisted of a single chromosome (7,036,071 bp) and two plasmids, designated as
      pMLa (351,911 bp) and pMLb (208, 315 bp). The chromosome comprises 6752 potential
      protein-coding genes, two sets of rRNA genes and 50 tRNA genes representing 47
      tRNA species. Fifty-four percent of the potential protein genes showed sequence
      similarity to genes of known function, 21% to hypothetical genes, and the
      remaining 25% had no apparent similarity to reported genes. A 611-kb DNA segment,
      a highly probable candidate of a symbiotic island, was identified, and 30 genes
      for nitrogen fixation and 24 genes for nodulation were assigned in this region.
      Codon usage analysis suggested that the symbiotic island as well as the plasmids
      originated and were transmitted from other genetic systems. The genomes of two
      plasmids, pMLa and pMLb, contained 320 and 209 potential protein-coding genes,
      respectively, for a variety of biological functions. These include genes for the
      ABC-transporter system, phosphate assimilation, two-component system, DNA
      replication and conjugation, but only one gene for nodulation was identified.

PMID- 11214969
TI  - Cloning and genomic organization of the mouse gene slc23a1 encoding a vitamin C
      transporter.
AB  - Vitamin C is known to exist in particularly high concentrations in brain tissue,
      and its free radical scavenging function is thought to represent a major
      antioxidative defense system. We have cloned, sequenced and analyzed the genomic
      structure of a mouse sodium-dependent vitamin C transporter gene, Slc23a1 (also
      known as Svct2). The mouse Slc23a1 cDNA is 6.4 kb long and was cloned directly
      from a mouse brain RNA preparation. Hybridization screening of a mouse genomic
      BAC library identified BAC 53L21 which contains at least the entire coding
      sequence of the mouse Slc23a1 gene. Determination of the exon-intron structure of
      the gene revealed 17 exons ranging from 58 bp to 4407 bp extending over 50 kb of
      the mouse genome, with the translation start codon located in exon 3. Its 1944
      nucleotide open reading frame encodes a polypeptide of 647 aa, which is highly
      similar to rat and human orthologs. The mouse gene was assigned to chromosome
      2qG2 by fluorescence in situ hybridization analysis. Expression of this gene was
      demonstrated in a wide range of tissues, with especially high levels in brain.
      Neurodegenerative diseases with an established role for oxidative stress in the
      cytoplasm may therefore be conditions of SLC23A1 dysfunction. Key words: gene
      structure; Vitamin C; transporter; oxidative stress

PMID- 11214970
TI  - Prediction of the coding sequences of unidentified human genes. XIX. The complete
      sequences of 100 new cDNA clones from brain which code for large proteins in
      vitro.
AB  - As an extension of our human cDNA project for accumulating sequence information
      on the coding sequences of unidentified genes, we here present the entire
      sequences of 100 cDNA clones of unidentified genes, named KIAA1673-KIAA1772, from
      three sets of size-fractionated cDNA libraries derived from human adult whole
      brain, hippocampus, and fetal whole brain. The average sizes of the inserts and
      corresponding open reading frames of cDNA clones analyzed here were 4.9 kb and
      2.7 kb (corresponding to 895 amino acid residues), respectively. By computer
      assisted analysis of the deduced amino acid sequences, 44 predicted gene products
      were classified into five functional categories of proteins relating to cell
      signaling/communication, nucleic acid management, cell structure/motility,
      protein management, and metabolism. Furthermore, the expression profiles of the
      genes were also studied in 10 human tissues, 8 brain regions, spinal cord, fetal
      brain and fetal liver by reverse-transcription-coupled polymerase chain reaction,
      the products of which were quantified by enzyme-linked immunosorbent assay.

PMID- 11214971
TI  - Characterization of long cDNA clones from human adult spleen.
AB  - As an extension of our analysis of long cDNAs, we here report the
      characterization of cDNA clones from human adult spleen. From 2000 cDNA clones
      randomly sampled from a size-fractionated human spleen cDNA library (average size
      4.5 kb), 97 clones were selected for sequencing according to their ability to
      code for protein at the 5'-end sequences and the novelty of their end sequences.
      The sequence data of these clones demonstrated that 87 out of 97 cDNA clones were
      derived from independent human genes. The average sizes of the inserts and
      corresponding open reading frames of these 87 cDNAs reached 4.5 kb and 1.4 kb
      (corresponding to 468 amino acid residues), respectively. In addition to these
      sequence analyses in silico, the expression profiles of the genes were also
      studied in ten human adult tissues by reverse transcription-coupled polymerase
      chain reaction, products of which were quantified by enzyme-linked immunosorbent
      assay. The results indicated that spleen could be used as an additional source of
      human long cDNAs to complement the list of human genes.

PMID- 11214972
TI  - Embarking on rice functional genomics via cDNA microarray: use of 3' UTR probes
      for specific gene expression analysis.

PMID- 11214973
TI  - Gene list on a plant tumor-inducing plasmid, pti-SAKURA in Agrobacterium
      tumefaciens MAFF301001.

PMID- 11214974
TI  - Complete genome structure of the nitrogen-fixing symbiotic bacterium
      Mesorhizobium loti (supplement).

PMID- 11214975
TI  - Effects of monaural versus binaural stimulation on P300 scalp topography in
      elderly listeners.
AB  - The P300 event-related potential was recorded from groups of young and elderly
      listeners in response to monaural and binaural stimulation. An oddball stimulus
      paradigm was used to record responses from 19 scalp locations. When listening to
      binaural stimuli, the young group showed midline and central P300 amplitude
      maxima, whereas the elderly group exhibited maximal responses in the midline and
      parietal regions. With monaural stimulation, the young group's responses were
      similar to those obtained with binaural stimulation. The elderly group, however,
      showed evidence of a greater contralateral hemisphere response to monaural
      stimulation during the early part of the P300 response. These findings support
      the possibility that the P300 neural generators may change with age with respect
      to temporal onset characteristics or their orientation and strength.

PMID- 11214976
TI  - Clinical application of the SADL scale in private practice II: predictive
      validity of fitting variables. Satisfaction with Amplification in Daily Life.
AB  - Predictive validity of 44 independent variables and their interactions with
      Satisfaction with Amplification in Daily Life (SADL) scores was assessed. SADL
      scores were influenced by patient age, years of hearing aid experience, hours of
      use per day, perceived hearing difficulty, pure-tone average, hearing aid style,
      processor type, and manufacturer's invoice cost. The relative importance of these
      variables to SADL measures was complex and very small, but the variables and
      their squares and interactions improved r2 predictions of SADL Global and
      subscale scores in a separate stepwise multiple linear regression procedure by 12
      to 33 percent compared to SADL norms alone. More research with additional
      variables is needed to develop a clinically useful model for predicting wearer
      satisfaction. Clinically, SADL scores yield subscale-specific patterns of
      satisfaction and dissatisfaction that help in intervention planning and serve as
      graphic "snapshots" of satisfaction status. A series of patient profiles are
      presented illustrating the potential usefulness of the SADL in predicting hearing
      aid satisfaction. With its good construct and psychometric properties, the SADL
      could serve as a gold standard for satisfaction outcomes and a basis for
      development of a predictive model of hearing aid fitting success.

PMID- 11214977
TI  - NAL-NL1 procedure for fitting nonlinear hearing aids: characteristics and
      comparisons with other procedures.
AB  - A new procedure for fitting nonlinear hearing aids (National Acoustic
      Laboratories' nonlinear fitting procedure, version 1 [NAL-NL1]) is described. The
      rationale is to maximize speech intelligibility while constraining loudness to be
      normal or less. Speech intelligibility is predicted by the Speech Intelligibility
      Index (SII), which has been modified to account for the reduction in performance
      associated with increasing degrees of hearing loss, especially at high
      frequencies. Prescriptions are compared for the NAL-NL1, desired sensation level
      [input/output], FIG6, and a threshold version of the Independent Hearing Aid
      Fitting Forum procedures. For an average speech input level, the NAL-NL1
      prescriptions are very similar to those of the well-established NAL-Revised,
      Profound procedure. Compared with the other procedures, NAL-NL1 prescribes less
      low-frequency gain for flat and upward sloping audiograms. It prescribes less
      high-frequency gain for steeply sloping high-frequency hearing losses. NAL-NL1
      tends to prescribe less compression than the other procedures. All procedures
      differ considerably from one another for some audiograms.

PMID- 11214978
TI  - Effects of exercise and noise on auditory thresholds and distortion-product
      otoacoustic emissions.
AB  - Differences in auditory thresholds and distortion-product otoacoustic emission
      (DPOAE) levels were investigated as a function of gender, ear, frequency, and
      experimental condition: quiet sedentary activity, exercise, noise, and exercise
      and noise combined. In general, participants displayed significant elevations in
      auditory thresholds of approximately 6 to 13 dB following the two conditions
      employing noise exposure. There were no significant differences in either
      auditory threshold differences before and following the quiet and exercise
      conditions or between the noise-alone and combined exercise and noise conditions.
      Participants also displayed significant reductions in DPOAE levels of
      approximately 6 to 7 dB following the two conditions employing noise exposure.
      The findings also showed no gender or ear effects on auditory threshold or DPOAE
      level differences. Further, there was no evidence of a synergistic combination of
      exercise and noise on auditory function as revealed by changes in hearing
      threshold or DPOAE levels.

PMID- 11214979
TI  - Relation between slopes of word recognition psychometric functions and
      homogeneity of the stimulus materials.
AB  - This tutorial paper examines the relation between the slope of a mean word
      recognition function and the homogeneity or variability (with respect to
      recognition) of the individual stimulus items that compose the test materials.
      This was studied in terms of both the location (Cartesian) and slope of the
      psychometric functions of the individual words that compose the materials. Word
      recognition performances were measured for 100 CID W-22 (Hirsh) words and 100 PB
      50 (Rush Hughes) words in quiet (0 to 56 dB HL in 8-dB steps) on 12 subjects with
      normal hearing. The functions for the individual W-22 words were more homogeneous
      (less variable) than were the functions for the individual PB-50 words. The mean
      function for the W-22 words was steeper (3.1%/dB) than the function for the PB-50
      words (1.9%/dB). This evaluation of the individual words demonstrates the direct
      relation between variability of the test items and the slope of the mean
      psychometric function. The more homogeneous performance is on the individual test
      items with respect to both location and slope, the steeper the slope of the mean
      psychometric function.

PMID- 11214980
TI  - Diagnosis and management of foodborne illnesses: a primer for physicians.
AB  - This primer is directed to primary care physicians, who are more likely to see
      the index case of a potential food-related disease outbreak. It is a teaching
      tool to update primary care physicians about foodborne illness and remind them of
      their important role in recognizing suspicious symptoms, disease clusters, and
      etiologic agents, and reporting cases of foodborne illness to public health
      authorities.

PMID- 11214982
TI  - Program budgeting and marginal analysis: a priority-setting framework for
      Canadian Regional Health Authorities.
AB  - Health regions in Canada are responsible for meeting the needs of local
      populations with limited resources. However, relatively little attention has been
      given to this within-region resource allocation problem. An economic approach to
      needs assessment, namely program budgeting and marginal analysis, may be of
      benefit. Its potential for use in Canada is examined, in particular with examples
      from two Alberta health regions, the Calgary Regional Health Authority and the
      Chinook Health Region.

PMID- 11214981
TI  - Organizational justice principles and large-scale change: the case of program
      management.
AB  - Many of the barriers to implementation of large-scale change in healthcare
      organizations seem to be related to a lack of attention to the human change that
      needs to occur. One element of this human dimension that change agents overlook
      is the role that perception of fairness to employees plays in implementing large
      scale organizational change. This article uses program management (an
      organizational design that has been implemented in many healthcare facilities
      across Canada) as an example of large-scale structural change and demonstrates
      the importance of applying procedural and interactional justice principles to
      enhance the implementation of organizational change.

PMID- 11214983
TI  - The electronic health record: a destination or a journey?

PMID- 11214984
TI  - Differentiating among research, evaluation and measures to assure quality.
AB  - This article explores the similarities, differences and overlaps among research,
      evaluation and quality measurement. Criteria for determining the differences are
      offered as a quick guide to differentiating among them. These criteria are the
      purpose of the project, generalizability, intended use of the findings, intended
      subjects and intent to prove causation. Determining the key differences among
      research, evaluation and quality measurement facilitates the choice of
      restrictions, supports and reporting process that should be applied to each.

PMID- 11214985
TI  - Initiating regional quality management.
AB  - In June 1999, the Eastern Regional Health Board began to structure a regional
      quality management program that included quality, satisfaction and risk
      management initiatives. A regional plan for our two programs (Addiction Services
      and Public Health) and nine acute care facilities was needed. All had internal
      quality programs in place, at varying levels of maturity. Synthesis into a
      regional quality management plan was required. This article describes how one
      region planned and implemented this task over 10 months. Suggestions are included
      relating to required resources, a workable timeline and a communication strategy.

PMID- 11214987
TI  - Changing ourselves to help change our teams and organizations. Interview by
      Matthew D. Pavelich.

PMID- 11214986
TI  - Going beyond triage in Tajikistan. Health reform in the former Soviet Union.
AB  - Tajikistan is among the few countries where life expectancy diminished during the
      1990's. To rebuild a health system fractured by economic collapse, political
      disintegration and civil war, the Essential Hospital Services Project was
      initiated to restore essential hospital services, encourage structural reform and
      build the health system's capacity to sustain itself. The article provides an
      overview of these reform efforts, outlines some of the challenges of health
      reform in Tajikistan and illustrates the benefits global partnerships can achieve
      when sharing creative new approaches to health reform.

PMID- 11214988
TI  - Hospitals taking second look at systems for thwarting infant kidnapping.

PMID- 11214989
TI  - Security and risk management coordination at a large medical center.

PMID- 11214990
TI  - Surveys: income of healthcare security directors continues to rise.

PMID- 11214991
TI  - Johnny Melles on replacing an older CCTV system with modern surveillance.

PMID- 11214992
TI  - How two major health systems are employing 'doing more with less' and 'value
      added' approaches to hospital security.
AB  - In efforts to achieve greater productivity from their security departments in the
      face of cutbacks, mergers, and other economic developments, a number of buzzwords
      have become popular recently that, in effect, call on security personnel to
      effectively provide additional services without increased funding or, in fact,
      with reduced budgets. Talking about such approaches is one thing, but achieving
      desired results is another. In this report, we'll present details on how security
      directors of two of the county's largest health operations have put concept into
      action.

PMID- 11214993
TI  - Dealing with census spikes at a state psychiatric facility.

PMID- 11214994
TI  - Ziegler: factors to be aware of in meeting JCAHO EOC requirements.

PMID- 11214995
TI  - Taking management of sickle cell disease to a new level.

PMID- 11214996
TI  - Patient, provider education targeted in efforts to curb antibiotic resistance.
AB  - Curb the overuse and misuse of antibiotics during the cough and cold season.
      Overuse is feeding the growing problem of antibiotic resistance. The result is
      billions spent to find new drugs and new cures for bugs that used to respond to
      front-line agents. Experts suggest the best way to address the problem is through
      patient and provider education. See how some regional efforts are faring, and
      take steps to address the problem in your organization.

PMID- 11214997
TI  - Patient empowerment touted as next step toward better preventive care.
AB  - Boost quality and outcomes through patient empowerment. How? By making claims
      information available to health plan members as well as physicians. At least one
      organization is making it happen with the help of a Web-based communications
      strategy.

PMID- 11214998
TI  - New guideline: step up efforts to prevent and treat diabetic foot disorders.
AB  - Prevent and treat diabetic foot disorders before complications multiply. They're
      the most common reason for hospitalization among diabetic patients, and such
      problems are costing billions each year to treat. However, some simple preventive
      steps at the primary care level could go a long way toward preventing or
      alleviating the more serious complications of diabetic foot disorders. Check out
      these new guidelines and new strategies for dealing with this costly issue.

PMID- 11214999
TI  - [In vitro antibacterial activity of prulifloxacin, a new oral quinolone, and
      comparative susceptibility rate at clinical breakpoint MIC].
AB  - In vitro drug sensitivity of clinically isolated bacteria against prulifloxacin
      (PUFX), which is a new quinolone, was investigated, and the antibacterial
      activity and susceptibility rate at clinical breakpoint were compared with those
      of norfloxacin, ofloxacin (OFLX), ciprofloxacin, tosufloxacin, fleroxacin,
      sparfloxacin and levofloxacin (LVFX). The following results were obtained. 1)
      PUFX showed a broad-spectrum antibacterial activity against both Gram-positive
      and Gram-negative bacteria. 2) MIC80 of PUFX was 0.25 and 1 microgram/ml, against
      methicillin susceptible Staphylococcus aureus and Streptococcus pneumoniae,
      respectively and below 0.125 microgram/ml against Gram-negative
      Enterobacteriaceae. MIC90 of PUFX against Pseudomonas aeruginosa, which has MIC
      not exceeding 4 micrograms/ml to OFLX, was 0.5 microgram/ml. 3) PUFX was judged
      as active against the bacteria under the criteria proposed presented by "the
      Sensitivity Determination Committee for Antibiotics, Japan Society of
      Chemotherapy: Break Point for Respiratory Infectious Diseases and Sepsis". It is
      suggested that the sensitivity of each bacterial species to PUFX was high. 4)
      From the correlation analysis of MIC, PUFX was shown to have two to eight times
      higher antibacterial acitivity than LVFX for Citrobacter freundii, Serratia
      marcescens and Pseudomonas aeruginosa.  5) PUFX showed potent short-time
      bactericidal activity against S. aureus and P. aeruginosa.

PMID- 11215000
TI  - [Concentration of isepamicin sulfate in bone marrow blood].
AB  - Fifteen patients who were performed a rotator cuff repair were subjected for the
      determination of a concentration of isepamicin sulfate (ISP), which was infused
      intravenously, in venous blood and bone marrow blood. The concentrations were
      measured at 0, 30, 60 minutes after the injection. There was no statistically
      significance between ISP concentrations in venous and bone marrow blood. This
      study revealed that the transference of ISP to the bone marrow was excellent.

PMID- 11215001
TI  - Journal transition points to a bright future for its contribution to public
      health.

PMID- 11215002
TI  - Diabetes in Victoria, Australia: the Visual Impairment Project.
AB  - OBJECTIVES: To establish the prevalence and characteristics of self-reported
      diabetes in a representative sample of Victorian residents aged 40 years and
      older, and to compare the vision between people with and without self-reported
      diabetes. DESIGN: Cross-sectional survey. SETTING: Nine randomly selected
      suburban Melbourne clusters and four randomly selected rural Victorian clusters.
      PARTICIPANTS: 4,744 subjects (86% participation rate) aged > or = 40 years. MAIN
      OUTCOME MEASURES: Subjects answered a detailed questionnaire which provided
      demographic details, body mass index, and the duration and treatment of any
      diagnosis of diabetes. Refraction was performed and best-corrected visual acuity
      was measured. RESULTS: The prevalence of self-reported diabetes was 5.1%. In a
      multivariate analysis, self-reported diabetes was positively associated with age
      (p < 0.01), male sex (p = 0.01), higher body mass index (p = 0.01), Mediterranean
      ethnicity (p = 0.01), unemployment (p = 0.05) and lack of private health
      insurance (p < 0.05). People with self-reported diabetes were more likely to have
      mild or moderate levels of visual impairment than people who reported no previous
      diagnosis of diabetes (p < 0.01). CONCLUSIONS: Diabetes in Victoria is more
      prevalent among men and among people of Mediterranean origin. When planning
      educational programs and health service delivery, it is also important to
      consider that, compared with the general population, people with diabetes are
      less likely to be employed or to have private health insurance, and are more
      likely to have impaired vision.

PMID- 11215003
TI  - Body mass index in aboriginal Australians in remote communities.
AB  - OBJECTIVES: To describe the distribution of body mass index (BMI) and estimate
      the prevalence of potential chronic energy deficiency (CED) and obesity in
      Aborigines in remote communities (ARC) in the Top End of the Northern Territory,
      Australia. METHODS: Centile charts were constructed for BMI from 1,631 sets of
      measurements from 1,138 Aborigines, aged five to 77 years, in three remote
      communities on the Tiwi Islands, using Cole's LMS method. These were compared
      with European, American white and American black reference charts. The
      prevalences of CED and obesity were also compared to the corresponding values
      from a national Indigenous sample. RESULTS: The BMI centiles change with age.
      Compared with reference populations, BMIs are lower in ARC children and adult
      males. Young adult females have similar BMIs to American black and higher BMIs
      than American white and French counterparts up to 45 years. Aborigines older than
      50 years are 'thinner'. Compared with a national sample of Indigenous
      Australians, our sample has a higher prevalence of CED and a lower prevalence of
      obesity. CONCLUSIONS: The BMI centile curves describe the contemporary
      nutritional status in the remote communities. Nutritional status measured by BMI
      is different in ARC than in other populations. IMPLICATIONS: The difference in
      nutritional status between ARC and other populations should be considered when
      planning nutritional intervention strategies. The centile charts will allow
      health workers to determine the relative ranking of BMI for individual Aborigines
      in the remote communities.

PMID- 11215004
TI  - The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes
      compared with weighed food records in young to middle-aged women in a study of
      iron supplementation.
AB  - OBJECTIVE: To assess the validity of the Anti Cancer Council of Victoria food
      frequency questionnaire (ACCVFFQ) relative to seven-day weighed food records
      (WFRs) in 63 women of child-bearing age. METHOD: 63 women completed WFRs to
      assess iron intake as part of a study on iron deficiency. These women also
      completed the ACCVFFQ. Nutrient intakes were computed independently for the WFRs
      and FFQs. Intakes were compared as group means, by correlation and by quintile
      classification, adjusting for day-to-day variation in intakes, and for energy
      intake. Individual differences in results were also examined. RESULTS: The
      strongest associations between WFR and FFQ results were energy-adjusted, log
      transformed and adjusted for day-to-day variability in intake. Correlation
      coefficients ranged from 0.28 for vitamin A to 0.78 for carbohydrate. Mean
      intakes from the WFRs and FFQs were within +/- 20% for 21 of 27 nutrients. Poor
      agreement between FFQs and WFRs for retinol intake was due to the inclusion of
      liver in two WFRs, an item which is not included in the FFQ. CONCLUSION: The
      ACCVFFQ performs as well as other FFQs for which validation data are available.
      The relatively poor measurement of retinol is consistent with other data, and
      with the limited number of foods in which this nutrient is abundant.
      IMPLICATIONS: The availability of an optically scannable valid instrument for
      assessing dietary intake will facilitate epidemiological studies of diet and
      disease, an area of current research priority.

PMID- 11215005
TI  - Neural tube defects in Victoria, Australia: potential contributing factors and
      public health implications.
AB  - OBJECTIVES: To measure population prevalence and determine potential predictors
      of neural tube defects. METHOD: Analysis of all births reported to a mandated
      collection of perinatal data, and terminations prior to 20 weeks' gestation that
      have been reported to a data collection of birth defects in Victoria from 1983 to
      1997. Prevalence at birth and risk ratios of infant and maternal characteristics
      associated with neural tube defects were calculated. RESULTS: Prevalence of spina
      bifida has remained steady for 15 years and was 8.8/10,000 in 1997. Anencephaly
      increased to 7.9/10,000 in 1997. After exclusion of pregnancy terminations, the
      1997 birth prevalence was 4.5/10,000 for spina bifida and 2.4/10,000 for
      anencephaly. Neural tube defects are identified in 1 in 1600 fetuses, the risk
      being significantly higher for epileptic women (Adjusted Odds Ratio (AOR) = 3.70,
      95% CI 2.25-6.07), multiple births (AOR = 4.56, 95% CI 3.46-6.02), teenage
      mothers (AOR = 1.47, 95% CI 1.09-2.00) compared with those aged 25-29, and women
      with three or more previous pregnancies (AOR = 1.40, 95% CI 1.10-1.78). The risk
      was lower for women of East Asian (AOR = 0.70, 95% CI 0.49-1.00) and Middle
      Eastern origin (AOR = 0.60, 95% CI 0.35-1.02) and these differences were
      approaching statistical significance. CONCLUSION: Total prevalence of neural tube
      defects did not decline up to 1997. IMPLICATIONS: It is unlikely that targeting
      'at risk' groups identified in this study would make a difference to neural tube
      defect incidence. However, consideration could be given to identifying larger 'at
      risk' groups such as those with homocysteine metabolism defects.

PMID- 11215006
TI  - What do women feel about community-based antenatal care?
AB  - OBJECTIVE: This study evaluated women's perceptions of a new community-based
      model of continuity of antenatal care, the St George Outreach Maternity Project
      (STOMP). The model was established in an attempt to address some of the ongoing
      concerns and criticisms regarding antenatal care in Australia: lack of continuity
      of care and caregiver; prolonged waiting times; and inaccessible clinics.
      METHODS: A randomised controlled trial was conducted with 1,089 women (550 in the
      experimental group and 539 in the control group). The experimental group (the
      STOMP group) received antenatal care from small teams of midwives and an
      obstetrician in community-based settings. Data were collected using a
      questionnaire administered at 36 weeks' gestation, with a response rate of 75%.
      RESULTS: Women in the STOMP group reported waiting significantly less time for
      antenatal visits with easier access to care. STOMP group women also reported a
      higher perceived 'quality' of antenatal care compared with the control group.
      STOMP group women saw slightly more midwives and fewer doctors than control group
      women did. CONCLUSION AND IMPLICATIONS: This model of care has implications for
      the planning and provision of antenatal services within the Australian public
      health system, which is increasingly moving towards a community-based emphasis.
      Antenatal care is a service that can be successfully transferred into community
      based settings with benefits for women.

PMID- 11215007
TI  - Cannabis use among Australian adolescents: findings of the 1998 National Drug
      Strategy Household Survey.
AB  - OBJECTIVE: To describe the prevalence, context and recent trends in cannabis use
      among Australian adolescents. METHOD: Data was collected from 1,581 adolescents
      aged 14-19 years as part of the 1998 National Drug Strategy Household Survey, and
      comparisons were made with data from 350 adolescents who participated in the 1995
      survey. RESULTS: Among 14-19 year olds, 47.8% have had the opportunity to use
      cannabis in the past year and 45.2% have used cannabis at least once in their
      lifetime. Substantial increases have occurred since 1995 in the prevalence of use
      among young females. While most cannabis use was fairly infrequent, a minority of
      14-19 year olds (9.4%) used cannabis at least weekly. Cannabis use was associated
      with regular tobacco and alcohol use, and other illicit drug use. Regular
      cannabis users had lower levels of health on the general health and vitality
      dimensions of the SF-36. IMPLICATIONS: These results show that cannabis
      availability and use is common among Australian adolescents, and confirm that
      there has been an increase in use between 1995 and 1998, although only among
      young females. Future research is required to understand why this recent increase
      has occurred, and trends in cannabis uptake and use patterns among this group
      should be carefully monitored. Interventions may need to be developed and made
      available to the group of young people who are using cannabis heavily.

PMID- 11215008
TI  - Impact of increasing the re-supply interval on the seasonality of subsidised
      prescription use in Australia.
AB  - OBJECTIVE: To evaluate the impact of increasing the minimum re-supply period for
      prescriptions on the Pharmaceutical Benefits Scheme (PBS) in November 1994. The
      intervention was designed to reduce the stockpiling of medicines used for chronic
      medical conditions under the PBS safety net. METHODS: Interrupted times series
      regression analyses were performed on 114 months of PBS drug utilisation data
      from January 1991 to June 2000. These analyses assessed whether there had been a
      significant interaction between the onset of the intervention in November 1994
      and the extreme levels of drug utilisation in the months of December (peak
      utilisation) and January (lowest utilisation) respectively. Both serial and 12
      month lag autocorrelations were controlled for. RESULTS: The onset of the
      intervention was associated with a significant reduction in the December peak in
      drug utilisation; after the introduction of the policy there were 1,150,196 fewer
      prescriptions on average for that month (95% CI 708,333-1,592,059). There was,
      however, no significant change in the low level of utilisation in January. The
      effect of the policy appears to be decreasing across successive post-intervention
      years, though the odds of a prescription being dispensed in December remained
      significantly lower in 1999 compared to each of the pre-intervention years (11%
      vs. 14%). CONCLUSION: Analysis of the impact of increasing the re-supply period
      for PBS prescriptions showed that the magnitude of peak utilisation in December
      had been markedly reduced by the policy, though this effect appears to be
      decreasing over time. Continued monitoring and policy review is warranted in
      order to ensure that the initial effect of the intervention be maintained.

PMID- 11215009
TI  - Dying to go on holiday.
AB  - OBJECTIVE: The Christmas period road toll is a highly publicized 'summary' of the
      number of road deaths that occur each year during New Zealand's summer holiday
      period. Our aims were to identify significant changes in the Christmas road toll
      during 1968-98, highlight the ability to detect changes and determine if focusing
      on the changes in the Christmas road toll provided a useful insight into trends
      in fatal crashes. METHODS: Regression modelling of the number of fatalities was
      used to examine trends in the Christmas road toll in New Zealand over time. A
      power analysis was used to investigate the ability to detect significant
      reductions in the Christmas road toll. RESULTS: The Christmas road toll has not
      decreased significantly in the past 30 years and has not improved significantly
      in contrast to the rest of the year. The number of deaths in any given year can
      be expected to vary 'naturally' between 10 and 39. The statistical power to
      detect a hypothetical 19% reduction in the Christmas road toll is minimal.
      CONCLUSIONS: Stochastic fluctuations in the Christmas road toll make it extremely
      difficult to identify underlying trends, even if substantial. Little insight can
      be gained from yearly comparisons of road tolls considered over short periods.
      More focus should be placed on road tolls that are calculated over longer
      periods, e.g. the previous six months. IMPLICATIONS: Natural fluctuations arising
      in small counts will make it difficult to highlight real improvements in road
      tolls.

PMID- 11215010
TI  - Socio-demographic correlates of screening intention for colorectal cancer.
AB  - OBJECTIVE: To assess the relationship between socio-demographic factors and
      screening intention for colorectal cancer (CRC). METHODS: A cross-sectional
      survey of a random sample of 884 Queenslanders aged 40-80 years was conducted
      using a computer-assisted telephone interviewing system. The factors measured
      included socio-demographic characteristics, personal history of CRC, knowledge of
      others with CRC and perceived symptom status. Chi-squared and Monte Carlo
      estimates of Fisher Exact Tests were performed to determine the associations
      between socio-demographic factors and screening intention. In multivariate
      analyses, multinomial logistic regression (MNLR) was utilised to examine
      potential determinants of screening intention. RESULTS: 77.5% (95% CI 74.0%
      80.7%) of the respondents indicated their intention to participate in CRC
      screening if it were recommended by their doctor or health authorities. The
      likelihood ratio chi-squared tests in the MNLR analyses show that age (chi(df =
      6)2 = 15.0; p = 0.02), education (chi(df = 8)2 = 19.4; p = 0.01), perceived
      symptom status (chi(df = 4)2 = 22.9; p = 0.00), sex (chi(df = 2)2 = 4.5; p =
      0.11), income (chi(df = 14)2 = 19.6; p = 0.14) and personal history of CRC
      (chi(df = 2)2 = 4.3; p = 0.12) were potential determinants of screening
      intention. Other socio-demographic factors, including country of birth, private
      health insurance status, Socio-economic Index for Areas, and Rural and Remote
      Areas Classification codes, were not associated with screening intention.
      CONCLUSIONS AND IMPLICATIONS: The results indicate that a variety of socio
      demographic factors are associated with screening intention and need to be
      considered in the future development of a population-based screening program for
      CRC.

PMID- 11215012
TI  - How well does a telephone questionnaire measure drinking water intake?
AB  - BACKGROUND: Few studies have assessed the validity or reliability of drinking
      water intake estimations. In studies investigating potential waterborne disease,
      this is very important. METHODS: We carried out a validity and reliability study
      to evaluate water intake estimations. The validity part of the study compared a
      telephone questionnaire to a diary. The reliability part of the study compared
      two telephone questionnaires. RESULTS: 253 participants were recruited. The most
      commonly consumed water intake categories were plain and boiled tap water. For
      persons aged less than 12 years, the median volume of plain water consumption was
      2.9 glasses/day according to the diary. For persons aged 12 years and over, the
      median volume of plain water consumption was 3.0 glasses/day and for boiled water
      3.0 glasses/day according to the diary. There was negligible systematic over or
      under reporting by participants for the telephone questionnaire in comparison to
      the diary and for the comparison of both telephone questionnaires. Water intake
      estimates were converted to categorical variables and the per cent agreement and
      weighted kappa statistics were calculated. For both the validity and reliability
      parts of the study the per cent agreement was 57-78% and the weighted kappa was
      0.57-0.81. CONCLUSION: Water intake estimates show only moderate levels of
      validity and reliability when using a telephone questionnaire in comparison to a
      diary. IMPLICATIONS: Investigators of potential waterborne disease or nutritional
      research should exercise some caution in drawing conclusions from minor
      differences in drinking water intake that are obtained from a telephone
      questionnaire.

PMID- 11215011
TI  - Participation of older males in a study on photography as an aid to early
      detection of melanoma.
AB  - OBJECTIVE: To examine the acceptability of photography as an aid to skin
      examinations in men over 50 years of age. METHODS: A randomised trial of men
      selected from the electoral roll. All participants were photographed, but only
      half received their photographs. Skin examinations by GPs at years one and two.
      RESULTS: 55% of men consented to have photographs taken and 51% did so. 86% of
      respondents had risk factors for melanoma (compared to 68% of non-responders) and
      47% had two or more risk factors (compared to 23% of non-responders). At year
      one, 91% of participants remaining in study regions had been examined.
      Photographs were lost by only six participants. CONCLUSIONS: Men over 50 years of
      age respond to personalised health messages about melanoma and respondents
      include a high proportion of males with risk factors for melanoma. IMPLICATIONS:
      These initial results suggest that photography may be a logistically acceptable
      approach for assisting in the early detection of melanoma.

PMID- 11215013
TI  - Aspects of tooth decay in recently arrived refugees.
AB  - OBJECTIVE: To measure and compare the prevalence and distribution of tooth decay
      among two refugee groups recently arrived in Australia. METHOD: The study
      included refugees aged 15-44 years from Iraq and the former Yugoslavia and
      random, age-matched social security recipients attending for emergency dental
      care in 1996. RESULTS: In younger persons, former Yugoslavian refugees had
      significantly greater decay experience than Iraqis and emergency care recipients.
      Refugees had significantly more untreated decay than emergency care recipients
      and a similar distribution of untreated decayed teeth, with only 15% having none
      and more than 10% having high decay levels. More than 33% of emergency care
      recipients had no untreated decay and less than 5% had high levels. CONCLUSION:
      Significant differences were found between refugees and emergency dental care
      recipients, with refugees having a higher prevalence and more uniform
      distribution of untreated decay. IMPLICATIONS: Consistent with public health
      objectives, the finding that refugees had significantly more untreated decay than
      other disadvantaged Australians provides support for improved access to dental
      care during the settlement period.

PMID- 11215014
TI  - The establishment of an industry-based education program in public health.
AB  - Commonwealth reforms have led to staff of the Department of Health and Aged Care
      needing a greater knowledge of public health, to more effectively evaluate
      evidence and to quickly acquire competence in new emerging areas. The
      department's requirements of a training program could not be met by existing
      university-based public health courses. A consortium of five universities and the
      department worked together to develop an industry-based course that would meet
      the Commonwealth's needs. The course was constituted within university
      regulations; had an incremental and articulated structure with exit points at
      certificate, diploma and Masters levels; was relevant to the work of staff;
      offered subjects which complemented the staff's existing skills, training and
      career aspirations; drew upon expertise across the universities; and was flexible
      in its delivery. The Commonwealth's and universities' experience has been
      sufficiently positive to conclude that a corporate public health postgraduate
      program has a place alongside university-based programs.

PMID- 11215015
TI  - Impacts of climate and climate change on medications and human health.
AB  - OBJECTIVE: To examine impacts of climate and climate change on medications and
      human health. METHODS: Literature review and analysis of MIMS. RESULTS: Changed
      climate associated with the enhanced Greenhouse Effect (e.g. increased
      temperature) may lead to medication-related health impacts through deterioration
      of storage conditions, increased heat stress from medication-induced heat
      intolerance, and by influencing pharmacokinetics. Increases in UV radiation from
      stratospheric ozone depletion may increase the significance of medications that
      can lead to an increased sensitivity to the damaging effects of UV radiation
      (i.e. photosensitivity). CONCLUSIONS AND IMPLICATIONS: Raising awareness of the
      impacts of climate on medications, and of climate-related side-effects, among
      both health care professionals and the public, should modify behaviour and
      therefore reduce the risks of such adverse impacts.

PMID- 11215016
TI  - Accidents in older people living at home: a community-based study assessing
      prevalence, type, location and injuries.
AB  - OBJECTIVES: To assess the prevalence, type, location of and injuries from home
      accidents, including falls and other accidents, and to explore whether variables
      including socio-demographic characteristics, medication use and home hazards were
      associated with all home accidents and falls. METHOD: 657 older people were
      interviewed about accidents in the previous four weeks. For a subsample (n =
      425), a home hazard check was completed. RESULTS: Of the 101 accidents reported,
      51% (n = 51) were falls and 50% (n = 50) were other accidents. The most common
      location for all accidents was outside (30%). Most resulted in minor injury to
      the legs (43%) or arms (39%). Medical treatment was sought for 14% of accidents.
      Having more than five hazards and infrequent home visits by healthcare providers
      were associated with having at least one accident and at least one fall. Use of a
      walking aid was also associated with falling. CONCLUSION: Rates of falls and
      other accidents are considerable. IMPLICATIONS: Work is required to confirm the
      importance of the relationships suggested and to provide data on the burden of
      injury associated with non-fall accidents.

PMID- 11215017
TI  - Cannabis: a Trojan horse for nicotine?

PMID- 11215018
TI  - Re: 'Birthweights and growth of infants in five aboriginal communities'.

PMID- 11215019
TI  - Just who is 'wrong' about the implications of heroin trials?

PMID- 11215020
TI  - Overwhelming support for smoking bans.

PMID- 11215021
TI  - The prevalence, incidence and distribution of human urinary schistosomiasis in
      Edo State, Nigeria.

PMID- 11215022
TI  - Digital architect . Self-service design.

PMID- 11215024
TI  - Surgeon General focuses on children with mental illnesses.

PMID- 11215023
TI  - Soothing the pain of soaring power prices.

PMID- 11215025
TI  - Dangers of psychoactive medication use in the elderly.

PMID- 11215026
TI  - Potential alternative to electroconvulsive therapy: pacemaker for the brain.

PMID- 11215027
TI  - Using structured writing experiences to promote mental health.
AB  - 1. Structured writing activities can be used in a therapeutic context for diverse
      purposes. 2. Selecting a particular writing modality should be based on
      individual clients' needs and abilities. 3. Therapeutic goals for writing
      interventions should be defined clearly prior to implementation.

PMID- 11215028
TI  - Dysphagia in psychiatric patients.
AB  - 1. Psychiatric patients in acute and long-term care settings may be at high risk
      for dysphagia and its sequelae. 2. The prevalence of dysphagia in the psychiatric
      population is higher than commonly believed. 3. Routine screening is essential
      for the safety and management of psychiatric patients at risk for dysphagia.

PMID- 11215029
TI  - Philosophical basis and practice of self-awareness in psychiatric nursing.
AB  - 1. Reflection on one's reasoning and judgments to become cognizant of what is in
      the unconscious mind, not what should be there according to a belief system,
      theory, or teachings, is necessary for the development of self-awareness. 2. The
      process of self-awareness compels nurses to examine their own value positions so
      these biases and prejudices are not projected onto others, and so nurses do not
      reject others who do not share similar values. 3. Seeking answers to the
      questions generated through self-awareness can make interpersonal work with
      clients dynamic, living experiences, which can bring a sense of satisfaction and
      meaning to nurses' work.

PMID- 11215030
TI  - Japanese expert public health nurses empower clients with schizophrenia living in
      the community.
AB  - 1. Home visiting psychiatric public health nurses are integral to expanding
      community-based mental health services for Japanese citizens living with
      schizophrenia and other mental illnesses. 2. Interviews with experienced
      psychiatric public health nurses revealed empowerment as the basic social process
      that guides their practice. Five empowering practice domains foster client
      autonomy. 3. Psychiatric public health nurses work with families, neighbors,
      educators, and employers to enable their clients' healthy living in the
      community.

PMID- 11215032
TI  - The definition of the situation is the situation.

PMID- 11215031
TI  - Listening.

PMID- 11215033
TI  - New ruling more than a bonus. HHS' approval of limited gain-sharing arrangement
      may lead to national trend.

PMID- 11215034
TI  - 2001 Trustees of the Year. Beth Israel's ironman rescues hospital from fiscal
      implosion.

PMID- 11215035
TI  - 2001 Trustees of the Year. Chairman's negotiating skills bring success to rural
      hospital.

PMID- 11215036
TI  - Patient-safety evangelism. Allina CEO Sprenger preaches importance of executive
      involvement.

PMID- 11215037
TI  - Blessed with a healthy bottom line. Bon Secours has avoided losses despite BBA,
      other operational challenges.

PMID- 11215038
TI  - For-profits take root in Pa. Many hospitals need cash, and big chains have it.

PMID- 11215039
TI  - More revenue, at a cost. Hospitals' price hikes imperil additional federal
      Medicare, Medicaid relief.

PMID- 11215040
TI  - Quantification of porcine follicle-stimulating hormone receptor messenger
      ribonucleic acid by reverse transcription-competitive polymerase chain reaction.
AB  - An easy and reliable method was developed for construction and quantification of
      competitive templates, which shared the same sequence as the amplified target DNA
      except for a 20-bp insertion in the middle by recombinant polymerase chain
      reaction (PCR). Among the advantages of competitive PCR is that any predictable
      or unpredictable variable that affects amplification has the same effect on both
      target and competitor species and that the final ratio of amplified products
      reflects exactly the initial targets. The utilization of a thermostable reverse
      transcriptase in the RT step was proposed to overcome the problem of the
      efficiency of target cDNA synthesis. In addition, to obtain reliable
      measurements, it was recommended to perform four PCR with amounts of competitive
      template flanking the concentration of the target mRNA.

PMID- 11215041
TI  - Influence of single base change in Shine-Dalgarno sequence on the stability of B.
      subtilis plasmid PSM604.
AB  - B. Subtilis expression plasmids generally require a stringent Shine-Dalgarno
      Sequence (SDS). Site-directed-mutagenesis was explored to change the Shine
      Dalgarno Sequence from AAAAATGGGG (mutant type) to AAAAAGGGGG (wild type) in
      recombinant plasmid PSM604. The single base substitution made the plasmid with
      wild SDS unstable in structure and segregation. The interaction of SDS with
      subtilisin leader sequence of PSM604 might be responsible for the instability of
      plasmid.

PMID- 11215042
TI  - Construction and identification of recombinant adenovirus vector containing the
      hVEGF165 gene.
AB  - To construct the recombinant adenovirus vector containing the cDNA for human
      vascular endothelial growth factor (hVEGF165), the cDNA for hVEGF165 was
      subcloned into pACCMV.pLpA. Subsequently, this recombinant pACCMV.hVEGF was co
      transfected into 293 cells together with pJM17 to obtain the replication
      deficient recombinant adenovirus containing hVEGF gene--AdCMV.hVEGF. The VEGF
      gene expression was detected by using RT-PCR and Western blot in rabbit aorta
      vascular smooth muscle cells (VSMC) infected with AdCMV.hVEGF. Cultured human
      umbilical vein endothelial cells (HUVEC) were incubated with the conditioned
      medium (CM) from above mentioned VSMC infected with AdCMV.hVEGF to observe the
      effect of VEGF on proliferation of HUVEC. 48 h after the infection with
      AdCMV.hVEGF, VSMC demonstrated VEGF expression, and the expressed VEGF could
      stimulate the proliferation of HUVEC in vitro. Successfully prepared
      AdCMV.hVEGF165 could express biologically active VEGF in infected VSMC, and
      stimulate proliferation of HUVEC.

PMID- 11215043
TI  - Effect of polypeptide CH50 on macrophage activation in vivo and anti-tumor
      function.
AB  - The main features of CH50, a recombinant polypeptide of human fibronectin,
      activating macrophages in vivo and its anti-tumor function were investigated.
      After injection of CH50 and(or) transfection of IFN-gamma gene in vivo, several
      kinds of factors produced by macrophages were determined and the growth of tumor
      in vivo was measured. CH50 could enhance the production of such factors as NO,
      TNF and IL-1 by macrophages, but the activation of macrophages was relatively
      slow when CH50 was used in vivo alone. CH50 and IFN-gamma could synergistically
      activate macrophages rapidly in vivo no matter whether the injection of CH50 or
      the transfection of IFN-gamma gene was performed first. Injection of CH50 alone
      inhibited the formation of tumor nodes in a dose-dependent manner. Low dose of
      CH50 could strongly inhibit the formation of tumor nodes less than 1 mm, while
      high dose of CH50 could inhibit those more than 1 mm. A stronger inhibition on
      the growth of tumor in vivo was obtained by the synergistic effect of CH50 and
      IFN-gamma. CH50 and IFN-gamma, as double-signal factors for activation of
      macrophages, will be potentially useful in tumortherapy.

PMID- 11215044
TI  - Effect of c-myc antisense oligodeoxynucleotides on hypoxia-induced proliferation
      of pulmonary vascular pericytes.
AB  - To study the effect of c-myc antisense oligodeoxynucleotides (ODNs) on
      proliferation of pulmonary vascular pericytes (PC) induced by hypoxia, cell
      culture, dot hybridization using probe of digoxigenin-11-dUTP-labeled cDNA, 3H
      thymidine incorporation, immunocytochemical technique and image analysis methods
      were used to observe the effect of c-myc antisense ODNs on expression of c-myc
      gene and proliferating cell nuclear antigen (PCNA), and 3H-thymidine
      incorporation of PC induced by hypoxia. The results showed that hypoxia could
      significantly enhance the expression of c-myc and PCNA (P < 0.01), and elevate 3H
      thymidine incorporation of PC (P < 0.01), but antisense ODNs could significantly
      inhibit the expression of c-myc and PCNA (P < 0.05), and 3H-thymidine
      incorporation of PC (P < 0.01). It was suggested that hypoxia could promote the
      proliferation of PC by up-regulating the expression of c-myc gene, but c-myc
      antisense ODNs could inhibit hypoxia-induced proliferation of PC by
      downregulating the expression of c-myc gene.

PMID- 11215045
TI  - Effects of prostaglandins and leukotrienes on hypoxic pulmonary vasoconstriction
      in rats.
AB  - To investigate the effects of prostaglandins (PGs) and leukotrienes (LTs) on
      hypoxic pulmonary vasoconstriction (HPV), in vivo rats experiment and in vitro
      perfused lung experiment were conducted. The effect of hypoxia on hemodynamics,
      concentrations of TXB2 and 6-keto-PGF1 alpha in serum and lung tissue during
      hypoxia and effects of PGs and LTs on HPV were observed. The results showed that
      pulmonary arterial pressure (Ppa) and pulmonary vascular resistance were
      increased during hypoxia, but cardiac output and systemic arterial pressure were
      decreased. There were increases of the concentrations of TXB2 and 6-keto-PGF1
      alpha and their ratio in serum and lung tissue during hypoxia. After use of
      cyclooxygenase inhibitor (indomethacin) in vivo and in vitro, HPV was augmented
      respectively, but after use of lipoxygenase inhibitor (diethylcorbamazine) or
      leukotriene receptor blocker (LY-171883), HPV was attenuated. It was suggested
      that LTs mediated pulmonary vasoconstriction, PGs inhibited pulmonary
      vasoconstriction and they played a modulating role during hypoxia.

PMID- 11215046
TI  - The change of interleukin-6 and tumor necrosis factor in patients with
      obstructive sleep apnea syndrome.
AB  - The levels of lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) and tumor
      necrosis factor-alpha (TNF-alpha) expression in culture of peripheral blood
      mononuclear cells (PBMC) and the plasma levels of IL-6 and TNF-alpha in the
      patients with obstructive sleep apnea syndrome (OSAS) were measured and the
      relationship between OSAS and IL-6 or TNF-alpha expression studied. Both IL-6 and
      TNF-alpha were detected by using ELISA in 22 patients with OSAS and 16 normal
      controls. The levels of LPS-induced IL-6 (787.82 +/- 151.97 pg/ml) and TNF-alpha
      (4165.45 +/- 1501.43 pg/ml) expression in the supernatant of the culture of PBMC
      and plasma level of IL-6 (50.67 +/- 4.70 pg/ml) and TNF-alpha (299.09 +/- 43.57
      pg/ml) in the patients with OSAS were significantly higher than those in the
      normal controls (in the supernatant of the culture of PBMC: 562.69 +/- 197.54
      pg/ml and 1596.25 +/- 403.08 pg/ml respectively; in the plasma; 12.69 +/- 2.75
      pg/ml and 101.88 +/- 21.27 pg/ml respectively). There were significantly positive
      correlation between the levels of IL-6 and TNF-alpha and the percentage of time
      of apnea and hyponea, as well as the percentage of time spending at SaO2 below
      90% in the total sleep time. It was concluded that LPS-induced IL-6 and TNF-alpha
      levels as well as plasma IL-6 and TNF-alpha levels in the patients with OSAS were
      up-regulated, which may be associated with the pathogenesis of OSAS.

PMID- 11215047
TI  - Study on the correlation of plasma NO, ET-1 and ALT in the patients with chronic
      hepatitis and cirrhosis.
AB  - The levels of plasma nitric oxide (NO), endothelin-1 (ET-1) and ALT in the
      patients with chronic hepatitis B and active cirrhosis and the correlation among
      them were observed and analyzed. NO3- was restored by using cadmium column assay
      and NO2- measured by heavy nitrogen assay. The primitive NO3- and total restored
      NO2- (NO3-/NO2-) in plasma of the patients with chronic hepatitis and cirrhosis.
      Plasma ET-1 and ALT levels were determined by using radioimmunological assay and
      Lai's assay, respectively. Compared with normal control group, the plasma levels
      of NO2-/NO2- and ET-1 in the patients with chronic active hepatitis and active
      cirrhosis were significantly increased (P < 0.05-0.01). There was a positive
      correlation between NO and ALT, and ET-1 and ALT in the patients with chronic
      active hepatitis and active cirrhosis respectively. It was suggested that
      elevation of both NO and ET-1 levels were closely related with injury severity of
      liver function.

PMID- 11215049
TI  - Methodological study of cell separation with domestic immunomagnetic beads.
AB  - To establish the method of cell separation with domestic immuomagnetic beads,
      three methods were investigated. Direct method, SPA method and Biotin-Avidin
      method were applied to separate cell strain Hut-78 and CD4 positive cells.
      Separation rate of strain Hut-78 was more than 90% in direct method. Detachment
      rate with papain was over 95%. Cell activity was well retained. SPA method and
      Biotin-Avidin methods were also effective, but the direct method was superior to
      the other two techniques. Before separated by the direct method, CD4 positive
      cells constituted 46.4% +/- 6.4% of mononuclear cells (MNC), but in eliminated
      suspension there was only 6.2% +/- 2.3% CD4 positive cells left. In the separated
      part, 80.6% +/- 7.2% of the cells combined with the beads. It is concluded that
      the direct method in separating cells had high sensitivity and specificity.

PMID- 11215048
TI  - Experimental study on the effect of ligustrazine in the prevention of intimal
      proliferation of deendothelial artery.
AB  - To evaluate the possibility of employing ligustrazine in the prevention of
      restenosis, the effects of ligustrazine on the intimal thickening of air-injured
      carotid artery of rats were investigated, and the effects of ligustrazine on the
      proliferation of rabbit aortic median smooth muscle cells (SMCs) cultivated in
      vitro were examined. Artery injury model of 18 rats of about 3 months old was
      established by Fishman air-dry method. Fourteen days after operation, the maximal
      artery intimal and medial thickness of the control and ligustrazine group was
      measured on the image analysis system. Using cell counting and thymidine (3H-TdR)
      up-take method, we also examined the effects of ligustrazine on the proliferation
      of aortic median SMC from 4 rabbits. Ligustrazine was found to inhibit the
      proliferation and 3H-TdR up-take of SMC in a dose-dependent manner in vitro (P <
      0.05 or P < 0.01 vs control). It also inhibited the intimal thickening of rat
      arteries after deendothelialization. The maximal intimal thickness of
      ligustrazine group was much thinner than that of the control (35.9 +/- 3.8
      microns vs 80.2 +/- 23.4 microns, P < 0.01). It was showed that ligustrazine
      could be used for prevention of restenosis in clinical practice.

PMID- 11215050
TI  - Study on P16 gene in acute leukemia.
AB  - To study the change of suppressing cancer gene P16 in acute leukemia, the P16
      antigen expression of leukemia cell surfaces in 61 cases were investigated with
      ABC assay and gene structural defects in 51 cases of acute leukemia were examined
      with multiple comparative PCR method. It was found that antigen expression of P16
      in leukemia was obviously lower than that innormal subjects (P < 0.001). At the
      same time, antigen expression in All was lower than that AML (P < 0.05). No
      significant difference was found between the complete remission (CR) and non
      remission (NR) subjects from AML and ALL groups (P > 0.05). THe exon 2 of P16
      gene showed homozygous deletion only inn 4 cases out of 30 cases in ALL. No
      structural defect was revealed in 21 cases of AML. It was suggested that
      expression defect of P16 gene was a main cause in development and progression of
      acute leukemia, and structural defect of exon 2 was not a primary molecular
      event.

PMID- 11215051
TI  - Clinical and biochemical characteristics of growth hormone-secreting pituitary
      tumors.
AB  - To investigate the difference of biochemical characteristics on gsp-positive and
      gsp-negative growth hormone (GH)-secreting pituitary tumors, 18 GH-secreting
      pituitary tumors were examined for their clinical characteristics and gsp
      oncogenes. All patients received the pituitary function combinative stimulating
      test. It was found that there were no difference in the sex, age, tumor size,
      course of disease and plasma basal GH levels with gsp-positive and gsp-negative
      patients. The plasma levels of PRL were increased in most patients (11/18), and
      the plasma levels of TSH in gsp-positive patients were higher than those in gsp
      negative patients (P < 0.05). There was no significant difference in the
      responses to pituitary combinative stimulating test in gsp-positive and gsp
      negative patients. It was concluded that there was little difference in the
      clinical biochemical characteristics of gsp-positive with gsp-negative GH
      secreting pituitary tumors.

PMID- 11215052
TI  - Preliminary study on the relationship between cAMP level and gsp expression in
      cultured human pituitary somatotrophinomas.
AB  - In order to investigate the relationship between abnormal intracellular signal
      transduction and tumorgenesis of human pituitary somatotrophinomas, the effects
      of protein kinase A (PKA)-dependent growth hormone (GH) releasing hormone (GHRH)
      and protein kinase C (PKC)-dependent GH-releasing peptide (GHRP-6) on cAMP
      production were observed by using cell culture and biochemical methods, and the
      expression of the gsp oncogene was detected by using PCR and direct sequence
      assay methods in 11 patients with human pituitary somatotrophinomas. It was found
      that GHRP-6 exerted significant stimulatory effect on cAMP production by 2 gsp
      positive tumors and no effect on the gsp-negative tumors. GHRP-6 could enhance
      the stimulation of cAMP production induced by GHRH in tumor without gsp
      oncogenes. It was suggested that both GHRH and GHRP-6 exert identical effects on
      human pituitary soamtotrophinomas, which was contributed to the cross-talk
      between the two intracellular signal transduction pathways in pituitary cells.

PMID- 11215053
TI  - The regulatory effects of protein kinase C on the proliferation of cultured human
      low-passage meningioma cells.
AB  - The potential role of the protein kinase C (PKC)-mediated signal transduction
      pathways in growth regulation was evaluated and the effects and the possible
      mechanism of PKC inhibitor on low-passage human meningioma cells in vitro
      investigated. Freshly resected meningiomas obtained from the operation were
      placed into cell cultures. Cells from early-passage were used for the following
      experiments. The numbers of the cultured meningioma cells were counted to
      evaluate the effect of the PKC inhibitor staurosporine on proliferation of
      meningioma cells. The basal phosphatidylinositol (PI) turnover rate and the
      inhibitory rate of starosporine on the proliferation of the meningioma cells were
      detected. It was found that the proliferation of the low-passage human meningioma
      cells was inhibited by staurosporine in a dose-dependent manner. The inhibitory
      rate of staurosporine was positively correlated with the basal PI turnover rate
      (r = 0.58, P < 0.01). It was suggested that PKC-mediated signal pathway is
      involved in the proliferation of the low-passage human meningioma cells. The
      procedure that PKC regulated the proliferation of human meningioma cells is a
      complex procedure. It is necessary to make more research in order to explore a
      non-operation therapy or an adjuvant therapy.

PMID- 11215054
TI  - Expression of p53 and p21 protein in transitional mucosa adjacent to rectal
      carcinoma and its clinical implication.
AB  - To study the biopathological characteristics of the transitional mucosa adjacent
      to rectal carcinoma, 34 cases were subjected to mucin histochemical and
      immunohistochemical study to observe the expression of p53 and p21 protein in
      distal mucosa adjacent to rectal carcinoma and its relationship to the mucin
      change. The expression of p53 protein was found in 29.4% (10/34) of distal
      transitional mucosa in the cytoplasm of goblet cells, and its positive staining
      was within 4 cm from carcinoma margin. All p53 positive mucosa was transitional
      mucosa. Overexpression of p21 protein was found in 26.5% (9/34) of distal
      transitional mucosa in cytoplasm of crypt cells, and its positive staining was
      within 2 cm from carcinoma margin. There was no relationship between the
      expression of p53 and p21 protein in carcinoma and that in transitional mucosa (P
      > 0.05). These findings indicated that there was aberrant alteration of p53 and
      p21 genes in transitional mucosa adjacent to colorectal carcinoma, which provided
      further evidence that transitional mucosa was an unstable pre-cancerous change.
      The aberrant mucin change and genetic alteration in distal mucosa of rectal
      cancer is within 4 cm.

PMID- 11215055
TI  - The relationship between apoptosis and the expression of proliferating cell
      nuclear antigen and the clinical stages in gastric carcinoma.
AB  - The relationship between the apoptosis and the expression of proliferating cell
      nuclear antigen (PCNA) and the clinical stages in gastric cancers was studied. By
      using terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL)
      technique and PCNA immunohistochemical staining, the apoptosis and the expression
      of PCNA in tissue of gastric carcinoma were assayed in situ, the index of
      apoptosis (AI), index of PCNA (PI) and the rate of AI/PI were calculated. AI and
      PI in gastric cancer tissues were (6.5 +/- 3.7)% and (49.8 +/- 15.9)%
      respectively, and the rate of AI/PI was 0.13 +/- 0.05, which were obviously
      different from those of normal gastric mucosa in paragastric cancer (P < 0.01).
      With the advanced TNM stages of gastric carcinoma, the AI was decreased, PI was
      increased and the rate of AI/PI decreased in gastric carcinoma. There was
      significant difference in them between the gastric cancer tissues and normal
      gastric mucosa in pericarcinoma in TNM stage II to IV (P < 0.05). It was
      suggested that the decreased apoptotic cells and the increased proliferating
      cells were obviously related to the tumor genesis and tumor progression in
      gastric carcinoma. The AI, PI and the rate of AI/PI would become the prognostic
      factors in advanced gastric carcinoma.

PMID- 11215056
TI  - Variation of perioperative blood cTnT levels in patients undergoing
      cardiopulmonary bypass and its clinical implication.
AB  - The clinical value of cardiac Troponin T (cTnT) as a marker in assessing
      myocardial cell damage in the patients undergoing open heart surgery was studied.
      Serum cTnT and CK-MB levels were measured in serial blood samples from 20
      patients undergoing open heart surgery before operation, at aorta clamping, aorta
      opening, the end of CPB and the operation, and subsequently one h, one day, 3
      days and one week after operation respectively. Ten patients receiving thoracic
      surgery were also subjected to the measurement of cTnT and CK-MB before and 24 h
      after operation. The results showed that peak concentrations were reached earlier
      in cTnT than in CK-MB, and the circulation cTnT remained high when CK-MB had
      already decreased to normal. In 10 patients receiving thoracic surgery, cTnT
      level was normal and CK-MB was increased in 4 patients after surgery. It was
      concluded that the sensitivity and specificity of cTnT was more than those of CK
      MB and cTnT could be used as a routine indicator for myocardiac protection.

PMID- 11215057
TI  - Study on angiogenesis factor of human osteosarcoma.
AB  - Angiogenesis factor of human osteosarcoma was partially purified and its
      biological features were studied. The active peptide with 8000 to 10,000 u
      molecular weight in the conditioned medium obtained from the cultivation of human
      osteosarcoma cells were partially purified by ultrafiltration, chromatography and
      dialysis. The angiogenic effects of the fractions were assessed by proliferation
      assay of human umbilical vein and pig aorta thoracic endothelial cells. The
      results showed that the chromatography fractions of 4 to 6 could significantly
      promote the proliferation of the endothelial cells. It was suggested that the
      human osteosarcoma cells could synthesize and secrete angiogenesis factor with a
      molecular weight of 8000 to 10,000 u.

PMID- 11215058
TI  - The effect of different interventional treatment on P-Glycoprotein in different
      histopathological types and grades of primary hepatocellular carcinoma.
AB  - To study the effect of the different interventional treatment on P-Glycoprotein
      (Pgp) in different histopathological types of primary hepatocellular carcinoma
      (PHC), 98 surgically and histologically verified PHC specimens were obtained. The
      patients included 57 patients treated by surgical resection alone and 41 patients
      receiving second-stage surgical resection after four kinds of interventional
      treatment. SABC immunohistochemical staining with a monoclonal antibody against
      human Pgp was used to observe the Pgp in all specimens. The positive rate of Pgp
      was 100% in group of chemotherapy alone (P < 0.05), 62.5% in group of
      chemotherapy combined with iodized oil (P > 0.05), 46.6% in group of chemotherapy
      combined with iodized oil and spongia gelatini absorbens (Sga) (P > 0.05), 18.18%
      in group of chemotherapy combined with Ethanol-iodized-oil and Sga (P < 0.05) and
      52.63% in group of surgical resection alone. The positive rate of Pgp varied with
      different histopathological types, with rate of clear cell PHC being the lowest,
      and that of poorly differentiated or undifferentiated PHC the highest. The
      positive rate of Pgp was increased as pathological grades increased.
      Overexpression of Pgp may be responsible for the intrinsic and acquired drug
      resistance of PHC. Multidrug resistance (MDR) varied with different histological
      types. Therapy of PHC should be tailored according to individual. Local
      chemotherapy combined with ethanol-iodized-oil and Sga embolization may become a
      new way to overcome MDR of PHC.

PMID- 11215059
TI  - Effect of vagotomy on acute pancreatitis in rats.
AB  - One hundred and eighty-two SD rats were randomly divided into the normal control
      group, fast operating group and food-intake operating group. The experimental
      model of acute pancreatitis (AP) in rats was established by injecting 5% sodium
      taurocholate into the pancreatic duct of rat according to Aho's method. The
      sandostatin was used for positive contrast. The concentrations of serum amylase,
      calcium, C reaction protein (CRP) and interleukin-6 (IL-6) were assayed
      respectively at different time points. The pathological sections were observed.
      Each operating group contained 10 rats. The mortality of the operating groups was
      observed during the 24 h. The serum amylase level in the AP rats was reduced
      after receiving vagotomy (VG, P < 0.05). Although the serum calcium level in most
      groups was decreased, the reduction in the group with VG plus sandostatin was not
      obvious (P > 0.05). The increase of CRP and IL-6 was not obvious after VG (P >
      0.05). The change of mortality was not significant (P > 0.05). The pathological
      sections showed that the AP pathological change was mild after VG. The disease
      condition of food-intake operating group was more serious than that of fast
      operating group. It was suggested that VG had some influence on the prognosis of
      AP in rats.

PMID- 11215060
TI  - Isolated pelvic hyperthermochemotherapeutic perfusion--an experimental study on
      isolating efficacy.
AB  - Hyperthermochemotherapeutic perfusion model through isolated pelvic vessels was
      developed to evaluate the leakage of hyperthermia and drugs (such as adriamycin)
      from the isolated pelvic circulation to systemic circulation and its associated
      side/toxic effects. The isolated pelvic circulation was perfused through a
      femoral artery catheter with hyperthermic (48 degrees C to 55 degrees C)
      adriamycin solution (50 micrograms/ml) for 30 min. The efflux was drained through
      a femoral vein catheter. And the pelvic temperature was kept at the level of 43
      +/- 0.5 degrees C. The temperature of pelvic circulation was kept at 4 degrees C
      to 5 degrees C greater than the systemic/core temperature. The adriamycin
      concentration of pelvic efflux was 12 to 46 folds of that of systemic serum. The
      difference between them was very significant (P < 0.001). As the perfusion
      pressure was increased, which kept lower than the mean systemic artery pressure,
      the leakage of the adriamycin from the isolated pelvic circulation to systemic
      circulation was increased, but there was no significant difference between them
      (P > 0.05). During isolated perfusion, the systemic blood dynamics remained
      stable and there were no organic injuries on the important organs. It was
      suggested that the isolating efficacy of the modality of isolated pelvic
      hyperthermochemotherapeutic perfusion through vessels was rather high. The
      hyperthermia and drugs could be effectively limited in the isolated pelvic region
      with minor side effects on the systemic circulation and important organs.

PMID- 11215061
TI  - Bovine calcined bone for the repair of radial defect in a rabbit model.
AB  - In order to investigate the bovine calcined bone's ability of repairing segmental
      bone defect and seek a new artificial bone substitute material, the bovine
      calcined bone (450 degrees C, 32 h) was implanted into the 10-mm middle radial
      defect of rabbits with tricalcium phosphate ceramics as the control. By using the
      methods of histology, radiology and biomechanics their osteogenic ability were
      measured. It was found that the bovine calcined bone's ability of repairing bone
      defect was better than that of tricalcium phosphate ceramics. The histological
      Nilsson's scores at 3rd, 5th, 9th week after operation were significantly
      increased (P < 0.01). At 12th week after operation the bending strength of radius
      in experimental group was much higher than that of control group and turned
      normal. It was suggested that bovine calcined bone is an ideal artificial bone
      substitute material with good ability of repairing segmental bone defect and some
      degree of mechanical strength.

PMID- 11215062
TI  - The role of neutrophil activation in pathogenesis of preeclampsia.
AB  - To investigate the effect of neutrophil activation on pathogenesis of pre
      eclampsia, neutrophil activation was examined by using flow cytometry to assess
      the CD11b expression and the levels of plasma endothelin-1 (ET-1) and serum NO2-
      were also measured by using non-equilibrium radioimmunoassay and by Griess assay
      in 29 pregnant women with pre-eclampsia and 31 normal pregnant women at third
      trimester. The expression of neutrophil CD11b was significantly elevated in women
      with pre-eclampsia as compared with that of normal pregnant women at third
      trimester. The mean fluorescence index of CD11b was 438.38 +/- 179.91 and 326.97
      +/- 170.14 respectively (P < 0.05). The plasma ET-1 level and serum NO2-
      concentration in pre-eclampsic women (63.69 +/- 48.33 pg/ml and 20.03 +/- 4.77
      mumol/L, respectively) were both significantly increased as compared with those
      in the normal pregnancy women (29.98 +/- 20.25 pg/ml and 15.47 +/- 5.47 mumol/L,
      respectively, P < 0.01). The neutrophil CD11b expression was significantly
      elevated in pre-eclampsia. The increased neutrophil activation may cause the
      damage of vascular endothelium and result in NO release compensatory increase in
      endothelial cells, suggesting that the neutrophil activation may play a key role
      in pathogenesis of pre-eclampsia.

PMID- 11215063
TI  - Pre-clinical experimental studies of indomethacin-releasing copper intrauterine
      device.
AB  - Effects of two types of intrauterine device (IUD) on the prostaglandins and
      endothelin (ET) in uterus and on the endometrial morphology in rats and rabbits,
      and Cu2+ releasing amounts of both IUDs in vitro were observed. The results
      showed that the inhibiting action of the indomethacin-releasing copper IUD (FICu
      IUD) on the PGI2 was stronger than that on the TXA2, the ratio of 6-keto-PGF1
      alpha/TXB2 was reduced with the increase of the doses. There were significant
      differences between the groups. The FICu-IUD could inhibit the rising of the ET
      level and lighten the endometrial impairment caused by the FCu-IUD, and promote
      copper ion release. It was suggested that indomethacin released by FICu-IUD could
      effectively reduce abnormal uterine bleeding.

PMID- 11215064
TI  - Metabolism of dauricine and identification of its main metabolites.
AB  - To study the metabolism of dauricine in vivo and in vitro and identify the
      structure of its main metabolites, urine of rats after drug administration as the
      samples of dauricine metabolism in vivo was studied. Rat liver S9 fraction was
      prepared and the oxygenation metabolism system reconstituted to perform phase I
      reaction of dauricine in vitro. TLC, HPLC-DAD and MS were used to analyze and
      identify dauricine and its main phase I metabolites in the samples. The results
      showed that besides the untransformed dauricine, in the urine samples there was
      little product of X' which had the same features of TLC, HPLC-DAD and MS as those
      of N-desmethyl dauricine (N-ddau). Part of dauricine could be transformed to a
      main metabolite X after incubating with S9 fraction in appropriate conditions.
      The molecular ion peak of X was m/z 611. The full scan MS2 spectrum of m/z 611
      peak from S9 sample were m/z 580, m/z 566, m/z 552, m/z 206, which were same as
      those of N-ddau. Liver is the major organ for dauricine metabolism and part of
      dauricine is biotransformed by liver. The major metabolite is considered to be N
      ddau.

PMID- 11215065
TI  - Preliminary studies on the application of retinal thickness analyzer in the
      diagnosis of glaucoma.
AB  - The patients with glaucoma underwent the examination of retinal thickness
      analyzer (RTA) to explore the diagnostic value of RTA in glaucoma. The retina of
      6 mm x 6 mm size (approximately 20 degrees, centered on the macula) at the
      posterior pole was scanned by using RTA to obtain the images in 35 eyes of 22
      patients with glaucoma. The images were processed by using SAS software package.
      The retinal thickness in the patients with glaucoma showed diffuse or local
      thinning. Twenty-seven eyes was definitely diagnosed as having glaucoma. There
      was a very significant difference in retinal thickness measurements by RTA
      between normal group and glaucomatous group (P = 0.0012). Except the measurements
      at the detected point 6 having no difference, the measurements at the detected
      point 3 showed a significant difference and the remaining 7 detected points
      presented a very significant difference between the two groups. Of the detected 9
      points, the changes at the points 4, 8, and 9 were the most obvious. The discrete
      analysis was performed on the glaucomatous patients by a discriminant function
      established through the data at the detected points 4, 8 and 9 and the accurate
      estimate rate for the diagnosis of glaucoma was up to 80.77%. The measurements of
      RTA examination was consistent with the results of the vision field test. It was
      suggested that diffuse or local thinning of retinal thickness exists in the
      patients with glaucoma. The temporal inferior arcuate fibers and the
      papillomacular bundle between the macular and optic nerve heads showed a serious
      damage. The sensitivity of RTA examination was higher than visual field test.

PMID- 11215066
TI  - Toxicity of magnetic albumin microspheres bearing adriamycin.
AB  - Magnetic albumin microspheres bearing adriamycin (ADM-MAM) is a novel
      chemotherapeutic compound with site-specific drug delivery characteristics. The
      acute and subacute toxic tests of the compound, local irritating test and
      anaphylactic test were performed on mice and guinea pigs. The results showed
      there was no macroscopically and microscopically direct cytotoxic injuries of the
      compound to the animal organs or to the cells. The LD50 value of the compound was
      higher than that of the single used adriamycin, indicating that the compound was
      less toxic than the single adriamycin and quite safe in its therapeutic dosage.
      Furthermore, there was also no side effects or toxic reactions to be observed on
      clinical patients with advanced carcinoma or gastric cancer.

PMID- 11215067
TI  - Change of coagulation factor VIII and antithrombin III activity in bank-stored
      blood.
AB  - Coagulation factor VIII and antithrombin III activity were detected in 15 health
      donors. It was found that antithrombin III activity decreased obviously 12 h
      after blood drawing. It lost 56% of the activity at the 3rd day, and 70% of the
      activity at the 7th day. FVIII:c showed no obvious change after 24 h, until the
      3rd day. It lost 40%-60% of the activity after 36 h and was reduced to the 30% of
      the original activity at the 5th day. Our results suggested that at the 3rd day
      coagulation factor VIII of bank-stored blood can be used to replenish
      antithrombin III, while bank-stored blood in one day can be used to replenish F
      VIII.

PMID- 11215068
TI  - Measuring up. Analyzing control and comparison charts.

PMID- 11215069
TI  - Protocols for information-driven surveys.

PMID- 11215070
TI  - Random unannounced surveys in 2001.

PMID- 11215071
TI  - Survey ready. Brushing up on competence assessment.

PMID- 11215072
TI  - Ask the experts. How behavioral restraint standards don't apply in your
      organization.

PMID- 11215073
TI  - Safety watch. Preventing fatal falls.

PMID- 11215074
TI  - Private healthcare. Let's drink to that.
AB  - The Commission for Health Improvement will have authority to monitor private
      hospitals treating NHS patients. The private sector will be subject to the NHS
      complaints procedure. The issue of medical staffing for private hospitals needs
      to be addressed. The uneven spread of private facilities across the country
      undermines the partnership. Arrangements to cut NHS waiting lists will reduce
      demand for private medical insurance.

PMID- 11215075
TI  - More frills than skills.

PMID- 11215076
TI  - US healthcare. Small add.

PMID- 11215077
TI  - Commissioning. When push comes to shove.
AB  - A study of four HAs in three regions found that they had little influence on
      encouraging trusts to implement the recommendations of the Changing Childbirth
      report over the period 1993-98. Where changes had been introduced this was often
      through the influence of an opinion leader in the trust, such as directors of
      midwifery. The results suggest healthcare professionals providing services have
      substantial influence over the fate of strategic change initiatives.

PMID- 11215078
TI  - Caring for diverse populations of HIV-infected patients.

PMID- 11215079
TI  - New bedfellows?

PMID- 11215080
TI  - When HIV is not the only diagnosis.

PMID- 11215081
TI  - Influenza vaccination does not accelerate HIV infection.

PMID- 11215082
TI  - Scientists at the Children's Hospital, Los Angeles, begin HIV gene therapy trial
      [news].

PMID- 11215083
TI  - HIVMA recruiting health professionals dedicated to HIV.

PMID- 11215084
TI  - AIDS-related Kaposi sarcoma trial is under way.

PMID- 11215085
TI  - Women's health. The role of gender in HIV progression.
AB  - Recent studies have examined the experience of women and the potential for gender
      differences with respect to HIV progression and the acceptance, tolerance,
      adherence, and response regarding HAART. Differences in CD4 cell count and viral
      load have not been reported in all studies. For any given CD4 cell count, women
      may be at a higher risk of HIV progression. Women appear to have an increased
      risk of progression to AIDS compared with men with the same viral load. They have
      lower initial viral loads than men in early-stage disease, but these catch up in
      advanced-stage disease. Because of depression and other psychological factors,
      women may be in greater need of supportive services, and this can affect the
      success of antiretroviral therapy. Women also have an increased risk of adverse
      drug reactions from HAART. Gender should be considered when prescribing therapy.

PMID- 11215086
TI  - HIV clinical trials in correctional settings: right or retrogression?
AB  - The right of incarcerated prison and jail inmates to health care is protected by
      the 8th and the 14th amendments of the Constitution, respectively. Does the right
      to health care include access to clinical trials? At the time of this writing,
      clinical trials have become part of the fabric of HIV/AIDS care, allowing
      patients to participate in studies of new and often lifesaving treatments.
      Participation in trials can also be dangerous, as illustrated by the recent death
      of a subject in a gene therapy trial. This danger is compounded by ethical
      dilemmas that can arise from the large amount of financial support for clinical
      trials (greater than 75%) that is derived from for-profit corporations. Indeed,
      clinical trials are the subject of grave concern on the part of the United States
      Government, which has recently taken steps to shore up human subject safeguards.
      Following a conference on the conduct of clinical trials in correctional
      settings, the Office for Human Research Protections suspended prison research
      conducted by 4 prestigious academic institutions.

PMID- 11215087
TI  - IRB/FDA requirements relevant to HIV/AIDS clinical trials in correctional
      settings.
AB  - Federally funded research involving inmates in US correctional facilities
      requires the approval of the Office for Protection from Research Risks (now
      called the Office for Human Research Protections [OHRP] and located in the Office
      of the Secretary of the Department of Health and Human Services). Trials that are
      carried out by pharmaceutical companies (not federally funded) fall under the
      jurisdiction of the FDA. This article reviews OHRP and FDA guidelines relevant to
      the conduct of HIV/AIDS clinical trials in correctional settings.

PMID- 11215088
TI  - Diagnostic and therapeutic dilemmas of a large scrotal lesion in an AIDS patient.
AB  - In the setting of HIV infection, chronic genital ulcerations may be challenging
      both diagnostically and therapeutically. The differential diagnosis of these
      lesions is very broad, and the causes can be multifactorial. We present a case of
      a chronic, extensive, ulcerating scrotal mass and review the salient clinical,
      diagnostic, and therapeutic considerations.

PMID- 11215089
TI  - World AIDS Day 2000: commentary by US United Nations Ambassador.

PMID- 11215090
TI  - Public perceptions. The generation claim.
AB  - There is a growing perception that support for the NHS is falling off among the
      young. The evidence for this is not conclusive. Dissatisfaction with the NHS is
      more likely to be linked to increased expectations rather than lack of social
      solidarity.

PMID- 11215091
TI  - Mental health. Eye off the ball?

PMID- 11215092
TI  - Cross-border care. Travellers' checks.
AB  - Interest in the costs of non-emergency operations in different countries is
      likely to growas movement increases between European Union countries. There are
      huge variations in the cost to the state of the same operation in different
      countries. These may influence where services are purchased in the future.

PMID- 11215093
TI  - Data briefing. Outpatient waiting.

PMID- 11215094
TI  - Cleaning. In a domestic vacuum?

PMID- 11215095
TI  - Procurement. Let's spend the cash together.

PMID- 11215096
TI  - Catering. Fancy that.

PMID- 11215097
TI  - Bedside TV/telephones. Pillow talk.

PMID- 11215098
TI  - [Molecular diagnosis and new gene engineering in hematological malignancies].
AB  - Advancement molecular diagnostics in hematological malignancy has provided us
      with a broad menu of new assays and techniques. By integrating the data gleaned
      from these techniques we can formulate a more rational broad-based diagnosis.
      Hematological malignancies have traditionally been classified by morphological
      criteria. However, molecular advances have provided new insights in the genetic
      backbone of chimeric genes. These malignancies have shown chromosome
      abnormalities of translocation with chimeric genes, and revealed the
      rearrangement of chimeric genes by PCR analysis and quantitative PCR system. This
      review summarized the recent technology for detecting chimeric genes along with
      concepts of laboratory performance.

PMID- 11215099
TI  - [Quality assurance of the molecular diagnostic tests in hematological
      malignancies].
AB  - Analyses of nucleic acid sequences in hematological malignancies are now
      essential in managing patients with hematological malignancies. Because of the
      impact of the test on decision-making in patient care, its accuracy is quite
      important. Detection of BCR-ABL mRNA by polymerase chain reaction, one of the
      most popular molecular diagnostic tests for hematological malignancies, has been
      used for diagnosis of Philadelphia-positive leukemias. Quality of the test must
      be assured in the process of diagnostic plan, sampling, measurement(nucleic acid
      isolation, amplification, detection), report and interpretation. Risk of false
      positive results due to contamination of in vitro nucleic acid amplification
      reactions can be decreased through the use of protocols for contamination
      control. False-negative results may be caused by variability in BCR breakpoint,
      and loss or degradation of RNA due to inappropriate procedures as well as an
      insufficient detection sensitivity. Presence of inhibitors of amplification is
      also to be considered as a cause of false-negative results. Thus, quality control
      techniques such as internal standards are mandatory to ensure efficient
      amplification as well as RNA extraction. For the precise evaluation of minimal
      residual diseases, accurate and sensitive quantitative analyses are required. For
      quality assurance of assays in the present status of no commercially available
      kits, it is particularly important to monitor the clinical validation of the
      results by correlating them with the patient's status to prove clinically
      relevant. Staffs need to be trained to be familiar with both molecular
      pathogenesis and technology so that they can provide informative test results
      with a high quality.

PMID- 11215100
TI  - [A report on staff development in advanced knowledge and technology of gene
      diagnosis for medical technologists by the Japanese Association of Medical
      Technologists: the view of medical technologists].
AB  - With advancement of the molecular biology, gene diagnosis is widely utilized in
      clinical application of medicine. For medical technologists, it is necessary to
      receive continued education to practice such advanced scientific trends. The
      Japanese Association of Medical Technologists established a working group for a
      staff development program of gene diagnosis and chromosome analysis in 1996, and
      has continued its activities in making inquiries about the present conditions,
      publishing a textbook, and providing seminars. The internal laboratory
      utilization of gene diagnosis was 8.7%(213 of 2437 hospitals). Based on the fact
      that about half of the hospitals use external laboratory, staff development for
      the internal utilization of gene diagnosis is an urgent issue. We have been
      providing seminars to meet the educational needs of our members. In addition to
      those activities, we have continued our efforts in providing a manual with
      clinically useful information, standardizing methods, establishing an information
      network, and conducting a controlled survey. The role of the working group is now
      shared by the local prefecture to further increase the numbers of those with
      expertise in gene diagnosis. We, medical technologists, need to have a global
      view of professional growth, and also to cooperate with academic societies
      related to gene diagnosis to establish a certification system.

PMID- 11215101
TI  - [Past, present and future of optical cards for medical use].
AB  - In the hospital, the chart is an important medical information record. However,
      it is not easy to refer to chart records. Although a computer is useful in
      referring to the chart, the most critical defect is the lack of exchangeability
      between hospitals. An optical card is a new medium for medical use. It has a
      large capacity for electronic storage, low price and high security. Therefore,
      the author considers this card a second medical chart. As another card, there is
      the IC card, which has some limitations in medical use. Although both systems are
      being examined experimentally, there is no actual practice in the medical field.
      The reason for this lack of wide use, it is thought that these systems are not
      yet supported by national health insurance.

PMID- 11215102
TI  - [Development of perinatal management system using optical card and regional
      health information network].
AB  - In Kagawa Prefecture, a perinatal management system using the optical medical
      card and the information network has been introduced since October 1998. Four
      hospitals(Kagawa Medical University, Sakaide Municipal Hospital, Uchinomi Town
      Hospital and Tsuda Prefectural Hospital) are connected with each other through
      the health information network(Kagawa Health and Welfare Information Network)
      organized by Kagawa Prefecture. (http://www.hw.kagawa-swc.or.jp/net/) Patients'
      clinical data are described on the optical card based on the "standard format of
      the Japan Association of Obstetricians and Gynecologists(JAOG).
      (http://www.jaog.or.jp/JAPANESE/MEMBERS/JOUHOU/H10/index.htm). Clinical
      information including the fetal heart rate(FHR) and sonography (JPG) can be
      easily transmitted through this network(on line). Without the network, patient
      data can also be transmitted using the optical card(off line). There are still
      many technical and social problems to be solved in the future, research into the
      use of medical information network should be continued.

PMID- 11215103
TI  - [On standardization of optical memory cards].
AB  - An optical card optimizes recording of medical data since it has a large memory
      capacity, data cannot be interpolated by the addition method, and data are
      protected from disruption by magnetic force or static electricity. Now that
      international standards have been established for the card, reader/writer
      control, and data management, a highly-compatible optical card system for medical
      use can be fabricated. The optical card is expected to play an important role in
      the social system as a promising medium for recording or exchanging individual
      health data, which is anticipated to grow in the near future.

PMID- 11215104
TI  - [Digital filling system for medical image data].

PMID- 11215105
TI  - [What should a laboratory physician expect from a microbiology laboratory?].
AB  - Remarkable changes are affecting the discipline of Clinical Pathology/Laboratory
      Medicine in Japan. Laboratories are changing from revenue centers to cost centers
      that have many serious problems(ex. closure of the clinical laboratories in the
      hospitals and outsourcing of laboratory tests due to restructuring in response to
      economic aspect, limited numbers of certified laboratory physicians, and other
      factors). And many clinicians in university hospitals do not know what they
      should expect correctly from the microbiology laboratory. Therefore, we,
      laboratory physicians and medical technologists must modify our behavior
      effectively and establish a good collaborative partnership with physicians,
      nurses and other health care professionals. The microbiology laboratory should
      provide information that will affect clinical management guidelines for obtaining
      specimens, microbial identification, antimicrobial susceptibilities, reporting of
      data and educational updating. Leadership and management skills must be
      increasingly critical to the success of laboratory physicians in and outside of
      academic centers.

PMID- 11215106
TI  - [Results of a questionnaire survey about "standardization" of connection methods
      in Laboratory Automation System or Laboratory Information System by the National
      University Hospital Clinical Laboratory Divisions].
AB  - "Standardization" is very important in the field of clinical laboratory medicine.
      Enzyme reference materials(ERM) and standard plasma proteins(CRM470) have already
      been developed. Reference methods for some clinical chemical tests have also been
      developed. We are studying "standardization" of electric communication methods
      between computers and automatic analyzers in Laboratory Automation System(LAS) or
      Laboratory Information System(LIS). We present the results of a questionnaire
      survey of 73 LAS or LIS making Companies in this paper. Although
      "standardization" of electric communications or local area network in LAS or LIS
      has been done in only 22 companies(34.9%), we are planning more functional
      standard electric communication methods such as Health Level 7(HL7) or American
      Society for Testing and Materials(ASTM).

PMID- 11215107
TI  - [Pathophysiological roles of angiotensin in the pathogenesis of hypertension and
      cardiovascular remodeling].
AB  - Angiotensin(Ang) II plays an important role in regulating cardiovascular
      hemodynamics and structure. Multiple lines of evidence have suggested the
      existence of Ang II receptor subtypes, and at least two distinct receptor
      subtypes have been defined on the basis of their differential pharmacological and
      biochemical properties and designated as type-1(AT1) and type-2(AT2). Most of the
      known effects of Ang II in adult tissues are attributable to the AT1 receptor.
      Recent cloning of the AT2 receptor contributes to reveal its physiological
      functions. Accumulating evidence demonstrates that the function and signaling
      mechanism of these receptor subtypes are quite different, and these receptors may
      exert opposite effects in terms of cell growth and blood pressure regulation.
      Growth inhibitory effects of AT2 receptor are unique in that this receptor
      activates a variety of phosphatases and cross talks with the signaling of other
      seven-transmembrane, G protein-coupled receptors as well as other classes of
      growth factor receptors. To further examine the role of the AT2 receptor, we
      generated the AT2 receptor knockout mouse using homologous recombination. Here,
      we review recent advances in the roles of AT1 and AT2 receptors in the
      pathogenesis of hypertension and the cardiovascular remodeling.

PMID- 11215108
TI  - [Positional cloning of the gene(WFS1) for Wolfram syndrome].
AB  - Wolfram syndrome(DIDMOAD syndrome) is an autosomal recessive neurodegenerative
      disorder characterized by juvenile-onset, insulin-requiring diabetes mellitus and
      optic atrophy. Other symptoms including diabetes insipidus, neurosensory
      deafness, urinary tract and neurological abnormalities are often accompanied. In
      patients, beta-cells are selectively lost from their pancreatic islets of
      Langerhans. The gene was previously mapped to 4p16.1. By haplotype analysis and
      recombination mapping in 5 families, we localized the gene within a region less
      than 250 kb on chromosome 6p. In the region, we identified a novel gene(WFS1)
      encoding a putative transmembrane protein. Mutations were identified in all
      affected members of the families and these mutations were associated with disease
      phenotype. This finding was further confirmed by other investigators and to date,
      more than 50 mutations were identified in the WFS1 gene from the patients with
      Wolfram syndrome. The WFS1 gene encodes a protein of 100.3 kDa with 9 to 10
      putative transmembrane domains. The protein appears to be important in the
      survival and maintenance of normal pancreatic beta-cells and neurons.
      Physiological function of the WFS1 protein and mechanisms by which defective WFS1
      lead to the development of Wolfram syndrome need to be clarified.

PMID- 11215109
TI  - [Technology and application of DNA array].
AB  - Recently DNA macro and micro array has just begun to use for analysis of DNA
      expression. The array technique allows us to analyze expression pattern of
      several hundreds and thousands of genes simultaneously. The array method enables
      us to analyze gene expression levels of each gene among different samples,
      however it does not provide comparative analysis of the expression level of
      multiple genes in a single array. Because intensity of each signal on the array
      is normalized by the expression intensity of several standard house keeping
      genes, intensity of signals of each genes among different array can be compared
      by the number of relative intensity based on normalization. Such characteristic
      feature of array allows us to analyze potential function of the genes even though
      function of genes are not known or well characterized.

PMID- 11215110
TI  - [Habitual abortion and high frequency of low frequent X chromosome monosomy
      mosaicism: detection by interphase FISH analysis of buccal mucosa cells and
      lymphocytes].
AB  - FISH analysis using X alpha satellite probe was performed to the nuclei of
      lymphocytes obtained from fourteen women with having a history of habitual
      abortion for unknown causes(WHA) and from 65 normal control women(NW), in order
      to determine whether low frequency X monosomy mosaicism is one of the factors of
      habitual abortion. In parallel, the nuclei of buccal mucosa from 8 of WHA and 65
      NW were also examined. Five hundreds of the interphase nuclei in each sample were
      observed. As results, the frequency of X monosomy in NW found in the lymphocytes
      or buccal mucosa was ranged from 0-3.2%(mean 1.59%, SD 0.69%) or from 0-3.2%(mean
      1.24%, SD 0.85%), respectively. However, the occurrence of X monosomy in WHA was
      significantly higher compared with that of NW; i.e., 0.8-5.8%(mean 3.21%, SD
      1.67) for lymphocytes, and 1.8-7.4%(mean 4.45%, SD 1.73%) for buccal mucosa.
      These results allowed us to define the reference intervals to discriminate WHA
      from NW were less than 2.97% or 2.94% for lymphocytes or buccal mucosa,
      respectively. Based on the reference intervals defined above, the high frequency
      of X monosomy mosaicism was actually found in 9 of 14 WHA. These results
      altogether strongly suggested that the low frequency X monosomy mosaicism was one
      of the factors of habitual abortion.

PMID- 11215111
TI  - [Epidemiological evaluation of Serratia marcescens isolates in one Japanese
      hospital during the two years from April 1997 to March 1999].
AB  - One hundred fourteen isolates of Serratia marcescens from different patients in
      Showa University Fujigaoka Hospital during the 2 years from April 1997 to March
      1999 were investigated in this study. The isolation frequency(37%, 43 of the
      isolates) of O-serotype 14(O14) was highest among the 16 different serotypes, and
      that(24%, 27 of the isolates) of O2 was secondarily highest, while these types
      were frequently isolated from patients in the surgical ward. O14 with major
      bacteriocin types 4 and 9(B4 and B9, respectively) showed resistance to
      piperacillin, the third and fourth generation cephems, new quinolones and
      aminoglycosides except gentamicin tested. However, O2 with major B1 and B5 showed
      much greater sensitivity to the antimicrobial agents tested than O14.
      Furthermore, O2 and O14 were frequently isolated from patients' sputa(41%, 11 of
      the 27 isolates) and urine(72%, 31 of the 43 isolates), respectively. These
      findings suggested that S. marcescens O14 with B4 and B9, more resistant to
      various agents, and O2 with B1 and B5, more sensitive to various agents, show a
      tendency to inhabit the urinary and respiratory tracts in the hospital patient's
      body, respectively, having a high risk of hospital infection.

PMID- 11215112
TI  - [Positive rate of anti-mitochondrial antibody in Japanese corporate workers].
AB  - Anti-mitochondrial antibody(AMA) has been reported to be detectable in
      approximately 85% of patients with primary biliary cirrhosis(PBC). Therefore, a
      test for AMA is acceptable to be essential for diagnosing PBC. However, the
      positive rate in Japanese general population has not yet been determined. We
      tested sera from 1,145 corporate workers who took an annual health check and
      evaluated the liver of AMA-positive subjects. An indirect immunofluorescence
      method was used for screening AMA. ELISA and immunoblotting method were used for
      detecting anti-M2 in AMA-positive cases. AMA was detected in 5 of 1,145(0.44%)
      corporate workers. AMA positive rate was higher in females than in males(0.91%
      and 0%, respectively) and the AMA-positive people are all females over age 40.
      All of the AMA-positive sera are also positive for Anti-M2. Liver biopsy was
      performed in two AMA-positive cases and the histology was compatible with PBC in
      both cases.

PMID- 11215113
TI  - [A Warthin's tumor showing extensive necrosis].
AB  - Warthin's tumors are one of the most easily recognizable tumors using light
      microscopy. However, histopathological diagnosis is difficult in a few cases when
      characteristic cystic cavities with papillary walling and underlying lymphoid
      stroma are obscured by reactive changes. We describe a case of an extirpated
      Warthin's tumor of the right parotid gland which demonstrated extensive necrosis,
      squamous metaplasia and xanthomatous inflammation. No characteristic structure
      for this tumor was noticed in a section of an initially sampled specimen. As a
      result, a destroyed fistula was suspected. An additional sampling was performed
      to confirm the diagnosis and the sampled specimen fortunately demonstrated the
      diagnostic structure of a Warthin's tumor excluding malignancy. An awareness of
      the morphological variation seen in this tumor should lead to additional sampling
      of specimens, thereby preventing erroneous interpretation.

PMID- 11215114
TI  - [B precursor lymphoblastic leukemia/lymphoma manifested at onset as
      hemophagocytic syndrome].
AB  - A 20 year-old male patient was admitted to our department for the treatment of
      recurrence of fever and pancytopenia developed despite of temporal remission of
      hemophagocytosis syndrome that had been treated with large doses of
      methylprednisolone in our hospital. Superficial lymph nodes were not palpable. CT
      scan and echography revealed neither findings of splenohepatomegalia or
      enlargement of intraabdominal lymph nodes. Bone marrow aspiration showed an
      increase of histiocytes, the cells phagocytizing erythrocytes and platelets, and
      a negative test for peroxidase stain. Analysis of surface antigens showed that
      11.3% of cells were blast cells positive for CD10, CD19, CD20, CD34 and TdT. Bone
      marrow biopsy revealed a localized increase in tumor cells positive for L26, CD10
      and negative for UCHL-1. Because of the absence of detectable tumor masses and
      the difficulty in differentiating between malignant lymphoma and lymphatic
      leukemia, we diagnosed the condition as B precursor lymphoblastic
      leukemia/lymphoma. If diagnosed with malignant lymphoma preceded by
      hemophagocytic syndrome(LAHS), he might have a rare type of LAHS-associated
      malignant lymphoma since histological examination did not reveal diffuse large
      cell lymphoma, a condition found in most patients with LAHS-associated malignant
      lymphoma. Whereas if diagnosed as ALL, he was the first adult patient with ALL
      with HPS at onset as far as we know. In any of these possibilities, the case was
      considered rare.

PMID- 11215115
TI  - [On bone and joint diseases].

PMID- 11215117
TI  - [Pathoetiology of chronic rheumatoid arthritis--from inflammation to bone
      destruction. 1) from the viewpoint of clinical genetics].

PMID- 11215116
TI  - [Molecular mechanism of bone metabolism].

PMID- 11215118
TI  - [Pathoetiology of chronic rheumatoid arthritis--from inflammation to bone
      destruction. 2) From the viewpoint of immunology].

PMID- 11215119
TI  - [Pathoetiology of chronic rheumatoid arthritis--from inflammation to bone
      destruction. 3) From the viewpoint of pathology].

PMID- 11215120
TI  - [Physiopathological interpretation and progress in diagnosis and therapy. 1.
      Osteoarthrosis].

PMID- 11215121
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 2)
      Gout and pseudogout].

PMID- 11215122
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 3.
      Infectious arthritis].

PMID- 11215123
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 4.
      Psoriatic arthritis and ankylosing spondylitis].

PMID- 11215124
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 5.
      Relapsing polychondritis].

PMID- 11215125
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 6.
      RS3PE syndrome].

PMID- 11215126
TI  - [Pathophysiological interpretation and progress in diagnosis and treatment. 7.
      Steroid-induced osteoporosis].

PMID- 11215127
TI  - [Physiopathological interpretation and progress in diagnosis and treatment. 8.
      Steroid-induced osteonecrosis].

PMID- 11215128
TI  - [New therapeutic approaches. 1. Non-steroidal anti-inflammatory agents and
      selective COX-inhibition].

PMID- 11215129
TI  - [New therapeutic approaches. 2. New anti-rheumatic drugs: with special reference
      to methotrexate].

PMID- 11215130
TI  - [New therapeutic approaches. 3. Current status and overview of biological
      products].

PMID- 11215131
TI  - [Diagnosis and treatment of diseases with the major symptoms involving the bone
      and joints: discussion].

PMID- 11215132
TI  - [Lemierre syndrome with extensive cervical venous thrombosis and multiple
      pulmonary embolisms].

PMID- 11215133
TI  - [Salmonella infection with endophthalmitis and arthritis].

PMID- 11215134
TI  - [An autopsy case of intravascular malignant lymphomatosis treated with
      combination chemotherapy].

PMID- 11215135
TI  - [Recurrent retroperitoneal fibrosis associated with hyperglobulinemia].

PMID- 11215136
TI  - [Successful rescue from fatal pulmonary thrombo embolism by percutaneous
      thrombectomy: a report of two cases].

PMID- 11215137
TI  - [Adrenal incidentaloma (including Cushing's syndrome)].

PMID- 11215138
TI  - [Mechanism for bile acid transport--recent progress].

PMID- 11215139
TI  - [The proposal of the activities of daily living (ADL) index for institutionalized
      older adults].
AB  - The purpose of this study was to propose the ADL index constructed with a
      unidimensional scale based on item difficulty for institutionalized older adults.
      Six hundreds and three subjects (159 males and 444 females) were divided into the
      following four groups based on assisting devices for movement: G1 did not use
      assisting devices for movement; G2 used a stick or a walker; G3 used a
      wheelchair; G4 could not move. As the results of examinations from the points of
      the approximation of proportions, non-answer rates and agreement rates of each
      item according to 74 ADL items representing 9 ADL domains, the 27 ADL items were
      selected as utility items. The reliability and unidimensionality of the ADL index
      consisting of 27 items were considered to be high. As the results of examining
      the difficulty of items and ADL ability characteristics of each group, the ADL
      concerning movement and other lower limb activity in G1 and G2, and concerning
      changes of posture and manual activity in G3 and G4 were considered to reflect
      the individual differences of ADL ability, respectively. The numbers of ADL items
      which should first be assessed in each group were as follows: 20 items in G1; 21
      items in G2; 21 items in G3; 11 items in G4.

PMID- 11215140
TI  - [Effects of low concentration of styrene monomer vapor on pregnancy].
AB  - To investigate the effects of exposure to styrene vapor on pregnancy, mice proved
      to be pregnant were exposed to 0, 2, 20 and 100 ppm styrene continuously for 24
      hours during the period from day 0 to day 15 of gestation. A special small
      exposure chamber which can accurately maintain a constant low concentration of
      styrene vapor was made and used in the experiment. 1) In the 100 ppm group,
      hyperkinesis was presented in the chamber during the exposure period and
      inhibition of body weight gain was found (p < 0.01). No deaths occurred in any of
      the groups. 2) At necropsy of dams, no significant difference was found between
      the styrene exposed groups and the control group in any of the fertility indices,
      number of implantations, number of live fetuses, percentage of resorptions, or in
      the percentage of dead fetuses. The 100 ppm group showed lower fetal and
      placental weights (p < 0.01). 3) Gross necropsy of dams in the 100 ppm group
      showed significantly decreased adipose tissue. The liver, kidney and spleen
      weights were also low (p < 0.01). 4) When exposed to 100 ppm, which corresponds
      to 5 times the permissible concentration, i.e., 20 ppm, for 24 hours, non
      pregnant dams showed no abnormality, while pregnant dams showed inhibition of
      body weight gain and significantly lower fetal and placental weights and maternal
      organ weights. Therefore, careful consideration should be given to exposure of
      women of childbearing age to styrene.

PMID- 11215141
TI  - [A study on the trend of tuberculosis in an area of Shanghai City using
      mathematical model].
AB  - A widely-used mathematical model (compartmental model) in epidemiological studies
      was utilized to analyze the tuberculosis situation in area Y of Shanghai from
      1971 till 1994. In this model, the whole population was divided into 5 groups,
      (susceptible, latent, prevalent, healed and immune). Six parameters (effective
      BCG coverage, immune loss rate, infection rate, disease risk, cure rate and heal
      loss rate) were introduced and discussed to describe the transmission of
      tuberculosis. The computed tuberculosis data from this model agree quite well
      with the observed data. The results show that the susceptible group is the
      largest among all groups. In 1994, the annual risk of infection was estimated to
      be 0.26%. It is predicted that elderly people will comprise an increasing
      percentage of tuberculosis patients in the future. It is also found that it will
      still take a long time to eliminate tuberculosis under current medical
      situations.

PMID- 11215142
TI  - [Smoking behaviors among medical doctors in Fukui, Japan].
AB  - This study was conducted in order to identify the smoking prevalence among all
      doctors (N = 874) belonging to the medical associations in Fukui Prefecture and
      factors that might possibly indicate causal smoking habits. A survey was
      conducted from December of 1996 to February of 1997, using a self-administered
      questionnaire, and the response rate for the survey was 91%. The main results of
      this survey were as follows: The prevalence of smoking among male and female
      medical doctors was 28% and 8% respectively, which was lower than that of adults
      in the general population, but higher than that of doctors in the developed
      countries. The prevalence of smoking among doctors was almost highest when they
      were 20 to 29 years old, and that among medical practitioners with their own
      institution was higher than doctors employed by an institution. In particular,
      medical practitioners who did not smoke were more likely to restrict or ban
      smoking in their hospitals or clinics.

PMID- 11215144
TI  - [Telomere heterochromatin in yeast].

PMID- 11215143
TI  - [Serotonin transporter].

PMID- 11215145
TI  - [Oxidized galectin-1 is a new type factor to promote nerve regeneration].

PMID- 11215147
TI  - [DNA replication mechanism in Archaeal cells].

PMID- 11215146
TI  - [Malignant transformation and regulation of cell division by a Rho exchange
      factor ECT2].

PMID- 11215149
TI  - [beta-D-xyloside-initiated oligosaccharides in cultured cells].

PMID- 11215148
TI  - [Juxtacrine and matricrine--the other ways of growth factor actions].

PMID- 11215150
TI  - [Biogenesis of iron-sulfur clusters].

PMID- 11215151
TI  - [Molecular mechanism of biological clock: for chronobiological approach to
      stress].
AB  - Recent progress in molecular chronobiology revealed that the clock genes control
      intracellular feedback loops. CLOCK protein and BMAL1 protein, first discovered
      as components of the circadian clock in mammals, are known to function as
      transcriptional activators in the circadian feedback loop of drosophila. PERIOD
      and TIMELESS proteins work as inhibitors for these activators in drosophila and
      possibly in mammals. The clock genes described above are also expressed in
      peripheral tissues with circadian rhythmicity. Cultured rat-1 fibroblast shows
      circadian expression of clock genes after serum shock or forskolin stimulation.
      These results indicate that the clock genes function not only as components of
      the endogenous clock, but also as a coordinator of the circadian activity of
      peripheral tissues. It will be important to study stress from the aspect of
      circadian rhythm.

PMID- 11215152
TI  - Functional dissociation of striatal and hippocampal cholinergic systems in
      egocentric and allocentric localization: effect of overtraining.
AB  - The effects of overtraining on the retention of egocentric localization (EL) and
      allocentric localization (AL) tasks using rats injected with 1.8 nmol/12
      microliters of ethylcholine mustard aziridinium ion (AF64A) in the striatum or
      hippocampus were examined. In the EL task, an arm positioning at in same
      direction of a randomly selected start arm was baited throughout trials. In the
      AL task, a baited arm was fixed throughout trials regardless of the position of
      the start arm. The performance of EL retention was disrupted only by
      intrastriatal AF64A injection. The overtrained striatal lesioned animals showed
      better performance compared to the non-overtrained striatal lesioned animals. In
      contrast, hippocampal AF64A injection selectively impaired AL retention. Unlike
      the effect of overtraining on EL retention in striatal lesioned animals, however,
      the AL performance of hippocampal lesioned animals was not significantly affected
      by overtraining. The results support the idea of functional dissociation of
      striatal and hippocampal cholinergic systems in EL and AL learning and provide
      further evidence that the striatal cholinergic system may be involved in the
      memory (consolidation or retrieval) process of EL learning, and the hippocampal
      cholinergic system in the processing of specific cues necessary for efficient
      performance in AL learning rather than memory.

PMID- 11215153
TI  - The effects of zolpidem and zopiclone on daytime sleepiness and psychomotor
      performance.
AB  - Zolpidem (ZLP), which has selective affinity to the BZ1 (omega 1) receptor and a
      short half-life, is a novel hypnotic. The objective of this study is to compare
      the residual effects of standard clinical doses of ZLP and zopiclone (ZPC), a
      short-acting hypnotic marginally selective for the BZ1 (omega 1) receptor, given
      in a single dose on daytime sleepiness and psychomotor function. This study was
      carried out as a double-blind cross-over study with 10 mg ZLP, 7.5 mg ZPC and a
      placebo in 12 healthy male adults. In the multiple sleep latency test, sleep
      latency was not reduced but increased by ZLP and ZPC as well as the placebo when
      drug plasma levels had nearly reached the peak. Subjects administered ZLP were
      significantly more feeble, lethargic and antagonistic in mood rating scales than
      those administered ZPC. The incidence of severe behavioral side effects was
      higher in the case of ZLP than in the case of ZPC over the same period. Sleep
      latency the next morning was significantly shorter in the case of ZPC than in the
      case of ZLP or the placebo. The tapping test performed at the same time
      demonstrated that the number of taps was significantly less in the case of ZPC
      than in the case of ZLP or the placebo. The results of the present study suggest
      that ZLP acts more rapidly than ZPC. On the other hand, ZLP has less residual
      effect on sleepiness and psychomotor function the next morning.

PMID- 11215154
TI  - [Formation mechanisms of stress adaptation: role of functional coupling of
      glucocorticoids and brain serotonergic nervous system].
AB  - It is known that the incompetence of stress adaptation mechanisms is a primary
      factor affecting disorders such as anxiety and depression. Increased clinical
      evidence indicates that hyperactivity of the hypothalamo-pituitary-adrenal (HPA)
      axis and dysfunction of the brain serotonin (5-HT) nervous system are risk
      factors associated with these disorders. Given the high sensitivity of
      hippocampal 5-HT responses to glucocorticoids, functional changes in the
      hippocampal 5-HT nervous system induced by chronic hypercorticism are attracting
      more attention. Repeated exposure to stress stimuli or chronic administration of
      corticosterone produces hippocampal 5-HT1A receptor dysfunction as well as an
      imbalance in mineralocorticoid and glucocorticoid receptors. We recently
      demonstrated that activation of the 5-HT1A receptors facilitates the adaptive
      responses to stress stimuli by acting on the HPA axis. These findings suggest
      that abnormal coupling of glucocorticoid-mineralocorticoid/glucocorticoid
      receptors-5-HT1A receptors in the hippocampus may be one factor disrupting
      adaptation to stress situations. Moreover, it is shown that activation of the
      coupling system affects learning and memory processes associated with stress
      stimuli. These findings suggest that the functional coupling of glucocorticoid
      mineralocorticoid/glucocorticoid receptors and serotonergic neurons in the brain
      may play a significant role in the recognition of stress stimuli and induction of
      stress adaptation, and dysfunction of this coupling system may be related to the
      onset of affective disorders.

PMID- 11215155
TI  - [Influence of stress on learning and memory].
AB  - This paper describes the influence of stress on learning and memory. The mice
      receiving inescapable electroshock fail to perform the active conditioned
      avoidance response of lever-pressing. This is called learned helplessness, which
      is ameliorated by treatment with antidepressants including one of the selective
      serotonin reuptake inhibitors (SSRIs). It is of particular interest that
      posttraumatic stress disease (PTSD) accompanied by memory impairment could be
      improved by treatment with SSRIs. The different kinds of stress including
      ischemia, footshock, psychological stress, and forced swimming influence learning
      and memory as indexed by spontaneous alternation performance as well as passive
      avoidance learning. In addition, a variety of stresses influence the activity of
      hormones and neurotransmitters like monoamines, neuropeptides, and excitatory
      amino acids resulting in changes in learning and memory. Finally, the
      accumulation of data is necessary to clarify the exact mechanism of stress on
      learning and memory.

PMID- 11215156
TI  - [Influences of chronic stress on central nervous systems].
AB  - Chronic mild or moderate stress elicits an adaptive change in central nervous
      systems that function to maintain homeostasis. The principal components of stress
      response are the extrahypothalamic corticotropin-releasing hormone (CRH) and the
      locus coeruleus (LC)-norepinephrine (NE) systems. CRH is known to produce various
      stress-, anxiety- and arousal-associated behaviors in animals. Moreover, CRH
      causes an increase in the firing rate and activity of tyrosine hydroxylase in the
      LC, and NE release in LC projection areas. It is thought that chronic inescapable
      and unpredictable stress can result in a sustained dysregulation of both CRH
      neuronal activity and LC-NE systems. One may hypothesize that the NE-CRH
      interaction occurs in the terminal projection of forebrain NE systems, the
      hypothalamic paraventricular nucleus (PVN), the bed nucleus of the stria
      terminalis (BNST) and the central nucleus of the amygdala (CeA) where NE
      stimulates CRH release. Such CRH-NE-CRH feed-forward systems elicit progressive
      augmentation of stress responsivity with repeated exposure. The beta-adrenergic
      receptor down-regulation is induced by acute and chronic exposure to moderate and
      predictable stress, implying an adaptation to stress. However, chronic
      unpredictable (variable) stress (CVS), a model for depression, up-regulated the
      beta-AR. In our laboratory, we found that concurrent treatment with the selective
      serotonin reuptake inhibitor (SSRI) citalopram caused beta-R down-regulation in
      the frontal cortex of rats treated with CVS for 14 days. As previously reported
      by the authors, an increase in 5-HT availability plays a role in preserving beta
      R down-regulation by NE potentiating agents. In depressed patients,
      hyperactivation of the CRH-NE systems caused by the CRH-NE feed-forward system is
      thought to be involved in generating anxiety, sympathetic activation and
      hyperarousal. Moreover, a decrease in the 5-HT turnover in depressed patients has
      been reported. Accordingly, it is proposed that an increase in 5-HT availability
      by SSRI might contribute to normalize beta-R down-regulation as an adaptive
      regulatory mechanism against excessive CRH-NE neurotransmission under a
      "stressful" situation.

PMID- 11215157
TI  - [Future trends in the treatment and diagnosis of rheumatoid arthritis].

PMID- 11215158
TI  - [Therapeutic efficacy of cyclosporin A in four cases of amyopathic
      dermatomyositis with rapidly progressive interstitial pneumonia].
AB  - OBJECTIVES: We investigated the clinical features of amyopathic dermatomyositis
      (ADM) with rapidly progressive interstitial pneumonia (IP), and the effectiveness
      of cyclosporin A (CsA) for IP. METHODS: In our four patients who were accorded
      with the notion of amyopathic dermatomyositis proposed by Euwer and treated with
      CsA for IP, and eight reported patients for whom we could obtain details of the
      clinical course, we investigated the relationship between the clinical features
      of them at the start of CsA administration and the clinical effectiveness of CsA.
      RESULTS: When we investigated the effectiveness of CsA in our four patients and
      eight reported patients, we could judge that effective cases were four and
      ineffective cases were eight. We compared the PaO2 at the start of CsA
      administration between effective and ineffective cases, the average PaO2 at the
      start of CsA administration was 65.7 mmHg in four effective cases, while it was
      51.0 mmHg in eight ineffective cases. There was a statistically significant
      difference between the groups. CONCLUSIONS: Because our results suggested that
      many ineffective cases were treated with CsA after they had developed severe
      respiratory failure, we think that CsA should be given to ADM patients with
      rapidly progressive IP before the progression of respiratory failure.

PMID- 11215159
TI  - [Interrelationship between disease activity and nutrient intake or serum cytokine
      in patients with rheumatoid arthritis].
AB  - OBJECTIVE: This study was designed to investigate the possibility of nutrition
      guidance for patients with rheumatoid arthritis (RA). We studied
      interrelationship between disease activity and nutrient intake or serum cytokine
      concentration in patients with RA. METHODS: Dietary survey was performed to
      assess nutrient intake of RA patients. Disease activity parameters, such as
      weariness index, arthritically index and QOL index were evaluated by self
      questionnaire. CRP and serum cytokine concentrations were measured. Interactions
      between these parameters and nutrient intake were analyzed. RESULTS: In
      comparison of nutrient intake between patients with RA and healthy controls, RA
      patients indicated lower ratio of polyunsaturated to saturated fatty acid (P/S)
      than controls. Preceding with the analysis between disease activity parameter and
      nutrient intake, RA patients were divided into two groups according to their
      activities. High weariness group indicated higher lipid intake and energy
      supplies from fat than low group, suggesting the relationship between disease
      activity and lipid intake in RA patients. From the comparative study of serum
      cytokine concentration between patients with RA and healthy controls, RA patients
      indicated higher concentration of IL-1 beta, IL-6 and IL-8. Serum concentrations
      of these proinflammatory cytokines correlated significantly with some nutrient
      intakes. CONCLUSION: These results imply the relationship between nutrient intake
      and disease activity in patients with RA. It is important to develop nutrition
      guidance to improve symptoms for patients with RA.

PMID- 11215160
TI  - [A case with juvenile rheumatoid arthritis who developed cerebral vasculitis and
      venovascular hypertension].
AB  - On November, 1997, a 15-year-old boy visited our hospital because of headache,
      fever and arthralgia. He was treated with 5 mg/day of prednisolone thereafter. On
      October 21, 1998, he was admitted because of remittent fever and multiple
      arthralgia and diagnosis of juvenile rheumatoid arthritis (JRA) was made. He was
      also found to have hypertension of 210/110 mmHg, and soon developed ptosis of the
      eye, facial paresis and perceptive deafness of the right side. Cerebrospinal
      fluid showed protein of 98 mg/dl and mildly elevated IgG, IgA and IgM levels with
      normal cell count. Brain MRI examination revealed multiple cerebral lesions in
      the frontal, parietal and cerebellar areas on the right, whose cause was thought
      to be vasculitis. Renal angiography demonstrated a right renal artery stenosis,
      compatible with renovascular hypertension. He was treated with 60 mg of
      prednisolone per day, which brought about a satisfactory improvement of the above
      rheumatic and neurologic signs. On November 17, 1998, he received a follow-up
      study of MRI, which failed to show any cerebral lesions, supporting the
      effectiveness of prednisolone. An angiotensin converting enzyme inhibitor
      successfully normalized hypertension and renin activity in serum, although renal
      blood flow did not increase.

PMID- 11215161
TI  - [Improvement of cerebral perfusion with argatroban in a patient with
      antiphospholipid syndrome].
AB  - A 22-year old woman developed erythema in her hands. She also suffered from
      general fatigue and arthralgia. In July of 1992, she visited the dermatology
      clinic of Nagoya City University Hospital. We made a diagnosis of subacute
      cutaneous lupus erythematosus with thrombocytopenia and gave her 30 mg of
      prednisolone daily. Her conditions were improved and had been stable with 5 mg of
      prednisolone daily. In the winter of 1993, she developed ulcer in her fingers and
      soles. These lesions were associated with antiphosholipid syndrome. She
      complained of mild headache. She was examined by CT, MRI and single photon
      emission computerized tomography (SPECT) using N-isopropyl-p-[123I]
      iodoamphetamine (IMP). Low perfusion areas in the bilateral occipital lobes and
      the right temporal lobe were found in SPECT, although no abnormalities were
      detected by CT and MRI. Low perfusion areas in antiphospholipid syndrome might be
      caused by microarterial thrombosis, microvenous thrombosis or spasms, although
      they could be reversible. Ten mg of argatroban daily for one month improved
      cerebral low perfusion, headache, and skin lesions. In this case, argatroban was
      effective for both cerebral low perfusion and skin ulcer, which were related to
      antiphospholipid syndrome.

PMID- 11215163
TI  - [Origin of the diversity and similarity of pathological manifestations of
      collagen disease: lessons from murine models in an aspect of pathogenomics].

PMID- 11215162
TI  - [A case of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) related
      glomerulonephritis associated with systemic sclerosis treated by steroid pulse
      therapy: a case report].
AB  - A 57-year-old woman had been diagnosed as systemic sclerosis (SSc) with Raynaud's
      phenomenon, acrosclerosis and polyarthritis since 1995. She admitted to our
      hospital in July 1996 because of general fatigue, hemosputa and progressive renal
      insufficiency. On admission, the blood pressure was normal and laboratory
      findings showed elevation of the serum creatinin level and a high titer of the
      myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) (> 1000 EU). The
      renal biopsy revealed crescentic glomerulonephritis. Both renal insufficiency and
      high titers of MPO-ANCA improved remarkably after methylpredonisolone pulse
      therapy. This case was suggestive of elucidating the pathogenesis of SSc and MPO
      ANCA related glomerulonephritis.

PMID- 11215164
TI  - [Rheumatoid arthritis and secondary amyloidosis].

PMID- 11215165
TI  - [Should we change some medical terms in rheumatology].

PMID- 11215166
TI  - [Dawning of laboratory automation; individually constructed automated systems].
AB  - In the early stages of laboratory automation, the first step toward automation
      was the use of a spectrophotometer equipped with a flow cell system. Then,
      automated machines were introduced. Furthermore, computing systems, which are
      necessary for automated machine systems, contributed to advances in laboratory
      automation. Under these primitive conditions, we devised a data processing system
      for clinical biochemistry and further advanced the first stage of automated
      laboratory system. These automated systems have gradually matured in to a total
      laboratory automation system. As described in this report, we designed and
      developed an automated system in our laboratory.

PMID- 11215167
TI  - [Present state and development of the network communication system].
AB  - Information technology is a dynamic technology that has sparked the development
      of many new products and new services and the medical field is not an exception.
      We would like to introduce our new service which started in December 1999, and is
      called "SNCS". Connecting Laboratory and Sysmex by a dedicated network, SNCS
      provides services such as 'On-line QC' and 'On-line Support' to support
      Laboratory technicians.

PMID- 11215168
TI  - [Developmental frontier of a modular automated system].
AB  - The clinical laboratory is faced with increasing problems such as healthcare
      reform, cost pressure and increased laboratory regulations. Despite these
      problems, the users have even higher expectations for laboratory services. To
      resolve these issues, the clinical laboratory must become more efficient by
      incorporating creative solutions and adapting to changes. One key word is
      increased automation of laboratory procedures and integration of automated
      systems. First, automation will reduce the dependence on manual labor. Second,
      laboratories could perform a larger menu of tests in-house. This not only reduces
      expense but also reduces the turn around time for testing. To realize cost
      reduction and reduce turn around time, we propose the Modular system.

PMID- 11215169
TI  - [Tele-micro-surgery system].
AB  - This paper describes a master-slave type tele-micro-surgical system with an
      intelligent user interface. To enhance the accuracy and the rigidity of the slave
      manipulator, multi-circular guides were adopted for the degrees of rotational
      freedom. To increase the operability of the system, an "anti-shadow" technique
      was used and the 3D relative information was presented on a 2D display.
      Furthermore, the anti-shadow was processed using a real-time tracking vision
      system to guide the slave-manipulator to the target position automatically. Multi
      axis force information was converted into auditory information to transmit the
      reality of the surgical field. It took approximately 25 minutes to suture a 1 mm
      diameter artificial micro-blood-vessel using the system. The carotid artery of a
      rat with a diameter of 0.3 mm was also successfully sutured.

PMID- 11215170
TI  - [Advances in the clinical laboratory automation system of Akita University
      Hospital].
AB  - Abstract Clinical laboratory automation, which was widely discussed in the
      1960's, was developed in late he 1970's. The computerized automatic analyzing
      system for clinical laboratories spread nationwide in the 1980's. Akita
      University Hospital was established in 1971. We have been making efforts to
      establish the automated clinical laboratory system. The hematological and
      clinical chemistry divisions were automated in 1981. In 1988, in order to
      establish a fully automated clinical laboratory, we introduced sample-conveying
      systems in each division including hematological, clinical chemistry, urinalysis,
      serological and immunological divisions. In 1998, we connected the sample
      conveying systems which had been separately established in each division to
      create a fully automated clinical laboratory with an integrated sample-conveying
      system.

PMID- 11215171
TI  - [Investigative application of a laboratory database].
AB  - An end user computing system (EUC) is usually part of the laboratory information
      system. Effective use of this EUC system is described in this article. The first
      application of this system is for monitoring the turn-around time (TAT) of
      laboratory work flow. Precise time sequential data were analyzed using this end
      user computing system. Weekly fluctuations of TAT depended on the cyclic changes
      in requisition numbers of test samples. Another application of EUC was phenotype
      screening of genetic abnormalities. Screenings from high triglyceride and low HDL
      cholesterol were effective for the phenotype screening for genetic lipoprotein
      lipase abnormalities, and phenotype screening from high albumin cholinesterase
      ratio was effective for genetic abnormalities causing silent cholinesterase.
      Investigational application of EUC was demonstrated in two areas of laboratory
      research.

PMID- 11215172
TI  - [The new generation of laboratory automation systems].
AB  - Laboratory automation is essential to release laboratory technicians from simple
      routine work, allowing them to make use their time for more skilled tasks. In
      1998, we developed a Total Infection Control System called "Dr. Fleming", and
      would like to introduce it into practical use. This systems is expected to help
      physicians by providing highly valuable test results and useful information.

PMID- 11215173
TI  - [Development of blood cell measurement].
AB  - Automated blood cell analyzers used in hematology laboratories are required to
      measure many specimens rapidly and efficiency has been realized through
      increasing the measurement parameters and throughput volume in one instrument. In
      the period of 1950's through the early part of 1960's, only red blood cells and
      white blood cells could be counted. In 1965, Technicon Corporation developed an
      instrument which can measure the number of blood cells, hemoglobin, hematocrit
      and calculate corpuscular constants simultaneously. Thereafter, the methodologies
      for simultaneous platelet measurement and precise determination of blood cell
      distribution have been developed. Then, the development of new reagents has
      achieved three part differentials in the distribution of white blood cells.
      Thanks to this development, microscopic white blood cell differentials has been
      replaced by blood cell analyzers in screening tests. Though blood cell analyzers
      may be further improved by expanding of the number of parameters available for
      simultaneous measurements, meeting social needs in the new era will not be
      possible without the creation and realization of new concepts employing new
      technologies such as IT (Information Technology).

PMID- 11215174
TI  - [Building bridges toward the 21st century].
AB  - Just as Rome was not built in a day, there are few great inventions and
      discoveries that can be made overnight. There are always historical circumstances
      behind them. Laboratory Automation is not an exception. With the end of World War
      II in 1945 as a turning point, a large volume of American medicine was introduced
      all over Japan, and clinical laboratory testing which was imported at the same
      time has taken root and matured. As a result, we can now carry out prompt and
      fully automated laboratory testing second to none at many hospital laboratories.
      In this paper, I recall the development and summarize the expansion by focusing
      on clinical laboratory automation as it has developed in the latter half of the
      20th century in Japan. I would feel amply rewarded for my efforts if this paper
      proved helpful to the young generation. The clinical laboratory of the 21st
      century rests on their shoulders.

PMID- 11215175
TI  - [Recent trends in the standardization of laboratory automation].
AB  - Laboratory automation systems have been introduced to many clinical laboratories
      since early 1990s. Meanwhile, it was found that the difference in the specimen
      tube dimensions, specimen identification formats, specimen carrier transportation
      equipment architecture, electromechanical interfaces between the analyzers and
      the automation systems was preventing the systems from being introduced to a
      wider extent. To standardize the different interfaces and reduce the cost
      necessary for the laboratory automation, NCCLS and JCCLS started establishing
      standards for the laboratory automation in 1996 and 1997 respectively. NCCLS has
      published five proposed standards which that are expected to be approved by the
      end of 2000.

PMID- 11215176
TI  - [Communications among components of automated clinical laboratory systems].
AB  - Laboratory Automation Systems has been developed with original specifications
      from each vender. To construct a system in a multi-vender environment, remodeling
      of the interface and software had to be done by the user. The standard concerning
      automated laboratory systems was made by NCCLS in 1997. This standard provides a
      protocol for communications among Laboratory Automation Systems(LAS), Laboratory
      Information Systems(LIS), automated instruments (analyzers), and pre- and post
      analytical automated devices. This document explains the current details and the
      overall content of the communication standards for automated laboratory systems
      developed by the NCCLS Subcommittee on Communications between Automation Systems.

PMID- 11215177
TI  - [Standardization of barcodes used for sample identification].
AB  - In the clinical laboratory, they are mainly using one-dimensional barcode
      (simply, barcode) for the sample identification. It has been proposed an
      international standard for the barcode by NCCLS with the cooperation of JCCLS and
      CODE128 was selected for its symbol. Other details for it also can be found in
      this article. The committee of JSCC has started to discuss a barcode for the next
      generation so that more information can be conveyed on test tubes. A two
      dimensional symbol barcode (2D barcode) is one system. NCCLS is interested in
      this act and therefore cooperation is anticipated in the development of
      international standards.

PMID- 11215178
TI  - [Standardization of operation monitoring and control of the clinical laboratory
      automation system].
AB  - Laboratory automation systems showed up in the 1980s and have been introduced to
      many clinical laboratories since early 1990s. Meanwhile, it was found that the
      difference in the specimen tube dimensions, specimen identification formats,
      specimen carrier transportation equipment architecture, electromechanical
      interfaces between the analyzers and the automation systems was preventing the
      systems from being introduced to a wider extent. To standardize the different
      interfaces and reduce the cost of laboratory automation, NCCLS and JCCLS started
      establishing standards for laboratory automation in 1996 and 1997 respectively.
      Operation monitoring and control of the laboratory automation system have been
      included in their activities, resulting in the publication of an NCCLS proposed
      standard in 1999.

PMID- 11215179
TI  - [Pursuit of economic efficiency in the hospital laboratory--full automatic re
      test system of clinical chemistry, hematology, immunology and cost control
      system].
AB  - Further business improvement is requested due to finance-based fluctuation and
      the influence of the revision in the medical treatment law. Therefore, new
      laboratories are needed. To achieving this in our hospital, economic efficiency
      is being pursued. The first issue is the use of space, the second issue is labor
      saving. The third issue is the simplification of business procedures. There is
      individual quality control by the zonal verification method that we developed, as
      well as the quality control of the batch method using controlled substances. The
      four issue is cost control. By controlling the delivery and use of reagents and
      materials including the term of validity control, we made an effort to abolition
      defective stock. The fifth issue is correspondence to circulation style society.
      The disposal of laboratory garbage is a major issue. We controlled garbage that
      occurs unnecessarily. Furthermore, we are improving the demand for reagents that
      exceeds the specification and use reagent containers.

PMID- 11215180
TI  - [Trial digitalization of analog-data obtained from the AutoAnalyzer].
AB  - The AutoAnalzer(Basic Model) manufactured on Technicon corporation was a very
      useful instrument for clinical laboratory automation, but it was necessary to
      convert the data obtained from the instrument to digital values used the chart
      reader. This was very troublesome and there was apprehension that there would be
      errors in A-D conversion. We tried converting data obtained from the AutoAnalzer
      to a digital value by on-line connection of the instruments with
      minicomputers(LINC-8 and FACOM-R). The output of the recorder was converted to
      voltage(0 to 100 V) using a potentiometer, quantitated(0 to 1.000) by the A-D
      converter attached to LINC-8, and processed by the minicomputer. The control-box
      was an experimental device mainly designed for the convenience of users. The
      functions of the control-box were designated analytical items, No. of A-D
      converters, start and stop of the AutoAnalzer operation to the minicomputer.
      Employing the control-box, a technician operated this system freely, without
      direct computer operation. We established a generally satisfactory system for
      clinical laboratory automation using the minicomputer.

PMID- 11215181
TI  - [Modularization by the open standard. (I)].
AB  - We are proceeding with the project called "Open LA21 Project" in the course of
      the clinical laboratory automation toward the 21st century. With the modular
      system that realizes integration, downsizing, a reasonable price, and is the
      future course in the clinical testing automation system as well, we aim to
      establish common standards among manufacturers as the only way to create user
      friendly market environments where the proper competition exists among the
      manufacturers. The common standards which are in preparation by the participating
      companies as "Open module system standards" are the standards which are going to
      be made public. They are intended to guarantee connection, compatibility of the
      products in conformity with the standards. In this project, we intend to realize
      the modular system that integrates each field, such as chemistry, hematology,
      coagulation/fibrinolysis, immunology, urinalysis in an early stage, and
      contribute positively to restructuring and upgrading the "raison d'etre" of the
      21st century clinical testing.

PMID- 11215182
TI  - [Modularization by the open standard. (II)].
AB  - In recent years, accompanied by the marvelous development and spread of
      Laboratory Automation System(LAS), the NCCLS is now proposing five international
      standards for laboratory automation. We have based our laboratory on these "NCCLS
      standards of laboratory automation", we take these standards ahead first, and we
      now propose an open standard called "Open LA 21", to establish more detailed
      standard replacing the NCCLS laboratory automation standards.

PMID- 11215183
TI  - [Visual backward masking in schizophrenia].
AB  - Visual backward masking is used to investigate the function of attention as the
      initial stage of visual information processing by measuring the shortest stimulus
      presentation time for accurate cognition. This is achieved by applying a masking
      stimulus after target stimulus presentation. In this study, 50 controls and 50
      schizophrenics (paranoid type) were examined by this method. In the control
      group, 1) there was a significant decline in correct answers to the target
      stimulus with age; and 2) there was a significant increase in correct answers
      with repetition. However, in the schizophrenic group, 1) there was a
      significantly lower number of correct answers in all age groups compared to that
      in the controls, along with a greater decline in correct answers with age; and 2)
      there was no increase in correct answers with repetition; 3) good performers
      among the schizophrenic patients were young with a short duration of illness and
      on a low dose of medication. Poor performers showed numerous positive and
      negative psychotic symptoms, were not on medication, or had positive findings on
      CTscan; furthermore, 4) longitudinal re-examination of the same subjects showed
      that even when psychotic symptoms improved and the subjects were able to return
      to society, their ability to give correct answers remained significantly
      different compared to that of the controls. These findings seem to reflect the
      trait-dependence aspect of schizophrenia (paranoid type) on a visual backward
      masking task. Furthermore, visual backward masking seems to be a convenient and
      useful measure for this aspect of attention and its trait-dependence in
      schizophrenia.

PMID- 11215184
TI  - [Study on pancreatic steatorrhea in patients with chronic pancreatitis].

PMID- 11215185
TI  - [Autoimmune pancreatitis].

PMID- 11215186
TI  - [Prognostic factors of hepatocellular carcinoma: analysis by the proportional
      hazard model].
AB  - Five hundred fifty patients hospitalized to our hospital during 1990 to 1999 were
      studied. Subjects consisted of 413 males and 102 females and mean age was 62.1
      years. Association with HBV infection, HCV infection and both infection was
      11.1%, 78.4% and 2.5% respectively. According to the criteria based in Liver
      Cancer Study of Japan, 5 year survival rate in clinical stage I, II, III was
      42.3%, 38.8% and 17.5%. Tumor morphology was nodular type in 78.9%, massive type
      in 9.1% and diffuse type in 10.5% of cases. Portal tumor thrombus and distal
      metastasis were observed in 19.9% and 6.3% of all cases. The 1-, 3- and 5-year
      survival rate in patients received any therapy was 80.8%, 44.6% and 28.7%,
      respectively. Analysis by the proportional hazard model showed that HBV
      infection, advanced clinical stage, multiple tumors, a tumor diameter in excess
      of 5 cm and AFP positivity were shown as significant factors on poor prognosis.

PMID- 11215187
TI  - [Signet ring cell carcinoma of the colon with monoclonal gammopathy of
      undetermined significance].

PMID- 11215189
TI  - [A case of upper jejunal gastrointestinal stromal tumor (GIST) accompanied with
      von Recklinghausen's disease].

PMID- 11215188
TI  - [A case of true enterolithiasis with acute appendicitis].

PMID- 11215190
TI  - [A case of ileal perforation due to intestinal tuberculosis simulating radiation
      ileitis].

PMID- 11215191
TI  - [A case of inflammatory fibroid polyp of the ileum presenting typical findings of
      intussusception by ultrasonography and computed tomography].

PMID- 11215192
TI  - [A case of arteriovenous malformation of the ileum with repeated bleeding].

PMID- 11215193
TI  - [Serum soluble interleukin-2 receptor levels in patients with renal cell
      carcinoma: a comparison of values before and after surgery].
AB  - This study was carried out in order to find out whether soluble interleukin II
      receptor (sIL-2R) levels were useful as a treatment biomarker in patients with
      renal cell carcinoma (RCC). The subjects consisted of 17 patients with RCC who
      had been scheduled for radical or partial nephrectomy. Serum levels of sIL-2R
      were measured before surgery and 1 and 3 months after surgery. We also analyzed
      the relationship of preoperative sIL-2R to pathologic TNM-stage, grading and
      presumptive tumor volume. The mean value of pre-operative sIL-2R in patients with
      RCC was 496.5 U/ml as compared with 302.7 U/ml in the control group (p = 0.056).
      Pre-operative sIL-2R values were 411.1 U/ml in stage I (n = 6), 481.4 U/ml in
      stage III (n = 11) and 1,330 U/ml in stage IV (n = 1). There was no significant
      difference between stage I and stage III. As compared with pathologic grading,
      pre-operative sIL-2R levels in patients with grade 2 were significantly higher
      than those with grade 1 (609.8 U/ml versus 288.7 U/ml, p = 0.016). There existed
      a significant correlation between preoperative sIL-2R and presumptive tumor
      volume (r = 0.61, p = 0.008). Three months after surgery, sIL-2R values were
      significantly higher than before surgery. Serum sIL-2R levels seemed to bear some
      relationship to the extent of disease in patients with RCC. Values of sIL-2R were
      significantly higher after than before surgery at least for a three-month
      postoperative period, suggesting a response to trauma of surgery. Further long
      term studies were required to clarify if sIL-2R could predict the progression of
      disease.

PMID- 11215194
TI  - Extracorporeal shock wave lithotripsy for upper urinary tract stones using the
      Dornier Lithotripter Compact: an experience in Japan.
AB  - Between May 1997 and February 1998, 40 cases of renal stones and 40 cases of
      ureteral stones in 60 males and 20 females were treated with the Dornier
      Lithotripter Compact. The size of the stones ranged from 5 mm to 80 mm. Three
      patients required epidural anesthesia and 4 patients required a ureteral stent.
      Fragmentation of the stones was observed in all patients. After 1 month, the
      efficacy and stone free rates were 91% and 54%, respectively. After 3 months,
      they were 91% and 68%, respectively. There were no serious side effects such as
      pyelonephritis, perirenal hematomas, and massive hematuria. In conclusion, the
      Dornier Lithotripter Compact proved to be a safe and highly effective
      lithotripter for the treatment of renal and ureteral stones.

PMID- 11215195
TI  - [Clinical evaluation of urinary basic fetoprotein and the BTA test for detection
      of bladder cancer].
AB  - We compared the results of urinary basic fetoprotein (BFP) and the BTA test with
      those of urinary cytology in patients with bladder cancer. We also analyzed the
      urinary BFP and the BTA test results in patients with benign diseases and
      postoperative bladder cancer with no evidence of recurrence. The cutoff value for
      urinary BFP was set at 10 ng/ml. Classes 4 and 5 according to urinary cytology
      were defined as positive. The sensitivity of urinary BFP for Ta, 1 bladder cancer
      was significantly higher than that of urinary cytology (p < 0.05). The urinary
      cytology positive rate for Ta, 1 bladder cancer improved when combined with
      urinary BFP and the BTA test. The urinary BFP positive rate for benign diseases
      was significantly higher in patients with pyuria than in patients without pyuria
      (p < 0.05). The BTA test positive rate for benign diseases was higher in patients
      with pyuria than in patients without pyuria. The urinary BFP and the BTA test
      positive rates for postoperative bladder cancer with no evidence of recurrence
      was significantly higher in patients with urinary diversion than in patients
      without urinary diversion (BFP: p < 0.01, BTA: p < 0.05).

PMID- 11215196
TI  - [Long-term clinical results of 5 cases of urachal carcinoma].
AB  - Five cases of urachal carcinoma experienced in our hospital during the past 20
      years are reported. Surgical resection is considered as the first treatment
      option of this disease, and other therapies to be less beneficial. Complete
      surgical extirpation and detection of recurrence in the early stage are
      considered to be important since local recurrence occurs frequently. We enforced
      the bladder preserving operation for 4 patients with urachal carcinoma except for
      1 case with peritonitis carcinomatosa in the initial diagnosis, and multiple
      surgical treatment was performed again for 2 patients with recurrence. The
      bladder was preserved with no evidence of malignancy in three patients for 24, 19
      and 5 years, respectively. In the initial management of urachal carcinoma, we
      believe that bladder-preserving surgery should be considered in selected cases
      though close follow-up is demanded. Herein, we also report the
      immunohistochemical study of paraffin-embedded specimens using anti-CEA, CA19-9,
      CA125 and p53 monoclonal antibodies. The positive reaction was observed in 100%
      (5/5) for CEA, 80% (4/5) for CA19-9, and 20% (1/5) for CA125. These results
      suggest that CEA may be a useful marker in the diagnosis of this neoplasm and
      early detection of its recurrence. Nuclear accumulation of p53 was observed in
      80% (4/5), but it did not correlate with the disease progression.

PMID- 11215197
TI  - [A case of primary renal carcinoid tumor].
AB  - The patient was a 44-year-old woman in whom a mass of the right kidney was found
      when she underwent abdominal ultrasonography in a physical checkup. The computed
      tomography of abdomen and the magnetic resonance imaging of abdomen revealed a 3
      x 3 cm solid mass at the right kidney. Excretory urograms showed a deformity of
      the right collecting system due to a mass lesion. The specimen of the resected
      tumor showed a cellular arrangement specific to carcinoid tumor and positive
      reaction of Grimelius stain. Electron microscopy confirmed the presence of dense
      core granules in the tumor cells. Gastrointestinal investigation after the
      operation revealed no particular findings suggesting a carcinoid syndrome. No
      evidence of metastasis or recurrence was noted for 5 months after the operation.
      This was a very rare case of primary renal carcinoid tumor, representing the 12th
      case in the literature in Japan.

PMID- 11215198
TI  - [A case of peripelvic extravasation related to pregnancy].
AB  - A 35-year-old woman was hospitalized at 39 weeks 0 days of gestation because of
      acute left flank pain. Magnetic resonance imaging (MRI) revealed bilateral
      hydronephrosis with peripelvic extravasation of contrast material around the left
      kidney. The pregnancy ended with a cesarean section and after the cesarean
      section a left double-J-stent was placed cystoscopically. An excretory urogram
      following the removal of the ureteral stent showed no extravasation or
      hydronephrosis in either kidney.

PMID- 11215199
TI  - [Metastatic bladder tumor disseminated lymphogenously from gastric cancer: a case
      report].
AB  - A 59-year-old man was referred to our clinic with a complaint of frequent
      urination, voiding pain, and macroscopic hematuria. He had undergone total
      gastrectomy for mucinous adenocarcinoma, 21 months earlier. Pelvic computed
      tomography revealed a thick bladder wall all around. There were no other
      metastatic sites except for paraaortic lymph nodes. Transurethral resection of
      the bladder tumor was performed. The specimen showed signet ring cell carcinoma
      and revealed the same pathological findings as the primary gastric cancer. We
      diagnosed him with metastastic bladder tumor lymphogenously disseminated from
      gastric cancer. Such lymphogenous metastases from gastric cancer at the entire
      bladder wall without other apparent lesions have rarely been reported in the
      Japanese literature.

PMID- 11215200
TI  - [A case of neurogenic bladder due to neuro-Behcet disease].
AB  - Behcet disease is a systemic vasculitis of unknown cause with variable clinical
      features. The central nervous system may also be involved in about 10% of the
      patients with Behcet disease. Half of them show marked central nervous system
      symptoms and are diagnosed as neuro-Behcet disease. Voiding symptom is seen in
      about 5% of the patients with neuro-Behcet disease. We report a case of
      neuropathic vesico-urethral dysfunction in a 39-year-old man with neuro-Behcet
      disease. Its radiological and urodynamic features and treatment are also
      presented with some discussion.

PMID- 11215201
TI  - Venous hemangioma of the scrotum: a case report.
AB  - We report a case of intrascrotal hemangioma. A 68-year-old man who had noticed a
      swelling in his left scrotum over the past 1 year was seen at our hospital. Under
      a diagnosis of intrascrotal tumor, total excision of the mass was performed.
      Histopathological examination revealed venous hemangioma of the scrotum.

PMID- 11215202
TI  - [Fournier's gangrene in a patient with malignant lymphoma: a case report].
AB  - We report a case of Fournier's gangrene. An 83-year-old man underwent biopsy of
      left inguinal tumor as an outpatient. Pathological diagnosis was malignant
      lymphoma (diffuse large cell type). Three weeks later, he developed reddened
      scrotal swelling accompanied with high fever (> 39 degrees C). On admission,
      antibiotic chemotherapy was initiated. Although his general condition was
      improved, scrotal necrosis had developed. A computed tomography scan demonstrated
      thickened subcutaneous tissue over the left lumbar region. Excision of necrotic
      tissue and sequential irrigation using povidone iodine liquid were effective. The
      patient then underwent chemotherapy for malignant lymphoma at the internal
      department. Nine months after the operation, the scrotal skin had completely
      recovered.

PMID- 11215203
TI  - Acute scrotal swelling in Henoch-Schonlein purpura: a case report.
AB  - Henoch-Schonlein purpura is a systemic vasculitis and sometimes presents as acute
      scrotal swelling in children. We report a case of Henoch-Schonlein purpura with
      acute scrotal swelling, which was correctly diagnosed based upon local physical
      findings. Scrotal ultrasonography showed normal testes and hydrocele testis
      around the affected testis 3 hours after the sudden onset of the pain. The
      scrotal symptoms improved in 2 days with steroid therapy. Scrotal ultrasonography
      was useful to diagnose Henoch-Schonlein purpura with scrotal involvement. Steroid
      treatment appeared to be effective for this condition.

PMID- 11215204
TI  - [MN/CA IX antigen as a potential target for renal cell carcinoma].
AB  - MN/CA IX is considered as a carbonic anhydrase isoenzyme expressed in the normal
      alimentary tract in a tissue-specific manner. This antigen is activated in the
      majority of renal cell carcinomas (RCC) but not in the normal kidney tissues. Our
      previous study revealed that increase of malignant potential is related to down
      regulation of MN/CA9. To investigate the mechanism of MN activation in RCC, we
      examined the methylation status of this gene (MN/CA9) in RCC cell lines (SKRC-1,
      6, 10, 12, 14, 44, 59). Moreover, we analyzed the circulating blood of patients
      for the presence of RCC cells by RT-PCR, to determine whether detection of
      circulating RCC cells could be useful as a biomarker. CpG methylation was
      investigated at 7 CpG sites in the MN/CA9 5' region. Clear mRNA signals were
      observed in 5 cell lines (SKRC-1, 6, 10, 44, 59), e.g., MN/CA9 positive. These 5
      MN-positive cell lines showed hypomethylation in the 5' region. In contrast, all
      CpG sites were methylated in the remaining 2 lines and 3 normal kidney tissue
      samples. These results suggest that hypomethylation in the 5' region may play an
      important role in the expression of MN/CA9 in RCC. RT-PCR analysis of blood
      samples from RCC patients revealed the presence of circulating MN-positive cancer
      cells in the blood. Although a significant correlation with tumor stage and grade
      was not observed, the analysis of blood samples from patients with metastases
      resulted in a high detection rate of 82%. These findings suggest the usefulness
      of MN/CA IX as a potential diagnostic marker for detection of RCC.

PMID- 11215205
TI  - [Significance of chromosome 9 alterations as an initial step in urothelial
      carcinogenesis].
AB  - One of the most important features of urothelial cancers of the bladder and upper
      urinary tract is metachronous and/or synchronous multifocal occurrence with high
      frequency. Since such multifocal recurrent tumors are derived from a common
      transformed cell, the chronological tracing of genetic alterations in such
      multifocal tumors may reveal the precise timing and role of genetic alterations
      in urothelial carcinogenesis. In this study, we tested the presence of
      microsatellite alterations in synchronous and/or metachronous multifocal
      urothelial cancers to examine the chronological genetic alterations for the
      presence of hierarchy of genetic alterations in urothelial cancer development.
      Genetic alterations at 20 microsatellite loci on 8 chromosomal arms (2q, 4p, 4q,
      8p, 9p, 9q, 11p, and 17p) were tested. Judging from the patterns of allelic
      deletion and microsatellite shifts, multifocal tumors in at least 21 (81%) of the
      26 evaluable patients were considered to be derived from a single progenitor
      cell. In patients with multifocal tumors of an identical clonal origin,
      discordant microsatellite alterations were observed at significantly lower
      frequencies on chromosome 9 compared with those on the other chromosomes tested.
      The heterotopic spread and genetic divergence may occur long before the clinical
      manifestation of multiplicity from a single transformed cell. The data
      strengthens the previous view that heterotopic spread of transformed progenitor
      cells and genetic divergence occur after chromosome 9 alterations in most of
      urothelial cancers.

PMID- 11215207
TI  - [Clinical role of cell cycle regulators in androgen-dependent cancer cell
      growth].
AB  - The functional and quantitative alterations in cell cycle regulators after
      androgen depletion in an androgen-dependent cancer cell and the interaction
      between androgen receptor and cell cycle regulators were examined in order to
      clarify the initial response of cancer cells to anti-androgen therapy.
      Fluorescence activated cell sorter analysis (FACS) of androgen-dependent cancer
      cell line (SC-3) cells cultured with or without 1 nM dihydrotestosterone (DHT)
      revealed that suppression of cell growth after androgen withdrawal was due to G1
      arrest. The protein level of cyclin D1 decreased without any apparent change in
      the amounts of Cdk2, Cdk4, cyclin E or cyclin A. Among various Cdk inhibitors
      (CKIs) examined, p27 was upregulated at both mRNA and protein levels 24 h after
      androgen depletion. On the other hand, cyclin E has been shown to increase the
      transactivation activity of the human androgen receptor (AR) in the presence of
      DHT. These results suggest that cell cycle regulators are critical targets in the
      initial response of androgen-dependent cancer cells to androgen depletion and
      play a key role in the transcriptional activity of AR.

PMID- 11215206
TI  - [Human heparanase: roles in invasion and metastasis of cancer].
AB  - Heparanase, which is an extracellular matrix degradative enzyme, degrades heparan
      sulfate and heparan sulfate proteoglycans, which are chief components of
      extracellular matrix and vascular basement membrane. The gene structure of this
      enzyme was recently determined. The biological functions of this enzyme in vivo
      were as follows: 1) this enzyme accelerates cancer cell invasion and metastasis
      though the degradation of vascular basement membrane and extracellular matrix by
      cancer cells; 2) this enzyme releases and activates heparin-binding growth
      factors such as bFGF and VEGF from heparan sulfate proteoglycans, and induces
      angiogenesis; 3) the degradative products of heparan sulfate proteoglycans by
      this enzyme suppress the biological function of activated T-lymphocytes.
      Therefore, heparanase is thought to be a favorable molecule for acceleration of
      cancer invasion and metastasis. The expression of heparanase is strongly
      correlated with the metastasis of melanoma and fibrosarcoma. Thus, heparanase may
      play important roles in invasion and metastasis of cancer.

PMID- 11215208
TI  - [Role of hepatocyte growth factor in invasion of prostate cancer cell lines
      through tumor-stromal interaction].
AB  - We examined how prostate stromal cell-derived hepatocyte growth factor (HGF)
      affects invasion of prostate cancer cells through tumor-stromal interaction. The
      effects of HGF, various growth factors [transforming growth factor (TGF)-alpha,
      TGF-beta 1, basic fibroblast growth factor, keratinocyte growth factor, and
      platelet-derived growth factor], and conditioned medium (CM) from prostate
      stromal cells (PrSC) on prostate cancer cells (LNCaP, PC-3 and DU145) were
      determined by collagen gel invesion assay. DU145 cells and PrSC were co-cultured
      for matrigel invasion chamber assay. LNCaP and PC-3 cells did not respond to any
      of the factors examined. Invasion of DU145 cells into the collagen gel matrix was
      induced by HGF and TGF-beta 1, but not by any of the other factors tested. When
      DU145 cells were cultured in CM from PrSC or co-cultured with PrSC, the cells
      acquired invasive potential, and this invasion was inhibited by an antibody
      against HGF, but not against TGF-beta 1. Induction activity of CM from cancer
      cells to stimulate HGF production by PrSC was studied by ELISA method and Western
      blotting. Native type HGF production in PrSC was enhanced by some unknown
      inducer(s) produced by cancer cells. In summary, PrSC-derived HGF enhanced
      invasive activity of the prostate cancer cell line DU145 through tumor-stromal
      interaction wherein DU145 cells secreted some HGF-inducer(s) for PrSC.

PMID- 11215209
TI  - [Correlation between expression of metastasis-related genes and lymph node
      metastasis in testicular cancer].
AB  - To investigate the factors related to lymph node metastasis of testicular germ
      cell tumors, we first established a seminoma orthotopic model with lymph node
      metastasis in SCID mice by inoculating small fragments from subcutaneous
      xenografts. Second, we compared the expression patterns of metastasis-related
      genes of the seminoma xenografts and of the TCam-2 cells which were established
      as a seminoma cell line from a primary testicular seminoma. Third, we
      immunohistochemically analyzed human germ cell tumors (25 seminomas, 17
      nonseminomas) using monoclonal antibodies to CD34, VEGF, VEGF-C, Flt-4, MMP-2 and
      E-cadherin. Testicular seminoma xenografts grew in 32/32 (100%) of the inoculated
      mice, of which 15 (47%) developed macroscopic metastasis to the renal hilar lymph
      node. Circulating tumor cells were detectable by using a PCR assay for the human
      beta-globin gene in 25/32 (78%) mice, although metastatic foci were not
      histologically evident in the visceral organs, including lungs, liver, kidneys
      and spleen. This may reflect the lymphophilic characteristics of the seminoma
      cells used. Regarding mRNA expression of metastasis-related genes, an increased
      expression of MMP-2 and VEGF compared with that in the s.c. xenografts was
      demonstrated by RT-PCR assay in the testicular seminoma xenografts. In addition,
      uPAR, MMP-1, MMP-2, MT1-MMP and MT3-MMP showed a a stronger expression and PAI-2
      a weaker expression in the seminoma xenografts than did TCam-2 cells. These
      results suggest a higher metastatic potential of the seminoma xenografts,
      especially testicular xenografts, as compared with TCam-2 cells. In the
      immunohistochemical study, a significant correlation was found between MMP-2
      expression and lymph node metastasis, which is compatible with the results for
      the metastasis-related gene expression from the seminoma xenografts.

PMID- 11215210
TI  - [Methicillin-resistant Staphylococcus aureus infection in the elderly].

PMID- 11215211
TI  - [Regeneration of neuronal cells].

PMID- 11215213
TI  - [Subcortical dementia in Parkinson's disease].

PMID- 11215212
TI  - [Dementia with Lewy bodies].
AB  - Dementia with Lewy bodies (DLB), the second most frequent cause of primary
      degenerative dementias following Alzheimer's disease, has been increasingly
      recognized since the proposal of the consensus name and clinical diagnostic
      criteria. Although DLB overlaps in clinical, pathological, and genetic features
      with Alzheimer's disease and Parkinson's disease, DLB should be understood as an
      entity with the essential feature of the presence of Lewy bodies in the brain
      stem and cerebral cortex. From the clinical point of view, DLB is characterized
      by the presence of progressive dementia without severe memory disorders at the
      early stage, with significant cognitive fluctuations, well-formed recurrent
      visual hallucinations, and spontaneous Parkinsonism. This article reviews recent
      clinical and research findings, including our own, to facilitate clinical
      recognition of DLB. In addition to the supportive features described in the
      consortium clinical diagnostic criteria for DLB such as falls and great
      sensitivity to neuroleptic drugs, our studies found other frequent disorders
      including disproportionately severe visuoconstructive and visuoperceptual
      disturbances, transitory alterations in consciousness with reduplication
      phenomena, misidentification delusions, and non-aphasic misnamings. Neuroimaging
      features include relatively preserved hippocampal volume on MRI and occipital
      involvement on metabolic and blood flow imagings. The correct diagnosis of DLB is
      important to administer adequate treatment, to avoid adverse effects with
      neuroleptic drugs, and to establish precise prognosis. The present summary of the
      clinical features is hopefully helpful for clinical diagnosis of DLB. From a
      therapeutic point of view, cholinesterase inhibitors seemingly show some efficacy
      in the treatment of cognitive alterations. Further research would result in
      advances in diagnostic methods and therapeutic approaches in the near future.

PMID- 11215214
TI  - [Prion diseases].

PMID- 11215215
TI  - [Vascular dementia].

PMID- 11215216
TI  - [A trial to improve the quality of care in our long-stay chronic care hospital].

PMID- 11215217
TI  - [Cooperation of nurse and careworker].

PMID- 11215218
TI  - [A focus on activity care].

PMID- 11215219
TI  - [End-of-life care in long-term care hospital (facilities)].

PMID- 11215220
TI  - [Effect of the level of basic activities of daily living on home caregiver
      burnout].
AB  - To relieve the stress of caregivers, it is critical to identify and classify the
      burden factors in the elderly patients. In order to determine the factors that
      exhaust caregivers, a cross sectional survey was done. The study employed a self
      recording questionnaire form which included the Pines' burnout scale and the
      level of patient's basic activities of daily living (BADL). Seventy-three
      caregivers filled in the questionnaire. They reported the difficulty of care for
      an elderly patient in the home, and the degree of the difficulty correlated well
      with the burnout score (r = -0.517; p < 0.001). The caregivers' burnout score did
      not correlate so well with the level of their patient's BADL (r = -307; p =
      0.014). Among the factors in BADL, aid for toilet use, feeding, sitting, and
      transferring raised the burnout scale. On the other hand, assistance for bathing
      and dressing did not correlate with the burnout score. On multiple regression
      analysis using the background factors for the burnout score as explanatory
      variables, aid for feeding and sitting were significant independent contributing
      factors. Since it became clear that the caregivers in the home were almost burnt
      out owing to the aid they need to give for the elderly person's BADL, attempts
      should be done to reduce their burden as soon as possible.

PMID- 11215221
TI  - [Calcium decreases urinary oxalate].
AB  - The effects of calcium supplementation on urinary oxalate excretion was tested in
      9 normal subjects, 4 males and 5 females between 23 and 49 years of age. In a
      crossover study 800 mg calcium was orally administered as active absorbable algal
      calcium (AAACa) (A) and calcium carbonate (B), and compared with non-calcium
      containing placebo (C). Calcium, oxalate, osmolality, creatinine and pH were
      measured in the first three morning urine samples and Ca/osmolality,
      Ca/osmolality/body weight, Ca/creatinine and oxalate/osmolality were calculated
      to correct for urine dilution. Ca x oxalate product was also calculated and Ca
      oxalate crystal in the sediment was microscopically examined and
      semiquantitatively estimated as -, +, ++, and +++ expressed as 0, 1, 2 and 3
      respectively. Urinary Ca excretion was similar in A and B, but significantly
      larger than C, regardless of the method of correction for dilution. Urinary
      oxalate excretion tended to be lower in A than in B and C. Urine pH was similar
      among all three groups. Ca x oxalate product was higher in C than in A and B.
      AAACa, unlike calcium carbonate, appeared to decrease urinary oxalate excretion
      and Ca x oxalate product more efficiently than Ca carbonate, suggesting a
      possibility of inhibiting the formation of Ca x oxalate kidney stones. Formation
      of calcium oxalate was also tested in vitro by adding oxalate to urine samples
      and aqueous calcium solution.

PMID- 11215222
TI  - [Clinical findings of arteriosclerosis and serum lipoprotein(a) concentration in
      elderly patients].
AB  - This study was conducted to evaluate the relationship between arteriosclerosis
      and lipoprotein(a) [Lp(a)] from the point of view of aging. A total of 354
      patients (167 men) aged 60 or more were enrolled and serum Lp(a) levels, vascular
      risks, and complications were studied. Patients were divided into 3 groups
      according to age: group I (n = 73: aged 60 to 69), group II (n = 144: aged 70
      79), and group III (n = 137: aged 80 or more). Vascular complications were
      assessed by carotid ultrasonography (US), ECG, and ankle pressure index (API), US
      findings were stratified according to the distribution of plaque lesions in
      unilateral and bilateral lesions, while plaque types were subdivided based on the
      morphology and US echogenicity. Male patients with risk factors (diabetes,
      hypercholesterolemia, cigarette smoking) as well as stroke were frequent in group
      I, indicating some selection bias. However, there was no difference in Lp(a)
      level among the three groups. Carotid lesions, especially bilateral lesions with
      more thickened plaques, and low API were both significantly frequent in group
      III. Logistic regression analysis showed that carotid lesions were influenced not
      only by aging, but also independently by high Lp(a) levels in group III, and by
      hypertension in group II. A high Lp(a) level was related to hypercholesterolemia
      and hypoechoic plaque. These findings indicated that atherosclerosis, which
      developed in both the carotid and peripheral arteries with aging, was related to
      different risks in each decade of life. Furthermore, it seems that a long period
      of high Lp(a) levels may promote the formation of hypoechoic plaque.

PMID- 11215223
TI  - [An autopsy case of anaplastic thyroid carcinoma that transformed from papillary
      carcinoma within 5 years from initial diagnosis].
AB  - An 84-year-old man was admitted to our hospital with right shoulder pain. He had
      been suffering from well-differentiated papillary thyroid carcinoma since 1994,
      and had undergone surgery three times, including procedures due to recurrence.
      Since CT showed a right cervical tumor, recurrence of thyroid carcinoma was
      diagnosed. He died in September 1999 due to progressive respiratory failure.
      Autopsy was performed and pathological examination revealed the recurrent tumor
      and metastatic lesions had totally transformed to anaplastic thyroid carcinoma.
      Since anaplastic carcinoma is characterized by exceptionally rapid progression
      with dire prognosis, physicians should be aware of the major risk factors of
      anaplastic transformation in elderly males aged over 60 years old, with repeated
      relapses of differentiated carcinoma, and a history of tumor irradiation.

PMID- 11215224
TI  - [An aged case of bilateral ballistic movement which was thought to be exacerbated
      by respiratory insufficiency].
AB  - We report a 75-year-old man who had shown bilateral ballistic movements. He had
      suffered from pulmonary emphysema for about 35 years and was treated with oxygen
      therapy 3 years before. When he was 70 years old, involuntary movements appeared
      in bilateral limbs. His involuntary movements were ballistic, and become
      gradually worse. T2-weighted MRI after admission demonstrated high signal
      intensities in the bilateral pallidum, indicating multiple brain infarcts in the
      subcortical white matter. Ultrasonography showed 2 plaques in the left common
      carotid artery. Laboratory studies revealed blood coagulation abnormalities and
      hypoxia. Medication with clonazepam and tiapride together with oxygen therapy
      normalized blood gas levels and improved his involuntary movements. But after
      discharge, he stopped oxygen therapy and involuntary movement became worse again,
      associated with hypoxia demonstrated by his blood gas analysis. These findings
      suggest that not only cerebrovascular disease but hypoxia might play an important
      role in the appearance and exacerbation of involuntary movements.

PMID- 11215225
TI  - [Relief of subacute herpetic pain and postherpetic neuralgia with repeated
      application of 10% lidocaine cream].
AB  - Analgesic efficacy of repeated application of a lidocaine cream formula was
      investigated in herpes zoster patients with subacute pain with no further
      improvement after continued treatment since their acute stage (S-HZ group, n =
      23), and in patients to whom past treatments had not provided adequate pain
      relief (PHN group, n = 28). In both groups, visual analog scale (VAS) values
      decreased significantly from their corresponding values before the present
      treatment with few cases of side effects and complete disappearances of the pain
      in 21.6% of all the patients. The results indicate that the repeated application
      of the lidocaine cream is a safe and effective treatment method. Significantly
      higher effectiveness was achieved in the S-HZ group in terms of the difference in
      the VAS values between before and after the treatment, effectiveness in improving
      the activities of daily life, and overall efficacy evaluation.

PMID- 11215226
TI  - [Correlation between prior coronary revascularization and perioperative cardiac
      events in patients for noncardiac surgery].
AB  - We evaluated the influence of interval between prior coronary revascularization
      and subsequent noncardiac surgery on perioperative cardiac events. We
      retrospectively identified 162 consecutive patients with previous
      revascularization procedures who had undergone noncardiac surgery. Postoperative
      cardiac complications occurred in 10 (6.2%) patients, cardiac death in 1 patient,
      and significant arrhythmia in 3 patients. These patients had higher rates of
      unstable angina, myocardial infarction within 3 months, cerebrovascular disease,
      peripheral vascular disease, renal dysfunction (Cr > or = 1.9 mg.dl-1) and higher
      preoperative risk scores as described by the Cleveland Clinic (P < 0.05). Also,
      the incidence of cardiac complications increased when noncardiac surgery was
      performed within 1 week of previous percutaneous transluminal coronary
      angioplasty (PTCA) and in more than 5 years after coronary artery bypass grafting
      or PTCA (P < 0.05). Although PTCA is widely accepted, especially in Japan, early
      lesion progression was observed during the first several days and atherosclerotic
      progression was apparent in more than 5 years after the procedure. Therefore, the
      time between coronary revascularization and noncardiac surgery, as well as
      atherosclerotic risk factors, is important in evaluating patients with history of
      previous revascularization procedures.

PMID- 11215227
TI  - [Anesthetic management of MICS with Port-Access system].
AB  - Port-Access system (P-A) is a catheter-based system for minimally invasive
      cardiac surgery (MICS) characterized by avoidance of full sternotomy with the aid
      of Endoaortic Clamp Catheter (EAC) for intra-aortic occlusion instead of the
      conventional external aortic crossclamping. In our hospital, eleven patients
      underwent MICS using P-A from August in 1998 to the present time. We compared the
      intra- and post-operative anesthetic management of these patients with that of
      fifteen patients done by using our conventional MICS method, Saitama Medical
      School system (SMS). Anesthetic management of these MICS patients is directed
      toward early extubation, and therefore all patients receive intravenous
      anesthesia with a small dose of fentanyl combined with inhalational agent or
      propofol. Without increasing the time of the cardiopulmonary bypass (CPB) and the
      amount of the intraoperative bleeding, MICS with P-A needs more time to begin CPB
      than that with SMS because it takes more time to insert these catheters,
      especially EAC into the suitable position using transesophageal echocardiography
      (TEE) and fluoroscopy. The time to start CPB must be shortened by skilled
      cannulation. There is no difference in the postoperative length of ICU and
      hospital stays between P-A and SMS. In MICS, TEE is the window to the heart for
      both surgeon and anesthesiologist and used to guide for the placing of the
      catheters and weaning from CPB, and anesthesiologist should be skillful in using
      TEE to evaluate the de-airing procedure and assess volume load and contractility
      of the left ventricle.

PMID- 11215228
TI  - [Intravenous patient controlled analgesia combined with continuous thoracic
      epidural analgesia for post-thoracotomy pain].
AB  - We compared the efficacy of intravenous patient controlled analgesia of
      buprenorphine plus continuous thoracic epidural infusion of bupivacaine (IV-PCA
      group) with the efficacy of continuous thoracic epidural infusion of bupivacaine
      and buprenorphine (the TEA group). No patient in IV-PCA group required
      supplemental analgesics, while 90% of TEA group required supplemental
      intramuscular buprenorphine to relieve post-thoracotomy pain. In TEA group, 94%
      of the supplemental drugs were administered during night shifts. These results
      indicate that IV-PCA of buprenorphine combined with continuous thoracic epidural
      infusion of bupivacaine is more effective analgesic management than continuous
      TEA with buprenorphine and bupivacaine.

PMID- 11215229
TI  - [Negative-pressure pulmonary edema associated with transurethral resection
      syndrome].
AB  - We described a patient who had developed negative-pressure pulmonary edema
      associated with severe transurethral resection syndrome. A relatively healthy, 67
      yr-old man (171 cm and 77 kg) with hypertrophic prostate was scheduled for
      transurethral resection of the prostate under spinal anesthesia. The patient was
      sedated with continuous propofol infusion because of his anxiety and wish of
      being asleep. Fifty minutes after starting the operation, electrolyte analysis
      revealed a decrease in serum Na+ concentration (116 mEq.l-1), and 10 mg of
      furosemide and hypertonic saline were administered. Thirty minutes later, the
      arterial oxygen saturation dropped suddenly and arterial blood gas analysis
      suggested marked pulmonary insufficiency (PaO2: 64 mmHg and PaCO2: 59.4 mmHg).
      The patient's trachea was intubated and endotracheal release of pinkish foamy
      sputum was observed. Chest X-ray showed severe lung edema. Massive absorption of
      the irrigation fluid might have decreased the electrolyte concentration (Na+:
      101.0 mEq.l-1) and colloid oncotic pressure. No evidence of cardiac failure was
      observed immediately after the incidence of pulmonary edema with pulmonary
      catheter monitoring. The patient's airway was almost intact under spontaneous
      breathing, but augmented negative-pressure derived from intermittent snoring was
      considered to be sufficient to break hydrostatic balance of pulmonary capillary
      vessels and lead to severe pulmonary edema.

PMID- 11215230
TI  - [Four cases of the anomalous origin of the left coronary artery from the
      pulmonary artery].
AB  - We report perioperative management of 4 patients with anomalous origin of the
      left coronary artery from the pulmonary artery. This report involves with 3
      infant cases and an adult. Two infants underwent coronary reimplantation
      procedure and Takeuchi's method was performed on the other infant. In all infant
      cases, mitral valve plasty was performed to correct mitral regurgitation
      secondary to papillary muscle dysfunction. The adult patient underwent CABG with
      ligation of LCA. General anesthesia was performed with high doses of fentanyl in
      all cases. We employed a relatively high PaCO2 and low FIO2 in order to maintain
      a high pulmonary vascular resistance. It aims to decrease the incidence of left
      to right shunt. We used epinephrine to wean one infant and the adult from
      cardiopulmonary bypass. Perioperative course was uneventful with the use of
      catecholamines and high doses of vasodilators for left ventricular dysfunction
      and coronary perfusion under mechanical ventilation.

PMID- 11215231
TI  - [Effect of pre-mixed lidocaine with propofol on propofol injection pain in
      elderly patients].
AB  - The purpose of this study was to compare the younger and older patients in the
      incidence and the severity of the pain during injection of propofol. Thirty-four,
      elderly patients (60-80-yr-old) and 52 patients (20-40-yr-old) scheduled to
      undergo elective surgery were studied. We conducted a prospective, randomized and
      double-blinded trial. All patients were randomly allocated to one of two groups
      according to the agents added to 1% propofol 20 ml; Group S, normal saline 2 ml,
      and Group L, 2% lidocaine 2 ml. The pain on injection was rated as none, mild,
      moderate, or severe. Seventy percent of patients in the S group of elderly
      patients experienced pain, while 22% of patients experienced pain in the L group
      in elderly patients. The incidence of pain on injection in the S group of older
      patients was comparable with S group of younger patients. The severity of pain in
      elderly patients was significantly decreased after premixing with lidocaine.
      There were no significant differences between older and younger patients in the
      severity of propofol injection pain in both S group and L group. In conclusion,
      elderly patients suffered the pain on injection of propofol with the same
      incidence as the younger patients did. Lidocaine premixed with propofol
      significantly reduces the incidence and the severity of pain associated with
      propofol in elderly patients.

PMID- 11215232
TI  - [Anesthetic management of tracheal stent insertion under total intravenous
      anesthesia--a report of two cases].
AB  - Tracheal stent insertion is a useful method for patients with malignant tracheal
      stenosis. Expandable metal stents were inserted in two patients with severe
      dyspnea due to tracheal stenosis caused by lung cancer and esophageal cancer. The
      tracheas were intubated after spraying the pharynx with 4% lidocaine solution.
      The respiration was assisted. Anesthesia was maintained by intravenous propofol.
      There were no episodes of coughing during and after the procedure.

PMID- 11215233
TI  - [Anesthetic management with veno-venous extracorporeal membrane oxygenator (VV
      ECMO) in a patient with severe tracheobronchial stenosis].
AB  - We conducted an anesthetic management to perform tracheostomy and tracheolysis in
      a 33 year-old female with severe stenosis extending to the lower trachea and
      right main bronchus. The minimal diameter of the stenotic lesion of the trachea
      was 3 mm according to the preoperative examinations including tomography, CT scan
      and magnetic resonance imaging. Since there was a high risk of airway collapse
      during anesthetic induction that could have made ventilation impossible, we
      decided to apply VV-ECMO to support gas-exchange prior to anesthetic induction.
      Blood gas analysis showed good results, and sufficient oxygenation and stable
      circulation were achieved during surgical procedures. Total intravenous
      anesthesia with propofol and fentanyl could provide adequate depth of anesthesia
      during surgery and rapid recovery with good spontaneous respiration after the
      termination of the infusion. VV-ECMO was a useful method to support gas-exchange
      in a case not requiring circulatory assistance without uneven oxygenation
      sometimes observed in VA-ECMO.

PMID- 11215235
TI  - [Left lung lavage affected the cardiac autonomic nervous activity more than right
      lung lavage during one lung ventilation in a patient with pulmonary alveolar
      proteinosis].
AB  - A 31-year-old man with pulmonary alveolar proteinosis underwent whole lung lavage
      using differential lung ventilation under general anesthesia with propofol and
      fentanyl. Left lung lavage was performed under the differential lung ventilation
      using extracorporeal lung assist. A month later, right lung lavage was performed
      under the differential lung ventilation alone. We compared left lung lavage with
      right one in the effects on heart rate variability and relationships between
      heart rate and arterial pressure. In the left lung lavage compared with the right
      one, arterial pressure was maintained higher; sympathetic nervous activity was
      kept tonic as shown in the power spectral analysis of heart rate variability;
      coherency showed lower; and a phase relationship analysis indicated a delay of
      almost 180 degrees. Therefore, we conclude that left lung lavage affected the
      cardiac autonomic nervous activity more than right one in differential lung
      ventilation.

PMID- 11215237
TI  - [Anesthetic management for MIDCAB using the target controlled infusion and the
      bispectral index].
AB  - We report our experience in using the target controlled infusion (TCI) of
      propofol combined with the bispectral index (BIS) monitoring for anesthetic
      management of minimally invasive direct coronary artery bypass (MIDCAB) in a 43
      year-old-male patient with angina pectoris. After premedication, the patient was
      connected to the monitor with electrodes for BIS monitor. Then, anesthesia was
      induced with fentanyl and propofol using TCI technique. When blood concentration
      of propofol reached 4 micrograms.ml-1, the trachea was intubated. Before starting
      the operation, we evaluated the relationship between blood concentration of
      propofol and the value of BIS, and the standard maintenance concentration of
      propofol was set at 3 micrograms.ml-1. When the concentration of propofol was 3
      micrograms.ml-1, the value of BIS was about 60. Anesthesia was maintained with
      nitrous oxide and oxygen and continuous infusion of propofol using TCI technique.
      When necessary, we gave additional injection of fentanyl and vecuronium bromide.
      Furthermore, diltiazem was infused continuously for cardiac rate control, as well
      as infusion of nicorandil, nitroglycerine for prevention of coronary artery
      spasms, and prostaglandin. After the operation, the patient was alert in 8
      minutes and we could extubate in 12 minutes. The use of TCI combined with BIS
      monitoring for maintenance of anesthesia for MIDCAB is useful and safe.

PMID- 11215234
TI  - [Two cases of ischemic changes indicated in the amplitude of motor evoked
      potentials during thoracoabdominal aortic aneurysm repair].
AB  - Monitoring of motor-evoked potentials (MEPs) is employed to examine functional
      integrity of descending motor pathway during thoracic aortic surgery. We
      experienced two cases of intraoperative changes in MEPs during thoracic aortic
      replacement. In one case, MEPs recovered after the intercostal artery
      reattachment, and in another case after the release of aortic clamping. No
      postoperative paraplegia was found in both cases. We conclude that monitoring of
      MEPs is useful not only because we can detect symptoms of the spinal cord injury
      from ischemia immediately but also because they give us a clue to decide
      operative procedures.

PMID- 11215236
TI  - [Anesthetic management for distal aortic arch aneurysm stent grafting].
AB  - A 76-year-old woman with thoracic aortic aneurysm involving distal aortic arch
      was scheduled for graft replacement from ascending to proximal aortic arch with
      endovascular stent graft to descending aorta. Surgical procedures were performed
      under median sternotomy with hypothermic systemic circulation arrest and
      selective cerebral perfusion. The stent graft composed of 30 mm Gianturco Z stent
      and 27.5 mm woven Dacron graft was introduced into the descending aorta under the
      guidance of transesophageal echocardiography (TEE) and fluoroscopy. Ascending and
      proximal aortic arch replacement was then performed with four branched woven
      Dacron graft. The aortic pathology was confirmed by TEE and the extent of the
      aneurysmal lesion was defined. TEE was also useful to find the dislodgement of
      the stent graft after deployment. This surgical technique, being less invasive
      than conventional thoracotomy, would be indicated for elderly patients with
      distal aortic arch aneurysm. TEE is the vital imaging technique for placement of
      the stent graft, as well as for intraoperative cardiac monitoring.

PMID- 11215238
TI  - [Tracheal tube damage by Harmonic Scalpel during tonsillectomy].
AB  - We experienced a case in which a tracheal tube was damaged by a Harmonic Scalpel
      during tonsillectomy. A 33-year-old man with chronic tonsillitis underwent
      tonsillectomy under general anesthesia. The trachea was intubated by Polar
      Preformed Tracheal Tube (Polar tube). About 45 minutes after the start of
      surgery, sudden massive air leakage in the trachea occurred. Surgery was
      accomplished under oral suctioning. After extubation, we found that an inflation
      cuff tube was cut off by the Harmonic Scalpel. The cause of damage was the
      position of an inflation cuff tube which had been in the dorsal side of the
      tracheal tube (near the surgical field) in the Polar tube. Anesthesiologists
      should be aware of the characteristics of the surgical equipment newly
      introduced.

PMID- 11215239
TI  - [A case of rectal excision in a patient with cervical spinal cord injury of
      chronic stage].
AB  - A 63-year-old man, scheduled for a Hartmann's procedure, sustained a cervical
      injury with resultant complete motor and sensory loss below the fourth cervical
      segment 39 years prior to admission. Anesthesia was induced with propofol 70 mg,
      vecuronium bromide 5 mg and an endotracheal tube was placed in the trachea.
      Anesthesia was maintained with nitrous oxide/oxygen and fentanyl. Ventilation was
      controlled to maintain normocapnea. We did not employ epidual anesthesia due to
      inability to flex the spine. We administered fentanyl to control hypertension,
      but it led to hypotension. And about 500 ml of bleeding also caused hypotension.
      These episodes of hypotension are associated with hypovolemia and instability of
      vascular tone. To control hypotension, we finally selected continuous intravenous
      administration of norepinephrine. The manifestations of cardiovascular
      instability during surgery in chronic stage of cervical spinal cord injury is not
      only hypertension associated with autonomic hyperreflexia, but also hypotension
      associated with instability of vascular tone and hypovolemia.

PMID- 11215240
TI  - [General anesthesia for a patient on hemodialysis with arteriosclerosis
      obliterans].
AB  - A 48-year-old man with arteriosclerosis obliterans was scheduled for
      axillofemoral bypass. He had chronic renal failure and on hemodialysis (HD) for
      22 years. On the morning of the day of surgery he received HD and two hours later
      anesthesia was induced with fentanyl 300 micrograms and midazolam 6 mg, and
      maintained with fentanyl, nitrous oxide and intermittent isoflurane. The common
      carotid artery was cannulated to measure arterial blood pressure because arteries
      in extremities were not available. Internal jugular vein at the other side of the
      arterial catheterization was cannulated to measure central venous pressure.
      Crystalloid and blood transfusion was performed to adjust hemodynamics and
      central venous pressure. Hemodynamics were stable during surgery and no
      complication occurred regarding the common carotid arterial line. The common
      carotid artery was useful for blood pressure monitoring in a patient whose
      extremities were not available. Midazolam and fentanyl could give stable
      hemodynamics to a patient with arteriosclerosis obliterans and chronic renal
      failure.

PMID- 11215241
TI  - [Airway obstruction after general anesthesia in a patient with the first and
      second branchial arch syndrome].
AB  - A 20-year-old female with the first and second branchial arch syndrome underwent
      plastic surgery. Due to her mandibular hypoplasia and trismus, tracheal
      intubation was difficult even with a broncho-fiberscope. Fentanyl 100 micrograms
      was used for nasal intubation. Anesthesia was maintained with nitrous oxide (4
      l.min-1), oxygen (2 l.min-1) and sevoflurane (0.5-3%). There were no troubles
      during surgery. The trachea was extubated after recovery of consciousness and
      spontaneous respiration. Five minutes after extubation, airway was obstructed
      suddenly after massive nasal bleeding. Sudden massive bleeding might have caused
      airway obstruction. Emergency insertion of an 18 G needle followed by Mini-trach
      II into the trachea through the cryothyroidal ligament improved her respiratory
      condition. The case suggests that preparing the instrument for the emergency
      cryothyroidal ligament puncture (for instance Mini-trach II) is useful for a
      patient with a risk of bleeding in the airway and with difficult intubation.

PMID- 11215242
TI  - [Perioperative management of two neonates with severe Ebstein's anomaly with
      pulmonary atresia].
AB  - Ebstein's anomaly appearing during the neonatal period carries a high mortality
      rate. We report the perioperative management of two neonates with severe
      Ebstein's anomaly associated with pulmonary atresia. Their chest radiography
      revealed massive cardiomegaly, with cardiothoracic ratio of 90% and 100%,
      respectively. Their tracheas were intubated immediately after birth because of
      severe respiratory distress. The babies were laid in the prone position and one
      of them was managed with high frequency oscillatory ventilation (HFO) for
      prevention of pulmonary barotrauma and extensive atelectasis in the preoperative
      period. On the 4th and 3rd day after birth, respectively, they underwent Starnes
      procedure which consists of closure of tricuspid valve, enlargement of atrial
      septal defect, reduction of right atrium and creation of aortopulmonary shunt
      reported to be a useful palliative treatment for critically ill neonates with
      Ebstein's anomaly. Case 1 baby could not be weaned from cardiopulmonary bypass
      because of low cardiac output. Case 2 could not be weaned from extracorporeal
      membrane oxygenation due to hypoxia. We consider, however, treatment of
      respiratory failure and lung protection after birth are important for the
      prognosis. Perioperative use of HFO may be advantageous for the neonate with
      severe Ebstein's anomaly with pulmonary atresia.

PMID- 11215243
TI  - [Unexpected difficult intubation caused by a laryngeal web].
AB  - We report a case of unexpected difficult intubation in an adult caused by a
      laryngeal web. A 43-year-old woman with uterine myoma was scheduled for abdominal
      hysterectomy. After induction of anesthesia, the vocal cords were seen clearly
      under laryngoscopy. Although intubation was attempted several times, a 6.5 mm
      internal diameter tracheal tube could not be passed below the level of the vocal
      cords because of resistance, and we used a laryngeal mask during anesthesia. Next
      morning after the operation, she developed dyspnea. Bronchoscopy revealed a very
      narrow airway below the level of vocal cords caused by a laryngeal web.
      Tracheostomy was performed. Two weeks later, tracheostomy was closed without any
      sequela.

PMID- 11215244
TI  - [A case of rhabdomyolysis after open heart surgery in a child].
AB  - Rabdomyolysis usually occurs after trauma and release of myoglobin from the
      damaged muscle, i.e.; after ishchemic myopathy due to arterial occlusion or
      malignant hyperthermia. We encountered a pediatric case of rhabdomyolysis after
      Ross-Konnos' operation in an 8-yr-old girl with aortic regurgitation. After the
      first weaning from cardiopulmonary bypass (CPB), ventricular fibrillation
      occurred due to an insufficiency in coronary blood flow and CPB was resumed with
      rapid cooling of body temperature. The total CPB lasted for 5 hr 43 min. After
      the second weaning from CPB, myoglobinuria was found. Furthermore, blisters and
      abrasions appeared on her back and CPK levels were abnormally elevated (maximum
      19,132 IU.l-1) without any elevation of body temperature in the postoperative
      course. Rhabdomyolysis due to intraoperative hypoperfusion was suspected and
      diuretics were administrated with a large amount of crystalloid to maintain urine
      output. The patient showed a good clinical course without acute renal failure.
      The course of this case suggests that rhabdomyolysis is one of rare complications
      of CPB and an early correct diagnosis of rhabdomyolysis and forced diuresis at an
      early stage are important to avoid acute renal failure.

PMID- 11215245
TI  - [New study on the history of anesthesiology--(5) and (6). Reevaluation of
      surgical achievements by Tokumei Takamine].
AB  - A half century has passed since K. Higaon-na, a historian from Okinawa, first
      reported that in 1689 Tokumei Takamine (1653-1738) had performed successfully a
      hare-lip operation under general anesthesia with mafutsu-san for a royal
      grandchild Sho-eki of the Ryukyu Dynasty in the Ruykuys, now known as Okinawa. As
      Higaon-na obtruded his opinion above mentioned without any substantial proof on
      the public, and many medical historians as well as historians have followed him
      thereafter. No historical documents are available concerning surgical
      achievements by Tokumei Takamine to clarify them in detail but it clearly says in
      the genealogy of the Takamines that Kou Kaiyu ([symbol: see text]) taught his
      ancestral prescription and surgical technique of hare-lip operation to Tokumei
      Takamine on his repeated solicitation when they stayed in Fu-chou. Takamine made
      two scrolls describing the secret prescription and surgical method of hare-lip,
      and presented them to a magistrate Genzaimon Murao and his physician Doh-yo
      Isashiki in 1690. In 1986, a scroll has been found in Sendai city of Kagoshima
      prefecture, which was transcribed by two physicians named Antei Kore-eda and
      Encho Nagai at Kagoshima in 1754. No information is available about biographies
      of these two physicians. A careful study of this scroll has revealed that it
      bears the prescription of an ointment including ten remedies to dress the
      incision and surgical method of hare-lip. Accordingly it is clearly proven by
      this newly discovered scroll that Tokumei Takamine did not administer any general
      anesthetics when he performed surgical operations for hare-lip on several
      occasions.

PMID- 11215246
TI  - [HLA-DPB1* 0501-associated opticospinal multiple sclerosis: clinical,
      neuroimaging and immunogenetic studies].

PMID- 11215247
TI  - [Genomic structure of the canalicular multispecific organic anion-transporter
      gene (MRP2/cMOAT) and mutations in the ATP-binding-cassette region in Dubin
      Johnson syndrome].

PMID- 11215249
TI  - [Mechanism of nitric oxide production in vascular endothelium and the
      significance as therapeutic target--special reference to the relationship with
      superoxides].

PMID- 11215248
TI  - [Guideline for therapy of patients with hypertension in Japan].

PMID- 11215250
TI  - Advantages of high-speed simultaneous electrocardiography: re-evaluation of r
      waves in V1, the initial forces in V6 and abnormal Q waves.
AB  - The main aim of this study is to re-evaluate the r wave in V1 (rV1) and the
      initial forces in V6 with normal QRS duration. A total of 741 high-speed
      simultaneous electrocardiograms of V1 and V6 with either aVF or aVL as reference
      lead were recorded in patients with cardiac or noncardiac conditions. Patients
      with a QS pattern in V1 and/or a wide QRS complex were excluded. The peak of rV1
      was beyond the nadir of the q wave in V6 (qV6) in 448 patients but coincided with
      the nadir of qV6 in 51 patients. The onset of the R wave in V6 (RV6) with absent
      qV6 was delayed in comparison with the onset of rV1 in 210 patients but coincided
      with the onset of rV1 in 30 patients. In this study, the nadir of a q wave either
      in aVL and/or aVF was never beyond the peak of an r wave in V1 except for high
      lateral and/or inferior infarction. In many cases rV1 appears to represent both
      septal activation and right ventricular activation. The absence of qV6 with some
      delay in the onset of RV6 in comparison with the onset of rV1 might indicate a
      nonpathologic absence of qV6 due to masked septal potential in the isoelectric
      line in V6, although the absence of qV6 with simultaneous onset of rV1 and RV6
      may suggest septal abnormalities. An abnormal Q wave in aVL and/or aVF may be
      defined as that the nadir of q wave exceeded the peak of r wave in V1.

PMID- 11215251
TI  - [Current status and role of the Japanese Association of Clinical Toxicology].
AB  - Since its foundation in 1983, the Japanese Association of Clinical Toxicology
      (JACT) has contributed greatly to the progress of intoxication medicine in Japan.
      It assists toxicologists and other medical experts in sharing clinical
      experience, including unusual intoxication cases and those found only in certain
      regions. As a result, toxicologists no longer must rely on intuition and personal
      experience. Today, the association focuses on disseminating useful intoxication
      information among toxicologists and the general public through the Japan
      Intoxication Information Center. With strong support from JACT, the center is
      developing a database that will provide useful information to physicians who need
      to identify poisonous chemicals quickly in their toxic patients. It is also
      building a system for registering intoxication treatment experts which will be
      publicly accessible, and an Internet Web site to provide intoxication-related
      information online. JACT itself is also preparing to establish the Japan
      Intoxication Analysis Center. JACT is committed to improving intoxication
      medicine in Japan by continuing to help train toxicologists and the medical
      specialists who support them, making useful information readily available to
      them, and assisting them to identify toxic materials.

PMID- 11215252
TI  - [Current activities of the Japan Poison Information Center and Information
      Network for Poisoning via the Internet].
AB  - The current activities of the Japan Poison Information Center and poison
      information originally collected by it are explained. The Information Network for
      Poisoning via the Internet in Japan is also introduced, including some useful
      related sites based abroad.

PMID- 11215253
TI  - [Role of level-1 trauma and critical care centers in treatment of acute
      poisoning].
AB  - In the summer of 1998, the so-called Wakayama currty poisoning case occurred, and
      subsequently additional murders took place in which the accusred used sodium
      aziede and thallium to posison their victims. When the poison victims were
      admitted to hospital, food poisoning was mistakenly diagnosed. Due to serious
      concerns that such misdiagnoses might recur, the Japanese Ministry of Health and
      Welfare equipped 10 level-1 trauma and critical care centers and 66 critical care
      centers nationwide with high-performance liquid chromotographs, ion
      chromatographs, gas chromatographs, fluorescence X-ray analyzers, and high
      frequency plasma mass spectrometers. This equipment will allow the detection of
      most types of industial and other chemicals as well as most therapeutic drugs.
      This report describes the current status of poison analysis systems and the role
      of level-1 trauma and critical care centers in cases of poisoning.

PMID- 11215254
TI  - [Toxicologic screening in Japan].
AB  - What we have learned from the Tokyo subway sarin gas attack on March 20, 1995,
      and the Wakayama poisoned curry incident on July 25, 1998, is that Japanese
      system for the analysis of drugs and poisons for medical treatment is extremely
      poor. The frequent occurrence of crimes involving drugs and poisons has become a
      serious problem. In response, the government established the Countermeasure
      Committee for Poisonous and Dangerous Substances, which submitted a report in
      November 1998. Based on that report, the Ministry of Health and Welfare equipped
      emergency medical centers with expensive analytical instruments, such as high
      performance liquid chromatography columns and fluorescence X-ray analyzers, upon
      request. However, problems in their operation have occurred, and few such
      facilities work efficiently. In the Wakayama incident, the initial was food
      poisoning. Only after 11 hours and the deaths of four people was the diagnosis of
      cyanide poisoning made public. During that process, at least three mistakes were
      made. We believe that a basic and correct understanding of those mistakes and the
      development of countermeasures are necessary to analyze drugs and poisons from a
      medical standpoint.

PMID- 11215255
TI  - [Diagnosis of acute poisoning].
AB  - The discrimination of poisoning from other conditions is essential. When multiple
      patients with similar clinical findings are seen, deliberate poisoning should be
      considered along with the possibility of resulting from accidental food
      poisoning, infection, diseases resulting from extreme circumstances, and mass
      hysteria. The diagnosis of causal poisoning chemicals based on clinical findings
      is essential. Breath odors, findings of vomitus, skin color, body temperature,
      autonomic nervous system findings, and seizures are important physical findings.
      On the other hand, laboratory findings such as ECG abnormalities, metabolic
      acidosis, increased serum hepatic enzyme levels, and increased serum blood urea
      nitrogen and creatinine levels are also useful in obtaining the correct
      diagnosis. X-ray films are useful in demonstrating several types of radiopaque
      drugs in the stomach. Rapid tests are valuable in diagnosing poisoning caused by
      such chemicals as paraquat and cyanides. Therapeutic diagnoses obtained by
      administering competitive blockers of specific receptors are also valuable when
      benzodiazepine or opiate poisoning is suspected. The final diagnosis of the
      causal chemical should be based on both the clinical findings and analytical
      results.

PMID- 11215256
TI  - [Poison elimination methods in acute poisoning].
AB  - This paper presents current ideas about the application of poison elimination
      methods in acute poisoning. The methods are divided into two groups: poison
      elimination before absorption; and enhancement of elimination after drug
      absorption. The former include washes, emesis, gastric lavage, and administration
      of activated charcoal and cathartics, while the latter include forced diuresis
      and extracorporeal toxin elimination such as hemodialysis or hemoperfusion. The
      indications, contraindications, techniques, and complications, associated with
      these elimination methods, except for extracorporeal toxin elimination, are
      discussed. In the treatment of poisoning, early and comprehensive poison
      elimination is important.

PMID- 11215257
TI  - [Blood purification in toxicology].
AB  - Although toxic substances can be removed by blood purification techniques such as
      hemodialysis and hemoperfusion, the complete elimination of toxic substances from
      the whole body is difficult even if clearance values are high. Blood purification
      over in a limited time sometimes cannot prevent the death of patients, because
      the volume of distribution of toxic substances is usually very high. It should
      also be stressed that initial general management of patients is very important
      whenever blood purification procedures are utilized.

PMID- 11215258
TI  - [Antidotes for poisoning and medication overdosage].
AB  - Supportive therapy is crucial in the treatment of severe intoxication.
      Furthermore, specific antidotes are available to neutralize or prevent the toxic
      effects of poisoning and overdosage. Recently it has become possible to determine
      the probable toxicity precisely by plotting plasma poison or drug levels. This is
      especially appropriate in severely intoxicated patients. We conclude that the
      screening of blood using special agents is the most important in the treatment of
      such patients at present.

PMID- 11215259
TI  - [Mass-casualties due to chemicals].
AB  - Mass casualties due to chemicals and chemical weapons are typical man-made
      disasters. As they occur without connection to time, place, and occasion, an
      adequate crisis control system is needed. Although the possibility that chemical
      weapons will be used in terrorism, as in Matsumoto and the Tokyo sarin attack,
      has recently increased, mass casualities due to the combustion and leakage of
      toxic chemicals in the chemical industry and traffic accidents during the
      transport of chemicals are more likely since about 5000 new chemical substances
      are synthesized every year.

PMID- 11215260
TI  - [Continuous monitoring of hepatic venous oxygen saturation (SHVO2) as a new
      diagnostic indicator of abdominal malperfusion in acute aortic dissection].
AB  - A 73-year-old woman was admitted with sudden-onset back and abdominal pain.
      Computed tomography scanning revealed type B acute aortic dissection with
      narrowing of the true lumen. We inserted an oximetric catheter into the right
      hepatic vein and started continuous measurement of ShvO2. The initial value was
      20%. Consecutive aortograms showed an intimal tear in the thoracic descending
      aorta. Endovascular stent graft placement was performed to close the entry, and
      ShvO2 rose to more than 60% immediately after the stent graft expansion. ShvO2 is
      an excellent indicator of abdominal blood flow, not only for early diagnosis but
      also for the evaluation of treatment.

PMID- 11215261
TI  - [A surgical case of abdominal aortic aneurysm accompanied by hamartomatous
      changes in the vascular wall].
AB  - The current patient was a 22-year-old woman with dyspnea on exertion that had
      exacerbated over the past two to three years. Chest X-ray indicated pneumothorax
      in the right lung, and chest computed tomography showed diffuse microcysts in
      both lungs. The patient was diagnosed with lymphangiomyomatosis based on pleural
      biopsy by intrathoracic endoscopy. Systemic testing revealed complications of
      tuberous sclerosis and abdominal aortic aneyrysm, and a prosthetic graft
      replacement was perfomed following pneumothorax treatment. Aortic wall tissue
      images showed hamartomatous changes in smooth muscle tissue, similar to the
      pulmonary lesion, and this was thought to have caused vascular fragility and
      aneurysmal change.

PMID- 11215262
TI  - [A case of acute type adult T cell leukemia and human T-lymphotropic virus type I
      associated myelopathy who presented meningitis and polyradiculoneuropathy and
      improved with steroid treatment].
AB  - We reported a 35-year-old male patient with acute type adult T cell leukemia(ATL)
      and human T-lymphotropic virus type I associated myelopathy. He presented
      meningitis and polyradiculoneuropathy and improved with steroid treatment. He
      presented headache and sensory ataxia and these symptoms responded to steroid
      treatment. The usual clinical features of ATL were absent at onset. There existed
      ATL-like cells in the cerebrospinal fluid and HTLV-I proviral DNA in the blood.
      Therefore, we surmised that there was monoclonal hyperplasia of the infected
      cells. He presented ATL after 2 years remission. We pointed out that there was
      acute type of ATL in patients with meningitis and polyradiculoneuropathy, for
      which steroid treatment could be effective.

PMID- 11215264
TI  - [Two cases of cranial pachymeningitis presenting only severe continuous headache
      or convulsion].
AB  - In cranial pachymeningitis, headache, cranial nerve palsies, and ataxia were the
      most common clinical manifestations. We reported two rare cases presenting only
      headache or convulsion as a main symptom. A 66-year-old man was suffering from
      severe continuous headache for years with no other clinical symptoms. Laboratory
      data revealed positive RA test and elevated RAPA. With oral steroid therapy, his
      headache was subsided. A 39-year-old woman visited us with convulsive attacks as
      only symptom. Biopsy of the thickened dura revealed granulated epithelioid cells
      without central necrosis. With antituberculosis therapy, hypertrophy of dura, as
      well as the symptom, was disappeared. It is difficult to diagnose pachymeningitis
      when patients manifest only headache or convulsion. We suggest to carry out Gd
      enhanced MR scan in these cases.

PMID- 11215263
TI  - [A case of antiphospholipid antibody syndrome with cerebral infarction showing
      slowly progressive pure motor monoparesis in unilateral upper extremity].
AB  - We reported a 68-year-old man with anti-phospholipid antibody syndrome who
      presented slowly progressive pure motor monoparesis(PMM) in left upper extremity
      as a sign of cerebral infarction. He had history of hypertension and
      hyperlipidemia. He first noticed clumsiness in left fingers, then weakness of
      left fingers with drop hand developing gradually in 2 to 6 weeks. He began to
      feel difficulty in raising left upper arm in 8 weeks and was admitted to our
      hospital. On admission, he exhibited severe weakness in distal portion and
      moderate weakness in proximal portion of left upper extremity. Deep tendon
      reflexes were slightly hyperactive in left side. Muscle strength of right upper
      extremity and bilateral lower extremities were normal. There was no sensory and
      autonomic abnormality. Laboratory examination revealed high titer of anti
      cardiolipin IgM antibody. Brain MRI demonstrated a small cortical infarction in
      the right precentral gyrus. Cerebral angiography revealed severe stenosis in
      right common carotid artery. Other examinations including EMG were unremarkable.
      PMM in left upper extremity was considered to be caused by the ischemic lesion in
      the precentral motor cortex. Slowly progressive course might be explained by the
      hypovolemic factor due to the marked stenosis in right common carotid artery,
      poor collateral circulation, and abnormal coagulation caused by anti-phospholipid
      antibody syndrome.

PMID- 11215266
TI  - [A case of bitemporal epilepsy that was well controlled after unilateral
      lobectomy].
AB  - Here we report a case of bitemporal epilepsy that was well controlled after
      unilateral temporal lobectomy. The patient was a 31-year-old woman, who was born
      in an asphyxia state and had a history of a febrile convulsion. Complex partial
      seizure(CPS) preceded by abdominal aura appeared at the age of three. Despite
      anticonvulsant medication, the seizures gradually increased in frequency and
      sometimes developed into secondary generalized convulsions. Her scalp
      electroencephalogram(EEG) showed interictal spikes and seizure activities arising
      from the bilateral temporal lobes. No apparent lateralities in regard to the size
      or blood flow at the hippocampus were detected by MRI and SPECT studies.
      Intracranial EEG monitoring revealed that 80% of the clinical seizures originated
      from the left mesial temporal lobe, which was the non-dominant side for speech
      and memory functions as demonstrated by Wada test. Therefore, we performed a left
      temporal lobectomy that resulted in the complete disappearance of CPS. The
      present case exemplified the usefulness of intracranial EEG monitoring to clarify
      the dominant epileptic focus for surgery.

PMID- 11215265
TI  - [Relationship between cardiac natriuretic peptide (ANP/BNP) and fluid intake in
      patients with subarachnoid hemorrhage].
AB  - Several authors described elevated natriuretic peptides, atrial natriuretic
      peptide(ANP) and brain natriuretic peptide (BNP), in patients with subarachnoid
      hemorrhage(SAH), which were account for inappropriate antidiuretic hormone(SIADH)
      or cerebral salt wasting syndrome(CSW). Although the secretion of natriuretic
      peptide depends on the total blood volume, central venous pressure, and cardiac
      output volume, the volume of fluid intake in patients with SAH had not been taken
      in consideration in previous report. We here examined the relationship between
      fluid intake and the natriuretic peptides in two cases without cardiac failure.
      ANP elevated 2 or 3 days after SAH and remained in normal range for 2 weeks. BNP
      elevated when the volume of fluid intake was increased, and BNP did not elevate
      during the periods with lower fluid intake. Several authors proposed the
      possibility of iatrogenic factor in natriuresis after SAH and these results
      supported this opinion.

PMID- 11215267
TI  - [Serial MRI of tuberculous meningitis].

PMID- 11215268
TI  - [Surgical therapy for Parkinson's disease].

PMID- 11215269
TI  - [Atopic myelitis and related disorders].

PMID- 11215270
TI  - [Isolated extensor digitorum brevis involvement in the population of normal
      systemic nerve conduction velocities].
AB  - To investigate the characteristics of isolated atrophy in extensor digitorum
      brevis(EDB), we analysed 262 patients whose polyneuropathy index(PNI) was 90% or
      more than the normal mean value. The PNI was determined as the mean percentage of
      the normal in 12 indices concerning to the velocity or long distance latency in
      motor nerve conduction studies. Latencies were adjusted to 160 cm height.
      Amplitude of compound muscle action potential (CMAP) in EDB showed no correlation
      with the patient's age. Similar result was obtained as well when studied in 115
      patients whose PNI level was 95% or more than the mean normal value. In 18(7%)
      out of 262 patients CMAP amplitude in EDB was 1 mV or less; larger prevalence(p <
      0.05) in women(10%) than in men(4%). The number of motor units which innervate
      EDB decreases along with the age, but this age-related change could be
      compensated by the magnification of each motor unit. In Western reports isolated
      EDB palsy has a predilection for emaciated men. Instead, our results showed the
      predominance in women. We may have some factors other than in Western countries,
      for example customs to sit directly on the mat for a long time, in the occurrence
      of isolated EDB palsy. In conclusion, amplitude reduction in EDB CMAP may reflect
      the following two factors; neuropathy-related factor and another factor
      independent of age or neuropathy.

PMID- 11215271
TI  - [A study of reduction of NF 2 protein, mRNA and loss of 22 q in sporadic
      meningiomas].
AB  - Neurofibromatosis 2(NF 2) is one of the tumor suppressor genes, and its disorder
      has been reported in sporadic meningiomas. We investigated some reduction of
      expression of NF 2 protein and mRNA in 33 sporadic meningiomas, using
      immunohistochemistry and in situ hybridization, respectively. Seventeen of 33
      (51.5%) meningiomas demonstrated significantly reduced or absent NF 2 protein
      expression. Its mRNA was also reduced or absent in 11 of 24(45.8%) meningiomas,
      and some statistically significant correlation was shown between reductions of NF
      2 protein and its mRNA. Furthermore, we studied about loss of 22 q in 5
      meningiomas with fluorescence in situ hybridization. In the cases with reduction
      of NF 2 protein and/or mRNA, 22 q telomere signals were observed as loss of
      heterozygosity. On the other hand, in the cases with expression of NF 2 protein
      and mRNA, 22 q telomere signals were normal. In conclusion, reduction or absence
      of NF 2 protein and mRNA may play an important role in the tumorigenesis of about
      half number of sporadic meningiomas.

PMID- 11215272
TI  - [Amnesia following herpes simplex encephalitis].
AB  - We describe three patients presenting themselves with amnesia following herpes
      simplex encephalitis. All three patients showed anterograde amnesia. Moreover,
      one patient showed retrograde amnesia extending about fifty years prior to the
      onset of the illness. Two patients revealed semantic memory disorder,
      disinhibitory behaviors and confabulations, which suggested the existence of
      frontal lobe dysfunction. MRI of all three patients disclosed uni- or bilateral
      temporal lesions. SPECT images showed decreased uptake not only in the temporal
      lobes but also in the frontal lobes. Amnesia following herpes simplex
      encephalitis has been thought to be caused by the temporal lobe disorder.
      However, we postulate that the frontal lobe dysfunction might contribute to the
      appearance of amnesia.

PMID- 11215273
TI  - [An analysis of characters and changes of the blood pressure in 29 cases on
      recurrence of cerebral infarction].
AB  - We investigated changes of the blood pressure in 29 stroke patients before stroke
      recurrence and after recurrence. Additional antihypertensive drugs were not
      administered to all patients after stroke recurrence. Twenty-five lacunar infarct
      patients and 4 atherothrombotic infarct patients were included in this study. A
      significant difference was observed between the systolic blood pressure(SBP)
      within 4 weeks before recurrence and that just after recurrence(132.8 +/- 17.2
      mmHg vs. 157.4 +/- 21.3 mmHg, Wilcoxon rank sum test, p < 0.001), or between the
      SBP just after and 2 weeks after stroke recurrence(157.4 +/- 21.3 mmHg vs. 138.0
      +/- 18.3 mmHg, Wilcoxon rank sum test, p < 0.001). The similar difference was
      found in the diastolic blood pressure(DBP) or in the mean arterial blood
      pressure(MABP). There was no significant difference in the SBP, the DBP or the
      MABP between the patients before and 2 weeks after the stroke recurrence. These
      results suggested that the elevation of the blood pressure at recurrence
      decreased spontaneously to the pre-recurrence level of the blood pressure in
      about 2 weeks.

PMID- 11215274
TI  - [rCBF study with 123I-IMP SPECT of dural arteriovenous fistula].
AB  - It is important for dural arteriovenous fistula (DAVF) to evaluate venous
      ischemia in the brain related to venous hypertension, but only a few such studies
      have been performed. In this study, regional cerebral blood flow(rCBF) in DAVF
      was examined for venous ischemia by 123I-IMP SPECT. The subjects were eighteen
      patients with DAVF. Of the eighteen patients, nine had DAVF with low perfusion
      areas and venous ischemia. The factors affecting rCBF in DAVF are: 1) the
      presence of retrograde leptomeningeal venous drainage, 2) sinus occlusion, and 3)
      DAVF with high flow. The presence of retrograde leptomeningeal venous drainage
      was observed in nine patients, sinus occlusion in four patients, high flow in
      three patients. In two patients, pure leptomeningeal venous drainage was formed
      by patent sinus, and blood regurgitated from DAVF on the sinus wall to cortical
      vein. When DAVF was associated with LMVD, most patients had venous hypertension
      and concomitant venous congestion in the same areas due to reduced venous
      circulation, resulting in a decrease in rCBF and an increase in regional cerebral
      blood volume. These hemodynamics suggest venous ischemia in the brain. 123I-IMP
      SPECT was useful for evaluating rCBF and as a parameter of the treatment.

PMID- 11215275
TI  - [A case of tentorial meningioma presented with pure word deafness].
AB  - It has been known that an isolation of Wernicke's area from auditory input
      results in pure word deafness. In this report, a 73-year-old female case with
      tentorial meningioma suffering from pure word deafness is reported. The patient
      initially presented with hydrocephalus, and was treated with a ventriculo
      peritoneal(V-P) shunt. A year after the V-P shunt, she suffered from a symptom of
      deafness. On admission, her repetition and auditory comprehension were severely
      impaired, while reading and visual comprehension were almost normal. Auditory
      brain stem response(ABR) revealed normal latency between wave I and V, while wave
      VI and VII was disappeared. Middle latency response(MLR) showed no wave peak. On
      MRI, tentorial meningioma compressed bilateral medial geniculate bodies, but not
      auditory radiation or temporal lobe. 99mTc-HMPAO single photon emission computed
      tomography(SPECT) showed hypoperfusion in the left temporal lobe, considered as a
      diaschisis resulting from the isolation of left temporal lobe from auditory input
      via bilateral medial geniculate bodies.

PMID- 11215277
TI  - Diagnosis of gram negative, ventilator associated pneumonia by assaying endotoxin
      in bronchial lavage fluid.
AB  - AIM: To investigate the usefulness of assaying endotoxin in non-directed
      bronchial lavage fluid (NBL), bronchoscopic bronchoalveolar lavage fluid (BAL),
      and sera as a means of diagnosing Gram negative, ventilator associated pneumonia.
      METHODS: Samples from 64 patients were investigated. Fifty nine BALs and 92 NBLs
      were assayed in total including specimens taken during 28 episodes of clinical
      ventilator associated pneumonia (VAP). RESULTS: The concentration of endotoxin in
      BAL from patients with VAP developing within four days of commencing ventilation
      was significantly higher than in those without VAP (p = 0.015). There was no
      significant difference in endotoxin concentration in NBL or serum when comparing
      patients with and without VAP. A BAL endotoxin concentration of 6 EU/ml yielded
      the optimal operating characteristics (sensitivity, 81%; specificity, 87%;
      positive predictive value, 67%; negative predictive value, 95%). However, Gram
      stain of BAL provided the same information as quickly as the endotoxin assay and
      is considerably cheaper. CONCLUSIONS: Despite its accuracy and rapidity, the BAL
      endotoxin assay must be shown to alter clinical management and patient outcome to
      be cost effective.

PMID- 11215276
TI  - Detection of herpesvirus DNA by the polymerase chain reaction (PCR) in vitreous
      samples from patients with necrotising retinitis.
AB  - AIMS: Viral uveitis and retinitis, usually caused by herpesviruses, are common in
      immunosuppressed patients. The diagnosis of viral anterior uveitis and retinitis
      is usually clinical. The polymerase chain reaction (PCR) has been used for the
      diagnosis of some viral infections, especially those caused by herpesviruses.
      This paper reports the use of PCR in the diagnosis of viral retinitis in vitreous
      samples from Brazilian patients. METHODS: PCR was used for the diagnosis of
      necrotising retinitis in vitreous samples from patients from the Hospital Sao
      Geraldo, Universidade Federal de Minas Gerais, Brazil. The vitreous samples were
      collected by paracentesis and stored until analysis. Samples were analysed by PCR
      using specific primers designed to amplify herpes simplex virus 1 (HSV-1),
      varicella zoster virus (VZV), or human cytomegalovirus (HCMV). In a case of
      anterior uveitis, PCR was performed with a sample from the anterior chamber.
      RESULTS: Herpesvirus DNA was amplified in 11 of 17 samples. HCVM DNA was detected
      in nine samples but DNA from HSV-1 and VZV were detected only once each.
      CONCLUSION: These results strongly suggest that PCR could be used for a rapid
      complementary diagnosis of viral uveitis and retinitis. A prospective study to
      evaluate the PCR results, clinical evolution, and treatment is imperative to
      corroborate the real value of PCR in diagnosis and how it could help the
      clinicians' approach.

PMID- 11215278
TI  - Apoptosis in squamous cell carcinoma of the lung: correlation with survival and
      clinicopathological features.
AB  - AIMS: Apoptosis is recognised as a physiological mechanism for controlling cell
      numbers and its subversion is thought to contribute to carcinogenesis. The aims
      of this study were to measure the apoptotic index (AI) in a series of squamous
      cell carcinomas (SCCs) of the lung using standard histological staining and
      confirm this by immunohistology using an antibody to an apoptosis specific
      protein (ASP), and to seek to correlate the AI with clinicopathological
      parameters. METHODS: Sections of 134 SCCs were stained by haematoxylin and eosin
      (H&E) for counting apoptotic bodies of determine the AI (number of apoptotic
      bodies/10,000 tumour cells); 26 of these were also stained with anti-ASP antibody
      and the proportion of ASP positive cells counted. Clinical data were obtained
      from hospital notes. RESULTS: The mean AI obtained by H&E staining of all 134
      SCCs was 30.3 (SD, 24.75). Anti-ASP staining allowed easy identification of
      apoptotic bodies, and generated a somewhat higher index (mean, 51.4; SD 39); this
      was not a result of the selection of tumours because the AI by H&E in the subset
      stained with anti-ASP was 31.1. Regression analysis showed that the correlation
      between the two values of AI was highly significant (Rs = 0.9760; p < 0.001),
      indicating that the two methods were both reliable measures of apoptosis but that
      the anti-ASP staining is the more sensitive method. The tumours were grouped into
      high AI (> 50) and low AI (< 50) and survival analysis was carried out. The mean
      survival of the high AI group was 109 weeks and of the low AI group 72 weeks (p =
      0.036). CONCLUSIONS: Anti-ASP staining is a reliable, easy, and sensitive method
      for assessing apoptosis in tumour sections and confirms the validity of the AI
      obtained by H&E staining. AI is a guide to the behaviour of SCCs of the lung.

PMID- 11215279
TI  - Prognostic value of vascularity and vascular endothelial growth factor expression
      in non-small cell lung cancer.
AB  - AIMS: High expression of the angiogenic factor vascular endothelial growth factor
      (VEGF) in tumours has been found to be associated with poor prognosis in some
      studies, but not in others. The aims of this study were to determine the
      prognostic value of VEGF in operable non-small cell lung cancer (NSCLC) and its
      possible association with vascularity. METHODS: Sections from 81 NSCLC archival
      specimens were stained with antibodies to von Willebrand factor (vWF) and VEGF.
      Vascularity was measured by the average density of vWF positive vessels. VEGF
      expression in tumour cells was assessed by consensus of two independent observers
      according to three indices, namely: (1) percentage of area stained, (2) intensity
      of staining, and (3) final score (product of area and intensity). RESULTS: VEGF
      immunoreactivity was present in all tumours and adjacent normal lung tissue. None
      of the three VEGF indices was associated with vascularity or the clinical
      parameters examined. Mean survival times were shorter in patients with high VEGF
      expression, but the difference was not significant. This applied to the full
      cohort of patients, or when analysed separately according to tumour type or
      stage. However, high VEGF expression was associated with poor survival in
      patients with high vascularity (p = 0.02). VEGF had no discriminant value among
      patients with low vascularity. Vascularity had no prognostic value, except for
      late stage patients (UICC stages II and IIIa combined; n = 36), where high
      vascularity was associated with longer survival (p = 0.01). CONCLUSIONS: VEGF on
      its own has no prognostic value in NSCLC, but may become a useful indicator when
      combined with vascularity. VEGF may play a physiological role in the normal lung.

PMID- 11215280
TI  - The role and histological classification of needle core biopsy in comparison with
      fine needle aspiration cytology in the preoperative assessment of impalpable
      breast lesions.
AB  - AIMS: To investigate the role of needle core biopsy (NCB) in the preoperative
      assessment of impalpable breast lesions, mainly derived from the NHS Breast
      Screening Programme (NHSBSP) and to assess our own modifications to a suggested
      system for the classification of breast NCBs. METHODS: The NCB, fine needle
      aspiration cytology (FNAC), and radiology scores from 298 women with non-palpable
      breast lesions presenting between January 1997 and December 1998, together with
      the open biopsy results (where available) were collated and analysed. RESULTS:
      The mean follow up period was 15.8 months (range, 5-28). The 298 NCB specimens
      were categorised as follows: unsatisfactory/non-representative (B1; n = 61;
      20.5%), benign but uncertain whether representative (B2r; n = 52; 17.4%), benign
      (B2; n = 103; 34.6%), lesions possibly associated with malignancy but essentially
      benign (B3a; n = 9; 3.0%), atypical epithelial proliferations (B3b; n = 10;
      3.4%), suspicious of malignancy (B4; n = 7; 2.3%), and malignant (B5; n = 56;
      18.7%). Excision biopsy was performed in 43 cases within the B1 (n = 19), B2r (n
      = 8), B2 (n = 8), and the B3a (n = 8; data unavailable in one case) categories,
      revealing malignancy in 18 (42.8%) cases and in 65 cases within the B3b, B4, and
      B5 categories, revealing malignancy in 64 cases (98.5%). The sensitivity of NCB
      for malignancy was 87.7%, with a specificity and positive predictive value of
      99.3% and 98.5%, respectively. FNAC had an inadequacy rate of 58.7%, a complete
      sensitivity of 34.5% and a specificity of 47.6%. CONCLUSIONS: This study confirms
      the value of NCB in the preoperative assessment of impalpable breast lesions. Two
      new categories are suggested for the NCB classification; category B2r for benign
      breast tissue where representativeness is uncertain, and the subdivision of
      category B3 into B3a for benign lesions potentially associated with malignancy
      (for example, radial scars and intraduct papillomas) and B3b for more worrisome
      atypical epithelial proliferations. These will aid the accurate audit of NCB and
      identify more clearly the intellectual pathway leading to a particular
      assessment.

PMID- 11215281
TI  - Molecular genetic alterations in hamartomatous polyps and carcinomas of patients
      with Peutz-Jeghers syndrome.
AB  - AIM: To investigate whether mutations in the STK11/LKB1 gene and genes implicated
      in the colorectal adenoma-carcinoma sequence are involved in Peutz-Jeghers
      syndrome (PJS) related tumorigenesis. METHODS: Thirty nine polyps and five
      carcinomas from 17 patients (from 13 families) with PJS were analysed for loss of
      heterozygosity (LOH) at 19p13.3 (STK11/LKB1 gene locus), 5q21 (APC gene locus),
      18q21-22 (Smad4 and Smad2 gene locus), and 17p13 (p53 gene locus), and evaluated
      for immunohistochemical staining of p53. In addition, mutational analysis of K
      ras codon 12, APC, and p53 and immunohistochemistry for Smad4 expression were
      performed on all carcinomas. RESULTS: LOH at 19p was seen in 15 of the 39 polyps
      and in all carcinomas (n = 5). Interestingly, six of the seven polyps from
      patients with cancer had LOH, compared with nine of the 31 polyps from the
      remaining patients (p = 0.01). In one polyp from a patient without a germline
      STK11/LKB1 mutation, no LOH at 19p or at three alternative PJS candidate loci
      (19q, 6p, and 6q) was found. No LOH at 5q was observed. However, mutational
      analysis revealed an APC mutation in four of the five carcinomas. LOH at 17p was
      not seen in polyps or carcinomas; immunohistochemistry showed expression of p53
      in one carcinoma and focal expression in three polyps. At subsequent sequence
      analysis, no p53 mutation was found. One carcinoma had an activating K-ras codon
      12 mutation and another carcinoma showed 18q LOH; however, no loss of Smad4
      expression was seen. CONCLUSIONS: These results provide further evidence that
      STK11/LKB1 acts as a tumour suppressor gene, and may be involved in the early
      stages of PJS tumorigenesis. Further research is needed to see whether LOH in PJS
      polyps could be used as a biomarker to predict cancer. Differences in molecular
      genetic alterations noted between the adenoma-carcinoma sequence and PJS related
      tumours suggest the presence of a distinct pathway of carcinogenesis.

PMID- 11215282
TI  - Evidence of type II pneumocyte apoptosis in the pathogenesis of idiopathic
      pulmonary fibrosis (IFP)/usual interstitial pneumonia (UIP).
AB  - BACKGROUND/AIMS: The pathogenesis of idiopathic pulmonary fibrosis (IPF)/usual
      interstitial pneumonia (UIP), a chronic and incurable human respiratory disease,
      is not well established. This study was designed to investigate whether the
      apoptosis of type II pneumocytes could be the precipitating factor in the
      pathogenesis of IPF. METHODS: Nineteen specimens obtained by retrospective review
      of the medical and pathological records of 55 patients with IPF, four normal
      subjects, and 10 disease control lungs were analysed. The selected specimens had
      normal alveoli with intervening patchy scarring of the lung parenchyma,
      fulfilling the pathological criteria for UIP. To identify individual cells
      undergoing apoptosis in the normal alveoli, electron microscopy and in situ end
      labelling of fragmented DNA were performed on paraffin was embedded sections
      using digoxigenin-11-dUTP and the enzyme terminal deoxynucleotidyl transferase.
      RESULTS: Apoptosis was detected in the normal alveoli of 17 of the 19 patients
      with IPF/UIP and was absent in the controls. Electron microscopy demonstrated
      apoptotic changes in type II pneumocytes. These results indicate that apoptotic
      type II pneumocyte death occurs in normal alveoli of IPF/UIP and could be the
      principal cause of several events that account for the histological, clinical,
      and functional alterations seen in IPF/UIP. CONCLUSIONS: In conclusion, numerous
      type II pneumocytes from the normal alveoli of most patients with IPF/UIP
      actively undergo programmed cell death. This finding may shed new light on the
      pathogenesis of this disease, with implications mainly for the treatment of
      affected patients.

PMID- 11215283
TI  - Age related changes in the tunica media of the vertebral artery: implications for
      the assessment of vessels injured by trauma.
AB  - AIMS: To provide an illustrated, detailed semiquantitative analysis of the
      important degenerative changes along the length of the vertebral artery so that
      pathologists faced with investigating a fatal arterial injury can identify
      important pre-existing wall abnormalities. METHODS: Ten transverse annuli were
      taken along 34 vertebral arteries from 17 subjects and stained sections were
      prepared using haematoxylin and eosin and the picro-sirius red method. After
      routine microscopy, the elastic fibres, collagen, and smooth muscle nuclei in the
      tunica media were quantified using an eyepiece graticule. An estimate of the
      severity and extent of elastic tissue fragmentation, collagenous scarring, and
      intimal thickening/atheroma was then undertaken. RESULTS: Smooth muscle counts
      remained constant along the artery but collagen counts were higher and elastic
      counts substantially lower within the intracranial segment. Elastic fibre
      fragmentation was recognised in infancy and was moderately advanced by early
      adulthood but considerable collagenous scarring developed later in life. Some
      individuals demonstrated severe fragmentation and scarring before the age of 35
      years. The degenerative changes were often focal and spared the intracranial
      segment almost completely. Atheroma increased with age but was rarely severe and
      appeared not to worsen appreciably beyond the age of 40 years. An unusual
      arrangement of the collagenous tissue was described within the upper cervical
      loops. CONCLUSION: Damaged vertebral arteries need to be sampled extensively to
      allow a proper histological assessment. The picro-sirius red method was
      successful in delineating the fine connective tissue structure of the wall and
      early degenerative changes. An understanding of the age and site specific changes
      should allow the pathologist to recognise important pre-existing abnormalities
      more easily.

PMID- 11215284
TI  - The importance of intracytoplasmic DPAS positivity in fine needle aspirates of
      breast lesions.
AB  - AIMS: For many years the presence of strong intracytoplasmic periodic acid Schiff
      (PAS) positive, diastase resistant (DPAS) staining within atypical cells has been
      used in this laboratory as a marker for carcinoma in fine needle aspirates from
      breast lesions. The aim of the current study was to document such DPAS positivity
      across the spectrum from benign to malignant breast disease and assess its value
      in the upgrading of cytology reports. METHODS: Over a six month period, 315
      aspirates were studied, each having sufficient cellular material for DPAS
      staining to be carried out on one whole slide. DPAS staining was recorded
      semiquantitatively as negative, equivocal, or positive (+, ++, or +++). The
      cytology results were correlated with any subsequent histology performed on these
      patients. RESULTS: DPAS positive material was seen in both intracellular and
      extracellular locations. Care was needed in its interpretation. Occasional cells
      with apparently genuine intracytoplasmic positivity (+) were found in both benign
      and malignant cases. Frequent or particularly strong intracellular DPAS
      positivity (++, +++) correlated best with malignancy. Two cases were reliably
      upgraded from immediate reports suspicious of malignancy to final reports
      diagnostic of malignancy on the basis of the intracytoplasmic DPAS staining.
      CONCLUSION: Strict criteria are required for the interpretation of
      intracytoplasmic DPAS positivity and routine cytological appearances should also
      be taken into account. Weak positivity in occasional cells, especially in flat
      epithelial sheets, may be seen in benign lesions and is not reliable as a marker
      of malignancy. DPAS positivity with internal structure and producing nuclear
      indentation, especially in dissociated or atypical cells, correlates well with
      malignant histology and can be reassuring in the cytological diagnosis of
      malignancy.

PMID- 11215285
TI  - Anaplastic large cell lymphoma with the t(2;5)(p23;q35) NPM/ALK chromosomal
      translocation and duplication of the short arm of the non-translocated chromosome
      2 involving the full length of the ALK gene.
AB  - This report describes a case of anaplastic large cell lymphoma with the canonical
      t(2;5)(p23;q35) translocation in association with duplication of the short arm of
      the non-translocated chromosome 2, as demonstrated by two colour fluorescence in
      situ hybridisation. Because the tumour cells were tetraploid, these abnormalities
      were in duplicate, with four copies of the full length ALK gene and two copies of
      the t(2;5)(p23;q35) translocation. Despite multiple copies of the normal ALK
      gene, immunohistochemical, reverse transcriptase polymerase chain reaction, and
      western blot analysis demonstrated that only the fusion gene NPM/ALK was
      expressed and that normal ALK genes remained silent. Although based on a single
      case, these data indicate that structural rather than numerical abnormalities of
      the ALK gene are implicated in the pathogenesis of anaplastic large cell
      lymphomas.

PMID- 11215286
TI  - The appropriateness of examining the entire cervix histologically in hysterectomy
      specimens from women with a previous history of cervical intraepithelial
      neoplasia or dyskaryosis.
AB  - BACKGROUND/AIMS: To investigate the necessity of examining the entire cervix in
      hysterectomy specimens from women with a previous history of cervical
      intraepithelial neoplasia (CIN) or dyskaryosis. METHODS: The overall frequency
      with which squamous CIN was encountered in hysterectomy specimens of women with a
      previous diagnosis of squamous CIN or dyskaryosis was calculated in a sample of
      71 women. The frequencies in women with positive or negative smears or biopsies
      between the initial diagnosis and hysterectomy, and in women with no intervening
      smear or biopsy, were also estimated. RESULTS: A persistent CIN lesion was
      identified in 18 patients (13 high grade cases; five low grade cases). A further
      eight patients who had high grade CIN also had microinvasive disease (seven cases
      of FIGO stage 1a1; one case of FIGO stage 1a2). Ten of the 20 patients with a
      positive smear or biopsy, but none of the 16 patients with a negative smear or
      biopsy between initial diagnosis and hysterectomy, had an abnormality on the
      hysterectomy specimen. Sixteen of the 35 patients who did not have an interim
      smear or biopsy had CIN in the hysterectomy cervix. CONCLUSIONS: These results
      support continuing the practice of examining the entire cervix in hysterectomy
      specimens from women with a previous cervical abnormality, regardless of its
      histological or cytological grade, if there has been a positive interim smear or
      biopsy or if neither investigation has been performed.

PMID- 11215288
TI  - The use of the Reflection computer program for facilitating report formulation in
      the medical microbiology laboratory.

PMID- 11215287
TI  - Evaluation of CHROMagar candida for rapid identification and Etest for antifungal
      susceptibility testing in a district general hospital laboratory.

PMID- 11215289
TI  - Immunology of chronic mucocutaneous candidiasis.

PMID- 11215290
TI  - Investigation of CMV disease in immunocompromised patients.
AB  - Cytomegalovirus (CMV) is a recognised cause of morbidity and mortality in
      immunocompromised individuals. This review will concentrate on recent advances in
      the understanding of the complex interplay between the host and parasite and the
      pathological consequences of perturbation of the host immune system. The classic
      view of CMV as a slowly replicating virus is challenged by recent in vivo
      findings suggesting that active replication occurs dynamically in the human host,
      with a doubling time of approximately one day. In addition, CMV load plays a
      major role in viral pathogenesis, such that increased CMV replication is a
      significant risk factor for disease in all immunocompromised groups studied to
      date. These studies focus attention on understanding the virological and
      immunological determinants of enhanced viral replication and its pathological
      consequences.

PMID- 11215291
TI  - Laboratory testing under managed care dominance in the USA.
AB  - The uncontrolled escalation of total health care expenditure despite the
      government's endeavours during the past decades in the USA had led to the rapid
      infiltration of managed care organisations (MCOs). Traditional hospital based
      laboratories have been placed in a crucial situation with the advent of the
      managed care era. A massive reduction of in house testing urged them to develop
      strategies against financial difficulty. Consolidation and networking,
      participation in the outreach testing market, and emphasis on point of
      care/satellite laboratory testing in non-traditional, ambulatory settings are
      major strategies for the survival of hospital laboratories. Several physicians'
      office laboratories (POLS) have closed their doors in response both to regulatory
      restrictions imposed by the Clinical Laboratory Improvement Amendments of 1988
      and to managed care infiltration. It seems likely that POLs and hospital
      laboratories will continue to reduce test volumes, whereas commercial reference
      laboratories will thrive through contracting with MCOs. In the current climate of
      managed care dominance in the USA, clinical laboratories are changing their basic
      operation focus and mission in response to the aggressively changing landscape.

PMID- 11215293
TI  - The use of material from the dead in forensic science research: is it lawful and
      is it ethical?

PMID- 11215292
TI  - The histopathological differential diagnosis of gastrointestinal stromal tumours.
AB  - Gastrointestinal stromal tumours (GISTs), initially presumed to be of "true"
      smooth muscle origin, encompass a heterogeneous, and as yet incompletely
      understood, group of mesenchymal tumours with respect to their origin, cellular
      differentiation, and prognosis. Cellular morphology ranges from predominantly
      spindle shaped to epithelioid in character, whereas differentiation pathways, as
      determined primarily by immunohistochemistry and ultrastructure, can vary from
      indeterminate to myoid and/or neural. Recent work has indicated that the
      interstitial cells of Cajal, a complex cellular network postulated to act as
      pacemaker cells of the gastrointestinal tract, which exhibit both myoid and
      neural features, could be candidates for tumour histogenesis. This would provide
      a plausible and attractive explanation for the variable differentiation pathways
      identified in the GIST category to date. Nevertheless, the occasional but
      undisputed location of GISTs outside the gastrointestinal tract (omentum,
      peritoneum, and retroperitoneum) might mitigate against such an origin, and their
      histogenesis remains open to debate. The c-kit proto-oncogene, encoding a growth
      factor receptor with tyrosine kinase activity, has been postulated to play an
      important role in tumorigenesis because "gain of function" mutations in this
      gene, localised to chromosome 4q11-21, are being increasingly identified in
      hereditary and sporadic cases. Monoclonal and polyclonal antibodies directed at
      the c-kit gene product expressed on the cell surface (CD117/c-kit) appear to be
      increasingly helpful in resolving the histopathological differential diagnosis
      between GISTs and true gastrointestinal smooth muscle neoplasms, schwannomas, and
      other far less frequently occurring mesenchymal tumours at this site. Although
      tumours with a clinically benign course appear to be more common than their
      malignant counterparts, no specific histological criteria have as yet been
      identified to enable an unambiguous prediction of biological behaviour.
      Increasing tumour size and mitotic activity favour aggressive tumour behaviour,
      whereas the prognostic value of germline and somatic mutations within the c-kit
      proto-oncogene remains to be elucidated further. It is the aim of this synopsis
      to highlight the relevant fundamental and diagnostic developments with respect to
      this complex group of neoplasms.

PMID- 11215294
TI  - A profession?

PMID- 11215295
TI  - Echo correlation analysis and the acoustic evidence in the Kennedy assassination
      revisited.
AB  - A Dallas Police Department recording contemporaneous with the Kennedy
      assassination contains five impulsive sounds that have the acoustic waveform of
      Dealey Plaza gunfire. One of the sounds matches the echo pattern of a test shot
      fired from the Grassy Knoll. The shock wave precedence associated with this
      pattern is consistent with the muzzle velocity of a .30 calibre rifle. Criticism
      of the acoustic identifications on statistical grounds is based on erroneous
      assumptions concerning the assignment of values to the parameters that determine
      the probability that random noises could resemble gunshot patterns. A
      conservative estimate of the true value of the probability that the putative
      Grassy Knoll shot is attributable to random radio noise is no greater than 0.037.
      Alleged asynchroneity of the sounds with the time of the assassination stemmed
      from several incorrect assumptions. Whatever their origin, the gunshot-like
      sounds occur exactly synchronous with the time of the shooting.

PMID- 11215296
TI  - The New Zealand DNA databank: its development and significance as a crime solving
      tool.
AB  - The New Zealand DNA Databank was established following the introduction of
      legislation in August 1996. Using the Second Generation Multiplex (SGM), DNA
      profiles from over 13,000 convicted offenders and volunteer donors have been
      completed to the National DNA Database. Since June 1998, DNA profiles from over
      1,400 unsolved crimes have been entered onto the Crime Sample Database. Of all
      unsolved crimes analysed, 33% are linked to individuals and 21% are linked to
      other unsolved crimes. Several high profile types of case including homicides,
      sexual offenses and burglaries are amongst those regularly solved.

PMID- 11215297
TI  - Glass on clothing and shoes of members of the general population and people
      suspected of breaking crimes.
AB  - The outer clothing and footwear of 122 people attending a university gymnasium
      and a private gymnasium were searched for fragments of glass. Both the surfaces
      and the pockets of the clothing and the uppers and soles of the footwear were
      searched. New Zealand forensic glass cases have been reviewed to determine the
      amount of non-matching glass present on the clothing of people who are suspected
      of breaking crimes. Data from 114 suspects who had no matching glass on their
      clothing and shoes were accumulated. Statistical modelling techniques have been
      applied to the data collected.

PMID- 11215298
TI  - Level of lung function required to use the Camic Datamaster breath alcohol
      testing device.
AB  - In the UK a person who, without reasonable excuse, fails to provide a breath
      specimen when required to under the 1988 Road Traffic Act, is guilty of an
      offense. In the past many suspects claim to have experienced difficulty providing
      breath samples for evidential machines. This paper describes experiments carried
      out on human subjects, both healthy and suffering a variety of respiratory
      illness. The experiments were designed to assess the level of respiratory
      performance required to provide a satisfactory breath sample for the Camic
      Datamaster. In this study it was found that both actual spirometry values and the
      percentage of predicted values were both important indicators.

PMID- 11215300
TI  - California Association of Criminalists. Founders' Lecture. The past, present, and
      future of criminalistics.

PMID- 11215299
TI  - Simplified estimation of Widmark "r" values by the method of Forrest.
AB  - To simplify blood alcohol calculations, tables are presented giving Widmark 'r'
      values estimated by the method of ARW Forrest (Journal of the Forensic Science
      Society 1986; 27: 249-252).

PMID- 11215301
TI  - Death and the maiden.

PMID- 11215302
TI  - The expert witness. Neither Frye nor Daubert solved the problem: what can be
      done?
AB  - Flawed expert scientific testimony has compromised truth finding in American
      litigation, including in medical malpractice and in product liability cases. The
      Federal Rules of Evidence and the Supreme Court in Daubert and other cases have
      established standards for testimony that include reliability and relevance, and
      established judges as gatekeepers. However, because of lack of understanding of
      scientific issues, judges have problems with this role, and juries have
      difficulties with scientific evidence. Professionals and the judiciary have made
      some advances, but a better system involving the court's use of neutral experts
      and a mechanism to hold experts accountable for improprieties is needed.

PMID- 11215303
TI  - Cellular and clinical implications of glutathione.

PMID- 11215304
TI  - Haem biosynthesis and human porphyria cutanea tarda: effects of alcohol intake.
AB  - The review describes the structural and biochemical properties of the haem
      biosynthetic enzyme, uroporphyrinogen decarboxylase (UROD), which sequentially
      catalyzes the removal of the four carboxyl groups from the acetate side chains of
      octacarboxylic uroporphyrinogen to form coproporphyrinogen, and the possible
      biochemical mechanism of the genesis of porphyria cutanea tarda (PCT). The
      disease is caused when the activity of UROD is significantly reduced. PCT is a
      multifactorial disease where both inherent and environmental factors such as
      alcohol, estrogens, halogenated aromatic hydrocarbons and viral infection (mainly
      hepatitis C) are involved in biochemical and clinical expression. In PCT, hepatic
      iron plays a key role. Alcohol intake could induce mobilization of iron from
      protein-bound ferritin. PCT should be managed by avoidance of these toxins and
      removal of iron by vigorous phlebotomy. Such iron-reduction therapy would provide
      additional benefit for hepatitis C patients by interferon therapy.

PMID- 11215306
TI  - Pulmonary histopathology and alteration in cellular pattern of bronchoalveolar
      lavage fluid in experimental silicosis.
AB  - Pathogenesis of silicosis is still being evaluated. Cellular and
      histopathological changes in lung following acute and chronic exposure of quartz
      in rats have been investigated. Inbred wistar rats were given single
      intratracheal injection of quartz (10 mg in 0.05 ml saline) in groups of acute
      model, and inhalation of quartz (40 mg/m3 with air flow 5 l/hr in a simulation
      chamber, 6 hr/day) in groups of chronic model. The control groups were exposed to
      vehicles only. Rats were sacrificed on day 3, 5 and 7 of intratracheal injection
      and after 2, 4 and 8 weeks of inhalation. Total and differential cell counts (TC
      and DC) were performed in bronchoalveolar lavage fluid (BALF). Histopathology was
      done in the lungs. There was significant (P < 0.001) increase in TC and
      significant (P < 0.001) changes in percentage of inflammatory cell counts on DC
      in the BALF of silicotic rats. Histopathology showed progressive inflammatory and
      fibrotic response in quartz exposed lungs in both acute and chronic models. The
      results indicate duration dependent inflammatory changes in lungs of both the
      models. Changes in cell counts precede the histopathological changes and may
      serve as early biological marker for detection of silicosis.

PMID- 11215305
TI  - Cold reactive lymphocytotoxic antibodies in pulmonary tuberculosis: correlation
      with disease activity and HLA.
AB  - Cold reactive lymphocytotoxic antibodies (LCA) are more reactive in cold than at
      37 degrees C and occur following infection, immunization or vaccination and in
      various autoimmune diseases. In the present study, LCA activity against T and B
      lymphocytes has been investigated in patients with pulmonary tuberculosis (PTB),
      their various clinical sub-groups and consanguineous relatives. Further, the
      relevance of HLA factors in LCA activity was analyzed. The sera from 144 PTB
      patients, 52 family contacts and 52 healthy individuals were tested for presence
      of LCAs by a modified two-stage NIH microlymphocytotoxicity assay. A significant
      increase in LCA activity against both T (32.6% vs 5.7%, P < 0.0001) and B (59.7%
      vs 13.4%, P < 0.0000001) cells was observed in PTB patients as compared to
      healthy controls. There was no correlation between serum LCA activity and sputum
      acid-fast bacilli status. However, only B cell LCAs revealed significant increase
      in parallel to disease advancement as assessed by X-ray chest examination.
      Further, LCA activity was more pronounced in drug responders than drug failure
      group of patients. No significant difference in the distribution of HLA class I
      and class II antigens was observed between LCA positive and LCA negative
      patients. However, panel cells carrying HLA-A1, -A11 and -DR3 were often found
      reactive in LCA positive patient sera. In household family contacts, LCAs were
      significantly increased only against B cells as compared to healthy controls
      (38.4% vs 13.4%, P < 0.01). This study suggests that Mycobacterium tuberculosis
      infection/exposure could account for the occurrence of LCAs in pulmonary
      tuberculosis and the strength of these antibodies is related to disease severity
      and the extent of lung involvement.

PMID- 11215307
TI  - Polymorphism in heat-shock protein 70-1 (HSP70-1) gene promoter region and
      susceptibility to tuberculoid leprosy and pulmonary tuberculosis in Asian
      Indians.
AB  - Heat shock proteins (HSP) act as immunological target structures either by
      themselves because of an unusual expression pattern, or they are carrier proteins
      for immunogenic peptides. A three-allele polymorphism of HSP70-1 promoter region
      was analysed in random patients with pulmonary tuberculosis (PTB), or with
      tuberculoid (TT) leprosy and healthy controls from North India. HSP70-1A and
      HSP70-1C occurred more frequently (> 60%) while HSP70-1B occurred infrequently in
      this population. Only HSP70-1A allele was significantly increased in TT leprosy
      as compared to healthy controls (91.8% Vs 71.1%, Pc < 0.03, RR = 4.58). Although
      a strong association of HLA-DR15 was observed with both of these patient groups
      in earlier studies, no correlation was found between HSP70-1 promoter alleles
      with any of the HLA allotypes. Amongst six possible genotype combinations of
      HSP70-1 promoter allele, only four (A/A, A/B, A/C, C/C) were encountered in Asian
      Indians. A significant increase of HSP70-1 A/C genotype was observed among DR15
      negative PTB patients as compared to DR15 negative controls (87.5% Vs 35.7%, X2 =
      8.6, Pc < 0.02) giving highest relative risk of 12.6. These findings suggest that
      HSP70-1 genes may play a secondary role to HLA-DR in governing susceptibility to
      mycobacterial infectious diseases.

PMID- 11215308
TI  - Adrenocorticotropic hormone and growth factor receptors in breast cancer.
AB  - Tissues from 100 cases of breast cancer were analysed immunohistochemically for
      the presence of adrenocorticotropic hormone (ACTH) or ACTH-like peptides and
      expression of c-erbB-2 oncoprotein, epidermal growth factor receptor (EGF-R) as
      well as oestrogen receptor (ER). Immunopositivity for ACTH was found in 15% cases
      of infiltrating duct carcinoma of the breast, whereas 38% and 36% breast tumours
      were positive for c-erbB-2 and EGF-R respectively. While 27% cases were positive
      for ER. The immunoexpressions of all parameters were higher in breast cancer
      cases with upper age group (45 years or above) than the patients below 45 years
      of age. A significant correlation was observed between the tumour grade and the
      expression of c-erbB-2 oncoprotein. Further, a positive association between the
      immunoexpression of c-erbB-2 and EGF-R was noticed. Interestingly, a
      statistically significant relationship was found between the immunopositivity of
      ACTH and ER. The study reflects a probable association of ACTH or ACTH-like
      peptides in pathological process of breast cancer.

PMID- 11215309
TI  - Modification of radiation induced damage in mouse intestine by WR-2721.
AB  - Intestinal protection in mice against radiation injury by WR-2721 (300 mg/kg body
      wt, i.p., 30 min before irradiation) was studied after whole body gamma
      irradiation (0.5, 1.5, 3.0, 4.5, or 6.0 Gy). Crypt survival and induction of
      apoptosis, and abnormal mitoses in crypt cells in the jejunum were studied on day
      1, 3 and 7 after irradiation. Irradiation produced a significant decrease in
      crypt survival, whereas apoptosis and abnormal mitoses showed a significant
      increase from sham-treated control animals. Maximum changes in all the parameters
      were observed on day 1 after irradiation and the effect increased linearly with
      radiation dose. There was recovery at later intervals, which was inversely
      related to radiation dose. WR-2721 pre-treatment resulted in a significant
      increase in the number of surviving crypts, whereas the number of apoptotic cells
      in the crypts showed a significant decrease from respective irradiated controls
      on day 1 after exposure. The recovery was also faster in WR-2721 pre- treated
      animals. It is concluded that WR-2721 protects against gastrointestinal death by
      reducing radiation induced cell death, thereby maintaining a higher number of
      stem cells in the proliferating compartment.

PMID- 11215310
TI  - Anticonvulsant and behavioral actions of triterpene isolated from Rubia
      cordifolia Linn.
AB  - Effect of a triterpene isolated from the acetone soluble part of petroleum ether
      extract of R. cordifolia was studied on convulsions induced by maximum electro
      shock (MES), electrical kindling and various chemoconvulsants in rats and mice.
      The effect of triterpene was also investigated on behavior and gamma-aminobutyric
      acid (GABA) and serotonin (5-HT) content in mouse brain. Triterpene inhibited
      seizures induced by MES, electrical kindling, pentylenetetrazol (PTZ), and
      lithium-pilocarpine. However, seizures induced by strychnine were not inhibited.
      Triterpene reduced locomotion as well as rearing. Pentobarbitone induced sleep
      was potentiated and amphetamine induced stereotypy was inhibited. The triterpene
      was found to possess anxiogenic activity. Brain GABA and 5-HT contents were
      raised by the compound. The study suggests that the triterpene isolated from R.
      cordifolia bear a potential for further study.

PMID- 11215311
TI  - Comparative chemotherapeutic efficacy of balhimycin, desgluco-balhimycin against
      experimental MSSA and MRSA infection in mice.
AB  - Balhimycin and desglucobalhimycin are glycopeptide antibiotics isolated from an
      Amycolatopsis spp during the search for novel antibacterials against MRSA from
      the natural product screening at the Research Centre of formerly Hoechst India
      Ltd. in Bombay, India. Both compounds show excellent in vitro activity against
      methicillin sensitive and resistant Staphylococcus aureus (MSSA, MRSA). Both
      compounds were also found to be active against a number of MRSA strain in the
      animal studies. The activities were comparable to that of the reference
      glycopeptides vancomycin and teicoplanin used in these studies. Teicoplanin
      displayed better in vivo efficacy against S. epidermidis 4929H and Streptococcus
      pyogenes A77 than either vancomycin or desgluco-balhimycin in the present study.
      Preliminary studies on pharmacokinetic and acute toxicity were done to get some
      idea at the early stage of the investigation about the promise of the compounds
      for development.

PMID- 11215312
TI  - Effects of a juvenoid, DPE-28, on biology and behaviour of Culex
      quinquefasciatus, the human filariasis vector.
AB  - Studies on the effect of a juvenoid, DPE-28 (2,4-dinitrophenyl-2',6'-di
      tertiarybutyl phenyl ether) on biology and behaviour of Cx. quinquefasciatus
      showed that the developmental duration, sex ratio, mating success and blood
      feeding were considerably affected by the exposure of larvae and pupae to the
      compound. Exposure of fourth instar larvae to 0.007 (EI90) and 0.0019 (EI50) ppm
      of DPE-28 prolonged the duration of pupation by 58.6 and 52.4 hr and delayed the
      adult emergence by 35.4 and 17.7 hr in males and 36.8 and 21.1 hr in females
      respectively. Exposure of freshly ecdysed pupae to 10 and 5 ppm delayed the adult
      emergence with respect to the control by 54.3 and 32.4 hr in males and 55.2 and
      33.2 hr in females respectively. The sex ratio of the adults emerged from treated
      larvae and pupae was also affected. The female mosquitoes that survived from the
      exposed fourth instar larvae and pupae exhibited a low blood engorgement ratio.
      This depression in blood feeding was more pronounced in adults emerged from
      treated pupae than that of treated fourth instar larvae. A significant proportion
      of adults emerged from treated larvae and pupae were able to feed only partially.
      Mating success of the treated populations declined considerably when crosses were
      made between the males and females emerged from treated fourth instar larvae and
      pupae. The adults emerged from treated larvae and pupae showed a significant
      reduction in the oviposition.

PMID- 11215313
TI  - Teratogenic effects of sinusoidal extremely low frequency electromagnetic fields
      on morphology of 24 hr chick embryos.
AB  - To examine the potential teratogenicity of electromagnetic fields (EMF;
      sinusoidal and rectangular) on development of chick embryos (white leghorn), 221
      freshly fertilized chicken eggs (55-65 g) were exposed during first 24 hr of
      postlaying incubation (38 degrees +/- 0.5 degree C) to 24 different EMFs, with
      50Hz repetition rate and 8.007-10.143 mT flux density. Following exposure, the
      exposed fertilized chicken eggs (n = 8-10) and sham-exposed fertilized chicken
      eggs (n = 15) were incubated simultaneously for 8 more days and unexposed control
      fertilized chicken eggs (n = 20) for 9 days in absence of EMFs. The embryos were
      removed from egg shells and studied blind. All 24 EMF exposed-groups (inside the
      coil with exposure) showed an increase in the percentage of developmental
      anomalies compared to sham-exposed (inside the coil with no exposure) and control
      groups (outside the coil). Further, egg's weight was evaluated on day 9. This
      variable did not show significant difference between control and exposed-groups.
      The investigation also covered the measurement of body weight, length of crown to
      rump, length of tip of the beak to occipital bone, heart and liver weight.
      Statistical comparison between sham-exposed and control values did not show
      significant differences, but comparison between 8.007, 8.453 and 8.713 mT exposed
      groups and control groups showed significant differences; in other exposed
      groups, the changes were not significant. These results revealed that 50 Hz
      electromagnetic fields can induce irreversible developmental alterations in 24 hr
      chick embryos and confirm that its strength could be a determinant factor for the
      embryonic response to extremely low frequency electromagnetic fields (window
      effects).

PMID- 11215314
TI  - Morphogenetic derangements in the reproductive system of Bracon hebetor, a
      beneficial parasitoid, bred on juvenoid treated host (Corcyra cephalonica)
      larvae.
AB  - Effect of juvenoids (hydroprene and methoprene) on the ecto-parasite B. hebetor
      was investigated by rearing them upon the juvenoid treated ultimate instar host
      larvae of C. cephalonica. Emerged adultoid wasps of either sexes obtained from
      treated series showed anatomical deformities in the reproductive systems. Ill
      developed ovaries with reduced length, terminally free ovarioles and abnormal
      testicular growth showing non-fusion of lobes were the important abnormal
      features. Data on measurements of male reproductive system, e.g., width
      (transverse axis) of testis, length of common vas deferens plus ejaculatory duct
      and length of accessory gland showed significant difference (P < 0.05) from
      control.

PMID- 11215315
TI  - Role of thyroidal and testicular hormones in regulation of tissue respiration in
      male air-breathing fish, Clarias batrachus (Linn.).
AB  - In vivo and in vitro effects of thyroidal hormones (MIT, DIT, T3, T4), propyl
      thiouracil (PTU), testosterone and cyproterone acetate were studied on the rate
      of tissue (liver, muscle, kidney and brain) respiration of adult male C.
      batrachus during winter and summer/rainy seasons. Monoiodotyrosine (MIT) and
      diiodothyrosine (DIT) increased the respiratory rate in a dose-dependent and
      temperature-independent manner. Triiodothyronine (T3) and thyroxine (T4)
      stimulated tissue respiration during summer/rainy months but not during winter.
      PTU decreased tissue respiration during summer/rainy season and also at simulated
      low temperature. Testosterone invariably stimulated the rate of respiration of
      the tissues, while in vivo treatment with cyproterone acetate significantly
      decreased the metabolic rate of all the tissues. The findings suggest that in C.
      batrachus MIT and DIT may be more important than T3 and T4 at low temperature,
      endogenous thyroid hormones are involved indirectly in energy metabolism even
      during winter/at low temperature and testicular hormones are actively involved in
      the respiration.

PMID- 11215317
TI  - Epididymal protein secretion and its androgenic control in wall lizards
      Hemidactylus flaviviridis (Ruppell).
AB  - The total protein level in different segments of epididymis of normal lizard
      exhibited noticeable increase from early February to late March of a same
      reproductive phase. Comparison among the protein level of different epididymal
      segments showed insignificant variation from anterior to posterior part in early
      February but in late March, the protein level in posterior segment was
      appreciably higher than in anterior and middle segments. Further, testosterone
      induced epididymal protein did not exhibit any significant quantitative variation
      among different regions. The electrophoretic pattern of luminal fluid from
      different epididymal regions of normal lizard showed 28 protein bands without any
      marked regional difference. However, only 16 protein bands could be demonstrated
      in the epididymal fluid of any region. Unlike molecular size, isoelectric
      focussing of testosterone induced epididymal proteins revealed that three regions
      of epididymis differ in their nature of protein. The number of proteins having
      alkaline pH range in anterior and middle regions were 4 and 3, respectively which
      increased upto 6 in posterior region.

PMID- 11215316
TI  - Effects of administration of testosterone on some biochemical correlates in
      seminal vesicle of Heteropneustes fossilis (Bloch) during preparatory phase: a
      study correlating changes in plasma testosterone level and testis activity.
AB  - In the catfish H. fossilis, administration of testosterone (0.25, 0.5, 1 and 2
      micrograms/g body weight for 20 days) during mid-preparatory phase (March)
      increased plasma testosterone, gonadosomatic index, seminal vesicle-somatic index
      and concentrations of total proteins, fructose and hexosamines in seminal vesicle
      (SV) and testis in a dose-related manner. In the lowest dosage (0.25 microgram)
      group, only the hexosamine and SV protein levels were significantly high. Glucose
      level decreased in a dose-related manner, the decrease being not significant in
      the 0.25 microgram group. The results indicate that testosterone stimulates SV
      and testicular secretions of total proteins, hexosamines and fructose in catfish.
      Decrease in glucose content suggests its conversion into fructose under
      testosterone stimulation.

PMID- 11215318
TI  - Hypolipidemic, hypoprostatic and pharmacological activity of oxohexaene polyene
      antibiotic (HA-1-92).
AB  - HA-1-92, a new oxohexaene polyene macrolide showed significant hypolipidemic and
      hypoprostatic activity both in rat and rabbit models. HA-1-92 did not elicit
      significant effect on blood pressure or respiration in anaesthetized rat or on
      various isolated tissue preparation studies.

PMID- 11215319
TI  - In vitro propagation of Acorus calamus Linn.--a medicinal plant.
AB  - High frequency in vitro propagation protocol was standardized from rhizome
      explants of A. calamus. Maximum shoot multiplication frequency was obtained on
      Murashige and Skoog's media supplemented with 4 mg/l 6-benzyl amino purine and
      0.5 mg/l indole-3-acetic acid. Regenerated shoots were rooted in vitro or
      directly transferred to sterile soil and well developed roots were observed
      within two weeks. The rooted plants were successfully established in the field.

PMID- 11215320
TI  - Synthesis, free solution capillary electrophoresis separation and toxicity of
      seven potential impurities of dobutamine.
AB  - The seven O-methylated analogs of dobutamine [(+/-)-4-[2-[[3-(p-hydroxyphenyl)-1
      methylpropyl]amino]ethyl]pyrocatechol, CAS 34368-04-2), a trihydroxy secondary
      amine, can be considered potential impurities of the latter, the ultimate step of
      the synthesis of dobutamine being the deprotection of the three phenolic groups.
      In order to enable the detection and the identification of such a contamination,
      the di- and the monomethylated derivatives of dobutamine were prepared and their
      mixture with dobutamine and its trimethoxy precursor completely resolved by Free
      Solution Capillary Electrophoresis (FSCE). Indeed, the above impurities proved to
      occur in dobutamine in consequence of improper demethylation conditions and to be
      significantly more toxic than the latter.

PMID- 11215321
TI  - Bioavailability and pharmacokinetic profile of dihydroergotoxine from a tablet
      and from an oral solution formulation.
AB  - Dihydroergotoxine mesylate (DHETM, CAS 8067-24-1), the combination of the
      mesylates of four dihydrogenated ergot alkaloid derivatives (dihydroergocornine,
      dihydroergocristine, alpha-dihydroergocryptine and beta-dihydroergocryptine), is
      used mainly for age-related cognitive impairment. The bioavailability of DHETM
      was investigated in a cross-over study on 20 male healthy volunteers to whom two
      single doses of 9 mg DHETM were administered either in tablets (Orphol spezial)
      or in oral solution (Orphol forte). DHETM was assayed in serum with a double
      radioimmunoassay method displaying a satisfactory cross-reactivity with the
      principal components of DHETM. After administration of tablets the peak of DHETM
      was (mean +/- SE) 124 +/- 16 pg/ml, the tmax 1.15 +/- 0.21 h, the AUC 790 +/- 93
      pg/ml x h and the terminal elimination half-life 7.54 +/- 1.23 h. After oral
      solution the peak of DHETM was 176 +/- 16 pg/ml, the tmax 0.50 +/- 0.04 h, the
      AUC 779 +/- 94 pg/ml x h and the terminal elimination half-life 6.13 +/- 0.76 h.
      The bioavailability of DHETM from tablets vs. that from oral solution differed
      only by a retard related to the dissolution time of DHETM from the tablets, but
      not for other pharmacokinetic parameters. The relatively high two single doses of
      9 mg DHETM administered to the 20 subjects were well tolerated, causing only
      known and expected adverse reactions to DHETM (tiredness, headache and vertigo)
      that did not require discontinuation of the study.

PMID- 11215322
TI  - Effect of long-term application of Crataegus oxyacantha on ischemia and
      reperfusion induced arrhythmias in rats.
AB  - The effect of long-term application of Crataegus oxyacantha on ischemia and
      reperfusion induced arrhythmias was investigated in Wistar rats on the heart in
      situ and on Langendorff preparations. Seventeen rats were fed for 8 weeks with
      0.5 g/kg b.w. Crataegus extract per day, standardised to 2.2% flavonoids. Twenty
      age-matched untreated rats served as controls. In the hearts in situ as well as
      in the Langendorff preparations the left anterior descending coronary artery
      (LAD) was ligated for 20 min and subsequently reperfused for 30 min. ECG was
      continuously recorded and the time spent between start of ischemia and onset of
      arrhythmias was measured. In addition, during ischemia and reperfusion the number
      of ventricular premature beats and bigemini and the duration of salvos and
      ventricular flutter and fibrillation were determined. The ischemic area was
      evaluated in all experiments and coronary flow was measured in Langendorff
      preparations. In the present experiments, no cardioprotective effects of
      Crataegus oxyacantha could be detected, neither in the heart in situ nor in the
      Langendorff preparations. Although the ischemic areas were identical, arrhythmias
      occurred even earlier in the Crataegus collectives than in the controls. Also the
      number and duration of ischemia and reperfusion induced arrhythmias tended to
      occur longer and more frequently in the Crataegus collectives, whilst coronary
      flow remained unchanged. The phenomenon that Crataegus rather aggravates than
      prevents arrhythmias may be reduced to a Crataegus induced increase in
      intracellular Ca(2+)-concentration proven true for the positive inotropic effects
      of Crataegus.

PMID- 11215323
TI  - Assessment of skin safety of a new glyceryl trinitrate transdermal patch. Animal
      and human studies.
AB  - The experimental models and the studies in man employed to assess the skin and
      general safety of a newly developed glyceryl trinitrate (GTN, CAS 55-63-0)
      transdermal patch, hereinafter coded EPI, are described. EPI was found well
      tolerated by the skin after single or 28-day repeated epicutaneous application on
      the rabbit, devoid of phototoxicity in the mouse, devoid of skin sensitizing
      potential in the guinea pig and devoid of photosensitizing effects in the guinea
      pig. Tested were also, with negative results, the cytotoxic, hemolytic and
      genotoxic potential, the presence of bacterial endotoxins, the systemic and
      intracutaneous toxicity, and the possible conjunctival irritant effects. The
      application of EPI for 14 consecutive days on the thoracic skin of 28 healthy
      volunteers did not provoke subjective discomfort such as itching, burning or
      pain, or objective skin lesions. On the application site a light and transient
      erythema was often found demonstrating the transcutaneous absorption of the
      vasodilating GTN from the patch. The 14-day application was followed after two
      weeks by the application of a challenge EPI patch to detect a possible skin
      sensitization by EPI. No skin reaction was elicited, showing that also in man EPI
      is devoid of skin sensitizing potential. During the 14-day application of EPI
      several GTN commonly induced systemic adverse reactions were observed,
      particularly headache, confirming the systemic bioavailability of GTN from the
      patch. Headache rapidly disappeared after removal of the patch, in parallel with
      the decrease of the blood concentrations of GTN and of its active metabolites,
      consistently with the previous pharmacokinetic findings. This is an advantage of
      the administration of GTN with the transdermal patch because, in the case of
      unbearable headache, the patient is relieved by the simple removal of the patch.

PMID- 11215324
TI  - Hypolipidemic effect of NK-104 and other 3-hydroxy-3-methylglutaryl coenzyme A
      reductase inhibitors in guinea pigs.
AB  - Hypolipidemic effects of various HMG-CoA reductase inhibitors (statins) were
      examined in guinea pigs. After 2-week administration of NK-104 ((+)-monocalcium
      bis((3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)-3-quinolyl]-3, 5-dihydroxy-6
      heptenoate), CAS 147526-32-7), simvastatin (SV), pravastatin (PV), fluvastatin
      (FV), cerivastatin (CV) and atorvastatin (AV) to guinea pigs at various doses,
      which did not affect body weight, plasma and liver lipids were measured. Liver
      endoplasmic reticulum (ER) was isolated and measured for lipid content and
      activity of ER enzymes (NK-104: 3 mg/kg, SV: 30 mg/kg). Each statin except CV
      dose-dependently lowered total cholesterol (TC), with NK-104 showing the greatest
      effect. Only NK-104 and AV, long-acting statins, significantly lowered
      triglycerides (TG). A significant reduction of the liver cholesterol content was
      observed for NK-104 and AV. The liver TG content increased with dose for SV or
      PV, but not for NK-104 or AV. The TG content in ER and activity of diacylglycerol
      acyltransferase of ER, increased with SV and slightly with NK-104. Activity of
      microsomal triglyceride transfer protein, which is necessary for both apoB
      particle formation at rough ER and TG droplet production at smooth ER, increased
      by SV but not by NK-104. It is suggested that statins with prolonged action lower
      TG by decreasing cholesterol ester supply necessary for very low density
      lipoprotein formation and by attenuating an increase in TG production at ER after
      HMG-CoA reductase inhibition.

PMID- 11215325
TI  - Effects of osutidine (T-593) and its enantiomers on gastric mucosal hemodynamics
      and mucosal integrity in anesthetized rats.
AB  - T-593 (osutidine, CAS 140695-21-2) is a new anti-ulcer agent that consists of two
      enantiomers, (+)-(R)-T-593 and (-)-(S)-T-593. The present study was designed to
      investigate the effects of T-593, (+)-(R)-T-593 and (-)-(S)-T-593 on ethanol
      induced gastric damage in rats. Rats were given intraperitoneal administration of
      vehicle, racemic T-593, (+)-(R)-T-593 or (-)-(S)-T-593. 30 min later, the rats
      intragastrically received a 1-ml solution of 40% ethanol, and 30 min thereafter,
      they were sacrificed for assessment of gastric damage. Gastric hemodynamics were
      assessed by reflectance spectrophotometry and laser Doppler flowmetry during the
      experiment. Gastric damage was significantly suppressed by racemic T-593 in a
      dose-dependent manner. While 60 mg/kg of (+)-(R)-T-593 and (-)-(S)-T-593 also
      suppressed ethanol-induced gastric injury, the same dose of racemic T-593 exerted
      the most potent anti-ulcerative activity. Both (+)-(R)-T-593 and racemic T-593
      increased gastric mucosal blood flow and abolished gastric mucosal blood flow
      stasis induced by 40% ethanol. Although (-)-(S)-T-593, which antagonizes
      histamine H2-receptors, exerts an antiulcerative effect, (+)-(R)-T-593 also
      protects the gastric mucosa from ethanol-induced injury, possibly by influencing
      gastric mucosal hemodynamics. Thus racemic T-593 may protect the gastric mucosa
      by antagonizing H2-receptors and by enhancing gastric circulation in rats.

PMID- 11215326
TI  - General pharmacology of IY-81149, a new proton pump inhibitor.
AB  - IY-81149 (2-[(4-methoxy-3-methyl)-2-pyridinyl]methylsulfinyl -5-(1H-pyrrol-1-yl)
      1H-benzimidazole, CAS 172152-36-2) is a new proton pump inhibitor and expected to
      be an antiulcer drug. Its general pharmacological effects were studied in this
      paper. The doses given were vehicle control, 0.3, 1, 3, 100, 300 and 1000 mg/kg
      and were administered orally. The animals used in this study were mouse, rat,
      guinea pig and beagle dog. IY-81149 decreased spontaneous locomotor activity at
      1000 mg/kg and showed a weak effect in motor performance at 300 and 1000 mg/kg.
      IY-81149 prolonged the hexobarbital-induced sleeping time dose dependently at
      100, 300 and 1000 mg/kg. Oral administration of IY-81149 caused a dose-dependent
      hypothermic effect up to 300 mg/kg and showed analgesic effect at 1000 mg/kg. IY
      81149 produced an antisecretory effect in pylorus ligated rats. The total gastric
      volume and acidity were significantly decreased at doses ranging from 1 to 3
      mg/kg. However, IY-81149 had no effects on general behavior, did not show
      anticonvulsant activity, and did not affect blood pressure and heart rate, LVP
      (left ventricular peak systolic pressure), LVEDP (left ventricular end diastolic
      pressure), LVDP (left ventricular developing pressure), DP (double product), HR
      (heart rate), CFR (coronary flow rate), smooth muscle contraction, respiration,
      intestinal transport and renal function. These findings demonstrate that IY-81149
      possesses weak central nervous system action and inhibitory effects on microsomal
      enzymes and gastric secretion after single administration. The results suggest
      that IY-81149 does not exert any notable pharmacological effects on the
      cardiovascular system, autonomic nerve system or smooth muscle function at all
      doses tested.

PMID- 11215327
TI  - Dose-related effects of controlled release dihydrocodeine on oro-cecal transit
      and pupillary light reflex. A study in human volunteers.
AB  - It is well accepted that long-term administration of opioids results in a dose
      related constipation. No data so far have demonstrated conclusively whether such
      constipation is also seen after intake of a controlled release formulation. It
      was therefore of interest to evaluate whether increasing doses of a controlled
      release formulation of dihydrocodeine (DHC, CAS 125-28-0) after oral
      administration also induces a dose-related increase in constipation.
      Additionally, it was of interest to study whether such a peripheral opioid
      related side effect is also seen in another, central receptor-mediated effect,
      the constriction of the pupil, at clinically relevant doses. Twelve volunteers
      were given controlled release DHC (60 and 120 mg, respectively) or placebo orally
      within a randomized, double-blind cross-over study. In order to determine the
      degree of constipation, oro-cecal transit time was measured using the H2
      exhalation test. Additionally, in order to evaluate a centrally mediated effect,
      the response of the pupil to light was quantified using the pupillary light
      reflex technique. Both, peripherally and centrally mediated effects were compared
      to placebo. DHC at both dosages induced a significant (p < 0.01) prolongation of
      oro-cecal transit time when compared to placebo. However, prolongation of oro
      cecal transit was not significantly longer when comparing the lower (60 mg) with
      the higher dose (120 mg). DHC also induced a significant (p < 0.005) depression
      of the pupillary light reflex from 53.9 mm (control) to 8.3 and 7.4 mm,
      respectively. Similar to intestinal transit, the pupillary light reflex was not
      significantly different among the two doses of DHC. Also, both dosages induced a
      similar amount of side effects. Tiredness and dry mouth were reported in 80%
      after both doses while vertigo was reported in 5% and 1% complained of headache.
      None of the volunteers reported nausea or emesis. It is concluded that opioid
      receptor sites, which are located in the plexus myentericus of the intestinal
      wall, are responsible for the delay in propulsion. Because of the controlled
      release of a fixed amount of DHC over time there is constant binding of the
      ligand followed by a constant conformational change of peripheral and central
      receptor sites. Thus constant release induces no dose-related increase in oro
      cecal transit and inhibition of the pupillary light reflex.

PMID- 11215328
TI  - Antimicrobial activity of new coumarin derivatives.
AB  - A preliminary exploration of coumarin analogs as novel antimicrobial agents was
      carried out to determine the basic features of the structure responsible for the
      observed biological activity. The substituents ester or carboxylic acid on the
      coumarin ring were needed to have potent inhibitory activity against both Gram
      positive and Gram-negative bacteria. The presence of phenolic hydroxyl group
      and/or carboxylic acid was necessary to possess higher activity against
      Helicobacter pylori.

PMID- 11215329
TI  - [Physical chemical, pharmacological and toxicologic properties  of fomocaine
      metabolites]  .
AB  - Fomocaine (4-[3-(4-phenoxymethylphenyl)-propyl]-morpholine, CAS 17692-39-6) is a
      highly effective local anaesthetic of low toxicity. The drug, which causes no
      allergic response, was introduced in the German Extrapharmacopoeia (DAC).
      Fourteen metabolites are formed after oral administration to rat and beagle dog.
      Less than 5% fomocaine are excreted unchanged. The metabolites were synthesized
      and their physico-chemical properties were investigated. No metabolite caused a
      surface or conduction anaesthesia with the exception of 2-hydroxyfomocaine (O/Se
      4). After topical and parenteral administration irritation could not be observed.
      All metabolites except O/Se 10 and O/Se 11 showed a lower toxicity than
      fomocaine. In both species O/Se 10 and O/Se 11 are formed only in a small amount
      and are detoxified by conjugation.

PMID- 11215330
TI  - Antifungal activity of some mono, bis and quaternary Mannich bases derived from
      acetophenone.
AB  - The development of resistance to current antifungal therapeutics drives search
      for new effective agents. Some Mannich bases have antifungal activity, but no
      information is available regarding the antifungal activity of acetophenone
      derived Mannich bases. Mono Mannich bases of acetophenone 1-3 were synthesized
      and converted into their corresponding bis derivatives, 5-7. Representative
      quaternary derivatives 4 and 8 were also synthesized. Antifungal activities of
      the compounds were evaluated using some yeasts and dermatophytes in vitro. Mono
      Mannich base 3 and quaternary compounds 4 and 8 were found to be 2-16 times more
      potent than the reference compound amphotericin B against dermatophytes:
      Trichophyton rubrum, Trichophyton mentagrophytes, and Microsporum canis.
      Compounds 4 and 8 were also found to be 2 times more effective compared with
      amphotericin B against the yeast Saccharomyces cerevisiae. Quaternization
      procedure improved the biological activity dramatically, whereas conversion of
      mono Mannich bases to corresponding bis derivatives generally did not affect
      antifungal activity. Our results suggest that acetophenone derived mono Mannich
      base 3 and quaternary derivatives 4 and 8 may serve as leading compounds for
      further studies to develop new antifungal agents with their highly potent
      antifungal activity.

PMID- 11215331
TI  - Immunopharmacological in vitro effects of Eleutherococcus senticosus extracts.
AB  - The objective of these investigations was to further elucidate the
      immunopharmacological profile of fluid extracts of Eleutherococcus senticosus and
      to identify the specific role of its characteristic eleutherosides B and E. An
      ethanolic dry extract of Eleutherococcus senticosus was used as starting material
      for the isolation of the eleutherosides B and E. Immunopharmacological studies
      included expression of major histocompatibility complex class I and II molecules
      by rat bone marrow-derived mononuclear phagocytes, human lymphocyte marker flow
      cytometry, and in vitro testing of human lymphocyte functions. In contrast to the
      isolated eleutherosides B and eleutherosides E and the re-mixed eleutherosides B
      and E, the whole ethanolic fluid extract of Eleutherococcus senticosus was able
      to induce and enhance interleukin-1 and interleukin-6 but not interleukin-2
      production in vitro. The effective concentration of the whole ethanolic extract
      ranged from 1.0-0.1 mg/ml for the enhancement of interleuking-1 alpha production
      and 1.0-0.03 mg/ml for the enhancement of interleukin-6 production. It is
      concluded that the observed enhancing immunopharmacological activities on acute
      phase response mediators are best exhibited by the induction with whole ethanolic
      extracts whereas the species-specific and characteristic eleutherosides B and E
      are not associated with these activities.

PMID- 11215332
TI  - Pharmacokinetics and pharmacodynamics of recombinant human erythropoietin in
      rats.
AB  - The pharmacokinetics and pharmacodynamics of recombinant human erythropoietin (rh
      EPO; CAS for EPO: 11096-26-7) after repeated intravenous and subcutaneous
      administrations in rats were studied. Administration of rh-EPO by both routes
      caused significant increases in hematocrit. The pharmacokinetics of rh-EPO after
      intravenous and subcutaneous administration exhibited nonlinearity. The
      pharmacodynamics of rh-EPO was analyzed using the maximum effect (Emax) and
      sigmoid maximum effect (sigmoid Emax) models. Both models involved the assumption
      that rh-EPO in plasma would stimulate the proliferation of erythroid progenitor
      cells. Akaike's information criterion for the Emax model was lower than that for
      the sigmoid Emax model, suggesting that the Emax model might be an optimal model.
      The rh-EPO concentration at which the effect is half of the maximum was 0.383
      ng/ml. This pharmacodynamic analysis suggests that the maintenance of effective
      plasma concentration might be important for the efficacy of rh-EPO.

PMID- 11215333
TI  - [Are uranium weapons to blame for leukemia cases? A little bit of atomic warfare
      in the Balkans? (interview by Dr. Beate Schumacher)].

PMID- 11215334
TI  - [Child abuse by the parents? Proper response].

PMID- 11215335
TI  - [Gastrointestinal reflux. When sour is not happy].

PMID- 11215336
TI  - [Sclerosing, coagulating, ligating... Managing hemorrhoids!].
AB  - Hemorrhoids are a pathophysiological consequence of hyperplasia of the corpus
      cavernosum recti, and can be classified into three grades of severity.
      Clinically, they usually manifest in the form of peri-anal bleeding, a diffuse
      sensation of discomfort, itching and secretion of mucus. The diagnosis is
      established on the basis of the dinical presentation. Treatment is mainly
      conservative, but is likely to be successful only in the early stages. Already
      second degree symptomatic hemorrhoids require definitive treatment. Although peri
      anal thrombosis is sometimes a very painful condition, it is usually harmless. If
      pain is severe, surgical incision is indicated.

PMID- 11215337
TI  - [Lesions around the rectum. Diagnosing and treatment abscesses and fistulas].
AB  - Anorectal abscesses and fistulas are among the most common anorectal lesions.
      They represent different phases of one and the same condition, the abscess being
      the acute manifestation, the fistula the chronic form. In the event of a strong
      suspicion, rapid referral to hospital, preferably one specializing in proctology,
      is indicated. The treatment of choice of both abscesses and fistulas is surgery.
      Abscesses are widely incised and decompressed. Fistulas showing signs of fresh
      secretion may be treated initially by the insertion of a thread, and subsequently
      undergo definitive surgical treatment. The surgical procedure is determined by
      the site of the fistula. Attendant risks include recurrence and incontinence.
      When fistulas occur in Crohn's disease, the indication for surgical treatment
      must be stringently applied. In the absence of complications, postoperative
      healing of the wound should be checked regularly.

PMID- 11215338
TI  - [An end to smearing! Detecting and treating rectal rectal and anal prolapse].
AB  - Rectal prolapse is defined as the invagination of the entire wall of the rectum
      into or through the lumen of the anal canal. In the main it is a disorder of
      elderly women. The leading symptom is a sensation of incomplete defecation.
      Patients commonly complain of incontinence of varying severity, tenesmus,
      unsuccessful straining, and the passage of blood and mucus in the stools. The
      diagnosis is based on the history and physical examination. Equipment-based
      diagnostic procedures serve treatment planning. For therapy, a range of
      possibilities are available. Anal prolapse is categorized as third-degree
      hemorrhoidal disease, and the diagnosis can be made by simple inspection.
      Reduction may be attempted during digital examination of the rectum. Treatment is
      determined by the clinical presentation.

PMID- 11215339
TI  - [Paths to sexual satisfaction. What will stimulate the tired man?].

PMID- 11215340
TI  - [Science or quackery? Complimentary medicine: mental healing].

PMID- 11215341
TI  - [Identification record for defibrillator patients. Basic documentation for ICD].

PMID- 11215342
TI  - [Disorders of thyroid function. Efficient diagnosis in general practice].

PMID- 11215343
TI  - [CD-ROM for malingerers. Deceiving the physician by simulation].

PMID- 11215344
TI  - [Instead of benzodiazepines. An antidepressant as sleep aid].

PMID- 11215345
TI  - [Diabetes and the heart. Sweet hearts beat for a shorter time].

PMID- 11215346
TI  - [Insulin analogs. More precise control for diabetic patients is possible].

PMID- 11215347
TI  - [When standard therapy fails. New therapy options in chronic hepatitis C].

PMID- 11215348
TI  - [Erectile dysfunction in coronary heart disease. No fear about the blue pill].

PMID- 11215349
TI  - [Stomach-saving "Coxibs". No reason for therapeutic risks].

PMID- 11215350
TI  - [The aging woman, an asexual being? Erotically more active than previously
      assumed].

PMID- 11215351
TI  - [Pain therapy. Which analgesics for elderly patients?].

PMID- 11215352
TI  - Bold approach curtails bronchitis antibiotic use.

PMID- 11215353
TI  - New outpatient procedures for GERD present alternatives.
AB  - Heartburn getting serious clinical attention. Gastroesophageal reflux disease, or
      GERD, can cause inflammation of the vocal cords or even cancer of the esophagus.
      But even the more prosaic symptoms should be enough to get clinicians to
      investigate these two new surgical interventions for heartburn.

PMID- 11215354
TI  - Heart failure intervention cuts return trips to hospital.
AB  - Hospitals collaborate to cut heart failure readmissions. A consortium of
      hospitals in New York state collaborate to reduce readmissions among their heart
      failure patients without compromising quality. The eye-opening part was
      discovering the cause of readmissions.

PMID- 11215355
TI  - Sickle cell center provides model for management of chronic disease.
AB  - Coordination, round-the-clock care reshapes sickle cell care. Sickle cell
      patients at Grady Health System in Atlanta know what it's like to be kept waiting
      interminably in the emergency department, sick and in pain. They even know how it
      feels to be mislabeled as drug addicts. No more. The Sickle Cell Center at Grady
      brings high quality care to such patients, improving outcomes, lowering costs,
      and increasing the satisfaction of those who use it.

PMID- 11215356
TI  - Boost outcomes--add a clinical pharmacist to the team.
AB  - Add a clinical pharmacist to the heart care team. Duke clinicians did, and found
      they could lower heart-failure related events as well as lower overall costs. The
      landmine is reorganizing the referral and care patterns in the hospital.

PMID- 11215357
TI  - [Therapy of active Crohn disease with Boswellia serrata extract H 15].
AB  - BACKGROUND: The purpose of this clinical trial was to compare efficacy and safety
      of the Boswellia serrata extract H15 with mesalazine for the treatment of active
      Crohn's disease. PATIENTS AND METHODS: Randomised, double-blind, verum
      controlled, parallel group comparison for which 102 Patients were randomised. The
      per protocol population included 44 patients treated with H15 and 39 patients
      treated with mesalazine. As primary outcome measure the change of the Crohn
      Disease Activity Index (CDAI) between the status of enrolment and end of therapy
      was chosen. H 15 was tested on non-inferiority compared to standard treatment
      with mesalazine. RESULTS: The CDAI between the status of enrolment and end of
      therapy after treatment with H15 was reduced by 90 and after therapy with
      mesalazine by 53 scores in the mean. In this non-inferiority-trial the test
      hypothesis was confirmed by the statistical analysis. The difference between both
      treatments could not be proven to be statistically significant in favor to H15
      for the primary outcome measure. The secondary efficacy endpoints confirm the
      assessment of the comparison of H15 and mesalazine. The proven tolerability of
      H15 completes the results of the shown clinical efficacy. CONCLUSIONS: The study
      confirms that therapy with H15 is not inferior to mesalazine. This can be
      interpreted as evidence for the efficacy of H15 according to the state of art in
      the treatment of active Crohn's disease with Boswellia serrata extract, since the
      efficacy of mesalazine for this indication has been approved by the health
      authorities. Considering both safety and efficacy of Boswellia serrata extract
      H15 it appears to be superior over mesalazine in terms of a benefit-risk
      evaluation.

PMID- 11215358
TI  - [Diagnosis and therapy of ulcerative colitis--results of an evidence-based
      consensus conference of the German Society of Digestive and Metabolic Diseases].

PMID- 11215359
TI  - [Guidelines of the DGVS. Clinical diagnosis. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215360
TI  - [Guidelines of the DGVS. Histopathological diagnosis. German Society of Digestive
      and Metabolic Diseases].

PMID- 11215361
TI  - [Guidelines of the DGVS. Nutrition. German Society of Digestive and Metabolic
      Diseases].

PMID- 11215363
TI  - [Guidelines of the DGVS. Fulminant process. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215362
TI  - [Guidelines of the DGVS. Acute process. German Society of Digestive and Metabolic
      Diseases].

PMID- 11215364
TI  - [Guidelines of the DGVS. Chronic active course. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215365
TI  - [Guidelines of DGVS. Remission. German Society of Digestive and Metabolic
      Diseases].

PMID- 11215366
TI  - Prospective study comparing human albumin vs. reinfusion of ultrafiltrate-ascitic
      fluid after total paracentesis in cirrhotic patients with tense ascites.
AB  - Although, total paracentesis associated with human albumin substitution has shown
      to be a rapid, effective and safe treatment of diuretic refractory ascites in
      advanced liver cirrhosis, it implies high costs and has a limited availability.
      Therefore an alternative procedure the reinfusion of concentrated ascites has
      gained popularity in recent years (Smart et al. 1990; Grazioto et al. 1997). It
      was the aim of the study to compare human albumin substitution vs. reinfusion of
      ascitic-ultrafiltrate after total paracentesis. 35 patients with cirrhosis and
      tense ascites received total paracentesis associated with either human albumin (5
      8 g/l ascites) (= group A) or reinfusion of an ascitic-ultrafiltrate fluid by
      means of hemofiltration technique (= group B). The mean volume of ascites removed
      was 9.41 (2.1-20.0) in group A and 11.41 (6.5-21.0) in group B. No significant
      differences in serum electrolytes, liver and renal function, coagulation profiles
      and hormones of the renin-angiotensin-aldosterone system were observed during
      hospitalization. In both groups sodium excretion increased significantly. 43% of
      the patients in group B developed pyrexia and chill after reinfusion of the
      ascitic-ultrafiltrate fluid. In one patient an anaphylactic bronchospasm occurred
      requiring IUC-treatment. The treatment cost in case of human albumin were 326.-DM
      vs. 290.-DM for each patient treated with ascitic-ultrafiltrate fluid reinfusion.
      The probabilities of hospital readmission and survival were similar in both
      groups during follow-up. The results indicate that i.v. infusion of ascitic
      ultrafiltrate fluid is as effective as total paracentesis and albumin infusion in
      case of diuretic refractory ascites. However, according to the costs of
      instruments and staff and due to the significant allergic reactions caused by
      ascitic fluid it cannot be considered as a real alternative to albumin
      substitution.

PMID- 11215367
TI  - [Guidelines of the DGVS. Prevention of carcinoma. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215368
TI  - [Guidelines of the DGVS. Surgical therapy. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215369
TI  - [Guidelines of the DGVS. Pouchitis. German Society of Digestive and Metabolic
      Diseases].

PMID- 11215371
TI  - [Guidelines of the DGVS. Psychosomatic aspects. German Society of Digestive and
      Metabolic Diseases].

PMID- 11215370
TI  - [Guidelines of the DGVS. Extraintestinal manifestations. German Society of
      Digestive and Metabolic Diseases].

PMID- 11215372
TI  - [Ultrasound diagnosis of Meckel diverticulitis in adults].
AB  - Meckel's diverticulitis is a rare disease. In addition to physical examination,
      abdominal ultrasound can help to pinpoint the diagnosis. By presenting a case
      report we would like to demonstrate the typical ultrasonographic findings in
      acute Meckel's diverticulitis and differentiate it from acute appendicitis. A 60
      year-old patient was admitted to our hospital with the diagnosis of acute
      appendicitis. Abdominal ultrasound was performed and a blind ending, liquid
      filled segment of small bowel in the right lower quadrant of the abdomen found.
      This segment was not compressible, no peristalsis was evident, nor was there any
      anatomical association with the cecum. Locally we found free fluid and hints of
      inflamed mesenteric fatty tissue. A perforated Meckel's diverticulum was
      diagnosed and confirmed intraoperatively. The major ultrasonographic difference
      between an inflamed Meckel's diverticulum and acute appendicitis is its
      anatomical location. In contrast to the appendix there is no association with the
      cecum. A diameter of up to 40 mm and a well-defined wall of small bowel with 3
      definite layers visible by ultrasound may help to distinguish between a Meckel's
      diverticulum and the appendix.

PMID- 11215373
TI  - [Secondary high-grade MALT lymphoma of the stomach in a 69-year-old patient with
      gastrocolic fistula].
AB  - A 69-year-old man was referred to our department with an exorbitant foetor ex
      ore, dysphagia and dyspepsia. Upper endoscopy had been performed prior by an
      outpatient gastroenterologist and the patient had received an eradication therapy
      for a Helicobacter pylori-induced gastritis. At admission upper endoscopy showed
      a gastric ulcer which drained a stinking fluid. Endosonography, computed
      tomography and an upper gastrointestinal series with water soluble media revealed
      a gastrocolic fistula. Multiple biopsies showed a low-grade gastric MALT
      lymphoma. Therefore, a surgical reconstruction with Roux-en-Y esophagojejunostomy
      and transverso-descendostomy was performed. The histology of the completely
      removed stomach revealed a high-grade Non Hodgkin Lymphoma (NHL) with parts of a
      low-grade NHL. 3 weeks after surgery chemotherapy was started with the CHOP
      regime which was well-tolerated by the patient.

PMID- 11215374
TI  - Oral zinc therapy in patients with supposed mild zinc deficiency--a critical
      review.
AB  - The importance of zinc in many processes of diseases remains unclear up today.
      Nevertheless many biochemical or clinical studies let support a high clinical
      relevance of trace elements especially zinc in the therapeutic concepts of
      diseases. Unfortunately the border between severe (or real) and mild (or
      subclinical) zinc deficiency is not clear defined. In addition methodical
      problems in determination of trace elements and misinterpretations of study
      results lead to unjustified assignment from several diseases in the group of zinc
      deficiency disorders. Another current problem is the consideration of
      bioavailability of oral commercial trace element products. Especially the
      regulation of zinc uptake in human under normal conditions and in case of zinc
      deficiency is not clear at this time. These problems let become tangled the
      actual literature for the clinical active physician at the field of zinc. In this
      mini review there is given an overview about published clinical studies with oral
      zinc supplementation in the past years.

PMID- 11215375
TI  - [Investigational new drugs among glycoprotein IIb/IIIa-receptor antagonists].
AB  - Glycoprotein IIb/IIIa receptors play an important role in platelet aggregation by
      binding fibrinogen. Drugs that antagonize this binding have been developed for
      the treatment of thrombotic diseases including acute coronary syndrome. These
      drugs are of four main types: [1] monoclonal antibody, [2] synthetized peptide,
      [3] non-peptide, and [4] oral antagonist. Since these drugs inhibit the final
      step in platelet aggregation, i.e., binding of fibrinogen to the platelet
      membrane, they were expected to 1) have high specificity for inhibiting platelet
      aggregation, 2) inhibit any kind of aggregation regardless of stimulation, 3)
      have high potency in aggregation suppression. As a result of large clinical
      trials, however, monoclonal antibody alone was revealed to be effective, but non
      peptide and oral antagonists were ineffective. The possible mechanisms that lead
      to such inefficiency are: 1) difference in binding duration to platelets, 2)
      concomitant suppression of other adhesion molecules beside IIb/IIIa, 3)
      difference in binding site in the receptor and presence of a partial agonist
      effect, 4) aggregation promotion or induction of apoptosis via caspase-3
      activation, 5) modified aggregation by gene polymorphism. New findings on
      platelet physiology through studying ways to overcome the above problems will
      lead to the development of new drugs and treatment.

PMID- 11215376
TI  - [Aggregation of human blood platelets by remnant-like lipoprotein particles].
AB  - The action of lipoprotein lipase on chylomicrons (CM) and very low density
      lipoproteins (VLDL) produces remnant lipoproteins (RLP) that are rich in
      triglycerides, cholesterol and apolipoprotein E (apo E). Apo E serves as a ligand
      for the LDL receptor and mediates uptake of RLP by macrophages, vascular wall and
      other cells that express the LDL receptor. Uptake of RLP can profoundly alter the
      physiology of cells and promote atherosclerosis and thrombosis. Like RLP, blood
      platelets also have roles in atherosclerosis and thrombosis; hence it is likely
      that RLP can influence platelet activity as well. Platelet aggregation was
      assessed by measuring the loss of single platelets. Apo E3/3-rich RLP derived
      from normal human plasma VLDL and CM were prepared by an immunoseparation method.
      At 2.5 to 10 microliters, RLP induced platelet aggregation that increased with
      the dose of RLP, but decreased it at 25 to 200 microliters. Unlike apo E3/3-rich
      RLP, apo E4/3 (heterozygous phenotype) rich RLP caused platelet aggregation in a
      dose-dependent manner, without producing a bell-shape dose-response relationship.
      Scanning electron microscopy revealed that activated platelets had adhered to and
      formed aggregates on the red cell membrane. The platelet response was unaffected
      by aspirin, but was inhibited by apyrase (an ADP scavenger), 2-chloroadenosine (a
      platelet ADP-receptor antagonist) and cilostazol, a phosphodiesterase type III
      inhibitor. It is thought that RLP cause leakage of ADP from red cells, which then
      mediates platelet aggregation.

PMID- 11215377
TI  - [New anticoagulants].
AB  - The quest to develop new antithrombotic agents has been stimulated by clinical
      needs and by advances in biotechnology that have made it possible to produce
      drugs that target specific steps in thrombogenesis. Established anticoagulants
      such as unfractionated heparin and the coumarins are effective, but have two
      major limitations: narrow therapeutic windows and highly unpredictable dose
      response relationships. Consequently, these drugs often cause complications such
      as serious bleeding that require close monitoring of their use by laboratory
      tests to balance safety and effect. These limitations provided the impetus for
      the development of new anticoagulants that inactivate thrombin, factor Xa, factor
      IXa or the factor VIIa/tissue factor complex. Similarly, agents that enhance the
      protein C anticoagulant pathway have also been developed. Of these, direct
      thrombin inhibitors, soluble thrombomodulin, protein C, and activated protein C
      have been evaluated clinically for parenteral administration. However, there is
      enormous interest in the development of safer and more effective oral
      anticoagulants. In the future, such orally active direct inhibitors of thrombin
      and factor Xa, if they can be given safely without the need for laboratory
      monitoring, may replace the coumarins for the long-term treatment of
      thromboembolic disorders. To achieve these goals, these compounds need high,
      consistent oral bioavailability.

PMID- 11215379
TI  - [Anti-thrombotic effect of activated protein C].
AB  - Protein C (PC) is an important anticoagulant protein in blood and converted to
      its active form, activated protein C (APC), by thrombin bound with
      thrombomodulin. APC exhibits an anticoagulant effect by the inactivation of FV a
      and FVIII a. In addition, APC exerts a profibrinolytic effect by inactivation of
      PAI-1 and inhibition of TAFI activation. APC is strongly anti-thrombotic because
      of its anticoagulant and profibrinolytic effect. APC has gamma-carboxyglutamic
      acid residues that bind to acidic phospholipids expressed on activated platelet
      or injured endothelial cells. Thus APC works only at the site where clots are
      formed and has a weak effect in primary hemostasis; this means that the use of
      APC is expected not to have any hemorrhagic risk. In both DIC animal models and
      clinical studies, we confirmed safer amelioration by APC than heparin. Recently,
      a specific receptor for PC/APC was found on endothelial cell membrane and anti
      inflammatory effects of APC were also reported. Thus APC is thought to play an
      important regulatory role in blood coagulation, fibrinolysis and inflammation,
      especially in thrombotic diseases.

PMID- 11215378
TI  - [Thrombomodulin].
AB  - Thrombomodulin (TM), a membrane-bound receptor for thrombin on the endothelial
      cell surface, contributes to the regulation of the coagulation system. TM is
      known to exist in human plasma and urine as soluble forms. We purified soluble TM
      from human urine (MR-33) and investigated the anticoagulant effects of MR-33 in
      vitro and in vivo. In human plasma, MR-33 inhibited not only the procoagulant
      activity of thrombin, but also the thrombin generation via accelerating the
      thrombin-catalyzed protein C activation. In rat disseminated intravascular
      coagulation (DIC) models, intravenous infusion of MR-33 improved the
      hematological abnormalities without excessive prolongation of APTT and bleeding
      time. Benefit (dose required for 50% inhibition of fibrinogen decrease: ED50) to
      risk (minimum dose required for significant prolongation of bleeding time) ratio
      was 1:27 for MR-33. Furthermore, the anticoagulant activities of MR-33 was
      independent of AT III activity, and MR-33 was effective on heparin-resistant DIC
      models with low AT III level in rats. Intravenous injection of MR-33 prevented
      the endotoxin-induced increases in TAT, TNF-alpha and IL-6 level and pulmonary
      vascular permeability in mice. These results indicate that MR-33 may be a
      clinically useful antithrombotic agent with reduced risk for hemorrhage, and this
      drug also has anti-inflammatory effects. Clinical trials of MR-33 for the
      treatment of DIC are now in progress in Japan.

PMID- 11215380
TI  - [Regulatory mechanism of fibrinolysis system by thrombin activatable fibrinolysis
      inhibitor (TAFI)].
AB  - Thrombin-activatable fibrinolysis inhibitor (TAFI) is a 60-kDa plasma protein
      that has been shown to be identical to plasma carboxypeptidase B (CPB) and
      carboxypeptidase U (CPU). TAFI is activated by thrombomodulin (TM)-bound thrombin
      and specifically removes the C-terminal Lys and Arg by its CPB activity. One of
      its target substrates is the C-terminal Lys residue in the alpha-chain of plasmin
      digested fibrin, which is critical for plasminogen binding to fibrin. Thus, its
      removal seems to be the main mechanism through which TAFI inhibits fibrinolysis.
      In this article, relevance of C-terminal Lys of plasmin-digested fibrin in
      fibrinolysis is described, and then possible roles of TAFI and TM-bound thrombin
      in a cross-talk between coagulation and fibrinolysis are discussed.

PMID- 11215381
TI  - [Pharmacological aspects of mammalian hibernation: central thermoregulation
      factors in hibernation cycle].
AB  - Hibernation in mammalians such as hamsters is a physiological state characterized
      by an extreme reduction of various functions such as body temperature and
      metabolism. Under such severe conditions, the central nervous system (CNS)
      activity is maintained at a functionally responsive level. Although hibernation
      is an interesting behavioral state, the physiological mechanisms of the
      introduction to and/or the arousal from hibernation have not been clearly
      defined. Intracerebroventricularly (i.c.v.) injected adenosine produces
      hypothermia in various animals. The effect of adenosine is generated by A1
      receptors and is caused by the suppression of the thermogenesis center of the
      posterior hypothalamus. At on ambient temperature of 5, i.c.v. injected N6
      cyclohexyladenosine (CHA) adenosine A1-receptor agonist induces profound
      hypothermia in hamsters. Although the time course of the descent of body
      temperature coincided with that of entry into natural hibernation, the effect was
      not antagonized by 8-cyclopentyltheophyllin (CPT), an adenosine A1-receptor
      antagonist. However, i.c.v. injection of CPT elevated the body temperature and
      interrupted hibernation, albeit the deep-phase (post-entry 30 h) was unaffected.
      This result suggests that a different system may suppress the thermogenesis
      center in the deep hibernation phase. Interestingly, i.c.v. injected thyrotropin
      releasing hormone (TRH) elevated the body temperature in both hibernation phases
      in hamsters. These findings suggest that the central adenosine and TRH play
      important roles in thermoregulation and that the new thermogenesis system,
      activating in low-body temperature, is induced in naturally hibernating animals.

PMID- 11215382
TI  - [Delayed emesis induced by the chemotherapeutic agent doxorubicin hydrochloride
      in dogs].
AB  - The occurrence of delayed emesis induced 24 h after the administration of a non
      platina chemotherapeutic agent, doxorubicin hydrochloride (doxorubicin), as well
      as behaviors such as feeding, drinking and defecation were examined in dogs. A
      single intravenous administration of 2 mg/kg doxorubicin induced emesis within 24
      h of administration in some dogs, while delayed emesis was observed 24 h after
      administration in all dogs. This delayed emesis emerged strongly at day 3 or 4
      and decreased at day 5. Hypophagia, the decreased frequency of drinking and the
      increased frequency of defecation were induced shortly after delayed emesis.
      Twenty-four hours after the administration of doxorubicin, a daily dose of 0.3
      and 1 mg/kg/day, p.o. azasetron, a 5-HT3 antagonist, was administered for 4 days.
      Doxorubicin-induced delayed emesis was observed to decrease by about 30 and 50%,
      respectively. This result suggests that 5-HT3 receptors play a role in the
      mechanism of delayed emesis. Azasetron was found to improve the increased
      frequency of defecation, but exerted no obvious effect on hypophagia or on the
      decreased frequency of drinking. Taken together, we suggest that doxorubicin
      induced emesis in dogs is a useful method to study further the mechanisms of
      delayed emesis and to investigate novel therapeutic agents against delayed
      emesis.

PMID- 11215383
TI  - [Legal matters in guardianship of adult patients with mental disorder].

PMID- 11215384
TI  - [Future task of the Japanese Society of Juvenile Psychiatry].

PMID- 11215385
TI  - [On the importance of the "decision-making model" view of diagnosis as a clinical
      framework in psychiatry].
AB  - After the advent of DSM-III, operational diagnostic criteria, along with the
      classification of disorders using such criteria, received considerable attention,
      and many studies on the reliability and validity of psychiatric diagnosis were
      conducted worldwide. Operational methodology was applied to diagnosis and
      classification, especially, in the area of research, and has contributed greatly
      to advances in reliable and refined clinical research. Such methodology, however,
      has not necessarily been accepted as a guiding principle in the area of clinical
      practice by all psychiatrists. Rather, some psychiatrists, especially more
      experienced psychiatrists, took a somewhat negative attitude toward the use of
      operational methodology. The author contends that one of the causes for the
      relatively poor acceptance of operational methodology in the area of clinical
      practice lies in the "classification model" view of diagnosis that forms the
      implicit background for the methodology. From a clinical perspective, it is not
      from the "classification model" basis but rather, from the "decision-making
      model" basis that the actual process of clinical diagnosis in psychiatry is
      explained properly. This is a very important point, because the latter model is
      potentially more useful both to psychiatric patients and to researchers in
      psychiatry than the former model. There have been however, few reports in
      psychiatry that highlight the importance of this model as the clinical framework.
      The author analyzes the limitations of the "classification model" view, and then,
      based on this analysis, lists prerequisites that a model for the framework of
      clinical practice should possess. The prerequisites listed are: that clinical
      information not sufficient to meet the disease criteria should be used as
      effectively as possible, that diseases low in probability but high in seriousness
      should be considered by clinicians in the differential diagnoses; that diagnosis
      should be readily changed when necessary; that the component of benefit to the
      patient should be included in the model; and that the relationship between
      nosological definition of diseases and practical diagnostic criteria should be
      explained explicitly. In addition, the author emphasizes that psychiatric
      diagnosis involves "decision-making under the condition of incomplete
      information", because most psychiatric diseases are still of unknown etiology.
      With all these conditions in mind, the author contends that the Bayesian
      statistical model of decision-making is suited to the frame of reference, and
      that it should replace the classification model as a guiding principle. This
      model can integrate various aspects of psychiatric clinical activities
      systematically and explicitly. A case is presented to illustrate the model in a
      clinical context. The author points out problems to be solved in current
      psychiatry from the perspective of the Bayesian model of decision-making.
      Finally, limitations of the Bayesian model view are discussed.

PMID- 11215386
TI  - [Retrospective and prospective view of psychiatry in Japan].

PMID- 11215387
TI  - [Working plan for the graduate education of psychiatry by committees of Japanese
      Society of Psychiatry].

PMID- 11215388
TI  - [Interdepartmental-rotation training of physicians in Japan--special reference to
      essentiality of psychiatry training].

PMID- 11215389
TI  - [Essentiality of graduate cross training in psychiatry].

PMID- 11215390
TI  - [Feasibility of graduate education in community psychiatric hospitals].

PMID- 11215391
TI  - [Midterm report on changing terminology of schizophrenia and the international
      trend].

PMID- 11215392
TI  - [Results of patient questionnaires on changing terminology of schizophrenia].

PMID- 11215393
TI  - [Clinical professional views on changing terminology of schizophrenia].

PMID- 11215394
TI  - [Care management views on changing terminology of schizophrenia].

PMID- 11215395
TI  - [Circumstances in changing terminology of mental retardation and the
      significance].

PMID- 11215396
TI  - [Future activities of the Committee for Changing Terminology of Mental
      Disorders].

PMID- 11215397
TI  - [Disruption of prepulse inhibition of acoustic startle as an animal model for
      schizophrenia].
AB  - Disruption of prepulse inhibition (PPI) of acoustic startle in rats has been
      widely used as an animal model for the sensorimotor gating deficit state usually
      found in schizophrenia. PPI was reported to be regulated by forebrain circuits,
      including mesolimbic cortex, nucleus accumbens, ventral pallidum, thalamus, and
      pedunculopontine tegmentum nucleus. Phencyclidine or dopamine agonists, which
      causes psychotomimetic symptoms in humans, disrupts PPI in animals. The ED50
      value of the drugs to reverse the phencyclidine-induced PPI disruption was
      significantly correlated with the affinity for the serotonin 2A receptor, but not
      for the dopamine D2 receptor of each drug (including atypical antipsychotics). In
      contrast, the ED50 value of the drugs to reverse the apomorphine-induced PPI
      disruption was significantly correlated with the affinity for the dopamine D2
      receptor (including typical antipsychotics). Thus the drug that antagonizes the
      disruption of PPI caused by PCP or DA agonists would be a candidate for a
      therapeutic agent for the sensorimotor gating deficit state in schizophrenic
      patients. Neural mechanisms underlying the disruption of PPI were reviewed.

PMID- 11215398
TI  - [On the role of glutamate within the locus coeruleus during the development of
      opioid dependence and on the expression of withdrawal from dependence on
      opioids].
AB  - The development of dependence with repeated use and the expression of withdrawal
      syndrome are characteristic features of all the opioids represented by morphine.
      Although many studies regarding several neurotransmitters and receptors have been
      conducted to define the mechanism involved in the development of dependence on
      opioids, the definitive evidence has still not been presented. Hyperactivity of
      noradrenergic neurons within the locus coeruleus has been proposed to play a
      critical role in the physiological and behavioral responses that comprise opioid
      withdrawal. Furthermore, much recent interest has been focused on the putative
      involvement of glutamate within the locus coeruleus, as one member of the
      excitatory amino acid neurotransmitter family, in the development of dependence
      on opioids, since several results obtained from a variety of molecular
      biological, electrophysiological, biochemical, and behavioral studies indicate
      that glutamate and its receptors participate in both the withdrawal-associated
      increase in neuronal activity of locus coeruleus and the expression of opioid
      withdrawal behaviors. Therefore the present review will evaluate a recent trend
      regarding the role of glutamate within the locus coeruleus during the development
      of opioid dependence and on the expression of withdrawal from dependence on
      opioids.

PMID- 11215399
TI  - [Successful treatment using low-dose carbamazepine for a patient of personality
      change after mild diffuse brain injury].
AB  - A 19-year-old male had a traffic accident while driving his motorbike and
      suffered an injury to the left frontotemporal part of the head. He remained
      conscious, had no focal neurological signs, and brain-computed tomography was
      unremarkable at the prefectural hospital, department of neurosurgery. Six months
      later he demonstrated a personality change, which was marked by irritability,
      aggression, labile moods, childishness, irresponsibility, and a lack of
      motivation. He sometimes made trouble for those around him, and he consulted our
      hospital 2 years and 9 months after the accident. He was diagnosed as having
      posttraumatic personality disorder and was treated with clonazepam, a dosage of
      up to 1.5 mg/day. Although his symptoms were moderately improved, he complained
      of sleepiness as an adverse effect. Carbamazepine (100 mg/day) was added in
      expectation of further improvement. Within a few days he improved to his
      preaccident personality. After the administration of clonazepam was discontinued,
      he maintained his good mental status. Now about two years after the initiation of
      therapy, he works in social welfare facilities and has no relapses. Even if a
      head injury is mild without definite organic signs in brain, it may have a
      possibility of causing personality change, which may be treatable.

PMID- 11215400
TI  - [Molecular mechanisms of differentiation and death of human neurons: with special
      reference to necdin and APP].
AB  - To elucidate the mechanisms underlying physiological development and
      neurodegenerative disorders of the human brain, information about molecular cell
      biology of human neurons is indispensable. Necdin, which is expressed in
      postmitotic neurons, binds to viral oncoproteins and the cell-cycle-related
      transcription factors E2F and p53. Ectopic expression of necdin in proliferative
      cells suppresses cell division. Necdin is expressed in neurons in
      phylogenetically old brain areas such as the brain stem and hypothalamus. The
      human necdin gene, which resides in the chromosome 15q11-q12 region, is not
      expressed in the Prader-Willi syndrome, suggesting that necdin is responsible for
      the pathogenesis of this genomic-imprinting-related neurobehavioral disorder. The
      Alzheimer amyloid precursor protein (APP) is a membrane-bound protein that is
      abundantly expressed in postmitotic neurons. The proteolytic processing of APP
      generates A beta, which is deposited in the brains of patients with Alzheimer's
      disease. APP is strongly expressed in neurons in phylogenetically new brain areas
      such as human association cortices. When APP is overexpressed in postomitotic
      neurons differentiated from human embryonal carcinoma by adenovirus-mediated gene
      transfer, it induces typical apoptosis through caspase-3 activation. Thus APP may
      be a proapoptotic molecule involved in neuronal death in Alzheimer's disease.

PMID- 11215401
TI  - [Neuronal cell damage in aceruloplasminemia].
AB  - Aceruloplasminemia is a newly recognized autosomal recessive disorder of iron
      metabolism that causes neurodegeneration of the retina and basal ganglia, as well
      as diabetes mellitus. The neurological symptoms in affected patients include
      involuntary movements, ataxia, and dementia reflecting the sites of iron
      deposition detected by MRI, and the regions of neurodegeneration observed at
      autopsy. Excess iron functions as a potent catalyst of biologic oxidation. CSF
      from affected patients revealed a threefold increased iron concentration
      associated with increased superoxide dismutase activity and lipid peroxidation
      products. We found that the amount of iron accumulated in various regions of the
      brain and visceral organs is correlated with the levels of the oxysterols,
      including 7-hydroxycholesterol, and 7-ketocholesterol, which are directly
      produced from cholesterol by active oxygen species. Positron emission tomography
      done on brains of aceruloplasminemia patients showed cortical glucose
      hypometabolism. Enzyme activities in the mitochondrial respiratory chain of the
      cerebral cortices of the patients were reduced to approximate 62% and 71%,
      respectively, for complexes I and IV. These findings suggest that iron-mediated
      free radicals contribute to lipid peroxidation and the impairment of
      mitochondrial energy metabolism in aceruloplasminemia.

PMID- 11215402
TI  - [Corticohistogenesis and Reelin signal cascade].
AB  - Corticohistogenesis follows highly regulated spatial and temporal patterns of
      cell proliferation, neuronal migration and neuronal differentiation to generate
      the characteristic cortical layers. We gained several insights into the
      mechanisms of the processes how a class of neurons attains an appropriate layer
      in developing neocortex. Using a neurological mutant mice reeler, we identified
      that the extracellular matrix protein Reelin that is specifically secreted from
      the Cajal-Retzius cells regulates the positioning of the cortical plate neurons.
      There has identified that Dab1 is one of the intracellular signaling components
      that respond to Reelin. Recently, three membrane proteins, apoER2, VLDLR and CNR
      are identified to bind Reelin. The double mutant--apoER2-/-; vldlr-/(-)--shows a
      phenotype indistinguishable from Reelin deficient mice. The CNRs are originally
      isolated through the interaction of their intracellular domain with Fyn, a member
      of the Src kinase family. The antibodies against Reelin or CNR disrupted Reelin
      CNR binding. These three classes of membrane proteins are thought to act in
      concert as components of the Reelin receptor.

PMID- 11215404
TI  - [Treatment of schizophrenia in the acute stage].

PMID- 11215403
TI  - [Evolution and update of detoxification techniques for opiate addicts].

PMID- 11215405
TI  - [Psychotherapy of delusion].

PMID- 11215406
TI  - [Stress coping and cognitive behavior therapy].

PMID- 11215407
TI  - [Employment and assistance in independent living].

PMID- 11215408
TI  - [Exaggerated expressed emotion, family intervention through psychological
      education, and drug therapy].

PMID- 11215410
TI  - [Regional life support system--practice at "Yadokari no Sato"].

PMID- 11215409
TI  - [Activities of the rehabilitation committee and a survey on group workshops].

PMID- 11215411
TI  - [Community participation and independence of the mentally handicapped].

PMID- 11215412
TI  - [Activities at "Step", a patients' advocacy center and problems in the future].

PMID- 11215413
TI  - [Problems related to regional support of patients in daily living].

PMID- 11215414
TI  - [The current status of personality disorders in psychiatry].
AB  - A growing body of research has elucidated the bio-psycho-social backgrounds and
      clinical facts of personality disorders defined in DSM-III-IV Axis II, and has
      endorsed the clinical value of the diagnoses. However, the concept of personality
      disorder still remains diaphanous, and requires further clarification. One
      complication is that personality disorder can be seen from either the perspective
      that is a milder variant of other Axis I disorders, or that it is an abnormally
      exaggerated form of normal personality traits. That the disorders can be grouped
      according to these viewpoints indicates that there may be heterogeneity within
      them, while they have common characteristics: a long duration, extended areas of
      affected functioning, subtle and marginal severity of symptoms, and "person-near"
      nature. These features may also account for the difficulty in defining and
      assessing the disorder. Treatment is another important focus for discussion.
      Patient-therapist cooperation is essential and of itself is a difficult goal.
      Most failures of the therapeutic relationship lead to a variety of problems,
      including legal or ethical ones. Prerequisites for involuntary treatment,
      remedies for the risk of treatment disruption by violent acting-out and
      preventing malpractice are issues to be discussed. Inexorably we must return to
      the principle that our task is to help our patients take ultimate responsibility
      for decisions about their personality.

PMID- 11215415
TI  - [On the improvement of everyday life behavior of chronic schizophrenic patients;
      from the viewpoint of "play-like behavior"].
AB  - In this study, the author examined the behavioral patterns of chronic
      schizophrenic inpatients to follow the process of the amelioration of abulic
      symptoms such as loss of interest, poverty of thought, lack of sociality, and
      poor communication. In everyday life in the ward, abulic patients had
      difficulties in accomplishing not only the basic habitual acts such as getting up
      or going to bed regularly, exchanging greetings, cleaning teeth, bathing, and
      washing clothes, but also their assigned duties on the ward. Furthermore, they
      were unable to behave according to the rules for inpatients, express their
      emotions appropriately, or build normal interpersonal relationship. The author
      found that five inpatients achieved some spontaneous behaviors of their own
      choices in the process of improvement in the above-mentioned habitual acts. As
      these spontaneous behaviors proceeded through several phases, obvious
      improvements in their behavioral patterns in everyday life were also observed.
      The initial phase of transient spontaneous behavior was followed by the second
      phase of continual spontaneous behavior. Finally, in the interview sessions, the
      patients became to express pleasurable emotions and physical feelings when they
      performed their own acts of continual spontaneous behavior. This phenomenon
      seemed valuable in the therapeutic context because schizophrenic patients are
      considered seldom capable of having positive feelings toward their own
      experiences. Therefore, these pleasurable continual spontaneous behaviors may be
      called "play-like behavior", as confirmed by comparison with the properties of
      "play" as defined by Caillois. In considering schizophrenic autism, Minkowski
      described "activite autiste" as an intrinsic quality of the way of life in
      schizophrenic patients. The manifestation of such quality in spontaneous
      behaviors can be regarded as having two meanings; an aspect of pathological
      acting out and a sign of recovery to realistic behaviors. Therapists should
      consider both aspects when conducting therapies. Although the patients regained
      the habits and norms of everyday life during hospitalization, the rules involved
      in "play-like" behavior seemed to contradict some rules in the habitual acts or
      assigned duties in their daily lives because within "play-like" behavior, freedom
      predominates over rules. The rules in "play-like" behavior are acquired mostly by
      mimicking other people. These rules are not fixed laws with penalties but are
      changeable rules depending on the circumstances of the behavioral process. From
      this viewpoint, "play-like" behavior allows the patients to acquire practical
      rules and to understand the relative nature of the rules. Most of the "play-like"
      behaviors originate from the preferences of the individual patients, which may be
      something that they have already experienced, something that they have longed
      for, or something that gives them self-fulfillment. These qualities contribute to
      the acquisition of experiences that they find pleasurable. For the patients,
      recalling each "play-like" behavior in the interview sessions enables them to
      grasp the whole picture of their behaviors, to reinforce their attachment to
      these behaviors as their own experiences, and to promote the dynamic process
      between behavior and thought. In this sense, psychotherapy incorporating the
      aspect of "play-like" behavior seems to prepare the schizophrenic patients to
      improve their way of thinking. To nurture "play-like" behavior helps the chronic
      schizophrenic patients to recover will power, independence and sociality, and
      contributes to the improvement of clinical symptoms and of daily life activities.

PMID- 11215416
TI  - [A patient with hemorrhage originating from an unknown coagulation pathway
      inhibitor].
AB  - The hemorrhagic disorders associated with circulating anticoagulant are rare but
      well known as the disease derived from inhibitors(alloantibody or autoantibody),
      which arise against specific coagulation factors. We encountered a patient with
      hemorrhage at the lower limbs originating from an unknown coagulation pathway
      inhibitor. Activated partial thromboplastin time(APTT) prolonged and cross mixing
      test indicated a coagulation pathway inhibitor. Levels of coagulation factors
      VIII, IX, XI, and XII were extremely low. Predonine therapy was effective to stop
      the hemorrhage. To clarify the inhibitor, we treated the patient's plasma with
      protein A Sepharose, and the factor VIII activity was recovered to a normal level
      after passing through the column. Gel filtration of the patient's plasma and
      protein A Sepharose adsorbed fraction of the patient's plasma with Superdex 200
      revealed that the inhibitor activity against blood coagulation eluted at the
      position of IgG, which was detected by the prolongation of APTT of normal pooled
      plasma. These data indicated that the inhibitor was IgG and its inhibitory
      spectrum was non-specific and broad. The results of laboratory tests and the
      clinical features in our patient were similar to those in a previous study by
      Dahlback(Blood 62, 218-225, 1983). The hemorrhagic abnormality of that patient
      was derived from the autoantibody to phospholipid, which inhibits the activation
      of prothrombin. An investigation into the effect of anti-phospholipid antibody in
      our patient is currently being performed in our laboratory.

PMID- 11215417
TI  - [Clinical cases of acquired coagulation inhibitors].
AB  - The acquired coagulation factor inhibitors are classified into alloantibodies,
      which appear in association with supplementary treatment for congenital
      coagulation factor deficiency, and autoantibodies, which are spontaneously
      produced. We report here 2 cases of acquired factor VIII inhibitor and 1 case of
      factor V inhibitor. Case 1: A 52-year-old woman noted swelling of the right
      parotid region in March 1988. Though contrast examination was scheduled, she was
      admitted for detailed examination due to a markedly prolonged coagulation time.
      An APTT correction test suggested that decreased factor VIII activity was due to
      the presence of an inhibitor. Since antinuclear antibody and SS-A antibody were
      positive and infiltration by lymphocytes in the salivary gland acini in a lip
      biopsy specimen was detected, Sjogren's syndrome was diagnosed. Case 2: A 33-year
      old woman had normal delivery of her second child in February 1998. In June 1998,
      she suffered slight contusion in the left lower limb. The affected site became
      swollen and painful, making walking difficult. Since both upper limbs became
      markedly swollen after 1 week, she visited our hospital. Prolonged APTT and a
      marked decrease in factor VIII activity were observed. Factor VIII inhibitor
      titer was high at 19 Bethesda units. Case 3: A 64-year-old man had had
      asymptomatic macroscopic hematuria since the beginning of August 1998 but was
      placed under observation since no abnormal findings were observed on various
      imaging tests. However, he was admitted to Osaka City General Medical Center
      because of vesicular tamponade. Factor V activity was markedly decreased to 1.0%.
      PT correction test suggested that decreased factor V activity was due to the
      presence of an inhibitor. The underlying disease could not be determined in this
      case. In patients with acquired coagulation inhibitors, bleeding symptoms are
      reported to be mild in many cases, and severe bleeding is rare. However, cases of
      death without severe bleeding or underlying disease have also been reported,
      indicating that the prompt diagnosis and treatment of this condition are
      necessary.

PMID- 11215418
TI  - [Clinical data obtained through coagulation testing suggests that hypothermia
      exerts influence on a patient's blood coagulation reaction].
AB  - It often takes longer to achieve hemostasis when performing an operation on a
      patient in cerebral hypothermia therapy than in a normal patient, despite the
      lack of abnormal clinical blood coagulation findings, and this study was
      conducted to investigate the cause of delays in coagulation in patients with
      hypothermia. In this study, 93 samples of plasma were collected at our center
      from 10 patients(7 men and 3 women; mean age, 33.7) who were in cerebral
      hypothermia therapy with a urinary bladder temperature maintained at 32-34
      degrees C. Each sample was divided into two, and PT(prothrombin time) and
      APTT(activated partial thromboplastin time) were measured at the normal analysis
      temperature of 37 degrees C in one sample, and at the hypothermia temperature of
      32-34 degrees C in the other sample. The results showed that PT and APTT tended
      to shorter at 37 degrees C, than those measured at 32-34 degrees C. Thus, we
      suggest that it is necessary to regulate the temperature of patients with
      accidental hypothermia or in whom hypothermia therapy is performed.

PMID- 11215419
TI  - [The examinations for diffuse lung diseases].
AB  - Diffuse lung diseases show an abnormal shadow that is widely scattered on the
      bilateral lung fields in the chest X ray view and includes many respiratory
      diseases such as the infectious or the non-infectious disease; neoplasms. Among
      these, idiopathic pulmonary fibrosis(IPF) has been studied extensively because of
      its high frequency and difficulty of treatment. IPF is defined by the respiratory
      functions, the radiological findings, which depend on HRCT, and the
      histopathological evaluation by surgical lung biopsy. In particular, the
      histopathological appearance of usual interstitial pneumonia(UIP) is essential
      for the diagnosis of IPF. Most serum examinations such as angiotensin-converting
      enzyme, anti-nuclear antibodies are applied to rule out other diffuse lung
      diseases. SP-D or KL-6, which is the marker of the type II epithelial cells, is
      thought to be very useful for revealing the disease activity, but since it is not
      increased in the early stages of IPF, it is not applied in the diagnosis of IPF.
      The definitive serum examinations for the diagnosis or determinations of the
      therapeutic effect or prognosis of IPF have not been established. Easier, more
      useful and critical examinations including genetic diagnosis are required to
      manage patients with IPF.

PMID- 11215420
TI  - [Clinical examinations for COPD].
AB  - The natural history of COPD such as pulmonary emphysema demonstrates that FEV1
      rapidly declines in smokers who are susceptible to cigarette smoke. The
      susceptible smokers who quit smoking do not regain only a little, but the rate of
      the FEV1 decline is no longer steep. These have been interpreted that early
      detection of this obstructive impairment is the most important issue to prevent
      the progression to severe emphysema. Pulmonary function tests, at least a measure
      of FEV1, in the all middle-aged smokers have been particularly recommended. The
      smokers with abnormal FEV1 defect should be advised to quit smoking. In moderate
      and severe cases, after staging of the disease by pulmonary function and exercise
      tests, assessments of complicated factors such as eosinophilic bronchitis are
      clinically important for constructing therapeutic strategies. Asthmatic component
      can be assessed by eosinophil count in the sputum and/or reversibility of the
      pulmonary function after challenging of bronchodilater inhalations. In the severe
      stage of the disease, examinations such as arterial blood gas analysis and pulse
      oxymetric measure are critical because oxygen therapy for the patients with
      respiratory failure has been known to improve survival prognosis. Portable
      devices which can assess arterial oxygen saturation during daily activity will be
      useful to decide its indication or to titrate oxygen. In conclusion, clinical
      examination in COPD, particularly in pulmonary emphysema in this paper, should
      appropriately be planned in each stage of the disease, or in each clinical
      purpose.

PMID- 11215421
TI  - [Tests for bronchial asthma].
AB  - One characteristic feature of bronchial asthma is an allergic inflammation of the
      airways involving eosinophil activation. Since adhesion molecules, cytokines, and
      chemokines play a critical role in eosinophil infiltration into the tissues, it
      is of paramount importance to utilize these inflammation-related factors as
      clinical parameters to assess the status of asthma. For this reason, we measured
      the level of RANTES and soluble ICAM-1 in patients with asthma. The concentration
      of plasma RANTES was significantly elevated in asthmatic patients as compared
      with normal subjects. Patients with asthma attacks exhibited higher RANTES levels
      than those in remission. sICAM-1 concentration was also higher in serum and
      sputum in patients with asthma than in healthy subjects. In order to detect
      eosinophil activation directly, we studied intracellular EG2 expression in
      eosinophils using whole-blood flow-cytometric analysis. The number of EG2
      positive eosinophils was significantly greater in patients with attacks than in
      asymptomatic subjects. We measured the temperature of expiratory flow and
      temperature flux as an alternative approach to assess airway inflammation. This
      study was based on a concept that inflammation would produce heat resulting in
      the higher temperature. The coefficient of temperature flux was significantly
      greater in asthmatic patients than in normal controls. Therefore, these new tests
      may be useful for the evaluation and treatment of allergic inflammation in
      asthma.

PMID- 11215422
TI  - [Recent progress in the diagnosis of respiratory disease: respiratory infection].
AB  - In Japan, molecular diagnostic techniques and some other diagnostic tools for
      respiratory infections have been clinically introduced and their use has spread
      in recent years. In particular, PCR is now commonly used even at the clinical
      microbiology laboratory level, because PCR based direct detection of infectious
      disease from various clinical specimens has some advantages over other diagnostic
      methods. Since PCR is a highly sensitive, specific, rapid method and suitable for
      slow-growing or culture-difficult pathogens, we must take care in regard to the
      risk of contamination, the possibility of false-negative results by various PCR
      inhibitors in the clinical sample, or unstable sensitivity easily influenced by
      the quality of samples and DNA extraction step.

PMID- 11215423
TI  - [Clinical examinations on lung cancer].
AB  - The incidence of lung cancer is increasing in Japan and it is important to know
      whether a patient has a history of primary smoking/second-hand smoking because
      smoking is the main cause of lung cancer. Lung cancer is often found on chest
      roentgenography. In order to determine the strategy of the treatment, the stage
      of the disease can be studied by the examinations of morphology(chest computed
      tomography), pathology(biopsy under bronchoscopy) and biochemistry(tumor markers
      and genetic analysis). Most lung cancers are detected in the advanced stage with
      metastasis. Performance status should be useful for the estimation of the
      prognosis of patients. In the symposium, we reported two of our clinical cases,
      in which urinary deoxypyridinoline, a bone absorption marker, facilitated the
      discovery of the bone metastasis of lung cancers with negative bone scans. We
      were requested to verify the early diagnosis of lung cancers with a collection of
      data on morphology, pathology and biochemistry.

PMID- 11215425
TI  - [Practice and application of evidence-based medicine].
AB  - Evidence-based medicine is an approach to clinical practice that aims to solve
      the patient's problems. EBM includes five steps: identifying patient's problems,
      searching medical literature efficiently, critically appraising the
      literature(evidence), applying it to patient care, and self-assessment of these
      steps. Since September 1999, we have practiced the EBM approach to patient care,
      in inpatient and outpatient settings at the department of General Medicine of
      Saga Medical School. We found ourselves more clearly differentiating between the
      EBM approach and past conventional practice. We found EBM to be more clinically
      useful and we have enjoyed reading medical literature because of the focus on
      patient's problems. To improve our use of the EBM approach, we need to study more
      about clinical epidemiology to evaluate and use medical literature in patient
      care.

PMID- 11215424
TI  - [Introducing EBM for postgraduate training].
AB  - The introduction of Evidence-based medicine(EBM) for residency training is
      recommended by the Japanese Society of Internal Medicine. At our hospital, we put
      the emphasis on learning vital clinical epidemiology through clinical experience.
      When educating EBM to our residents, we especially focus on the diagnostic
      process, because the knowledge of clinical epidemiology is useful while making
      the diagnosis and evaluating the diagnostic hypothesis. In our daily conference
      among residents and medical educators, the logic of clinical epidemiology is used
      for evaluating the validity of clinical judgment on diagnosis. We suggest three
      components upon making a diagnosis: 1. Always suspect a particular disease when
      ordering a laboratory test 2. Know the sensitivity and specificity of the test 3.
      Apply the test result in order to reevaluate the pretest hypothesis In this
      article, interaction among staff and residents are presented and discussed with
      these components in our minds. By repeating these interactions, the residents
      will be able to understand the importance of EBM and will be able to apply it in
      the clinical practice.

PMID- 11215426
TI  - [Nosocomial infection monitoring system featuring detection of local clustering].
AB  - We have developed a nosocomial infection surveillance system making use of data
      from laboratory information system. The system makes cross-reference table of
      detected bacteria according to either the site of occurrence(hospital wards) or
      antibiotic sensitivity. It is capable of listing all the patients or serial
      changes in frequency for any specified bacterium. Furthermore, we have developed
      an algorism to detect local clustering. For each ward, the system calculates all
      combinations of distance between beds of patients with specified bacteria. We
      named the statistics as DC(degree of cluster) and its significance was judged by
      a confidence interval of DC obtained by a bootstrap method by randomly assigning
      the same number of patients to the beds in the same wards. Retrospective analysis
      of the distribution of 4 major bacteria in the wards proved that DC is a
      sensitive indicator of local clustering.

PMID- 11215427
TI  - [Homogenous low-density lipoprotein assay in type III hyperlipoproteinemia].
AB  - To investigate whether homogenous analysis of serum low-density lipoprotein
      cholesterol(LDL-C) was applicable in type III hyperlipoproteinemic subjects, 3
      reagents were used to estimate LDL-C in 2 cases with apoE 2/2 phenotype. Each
      measurements were compared to LDL-C levels by ultracentrifugation(density: 1.019
      1.063). LDL-C levels by homogenous analysis with any of the reagents were higher
      than those by ultracentrifugation, and the difference was varied between the
      reagents: +14-24% by LDL-EX, +29-55% by Cholestest LDL, and +89-115% by
      Determiner LDL-C. The cross-reaction by the reagents to intermediate density
      lipoprotein(IDL) and very low density lipoprotein(VLDL) cholesterol was studied
      in a case; 22% of cholesterol in these fractions was measured by LDL-EX, 32% by
      Cholestest LDL, and 110% by Determiner LDL-C. A part of the sample serum was
      stored at -60 degrees C for several days and melted for re-analysis of homogenous
      LDL-C levels. After the freezing process, IDL fraction pattern on electrophoresis
      had been changed and homogenous LDL-C levels by all reagents were different from
      the measurements of native serum. These results indicated that using reagents
      with low cross-reaction to IDL and VLDL fractions and careful sample handling are
      important in homogenous LDL-C analysis in type III hyperlipoproteinemia.

PMID- 11215428
TI  - [Clinical utility of transcription mediated amplification-hybridization
      protection method(TMA-HPA) for the detection of HBV DNA: a comparison with the
      branched DNA probe assay].
AB  - The clinical utility of the TMA-HPA method for the detection of HBV DNA was
      evaluated by comparing results with the branched DNA probe(b-DNA) assay. Sera
      from 135 biopsy-confirmed HBV carriers were included in the study. Dilution tests
      with two representative sera revealed the sensitivity of the TMA-HPA method to be
      100-fold higher than that of the b-DNA assay. Among the 135 test sera, HBV DNA
      measurements obtained by the two assays showed a high degree of correlation(r =
      0.861, p < 0.0001). Of the 72 sera which tested positive for HBe antigen, 71 and
      67 were positive for HBV DNA when tested by TMA-HPA and b-DNA assay,
      respectively. In contrast, of the 63 which tested negative for HBe antigen, 42
      were positive for HBV DNA when tested by TMA-HPA, and only 19 were positive when
      tested by b-DNA assay(p < 0.05). Among HBe antigen-positive HBV carriers, HBV DNA
      levels as determined both TMA-HPA and b-DNA assay showed an inverse relationship
      with pathological stage, but among HBe antigen-negative HBV carriers, no such
      tendency was observed. Based on these results, it is felt that the detection of
      HBV DNA by TMA-HPA is useful for the evaluating anti-viral therapeutic effect in
      HBV carriers, and in estimating a prognosis.

PMID- 11215429
TI  - [Anesthesiology in the new century].

PMID- 11215430
TI  - [Perioperative care for transplantation recipients(discussion)].

PMID- 11215431
TI  - [Physiological monitoring in the new century(discussion)].

PMID- 11215432
TI  - [Body temperature control in Perioperative period].

PMID- 11215433
TI  - [Blood coagulation disorders and anesthesia].

PMID- 11215434
TI  - [Basic and clinical studies on chronic pain and the diagnosis with drug challenge
      test].

PMID- 11215435
TI  - [Anesthetic management in great vessel operations].

PMID- 11215436
TI  - [Knowledge of drug interactions necessary to anesthetic managements].

PMID- 11215437
TI  - [Management of postoperative pain in pediatrics].

PMID- 11215438
TI  - [Perioperative care for surgical patients with endocrine disorders].

PMID- 11215439
TI  - [Evaluation of intraoperative tissue ischemia and the anesthetic management].

PMID- 11215440
TI  - [Opioid and pruritus].

PMID- 11215441
TI  - [Postoperative central nervous system disorders and the management].

PMID- 11215442
TI  - [Perioperative anesthetic management for surgical patients with respiration
      disorders].

PMID- 11215443
TI  - [Role of vasoconstrictor agents in anesthesiology and the effects on other
      physiological functions].

PMID- 11215444
TI  - [Introduction of bupivacaine as spinal anesthetic agents].

PMID- 11215445
TI  - [Balanced anesthesia in the 21st century(discussion)].

PMID- 11215446
TI  - [Recent studies in anesthesiology--special reference to respiration(discussion)].

PMID- 11215448
TI  - [Medical treatment and medicine in the 21st century: medicine and human beings].

PMID- 11215447
TI  - [Women physicians and anesthesiology(discussion)].

PMID- 11215449
TI  - [Analgesic management in the new century--special reference to opioids, NSAIDs,
      and local anesthetics(discussion)].

PMID- 11215450
TI  - [Retrospect of anesthesiology in last century and prospects on the
      future(discussion)].

PMID- 11215451
TI  - [Emergency medicine in the new century(discussion)].

PMID- 11215452
TI  - [Various tasks suggested for intensive care in the new century(discussion)].

PMID- 11215453
TI  - [Recent progress on studies of anesthesiology--cardiovascular
      circulation(discussion)].

PMID- 11215454
TI  - [Epidural anesthesia and spinal anesthesia in the new century(discussion)].

PMID- 11215456
TI  - [Liver transplantation in Japan].

PMID- 11215455
TI  - [Perioperative care for surgical patients with respiratory tract disease-
      preparation of the guideline(discussion)].

PMID- 11215457
TI  - [Expectation on liver transplantation: discussion].

PMID- 11215458
TI  - [Multicentric Castleman's disease with reversible left ventricular diffuse
      hypokinesis].

PMID- 11215459
TI  - [Adult T-cell leukemia/lymphoma following Sjogren's syndrome].

PMID- 11215460
TI  - [Multiple cystic adenocarcinoma of the lung].

PMID- 11215461
TI  - [Non-producer Multiple myeloma].

PMID- 11215462
TI  - [Aortic valve infective endocarditis due to Campylobacter fetus].

PMID- 11215463
TI  - [Drug-induced pulmonary diseases and clinical practice].

PMID- 11215464
TI  - [Mechanism of the development of fibrosis in dermal and visceral sclerosis].

PMID- 11215465
TI  - ["Domino" transplantation].

PMID- 11215466
TI  - [Collagen diseases and multiple drug resistance genes].

PMID- 11215467
TI  - [Liver transplantation from brain dead patients].

PMID- 11215468
TI  - [Primary sclerosing cholangitis].

PMID- 11215469
TI  - [Primary biliary cirrhosis].

PMID- 11215470
TI  - [Disease conditions and indications for liver transplantation].

PMID- 11215471
TI  - [Metabolic liver diseases].

PMID- 11215472
TI  - [Type B liver cirrhosis].

PMID- 11215473
TI  - [Type C liver cirrhosis].

PMID- 11215474
TI  - [Liver transplantation in fulminant hepatitis--from the viewpoint of a
      transplantation specialist].

PMID- 11215475
TI  - [Liver cancer].

PMID- 11215476
TI  - [Pathology of liver transplantation].

PMID- 11215477
TI  - [Postoperative care and complications].

PMID- 11215478
TI  - [Partial liver transplantation from living donors].

PMID- 11215479
TI  - [Artificial liver].

PMID- 11215480
TI  - [Blood group genes].
AB  - Blood group antigens are surface markers on the red blood cell membrane.
      Biochemical analysis of blood group antigens has shown that these antigens divide
      into two types of proteins and carbohydrates attached to lipids or proteins.
      Protein determinants are directly coded on blood group genes, while carbohydrate
      determinants are controlled through the expression of glycosyltransferase
      enzymes. For the past ten years, considerable information has been gained from
      molecular studies of many blood group systems, thereby clarifying several aspects
      of these genes, genetic backgrounds of variants, and molecular evolution.
      Additionally, it has become possible to genotype blood groups and to genetically
      engineer the expression of protein antigens and the activity and specificity of
      enzymes. ABO system on the carbohydrate and Rh system on the protein are the most
      important systems in transfusion medicine. In this paper, we will review recent
      progress in the field of blood grouping; mainly ABO and Rh.

PMID- 11215481
TI  - [Neuroimaging and electrophysiological study in epilepsy].
AB  - There exist various morphological and biochemical changes closely associated with
      electrophysiological phenomena which cause epileptic seizures in the brains of
      epilepsy patients. Recent developments in investigation methods, not only
      electrophysiological(EEG and MEG), but also neuroimaging involving morphological
      imaging(CT and conventional MRI) and functional imaging(SPECT, PET, functional
      MRI and MRS) is able to demonstrate these changes. SPECT and PET can particularly
      clarify the changes of cerebral blood flow and glucose metabolism between
      interictal and ictal periods. In our experience of 423 patients who underwent
      epilepsy surgery for intractable seizures, these interventions provide important
      information to identify the epileptogenic foci. However, in practice, discordance
      in the results of these presurgical evaluations is recognized, and invasive
      intracranial recordings are needed in such cases. These problems in diagnosis
      were shown especially in patients with mesial temporal sclerosis and focal
      cortical dysplasia. To detect an epileptogenic focus more clearly, a combination
      of morphological and functional findings, new functional imaging such as
      neurotransmitter receptor imaging, EEG-triggered or neuropharmacological
      functional MRI, as well as, statistical parametric analysis may be needed.

PMID- 11215482
TI  - [Clinical significance of serum LpA-I levels measured by immunoturbidimetric
      assay in type 2 diabetes mellitus patients].
AB  - Previously, we developed an immunoturbidimetric assay method for lipoprotein A
      I(LpA-I) on sera pre-absorbed with anti-apolipoprotein A-II. In the present
      study, correlations between serum lipoprotein A-I and other serum parameters
      levels were examined and LpA-I levels were studied in patients with type 2
      diabetes mellitus. The serum levels of LpA-I did not correlate with those of
      diabetic markers such as fasted blood glucose, glycohemoglobin(HbA1c) and
      fructosamine, but correlated well with the levels of total cholesterol and HDL
      cholesterol, phospholipids, apolipoprotein A-I and seemed to correlate inversely
      with arteriosclerosis index. In patients with type 2 diabetes mellitus, LpA-I
      levels were significantly lower than those in normal subjects. Especially, LpA-I
      levels of patients with diabetic complications were significantly lower than
      those in normal subjects and non-complicated diabetic patients. Then, the
      measurement of LpA-I levels in patients with type 2 diabetes mellitus was
      considered to be useful for prevention and management of arteriosclerosis.

PMID- 11215483
TI  - [The ratios of apoC-III/apoC-II in normal full-term maternal bloods and their
      umbilical cord bloods].
AB  - In this paper, serum concentrations of CII and CIII in MB(n = 12) represented
      158% and 237% of those in 20 specimens of normolipidemic venous blood from
      healthy fasting non-pregnant females(Control), and the CIII/CII ratio of MB(mean
      +/- SD = 3.6 +/- 0.4) was significantly higher than that of the Control(2.38 +/-
      0.42). While the difference between the serum CII level in MB and that of 14
      specimens of postmenopausal patients lipid-matched to MB(postM HL) was not
      significant, serum CIII concentration of MB was significantly higher than that of
      postM HL. Furthermore, while the difference between the CIII level in apoB
      containing lipoproteins of MB and that of postM HL was not significant, the CIII
      concentration in HDL(HDL-CIII) of MB was significantly higher than that of postM
      HL. It was suggested that the effect of pregnancy on apoC levels which change in
      parallel with the TGs level might reflect the selective increase in HDL-CIII
      concentration. In addition, the positive correlation between HDL-CIII and apoA-I
      concentration in MB was significant. However, it has been reported that the
      CIII/CII ratio of patients with type III hyperlipidemia treated with estrogens
      had been successively increased, and it was also reported that estrogens
      stimulate the synthesis of CIII in hepatocytes. It was thus suggested that
      maternal CIII as well as apoA-I might be selectively overproduced in the liver by
      stimulation from increased endogenous estrogens during normal pregnancy. On the
      contrary, the serum concentrations of CII and CIII in UCB represented 71% and 55%
      of those in Control, and the CIII/CII ratio of UCB(1.87 +/- 0.5) was
      significantly lower than those of the Control. In UCB, the positive correlation
      between CIII and TGs was weak(p < 0.1) and CII did not correlate with markedly
      decreased TGs. Serum concentrations of CII, CIII and the ratio of CIII/CII in MB
      did not correlate with those in UCB, respectively. Moreover, birth weight and
      birth length of neonates positively correlated with concentrations of TGs, CII
      and CIII in MB, respectively, but not in UCB. In conclusion, the increased
      maternal CIII/CII ratio is due to the estrogen-induced raise of CIII while the
      reduced neonatal CIII/CII is related to the decrease in TGs. These observations
      suggest that fetal TGs-rich lipoprotein metabolism is not affected by maternal
      lipoprotein metabolism.

PMID- 11215484
TI  - [Development for the determination of band 5b tartrate-resistant acid phosphatase
      activity in serum].
AB  - Band 5 Tartrate-resistant acid phosphatase(TRACP; EC 3.1.3.2) consists of two
      isoenzymes, bands 5a and 5b, of which band 5b TRACP, an enzyme expressed in bone
      resorbing osteoclasts, is secreted into the circulation during bone resorption.
      Band 5b TRACP was measured kinetically in serum as tartrate-resistant fluoride
      sensitive heparin-resistant ACP with 2,6-dichloro-4-acetylphenyl phosphate as
      substrate at pH6.6. The within-run(n = 20) and between-run(n = 20) CVs of band 5b
      TRACP activity were 3.3-5.8% and 5.0-7.3%, respectively. The reference range of
      band 5b TRACP activity in males(n = 72) and females(n = 87) 20-39 years of age by
      this method were 3.7-12.5 U/l and 2.7-9.9 U/l, respectively. The band 5b TRACP
      value was significantly higher in post-menopausal women compared with the
      menstruating women. The relationship of band 5b TRACP and ultrasound findings in
      healthy women aged 31-75 years(n = 139) were inversely correlated with
      stiffness(r = -0.401), speed of sound(SOS; r = -0.386) and broadband ultrasound
      attenuation(BUA; r = -0.338). These results suggest that band 5b TRACP may be a
      useful in the evaluation of bone turnover.

PMID- 11215485
TI  - [Assay for determination of the serum procalcitonin level: biochemical and
      clinical evaluation].
AB  - In patients with inflammatory conditions such as infection, cytokines induce the
      production of C-reactive protein(CRP) and serum amyloid A protein(SAA) in hepatic
      cells. It has been reported that upon viral infection, the serum SAA level
      increases by a greater degree than the serum CRP level. Procalcitonin (PCT), the
      precursor of calcitonin, is a new type of inflammatory marker that is
      specifically induced by bacterial infection, sepsis and lethal multiple organ
      failure, but not by viral infection, autoimmune diseases, tumors or surgical
      stress. To evaluate the immunoluminometric assay(LUMI test PCT; Brahms
      Diagnostics, Berlin, Germany) procedure for determining the PCT level and to
      study the clinical significance of the serum PCT level, we determined the serum
      levels of PCT, CRP and SAA in patients with various inflammatory diseases and
      normal subjects. The serum PCT level in the normal subjects was < 0.3 ng/ml.
      Among the patients with inflammatory disease who had a high CRP level(CRP > 20000
      micrograms/dl), the PCT level was elevated only in those patients with severe
      bacterial infection. These results suggest that determining the PCT level may be
      useful in the differential diagnosis of severe bacterial infection. The patients
      who had a low CRP level(CRP < 150 micrograms/dl), had a PCT level within the
      normal range. The patients with autoimmune disease, viral infection, and fungal
      infection did not have an elevated PCT level.

PMID- 11215486
TI  - [Decreased growth hormone secreting cells of the hypophysis in senile cachexia].
AB  - Basic morphometry of the pituitary gland in aged patients with cachexia was
      performed. In 10 control specimens, growth hormone(GH) cells accounted for 42.9
      +/- 3.4% of the total, compared with 33.8 +/- 7.0%(p < or = 0.01) in patients
      with severe cachexia senilis. ACTH cells accounted for 16.0 +/- 7.4% in the
      control group and 14.1 +/- 9.0% in the senile cachexia group(p > or = 0.1). The
      mean pituitary weight was 0.60 g in control cases and 0.46 g in cases of extreme
      cachexia(p < or = 0.01). In the hypophyses of patients with senile cachexia,
      atrophy of GH cells and increase of the fibrous stroma were also prominent. The
      ratio of the summarized value for total GH cells in cachexia senilis patients and
      controls was 1:2.2. The difference was regarded as sufficiently large to be a
      causative factor in the establishment of cachexia senilis.

PMID- 11215487
TI  - [Pathological, cytological and immunohistochemical study of normal-sized ovary
      carcinoma syndrome].
AB  - Normal-sized ovary carcinoma syndrome(NOCS) is characterized by diffuse
      metastatic malignant disease of the abdominal cavity in females, with normal
      sized ovaries, and no origin assigned definitively by intraoperative evaluation.
      To elucidate the characteristics of NOCS arising from ovarian carcinoma, we
      investigated the immunohistochemical reactivities of keratin, epithelial membrane
      antigen(EMA), vimentin, and proliferative cell nuclear antigen(PCNA) in 4 cases
      of ovarian carcinoma with NOCS(NOCS group), including 3 cases of serous surface
      papillary adenocarcinoma(SSPC) and 1 case of small ovarian primary serous
      papillary adenocarcinoma(SPC). These cases were compared with 3 cases of ovarian
      carcinoma without NOCS(non-NOCS group), including 3 cases of SPC. Cytological and
      histological testing of the NOCS and non-NOCS groups showed the same findings.
      Similar reactivities for keratin, EMA and vimentin were observed in the NOCS and
      non-NOCS groups. No significant change of PCNA labeling index between the groups
      was seen. However, clinical stage of the NOCS group was higher than that of non
      NOCS group. It was hypothesized that exposure of cancer cells to peritoneal
      cavity in ovarian SSPC leads to the spread. In NOCS case arising from small-sized
      ovarian carcinoma, another factor was thought to be involved, such as genetic
      alteration, but it is not known.

PMID- 11215488
TI  - [Analysis of unusual late responses of peripheral nerves].
AB  - F-waves are routinely evaluated in nerve conduction studies on proximal
      peripheral nerves. However, unusual late responses other than F-waves that show
      variation in latency and configuration sometimes confound evaluation of the F
      waves. The unusual late responses were analyzed in this study. In two patients
      with cervical radiculopathy, two patients with brachial plexus injury and 9
      patients with polyneuropathy, A-waves showing constant latency and configuration
      were recorded in addition to temporally dispersed F-waves. The A-waves in these
      patients persisted after supramaximal stimulation of the peripheral nerves,
      although the A-waves should normally disappear in response to supramaximal
      stimulation. The supramaximally stimulated A-waves were prominent in
      polyneuropathy and nerve lesions with demyelinating pathology. A patient with
      Guillain-Barre syndrome showed unusual repetitive discharges that might be
      important electrodiagnostic findings in the early stage of illness. In patients
      with myotonic dystrophy, electrical stimulation elicited repetitive discharges
      that continued from the M-waves. Recordings with a concentric needle electrode
      showed characteristics similar to those of myotonic discharges recorded during
      needle electrode insertion. When the repetitive discharges were mild, the F-waves
      were recorded. Absence of the F-waves in myotonic dystrophy might be related to
      the myotonic discharges elicited by electrical stimulation, and may not imply
      impaired conduction of the peripheral nerves. A patient with myokymia showed
      repetitive discharges with constant configuration but variable latency, although
      the F-waves were normal. These repetitive discharges may be evoked by ephaptic
      transmission resulting from abnormal excitability of the peripheral nerves or
      muscles of different etiologies.

PMID- 11215489
TI  - [An autopsy case of primary aortoduodenal fistula complicated by both gastric
      carcinoma and acute gastric mucosal lesions].
AB  - We present an autopsy case of aortoduodenal fistula complicated by both gastric
      carcinoma and acute gastric mucosal lesions(AGML). A 73-year-old man with a past
      history of gastric ulcer, myocardial infarction, and arteriosclerosis of the
      right femoral artery presented to Osaka National Hospital complaining of
      intermittent claudication of the right lower extremity. After a diagnosis of
      arteriosclerosis obliterans, percutaneous angioplasty was performed. The
      postoperative course was initially good. However, two weeks after the angioplasty
      procedure he suddenly vomited blood. Emergency endoscopy revealed both polypoid
      gastric carcinoma and AGML, which were considered to be the major cause of his
      gastrointestinal bleeding. And he died of uncontrollable gastrointestinal
      bleeding two weeks after this examination. Autopsy showed an atherosclerotic
      aneurysm of the abdominal aorta that had ruptured into the third part of the
      duodenum. To our knowledge, there has been no previous autopsy on a primary
      aortoduodenal fistula from an atherosclerotic abdominal aneurysm complicated by
      similar hemorrhagic gastric lesions. This case emphasizes the difficulty of
      making a clinical diagnosis of primary aortoduodenal fistula.

PMID- 11215490
TI  - [A case of hookworm infestation with dissociation values between FDP-E and FDP-D
      dimer].
AB  - We previously reported a five-year-old girl showing bleeding tendency and
      transient morphological and functional platelet abnormalities probably due to a
      hookworm, Necator Americanus, infestation. In this report, we describe the rarely
      accelerated fibrinogenolysis and/or fibrinolysis in this patient whose value of
      fibrinogen and/or fibrin degradation products(FDP) determined with an FDP-E assay
      was much higher than that determined with a D-dimer assay. Namely, on day-1 and
      day-13 of hospitalization, her D-dimer values were only 10 to 20% of the
      prospected values from FDP-E values. We speculated this phenomenon was induced by
      circulating protease(-like) agent(s) produced by hookworm, because the only
      slightly participation of plasmin and/or granulocyte elastase was evaluated by
      the determination of enzyme-inhibitor complexes. And the other possibility of
      fibrinogen degradation by blast- or tumor-associated protease was excluded by the
      clinical manifestations and primary disorders. In conclusion, we report a very
      rare case with the accelerated fibrinogenolysis and/or fibrinolysis in a patient
      with the hookworm infestation. We are interested in the mechanism that manifested
      the patient's bleeding tendency accompanied with morphological and functional
      platelet abnormalities.

PMID- 11215491
TI  - [Molecular biology techniques as clinical laboratory tests].
AB  - The quality of results obtained with molecular biology techniques depends on the
      control of preanalytical and analytical error associated with such techniques.
      Preanalytical error can be introduced during the isolation of DNA and RNA. The
      type of detergent used in cell lysis can affect the amplification of DNA by
      techniques such as the polymerase chain reaction(PCR). Ribonuclease(RNase)
      contamination is a serious problem in the isolation of undegraded RNA, and, thus,
      this enzyme should be inhibited. Anticoagulants used for blood collection can
      affect the quality of results with molecular biology techniques. The control of
      contamination from the working environment is essential to the minimization of
      preanalytical, analytical and postanalytical error. Molecular biology techniques
      for a wide range of clinical laboratory tests have been established in hospitals
      such as clinical laboratory tests for infections, molecular diagnoses of leukemia
      and aberrant genes in metabolism.

PMID- 11215492
TI  - Efficacy of polyvinylpolypyrrolidone in reducing the immunotoxicity of aflatoxin
      in growing broilers.
AB  - 1. Protective action of an enzyme-linked polyvinylpolypyrrolidone (PVPP, Mycofix
      Plus) against the immunosuppressive effect of afatoxins (AF) was evaluated by
      determination of peripheral blood T-lymphocyte proportions and splenic plasma
      cell counts. Histological changes in lymphoid organs were also investigated by
      light microscopy. One-d-old broiler chicks (Hybro) received 2.5 mg/kg diet AF
      (83.06% AFB1, 12.98% AFB2, 2.84% AFG1, 1.12% AFG2) with or without PVPP (3g/kg
      diet) until 21 d of age. When compared with controls, AF treatment significantly
      decreased peripheral T-lymphocyte counts. AF caused a slight decrease in splenic
      plasma cell counts. The addition of PVPP to an AF-containing diet significantly
      increased T-lymphocyte counts. Splenic plasma cell counts were numerically
      intermediate between control and AF groups.  3. The dietary addition of PVPP to
      AF-free diet did not significantly alter either T-lymphocyte or splenic plasma
      cell counts.

PMID- 11215493
TI  - A novel anti-HBeAg homolignan, taiwanschirin D from Kadsura matsudai.
AB  - A novel C19 homolignan, taiwanschirin D (1), possessing a 3,4-(1-[(Z)-2-methoxy-2
      oxoethylidenel)pentano (2,3-dihydrobenzo[b]furan)-3(2-oxoacetate) skeleton, was
      isolated from the stem of Kadsura matsudai Hayata. Its structure was determined
      from physical and spectral data including 2D NMR spectra. The Anti-HBeAg test
      revealed that taiwanschirin D (1) had moderate activity at a concentration of
      94.3 microM (50 microg/ml).

PMID- 11215494
TI  - [Environmental pollution with endocrine disrupting chemicals and the effects to
      human] .

PMID- 11215495
TI  - Invertases and life beyond sucrose cleavage.

PMID- 11215496
TI  - New mutants provide clues into regulation of systemic acquired resistance.

PMID- 11215498
TI  - Bibliography. Current world literature.

PMID- 11215497
TI  - Systemic transport of RNA in plants.

PMID- 11215499
TI  - Information and communication.

PMID- 11215500
TI  - Stress resistance, heterogeneity, and mortality plateaus: a comment on Drapeau et
      al.

PMID- 11215501
TI  - Meeting report: first conference of the EU-supported Thematic Network on
      Immunology and Ageing in Europe (ImAginE), Schloss Hohentubingen, April, 2000.

PMID- 11215502
TI  - ImAginE: Immunology and Ageing in Europe--a thematic network of the EU 5th
      Framework Program.

PMID- 11215503
TI  - Venture capital. Big biz bets on... .

PMID- 11215504
TI  - Information technology. rapid hire.

PMID- 11215505
TI  - Disciplining abusive docs.

PMID- 11215506
TI  - 2001 benchmarking guide.
AB  - Our fifth annual guide to benchmarking under managed care presents data that is a
      study in market dynamics and adaptation. New this year are financial indicators
      on HMOs exiting the market and those remaining. Hospital financial ratios and
      details on department performance are included. The physician group practice
      numbers show why physicians are scrutinizing capitated payments. Overall,
      hospitals in markets with high managed care penetration are more successful in
      managing labor costs and show productivity gains in imaging services, physical
      therapy and materials management.

PMID- 11215507
TI  - The honorary enzyme haemoglobin turns out to be a real enzyme.

PMID- 11215508
TI  - Introduction: the selenium conundrum.
AB  - Selenium was first suspected of being an essential dietary trace element in the
      1950s. We now know that indeed it is an essential biological element that serves
      as an integral component of several enzymes, including those in the families of
      deiodinases and glutathione peroxidases as well as selenoproteins P and W. The
      multi-author review that follows this introduction concentrates on the important
      biological role of selenium in enzymes as well as some of the physiological
      aspects of selenium as either a potential anticarcinogenic agent or insulin
      mimetic. What should become clear from these contributed articles is the complex
      and dynamic role that selenium plays in many biological processes and that the
      investigations in these areas are at the edge of exciting new frontiers.

PMID- 11215509
TI  - The glutathione peroxidases.
AB  - There are several proteins in mammalian cells that can metabolize hydrogen
      peroxide and lipid hydroperoxides. These proteins include four selenium
      containing glutathione peroxidases that are found in different cell fractions and
      tissues of the body. This review considers the structure and distribution of the
      selenoperoxidases and how this relates to their biological function. The
      functions of the selenoperoxidases were originally studied in systems where their
      activity was manipulated by changing dietary selenium levels. More recently,
      molecular techniques have allowed overexpression of selenoperoxidases in cell
      lines and animals. Additionally, cellular glutathione peroxidase knockout mice
      have been used to investigate the functions of this protein. From this work it is
      clear that the selenoperoxidases are involved in cell antioxidant systems.
      However, they also have more subtle functions in ensuring the regulation and
      formation of arachadonic acid metabolites that are derived from hydroperoxide
      intermediates. The range of biological processes, which are potentially dependent
      on optimal selenoperoxidase activity in mammals, emphasises the importance of
      achieving adequate selenium intake in the diet.

PMID- 11215510
TI  - Selenoprotein P.
AB  - Selenoprotein P (SeP) is an extracellular, monomeric glycoprotein containing up
      to 10 selenocysteine residues in the polypeptide chain. It is ubiquitously
      expressed in mammalian tissues, and in human plasma it accounts for at least 40%
      of the total selenium concentration. SeP binds to heparin and cell membranes, and
      is associated with endothelial cells. SeP in human plasma protects against
      peroxynitrite-mediated oxidation and reduces phospholipid hydroperoxide in vitro,
      in accordance with the presumption that it has a function as an extracellular
      oxidant defense. Immunochemical assays have demonstrated that its concentration
      in plasma varies much with selenium intake, but other factors also have an
      influence.

PMID- 11215511
TI  - Selenoprotein W: a review.
AB  - Purification of selenoprotein W (Se-W) from rat and monkey muscles was shown to
      exist in multiple forms: with or without reduced glutathione and/or a 41-Da
      moiety (identity still unknown). TGA is located at coding position 13 in Se-W
      complementary DNA (cDNA) from all five species studied (rats, mice, sheep, human
      and monkey). TGA is also the stop codon in the rodents and sheep cDNA, but TAA is
      the stop codon in primates. There is an 80% homology of the nucleotide sequence
      in the coding region among the five species of animals, and the predicted amino
      acid sequences are 83% identical (rodents identical and primates identical). Se-W
      levels are highest in muscle, heart and brain from sheep and primates, but very
      low in rodent hearts. Studies with tissue cultures of muscle and brain cells
      indicated that selenium influenced Se-W levels. Although the metabolic function
      of Se-W is unknown, preliminary data suggest that it has an antioxidant function.

PMID- 11215512
TI  - The deiodinase family: selenoenzymes regulating thyroid hormone availability and
      action.
AB  - Thyroid hormones control growth, development, differentiation and metabolism in
      vertebrates. Most of the actions of the active thyroid hormone T3 (3,5,3'-triiodo
      L-thyronine) are exerted via ligand-activated nuclear T3 receptors. Activation of
      the secretory product of the thyroid gland, L-thyroxine (3,3',5,5'-tetraiodo-L
      thyronine), or T4, is catalyzed by two enzymes, iodothyronine-5'-deiodinases type
      I and type II. Inactivation of T4 and T3 occurs via type III iodothyronine-5
      deiodinase and to some extent by type I 5'deiodinase. Complementary DNAs (cDNAs)
      encoding the substrate-binding selenocysteine-containing subunits of the
      deiodinases were cloned, though some controversy still exists on the type II 5'
      deiodinase subunits. Characterization of tissue-specific expression patterns
      indicates that these selenium-dependent enzymes exert tight control on local and
      systemic availability of active T3. Thus, deiodinases are envisaged as guardians
      to the gate of thyroid hormone action mediated by T3 receptors.

PMID- 11215513
TI  - Anticarcinogenic effects of selenium.
AB  - Selenium (Se) exerts its anticarcinogenic effects by multiple mechanisms. In the
      physiological dosage range, Se appears to function as an antimutagenic agent,
      preventing the malignant transformation of normal cells and the activation of
      oncogenes. These protective effects of Se seem to be primarily associated with
      its presence in the glutathione peroxidases, which are known to protect DNA and
      other cellular components from damage by oxygen radicals. Selenoenzymes are also
      known to play roles in carcinogen metabolism, in the control of cell division,
      oxygen metabolism, detoxification processes, apoptosis induction and the
      functioning of the immune system. Other modes of action, either direct or
      indirect, may also be operative, such as the partial retransformation of tumor
      cells and the inactivation of oncogenes. However, the effects of Se in the
      physiological dosage range are not attributable to cytotoxicity, allowing Se to
      be defined as a genuine nutritional cancer-protecting agent. The anticarcinogenic
      effects of Se are counteracted by Se-antagonistic compounds and elements. For
      maximal utilization of its cancer-protective potential, Se supplementation should
      start early in life and be maintained over the entire lifespan. In addition,
      exposure to Se antagonists and carcinogenic risk factors should be minimized by
      appropriate dietary and lifestyle changes.

PMID- 11215514
TI  - Selenium: an insulin-mimetic.
AB  - Insulin or agents that can mimic its action (insulin-mimetics) are necessary to
      promote the entry of glucose into tissues where the glucose can either be
      converted into energy or stored for later use. In recent years, selenium has been
      shown to mediate a number of insulin-like actions both in vivo and in vitro.
      These insulin-like actions include stimulating glucose uptake and regulating
      metabolic processes such as glycolysis, gluconeogenesis, fatty acid synthesis and
      the pentose phosphate pathway. The mechanism by which selenium is capable of
      mimicking insulin is not clear; however, reports indicate that selenium does
      activate key proteins involved in the insulin-signal cascade. Various proteins in
      the insulin-signal cascade have been shown to be necessary for different insulin
      regulated events, and presumably data will be forthcoming soon that illustrate
      this similarly for selenium. This review compares the action of selenium to that
      of insulin and discusses the available evidence in support of selenium as an
      insulin-mimetic.

PMID- 11215515
TI  - Biosynthesis of cobalamin (vitamin B12): a bacterial conundrum.
AB  - The biosynthesis of cobalamin (vitamin B12) is described, revealing how the
      concerted action of around 30 enzyme-mediated steps results in the synthesis of
      one of Nature's most structurally complex 'small molecules'. The plethora of
      genome sequences has meant that bacteria capable of cobalamin synthesis can be
      easily identified and their biosynthetic genes compared. Whereas only a few years
      ago cobalamin synthesis was thought to occur by one of two routes, there are
      apparently a number of variations on these two pathways, where the major
      differences seem to be concerned with the process of ring contraction. A
      comparison of what is currently known about these pathways is presented. Finally,
      the process of cobalt chelation is discussed and the structure/function of the
      cobalt chelatase associated with the oxygen-independent pathway (CbiK) is
      described.

PMID- 11215516
TI  - Alpha-synuclein and Parkinson's disease.
AB  - The involvement of alpha-synuclein in neurodegenerative diseases was first
      suspected after the isolation of an alpha-synuclein fragment (NAC) from amyloid
      plaques in Alzheimer's disease (AD). Later, two different alpha-synuclein
      mutations were shown to be associated with autosomal-dominant Parkinson's disease
      (PD), but only in a small number of families. However, the discovery that alpha
      synuclein is a major component of Lewy bodies and Lewy neurites, the pathological
      hallmarks of PD, confirmed its role in PD pathogenesis. Pathological aggregation
      of the protein might be responsible for neurodegeneration. In addition, soluble
      oligomers of alpha-synuclein might be even more toxic than the insoluble fibrils
      found in Lewy bodies. Multiple factors have been shown to accelerate alpha
      synuclein aggregation in vitro. Therapeutic strategies aimed to prevent this
      aggregation are therefore envisaged. Although little has been learned about its
      normal function, alpha-synuclein appears to interact with a variety of proteins
      and membrane phospholipids, and may therefore participate in a number of
      signaling pathways. In particular, it may play a role in regulating cell
      differentiation, synaptic plasticity, cell survival, and dopaminergic
      neurotransmission. Thus, pathological mechanisms based on disrupted normal
      function are also possible.

PMID- 11215517
TI  - Ferrochelatase at the millennium: structures, mechanisms and [2Fe-2S] clusters.
AB  - Ferrochelatase (E.C. 4.99.1.1, protoheme ferrolyase) catalyzes the insertion of
      ferrous iron into protoporphyrin IX to form protoheme (heme). In the past 2
      years, the crystal structures of ferrochelatases from the bacterium Bacillus
      subtilis and human have been determined. These structures along with years of
      biophysical and kinetic studies have led to a better understanding of the
      catalytic mechanism of ferrochelatase. At present, the complete DNA sequences of
      45 ferrochelatases from procaryotes and eucaryotes are available. These sequences
      along with direct protein studies reveal that ferrochelatases, while related,
      vary significantly in amino acid sequence, molecular size, subunit composition,
      solubility, and the presence or absence of nitric-oxide-sensitive [2Fe-2S]
      cluster.

PMID- 11215518
TI  - Mitochondrial defects and hearing loss.
AB  - The techniques of human molecular genetics have been rapidly applied to the study
      of hearing loss. These studies have implicated more than 60 loci as causes of
      nonsyndromic hearing loss. Mutations at more than a dozen nuclear genes have been
      demonstrated to cause hearing loss, and these have been covered in recent
      reviews. However, a perhaps unexpected feature of the molecular characterization
      of human hearing loss has been the occurrence of mutations in the mitochondrial
      DNA (mtDNA). The importance of mitochondrial function in hearing is emphasized by
      the recent discovery of mutations in a nuclear-encoded mitochondrial protein
      which results in hearing loss. This article reviews the current status of our
      knowledge of mtDNA mutations that have been shown to cause hearing loss, and the
      suggestion of potential molecular, cellular and tissue-specific
      pathophysiological mechanisms by which dysfunction of mitochondria may lead to a
      loss of hearing.

PMID- 11215519
TI  - Regulation of the type III InsP3 receptor and its role in beta cell function.
AB  - The type III inositol 1,4,5-trisphosphate receptor (InsP3R) is an important
      intracellular calcium (Ca2+) release channel in the pancreatic beta cell.
      Pancreatic beta cells secrete insulin following a characteristic change in
      membrane potential that leads to an increase in cytoplasmic Ca2+. Both
      extracellular Ca2+ and Ca2+ mobilized from InsP3-sensitive stores contribute to
      this increase. RIN-m5F cells, an insulin-secreting beta cell line, preferentially
      express the type III InsP3R. These cells have been useful in determining the
      regulatory properties of the type III InsP3R and the role of this isoform in an
      intact cell. The type III InsP3R is ideal for signal initiation because high
      cytoplasmic Ca2+ does not inhibit its activity. Altered insulin secretion, the
      result of changes in Ca2+ handling by the beta cell, has significant clinical
      consequences.

PMID- 11215521
TI  - Polysialic acids: potential in improving the stability and pharmacokinetics of
      proteins and other therapeutics.
AB  - Naturally occurring polymers of N-acetylneuraminic acid (polysialic acids) are
      biodegradable, highly hydrophilic and have no known receptors in the body.
      Following intravenous injection, polysialic acids exhibit long half-lives in the
      blood circulation and have therefore been proposed as carriers of short-lived
      drugs and small peptides. In addition, shorter-chain polysialic acids can be used
      as a means to increase the circulatory half-life of proteins and thus serve as an
      alternative to the nonbiodegradable monomethoxypoly(ethylene glycol). Recent work
      has shown that covalent coupling of a low molecular weight polysialic acid
      (colominic acid) to catalase and asparaginase leads to a considerable increase of
      enzyme stability in the presence of proteolytic enzymes or blood plasma.
      Comparative studies in vivo with polysialylated and intact asparaginase revealed
      that polysialylation significantly increases the half-life of the enzyme. The
      highly hydrophilic and innocuous nature of polysialic acids renders them suitable
      as a means to prolong the circulation of peptides and proteins.

PMID- 11215520
TI  - The role of ras and other low molecular weight guanine nucleotide (GTP)-binding
      proteins during hematopoietic cell differentiation.
AB  - Recent progress in the understanding of signal transduction and gene regulation
      in hematopoietic cells has shown that many intracellular signalling pathways are
      modulated by low molecular weight guanine nucleotide (GTP)-binding proteins
      (LMWGs). LMWGs act as molecular switches for regulating a wide range of signal
      transduction pathways in virtually all cells. In hematopoietic cells, LMWGs have
      been shown to participate in essential functions such as growth control,
      differentiation, cytoskeletal organization, cytokine and chemoattractant-induced
      signalling events, reduced nicotinamide adenine dinucleotide phosphate oxidase
      activity, intracellular vesicle transport and secretion. In human leukemias,
      myelodysplastic syndromes and myeloproliferative disorders, Ras activation occurs
      by point mutations, overexpression or by alteration of NF-1 Ras-GTPase activating
      protein (GAP). These are postinitiation events in leukemia but may modulate
      growth-factor-dependent and independent leukemic growth. Two animal models of
      mutated N-ras expression resulting in myelodysplastic and myeloproliferative
      features are discussed. The role of Ras in organ development is discussed in the
      context of transgenic knockout mice. More LMWG functions will certainly be
      identified as we gain a better understanding of regulatory pathways modulating
      myeloid signal transduction. This review will summarize our current understanding
      of this rapidly advancing area of research.

PMID- 11215522
TI  - Protein surface similarities: a survey of methods to describe and compare protein
      surfaces.
AB  - Many methods have been developed to analyse protein sequences and structures,
      although less work has been undertaken describing and comparing protein surfaces.
      Evolution can lead sequences to diverge or structures to change topology;
      nevertheless, surface determinants that are essential to protein function itself
      may be mantained. Moreover, different molecules could converge to similar
      functions by gaining specific surface determinants. In such cases, sequence or
      structure comparisons are likely to be inadequate in describing or identifying
      protein functions and evolutionary relationships among proteins. Surface analysis
      can identify function determinants that are independent of sequence or secondary
      structure and can therefore be a powerful tool to highlight cases of possible
      convergent or divergent evolution. This kind of approach can be useful for a
      better understanding of protein molecular and biochemical mechanisms of catalysis
      or interaction with a ligand, which are usually surface dependent. Protein
      surface comparison, when compared to sequence or structure comparison methods, is
      a hard computational challenge and evaluated methods allowing the comparison of
      protein surfaces are difficult to find. In this review, we will survey the
      current knowledge about protein surface similarity and the techniques to detect
      it.

PMID- 11215523
TI  - Lysophosphatidic acid: receptors, signaling and survival.
AB  - Though the mitogenic activity of lysophosphatidic acid (LPA) has been well
      established through classical studies, its mechanism of action was long obscure.
      Recent identification and cloning of LPA-specific receptors has led to the
      elucidation of the G-proteins and signaling pathways through which this molecule
      functions. In addition to its mitogenic properties, recent reports have suggested
      that LPA may also promote cell survival. This review will summarize the current
      literature regarding LPA signaling and its role as an antiapoptotic factor.

PMID- 11215524
TI  - Effect of plant lectins on Ustilago maydis in vitro.
AB  - Ustilago maydis is an edible parasitic basidiomycete, which specifically infects
      corn (Zea mays) and teocintle (Z. diploperennis). To characterise the interaction
      between the basidiomycete and its host organism, we tested the effect of plant
      lectins with well-known sugar specificity on the growth and germination of U.
      maydis spores. Lectins specific for N-acetyl-D-galactosamine, such as those from
      Dolichos biflorus and Phaseolus lunatus, and the wheatgerm agglutinin specific
      for N-acetyl-D-glucosamine inhibited spore germination, but were ineffective in
      modifying U. maydis cell growth. The galactose-specific lectin from the corn
      coleoptyle inhibited both germination and cell growth, while the lectin
      concanavalin A (mannose/glucose specific) activated spore germination and growth.
      Our results suggest that specific saccharide-containing receptors participate in
      regulating the growth and maturation of U. maydis spores.

PMID- 11215525
TI  - A morphological study of the expression of the small G protein RhoA in resting
      and activated MDCK cells.
AB  - The small G protein Rho subfamily controls several cellular events such as
      growth, movement, proliferation and differentiation by rearranging actin and
      cytoskeleton proteins. Most of these effects are mediated by the activation of
      growth factor and extracellular matrix molecule receptors, suggesting a role for
      Rho molecules in the transduction pathway of these receptors. Despite the
      importance of Rho peptides in fundamental cellular events, data on their
      subcellular immunolocalisation are sparse: here we investigated the expression
      and subcellular localisation of RhoA in resting (cultured on plastic) and
      activated (Matri-cell or hepatocyte growth factor) MDCK cells by immunoperoxidase
      and immunogold techniques. Resting MDCK cells contain detectable amounts of RhoA
      mainly localised in the cytoplasm; RhoA expression is significantly enhanced by
      Matri-cell substrates that promote translocation of RhoA at the membrane level.
      This enhancing effect is reduced after exposure to hepatocyte growth factor.

PMID- 11215527
TI  - Perfusion-contraction match and mismatch.
AB  - The present article describes the concept of perfusion-contraction matching
      originally proposed by Ross, goes on to critically discuss the available
      techniques to measure both regional myocardial blood flow and function in the
      experimental and clinical setting, and finally analyzes the available evidence
      for perfusion-contraction match and mismatch during normoperfusion and various
      scenarios of myocardial ischemia/reperfusion, including acute and subacute
      ischemia, coronary microembolization, stunning and hibernation.

PMID- 11215526
TI  - Tyrosine phosphorylation of cytoplasmic proteins in proliferating,
      differentiating, apoptotic HL-60 cells and blood neutrophils.
AB  - Two-dimensional electrophoretic analysis was used to assess quantitative and
      qualitative changes in the expression and tyrosine phosphorylation of cytoplasmic
      proteins of proliferating, differentiating HL-60 cells and mature human blood
      neutrophils. The total tyrosine phosphorylation level of cytoplasmic proteins
      appeared approximately constant during the pre-commitment period, i.e., 6-24 h
      after induction of differentiation by 700 nM all-trans retinoic acid. At the time
      of granulocytic phenotype formation (48-120 h), the total level of tyrosine
      phosphorylation of cytoplasmic proteins increased significantly. Tyrosine
      phosphorylation of cytoplasmic proteins in matured blood neutrophils was
      significantly lower than that of cytoplasmic proteins of HL-60 cells
      differentiated for 96 h with retinoic acid. Immunoblotting with anti-Erk2 and
      anti-phosphotyrosine monoclonal IgG2bk antibodies showed that Erk2 was expressed
      and tyrosine-phosphorylated at different levels in HL-60 proliferating cells and
      in cells at all stages of differentiation. Our data showed that tyrosine
      phosphorylation of cytoplasmic proteins in differentiating HL-60 cells changes
      dramatically during the period of phenotype formation and is accompanied by
      increasing activity of Erk2. An increasing number of apoptotic cells appeared in
      the differentiating HL-60 cell population during the granulocyte maturation stage
      (48-120 h of differentiation). The appearance at this time of differentiation of
      a new set of tyrosine-phosphorylated cytoplasmic proteins (also distinctive for
      apoptotic HL-60 cells mediated by etoposide) together with an increasing number
      of apoptotic cells in the differentiating population strongly suggests that these
      proteins are associated with the apoptotic process.

PMID- 11215528
TI  - Apoptosis in the vascular wall and atherosclerosis.
AB  - Apoptosis, programmed cell death, has emerged as a key element in the complex
      pathophysiology underlying the development as well as the progression of
      atherosclerosis. A number of recent reports provided evidence for both in vivo
      and in vitro occurrence of apoptotic cell death of vascular cells, namely
      endothelial cells, macrophages, and vascular smooth muscle cells. In addition,
      functional studies in disease models underscore the relevance of these findings
      for the understanding of processes which lead to lesion development, plaque
      rupture, and thrombus formation. Pathomechanistic in vitro investigations
      provided an increasingly detailed picture of the involved intracellular signaling
      pathways that regulate onset and execution of apoptosis. These insights offer the
      potential of therapeutic interventions targeted to interfere with the molecular
      processes involving apoptotic cell death in the vascular wall.

PMID- 11215529
TI  - Cardiac isoform of alpha-2 macroglobin, a novel serum protein, may induce cardiac
      hypertrophy in rats.
AB  - Earlier studies from this laboratory have identified a novel high molecular
      weight (182 kDa) serum protein suggested to be involved in the development of
      cardiac hypertrophy. In the present case the role of this novel serum protein in
      the development of pressure-induced cardiac hypertrophy and the molecular events
      associated with it in experimental rats has been investigated. Multiple
      injections of this purified protein intravenously (through tail vein) into the
      normal animals lead to the development of cardiac hypertrophy and this is
      accompanied by an induction of muscle specific genes such as that of MLC2 and
      beta-MHC characteristic of pressure overloaded heart. Further, the hypertrophy
      specific serum protein has been found to be identical to rat alpha-2
      macroglobulin (alpha-2M) in molecular weight (182 kDa) and in its appearance in
      blood serum. alpha-2M is an acute phase serum protein that increases markedly
      after inflammatory stimuli in hepatocytes in liver and gets secreted into the
      blood. The studies at present suggest that the 182kDa serum protein that appeared
      during the early stage of development of cardiac hypertrophy in aorta constricted
      rats is a glycoprotein localized in the heart that showed immunological cross
      reactivity with alpha-2M and is expressed in the heart as evinced by Northern
      blot analysis. Further this protein showed certain differences from rat alpha-2M
      under denaturing conditions in isoelectric focusing and partial peptide mapping.
      Partial peptide sequencing of the internal peptides of tryptic digest of 182 kDa
      showed 100% identity of the sequences with alpha-2M sequences. Rat alpha-2M does
      not, however, have any influence on the development of cardiac hypertrophy and
      its antibody does not cross react with the 182 kDa protein. These data suggest
      that the 182 kDa protein that may play an indispensable role in the development
      of cardiac hypertrophy in experimental rats is cardiac specific, and may be an
      isoform of liver alpha-2M belonging to macroglobulin family.

PMID- 11215530
TI  - Interaction between the opposing functional effects of cyclic AMP and cyclic GMP
      in hypertrophic cardiac myocytes.
AB  - We tested the hypothesis that in isolated cardiac myocytes, the negative
      functional effects of cyclic GMP would be blunted when the level of cyclic AMP
      was increased and that this interaction would be altered in renal hypertensive
      (One-Kidney-One-Clip, 1K1C) cardiac hypertrophic rabbits. Using isolated control
      and 1K1C ventricular myocytes, cyclic AMP and cell shortening (%) data were
      collected: 1) at baseline, 2) after the addition of 8-Br-cGMP 10(-7), -6, -5 M,
      and 3) after forskolin (10(-6) M), an adenylate cyclase activator, followed by 8
      Br-cGMP 10(-7), -6, -5 M. Basal levels of cyclic AMP were similar in control vs.
      1K1C myocytes (10.2 +/- 1.6 vs. 11.3 +/- 2.6 pmol/10(5) myocytes). We found that
      8-Br-cGMP decreased the percent shortening in a dose related manner in both
      control myocytes (5.1 +/- 0.6 to 3.2 +/- 0.4%) and hypertrophic myocytes (5.2 +/-
      0.4 to 3.6 +/- 0.5). The level of cyclic AMP significantly increased after the
      addition of 8-Br-cGMP in control myocytes (14.1 +/- 2.1), but not in 1K1C
      myocytes. Forskolin increased the percent shortening in the control myocytes (3.8
      +/- 0.1 to 4.8 +/- 0.4), but no significant increase was noted in the
      hypertrophic myocytes (3.6 +/- 0.3 to 3.7 +/- 0.3). The level of cyclic AMP
      significantly increased after the addition of forskolin in both control (13.9 +/-
      2.0), and 1K1C cells (14.6 +/- 3.8). Forskolin attenuated the negative functional
      effects of 8-Br-cGMP in the control (4.8 +/- 0.4 to 3.2 +/- 0.1) and 1K1C
      myocytes (3.7 +/- 0.3 to 2.7 +/- 0.3). The addition of 8-Br-cGMP did not affect
      the level of cyclic AMP after forskolin in either control (13.9 +/- 2.0 to 14.8
      +/- 2.5) or 1K1C myocytes (14.6 +/- 3.8 to 13.8 +/- 1.9). These data indicated
      that in hypertrophic cardiac myocytes the negative functional effects of 8-Br
      cGMP were similar to control, but the positive functional effects of cyclic AMP
      were blunted. There was an increase in cyclic AMP levels after addition of 8-Br
      cGMP in control but not 1K1C cells. We conclude that in control and hypertrophic
      myocytes, the effects of cyclic GMP were blunted after forskolin, but this did
      not seem to be related to cyclic AMP phosphodiesterase activity.

PMID- 11215531
TI  - Integrins alphavbeta3 and alphavbeta5 mediate VSMC migration and are elevated
      during neointima formation in the rat aorta.
AB  - Neointima formation involves tissue expression of matrix proteins and growth
      factors. The role of alphavbeta3, but not alphavbeta5 integrin in vascular cells
      has been sufficiently investigated. The aim of the present study was to determine
      and compare the function of alphavbeta3 and alphavbeta5 integrins in rat aortic
      (RASMC) and human coronary vascular smooth muscle cells (HCSMC) and to
      characterize their expression accompanying neointima formation in vivo. RASMC and
      HCSMC express alphavbeta3 and alphavbeta5 integrin subunits. The alphavbeta5
      integrin predominantly mediated adhesion of RASMCs to vitronectin and spreading
      on vitronectin via RGD-binding sequences. In contrast, the alphavbeta3 integrin
      did not contribute to the adhesion and spreading on fibronectin, vitronectin,
      gelatin or collagen I coated layers. PDGF-directed migration through gelatin
      coated membranes involved both alphavbeta3 and alphavbeta5 integrins. Selective
      blocking antibodies for alphavbeta3 and alphavbeta5 inhibited migration of RASMC
      and HCSMC by more than 60 % (p < 0.01). Integrin expression was studied in vivo
      in thoracic aorta of Sprague Dawley rats before and after balloon injury. In situ
      hybridization demonstrated low signals for alphav, beta3 and beta5 mRNA in
      uninjured aorta, which increased significantly at 14 days, localized
      predominantly in the neointima. Northern analysis of aorta after 14 days of
      injury also demonstrated an upregulation of alphav, beta3 and beta5 mRNA compared
      to uninjured aorta. Consistent with the increase in message levels, increased
      integrin protein expression was seen in the neointima after 7 and 14 days. This
      study provides evidence that alphavbeta3 and alphavbeta5 are elevated during
      neointima formation in the rat and indicates a novel role for alphavbeta5
      participating in mechanisms regulating smooth muscle cell migration.

PMID- 11215532
TI  - Phosphorylation of cytokeratin 8 and 18 in human vascular smooth muscle cells of
      atherosclerotic lesions and umbilical cord vessels.
AB  - Expression of cytokeratins (CK) is considered a hallmark of the state of
      epithelial differentiation. CK also occur in certain vascular smooth muscle cells
      (VSMC), inferring an association with a less differentiated phenotype. Recently,
      CK posttranslational modification was shown to occur in epithelial cells in
      stress, mitosis or apoptosis. The aim of this study was to determine potential CK
      phosphorylation patterns in human VSMC. Tissue samples of normal peripheral and
      coronary arteries, atherosclerotic lesions and umbilical cord vessels were
      evaluated by immunofluorescence microscopy applying antibodies specific for
      cytokeratins 8 and 18, specific cytokeratin phosphorylation sites, Ki-67-antigen
      as a proliferation marker and nick end labeling (TUNEL) to detect apoptosis. All
      samples contained cytokeratin-positive VSMC but diverse phosphorylation patterns.
      The C-terminal serine 431 of cytokeratin 8 (CK8Ser-431) was phosphorylated in the
      vast majority of CK-expressing VSMC of coronary artery lesions. Only a subset of
      these cells demonstrated phosphorylation of CK18Ser-33 or, to an even lesser
      extent, CK8Ser-73. DNA fragmentation occurred predominantly in samples containing
      cells with phosphorylated CK8Ser-431 domains. In contrast, occluded peripheral
      lesions exhibited little or no phosphorylation. Neonatal VSMC in umbilical cord
      vessels contain abundant phosphorylated CK domains, again predominantly CK8Ser
      431, but also CK18Ser-33. Again, only single cells were found to be proliferating
      or to contain DNA fragmentation. Thus, abundant CK phosphorylation in VSMC of
      atherosclerotic lesions suggests a specific functional response to cell stress
      and a possible relation to apoptosis.

PMID- 11215533
TI  - Serotonin-induced human coronary microvascular contraction during acute
      myocardial ischemia is blocked by COX-2 inhibition.
AB  - Since serotonin (5-HT) is implicated in exacerbating acute coronary syndromes, we
      studied the reactivity of atrial coronary arterioles (70-140 microm) of
      atherosclerotic patients undergoing cardiac surgery to 5-HT, substance P (Sub P),
      and sodium nitroprusside by video-microscopy. Before ischemia, 5-HT-induced
      relaxation was not affected by NS398 (cyclooxygenase inhibitor), H2O2 or U63557A
      (thromboxane A2 synthase inhibitor), but was reduced by L-NNA. 5-HT elicited a
      potent contractile response after ischemia that was inhibited by NS398, Indo, and
      U63557A. While Sub P relaxation was decreased after ischemia, SNP relaxation was
      unchanged. The mRNA steady-state levels of NOS-3, NOS-2, prostacyclin synthase,
      and COX- 1 were not altered by ischemia. COX-2 mRNA and protein levels
      (Westernblotting), however, were increased (mean +/- SEM) 2.4 +/- 0.4 and 3.2 +/-
      0.7 fold, respectively, in ischemic atrium corroborating with the
      immunohistochemistry of atrial tissue. It is concluded that myocardial ischemia
      enhanced contractile response of coronary arterioles to 5-HT maybe due to the
      stimulated prostaglandin release (likely thromboxane A2) secondary to induction
      of COX-2 expression. These findings may have implications regarding the cause of
      coronary spasm during acute myocardial ischemia.

PMID- 11215534
TI  - Ischemia-induced ventricular fibrillation in isolated perfused rat heart: role of
      alpha1A-adrenoceptor mediated activation of protein kinase C.
AB  - It previously has been reported in ischemic rat hearts that local release of
      noradrenaline triggers ventricular fibrillation via alpha1A-adrenoceptor
      stimulation. In order to elucidate the intracellular pathway mediating
      ventricular fibrillation in this setting, we used inhibitors or activators of
      protein kinase C in the absence or presence of the alpha1A-adrenoceptor
      antagonist WB 4101. Regional ischemia was induced in isolated perfused rat heart
      byligature of the left coronary artery. Pharmacological interventions were tested
      by addition of drugs to the perfusate 10 min prior to ligature and throughout 30
      min of ischemia while the epicardial electrocardiogram was continuously
      monitored. Blockade of protein kinase C by polymyxin B (1 micromol/l)
      significantly reduced ventricular fibrillation to 40% (from 87% in controls).
      Similar effects were seen with the protein kinase C inhibitors staurosporine 10
      nmol/l (46% vs. 91%) and cremophor RH 40 100 micromol/l (33% vs. 77%). Activation
      of protein kinase C by 1,2-dioctanoyl-sn-glycerol (DOG, 10 micromol/l) or phorbol
      12-myristate 13-acetate (PMA, 10 nmol/l) did not affect ventricular fibrillation.
      In the presence of the alpha1A-adrenoceptor antagonist WB 4101 (0.1 micromol/l),
      which per se suppressed ventricular fibrillation to 17%, both DOG and PMA
      increased the occurrence of ventricular fibrillation to 73% and 75%,
      respectively, whereas the inactive phorbol ester 4alpha-phorbol 12,13-didecanoate
      (4alpha-PDD, 10 nmol/l) revealed no proarrhythmic effect. In summary, during
      regional ischemia in the isolated perfused rat heart, alpha1A-adrenoceptor
      stimulation induces ventricular fibrillation mainly by activating protein kinase
      C.

PMID- 11215535
TI  - Antiendothelial antibodies in sera of patients with infective endocarditis.
AB  - Infective endocarditis is characterized by the colonization of endocardium by
      microorganisms. Except for Staphylococcus aureus, microorganisms are not able to
      adhere to and grow on endocardial cells; prior damage, e.g., by shear stress or
      other mechanical factors, is necessary. But other causes may well have a share.
      This study was, therefore, designed to identify immunological factors, especially
      antibodies against endothelial cells, which could contribute to the initiation of
      endocardial injury. Sera of patients with infective endocarditis and healthy
      controls were investigated for the presence of antibodies against endothelial
      antigen. As the antigen source human umbilical vein endothelial cells were used.
      Antibodies against endothelial cells were detected by indirect
      immunofluorescence, ELISA, immunoblotting, antibody dependent cellular
      cytotoxicity, and antibody mediated cytotoxicity. Antibodies against endothelial
      cells were found in seven out of fifteen patients. These antibodies were directed
      against cytoplasmic structures and only appeared in the course of the disease. A
      correlation between the presence of these antibodies and disease activity or the
      outcome of disease was not observed. These antibodies may develop as a
      consequence of damage to endocardial cells (thereby exposing intracellular
      antigen to the immune system) and do not seem to play a role in the pathogenesis
      of infective endocarditis.

PMID- 11215536
TI  - Atrial L-type Ca2+-channel, beta-adrenorecptor, and 5-hydroxytryptamine type 4
      receptor mRNAs in human atrial fibrillation.
AB  - Molecular and electrical remodeling of ion channels determining action potential
      duration has been proposed as a major mechanism in chronic atrial fibrillation.
      We investigated the mRNA expression of the cardiac L-type Ca2+-channel subunits
      alpha1c, alpha2/delta1, beta1a, and beta1b/c in atrial tissue of patients with
      chronic atrial fibrillation compared to patients in sinus rhythm. In addition,
      the mRNA expression of the 5-hydroxytryptamine type 4-, beta1-, and beta2
      adrenergic receptors, which are known to stimulate the L-type Ca2+-current in
      human atrium, was analyzed and the effect of chronic beta-blocker treatment on
      the mRNA expression of these receptors and of the L-type Ca2+-channel subunits
      was assessed. Total RNA was isolated from right atrial appendages of patients in
      sinus rhythm and of patients with chronic atrial fibrillation. Then,
      semiquantitative RT-PCR using 18S RNA as the "housekeeping gene" was performed.
      In patients with chronic atrial fibrillation, there were only mild reductions in
      mRNA expression of the alpha1c-subunit (-15.5 %, p = 0.13), and of the beta1
      subunit isoforms a and c (-13.3 %, p = 0.14 and -16.6%, p = 0.18, respectively).
      However, mRNA expression of the alpha2/delta1-subunit (-31.5 %, p < 0.01) and of
      the beta1-subunit isoform b (-39.9 %, p < 0.0005) was significantly reduced in
      patients with chronic AF. Taken together, the mRNA expression of the beta1
      subunit isoforms b and c, which are splice variants, was significantly down
      regulated by 26.5 % (p < 0.05) in these patients. The analysis of the
      beta1c/beta1b ratio resulted in a significant shift by 39.2 % (p < 0.0001) in
      favor of beta1c in patients with chronic atrial fibrillation. In the AF patients,
      the abundance of the 5-HT4-receptor transcript was significantly reduced by 36 %
      (p < 0.05). The beta-adrenoreceptor transcription was unchanged. In both SR and
      AF patients, chronic beta-blocker treatment did neither significantly effect the
      mRNA expression of the L-type Ca2+-channel subunits, the beta-adrenoreceptor
      subtypes 1 and 2, nor that of the 5-HT4-receptor. Our data show that chronic AF
      is associated with a decrease in the atrial mRNA amount of auxiliary subunits of
      the L-type Ca2+-channel and of the 5-HT4-receptor. This supports the hypothesis
      that the observed alterations in mRNA transcription in AF patients may lead to a
      decrease in the availability of functional L-type Ca2+-channels and 5-HT4
      receptors and/or reduce L-type Ca2+-current amplitude and density, thus,
      promoting and stabilizing the arrhythmia.

PMID- 11215537
TI  - Pulmonary beta adrenoceptor density in arrhythmogenic right ventricular
      cardiomyopathy and idiopathic tachycardia.
AB  - OBJECTIVE: In recent in vivo studies using positron emission tomography (PET) our
      group demonstrated that the myocardial beta adrenoceptor (betaAR) density is
      reduced in arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic
      right ventricular outflow tract tachycardia (RVO-VT) associated with an increased
      presynaptic catecholamine washout. It was hypothesised that the reduction of
      myocardial betaAR density is secondary to an increase of local catecholamines in
      the myocardium resulting from the presynaptic dysfunction since circulating
      plasma catecholamines were demonstrated to be unchanged in these conditions. To
      further prove this hypothesis of an organ-limited adrenergic nervous dysfunction
      of the heart, this study aimed to investigate betaAR density in another thoracic
      organ, the lung. METHODS: Pulmonary and myocardial betaAR density was measured in
      7 ARVC patients, 8 RVO-VT patients and in a group of healthy controls (n = 13)
      using the non-selective beta-blocker [11C]-CGP 12177 and PET. RESULTS: Pulmonary
      betaAR density was similar in controls (12.4 +/- 1.7 pmol/g tissue), ARVC (11.6
      +/- 1.7 pmol/g tissue, p = ns) and RVO-VT (12.8 +/- 2.0 pmol/g tissue, p = ns),
      whereas myocardial betaAR density was significantly reduced in ARVC (6.3 +/- 1.1
      pmol/g tissue, p = 0.006) and RVO-VT (6.8 +/- 1.2 pmol/g tissue, p=0.02) as
      compared to controls (8.8+/-1.5 pmol/g tissue). CONCLUSION: The unchanged
      pulmonary betaAR density in the presence of a previously described significant
      reduction in myocardial betaAR density in the same patient principally supports
      our pathophysiological hypothesis that the myocardial betaAR density may be
      reduced in ARVC and RVO-VT because of an increase in local synaptic catecholamine
      levels due to an organ-limited presynaptic adrenergic dysfunction of the heart.
      Since in the present study only pulmonary betaAR density was measured, future
      functional studies excluding pulmonary betaAR desensitisation are required to
      finally prove the unchanged pulmonary sympathetic innervation in ARVC and RVO-VT.

PMID- 11215538
TI  - Signal characteristics of multichannel epicardial electrograms in chronic
      ischaemic and scarred myocardium: electromechanical mismatch indicates viability
      in regions of myocardial dysfunction.
AB  - BACKGROUND: To predict the outcome after myocardial revascularisation, a clear
      separation between hibernation and/or repetitive stunning on the one hand and
      myocardial scarring on the other hand is of importance. METHODS AND RESULTS: A
      total of 44 patients was included in this study. In 35 patients with chronic
      myocardial ischaemia and an indication for coronary bypass-surgery, epicardial
      mapping of local activation was performed. Nine patients with LV aneurysm and an
      indication for antitachycardia surgery were also included. For simultaneous
      recording of the local electrograms during sinus rhythm, a sock electrode with
      102 bipolar leads was used. The regional myocardial contraction pattern was
      assessed from preoperative angiograms and regional myocardial metabolism
      (viability) from 18F-FDG PET, respectively. The results were projected on the
      grid of the intraoperative position of the sock electrode. This enabled regional
      comparison of electrogram characteristics to local contraction patterns and
      viability. For the characterisation of local electrograms, peak-to-peak amplitude
      and duration of activation were calculated using custom-made automated computer
      algorithms. Dysfunctional but viable areas showed normal or almost normal
      electrographic signal characteristics. In contrast, dysfunctional and non-viable
      myocardium showed a distinct reduction of local amplitudes and prolongation of
      signal duration. These changes were even more intense in areas of LV aneurysms.
      CONCLUSIONS: In patients with chronic ischaemic myocardium, a mismatch between
      mechanical function and local electrogram characteristics was observed in areas
      with preserved metabolism. Thus, normal epicardial electrograms in regions of
      myocardial dysfunction may be an indicator for myocardial viability.

PMID- 11215539
TI  - "Schizotaxia": clinical implications and new directions for research.
AB  - We sought to show that (1) schizotaxia (Meehl's term for the predisposition to
      schizophrenia) is a clinically consequential condition, and (2) distinguishing it
      from schizotypal personality disorder may be useful from both clinical and
      scientific perspectives. We review the features of schizotaxia that may be
      relevant in clinical settings and discuss their implications for the diagnosis,
      psychosocial functioning, family intervention and treatment of people in
      schizophrenia families. Our review indicates that prior work finds some of the
      nonpsychotic and nonschizotypal relatives of schizophrenia patients to have a
      psychiatric syndrome characterized by negative symptoms, neuropsychological
      impairment, and psychosocial dysfunction. Following Meehl, we call this
      constellation of clinical and neurobiological features schizotaxia. The studies
      we review suggest it may be worthwhile to consider schizotaxia as a separate
      diagnostic class. Doing so would alert clinicians to a neurobehavioral syndrome
      not adequately covered by current diagnostic criteria and would motivate
      researchers to develop diagnostic and therapeutic approaches aimed at helping
      schizotaxic individuals and, perhaps, preventing the onset of schizophrenia.

PMID- 11215540
TI  - Gender differences in poor outcome patients with lifelong schizophrenia.
AB  - Gender effects have been reported quite consistently in schizophrenia, with male
      patients having an earlier age of onset, poorer functional outcome, greater
      negative symptoms and cognitive impairment, and less severe positive symptoms.
      Because age of onset, cognitive impairments, and negative symptoms are all
      correlated with poorer functional status, it is not clear if previously reported
      gender differences in symptoms are just recapturing gender differences in
      functional outcome. In this study, 205 geriatric patients with lifelong poor
      outcome schizophrenia (43% male) were examined for the severity of schizophrenic
      symptoms, cognitive impairments, and specific deficits in adaptive skills, as
      well as for demographic differences such as age at first psychiatric admission,
      premorbid education, and current treatment status. Previously reported gender
      differences were replicated in these patients with a uniformly poor functional
      outcome, with male patients having more severe negative symptoms and an earlier
      age of first psychiatric admission. No differences in cognitive functioning or
      specific functional deficits were found, however. These findings suggest that
      negative symptom severity is greater in male patients regardless of functional
      outcome and that the association of cognitive deficits with gender may be found
      only in patients with better functional outcome. The study of gender-related
      differences in brain structure or function and their interaction with overall
      course of illness might help understand these differences in symptom
      presentation.

PMID- 11215541
TI  - Subtyping schizophrenia according to outcome or severity: a search for
      homogeneous subgroups.
AB  - There is a growing consensus that current definitions of schizophrenia (SZ)
      include different disorders, or else different dimensions underlain by different
      pathophysiologies. This article reviews the evidence for the validity of three
      novel strategies to subtype SZ according to outcome or severity (deficit vs.
      nondeficit, Kraepelinian vs. non-Kraepelinian, congenital vs. adult-onset).
      Medline and bibliographies were used to locate articles. The methodology of the
      studies was reviewed, and their results were grouped according to seven
      validating criteria. Several differences were found between subtypes,
      particularly for the deficit/nondeficit subtypes. However, for most of these
      differences, replications have yet to be undertaken. Important indicators of
      etiology from the environmental risk factors and genetic domains have received
      very little attention. These three subtyping strategies represent promising
      attempts to address the etiologic heterogeneity of SZ. However, one cannot
      conclude whether these strategies identify etiologically distinct SZ subgroups.
      We propose ten methodological and conceptual recommendations for future studies
      aimed at the identification of valid SZ subtypes according to outcome or
      severity.

PMID- 11215542
TI  - Work-related social skills training for people with schizophrenia in Hong Kong.
AB  - This article describes a prospective blinded outcome study of a vocational social
      skills training program developed in Hong Kong for people affected by chronic
      schizophrenia. The aim was to improve their ability to find and keep a job.
      Participants were randomly assigned to three groups: a social skills training
      group with followup support, a social skills training group without followup
      support, and a comparison group who received standard after-care treatment.
      Participants who had participated in either of the training groups statistically
      outperformed those in the comparison group. Those receiving the training plus
      followup were statistically much more successful at finding and keeping a job
      than participants in either of the other two groups. A comparatively small amount
      of followup contact (a monthly group meeting or phone call) for 3 months after
      the training finished had a very significant effect on participants' success
      rate.

PMID- 11215543
TI  - Negative symptoms of schizophrenia and compliance with medication.
AB  - Poor compliance with medication has been reported in up to 40 percent of
      outpatients with schizophrenia. This study examines the relationship between
      compliance with depot neuroleptic medication and severity of negative symptoms of
      schizophrenia. Compliance with depot neuroleptic medication during the preceding
      year was calculated for 64 patients with a DSM-III-R diagnosis of schizophrenia.
      The severity of negative symptoms was assessed using the Scale for the Assessment
      of Negative Symptoms (SANS). Patients who complied poorly with medication had
      significantly greater severity of negative symptoms of schizophrenia, especially
      avolition, apathy, and alogia. Duration of illness and duration of prescribed
      medication were independently associated with compliance, but no other features
      were associated in the multiple regression model. These findings suggest that
      negative symptoms are one of the factors of importance in determining whether a
      patient will attend for depot neuroleptic medication.

PMID- 11215544
TI  - Working memory in schizophrenia: transient "online" storage versus executive
      functioning.
AB  - Working memory has been described as the temporary "online" storage and the
      subsequent manipulation and retrieval of information. It has been suggested that
      the prefrontal cortex is a primary site of working memory. Schizophrenia
      patients, who are thought to have prefrontal cortical dysfunction, have
      demonstrated inconsistent deficits on a variety of verbal and spatial working
      memory tests. This has led to questions about how to define and measure working
      memory, whether these deficits are distinct to one cognitive domain, and what
      role factors such as intelligence and symptoms play in working memory
      performance. We compared schizophrenia patients to normal comparison subjects in
      four separate studies. Based upon the results we recommend that working memory
      tests be characterized as either transient "online" storage and retrieval tasks
      (where short-term storage and retrieval of information is required) or executive
      functioning working memory tasks (where storage, manipulation, and retrieval of
      information is required). The importance of clearly identifying which distinct
      aspects of working memory are assessed is discussed.

PMID- 11215545
TI  - First person account: schizophrenia, medication, and outpatient commitment.
AB  - The article that follows is part of the Schizophrenia Bulletin's ongoing First
      Person Account series. We hope that mental health professionals-the Bulletin's
      primary audience--will take this opportunity to learn about the issues and
      difficulties confronted by consumers of mental health care. In addition, we hope
      that these accounts will give patients and families a better sense of not being
      alone in confronting the problems that can be anticipated by persons with serious
      emotional difficulties. We welcome other contributions from patients, ex
      patients, or family members. Our major editorial requirement is that such
      contributions be clearly written and organized, and that a novel or unique aspect
      of schizophrenia be described, with special emphasis on points that will be
      important for professionals. Clinicians who see articulate patients with
      experiences they believe should be shared might encourage these patients to
      submit their articles to Schizophrenia Bulletin, First Person Accounts, EEI
      Communications, 66 Canal Center Plaza, Suite 200, Alexandria, VA 22314.-The
      Editors.

PMID- 11215546
TI  - Depressive factors and their relationships with other symptom domains in
      schizophrenia, schizoaffective disorder, and psychotic depression.
AB  - Relationships among different symptom domains were investigated in patients with
      acute exacerbation of schizophrenia with depressive symptoms, psychotic
      depression, or schizoaffective disorder, depressive subtype. Scores for
      depression and depressive factors were correlated with positive, negative, and
      extrapyramidal symptoms within diagnostic categories. No between-group
      differences in the relationship of different symptom domains could be found, and
      no substantial relationship between depression and positive symptoms could be
      revealed in any diagnostic subgroup. Only the retardation factor of depression
      showed a significant overlap with negative symptoms; depressive core symptoms did
      not. Core symptoms of depression were independent from other symptoms in all
      investigated diagnostic groups. Depression seems to represent a heterogeneous
      symptom domain with unique relationships of components to positive and negative
      symptoms across nosological borders. A more differentiated assessment, analysis,
      and treatment of depressive symptoms is therefore recommended for patients with
      combined depressive and psychotic symptoms.

PMID- 11215547
TI  - Differences in rates of depression in schizophrenia by race.
AB  - The purpose of this study was to determine whether demographic and clinical
      factors are associated with a diagnosis of depression among persons with
      schizophrenia and to determine the association of depression with subjective
      quality of life. A consecutively admitted sample of psychiatric inpatients
      diagnosed with schizophrenia (n = 123) were assessed for depression and quality
      of life. Logistic regression was used to determine factors associated with a
      diagnosis of depression. Multiple regression analyses were used to determine the
      relationship between depression and quality of life. The odds of being diagnosed
      with depression were seven times greater in Caucasians than in African-Americans,
      and three times greater in persons who were ever married. Depression was
      significantly associated with reduced life satisfaction in Caucasians but not
      African-Americans. This suggests the importance of race as a predictor of a
      diagnosis of depression in schizophrenia and the possibility of underdiagnosis of
      depression among African-Americans. The absence of the expected association
      between depression and quality of life in African-Americans casts doubt on the
      validity of the depression diagnosis using conventional diagnostic tools.

PMID- 11215548
TI  - Confirmation of a two-factor model of premorbid adjustment in males with
      schizophrenia.
AB  - Because schizophrenia is considered to be a neurodevelopmental disorder,
      premorbid adjustment is of particular interest. Premorbid adjustment is probably
      not a unitary construct but rather is expressed across a number of developmental
      domains. The current investigation examined the validity of a two-factor model
      that differentiated premorbid adjustment across social and academic domains and
      evaluated relationships between these premorbid adjustment domains and other
      variables of interest. Participants with schizophrenia (n = 141) underwent
      evaluation of premorbid adjustment (using the Premorbid Adjustment Scale),
      intellectual functioning, and psychiatric symptoms. Using confirmatory factor
      analysis, a two-factor model of premorbid adjustment was identified that included
      an academic domain and a social domain. The social domain was associated with
      symptom variables, while the academic domain was associated with measures of
      intelligence. Results provide evidence for at least two domains of premorbid
      adjustment in schizophrenia. Distinguishing between these two premorbid domains
      may be theoretically important because of potential differences in incidence
      rates and deterioration courses; some individuals with schizophrenia may exhibit
      adequate academic adjustment but poor social adjustment, while others may exhibit
      the opposite pattern.

PMID- 11215549
TI  - Genetic and environmental influences on schizotypy: a community-based twin study.
AB  - This study investigated the factor structure and etiology of four self-report
      schizotypy questionnaires during young adulthood (age 18-27) in 98 monozygotic
      and 59 same-sex dizygotic twin pairs from the community. A single phenotypic
      factor was identified that was primarily associated with Perceptual Aberration,
      Magical Ideation, and the Rust Inventory of Schizotypal Cognitions scales, and
      less so with Social Anhedonia. Univariate etiologic models suggested that in
      addition to nonshared environmental influences, Perceptual Aberration and Social
      Anhedonia were significantly influenced by either genes or shared family
      environment, whereas Magical Ideation and the Rust Inventory were influenced by
      shared family environment, but not genes. Multivariate twin analyses detected a
      common schizotypy factor, primarily defined by Perceptual Aberration, Magical
      Ideation, and the Rust Inventory scales, that was influenced by genes or shared
      environment as well as nonshared environment. Contrary to expectations, these
      results suggest that, at least in community-based samples, these "positive"
      schizotypy questionnaires are not strongly genetically influenced.

PMID- 11215550
TI  - Latent class analysis of DSM-IV schizotypal personality disorder criteria in
      psychiatric patients.
AB  - The aim of the study was to evaluate the latent structure of DSM-IV schizotypal
      personality disorder (SPD) diagnostic criteria. The sample consisted of 564
      consecutively admitted inpatients and outpatients. Exploratory latent class
      analysis identified a four-class model as the best fitting model for DSM-IV SPD
      criteria. The first of the SPD latent classes was mainly characterized by odd
      thinking, inappropriate affect, and interpersonal features; the second class by
      cognitive/perceptual difficulties; the third class by paranoid features; and the
      fourth class by absence of SPD features. The conditional probability pattern of
      the fourclass solution could be safely replicated across confounder strata.
      Unlike previous findings, oddness, aloofness, and social withdrawal, rather than
      positive symptoms, best characterized SPD even in clinical samples.

PMID- 11215551
TI  - The effect of family interventions on relapse and rehospitalization in
      schizophrenia--a meta-analysis.
AB  - Twenty-five intervention studies were meta-analytically examined regarding the
      effect of including relatives in schizophrenia treatment. The studies
      investigated family intervention programs to educate relatives and help them cope
      better with the patient's illness. The patient's relapse rate, measured by either
      a significant worsening of symptoms or rehospitalization in the first years after
      hospitalization, served as the main study criterion. The main result of the meta
      analysis was that the relapse rate can be reduced by 20 percent if relatives of
      schizophrenia patients are included in the treatment. If family interventions
      continued for longer than 3 months, the effect was particularly marked.
      Furthermore, different types of comprehensive family interventions have similar
      results. The bifocal approach, which offers psychosocial support to relatives and
      schizophrenia patients in addition to medical treatment, was clearly superior to
      the medication-only standard treatment. The effects of family interventions and
      comprehensive patient interventions were comparable, but the combination did not
      yield significantly better results than did a treatment approach, which focused
      on either the patient or the family. This meta-analysis indicates that
      psychoeducational interventions are essential to schizophrenia treatment.

PMID- 11215552
TI  - Family support and substance use outcomes for persons with mental illness and
      substance use disorders.
AB  - This paper explores the relationship between direct support from family members
      and friends and substance use outcomes for people with co-occurring severe mental
      illness and substance use disorders. Data are from a 3-year randomized trial of
      203 patients in treatment for dual disorders. Informal (family) caregivers for
      174 participants were asked about economic assistance and direct care that they
      provided to participants. Associations between family support and substance use
      outcomes were examined with bivariate comparisons of abstainers and nonabstainers
      and with regression models using change in substance use and cumulative substance
      use as dependent measures. Family economic support was associated with substance
      abuse recovery in bivariate and regression analyses. Caregiving hours were
      significantly associated with substance use reduction but not with cumulative
      substance use. Informal support was not associated with changes in psychiatric
      symptoms. The findings suggest that direct family support may help people with
      dual disorders to reduce or eliminate their substance use. Further research is
      needed to confirm this connection and to establish the mechanisms by which
      support is useful.

PMID- 11215553
TI  - Primary sclerosing cholangitis: challenges of a new millenium.

PMID- 11215554
TI  - Role of Helicobacter pylori infection in pernicious anaemia.
AB  - BACKGROUND: Pernicious anaemia is associated with atrophic body gastritis and
      considered an autoimmune disease. Whether Helicobacter pylori is involved in the
      induction of pernicious anaemia is uncertain. AIMS: To investigate the prevalence
      of Helicobacter pylori infection in pernicious anaemia patients and to ascertain
      whether the Helicobacter pylori-positive patients had distinctive clinical and
      gastric morphofunctional characteristics. PATIENTS AND METHODS: A series of 81
      consecutive pernicious anaemia patients underwent serological, functional and
      endoscopic/histological investigations. RESULTS: A total of 49 (60.5%) patients
      were Helicobacter pylori-positive (males 61.2% vs females 38.8%). No difference
      was observed in clinical and morphofunctional characteristics between
      Helicobacter pylori-positive and negative patients, whereas distinctive
      functional/histological features between histologically Helicobacter pylori
      positive (n=8) and serologically Helicobacter pylori-positive (n=41) cases were
      detected. In the histologically Helicobacter pylori-positive group, Pepsinogen I
      was higher [13 (058) vs 5 (0-26) ng/ml; p=0.0025)] and positivity for anti
      parietal cell antibodies was lower [42.9% vs 76.9, p=0.0867]. Antral histological
      variables of the gastritis score were significantly higher in the histologically
      Helicobacter pylori-positive than in the serologically Helicobacter pylori
      positive patients, but this latter group had a higher score of body atrophy
      (2.63+/-0.12 vs 1.71+/-0.29; p=0.0051). Body inflammation was also significantly
      higher in the histologically Helicobacter pylori-positive group (chronic
      inflammation: 1.43+/-0.2 vs 1.05+/-0.06; p=0.0271; inflammation acitivity: 0.
      57+/-0.3 vs 0.15+/-0.06, p=0.0220). Antral mucosa was normal in 24/41 (58.5%) of
      the serologically Helicobacter pylori-positive patients, but only in 1/8 (12.5%)
      of the histologically Helicobacter pylori-positive patients (p=0.0232).
      CONCLUSIONS: Almost two thirds of pernicious anaemia patients have evidence of
      Helicobacter pylori, but only those with an active Helicobacter pylori infection
      have distinctive functional and histological features. These findings support the
      hypothesis that Helicobacter pylori infection could play a triggering role in a
      subgroup of pernicious anaemia patients.

PMID- 11215555
TI  - Prevalence of Helicobacter pylori resistance to antibiotics in Northeast Italy: a
      multicentre study. GISU. Interdisciplinary Group for the Study of Ulcer.
AB  - AIMS: To evaluate prevalence of primary Helicobacter pylori antibiotic
      resistances in Northeast Italy and to identify risk factors associated with this
      resistance. MATERIALS AND METHODS: A total of 248 patients undergoing upper
      gastrointestinal endoscopy were enrolled from 19 Endoscopy Units over a 6-month
      period. From each patient, 4 gastric biopsies were taken for histology and 2 were
      sent to the Central Referral Microbiological Laboratory for culture and
      determination of antibiotic activity against Helicobacter pylori by means of E
      test. Strains were considered resistant when minimum inhibitory concentration was
      >8 microg/ml for metronidazole and >1 microg/ml for clarithromycin. No cut-off
      value was predefined for amoxycillin. RESULTS: Culture of Helicobacter pylori was
      successfully performed in 167 patients. Primary resistance to metronidazole,
      clarithromycin or amoxycillin was 14.9%, 1.8% and 0%, respectively Patients
      infected with Helicobacter pylori strains resistant to antibiotics were more
      frequently females than males (70.3% vs 41.4%), had a significantly lower coffee
      intake (66.6% vs 86.6%) and lower body mass index (23.7+/-2.6 vs 25.3+/-3.6) than
      patients with susceptible Helicobacter pylori strains. Age, smoking, alcohol use,
      family history of Helicobacter pylori infection, concomitant diseases and
      treatments, endoscopic diagnoses, Helicobacter pylori density and histological
      activity of chronic gastritis were not associated with antibiotic resistance.
      Multivariate analysis confirmed that female gender (odds ratio = 2.74, 95%
      confidence interval = 1.03-7.27) was the only significant risk factor associated
      with antibiotic resistance. CONCLUSIONS: In this population, primary Helicobacter
      pylori resistance to metronidazole was higher than resistance to clarithromycin,
      and female gender was significantly associated with this resistance. The low
      prevalence of resistance to metronidazole, clarithromycin and amoxycillin
      identified in this geographical area suggests that proton pump inhibitor-based
      triple regimens including these antibiotics may still be used as first line
      therapies against Helicobacter pylori infection.

PMID- 11215556
TI  - Oral nutritional supplementation is effective in the maintenance of remission in
      Crohn's disease.
AB  - BACKGROUND: Enteral feeding with either elemental or polymeric diets is an
      established primary therapy for active Crohn's disease. However, the role of
      supplementing normal food with elemental diet in the long-term management of
      Crohn's disease has hitherto not been explored. PATIENTS AND METHODS: A series of
      39 consecutive patients with Crohn's disease in clinical remission were studied.
      Of these, 21 patients (Group 1) received oral nutritional supplementation, taken
      in addition to their normal diet. Their outcome (relapse rate, Crohn's disease
      activity index, inflammatory markers) was compared with that of 18 patients
      (Group 2), who were maintained on a normal unrestricted diet over an observation
      period of 12 months. RESULTS: A total of 17 patients (81%) tolerated the
      nutritional supplementation. On an intention-to-treat basis, 10 patients (48%)
      remained in remission for 12 months, compared to 4/18 (22%) patients in Group 2,
      p<0.0003. Their Crohn's disease activity index and CRP remained stable while
      their weight and body mass index improved during the period of nutrition therapy
      Seven patients in Group 1 and 14 in Group 2 relapsed at a mean of 7.4+/-0.9 and
      6.2+/-0.4 months, respectively. The response to nutrition supplement was
      independent of age, sex, disease duration or location. Four patients (19%) were
      intolerant to enteral feeding. CONCLUSIONS: Nutritional supplementation is safe,
      well tolerated and effective in the long-term management of patients with
      quiescent Crohn's disease.

PMID- 11215557
TI  - Prevalence of silent coeliac disease in atopics.
AB  - BACKGROUND: Coeliac disease sometimes runs a subclinical/silent course and is
      often associated with immunologic and non-immunologic diseases. Although atopy is
      described as one of the most frequently associated conditions, the prevalence of
      coeliac disease in atopics has not yet been established. AIM: To evaluate the
      frequency of coeliac disease in an Italian series of atopics. PATIENTS AND
      METHODS: Sera from 401 consecutive atopics with no clinical evidence of
      malabsorption were tested for IgA antiendomysial antibodies by indirect
      immunofluorescence on human umbilical cord and IgA anti tissue transglutaminase
      by enzyme-linked immunosorbent assay Results. Four patients (1%) were found to be
      positive for both autoantibodies. Intestinal biopsy confirmed the diagnosis of
      active coeliac disease. One of the 4 coeliacs was also affected by Down's
      syndrome, autoimmune thyroiditis and coeliac hepatitis. In another case, a
      previously unknown severe iron deficiency was detected. CONCLUSIONS: The present
      study shows, for the first time, that the prevalence of coeliac disease in
      atopics is 1%, which is significantly higher than that in the general Italian
      population. Therefore, atopy should be considered a condition at risk and atopic
      patients routinely screened by means of specific autoantibody testing.

PMID- 11215558
TI  - Do we have to screen the general population for coeliac disease instead of only
      patients with so-called associated diseases?

PMID- 11215559
TI  - Prognostic indicators of successful endoscopic sclerotherapy for prevention of
      rebleeding from oesophageal varices in cirrhosis: a long-term cohort study.
AB  - BACKGROUND: Although band ligation is now recommended for prevention of
      rebleeding from oesophageal varices in cirrhosis, sclerotherapy is still widely
      used. Patients submitted to chronic sclerotherapy undergo several endoscopies and
      experience a large number of serious complications. However, long-term outcome is
      poorly defined. AIMS: To assess the clinical course and prognostic indicators of
      patients undergoing chronic sclerotherapy for prevention of variceal rebleeding
      as a basis for future evaluation of long-term band ligation outcome. METHODS:
      Prospective cohort study; prognostic analysis by the Cox proportional hazards
      model. RESULTS: A total of 218 consecutive cirrhotic patients (37 Child class A,
      154 B, 27 C) were enrolled in the study Varices were obliterated in 139 (64%)
      patients in a mean of 5 (+/-2.6) sessions and recurred in 58/139 (41.7%) within
      one year. A total of 132 (60%) patients experienced 283 rebleeding episodes and
      73 (33%) died. Bleeding from oesophageal ulcers was the most serious complication
      causing 14% of all rebleeding episodes. Significant prognostic indicators of
      sclerotherapy outcome were: Child-Pugh class for variceal obliteration; gastric
      varices and platelet count for recurrence of varices; failure to obliterate
      varices, variceal size and gastric varices for rebleeding; blood urea nitrogen
      and failure to obliterate varices for death. Presence of gastric varices was the
      only prognostic indicator for death in the 79 patients not achieving variceal
      obliteration. A mean of 10 endoscopies and of 6 hospital admissions were needed
      per each patient with an estimated cost of US dollars 7154 per patient during the
      first two years of therapy. CONCLUSIONS: Sclerotherapy is a very demanding and
      costly treatment, and is associated with frequent and serious side-effects. The
      probability of treatment failure is significantly higher in Child C patients with
      gastric varices. Alternative treatments should be considered for these patients.

PMID- 11215561
TI  - Hepatic amyloidosis with light chain deposition disease. A rare association.
AB  - Monoclonal immunoglobulin deposition diseases are due to pathological protein
      deposition in various tissues and organs. Protein deposits may be found in a
      single tissue or systemically and the organs most frequently involved are kidney,
      heart, peripheral nerves and the liver. Depending on the pattern of the deposits
      and the type of immunoglobulin, these diseases are distinguished as primary
      amyloidosis, light chain deposition disease. Differential diagnosis is made in
      tissue specimens: microscopically by the identification of positive Congo red
      staining of the deposits, by immunohistochemical demonstration of proteins
      reacting with light chain (lambda or kappa) antisera or by recognition of
      fibrillar structures on electron microscopy. We report an unusual case of light
      chain deposition disease associated with amyloidosis, where hepatomegaly was the
      presenting manifestation and liver failure the cause of death, without any kidney
      involvement.

PMID- 11215560
TI  - A girl with severe fistulizing Crohn's disease.
AB  - We report the case of a girl with a severe perianal fistulizing Crohn's disease
      who during intravenous infusion of cyclosporine developed headache, general
      seizures and cortical blindness. Head magnetic resonance imaging showed spread,
      cortical-subcortical nonenhancing signal changes. Full neurological recovery was
      achieved in 24 hours. Cyclosporine was stopped and a single dose of infliximab
      was infused with rapid improvement of the fistula that at 7 months' follow-up is
      still closed.

PMID- 11215562
TI  - Liver transplantation for erythropoietic protoporphyria: report of a case with
      medium-term follow-up.
AB  - A case of liver transplantation is described in a 35-year-old male with hepatic
      failure due to erythropoietic protoporphyria. Data regarding protoporphyrin
      levels in erythrocytes and faeces, before and after transplantation, seem to
      indicate that, in this case, protoporphyrin overproduction was, in part, due to
      liver synthesis. Four years after surgery, the patient is completely free of skin
      photosensitivity. Liver function tests are normal and there are no significant
      protoporphyrin deposits in the new liver. However, recurrence of the disease in
      the long-term cannot be excluded, since erythrocyte protoporphyrin levels have
      remained elevated after liver transplantation.

PMID- 11215563
TI  - Granular cell tumour of the oesophagus: a rare cause of dysphagia with
      differential diagnosis of oesophageal neoplastic lesions.
AB  - Granular cell tumour is a relatively uncommon, typically benign neoplasm of soft
      tissue. The macroscopic appearance of oesophageal granular cell tumour is a
      polypoid lesion, which is often asymptomatic and can be found incidentally, but,
      in some cases, is symptomatic and requires a correct differential diagnosis with
      malignant neoplasms of the oesophagus. We describe the case of a 28-year-old
      female who came to our attention due to a six-month history of heartburn and
      dysphagia. Oesophagogastroduodenoscopy showed the presence of a polypoid lesion 2
      cm above the gastro-oesophageal junction. The overlying mucosa was normal and the
      lesion seemed to be an isolated submucosal nodule with a "submucosal pill"
      appearance. It was excised completely using a standard diathermic snare, and
      diagnosis of oesophageal granular cell tumour was made by histological and
      immunohistochemical staining. The patient's symptoms disappeared immediately
      after removal of the nodule by endoscopic polypectomy, and no macroscopic or
      microscopic recurrence of granular cell tumour was noted during follow-up.
      Likewise, the patient was symptom-free during follow-up. This case shows that
      endoscopy is very effective, not only in the diagnosis, but also in the treatment
      of oesophageal lesions which require careful differential diagnosis.

PMID- 11215564
TI  - Pathogenesis of colorectal cancer.
AB  - The development of colorectal cancer has been viewed as an ordered process in
      which three main phases can be identified: initiation, promotion and progression.
      There is definite proof that stable alterations of the structure or sequence of
      DNA (mutations) represent the initiating event; these are followed by an
      uncontrolled expansion of the neoplastic clones which characterizes tumoural
      growth. Several classes of genes have been identified foncogenes, tumour
      suppressor genes and "mutator" genes) the alterations of which are important in
      the initiation as well as in the promotion and progression of tumours. Colorectal
      cancer, therefore, results from a series of genetic changes which lead to the
      progressive and irreversible loss of normal control of cell growth and
      differentiation. Available evidence is consistent with the hypothesis that there
      are several molecular pathways underlying the passage from normal mucosa to
      colorectal carcinoma, thus explaining the existence of intestinal tumours with a
      different biological nature, which may represent specific targets for prevention
      and cure. Well-defined molecular pathways have been identified for: A) sporadic
      colorectal cancer ("Loss of heterozygosity pathway"); B) familial adenomatous
      polyposis and related polyposis syndromes; C) hereditary non-polyposis colorectal
      cancer ("mutator genes/microsatellite instability pathway"); D) cancer developing
      in inflammatory bowel diseases; E) familial colorectal cancer. Thus, there is
      consistent and considerable evidence suggesting the existence of several
      biological pathways leading to the same phenotypical expression (i.e., colorectal
      cancer), and it is likely that additional pathways will be clarified in the
      future. From a practical point of view, tumours with a diverse biology might
      offer different and more effective preventive and curative approaches.

PMID- 11215565
TI  - Occult hepatitis B virus infection.
AB  - Many studies have shown that hepatitis B virus infection may also occur in
      hepatitis B surface antigen-negative patients. This occult infection has been
      identified both in patients with cryptogenic liver disease and in patients with
      hepatitis C virus-related chronic hepatitis, and much evidence suggests that it
      may be a risk factor of hepatocellular carcinoma development. However several
      aspects of this occult infection remain unclear such as its prevalence and the
      factor(s) involved in the lack of circulating hepatitis B surface antigen.
      Moreover, it is uncertain whether the occult hepatitis B virus infection may
      contribute to chronic liver damage, considering that it is usually associated
      with a suppressed viral replication. Evidence and hypotheses concerning this
      fascinating field of bio-medical research are reviewed.

PMID- 11215566
TI  - Muscle paralysis produced by botulinum toxin type A injection in treated
      torticollis patients compared with toxin naive individuals.
AB  - We sought to determine whether the response to varying doses of botulinum toxin
      type A (BTX-A) injected in BTX-A-treated torticollis patients differed from the
      same injections given in toxin-naive individuals. We have developed a technique
      to objectively measure muscle weakness resulting from BTX injections in humans
      and have validated the technique in those not previously treated with BTX. We now
      examine BTX-A-treated torticollis patients to see if their response to BTX-A
      injection is similar to that of toxin-naive individuals. We injected 11
      torticollis patients who had been receiving BTX-A injections with a standard 5
      mouse unit (mu) dose into one extensor digitorum brevis (EDB) muscle and a
      varying dose into the other EDB, measuring muscle paralysis 2 weeks after the
      injection. Nine of the 11 patients were clinical and electrophysiologic
      responders. Two patients were non-responders. In the 9 responding patients the
      dose response curve to increasing doses of BTX-A was very similar to that seen in
      toxin-naive individuals. The mean muscle paralysis from the standard 5 mu dose
      was also similar to that previously reported in toxin-naive individuals.
      Torticollis patients who continue to respond clinically to BTX-A injections
      demonstrate essentially the same degree of muscle paralysis from the EDB
      injections as do subjects who have never been exposed to BTX-A.

PMID- 11215567
TI  - Inherited myoclonus-dystonia: evidence supporting genetic heterogeneity.
AB  - Inherited myoclonus-dystonia (IMD) is a new term used to describe an autosomal
      dominant form of myoclonus. Recently a family with IMD was linked to a region on
      chromosome 11q23 and a possible mutation identified in the D2 dopamine receptor.
      We have identified a large family with 12 affected individuals. Using linkage
      analysis and direct sequencing, the D2 receptor gene was excluded as a cause of
      myoclonus in this family. These results indicate that the Val154Ile D2 receptor
      substitution is not the universal cause of IMD. This suggests either that it is a
      rare, family specific polymorphism not causative of IMD, or that IMD is
      genetically heterogeneous.

PMID- 11215569
TI  - Re-emergence of childhood stuttering in Parkinson's disease: a hypothesis.
AB  - OBJECTIVE: To characterize speech patterns in patients with Parkinson's disease
      (PD) who have a history of childhood stuttering. BACKGROUND: Childhood stuttering
      usually resolves, but it re-emerges in some patients after stroke or other brain
      disorders. This phenomenon of recurrent stuttering has not been characterized in
      childhood stutterers who later develop PD. METHODS/PATIENTS: Twelve patients with
      a history of childhood stuttering that remitted and subsequently recurred were
      included in the study. A structured interview was administered to seven patients,
      and six were able to answer questions about childhood stuttering. The Johnson
      Severity Scale (JSS) (range 0-7) and a Situation Avoidance Scale (SAS) were used
      to rate stuttering severity (range 0-15) and avoidance (range 0-15). RESULTS: The
      mean age at onset of childhood stuttering was 6.2 years (range 5-10); the mean
      latency from the onset of childhood stuttering to adult stuttering was 46.1
      years; and the stuttering recurred on average 5.9 years (range 0-21) after the
      onset of PD. The stuttering characteristics in childhood and adulthood included
      repetitions of sounds and syllables at the beginnings of words, blocks and
      interjections, physical tension, and a worsening of symptoms with stress. The
      patients rated themselves as having mild-to-moderate childhood stuttering by the
      JSS (mean 3.0, range 2-4) and mild-to-moderate stuttering and avoidance by the
      SAS (mean stuttering score 5.3, range 3-7; mean avoidance score 4.2, range 3-6).
      There was no apparent association between the severity of childhood stuttering
      and the severity of PD, but those patients who had higher Unified Parkinson's
      Disease Rating Scale scores tended to have more and worse symptoms of stuttering.
      CONCLUSION: Our patients provide evidence for the hypothesis that childhood
      stuttering may re-emerge in adulthood with the onset of PD.

PMID- 11215568
TI  - Prevalence of homozygous deletions of the parkin gene in a cohort of patients
      with sporadic and familial Parkinson's disease.
AB  - Mutation of the parkin gene is a cause of familial Parkinson's disease of the
      autosomal recessive form; however, its significance in all Parkinson's disease
      cases is unclear. Deletions in the parkin gene were found in only 2.2% of 184
      Japanese patients with Parkinson's disease. However, deletions were present in
      25.0% and 40.0% of the patients with juvenile-onset (< 40 y) and with
      familiality, respectively. On the other hand, deletions were not found in any
      adult-onset cases (> 40 y). Half of the patients with parkin gene-related
      Parkinson's disease lacked both heredity and consanguinity.

PMID- 11215570
TI  - Stroke and idiopathic Parkinson's disease: does a shortage of dopamine offer
      protection against stroke?
AB  - Data on the relationship between idiopathic Parkinson's disease (IPD) and stroke
      are conflicting. In this study, we examined the frequency of IPD in stroke
      patients registered in the Maastricht Stroke Registry. With the use of three
      different search strategies, we found eight individuals with IPD amongst a total
      of 1,516 stroke patients. We had expected to find approximately 30 IPD patients
      (relative risk 0.27; 95% confidence interval 0.11-0.53), based on IPD prevalence
      figures from a Dutch population-based study. We speculate that dopamine
      deficiency may protect against ischaemic brain damage, perhaps by reducing the
      effects of excitotoxicity.

PMID- 11215571
TI  - [123I]beta-CIT SPECT demonstrates decreased brain dopamine and serotonin
      transporter levels in untreated parkinsonian patients.
AB  - Striatal dopamine transporters (DATs) and serotonin transporters (SERTs) were
      evaluated in untreated patients with Parkinson's disease (PD) and controls using
      single-photon emission computed tomography (SPECT) with 2beta-carboxymethoxy
      3beta-(4-iodophenyl)tropane ([123I]beta-CIT). The striatal DAT specific to non
      displaceable uptake ratios of 29, and the SERT uptake measurements of 27, PD
      patients were compared with those of 21 and 16 controls, respectively. The
      results were correlated with Unified Parkinson's Disease Rating Scale (UPDRS)
      scores, the Hoehn & Yahr stage, age, duration of the disease, and the major PD
      signs. The specific DAT binding in the caudate, the putamen and the
      caudate/putamen ratio were measured. In all of the PD patients the striatal
      uptake values were bilaterally reduced, being 36.9% (P < 0.001) lower than those
      of the controls. In the hemiparkinsonian patients the reduction was greater on
      the side contralateral to the initial symptoms (33.3% vs. 27.8%) and the uptake
      ratios indicated a more pronounced deficit in the putamen (39.1%) than in the
      caudate (27.9%). The DAT uptake correlated with the UPDRS total score and
      activities of daily living (ADL) and motor subscores, the Hoehn & Yahr stage, and
      rigidity score. PD patients had significantly higher caudate to putamen ratios
      than the controls. In the PD patients the SERT values were lower in the thalamic
      and frontal regions. The SERT uptake ratio of the frontal area correlated with
      the UPDRS subscore I. [123I]beta-CIT SPECT provides a useful method for
      confirming the clinical diagnosis of PD with correlation to disease severity.
      Additionally, this technique allows the simultaneous measurement of SERT uptake
      and shows that PD patients, interestingly, seem to have decreased SERT
      availability in the thalamic and frontal areas.

PMID- 11215572
TI  - Can peripheral trauma induce dystonia? No!

PMID- 11215573
TI  - Assessment of plasma lactoferrin in Parkinson's disease.
AB  - Iron may play an important role in the pathogenesis of Parkinson's disease (PD).
      Recent studies have shown that the iron-transporting glycoprotein lactoferrin
      (LF) and its receptor are increased in the substantia nigra (SN) in PD. We
      investigated whether plasma levels of LF are altered in dopa-responsive PD.
      Plasma LF was not different between patients with PD (n = 23; 306 +/- 116 [mean
      +/- standard deviation] ng/ml) and age- and sex-matched healthy control subjects
      (n = 15; 359 +/- 126 ng/ml ). However, LF was inversely correlated with PD
      severity (r = -0.68, P = 0.002), an association that remained significant after
      adjustment for treatment with levodopa, monoaminooxidase inhibitors, and dopa
      agonists (r = -0.53, P = 0.017). Plasma transferrin and ferritin levels were not
      different between groups and neither correlated with disease severity nor with LF
      levels. Together with the result of increased nigral lactoferrin, this finding is
      compatible with the hypothesis of an imbalance between LF levels in blood and SN
      in progressing PD. Larger and particularly longitudinal studies and measurements
      of LF in cerebrospinal fluid are warranted to further examine the role of LF in
      PD.

PMID- 11215574
TI  - Clozapine for the treatment of drug-induced psychosis in Parkinson's disease:
      results of the 12 week open label extension in the PSYCLOPS trial.
AB  - OBJECTIVE: To report the results of the 12-week, prospective, open label
      extension of the 4-week, multicenter, placebo-controlled, double-blind PSYCLOPS
      (PSYchosis and CLOzapine in the treatment of Parkinsonism) trial. This extension
      examined the chronic safety and efficacy of clozapine in the treatment of drug
      induced psychosis in Parkinson's disease (PD). BACKGROUND: Psychosis is a serious
      late complication of PD and may be a harbinger to increased mortality. Clozapine,
      the first atypical antipsychotic, was shown in several small open label studies
      to improve psychosis without worsening of motor symptoms. This was recently
      confirmed in the double-blind PSYCLOPS trial. METHODS: The 53 patients who
      completed the double-blind portion of PSYCLOPS were evaluated on their original
      randomized treatment (clozapine or placebo), then had study medication stopped.
      All were started on clozapine. The patients from both treatment groups were
      evaluated every 4 weeks over a 12-week period using standardized measures for
      psychosis and PD. RESULTS: The mean dose of clozapine was 28.78 mg/day. Those
      originally treated with placebo improved significantly in Brief Psychiatric
      Rating Scale and clinical global scores for psychosis to the same degree as the
      group originally randomized to clozapine in the double-blind study. Both groups
      maintained their response to week 16 (end of the combined double-blind and open
      label portions). There was no worsening of motor features as measured by the
      Unified Parkinson's disease rating scale. Eighteen patients were either
      hospitalized or died during the trial. The most common reasons were pulmonary.
      CONCLUSIONS: Low-dose clozapine is effective in treating drug-induced psychosis
      without worsening motor features of PD, and the response is maintained for at
      least 4 months. Patients with psychosis and PD were previously described as a
      group with high risk for morbidity and mortality. The high risk continues despite
      antipsychotic therapy.

PMID- 11215576
TI  - CSF dopamine, serotonin, and biopterin metabolites in patients with restless legs
      syndrome.
AB  - PURPOSE: To evaluate the role of CNS dopaminergic systems in Restless Legs
      Syndrome (RLS), homovanillic acid (HVA), tetrahydrobiopterin (BH4), and neopterin
      (NEOP), were assayed in CSF from RLS patients. The serotonin metabolite, 5
      hydroxyindoleacetic acid (5-HIAA), was also measured. METHODS: CSF was taken from
      16 RLS patients after 2 weeks off medication and from 14 control subjects. The
      CSF metabolites were determined using HPLC techniques. RESULTS: There was no
      significant difference in HVA or 5-HIAA, but NEOP and BH4 were higher in RLS
      patients. The RLS group was significantly older than the control group (64.2 +/-
      9.2 years vs. 51.4 +/- 6.3 years; P < 0.001). A multiple regression analysis
      showed a strong correlation between age and 5-HIAA (r = 0.46, P = 0.04) and
      between age and NEOP (r = 0.61, P < 0.01). To eliminate the potential error
      created by the age difference between groups, an age-adjusted subgroup of RLS and
      control subjects were compared. There was still no difference found for HVA;
      however, 5-HIAA was now significantly lower (P < 0.01) in the RLS subgroup. Age
      adjustment eliminated the differences previously found for NEOP, (P = 0.12), but
      BH4 continued to remain higher in the RLS group (P < 0.01). CONCLUSION:
      Differences in CSF HVA concentrations were not found. The changes in 5-HIAA and
      BH4 are of unclear clinical significance and require further assessment with
      appropriate age-matched controls.

PMID- 11215575
TI  - Comparison of thalamotomy to deep brain stimulation of the thalamus in essential
      tremor.
AB  - OBJECTIVE: To compare outcome in Essential Tremor (ET) patients who have
      undergone either thalamotomy or Deep Brain Stimulation (DBS) of the thalamus.
      BACKGROUND: Although both thalamotomy and thalamic DBS are effective surgical
      treatments of tremor, it is not known if one procedure is superior to the other.
      DESIGN/METHODS: Thirty-five ET patients underwent thalamotomy between 1994-1998.
      Data on 18 patients were excluded. The remaining 17 patients were matched for
      age, sex, side of surgery, and tremor severity to 17 ET patients who underwent
      thalamic DBS. There were nine men and eight women in each group. The mean age of
      the thalamotomy group was 74.4 years and that of the thalamic DBS group was 73.1
      years. RESULTS: There were no significant differences between any efficacy
      outcome variables comparing thalamotomy to DBS of the thalamus at baseline or
      follow-up visits. The surgical complications were higher for the thalamotomy
      group as compared to the DBS group. However, a larger number of DBS patients
      underwent repeat surgeries due to problems with the device and the leads.
      CONCLUSION: Although the efficacy is similar for thalamotomy and DBS of the
      thalamus for ET, thalamotomy is associated with a higher complication rate. DBS
      of the thalamus should be the procedure of choice for the surgical treatment of
      ET in most cases.

PMID- 11215577
TI  - Kainate acid lesions of the pedunculopontine region in the normal behaving
      primate.

PMID- 11215578
TI  - The basal ganglia: part 1 of the MDS-sponsored History of Movement Disorders
      Exhibit, Barcelona, June 2000.

PMID- 11215579
TI  - The history of Parkinson's disease: part 2 of the MDS-sponsored History of
      Movement Disorders Exhibit, Barcelona, June, 2000.

PMID- 11215580
TI  - Negative myoclonus in posthypoxic patients: historical note.

PMID- 11215581
TI  - Clinical and genetic studies on familial parkinsonism: the first report on a
      parkin gene mutation in a Taiwanese family.

PMID- 11215582
TI  - Hardware failure in parkinsonian patients with chronic subthalamic nucleus
      stimulation is a medical emergency.

PMID- 11215583
TI  - Delayed intracerebral electrode infection after bilateral STN implantation for
      Parkinson's disease. Case report.

PMID- 11215584
TI  - Bilateral thalamic stimulation for Holmes' tremor caused by unilateral brainstem
      lesion.

PMID- 11215585
TI  - Unusual tremor associated with a posterolateral thalamic lesion in a drummer.

PMID- 11215586
TI  - Task-specific dystonia in a horn player.

PMID- 11215587
TI  - Acute onset dystonic camptocormia caused by lenticular lesions.

PMID- 11215588
TI  - Asymmetrical blepharospasm associated with a left frontal cortical infarct.

PMID- 11215589
TI  - Neuroimaging in basal ganglia disorders: perspectives for transcranial
      ultrasound.
AB  - Transcranial sonography is a new diagnostic tool, allowing not only the
      evaluation of cerebral arteries but also the two-dimensional display of the brain
      parenchyma. In this review we will summarize basics of the application, the
      ultrasound anatomy of the brain and sonographic findings in some movement
      disorders. While in normal adults basal ganglia nuclei are hypoechogenic, they
      are hyperechogenic in certain basal ganglia disorders. In Parkinson's disease,
      for example, the substantia nigra can be depicted as a distinctly echogenic area.
      An elevated echogenicity of the lentiform nuclei was noticed in patients with
      primary adult-onset dystonia. In both disorders the altered echogenicity may
      arise from higher heavy metal tissue content (i.e. iron in Parkinson's disease
      and copper in primary dystonia). Our findings converge to the hypothesis that
      transcranial ultrasound sensitively detects pathological metal accumulation not
      identified by other neuroimaging techniques (CT and MRI) and therefore provides
      new insights in the diagnosis of basal ganglia disorders. The implications of
      these findings for the understanding of the pathogenesis and its usefulness for
      the early diagnosis of movement disorders are outlined.

PMID- 11215590
TI  - Discriminating mild parkinsonism: methods for epidemiological research.
AB  - Methods for the efficient and accurate detection of parkinsonism are essential
      for epidemiological studies. We sought to determine whether parkinsonism could be
      detected by a neurologist from a videotaped assessment and whether
      neurobehavioral methods (motor, cognitive, and sensory) discriminated between
      patients with Parkinson's disease (PD) and controls. Fifteen patients with mild
      PD (Hoehn and Yahr I-III) were compared to 15 age-, sex-, and education- matched
      controls. Each participant underwent a videotaped neurological examination (based
      on the Unified Parkinson's Disease Rating Scale, UPDRS), administered by a
      trained technician, and reviewed by a neurologist, as well as a series of
      neurobehavioral tests. The neurologist identified PD patients with 86%
      sensitivity and 100% specificity. Among the neurobehavioral tests, finger
      tapping, combined with one or more among olfaction, visual contrast sensitivity,
      or Paired Associates Learning, correctly classified 90%, or more, of subjects.
      Individual psychological tests did not discriminate reliably between groups. We
      conclude that videotaped assessments of parkinsonism or objective tests of motor
      and sensory function can accurately detect patients with PD. Both approaches have
      potential for identifying PD cases, but the latter may be more efficient for
      screening.

PMID- 11215591
TI  - Loss of olfaction in de novo and treated Parkinson's disease: possible
      implications for early diagnosis.
AB  - Olfactory dysfunction is a common finding in patients with Parkinson's disease
      (PD). As most studies reported on odor identification in more advanced and
      treated PD, we administered an odor detection, discrimination, and identification
      test to a heterogeneous, partly de novo, group of patients. Forty-one non
      demented PD patients, 24 of whom had untreated early PD, and 18 healthy controls,
      were examined. Odor identification and discrimination data were corrected for
      odor detection scores. PD patients scored significantly lower on all olfactory
      tests. Interestingly, the subgroup of de novo patients with early PD also showed
      significant olfactory disturbances compared with healthy subjects. Within the PD
      group, using multiple regression analysis, we found a significant, negative
      correlation between odor discrimination measures and disease The present study is
      the first to describe decreased performance of PD patients on odor
      discrimination, in addition to the already well-established deficits in odor
      detection and identification. Furthermore, odor discrimination measures were
      related to disease severity, possibly indicating that at least some aspects of
      olfactory dysfunction in PD may be secondary to ongoing degenerative processes in
      PD. As significant olfactory impairments were found in early, de novo PD,
      olfactory tests may be useful in the early diagnosis of PD.

PMID- 11215592
TI  - The relation between EMG activity and kinematic parameters strongly supports a
      role of the action tremor in parkinsonian bradykinesia.
AB  - The kinematics characteristics of an upper arm extension of large amplitude (90
      degrees) performed in the horizontal plane and the simultaneous activity of the
      shoulder muscles were recorded in 12 parkinsonian patients and in six normal
      control subjects. The movement, triggered by an acoustic "go" signal, was
      preceded by an isometric adduction. Within the whole population of individuals (n
      = 18) a strong, positive correlation was observed between the root mean square
      value of agonist EMG activity, evaluated during the acceleration phase of the
      movement, and both peak velocity and acceleration. In six patients tremor bursts
      at the frequency of 8-14 Hz (action tremor) were observed during the movement
      phase in the anterior, middle, and posterior deltoid: all these patients showed
      low root mean square values and were bradykinetic with respect to the control
      subjects. The remaining six patients did not show this action tremor during the
      movement phase. All but one had an agonist activation of normal duration and
      amplitude, showed high root mean square values, and performed well in the range
      of control subjects. We conclude that the inability to suppress the activity of
      pathological oscillator(s) responsible for the action tremor plays a fundamental
      role in the bradykinesia associated with Parkinson's disease.

PMID- 11215593
TI  - Accelerometric assessment of levodopa-induced dyskinesias in Parkinson's disease.
AB  - Our objective was to develop parameters for objective ambulatory measurements of
      levodopa-induced dyskinesias (LID) in patients with Parkinson's disease (PD).
      Twenty-three PD patients with mild to severe LID were submitted to a standardized
      protocol of 1-minute recordings during rest, talking, stress, and four activities
      of daily life (ADL). Patients were simultaneously monitored with portable multi
      channel accelerometry (four pairs of bi-axial sensors mounted onto the most
      affected arm, leg, and at the trunk) and recorded by video. LID severity was
      assessed with a modified Abnormal Involuntary Movement Scale (m-AIMS). The
      signals were analyzed, and every 1/8-second interval the amplitude was obtained
      of the dominant frequency within 1-4 Hz and 4-8 Hz frequency bands (Amp1-4 and
      Amp4-8). For both measures, convergent validity, reproducibility, and
      responsiveness were determined. In absence of voluntary movements, a significant
      relation was found between Amp1-4 and Amp4-8 and m-AIMS. Repeated measurements
      during rest showed a high reproducibility (intraclass correlation coefficient =
      0.90 [Amp1-4] and 0.86 [Amp4-8]). The extent to which LID increased with talking
      and stress correlated significantly (p = 0.02) between the objective and clinical
      measures (intraclass correlation for differences = 0.67). During ADL, LID
      occurred in a similar frequency band as voluntary movements and only Amp1-4 and
      Amp4-8 of the trunk and leg sensor remained highly correlated with m-AIMS.
      Although objective measures of LID are reliable and responsive, they fail to
      distinguish LID from voluntary movements. These measures are of value only when
      obtained during rest (all sensor sites) or during ADL when derived from those
      body segments that are normally not involved in these ADL tasks (trunk and leg).

PMID- 11215594
TI  - The auditory startle reaction in parkinsonian disorders.
AB  - The auditory startle reaction to an unexpected loud stimulus is regarded as a
      brainstem reflex originating in the nucleus reticularis pontis caudalis and being
      distributed up the brainstem and down the spinal cord along slowly conducting
      pathways. Auditory startle responses (ASR) have been reported absent or reduced
      in progressive supranuclear palsy (PSP), and delayed in Parkinson's disease (PD),
      but normal in multiple-system atrophy (MSA). For the first time we studied ASR in
      patients fulfilling the clinical criteria of dementia with Lewy bodies (DLB) (n =
      8), a neurodegenerative disorder characterized by cortical and subcortical
      depositions of Lewy bodies resulting in parkinsonism and progressive cognitive
      decline. For comparison, we also investigated patients with PD (n = 10), MSA (n =
      7), PSP (n = 10), and age-matched healthy controls (n = 10). ASR were elicited by
      binaural high-intensity auditory stimuli. Surface electromyographic activity was
      simultaneously recorded from facial, upper, and lower extremity muscles. For each
      muscle, we assessed response probability and measured latency, amplitude,
      duration, and habituation rate. Patients with DLB had fewer and abnormally
      delayed ASR of low amplitude and short duration in extremity muscles compared to
      healthy controls. Furthermore, we confirm and extend previous findings of
      abnormal ASR in PSP and PD, and also demonstrate exaggerated ASR in extremity
      muscles of MSA patients. The different patterns of ASR abnormalities may reflect
      distinct types of brainstem dysfunction in DLB.

PMID- 11215595
TI  - Can peripheral trauma induce dystonia and other movement disorders? Yes!

PMID- 11215596
TI  - Dorsal subthalamotomy for Parkinson's disease.
AB  - We report our experience of unilateral subthalamotomy in patients with
      Parkinson's disease (PD). Eleven patients were included in a pilot, open-labeled
      study to assess the effect of unilateral lesion of the subthalamic nucleus (STN)
      with a minimum of 12 months of follow-up. The guidelines of CAPIT (Core
      Assessment Program for Intracerebral Transplantation) were followed for
      recruitment into the study and follow-up assessment. Levodopa equivalents daily
      intake (mean 967 mg) were unchanged during the first 12 months in all but one
      patient who stopped medication. The sensorimotor region of the STN was defined by
      semimicrorecording and stimulation and a thermolytic lesion was placed
      accordingly. There was a significant reduction in both UPDRS parts II and III in
      the "off" state at 1-, 6-, and 12-month follow-up. This effect was maintained in
      four patients up to 24 months. The dyskinesia score did not change
      postoperatively. Lesion-induced dyskinesias were not a management problem except
      in one patient who developed a large infarction several days postsurgery. This
      initial study indicates that a lesion of the STN is not generally associated with
      hemiballismus in PD. Subthalamotomy may induce considerable motor benefit and
      could become another surgical option under specific circumstances.

PMID- 11215597
TI  - Changes in vocal loudness following intensive voice treatment (LSVT) in
      individuals with Parkinson's disease: a comparison with untreated patients and
      normal age-matched controls.
AB  - This study assessed the impact of the Lee Silverman Voice Treatment (LSVT) on
      vocal loudness [sound pressure level (SPL)] in a group of dysarthric individuals
      with idiopathic Parkinson's disease (IPD). Pre- to post-treatment changes in SPL
      in the treated group were compared with changes in voice SPL during the same time
      in two control groups: individuals with IPD not treated with the LSVT and in non
      disordered individuals, age-matched to the patients. All subjects produced the
      same voice and speech tasks--sustaining vowel phonation, reading the "Rainbow
      Passage," producing a short monologue, and describing a picture. These tasks were
      recorded at three different occasions: just prior to treatment, just after
      treatment, and 6 months following treatment. The individuals treated with LSVT
      increased voice SPL from baseline to post-treatment by an average of 8 dB and
      from baseline to 6 months follow-up by an average of 6 dB. These changes were
      statistically significant and perceptibly audible. No significant changes in SPL
      were observed in the control groups during the time corresponding to the
      treatment and follow-up. Differences in SPL between the treated and untreated
      patients at post-treatment and follow-up were statistically significant for all
      voice and speech tasks. These findings, along with others, provide additional
      support for the efficacy of the LSVT.

PMID- 11215598
TI  - Suppression of harmaline-induced tremor in rats by vagus nerve stimulation.
AB  - We studied whether vagus nerve stimulation could suppress tremor in the harmaline
      tremor model in the rat. Animals were chronically implanted with helical leads
      around the left vagus nerve and a disk-shaped electrode positioned subcutaneously
      in the dorsal neck. Harmaline-induced tremor was recorded on a physiograph while
      each animal received a sequence of five 20-minute trials. Each trial consisted of
      five minutes of pre-stimulation baseline, five minutes of vagus nerve
      stimulation, and ten minutes of post-stimulation. Vagus nerve stimulation
      significantly suppressed harmaline-induced tremor. The suppressive effect was
      present within the first minute of stimulation and was reproducible across the
      five trials of the study. The results of this study suggest that the central
      generator or expression of tremor in the harmaline animal model can be suppressed
      by vagus nerve stimulation.

PMID- 11215599
TI  - A teaching videotape for the assessment of essential tremor.
AB  - Teaching videotapes, developed to aid in the evaluation of several movement
      disorders, have not been used in essential tremor research. As part of the
      Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET), we
      developed a reliable and valid tremor rating scale. Because this rating scale is
      currently being used by investigators at other centers, we developed a teaching
      videotape to aid in the consistent application of this scale. OBJECTIVE: To
      develop a teaching videotape for a revised version of the WHIGET Tremor Rating
      Scale and to assess the interrater agreement among raters who used this videotape
      to rate tremor. METHODS: The revised WHIGET Tremor Rating Scale was used to rate
      action tremor from 0 to 4 during six tests: arm extension, pouring, drinking,
      using a spoon, finger-to-nose, and drawing spirals. A 22-minute teaching
      videotape was developed that includes a 29-item educational section and a self
      assessment section consisting of 20 examples of tremor ratings chosen by the two
      WHIGET study neurologists. Eight raters, including senior movement disorder
      specialists, movement disorder fellows, general neurologists, and a movement
      disorder nurse practitioner, independently viewed the videotape and rated tremor
      during the self-assessment section. Interobserver reliability was assessed with
      weighted kappa statistics (kappa(w)). RESULTS: Eight raters each rated 20 items
      (160 ratings total). Total kappa(w) was 0.97 (nearly perfect agreement).
      Interrater reliability was as follows: kappa(w) = 0.99 (movement disorder
      specialists), kappa(w) = 0.98 (movement disorder fellows), and kappa(w) = 0.97
      (general neurologists); all kappa(w) were nearly perfect. CONCLUSIONS: This
      teaching videotape may be used to improve the uniform application of the revised
      WHIGET Tremor Rating Scale by raters with various levels of experience in
      movement disorders.

PMID- 11215600
TI  - Abnormalities of spatial and temporal sensory discrimination in writer's cramp.
AB  - Clinical observations of patients with writer's cramp suggest that abnormalities
      of the sensory system may be a frequent finding in this disorder.
      Neurophysiological data from an animal model of focal dystonia have revealed
      cells in somatosensory cortex with enlarged and overlapping tactile receptive
      fields. However, psychophysical studies so far have been unable to document a
      clinical correlate supporting a similar enlargement of receptive fields in
      humans. We compared the fingertip discrimination of the orientation of fine
      spatial gratings between writer's cramp and control subjects and found a
      significant decrease in grating sensitivity in the patients, consistent with the
      possibility of enlarged tactile receptive fields. In addition, we duplicated
      previous experiments showing an abnormality of tactile temporal discrimination.
      The results provide psychophysical measures which may relate to the development
      of sensory cortical reorganization in patients with writer's cramp.

PMID- 11215601
TI  - Disinfection efficacy of contact lens care solutions against ocular pathogens.
AB  - PURPOSE: Three commercially available products labeled as multi-purpose contact
      lens solutions, one multi-purpose disinfecting solution, and a hydrogen peroxide
      system were evaluated for antimicrobial activity according to the current
      International Organization for Standardization (ISO) and the U.S. Food and Drug
      Administration (FDA) stand-alone procedure for disinfecting products. One multi
      purpose solution was selected to assess its antimicrobial activity against two
      human corneal isolates of Pseudomonas aeruginosa. METHODS: Products were
      challenged with bacteria and fungi, and following a specified period, aliquots of
      inoculated test solution were neutralized and plated on validated recovery media.
      After incubation the number of viable microorganisms was enumerated and mean log
      reductions determined. RESULTS: ReNu MultiPlus (Bausch & Lomb, Rochester, NY),
      AOSEPT (CIBA Vision Corporation, Duluth, GA), and Opti-Free Express with Aldox
      (Alcon Laboratories, Ft. Worth, TX) were the only lens care products that met the
      stand-alone criteria for all required microorganisms within their minimum
      recommended disinfection time. Of these, ReNu MultiPlus provided the greatest
      overall antimicrobial activity. ReNu MultiPlus demonstrated a significantly
      higher mean log reduction of Staphylococcus aureus and Serratia marcescens than
      Opti-Free Express. ReNu MultiPlus also gave a higher mean log reduction of S.
      aureus and S. marcescens than AOSEPT, and a higher mean log reduction of Candida
      albicans and Fusarium solani than AOSEPT, Complete Comfort Plus (Allergan,
      Irivine, CA), and Solo-Care (CIBA Vision Corp.) (at 4 hours). Both Complete
      Comfort Plus and Solo-Care (at 4 hours) met the primary acceptance criteria for
      bacteria; however, neither product possessed enough antimicrobial activity to
      meet the minimum criteria for yeast or mold. ReNu Multiplus was effective against
      corneal isolates of P. aeruginosa. CONCLUSION: ReNu MultiPlus, AOSEPT, and Opti
      Free Express met the requirements of the stand-alone primary criteria for
      disinfecting solutions. ReNu MultiPlus demonstrated the greatest overall
      disinfection efficacy, as well as excellent activity against clinical strains of
      P. aeruginosa.

PMID- 11215602
TI  - Evaluation of the spectral transmittance of UV-absorbing disposable contact
      lenses.
AB  - PURPOSE: Increasing evidence suggesting deleterious effects of ultraviolet
      radiation (UVR) on the eye has prompted manufacturers to develop UV-absorbing
      disposable contact lenses. The spectral transmittances of a sample of these
      lenses were measured in order to determine if they provide adequate protection
      from UVR. METHODS: Four types of UV-absorbing disposable lenses were studied
      (Acuvue [Vistakon, Jacksonville, FL], Precision UV [Wesley-Jessen, Des Plaines,
      IL], Specialty Sport [Specialty UltraVision, Sunnyvale, CA], and Surevue
      [Vistakon]). For comparison, a lens without UV-absorbing properties (Acuvue), a
      conventional soft lens (Permaflex UV [Cooper Vision, San Jose, CA]) and an RGP
      lens (Boston ES [Polymer Technology, Rochester, NY]) were also evaluated. The
      tested lens was placed in a silica wet cell filled with saline. Spectral
      transmittance was measured over the 200-800 nm waveband. RESULTS: Each disposable
      lens exhibited a transmittance window in the 240-320 nm waveband. Computing
      indices of protection factor and safe exposure duration allowed for the
      assessment of the level of protection afforded by each lens. Among disposable
      lenses studied, the Surevue performed best with a transmittance of less than 1%
      in the waveband 280-348 nm and the longest safe exposure duration, while the
      Specialty Sport had the highesttransmittance of UVB (290-315 nm). CONCLUSION: All
      UV-absorbing lenses studied provided a better level of protection from UVR
      exposure than lenses without UV absorber. These results will help the eyecare
      practitioner in prescribing the most appropriate UV-blocking lens for each
      patient.

PMID- 11215603
TI  - Bacterial populations on 30-night extended wear silicone hydrogel lenses.
AB  - PURPOSE: Ocular infection and inflammation during hydrogel lens extended wear is
      often associated with colonization of the lenses with bacteria. This study
      compares colonization of a high Dk silicone hydrogel contact lens (lotrafilcon A)
      worn on a 30-night extended wear basis to a low Dk HEMA-based lens (etafilcon A)
      worn on a 6-night extended wear schedule. METHODS: The group wearing the low Dk/t
      soft contact lens (n = 63) replaced their lenses weekly and the group wearing
      high Dk/t soft contact lenses replaced their lenses monthly (n = 64). Lens
      allocation was assigned randomly at enrollment. Worn lenses, from one eye only,
      were collected aseptically and placed in sterile vials. Microbial growth on
      various media was enumerated and the number of colony forming units (cfu) per
      lens was calculated in categories of normal ocular microbiota (such as coagulase
      negative staphylococci and Propionibacterium spp.) and known ocular pathogens
      (such as Staphylococcus aureus and gram-negative bacteria). The proportion of
      samples colonized with these bacteria and the extent of colonization were
      compared between the two groups. The proportion of sterile lenses was calculated,
      and the types of bacteria on each lens group were compared. RESULTS: No
      differences between the low and high Dk/t Soft contact lens groups were observed
      in the proportion of lenses colonized by Propionibacterium spp. (48% vs 43%, P =
      0.4) or coagulase-negative staphylococci (47% vs 54%, P = 0.2). Similarly, no
      differences were found for lenses colonized by S. aureus (0% vs 2%, P = 0.1) or
      gram-negative bacteria (3% vs 2%, P = 0.8). The types of bacteria isolated from
      the high and low Dk/t lenses were similar. There were no differences in the
      number of sterile samples (28% vs 27%, P = 0.8) from each group. CONCLUSIONS:
      These findings suggest that high Dk/t silicone hydrogel materials are colonized
      by similar numbers and types of microorganisms during extended wear compared to
      HEMA-based material. Most lenses were colonized by commensal bacteria during 30
      night extended wear with high Dk/t lenses and during 6-night extended wear with
      low Dk/t lenses. The incidence of sterile samples was the same between the high
      and low Dk/t soft contact lens groups.

PMID- 11215604
TI  - Conjunctival histologic findings of dry eye and non-dry eye contact lens wearing
      subjects.
AB  - PURPOSE: To determine if contact lens wearers with dry eye (DE CL) have greater
      histological and inflammatory conjunctival epithelial changes compared to non-dry
      eye contact lens wearers (CL). METHODS: Fifty-eight myopic subjects were
      recruited for the study: DE CL group (N=27), CL group (N=11), and control group
      (N=20). Contact lens groups were matched for proportions of rigid gas permeable
      (RGP) lenses, disposables, and conventional soft contact lenses. Dry eye was
      defined by McMonnies dry eye symptom survey score of > or =14, fluorescein break
      up time (FBUT) of <10 seconds, and the presence of rose bengal staining. Ocular
      surface samples were taken using conjunctival impression cytology to determine
      nucleo-cytoplasm ratio, goblet cell density (GCD), and expression of conjunctival
      antigens to HLA DR and CD23. RESULTS: HLA DR and CD23 expression were
      significantly greater for the DE CL group compared to the CL group (P=0.0122 and
      P=0.0072, respectively). The CL group had a significant reduction in GCD
      (P=0.0001), and greater expression of ocular surface antigens to HLA DR (P=0.04)
      and CD23 (P=0.04) compared to the control group. CONCLUSIONS: The results of this
      study support the view that mechanical influences are responsible for the
      conjunctival squamous metaplasia changes in contact lens wear. Dry eye in contact
      lens wear is associated with allergic and immune mediated inflammatory processes.

PMID- 11215605
TI  - Practical experience with a high Dk lotrafilcon A fluorosilicone hydrogel
      extended wear contact lens in Spain.
AB  - PURPOSE: Several research studies on high Dk soft contact lens materials have
      been published, but little has been reported from practical clinical experience
      with these new materials. This study reports in-practice clinical experience with
      the lotrafilcon A fluorosilicone hydrogel material from a 6-month study in Spain.
      METHODS: Eighty-five patients were dispensed lotrafilcon A lenses (Focuse NIGHT &
      DAY [CIBA Vision Corporation]) for monthly replacement by 13 investigators from
      eight practices. The recommended wear schedule was daily wear for the first week
      and then up to 6-night extended wear through the first month and up to 30-night
      extended wear through 6 months. Follow-up visits were at 1 week, 1 month, 3
      months, and 6 months. Clinical and patient subjective data were collected at each
      visit. RESULTS: Among patients who continued in the study at each visit, Snellen
      visual acuity (VA) of 20/25 or better was achieved by at least 96% of all eyes at
      all visits; lens surfaces assessments for front surface deposits, front surface
      wetting, and back surface debris averaged less than grade 1 (0-4 scale) for all
      lenses at all visits; biomicroscopy grades averaged well below grade 1 (0-4
      scale) for all eyes at all visits; acceptable or optimal fit was assessed for 97%
      or more of all lenses at all visits. These patients rated the average overall
      comfort, vision, and handling above 9 (0-10 scale) at 6 months and 98% reported
      satisfaction with the lenses at 6 months. Eighty-two percent of patients
      dispensed completed the study. Seven patients were discontinued because of fit,
      and seven were discontinued because of positive biomicroscopy signs. CONCLUSIONS:
      The lotrafilcon A lens performed well clinically and it was accepted well by
      patients, with most practitioners recommending and most patients wearing it for
      up to 30 nights extended wear. Practitioners should be attentive to fit and
      discomfort complaints at dispensing and follow-up and may want to recommend
      lubricating or rewetting drops for those patients with dryness symptoms.

PMID- 11215606
TI  - Microbiological profile of a shipboard environment and the flora on contact
      lenses of seamen.
AB  - PURPOSE: The purpose of this study was to culture and identify the spectrum of
      organisms (and their sensitivities) that contaminate the extended wear contact
      lenses of seamen in their working environment. A secondary aim was to identify
      the most appropriate first-line antibiotic regimen to be used on seamen who
      sustain contact lens-related corneal keratitis on board ship. METHODS: Twenty
      pairs of contact lenses of 20 seamen in one group and 24 pairs in another group
      wearing contact lenses were collected at the end of 1 week of extended wear.
      Groups one and two differed only in the way lenses were stored prior to
      culturing. All contact lenses were then brought to the microbiological lab within
      24 hours for culture and sensitivity testing. RESULTS: The most common
      contaminants on the contact lenses in this study were Staphylococcus epidermidis
      and Staphylococcus aureus, organisms resident on the normal eyelids.
      Enterobacterand Pseudomonas species, present in a shipboard environment, were
      also identified as contaminants on the contact lenses. The organisms cultured
      from the contact lenses correlated well with those of normal lid flora as well as
      from the ship environment and are probably derived from these sources. Storage in
      saline-containing preservatives yielded significantly less positive bacterial
      cultures from the contact lenses in our study. All bacterial isolates were
      sensitive to ciprofloxacin whereas several bacteria resistant to cefazolin and
      gentamicin were identified. CONCLUSION: The most common contaminants on the
      contact lenses in this study were Staphylococcus epidermidis and Staphylococcus
      aureus, organisms resident on the normal eyelids. Enterobacter and Pseudomonas
      species, which are normally present in a shipboard environment, were also
      identified as contaminants on the contact lenses. Ciprofloxacin is effective
      against all organisms identified as contaminants on the contact lenses in this
      study. Of all the antibiotics tested, it is probably the most suitable agent
      against contact lensrelated keratitis under such shipboard circumstances and is
      thus recommended in these situations.

PMID- 11215607
TI  - Diagnosis of hemophilia made after intraoperative bleeding during attempted
      penetrating keratoplasty in an elderly patient.
AB  - PURPOSE: To report an unusual case where the diagnosis of hemophilia was made
      after attempted penetrating keratoplasty in an elderly patient. METHODS: A 75
      year old white male with a full-thickness corneal scar in the visual axis and a
      visually significant cataract OD was to undergo penetrating keratoplasty and
      cataract extraction with lens implantation for visual rehabilitation. There was
      no history of bleeding diathesis given. RESULTS: During placement of the
      Flieringa ring, a progressively enlarging 360 degrees subconjunctival hemorrhage
      was observed. Given the unusual bleeding,the procedure was aborted and the
      patientwas referred to the hematology service for further evaluation. Laboratory
      studies revealed a diagnosis of atypical hemophilia of mild severity.
      CONCLUSIONS: The initial diagnosis of hemophilia in any elderly patient is
      unusual. This case is even more unusual asthe diagnosis of a bleeding disorder
      was first considered after excessive subconjunctival hemorrhage developed during
      attempted penetrating keratoplasty.

PMID- 11215608
TI  - Comamonas acidovorans keratitis in a hydrogel contact lens wearer.
AB  - PURPOSE: To present an unusual case of keratitis in a patient who wears hydrogel
      contact lenses that are replaced on a monthly basis. The agent isolated was
      Comamonas acidovorans, a species of Pseudomonas. METHODS AND RESULTS: A 40-year
      old patient who wears hydrogel contact lenses that are replaced on a monthly
      basis presented with a red eye. The patient reported that the eye had been red
      for 2 days. A peripheral corneal stromal infiltrate was found and Comamonas
      acidovorans was isolated in culture. The patient was initially treated with high
      dose gentamicin. After the results of cultures and sensitivity studies were
      obtained, she was given ciprofloxacin, leading to the remission of the case.
      CONCLUSIONS: Comamonas acidovorans should be considered as a possible agent of
      keratitis in hydrogel contact lens wearers-a culture and sensitivity studies may
      be indicated.

PMID- 11215609
TI  - Contact lenses, refractive surgery, and spectacles: competing modalities or
      something else?

PMID- 11215610
TI  - Macroscopic water deposits on polycrystalline gold measured by scanning force
      microscopy.
AB  - Data of water adsorption on polycrystalline gold show the formation of a
      multilayer film of several nanometers with the increase of relative humidity. We
      have measured this adsorption process by scanning force microscopy in both
      dynamic and jumping modes. We find interesting differences in the adsorption of
      water on the terraces and at grain boundaries. Measurements of adhesion force are
      also reported.

PMID- 11215611
TI  - Quantification of red blood cells using atomic force microscopy.
AB  - For humans the sizes and shapes of their red blood cells are important indicators
      of well being. In this study, the feasibility of using the atomic force
      microscope (AFM) to provide the sizes and shapes of red blood cells has been
      investigated. An immobilisation procedure has been developed that enabled red
      blood cells to be reliably imaged by contact AFM in air. The shapes of the red
      blood cells were readily apparent in the AFM images. Various cell quantification
      parameters were investigated, including thickness, width, surface area and
      volume. Excellent correlation was found between the AFM-derived immobilised mean
      cell volume (IMCV) parameter and the mean cell volume (MCV) parameter used in
      current haematological practice. The correlation between MCV and IMCV values has
      validated the immobilisation procedure by demonstrating that the significant cell
      shrinkage that occurs during immobilisation and drying does not introduce
      quantification artifacts. Reliable IMCV values were obtained by quantifying 100
      red blood cells and this typically required 3-5 AFM images of 100 microm x 100
      microm area. This work has demonstrated that the AFM can provide in a single test
      the red blood cell size and shape data needed in the assessment of human health.

PMID- 11215612
TI  - Investigation by atomic force microscopy of forces at the origin of cement
      cohesion.
AB  - In cement paste, the cohesion results of the interactions between calcium
      silicate hydrate (CSH) surfaces in an interstitial ionic solution. (N, V, T)
      Monte Carlo simulations show that the interactions are due to the ion correlation
      forces influenced by the surface charge density, the ionic concentration and the
      ion valence. This paper deals with the direct measurement in solutions by atomic
      force microscopy (AFM) of the forces and the interaction ranges between a probe
      and an atomically smooth substrate covered by CSH nanoparticles. Different
      electrolytic solutions (Ca(OH)2, CaCl2, NaCl, NaOH) have been used in order to
      determine influent parameters permitting to identify the nature of acting forces.
      Investigations have been rendered possible by selecting appropriate experimental
      setup and solutions. The selected probe and substrate on which CSH nanoparticles
      have previously grown are neutral regarding the reactivity during experiments
      permitting the exchange of solutions. Results show that a force originates from
      electrostatic nature and differs from Derjaguin-Landau-Verwey-Overbeek (DLVO)
      theory. Agreement is found between experiments and (N,V,T) Monte Carlo
      simulations of ionic correlation forces. These forces are at the origin of the
      cohesion of cement paste.

PMID- 11215613
TI  - Probing molecular interactions and mechanical properties of microbial cell
      surfaces by atomic force microscopy.
AB  - Knowledge of the surface properties of microbial cells is a key to gain a
      detailed understanding of their functions in the natural environment and to
      efficiently exploit them in biotechnological processes. In this paper, we present
      force-distance curves recorded, by atomic force microscopy (AFM) in aqueous
      solutions, on various microbial samples: reconstituted S-layers, whole fungal
      spores and several bacterial strains. The approach and retraction curves
      exhibited important differences--depending on the type of microorganism, on the
      physiological state (dormancy versus germination) and on the environmental
      conditions (ionic strength)--which were shown to reflect differences in long
      range surface forces, adhesion forces and mechanical properties. These data
      illustrate the great potential of AFM force measurements to elucidate the
      physical properties of microbial cells and to understand, at the molecular level,
      biointerfacial phenomena such as cell adhesion and cell aggregation.

PMID- 11215614
TI  - Comparative studies of bacteria with an atomic force microscopy operating in
      different modes.
AB  - Escherichia coli bacterial cells of two strains JM109 and K12 J62 were imaged
      with atomic force microscopy (AFM) in different environmental conditions. The AFM
      results show that the two strains have considerable difference in the surface
      morphology. At the same time after rehydration both strains show the loss of the
      topographic features and increase in lateral and vertical dimensions. Results
      obtained in different AFM modes (contact, tapping, MAC) were compared. Imaging in
      culture medium was applied for direct observation of the surface degradation
      effect of lysozyme. The treatment of the cells with the enzyme in the culture
      medium lead to the loss of surface rigidity and eventually to dramatic changes of
      the bacteria shape.

PMID- 11215616
TI  - Spin-column isolation of DNA-protein interactions from complex protein mixtures
      for AFM imaging.
AB  - Applications of atomic force microscopy (AFM) to investigate structural
      functional interactions between DNA and proteins, at the molecular level, should
      prove valuable for gaining a better understanding of gene expression. Specific
      genomic DNA-protein interactions occur within a sea of intracellular proteins.
      Successful AFM imaging requires isolating the specific DNA-protein complex free
      of background protein contamination. Using spin-column chromatography, we report
      the successful isolation and AFM imaging of transcription factor DNA complexes
      from DNA molecules incubated with crude cell lysates. This method should be
      applicable for the isolation and imaging of other specific DNA-protein complexes
      pertinent to functional genomic research.

PMID- 11215615
TI  - Recognition force microscopy/spectroscopy of ion channels: applications to the
      skeletal muscle Ca2+ release channel (RYR1).
AB  - The skeletal muscle Ca2+ release channel (ryanodine receptor 1, RYR1) plays an
      important role in the excitation-contraction coupling process. We purified
      ryanodine receptor type 1 from rabbit white muscle and adsorbed it to mica sheets
      with the cytoplasmic side facing up. Single receptors of uniformly distributed
      size and shape of 10-12 nm height and 40-50 nm width, and occasionally some
      aggregates were seen in contact mode AFM images. These immobilized RYR1 were
      specifically recognized by rabbit anti-RYR1 (antibody#8) with at least 30%
      efficiency, as measured by an enzyme immunoassay with goat-anti-rabbit. Single
      specific antibody-antigen recognition events were detected with AFM tips to which
      an antibody#8 was tethered. In linear scans, the occurrence of antibody-antigen
      binding showed significant lateral dependence, which allowed for the localization
      of binding sites with nm resolution. Variation of the loading rate in force
      spectroscopy experiments revealed a logarithmic dependence of the unbinding
      forces, ranging from 42 to 73 pN. From this dependence, a bond width of the
      binding pocket of L = 0.2 nm and a kinetic off-rate of koff = 12.7s(-1) was
      determined.

PMID- 11215617
TI  - The scanning near-field optical microscope as a tool for proteomics.
AB  - The identification of the entire genetic code of human DNA is more or less
      completed. With this knowledge, research in identifying the real information
      lying in the genes, will begin. This information is contained in the proteins,
      which are the main biological actors in the cell. For this reason proteins will
      be targeted in biological investigations in the future. The structure, affinity
      and reactivity of each identified protein has to be determined, which is a
      primary goal in the field of proteomics. This will require new and better
      strategies to identify protein-protein interaction. Our approach, based on the
      detection and visualization of single proteins by scanning near-field optical
      microscopy (SNOM), has allowed us to visualize various fixed and fluorochrome
      labelled proteins at the nanometer scale. Subsequently SNOM may then be developed
      to efficiently detect the specific behavior of a certain protein in response to
      other biomolecules.

PMID- 11215618
TI  - Temperature dependence of the topology of supported dimirystoyl-distearoyl
      phosphatidylcholine bilayers.
AB  - Topology of fluid and gel domains in the supported bilayer two-component system
      formed from equimolar mixtures of dimyristoylphosphatidylcholine (DMPC) and
      distearoylphosphatidylcholine (DSPC) was determined by AFM, at various
      temperatures corresponding to the gel and the gel + fluid region of the phase
      diagram. The data show that, in the disconnected fluid part of the DMPC/DSPC gel
      liquid crystal-phase-separation region, the size of fluid domains markedly
      exceeds that predicted from spectroscopic experiments or from Monte Carlo
      simulations. They provide a direct evidence for the transition from the
      disconnected fluid to the disconnected gel region of the phase diagram, again
      with gel-phase domains much larger than expected. Finally, images of the gel
      phase at different temperatures suggest that structural rearrangements of the
      phospholipids can disrupt the continuity of the supported bilayer.

PMID- 11215619
TI  - Analysis of protein crystal growth at molecular resolution by atomic force
      microscopy.
AB  - High-resolution atomic force microscopy (AFM) studies have been performed to
      analyze the molecularity of growth steps of the (1 1 0) face of tetragonal
      lysozyme crystals. Besides a major population of step heights of about 5.5 nm
      also step heights of about half this size were observed. The latter steps always
      appeared pairwise. Both surfaces the 1 1 0) face and the (1 0 1) face could be
      imaged at molecular level. Comparison of the height pattern of the corresponding
      surface structure indicates that the (1 1 0) face is relatively smooth of less
      than 0.2 nm compared to the (1 0 1) face of about 1.5 nm. AFM linescan images of
      the (1 0 1) face indicate the insertion of lysozyme aggregates in solution to the
      crystal surface rather than lysozyme monomers. This study suggests that insertion
      of lysozyme aggregates in the solution yields growth steps of the (1 1 0) face of
      monomolecular as well as of bimolecular unit height.

PMID- 11215621
TI  - Measuring magnetic susceptibilities of nanogram quantities of materials using
      microcantilevers.
AB  - We describe a novel technique for measuring magnetic susceptibilities of nanogram
      quantities of magnetic materials that utilizes the extreme force sensitivity of
      microcantilevers. The magnetic force acting on samples attached to the free end
      of a cantilever can be measured as changes in the resonance response of the
      cantilever. The shift in resonance frequency of the cantilever is proportional to
      the field gradient, whereas the deflection of a cantilever is proportional to the
      magnetic force. The magnetic susceptibility measurement is based on comparison of
      the forces acting on the sample and a reference material in the same magnetic
      field and field gradient. We have determined the magnetic susceptibilities of
      nanogram quantities of many paramagnetic materials. The measured magnetic
      susceptibilities show excellent agreement with values found in the literature.

PMID- 11215620
TI  - Chemical sensors and biosensors in liquid environment based on microcantilevers
      with amplified quality factor.
AB  - A new technique is presented for bio/chemical sensors, based on microcantilevers,
      for detection in liquid environment. The low quality factor of the cantilever in
      liquid is increased up to three orders of magnitude by using Q-control. This
      enables AC detection that is immune to the long-term drift of the DC cantilever
      response in liquids, and to temperature variations. This technique has been
      applied for the detection of ethanol in aqueous solution by using the
      microbalance method, and for antibody/antigen recognition by the surface stress
      method. The results show the feasibility and very high sensitivity of these novel
      devices.

PMID- 11215622
TI  - Implementation of self-sensing SPM cantilevers for nano-force measurement in
      microrobotics.
AB  - Micromanipulation tasks have to be solved in the assembly of microsystems, the
      handling of biological cells and the handling of specimens for scanning electron
      microscopy. For these applications, we have developed a flexible
      micromanipulation station, including direct-driven robots a few cubic centimeters
      small. The robots are able to perform high-precise manipulation and positioning
      of microobjects. Force-controlled microgripping strategies are now necessary to
      develop robust microassembly strategies. Microgripping is different from
      conventional gripping in two ways. First, microparts with dimensions less than
      100 microm are often fragile and can easily be damaged during gripping, thus
      special grasping techniques are needed. Second, the mechanics of manipulation in
      the microworld are much different than in the macro-world. Part interactions in
      the microworld are dominated by adhesive forces making it difficult to release
      parts during manipulation tasks. Several microgrippers that do not employ force
      feedback have been developed; force-controlled microgrippers are much less
      common. Grippers with integrated piezoresistive force sensors and with attached
      strain gauges have been reported. These approaches, however, are limited in their
      ability to resolve the gripping force. Hence, we are currently integrating self
      sensing SPM cantilevers into a gripper of our microrobots. These cantilevers
      operate by measuring stress-induced electrical resistance changes in an implanted
      conductive channel in the flexure legs of the cantilever. The real-time force
      feedback provided by these sensors enables us to better understand the prevailing
      nano forces and dynamics, what is indispensable for reliable micromanipulation
      strategies.

PMID- 11215623
TI  - Fabrication of quantum well microcantilever photon detectors.
AB  - We have developed a new method for fabricating quantum well microcantilever
      arrays that can be used in a variety of sensing applications. Microcantilevers
      with quantum wells allow real-time manipulation of energy states using external
      stress thus providing photon wavelength tunability. For example, this can result
      in an effective and rapid change in electron energy levels in photon detection
      devices. We applied this microfabrication technique to develop InSb
      microcantilevers and small arrays of GaAs/GaA1As microcantilever quantum wells.
      Such arrays can be useful in the detection of infrared (IR) radiation at room
      temperature.

PMID- 11215624
TI  - Thermomechanical noise of a free v-shaped cantilever for atomic-force microscopy.
AB  - We have calculated the thermal noise of a v-shaped AFM cantilever (Microlever,
      Type E, Thermomicroscopes) by means of a finite element analysis. The modal
      shapes of the first 10 eigenmodes are displayed as well as the numerical
      constants, which are needed for the calibration using the thermal noise method.
      In the first eigenmode, values for the thermomechanical noise of the z
      displacement at 22 degrees C temperature of square root of u2(1) = A/square root
      of c(cant) and the photodiode signal (normal-force) of S2(1) = A/square root of
      c(cant) were obtained. The results also indicate a systematic deviation ofthe
      spectral density of the thermomechanical noise of v-shaped cantilevers as
      compared to rectangular beam-shaped cantilevers.

PMID- 11215625
TI  - Intermittent contact AFM using the higher modes of weak cantilever.
AB  - Employing the higher vibration modes of weak cantilevers enables operating
      frequencies up to megahertz to be reached, at the same time keeping the force on
      the sample reasonably low. This allows the interaction time between the tip and
      the surface to be reduced and should cause the response of surface to be
      dominated by surface stiffness. The simple distributed mass cantilever model is
      presented which shows that higher eigenmodes exhibit better sensitivity to
      surface properties. The images of laser-treated polymer on glass show the ability
      of the method to distinguish between the material phases with different
      properties.

PMID- 11215626
TI  - Modeling of cylindrically tapered cantilevers for transverse dynamic force
      microscopy (TDFM).
AB  - In transverse dynamic force microscopy a cylindrically tapered cantilever is
      mounted perpendicularly to the sample surface and set into transversal
      oscillation. The dynamics of the cantilever has been studied using the continuum
      mechanical model with discrete element analysis. A viscoelastic model has been
      used to describe the tip-sample interaction. In this way an in-phase and an out
      of-phase component of the force has been extracted from the experimental data.
      Two different techniques, involving two experimental setups and two corresponding
      data analysis routines, have been developed to calculate the two components of
      the force at different tip-sample separations. In one case the change in resonant
      frequency and corresponding oscillation amplitude is measured whereas in the
      second case the usual way of recording amplitude and phase signal at a fixed
      driving frequency is applied. The results from these two methods are shown to be
      completely consistent and produce almost identical force curves.

PMID- 11215627
TI  - STM studies of 1-D noble metal growth on silicon.
AB  - Our scanning tunneling microscopy (STM) studies show that noble metals (Ag, Au)
      form a wide variety of 1-D structures on the high-index Si(5 5 12) surface. At
      coverages below 0.25 monolayer (ML), both metals grow as overlayer rows with an
      inter-row spacing of approximately 5 nm. At higher coverages and annealing
      temperatures, the underlying Si reconstruction is removed, but periodic row
      structures persist. Au can also induce faceting to nearby planes, e.g. (7 7 15)
      and (2 2 5), at temperatures above 500 degrees C. For all coverages and annealing
      temperatures studied here (0.02-1 ML, 450-800 degrees C), the Si(5 5 12) template
      initiates 1-D growth of the deposited noble metals.

PMID- 11215628
TI  - Imaging tip formation in single-mode optical fibres.
AB  - The formation of probe tips is a crucial step in all forms of scanning probe
      microscopy (SPM). In this work single-mode optical fibres are chemically etched
      in a variable temperature bath of etchant solution (HF acid buffered with
      ammonium fluoride) to produce tips for optical SPM. Tip evolution is monitored by
      prematurely truncating the etching process and imaging the tip end-structure
      using atomic force microscopy (AFM). In the case of a visible regime single-mode
      fibre the AFM images show a remarkable ring structure in the central cladding
      region and a tip structure in the core with a central depression; this serves to
      demonstrate the efficacy of chemical etching for converting compositional
      variation to three-dimensional topography. In the case of a standard, single-mode
      optical communications fibre the (projected) tip cone angle is assessed from AFM
      images in the early stages of tip formation. Values of the cone angle thus
      determined, for different etch conditions, are compared to those predicted by a
      model in which the independently determined core and cladding etch rates, and
      core diameter are the sole determinants of the final tip geometry. The model was
      devised in the context of etching multi-mode fibres and is shown to be valid here
      for single-mode fibres within the range of experimental accuracy and etch
      conditions examined.

PMID- 11215629
TI  - Scaling-index method as an image processing tool in scanning-probe microscopy.
AB  - The scaling-index method (SIM) is a novel tool for image processing in scanning
      probe microscopy. Originating from the theory of complex systems, the SIM can be
      used in order to extract structural information from arbitrary data sets. This
      method can readily be applied to the analysis of digital atomic-force microscopy
      (AFM) images. Especially for biomedical diagnostics, where genetic material is
      investigated by various microscopic methods, a reliable image segmentation based
      on the SIM algorithm is helpful. As a first application, AFM-images of GTG-banded
      human metaphase chromosomes (with G bands obtained by Trypsin using Giemsa) are
      compared with micrographs from conventional light microscopy by means of a
      scaling-index analysis. While the grey-level distributions of the optical and the
      AFM-images are largely different from each other, the scaling-index images are
      remarkably similar. Using this method, a fingerprint of an image can be produced
      which helps in the classification and interpretation of the measured data.

PMID- 11215630
TI  - A sample scanning system with nanometric accuracy for quantitative SPM
      measurements.
AB  - A sample scanning device operating in a working volume of 30 x 30 x 18 microm
      with interferometer and capacitance-based controls of displacements, is
      described. The xy-stage uses plane mirror linear interferometers and fast phase
      meters for control of displacements of precise ball-bearing stages driven by
      piezo flexure actuators. The stage operates with a full range bandwidth of 200
      Hz, and an estimated accuracy (k = 2) of 3 nm + 1 x 10(-3) L, where L is the
      lateral displacement. A novel z-stage based on a kinematic coupling between two
      plates, the upper one being moved by three bimorph plates and the distance being
      measured by three capacitive sensor, is described. The tilt of the z-stage is
      kept within fractions of a microrad, leading to a full range estimated accuracy
      of 2 nm + 2 x 10(-3) h, where h is the vertical displacement. The control
      bandwidth is of about 1 kHz, thus allowing fast and accurate step-height
      measurements. In order to test the device used in a scanning probe microscope,
      micrometric patterned surfaces made using high resolution e-beam lithography and
      precise metal deposition on silicon are imaged. Results of pitch measurements are
      discussed and compared with those obtained using optical diffractometry.

PMID- 11215631
TI  - A model for the hillock formation on graphite surfaces by 246 MeV Kr+ ions.
AB  - Scanning tunnelling microscopy has been used to study the effect of ion
      bombardment at different angles of incidence on a graphite surface. The 246 MeV
      energy of Kr+ ions was selected in the medium energy range, where the electronic
      and nuclear stopping is nearly balanced. The low dose (1 x 10(12)/cm2) of ions
      allows the characterization of single features caused by bombardment in
      perpendicular, at 30 degrees and at 60 degrees incidence. The density of hillocks
      caused by the ion bombardment is significantly lower than the ion dose and this
      density depends on the angle of incidence. The hillocks are attributed to knocked
      on atoms leaving the sample surface. A simple model for the scattering process is
      presented to enlighten the hillock density differences. Other features produced
      by the ion bombardment, such as elongated traces and (square root of 3 x square
      root of 3) R30 superstructures are also reported.

PMID- 11215632
TI  - Role of ripening and defects in the formation of mesotaxial cobalt-disilicide
      layers.
AB  - Previous studies of the formation of buried silicide layers through mesotaxy,
      i.e., the introduction of the metal component by ion implantation with subsequent
      annealing of the structure, have shown that high-quality films can be achieved,
      but at processing temperatures too high to be useful for integration with silicon
      device technology. Recently, we proposed a modified ripening model to describe
      the early stages of the formation of a buried film which intentionally excluded
      the role of defects. In the current study, the predictions of that model are
      tested by varying sample preparation conditions. We show that the shift of the
      silicide precipitate layer is correlated with the narrowing of the cobalt
      profile, thus requiring both processes to be described by the same mechanism. We
      also show in a TEM study that specific defect morphologies are correlated with
      specific properties of the forming buried film, requiring an extension of the
      previous model.

PMID- 11215633
TI  - Nanotribology of Si oxide layers on Si by atomic force microscopy.
AB  - Atomic force microscopy (AFM) has been used for tribological studies of Si
      surfaces covered by oxide layers of various kinds: chemical oxides prepared by
      the SC1 (NH4OH/H2O2/H2O) and the SC2 (HCl/H2O2/H2O) treatments and a thermal
      oxide. In the case of the SC1 chemical oxide, the oxide layer was scratched and
      the underlying Si substrate was ploughed by the Si3N4 AFM tip. On the other hand,
      no wear of the sample was noted on the other surfaces: the AFM often produced
      elevated patterns in the shape of the scanned area, which were no longer visible
      after HF etching. By annealing the SC1-treated surface in N2 gas at above 200
      degrees C for 30 min, the oxide layer could not be scratched any more. By soaking
      the thermal oxide in KOH, the oxide layer was then scratched. It is concluded
      that the presence of OH bases is the necessary condition for the nano-scratching
      of the oxide layers.

PMID- 11215634
TI  - Atomic surface characterisation and modification of the layered compounds Bi2Se3,
      Bi1.9Sb0.1Se3 and Bi1.6Sb0.4Se3.
AB  - In this work, we show atomic STM images of the layered compound Bi2Se3. We study
      the effect in the surface of the substitution of 5% and 20% of the Bi atoms for
      Sb in Bi1.9Sb0.1Se3 and Bi1.6Sb0.4Se3. The images of the three samples show
      similar trigonal structures corresponding probably to the van der Waals Se atoms.
      The distance measured between surface atoms in Bi2Se3 is 4.04 A, in Bi1.9Sb0.1Se3
      is 4.16 A and in Bi1.6Sb0.4Se3 is 4.26 A. In Bi1.6Sb0.4Se3 some atomic sites
      appear brighter than others. The effect is accentuated at higher tunnelling
      currents and is not observed in the other compounds. Nanoscopic range depressions
      on the sample might be related to the skeletal crystal structure since the images
      show atomic corrugations that align slightly in one direction. We explain the
      results as the effects of the interactions between tip and sample, and discuss
      two interpretations: on the one hand, localised depression of the individual
      atomic sites, and on the other the possible elevation of the atoms of the surface
      due to a phase transition of the compounds induced by STM.

PMID- 11215635
TI  - Chemical force microscopy of self-assembled monolayers on sputtered gold films
      patterned by phase separation.
AB  - Patterned self-assembled monolayers (SAMs) were formed on gold films and observed
      by friction force microscopy (FFM) and adhesive force mapping with pulsed-force
      mode atomic force microscopy (PFM-AFM). The substrate gold films were prepared by
      sputtering gold on flat surfaces of osmium-coated cover glass with surface
      roughness, Ra, of 0.3 nm. The patterned samples with the CH3 and COOH terminated
      regions were prepared using the Langmuir-Blodgett (LB) method, partial removal of
      the LB film by ultrasonication, and SAM formation. The CH3 and COOH terminated
      regions of the patterned SAMs in air and in water were observed by mapping
      friction and adhesive forces with FFM and PFM-AFM, respectively, using gold
      coated AFM tips chemically modified with a thiol compound terminating in CH3 or
      COOH. The adhesive forces measured in air increased in the order of CH3/CH3,
      CH3/COOH (or COOH/CH3) and COOH/COOH, while those in water increased in reverse
      order. The enormous high adhesive force observed in water for CH3/CH3 was
      attributed to hydrophobic interaction between the CH3 tip and the CH3 terminated
      sample surface. With CH3 tip, the lower friction force was observed, however, in
      water on the CH3 terminated region than on the COOH terminated region. This
      experimental finding raises a question as to what is the effective normal load in
      friction measurements in water.

PMID- 11215636
TI  - Study of microcontact printed patterns by chemical force microscopy.
AB  - Patterned self-assembled monolayers (SAMs) on sputtered gold films prepared by
      microcontact printing (microCP) were studied by mapping adhesive forces with
      pulsed-force-mode atomic force microscopy. A stamp for microCP was fabricated by
      pouring polydimethylsiloxane (PDMS) over a photolithographically prepared master.
      The patterned SAMs were prepared by two methods. One is called the wet-inking
      method, in which inking was done by placing a thiol ethanol solution for 30 s on
      the stamp and then removing the excess ink solution under a stream of nitrogen.
      The other is called the contact-inking method, in which a pad made of PDMS was
      dipped overnight in a thiol ethanol solution and then the stamp was placed on the
      inker pad impregnated with the thiol ethanol solution. The second step for
      pattern formation was the same for both of the two different microCP methods.
      Namely, the gold surfaces stamped with alkanethiols were further reacted with a
      thiol terminating in COOH in ethanol. The resulting patterns with CH3- and COOH
      terminated regions were analyzed by imaging the adhesive forces with the
      chemically modified gold coated AFM tips with a SAM of CH3 or COOH terminal
      functional groups.

PMID- 11215638
TI  - EGF-stimulated lamellipod extension in adenocarcinoma cells.
AB  - The extension of lamellipodia has been triggered by the application of epidermal
      growth factor (EGF). We have used an atomic force microscope (AFM) to investigate
      this lamellipodial extension. During extension we could detect an increase in
      height from about 500 nm for the stable lamellipodium to typical values of 600
      800 nm for the extending lamellipodium. The AFM was also used to determine the
      mechanical properties of the lamellipodium where we found a decrease of the
      elastic modulus by a factor of 1.4 at the same location within the same cell.
      Both findings are consistent with the cortical expansion hypothesis, suggesting
      that severing of actin filaments, leading to a swelling of the cytoskeleton,
      generates the protrusive force during lamellipodial extension.

PMID- 11215637
TI  - Atomic force microscopy can be used to mechanically stimulate osteoblasts and
      evaluate cellular strain distributions.
AB  - In this study, atomic force microscopy (AFM) was used to mechanically stimulate
      primary osteoblasts. In response to mechanical force applied by the AFM, the
      indented cell increased its intracellular calcium concentration. The material
      properties of the cell could be estimated and the membrane strains calculated. We
      proceeded to validate this technique experimentally and a 20% error was found
      between the predicted and the measured diameter of indentation. We also
      determined the strain distributions within the cell that result from AFM
      indentation using a simple finite element model. This enabled us to formulate
      hypotheses as to the mechanism through which cells may sense the applied
      mechanical strains. Finally, we report the effect of the Poisson ratio and the
      cell thickness on the strain distributions. Varying the Poisson ratio did not
      change the order of magnitude of the strains; whereas the cellular thickness
      dramatically changed the order of magnitude of the cellular strains. We conclude
      that AFM can be used for controlled mechanical stimulation of osteoblasts and
      that cellular strain distributions can be computed with a good accuracy when the
      cell is indented in its highest part.

PMID- 11215639
TI  - Bioremediation of residual fertilizer nitrate: I. Laboratory demonstration of an
      on-farm in situ pollution control system.
AB  - This exploratory laboratory study was undertaken to develop and test an in situ
      bioremediation system intended to point the way toward a possible field
      application. The proposed method uses a water table management (WTM) system to
      deliver nutrients or other amendments to subsoil microorganisms for
      biostimulation and subsequent biodegradation of pollutants in the saturated and
      unsaturated zones of the soil. The study was carried out on packed soil columns
      and bioremediation of residual fertilizer nitrate was attempted. Different levels
      of organic carbon supplement (glucose C) were introduced into these columns via
      subirrigation in order to supplement the readily available organic carbon levels
      in the soil. The study was carried out in two experimental setups. The first
      setup investigated (i) the effect of addition of a high (970 mg L(-1)) and a low
      (120 mg L(-1)) glucose C level and (ii) the efficacy of using the subirrigation
      system as a method for nutrient delivery in bioremediation of leached nitrate.
      This setup was monitored with time, depth, and with reference to the nitrate
      residue in the soil solution. Leached nitrate was denitrified to less than 10 mg
      L(-1) nitrate N at both glucose levels. The second setup investigated the effect
      of a range of low levels of glucose C on nitrate decontamination, soil pH, and
      total microbial count in order to find out an optimal glucose C level that
      reduced the most nitrate and maintained the pH homeostasis of soil.

PMID- 11215640
TI  - Spatial extrapolation of soil characteristics using whole-soil particle size
      distributions.
AB  - Soils support ecosystem functions such as plant growth and water quality because
      of certain physical, chemical, and biological properties. These properties have
      been studied at different spatial scales, including point scales to satisfy basic
      research needs, and regional scales to satisfy monitoring needs. Recently, soil
      property data for the entire USA have become available in the State Soil
      Geographic Data Base (STATSGO), which is appropriate for regional-scale research.
      We analyzed and created models of STATSGO data in this study to serve as a
      research tool, for example, for linking the soil to regional water quality
      monitoring data in our companion paper. Map units in STATSGO define geographic
      land areas by soil characteristics (SCs) of similar soil series. We selected 27
      SCs that influenced water properties (in varying degrees), aggregated the layer
      and component SCs to map unit SCs, and used SCs to calculate relationships among
      map units. The relationships were defined by equations of conditional mean for
      the qth SC (SCq), while using the remaining 26 SCs as predictors. The relative
      standard errors for 22 of the 27 SCs were less than 10%, and less than 22% for
      the remaining five. We conclude that spatial extrapolation of SCs is feasible and
      the procedures are a first step toward extrapolating information across a region
      using SC-water property relationships. Although our procedure is for regional
      scale monitoring, it is also applicable to finer spatial scales commensurate with
      available soil data.

PMID- 11215641
TI  - Bioremediation of residual fertilizer nitrate: II. Soil redox potential and
      soluble iron as indicators of soil health during treatment.
AB  - The prospect of using wastewater containing high loads of soluble organic matter
      (OM) for removing residual agricultural chemicals (fertilizer, pesticide, or
      herbicide) in farm soil, although promising, could have adverse effects on soil
      agricultural quality as a result of development of redoximorphic features in the
      soil profile. In this study, the effect of organic carbon supplement for
      bioremediation of residual fertilizer nitrate on soil properties, redox potential
      (Eh), pH, and metal ion mobilization was studied using sandy soils packed in
      columns. The study was included in a general project, described elsewhere
      (Ugwuegbu et al., 2000), undertaken to evaluate use of controlled water table
      management (WTM) systems to supply organic carbon for creating a reduced
      environment conducive to denitrification of residual fertilizer nitrate leaching
      from the farm to subsurface water. The columns were subjected to subirrigation
      with water containing soluble organic carbon in the form of glucose. The work was
      carried out in two experimental setups and the long-term effect of a range of
      glucose concentrations on the Eh, pH, and soluble levels of Fe and Mn was
      investigated. From the results obtained, it could be concluded that excessive
      organic carbon supplement to soil can have adverse effects on soil quality and
      that Eh and soluble Fe are the two most practical parameters for monitoring soil
      health during treatment of farm chemicals.

PMID- 11215642
TI  - Predicting physical and chemical water properties from relationships with
      watershed soil characteristics.
AB  - The Surface Waters component of the Environmental Monitoring and Assessment
      Program (EMAPSW) was developed by the USEPA to evaluate the extent and condition
      of lakes and streams over national and regional scales. Realistically, chemical
      or physical water properties (WPs) such as acidity or turbidity can be field
      sampled for only a small portion of all lakes and streams. However, soil
      characteristics (SCs) affect WPs and broad-scale soil survey data have become
      available in the State Soil Geographic Data Base (STATSGO). We developed models
      relating observed WPs to SCs to extrapolate the sampled WPs to a region,
      potentially reducing extensive monitoring needs. Our study region consisted of 13
      northeastern and Mid-Atlantic states and contained 882 STATSGO soil map units. We
      used map units as the spatial component of WP analysis. The WPs were sampled in
      721 randomly selected EMAPSW study sites. The watersheds of these sites represent
      7.1% of the region's total area and spatially intersect 400 of its soil map
      units. Each intersected map unit was assigned the weighted average WPs from the
      corresponding watersheds. Conditional expectation models were used to extrapolate
      sampled WPs to 882 map units. The relative standard errors ranged from low for pH
      (0.8%), intermediate for total P (12.1%), and very high for chloride (54.8%). The
      high extrapolation errors indicate outlier conditions from natural, non-soil, or
      anthropogenic sources.

PMID- 11215643
TI  - Photodegradation of selected herbicides in various natural waters and soils under
      environmental conditions.
AB  - The photochemical degradation of herbicides belonging to different chemical
      groups has been investigated in different types of natural waters (ground, river,
      lake, marine) and distilled water as well as in soils with different texture and
      composition. Studied herbicides and chemical groups included atrazine, propazine,
      and prometryne (s-triazines); propachlor and propanil (acetanilides); and
      molinate (thiocarbamate). The degradation kinetics were monitored under natural
      conditions of sunlight and temperature. Photodegradation experiments were
      performed in May through July 1998 at low concentrations in water samples (2-10
      mg/L) and soil samples (5-20 mg/kg), which are close to usual field dosage. The
      photodegradation rates of all studied herbicides in different natural waters
      followed a pseudo-first order kinetics. The half-lives of the selected herbicides
      varied from 26 to 73 calendar days in waters and from 12 to 40 d in soil
      surfaces, showing that the degradation process depends on the constitution of the
      irradiated media. The presence of humic substances in the lake, river, and marine
      water samples reduces degradation rates in comparison with the distilled and
      ground water. On the contrary, the degradation in soil is accelerated as the
      percentage of organic matter increases. Generally, the photodegradation process
      in soil is faster than in water. The major photodegradation products identified
      by using gas chromatography-mass spectrometry (GC-MS) techniques were the hydroxy
      and dealkylated derivatives for s-triazines, the dechlorinated and hydroxy
      derivative for the anilides, and the keto-derivative for the thiocarbamate,
      indicating a similar mode of degradation for each chemical category.

PMID- 11215644
TI  - Behavior of cinosulfuron in paddy surface waters, sediments, and ground water.
AB  - Cinosulfuron (3-(4,6-dimethoxy-1,3,5-triazin-2-yl)-1-[2-(2-methoxyethoxy)
      phenylsulfonyl]-urea) is a sulfonylurea herbicide used to control a wide range of
      broadleaf weeds in rice (Oryza sativa L.). A 2-yr field study was conducted in
      northwest Italy to determine the effect of cinosulfuron on surface and subsoil
      waters in rice paddies. Cinosulfuron was applied at 70 g a.i. ha(-1) on 35 ha of
      flooded rice. After the treatment, the change in herbicide concentration over
      time was studied by analyzing water and sediment samples in a test paddy field
      (2.16 ha, located in the treated area), water in a spring and a pond (both
      located near the test paddy), two wells (up- and downhill to the treated area),
      and two piezometers (along the test paddy levee). To better understand some of
      the field study results, cinosulfuron degradation was also evaluated in the
      laboratory in solutions buffered to different pH values. Two weeks after the
      treatment, the cinosulfuron concentration in the paddy water decreased by about
      60%. No cinosulfuron was detected at about 2.5 mo after the treatment. The
      concentration in the sediment gradually increased after the treatment, reaching
      the highest value (13.53 microg kg(-1)) 3 wk later. The maximum cinosulfuron
      content in the spring and pond were 0.91 and 0.29 microg L(-1), respectively, and
      these were detected 60 to 90 days after treatment (DAT). The water collected in
      the piezometers reached the highest concentration (0.99 microg L(-1)) 29 DAT.
      Cinosulfuron was never detected in the wells. In the degradation study at
      different pH values, cinosulfuron degraded rapidly at low pH values.

PMID- 11215645
TI  - Bioavailability of biosolids molybdenum to corn.
AB  - This study was part of a larger effort to generate field data appropriate to the
      assessment of biosolids molybdenum (Mo) risk to ruminants. Corn (Zea mays L.) is
      an important component of cattle diet, and is a logical crop for biosolids
      amendment owing to its high N requirement. Paired soil and corn stover samples
      archived from two unique field experiments were analyzed to quantify the
      relationship (uptake coefficient, UC) between stover Mo and soil Mo load. Both
      studies used biosolids with total Mo concentrations typical of modern materials.
      Data from long-term (continuous corn) plots in Fulton County, IL confirm expected
      low Mo accumulation by corn stover, even at very high biosolids loads and soil Mo
      loads estimated to be near 18 kg Mo ha(-1). Uptake slopes were actually negative,
      but USEPA protocol would assign UC values of 0.001. Data from plots in Minnesota
      also suggested essentially no correlations between stover Mo and soil Mo loads
      for continuous corn. However, greater Mo accumulation in corn grown following
      soybean [Glycine max (L.) Merr.] suggests the possibility of enhanced Mo
      bioavailability to corn in corn-soybean rotations. Nevertheless, molybdenosis
      risk to cattle consuming corn stover produced on biosolids-amended land is small
      as stover Mo concentrations were always low and stover Cu to Mo ratios exceeded
      2:1, which avoids molybdenosis problems.

PMID- 11215646
TI  - The relationship between microbial carbon and the resource quality of soil
      carbon.
AB  - The biological health of soil is an important aspect of soil quality because of
      the many critical functions performed by organisms in soil. Various indicators of
      soil quality have been proposed, but measurements of microbial biomass are most
      commonly used. During decomposition of plant residues in soil the relative
      intensities of the O-alkyl-C signal decreases and the alkyl-C signal increases in
      nuclear magnetic resonance (NMR) spectra. This leads to the suggestion that the
      alkyl-C to O-alkyl-C ratio of a soil may indicate the degree of decomposition.
      Consequently, the overall resource quality of soil C as a substrate for
      heterotrophic microorganisms may be inversely related to the alkyl-C to O-alkyl-C
      ratio. Our hypothesis is that a relationship exists between the size of the soil
      microbial community (microbial biomass) and the quality of soil carbon as a
      resource for microorganisms. New data have been combined with previously
      published data to show that there was a significant, negative correlation between
      the biomass C to total C (Cmic, to Corg) ratio and the alkyl-C to O-alkyl-C ratio
      (p < 0.01), which supports our hypothesis.

PMID- 11215647
TI  - Modeling pollutant release from a surface source during rainfall runoff.
AB  - Though runoff from manure spread fields is recognized as an important mode of
      nonpoint-source pollution, there are no models that mechanistically describe
      transport from a field-spread manure-type source. A mechanistic, physically based
      model for pollutant release from a surface source, such as field-spread manure,
      was hypothesized, laboratory tested, and field-applied. The primary objective of
      this study was to demonstrate the potential applicability of a mechanistic model
      to pollutant release from surface sources. The laboratory investigation used
      stable sources and a conservative "pollutant" (KCl) so that the dynamic effects
      of source dissolution and chemical transformations could be ignored and transport
      processes isolated. The field investigation used runoff and soluble reactive
      phosphorus (SP) data collected from a dairy-manure-spread field in the
      Cannonsville watershed in the Catskills region of New York State. The model
      predictions corroborated well with observations of runoff and pollutant delivery
      in both the laboratory and the field. "Pollutant" release from surface sources
      was generally predicted within 11% of laboratory KCl measurements and field SP
      observations. Laboratory flume runoff predictions with 15 and 26% errors for 25
      and 15 mm h(-1) simulated rainfall intensity experiments, respectively,
      represented root mean square errors of less than 0.2 mLs(-1). A 26% error was
      calculated for overland flow predictions in the field, which translated into
      approximately a 39 mLs(-1) error. Results suggest that the hypothesized model
      satisfactorily represents the primary mechanisms in pollutant release from
      surface sources.

PMID- 11215648
TI  - Biosolids application in the Chihuahuan desert: effects on runoff water quality.
AB  - Surface-applied biosolids, the option most often used on range-lands, can
      increase the concentration of macronutrients and trace elements in the runoff
      water and can potentially produce eutrophication or contamination of surface
      waters. In this study, the effects of postapplication age of biosolids (18, 12,
      6, and 0.5 mo) and rate of application (0, 7, 18, 34, and 90 Mg ha(-1)) on the
      quality of runoff water from shrubland and grassland soils were assessed. Between
      July and October 1996 simulated rainfall was applied to 0.50-m2 plots for 30 min
      at a rate of 160 mm h(-1). All of the runoff water was collected. The
      concentration of NH4+ -N, NO3- -N, PO4(3-)-P, total dissolved phosphorus (TDP),
      Cu, and Mn in the runoff water increased with rate of biosolids application and
      decreased with time of postapplication on the two soils. The highest PO4(3-)-P
      and NH4+ -N concentrations, 4.96 and 97 mg L(-1), respectively, were recorded in
      the grassland soil treated with 90 Mg ha(-1) of biosolids 0.5 mo postapplication.
      For the same soil, rate, and postapplication age of biosolids, Cu exceeded the
      upper limit (0.50 mg L(-1) in drinking water for livestock. Ammonium N and PO4(3
      )-P should be the main compounds considered when surface-applying biosolids.
      Ammonium N at concentrations found in all biosolids-treated plots may affect the
      quality of livestock drinking water by causing taste and smell problems.
      Orthophosphate can contribute to eutrophication if the runoff from biosolids
      treated areas enter surface waters.

PMID- 11215649
TI  - Using zebra mussels to monitor Escherichia coli in environmental waters.
AB  - Use of the zebra mussel (Dreissena polymorpha) as an indicator of previously
      elevated bacteria concentrations in a watershed was examined. The ability of the
      zebra mussel to accumulate and purge Escherichia coli over several days was
      investigated in both laboratory and field experiments. In laboratory experiments,
      periodic enumeration of E. coli in mussels that had been exposed to a dilute
      solution of raw sewage demonstrated that (i) maximum concentrations of E. coli
      are reached within a few hours of exposure to sewage, (ii) the tissue
      concentration attained is higher than the concentration in the ambient water, and
      (iii) the E. coli concentrations take several days to return to preexposure
      concentrations when mussels are subsequently placed in sterile water. In field
      experiments conducted in southeast Michigan in the Clinton River watershed, brief
      increases in E. coli concentrations in the water were accompanied by increases in
      mussel concentrations of E. coli that lasted 2 or 3 d. The ability of mussels to
      retain and to concentrate E. coli made it possible to detect E. coli in the
      environment under conditions that conventional monitoring may often miss.
      Sampling caged mussels in a river and its tributaries may enable watershed
      managers to reduce the sampling frequency normally required to identify critical
      E. coli sources, thereby providing a more cost-effective river monitoring
      strategy for bacterial contamination.

PMID- 11215650
TI  - In vitro pesticide degradation in turfgrass soil incubated under open and sealed
      conditions.
AB  - Degradation of selected pesticides was conducted in a turfgrass soil from a golf
      course under open (i.e., allowing gas exchange with atmosphere) and sealed
      systems. The time required for 50% of the initial dose of fenitrothion (O,O
      dimethyl O-4-nitro-m-tolyl phosphorothioate), diazinon (O,O-dimethyl O-2
      isopropyl-6-methylpyrimidin4-yl phosphorothioate), iprodione [3-(3,5
      dichlorophenyl)-N-isopropyl-2,4-dioxo-imidazolidine-1-carboxamide], mecoprop
      [(RS)-2-(4-chloro-otolyloxy)propionic acid], and asulam (4-aminophenylsulfonyl
      carbamate) to dissipate (half-life, t 1/2) was less than 2 wk under both
      conditions. The t 1/2 values of dithiopyr (S,S'-dimethyl 2-difluoromethyl-4
      isobutyl-6-trifluoro-methylpyridine-3,5-dicarbothioate) were 324 and 185 d under
      the open and sealed conditions, respectively. The t 1/2 values of isoprothiolane
      (di-isopropyl 1,3-dithiolan-2-ylidene-malonate), flutolanil (alpha,alpha,alpha
      trifluoro-3'-isopropoxy-o-toluanilide), and benefin (N-butyl-N-ethyl
      alpha,alpha,alpha-trifluoro-2,6-dinitro-p-toluidine) under the open conditions
      were 154, 336, and 47 d, respectively. The t 1/2 values of these pesticides
      increased slightly under the sealed conditions. The t 1/2 values of terbutol (2,6
      di-tert-butyl-4-methylphenyl N-methycarbamate) and one of the major degradation
      products, N-demethyl-terbutol (2,6-di-tert-butyl-4-methylphenyl carbamate), were
      182 and 291 d under the open conditions and increased by six- and threefold under
      the sealed conditions, respectively. The degradation system under the sealed
      conditions could characterize the persistence of terbutol and N-demethyl
      terbutol, which were the most persistent in the field.

PMID- 11215651
TI  - Phosphorus transfer in runoff following application of fertilizer, manure, and
      sewage sludge.
AB  - Phosphorus (P) transfer in surface runoff from field plots receiving either no P,
      triplesuperphoshate (TSP), liquid cattle manure (LCS), liquid anaerobically
      digested sludge (LDS), or dewatered sludge cake (DSC) was compared over a 2-yr
      period. Dissolved inorganic P concentrations in runoff increased from 0.1 to 0.2
      mg L(-1) on control and sludge-treated plots to 3.8 and 6.5 mg L(-1) following
      application of LCS and TSP, respectively, to a cereal crop in spring. When
      incorporated into the soil in autumn, runoff dissolved P concentrations were
      typically < 0.5 mg L(-1) across all plots, and particulate P remained the
      dominant P form. When surface-applied in autumn to a consolidated seedbed, direct
      loss of LCS and LDS increased both runoff volume and P transfers, but release of
      dissolved P occurred only from LCS. The largest P concentrations (>70 mg L(-1))
      were recorded following TSP application without any increase in runoff volume,
      while application of bulky DSC significantly reduced total P transfers by 70%
      compared with the control due to a reduced runoff volume. Treatment effects in
      each monitoring period were most pronounced in the first runoff event.
      Differences in the release of P from the different P sources were related to the
      amounts of P extracted by either water or sodium bicarbonate in the order TSP >
      LCS > LDS > DSC. The results suggest there is a lower risk of P transfer in land
      runoff following application of sludge compared with other agricultural P
      amendments at similar P rates.

PMID- 11215652
TI  - Nitrogen fertilization effects on stream water cadmium concentration.
AB  - High transition metal concentrations were previously unexpectedly observed in
      soil water extracted by suction lysimeters following forest N fertilization. This
      observation called for additional measurements to investigate if the finding is a
      general phenomenon and, if so, whether stream water concentrations of transition
      metals could increase as a result of N fertilization. The measured levels of Cd
      in the preliminary findings were well above health limits for drinking water.
      Hence, the problem could be of major concern. Here we report on soil water and
      stream water concentrations at two partly fertilized watersheds. All sites were
      situated in the central part of Sweden. The N application (150 kg N ha(-1) in the
      form of calcium ammonium nitrate) resulted in increased concentrations of
      nitrate, and a pulse of acidity through the soil profile, which increased the
      solubility of transition metals (mainly Cd and Zn) and Al. Stream water
      concentrations of transition metals, on the other hand, were not affected during
      the studied period by the increased solubility of transition metals in the soil.
      The data imply that the solubilized transition metals probably insolubilize
      further down the soil profile, and that there is no risk from forest N
      fertilization (at normal soil pH levels) of transition metal levels increasing in
      nearby surface waters. To our knowledge, this is the first time this side effect
      of N fertilization has been considered.

PMID- 11215653
TI  - Field-scale preferential transport of water and chloride tracer by depression
      focused recharge.
AB  - A tracer study was initiated in November 1993 to investigate depression-focused
      recharge and to monitor solute movement through the vadose zone into the shallow
      ground water in southeastern North Dakota. Granular potassium chloride (KCl) was
      surface-applied to two areas overlying subsurface drains and to one area
      instrumented with soil solution samplers, ground water monitoring wells, time
      domain reflectometry (TDR) probes, and temperature probes. One of the subsurface
      drain tracer plots was located on level ground while the other two sites were in
      small topographic depressions. Formation of ground water mounds beneath the
      depressions indicated that these areas are recharge sites. The applied Cl- tracer
      was found to move rapidly to the shallow ground water under the depressional
      areas after infiltration of spring snowmelt in 1994. Excessive rainfall events
      were also responsible for focused recharge and the rapid transport of the applied
      Cl- tracer. Water flow through partially frozen soil at the bottom of the
      depressions during thaw enhanced preferential movement of the tracer.

PMID- 11215654
TI  - Artificial recharge of humic ground water.
AB  - The purpose of this study was to investigate the efficiency of soil in removing
      natural organic matter from humic ground waters using artificial recharge. The
      study site, in western Denmark, was a 10,000 ml football field of which 2,000 m2
      served as an infiltration field. The impact of the artificial recharge was
      studied by monitoring the water level and the quality of the underlying shallow
      aquifer. The humic ground water contained mainly humic adds with an organic
      carbon (OC) concentration of 100 to 200 mg C L(-1). A total of 5,000 mS of humic
      ground water were sprinkled onto the infiltration field at an average rate of
      4.25 mm h(-1). This resulted in a rise in the water table of the shallow aquifer.
      The organic matter concentration of the water in the shallow aquifer, however,
      remained below 2.7 mg C L(-1). The organic matter concentration of the pore water
      in the unsaturated zone was measured at the end of the experiment. The organic
      matter concentration of the pore water decreased from 105 mg C L(-1) at 0.5 m to
      20 mg C L(-1) at 2.5 m under the infiltration field indicating that the soil
      removed the organic matter from the humic ground water. From these results we
      conclude that artificial recharge is a possible method for humic ground water
      treatment.

PMID- 11215655
TI  - Nutrient movement and removal in a switchgrass biomass-filter strip system
      treated with dairy manure.
AB  - Manure use on cropland has raised concern about nutrient contamination of surface
      and ground waters. Warm-season perennial grasses may be useful in filter strips
      to trap manure nutrients and as biomass feedstock for nutrient removal. We
      explored the use of 'Alamo' switchgrass (Panicum virgatum L.) in a biomass
      production-filter strip system treated with dairy manure. We measured changes in
      extractable P in the soil, NO3 -N in soil water, and changes in total reactive P
      and chemical oxygen demand (COD) of runoff water before and after a switchgrass
      filter strip. Five rates of dairy manure (target rates of 0, 50, 100, 150, and
      200 kg N ha(-1) from solid manure in 1995; 0, 75, 150, 300, and 600 kg N ha(-1)
      from lagoon effluent in 1996 and 1997) were surface-applied to field plots of
      switchgrass (5.2 by 16.4 m) with a 5.2- by 16.4-m switchgrass filter strip below
      the manured area. Yield of switchgrass from the manured area increased linearly
      with increasing manure rate in each year. Soil water samples collected at 46 or
      91 cm below the soil surface on 30 dates indicated < 3 mg L(-1) of NO3-N in all
      plots. Concentrations of total reactive P in surface runoff water were reduced an
      average of 47% for the 150 kg N rate and 76% for the 600 kg N rate in 1996 and
      1997 after passing through the strip. Manure could effectively substitute for
      inorganic fertilizer in switchgrass biomass production with dual use of the
      switchgrass as a vegetative filter strip.

PMID- 11215656
TI  - Rapid methods to determine potentially mineralizable nitrogen in broiler litter.
AB  - Although broiler (chicken, Gallus gallus domesticus) litter has long been used as
      a fertilizer, estimating the rate required to supply a desired amount of plant
      available N is still hampered by the lack of rapid methods to estimate
      potentially mineralizable nitrogen (PMN). Previous research has suggested that
      near infrared reflectance spectroscopy (NIRS) and certain poultry litter
      characteristics, such as water-soluble organic nitrogen (WSON), may be useful for
      estimating PMN. The objectives of this study were to evaluate NIRS and WSON as
      tools to estimate PMN in broiler litter. Sixty sieved (2 mm) and freeze-dried
      broiler litter samples were mixed with Cowarts sandy loam soil (fine-loamy,
      kaolinitic, thermic Typic Kanhapludult) and incubated at 25 degrees C for 112 d.
      Cumulative net N mineralized with time was fitted to a single-pool exponential
      model to determine PMN for each broiler litter sample. The PMN values obtained
      were regressed against NIRS (780 to 2500 nm) and WSON measurements. We found
      strong relationships between measured- and NIRS-predicted PMN (R2 = 0.82), and
      between measured PMN and WSON (R2 = 0.87). These results demonstrate the
      feasibility of using either of these two methods to estimate PMN in broiler
      litter. Future work should further test both methods for their ability to
      estimate mineralizable N in whole, moist broiler litter under field conditions.

PMID- 11215657
TI  - Effects of sample storage on biosolids compost stability and maturity evaluation.
AB  - Compost stability and maturity are important parameters of compost quality. To
      date, nearly all compost characterization has been performed using samples
      freshly collected because sample storage can affect compost stability and
      maturity evaluation. However, sample preservation is sometimes necessary,
      especially for scientific research purposes. There is little information
      available on the effects of sample storage on compost stability and maturity.
      Samples of biosolids compost with different levels of stability and maturity were
      collected from four compost facilities in Florida (referred to as Register,
      Winslow, Sunset, and Meadow). Comparisons of CO2 evolution, seed germination
      rate, and water-soluble organic carbon (WSOC) were made between fresh samples
      with short storage at 4 degrees C for less than 1 wk and air-dried or frozen
      compost samples stored for 1 yr. The effects of storage (air-dry or frozen) on
      the measured parameters depended on compost stability and maturity and on the
      compost material source. Frozen storage reduced the peak CO2 evolution of
      Register samples by 12 to 29%, while accumulated CO2 evolution was reduced by 43
      to 64% and 110 to 277% with air-dry and frozen storage, respectively. The storage
      effect on CO2 evolution with more stable compost was inconsistent. Storage did
      not affect compost phytotoxicity, except for samples from the Sunset facility.
      Air-drying reduced the WSOC by up to 35%, and freezing increased it by up to 34%,
      while both storage methods had no significant effect on samples of low WSOC.
      Despite all these variations, WSOC had a significant and consistent relation to
      CO2 evolution and seed germination rates with R2 of 0.78 and 0.57, respectively,
      regardless of storage methods.

PMID- 11215658
TI  - Phosphorus accumulation in cultivated soils from long-term annual applications of
      cattle feedlot manure.
AB  - Historically, manure has been recognized as an excellent soil amendment that can
      improve soil quality and provide nutrients for crop production. In areas of high
      animal density, however, the potential for water pollution resulting from
      improper storage or disposal of manure may be significant. The objective of this
      study was to determine the P balance of cultivated soils under barley (Hordeum
      vulgare L.) production that have received long-term annual manure amendments.
      Nonirrigated soils at the study site in Lethbridge, AB, Canada, have received 0,
      30, 60, or 90 Mg manure ha(-1) (wet wt. basis) while irrigated plots received 0,
      60, 120, and 180 Mg ha(-1) annually for 16 yr. The amount of P removed in barley
      grain and straw during the 16-yr period was between 5 and 18% of the cumulative
      manure P applied. There was a balance between P applied in manure and P recovered
      in crops and soils (to the 150-cm depth) of nonirrigated plots during the 16-yr
      study. In irrigated plots, as much as 1.4 Mg P ha(-1) added (180 Mg ha(-1) yr(-1)
      treatment) was not recovered over 16 yr, and was probably lost through leaching.
      The risk of ground water contamination with P from manure was greater in
      irrigated than nonirrigated plots that have received long-term annual manure
      amendments. Manure application rates should be reduced in nonirrigated and
      irrigated plots to more closely match manure P inputs to crop P requirements.

PMID- 11215659
TI  - Transport of Escherichia coli in sand columns with constant and changing water
      contents.
AB  - Understanding how changes in volumetric water content (theta) affect bacterial
      adsorption could help reduce transport of pathogenic and indicator bacteria that
      may be present in infiltrating wastewater. Three flow regimes that simulated
      infiltration from a household septic system were evaluated: saturated,
      unsaturated with a constant volumetric water content theta (constant unsaturated
      flow), and unsaturated with cyclic changes in theta (variable unsaturated flow).
      Escherichia coli was suspended in artificial sewage (AS) and applied as step
      inputs to sand columns, with regular interruptions in input for variable
      unsaturated flow. A transport model was fit to the saturated and constant
      unsaturated flow breakthrough curves to determine retardation (R), the first
      order filtration coefficient (mu), and the maximum outflow relative concentration
      (Cmax). The total cells transported as a fraction of input (tau) in all three
      flow regimes was calculated. Constant unsaturated flow resulted in a
      significantly lower Cmax (0.633) in comparison with saturated flow (0.803, P < or
      = 0.05), although unsaturated mu (0.0693 h(-1)) was not significantly different
      from saturated mu (0.0259 h(-1)). Constant unsaturated flow also resulted in a
      significantly smaller tau (0.617) than saturated (0.806) or variable unsaturated
      flow (0.734). In variable unsaturated flow, cell concentrations were out of phase
      with theta--as the column drained, cell concentrations in the outflow increased;
      and when a pulse of suspension was applied, cell concentrations decreased.
      Constant unsaturated flow is probably the best for removal of pathogenic bacteria
      because this regime resulted in lower maximum concentrations of E. coli and
      greater cell removal, in comparison with saturated and variable unsaturated flow.

PMID- 11215660
TI  - Potential mineralization of four herbicides in a ground water--fed wetland area.
AB  - Herbicides may leach from agricultural fields into ground water feeding adjacent
      wetlands. However, only little is known of the fate of herbicides in wetland
      areas. The purpose of the study was to examine the potential of a riparian fen to
      mineralize herbides that could leach from an adjacent catchment area. Slurries
      were prepared from sediment and ground water collected from different parts of a
      wetland representing different redox conditions. The slurries were amended with
      O2, NO3-, SO4(2-), and CO2, or CO2 alone as electron acceptors to simulate the in
      situ conditions and their ability to mineralize the herbides mecoprop,
      metsulfuron-methyl, isoproturon and atrazine. In addition, the abundance of
      bacteria able to utilize O2, NO3-, SO4(2-) + CO2, and CO2 as electron acceptors
      was investigated along with the O2-reducing and methanogenic potential of the
      sediment. The recalcitrance to bacterial degradation depended on both the type of
      herbicide and the redox conditions pertaining. Mecoprop was the most readily
      degraded herbicide, with 36% of [ring-U-14C]mecoprop being mineralized to 14CO2
      under aerobic conditions after 473 d. In comparison, approximately 29% of [phenyl
      U-14C]metsulfuron-methyl and 16% of [ring-U-14C]isoproturon mineralized in
      aerobic slurries during the same period. Surprisingly, 8 to 13% of mecoprop also
      mineralized under anaerobic conditions. Neither metsulfuron-methyl nor
      isoproturon were mineralized under anaerobic conditions and atrazine was not
      mineralized under any of the redox conditions examined. The present study is the
      first to report mineralization of meco-prop in ground water in a wetland area,
      and the first to report mineralization of a phenoxyalcanoic acid herbicide under
      both aerobic and anaerobic conditions.

PMID- 11215661
TI  - Chemical characterization of synthetic soil from composting coal combustion and
      pharmaceutical by-products.
AB  - Land application of coal combustion by-products (CCBs) mixed with solid organic
      wastes (SOWs), such as municipal sewage sludge, has become increasingly popular
      as a means of productively using what were once considered waste products.
      Although bulk chemical and physical properties of several of these CCB-SOW
      materials have been reported, detailed information about their synthesis and
      mineralogy of the CCB-SOW materials has not been reported. In this paper,
      chemical and mineralogical properties of a soil-like material obtained from
      composting a mixture of CCBs with a pharmaceutical fermentation by-product (FB)
      were investigated at the laboratory and field scale. All starting materials and
      products were characterized by X-ray diffraction (XRD), fourier transform
      infrared (FFIR) spectroscopy, and elemental analyses. The results showed that the
      FB was strongly bound to the CCBs and could not be removed by washing. Within 2
      wk of the start of a composting study, there was a rapid drop in pH from 12 to 8,
      an increase in temperature to 70 degrees C, and a reduction in the dissolved
      oxygen content, attributed to the rapid establishment of a highly active
      microbial population. Composting produced a soil-like material with high levels
      of plant nutrients, a high nutrient retention capacity, and metal contents
      similar to median levels of those metals reported for soils. The levels of boron
      and soluble salts are such that sensitive plants may initially show toxicity
      symptoms. However, with adequate rainfall, leaching should rapidly remove most of
      the B and soluble salts. With care, the material produced is safe for use as a
      synthetic topsoil.

PMID- 11215662
TI  - Nitrate removal in a riparian wetland of the Appalachian Valley and Ridge
      physiographic province.
AB  - Riparian zones within the Appalachian Valley and Ridge physiographic province are
      often characterized by localized variability in soil moisture and organic carbon
      content, as well as variability in the distribution of soils formed from alluvial
      and colluvial processes. These sources of variability may significantly influence
      denitrification rates. This investigation studied the attenuation of nitrate (NO3
      -N) as wastewater effluent flowed through the shallow ground water of a forested
      headwater riparian zone within the Appalachian Valley and Ridge physiographic
      province. Ground water flow and NO3- -N measurements indicated that NO3- -N
      discharged to the riparian zone preferentially flowed through the A and B
      horizons of depressional wetlands located in relic meander scars, with NO3- -N
      decreasing from > 12 to < 0.5 mg L(-1). Denitrification enzyme activity (DEA)
      attributable to riparian zone location, soil horizon, and NO3- -N amendments was
      also determined. Mean DEA in saturated soils attained values as high as 210
      microg N kg(-1) h(-1), and was significantly higher than in unsaturated soils,
      regardless of horizon (p < 0.001). Denitrification enzyme activity in the shallow
      A horizon of wetland soils was significantly higher (p < 0.001) than in deeper
      soils. Significant stimulation of DEA (p = 0.027) by N03- -N amendments occurred
      only in the meander scar soils receiving low NO3- -N (<3.6 mg L(-1))
      concentrations. Significant denitrification of high NO3- -N ground water can
      occur in riparian wetland soils, but DEA is dependent upon localized differences
      in the degree of soil saturation and organic carbon content.

PMID- 11215663
TI  - Phosphorus flux from wetland soils affected by long-term nutrient loading.
AB  - Wetland soils play a key role in the cycling of nutrients within an ecosystem.
      Since soils are potentially a source or a sink for inorganic nutrients, it is
      important to quantify their influence on overlying water quality in order to
      understand their importance in overall ecosystem nutrient budgets. Laboratory and
      field studies were performed in the northern Everglades (WCA-2A) to determine the
      magnitude of phosphorus (P) flux between the soil and the overlying water column,
      under various redox conditions. The P flux was estimated using three techniques:
      intact soil cores, in situ benthic chambers, and porewater equilibrators. There
      was reasonable agreement between the P flux estimated using intact soil cores and
      benthic chambers; however, P flux estimates using the porewater equilibrators
      were considerably lower than the other two techniques. Models of solute flux,
      based solely on soil physico-chemical characteristics, may substantially
      underestimate soil-water nutrient exchange processes. Phosphorus flux measured
      with the intact soil cores varied from 6.5 mg m(-2) d(-1) near nutrient inflow
      areas to undetectable flux 4 km away from the inflow. Oxygen consumption varied
      from 4 mg m(-2) d(-1) near the inflow to a constant 1 to 2 mg m(-2) d(-1) at a
      distance of 4 km from the inflow. Rate of consumption of NO3- -N and SO4(2-)
      showed no significant trend with respect to distance from inflow. Nitrate N and
      SO4 consumption rates averaged 120 and 130 mg m(-1) d(-1), respectively.
      Consumption of O2 was correlated with P flux, whereas NO3- -N and SO4(2-)
      consumption were not.

PMID- 11215664
TI  - Alfalfa rapidly remediates excess inorganic nitrogen at a fertilizer spill site.
AB  - By 19%, standard remediation techniques had significantly reduced the
      concentration of nitrate nitrogen (NO3- -N) in local ground water at the site of
      a 1989 anhydrous ammonia spill, but NO3- -N concentrations in portions of the
      site still exceeded the public drinking water standard. Our objective was to
      determine whether local soil and ground water quality could be improved with
      alfalfa (Medicago sativa L.). A 3-yr study was conducted in replicated plots (24
      by 30 m) located hydrologically upgradient of the ground water under the spill
      site. Three alfalfa entries ['Agate', Ineffective Agate (a non-N2-fixing elite
      germplasm similar to Agate), and MWNC-4 (an experimental germplasm)] were seeded
      in the spring of 1996. Corn (Zea mays L.) or wheat (Triticum aestivum L.) was
      seeded adjacent to the alfalfa each year. Crops were irrigated with N-containing
      ground water to meet water demand. During the 3-yr period, about 540 kg of
      inorganic N was removed from the aquifer through irrigation of 4.9 million L
      water. Cumulative N removal from the site over 3 yr was 972 kg N ha(-1) in
      Ineffective Agate alfalfa hay, compared with 287 kg N ha(-1) for the annual
      cereal grain. Soil solution NO3- concentrations were reduced to low and stable
      levels by alfalfa, but were more variable under the annual crops. Ground water
      quality improved, as evidenced by irrigation water N concentration. We do not
      know how much N was removed by the N2-fixing alfalfas, but it appears that either
      fixing or non-N2-fixing alfalfa will effectively remove inorganic N from N
      affected sites.

PMID- 11215665
TI  - Accumulation of rare earth elements in corn after agricultural application.
AB  - Using both pot and plot experiments, the dose-dependent accumulation of rare
      earth elements (REs) in corn (Zea mays L.) after application of an agricultural
      REs mixture was measured. In the pot experiment, the dose-dependent accumulation
      of REs in corn root and stem was observed, but it could not be detected in corn
      leaf under the dosage of 20 mg REs kg(-1) soil (oven-dry mass). The non-observed
      effect concentration (NOEC) for accumulation of REs in corn seedling with the pot
      experiment was 1.0 mg REs kg(-1). In the plot experiment, the dose-dependent
      accumulation was observed at an early stage after application of REs and the NOEC
      value of 32 mg REs m(-2) was obtained. At harvest, no dose-dependent accumulation
      of REs was observed in any part of the corn. These results can be confirmed by
      the fingerprinting analysis based on the differences between La to RE ratios in
      the REs mixture and in pot or plot soil. We observed that the plant shows no
      preference on individual RE and the results of fingerprinting indicated clearly
      the incorporation of exogenous REs in plant tissues, in a similar manner as that
      observed in the dose-dependent distribution of RE concentrations. The results
      indicated also a translocation process of REs from plant root to leaf when
      applied to soil or from leaf to root when applied to leaf. A homeostatic
      regulation mechanism for excessive uptake of REs in plants is suggested to
      regulate the concentrations of REs in the plant.

PMID- 11215666
TI  - Implementation of sulfate adsorption in the SAFE model.
AB  - An SO4(2-) adsorption submodel has been implemented in the dynamic soil chemistry
      model SAFE. The submodel calculates pH-dependent SO4(2-) and H+ adsorption to the
      soil, as well as the net surface charge development due to uneven adsorption of
      SO4(2-) and H+, using the empirical equations derived from an electrostatic model
      (Extended Constant Capacitance Model, ECCM) of SO4(2-) adsorption. The resulting
      new SAFE model was applied on a roof experiment plot in the Norway spruce [Picea
      abies (L.) H. Karst.] stand at Solling, Germany, where atmospheric S and N
      deposition was artificially reduced by the roof construction. The model
      performance was compared with the previous versions that used a pH-independent
      Freudlich model of SO4(2-) adsorption or assumed no SO4(2-) adsorption. With the
      ECCM-based SO4(2-) adsorption submodel, SAFE simulated soil solution SO4(2-)
      concentration and base saturation better, in comparison with measured data, than
      with the previous SO4(2-) adsorption formulations. Through the model application,
      also, need of additional improvement was suggested, such as calibration of mass
      transfer coefficients.

PMID- 11215667
TI  - Nitrogen and carbon leaching in agroecosystems and their role in denitrification
      potential.
AB  - The drainage of water and leaching of dissolved constituents represent major
      components of agroecosystem mass budgets that have been exceedingly difficult to
      measure. Equilibrium-tension lysimeters (ETLs) were used to monitor drainage,
      nitrogen (N), and carbon (C) leaching through Plano silt loam (fine-silty, mixed,
      superactive, mesic Typic Argiudoll) for a 4-yr period in a restored prairie and N
      fertilized no-tillage and chisel-plowed maize (Zea mays L.) agroecosystems. Mean
      drainage recorded during 4 yr for the prairie, no-tillage, and chisel-plowed
      ecosystems totaled 461, 1,116, and 1,575 mm and represented 16, 33, and 47% of
      precipitation plus melting of drifted snow received, respectively. Total
      inorganic N leaching losses during the 4-yr period for the prairie, no-tillage,
      and chisel-plowed ecosystems were 0.6, 201, and 179 kg N ha(-1), respectively.
      Inorganic N leaching represented 26 and 24% of applied fertilizer N additions to
      the no-tillage and chisel-plowed agroecosystems. Total dissolved C leaching
      losses were 119, 435, and 502 kg C ha(-1) for the prairie, no-tillage, and chisel
      plowed ecosystems, respectively. Sufficient dissolved organic carbon (DOC) and
      nitrate N (NO3- -N) existed in the prairie and agroecosystems to support subsoil
      denitrification. Potential denitrification, however, was limited by insufficient
      lengths of saturated soil conditions in all three ecosystems, the supply of DOC
      in the agroecosystems, and the supply of nitrate N in the prairie. Based on
      available DOC and nitrate N, the maximum contribution of denitrification below
      the root zone in the agroecosystems was less than 25% of the total amount of
      leached nitrate N and the probable contribution of denitrification was much less.

PMID- 11215668
TI  - Fate of atrazine in sandy soil cropped with sorghum.
AB  - A field study was conducted to determine the fate of atrazine (6-chloro-N2-ethyl
      N4-isopropyl-1,3,5-triazine-2,4-diamine) within the root zone (0 to 90 cm) of a
      sandy soil cropped with sorghum [Sorghum bicolor (L.) Moench] in Gainesville,
      Florida. Atrazine was uniformly applied at a rate of 1.12 kg ai. ha(-1) to a
      sorghum crop under moderate irrigation, optimum irrigation, and no irrigation
      (rainfed), 2 d after crop emergence. Bromide as a tracer for water movement was
      applied to the soil as NaBr at a rate of 45 kg Br ha(-1), 3 d before atrazine
      application. Soil water content, atrazine, and Br concentrations were determined
      as a function of time using soil samples taken from the root zone. Atrazine
      sorption coefficients and degradation rates were determined by depth for the
      entire root zone in the laboratory. Atrazine was strongly adsorbed within the
      upper 30 cm of soil and most of the atrazine recovered from the soil during the
      growing season was in that depth. The estimated half-life for atrazine was 32 d
      in topsoil to 83 d in subsoil. Atrazine concentration within the root zone
      decreased from 0.44 kg ai. ha(-1) 2 days after application (DAA) to 0.1 kg a.i.
      ha(-1) 26 DAA. Negligible amounts of atrazine (approximately 5 microg kg(-1))
      were detected below the 60-cm soil depth by 64 DAA. Most of the decrease in
      atrazine concentration in the root zone over time was attributed to degradation.
      In contrast, all applied bromide had leached past the 60-cm soil depth during the
      same time interval.

PMID- 11215669
TI  - Cupric ion activity in peat soil as a toxicity indicator for maize.
AB  - Copper phytotoxicity in soils is difficult to assess because Cu accumulates at
      and damages roots, and is not readily transferred to shoots. Soil chemical
      properties strongly influence Cu speciation, so that total soil Cu alone is not a
      broadly useful indicator of potential toxicity to plants. The present study
      measured free Cu2+ activity in Cu-enriched peat soils using the ion selective
      electrode. The soil Cu2+ activity was related to the severity of phytotoxicity as
      measured by several indicators in a maize (Zea mays L.) bioassay, including leaf
      chlorosis, root stunting, and reduced shoot growth and Fe concentration. A soil
      Cu2+ activity of 10(-7.0) to 10(-7.5), corresponding to total Cu of about 275
      mg/kg in the peat soil, caused phytotoxicity in maize seedlings. It is proposed
      that Cu2+ activity is more directly related to phytotoxic effects than other soil
      tests, such as extractions with strong acids or chelating agents, because it is
      the free Cu2+ in soil solution that has the most direct toxic effects on roots.
      There was very limited uptake of Cu into maize shoots, and even when Cu2+
      activity and total soil Cu were raised into the extreme toxicity range of 10(-5)
      and 4,000 mg/ kg, respectively, shoot Cu remained less than 35 mg/kg. These
      results indicate the inadequacy of the USEPA risk assessment of potential for Cu
      toxicity to crops amended with sewage sludge, which assumed a no-effect level of
      maize shoot Cu of 40 mg/kg.

PMID- 11215670
TI  - Nickel increases susceptibility of a nickel hyperaccumulator to Turnip mosaic
      virus.
AB  - Hyperaccumulated Ni can defend plant tissues against herbivores and pathogens.
      The effectiveness of this defense, however, has not been tested with a viral
      pathogen. Turnip mosaic virus (TuMV) accumulation was studied in two serpentine
      species of Streptanthus with different Ni uptake abilities. Plants of a Ni
      hyperaccumulator, milk-wort jewelflower (S. polygaloides Gray), and a non
      hyperaccumulator, plumed jewelflower (S. insignis Jepson), were grown on Ni
      amended and unamended soils. Plants were inoculated with TuMV at three different
      phenological stages: basal rosette, bolting, and flowering. Susceptibility of
      experimental plants to TuMV was determined either by the magnitude of TuMV
      accumulation (measured by indirect enzyme-linked immunosorbent assay [ELISA]) or
      by plant survival. Streptanthus polygaloides plants grown on high-Ni soil were
      more susceptible to TuMV than low-Ni S. polygaloides at all three phenological
      stages. All rosette and pre-bolt S. insignis plants were infected by TuMV, but
      survival and TuMV accumulation were not significantly affected by soil Ni. At
      flowering, only high-Ni S. polygaloides plants became infected. For S.
      polygaloides, elevated tissue Ni concentrations enhanced TuMV infection instead
      of defending plants from the virus. To reduce risks to nearby agricultural crops,
      future phytoremed. iation and phytomining operations using this species should
      incorporate management plans to prevent the creation of artificial reservoirs of
      TuMV inoculum.

PMID- 11215671
TI  - Phosphate release from seasonally flooded soils: a laboratory microcosm study.
AB  - Phosphorus derived from agricultural practices has been targeted as a leading
      cause of water quality degradation in Lake Champlain. Mobilization of P from
      seasonally flooded agricultural soils is a concern. Using 14 soils from a
      research farm in New York's Champlain Valley, we characterized the available P
      status, extractable Fe and Al, P sorption capacities, and soluble phosphate
      release in flooded laboratory microcosms. Quantities of NH4-acetate available P
      ranged from 3 to 100 mg kg(-1) and fluoride-extractable P from 10 to 211 mg kg(
      1). Flooding soils induced significant release of phosphate to the porewater over
      a 60- to 90-d period in 13 of the 14 soils studied. Porewater phosphate increases
      ranged from 2.2 to 27.0 times the initial phosphate concentrations. However,
      floodwater phosphate increases were much lower, with a maximum of 3.6 times the
      initial concentration. Average porewater phosphate concentrations over the
      flooding period ranged from 0.046 to 7.0 mg L(-1) and average floodwater P from
      0.032 to 3.70 mg L(-1). Ammonium-acetate P and the degree of phosphorus
      saturation (DPS) were highly correlated with the average porewater and floodwater
      phosphate concentration. Average ratio of porewater to floodwater phosphate
      concentrations ranged from 1.0 to 3.3. Five soils that were lower in fluoride
      extractable P had increasing porewater phosphate accompanied by increasing
      porewater Fe2+ and decreasing floodwater phosphate. Results suggest that P
      solubility and mobility were a function of both the available P status and redox
      cycling.

PMID- 11215672
TI  - "Toxicologic pathology of the reproductive and endocrine systems".

PMID- 11215673
TI  - Uterine leiomyomas: mechanisms of tumorigenesis.
AB  - Uterine leiomyomas, also called fibroids, are the most common reproductive tract
      neoplasm and the leading indication for hysterectomy in premenopausal women. The
      discovery and development of medicinal therapies for uterine leiomyoma have been
      hampered by a lack of understanding regarding the etiology and molecular
      mechanisms underlying the development of these lesions. Although the estrogen
      responsiveness of uterine leiomyoma is well established, the impact of
      environmental estrogens and their contribution to the development of these tumors
      is currently unknown. The Eker rat model of uterine leiomyoma has proven useful
      for addressing these issues and understanding the pathophysiology of this
      disease. The Eker rat is the only animal model that develops spontaneous uterine
      leiomyomas, and these tumors share many characteristics with those found in
      humans. The availability of tumor-derived cell lines from these rats has made
      this a valuable in vitro/in vivo model system for experimental studies to
      investigate molecular mechanisms of disease and to design interventional and
      preventative strategies for this clinically relevant tumor.

PMID- 11215674
TI  - Genetically engineered rodent models of mammary gland carcinogenesis: an
      overview.
AB  - Breast cancer is a multifactorial disease that develops as a result of
      interactions among genetic, environmental, and hormonal factors. Multiple genetic
      derangements are believed to be involved in the pathogenesis of breast cancer,
      including the inactivation of tumor suppressor genes and/or the disregulation of
      proto-oncogenes. Age, hormones, and environmental factors further influence these
      genetic derangements. Spontaneous and chemically induced animal models of breast
      cancer have been limited in their usefulness. The advent of targeted gene
      mutations has allowed for a more specific exploration of the pathogenesis of
      breast cancer by creating mouse models that mimic single or multiple gene
      alterations found in human mammary tumors. The genes targeted in these models
      include mouse mammary tumor integration sites and genes that encode for growth
      regulators, signal transduction proteins, cell cycle proteins, and cell matrix
      proteinases. In this review, I summarize tumor morphology and the relevance of
      each model to the pathogenesis and progression of human breast cancer. These
      models have great potential for elucidating the multistep process of mammary
      gland carcinogenesis and for contributing to the identification of novel
      therapeutic targets.

PMID- 11215675
TI  - Mammary tumor induction and premature ovarian failure in ApcMin mice are not
      enhanced by Brca2 deficiency.
AB  - Inherited BRCA2 mutations predispose individuals to breast cancer and increase
      risk at other sites. Recent studies have suggested a role for the APC I1307K
      allele as a low-penetrance breast cancer susceptibility gene that enhances the
      phenotypic effects of BRCA1 and BRCA2 mutations. To model the consequences of
      inheriting mutant alleles of the BRCA2 and APC tumor suppressor genes, we
      examined tumor outcome in C57BL/6 mice with mutations in the Brca2 and Apc genes.
      We hypothesized that if the Brca2 and Apc genes were interacting to influence
      mammary tumor susceptibility, then mammary tumor incidence and/or multiplicity
      would be altered in mice that had inherited mutations in both genes. Female and
      male offspring treated with a single IP injection of 50 mg/kg N-ethyl-N
      nitrosourea (ENU) at 35 days of age developed mammary adenoacanthomas by 100 days
      of age. The female Apc-mutant and Brca2/Apc double-mutant progeny had mean
      mammary tumor multiplicities of 6.7+/-2.8 and 7.2+/-2.7, respectively, compared
      to wild-type and Brca2-mutant females, which had mean mammary tumor
      multiplicities of 0.1+/-0.4 and 0.3+/-0.5, respectively. Female ENU-treated Apc
      mutant and Brca2/Apc double heterozygotes were also susceptible to premature
      ovarian failure. Thus, the inheritance of an Apc mutation predisposes ENU-treated
      female and male mice to mammary tumors and, in the case of female mice, to
      ovarian failure. These results indicate that mammary tumor development in Apc
      mutant mice can progress independently of ovarian hormones. The Apc mutation
      driven phenotypes were not modified by mutation of Brca2, perhaps because Brca2
      acts in a hormonally dependent pathway of mammary carcinogenesis.

PMID- 11215677
TI  - Cancer prevention studies in p53-deficient mice.
AB  - Future progress in mechanism-based cancer prevention research may be facilitated
      by animal models displaying specific genetic susceptibilities for cancer, such as
      mice deficient in 1 (+/-) or both (-/-) alleles of the p53 tumor suppressor gene.
      We observed in p53-/- mice that calorie restriction (CR) increased the latency of
      spontaneous tumor development (mostly lymphomas) by approximately 75%, decreased
      serum insulin-like growth factor-1 (IGF-1) and leptin levels, slowed thymocyte
      cell cycle traverse, and induced apoptosis in immature thymocytes. In p53+/-
      mice, CR and a 1 d/wk fast each delayed spontaneous tumor development (a mix of
      lymphomas, sarcomas, and epithelial tumors) and decreased serum IGF-1 and leptin
      levels, even when begun late in life. In p53+/-Wnt-1 transgenic mice, a mammary
      tumor model, the same interventions increased mammary tumor latency and reduced
      mean serum IGF-1 and leptin levels to <50% of those of control mice. We
      capitalized on the susceptibility of p53+/- mice to chronic, low-dose aromatic
      amine-induced bladder carcinogenesis to develop a useful model for evaluating
      bladder cancer prevention approaches. These examples clearly indicate that mice
      with specific (and humanlike) genetic susceptibilities for cancer are powerful
      models for testing interventions that may inhibit carcinogenesis in humans.

PMID- 11215676
TI  - The effect of short intermittent light exposures on the melatonin circadian
      rhythm and NMU-induced breast cancer in female F344/N rats.
AB  - We investigated the effects of altered endogenous nighttime melatonin
      concentrations on mammary tumor production in an N-nitroso-N-methylurea (NMU)
      induced breast cancer model in female Fischer 344 (F344)/N rats. Experiments were
      designed 1) to evaluate whether short-duration intermittent exposures to light at
      night would affect the nocturnal rise of melatonin, resulting in a decrease in
      nighttime serum melatonin concentrations, 2) to evaluate whether any suppression
      of nighttime serum melatonin concentrations could be maintained for a period of
      weeks, and 3) to determine the effects of suppressed serum melatonin
      concentrations on the incidence and progression of NMU-induced breast cancer. In
      vivo studies were used to assess serum melatonin concentrations after 1 day and 2
      and 10 weeks of nightly administration of short-duration intermittent light
      exposure at night and incidence of NMU-induced tumors. Five 1-minute exposures to
      incandescent light every 2 hours after the start of the dark phase of the light:
      dark cycle decreased the magnitude of the nocturnal rise of serum melatonin
      concentrations in rats by approximately 65%. After 2 weeks of nightly
      intermittent light exposures, an average decrease of the peak nighttime serum
      melatonin concentrations of approximately 35% occurred. The amelioration
      continued and, at 10 weeks, peak nighttime serum melatonin concentrations were
      still decreased, by approximately 25%. Because peak endogenous nighttime serum
      melatonin values could be moderately suppressed for at least 10 weeks, a 26-week
      NMU mammary tumor study was conducted. Serum melatonin concentrations and
      incidence, multiplicity, and weight of NMU-induced mammary tumors were assessed.
      A group of pinealectomized (Px) animals was also included in the tumor study. No
      effect on the development of mammary tumors in an NMU-induced tumor model in rats
      occurred when endogenous nighttime serum melatonin concentrations were moderately
      suppressed by short-duration intermittent light exposures at night. At necropsy,
      there were no alterations in mammary tumor incidence (28/40 NMU controls, 28/40
      NMU + light, 31/40 NMU + Px), multiplicity (2.18 tumors/tumor-bearing NMU
      control, 1.89 NMU + light, 2.39 NMU + Px), or average tumor weight (1.20 g NMU
      control, 1.19 g NMU + light, 0.74 g NMU + Px). Tumor burden had no effect on the
      serum melatonin cycle. At 26 weeks, however, animals exposed to intermittent
      light at night exhibited approximately 3-fold higher serum melatonin
      concentrations as compared with controls. Additionally, rats that had been
      pinealectomized at 4 weeks of age had serum melatonin concentrations that were
      markedly higher than the expected baseline concentrations for pinealectomized
      rats (<15 pg/ml), suggesting the reestablishment of a melatonin cycle. This
      finding was unexpected and suggests that melatonin can be produced by an organ or
      tissue other than the pineal gland.

PMID- 11215678
TI  - Naturally occurring and experimental diabetes in cynomolgus monkeys: a comparison
      of carbohydrate and lipid metabolism and islet pathology.
AB  - Diabetes is a major health problem of increasing incidence in the United States.
      Diabetes research has been limited by lack of availability of good animal models,
      particularly for the study of comorbidities associated with diabetes. We
      investigated the use of cynomolgus monkeys as an animal model of both type 1 and
      type 2 diabetes and compared these naturally occurring diseases with
      streptozotocin-induced diabetes. Both type 1 diabetics and streptozotocin-induced
      diabetics present with sudden onset of hyperglycemia and are ketosis prone
      without exogenous insulin. Type 2 diabetics can have a very long period of
      moderate hyperglycemia and hypertriglyceridemia and only require exogenous
      insulin therapy if pancreatic islet reserves are depleted. Type 2 diabetes is
      preceded by a relatively long period of insulin resistance that is associated
      with obesity and dyslipidemia. As insulin resistance progresses, islet size and
      insulin content increases initially. However, with sustained periods of insulin
      resistance, islet amyloid polypeptide (IAPP) is deposited in islets and can
      replace normal islet architecture, resulting in an insulin-deficient state.
      Appearance of IAPP also occurs in human type 2 diabetics but not in conventional
      rodent models. Unlike type 2 diabetes, neither type 1 nor streptozotocin-induced
      diabetes is associated with IAPP. Rather, islets can appear normal
      histologically, but have decreased insulin secretion and immunostaining. Further,
      the amount of insulin present in the islet is correlated with plasma insulin
      levels following glucose challenge. Studies are ongoing to determine the
      pathogenic changes associated with the progression of diabetes and to find novel
      drug treatments for diabetics.

PMID- 11215680
TI  - Summary of panel discussion: past, present and future of toxicologic pathologists
      and the contributions to hazard identification and molecular mechanisms of
      action.
AB  - One of the major roles for the toxicologic pathologists now and into the future
      will be to determine the biologic significance of chemically induced biochemical
      and molecular alterations detected in whole tissue homogenates or cell cultures.
      The biologically significant effects will then require further analysis to
      determine their relevance to human health effects. The challenge is to train
      pathologists for toxicologic and molecular pathology experience without diluting
      basic pathology skills. Programs and approaches reviewed and suggested during the
      panel discussion should provide ideas and the impetus for those in a position to
      engage in similar activities.

PMID- 11215679
TI  - Role of thyroid hormones in hepatic effects of peroxisome proliferators.
AB  - Peroxisome proliferators are endocrine disrupting chemicals that cause liver
      tumors in rodents but not humans. Although the receptor that mediates key hepatic
      effects, the peroxisome proliferator-activated receptor alpha (PPAR-alpha), and
      its endogenous ligands have been identified, the mechanism whereby these commonly
      used chemicals cause liver tumors in rodents has yet to be elucidated. Species
      differences in PPAR-alpha and DNA response elements may explain some of the
      variability in response upon exposure to peroxisome proliferators. The
      possibility that thyroid-modulating effects of peroxisome proliferators may
      contribute to the hepatic effects of peroxisome proliferators has yet to be fully
      explored. When the potent peroxisome proliferator, WY-14,643, was given to
      hypothyroid rats, there was a blunting of the hepatomegaly and hepatocyte
      proliferative responses seen in thyroid-intact animals. Acyl-CoA oxidase activity
      was unaltered by changes in thyroid hormone status. In addition, preliminary
      evidence indicates that peroxisome proliferators increased hepatic thyroid
      receptor (TRalpha1) expression, but TRalpha1 levels in liver tumors were similar
      to those in unexposed animals. Significant differences between humans and rodents
      with respect to thyroid hormone physiology and metabolism, in conjunction with
      the results of these studies, may be indicative of yet another mechanism to
      explain differential sensitivity to hepatic effects of peroxisome proliferators.

PMID- 11215681
TI  - Regulation of xenobiotic metabolism by orphan nuclear receptors.
AB  - Nuclear receptors control gene transcription by binding to specific promoter
      regions of DNA in the presence of ligand. Orphan nuclear receptors are nuclear
      receptors for which the endogenous ligand(s) has yet to be identified. Systematic
      evaluation of orphan nuclear receptors can elucidate species differences in
      xenobiotic metabolism in addition to aiding in identification of endogenous
      ligands. The receptor-binding affinity and specificity of various chemicals, with
      subsequent determination of the genes controlled by nuclear receptors, are goals
      of investigations into orphan nuclear receptor structure/function and can provide
      valuable tools in predicting drug interactions and toxicity.

PMID- 11215682
TI  - Effects of microsomal enzyme inducers on thyroid follicular cell proliferation
      and thyroid hormone metabolism.
AB  - The effects of microsomal enzyme inducers on thyroid hormone homeostasis and the
      thyroid gland are of concern. We have investigated the effects of microsomal
      enzyme inducers on thyroid follicular cell proliferation and thyroid hormone
      metabolism in rats. We have shown that small increases in serum TSH can result in
      large increases in thyroid follicular cell proliferation. Furthermore, only those
      microsomal enzyme inducers that increase serum TSH--that is, phenobarbital (PB)
      and pregnenolone-16alpha-carbonitrile (PCN)-increase thyroid follicular cell
      proliferation, whereas those microsomal enzyme inducers that do not increase
      serum TSH--that is, 3-methylcholanthrene (3MC) and Aroclor 1254 (PCB)-do not
      increase thyroid follicular cell proliferation. Deiodination does not appear to
      be the reason why serum T3 concentrations are maintained in microsomal enzyme
      inducer-treated rats. We have also shown that those microsomal enzyme inducers
      that increase serum TSH increase T3 UDP-glucuronosyltransferase (UGT) activity,
      whereas those microsomal enzyme inducers that do not increase serum TSH do not
      increase T3 UGT activity. This finding suggests that induction of T3
      glucuronidation, rather than T4 glucuronidation, mediates increases in serum TSH
      of microsomal enzyme inducer treated rats.

PMID- 11215683
TI  - Adrenal gland: structure, function, and mechanisms of toxicity.
AB  - The adrenal gland is one of the most common endocrine organs affected by
      chemically induced lesions. In the adrenal cortex, lesions are more frequent in
      the zona fasciculata and reticularis than in the zona glomerulosa. The adrenal
      cortex produces steroid hormones with a 17-carbon nucleus following a series of
      hydroxylation reactions that occur in the mitochondria and endoplasmic reticulum.
      Toxic agents for the adrenal cortex include short-chain aliphatic compounds,
      lipidosis inducers, amphiphilic compounds, natural and synthetic steroids, and
      chemicals that affect hydroxylation. Morphologic evaluation of cortical lesions
      provides insight into the sites of inhibition of steroidogenesis. The adrenal
      cortex response to injury is varied. Degeneration (vacuolar and granular),
      necrosis, and hemorrhage are common findings of acute injury. In contrast,
      chronic reparative processes are typically atrophy, fibrosis, and nodular
      hyperplasia. Chemically induced proliferative lesions are uncommon in the adrenal
      cortex. The adrenal medulla contains chromaffin cells (that produce epinephrine,
      norepinephrine, chromogranin, and neuropeptides) and ganglion cells.
      Proliferative lesions of the medulla are common in the rat and include diffuse or
      nodular hyperplasia and benign and malignant pheochromocytoma. Mechanisms of
      chromaffin cell proliferation in rats include excess growth hormone or prolactin,
      stimulation of cholinergic nerves, and diet-induced hypercalcemia. There often
      are species specificity and age dependence in the development of chemically
      induced adrenal lesions that should be considered when interpreting toxicity
      data.

PMID- 11215684
TI  - Overview of male reproductive pathology.
AB  - An understanding of form and function is important for examination of the male
      reproductive tract. A basic understanding of spermatogenesis and hormonal
      function in the reproductive tract is essential for the pathologists in this
      evaluation. Gross and histologic reproductive changes need to be distinguished
      from normal variation and correlated with the reproductive status of the animal.
      This is especially important when correlating histologic changes with organ
      weight and other reproductive parameters, such as seminal analysis data. Sexual
      maturity of animals and tissue handing can impact interpretation. Sexual
      immaturity of preclinical safety animals can present challenges for accurate
      identification of compound-related changes. Likewise, proper handling of unfixed
      reproductive tissues and appropriate selection of a fixation protocol are
      important in avoiding artifacts that may interfere with the microscopic
      evaluation. The histopathology technician needs to recognize testicular landmarks
      that allow for correct orientation at trimming so the pathologist can assess not
      only the morphology of seminiferous tubules but also the outflow tract. For the
      most effective evaluation of the male reproductive tract, the testes and
      epididymides should be examined concurrently. Although the term "staging" is
      often used inappropriately, the pathologist should review testicular tissues in a
      "stage-aware" manner. This article reviews gross and histologic changes of the
      male reproductive tract as well as tissue orientation and fixation to assist in
      accurate interpretation of potential treatment-related changes in male
      reproduction.

PMID- 11215685
TI  - Molecular basis of dioxin actions: evidence supporting chemoprotection.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD or dioxin), a highly publicized
      environmental contaminant, was shown to be chemoprotective against breast cancer
      in both rats and mice in bioassays conducted in the late 1970s. This finding went
      largely unnoticed as investigators focused on animal tumors that were increased
      by dioxin. The position that dioxin causes human tumors remains a subject for
      debate; however, recent epidemiological studies of a population highly exposed to
      dioxin in 1976 as a result of an industrial accident suggest that women with
      higher dioxin body burdens may have a lower incidence of breast cancer. With the
      growth of new knowledge about the molecular basis of dioxin actions in humans and
      animals, it is clear that most of the responses produced by this agent are
      initiated by a specific recognition protein (designated the Ah receptor) found in
      almost all animal and human tissues and organs. The recognition event between the
      Ah receptor and environmental agents like dioxin is due to the formation of a
      complex. We have observed that in the presence of dioxin, the Ah receptor turns
      off proliferation in tumor cells and suppresses the ability of these cells to
      invade normal tissue. We believe that these findings provide a molecular and
      biochemical basis for understanding the chemoprotective mechanisms suggested by
      the findings of rodent bioassays and could lead to the development of novel
      therapeutic agents targeting the Ah receptor.

PMID- 11215686
TI  - Pathogenesis of male reproductive toxicity.
AB  - Toxicologic disturbance of male reproductive function can occur at many sites and
      produce a range of effects, some primary and some secondary to the initial
      insult. The challenge to the toxicological pathologist is to identify the primary
      site of damage and provide an insight into the pathogenesis of the morphologic
      lesion or functional deficit. Target sites include the testis, the epididymis,
      the mature sperm, and the hormonal regulatory system. Detection of effects at
      these varied sites requires the measurement of multiple endpoints only 1 of which
      is histopathology, but once identified, careful microscopic examination of the
      early changes in lesion development can provide essential information on the
      probable target cell and possible mechanisms of toxicity. Chemicals that affect
      different cell types or specific cellular functions generally elicit predictable
      patterns of pathological changes that can be readily recognized. Understanding
      the pathogenesis, the likely reversibility and the significance of reproductive
      tract lesions is aided by a sound knowledge of the physiology of the testis and
      epididymis and, in particular, an understanding of the timing of sperm production
      and transport.

PMID- 11215687
TI  - Reproductive endocrinology and toxicological pathology over the life span of the
      female rodent.
AB  - Understanding the pathology of the female reproductive system with respect to
      toxicology requires a basic understanding of morphology and function of the
      system over time because the nature of the female reproductive system is
      cyclical. Thus, the morphology and the endocrinology is dependent on age and
      time, as form follows function and function follows form. The life span of the
      rodent is used as an outline to present an overview of key morphological and
      endocrinological events important for toxicologic pathologists to consider in
      study evaluations. Environmental and pharmaceutical compounds differentially
      impact the organs individually and/or the system in its entirety in a time- and
      dose-dependent way. Examples are used to illustrate the consequences of exposures
      at different times and with different outcomes.

PMID- 11215688
TI  - Overview of structural and functional lesions in endocrine organs of animals.
AB  - The objective of this review is to summarize the pathogenic mechanisms
      responsible for perturbations of endocrine function and development of structural
      lesions that result in important diseases in domestic and laboratory animals. For
      each major category, several specific disease problems have been selected to
      illustrate the functional and morphologic lesions that are characteristic for
      either a naturally occurring endocrinopathy or endocrine disturbances induced by
      the administration of large doses of xenobiotic chemicals. The major pathogenic
      mechanisms responsible for disruption of endocrine function include primary
      hyperfunction, secondary hyperfunction, primary hypofunction, secondary
      hypofunction, endocrine hyperactivity secondary to other conditions,
      hypersecretion of hormones by nonendocrine tumors, failure of target cells to
      respond to a hormone, failure of fetal endocrine function, abnormal degradation
      (increased or decreased rate) of hormone, and iatrogenic syndromes of hormone
      excess (direct and indirect). Disorders of the endocrine system are encountered
      in a wide variety of domestic and laboratory animal species and often present
      challenging diagnostic problems. The development of proliferative lesions,
      usually hyperplasia and benign tumors, in endocrine organs and hormone-responsive
      tissues are common findings in chronic studies with high doses of many
      nongenotoxic xenobiotic chemicals administered to sensitive rodent species and
      may have limited significance for human safety assessment.

PMID- 11215689
TI  - Assessment of hormonally active agents in the reproductive tract of female
      nonhuman primates.
AB  - Using the ovariectomized macaque model of postmenopausal women's health, we
      investigated the effects of long-term treatments (5 weeks-3 years) with
      estradiol, conjugated equine estrogens (CEE), esterified estrogens, progestins
      such as medroxyprogesterone acetate (MPA) and nomegestrol acetate, CEE + MPA,
      tamoxifen, soybean phytoestrogens (SPEs), a variety of putative selective
      estrogen receptor modulators (SERMs), and androgens. Agents tested were selected
      on the basis of beneficial effects on arteries and/or bone. Doses were scaled on
      a caloric or serum-concentration basis to approximate human clinical doses. We
      evaluated endometrial and mammary gland histopathology and morphometry and used
      immunohistochemistry to evaluate cell proliferation and expression of estrogen
      receptor alpha and progesterone receptor (PR). Both estradiol and CEE induced
      endometrial hyperplasia. MPA antagonized epithelial proliferation induced by CEE
      in endometrium and induced pseudodecidual stromal hyperplasia in some animals.
      Tamoxifen induced endometrial polyps, cystic hyperplasia, stromal fibrosis, and
      PR expression but not Ki-67 expression. SPEs were not estrogenic at dietary doses
      and antagonized estrogen-induced proliferation in the endometrium and breast.
      Nandrolone induced mucometra and an adenomyosis-like change. The potential SERM
      17 alpha dihydroequilenin did not have uterotrophic or mammotrophic effects. In
      general, experimental findings in macaques have been predictive of outcomes in
      human clinical trials of the same agents.

PMID- 11215690
TI  - Ovarian toxicity of 4-vinylcyclohexene diepoxide: a mechanistic model.
AB  - Female mammals are born with a finite number of ovarian primordial follicles that
      cannot be regenerated; thus, chemicals that destroy oocytes contained in these
      follicles can produce premature ovarian failure (early menopuase in women).
      Exposure of women to known ovotoxicants, such as contaminants in cigarette smoke,
      is associated with early menopause. Thus, the potential risks posed by ovotoxic
      chemicals is of concern. Our studies have focused on the environmental chemical 4
      vinylcyclohexene (VCH), which is produced during the manufacture of rubber tires,
      flame retardants, insecticides, plasticizers, and antioxidants. Dosing of female
      rats and mice with the ovotoxic diepoxide metabolite of VCH, 4-vinylcyclohexene
      diepoxide (VCD), for 30 days destroyed the majority of ovarian primordial
      follicles. Using VCD in rats as a generalized model for ovotoxicity, we
      determined that 1) repeated daily dosing is required, 2) cell death is via
      apoptosis, and 3) altered expression of specific genes is involved. An integrated
      approach at the morphologic, biochemical, and molecular level was used to support
      these conclusions. Studies in isolated rat small preantral follicles (targeted
      for VCD-induced ovotoxicity) focused on the role of cell death genes,
      mitochondrion-associated events, and VCD metabolism. We also evaluated how this
      information relates to human risk for early menopause. These animal research
      results provide a better understanding of the potential risk of human exposure to
      environmental ovarian toxicants and greater insight as to the impact of these
      toxicants on reproductive health in women.

PMID- 11215691
TI  - Synthetic vitreous fibers: a review of toxicology research and its impact on
      hazard classification.
AB  - Because the inhalation of asbestos, a naturally occurring, inorganic fibrous
      material, is associated with lung fibrosis and thoracic cancers, concerns have
      been raised about the possible health effects of synthetic vitreous fibers
      (SVFs). SVFs include a very broad variety of inorganic fibrous materials with an
      amorphous molecular structure. Traditionally, SVFs have been divided into three
      subcategories based on composition: fiberglass, mineral wool (rock, stone, and
      slag wools), and refractory ceramic fiber. For more than 50 years, the
      toxicologic potential of SVFs has been researched extensively using human
      epidemiology and a variety of laboratory studies. Here we review the research and
      its impact on hazard classification and regulation of SVFs. Large, ongoing
      epidemiology studies of SVF manufacturing workers have provided very little
      evidence of harmful effects in humans. Several decades of research using rodents
      exposed by inhalation have confirmed that SVF pulmonary effects are determined by
      the "Three D's", fiber dose (lung), dimension, and durability. Lung dose over
      time is determined by fiber deposition and biopersistence in the lung. Deposition
      is inversely related to fiber diameter. Biopersistence is directly related to
      fiber length and inversely related to fiber dissolution and fragmentation rates.
      Inhaled short fibers are cleared from the lung relatively quickly by mobile
      phagocytic cells, but long fibers persist until they dissolve or fragment. In
      contrast to asbestos, most of the SVFs tested in rodent inhalation studies
      cleared rapidly from the lung (were nonbiopersistent) and were innocuous.
      However, several relativley biopersistent SVFs induced chronic inflammation, lung
      scarring (fibrosis), and thoracic neoplasms. Thus, biopersistence of fibers is
      now generally recognized as a key determinant of the toxicologic potential of
      SVFs. In vitro dissolution of fibers in simulated extracellular fluid correlates
      fairly well with fiber biopersistence in the lung and pulmonary toxicity, but
      several exceptions suggest that biopersistence involves more than dissolution
      rate. Research demonstrating the relationship between biopersistence and SVF
      toxicity has provided a scientific basis for hazard classification and regulation
      of SVFs. For a nonhazardous classification, legislation recently passed by the
      European Union requires a respirable insulation wool to have a low lung
      biopersistence or be noncarcinogenic in laboratory rats. U.S. fiberglass and
      mineral wool industries and the Occupational Health and Safety Administration
      (OSHA) have formed a voluntary Health and Safety Partnership Program (HSPP) that
      include: a voluntary permissible exposure level (PEL) in the workplace of 1
      fiber/cc, a respiratory protection program for specified tasks, continued
      workplace air monitoring, and, where possible, the development of fiber
      formulations that do not persist in the lung. RCF manufacturers have implemented
      a Product Stewardship Program that includes: a recommended exposure guideline of
      0.5 fibers/cc; a 5-year workplace air monitoring program; and research into the
      development of high-temperature-resistant, biosoluble fibers.

PMID- 11215692
TI  - Paracetamol (acetaminophen)-induced toxicity: molecular and biochemical
      mechanisms, analogues and protective approaches.
AB  - An overview is presented on the molecular aspects of toxicity due to paracetamol
      (acetaminophen) and structural analogues. The emphasis is on four main topics,
      that is, bioactivation, detoxication, chemoprevention, and chemoprotection. In
      addition, some pharmacological and clinical aspects are discussed briefly. A
      general introduction is presented on the biokinetics, biotransformation, and
      structural modification of paracetamol. Phase II biotransformation in relation to
      marked species differences and interorgan transport of metabolites are described
      in detail, as are bioactivation by cytochrome P450 and peroxidases, two important
      phase I enzyme families. Hepatotoxicity is described in depth, as it is the most
      frequent clinical observation after paracetamol-intoxication. In this context,
      covalent protein binding and oxidative stress are two important initial (Stage I)
      events highlighted. In addition, the more recently reported nuclear effects are
      discussed as well as secondary events (Stage II) that spread over the whole liver
      and may be relevant targets for clinical treatment. The second most frequent
      clinical observation, renal toxicity, is described with respect to the
      involvement of prostaglandin synthase, N-deacetylase, cytochrome P450 and
      glutathione S-transferase. Lastly, mechanism-based developments of
      chemoprotective agents and progress in the development of structural analogues
      with an improved therapeutic index are outlined.

PMID- 11215693
TI  - Severe canine hereditary hemolytic anemia treated by nonmyeloablative marrow
      transplantation.
AB  - Severe hemolytic anemia in Basenji dogs secondary to pyruvate kinase (PK)
      deficiency can be corrected by marrow allografts from healthy littermates after a
      conventional high-dose myeloablative conditioning regimen. The nonmyeloablative
      conditioning regimen used here, which consisted of a sublethal dose of 200 cGy
      total body irradiation before and immunosuppression with mycophenolate mofetil
      and cyclosporine after a dog leukocyte antigen (DLA)-identical littermate
      allograft, has been found to be effective in establishing stable mixed donor/host
      hematopoietic chimerism in normal dogs. We explored the feasibility of
      nonmyeloablative marrow allografts for the treatment of canine PK deficiency and
      studied the effect of stable allogeneic mixed hematopoietic chimerism on the
      natural course of the disease. Five affected dogs received transplants, of which
      3 dogs had advanced liver cirrhosis and myelofibrosis. Both complications were
      presumed to be due to iron overload. All 5 dogs showed initial engraftment. Two
      rejected their grafts after 6 weeks but survived with completeautologous marrow
      recovery and return of the disease. One died from liver failure on day 27 with
      60% donor engraftment. Two dogs have shown sustained mixed donor/host chimerism
      for more than a year with 85% and 12% donor hematopoietic cells, respectively.
      Overall clinical response correlated with the degree of donor chimerism. The dog
      with the low degree of chimerism achieved partial resolution of hemolysis, but
      the disease symptoms persisted as manifested by increasing iron overload
      resulting in progression of marrow and liver fibrosis. The dog with the high
      degree of donor chimerism achieved almost complete resolution of hemolysis with a
      decrease of marrow iron content and resolution of marrow fibrosis. These
      observations suggest that mixed hematopoietic chimerism can be relatively safely
      established in dogs with PK deficiency even in the presence of advanced liver
      cirrhosis. However, although effective in correcting or delaying the development
      of myelofibrosis, a low degree of mixed chimerism was not sufficient to prevent
      continued hemolysis of red blood cells of host origin. Complete donor chimerism
      appears necessary to achieve a long-term cure.

PMID- 11215694
TI  - Vbeta spectratype analysis reveals heterogeneity of CD4+ T-cell responses to
      minor histocompatibility antigens involved in graft-versus-host disease:
      correlations with epithelial tissue infiltrate.
AB  - Lethal graft-versus-host disease (GVHD) can be induced after hematopoietic stem
      cell transplantation between major histocompatibility complex-matched murine
      strains expressing multiple minor histocompatibility antigen (miHA) differences.
      In the C57BL/6By (B6)-->C.B10-H2b/LiMcdJ (BALB.B) irradiation model, both CD4+
      and CD8+ donor T cells can mediate lethal GVHD, whereas in the B6-->CXB-2/By
      (CXBE) model, in which the recipient expresses a subset of BALB.B miHA, only the
      CD8+ T cells are lethal. Phenotypic analysis of CD4+ T cells collected from the
      thoracic duct lymphocyte pool of recipient mice had indicated expansion of the
      donor T-cell receptor Vbeta6-9 families in BALB.B recipients, and only Vbeta7 and
      Vbeta9 populations in CXBE mice. CDR3-size spectratyping, used to further analyze
      these responses, revealed overlapping oligoclonal expansion of Vbeta4, Vbeta6-10,
      and Vbeta12-14 families in both BALB.B and CXBE recipients injected with host
      presensitized B6 T cells. In addition, the B6-->BALB.B CD4+ T-cell response
      appeared to involve the recognition of unique BALB.B-specific miHA, indicated by
      additional skewing of Vbeta2 and Vbeta11 families. On the other hand, the B6-
      >CXBE strain combination exhibited unique skewing of the Vbeta16 and Vbeta18
      families. Immunohistochemical staining of lingual epithelial sections from BALB.B
      recipients of naive B6 CD4+ T cells correlated with the involvement of several of
      the spectratype-skewed Vbeta families in GVHD lesions. Furthermore, magnetic cell
      separation techniques were used to positively select the spectratype-skewed Vbeta
      families from the donor B6 CD4+ T cells; the former were found to have
      significant GVHD potential upon transplantation into lethally irradiated BALB.B
      recipients. In contrast, mice that received transplants from the unskewed Vbeta
      families all survived with minimal symptoms of GVHD. Taken together, these
      results demonstrate that the expansion of particular Vbeta families, as
      identified by spectratype analysis, correlates with the induction and
      pathogenesis of lethal GVHD.

PMID- 11215695
TI  - Modulation of graft-versus-tumor effects in a murine allogeneic bone marrow
      transplantation model by tumor-derived transforming growth factor-betaI.
AB  - Although graft-versus-leukemia effects in allogeneic bone marrow transplantation
      (alloBMT) are well documented, graft-versus-tumor (GVT) effects are poorly
      defined. To investigate the latter, we established a murine model of breast
      cancer using TS/A, a transforming growth factor (TGF)-beta1-secreting breast
      cancer cell line of BALB/c origin. In the setting of disparate (parent into F1)
      alloBMT, no appreciable GVT was identified. To assess whether TGF-beta1 secreted
      by the tumor might inhibit the antitumor response, TGF-beta1 antisense vector was
      transfected into the TS/A breast cancer cell line. Mice were inoculated with
      either TGF-beta1 antisense transfected or the mock transfected cell line and
      underwent syngeneic or alloBMT. No evidence of GVT was appreciated for the mock
      transfected breast cancer cell line as assessed by an absence of a statistically
      significant difference in survival between syngeneic and alloBMT groups. However,
      there was a highly statistically significant survival difference between
      allogeneic versus syngeneic bone marrow transplantation groups inoculated with
      the TGF-beta1 antisense-transfected cell line (P = .00001) as well as when
      comparing the survival of mice that received alloBMT for TGF-beta1 antisense
      transfected tumor versus mock-transfected tumor (P = .0008). These data suggest
      that (1) GVT exists against the antisense-transfected breast cancer cells in this
      experimental model and (2) TGF-beta1 may be involved in suppressing antitumor
      responses in the setting of alloBMT for breast cancer.

PMID- 11215696
TI  - The role of disease stage in the response to donor lymphocyte infusions as
      treatment for leukemic relapse.
AB  - Between 1991 and 1999, 44 leukemic patients received donor lymphocyte infusions
      (DLIs) at our center (22 patients with chronic myelogenous leukemia [CML]; 10
      with acute myelogenous leukemia; 11 with acute lymphatic leukemia; and 1 with
      myelodysplastic syndrome). Seventeen patients received graft-versus-host disease
      (GVHD) prophylaxis with methotrexate (MTX) at the time of DLI. In CML patients,
      15 of 22 (68%) re-entered complete remission after DLI. At 3 years post-DLI,
      patients with cytogenetic (n = 10) or molecular (n = 3) relapse had a current
      leukemia-free survival (cLFS) rate of 85% compared with 0% for patients with
      hematologic relapse (P < .001). Among 15 CML patients who initially responded to
      DLI, 4 patients relapsed within the first 2 years. Four of 16 patients (25%) with
      acute leukemia had an initial response with complete remission after DLI. Two of
      them subsequently relapsed within 1 year. Patients with acute leukemia who
      relapsed within 1 year of hematopoietic stem cell transplantation (n = 9) had 0%
      cLFS at 18 months; patients with later relapse had 29% cLFS (P = .015). The
      overall probability of cLFS at 3 years for CML patients was 46%. For other
      diseases, cLFS was 13% at 18 months after DLI. Patients who developed chronic
      GVHD secondary to DLI showed a 3-year cLFS of 51% compared with 18% for patients
      without chronic GVHD (P = .022). This study emphasizes the importance of early
      disease stage and presence of chronic GVHD for effective DLI.

PMID- 11215698
TI  - Assessment of barriers to bone marrow donation by unrelated African-American
      potential donors.
AB  - African Americans have a lower registration rate for becoming potential bone
      marrow and stem cell donors. The same attitudes and behaviors are exhibited in
      regard to solid organ and blood donations, causing a serious under-representation
      of the African-American population in the donor pool. In our efforts to increase
      donor availability for African Americans through a project funded by the Medical
      University of South Carolina, we used a survey to determine the reasons African
      Americans do not participate as donors for bone marrow. We surveyed 589 African
      Americans, a great majority of whom were women. Our survey identified major
      barriers to donation to be the lack of awareness that transplantation can save
      lives, the cost of donation, and the lack of opportunities to donate. The most
      effective interventions in increasing donation have been to provide both
      educational programs preceding marrow drives and the opportunity to donate.
      Through these efforts, the number of potential African-American donors has
      increased from 768 (accrued over a period of 12 years) to 1977 in less than 2
      years. We conclude that a minority recruitment program targeting African-American
      volunteers for the National Marrow Donor Program (NMDP) should include an
      education component addressing the most common barriers before drives.

PMID- 11215697
TI  - Cyclophosphamide and antithymocyte globulin to condition patients with aplastic
      anemia for allogeneic marrow transplantations: the experience in four centers.
AB  - This report summarizes the experience with a conditioning regimen of
      cyclophosphamide and antithymocyte globulin in patients with severe aplastic
      anemia given HLA-matched related marrow grafts at 4 transplantation centers.
      Enrolled were 94 consecutive patients, of whom 87 had received multiple
      transfusions and 38 had failed immunosuppressive therapy. Their ages ranged from
      2 to 59 years. After transplantation, 89 patients received a
      methotrexate/cyclosporine regimen for graft-versus-host disease (GVHD)
      prevention. Cyclosporine with or without prednisone was given in 4 patients, and
      no immunosuppression was given in 1 patient. Ninety-six percent of patients had
      sustained grafts, whereas 4% rejected grafts between 2 and 7 months after
      transplantation. Of the 4 rejecting patients, 3 are alive with successful second
      engraftments. Acute grade II GVHD was seen in 21% of patients, grade III in 7%,
      and grade IV in 1% of patients. Chronic GVHD was seen in 32% of patients, most of
      whom responded completely to immunosuppressive therapy. With a median follow-up
      of 6.0 years (range, 0.5-11.6 years), the survival rate was 88%. No unusual long
      term side effects have been seen with the regimen. We conclude that the
      cyclophosphamide/antithymocyte globulin regimen combined with
      methotrexate/cyclosporine after transplantation is well tolerated and effective
      in heavily pretreated patients with aplastic anemia.

PMID- 11215699
TI  - High-dose therapy and autologous hematopoietic cell transplantation in children
      with primary refractory and relapsed Hodgkin's disease: atopy predicts idiopathic
      diffuse lung injury syndromes.
AB  - The use of high-dose therapy (HDT) and autologous hematopoietic cell
      transplantation (AHCT) for children and adolescents with primary refractory and
      relapsed Hodgkin's disease is increasing. The purpose of this retrospective
      analysis was to: (1) evaluate the outcome of HDT and AHCT in pediatric patients
      with Hodgkin's disease, and (2) identify factors that predispose patients to the
      development of transplantation-related complications. We describe the experiences
      of 34 pediatric patients from a single institution with primary refractory or
      relapsed Hodgkin's disease. HDT regimens consisted of cyclophosphamide and
      etoposide combined with either carmustine, chloroethylcyclohexylnitrosurea, or
      fractionated total body irradiation. Kaplan-Meier survival predicts that 67% (95%
      confidence interval [CI] 47%-87%) of patients will be alive and disease-free at 5
      years. Nine patients had disease recurrence, of whom 5 relapsed after 1 year (1.5
      6.3 years). Five patients succumbed to treatment-related toxicities, of whom 4
      died of pulmonary failure. Fifteen patients (44%) developed post-AHCT idiopathic
      diffuse lung injury syndrome: acute alveolitis (n = 2); diffuse alveolar
      hemorrhage (n = 2); acute respiratory distress syndrome (n = 2); delayed
      interstitial pneumonitis (n = 8); and bronchiolitis obliterans (n = 1). The
      following factors did not predict for the development of a diffuse lung injury
      syndrome in univariate analysis: prior treatment with bleomycin, pre-HDT
      pulmonary function tests, and prior thoracic irradiation. Of the patients in our
      cohort, 44% had a history of atopy (allergic rhinitis and/or asthma).
      Multivariate logistic analysis revealed that a preexisting history of atopy was
      highly predictive of idiopathic pulmonary complications (P = .0001, odds ratio =
      21, CI 3.6-125). Our experience shows that HDT followed by AHCT results in
      durable remissions in two thirds of pediatric patients with refractory and
      relapsed Hodgkin's disease, and a history of atopy is associated with post-AHCT
      pulmonary complications.

PMID- 11215700
TI  - Stress-inducible DNA repair in Saccharomyces cerevisiae.
AB  - Saccharomyces cerevisiae shows altered radiation response under various stress
      conditions, such as nutrition depletion, nitrogen starvation, osmotic shock, heat
      shock, and mild chemical treatments. In general, the cells show higher levels of
      UV or gamma radiation resistance under the stress. However, not all the stress
      conditions affect the repair system in the same manner. For example, depletion of
      nitrogen supply in the growth medium has been shown to enhance the repair of
      gamma ray-induced DNA damage without significantly affecting the UV response of
      the cells. On the other hand, a mild treatment with alkali or hydrogen peroxide
      improves the response to UV light but not to gamma radiation. It has further been
      shown that the effect of these stresses are not additive, e.g., the alkali and
      hydrogen peroxide treatments given simultaneously show the same effect as either
      of them alone. Low levels of gamma and UV radiation exposures are also treated as
      stress in the present context. Studies show that irradiation of low-dose gamma
      rays results in enhanced excision repair of UV-induced pyrimidine dimers.
      However, in all the wild-type strains tested, none showed any effect on gamma
      rays response. The exposure to low doses of UV light did not show any effect on
      either the gamma rays or the UV response. It is suggested that the stress-induced
      enhancement of DNA repair can be of two types: 1) A general response to stress,
      which prepares the organism to survive in adverse circumstances (some of the
      proteins produced during this response also take part in the DNA repair), and 2)
      a particular response involving DNA damage, such as that caused by gamma
      irradiation. In this case, the DNA damage may act as a signal for enhancement of
      the DNA repair.

PMID- 11215701
TI  - Development of a novel plant system as biosensor for detecting environmental
      hazards and bioactive molecules through distinct responses.
AB  - Currently, chemicals are used excessively in medicine, industry, and agriculture
      throughout the world. Because of the current rise in environmental pollutants and
      hazardous exposures of human beings, there is an imperative need for monitoring
      the environment for biosafety. In addition, the importance of natural products
      with novel activity for drug or agrochemical scopes is being more and more
      realized. We report on a novel test system that can act as biosensors for
      detecting useful compounds while simultaneously monitoring or forecasting the
      biohazard exposure of organisms to chemicals as well as to physical factors in a
      given environment. Using different compounds and factors with known biological
      and cytotoxic activities, a detail plant test procedure has been developed that
      can be used in detecting and analyzing the value and/or danger of any given
      compound or treatment, including cell division inhibition, cytotoxicity, growth
      inhibition, and anticancer activities. The method provides a highly efficient
      single biosensor system that can replace several individual biotesting
      procedures. This plant assay procedure is a highly sensitive system for
      monitoring physical stress factors in the environment, including ionizing and
      nonionizing radiation. The procedure can be followed throughout the year because
      of the rapid growth rate of the plant used and its regeneration in ambient
      conditions. Therefore, the described system is highly useful to thoroughly
      monitor the environment and detection of new chemicals/compounds.

PMID- 11215702
TI  - A common regulator of cold and radiation response in Escherichia coli.
AB  - High levels of the protein product of gicA/cspE, a member of cspA family of cold
      stress genes, are known to be associated with several pleiotropic phenotypes in
      Escherichia coli. These include growth retardation in cold, suppression of rpsL31
      mediated streptomycin resistance in cold, suppression of the chromosome
      partitioning mutation mukB, and cellular resistance to camphor. In this article,
      we demonstrate that the product of this gene is also involved in regulating UV
      and gamma radiation sensitivity. When present on a multicopy plasmid, gicA
      conferred UV sensitivity on those strains of E. coli K-12, in which it produces
      the cold-dependent growth retardation and streptomycin sensitivity but did not
      confer any gamma radiation sensitivity. A gicA::cat mutation, that inactivates
      the chromosomal gicA, made the cells highly sensitive to both UV and gamma
      radiation. These results indicate that the cellular level of GicA is quite
      critical in some aspects of DNA metabolism and suggest that this protein is a
      global regulator of multiple pathways affecting growth and translational fidelity
      in cold, DNA condensation, and chromosome partitioning during cell division.

PMID- 11215703
TI  - Molecular basis of UV-sensitive mutant strain MBH3 of Haemophilus influenzae Rd:
      identification of mutation in the uvrA gene.
AB  - We have previously reported on cloning a DNA repair gene designated as uvr3 by
      virtue of its ability to phenotypically complement the UV sensitivity of mutant
      strain MBH3. Subsequently, we identified the uvr3 gene to be the uvrA gene (gene
      identification number HI0249) of Haemophilus influenzae Rd. The uvrA gene is a
      component of the UvrABC excision repair pathway. We studied molecular basis of
      the UV sensitivity of the MBH3 strain and identified a G-->A transition at
      nucleotide position 2700 of the uvrA gene, altering the Trp-900 codon (TGG) to a
      nonsense codon (TGA). Thus, the UvrA protein produced in the mutant strain MBH3
      is likely to be truncated and unable to carry out the UV-induced DNA repair,
      thereby rendering the strain UV sensitive.

PMID- 11215704
TI  - Expression of p53 and lactate dehydrogenase in murine fibrosarcoma following
      exposure to gamma-radiation.
AB  - Radiation-induced alterations in the levels of p53 and lactate dehydrogenase
      activities were studied in fibrosarcoma, following exposure to different doses of
      gamma-irradiation (2-10 Gy). The levels of p53 were elevated in the cytoplasm,
      while the lactate dehydrogenase activity in tumor tissue was considerably
      decreased.

PMID- 11215705
TI  - Effect of caffeine on the genotoxic effects of gamma radiation and 4-NQO in
      diploid yeast.
AB  - Caffeine is an environmental agent to which people are commonly exposed through
      medicines, drinks, food items, etc. It has been shown to be mutagenic in a number
      of test systems. In addition, it has also been shown to modify the mutagenic
      response of ionizing radiation, UV, and several chemical mutagens in a number of
      test systems. We have studied the effect of caffeine on gamma radiation and 4
      Nitroquinoline 1-oxide (4-NQO)-induced gene conversion in the yeast Saccharomyces
      cerevisiae D7. Stationary phase cells were either exposed to 100-600 Gy of 60Co
      gamma radiation or treated with 0.15-0.3 microM 4-NQO (30 degrees C, 1 hour),
      after which they were plated on synthetic complete or minimal media with or
      without caffeine. Caffeine concentrations ranged from 5 to 15 mM. The results
      indicated that caffeine at 5 and 10 mM decreased gamma radiation-induced gene
      conversion frequencies significantly at 400 and 600 Gy. At 600 Gy, the decrease
      was about 30% and 50% with caffeine concentrations of 5 and 10 mM, respectively.
      In contrast, caffeine was found to increase the induced gene conversion frequency
      when cells treated with 0.15, 0.225, and 0.3 microM 4-NQO were plated on media
      containing caffeine. The increase with 5, 10, and 15 mM caffeine was
      approximately 1.5, 2, and 2.5, respectively, times the value of 4-NQO alone. The
      results indicate that the posttreatment repair processes following gamma
      irradiation or 4-NQO treatment are modified via different pathways.

PMID- 11215706
TI  - Retrospective dosimetry based on cytogenetic study of individuals chronically
      exposed to ionizing radiation.
AB  - Analysis of chromosomal aberrations (CAA) was carried out in 27 radiation workers
      with cumulative exposures of approximately 500 mSv received over a period of 2-3
      decades. A similar study was carried out in 20 age- and gender-matched healthy
      individuals who served as controls. The average age of the exposed group was 50
      years, and that of the controls was 51 years. The absorbed radiation dose was
      calculated by using the linear component of the in vitro dose response curve
      established for 60Co gamma-rays. In the controls we found only 3 dicentrics in
      5,500 metaphases analyzed. In the exposed group, we detected 49 dicentrics and 1
      centric ring in 13,900 metaphases analyzed. Because of the small number of
      dicentrics scored in each individual, the dose estimates of our method of study
      suffers from a large statistical uncertainty. The collective dose calculated from
      our data was 3.4 Sv. The difference in the physical dose based on personal
      monitoring and that from biological dosimetry may be attributed to the
      disappearance of lymphocytes carrying the aberrations from the living system.
      These results are consistent with the present knowledge of the kinetics of
      turnover of T-lymphocytes. Most residual damage appears to be from the long-lived
      component of T-lymphocytes with a mean life of 10 years.

PMID- 11215707
TI  - Combined effect of radiation and other agents: is there a synergism trap?
AB  - Most assessments of possible deleterious outcomes from environmental and
      occupational exposures concentrate on single agents and neglect the potential for
      combined effects--that is, synergisms or antagonisms. Biomechanistic
      considerations based on multistep processes, such as carcinogenesis, indicate the
      potential for highly detrimental interactions if two or more consecutive rate
      limiting steps are specifically effected by different agents. However, low
      specificity toward molecular structure or DNA sequence--and, therefore,
      exchangeability--of many genotoxic agents indicate little functional specificity
      and, hence, little vulnerability toward synergism in most occupational and
      environmental exposure situations. It is also evident that a low potential exists
      for the combined effects of common low-exposure situations wherein nongenotoxic
      agents with highly nonlinear dose-effect relationships and apparent thresholds
      are involved. A quantitative assessment of the contribution of synergistic
      interactions to the total detriment from natural and man-made toxicants based on
      experimental data is far away. There are important examples of combined exposures
      shown to lead to health effect risks that differ from those expected from simple
      addition-for example, the influence of smoking on radon- or asbestos-induced lung
      cancer and on ethanol-induced esophageal cancer. The existing data on combined
      effects is rudimentary, mainly descriptive, and rarely covers exposure ranges
      large enough to make direct inferences to present-day low-dose exposure
      situations. In view of the multitude of possible interactions among the large
      number of potentially harmful agents in the human environment, descriptive
      approaches will have to be supplemented by the use of mechanistic models for
      critical health endpoints, such as cancer. Finally, considering the shape of dose
      effect relationships for ionizing radiation, an important question arises from
      the unresolved question of whether real or apparent thresholds may be used for
      any genotoxic agent, separately or one time, for an exposed genome.

PMID- 11215708
TI  - Effects of turmeric on the activities of benzo(a)pyrene-induced cytochrome P-450
      isozymes.
AB  - Turmeric and/or its main coloring component, curcumin (diferuloylmethane), have
      been shown to inhibit benzo(a)pyrene [B(a)P]-induced forestomach papillomas in
      mice. However, the mechanisms of turmeric-mediated chemoprevention are not well
      understood. To study the mechanisms of turmeric-mediated chemoprevention, we
      investigated the effects of turmeric feeding on the activities of isozymes of
      cytochrome P-450 (CYP450)--namely, ethoxyresorufin O-deethylase (EROD, CYP1A1)
      and methoxyresorufin O-demethylase (MROD, CYP1A2)--which are predominantly
      involved in the metabolism of B(a)P. We determined the activities of EROD and
      MROD by monitoring the formation of resorufin from respective substrates in the
      presence of microsomal proteins obtained from tissues of control, 1% turmeric, 1
      mg B(a)P, and 1% turmeric + 1 mg B(a)P-fed Swiss mice. The results indicate that
      the administration of turmeric through diet significantly inhibited the
      activities of both EROD and MROD in forestomach (target organ), liver, and lung.
      In vitro studies employing curcumin, demethoxycurcumin, and bis-demethoxycurcumin
      suggest that curcumins are the inhibitors in turmeric. Inhibition of B(a)P
      metabolizing phase I enzymes (EROD, MROD) may be at least in part one of the
      possible modes of chemopreventive action of turmeric/curcumin.

PMID- 11215709
TI  - Low doses of heavy metals disrupt normal structure and function of rat platelets.
AB  - Aggregation, an important property of platelets, plays a key role in the
      coagulation of blood and is potentiated by ADP and adrenaline, whereas cAMP acts
      as a strong inhibitor. Because of the rise in the heavy metal load in the
      environment, more studies are necessary to look at its subtle effects in the
      animal system, wherein platelet structure and function can be targeted. We
      carried out structural analyses under phase contrast and scanning
      electronmicroscopy of the platelets prepared from 1/10 LD50 metal-treated rats.
      After mercury (Hg) and arsenic (As) treatment, the cell margins appeared
      irregular and wavy, with small pseudopodia-like protrusions from the surface.
      Cadmium (Cd) treatment caused loss of the general spindle shape, and the
      platelets assumed a round spongy appearance. All metal treatments effected
      enhanced collagen-induced aggregation and inhibited ADP- and arachidonic acid
      induced aggregation, whereas epinephrine accelerated aggregation in Hg and Cd
      treatment but inhibited aggregation in As treatment. Cd proved a potent inhibitor
      of phosphodiesterase, increasing the cAMP level in in vitro treatments at
      equimolar (5, 10, and 20 pmoles) concentrations. The rate of aggregation was
      enhanced with all the agonists used in in vitro Hg and As treatments, with
      concomitant reduction in cAMP, while Cd inhibited platelet aggregation. Thus, we
      can conclude that cytosolic cAMP, which is decreased by the metal-induced
      inhibition of phosphodiesterase, is a regulator molecule in platelet aggregation.
      Furthermore, it is also abundantly clear that equimolar doses of metals are not
      always equitoxic. Therefore, the action of each xenobiotic is not only due to the
      concentration used but also to the type of xenobiotic depending on its unique
      mechanism of action.

PMID- 11215710
TI  - Antimutagenic potential of extracts isolated from Terminalia arjuna.
AB  - Terminalia arjuna is an important medicinal plants widely used in the preparation
      of Ayurvedic formulations used against several ailments. The present
      investigation was aimed at the fractionation of crude extracts from the bark of
      T. arjuna in order to isolate and purify the antimutagenic factors present. The
      antimutagenicity assay was performed to check the modulatory effect of these
      fractions against NPD, sodium azide, and 2AF, using the Ames Salmonella his+
      reversion assay. Most of the phenolic fractions exhibited mutagen specificity
      against direct-acting mutagens, being effective in suppressing the frameshift
      mutagen NPD but failing to inhibit sodium azide (base pair substitution)-induced
      his+ revertants. ET-1 fraction triterpenoid diglycoside showed a marked effect
      against sodium azide but was ineffective against NPD. In the case of the indirect
      acting mutagen 2AF, all the fractions were found to be quite potent in modulating
      its mutagenicity in both TA98 and TA100 tester strains of Salmonella typhimurium.
      The results indicate that the bark of T. arjuna harbors constituents with
      promising antimutagenic/anticarcinogenic potential that should be investigated
      further.

PMID- 11215711
TI  - Fetal magnetic resonance imaging.

PMID- 11215712
TI  - Magnetic resonance imaging of fetal thoracic abnormalities.
AB  - Fetal thoracic abnormalities are increasingly being detected using prenatal
      ultrasound. Prenatal magnetic resonance imaging is an important adjunct in
      evaluation of fetal chest lesions. It can help differentiate different masses and
      is most helpful in evaluation of large or atypical masses. It also is very
      important in planning in utero interventional procedures, delivery, and immediate
      postnatal surgery.

PMID- 11215713
TI  - Ultrasound versus magnetic resonance imaging in fetal evaluation.
AB  - Ultrasound is the screening modality of choice for fetal imaging. However, there
      are circumstances in which an alternate imaging modality is needed for additional
      information regarding fetal anatomy or pathology. Fast magnetic resonance imaging
      (MRI) is increasingly being used as a correlative imaging modality in pregnancy
      because it uses no ionizing radiation, provides excellent soft-tissue contrast,
      and has multiple planes for reconstruction and a large field of view. However,
      sonographic evaluation of the fetus still is important to select the appropriate
      fetuses for magnetic resonance (MR) examination and to guide the protocol of the
      examination. Performance of high-quality sonographic and MR examinations as well
      as interpretation by individuals familiar with prenatal diagnosis are important
      factors for optimal parental counseling. MRI frequently adds additional
      information beyond that available with ultrasound. This information commonly
      changes patient counseling and, at times, patient management.

PMID- 11215714
TI  - Normal fetal anatomy as visualized with fast magnetic resonance imaging.
AB  - The development of ultrafast sequences has revolutionized fetal magnetic imaging
      (MRI). Fetal anatomy can be characterize precisely by MRI. This is particularly
      true for evaluation of the central nervous system, for which magnetic resonance
      (MR) evaluation is superior to ultrasound evaluation. MR allows analysis of
      development of the cerebrum as well as posterior fossa structures. Awareness of
      the normal sequence of maturation as well as the approximate timing of
      development of key structures is useful for evaluating the developing fetus. MRI
      also permits evaluation of the oropharynx, lungs, diaphragm, and intra-abdominal
      and retroperitoneal structures. Occasionally, beautiful depiction of smaller
      structures, including extremities and details of the face and neck may be
      obtained, but this is dependent on the orientation of the fetus and the plane of
      imaging as well as the section thickness. MRI is useful in assignment of fetal
      gender as well as in evaluation of the chorionicity of twin gestations. This
      report illustrates the normal appearance of the developing fetus as seen on fast
      sequences during the second and third trimesters.

PMID- 11215715
TI  - Role of magnetic resonance imaging in fetal surgery.
AB  - Prenatal magnetic resonance imaging (MRI) has several advantages over obstetric
      ultrasound, including a larger field of view, superior soft-tissue contrast, more
      precise volumetric measurements, and greater accuracy in the demonstration of
      intracranial abnormalities. Prenatal MRI has been shown to positively and
      incrementally influence management in a substantial proportion of patients being
      considered for fetal intervention. Despite these findings, precise indications
      for prenatal MRI in the setting of fetal surgery are not yet established, because
      both prenatal MRI and fetal surgery are relatively new techniques that remain in
      evolution. Conditions in which prenatal MRI appears to contribute to fetal
      surgical planning and postoperative evaluation are described in this review.
      These conditions include congenital diaphragmatic hernia, cystic adenomatoid
      malformation, sacrococcygeal teratoma, complicated twin pregnancies, upper airway
      obstruction, and myelomeningocele.

PMID- 11215716
TI  - Fetal and placental volumetric and functional analysis using echo-planar imaging.
AB  - Recent and past work using echo-planar imaging (EPI) in pregnancy has allowed
      important anatomic and physiological information to be obtained, giving
      advantages over conventional radiological methods such as ultrasound. EPI is a
      quick, convenient method of measuring organ volumes. The volumetric estimates
      throughout gestation correlate well with known fetal weight at these gestations.
      Relaxation time measurements also can be made in the placenta and lungs. By
      combining the changes in relaxation and volume with gestation in the future, it
      may be possible to develop an "index of maturity." This could be used to
      accurately reflect lung maturation. T1 and T2 parameters in the placenta
      decreased with gestational age and with abnormal placentation. EPI can be used to
      assess perfusion in the placenta and flow in the uterine arteries because of its
      rapid acquisition times. These techniques have been applied to assess perfusion
      within the fetal brain.

PMID- 11215717
TI  - Fast fetal magnetic resonance imaging techniques.
AB  - New hardware and software allow for increased magnetic resonance imaging (MRI)
      speed. This speed is crucial for MRI of the fetus, where motion degrades image
      quality. Single-shot sequences such as echo-planar and single-shot fast spin echo
      now are practical with most clinical scanners. This article reviews and
      illustrates the physics of fast magnetic resonance sequences.

PMID- 11215718
TI  - Update: outbreak of acute febrile illness among athletes participating in Eco
      Challenge-Sabah 2000--Borneo, Malaysia, 2000.
AB  - During September 7-11, 2000, CDC was notified by the Idaho Department of Health,
      the Los Angeles County Department of Health Services, and the GeoSentinel Global
      Surveillance Network of at least 20 cases of acute febrile illness in three
      countries; all ill patients had participated in the Eco-Challenge-Sabah 2000
      multisport expedition race in Borneo, Malaysia, during August 21-September 3,
      2000. Participants included athletes from 29 U.S. states and 26 countries. This
      report updates the ongoing investigation of this outbreak through December 2,
      which suggests that Leptospira were the cause of illness and that water from the
      Segama River was the primary source of infection. Participants in adventure
      sports and exotic tourism should be aware of potential exposure to unusual and
      emerging infectious agents.

PMID- 11215719
TI  - Health-related quality of life among persons with epilepsy--Texas, 1998.
AB  - Epilepsy is a central nervous system disorder characterized by unprovoked,
      recurrent seizures that may affect physical, mental, or behavioral functioning.
      In 1995, approximately 2.3 million persons residing in the United States had
      epilepsy. Approximately 181,000 new cases of epilepsy are diagnosed each year,
      with annual estimated costs of $12.5 billion in medical care and lost
      productivity. Because epilepsy has a substantial impact on health (e.g., physical
      and psychosocial difficulties, side effects of anticonvulsant therapy, lifestyle
      restrictions, and perceived stigmatization), self-reported physical and mental
      health-related quality of life (HRQOL) measures are useful in gauging the impact
      of epilepsy on persons with the disorder. Persons with chronic health disorders
      are at risk for impaired HRQOL. Few studies have examined the HRQOL of persons
      with epilepsy, and none has used a representative sample of adults residing in
      the United States. This report examines data from the 1998 Texas Behavioral Risk
      Factor Surveillance System (BRFSS) that included a question about epilepsy;
      findings indicate that persons with epilepsy reported substantially worse HRQOL
      than persons without epilepsy. Community-based interventions such as the
      Sepulveda Epilepsy Education Program that address medication self-management,
      psychosocial self-management, and other education interventions can improve the
      quality of life for persons with epilepsy.

PMID- 11215720
TI  - Nongranulomatous chronic idiopathic enterocolitis: a primary histologically
      defined disease.
AB  - Nongranulomatous chronic idiopathic enterocolitis is characterized by sudden
      onset of severe watery diarrhea, malabsorption, exudative enteropathy, frequent
      appearance of shallow ulcerations, and variable degrees of villus atrophy. In the
      absence of infectious and pharmacologic causes, the presence of a predominantly
      acute inflammatory infiltrate limited to the lamina propria establishes the
      diagnosis. No underlying disease appears during prolonged follow-up. The etiology
      remains unknown. The disease is generally corticosteroid-responsive; low-dose
      maintenance therapy is frequently required. The long-term prognosis is guarded.
      Three of 11 patients died of opportunistic infections or resistance to therapy.

PMID- 11215721
TI  - Low endogenous prostaglandin E2 predisposes to relapsing inflammation in
      experimental rat enterocolitis.
AB  - Intramural injection of peptidoglycan-polysaccharide (PG-PS) induces acute
      enterocolitis that spontaneously relapses in Lewis but not Fischer rats.
      Interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) induce
      prostaglandin E2 (PGE2) secretion, which inhibits secretion of these cytokines by
      macrophages, suggesting an inhibitory feedback mechanism. We postulate that Lewis
      rat susceptibility to relapse is due to an imbalance between protective
      prostaglandins and cytokines. Female Fischer and Lewis rats were injected with PG
      PS (37.5 microg/g) or human serum albumin intramurally. Tissue IL-1alpha and PGE2
      immunoreactivities and myeloperoxidase (MPO) activity were determined. Relapsing
      rats had lower PGE2 and PGE2/IL-1alpha ratios than nonrelapsing rats (P < 0.05).
      In Fischer rats, 2 mg/kg/day of indomethacin potentiated cecal MPO and IL-1alpha
      concentrations above PG-PS alone (P < 0.05). Misoprostol treatment blocked PG-PS
      induced IL-1alpha and MPO and inhibited the potentiating effect of indomethacin
      on MPO and IL-1alpha (P < 0.05). In conclusion, increased endogenous PG may be
      protective against relapsing inflammation in PG-PS induced enterocolitis, at
      least partially via inhibition of proinflammatory cytokines. Imbalance between
      protective prostaglandins and proinflammatory cytokines may be involved in the
      pathogenesis of chronic relapsing inflammation in genetically susceptible hosts.

PMID- 11215722
TI  - Somatostatin and octreotide stimulate short-circuit current in human colonic
      epithelium.
AB  - In vitro somatostatin is a potent inhibitor of intestinal ion secretion in animal
      models and cultured human cell lines, providing a rationale for its use in
      secretory diarrheas. However, the effects of somatostatin on ion transport in
      native human colonic epithelium have not been reported. In this study the effects
      of somatostatin and octreotide on the basal short-circuit current and the cAMP-
      and Ca2+-stimulated short-circuit current were studied in isolated human colonic
      mucosa mounted in Ussing chambers. Under basal conditions somatostatin and
      octreotide (1 micromol/liter) stimulated a small, bumetanide-sensitive increase
      in short-circuit current. Following stimulation of secretion with prostaglandin
      E2, somatostatin and octreotide further increased the short-circuit current in a
      dose dependent fashion (ED50 approximately 10 nmol/liter for both). This
      stimulation of short-circuit current was not affected by pretreatment of the
      tissue with basolateral tetrodotoxin (1 micromol/liter) or mucosal amiloride (10
      micromol/liter). In contrast, somatostatin and octreotide had no effect when
      secretion was stimulated with 8-bromo-cAMP, and pretreatment of the tissue with
      somatostatin and octreotide (0.1 micromol/liter) did not alter the secretory
      response to carbachol. The absence of any inhibitory effect of somatostatin and
      octreotide on electrogenic secretion in the human colon may explain the variable
      results obtained when somatostatin or octreotide are used for the treatment of
      secretory diarrheas.

PMID- 11215723
TI  - Oxygen diffusive barriers of rat distal colon: role of subepithelial tissue,
      mucosa, and mucus gel layer.
AB  - The contributions of subepithelial tissue, mucosa, and mucus gel layer as
      restraints for oxygen diffusion in rat distal colon in vitro were assessed by
      comparing oxygen transfer through preparations of isolated submucosa, isolated
      mucosa with and without the superficial mucus gel layer, and mucosa-submucosa
      mounted as flat sheets in a diffusion chamber. One side of the chamber was gassed
      with 95% O2-5% CO2 while the time course of oxygen concentration rise was
      measured in the continuously stirred opposite side, initially equilibrated with
      near-zero oxygen solution. The procedure does not affect epithelial viability.
      Diffusion in isolated mucosa was the same before and after KCN (5 mM) treatment,
      suggesting that epithelial oxygen consumption does not influence transfer rates.
      Subepithelial tissue, mucosa, and mucus gel layer are roughly responsible,
      respectively, for 12%, 56%, and 32% of oxygen diffusive hindrance. Diffusion
      coefficients range from 13% (mucosa-submucosa) to 54% (isolated submucosa) of
      that of water. Subepithelial tissue accounts for about 12% of total diffusive
      restraint.

PMID- 11215724
TI  - Induction of enlarged intestinal lymphoid aggregates during acute glutathione
      depletion in a murine model.
AB  - Glutathione is a nonenzymatic antioxidant synthesized by most animal cells and is
      depleted in inflammatory bowel disease. The effects of glutathione depletion on
      intestinal histology and inhibitory neurochemicals was examined in a mouse model.
      Glutathione depletion in A/J mice involved inhibition of gamma-glutamylcysteine
      synthetase using L-buthionine-(S,R)-sulfoximine (BSO) for 10 days. Ileum and
      colon were obtained from saline-control mice, BSO-treated mice, and BSO-treated
      mice receiving ascorbate or glutathione monoethylester. Glutathione, lipid
      peroxides, and nicotineamide adenine dinucleotide phosphate diaphorase activity
      were measured by colorimetric assays. Vasoactive intestinal peptide was measured
      by radioimmunoassay. Glutathione depletion induced enlargement of mucosal
      submucosal lymphoid aggregates without germinal centers in ileum and colon. These
      aggregates were prevented by supplementation with glutathione monoethylester but
      not ascorbate. Tissue levels of inhibitory neurochemicals were unchanged.
      Depletion of glutathione appears to induce enlarged lymphoid aggregates by
      recruitment of lymphocytes from the peripheral circulation. A component of the
      inflammation that develops in inflammatory bowel disease could be related to
      depletion of tissue levels of glutathione.

PMID- 11215725
TI  - Noninvasive in vivo analysis of human small intestinal paracellular absorption:
      regulation by Na+-glucose cotransport.
AB  - Activation of intestinal Na+-glucose cotransport increases paracellular movement
      of inert tracers in cultured monolayers, isolated rodent intestinal mucosae, and
      in rodents in vivo. However, not all studies have demonstrated comparable effects
      on human intestinal paracellular absorption. We sought to assess the effects of
      Na+-glucose cotransport on paracellular absorption in human beings using a simple
      noninvasive assay. Study subjects drank six 200-ml doses of test solution,
      composed of 0.8% w/v creatinine (sufficient to overwhelm endogenous creatinine)
      in 277 mM glucose or mannitol and urine was collected. Intestinal creatinine
      absorption is paracellular. Once absorbed, creatinine is cleared into the urine.
      Therefore, urinary creatinine recovery reflects intestinal paracellular
      creatinine absorption. Total urinary creatinine recovery was 55% +/- 4% of
      creatinine ingested with glucose and 38% +/- 9% of creatinine ingested with
      mannitol (p < 0.001). Thus, intestinal paracellular absorption of creatinine is
      increased by the presence of luminal glucose. Our results are consistent with in
      vivo human regulation of mucosal permeability by Na+-glucose cotransport.

PMID- 11215726
TI  - Insecure attachment in a subgroup with ulcerative colitis defined by ANCA status.
AB  - This study is the first test of the novel hypothesis that perinuclear anti
      neutrophil cytoplasmic antibody (p-ANCA) marks an etiological division between
      stress-susceptible and stress-neutral ulcerative colitis. Subjects were 47 UC
      patients with known p-ANCA status (19 p-ANCA-positive, 28 p-ANCA-absent).
      Controls were 77 university students. Subjects and controls completed the
      Reciprocal Attachment Questionnaire. Subjects were categorized as
      avoidant/nonavoidant and anxious/nonanxious based on scores for compulsive self
      reliance and compulsive care seeking, respectively. A higher prevalence of
      avoidant attachment was present in p-ANCA-absent (58.6%) than p-ANCA-positive
      subjects (22.2%, chi-square = 5.95, P < 0.02). There was no difference in the
      prevalence of anxious attachment between p-ANCA-absent and p-ANCA-positive
      subjects. There was no difference in clinical and psychiatric variables between
      groups. This finding provides support for a psychobiological contribution to UC
      in a subgroup identified by the absence of p-ANCA.

PMID- 11215727
TI  - Histoplasmosis capsulatum as a cause of lower gastrointestinal bleeding in common
      variable immunodeficiency.
AB  - Infection with Histoplasma capsulatum is the most common systemic fungal
      infection in the United States, but symptomatic gastrointestinal disease is rare.
      Gastrointestinal involvement is seen in patients with an established
      immunosuppressed state that predates any infection. We report a patient
      presenting with gastrointestinal bleeding ultimately diagnosed with disseminated
      histoplasmosis. Work-up led to the diagnosis of common variable immunodeficiency,
      a diagnosis not previously described as associated with gastrointestinal
      histoplasmosis. Resolution of the colonic ulcer was documented after appropriate
      antifungal therapy, underscoring the importance of including this infectious
      process in the differential of a patient without other risk factors for colonic
      ulceration.

PMID- 11215728
TI  - Response by Dr. Allen. Anal canal resting tone.

PMID- 11215729
TI  - Misinterpretation of human electrogastrograms related to inappropriate data
      conditioning and acquisition using digital computers.
AB  - Despite the fact that digital techniques for data acquisition and processing were
      widely used in electrogastrographic (EGG) research during the last decade,
      inappropriate signal conditioning and digitization are still potential pitfalls
      threatening the reliability of the experiments. The aim of this paper was to
      review: (1) the importance of the antialiasing low-pass filtering for reducing
      recording artifacts and interferences, (2) the advantages brought by the proper
      choice of filter cutoff frequency and the slope for the decrement of the minimal
      required sampling frequency, (3) the impact of incorrectly selected sampling
      frequency on data interpretations, with particular attention to the percent
      distribution ranges, and (4) the "leakage effect" related to the finite number of
      samples processed simultaneously in frequency domain representation of the
      recordings. A model of electrogastrographic (EGG) recording was mixed with a
      model of electrocardiographic (ECG) artifact. The resulting finite-duration
      signal was low-pass filtered and then digitized with a sampling frequency of 1
      Hz. The cutoff frequency of the first-order low-pass filter was altered from 0.5
      to 0.1 Hz. Amplitude frequency spectra of the digitized recordings were
      investigated. An example with a real human electrogastrogram in which an ECG
      artifact was present confirmed the simulation results. When a first-order anti
      aliasing filter is utilized at least a fivefold difference between the filter
      cutoff frequency and the sampling frequency is recommended for compliance with
      the Nyquist theorem of digitization. Leakage effects associated with the finite
      time duration of the recordings and the use of the discrete Fourier transform
      should be considered when frequency domain analysis is performed.
      Misinterpretation of the "bradygastric" and "tachygastric" ranges in the percent
      distribution of EGG frequency components is possible if inappropriate signal
      conditioning and digitization are employed.

PMID- 11215730
TI  - Abnormally rapid gastric emptying of an isosmotic liquid meal in patients with
      megaduodenum.
AB  - Duodenal resistance to gastric outflow is known to participate in the regulation
      of gastric emptying of liquids in animals, but the role of this mechanism in
      humans has not been extensively investigated. In this work we studied the gastric
      emptying of liquids in patients with megaduodenum, who putatively have increased
      duodenal receptivity to gastroduodenal transfer of liquids. Subjects included
      eight patients with megaduodenum and eight healthy volunteers. Since megaduodenum
      in all cases was associated with Chagas' disease, a further reference group
      consisting of 11 chagasic patients without megaduodenum was also studied. Fasted
      subjects ingested 200 ml of an isotonic dextrose solution labeled with 15 MBq of
      technetium-99m coupled to sulfur colloid, as an unabsorbable marker. Images of
      the anterior aspect of the stomach were taken immediately after test meal
      ingestion and thereafter up to 1 hr. Decay-corrected counts over the gastric
      region along time yield the calculation of early (5 min) and late (60 min)
      gastric retention as well as gastric emptying half-times (T1/2). Early gastric
      retention in patients with megaduodenum (median; range: 48%; 18-64%) was
      significantly lower (P < 0.05) than in both patients without megaduodenum (59%;
      40-86%) and controls (82%; 68-99%). T1/2 values in patients with megaduodenum (5
      min; 3-17 min) were also significantly lower (P < 0.01) than in patients without
      megaduodenum (23 min; 4 to >60 min) and controls (29 min; 13-60 min). There were
      no significant differences between the three groups concerning late gastric
      retention. We conclude that the early phase of gastric emptying of liquids is
      abnormally accelerated in patients with megaduodenum, which suggests that
      increased duodenal receptivity may have a significant effect on the
      gastroduodenal transfer of liquids in humans.

PMID- 11215731
TI  - Abnormal propagation pattern of duodenal pressure waves in the irritable bowel
      syndrome (IBS) [correction of (IBD)].
AB  - The propagation pattern of individual pressure waves in the gastroduodenal area
      in IBS is unexplored. We performed antroduodenojejunal manometry on 26 patients
      with IBS--13 with diarrhea predominant IBS (IBS-D) and 13 with constipation
      predominant IBS (IBS-C)--and 32 healthy controls. Neuropathic-like motor
      abnormalities were found in 38% of the patients with conventional manometric
      evaluation. With high-resolution analysis additional abnormalities were observed
      in the majority of the patients, with increased frequency of retrograde pressure
      waves postprandially in both IBS subgroups and in phase II in IBS-D. A
      correlation between subjective gastrointestinal symptoms and the frequency of
      retrograde pressure waves in phase II in IBS-D was demonstrated. Motility indices
      and the number of long clusters were also higher in patients compared to
      controls. To conclude, an abnormal propagation pattern of individual duodenal
      pressure waves in IBS patients was demonstrated and found to be related to
      symptom severity in diarrhea-predominant IBS. High-resolution analysis adds
      information to standard manometry.

PMID- 11215732
TI  - Helicobacter pylori in the oral cavity: high prevalence and great DNA diversity.
AB  - To test the hypothesis that Helicobacter pylori may be transmitted by the oral
      oral route, we applied nested PCR and DNA sequencing to detect and analyze H.
      pylori DNA in the oral cavity of 20 adult patients undergoing endoscopy. Dental
      plaques of molars, premolars, and incisors and saliva were collected. Additional
      paraffin-embedded gastric biopsies were analyzed in four patients. Two sets of
      highly sensitive and specific primers, EHC-U/EHC-L and ET5-U/ET-5L directed to a
      860-bp fragment of H. pylori DNA, were used in the nested PCR. Eight patients had
      an active infection in the stomach determined with the [13C]urea breath test and
      the other 12 were negative. Nested PCR showed that all 20 subjects (100%) were
      positive for H. pylori in the oral cavity. DNA sequencing demonstrated that all
      tested PCR products of the expected size from the oral samples have more than 97%
      identity with that from H. pylori type strain ATCC 43629. However, sequences
      differed in oral samples from different subjects as well as between different
      oral locations and gastric biopsies within the same individuals. In conclusion,
      the oral cavity may be a permanent reservoir for H. pylori and can harbor
      multiple H. pylori strains at the same time.

PMID- 11215733
TI  - Isotope ratio mass spectrometry (IRMS) versus laser-assisted ratio analyzer
      (LARA): a comparative study using two doses of.
AB  - This study was carried out to compare the measurements and the diagnostic
      accuracy of the traditional expensive IRMS and the new economical LARA system
      using two doses of [13C]urea + two different test meals in patients undergoing
      upper gastrointestinal endoscopy, both before and after anti-Helicobacter
      treatment. A total of 354 dyspeptic patients underwent endoscopy with gastric
      biopsies to diagnose H. pylori infection by CLO-test and histology. No patients
      had taken antibiotics, bismuth, or antisecretory drugs in the 4 weeks before
      testing. After overnight fasting, breath samples were collected simultaneously in
      both plastic and glass tubes at baseline and at 30 and 60 min after urea
      ingestion. In 237 patients 100 mg [13C]urea + Ensure and in 117 patients 75 mg
      [13C]urea + citric acid were given. The test was also performed with the two urea
      dosages and meals in 67 and 64 infected patients, respectively, four weeks after
      anti-Helicobacter therapy. H. pylori was considered eradicated when both biopsy
      based tests were negative. A delta value >5 per thousand was considered positive.
      Breath samples with insufficient CO2 levels at both 30 and 60 min were excluded
      from final analysis (N = 37 in pre- and N = 8 in posttreatment). There was
      excellent agreement between overall delta values of the two machines with both
      [13C]urea 100 mg + Ensure and [13C]urea 75 mg + citric acid. The 95% CI of the
      difference against the mean was wider with the former (mean -1.3, +6.3, and -9.4)
      than with the latter urea dosage and test meal (mean -1.2, +5.2 and -8.1). LARA
      and IRMS were equally effective (P = NS) in distinguishing infected from
      uninfected patients before therapy using both doses of [13C]urea and test meals
      (sensitivity ranged from 95% to 99% and specificity from 95% to 97%). This good
      performance was maintained in the posttreatment phase (sensitivity ranged from
      90% to 100% and specificity from 90% to 97%), without any statistical difference
      among the various combinations (P = NS). The LARA system is a valid alternative
      to IRMS in the diagnosis of H. pylori infection. Both machines provide highly
      reliable results after 30 min, so that the 60 min sample can be avoided. The dose
      of 75 mg + citric acid suffices to ensure an accurate UBT. The test performed
      with both devices and [13C]urea dosages is very effective also for posttherapy
      evaluation of H. pylori status.

PMID- 11215735
TI  - Ambulatory pH monitoring: how to truly test the patient?

PMID- 11215734
TI  - Role of mucus reduction and luminal acid elevation in increased susceptibility of
      stomach to nonsteroidal antiinflammatory drug-induced injury in arthritic rats.
AB  - We investigated the role of gastric mucus and acid secretion in the increase of
      nonsteroidal antiinflammatory drug-induced gastric lesions in adjuvant-induced
      arthritic rats. Both aspirin- and indomethacin-induced gastric injury were
      remarkably worsened in the arthritic rats. In the arthritic rats, the amounts of
      mucus glycoprotein in both the mucosa and adherent gel layer were respectively
      decreased to 70% and 34% of those in normal rats, while gastric acid secretion
      was augmented to 1.5-fold. The gastroprotective antiulcer agent ecabet sodium,
      which increased the mucus content in the gel layer but did not affect the luminal
      acid contents, prevented the increase of both lesions induced by aspirin and
      indomethacin. Cimetidine also inhibited the formation of aspirin- and
      indomethacin-induced damage as well as the acid secretion in the arthritic rats.
      In conclusion, an imbalance between gastric defensive and aggressive systems due
      to the loss of adherent mucus glycoprotein and the elevation of the luminal acid
      contents seems to account for the increased susceptibility of the lesion-inducing
      properties of nonsteroidal antiinflammatory drugs in arthritic rats.

PMID- 11215736
TI  - Enterococcal bactibilia in patients with malignant biliary obstruction.
AB  - Biliary obstruction due to pancreaticobiliary malignancy is often accompanied by
      bactibilia. The aims of this study were to clarify the impact of preoperative
      antibiotic use on bile bacterial flora and to identify the bile bacteria
      responsible for postoperative septic complications in patients with malignant
      biliary obstruction. Eighty-four patients with malignant biliary obstruction
      underwent a biliary decompression procedure before definitive surgery. In 63
      patients (75%), preoperative bile culture was positive, with nine species being
      detected. Only the incidence of enterococcal bactibilia increased after
      antibiotic use (P = 0.0009), with a 16% incidence before and 63% after antibiotic
      use. When analyzing the correlation between preoperative bile bacteria and
      postoperative complications, only the Enterococcus species was associated with
      the occurrence of complications (P = 0.037). In conclusion, bile bacterial flora
      changes after preoperative antibiotic use, with a significant increase in the
      incidence of enterococcal bactibilia. The Enterococcus species is most
      responsible for postoperative septic complications in patients with malignant
      biliary obstruction.

PMID- 11215738
TI  - Immunochemical fecal occult blood test is inadequate for screening test of
      stomach cancer.
AB  - The present study was carried out to investigate the diagnostic accuracy of the
      immunochemical fecal occult blood test in the screening for stomach cancer. In
      the hospital-based case-control study, the test was positive in 6 (14.3%)
      subjects with stomach cancer, in 32 (76.2%) subjects with colorectal cancer, and
      in 10 (7.9%) healthy subjects, respectively, showing a significant difference in
      detection rate between the subjects with stomach cancer and colorectal cancer (p
      < 0.01). In the population-based cross-sectional study, detection rate for
      stomach cancer was 0.13% and 0.15% for negative and positive groups decided by
      immunochemical fecal occult blood test, indicating no significant difference.
      These results reveal that the immunochemical fecal occult blood test is
      inadequate as the screening test for stomach cancer and suggest that examination
      of the upper digestive tract is unnecessary in cases where the result of fecal
      occult blood test is positive with no sign of colorectal diseases.

PMID- 11215737
TI  - No major difference in K-ras and p53 abnormalities in sporadic and hereditary
      nonpolyposis colorectal adenomas.
AB  - K-ras and p53 gene mutations are known to occur in high frequencies in sporadic
      colorectal cancers, but findings are inconsistent in hereditary nonpolyposis
      colorectal cancer (HNPCC). We compared K-ras codon 12 and 13 gene mutations and
      p53 protein overexpression in 48 HNPCC (positive for Amsterdam criteria) and 59
      sporadic colorectal adenomas, to examine whether they may represent similar or
      different molecular pathways to cancer. In sporadic adenomas K-ras mutations were
      detected in 32% and p53 overexpression in 31% of the cases. Similarly, K-ras
      mutations and p53 overexpression were both found in 25% of HNPCC adenomas. The
      frequencies of these abnormalities were not significantly different between HNPCC
      and sporadic adenomas. When taking differences in adenoma size into account, the
      frequencies were even more similar. In conclusion, these results suggest a
      similar molecular pathway to adenomas in HNPCC and sporadic carcinogenesis, with
      respect to involvement of K-ras and p53.

PMID- 11215739
TI  - Mutations at vicinity of catalytic sites of hepatitis C virus NS3 serine protease
      gene isolated from hepatocellular carcinoma tissue.
AB  - The mechanism of hepatitis C virus (HCV) -induced hepatotocellular carcinoma
      (HCC) is still unknown, but in vitro studies clearly suggest that HCV proteins
      exert a direct effect on liver carcinogenesis. HCV NS3 serine protease is known
      to play a key role in the life cycle of the virus and may interact with the host
      cellular regulatory proteins. The aim of the present study was to conduct a
      genetic analysis of the HCV NS3 gene coding for the serine protease isolated from
      serum, tumor, and nontumor tissue of HCC patients. RNA was extracted and HCV cDNA
      was amplified by nested reverse transcriptase-polymerase chain reaction (RT-PCR).
      Sequence comparison yielded unique changes at the vicinity of the catalytic sites
      of the NS3 clones isolated only from HCC tissue. These changes included the
      insertion of a "large" and charged amino acid, substitution of a polar with a
      hydrophobic amino acid, and substitution of a charged with a polar amino acid.
      Those changes affect the electrostatic charge around the active site, and thus
      the activity and substrate specificity of the serine protease. This is the first
      study to define significant amino acid changes at the catalytic domain of the NS3
      serine protease gene isolated from HCC tissue.

PMID- 11215740
TI  - Hepatocellular carcinoma associated with adult-type citrullinemia.

PMID- 11215741
TI  - Early mutation of precore (A1896) region prior to core promoter region mutation
      leads to decrease of HBV replication and remission of hepatic inflammation.
AB  - To evaluate the relationship between mutations and clinical courses, we
      investigated precore (preC) and core promoter (CP) mutations and serum HBV DNA
      levels in HBe-antibody-positive HBV carriers. Fifty-six asymptomatic carriers
      (ASC), 29 patients with chronic hepatitis who showed normal ALT levels for more
      than two years (CH-ASC), 31 patients with chronic hepatitis (CH), and 32 patients
      with hepatocellular carcinoma (HCC) were studied. Almost all patients (99.2%) had
      mutations in either CP or preC. Mutation only in preC (A1896) was present in
      52.2% with ASC, 25.0% with CH-ASC, 16.1% with CH, and 8.0% with HCC, and was
      significantly higher in ASC (P < 0.01). The patients with only preC mutation
      showed low HBV DNA levels in each clinical stage. The mutation of preC (A1896)
      prior to the mutation of CP might control the replication of HBV, which leads to
      the remission of hepatitis.

PMID- 11215742
TI  - Seroepidemiology of TT virus infection and relationship between genotype and
      liver damage.
AB  - TT virus (TTV) has been identified in patients with posttransfusion hepatitis of
      unknown etiology and is thought to be a new hepatitis virus. We determined the
      extent of TTV infection in the Japanese general population and the relationship
      between TTV DNA genotype and liver damage. In 1998, we tested 847 serum samples
      for TTV. TTV DNA was assayed by a nested polymerase chain reaction and classified
      into three different genotypes and eight subtypes. TTV DNA was detected in 25.3%
      and 32.4% of the inhabitants of the two areas studied, respectively. The genotype
      distribution was similar in both areas. G1, G2, and G3 were 60%, 20%, and 5%,
      respectively. Of the 20 subjects with TTV DNA alone and elevated serum ALT
      levels, 18 were G1, one was G2, and one was G3. TTV infection is endemic in the
      Japanese general population studied. The main TTV genotype, G1, may be related to
      the ensuing liver damage.

PMID- 11215743
TI  - Liver damage in hemodialysis patients with hepatitis C virus viremia: a
      prospective 10-year study.
AB  - Hepatitis C virus (HCV) infection is a major problem associated with
      hemodialysis. The extent of liver damage in hemodialysis patients with chronic
      HCV infection has not been thoroughly documented. The aim of this study was to
      evaluate liver damage of hemodialysis patients infected with HCV. A total of 233
      hemodialysis patients were categorized into two groups at entry: group X, 80
      positive for serum HCV RNA, and group Y, 153 negative for serum HCV RNA. All were
      tested for serum alanine aminotransferase (ALT) serially from 1989 to 1998, and
      serum hyaluronic acid (HA), serum type-IV collagen (IV-C), platelet counts, and
      ultrasonographic examination of the liver was done in 1998. In group X, 61.3% had
      continuously abnormal ALT levels for over six months followed by normal ALT
      levels. Of the group X patients, 11.3% had abnormal ALT levels in 1998, and in
      three, hepatocellular carcinoma occurred. Mean HA and IV-C levels in group X
      (648.8 and 188.7 ng/ml, respectively) were significantly higher than in group Y
      (213.1 and 165.5 ng/ml, respectively) (P < 0.05). Ultrasonographic findings
      significantly correlated with serum HA level and platelet counts and showed
      significantly more abnormalities in group X than in group Y (P < 0.05). From
      these findings, a combined examination with ultrasonography and serum
      fibrogenesis markers is useful for detection of liver damage in hemodialysis
      patients with HCV viremia.

PMID- 11215744
TI  - Correlation of high levels of hyaluronan and cytokines (IL-1beta, IL-6, and TGF
      beta) in ascitic fluid of cirrhotic patients.
AB  - Our objective was to investigate the relationship between endotoxin and
      hyaluronan synthesis and release in serum and ascitic fluid from cirrhotic
      patients. We studied hyaluronan, endotoxin, albumin, and creatinine levels in
      ascitic fluid and plasma and cytokine levels (IL-1beta, IL-6, TGF-beta) in
      ascitic fluid. TGF-beta, IL-6, and IL-1beta correlation analyses indicated a
      strong dependence of the production of these cytokines on endotoxin levels.
      Correlation analyses for TGF-beta and IL-6 indicated a strong dependence of the
      production of hyaluronan on cytokine levels and, to a lesser extent, on IL-1beta
      levels. Hyaluronan analysis indicated that a certain glycosaminoglycan level is
      required in ascites before its appearance in plasma. Our results disclosed
      elevated plasma hyaluronan concentrations. The simultaneous increased hyaluronan
      levels in ascitic fluid do not seem to be derived from the systemic circulation.
      In conclusion, the high hyaluronan-ascites/hyaluronan-plasma ratio suggests an
      intrinsic hyaluronan production from peritoneal cells induced by endotoxins.

PMID- 11215746
TI  - Paroxysmal nocturnal hemoglobinuria with no evidence of hemolysis presenting as
      Budd-Chiari syndrome.

PMID- 11215745
TI  - Parameters of microsomal and cytosolic liver function but not of liver perfusion
      predict portal vein velocity in noncirrhotic patients with chronic hepatitis C.
AB  - Our aim was to compare color-coded Doppler sonography (CCDS) and quantitative
      testing of liver function (QTLF) in patients with chronic hepatitis C. In all, 74
      patients with chronic hepatitis C and mild fibrosis underwent QTLF, which
      included aminopyrine breath test (ABT), galactose elimination capacity (GEC),
      sorbitol clearance (SC), and indocyanine green clearance (ICG). Hepatic artery
      velocity and resistance index (HA-V, HA-RI) as well as portal vein velocity (PV
      V) were measured by CCDS. ABT, GEC, and PV-V were significantly reduced, whereas
      SC1, ICG, HA-V, and HA-RI showed normal levels. There was a significant
      correlation between reduction in PV-V only with GEC and ABT. QTLF did not
      correlate with HA-V and HA-RI. In conclusion, in hepatitis C patients with liver
      fibrosis, ABT and GEC are decreased significantly, which was paralleled by a
      reduction of PV-V. Unexpectedly SC1 and ICG, the classical hepatic perfusion
      parameters, do not correlate with the parameters measured by CCDS.

PMID- 11215748
TI  - Octreotide treatment in patients with severe acute pancreatitis.
AB  - We investigated the effect of octreotide in the treatment of severe acute
      pancreatitis in a case-control study. Experimental and clinical studies on the
      effect of octreotide in the treatment of acute pancreatitis have shown
      controversial results. Since January 1992, we have been conducting a prospective
      randomized study on the effect of octreotide in severe acute pancreatitis, in
      three hospitals in Israel. The entering criteria included three or more of the
      Ranson prognostic signs and CT findings of severe pancreatitis. Patients were
      randomly assigned to conservative treatment either with or without octreotide
      (0.1 mg subcutaneously three times a day). The end points of the study included:
      complication rate (ARDS, sepsis, renal failure, pseudocyst, fistula, and
      abscess), length of hospital stay, and mortality. From January 1992 to December
      1996, 60 patients entered the study. After evaluating the files, 10 patients were
      excluded due to failure to meet the entering criteria, incomplete data, or
      incorrect diagnosis. Of the remaining 50 patients, 25 were assigned to octreotide
      (treatment group) and 25 to conservative treatment only (control group). The two
      groups matched with regard to age, sex, etiology, and severity of the disease.
      The complication rate was lower in the treatment group with regard to sepsis (24%
      vs 76%, P = 0.0002) and ARDS (28% vs 56%, P = 0.04). The hospital stay was
      shorter in the treatment group (20.6 vs 33.1 days, P = 0.04). Two patients died
      in the treatment group and eight in the control group (P < 0.019). These results
      suggest that octreotide may have a beneficial effect in the treatment of severe
      acute pancreatitis.

PMID- 11215747
TI  - Ki-1 lymphoma with nodular involvement in liver and spleen: possible role of
      cytokines in systemic manifestation of fever and leukocytosis.

PMID- 11215749
TI  - Heat shock response is associated with protection against acute interstitial
      pancreatitis in rats.
AB  - We recently reported that hyperthermia induces pancreatic expression of heat
      shock proteins (HSPs), particularly HSP70 isoforms, and protects against cerulein
      pancreatitis. We have now studied whether a double hyperthermia amplifies these
      effects and whether hyperthermia also protects against dibutyltin dichloride
      (DBTC)-induced pancreatitis. A further aim was to examine whether hyperthermia
      induces changes in transforming growth factor-beta1 (TGF-beta1). Following
      pretreatment without or with a single or double hyperthermia, pancreatitis was
      induced by application of cerulein or DBTC. Pancreatic HSP and TGF-beta1
      expression were studied by immunoblotting. Pancreas injury was assessed by light
      microscopy and serum pancreatic enzyme activity. Hyperthermia as well as DBTC
      induced HSP72, whereas cerulein did not. A double hyperthermia led to a further
      increase in HSP72 compared to a single heat stress. In both models, hyperthermia
      significantly reduced pancreatic injury. Although a double hyperthermia slightly
      decreased the severity of cerulein pancreatitis compared to a single heat
      treatment, an improved pancreas protection against DBTC cytotoxicity was not
      achieved. We also found that hyperthermia induces the expression of TGF-beta1. In
      conclusion, hyperthermia preconditioning exerts protective effects against two
      pathophysiologically different types of pancreatitis by a mechanism that involves
      the up-regulation of HSP70 isoforms as well as TGF-beta1.

PMID- 11215750
TI  - Impaired fecal elastase excretion in uremic pancreopathy.
AB  - To evaluate pancreatic exocrine function in uremia, 25 patients undergoing
      regular hemodialysis without clinical evidence of pancreatic disease and 25
      healthy control subjects were studied by fecal elastase 1 and chymotrypsin.
      Abdominal ultrasonography and measurement of serum lipase, calcium, phosphate,
      and parathormone were also carried out. Fecal elastase was significantly lower (P
      < 0.001) in patients than in controls. Abnormally low values were found in 12/25
      patients of whom six had values <100 microg/g. Fecal chymotrypsin was
      significantly lower (P < 0.05) in patients than in controls, with lower than
      normal values found in 10/25 patients. Fecal elastase was not related to the
      serum calcium, phosphate, or parathormone levels or to the period of dialysis. In
      patients serum lipase was normal or slightly elevated (<300 units/liter), and
      there was no evidence of pancreatic disease at ultrasound examination. The
      results lend further support to the existence of pancreatic function impairment
      in a significant number of patients with renal failure despite the absence of
      clinical and morphological evidence of pancreatic disease.

PMID- 11215751
TI  - Vitamin E protects neurons against oxidative cell death in vitro more effectively
      than 17-beta estradiol and induces the activity of the transcription factor NF
      kappaB.
AB  - Antioxidants can function as powerful protectants for neurons in vitro. Here, the
      neuroprotective activity of lipophilic free radical scavengers synthetic (+/-)
      alpha-tocopherol (synthetic vitamin E) and natural (+) alpha-tocopherol (natural
      vitamin E) against oxidative stress was investigated and compared to the
      neuroprotective effect of the female sex hormone estradiol. Employing mouse
      clonal hippocampal HT22 cells and rat cerebellar granule neurons, we found that
      both types of alpha-tocopherol exerted a higher neuroprotective antioxidant
      activity than 17-beta estradiol. At concentrations as low as 100 nM, synthetic
      (+/-) alpha-tocopherol and natural (+) alpha-tocopherol protected neurons
      effectively against the oxidative cell death caused by the Alzheimer's disease
      associated amyloid beta protein, hydrogen peroxide, and the excitatory amino acid
      glutamate. Moreover, vitamin E induced the activity of the redox-sensitive
      transcription factor NF-kappaB, which is involved in the control of nerve cell
      survival and, therefore, may play also a role in vitamin E-induced
      neuroprotection. These results may have implications regarding the prevention and
      treatment of oxidative stress-related degenerative disorders such as Alzheimer's
      disease.

PMID- 11215752
TI  - The novel type B MAO inhibitor PF9601N enhances the duration of L-DOPA-induced
      contralateral turning in 6-hydroxydopamine lesioned rats.
AB  - The present study examined the effect of the highly potent and selective MAO B
      inhibitor PF9601N on L-DOPA-induced rotational behavior in unilateral
      nigrostriatal 6-hydroxydopamine lesioned rats. Three doses of PF9601N (20, 40 and
      60mg/kg) were administered 30 min before an injection of L-DOPA (25mg/kg), and
      both contralateral and ipsilateral rotational behavior was measured. In addition,
      we also studied the effect produced by another MAO B inhibitor, deprenyl
      (20mg/kg), the MAO A inhibitor, clorgyline (20mg/kg), and the dopamine reuptake
      inhibitor, GBR2909 (7.5 mg/kg) on L-DOPA-induced rotational behavior. The results
      showed that PF9601N plus L-DOPA significantly enhanced the duration of
      contralateral rotational behavior with respect to L-DOPA plus vehicle in a dose
      related manner. At the dose of 40 and 60mg/kg, PF9601N produced significantly
      more overall contralateral turning than L-DOPA plus vehicle, and at the dose of
      60mg/kg, PF9601N produced significantly more turning behavior than L-DOPA plus
      deprenyl. These results suggest that PF9601N may be used as a novel tool in the
      treatment of Parkinson's disease.

PMID- 11215753
TI  - Sexual differences and estrous cycle in methamphetamine-induced dopamine and
      serotonin depletions in the striatum of mice.
AB  - Four consecutive doses (10 mg/kg) of methamphetamine, s.c., produced a
      substantial striatal dopamine depletion in both sexes of BALB/c and C57BL/6J
      mice. Male C57BL/6J mice exhibited greater dopamine depletions in the striatum
      compared to female C57BL/6J mice. In contrast, male and female BALB/c mice
      demonstrated an equivalent magnitude of striatal dopamine depletion. Regardless
      of sex, C57BL/6J mice demonstrated approximately 1.4 to 2.2 times greater
      dopamine depletions in the striatum compared to BALB/c mice. Moreover,
      methamphetamine caused 4 times greater serotonin depletions in male as opposed to
      female BALB/c mice while sparing either sex of the C57BL/6J mice. Furthermore,
      female mice of both strains appeared to have the greatest basal dopamine levels
      during proestrus and the lowest basal dopamine levels during diestrus. Likewise,
      female mice of both strains exhibited the lowest dopamine depletions in the
      striatum when the dosing regimen of methamphetamine started at proestrus whereas
      the greatest dopamine depletions in the striatum occurred when the regimen
      started during diestrus. These results suggest that sex hormones and other
      modulating factors may play a role in methamphetamine-induced dopamine and
      serotonin neurotoxicity.

PMID- 11215754
TI  - SCH 23390 enhances exogenous L-DOPA decarboxylation in nigrostriatal neurons.
AB  - Exogenous L-DOPA enhances dopamine metabolism in the intact and denervated
      striatum, and is the treatment of choice for Parkinsonism. Aromatic L-amino acid
      decarboxylase (AAAD) converts L-DOPA to dopamine. Blockade of dopamine D1-like
      receptors increases the activity of AAAD in both intact and denervated striatum.
      A single dose of SCH 23390, a dopamine D1-like receptor antagonist, increases the
      activity of AAAD in the striatum and midbrain and induces small changes in
      dopamine metabolism. When L-DOPA is administered after SCH 23390, there is a
      significant increase in the formation of 3,4-dihydroxyphenylacetic acid and
      dopamine turnover in striatum and midbrain compared to L-DOPA alone, suggesting
      further enhancement of dopamine metabolism. When the studies are repeated in the
      MPTP mouse model of Parkinson's disease, there is significantly more dopamine
      metabolism in the striatum of lesioned mice pretreated with SCH 23390 than in a
      comparison group treated with L-DOPA alone. These studies suggest that it may be
      possible to enhance the conversion of L-DOPA to dopamine in Parkinson's disease
      patients by administering substances that augment brain AAAD.

PMID- 11215755
TI  - Normal cerebrospinal fluid levels of insulin in patients with Parkinson's
      disease.
AB  - We compared CSF levels insulin, measured by a Radioimmunoanalysis method, in 24
      patients with Parkinson's disease (PD) and 21 matched controls. The CSF insulin
      levels did not differ significantly between PD patients and controls. CSF insulin
      levels were not correlated with age, age at onset, duration of the disease,
      scores of the Unified Parkinson Disease Rating Scale of the Hoehn and Yahr
      staging in the PD group. Antiparkinsonian therapy did not influence significantly
      and CSF levels of insulin. These results suggest that CSF insulin concentrations
      are not a biological marker of PD and its severity.

PMID- 11215756
TI  - Modulation of APP processing and secretion by okadaic acid in primary guinea pig
      neurons.
AB  - Primary cultures of guinea pig neurons were used as a model system to study the
      influence of the protein phosphatase inhibitor okadaic acid (OA) on the
      secretion, processing and phosphorylation of the amyloid precursor protein (APP).
      This primary cell culture system mimics more closely than other cell culture
      systems the human in vivo condition, as guinea pig APP is 98% homologous to human
      APP at the protein level, identical regarding the Abeta sequence and is processed
      in a similar manner as human APP. Both intracellular and secreted APP was
      upregulated by OA treatment (0.3 nM-10 nM) of 14 days old cultures in a
      concentration dependent manner while the amount of Abeta in the medium was
      decreased. OA treatment did not affect cell membrane integrity of primary neurons
      but induced DNA fragmentation. Phosphorylation of APP was unchanged by the low OA
      concentration used. These results show that OA treatment of guinea pig primary
      cultures might be used as a model to study the effects of modulation of signal
      transduction on secretion and processing of APP.

PMID- 11215757
TI  - Growth-associated protein GAP-43 in the frontal cortex and in the hippocampus in
      Alzheimer's disease: an immunohistochemical and quantitative study.
AB  - We studied the growth-associated protein, GAP-43 (also called neuromodulin and B
      50) in post-mortem brain tissue using immunohistochemistry and quantitative
      Western blotting, from patients with Alzheimer's disease (AD) and age-matched
      control subjects. By immunohistochemistry, we found a clear reduction of GAP-43
      in the frontal cortex, while in the hippocampus, there was a marked reduction in
      some areas (dentate molecular layer, stratum moleculare and radiale of CA1 and
      CA4), while not in other areas (stratum lacunosum, pyramidale and oriens of CA1).
      Moreover, in the hippocampus, neuritic staining was prominent, and was often
      associated with senile plaques. Quantitative analysis showed that GAP-43 was
      significantly reduced in AD, both in the frontal cortex (70% of the control
      value, p < 0.01) and in the hippocampus (81% of the control value, p < 0.05). In
      the frontal cortex, there was a significant negative correlation between GAP-43
      and duration of dementia (r = -0.58; p < 0.02) and a positive correlation between
      GAP-43 and the synaptic vesicle-specific protein rab3a (r = 0.62; p < 0.05),
      while no such correlation were found in the hippocampus. In contrast, a
      significant positive correlation was found between GAP-43 and the number of
      senile plaques in the hippocampus (r = 0.64; p < 0.05), but not in the frontal
      cortex. GAP-43 is known to be involved in maintenance of synapses and in neuritic
      regeneration. Our findings may suggest that in the frontal cortex, GAP-43 levels
      decline as a consequence of the synaptic degeneration, while in the hippocampus,
      sprouting processes, involving GAP-43, are active.

PMID- 11215758
TI  - Haloperidol-induced neurotoxicity--possible implications for tardive dyskinesia.
AB  - Tardive dyskinesia (TD) is one of the major side effects of long term neuroleptic
      treatment. The pathophysiology of this disabling and commonly irreversible
      movement disorder is still obscure. The traditional concept of supersensitivity
      of striatal dopamine receptors as the mechanism involved in the development of TD
      is not satisfying, and current studies have focused on the role of neuroleptic
      induced neuronal toxicity in the development of TD. We performed a series of
      experiments to gain a better understanding on the mechanisms involved in
      induction of TD. We have evaluated the direct neurotoxic effect of haloperidol
      (HP), a widely--used neuroleptic drug, and its three metabolites, in mouse
      neuronal cultures and in PC-12 cells. We found that the features of HP-induced
      cell death were apoptotic rather than necrotic, as indicated by different DNA
      staining methods and specific caspases inhibitors. Moreover, cotreatment with
      antioxidants such as vitamin E and N-acetylcysteine (NAC) significantly protected
      the cultures. Further studies on the mechanisms underlying HP-induced toxicity
      may lead to the development of new neuroprotective therapeutic strategies.

PMID- 11215759
TI  - An association study between two missense variations of the benzodiazepine
      receptor (peripheral) gene and schizophrenia in a Japanese sample.
AB  - The benzodiazepine receptor (peripheral) (BZRP) mainly localized on glial cells
      plays a role in neurosteroid synthesis, and increases with glial proliferation.
      We have recently reported a significant decrease in the density of BZRP labeled
      by [3H] PK 11195 in the postmortem brain of chronic schizophrenics, suggesting
      that dysfunctions of the BZRP are involved in the pathophysiology of
      schizophrenia. We screened 11 patients with schizophrenia and 10 controls, which
      were used in a previous postmortem study, for their genomic sequences of the BZRP
      gene in order to find DNA sequence variations. One novel missense polymorphism
      (His162Arg) and another previously reported missense mutation (Ala147Thr) were
      detected. An association study of the identified variations was then performed in
      an extended Japanese sample of 304 schizophrenic patients and 369 controls. While
      there was an increased tendency in the frequency of the 162Arg allele of
      schizophrenics compared to that of the controls (p = 0.0603), no statistically
      significant association with schizophrenia was observed in the Ala147Thr allele
      (p = 0.1016). These results do not suggest that the two missense polymorphisms
      play a major role in the genetic predisposition of schizophrenia in the Japanese
      sample.

PMID- 11215760
TI  - Abnormal protein phosphorylation in post-mortem brain tissue from bipolar
      patients.
AB  - Abnormal phosphorylation has been proposed to be involved in the pathogenesis of
      affective disorders. The present study investigated basal and cAMP-stimulated
      endogenous protein phosphorylation in human post-mortem brain tissue from bipolar
      and schizophrenic patients. Furthermore, basal kinase activity and stimulated
      protein kinase A activity were measured. The frontal and occipital cortex were
      analysed. Using [gamma-32P]ATP as phosphate donor, basal and cAMP-stimulated
      phosphorylation of endogenous proteins was measured in the absence or presence of
      8-Br-cAMP, respectively. The proteins were separated on SDS-gels and the
      radioactivity in the individual bands was measured. We observed a significant
      reduction of 32P incorporation in three protein substrates (15, 16 and 21 kD) in
      frontal cortex of bipolar patients. However, there were no differences in the PKA
      activity between any of the groups. The present study demonstrates abnormal
      phosphorylation of specific proteins in brain tissue obtained from bipolar
      patients in comparison to schizophrenics and controls.

PMID- 11215761
TI  - Hair bundle profiles along the chick basilar papilla.
AB  - Cochlear hair cells play a central role in the transduction of sound into neural
      output. Anatomical descriptions of these cells, and their protruding hair
      bundles, are of fundamental interest since hair cell transduction is dependent on
      hair bundle micromechanics and hair bundle micromechanics depends on hair bundle
      morphology. In this paper, we describe quantitatively changes in the staircase
      profile of the hair bundle along the apical portion of the chick's basilar
      papilla. Images of hair cells from 8 discretely dissected segments of the apical
      3rd of the basilar papilla were archived, and the profile contour outlined by the
      tips of the stereocilia was digitised and curves were fitted by linear and power
      equations. The hair bundles of tall hair cells exhibited both linear and
      curvilinear profiles, which were equally distributed along the papilla. All short
      hair cells in our sample had straight contours. The differences in hair bundle
      shape among the tall hair cells may lead to differential susceptibility to injury
      and some variance in the current-displacement transduction curves due to
      differences in the translation of forces throughout the hair bundle.

PMID- 11215762
TI  - Separation between the digestive and the respiratory lumina during the human
      embryonic period: morphometric study along the tracheo-oesophageal septum.
AB  - An isolated tracheo-oesophageal fistula could be caused by close proximity of the
      epithelia of both organs (O'Rahilly & Muller, 1984; Kluth et al. 1987) at certain
      embryonic stages, the most frequent location being the tracheal bifurcation. Thus
      the relative position and degree of separation between the digestive and the
      respiratory tubes throughout their development may be relevant to the origin of
      this anomaly. The aim of this study was to analyse along the different segments
      of the tracheo-oesophageal septum (TES) where the closest relationship between
      both lumina occurred and what degree of separation was present at each segment.
      Computer imaging techniques were applied on cross sections of a graded series of
      normal human embryos (Carnegie stages (CS) 13-23). In addition, the
      differentiation of the primitive TES was also studied (from CS 12) by light
      microscopy. Between CS 13 and 16 both tubes tended to separate (phase of
      separation), principally at the proximal segments of the laryngopharyngeal and
      the tracheo-oesophageal portions of the TES. During this phase the separation
      between the trachea and oesophagus was wider than between the larynx and pharynx.
      From CS 17 to CS 23 the digestive and respiratory lumina reached their widest
      separation at different levels of the laryngopharyngeal portion. Below these
      levels they tended to come closer together, principally at the proximal segment
      of the tracheo-oesophageal portion, but also at the distal part of the
      laryngopharyngeal portion. During this phase of approximation they reached their
      closest relationship at the proximal (CS 17) and the distal (from CS 18) segments
      of the tracheo-oesophageal portion. When finally the distal segment of the
      trachea (which includes the bifurcation) comes closest to the oesophagus, the
      coats of both organs have already undergone an appreciable differentiation.
      According to these observations, the origin of the most frequent isolated tracheo
      oesophageal fistula at the bifurcation region could not be explained from the
      normal development of the TES.

PMID- 11215763
TI  - The hip joint: the fibrillar collagens associated with development and ageing in
      the rabbit.
AB  - The fibrillar collagens associated with the articular cartilages, joint capsule
      and ligamentum teres of the rabbit hip joint were characterised from the 17 d
      fetus to the 2-y-old adult by immunohistochemical methods. Initially the putative
      articular cartilage contains types I, III and V collagens, but when cavitation is
      complete in the 25 d fetus, type II collagen appears. In the 17 d fetus, the
      cells of the chondrogenous layers express type I collagen mRNA, but not that of
      type II collagen. Types III and V collagens are present throughout life,
      particularly pericellularly. Type I collagen is lost. In all respects, the
      articular cartilage of the hip joint is similar to that of the knee. The joint
      capsule contains types I, III and V collagens. In the fetus the ligamentum teres
      contains types I and V collagens and the cells express type I collagen mRNA; type
      III collagen is confined mainly to its surface and insertions. After birth, the
      same distribution remains, but there is more type III collagen in the ligament,
      proper. The attachment to the cartilage of the head of the femur is marked only
      by fibres of type I collagen traversing the cartilage; the attachment cannot be
      distinguished in preparations localising types III and V collagens. The
      attachment to the bone at the lip of the acetabulum is via fibres of types I and
      V collagens and little type III is present. The ligament is covered by a sheath
      of types III and V collagens. Type II collagen was not located in any part of the
      ligamentum teres. The distribution of collagens in the ligamentum teres is
      similar to that in the collateral ligaments of the knee. Its insertions are
      unusual because no fibrocartilage was detected.

PMID- 11215764
TI  - Fos expression in the midbrain periaqueductal grey after trigeminovascular
      stimulation.
AB  - There is an accumulating body of evidence suggesting that the periaqueductal grey
      (PAG) is involved in the pathophysiology of migraine. Positron emission
      tomography (PET) studies in humans have shown that the caudal ventrolateral
      midbrain, encompassing the ventrolateral PAG, has activations during migraine
      attacks. The PAG may well be involved not only through the descending modulation
      of nociceptive afferent information, but also by its ascending projections to the
      pain processing centres of the thalamus. In this study the intranuclear oncogene
      protein Fos was used to mark cell activation in the PAG following stimulation of
      the trigeminally-innervated superior sagittal sinus (SSS) in both cats and in
      nonhuman primates (Macaca nemestrina). Fos expression in the PAG increased
      following stimulation to a median of 242 cells (interquartile range 236-272) in
      the cat and 155 cells (range 104-203) in the monkey, compared with control levels
      of 35 cells (21-50) and 26 cells (18-33), respectively. Activation was
      predominantly in the ventrolateral area of the caudal PAG suggesting that the PAG
      is involved following trigeminally-evoked craniovascular pain.

PMID- 11215765
TI  - A comparative analysis of the differential spatial and temporal distributions of
      the large (aggrecan, versican) and small (decorin, biglycan, fibromodulin)
      proteoglycans of the intervertebral disc.
AB  - This study provides a comparative analysis of the temporal and spatial
      distribution of 5 intervertebral disc (IVD) proteoglycans (PGs) in sheep. The
      main PGs in the 2 and 10 y old sheep groups were polydisperse chondroitin
      sulphate and keratan sulphate substituted species. Their proportions did not
      differ markedly either with spinal level or disc zone. In contrast, the fetal
      discs contained 2 slow migrating (by composite agarose polyacrylamide gel
      electrophoresis, CAPAGE), relatively monodisperse chondroitin sulphate-rich
      aggrecan species which were also identified by monoclonal antibody 7-D-4 to an
      atypical chondroitin sulphate isomer presentation previously found in chick limb
      bud, and shark cartilage. The main small PG detectable in the fetal discs was
      biglycan, whereas decorin predominated in the 2 and 10 y old IVD samples; its
      levels were highest in the outer annulus fibrosus (AF). Versican was most
      abundant in the AF of the fetal sheep group; it was significantly less abundant
      in the 2 and 10 y old groups. Furthermore, versican was immunolocalised between
      adjacent layers of annular lamellae suggesting that it may have some role in the
      provision of the viscoelastic properties to this tissue. Versican was also
      diffusely distributed throughout the nucleus pulposus of fetal IVDs, and its
      levels were significantly lower in adult IVD specimens. This is the first study
      to identify versican in ovine IVD tissue sections and confirmed an earlier study
      which demonstrated that ovine IVD cells synthesised versican in culture (Melrose
      et al. 2000). The variable distribution of the PGs identified in this study
      provides further evidence of differences in phenotypic expression of IVD cell
      populations during growth and development and further demonstrates the complexity
      of the PGs in this heterogeneous but intricately organised connective tissue.

PMID- 11215766
TI  - Cerebellar connections to the dorsomedial and posterior nuclei of the
      hypothalamus in the rat.
AB  - The stimulation or ablation of cerebellar structures has produced a variety of
      visceral responses, indicating a cerebellar role in visceral functions. Studies
      using anterograde and retrograde tracing methods have revealed connections
      between the hypothalamus and cerebellar structures. The aim of this study is to
      investigate the cerebellar connections of the dorsomedial (DMH) and posterior
      hypothalamic nuclei using retrograde axonal transport of horseradish peroxidase
      (HRP). In the present study, micro-injection of HRP restricted within the borders
      of the DMH showed that the projections of this nucleus are not uniform throughout
      its extent. The posterior DMH receives projections from the cerebellum, whereas
      the anterior DMH does not. These projections were from the (greatest to least
      concentration) lateral (dentate), anterior interposed (emboliform), and medial
      (fastigial) cerebellar nuclei. In addition, both the anterior and posterior DMH
      receive projections from various areas of the brainstem which confirms earlier
      studies and provides detailed descriptions. This study also demonstrates the
      distribution of labelled neurons to cerebellar and brainstem nuclei following HRP
      injection into the posterior hypothalamic nucleus. It provides clear evidence for
      a direct cerebellar nuclei-posterior DMH and cerebellar nuclei-posterior
      hypothalamic nucleus connections. We suggest that the brainstem reticular nuclei
      and other connections, such as the solitary, trigeminal and vestibular nuclei, of
      both DMH and posterior hypothalamus may contribute to the indirect
      cerebellohypothalamic connections. These observations offer a new perspective on
      the question of how the cerebellum may influence autonomic activity.

PMID- 11215768
TI  - The structural organisation of sperm head components of the wombat and koala
      (suborder: Vombatiformes): an enigma amongst marsupials.
AB  - The sperm head structural organisation of the koala and hairy-nosed wombat, and
      the effects of varying concentrations of the ionic detergent, Triton X-100, on
      its component parts, were determined by electron microscopy. Although alike in
      form between the 2 species, the sperm nucleus of the former, but not the latter,
      had nuclear vacuoles and appeared to be more easily dispersed by the Triton X
      100. The structure of the acrosome of the spermatozoon was similar between the 2
      species and, in both, previously undescribed thin posterior and lateral segments
      were found to be present. It is suggested that this thin segment may facilitate
      sperm-zona and/or sperm-oolemma binding and fusion.

PMID- 11215767
TI  - Carbohydrate moieties of the interstitial and glandular tissues of the amphibian
      Pleurodeles waltl testis shown by lectin histochemistry.
AB  - The amphibian testis is a useful model because of its zonal organisation in
      lobules, distributed along the cephalocaudal axis, each containing a unique germ
      cell type. Sperm empty lobules form the so-called glandular tissue at the
      posterior region of the gonad. Androgen production is limited to the cells of the
      interstitial tissue surrounding lobules with spermatozoa bundles and to the cells
      of the glandular tissue. In this work, we have studied the distribution of
      terminal carbohydrate moieties of N- and O-linked oligosaccharides in the
      interstitial and glandular tissue of the Pleurodeles waltl testis, by means of 14
      lectins combined with chemical and enzymatic deglycosylation pretreatment. Some
      differences in glycan composition between the interstitial and the glandular
      tissue have been detected. Thus in both tissues, N-linked oligosaccharides
      contained mannose, Gal(beta1,4)GlcNAc, and Neu5Ac(alpha2,3)Gal(beta1,4)GlcNAc,
      while O-linked oligosaccharides contained Con A-positive mannose,
      Gal(beta1,3)GalNAc, Gal(beta1,4)GlcNAc, Neu5Ac(alpha2,3)Gal(beta1,4)GlcNAc, and
      WGA-positive GlcNAc. Fucose was also detected in both tissues. However, GlcNAc on
      N-linked oligosaccharides and GalNAc and Neu5Ac(alpha2,6)Gal/GalNAc on both N-
      and O-linked oligosaccharides were found only in the interstitial tissue. As
      glandular tissue cells arise from the innermost cells of interstitial tissue that
      surround lobules, the differences in the glycan composition of interstitial and
      glandular tissue shown in this work may be related to the start of androgen
      synthesis when steroid hormone (SH)-secreting cells develop.

PMID- 11215769
TI  - Glial fibrillary acidic protein and vimentin immunoreactivity of astroglial cells
      in the central nervous system of adult Podarcis sicula (Squamata, Lacertidae).
AB  - The present immunoperoxidase cytochemical study describes the distribution of
      glial intermediate filament molecular markers, glial fibrillary acidic protein
      (GFAP) and vimentin, in the brain and spinal cord of the adult lizard, Podarcis
      sicula. GFAP immunoreactivity is abundant and the positive structures are mainly
      represented by fibres of different lengths which are arranged in a rather regular
      radial pattern throughout the CNS. They emerge from generally immunopositive
      radial ependymoglia and are directed from the ventricular wall towards the
      meningeal surface. The glial fibres give origin to endfeet which are apposed to
      the blood vessel walls and subpial surface where they form the continous
      perivascular and subpial glia envelopes, respectively. In the optic tectum and
      spinal cord, star-shaped astrocytes coexist with radial glia. In the spinal cord,
      cell bodies of immunopositive radial glia are displaced from the ependyma. While
      vimentin immunoreactive elements are almost completely absent in the brain except
      for a few diencephalic radial fibres, the spinal cord ependyma exhibits a clearly
      vimentin positivity and no GFAP staining. In the Podarcis CNS the
      immunocytochemical response of the astroglial intermediate filaments appears
      typical of mature astroglia cell lineage since it fundamentally expresses GFAP
      immunoreactivity. Moreover, this immunocytochemical study shows that the Podarcis
      fibre pattern with predominant radial glial cells is morphologically more
      immature than in avians and mammalians, a condition suggesting that reptiles
      represent a fundamental step in the phylogenetic evolution of vertebrate
      astroglial cells.

PMID- 11215770
TI  - The existence of the vomeronasal organ in postnatal chimpanzees and evidence for
      its homology with that of humans.
AB  - It is currently thought that New World monkeys, prosimians, and humans are the
      only primates to possess vomeronasal organs (VNOs) as adults. Recent studies of
      the human VNO suggest that previous investigations on Old World primates may have
      missed the VNO. We examined nasal septa from the chimpanzee (Pan troglodytes)
      grossly and histologically for comparison with nasal septa from humans, Old World
      monkeys (Macaca fascicularis, M. nemistrina) and prosimian primates (Microcebus
      murinus, Otolemur garnettii). Grossly, chimpanzees had depressions on the nasal
      septum similar to fossae reported anterior to the VNO openings in humans.
      Histologically, chimpanzees and humans had bilateral epithelial tubes which were
      above the superior margin of the paraseptal cartilages (vomeronasal cartilage
      homologue). The epithelial tubes had a homogeneous ciliated epithelium. These
      structures were thus positionally and structurally identical to the human VNO and
      unlike the well-developed prosimian VNOs which were surrounded by vomeronasal
      cartilage. Macaques had no structures which resembled the VNO of either the
      prosimians or humans. The results demonstrate that the VNO is present postnatally
      in the chimpanzee and is almost identical to the human VNO in its anatomical
      position and histological structure. This in turn suggests that the reported
      absence of the VNO in at least some adult Old World primates is artifactual, and
      that further study may provide evidence for its existence in other species.

PMID- 11215771
TI  - Semiquantitative analysis of collagen types in the hypertrophied left ventricle.
AB  - Cardiac fibrosis is a characteristic feature of left ventricular hypertrophy. The
      aim of this study was to develop a simple and accurate method to analyse collagen
      accumulation, taking into account the variation in cardiac muscle fibre
      orientation and nonuniform collagen distribution. This technique was used to
      determine the amount and types of collagen that accumulate during pressure
      overload cardiac hypertrophy. These data were correlated with myocyte size, and
      with the diastolic stress-strain relationship of the intact myocardium. Myocyte
      size was significantly increased in the hypertrophied hearts, compared with age
      and sex matched controls (control 363 +/- 25 microm2 vs experimental 244 +/- 12
      microm2; mean +/- S.E., P < 0.05). No overall collagen accumulation was observed
      in the hypertrophied hearts, but a significant increase in collagen I was found
      with a reduction in the amount of collagen III in experimental animals. Since no
      increase in diastolic stiffness of the hearts was observed, these results
      indicate that an increase in the overall collagen content of the heart, rather
      than the upregulation of a specific type, may be necessary to cause diastolic
      dysfunction.

PMID- 11215772
TI  - Actin polymerisation during morphogenesis of the acrosome as spermatozoa undergo
      epididymal maturation in the tammar wallaby (Macropus eugenii).
AB  - In the tammar wallaby (Macropus eugenii), post-testicular acrosomal shaping
      involves a complex infolding and fusion of the anterior and lateral projections
      of the scoop-shaped acrosome into a compact button-like structure occupying the
      depression on the anterior end of the sperm nucleus. The present study has
      generated cytochemical and histological evidence to demonstrate that the
      occurrence of actin filaments (F-actin, labelled by Phalloidin-FITC) in the
      acrosome of tammar wallaby spermatozoa is temporally and spatially associated
      with the process of acrosomal shaping in the epididymis, through a pool of
      monomeric actin (G-actin, labelled by Rh-DNase I) present in the acrosome
      throughout all stages of epididymal maturation. F-actin was not detected in the
      acrosome of testicular spermatozoa, but was found in the infolding and condensing
      acrosome of caput and corpus epididymal spermatozoa. When the spermatozoa
      completed acrosome shaping in the cauda epididymidis, F-actin disappeared from
      the acrosomal area. The strong correlation between the occurrence of F-actin and
      the events of acrosomal shaping suggested that the post-testicular shaping of the
      acrosome might depend on a precise succession of assembly and disassembly of F
      actin within the acrosome as the spermatozoa transit the epididymis. Thus, actin
      filaments might play a significant role in the acrosomal transformation, as they
      are commonly involved in morphological changes in somatic cells.

PMID- 11215773
TI  - Surgical treatment of differentiated thyroid carcinoma in children.
AB  - INTRODUCTION: A retrospective clinical study was carried out to define the
      appropriate definitive operation for treating differentiated thyroid carcinoma
      (DTC) in children. METHODS: During a 24-year period between 1974 and 1997, 18
      children younger than 16 years at presentation were histopathologically proven to
      have DTC in Hacettepe University Children's Hospital, Department of Pediatric
      Surgery. The clinical characteristics on admission, operative findings,
      procedures, operative complications, and follow-up results according to
      definitive operations were compared to find out the appropriate procedure.
      RESULTS: There were 15 female (83.3%) and 3 male (16.7%) patients yielding a
      female/male ratio of 5 and the average age being 11.6+/-2.1 years. The definitive
      operations were near total thyroidectomy, total thyroidectomy, near total
      thyroidectomy plus excision of the only palpable lymph nodes (EPLN), total
      thyroidectomy plus EPLN and total thyroidectomy plus modified radical neck
      dissection (MRND) in 3 (16.7%), 3 (16.7%), 1 (5.5%), 9 (50%), and 2 (11.1 %)
      patients respectively. Among the patients having undergone near total
      thyroidectomy, one had recurrences both in the thyroid bed and the cervical lymph
      nodes. In a patient undergoing almost total thyroidectomy and EPLN, recurrences
      involving thyroid bed, cervical lymph nodes and lungs were encountered. In 9
      patients undergoing total thyroidectomy and EPLN 4 had cervical lymph node
      recurrences. Complications have included permanent hypoparathyroidism following
      total thyroidectomy and MRND. Additionally, operations for recurrences resulted
      in unilateral permanent recurrent laryngeal nerve palsies in two patients.
      CONCLUSIONS: Total thyroidectomy with evaluation of central compartment, entire
      jugular chain and region of lower spinal accessory nerve and removal of all
      identifiable lymph nodes seems to be the most appropriate surgical treatment for
      DTC encountered in children.

PMID- 11215774
TI  - The characteristics of mediastinal neuroblastoma.
AB  - The prognosis of mediastinal neuroblastoma has been reported to be better than
      for other neuroblastomas. The reason for this is however not clear. Furthermore,
      a comparison between mediastinal neuroblastoma and the other neuroblastomas has
      been rarely reported so far. In this study, the characteristics of mediastinal
      neuroblastoma (84 cases) are investigated and compared with those of other
      neuroblastomas (440 cases). Regarding clinical factors, the age distribution and
      the rate of cases detected at mass screening were similar in both groups.
      According to Evan's staging system, the rates of early stage (I, II) were 62% in
      the mediastinal neuroblastoma and 38% in the other neuroblastomas (p<0.001).
      Regarding the biological prognostic factors, a favorable histology based on
      Shimada's classification was found in 100% (35/35) of the mediastinal
      neuroblastoma cases and in 85% (112/132) of the other neuroblastoma cases
      (p<0.05). With regard to N-myc amplification, all of the examined 42 cases in
      mediastinal neuroblastoma had a N-copy number of less than 10 copies, while 32 of
      the examined 263 cases (12%) in the other neuroblastomas had an amplification of
      N-myc of more than 10 copies (p<0.05). The 5-year survival rates were 78% in the
      mediastinal neuroblastoma and 59% in the other neuroblastomas, respectively. Of
      the cases who underwent an incomplete resection of primary tumors in localized
      neuroblastoma, the 5-year survival rate of the mediastinal neuroblastoma cases
      was significantly more favorable than that of the other neuroblastomas. The
      majority of mediastinal neuroblastoma cases showed an early stage and favorable
      prognostic factors. It is likely that the clinical and biological prognostic
      factors of the tumor are therefore more closely correlated with the outcome of
      mediastinal neuroblastoma rather than the degree of the surgical resection.
      Regarding the treatment for mediastinal neuroblastoma, it is most important to
      evaluate the biology of the tumor after surgical resection.

PMID- 11215775
TI  - Gastroesophageal reflux and diaphragmatic motility after repair of congenital
      diaphragmatic hernia.
AB  - At the Department of Pediatric Surgery in Graz, 31 boys and 23 girls were
      operated on for congenital diaphragmatic hernia (CDH) from 1978 to 1994. In 49
      patients the defect was on the left, in five on the right side. In 46 cases, the
      hernia was diagnosed within the first week of life; in eight children at a later
      date. 19 children (35%) died. 25 of the 35 survivors (71%) came to a follow-up
      examination on average 9.4 (1-17) years after the operation. 24 h pH-monitoring
      or manometry and Upper G.I. series revealed pathological gastroesophageal reflux
      (GER) in 16 patients. Nine children were treated conservatively; in seven
      patients an antireflux procedure was performed. A thoracic position of the
      stomach or left liver lobe, presence of a hernial sac, gestational age, prenatal
      diagnosis, use of a patch or severity of lung hypoplasia did not significantly
      influence the incidence of GER. In three patients, a hiatal hernia was found. The
      motility of the diaphragm was documented with M-mode sonography (n = 18); a
      restricted motility could be demonstrated in five patients. GER is very common in
      patients after repair of CDH. We recommend long-term follow-up with special
      interest in respect of GER.

PMID- 11215776
TI  - Long-term investigations after pyloromyotomy for infantile pyloric stenosis.
AB  - Between 1919 and 1941, 71 infants suffering from pyloric hypertrophy were
      operated on by Ramstedt performing an extramucosal pyloromyotomy. Of these
      patients, we could identify and investigate 41. Four out of 31 long-term
      surviving patients have been Billroth II-resected (BII). One of these needed re
      resection because of an anastomotic ulcer. None of all the long-term survivors
      developed a carcinoma. Two patients were treated conservatively because of
      gastritis and one because of esophagitis. All patients, except the one requiring
      re-resection and one suffering from maldigestion, were absolutely free of
      complaints. The average time between operation and re-checking was 57 years. The
      oldest patient was examined 72 years after the operation.

PMID- 11215777
TI  - Early biliary pseudolithiasis during ceftriaxone therapy for acute pyelonephritis
      in children: a prospective study in 34 children.
AB  - The prolonged biological half-life of Ceftriaxone, allowing once-daily dosing,
      has contributed to the large diffusion of this third-generation cephalosporin in
      children. Ceftriaxone is known to induce reversible precipitates in the
      gallbladder of adults and children. A prospective study was conducted during 1997
      in 34 children admitted for the treatment of acute pyelonephritis. Ceftriaxone
      (intravenous daily single-dose of 50 mg/kg under 2g/day) was initially used. A
      first gallbladder sonogram, performed before the first or second injection, was
      normal in all cases. A second evaluation was performed before the fifth and last
      injection. On this second evaluation the presence of one (n = 3) or two
      gallstones was recorded in 5 children (15%) on a sonogram made after 3 (n = 4) or
      5 (n = 1) injections. Their median age was 7 years (range 4 months to 11 years).
      All five children remained symptom-free and the normalization of the sonographic
      patterns was constant on the last sonogram performed 2 (n = 1), 3 (n = 2) and 5
      months (n = 2) after discontinuation of Ceftriaxone. This study confirms the
      possibility of precocious biliary lithiasis under Ceftriaxone therapy in
      childhood and their spontaneous dissolution after discontinuation of the drug.
      They seem unpredictable and independent of the age, sex in a cohort homogeneous
      for the nature of the infection, modality of a short- and low-dose therapy.
      Clinicians and radiologists should be aware of this complication as an etiology
      of a so-called primary cholelithiasis and to prevent anxiety or unnecessary
      cholecystectomy. The antibacterial and pharmacokinetic benefits of Ceftriaxone
      outweigh the problem of reversible biliary pseudolithiasis with this drug.

PMID- 11215778
TI  - Carcinoid tumors of the appendix in children--epidemiology, clinical aspects and
      procedure.
AB  - INTRODUCTION: Incidental detection of a carcinoid tumor of the appendix after
      appendectomy is often accompanied by uncertainty about the further procedure. The
      tumor frequency in our own patient population, the further course in these
      children and a practicable follow-up protocol have to be determined. PATIENTS AND
      METHODS: All appendectomies performed between January 1, 1982, and December 31,
      1996, were retrospectively evaluated with regard to carcinoids, monitoring the
      clinical course, and follow-up of the patients involved. RESULTS: A total of 4747
      appendectomies were performed, 8 children had a histologically manifest carcinoid
      (0.169%). All patients were symptom-free in the further course, no metastases or
      signs of a carcinoid were documented during a mean follow-up period of 6.6 years.
      CONCLUSION: The youngest patient with a metastasizing carcinoid tumor of the
      appendix reported in the literature was 19 years old. Nevertheless, all younger
      patients should undergo regular follow-ups; this is done in our department by
      serum serotonin and chromogranin A determination.

PMID- 11215779
TI  - Proximal segment histology of resected bowel in Hirschsprung's disease predicts
      postoperative bowel function.
AB  - The authors present an overview of 101 patients operated for Hirschsprung's
      disease by Rehbein procedure. Special attention is directed to the
      histomorphological findings in the proximal segment of the resected bowel
      specimens. A strong link was confirmed between these specific features and
      postoperative bowel function. A histologically regular proximal bowel segment
      generally predicted good postoperative bowel function with a constipation rate of
      10.5%. In patients with intestinal neuronal dysplasia (IND) of the proximal
      segment the overall clinical result remained unchanged, although the constipation
      rate rose to 17.8%. Postoperative bowel function was seriously affected in cases
      characterized by proximal segment hypoganglionosis with a constipation rate of
      23.1% and an additional 7.7% with encopresis. Finally, the distinct group of
      children with aganglionosis of the proximal segment followed a complicated
      postoperative course with secondary bowel resections and recurrent episodes of
      enterocolitis. In addition, the authors state their general observation that
      histological findings become less important whenever a more extensive resection
      than left hemicolectomy is required. Discussing the results, guidelines are given
      to further patient treatment once the particular proximal segment histology is
      diagnosed.

PMID- 11215780
TI  - Quantitation of defecation function using radionuclide artificial stool in
      children with chronic constipation.
AB  - We aimed to investigate the value of scintigraphically determined evacuation
      fraction (EVF) as an objective follow-up criterion in medically treated children
      with chronic constipation, and to evaluate the relation between patients'
      symptoms and rectal emptying rate. Thirty children (m: 22, f: 8, mean age: 8.9 +/
      0.9 year) suffering from chronic constipation were assessed by scintigraphic
      evacuation study. All patients underwent anal manometric and scintigraphic
      examinations before their therapy was started. During 3 months, they received
      conventional laxative treatment for constipation, and scintigraphic studies were
      repeated in 20 of 30 patients. Scintigraphic examinations consisted of
      instillation of artificial stool into the rectum up to the volume impending
      rectal evacuation, and acquisition of pre- and post-evacuation images. EVF values
      were then calculated from the images using a fixed region of interest. All of the
      patients had high resting anal canal pressure (75 +/- 12 mmHg) and had positive
      rectoanal inhibitory reflex. In 14/20 patients (70%) who benefited from therapy,
      mean EVF changed from 43.6% to 62.2% (p < 0.001), while decreasing in 6120 who
      did not benefit. The volume arousing rectal evacuation was significantly lower at
      the second scintigraphic study (261 +/- 98 ml) than the first study (354 +/- 138
      ml) (p < 0.05). As a conclusion: 1) EVF was low in chronically constipated
      children, 2) it was improved after conventional laxative treatment and, 3)
      radionuclide EVF determination may be a useful method for follow-up.

PMID- 11215781
TI  - Type 1-primary cutaneous meningioma of the scalp.
AB  - Type 1-primary cutaneous meningioma is a rare and often clinically unsuspected
      lesion of the scalp, forehead or paravertebral region which occurs at birth or
      during childhood. The pathogenesis of these lesions still remains uncertain.
      Several authors have emphasized that type 1-cutaneous meningiomas are not real
      tumors but sequestrated meningoceles or heterotopic meningeal nodules of the
      skin. Nevertheless, the search for an intracranial or intravertebral connection
      should be carried out. We describe the clinical and pathological features of a
      congenital type 1-meningioma of the vertex. No cranial defect or intracranial
      tumor was found. However, the cutaneous lesion was directly linked to a large
      cranial vein. The purpose of this study was to illustrate this rare lesion and to
      indicate the possible surgical risks and the pathological characteristics.

PMID- 11215782
TI  - Giant-cell fibroblastoma and dermato fibro sarcoma protuberans: the same tumoral
      spectrum? Report of two cases of association in children.
AB  - We describe two cases of giant-cell fibroblastoma (GCF) with dermato fibro
      sarcoma protuberans (DFSP) component, occurring in two children in a chest wall
      localization. One case recurred 1 year later. The two patients were tumor-free 12
      and 8 years later. GCF is a rare mesenchymal cutaneous and subcutaneous tumor
      reported mostly in the first two decades of life. Dermato fibro sarcoma
      protuberans, occurring preferentially in adults, is a rare skin tumor with a
      pronounced tendency to local recurrence. Some cases of association of recurrence
      of GFC under the form of DFSP have been reported, raising the question of a
      continuum between the two tumors. The treatment of choice of the two tumors is a
      wide local excision.

PMID- 11215783
TI  - Effective percutaneous transhepatic biliary drainage for cystic dilatation of the
      intrahepatic biliary system in biliary atresia: a case report.
AB  - We report on a 16-year old girl with postoperative biliary atresia developing
      cystic dilatation of the intrahepatic biliary system (CDIB) with abdominal pain,
      which was relieved after percutaneous transhepatic biliary drainage (PTBD). A
      cyst was detected in segment 4 of the liver at the age of 14 years. She developed
      severe right hypochondralgia, subfever and liver dysfunction. Percutaneous
      cholangiogram showed a solitary cyst without communication and a PTBD tube was
      placed within the cyst. After lavage of the cyst through PTBD, CDIB was re
      communicated with the intestine and the pain was relieved with reduction of the
      cyst size. From this experience, PTBD may be a less invasive treatment as the
      first choice for non-communicating CDIB and may alleviate the symptoms when
      recommunication with the intestine is obtained.

PMID- 11215784
TI  - Internal drainage into an Onlay-Roux-en-Y jejunal loop in isolated pancreatic
      injury with ductal transection: short-term and long-term follow-up in two
      pediatric cases.
AB  - Two pediatric cases of isolated pancreatic injury treated by internal drainage
      into an Onlay-Roux-en-Y jejunal loop are reported. The discussion concerns the
      difficulties of early diagnosis, the importance of endoscopic retrograde
      cholangiopancreatography (ERCP) in surgery and the reasons for the choice of
      internal drainage by Onlay-Roux-en-Y jejunal loop in our two cases.

PMID- 11215785
TI  - A case of mesenteric cysts caused by abdominal tuberculosis.
AB  - We report on a 10-year old boy suffering from chronic abdominal pain. Clinical
      examination and imaging modalities revealed that the patient had mesenteric
      cysts. Exploratory laparotomy revealed two mesenteric cysts of various size and
      multiple enlarged mesenteric lymph nodes. M. tuberculosis was identified and
      histology of the specimens proved the existence of abdominal tuberculosis.

PMID- 11215786
TI  - Meconium periorchitis: case report and literature review.
AB  - Meconium periorchitis (MPO) is an uncommon entity associated with healed meconium
      peritonitis. The typical presentation is soft hydrocele at birth which becomes
      harder in weeks as the meconium calcifies. It mimics a scrotal mass, and, without
      knowledge of this rare disease, this may lead to unnecessary surgery. Both the
      masses and the calcifications have the tendency to resolve spontaneously without
      compromising the testicle. Sonographic features together with an abdominal plain
      film are diagnostic, and visualization of the normal testicle may be helpful in
      differentiating this tumor-like lesion from scrotal tumors. A case of a meconium
      periorchitis is reported on and the radiological and histological features are
      discussed with a literature review on the subject.

PMID- 11215787
TI  - Certification of poliomyelitis eradication--Western Pacific Region, October 2000.
AB  - On October 29, 2000, the Regional Commission for the Certification of
      Poliomyelitis Eradication certified that the Western Pacific Region (WPR) of the
      World Health Organization (WHO) is free of indigenous wild poliovirus
      transmission. The last known case of indigenous poliovirus transmission occurred
      in Cambodia in March 1997 in a 15-month-old girl. WPR is the second of the six
      WHO regions to be certified as poliomyelitis-free; the first was the Region of
      the Americas in 1994. WPR comprises 37 countries and territories (Figure 1) with
      an estimated 1.6 billion persons (27% of the world's population).

PMID- 11215788
TI  - Progress in development of immunization registries--United States, 2000.
AB  - Immunization registries are confidential, population-based, computerized
      information systems that attempt to collect vaccination data about all children
      within a geographic area. Registries are an important tool to increase and
      sustain high vaccination coverage by consolidating vaccination records of
      children from multiple providers, generating reminder and recall vaccination
      notices for each child, and providing official vaccination forms and vaccination
      coverage assessments. One of the national health objectives for 2010 is to
      increase to 95% the proportion of children aged <6 years who participate in fully
      operational population-based immunization registries (objective 14.26). To assess
      the status of immunization registry development, CDC analyzed self-reported data
      from 62 immunization grantees on the basis of data from the 2000 Immunization
      Registry Annual Report (IRAR). This report summarizes the results of this
      analysis, which indicate that approximately half of the grantees are operating
      population-based immunization registries that target their entire catchment
      areas; however, approximately 75% of children aged <6 years still need to be
      included in an immunization registry to reach the national health objective.

PMID- 11215789
TI  - Recommended childhood immunization schedule--United States, 2001.
AB  - Each year, CDC's Advisory Committee on Immunization Practices (ACIP) reviews the
      recommended childhood immunization schedule to ensure that it remains current
      with changes in manufacturers' vaccine formulations, revisions in recommendations
      for the use of licensed vaccines, and recommendations for newly licensed
      vaccines. This report presents the recommended childhood immunization schedule
      for 2001 (Figure 1) and documents the changes that have occurred since the
      January 2000 publication.

PMID- 11215790
TI  - Association of surfactants and polymers studied by luminescence techniques.
AB  - Light emission spectroscopy has unique possibilities for the study of central
      issues of surfactants and associating polymers. With the help of luminescent
      probes, information may be obtained on matters such as molecular association,
      microstructure, and molecular dynamics; this constitutes an important
      contribution to the understanding and control of macroscopic properties, as well
      as biological function and technical applications. Important aspects of these
      systems considered in this review are: formation of micelles and hydrophobic
      microdomains; aggregation numbers of surfactants; shape of molecular aggregates;
      size of droplets in water or in oil in microemulsions; formation and stability of
      vesicles; intra- vs. intermolecular association in polymers; conformational
      changes in polymers; polymer-surfactant association; surfactant organization in
      adsorbed layers; kinetic aspects regarding the formation and disintegration of
      self-assembly structures; residence times of molecules in microdomains and
      migration of active molecules.

PMID- 11215791
TI  - Diffusing probe measurements in Newtonian and elastic solutions.
AB  - The diffusion coefficients of polystyrene latex spheres and hematite particles in
      both Newtonian and elastic liquids have been measured using dynamic light
      scattering. The diffusion coefficients of the latex particles measured in
      glycerol/water (Newtonian) solutions obey Stokes-Einstein behaviour over a range
      of solvent viscosities and temperatures. Two apparent diffusion coefficients for
      the particles are measured in visco-elastic polyacrylamide and polyacrylate
      solutions and are designated Dfast and Dslow. The apparent fast diffusion
      coefficients measured in the elastic solutions show an increase to a maximum,
      above that measured in the solvent water, with increasing polyelectrolyte
      concentration. At higher polyelectrolyte concentrations the observed Dfast values
      decrease below the value obtained in the solvent water. Dfast increases with the
      scattering vector squared (q2) while Dslow, is independent of q2.

PMID- 11215792
TI  - Supra-aggregates.
AB  - Mixtures of oil (isooctane), water, and a double-chained ionic surfactant,
      Cu(AOT)2 [copper(II) bis(2-ethylhexyl)sulfosuccinate] form equilibrium phases
      consisting of spontaneous emulsions thermodynamically stable systems. The
      experimental conditions are such that the head polar group of the surfactant is
      totally hydrated. The emulsion droplets are comprised of supra aggregates,
      lamellar spherulites in which interior and exterior are bicontinuous
      microemulsions. The microstructures and component ratios can be predicted from
      elementary considerations that require only the notion of local and global
      packing constraints. The phenomenon of supra aggregation, microphases within any
      topologically closed container, in equilibrium with an external phase, appears
      quite general. The results throw some light on the meaning of 'phase' in
      mesostructured fluids.

PMID- 11215793
TI  - Aggregation numbers and microstructure characterization of self-assembled
      aggregates of poly(ethylene oxide) surfactants and related block-copolymers,
      studied by spectroscopic methods.
AB  - This review presents typical examples of micellar size measurements and
      structural characterization of self-assembled systems as determined with
      spectroscopic methods, selected from our representative results accumulated in
      recent years of systematic studies. The choice of examples has aimed at
      emphasizing the potentiality of the methods used in the study of poly(ethylene
      oxide) (PEO) surfactants. By using the time-resolved fluorescence quenching
      method aggregation numbers have been determined for direct and reverse micelles
      as well as for micelle-like clusters formed in (bio)polymer-surfactant solutions.
      By using specific spectral parameters of a variety of properly chosen molecular
      probes [fluorescence, UV-VIS and electron spin resonance (ESR) spin probes],
      problems such as hydration degree and profile of the PEO chains, local viscosity,
      ordering and packing of surfactant chains have been addressed. The intention was
      to correlate results obtained from different spectroscopic methods and to refer
      all polarity data to a common scale, such as Kosower's polarity factor.

PMID- 11215794
TI  - Various aspects of the constraints imposed on the photochemistry of systems in
      porous silica.
AB  - This manuscript briefly reviews the photochemistry of organic molecules on porous
      silica (or SiO2). To gain an understanding of the chemistry on silica, data are
      displayed and discussed with respect to studies in homogeneous solution. In
      particular, the exact dimensionality of kinetic processes on porous SiO2 is a
      matter for debate. Hence, units of concentration of an adsorbate on the surface
      are expressed as moles per nanometer squared and as moles per liter, in order to
      compare with solution. Many studies show that organic molecules adsorb to SiO2
      via the surface silanol (or surface hydroxyl OH) groups. The adsorption is
      heterogeneous, due to various clusters of silanol groups and to charge transfer
      (CT) sites. Photophysical studies clearly show these effects. The photo-induced
      reactions on SiO2 may be described by 'fractal' approaches, but a 'Gaussian'
      approach is often more useful to the photochemist. Photo-induced reactions occur
      via movement of the reactants on the surface, as in the case of the Langmuir
      Hinshelwood (LH) mechanism or, as in the case of the Eley-Rideal (ER) mechanism,
      by bombardment of a surface bound excited state by a gaseous reactant, such as
      O2. Quenching of excited singlet states by O2 produces excited triplet states,
      which in turn are quenched to give singlet molecular oxygen. At room temperature
      the O2 quenching process on silica occurs by both mechanisms to approximately the
      same extent. However, the LH mechanism is dominant at lower temperatures and the
      ER mechanism is dominant at higher temperatures. Some quenchers, including carbon
      tetrachloride and tetranitromethane only quench by the LH mechanism giving rise
      to static quenching and chloro or nitro derivatives of the excited state. Photo
      induced electron transfer between excited arenes and amines occurs readily, but
      the ionic products are short-lived compared to solution. This is due to the
      limited diffusion of the products on the surface, which in turn promotes back
      electron transfer. Photoionization of arenes occurs on SiO2 via a two-photon
      process and gives very long-lived ions compared to solution. This is due to
      trapping of the photo-produced electrons by the SiO2 itself. Finally, the effects
      of co-adsorbants, including solvents, surfactants, and polymers, in
      photoreactions at the SiO2 surface are considered. The review ends with
      suggestions for future studies.

PMID- 11215795
TI  - Phase diagrams of systems with cationic alpha-helical membrane-spanning model
      peptides and dioleoylphosphatidylcholine.
AB  - Ternary phase diagrams have been constructed of systems with
      dioleoylphosphatidylcholine (DOPC) and water, and two alpha-helical membrane
      spanning model peptides, KKLAKK16[KK(LA)6KK] and KKLAKK20[KK(LA)8KK]. It was
      found that these peptides induced non-lamellar liquid crystalline phases. The
      amount of peptide needed for this phase transition depended on the water content
      and the temperature; and for KKLAKK16, a smaller amount of peptide was needed to
      induce non-lamellar phases than for KKLAKK20. Both peptides were found to induce
      an isotropic phase, and KKLAKK16 also induced a reversed hexagonal phase. Both
      peptides may also reside in a lamellar (L(alpha)) phase. When magic angle
      spinning (MAS) 31P NMR experiments were performed on samples containing the
      L(alpha) phase and an isotropic phase, four different isotropic chemical shifts
      were observed. The isotropic chemical shifts could be assigned to the phases,
      using spinning sidebands to calculate the chemical shift anisotropy (CSA)
      corresponding to each isotropic shift. MAS 13C NMR also indicated a difference in
      the aggregational state of the peptides between the L(alpha) and isotropic
      phases. The phase diagrams were compared to the phase diagram of a similar model
      peptide, AWW(LA)5WWA in systems with DOPC and water. It was concluded that the
      phase behaviour was influenced by both electrostatic interactions between the
      peptides and the lipid headgroups, and the difference between the hydrophobic
      length of the peptide and the hydrophobic thickness of the lipid bilayer.

PMID- 11215796
TI  - Solute exchange between surfactant micelles by micelle fragmentation and fusion.
AB  - Stopped-flow time-scan experiments on both Triton X-100 (TX100) micelle and
      sodium dodecylsulfate (SDS) micelles, with the pyrene-containing triglyceride 1
      as a probe, establish that there are two distinct solute exchange mechanisms with
      rates on the time scale of milliseconds to minutes. One process exhibits second
      order kinetics with a rate proportional to the concentration of empty micelles.
      For TX100 micelles, this process is rapid (k2 approximately 10(6) M(-1) s(-1) at
      24.6 degrees C) and is characterized by an activation energy of 160 kJ mol(-1).
      From the fact that this rate is nearly independent of the structure of the probe
      we infer that the exchange involves micelle fusion to form a short-lived super
      micelle, followed by fragmentation to form two normal (or 'proper') micelles. The
      rate of the first-order process decreases as the size of the probe increases (1
      octylpyrene > 1-dodecylpyrene > 1). For SDS, both rates are very sensitive to the
      salt (NaCl) concentration. All indications point to this exchange process
      involving rate-limiting fragmentation of the micelle into two sub-micelles, these
      in turn grow back to normal micelles by addition of surfactant monomers or by
      collision with other sub-micelles. We explain the dependence of this rate on the
      nature of the probe by suggesting that only sub-micelles of a certain size are
      capable of carrying the probe with them as they separate from the original
      micelle.

PMID- 11215797
TI  - The dipole potential of phospholipid membranes and methods for its detection.
AB  - The dipole potential is an electrical potential within phospholipid membranes,
      which arises because of the alignment of dipolar residues of the lipids and/or
      water dipoles in the region between the aqueous phases and the hydrocarbon-like
      interior of the membrane. For a fully saturated phosphatidylcholine membrane, its
      value is believed to be in the range 220-280 mV, positive in the membrane
      interior. This results in an enormous electric field strength within the membrane
      of 10(8)-10(9) Vm(-1). The dipole potential is thus likely to have great
      significance in controlling the conformation of ion-translocating membrane
      proteins and so in regulating enzyme function. Because of its location within the
      membrane, quantification of the dipole potential is extremely difficult and
      presents a great challenge to the experimentalist and theoretician alike. Both
      electrical and spectroscopic methods developed for the determination of the
      dipole potential on lipid bilayers and monolayers are presented and possible
      causes for differences in the values derived are discussed.

PMID- 11215798
TI  - Formation of vesicles in diluted aqueous solutions of surfactant investigated by
      direct analysis of light scattering.
AB  - Formation of aggregates in the binary systems of double-tailed surfactant, sodium
      4-(1-pentylheptyl)benzenesulfonate, and water in the dilute regime was supposed
      to occur within 5.0-8.5% of surfactant concentration. The size of particles was
      determined by light scattering. In addition, the samples were observed at room
      temperature using an Axiovert 35 Zeiss polarized light microscope operated with
      differential interference contrast optics. The observed aggregates could, in
      theory, belong a vesicle phase. All the histograms obtained by light scattering
      showed a bimodal distribution of particles. Weight factors including intensity,
      volume and number distribution indicate 97-100% of small aggregate sizes, since
      the peaks for the big sizes indicate only a small number of the aggregate
      population. Small aggregates have shown monodispersity with diameters of the
      aqueous core amounting to 38.94 and 54.94 nm relating to the surfactant
      concentration of 6.0 and 8.0%, respectively. Hydrodynamic radii determined by the
      Cumulant method, by the inverse Laplace transformation, and using a plot 1/tau
      vs. q2, showed values within the usual precision limits.

PMID- 11215799
TI  - The surface pressure effect of pentaoxyethylene and maltoside surfactant head
      groups.
AB  - From experimental surface tension data for water solutions of dodecyl-beta
      maltoside, C12M, and dodecyl-penta-(ethylene oxide), C12EO5, in the range below
      the CMC, the corresponding head group surface pressure functions vs. packing
      density were derived. These functions were compared with theoretical expressions
      based on some different models of the mixed head group/water film. Tentatively,
      we concluded that the two-dimensional hard fluid approach provides a convenient
      starting-point in order to account for the observed surface pressures of both the
      maltoside and EO head groups.

PMID- 11215800
TI  - Enzymatic degradation of polymer covered SOPC-liposomes in relation to drug
      delivery.
AB  - Polyethylenoxide (PEG) covered liposomes are used as lipid-based drug-delivery
      systems. In comparison to conventional liposomes the polymer-covered liposomes
      display a long circulation half-life in the blood stream. We investigate the
      influence of polyethyleneoxide-distearoylphosphatidylethanolamine (DSPE-PEG750)
      lipopolymer concentration on phospholipase A2 (PLA2) catalyzed hydrolysis of
      liposomes composed of stearoyloleoylphosphatidylcholine (SOPC). The
      characteristic PLA2 lag-time was determined by fluorescence and the degree of
      lipid hydrolysis was followed by HPLC analysis. Particle size and zeta-potential
      were measured as a function of DSPE-PEG750 lipopolymer concentration. A
      significant decrease in the lag-time, and hence an increase in enzyme activity,
      was observed with increasing concentrations of the anionic DSPE-PEG750
      lipopolymer lipids. The observed decrease in lag-time might be related to changes
      in the surface potential and the PLA2 lipid membrane affinity.

PMID- 11215801
TI  - Transformation of phospholipid membranes by thiyl radicals via cis-trans
      isomerization of fatty acid residues.
AB  - Thiyl radical-mediated transformation of unsaturated fatty acid residues are
      reported. Beside the initiation of lipid peroxidation, thiyl radicals can
      efficiently cause isomerization of fatty acid residues in a catalytic manner. The
      latter process is observed in homogeneous solutions as well as in organized
      assemblies, leading to a denaturation of the natural all-cis-isomers of fatty
      acid residues of lipid bilayers. The degree of denaturation goes parallel with an
      increase in the number of double bonds and in the hydrophobicity of thiols. For
      arachidonic acid methyl ester, a decay of the all-cis-isomer to approximately 30%
      after a gamma irradiation dose of 1.8 kGy in micelles is observed. The
      reversibility of the isomerization reaction is demonstrated in liposomes by the
      fact that the cis/trans-equilibrium is independent of configuration of the
      starting compound.

PMID- 11215802
TI  - Mats Almgren and colloid chemistry.
AB  - His sixtieth birthday provides an opportunity to describe Mats Almgren's impact
      on colloid chemistry.

PMID- 11215803
TI  - Spontaneous vesiculation.
AB  - The thermodynamics of vesicle formation was analyzed by using the elastic bending
      energy approach. Several different possibilities of spontaneous vesiculation, due
      to soft bilayers, non-zero spontaneous curvature and Gaussian curvature,
      respectively, were presented and discussed. Intermediate structures in the closed
      vesicle-disklike mixed micelle phase transition could be either cup-like
      particles or open bilayers partially rolled into lipid tubules.

PMID- 11215804
TI  - Modification of the lyotropic liquid crystalline microstructure of amphiphilic
      block copolymers in the presence of cosolvents.
AB  - This article reviews the results of recent investigations on the macroscopic
      (phase behavior) and microscopic (microstructure) aspects of the role of
      cosolvents on the self-assembly of amphiphilic copolymers. A comprehensive
      account of the systematic studies performed in ternary isothermal systems
      consisting of a representative poly(ethylene oxide)-poly(propylene oxide)
      poly(ethylene oxide) (PEO-PPO-PEO) block copolymer (Pluronic P105, EO37PO58EO37),
      water and a polar cosolvent (such as glycerol, propylene glycol or ethanol) is
      presented. The effect of cosolvents on the copolymer phase behavior is quantified
      in terms of the highest cosolvent/water ratio able to maintain the liquid
      crystalline structures. The effect of cosolvents on the microstructure of the
      lyotropic liquid crystals is quantified in terms of the degree of relative
      swelling per cosolvent content per copolymer content, a parameter that
      characterizes the given cosolvent and copolymer. The set of correlations on the
      cosolvent effects on the phase behavior or microstructure to the cosolvent
      physicochemical characteristics (such as octanol/water partition coefficient or
      solubility parameter) have led to the development of a hypothesis that accounts
      for the cosolvent effects on the self-assembly of PEO-PPO-PEO block copolymers
      and can be used to predict them. The rich structural diversity and the potential
      for a precise an convenient modification of the lyotropic liquid crystalline
      microstructure of the PEO-PPO-PEO block copolymers is discussed in comparison to
      the phase behavior of the low-molecular nonionic surfactants.

PMID- 11215805
TI  - Adsorption of liposomes and emulsions studied with a quartz crystal microbalance.
AB  - The adsorption from phospholipid liposome solutions (1.2%) and phospholipid
      stabilized oil-in-water emulsions (20% purified soybean oil) with the same
      phospholipid liposome concentration, has been followed by means of a quartz
      crystal microbalance allowing the simultaneous determination of changes in
      resonance frequency and energy dissipation. Both the fundamental resonance
      frequency and the third overtone were used for following the interfacial
      processes. The adsorption from the liposome solution resulted in formation of a
      phospholipid bilayer with an additional and incomplete outer layer of liposomes.
      The outer layer was removed by dilution leaving a bilayer of phospholipids on the
      surface. The adsorption process observed from the concentrated emulsion solution
      was considerably more complex. A slow spreading process that also resulted in
      some expulsion of material from the interface followed the rapid initial
      adsorption of emulsion droplets. After rinsing with water a phospholipid bilayer
      was retained on the surface.

PMID- 11215806
TI  - On the formation of concentrated stable w/o emulsions.
AB  - The conditions for the formation of concentrated w/o emulsions based on Aerosol
      OT and aliphatic hydrocarbons were studied. It was found that high stability is
      obtained if the attraction between the emulsion droplets is kept to a minimum.
      This is achieved by matching the refractive index of the dispersed phase and the
      organic phase. Furthermore, it is shown that the mere presence of salt does not
      render any stability. Hence, the speculated mechanism that salt stabilises
      against Ostwald ripening does not hold for these emulsions.

PMID- 11215807
TI  - Ultrasonic shear wave rheology of weak particle gels.
AB  - Weak particle gels have attracted increasing attention in the last decade. These
      gels have a very short region of deformation over which their viscoelastic
      parameters are constant. They can be broken easily in response to external
      forces. Therefore the rheological measurements in these systems must be performed
      at very small deformations, which may frequently be below the accuracy limits of
      conventional rheological instruments. In the present paper we discuss the
      application of the thickness shear mode resonator technique for the measurement
      of viscoelastic parameters of weak particle gels in the MHz frequency range. The
      technique provides information on the viscoelasticity of weak gels in the time
      scale 10(-7)-10(-9) s. The length scale of the measurements, determined by the
      depth of penetration and the wavelength of the shear wave, falls in the submicron
      and micron range. The displacements in the shear deformations generated in this
      technique are extremely small, in the order of Angstroms, and the shear strain,
      approximately 10(-3), corresponds to the low limits in the classical dynamic
      rheology measurements. Only small volumes, down to 0.1 ml, of sample are required
      and this is another advantage of this technique. The measurements of the storage,
      G', and the loss, G'', moduli can be carried out non-invasively and continuously
      at various frequencies in the same sample during the whole length of the process
      of gelation. General and specific aspects of the measurements and interpretation
      of experimental results are discussed in the present paper.

PMID- 11215808
TI  - The effect of surface active solutes on bubbles exposed to ultrasound.
AB  - A review of the effects of a range of surface active solutes, aliphatic alcohols,
      alkyl amines, carboxylic acids and surfactants on bubbles exposed to ultrasound
      is presented. The solutes are shown to affect the phenomenon of sonoluminescence
      (SL) in quite a number of different ways. Ionic surfactants have a strong
      influence on interbubble interactions which at low concentrations (1 mM) results
      in an enhancement in SL. Alcohols and the neutral forms of the organic acids and
      amines induce SL quenching. The SL quenching is attributed to the formation and
      accumulation of decomposition products in the hot core of an oscillating bubble
      resulting from the evaporation of volatile solute adsorbed at the bubble
      interface. Some results are presented on the influence of low concentrations of
      alcohol on the SL generated from a single bubble and on the bubble dynamics, when
      exposed to ultrasound. These results add support to the interpretation given for
      solute-induced effects observed in multibubble systems. It is also shown that SL
      can be used as an internal light source to excite aromatic solutes that
      subsequently fluoresce, a process referred to as sonophotoluminescence.

PMID- 11215809
TI  - Synthesis, characterization and potential applications of new materials in the
      mesoporous range.
AB  - M41S is the designation of a new type of mesoporous structures. The
      characteristics of these materials are large surface areas and very narrow pore
      size distributions, with pore diameters tunable from 15 to 100 A. The M41S family
      consists of MCM-48, which has a cubic ordered pore structure, MCM-41, which has a
      hexagonally ordered pore structure and MCM-50, which has an unstable lamellar
      structure. In this review we cover the synthesis, modification, characterization
      and potential applications of these materials.

PMID- 11215810
TI  - Polyelectrolyte and surfactant mixed solutions. behavior at surfaces and in thin
      films.
AB  - Dilute mixed solutions of non-surface active anionic polymers (polyacrylamide and
      polystyrene sulfonate, xanthan) and various surfactants have been studied with
      several methods: surface tension, ellipsometry, X-ray and neutron reflectivity,
      thin film balance, surface and bulk rheology. A strong synergistic lowering of
      the surface tension is found with cationic surfactants in the concentration range
      where no appreciable complexation of surfactant and polymer occurs in the bulk
      solution (as seen from viscosity measurements). Despite appreciable differences
      between surface tension behaviour, the adsorbed layer is very similar for all the
      polymers: their thickness is small and the polymer chains are stretched along the
      surface. The surface tension behaviour of these polymers with non-ionic
      surfactants is also different. When the polymers are confined in thin films, the
      forces between surfaces are similar, and independent of surfactant nature:
      oscillatory forces are measured, which reflect the existence of a polymer network
      with a well defined mesh size. The connection of foam stability with surface and
      bulk complexation is far from clear.

PMID- 11215811
TI  - Kinetics of diffusion-assisted reactions in microheterogeneous systems.
AB  - This review is focused on the basic theory of diffusion-assisted reactions in
      microheterogeneous systems, from porous solids to self-organized colloids and
      biomolecules. Rich kinetic behaviors observed experimentally are explained in a
      unified fashion using simple concepts of competing distance and time scales of
      the reaction and the embedding structure. We mainly consider pseudo-first-order
      reactions, such as luminescence quenching, described by the Smoluchowski type of
      equation for the reactant pair distribution function with a sink term defined by
      the reaction mechanism. Microheterogeneity can affect the microscopic rate
      constant. It also enters the evolution equation through various spatial
      constraints leading to complicated boundary conditions and, possibly, to the
      reduction of dimensionality of the diffusion space. The reaction coordinate and
      diffusive motion along this coordinate are understood in a general way, depending
      on the problem at hand. Thus, the evolution operator can describe translational
      and rotational diffusion of molecules in a usual sense, it can be a discrete
      random walk operator when dealing with hopping of adsorbates in solids, or it can
      correspond to conformational fluctuations in proteins. Mathematical formulation
      is universal but physical consequences can be different. Understanding the
      principal features of reaction kinetics in microheterogeneous systems enables one
      to extract important structural and dynamical information about the host
      environments by analyzing suitably designed experiments, it helps building
      effective strategies for computer simulations, and ultimately opens possibilities
      for designing systems with controllable reactivity properties.

PMID- 11215812
TI  - Applications and limitations of uranyl ion as a photophysical probe.
AB  - Uranyl ion has a long-lived luminescent excited state, which can be used as a
      probe for the aggregation behaviour in a variety of surfactant and polymeric
      systems. The general spectroscopy and photophysics of this species are discussed,
      and the applications to specific micellar, microemulsion, vesicular and liquid
      crystalline systems presented. It is shown that both dynamic and structural
      information can be obtained from spectral and kinetic data. Examples of
      applications of uranyl probe studies to technologically important mesoscopic and
      mesoporous systems involving metal oxides, or their salts, and to humic acids and
      soils will also be reviewed. Emphasis will be given to both the advantages and
      restrictions on the use of this useful photophysical probe.

PMID- 11215813
TI  - Gross cystic disease fluid protein (GCDFP-15) in the breast: past and present.

PMID- 11215814
TI  - Differential induction of the 200-family proteins in Daudi Burkitt's lymphoma
      cells by interferon-alpha.
AB  - Interferon (IFN)-inducible "effector" proteins mediate the biological activities
      of the IFNs. Therefore, the identification of the functional role(s) of IFN
      inducible proteins in IFN action is important to elucidate the molecular
      mechanisms by which IFNs inhibit cell growth. One family (the "200-family") of
      IFN-inducible proteins includes structurally related murine (p202a, p202b, p203,
      p204 and D3) and human (MNDA, IFI-16 and AIM2) proteins. However, their role in
      IFN action remains to be established. Here we report that IFN-alpha treatment of
      Daudi Burkitt's lymphoma cells resulted in differential induction of MNDA, IFI
      16, and a p202-related protein (p202RP). Interestingly, IFN induction of p202RP
      preceded the induction of MNDA and IFI 16 proteins and the growth inhibition by
      IFN. Additionally, the induction of these proteins by IFN was accompanied by: (i)
      a transient increase in p21(WAF1/CIP1) levels; (ii) an increase in the functional
      form of pRb and p130; (iii) an inhibition of the sequence-specific DNA binding
      activity of E2F complexes; and (iv) a marked decrease in c-Myc levels. Our
      observations reported herein provide support to the hypothesis that IFN-inducible
      p202RP and MNDA proteins from the 200-family contribute to the growth inhibitory
      activities of the IFNs.

PMID- 11215815
TI  - TCR and immunophenotype changes in dimethyl sulfoxide-dependent programmed cell
      death.
AB  - In the thymus most deleted cells are immature thymocytes and the high rate of
      cell death within the thymus is involved in the development of the initial T-cell
      receptor repertoire. Functional T-cell receptor recognition units are created by
      somatic rearrangements of gene segments, and the expression of successfully
      assembled TCR complex is the key to molecular events that culminate in T-cell
      activation, growth and differentiation. Previously, we reported that DMSO induces
      apoptosis in RPMI-8402 human pre-T cells. Here we examine the fate of pre-T cells
      undergoing negative selection analysing the responsiveness to DMSO-enforced TCR
      expression and immunophenotype modulation. Our results demonstrate that DMSO
      induces cell growth inhibition, cell phenotype changes, with down-regulation of
      CD2 and CD7, and increases in alpha/beta or gamma/delta TCR chains led by TdT,
      RAG-1 and RAG-2 activity. These modifications are associated with an apoptotic
      program. Taken together, these data suggest the existence of an early checkpoint
      that ensures in vivo the effective intrathymic differentiation supported from
      another point of view, the linkage between immunophenotypes and TCR regulation in
      T-cell differentiation and programmed cell death.

PMID- 11215816
TI  - Serum concentrations of interleukin-18 in early and advanced cancer patients:
      enhanced secretion in metastatic disease.
AB  - The recent availability of adequate methods for cytokine measurement could
      contribute to better understanding the immunophysiopathology of neoplastic
      disease. Unfortunately, very little data is available about cytokine secretion in
      cancer patients. At present, IL-2, IL-12 and IL-15 represent the major antitumor
      cytokines in humans. Preliminary clinical studies have shown a progressive
      decline in IL-2 levels with cancer progression, whereas IL-12 seems to increase
      in the advanced disease. IL-18 is the latest cytokine discovered by potential
      anticancer and anti-angiogenetic activity, and it has effects similar to those of
      IL-12. This preliminary study was carried out to analyze IL-18 secretion in early
      or advanced cancer patients. The study included 40 cancer patients (lung cancer,
      21; gastrointestinal tumors, 19), 17 of whom had metastatic disease, and 50
      healthy controls. Serum levels of IL-18 were measured by ELISA. No significant
      difference in IL-18 mean levels was seen between controls and non-metastatic
      patients. In contrast, metastatic patients showed significantly higher IL-18 mean
      values with respect to both healthy controls and non-metastatic patients. This
      preliminary study seems to suggest that metastatic disease may be characterized
      by enhanced IL-18 secretion the biological and prognostic significance to be
      established by successive clinical investigation.

PMID- 11215817
TI  - B lymphocyte differentiation antigens.

PMID- 11215818
TI  - CD37.

PMID- 11215819
TI  - CDw75.

PMID- 11215820
TI  - CDw76.

PMID- 11215821
TI  - CD77.

PMID- 11215822
TI  - CD84.

PMID- 11215823
TI  - CD21.

PMID- 11215824
TI  - CD22.

PMID- 11215825
TI  - CD74.

PMID- 11215827
TI  - CD31.

PMID- 11215828
TI  - CD32 (Fc gammaRII).

PMID- 11215829
TI  - CD56.

PMID- 11215830
TI  - CD57.

PMID- 11215831
TI  - CD87.

PMID- 11215832
TI  - CD147.

PMID- 11215833
TI  - The AIDS drug assistance programs and coverage of HIV-related medications.
AB  - BACKGROUND: AIDS drug assistance programs (ADAPs) have been implemented in each
      state to facilitate access to medications for low-income, uninsured, and
      underinsured people with HIV disease. Policies for each ADAP differ, and these
      differences influence the access people with HIV have to medications. OBJECTIVE:
      To compare the coverage of medications and sources of program funding for the
      state ADAPs. DESIGN: A self-administered mailed survey, sent to administrators of
      the 50 state ADAPs and the District of Columbia ADAP in December 1998. RESULTS:
      Forty-nine of the 51 ADAPs (96%) responded to the survey. Title II of the Ryan
      White Comprehensive AIDS Resources Emergency Act provided a large majority of the
      funding for the ADAPs, with a number of states also using state funds and/or
      Title I funds for their programs. The formularies of all ADAPs were nearly
      identical with respect to coverage of antiretrovirals, but differed in the number
      and types of other medications included. Some states limited access to
      medications through waiting lists, enrollment caps, and other policies. Sixteen
      ADAPs reported that the coverage of protease inhibitors resulted in an
      appropriation of state government funds to their ADAP, while eight states
      reported an ADAP budget shortfall. In general, ADAPs in poorer and more rural
      states included a fewer number of medications on their formularies. CONCLUSIONS:
      Access to antiretrovirals and other medications is available through state ADAPs,
      but may be limited in some states due to waiting lists, controls on the
      enrollment of new beneficiaries, and policies on the number and types of
      medications beneficiaries may receive.

PMID- 11215834
TI  - The relationship between preadmission indicators and basic math skills at a new
      school of pharmacy.
AB  - OBJECTIVE: To examine the relationship between preadmission indicators of 49
      PharmD students entering their first professional year at a new school of
      pharmacy and their scores on a Basic Math Skills Test (BMST). A secondary
      objective was to determine what factors, if any, contributed to the successful
      completion of the BMST. METHODS: This cross-sectional investigation used a
      convenience sample of PharmD students entering the first professional year at a
      three-year-old, private, southeastern school of pharmacy. All first-year students
      who took the mandatory BMST, as part of a math mentor plot program, were eligible
      for enrollment. The BMST covered nine different competencies and was validated at
      the grade-8 level. Math test scores, the student's Pharmacy College Admissions
      Test (PCAT), and other demographic and scholastic information was obtained from
      the student's application file in a retrospective manner. All identifiers were
      removed before the data were submitted to the investigators. RESULTS: Statistical
      analysis suggested that two preadmission indicators strongly influenced BMST
      performance: percentile scores on the quantitative section of the PCAT (POAT-OP)
      and whether the student attended a private or public university prior to
      admission to the pharmacy school. In addition, four factors significantiy
      contributed to successful completion of the BMST: math/science grade point
      average (MS-GPA), PCAT percentile scores, PCAT-QP percentile scores, and the
      number of BMST Items left blank. CONCLUSIONS: A relationship exists between
      preadmission indicators of PharmD students entering their first professional year
      and their BMST score. In addition, certain identifiable factors impact BMST
      scores of first-year PharmD students. Admissions committees may find this useful
      in identifying students who may need remedial math assistance prior to beginning
      math-intensive courses such as pharmaceutical calculations and pharmacokinetics.

PMID- 11215835
TI  - Topiramate titration and tolerability.
AB  - OBJECTIVE: To evaluate the tolerability and efficacy of two titration rates for
      topiramate initiated as adjunctive therapy in adults with partial-onset seizures,
      with or without secondary generalization, in a multicenter, double-blindtrial.
      METHODS: After a two-week baseline phase, 188 patients were randomized to either
      a 50/50 titration schedule (initial dosage 50 mg/d increased in 50-mg/d
      increments at weekly intervals; n = 95) or to a 100/200 titration schedule
      (initial dosage 100 mg/d increased by 100-200 mg/d at weekly intervals; n = 93).
      The maximum dosage of 400 mg/d was therefore achieved in eight weeks or three
      weeks, respectively. RESULTS: Compared with the 100/200 titration rate, the 50/50
      titration rate significantly reduced the cumulative incidence of treatment
      emergent adverse events (TEAEs) leading to changes in topiramate therapy (ie.,
      dosage reductions, interruptions or discontinuations of therapy) (p = 0.048) and
      significantly reduced treatment interruptions or withdrawals due to TEAEs (p =
      0.040). Mild or moderate effects involving the central nervous system were the
      most frequent adverse events. At the final visit, therapeutic responses were
      comparable in the 50/50 and 100/200 titration groups: median percent seizure
      reduction was 42% vs. 33%, proportion of patients with 250% seizure reduction was
      42% vs. 38%, and proportion of patients with no seizures during double-blind
      treatment was 14% vs. 10%, respectively. Seizure frequency was substantially
      reduced from baseline during topiramate titration. At day 22, with the 50/50
      titration group receiving 150 mg/d and the 100/200 titration group receiving 400
      mg/d, the mean percent seizure reduction was 51% and 54%, respectively.
      CONCLUSIONS: Gradual initiation of topiramate therapy can significantly enhance
      patient tolerability without delaying therapeutic response.

PMID- 11215836
TI  - Possible serotonin syndrome associated with clomipramine after withdrawal of
      clozapine.
AB  - OBJECTIVE: To report on the possible development of serotonin syndrome in a
      patient receiving clomipramine after clozapine was withdrawn from the treatment
      regimen. CASE REPORT: A 44-year-old white man with a 23-year history of
      undifferentiated schizophrenia and obsessive-compulsive behavior had been treated
      with clozapine and clomipramine for several years. He tolerated both agents
      together well, with the exception of experiencing chronic constipation.
      Clomipramine was tapered and reduced to 50 mg over a period of 10 days. A
      worsening of ritualistic behavior was noted, and the clomipramine dosage was
      increased to 150 mg/d over 14 days. Simultaneously with the clomipramine dosage
      increase, clozapine was tapered and stopped ever a period of 19 days. The day
      after clozapine was stopped, while he was still receiving clomipramine 150 mg/d,
      he began behaving oddly, started sweating profusely, shivering, and became
      tremulous, agitated, and confused. He was diagnosed with possible serotonin
      syndrome; his symptoms resolved after clomipramine was stopped but before
      clozapine was restarted eight days later. DISCUSSION: There are similarities in
      symptoms between serotonin syndrome and clozapine withdrawal. This article
      discusses the reasons why this case may represent serotonin syndrome rather than
      clozapine withdrawal and the possible pharmacologic mechanisms involved.
      CONCLUSIONS: Clinicians should be aware that removing a serotonin-2a (S-HT2a)
      antagonist 1mm a treatment regimen including an agent that increases serotonin in
      the synaptic cleft may worsen clozapine withdrawal or potentially result in
      serious adverse drug reactions, such as serotonin syndrome.

PMID- 11215837
TI  - Subtherapeutic INR values associated with a switch to generic warfarin.
AB  - OBJECTIVE: To discuss the effect on the international normalized ratio (INR) when
      patients are converted from therapy with Coumadin to generic warfarin. CASE
      SUMMARY: Two cases at a family medicine center anticoagulation clinic in Oklahoma
      City, OK, in which subtherapeutic INR values occurred after a switch from
      Coumadin to generic warfarin, while all other variables were kept consistent
      demonstrate the need for close monitoring of the INR when patients are switched
      between brands of warfarin. DISCUSSION: Warfarin is a narrow therapeutic index
      drug since small changes in systemic concentration can lead to significant
      variation in phamacodynamic response. In March 1997, the Food and Drug
      Administration (FDA) approved generic warfare based on the FDA and United States
      Pharmacopoeia (USP) standards. Due to different specifications between Dupont
      Pharma and the USP, content uniformity may differ between brand and generic forms
      of warfarin. United studies have demonstrated bioequivalence between brand and
      generic. The two cases presented demonstrate the potential for fluctuations in
      the INR when switching between generic and brand. Thus, these eases illustrate
      the need for close monitoring if a change is made. CONCLUSIONS: While considered
      bioequivalent by the FDA, switching between Coumadin and generic warfarin may
      lead to significant changes in the INR, warranting dose alterations due to
      different content uniformity specifications between Dupont Pharma and the USP.
      Patients switching between Coumadin and generic warfarin should have their INR
      monitored more carefully.

PMID- 11215838
TI  - Anticoagulation therapy for radiation-induced myelopathy.
AB  - OBJECTIVE: To report the use of heparin and enoxaparin for radiation-induced
      myelopathy. CASE SUMMARY: A 48-year-old White woman with presumed metastatic lung
      cancer presented with worsening numbness and weakness of both legs. The neuro
      oncology service was consulted and determined that the symptoms were consistent
      with radiation-induced myelopathy. The patient briefly responded to steroid
      treatment. A trial of intravenous heparin therapy was initiated by the primary
      team and managed by the clinical pharmacy services. Her symptoms improved when
      heparin was begun. She was able to walk and was subsequently discharged home on
      enoxaparin. DISCUSSION: Spinal cord injury is one of the known adverse effects of
      radiation. The onset of symptoms can be acute or delayed. The clinical signs and
      symptoms of delayed neurologic injury are related to the narrowing and occlusion
      of the vessel lumen, ischemia, edema, and cell death in the surrounding nervous
      tissue. Treatment often consists of corticosteroids and/or hyperbaric oxygen;
      however, the outcomes are often disappointing. In addition to the inhibition of
      serum protein-mediated coagulation, heparin inactivates or prevents the release
      of mediators of vascular injury inflammation, permeability, and edema. Therefore,
      patients with radiation-induced spinal cord injury may benefit from anticoagulant
      therapy. CONCLUSIONS: Heparin and/or enoxaparin may be considered as potential
      treatments for patients with radiation-induced myelopathy.

PMID- 11215839
TI  - Probable colchicine-induced neutropenia not related to intentional overdose.
AB  - OBJECTIVE: To report a case of neutropenia caused by colchicine not associated
      with intentional overdose or with preceding severe gastrointestinal symptoms.
      CASE SUMMARY: A 68-year-old white man was admitted to the hospital with
      intractable pain from an acute attack of gout. The patient was treated with
      standard doses of oral colchicine for several days. He experienced mild loose
      stools, but no severe diarrhea or nausea during treatment. The patient then
      developed severe neutropenia, with an absolute neutrophil count of 240 cells/mm3.
      His white blood cell count returned to normal after discontinuing colchicine and
      administering filgrastim. DISCUSSION: Although colchicine is commonly associated
      with neutropenia in cases of intentional or accidental overdose, the patient
      developed this adverse effect after being treated with doses commonly used for
      the acute treatment of gout. In addition, this patient had taken low-dose
      colchicine for many years without experiencing hematologic adverse effects.
      CONCLUSIONS: Colchicine is often an attractive alternative to nonsteroidal
      antiinflammatory agents for the treatment of gout, especially in patients at risk
      for renal impairment or gastropathy. Our case illustrates that colchicine
      treatment can cause hematologic adverse effects; the clinician should monitor
      cell counts in patients receiving this agent, especially at the higher doses used
      for acute treatment of gout.

PMID- 11215840
TI  - Idiopathic pneumonia syndrome following myeloablative chemotherapy and autologous
      transplantation.
AB  - OBJECTIVE: To report the outcome as well as the clinical, radiographic, and
      pathologic features of idiopathic pneumonia syndrome (IPS) following autologous
      peripheral blood stem cell transplantation (aPBSCT). CLINICAL FINDINGS: A total
      of 271 patients with a variety of underlying malignancies received busulfan
      containing myeloablative chemotherapy prior to aPBSCT; none of these patients
      received total body irradiation. Ten individuals developed IPS, with a median
      time of onset of 102 days after stem cell infusion. The major clinical and
      radiographic findings included an acute or subacute onset of dyspnea, cough,
      hypoxemia, and bilateral or unilateral infiltrates with or without pleural
      effusion. Pathologic findings consisted mainly of diffuse interstitial
      pneumonitis, organizing alveolitis, and cellular atypia. Nine patients diagnosed
      with IPS were treated with high doses of glucocorticoids parenterally. Despite
      heroic measures, eight patients died of IPS. The two remaining individuals
      recovered without experiencing significant long-term pulmonary sequelae.
      DISCUSSION: Chronic low-dose busulfan therapy results in lung injury in 4-6% of
      patients after several years of treatment and once the cumulative dosage begins
      to approach 3g. High-dose, short-course busulfan (16 mg/kg)-containing
      conditioning chemotherapy prior to aPBSCT can also be complicated by IPS. IPS
      differs from lung damage due to chronic busulfan therapy by its earlier onset, an
      acute or subacute rather than indolent presentation, characteristic clinical and
      radiographic features, and lack of multinucleated giant cells on pathologic
      review. The pathophysiology of IPS secondary to high-dose busulfan-containing
      myeloablative regimens is not known, but cell-mediated immune reactions and
      release of cytokines may contribute to the lung injury. Mortality is high (80%)
      despite the use of heroic measures, including mechanical ventilation. Some
      patients, however, can respond to high doses of parenteral corticosteroid
      therapy. CONCLUSIONS: IPS following high-dose, short-course busulfan-containing
      regimens exhibits unique clinical, radiographic, and pathologic features that
      differ from lung damage characteristic of chronic, low-dose busulfan therapy.
      Mortality from this complication is 80%, but some patients survive without long
      term pulmonary sequelae following early treatment with glucocorticoids.

PMID- 11215841
TI  - Successful use of donepezil for the treatment of dementia with Lewy bodies.
AB  - OBJECTIVE: To report a case of the successful use of donepezil for treatment of
      cognitive and noncognitive symptoms in a patient with dementia with Lewy bodies.
      CASE SUMARY: An 86-year-old white woman with dementia was experiencing early
      onset significant fluctuation of her cognitive status, functional impairment,
      visual hallucinations, aggression, and parkinsonism. She was intially diagnosed
      with Alzheimer disease and Parkinsons disease and prescribed donepezil 5 mg/d and
      benztropine 1 mg twice daily. On reexamination of the case by a neurologist, the
      diagnoses were revised to dementia with Lewy bodies. The benztropine was
      discontinued, and donepezil was increased to 10 mg/d. The patient's cognitive and
      functional status significantly improved, as did her visual hallucinations.
      DISCUSSION: This case supports previous reports of the marked responsiveness of
      patients with dementia with Lewy bodies to acetylcholinesterase inhibitors. This
      may be explained by the marked cholinergic deficit observed in patients with
      dementia with Lewy bodies and the evidence linking cognitive as well as
      noncognitive symptoms to this deficit. CONCLUSIONS: The present case suggests
      that patients with dementia with Lewy bodies respond well to acetylcholinesterase
      inhibitors. Controlled trials are necessary to further define the role of these
      drugs for this disease.

PMID- 11215842
TI  - Practice guidelines for lipid-based amphotericin B in stem cell transplant
      recipients.
AB  - OBJECTIVE: To provide clinicians who practice in the stem cell transplantation
      (SCT) setting with practical guidelines for the use of lipid-based amphotericin B
      (AmB) formulations in SCT patients who have documented or probable invasive
      fungal infections, are experiencing neutropenic fever, or require secondary
      prophylaxis for fungal infections. DATA SOURCES: Recommendations are based on the
      results of a two-day consensus meeting that convened clinicians versed in the
      management of infectious complications in patients undergoing SCT. This meeting,
      which was held October 21-23, 1998, in Orlando, Florida, was sponsored by an
      educational grant from The Liposome Company. In addition, primary articles were
      identified by MEDLINE search (1980-December 1999) and through secondary sources.
      STUDY SELECTION AND DATA EXTRACTION: All of the articles identified from the data
      sources were evaluated, and all information deemed relevant was included in this
      review. DATA SYNTHESIS: Immunocompromised patients, particularly patients
      undergoing high-dose chemotherapy with SCT, experience a high degree of morbidity
      and mortality from invasive fungal infections. Historically, treatment for such
      infections with conventional AmB had been limited primarily by its associated
      nephrotoxicity. Lipid-based formulations of AmB have helped to advance the
      management of invasive fungal infections in the SCT population by offering a
      treatment alternative that allows for administration of adequate amounts of
      active drug to produce clinical and mycologic responses, compared with
      conventional AmB, in a delivery system that is less nephrotoxic. Unfortunately,
      these agents are relatively expensive. Therefore, patients who are candidates for
      lipid-based products must be selected carefully. CONCLUSIONS: Practical
      guidelines are provided for the use of lipid-based AmB formulations in SCT
      patients who have documented or probable invasive fungal infections, are
      experiencing neutropenic fever, or require secondary prophylaxis for fungal
      infections.

PMID- 11215843
TI  - Fluorouracil and the new oral fluorinated pyrimidines.
AB  - OBJECTIVE: To briefly review the biotransformation and bioavailability of
      fluorouracil (5-FU); discuss the effects of dihydropyrimidine dehydrogenase (DpD)
      on the efficacy and toxicity profiles of 5-FU; and review a new class of drugs
      known collectively as the oral fluorinated pyrimidines, which inhibit or
      circumvent DpD activity and, when administered with 5-FU, alter its
      pharmacokinetic and pharmacodynamic properties. DATA SOURCES: A MEDLINE
      literature search was conducted (1966-March 1999) using the search terms
      fluoropyrimidines, fluorouracil, 5-FU, fluorinated pyrimidines, capecitabine,
      eniluracil, uracil-tegafur, uracil-ftorafur, UFT, S1, BMS-247616, and BOF-A2.
      Reference lists, bibliographies of pertinent articles, and abstracts from the
      American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium
      annual meetings were also identified and reviewed. Both preclinical and clinical
      literature were reviewed and analyzed. DATA SYNTHESIS: The new oral fluorinated
      pyrimidines appear to produce antitumor activity equivalent or superior to that
      of intravenously administered 5-FU by achieving higher intratumoral 5-FU
      concentrations or sustained 5-FU exposure. These agents are generally associated
      with manageable and non-life-threatening toxicities. The oral route of
      administration facilitates ease of administration and may reduce total healthcare
      costs associated with 5-FU-sensitive tumors. More studies are needed to assess
      the therapeutic and economic benefits of the oral fluorinated pyrimidines.
      CONCLUSIONS: The bioavailability, efficacy, and toxicity of 5-FU depend on its
      catabolic rate-limiting enzyme, The new oral fluorinated pyrimidines inhibit or
      circumvent DpD activity and, when combined with 5-FU, increase 5-FU's
      bioavailability and cytotoxic effects and decrease its toxicities. Results of
      Phase I and II studies in patients with a variety of malignancies suggest
      positive outcomes, including greater efficacy, less drug-related toxicity, lower
      costs related to drug administration, and greater patient convenience.

PMID- 11215844
TI  - Ping wei san, a Chinese medicine for gastrointestinal disorders.
AB  - OBJECTIVE: To describe the dilemma that American pharmacists face when their
      patient uses a traditional Chinese herbal formula. Ping wei san (PWS), an agent
      used to treat gastrointestinal disorders, is used to illustrate the problems
      encountered and to identify resources on Chinese herbal medicines available to
      pharmacists. DATA SYNTHESIS: In the US, Chinese herbal medicine is making its way
      into mainstream Western medicine. Patients may discover PWS in their search for a
      substitute for cisapride, which was partially withdrawn from the US market in
      July 2000. The pharmacist may be called on to assist in the management of
      patients who wish to use PWS for treatment of common gastrointestinal disorders
      like gastritis, esophageal reflux, gastric or duodenal ulcers, and acute or
      chronic enteritis. As with most other Chinese herbal formulas, English-language
      literature about PWS is limited and is often difficult to interpret. Pharmacists
      who are unfamiliar with the basic principles and terminology used in traditional
      Chinese medical practices will need to identify sources of information about this
      complementary alternative practice to be able to provide pharmaceutical care for
      patients taking a Chinese herbal formula like PWS. CONCLUSIONS: To develop a
      pharmaceutical care plan for patients using a Chinese herbal medicine therapy
      such as PWS, the pharmacist will need to become familiar with traditional Chinese
      medical practices and terminology describing indications, therapeutic effects,
      and risks. Fortunately, resources are available to pharmacists who need
      assistance in interpreting information on Chinese herbal therapies so that they
      can appropriately manage patients using them.

PMID- 11215845
TI  - Do HMG-CoA reductase inhibitors affect fibrinogen?
AB  - OBJECTIVE: To review commonly used fibrinogen assay methods and the evidence
      demonstrating an association between fibrinogen and increased risk of coronary
      artery disease and to review the current literature to determine and assess the
      impact of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors on
      fibrinogen. DATA SOURCES: Primary and review articles identified from a MEDLINE
      search (1966-December 1999); references obtained from these publications were
      subsequently reviewed for additional relevant articles. STUDY SELECTION AND DATA
      EXTRACTION: All articles were evaluated, and all relevant information was
      included in this review. DATA SYNTHESIS: The Clauss method is currently the
      preferred method for determining plasma fibrinogen concentrations, due to its
      high degree of accuracy and precision. Furthermore, unlike immunologic methods,
      its reliability is unaffected by change in triglycerides. The effects of four HMG
      CoA reductase inhibitors (atorvastatin, lovastatin, simvastatin, pravastatin) on
      fibrinogen have been evaluated. Atorvastatin has been shown to induce significant
      increases in fibrinogen (22% increase; p <0.05) by using the immunonephelometric
      method. This method also demonstrated that lovastatin use was associated with a
      24.4% increase (p < 0.0001) in plasma fibrinogen concentration. Simvastatin has
      been shown in multiple studies using the Clauss method to have a neutral effect
      on fibrinogen. The majority of studies have revealed significant decreases (7
      19%) in fibrinogen following treatment with pravastatin. CONCLUSIONS: Future
      studies need to be performed evaluating the effects of HMG-CoA reductase
      inhibitors on fibrinogen, but using direct comparisons and clotting assay
      methodology.

PMID- 11215846
TI  - Combined therapy with an angiotensin II receptor blocker and an angiotensin
      converting enzyme inhibitor in heart failure.
AB  - OBJECTIVE: To evaluate the safety, tolerability, and efficacy of chronic
      combination therapy with an angiotensin-converting enzyme (ACE) inhibitor and an
      angiotensin II receptor blocker (ARB) in the management of heart failure. DATA
      SOURCES: Clinical literature was accessed through MEDLINE (January 1966-June
      2000). Key search terms included angiotensin-converting enzyme inhibitor;
      losartan; combined modality therapy; drug effects; heart failure, congestive; and
      receptors, angiotensin. DATA SYNTHESIS: Heart failure is widely prevalent and
      continues to be associated with high morbidity and mortality, even with currently
      recommended care. At the moderate doses studied for patients with mild heart
      failure in brief trials, combined ACE inhibitor and ARB therapy was well
      tolerated and had an additive effect in reducing blood pressure and relieving
      symptoms of heart failure. CONCLUSIONS: An ARB combined with an ACE inhibitor may
      benefit heart failure patients who are receiving all other recommended therapies.
      Further trials are needed to evaluate long-term safety effectiveness, quality of
      life, and survival before the combination can be recommended for routine use.

PMID- 11215847
TI  - The effect of helicobacter pylori eradication on NSAID-induced gastrointestinal
      toxicity.
AB  - OBJECTIVE: To review the data to determine whether Helicobacter pylori
      eradication alters nonsteroidal antiinflammatory drug (NSAID)-induced
      gastrointestinal toxicity. DATA SOURCE: Literature accessed through MEDLINE from
      1966 to May2000 and abstracts of recently presented data at scientific meetings.
      DATA SYNTHESIS: NSAID use and H. pylon infection are independent risk factors for
      the development of gastrointestinal ulcers. An evaluation of the relationship
      between these two risk factors and the impact of H. pylori eradication on NSAID
      induced gastrointestinal toxicity was conducted. CONCLUSIONS: H. pylori
      colonization and NSAID use are independent risk factors for the development of
      gastrointestinal ulcers. The data regarding the interaction between these two
      risk factors in the development of gastrointestinal ulcers are conflicting.
      Eradication of H. pylori does not appear to decrease the risk of NSAID-induced
      gastrointestinal toxicity in the majority of patients. As there is little
      evidence to support a clear benefit of eradicating H. pylori in patients
      requiring NSAID therapy, routine screening for and eradication of H. pylori in
      these patients is not recommended.

PMID- 11215848
TI  - Postpartum alopecia.
AB  - OBJECTIVE: To determine whether there are effective treatments for postpartum
      alopecia. DATA SOURCES: Clinical literature identified through MEDLINE (January
      1966-May 2000), EMBASE (June 1980-March 2000), and International Pharmaceutical
      Abstracts (January 1970-March 2000). Key search terms included alopecia,
      puerperium, and postpartum. DATA SYNTHESIS: Postpartum alopecia is a diffuse
      shedding of scalp hair that can begin two to five months following parturition.
      Few articles examine the treatment of this condition. Treatments in the form of
      thyroid supplementation, topical progesterone and estradiol lotions, and an oral
      contraceptive have been studied. All available studies on this subject have
      significant limitations, such as small sample size, absence of a control group,
      or subjective measurement of treatment response. Nondrug therapy for a related
      type of hair loss has been recommended and includes education about hair cycles
      and reassurance to minimize anxiety. CONCLUSIONS: From the available studies, no
      specific treatment has been studied well enough with sufficient treatment justify
      recommendation or to be termed effective.

PMID- 11215849
TI  - Dalteparin-induced retroperitoneal bleeding.

PMID- 11215850
TI  - Development of an intensive care unit bedside sedation scale.

PMID- 11215851
TI  - GERD and H. pylori: is there a link?
AB  - The incidence of gastroesophageal reflux disease (GERD) and esophageal
      adenocarcinoma have increased in recent years as the incidence of peptic ulcer
      disease and distal gastric cancer have declined. Given the simultaneous decline
      in Helicobacter pylori infection, it is tempting to propose a relationship
      between H. pylori infection and these opposing time trends. Although H. pylori
      infection clearly does not cause GERD, it may protect certain susceptible
      individuals from developing GERD and its complications. The most likely mechanism
      in which H. pylori infection protects against GERD is by decreasing the potency
      of the gastric refluxate in patients with corpus predominant gastritis. A variety
      of implications of H. pylori infection on GERD treatment have also arisen in
      recent years. These focus on the risk of gastric atrophy while on proton pump
      inhibitor therapy and the efficacy of proton pump inhibitors before and after
      eradication of H. pylori. This article puts into perspective our current
      understanding of the complex, incompletely understood relationship between H.
      pylori infection and GERD.

PMID- 11215852
TI  - Controversies in Barrett's esophagus: management of high grade dysplasia.
AB  - Barrett's esophagus is the premalignant lesion for adenocarcinoma of the
      esophagus and the esophagogastric junction. The incidence of esophageal
      adenocarcinoma has been rapidly rising in the Western world over the last two
      decades, and Barrett's esophagus is the only known premalignant lesion for this
      cancer. Esophageal adenocarcinoma develops through the metaplasia-dysplasia
      sequence with progression from no dysplasia, low grade dysplasia, high grade
      dysplasia, and ultimately to esophageal adenocarcinoma. The diagnosis and
      management of high grade dysplasia (HGD) in patients with Barrett's esophagus is
      extremely controversial. Patients with HGD within Barrett's esophagus are at the
      highest risk for development of esophageal adenocarcinoma if concurrent
      adenocarcinoma doesn't already exist. Given the high likelihood of metastatic
      disease and poor prognosis associated with invasive cancer, detection of HGD
      within Barrett's esophagus is considered by many as the final endpoint requiring
      definitive therapy in the form of surgical resection. However, other limited data
      seem to suggest that a number of patients with HGD may actually regress or
      persist and not develop cancer, thus suggesting a less aggressive approach for
      management. Finally with the advent of local endoscopic therapy, reversal therapy
      is being studied in patients with HGD and may be validated for this major
      indication. Currently, surgery remains the goal standard and the most definitive
      therapy for HGD. This articles critically reviews the risks and benefits
      associated with each approach of managing HGD.

PMID- 11215853
TI  - Management of GERD: medical versus surgical.
AB  - Both laparoscopic Nissen fundoplication and proton pump inhibitors are effective
      modern therapies for reflux disease that have yet to be directly compared in a
      well-designed clinical trial. In terms of a risk/benefit analysis, the risk of an
      undesirable outcome or death from laparoscopic Nissen fundoplication exceeds that
      of maintenance treatment with proton pump inhibitors making the later the
      preferable therapy. Neither therapy increases or reduces the risk of death from
      cancer and there are no compelling economic arguments favoring surgical
      management. Instances in which laparoscopic Nissen fundoplication should be
      considered include: 1) Individuals who are intolerant of proton pump inhibitor
      therapy because of side effects, 2) When patients are inadequately responsive to
      proton pump inhibitor therapy even after dosage and dose interval have been
      optimized, and 3) When a patient desires a permanent solution to their reflux
      problem that frees them of the need to chronically consume pharmaceuticals.
      However, regardless of the motivation for pursuing surgical management, patients
      must be advised of potential suboptimal results and the irreversibility of the
      procedure.

PMID- 11215854
TI  - Nonerosive reflux disease.
AB  - Until recently, the finding of erosive esophagitis in patients with chronic
      heartburn was thought to indicate more severe gastroesophageal reflux disease.
      However, recent data suggests that this is not necessarily true. Seventy-five
      percent of patient's chronic heartburn have moderate to severe symptoms,
      regardless of the presence or absence of esophagitis. Nonerosive reflux disease
      (NERD) is characterized by heartburn symptoms for at least 3 months with no
      evidence of esophagitis. Patients with NERD are similar to patients with
      esophagitis in symptom severity, quality of life scores, and response to anti
      reflux therapy. There are probably 3 distinct groups of NERD patients, those with
      pathologic reflux, those with a heightened sensitivity to physiologic reflux and
      those with other medical problems mistaken for reflux. This article discusses the
      3 clinical scenarios.

PMID- 11215855
TI  - Gastroesophageal reflux disease: extraesophageal manifestations and therapy.
AB  - Gastroesophageal reflux disease (GERD) can present with both typical symptoms
      such as heartburn and regurgitation as well as atypical symptoms. These symptoms
      may include chest pain, asthma, chronic cough, hoarseness, otitis media, atypical
      loss of dental enamel, idiopathic pulmonary fibrosis, recurrent pneumonia,
      chronic bronchitis and even sudden infant death. The diagnosis of GERD in these
      patients can often present a challenge and usually requires a combination of
      selected testing and therapeutic trials. Acid suppression by using proton pump
      inhibitors remains the treatment of choice in GERD, but some patients will also
      respond well to antireflux surgery. This article addresses the presentations,
      diagnostic challenges, and therapeutic opportunities in GERD patients with
      atypical presentations.

PMID- 11215856
TI  - Diabetes mellitus in young Thai adults.
AB  - The purposes of the present study were to 1) find the prevalence of various types
      of diabetes; 2) determine the prevalence of glutamate decarboxylase autoantibody
      (anti-GAD) and 3) identify clinical characteristics which may help in predicting
      insulin deficiency in young Thai adults with diabetes. Subjects consisted of 93
      adults with diabetes mellitus aged 15-40 years. In each subject, basal and post
      glucagon C-peptide levels were determined by radioimmunoassay. Anti-GAD was
      measured by radioimmunoassay and mitochondrial 3243 tRNA(Leu(UUR)) gene mutation
      was detected by PCR-RFLP. Data were expressed as mean +/- SEM. The mean age of
      subjects was 31.0 +/- 0.7 years with age at diagnosis of 25.6 +/- 0.9 years.
      Thirty nine (41.9%) were males and 54 (58.1%) were females. Pancreatic
      calcification was found in 7 (7.5%) of the patients while 2 (2.2%) were
      identified as having Wolfram syndrome. Four (4.3%) had nonketotic diabetes with
      affected family members in multiple generations consistent with MODY.
      Mitochondrial 3234 tRNA(Leu(UUR)) gene mutation was detected in only one patient.
      After excluding 14 subjects with pancreatic calcification, Wolfram's syndrome,
      MODY or mitochondrial gene mutation, 45 (57.0%) were found to be insulin
      deficient and 34 (43.0%) were insulin-sufficient based on post-glucagon C-peptide
      levels. Using stepwise logistic regression analysis, it was found that younger
      age at diagnosis (p<0.001), smaller waist circumference (p<0.01), previous
      history of DKA (p<0.01) was significantly associated with insulin deficiency.
      After excluding patients with DKA, younger age at diagnosis of diabetes (p<0.05)
      and lower BMI (p<0.01) were related to insulin deficiency. Concerning the role of
      autoimmunity, it was found that 13 (28.3%) of insulin-deficient subjects were
      positive for anti-GAD while 4 (11.8%) of those who were insulin-sufficient had
      positive results. Of the 54 patients currently on insulin, 42 (77.8%) are insulin
      deficient and 14 (25.9%) have positive anti-GAD. There were 10 (18.5%) who were
      both insulin sufficient and negative for anti-GAD suggesting that insulin therapy
      may not be required. We concluded that about half of young Thai adults with
      diabetes are not insulin-deficient and treatment with insulin may be unnecessary.
      The prevalence of glutamate decarboxylase antibody and mitochondrial 3234
      tRNA(Leu(UUR)) gene mutation is low and as yet undefined factors are accountable
      for insulin deficiency in a significant number of patients.

PMID- 11215857
TI  - Food poisoning outbreak from contaminated fish-balls.
AB  - On February 9th, 1998, a food poisoning outbreak occurred at a boarding school
      for underprivileged students. An unmatched case-control study was done. An
      environmental survey, laboratory study of rectal swab culture, fish-balls, water
      and the cooking utensils were also performed. There were 132 suspect cases, of
      which the attack rate in teachers was 9.8 per cent (4/41), 16.7 per cent (1/6) in
      the food handlers and 15.7 per cent (127/810) in the students. The median
      incubation period was 18 hours. Analysis of food consumption revealed those who
      ate lunch noodles had the highest risk (OR 3.8, 95% CI 0.6-5.9). In details of
      food components, those who ate fish-balls in curry had the only significant risk
      (OR 3.5, 95% CI 1.2-0.8) of becoming ill when compared to those who did not. Fish
      balls in noodles and curry had a dose response relationship. Bacterial culture
      from 25 grams of fish-balls was positive for Vibrio parahaemolyticus. The fish
      balls in noodles and curry were identified as the implicated food. The modes of
      contamination were uncooked food, cooking utensils and the food handlers. The
      manufacturer, which had no license to operate and had poor standards of
      sanitation, was closed by the Food and Drug Administration.

PMID- 11215859
TI  - Efficacy of intranasal stent with filters for different laser smoke particle
      concentration.
AB  - Intranasal, hollow, cylindrical, medical grade, silicone stent with two layers
      and one layer of half face mask outer filter at each end was tested with
      different concentrations of laser smoke particles. A single pulse mode of carbon
      dioxide laser smoke particle created suitable polydisperse atmospheric suspended
      particulate matter amount. The personal respiratory protective device efficacy
      was done at the Otolaryngology Department, Ramathibodi Hospital from July to
      September 1998. The Whatman filter had the same laser smoke particle amount that
      passed through each filter of the intranasal stent. The cyclical air flow rate of
      2 l/min in the nasal model was controlled by a lung model machine and
      respirometer. The particle deposition in filter materials was counted under a
      high power optical microscope. The filtration efficacy of an intranasal stent
      with filters for 5, 10 and 20 shots of laser smoke particle were 90.5, 94.6 and
      95.6 per cent respectively with a mean of 93.6 per cent. The device application
      in a human nasal vestibule depended on acceptable nasal air flow resistant in
      various highly air-polluted areas.

PMID- 11215858
TI  - Significance of a widened mediastinum in blunt chest trauma patients.
AB  - Eighteen blunt chest trauma patients who had mediastinal widening on chest
      roengenogram were studied for the correlation with traumatic ruptured of the
      aorta or its major branches. Seventeen patients were male and one was female. The
      age ranged from 18 to 39 years, mean 26.17+/-6.85SD. The Injury Severity Score
      (ISS) ranged from 9 to 34, mean 25.5+/-6.49SD. Fourteen patients (77.8%)
      sustained motorcycle accidents, 3 patients (16.7%) sustained car accidents and 1
      patient (5.5%) fell from a 4 storey building. All patients underwent aortography
      to search for traumatic rupture of the aorta or its major branches. Six patients
      had computed tomography of the chest before aortography. Nine patients (50%) had
      normal aortography. The remaining 9 patients who had positive aortography
      underwent urgent thoracotomies, 8 of them had traumatic rupture of the aorta or
      its major branches, the remaining 1 patient had normal operative finding. Of the
      8 patients who had traumatic rupture of the aorta or its major branches, 1
      patient died. The mortality was 12.5 per cent. The rate of traumatic rupture of
      the aorta or its major branches in patients who had blunt chest trauma and
      widening of the mediastinum on chest roengenogram in our study was 44.4 per cent.
      The sensitivity of aortography for diagnosis of traumatic rupture of the aorta or
      its major branches was 100 per cent and the specificity was 90 per cent. On the
      basis of this study, we conclude that blunt chest trauma patients with widened
      mediastinum on chest roengenogram have a significantly high rate of traumatic
      rupture of the aorta or its major branches. All blunt chest trauma patients who
      have widened mediastinum on chest reongenogram should undergo further
      investigations to exclude traumatic rupture of the aorta or its major branches.
      We recommend aortography as the investigation of choice due to its accuracy and
      usefulness in management plan.

PMID- 11215860
TI  - Pharmacokinetic studies of cyclosporin in Thai kidney transplantation patients.
AB  - Pharmacokinetic studies were performed in 10 Thai patients with kidney
      transplantation who received microemulsion formulation (Neoral) of cyclosporin A
      (CsA) twice daily. No agents having pharmacokinetic effect on CsA had been used
      in these patients. The mean values of 12-h AUC (area under the concentration
      blood curve) were 4603.63 +/- 344.61 ng x h/ml. CsA concentrations at 2 hours
      after dosing had the best value of correlation coefficient with the 12-h AUC.
      Abbreviated AUC could be calculated by stepwise multiple linear regression
      analysis and linear trapezoidal rule. The latter is more simple and superior to
      the former one.

PMID- 11215861
TI  - Development of coagglutination reagents for serological grouping of streptococci.
AB  - Coagglutination reagents for the rapid serological grouping of groups A, B, C, F
      and G Streptococcus have been developed. Antisera to groups A, B, C, F and G
      Streptococcus were raised in rabbits. After absorption with cross-reacting
      antigens, the specific antibodies were coated on Staphylococcus protein-A and
      used as group-specific coagglutination reagents. The sensitivity of the reagents
      for groups A, C and G Streptococcus was 100 per cent and the specificity was 100,
      100, and 98.77 per cent, respectively. The sensitivity and specificity of these
      reagents were consistent up to 12 months, although specificity declined with
      longer storage. The in-house coagglutination reagents for groups A, C and G
      streptococcus were also tested in comparison with the commercially available
      Streptococcus Phadebact test and yielded almost identical results. Sensitivity of
      the in-house of group B Streptococcus reagent was low, while the group F reagent
      gave a high incidence of false positive reaction.

PMID- 11215862
TI  - A multicenter randomized double-blind comparison of remifentanil and alfentanil
      during total intravenous anaesthesia for out-patient laparoscopic gynaecological
      procedures.
AB  - We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part
      of the total intravenous anesthesia with propofol and atracurium for out-patient
      laparoscopic gynaecological procedures in a multicenter randomized, double-blind
      study. We chose Remifentanil 1 mg./kg.for bolus injection and a continuous
      infusion of 0.25-0.5 microg./kg./min, compared to Alfentanil 20 microg./kg. For
      bolus injection and a continuous infusion of 0.5-1 microg./kg./min. Fifty-nine
      patients received Remifentanil, and sixty-three received Alfentanil. Patients who
      received Remifetanil experienced significantly fewer stress responses to surgical
      stimuli (p < 0.05) and required fewer additional boluses of study drugs and
      propofol (p < 0.05) than Alfentanil during the intraoperative period. Response
      time to verbal commands, spontaneous respiration, adequate respiration and
      tracheal extubation, were not significantly different between these two opioids.
      Remifentanil patients, required more fentanyl for post operative pain control, 40
      from 59 cases in the Remifentanil group and 22 from 63 cases in the Alfentanil
      group (p < 0.05) but still showed significantly better recovery of psychomotor
      function by Aldrete score of ten at 50 and 60 min (p < 0.05) than Alfentanil
      patients. The incidence of intraoperative bradycardia was significantly higher
      with Remifentanil. Other incidences of nausea, emesis, urinary retention and
      postural hypotension were similar. All patients were ready to be discharged from
      the hospital within two hours after extubation except for one patient in the
      Alfentanil group who needed five hours of hospital stay because of urinary
      retention, nausea and severe emesis.

PMID- 11215863
TI  - Genotyping of human platelet antigens in ethnic Northeastern Thais by the
      polymerase chain reaction-sequence specific primer technique.
AB  - Human platelet antigens (HPA) are important in neonatal alloimmune
      thrombocytopenia (NAITP), post-transfusion purpura (PTP), refractoriness to
      platelet transfusion therapy and population genetics. The distribution of HPA in
      a Northeast Thai population was studied. 300 healthy, unrelated, and ethnic
      Northeastern Thais were randomly selected. Using the polymerase chain reaction
      sequence specific primer technique (PCR-SSP), the frequency of HPA-1, -2, -3, -4,
      -5 and -6 were determined. The phenotype frequencies were 100 per cent for HPA
      1a, 4a, 5a, and 6a. For HPA-1b, 2a, 2b, 3a, 3b, 5b and 6b, the frequencies were
      5.7, 99.7, 12.3, 78.0, 71.3, 7.3 and 3.0 per cent, respectively. The HPA-4b was
      not found. The HPA frequencies in our subjects were quite similar to other Asian
      populations but were different from Caucasians. The distribution of HPA genotypes
      encountered in our study indicate that HPA-1a, -4a, -4b, -5a and -6a will not be
      involved in NAITP, PTP and refractoriness to platelet transfusion therapy in
      Northeastern Thais. Moreover, HPA-1b, -2a, -2b, -3a, -3b, -5b and -6b may induce
      alloantibodies in these patients.

PMID- 11215864
TI  - Radiofrequency catheter ablation in pediatrics: experience at Siriraj Hospital.
AB  - Tachyarrhythmia is one of the life threatening cardiac electrophysiology problems
      in children. It also affects quality of life of the patients. Radiofrequency
      catheter ablation (RFCA) has made a significant impact in the treatment of
      tachyarrhythmia since 1989. The present report is the first and largest report in
      Thai children. There have been 24 RFCA procedures in 21 children since it was
      initially performed at Siriraj Hospital from January 1996 to December 1999. The
      electrophysiology studies and medical records were analyzed retrospectively.
      Median age and weight at the time of the procedure were 11 (1.1-13) years old and
      38.8 (6.8-78.2) kg respectively. The presenting symptoms were palpitation 66.7
      per cent, presyncope 16.7 per cent, congestive heart failure and cardiogenic
      shock 8.3 per cent, syncope 4.2 per cent, and chest pain 4.2 per cent. Median
      duration of symptom was 3.5 (0.1-8.0) years. The underlying cardiac arrhythmias
      were Wolff Parkinson White (WPW) syndrome 50 per cent, concealed accessory
      pathway 16.7 per cent, atrioventricular node re-entry tachycardia (AVNRT) 16.7
      per cent, atrial ectopic tachycardia (AET) 12.5 per cent, and WPW with AVNRT 4.2
      per cent. The median fluoroscopy time and procedure time were 25 (4-145) minutes
      and 125 (60-320) minutes respectively. The median tachycardia cycle length was
      332.5 (220-460) seconds. The immediate success rate was 21/24 (87.5%) procedures.
      The procedural complication was 1/24 (4.2%). Two patients (8.3%) had recurrences
      of tachycardia and were successfully controlled with antiarrhythmic drugs.
      CONCLUSION: RFCA is a safe, effective, and curative procedure with high success
      rate for pediatric tachyarrhythmias.

PMID- 11215865
TI  - Blood lactate determined by a portable device in critically ill patients.
AB  - Patients with tissue perfusion deficit usually have lactic acidosis or
      hyperlactacidemia and blood lactate level has been used to diagnose this
      condition and to monitor the disease progression. We conducted a study to examine
      the diagnostic accuracy of capillary and arterial lactate (C LAC and strip A LAC)
      obtained by using a portable lactate analyzer (Accusport) compared with the
      standard method (A LAC) in this condition. Forty eight patients were included in
      the study. Strong correlation between C LAC and A LAC as well as strip A LAC and
      A LAC were demonstrated (r = 0.89 and 0.98 respectively, p <0.05). When
      determining agreement between C LAC and strip A LAC with the standard method, all
      but 2 of C LAC - A LAC differences and 2 of strip A LAC - A LAC differences were
      within the agreement limits (mean +/- 2SD). We conclude that capillary and
      arterial lactate determined by the tested device, when used and interpreted
      cautiously, can substitute arterial lactate in the diagnosis of hyperlactacidemia
      and monitoring the effectiveness of therapy.

PMID- 11215866
TI  - Hyperhomocysteinemia in patients with coronary artery disease.
AB  - Hyperhomocysteinemia has been recognized as a risk factor of atherosclerosis.
      This study was aimed to measure the risk of coronary artery disease in patients
      with hyperhomocysteinemia. Age, HDL level, tHcy level and history of DM were
      independent risk factors for coronary artery disease. The level of tHcy of 11.0
      mmol/L provides the best sensitivity and specificity of predicting coronary
      artery disease.

PMID- 11215867
TI  - Songkla uterine manipulator.
AB  - The Songkla Uterine Manipulator (SUM) was developed for laparoscopic procedures.
      Its shaft consists of two stainless steel rods, which pivot a head and locking
      system. The obturator has a plate and is connected to the pivot head with a
      screw. The obturator has a diameter of 4.7 mm with three standard lengths of 6,
      8, and 10 cm and there is a spring hook to retain it with the tenaculum. The SUM
      allows antevertion of the uterus up to 95 degrees and lateral motion of about 45
      degrees bilaterally. From December 1996 to December 1999, the SUM was used
      successfully in 150 laparoscopic procedures, including 51 tubal sterilizations,
      42 cases of adnexal surgery, 12 total laparoscopic hysterectomies and 45
      laparoscopic assisted vaginal hysterectomies. The visualization of pelvic organs
      including both adnexae was good in all cases without trauma to the vagina, cervix
      or uterus. CONCLUSION: The simplified low cost uterine manipulator was developed.
      Early results were good but more modifications are needed, such as mechanism to
      retain it to the cervix without the tenaculum and sealing of gas leakage from the
      vagina during laparoscopic hysterectomy.

PMID- 11215868
TI  - Tricyclic antidepressants for depressive disorders in children and adolescents: a
      meta-analysis of randomized-controlled trials.
AB  - The tricyclic antidepressants (TCAs) are effective for the treatment of adult
      depression. However, their efficacy of these in the treatment of children and
      adolescents with depression is equivocal. Therefore, it is necessary to determine
      the efficacy and acceptability of TCAs in the treatment of depressive disorders
      in children and adolescents. The databases of MEDLINE (from 1966 to October 1999)
      and Controlled Clinical Trials Registered (from 1980 to October 1999) were
      searched for randomized-controlled trials relevant to the use of TCAs for
      treating depressed children and adolescents. The reviewers also examined the
      reference lists of identified papers and that of a previous meta-analysis. In
      each trial, both nonresponse rates and dropout rates were taken into account and
      extracted on an intention-to-treat basis. The nonresponse-rate and dropout-rate
      odd ratios (ORs) with 95 per cent confidence intervals (95% CIs) of each trial
      and the pooled non-response-rate and dropout-rate ORs (95% CIs) of all trials
      were computed. Nine trials included in this meta-analysis were 2 amitriptyline, 3
      desipramine, 2 imipramine, and 2 nortriptyline studies. By using a fixed-effect
      model, the pooled nonresponse-rate OR (95% CI) and the pooled dropout rate OR
      (95% CI) of antidepressant-treated group were 0.92 (0.57 to 1.47) and 2.14 (1.12
      to 4.09), respectively. In summary, the evidence so far does not support that
      TCAs are more effective or more acceptable than placebo in the treatment of
      depressive disorders in children and adolescents. However, the studies of
      selective serotonin reuptake inhibitors and newer antidepressants for the
      treatment of these disorders should be further investigated.

PMID- 11215869
TI  - Nutritional problems in children aged 1-24 months: comparison of hill-tribe and
      Thai children.
AB  - A cross-sectional survey was conducted in Maecham district, Chiang Mai. The
      objective was to determine the magnitude of nutritional problems in children aged
      1-24 months, both of hill-tribe and Thai communities, where breast-feeding is
      highly prevalent. Three hundred and fifty nine children were recruited, 252 were
      hill-tribe (Karen and Lahu), and 107 were Thai children. Anthropometric
      measurements were taken and mothers were interviewed. In a group of hill-tribe
      children, the prevalence of malnutrition (Z score of weight for age < -2) was
      25.0 compared with 12.1 per cent for Thai children (p <0.01). The prevalence was
      highest in children aged between 12-24 months. This corresponded to the time
      children were weaned. The prevalence of stunting (Z score of height for age < -2)
      in hill-tribe and Thai children was 25.4 and 12.1 per cent respectively (p
      <0.01). There was no significant difference of wasting (Z score of weight for
      height < -2) between hill-tribe and Thai children, 9.1 and 8.4 per cent
      respectively. The mean (SD) Z scores of weight for age, weight for height, and
      height for age for both groups declined significantly as the age increased (p
      <0.001). In conclusion, this study revealed the nutritional problems of young
      hill-tribe children were more severe than those of Thai children. The factors
      that could be related with this, were socioeconomic status, as also genetics, as
      well as cultural beliefs concerning child raising. Such ethnic minorities
      therefore should be considered as special cases in programs of health and
      nutrition promotion.

PMID- 11215870
TI  - A Thai boy with hereditary enzymopenic methemoglobinemia type II.
AB  - Individuals with methemoglobin exceeding 1.5 g/dl have clinically obvious central
      cyanosis. Hereditary methemoglobinemia is due either to autosomal dominant M
      hemoglobins or to autosomal recessive enzymopenic methemoglobinemia. Four types
      of enzymopenic methemoglobinemia have been described. In addition to
      methemoglobinemia, individuals with type II, which is the generalized cytochrome
      b5 reductase deficiency, have severe and progressive neurological disabilities.
      Here we report a 3-year-old Thai boy with type II hereditary enzymopenic
      methemoglobinemia. He was born to a second-cousin couple. His central cyanosis
      was first observed around 10 months of age. His neurological abnormalities were
      seizures beginning at 1 year of age, microcephaly, and inability to hold his head
      up. His cardiovascular and pulmonary evaluations were unremarkable. Methemoglobin
      level by spectral absorption pattern was 18 per cent. A qualitative enzymatic
      assay confirmed the deficiency of the cytochrome b5 reductase enzyme. With this
      definite diagnosis, a prenatal diagnosis for the next child of this couple will
      be possible.

PMID- 11215871
TI  - Poor physical fitness of adolescents with mental retardation at Rajanukul School,
      Bangkok.
AB  - OBJECTIVE: To study the physical condition of adolescents with mild to moderate
      mental retardation (MR), twenty-eight MR students from Rajanukul school were
      evaluated for their fitness components compared to 14 normal students. METHOD:
      Per cent body fat (%BF) was calculated from three sites of skinfold thickness.
      The cardiorespiratory endurance was assessed using graded exercise testing and
      Quinton gas analyzer. Isometric leg strength was measured with dynamometer, and
      flexibility was measured by sit and reach test. RESULTS: Compared between MR and
      normal subjects, %BF was higher in the MR group without statistic significance.
      Five MR females had %BF > 30. The mean VO2peak was about 70 per cent of normal.
      The leg strength and flexibility were very poor. CONCLUSION: The MR adolescents
      had a significantly lower level of physical fitness and more prevalence of
      obesity than normal students. Appropriate physical activities should be
      emphasized for health promotion and disease prevention.

PMID- 11215872
TI  - Transcatheter oily chemoembolization of the extrahepatic collaterals in
      hepatocellular carcinoma.
AB  - Twenty patients with hepatocellular carcinoma who had hepatic artery occlusion
      from repeated transcatheter oily chemoembolization (TOCE), were treated with
      additional TOCE through extrahepatic collaterals. Repeated TOCE were performed
      through the inferior phrenic artery (10 patients), branches of the gastroduodenal
      artery (6 patients), the internal mammary artery (2 patients), the pancreatico
      duodenal arcade (1 patient), the accessory hepatic artery (1 patient), the
      capsular branch of the right renal artery (1 patient) and the 12th intercostal
      artery (1 patient). The TOCE was unsuccessful in 4 patients with accessory
      hepatic artery, one patient with cystic artery arising from superior mesenteric
      artery, one patient with omentoepiploic artery and one patient with left gastric
      anastomose with right gastric artery. The success rate of TOCE in the
      extrahepatic arteries was 76.67 per cent while there was a 23.33 per cent failure
      rate. The overall cumulative survival rates were 80 per cent (6 months), 50 per
      cent (12 months) and 18.8 per cent (18 months). One patient developed skin
      necrosis at the right chest wall following TOCE of the right internal mammary
      artery for HCC. One patient developed hemiplegia following TOCE of the right 12th
      intercostal artery. The extrahepatic collaterals are important alternative routes
      for continuous transcatheter management of hepatocellular carcinoma following
      hepatic artery occlusion.

PMID- 11215874
TI  - Acute external laryngeal injury.
AB  - A retrospective study of 35 patients with acute external laryngeal injury who
      were treated at Maharaj Nakorn Chiang Mai Hospital from January 1989 to 1998 was
      done. Eighty-six per cent of the patients with blunt trauma had been injured from
      a motor vehicle accident and the rest had a penetrating injury from a stab wound.
      The frequent signs and symptoms were hoarseness, skin contusion, pain and
      subcutaneous emphysema. The severity of the injury was classified into minor and
      major groups. There were 2 patients in the minor group and 33 in the major group.
      Both patients in the minor injury group had good result from conservative
      treatment. All patients in the major injury group, except one with left vocal
      cord paralysis, required surgical management. No airway problem was found in any
      patient and only one patient had unintelligible voice after treatment. Twenty
      three per cent had minor complications and responded well to conventional
      treatment. Early diagnosis and proper management gave the best outcome of the
      patient's airway and voice.

PMID- 11215873
TI  - Immunohistochemistry for intestinal ganglion cells and nerve fibers: aid in the
      diagnosis of Hirschsprung's disease.
AB  - Hirschsprung's disease is a disease of congenital abnormalities characterized by
      absence of the enteric ganglion cell of the colon. To make a definite diagnosis,
      biopsy of the aganglionic zones of colon is required. A specimen from submucosal
      biopsy of the colon is very small and difficult to identify submucosal ganglion
      cells. Our study reports an immunohistochemical technique to detect submucosal
      ganglion cells. Six antineural markers, peripherin, cathepsin D, PGP 9.5,
      synaptophysin, chromogranin and S-100 protein, were used. The best antibody for
      the detection of submucosal ganglion cells in our study was peripherin. The
      additional measurement of nerve fiber caliber using S-100 protein staining is a
      valuable aid in the diagnosis of Hirschsprung's disease. It can be applied to the
      suction submucosal biopsy in a patient suspected of having Hirschsprung's
      disease, therefore, the complicated full thickness colonic and rectal biopsy can
      be avoided.

PMID- 11215875
TI  - Preschool sarcoidosis.
AB  - Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology, most
      commonly affecting young adults and presenting most frequently with bilateral
      hilar lymphadenopathy, pulmonary infiltration, and skin or eye lesions.
      Sarcoidosis in children under the age of 4, preschool sarcoidosis, is rare and
      has very different clinical mainfestations characterized by the typical triad of
      skin, eye and joint involvement without lung disease. Diagnosis is established
      when compatible clinical findings are supported by histological evidence of
      widespread noncaseating epithelioid-cell granulomas in more than one organ or a
      positive Kveim-Siltzbach skin test. This report describes a 2-year-old Thai girl
      with typical clinical manifestations of preschool sarcoidosis. The
      histopathological studies of tissue specimens and the laboratory investigations
      support the diagnosis of sarcoidosis. The patient responded to systemic
      corticosteroid therapy.

PMID- 11215876
TI  - Pseudotumor cerebri caused by all-trans-retinoic acid: a case report.
AB  - Pseudotumor cerebri is a condition characterized by increased intracranial
      pressure with normal cerebrospinal fluid composition. It is usually associated
      with many medical conditions and drugs. It has been reported that all-trans
      retinoic acid can induce pseudotumor cerebri. The authors report a 35-year-old
      patient diagnosed with acute promyelocytic leukemia who developed pseudotumor
      cerebri after receiving all-trans-retinoic acid. The patient was treated with 60
      mg/day of all-trans-retinoic acid. Two weeks later, she had severe headache and
      blurred vision. The neurological examination revealed papilledema and decreased
      visual acuity. Other physical examinations were unremarkable. Brain CT was
      normal. Additionally, lumbar puncture was performed and the CSF finding was
      normal except for high CSF pressure. According to modified Dandy criteria, the
      diagnosis was pseudotumor cerebri. The patient's symptoms disappeared after all
      trans-retinoic acid was discontinued. To our knowledge, this is the first case
      report in Thailand.

PMID- 11215877
TI  - Extensive ossification in a craniopharyngioma.
AB  - A rare extensive ossification occurred in a suprasellar craniopharyngioma of a
      man who died at 21 years of age. The tumor produced headache, retarded physical
      and mental development, visual disturbances, and increased intracranial pressure.
      The neoplasm recurred after surgical and roentgenological treatments.
      Differentiation of multipotential mesenchymal cells or mesenchymal type cells
      within the tumor has been suggested as the mode of occurrence of bone in this
      craniopharyngioma.

PMID- 11215878
TI  - Improvement of tardive dyskinesia with risperidone: a case report.
AB  - This case report illustrates the improvement of tardive dyskinesia (TD) and
      psychotic symptoms in an elderly Thai female with chronic schizophrenia with a
      long history of conventional antipsychotic exposure following the treatment with
      risperidone 2 mg/day. TD disappeared in 9 months and continued to be in remission
      at her 5-month follow-up visit recently.

PMID- 11215879
TI  - The speech delivered by Professor Dr. Kasem Suwanagul at the press conference
      called by Deputy Prime Minister Pichai Ratakul to introduce the National
      Distinguished Citizen of 1998.

PMID- 11215880
TI  - Serosurveys for West Nile virus infection--New York and Connecticut counties,
      2000.
AB  - In 2000, 21 persons were reported with acute illness attributed to West Nile
      virus (WNV) infection; 19 were hospitalized with encephalitis or meningitis. Of
      the 21, 10 resided in the Staten Island borough (Richmond County) of New York
      City. Other ill persons resided in nine other counties--Kings (Brooklyn), New
      York (Manhattan), and Queens counties in New York; Hudson, Passaic, Monmouth,
      Morris, and Bergen counties in New Jersey; and Fairfield County in Connecticut.
      Because ill persons represent only a fraction of the persons who are infected,
      many more persons probably were infected in 2000. To determine the prevalence of
      recently acquired WNV infection and associated risk factors for infection, random
      household cluster serosurveys were conducted in Staten Island and portions of
      Fairfield County, Connecticut, and Suffolk County, New York, during October
      November 2000. All three areas had intense WNV epizootics as determined by avian
      mortality and mosquito surveillance systems. This report summarizes the
      preliminary results of this survey and indicates that in areas with intense
      epizootic WNV activity, asymptomatic or mildly symptomatic human infections can
      occur.

PMID- 11215881
TI  - Influenza activity--United States, 2000-01 season.
AB  - This report summarizes influenza activity in the United States during November
      26, 2000-January 13, 2001. Influenza activity was low to moderate but increasing
      in the United States. Since October 1, the most frequently isolated viruses were
      influenza A (H1N1) and were well matched antigenically with the 2000-01 influenza
      A (H1N1) vaccine strain.

PMID- 11215882
TI  - Circulation of a type 2 vaccine-derived poliovirus--Egypt, 1982-1993.
AB  - In 1988, the World Health Assembly resolved to eradicate poliomyelitis globally
      by 2000. Substantial progress has been achieved toward this goal, and with the
      circulation of wild poliovirus eliminated in most of the world, attention has
      focused on examining the potential for vaccine-derived poliovirus to circulate
      where wild poliovirus has disappeared. During 1999, sequences of historic
      poliovirus isolates were examined. This report summaries the results of that
      study, which indicate that oral poliovirus vaccine (OPV)-derived poliovirus type
      2 circulated in Egypt during the 1980s and early 1990s and caused widespread
      infection and paralytic disease. The findings underscore the need for countries
      using OPV to target communities with low vaccine coverage for intense vaccination
      activities to prevent circulation of both wild and vaccine-derived polioviruses.

PMID- 11215883
TI  - Polysaccharide-based chiral stationary phases for high-performance liquid
      chromatographic enantioseparation.
AB  - Recent developments of polysaccharide-based chiral stationary phases (CSPs) for
      the direct separation of enantiomers in high-performance liquid chromatography
      (HPLC) are mainly reviewed together with the results on mechanistic studies by
      means of chromatography, NMR and mass spectroscopies, and computational methods.
      Miscellaneous applications of polysaccharide derivatives to the newly developed,
      chiral dynamic high-performance liquid chromatography (DHPLC) for obtaining a
      nonracemic compound are also described.

PMID- 11215884
TI  - Reversed-phase liquid chromatographic separation of enantiomers on polysaccharide
      type chiral stationary phases.
AB  - The direct chiral separation by chiral stationary phases (CSPs) is one of the
      most important techniques to analyze enantiomeric purity as well as to get
      enantiomerically pure material quickly. Among various types of CSPs,
      polysaccharide type CSPs are well known by their versatility and durability. They
      are not only effective under normal-phase conditions, but also under reversed
      phase conditions. In order to get a good separation under the reversed-phase
      conditions, it is the key to choose an appropriate mobile phase. For example, a
      simple mixture of water/acetonitrile or water/methanol are sufficient for a
      neutral analyte, while it is necessary to use an acidic solution instead of water
      for an acidic analyte and a solution of a chaotropic salt (or a basic solution)
      for a basic analyte, respectively. The paper also presents lists of more than 350
      separation examples that include 22 validated methods for drug analyses from
      serum, plasma, or urine samples on polysaccharide type CSPs under reversed-phase
      conditions.

PMID- 11215885
TI  - Covalently bonded polysaccharide derivatives as chiral stationary phases in high
      performance liquid chromatography.
AB  - Polysaccharide derivatives have been extensively used as chromatographic chiral
      selectors in chiral stationary phases (CSPs) for the separation of enantiomers by
      HPLC. When coated onto a silica matrix, they represent nowadays one of the most
      popular type of CSPs. However, they are only compatible with a limited choice of
      solvents. The main drawback of these CSPs is related to the solubility of the
      chiral selector in a number of solvents, which limits their applicability. The
      different attempts which have been described up to now to overcome this problem
      by covalently fixing the chiral selector to a matrix are reviewed in this paper.

PMID- 11215886
TI  - Regioselectively modified polysaccharide derivatives as chiral stationary phases
      in high-performance liquid chromatography.
AB  - This review summarizes several regioselectively modified polysaccharide
      derivatives which have been prepared in order to be used for chiral separations
      chromatography. The goal was to combine the effects of the known tris
      arylcarbamate and tris-arylesters of polysaccharides. The use of new materials as
      chiral stationary phases (CSPs) in liquid chromatography for enantiomeric
      discrimination was investigated and compared to the homogeneously substituted
      polysaccharide derivatives. The different works describing the preparations, the
      performances and the applications of regioselectively modified polysaccharide
      derivatives have been resumed.

PMID- 11215887
TI  - High-performance liquid chromatographic enantioseparation of drugs containing
      multiple chiral centers on polysaccharide-type chiral stationary phases.
AB  - Enantioseparation of drugs with multiple chiral centers is challenging. This
      article describes resolution of some drugs with multiple chiral centers using
      polysaccharide-type chiral stationary phases. Also, the use of the column
      switching technique is demonstrated to achieve the resolution of this type of
      compounds.

PMID- 11215888
TI  - Unusual effects of separation conditions on chiral separations.
AB  - Unusual effects in liquid chromatographic separations of enantiomers on chiral
      stationary phases are reviewed with emphasis on polysaccharide phases. On protein
      phases and Pirkle phases reversal of the elution order between enantiomers due to
      variation of temperature and mobile phase composition has been reported. Most of
      the nonanticipated observations have dealt with the widely used polysaccharide
      phases. Reversed retention order and other stereoselective effects have been
      observed by variation of temperature, organic modifier and water content in
      nonpolar organic mobile phases.

PMID- 11215889
TI  - Optically active synthetic polymers as chiral stationary phases in HPLC.
AB  - Synthetic, optically active polymers used as CSP are reviewed. The polymers are
      classified into three major categories, namely, addition polymers, condensation
      polymers, and cross-linked gels. The emphasis lies on polymethacrylates having
      helical conformation belonging to the first category. Helical polymethacrylates
      are synthesized using asymmetric anionic or radical polymerization techniques and
      show resolving ability towards a wide range of racemate.

PMID- 11215890
TI  - Imprinted chiral stationary phases in high-performance liquid chromatography.
AB  - Polymers imprinted with chiral templates offer a new generation of tailor-made
      chiral stationary phases (CSPs) with predictable selectivities. This review
      summarizes the present state of the art of molecular imprinting to generate
      tailor-made CSPs and provides an overview of the main factors involved in the
      manufacturing process that are crucial to the chromatographic performance of the
      phases.

PMID- 11215891
TI  - Protein-based chiral stationary phases for high-performance liquid chromatography
      enantioseparations.
AB  - The enantioseparations of various compounds using proteins as the chiral
      selectors in high-performance liquid chromatography (HPLC) are considered in this
      review. The proteins used include albumins such as bovine serum albumin and human
      serum albumin, glycoproteins such as alpha1-acid glycoprotein, ovomucoid,
      ovoglycoprotein, avidin and riboflavin binding protein, enzymes such as trypsin,
      alpha-chymotrypsin, cellobiohydrolase I, lysozyme, pepsin and amyloglucosidase,
      and other proteins such as ovotransferrin and beta-lactoglobulin. This review
      deals with the properties of HPLC chiral stationary phases based on proteins, and
      the enantioselective properties and chiral recognition mechanisms of these
      stationary phases.

PMID- 11215892
TI  - Separation of enantiomers by gas chromatography.
AB  - The separation of enantiomers by gas chromatography is performed on chiral
      stationary phases (CSPs) via hydrogen bonding, coordination and inclusion. Thus,
      typical chiral selectors are amino acid derivatives, terpene-derived metal
      coordination compounds and modified cyclodextrins. In Chirasil-type stationary
      phases the chiral selector is anchored to a polysiloxane backbone improving gas
      chromatographic performance. The present review article describes the state-of
      the-art, scope and limitations, applications and mechanistic considerations at
      the advent of the millennium incorporating 16 figures and 168 references.

PMID- 11215893
TI  - Separation of enantiomers: needs, challenges, perspectives.
AB  - Chiral drugs, agrochemicals, food additives and fragrances represent classes of
      compounds with high economic and scientific potential. First the present
      implications of their chiral nature and necessity of separating enantiomers are
      summarised in this article. In the following a brief overview of the actual
      approaches to perform enantioseparations at analytical and preparative scale is
      given. Challenging aspects of these strategies, such as problems associated with
      data management, choice of suitable chiral selectors for given enantioseparations
      and enhanced understanding of the underlying chiral recognition principles, are
      discussed. Alternatives capable of meeting the requirements of industrial
      processes, in terms of productivity, cost-effectiveness and environmental issues
      (e.g., enantioselective membranes) are critically reviewed. The impact of
      combinatorial methodologies on faster and more effective development and
      optimisation of novel chiral selectors is outlined. Finally, the merits and
      limitations of most recent trends in discrimination of enantiomers, including
      advances in the fields of sensors, microanalysis systems, chiroptical methods and
      chemical force microscopy are evaluated.

PMID- 11215894
TI  - Enantioseparations in super- and subcritical fluid chromatography.
AB  - The separation of chiral compounds by sub- and supercritical fluid chromatography
      has been a field of great progress since the first demonstration of a chiral
      separation by SFC in 1985. Almost all of the chiral selectors used in gas or
      liquid chromatography have been successfully applied to sub-/supercritical
      chromatography. Easier and faster method development, high efficiency, superior
      and rapid separations of a wide variety of analytes, extended-temperature
      capability, analytical and preparative-scale equipment improvements and a
      selection of detection options have been reported.

PMID- 11215895
TI  - Enantioseparations in capillary electromigration techniques: recent developments
      and future trends.
AB  - This review summarizes the current status of enantioseparations using capillary
      electromigration techniques and gives the authors insights on the selected
      fundamental aspects and future trends in this field. The most recent developments
      in the field of chiral separations using capillary electrophoresis (CE) and
      capillary electrochromatography (CEC) are summarized. The status of chiral
      electromigration techniques is evaluated tacking into account the most recent
      developments in related techniques such as chiral HPLC, GC and SFC.

PMID- 11215897
TI  - Enantioseparations in counter-current chromatography and centrifugal partition
      chromatography.
AB  - Examples of chiral separations in counter-current chromatography (CCC) and
      centrifugal partition chromatography (CPC) are not numerous, due to the
      difficulty of finding chiral selectors highly selective in the liquid phase as
      well as a combination of solvents that does not destroy the selectivity and
      retains the capacity to elute chiral isomers of interest. New ideas and new
      chiral selectors generally come from other separation techniques, as will be
      highlighted in this review.

PMID- 11215896
TI  - High-performance liquid chromatography chiral stationary phases based on low
      molecular-mass selectors.
AB  - A review of HPLC chiral stationary phases (CSPs) based on low molecular mass
      selectors is given. The review is focused on brush- and monomeric-type CSPs
      obtained by covalent linkage of chiral selectors, with emphasis on those obtained
      by total synthesis. Emphasis is given to new, emerging aspects like
      enantioseparations on receptor-like chiral stationary phases and dynamic
      enantioselective chromatography of stereolabile compounds.

PMID- 11215898
TI  - Enantioselective chromatography as a powerful alternative for the preparation of
      drug enantiomers.
AB  - The preparative separation of enantiomers by chromatography on chiral stationary
      phases (CSPs) has been recognized as being a useful alternative to the more
      conventional approaches such as enantioselective synthesis and enzymatically
      catalyzed transformations. The possible contribution of enantioselective
      chromatography with respect to the preparation of enantiomerically pure compounds
      is reviewed in the context of the competitive approaches and depending on the
      application scale, with a special emphasis on the recent progresses achieved in
      this particular field of separation.

PMID- 11215899
TI  - Preparative enantioseparation by simulated moving bed chromatography.
AB  - Simulated moving bed (SMB) chromatography was invented in the 1960s in the
      petrochemical industry and has since then been widely used to produce
      petrochemicals and sugars at the multi-ton scale. In the early 1990s its
      principle could be successfully adapted to chromatographic enantioseparation, due
      to developments in system design, chiral stationary phase synthesis and
      improvements in modelling and simulation of non-linear chromatographic behaviour.
      Since then a lot of separation systems have been brought into production, which
      are reviewed. In addition new developments are outlined in the field of system
      design and stationary phase development.

PMID- 11215900
TI  - Atomistic modeling of enantioselection in chromatography.
AB  - A review of atomistic molecular modeling studies related to chromatographic
      separations of enantiomers is presented. Only those types of calculations where
      direct interactions between a selector and a selectand are involved are described
      in this review; omitted are regression models. An emphasis is placed on comparing
      methods used for sampling potential energy surfaces implementing different
      methodologies like quantum and molecular mechanics for energy calculations, and
      molecular dynamics and Monte Carlo sampling strategies for simulations. Type I-V
      chiral stationary phases and additives for capillary electrophoresis and ion-pair
      chromatography are covered in this review.

PMID- 11215902
TI  - Chromatographic and electrophoretic studies of protein binding to chiral solutes.
AB  - Protein interactions are important in determining the transport, metabolism
      and/or activity of many chiral compounds within the body. This review examines
      data that have been obtained on these interactions by various chromatographic and
      electrophoretic methods, especially those based on either high-performance liquid
      chromatography or capillary electrophoresis. Zonal elution, frontal analysis and
      vacancy methods are each considered, as are approaches that employ either soluble
      or immobilized proteins. There are a variety of different items that can be
      learned about a solute-protein system through these techniques. This includes
      information on the binding constants and number of binding sites for a solute
      protein system, as well as the thermodynamic parameters, rate constants,
      interaction forces and binding site structure for the protein and solute.
      Numerous examples are provided throughout this review, as taken from the
      literature and from work performed within the author's laboratory.

PMID- 11215901
TI  - Reviewing mobile phases used on Chiralcel OD through an application of data
      mining tools to CHIRBASE database.
AB  - During the past decade, thousands of compounds have been resolved on Chiralcel OD
      (a cellulose-based chiral stationary phase) under diverse eluting conditions.
      Many researches have documented the effects of mobile phase on enantioselectivity
      for a given family of samples but today no comprehensive study aimed at
      identifying the associations between the structural features present on solute
      and appropriate mobile phase conditions has yet been proposed. In this review of
      mobile phases used on Chiralcel OD, we try to go far beyond a simple enumeration
      of eluting conditions and an effort is made to explore the utility of data mining
      tools for assessing the knowledge contained in CHIRBASE database. We have
      extracted from CHIRBASE the chemical features of 2363 chiral compounds separated
      on Chiralcel OD and their corresponding mobile phases. This data set was
      submitted to data mining programs for molecular pattern recognition and mobile
      phase predictions for new cases. Some substructural characteristics of solutes
      were related to the efficient use of some specific mobile phases. For example,
      the application of CH3CN/salt buffer at pH 6-7 was found convenient for reversed
      phase separation of compounds bearing a tertiary amine functional group.
      Furthermore, a cluster analysis allowed the arrangement of the mobile phases
      according to similarity found in molecular patterns of solutes. A decision tree,
      which may lead to a more rational choice of the mobile phase under reversed-phase
      conditions, is also proposed.

PMID- 11215903
TI  - Chiral chromatographic separations based on ligand exchange.
AB  - Taking ligand-exchange chromatographic systems as an example, the effect of the
      stoichiometry of the solute-chiral selector interaction on the efficiency,
      selectivity and solute peak profile is discussed. Recent achievements and
      practical applications of chiral ligand-exchange chromatography are also briefly
      reviewed.

PMID- 11215904
TI  - Chiral separations using the macrocyclic antibiotics: a review.
AB  - The macrocyclic antibiotics have recently gained popularity as chiral selectors
      in CE, HPLC and TLC. The macrocyclic antibiotics used for chiral separations
      include the ansamycins, the glycopeptides, and the polypeptide antibiotic
      thiostrepton. Although not strictly considered macrocyclic antibiotics, the
      aminoglycosides are antibiotics that have been used for chiral separations in CE.
      More chiral analytes have been resolved using the glycopeptides than with the
      other macrocyclic antibiotics combined. The glycopeptides vancomycin, ristocetin
      A and teicoplanin have been used extensively as chiral selectors in CE, with
      ristocetin A appearing to be the most useful chiral selector followed by
      vancomycin and teicoplanin, respectively. The macrocyclic antibiotics have also
      been used as chiral bonded phases in HPLC, and HPLC stationary phases based on
      vancomycin, ristocetin A and teicoplanin have been commercialized. Ristocetin A
      seems to be the most useful glycopeptide HPLC bonded phase, but its greater
      expense can be a drawback. The macrocyclic antibiotics have been used with
      micelles to improve efficiency, provide unique selectivity, and extend the range
      of separations to neutral solutes. Changing the macrocyclic antibiotic used in CE
      or HPLC can significantly alter the enantioselectivity of the separations. In
      fact, the glycopeptide antibiotics are complementary to one another, where if a
      partial enantioresolution is obtained with one glycopeptide, there is a high
      probability that a baseline or better separation can be obtained with another.

PMID- 11215905
TI  - High-performance liquid chromatographic and capillary electrophoretic
      enantioseparation of plant growth regulators and related indole compounds using
      macrocyclic antibiotics as chiral selectors.
AB  - Enantioseparation of plant growth regulators, such as 3-(3-indolyl)-butyric acid,
      abscisic acid and structurally related molecules including a variety of
      substituted tryptophan compounds, has been achieved by HPLC and/or CE. The
      covalently bonded macrocyclic antibiotics, teicoplanin, ristocetin A and
      vancomycin, were used as chiral stationary phases (CSPs) in HPLC. Most of the
      racemates were baseline resolved in the reversed-phase mode (EtOH-H2O) using the
      teicoplanin CSP. The chiral recognition mechanism is discussed in regard to the
      structure of the analytes. In CE, the three aforementioned macrocyclic
      antibiotics were used as chiral additives in a phosphate run buffer. The effect
      of pH and the concentration of the organic modifiers were considered. The results
      obtained by HPLC and CE were compared.

PMID- 11215906
TI  - Immune cell populations within the duodenal mucosa of dogs with enteropathies.
AB  - The mucosal immune system may play a critical role in the pathogenesis of small
      intestinal enteropathies. The aim of the current study was to assess mucosal
      immune cell populations in dogs with inflammatory bowel disease (IBD), idiopathic
      antibiotic-responsive diarrhea (ARD), and adverse reactions to food (FR).
      Endoscopic biopsies were performed of the duodenum of dogs with these conditions
      and from a group of dogs without enteric disease. Additional control samples were
      collected after death from other dogs that did not have evidence of enteric
      disease. Immunohistochemistry and computer-aided morphometry were used to assess
      the distribution of immune cell subsets in both lamina propria and intestinal
      epithelium. Compared with controls, dogs with ARD had increased numbers of lamina
      propria immunoglobulin (Ig) A- plasma cells and CD4+ cells. More marked
      alterations were noted in dogs with IBD, with significant increases in lamina
      propria IgG+ plasma cells, T cells (CD3+), CD4+ cells, macrophages, and
      neutrophils, but with reduced mast cell numbers. Increased intraepithelial CD3+ T
      cells were also present in the dogs with IBD, compared with controls. However,
      lamina propria and epithelial populations were unaltered in dogs with FR when
      compared with controls. The altered mucosal immune cell populations observed in
      dogs with ARD or IBD may reflect an underlying immunologic pathogenesis in these
      disorders.

PMID- 11215907
TI  - Subnormal concentrations of serum cobalamin (vitamin B12) in cats with
      gastrointestinal disease.
AB  - The present study sought to determine the spectrum of diseases associated with
      subnormal concentrations of serum cobalamin in cats undergoing investigation of
      suspected gastrointestinal problems. The solid-phase boil radioassay (RA) for
      cobalamin employed in the present study was immunologically specific, precise,
      and accurate, with a sensitivity of 15 pg/mL. The RA yielded results that
      strongly correlated with those obtained by bioassay (Spearmann rho = .805; P <
      .0001), although the absolute values were lower for the RA. Forty-nine of 80
      serum samples submitted during the period of January 1996-January 1998 had
      cobalamin concentrations below the reference range for healthy cats (range 900
      2,800 pg/mL; mean +/- SD, 1,775 +/- 535 pg/mL; n = 33). Cats with subnormal
      cobalamin concentrations (mean +/- SD; 384 +/- 272 pg/mL, range 3-883 pg/mL) were
      middle-aged or older and were presented for weight loss. diarrhea, vomiting,
      anorexia, and thickened intestines. Definitive diagnoses in 22 cats included
      inflammatory bowel disease (IBD), intestinal lymphoma, cholangiohepatitis or
      cholangits, and pancreatic inflammation. Serum concentrations of cobalamin were
      particularly low in cats with intestinal lymphoma, three-fifths of whom also had
      subnormal serum concentrations of folate (< 9 ng/mL). The simultaneous presence
      of disease in the intestines, pancreas, or hepatobiliary system in many cats made
      it difficult to determine the cause of subnormal cobalamin concentrations. The
      circulating half-life of parenteral cyanocobalamin was shorter in 2 cats with IBD
      (5 days) than in 4 healthy cats (12.75 days). The presence of subnormal serum
      concentrations of cobalamin in 49 of 80 cats evaluated suggests that the
      measurement of serum cobalamin may be a useful indirect indicator of enteric or
      pancreatic disease in cats. The rapid depletion of circulating cobalamin in cats
      suggests that cats may be highly susceptible to cobalamin deficiency. However,
      the relationship of subnormal serum cobalamin concentrations to cobalamin
      deficiency and the effect of cobalamin deficiency on cats remain to be
      determined.

PMID- 11215908
TI  - Prevalence of enteric zoonotic agents in cats less than 1 year old in central New
      York State.
AB  - A prevalence study of several enteric zoonotic bacterial and parasitic infections
      was conducted in 263 fecal samples from cats that were between 1 and 12 months
      old, and that were in humane shelters (n = 149) or were presented to primary-care
      veterinarians (n = 114). Of these samples, 2 (0.8%) were positive for
      Campylobacter, 2 (0.8%) were positive for Salmonella, and 10 (3.8%) were positive
      for Cryptosporidium, confirming that these zoonotic agents are relatively rare in
      cats. Toxocara cati (33.0%) and Giardia (7.3%) were found more commonly. At least
      1 zoonotic agent was detected in 105 samples (40.7%). Our results suggest that
      clinical signs such as diarrhea are not reliable predictors of whether a cat is
      actively shedding enteric organisms. Therefore, the decision to test a newly
      adopted cat should be based on the potential risks to the client rather than on
      the cat's clinical presentation. The high prevalence of T. cati confirms that
      comprehensive testing or treatment for ascarids is warranted in newly adopted
      kittens.

PMID- 11215909
TI  - Long-term clinical management of right-to-left ("reversed") patent ductus
      arteriosus in 3 dogs.
AB  - A small number of dogs with patent ductus arteriosus (PDA) have right-to-left
      flow of blood through the ductus, leading to polycythemia and clinical signs
      associated with hyperviscosity. Three dogs with right-to-left-shunting PDA are
      described. Treatment consisted solely of phlebotomy, performed on an outpatient
      basis when indicated by exacerbation of clinical signs, for a total of 11-68
      times on each dog. Each treatment entailed the removal of a mean of 19% (maximum
      28%) of circulating blood volume, divided into 2 phlebotomies several hours
      apart, without intravenous fluid replacement. Subjectively, marked clinical
      improvement was noted. Intermittent clinical signs decreased in frequency and
      severity in all dogs. Adverse effects were rare (1 for 98 phlebotomies) and
      reversible. Dogs lived > 2 to > 8 years during treatment. Outpatient phlebotomy
      without fluid replacement was safe, and was associated with subjective
      improvement and prolonged survival in these dogs.

PMID- 11215910
TI  - Equine basal cell tumors: 6 cases (1985-1999).
AB  - Basal cell tumors are rare benign tumors in horses. Over a 15-year period, 6
      horses were diagnosed with basal cell tumors. The tumors were well-circumscribed.
      freely moveable, firm, raised papules, nodules, or masses that ranged from 0.6 to
      5 cm in diameter. Five of the 6 tumors were ulcerated. Based on gross appearance,
      the tumors were diagnosed as sarcoids, and 1 was diagnosed as a melanoma. The
      range of age of affected horses was 6-26 years. The tumors were identified
      clinically 1 week to 3 years before excision. In 4 horses for which information
      was available, complete surgical excision was curative with no recurrence 4
      months to 2 years after removal.

PMID- 11215911
TI  - Long-term health and predictors of survival for hyperthyroid cats treated with
      iodine 131.
AB  - Two hundred thirty-one cats treated with radioactive iodine at the Texas
      Veterinary Medical Teaching Hospital were followed for a median of 25 months by
      means of an ambidirectional (prospective, retrospective) cohort study design. Cox
      proportional hazards models were used to determine predictors of survival based
      on data at the time of hyperthyroid diagnosis (collected retrospectively) and
      found that only age at diagnosis and sex of the cat were predictors of survival.
      Increasing age (for each year of age, relative risk [RR] = 1.2, 95% confidence
      interval [CI] = 1.1-1.3) and being male (RR = 0.68, 95% CI = 0.5-0.9) increased
      likelihood of death. Tables predicting survival after diagnosis and treatment of
      hyperthyroidism for various age and sex combinations were created. In addition,
      Cox proportional hazard models were run with all data available at the end of the
      study (collected retrospectively and prospectively) including number and type of
      major health problems reported at the time of death or censoring. In this model,
      significant factors were age at diagnosis, sex, and either type of major health
      problem or number of health problems. Cats with renal disease or cancer were more
      likely not to survive and increasing from none to 2 health problems also
      decreased survival. Renal problems and cancer were the most common health
      problems at the time of death or censoring. This study provides estimates of
      duration of survival for cats successfully treated for hyperthyroidism with
      radioactive iodine, which can be useful in assisting with client treatment
      decisions.

PMID- 11215912
TI  - Diarrhea, diet, and diagnostics.

PMID- 11215913
TI  - Effect of amlodipine on echocardiographic variables in cats with systemic
      hypertension.
AB  - Left ventricular hypertrophy signals a poor prognosis in hypertensive humans.
      Cardiac disease is common in cats with systemic hypertension. The aims of this
      study were to characterize the echocardiographic findings of cats with systemic
      hypertension and to determine if reducing the degree of hypertension is
      associated with resolution of cardiac hypertrophy. Echocardiographic examinations
      were performed on 19 cats with naturally occurring systemic hypertension.
      Fourteen of these cats were subsequently studied after a minimum of 3 months of
      treatment with the antihypertensive agent amlodipine. Hypertensive cats had a
      significantly thicker interventricular septum in both systole and diastole,
      thicker left ventricular free wall in both systole and diastole, and larger left
      atrium compared to the published normal values and 74% (14/19) of the cats met
      criteria for left ventricular hypertrophy (diastolic septal or free-wall
      thickness > 0.60 cm). Systolic blood pressure was lower after treatment (217 +/-
      25 mm Hg, range: 180-275 mm Hg; and 142 +/- 27 mm Hg, range: 90-200 mm Hg). No
      difference was found in any of the echocardiographic measurements between the
      untreated and treated cats, although more cats had ventricular hypertrophy before
      treatment (11/14) than after initiating amlodipine (6/14; P = .006). Ventricular
      hypertrophy is common in hypertensive cats and may resolve after the initiation
      of amlodipine.

PMID- 11215914
TI  - Common atrium in a dog.

PMID- 11215915
TI  - Clinical vignette. Von Willebrand disease in a Thoroughbred mare and foal.

PMID- 11215916
TI  - Food sensitivity in cats with chronic idiopathic gastrointestinal problems.
AB  - The objectives of this study were to investigate the prevalence of food
      sensitivity in cats with chronic idiopathic gastrointestinal problems, to
      identify the food ingredients responsible, and to characterize the clinical
      features. Seventy cats that presented for chronic gastrointestinal signs
      underwent diagnostic investigation. Fifty-five cats had idiopathic problems and
      were entered into the study. Diagnosis of food sensitivity was made by dietary
      elimination-challenge studies by using commercial selected-protein diets as the
      elimination diet. Sixteen (29%) of the 55 cats with chronic idiopathic
      gastrointestinal problems were diagnosed as food sensitive. The clinical signs of
      another 11 cats (20%) resolved on the elimination diet but did not recur after
      challenge with their previous diet. The foods or food ingredients responsible for
      the clinical signs were dietary staples. Fifty percent of affected cats were
      sensitive to more than 1 food ingredient. The clinical feature most suggestive of
      food sensitivity was concurrent occurrence of gastrointestinal and dermatological
      signs. Weight loss occurred in 11 of the affected cats, and large-bowel diarrhea
      was more common than small-bowel diarrhea. Assay of serum antigen-specific
      immunoglobulin E (IgE) had limited value as a screening test, and gastroscopic
      food sensitivity testing was not helpful. In conclusion, adverse reactions to
      dietary staples were common in this population of cats, and they responded well
      to selected-protein diets. Diagnosis requires dietary elimination-challenge
      trials and cannot be made on the basis of clinical signs, routine
      clinicopathological data, serum antigen-specific IgE assay, gastroscopic food
      sensitivity testing, or gastrointestinal biopsy.

PMID- 11215917
TI  - A system for determination of 3D vessel tree centerlines from biplane images.
AB  - With the increasing number and complexity of therapeutic coronary interventions,
      there is an increasing need for accurate quantitative measurements. These
      interventions and measurements may be facilitated by accurate and reproducible
      magnifications and orientations of the vessel structures, specifically by
      accurate 3D vascular tree centerlines. A number of methods have been proposed to
      calculate 3D vascular tree centerlines from biplane images. In general, the
      calculated magnifications and orientations are accurate to within approximately 1
      3% and 2-5 degrees, respectively. Here, we present a complete system for
      determination of the 3D vessel centerlines from biplane angiograms without the
      use of a calibration object. Subsequent to indication of the vessel centerlines,
      the imaging geometry and 3D centerlines are calculated automatically and within
      approximately 2 min. The system was evaluated in terms of the intra- and inter
      user variations of the various calculated quantities. The reproducibilities
      obtained with this system are comparable to or better than the accuracies and
      reproducibilities quoted for other proposed methods. Based on these results and
      those reported in earlier studies, we believe that this system will provide
      accurate and reproducible vascular tree centerlines from biplane images while the
      patient is still on the table, and thereby will facilitate interventions and
      associated quantitative analyses of the vasculature.

PMID- 11215918
TI  - Quantification of 3-D coronary arterial motion using clinical biplane
      cineangiograms.
AB  - Speculation that the motion of the coronary arteries might be involved in the
      pathogenesis of coronary atherosclerosis has generated growing interest in the
      study of this motion. Accordingly, a system has been developed to quantify 3-D
      coronary arterial motion using clinical biplane cineangiograms. Exploiting the
      temporal continuity of sequential angiographic images, a template matching
      technique is designed to track the non-uniform frame-to-frame motion of coronary
      arteries without assuming that the vessels experience uniform axial strain. The
      implementation of the system is automated by a coarse-to-fine matching process,
      thus improving the efficiency and objectivity of motion analysis. The system has
      been validated and employed to characterize the in vivo motion dynamics of human
      coronary arteries; illustrative results show that this system is a promising tool
      for routine clinical and laboratory analysis of coronary arterial motion.

PMID- 11215919
TI  - Three-dimensional echocardiographic measurement of left ventricular mass:
      comparison with magnetic resonance imaging and two-dimensional echocardiographic
      determinations in man.
AB  - This study was performed to compare a novel three-dimensional echocardiography
      (3DE) system to clinical two-dimensional echocardiography (2DE) and magnetic
      resonance imaging (MRI) for determination of left ventricular mass (LVM) in
      humans. LVM is an independent predictor of cardiac morbidity and mortality.
      Echocardiography is the most widely used clinical method for assessment of LVM,
      as it is non-invasive, portable and relatively inexpensive. However, when
      measuring LVM, 2DE is limited by assumptions about ventricular shape which do not
      affect 3D echo. METHODS: A total of 25 unselected patients underwent 3DE, 2DE and
      MRI. Three-dimensional echo used a magnetic scanhead tracker allowing
      unrestricted selection and combination of images from multiple acoustic windows.
      Mass by quantitative 2DE was assessed using seven different geometric formulas.
      RESULTS: LVM by MRI ranged from 91 to 316 g. There was excellent agreement
      between 3DE and MRI (r = 0.99, SEE = 6.9 g). Quantitative 2D methods correlated
      well with but underestimated MRI (r = 0.84-0.92) with SEEs over threefold greater
      (22.5-30.8 g). Interobserver variation was 7.6% for 3DE vs. 17.7% for 2DE.
      CONCLUSIONS: LVM in humans can be measured accurately, relative to MRI, by
      transthoracic 3D echo using magnetic tracking. Compared to 2D echo, 3D
      echocardiography significantly improves accuracy and reproducibility.

PMID- 11215920
TI  - Stentless bioprostheses have ideal haemodynamics, even in the small aortic root.
AB  - OBJECTIVE: To determine normal Doppler and 2D gradients and flow characteristics
      of the Freestyle stentless aortic bioprosthesis related to valve size.
      BACKGROUND: The Freestyle stentless aortic bioprosthesis is one of the newer
      aortic xenografts. Only limited data are available of the echocardiographic flow
      characteristics during a mid-term follow-up period of this valve. Therefore valve
      performance related to valve size was measured during a follow-up period of two
      years. METHODS: 175 consecutive patients with a Freestyle aortic bioprosthesis
      underwent an echocardiographic and Doppler examination according to a common
      protocol. Investigations were done within 4 weeks after operation, after 3 to 6
      months, and after 1 and 2 years. RESULTS: With a valve size from 19 to 27 mm mean
      gradients decreased from 8.0 +/- 5.1 mmHg at discharge to 5.8 +/- 3.8 mmHg after
      3-6 months (p < 0.001). Thereafter gradients remained stable. The performance
      index, the ratio of the measured effective orifice area in the patient divided by
      the effective orifice area measured in vitro increased from 69 +/- 20% at
      discharge to 79 +/- 29% after one, two and three years. Performance index was
      especially very high in the smaller sized valves with a performance index of 85
      +/- 17% for the 21 mm valve. During follow-up mean gradients remained below 10
      mmHg even in the 21 mm valve. CONCLUSION: Stentless xenografts have ideal
      haemodynamics, even in the small aortic root.

PMID- 11215921
TI  - Reliability of mechanical and phased-array designs for serial intravascular
      ultrasound examinations--animal and clinical studies in stented and non-stented
      coronary arteries.
AB  - BACKGROUND: Both mechanical and multi-element intravascular ultrasound designs
      have potential advantages and limitations that may impact on their value for
      clinical and research purposes. Determination of the reproducibility of
      measurements is critical before a given system can be used in studies such as
      regression of atherosclerosis trials. METHODS: We performed serial intravascular
      ultrasound imaging with catheters using mechanical and phased-array designs in
      stented and non-stented coronary arteries in dogs and in patients. RESULTS: Both
      systems correlated well for areas (r > or = 0.90, p < 0.0001) and diameters (r >
      or = 0.84. p < 0.0001) in dogs and in patients. There was a slight difference
      between multi-element and mechanical designs for measurements of area (mean
      difference in dogs and in patients: -0.24 and 0.96 mm2, p < 0.055) and diameter (
      0.08 and 0.16 mm, p < 0.0001). The reproducibility of the multi-element system
      for reanalysis of the same frames and for analysis of serial pullbacks was
      similar to the same measurements with the mechanical system (r > or = 0.96 for
      all measurements). The differences in absolute and relative variability between
      the mechanical and phased-array designs, both for reanalysis of same frames and
      serial pullbacks, were very small. CONCLUSIONS: Although multi-element and
      mechanical intravascular ultrasound designs are not strictly interchangeable,
      their similar reproducibility and the small differences in measurements
      demonstrate that both designs are acceptable alternatives for trials of
      regression of atherosclerosis. Determination of the variability for serial
      pullbacks of both designs was also important to assess the statistical power of
      such trials.

PMID- 11215922
TI  - Cardiac thrombosis in a patient with Behcet's disease: two years follow-up.
AB  - A 28-year-old man with Behcet's disease was presented with cardiac symptoms in
      addition to previous complaints of oral and genital ulcers. A diagnosis of
      thrombosis was made and patient began to receive anticoagulant and
      immunosuppressive therapy and was followed by echocardiographic examination.
      Despite medical therapy, thrombosis recurred. Surgical excision was performed and
      histological findings were consistent with organizing thrombus. Nature of cardiac
      involvement and review of literature on cardiac thrombosis in Behcet's disease
      was discussed.

PMID- 11215923
TI  - A simple single slice method for measurement of left and right ventricular
      enlargement by electron beam tomography.
AB  - RATIONALE AND OBJECTIVE: We devised to test the feasibility of measuring the left
      and right ventricular sizes by non-contrast electron beam tomographic images.
      METHODS: Ventricular sizes consist of the sum of the intracavitary cavity and
      myocardial mass for each ventricle. A total of 50-image studies from subjects
      undergoing contrast-enhanced studies were used to develop the measurement
      methodology. About 20 contrast studies were used to test the measure. The
      methodology was then prospectively tested on 75 patients with non-contrast
      studies to estimate the intra-observer, inter-observer and inter-study
      reproducibility. RESULTS: Multiple linear regression analysis was completed and
      the correct regression formulas to calculate ventricular volumes were acquired by
      using the area and span from the contrast studies. There was excellent
      correlation between the estimate of LV (r > 0.97, p < 0.001) and RV (r > 0.93, p
      < 0.001) sizes between measured and calculated (contrast, single slice) left and
      right ventricular volumes. The intra-observer, inter-observer and inter-study
      reproducibility demonstrated excellent results with < 7% difference in absolute
      values and a high correlation (r > 0.89, p < 0.001). CONCLUSION: We conclude that
      the left and right ventricular sizes can be accurately estimated from a single
      mid-ventricular slice on non-contrast electron beam tomographic images.

PMID- 11215924
TI  - Accurate measures of left ventricular ejection fraction using electron beam
      tomography: a comparison with radionuclide angiography, and cine angiography.
AB  - BACKGROUND: Quantitative determination of ejection fraction is predicated on
      precise measurement of end-diastolic and end-systolic volumes of the left
      ventricle. Contrast enhanced electron beam tomography (EBT), with excellent
      temporal and spatial resolution, has the potential for highly accurate measures
      of ejection fraction. METHODS: EBT protocol used a short axis scan of the left
      ventricle (8-12 levels, apex to base) during infusion of iodinated contrast. To
      assess the accuracy of the measured left ventricular ejection fraction (LVEF), we
      compared EBT with first-pass radionuclide angiography (RNA) and cine angiography
      (CINE). RESULTS: A total of 41 patients (26 men and 15 women) underwent all three
      tests within 1 week. Resting ejection fraction using each modality was assessed
      in a linear regression model to assess inter-test correlation with the other two
      modalities. Correlation between CINE and EBT was high (r = 0.90, intercept 4.67,
      p < 0.001). Similarly, correlation of CINE and RNA (r = 0.87, intercept -5.48, p
      < 0.001) and between EBT and RNA (r = 0.87, intercept -4.6, p < 0.001) were high.
      In a subset of those patients with LVEF < or = 40%, correlation was consistently
      high between EBT and CINE. However, correlations were poor for the comparisons
      between RNA and CINE (r = 0.40), and between the RNA and EBT (r = 0.47). The mean
      differences of measured ejection fractions between each of the imaging modality
      were small. However, there was only modest agreement between each of the
      comparisons as measured using 95% confidence interval (CI) on Bland-Altman plots.
      CONCLUSION: These data indicate that the LVEF results are comparable among EBT,
      RNA, and CINE and can be used interchangeably to assess ventricular function for
      LVEF > 40%. For LVEF < or = 40%, we demonstrated some disparate results between
      cine angiography and RNA and between EBT and RNA, indicating that CINE or EBT may
      provide more accurate assessment.

PMID- 11215925
TI  - Safety of EBCT contrast injection studies in severe pulmonary hypertension.
AB  - PURPOSE: There is considerable literature published on noninvasive contrast
      enhanced techniques to diagnose pulmonary vascular abnormalities, however little
      data exists on the safety of contrast injections in patients with elevated
      pulmonary arterial pressures. We studied the safety of contrast-enhanced electron
      beam computed tomography (EBCT) in 29 patients with severe pulmonary
      hypertension. The mean dose of intravenous contrast used was 124 +/- 39 cc.
      MATERIALS AND METHODS: Subjects underwent EBCT using contrast injected at a rate
      of 2-4 ml/s. All patients were watched closely for at least 15 min post-procedure
      prior to being released. Patients had Doppler echocardiograms to estimate
      pulmonary artery pressure. Right heart catheterization data was collected for
      patients in which echocardiographic data was unavailable. RESULTS: A total of 29
      patients with pulmonary arterial hypertension were studied. There were 17
      patients with primary pulmonary hypertension (PPH), and 12 patients with
      secondary forms of pulmonary hypertension. None of the patients developed
      complications from their study. CONCLUSION: There is a paucity of data on the
      safety of contrast injections in patients with severely elevated pulmonary
      arterial pressures. Contrast-enhanced EBCT was well-tolerated in our diverse
      series of patients with severely elevated pulmonary arterial pressures.
      Clinicians concerned about invasive pulmonary angiography should consider
      contrast-enhanced EBCT as a safe alternative to angiography.

PMID- 11215926
TI  - Esophageal varices in congenital heart disease with total anomalous pulmonary
      venous connection.
AB  - Total anomalous pulmonary venous connection (TAPVC) is an uncommon congenital
      anomaly in which the anatomical presentations vary widely among patients. We
      hereby present two newborns with TAPVC associated with asplenia syndrome; both
      had severe esophageal varices due to infradiaphragmatic pulmonary venous
      drainage. Ultrafast computed tomography (CT) scanning was superior to color
      Doppler echocardiography and cardiac catheterization as it provided a detailed
      portrait of the pulmonary drainage. The remarkable radiographic manifestations
      are presented.

PMID- 11215927
TI  - [Nobel Prize in physiology or medicine 2000].

PMID- 11215928
TI  - [Darwin in medicine].

PMID- 11215929
TI  - [Is it possible to learn empathy?].

PMID- 11215930
TI  - [Sons and fathers].

PMID- 11215931
TI  - [Physicians as detectives].

PMID- 11215932
TI  - [Personal responsibility and public control].

PMID- 11215933
TI  - [Norwegian newspapers' presentation of Salmonella].
AB  - BACKGROUND: Compared to other microbes, Salmonella gets rather frequent coverage
      in Norwegian newspapers. METHODS: This article reports a qualitative content
      analysis of three Norwegian newspapers' coverage of Salmonella in the period
      January 1996 to July 1998. We focus on aspects of the "risk image" given to
      Salmonella, with special emphasis on the type of solutions or measures that are
      associated with the Salmonella problem. RESULTS: The analysis shows that when a
      newspaper defines Salmonella as a potential risk in Norway, the responsibility
      and relevant solutions are placed mainly at the political and to some extent at
      the central administrative level. When Salmonella is defined as a current risk,
      there seems to be a shift to central and individual levels. With individual
      solutions the responsibility for Salmonella illness is placed at the consumers
      and their personal and food hygiene, and a relevant measure seems to be to
      educate the consumers to cope with the Salmonella risk themselves.
      INTERPRETATION: In Norway, Salmonella is a minor health problem compared to other
      countries. With the ongoing harmonisation between Norwegian and EU regulations,
      the Salmonella situation may change, and the relevant solutions may then imply a
      transfer of the responsibility for health to the individual. This raises the
      question of whether solutions based on individuals bearing responsibility for
      their personal health are desirable when it comes to such aspects as food,
      microbes and related risks.

PMID- 11215934
TI  - [Salmonella infection from turtles].
AB  - Small turtles are asymptomatic carriers of Salmonella. Infants are particularly
      at risk of clinical infection. We describe an eight months old boy who became
      sick with Salmonella. The family had two turtles. Salmonella Abony was found in
      faeces from the child and in samples from both turtles. Commercial distribution
      of reptiles is prohibited in Norway. However, illegal import from other countries
      where no such ban exist is common. There are an estimated 10,000 pet reptiles in
      the Oslo region, most of them are turtles. More than 90% of turtles may be
      carriers of Salmonella. Many owners of turtles are not aware of the risk of
      salmonellosis from their pets.

PMID- 11215935
TI  - [Skin reaction after St Lucia holiday celebration].
AB  - A 37-year-old man developed contact dermatitis on the front head after being
      exposed to dripping candles. The candles were placed in a crown on his head as he
      played St. Lucia in the traditional Lucia Day (13th December) pageant, trying to
      entertain the administrative staff of the University of Bergen where he was
      employed. Afterwards he washed his head with a soap he normally did not use.
      Probably the contact dermatitis is a skin reaction to the soap, but it is
      difficult to say whether the reaction was irritative or allergic. A similar case
      has not been reported earlier. It is of importance that noone stops celebrating
      the Lucia Day. However, proper precautions must be taken, with routines for
      avoiding exposure to stearine or unfamiliar soaps on the head of Lucia.

PMID- 11215936
TI  - [Fall from high altitude].
AB  - BACKGROUND: It is controversial in which way the human body can tolerate
      mechanical stress and later develop sequelae after deceleration trauma. MATERIAL
      AND METHODS: A report on a 26-year-old male who survived a free fall of 28 metres
      from a building. RESULTS: It is accounted for an achieved velocity of 81 kph and
      accumulated energy of 21,000 Joule. The incident lead to multiple complicated
      fractures, nerve injuries and an acute head injury. The patient's cognitive
      function was restored after a few months, and he is satisfied with the outcome.

PMID- 11215937
TI  - [Are emergency admissions to medical departments dependent on weather?].
AB  - BACKGROUND: It is widely believed that patients are more frequently admitted to
      hospital in bad weather. MATERIAL AND METHODS: We evaluated all 15,060 emergency
      admissions to the Medical Department of Rogaland Central Hospital during a 17
      month period and compared this material with meteorological data. RESULTS: We
      found no correlation between the number of admissions and "good weather" (as
      defined by the amount of cloud cover), but we found a significant difference of
      about two more patients (6.6%) being admitted on days with rain and snow. There
      was no correlation between the amount of precipitation and the number of admitted
      patients, but a small, significant inverse relation between temperature and
      admissions. We have also demonstrated a considerable difference in the number of
      admissions on the different weekdays, with the highest number on Mondays and the
      lowest on Saturdays. INTERPRETATION: Both the incidence of disease and doctor
      availability may partially explain the influence of weather and the daily
      variation in emergency admissions to hospital.

PMID- 11215938
TI  - ["Now I am humble. Indeed." From Germany to Norway in 1934].
AB  - A huge refugee problem arose when the Nazis came to power in Germany in 1933. The
      most acute stages were just after 1933 and from the summer of 1938. This refugee
      drama involved all the western countries, including Norway. This paper describes
      the fate of the German gynaecologist Hans Saenger (1884-1943), professor in
      Munich, who in 1933 was dispelled by the Nazis because of his Jewish descent. He
      fled to Norway in 1934 and settled in Fredrikstad. However, the attitude in
      Norway to refugees in general and Jews in particular was hostile, mainly because
      of fear of unemployment. Prejudice and xenophobia were of importance, also in the
      medical profession.

PMID- 11215939
TI  - [Help during the paratyfoid-A epidemic in Kirkenes in 1943-44].
AB  - Finnmark is the northernmost county in Norway. Kirkenes played a prominent part
      in the Second World War, and suffered 328 Russian bombing raids. In June 1943,
      there was an outbreak of paratyphoid A in the town. Its water reservoirs were
      heavily contaminated from a camp for Russian prisoners of war. In November the
      situation became disastrous with 208 new cases. Six advanced medical students
      from Oslo and 16 volunteering Red Cross nurses were sent to Kirkenes for medical
      support. Their biggest problem turned out to be the large number of convalescent
      carriers excreting bacilli in the faeces. A provisional bacteriological
      laboratory was established. Almost the entire population of Sor-Varanger (10,000
      inhabitants) was vaccinated with combined typhoid and paratyphoid A and B vaccine
      (TAB). The children were also vaccinated against diphtheria. Obviously the TAB
      vaccine did not protect against paratyphoid A. Officially, 254 Norwegian cases of
      paratyphoid A were registered in the course of the epidemic; the true number,
      however, was probably about 300. There was only one death, from intestinal
      perforation.

PMID- 11215940
TI  - [Smallpox in Telemark in the last part of the 19th century].
AB  - Was vaccination the only cause of the decline of smallpox in Norway during the
      19th century? This regional study focuses on the history of the disease in
      Telemark county with special emphasis on the last, extensive epidemic in 1868. In
      addition to vaccination, other possible causal relations are discussed. In
      Telemark, smallpox seems to have been relatively mild in the 19th century with
      the exception of the epidemics at the end of the 1830s and in 1868. In 1868 the
      disease spread along the main transportation routes northward through the western
      part and eastward through the more densely populated districts along the coast.
      The importance of vaccination is apparent from the fact that the municipalities
      with the lowest annual percentage of newborns vaccinated were most heavily struck
      by the epidemic. Despite vaccination procedures, both adults and unvaccinated
      children were groups at risk. Local initiatives--especially isolation and
      revaccination--largely prevented or restricted outbreaks of smallpox. It seems
      that the efforts of the district medical officers and local health administrators
      after 1860 were of decisive importance for the decline in smallpox cases in the
      period in question.

PMID- 11215941
TI  - [A matter of heart--two examinations of the same heart with a sixty year
      interval].
AB  - The 20th of May 1869, Professor Emanuel Winge used a human heart as an exhibit at
      a meeting of The Medical Society in Christiania. This heart was later conserved
      and kept in the museum of the Institute of Pathology. Sixty years later, one of
      Winge's successors, Professor Francis Harbitz, used the very same heart, also at
      a meeting of The Medical Society. Harbitz had then confirmed Winge's hypothesis
      of 1869, that the endocarditis of this heart was due to a bacterial infection.
      This article contemplates the disparity between the "scientific gazes" of Winge
      and Harbitz, and why Harbitz was able to convert Winges hypothesis of 1869 into a
      scientific discovery in 1929.

PMID- 11215942
TI  - [Doctor Eyvind Kraft--halfway around the world in the 1880s].
AB  - More than every second Norwegian 19th century physician made one or more study
      trips abroad. Some of them were probably more inspired by love of adventure than
      by the prospect of gaining new medical insight. This was probably also true of my
      great-grandfather, Eyvind Kraft. Shortly after completing medical school in 1879,
      he left Norway on the "Musca", an emigrant vessel, bound for Hawaii. He returned
      home approximately six years later to establish a sanatorium. In the meantime he
      worked as a ship's doctor, made a contribution to the understanding of the
      contagiousness of leprosy, and was among the founding members of the first
      medical society in the state of Wisconsin. Back in Norway he worked at the
      sanatorium, but also as a general practitioner and among fishermen during the
      seasonal fisheries. He had to travel to the Continent in an attempt to cure his
      "nerve disease". Eyvind Kraft's life tells an exciting story of exotic places and
      of the view of disease in his time.

PMID- 11215943
TI  - [Thomas H.Huxley--the naval doctor who became Darwin's bulldog].
AB  - Thomas H. Huxley (1825-1895) was an English physician and biologist who had a
      deep impact on the Victorian age. More than any other at his time he introduced
      scientifically based values. As a member of London's school board he brought
      science into the curriculum, encouraging school-children to ask questions and to
      make their own observations. Huxley came from a lower middle class family with
      little money. By sheer determination and hard work he managed to get a medical
      education at Charing Cross Hospital Medical School. He then obtained a posting on
      H.M.S. Rattlesnake, which gave him a chance to explore the southern seas and to
      study marine species. The results were published by the Royal Society of which
      Huxley became a member at the age of 26, and later its president. After several
      years of uncertainty he secured a position at the Royal School of Mines, which he
      transformed into the Imperial College of Science. He was a prolific scientist
      with wide interests, doing valuable work in paleontology, taxonomy and ethnology.
      Huxley wrote numerous essays on philosophy and scientific subjects. He coined the
      word agnostic to explain his attitude to Christian dogma. His style was clear and
      direct, and his essays still read very well. However, Huxley is now mostly,
      perhaps unfairly, remembered for his defence of Darwin's theory of evolution. In
      his book Evidence as to man's place in nature, Huxley, in contrast to Darwin,
      deals with the evolution of humans, mainly based on comparative anatomy. Huxley
      advocated a firmly held belief that scientific truths will have a liberating
      effect on the minds of men. His lectures on scientific subjects attracted large
      audiences of people who had not had the benefit of a higher education.

PMID- 11215944
TI  - [From The Origin of Species to Artenes Oprindelse].
AB  - The Origin of Species, Charles Darwin's most important work, was published in
      London in 1859. The first presentation in Norway, by P. Chr. Asbjornsen, appeared
      in the journal Budstikken. About 30 years passed before it was translated into
      Norwegian, and it took some time before Darwin's theories were debated in Norway.
      The zoologist Michael Sars introduced them in the Scientific Society in
      Christiania (i.e., Oslo) in 1869, but he was not met with a great deal of
      interest. However, a new generation of scientist saw this differently, mainly the
      botanist Axel Blytt, the zoologist G.O. Sars and the geologist W.C. Brogger. Two
      prominent professors of medicine were also involved in the debate, on different
      sides. The Darwinist Gerhard Henrik Armauer Hansen, who discovered the lepra
      bacillus, wrote several books and articles about Darwinism, while Professor Ernst
      Ferdinand Lochmann, though admiring Darwin as a prominent naturalist, strongly
      rejected Darwinism as a scientific theory.

PMID- 11215945
TI  - [The olfactory sense].
AB  - BACKGROUND: In mammals, olfactory stimuli influence various aspects of life
      including feeding, social behaviour, and reproduction. METHODS: We review the
      progress in olfactory research in the last decade. RESULTS: In this era of gene
      based techniques, a breakthrough in our knowledge on odorant and pheromone
      detection has occurred. Most importantly, a large gene family of odorant
      receptors expressed in the olfactory epithelium has been discovered. Subsets of
      receptor cells express one and only one receptor type and send their axons to a
      corresponding glomerulus in the olfactory bulb, giving rise to an odor-specific
      map in this structure. Two gene families of pheromone receptors expressed in the
      vomeronasal organ have also been discovered, and a role of pheromones in
      mammalian reproduction has been established. INTERPRETATION: Although the crucial
      steps in odorant binding and transduction to nerve signals have been revealed,
      the central processing of this sensory information is basically unknown.
      Moreover, whether pheromones serve a significant role in human behaviour is still
      an open question.

PMID- 11215946
TI  - [Arne Thorkildsen and Thorkildsen's surgery].
AB  - Arne Torkildsen (1899-1968) studied neurosurgery for one year at Queen Square and
      for four years (1930-34) with Wilder Penfield in Montreal. He returned to Oslo,
      Norway, in 1935 and took up responsibility for the neurosurgical section of the
      Department of Neurology of the National Hospital of Norway. In 1939, he
      introduced a new technique for operative treatment of hydrocephalus
      (ventriculocisternostomy, Torkildsen's shunt). His technique was the first
      successful procedure for shunting of cerebrospinal fluid and soon became
      internationally known and accepted as the standard operation for obstruction of
      the aqueduct or posterior third ventricle. In 1950, he defended his doctoral
      thesis at the University of Copenhagen, describing the technique and the results
      of the operation. He was professor of neurosurgery at the University of Cairo,
      Egypt 1951-1954.

PMID- 11215947
TI  - [Statins and muscular adverse effects].

PMID- 11215948
TI  - [The "two cultures" in medicine].
AB  - "The two cultures", a concept launched by C.P. Snow in 1959, points to the schism
      between science and the humanities, two distinct professional cultures which not
      only has gone separate ways, but also developed deep tensions between them.
      Historically, medicine is part of the scientific culture as well as that of the
      humanities. However, contemporary doctors see themselves first and foremost as
      scientists, and modern medicine leaves little scope for the tradition of the
      humanities. Including humanities in medical undergraduate, graduate and
      continuous education does not necessarily make doctors more humane, but insight
      in these disciplines may stimulate reflection and broaden their perspective on
      the practice of medicine. Given the expectations and pressures for efficiency to
      which doctors and other health care workers are subjected, a greater emphasis on
      the humanities in medicine may be of help to doctors in coping with their
      patients, society--and themselves.

PMID- 11215949
TI  - [What is the humanistic medicine?].
AB  - At the Karolinska Institute, Stockholm's medical university, a new academic
      discipline was established in 1998. Humanistic medicine, or medical humanities,
      is a response to the need in an increasing technological medicine for a
      humanistic dimension in medical education and clinical practice. The mission of
      medical humanities is to contribute to the understanding of the scientific and
      ethical structure of medicine. Medical humanities should focus on clinical
      practice. At the Karolinska Institute, the discipline has three aspects: medical
      history, philosophy of medical science, and the "medical meeting", i.e. issues
      such as: What happens in the relation between patient and caregiver? What is the
      art of medicine? How is suffering and disease expressed in art and literature?
      Medical humanities can be a tool for critical reexamination and a radical
      reorientation of the ethos of medicine. After all, health care is at its very
      core a moral project.

PMID- 11215950
TI  - [Humanities and art as a part of medical education].
AB  - From superstition and witchcraft, to detailed scientific insight into the human
      body in health and disease: Stupendous though the development of medical science
      has been over the last few centuries, it does not in itself give doctors a
      sufficient basis for meeting their patients and the people around them. In these
      interpersonal encounters, fundamental, immaterial values are the all-important
      basis. These values and their place in life are not visible in science itself,
      hence the humanities and the arts offer approaches and inspiration that are of
      the greatest value in the education of doctors at all levels.

PMID- 11215951
TI  - [The best available explanations].
AB  - In 1959, C.P. Snow distinguished between the "two cultures"--the cultures of the
      natural and the human sciences. Medicine, however, does not and cannot belong to
      only one of these two cultures. It belongs essentially to both. The reason is
      that medicine is governed by certain ideals about what characterises a human life
      in dignity. These ideals define certain basic alternatives for action as immoral,
      for instance not to attempt to cure illness. This being so, there are certain
      phenomena which medicine cannot permit itself to ignore, thus it must seek the
      best available explanations of such phenomena where these explanations are to be
      found. Often the best explanations are to be found in the human sciences.
      Medicine needs concepts, theories and methods which enable its practitioners to
      grasp meaning, to describe social relations and to understand history.

PMID- 11215952
TI  - [The value basis of future medicine].
AB  - The aim of this article is to propose a way of structuring the values that should
      constitute the basis of future medical practice, starting with the values that
      are common in contemporary medical practice. First, medicine must acknowledge
      that human worth is inviolable. This leads to activities aimed at strengthening
      autonomy as well as protecting the weak and vulnerable aspects of human life.
      Second, medicine must be based on sound professional practice. Medical knowledge
      should be developed by scientific means, but not only by biomedical methods. The
      fundamentally stochastic nature of medicine must be acknowledged. The third set
      of values relates to equity in the access to medical care. Services for the
      weakest among us should have high priority. Finally, medical practice has to be
      predictable and transparent.

PMID- 11215954
TI  - [Have you met Mao?].
AB  - What is a clinical discourse, and what elements of the patient-doctor encounter
      are most important for the outcome in medical practice? I approach these
      questions by using the notion of narratology and some key concepts from discourse
      analysis: interaction, transaction and context. Traditionally, clinical discourse
      is either consultative or psychotherapeutic. I argue for a third approach to the
      patient-doctor discourse, a "narrative dialogue". In the narrative dialogue, the
      patient-doctor-interchange is supposed to be less structural, more flexible, more
      individualistic than what has traditionally been the case. The doctor is supposed
      to be visible as a person more than as a professional persona, and the patient is
      encouraged to participate in the dialogue with his or her own personal narrative
      as a substantial contribution to the consultation.

PMID- 11215953
TI  - [To see oneself in a context--medicine and historia--the two cultures].
AB  - Historians and physicians have different social vantage points and have developed
      widely different professional cultures. This diversity is a distinct feature of
      their research, their theoretical approaches, and their scholarly methods. The
      historian's and the physician's points of view both seem to be necessary parts of
      medical history. The subject itself as well as the scholars involved may profit
      from teamwork. The author also asks whether historical knowledge in the field of
      medicine is useful for today's practitioners. Her answer is yes. Historical
      insight might contribute to a better understanding of day-to-day problems and the
      complex structures of which physicians are part. Furthermore, it is suggested
      that physicians will benefit from insights into why their discipline and their
      professional position have developed in the ways they have. At its best,
      historical knowledge can contribute to a deeper understanding of the limitations
      of medicine, and so may add to physicians' ability to adjust their role in line
      with the present time. Historical knowledge might even contribute to increased
      respect for other branches of knowledge and for other people's skills and
      professional problems.

PMID- 11215955
TI  - [What does a hospital building tell?].
AB  - Hospital architecture may be seen as an artistic expression and interpreted as
      such. In general, architecture is more dependent than other form of art on
      external forces: The requested function of the building normally puts important
      constraints on the implementation of architectural ideas. In addition, buildings
      are often rebuilt and altered in ways that make a retrospective analysis of the
      basic ideas behind them difficult. Hospital buildings usually reflect the state
      of the art of medicine at the time of construction or reconstruction, and their
      architecture should be interpreted in the light of the medical setting of the
      time. Other elements and influences, such as general views on health and
      sickness, religion, economy, style etc. should also be taken into consideration.
      This article discusses examples that show some of the possible pitfalls when we
      attempt to give a cultural interpretation of hospital buildings. The conflict
      between charity and rationality seems to be a basic problem in modern hospitals,
      an example is given where this conflict is reflected in the architecture.

PMID- 11215956
TI  - [Pleasure of reading through the forehead mirror].
AB  - Doctors need not put aside their scientific curiosity when reading fiction. The
      search for medical matters in fiction does not put a constraint on the
      appreciation of literature; it may, in fact, add to the pleasure of reading. This
      article presents some examples of how novelists use medical matters. Unexpected
      medical information may be found, and authors' portrayal of doctors as heroes or
      villains may set off new trains of thought in the reading physician. The
      pleasures of reading and discovering may benefit doctors as well as patients.

PMID- 11215957
TI  - [The human face of medicine--the visual art].
AB  - This article discusses the role of art in medicine on the background of
      experience with art lectures for medical students and courses and exhibitions for
      doctors. From the last half of the 19th century, Norwegian artists have taken an
      interest in medical themes. Their paintings are an important contribution to
      medical history in Norway; more generally, they contribute to our understanding
      of the development of Norwegian society. Visual art is an important element in
      the decoration of hospitals. The works on display in the new National Hospital
      buildings in Oslo show how art may successfully be used in indoor as well as
      outdoor areas. It is important to let artists in on the planning process prior to
      the building of a new hospital.

PMID- 11215958
TI  - [Is there a place for humanistic dimension in medical education?].
AB  - Inspired by the concept of "two cultures", coined by C.P. Snow, this paper
      discusses the role of the humanities in relation to the natural sciences in a
      recently (since 1993) revised medical curriculum at the Faculty of Medicine in
      Trondheim, Norway. A concept of a "third culture" is identified as well:
      community medicine in a broad sense, disciplines dealing with health, illness and
      disease in the context of society and the environment. The implementation of the
      new curriculum was affected by intended and unintended social forces. The result
      was a hybrid model rather than the planned "pure" problem-based model. The
      humanities and "third culture" disciplines tended to yield to the pressure from
      the basic sciences when numbers of formal lectures were strictly limited, while
      the basic sciences themselves felt cut short by clinical disciplines. Problem
      based learning in groups did seem efficient in basic sciences and clinical
      subjects, but not for the humanities or third culture disciplines. This apparent
      limitation in the problem-based approach was probably due to contextual factors,
      rather than inherent in the method itself.

PMID- 11215959
TI  - [How to teach ballet to a swat?].
AB  - There is increasing interest in including humanities subjects in the medical
      curriculum, as a means of accelerating students' personal development and of
      helping them in their meeting with patients, in order to counteract a perceived
      communication deficit in the health care system. Traditionally, medical schools
      have favoured students who concentrate on what is most relevant for their exams,
      possibly at the expense of reflection, idealism and empathy. As medical students
      in the University of Oslo, we do not feel that the situation is as bad as some
      claim it is. Most medical students have a wide range of ability and show interest
      and involvement in their own as well as their patients' situation. Humanities
      subjects are included in the curriculum, but it is tempting to see them as
      "spice" added for flavour and spread out over the course with no clear logic
      behind it. We do not necessarily see the need for more humanities courses, but we
      do see a need for more critical evaluation of what is taught. Humanities in the
      medical education should aim not just at improving communication skills, they
      should also include perspectives on how health care professionals can take of
      themselves, and put medicine into a wider scientific and historical perspective.

PMID- 11215960
TI  - [Sigmoid Freud and Harald Schjelderup--views on telepathy and parapsychology].

PMID- 11215961
TI  - [Oskar Pfister as psychotherapist of the brothers Kristian and Harald
      Schjelderup].

PMID- 11215962
TI  - [The Amish people and the simple life--glimpses from the history, society and
      health of a religious minority].

PMID- 11215963
TI  - [To be on call during the New Year's Eve].

PMID- 11215964
TI  - [To commit, to make or to take suicide--changing language norm].

PMID- 11215965
TI  - [Legionella pneumonia].

PMID- 11215966
TI  - [Oxytocin prevention in labor].

PMID- 11215967
TI  - [To get a premature baby].

PMID- 11215968
TI  - [Maintenance treatment of opiate addicts].

PMID- 11215969
TI  - [You are dead--but your personal integrity is still alive].

PMID- 11215970
TI  - [Is the era of general practice over?].

PMID- 11215971
TI  - Risk factors for Alzheimer's disease.

PMID- 11215972
TI  - Alzheimer's. Dispelling the myths (a personal view).

PMID- 11215973
TI  - Stoma surgery in the older adult.
AB  - In this article Barbara Stuchfield discusses the care of the older adult
      undergoing stoma-forming surgery, and outlines the assessments and postoperative
      care that should be undertaken by nurses.

PMID- 11215974
TI  - Assessing older people.

PMID- 11215975
TI  - That was the year that was.

PMID- 11215976
TI  - Guiding continence care.

PMID- 11215977
TI  - Skin care for older people with incontinence.

PMID- 11215978
TI  - Old age in today's Britain.

PMID- 11215979
TI  - Quality care: the inside story.

PMID- 11215980
TI  - Enhancing family therapy: the addition of a community resource specialist.

PMID- 11215981
TI  - Approaches to the study of gender in marriage and family therapy curricula.
AB  - This study compares two accredited marriage and family therapy programs: One
      includes a separate course on gender, and the other integrates gender throughout
      the curriculum. Students from the two programs rated their own and their peers'
      experience of how gender education effects therapy, program culture, and personal
      life. Results indicate that students from the integrated program view their peers
      as incorporating gender ideas in therapy to a significantly greater extent (t =
      2.83, p < .05) than do students in the gender course program. However, students
      from the program that has a gender course leaned more toward agreement with
      feminist concepts than did students from the integrated program. Overall,
      students appear to be learning about gender and integrating these concepts into
      their work as therapists. Discussion is included on how to choose a gender
      curriculum.

PMID- 11215982
TI  - Teaching family therapists about sexual attraction in therapy.

PMID- 11215983
TI  - Clients' views of live supervision and satisfaction with therapy.
AB  - In this study we examined clients' perceptions of live supervision and their
      satisfaction with therapy in a university-based training clinic for marriage and
      family therapists. A total of 108 clients completed the Client Satisfaction
      Questionnaire-8 and a modified version of the Purdue Live Observation
      Satisfaction Scale. Clients' comments on the advantages and disadvantages of live
      supervision were also solicited through short-answer questions. Results indicated
      that clients were generally satisfied with therapy and found the live-supervision
      process satisfactory as long as the perceived helpfulness of live supervision
      outweighed its perceived intrusiveness. The challenge for training clinics is
      striking a balance between helpfulness and intrusiveness in an effort to both
      train competent therapists and provide quality treatment.

PMID- 11215984
TI  - All those in favor of saving the planet, please raise your hand: a comment about
      "family therapy saves the planet".

PMID- 11215985
TI  - Healing the world in fifty-minute intervals: a response to "family therapy saves
      the planet".

PMID- 11215986
TI  - Saving the planet--or ourselves?

PMID- 11215987
TI  - Reconstituting racial histories and identities: the narratives of interracial
      couples.
AB  - This study explores the process by which interracial spouses construct narratives
      about their racial histories, identities, and experiences in their relationship
      together. Ten black-white couples were interviewed individually and conjointly.
      The results reflected interracial spouses' experience of their life together,
      their perception of others' perceptions of them, and their unique processes of
      negotiating racial, gender, and class differences. Black spouses, compared with
      white spouses, demonstrated a greater awareness of and sensitivity to social
      resistance to interracial couples, and black spouses' familial and personal
      histories were sometimes relegated to silence in the couple relationship. I
      discuss recommendations for marriage and family therapists working with
      interracial spouses.

PMID- 11215988
TI  - Family therapy saves the planet: messianic tendencies in the family systems
      literature.
AB  - It is not unusual occasionally to hear individual family therapists describe
      their work as an effort to "save the world." The messianic notion that family
      therapy should be the world's salvation is not simply a fancy of individual
      clinicians, but is deeply imbedded in several of our field's most fundamental
      theories. This article explores messianic arguments in the work of some of family
      therapy's most important thinkers, including von Bertalanffy, Bateson, and
      Keeney, and then discusses the implications that these arguments have for the
      clinical and theoretical development of our field.

PMID- 11215989
TI  - Developing culturally competent marriage and family therapists: guidelines for
      working with Hispanic families.
AB  - As the Hispanic population of the United States continues to grow, so will the
      need for therapists who have been trained to work with Hispanic families. This
      content analysis of the available treatment literature generated several specific
      guidelines that can be used in training and evaluating culturally competent
      therapists. Guidelines included: Use family therapy, act as advocate for the
      family, assess immigration experience, assess acculturation, respect father,
      interview family subsystems separately, do not force changes, provide concrete
      suggestions, and warmly engage the family. Empirical and conceptual support for
      each guideline is discussed and several conclusions are made regarding culturally
      competent therapy with Hispanic families.

PMID- 11215990
TI  - Mars and Venus: unequal planets.
AB  - Self-help books, a pervasive and influential aspect of society, can have a
      beneficial or detrimental effect on the therapeutic process. This article
      describes a thematic analysis and feminist critique of the best-selling self-help
      book, Men are from Mars, Women are from Venus. This analysis revealed that the
      author's materials are inconsistent with significant family therapy research
      findings and key principles of feminist theories. His descriptions of each gender
      and his recommendations for improving relationships serve to endorse and
      encourage power differentials between women and men.

PMID- 11215991
TI  - The feminist/emotionally focused therapy practice model: an integrated approach
      for couple therapy.
AB  - Emotionally focused therapy (EFT) is a well-developed, empirically tested
      practice model for couple therapy that integrates systems, experiential, and
      attachment theories. Feminist family therapy theory has provided a critique of
      biased assumptions about gender at play in traditional family therapy practice
      and the historical absence of discussions of power in family therapy theory. This
      article presents an integrated feminist/EFT practice model for use in couple
      therapy, using a case from practice to illustrate key concepts. Broadly, the
      integrated model addresses gender roles and individual emotional experience using
      a systemic framework for understanding couple interaction. The model provides
      practitioners with a sophisticated, comprehensive, and relevant practice approach
      for working with the issues and challenges emerging for contemporary heterosexual
      couples.

PMID- 11215992
TI  - Methods of feminist family therapy supervision.
AB  - Although feminist family therapy has been studied and practiced for more than 20
      years, writing about feminist supervision in family therapy has been limited.
      Three supervision methods emerged from a qualitative study of the experiences of
      feminist family therapy supervisors and the therapists they supervised: The
      supervision contract, collaborative methods, and hierarchical methods. In
      addition to a description of the participants' experiences of these methods, we
      discuss their fit with previous theoretical descriptions of feminist supervision
      and offer suggestions for future research.

PMID- 11215993
TI  - Couples therapy for women survivors of child sexual abuse who are in addictions
      recovery: a comparative case study of treatment process and outcome.
AB  - Treatment for women who are survivors of child sexual abuse and who have a
      history of substance abuse has largely involved gender-specific interventions.
      This study examines the use of conjoint couple therapy with a cohort of women who
      were survivors of child sexual abuse and who are in addiction recovery and with
      their partners. A comparative case study analysis incorporated standardized
      clinical measures with client and therapist interviews. Brief conjoint therapy
      was found to assist couples in the specific relationship skill areas of
      communication and mutual problem solving. Further, substantive gains were found
      in the realm of affective relations. The women reported an increase in support
      from their male partners, and the men reported a decrease in negative emotional
      atmosphere in the relationship.

PMID- 11215994
TI  - The relative buffering capacities of saliva and moist snuff: implications for
      nicotine absorption.
AB  - Commercial moist snuff products are used by placing a portion of tobacco inside
      the mouth between the inner cheek or lip and gum. Nicotine is absorbed into the
      blood stream via transfer across various oral membranes including the buccal
      mucosa (cheek lining). The resulting salivary pH when a given moist snuff product
      is placed in the mouth is an important factor for nicotine absorption because it
      will affect the proportion of free base nicotine that is readily available for
      absorption. The resulting salivary pH for a given moist snuff product will be
      determined in part by the relative acid-base buffering capacities of the saliva
      and moist snuff, as well as the pHs of the saliva and moist snuff prior to coming
      in contact with one another. In the current study, the acid-base buffering
      capacities (mu eq/g) of a series of commercial moist snuff products were
      determined and compared to the acid-base buffering capacity for unstimulated,
      whole human saliva. The buffering capacities of the moist snuff products were
      determined to be 10-20 times higher than the buffering capacity of human saliva.
      The resulting salivary pH ranges after contact between an artifical saliva and
      the various moist snuff products were also determined; the results were used to
      predict the proportion of free base nicotine that can be expected to occur in the
      mouth during the first few minutes of product use. These studies provide a basis
      for examining and understanding the effects that moist snuff product pHs and
      buffering capacities may be expected to have on nicotine absorption.

PMID- 11215995
TI  - Stability of morphine, morphine-3-glucuronide, and morphine-6-glucuronide in
      fresh blood and plasma and postmortem blood samples.
AB  - The present study was designed to determine the stability of morphine and its
      glucuronides in spiked fresh blood and plasma from live individuals as well as in
      four authentic postmortem blood specimens for a time interval of up to six
      months. The samples were stored in glass vials at -20 degrees C, 4 degrees C, and
      20 degrees C. Additionally, spiked samples were exposed to light through window
      glass and subjected to a forced-degradation study at 40 degrees C. Data were
      established using solid-phase extraction and high-performance liquid
      chromatography coupled to atmospheric pressure ionization mass spectrometry for
      isolation and quantitation, providing a sensitive and specific detection method
      for the parent drug in the presence of its glucuronide metabolites. Morphine and
      its glucuronide metabolites were found to be stable in both blood and plasma at 4
      degrees C for the whole observation period. In postmortem blood the analytes were
      stable only when stored at -20 degrees C. The thermal decomposition of morphine
      and morphine-6-glucuronide in spiked blood and plasma could be interpreted using
      pseudo first-order kinetics. Photodegradation of morphine-3-glucuronide in plasma
      was consistent with a second-order reaction. In postmortem samples the
      degradation pattern differed completely from that observed in fresh blood and
      plasma. The elevated morphine levels observed were primarily due to postmortem
      hydrolysis of morphine glucuronides.

PMID- 11215996
TI  - FT-IR breath test in the diagnosis and control of treatment of methanol
      intoxications.
AB  - A portable Fourier transform infrared (FT-IR) multicomponent point-of-care
      analyzer was tested for the diagnosis of methanol intoxications. Breath analysis
      with FT-IR was fast and easy, and no sample preparation was needed. The analyzer
      was adequately sensitive and accurate in detecting and quantitating clinically
      relevant amounts of ethanol and methanol in the breath of seriously ill patients.
      FT-IR spectrometry was also suitable for nearly on-line monitoring of the exhaled
      ethanol and methanol during hemodialysis. The breath analysis results correlated
      well with blood samples. The FT-IR method used also has a traceable calibration
      to physical properties of the analyte, and the measured spectra can be saved for
      later analysis.

PMID- 11215997
TI  - Detection and quantitation of morphine in fixed tissues and formalin solutions.
AB  - The study reports the results of the detection and quantitation of morphine in
      tissues fixed in formalin and in the formalin solutions in which the same tissues
      were fixed. Toxicological analyses were performed on formalin-fixed liver and
      kidney samples from five cases of opiate poisoning and on the formalin solutions
      (10% buffered pH 7) in which the samples were preserved. Analyses carried out at
      the time of autopsy on body fluids and tissues allowed identification of opiate
      as the cause of death and its quantitation. Tissue samples were preserved in
      formalin solutions for 12 weeks before analysis. The mean levels of recovery of
      morphine in fixed tissues were 36.29% in liver, 29.41% in kidney, 74.93% in
      formalin from liver, and 42.17% in formalin from kidney. Results indicated that
      this particular toxic substance shows good stability even in biological specimens
      subjected to chemical fixation.

PMID- 11215998
TI  - Simultaneous determination of 2,4-D and MCPA in canine plasma and urine by HPLC
      with fluorescence detection using 9-anthryldiazomethane (ADAM).
AB  - A method for the simultaneous determination of 2,4-dichlorophenoxyacetic acid
      (2,4-D) and 2-methyl-4-chlorophenoxyacetic acid (MCPA) in canine plasma and urine
      has been developed. This method used derivatization of extracted samples with 9
      anthrylmethane (ADAM) for analysis by reversed-phase high-performance liquid
      chromatography with fluorescence detection. Precision and accuracy were within
      the accepted limits of 15% and 85-115%, respectively, for both analytes in plasma
      and urine. Calibration curves for 2,4-D and MCPA in plasma were linear (r2 >
      0.99) between 0.50 and 5.0 mg/L and 5.0 and 100 mg/L. Calibration curves for 2,4
      D and MCPA in urine were linear (r2 > 0.99) between 5.0 and 70.0 mg 2,4-D/L and
      10.0 and 70.0 mg MCPA/L. The lower limit of detection was 62.5 ng/mL for both 2,4
      D and MCPA.

PMID- 11215999
TI  - Analysis of methadone and its metabolites in meconium by enzyme immunoassay
      (EMIT) and GC-MS.
AB  - An EMIT-ETS d.a.u. immunoassay screening method for methadone in meconium and a
      gas chromatography-mass spectrometry (GC-MS) method for methadone and its
      metabolites including 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP)
      and 2-ethyl-5-methyl-3,3-diphenylpyrroline (EMDP) in meconium were described. The
      GC-MS method showed good linearity (r2 > or = 0.998) over a concentration range
      of 25-2000 ng/g with limits of detection of 10, 25, and 10 ng/g for methadone,
      EDDP, and EMDP, respectively, and a limit of quantitation of 25 ng/g for all
      three analytes. Fifty pooled meconium samples were screened using a cutoff of 200
      ng/g, and all samples screened negative. GC-MS analysis of all samples showed
      four samples to contain methadone (35.2 to 79.9 ng/g), EDDP (28.5 to 557.2 ng/g),
      or both, with no detectable amount of EMDP. The negative results on the four
      specimens at the cutoff used may be explained by the fact that EMIT-ETS d.a.u.
      antibody for methadone was specific to the parent drug. The results point to the
      fact that immunoassays should be directed to EDDP for detection of prenatal
      exposure of methadone through analysis of meconium specimens.

PMID- 11216000
TI  - Computer-aided screening for hallucinogenic and stimulant amphetamines with gas
      chromatography-Fourier transform infrared spectroscopy (GC-FTIR).
AB  - An expert system applied as a screening test for amphetamine analogues found in
      recreational-drug exhibits (tablets or powders) is described. The knowledge base
      defining the reference Fourier transform infrared spectroscopic (FTIR) spectral
      patterns has been built according to criteria encompassing toxicological,
      pharmacological, and neurochemical aspects. The class identity of a compound is
      determined within seconds using soft independent modeling of class analogy
      (SIMCA). The predictive value of the system, as assessed at a testing accuracy of
      95%, is expressed by a total correct classification rate of 93.93% and by a
      96.30% rate of true-positive amphetamines. The specificity and the selectivity of
      the screening test, evaluated by testing 159 toxicologically relevant compounds,
      are discussed, emphasizing the chemical and physical factors affecting these
      parameters. Medicinal amphetamines giving cross-reactions with traditional
      screening techniques produce a negative result. The specificity of the system
      characterizes the expert system as a highly sensitive, selective, fast, and user
      friendly screening test that screens for amphetamines with prediction accuracy
      adequate for investigations in analytical toxicology.

PMID- 11216001
TI  - Bioanalysis of the enantiomers of (+/-)-sarin using automated thermal cold-trap
      injection combined with two-dimensional gas chromatography.
AB  - A fully automated multidimensional gas chromatographic system with thermal
      desorption injection and alkali flame detection was developed for analysis of the
      enantiomers of the nerve agent (+/-)-sarin. The chiral stationary phase was CP
      Cyclodex B on which the sarin enantiomers were completely resolved. The absolute
      detection limit was 2.5 pg per enantiomer. The method is intended to be used for
      the analysis of the sarin enantiomers in biological samples. For this purpose,
      sarin was isolated from guinea pig blood via solid-phase extraction. Deuterated
      sarin was used as internal standard. Stabilization of sarin in the blood sample
      by acidification and addition of an excess of a competitive organophosphorus
      compound (neopentyl sarin) appeared to be essential. The absolute recovery of the
      extraction procedure was 60%, whereas the recovery relative to the internal
      standard was 100%.

PMID- 11216002
TI  - Immunoassay for detection of cocaine/metabolites in oral fluids.
AB  - There is growing interest in the use of alternate biological fluids for drug
      testing. An advantage of oral fluids is that collection can be made from
      individuals under direct observation without undue embarrassment or invasion of
      privacy. This study evaluated the STC Cocaine Metabolite MICRO-PLATE EIA for use
      in detection of cocaine and metabolites in oral fluids. Intra- and interassay
      precision of the EIA was < 10%. The EIA was cross-reactive to benzoylecgonine
      (100%), cocaine (> 12.9%), and cocaethylene (13.8%), but did not demonstrate
      detectable cross-reactivity with other commonly encountered medicants. Evaluation
      of a series of potential adulterants of oral fluids indicated that common
      household chemicals and foodstuffs did not alter the outcome of EIA testing for
      cocaine metabolite. Analysis by EIA and by gas chromatography-mass spectrometry
      (GC-MS) of oral fluids and urine specimens collected from current drug users in
      treatment programs and subjects participating in research studies involving
      controlled dosing of cocaine provided assessment of the clinical sensitivity and
      specificity of the STC Cocaine Metabolite EIA. Analysis of the data by means of
      receiver operating characteristic (ROC) plot indicated that the optimal cutoff
      concentration for the oral fluids EIA was 10 ng/mL. In comparison to GC-MS (10
      ng/mL combined cutoff concentration for cocaine and benzoyleogonine), the EIA (10
      ng/mL cutoff concentration) demonstrated a sensitivity, specificity, and accuracy
      of 95%, 82%, and 88%, respectively. The oral fluids EIA was slightly less
      sensitive than the urine EIA (300-ng/mL cutoff concentration) for the detection
      of cocaine metabolite with a sensitivity, specificity, and accuracy of 73%, 85%,
      and 88%, respectively. Overall, testing of oral fluids for cocaine metabolite
      with the STC Cocaine Metabolite MICRO-PLATE EIA appears to offer a viable
      alternative to urine for detection of recent cocaine use.

PMID- 11216003
TI  - Rapid confirmation/quantitation of ecgonine methyl ester, benzoylecgonine, and
      cocaine in urine using on-line extraction coupled with fast HPLC and tandem mass
      spectrometry.
AB  - A rapid, rugged, and highly specific assay for the quantitation of cocaine (COC)
      and especially its primary metabolites benzoylecgonine (BZE) and ecgonine methyl
      ester (EME) in human urine has been established. Here, we investigated the use of
      on-line sample extraction coupled to rapid chromatography systems for tandem mass
      analysis of COC, EME, and BZE in human urine. Using this method, sample
      preparation consisted of a sole centrifugation step. Combined extraction and
      chromatographic run times were < 3.5 min. The lower limits of detection were 0.5
      ng/mL, 2.0 ng/mL, and 0.5 ng/mL for EME, BZE, and COC, respectively. Linear
      calibration curves ranging from 7.5 ng/mL to 1000 ng/mL were produced for the
      test analytes. Within-day and between-day precision and accuracy of the assay
      were determined using human urine quality-control specimens at 5, 10, or 15; 150;
      and 1000 ng/mL. The analyses were performed over the course of five days,
      rendering %CVs < 10% for EME, BZE, and COC. Percent mean accuracy for the three
      analytes of 97 to 113% were obtained. Our data suggest that on-line sample
      extraction coupled with rapid high-performance liquid chromatography-tandem mass
      spectrometry may be a viable alternative for EME, BZE, and COC analyses in human
      urine.

PMID- 11216004
TI  - A mass spectrometric method for quantitation of intact insulin in blood samples.
AB  - An analytical method was developed for the quantitation of intact insulin in
      blood samples. Solid-phase extraction (SPE) was used to purify and concentrate
      the protein after the plasma is separated. Analysis is performed by electrospray
      liquid chromatography-mass spectrometry (LC-MS) using a trifluoroacetic acid
      mobile phase. The limit of quantitation of the SPE LC-MS method has been
      determined to be 1.0 ng/mL for endogenous levels of insulin. Base levels of human
      insulin in plasma have been quantitated, and values ranging from 1.0 to 1.4 ng/mL
      were observed. In a single analysis, the method can determine human, porcine, and
      bovine insulin. Reproducibility was tested for both blood samples and aqueous
      standards and produced relative standard deviations of approximately 10% and
      lower. Calibration curves were constructed corresponding to plasma levels of 0.4
      to 80 ng/mL and found to be linear with R2 values greater than 0.99. Stability
      studies of human and porcine insulin were performed over a period of 21 days for
      whole human blood samples stored at both room temperature and 4 degrees C.
      Hemolyzed blood samples were also analyzed using the developed method and were
      found to produce quantitatable levels of insulin. The advantage of the
      application of SPE and LC-MS for the quantitation of insulin is the high
      specificity compared to other techniques such as radioimmunoassay (RIA). In
      addition, the developed LC-MS method is not subject to interferences that cause
      problems with RIA, such as hemolysis. The method is efficient and rapid and
      produces results more specific than those obtained with RIA.

PMID- 11216005
TI  - [High rate of recurrence, misplaced surgical mesh. Technical errors in hernia
      surgery? (interview by Petra Eiden)].

PMID- 11216006
TI  - [Botulinum toxin also has an analgesic effect. Nerve poison against headache].

PMID- 11216007
TI  - [The best nutrition for the brain. Can one become intelligent by eating?].

PMID- 11216008
TI  - [Nodules in the thyroid gland. What is important in suspected carcinoma].

PMID- 11216009
TI  - [Thyroid carcinoma. Diagnosis--nonoperative therapy--after care].
AB  - Thyroid carcinomas may originate in the thyroid cells (follicular and papillary,
      carcinoma, so-called differentiated carcinomas, constituting roughly 80-90% of
      cases), and the calcitonin-producing parafollicular C cells (medullary carcinoma,
      roughly 10%). The suspected diagnosis is clarified with the aid of
      ultrasonography, scintigraphy and fine-needle aspiration cytology. Primarily,
      carcinomas of the thyroid are treated surgically; in the case of differentiated
      carcinomas, surgery is followed by radio-iodine treatment, and in the follow-up
      period 131I scintigraphy is performed. During this period, physical examination,
      ultrasonography of the neck, monitoring of the tumours markers, and treatment
      with levothyroxine are applied (TSH-suppressive in cases of differentiated
      carcinoma). In the event of a recurrence showing rapid progression, when surgical
      and nuclear medical treatment modalities have been exhausted, chemotherapy can be
      given.

PMID- 11216010
TI  - [When is total thyroidectomy indicated? What applies in thyroid carcinoma:
      radical surgery according to findings].
AB  - Today, surgical treatment of thyroid carcinoma is oriented to the underlying
      histology and the extent of the tumourous process. Total thyroidectomy with
      postoperative radioiodine treatment represents only one of the spectrum of
      possibilities that ranges from limited to extended radical interventional
      procedures. Such an individualized operative strategy should be applied not only
      for the primary intervention, but also for locoregional tumour recurrence and
      confirmed distant metastases, with the aim of keeping operative morbidity to a
      minimum.

PMID- 11216011
TI  - [Ulcer therapy with a new proton pump inhibitor. One week of treatment is
      enough].

PMID- 11216012
TI  - [Not vaccinated--pneumococci become life threatening. Case report of pneumonia
      requiring artificial respiration].

PMID- 11216013
TI  - [Diabetic food syndrome. Angiologic diagnosis and therapy].

PMID- 11216014
TI  - [The post-infarction patient. When anxiety handicaps daily life].

PMID- 11216015
TI  - [Diagnostic quiz. A sclerosed vertebral body. Paget disease].

PMID- 11216016
TI  - [Non-cardiac vascular surgery. Perioperative beta blockade protects the heart].

PMID- 11216017
TI  - [Fasting blood glucose has little value. Postprandial glucose indicates risk].

PMID- 11216018
TI  - [Germany as an island? Depression: America manages differently].

PMID- 11216019
TI  - [Approaching Western scientific standards. Learning acupuncture in Peking].

PMID- 11216020
TI  - [Violence against physicians. Colleagues, who are assaulted, are behaving wrong].

PMID- 11216021
TI  - Joint replacement. Help for when pain changes your lifestyle.

PMID- 11216022
TI  - Can telehealth technology be used for the education of health professionals?
AB  - The purpose of this report is to describe the usefulness and desirability of
      using telehealth technology in the education of health care professionals. The PC
      compatible, Windows-based system allowed for both real-time videoconferencing and
      store-and-forward (sending information from one site and stored at a distant site
      for access at a later time) functions. Student responses indicated that they
      thought they would benefit from this type of technology in their clinical
      education. They were most positive with respect to increasing access to a wider
      range of clients they may not otherwise access and least positive for the ability
      to learn from a televideo interaction when compared with a clinic experience.
      Similarly, faculty were least interested in using videoconferencing for patient
      rounds and more interested in using telehealth to enhance classroom
      presentations.

PMID- 11216023
TI  - The experience of caring for a family member with Alzheimer's disease.
AB  - The purpose of this phenomenological study was to describe the experience of
      caring for a family member with Alzheimer's disease or related disorder (ADRD)
      living at home among a diverse sample of 103 family caregivers. The study
      involved secondary analysis of in-depth transcribed interview data using van
      Kaam's rigorous four phase, 12-step psychophenomenological method. A total of
      2,115 descriptive expressions were categorized into 38 preliminary structural
      elements. Eight essential structural elements emerged from an analysis of the
      preliminary structural elements. The eight elements were then synthesized to form
      the following synthetic structural definition: Caring for a family member living
      at home with ADRD was experienced as "being immersed in caregiving; enduring
      stress and frustration; suffering through the losses; integrating ADRD into our
      lives and preserving integrity; gathering support; moving with continuous change;
      and finding meaning and joy."

PMID- 11216024
TI  - Violence on TV and aggression in children.

PMID- 11216025
TI  - Evaluation of a home health patient classification instrument.
AB  - The purpose of this study was to assess reliability and validity of the Revised
      Easley-Storfjell Patient Classification Instrument (R-ESPCI). Content validity
      was assessed by expert home health nurses. Interrater reliability was assessed by
      staff nurse ratings of patients on home visits (N = 34) and by chart review by
      the investigators (N = 30). Concurrent validity was also assessed. Percentage
      agreement for staff nurses was 36% (kappa = -.15) and 52% (kappa = .04) in two
      phases and for investigators 90% (kappa = .63) and 50% (kappa = .02) in two
      phases. Minimal support for concurrent validity was found. Content validity was
      established, but revised reimbursement policy eliminated less acutely ill
      patients, narrowing the acuity range. More discrete rating criteria or scoring
      changes may be needed, followed by further assessment of the R-ESPCI. Agency
      stability and adequate resources for staff training are required for additional
      testing of the instrument.

PMID- 11216026
TI  - The created environment for physical assessment by case managers.
AB  - Goals of gerontological nursing include maximizing health and confronting
      functional impairments. The health of older adults is often fragile because of
      age-related change, complicated by chronic illnesses. Identification of changes
      in health status permits responsive care and consultation but requires
      proficiency in physical assessment. In 1995, research was conducted in Alberta,
      Canada, on registered nurse case managers' reported use of assessment skills.
      Nineteen continuing-care facilities in 1 of 17 provincial health regions
      participated (N = 189). After expert review and pilot testing, questionnaires
      were distributed to two independent groups: nurse administrators/staff
      development coordinators and case managers (response rate = 73%). Qualitative
      data were subjected to descriptive, interpretive, and pattern coding. Reported
      are factors constraining or facilitating physical assessment in continuing care.
      Neuman's concept of the created environment provided a factor-organizing
      framework. A holistic view of environment and data source triangulation increased
      confidence in the comprehensiveness and credibility of results.

PMID- 11216027
TI  - Measuring adherence to a women's walking program.
AB  - The purpose of this study is to demonstrate the use of a self-report exercise log
      and a heart-rate monitor in the measurement of adherence to the dimensions of an
      exercise prescription and to propose an alternative way to define adherence to a
      24-week home-based women's walking program, which reflects the dynamic process of
      behavior change. Adherence was measured with exercise logs, Polar Vantage XL
      Heart-Rate Monitors, and pre- to postintervention change in VO2 max. Of the
      dimensions of the exercise prescription, frequency of walks documented by both
      the heart-rate monitor and the exercise log had a higher correlation than
      duration and intensity of walking, with change in VO2 max suggesting that
      frequency was potentially the most predictive adherence measure. Examination of
      the total number of walks and the number and sequence of weeks without walks over
      the 24-week intervention revealed dynamic patterns of adherence suggesting
      variation in the degree of behavioral change.

PMID- 11216028
TI  - Spiritual perception, attitudes about spiritual care, and spiritual care
      practices among nurse practitioners.
AB  - The purpose of the nonexperimental study was to examine the relationships among
      spiritual perception, attitudes about spiritual care, and spiritual care
      practices in nurse practitioners. Attitudes about providing spiritual care and
      spiritual care practices have been studied among nurse generalists, but little
      research has been conducted on nurses in advanced practice. All nurse
      practitioners registered by the state of Indiana were sent Reed's Spiritual
      Perspective Scale (SPS) and a modified version of the Nurses' Spiritual Care
      Perspectives Scale developed by Taylor, Highfield, and Amenta. Pearson
      correlation techniques were used to test for significant relationships.
      Statistically positive relationships were between perception of personal
      spirituality and 9 of the 12 spiritual care practices. Eight of the 13 items
      describing attitude toward providing spiritual care were statistically
      significant with the SPS. Implications of the findings are discussed.

PMID- 11216029
TI  - Vascular skin ulcers. Handle with care.

PMID- 11216030
TI  - Health tips. Constipation while traveling.

PMID- 11216031
TI  - New cholesterol-lowering drug is now available.

PMID- 11216032
TI  - Colon cancer screening may change with DNA test.

PMID- 11216033
TI  - Sudden cardiac death. Fast action is needed.

PMID- 11216034
TI  - Laparoscopic hernia repair. A faster, easier way.

PMID- 11216035
TI  - Chocolate. Your heart's delight?

PMID- 11216036
TI  - A friend sent me a copy of the Mayo Clinic Diet. It seems to advocate a lot of
      grapefruit and high protein foods. Is this the "real" Mayo Clinic Diet?

PMID- 11216037
TI  - I've heard of an herbal alternative to Viagra for impotence. Does it work and is
      it safe?

PMID- 11216038
TI  - Staying ahead of the game.

PMID- 11216039
TI  - A review of Congressional action 2000.

PMID- 11216040
TI  - Measuring HIPAA's impact.

PMID- 11216041
TI  - Communication, collaboration, and compliance.

PMID- 11216042
TI  - Is PKI (public key infrastructure) the solution to HIPAA security?

PMID- 11216043
TI  - The journey of 1,000 miles: are providers really ready for HIPAA's privacy
      requirements?

PMID- 11216044
TI  - Final privacy rule puts health information in national spotlight.

PMID- 11216045
TI  - The new privacy officer's game plan.
AB  - The HIPAA-mandated privacy officer role offers a new opportunity for HIM
      professionals. What skills are required, and what needs to be done first? This
      article answers these questions.

PMID- 11216046
TI  - Wrestling the HIPAA security regulations: two experts' advice. Interview by
      Steven Austin.

PMID- 11216047
TI  - HIPAA compliance questions for business partner agreements.
AB  - If your organization is covered by HIPAA, do you know what's expected of you--and
      of your vendors--with regard to privacy of health information? To make sure your
      organization is in compliance, contracts with business partners will need careful
      review. The author offers an overview of the proposed regulations and offers some
      tips to get started.

PMID- 11216048
TI  - 10 HIPAA tips for the physician office.

PMID- 11216049
TI  - New APCs (ambulatory patient classifications) for a new year: more OPPS changes.

PMID- 11216050
TI  - Remote coding at home: tips for success.

PMID- 11216051
TI  - Improving performance, managing change.

PMID- 11216052
TI  - Electronic signatures at work.

PMID- 11216053
TI  - Practice brief. Verbal/telephone order authentication and time frames. American
      Health Information Management Association.

PMID- 11216054
TI  - Helping star performers shine.

PMID- 11216055
TI  - Another look at home care PPS.

PMID- 11216056
TI  - Preparing the physician office for HIPAA.

PMID- 11216057
TI  - Opening a window to a hospital's soul.

PMID- 11216058
TI  - Is managed care going small?

PMID- 11216059
TI  - Medical cost offset: do the numbers add up? Yes.

PMID- 11216060
TI  - Medical cost offset: do the numbers add up? No.

PMID- 11216061
TI  - Credo for a care manager. Use of clinical principles can improve relations with
      providers.

PMID- 11216063
TI  - Using the Internet to really connect.

PMID- 11216062
TI  - Is generic really the same?

PMID- 11216064
TI  - Information on the Internet: consumers take the lead.

PMID- 11216065
TI  - Universal connectivity. The Internet race is on.

PMID- 11216066
TI  - Congress restores Medicare funding.

PMID- 11216067
TI  - OSHA's ergonomic standard in the health care workplace.

PMID- 11216068
TI  - Surviving the survey. Is process hurtful or helpful?

PMID- 11216069
TI  - Caregiving. Keep aging minds alert.

PMID- 11216070
TI  - Is liability coverage an endangered species?

PMID- 11216071
TI  - Unmasking fraud and abuse. The pursuit is on via internal compliance programs.

PMID- 11216072
TI  - Basic marketing 121. Long term care marketing is as easy as one-to-one.

PMID- 11216073
TI  - The income statement. The "financial engine" for assisted living.

PMID- 11216074
TI  - A 'long-term' administrator. Interview by Suzanne Bilyeu.

PMID- 11216075
TI  - [Use of digitalis in chronic heart failure: an unresolved problem?].
AB  - The role of digitalis in the treatment of patients with heart failure is still
      being debated. The DIG study, a trial which enrolled about 6800 patients with the
      aim at overcoming the doubts on efficiency and safety of digoxin, showed a
      neutral effect on mortality but there was a statistically significant decreased
      risk of hospitalization due to worsening heart failure in the digoxin group
      compared to the placebo group. The trial disclosed several problems about patient
      selection (many patients were on digitalis before the start of the trial),
      digoxin dosage, which seemed to be high, and about the true reported beneficial
      effects of this therapy. Finally the data available do not permit any evaluation
      on the use of beta-blockers and the association between digitalis and beta
      blockers considering the properties of these drugs in suppressing
      orthosympathetic activation.

PMID- 11216076
TI  - [Controversies regarding distribution, instrumentation, and competence of
      hemodynamics laboratories].
AB  - In the last few years we have witnessed a substantial growth in the number of
      catheterization laboratories, especially in the northern regions of Italy, a
      phenomenon which has met some controversy and has been discussed in a Symposium
      at the ANMCO National Conference (Florence, May 20-23, 2000). The controversy is
      essentially between those who believe in the implementation of catheterization
      laboratories in all cardiology units equipped with a cardiological intensive care
      unit (and the creation of a functional network with the tutorial centers) and
      those who refer to the existing guidelines, standards and VRQ which envisage a
      geographical distribution of laboratories on the basis of a balance between needs
      of the population and the minimum quantity of procedures performed by each center
      in order to guarantee the best quality and cost-effectiveness. The aim of the
      Symposium was to clarify whether the two "innovations" of these last few years,
      namely the introduction of new portable radiological equipment on the one hand
      and the effectiveness of primary angioplasty in the treatment of acute myocardial
      infarction on the other, may influence the redefinition of criteria regarding the
      distribution of laboratories, taking into account as well the expansion of
      indications for coronary angioplasty and coronary angiography. After a lively
      discussion, the proceedings can be summed up as follows: no agreement was reached
      regarding the role of portable radiological equipment in the decisional process
      regarding the setting up of a new catheterization laboratory; primary angioplasty
      should be carried out in centers with an adequate volume of activity and a
      functioning inter-hospital organizational structure for this demanding activity;
      otherwise it does not offer any advantages over fibrinolytic therapy; the
      proposal of a new organizational model is based on the creation of transverse
      inter-hospital cardiology departments, the size of which is based on the overall
      size of the user population, with interventional laboratories distributed in the
      reference hospitals and diagnostic laboratories in hospitals equipped with a
      cardiologic intensive care unit (where there is a sufficiently large user
      population to guarantee at least the minimum number of procedures envisaged by
      the standards); both parts should work in close cooperation. On this last point
      there was a contrasting opinion and it was not possible to reach a consensus. The
      Scientific Societies should formally express their views on this controversial
      topic, so that guidelines, standards and VRQ can be updated rapidly. The latter
      should constitute the reference for the procedures of accreditation to which all
      laboratories and cardiology departments are subjected to, and it is likely that
      this will be the best way to overcome the present controversy.

PMID- 11216077
TI  - [Need and quality assurance: can the introduction of the new generation mobile
      systems change the reference standards?].
AB  - The new generation of radiological mobile systems, by lowering the installation
      and depreciation expenses, has led to start new low volume catheterization
      laboratories. These equipments allow to obtain good quality images, but they are
      not so reliable for extended performances, so that they are not suitable for
      interventional procedures. On the other hand, the extension of the indications to
      coronary angiography and angioplasty, with the related increase in the population
      needs, leads the resetting of the reference areas to start new catheterization
      laboratories. Anyhow lowering of expenses and of the extension of the reference
      areas does not change the need for maintaining high activity levels of centers
      and first operators in order to guarantee the quality of diagnostic and
      interventional procedures. The optimal levels of centers in national standards
      are 800 coronary angiographies and 400 coronary angioplasties per year: these
      numbers indicate the experience necessary to warrant the quality of procedures,
      with optimal results and low rate of complications, therefore they should not be
      changed. The spreading of laboratories due to the new low cost radiological
      equipments leads to an increase in inappropriate procedures and in the total
      expenses for the management of cardiac patients, without a proportional advantage
      in prognosis and quality of life. In order to ensure a quick diagnostic and
      therapeutic process to all the patients who need invasive procedures, instead of
      starting new centers, it is worthwhile to perfect the efficiency of links among
      small and main centers following shared pathways.

PMID- 11216078
TI  - [Can primary angioplasty result in the increase of the number of hemodynamics
      laboratories?].
AB  - Randomized studies comparing primary angioplasty with fibrinolysis have shown
      that mechanical intervention is superior to fibrinolytic treatment in terms of
      effective reperfusion, resulting in a decreased mortality rate and a lower
      incidence of reinfarction and recurrent ischemia. However, the effectiveness of a
      primary angioplasty strategy is strongly dependent on logistic models. Survey
      studies, and the GUSTO IIb trial have shown no clinical benefits of primary
      angioplasty over pharmacologic treatment in the "real world". Thus, a primary
      angioplasty program should be considered only if high performance technical and
      logistic models can be applied. These include surgical back-up, high volume cath
      lab, and an effective network of patient transportation, and as a consequence,
      the most cost/effective model may be identified in a tertiary referral center,
      and in the regionalization of the myocardial infarction centers.

PMID- 11216079
TI  - [Hemodynamics studies with the new generation portable systems: cost-benefit
      analysis].
AB  - Coronary angiography facilities are usually available only in major medical
      centers despite an increasing utilization in managing patients with ischemic
      heart disease. In recent years portable fluoroscopic imaging systems have been
      developed to reduce costs and bring coronary angiography services closer to
      patients. Our experience with the OEC Medical System 9600 demonstrates that the
      portable systems of new generation are reliable both regarding the quality of
      coronary angiograms and the routine use in a multipurpose cardiac catheterization
      laboratory. This statement is based on our 1-year experience (1999) with a
      caseload of 740 studies or procedures: 342 coronary angiographic studies, 159
      electrophysiological studies, 74 radiofrequency catheter ablations, 126 pacemaker
      implantations/replacements, 16 cardioverter-defibrillator
      implantations/replacements, and 23 other studies or procedures. The mean cost of
      a coronary angiography was Itl 512,000 (265 Euro) in the in-house laboratory; it
      would have been Itl 694,000 (359 Euro) in the historical scenario, i.e. with
      referral to a 25 km distant laboratory, with Itl 182,000 (94 Euro) saved. Our
      experience is consistent with the accepted criteria of good laboratory
      performance and cost-effectiveness.

PMID- 11216080
TI  - [A new organization model for hemodynamic cardiology diagnosis and intervention
      cardiology].
AB  - In centers without hemodynamic laboratories the quality of medical care may be
      suboptimal since the unavailability of these technologies may reduce medical
      experience in the treatment of heart disease, mostly in acute coronary syndromes,
      and may increase the need for referring some patients to other hospitals. The
      problem will be of great relevance in the case of expansion of the aggressive
      approach in the treatment of acute ischemic syndromes such as acute myocardial
      infarction and unstable angina. The impelling need for small centers of improving
      medical care may promote the spontaneous and uncontrolled proliferation of
      hemodynamic laboratories. The high number of hemodynamic laboratories may lead to
      a low institutional volume and, as a consequence, may negatively influence the
      outcome of coronary intervention and increase health care costs. The experience
      of operators and the costs are probably more relevant as regards angioplasty than
      coronary angiography. Therefore we propose the implementation of departments of
      interventional hemodynamic laboratories including different hospitals: diagnostic
      laboratories will be allocated in hospitals with coronary care units, while
      interventional laboratories will be allocated in referring hospitals.

PMID- 11216081
TI  - [Effectiveness and adequacy of management of acute coronary syndromes].
AB  - A rational utilization of resources represents a key issue in modern treatment of
      cardiac patients. The aim of our study was to highlight a few essential aspects
      for an efficient and appropriate management of patients with an acute coronary
      syndrome. Clinical evaluation of the patient's risk (i.e. clinical assessment of
      the probability of developing a cardiac event), incremental value of the chosen
      test for risk stratification, value of a strategy in modifying outcome and direct
      determinants of medical cost of the strategy are selected as the main aspects to
      be considered in order to optimize management of these patients.

PMID- 11216082
TI  - [The new limitations of the Italian Regulatory Agency on Drugs].
AB  - In Italy the reimbursement of few free-of-charge drugs is limited to subgroups of
      patients or to one of the approved indications. In February 2001 new rules will
      become mandatory for Italian physicians. The text of the new rules related to
      drugs mostly used by cardiologists (levocarnitine, ticlopidine, hypolipemic
      drugs) is reported.

PMID- 11216083
TI  - [Effectiveness and side effects of the treatment with propafenone and flecainide
      for recent-onset atrial fibrillation].
AB  - BACKGROUND: The authors report their experience in recent-onset atrial
      fibrillation treated with intravenous flecainide and propafenone, in comparison
      with the placebo group. METHODS: We randomized 352 (138 in the flecainide group,
      164 in the propafenone group and 50 in the control group) consecutive patients
      (167 males, 185 females, mean age 59 +/- 12 years) with recent-onset atrial
      fibrillation. The electrocardiogram of all patients was monitored for at least 24
      hours. RESULTS: The restoration of sinus rhythm occurred in 72.5, 80.4, 86.2 and
      89.8% of patients in the flecainide group; in 54.3, 68.3, 75 and 92.1% in the
      propafenone group; in 22.2, 27.8, 35.2 and 46.3% in the control group, at 1, 3, 6
      and 24 hours respectively. The occurrence of side effects was the same in all
      treatment groups, and occurred in about 10% of patients in the flecainide and
      propafenone groups, and in 4% in the control group. In our study population the
      treatment of recent-onset atrial fibrillation with flecainide was faster in
      converting the arrhythmia to sinus rhythm (p < 0.005 at 1 hour, p < 0.05 at 3
      hours, p = 0.05 at 6 hours). However within 24 hours the efficacy of either
      flecainide or propafenone was the same (p = NS at 24 hours). CONCLUSIONS: Side
      effects were similar in both treatment groups. In particular malignant
      arrhythmias did not occur in the treatment groups and in the control group.

PMID- 11216084
TI  - [Criteria for work capacity evaluation, adequacy for specific jobs, attitudes
      towards physical activity and sports, and insurance eligibility in subjects with
      congenital cardiopathy].

PMID- 11216086
TI  - [Physical activity and mortality in older men with diagnosed coronary heart
      disease].

PMID- 11216085
TI  - [New anti-platelet strategies].
AB  - In the 1960s, the platelet inhibitory properties of several drugs were
      discovered. Like aspirin, they were already in clinical use for other therapeutic
      indications. Since then, the search for new and more rational antiplatelet
      strategies has been constant but only moderately successful, although new
      molecules with high selectivity for platelet function have been developed. The
      authors briefly review some recent advances in platelet pharmacology and focus
      their attention on pharmacogenetics, a potential approach to new antiplatelet
      strategies. Would this approach be successful, individuals rather than
      epidemiologically defined groups of patients might better benefit from newly
      targeted antiplatelet drugs.

PMID- 11216087
TI  - [Plasma homocysteine predicts mortality independently of traditional risk factors
      and C-reactive protein in patients with angiographically defined coronary artery
      disease].

PMID- 11216088
TI  - [Comparison of vasopeptidase inhibitor, omapatrilat, and lisinopril on exercise
      tolerance and morbidity in patients with heart failure].

PMID- 11216089
TI  - [Effect of amlodipine on the progression of atherosclerosis and the occurrence of
      clinical events].

PMID- 11216090
TI  - [Multiple complex coronary plaques in patients with acute myocardial infarction].

PMID- 11216091
TI  - [Risk stratification].

PMID- 11216092
TI  - [Evidence-based and everyday medicine: a problem not only Italian].

PMID- 11216094
TI  - [Drug administration in tube-fed patients ].

PMID- 11216093
TI  - [Evidence-based medicine: several clarifications].

PMID- 11216095
TI  - [Metabolic response to stress, can we control it?].
AB  - When faced by an external aggression such as shock, sepsis, burns or surgery, the
      body develops a response, known as stress, comprising hypermetabolism and
      hypercatabolism related to an alteration in tissue sensitivity to insulin. This
      alteration seems to be rooted in the transmembrane protein GLUT-4 which takes
      care of the cell uptake of glucose in skeletal muscle. As a result, there are
      alterations in the metabolism of carbohydrates, fats and proteins (reduction of
      immunoglobulins). In the case of surgery, it has been shown that, on the one
      hand, factors such as rest, pre-operative fasting or the release of inflammatory
      response factors constrain an even greater alteration in the sensitivity to
      insulin; and on the other hand that the degree of resistance to insulin depends
      on the magnitude of the surgery, its duration, bleeding, or on hypothermia and
      extracorporeal circulation in the case of heart surgery. These metabolic
      alterations may lead to an increase in the number of infections, mean stay in
      hospital, and even lead to diabetes mellitus in the long term. Over the last few
      years, all of this has led several researchers to try to minimize the stress
      response associated with planned surgery through replacing pre-operative fasting
      by the administration of carbohydrates, whether or not in association with
      insulin in perfusion. Beneficial results have been described: control of
      hyperglycaemia, lower consumption of neoglycogenic amino acids and less
      alteration of plasma immunity (interleukins, TNF). Future studies will evaluate
      the influence of these measures on plasma immunity, mean hospital stay and
      morbidity/mortality.

PMID- 11216096
TI  - [Feeding and nutrition in Alzheimer's disease].
AB  - Dementia is an organic brain disease. The most frequent type of dementia is
      Alzheimer's and it affects mostly elderly people. Due to the increase in life
      expectancy and to the ageing of the population, Alzheimer's has recently become
      an area of research of interest. The eating behaviour and nutrition of elderly
      people has some special characteristics which become particularly relevant during
      illness. An Alzheimer's patient suffers a progressive decay in their functional
      and physical abilities, and these renders them at high nutritional risk.
      Prevention, rapid intervention and ensuring an adequate nutritional intake is
      essential in each of the dementia stages. This paper reviews the most important
      nutrients influencing the development or worsening of dementia and the guidelines
      for food intake throughout the disease.

PMID- 11216097
TI  - [Follow-up of drug administration through nasogastric tube: development of a
      practice guideline].
AB  - GOAL: To carry out a study of how medication is administered by catheter in daily
      practice in our hospital. To prepare a practical guide for the administration of
      medication by catheter. SCOPE:  STUDY POPULATION: in-patients using enteral
      feeding tubes, except ICU. Study duration: 2 months. INTERVENTIONS: Through a
      single-dose medication distribution system, the nutrition team's pharmacist
      prospectively collects the data on the medication of patients subjected to
      enteral feeding through a catheter and compares these data with the nursing
      record and, if the medication has been incorrectly handled, makes the pertinent
      recommendations. Using the information obtained from the pharmaceutical industry
      and a review of the literature, a guide is drawn up for the medicines used with
      catheters. RESULTS: The study was carried out with 25 patients receiving enteral
      nutrition. A total of 55 different pharmaceutical preparations were used.
      Administration was correct in 116 of the 123 medicines prescribed (91%); the
      other 5 drugs (9%) were incorrectly handled. A total of 16 alterations were
      recommended in 25 patients (64 recommendations/100 patients), of which 9 involved
      a change of pharmaceutical form from solid to liquid, 4 were due to incorrect
      handling of the solid form, 2 because of interaction between the medication and
      enteral nutrition and 1 because of interaction between concomitant medications. A
      guide was drawn up for the administration of medication by catheter, covering a
      total of 179 active substances and 197 pharmaceutical products. CONCLUSIONS: The
      presence of a pharmacist in clinical units facilitates the detection and solution
      of problems associated with the administration of medication via catheters. The
      preparation of a handbook as a tool for the intra-catheter administration of
      medicines is a useful starting point for improving the use of medication and
      facilitating nursing tasks.

PMID- 11216098
TI  - [Nutritional status of the HIV patient. Description and clinical course of a
      group of patients over a year].
AB  - GOAL: To know the nutritional and immunological status of a sample of patients
      infected by HIV and their evolution over a one-year period. Relationship between
      nutritional status, immunological status and clinical evolution. METHOD:
      Longitudinal descriptive study of 30 HIV-infected patients. Anthropometric
      evaluation (weight, height, skin folds, arm circumference) and immunological
      assessment (CD4 and CD4/CD8). STATISTICAL ANALYSIS: means, absolute and relative
      frequencies, Student's T test. RESULTS: 30 patients, 73.3% males and 27.7%
      female. Mean age 34.7 years. Initial nutritional assessment: 30% of patients had
      normal weight, 36.7% presented mild undernourishment, 16.7% moderate
      undernourishment, 6.7% were overweight and 10% were obese. The evolution of CD4
      and CD4/CD8 levels was not significantly influenced by nutritional status.
      CONCLUSIONS: The patients in the study presented a deterioration of their
      nutritional status, as assessed by triceps skin fold. The nutritional status of
      the HIV-infected patients in our study is not dependent on their immunological
      status. The diagnosis and treatment of their de-nourishment on diagnosis of HIV
      infection will contribute to the prevention of complications, thus reducing the
      human and health-care costs. An increase in food intake, on its own, does not
      improve the condition of the patients, indicating the need to provide them with
      the necessary dietary supplements from the early stages of illness.

PMID- 11216099
TI  - [Reversible hypertransaminasemia after diet therapy].
AB  - An increase in transaminases may be due to multiple causes. We present a case of
      reversible hypertransaminasemia following specific dietary therapy. The various
      potential aetiopathogenies are reviewed to explain the raising of transaminase
      levels and the improvement in analytical results after the institution of this
      dietary treatment.

PMID- 11216100
TI  - Pharmacy immunization partnerships: a rural model.
AB  - OBJECTIVES: To describe the Pharmacy Immunization Project, a pharmacy/county
      health department (CHD) partnership model for immunizing infants and adults in
      rural areas, and to develop service procedures and disseminate lessons learned
      for adapting the model to different settings. SETTING: Independent community
      pharmacies in five contiguous rural counties in West Virginia. PRACTICE
      DESCRIPTION: Participating pharmacies varied markedly in space, prescription
      volume, and population of service areas. PRACTICE INNOVATION: Childhood and adult
      immunization service. INTERVENTIONS: Pharmacists partnered with nurses from CHDs
      to offer year-round immunizations at times when other providers were typically
      closed. Working under standing orders of the CHD medical directors, nurses also
      conducted routine well-baby examinations in the pharmacy. Promotions involved
      direct mailing, posters, fliers, direct communication, and ads in newspapers,
      radio, and TV. MAIN OUTCOME MEASURES: Pharmacists' and CHDs' continued
      willingness to participate, use of the service by local citizens, and feedback
      from participants and other health care providers and the West Virginia
      Immunization Program (WVIP). RESULTS: All sites except one continued their
      participation through the life of the project. The one exception was a pharmacy
      with few infant patients, which discontinued participation during year 4 of the
      project. Remaining sites were used and well accepted by the community. The WVIP
      remains a loyal supporter, and no problems arose with local health care
      providers. CONCLUSION: The model appears adaptable to urban as well as rural
      practice and to chain as well as independent practice in states not authorizing
      pharmacists to administer vaccines, for pharmacists who for other reasons prefer
      not to administer, and for those who prefer to offer adult immunization on a
      seasonal basis. From the CHD perspective, the partnership model is useful in
      establishing "satellite" locations to target hard-to-reach patients.
      Recommendations regarding agreements and responsibilities are available, as are
      lessons learned during project development.

PMID- 11216101
TI  - Regulating for outcomes as a systems response to the problem of drug-related
      morbidity.
AB  - OBJECTIVE: To describe the evidence that preventable adverse outcomes of drug
      therapy are prevalent in the United States and Europe, to describe the causes of
      this problem, to outline a systems response that would correct or improve the
      problem, to discuss pharmacy's contribution to that solution, and to propose a
      strategy for implementation. SUMMARY: The causes of the widespread problem of
      preventable drug-related morbidity (PDRM) that have been identified in the
      literature constitute system failure. Health professionals can understand an
      individual patient's care system if they organize their thinking about systems as
      efficiently as they organize their thinking about medical or pharmaceutical
      problems. Six essential system characteristics are proposed, based on the PDRM
      literature. Regulations should mandate regular patient and system performance
      assessments--specifically, that health professionals (1) identify, resolve, and
      document specific pharmacotherapy problems; (2) assess system performance and
      identify recurring root causes of problems; and (3) document assessments,
      problems found, actions taken, and follow-up. These regulations would, in
      essence, mandate individual quality improvement (QI) programs. QI and
      pharmaceutical care require similar processes of decisions and actions, one from
      a practice (multipatient) perspective and the other from a patient perspective.
      CONCLUSION: Health care accreditation agencies are moving toward regulation for
      outcomes. Pharmacy managers should embrace and regulatory boards should
      participate in this movement. Such regulations would clarify pharmacy's role in
      support of safe and effective pharmacotherapy and would constitute a commitment
      to pharmaceutical care as public service. A widely adopted system of measuring
      and improving the quality of medication use and outcomes could eventually lead to
      quality benchmarks in the community pharmacy setting, which would more firmly
      establish the value of the pharmacist in pharmacotherapy.

PMID- 11216102
TI  - Credentialing in pharmacy.

PMID- 11216104
TI  - Collaborative practice agreements--further evidence of acceptance and success.

PMID- 11216103
TI  - Pharmacy-based immunizations--an idea whose time has come.

PMID- 11216105
TI  - From professional advocacy to patient advocacy: a gambit for pharmacists.

PMID- 11216106
TI  - Pharmaceutical care: how pharmacy could benefit from regulatory action.

PMID- 11216107
TI  - The American Practice of Pharmacy, 1902-1952.

PMID- 11216108
TI  - APhA drug treatment protocols: comprehensive weight management in adults.

PMID- 11216109
TI  - Pharmacists and immunizations: a national survey.
AB  - OBJECTIVES: To obtain information about pharmacists' current involvement in and
      willingness to provide immunization services, and to assess perceived barriers to
      providing immunization services. DESIGN: Cross-sectional mail survey. SETTING:
      National. PATIENTS OR OTHER PARTICIPANTS: Random sample of 5,342 pharmacists from
      chain, independent, mass merchandiser/grocery, primary care clinic, and health
      maintenance organization settings. INTERVENTIONS: None. MAIN OUTCOME MEASURES:
      Responses to survey on pharmacy-based immunization services--current involvement,
      willingness to get involved, perceived obstacles, and patients' interest.
      RESULTS: Three mailings yielded a response rate of 25.3% (1,348 responses). Only
      53.1% of respondents knew correctly whether their state allowed pharmacists to
      administer immunizations. Although a significant number of pharmacists were
      involved in immunization activities, such as counseling and promotion, only 2.2%
      and 0.9% of respondents were involved in actual administration of adult and
      childhood immunizations, respectively. In general, men, independents,
      owners/partners, and pharmacists who had attended immunization-related
      educational programs were more willing to provide immunization services than were
      women, chain and staff pharmacists, and educational program nonattendees.
      Pharmacists who had attended immunization-related educational programs also
      perceived pharmacist- and patient-related factors as less problematic for
      pharmacy-based immunization services than did nonattendees. CONCLUSION: This
      survey provides a baseline measure of the nature and extent of pharmacist
      involvement in immunizations that can be used now and in future years. The
      profession can use the findings on pharmacists' willingness to provide
      immunization services and their perception of obstacles to such services as a
      basis for targeted educational and promotional programs and materials.

PMID- 11216110
TI  - Payment for pharmaceutical care?

PMID- 11216111
TI  - People vaccinated by pharmacists: descriptive epidemiology.
AB  - OBJECTIVE: To describe the demographic, clinical, and attitudinal characteristics
      of people vaccinated by pharmacists, using a multistate sample of pharmacists and
      a more extensive set of parameters than previous studies. DESIGN: Cross-sectional
      survey. PATIENTS AND OTHER PARTICIPANTS: 1,730 adults vaccinated at 21 community
      pharmacies in 17 cities in 10 states. MAIN OUTCOME MEASURES: Vaccinees' age, sex,
      and selected demographic characteristics; current medications and prescription
      use patterns; distance traveled to pharmacy; and opinions about vaccine
      providers. RESULTS: 60% of respondents were women; average age was 54 +/- 15
      years. One-quarter were age 65 years or older. About 9% were younger than 65 and
      took medication for chronic heart or lung disease or diabetes. Almost half took
      prescribed medications chronically, and 84% came to the pharmacy intending to be
      vaccinated. All of the respondents believed they were treated respectfully. Many
      respondents considered the pharmacy advantageous, compared with other vaccine
      providers, based on access, proximity, trust, convenience, and/or cost.
      CONCLUSION: Respondents vaccinated by a community pharmacist were satisfied with
      the experience and would recommend it to others.

PMID- 11216112
TI  - Role of CYP3A4 and P-glycoprotein in drug interactions involving the HMG-CoA
      reductase inhibitors.

PMID- 11216113
TI  - Patients' acceptance of traditional and nontraditional immunization providers.
AB  - OBJECTIVE: To examine patients' acceptance and reported use of traditional and
      nontraditional immunization providers and settings. DESIGN: Survey. SETTING:
      Stratified sample of private family physician clinics, family medicine residency
      training programs, community pharmacies that provide immunizations under standing
      order protocols, and nonimmunizing community pharmacies, all located in Iowa.
      PATIENTS OR OTHER PARTICIPANTS: Individuals presenting for medical care or
      pharmacy services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sources
      of past immunizations, 'access to immunizations, importance of immunization
      records, and future use of different health care providers and settings for
      immunizations. Univariate and multivariate analyses were performed to examine the
      relationships between patient demographics and recruitment site on the question
      responses. RESULTS: 420 surveys were returned (67% response rate). Respondents
      frequently received immunizations at sites other than physician offices. Younger
      patients and those living in smaller towns were more likely to report receiving
      an immunization from a nonphysician. Patients recruited in immunizing pharmacies
      more often reported previous immunization by a pharmacist (P < .001), most often
      for influenza. Respondents often reported that it was more convenient to receive
      an immunization outside a physician office. Greater support was noted for
      receiving adult immunizations from nonphysicians and in nontraditional settings,
      whereas traditional settings and providers (physician offices, community health
      departments) were preferred for childhood immunizations. CONCLUSION: Iowans
      report accessing different health care providers and settings for their routine
      immunizations. In general, they are more likely to support using traditional
      immunization providers and settings for childhood immunizations but are less
      exclusive about where they receive adult immunizations. Pharmacists should
      consider focusing initial efforts on administering adult immunizations, due to
      greater patient acceptance of nontraditional immunizers for adult immunizations.

PMID- 11216114
TI  - Children and smoking.

PMID- 11216115
TI  - The emergency contraception collaborative prescribing experience in Washington
      State.
AB  - OBJECTIVE: To describe how prescribers and pharmacists view the Emergency
      Contraceptive Pills (ECP) program, and to evaluate pharmacists' performance
      through the use of a consumer survey. DESIGN: Self-administered provider
      satisfaction surveys were mailed 6 months after the program's inception. Consumer
      satisfaction surveys were distributed at the point of ECP service for return by
      mail. SETTING: The program encouraged pharmacists and prescribers in western
      Washington to enter into collaborative prescribing agreements, increasing
      consumers' access to ECP. PATIENTS OR OTHER PARTICIPANTS: Pharmacists who had
      attended ECP training sessions, prescribers who had authorized pharmacists to
      prescribe ECP, and women who had been prescribed ECP by pharmacists. MAIN OUTCOME
      MEASURES: Providers' reasons for participating, attitudes toward the ECP program,
      and experiences with ECP as a result of the program; feedback from women
      receiving ECP from pharmacists. RESULTS: 309 pharmacist surveys and 55 prescriber
      surveys were sent, of which 159 (51%) and 27 (49%), respectively, were returned.
      Meeting patient needs and having a professional responsibility to participate
      were commonly reported reasons for ECP program involvement. Both pharmacists and
      prescribers (92%) reported being "satisfied" or "very satisfied" with their
      prescribing agreements. On the 470 consumer surveys returned out of 7,000
      distributed (6.5%), pharmacists were rated highly satisfactory for their
      interactions with patients and the quality of information about ECP use given,
      but less satisfactory for information about adverse effects, recognition and
      follow-up of ECP failure, and regular contraceptive methods. CONCLUSION: All
      participants expressed satisfaction with the ECP program. This example should
      support the initiation of similar programs in other states.

PMID- 11216116
TI  - Medication management in primary and secondary schools.
AB  - OBJECTIVE: To summarize present knowledge about medication management in primary
      and secondary schools; to place this knowledge in its drug use and organizational
      contexts; and to provide a foundation for studying the problem and developing
      policy- and practice-level interventions aimed at alleviating it. To offer
      recommendations for practitioners, policy makers, and health professions
      educators aimed at improving the situation. DATA SOURCES: MEDLINE database (1966
      1998); International Pharmaceutical Abstracts database (1977-1998); complete
      Medscape full-text search; contents of the Journal of School Nursing and the
      Journal of School Health (1966-present). STUDY SELECTION: We reviewed 95% of all
      articles, books, and reports identified using the search terms elementary school,
      middle school, junior high school, high school, primary school, secondary school,
      school nurse, school health, and schoolchildren. DATA EXTRACTION: The literature
      on this topic includes background material describing the nature of the problem
      and its political and organizational context and implying its significance;
      summaries of regulations, guidelines, and recommendations regarding medication
      management in the schools; and empirical studies. Few articles address pharmacist
      involvement in medication management in schools. DATA SYNTHESIS: Although
      approaches to this important problem vary widely, a set of core medication
      management guidelines is identifiable. Formal research is sparse, but it shows
      that medication use is widespread in schools and carries significant therapeutic
      and safety consequences. CONCLUSION: Pharmacists and school nurses must cross
      professional borders if they wish to play a role in solving this important drug
      therapy problem. Pharmacists can provide therapeutic and contextual perspectives
      on the problem, while school nurses can implement solutions within the schools.

PMID- 11216117
TI  - Drug abuse and dependency: understanding gender differences in etiology and
      management.
AB  - OBJECTIVE: To review the etiology, consequences, and treatment needs of drug
      abuse and dependency, especially in women. DATA SOURCES: Original studies and
      literature reviews published primarily since 1990. DATA SYNTHESIS: Many studies,
      conducted mostly during the past 10 years, are providing new information
      regarding the genesis of two separate drug problems: willful abuse (misuse) of
      drugs and pathological drug dependency. Recent studies have also highlighted
      important differences between the sexes in the causes, consequences, and
      management of drug abuse and dependency. The neurobiologic and genetic
      contributions to the pathological disease of addiction provide important
      directions for future treatments, as a supplement to existing self-help and
      structured behavioral therapies. Pharmacotherapy also has an important role in
      reducing drug craving and relapse in addicted patients. CONCLUSION: Although the
      precise causes of drug abuse and dependency continue to challenge researchers,
      important differences have been identified between men and women in terms of how
      drug use begins, how it progresses, and effective methods of treatment.
      Pharmacists and other health care professionals need to understand gender
      differences in the etiology and management of drug abuse and dependency and
      develop the capacity to recognize and refer women who may be abusing or dependent
      on drugs.

PMID- 11216119
TI  - Dueling forces: I-Med vs. Fed-Med.

PMID- 11216118
TI  - A tool for corporate decision making about cognitive pharmaceutical services.
AB  - OBJECTIVE: To present and discuss the models, theories, ideas, and frameworks
      that corporate decision makers would apply to the implementation of cognitive
      pharmaceutical services. BACKGROUND: Large chains and integrated delivery
      networks dominate the pharmacy marketplace. As a result, in many instances
      implementing cognitive pharmaceutical services, or expanding their delivery,
      first requires approval of a corporate decision maker, often not a pharmacist,
      who is schooled in marketing, management, and finance, and who necessarily views
      proposals for cognitive pharmaceutical services from those frames of reference.
      This article focuses on the following six marketing and management questions that
      corporate decision makers likely want answered before approving and funding the
      implementation of cognitive pharmaceutical services: (1) What is our product? (2)
      Who will pay, and what is the price? (3) Is there a market, and can it be
      reached? (4) What procedures must be put in place? (5) Who will deliver the
      service? (6) Where are the services to be delivered, and how is the facility to
      be presented? DISCUSSION: For a pharmacy manager charged with bringing cognitive
      pharmaceutical services to the marketplace, consideration of the issues detailed
      here meets a reasonable test of due diligence in committing human, financial, and
      organizational resources. CONCLUSION: It is natural for a pharmacist to look at
      cognitive pharmaceutical services through a professional lens. It is just as
      natural for a corporate decision marker to look at cognitive pharmaceutical
      services through a marketing and management lens. Unless both lenses are put
      together, one gets only half the picture.

PMID- 11216120
TI  - CEO performance appraisal: review and recommendations.
AB  - CEO performance appraisal (PA) is very valuable to an organization, but the
      chances of obtaining a PA of high quality decrease as executive responsibility
      increases. The realities of CEO PA are that it: (1) is inevitable; (2) is
      creative and complex; (3) involves politics; and (4) has a significant effect on
      the organization and the executive. PA is conducted for legal and social
      requirements, to enhance communication, to provide opportunities for improvement,
      and to relate performance to compensation. This article discusses several
      problems with chief executive officer (CEO) PA and the contemporary approaches
      that seek to improve it. Three fundamental areas for evaluation are identified:
      (1) organizational success; (2) areawide health status; and (3) professional role
      fulfillment. These provide an outline for successful healthcare PA. In addition
      to a discussion of the strategic considerations behind a successful CEO PA
      system, several recommendations are offered for the implementation of the annual
      evaluation process. The final goal of CEO PA is to link its results to CEO
      incentive compensation. It is strongly recommended that some portion of the CEO's
      salary directly hinge on his performance in two critical areas: organizational
      effectiveness and community health status.

PMID- 11216121
TI  - Interview with John R. Griffith, FACHE, author of the Well-Managed Healthcare
      Organization. Interview by Kyle L. Grazier.

PMID- 11216122
TI  - Spirituality and healthcare organizations.
AB  - In recent years, the place of spirituality in organizations has become
      increasingly discussed and advocated. On a personal level, this may involve
      achieving personal fulfillment or spiritual growth in the workplace. In the
      broader sense, spirituality is considered by many to be essential in an
      organization's interactions with employees, customers, and the community. This
      article describes a possible role for greater spirituality in healthcare
      organizations, whose cultures in recent decades have largely excluded
      spirituality or religiousness. This is the consequence of an analytical,
      scientific perspective on human health; a reductionist paradigm in biomedical
      research; and the inevitable bureaucratization occurring in large healthcare
      organizations. However, in recent decades, numerous scientific articles
      supporting a connection between faith or religiousness and positive health
      outcomes have been published. Because individuals seek meaning when experiencing
      severe illnesses, and humans universally respond to compassion and caring,
      spirituality among healthcare workers and managers appears highly appropriate.
      The article describes organizational barriers to the greater inclusion of
      spirituality in healthcare and presents several approaches to developing a more
      caring organization. These include eliciting extensive input from all staff and
      clinicians in identifying core or common values, ethics, and a philosophy of
      caring. Programs should ensure that the views of nonreligious staff and patients
      are respected and that clear guidelines are established for the extent and nature
      of affective or spiritual support for patients.

PMID- 11216123
TI  - Better information for the board.
AB  - Healthcare managers are making quicker, riskier decisions in an increasingly
      competitive and regulated environment. Questions have been raised regarding the
      accountability and performance of boards of these organizations, as board members
      are not always selected based on their competencies to guide such decisions.
      Adapting mission and strategy and monitoring organizational performance require
      information that boards get mostly from management. The purpose of this study was
      to examine the information that boards regularly get to carry out their
      functions. I obtained board documents from four not-for-profit hospitals and
      health systems in different boroughs of New York City. At each institution, I
      conducted one-hour interviews with at least three board members and three top
      managers. I also attended at least one board or executive committee meeting and
      one additional meeting, usually of the finance committee. Principal findings were
      that the boards get too much data, the same data that management gets, and little
      comparative data on performance of similar benchmarked organizations. Board
      members and managers are satisfied with the information that board members get
      and have no plans to improve their system of shaping, or the quality of,
      information. Key recommendations to boards and managers are: (1) boards must take
      greater responsibility for identifying the information that they get and how they
      wish to get it, (2) managers must ensure that measurable objectives are
      developed, against which organizational performance can be evaluated, (3) boards
      must get information that is targeted and shaped to better fit board functions,
      (4) managers must develop information sets for main service lines, (5) boards
      must get information on the expectations and satisfaction levels of key
      stakeholders, (6) boards must get better and more focused information on
      performance of benchmarked institutions, and (7) boards must get less hospital
      operating data on a monthly basis.

PMID- 11216124
TI  - Developing an air ambulance service for a remote area of west Texas.

PMID- 11216125
TI  - Career performance: how are we doing?

PMID- 11216127
TI  - Self-functioning traits affecting meal compliance in eating disorder patients.
AB  - The objective of this study was to measure the extent to which self-functioning
      traits relate to meal compliance in eating disorder patients by using multiple
      regression analysis. Compliance was the dependent variable. It was recorded on a
      meal flowsheet during breakfast, lunch and dinner and compiled for the 8 days
      immediately preceding each patient's discharge. The independent variables were
      gender, self-esteem (Rosenberg Scale) and 7 subscales of the Eating Disorder
      Inventory (EDI-2): drive for thinness, body dissatisfaction, ineffectiveness,
      perfectionism, interpersonal distrust, interoceptive awareness and maturity
      fears. A random sample of 30 subjects who completed the above instruments before
      May 1999 were included in the study. The results suggest that close to 50% of
      their meal compliance can be explained by variations in four explanatory
      variables: gender, ineffectiveness, interoceptive awareness and distrust. The
      adjusted r2 was 0.497 and the significance of the equation, measured by the p
      value, was p = 0.0002. We conclude that multiple regression analysis is a
      valuable tool to identify patients' traits with the strongest effect in meal
      compliance.

PMID- 11216128
TI  - The Eating Disorder Inventory in evaluation of impaired eating behaviour in
      subjects requesting nutritional consultation.
AB  - The present study evaluated impaired eating behaviour in women seeking
      participation in a diet-based programme of weight reduction or achievement of
      ideal body weight. Forty-seven obese, 42 overweight and 14 normal-weight
      subjects, attending an Italian university outpatient clinic completed the Eating
      Disorder Inventory (EDI). Forty-eight mothers of primary school children (25
      normal-weight and 23 overweight) were used as controls. The EDI consists of 8
      subscales, 3 evaluating psychopathology related to eating disorders (drive for
      thinness, bulimia, body dissatisfaction) and 5 evaluating general psychopathology
      (intereoceptive awareness, ineffectiveness, maturity fears, perfectionism,
      interpersonal distrust). Significantly altered scores in the first three
      subscales were observed both in normal-weight and overweight outpatients compared
      to the controls. The overweight outpatients scored higher than the obese patients
      in terms of drive for thinness and bulimia and higher than the normal-weight
      women for terms of bulimia, body dissatisfaction and drive for thinness. The
      overweight controls scored significantly higher than the normal-weight controls
      in the first three subscales in the remaining subscales, mean values were also
      higher in the overweight group, though significance was only reached in the
      interpersonal distrust and interoceptive awareness subscales. Impaired eating
      behaviour is frequent in subjects seeking participation in weight reduction or
      ideal body weight achievement programmes.

PMID- 11216126
TI  - Eating disorders in the Far East.
AB  - OBJECTIVE: To investigate eating disorders (EDs) prevalence rates among Asian
      populations and identify characteristics that distinguish them from their Western
      counterparts. METHOD: Potential references were identified through an English
      language literature search using Medline, Psychinfo, Dissertation Abstracts (1966
      to 1999) and through extensive manual searching of textbooks, reviews and
      reference lists. RESULTS: The majority of studies related to EDs were conducted
      in Japan and China and a few were conducted in Singapore, Malaysia, Taiwan, and
      Korea whereas there was none in the Philippines, Laos, Vietnam, Cambodia,
      Myanmar, Indonesia and Thailand. Prevalence rates in Japan range from 0.025 to
      0.030% for anorexia nervosa (AN) and from 1.9 to 2.9% for bulimia nervosa (BN).
      Community studies in China have found the AN prevalence to be 0.01% and BN rates
      ranging from 0.5% to 1.3%. These rates are lower than ED rates in the West
      (particularly the U.S. and Britain). Body dissatisfaction (BD) and dieting rates,
      however, were similar to those in the West. BD rates ranged from 68% (Taiwan) to
      81% (Korea) and dieting rates ranged from 34% (Taiwan) to 68% (Japan).
      Sociocultural and developmental risk factors were relevant to this population.
      CONCLUSIONS: EDs in Asian populations have received little attention because they
      have been predominantly viewed as associated with Western culture. Classified by
      many as a "culture-bound syndrome" of the West, they may really be a culture
      change syndrome.

PMID- 11216129
TI  - Hospital admission and mortality rates in anorexia nervosa: experience from an
      integrated medical-psychiatric outpatient treatment.
AB  - OBJECTIVES: To evaluate the effectiveness of an integrated medical-psychiatric
      treatment of major eating disorders. DESIGN: Historical cohort study. SETTING:
      Outpatient Unit for Protein Energy Malnutrition of the Department of Clinical and
      Experimental Medicine, "Federico II" University of Naples, time of study: January
      1994 to December 1997 PARTICIPANTS: 147 female patients with restrictive or
      bulimic anorexia nervosa (mean age 19.8 +/- 13.7, BMI 14.7 +/- 2.1 Kg/m2)
      consecutively attending the outpatient unit between January 1994 and December
      1997. MAIN OUTCOME MEASURES: Hospitalization and mortality rates were evaluated
      up to Jan 1999 with a minimum follow-up of 18 months. RESULTS: There were 23
      admissions to the Clinical Nutrition ward for 19 patients (i.e. 12.9%) mostly due
      to severe protein energy malnutrition, and 2 deaths, only 1 strictly related to
      anorexia (mortality rate 0.7%). CONCLUSIONS: Integrated outpatient medical
      psychiatric treatment for major eating disorders is an effective and inexpensive
      procedure that reduces mortality and admissions due to medical complications in
      the medium term.

PMID- 11216131
TI  - Interdisciplinary team for the treatment of eating disorders.
AB  - Eating disorders are pathologies with a complex, multifactorial etiopathogenesis.
      Their treatment requires an interdisciplinary team. This paper discusses some
      characteristics and the most common difficulties encountered by such a team
      (multiple transfers, concealed alliances, role inversion, dissociation). Since
      their task that is carried out with patients in a critical situation and
      conflicting families, the team members are exposed to stressing conditions
      (illustrated by their dreams), and faced with possibilities of withdrawal and/or
      burn-out.

PMID- 11216130
TI  - The compliance of hypocaloric diet in type 2 diabetic obese patients: a brief
      term study.
AB  - In studies of the effect of diets in obese type 2 diabetic patients, information
      about the degree of compliance or non-compliance is generally lacking or
      incomplete, though their poor long-term success rate is widely recognized. We
      have quantified the degree of short-term compliance with a personalized
      hypocaloric diet (800-1500 kcal) in 77 obese type 2 diabetic patients (mean age
      60, mean BMI 34.4) three months after explaining their dietary schedule and its
      expected advantages by means of simple but essential nutritional advice lasting
      about 20 minutes of the type currently used for such patients attending diabetes
      care institutions or outpatient departments. Even though a mean 14% reduction in
      daily food intake was achieved, the mean daily energy intake at the interview
      (assessed by means of the 3-day recall method) still exceeded the prescribed diet
      by 40-50%. The worst compliance in terms of total excess energy intake or
      carbohydrate and fat intake was found in the older patients. The greater the
      excess of food intake, the poorer the metabolic control, as expected.

PMID- 11216132
TI  - Gastrointestinal complications in a patient with eating disorders.
AB  - Eating disorders are frequently observed in young people. They can induce major
      complications involving several organs, either directly or through protein energy
      malnutrition. Gastrointestinal problems are the most common and somewhat
      different in restrictive and bulimic anorexia. Delayed gastric emptying prevails
      in restrictive anorexia, with slower intestinal transit and atrophy of the smooth
      muscles of the gastrointestinal tract. In bulimic anorexia, vomiting is the cause
      of several oesophageal and gastric lesions, from oesophagitis to perforation of
      the oesophagus or stomach. C.G. is a 16-year old boy who weighs 41.8 kg, is 174
      cm tall and has a BMI 13.7 (kg/m2). At 14 he started to suffer from restrictive
      anorexia, then bulimic anorexia for the last two months. The day before
      admission, the patient ate a large quantity of "sfoglia-telle" in about 2 hours
      during a bulimic crisis. After 8 hours, he had spontaneous vomiting, malaise,
      abdominal tension and slight mental confusion. Physical examination showed a
      tense and tender abdomen with infrequent peristalsis, mental confusion and
      dehydration. Laboratory evaluation confirmed dehydration (serum albumin 5.7
      g/dL); a plain abdomen film showed marked gastrectasia. Instrumental examinations
      (abdominal CT scan, upper endoscopy) confirmed the diagnosis of gastrectasia with
      tight pyloric stenosis.

PMID- 11216133
TI  - Conditions predisposing to maternal mortality in twins and singletons, US birth
      cohort 1989.
AB  - Twin pregnancy is one of the most important conditions associated with increased
      perinatal mortality and morbidity. The consequences of twin pregnancy on the
      mother have not been explored in great detail. The aim of this study was to
      analyze the population-based data from the United States and delineate the
      various conditions of twin pregnancies which predispose to maternal mortality.
      Results of this study show that multiple pregnancy is strongly associated with
      maternal mortality and requires further analysis in order to prepare appropriate
      therapeutic and prophylactic protocols.

PMID- 11216134
TI  - Zygosity of twins: is it time for a new terminology?
AB  - The term zygosity reflects the origin of twins--when twins are monozygotic, they
      are derived from a single fertilized ovum; when twins are dizygotic--the come
      from two fertilized ova. Zygosity assessment seemed straightforward 50 years ago.
      Currently, as more information and more technology becomes available, zygosity
      testing becomes a real problem. It is important to realize the importance of
      correct zygosity testing not only in the antepartum care of the pregnant mother,
      but more importantly--during the whole lifetime of twin individuals. This paper
      discusses revolving around zygosity, methods of assessment, their limitations and
      proposes new terminology which incorporates the recent knowledge about early
      human development.

PMID- 11216135
TI  - Perinatal management and problems of preterm twins less than 32 weeks of
      gestation in Japan.
AB  - Between 1983 and 1998 there were 23433 births at Kitasato University Hospital,
      including 359 births. A retrospective analysis was performed on 320 twin pairs
      analyzing survivability indexes with respect to fetal age, chorionicity and birth
      weight discordance. Furthermore, the paper illustrates an analysis of causes of
      neonatal deaths as well as the rate of various complications of twins delivered
      before 32 weeks gestation such as twin-twin transfusion syndrome and
      periventricular leukomalacia.

PMID- 11216136
TI  - [Possibilities and applications of pulse oximetry during labor].
AB  - Fetal pulsoxymetry gives the opportunity of constant registration of oxygen
      saturation in the fetus during delivery. Important changes of the utilized
      equipments are crucial for proper assessment of this parameter. Construction of
      the sensors is of special importance. A good fixation of the sensors is
      prerequisite for the avoidance of artefacts. So far this procedure has not been
      used for diagnosing threatened fetal hypoxemia. Recent clinical research shows
      that the above method reflects a good state of the fetus if only good quality of
      signal and constant high saturation is maintained. That is why the method helps
      in the case of suspicious cardiotocographic records. Besides the application in
      fetal arrhythmias, the method can be used to decrease the number of blood gas
      analyses. The quality of pulsoxymetry should be confirmed by prospective studies
      in the nearest future.

PMID- 11216137
TI  - [Peculiarities of multiple pregnancy: epidemiology].
AB  - The epidemiology of multiple pregnancy is complex and depends on various factors
      including age, race, genetic and environmental factors, season of conception and,
      more recently, iatrogenic factors. In recent years, twinning rate increased
      dramatically especially in countries where ovulation induction and assisted
      reproductive technologies are widely used. Multiple pregnancies are most frequent
      in Nigeria where majority of them are dizygotic. The lowest frequency of twinning
      is observed in Japan where almost 70% of multiples are monozygotic. This paper
      discusses genetic, environmental and sociocultural factors which are related to
      the "epidemic" of multiples.

PMID- 11216138
TI  - [Peculiarities of multiple pregnancy: embryology].
AB  - Multiple pregnancies are not physiologic in humans and the understanding of the
      pathogenesis of this phenomenon is not fully established. Embriology of multiple
      pregnancy has been extensively investigated and this paper presents the phases of
      embrional development of monozygotic and dizygotic twins.

PMID- 11216139
TI  - [Peculiarities of multiple pregnancy: diagnosis].
AB  - Before ultrasound was aggressively introduced into everyday obstetrical practice,
      diagnosis, prophylaxis and active pre- and perinatal management were at best
      inadequate, but more often nonexistent. Twin pregnancies were complicated by high
      perinatal morbidity and mortality. The use of classical radiography was limited
      due to proven teratogenic and carcinogenic properties. Introduction of ultrasound
      dramatically changed the obstetrician's approach to twin pregnancy management.
      This paper discusses in detail the recent advances in ultrasound diagnosis of
      twin pregnancy.

PMID- 11216140
TI  - [Peculiarities of multiple pregnancy: complications].
AB  - Multiple pregnancies are considered high risk. This qualification is associated
      with the multitude of conditions which are known to complicated these
      pregnancies. Early diagnosis of these complications is the fundamental element of
      clinical managements. In numerous cases therapeutic protocols are widely known
      and in many others intensive monitoring and appropriate management may save the
      fetus from early and late complications. This paper will discuss the most common
      prenatal and perinatal complications associated with multiple pregnancies as well
      as the most widely accepted therapeutic protocols.

PMID- 11216141
TI  - [The influence of infertility treatment and assisted reproduction techniques on
      multiple pregnancy rates].
AB  - It has to be remembered that pregnancies resulting from assisted reproductive
      technologies are more complicated that spontaneous pregnancies. There are higher
      rates of spontaneous abortions, ectopic, and multiple pregnancies. This work
      summarizes the latest year's experiences from the best world's clinics with
      multifetal pregnancy incidence in assisted reproductive technologies programs.

PMID- 11216142
TI  - [Maternal weight gain during twin pregnancy. Its relationship to the incidence of
      preterm delivery].
AB  - OBJECTIVES: To determine maternal weight gain curve for twin gestation and to
      examine the risk of preterm birth associated with rates of weight gain (kg/week)
      to and from 24 weeks to delivery. PATIENTS: This study involved analysis data
      collected retrospectively on a cohort of women who received prenatal care from
      Outpatient Department for Women in Czechow district in Lublin, from 1986 to 1998.
      The study sample included 39 twin pregnancies. 12 (30.8%) women delivering twins
      before 37 weeks. METHODS: Gestational age was estimated from first day of last
      menstrual period. Information on prepregnancy weight was obtained by interview at
      the first prenatal visit. Weight gain was expressed in several ways: 1) For the
      descriptive analysis of weight gain by gestational age, the woman's pregravid
      weight was subtracted from the weight measured at each visit. 2) The weekly rate
      of weight gain was calculated by dividing the amount of weight gained between
      visits by the number of weeks during the time interval. Then we calculated the
      mean weekly rates before and after 24 weeks for each individual. RESULTS: Weight
      curve in group of women pregnant with twins showed similar linear trends. In
      women delivering twins before 37 weeks, the rate of weekly gain to and from 24
      weeks to delivery was lower (statistically nonsignificant) when compared with
      mothers delivering at term (0.38 versus 0.53 and 0.58 versus 0.69 kg/week,
      respectively). CONCLUSION: The results suggested, that spontaneous preterm
      delivery was associated with lower rate of weight gain before and after 24 weeks.

PMID- 11216143
TI  - [Analysis of premature twin pregnancies and deliveries].
AB  - Preterm labor is the most frequent complication of twin gestation. Between 1988
      1998, 123 twin pregnancies complicated by preterm labor were observed.
      Complications during pregnancy, mode of delivery, neonatal outcomes, mortality
      and morbidity were presented. We compared our outcomes to data from current
      literature.

PMID- 11216144
TI  - [The role of ultrasonographic evaluation of uterine cervix length and dilation
      for diagnosis and management of twin pregnancy].
AB  - OBJECTIVE: This study assesses ultrasonographic parameters concerning cervix
      length and cervical canal width of women with bigeminal pregnancy. The parameters
      mentioned proved to be useful while taking a right therapeutical decision i.e.
      using tocolysis or surgical treatment (cerclage). MATERIALS AND METHODS: This
      study included 52 women with bigeminal pregnancy. There were 14 women with the
      first pregnancy and 38 with the second and more pregnancies--ranging from 18 to
      35 years of age. The negative obstetrics past and non-invasive treatment as well
      as surgical treatment were taken into consideration. 43 women were diagnosed
      using ultrasonographic examination. The cervix length and cervical canal width
      were checked every 7-14 days. In 9 of them the cerclage was done. RESULTS: In the
      group of women with cerclage 66.6% of pregnancies ended before the 37th week. The
      mean pregnancy duration was 29.4 weeks. 46.3% of infants were discharged in
      satisfactory condition. In the other group (tocolysis) 54.8% of pregnancies ended
      before 37th week. The mean pregnancy duration was 34.2 weeks. 72.7% of infants
      were discharged in satisfactory condition. CONCLUSIONS: The assessment of the
      length of the cervix and the width of the cervical canal in the bigeminal
      pregnancy by the case examination is performed in order to take proper
      therapeutical decisions i.e. tocolysis or surgical treatment.

PMID- 11216145
TI  - [Levels of tumor necrosis factor-alpha and interleukin-2 in sera of twins
      delivered prematurely and at term].
AB  - The concentration of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2
      (IL-2) was estimated in first day of live in sera of premature (n = 8 pair) and
      in term delivered twins (n = 12 pair). One of premature delivered newborns was
      born vaginally 48 hours after first twin. Concentrations of TNF-alpha were
      approximately 4-times higher in sera of premature delivered in comparison to term
      delivered twins and a highest, more than 5-times higher level, was detected in
      serum of premature newborn born a 48 hours after first twin. Concentrations of IL
      2 in sera of premature delivered were approximately 2.5-times higher than in term
      delivered twins and not significantly variations were observed in delayed
      delivered twin.

PMID- 11216146
TI  - [Analysis of twin pregnancies in material from the Department of Obstetrics and
      Pathology of Pregnancy in Lublin from 1991-1998].
AB  - The course of multiple pregnancies and multiple fetus labor were analyzed in 111
      women delivered in the Department of Obstetrics, School of Medicine in Lublin in
      the years 1991-1998. It has been found that the most frequent patients were those
      aged 25-29 coming from the cities and after the infertility treatment. The aim of
      this research was to characterize twin pregnant patients, and present the outcome
      of multiple pregnancy. The studies were performed on 67 women from the cities and
      44 women from the villages. It is significant that almost 55% pregnant women
      underwent the cesarean section and their average birth weight was 2490 g. These
      results indicate that multiple pregnancy is in high risk pregnancy.

PMID- 11216147
TI  - [Triplet pregnancies in materials from the Obstetrics and Perinatology AM in
      Lublin in 1989-1999].
AB  - A retrospective analysis of 14 triplet pregnancies at the Department of
      Obstetrics and Perinatology, University School of Medicine in Lublin, from
      January 1, 1989 to June 30, 1999 was undertaken. All pregnancies were ended by
      cesarean section. No difference in Apgar score and in average birth weight
      between I, II and III foetus was observed. The mean hospitalisation time for
      mothers was 32.5 +/- 29.01 days and the mean gestational age at delivery was
      32.14 +/- 3.44 weeks. The indication for cesarean section in all cases was
      triplet pregnancy and additional complications: threatened intrauterine
      infection, threatened intrauterine asphyxia, abruptio placentae, preterm labour.
      Perinatal mortality rate was 12.82%.

PMID- 11216148
TI  - [Analysis of prognostic factors in a group of infants from multiple pregnancy and
      very low birth weight].
AB  - Preterm birth remains a major cause of perinatal morbidity and mortality. The
      purpose of the study was to examine factors influencing on the survival and early
      prognosis of very low birth weight premature infants in multiple gestation born
      at the Department of Obstetrics and Perinatology University School of Medicine in
      Lublin. Congenital malformations were excluded from the study. CONCLUSION: In
      this retrospective analysis the reduction in the incidence of respiratory
      distress syndrome in multiple gestation was observed. Survival was significantly
      correlated to prenatal corticoid prophylaxis, Apgar score and lack of the
      respiratory distress syndrome. The mortality showed an inverse correlation to
      birth weight and age of gestation.

PMID- 11216149
TI  - [Twin pregnancy complicated by "twin reversed arterial perfusion" syndrome].
AB  - We have reported twin pregnancy complicated by uncommon "twin reversed arterial
      perfusion" syndrome. Ultrasound scan at 27th week of gestation revealed one
      normal foetus and the second one "acardiac" with severe malformations. Since the
      cardiac failure of the first twin was observed, the digitalis were administered
      till the end of pregnancy. The pregnancy was terminated at 31st week by caesarean
      section. We succeed in delivering one healthy newborn, which was possible by
      appropriate management including elective termination, observation
      (ultrasonography and cardiotocography) and nonsurgical intervention (digitalis).

PMID- 11216150
TI  - [Cesarean section for the second twin during the course of delivering twins].
AB  - We have analysed 6 cases of twin pregnancies with vertex presentation of the
      first foetus. In this cases after delivery of the first twin by vaginal route
      caesarean, section was made. Caesarean section of the second twin was made
      because of: transversal presentation with fetal distress syndrom (four cases),
      umbilical cord drop (one case), and premature placenta ablation (one case). We
      have determined acid base balance and Apgar score. We have noted worse results
      for the second twin, independently too of the time between deliveries both twins.
      Caesarean section of the second twin is the rarely clinical situation, but in
      motivated situation is accepted and reasonable solution.

PMID- 11216151
TI  - [Multiple pregnancy in the Obstetrics and Perinatology AM in Lublin in 1989
      1999].
AB  - A retrospective analysis of 400 twin and 14 triplet pregnancies at the Department
      of Obstetrics and Perinatology, University School of Medicine in Lublin, from
      January 1, 1989 to June 30, 1999 was undertaken. A number increase of multiply
      pregnancies was observed--from 124 in the period 1989-1992 to 181 in the period
      1996-1999. A percentage increase of cesarean sections was observed--from 52.42%
      to 77.34% respectively. The most frequent indications for the cesarean sections
      were non-vertex presentation of the first twin, threatened intrauterine infection
      and threatened intrauterine asphyxia.

PMID- 11216152
TI  - [Breast feeding of twins with regard to pre-term infants].
AB  - The benefits of breast-feeding for health and development pre-term and full-term
      infants changed the attitude towards nutrition of twins and higher-order
      multiples. Mothers of twins are often at risk of unsuccessful initiation of
      lactation while in hospital. The possibilities to provide appropriate
      intervention and support when a mother breastfeeds twins are presented.

PMID- 11216153
TI  - [The significance breast feeding on the course of the adaptation period in
      neonates from multiple pregnancies].
AB  - Neonates from multiple pregnancies were evaluated taking into account their
      condition in the 1st and 5th minutes after birth, their birth weight, time which
      they spent in the neonatal department and occurrence of complications during the
      adaptation period, such as respiratory insufficiency, intrauterine infection and
      hyperbilirubinaemia. On the basis of our research, we think that multiple
      pregnancy requires particular diagnostics and individualisation of prenatal care.
      We believe also that neonates from such pregnancies are particularly exposed to
      development of a severe form of diverse complications. In our investigations, we
      observed a beneficial influence of breast-feeding--from the first hours of life-
      on the course of adaptation of neonates. However, we think that confirmation of
      these findings requires more detailed investigations.

PMID- 11216154
TI  - [Delivery of twins by Cesarean section with the Misgav Ladach method].
AB  - Between September 1998 and July 1999, 34 patients with twin pregnancy (79.1%)
      underwent cesarean section with Misgav Ladach method in the Department of
      Obstetrics and Perinatology of the Medical Academy in Lublin. The aim of this
      study was to evaluate safety and other advantages of the Misgav Ladach method.
      Body temperature, usage of antibiotics, analgesics, hematinics, and postoperative
      complications were evaluated in the postoperative course. No postoperative
      complications were noted at 32 patients (94.1%). 67.6% of patients did not
      receive antibiotics. Stitches were removed on the fourth p.o. day at 70.6% of
      patients. This study highlights the safety of the Misgav Ladach method, and
      points out some advantages like reduction of postoperative pain, speeded
      recovery, and no indication for transfusion.

PMID- 11216155
TI  - [Twin pregnancy and preeclampsia].
AB  - INTRODUCTION: Preeclampsia is a pregnancy-specific disorder of humans which rates
      among one of the major cases of maternal and fetal morbidity and mortality.
      Etiology of preeclampsia is still largely unraveled and treatment is syndrome
      specific. OBJECTIVE: Evaluation of the incidence of preeclampsia in twin
      pregnancies and comparison of selected clinical characteristics among
      preeclamptic and non-preeclamptic twin pregnancy patients. METHODS: Retrospective
      analysis of 194 normotensive and 25 preeclamptic patients with twin pregnancies
      admitted to the Lublin State Hospital Nr 4 between January 1st 1992 and December
      31st 1997. Patients were matched for gravidity, parity, maternal age and selected
      biochemical parameters. RESULTS: Preeclampsia occurred two times more frequently
      in nulliparous women (68% vs 32%). Gravidas with preeclampsia had significantly
      higher serum uric acid levels than their non-preeclamptic counterparts (6.7 +/-
      0.3 vs 4.3 +/- 0.1; p < 0.001). Hypertension, proteinuria and edema coexisted
      concomitantly in 52% of preeclamptic patients. CONCLUSIONS: 1. Preeclampsia
      complicates one tenth of twin pregnancies. 2. In preeclamptic women nulliparas
      were two times more frequent. 3. In preeclamptic women is significantly higher
      level of uric acid.

PMID- 11216156
TI  - [Analysis of the frequency of diseases during twin pregnancy, methods of its
      completion and complications ascertained in newborns from personal clinical
      materials].
AB  - One analysed course 49 of pregnancies and labours, which one took place in Clinic
      of Obstetrics Medical Academy in Bialystok in years 1997-1999. Most frequent
      complication of bigeminal pregnancy was premature labour (53.1%). Considerable
      percentage of gemellary pregnancies was delivered of caesarean section. In
      chances of pregnancies finished before term--62% and 57% in pregnancies finished
      in term. Indication to caesarean section was most often threatening intrauterine
      infection of embryo at premature departure amniotic fluid in premature delivery
      and complications of preeclampsia in delivery at term. Labour in operating way
      was more profitable for new-born child than childbirth ways of nature.

PMID- 11216157
TI  - [Complications of multiple pregnancy in the 2nd and 3rd trimesters].
AB  - Multiple pregnancy contributes to higher maternal and fetal risks than a single
      one. Complications typical only for multiple pregnancy such as PROM with preterm
      delivery, intrauterine death or IUGR of one of twins can occur during 2nd and 3rd
      trimester. Treatment in such situations is usually difficult and often
      controversial because of simultaneous presence of an alive and/or healthy fetus
      and possible risk for mother. The paper presents such situations and possible
      ways of treatment.

PMID- 11216158
TI  - [Triplet gestation--analysis of pregnancy course, delivery and neonatal outcome,
      based on personal material].
AB  - Triplet gestation appears in 0.1-0.3% of all pregnancies and it is high risk
      pregnancy for mother and foetus. It appears more frequently in Afroamerican
      women, rarely in Japan women. In multifetal pregnancy early prenatal diagnosis
      and management are very important. AIM: Analysing course of pregnancy, way of
      delivery, condition of newborns, influence of environmental factors, and
      concomitant diseases in triplets gestation. MATERIAL: 30 women treated between
      1989-1998, in Division of Perinatology, University of Medical Sciences in Poznan,
      Poland. RESULTS: 21 pregnancies were ended by caesarean section, 9 by vaginal
      delivery. Apgar score for II and III foetus decreases significantly. pH value of
      umbilical artery was without significant differences. CONCLUSIONS: Almost all
      triplets have ended preterm. Route of delivery of triplets have to be considered
      individually. Environment factors could play an important role in multifetal
      pregnancy.

PMID- 11216159
TI  - [The influence of delivery methods for twins on obstetric results].
AB  - The analysis covered 100 twin gestations over the years 1996-1998 in the material
      of Gynecology and Obstetrics Clinic in Bydgoszcz. The authors estimated the
      relations between the mode of delivery and presentations of the twins. Abnormal
      foetal presentation occurred in 68 pregnancies (68%), and was more often in the
      second twin (61.8%). The highest percentage of cesarean sections (29%) we have
      observed in the case of an abnormal presentation of the first twin. The condition
      of the twins in their first minute after the birth was estimated according to the
      birth weight, the gestational age, and the mode of surgical procedures performed.
      Better condition after the birth of the second twin with the birth weight above
      1000 g comparing to the first twin was established in cesarean sections, not in
      other obstetrical procedures. There was no essential difference between the
      mortality rate of the first and the second twin. Early diagnosis of the twin
      pregnancy using USG helps us to choose a suitable management during pregnancy and
      an optimal mode of delivery.

PMID- 11216160
TI  - [Ultrasonic diagnosis in the first trimester of multiple pregnancy].
AB  - Higher rate of morbidity and mortality has been noted in tween pregnancies
      comparing to singleton pregnancies. Early ultrasound investigation between 6 and
      12 week of gestation is useful in determining time of gestation, amniocity and
      chorionicity (adequacy of diagnosis ranged from 95 to 100%). Determining of
      chorionicity and amniocity is extremly important in monozygotic twins, because of
      high risk of complications during next stages of pregnancy. First trimester
      ultrasound investigation allows to define abnormalities commonly associated with
      twin pregnancy and is useful in monitoring of fetal well-being.

PMID- 11216161
TI  - [Multiple pregnancy as a cause of premature delivery].
AB  - Authors analysed management, complications and outcome of 13 multifetal
      pregnancies (11 triplet and 2 quadruplet), their duration, the way of delivery,
      indications for cesarean section and perinatal mortality rate. A majority of the
      multifetal pregnancies were diagnosed before the end of 20 weeks gestation, and
      69.2% of women had cervical cerclages. Tocolysis was used in 9 cases (69.2%). The
      mean gestational age at delivery was 32.8 weeks. Cesarean section was performed
      in nine cases (29 neonates). Of the 41 neonates there were 2 stillbirth (4.88%)
      and 3 neonatal death (7.31%). In 87.9% of cases, delivery occurred before the end
      of 37 weeks gestation. The most common maternal complications were toxemia
      (23.1%) and anemia (46.2%).

PMID- 11216162
TI  - [Prenatal diagnosis in twin pregnancy].
AB  - There are some unique problems of prenatal diagnosis and genetic counselling of
      twins, although methods of evaluation are similar in multiply and singleton
      pregnancies. Indications, risk and complications of this techniques were
      described. Also sensitivity and specificity of biochemic screening examination
      were compared between singleton and multiply pregnancy. Prenatal diagnosis based
      on amniopunction and chorionbiopsy seems to be safe and useful method determining
      aneuploidy. The risk of this methods is higher in twins than in singleton
      pregnancies. Although, in twin pregnancies, it is related rather to higher
      complications rate, than to procedures pregnancies losses.

PMID- 11216163
TI  - [Mode of delivery in twin gestations from material at the Department of
      Obstetrics in the District hospital of Lublin].
AB  - The aim of this study was to review 39 twin deliveries in the Department of
      Obstetrics in District Hospital in Lublin in 1998. The incidence of twin
      pregnancies was 2.01%. Eighteen patients (46.15%) were term at delivery whereas
      21 (53.8%) were premature (mean gestational age at delivery 35 weeks). Vertex
      presentation of both twins was the most common with an incidence of 48.7%
      followed by vertex-nonvertex (25.6%) and non-vertex presentation of first twin
      (15.4%). Twenty patients (51.28%) delivered vaginally and 19 women (48.7%)
      underwent cesarean section including 2 cesarean birth of second twin after
      vaginal delivery of first twin. In our results, we conclude that the techniques
      of twin delivery, whether vaginal or by cesarean section, would depend on the
      judgement and expertise of the labour in twin gestations.

PMID- 11216164
TI  - [Twin pregnancy complicated by intrauterine death of one twin].
AB  - In twin pregnancies single intrauterine death of one fetus is associated with
      significant morbidity and mortality of the surviving infant. The aims of our
      retrospective study were to review conditions of twin pregnancies complicated
      with SIUD in Polish Mother's Memorial Hospital in Lodz between 1989-1999 and to
      assess the fetal outcome when conservative management had undergone. In this
      study we reviewed 30 twin gestations involving the intrauterine death of one
      fetus. The incidence of preterm delivery among pregnancies with fetal death was
      83.3%; Caesarean section was the method of delivery in 53.3% cases. Monochorionic
      placentation was found in 60%. Conservative management until there is no risk for
      the fetus is apt.

PMID- 11216165
TI  - [Risk of preterm birth in twin pregnancy].
AB  - The aim of the study was to analyze the selected risk factors in twin
      pregnancies. Retrospective analysis was carried out in the Research Institute
      Polish Mother's Memorial Hospital (ICZMP) in Lodz and covered data from the
      period of time between 1989-1999. Out of 38,066 deliveries which had place in the
      ICZMP 538 twin pregnancies were enrolled in the study. We evaluated usual risk
      factors for preterm birth such as body mass index, short cervical length, beta
      mimetics admission, presence of bleeding and contractions as well as socio
      demographical characteristics such as age, parity, martial status and educational
      level. Univariate analysis and ?2 test were preformed. Odds ratios and 95%
      confidence intervals were calculated. For multivariate analysis logistic
      regression model was used. Most of the risk factors for preterm birth were not
      significantly associated with spontaneous preterm birth of twins.

PMID- 11216166
TI  - [Perinatal outcome in multiple pregnancy after natural reproduction and ART
      techniques].
AB  - In this study we analysed occurrence of multifetal pregnancy in groups of
      patients after natural reproduction and after using ART between 1991-1998 in
      clinical material. We showed the most important complications during pregnancy,
      occurrence of TTTS, percentage of prematurity, percentage and indications to
      caesarean sections. We found that above-mentioned manifestations of perinatal
      care were comparable with reports of Polish and foreign authors.

PMID- 11216167
TI  - [Term delivery in twin pregnancy].
AB  - We analyzed the data on 55,839 births that taken place in 1998 year in the
      southeast region of Poland. The incidence of twin pregnancy was about 1%. A half
      of them delivered before 259 day of gestational age, the beginning of birth
      occurring norm for human. This means that onset of this norm for singleton
      pregnancies is the mean of 12 weeks births occurring norm (215-303 days of
      gestational age) for multifetal pregnancies simultaneously. The particular
      meaning has prevention of preterm delivery and in this case the computer-aided
      monitoring of pregnancy and prediction of birth date is a very useful invention.

PMID- 11216168
TI  - [Selective salpingography in cases of proximal tubal occlusion].
AB  - The technical performance and results of selective salpingography (SGS) in 28
      infertile women with proximal tubal occlusion (PTO) are presented. In 50 cases of
      PTO, diagnosed first by hysterosalpingography (HSG) and/or laparoscopy, 14
      oviducts (28%) were patent during initial HSG using the baloon catheter tightly
      filling the internal cervical orificium and from remaining 36 tubes 27 (75%) were
      successfully recanalized by SGS. Three patients after successful SGS became
      pregnant. One of the pregnancies was ectopic. The SGS should be widely accepted
      in diagnosing and treatment of PTO as a cheap, simple, noninvasive and very
      effective method.

PMID- 11216169
TI  - [The value of computerized topographic evaluation for CIN changes in the cervix
      of young women based on effectiveness of CO2 laser therapy].
AB  - OBJECTIVES: Cervical cancer is one of the commonest neoplasms occurring in the
      female population of Poland. The discontinuance of radical treatment in CIN
      (Cervical Intraepithelial Noeplasia) cases for several years now is of particular
      importance for young women who are still in the reproductive age. DESIGN: The aim
      of the study was to evaluate early changes in the epithelium of the cervix by
      means of computer analysis of the fluorocolposcopic pattern. MATERIALS AND
      METHODS: The study included 164 young women (out of 2,098 women with cervical
      lesions) aged 18-35 years with a diagnostic of incipient CIN I-III changes in the
      cervix. The precise topography of the lesions was determined in fluorocolposcopy
      by the Berthalanffy technique using acridine orange. In the method the
      fluorocolposcopy made by "Polskie Zaklady Optyczne" was used. The analysis of the
      picture was made on the basis of a "MicroScan" programme. The florocolposcopic
      ones was transferred directly to the IBM Pentium II computer by means of a highly
      sensitive colour CCD OSCAR 35 camera. The image analysis was made simultaneously
      using a monochromatic camera CCD 6012P basing on a defined scale of greyness that
      corresponded to the luminescent of the method. The patients were treated
      exclusively with CO2 laser in the clinical reference centre. RESULTS: Of all the
      patients treated, a cure after one application of CO2 laser was achieved in
      94.6%. 1 women with a pretreatment diagnosis of a CIN III lesions required
      further therapy. In all the 9 women (5.4%) requiring also further treatment, the
      degree of progression of the lesions was never greater than that found in the
      pretreatment evaluation. CONCLUSIONS: Extended colposcopic techniques (especially
      fluorocolposcopy) give a good insight into the biology of tissues involved in CIN
      processes. The introduction of computer analysis of fluorocolposcopic patterns
      permits precise determination of the topography of the lesions; especially to
      increased the efficacy of destructive treatment by CO2 laser. After the
      introduction of computer techniques in evaluation patterns of lesions, the
      efficacy of CO2 laser treatment of CIN lesions in young women is expected to rise
      to 99%.

PMID- 11216170
TI  - [The value of serum tissue polypeptide specific antigen TPS concentration in
      therapeutic monitoring of patients with epithelial malignant ovarian neoplasms].
AB  - DESIGN: The aim of this study was compare the concentrations TPS and CA 125 in
      serum 37 patients with ovarian carcinoma in order to evaluate the usefulness of
      markers in monitoring therapy. MATERIAL AND METHODS: The concentrations of TPS
      and CA 125 were determined prior to surgery, 1 week after surgery, prior
      chemotherapy, after 3 and 6 course chemotherapy next every 3 months for the first
      year and every 6 month for the next 2 years. RESULTS: The concentration of TPS
      decreased above cutoff values in all patients with remission after 3 course
      chemotherapy, CA 125 after 6 course chemotherapy. In patients with remission the
      increase of TPS preceded 3 to 12 months, of CA 125 1 to 3 month the reoccurence
      of the disease. In of patients with progressive disease the TPS levels decreased
      during therapy and next rise. CONCLUSIONS: The current observations demonstrate
      that serial measurements of TPS appear to be useful for the evaluation of therapy
      and monitoring of patients.

PMID- 11216171
TI  - [Analysis of effectiveness for treating endometriosis with a Synarel (acetate
      naphareline) preparation].
AB  - The aim of the work was estimation of effectiveness of Synarel preparation in the
      treatment of pelvic pain syndrom caused by endometriosis, and assessment of
      remission of endometriosal focuses, situated in the small pelvis. Examination
      were performed on 10 cases which were divided into two groups. First of them the
      group of 6 patients with the intensive premenstrual pain complaints. The second
      group involved 4 patients with the little subjective pain ailments, which were
      treated for sterility. The patients were qualified for the 6-months Synarel
      treatment in according to the grade of intensification of endometriosis. The
      studies proved that Synare therapy was well-tolerate and effective in the
      treatment of intermediate and low-advanced cases of endometriosis with pelvic
      pain complaints.

PMID- 11216172
TI  - [Abrikosov's tumor of the vagina--clinical case report].
AB  - OBJECTIVES: Granular cell myoblastoma (Abricosov's tumor) is an uncommon benign
      tumor of mesodermal origin of which no more than sixty cases with genital
      involvement have been reported. Among the genital organs, the labium majus of the
      vulva are the predilect site. STUDY DESIGN: The authors describe a case of the
      Abricosov's tumor in woman aged 58 years which became directed to Department of
      Gynecology & Obstetric in Hospital of Slupsk on account suspicions of vagina
      tumor. RESULTS: The origin and nature of granular cell myoblastoma have been
      debated since the original description of a granular cell tumor by Abricosov in
      1926. Many cell types have been implicated in its histogenesis, including muscle
      cells, histiocytes, fibroblasts, neural sheath cells and undifferentiated
      mesenchymal cells, but the origin of the lesion remains still controversial. It
      is rarely diagnosed clinically and frequently discovered only as an incidental
      finding on physical examination. It usually occurs in the tongue, skin, breast,
      or subcutaneous tissue and very rarely in genital organs. Treatment remains
      controversial, but most studies suggest surgical or endoscopic resection as the
      treatment of choice. The prognosis is good but is dependent upon complete
      removal.

PMID- 11216173
TI  - [Recommended procedures in cases of suspected fetal/newborn malformation].

PMID- 11216174
TI  - [Report from the III Conference on bacterial vaginosis-2000 September 14-17 YSTAD
      -Sweden].

PMID- 11216175
TI  - Psychosocial issues in transplantation.

PMID- 11216176
TI  - A center-based approach to a transplant employment program.
AB  - The return to work after transplantation has been actively discussed in the
      transplant community for years. However, despite the desire for transplant
      practitioners to have recipients return to being healthy, contributing members of
      society as well as return to work, practitioners often passively support the sick
      role. We discovered that patients who are returning to work after transplantation
      may have been out of the work force for several years, and require assistance
      that we as healthcare providers were unable or untrained to provide. An
      employment specialist was added to the transplant staff and became a vital part
      of our attempts to create a proactive employment atmosphere and enhance our
      patients' quality of life. Adding an advocate for employment in our center has
      also facilitated the shift in our thinking and approach to care from the sick
      role to one of rehabilitation and from reactive to proactive. This change in
      attitude has assisted in empowering our recipients to feel as if they can truly
      resume a normal life.

PMID- 11216177
TI  - Xenotransplantation: the challenge to current psychosocial attitudes.
AB  - Because of the limited availability of transplantable human organs,
      xenotransplantation, the use of animal organs as an alternative source, has
      received considerable attention in recent years. Xenotransplantation would
      provide an unlimited supply of organs, and these organs would be available
      whenever required. Although the pig is considered the best source for organs,
      significant immunologic barriers currently prohibit the implementation of a
      clinical trial of organ transplantation. However, as medical research gains more
      insight into the mechanisms underlying rejection of pig organs in primates,
      therapeutic xenotransplantation is becoming more feasible. Clinical trials of
      porcine cell transplants are currently underway. Although xenotransplantation
      will minimize the waiting period for an organ and obviate the feelings of guilt
      or indebtedness commonly experienced by recipients of human organs, several
      psychosocial issues may hinder the reintegration of patients into society. For
      example, concerns that infectious pathogens could be transferred to recipients of
      pig organs will necessitate life-long monitoring and perhaps even temporary
      isolation of patients. The possible risk of the spread of a xenozoonosis from the
      patient to other members of the community may inspire public controversy and even
      fear, which may have an adverse impact on the patient's emotional state.
      Additionally, some patients may be psychologically disturbed by the need to
      incorporate pig organs into their body. This article addresses these and other
      psychosocial issues that may be associated with clinical xenotransplantation.

PMID- 11216178
TI  - Personality disorders: a challenge for transplantation.
AB  - Evidence concerning personality disorders is limited in the transplant
      literature, but the existence of a personality disorder in a transplant candidate
      does appear to be a risk factor for poor outcome after transplantation. This
      article addresses the issue of personality disorders in transplantation,
      including a definition and diagnostic criteria of personality disorders and the
      value of possible interventions to treat patients with personality disorders.
      Directions for treating personality disorders as part of the broader clinical
      management of transplant recipients are also provided.

PMID- 11216179
TI  - Adaptation of a weight management program for a potential lung transplant
      candidate.
AB  - Obesity is a relative contraindication for heart and lung transplantation at most
      transplant centers. Surgical risks are higher for obese patients, and 1 study
      suggests that obesity is significantly correlated with higher posttransplant
      death rates in cardiac transplantation. Obesity is a restrictive disease that
      contributes to exercise intolerance in patients with lung disease. A weight
      management group was formed at a transplant center to help obese patients with
      heart and/or lung disease lose weight and maintain their goal weight, with the
      hope of decreasing their waiting time to be listed for transplantation and their
      incidence of weight-related complications. Some patients experienced symptomatic
      improvement, which delayed their need for heart or lung transplantation.

PMID- 11216180
TI  - Social network mapping with transplant recipients.
AB  - Social support can have great influence on health, well-being, and general
      quality of life To promote awareness of the social network that surrounds each
      transplant recipient, transplant social workers are now using the Social Network
      Map as an intervention. Because perceptions of availability and accessibility of
      support are key elements in the use of social network resources, awakening an
      individual's awareness of available resources is a significant first step in
      enhancing social support and, ultimately, quality of life. The Social Network Map
      is used to establish dialogue regarding individuals' needs and sources of
      support, and then how the support system can meet those needs. Transplant social
      workers thus foster active use of those people in transplant recipients' networks
      who can meet the particular needs recipients identify.

PMID- 11216181
TI  - Mentorship programs for transplant patients.
AB  - The concept of mentoring has been used successfully in numerous settings, but
      only in the past decade have mentoring programs been used with organ transplant
      recipients. This paper describes how the Toronto Multi Organ Transplant Mentor
      Programme works, is administered, augments patient care, is evaluated, and has
      been adapted to meet the needs of various transplant patient populations.

PMID- 11216182
TI  - MD $200,000 richer after damning court judgement.

PMID- 11216183
TI  - Cisapride (Prepulsid): interactions with grapefruit and drugs.

PMID- 11216184
TI  - Pemoline (Cylert): market withdrawal.

PMID- 11216185
TI  - Bupropion (Zyban, sustained-release tablets): update.

PMID- 11216186
TI  - Diabetes in Aboriginal populations.

PMID- 11216187
TI  - A worthy Web site.

PMID- 11216188
TI  - Anticoagulant prophylaxis against stroke.

PMID- 11216189
TI  - Reference-based pricing.

PMID- 11216190
TI  - Reference-based pricing.

PMID- 11216191
TI  - Much ado about Furbies.

PMID- 11216192
TI  - Old ways of treating TB may hold new appeal.

PMID- 11216193
TI  - A false-positive tuberculin test result.

PMID- 11216194
TI  - HIV infection and risk behaviours among young gay and bisexual men in Vancouver.
AB  - BACKGROUND: Young gay and bisexual men may perceive that the consequences of HIV
      infection have dramatically improved with the availability of highly active
      antiretroviral therapy. We therefore sought to identify trends in HIV infection
      rates and associated risk behaviours among young gay and bisexual men in
      Vancouver. METHODS: Prospective cohort study involving gay and bisexual men aged
      18-30 years who had not previously tested HIV positive. Subjects were recruited
      through physicians, clinics and community outreach in Vancouver. Annually
      participants were tested for HIV antibodies and asked to complete a self
      administered questionnaire pertaining to sociodemographic characteristics, sexual
      behaviours and substance use. Prevalence of HIV infection and risk behaviours
      were determined for eligible participants who completed a baseline questionnaire
      and HIV testing as of May 1998. The primary outcome was the proportion of men who
      reported having protected sex during the year before enrollment and who reported
      any episode of unprotected sex by the time of the first follow-up visit. RESULTS:
      A total of 681 men completed a baseline questionnaire and HIV testing as of May
      1998. The median duration between baseline and the first follow-up visit was 14
      months. The median age was 25 years. Most of the subjects were white and of high
      socioeconomic status. The majority (549 [80.6%]) reported having sex only with
      men; 81 (11.9%) reported bisexual activity. Of the 503 men who had one or more
      regular male partners, 245 (48.7%) reported at least one episode of unprotected
      anal sex in the year before enrollment; the corresponding number among the 537
      who had one or more casual male partners was 140 (26.1%). The prevalence and
      incidence of HIV seropositivity were 1.8% (95% confidence interval [CI] 0.8%
      2.8%) and 1.7 per 100 person-years [95% CI 0.7-2.7], respectively. Fifty-two
      (26.5%) of the 196 and 55 (29.7%) of the 185 men with regular partners who
      reported having practiced protected insertive and receptive anal sex in the year
      before the baseline visit reported engaging in these activities without a condom
      at the follow-up visit; the corresponding numbers among the 232 and 242 men with
      causal partners who had practiced protected insertive and receptive anal sex
      before the baseline visit were 43 (15.5%) and 26 (9.4%) respectively at follow
      up. INTERPRETATION: The incidence of HIV infection is unacceptably high among
      this cohort of young gay and bisexual men. Preliminary results suggest a
      disturbing trend toward increasing levels of unprotected anal intercourse.

PMID- 11216196
TI  - A quantitative ranking of Canada's research output of original human studies for
      the decade 1989 to 1998.
AB  - BACKGROUND: Since 1987 research articles have been catalogued with the author's
      affiliation address in the 40 databases of the Medical Literature Analysis and
      Retrieval System (MEDLARS) of the National Library of Medicine, Bethesda, Md. The
      present study was conducted to examine the Canadian entries in MEDLARS to
      interpret past and future trends and to combine the MEDLARS demographic data with
      data from other sources to rank Canadian research output of human studies both
      nationally and internationally. METHODS: The PubMed Web site of the National
      Library of Medicine was used to count medical articles archived in MEDLARS and
      published from Jan. 1, 1989, through Dec. 31, 1998. The articles attributed to
      Canadian authors were compared by country, province, city, medical school,
      hospital, article type, journal and medical specialty. RESULTS: During the study
      period Canadian authors contributed on average 3% (standard deviation [SD] 0.2%)
      of the worldwide MEDLARS content each year, which translated to a mean of 11,067
      (SD 1037) articles per year; 49% were human studies, of which 13% were clinical
      or controlled trials, and 55% involved people aged 18 years or less. In total,
      68% of the articles were by authors affiliated with Canadian medical schools;
      those affiliated with the University of Toronto accounted for the greatest number
      (8604), whereas authors affiliated with McGill University had the greatest rate
      of annual increase in the quantity published (8%). Over one-third (38%) of the
      articles appeared in Canadian journals. When counted by specialty, 17% of the
      articles were by authors with clinical specialties, 5% by those with surgical
      specialties and 3% by those with laboratory specialties. INTERPRETATION: The
      annual rate of increase in research output for Canada was more than 3 times
      higher than that seen world wide. Canada is now ranked seventh among countries
      contributing human studies to MEDLARS. The increase indicates that Canada's
      medical schools are productive, competitive in making contributions to medical
      science and are supporting Canadian journals.

PMID- 11216195
TI  - Development, dissemination, implementation and evaluation of a clinical pathway
      for oxygen therapy.
AB  - BACKGROUND: Oxygen is commonly administered to patients in hospital, but
      prescribing and monitoring of such therapy may be suboptimal. The objective of
      this study was to develop, disseminate, implement and evaluate a
      multidisciplinary clinical pathway for the administration of oxygen. METHODS: The
      authors developed a clinical pathway for the ordering, titration and
      discontinuation of oxygen, which was disseminated through teaching sessions, in
      service training sessions and information posters in a medical clinical teaching
      unit (CTU). Implementation of the pathway was ensured by means of reminders and
      patient-centred audit and feedback to CTU nurses and house staff. During a 3
      month intervention phase, consecutive patients requiring supplemental oxygen were
      treated according to the pathway. During a 1-month "wash-out" phase followed by a
      3-month non-intervention phase, patients were treated at the discretion of the
      CTU team. Clinical and economic data were collected in both phases. RESULTS: In
      the 2 phases, patient characteristics, the concentration and duration of oxygen
      prescribed, the frequency of oxygen saturation monitoring, the frequency of
      arterial blood gas testing and the clinical outcomes were similar. However, there
      were more discontinuation orders in the intervention phase (p < 0.001). In the
      intervention phase, costs were higher for monitoring of oxygen saturation
      ($44.95/patient v. $36.17/patient, p = 0.048) and for order transcription
      ($2.71/patient v. $1.28/patient, p < 0.001); total costs, including those for
      personnel, were also higher in the intervention phase ($76.93/patient v.
      $56.67/patient, p = 0.02). The cost of education about the oxygen pathway was
      $45.71/patient. When the education cost was included, the total cost of oxygen
      therapy during the intervention phase was $122.64/patient; this was significantly
      higher than the total cost of oxygen therapy during the non-intervention phase
      ($56.67/patient) (p < 0.001). INTERPRETATION: This multidisciplinary, multimethod
      oxygen pathway led to changes in oxygen-prescribing behaviour, consumed more
      resources than standard management and was not associated with changes in patient
      outcome. Appropriate management of oxygen prescribing and monitoring by
      physicians and nurses take time and costs money.

PMID- 11216197
TI  - Hypertension, self-perceived health status and use of primary care services.

PMID- 11216198
TI  - Stroke thrombolysis: is tissue plasminogen activator a defibrillator for the
      brain?

PMID- 11216199
TI  - Food irradiation: let's do it.

PMID- 11216200
TI  - Beyond polemic.

PMID- 11216201
TI  - HIV: the millennium bug.

PMID- 11216202
TI  - Tuberculosis: 12. Global disease and the role of international collaboration.

PMID- 11216204
TI  - Erythema ab igne: an old condition new again.

PMID- 11216205
TI  - Managing neuropsychiatric disease with transcranial magnetic stimulation.

PMID- 11216206
TI  - Reason for hope: the advent of disease-modifying therapies in multiple sclerosis.

PMID- 11216203
TI  - Causes of Alzheimer's disease.
AB  - It is now understood that genetic factors play a crucial role in the risk of
      developing Alzheimer's disease (AD). Rare mutations in at least 3 genes are
      responsible for early-onset familial AD. A common polymorphism in the
      apolipoprotein E gene is the major determinant of risk in families with late
      onset AD, as well as in the general population. Advanced age, however, remains
      the major established risk factor for AD, although environmental variables may
      also have some role in disease expression. Some pathogenic factors directly
      associated with aging include oxidative damage and mutations in messenger RNA.
      Other factors unrelated to the aging process may, in the future, be amenable to
      therapeutic intervention by way of estrogen replacement therapy for
      postmenopausal women, anti-inflammatory drug therapy and reducing vascular risk
      factors. Older theories, such as aluminum playing a role in the pathogenesis of
      AD, have been mostly discarded as our understanding of pathogenic mechanisms of
      AD has advanced.

PMID- 11216207
TI  - Inhaled nitric oxide for hypoxemic respiratory failure: passing bad gas?

PMID- 11216208
TI  - Poor penmanship costs MD $225,000.

PMID- 11216209
TI  - Auditor general slams feds' response to Salmonella outbreak.

PMID- 11216210
TI  - Caring for sick a strain on families.

PMID- 11216212
TI  - One HIPAA positive. Hospitals can target marketing based on patients' health
      background.

PMID- 11216211
TI  - Anthem takes steps toward IPO. Move provokes yawns from hospitals, concerns from
      consumers, docs.

PMID- 11216213
TI  - No silver bullet. Online purchasing company moves slowly in hopes of ensuring
      success.

PMID- 11216214
TI  - Chiropractors sue the Blues. Coalition accuses plans of discrimination in
      payments to practitioners.

PMID- 11216215
TI  - Turnaround, not runaround. Two systems look internally for fast fiscal fix; no
      scapegoat in sight.

PMID- 11216216
TI  - Medicare HMOs first in line. Shorted by $1 billion, health plans will ask
      Congress for more payment increases.

PMID- 11216217
TI  - Tupelo bucks the Miss. trends. Local health system provides primary care in
      clinics to improve public health.

PMID- 11216218
TI  - New doc databank open to public. $9.95 buys report from the Federation of State
      Medical Boards.

PMID- 11216219
TI  - Autopsies R Us. As hospitals, coroners change routines, private companies step in
      to determine causes of death.

PMID- 11216220
TI  - Country is king. Congress is singing a rural tune on health spending this year.

PMID- 11216221
TI  - Wanting more from information technology. But smaller budgets force providers to
      revise their expectations.

PMID- 11216222
TI  - The CEO who couldn't slow down retires. McMeekin follows his own principle in
      making room for fresh leadership.

PMID- 11216223
TI  - Rebuilding from within. Britain's providers helping to resuscitate public
      healthcare system.

PMID- 11216224
TI  - Shake, rattle and disenroll. Membership erodes as HMOs exit markets, but profits
      begin to stabilize.

PMID- 11216226
TI  - Why pro-lifers are missing the point.

PMID- 11216225
TI  - Diversity goal reached. Appointment of minorities to hospital board eases
      controversy.

PMID- 11216227
TI  - Ritalin: mom's little helper. A disorder long linked to sons migrates up the
      family tree.

PMID- 11216228
TI  - A new "time out". Parents who want to discipline their misbehaving kids should
      apply the hiatus to themselves.

PMID- 11216229
TI  - Sticks and stones. Osteoporosis can break your bones, even if you are a man. This
      disease is not for women only.

PMID- 11216230
TI  - The 'poor man's heroin'. An Ohio surgeon helps feed a growing addiction to
      OxyContin.

PMID- 11216231
TI  - Natural hazards. Tonic or toxic? Americans are gobbling up nature's remedies for
      everything from obesity to depression.

PMID- 11216232
TI  - The debt to pleasure. Explaining craving.

PMID- 11216233
TI  - Heart trouble could come straight from your parents.

PMID- 11216234
TI  - Unions. Divided they'll fall.

PMID- 11216235
TI  - Outpatients. A pretty little sum.
AB  - Achieving the government's target of a maximum wait of 13 weeks for a first
      outpatient appointment requires a greater appreciation of randomness in the GP
      referral rate and non-attendance rate. It is possible to analyse what effect
      randomness will have on waiting times. The number of GP referrals received in
      December is a critical factor in determining end-of-year performance in meeting
      the 13-week target.

PMID- 11216236
TI  - Treating acute pain in addicted patients.

PMID- 11216237
TI  - Assessing thyroid function with serum tests.

PMID- 11216239
TI  - Reviewing the nervous system.

PMID- 11216238
TI  - Safeguarding contrast media injections.

PMID- 11216240
TI  - Take a look at ginseng.

PMID- 11216241
TI  - What you should know about managing burn emergencies.

PMID- 11216242
TI  - Action stat. Neuroleptic malignant syndrome.

PMID- 11216243
TI  - Is professional liability insurance for you? Before you say no, weigh these
      considerations.

PMID- 11216244
TI  - Expanded ECGs: easy as V4, V5, V6. Use these techniques to get a wider view of
      myocardial damage.

PMID- 11216245
TI  - What the future holds for gerontology.

PMID- 11216246
TI  - New drugs 2001. Part I.

PMID- 11216247
TI  - The child left behind.

PMID- 11216248
TI  - Managing a pressure ulcer.

PMID- 11216249
TI  - Applying a condom catheter.

PMID- 11216250
TI  - Chlamydia trachomatis.

PMID- 11216251
TI  - Myths & facts ... about kidney stones.

PMID- 11216252
TI  - What's "professional" work?

PMID- 11216253
TI  - Actions speak louder than words.

PMID- 11216254
TI  - "Don't forget me".

PMID- 11216255
TI  - Breast feeding.

PMID- 11216256
TI  - Midwives in Victoria, Australia: a survey of current issues and job satisfaction.
AB  - OBJECTIVE: To describe demographic and work profiles of registered practising
      midwives, to assess their job satisfaction and their knowledge of and attitudes
      to the 1990 Victorian Birthing Services review. DESIGN: A questionnaire posted in
      1995 to a population-based random sample of registered midwives. PARTICIPANTS:
      Two hundred and forty midwives currently using their midwifery skills in their
      work. SETTING: One thousand names and addresses were randomly selected from a
      database of midwives registered to practise in Victoria, Australia in 1993.
      FINDINGS: There was a 72% response rate to the postal questionnaire. Two hundred
      and forty practising midwives returned completed questionnaires. Seventy-three
      per cent were in full time employment, 49% lived in rural Victoria, 80% were born
      in Australia, more than half were aged 40 or more years and 72% had at least one
      child. Twenty-six per cent worked in postnatal wards, 9% in each the labour ward
      and the neonatal nursery, 2% in birthing centres and 12% in out of hospital
      settings. Eighty per cent were satisfied with their work and interactions with
      women were the most important aspect. Satisfaction was associated with working in
      a labour ward, feeling adequately prepared by midwifery education and training,
      nursing for more than 15 years and having continuing education. Neonatal and
      rotating positions were significantly associated with dissatisfaction. Less than
      one-half of the midwives had read some of the Birthing Services Review, and of
      these only one-half had changed their attitudes or practice. One-third knew
      little of the imminent changes to the Midwifery Regulations. CONCLUSION: Although
      most midwives enjoyed their work there was little evidence of increasing autonomy
      or involvement in change.

PMID- 11216257
TI  - Falling by the wayside: a phenomenological exploration of perceived breast-milk
      inadequacy in lactating women.
AB  - OBJECTIVE: To provide insight into the lived experience of breast feeding, in
      primiparous women. The main focus was upon women's perceptions related to the
      adequacy of their breast milk, for the purpose of exclusively nourishing their
      babies. DESIGN: A longitudinal, phenomenological study involving in-depth,
      interactive interviews, conducted at 6, 12 and 18 weeks following the birth of
      the women's babies. PARTICIPANTS AND SETTING: A convenience sample of ten
      primiparous women were recruited prior to discharge from a maternity unit, in the
      north of England, in 1998. FINDINGS: Two groups of participants emerged, three
      who became increasingly confident and empowered by breast feeding and the
      remaining seven whose confidence progressively diminished, with six of them
      expressing concern that their breast milk was inadequate. Four major themes
      related to the participants' perceptions emerged from the analysis: the quest to
      quantify and visualise breast milk; anxiety regarding the adequacy of their diet;
      breast feeding as a challenging journey, with most feeling that they had 'fallen
      by the wayside' (this related partly to inadequate and conflicting advice given
      by health professionals); and finally, unmet needs for support, nurturing and
      replenishment in return for 'giving out'. CONCLUSION: Perceived breast-milk
      inadequacy is underpinned by a complex and synergistic interaction between socio
      cultural influences, feeding management, the baby's behaviour, lactation
      physiology and the woman's psychological state. IMPLICATIONS: Education of
      midwives and health visitors is required in relation to the needs of breast
      feeding mothers within a Western industrialised society. Strong social policy is
      vital in the UK, to initiate socio-cultural changes, which would enable women who
      commence breast feeding to perceive it as an empowering and fulfilling experience
      and not one of 'falling by the wayside'.

PMID- 11216258
TI  - A feminist analysis of women's experiences of perineal trauma in the immediate
      post-delivery period.
AB  - OBJECTIVE: To provide an account of women's experiences of perineal trauma in the
      immediate post-delivery period. DESIGN: Qualitative, using unstructured
      interviews with broad questions about experiences of childbirth and perineal
      trauma. SETTING: The South Wales. PARTICIPANTS: A snowball technique was employed
      to recruit six participants, all of whom were between 25 and 40 years of age,
      white, British and had had access to further education. FINDINGS: The women
      identified several factors which informed their experience. Of significance to
      midwives are the following: the doctor--'patient' relationship, particularly in
      relation to gender, not feeling heard, the expression of feelings; and a lack of
      available information and advice. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE:
      The study identified some of the reasons why women sufferers find it difficult to
      get these issues on the health-care agendae and the need for more research.
      Improvements in care are necessary in the areas of interpersonal skills and
      perineal suturing. Listening to women is the key to responsive care.

PMID- 11216259
TI  - To see or not to see? Midwives' perceptions of reduced antenatal attendances for
      'low-risk' women.
AB  - OBJECTIVE: To explore the views of midwives towards traditional and flexible
      schedules of antenatal attendance for women at low risk. DESIGN: A qualitative
      approach using focus groups. SETTING: Three NHS Trusts providing maternity care
      in and around Bristol. SAMPLE: 14 midwives who had provided antenatal care to
      women participating in the Bristol Antenatal Care Study. FINDINGS: Midwives
      generally expressed support for a move away from the traditional schedule of
      antenatal attendances, suggesting that this represented a move towards the
      acceptance of pregnancy as a normal life event. They recognised that some women
      would prefer flexible care and the possibility of a reduction in the number of
      antenatal attendances. However, they suggested that some women would require
      additional information in order to feel confident in these circumstances. The
      midwives also recognised that both they and pregnant women have reservations
      about reducing contact during the antenatal period. Central to these reservations
      is a concern that women's psychosocial as well as physical needs may go unmet if
      antenatal contact is reduced. IMPLICATIONS FOR PRACTICE: Although in principle
      supporting a move away from the traditional schedule of antenatal attendances,
      the reservations felt by midwives towards a reduction in antenatal attendances
      are reflected in their practice. These concerns currently impede any radical move
      away from the traditional schedule of antenatal check-ups and will need to be
      addressed by midwifery managers prior to the implementation of a more flexible
      schedule of antenatal attendances, if any such change is to be sustainable.

PMID- 11216260
TI  - Student midwives' views of 'learning to be a midwife' in Ireland.
AB  - OBJECTIVE: To explore the opinions, feelings and views of student midwives of
      their education as they progressed through their two-year programme in Ireland,
      with the intention of interpreting and understanding the working and learning
      world of the participants so that future students might be assisted to improve
      their educational experiences. DESIGN: Quantitative and qualitative methods. A
      phenomenological approach was used to guide the qualitative section of the study.
      SETTING: All seven midwifery schools in Southern Ireland. PARTICIPANTS: All
      students in the first intake of 1995 in every midwifery school in Ireland (n =
      125). DATA COLLECTION: Individual and group interviews, diary-keeping and
      questionnaires. KEY CONCLUSIONS: The findings presented in this paper illustrate
      the students' views of their education. Students perceived themselves as part of
      the workforce and believed that their educational needs were denied. They were
      given little clinical teaching and guidance and were not assisted to learn the
      skills of decision-making or judgement. Much of their learning took place by
      trial and error. The 13 weeks allocated for theoretical input in the midwifery
      education programme in Southern Ireland is far too short and many students
      thought that time was wasted. Relationships with the teaching staff were good,
      although some authoritarian attitudes were evident and teaching did not appear to
      be student-focused. IMPLICATIONS FOR PRACTICE: Theoretical teaching needs to be
      broadened and thought given to the integration of theory and practice. Clinical
      teaching is a necessity throughout the two-year programme and opportunities to
      teach while giving care should be identified and utilised. The use of prepared
      mentors, sufficient support staff and longer allocations to each area are
      recommended.

PMID- 11216261
TI  - A comparison of two methods of antenatal breast-feeding education.
AB  - OBJECTIVE: To compare a woman-centered antenatal breast-feeding programme based
      on concepts of peer and husband/partner support with a control group, who
      received antenatal breast-feeding education led by a midwife childbirth educator.
      DESIGN: Longitudinal, quasi-experimental study. SETTING: A large private hospital
      in Sydney. PARTICIPANTS: A convenience sample of 179 primiparous women who
      attended childbirth education classes were recruited. One hundred and fifty-four
      participants remained following attrition and the application of selection
      criteria. There were 86 participants in the control group and 68 in the
      experimental group. The study population had a mean age of 30.4 years, were all
      married or living with a partner, were predominantly Australian born citizens
      (84%), and recorded a higher than average level of education than the population
      in general (Australian Bureau of Statistics 1997). INTERVENTION: Nursing Mothers
      Association Australia (NMAA) representatives, their male partners and a mother
      who was willing to demonstrate breast-feeding, facilitated the experimental
      group. MEASUREMENTS AND FINDINGS: Maternal perceptions of success using the
      Maternal Breastfeeding Evaluation Scale (MBFES) (Leff et al. 1994) and breast
      feeding duration rates up to 25 weeks after birth were the outcome measures. No
      differences were found between groups in relation to maternal perceptions of
      success or duration rates. A difference was, however, detected in the qualitative
      data used to explore questions related to breast-feeding support and are to be
      reported elsewhere. Overall, breast-feeding duration rates were very high when
      compared to previously reported breast-feeding duration rates in Australia. There
      were no differences in breast-feeding duration rates or in maternal perceptions
      of success between those babies given supplementary feeds in hospital and those
      who were not, although early supplementation at home appeared to reduce breast
      feeding duration. IMPLICATIONS FOR PRACTICE: While no differences were found
      between groups in relation to breast-feeding duration and maternal perceptions of
      success, the homogeneity of the sample limits its extrapolation. The
      extraordinary rates of breast-feeding and the lack of research into antenatal
      breast-feeding education, warrants further investigation of these teaching styles
      across other populations. Importantly, this research found that a peer-led model
      of breast-feeding education was as effective as a midwife-led group in producing
      breast-feeding initiation and duration rates higher than other previously
      reported breast-feeding rates with the potential to enhance social support
      networks.

PMID- 11216262
TI  - Aspects of the preparation of student midwives for autonomous practice.
AB  - OBJECTIVE: To investigate aspects of the preparation of student midwives for
      autonomous practice, within the context of the relationship between the student
      and her supervising midwife. DESIGN: A qualitative research design was used and
      responses from in-depth interviews were analysed utilising the principles of
      grounded theory. SETTING: Interactions between the student and supervising
      midwife in the clinical setting were used to explore preparation for autonomous
      practice including issues in socialisation, role of the midwife, variations in
      placements and practice. SUBJECTS: Seven student midwives and their seven
      identified midwife 'supporters' and four midwives working on night duty.
      Initially purposeful in nature, the sample developed towards a theoretical
      sample. FINDINGS: Analysis revealed nine related categories common to this
      relationship presented within the themes of Recognition, Incorporation and
      Facilitation. KEY CONCLUSIONS: The findings suggest that students exhibited a
      fear of independent action through non-assertive behaviour, passive learning and
      subsequent compliance. Students were observing role conflict as the midwives in
      the hospital environment aimed to provide women-centred care whilst juggling with
      the restrictions on their practice, a situation which may be accepted or, at
      times, challenged by the student. IMPLICATIONS FOR PRACTICE: Midwives need to be
      aware of factors which influence their ability to be autonomous practitioners and
      how this relates to educational preparation in midwifery.

PMID- 11216263
TI  - [Electroconvulsive therapy: indications and contraindications. Nursing care].

PMID- 11216264
TI  - Water birth: a safe practice?

PMID- 11216265
TI  - Nurse prescribing: understanding generic medicines.

PMID- 11216266
TI  - Recent advances in natural family planning.

PMID- 11216267
TI  - Postnatal depression: involving partners in promoting recovery.

PMID- 11216268
TI  - Children's feet: common worries of parents--2.

PMID- 11216269
TI  - A busman's holiday with PEAK.

PMID- 11216270
TI  - Menstruation in schoolgirls--2: Early and late puberty.

PMID- 11216271
TI  - Educating patients and families about solid organ transplantation.

PMID- 11216272
TI  - Use of arginine vasopressin in the absence of diabetes insipidus: a case study.
AB  - This case study details the use of arginine vasopressin in a pediatric organ
      donor. Although arginine vasopressin is primarily administered for its
      antidiuretic effects in the treatment of diabetes insipidus, the study
      demonstrates the often overlooked vasoactive effect of arginine vasopressin and
      its use in a patient without diabetes insipidus.

PMID- 11216273
TI  - Regulation of coagulation abnormalities and temperature in organ donors.
AB  - The 3 most common reasons for abnormal coagulation of blood in organ donors
      result from prior medications, consumption or dilution of coagulation factors and
      platelets during massive transfusion, and disseminated intravascular coagulation.
      Evaluation and treatment of these conditions are reviewed, and recommendations
      are provided for ordering appropriate laboratory tests and blood bank products.

PMID- 11216274
TI  - Overcoming families' fears and concerns in the donation discussion.
AB  - Research into the fears and concerns families have about donation and other
      issues at the time of the donation discussion substantiates that many fears and
      concerns act as impediments to consent. Twenty fears and concerns voiced by
      families at the time of the donation discussion have been identified. Specific
      strategies have been developed to deal with 19 of those concerns. Using gentle
      probing questions and targeted strategies, trained requestors may successfully
      address many fears and concerns, thus increasing the likelihood of the family
      consenting to donation.

PMID- 11216275
TI  - Clinical risk associated with appointment noncompliance in heart transplant
      recipients.
AB  - This study examined the prevalence of appointment noncompliance in 101 heart
      transplant recipients and how appointment noncompliance is related to patient
      profile and clinical risk. Appointment noncompliance was defined as patients not
      showing up at 1 or more planned clinic appointments (at a minimal frequency of
      every 3 months) during the previous year. Clinical variables were collected from
      medical files. Psychosocial variables were measured using established
      instruments. Medication noncompliance was assessed using electronic event
      monitoring. Paired t test, Wilcoxon 2-sample test, chi-square test, or Fisher
      exact test were used for statistical analysis as appropriate. The prevalence of
      appointment noncompliance was 7%. Appointment noncompliers were significantly
      younger, were less likely to live in a stable relationship with a partner, were
      more depressed, perceived their health as poorer, experienced more symptom
      distress, and had significantly more drug holidays. Fifty-seven percent of the
      appointment noncompliers experienced 1 or more late acute rejection episodes,
      compared to 2% of the appointment compliers. Appointment noncompliance is a
      critical behavioral risk factor in the occurrence of late acute rejection
      episodes in heart transplant patients. Patient profiles allow the identification
      of patients at risk for appointment noncompliance.

PMID- 11216276
TI  - Teaching patients about kidney transplantation: documentation.
AB  - Increasing demands are being placed on transplant nurse coordinators for more
      precise documentation of their teaching of kidney transplant patients, but the
      amount of time nurses have for this added documentation remains unchanged or has
      diminished. After a thorough review of the literature, our transplant team found
      no patient teaching documentation format that assisted us in overcoming the
      problem of increased demands. Consequently, following the Joint Commission on
      Accreditation of Healthcare Organization standards, we developed a Renal
      Transplant Patient Teaching Record that has assisted our team in documenting the
      pre- and post-transplant patient teaching that we complete.

PMID- 11216277
TI  - Hostility toward caregivers as a selection criterion for transplantation.
AB  - Researchers have focused on hostility and aggression of psychiatric patients but
      little is known about what effects transplant candidates' hostility toward their
      caregivers has on the care the candidates receive. Hostility is defined as any
      verbal, nonverbal, or physical behavior which threatens persons or property.
      Although hostility may be one of the precipitating factors in the need for an
      organ transplant, it may also be a response of the patient to his or her
      condition. This study focused on whether transplant coordinators felt that
      hostility should be used as a criterion for accepting or rejecting a transplant
      candidate. A nonexperimental descriptive survey design targeted 559 organ
      transplant coordinators who were members of the North American Transplant
      Coordinators Organization. Many coordinators in this study (62%) felt that a
      hostile candidate should not receive an organ transplant. Different methods of
      caring for hostile patients should be explored, especially for those who are
      antagonistic and who exhibit aggressive behaviors. Given the scarcity of donor
      organs, ethical principles must guide the allocation of these organs and the
      selection of transplant recipients.

PMID- 11216279
TI  - Giving carers a choice and a voice.

PMID- 11216278
TI  - Reliability of ultrasound screening of liver and kidney donors: a retrospective
      study.
AB  - The reliability of abdominal ultrasound in screening liver and kidney donors was
      assessed by correlating ultrasound findings with the suitability of organs for
      transplantation as determined by direct examination of the organs. We evaluated
      100 multiorgan donors (100 livers, 200 kidneys) during a 15-month period.
      Abdominal ultrasound showed the following results for liver and kidney,
      respectively: specificity, 95.6% and 98.9%; sensitivity, 62.5% and 66.6%; and
      accuracy, 93% and 97%. These results show that abdominal ultrasound is a valuable
      tool for determining suitability of organs for transplantation when the
      ultrasound findings are normal. When ultrasound findings are abnormal, further
      studies are necessary to determine the suitability of the organs for
      transplantation.

PMID- 11216280
TI  - Audit of emergency detention.

PMID- 11216281
TI  - Pressure sore prevention in nursing homes.
AB  - Staff working in nursing homes are caring for ever more dependent residents who
      are consequently at great risk of developing pressure sores. Mary Clay offers a
      guide to the essential principles as a teaching aid for all caring staff.

PMID- 11216282
TI  - We are people, not diseases.

PMID- 11216283
TI  - A learning organisation.

PMID- 11216284
TI  - Changes to the RCN membership structure.

PMID- 11216286
TI  - Assessment of incontinence.

PMID- 11216285
TI  - A patient's view.

PMID- 11216287
TI  - Life across three centuries.

PMID- 11216288
TI  - New guideline represents 'processed-oriented' approach for ISO 9000.
AB  - Hospitals that have been tracking the development of ISO 9000 in the health care
      industry should pay close attention to a new guideline about to emerge. According
      to Laura Preole, health care services manager of SGS International Certification
      Services based in Rutherford, NJ, the new guideline is the latest step in an
      effort to establish a more 'process-oriented' method of looking at the health
      care environment from the moment a patient walks into a facility to the moment he
      or she is discharged.

PMID- 11216289
TI  - Final privacy rules create more questions.
AB  - Buried in the final patient privacy regulations released by the Clinton
      administration are a host of changes from the proposed regulations that will
      directly affect quality assurance managers, according to experts who have been
      sifting through the 1,500-page document since it was released Dec. 21.

PMID- 11216290
TI  - HHS database is risky source for credentialing.
AB  - Hospitals are running a considerable risk if they rely too heavily on the
      National Practitioner Data Bank (NPDB) as a source of information throughout
      their credentialing process. A report released recently by the General Accounting
      Office, which found the data bank riddled with problems, only underlines that
      point. The government watchdog agency says problems of underreporting to the NPDB
      make it a questionable source of information regarding disciplinary actions taken
      against health care practitioners by hospitals and other health care providers.

PMID- 11216291
TI  - Use XmR (individual and moving range) charts to better understand performance.
      Part 2.

PMID- 11216292
TI  - JCAHO alert on infusion pumps raises concern.
AB  - The Joint Commission on Accreditation of Healthcare Organizations issued a
      Sentinel Event Alert Nov. 30 that says human and medical errors involving the use
      of infusion pumps have led to several deaths and near-fatal drug overdoses. But
      industry representatives fault the Joint Commission for failing to provide
      adequate guidance for ongoing assessment.

PMID- 11216293
TI  - Going super slow. Lifting weights at a snail's pace can work wonders. Is it the
      whole key to fitness?

PMID- 11216294
TI  - The efficacy of communicative fairness and rhetorical aesthetics in contributions
      to argumentation.
AB  - This paper deals with the effects of aesthetic quality and argumentational
      integrity or fairness on the persuasiveness of contributions to argumentation.
      Contemporary discussions of aesthetics and morality distinguish three possible
      relationships: (a) superiority of aesthetics in making contributions persuasive,
      (b) integrity as a necessary precondition for the efficacy of aesthetics, and (c)
      a compensatory relationship between aesthetics and integrity. Basic argumentative
      dialogs were varied in aesthetic quality via the use of figurative language and
      in fairness via the addition of faulty, insincere, or unjust arguments. Materials
      were presented in a written (Study I) or spoken form (Study II), and followed
      with questions exploring cognitive, emotional, and conative aspects of persuasive
      efficacy. Results of both studies strongly support case (b): Only in arguments
      perceived as fair can persuasive impact be enhanced by aesthetic means.

PMID- 11216295
TI  - Garden path repair: diagnosis and triage.
AB  - Meng and Bader (2000b) have shown that for garden-path repair in German, case is
      a more effective cue than number. They argue that sensitivity to the nature of
      the cue supports a diagnosis model of garden path repair such as we have
      proposed. However, in making this argument Meng and Bader introduced a new notion
      of diagnosis. Retaining the original "basic" diagnosis system, they added a new
      function that we call triage. Triage determines the probable revisability of a
      structure, in order to decide whether to make the effort of trying to reanalyze
      it. To determine whether triage is a feature of human parsing, its scope must be
      established. We compare four hypotheses about how much work triage could do. A
      powerful triage component would succeed where the human parser fails. Limited
      local triage does no work if symptom effectiveness varies within a language. An
      intermediate hypothesis discriminates better between easy and difficult
      revisions. However, this variant of triage with the strongest claim to
      psychological reality is the most difficult to distinguish from no triage at all,
      since it shares important properties with basic diagnosis. We identify some
      empirical predictions that differentiate diagnosis with triage from simple basic
      diagnosis. What little evidence there is at present suggests that the human
      sentence parser has no triage capability.

PMID- 11216296
TI  - The effect of cue-enhancement on consonant intelligibility in noise: speaker and
      listener effects.
AB  - Our previous work (Hazan & Simpson, 1998) has shown that increasing the salience
      of perceptually important regions of nonsense word and sentence materials aids
      speech perception in noise. This study aimed to extend these findings by
      investigating the robustness of these enhancement techniques in improving
      consonant intelligibility for a range of different speakers and for groups of
      listeners with different language backgrounds. In Experiment 1, nonsense vowel
      consonant-vowel (VCV) tokens produced by two female and two male speakers without
      phonetic training were annotated to highlight segments of the signal
      corresponding to the consonant constriction/occlusion and vowel onset/offset
      regions. These regions were selectively amplified to enhance the cues they
      contained, then combined with speech-shaped noise at 0 dB SNR and presented to
      normally hearing listeners. Significant improvements in intelligibility were
      found for all speakers although the extent of the improvement varied across
      speakers. In Experiment 2, a subset of these stimuli were presented to two groups
      of learners of English--a Japanese-L1 group and a Spanish-L1 group--and a new
      group of native-English controls. Results showed a significant effect of
      enhancement in all listener-groups and similar speaker effects for the non-native
      and native English listeners. Error patterns were related to the distance between
      the phonological systems of listeners' L1 and L2.

PMID- 11216297
TI  - The Hebrew vowel system: raw and normalized acoustic data.
AB  - It is well known that different languages use different vowel systems in terms of
      variety and number. The Hebrew vowel system consists of five vowels /i, e, a, o,
      u/. The present research identified the acoustic features of the vowels produced
      by Hebrew speakers differing in age and sex. Ninety speakers (men, women, boys,
      and girls) were recorded. The vowels were presented in a nonword context that was
      placed in a meaningful Hebrew sentence. The data included measurements of F0, F1,
      F2, F3, F4, and vowel duration for the five different vowels produced by the four
      groups of participants. Conversion of the physical frequency measures of formants
      into a critical band (bark) scale was performed as well. The results indicated
      that the F2/F1 ratio is a distinctive feature of all five vowels, keeping with
      the findings of previous research in other languages. Nevertheless, the values of
      the F2/F1 ratios led to an overlap between different vowels produced by different
      groups of speakers. Applying the bark transformation as speaker normalization
      procedure succeeded in reducing speaker differences while increasing vowel
      differences.

PMID- 11216298
TI  - Prosodic variation in southern British English.
AB  - A neglected aspect of intonation research has been the nature and extent of
      variability in the use of prosodic features within a speech community. Cross
      speaker variability in intonation was investigated through analysis of data
      collected from 90 adult speakers of English from London, England, using a new
      prosodic test battery (PEPS). PEPS is designed to elicit information about how
      speakers use prosodic features to realize different types of linguistic and
      communicative function in their own speech, and also how they perceive and
      interpret these features. Although there were no significant effects of gender or
      age in isolation on prosodic performance, there was a small effect of educational
      level among younger adults. Despite this group homogeneity, qualitative analysis
      of data from two of the production tasks showed considerable variation across
      participants in their use of prosodic features, suggesting that speakers'
      realization of communicative functions through prosody is more variable than has
      hitherto been assumed.

PMID- 11216299
TI  - Re-examination of the role of within-compound associations in the retrospective
      revaluation of causal judgements.
AB  - We investigated blocking and retrospective revaluation of causal judgements using
      a scenario in which food cues acted as potential causes of an allergic reaction
      as the outcome. In the blocking contingency, the treatment cues were either
      paired or unpaired with the outcome prior to a second stage in which sequential
      compounds of treatment and target cues were paired with the outcome. The order of
      this compound and treatment training was reversed in retrospective revaluation
      contingencies. When the interstimulus interval between the treatment and target
      cues was unfilled on compound trials (Experiments 1 and 3), both blocking and
      retrospective revaluation were observed in that the target cue trained in
      compound with the paired treatment cue attracted lower causal ratings than the
      target cue trained in compound with the unpaired treatment cue. By contrast,
      performing a mental arithmetic task using numerals presented during the
      interstimulus interval had no effect on the magnitude of blocking but rendered
      retrospective revaluation unreliable (Experiments 2 and 3). These results provide
      further support for accounts of revaluation based upon within-compound
      associations.

PMID- 11216300
TI  - The 28th Bartlett Memorial Lecture. Causal learning: an associative analysis.
AB  - The concordance between performance and judgements of the causal effectiveness of
      an instrumental action suggests that such actions are mediated by causal
      knowledge. Although causal learning exhibits many associative phenomena-
      blocking, inhibitory or preventative learning, and super-learning--judgements of
      the causal status of a cue can be changed retrospectively as a result of learning
      episodes that do not directly involve the cue. In order to explain retrospective
      revaluation, a modified associative theory is described in which the learning
      processes for retrieved cue representations are the opposite to those for
      presented cues, and this theory is evaluated by studies of the role of within
      compound associations in retrospective revaluation and blocking. However, this
      modified theory only applies when the within-compound association represents a
      contiguous rather than a causal cue relationship.

PMID- 11216301
TI  - Unequal associative changes when excitors and neutral stimuli are conditioned in
      compound.
AB  - In four experiments a compound of a previously conditioned excitor and a neutral
      stimulus was either reinforced with food or nonreinforced. Two experiments used a
      magazine approach procedure in rats, and two used an autoshaping procedure in
      pigeons. All experiments employed a novel compound test procedure, which
      permitted evaluation of the size of the associative change that took place for
      the excitatory and neutral stimuli. Reinforcement of the compound resulted in
      greater increments in the associative strength of the neutral stimulus than of
      the excitor. Nonreinforcement of the compound resulted in greater decrements in
      the associative strength of the excitor than of the neutral stimulus. These
      results agree with earlier experiments with compounds of excitors and inhibitors
      and provide an additional challenge to contemporary error-correction models of
      conditioning.

PMID- 11216302
TI  - A differential outcomes effect using biologically neutral outcomes in delayed
      matching-to-sample with pigeons.
AB  - The differential outcomes effect (DOE) pertains to enhanced conditional
      discrimination performance if each correct stimulus-choice sequence is always
      followed by a different outcome (e.g., food vs. water) compared to when each
      correct sequence is followed equally often by either outcome. The present
      experiments sought evidence of a DOE in pigeons, using biologically neutral
      outcomes. Experiment 1 replicated findings with rats demonstrating that a DOE can
      occur when one outcome is a biologically neutral light and the other is the
      absence of that light. Experiment 2 extended these findings by demonstrating a
      DOE when two biologically neutral outcomes of similar sensory and associative
      properties were employed.

PMID- 11216303
TI  - Guidelines for psychologists working with animals.

PMID- 11216304
TI  - Should antibiotics now be part of routine treatment of coronary heart disease?

PMID- 11216305
TI  - Malaria, mefloquine and oil-workers.

PMID- 11216306
TI  - Munchausen files in Scottish A&E Departments: a review of current practice.
AB  - Our objective was to describe current use of Munchausen files in Scottish
      Accident and Emergency Departments. A Postal questionnaire survey was sent to
      lead A&E consultant/clinical directors in each department in Summer 1998. A total
      of 29 departments replied with 27 saying they kept a Munchausen file, of which
      only two were updated regularly. Organisation of information was variable or
      absent. Six departments kept data on other groups such as drug misusers, violent
      patients, missing persons or children at risk in the same file. Of the 27
      replies, only 14 departments would review their own files if suspecting a case;
      only 11 would report a suspected incident, to a variety of destinations. The
      majority of Scottish A&E departments do keep a Munchausen file although there
      appears to be little consistency in the collection, use and dissemination of the
      information therein. An improved data system may lead to more appropriate patient
      management.

PMID- 11216307
TI  - Lithium therapy.
AB  - Affective (mood) disorders are common in all ages often chronic or recurrent,
      destructive of personal and social functioning with significant morbidity and
      mortality. Diagnosis still rests on the clinical skills of interview, observation
      and a knowledge of the disorders. Lithium is simple, cheap and effective although
      underused. It is the main pharmacological agent currently used in bipolar
      disorders and as an adjunct in other affective disorders. While it does have a
      narrow therapeutic window and can cause serious morbidity itself, it is safe when
      delivered properly reducing both morbidity and mortality. Lithium therapy should
      only be started in a specialist psychiatric setting but other clinicians will be
      involved either in maintenance treatment or in treating patients for separate
      disorders who happen also to be on lithium.

PMID- 11216308
TI  - An evaluation of a primary care psychological therapies clinic.
AB  - The present study evaluates a primary care psychological therapies clinic
      providing input one day per week to a GP practice in a rural area of Scotland.
      Routine data was collected over a 17 month period and a rating scale was used to
      evaluate treatment outcomes by both GPs and therapist. In addition GP
      satisfaction with the service was also evaluated. No significant differences were
      found between counselling and psychology cases on any of the variables examined.
      Treatment outcome evaluation showed an overall rate of improvement following
      treatment, with a mean score of 7 on a 1-10 scale, with 10 representing 'much
      better'. Significant agreement was found between therapist and GP on rating
      outcome and no significant differences were found between ratings given by
      psychologist and counsellor. The GPs involved also expressed high levels of
      satisfaction with the service.

PMID- 11216309
TI  - Trilucent breast implants--a personal review of the current controversies (May
      1999).
AB  - Trilucent ("Soya Bean") breast implants were marketed as a safe alternative to
      silicon implants. Following their use in the UK for the past four years, a
      reassessment of this has currently been announced (March 1999) and further
      implantation has been suspended by the Trilucent company in conjunction with the
      MDA (Medical Devices Agency). This has been the result of some reports of adverse
      reactions to the triglyceride filling material when the implant ruptures. All
      patients with trilucent implants were advised to return to their respective
      surgeons for review and advice. A personal review has been undertaken by the
      author of this paper. The results obtained are discussed. The majority of
      patients were concerned, but were happy with cosmetic results, and did not at
      present wish their implants removed. None appeared as yet to have had serious
      complications that could be attributed to the implants.

PMID- 11216310
TI  - Management of myocardial infarction in the very elderly--impact of clinical
      effectiveness on practice.
AB  - The presentation of myocardial infarction in the elderly is often atypical and
      there is therefore a broad range of clinical presentations where this diagnosis
      should be actively considered and the appropriate investigations arranged. The
      early use of aspirin and thrombolytic therapy has revolutionised management and
      efforts should be made to employ these interventions wherever possible. We
      present the results of an audit showing how the introduction of local guidelines
      improved the early management of myocardial infarction in the elderly. We also
      found that in this group of patients cardiac enzyme assays were more useful in
      establishing the diagnosis than the electrocardiogram.

PMID- 11216311
TI  - Tuberculosis revisited or how we nearly conquered tuberculosis.
AB  - This article recounts the author's experience as a chest physician in the years
      after the Second World War when Scotland experienced a serious epidemic of
      tuberculosis. With the discovery of streptomycin, PAS and isoniazid this disease
      became for the first time eminently treatable, and the team in Edinburgh
      demonstrated how the routine use of these three drugs in all cases ensured that
      the patient progressed to cure with virtually no cases of drug resistance. This
      policy, although fully supported by follow-up studies, was only very slowly
      adopted elsewhere, and since that time there have been numerous errors and
      difficulties in treatment regimens in many parts of the world. The result is that
      a great therapeutic opportunity has been lost and the Worldwide situation is
      worse than ever, mainly due to increased incidence of TB in the countries of the
      Third World.

PMID- 11216312
TI  - Dissociable lexical and phonological influences on serial recognition and serial
      recall.
AB  - The impact of the lexicality of memory items on memory performance was compared
      in two paradigms, serial recall and serial recognition. Experiments 1 to 3 tested
      7- and 8-year-old children. Memory accuracy was only mildly impaired in lists
      containing nonwords compared with words in a serial recognition task involving
      judgments of whether the items in two sequences were in the same order
      (Experiment 1), although a substantial advantage for word over nonword items from
      the same stimulus pool was found in serial recall (Experiment 2). A stronger
      influence of lexicality on serial recall than serial recognition was further
      demonstrated in Experiments 3A and 3B, and in 4A and 4B using adult participants.
      These experiments also established comparable degrees of sensitivity to the
      phonological similarity of the memory sequences in the two paradigms. The
      phonological similarity effect in serial recall was found to arise from increased
      phoneme order errors, whereas the lexicality effect was due principally to the
      greater frequency of phoneme identity errors for nonwords. It is proposed that
      the lexicality effect originates in the redintegration of item information just
      prior to recall, and that this process is largely bypassed in serial recognition.

PMID- 11216313
TI  - Can actions affect perceptual processing?
AB  - Previous studies reported impairments in a perceptual task performed during the
      selection and execution of an action. These findings, however, always raise the
      question of whether the impairment actually reflects a reduction in perceptual
      sensitivity or whether it results only from an unspecific reduction in
      attentiveness given the perceptual task. Recent studies by the authors indicate
      that actions can also have a specific impact on perception in a dual-task
      situation. The identification of a left or right arrow is impaired when it
      appears during the execution of a compatible left or right keypress. In three
      experiments Signal Detection Theory is applied to test whether this impairment is
      also found in the sensitivity measure d' or whether it originates only from a
      response tendency. The results revealed a general lower d' for the identification
      of arrows that were compatible to simultaneously executed keypresses than for
      arrows that were incompatible. The bias measure c was small and/or did not differ
      between conditions. Additional analyses revealed that the impairment is due to a
      higher mean perceptual degradation of stimuli in the compatible condition and
      that it is restricted to the point in time when the central movement command is
      generated. Thus, actions actually seem able to affect perceptual processing.

PMID- 11216314
TI  - Location and attention.
AB  - A discrepancy exists in the literature concerning attention and visual
      localization accuracy. Prinzmetal, Amiri, Allen, and Edwards (1998), and Tsal and
      Bareket (1999a) found that localization accuracy increases with attention. Using
      an inattention paradigm, Rock, Linnett, Grant, and Mack (1992) found no
      difference between localization accuracy in three attention conditions:
      inattention, divided attention, and control. Using a similar inattention
      paradigm, the current study addressed this discrepancy. Subjects were instructed
      to perform a line judgement task, and attention for an additional location task
      was manipulated. In Experiment 1, location accuracy was worse in the inattention
      condition than in either the divided-attention or the control condition. There
      was no difference between the divided-attention and control conditions.
      Experiment 2 controlled for the possibility that improved location accuracy in
      the divided and control conditions was due to the expectation of performing a
      location response, rather than the manipulation of attention. Our results are in
      agreement with previous findings (Prinzmetal et al., 1998; Tsal & Bareket, 1999a)
      and suggest that the apparent discrepancy is due to coarse coding of the location
      responses in the study by Rock et al. (1992).

PMID- 11216315
TI  - The attentional blink is immune to masking-induced data limits.
AB  - The attentional blink is the robust finding that processing a masked item (T1)
      hinders the subsequent identification of a backwards masked second item (T2),
      which follows soon after the first one. There has been some debate about the
      theoretically important relation between the difficulty of T1 processing and the
      ensuing blink. In Experiment 1 we manipulated the difficulty of T1 in such a way
      as to affect the quality of data without altering the amount of resources
      allocated to its identification. We found no relation between the accuracy of T1
      identification and the blink. In Experiment 2, the same difficulty manipulation
      was applied to T2, and we observed an additive pattern with the blink. Together,
      this pattern of results indicates that a data-limited difficulty manipulation
      does not affect the blink, whether applied to T1 or T2. In Experiment 3 we used
      an individual differences methodology to show that performance in the traditional
      "stream"-like presentation (rapid serial visual presentation) was highly
      correlated with performance in our modified "target mask, target mask" paradigm,
      thus allowing for comparisons beyond the present methodology to much of the
      previous literature that has used the stream paradigm.

PMID- 11216317
TI  - Accessing source information in analogical problem-solving.
AB  - Several studies showed that people presented with source information fail to
      apply it to an analogous target problem unless they are instructed to use the
      source. Seven experiments were carried out to assess whether such a lack of
      spontaneous transfer occurs because individuals do not activate the source during
      the target task or because they do not realize the source-target relationship.
      Experiment 1 compared a condition in which the source was activated with no cue
      about the source-target connection to conditions in which subjects were informed
      about this connection. Results suggested that the lack of spontaneous transfer
      does not depend on failure in activating source information. Experiments 2, 3,
      and 4 were devised to falsify this finding by activating the source closer and
      closer to the target and by focusing participants' attention toward the relevant
      aspects of the source. Experiments 5, 6, and 7 were aimed at stressing source
      target correspondences by introducing surface similarities. All experiments
      showed that the mere activation of the source does not facilitate analogical
      transfer. Results suggested that two processes should be distinguished in the
      access phase of analogical problem-solving: Source retrieval and identification
      of the source-target connection.

PMID- 11216316
TI  - Central tendencies, extreme points, and prototype enhancement effects in ill
      defined perceptual categorization.
AB  - In three perceptual classification experiments involving ill-defined category
      structures, extreme prototype enhancement effects were observed in which
      prototypes were classified more accurately than other category instances. Such
      empirical findings can prove theoretically challenging to exemplar-based models
      of categorization if prototypes are psychological central tendencies of category
      instances. We found instead that category prototypes were sometimes better
      characterized as psychological extreme points relative to contrast categories.
      Extending a classic and widely cited study (Posner & Keele, 1968), participants
      learned categories created from distortions of dot patterns arranged in familiar
      shapes. Participants then made pairwise similarity judgments of the patterns.
      Multidimensional scaling (MDS) analyses of the similarity data revealed the
      prototypes to be psychological extreme points, not central tendencies. Evidence
      for extreme point representations was also found for novel prototype patterns
      displaying a symmetry structure and for prototypes of grid patterns used in
      recent studies by McLaren and colleagues (McLaren, Bennet, Guttman-Nahir, Kim, &
      Mackintosh, 1995). When used in combination with the derived MDS solutions, an
      exemplar-based model of categorization, the Generalized Context Model (Nosofsky,
      1986), provided good fits to the observed categorization data in all three
      experiments.

PMID- 11216318
TI  - Hypothesis testing in a rule discovery problem: when a focused procedure is
      effective.
AB  - We investigated individuals' ability to use negative evidence in hypothesis
      testing. We compared performance in two versions of Wason's (1960) rule discovery
      problem. In the original version, a triple of numbers--(2, 4, 6)--was presented
      as an example of a rule that the experimenter had in mind (i.e., "increasing
      numbers"). Participants had to discover the rule by proposing new triples. In the
      other version, the same triple was presented as a counter-example to the
      experimenter's rule (i.e., "decreasing numbers"). We predicted that, in both
      conditions, participants would form hypotheses based on the features of the
      triple, and test only instances of the hypothesized rule. However, in the counter
      example condition, such focused testing would invariably produce negative
      evidence. As a consequence, participants would be forced to revise their
      hypotheses. The reported results corroborated our predictions: Participants
      solved the counter-example version significantly better than the original
      problem.

PMID- 11216319
TI  - Collecting information: optimizing outcomes, screening options, or facilitating
      discrimination?
AB  - Collection of information prior to a decision may be integrated into a
      compensatory choice process; if it is, the information packet that is collected
      should be the one that produces the highest net gain. Alternatively, information
      may be collected in order to screen out options that fail to meet minimum
      standards; if this is the case, people should not choose options on which they
      have not collected available information. We tested these and other predictions
      from the two approaches in four experiments. Participants were given specific
      information about three attributes of each choice option but only probabilistic
      information about a fourth one. They rated attractiveness of options, decided
      whether to collect specific information about the fourth attribute of each one,
      rated options again, and then selected one of them. Data were consistent with
      neither of the above approaches. Instead they suggested that people collect
      information in order to facilitate their ability to discriminate between the
      attractiveness of options.

PMID- 11216320
TI  - Processing and storage in working memory span.
AB  - Two experiments are reported that address theoretical assumptions as to the
      nature of working memory involved in working memory span tasks (Daneman &
      Carpenter, 1980). Experiment 1 used a version of the sentence span task, and
      Experiment 2 combined arithmetic verification with recall of presented words. In
      each experiment, working memory processing span was assessed independently of
      temporary storage span prior to their combination. Combined task performance
      under high demand for each component resulted in substantial residual performance
      for both task elements, particularly in Experiment 2. The results do not
      challenge the utility of the sentence span task as a measure of on-line
      cognition, but they raise concerns as to how resource might be allocated to
      processing and storage elements of the task within a single flexible resource
      pool, or between different resources of a multiple component working memory
      system. Although both models lack predictive power regarding resource allocation
      in these tasks, the multiple resource model appears to offer the better account.

PMID- 11216321
TI  - Memory discrimination for self-performed and imagined acts: bizarreness effects
      in false recognition.
AB  - Two experiments investigated the susceptibility of common and unusual action
      events to memory distortion under incidental learning and delayed testing
      conditions. Experiment 1 tested the influence of imaginal and enactment
      instructions at testing on memory discrimination for self-performed and imagined
      acts. The influence of hypnotic procedures at testing on memory discrimination
      for action events was tested in Experiment 2. The results of both experiments
      suggest that the likelihood of confusing details associated with separate,
      previously experienced unusual action events is greater than the likelihood of
      confusing details associated with separate, previously experienced common action
      events. Based on the results of both experiments, it is concluded that
      bizarreness has both memory-facilitating and memory-inhibiting qualities.

PMID- 11216322
TI  - Information and action in punching a falling ball.
AB  - Lee, Young, Reddish, Lough, and Clayton (1983) reported that the timing control
      of jumping and vertically punching a dropping ball exploits the inverse of the
      rate of change of optical expansion, tau(r). We raise a number of methodological
      and logical criticisms against their experiment and conclusions and attempt to
      rectify them by examining elbow joint angles only, in seated punchers, under both
      monocular and binocular conditions, with two ball sizes, dropped from two
      heights. Differences between the binocular and monocular cases suggest the
      exploitation of different information. We present several techniques to help
      determine the operative variable(s) controlling the action. The optical variable
      used to initiate and guide flexion appeared to be expansion velocity (looming),
      rather than tau(r); extension appeared to be under the control of different
      variables in the monocular and binocular cases. Simulations using single
      variables and single perceptuo-motor intervals were of mixed success.

PMID- 11216323
TI  - Influence of irrelevant information on human performance: effects of S-R
      association strength and relative timing.
AB  - Six experiments examined effects of stimulus-response (S-R) association strength
      and relative timing on the magnitude of consistency effects for irrelevant
      information in Stroop-like tasks. Keypresses were made to two-dimensional stimuli
      (a colour or location word surrounded by a coloured rectangle or arrow), with the
      irrelevant information presented simultaneously with or prior to the relevant
      information. With simultaneous presentation, irrelevant information affected
      performance regardless of whether its S-R association was weak or strong, if the
      relevant S-R association was weak (e.g., colour word to keypress). However, a
      weak irrelevant S-R association (location word to keypress) had little effect
      when paired with a strong relevant S-R association (arrow direction to keypress),
      except when the stimulus onset asynchrony (SOA) between the irrelevant and
      relevant information was 300 ms. When the relevant information was colour, the
      effect of an irrelevant colour word persisted at a 500-ms SOA but that of an
      irrelevant physical colour did not, reflecting different decay functions for
      irrelevant verbal and non-verbal information. The persisting effect of an
      irrelevant colour word was reduced by articulatory suppression and eliminated at
      extended SOAs of 3 s. The results indicate that whether the consistency effect
      patterns are symmetric or asymmetric is determined by the relative strengths of
      the relevant and irrelevant S-R associations, as specified by the criteria of
      conceptual and mode similarity. The magnitude of the consistency effect is also a
      function of the temporal overlap of the resulting response activation, which is
      determined primarily by mode similarity.

PMID- 11216324
TI  - Psychosocial dysfunction in tuberculosis patients.
AB  - Tuberculosis continues to be a major health problem in India. It carries social
      stigma and results in adverse psychological sequelae. In the present study, 50
      patients suffering from tuberculosis were examined. There was higher degree of
      neuroticism and the patients with tuberculosis showed marked to severe
      psychosocial dysfunctioning in personal, familial, vocational, social and
      cognitive areas.

PMID- 11216325
TI  - Genetic analysis of fragile X-syndrome.
AB  - Fragile X-syndrome is the most common inherited cause of mental retardation. The
      key clinical features of the fragile X-syndrome in males are mental retardation,
      a long face with large everted ears and large testes. The disorder is associated
      with a visible fragile site at Xq27.3 at FMR-1 loucs with the amplification of
      (CGC) n repeat sequence. The early diagnosis of affected individuals are carriers
      who are not aware of their high risk of having an affected child is important for
      proper management and counselling.

PMID- 11216326
TI  - Critical issues in determining citizen's right to health care in India.

PMID- 11216327
TI  - Malignant potential of oral submucous fibrosis due to intraoral trauma.
AB  - It is not very clear why oral submucous fibrosis (OSF) is prone to develop
      squamous cell carcinoma (SCC). Experimental studies on hamster have shown that
      wounding of oral mucosa promotes induction of epithelial dysplasia (ED) initiated
      with carcinogens. Hence, a study was undertaken to find the effect of intraoral
      traumatic factors (ITF) in OSF. Randomly selected 110 OSF patients were divided
      into 2 groups: Traumatic group (TG), having tooth/malposed impacted third
      molar/appliance/calculus; and Non-traumatic group (NTG). Clinico-pathological
      features of traumatic mucosa of TG were compared with non-traumatized mucosa of
      NTG. It was found that amongst 60 TG cases there were 8 cases of SCC, 4 cases of
      leukoplakia and 1 case of lichenoid dysplasia and erythema, erosion and ulcer
      were mostly observed with sharp tooth (28) cases and malposed impacted tooth (19)
      cases. Further, various degrees of ED were seen in more cases of TG (23%) than in
      NTG (8%). This study concludes that traumatised mucosa in OSF due to various ITF
      may concentrate the carcinogens which by penetrating cause carcinogenesis of
      susceptible cells.

PMID- 11216328
TI  - Bacteriological study on pulmonary & extra-pulmonary cases of tuberculosis from
      central India.

PMID- 11216329
TI  - Post MTP haematometra--simulating ectopic pregnancy case report.

PMID- 11216330
TI  - Professional advice and readiness to change behavioral risk factors among members
      of a managed care organization.
AB  - OBJECTIVE: To ascertain factors related to readiness to change behavioral risk
      factors in members of a managed care organization (MCO). STUDY DESIGN: Cross
      sectional study. PATIENTS AND METHODS: A telephone survey reached 4667 (73%) of
      6409 adult members of a Minnesota MCO attending 2 primary care clinics. Of these,
      3826 members (82%) completed an interview designed to identify behavioral risk
      factors (smoking, consuming a high-fat diet, and physical inactivity) and
      readiness to change these behaviors. RESULTS: Among MCO members consuming a high
      fat diet, those most ready to change were older, were women, used more preventive
      services, and reported receiving professional advice about diet. For physical
      inactivity, those most ready to change were younger, women, and more educated;
      used more preventive services; and reported receiving professional advice about
      physical activity. Among smokers, those with higher readiness to change smoked
      fewer than 15 cigarettes a day, had higher self-efficacy, had no other smokers in
      the household, and reported receiving professional advice about smoking. After
      controlling for demographic variables and for use of preventive services, greater
      readiness to change for smoking (beta = 0.336, odds ratio [OR] = 1.40, P = .056),
      physical activity (beta = 0.651, OR = 1.92, P < .001), and diet (beta = 0.532, OR
      = 1.70, P < .001) was associated with having received professional advice to
      change these behaviors. CONCLUSIONS: Levels of readiness to change behaviors in
      MCO members who smoke, are inactive, or consume high-fat diets are similar to
      those reported in other populations. The association of professional advice to
      change behaviors with increased readiness to change for smoking, physical
      activity, and diet suggests that receiving professional advice on these topics
      might assist patients in changing adverse health-related behaviors.

PMID- 11216331
TI  - Comparison of cesarean section rates in fee-for-service versus managed care
      patients in the Ohio Medicaid population, 1992-1997.
AB  - OBJECTIVE: To examine changes over time in the cesarean section rates for fee-for
      service (FFS) beneficiaries versus enrollees of managed care programs (MCPs) in
      the Ohio Medicaid population. STUDY DESIGN: Cross-sectional study using linked
      Ohio birth certificates and Medicaid files. PATIENTS AND METHODS: Study patients
      were Medicaid-enrolled residents of urban counties who had singleton, live births
      from 1992 through 1997 (n = 86,459). Changes in primary and repeat cesarean
      section rates were analyzed in the FFS and MCP groups. The test of homogeneity of
      odds ratios was used to measure the statistical difference between unadjusted
      odds ratios. Logistic regression analysis was conducted to adjust for risk
      factors. RESULTS: From 1992 to 1997, the difference in the rates of primary and
      repeat cesarean sections between FFS and MCP patients decreased. The unadjusted
      odds ratio (OR) increased from 0.66 to 0.81 (P = .06) for primary cesarean
      sections and from 0.67 to 1.04 (P = .03) for repeat cesarean sections; this
      indicated that the likelihood of undergoing a cesarean section increased over
      time for MCP enrollees compared with FFS beneficiaries. The results of the
      multivariate analysis indicated that the interaction term of payment source by
      year was not significant for primary cesarean sections (adjusted OR = 0.93; 95%
      confidence interval = 0.83, 1.04), but was highly significant for repeat cesarean
      sections (adjusted OR = 0.53; 95% confidence interval = 0.44, 0.64). CONCLUSION:
      We observed a reduction in the difference between the rates of both primary and
      repeat cesarean sections in FFS and MCP patients over time. The reduction was not
      statistically significant for primary cesarean sections. For repeat cesarean
      sections, however, we observed a convergence of the rates for FFS and MCP
      patients.

PMID- 11216332
TI  - Predictive power of a risk-assessment questionnaire across different disease
      states: results in an elderly managed care enrolled population.
AB  - OBJECTIVE: To examine the predictive power of self-reported assessment
      questionnaire data to explain changes in healthcare service utilization and
      expenditures of a population of Medicare health maintenance organization
      enrollees during a 2-year period. STUDY DESIGN: A prospective cohort study with a
      2-year postenrollment follow-up period. Multiple robust regression analyses were
      conducted to examine associations among self-reported health status variables
      obtained from responses to the questionnaire. SAMPLE AND METHODS: Participants
      were administered a voluntary comprehensive questionnaire at enrollment that
      collected self-reported information on morbidity, health status, perceptions of
      health, and healthcare service utilization during the preenrollment year.
      Questionnaire responses were combined with actual 2-year postenrollment claims
      data. For the complete follow-up period, 4128 patients were available. RESULTS:
      Participants with such chronic conditions as depression and diabetes were
      likelier than the average enrollee to have higher healthcare service utilization.
      Self-reported health status predictors examined in this study explained a larger
      percentage of the variance (as much as 20%) in such chronic conditions as cancer
      and depression. Despite evidence of underreporting of preenrollment healthcare
      service utilization, these variables were highly predictive of actual
      postenrollment utilization patterns. CONCLUSIONS: Self-reported health status
      information collected at baseline is as predictive of postenrollment risk as are
      currently used traditional approaches that require archival healthcare service
      utilization data. In addition, this approach is sensitive to changes in
      healthcare service utilization across differing morbidity states in older adults.

PMID- 11216333
TI  - A satisfaction and return-on-investment study of a nurse triage service.
AB  - OBJECTIVE: To assess patient satisfaction and a health plan's return on
      investment associated with a telephone-based triage service. STUDY DESIGN: A pre
      post study design, with medical claims data, to assess changes in medical service
      utilization and health plan expenditures associated with members' use of the
      triage service. PATIENTS AND METHODS: This study is based on data on 60,000
      members of a health plan. A telephone survey was conducted to assess member
      satisfaction and outcomes with the triage service. The plan's medical claims and
      encounter data were used to calculate medical utilization rates and plan
      expenditures for those services. The health plan's return-on-investment was
      evaluated using a pre/post study design to assess changes in medical service
      utilization between the baseline (December 1995 through November 1996) and
      program (December 1996 through November 1997) periods. RESULTS: The average nurse
      response time to a call was just less than 50 seconds, which indicates the
      service provided ready access to medical advice 24 hours per day, 7 days per
      week. More than 90% of users were satisfied, and utilization of hospital
      emergency department (ED) and physician office services decreased significantly
      after the service was implemented. The changes in medical service utilization
      resulted in reductions in health plan expenditures that exceeded the plan's costs
      of providing the service. The plan's estimated return for every dollar invested
      in the nurse triage service was approximately $1.70. CONCLUSIONS: The telephone
      based nurse triage service appears to be a cost-effective intervention that
      improves access to medical advice, thereby encouraging appropriate use of medical
      services. The service is associated with reductions in utilization of hospital ED
      and physician office services and with high levels of member satisfaction.

PMID- 11216334
TI  - Cost-effective treatment of depression with selective serotonin reuptake
      inhibitors.
AB  - OBJECTIVE: To compare factors that influence cost of antidepressant therapy
      between older tricyclic antidepressants (TCAs) and selective serotonin reuptake
      inhibitors (SSRIs) and among drugs in the SSRI class. STUDY DESIGN: Literature
      review. RESULTS: Pharmacoeconomic data from the primary care and managed care
      settings demonstrate that the higher acquisition cost of the SSRIs is offset by
      reduced medical utilization because of a lower incidence of treatment-related
      adverse events, drug switching, and dosage adjustments than among patients taking
      TCAs. Analysis of pharmacy claims data suggests that drug acquisition costs, use
      of concomitant medications, incidence of dose titration, frequency of multitablet
      therapy (dose stratification), and duration of therapy are the key factors in
      determining the cost of SSRI therapy. Among the established SSRIs, drug
      acquisition costs are lowest for paroxetine and sertraline. Costs for concomitant
      medications may vary by healthcare plan. Recent reports indicate that paroxetine
      is associated with a low incidence of dose titration. Paroxetine and sertraline
      are available in extended dosage forms to reduce the need for multitablet
      therapy. Duration of therapy with all SSRIs is typically shorter than
      recommended. CONCLUSION: Antidepressant therapy with SSRIs has been shown to be
      more cost effective than treatment with TCAs when overall healthcare utilization
      and expenses are considered.

PMID- 11216335
TI  - Studies demonstrating improved outcomes in patients with asthma: a 10-year
      review.

PMID- 11216336
TI  - What Catholic social teaching says to Catholic sponsors of church plans.

PMID- 11216337
TI  - Unconstitutional or impossible: the irreconcilable gap between managed care and
      due process in Medicaid and Medicare.

PMID- 11216338
TI  - Is there a ceiling cap on your health care? Life after Doe v. Mutual of Omaha.

PMID- 11216339
TI  - Long-term care after Olmstead v. L.C.: will the potential of the ADA's
      integration mandate be achieved?

PMID- 11216340
TI  - Health is a human right: why the U.S. immigration law response to gender-based
      asylum claims requires more attention to international human rights norms.

PMID- 11216341
TI  - Legal implications of lay use of automatic external defibrillators in non
      hospital settings.

PMID- 11216342
TI  - The viatical settlement industry: betting on people's lives is certainly no
      "exacta".

PMID- 11216343
TI  - The Family and Medical Leave Act: well meaning legislation meets the strong arm
      of the constitution of the United States.

PMID- 11216344
TI  - Caveat emptor: regulating the online medicine man in the new frontier.

PMID- 11216345
TI  - Informed consent for neonatal circumcision: an ethical and legal conundrum.

PMID- 11216346
TI  - Health, heart and mind: the contributions of Richard A. Posner to health law and
      policy.

PMID- 11216347
TI  - Leader of the Seventh.

PMID- 11216348
TI  - Judge Posner through dissenting eyes.

PMID- 11216349
TI  - Micro and macro approaches to local and global problems.

PMID- 11216350
TI  - Doctor Janeway and the Cameroon project.

PMID- 11216351
TI  - The joys of international work.

PMID- 11216352
TI  - A working visit to a developing country.

PMID- 11216353
TI  - Doctor Cynthia.

PMID- 11216354
TI  - Looking back fifty years.

PMID- 11216355
TI  - Bluebird.

PMID- 11216356
TI  - A man committed to helping to prevent a nation from dying.

PMID- 11216357
TI  - Affirmative action in medical school admissions: minority underrepresentation in
      medicine.

PMID- 11216358
TI  - Diversity in medicine is key to improving America's health.

PMID- 11216359
TI  - Occupational therapists and research: lessons learned from a qualitative research
      course.

PMID- 11216360
TI  - The future of computer access.

PMID- 11216361
TI  - Choosing books to guide evidence-based practice.

PMID- 11216362
TI  - From student to therapist: exploring the first year of practice.
AB  - OBJECTIVES: The transition from classroom to clinical practice challenges many
      health professional students. This study used a phenomenological approach to
      explore the lived experience of rehabilitation students during their final
      placement and first year of practice. METHOD: Students (n = 6) in occupational
      therapy and physical therapy wrote reflective journals every 2 weeks during their
      final fieldwork placement and first year of practice. The researchers
      independently analyzed the journals for common themes. An independent peer
      completed a blind analysis of two journals. Data were also compared with
      published first-person accounts of novice practitioners. RESULTS: The lived
      experience of the first year of practice included four consecutive stages:
      Transition, Euphoria and Angst, Reality of Practice, and Adaptation. Themes from
      the journals included great expectations, competence, politics, shock, education,
      and strategies. CONCLUSION: Recognizing the stages in the process of transition
      from student to therapist may assist in educational curriculum development and
      clinical support and supervision for new graduates. Educators need to continue to
      make education practice relevant while maintaining a theoretical perspective.

PMID- 11216363
TI  - Variables affecting the competency maintenance behaviors of occupational
      therapists.
AB  - OBJECTIVE: The purpose of this study was to examine the relationship between work
      environment and the competency maintenance activities of occupational therapists.
      METHOD: A survey of 121 occupational therapists in three states and interviews
      with 8 occupational therapists in Ohio were used. RESULTS: Analysis of survey
      data indicated that workplace support and the degree of competency monitoring are
      significant determinants of competency maintenance behavior. State continuing
      education requirements had no impact on reported levels of competency
      maintenance. Personal motivation of the therapist emerged as a potentially
      important moderator of the relationship between environment and competency
      maintenance. CONCLUSIONS: Although environmental factors enhance competency
      maintenance activities, active participation in competency maintenance is also
      related to the personal commitment of the individual therapist. Strategies that
      reduce barriers to effective competency maintenance and promote a culture of
      continuing competency in the profession merit further investigation.

PMID- 11216364
TI  - Occupational therapy goal achievement for persons with postacute cerebrovascular
      accident in an on-campus student clinic.
AB  - OBJECTIVES: A retrospective study was conducted to determine to what extent
      persons with postacute cerebrovascular accident (CVA) made progress toward
      rehabilitation goals during occupational therapy treatment and whether age and
      time since CVA onset affected the rate of goal achievement. METHOD: Data were
      collected from the admission and discharge records of persons with CVA who had
      received occupational therapy at a university clinic, who were at least 8 months
      post CVA, and who had not received therapy in the community for at least 6
      months. The treatment was provided by occupational therapy students under
      supervision and had a mean length of 12 1-hr sessions over one semester. A sample
      size of 85 was obtained from 13 years of clinic records. RESULTS: All patients in
      the sample except one made progress toward at least one of their selected
      rehabilitation goals. The group mean score for goal progress indicated that as a
      whole, the patients made significant gains. In addition, independent t tests
      showed no significant differences in mean scores between younger and older
      patients, between longer and shorter times since onset, between men and women, or
      between right and left CVA. There was no significant linear association between
      mean score and the number of treatments received. CONCLUSION: Patients with CVA
      showed progress toward rehabilitation goals during postacute treatment. Patients
      with recent CVA onset or of younger age did not achieve goals at a significantly
      higher rate than those with less recent onset or of greater age.

PMID- 11216365
TI  - Clinical interpretation of "occupational therapy goal achievement for persons
      with postacute cerebrovascular accident in an on-campus student clinic".
AB  - Occupational therapy practitioners, educators, and researchers can gain important
      information from Lavelle and Tomlin's study for initiating programs that meet the
      needs of a population of persons who typically cannot access occupational therapy
      services. The study provides evidence of the effectiveness of occupational
      therapy for persons with postacute CVA for clinicians seeking alternative funding
      for community-based practice. The study also suggests that the free university
      clinic in which Lavelle and Tomlin's research took place was providing a valuable
      service to persons living near the university, creating important links between
      the university and the community in which it resides. Lastly, the study raises
      intriguing questions that provide research opportunities for occupational therapy
      practitioners, educators, and students that can enhance our understanding of the
      impact of occupational therapy services on persons long after a CVA.

PMID- 11216366
TI  - Training to improve awareness of disabilities in clients with unilateral neglect.
AB  - OBJECTIVE: Awareness of disabilities is known to be a central problem of
      rehabilitation among clients with large right cerebrovascular lesions and
      unilateral neglect. The aim of this study was to evaluate the effect of an
      intervention program focused on improving the awareness of disabilities in four
      participants with unilateral neglect. The intervention program developed for this
      study was based on the assumption that awareness of disabilities is a
      prerequisite for being able to learn and use compensatory techniques in the
      performance of activities of daily living (ADL). METHOD: The study followed a
      single-case experimental ABA design. The Assessment of Awareness of Disability
      was used to measure awareness of disabilities; the Assessment of Motor and
      Process Skills was used to measure ADL ability; and neuropsychological tests were
      used to assess unilateral neglect and sustained attention. The intervention
      program used meaningful and purposeful occupations as therapeutic change agents
      to improve awareness of disabilities. RESULTS: Awareness of disabilities and ADL
      ability improved in all four participants; unilateral neglect decreased in three
      participants; and sustained attention improved in two participants. CONCLUSION:
      The preliminary findings indicate that training to improve awareness of
      disabilities might improve the ability to learn the use of compensatory
      techniques in the performance of ADL in clients with unilateral neglect. The
      effects of the intervention strategy need to be evaluated further in future
      research.

PMID- 11216367
TI  - The Movement Assessment Battery for Children: a comparison of 4-year-old to 6
      year-old children from Hong Kong and the United States.
AB  - OBJECTIVE: There is little information available on the appropriateness of tests
      developed in the West for children of different ethnicities. The aim of this
      study was to examine the suitability of the Movement Assessment Battery for
      Children (Movement ABC) for use with Hong Kong Chinese preschool children.
      METHOD: The performance of 255 Hong Kong Chinese children between the ages of 4
      years and 6 years was compared with that of the 493 children of the same age from
      the United States who took part in the most recent standardization of the
      Movement ABC. RESULTS: The test content was found to be suitable for use with
      Hong Kong Chinese children. However, cross-cultural differences were found on a
      number of the test items. Chinese children performed significantly better on
      items contained in the manual dexterity and dynamic balance sections, whereas
      American children were better at the projection and reception of moving objects.
      CONCLUSION: These findings highlight the need to ensure that norms for all tests
      are appropriate for the specific cultural groups being assessed.

PMID- 11216368
TI  - The comparison of motor performance between part and whole tasks in elderly
      persons.
AB  - OBJECTIVE: When teaching clients a multistep functional task, therapists tend to
      break down the task into part tasks with discrete movements. The purpose of this
      study was to compare the kinematic performance between part and whole tasks in
      elderly persons. METHOD: A counterbalanced repeated-measures design was used.
      Twenty elderly persons without motor problems (7 men, 13 women) performed a
      signature task in two conditions. For the part-task condition, the participants
      did the task in a step-by-step manner: (a) reach for a pen, (b) bring the pen to
      the paper, and (c) sign the name. For the whole-task condition, the participants
      performed the task in an integrated continuous flow. Kinematic performances for
      two movement segments (i.e., reaching for the pen, bringing the pen to the paper)
      were compared between conditions. RESULTS: Generally, the whole-task condition
      elicited a more efficient, more forceful, and smoother movement than the part
      task condition. CONCLUSION: The results suggest the importance of keeping a
      multistep functional task whole.

PMID- 11216369
TI  - Changes in health status for persons with wrist or hand impairments receiving
      occupational therapy or physical therapy.
AB  - OBJECTIVE: The purpose of this study was to describe changes of health status as
      perceived by clients with hand or wrist impairments who received rehabilitation
      in acute, orthopedic outpatient facilities from occupational therapy or physical
      therapy personnel. METHOD: One thousand three hundred ninety-nine adults with
      wrist (n = 692) or hand (n = 707) impairments who were treated between July 1996
      and June 1997 were selected from the Focus On Therapeutic Outcomes, Inc. (FOTO)
      national rehabilitation database. Each client completed a health status
      questionnaire on intake and discharge. Data consisted of number of outpatient
      visits, duration of treatment episode, and health status scores for six
      functional scales. Measures of intensity, global health status, global
      utilization, and client satisfaction were calculated. Outcomes were evaluated
      across occupational therapists and physical therapists. RESULTS: Clients
      perceived improvement (p < .05) in their health status over the course of
      therapy. Number of visits and measures of health status and client satisfaction
      were similar across type of therapist. Episode duration was longer (p < .05) and
      intensity was less (p < .05) for clients seen by occupational therapists.
      CONCLUSION: Clients receiving rehabilitation in acute orthopedic outpatient
      centers perceived improvement in their functional abilities and health and well
      being (global health status and individual functional scales) over the time
      during which treatment was provided. Results confirm the responsiveness of the
      outcomes instrument to clinical change in the clients' perception of their health
      status over the course of therapy and support the use of health status as a
      measure of clinical outcome.

PMID- 11216370
TI  - The Adult Sensory Profile: measuring patterns of sensory processing.
AB  - OBJECTIVE: This article describes a series of studies designed to evaluate the
      reliability and validity of the Adult Sensory Profile. METHOD: Expert judges
      evaluated the construct validity of the items. Coefficient alpha, factor
      analysis, and correlations of items with subscales determined item reliability,
      using data from 615 adult sensory profiles. A subsample of 20 adults furnished
      skin conductance data. A heterogeneous group of 93 adults completed the revised
      Adult Sensory Profile, and item reliability was reexamined. RESULTS: Expert
      judgment indicated that items could be categorized according to Dunn's Model of
      Sensory Processing. Results suggested reasonable item reliability for all
      subscales except for the Sensation Avoiding subscale. Skin conductance measures
      detected distinct patterns of physiological responses consistent with the four
      quadrant model. Revision of the Adult Sensory Profile resulted in improved
      reliability of the Sensation Avoiding subscale. CONCLUSION: The series of studies
      provides evidence to support the four subscales of the Adult Sensory Profile as
      distinct constructs of sensory processing preferences.

PMID- 11216371
TI  - Team collaborative practices between teachers and occupational therapists.
AB  - OBJECTIVE: A descriptive, correlational study using a survey instrument and
      record review was designed to describe collaboration practices between teachers
      and occupational therapists in public schools and to explore relationships of
      these practices to individual education plan (IEP) objectives and teachers'
      perceptions of occupational therapy contributions to student skill development.
      METHOD: Forty teachers of students who receive occupational therapy comprised the
      sample. Descriptive statistics and Spearman rank order correlations were used to
      describe the practices and to determine associations among the variables. RESULTS
      AND CONCLUSIONS: The findings indicated that teachers and occupational therapists
      were using collaborative team practices, such as jointly developing goals and
      objectives, collaboration within the classrooms, jointly monitoring
      interventions, and jointly reviewing student progress. However, scheduling team
      meetings was difficult. The majority of respondents stated that occupational
      therapy contributed to student skill development, and as collaboration practices
      increased, the teachers' perceptions of occupational therapy contribution to
      student skill development increased. A significant negative correlation was found
      between the percentage of IEP objectives met variable and three collaborative
      variables--team meetings, reviewing progress, and develop goals and objectives.
      This finding indicated that as the frequency of these team processes increased,
      fewer objectives were met.

PMID- 11216372
TI  - The experience of clinician-researchers in occupational therapy.
AB  - This study examined the experience of occupational therapy clinicians who do
      research to illuminate factors that influenced their research, the processes
      involved, and the outcomes. The qualitative approach of grounded theory was used.
      Purposive sampling of all research-productive clinicians in acute care hospitals
      in one Australian city occurred. Fifteen clinicians participated in in-depth
      interviews that explored their experiences of research. Results were analyzed
      with the constant comparative method, and six conceptual categories were
      developed. These categories were further analyzed in terms of their
      relationships, and a core category that explained and synthesized the data was
      identified--becoming a clinician-researcher. This category encompassed a process
      of role change during which the person changed from clinician to clinician
      researcher. Conditions for this change were identified, and three key concepts
      were derived to elaborate the core category. In becoming a clinician-researcher,
      the person was active in (a) identifying research as significant, (b)
      constructing actions in relation to research, and (c) evaluating the experience.
      The findings further the understanding of clinician-researchers through the
      description of their experience and the empirically based theoretical formulation
      that explains it.

PMID- 11216373
TI  - Occupation as means to mental health: a single-case study.

PMID- 11216374
TI  - Building an occupational therapy library collection.

PMID- 11216375
TI  - Effect of treatment on growth in congenital adrenal hyperplasia.
AB  - In 22 patients with congenital adrenal hyperplasia (CAH), the effect of treatment
      on growth was evaluated retrospectively. The degree of control with treatment had
      generally been assessed by measurements of serum 17-hydroxyprogesterone (17-OHP)
      and/or urinary pregnanetriol levels. In 20 patients, there were no significant
      differences in both height SDS for bone age (-2.05 +/- 1.89 vs -1.85 +/- 1.30)
      and height SDS for chronological age (CA) (0.23 +/- 1.94 vs -0.36 +/- 1.81) in a
      mean uninterrupted treatment period of 5.80 +/- 3.58 years. Further analysis in
      salt-losers and nonsalt-losers separately showed that height SDS for bone age had
      decreased in the salt-losers and had increased in the nonsalt-losers. Six
      patients had signs of early puberty. In 22 patients, there was a negative
      correlation between the prednisolone dose on one hand and height velocity SDS for
      CA and bone age velocity on the other. It was also found that the mean serum
      levels of 17-OHP did not always reflect the degree of long term control measured
      by auxological parameters. These findings indicate that our treatment in the
      patients did not result in a significant improvement in height prognosis. We can
      conclude that growth prognosis in CAH patients can be improved by relying on
      auxological parameters rather than serum 17-OHP and urinary pregnanetriol levels
      for monitoring control. Special attention should be paid to salt-losers in this
      respect.

PMID- 11216376
TI  - Intellectual psycho-educational and functional status of low birth weight
      survivors beyond 5 years of age.
AB  - To determine the intellectual, psycho-educational and functional status of low
      birth weight (LBW) survivors (birth weight < or = 2000 gms) beyond 5 years of age
      and to compare their status with normal birth weight counterparts. This was cross
      sectional study. On hospital based cohort on longitudinal follow-up at the High
      Risk and Well Baby Clinics of a teaching hospital. The demographic data of these
      children was recorded. A detailed physical examination was performed. The tests
      of cognition included the Stanford Binet and the Raven's Progressive Matrices.
      Academic achievement was evaluated by the Wide range achievement test-Revised
      (WRAT-R). Assessment of visuo motor integration was done by the Bender Gestalt
      Test. The proportion of children having soft neurological signs was determined.
      Vineland Social Maturity Scale was performed on all children. Fifty-nine LBW
      children and fifty-seven matched control children participated in the study. 27
      of LBW children were examined at a mean age of 7.0 +/- 1.1 years (group I) and 32
      were examined at a mean age of 10.6 +/- 1.2 years (group II). The LBW children as
      a group performed in the normal range on the tests of cognition and academic
      achievement, but were significantly disadvantaged (p < 0.005) as compared to
      controls. A higher percentage of LBW children had low scores on the Bender
      Gestalt. Test as compared to controls but the difference was not significant. A
      significantly higher proportion of LBW children of both the groups showed the
      presence of soft neurological signs as compared to controls. The social quotient
      as assessed by the vineland Social Maturity Scale was significantly lower in the
      LBW children as compared to controls. Thus, though the LBW children were
      performing in the normal range on various measures, comparison with the control
      group showed that they were clearly disadvantaged on nearly every measure tested,
      emphasizing the need for early detection and referral for special education.

PMID- 11216378
TI  - Spectrum of respiratory distress in very low birthweight neonates.
AB  - The incidence, etiology and the outcome of respiratory distress in 243
      consecutive liveborn very low birth weight neonates (VLBW) were analysed. One
      hundred and forty six (60%) VLBW neonates developed respiratory distress. Hyaline
      membrane disease, congenital pneumonia and transient tachypnea of the newborn
      were the major underlying causes (35.6%, 28.1%, and 27.4% respectively). The
      mortality rate was significantly higher in neonates with respiratory distress (72
      of 146, 49.3%) than in those without distress (28 of 97, 28.8%) (p < 0.05). This
      difference was more sharply reflected in the 1000-1249 birth weight group and in
      the 29-32 weeks gestation group. Respiratory distress is a significant
      determinant of VLBW mortality.

PMID- 11216377
TI  - Body proportions in Fanconi anemia heterozygotes.
AB  - To study the anthropometric ratios in parents (heterozygotes) of children with
      Fanconi anemia. The study was carried out in the Department of Hematology,
      Institute of Child Health & Hospital for Children, Chennai. Parents of children
      with Fanconi anemia were the subjects of the study. Applying standard instruments
      and methods, various body measurements were recorded. 31 fathers and 37 mothers
      were included in the study. A hundred male and female controls of the same ethnic
      group were also studied for the same parameters. The ratios were calculated and
      statistically analyzed. It was observed that fathers (male heterozygotes) had
      shorter forearms, the ratio of upper arm: forearm was significantly increased
      compared to male controls. In mothers (female heterozygotes) the inter-pupillary
      distance was increased, the ratio of head circumference to inter-pupillary
      distance was decreased compared to female controls.

PMID- 11216379
TI  - Oxidative stress, phototherapy and the neonate.
AB  - Phototherapy is the most widely used form of therapy for unconjugated
      hyperbilirubinaemia. Its non-invasive nature and few side effects reported
      earlier have led to the assumption that it is innocuous. Recent research has
      revealed that phototherapy is a photodynamic stress and can induce lipid
      peroxidation. There is increasing evidence that many severe diseases of the
      neonate are caused by oxidative injury and lipid peroxidation. In the present
      communique, we review the oxidative susceptibility of the neonate and the
      evidence now available that phototherapy induces oxidative stress. Although
      intensive phototherapy (up to 40 mwatt/cm2/nm) has been reported to be
      increasingly effective, a little caution, we believe is warranted, till more
      definite data in the human neonate, help resolve the issue.

PMID- 11216380
TI  - Challenges in human genetics in India in the new millennium.
AB  - This editorial provides information on the first draft of the human genome, and
      examines the impact this will have on the practice of medicine, with special
      reference to India. It examines what is currently possible in India, what we
      should do in the immediate future, and what is in store in the long run. The
      future is indeed bright and India needs to expand the genetic services and
      research facilities.

PMID- 11216381
TI  - Prenatal diagnosis and treatment of steroid 21-hydroxylase deficiency (congenital
      adrenal hyperplasia).
AB  - Steroid 21-hydroxylase deficiency congenital adrenal hyperplasia is the most
      common cause of genital ambiguity in females at birth. Inhibited formation of
      cortisol causes increase in the release of ACTH in turn leading to overproduction
      of adrenal androgens. This predisposes the affected female fetus to prenatal
      development of genital ambiguity. A large number of patients also have
      aldosterone insufficiency which manifests after birth in form of inability to
      conserve sodium and to excrete potassium which can lead to adrenal shock and
      neonatal death, if left untreated. Prenatal diagnosis is possible using several
      methods like steroid assay of amniotic fluid and, HLA typing. Recently with
      advancement more accurate direct molecular genetic techniques have been utilized
      on chorionic villus samples in first trimester of pregnancy. Prenatal treatment
      is also possible and pregnancies can be managed by administering dexamethasone to
      the mother as soon as pregnancy is diagnosed. This suppresses fetal androgen
      production in genetic females preventing virilization and leading to normal
      development. Prenatal diagnosis and treatment are highly desirable in families
      with a positive family history towards birth of a child without features of the
      disease.

PMID- 11216382
TI  - Diagnostic approach to children with birth defects.
AB  - Clinical genetics deals with the diagnosis, management and prevention of
      genetically determined disorders. Our current understanding of the role genes
      play in the pathogenesis of everything from fetal malformation to
      neurodegenerative and malignant disorders of late adulthood make it somewhat
      difficult to draw a clear boundary for this rapidly expanding specialty. With the
      recent completion of a preliminary draft of the entire sequence of the human
      genome it is not unreasonable to dream of novel therapeutic approaches such as
      "gene therapy", to cure disorders heretofore treatable with supportive measures
      only. Nevertheless, the clinical assessment of the patient will continue to be
      the cornerstone of good practice of medicine. In this article we review a
      clinical approach to the diagnostic challenge presented by children with birth
      defects. The principles we illustrate apply to other aspects of "genetic
      medicine" as well.

PMID- 11216383
TI  - Advances in laboratory evaluation of Turner syndrome and its variants: beyond
      cytogenetics studies.
AB  - Turner syndrome is a clinically defined phenotype that is characterized by
      partial or complete X chromosome monosomy. A host of cytogenetic aberrations and
      mosaicism have been associated with this syndrome. Some individuals, Turner
      syndrome variants, have cytogenetic findings consistent with Turner syndrome, but
      exhibit atypical clinical phenotypes. Recently, several molecular tests have been
      presented to allow for the refined clinical study of Turner syndrome and its
      variants.

PMID- 11216384
TI  - Medical genetics in primary health care.
AB  - Medical genetics has been at the forefront of developments in medicine for the
      last 50 years. This progress has mainly benefited industrialized countries. Due
      to continuing improvements in the socio-economic and health indices in developing
      nations more than half of them have now reached a stage where it has become
      relevant for them to initiate and develop medical genetic services. The WHO
      foresaw this eventuality in 1985 and further recognised the need to develop
      community based medical genetic services that are relevant to and can be
      incorporated into primary health care. The need for primary health care based
      medical genetic services has subsequently also been accepted in industrialized
      nations. This paper summarises those primary health care based interventions that
      can be undertaken to ensure the control of genetic disorders and birth defects.

PMID- 11216386
TI  - Radial artery cannulation in neonates: a new method.
AB  - In neonates arterial cannulation is a relatively difficult procedure without the
      aid of transillumination. This paper discusses a simple method to make the radial
      artery prominent in neonates. The principle used is displacement of perivascular
      interstitial fluid to make the course of the artery visible so that, under direct
      vision, cannulation of the artery becomes almost as easy as a venous cannulation.

PMID- 11216385
TI  - Advances in management of meconium aspiration syndrome.
AB  - Meconium Aspiration Syndrome (MAS) is a leading cause of respiratory distress in
      the newborn. Antenatal diagnosis of meconium stained amniotic fluid and fetal
      distress is important to reduce morbidity and mortality in the neonates.
      Amnioinfusion of saline and tracheal suctioning of meconium are preventive
      interventions. Babies with MAS who continue to have respiratory distress need to
      be put on conventional ventilators. Increasing hypoxia, hypercarbia and
      barotrauma warrants changing to high frequency oscillatory ventilation. Pulmonary
      hypertension is an important complication which should be promptly recognized.
      Nitric oxide therapy used with high frequency ventilation has improved the
      outcome of babies with severe MAS and pulmonary hypertension. Some of these
      babies who continue to worsen clinically need to be put on ECMO circuit.
      Surfactant infusion in babies with MAS has been shown to improve gas exchange,
      resolve pulmonary hypertension and decrease oxygenation index. Total and partial
      liquid ventilation with perflurocarbon improves oxygenation, increases lung
      expansion and increases pulmonary blood flow in model studies of animals with
      MAS. Surfactant infusion and liquid ventilation are newer promising modes of
      therapeutic interventions in babies with severe MAS.

PMID- 11216387
TI  - Idiopathic origin of meconium peritonitis.
AB  - A 26-year-old, gravida 3 presented at 31 weeks of gestation with polyhydramnios.
      On ultrasound there was marked foetal ascitis with unilateral hydrocele. Patient
      delivered a 3.15 kg, large-for-date baby at 33 weeks and 3 days of gestation. On
      basis of clinical, radiological and sonographic features, diagnosis of meconium
      peritonitis was made. Ascitic tapping was done. Surgery was withheld, as there
      were no signs of intestinal obstruction. DNA testing for cystic fibrosis was
      negative. Baby did not deteriorate so he was discharged. Baby was doing well on 2
      months follow up. Hydrocele and ascitis were resolving. Rarely meconium
      peritonitis may occur without an underlying cause when peritonitis may be
      innocuous and intervention may not be required.

PMID- 11216388
TI  - Endolaryngeal foreign bodies.
AB  - Unusual foreign bodies of the larynx viz. a toy gear, a metallic spring, a safety
      pin, a piece of stone, lodged in the endolaryngeal region are reported.
      Radiographic documentation with the rare feature of absence of symptoms inspite
      of lodgement for long duration is recorded.

PMID- 11216389
TI  - Intrauterine intussusception--a cause for ileal atresia.
AB  - A case of ileal atresia consequent to intrauterine intussusception is reported.
      The baby presented with features of neonatal intestinal obstruction but signs of
      peritonitis were absent. The intussusception was discovered on gross examination
      of distal atretic ileal segment. The case was managed successfully by resection
      and end to back anastomosis. This case is reported to highlight intrauterine
      intussusception as one of the causes of ileal atresia.

PMID- 11216390
TI  - Askin tumor: a malignant small cell tumor.
AB  - Malignant tumours of the chest wall are rare in the pediatric age group. Askin
      tumour, a primitive neuroectodermal tumour with aggressive nature, is extremely
      rare. Clinico-pathological features make it quite distinct from Ewing's sarcoma.
      Aggressive nature of the tumour results in short clinical presentation of the
      patient. Diagnosis of Askin tumour is mainly by histo-pathology. Imaging
      modalities play only a complimentary role. We present a case diagnosed to have
      this rare malignant tumour in the thoraco-pulmonary area in a child.

PMID- 11216391
TI  - Mesenteric leiomyoma in infancy.
AB  - Leiomyoma of the mesentery is an uncommon tumor. This has been documented in
      adults and children. However, there is no such case reported in an infant, which
      is being presented in this report.

PMID- 11216392
TI  - Familial hyperphosphatasemia.

PMID- 11216393
TI  - MtDNA haplogroups in the populations of Croatian Adriatic Islands.
AB  - The number of previous anthropological studies pointed to very complex
      ethnohistorical processes that shaped the current genetic structure of Croatian
      island isolates. The scope of this study was limited to the general insight into
      their founding populations and the overall level of genetic diversity based on
      the study mtDNA variation. A total of 444 randomly chosen adult individuals from
      32 rural communities of the islands of Krk, Brac, Hvar and Korcula were sampled.
      MtDNA HVS-I region together with RFLP sites diagnostic for main Eurasian and
      African mtDNA haplogroups were analysed in order to determine the haplogroup
      structure. The most frequent haplogroups were "H" (27.8-60.2%), "U" (10.2-24.1%),
      "J" (6.1-9.0%) and "T" (5.1-13.9%), which is similar to the other European and
      Near Eastern populations. The genetic drift could have been important aspect in
      history, as there were examples of excess frequencies of certain haplogroups
      (11.3% of "I" and 7.5% of "W" in Krk, 10.5% of "HV" in Brac, 13.9% of "J" in Hvar
      and 60.2% of "H" in Korcula). As the settlements on the islands were formed
      trough several immigratory episodes of genetically distant populations, this
      analysis (performed at the level of entire islands) showed greater genetic
      diversity (0.940-0.972) than expected at the level of particular settlements.

PMID- 11216394
TI  - Microsatellite haplotypes associations with 5 CFTR mutations in "Grande Briere",
      an isolate located in southern Brittany.
AB  - The variability at three microsatellites in the Cystic Fibrosis Transmembrane
      Conductance Regulator Gene (CFTR) locus has been studied for frequent mutations
      encountered in an isolated population of "Grande Briere", a small region located
      in Southern Brittany. Fluorescent multiplex PCR of these microsatellites were
      assayed in 16 Cystic Fibrosis (CF) families carrying 5 different mutations. The
      four most frequent haplotypes on df508 chromosomes were the same as those found
      in Northern France and Europe but the distribution of these haplotypes provides
      new enlightenment on the population origin of this insular community.

PMID- 11216395
TI  - Characteristics of myotonic dystrophy in Istria: molecular genetic approach. Part
      II: Analysis of genetic polymorphisms.
AB  - One of the world highest prevalence estimates of myotonic dystrophy (DM) has been
      reported in the Croatian region Istria. To analyse the population genetic
      characteristics of DM locus in Istria, two intragenic and three extragenic
      polymorphic markers were tested. The Southern blot technique was used for D19S63
      locus analysis, whereas PCR analysis was performed for CKMM, Alu polymorphism,
      DMPK (G/T) intron 9/HinfI polymorphism, and D19S207 genetic markers. The compound
      haplotypes segregating with DM were established. A complete association between
      the DM mutation and D19S63, D19S207, intron 9/HinfI polymorphism and Alu
      polymorphism markers were found. In all DM chromosomes: D19S63 and Alu markers
      had the allele 1 in common; D19S207 had the allele 3 in common, DMPK (G/T) intron
      9/HinfI marker had the allele 2 in common. The analysis of CKMM polymorphism
      revealed genotype heterogeneity; in DM chromosomes either allele 2 or allele 4
      were found. The haplotype analysis in the population of Croatian Istria supports
      the linkage disequilibrium between the DM mutation and Alu polymorphism, intron
      9/HinfI polymorphism, D19S63 and D19S207 markers as reported worldwide. The
      results of the haplotype analysis suggest a common origin of the mutation in
      Istrian population.

PMID- 11216396
TI  - Anthropogenetical analysis of abnormal human alpha-globin gene cluster
      arrangement on chromosome 16.
AB  - An earlier study of human globin gene polymorphism in two Adriatic islands of
      Olib and Silba showed an abnormal arrangement of alpha-globin genes in two
      different individuals. The next step was to determine the degree of the kinship
      relationship between the two probands, one with a deleted and another with
      triplicated alpha-globin gene on the island Silba, and to determine the stability
      of this disorder through generations. We reviewed the parish registers (Status
      Animarum) of the island of Silba, dating from the year 1527, and constructed
      family trees for the two probands. Restriction endonuclease mapping was performed
      to study the arrangement of the alpha-globin genes in the offspring of our
      probands. A total of 183 ancestors completed the two family trees. The kinship
      relationship between them was established in the 5th, 6th, and 7th generation.
      The analysis of alpha-globin genes in the offspring of our probands showed the
      triplicated alpha-globin genes in two persons. We also found alpha-globin gene
      triplication in other three relatives. We did not find any deleted alpha-globin
      genes. We determined the kinship relationship between the two probands, one with
      deleted and the other with triplicated alpha-globin genes. This finding enabled
      us to determine the stability of this gene disarrangement through generations. It
      also showed new possibilities in anthropogenetic research, by combining the
      analyses of parish registers with those of modern genetic methods, such as
      restriction endonuclease mapping.

PMID- 11216397
TI  - HLA class I polymorphism in the Albanian population.
AB  - The HLA class I polymorphism was studied in a sample of the Albanian population.
      Ninety-three unrelated healthy Albanians were typed for HLA-A, -B and -Cw
      antigens by standard microlyphocytotoxicity test. The antigens with the highest
      frequencies were: HLA-A2 (34.4%), A3 (14.5%) and A1 (12.4%); B51 (19.3%), B35
      (12.4%) and B18 (10.2%); Cw4 (16.2%), Cw7 (16.2%) and Cw6 (10.8%). The HLA
      haplotypes with high frequency in Albanians included A2-B51 (4.3%), A2-B18
      (2.4%), A2-B35 (2.4%), Cw4-B35 (7.6%), and Cw7-B18 (6.5%), which are not
      significantly different from the other neighboring populations. Low frequency of
      HLA-A1-B8 haplotype (1.1%) is noted in the Albanian population. The frequency of
      HLA-B27 antigen (1.1%) is one of the lowest frequencies observed in Caucasians.
      Such results are important in studies of HLA-A1-B8, HLA-B27 and disease
      associations. These findings should be also useful in understanding the origin of
      Albanians, representing a base for future studies about HLA polymorphism in the
      Albanian population.

PMID- 11216398
TI  - How many markers or how many alleles per system are appropriate in zygosity
      testing?
AB  - Due to the development in DNA-PCR-technique more and more systems with a high
      number of alleles have been established in twin diagnosis. Because of their high
      effectiveness in resolving of genetic questions it is not amazing that some
      authors have postulated the thesis that typing of 5 to 10 DNA-PCR systems can
      prove monozygosity. For this paper the use of different systems (conventional and
      PCR systems) has been tested for twin diagnosis and the observed effects are
      discussed.

PMID- 11216399
TI  - Anthropological cybernetic model of demography of the island of Hvar.
AB  - Intentions of the present investigation were to apply a cybernetic model in
      description of demography on the island of Hvar for a time period from year 1800
      till now. The basic idea of the model applied in this anthropological study
      (LOPI) is that the rate of reproduction is given by the non-linear controller:
      Y2/Te(1-(Y3/G)). Constant G represents an environmental carrying capacity of a
      community with respect to the cohort of older people (no longer a part of the
      pool of reproductive inhabitants; Y3) sharing limited survival resources. The
      proportional constant 1/Te connected with the pool of reproductive inhabitants
      (Y2) correspond to the reproduction maximum. The consistency of the model is
      evaluated through comparison between model data and census. The LOPI model
      describes incredibly well the demography of the island of Hvar from the year 1800
      till 1940. After year 1950 there were more inhabitants on the island then the
      model would predict. This fact is connected with changes in the migration or also
      in the increased carrying capacity (G). On the basis LOPI model, population
      dynamic oscillates in its development. The example of the island of Hvar has
      proved that population reaches a maximal number of inhabitants every 200 years.
      The oscillation of population dynamics is influenced by the migration processes.
      The mere fact that oscillating population size is connected to population
      genetics and probably also to sociocultural factors suggests that a cybernetics
      demographic model can be a guide in the holistic anthropological approach.

PMID- 11216400
TI  - Risk factors in asthmatic patients in Croatia.
AB  - The aim of this case-control study was to investigate whether some factors, that
      are associated with development of asthma, are significantly more present in the
      observed group of asthmatic patients, in comparison to the control group.
      Participants included 111 cases with asthma, and 108 controls with no asthma.
      Data obtained from cases and controls were compared according the sex. The study
      was performed using a specially developed questionnaire and data were collected
      from medical documentation of cases. Results showed that a significantly high
      proportion of cases had lower socio-economic status, higher proportion of atopic
      diseases, and were more exposed to dampness in working environment, and passive
      smoking, both at home and at work. Cases also exhibited poorer sustainment of
      physical strains and psychological stresses, and considered their life quality
      was greatly reduced by asthma. Among asthmatic participants, there were fewer
      current smokers and non-smokers, and more ex-smokers.

PMID- 11216402
TI  - Psychosocial characteristics of patients with bronchial asthma and coronary
      disease: similarities and differences.
AB  - The authors compare two groups of subjects: patients with bronchial asthma and
      those with coronary disease, with regard to some social characteristics,
      abilities and perception of factors which they conceive are important in the
      etiology of their disease. Data were obtained by means of a questionnaire based
      on a known calibrated scale. A group of 100 patients with bronchial asthma and a
      group of 102 patients with coronary disease were examined. The significance of
      the difference was tested by chi 2, t-test, Wilcoxon's test and multivariate
      discriminative analysis. The results showed statistically significant differences
      between the patients with bronchial asthma and those with coronary disease in
      some social and psychological characteristics and also with regard to perception
      of potential etiological factors of their disease. However, no difference was
      found in life style and habits between the coronary and asthmatic patients.

PMID- 11216403
TI  - Alcoholic drinkers and road safety in the Republic of Slovenia.
AB  - In this study we were therefore interested in the percentage of road traffic
      offenses (RTO) and road traffic accidents (RTA) involving inebriated drivers one
      year before and one year after the passing of the new Law on Road Traffic Safety
      (LRTS) as well as measures (referrals, punishments and final decisions on the
      revoking of driver's licenses due to drunk driving). One year before the passing
      of the new LRTS, there were 40,702 RTA-s in the Republic of Slovenia (12.2%
      caused by drunk drivers). The average alcohol concentration in exhaled air for
      those analysed was 1.19 g/kg. One year after the passing of this law there were
      36,479 RTA-s (8.6% caused by drunk drivers). The average alcohol concentration in
      exhaled air for those analysed was 1.32 g/kg (the differences were statistically
      significant). In 13.8% cases the reason for performing a measurement of the
      alcohol concentration in exhaled aier was an RTA with an average alcohol
      concentration in exhaled air of 1.22 g/kg and in 86.2% of cases an RTO with an
      average alcohol concentration in exhaled air of 1.25 g/kg (the differences were
      statistically significant). We found it interesting that the number of events
      minvolving lower concentrations decreased, but the percentage involving higher
      alcohol concentrations even increased. The results of this study indicate without
      a doubt that the law was not successful enough with its repressive and
      preventative measures in the field of drunk drivers. Experts on alcohol believe
      that punishment cannot make alcoholics and other drivers abandon their
      behavioural patterns and stop driving under the influence of alcohol. This can be
      achieved only by treatment, and the present practice (police--misdenveanour
      counts--repeat general medical check-up) has been ineffective as prevention among
      alcoholic drivers. We therefore believe that supplements to the LRTS should be
      adopted urgently, that would contribute, through better medical selection, to a
      reduction in the number of drunk drivers behind the wheel, both those who are
      alcohol dependent (and should be referred to treatment).

PMID- 11216401
TI  - Are respiratory allergic diseases related to atopic dermatitis?
AB  - The difference of test results between patients with "pure" atopic dermatitis
      (AD) and "mixed" AD (with concomitant respiratory allergy, RA) was investigated
      in 30 AD patients. The results showed the onset of disease that mostly occur in
      the early infancy [15 (50%) patients had developed the disease under the age of 2
      2/10 in "pure" AD, and 13/20 in "mixed" AD]. Twenty (66.6%) of them had a history
      of RA ("mixed" AD) whereas the remaining 10 (33.3%) had "pure" AD. Seventeen
      (56.6%) AD patients had one concomitant allergic disease, while 3 (10%) patients
      had two comorbid conditions (AR and AB) each. Family history was positive for
      atopy in 22 (73.3%) AD patients [in 14 (46.6%) patients in a first-degree
      relative]. Twenty-four (80%) patients had positive prick test [9/10 (90%) in
      "pure" AD and 15/20 (75%) in "mixed" AD], mostly for house dust (20). Positive
      scratch test was observed in 16 (53.3%) patients [4/10 in "pure" AD, and 12/20 in
      "mixed" AD]. Nineteen (63.3%) AD patients showed positive patch test reaction
      [5/10 in "pure" AD, and 14/20 in "mixed" AD]. AD patients had higher serum IgE
      (21/30) than non-atopic ones but similar in "pure" AD, and "mixed" AD [7/10 (70%)
      in "pure" AD, and 14/20 (70%) in "mixed" AD]. Determination of CD23 marker on B
      lymphocytes showed normal values in 24, and increased values in six patients
      [2/10 in "pure" AD, and 4/20 in "mixed" AD]. The values of CD21 were decreased in
      16 AD patients [6/10 in "pure" AD, and 10/20 in "mixed" AD]. HLA-DR expression
      was normal in almost all patients. There were no statistically significant
      differences (p < 0.05) between the "pure" AD and "mixed" AD patient groups,
      except for the age at onset, which was younger in the group of patients with
      concomitant RA. Accordingly, study results pointed to the association between AD
      and RA.

PMID- 11216404
TI  - Glaucoma triple procedure: a one-site vs. a two-site approach.
AB  - The purpose of this study is to describe and evaluate the success rate of
      combined glaucoma and small cataract surgery by means of a one-site versus two
      site approach. Fifty-eight eyes of fifty-five patients undergoing combined
      surgery were operated: thirty-one eyes underwent two-site approach and twenty
      seven eyes underwent one-site approach. Short term and long term mean intraocular
      pressure (IOP) was similar in both groups. There was no significant difference in
      postoperative inflammation and complication rates between two groups. There is no
      significant difference in the postoperative results in those two different
      approaches to perform combined operations of cataract and glaucoma.

PMID- 11216405
TI  - Plasma cholinesterase activity in patients with uterine cervical cancer during
      radiotherapy.
AB  - The objectives of this study were to investigate: 1) the activity of
      pseudocholinesterase (PChE) in patients with uterine cervical cancer in different
      stages (uterine cervical carcinoma in stages II b and III and recurrent cervical
      carcinoma in stages III and IV a,b) and to compare it to the enzyme activity in
      patients with benign tumour of the uterus, and 2) the effects of radiotherapy on
      enzyme activity in those patients with uterine cervical carcinoma for which the
      chosen treatment was radical radiotherapy. Thirty patients with uterine cervical
      carcinoma in stages II b and III (Group A), sixteen patients with recurrent
      cervical carcinoma in stages III and IV a,b (Group B) and thirty-eight patients
      with benign tumours of the uterus (control, Group C) were evaluated and their
      PChE activity was determined prior to any treatment (pre-therapy enzyme
      activity). All eighty-four patients were free of any liver disease. The results
      have shown that the patients of Group A had the pre-therapy PChE activity
      practically identical to those in group C, but patients of Group B had
      significantly lower values of PChE with respect to enzyme activities of Groups A
      and C (p < 0.001). That is to say, PChE activity was influenced by the extent to
      which the malignancy had spread. Radical radiotherapy (up to 8 weeks in doses
      higher than 50 Gy into point A; average 80 Gy) which was the chosen treatment
      only for patients from group A did not cause a significant inhibition of PChE
      activity in any patients in comparison with their control values. With regard to
      the role of PChE in hydrolysis of succinylcholine, our results about the
      influence of the malignant disease and the radiotherapy on PChE activity are
      clinically significant.

PMID- 11216406
TI  - Safety of simultaneous resections of colorectal cancer and liver metastases.
AB  - Liver resection is the only potentially curative method for patients with
      colorectal cancer metastases and 5-year survival rates are 20%-40%. Simultaneous
      resection of colorectal cancer and synchronous liver metastases has been
      recommended if minor hepatectomy is indicated. The purpose of this paper is to
      analyze the treatment of hepatic colorectal secondaries and to assess the safety
      of simultaneous and delayed liver resections and relations of morbidity to the
      extensiveness of hepatectomy and perioperative factors. Analyzed were 21 patients
      with liver metastases from colorectal cancer operated between 1997 and 1999 in
      the Clinical Hospital "Sestre milosrdnice". Operating time for simultaneous
      colorectal and liver resections was not significantly longer compared to liver
      resections alone. No significant difference in complication rate was found after
      simultaneous procedures and liver resection alone (38% vs. 31%). Complication
      rate after major liver resections was not significantly greater than after minor
      resections (38% vs. 31%). No statistically significant differences were found in
      operation time and blood replacement between patients who developed postoperative
      complications and those who did not. In conclusion, simultaneous resections of
      primary colorectal cancer and liver metastases may be considered safe. Morbidity
      rates are not significantly different from those after liver resections alone,
      nor depend significantly upon the extensiveness of liver resection, providing
      that the operation time and blood loss are within the range observed in this
      study.

PMID- 11216407
TI  - Early diagnosis and treatment of ectopic pregnancy.
AB  - During the period from 1995 to 1999, 64 patients were treated for ectopic
      pregnancy. All patients admitted to the department passed the same procedure
      including (complete preoperative laboratory findings, Beta HCG, serum
      progesterone and transvaginal colour Doppler). In patients who had ultrasound
      finding typical for ectopic pregnancy in combination with positive Beta HCG,
      conservative treatment was primarily done. In the rest of the patients, Beta HCG
      was tested every second day and in combination with the clinical and
      vaginosonographical findings the patients underwent diagnostic or operative
      laparoscopy. Out of 64 patients 36 had visible ectopic pregnancy when admitted to
      the clinical department. Three patients had no visible ectopic pregnancy neither
      at the time of their admission to the department nor at the time of laparoscopy.
      One of them had cervical pregnancy and the other two had pregnancies in the
      uterine part of the tube. The patient with cervical pregnancy was treated with
      metrotrexat (MTX) 12 mg daily in 5 doses. One patient with cornual pregnancy was
      treated with high doses of oxytocin infusion in combination with MEB
      intravenously 3 x 1 amp. The other patient with cornual pregnancy underwent
      laparoscopy with cornual resection and salpingectomy. Four of other tubar
      pregnancies were treated with metrotrexat 12 mg/day for 5 days. Other ectopic
      pregnancies were treated as follows: 36 laparoscopic salpingectomies, 10
      laparoscopic salpingotomies with ovum expression, 9 adnexectomies by laparotomy,
      and 2 laparoscopic adnexectomies.

PMID- 11216408
TI  - Epidemiology of coeliac disease in children in one Croatian county: possible
      factors that could affect the incidence of coeliac disease and adherence to a
      gluten-free diet (Part II).
AB  - Coeliac disease is a life-long disorder characterised by small-intestinal mucosal
      damage caused by gluten. The treatment, gluten-free diet, leads to mucosal
      restoration and reduces the risk of malignant and non-malignant complications.
      According to our recent results, cumulative incidence in Croatian children is
      1:519 life-births. Coeliac disease presents early, mostly with typical symptoms.
      We investigated possible influences of breast-feeding duration and time of gluten
      introduction on such presentation of the disease. Study included coeliacs born in
      Medimurje between 1985 and 1994 (N = 31). Patients' adherence to treatment was
      also studied. Although short breast-feeding (mean 2.9 months) and early gluten
      introduction (mean 4.9 months) were shown, no correlation was found between those
      factors and time of the disease presentation. Concerning adherence to gluten-free
      diet, only 50% of patients maintained it strictly, 23% irregularly, while 27%
      were on normal diet. In order to improve it, regular follow-ups are recommended.

PMID- 11216409
TI  - Urban hypothermia and hyperglycemia in the elderly.
AB  - From December 1993 to March 1999 we treated 18 elderly patients aged 66-87 years,
      suffering from urban hypothermia: 11 women and 7 men. Ten patients suffered from
      moderate hypothermia (rectal temperature 32-35 degrees C), and eight from severe
      hypothermia (rectal temperature < 32 degrees C). Regarding consciousness, in the
      group suffering from moderate hypothermia, 3 were somnolent and 6 in various
      degrees of comatose states. In the group suffering from severe hypothermia, 3
      patients were somnolent or soporous and 5 in comatose states of various degrees.
      Values of arterial blood pressure in the group with moderate hypothermia was
      normal in one, in 3 arterial hypotension was observed and 6 were in a state of
      shock. In the group with severe hypothermia, 3 presented arterial hypotension and
      5 were in a state of shock. In the group with moderate hypothermia the blood
      glucose level was elevated in six: 9.3-10.2-10.7-17.9-21.3-99.0, and in one
      patient the blood glucose level was low: 2.3 mmol/L, in correlation with
      hypoglycemic coma. In the group with severe hypothermia in all eight patients the
      values were elevated: 6.7-7.4-7.6-8.7-9.1-11.2-12.4-17.9 mmol/L.

PMID- 11216410
TI  - Overweight and fatness in Dalmatia, Croatia: comparison with the U.S. population
      reference.
AB  - Subscapular skinfold, elbow breadth and upper arm indicators of nutritional
      status were studied in the population of Dalmatia in Croatia. Age- and sex
      specific percentiles were obtained from 4373 subjects, 18 to 74 years of age, and
      compared to the U.S. NHANES I and II reference data. There were significant
      differences between these data sets in all studied variables. The results
      complement those reported previously for BMI and triceps skinfold and indicate
      that high prevalence of overweight in Dalmatians largely reflects their
      muscularity and skeletal robustness rather than excess body fatness. The findings
      suggest that the U.S. upper percentiles of BMI and skinfolds are inadequate for
      the assessment of excess body fatness in Dalmatian population. The obtained
      population-specific percentile distributions should be used provisionally as the
      reference data for group comparisons in the Dalmatian region.

PMID- 11216411
TI  - Nutrition, infection and child growth in Papua New Guinea.
AB  - Growth patterns of populations in Papua New Guinea (PNG) have traditionally shown
      considerable variation, with the greatest difference lying between coastal and
      highland populations. While genetic differences in explaining these patterns
      cannot be excluded, the generally poor growth relative to western growth
      references is largely due to the complex interactive effects of undernutrition
      and infection. The effects of diet, nutrition and infection on the nutritional
      status of a child vary with age, the general disease ecology and the type and
      extent of exposure to it, patterns of infant and young child feeding, and types
      of food consumed. There are two possible ways in which the relationship between
      undernutrition and infection can begin; one in which poor nutritional status
      leads to impaired immunocompetence and reduced resistance to infection, and the
      other in which exposure to infectious disease can lead to a range of factors that
      reduce food intake, absorption of nutrients, or increase nutrient requirements.
      In PNG prior to, and at early stages of modernisation, primary malnutrition is
      likely to have been the usual initiating factor in the onset of growth faltering
      due to undernutrition-infection interactions. However, the possibility that
      infection may have been the initiating event in some societies cannot be
      excluded. This would have happened by way of early dietary supplementation of
      infants with foods of minor nutritional significance, which could have acted as a
      vehicle for the introduction of infectious disease to the child. With
      modernisation and adoption of primary health care principles, earlier
      supplementation of infant diet than was previously the case became common in PNG.
      This has lead to general improvements in growth and nutritional status. However,
      in populations where undernutrition is still common, infection has become more
      important than primary malnutrition as the initiator of growth faltering due to
      undernutrition-infection interactions.

PMID- 11216412
TI  - Half-a-century of the "Kormend Growth Study".
AB  - The authors give a sketch about the "Kormend Growth Study" which is series of
      cross-sectional growth studies, carried out in Kormend, a small town in Western
      Hungary. The first investigation was carried out in 1958 (K-58) and it has been
      repeated every ten years (K-68, K-78, K-88, and K-98). All 3-18 year-old healthy
      boys and girls in nurseries and schools in Kormend were involved in the study.
      Twenty-three body measurements were taken. This paper focuses on changes in
      height, weight, and BMI. Means of these two body measurements show an increase
      from time to time (as a phenomenon of positive secular trend), however, the
      secular trend for increasing height and weight is declining. BMI follows a
      similar pattern.

PMID- 11216413
TI  - Empirical verification of the weighted system of criteria for the elite
      basketball players quality evaluation.
AB  - This article is a continuation of research aimed at formation of a system of
      criteria for the expert evaluation of the basketball players' actual quality. So
      far, the external standards for assessing players' performance have been defined
      and described and the relative importance coefficients of each criterion for the
      performance evaluation per positions in the game have been established as well.
      The purpose of this research was to test empirically the latter--the weighted
      system of criteria for evaluating the actual quality of basketball players
      proposed by Trninic and Dizdar (2000). Based on the determined descriptive
      indicators and the coefficients of importance of criteria, and on the degree of
      the objectivity level (interobservers' agreement) of the expert evaluations, it
      can be concluded that the measuring attributes (objectivity and sensitivity) for
      most of the criteria are in accordance with their relative importance
      coefficients for a particular position in the game. Consequently, the structure
      of the relevant criteria for each play position in the basketball is proposed.

PMID- 11216414
TI  - The influences of training on rowers of different age.
AB  - We measured 14 rowers and divided them into two groups according to age and years
      of training. Our goal has been to establish the influence of several years of
      programmed training on the structure of the body, oxygen carrying capacity and
      oxidation capacity of muscle cells, the chemical composition of blood and
      characteristics of pulse and lactate curves in rowers. As to the structure of the
      body, the two groups did not differ if we equalised them according to body
      height. Differences existed in the determinants of oxygen carrying capacity and
      oxidation capacity of muscle cells. Older rowers had lower pulse at rest, higher
      step test index, lower pulse immediately after the step test and in the last
      minute of the test on a bicycle ergometer and higher maximal oxygen pulse. While
      at rest, no significant differences between the groups were observed in most of
      the analysed substances in the blood serum. With the increase of age and training
      period an increase of the concentration of creatinin and activity of creatine
      kinase and lessening of the activity of alkaline phosphatase was noted. Length of
      training period lowers the levels of cholesterol and free fatty acids and
      increases the level of triglycerides in blood serum. An increase of the activity
      of creatine kinase and lactate dehydrogenase and the formation of a specific
      pattern of isoenzymes was observed. The pulse and lactate curve flattened and
      moved to the right.

PMID- 11216415
TI  - Terminal hinge axis--Hobo point--Frankfurt horizontal relations.
AB  - Aim of this investigation was to determine the spatial relations of the terminal
      hinge axis of the temporomandibular joints toward Frankfurt horizontal. The
      sample consisted of 50 examinees. Terminal hinge axis was located, using
      Lauritzen's technique, on the left side of face for each examinee. Arbitrary
      point, as proposed by Sumiya Hobo, was measured and point Orbital was defined by
      palpation. On designated points steel pellets 0.25 mm in diameter were stocked.
      Lathero--latheral cephalogram was obtained for each examinee. Cephalograms were
      traced down on a transparent foil and points Orbital, THA--terminal hinge axis,
      Hobo and Porion--as the uppermost point of the metal ear rod of the cephalostat,
      were designated. Connecting points Orbital and Porion, Frankfurt horizontal was
      defined, and shortest distance toward points THA and Hobo, as well as between
      them were measured. Lines parallel and perpendicular to Frankfurt horizontal were
      drawn through point THA. In a co-ordinate system defined in such a way, upper
      left quadrant was first, upper right second, lower right third, and lower left
      was fourth. Observation was made in which quadrant Hobo point was located.
      Measured values were statistically evaluated. Results revealed that Hobo point is
      located in first quadrant in 5 cases, in second in 7, third quadrant in 18, and
      in fourth in 20 cases. That means that Hobo point is located lower to the THA
      point in majority of our population. Points THA and Hobo were not identical in
      any case. Mean values of variables showed that investigated points were inferior
      to the FH. Measures of variability revealed great variability of both points
      toward FH, as well as for their mutual distance. It could be pointed out that THA
      point should be defined kinematically during prosthodontic procedures, and that
      orientation in articulator's space should not be according to the FH.

PMID- 11216416
TI  - The satisfaction with the removable partial denture therapy in the Croatian adult
      population.
AB  - Little is known about the outcomes of treatment and patient's satisfaction with
      removable partial dentures in adult Croatian population. Therefore patient's
      satisfaction with their partial dentures in relation to some socio-economic
      variables was studied. Patient's satisfaction with denture retention, speech,
      aesthetics, comfort of wearing dentures, chewing ability was also studied in
      relation to different denture classification, construction, material, denture
      base shape (major connectors), denture support and the number of missing teeth. A
      total of 165 patients, 59 males and 105 females between 38 and 87 years took part
      in this study. A questionnaire, devised for a purpose of the study, was divided
      into three parts. In the first part, patients answered questions about age,
      gender, marital status, education, general health, socio-economic status, self
      supporting life, period of tooth loss and number of previous denture experiences
      and in the second part, patients graded their partial dentures, depending on the
      level of satisfaction, by using a scale from 1 to 5. In the third part a dentist
      determined Kennedy classification and their modifications, denture material and
      denture support, denture base shape and the number of missing teeth and graded a
      denture construction. Influence of these factors on patient's satisfaction was
      analyzed. A majority of the examined patients were satisfied with the partial
      prosthesis, but a small amount of dissatisfaction existed. More then half of them
      scored all the examined parameters to the best score category. Considering
      chewing with lower partial dentures, women were more satisfied than men (p <
      0.05). Patients with more missing teeth gave lower grades for the comfort of
      wearing dentures (p < 0.05). Patients of higher education gave lower grades (p <
      0.05) for the aesthetics. Patients were not satisfied with speech if the dentist
      graded a construction of a lower partial denture low (p < 0.05). Dissatisfaction
      was related to mastication, aesthetics, number of missing teeth and ability of
      speech. These findings can aid a clinician in discussing a treatment plan and
      help a patient understand the risk of dissatisfaction in the presence of certain
      factors.

PMID- 11216417
TI  - Ten-year evaluation of conservative and surgical treatment of gingival recession.
      A case series study.
AB  - In the last years the treatment of non-inflammatory periodontal diseases has
      greatly changed. Apico-coronal dimension of gingival tissue is not considered to
      be of utmost importance, but significance of tissue thickness over each tooth is
      stressed. Purpose of this study was to show results of conservative and surgical
      treatment of gingival recession. Sample consisted of two groups of subjects,
      which have been treated in one of stated ways during ten years. The data was
      obtained on the beginning and after ten years of recall. Both groups showed
      increased dimension of keratinized gingiva during observed time with decrease of
      gingival recession, plaque- and gingival index. It is considered that treatment
      should start with conservative measures with necessary motivation of the
      patients. If it does not show improvement, one should consider best surgical
      method available for each patient. Clinical results show success in both groups,
      meaning that treatment was properly decided on.

PMID- 11216418
TI  - Effect of amine fluoride on enamel surface morphology.
AB  - In this in vitro study, examination of the enamel surface morphology after
      topical application of an amine fluoride solution with different fluoride (F)
      content was carried out. Sound human enamel slabs were treated with an amine
      fluoride solution containing either 1.0, 0.5 or 0.25% F for 3 min. during 3 days.
      All slabs were examined using scanning electron microscopy and energy-dispersive
      spectroscopy (SEM/EDS) qualitative analysis. The globular precipitates were
      revealed in all treated specimens, regardless of F content. The distribution of
      the deposits was more homogeneous in groups treated with higher concentrations;
      however, the globules were larger and more cubical in groups treated with lower
      fluoride concentrations. These larger globules could be less soluble and thus
      serve as a fluoride reservoir for a more extended period and so they could
      contribute to the caries preventive effect in professional topical products with
      lower fluoride concentration. Following the 24-hour treatment with KOH the
      precipitates could be removed; however, the enamel surfaces covered with the
      precipitates were less degraded than the untreated enamel. The EDS qualitative
      analysis showed that the intensities of fluoride signals were increased with the
      higher concentration of fluoride in an amine fluoride solution, while the
      intensities of calcium signals were decreased. The enamel surface precipitates
      were alkali-soluble, but we were not able to demonstrate that they are pure
      calcium fluoride.

PMID- 11216419
TI  - Interpopulation differences in acoustic characteristics of phonation.
AB  - The purpose of this study was to investigate possible differences in acoustic
      characteristics of phonation between populations of European and African origin.
      The subjects were 33 adult males divided in two groups. Group One consisted of 17
      men of African origin, and Group Two included 16 men of European origin. All
      subjects were without vocal pathology at the time of the investigation, smokers
      and non-smokers. Sustained phonation of the vowel /a/ was acoustically analyzed
      by the Real-time Frequency Analyzer (Bruel and Kjaer, type 2123). Variables
      included f0, intensity of f0, intensity of harmonics 1-7, jitter and noise level
      intensity. One-way variance analysis showed statistically significant difference
      between the two groups in intensity of the second harmonic only. The same
      analysis has been repeated with non-smokers and showed statistically significant
      differences in intensities of the second and the third harmonic leading to
      assumption that there may be fine differences in vocal fold vibration between
      Group One and Group Two. Factor congruence analysis showed differences between
      samples in factor structures. It could be possible that these differences reflect
      psychoacoustic level.

PMID- 11216420
TI  - Femoral neck anteversion: values, development, measurement, common problems.
AB  - The femoral neck anteversion angle is an important factor for hip stability and
      normal walking. It is multifactoral result of evolution, heredity, fetal
      development, intrauterine position, and mechanical forces. Abnormal FNA sometimes
      can be associated with many clinical problems ranging from harmless intoeing gait
      in the early childhood, to disabling osteoarthritis of the hip and the knee in
      the adults. In most cases is associated with minor functional problems in
      children during growth, but cause a concern in parents for children future. The
      child must be examined carefully and an accurate diagnosis must be established.
      The most important part of care is observation of the children. If abnormal
      femoral neck anteversion produces severe functional disability, derotational
      osteotomy should be done, but delayed until late childhood.

PMID- 11216421
TI  - Morphological and biomechanical analysis of a skeleton from Roman imperial
      necropolis of Casalecchio di Reno (Bologna, Italy, II-III c. A. D.). A possible
      case of crutch use.
AB  - A Roman skeleton (T.130) from the roman necropolis of Casalecchio di Reno has
      been studied in order to understand if the hypothesis of crutch use, suggested by
      the severe articular degeneration at the hip joint that caused evident reduction
      of his locomotory possibilities, could be supported by the morphological
      alterations of other bones and joints. The pathological changes and muscular
      development of the upper limbs and shoulder girdle bones suggest that these parts
      were submitted to a great mechanical stress. The observations are consistent with
      the hypothesis of crutch use that would have involved a new weight-bearing
      function of the upper limbs in order to help locomotion, even though it is
      difficult to assess the number and type of the crutches. The comparison with
      other possible cases of crutch use reported in literature gives an additional
      support to the interpretation of the findings.

PMID- 11216422
TI  - Symbolism in prehistoric man.
AB  - The aptitude for symbolization, characteristic of man, is revealed not only in
      artistic representations and funerary practices. It is exhibited by every
      manifestation of human activity or representation of natural phenomena that
      assumes or refers to a meaning. We can recognize functional symbolism (tool
      making, habitative or food technology), social symbolism, (language and social
      communication) and spiritual symbolism (funerary practices and artistic
      expressions). On the basis of these concepts, research into symbolism in
      prehistoric man allows us to recognize forms of symbolism already in the
      manifestations of the most ancient humans, starting with Homo habilis (or
      rudolfensis). Toolmaking, social organization and organization of the territory
      are oriented toward survival and the life of the family group. They attest to
      symbolic behaviors and constitute symbolic systems by means of which man
      expresses himself, lives and transmits his symbolic world. The diverse forms of
      symbolism are discussed with reference to the different phases of prehistoric
      humanity.

PMID- 11216423
TI  - Initiation of healers in Ethiopia: a case study.
AB  - The aim of this study is to see how healers are initiated in Ethiopia. The paper
      also describes the position of traditional healers in the current situation of
      Ethiopia. It is found out that most of spiritual healers believed that they are
      selected by divine power or spirit. The selections are manifested by a single or
      a combination of ways namely: through dream, escaping mortal accident, and
      miraculous healing from chronic illnesses. However, secular healers got the
      initiation through apprenticeship. It is noted that in many cases "spirit
      selected healers" could also undergo apprenticeship.

PMID- 11216424
TI  - Genograms of exile and return families in Croatia--a medical anthropological
      approach.
AB  - This article presents the most important results of an applied anthropological
      long-term study of the prolonged exile and return that many families are
      currently undergoing in Croatia. The results are elaborated with a special
      reflection upon two important overlapping issues concerning the methodological
      approach that was applied: firstly, it discusses the crucial questions which
      motivated the search for a tool that will not distort the experiences, reality
      and suffering of exile families; and secondly, it critically describes the
      application of the genogram (a tool borrowed from systemic family therapy) in the
      exile setting. This tool was not only useful in the clinical sense of
      psychotherapeutically helping the families, but was also a very flexible part of
      the methodology orientated towards evoking family history and providing valid
      knowledge about different family and living circumstances.

PMID- 11216425
TI  - The impact of traumatic experience on attitude towards future in refugee
      adolescents.
AB  - Traumatic experience has overall far reaching consequences on personality. In
      particular, it has significant impact on teenagers that are just approaching the
      phase of solving their identity problems. This research examines the relation of
      traumatic experience and attitude towards the future in two groups of
      adolescents. The first group consists of 20 adolescents-refugees from the East
      Slavonia that were settled in Rijeka area with their parents during the last six
      years. The second group consists of 20 adolescent's local inhabitants that were
      influenced by the war only indirectly. Results show significant difference
      between refugees and non-refugees in expressed interpersonal trust, frustration
      tolerance, and formation of close contacts, adaptability, precaution, bitterness,
      and social desirability. Both groups show increased depression, pessimism and
      poor self-control. This might be considered as general characteristic of society
      in war.

PMID- 11216426
TI  - Adolescent development and external influences.
AB  - There are two different approaches to the definition of "normal" in adolescence:
      psychoanalytic interpretation and empirical research. They are not necessarily at
      odds but can complement each other if normalcy is viewed as a dependent variable.
      Its definition depends also on cultural rules, social values and expectancies,
      professional orientations, personality traits and political climate, which all
      determine the tolerance level for aberrance. The adolescent development including
      biological, cognitive and psychosocial changes is related to the existing social
      formations and processes. It is affected by family, peer groups, neighborhood,
      work and wider community. The paper describes the adolescent development in
      particular social contexts.

PMID- 11216427
TI  - Study on the ethical concepts of the Japanese writer Yukio Mishima, ultra
      nationalist.
AB  - After WWII, ultra-nationalism, which was the leading ideology of wartime Japan,
      seemed to have lost its power to inspire the Japanese. In the 1960s, when the
      Japanese began to enjoy economic prosperity, Yukio Mishima, deploring that the
      Japanese were losing the traditional spirit and morality of the nation, was one
      of those citizens who felt a strong nostalgia for wartime Japan. In an attempt to
      revive the spiritual exaltation of wartime Japan, Mishima took radical action as
      an ultra-nationalist, and killed himself by Hara-kiri. Mishima's ethical
      concepts, which center on the ethos of warriors who dedicate themselves to the
      defense of their commune, have structural similarities to the ethical structure
      of the Kanun, which may be called the ethics of "blood". Mishima's theory of
      ultra-nationalism has a paradoxical logic, which seems to be related to the
      ethical concepts of a society without state power.

PMID- 11216428
TI  - [Laparoscopy in differential internal medicine diagnosis].
AB  - Diagnostic laparoscopy has still important implications in the differential
      diagnosis of numerous diseases despite the impact of non invasive imaging
      procedures. One of the most important indication, besides chronic liver diseases,
      is staging of malignancies. Laparoscopy improves considerably the predictability
      whether a distal carcinoma of the esophagus, or a stomach cancer or a pancreatic
      carcinoma can be resected. Laparoscopy is unbeaten in diagnosing peritoneal
      metastases. Thus, laparoscopy prevents unnecessary explorative laparotomies.
      Regarding tumor staging, a comparison is mandatory between minilaparoscopy,
      conventional laparoscopy in analgosedation performed by the gastroenterologist
      and laparoscopy in intubation anesthesia performed by the surgeon immediately
      before planned laparotomy. The significance of minilaparoscopy especially
      regarding chronic liver diseases and correct diagnosis of liver cirrhosis and
      hepatocellular carcinoma in cirrhosis will certainly increase. Laparoscopy
      remains to be an important diagnostic tool in diseases of unknown causes, i.e.
      fever of unknown origin. Laparoscopic sonography is the most sensitive method to
      detect small liver tumors, such as metastases or multilocular hepatocellular
      carcinoma.

PMID- 11216429
TI  - [Safety and value of minilaparoscopy in high risk patients].
AB  - INTRODUCTION: Coagulopathies and thrombocytopenia may constitute
      contraindications for percutaneous liver biopsy. We investigated the safety and
      value of visually guided liver biopsy using minilaparoscopy in patients with
      coagulation disorders. PATIENTS AND METHODS: We studied 50 patients requiring a
      liver biopsy, but whose risk of severe bleeding complications was considered too
      high for the following reasons: INR > 1.5 (40%), platelets 50/nl (36%) or both
      (18%), other coagulopathies (6%). Indications for liver biopsy were: Hepatopathy
      of unknown etiology (38%), fulminant liver failure (18%), virus induced hepatitis
      (6%) and evaluation for liver transplantation (38%). Patients underwent minimally
      invasive diagnostic laparoscopy and liver biopsies were obtained with a Silverman
      or Menghini needle. Bleeding was stopped or prevented by coagulation with the
      argon beamer or a monopolar probe or application of fibrin glue. RESULTS:
      Macroscopical assessment of the liver was possible in all patients. A liver
      biopsy was performed in 47/50. 46/47 biopsy specimens were large enough to allow
      reliable histological evaluation. The diagnostic procedure had major therapeutic
      consequences in 35/40 patients. No relevant bleeding from the liver biopsy site
      occurred. CONCLUSION: We demonstrated that laparoscopically guided liver biopsy
      is safe even in patients with a very high risk of bleeding complications because
      of coagulation disorders. It is therefore an attractive and preferable
      alternative to transjugular liver biopsy.

PMID- 11216430
TI  - [Value of minilaparoscopy in comparison with conventional laparoscopy in
      diagnosis of liver diseases--intermediate term results of a prospective,
      randomized study].
AB  - INTRODUCTION: Laparoscopy plays an essential role in the diagnosis of hepatic
      diseases. During the past few years, minilaparoscopy (ML) has increasingly
      emerged as an alternative diagnostic method in this field. We hereby present the
      preliminary results of a randomized trial comparing ML with conventional
      laparoscopy (CL). PATIENTS AND METHODS: 92 with suspected hepatic disease were
      randomized either to undergo CL (n = 47) or ML (n = 45). For CL, we used a
      Hopkins-laparoscope (O 11 mm, Storz, Tuttlingen) and ML was performed with a 1.9
      mm small-diameter optic (Wolf, Knittlingen). RESULTS: Laparoscopy with
      simultaneous liver biopsy could successfully be performed in 88/92 patients. ML
      could be performed in a significantly shorter time than CL (25 vs. 28 min, p <
      0.05). Liver cirrhosis was diagnosed by laparoscopy in a similar proportion of
      patients (70% in CL, 56% in ML). In 76% of cases, histology confirmed macroscopic
      signs of liver cirrhosis. Cirrhosis was found in one patient of each group solely
      by histologic examination of biopsy specimens. The number of bleeding
      complications during CL equaled the proportion of hemorrhagias in the ML-group.
      DISCUSSION: In the workup of hepatic disease, ML is a diagnostic tool comparable
      with CL. The fact that ML can be performed in significantly shorter time and
      seems subjectively less invasive might be an argument for a better acceptance by
      patients.

PMID- 11216432
TI  - Staging laparoscopy for gastrointestinal malignancies: current indications.

PMID- 11216431
TI  - [Laparoscopic tumor staging in gastrointestinal carcinomas: significance of
      internal medicine laparoscopy].
AB  - This study was performed to assess the role of additional diagnostic laparoscopy
      in the preoperative staging of patients with gastric cancer and pancreatic cancer
      prior to intended curative surgery. Furthermore patients with ascites of unknown
      origin were evaluated. 127 patients with primary solid abdominal tumors were
      eligible for evaluation; of those 66 patients had a gastric cancer and 61 a
      pancreatic cancer. Patients without histologically proven metastases proceeded to
      laparotomy. Ascites of unknown origin was the indication for performing a
      diagnostic laparoscopy in 23 patients. Metastases were detectable
      laparoscopically in 13 of 66 patients (20%) with gastric cancer. Intraoperatively
      metastases were evident in further 7 cases. In 14 of 61 patients (23%) with
      pancreatic cancer metastases were detected by laparoscopy and in further 5
      patients intraoperatively. A peritoneal carcinosis was diagnosed laparoscopically
      in 17 of 23 patients with ascites of unknown origin. Preoperative staging by
      additional diagnostic laparoscopy proved effective in patients with gastric- and
      pancreatic cancer.

PMID- 11216433
TI  - [Staging laparoscopy with laparoscopic ultrasound--indications and value in the
      surgical oncological therapy concept].

PMID- 11216434
TI  - [Significance of staging laparoscopy in pancreatic carcinoma: a case report].
AB  - Accurate staging of pancreatic malignancy is essential to properly plan
      appropriate therapy. The purpose of preoperative staging of intraabdominal
      malignancies is to identify patients in whom malignancies are unresectable and
      therefore would not be candidates for curative surgery. Routine preoperative
      evaluation of intraabdominal malignancies typically include abdominal helical
      computed tomographic (CT) scanning and/or ultrafast magnetic resonance (MR)
      imaging. In fact both investigations are considered mandatory for intraabdominal
      malignancies. But despite modern techniques a significant number of false
      negative results occur (more than 20%). This has led to the investigation of
      additional staging modalities to better identify patients with unresectable
      disease. In this purpose we present the case of a patient with pancreatic
      carcinoma. After preoperative imaging (ultrasound, endosonography and MRI) there
      was no evidence for metastatic disease (uT3uN1). He underwent laparoscopy and a
      hepatic lesion was detected, histologically consistent with a liver metastasis.
      In this patient an unnecessary laparotomy could be avoided. In conclusion
      laparoscopy is an important tool in the staging of intraabdominal malignancy for
      patients with locally advanced disease without signs of tumor spread in CT or
      MRT. It is a relatively simple, well-tolerated and safe procedure and decreases
      the rate of unnecessary laparotomies. It should be considered in all patients
      with pancreatic malignancy in whom laparotomy is planned, either to establish the
      diagnosis or before an attempt at curative resection.

PMID- 11216435
TI  - What is the future of laparoscopy and can we do without it?

PMID- 11216436
TI  - [Minilaparoscopy in liver diagnosis--an advantage?].

PMID- 11216437
TI  - Performance-based home care for the elderly: the quality of circumstance
      protocol.
AB  - The paper introduces a performance-based protocol for use by case managers in
      home care programs for the elderly. Drawing upon the goal attainment approach to
      service planning and evaluation, the protocol specifies a set of five observable
      conditions ranging from the highly desirable to the highly undesirable that
      correspond to each ADL and IADL dimension plus five other dimensions of
      importance to community residing frail elders. The conditions documented through
      the protocol provide a basis for setting explicit expectations of what can be
      achieved through home care interventions. The paper describes a pilot effort to
      test the protocol in the Massachusetts state funded home care program. Both the
      protocol's client assessment form and data collection guide are included as
      appendices.

PMID- 11216438
TI  - Additional psychometric evaluation of the Outcomes and Assessment Information Set
      (OASIS).
AB  - The OASIS represents a rich opportunity for researchers interested in home health
      care outcomes. However, little psychometric information has been published. The
      purpose of this study was to provide additional psychometric data for selected
      portions of the OASIS using a sub-set of 201 subjects from a previously published
      study. Conceptual domains were identified-functional, affect, behavioral and
      clinical. Reliability was evaluated using Cronbach's alpha and the kappa
      coefficient for intra-rater reliability. Construct validity was evaluated by
      principal axis factor analysis within each domain. The functional domain had the
      best reliability and validity. The affect and behavioral domains had adequate
      kappa scores, but the alphas and the factor analyses were problematic. Two of the
      clinical items did not perform well with kappa scores. Recommendations and
      suggestions for use of the OASIS are made.

PMID- 11216439
TI  - Balancing resources and risk: selecting home care clients in Florida's CARES
      program.
AB  - Selecting home care patients who would otherwise go into a nursing home always
      involves error: serving too many or two few. To clarify the choices program and
      case managers must make, we propose a risk-based alternative to current selection
      methods that involves scientifically-derived variable weighting and conscious
      choice of cut-off score for bestowing home care eligibility. We illustrate our
      proposal with data from Florida's Comprehensive Assessment and Review of Long
      term Care Services (CARES) program. Using logistic regression we identify
      characteristics that distinguish clients recommended for nursing home placement
      from those referred to the community and use these results to estimate the risk
      of nursing home recommendation for each client. An approach to using these risk
      scores to determine eligibility is demonstrated along with assessment of the
      impact of alternative risk score cut-offs on denying care to as many as half or
      as few as 5% of clients served.

PMID- 11216440
TI  - State Medicaid home health licensing and certification.
AB  - This study collected and analyzed data on the number of licensed and certified
      home health care agencies and licensed home care/personal care agencies in the
      US. The study also examined the state laws and regulations pertaining to Medicaid
      home health agency requirements. There were 14,045 licensed home health agencies
      and 801 other licensed home care or personal care agencies in the US, but only 59
      percent of these agencies were certified in 1998. The percent of certified
      agencies ranged from 22 percent in Maryland to 100 percent in ten states that
      only allowed certified agencies to provide home care. There was a wide range in
      the number of agencies in states with the average being 6.1 agencies per 100,000
      population. The 41 states with state licensing of home health agencies had a wide
      range of policies but most were more lenient than the federal Medicare
      certification requirements.

PMID- 11216441
TI  - The bible: truth or legend, fact or fantasy?

PMID- 11216442
TI  - Resistance to Antimicrobial Agents. Proceedings of a meeting. Monte Carlo,
      Monaco, 20-23 October 1999.

PMID- 11216443
TI  - [59th Annual Meeting of the Japanese Cancer Association. Yokohama, October 4-6,
      2000. Abstracts].

PMID- 11216445
TI  - 5-HT receptors mediating external carotid vasoconstriction in
      vagosympathectomized dogs.
AB  - One specific example reflecting the complexity of cardiovascular responses
      induced by serotonin (5-hydroxytryptamine; 5-HT) and the progress achieved in the
      pharmacological characterization of the receptors involved can be illustrated by
      the effects of 5-HT on the canine external carotid artery bed. Within this
      framework, it has been shown that the external carotid vasoconstrictor response
      to 5-HT in the dog is mediated by '5-HT1-like' receptors, which being blocked by
      the 5-HT1B/1D receptor antagonist GR127935, resemble 5-HT1B/1D (previously called
      5-HT1D beta/1D alpha) receptors. It was proposed that these receptors could
      belong to the 5-HT1B, rather than the 5-HT1D, subtype on the basis of their
      resistance to blockade by a high dose of ritanserin (a potential 5-HT1D receptor
      antagonist) and the presence of mRNA for 5-HT1B(5-HT1D beta) receptors, but not
      for 5-HT1D(5-HT1D alpha) receptors, in vascular smooth muscle. With the advent of
      subtype-selective antagonists it was subsequently shown that external carotid
      vasoconstriction to 5-HT and sumatriptan is dose-dependently antagonized by the
      selective 5-HT1B receptor antagonist SB224289 (2,3,6,7-tetrahydro-1'-methyl-5-[2'
      methyl-4' (5-methyl-1,2,4-oxadiazol-3-yl) biphenyl-4-carbonyl] furo [2,3-f]
      indole-3-spiro-4'-piperidine hydrochloride), whereas the selective 5-HT1D
      receptor antagonist BRL15572 (1-(3-chlorophenyl)-4-[3,3-diphenyl (2-(S,R)
      hydroxypropanyl) piperazine] hydrochloride) was ineffective. These findings
      represent the first in vivo evidence showing that vascular constriction induced
      by 5-HT and sumatriptan is mediated primarily via 5-HT1B, but not 5-HT1D
      receptors. The pharmacological profile of these receptors could be similar
      (isolated human temporal artery and porcine carotid arteriovenous anastomoses) to
      other putative 5-HT1B receptors mediating vasoconstrictor responses. In view of
      the putative pathophysiologic role of external carotid (and extracerebral)
      vasodilation in migraine, the constriction of these blood vessels by sumatriptan
      via 5-HT1B receptors may be, at least partly, responsible for its therapeutic
      efficacy in migraine.

PMID- 11216446
TI  - CB1 receptor localization in rat spinal cord and roots, dorsal root ganglion, and
      peripheral nerve.
AB  - AIM: The localization of CB1 receptors in the spinal cord, spinal roots, dorsal
      root ganglion (DRG), and peripheral nerve of the rat was determined. METHODS: We
      studied the distribution of CB1 cannabinoid receptors by immunohistochemistry
      using an antibody raised against the N-terminal of the receptor. RESULTS: The
      spinal cord showed numerous transverse fibers labelled for CB1 receptors
      throughout and concentrated in the dorsal horn. Lightly-stained cells were
      observed throughout the spinal cord gray matter. The DRG also showed cells and
      fibers labelled for CB1 receptors. Labelled fibers were observed in both dorsal
      and ventral roots as well as in peripheral nerves. CONCLUSION: The presence of
      CB1 receptors in the DRG, the dorsal root, and the dorsal horn is in accordance
      with the analgesic effects of cannabinoids. The presence of labelled cells and
      fibers in the ventral horn and ventral root provides a substrate for cannabinoid
      induced muscle relaxant and antispastic effects.

PMID- 11216447
TI  - Dopaminergic system does not play a major role in the precipitated cannabinoid
      withdrawal syndrome.
AB  - AIM: To determine the dopaminergic system involvement in precipitated cannabinoid
      withdrawal syndrome. METHODS: The dopamine D1 receptor antagonist SCH23390 or the
      dopamine D2 receptor antagonist sulpiride was administered to rats chronically
      treated with either delta 9-tetrahydrocannabinol (THC) or vehicle. Subjects were
      then injected with either SR141716A or vehicle and behavior was observed for 1 h.
      RESULTS: Administration of the cannabinoid receptor antagonist SR141716A to
      animals chronically treated with THC as described by Tsou et al (1995) produced a
      profound withdrawal syndrome. Treatment with dopamine antagonists did not
      attenuate cannabinoid precipitated withdrawal syndrome in THC tolerant animals
      while the agonists increased the syndrome. CONCLUSION: It is unlikely that the
      dopaminergic system plays a major role in mediating the behavioral aspects of the
      cannabinoid withdrawal syndrome.

PMID- 11216449
TI  - Analysis of antibodies raised against soluble and membrane bound proteins of
      Nosema grylli (Microspora) spores.
AB  - Microsporidia (M), representatives of the phylum Microspora, make a world-wide
      distributed group of intracellular protists, parasitic in the vast number of
      hosts, from Protozoa to Primates. In their morpho-functional organization, both
      very primitive and extremely specialized features are seen definitely combined.
      Data available on RNA and DNA sequences suggest that M may be the most ancient
      eukaryotes. By the present, as many as 13 microsporidian species have been
      recognized as opportunistic pathogens in AIDS and transplant patients.
      Information about structural, transport and regulatory proteins of M, as well as
      on their enzymes is scarce, though it could serve as a basis for understanding
      pathogenicity of M and indicate some possible sites of relevant suppressive
      therapy. The present study persuaded two main goals: 1) to examine two ways of
      antigen preparation (from the infected organ and from the purified spores) and to
      evaluate their relation to the yield of the resulting antibodies; 2) to identify
      and localize new proteins with the help of the obtained antibodies by means of
      IFA, IEM and WB. Mice were immunized: 1) with dissolved proteins of heavily
      loaded with parasites fat bodies isolated from crickets Gryllus bimaculatus
      infected with Nosema grylli, and 2) with proteins of the purified spores of N.
      grylli. As a result two antisera were obtained. Antiserum 1 reacted predominantly
      with spore walls on IFA slides and ultrathin sections (IEM). It also reacted with
      a broad spectrum of parasite and host cell proteins on WB. Antiserum 2 recognized
      polar filaments and walls of discharged spores in IFA and IEM tests. It did not
      react with undischarged spores or fat bodies of uninfected crickets and gave a
      comparatively weak reaction with those of the infected hosts. Hybridization of
      spleen cells of immune mice with murine myeloma cells resulted in several
      hybridoma clones. They produced Mabs, 5 of which were tested by IFA, IEM and WB.
      Mab 1BF3 recognized 55 kDa protein connected with polar filaments as it was
      clearly suggested by IEM and IFA. Mab 1BD9 recognized 25, 34, 43 kDa proteins
      from the fraction of membrane bound proteins of spore walls, the sites of their
      interaction with antigens being marked with uneven fluorescence (IFA) and by gold
      precipitates on spore walls (IEM). Mab 1BB9 reacted with 36, 45, 65 and 75 kDa
      proteins, which belong mainly to the fraction of membrane-bound spore proteins,
      and gave a weak fluorescence associated with spores. Mab 2AB3 recognized 44 and
      60 kDa proteins from the fraction of soluble spore proteins, and Mab 2AD4
      acknowledged a single protein of 55 kDa from the same fraction. The obtained
      antibodies add to the existing microsporidian antibody bank and can be used for
      further work of isolation, description and sequencing the microsporidian proteins
      in order to understand eventually their functions.

PMID- 11216448
TI  - Intrathecal cannabinoid administration suppresses noxious stimulus-evoked Fos
      protein-like immunoreactivity in rat spinal cord: comparison with morphine.
AB  - AIM: To determine whether cannabinoids suppress noxious stimulus-evoked Fos
      protein-like immunoreactivity (FLI) through direct actions at the spinal level.
      METHODS: Rats were implanted with intrathecal (ith) catheters at least one week
      prior to evaluation in the formalin test. Effects of the cannabinoid agonist,
      CP55,940 (80 micrograms ith) on formalin pain and FLI in rat spinal cord were
      compared with that of the prototypic narcotic analgesic, morphine (20 micrograms
      ith). CP55,940 suppressed pain behavior and FLI induced by intraplantar formalin.
      The cannabinoid suppressed Fos in the neck region of the dorsal horn and in the
      ventral horn, but not in the nucleus proprius. The efficacy of the cannabinoid in
      suppressing FLI in these laminae and pain behavior was comparable to morphine
      administered via the same route. However, only morphine suppressed FLI in the
      superficial dorsal horn relative to vehicle treatment. CONCLUSION: Cannabinoids
      suppress nociceptive processing, in part, through actions at the spinal level.
      However, morphine showed greater potency and efficacy than CP55,940 in
      suppressing formalin-induced FLI following spinal administration.

PMID- 11216450
TI  - Proceedings of the 17th International Pigment Cell Conference. Nagoya, Japan.
      October 30-November 3, 1999.

PMID- 11216451
TI  - [Proceedings of a symposium on the kidney and lipids. Grenoble, France, 16-17
      April 1999].

PMID- 11216452
TI  - Reporting of occupational and environmental research: use and misuse of
      statistical and epidemiological methods.

PMID- 11216454
TI  - Air pollution research databases.

PMID- 11216453
TI  - Occupational exposures and pancreatic cancer: a meta-analysis.

PMID- 11216455
TI  - [Vascular tunnel creation to improve the effect of decompressive craniectomy in
      severe traumatic cerebral edema].
AB  - More than million people/year die after head injury. The cause of death in 50% is
      the secondary brain swelling with incuneation. Today decompressive craniectomy
      with durotomy for traumatic brain swelling is performed as second--tier therapy
      at many clinics and hospitals. The literature mentions this method only as an
      option. The problem so far existed in the following fact: although the above
      mentioned method successfully diminished the ICP still despite this result,
      partial or total lesion occurred in the herniated part of the brain. The actual
      cause of these symptoms is found in the blockage of the veins and arteries,
      caused by shearing and compressive forces between the dural edge and brain
      tissue. Venous congestion induces further edema in the protruding parts of the
      brain, thus causing lesion by strangulated necrosis and hypoxia. The new surgical
      technique consists of a stellate manner durotomy and of creating a vascular
      tunnel by supporting pilasters made of haemostatic sponge around the main
      cortical veins and arteries of herniated brain. With the help of new technique
      the authors managed not only to reduce the intracranial pressure significantly
      but they could avoid further edema and vascular lesion as well. This due to the
      fact that with this method we assure the blood circulation and venous drainage of
      the herniated part of the brain. We think, that in this case despite of the
      initially severe status, the properly indicated combination of craniectomy,
      durotomy and vascular tunnel creation, could be the main factor of the
      surprisingly favorable outcome.

PMID- 11216456
TI  - [[In vitro culture of iris cells].
AB  - BACKGROUND: The biological behaviour of iris cells in vitro was not yet
      completely investigated. For a more detailed study of the scope of cultivation of
      iris cells in vitro we isolated human iris pigment epithelium (IPE) cells and
      iris fibroblasts. MATERIALS AND METHODS: For the purpose of this study iris cells
      were isolated from 19 donor eyes. A method was established for isolation and
      cultivation of IPE cells by means of fibronectin coating and the use of a special
      cell culture medium. Additionally, a method was developed for the selection of
      fibroblasts from iris stroma (IS) in vitro by means of fibronectin coating,
      passaging and proliferation in cell culture medium. RESULTS: The IPE and IS cells
      could be cultivated successfully. The IPE cells started to divide after a mean
      interval of 5.4 +/- 0.7 days in culture. The mitosis of IS cells was observed
      after 3.3 +/- 0.87 days in culture. Confluency of IPE cells was reached after
      14.7 +/- 4.92 days and by IS cells after 8.1 +/- 1.45 days. Immunocytochemical
      staining using two antibodies for cytoceratin and one for human fibroblast showed
      that the IPE cell culture was pure and that the IS culture consisted of
      fibroblasts. Furthermore, electron microscopy of IPE and IS cultures confirmed
      the results of the immunocytochemical staining. CONCLUSIONS: The use of human IS
      and IPE cells in vitro has established a novel model for the research on iris
      cells. The model might possibly be applied in the research of metabolic
      structures and diseases of the iris.

PMID- 11216457
TI  - Early establishment of epithelial apoptosis in the developing human small
      intestine.
AB  - In the adult small intestine, the dynamic renewal of the epithelium is
      characterized by a sequence of cell production in the crypts, cell maturation and
      cell migration to the tip of villi, where apoptosis is undertaken. Little is
      known about enterocytic apoptosis during development. In man, intestinal
      architectural features and functions are acquired largely by mid-gestation (18-20
      wks); the question whether the establishment of enterocytic apoptotic processes
      parallels or not the acquisition of other intestinal functional features remains
      open. In the present study, we approached this question by examining enterocytic
      apoptosis during development of the human jejunum (9-20 wks gestation), using the
      ISEL (in situ terminal uridine deoxynucleotidyl nick-end labelling) method.
      Between 9 and 17 wks, apoptotic enterocytes were not evidenced. However,
      beginning at the 18 wks stage, ISEL-positive enterocytes were regularly observed
      at the tip of villi. Since the Bcl-2 family of proteins constitutes a critical
      checkpoint in apoptosis, acting upstream of the apoptotic machinery, we
      investigated the expression of six Bcl-2 homologs (Bcl-2, Bcl-X(L), Mcl-1, Bax,
      Bak, Bad) and one non-homologous associated molecule (Bag-1). By
      immunofluorescence, we found that all homologs analyzed were expressed by
      enterocytes between 9 and 20 wks. However, Bcl-2 homologs underwent a gradual
      compartmentalization of epithelial expression along the maturing crypt-villus
      axis, to establish gradients of expression by 18-20 wks. Western blot analyses
      indicated that the expression levels of Bcl-2 homologs were modulated during
      morphogenesis of the crypt-villus axis, in parallel to their gradual
      compartmentalization of expression. Altogether, these data suggest that
      regulatory mechanisms of human enterocytic apoptosis become established by mid
      gestation (18-20 wks) and coincide with the maturation of the crypt-villus axis
      of cell proliferation, differentiation and renewal.

PMID- 11216458
TI  - Mental health, health, and education staff working together in schools.
AB  - The movement to develop expanded school mental health programs is still in its
      early stages. For child and adolescent psychiatrists to become involved and
      effective means negotiating a culture that is novel for many schools and forming
      and maintaining relationships with diverse staff in mental health, health, and
      education.

PMID- 11216459
TI  - Complexes between double-stranded DNA and chitosan can form cholesteric liquid
      crystalline dispersions.

PMID- 11216460
TI  - Acceleration of the recombination reaction between photooxidized
      bacteriochlorophyll and reduced primary quinone in reaction centers of
      Rhodobacter sphaeroides at T > 300 K.

PMID- 11216461
TI  - What osteopathists stand for in legislation. 1910.

PMID- 11216462
TI  - The future in retrospect. 1935.

PMID- 11216463
TI  - Tendencies in a social, political, and governmental way which may influence
      doctors. 1937.

PMID- 11216464
TI  - [Problems of child sexual abuse in Africa or the imbroglio of a double paradox:
      the example of Cameroon].
AB  - OBJECTIVE: This study has investigated the prevalence of sexual abuse cases in
      Cameroon (Africa) and approached the way these cases are solved. METHOD: 405
      medical certificates have been reviewed within a three years period. RESULTS:
      Over 405 medical certificates, 19 cases of sexual abuse have been identified. All
      the victims were girls. The great majority of them were aged 10-14 (57.9%) and 15
      19 (31.6%). The sexual assaults have been perpetrated out of the family.
      CONCLUSION: The results show evidence of sexual abuse cases in Africa. Friendly
      adjustments by private contracts and family interventions with financial amends
      for the parents of the victims are often preferred to the court of justice,
      because of poverty, cultural pressures and judicial injunctions.

PMID- 11216465
TI  - Intermittent facial swelling.

PMID- 11216466
TI  - 30th Annual Meeting of the AADR (American Association for Dental Research) and
      the 25th Annual Meeting of the CADR. March 7-10, 2001. Chicago, Illinois, USA.
      Abstracts.

PMID- 11216467
TI  - 50th Annual Scientific Session of the American College of Cardiology. Orlando,
      Florida, USA. March 18-21, 2001.

PMID- 11216468
TI  - Approach to the patient with unexplained chest pain.
AB  - Patients with unexplained or noncardiac chest pain continue to present a
      difficult challenge to the gastroenterologist. Cardiac disease must be ruled out
      first as the history will not distinguish between coronary artery disease and
      other causes of substernal chest pain. A systematic approach to evaluation should
      include reassurance that the heart is normal and attempts to confirm an
      esophageal etiology. Gastroesophageal reflux disease is the most common
      esophageal abnormality associated with unexplained chest pain and may be
      identified by an aggressive trial of anti-reflux therapy or an abnormal prolonged
      ambulatory pH monitoring study. Endoscopy is almost always normal and of less use
      in this population than in those with heartburn as the presenting symptom.
      Judicious use of manometry with provocative testing to evaluate for esophageal
      motility abnormalities or esophageal sensitivity allows for optimal evaluation of
      those who do not have gastroesophageal reflux disease. This article reviews the
      clinical presentation, differential diagnosis, and approach to evaluation and
      therapy of this complex group of patients.

PMID- 11216469
TI  - Chemopreventive effects of coffee bean and rice constituents on colorectal
      carcinogenesis.
AB  - Polyphenolic compound chlorogenic acid (CGA) known to be much contained in coffee
      beans was found to have a regressive effect on induced aberrant crypt foci (ACF)
      as well as on development of ACF in azoxymethane (AOM)-induced colorectal
      carcinogenesis in rats. Rice germ and gamma-aminobutyric acid-enriched defatted
      rice germ inhibited AOM-induced ACF formation and colorectal carcinogenesis in
      rats. Ferulic acid (FA) also known to be contained in coffee beans and rice
      prevented AOM-induced ACF formation and intestinal carcinogenesis in rats. Both
      of food factors, coffee and rice may be of benefit to prevention of human
      colorectal cancers.

PMID- 11216470
TI  - Inhibitory effects of curcumin and capsaicin on phorbol ester-induced activation
      of eukaryotic transcription factors, NF-kappaB and AP-1.
AB  - Recently, considerable attention has been focused on identifying dietary and
      medicinal phytochemicals that can inhibit, retard or reverse the multi-stage
      carcinogenesis. Spices and herbs contain phenolic substances with potent
      antioxidative and chemopreventive properties. Curcumin, a yellow colouring agent
      from turmeric and capsaicin, a pungent principle of red pepper exhibit profound
      anticarcinogenic and antimutagenic activities. Two well-defined eukaryotic
      transcription factors, nuclear factor-kappa B (NF-kappaB) and activator protein 1
      (AP-1) have been implicated in pathogenesis of many human diseases including
      cancer. These transcription factors are known to be activated by a wide array of
      external stimuli, such as tumor promoter 12-O-tetradecanoylphorbol-13-acetate
      (TPA), tumor necrosis factor, reactive oxygen species, bacterial
      lipopolysaccharide, and ultraviolet. In the present study, we found that topical
      application of TPA onto dorsal skin of female ICR mice resulted in marked
      activation of epidermal NF-kappaB and AP-1. Curcumin and capsaicin, when
      topically applied prior to TPA, significantly attenuated TPA-induced activation
      of each transcription factor in mouse skin. Likewise, both compounds inhibited NF
      kappaB and AP-1 activation in cultured human promyelocytic leukemia (HL-60) cells
      stimulated with TPA. Based on these findings, it is likely that curcumin and
      capsaicin exert anti-tumor promotional effects through suppression of the tumor
      promoter-induced activation of transcription factors, NF-kappaB and AP-1.

PMID- 11216471
TI  - Role of antimutagens/anticarcinogens in cancer prevention.
AB  - Recently it has become increasingly clear that chemicals found in our foods and
      beverages can prevent the genetic damage that leads to cancer initiation. Such
      substances may also affect subsequent events in the pathways that lead to cancer,
      and may have the potential to inhibit the mutations that allow tumor cells to
      become resistant to antitumor agents. We describe here the antimutagenic
      potential of Glabrene analogs against EMS-induced mutations utilizing modified
      Ames tests in S. typhimurium TA 100 and E. coli JC 5088. Results of studies of
      the ability of well-known antioxidants such as EGCG and related compounds to
      prevent drug resistance mutations in microorganisms are described, and their
      possible significance in the prevention of chemotherapeutic drug-resistance in
      tumor cells is discussed.

PMID- 11216472
TI  - Prevention of the formation of mutagenic and/or carcinogenic heterocyclic amines
      by food factors.
AB  - Introduction of phenolic antioxidants, thiol compounds and reductones into the
      heated model system composed of glucose/glycine/creatinine was effective to
      scavenge the intermediary pyrazine cation radical and to reduce the mutagenicity
      due to imidazoquinoxaline heterocyclic amines. Addition of a reductone, ascorbate
      or erythorbate, at 0.3% to ground beef effectively reduced the mutagenicity of
      cooked hamburger. Mutagenicity of cooked hamburger was also decreased by addition
      of glucose at more than 0.7% to ground beef.

PMID- 11216473
TI  - COX-2 and iNOS, good targets for chemoprevention of colon cancer.
AB  - Cyclooxygenase (COX)-2 has been suggested to play an important role in colon
      carcinogenesis. We found that the COX-2 selective inhibitor, nimesulide, reduces
      azoxymethane (AOM)-induced aberrant crypt foci (ACF) in rats and colon
      carcinogenesis in mice, as well as formation of intestinal polyps in Min mice.
      Thus, selective inhibitors of COX-2, which catalyzes the synthesis of
      prostanoids, could be good candidates as chemopreventive agents against colon
      cancer. Examination of the effect of prostanoid receptor deficiency and a
      selective antagonist of prostanoid receptor on the development of AOM-induced ACF
      in mice revealed the involvement of the EP1 receptor. Moreover, a selective EP1
      antagonist reduced the number of intestinal polyps in Min mice. These results
      suggest that PGE2 contributes to colon carcinogenesis through binding to the EP1
      receptor. Nitric oxide synthase (NOS) is known to be overexpressed in colon
      cancers of humans and rats, and a NOS inhibitor, L-NG-nitroarginine methyl ester,
      was found to inhibit the development of AOM-induced ACF in rats. Thus, NOS
      including iNOS could also be a good target for chemoprevention of colon cancer,
      as in the COX-2 case.

PMID- 11216474
TI  - Functional food science in Japan: state of the art.
AB  - In 1984, a new science related to functional food was initiated by a National
      Project team under the auspices of the Japan Ministry of Education and Science.
      It was followed by a great many academic and industrial studies to occupy a
      central position in the field of food and nutritional sciences. In 1993, the
      Ministry of Health and Welfare established a policy of "Foods for Specified
      Health Uses" (FOSHU) by which health claims of some selected functional foods are
      legally permitted. Up to now (November 22. 1999), 167 FOSHU products have been
      born. Since the time (1984) when the concept of functional food" was proposed, it
      seems that the science in Japan has been progressing along, among others, a
      unique path of development. The uniqueness is seen in the development of
      functional foods by minimizing undesirable as well as maximizing desirable food
      factors. Hypoallergenic foods, developed from their materials by removing
      allergens, offer a good example. Another characteristic may be found in the field
      of sensory science which aims at elucidating a molecular logic of the senses of
      taste and smell in reference to their effects on physiological systems in the
      body. The paper discusses some characteristics of functional food science in
      Japan, with special emphasis on these topics.

PMID- 11216475
TI  - Effects of L-lysine deficient diet on the hypothalamic interstitial
      norepinephrine and diet-induced thermogenesis in rats in vivo.
AB  - Rats readily recognize an amino acid deficient diet, presumably via central
      mechanisms that involve hypothalamic circuits. Presently, effects of the
      essential amino acid L-lysine deficiency on the ventromedial (VMH) and lateral
      (LH) hypothalamus norepinephrine (NE) release were evaluated in free moving rats.
      Microdialysis measurement was undertaken once in 48 h (12:00 noon-14:00) in rats
      that had free access to food and drink. Significant decline in the food intake
      and VMH NE release were found in rats fed L-lysine diet. No changes were
      identified in LH NE release. Additionally, no significant differences in diet
      induced spatial thermogenesis between normal and L-lysine deficient non-stressed
      rats were found in vivo. The results suggested that the VMH NE release was
      specifically involved in the integration of signals about amino acid deficiency.
      However, the decrease in VMH NE was not translated into changes of thermogenic
      responses to diet.

PMID- 11216477
TI  - Protein hydrolysates for oral tolerance.
AB  - To induce oral tolerance in multiple sclerosis treatment, we proposed to use the
      predigested protein of pig spinal cord. The most biologically active composition
      was obtained from the hydrolysis of an undenaturated homogenate of proteins
      digested with pepsin. Feeding the rats with our preparation, before or after
      immunization with MS antigens, strongly reduced development of the experimental
      autoimmune encephalomyelitis (EAE). The biological results obtained in animals
      suggest that the developed method of induction of the oral tolerance should be
      effective in human treatment, at least as a support mechanism in combination with
      other treatment methods.

PMID- 11216476
TI  - Bioactive peptides derived from food proteins preventing lifestyle-related
      diseases.
AB  - Many kinds of bioactive peptides which might prevent lifestyle-related diseases
      are released from food proteins after enzymatic digestion. Inhibitory peptides
      for angiotensin I-converting enzyme (ACE) having anti-hypertensive effect have
      been isolated from enzymatic digests of various food proteins. LKPNM, which was
      isolated from the thermolysin digest of dried bonito was activated 8-fold by ACE
      itself and showed a prolonged effect after oral administration. Two vasorelaxing
      peptides, ovokinin and ovokinin(2-7), showing antihypertensive effect after oral
      administration were obtained from ovalbumin digests. We found that low molecular
      weight peptides derived from food proteins lowered serum cholesterol without
      increasing excretion of cholesterol and bile acids. An immunostimulating peptide
      isolated from an enzymatic digest of soybean protein prevented alopecia induced
      by cancer chemotherapy.

PMID- 11216478
TI  - Anticancer activity of hydrophobic peptides from soy proteins.
AB  - An anticancer peptide from soy protein was purified and isolated. Defatted soy
      protein was hydrolyzed with thermoase and hydrophobic peptides were extracted
      with ethanol. The peptide extract was fractionated by XAD-2 hydrophobic, gel
      filtration chromatography, and different C18 HPLCs. Anticancer activity of each
      fraction was assayed by measuring in vitro cytotoxicity on P388D1, a mouse
      monocyte macrophage cell line. IC50 value of a peptide fraction from Sephadex G
      25 chromatography was 0.16 mg/ml. This peptide fraction at 1 mg/ml significantly
      affected cell cycle progression by arresting P388D1 at G2/M phases. Finally
      purified peptide from analytical C18 HPLC was nonapeptide of which molecular
      weight was 1157 Da and the sequence was X-Met-Leu-Pro-Ser-Tye-Ser-Pro-Tyr.

PMID- 11216480
TI  - Development of functional foods based on physiological activity of amino acids
      and peptides in Japan.

PMID- 11216479
TI  - Antitumor protein (AP) from a mushroom induced apoptosis to transformed human
      keratinocyte by controlling the status of prb, c-MYC, cyclin E-cdk2, and p21WAF1
      in the G1/S transition.
AB  - Antitumor protein (AP) from a mushroom, induced the morphological changes typical
      to apoptosis such as nuclear condensation, aneuploidity, and DNA fragmentation at
      concentrations as low as 5-20 ng/ml to cancer cells. Molecular alterations
      related to cell cycle. Molecular alterations related to cell cycle, especially
      G1/S transition were investigated with a human keratinocyte transformed with
      oncoproteins, E6 and E7 of human pappiloma virus(HPV)-16. AP didn't alter
      significantly and oncosuppressor p53 level, but induced hyperphosphorylation of
      pRb. Time-dependent change of G1 cyclins, cdk2 and cdk4 after addition of AP
      showed that expression level of cdk inhibitors, INK4 family, and p27KIP1 did not
      altered, while that of p21WAF1 was downregulated.

PMID- 11216481
TI  - Respective bioavailability of quercetin aglycone and its glycosides in a rat
      model.
AB  - A large number of flavonoids, mostly O-glycosides, are found in foods of plant
      origin. The bound sugar moiety is known to influence their bioavailability. We
      examined here the effect of the nature of the sugar on the absorption of the
      glycosides. Four groups of rats (n = 6) received a meal containing 20 mg of
      quercetin equivalents supplied as aglycone, quercetin 3-glucoside, quercetin 3
      rhamnoside or rutin. Plasma were hydrolysed by a beta-glucuronidase/sulfatase and
      analyzed by HPLC coupled to UV detection at 370 nm. Four hours after the
      beginning of the meal, the quercetin metabolites present in plasma were identical
      in all groups but their total concentrations were quite different. With pure
      quercetin the circulating levels were 1.7 +/- 1.8 microM, but this level was
      three fold higher when quercetin was supplied as quercetin 3-glucoside (33.2 +/-
      3.5 microM). By contrast, the plasma concentrations of quercetin metabolites was
      quite low with the rutin meal (about 3 microM) and undetectable after the
      quercetin 3-rhamnoside meal. These data suggest that the 3-O-glucosylation
      improves the absorption of quercetin in the small intestine, whereas the binding
      of a rhamnose or of a glucose-rhamnose moiety to the aglycone markedly depressed
      its absorption. Additionnal experiments have shown that the higher plasma levels
      measured after the meal containing quercetin 3-glucoside compared to quercetin
      were maintained throughout a 24 hour period following the meal. In conclusion,
      the nature of the glycosylation markedly influences the efficiency of quercetin
      absorption in rats. Quercetin 3-glucose can be absorbed in the small intestine
      and is better absorbed than quercetin itself. By contrast, glycosides containing
      a rhamnose moiety could not be absorbed in the small intestine.

PMID- 11216482
TI  - Effects of food factors on signal transduction pathways.
AB  - Consumption of plant-derived foods, especially fruits and vegetables, has been
      linked to decreased risk of cancer. Laboratory studies with animals and cells in
      culture have shown cancer preventive activity of chemicals isolated from soy,
      tea, rice and many green, yellow and orange fruits and vegetables. Using cell
      culture, transgenic mice and knockout mice models to examine the anti-cancer
      effects of these dietary factors at the molecular level, we found that (11) (-)
      epigallocatechin gallate (EGCG), the major active polyphenol in green tea, and
      theaflavins, the major active components in black tea, inhibit epidermal growth
      factor (EGF)- or 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced JB6 cell
      transformation. At the same dose range that inhibited cell transformation, EGCG
      and theaflavins inhibited activator protein-1 (AP-1) activation. These compounds
      also inhibited ultraviolet B (UVB)-induced AP-1 and nuclear factor kappa B
      (NFkappaB)-dependent transcriptional activation; (2) resveratrol, found at high
      levels in grapes, inhibited cell transformation through the induction of
      apoptosis, mediated through JNK and p53-dependent pathways; (3) inositol
      hexaphosphate (InsP6), an active compound from rice and other grains, inhibited
      TPA- or EGF-induced transformation and signal transduction through its effects on
      phosphatidylinositol-3 kinase (PI-3) kinase; (4) phenethyl isothiocyanate
      (PEITC), which occurs as a conjugate in certain cruciferous vegetables, inhibited
      cell transformation corresponding with the induction of apoptosis. An elevation
      of p53 is required for PEITC-induced apoptosis. Our studies indicated that the
      chemopreventive effect of these food factors may be mediated by their effects on
      different signal transduction pathways; (5) retinoids (vitamin A and its
      metabolites) inhibited tumor promoter-induced cell transformation and tumor
      promotion in transgenic mice through the inhibition of AP-1 action but not
      through the activation of retinoic acid response element (RARE).

PMID- 11216483
TI  - Factors affecting flavonoids absorption.
AB  - In experiments on rats, some of the factors affecting flavonoids absorption
      (solubility, glycosylation and nutritional status: fasted and not-fasted animals)
      were examined. Administration of quercetin with different solubilization degree
      showed no direct correlation between the quercetin absorption extent and
      solubility, i.e. despite 3 orders of difference in solubilization degree, the
      extent of absorption varied only about 4-fold. Absorption comparison of genistein
      and its glycoside genistin showed no difference in the extent of absorption;
      however, aglycone, in contrast to glycoside, was absorbed already from the rat
      stomach. Conjugation patterns (sulfation and glucuronization) of genistein
      metabolites demonstrated that the plasma of animals fasted prior to isoflavone
      administration contained significantly more sulfates and less glucuronides and
      mixed sulfates/glucuronides conjugates than the plasma of non-fasted animals.

PMID- 11216484
TI  - Metabolic fate of luteolin and its functional activity at focal site.
AB  - Luteolin has been shown to possess potent antioxidant and anti-inflammatory/anti
      allergic activities. In order to evaluate a chemopreventive role of luteolin in
      inflammatory responses involved in the pathogenesis of atherosclerosis and cancer
      etc., the metabolic fate of luteolin in rats and humans was investigated by HPLC
      analysis, and its effect on cell surface expression of adhesion molecules in
      human umbilical vein endothelial cells(HUVECs) was examined by ELISA. Luteolin
      monoglucuronide, which was a main metabolite, and free luteolin were detected in
      rat plasma and human serum. Luteolin monoglucuronide was hydrolyzed to free
      luteolin by beta-glucuronidase released from neutrophils stimulated with
      lonomycin and Cytocharasine B. Luteolin suppressed the TNF-alpha induced ICAM-1
      expression significantly. Among nine flavonoids (40 microM) examined, chrysin,
      apigenine, quercetin and galangin also demonstrated suppressive effct on it.
      These results suggest the posssibility that deconjugation of luteolin
      monoglucuronide occurs and that free luteolin showed functional acyivities such
      as suppression of TNF-alpha induced ICAM- 1 expression at inflammation site.

PMID- 11216485
TI  - Suppressive effects of citrus fruits on free radical generation and nobiletin, an
      anti-inflammatory polymethoxyflavonoid.
AB  - Citrus fruit intake is known to be associated with a reduction of cancer
      incidence. Free radicals, including superoxide (O2-) and nitric oxide (NO), are
      involved in some epithelial carcinogenesis processes. In the present study, we
      screened thirty-one citrus fruits for their suppressive activities toward three
      lines of free radical generating systems: 1) O2- generation by the xanthine (XA)
      xanthine oxidase (XOD) system; 2) O2- generation induced by 12-O
      tetradecanoylphorbol-13-acetate (TPA) in differentiated human promyelocytic HL-60
      cells; and 3) NO generation in murine macrophage RAW264.7 cells stimulated with
      lipopolysaccharide (LPS) and interferon (IFN)-gamma. As a result, the inhibitory
      activities of peel parts were largely found to be higher than those of the
      corresponding juice sac parts. In particular, the peel portion of Dancy tangerine
      (Citrus tangerinia) showed marked anti-oxidative activities in these systems. In
      addition, nobiletin, a polymethoxyflavonoid isolated from C. nobilis, showed a
      higher anti-inflammatory activity than indomethacin in a TPA-induced edema
      formation test in mouse ears. These results indicate that citrus fruits could be
      notable sources of anti-oxidative, anti-inflammatory, and cancer preventive
      compounds.

PMID- 11216487
TI  - Suppressive effects of flavonoids on dioxin toxicity.
AB  - Dioxin type chemicals such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) cause a
      variety of toxicity. Most of the toxicity of TCDD has been attributed to a
      mechanism by which TCDD is bound to aryl hydrocarbon receptor (AhR) and
      transforms the receptor. Thus, suppression of the AhR transformation by food
      factors can suppress the dioxin toxicity. In this study, flavonoids at various
      concentrations were treated to a rat cytosolic fraction containing AhR before
      adding 1 nM TCDD. The transformed AhR was detected by an electrophoretic mobility
      shift assay with a DNA oligonucleotide consensus to dioxin response element. As
      the results, flavones and flavonols at dietary levels act as the antagonists for
      AhR and suppress the transformation. The antagonistic IC50 values were in a range
      between 0.14 and 10 microM, which are close to the physiological levels in human.
      These results suggest that a plant-based diet can prevent the dioxin toxicity.

PMID- 11216486
TI  - Mechanisms involved in the chemoprevention of flavonoids.
AB  - Flavonoids, widespread in edible plants, have been studied extensively for their
      anticarcinogenic properties. However, only few studies have been done with these
      constituents being administered by the dietary route. In our research, the
      effects of feeding rats with flavone, flavanone, tangeretin, and quercetin were
      investigated on two steps of aflatoxin B1 (AFB1)-induced hepatocarcinogenesis
      (initiation and promotion). Nonpolar flavonoids such as flavone, flavanone and
      tangeretin administered through the initiation period, decreased the number of 
      gamma-glutamyl transpeptidase-preneoplastic foci. In the same conditions of
      administration, quercetin, a polyhydroxylated flavonoid, showed no protective
      effect. Moreover, feeding rats with flavanone during the phenobarbital-induced
      promotion step significantly reduced the areas of placental glutathione S
      transferase preneoplastic foci. Quercetin, flavone, and tangeretin, administered
      in the same conditions, caused no significant effect. Therefore flavanone act as
      an anti-initiator as well as an anti-promotor. Several mechanisms were involved
      in the anti-initiating effects of flavone, flavanone, and tangeretin: enhancement
      of enzymes involved in the detoxication of AFB1 (glutathione S-transferase, UDP
      glucuronyl transferase), increase of the formation of AFB1-glutathione conjugates
      and inhibition of the binding of AFB1 to DNA. Although the relevance of these
      data to the human situation remains to be demonstrated, they confirm that several
      flavonoids administered by the dietary route possess promising chemoprotective
      effects.

PMID- 11216488
TI  - Isoflavonoids and chronic disease: mechanisms of action.
AB  - Soy and its isoflavones are associated with a reduced risk of chronic disease.
      The mechanisms of action of isoflavones include their roles as weak estrogens,
      inhibitors of tyrosine kinase-dependent signal transduction processes and as
      cellular antioxidants. Although estrogen receptor beta binds genistein with an
      affinity close to that of 17beta-estradiol, it remains to be determined whether
      it is a mediator of genistein's activity in vivo. Genistein's inhibition of
      protein tyrosine kinases is not limited to direct effect on these kinases, but
      may result from alteration in kinase expression. Genistein is not a particularly
      good scavanger of cellular oxidants; however, it reacts vigorously with the
      prooxidant hypochlorous acid, produced by neutrophils as part of the inflammatory
      response. The chlorinated isoflavones may have altered biochemical and biological
      effects compared to their parent compounds and may provide increased protection
      against inflammatory disease.

PMID- 11216489
TI  - Comparison of plasma and urinary phytoestrogens in Japanese and Finnish women by
      time-resolved fluoroimmunoassay.
AB  - Time-resolved fluoroimmunoassays (TR-FIA), with europium labeled phytoestrogens
      as tracers, were developed for the quantitative measurement of genistein,
      daidzein and enterolactone in plasma and urine for the purpose of screening large
      populations and studies on possible correlation between the values in biological
      fluids and the risk of western diseases. The mean values of the three
      phytoestrogens in plasma as determined by TR-FIA were similar to those obtained
      by gas chromatography-mass spectrometry (GC-MS). The urinary excretion levels of
      total individual phytoestrogens were higher than those obtained by GC-MS, with
      the exception of the daidzein values. However, comparing the assay results
      obtained by the present method and those obtained by GC-MS, a strong correlation
      was evident (r = 0.87 - 0.99, p < 0.001). We measured plasma levels of genistein,
      daidzein and enterolactone in 111 healthy Japanese women The mean and median
      levels of genistein were 406.8 and 306.3 nmol/l, respectively, and those of
      daidzein were 118.4 and 76.8 nmol/l, respectively. These levels are higher than
      those reported for Americans and Western Europeans. Isoflavone intake as
      calculated from dietary records (genistein: mean, 86.5 mircomol/day and daidzein:
      mean, 57.4 micromol/day) was correlated with the plasma concentrations observed
      (genistein: r = 0.287, p < 0.01 and daidzein: r = 0.313, p < 0.01). Plasma
      enterolactone levels were low in Japanese women (mean, about 10 nmol/l). The
      levels of urinary excretions of genistein, daidzein were also measured and it was
      found that, in the majority, the levels ranged between 5-25 and 5-50 micromol/24
      h, respectively. In contrast, healthy Finnish women showed very low values of
      isoflavones (below 10 nmol/l in plasma (n = 87) and below 0.6 micromol/24 h in
      urine (n = 126) for both compounds) and high levels of enterolactone in both
      plasma and urine (plasma: mean, 25 nmol/l and urine: majority range, 1-7
      micromol/24 h).

PMID- 11216490
TI  - Antioxidant activity of soya hypocotyl tea in humans.
AB  - Antioxidative activity of isoflavones has not been shown in humans. Newly
      developed isoflavone-rich soya hypocotyl tea contains about 12 mg isoflavones per
      liter. 15 tea drinkers and 23 control young female students were randomly
      selected from volunteers, and underwent physical examination, blood chemistry and
      urinary analysis before and after one month of tea drinking. A three-day dietary
      record was taken before each physical examination. The tea drinkers showed a
      lower level of phosphatidylcholine hydroperoxide (PCOOH) and phosphatidyl
      ethanolamine hydroperoxide (PEOOH) in the red blood cells and a significant
      reduction of 8-hydroxydeoxyguanine (8ohdG) in the urine compared to the controls.

PMID- 11216491
TI  - Effects of isoflavone supplement on healthy women.
AB  - Effects of the isoflavone supplement on hormonal states in young premenopausal
      women were studied by cross-over study design. Administration of 20 mg or 40 mg
      isoflavones (IF) by tablets, of which 1 g contained 43.5 mg daidzein, 6.0 mg
      genistein, 24.0 mg glycitein, to 40 young female students for one month caused a
      prolonged menstruation in 60% of young women, shortened menstruation in 20% of
      young women, 17% remained unchanged and 3% became irregular. Larger dose tended
      to elongate more, but 17beta-estradiol levels in both follicular and luteal
      phages were not different between 20 mg and 40 mg isoflavone intake. Equor
      excreters tended to show low plasma progesteron level in the luteal phase.
      Detailed hormonal analysis on 3 of students by a cross over study design showed
      decreased level of 17beta-estradiol throughout the menstruation cycle. SHBG
      significantly increased about 10% in all three. DEAS, androstendione, and
      testosterone showed different responses according to the follicular or luteal
      phase. T3 and T4 increased as a result of isoflavone tablet administration in the
      follicular phase, but it decreased in the luteal phase. These changes suggest
      that isoflavones influence not only estrogen receptor-related functions but the
      hypothalamo-hypophysis-gonadal axis.

PMID- 11216492
TI  - Attenuation of neurodegeneration-relevant modifications of brain proteins by
      dietary soy.
AB  - Epidemiological studies show that postmenopausal women who undertake estrogen
      replacement therapy have significantly lower risk for the onset of Alzheimer's
      disease (AD) than women who do not. Animal behavior studies have shown that
      ovariectomy results in the development of cognitive dysfunction that is prevented
      by estrogen-replacement, suggesting that normal mammalian cognitive function is
      impaired by estrogen reduction. Soy isoflavones in particular genistein have been
      demonstrated to have weak and selective estrogenic actions in various models of
      human chronic diseases. A hallmark of several human dementias including AD and
      fronto temporal dementia with Parkinsonism on chromosome 17 (FTDP-17) is the
      hyperphosphorylation of the microtubule-associated protein tau. Preliminary
      experiments are discussed here which show that isoflavones delivered in a soy
      protein matrix attenuated selected AD-relevant tau phosphorylations in a primate
      model of menopause. The rationale is discussed for the use of soy-based foods for
      protection against postmenopausal neurodegeneration.

PMID- 11216493
TI  - The effects of soy protein in women and men with elevated plasma lipids.
AB  - Fifty four postmenopausal women with elevated cholesterol were recruited for a
      randomised, double-blind controlled trial of soy protein containing isoflavones.
      (ISP+) or a soy protein with a low isoflavone content (ISP-), taken daily for 12
      weeks. There was an overall reduction after 12 weeks in total cholesterol (TC),
      LDL cholesterol (LDL-C), sex hormone binding globulin (SHBG), and luteinizing
      hormone (LH). There were no significant differences between treatment groups. In
      a separate study 27 male subjects with a TC > 5.5 mmol/l were given ISP+ for 12
      weeks. In this male study there was a significant increase in HDL cholesterol
      (HDL-C) and SHBG. Soy protein has a cholesterol lowering effect in both women and
      men. These studies suggest that this effect is independent of isoflavones. Soy
      protein also reduces SHBG levels in both sexes.

PMID- 11216494
TI  - Modulation of cell-cell communication in the cause and
      chemoprevention/chemotherapy of cancer.
AB  - Chemopreventive or chemotherapeutic agents have been those that either kill
      cancer cells to a differential degree over the non-cancer cells or those
      chemicals that either block the induction of tumors in carcinogen-treated animals
      or retard transplanted tumors in animals. Carcinogenesis is a multi-stage, multi
      mechanism process, involving the irreversible alteration of a stem cell
      ("initiation"), followed by the clonal proliferation of the initiated cell
      ("promotion"). To develop a strategy for intervention with
      chemoprevention/chemotherapeutic chemicals, the basic mechanism(s) of
      carcinogenesis must be understood. Gap junction intercellular communication
      (GJIC) regulates cell growth, differentiation, apoptosis and adaptive functions
      of differentiated cells. Normal cells have functional GJIC while cancer cells do
      not. Tumor promoters and oncogenes inhibit GJIC, while anti-tumor promoter and
      anti-oncogene drugs can reverse the down-regulation of GJIC. Transfection of gap
      junction genes (connexins) has been shown to reverse the tumorigenic phenotype.
      If prevention/treatment of cancer is to occur, prevention of the chronic down
      regulation of GJIC by tumor promoters in non-tumorigenic but initiated cells or
      the up-regulation of GJIC in stably down-regulated GJIC in tumor cells must occur
      to prevent or to treat cancers.

PMID- 11216496
TI  - Anti-tumor polysaccharides from mushrooms during storage.
AB  - The changes in the contents of an anti-tumor polysaccharide from Lentinus edodes
      (lentinan) and Grifolafrondosa (GGF) during storage were investigated using by an
      ELISA inhibition assay. When the mushrooms were stored at low temperature, the
      contents of their anti-tumor polysaccharides show hardly any changes, but their
      contents decreased markedly at higher temperature (20 degrees C). Moreover, the
      effect of the extract from Lentinus edodes stored at different temperatures on
      tumor necrosis factor (TNF)-alpha and nitric oxide (NO) productions from
      macrophages was investigated to confirm the influence to the stimulation of
      macrophages. Because lentinan stimulates macrophages to augment their antitumor
      activity. Their productions showed little difference between Lentinus edodes
      stored at low temperature and the fresh mushroom, although the cytokine
      production decreased significantly in Lentinus edodes stored at 20d egrees C.
      These results suggest that low-temperature storage is more effective in
      maintaining not only the quality of the mushrooms but also the contents of anti
      tumor polysaccharides as health-beneficient foods.

PMID- 11216495
TI  - Anti-ulcer effects and biological activities of polysaccharides from marine
      algae.

PMID- 11216497
TI  - Butyrate as a model for "gene-regulating chemoprevention and chemotherapy.".
AB  - Recent progress in molecular genetics has facilitated understanding of the
      mechanisms of carcinogenesis. However, there is not yet any effective therapy or
      prevention for cancer based on the molecular mechanisms of carcinogenesis. So
      called "gene therapy" for cancer is expected to become a new method of treatment,
      but there are still several serious problems with gene therapy. As a matter of
      fact, it seems impossible to adopt gene therapy for prevention. We therefore
      tried to develop a different method of cancer prevention or therapy based on the
      molecular mechanisms of carcinogenesis. For instance, the tumor-suppressor gene
      p53 is mutated in about 50% of human malignancies. It is known that p53
      stimulates the promoter activities of p21/WAF1, gadd45 and bax genes, resulting
      in cell cycle arrest, DNA repair and apoptosis, respectively. Therefore, chemical
      compounds that can stimulate these genes should compensate for the function of
      p53. As a model of this, we found that histone deacetylase inhibitors such as
      butyrate or trichostatin A dramatically stimulate the p21/WAF1 gene promoter
      through the Spl sites, resulting in cell cycle arrest. Interestingly, another
      group has recently reported that phenylbutyrate, which is also known as a histone
      deacetylase inhibitor, is very effective for leukemia patients. We therefore
      consider methods of up-regulating p21/WAF, gadd45 or bax genes should be useful
      for cancer therapy and termed this method "Gene-regulating chemotherapy".
      Theoretically, the chemicals up-regulating such genes should be also useful for
      chemoprevention, and we also termed it as "Gene-regulating chemoprevention". In
      conclusion, we propose that "Gene-regulating chemotherapy or chemoprevention" may
      be a promising new method for cancer therapy or prevention and histone
      deacetylase inhibitor is a good candidate for this method.

PMID- 11216498
TI  - When is dietary fiber considered a functional food?
AB  - Before answering the question of when dietary fiber can be considered a
      functional food we must first decide what can be called a dietary fiber. The
      generally accepted definition of dietary fiber is that of Trowell that dietary
      fiber consists of the remnants of edible plant cells polysaccharides, lignin, and
      associated substances resistant to (hydrolysis) digestion by the alimentary
      enzymes of humans. In Japan the food tables list the dietary fiber content of
      animal as well as plant tissues, while many countries accept saccharides of less
      than DP-10 as dietary fiber (inulin, oligofructose, Fibersol-2, polydextrose,
      fructooligosaccharides, galactooligosaccharides etc.). These shorter chain
      oligosaccharides do not precipitate as dietary fiber in the standard Association
      of Official Analytical Chemists (AOAC) method, which is accepted by the US Food &
      Drug Administration, the US Department of Agriculture and the Food & Agriculture
      Organization of the World Health Organization for nutrition labeling purposes. In
      the United Kingdom the term dietary fiber has been replaced in nutrition labeling
      by nonstarch polysaccharides. Therefore the American Association of Cereal
      Chemists (AACC) commissioned an ad hoc committee of scientists to evaluate
      continuing validity of the currently used definition, and if appropriate, to
      modify and update that definition. Obtaining scientific input from the community
      of analysts, health professionals, and dietary fiber researchers was considered a
      high priority. To this end three meetings were held in the space of six months to
      assure input from all persons knowledgeable in the field with the answer expected
      sometime before 2000. Dietary fiber can be considered a functional food when it
      imparts a special function to that food aside from the normal expected function
      and similarly when the dietary fiber is used as an additive to foods. For
      example, dietary fiber contributes to colonic health, bifidobacterial or
      lactobacillus stimulation in the gut, coronary artery health, cholesterol
      reduction, glucose metabolism, insulin response, blood lipids, cancer etc. The
      author discusses in detail the functional food properties of dietary fiber.

PMID- 11216499
TI  - Food allergens and the mucosal immune system.

PMID- 11216500
TI  - Effects of the administration of wheat bran biscuit: changes in the diet.
AB  - We developed hard biscuit containing 30% wheat bran (WB biscuit) and administered
      it to 12 volunteers at 7.5 g/day (7.5 g group) or 15 g/day (15 g group) as wheat
      bran for 12 weeks. After 12 weeks, the dietary fiber intake from foods other than
      wheat bran decreased slightly in the both groups, in the 15 g group was the
      decrease notable especially, after the beginning of WB biscuit administration. We
      suggest that a closest attention to changes in dietary habit associated with
      intervention is needed in intervention studies using patients leading a normal
      life.

PMID- 11216501
TI  - Going against the grain? Current status of the dietary fiber-colorectal cancer
      hypothesis.

PMID- 11216502
TI  - The concept of intracellular-, extracellular- and bone-minerals.
AB  - A new concept of grouping of minerals, which will be helpful for understanding
      the actual status of human health, on the basic of elementological biology.

PMID- 11216503
TI  - Food system-based approaches to improving micronutrient nutrition: the case for
      selenium.
AB  - Micronutrient deficiencies affect nearly half the world's population, impairing
      child development, reducing work productivity, and increasing mortality and
      morbidity rates by affecting both infectious and chronic diseases. To feed a
      growing world, it will be necessary to consider agriculture in the broad context
      of a food system as an instrument of public health and, thus, to address nutrient
      balance while also seeking sustainability. Such efforts would include increasing
      cropping system diversity, enhancing micronutrient outputs and promoting
      environmental sustainability. Example of this approach are presented for the
      essential trace element selenium (Se), which at high intakes can reduce cancer
      risks but is deficient in many parts of the world. Food systems-based approaches
      are discussed for preventing Se deficiency by enhancing intakes of any of several
      biologically available forms of Se, and for reducing cancer risk by enhancing
      intakes of forms of the element that support anti-tumorigenic Se-metabolites.

PMID- 11216504
TI  - Role of diet modification in cancer prevention.
AB  - Carcinogenesis encompasses a prolonged accumulation of injuries at several
      different biological levels and include both genetic and biochemical changes in
      the cells. At each of these levels, there are several possibilities of
      intervention in order to prevent, slow down or even halt the gradual march of
      healthy cells towards malignancy. Diet modification is one such possibility. A
      number of natural foodstuffs, especially fruits and vegetables contain
      substantial quantities of molecules that have chemopreventive potential against
      cancer development. Such compounds include vitamins, trace elements and a variety
      of other molecules with antioxidant properties. Carotenoids, flavanoid
      polyphenols, isoflavones, catechins, and several other components that found in
      cruciferous vegetables are molecules that are known to protect against the
      deleterious effect of reactive oxygen species. A number of epidemiological and
      experimental studies have shown that vitamin C and E, Beta-carotene and the
      essential trace element selenium can reduce the risk of cancer. Consistent
      observations during the last few decades that cancer risk is reduced by a diet
      rich in vegetables, fruits, legumes, grains and green tea have encouraged
      research to identify several plant components especially phytochemicals that
      protect against DNA damage. Many of these substances block specific carcinogen
      pathways. Dietary supplements are part of an overall health program, along with a
      high intake of fruits and vegetables that help to combat damage to cells, which
      in turn may initiate cancer development. This paper will review current knowledge
      concerning diet modification and cancer prevention with special reference to
      minerals and trace elements.

PMID- 11216505
TI  - Chemoprotection against cancer by induction of phase 2 enzymes.
AB  - Induction of Phase 2 enzymes is an effective and sufficient strategy for
      achieving protection against the toxic and neoplastic effects of many
      carcinogens. It is proposed that the concept of Phase 2 enzymes as being
      responsible only for the conjugation of functionalized xenobiotics with
      endogenous cellular ligands such as glutathione (glutathione S-transferases) and
      glucuronic acid (UDP-glucuronosyltransferases) be expanded to include proteins
      with the following common characteristics: (a) coordinate induction by a broad
      range of chemical agents that all have the capacity to react with sulfhydryl
      groups; (b) possible regulation by common promoter elements; and (c) catalysis of
      reactions that lead to comprehensive protection against electrophile and reactive
      oxygen toxicities, by a wide variety of mechanisms. These mechanisms include:
      conjugation with endogenous ligands, chemical modification of reactive features
      of molecules that can damage DNA and other macromolecules, and generation or
      augementation of cellular antioxidants. In addition to the above conjugating
      enzymes, a provisional and partial list of Phase 2 proteins might include:
      NAD(P)H:quinone reductase, epoxide hydrolase, dihydrodiol dehydrogenase, gamma
      glutamylcysteine synthetase, heme oxygenase-1, leukotriene B4 dehydrogenase,
      aflatoxin B1 dehydrogenase, and ferritin.

PMID- 11216506
TI  - High phosphorus feeding decreases the expression of renal PTH/PTHRP-receptor mRNA
      in rats.
AB  - Dietary intake of high phosphorus (P) is well-described to increase serum levels
      of PTH, however, how this increased serum PTH affects the PTH actions in major
      target tissues, particularly in kidney, remains uncovered. We therefore undertook
      to clarify this point in intact animals fed the high-P diet by examining various
      parameters of the PTH actions. Twelve weanling Wistar male rats were assigned
      randomly into the groups; a control group Ca: P = 1: 1 and a high-P group (Ca: P
      = 1: 3) fed the standard AIN 76 diet supplemented with P (0.5 and 1.5 g/100 g
      diet). After 3 week feeding, in the high-P diet group, we observed that serum Ca
      is lowered without difference in serum P when compared to those in the control
      group. Excretion of urine cAMP, an index of the renal PTH action, was also
      decreased with higher excretion of urine P by feeding the high P diet. In
      agreement with the decreased cAMP excretion, a clear reduction in the PTH/PTHrP
      receptor gene expression estimated by Northern blotting was observed in the
      kidney irrespective of increased levels of serum PTH. Thus, the present study
      indicated that high P dietary intake rather reduces the PTH actions in kidney
      though the serum PTH is increased.

PMID- 11216507
TI  - Influence of food ingredients on iron availability.

PMID- 11216508
TI  - Zinc deficiency and taste dysfunction; contribution of carbonic anhydrase, a zinc
      metalloenzyme, to normal taste sensation.
AB  - The present study was designed to clarify the effect of zinc deficiency on sodium
      chloride preference, the lingual trigeminal and taste nerves transduction, and
      carbonic anhydrase (CA) activity of the tongue surface and salivary gland. Male
      SD rats, 4 weeks old, were divided into four groups, and fed zinc-deficient (Zn
      Def), low-zinc (Low-Zn), and zinc-sufficient diets with free access (Zn-Suf) and
      pair-feeding (Pair-fed). After taking part in the preference tests for 42 days,
      the rats were provided for the chorda tympani and lingual trigeminal nerves
      recordings, then finally sacrificed and the tongue and submandibular gland
      excised to measure CA activity. Sodium chloride preference increased only after 4
      days of the feeding of zinc-deficient and low-zinc diets, which means that the
      taste abnormality appears abruptly in zinc deficieny and even though in marginal
      zinc deficiency. Reduced CA activities of the taste-related tissues in zinc
      deficient group paralleled well with the decreased taste and lingual trigeminal
      nerves sensitivities.

PMID- 11216509
TI  - Prevention of cancer and other chronic diseases worldwide based on sound
      mechanisms.
AB  - The transformation of normal cells by DNA reactive, genotoxic carcinogens and the
      growth promotion and development of mutated cells by enhancing factors is
      involved in the overall basic mechanism of cancer induction. Thus, discrimination
      between genotoxic carcinogens and nongenotoxic chemicals is essential. The dose
      response curves, reversibility, and organ-and species specificity are distinct.
      Genotoxic carcinogens are mutagenic, form DNA adducts, induce DNA repair, and
      form hydroxy radicals and inappropriate peroxidation reactions that antioxidants
      such as those in vegetables, fruits, and tea can decrease. In contrast, promoters
      do not form DNA adducts, but raise cell duplication rates, among other
      attributes. In the USA, about 35% of known cancers are associated with tobacco
      use and about 55% with inappropriate nutritional habits. Cancer induction can be
      decreased by avoiding the formation of carcinogens, reducing their metabolic
      activation, or increasing their detoxification. Excessive dietary salt, and
      heterocyclic arylamines formed in cooking of meats or fish, and high intake of
      40% of calories in fats are health risks, but vegetables, fruits, tea, soy
      products, and fibers are protective. We review nutritional factors involved in
      cancer and chronic disease causation and prevention.

PMID- 11216510
TI  - Prevention of colon carcinogenesis and carcinoma metastasis by orally
      administered bovine lactoferrin in animals.
AB  - Bovine lactoferrin (bLF), a milk protein known to have bacteriostatic properties
      was examined for its preventive effects on colon and other organ carcinogenesis
      and experimental metastasis. (Experiment 1) The influence on colon carcinogenesis
      was investigated in male rats treated with azoxymethane (AOM), then received 2 or
      0.2% bLF for 36 weeks. Significant reduction in the incidence (27% and 46% of the
      control, respectively) and number of adenocarcinomas of the large intestine was
      observed. (Experiment 2) In BALB/c mice bearing subcutaneous (s.c.) implants of
      colon carcinoma 26 (Co 26Lu). bLF demonstrated significant inhibition of
      spontaneous lung metastasis (approximately 43% of the control). Number of
      cytotoxic asialoGM1+ and CD8+ cells in white blood cells increased (171% and 122%
      of control, respectively) after treatment. Results of those experiments indicate
      that bLF remarkably prevents colon carcinogenesis and lung metastasis of colon
      carcinoma cells, possibly due to increasing cytotoxic cells in the peripheral
      blood.

PMID- 11216511
TI  - Food containing phytoestrogens, and breast cancer.

PMID- 11216512
TI  - Dietary intake and cancer mortality in Japan.
AB  - We examined the correlation between the prefectural variation of standardized
      mortality ratio (SMR) for lung and colon cancer and the consumption of foods
      using dietary data from National Nutrition Survey in Japan from 1976 to 1995. We
      found partly the same results on promoting factors and preventing factors of
      these cancers as the previously reported large scale cohort studies. But, we also
      found the inconsistent results. This might be partly because of the limitation of
      data collection method in the National Nutrition Survey. It was thought that the
      method of National Nutrition Survey should be modified to monitor nutrition and
      health conditions to correspond the epidemiological study and to prevent chronic
      diseases.

PMID- 11216514
TI  - Diastolic dysfunction in patients with systemic sclerosis detected by gated
      myocardial perfusion SPECT: an early sign of cardiac involvement.
AB  - Diagnosis of cardiac involvement is important for the management of patients with
      systemic sclerosis (SSc). This study was undertaken to determine the significance
      of gated myocardial perfusion SPECT in patients with SSc and whether diastolic
      function measured by gated SPECT is an early sign of cardiac complications.
      METHODS: Thirty-four patients with SSc and 16 control patients were studied using
      exercise nongated and resting gated myocardial perfusion SPECT. The SSc was
      classified by the modified Rodnan total skin score (TSS) into high-TSS (score >
      or = 10; n = 18) and low-TSS (score < 10; n = 16) groups. Gated SPECT was
      performed using 99mTc-methoxyisobutylisonitrile with 16 frames per cardiac cycle
      and quantitatively analyzed by QGS software and Fourier filtering of the volume
      curve. The parameters of ejection fraction (EF), peak filling rate (PFR), one
      third mean filling rate, and time to PFR (TPFR) were calculated. RESULTS: A
      slight perfusion abnormality was observed in four and five patients in the low
      TSS and high-TSS groups, respectively (not statistically significant). A
      decreased resting EF less than 55% was found in no and two patients in the low
      TSS and high-TSS groups, respectively. TPFR was 166 +/- 22, 168 +/- 38, and 216
      +/- 82 ms (P = 0.05, high-TSS group versus low-TSS group; P = 0.04, control group
      versus high-TSS group) and TPFR/R-R interval was 0.18 +/- 0.02, 0.19 +/- 0.04,
      and 0.26 +/- 0.09 (P = 0.01, high-TSS group versus low-TSS group; P = 0.005,
      control group versus high-TSS group) for the control, low-TSS, and high-TSS
      groups, respectively. CONCLUSION: Diastolic function can be evaluated by gated
      myocardial perfusion SPECT. Significant diastolic abnormalities were shown even
      in patients with normal perfusion and systolic function and were related to the
      severity of SSc.

PMID- 11216516
TI  - Use of wavelet transforms in analysis of time-activity data from cardiac PET.
AB  - Because of its intrinsic quantitative properties, PET permits measurement of
      myocardial perfusion and metabolism in absolute terms (i.e., mL/g/min). However,
      quantification has been limited by errors produced in image acquisition,
      selection of regions of interest, and data analysis. The goal of this study was
      to evaluate a newly developed, novel, wavelet-based noise-reduction approach that
      can objectively extract biologic signals hidden within dynamic PET data. METHODS:
      Quantification of myocardial perfusion using dynamic PET imaging with 82Rb,
      H2(15)O, and 13NH3 was selected to evaluate the effects of the wavelet-based
      noise-reduction protocol. Dynamic PET data were fitted to appropriate mathematic
      models before and after wavelet-based noise reduction to get flow estimates. Time
      activity curves, precision, accuracy, and differentiating capacity derived from
      the wavelet protocol were compared with those obtained from unmodified data
      processing. A total of 84 human studies was analyzed, including 43 at rest (18
      82Rb scans, 18 H2(15)O scans, and 7 13NH3 scans) and 41 after coronary hyperemia
      with dipyridamole (17 82Rb scans, 17 H2(15)O scans, and 7 13NH3 scans). RESULTS:
      For every tracer tested under all conditions, the wavelet method improved the
      shape of blood and tissue time-activity curves, increased estimate-to-error
      ratios, and maintained fidelity of flow in regions as small as 0.85 cm3. It also
      improved the accuracy of flow estimates derived from 82Rb to the level of that
      achieved with H2(15)O, which was not affected markedly by the wavelet process. In
      studies of patients with coronary disease, regional heterogeneity of myocardial
      perfusion was preserved and flow estimates in infarcted regions were
      differentiated more easily from normal regions. CONCLUSION: The wavelet-based
      noise-reduction method effectively and objectively extracted tracer time-activity
      curves from data with low signal-to-noise ratios and improved the accuracy and
      precision of measurements with all tracer techniques studied. The approach should
      be generalizable to other image modalities such as functional MRI and CT and,
      therefore, improve the ability to quantify dynamic physiologic processes.

PMID- 11216515
TI  - Automated assessment of dipyridamole 201Tl myocardial SPECT perfusion
      scintigraphy by case-based reasoning.
AB  - This study evaluated the diagnostic accuracy of case-based reasoning (CBR) to
      automatically detect significant coronary artery disease from dipyridamole 201Tl
      myocardial SPECT perfusion scintigrams. METHODS: The study population included
      240 patients (182 men, 58 women; mean age +/- SD, 61 +/- 12 y) on whom coronary
      angiography and perfusion scintigraphy were performed within 6 +/- 11 d of each
      other. The patients were divided into two groups according to the presence or
      absence of significant coronary disease in any major coronary vessel. Regional
      myocardial tracer uptake was observed in 84 segments by polar map analysis. For
      each scintigraphic image, a CBR algorithm based on a similarity metric was used
      to identify similar scintigraphic images within the case library. The
      angiographic results of these similar cases were used to obtain the CBR reading,
      which was compared with the true angiographic results. Myocardial scintigrams
      were also analyzed by a first-generation Cedars-Sinai (CS) method, including a
      comparison with a reference database, and by the visual analysis of an expert
      reader. RESULTS: By receiver-operating-characteristic analysis, the diagnostic
      accuracy of CBR was not different from the interpretation by the CS algorithm and
      from visual interpretation (P = not significant [NS]). For detection of
      significant coronary disease, the respective sensitivities at 50% and 80%
      specificity were 90% and 67% for CBR, 88% and 65% for CS polar map analysis, and
      91% and 74% for visual interpretation. For the detection of coronary disease in
      the vascular territories assigned to the left anterior descending and the right
      coronary arteries, CBR and CS polar map analysis showed similar diagnostic
      accuracy (P = NS). However, for detection of disease in the circumflex artery, CS
      polar map analysis was slightly better than CBR (P = 0.03). CONCLUSION: Automated
      interpretation of dipyridamole 201Tl myocardial SPECT perfusion images by CBR has
      diagnostic accuracy similar to that of visual interpretation or CS analysis.
      Thus, use of a case library that includes a variety of normal and abnormal
      perfusion images does not appear to have greater diagnostic power than use of
      reference limits.

PMID- 11216517
TI  - Quantification of myocardial perfusion in human subjects using 82Rb and wavelet
      based noise reduction.
AB  - Quantification of myocardial perfusion with 82Rb has been difficult to achieve
      because of the low signal-to-noise ratio of the dynamic data curves. This study
      evaluated the accuracy of flow estimates after the application of a novel
      multidimensional wavelet-based noise-reduction protocol. METHODS: Myocardial
      perfusion was estimated using 82Rb and a two-compartment model from dynamic PET
      scans on 11 healthy volunteers at rest and after hyperemic stress with
      dipyridamole. Midventricular planes were divided into eight regions of interest,
      and a wavelet transform protocol was applied to images and time-activity curves.
      Flow estimates without and with the wavelet approach were compared with those
      obtained using H2(15)O. RESULTS: Over a wide flow range (0.45-2.75 mL/g/min),
      flow achieved with the wavelet approach correlated extremely closely with values
      obtained with H2(15)O (y = 1.03 x -0.12; n = 23 studies, r = 0.94, P < 0.001). If
      the wavelet noise-reduction technique was not used, the correlation was less
      strong (y = 1.11 x + 0.24; n = 23 studies, r = 0.79, P < 0.001). In addition, the
      wavelet approach reduced the regional variation from 75% to 12% and from 62% to
      11% (P < 0.001 for each comparison) for resting and stress studies, respectively.
      CONCLUSION: The use of a wavelet protocol allows near-optimal noise reduction,
      markedly enhances the physiologic flow signal within the PET images, and enables
      accurate measurement of myocardial perfusion with 82Rb in human subjects over a
      wide range of flows.

PMID- 11216518
TI  - Assessment of the clinical significance of asymptomatic lower extremity uptake
      abnormality in young athletes.
AB  - This study was undertaken to evaluate our hypothesis that most asymptomatic lower
      extremity uptake abnormalities are of no clinical consequence and to assess
      whether these findings should affect patient care. METHODS: One hundred
      consecutive young athletes referred for bone scintigraphy by a sports medicine
      clinic because of low back pain were evaluated for the presence of asymptomatic
      bone scan abnormalities in the lower extremities. The patients were then
      reexamined by the referring sports medicine physician, who had full knowledge of
      the bone scan results. Scintigraphic findings were correlated with the clinical
      evaluation at the time of scintigraphy and on follow-up evaluations ranging from
      8 to 14 mo later. RESULTS: Asymptomatic lower extremity abnormalities were
      present in 34% of patients. There were abnormalities of the feet in 30 patients
      (focal uptake in 26 patients, diffuse uptake in 10 patients), the tibia in 13
      patients (2 focal uptake, 11 diffuse uptake), and the femur in 2 patients (both
      with diffuse uptake). None of the regions of abnormal lower extremity uptake was
      symptomatic at the time of initial evaluation. There was no change in the
      clinical management of any patient because of the scan findings. None of the
      patients was advised to restrict the activity level because of the asymptomatic
      scan findings. None of the regions of scan abnormality became symptomatic on
      follow-up evaluation. CONCLUSION: This study shows that asymptomatic bone
      scintigraphic abnormalities of the feet, as well as diffuse abnormalities of the
      tibia, are common in young athletes. These findings are most likely of no
      clinical consequence and do not require a change in the activity level. Focal
      abnormalities of the femur or tibia are not commonly seen in asymptomatic young
      athletes.

PMID- 11216519
TI  - 64Cu-TETA-octreotide as a PET imaging agent for patients with neuroendocrine
      tumors.
AB  - 64Cu (half-life, 12.7 h; beta+, 0.653 MeV [17.4%]; beta-, 0.579 MeV [39%]) has
      shown potential as a radioisotope for PET imaging and radiotherapy. (111)In
      diethylenetriaminepentaacetic acid (DTPA)-D-Phe1-octreotide (OC) was developed
      for imaging somatostatin-receptor-positive tumors using conventional
      scintigraphy. With the advantages of PET over conventional scintigraphy, an agent
      for PET imaging of these tumors is desirable. Here, we show that 64Cu-TETA-OC
      (where TETA is 1,4,8,11-tetraazacyclotetradecane-N,N',N'',N'''-tetraacetic acid)
      and PET can be used to detect somatostatin-receptor-positive tumors in humans.
      METHODS: Eight patients with a history of neuroendocrine tumors (five patients
      with carcinoid tumors and three patients with islet cell tumors) were imaged by
      conventional scintigraphy with (111)In-DTPA-OC (204-233 MBq [5.5-6.3 mCi]) and by
      PET imaging with 64Cu-TETA-OC (111 MBq [3 mCi]). Blood and urine samples were
      collected for pharmacokinetic analysis. PET images were collected at times
      ranging from 0 to 36 h after injection, and the absorbed doses to normal organs
      were determined. RESULTS: In six of the eight patients, cancerous lesions were
      visible by both (111)In-DTPA-OC SPECT and 64Cu-TETA-OC PET. In one patient,
      (111)In-DTPA-OC showed mild uptake in a lung lesion that was not detected by 64Cu
      TETA-OC PET. In one patient, no tumors were detected by either agent; however,
      pathologic follow-up indicated that the patient had no tumors. In two patients
      whose tumors were visualized with (111)In-DTPA-OC and 64Cu-TETA-OC, 64Cu-TETA-OC
      and PET showed more lesions than (111)In-DTPA-OC. Pharmacokinetic studies showed
      that 64Cu-TETA-OC was rapidly cleared from the blood and that 59.2% +/- 17.6% of
      the injected dose was excreted in the urine. Absorbed dose measurements indicated
      that the bladder wall was the dose-limiting organ. CONCLUSION: The high rate of
      lesion detection, sensitivity, and favorable dosimetry and pharmacokinetics of
      64Cu-TETA-OC indicate that it is a promising radiopharmaceutical for PET imaging
      of patients with neuroendocrine tumors.

PMID- 11216520
TI  - Somatostatin receptor scintigraphy in the initial staging of low-grade non
      Hodgkin's lymphomas.
AB  - In this prospective study, somatostatin receptor (SS-R) scintigraphy was compared
      with conventional staging procedures for the initial staging of patients with low
      grade non-Hodgkin's lymphoma (NHL). METHODS: Fifty consecutive untreated patients
      with low-grade NHL underwent SS-R scintigraphy as part of their initial staging.
      Planar images were obtained 24 and 48 h after intravenous injection of 220 MBq
      (111)In-pentetreotide. SPECT images of the upper abdomen were obtained from all
      patients. SS-R scans were evaluated blindly without knowledge of the results of
      the conventional staging methods. SS-R scintigraphy findings were compared with
      the results of physical and radiologic examinations. RESULTS: SS-R scintigraphy
      findings were positive in 42 of 50 patients (84%). In 10 patients (20%), the SS-R
      scan revealed new lesions that had not been revealed by conventional staging
      procedures. These 10 patients were all upgraded to a higher stage. Consequently,
      the treatment plan would have been altered in 5 patients (10%). However, in 19
      patients (38%), lesions apparent after conventional staging methods were missed
      by SS-R scintigraphy. The sensitivity of SS-R scintigraphy varied from 62% for
      supradiaphragmatic lesions to 44% for infradiaphragmatic lesions. The specificity
      of SS-R scintigraphy was high (98%-100%). In comparison with CT scanning and
      sonography, SS-R scintigraphy is inferior for the visualization of NHL lesions in
      the thorax and abdomen. CONCLUSION: Although SS-R scintigraphy findings are
      positive in a large proportion of patients with low-grade NHL, in most patients
      only part of the lesions can be visualized. Because of the limited sensitivity,
      we recommend SS-R scintigraphy for initial staging of patients with low-grade NHL
      only in selected conditions and not for the general work-up.

PMID- 11216521
TI  - Skeletal uptake and soft-tissue retention of 186Re-HEDP and 153Sm-EDTMP in
      patients with metastatic bone disease.
AB  - The aim of this study was to introduce a new quantification method for 153Sm
      ethylenediaminetetramethylenephosphonate (EDTMP) and 186Re-(tin)1,1
      hydroxyethylidene diphosphonate (HEDP) to separately measure bone uptake and soft
      tissue retention of these radiopharmaceuticals. METHODS: Studies were performed
      on 23 men and 6 women undergoing radionuclide therapy for palliation of bone
      pain. Whole-body images were acquired at 3 min, 3-4 h, and 24-72 h after
      injection of 1,295 MBq 186Re-HEDP and 37 MBq 153Sm-EDTMP per kilogram of body
      weight. The activities for whole body, urinary bladder, and both thighs, as
      representative of soft tissue, were measured by region-of-interest technique. A
      background region of interest adjacent to the head was used to correct for
      bremsstrahlung. Bone uptake was calculated as initial whole-body activity minus
      urinary excretion and remaining soft-tissue activity. RESULTS: For 186Re-HEDP (n
      = 11) the mean bone uptake at 3 h after injection was 13.7% +/- 8.6% of initial
      whole-body activity. The remaining soft-tissue activity was 49.4% +/- 16.9%, and
      urinary excretion was 36.9% +/- 14.4%. At 24 h after injection, bone uptake
      reached a value of 21.8% +/- 9.0%. Urinary excretion increased to 65.3% +/- 12.8%
      according to a decreasing soft-tissue remainder activity of 12.8% +/- 5.4%. The
      corresponding results for 153Sm-EDTMP (n = 18) at 3 h after injection were 29.2%
      +/- 15.5% for bone uptake, 32.3% +/- 12.9% for urinary excretion, and 38.4% +/-
      14.5% for soft tissue. At 24 h after injection, we calculated values of 47.7% +/-
      11.2% for bone uptake, 39.5% +/- 13.8% for urinary excretion, and 12.7% +/- 4.7%
      for soft tissue. CONCLUSION: Bone uptake and soft-tissue retention for both 186Re
      HEDP and 153Sm-EDTMP as obtained in this study agree well with the conventional
      24-h whole-body retention measurements for these tracers. However, by this new
      scintigraphic quantification method, bone uptake and soft-tissue retention can be
      calculated separately, thus providing more detailed kinetic data and potentially
      improving the dosimetry of these radiopharmaceuticals in, for example, assessment
      of radiation dosage to bone and bone marrow.

PMID- 11216522
TI  - Neuroblastoma imaging using a combined CT scanner-scintillation camera and 131I
      MIBG.
AB  - High-dose administration of 131I-metaiodobenzylguanidine (131I-MIBG) continues to
      be a promising treatment for neuroblastoma. However, currently used methods of
      estimating 131I-MIBG uptake in vivo may be too inaccurate to properly monitor
      patient radiation exposure doses. To improve localization and uptake measurements
      over currently practiced techniques, we evaluated different methodologies that
      take advantage of the correlated patient data available from a combined CT
      scintillation camera imaging system. METHODS: Serial CT and radionuclide scans of
      three patients were obtained on a combined imaging system. SPECT images were
      reconstructed using both filtered backprojection and maximum-likelihood
      expectation maximization (MLEM). Volumes of interest (VOIs) were defined on
      anatomic images and automatically correlated to spatial volumes in reconstructed
      SPECT images. Several radionuclide quantification methods were then compared.
      First, the mean reconstructed values within coregistered SPECT VOIs were
      estimated from MLEM reconstructed images. Next, we assumed that reconstructed
      activity in SPECT voxels were linear combinations of activities present in
      individual objects, weighted by geometric factors derived from CT images. After
      calculating the weight factors by modeling the SPECT imaging process with
      anatomically defined VOIs, least-squares fitting was used to estimate the
      activities within lesion volumes. We also estimated the lesion activities
      directly from planar radionuclide images of the patients using similar linearity
      assumptions. Finally, for comparison, lesion activities were estimated using a
      standard conjugate view method. RESULTS: Activities were quantified from three
      patients having a total of six lesions with volumes ranging from 0.67 to 117 mL.
      Methods that used CT data to quantify lesion activities gave similar results for
      planar and tomographic radionuclide data. Estimating activity directly from mean
      VOI values in MLEM-reconstructed images alone consistently provided estimates
      lower than CT-aided methods because of the limited spatial resolution of SPECT.
      Values obtained with conjugate views produced differences up to fivefold in
      comparison with CT-aided methods. CONCLUSION: These results show that anatomic
      information available from coregistered CT images may improve in vivo
      localization and measurement of 131I-MIBG uptake in tumors.

PMID- 11216523
TI  - Quantitative PET studies in pretreated melanoma patients: a comparison of 6
      [18F]fluoro-L-dopa with 18F-FDG and (15)O-water using compartment and
      noncompartment analysis.
AB  - The purpose of the study was to evaluate the 6-[18F]fluoro-L-dopa (FDOPA)
      kinetics with PET in patients with treated melanoma metastases and to compare it
      with the standard tracer 18F-FDG as well as with the perfusion tracer (15)O-water
      in selected cases. METHODS: The study included 11 patients (22 lesions) with
      pretreated metastatic melanomas. Dynamic studies with FDG and in selected cases
      with (15)O-water (eight patients) preceded the FDOPA study. A one-tissue
      compartment model was used for the evaluation of the FDOPA and (15)O-water
      studies, and a two-tissue-compartment model and Patlak analysis were used for the
      FDG data. A noncompartment model based on chaos theory was used for calculating
      fractal dimension, which is a parameter for heterogeneity. RESULTS: The FDG
      studies showed a 1.5-fold increased uptake in comparison with surrounding tissue
      in 19 of 22 metastatic lesions (sensitivity of 86.4%). False-negative FDG results
      were obtained in 2 patients (three lesions). FDOPA uptake was enhanced in 14 of
      22 metastatic lesions (sensitivity of 64%). FDG uptake was 1.5-fold higher than
      FDOPA uptake in 18 of 22 metastases from melanoma, whereas FDOPA uptake was 1.5
      fold higher than FDG uptake in 2 patients with liver metastases. The data did not
      show a statistically significant correlation between the transport constant (K1)
      for FDOPA and that for FDG or between the standardized uptake value for FDOPA and
      FDG in metastases. No statistically significant correlation was found between K1
      for FDOPA and that for (15)O-water. The data show that FDOPA uptake is not
      perfusion dependent and provides different information from FDG. The fractal
      dimension was similar for all tracers within the tumor region. Detectability of
      metastases was enhanced when both tracers were used (sensitivity of 95%).
      CONCLUSION: In patients with negative FDG findings, FDOPA can help to identify
      viable melanoma metastases and thus may help to select patients who would benefit
      from further treatment.

PMID- 11216524
TI  - Combined 18F-FDG-FDOPA tumor imaging for assessing response to therapy.

PMID- 11216525
TI  - Brain SPECT in clinical practice. Part I: perfusion.
AB  - Brain perfusion SPECT is a functional neuroimaging technique that allows
      noninvasive study of physiologic and physiopathologic events in the human brain.
      With the appropriate technique and careful interpretation of the information
      provided, brain perfusion SPECT has proven potential for patient management.
      SPECT has clinical value in the diagnosis, therapeutic management, and follow-up
      of patients. The diversity of central nervous system diseases and the still
      incomplete knowledge of the mechanisms that underlie them have contributed to the
      success of brain perfusion SPECT as a research tool in neurosciences. This
      article provides fundamental knowledge on how and when to perform brain perfusion
      SPECT in clinical practice. A general overview of the clinical value of this
      technique is followed by relevant information on cerebral physiology for proper
      understanding of brain SPECT images. Practical considerations on quantification
      and interventional studies are also offered. Finally, step-by-step
      recommendations for interpreting and reporting brain perfusion SPECT images are
      provided to obtain the maximum clinical benefit from this technique.

PMID- 11216526
TI  - Kinetic analysis of 125I-iodorotenone as a deposited myocardial flow tracer:
      comparison with 99mTc-sestamibi.
AB  - The goal of this investigation was to assess the accuracy of 7'-Z
      [125I]iodorotenone (125I-iodorotenone) as a new deposited myocardial flow tracer
      and compare the results with those for 99mTc-sestamibi. METHODS: The kinetics of
      these two flow tracers were evaluated in 25 isolated, erythrocyte- and albumin
      perfused rabbit hearts over a flow range relevant to patients. The two flow
      tracers and a vascular reference tracer (131I-albumin) were introduced
      simultaneously as a compact bolus through a port just above the aortic cannula in
      the absence of tracer recirculation. Myocardial extraction, retention, washout,
      and uptake parameters were computed from the venous outflow curves using the
      multiple-indicator dilution technique and spectral analysis. RESULTS: The
      extraction of 125I-iodorotenone was much higher than the extraction of 99mTc
      sestamibi (0.84 +/- 0.05 vs. 0.48 +/- 0.10, respectively, P < 0.001). 125I
      iodorotenone extraction was also less affected by flow than was 99mTc-sestamibi
      (P < 0.001). Net retention of 125I-iodorotenone was significantly greater than
      99mTc-sestamibi net retention at 1 min (0.77 +/- 0.08 vs. 0.41 +/- 0.11,
      respectively, P < 0.001) and 26 min (0.46 +/- 0.13 vs. 0.27 +/- 0.11,
      respectively, P < 0.001) after tracer injection. Flow had less effect on 125I
      iodorotenone net retention than on 99mTc-sestamibi net retention 1 min after
      tracer injection (P < 0.04). However, at 26 min, flow had an equivalent effect on
      the retention of both flow tracers (P < 0.4). The relationship between 125I
      iodorotenone and 99mTc-sestamibi washout was complex and depended on elapsed time
      after isotope introduction and perfusion rate. Reflecting the favorable
      extraction and retention characteristics of 125I-iodorotenone, both its maximum
      myocardial uptake and its 26-min uptake were more closely related to flow than
      were those of 99mTc-sestamibi (P < 0.001 for both comparisons). CONCLUSION: The
      extraction and retention of 125I-iodorotenone were greater than those of 99mTc
      sestamibi, making 125I-iodorotenone the superior flow tracer in the isolated
      rabbit heart.

PMID- 11216527
TI  - The quest for the perfect myocardial perfusion indicator...still a long way to
      go.

PMID- 11216528
TI  - Serial changes in 14C-deoxyglucose and 201Tl uptake in autoimmune myocarditis in
      rats.
AB  - This study was designed to examine the relationships between the uptake of 14C
      deoxyglucose (DG) and the uptake of 201Tl in a rat model of autoimmune
      myocarditis. METHODS: Autoimmune myocarditis was induced in normal rats by
      immunization with pig cardiac myosin. Dual-tracer autoradiography with DG and
      201Tl was performed on frozen slices of the animals' hearts 3 wk (acute phase), 8
      wk (subacute phase), and 14 wk (chronic phase) (each n = 5) after immunization.
      The extent of inflammatory damage was classified histologically into three
      categories on the basis of cell infiltration: mild (Mi), moderate (Mo), and
      severe (Sv). The regional count in the region of interest set on the
      autoradiogram was normalized on the basis of that of control rats. The ratio of
      total cardiac uptake to the injected dose (%ID/g x BW, where ID is injected dose
      and BW is body weight) was calculated by tissue counting. Expressions of glucose
      transporters GLUT1 and 4 were evaluated by the enzyme-labeled antibody method.
      RESULTS: The total cardiac uptake of DG in the acute phase of myocarditis was
      significantly higher than in normal control rats (3.43% +/- 0.92% vs. 0.97% +/-
      0.38%; P < 0.0001); it then decreased in the chronic phase but was still higher
      than in the controls (1.85% +/- 0.37% vs. 0.97% +/- 0.38%; P < 0.01). The total
      cardiac uptake of 201Tl in the acute phase of myocarditis was significantly lower
      than in the controls (7.4% +/- 0.7% vs. 12.0% +/- 3.3%; P < 0.005); it then
      increased in the chronic phase and reached normal levels (13.0% +/- 3.3% vs.
      12.0% +/- 3.3%; not significant [NS]). In the acute phase, the regional uptakes
      of DG in the Mi, Mo, and Sv regions were 143.1% +/- 107.9%, 169.6% +/- 59.9%, and
      317.5% +/- 103.3%, respectively, whereas those of 201Tl were 88.4% +/- 31.9%,
      72.1% +/- 34.6%, and 48.4% +/- 21.5%, respectively. GLUT expression was evaluated
      visually and classified into four grades (0, 1, 2, and 3). In the acute phase,
      GLUT1 expression was higher in rats in the Sv group than in the controls (2.87
      vs. 0.87). GLUT4 was not expressed in the Sv areas but was found in the Mi areas.
      CONCLUSION: In the acute phase of autoimmune myocarditis in rats, cardiac uptake
      of DG was accelerated by severe inflammation. Cardiac uptake of 201Tl, on the
      other hand, was suppressed. Our results suggest that GLUT1 expression accelerates
      DG uptake by cells in areas of severe inflammation.

PMID- 11216529
TI  - Early retardation of 99mTc-DTPA radioaerosol transalveolar clearance in
      irradiated canine lung.
AB  - The alteration of 99mTc-labeled diethylenetriaminepentaacetic acid (DTPA)
      transalveolar clearance in an initial phase of radiation lung injury was
      experimentally investigated. METHODS: Fourteen dogs were irradiated to the
      hemithorax with a single dose of 20 Gy. A DTPA radioaerosol study was performed
      before irradiation and on day 12 after irradiation. On day 14, the DTPA study was
      repeated again, with seven animals undergoing the study after inhalation of an
      aerosolized synthetic surfactant. The penetration index (P.I.) and clearance half
      time (T(1/2)) of DTPA were measured in each lung. To evaluate the changes in lung
      surfactant after irradiation, alveolar lipids were stained in the resected lungs
      (n = 14), and the amounts of alveolar surfactant phospholipid and protein were
      measured by a bronchoalveolar lavage study in another six irradiated dogs.
      RESULTS: In all of the 14 irradiated animals, DTPA radioaerosol distributed
      uniformly throughout the lungs without significant changes in P.I. The T(1/2)
      values in irradiated lungs were significantly prolonged compared with the matched
      baseline values and those in nonirradiated lungs (P < 0.05 and 0.001,
      respectively). The aerosolized synthetic surfactant retarded the DTPA clearance
      both in the irradiated and in the nonirradiated lungs (P < 0.001) without
      significant changes in P.I. The histologic and bronchoalveolar lavage studies
      revealed an increase of alveolar surfactant materials in the irradiated lungs
      without substantial histologic changes in the alveolar structures. CONCLUSION:
      DTPA transalveolar clearance was retarded soon after irradiation. Increased
      alveolar surfactant may be partly responsible for this retarded DTPA clearance
      because the aerosolized synthetic surfactant also prolonged the clearance in
      nonirradiated lungs. A DTPA clearance test is sensitive for the early detection
      of radiation lung injury and seems helpful for clarifying the association of
      epithelial integrity changes and lung surfactant in radiation lung injury.

PMID- 11216530
TI  - Absolute activity quantitation in simultaneous 123I/99mTc brain SPECT.
AB  - Dual-isotope imaging can allow simultaneous assessment of brain perfusion using a
      99mTc-labeled tracer and neurotransmission using an 123I-labeled tracer. However,
      the images are affected by scatter, cross talk, attenuation, distance-dependent
      collimator response (DCR), and partial-volume effect. We determined the accuracy
      and precision of activity quantitation in simulated normal and pathologic studies
      of simultaneous 123I/99mTc brain SPECT when compensating for all degrading
      phenomena. METHODS: Monte Carlo simulations were performed using the Zubal brain
      phantom. Contamination caused by high-energy 123I decay photons was incorporated.
      Twenty-four 99mTc and 123I activity distributions were simulated on the basis of
      normal and pathologic patient activity distributions. Cross talk and scatter were
      corrected using a new method based on a multilayer perceptron artificial neural
      network (ANN), as well as by the asymmetric window (AW) approach; for comparison,
      unscattered (U) photons of 99mTc and 123I were recorded. Nonuniform attenuation
      and DCR were modeled in an iterative ordered-subset expectation maximization
      (OSEM) algorithm. Mean percentage biases and SDs over the 12 normal and 12
      pathologic simulated studies were computed for each structure with respect to the
      known activity distributions. RESULTS: For 123I, AW + OSEM yielded a bias of 7%
      in the cerebellum, 21% in the frontal cortex, and 36% in the corpus callosum in
      the simulated normal population. The bias was increased significantly in the
      striata of simulated pathologic studies (P < 0.05). The bias associated with ANN
      was significantly lower (<9% in these brain structures, P < 0.05). For 99mTc with
      AW + OSEM, the bias was 60% in the corpus callosum, 36% in the striata, and 18%
      22% in the cortical lobes in the simulated normal population. This bias was <11%
      in all brain structures with ANN. In the simulated pathologic population, the
      bias associated with AW increased significantly in the cortical lobes to 55% (P <
      0.05), although it did not change significantly with ANN. CONCLUSION: The
      accuracy and variability over simulated normal and pathologic studies of both
      99mTc and 123I activity estimates were very close with ANN to those obtained with
      U + OSEM. ANN + OSEM is a promising approach for absolute activity quantitation
      in simultaneous 99mTc/123I SPECT.

PMID- 11216531
TI  - Imaging cyclophosphamide-induced intramedullary apoptosis in rats using 99mTc
      radiolabeled annexin V.
AB  - Intramedullary apoptosis of hematopoietic tissue is believed to play a major role
      in the pathophysiology of myelodysplastic syndrome. Annexin V, a specific marker
      of the early to intermediate phases of apoptosis, has been applied to the in
      vitro study of bone marrow aspirates. A noninvasive measure of intramedullary
      apoptosis in vivo that could serially monitor the clinical progression of
      myelodysplastic syndrome may be helpful. METHODS: We used 99mTc-radiolabeled
      annexin V and radionuclide gamma camera imaging to serially study the sites,
      extent, and severity of intramedullary apoptosis induced by cyclophosphamide
      treatment. RESULTS: Intravenously administered radiolabeled annexin V localized
      preferentially in the femur, pelvis, vertebrae, and spleen; increased uptake in
      these organs was easily visualized as early as 8 h after injection of 100 mg/kg
      cyclophosphamide in 8- to 10-wk-old animals. Higher doses of cyclophosphamide
      (150 mg/kg) in animals of the same age increased annexin V uptake in the bone
      marrow and splenic tissue and delayed recovery of these organs as seen
      histologically compared with lower doses. Older animals, 5-6 mo old, showed a
      slower response to cyclophosphamide treatment and delayed recovery of bone marrow
      and splenic tissues. CONCLUSION: Radiolabeled annexin V can be used to detect and
      directly quantify the degree of intramedullary and splenic apoptosis in a
      noninvasive fashion using current clinical radionuclide imaging equipment.
      Annexin V imaging may be useful clinically in the diagnosis and management of
      myelodysplastic syndrome.

PMID- 11216532
TI  - Transfer of the human NaI symporter gene enhances iodide uptake in hepatoma
      cells.
AB  - The characteristic feature of thyroid cells of taking up iodide enables benign
      thyroid diseases and differentiated thyroid carcinoma to be successfully treated
      with radioiodide therapy. The transport of iodide across the cell membrane is
      mediated by the human NaI symporter (hNIS). We therefore investigated whether the
      accumulation of iodide may be induced by the retroviral transfer of the hNIS gene
      in nonthyroid tumor cells. METHODS: With use of a bicistronic retroviral vector
      for the transfer of the hNIS coding sequence and the hygromycin resistance gene,
      rat Morris hepatoma (MH3924A) cells were infected with retroviral particles and
      32 hNIS-expressing cell lines were generated by hygromycin selection. After
      incubation of the genetically modified and wild-type hepatoma cells and the rat
      thyroid cell line FRTL5 with Na125I, the uptake and efflux of iodide were
      determined. In addition, the iodide distribution in rats bearing wild-type and
      genetically modified hepatomas was monitored. RESULTS: Genetically modified
      MH3924A cell lines accumulated up to 235 times more iodide than did noninfected
      hepatoma cells. The maximal iodide uptake in the cells was observed after 60 min
      incubation time. Competition experiments in the presence of sodium perchlorate
      revealed a dose-dependent decrease of iodide uptake (87%-92%). Moreover, carbonyl
      cyanide p-trifluoromethoxyphenylhydrazone led to a loss of accumulated I- (32%),
      whereas 4,4'-diisothiocyano-2,2'-disulfonic acid stilbene increased the I- uptake
      into the cells (22%). However, a rapid efflux of the radioactivity (80%) was
      observed during the first 10 min after 125I(-)-containing medium had been
      replaced by nonradioactive medium. In rats, the hNIS-expressing tumors
      accumulated six times more iodide than did the contralateral wild-type tumor as
      monitored by scintigraphy. The ex vivo quantitation of the iodide content
      performed 1 h after tracer administration in 1 g of tumor tissue revealed a 17
      fold higher iodide accumulation in the genetically modified tumors. In accordance
      with the in vitro data, we also observed a rapid efflux of radioactivity from the
      tumor in vivo. CONCLUSION: The transduction of the hNIS gene per se is sufficient
      to induce 125I transport in Morris hepatoma cells in vitro and in vivo. With
      regard to a therapeutic application, however, additional conditions need to be
      defined that inhibit the iodide efflux from the tumor cells.

PMID- 11216533
TI  - Glycosylated RGD-containing peptides: tracer for tumor targeting and angiogenesis
      imaging with improved biokinetics.
AB  - The alpha(v)beta3 integrin plays an important role in metastasis and tumor
      induced angiogenesis. Targeting with radiolabeled ligands of the alpha(v)beta3
      integrin may provide information about the receptor status and enable specific
      therapeutic planning. Previous studies from our group resulted in tracers that
      showed alpha(v)beta3-selective tumor uptake. However, these first-generation
      compounds predominantly revealed hepatobiliary excretion with high radioactivity
      found in the liver. In this report, the synthesis and biological evaluation of
      the first glycosylated RGD-containing peptide (RGD-peptide) for the noninvasive
      imaging of alpha(v)beta3 expression are described. METHODS: Peptides were
      assembled on a solid support using fluorenylmethoxycarbonyl-coupling protocols.
      The precursor cyclo(-Arg-Gly-Asp-D-Tyr-Lys(SAA)-) GP1 was synthesized by coupling
      3-acetamido-2,6-anhydro-4,5,7-tri-O-benzyl-3-deoxy-beta-D-glycero-D-gulo-heptonic
      acid (SAA(Bn3)) with cyclo(-Arg(Mtr)-Gly-Asp(OtBu)-D-Tyr(tBu)-Lys-) and
      subsequent removal of the protection groups. Iodine labeling was performed by the
      Iodo-Gen method (radiochemical yield > 50%). The in vitro binding assays were
      performed using purified immobilized alpha(IIb)beta3, alpha(v)beta5, and
      alpha(v)beta3 integrins. For in vivo experiments, nude mice bearing
      xenotransplanted melanomas and mice with osteosarcomas were used. RESULTS: The
      glycosylated peptide 3-iodo-Tyr4-cyclo(-Arg-Gly-Asp-D-Tyr-Lys(SAA)-) GP2 showed
      high affinity and selectivity for alpha(v)beta3 in vitro (50% inhibitory
      concentration = 40 nmol/L). Pretreatment studies indicate specific binding of
      [125I]GP2 on alpha(v)beta3-expressing tumors in vivo. Comparison of the
      pharmacokinetics of [125I]GP2 and [125I]-3-iodo-Tyr4-cyclo(-Arg-Gly-Asp-D-Tyr-Val
      ) [125I]P2 revealed for [125I]GP2 an increased activity concentration in the
      blood (e.g., 3.59 +/- 0.35 percentage injected dose [%ID]/g vs. 1.72 +/- 0.44
      %ID/g at 10 min postinjection) and a significantly reduced uptake in the liver
      (e.g., 2.59 +/- 0.24 %ID/g vs. 21.96 +/- 2.78 %ID/g at 10 min postinjection).
      Furthermore, a clearly increased activity accumulation in the tumor was found
      (e.g., 3.05 +/- 0.31 %ID/g vs. 0.92 +/- 0.16 %ID/g at 240 min postinjection),
      which remained almost constant between 60 and 240 min postinjection. This
      resulted in good tumor-to-organ ratios for the glycosylated tracer (e.g., 240-min
      postinjection osteosarcoma model: tumor-to-blood = 16; tumor-to-muscle = 7; tumor
      to-liver = 2.5), which were confirmed by the first gamma-camera images of
      osteosarcoma-bearing mice at 240 min postinjection. CONCLUSION: This study
      demonstrates that the introduction of a sugar moiety improves the pharmakokinetic
      behavior of a hydrophobic peptide-based tracer. Additionally, this alpha(v)beta3
      selective glycosylated radioiodinated second-generation tracer GP2 shows high
      tumor uptake and good tumor-to-organ ratios that allow noninvasive visualization
      of alpha(v)beta3-expressing tumors and monitoring therapy with alpha(v)beta3
      antagonists. Finally, the favorable biokinetics make the glycosylated RGD-peptide
      a promising lead structure for tracers to quantify the alpha(v)beta3 expression
      using PET.

PMID- 11216534
TI  - Marking hypoxia in rat prostate carcinomas with beta-D-[125I]azomycin
      galactopyranoside and.
AB  - The purpose of this study was to determine, with a rodent tumor model, if
      microelectrode measurements of unmodulated tumor oxygenation predict for the
      avidity of hypoxic markers to tumor tissue. METHODS: The rapidly growing,
      anaplastic variant of the Dunning rat prostate carcinoma cell line (R3327-AT) was
      implanted subcutaneously on the upper backs of Fischer X Copenhagen rats.
      Approximately 100 measurements of PO2 were obtained from tumors of 5-10 g in
      animals that were restrained and then subjected to different anesthetic
      procedures. Values of median PO2 (in mm Hg) and percentage of measurements <5 mm
      Hg obtained from individual tumors were used to define tumor oxygenation status.
      The radiodiagnostic hypoxic markers beta-D-iodinated azomycin galactopyranoside
      (IAZGP) and [99mTc]HL-91 were simultaneously administered to 26 animals whose
      tumor oxygen levels had been measured. Six hours after marker administration, the
      animals were killed; tumor, blood, and muscle tissues were sampled; and
      percentage injected dose per gram (%ID/g*), tumor/blood ratio (T/B), and
      tumor/muscle ratio (T/M) parameters were determined. Parameters of marker avidity
      to individual tumors were linearly correlated with microelectrode measurements of
      tumor oxygenation to determine the significance of inverse associations. RESULTS:
      The median PO2 of 41 tumors varied from 2.0 to 20.9 mm Hg, with an average value
      of 7.5 +/- 1.4 mm Hg. Six tumors had unusually high values; that is, >10 mm Hg,
      and when these were excluded from the analysis, the average median PO2 of the
      remaining 35 was 4.3 +/- 0.7 mm Hg. When electrode measurements of tumor
      oxygenation were obtained under conditions of halothane anesthesia with the
      animals breathing O2, carbogen, or air, median PO2 values increased significantly
      (P = 0.001). When animals were deeply anesthetized by intraperitoneal injection
      of ketamine-xylazine, median PO2 values were not significantly different (P =
      0.13) from those obtained while the animals were restrained and breathing air.
      There was no inverse correlation of significance between the electrode
      measurements of median PO2 and the avidity of beta-D-IAZGP nor [99mTc]HL-91 in
      this tumor model. The range of median PO2 values in these tumors was at least 3
      mm Hg, and the range of hypoxic marker avidity was less than twofold. CONCLUSION:
      These data demonstrate that microelectrode measurements of rat tumor oxygenation
      did not correlate with the avidity of the two hypoxic markers, at least in this
      tumor model. The larger dynamic range of tumor oxygen measurements obtained with
      microelectrodes might be biased to low values by their necrotic fractions, the
      zones within solid tumors that contain dead cells and debris that will not be
      labeled by bioreducible hypoxic markers. Hypoxic marker avidity to individual
      tumors will have to be validated by other assays that can predict for their
      radiosensitivity.

PMID- 11216535
TI  - Preclinical evaluation of locoregional delivery of radiolabeled iododeoxyuridine
      and thymidylate synthase inhibitor in a hepatoma model.
AB  - We report improved incorporation of the radiolabeled-thymidine analog
      [125I/131I]5-iodo-2'-deoxyuridine ([125I/131I]IdUrd) into DNA by the addition of
      Thymitaq, a thymidylate synthase inhibitor, as a strategy of molecular
      radiotherapy for hepatoma treatment. METHODS: The synergistic effect of
      combination [125I]IdUrd and Thymitaq in clonogenic survival and DNA incorporation
      was shown on the human hepatoma cell line Hep3B. Radiobiodistribution of
      intrahepatic arterially injected [125I]IdUrd and Thymitaq was studied in a rat
      N1S1 hepatoma model. In vivo therapeutic effects of locoregional delivery of both
      drugs were evaluated in mouse subcutaneous hepatoma and ascitic hepatoma models.
      RESULTS: In a clonogenic assay, Thymitaq showed a synergistic effect with
      [125I]IdUrd but not cold IdUrd. Thymitaq had a dose-dependent modulation effect
      on DNA-[125I]IdUrd incorporation. The biodistribution study indicated a slower
      clearance rate of [125I]IdUdR in the hepatoma as well as an initially higher
      uptake of [125I]IdUrd into DNA when the [125I]IdUrd was combined with Thymitaq.
      In vivo studies showed a superior therapeutic effect of combination Thymitaq and
      [125I]IdUrd in both subcutaneous and ascites tumor models, but the combination of
      [131I]IdUrd and [125I]IdUrd may be more effective than Auger electron emitters
      alone for the treatment of subcutaneous tumor. CONCLUSION: The strategy of
      locoregional delivery of [125I/131I]IdUrd to a tumor site through an intrahepatic
      arterial, intratumoral, or intraperitoneal route in combination with Thymitaq is
      promising and may also have a favorable therapeutic index in vivo.

PMID- 11216536
TI  - Performance of a dual, solid-state intraoperative probe system with 18F, 99mTc,
      and (111)In.
AB  - The use of tracer-avid radiopharmaceuticals and handheld, intraoperative,
      radiation-sensitive probes to localize areas of tumors promises to improve
      surgical treatments of cancer. Currently several beta- and gamma-ray-emitting
      radiopharmaceuticals are proposed for use in these procedures. Therefore,
      intraoperative-probe systems should be capable of optimum performance with
      several different radionuclides. The goal of this study was to evaluate the
      performance of a dual, solid-state probe with three of these radionuclides (18F,
      99mTc, and (111)In). METHODS: The detector unit of the intraoperative-probe
      system used in this investigation consisted of a stack of two ion-implanted
      silicon detectors separated by 0.5 mm. The system could be operated in two modes:
      beta optimized, in which the difference between the signals from the two
      detectors was calculated to correct the beta signal for photon contamination, and
      photon-optimized mode, in which the signals were summed. Detection sensitivity
      and an index measuring beta detection selectivity were measured in both
      acquisition modes with the three different radionuclides. The gamma-ray detection
      sensitivity of a commercially available probe was measured with 99mTc and
      compared with the results with a solid-state probe. RESULTS: Beta and photon
      emissions (gamma-rays and annihilation photons) produced by all three
      radionuclides were detected by the probe. In beta-optimized acquisition mode, the
      greatest beta-detection sensitivity was achieved with 18F; photon sensitivity was
      greatest for measurements with (111)In. The lowest detection sensitivities (beta
      and photon) were obtained with 99mTc. With the probe system in gamma-optimized
      mode, the greatest beta and photon sensitivities were achieved with 18F; the
      lowest were obtained with 99mTc. The gamma-detection sensitivity measured with
      99mTc in gamma mode (5.59 +/- 0.41 counts per second [cps]/kBq) compared
      surprisingly well with the results from the commercial probe (8.75 +/- 0.47
      cps/kBq). CONCLUSION: The results from this investigation demonstrate the
      flexibility and versatility of the dual, solid-state probe system used in this
      study. These capabilities may be used to improve existing techniques or lead to
      new methods for performing radionuclide-guided surgeries.

PMID- 11216537
TI  - Automated stereotactic standardization of brain SPECT receptor data using single
      photon transmission images.
AB  - Intra- or intersubject registration of anatomically poorly defined SPECT data,
      such as in neuroreceptor imaging, is important for longitudinal or group
      analysis. However, accurate registration is difficult with only emission CT (ECT)
      data. We investigated fully automated registration using transmission CT (TCT)
      data as an intermediary image set. METHODS: The accuracy of TCT registration was
      compared to that of ECT registration for four types of data: gray-matter
      distribution (with [99mTc]ethylcysteinate dimer (ECD)), neocortical distribution
      (with [123I]R91150, a highly specific 5-HT2a receptor ligand), and striatal
      distribution of the D2-receptor ligand (with [123I]iodobenzamide (IBZM)) and the
      dopamine transporter ligand (with [123I]2beta-carbomethoxy-3beta-(4
      fluorophenyl)tropane (CIT)). In total, 10 datasets of the various study types
      were used, all collected on a Toshiba GCA9300 gamma camera with super-high
      resolution fanbeam collimators and 3 x 370 MBq of 153Gd transmission sources (4
      min sequential TCT scanning for receptor studies and 20-min simultaneous scanning
      for [99mTc]ECD studies). Per dataset, 15 random misalignments of 9 rigid-body
      parameters (translation, rotation, and anisotropic scaling) were conducted. All
      coregistrations were done twice, both to the subject's original scan and to a
      study-specific template. This was done manually by two independent experienced
      observers and with three automated voxel similarity algorithms: mutual
      information (M.I.), count difference (C.D.), and uniformity index (U.I.). As an
      outcome measure, the impact of misregistration on semiquantification for the
      various study types was established. RESULTS: TCT matching allowed registration
      within 3.3 mm, 2.4 degrees, and 1.2% scaling (mean squared values for all
      directions) with an overall accuracy decrease in the following order: C.D. > M.I.
      > manual > U.I. For [99mTc]ECD and [123I]IBZM, TCT registration was as accurate
      as ECT registration, while it was far superior for the other receptor data types,
      especially for abnormal studies. The automated TCT registration accuracy
      corresponded to average quantification errors of 2.9% ([99mTc]ECD), 4.2%
      ([123I]BZM), 5.7% ([123I]R91150), and 6.1% ([123I]beta-CIT). CONCLUSION: Fully
      automated registration through intermediary TCT images is clinically feasible,
      fast, and accurate. In addition to nonuniform attenuation correction, TCT
      scanning therefore allows coregistration for group comparisons of SPECT receptor
      data on a standardized or pixel-by-pixel basis.

PMID- 11216538
TI  - Biodistribution and radiation dosimetry of the dopamine transporter ligand.
AB  - 18F-labeled 2 beta-carbomethoxy-3beta-(4-chlorophenyl)-8-(-2
      fluoroethyl)nortropane ([18F]FECNT) is a recently developed dopamine transporter
      ligand with potential applications in patients with Parkinson's disease and
      cocaine addiction. METHODS: Estimates of the effective dose equivalent and doses
      for specific organs were made using biodistribution data from 16 Sprague-Dawley
      rats and nine rhesus monkeys. PET images from two rhesus monkeys were used to
      calculate the residence time for the basal ganglia. The computer program MIRDOSE3
      was used to calculate the dosimetry according to the methodology recommended by
      MIRD. RESULTS: The basal ganglia were the targeted tissues receiving the highest
      dose, 0.11 mGy/MBq (0.39 rad/mCi). The effective dose equivalent was 0.018
      mSv/MBq (0.065 rem/mCi), and the effective dose was 0.016 mSv/MBq (0.058
      rem/mCi). CONCLUSION: Our data show that a 185-MBq (5-mCi) injection of
      [18F]FECNT leads to an estimated effective dose of 3 mSv (0.3 rem) and an
      estimated dose to the target organ or tissue of 19.4 mGy (1.93 rad).

PMID- 11216539
TI  - Patient dosimetry of intravenously administered 99mTc-annexin V.
AB  - Annexin V labeled with 99mTc is evaluated as a potential in vivo marker for
      tissue with increased apoptosis. Promising results in patients have been obtained
      with 99mTc-(n-1-imino-4-mercaptobutyl)-annexin V (99mTc-i-AnxV). Because
      information on biodistribution and radiation burden is desired for the
      application of any radiopharmaceutical, a dosimetric study of 99mTc-i-AnxV was
      undertaken. METHODS: Eight persons with normal kidney and liver functions were
      included in this study: six patients with myocardial infarction, one with Crohn's
      disease, and one healthy volunteer. Approximately 600 MBq 99mTc-i-AnxV were
      injected intravenously immediately before a dynamic study with a dual-head gamma
      camera in conjugate view mode. In the next 24 h, two to four whole-body scans
      were acquired. Patient thickness was determined from a transmission scan with a
      57Co flood source. Organ uptake was estimated after correction for background,
      attenuation, and scatter, using a depth-independent buildup factor and an organ
      size-dependent attenuation correction. Residence times were calculated from the
      dynamic and whole-body studies and used as input for the MIRDOSE 3.1 program to
      obtain organ-absorbed doses and effective dose. RESULTS: Activity strongly
      accumulated in the kidneys (21% +/- 6% of the injected dose at 4 h postinjection)
      and the liver (12.8% +/- 2.2%). Uptake in the target tissues (myocardium or
      colon) was limited and negligible from a dosimetric point of view. The biologic
      half-life of activity registered over the total body was 62 +/- 13 h. Of the
      excreted activity, approximately 75% went to the urine and 25% to the feces. The
      absorbed dose for the more strongly exposed organs was (in microGy/MBq): kidneys,
      93 +/- 24; spleen, 22 +/- 6; liver, 17 +/- 2; testes, 15 +/- 3; thyroid, 10 +/-
      6; urinary bladder wall, 7.5 +/- 2.6; and red bone marrow, 5.5 +/- 0.8. The
      effective dose was 9.7 +/- 1.0 microSv/MBq, corresponding to a total effective
      dose of 5.8 +/- 0.6 mSv for a nominally injected activity of 600 MBq. CONCLUSION:
      99mTc-i-AnxV strongly accumulates in the kidneys and to a lesser degree in the
      liver. The associated effective dose per MBq is in the midrange of values found
      for routine 99mTc-labeled compounds. From a dosimetric point of view 99mTc-i-AnxV
      is therefore well suited for the study of apoptosis in patients.

PMID- 11216540
TI  - Advanced medical imaging project.

PMID- 11216541
TI  - Hemodialysis in a patient being treated with 153Sm.

PMID- 11216542
TI  - New algorithm for quantification of myocardial perfusion SPECT.

PMID- 11216543
TI  - HIPAA: the promise of privacy--at what cost?

PMID- 11216544
TI  - Managing ultrafiltration failure by peritoneal resting.

PMID- 11216545
TI  - How should iron be given to peritoneal dialysis patients?

PMID- 11216546
TI  - Optimization of fill volumes in automated peritoneal dialysis.

PMID- 11216547
TI  - Optimal volume prescription for children on peritoneal dialysis.

PMID- 11216548
TI  - Guidelines for the treatment of peritonitis in children.

PMID- 11216549
TI  - Consensus guidelines for the treatment of peritonitis in pediatric patients
      receiving peritoneal dialysis.

PMID- 11216550
TI  - Prevention of peritonitis in children on peritoneal dialysis.
AB  - We reviewed methods of preventing peritonitis in children. A considerable body of
      evidence indicates that peritonitis rates are lowest with the use of a double
      cuffed catheter, with a downward directed tunnel, placed by an experienced
      surgeon. Evidence in adults, but lacking in children, suggests that exit-site
      mupirocin will lower Staphylococcus aureus exit-site infections and thus
      peritonitis rates. The risk of peritonitis due to contamination can be diminished
      by the avoidance of spiking and by the provision of a long training period.
      Catheter removal and replacement for catheter-related peritonitis may be done
      simultaneously in certain circumstances and is useful in decreasing the risk of
      recurrent peritonitis. Antibiotic prophylaxis at the time of catheter insertion,
      for contamination, during dialysate leaks, and for invasive procedures appears to
      be useful in diminishing peritonitis risk.

PMID- 11216551
TI  - Risk factors responsible for ultrafiltration failure in early stages of
      peritoneal dialysis.
AB  - OBJECTIVE: To define risk factors for ultrafiltration failure (UFF) during early
      stages of peritoneal dialysis (PD). DESIGN: Retrospective analysis of a group of
      patients whose peritoneal function was prospectively followed. SETTING: A
      tertiary-care public university hospital. PATIENTS: Nineteen of 90 long-term PD
      patients required a peritoneal resting period to recover UF capacity: 8 had this
      requirement before the third year on PD (early, EUFF group) and 11 had a late
      requirement (LUFF group). The remaining 71 patients, those with stable peritoneal
      function over time, constituted the control group. MAIN OUTCOME MEASURES:
      Peritoneal UF capacity under standard conditions (monthly) and small solute
      peritoneal transport (yearly). RESULTS: None of the conditions appearing at the
      start of PD or during the observation period could be definitely identified as
      the cause of UFF. There were no differences in characteristics between the EUFF
      group and the other two groups, except for the higher prevalence of diabetes in
      the EUFF group. Residual renal function (RRF) declined in all three groups during
      the first 2 years, with rapid loss during the third year in the EUFF group. This
      rapid loss in RRF was coincident with UFF. Peritoneal solute and water transport
      at baseline was similar in the three groups. After 2 years on PD, individuals in
      the EUFF group showed a significantly lower UF and higher creatinine mass
      transfer coefficient values than those in the LUFF group. Diabetic patients in
      the control group showed remarkable stability in UF capacity over time. During
      the second year on PD, requirement for increases in dialysate glucose
      concentration was 3.4 +/- 0.5% in the LUFF group, but as high as 25.5 +/- 24.2%
      in the EUFF group. The accumulated days of active peritonitis (APID, days with
      cloudy effluent) were similar for the three groups after 1, 2, and 3 years on PD.
      Interestingly, diabetic patients in the control group showed an APID index
      significantly lower than the overall EUFF group. Diabetics in the control group
      also had significantly lower APID versus nondiabetics in the control group (p =
      0.016). CONCLUSIONS: Our findings suggest that certain patients develop early UFF
      type I. Diabetic state and a higher glucose requirement to obtain adequate UF
      suggest that glucose on both sides of the peritoneal membrane could be
      responsible. The mechanisms for this higher requirement remain to be elucidated.
      The identification of a larger cohort of these early UFF patients should lead to
      a better exploration of the primary pathogenic mechanisms.

PMID- 11216552
TI  - High peritoneal permeability predisposes to hepatic steatosis in diabetic
      continuous ambulatory peritoneal dialysis patients receiving intraperitoneal
      insulin.
AB  - OBJECTIVE: To evaluate hepatic fat accumulation in diabetic patients taking
      intraperitoneal or subcutaneous insulin treatment during continuous ambulatory
      peritoneal dialysis (CAPD). DESIGN: Cross-sectional study. SETTING: Tertiary-care
      university hospital. PATIENTS: We studied 16 patients with diabetic end-stage
      renal disease currently treated with CAPD. Median age was 42 years (range: 34-70
      years), duration of diabetes was 27.5 years (range: 17-39 years), and duration of
      CAPD was 16.5 months (range: 2-59 months). OUTCOME MEASURES: Ultrasound measures
      of liver steatotic area and thickness, peritoneal equilibration test (PET),
      weekly Kt/V urea, protein catabolic rate (PCR), hemoglobin A1c (HbA1c),
      lipoproteins, alanine aminotransferase, alkaline phosphatase, insulin dose, and
      dialysate glucose load. RESULTS: Focal hepatic fat accumulation was found. The
      location of steatosis was subcapsular; a negligible amount was periportal.
      Hepatic subcapsular steatosis was present in 7 of 8 patients taking insulin
      intraperitoneally and in 0 of 8 patients taking insulin subcutaneously. The
      maximal thickness of subcapsular steatosis correlated directly with peritoneal
      transport rate (2-hour dialysate-to-plasma creatinine ratio in PET, r = 0.80, p <
      0.05) and inversely with PCR (r = -0.82, p < 0.05). The area of the lesions
      correlated directly with body weight (r = 0.80, p < 0.05) and inversely with
      weekly Kt/V urea (r = -0.90, p < 0.01). CONCLUSIONS: Intraperitoneal insulin,
      together with glucose-based peritoneal dialysate, induces hepatic subcapsular
      steatosis. The amount of hepatic subcapsular steatosis increases when peritoneal
      transfer rate and body weight are high.

PMID- 11216553
TI  - Advanced glycosylation end-products in diabetic rats on peritoneal dialysis using
      various solutions.
AB  - OBJECTIVE: To evaluate and compare the effects of glucose-based solutions to
      those of icodextrin with respect to peritoneal transport characteristics and
      advanced glycosylation end-product (AGE) formation in the peritoneal membrane in
      a diabetic rat model of peritoneal dialysis (PD). DESIGN: Thirty-three male
      Sprague-Dawley rats weighing between 275-300 g were divided into five groups:
      group C (n = 6), control rats implanted with a catheter but not dialyzed; group D
      (n = 5), diabetic rats implanted with a catheter but not dialyzed; group G (n =
      7), diabetic rats implanted with a catheter and dialyzed with standard 2.5%
      glucose solution for daytime exchanges and 4.25% glucose solution for overnight
      exchanges; group H (n = 8), diabetic rats implanted with a catheter and dialyzed
      with standard 2.5% glucose solution for daytime exchanges and 7.5% icodextrin
      solution for overnight exchanges; group I (n = 7), diabetic rats implanted with a
      catheter and dialyzed with 7.5% icodextrin solution for all exchanges. Dialysis
      exchanges (25 mL per exchange) were performed three times daily for a period of
      12 weeks. Tissue sections were stained using a monoclonal anti-AGE antibody. One
      hour peritoneal equilibration tests (PET) were performed every 4 weeks for
      comparison of transport characteristics. RESULTS: The level of immunostaining was
      lowest in group C and highest in group G. Significant differences in
      immunostaining were seen between group C and group G (p < 0.001), group C and
      group H (p = 0.001), and group C and group I (p < 0.05). Significant differences
      were also found between group G and group D (p < 0.05), and between group G and
      group I (p < 0.05). Over time, the ratio of glucose concentration after 1 hour to
      glucose concentration at instillation (D/D0) decreased and the dialysate-to
      plasma ratio (D/P) of urea increased. Significant differences in D/D0 glucose and
      D/P urea were found between group C and group H (D/D0: 0.40 +/- 0.01 vs 0.35 +/-
      0.01, p < 0.05; D/P urea: 0.87 +/- 0.03 vs 0.97 +/- 0.02, p < 0.05). CONCLUSIONS:
      These results suggest that AGE formation is lower with the use of peritoneal
      dialysis solution containing icodextrin than with glucose-based solution. We
      conclude that use of icodextrin may help to slow the deterioration of the
      peritoneal membrane, prolonging its use for dialysis.

PMID- 11216554
TI  - Marked variation in peritoneal insulin absorption in peritoneal dialysis.
AB  - OBJECTIVE: To assess both peritoneal insulin absorption and adsorption of insulin
      to the plastic delivery system, and to assess whether variation in peritoneal
      absorption is related to transport status. DESIGN: Eight insulin-dependent
      diabetic patients on continuous ambulatory peritoneal dialysis were studied.
      Insulin was added to the dialysate. The amount adsorbed by the bag tubing was
      determined; peritoneal absorption was measured by complete spent dialysate
      collection. RESULTS: Only 14% +/- 5% of added insulin was adsorbed onto the
      dialysate delivery system. Marked variation in peritoneal absorption occurred
      (38% +/- 14%, range 17%-66%). Variations in membrane transport status did not
      account for variation in absorption. CONCLUSION: Marked variation in peritoneal
      absorption of insulin occurs, accounting for some of the variation in
      intraperitoneal insulin requirements. This is not related to membrane transport
      status.

PMID- 11216555
TI  - Intraperitoneal infusion of glucose-based dialysate in the rat--an animal model
      for the study of peritoneal advanced glycation end-products formation and effect
      on peritoneal transport.
AB  - OBJECTIVE: Glucose-based dialysate induces non enzymatic glycation within the
      peritoneal cavity. To evaluate the relationship between the formation of advanced
      glycation end-products (AGEs) and peritoneal transfer for small solutes and
      macromolecules, we developed a model of simulated peritoneal dialysis (PD) in
      normal rats. METHODS: Male albino rats of the Charles River strain were divided
      into two sets of 3 groups (15-25 rats in each group). In the experimental (E)
      group, the rats were intraperitoneally (i.p.) injected daily with a commercially
      available 4.25% dextrose solution. In the control puncture (CP) group, the
      peritoneum was punctured daily, but no PD solution infused. In an age-matched
      control (CC) group, no intervention was given. Two study protocols were used.
      Protocol A (duration 20 weeks) consisted of a daily i.p. injection of 10 mL PD
      solution per 100 g body weight. In protocol B, a double volume of PD solution was
      introduced (20 mL per 100 g body weight). At 9, 16, and 20 weeks in protocol A,
      and at 9 weeks in protocol B, urea, creatinine, microalbumin [(MAL) measured
      using specific anti-rat albumin monoclonal antibody], and AGEs (measured by
      fluorescent assay with excitation at 370 nm and emission at 440 nm) were measured
      in peritoneal effluent and serum. RESULTS: At no time during the study were AGEs
      detected in serum from any group in either protocol. In both protocols, no
      differences were found between the control groups (CP, CC) with respect to all
      parameters. In protocol A, the dialysate-to-plasma ratio (D/P) of urea was
      significantly higher in the experimental group as compared with the control
      groups at 9, 16, and 20 weeks [9 weeks: 0.59 +/- 0.03 (E) vs 0.39 +/- 0.02 (CP)
      vs 0.46 +/- 0.02 (CC), p < 0.0004 and p < 0.002, respectively; 16 weeks: 0.71 +/-
      0.08 (E) vs 0.42 +/- 0.01 (CP) vs 0.46 +/- 0.01 (CC), p < 0.0001 and p < 0.02,
      respectively; 20 weeks: 0.57 +/- 0.03 (E) vs 0.39 +/- 0.01 (CP) vs 0.41 +/- 0.02
      (CC), p < 0.002 and p < 0.004, respectively]. At 16 and 20 weeks, dialysate MAL
      levels were significantly increased in group E [16 weeks: 354.00 +/- 80.35
      microg/mL (E) vs 134.75 +/- 14.36 microg/mL (CP) vs 110.69 +/- 7.83 microg/mL
      (CC), p < 0.04 and p < 0.03, respectively; 20 weeks: 283.17 +/- 14.71 microg/mL
      (E) vs 105.14 +/- 12.11 microg/mL (CP) vs 135.50 +/- 19.03 microg/mL (CC), p <
      0.00001 and p < 0.0001, respectively]. In protocol B, at completion of the study
      (week 9), D/P urea, effluent MAL, and AGEs were significantly higher in the
      experimental group as compared with the control groups [D/P: 0.67 +/- 0.04 (E) vs
      0.46 +/- 0.07 (CP) vs 0.41 +/- 0.02 (CC), p < 0.0002 and p < 00001, respectively;
      MAL: 336.8 +/- 63.30 microg/mL (E) vs 125.71 +/- 16.77 microg/mL (CP) vs 119.00
      +/- 39.75 microg/mL (CC), p < 0.008 and p < 0.007, respectively; AGEs: 265.77 +/-
      33.49 U/mg creatinine (E) vs 163.10 +/- 21.99 U/mg creatinine (CP) vs 83.17 +/-
      22.66 U/mg creatinine (CC), p < 0.02 and p < 0.001, respectively]. Peritoneal
      effluent AGEs were found to be significantly correlated with D/P urea and
      dialysate MAL (r = 0.42, p < 0.04, and r = 0.7, p = 0.00001, respectively).
      CONCLUSIONS: In situ generation of AGEs constitutes the chief origin of
      peritoneal AGEs. Advanced glycation end-products affect peritoneal
      permselectivity for both small and large solutes. The rat model of simulated
      peritoneal dialysis developed in this experiment provides a reliable method for
      studying peritoneal AGE formation and effect on peritoneal transfer of small
      solutes and macromolecules.

PMID- 11216556
TI  - Iron absorption after single pharmacological oral iron loading test in patients
      on chronic peritoneal dialysis and in healthy volunteers.
AB  - OBJECTIVE: Oral iron is poorly absorbed in chronic dialysis patients. We tested
      the hypothesis that a superpharmacologic dose of iron sulfate (260 mg elemental
      iron) administered on an empty stomach results in significant iron absorption in
      these patients. DESIGN: A prospective open controlled trial. SETTING: Outpatient
      department of a university hospital. PATIENTS: Nine stable chronic peritoneal
      dialysis (PD) patients and seven normal control subjects. METHOD: All subjects
      ingested a single dose of 4 tablets of iron sulfate (260 mg elemental iron total)
      in the morning while fasting. OUTCOME MEASURES: Serum iron concentrations at
      baseline, and at 2 and 4 hours after the oral dose were compared between the two
      groups. RESULTS: The control group showed a significant rise in mean [standard
      error (SE)] serum iron concentration, from a baseline value of 76.5 +/- 7
      microg/dL to 191 +/- 10.5 microg/dL at 2 hours and to 190 +/- 24 microg/dL at 4
      hours. This result represents a percentage rise of 164% +/- 32% at 2 hours and
      152% +/- 28.5% at 4 hours. In the PD patients, a significant rise in serum iron
      concentration was also seen, from a baseline value of 64 +/- 8 microg/dL to 130
      +/- 3 microg/dL at 2 hours and 111 +/- 18 microg/dL at 4 hours. This result
      represents a percentage rise of 105% = 29% at 2 hours and 77% +/- 23.5% at 4
      hours. However, the absolute change in serum iron concentration in PD patients at
      2 and 4 hours was approximately equal to 50% of the change in control subjects at
      those time points. None of the PD patients experienced gastrointestinal side
      effects; 4 control subjects experienced mild side effects. CONCLUSION: Despite
      impaired oral iron absorption in chronic dialysis patients, a large pharmacologic
      dose given orally can result in significant iron absorption and may prove to be a
      more efficient means of oral iron supplementation therapy in these patients.

PMID- 11216557
TI  - Is absorption of high-dose oral iron sufficient in peritoneal dialysis patients?
AB  - OBJECTIVE: Iron supplementation plays a major role in erythropoietin-treated end
      stage renal disease patients. For peritoneal dialysis (PD) patients, oral iron
      substitution is more convenient than intravenous therapy. However, disturbed iron
      absorption and adverse effects may be limiting factors for oral treatment.
      Nevertheless, we compared the response to a high-dose and low-dose oral iron
      absorption test between PD patients and healthy control subjects. PATIENTS AND
      INTERVENTIONS: In 34 PD patients and 15 healthy control subjects, blood samples
      were taken at baseline as well as 2, 4, and 8 hours after oral intake of 4
      tablets iron sulfate (105 mg elemental iron per tablet). In a subgroup of 6 PD
      patients and 6 control subjects, the oral iron absorption test was repeated using
      1 tablet iron sulfate. RESULTS: There was no significant difference in the
      increase in serum iron during the test between the two groups. As known for
      healthy subjects, iron absorption was significantly better in PD patients with
      absolute iron deficiency compared to those with functional iron deficiency. Iron
      repleted PD patients showed the lowest iron absorption, indicating that a high
      dose of oral iron did not overwhelm the ability of the bowel tract to reject
      unneeded iron. Increasing the oral iron dose from 1 to 4 tablets was followed by
      a better response in a small subgroup of PD patients compared to control
      subjects. Side effects such as nausea and vomiting occurred more frequently
      during high-dose oral iron in control subjects than in PD patients (20% vs 8.8%).
      CONCLUSION: High-dose oral iron is well absorbed in iron-depleted PD patients.
      This kind of oral iron therapy should be considered in some subgroups of PD
      patients with iron deficiency, particularly in those patients with poor
      vascularization of arm veins or intolerance to intravenous iron preparations.

PMID- 11216558
TI  - Incidence of peritonitis in chronic peritoneal dialysis patients infused with
      intravenous iron dextran.
AB  - BACKGROUND: The Dialysis Outcomes Quality Initiative (DOQI) guidelines, published
      in 1997, emphasize the need for careful monitoring of iron stores and for
      provision of adequate iron replacement therapy to achieve target goals of
      hemoglobin concentration in end-stage renal disease (ESRD) patients, especially
      those treated with recombinant erythropoietin (rHuEPO). Intravenous iron dextran
      (IVID) therapy, which has long been used in hemodialysis patients, is
      increasingly being used in chronic peritoneal dialysis (CPD) patients. In 1997,
      we began using this form of iron therapy for our CPD patients. However, because
      considerable data exists to show a relationship between iron metabolism and acute
      infections, we questioned whether IVID infusion placed our patients at greater
      risk for peritonitis, the leading cause of death and patient drop-out from CPD
      therapy. OBJECTIVE: To evaluate the relationship between iron and infection, we
      studied episodes of peritonitis in CPD patients who were infused with IVID.
      DESIGN: In a retrospective study of adult CPD patients who received IVID during
      1998, we investigated the occurrence of peritonitis episodes and the spectrum of
      causative organisms. Patients with a hemoglobin level of < 12.5 g/dL who also had
      a ferritin level < 100 ng/mL or a transferrin saturation level < 20% (or both)
      and who did not respond to oral iron therapy, were administered between 0.5 g and
      1.0 g of IVID in an outpatient hospital setting. We calculated the expected and
      observed number of peritonitis episodes in these patients within 30, 60, and 90
      days after infusion of IVID. RESULTS: During the study period, 56 patients
      received 77 doses of IVID, with 14 patients requiring 2 or more infusions. Of the
      77 doses, 71 were given as a 1-g bolus. The IVID was well tolerated by all
      patients. Within 90 days of IVID administration, 14 patients developed
      peritonitis: 6 episodes occurred within 30 days, 7 episodes occurred between 31
      and 60 days, and 1 episode occurred between 61 and 90 days after the IVID dosing.
      The peritonitis rate for patients not receiving IVID was 1 episode per 13.7
      patient-months. Taking this rate as the "expected" rate, the expected number of
      episodes of peritonitis for the study population was 5.6 episodes within 30 days,
      11.2 episodes within 60 days, and 16.8 episodes within 90 days following IVID
      administration. The difference between the expected and observed rates of
      peritonitis in patients who were dosed with IVID was not statistically different.
      The spectrum of organisms seen in the peritonitis episodes in the study
      population was not significantly different from that seen in the peritonitis
      episodes in our CPD unit population. CONCLUSIONS: There is evidence that IVID
      infusion therapy can improve anemia and reduce rHuEPO requirements in CPD
      patients, usually without adverse reaction and without exposing patients to an
      increased risk of peritonitis. More research is needed in the area of potential
      increased risk of infection in ESRD patients who are (1) infused with large doses
      of IVID, and (2) iron-overloaded.

PMID- 11216559
TI  - Longitudinal study of peritoneal membrane function in continuous ambulatory
      peritoneal dialysis: relationship with peritonitis and fibrosing factors.
AB  - BACKGROUND: The peritoneal equilibration test (PET) is a useful assessment of
      peritoneal function in continuous ambulatory peritoneal dialysis (CAPD) patients.
      However, the natural course of longitudinal change in peritoneal transport is not
      well defined. PATIENTS: We studied 105 unselected CAPD patients. Average age at
      enrollment was 50.7 +/- 11.3 years. METHODS: A PET was performed at enrollment.
      Peritoneal transport was expressed as dialysate-to-plasma creatinine ratio at 4
      hours (DIP). Fibrosing factors and mesothelial cell markers, including TGFbeta,
      epidermal growth factor (EGF), platelet-derived growth factor (PDGF), hyaluronan,
      and cancer antigen 125 (CA125), were measured in overnight peritoneal dialysate
      effluent (PDE). Patients were followed for two years. Peritonitis episodes were
      recorded. Severe peritonitis was defined as an episode that required catheter
      removal or antibiotic therapy for more than 3 weeks. After two years, 75 patients
      were still alive and on CAPD. RESULTS: The PET was repeated in 64 patients, of
      whom 35 were male and 9 had diabetes. The change in D/P over two years was
      represented as AD/P. No significant change in peritoneal transport was seen after
      two years (D/P: 0.56 +/- 0.12 vs 0.55 +/- 0.13). A centripetal pattern of change
      in D/P was observed. The deltaD/P had normal distribution and was inversely
      correlated with D/P at baseline (r = -0.427, p < 0.005). Both results suggest a
      regression-to-mean phenomenon. The deltaD/P had no significant correlation with
      the total number of peritonitis episodes (Spearman r = 0.052, p = 0.74), but
      after severe peritonitis, affected patients had higher deltaD/P than patients who
      experienced no severe infection (0.040 +/- 0.136 vs -0.032 +/- 0.120, p < 0.05).
      For patients with no episodes of severe peritonitis (n = 47), deltaD/P was weakly
      correlated with baseline TGFbeta level (r = -0.506, p < 0.01). No correlation was
      seen between the levels of other fibrosing factors and change in peritoneal
      transport. CONCLUSIONS: Our findings suggest that the centripetal change of
      peritoneal transport probably reflects a regression-to-mean phenomenon.
      Peritoneal transport increases after severe peritonitis. The role of TGFbeta
      levels in PDE with regard to longitudinal change in peritoneal transport requires
      further study.

PMID- 11216560
TI  - Intermittent intravenous piperacillin pharmacokinetics in automated peritoneal
      dialysis patients.
AB  - BACKGROUND: Use of intermittent antibiotic dosing is increasing in the treatment
      of peritoneal dialysis (PD)-related peritonitis. We studied the pharmacokinetics
      of intravenous (i.v.) piperacillin in automated PD patients. PATIENTS AND
      METHODS: Eight patients (3 males, 5 females) were recruited and received a single
      i.v. dose of piperacillin (35 mg/kg actual body weight). Blood and dialysate
      samples were collected at the beginning, middle, and end of dwells 1-3 (on
      cycler), and end of dwells 4-5 (off cycler) for a 24-hour period. Baseline and 24
      hour urine samples (nonanuric patients, n = 7) were collected. Pharmacokinetic
      parameters were calculated assuming a one-compartment model. Glomerular
      filtration rate (GFR) and piperacillin clearance (CL) values were normalized to
      1.73 m2. RESULTS: The patients were 49.5 +/- 10.1 years of age (mean +/- SD) and
      had been receiving PD for a median of 3 months (range 2-66 months). Dwell times
      were 2.25 +/- 0.06 hours on cycler and 7.26 +/- 0.14 hours off cycler.
      Piperacillin half-life was not statistically different on or off the cycler (on
      cycler 1.99 +/- 0.39 hr, off cycler 4.39 +/- 5.4 hr; p = 0.12) and remained
      insignificant, even accounting for an outlier (on cycler 2.01 +/- 0.41 hr, off
      cycler 2.54 +/- 1.48 hr; p = 0.19). Piperacillin total CL (CL(T)) was 31.29 +/-
      6.02 mL/minute. Renal CL (CL(R)) and PD CL (CL(PD)) accounted for 8.8% and 16.8%
      of CL(T); CL(R) correlated well with GFR (CL(R) = 0.86 GFR + 0.1; p < 0.00003).
      Mean piperacillin serum and dialysate end-of-dwell concentrations were above
      minimum inhibitory concentration of susceptible organisms (8 microg/mL) for the
      three cycler exchanges only. Serum and dialysate concentrations predicted using a
      one-compartment model suggest that i.v. piperacillin 4000 mg would provide
      adequate concentrations for susceptible organisms over a 12-hour period.
      CONCLUSION: The current i.v. piperacillin dosing recommendations of 4000 mg every
      12 hours for PD-related peritonitis are appropriate for patients on automated PD.
      Intermittent intraperitoneal piperacillin is not recommended.

PMID- 11216561
TI  - Correlation of intraperitoneal antibiotic pharmacokinetics and peritoneal
      membrane transport characteristics.
AB  - OBJECTIVE: To identify correlations between the pharmacokinetic variables that
      describe drug disposition in peritoneal dialysis (PD) patients and the measures
      used to assess dialysis adequacy. DESIGN AND METHODS: This retrospective study re
      evaluated data collected during previous pharmacokinetic studies for
      intraperitoneally administered cefazolin, ceftazidime, and gentamicin in
      continuous ambulatory peritoneal dialysis (CAPD) patients, and intravenous
      cefazolin and tobramycin in automated PD patients. Pharmacokinetic variables were
      compared to creatinine clearance (CCr), Kt/V, and peritoneal equilibration test
      data using the Pearson product correlation coefficient (r). RESULTS: Prominent
      correlations were found between renal CCr and renal Kt/V, with renal clearances
      of CAPD cefazolin and ceftazidime, and automated PD tobramycin and cefazolin (r
      values ranged from 0.698 to 0.986; p < 0.05). CONCLUSION: These findings support
      current peritonitis treatment recommendations that patients with residual renal
      function may require higher doses or more frequent drug administration.

PMID- 11216562
TI  - Chronic peritoneal inflammation by cyanate in rats.
AB  - OBJECTIVE: During peritoneal dialysis, the peritoneum is exposed to waste
      products, including urea. Urea forms cyanate spontaneously at body temperature
      and pH, and cyanate carbamylates amino acids, peptides, and proteins. Cyanate may
      contribute to peritoneal injury with morphological changes in the peritoneum. To
      test this hypothesis, we injected cyanate into rats. METHODS: Experiments were
      performed in two groups of 7 rats each. In the cyanate group, each rat received 1
      mL of 1.5 micromol/L potassium cyanate dissolved in 40 mmol/L sodium bicarbonate
      solution intraperitoneally each experiment day. In the control group, each rat
      received 1 mL of 1.5 micromol/L potassium bicarbonate instead of potassium
      cyanate. The rats in both groups were anesthetized and killed at the 85th day
      after the first injection. After formalin fixation, tissue samples from abdominal
      walls and livers were sliced, embedded in a standard manner, and stained with
      hematoxylin and eosin. RESULTS: Parietal peritoneum from rats in the cyanate
      group showed a mild increase in the number of fibroblasts, with collagen
      deposits, infiltration by mononuclear cells, vascular congestion, round-shaped
      transformation of mesothelial cells, widening of submesothelial spaces, and
      abundant denudation of mesothelial cells. The visceral peritoneum from rats in
      the cyanate group showed collagen deposits with fibroblastic proliferation.
      CONCLUSIONS: Cyanate can induce chronic inflammation in the peritoneum, and
      exposure of the peritoneum to cyanate may contribute to peritoneal injury in
      patients being treated with peritoneal dialysis.

PMID- 11216563
TI  - Serum albumin and other serum protein fractions in stable patients on peritoneal
      dialysis.
AB  - BACKGROUND: Hypoalbuminemia is common in peritoneal dialysis (PD) patients; but
      the reduction in serum albumin levels (SAlb) that should be expected in stable PD
      patients is less clear. OBJECTIVES: To determine prospectively, in a group of
      stable PD patients without comorbid conditions, the changes in SAlb concentration
      and in the concentrations of the other serum protein fractions. To investigate
      the best determinants of a significant decrease in SAlb levels. DESIGN:
      Prospective observational study. METHODS: Seventeen PD patients in stable
      clinical condition, with no signs of systemic inflammatory response, were
      included in the study. SAlb and the electrophoretic pattern of serum proteins
      were determined immediately before PD start, and after 6, 9, 12, 15, 18, 21, and
      24 months on PD. In each study period, clinical characteristics, adequacy
      parameters, protein catabolic rate (PNPNA: protein equivalent of non protein
      nitrogen appearance), and protein losses were determined. Patients were divided
      into two subgroups according to whether SAlb decreased less than 10%, or 10% or
      more, from baseline values after 24 months on PD. The main differences between
      the subgroups were investigated. RESULTS: Mean SAlb did not decrease
      significantly after 24 months on PD (from baseline 3.99 +/- 0.46 g/dL to 3.80 +/-
      0.54 g/dL), though percentage SAlb values did (58.36% +/- 5.58% vs 55.15% +/-
      5.42%, p < 0.01). A weak increase in alpha2-globulin was observed after 18 months
      on PD (from 10.62% +/- 2.53% to 12.96% +/- 2.51%, p = 0.001). Alpha-globulin
      showed a sustained increase from a mean baseline value of 3.51% +/- 1.09% to
      6.83% +/- 2.13% after 24 months (p < 0.0001). Seven patients had a reduction in
      SAlb greater than 10% after 24 months on PD. Kt/V urea and residual renal
      function tended to be lower in patients whose SAlb decreased. Mean PNPNA was
      significantly lower in patients who had a reduction in SAlb (0.76 +/- 0.12
      g/kg/day vs 0.96 +/- 0.12 g/kg/day, p < 0.0001). However, total protein loss was
      even greater in patients who had no SAlb reduction. CONCLUSIONS: After 24 months
      on PD, a mean reduction in SAlb of 10%-15% from baseline values should be
      expected only in those stable patients whose PNPNA is low.

PMID- 11216564
TI  - The role of lean body mass as a nutritional index in Chinese peritoneal dialysis
      patients--comparison of creatinine kinetics method and anthropometric method.
AB  - OBJECTIVE: To compare, in Chinese continuous ambulatory peritoneal dialysis
      (CAPD) patients, the creatinine kinetics method (LBM-CK) and the anthropometric
      method (LBM-AM) for determining lean body mass (LBM). DESIGN: Single-center cross
      sectional study. PATIENTS AND METHODS: We studied 151 unselected CAPD patients
      (78 males, 73 females). We calculated LBM-CK and LBM-AM using standard formulas.
      The results of the two methods were then compared by the Bland and Altman method.
      Dialysis adequacy and other nutritional indices, including total Kt/V, weekly
      creatinine clearance (CCr), residual glomerular filtration rate (GFR), protein
      nitrogen appearance (PNA), subjective global assessment (SGA), and serum albumin,
      were measured simultaneously. RESULTS: The mean age of the patients was 55.6 +/-
      12.2 years, and the mean duration of dialysis was 33.6 +/- 28.5 months. The mean
      body mass index (BMI) was 22.7 +/- 3.7. The average LBM-AM was 43.6 +/- 8.0 kg;
      the average LBM-CK was 33.0 +/- 9.3 kg. The difference between the calculated LBM
      AM and LBM-CK was 10.7 kg, with LBM-AM always giving a higher value; the limits
      of agreement were -5.8 kg and 27.1 kg. The difference between the two measures
      correlated with residual GFR (Pearson r = 0.629, p < 0.001). After normalizing
      for desired body weight, LBM-AM was only modestly correlated with serum albumin
      level. No correlations were found between overall SGA score or normalized protein
      nitrogen appearance (nPNA) and LBM-AM or LBM-CK. CONCLUSIONS: In Chinese patients
      at least, a substantial discrepancy exists between LBM-AM and LBM-CK. The
      difference is especially marked in patients with significant residual renal
      function. The optimal method for determining LBM remains obscure in Chinese CAPD
      patients. Moreover, LBM correlated poorly with other nutritional indices.
      Multiple parameters should be taken into consideration in an assessment of
      nutritional status of CAPD patients.

PMID- 11216565
TI  - Is obesity a favorable prognostic factor in peritoneal dialysis patients?
AB  - OBJECTIVE: To determine the influence of an elevated body mass index (BMI) on
      cardiovascular outcomes and survival in peritoneal dialysis (PD) patients.
      DESIGN: Prospective, observational study of a prevalent PD cohort at a single
      center. SETTING: Tertiary care institutional dialysis center. PATIENTS: The study
      included all patients with a BMI of at least 20 who had been receiving PD for at
      least 1 month as of 31 January 1996 (n = 43). Patients were classified as
      overweight [BMI > 27.5; mean +/- standard error of mean (SEM): 32.1 +/- 1.1; n =
      14] or normal weight (BMI 20-27.5; mean +/- SEM: 23.8 +/- 0.4; n = 29). OUTCOME
      MEASURES: Patient survival and adverse cardiovascular events (myocardial
      infarction, congestive cardiac failure, cerebrovascular accident, and symptomatic
      peripheral vascular disease) were recorded over a 3-year period. RESULTS: At
      baseline, no significant differences were seen between the groups in clinical,
      biochemical, nutritional, or echocardiographic parameters, except for a lower
      dietary protein intake (0.97 +/- 0.10 g/kg/day vs 1.44 +/- 0.10 g/kg/day, p =
      0.004) and a higher proportion of well-nourished patients by subjective global
      assessment (100% vs 72%, p < 0.05) in the overweight group. After 3 years of
      follow-up, 29% of overweight patients and 69% of normal-weight patients had died
      (p < 0.05). Using a Cox proportional hazards model, a BMI greater than 27.5 was
      shown to be an independent positive predictor of patient survival, with an
      adjusted hazard ratio (HR) of 0.09 [95% confidence interval (CI): 0.01-0.85; p <
      0.05]. However, being overweight did not significantly influence myocardial
      infarction-free survival (adjusted HR: 0.33; 95% CI: 0.07-1.48; p = 0.15) or
      combined adverse cardiovascular event-free survival (adjusted HR: 0.67; 95% CI:
      0.23-1.93; p = 0.46). CONCLUSIONS: Obesity conferred a significant survival
      advantage in our PD population. Obese patients should therefore not be
      discouraged from receiving PD purely on the basis of BMI. Moreover, maintaining a
      higher-than-average BMI to preserve "nutritional reserve" may help to reduce the
      mortality and morbidity rates associated with PD.

PMID- 11216566
TI  - Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in peritoneal
      dialysis patients.
AB  - OBJECTIVE: The aim of the present study was to examine the association between
      infection with Chlamydia pneumoniae and symptomatic atherosclerosis in peritoneal
      dialysis (PD) patients. DESIGN: Cross-sectional study. SETTING: Peritoneal
      Dialysis Unit of Kingston General Hospital. PATIENTS: Fifty-five prevalent PD
      patients. OUTCOME MEASURES: (1) Infection with C. pneumoniae diagnosed by
      detection of DNA in peripheral blood mononuclear cells (PBMCs) using polymerase
      chain reaction. (2) Symptomatic atherosclerosis involving the coronary, cerebral,
      or peripheral circulation. RESULTS: The DNA of C. pneumoniae was detected in
      PBMCs in 33 patients (60.0%). Atherosclerosis was present in 16 of 33 (48%) PBMC
      C. pneumoniae DNA-positive patients, and in 10 of 22 (45%) PBMC C. pneumoniae DNA
      negative patients (p = 0.83). Using multiple logistic regression and controlling
      for a number of known cardiovascular risk factors, PBMC C. pneumoniae DNA status
      was not predictive of atherosclerosis. The only significant independent
      predictors of atherosclerosis were diabetes and age. CONCLUSIONS: In prevalent PD
      patients, a high prevalence of symptomatic atherosclerosis and of Chlamydia
      pneumoniae DNA in PBMCs were seen; however, the results of the present study do
      not support the presence of an association between infection with C. pneumoniae
      and atherosclerosis.

PMID- 11216567
TI  - Evaluation of several saccharides as osmotic agent for peritoneal dialysate.
AB  - OBJECTIVE: The carbonyl group of glucose reacts non-enzymatically with the amino
      group of protein to form advanced glycosylation end-products (AGEs). AGEs are
      found in the peritoneum of continuous ambulatory peritoneal dialysis patients,
      and this AGE formation is suspected to be one of the causes of impaired
      peritoneal function. In order to control AGE formation in the peritoneum, AGE
      formation and ultrafiltration in rats were examined with peritoneal dialysates
      using as osmotic agents saccharides that lack a carbonyl group, the saccharic
      acid lactobionate [molecular weight (MW) 358.30], the sugar alcohol maltitol (MW
      344.32), and the nonreducing sugar nistose (MW 666.58). DESIGN: Bovine serum
      albumin (BSA) (25 mg/mL) was incubated with 18, 36, and 72 mg/mL maltitol,
      lactobionate, nistose, and glucose at 37 degrees C. After 3 or 6 weeks, amounts
      of furosine and N-(carboxymethyl) lysine were measured. A 20-mL intraperitoneal
      injection of a lactate-based dialysate (osmotic pressure 388 mOsm/kg) containing
      4.34% maltitol, 4.52% lactobionate, or 8.4% nistose was given to Sprague-Dawley
      rats and, after 2, 4, or 6 hours, the quantity of effluent and levels of urea
      nitrogen and creatinine in the effluent and in serum were measured. RESULTS: No
      increases in furosine or N-(carboxymethyl) lysine were seen with maltitol,
      lactobionate, or nistose after 3 and 6 weeks of incubation with BSA; AGE
      formation was not observed. In the study in rats, the quantity of abdominal fluid
      after a 6-hour dwell was nistose > lactobionate > maltitol > glucose. No
      differences in dialysate-to-plasma ratios for urea nitrogen or creatinine were
      seen in any group. CONCLUSIONS: AGE formation in peritoneal tissue might be
      controlled by using saccharides with a modified carbonyl group as osmotic agents
      for peritoneal dialysates. Nistose is considered to yield the most efficient
      dialysis.

PMID- 11216568
TI  - A comparison between 1.36% and 3.86% glucose dialysis solution for the assessment
      of peritoneal membrane function.
AB  - OBJECTIVE: To assess peritoneal membrane function with respect to fluid
      transport, parameters of low molecular weight solute transport, and estimations
      of the function of peritoneal water channels, comparing the results from a
      1.36%/1.5% glucose solution with those from a 3.86%/4.25% solution in
      standardized peritoneal function tests. DESIGN: The study was performed in 40
      stable continuous ambulatory peritoneal dialysis (CAPD) patients [median age 50
      years (range: 22-74 years); duration of CAPD 9 months (range: 2-45 months)] who
      underwent two standard peritoneal permeability analyses (SPAs) within 1 month.
      One SPA used 1.36% glucose; the other, 3.86% glucose. Mass transfer area
      coefficients (MTACs) and dialysate-to-plasma (D/P) ratios were compared for the
      two solutions. Also, two different methods of estimating aquaporin-mediated water
      transport were compared: the sieving of sodium (3.86% glucose) and the difference
      in net ultrafiltration (deltaNUF), calculated as NUF 3.86% SPA - NUF 1.36% SPA.
      RESULTS: Median NUF in the 1.36% glucose SPA was -46 mL (range: -582 mL to 238
      mL); in the 3.86% SPA, it was 554 mL (range: -274 mL to 1126 mL). The median
      difference in NUF for the two SPAs was 597 mL (range: 90-1320 mL). No difference
      between the two solutions was seen for the MTAC of creatinine (11.4 mL/min for
      1.36% vs 12.0 mL/min for 3.86%) and absorption of glucose (64% vs 65%,
      respectively). Also, D/P creatinine was not different: 0.77 (1.36%) and 0.78
      (3.86%). However, the ratio of dialysate glucose at 240 minutes and at 0 minutes
      (Dt/D0) was 0.34 (1.36%) and 0.24 (3.86%), p < 0.01. Values of D/P creatinine
      from the two glucose solutions were strongly correlated. The intra-individual
      differences were small and showed a random distribution. Patient transport
      category was minimally influenced by the tonicity of the dialysate. The minimum
      D/P Na+ (3.86%) was 0.884, and it was reached after 60 minutes. After correction
      for Na+ diffusion, D/P Na+ decreased to 0.849 after 120 minutes. The correlation
      coefficient between the diffusion-corrected D/P Na+ and the deltaNUF was 0.49, p
      < 0.01. An inverse relationship was present between MTAC creatinine and D/P Na+
      (p < 0.01) This correlation can be explained by the rapid disappearance of the
      osmotic gradient owing to a large vascular surface area. Such a correlation was
      not present between MTAC creatinine and deltaNUF. CONCLUSIONS: We conclude that a
      standardized 4-hour peritoneal permeability test using 3.86%/4.25% glucose is the
      preferred method to assess peritoneal membrane function, including aquaporin
      mediated water transport. The D/P Na+ after correction for Na+ diffusion is
      probably more useful for the assessment of aquaporin-mediated water transport
      than is deltaNUF obtained with 3.86%/4.25% and 1.36%/1.5% glucose-based dialysis
      solutions.

PMID- 11216570
TI  - Characteristics of peripheral and peritoneal white blood cells in children with
      chronic renal failure, dialyzed or not.
AB  - OBJECTIVE: To explore further the mechanisms leading to immune deficiency in
      chronic renal failure and the role of dialysis treatment in these mechanisms.
      DESIGN: Cross-sectional and longitudinal analysis. PATIENTS: We studied 39
      children treated with peritoneal dialysis (PD), 23 children treated with
      hemodialysis (HD), 33 children not yet dialyzed [chronic renal failure (CRF)],
      and 27 healthy children. Peritoneal cells were also obtained from PD children for
      analysis. METHODS: White blood cells (WBCs) were isolated from blood and
      peritoneal dialysis effluent by centrifugation. The number of CD2+, CD4+, and
      CD8+ T cells, B cells, and natural killer cells were measured by flow cytometry.
      RESULTS: The total peripheral blood lymphocyte count was lower in PD children
      (2.6 x 10(9)/L), HD children (2.1 x 10(9)/L), and CRF children (2.0 x 10(9)/L)
      compared with healthy children (3.1 x 10(9)/L, p < 0.05). The B lymphocyte count
      was also lower in PD children (0.34 x 10(9)/L), HD children (0.22 x 10(9)/L), and
      CRF children (0.33 x 10(9)/L) compared with healthy children (0.52 x 10(9)/L, p <
      0.01). Numbers of CD4+ T cells were not different, but numbers of CD8+ T cells
      were lower in PD children (0.56 x 10(9)/L), HD children (0.63 x 10(9)/L), and CRF
      children (0.53 x 10(9)/L) compared with healthy children (0.77 x 10(9)/L, p <
      0.05). The count of natural killer cells was lower in PD children (0.21 x
      10(9)/L), HD children (0.17 x 10(9)/L), and CRF children (0.18 x 10(9)/L)
      compared with healthy children (0.50 x 10(9)/L, p < 0.0001). The CD4/CD8 ratio of
      lymphocytes in peritoneal effluent was 0.8 versus 1.9 in peripheral blood (p <
      0.001). The CD2/CD19 ratio was not different. The cell subsets remained stable
      during the first year of PD treatment. The CD2/CD19 ratio in peritoneal effluent
      was higher in children with a peritonitis incidence > or = 1 per year.
      CONCLUSIONS: The reduced numbers of B lymphocytes, CD8+ T cells, and natural
      killer cells found in CRF children, dialyzed or not, may favor the frequent
      occurrence of infections.

PMID- 11216569
TI  - Icodextrin effluent leads to a greater proliferation than glucose effluent of
      human mesothelial cells studied ex vivo.
AB  - OBJECTIVE: To compare the effect of glucose (Glu) and icodextrin (Ico) dialysate
      on in vitro culture of mesothelial cells (MC) from peritoneal dialysis (PD)
      patients. DESIGN: Prospective, controlled comparative study on the effects of two
      PD solutions. SETTING: A tertiary-care public university hospital. PATIENTS:
      Sixteen PD patients regularly using Glu dialysate were asked to collect an 8-hour
      dwell peritoneal effluent on 2 different days, with an interval shorter than 7
      days. In the first collection, 2.27% Glu solution and in the last, 7.5% Ico
      solution was infused. Human MC were isolated from the nocturnal peritoneal
      effluent bags and grown ex vivo. MAIN OUTCOME MEASURES: Mesothelial cell
      proliferative capacity ex vivo. RESULTS: Mesothelial cells were present in all
      patient dialysates except that of a single patient's Glu dialysate. The number of
      MC drained was similar with both solutions. After the initial culture reached
      confluence, MC were identified in 14 and 12 patients receiving Ico and Glu,
      respectively. However, in 1 patient using Ico and in 2 using Glu, the MC count at
      this stage was so low that further subculture could not be performed. Cells from
      Ico-derived solutions exhibited a higher degree of proliferation than cells from
      Glu-derived solutions. The morphology of MC was also different. Cells from
      drained effluent were typical in 11 patients using Glu solution in contrast with
      14 patients using Ico. At confluence, the percentages of typical appearance were
      50% and 92.9% (p < 0.05) in Glu and Ico respectively. CONCLUSIONS: Mesothelial
      cells taken from icodextrin effluent show a greater proliferation ex vivo than
      those taken from glucose effluent.

PMID- 11216571
TI  - A laparoscopic approach under local anesthesia for peritoneal dialysis access.
AB  - OBJECTIVE: Presented herein is a technical description of a time-proven
      laparoscopic approach to establishing successful long-term peritoneal dialysis
      access. DESIGN: Using a two-port technique, the peritoneal catheter is inserted
      through a paramedian port site while continuously monitoring the implant
      procedure with a laparoscope from a second port location. A long rectus sheath
      tunnel created with a nontrocar port device keeps the dialysis catheter oriented
      toward the pelvis. Helium abdominal insufflation enables full surgical
      laparoscopy under local anesthesia. Validation of the effectiveness of the
      technique is made by comparison to previous implantation experience using an open
      dissection method. PATIENTS: Laparoscopic implantation of peritoneal catheters
      was performed in 150 patients, and placement by open dissection was accomplished
      in 63 patients. MAIN OUTCOME MEASURE: The incidence of complications and revision
      free catheter survival between implantation methods were compared. RESULTS:
      Catheters implanted laparoscopically had a significantly lower incidence of flow
      dysfunction (p < 0.05) and better survival (p < 0.001) than those placed by open
      dissection. CONCLUSIONS: Compared to implantation by open dissection, the
      laparoscopic approach provides the patient reduced perioperative discomfort. The
      procedure can be performed safely with the patient under local anesthesia on an
      ambulatory basis. Laparoscopic implantation significantly reduces the incidence
      of catheter flow dysfunction and permits simultaneous identification and
      correction of other problems that could complicate dialysis therapy.

PMID- 11216572
TI  - Peritoneal homocysteine clearance is inefficient in peritoneal dialysis patients.
AB  - OBJECTIVES: To investigate the degree and the determinants of peritoneal
      homocysteine (Hcy) clearance and to compare measured Hcy clearance with the Hcy
      clearance predicted based on molecular weight (MW). DESIGN: Cross-sectional
      observational analysis. SETTING: Tertiary care institutional dialysis center.
      PATIENTS: Sixty-five stable peritoneal dialysis (PD) patients. OUTCOME MEASURES:
      Fasting blood and 24-hour pooled dialysate effluents were collected for
      determination of peritoneal clearances of Hcy (CpHcy), urea (CpUr), and
      creatinine (CpCr). The dialysate-to-plasma creatinine ratio at 4 hours (D/P Cr 4
      h) and levels of red cell folate, B12, ferritin, and C-reactive protein (CRP)
      were measured concurrently. Observed CpHcy was compared with predicted clearance,
      based on Hcy plasma protein binding and the relative molecular weights of Hcy,
      urea, and creatinine. RESULTS: Plasma concentrations of Hcy averaged 24.6 +/- 1.1
      micromol/L and were elevated above the upper limit of normal in 59 (91%)
      patients. The mean dialysate concentration of Hcy was 2.9 +/- 0.3 micromol/L,
      equating to a daily peritoneal elimination of 34.6 +/- 3.6 micromol. Observed
      CpHcy was closely approximated by predicted CpHcy (8.7 +/- 0.6 L/week/1.73 m2 vs
      9.0 +/- 0.3 L/week/1.73 m2 respectively, p = 0.55). Patients maintained on
      automated PD (n = 5) had a CpHcy similar to that of patients treated with
      continuous ambulatory peritoneal dialysis (8.9 +/- 1.0 L/week/1.73 m2 vs 8.7 +/-
      0.6 L/week/1.73 m2, p = 0.92). The CpHcy was significantly correlated with C
      reactive protein (CRP), D/P creatinine, CpUr, CpCr, and peritoneal protein loss,
      but not with plasma Hcy, albumin, B12, ferritin, age, dialysis duration,
      peritonitis episodes, or daily dialysate effluent volume. By multivariate
      analysis, the only variables that remained significant independent predictors of
      CpHcy were CRP and D/P Cr 4 h. High and high-average transporters had a higher
      CpHcy than low and low-average transporters (9.7 +/- 0.8 L/week/1.73 m2 vs 7.0 +/
      0.7 L/week/1.73 m2, p < 0.05), despite comparably elevated plasma Hcy
      concentrations [25.2 +/- 1.5 micromol/L vs 23.4 +/- 1.6 micromol/L, p =
      nonsignificant (NS)]. CONCLUSIONS: Elevated plasma concentrations of Hcy are not
      efficiently reduced by PD. The relatively low peritoneal clearance of Hcy is
      largely accounted for by a high degree of plasma protein binding and is
      significantly influenced by peritoneal membrane permeability.

PMID- 11216573
TI  - Human peritoneal mesothelial cells produce nitric oxide: induction by cytokines.
AB  - OBJECTIVE: To investigate the induction of nitric oxide synthase type II (iNOS)
      in human peritoneal mesothelial cells (HPMC) using cytokines and bacterial
      lipopolysaccharide (LPS). DESIGN: Confluent monolayers of HPMC were exposed to
      cytokines [tumor necrosis factor alpha (TNFalpha), interleukin-1 beta (IL-1beta),
      interferon gamma (IFNgamma)] or LPS, individually or in various double and triple
      combinations, for 24-72 hours. Concentrations of nitrate and nitrite in the media
      were quantified using the Griess reaction and used as indirect indices of nitric
      oxide (NO) production. The expression of iNOS was assessed using reverse
      transcriptase-polymerase chain reaction (RT-PCR) and Western blot. RESULTS:
      Neither single cytokines nor LPS was able to induce iNOS mRNA or NO production.
      Both double combinations of TNFalpha + IFNgamma and IL-1beta + IFNgamma were able
      to induce iNOS mRNA expression, but only TNFalpha + IFNgamma induced significant
      NO production. The triple combination of TNFalpha + IFNgamma + IL-1beta induced
      even more NO production than TNFalpha + IFNgamma. There was no constitutive NO
      synthase type III (eNOS) expression in HPMC. CONCLUSIONS: Certain combinations of
      cytokines could stimulate cultured HPMC to produce NO, and HPMC might be a source
      of intraperitoneal NO production during peritonitis.

PMID- 11216575
TI  - The effect of hemodialysis during break-in period on residual renal function in
      CAPD patients.

PMID- 11216574
TI  - Thrombin suppresses matrix metalloproteinase 2 activity and increases tissue
      inhibitor of metalloproteinase 1 synthesis in cultured human peritoneal
      mesothelial cells.
AB  - OBJECTIVE: Recently, high levels of intraperitoneally generated thrombin were
      found in the effluent of patients treated with continuous ambulatory peritoneal
      dialysis (CAPD). The aim of the present study was to investigate in human
      peritoneal mesothelial cells (HMCs) the effect of thrombin on the activity and
      synthesis of matrix metalloproteinases (MMPs), which regulate the degradation of
      basement membrane collagen. METHODS: Cultured HMCs were isolated from omental
      tissue and used at confluence for the experiments. Conditioned media were
      obtained by incubating cells with serum-free M199 containing the relevant doses
      of thrombin. Activity of MMP-2 and MMP-9 were determined by an activity assay
      system. The antigen levels of MMPs and of the specific tissue inhibitor of
      metalloproteinases 1 (TIMP-1) were measured by ELISA. Northern blot analysis was
      applied to analyze mRNA expression of MMP-2 and TIMP-1. RESULTS: Incubation of
      HMCs with increasing doses of thrombin resulted in a concentration- and time
      dependent suppression of MMP-2 activity. No changes in MMP-9 activity were seen.
      After a 48-hour stimulation period with thrombin (5 U/mL), MMP-2 activity
      decreased to 53% of that seen in control conditions. Antigen measurements
      revealed that this decrease was paralleled by a slight reduction in MMP-2 levels,
      which became significant at a thrombin dose of 5 U/mL [50.65 +/- 7.5 ng/10(5)
      cells (48 hours, 5 U/mL) vs 64.6 +/- 10.1 ng/10(5) cells (control)]. Under the
      same conditions, TIMP-1 levels were considerably increased [3.9 +/- 0.46
      microg/10(5) cells (48 hours, 5 U/mL) vs 1.2 +/- 0.14 microg/10(5) cells
      (control)]. Hirudin (10 U/mL) completely inhibited the thrombin-induced effects
      on MMP-2 and TIMP-1 synthesis. These results were also reflected by Northern blot
      hybridization, where a slight decrease in MMP-2 and an increase in TIMP-1 mRNA
      expression were observed in response to thrombin. CONCLUSIONS: Our results
      suggest that high thrombin levels suppress MMP-2 activity through decreased MMP-2
      and increased TIMP-1 synthesis. Thus, thrombin may promote the accumulation of
      basement membrane collagen. In addition to fibrin formation, this mechanism may
      represent a further contribution by thrombin to peritoneal thickening during
      CAPD.

PMID- 11216576
TI  - Pruritus and anemia in a patient on peritoneal dialysis--pitfalls in diagnosis
      for common symptoms.

PMID- 11216577
TI  - Gastrointestinal transit of an indigestible solid in patients on CAPD.

PMID- 11216578
TI  - Early postoperative complications of removal of Tenckhoff peritoneal dialysis
      catheter.

PMID- 11216579
TI  - Practical aspects of the addition of sodium bicarbonate to peritoneal dialysate.

PMID- 11216580
TI  - Campylobacter jejuni bacteremia, peritonitis, and exacerbation of chronic
      pancreatitis in a patient on CAPD: case report and literature review.

PMID- 11216581
TI  - Reduced 1,2-dicarbonyl compounds in bicarbonate/lactate-buffered peritoneal
      dialysis (PD) fluids and PD fluids based on glucose polymers or amino acids.

PMID- 11216583
TI  - Short-term efficacy of tacrolimus ointment in severe uremic pruritus.

PMID- 11216582
TI  - Spontaneous VEGF production by cultured peritoneal mesothelial cells from
      patients on peritoneal dialysis.

PMID- 11216584
TI  - Intensive continuous peritoneal dialysis as treatment of uremic pericarditis.

PMID- 11216585
TI  - Rate of decline in residual renal fuction is equal in CAPD and automated
      peritoneal dialysis patients.

PMID- 11216586
TI  - Endoluminal brush for clearing peritoneal dialysis catheter obstruction.

PMID- 11216588
TI  - Prolonged periodic intra-abdominal bleeding without serious consequences in a
      female patient on CAPD.

PMID- 11216587
TI  - Shigella sonnei peritonitis in a patient on CAPD.

PMID- 11216589
TI  - Tuberculin and anergy testing in CAPD patients.

PMID- 11216590
TI  - Uremic anorexia: a consequence of persistently high brain serotonin levels? The
      tryptophan/serotonin disorder hypothesis.
AB  - Anorexia is a frequent part of uremic syndrome, contributing to malnutrition in
      dialysis patients. Many factors have been suggested as responsible for uremic
      anorexia. In this paper we formulate a new hypothesis to explain the appetite
      disorders in dialysis patients: "the tryptophan/serotonin disorder hypothesis."
      We review current knowledge of normal hunger-satiety cycle control and the
      disorders described in uremic patients. There are four phases in food intake
      regulation: (1) the gastric phase, during which food induces satiety through
      gastric distention and satiety peptide release; (2) the post absorptive phase,
      during which circulating compounds, including glucose and amino acids, cause
      satiety by hepatic receptors via the vagus nerve; (3) the hepatic phase, during
      which adenosine triphosphate (ATP) concentration is the main stimulus inducing
      hunger or satiety, with cytokines inhibiting ATP production; and (4) the central
      phase, during which appetite is regulated through peripheral (circulating plasma
      substances and neurotransmitters) and brain stimuli. Brain serotonin is the final
      target for peripheral mechanisms controlling appetite. High brain serotonin
      levels and a lower serotonin/dopamine ratio cause anorexia. Plasma and brain
      amino acid concentrations are recognized factors involved in neurotransmitter
      synthesis and appetite control. Tryptophan is the substrate of serotonin
      synthesis. High plasma levels of anorectics such as tryptophan (plasma and
      brain), cholecystokinin, tumor necrosis factor alpha, interleukin-1, and leptin,
      and deficiencies of nitric oxide and neuropeptide Y have been described in
      uremia; all increase intracerebral serotonin. We suggest that brain serotonin
      hyperproduction due to a uremic-dependent excess of tryptophan may be the final
      common pathway involved in the genesis of uremic anorexia. Various methods of
      ameliorating anorexia by decreasing the central effects of serotonin are
      proposed.

PMID- 11216592
TI  - Literature: November-December 2000.

PMID- 11216591
TI  - Intermittent severe abdominal pain with normal peritoneal fluid findings on
      presentation.

PMID- 11216593
TI  - Fever in infants and children.

PMID- 11216594
TI  - What's new with enteroviral infections?

PMID- 11216596
TI  - Bibliography. Current world literature. Orthopedics.

PMID- 11216595
TI  - Bibliography. Current world literature. Hematology and oncology.

PMID- 11216597
TI  - Bibliography. Current world literature. Infectious diseases.

PMID- 11216598
TI  - The nasomaxillary retractor: a new method to prevent nasoendotracheal tube and
      vascular injury.

PMID- 11216599
TI  - The lateral osteotomy in rhinoplasty.

PMID- 11216600
TI  - Silastic implants for temporomandibular joint disorders.

PMID- 11216601
TI  - Breast reconstruction using a deepithelialized rectus abdominis musculocutaneous
      flap.
AB  - There are many methods for breast reconstruction. Using implants can achieve good
      results without conspicuous scarring, but this method has disadvantages, such as
      infection, exposure, and capsular contracture. The rectus abdominis
      musculocutaneous (RAM) flap has become a standard technique because of its safety
      and abundant volume, but its main problem is the lack of a color and texture
      match between the skin paddle and the skin around the flap. To overcome such
      shortcomings, the authors perform breast reconstruction using tissue expansion
      and a RAM flap. First a tissue expander is inserted superficially to the
      pectoralis major muscle at the time of or after mastectomy, and is expanded to a
      size larger than the contralateral breast. The expander is replaced with the
      deepithelialized RAM flap. Scar revision is performed if the expander is inflated
      satisfactorily. The authors used this technique in 11 patients and obtained good
      results without severe complications.

PMID- 11216602
TI  - Lower extremity salvage using a free flap associated with the Ilizarov method in
      patients with massive combat injuries.
AB  - Nine patients with massive combat injuries of the lower extremities were treated
      with Ilizarov bone transport in conjunction with free muscle flap coverage. In 4
      patients soft-tissue coverage was applied first, and distraction osteogenesis was
      initiated 4 to 6 weeks later. In 3 patients both methods were applied
      simultaneously, and in 2 patients soft-tissue coverage occurred after
      distraction. The bones healed well, and all flaps survived. The segmental defects
      ranged from 8 to 16.5 cm in greatest dimension. The total disability time from
      initial injury ranged from 16 to 25.5 months. In all patients, full union of the
      tibia was achieved, and no osteomyelitis occurred. However, in 2 patients the
      applied flap became depressed, necessitating another flap operation. Despite late
      treatment in all 9 patients, successful results were obtained. Maintaining the
      original length of the tibia and providing timely, definitive treatment offer the
      best outcome for repair of massive injuries of the lower extremities. The
      Ilizarov transport method, used in combination with muscle flap coverage,
      represents an effective therapy for repair of massive injury of the lower
      extremities.

PMID- 11216603
TI  - One-stage emergency treatment of open grade IIIB tibial shaft fractures with bone
      loss.
AB  - The purpose of this study was to report the authors' experience with emergency
      reconstruction of severe tibial shaft fractures. Five male patients were admitted
      to the emergency room with a grade IIIB open tibial shaft fracture with bone loss
      (average age, 33 years; age range, 18-65 years). Injuries were the result of
      motorcycle accidents (N = 2), pedestrian accidents (N = 1), gunshot wound (N =
      1), and paragliding fall (N = 1). Primary emergent one-stage management for all
      patients consisted of administration of antibiotics, debridement, stabilization
      by locked intramedullary nailing, bone grafting from the iliac crest, and
      coverage using free muscle flaps (four latissimus dorsi and one gracilis). The
      average follow-up was 21 months (range, 8 months-3.5 years). Partial weight
      bearing with no immobilization was started at 3 months, and full weight bearing
      began 5 months after trauma. No angular complications and no nonunions were
      observed. There was one case of superficial infection without osteitis. All
      fractures healed within 6 months in 4 patients and within 10 months in 1 patient.
      At the last follow-up examination, ankle and knee motion was normal and no pain
      was noted, except for 1 patient who had associated lesions (ankle motion reduced
      by 50%). Aggressive emergency management of severe open tibial fractures provides
      good results. It improves end results markedly, not only by reducing tissue loss
      from infection, but also reducing healing and rehabilitation times.

PMID- 11216604
TI  - Hand elevation: a new test for carpal tunnel syndrome.
AB  - Hand elevation can reproduce the symptoms of carpal tunnel syndrome. This
      phenomenon prompted the idea of developing a simple hand elevation test to
      diagnose carpal tunnel syndrome. A total of 200 hands in 118 patients diagnosed
      with carpal tunnel syndrome were tested prospectively from September 6, 1999, to
      February 3, 2000. Three provocative tests (hand elevation test, Phalen's test,
      and Tinel's test) were performed on each hand for both the experimental group
      (200 hands) and the control group (200 hands). McNemar chi-squared analysis was
      used to compare the sensitivity and specificity of the new hand elevation test
      with those of Phalen's test and Tinel's test. The sensitivity and specificity of
      the hand elevation test is 75.5% and 98.5% respectively. Phalen's test had 67.5%
      sensitivity and 91.0% specificity. Tinel's test had 67.5% sensitivity and 90.0%
      specificity. The difference in sensitivities between the hand elevation test and
      Phalen's test was significant (p = 0.05). No significant difference was found in
      the sensitivity between the hand elevation test and Tinel's test. The comparison
      of specificity of the hand elevation test and Phalen's test was significant (p =
      0.001). Significance was also observed in specificity between the hand elevation
      test and Tinel's test (p = 0.001). In this study, the sensitivity and specificity
      of the elevation test were higher than those of Phalen's test and Tinel's test.
      Statistical analysis confirms the eligibility of the hand elevation test as a
      useful, provocative test.

PMID- 11216605
TI  - Severe, traumatic soft-tissue loss in the antecubital fossa and proximal forearm
      associated with radial and/or median nerve palsy: nerve recovery after coverage
      with a pedicled latissimus dorsi muscle flap.
AB  - A total of 6 patients with complex, traumatic wounds of the antecubital fossa and
      proximal forearm were included in this study. All patients presented with radial
      and/or median nerve palsies in addition to their soft-tissue defect. Except for 1
      patient with a 15-cm defect of the radial nerve, all other traumatized nerves
      appeared in-continuity at the time of surgery. However, the nerve injury was
      severe enough to induce Wallerian degeneration (i.e., axonotmesis in traumatized
      nerves in-continuity). Three patients required brachial artery reconstruction
      with a reverse saphenous vein graft. Wound coverage was accomplished using a
      pedicled latissimus dorsi muscle flap, which was covered with a split-thickness
      skin graft. Successful reconstruction was obtained in all patients. Follow-up
      ranged from 2 to 6 years. The range of motion at the elbow and forearm was
      considered excellent in 5 patients and good in the remaining patient who had an
      intra-articular fracture. Motor recovery of traumatized nerves in-continuity was
      observed in all but 1 patient who had persistent partial anterior interosseous
      nerve palsy. The grip strength of the injured hand measured 70% to 85% of the
      contralateral uninjured hand. Median nerve sensory recovery was excellent in all
      patients. The versatility of the pedicled latissimus dorsi muscle flap for
      coverage of these complex wounds with traumatized neurovascular bundles around
      the elbow is discussed.

PMID- 11216606
TI  - Triangular mattress suture in abdominal diastasis to prevent epigastric bulging.
AB  - In the classic abdominoplasty, the treatment of large diastasis recti with simple
      or vertical mattress sutures may result in a nonaesthetic bulge. The surgeon may
      produce a craniocaudal bulge deformity by treating the flaccidity in the
      horizontal plane only, although it occurs in all directions. The authors describe
      the triangular mattress suture for the treatment of large diastasis recti, and
      demonstrate the mechanism involved in producing an epigastric bulge. Also
      presented is their clinical experience with 56 patients, with a 3-year follow-up,
      using this new plication method. The triangular mattress suture is a simple,
      quick, and effective way to correct abdominal diastasis and to avoid the
      epigastric bulge deformity with no added morbidity.

PMID- 11216607
TI  - A new surgical treatment of keloid: keloid core excision.
AB  - Keloids and hypertrophic scars result from excessive collagen deposition, the
      cause of which is not yet known. Unlike hypertrophic scars, keloids frequently
      persist at the site of injury, often recur after excision and always overgrow the
      boundaries of the original wound. There have been many trials to control keloids,
      but most of them have been unsuccessful. The authors propose a new surgical
      technique to treat keloids and name it keloid core extirpation. They excise the
      inner fibrous core from the keloid and cover the defect with a keloid rind flap,
      which is arterialized by the subcapsular vascular plexus. The authors treated 24
      keloids of the ear, trunk, face, and genitalia with keloid core excision. Four
      cases of partial rind flap congestion or necrosis occurred. Those patients who
      healed primarily after surgery showed no evidence of keloid recurrence as long as
      they were followed. The authors have found the keloid core extirpation technique
      to be excellent in preventing keloid recurrence, with no adjuvant therapy after
      surgery.

PMID- 11216608
TI  - Could ionizing radiation forestall cauliflower ear?
AB  - Repeated trauma to the ear very often results in "cauliflower ear." Many methods
      have been suggested to prevent an injured ear from demonstrating a
      cauliflowerlike deformity. The principles of treatment are evacuation of the
      hematoma, control of the reaccumulation of fluid, and maintenance of the
      cartilage contour. The authors studied the effect of ionizing radiation on
      deformed rabbit ears induced by repeated trauma. Twenty ears (10 rabbits) were
      used in the experiment. The animals were divided into four groups (control,
      preradiation, low dose, and high dose). Hematoma was produced by pounding the
      lateral side of the auricle 10 times with a 50-g weight at a height of 15 cm. The
      thickness of the injured and uninjured sites was measured, and histological
      analysis was performed for each group. The thickness of the ears of the
      irradiated groups was significantly less than the control group. The authors
      think that radiation treatment of repeatedly injured ears could prevent ear
      deformity, and could possibly be an adjunctive form of management of cauliflower
      ear in addition to hematoma evacuation and compression therapy.

PMID- 11216609
TI  - Dermal fibroblasts do not enhance the graft take rate of autologous, cultured
      keratinocyte suspension on full-thickness wounds in rats.
AB  - Dermal fibroblasts are known to play an important role in wound healing. In this
      study, cultured autologous keratinocyte suspension was applied with fibrin glue
      to the full-thickness wounds in rats (N = 20). Histological analysis on day 14
      showed regenerated epithelium in 10 wounds (50%). Keratinocytes were also
      premixed with allogeneic dermal fibroblasts in a ratio of 3:1 and 5:1 before
      application to other full-thickness wounds (N = 20) with fibrin glue.
      Regeneration of epithelium was observed in 10 (50%) and 9 (45%) wounds
      respectively. Acute inflammatory reaction and mild to moderate proliferation of
      fibroblasts in the subepithelial layer of the allogeneic fibroblasts were noted.
      The addition of dermal fibroblasts to keratinocytes/fibrin glue does not enhance
      the take rate of the cultured keratinocyte suspension.

PMID- 11216610
TI  - Botfly myiasis: case report and brief review.
AB  - The painful, boil-like lesion of furuncular myiasis is a result of the invasion
      of subcutaneous tissues by larvae of Dermatobia hominis, the human botfly. This
      arthropod is indigenous to Mexico, and Central and South America, and imported
      cases to the United States are increasing as travel to these regions continues to
      rise. There are several dozen reports of furuncular myiasis in the United States
      and Canadian literature since the initial description of this disease in 1920.
      None of the reports are in the surgical literature, which is surprising because
      the treatment of choice is surgical excision. Surgical removal sometimes results
      in damage to the larva with retention of larval fragments in the wound. The
      authors describe a patient and a novel approach that ensures removal of the
      intact larva and its surrounding burrow.

PMID- 11216611
TI  - Munchausen syndrome.
AB  - Munchausen syndrome is a rare condition in which the patient repeatedly seeks
      medical care for factitious illnesses. With this self-inflicted disease, the
      patients characteristically travel from one hospital to another, feigning acute,
      usually spectacular illnesses. The patients willingly submit themselves to
      extensive as well as invasive diagnostic and therapeutic procedures. Munchausen
      syndrome is a psychiatric disorder that requires psychiatric treatment.
      Reconstructive surgical procedures may be required to correct the acquired
      deformities. The difficulty in Munchausen syndrome lies essentially in early
      recognition of the psychiatric syndrome. Two exceptional cases are reported, and
      diagnosis and treatment are presented in the light of the current literature.

PMID- 11216612
TI  - Life-threatening bleeding in a facial fracture.
AB  - Life-threatening bleeding in facial fractures is considered rare, and most
      reports do not recommend a precise treatment guideline. Although various methods
      have been suggested, they are unpredictable in efficacy and may lead to
      irreversible shock. To avoid irreversible shock, early detection and correct,
      effective treatment are mandatory. The authors report a patient who presented
      with a complex midface fracture after falling on June 23, 1999. Life-threatening
      oronasal bleeding developed 1 hour after arriving at the emergency room. Initial
      nasal packing failed to stop the nasal bleeding. After resuscitation, the
      patient's vital signs were stable but bleeding persisted. Angiography showed
      diffuse extravasation of contrast medium over the territory of the right internal
      maxillary artery. Embolization was performed successfully to stop the bleeding.
      The authors review the literature regarding the incidence, diagnosis, and
      treatment of life-threatening facial fracture. In the literature, the lack of a
      precise definition leads to various results by various treatments. The authors
      have formulated a succinct treatment guideline. They favor angiographic
      embolization as the first choice of treatment when tight nasal and/or oral
      packing fails.

PMID- 11216613
TI  - Bilateral breast reconstruction with the latissimus dorsi musculocutaneous flap:
      the importance of patient positioning.
AB  - This report of 2 patients demonstrates that bilateral breast reconstruction with
      the latissimus dorsi musculocutaneous flap is facilitated by simultaneous
      elevation of the flaps in the prone position and simultaneous insetting of the
      flaps in the supine position. Operative time, blood loss, and position changes
      are minimized using this technique.

PMID- 11216614
TI  - Replantation and triple expansion of a three-piece total scalp avulsion: six-year
      follow-up.
AB  - Total scalp avulsion in three scalp segments is an unusual injury. The authors
      describe the replantation of three scalp segments in a 15-year-old girl.
      Replantation of the middle scalp piece was unsuccessful, but a satisfactory
      aesthetic and functional result was obtained by expanding the same replanted
      tissue three times. Every effort should be undertaken to save the avulsed scalp,
      even in a severely damaged situation.

PMID- 11216615
TI  - Hydatid cyst in the soft tissue of the face without any primary.
AB  - Hydatid cyst of the subcutaneous tissue is rare, and often presents as a simple
      soft-tissue mass. A case of primary subcutaneous hydatid disease arising in the
      malar region is reported. Histopathological examination revealed the
      characteristic findings, which are consistent with soft-tissue hydatid disease.
      There was no sign of echinococcal involvement of organs other than the soft
      tissue of the face. To the authors' knowledge, this is the first reported case of
      a primary subcutaneous hydatid cyst arising in the skin in the absence of
      internal involvement. The patient remains disease free 14 months after surgery.
      The authors present their clinical findings, diagnostic techniques, and treatment
      of the patient, and review the literature.

PMID- 11216616
TI  - Calcific myonecrosis: case report and review.
AB  - Although a rare diagnosis, with few reports in the literature, calcific
      myonecrosis is a diagnosis that must be entertained in individuals presenting
      with expanding masses in the muscle compartments occurring years after an initial
      injury. The authors report a previously healthy 66-year-old man with an expanding
      right lower extremity mass felt initially to be an abscess. Despite presumably
      appropriate antimicrobial therapy, the lesion continued to expand, causing pain
      and loss of function. The patient subsequently underwent extensive debridement
      and free muscle flap transfer with an excellent outcome. This patient serves to
      remind us that, although calcific myonecrosis is an uncommonly encountered
      condition, it must be maintained in the differential diagnosis of an expanding
      muscle compartment mass.

PMID- 11216617
TI  - Nasal angiocentric lymphoma: an entity that should be remembered.
AB  - After four nasal aesthetic functional surgeries in a period of 18 months, a 46
      year-old woman was evaluated who presented with moderate functional alteration,
      saddle-nose deformity, and total loss of the septal cartilage. Four months before
      presentation the patient sustained severe nasal trauma, resulting in depression
      of the nasal bridge without loss of function. Her problem was diagnosed initially
      as a consequence of an infected septal hematoma and loss of the septal cartilage.
      Based on this diagnosis, the patient was subjected, in an 18-month period, to
      four reconstructive surgeries by different specialists, without any improvement
      and with worsening of clinical presentation. During the authors' physical
      examination of the patient, she demonstrated marked nasal cutaneous retraction,
      atrophic nasal conchae with total loss of the septal cartilage, and a large loss
      of septal bone. Three nasal mucosa biopsies were acquired and the authors
      proceeded to carry out complete nasal reconstruction using external cranial table
      and rib cartilage. Histopathologically, a lesion was noted that was compatible
      with angiocentric lymphoma, for which treatment was administered according to
      this type of illness. The authors point out the importance of establishing an
      adequate diagnosis in the face of an apparently obvious clinical case, present
      cross-disciplinary treatment, and discuss the study protocol that should be used
      for this type of pathology. They present their reconstructive technique of the
      nasal structure using a combination of bone tissue and cartilage, the results,
      and the current state of the patient.

PMID- 11216618
TI  - The digital pulp as a presenting site of metastatic esophageal carcinoma.
AB  - An unusual skin lesion may be a primary skin cancer or a sign of internal
      malignancy. Metastatic lesions to the hand are rare. The authors describe a
      patient who presented with a nodule of the digital pulp. Workup, including X-ray
      films and biopsy, revealed a metastatic squamous cell carcinoma invading the
      distal phalanx. The primary site of the tumor was the esophagus. To the best of
      their knowledge, this is the second case described in the literature of a
      metastatic carcinoma of the esophagus presenting as a lesion of the digital pulp.

PMID- 11216619
TI  - Expanded applications for octyl-2-cyanoacrylate as a tissue adhesive.
AB  - The commercial introduction of octyl-2-cyanoacrylate as a medical-grade tissue
      adhesive was intended to be a rapid, painless, suture-free method for closure of
      simple lacerations and surgical wounds. The efficiency and therefore potential
      economic advantage of this material has led to further investigations of other
      possible indications. This glue has now been used in more than 100 different
      occasions for "off-label" applications including nailbed repair, skin graft
      fixation, temporary otoplasty, wound sealant, and other forms of wound closure.
      Complications are virtually nonexistent, and there has been no evidence of
      histotoxicity. The role of this material as an important reconstructive tool has
      not yet been delineated completely, but it appears to have no contraindications
      if used sensibly.

PMID- 11216620
TI  - A Cinderella story.

PMID- 11216621
TI  - Re: invited discussion. Role of three-dimensional computed tomography in the
      asessment of nasoorbitoethmoidal fractures.

PMID- 11216622
TI  - Reply: increased axonal regeneration through a biodegradable amnionic tube nerve
      conduit.

PMID- 11216623
TI  - Re: granular cell tumors in a child's finger.

PMID- 11216624
TI  - The legacy of Icarus in the 21st century: report of a case of aggressive
      submental basal cell carcinoma resulting from frequent use of a metallic
      ultraviolet reflector.

PMID- 11216625
TI  - Reversed skin island fascial pedicle flap of the posterior calf for distal
      defects of the leg and foot: an alternative for free flap transfer.

PMID- 11216626
TI  - An idea for umbilicus reconstruction.

PMID- 11216627
TI  - Subcutaneous emphysema of the eyelid and orbital cone after maxillary fracture.

PMID- 11216628
TI  - A ganglionic cyst in the axilla.

PMID- 11216629
TI  - Superficial scalp necrosis after replantation.

PMID- 11216630
TI  - A case of Merkel cell carcinoma with extension into the orbital cavity.

PMID- 11216631
TI  - The use of hyperbaric oxygen in treating meningococcemic skin necrosis.

PMID- 11216632
TI  - Ultrastructural anatomy of contracted capsules around textured implants in
      augmented breasts.
AB  - The development of a capsule around an implant is part of the physiological
      response to a foreign body. Capsular contracture is the most specific and
      frustrating complication of augmentation mammaplasty, and a lot of studies have
      been devoted to it. The aim of the current study is to examine the fine
      architecture of the contracted capsule around textured implants in humans. Eight
      capsules from augmented and contracted breasts with gel-filled, textured-surface
      silicone implants were studied after standard preparation for light and scanning
      electron microscopy, and after partial digestion in sodium hydroxide. Two
      capsules from contracted breasts around smooth implants and two noncontracted
      capsules around textured implants were prepared and studied in the same fashion
      as controls. A multilayer structure of the contracted capsule was seen, and the
      architecture of the various layers is described. The inner surface presents
      irregular craterlike depressions. The arrangement of collagen fibers varies in
      capsule layers. The effect of a textured-surface implant on the mechanism of
      capsule contraction based on the observed capsular architecture is that only part
      of the capsule is effective mechanically in producing a contracting force. A thin
      vascular layer was identified near the inner surface in contracted capsules
      around textured implants, and the authors' think that this layer is probably the
      key structure in the histological development and growth of the capsule.

PMID- 11216633
TI  - Focal adhesion kinases: interest in immunoendocrinology, developmental biology,
      and cancer.
AB  - The research field on focal adhesion-related kinases started a decade ago, but
      the term focal adhesion was introduced for the first time nearly 20 yr before.
      Since its identification, many studies have enlightened the role of the first
      intermediate of focal adhesion-related signals in a large number of biologic and
      physiologic processes. In this review, we try to integrate the most recent data
      about the known focal adhesion-related kinases, and we focus on three topics in
      which they deserve great interest: neuroendocrine-immune interactions,
      developmental biology, and proliferative diseases.

PMID- 11216634
TI  - Growth hormone: roles in male reproduction.
AB  - Growth hormone (GH), as its name suggests, is obligatory for growth and
      development. It is, however, also required for sexual differentiation and
      pubertal maturation and participates in gonadal steroidogenesis and
      gametogenesis. These roles are likely to reflect the endocrine actions of
      pituitary GH, directly at gonadal sites and indirectly via hepatic insulin-like
      growth factor-1. However, because GH is also produced in gonadal tissues, it may
      act in paracrine or autocrine ways to regulate local processes that are
      strategically regulated by pituitary GH. The concept that GH is a major regulator
      of male reproduction is the focus of this review.

PMID- 11216636
TI  - Large and asymptomatic pancreatic islet cell tumor in a patient with multiple
      endocrine neoplasia type 1.
AB  - The major phenotypes of multiple endocrine neoplasia type 1 (MEN 1) consist of
      three lesions characterized by hyperparathyroidism, pituitary tumors, and
      endocrine pancreatic tumors. The endocrine pancreatic tumors are a significant
      cause of disease-related mortality in MEN 1. Although symptomatic pancreatic
      tumors such as insulinoma and gastrinoma should be resected, the management of
      asymptomatic pancreatic tumors is not established. In asymptomatic pancreatic
      tumors, the most important factor is the propensity for malignant transformation
      of the tumors. Although there are no means to foresee it, the size of the
      pancreatic tumors might be predictive of malignant development in MEN 1. We
      report here a patient with MEN 1 who had a large asymptomatic pancreatic tumor.
      The patient (72-yr-old man) was diagnosed with primary hyperparathyroidism and
      underwent a total parathyroidectomy. Genetic examination showed a germline
      mutation of the MEN1 gene (E45G). Abdominal magnetic resonance imaging revealed a
      large (>6 cm) tumor with a heterogeneous pattern in the tail of the pancreas. No
      metastases of the tumor were evident. Serum levels of insulin, gastrin, and
      glucagon were normal, and the patient had no symptoms. Operative resection was
      performed, and microscopic examination revealed that the tumor was an islet cell
      tumor stained with multiple hormones. This is a case indicating that asymptomatic
      pancreatic tumors associated with MEN 1 might be indolent independent of their
      size.

PMID- 11216635
TI  - Localized calcium influx in pancreatic beta-cells: its significance for Ca2+
      dependent insulin secretion from the islets of Langerhans.
AB  - Ca2+ influx through voltage-dependent Ca2+ channels plays a crucial role in
      stimulus-secretion coupling in pancreatic islet beta-cells. Molecular and
      physiologic studies have identified multiple Ca2+ channel subtypes in rodent
      islets and insulin-secreting cell lines. The differential targeting of Ca2+
      channel subtypes to the vicinity of the insulin secretory apparatus is likely to
      account for their selective coupling to glucose-dependent insulin secretion. In
      this article, I review these studies. In addition, I discuss temporal and spatial
      aspects of Ca2+ signaling in beta-cells, the former involving the oscillatory
      activation of Ca2+ channels during glucose-induced electrical bursting, and the
      latter involving [Ca2+]i elevation in restricted microscopic "domains," as well
      as direct interactions between Ca2+ channels and secretory SNARE proteins.
      Finally, I review the evidence supporting a possible role for Ca2+ release from
      the endoplasmic reticulum in glucose-dependent insulin secretion, and evidence to
      support the existence of novel Ca2+ entry pathways. I also show that the beta
      cell has an elaborate and complex set of [Ca2+]i signaling mechanisms that are
      capable of generating diverse and extremely precise [Ca2+]i patterns. These
      signals, in turn, are exquisitely coupled in space and time to the beta-cell
      secretory machinery to produce the precise minute-to-minute control of insulin
      secretion necessary for body energy homeostasis.

PMID- 11216637
TI  - Regulation of adenohypophyseal pyroglutamyl aminopeptidase II activity by
      thyrotropin-releasing hormone and phorbol esters.
AB  - Thyrotropin-releasing hormone (TRH) is inactivated by a narrow specificity
      ectopeptidase, pyroglutamyl aminopeptidase II (PPII), in the proximity of target
      cells. In adenohypophysis, PPII is present on lactotrophs. Its activity is
      regulated by thyroid hormones and 17beta-estradiol. Studies with female rat
      adenohypophyseal cell cultures treated with 3,3',5'-triiodo-L-thyronine (T3)
      showed that hypothalamic/paracrine factors, including TRH, can also regulate PPII
      activity. Some of the transduction pathways involve protein kinase C (PKC) and
      cyclic adenosine monophosphate (cAMP). The purpose of this study was to determine
      whether T3 levels or gender of animals used to propagate the culture determine
      the effects of TRH or PKC. PPII activity was lower in cultures from male rats. In
      cultures from both sexes, T3 induced the activity. The percentages of decrease
      due to TRH or PKC were independent of T3 or gender; the percentage of decrease
      due to cAMP may also be independent of gender. These results suggest that T3 and
      hypothalamic/paracrine factors may independently control PPII activity in
      adenohypophysis, in either male or female animals.

PMID- 11216638
TI  - Diabetogenic role of insulin's counterregulatory hormones in the isletectomized,
      diabetic goby.
AB  - In an experimental model of insulin-dependent diabetes mellitus (IDDM) in the
      teleost fish, the goby Gillichthys mirabilis, an isletectomy procedure completely
      removes the pancreatic endocrine tissue without affecting the exocrine acini or
      other essential tissues. Interestingly, isletectomized (Ix) gobies do not exhibit
      a significant hyperglycemia until 10-15 d after this procedure, suggesting a lack
      of initial diabetogenic actions of a pancreatic factor(s). Administering
      exogenous glucagon in otherwise nonsymptomatic 7-d Ix gobies, however, induces a
      hyperglycemic state comparable to that in severely diabetic rats or gobies (after
      20 d post-Ix). The spontaneously arising hyperglycemia observed between 10 and
      15d post-Ix, on the other hand, is significantly correlated with increasing serum
      cortisol concentrations, with both exhibiting sustained elevated levels (approx
      23 mmol/L and >100 ng/mL, respectively) at 20- and 25-d post-Ix. Exogenous
      cortisol treatment also significantly induced hyperglycemia in nonsymptomatic, 7
      d Ix gobies. By contrast, growth hormone (GH) had no detectable diabetogenic
      effect in 7-d Ix gobies. Serum levels of ammonia, the principal nitrogenous waste
      in this species, were not affected by glucagon treatment but were reduced
      slightly by GH treatment (30% reduction; p < 0.05). Cortisol treatment, on the
      other hand, increased ammonia levels twofold, suggesting that the glucocorticoid
      induces a negative nitrogen balance. These results indicate that the
      counterregulatory hormones--glucagon and cortisol--are effective diabetogenic
      factors in the Ix goby, capable of driving metabolic imbalance in this model of
      IDDM.

PMID- 11216639
TI  - Effects of chronic dietary exposure to genistein, a phytoestrogen, during various
      stages of development on reproductive hormones and spermatogenesis in rats.
AB  - Developmental, hormonal, and gametogenic parameters were evaluated in male
      progeny following chronic dietary exposure to the phytoestrogen genistein. Twenty
      pregnant rats were fed a diet containing genistein (50 microg/d) from d 17 of
      gestation, and 12 were fed a control diet without genistein. Four litters each of
      control and genistein-fed rats were euthanized on d 21. The remaining pups were
      weaned on d 21 and only male rats were used in this study. On d 21, eight litters
      of genistein-fed rats were placed on control diet (gestational and lactational
      exposure alone [GL-G]), and the remaining eight continued on genistein diet
      (lifelong exposure group [LL-G]). These rats were euthanized (four litters/group)
      on d 70 or 130 of life. Serum testosterone, which was slightly reduced in
      genistein-exposed rats on d 21, did not differ among treatment and control groups
      on d 70 and 130. Serum luteinizing hormone of genistein-exposed rats was reduced
      on d 21 and 130, but not on d 70. Serum follicle-stimulating hormone did not vary
      among groups at any age. Treatment-related effects of dietary genistein were not
      observed on the weights of the testes of 21-d-old rats. Except for a slight
      decrease in testis weight of GL-G rats at 130 d, no significant effect of dietary
      exposure was observed on the weight of the testes in any other group. However,
      epididymal weights were significantly reduced in both treated groups at d 130.
      Testicular sperm count (on d 70 as well as 130) also was not affected in GL-G or
      LL-G rats. We conclude that gestational plus lactational exposure to genistein
      and subsequent dietary exposure to genistein have no adverse effects on
      gametogenic function in male rats.

PMID- 11216640
TI  - The N-terminal domain of the mineralocorticoid receptor modulates both
      mineralocorticoid receptor- and glucocorticoid receptor-mediated transactivation
      from Na/K ATPase beta1 target gene promoter.
AB  - Mineralocorticoid and glucocorticoid hormones activate the expression of the Na/K
      ATPase beta1 through direct binding of the mineralocorticoid receptor (MR) and
      glucocorticoid receptors (GR) to a mineralocorticoid- and glucocorticoid
      responsive element in the beta1 promoter region, but activation of the beta1
      promoter is inhibited by coexpression of both receptors. Here, using a series of
      mutated and chimeric receptors, we show that the N-terminal region of MR mediates
      an inhibitory effect on MR and GR activation from the beta1 promoter, in CV-1
      cells. Deletion of the N-terminal region of MR (1-603) enhanced MR activation
      four-fold. Activation by chimeric MR, in which the N-terminus of GR replaces the
      N-terminal region of MR, was threefold that of wild-type MR. In addition, whereas
      coexpression of wild-type MR and GR was inhibitory, coexpression of chimeric MR
      and wild-type GR was nearly equal to that of MR. By contrast, mutated GR lacking
      its N-terminal region (1-420) was less efficient than the wild type in activating
      this promoter. These results demonstrate that the N-terminal domains of MR and GR
      have opposite transactivation properties and that MR region 1-603 is indeed
      inhibitory for both MR- and GR-mediated regulation of the Na/K ATPase beta1 gene
      promoter.

PMID- 11216641
TI  - Autocrine role of gonadotropin-releasing hormone and its receptor in ovarian
      cancer cell growth.
AB  - We have recently proposed an autocrine role of gonadotropin-releasing hormone
      (GnRH) and its receptor (GnRH-R) in human ovarian surface epithelium. In the
      present study, we examine the presence and role of a GnRH/GnRH-R loop in
      epithelial ovarian cancer cells, OVCAR-3. A dose-dependent biphasic response in
      GnRH and GnRH-R mRNA levels were observed after treating with GnRH agonist
      [GnRHa, (D-Ala6)-GnRH], for 24 h. High concentrations of GnRHa (10(-9) M and 10(
      7)) decreased the GnRH and GnRH-R mRNA levels, whereas a low concentration (10(
      11) M) resulted in an upregulation of GnRH and GnRH-R genes expression.
      Cotretment with the competitive antagonist, antide, prevented the biphasic effect
      induced by GnRHa, confirming the specificity of the response. In addition, GnRHa
      treatment resulted in a time- and dose-dependent inhibition on OVCAR-3 cells
      growth. A significant inhibition of proliferation was detected as early as the d
      2 of treatment. Treatment with 10(-7) M GnRHa induced DNA fragmentation in OVCAR
      3 cells, suggesting that the GnRHa-induced antiproliferation in OVCAR-3 cells was
      mediated by apoptosis. Again, this effect was prevented by cotreatment of antide.
      Taken together, our findings strongly support the notion that GnRH acts as an
      autocrine/paracrine regulator of ovarian cancer cell proliferation.

PMID- 11216642
TI  - Parathyroid hormone and transforming growth factor-beta1 coregulate chondrocyte
      differentiation in vitro.
AB  - Parathyroid hormone (1-34) (PTH(1-34) and transforming growth factor-beta1 (TGF
      beta1) regulate chondrocyte proliferation, differentiation, and matrix synthesis.
      Both proteins mediate their effects in a dose- and time-dependent manner, and the
      effects are cell maturation specific. Moreover, similar signaling pathways are
      used, suggesting that there may be cross talk leading to coregulated cell
      response. To test this hypothesis, confluent cultures of rat costochondral
      resting zone and growth zone chondrocytes were treated with 0.22, 0.44, or 0.88
      ng/mL of rhTGF-beta1 for 24 h, followed by treatment with 10(-11) to 10(-8) M
      PTH(1-34) for 10 min or 24 h. [3H]-Thymidine incorporation, specific activity of
      alkaline phosphatase (AP), and [35S]-sulfate incorporation were measured. PTH(1
      34) had no effect on [3H]-thymidine incorporation by growth zone cells pretreated
      with 0.22 or 0.44 ng/mL of TGF-beta1, but in cultures treated with 0.88 ng/mL,
      PTH(1-34) caused a dose-dependent decrease that was maximal at the lowest
      concentration tested. By contrast, PTH(1-34) stimulated [3H]-thymidine
      incorporation by resting zone cells, and this effect was additive with the
      stimulation caused by 0.22 ng/mL of TGF-beta1. PTH(1-34) caused a synergistic
      increase in AP in growth zone cells treated with 0.44 or 0.88 ng/mL of TGF-beta1,
      but not in cells treated with 0.22 ng/mL of TGF-beta1. It had no effect on AP in
      resting zone cells pretreated with any concentration of TGF-beta1. PTH(1-34)
      increased [35S]-sulfate incorporation in growth zone and resting zone cell
      cultures treated with 0.22 ng/mL of TGF-beta1 to levels seen in cultures treated
      with 0.88 ng/mL of TGF-beta1 alone. These results support the hypothesis that
      PTH(1-34) and TGF-beta1 coregulate growth plate chondrocytes and that the effects
      are cell maturation dependent.

PMID- 11216644
TI  - Thyroid-associated ophthalmopathy in black South Africans with Graves' disease:
      relationship to serum antibodies reactive against eye muscle and orbital
      connective tissue autoantigens.
AB  - The prevalence of hyperthyroidism owing to Graves' disease is increasing among
      urban black South Africans. Thyroid-associated ophthalmopathy is often observed
      in this context, but its pathogenesis remains unclear. No close relationship has
      been noted between antiflavoprotein (Fp) antibodies or thyrotropin receptor
      antibodies and ocular involvement in black patients. We measured serum antibodies
      against eye muscle and orbital connective tissue antigens in black patients with
      Graves' disease, correlating them with eye signs. Of 11 patients with clinical
      ophthalmopathy, 2 (18%) had antibodies against collagen type XIII, 3 (27%)
      against flavine adenine dinucleotide (FAD), 1 (9%) against Fp, and 4 (35%)
      against G2s. Antibody prevalences in eight patients without clinical
      ophthalmopathy were 12.5% for collagen XIII, 12.5% for FAD, 25% for Fp and 0% for
      G2s. These differences were not statistically significant. None of the individual
      mean antibody levels were significantly different between the two subgroups of
      thyrotoxic patients. Serum antibody levels were negative in 10 black South
      African controls. In summary, eye muscle and orbital connective tissue antibodies
      were found in small proportions of patients with Graves' disease with no close
      relationship of any antibody to eye signs. Thus, a substantial proportion of
      black South Africans with overt clinical ophthalmopathy remains in whom currently
      availabe serologic tests are unhelpful for screening and laboratory confirmation.

PMID- 11216643
TI  - Neuroendocrine mechanisms for reproductive senescence in the female rat:
      gonadotropin-releasing hormone neurons.
AB  - Reproductive aging in female rats is characterized by profound alterations in the
      neuroendocrine axis. The preovulatory luteinizing hormone (LH) surge is
      attenuated, and preovulatory expression of the immediate early gene fos in
      gonadotropin-releasing hormone (GnRH) neurons is substantially reduced in middle
      aged compared with young rats. We tested the hypothesis that alterations in GnRH
      gene expression may be correlated with the attenuation of the LH surge and may be
      a possible mechanism involved in neuroendocrine senescent changes. Sprague-Dawley
      rats ages 4 to 5 mo (young), 12-14 mo (middle-aged), or 25 to 26 mo (old) were
      killed at 10:00 AM or 3:00 PM on proestrus, the day of the LH surge, or diestrus
      I in cycling rats, and on persistent estrus or persistent diestrus in acyclic
      rats. RNase protection assays of GnRH mRNA and GnRH primary transcript were
      performed. GnRH mRNA levels increased significantly with age, whereas GnRH
      primary transcript levels, an index of GnRH gene transcription, decreased in old
      compared to young and middle-aged rats. This latter result suggests that an age
      related change in GnRH mRNA levels occurs independently of a change in gene
      transcription, indicating a potential posttranscriptional mechanism. On
      proestrus, GnRH mRNA levels increased significantly from 10:00 AM to 3:00 PM in
      young rats. This was in contrast to proestrous middle-aged rats, in which this
      afternoon increase in GnRH mRNA levels was not observed. Thus, the normal
      afternoon increase in GnRH mRNA levels on proestrus is disrupted by middle age
      and may represent a substrate for the attenuation of the preovulatory GnRH/LH
      surge that occurs in rats of this age, prior to reproductive failure.

PMID- 11216646
TI  - Low frequency of rearrangement of TRK protooncogene in Chinese thyroid tumors.
AB  - The TRK protooncogene (NTRK1) encodes a cell-surface transmembrane tyrosine
      kinase (TK) acting as a receptor for nerve growth factor. Oncogenic potential in
      thyrocytes results from replacing the 5' portion by regulatory parts of other
      genes, leading to constitutive TK expression. In Italy, human papillary thyroid
      carcinoma (PTC) shows a frequent activation (50%) of the TK receptor genes NTRK1
      and RET. Both genes undergo oncogenic rearrangements by the same mechanism. We
      previously reported high frequency (6/11) of rearrangement of the RET
      protooncogene in Chinese PTCs. Wide differences in the frequency (0-10.9%) of the
      NTRK1 rearrangement in PTCs have been reported in different populations. To
      investigate the frequency of TRK protooncogene rearrangement in Chinese thyroid
      tumors, we performed reverse transcriptase polymerase chain reaction to amplify
      specific TRK rearrangement transcripts. We examined thyroid tumors of 40
      patients, including 14 papillary carcinomas, 4 follicular carcinomas, 1 Hurthle
      cell carcinoma, 1 insular carcinoma, and 20 nodular goiters. NF874 NIH3T3, NF723
      NIH3T3, NF861 NIH3T3, and NF881 NIH3T3 were used as controls for TRK-T3, TRK-T2,
      TRK-T1, and TRK, respectively. No known TRK protooncogene rearrangements were
      detected among the 40 thyroid tumors in our studies. We suggest that the TK
      receptor NTRK1 activation seems less important than RET activation in PTCs in the
      Chinese population.

PMID- 11216645
TI  - Stimulus-secretion coupling of arginine-induced insulin release: comparison
      between the cationic amino acid and its methyl ester.
AB  - The role currently ascribed to the accumulation of L-arginine in the pancreatic
      islet B-cell as a determinant of its insulinotropic action was reevaluated by
      comparing the uptake and the metabolic, ionic, electric, and secretory effects of
      the cationic amino acid with those of its more positively charged methyl ester in
      rat pancreatic islets. The response to L-arginine methyl ester differed from that
      evoked by the unesterified amino acid by a lower uptake and oxidation, lack of
      inhibitory action on D-glucose metabolism, more severe inhibition of the
      catabolism of endogenous L-glutamine, inhibition of 45Ca net uptake, decrease in
      both 86Rb outflow from prelabeled islets perifused at normal extracellular Ca2+
      concentration and 45Ca efflux from prelabeled islets perifused in the absence of
      extracellular Ca2+, and delayed and lesser insulinotropic action. These findings
      reinforce the view that the carrier-mediated entry of L-arginine into the islet B
      cells, with resulting depolarization of the plasma membrane, represents the
      essential mechanism for stimulation of insulin release by this cationic amino
      acid.

PMID- 11216648
TI  - Evidence for biosynthesis of preproinsulin in gut of rat.
AB  - Glucagon and other pancreatic peptides are made in the gut, but there is little
      evidence for the formation of insulin. The demonstration of insulin receptors on
      the mucosa of gut epithelium suggests that there may be an autocrine or paracrine
      role for insulin made in the gut. Such insulin may control cell division, the
      secretion of other peptides from the same or neighboring cells, or motility and
      absorption. To search for the ability of the gut to make insulin, sections of
      freshly excised segments of rat gut were treated with an antiserum against
      porcine insulin. Intracellular immunoreactivity appeared in glandular cells in
      the stomach and colon but not in the small intestine. Preproinsulin mRNA was
      detected in similar cells in the stomach and colon by in situ hybridization,
      using specific oligonucleotide probes. Rat preproinsulin 1 and 2 mRNAs were
      transcribed by reverse transcriptase to the corresponding cDNAs, which were then
      amplified by polymerase chain reaction, utilizing specific oligonucleotide
      primers. Restriction analysis confirmed the identity of rat preproinsulin 1 and 2
      mRNA in the colon and rat preproinsulin 1 mRNA in the stomach. Neither was found
      in the small intestine. Base sequences of the cDNAs were identical to the coding
      regions of pancreatic rat preproinsulin 1 and 2 messages. These observations are
      strong evidence for the synthesis of preproinsulin in the gut of the rat.

PMID- 11216647
TI  - Real-time detection of insulin-like growth factor-1 stimulation of the MAC-T
      bovine mammary epithelial cell line.
AB  - Binding of growth factors by cell-surface receptors is an essential means by
      which cells regulate normal tissue growth and differentiation. Exposure to growth
      factors is often transient, and our goal was to determine whether short-term
      exposure to insulin-like growth factor-1 (IGF-1) would lead to activation,
      assayed as cell proliferation, of mammary epithelial cells. The MAC-T cell line
      is an immortalized bovine mammary epithelial cell line, chosen as our model
      mammary cell line because of its known sensitivity to IGF-1. Using the Cytosensor
      Microphysiometer System, a biosensor capable of measuring extracellular
      acidification, we were able to measure activation of the cells owing to IGF-1
      addition in real time and found that peak acidification occurred in only 14 min.
      We show that this rapid response to IGF-1 is dose dependent and specific for IGF
      1. A significant increase in [3H]thymidine incorporation by cells after a similar
      short-term exposure to IGF-1 suggests that the measured increase in extracellular
      acidification following IGF-1 addition is physiologically relevant. This
      technology offers a new, novel, and rapid means for the study of IGF-1 activity,
      as well as the screening of IGF-1 inhibitors, in mammary epithelial cells.

PMID- 11216649
TI  - A follicle-stimulating hormone receptor ecto-domain epitope that is a target for
      receptor immunoneutralization yet does not affect ligand contact and activation.
AB  - The follicle-stimulating hormone receptor (FSHR) large extracellular domain
      suggests that interaction of ligand with receptor is likely to be complex.
      Residues 265-296 of the FSHR are part of a sequence primarily nonhomologous with
      other glycoprotein hormone receptors. A reasonable hypothesis is that this
      sequence of the FSHR plays a role in binding FSH. Flow cytometry studies of this
      region revealed that antibody X179 against peptide R265-S296 binds to human FSHR
      expressed by CHO cells and can be competed against by preincubating the cells
      with hFSH. These results suggested that the region corresponding to residues 265
      296 in the extracellular domain of the FSHR is involved in binding to hormone. To
      test this hypothesis 10 scanning alanine mutants of rFSHR at the 265-296 epitope
      were generated, and the binding characteristics of these mutants were studied.
      Their affinity constants for 125I-hFSH did not deviate greatly from that of wild
      type FSHR, in which some mutants exhibited an approximately two- to threefold
      reduction in Ka compared to wild-type receptor, and no mutation abolished signal
      transduction. These results lead to rejection of the hypothesis that this region
      contains residues critical for conveying hormone specificity and receptor
      dependent hormone action.

PMID- 11216651
TI  - Progesterone together with estrogen attenuates homologous upregulation of
      gonadotropin-releasing hormone receptor mRNA in primary cultured rat pituitary
      cells.
AB  - In a previous study, we clearly demonstrated that an application of gonadotropin
      releasing hormone (GnRH) to cultured rat pituitary cells increased the expression
      of GnRH receptor (GnRH-R) mRNA through transcriptional activation of GnRH-R gene
      rather than suppression of the turnover rate of GnRH-R mRNA. Along with GnRH,
      gonadal steroids seem to be an important regulator for GnRH-R expression in the
      pituitary gland. Recent in vivo studies reported that an application of gonadal
      steroids to gonadectomized animals modulated GnRH-R mRNA expression in the
      pituitary gland. However, it has not been clearly understood whether steroids may
      act directly at the pituitary or indirectly via modulation of hypothalamic GnRH
      release. Therefore, we assessed the effects of estrogen and progesterone on GnRH
      R mRNA expression in primary cultured female rat pituitary cells. Neither
      estradiol nor progesterone modulates the basal expression of GnRH-R mRNA in
      primary cultured pituitary cells. When cultured pituitary cells were exposed to
      different doses of estradiol in combination with GnRH (0.2 nM), the GnRH
      stimulated increment of GnRH-R mRNA expression was not significantly changed by
      estradiol at any given doses. However, when different doses of progesterone were
      added to primary cultured pituitary cells in combination with GnRH (0.2 nM), GnRH
      induced increases in GnRH-R mRNA levels were reduced in a dose-related manner,
      showing a significant reduction at 100 nM progesterone. Furthermore, the addition
      of estradiol reinforced the suppressive effect of progesterone on the homologous
      upregulation of GnRH-R mRNA expression. Collectively, our results clearly
      demonstrated that progesterone directly attenuates the homologous upregulation of
      GnRH-R mRNA expression at the pituitary level, and that estradiol potentiates the
      effect of progesterone.

PMID- 11216650
TI  - Stimulation by interleukin-6 and inhibition by tumor necrosis factor of cortisol
      release from bovine adrenal zona fasciculata cells through their receptors.
AB  - Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) are synthesized
      and released from adrenal cells. Therefore, the effects of TNF-alpha and IL-6 on
      cortisol release from bovine zona fasciculata (ZF) cells were investigated. IL-6
      (10-1000 pg/mL) significantly increased basal and adrenocorticotropic hormone
      (ACTH)-stimulated cortisol release in a concentration-dependent manner. This
      stimulatory effect of IL-6 became apparent at intervals as short as 4 h and
      continued through 24 h. IL-6 also potentiated the cortisol release stimulated by
      the adenylyl cyclase activator forskolin. By contrast, TNF-alpha (0.1-10 ng)
      inhibited basal and ACTH-stimulated cortisol release in a concentration-dependent
      manner. The inhibitory effects of TNF-alpha on cortisol release were significant
      at time intervals as short as 4 h and continued through 24 h. TNF-alpha inhibited
      forskolin-stimulated cortisol release. Binding studies demonstrated that ZF cells
      have IL-6 receptors (100 receptors/cell, Kd of 7.5 x 10(-11)) and TNF receptors
      (200 receptors/cell, Kd of 2.4 x 10(-9) M). Immunohistochemical analysis provided
      evidence that the majority of ZF cells have IL-6 receptors, TNF type 1 receptors,
      and TNF type 2 receptors. Because IL-6 and TNF-alpha are released from the
      adrenal cortex and these cytokines modify the release of cortisol from the ZF, IL
      6 and TNF-alpha may play a paracrine or autocrine role in the regulation of
      adrenal function.

PMID- 11216652
TI  - Involvement of phosphoinositide-3-kinase and p70 S6 kinase in regulation of
      proliferation of rat lactotrophs in culture.
AB  - Phosphoinositide-3-kinase (PI-3K) and p70 S6 kinase (p70S6k) are suggested as
      important molecules for mediating mitogenic actions of growth factors and
      cytokines in a variety of cell types. The purpose of the present study was to
      investigate whether these kinases were involved in mediation of the mitogenic
      actions of not only the growth factor insulin but also cyclic adenosine
      monophosphate (cAMP) and estrogen on rat cultured lactotrophs. Treatment with
      wortmannin or LY294002, a PI-3K inhibitor, or rapamycin, a p70S6k inhibitor,
      decreased basal levels of 5-bromo-2-deoxyuridine (BrdU)-labeling indices of
      lactotrophs in a dose-dependent manner. These inhibitors were effective in
      blocking an increase in BrdU-labeling indices induced by insulin. LY294002 and
      rapamycin also suppressed an increase in BrdU-labeling indices induced by
      forskolin, an adenylate cyclase activator, or dibutyryl cAMP, a membrane
      permeable cAMP analog, as well as that induced by estradiol, a physiologic
      extracellular activator of lactotroph proliferation. However, the dibutyryl cAMP
      , but not insulin-induced proliferation, acquired a resistance to LY294002 and
      rapamycin by pretreatment with bromocriptine, a dopaminergic agonist that is able
      to suppress lactotroph proliferation. These results suggest that the mitogenic
      actions of cAMP and estradiol on rat lactotrophs are mediated by PI-3K and
      p70S6k, and that dopaminergic inhibition modifies the PI-3K and p70S6k dependence
      of the regulation of lactotroph proliferation.

PMID- 11216653
TI  - Effect of angiotensin II on rat renal cortical 11beta-hydroxysteroid
      dehydrogenase.
AB  - Renal 11beta-hydroxysteroid dehydrogenases (11beta-HSDs) are subject to
      modulation by various endogenous factors. 11beta-HSDs convert glucocorticoids
      into inactive 11-ketones and thereby determine tissue levels of active
      glucocorticoids and thus the extent of glucocorticoid receptor (GR) and
      mineralocorticoid receptor (MR) activation. As such, modulation of the activity
      of renal 11beta-HSDs may contribute to the cascade of regulatory events involved
      in renal electrolyte water handling. We investigated whether renal 11beta-HSDs
      are modulated by elevated circulating angiotensin II. In rats infused for 2 wk
      with angiotensin II (250 ng/[kg x min] subcutaneously), plasma angiotensin II,
      aldosterone, and corticosterone were raised 5.1-, 10.7-, and 2.3-fold,
      respectively, compared with control rats. Angiotensin II infusion raised
      corticosterone 11beta-oxidation 1.46- and 1.35-fold in renal cortical proximal
      and distal tubules (enriched by Percoll centrifugation), respectively, but had no
      effect on 11beta-HSD1 and 11beta-HSD2 mRNA levels (semiquantitative reverse
      transcriptase polymerase chain reaction), except for distal tubular 11beta-HSD1
      mRNA, which was decreased to 50%. In vitro treatment of freshly isolated tubules
      with angiotensin II for 45 min prior to assessment of 11beta-HSD activity showed
      no direct acute effects of angiotensin II on tubular corticosterone 11beta
      oxidation. The enhanced renal tubular corticosterone 11beta-oxidation in vivo may
      partly protect renal GR and MR from elevated plasma corticosterone on angiotensin
      II infusion.

PMID- 11216654
TI  - Combined modification of intracellular and extracellular loci on human
      gonadotropin-releasing hormone receptor provides a mechanism for enhanced
      expression.
AB  - The mammalian gonadotropin-releasing hormone (GnRH) receptor (GnRH-R) has been a
      therapeutic target for human and animal medicine. This receptor is a unique G
      protein-coupled receptor that lacks the intracellular C-terminal domain commonly
      associated with this family. Development of highthrough put screens for agents
      active in humans has been hampered by low expression levels of the hGnRH-R in
      cellular models. Two sites have attracted the interest of laboratories studying
      regulation of expression. The chimeric addition of the C-terminal tail from
      catfish GnRH-R (cfGnRH-R) to the rat GnRH-R significantly augmented receptor
      expression in GH3 cells. In addition, rodent GnRH-R contains 327 amino acids, but
      cow, sheep, and human GnRH-R (hGnRH-R) contain 328 residues, the "additional"
      residue being a Lys 191. Deletion of Lys 191 (del 191) from the hGnRH-R resulted
      in increased receptor expression levels and decreased internalization rates in
      both COS-7 and HEK 293 cells. In this study, the combined effect of the addition
      of the C-tail from cfGnRH-R and deletion of the Lys 191 from the hGnRH-R was
      compared to expression of the wild-type (WT) or either alteration alone in a
      transient expression system using primate cells. The altered receptor (hGnRH
      R[del 191]-C-tail) showed significantly increased receptor expression at the cell
      surface compared with the WT or either modification alone. The inositol phosphate
      response to stimulation was also significantly elevated in response to GnRH
      agonist. After treatment with a GnRH agonist, the altered receptors showed a
      slower internalization rate. The homologous steady-state regulation of the WT and
      the altered receptors was similar, although the response of the altered receptors
      was significantly decreased. These results suggest that the conformational change
      in the receptor as a result of the deletion of Lys 191 and the addition of the C
      terminus tail substantially increased the steady-state receptor expression and
      decreased internalization and homologous regulation. Because the effects on
      expression are greater than additive, it appears that these alterations exert
      their effects by differing means. These techniques for expression of the hGnRH-R
      in transfected mammalian cells provide the basis for a therapeutic screen for
      GnRH analogs, agonists, and antagonists of the hGnRH.

PMID- 11216655
TI  - Pancreatic fate of 6-deoxy-6-[125I]iodo-D-glucose: in vitro experiments.
AB  - The apparent distribution space of 6-deoxy-6-[125I]iodo-D-glucose, recently
      proposed as a tracer of D-glucose transport, was measured in rat isolated islets,
      acinar tissue, and pieces of pancreas. While such a space reached a steady-state
      value corresponding to the 3HOH volume in pancreatic islets within 5 min, it
      slowly increased in pieces of pancreas and, even after 60-min incubation,
      remained lower than the 3HOH volume. Moreover, the net uptake of 6-deoxy-6
      [125I]iodo-D-glucose by pancreatic pieces was inhibited by unlabeled 6-deoxy-6
      iodo-D-glucose, D-glucose, and cytochalasin B, while being less or not affected
      by these agents in isolated islets. A preferential labeling of the endocrine,
      relative to exocrine, moiety of the pancreas was documented both by comparing,
      after 2 min incubation, the uptake of 6-deoxy-6-[125I]iodo-D-glucose by pieces of
      pancreas from normal vs streptozotocin-injected rats and by comparing the
      radioactive content of pancreatic islets and acinar tissue obtained from normal
      rats injected intravenously 3 min before sacrifice with 6-deoxy-6-[125I]iodo-D
      glucose. It is proposed, therefore, that advantage could conceivably be taken
      from the vastly different time course for the uptake of selected monosaccharides
      by pancreatic islets vs acinar cells in the perspective of imaging of the
      endocrine pancreas by a non invasive method.

PMID- 11216656
TI  - The M34T allele variant of connexin 26.
AB  - GJB2 encodes the protein Connexin 26, one of the building blocks of gap
      junctions. Each Connexin 26 molecule can oligomerize with five other connexins to
      form a connexon; two connexons, in turn, can form a gap junction. Because
      mutations in GJB2 are the most common cause of congenital severe-to-profound
      autosomal recessive nonsyndromic hearing loss, the effect of the Connexin 26
      allele variants on this dynamic 'construction' process and the function of any
      gap junctions that do form is particularly germane. One of the more controversial
      allele variants, M34T, has been hypothesized to cause autosomal dominant
      nonsyndromic hearing loss. In this paper, we present clinical and genotypic data
      that refutes this hypothesis and suggests that the effect of the M34T allele
      variant may be dependent on the mutations segregating in the opposing allele.

PMID- 11216657
TI  - Connexin-26 gene analysis in hearing-impaired newborns.
AB  - The efficacy and utility of the Connexin-26 (Cx-26) gene (also called GJB2)
      analysis from DNA isolated from Guthrie newborn screening cards is demonstrated.
      This analysis precisely defined a major cause of prelingual nonsyndromic deafness
      in those children requiring amplification in our study. Guthrie cards were
      obtained from 49 deaf children requiring amplification identified over the last 5
      years by the Rhode Island Newborn Screening Program. Children with syndromes or
      other recognizable causes of hearing loss were excluded. DNA was extracted from
      the Guthrie cards and analyzed sequentially for the Cx-26 35delG mutation and
      then for the 167delT mutation followed by gene sequencing on remaining
      heterozygotes. Three of 42 children were 35delG homozygotes; 2/42 children were
      35delG/167delT compound heterozygotes. One child was identified as being a 35delG
      heterozygote with no other mutation found by sequencing. Nine Guthrie cards
      yielded no amplification or uninterpretable results. Cx-26 mutations were
      identified as causing 11.9% of the deafness in the children studied. In
      conclusion, Cx-26 analysis is an important test that identifies a major cause of
      prelingual nonsyndromic deafness. Molecular analysis of hearing-impaired newborns
      will be important for genetic counseling in these families. Failures with Guthrie
      cards may make use of other collection methods preferable.

PMID- 11216658
TI  - Biallelic discrimination assays for the three common Ashkenazi Jewish mutations
      and a common non-Jewish mutation, in Tay-Sachs disease, using fluorogenic TaqMan
      probes.
AB  - We have developed rapid semiautomated fluorogenic TaqMan assays for the three
      common Jewish mutations that occur in Tay-Sachs disease, the TATC 4-bp insertion
      in exon 11 (1,278insTATC), the IVS 12 + 1G --> C, splice site mutation in intron
      12 (1421 + 1 G --> C), and the G --> A change at the 3' end of exon 7 (G269S), as
      well as for a non-Jewish mutation, IVS9 + I G --> A, believed to be prevalent in
      patients of Celtic descent. The TaqMan assays are designed to run on the ABI SDS
      7700 sequence detection system, using allele-specific probes that carry a
      reporter dye at the 5' end and a quencher dye at the 3' end. Using a 96-well
      format, all four assays can be performed simultaneously on the same plate, with
      real-time fluorescence detection or just an end-point plate read. DNA samples
      from 78 patients identified as carriers by biochemical screening and genotyped by
      conventional techniques were used to assess the accuracy and efficiency of the
      probes in allelic discrimination assays. There were no discrepancies noted
      between previously assigned genotypes and the results obtained by application of
      this methodology.

PMID- 11216659
TI  - Disclosure of Huntington's disease to family members: the dilemma of known but
      unknowing parties.
AB  - Predictive genetic testing presents unique issues in the legal and ethical debate
      concerning disclosure of information within the physician-patient relationship. A
      duty to disclose information to family members has been found when the disclosure
      is likely to result in the ability to mitigate the damaging effects of the
      disease. When evaluating the situation where a individual is at risk of
      Huntington's disease, the analysis must be different, as shown in this paper, and
      necessitates an ethical and legal examination of the consequences of receipt of
      the information on family members, those known but unknowing parties who are at
      risk of inheriting a genetic disease. This paper analyzes the potential legal
      duty of a physician to disclose or withhold genetic information from the family
      members of patients. Existing statutes governing genetic information do not
      directly address the interests of family members. Courts that have ruled on the
      duty to disclose medical or genetic information have analyzed these issues using
      traditional concepts of tort law. Yet the situation presented by Huntington's
      disease is unique and demands a different framework for analysis, given the late
      onset and lack of curative or ameliorative treatment. This paper also analyzes
      the ethical standards to be invoked when considering violating the privacy of a
      patient or a family member. The principles of autonomy and self-determination of
      family members are considered, versus the risk of harm and the privacy interest
      in not knowing potentially devastating information.

PMID- 11216660
TI  - Novel mutations in the duplicated region of the polycystic kidney disease 1
      (PKD1) gene provides supporting evidence for gene conversion.
AB  - Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common
      human single-gene disorders, and is the most common inherited form of cystic
      kidney disease. It is estimated that approximately 85% of ADPKD is due to
      mutations in the PKD1 gene, which is located on chromosome 16p13.3. Mutation
      analysis in this gene is difficult, because more than two-thirds of reiterated
      several times at 16p13.1. In this study, mutation screening in 90 ADPKD patients
      was carried out on exons in the duplicated region of the PKD1 gene (23-34), using
      genomic long-range PCR followed by nested PCR and single-strand conformation
      polymorphism (SSCP), and finally cycle sequencing. Two nonconservative missense
      mutations were detected in exons 25 and 31, and two conservative mutations were
      found in exons 24 and 29. A novel splicing mutation, which is expected to cause
      skipping of exon 30, was detected in one case. Moreover, six intronic variants,
      three silent variants, and one polymorphic variant were detected in this study.
      Comparison between some of these changes and published sequences from the
      homologous genes on 16p13.1, revealed supporting evidence for the gene conversion
      theory as a mechanism responsible for some of the mutations in the PKD1 gene.
      Factors likely to facilitate gene conversion in this region of the PKD1 gene are
      discussed.

PMID- 11216661
TI  - Detection of an unusual combination of mutations in the HFE gene for
      hemochromatosis.
AB  - In the present paper, we describe an individual, found as part of a screening
      study, being homozygous for the C282Y mutation and at the same time heterozygous
      for the H63D mutation in the HFE gene. Identical results were obtained by three
      different methods, i.e., by PCR-RFLP, by sequencing, and by melting curve
      analysis. Thus, the common conception that the C282Y and the H63D mutations are
      mutually exclusive is not valid. Clinical symptoms and laboratory data on the
      individual were similar to hemochromatosis patients homozygous for the C282Y
      mutation. The implications of our finding for diagnostic analytical laboratory
      procedures are briefly discussed.

PMID- 11216662
TI  - Prenatal genotyping for the RhD blood group antigen: considerations in developing
      an accurate test.
AB  - Experience performing prenatal genotyping for RHD has shown that consideration
      must be given to developing a molecular test capable of detecting
      recombination/gene conversion events involving the RHD and RHCE genes that can
      lead to erroneous results. Out of 50 prenatal RHD tests performed over the past 5
      years, four samples were encountered that gave false-positive results. In only
      one of the tests, incorrect results were issued to the physician. In the other
      three instances, the erroneous nature of the test results was revealed through
      the analysis of multiple regions of the RHD gene and, more importantly, because
      the mother, and sometimes the father, were tested in parallel with the fetus. In
      an extension of the observations obtained from the prenatal testing program, a
      large panel of RhD-negative blood donors were subjected to molecular analysis of
      the RHD gene. Of 1,183 donors screened, 187 were found to phenotype as RhD
      negative. Of the 187 donors confirmed RhD negative serologically, 22 (11.8%) were
      found to retain remnants of the RHD gene that, depending upon the characteristics
      of the molecular assay performed, could lead to a false-positive result in a
      genotyping assay. On the basis of the experience presented here, it is
      recommended that any molecular RHD assay include an analysis of multiple areas of
      the RHD gene so as to allow for the detection of recombination/gene conversion
      events between the RHD and RHCE genes. Moreover, it is strongly recommended that
      the mother (at a minimum) and father be subjected to molecular analysis
      simultaneously with the fetus to confirm that the known phenotypes of the
      parent(s) are consistent with their respective genotypes.

PMID- 11216663
TI  - Does the A3333G mutation in the CACNL1A3 gene, detected in malignant
      hyperthermia, also occur in central core disease?
AB  - Malignant hyperthermia (MH) and central core disease (CCD) are two conditions
      associated with susceptibility to volatile anesthetics and depolarizing muscle
      relaxants. The gene RYR1, encoding the Ca2+ release channel of skeletal muscle
      sarcoplasmic reticulum, is responsible for about 50% of the cases of MH and some
      cases of CCD. However, genetic heterogeneity occurs in MH and a mutation in a
      second gene (CACLN1A3), encoding the alpha1-subunit of the dihydropyridine (DHP)
      channel, has recently been found in a large MH French family. The presence of
      this mutation in patients with CCD has not yet been reported. In this study, we
      analyzed the A3333G mutation in 5 unrelated patients affected by CCD and 31 MH
      susceptible relatives (from 19 MH families) and did not find this mutation in any
      of them. Nevertheless, the report of data on newly described mutations in
      different populations is important to estimate the contributions of each gene
      mutation to the phenotype of MH and CCD.

PMID- 11216664
TI  - Prader-Willi syndrome: genetic tests and clinical findings.
AB  - Here we describe the genetic studies performed in 53 patients with the suspected
      diagnosis of Prader-Willi syndrome (PWS). PWS is characterized by neonatal
      hypotonia, hypogonadism, delayed psychomotor development, hyperphagia, obesity,
      short stature, small hands and feet, learning disabilities, and obsessive
      compulsive behavior. Through the methylation analysis of the SNRPN gene,
      microsatellite studies of loci mapped within and outside the PWS/AS region, and
      fluorescence in situ hybridization (FISH) study, we confirmed the diagnosis in 35
      patients: 27 with a paternal deletion, and 8 with maternal uniparental disomy
      (UPD). The clinical comparisons between deleted and UPD patients indicated that
      there were no major phenotype differences, except for a lower birth length
      observed in the UPD children. Our sample was composed of more girls than boys;
      UPD patients were diagnosed earlier than the deleted cohort (2(10/12) s. 7(9/12)
      years); and, in the deleted group, the boys were diagnosed earlier than the girls
      (5(2/12) vs. 7(8/12) years, respectively).

PMID- 11216665
TI  - Characterization of a novel D1S80 pseudoallele.
AB  - During a D1S80 population study conducted for databasing purposes in the New York
      City Ashkenazi Jewish population, eight out of 96 samples were typed with a band
      corresponding to the position of a #15 allele. In seven of the eight samples,
      three bands appeared. Further investigation was needed to explain the high
      frequency of an allele considered so rare that it is not included in the
      commercially provided allelic ladder. After extraction of the putative D1S80 15
      repeat amplicon band from the 6% polyacrylamide genotyping gel, the amplicon
      bands were reamplified with D1S80 primers. After retyping as putative 15 alleles,
      these samples underwent Southern hybridization with a D1S80 locus-specific probe
      followed by DNA sequence analysis. Sequence analysis revealed that these bands
      did not arise from true D1S80 15 alleles. However, the PCR product was of a size
      that fell within the allelic ladder region corresponding to the 15 band and
      contained end sequences with strong homology to the D1S80 primers. An alignment
      search of the sequenced product revealed that a portion of the amplicons
      contained 72% identity to a known gene. These results emphasize the importance of
      sequencing analysis when questions arise about the authenticity of an allele.

PMID- 11216666
TI  - Delineation of the spectrum of Wilson disease mutations in the Greek population
      and the identification of six novel mutations.
AB  - In this study, we report the further results of an ongoing project on the
      delineation of the spectrum of mutations on the ATP7B gene in Wilson disease (WD)
      patients of Greek origin. We have analyzed 24 additional families and detected 16
      mutations (five frameshifts, two splice site, two nonsense, and seven missense),
      of which six are novel. On adding these results to the ones already published by
      us, we conclude that WD shows a marked allelic heterogeneity in the Greek
      population. Of the total number of mutations so far detected, the most common
      eight account for the molecular defect in 72.8% of the WD chromosomes. The most
      frequent mutation is the His0169Gln, which has a frequency of 28.5%, similar to
      those reported in North European populations. Using these data, an efficient
      strategy of mutation screening for WD is possible in this population, thus
      improving the possibility of preclinical diagnosis.

PMID- 11216667
TI  - The founder mutations in the BRCA1, BRCA2, and ATM genes in Moroccan Jewish women
      with breast cancer.
AB  - To gain insight into the molecular mechanisms underlying the inherited
      predisposition to breast cancer in non-Ashkenazi Jews, we genotyped 54 Jewish
      Moroccan women with breast cancer, unselected for family history of cancer, for
      the predominant Jewish mutations in BRCA1, BRCA2, and ATM. One patient (2%) was
      found to have the 185de1AG BRCA1 mutation, none was a carrier of the 6174delT
      BRCA2 mutation, and 2/54 (4%) were heterozygous for the ATM mutation. These rates
      were not significantly different from the rates in the general non-Ashkenazi
      population. These preliminary data may indicate that the predominant Jewish
      mutations in BRCA1, BRCA2, and ATM genes contribute little, if any, to breast
      cancer predisposition and risk among Moroccan Jews.

PMID- 11216668
TI  - Disease genes and chromosomes: disease maps of the human genome.

PMID- 11216669
TI  - Structure-activity studies of novobiocin analogs as modulators of the
      cytotoxicity of etoposide (VP-16).
AB  - We have previously reported that the antibiotic novobiocin enhanced the toxicity
      of the anticancer agent etoposide (VP-16) to several drug-sensitive and 
      resistant tumor cell lines. The increase in VP-16 cytotoxicity produced by
      novobiocin was not due to the combined effects of these agents on topoisomerase
      II, but to inhibition by novobiocin of VP-16 efflux, which in turn led to
      increased accumulation of VP-16 and increased formation of potentially lethal VP
      16-stabilized topoisomerase II-DNA covalent complexes. We have now identified
      novobiocin analogs that are essentially equivalent to novobiocin as inhibitors of
      the activity of topoisomerase II, but that are more potent than novobiocin (a) as
      modulators of the cytotoxicity of VP-16 to WEHI-3B leukemia and A549 lung
      carcinoma cells and (b) in increasing VP-16 accumulation in these cell lines.
      Thus, removal of the sugar moiety of novobiocin to form novobiocic acid enhanced
      the potency of the antibiotic as a modulator of VP-16, whereas the substituted
      coumarin ring alone (U-7587) was devoid of VP-16 modulatory activity.
      Modifications of the side chain of novobiocin significantly influenced modulatory
      activity, with cyclonovobiocic acid, which was formed from novobiocic acid by
      acid-catalyzed cycloaddition, being the most active in enhancing the cytotoxicity
      of VP-16. The increased potency of novobiocic acid and cyclonovobiocic acid as
      modulators of VP-16 activity was achieved with no change from novobiocin in the
      capacity of these analogs to inhibit the catalytic activity of mammalian
      topoisomerase II, indicating a change in the specificity of these analogs.

PMID- 11216670
TI  - Induction of hepatocellular carcinoma with high metastatic potential in WS/Shi
      rats: discovery of an inbred strain highly susceptible to the liver carcinogen N
      nitrosomorpholine.
AB  - We investigated the susceptibility of three inbred strains of rats to the
      hepatocarcinogen, N-nitrosomorpholine (NNM), to establish a spontaneous
      metastatic model of hepatocellular carcinoma (HCC). WS/Shi. SD/gShi, and
      F344/DuCrj rats were given 0.02% NNM in drinking water for 8 weeks and thereafter
      left without any treatment. The experiment ceased at week 20, because mortality
      markedly increased after this time point in WS/Shi rats. Liver weight was highest
      in WS/Shi rats among the three strains examined. The incidence of HCC was 15/15
      (100%) in WS/Shi rats, 1/16 (6%) in SD/gShi rats, and 13/16 (81%) in F344/DuCrj
      rats surviving after NNM treatment. Metastasis to the lung was observed in HCC
      bearing rats at an incidence of 13/15 (87%) in WS/Shi, 1/1 in SD/gShi, and 6/13
      (46%) in F344/DuCrj. Four-week administration of NNM resulted in a significantly
      higher BrdU-labeling index of hepatocytes in WS/Shi rats than in the other
      strains. These findings indicated that WS/Shi is the most sensitive strain to NNM
      and may be the most suitable strain for use as a spontaneous metastatic model of
      HCC among the strains of rats examined in the present study.

PMID- 11216671
TI  - Tumor amplified protein expression therapy: Salmonella as a tumor-selective
      protein delivery vector.
AB  - Attenuated strains of Salmonella typhimurium, VNP20009 and YS7212, when injected
      systemically to tumor-bearing mice, accumulated preferentially in tumors at
      levels at least 200-fold and, more commonly, 1000-fold greater than in other
      normal tissues. This selectivity occurred in subcutaneously implanted murine
      tumors, including B16F10 melanoma, M27 lung carcinoma, and colon 38 carcinoma.
      The preferential accumulation was also manifested in animals bearing human tumor
      xenografts, including Lox, C8186, DLD1, SW620, HCT116, HTB177, DU145, MDA-MB-231,
      and Caki. Four to five days after a single IV injection of 1 x 10(6) colony
      forming unit (cfu)/mouse, we routinely detected VNP20009 proliferation and
      accumulation at levels ranging from 1 x 10(8) to 2 x 10(9) cfu/g tumor. The
      amount of VNP20009 accumulated in the liver ranged from 3 x 10(4) to 2 x 10(6)
      cfu/g. The distribution of Salmonella in tumors was homogenous; YS7212 could be
      detected from the periphery to the interior portion of the tumors. Using mice
      with various immunodeficiencies, we also discovered the same preferential
      accumulation of Salmonella in tumors implanted in these mice. The use of
      Salmonella as a protein delivery vector was shown by IV administration of the
      bacteria expressing either green fluorescent protein (GFP) or cytosine deaminase
      (CD) into tumor-bearing mice. GFP and CD were detected in tumors, but not in
      livers, taken from mice inoculated with Salmonella carrying these genes. Bacteria
      accumulation and CD expression persisted in the tumors for up to 14 days after a
      single bolus IV administration of bacteria to tumor-bearing mice.

PMID- 11216672
TI  - Schedule-dependent interaction between raltitrexed and 5-fluorouracil in human
      colon cancer cell lines in vitro.
AB  - Raltitrexed (Tomudex) is a novel thymidylate synthase inhibitor with significant
      activity against advanced colorectal cancer. We studied the cytotoxic
      interactions of raltitrexed and 5-fluorouracil (5-FU) in four human colon cancer
      cell lines on various schedules. The cell growth inhibition after 5 days was
      determined using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide
      (MTT) assay. The cytotoxic interactions at the IC80 level were evaluated by the
      isobologram method. Simultaneous exposure to raltitrexed and 5-FU for 5 days
      produced additive to synergistic effects in Colo201 cells, and produced additive
      effects in Colo321, LoVo, and WiDr cells. Simultaneous exposure to raltitrexed
      and 5-FU for 24 h produced additive effects in Colo201, LoVo, and WiDr cells, and
      produced antagonistic effects in Colo320 cells. Sequential exposure to
      raltitrexed for 24 h followed by 5-FU for 24 h produced additive effects in
      Colo201, Colo320, and LoVo cells, and produced antagonistic effects in WiDr
      cells. The reverse sequence produced additive effects in Colo201 cells, and
      produced antagonistic effects in Colo320, LoVo, and WiDr cells. Simultaneous
      exposure to raltitrexed and 5-FU for 4 h and sequential exposure to raltitrexed
      for 4 h followed by 5-FU for 4 h with a 20-h interval produced additive effects,
      while the reverse sequence produced antagonistic effects in LoVo and WiDr cells.
      These findings suggest that the simultaneous administration of raltitrexed and 5
      FU or the sequential administration of raltitrexed followed by 5-FU may be the
      optimal sequence, while the reverse sequence may be inappropriate. Preclinical
      and clinical studies of the simultaneous administration of raltitrexed and 5-FU
      and the sequential administration of raltitrexed followed by 5-FU are required to
      better understand the antitumor, toxic, and pharmacokinetic interactions of this
      combination in order to develop the combination chemotherapy of raltitrexed and 5
      FU.

PMID- 11216673
TI  - Radiation-induced cell cycle delays and p53 status of early passage melanoma cell
      lines.
AB  - Cell cultures exposed to DNA-damaging agents such as gamma radiation respond by
      arresting at cell cycle checkpoints, and the p53 tumor suppressor protein is
      strongly implicated in this behavior. We have investigated the TP53 status and
      cell cycle response to ionizing radiation of a series of early passage cell lines
      (designated NZM1 to NZM15) previously developed from patients with metastatic
      melanoma. The TP53 status of each of the cell lines was determined by single
      strand conformation polymorphism and DNA sequence analysis. The majority of the
      lines appeared to have a wild-type TP53 gene sequence, consistent with published
      studies. Two lines (NZM4 and NZM7.2) were found to have an identical T-->C
      transition mutation in nucleotide 721 (exon 7) of the coding region. NZM7.2
      (mutant) and NZM7.4 (wild-type) were clonally derived from the same line (NZM7).
      The existence of radiation-induced cell cycle arrest in G and/or G2M phase was
      determined 16 h after irradiation (6.3 Gy) by DNA staining and flow cytometric
      analysis. The mitotic inhibitor paclitaxel was used as a reference compound, with
      or without irradiation, to assess the efficiency of radiation-induced cell cycle
      arrest. G1 phase arrest was associated only with the presence of the wild-type
      TP53 gene, but the efficiency of induced arrest varied among the cell lines and
      the period of G phase arrest appeared to be short. A significant difference (P <
      0.002) was also found between the efficiency of induction of G2 phase arrest and
      the presence of wild-type TP53 gene. The results provide evidence that although
      the melanoma cell lines generally had an intact TP53 gene, the efficiency of p53
      mediated cycle arrest might be deficient and contribute to the resistance of this
      tumor to treatment.

PMID- 11216674
TI  - Smad protein expression and activation in transforming growth factor-beta
      refractory human squamous cell carcinoma cells.
AB  - In contrast to nonneoplastic keratinocytes, human squamous carcinoma cell lines
      are able to proliferate in the presence of transforming growth factor-beta (TGF
      beta) in vitro. This has raised the question whether, how frequently, by which
      mechanism, and at which stage of development squamous carcinomas escape from TGF
      beta control in vivo. We have developed a method to rapidly identify the most
      common molecular alterations in the TGF-beta signaling pathway by combining
      measurements of the levels and the activation state of Smad signaling
      intermediates with DNA-based diagnostic assays. In this report, we demonstrate
      the validity of this approach using a panel of seven squamous cell carcinoma
      (SCC) lines known to be refractory to TGF-beta-mediated cell cycle arrest. Each
      of the SCCs expressed the pathway-restricted Smad proteins, Smad2 and-3.
      Furthermore, treatment with TGF-beta induced phosphorylation of Smad2 in each of
      the SCCs with the exception of the two cell lines that carry inactivating
      mutations of the TGF-beta type II receptor. Three of the remaining SCC lines
      failed to express the common mediator Smad4, two on the basis of loss of
      transcription and one by a posttranscriptional mechanism. Thus, a mechanism for
      TGF-beta resistance was identified in five of the seven tumor cell lines.
      Interestingly, in the two remaining lines, no abnormalities of signaling
      intermediates were found, and TGF-beta was able to activate TGF-beta-responsive
      promoters. This suggests that the ability of these two cell lines to grow in the
      presence of TGF-beta is due to factors extraneous to the TGF-beta pathway itself.
      Application of our protein-based strategy to interrogate the TGF-beta signaling
      pathway should allow us to determine whether or not and, if so, how and at which
      stage human squamous cell carcinomas become TGF-beta resistant in vivo.

PMID- 11216675
TI  - Update on human rights issues in clinical research.

PMID- 11216676
TI  - Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one
      year results.
AB  - BACKGROUND: Although high tibial osteotomy has been proved effective for the
      treatment of painful osteoarthritis of the medial compartment of the knee, the
      role of proximal tibial varus osteotomy for the treatment of painful
      osteoarthritis of the lateral compartment still remains controversial. METHODS:
      From 1974 to 1993, we performed proximal tibial varus osteotomy for the treatment
      of osteoarthritis of the lateral compartment of the knee in thirty-six
      consecutive patients. The procedure consisted of a proximal lateral opening-wedge
      varus osteotomy of the tibia with use of corticocancellous bone grafts from the
      iliac crest. The valgus deformity was posttraumatic in twenty-three patients,
      followed a lateral meniscectomy in five, was due to overcorrection of a varus
      deformity in four, and was idiopathic in four. The preoperative valgus deformity
      averaged 11.6 degrees (range, 4 degrees to 22 degrees ). RESULTS: At a mean of
      eleven years (range, five to twenty-one years) after the operation, the clinical
      results for thirty-four of the thirty-six patients were analyzed. None of the
      patients had severe progression of the osteoarthritis after the osteotomy, and
      none had a meaningful loss in the range of motion of the knee joint. A
      superficial wound infection developed in one patient, and another patient had
      thrombophlebitis. Three patients (9%) had a transient palsy of the peroneal
      nerve. According to the system of Insall et al., the mean knee score was 84
      points (range, 54 to 99 points). According to the knee score described by Lysholm
      and Gillquist, the subjective result was excellent in nine patients (26%), good
      in twenty-one (62%), fair in three (9%), and poor in one (3%). CONCLUSIONS: We
      concluded that when the indications outlined in this study are followed and our
      opening-wedge technique is used, a proximal lateral opening-wedge varus osteotomy
      of the tibia is a good alternative for the treatment of isolated osteoarthritis
      of the lateral compartment of the knee. High accuracy in preoperative planning,
      based on a slight overcorrection, is important to prevent failure.

PMID- 11216677
TI  - Bone-grafting for severe patellar bone loss during revision knee arthroplasty.
AB  - BACKGROUND: Severe patellar bone loss may preclude adequate fixation of another
      patellar prosthesis as a part of revision knee replacement. The purpose of this
      study was to describe the surgical technique and early clinical results of an
      alternative to the conventional treatment options of either patellectomy or
      retention of the remaining patellar osseous shell. The goals of this procedure
      are to restore patellar bone stock and potentially to improve the functional
      outcome. METHODS: Severe patellar bone loss had left a "patellar shell" that
      precluded insertion of another patellar implant in nine of 100 consecutive knees
      undergoing revision total knee arthroplasty. Rather than performing a
      patellectomy or simply retaining the patellar osseous shell in these nine knees
      (eight patients), I performed a surgical procedure in which a tissue flap was
      secured to the patellar rim to contain cancellous bone graft inserted into the
      patellar bone defect. Final follow-up was at a mean of 36.7 months (range, twenty
      four to fifty-five months) after the patellar bone-grafting procedure. RESULTS:
      The mean preoperative Knee Society scores for function and pain were 39 points
      (range, 18 to 82 points) and 40 points (range, 20 to 80 points), respectively. At
      the time of final follow-up, the Knee Society function and pain scores had
      improved significantly, to a mean function score of 91 points (range, 80 to 98
      points) and a mean pain score of 84 points (range, 65 to 100 points) (p<0.05).
      The point of greatest patellar thickness measured intraoperatively ranged from 7
      to 9 mm. Patellar thickness on immediate postoperative Merchant radiographs
      averaged 22 mm (range, 20 to 25 mm) whereas, at the time of final follow-up,
      patellar thickness averaged 19.7 mm (range, 17 to 22.5 mm). CONCLUSIONS: In
      contrast with other treatment alternatives, this surgical procedure imparts the
      potential for restoring patellar bone stock and may improve functional outcome by
      facilitating patellar tracking and improving quadriceps leverage. On the basis of
      satisfactory short-term to mid-term clinical results, this technique of patellar
      bone-grafting appears to be an important addition to the armamentarium of
      surgeons performing revision knee arthroplasties.

PMID- 11216678
TI  - Lunate excision, capitate osteotomy, and intercarpal arthrodesis for advanced
      Kienbock disease. Long-term follow-up.
AB  - BACKGROUND: Kienbock disease is caused by aseptic necrosis of the lunate. In the
      advanced stages of the disease, carpal collapse, joint incongruity, and
      osteoarthritis develop. We performed lunate excision, capitate osteotomy, and
      intercarpal arthrodesis (the modified procedure of Graner et al.) on fifteen
      patients with stage-IIIB or IV Kienbock disease. This report is a review of the
      findings in these patients. METHODS: The subjects ranged in age from twenty-six
      to fifty-four years (mean, 39.2 years) at the time of surgery. We evaluated the
      results more than five years postoperatively (range, sixty-two to 145 months
      postoperatively; mean, 79.3 months postoperatively). Therapeutic results were
      evaluated according to the scoring system of Evans et al. RESULTS: Pain
      disappeared after surgery in most patients. Others had a reduction in the
      intensity of the pain to a mild level. The grip strength on the affected side had
      recovered to about 80% of that on the unaffected side twelve months after
      surgery. The long-term results were graded as good in eleven of the patients, as
      fair in two, and as poor in two. Postoperative radiographs showed that the carpal
      bone parameters (carpal height index and radioscaphoid angle) had improved.
      Radiographic osteoarthritic changes occurred in all of the patients; however,
      except for moderate limitation of the range of motion at the wrist joint, these
      findings did not affect the level of pain, grip strength, or activities of daily
      living. CONCLUSIONS: Lunate excision followed by capitate osteotomy and
      intercarpal arthrodesis (the modified procedure of Graner et al.) is a reliable
      form of treatment for advanced Kienbock disease, with favorable results for at
      least five years postoperatively.

PMID- 11216679
TI  - Anterior innominate osteotomy in repair of bladder exstrophy.
AB  - BACKGROUND: Classic bladder exstrophy is a developmental defect presenting at
      birth with a wide pubic separation and an exposed bladder; cloacal exstrophy
      involves, in addition, intestinal prolapse. Reconstruction requires several
      surgical procedures. The use of anterior iliac osteotomies in this process has
      not been reviewed in a large series. METHODS: We reviewed the results of eighty
      six anterior innominate osteotomies performed in conjunction with genitourinary
      repair of classic and cloacal bladder exstrophy in eighty-two patients. Clinical
      outcome measures were successful bladder closure, achievement of continence, and
      maintenance of a normal gait. Radiographs of the pelvis were reviewed, and the
      pubic intersymphyseal diastasis (a measure of the reduction in tension on the
      anterior closure) was measured preoperatively and at three time-points
      postoperatively. Children with classic exstrophy who had undergone osteotomy and
      bladder neck reconstruction but not bladder augmentation were divided into four
      groups on the basis of the degree of continence. In addition, children with
      classic exstrophy were stratified according to age at the time of the osteotomy.
      The mean postoperative percent reduction in the amount of the original diastasis
      was determined for all groups. RESULTS: Children with classic exstrophy and those
      with cloacal exstrophy had correction of the diastasis after the osteotomy, with
      greater correction in those with classic exstrophy, presumably because of better
      bone quality. Daytime continence was achieved with anterior osteotomy and bladder
      neck reconstruction in 74% of the children for whom continence was a goal.
      However, no difference in the symphyseal diastasis or in the percentage of pubic
      reduction was detected among the four continence groups. Children who were older
      at the time of the osteotomy maintained better correction over time. Wound
      dehiscence or bladder prolapse occurred in 4% of the patients who had osteotomy
      and primary closure, and the only important complication of the osteotomies was
      transient palsy of the left femoral nerve in seven children. CONCLUSIONS:
      Anterior innominate osteotomy is an effective part of reconstructive repair of
      bladder exstrophy. The primary goals of the osteotomy are to reduce the tension
      in the closed bladder and the lower abdominal wall and to promote continence by
      restoring the sling of the pelvic floor muscles. These goals can be achieved in
      the majority of patients.

PMID- 11216680
TI  - Diagnosing basilar invagination in the rheumatoid patient. The reliability of
      radiographic criteria.
AB  - BACKGROUND: Basilar invagination can be difficult to diagnose with plain
      radiography in patients with rheumatoid arthritis. Although numerous radiographic
      criteria have been described, few studies have addressed the reliability of these
      parameters in the rheumatoid population. The purpose of the present study was to
      validate and compare the most widely accepted plain radiographic criteria for
      basilar invagination in this patient population. METHODS: Cervical radiographs of
      131 rheumatoid patients were examined. Of these patients, sixty-seven (twenty
      nine with basilar invagination and thirty-eight without it) were also evaluated
      with tomograms, magnetic resonance imaging, and/or sagittally reconstructed
      computed tomography scans to detect the presence of basilar invagination. Three
      observers who were blinded with regard to the diagnosis independently scored each
      radiograph as positive, negative, or indeterminate according to the established
      criteria for invagination proposed by Clark et al., McRae and Barnum,
      Chamberlain, McGregor, Redlund-Johnell and Pettersson, Ranawat et al., Fischgold
      and Metzger, and Wackenheim. Interobserver and intraobserver variability,
      sensitivity, specificity, total percentage of correct results, and negative and
      positive predictive values were determined for each criterion as well as for
      various combinations of the criteria. RESULTS: No single test had a sensitivity
      and a negative predictive value of greater than 90% as well as a reasonable
      specificity and a reasonable positive predictive value. The combination of the
      Clark station, the Redlund-Johnell criterion, and the Ranawat criterion, scored
      as positive for basilar invagination if any of the three were positive, proved to
      be better than any single criterion; the sensitivity of the combined criteria was
      94%, and the negative predictive value was 91%. CONCLUSIONS: A screening test for
      basilar invagination should have a high sensitivity and a high negative
      predictive value, so that the disease will not be missed, and yet be specific, so
      that the disease will not be overdiagnosed. Our data suggest that none of the
      widely utilized plain radiographic criteria meet these goals. We recommend that
      measurements be made according to the methods described by Clark et al., Redlund
      Johnell et al., and Ranawat et al. and, if any of these suggests basilar
      invagination, tomography or magnetic resonance imaging should be performed. Since
      approximately 6% of the cases of basilar invagination in rheumatoid patients
      would still be missed with this approach, tomography or magnetic resonance
      imaging should be performed on a rheumatoid patient whenever plain radiographs
      leave any doubt about the diagnosis of basilar invagination.

PMID- 11216681
TI  - The effects of particulate wear debris, cytokines, and growth factors on the
      functions of MG-63 osteoblasts.
AB  - BACKGROUND: Particle-challenged cells release cytokines, chemokines, and
      eicosanoids, which contribute to periprosthetic osteolysis. The particle-induced
      activation of macrophages and monocytes has been extensively studied, but only
      limited information is available on the response of osteoblasts to particulate
      wear debris. This study examines the effects of particulate wear debris,
      proinflammatory cytokines, and growth factors on osteoblast functions. METHODS:
      MG-63 osteoblasts were treated with metal particles (titanium, titanium alloy,
      and chromium orthophosphate) or polymeric particles (polyethylene and
      polystyrene) of phagocytosable sizes or were treated with exogenous cytokines and
      growth factors. The kinetics of particle phagocytosis and the number of engulfed
      particles were assessed with use of fluoresceinated particles. Cell proliferation
      was determined according to [3H]-thymidine incorporation, and cell viability was
      determined by either fluorescein diacetate uptake or trypan blue exclusion.
      Expressions of osteoblast-specific genes were quantified with Northern blot
      hybridization, and the secretions of osteoblast-specific proteins and cytokines
      were analyzed by enzyme-linked immunosorbent assays. RESULTS: MG-63 osteoblasts
      phagocytosed particles and became saturated after twenty-four hours. A maximum of
      forty to sixty particles per cell were phagocytosed. Each type of particle
      significantly suppressed procollagen alpha1[I] gene expression (p<0.05), whereas
      other osteoblast-specific genes (osteonectin, osteocalcin, and alkaline
      phosphatase) did not show significant changes. Particle-stimulated osteoblasts
      released interleukin-6 (p<0.05) and a smaller amount of transforming growth
      factor-beta1. Particles reduced cell proliferation in a dose-dependent manner
      without affecting cell viability (p<0.05). Exogenous tumor necrosis factor-alpha
      also enhanced the release of interleukin-6 (p<0.01) and transforming growth
      factor-beta1 (p<0.05), whereas the secretion of transforming growth factor-beta1
      was increased by insulin-like growth factor-I and prostaglandin E2 as well.
      Insulin-like growth factor-I and transforming growth factor-beta1 significantly
      increased procollagen alpha1[I] gene expression in osteoblasts (p<0.05), while
      tumor necrosis factor-alpha and prostaglandin E2 significantly suppressed
      procollagen alpha1[I] gene expression (p<0.01). In contrast, neither exogenous
      nor endogenous interleukin-6 had any effect on other cytokine secretion, on
      proliferation, or on procollagen alpha1[I] gene expression. The transcription
      inhibitor actinomycin D reduced both procollagen alpha1[I] transcription and
      interleukin-6 production. Inhibitors of protein synthesis (cyclohexamide) and
      intracellular protein transport (brefeldin A and monensin) blocked the release of
      interleukin-6, but none of these compounds influenced the suppressive effect of
      titanium on procollagen alpha1[I] gene expression. CONCLUSIONS: MG-63 osteoblasts
      phagocytose particulate wear debris, and this process induces interleukin-6
      production and suppresses type-I collagen synthesis. Osteoblast-derived
      interleukin-6 may induce osteoclast differentiation and/or activation, but the
      resorbed bone cannot be replaced by new bone because of diminished osteoblast
      function (reduced type-I collagen synthesis). Exogenous cytokines (tumor necrosis
      factor-alpha and interleukin-1beta), growth factors (insulin-like growth factor-I
      and transforming growth factor-beta1), and prostaglandin E2 can modify
      particulate-induced alterations of osteoblast functions.

PMID- 11216682
TI  - Radiocarpal dislocations: classification and proposal for treatment. A review of
      twenty-seven cases.
AB  - BACKGROUND: The radiographic characteristics and treatment of radiocarpal
      dislocation are not well defined. There have been only two reported series of
      more than eight patients. Thus, there are many questions concerning treatment and
      functional results. METHODS: Two groups of patients were defined. Group 1
      included all patients with pure radiocarpal dislocation and patients with only a
      fracture of the tip of the radial styloid process. Group 2 included patients with
      radiocarpal dislocation and an associated fracture of the radial styloid process
      that involved more than one-third of the width of the scaphoid fossa. A
      retrospective review and a clinical evaluation were performed. RESULTS: From 1975
      to 1998, we observed twenty-seven cases of radiocarpal dislocation. Four were
      displaced volarly, and twenty-three were displaced dorsally. Fourteen patients
      presented with associated lesions. Four patients were treated with closed
      reduction and immobilization in a plaster cast; five, with percutaneous Kirschner
      wire fixation and cast immobilization; and two, with an external fixator. Eleven
      patients had open reduction with Kirschner wire fixation and cast immobilization.
      The seven patients in Group 1 had a highly unstable injury, and four of the seven
      patients presented with ulnar translation of the carpus. At the time of follow
      up, at an average of 26.8 months, pronation averaged 76 degrees; supination, 66
      degrees; wrist flexion, 54 degrees; wrist extension, 54 degrees; radial
      inclination, 15 degrees; and ulnar inclination, 18 degrees. The average grip
      strength was 27 kg. Group 2 included twenty patients. Only thirteen, with dorsal
      dislocation, were evaluated at the time of follow-up, which averaged fifty-one
      months. At that time, six reported no pain; four, slight pain; and two, moderate
      pain. Pronation averaged 63 degrees; supination, 76 degrees; wrist flexion, 51
      degrees; wrist extension, 56 degrees; radial inclination, 21 degrees; and ulnar
      inclination, 39 degrees. Grip strength averaged 38 kg. Seven patients had
      complications. CONCLUSIONS: On the basis of our experience and a review of the
      literature, we believe that patients with pure radiocarpal dislocation or with
      radiocarpal dislocation with a fracture of the tip of the radial styloid process
      should be treated with reattachment of the ligaments through a volar approach. In
      patients with radiocarpal dislocation and a fracture of the radial styloid
      process that involves more than one-third of the width of the scaphoid fossa, the
      ligaments are still attached to the radial fragment. We believe that in this
      group of patients, exact articular reduction should be performed through a dorsal
      approach. Additional studies are needed to support these hypotheses.

PMID- 11216683
TI  - Long-term results following ankle arthrodesis for post-traumatic arthritis.
AB  - BACKGROUND: Ankle arthrodesis is considered by many to be the standard operative
      treatment for end-stage ankle arthritis; however, the long-term effect of ankle
      arthrodesis on other lower-extremity joints remains largely unknown. The purpose
      of this study was to perform a clinical and radiographic review to determine the
      effect of ankle arthrodesis on the development of osteoarthritis in other lower
      extremity joints. METHODS: Twenty-three patients who had had an isolated ankle
      arthrodesis for the treatment of painful posttraumatic arthritis of the ankle
      were followed for a mean of twenty-two years (range, twelve to forty-four years)
      after the operation. Each completed standardized, self-reported outcome
      questionnaires (the Foot Function Index, Western Ontario and McMaster University
      Osteoarthritis Index [WOMAC], and Short Form-36 [SF-36]), was examined clinically
      by two of the investigators, and underwent complete radiographic examination of
      the knee, ankle, and foot bilaterally. The radiographic grade of osteoarthritis
      was determined for each joint, and the levels of overall activity limitation,
      pain, and disability were determined for each patient from the clinical findings
      and questionnaire information. RESULTS: Osteoarthritis of the ipsilateral
      subtalar (p<0.0001), talonavicular (p<0.0001), calcaneocuboid (p<0.0001),
      naviculocuneiform (p = 0.0012), tarsometatarsal (p = 0.0009), and first
      metatarsophalangeal joints (p = 0.0012) was consistently more severe than the
      osteoarthritis of those joints on the contralateral side. Osteoarthritis did not
      develop more frequently in the ipsilateral knee or lesser metatarsophalangeal
      joints than it did on the contralateral side. Significant differences between the
      two sides were found with regard to overall activity limitation (p<0.0001), pain
      (p<0.0001), and disability (p<0.0001), with the involved side consistently more
      symptomatic. CONCLUSIONS: To our knowledge, the present series represents the
      longest follow-up study of ankle arthrodesis to date. Our cohort of patients all
      had isolated post-traumatic ankle arthritis, and each underwent a successful
      isolated ankle arthrodesis. At a mean of twenty-two years, the majority of the
      patients had substantial, and accelerated, arthritic changes in the ipsilateral
      foot but not the knee. They were often limited functionally by foot pain.
      Although ankle arthrodesis may provide good early relief of pain, it is
      associated with premature deterioration of other joints of the foot and eventual
      arthritis, pain, and dysfunction.

PMID- 11216684
TI  - Radiographic analysis of low contact stress meniscal bearing total knee
      replacements.
AB  - BACKGROUND: Meniscal bearing total knee replacements were developed to decrease
      the contact stresses on polyethylene and to reduce polyethylene wear. The
      kinematics of meniscal bearing knee replacements is poorly understood. The
      present study was designed to evaluate, with radiographic analyses, the motion of
      the meniscal bearings and the femoral rollback of the Low Contact Stress meniscal
      bearing knee replacement during knee flexion. METHODS: Eighty-one Low Contact
      Stress meniscal bearing total knee replacements in seventy-six male patients were
      assessed on fluoroscopically centered lateral radiographs made with the knee in
      full extension and in full flexion at an average of six years (range, twenty-four
      to 147 months) after the operation. The distance and direction of motion of the
      meniscal bearings and the center contact position of the femoral condyles were
      measured. Knee evaluations were performed with use of the Knee Society rating
      system. RESULTS: The average range of motion of the knees, measured on lateral
      radiographs, was 90 degrees (range, 45 degrees to 136 degrees). As they moved
      from terminal extension to terminal flexion, thirty-nine knees (48%) exhibited
      anterior motion of both bearings and sixteen (20%) demonstrated posterior motion
      of both bearings. Ten knees (12%) had reciprocal motion of the two bearings (one
      bearing moving anteriorly and one bearing moving posteriorly) with flexion, nine
      knees (11%) had motion of only one bearing, and seven knees (9%) had no motion of
      either bearing. When moving from full extension to full flexion, eighteen knees
      (22%) demonstrated femoral rollback, six knees (7%) showed no change in the
      position of femoral contact, and fifty-seven knees (70%) exhibited anterior
      sliding of the femoral condyles. Flexion of the knees demonstrating femoral
      rollback averaged 104 degrees (range, 76 degrees to 128 degrees), and flexion of
      the knees demonstrating anterior sliding averaged 94 degrees (range, 45 degrees
      to 125 degrees). The difference was significant (p = 0.03). According to the Knee
      Society rating system, the average clinical score for the entire group was 76
      points (range, 27 to 100 points) and the average functional score for the entire
      group was 72 points (range, 30 to 100 points). The average clinical score was 79
      points (range, 27 to 98 points) for the knees that exhibited anterior sliding of
      the femoral condyles and 87 points (range, 52 to 100 points) for those exhibiting
      femoral rollback (p = 0.09). The average functional scores were 64 points (range,
      30 to 100 points) and 72 points (range, 45 to 100 points), respectively (p =
      0.15). CONCLUSIONS: Radiographic analysis of meniscal bearing total knee
      replacements demonstrated an average anterior motion of both the medial and the
      lateral meniscal bearing of 4.7 mm (range, 1 to 14 mm) in thirty-nine knees (48%)
      as they moved from terminal extension to terminal flexion. Sixty-three knees
      (78%) demonstrated no femoral rollback as they were flexed. Knees with anterior
      sliding of the condyles had a significantly smaller average range of flexion (p =
      0.03) and a lower average Knee Society score than did knees demonstrating femoral
      rollback. We believe that lack of rollback indicates a functional insufficiency
      of the posterior cruciate ligament.

PMID- 11216685
TI  - Magnetic resonance imaging of the interosseous membrane of the forearm.
AB  - BACKGROUND: Diagnosis of damage to the interosseous membrane of the forearm after
      trauma is difficult. Patients with a proximal radial fracture and associated
      damage to the interosseous membrane may have wrist pain in association with
      subluxation or dislocation of the distal radioulnar joint. Accurate
      identification of injury to the interosseous membrane may allow better planning
      of surgical treatment. METHODS: T1 and T2-weighted magnetic resonance images that
      were made in the axial, sagittal, and coronal planes were used to evaluate the
      interosseous membrane in the forearms of cadavera, volunteers, and patients. The
      images were evaluated subjectively by two orthopaedic surgeons and a
      musculoskeletal radiologist. RESULTS: The interosseous membrane was most
      consistently visualized on the axial images. Axial T2-weighted images showed the
      interosseous membrane clearly. The addition of fat-suppression techniques allowed
      abnormalities to be identified more accurately. Fast-spin-echo techniques were
      used to obtain data quickly and accurately. CONCLUSIONS: The intact and disrupted
      interosseous membrane can be evaluated with use of magnetic resonance imaging.
      Axial T2-weighted fast-spin-echo images with fat suppression in the middle one
      third of the forearm provide the most accurate information.

PMID- 11216686
TI  - Functional donor-site morbidity during level and uphill gait after a
      gastrocnemius or soleus muscle-flap procedure.
AB  - BACKGROUND: There is only limited objective information about functional donor
      site morbidity after harvest of one head of the triceps surae muscles to cover a
      severe soft-tissue defect of the leg. The purpose of the present study was to
      investigate whether a functional deficit is present during level and uphill
      walking after such a procedure. METHODS: Five subjects who had completely
      recovered from the initial injury were studied with use of comprehensive gait
      analysis during free level, fast level, and uphill walking on a ramp at a 10
      degrees inclination. RESULTS: Gait analysis revealed no relevant donor-site
      morbidity affecting level gait at a free walking speed (mean, 1.27 m/sec; range,
      1.18 to 1.40 m/sec). When the subjects walked at a higher velocity (mean, 1.89
      m/sec; range, 1.58 to 2.43 m/sec), an asymmetry of the ground-reaction forces was
      seen. The second vertical peak force during push-off was reduced by a mean of
      7.3% (range, 0.94% to 12.24%), and the impulse in the direction of progression
      was reduced by a mean of 8.7% (range, 0.13% to 17.87%) on the affected side (p =
      0.04). During uphill walking, a compensatory strategy to reduce the demand on the
      posterior calf muscles was seen in all subjects-that is, they shortened the
      length of the step on the contralateral side by a mean of 3.9 cm (range, 2.2 to
      6.2 cm), which corresponded to a mean side-to-side difference of 5.6% (range,
      2.18% to 6.18%) (p = 0.04). A calcaneal motion pattern, denoted as increased
      ankle dorsiflexion, was seen in three of the five subjects during uphill walking
      as a sign of decreased function of the posterior calf muscles. Two of them (both
      with a soleus flap) also had a calcaneal pattern during fast gait. CONCLUSIONS:
      We concluded from this study that the functional donor-site morbidity after
      harvest of one head of the triceps surae muscles is mild in subjects who have had
      a complete recovery from their initial injury. Normal level gait is possible.
      However, deficits are seen in more demanding tasks such as fast walking or uphill
      walking.

PMID- 11216687
TI  - Altered fibular growth patterns after tibiofibular synostosis in children.
AB  - BACKGROUND: Iatrogenic synostosis of the tibia and fibula following an operation
      on the leg in a child has been reported rarely in the literature, and the effects
      of this complication on future growth, alignment, and function are not known.
      This is a retrospective case series, from one institution, of crossunions of the
      distal parts of the tibia and fibula complicating operations on the leg in
      children. The purpose is to alert surgeons to this possible complication.
      METHODS: The senior author identified eight cases of iatrogenic tibiofibular
      synostosis seen in children since 1985. The patients had various diagnoses and
      were from the practices of four pediatric orthopaedic surgeons. Synostosis
      developed in six patients after osteotomies of the distal parts of the tibia and
      fibula, in one after internal fixation of distal tibial and fibular metaphyseal
      fractures through a single incision, and in one after posterior transfer of the
      anterior tibialis tendon through the interosseous membrane combined with peroneus
      brevis transfer to the calcaneus. Medical records were reviewed, and preoperative
      and follow-up radiographs were analyzed for changes in the relative positions of
      the proximal and distal tibial and fibular physes and in the alignment of the
      ankle. RESULTS: Five patients were symptomatic after crossunion; they presented
      with prominence of the proximal part of the fibula, ankle deformity, or ankle
      pain. Three patients were asymptomatic, and a synostosis was identified on
      routine follow-up radiographs. Intraoperative technical errors caused two of the
      crossunions; the cause of the others was unknown. Following tibiofibular
      synostosis, growth disturbances were noted radiographically in every patient. The
      normal growth pattern of distal migration of the fibula relative to the tibia was
      reversed, resulting in a decreased distance between the proximal physes of the
      tibia and fibula as well as proximal migration of the distal fibular physis
      relative to the distal part of the tibia. Shortening of the lateral malleolus led
      to greater valgus alignment of the ankle. CONCLUSIONS: Tibiofibular synostosis
      can complicate an operation on the leg in a child. After crossunion, the normal
      distal movement of the fibula relative to the tibia is disrupted, resulting in
      shortening of the lateral malleolus and ankle valgus as well as prominence of the
      fibular head at the knee. The synostosis also interferes with the normal motion
      that occurs between the tibia and fibula with weight-bearing, potentially leading
      to ankle pain.

PMID- 11216688
TI  - Spontaneous resolution of symptomatic post-traumatic cervical epidural hematoma.
      A case report.

PMID- 11216689
TI  - The use of low-intensity ultrasound to accelerate the healing of fractures.

PMID- 11216690
TI  - Design of the Northern Nevada Orthopaedic Trauma Panel: a model, level-II
      community-hospital system.

PMID- 11216691
TI  - Report of the 2000 Japanese American Traveling Fellows.

PMID- 11216692
TI  - The team physician: ethics and enterprise.

PMID- 11216693
TI  - Timing of femoral fracture stabilization.

PMID- 11216694
TI  - Postoperative pain in research animals, and use of interbody fusion cages.

PMID- 11216695
TI  - The semantics of gait mechanics.

PMID- 11216696
TI  - Second-generation cementing techniques.

PMID- 11216697
TI  - Fluoroscopic and 3-D computed tomographic guidance in percutaneous fixation of
      acetabular fractures.

PMID- 11216698
TI  - Preoperative skin traction was not useful for hip fractures.

PMID- 11216699
TI  - What's new in sports medicine?

PMID- 11216700
TI  - Clinical presentation of rhabdoid tumors of the kidney.
AB  - PURPOSE: We designed this study to differentiate the clinical presentation,
      particularly the incidence of hematuria, of a rhabdoid tumor of the kidney (RTK),
      a rare but highly malignant tumor, from a Wilms tumor. PATIENTS AND METHODS: We
      reviewed patient flow charts from the National Wilms Tumor Study Group and
      queried participating hospitals to obtain additional information regarding
      presenting symptoms and laboratory data for fifty patients. Patient ages ranged
      from 2 days to 3.5 years with a mean of 11 months. We documented the presence of
      gross and microscopic hematuria, fever, and hypercalcemia. RESULTS: Whereas 75%
      of children with rhabdoid tumor of the kidney (RTK) had stage III (44%), IV
      (27%), or V (4%) tumors, 67% of children with Wilms tumors had stage I (41%) or
      II (26%) tumors. Either gross or microscopic hematuria was present in 84.4%
      (27/32) of the patients with RTK. Gross hematuria was present in 59% (22/37) of
      children with RTK compared with 18% previously reported with Wilms tumor.
      Microscopic hematuria was present in 76% (22/29) of children with RTK compared
      with 24% previously reported with Wilms tumor. Fever was found in 44% (16/36) of
      children with RTK, compared with 22% of children previously reported with Wilms
      tumor. Hypercalcemia was seen 26% (6/23) of children with RTK. CONCLUSION:
      Although diagnosis of any renal mass still must be confirmed with histopathologic
      features, a distinct clinical presentation with fever, hematuria, a young age,
      and high-tumor stage at presentation suggests the diagnosis of RTK.

PMID- 11216701
TI  - Secondary acute myelogenous leukemia in patients previously treated for childhood
      renal tumors: a report from the National Wilms Tumor Study Group.
AB  - PURPOSE: This review characterized cases of secondary acute myelogenous leukemia
      (AML) occurring after treatment of renal neoplasms on protocols of the National
      Wilms Tumor Study Group (NWTSG) between October 1969 and December 1991. PATIENTS
      AND METHODS: The NWTSG database was reviewed for cases of secondary AML and for
      WT1 status of the affected patients. Referring institutions were contacted by a
      confidential letter requesting pathology reports, results of immunophenotyping,
      cytogenetic, and molecular analyses, and details concerning treatment of AML.
      RESULTS: Of the 5,278 patients treated during the study period, 43 had second
      malignant neoplasms, and 7 of these 43 had AML. At the time of diagnosis of Wilms
      tumor, the median age of the seven patients (4 boys) was 3.2 years. Five of the
      seven renal neoplasms had favorable histologic characteristics. The most common
      French-American-British morphology was M5. One patient had bilateral tumors, and
      two were treated for recurrent Wilms tumor. All patients received chemotherapy
      regimens that included doxorubicin (6) or etoposide (1), and six were treated
      with infradiaphragmatic irradiation. The median latency period from initial
      diagnosis of the renal neoplasm to development of secondary AML was 3 years
      (range, 1.2-4 yrs). One patient had the translocation t(9:11)(p22;q23); WT1
      status was not noted for any of the seven patients. CONCLUSIONS: The development
      of secondary AML in this subset of patients after treatment of renal neoplasms
      may reflect the interaction of the effects of treatment and possible genetic
      predisposition toward cancer.

PMID- 11216702
TI  - Parental health beliefs and compliance with prophylactic penicillin
      administration in children with sickle cell disease.
AB  - PURPOSE: Prophylactic penicillin is effective in preventing severe invasive
      pneumococcal infection in children with sickle cell disease. In some families,
      compliance has been problematic. The aims of this study were to monitor
      compliance and to assess the efficacy of the Health Belief Model (HBM) in
      predicting compliance. METHODS: Fifty mothers of children with sickle cell
      disease, ages 6 to 60 months, participated in the study. On enrollment, mothers
      completed surveys assessing their health beliefs regarding sickle cell disease
      and infections. Compliance was assessed through self-reporting by the mothers and
      through review of local pharmacy records of penicillin refills. RESULTS: Sixty
      percent of the mothers reported that they were highly compliant with obtaining
      the prescribed 14-day refills. Pharmacy records indicated that only 12% actually
      adhered to this schedule. The self-reports were significantly related to
      compliance ratings; mothers who admitted less than optimal compliance averaged 42
      days between refills, compared with 19 days for mothers who reported good
      compliance. Varying perceptions identified through the HBM accounted for
      approximately 30% of the variance in compliance rates. The perceived burdens of
      picking up the refills and remembering to administer the medication were the most
      significant factors. CONCLUSIONS: Educational efforts alone are not sufficient to
      ensure compliance with penicillin prophylaxis. Routinely monitoring compliance
      through pharmacy records, reviewing parental beliefs about sickle cell disease
      and infections, and exploring barriers to treatment will promote dialogue about
      the importance of strict compliance with this relatively simple yet life-saving
      prophylaxis.

PMID- 11216703
TI  - Hepatic dysfunction as the presenting feature of acute lymphoblastic leukemia.
AB  - PURPOSE: Hepatic dysfunction is a rare presentation of leukemia in children.
      Because most chemotherapy agents are metabolized by the liver, this complication
      may have major adverse consequences and effective treatment could be compromised.
      PATIENTS AND METHODS: The MEDLINE database and current management guidelines from
      the United States Pediatric Cooperative Cancer Groups were reviewed and analyzed.
      Data from two institutional cases are described. RESULTS: Although previous
      literature is not informative, our experience suggests that children with
      leukemia and moderate hepatic dysfunction may tolerate aggressive chemotherapy.
      CONCLUSION: Current protocol guidelines for dose modification for liver disease
      may be overly stringent and modification may be beneficial.

PMID- 11216704
TI  - Hypogammaglobulinemia and reduced numbers of B-cells in children with
      myelodysplastic syndrome.
AB  - BACKGROUND: Immunodeficiency in pediatric patients with myelodysplastic syndrome
      (MDS) has not been described. We report the clinical course of three children
      with MDS, hypogammaglobulinemia, and reduced numbers of B-cells and B-cell
      precursors. OBSERVATIONS: Three patients with recurrent infection who were
      younger than 1-year-old had MDS of the refractory anemia (RA) subtype diagnosed.
      All had reduced numbers of circulating B-cells and hypogammaglobulinemia. In two
      patients, cytogenetic studies revealed a monosomy 7 karyotype and bone marrow
      studies showed decreased numbers of CD34+ progenitor cells and CD 19+ B-cells.
      Both patients had prolonged courses (7 yrs 10 mos and 6 yrs 9 mos) characterized
      by recurrent infection and slowly progressive pancytopenia. Both received
      allogeneic bone marrow transplantation (BMT). The third patient had normal
      cytogenetic studies and a normal number of CD34+ progenitors but decreased CD19+
      B-cells in the bone marrow. She had a stable course with refractory anemia over
      the course of 7 years. CONCLUSIONS: Pediatric patients with MDS may have
      hypogammaglobulinemia and reduced numbers of B-cells. These findings do not
      preclude a relatively stable and prolonged clinical course. Children with newly
      diagnosed MDS should have an immunologic evaluation in addition to their
      hematologic assessment.

PMID- 11216705
TI  - Bilateral breast relapse in acute myelogenous leukemia.
AB  - We present the case of an 11.5-year-old girl with M1 acute myelogenous leukemia
      (AML) who had isolated extramedullary relapse develop in both breasts 12 months
      after diagnosis and 7 months off chemotherapy. She received further chemotherapy,
      focal radiation therapy, then underwent a matched, unrelated bone marrow
      transplant and continues in remission 37 months later. Review of the literature
      revealed 10 cases in other children younger than 21-years-old with AML and breast
      involvement. These cases are summarized, and potential pathophysiologic
      mechanisms of spread are discussed. Breast involvement in AML is rare in
      children. However, regular breast examinations should be performed as part of
      routine follow-up in all girls with AML.

PMID- 11216707
TI  - Temporary response of localized intracranial mast cell sarcoma to combination
      chemotherapy.
AB  - Cerebral involvement of systemic mastocytosis and intracranial sarcoma of
      myelogenic origin are well known entities. An 8-year-old girl with an isolated
      cerebral mast cell tumor is presented. Specific histopathologic stains were used
      to confirm the diagnosis detecting immunophenotype and proliferative activity.
      Treatment with irradiation, intrathecal cytarabine, and interferon-alpha2b did
      not induce regression whereas polychemotherapy did. Systemic combination
      chemotherapy led to marked transient tumor regression in this proliferating mast
      cell sarcoma in an unusual intracranial location.

PMID- 11216706
TI  - Primary central nervous system lymphoma in childhood presenting as progressive
      panhypopituitarism.
AB  - We report a 15-year-old boy who had isolated central diabetes insipidus initially
      diagnosed at age 11 years. A brain magnetic resonance imaging (MRI) was normal at
      the time. At age 12 years, growth hormone (GH) testing was performed because of a
      decline in linear growth rate and demonstrated GH deficiency. After a repeat
      normal brain MRI, GH therapy was begun. Three years later, hormonal testing
      revealed prepubertal gonadotropins and low testosterone levels, free thyroxine
      index, and morning cortisol levels. Repeat brain MRI demonstrated a 9-mm
      enhancing lesion in the region of the pituitary stalk. The pathologic diagnosis
      was that of a high-grade malignant B-cell lymphoma, suggestive of Burkitt
      Lymphoma. Growth hormone therapy has not been associated with an increased
      incidence of lymphoma. This report underscores the need for vigilance in follow
      up brain imaging and hormonal evaluation in children with diabetes insipidus,
      especially those with evolving anterior hormone deficiencies.

PMID- 11216708
TI  - Smooth muscle tumor developing in an immunocompromised child after therapy for
      leukemia.
AB  - We report a 5.5-year-old boy who underwent autologous peripheral blood stem cell
      transplantation for high-risk acute lymphoblastic leukemia and who had two
      abdominal masses develop 6 months later. Macroscopically complete resection of
      the abdominal tumors was performed and revealed a well-differentiated
      leiomyosarcoma. Smooth muscle tumors, benign or malignant, are increasingly
      recognized in children with various immunodeficiencies; the association with
      acute lymphoblastic leukemia is rarely described.

PMID- 11216709
TI  - Tumor lysis syndrome in an infant with Langerhans cell histiocytosis successfully
      treated using continuous arteriovenous hemofiltration.
AB  - Langerhans cell histiocytosis (LCH) is an enigmatic disease usually occurring in
      children. Tumor lysis syndrome (TLS) is a clinical syndrome associated with
      severe metabolic derangement and oliguric acute renal failure. In this report, we
      present the clinical course of an infant with advanced LCH who had TLS develop
      after chemotherapy. Treatment with continuous arteriovenous hemofiltration
      resulted in effective control of serum uric acid, potassium, creatinine,
      phosphorus, and blood urea nitrogen levels in the blood.

PMID- 11216710
TI  - Incomplete cerebral infarctions are not silent.

PMID- 11216711
TI  - Cyclophosphamide-based, seven-drug hybrid and low-dose involved field radiation
      for the treatment of childhood and adolescent Hodgkin disease.
AB  - PURPOSE: The outlook for children and adolescents with Hodgkin disease (HD) is
      excellent with combined modality therapy. However, the long-term toxicities of
      multiagent therapy and radiation therapy remain of concern for these patients
      with curable disease. In an attempt to reduce long-term toxicities while
      preserving excellent cure rates, we developed a combined-modality protocol using
      a modified seven-drug hybrid and low-dose (2,000 cGy) involved field radiation
      therapy (RT). The hybrid used cumulative doses of alkylating agents and
      anthracyclines that were lower than those used in previous four-drug regimens and
      substituted a less leukemogenic agent, cyclophosphamide, for nitrogen mustard.
      PATIENTS AND METHODS: From 1991 through 1994 a cyclophosphamide, vincristine,
      procarbazine, and prednisone/adriamycin, bleomycin, and vinblastine hybrid was
      used to treat 29 patients with HD. Median age was 12 years (range 6-16 yrs).
      Patients who were postpubertal with early stage disease as determined by surgical
      staging were excluded. Treatment consisted of four cycles of therapy for stages I
      and IIA, six cycles for stages IIB and III, and eight cycles for stage IV. Twenty
      two patients also received low-dose RT to areas of bulky disease. RESULTS: Twenty
      eight patients (97%) had a complete response to chemotherapy. Five patients
      experienced relapse; two died from disease 27 and 29 months after initial
      diagnosis; three received additional therapy and are alive with no evidence of
      disease. Follow-up for all other patients is a median of 56 months (range 24-78
      mos) from cessation of therapy and all have remained disease-free. At 5 years
      follow-up, actuarial disease-free survival is 82%, and the overall survival is
      93%. There have been no clinically significant cardiac or pulmonary toxicities
      and no secondary malignancies. CONCLUSIONS: This therapy has resulted in 5-year
      overall survival and disease-free survival rates similar to regimens using higher
      doses of alkylating agents, anthracyclines, and radiation. Longer follow-up will
      be necessary to fully evaluate disease-free survival, organ damage, and quality
      of life.

PMID- 11216712
TI  - Cytochemical staining and flow cytometry methods applied to the diagnosis of
      acute leukemia in the pediatric population: an assessment of relative usefulness.
AB  - BACKGROUND: Cytochemical staining has been used in the diagnosis of acute
      leukemia for more than 20 years. The general availability of flow cytometers and
      an extensive panel of antibody reagents useful for characterizing blood cell
      lineage question the usefulness of continuing routine use of the cytochemical
      staining for the diagnosis of acute leukemia. PATIENTS AND METHODS: Test results
      were evaluated in 122 (n = 122; 112 with acute lymphocytic leukemia and 10 with
      acute myeloid leukemia) patients selected from among 320 patients with acute
      leukemia at Texas Children's Hospital in 1997 and 1998. Results were selected for
      review if the clinical encounter represented the initial diagnostic work-up and
      if data were available from cytochemical staining and flow cytometry studies.
      RESULTS: Cell lineage classification derived from flow cytometry and cytochemical
      stains were in agreement in all cases. Definitive diagnoses were feasible using
      flow cytometry results alone in 120 of 122 patients (98.4%) as compared with only
      99 of 122 patients (81.2%) when only cytochemical staining results were
      considered. In two patients with inconclusive flow cytometry results,
      cytochemical staining alone provided information sufficient for diagnosis.
      CONCLUSIONS: Results from this study indicate that with few exceptions, flow
      cytometry studies alone provide sufficient information for diagnosis and
      management of acute leukemia in children. Nevertheless, cytochemical staining
      should be available for those cases in which flow cytometry results fail to allow
      a definitive diagnosis. A modified testing protocol is recommended.

PMID- 11216713
TI  - Selective use of whole-lung irradiation for patients with Ewing sarcoma family
      tumors and pulmonary metastases at the time of diagnosis.
AB  - PURPOSE: The benefit of whole-lung irradiation (WLI) for patients who have
      pulmonary metastases (PM) of Ewing sarcoma family tumors (ESFT) is unclear. At
      our institution, WLI is reserved for patients with PM that do not respond
      completely to induction chemotherapy. We reviewed our experience to assess the
      impact of WLI on clinical outcome. PATIENTS AND METHODS: Twenty-eight patients
      with ESFT and PM were treated in three consecutive institutional trials (1979
      1996). Extent of pulmonary involvement at diagnosis, response of PM after
      induction chemotherapy, local treatment of PM thereafter, and clinical outcome
      were recorded. Treatment included primary tumor surgery and/or radiotherapy and
      42 to 58 weeks of multiagent chemotherapy. RESULTS: Only eight patients (29%)
      received WLI. For the entire study group, the estimated 5-year event-free
      survival was 22.9% +/- 9.0%; the 5-year survival was 37.3% +/- 9.8%. Complete
      resolution of PM after induction chemotherapy was not correlated with survival (P
      = 0.53), nor was treatment with WLI (P = 0.87). CONCLUSIONS: The comparable
      survival of patients with poor and good response of PM to induction chemotherapy
      suggests that WLI may benefit poor responders. The use of WLI in good responders
      may provide similar benefit and merits further study.

PMID- 11216714
TI  - Use of reverse transcriptase polymerase chain reaction for diagnosis and staging
      of alveolar rhabdomyosarcoma, Ewing sarcoma family of tumors, and desmoplastic
      small round cell tumor.
AB  - PURPOSE: To compare the use of reverse transcriptase polymerase chain reaction
      (RT-PCR) with that of morphology-based methods for diagnosis, staging, and
      detection of metastatic disease in pediatric alveolar rhabdomyosarcoma (ARMS),
      Ewing sarcoma family of tumors (ESFT), and desmoplastic small round cell tumors
      (DSRCT). MATERIALS AND METHODS: RT-PCR assays for the EWS-FLII, EWS-ERG, PAX3
      FKHR, PAX7-FKHR, and EWS-WTI fusion transcripts were performed on RNA extracted
      from the primary tumor tissue, bone marrow, and body fluids obtained at initial
      presentation and relapse. Molecular findings were compared with original
      histologic diagnoses and results of staging procedures. RESULTS: Eighty-eight
      samples from 47 patients with ARMS (n = 13), ESFT (n = 31), or DSRCT (n = 3) were
      analyzed. The detection rate of metastatic disease was significantly higher with
      RT-PCR (95%) as compared with the morphologic methods (70%) for the three
      pediatric sarcomas studied. In primary tumors with characteristic fusion
      transcript, RT-PCR was positive in all cases with morphologic evidence of
      metastatic disease. Moreover, in six patients (3 with ARMS, 2 with DSRCT, and 1
      with ESFT) with metastatic disease, micrometastases in bone marrow (4) and other
      sites (2) were detected by RT-PCR alone. Importantly, none of the patients with
      localized disease diagnosed had micrometastases detected by RT-PCR in bone
      marrow. CONCLUSIONS: The high sensitivity and specificity of RT-PCR for the
      characteristic fusion transcripts of pediatric sarcomas make it an ideal method
      to aid in the routine staging of these patients. In addition, the 100%
      sensitivity of RT-PCR in detection of micrometastasis makes it useful for follow
      up and detection of minimal residual disease. However, the clinical significance
      of molecularly-detectable disease remains unknown. Further studies should aim to
      elucidate the therapeutic and prognostic implications of micrometastases detected
      by RT-PCR alone.

PMID- 11216715
TI  - Patellar tendon rupture repair using Dall-Miles cable.
AB  - Ten patients underwent patellar tendon repair with end-to-end suture technique
      and medial and lateral retinacular repair, as well as reinforcement with a Dall
      Miles cable through the patella and tibial tubercle. The cable was tensioned at
      60 degrees of flexion to allow immediate range of motion to at least 100 degrees
      of flexion and to protect the repair from undue tension while healing. Accurate
      tendon length was obtained from a lateral radiograph of the noninvolved knee in
      60 degrees of flexion. Patients were allowed to bear full weight as tolerated
      postoperatively. A knee immobilizer was worn for approximately 2 weeks when
      adequate muscular control of the leg was attained. The cable was removed 6-8
      weeks postoperatively, at which time range of motion equal to the opposite
      extremity was sought. Full extension was obtained by 1 week postoperatively.
      Average postoperative knee flexion was 88 degrees at 2 weeks, 112 degrees at 1
      month, 133 at 3 months, and 138 degrees at 6 months compared to flexion of 141
      degrees in the noninvolved knee. Mean quadriceps muscle strength 1 year
      postoperatively was 72%+/-11% of the noninvolved leg. No patient had patella
      infera or rerupture after surgery. Repair of a patellar tendon rupture with end
      to-end techniques reinforced with a Dall-Miles cable allows immediate
      rehabilitation without the need for prolonged immobilization. This technique
      allows restoration of full range of motion early postoperatively and enables
      patients to regain adequate quadriceps strength.

PMID- 11216716
TI  - Revision anterior cruciate ligament reconstruction using the lateral third of the
      ipsilateral patellar tendon after failure of a central-third graft: a preliminary
      report on 10 patients.
AB  - Long-term outcomes were reported for 10 (77%) of 13 cases of revision anterior
      cruciate ligament (ACL) reconstruction using the lateral third of the ipsilateral
      patellar tendon as a graft. All primary ACL reconstructions were ipsilateral
      central-third bone-patellar tendon-bone graft procedures. Mean age at follow-up
      was 30.7 years, and mean time from revision ACL surgery to follow-up was 42.9
      months. At follow-up, average KT-1000 difference between knees was 2.4 mm. All
      patients had a negative pivot shift, extension within 5 degrees of the
      contralateral knee, and flexion within 15 degrees. Mean bilateral comparison
      ratios for isokinetic strength and hop testing were: extension, 83.5%; flexion,
      96%; and single-leg hop 96.9%. No patella fractures or tendon ruptures had
      occurred. All patients had returned to their previous work level, and 8 of the 10
      patients could participate in at least "moderate" sports activities (e.g., skiing
      and tennis). The results were comparable to published outcome reports for both
      primary and revision ACL reconstruction. The lateral third of the ipsilateral
      patellar tendon is a good graft option for revision ACL reconstruction.

PMID- 11216717
TI  - Operative versus nonoperative treatment of knee dislocations: a meta-analysis.
AB  - Although several studies have investigated the optimal treatment of knee
      dislocations, all have been composed of a small number of patients and therefore
      have made it difficult to draw definitive conclusions. The literature on knee
      dislocation was reviewed to allow a meta-analysis and determine whether operative
      or nonoperative treatment had better outcomes. Range of motion, flexion
      contracture, Lysholm score, instability, ability to return to preinjury
      employment, and ability to return to preinjury athletic activities were compared
      using statistical methods. A total of 132 knee dislocations treated surgically
      and 74 treated nonoperatively were included. Average range of motion was 123
      degrees in the surgical group and 108 degrees in the nonoperative group (P<.001).
      Flexion contracture averaged 0.5 degrees for the surgical group and 3.5 degrees
      for the nonoperative group (P<.05). A significant difference (P<.001) also was
      found in the Lysholm scores, with a surgical group mean of 85.2 and a
      nonoperative group mean of 66.5. There was no significant difference in the
      ability to return to preinjury employment or athletic activity or in the amount
      of instability between the two groups. Surgical treatment appears to be
      associated with improved outcomes, although significant disability is still
      possible after successful surgical treatment.

PMID- 11216718
TI  - Patient demand matching in total knee arthroplasty: is it necessary?
AB  - Patient demand matching has been accepted as an appropriate method of implant
      management by hospitals for cost reduction. However, there have been no
      prospective studies to substantiate whether these patients change their demand
      levels postoperatively. Theoretically, functional activity levels should not
      increase significantly postoperatively in patients with preoperative low demand
      levels for patient demand matching to be effective in avoiding premature
      prosthetic failure. Preoperative and postoperative demand levels were
      prospectively reviewed in 279 patients undergoing total knee arthroplasty (TKA).
      Preoperatively, the medium/high-demand patients performed significantly more
      activities overall than low-demand patients. Postoperatively, both low- and
      medium/high-demand patients dramatically increased the number of activities
      performed. The hypothesis that prosthetic choice should be determined by
      preoperative activity level (demand matching) was not validated by this study
      because patient activity levels significantly increased in all categories
      subsequent to TKA.

PMID- 11216719
TI  - Surgical aspects of patellar tendonitis: technique and results.
AB  - Patellar tendonitis is a difficult clinical problem, and surgical treatment
      remains unclear in its indications, technique, and functional outcome. This
      article reviews 17 patients (18 knees) with either primary or secondary patellar
      tendonitis who required operative treatment. Twelve men and 5 women aged 19-50
      years comprised the study population. The right knee was involved in 10 patients,
      and the left knee was involved in 8. Average time from injury to surgery was 24
      months, and average postoperative follow-up was 12 months (range: 6-24 months).
      Criteria were developed for subjective, objective, functional, and overall
      evaluation. All knees that were operated on were rated as "very abnormal"
      preoperatively. Postoperatively, 16 (89%) knees were rated as normal or nearly
      normal, whereas 2 (11%) knees were rated as abnormal. A surgical technique is
      described, with emphasis on the rationale and technique, and reasons for initial
      surgical failure and poor functional outcomes are discussed.

PMID- 11216720
TI  - Nonunion of the tibial tubercle shingle following Fulkerson osteotomy.

PMID- 11216721
TI  - Fracture of the tibial spine of a Total Condylar III knee prosthesis secondary to
      malrotation of the femoral component.

PMID- 11216722
TI  - Primary and delayed exchange for infected total knee arthroplasty.

PMID- 11216723
TI  - Results of two-stage revision of the infected total knee arthroplasty.

PMID- 11216724
TI  - Identifying ongoing infection after resection arthroplasty and before second
      stage reimplantation.

PMID- 11216725
TI  - Patella fracture after anterior cruciate ligament reconstruction with the
      patellar tendon: a comparison between different shaped bone block excisions.
AB  - Tensile failure of a patella after anterior cruciate ligament (ACL)
      reconstruction with autogenous patellar tendon graft is an uncommon but serious
      complication. One factor that may affect post-harvest patella strength is the
      shape of the bony defect. The effect of patella defect shape on ultimate tensile
      strength and mode of failure of the extensor mechanism has not been studied using
      physiologic moments. Twelve matched pair knee specimens were randomly distributed
      within three groups comparing rectangular versus triangular, rectangular versus
      circular, and circular versus triangular shaped patella defects. Specimens were
      loaded in tension to failure using physiologic moments. Patella fracture occurred
      in 21 of 24 specimens. Mean ultimate strength for all patellae with a circular
      defect was 2540 N (+/-651), rectangular defect was 3267 N (+/-920), and
      triangular defect was 3009 N (+/-1057). There was no significant difference in
      mean ultimate tensile strength between defect shapes or between matched pairs
      within the groups. Mode of failure also was similar in all three groups. No
      defect shape was found to be superior in this investigation comparing ultimate
      tensile strength or mode of failure between different shaped patella defects.

PMID- 11216726
TI  - Acute endocarditis treated with radical debridement and implantation of
      mechanical or stented bioprosthetic devices.
AB  - BACKGROUND: Operation for active infective endocarditis carries high mortality
      and morbidity rates, especially when the annulus is involved. Overall the
      literature favors the use of autograft and homograft valves because of better
      resistance to infection. In our clinic during the last 5 years we used an
      aggressive surgical approach to infective endocarditis in combination with
      implantation of mechanical or stented bioprosthetic devices. METHODS: From 1994
      to 1999, 50 adults with aortic and/or mitral valve endocarditis underwent valve
      replacement. The median age of the 36 men and 14 women was 58 years (range, 17 to
      78 years). All patients had active endocarditis at the time of operation. Native
      valve endocarditis was present in 48 patients and prosthetic valve endocarditis
      was present in 2 patients. The aortic valve was affected in 24 patients, the
      mitral valve in 21 patients, and both the aortic and mitral valves in 5 patients.
      Two of the patients with mitral endocarditis also had infection of the tricuspid
      valve. Annular destruction was present in 24 patients (48%). The patients were
      treated with radical excision of all infected tissue. The annular defects were
      closed, if possible, with direct sutures. Otherwise, a reconstruction was
      performed. Follow-up was 100% complete with a median follow-up period of 45
      months (range, 6 to 66 months). RESULTS: The procedures were performed without
      lethal bleeding complications. Early mortality was 12% and the actuarial survival
      at follow-up was 80%. In none of the patients who died was death related to the
      prosthetic valve or recurrence of the endocarditis. Only 1 patient (2%) developed
      recurrence of the infective endocarditis and was reoperated with a Ross
      procedure. Three and a half years later the patient developed severe valve
      insufficiency of the autograft and was operated again with implantation of a
      mechanical device. CONCLUSIONS: Native and prosthetic valve endocarditis can be
      treated successfully with aggressive surgical debridement and implantation of
      mechanical or stented bioprosthetic devices with a low risk of recurrent
      endocarditis.

PMID- 11216727
TI  - Tricuspid valve replacement with bioprostheses: long-term results and causes of
      valve dysfunction.
AB  - BACKGROUND: Although the clinical performance of bioprostheses after valve
      replacement in the aortic and mitral position has been reported, little is known
      of the performance of tricuspid bioprostheses. The mechanism of bioprosthetic
      valve dysfunction after tricuspid valve replacement (TVR) is not clear. METHODS:
      We reviewed 98 cases of TVR with bioprostheses. To clarify the causes of valve
      dysfunction, pathologic examination of the explanted valve at the reoperation was
      performed. RESULTS: Actuarial survival at 18 years was 68.7% +/- 5.8%. There were
      12 redo TVRs. In six of the 12 cases, isolated redo TVR was performed. In the
      other cases, concomitant cardiac procedures were performed. The causes of
      prosthetic valve dysfunction were pannus formation on the cusps of the right
      ventricle side (four cases), native valve attachment (two cases), pannus
      formation + native valve attachment (two cases), sclerotic change (one case),
      pannus formation + sclerotic change (one case), and native valve attachment +
      valve infection (one case). Freedom from reoperation, structural valve
      deterioration, and nonstructural dysfunction at 18 years was 62.7% +/- 10.7%,
      96.0% +/- 2.9%, and 76.7% +/- 8.3%, respectively. CONCLUSIONS: In our 18 years of
      experience, although the survival after TVR with bioprostheses is acceptable, the
      reoperation free rate is not satisfactory. Pannus formation on the cusps of the
      ventricular side seems to be a serious problem that causes bioprosthetic
      dysfunction in the tricuspid position.

PMID- 11216728
TI  - Temperature during coronary artery bypass surgery affects quality of life.
AB  - BACKGROUND: The objective of this study was to examine the effects of temperature
      on a variety of indices of psychologic adjustment and quality of life. METHODS: A
      total of 209 patients randomly received normothermic (warm) or hypothermic (cold)
      conditions during coronary artery bypass surgery (CABS), and a number of
      physical, social, and psychologic measures were assessed before as well as 6
      weeks and 6 months after CABS. RESULTS: Repeated measures analyses of covariance
      revealed significant temperature group main effects for anxiety (p = 0.008) and
      depression (p = 0.039), with the normothermic group obtaining lower anxiety and
      depression levels than the hypothermic group at both 6 weeks and 6 months after
      surgery. Additionally, among patients who entered the study with higher
      depression levels, those in the hypothermic group tended to have higher
      depression scores at follow-up compared with patients in the normothermic
      condition (p = 0.012). No temperature group differences were observed on other
      quality of life indices. CONCLUSIONS: The results of the present study indicate
      that hypothermic conditions during CABS are associated with higher levels of
      emotional distress after CABS than normothermic conditions, particularly for
      patients with greater stress to begin with.

PMID- 11216729
TI  - Increased incidence of acute ascending aortic dissection with off-pump
      aortocoronary bypass surgery?
AB  - BACKGROUND: An apparent increase in the incidence of acute ascending aortic
      dissection following off-pump coronary artery bypass grafting (OPCAB) led us to
      assess retrospectively the rate and circumstances of this complication in our
      institution on a consecutive series of patients undergoing aortocoronary bypass
      performed with and without extracorporeal circulation (ECC). METHODS: A
      retrospective analysis of acute ascending aortic dissections complicating
      coronary artery bypass grafting surgery in 3,031 patients in our institution
      since April 1, 1995, was performed using the database of the Montreal Heart
      Institute. RESULTS: There was a greater frequency of hypertension in the OPCAB
      group. Iatrogenic acute aortic dissection occurred in 3 patients among 308
      operated on without ECC (0.97%) and 1 patient among 2,723 operated on under ECC
      (0.04%). This difference was statistically significant (p < 0.00001).
      CONCLUSIONS: The risk of aortic dissection may be increased in OPCAB. Careful
      manipulation of the aorta with a single side-clamping and a control of the
      arterial pressure should be used to minimize aortic trauma. High-risk patients
      should undergo CABG without side-clamping of the aorta or CABG with ECC to
      prevent this redoubtable complication of myocardial revascularization.

PMID- 11216730
TI  - Coronary endothelial injury after local occlusion on the human beating heart.
AB  - BACKGROUND: Occlusion of coronary arteries during beating heart surgery bears the
      potential for mechanical trauma to the arterial wall with consequent endothelial
      injury. The aim of this study was to elucidate the effects of local occlusion on
      the beating heart in human coronary arteries. METHODS: Coronary arteries of
      patients with dilated cardiomyopathy (n = 7) or ischemic heart disease (n = 10)
      undergoing heart transplantation were locally occluded after starting
      cardiopulmonary bypass. Immediately after excision of the diseased heart, the
      vessels were fixed. Unoccluded segments served as controls. Integrity of
      endothelial lining was observed with scanning electron microscopy. RESULTS:
      Scanning electron microscopy revealed significantly more severe endothelial
      injury in the area of occlusion than in the adjacent, not manipulated control
      segments. In the region of local occlusion, plaque rupture was noted in three of
      34 atherosclerotic vessel specimens, injury to side branches was evident in two
      of 44, and local microthrombus formation was evident in six of 44 samples.
      CONCLUSIONS: Local occlusion of human coronary arteries during beating heart
      coronary surgery may cause focal endothelial denudation, local microthrombosis,
      atherosclerotic plaque rupture, and injury to target vessel side branches.

PMID- 11216731
TI  - Left hemispheric strokes in coronary surgery: implications for end-hole aortic
      cannulas.
AB  - BACKGROUND: Perioperative stroke (POS) is a devastating complication of coronary
      artery bypass grafting (CABG). Many studies have been published concerning risk
      factors and possible causes of POS but none have studied which side of the brain
      is more frequently involved. The finding of a strong preponderance of left-sided
      strokes calls into question some widely held theories as to the cause of POS and
      implicates end-hole aortic perfusion catheters as a major factor. METHODS: During
      a 3-year period (1996 to 1998), prospective data were collected on all 2,217
      consecutive CABG patients at one hospital (with surgery by different surgeons in
      different groups). Strokes were classified as perioperative (within 3 days of
      surgery) or late (beyond 3 days but during hospitalization). RESULTS: There were
      a total of 51 strokes (2.3%): 21 left, 10 right, 7 bilateral, 7 lacunar, 1
      brainstem, and 5 indeterminate. There were 18 major territorial perioperative
      strokes on the left side and 6 on the right side. Thus, 75% (18 of 24) of POS
      were left-sided. Stroke patients were significantly younger than nonstroke
      patients (66.3 +/- 10.52 versus 71.4 +/- 8.47 years, p = 0.009). Other
      demographic data did not differ significantly. CONCLUSIONS: If aortic clamping,
      cannulation, or manipulation were responsible for most strokes, then right-sided
      strokes should predominate, as the innominate artery is closest to the source of
      such emboli. In contrast, end-hole aortic cannulas direct a high-velocity jet at
      the left carotid orifice and may be responsible for a large proportion of POS.
      Side-hole aortic cannulas may reduce the incidence of this complication.

PMID- 11216732
TI  - Direct measurement of nitric oxide release from saphenous vein: abolishment by
      surgical preparation.
AB  - BACKGROUND: Surgical preparation (distension) of the saphenous vein (SV) is
      applied routinely during harvesting in coronary artery bypass grafting (CABG).
      However, mechanical distension may impair the endothelium, which plays an
      important role in long-term patency. The present study investigated the effect of
      surgical preparation of the SV on nitric oxide (NO) release from the endothelium
      by direct measurement of NO. METHODS: Saphenous vein segments taken from CABG
      patients were cut open longitudinally and placed in an organ chamber. An NO
      sensitive electrode and NO meter were used to directly measure NO release induced
      by acetylcholine (ACh) and bradykinin (BK) from the surgically prepared veins
      (PV) compared with the control (nondistended) veins. RESULTS: The basal release
      of NO in the PV group was significantly lower than that in the control group (3.4
      +/- 1.4 nM, n = 9 versus 9.9 +/- 2.8 nM, n = 13, p = 0.002). The maximum
      concentrations of NO release induced by ACh and BK in the PV group were also
      significantly lower than those in the control veins (for ACh 10(-6) mol/L: 9.6 +/
      3.1 nM, n = 8 versus 41.9 +/- 11.2 nM, n = 12, p = 0.005; for BK 10(-8) mol/L:
      8.3 +/- 3.7 nM, n = 7 versus 37.9 +/- 6.1 nM, n = 9, p = 0.003). Further, the
      duration of NO release in the PV group was significantly shorter than that in
      control veins (1.5 +/- 1.3 minutes, n = 8 versus 8.1 +/- 1.9 minutes, n = 8, p <
      0.001). CONCLUSIONS: Surgical preparation almost abolishes NO release by the SV
      and this may significantly contribute to the low long-term patency rate of the
      vein graft.

PMID- 11216733
TI  - Comparison of systemic vasodilators: effects on flow in internal mammary and
      radial arteries.
AB  - BACKGROUND: Spasm is a major concern with the use of arterial conduits in
      coronary artery bypass surgery (CABG). We evaluated the effect of systemic
      vasodilators on in vivo radial artery flow compared with internal mammary artery
      (IMA) flow. METHODS: Fifty patients undergoing primary CABG with a mean age of 69
      +/- 5 years enrolled in this study and were randomized to 1 of 5 groups based on
      the vasodilating agent administered (nitroglycerin, nitroprusside, dobutamine,
      milrinone, and normal saline as control group). Radial artery and IMA flows,
      blood pressure, central venous pressure, and heart rate were measured before and
      10 minutes after drug administration. RESULTS: Mean arterial pressure decreased
      significantly after drug administration in both the nitroglycerin (p = 0.007) and
      nitroprusside (p < 0.001) groups and increased in the dobutamine group (p <
      0.001). There were no significant differences between IMA flow or radial flow
      among the groups before drug administration. A multivariate general linear model
      was created and revealed drug (specifically nitroglycerin) as the only predictor
      to increase flow in the IMA (p < 0.001) or the radial artery (p = 0.009).
      CONCLUSIONS: We conclude that intravenous nitroglycerin causes in vivo
      vasodilatation of both the IMA and radial artery and is a good systemic
      vasodilator to be given when harvesting these two conduits.

PMID- 11216734
TI  - Deep hypothermic circulatory arrest: I. Effects of cooling on
      electroencephalogram and evoked potentials.
AB  - BACKGROUND: Deep hypothermia is an important cerebral protectant and is critical
      in procedures requiring circulatory arrest. The purpose of this study was to
      determine the factors that influence the neurophysiologic changes during cooling
      before circulatory arrest, in particular the occurrence of electrocerebral
      silence. METHODS: In 109 patients undergoing hypothermic circulatory arrest with
      neurophysiologic monitoring, five electrophysiologic events were selected for
      detailed study. RESULTS: The mean nasopharyngeal temperature when periodic
      complexes appeared in the electroencephalogram after cooling was 29.6 degrees C
      +/- 3 degrees C, electroencephalogram burst-suppression appeared at 24.4 degrees
      C +/- 4 degrees C, and electrocerebral silence appeared at 17.8 degrees C +/- 4
      degrees C. The N20-P22 complex of the somatosensory evoked response disappeared
      at 21.4 degrees C +/- 4 degrees C, and the somatosensory evoked response N13 wave
      disappeared at 17.3 degrees C +/- 4 degrees C. The temperatures of these various
      events were not significantly affected by any patient-specific or surgical
      variables, although the time to cool to electrocerebral silence was prolonged by
      high hemoglobin concentrations, low arterial partial pressure of carbon dioxide,
      and by slow cooling rates. Only 60% of patients demonstrated electrocerebral
      silence by either a nasopharyngeal temperature of 18 degrees C or a cooling time
      of 30 minutes. CONCLUSIONS: With the high degree of interpatient variability in
      these neurophysiologic measures, the only absolute predictors of electrocerebral
      silence were nasopharyngeal temperature below 12.5 degrees C and cooling longer
      than 50 minutes.

PMID- 11216735
TI  - Growth potential of left internal thoracic artery grafts: analysis of
      angiographic findings.
AB  - BACKGROUND: The growth potential of the internal thoracic artery (ITA) is still
      undetermined, and little is known about the long-term effects of anastomosing it
      to the coronary artery. METHODS: Fifty-three patients whose left ITA (LITA) had
      been anastomosed to the left anterior descending (LAD) coronary artery underwent
      coronary angiography within 1 month of operation and in late follow-up (mean
      interval: 4.5 +/- 1.5 years). The diameter ratios of LITA to LAD were designated
      as the matching ratio. RESULTS: In follow-up, the diameter of the LITA increased
      from 1.83 +/- 0.40 to 2.46 +/- 0.53 mm in the 29 patients with progressive
      proximal native coronary stenosis. However, late results indicate that the
      matching ratio did not vary according to the location of the LITA anastomosis on
      the LAD (proximal portion: 1.13 +/- 0.16, distal portion 1.19 +/- 0.13), and
      reached an upper limit of about 1.4. CONCLUSIONS: Growth potential of the LITA is
      limited by the diameter of the coronary artery onto which it is anastomosed. The
      most effective procedure for enhancing the growth potential of the LITA is to
      anastomose as proximally as possible onto the LAD.

PMID- 11216736
TI  - The impact of chronic renal failure on atherosclerosis of the internal thoracic
      arteries.
AB  - BACKGROUND: Little is known about the impact of renal failure on atherosclerotic
      changes in the internal thoracic artery (ITA). METHODS: A total of 20 consecutive
      patients on chronic dialysis who underwent coronary artery bypass grafting (CABG)
      during April 1998 through September 1999 were investigated. The 20 control
      patients were selected from the same interval to rigorously match risk factors.
      Atherosclerosis of the ITA collected from each patient was analyzed using the
      subjective evaluation proposed by Kay and colleagues. RESULTS: There were no
      cases of greater than 25% atherosclerotic luminal narrowing among a total of 35
      ITA specimens from dialysis patients. The degree of atherosclerosis was not
      significantly different from that of the specimens from matched patients (p =
      0.18). No calcification was found in ITA grafts either microscopically or
      macroscopically. The number of elastic lamellae, an index of the elasticity of
      the ITA graft, was not significantly different from those obtained from the
      matched patients. Analysis of preoperative coronary angiography revealed that
      coronary calcification was significantly more frequent in dialysis patients (15
      patients, 75%) than in matched patients (p < 0.05). By analysis of postoperative
      angiography in dialysis patients, no evidence of atherosclerotic changes was
      found in 28 opacified ITAs. In addition, despite the presence of calcification in
      the native coronary, no calcification was evident along the entire length of the
      ITAs. CONCLUSIONS: This study revealed the minimal impact of chronic renal
      failure on atherosclerotic changes in the ITA. The results of this study support
      the continued use of ITA grafting in dialysis patients.

PMID- 11216737
TI  - Different CABG methods in patients with chronic obstructive pulmonary disease.
AB  - BACKGROUND: Pulmonary dysfunction is still a major problem in coronary artery
      bypass grafting (CABG). The purpose of this randomized study was to determine the
      effect of different CABG techniques on pulmonary function. METHODS: Fifty eight
      patients with severe obstructive pulmonary disease had elective isolated coronary
      surgery. The surgical methods for the patients with chronic obstructive pulmonary
      disease (COPD) were standard CABG in 18 patients (group 1), beating heart surgery
      in 19 patients (group 2), and minimally invasive direct coronary artery bypass
      grafting (MIDCABG) in 21 patients (group 3). RESULTS: The earliest extubation
      time was from group 3 (p < 0.001). The average stay in the intensive care unit
      was significantly longer in group 1 (2.6 +/- 1.5 days) than in groups 2 (1.4 +/-
      0.8 days) and 3 (1.1 +/- 0.8 days) (p < 0.05). The most prevalent respiratory
      morbidity was atelectasis that developed in 6 patients from group 1, in 2
      patients from group 2, and in 3 patients from group 3. Forced expiratory volumes
      in 1 second (FEV1) obtained in the second postoperative month were significantly
      lower than preoperative values only in group 1 (p < 0.05). Forced vital capacity
      (FVC) values were significantly lower than the preoperative values in all three
      groups (p < 0.05). CONCLUSIONS: Off-pump bypass surgical procedures are more
      advantageous than on-pump methods for patients with COPD. These patients can be
      operated on using the beating heart technique or by using MIDCABG to prevent side
      effects of CPB on pulmonary function and effects of sternotomy.

PMID- 11216738
TI  - Ultra-low dose aprotinin decreases transfusion requirements and is cost effective
      in coronary operations.
AB  - BACKGROUND: The recommended dose of aprotinin has been shown to reduce blood loss
      and need for blood transfusions, but the cost precludes its routine use. This
      study was designed to determine whether a less expensive, ultra-low dose of
      aprotinin is effective when used in coronary artery bypass grafting with left
      internal mammary artery. METHODS: Patients (n = 202) were randomized to receive
      either placebo or aprotinin, 0.5 million KIU before incision and 0.5 million KIU
      during initiation of cardiopulmonary bypass. Differences in quantity of blood
      transfused were analyzed. Further groups were analyzed to account for the effect
      of aspirin. Multivariable analysis was performed to determine risk factors for
      transfusion. Direct costs of blood products and aprotinin were tabulated for each
      group. RESULTS: There was an important reduction in the proportion of patients
      transfused, and number of blood units transfused when aprotinin was given before
      coronary artery bypass grafting. These differences were even more important in
      patients on aspirin preoperatively. Independent predictors for increased number
      of transfusions were aspirin continued before operation, smaller body surface
      area, and the use of placebo instead of ultra-low dose aprotinin. There was no
      difference in morbidity between treatment groups. There was a reduction in direct
      costs associated with the use of aprotinin. CONCLUSIONS: These data support the
      routine use of aprotinin 1 million KIU in coronary artery bypass grafting with
      left internal mammary artery to reduce cost and transfusion requirements.

PMID- 11216739
TI  - Complete revascularization in coronary artery bypass grafting with and without
      cardiopulmonary bypass.
AB  - BACKGROUND: The feasibility of complete revascularization on the beating heart
      without cardiopulmonary bypass (CPB) as compared with the standard operation with
      CPB in elective low-risk patients with multivessel disease has not been clearly
      demonstrated in a prospective trial. METHODS: Eighty selected low-risk patients
      were enrolled. In preoperative study with coronary angiography, the decision was
      made whether complete revascularization without CPB could be performed. Patients
      were randomly assigned to receive CABG either with (n = 40) or without CPB (n =
      40). Randomization criteria were age, sex, and left ventricular ejection
      fraction. Completeness of revascularization as well as short- and mid-term
      clinical outcome in a 13.4 +/- 6.5 month follow-up period were monitored.
      RESULTS: Twenty-six of 40 (65%) patients undergoing CABG without CPB underwent
      complete revascularization. In 5 of these patients (12.5%) suitable vessels were
      discarded for technical reasons and 9 patients (22.5%) were switched to CABG with
      CPB owing to the deeply intramyocardial course of target vessels (n = 5) or to
      hemodynamic instability (n = 4). In the group of patients operated on with CPB,
      34 of 40 patients (85%) received complete revascularization. In 6 patients (15%)
      suitable vessels were discarded for technical reasons. Mean number of bypass
      grafts was 3.1 +/- 0.8 with CPB and 2.6 +/- 0.5 without CPB (p = 0.043). Clinical
      outcome and hospital stay were comparable in both groups. No patient died during
      the study period. No myocardial infarction was observed. Three patients
      undergoing CABG without CPB underwent successful PTCA 3 months after surgery.
      CONCLUSIONS: CABG without the use of CPB is effective for complete
      revascularization in the majority of selected low-risk patients. Nevertheless, it
      has to be stated that the rate of incomplete revascularization in this early
      series of CABG without CPB is higher, and compromises the basic principle of
      complete revascularization.

PMID- 11216741
TI  - Revascularization of severe hibernating myocardium in the beating heart: early
      hemodynamic and metabolic features.
AB  - BACKGROUND: We investigated the effects of coronary artery bypass grafting (CABG)
      without cardiopulmonary bypass (CPB) in selected patients with severe hibernating
      myocardium. METHODS: Twelve patients (EF = 25% +/- 0.7%) with reversible
      ventricular dysfunction (from 2.0 +/- 0.06 to 1.6 +/- 0.05 left ventricular score
      index by echodobutamine, p < 0.01) in the territory of the left anterior
      descending artery (LAD) have been studied. Revascularization was achieved by
      anastomosing the left internal mammary artery to the LAD. The ischemic time of
      LAD was 9.0 +/- 0.4 minutes. RESULTS: Left ventricular function increased 6 hours
      and 48 hours after revascularization (left ventricular stroke work index from 32
      +/- 1.8 to 42 +/- 1.5 and 40 +/- 0.6 gxm/m2, respectively: p = 0.0001). During
      the surgical procedure, the heart did not release lactate or creatine
      phosphokinase. There were no perioperative deaths or severe complications.
      CONCLUSIONS: Early hemodynamic and metabolic features of CABG without CPB in
      patients with hibernating myocardium suggest that this procedure is safe and
      results in a significant improvement of cardiac function without affecting
      myocardial metabolism.

PMID- 11216740
TI  - Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump
      cardiopulmonary bypass grafting: does eliminating the pump reduce morbidity and
      cost?
AB  - BACKGROUND: Cardiopulmonary bypass (CPB) may contribute to the complications and
      cost of coronary artery bypass grafting (CABG). Off-pump CABG (OPCAB) allows
      coronary revascularization without CPB. We hypothesized that OPCAB provides
      satisfactory graft patency while reducing complications and cost compared with
      CABG with CPB. METHODS: We prospectively followed 80 patients undergoing CABG: 40
      patients undergoing OPCAB and 40 patients undergoing CABG with CPB. OPCAB
      patients underwent angiography within 48 hours of surgery to determine early
      graft patency. Incidence of complications, length of stay, and costs were
      recorded for each patient. The influence of the number of vessels bypassed was
      analyzed. RESULTS: OPCAB patients (n = 40) underwent grafting of 2.7 +/- 0.7
      vessels per patient compared with 3.6 +/- 0.8 vessels per patient in the CABG
      with CPB group (n = 40) (p < 0.0001). Angiography demonstrated 105 of 108 (97%)
      of grafts were patent in the OPCAB group. Incidence of complications, length of
      stay, and costs did not differ between the OPCAB and CABG with CPB groups. Number
      of vessels grafted showed a positive correlation to total costs in both groups.
      CONCLUSIONS: While OPCAB provided satisfactory early graft patency, there was no
      significant difference between OPCAB and CABG with CPB with regard to cost,
      length of stay, or incidence of complications. In this study, eliminating CPB did
      not reduce morbidity or cost after CABG.

PMID- 11216742
TI  - The radial artery versus the saphenous vein graft in contemporary CABG: a case
      matched study.
AB  - BACKGROUND: Although use of the internal thoracic artery has been shown to
      improve outcomes after coronary artery bypass grafting, the same cannot be said
      of alternative arterial conduits. To determine the benefit of radial artery (RA)
      grafting, a case-matched review was undertaken. METHODS: Between March 1994 and
      March 1999, 2,847 patients underwent isolated coronary artery bypass grafting
      with a left internal thoracic artery graft, plus saphenous vein grafts (SVGs). Of
      these patients, 478 also received an RA graft (RA group). The RA patients were
      matched at a ratio of 1:2 with patients receiving only SVGs and a left internal
      thoracic artery graft (SVG group; n = 956) using six prognostic risk factors:
      age, sex, Canadian Cardiovascular Society class, left ventricular grade, number
      of diseased vessels, and timing of operation. Target vessels were graded
      according to quality and graftability and were similar between groups. Outcomes
      were evaluated by univariate and multivariate analyses. RESULTS: There was a
      significantly higher prevalence of diabetes, hypertension, and peripheral
      vascular disease in the RA group (p < 0.05). Although stay in the intensive care
      unit was shorter in the RA group (RA, 30 +/- 2 hours, and SVG, 37 +/- 2 hours; p
      = 0.0002), total hospital stay was similar between groups. The incidence of
      perioperative myocardial infarction was higher in the SVG group (SVG, 31 of 956
      or 3.2%, and RA, 6 of 478 or 1.3%; p = 0.02). Multivariate analysis revealed RA
      grafting to be protective against early mortality and morbidity (odds ratio =
      0.58; 95% confidence interval, 0.37 to 0.90; p = 0.015) and late mortality and
      morbidity including late reintervention (risk ratio = 0.60; 95% confidence
      interval, 0.37 to 0.93; p = 0.02). Actuarial freedom from events at 36 months
      postoperatively was greater in the RA group (RA, 95% +/- 2%, and SVG, 86% +/- 4%;
      p = 0.01). CONCLUSIONS: Despite a higher prevalence of preoperative comorbidity,
      patients in the RA group demonstrated improved outcomes after coronary artery
      bypass grafting. The RA is a viable and beneficial conduit for this operation.

PMID- 11216743
TI  - Concomitant subclavian and coronary artery disease.
AB  - BACKGROUND: Proximal subclavian artery occlusive disease in the presence of a
      patent internal mammary artery used as a conduit for a coronary artery bypass
      graft procedure may cause reversal of internal mammary artery flow (coronary
      subclavian steal) and produce myocardial ischemia. METHODS: We reviewed outcome
      to determine whether subclavian artery revascularization can provide effective
      protection from and treatment for coronary-subclavian steal. Between 1985 and
      1997, 20 patients had either concomitant subclavian and coronary artery disease
      diagnosed before operation (group 1, 5 patients) or symptomatic coronary
      subclavian steal occurring after a previous coronary artery bypass graft
      procedure (group 2, 15 patients). Patients in group 1 received direct subclavian
      artery bypass and a simultaneous coronary artery bypass graft procedure in which
      the ipsilateral internal mammary artery was used for at least one of the bypass
      conduits. Patients in group 2 received either extrathoracic subclavian-carotid
      bypass (5 patients, 33.3%) or percutaneous transluminal angioplasty and stenting
      (10 patients, 66.7%) as treatment for symptomatic coronary-subclavian steal.
      RESULTS: All patients were symptom-free after intervention. One patient treated
      with percutaneous transluminal angioplasty and stenting died of progressive renal
      failure. Follow-up totaled 58.5 patient-years (mean, 3.1 years/patient). In group
      1, primary patency was 100% (mean follow-up, 3.7 years). In group 2, one late
      recurrence was treated by operative revision, yielding a secondary patency rate
      of 100% (mean follow-up, 2.9 years). CONCLUSIONS: Subclavian artery
      revascularization can provide effective protection from and treatment for
      coronary-subclavian steal with acceptably low operative risk. Midterm follow-up
      demonstrates good patency.

PMID- 11216744
TI  - Coronary artery fistulas: long-term results of surgical correction.
AB  - BACKGROUND: Opinions vary as to whether operation should be offered patients with
      coronary artery fistula, particularly to those who are asymptomatic. Published
      studies lacked long-term follow-up data. METHODS: We studied 41 patients with
      coronary artery fistula operated in our unit in the past 30 years with restudies
      including coronary angiograms in those who agreed to the investigation. RESULTS:
      There was no operative mortality and operative morbidity was low. The mean
      duration of follow-up was 9.1 years and 96.9% of the patients were asymptomatic.
      Twenty-one patients had a coronary angiogram. The native coronary artery either
      remained dilated and tortuous, or more frequently had thromboses with a short
      proximal stump. (None of these patients had evidence of myocardial ischemia.)
      Four patients had demonstrable recurrence fistula but without hemodynamic
      disturbance. CONCLUSIONS: We advocate operation for all patients with coronary
      artery fistulas and demonstrable shunting in view of minimal operative risks.
      Small asymptomatic fistulas without demonstrable shunting should be left alone.
      The relatively high incidence of residual or recurrent fistula makes long-term
      follow-up mandatory.

PMID- 11216745
TI  - Reoperative CABG using left thoracotomy: a tailored strategy.
AB  - BACKGROUND: Reoperative coronary artery bypass grafting (CABG) through a left
      thoracotomy is a challenging operation with no one dominant approach. We
      developed a tailored strategy for this difficult group of patients, integrating
      the currently available newer technologies for each patient indication. METHODS:
      Between October 1991 and October 1999, 50 consecutive patients underwent
      reoperative CABG through a left thoracotomy. Age was 65 +/- 9 years, 40 (80%)
      were men, and preoperative ejection fraction was 40 +/- 13. In 36 patients (72%)
      the left internal mammary artery had been placed to the left anterior descending
      coronary artery during the primary CABG and in 25 of 36 patients (70%) this left
      internal mammary artery-left anterior descending coronary artery graft was
      patent. The mean duration from previous CABG was 8.0 +/- 4.8 years. Three
      approaches were used: (1) conventional cardiopulmonary bypass using fibrillatory
      or circulatory arrest (n = 33, 66%); (2) Heartport endoaortic balloon occlusion
      (n = 4, 8%); and (3) off-pump beating heart techniques (n = 13, 26%). RESULTS:
      The off-pump CABG technique was used in the majority of recent patients and 1
      (7.7%) had to be converted to cardiopulmonary bypass due to hemodynamic
      instability. When cardiopulmonary bypass was used its duration was 122 +/- 59
      minutes and mean temperature on bypass was 24 degrees +/- 6 degrees C. In the 4
      patients in whom the Heartport system was used, the median endoaortic occlusion
      duration was 49 minutes. Patients received an average of 1.4 grafts/patient. In
      60 of 70 patients (89%) distal anastomoses were performed to an anterolateral
      coronary target. There were 3 of 50 (6%) operative deaths, 2 in the conventional
      group and 1 in the endoaortic balloon occlusion group. The mean length of stay in
      the 47 survivors was 7.8 +/- 3.9 days (median, 7 days). CONCLUSIONS: Reoperative
      CABG by left thoracotomy remains a challenging operation. Several techniques,
      including off-pump CABG, conventional cardiopulmonary bypass, circulatory arrest,
      and endoaortic balloon occlusion, should be in the surgeon's armamentarium to
      allow a tailored approach for each operation based on patient indications.

PMID- 11216746
TI  - Surgical strategy for left ventricular free wall rupture after acute myocardial
      infarction.
AB  - BACKGROUND: Left ventricular free wall rupture is usually fatal without surgical
      intervention. However, the most appropriate surgical procedure remains
      controversial. METHODS: Seventeen patients (14 men, 3 women) who developed left
      ventricular free wall rupture after acute myocardial infarction were treated
      surgically. Their mean age was 65.4 years (range, 55 to 79 years). The following
      surgical procedures were performed: infarctectomy and patch reconstruction in 1
      patient, direct closure with or without patch covering in 4 patients, simple
      patch covering anchored by running suture in 4 patients, and a sutureless
      technique in 7 patients. Endventricular patch closure was performed in 1 patient
      with ventricular septal perforation. RESULTS: One of 3 patients with a blow-out
      type rupture and 1 of 13 patients with an oozing type rupture died shortly after
      operation. The overall surgical mortality rate was 11.8%. CONCLUSIONS: Selection
      of the optimal procedure for each cardiac condition is important for obtaining
      good results. For patients with ongoing squirting bleeding, patch covering is the
      technique of choice. For oozing, the sutureless technique is preferable.

PMID- 11216747
TI  - Improved outcomes with an implantable left ventricular assist system: a
      multicenter study.
AB  - BACKGROUND: Cumulative experience with the Novacor wearable electric left
      ventricular assist system (LVAS) now exceeds 850 recipients. The pump inflow
      conduit (IFC) has been implicated in embolic complications. METHODS: Clinical
      outcomes were compared for two IFC designs in a retrospective, nonrandomized,
      multicenter study. The original IFC (woven, unsupported, crimped polyester:
      control group) and an alternative IFC (knitted, gelatin-sealed, integrally
      supported, uncrimped polyester: test group) were utilized upon availability in
      North American and European centers. Differences in cerebral embolism to 180 days
      postimplant were analyzed. RESULTS: Four hundred ninety patients implanted
      between August 1996 and August 1999, were studied. Two hundred eighty-eight
      received the control IFC and 202 received the test IFC. The groups (control,
      test) were well matched for age (48, 49 years), etiology (idiopathic 53%[152 of
      288], 55% [112 of 202]; ischemic 34% [97 of 288], 33% [66 of 202]) and mean
      observation time (97, 91 days). The incidence of embolic cerebrovascular
      accidents (CVA) was 21% (60 of 288) in the control and 12% (24 of 202) in the
      test group (p = 0.010). Independent risk factors for embolic CVA were found to be
      preimplant acute myocardial infarction (odds ratio 4.3), age above 50 years (odds
      ratio 2.1), and ischemic etiology (odds ratio 1.7). There was no difference in
      survival between the groups (71% [205 of 288], 68% [137 of 202]). CONCLUSIONS:
      The alternative (test) IFC has significantly reduced the incidence of embolic
      CVA. This improvement is likely due to increased resistance to deformation at
      implant, improved neointimal adhesion, and more favorable blood flow
      characteristics within the conduit.

PMID- 11216748
TI  - When to discontinue extracorporeal membrane oxygenation for postcardiotomy
      support.
AB  - BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has demonstrated limited
      success in adult postcardiotomy shock. The goal of this study was to determine
      when to discontinue ECMO for postcardiotomy support. METHODS: During a 7-year
      period ECMO was used in 51 postcardiotomy patients, of whom 16 (31%) weaned and 8
      (16%) survived. RESULTS: Patients in the heart transplant group were more likely
      to wean compared with patients in the non-heart transplant group (p = 0.03).
      Patients aged greater than 65 years (p = 0.04) or with ejection fractions of less
      than 30% after 48 hours of ECMO (p < 0.001) were less likely to wean. Time on
      ECMO was significantly longer for survivors in the heart transplant group (101.3
      +/- 7.5 hours) compared with survivors in the non-heart transplant group (28.3 +/
      11.9 hours, p < 0.001). CONCLUSIONS: After 48 to 72 hours, consideration should
      be given to discontinuing ECMO, either by moving to an implantable ventricular
      assist device or by withdrawal of support, except in those patients with heart
      transplants. In the latter, both severe postoperative pulmonary hypertension and
      reperfusion injury may take as long as 120 hours to reverse.

PMID- 11216749
TI  - A new method of monitoring recovery and weaning the Thoratec left ventricular
      assist device.
AB  - BACKGROUND: Recent scientific and clinical data suggest that chronic mechanical
      ventricular unloading may lead to myocardial recovery. Evaluating and monitoring
      patients for myocardial recovery and the optimal methods of weaning the left
      ventricular assist device are not well defined. METHODS: Six patients with
      advanced heart failure and severe mitral regurgitation have undergone successful
      bridge to recovery using a Thoratec left ventricular assist device. Data that
      details their monitoring for myocardial recovery and weaning from the left
      ventricular assist device were prospectively collected. RESULTS: Clinical data
      collected during the recovery phase included chest roentgenogram,
      echocardiography, plasma norepinephrine, tumor necrosis factor-alpha,
      bioimpedance, and cardiopulmonary exercise testing (peak oxygen consumption).
      Normalization of these variables with a 10% increase in the peak oxygen
      consumption was obtained before weaning. The Thoratec device rate and percent
      systole were manipulated to allow gradual reloading of the ventricle. The weaning
      process occurred for more than 5 to 10 days to allow time for observation of the
      ventricle and its response to the increasing workload. CONCLUSIONS: Select
      patients with advanced congestive heart failure and severe mitral insufficiency
      can benefit from mechanical device support. We describe our technique of
      monitoring for myocardial recovery using clinical variables. Our technique of
      weaning allows for gradual reloading of the ventricle and a longer period of
      observation before device removal. Additional research is needed to determine
      which variables will accurately predict long-term myocardial recovery and the
      optimal weaning method.

PMID- 11216750
TI  - Effects of metabolic stimulation on cardiac allograft recovery.
AB  - BACKGROUND: We previously demonstrated that continuous perfusion of cardiac
      allografts during hypothermic storage with donor blood harvested at the time of
      organ retrieval improves myocardial recovery after transplantation. However,
      myocardial metabolism and function remain depressed compared to base line values.
      This study evaluated the use of a continuous infusion of donor blood enhanced
      with insulin to augment aerobic myocardial metabolism during and after
      hypothermic storage. METHODS: Yorkshire pigs (45 to 50 kg) were used to perform
      14 orthotopic cardiac transplants using either continuous perfusion with donor
      blood (blood group, n = 7) or perfusion with donor blood enhanced with 10 IU/L
      insulin (insulin group, n = 7). After heparinization, hypothermic (4 degrees C)
      cardioplegic arrest, and donor heart extraction, donor blood (2,844 +/- 210 mL)
      was harvested in both groups and perfused at room temperature (20 degrees C) at a
      pressure of 60 mm Hg for 3 hours. Blood cardioplegia was delivered after each
      anastomosis in both groups and arterial and coronary sinus blood samples were
      obtained to examine myocardial metabolism. A Millar micromanometer was used to
      measure left ventricular developed pressure and the rate-pressure product at
      varying preloads. RESULTS: There were no differences in either myocardial lactate
      or acid release between the two groups. Hearts in the insulin group displayed
      higher myocardial oxygen extraction than those in the blood group. The recovery
      of developed pressure was higher in the insulin group compared to the blood group
      (91% +/- 19% vs 73% +/- 2%, p = 0.04). CONCLUSIONS: In this model, continuous
      perfusion of cardiac allografts with donor blood and insulin preserves myocardial
      metabolism during hypothermic storage and improves metabolic and functional
      recovery after orthotopic cardiac transplantation.

PMID- 11216751
TI  - Deep hypothermic circulatory arrest: II. Changes in electroencephalogram and
      evoked potentials during rewarming.
AB  - BACKGROUND: Electrophysiologic studies during rewarming after deep hypothermic
      circulatory arrest probe the state of the brain during this critical period and
      may provide insight into the neurological effects of circulatory arrest and the
      neurologic outcome. METHODS: Electroencephalogram (EEG) and evoked potentials
      were monitored during rewarming in 109 patients undergoing aortic surgery with
      hypothermic circulatory arrest. RESULTS: The sequence of neurophysiologic events
      during rewarming did not mirror the events during cooling. The evoked potentials
      recovered first followed by EEG burst-suppression and then continuous EEG. The
      time to recovery of the evoked potentials N20-P22 complex was significantly
      correlated with the time of circulatory arrest even in patients without
      postoperative neurologic deficits (r = 0.37, (p = 0.002). The nasopharyngeal
      temperatures at which continuous EEG activity and the N20-P22 complex returned
      were strongly correlated (r = 0.44, p = 0.0002; r = 0.41, p = 0.00003) with
      postoperative neurologic impairment. Specifically, the relative risk for
      postoperative neurologic impairment increased by a factor of 1.56 (95% CI 1.1 to
      2.2) for every degree increase in temperature at which the EEG first became
      continuous. CONCLUSIONS: No trend toward shortened recovery times or improved
      neurologic outcome was noted with lower temperatures at circulatory arrest,
      indicating that the process of cooling to electrocerebral silence produced a
      relatively uniform degree of cerebral protection, independent of the actual
      nasopharyngeal temperature.

PMID- 11216752
TI  - Induction of inflammatory mediators during reperfusion of the human heart.
AB  - BACKGROUND: Cardioplegia and reperfusion may induce an inflammatory reaction,
      which may contribute to postoperative morbidity and mortality. METHODS: Gene
      expression of cytokines, adhesion molecules, and vasoactive substances was
      evaluated in left ventricular biopsies taken before cardioplegia (lasting
      approximately 70 minutes) and after reperfusion (approximately 40 minutes) from
      19 patients (5 with valvular or combined disease, 7 with stable angina pectoris,
      7 with unstable angina). mRNA was extracted and amplified with a semiquantitative
      reverse transcription polymerase chain reaction. RESULTS: Cardioplegia
      reperfusion increased mRNA for E-selectin by a factor of 17 +/- 5 (p < 0.002)
      (mean +/- SEM), interleukin-1beta, with 9 +/- 3 (p < 0.007), tumor necrosis
      factor-alpha with 6 +/- 3 (p < 0.05), interleukin-2 receptor alpha chain CD25
      with 2 +/- 0.6 (p < 0.04), and intercellular adhesion molecule-1 with 2 +/- 0.4
      (p < 0.005). Before cardioplegia, mRNA for endothelial nitric oxide synthase was
      predominantly detected in unstable angina patients, and increased by a factor of
      11 +/- 6 (p < 0.02) during reperfusion. mRNA for endothelin-1 decreased by a
      factor of 0.5 +/- 0.1 (p < 0.0005). The changes were more pronounced in unstable
      patients. The transcription factor nuclear factor kappa B (NFkappaB), which
      regulates expression of inflammatory mediators, was activated during reperfusion
      (n = 10, p < 0.0001). CONCLUSIONS: Open heart surgery induces an inflammatory
      response in the human heart, which is more pronounced in patients with unstable
      angina. It involves NFkappaB activation and expression of several NFkappaB
      regulated genes.

PMID- 11216753
TI  - Beta-chemokine secretion patterns in relation to clinical course and outcome in
      children after cardiopulmonary bypass: continuing the search to abrogate systemic
      inflammatory response.
AB  - BACKGROUND: Surgery involving cardiopulmonary bypass (CPB) is frequently
      accompanied by a systemic inflammatory response partly triggered by neutrophils
      and monocyte-macrophages. Certain cytokines that are powerful leukocyte
      chemotactic factors have recently been characterized and shown to be important in
      evoking inflammatory responses: monocyte chemoattractant protein-1 (MCP-1) has
      monocyte-macrophage chemotactic activity, and regulated-upon-activation normal T
      cell expressed and secreted (RANTES) has a potent chemoattractant activity for
      mononuclear phagocytes. This prospective cohort study investigated possible roles
      of these chemokines in the inflammatory response to CPB and relationships between
      the changes in chemokine levels and the clinical course and outcome. METHODS:
      Systemic blood of 16 children undergoing CPB was collected after induction of
      anesthesia (base line); at 15 minutes after bypass onset; at CPB cessation; and
      at 1, 2, 4, 8, 12, and 24 hours afterward to measure MCP-1 and RANTES. RESULTS:
      The significant changes of plasma beta chemokine levels following CPB were
      associated with patient characteristics, operative variables, and postoperative
      course. Cardiopulmonary bypass of more than 2 hours, longer surgical times,
      inotropic support, and reoperation were associated with higher MCP-1 levels and
      lower RANTES levels. CONCLUSIONS: Our results suggest a relation between CPB
      induced mediators and clinical effects, implying pathogenic roles for chemokines
      following CPB. These molecules should be considered as possible targets for
      therapeutic intervention.

PMID- 11216754
TI  - Effects of a platelet-activating factor antagonist on lung injury and ventilation
      after cardiac operation.
AB  - BACKGROUND: Platelet-activating factor is a mediator of lung injury during
      cardiac operation. Platelet-activating factor antagonists reduce lung injury in
      animal models of cardiopulmonary bypass but there is no confirmatory evidence in
      clinical practice. METHODS: The effect of a low or high dose of a platelet
      activating factor antagonist (Lexipafant) was assessed in a single center, double
      blind, placebo-controlled, parallel group study. One hundred fifty patients
      undergoing coronary artery bypass grafting were randomized by minimization into
      three groups to receive placebo infusion, 10 or 100 mg of lexipafant for over 24
      hours. Serial arterial oxygen and carbon dioxide tension, alveolar arterial
      oxygen gradient, and percent saturation were measured before operation and at 1,
      6, 24, 48 hours, and 5 days after operation. RESULTS: Patient groups were similar
      with respect to age, sex, body surface area, and urgency of operation. Likewise,
      the groups were similar with respect to duration of cardiopulmonary bypass and
      the number and type of grafts. Maximum lung injury occurred at 48 hours when the
      arterial oxygen tension and percent saturation reached a nadir (both p < 0.001)
      accompanied by the maximum increase in the alveolar arterial gradient (p <
      0.001). All measurements demonstrated partial recovery by 5 days but remained
      significantly (p < 0.001) impaired in comparison to baseline values. Duration of
      ventilation was similar in all groups. Lexipafant, at low or high dose, did not
      moderate lung injury after cardiopulmonary bypass and did not influence the
      duration of postoperative ventilation. CONCLUSIONS: Despite experimental and
      clinical evidence implicating platelet-activating factor in the pathophysiology
      of lung injury after cardiopulmonary bypass, no beneficial effect of a platelet
      activating factor antagonist on lung function or ventilation could be
      demonstrated in this clinical trial.

PMID- 11216755
TI  - Morphometric identification of luminal narrowing of myocardial capillaries after
      cardioplegic arrest.
AB  - BACKGROUND: Because there is no smooth muscle cell surrounding the capillary
      endothelial cells, the effect of coronary microcirculation at the capillary level
      following cardioplegic arrest and reperfusion would be much different from that
      of resistant arterioles. We therefore studied the effect of hypothermic blood
      cardioplegic arrest and subsequent reperfusion on the myocardial capillaries in
      cardiac operation patients. METHODS: Twenty-seven patients who underwent cardiac
      operations were included in this study. Three sequential biopsies (preischemia,
      ischemia, and reperfusion) were obtained from the right atrium. This study was
      restricted to blood vessels with a diameter of less than 8 microns. Ten randomly
      selected capillaries from each biopsy were measured for luminal surface area,
      endothelial cytoplasmic surface area, and total cross-sectional surface area of
      capillaries. RESULTS: From stereologic morphometric studies, the serial changes
      in total cross-sectional surface area were not statistically significant (p =
      0.152). However, there was a significant swelling of endothelial cytoplasm
      following ischemia and reperfusion (p = 0.0007). Meanwhile, changes in luminal
      surface area of capillaries following ischemia and reperfusion were also
      remarkable (p = 0.0008). CONCLUSIONS: The most striking finding of this study was
      the progressive decrease in capillary lumen during ischemia and after
      reperfusion. The swelling of endothelial cells is a major determinant of luminal
      narrowing of capillaries in patients receiving cardioplegic arrest.

PMID- 11216756
TI  - Retrograde versus antegrade crystalloid cardioplegia in coronary surgery: value
      of troponin-I measurement.
AB  - BACKGROUND: The optimal route for delivery of cardioplegia is still in debate in
      patients with ischemic heart disease. Cardiac troponin-I is a new marker with the
      potential for detection of minor differences in myocardial ischemia. METHODS: In
      a prospective randomized trial 58 patients undergoing elective coronary artery
      bypass grafting for two- or three-vessel coronary artery disease were divided
      into groups with antegrade (group A, n = 29) and retrograde (group R, n = 29)
      application of crystalloid cardioplegia (St. Thomas II). Patients with major risk
      factors were excluded. In addition to routine electrocardiogram monitoring,
      cardiac troponin-I and creatine kinase-MB activity were measured in all patients
      preoperatively at 2, 5, 8, 24, and 48 hours after aortic cross-clamp release, and
      at hospital discharge. RESULTS: In both groups, there were no differences
      regarding operative parameters. A significantly higher cardiac troponin-I
      concentration was observed in the antegrade group at 24 hours after cross-clamp
      (8.2 +/- 8.5 microg/L vs 3.2 +/- 3.1 microg/L; p = 0.02). Patients with subtotal
      stenosis or occlusion of one or more main coronary arteries showed significantly
      lower cardiac troponin-I levels after retrograde application. CONCLUSIONS: Lower
      concentrations of the cardiac troponin-I marker after retrograde application of
      cardioplegia indicate advantages of myocardial protection in ischemic heart
      disease.

PMID- 11216757
TI  - Effects of carnitine on cardiac function after cardioplegic ischemia in neonatal
      rabbit hearts.
AB  - BACKGROUND: Ischemia immediately impairs myocardial fatty acid metabolism and
      reduces the concentration of carnitine which is an essential cofactor for fatty
      acid metabolism in the mitochondria. The purpose of this study was to investigate
      the effects of carnitine administration on recovery of cardiac function after
      cardioplegic ischemia in the neonatal heart where fatty acid metabolism is not a
      predominant source of adenosine triphosphate. METHODS: Isolated blood-perfused
      neonatal rabbit hearts underwent 3 hours of cold cardioplegic ischemia. The
      control group (n = 10) was reperfused with unmodified diluted blood. The
      carnitine group (n = 10) was reperfused with the blood containing 5 mM/L of
      carnitine. Before ischemia (base line) and after 15 and 30 minutes reperfusion,
      left ventricular (LV) function and LV compliance were measured using a
      intraventricular conductance catheter combined with an isovolumic balloon.
      Coronary blood flow was measured and myocardial oxygen consumption was
      calculated. RESULTS: Carnitine significantly improved not only LV systolic
      function but also LV diastolic function (p < 0.05) as well as LV compliance after
      ischemia. Coronary blood flow and myocardial oxygen consumption were
      significantly improved after ischemia in the carnitine group compared with the
      control group (p < 0.05). CONCLUSIONS: These results suggest that carnitine
      strikingly improves LV functional recovery and aerobic metabolism after cold
      cardioplegic arrest, and may improve cardiac performance in neonates after open
      heart surgery.

PMID- 11216758
TI  - Hierarchy of regional oxygen delivery during cardiopulmonary bypass.
AB  - BACKGROUND: Relative to the nonbypass state, cardiopulmonary bypass may decrease
      whole-body oxygen (O2) delivery. We predicted that during cardiopulmonary bypass,
      a hierarchy of regional blood flow and O2 delivery could be characterized.
      METHODS: In 8 46.5 +/- 1.2-kg pigs, fluorescent microspheres were used to
      determine blood flow and O2 delivery to five organ beds before and during 37
      degrees C cardiopulmonary bypass at four randomized bypass flows (1.4, 1.7, 2.0,
      and 2.3 L/min/m2). At completion, 18 tissue samples were obtained from the
      cerebral cortex (n = 4), renal cortex (n = 2), renal medulla (n = 2), pancreas (n
      = 3), small bowel (n = 3), and limb muscle (n = 4) for regional blood flow
      determination. RESULTS: At conventional cardiopulmonary bypass flow (2.3
      L/min/m2), whole-body O2 delivery was reduced by 44 +/- 6% relative to the pre
      cardiopulmonary bypass state (p < 0.05). Over a range of cardiopulmonary bypass
      flows (2.3 to 1.7 L/min/m2), brain and kidney maintained their perfusion. Blood
      flow and O2 delivery to both regions were reduced when the cardiopulmonary bypass
      flow was reduced to 1.4 L/min/m2. However, perfusion and O2 delivery to other
      visceral organs (pancreas, small bowel) and skeletal muscle showed pump flow
      dependency over the range of flows tested. CONCLUSIONS: This study characterizes
      the organ-specific hierarchy of blood flow and O2 distribution during
      cardiopulmonary bypass. These dynamics are relevant to clinical decisions for
      perfusion management.

PMID- 11216759
TI  - Short ischemia causes endothelial dysfunction in porcine coronary vessels in an
      in vivo model.
AB  - BACKGROUND: The aim of this study was to evaluate the effects of a short period
      of ischemia (10 mins) and a prolonged period of ischemia (60 mins) followed by
      reperfusion on coronary flow changes induced by acetylcholine (ACh), adenosine
      (ADO), and endothelin (ET). METHODS: The left anterior descending coronary artery
      in anesthetized pigs was occluded for 10 or 60 minutes followed by 120 minutes
      reperfusion. Thereafter, the flow changes in the left anterior descending
      coronary artery were studied after intracoronary infusion of ACh, ADO, and ET.
      RESULTS: Short-term ischemia (10 minutes) caused a decrease in vasodilatation,
      but not the vasoconstriction response to ACh. Prolonged ischemia (60 minutes)
      impaired ADO induced vasodilatation and aggravated ET evoked vasoconstriction.
      CONCLUSIONS: The present findings suggest that a short period of ischemia (10
      minutes) causes disturbances of the endothelial regulation of coronary vascular
      tone and that this endothelial regulation is more sensitive, and precedes changes
      in vascular smooth muscle function after ischemia and reperfusion.

PMID- 11216760
TI  - Safety and efficacy of a heparin removal device: a prospective randomized
      preclinical outcomes study.
AB  - BACKGROUND: Systemic protamine sulfate for heparin reversal after cardiopulmonary
      bypass (CPB) is associated with uncommon, but life-threatening adverse reactions.
      METHODS: In a prospective randomized 3-day outcomes study, a heparin removal
      device (HRD) group (n = 12; 60-, 80-, 100-kg subgroups) was compared with a
      matched systemic Protamine group (Protamine; n = 6) for safety and efficacy using
      an adult swine model of CPB (60 minutes, 28 degrees C). RESULTS: HRD run time was
      25 to 38 minutes depending on weight without complications. After HRD, heparin
      concentration decreased from 4.77 +/- 0.17 to 0.45 +/- 0.06 U/mL (activated
      clotting time [ACT] 776 +/- 83 to 180 +/- 12 seconds), and in Protamine, 3.94 +/-
      0.63 to 0.13 +/- 0.02 U/mL (ACT 694 +/- 132 to 101 +/- 5 seconds) (p = 0.01
      between groups, but no significant differences 60 minutes later). No significant
      difference between HRD and Protamine to 72 hours was seen in plasma-free
      hemoglobin C3a, heparin concentration, thromboelastogram index, platelet count,
      activated partial thromboplastin time, anti-thrombin III, fibrinogen, ACT, and
      tissue histology. CONCLUSIONS: In a prospective randomized outcomes study, HRD
      achieved predictable reversal of systemic heparinization after CPB with no
      difference in safety or outcomes compared with protamine.

PMID- 11216761
TI  - Posttransplant function of a nonbeating heart is predictable by an ex vivo
      perfusion method.
AB  - BACKGROUND: We attempted to predict the posttransplant cardiac function of
      nonbeating donor hearts. METHODS: A total of 13 dogs were studied. Hearts were
      left in situ for 45 minutes after cardiac arrest caused by exsanguination. Hearts
      were then excised and reperfused in an ex vivo perfusion apparatus after 60
      minutes of warm ischemia to test whether they could eject against an 80 mm Hg
      afterload from a preload of 10 mm Hg. Thereafter, all hearts were transplanted
      orthotopically. RESULTS: Four of 13 hearts were able to eject in the apparatus
      (group A). However, the other nine hearts could not eject under the defined
      conditions (group B). All four hearts in group A showed good posttransplant
      hemodynamics (systolic arterial pressure > 80 mm Hg with mean left atrial
      pressure < 10 mm Hg) without dopamine. However, none of nine hearts in group B
      could support the circulation without dopamine. CONCLUSIONS: Nonbeating donor
      heart function evaluated in the perfusion apparatus predicts posttransplant heart
      function. This method may be applicable for selection of transplantable hearts
      from nonbeating heart donors.

PMID- 11216762
TI  - Increased coronary artery blood flow with aortomyoplasty in chronic heart
      failure.
AB  - BACKGROUND: We hypothesized that diastolic counter-pulsation using aortomyoplasty
      will increase coronary blood flow. METHODS: In dogs (n = 6, 20 to 25 kg), the
      left latissimus dorsi muscle was isolated, wrapped around the descending thoracic
      aorta, and conditioned by chronic electrical stimulation. Heart failure was
      induced by rapid ventricular pacing. In a terminal study, left ventricular and
      aortic pressures, and blood flow in the left anterior descending coronary artery
      and descending aorta were measured. The endocardial-viability ratio was
      calculated. RESULTS: Aortomyoplasty increased mean diastolic aortic pressure (70
      +/- 5 to 75 +/- 5 mm Hg, p < 0.05) and reduced peak left ventricular pressure (86
      +/- 4 to 84 +/- 4 mm Hg, p < 0.05), leading to a 16% increase in endocardial
      viability ratio (1.29 +/- 0.05 to 1.49 +/- 0.05, p < 0.05). Coronary blood flow
      was increased by 15% (8.2 +/- 1.5 to 9.4 +/- 1.6 mL/min, p < 0.05). During muscle
      contraction, 2.7 +/- 0.5 mL was ejected from the wrapped aortic segment.
      CONCLUSIONS: These data demonstrate that aortomyoplasty provides successful
      diastolic counterpulsation after muscle conditioning and heart failure.

PMID- 11216763
TI  - Thoracic and thoracoabdominal aneurysm repair under deep hypothermia using
      subclavian arterial perfusion.
AB  - BACKGROUND: Hypothermic circulatory arrest is a valuable adjunct for thoracic and
      thoracoabdominal aortic aneurysm repair. Retrograde aortic perfusion through the
      femoral artery, however, carries a risk of cerebral embolism or malperfusion. To
      avoid these complications we adopted antegrade aortic perfusion through a
      prosthetic graft attached to the left subclavian artery through a left
      thoracotomy. METHODS: Ten patients had repair of descending thoracic and
      thoracoabdominal aortic aneurysm under deep hypothermia with antegrade aortic
      perfusion through the left subclavian artery. Hypothermic circulatory arrest was
      used because proximal aortic control was hazardous due to rupture or intraluminal
      disease, or for spinal cord protection. RESULTS: There was no brain injury and
      one hospital death. The cause of death was massive bleeding from the
      gastrointestinal tract not related to deep hypothermia or the perfusion method.
      All 9 survivors were alive and well after a mean follow-up period of 9 months.
      CONCLUSIONS: Using the left subclavian artery as a site of aortic perfusion can
      avoid retrograde aortic perfusion, hence reducing the potential for brain injury
      due to embolic stroke or malperfusion through a dissected thoracoabdominal aorta.

PMID- 11216764
TI  - Evaluation of lymph node metastases in squamous cell carcinoma of the esophagus
      with positron emission tomography.
AB  - BACKGROUND: Previous studies suggest positron emission tomography (PET) may
      improve staging accuracy of esophageal cancer compared with conventional methods,
      especially in detecting occult distant metastases. We evaluated the accuracy of
      PET in the detection of lymph node metastasis prospectively with pathologic
      findings. METHODS: Fifty-three patients with squamous cell carcinoma underwent
      whole-body PET scan and chest computed tomography (CT). The findings of PET and
      chest CT of 50 patients who underwent curative esophagectomy with radical lymph
      node dissection were compared with the pathologic findings. RESULTS: Among 53
      primary esophageal tumors, PET detected 51 (96.2%) and CT detected 49 (92.5%)
      tumors correctly. Nodal metastases were present in 108 of 436 dissected lymph
      node groups. PET detected 56 metastatic node groups (51.9% sensitivity, 94.2%
      specificity, 83.7% accuracy), compared with CT, which detected 16 (14.8%
      sensitivity, 96.7% specificity, 76.6% accuracy; sensitivity: p < 0.005).
      CONCLUSIONS: PET was more sensitive than CT in the detection of nodal metastases
      and may improve staging of squamous cell carcinoma of the esophagus.

PMID- 11216765
TI  - Induction of MAGE-3 expression in lung and esophageal cancer cells.
AB  - BACKGROUND: Although MAGE-3 has been detected in approximately 40% of lung and
      esophageal cancers, expression of this cancer testis antigen appears to be below
      the threshold for immune recognition in patients with these malignancies. The aim
      of this study was to determine if the demethylating agent, 5-Aza-2'-deoxycytidine
      (DAC) and if the histone deacetylase inhibitor Depsipeptide FR901228 (DP) could
      enhance MAGE-3 expression in lung and esophageal cancer cells. METHODS: Eleven
      lung and esophageal cancer lines and cultured normal human bronchial epithelial
      (NHBE) cells were exposed to normal media (NM), DAC, DP, or combination DAC/DP at
      varying concentrations and exposure durations. MAGE-3 expression was evaluated by
      quantitative RT-PCR (TaqMan) and immunohistochemistry techniques. Trypan blue
      exclusion techniques were used to examine the proliferation of cancer cells after
      drug exposure. RESULTS: Relative to untreated controls, MAGE-3 expression was
      enhanced 32-fold (range 3.9 to 110) by DAC alone (0.1 micromol/L x 72 h), 2.1
      fold (0.4 to 4.2) by DP alone (25 ng/mL x 6h), and 57-fold (4.6 to 209) by
      sequential DAC/DP exposure. Increased MAGE-3 mRNA copy numbers coincided with
      enhanced protein levels in these cells. MAGE-3 expression persisted after drug
      exposure. Flow cytometry confirmed the presence of functional HLA class I
      expression in these cells. Sequential DAC/DP treatment mediated pronounced growth
      inhibition in cancer cells but not NHBE. CONCLUSIONS: Sequential DAC/DP treatment
      may be a novel strategy to simultaneously augment MAGE-3 expression and induce
      growth arrest in thoracic malignancies.

PMID- 11216766
TI  - Colon interposition for esophageal replacement: isoperistaltic or
      antiperistaltic? Experimental results.
AB  - BACKGROUND: Isoperistaltic colon is preferred to antiperistaltic colon for
      esophageal replacement, but experimental data do not exist to support this
      practice. METHODS: In 7 dogs a 20 cm long colon loop was interposed between the
      skin and the small bowel, isoperistaltically in 3 dogs and antiperistaltically in
      4 dogs. Three months later five strain-gauges were implanted and evacuation was
      investigated by motility testing, barium studies, and scintigraphy. RESULTS:
      Motility recording showed normal colon motility in the excluded loops. Quiescent
      states (duration 40.2 +/- 13.6 minutes) were followed by contractile states
      (duration 7.5 +/- 2.4 minutes, frequency 3.3 +/- 0.6 per minute). The main
      peristaltic direction of isoperistaltic loops was isoperistaltic, and the main
      peristaltic direction of antiperistaltic loops was antiperistaltic. Evacuation
      took place exclusively during the contractile status. Half time emptying was more
      rapid in isoperistaltic loops (35 +/- 11 vs 69 +/- 16 minutes). The content of
      antiperistaltic loops was held back by antiperistaltic activity. Application of
      oatmeal porridge into the loops shortened the quiescent status from 40.2 to 13.2
      +/- 4.8 minutes. CONCLUSIONS: The colon graft for esophageal replacement is an
      active system. Food is stored during the quiescent states and evacuated during
      the contractile states. The original peristaltic direction is preserved so that
      retroperistalsis in antiperistaltic loops may lead to patient discomfort and
      pulmonary complications.

PMID- 11216767
TI  - Survival after resection of metachronous non-small cell lung cancer in 127
      patients.
AB  - BACKGROUND: In a number of patients with treated primary non-small cell lung
      cancer (NSCLC) a second primary tumor will be diagnosed. Our experience with
      surgery in these patients was analyzed and possible prognostic parameters were
      defined. METHODS: Patients with metachronous NSCLC (n = 127) who underwent
      resection from 1970 through 1997 were analyzed. All tumors were classified
      postsurgically. Median interval between the tumors was 3.7 years. Actuarial
      survival time was estimated and risk factors influencing survival were evaluated.
      RESULTS: Overall 5-year survival after the first resection was 70% and after the
      second resection was 26%. Patients with stage IA of the second primary tumor did
      have a significantly better survival (p < 0.005) as compared with patients with
      higher staged second primaries. Stage of second primary tumor and age were
      significant predictors of survival, whereas stage of first tumor, interval
      between resections, histology, and type of resection were not. CONCLUSIONS:
      Survival of patients with metachronous NSCLC and resection of both tumors is
      high, but poorer than after resection of the first tumor. Irrespective of the
      interval, patients with stage IA second primary tumor may benefit more from
      pulmonary resection.

PMID- 11216768
TI  - Blunt chest trauma with deep pulmonary laceration.
AB  - BACKGROUND: Deep pulmonary laceration (DPL) is rare and its survival rate is low.
      The present study focused on the prognostic factors of DPL. METHODS: The present
      study concerned 17 DPL patients treated in Tokai University Hospital between 1988
      and 1998. The prognostic factors of DPL were compared with systolic blood
      pressure (SBP), PaO2, and the volume of intrathoracic blood loss. Characteristic
      findings of initial chest roentgenograms of DPL were investigated. RESULTS:
      Eleven patients were saved and 6 patients died. An SBP of less than 80 mm Hg on
      arrival at the hospital and a blood loss of more than 1,000 mL through the chest
      tube within 2 hours after arrival were poor prognostic factors. Hypoxemia on
      arrival was not a poor prognostic factor. Chest roentgenograms showed macular
      infiltrative shadow with moderate lung collapse and deviation of the mediastinal
      shadow toward the unaffected side. Selective bronchial occlusion with a Univent
      prevented suffocation by intrabronchial blood. CONCLUSIONS: Two poor prognostic
      factors of DPL are SBP less than 80 mm Hg on arrival and blood loss of more than
      1,000 mL through the chest tube within 2 hours after arrival.

PMID- 11216769
TI  - A comparative study of buttressed versus nonbuttressed staple line in pulmonary
      resections.
AB  - BACKGROUND: Prolonged air leak is the major limiting factor in early hospital
      discharge following pulmonary resection. The purpose of this study was to
      determine whether the use of bovine pericardial strips as a buttress along the
      lung staple line would decrease air leaks and hospital stay after lobectomy and
      segmentectomy. METHODS: This was a multicenter trial consisting of 80 patients
      undergoing pulmonary resection, randomly assigned to the control group (40
      patients) or treatment group (40 patients). The treatment group had reinforcement
      with bovine pericardium. RESULTS: No statistical differences were noted in the
      mean intensive care unit length of stay (p = 0.9), number of days with a chest
      tube (p = 0.6), or total length of stay (p = 0.24). Increased air leak duration
      was associated with assignment to the control group (r = 0.27, p = 0.02). The
      mean duration of air leak was 2 days and the mean time to chest tube removal was
      5.9 days in patients with a buttressed staple line compared to 3 days and 6.3
      days, respectively, for patients with nonbuttressed staple lines. CONCLUSIONS:
      Within the data of this study, no statistical differences were noted between
      buttressed and nonbuttressed patients. However, the trend toward shortened air
      leak time and tube removal time was apparent in the buttressed group. With
      greater number of patients studied, it is likely that the cost of bovine
      pericardium would be justified by shorter air leak duration and hospitalization.

PMID- 11216770
TI  - Variables predicting adverse outcome in patients with deep sternal wound
      infection.
AB  - BACKGROUND: Mortality after deep sternal wound infection (DSWI) ranges between 5%
      and 47%. Variables predicting hospital mortality and prolonged hospital stay are
      still to be assessed. METHODS: Among 13,420 patients who underwent cardiac
      surgery in our institution between 1979 and 1999, DSWI developed in 112 cases
      (0.8%). Multiple variables were recorded prospectively and analyzed
      retrospectively as predictors of hospital death and prolonged (>30 days) hospital
      stay. The analyzed variables were divided into three groups: (1) related to the
      patient, including demographic variables and preoperative conditions; (2) related
      to cardiac operation; and (3) related to infection. Predictive variables were
      assessed by univariate and multivariate logistic regression analysis. RESULTS:
      Hospital mortality was 16.9%. The hospital stay of the 93 discharged patients
      ranged between 16 and 180 days (mean 31.3 +/- 15.2). Length of cardiac operation,
      length of stay in intensive care unit, interval between symptoms of DSWI and
      wound debridement were found to be the most significant predictors of bad outcome
      following DSWI. CONCLUSIONS: In our study demographic variables and preoperative
      conditions did not affect the prognosis of DSWI. Lower mortality rate and shorter
      hospital stay could be achieved with earlier and aggressive treatment of DSWI.

PMID- 11216771
TI  - Emergency operation for acute type A aortic dissection: neurologic complications
      and early mortality.
AB  - BACKGROUND: Acute type A aortic dissection is a surgical emergency still
      associated with high postoperative complications. The aim of this study was to
      investigate factors for hospital mortality and neurologic deficit in patients
      undergoing emergency operation for acute type A aortic dissection. METHODS:
      Eighty-five consecutive patients (age range, 20 to 82 years) operated on for
      acute type A aortic dissection over a 6-year period were evaluated. Univariate
      and stepwise multiple logistic regression analyses were conducted among 32
      perioperative variables. RESULTS: All patients underwent surgical procedures
      under deep hypothermic circulatory arrest. Antegrade or retrograde cerebral
      perfusion was used in 23 patients (27.1%) and 18 patients (21.2%), respectively.
      Forty-three patients underwent arch/hemiarch replacement and the ascending aorta
      was replaced in 42 patients. Overall mortality rate was 25.9% (22 of 85
      patients). Multiple logistic regression analysis showed that lack of cerebral
      perfusion (p = 0.021) and postoperative renal failure (p = 0.006) were the best
      predictors for hospital death. Twenty-one patients (24.7%) experienced neurologic
      accidents. The risk factor for postoperative neurologic complication was lack of
      cerebral perfusion (p = 0.013). Hospital mortality was 13% (3 of 23 patients) and
      16.7% (3 of 18 patients) in the antegrade and retrograde cerebral perfusion
      groups (p > 0.05) and neurologic deficit was 13% (3 of 23 patients) and 11.1% (2
      of 18 patients), respectively (p > 0.05). CONCLUSIONS: Hospital mortality and
      neurologic complications in patients undergoing emergent operation for acute type
      A aortic dissection were reduced when cerebral perfusion was used with deep
      hypothermic circulatory arrest.

PMID- 11216772
TI  - Bronchial transsection and reanastomosis in pigs with and without bronchial
      arterial circulation.
AB  - BACKGROUND: The bronchial artery may be vital to the bronchi and lung parenchyma,
      but results of lung transplantation have raised doubts. This study was performed
      to examine the effect of bronchial arterial devascularization on bronchial
      morphology after bronchial transsection and reanastomosis. METHODS: In 6 pigs
      (study group), the left main bronchus was transsected, reanastomosed, and
      devascularized. Six control pigs had the same operation without
      devascularization. After 1 week, bronchial arterial angiography was performed,
      and specimens were examined with conventional histology and scanning electron
      microscopy. RESULTS: Histology showed significant changes (inflammation, edema,
      and fibrosis) in bronchi and lung parenchyma of the study group compared with the
      unoperated side (p = 0.028) and with the control group (p = 0.050). Scanning
      electron microscopy showed significant ciliary denudation in the study group's
      left bronchus compared with the unoperated side (p = 0.043) and with the control
      group (p = 0.0071). CONCLUSIONS: The loss of cilia of the bronchial epithelium
      and the occurrence of inflammation, edema, and fibrosis in bronchi and lung
      parenchyma 1 week postoperatively were significantly related to the absence of
      the bronchial arterial circulation.

PMID- 11216773
TI  - Duration of knowledge in general thoracic surgery.
AB  - BACKGROUND: Medical knowledge changes rapidly, so current medical education
      approaches emphasize the development of life-long learning skills ("teaching the
      learner to learn") as opposed to the simple acquisition of contemporary medical
      knowledge. Because there are no data on the rapidity of change of general
      thoracic surgical knowledge, we do not know whether this trend in medical
      education is appropriate for thoracic surgical trainees. We undertook a study to
      assess the duration of knowledge in general thoracic surgery. METHODS: The first
      general thoracic surgery article from each issue of The Annals of Thoracic
      Surgery between 1965 and 1997 was abstracted into a summary statement. A form,
      made up of 360 summary statements in random order, was assessed by 6 general
      thoracic surgeons. They assessed statement validity on a 5-point scale (1 =
      statement false; 5 = statement true). Average statement validity scores for 30
      time intervals were calculated. The relationship between time of publication and
      statement validity was analyzed. RESULTS: Average validity scores ranged from
      2.24 (represents 1965 to 1966) to 4.32 (represents 1969 to 1970). Validity scores
      increased with time (y = 3.46 + 0.017x, where y is validity score and x is time),
      and this was significant (r = 0.40; p = 0.027). However, the absolute change in
      average validity scores over the 33-year study period was only 0.52 or 13.1% of
      the "modern" era scores. CONCLUSIONS: The assumption that medical knowledge
      changes quickly may not be true in general thoracic surgery. Although life-long
      learning skills are important, general thoracic surgery training programs should
      continue to emphasize fundamental knowledge in the specialty.

PMID- 11216774
TI  - Cocaine abuse and coronary artery dissection.
AB  - A 33-year-old man with a history of recent cocaine use presented with dissection
      of the left main coronary artery extending distally to involve the left anterior
      descending (LAD) and circumflex arteries. He required emergency four-vessel
      aortocoronary bypass, which was uncomplicated.

PMID- 11216775
TI  - Vineberg graft: flow reserve of bilateral implantation after 27 years.
AB  - We report a patient who underwent bilateral internal thoracic artery implantation
      into the myocardium known as a Vineberg procedure 27 years ago. Coronary
      angiography and Doppler echocardiography revealed patent grafts with total
      occlusion of all native coronary arteries. We measured flow velocities at rest
      and under stress conditions with noninvasive ultrasonic Doppler echocardiography.
      The flow patterns in both grafts were biphasic as in native coronary arteries.
      Under stress conditions no increase in flow was detectable as a marker of end
      stage coronary artery disease with refractory angina pectoris.

PMID- 11216776
TI  - Left ventricular-right atrial fistula complicating redo mitral valve replacement.
AB  - We describe the case of a 58-year-old female patient who underwent redo mitral
      valve replacement and remained in heart failure. The diagnosis of a left
      ventricular-right atrial fistula was made. The fistula was closed surgically with
      a patch of autologous pericardium. The patient improved immediately after the
      operation and has been asymptomatic since.

PMID- 11216777
TI  - Surgical treatment of a hemangioma of the mitral valve.
AB  - Hemangioma of the heart is a rare lesion, representing 5% to 10% of benign
      cardiac tumors. Hemangioma of the mitral valve has been reported previously in
      one autopsy case report. We describe the excision and repair of a hemangioma of
      the mitral valve in a 33-year-old African-American woman.

PMID- 11216778
TI  - Thoracoabdominal aortic repair in a 190-kg patient: optimized perfusion with two
      oxygenators.
AB  - A 190-kg patient was referred because of an acute type B aortic dissection.
      Conservative management was initially performed but the 34-year-old patient was
      shown to have an increasing aortic diameter 2 months later and was scheduled for
      elective repair of the thoracoabdominal aorta. To anticipate potential
      difficulties with perfusion and oxygenation the cardiopulmonary bypass circuit
      was constructed with two parallel oxygenators, which allowed an adequate oxygen
      supply through all phases of the intervention and accelerated the estimated
      rewarming time.

PMID- 11216779
TI  - Pyodera gangrenosum after aortic valve replacement.
AB  - A 68-year-old male patient developed pyoderma gangrenosum after elective aortic
      valve replacement. Treatment with steroids and clofazimine was initiated, which
      resulted in rapid cessation of the necrotic process. Due to thoracic instability,
      stabilization of the sternum was performed followed by surgical debridement and
      atraumatic wound closure. Postoperatively, immunosuppression with cyclosporine A
      was added; the patient recovered completely. Pyoderma gangrenosum is a potential
      life-threatening complication that must be considered in patients with severely
      impaired wound healing after cardiac operation.

PMID- 11216781
TI  - Stunned myocardium after off-pump coronary artery bypass grafting.
AB  - Off-pump coronary artery bypass grafting is increasingly performed. Because these
      procedures are associated with temporary myocardial ischemia, there is a risk of
      ischemia-related complications. We report two cases of myocardial stunning after
      off-pump coronary artery bypass grafting using the Octopus tissue stabilizer. On
      the basis of our experiences, means to prevent stunning are discussed.

PMID- 11216782
TI  - Pulmonary atresia, ventricular septal defect, and coronary-pulmonary artery
      fistula.
AB  - We report 2 patients with pulmonary atresia, ventricular septal defect, and
      coronary-pulmonary fistula. The fistula originated from the left anterior
      descending artery in 1 patient, and from the right coronary artery in the other.
      Both patients survived staged correction in which right ventricular outflow was
      reconstructed with autologous fistula tissue. One patient with pulmonary
      hypertension suddenly died 9 months after surgery. Twenty-four patients with
      pulmonary atresia, ventricular septal defect, and coronary-pulmonary fistula have
      been reported previously.

PMID- 11216780
TI  - Cardiac operation for a patient with autoimmune hemolytic anemia with warm
      reactive antibodies.
AB  - We present a case of a patient with autoimmune hemolytic anemia with warm
      reactive antibodies who underwent successful coronary artery bypass grafting. We
      discuss some of the important problematic issues related to perioperative
      management.

PMID- 11216783
TI  - Anomalous right coronary artery originating from the left main coronary artery.
AB  - A 54-year-old man with no cardiac history presented with exertional angina.
      Cardiac catheterization revealed an anomalous right coronary artery originating
      from the left main coronary artery with external compression during its course
      between the aorta and the pulmonary artery. He was successfully managed with
      surgical reimplantation of the right coronary artery into the aorta.

PMID- 11216784
TI  - Double orifice right atrioventricular valve in atrioventricular septal defect:
      morphology and extension of the concept of fusion of leaflets.
AB  - A rare observation of a double orifice right atrioventricular valve in a partial
      form of atrioventricular septal defect is reported. The concept of leaflet fusion
      along part of their anticipated zones of apposition is used to explain the
      formation of this anomaly. We show that this concept can account for the
      different morphologic presentations of atrioventricular septal defect.

PMID- 11216785
TI  - Absorbable pulmonary artery banding in tricuspid atresia.
AB  - A child with tricuspid atresia, concordant ventriculoarterial connections, large
      ventricular septal defect, and elevated pulmonary artery pressure underwent
      pulmonary artery banding with a polydioxanone ribbon. This procedure was
      successful in this patient as the ventricular septal defect became restrictive
      while the banding was fully absorbed after 5 months. This technique could be
      included in the panel of surgical strategies for patients with single ventricle
      physiology and potential but insufficient subpulmonary stenosis in early infancy.

PMID- 11216786
TI  - Simplified retrograde systemic perfusion for removal of air from the aorta in an
      infant.
AB  - Total circulatory arrest with full venous drainage can result in air entering the
      arterial system through several possible sites such as the aortic cannulation
      site or collateral vessels. Air present in the arterial system during total
      circulatory arrest imposes a special problem. We describe a simple technique of
      short-term retrograde systemic perfusion to remove air from the arterial system
      before restarting systemic arterial perfusion after total circulatory arrest.

PMID- 11216787
TI  - Nitric oxide usage after posttraumatic pneumonectomy.
AB  - Pneumonectomy is rarely required in the surgical management of thoracic traumatic
      injuries with high mortality rates. Right heart failure due to elevated pulmonary
      artery pressure and the adult respiratory distress syndrome have been leading
      causes of mortality reported after posttraumatic pneumonectomy. The beneficial
      effect of inhaled nitric oxide has been shown in pulmonary hypertension and in
      adult respiratory distress syndrome. We report the use of inhaled nitric oxide in
      the perioperative management of a patient undergoing emergent pneumonectomy.

PMID- 11216788
TI  - Successful treatment of mucoepidermoid carcinoma of the carina.
AB  - We successfully treated a 33-year-old man with mucoepidermoid carcinoma at the
      carina. Through preoperative spiral computed tomography with multiplanar and
      three-dimensional reconstructions, the lesion extended along the right main
      bronchus across the orifice of the right upper lobe. He underwent a carinal
      resection plus right upper lobectomy and reconstruction of the carina. He shows
      neither anastomotic complication nor recurrence of disease 1 year after surgery.
      Spiral computed tomography was used to evaluate the preoperative and
      postoperative state of the central airway.

PMID- 11216789
TI  - Removal of an intrathoracic migrated fixation pin by thoracoscopy.
AB  - Migration of orthopedic fixation pins into the thoracic cavity can result in
      perforation of pulmonary vasculature, aorta, bronchus, atrium, or ventricle.
      Prompt diagnosis and treatment is tantamount in preventing devastating
      consequences. A patient who had fixation of a right humeral fracture weeks later
      had intrathoracic migration of a fixation pin, found by routine postoperative
      radiographic examination. Because the patient was asymptomatic, we removed the
      pin with a thoracoscopic operation. The foreign body was retrieved successfully
      without intraoperative or postoperative complication.

PMID- 11216790
TI  - Ruptured thymoma causing mediastinal hemorrhage resected via partial sternotomy.
AB  - A case of a ruptured thymoma causing mediastinal hemorrhage and hemothorax that
      was electively resected by a partial sternotomy approach is presented. This case
      and others previously reported illustrate that a sudden onset of dyspnea and
      chest pain accompanied by acute mediastinal widening on chest roentgenogram in a
      previously healthy patient should suggest the diagnosis of a ruptured thymoma. An
      upper part sternotomy approach may be as safe and effective as a less invasive
      surgical procedure in resection of noninvasive thymomas, even if dense tumor
      adhesion exists.

PMID- 11216792
TI  - Intramural aortic hematoma syndrome.

PMID- 11216791
TI  - Hydatid disease of rib.
AB  - Osseous hydatidosis, especially when located in the rib, is a very rare disease.
      In 1978, only 39 costal echinococcosis cases were published. The course of the
      disease is generally slow and laboratory tests are frequently negative. Diagnosis
      is generally made through the combined assessment of clinical, radiologic, and
      laboratory data. Living in a rural area is an important risk factor for the
      disease. The gold standard for therapy is radical removal of the involved ribs or
      chest wall. We present the case of a 63-year-old herdsman with costal
      echinococcosis and a review of the literature.

PMID- 11216793
TI  - A new operation for ventricular septal defect with aortic incompetence.
AB  - Two boys, 10 years of age, with ventricular septal defect and severe aortic
      insufficiency were treated using a new method. An autograft of anterior pulmonary
      artery wall and the adjacent leaflet and subpulmonary muscle was excised. The
      excised pulmonary artery segment was used to replace the prolapsed right coronary
      cusp, and the autograft muscle was used to close the ventricular septal defect.
      The right ventricular outflow tract and pulmonary valve were repaired using an
      autologous pericardial patch with an autologous single cusp. The results in both
      cases were satisfactory.

PMID- 11216794
TI  - Transaortic approach for the Alfieri stitch.
AB  - The management of associated mitral regurgitation in patients undergoing cardiac
      surgery is controversial. A simple, reliable, and fast repair is advantageous,
      especially in critically ill patients. We describe a simple method of transaortic
      edge-to-edge repair in patients with associated mitral regurgitation undergoing
      aortic valve surgery.

PMID- 11216795
TI  - Triangular resection of the anterior leaflet for repair of the mitral valve.
AB  - Isolated anterior mitral leaflet prolapse, unlike posterior prolapse, is a
      difficult lesion to repair and may become a demanding surgical procedure. We
      report our experience with a technique of a triangular resection of the anterior
      leaflet to repair isolated segmental anterior leaflet prolapse in 18 patients.
      This technique simplifies the repair procedure and is a safe and rapid procedure
      which allows excellent results.

PMID- 11216796
TI  - Redo left anterior descending artery grafting via left anterior small
      thoracotomy: an alternative approach.
AB  - Reoperative left anterior descending artery (LAD) revascularization can be
      performed through a left anterior small thoracotomy (LAST approach) in patients
      requiring isolated LAD revascularization. If the left internal mammary artery has
      been previously used, however, the operation is generally performed either
      through a median sternotomy or through a full posterolateral thoracotomy for the
      necessity of connecting the vein graft to the ascending aorta or to the
      descending thoracic aorta, thus losing the advantages of a minimally invasive
      approach. In the case reported herein, we describe a technique in which
      reoperative revascularization of the LAD is accomplished through the LAST
      approach, using the stump of the left internal mammary artery as the inflow site
      of a saphenous vein coronary graft to the LAD.

PMID- 11216797
TI  - Giant bronchial carcinoid tumors: a multidisciplinary approach.
AB  - BACKGROUND: Bronchial carcinoid tumors account for approximately 2% of all lung
      tumors. Although they were considered benign lesions, they are now categorized
      malignant, occasionally with poor prognosis. The clinical symptoms can be highly
      variable and are often present for many years before diagnosis. Whereas some
      carcinoids are entirely asymptomatic, others are accompanied by carcinoid or
      paraneoplastic syndromes. METHODS: We describe the multidisciplinary management
      of a 34-year-old female patient with a massive actively secreting bronchial
      carcinoid tumor of the right lung. Furthermore, we provide a review of the
      literature regarding the operative treatment and the perioperative management of
      pulmonary carcinoid tumors with respect to surgical, anesthetic, radiologic, and
      pathologic considerations. RESULTS: In the reported case, the first symptoms were
      chronic watery diarrhea, skin flushing, progressive shortness of breath, and
      increasing right shoulder pain. When the patient initially presented at our
      institution, the tumor had already reached an enormous size and it involved the
      right and left atrium as well as the atrial septum. Using an evidence-based,
      multidisciplinary approach the patient was treated successfully with extended
      surgical resection. CONCLUSIONS: Carcinoid tumors are potentially curable even if
      they reach a significant size and thus an aggressive strategy is warranted. The
      management of such cases requires careful investigation, planning, and treatment
      with collaborative expertise provided by a multidisciplinary team. We
      demonstrated that this approach can lead to a favorable outcome in what first
      appeared to be a formidable and unresectable tumor.

PMID- 11216798
TI  - Choice of venous cannulation for bypass during repair of traumatic rupture of the
      aorta.
AB  - BACKGROUND: Choices for venous cannulation for left heart bypass, to assist
      repair of traumatic rupture of the thoracic aorta, are between the left atrial
      appendage and pulmonary veins. METHODS: A retrospective chart review was
      performed of patients who underwent operative repair of ruptured aorta. RESULTS:
      Over a 15-year period between March 1985 and February 2000, 133 patients were
      admitted to a level I trauma center with aortic rupture. Of the 50 procedures
      performed with left heart bypass, the left atrial appendage was cannulated in 19
      and pulmonary veins in 31 (four superior, 27 inferior). Complications occurred in
      7 of the 19 patients who underwent venous cannulation via the atrial appendage
      (two ventricular fibrillation, three atrial fibrillation, one pericardial
      effusion leading to tamponade, and one phrenic nerve injury). Complications
      occurred in 2 patients who underwent cannulation via pulmonary vein (one atrial
      fibrillation, one pericardial effusion requiring tapping) (p = 0.02).
      CONCLUSIONS: Cannulation via the pulmonary veins is associated with a decrease in
      complication rates compared with cannulation of the atrial appendage.

PMID- 11216799
TI  - Severe respiratory failure.

PMID- 11216800
TI  - Reversibility of anorexigenic valvulopathy.

PMID- 11216801
TI  - Epiaortic ultrasound, Y graft, and postoperative neuropsychological dysfunction.

PMID- 11216802
TI  - Resident training in off-pump CABG.

PMID- 11216803
TI  - Innominate artery cannulation in patients with severe porcelain aorta.

PMID- 11216804
TI  - Stroke after coronary artery bypass grafting: are we forgetting atrial
      fibrillation?

PMID- 11216805
TI  - Advantages of pressure-controlled intermittent coronary sinus occlusion over left
      ventricle-powered coronary sinus retroperfusion.

PMID- 11216806
TI  - Minimally invasive resection of mediastinal parathyroid adenomas.

PMID- 11216807
TI  - Long-term preservation of isolated heart.

PMID- 11216809
TI  - Surgical outcome of double-outlet right ventricle with subpulmonary VSD.
AB  - BACKGROUND: Optimal management of double-outlet right ventricle with subpulmonary
      ventricular septal defect remains controversial. We reviewed our 7-year
      experience with patients who had this anatomic configuration. METHODS: Between
      January 1992 and January 1999, 20 patients underwent an arterial switch operation
      (ASO group), and 12 underwent a bidirectional Glenn procedure followed by a
      modified Fontan in 10 (Glenn/Fontan). Mean follow-up was 23 +/- 18 months.
      RESULTS: An initial palliative operation was done in 19 patients (9 in the ASO
      group, 10 in the Glenn/Fontan group). There were no deaths in the Glenn/Fontan
      group. Four patients in the ASO group died within 33 days postoperatively. Two of
      them had a single coronary artery, 1 had a straddling mitral valve, 1 had a
      hypoplastic aortic arch, and 1 had multiple ventricular septal defects. Three
      patients had reoperation for subaortic stenosis (n = 2) or pulmonary stenosis (n
      = 1) after the ASO. Four patients (3 in the ASO group, 1 in the Glenn/Fontan)
      required a pacemaker for postoperative complete atrioventricular block. Actuarial
      survival at 5 years for the entire group was 87% (70% confidence interval, 81% to
      93%). CONCLUSIONS: The ASO remains our preferred treatment for infants with
      double-outlet right ventricle and subpulmonary ventricular septal defect.
      However, associated anatomic defects are important risk factors.

PMID- 11216808
TI  - Prospective randomized trial of azathioprine in cryopreserved valved allografts
      in children.
AB  - BACKGROUND: The purpose of this study was to prospectively assess the effects of
      azathioprine on the humoral immune response to HLA alloantigens and allograft
      function in children receiving cryopreserved valved allografts. METHODS: We
      randomized 13 children to receive azathioprine or not to receive azathioprine
      (controls) after receiving a cryopreserved valved allograft. Azathioprine
      patients received intraoperatively 4 mg/kg of azathioprine and 2.0 +/- 0.5 mg/kg
      once daily for 3 months after operation. Panel reactive antibodies against HLA
      class I and class II alloantigens were measured before, 1 month, and 3 months
      after operation. RESULTS: Panel reactive antibodies were not significantly
      different between the azathioprine and control groups before (0.0% +/- 0% versus
      1.6% +/- 1%), 1 month (59% +/- 17% versus 71% +/- 12%), or 3 months (84% +/- 15%
      versus 96% +/- 1.3%) after operation. There were no differences in degree of
      allograft valve stenosis between azathioprine (31.5 +/- 26 mm Hg, 13.4 +/- 7
      months postoperatively) and control groups (25.4 +/- 11 mm Hg, 17.2 +/- 10 months
      postoperatively) or allograft valve insufficiency. CONCLUSIONS: Azathioprine does
      not significantly decrease the immune response to HLA alloantigens or affect the
      function of cryopreserved valved allografts used in children to repair congenital
      heart defects.

PMID- 11216810
TI  - Cryopreserved homografts in the pulmonary position: determinants of durability.
AB  - BACKGROUND: The cryopreserved homograft has emerged as the pulmonary conduit of
      choice for the repair of many congenital heart defects. It is also used for
      pulmonary valve replacement in the Ross procedure. Because of a wide range of
      patient ages and diagnoses, the risk of homograft failure may vary. METHODS: We
      reviewed 185 consecutive pulmonary position implants performed between September
      1985 and January 1999. We examined three age groups: patients less than 1 year of
      age (n = 53), patients 1 to 10 years of age (n = 46), and patients more than 10
      years of age (n = 86). RESULTS: Five-year Kaplan-Meier homograft survival was
      25%, 61%, and 81% for the groups, respectively (p < 0.02). Smaller homograft
      size, younger patient age, and truncus arteriosus were risk factors for homograft
      failure in univariate analysis (p < 0.05). Smaller homograft size was the only
      predictor for homograft failure in multivariate analysis (p < 0.001). Twenty of
      99 implants in patients less than 10 years old underwent transcatheter
      intervention. The 3-year Kaplan-Meier implant survival of this group (79%) was
      not different from those who did not undergo intervention (77%, p = 0.84).
      Survival of aortic and pulmonary homografts in patients less than 10 years of age
      was not different (p = 0.35). Ross procedure implants appear to have optimal
      survival (94%) at 5 years. Non-Ross implants in patients more than 10 years of
      age have 76% 5-year Kaplan-Meier survival, which is not different from Ross
      patients (p = 0.33). CONCLUSIONS: Small homografts have limited durability.
      Aortic homografts perform as well as pulmonary homografts in young patients. Once
      patients receive an "adult-size" homograft, at approximately 10 years of age,
      risk for implant failure approximates that of patients undergoing the Ross
      procedure. Transcatheter interventions, when indicated, may prolong homograft
      life.

PMID- 11216811
TI  - Unexpected death after reconstructive surgery for hypoplastic left heart
      syndrome.
AB  - BACKGROUND: Although operative mortality for reconstructive surgery for
      hypoplastic left heart syndrome continues to improve, nonoperative mortality,
      especially in the first year of life, remains relatively high. A number of
      patients who are thought to be clinically well at hospital discharge die
      unexpectedly. The goal of the present study was to determine the incidence of and
      risk factors for unexpected death in patients with hypoplastic left heart
      syndrome. METHODS: Retrospectively, we determined the incidence of unexpected
      death among 536 patients with hypoplastic left heart syndrome who were discharged
      to home after stage I surgical procedure. To identify potential risk factors, a
      nested case-control analysis was undertaken. RESULTS: Unexpected death occurred
      in 22 of 536 patients (4.1%) discharged to home after stage I surgical procedure.
      The median age at unexpected death was 79 days (range, 25 to 227 days). Seizures
      preceded cardiac arrest in 2 patients, and ventricular arrhythmias were
      documented in 3 additional patients during attempted resuscitation. Autopsy
      studies were performed in 12 patients and identified residual lesions that may
      have contributed to death in 2 patients. In multivariate analysis documented
      perioperative arrhythmia and earlier year of stage I surgical procedure were
      associated with an increased risk for unexpected death (p = 0.03 and p = 0.04,
      respectively). There were 4 additional patients who had unexpected death after
      subsequent cavopulmonary operation at a median age of 1.6 years (range, 0.9 to
      3.8 years). CONCLUSIONS: Unexpected death occurred in more than 4% of patients
      with hypoplastic left heart syndrome who were discharged to home after stage I
      surgical procedure and was most common in the first several months of life.
      Factors that may contribute to unexpected death include residual lesions,
      arrhythmias, and neurologic events, although in the majority of cases the cause
      remains largely unknown.

PMID- 11216812
TI  - Pediatric cardiac retransplantation: intermediate-term results.
AB  - BACKGROUND: Cardiac retransplantation (re-CTx) in children is a controversial
      therapy, yet it remains the best treatment option to recipients with failing
      grafts. Our objective was to determine the incidence of re-CTx in a large
      pediatric population of recipients and evaluate the outcome of such therapy.
      METHODS: Between November 1985 and November 1999, 347 children underwent cardiac
      transplantation at the Loma Linda University Medical Center. Of these, 32
      children were listed for re-CTx. Ten patients died while waiting, and 22
      recipients underwent re-CTx. Median age at re-CTx was 7.1 years (range, 52 days
      to 20.1 years). RESULTS: Indications for re-CTx were allograft vasculopathy (n =
      16), primary graft failure (n = 5), and acute rejection (n = 1). Two patients
      with primary graft failure underwent retransplantation within 24 hours of the
      first transplantation procedure while on extracorporeal membrane oxygenation
      support. Median time interval to re-CTx for the others was 7.2 years (range, 32
      days to 9.4 years). Operative mortality for all cardiac re-CTx procedures was
      13.6%. Causes of hospital mortality were pulmonary hypertension with graft
      failure (n = 2) and multiorgan failure (n = 1). Median hospital stay after re-CTx
      was 14.1 days (range, 6 to 45 days). There was one late death from severe
      rejection. Actuarial survival at 3 years for re-CTx was 81.9% +/- 8.9% compared
      with 77.3% +/- 2.6% for primary cardiac transplantation recipients (p = 0.70).
      CONCLUSIONS: Elective re-CTx can be performed with acceptable mortality. Although
      the number of patients undergoing retransplantation in this report is small and
      their long-term outcome is unknown, the intermediate-term survival after re-CTx
      is similar to that of children undergoing primary cardiac transplantation.

PMID- 11216813
TI  - Early experience with extracardiac Fontan operation.
AB  - BACKGROUND: The extracardiac Fontan (ECFO) operation has gained more widespread
      use over last decade. In this article we analyze our early experience with ECFO.
      METHODS: Thirty-three patients underwent ECFO at median age 4.1 years.
      Normothermic perfusion with the heart beating was used in 24 patients and
      cardioplegia in 7. Fenestration was not performed in the last 16 patients who
      underwent surgery without cardioplegia. RESULTS: The hospital mortality was 6% (2
      patients). Necessity or duration of inotropic support, duration of mechanical
      ventilation, intensive care unit and hospital stay, and incidence of prolonged
      pleural effusions of patients operated on without cardioplegia were shorter and
      the rate of complications in these patients was lower than in patients who
      underwent cardioplegia. CONCLUSIONS: Our preliminary experience shows that ECFO
      can be performed in many patients with normothermic cardiopulmonary bypass and
      without cardioplegia and fenestration. Avoidance of cardioplegia seems to
      decrease postoperative morbidity. Incidence of early postoperative arrhythmias is
      low. Despite encouraging early results, longer follow-up is necessary to prove
      the real advantages of ECFO.

PMID- 11216814
TI  - Valvuloplasty with glutaraldehyde-treated autologous pericardium in patients with
      complex mitral valve pathology.
AB  - BACKGROUND: Severe mitral regurgitation associated with complex mitral valve
      disease often precludes successful surgical repair. The feasibility and the
      results of valvuloplasty with glutaraldehyde-treated autologous pericardium
      remain largely unknown. METHODS: The cases of 63 patients who underwent operation
      within an 11-year period were studied. A pretreated autologous pericardial patch
      was used for leaflet extension plasty, for paracommissural plasty, as a
      substitute for part of the leaflet, and for reimplantation of ruptured papillary
      muscles to eliminate severe mitral regurgitation. Patients with a severely
      calcified annulus after en bloc decalcification had straddling endoventricular
      pericardial patch annuloplasty for reconstruction of the affected
      atrioventricular groove. Chordal replacement with a strip of pericardium was
      chosen if no suitable chordae were available. Pericardium-reinforced suture
      annuloplasty was used in patients with acute endocarditis resistant to medical
      therapy. Associated valvuloplasty procedures with Carpentier techniques were also
      employed. RESULTS: There were no operative deaths in this series. At a mean
      follow-up of 61.1 months (range, 4 to 132 months), mitral regurgitation was
      absent or trivial in 92.1% of patients by echocardiography. Freedom from
      reoperation was 95.2% at 1 year and 5 years. Thromboembolic events have not been
      detected. Thirty percent of patients returned to sinus rhythm. Two patients
      required valve replacement. CONCLUSIONS: Our beneficial results indicate that
      glutaraldehyde-treated autologous pericardium is suitable for valvuloplasty. It
      provides durable and predictable repair of valves that might otherwise need to be
      replaced because of the complex mitral valve disease. The technique is reliable,
      allows further efficacious repair possibilities, and improves postoperative
      outcomes. Whether it can prevent late deterioration and calcification requires
      more investigation.

PMID- 11216816
TI  - Results of continual devaluation of cardiothoracic surgical codes by the HCFA
      between 1984 and 1999.
AB  - BACKGROUND: The devaluation of surgical procedural services by Medicare began in
      1989 as a result of the federal government's adoption of the Resource Based
      Relative Value Scale, a method of redistribution of payments to physicians from
      surgical to primary care services. This method gave to the Health Care Financing
      Administration (HCFA) effective and complete control of Medicare payments to
      physicians for the first time. The resultant decrease in the nominal dollar value
      is well understood, but the effect of changes in inflation frequently is not
      calculated into the reported loss. METHODS: A method of determining the true
      extent of this devaluation using the nominal dollar decrease plus the effect of
      inflation was presented in 1995. RESULTS: Since then, repeated devaluation by the
      HCFA and other third parties plus continual inflation has further eroded the
      remuneration for cardiothoracic surgical services. Three different sets of data
      are used to determine the devaluation of five cardiothoracic operations. One set
      shows the change between 1988 and 1998; one the change between 1988 and 1999; and
      one the change between 1984 and 1999. CONCLUSIONS: Depending on the geographic
      location, it appears that the remuneration for pulmonary procedures between 1988
      and 1999 decreased 35% to 60%. Similarly, depending on the years reviewed
      (between 1984 and 1999) and the geographic location, the fee for cardiac
      procedures decreased 46% to 69%.

PMID- 11216815
TI  - The CryoLife O'Brien stentless porcine aortic bioprosthesis: 5-year follow-up.
AB  - BACKGROUND: Mortality, morbidity, complication rates, and echo hemodynamic
      results using the Cryolife O'Brien stentless aortic bioprosthesis over a 5-year
      period are reported. METHODS: The stentless valve was implanted in 97
      conscecutive patients, 54 male and 43 female, mean age 70.9 +/- 6.5 years. All
      patients underwent preoperative, discharge (early study), 6-month (intermediate
      study), and late (18.3 +/- 10.4 months) echocardiography. RESULTS: The actuarial
      5-year survival rate was 93.9% +/- 3%. Aortic regurgitation was absent in 95.5%,
      mild in 3.4%, and moderate in 1.1%. Peak and mean systolic gradients were
      significantly lower at discharge (p < 0.001) and at the 6-month follow-up (p <
      0.001) but did not significantly fall further at the late study (p = NS). The
      effective orifice area index at discharge (p < 0.001) and at 6 months (p < 0.001)
      differed significantly from preoperative values, but variations at late study
      were not significant (p = NS). Left ventricular mass index decreased early
      postoperatively (p < 0.001) and at 6-month assessment (p < 0.001) with a further
      significant reduction at late echocardiography (p = 0.04). CONCLUSIONS: The 5
      year results of this stentless valve showed a low rate of valve-related
      complications with excellent hemodynamic performance in all valve sizes.

PMID- 11216817
TI  - In vivo hemodynamic, histologic, and antimineralization characteristics of the
      Mosaic bioprosthesis.
AB  - BACKGROUND: Performance of bioprosthetic valves is limited by tissue degeneration
      due to calcification with reduced performance and longevity. The Mosaic
      bioprosthetic valve (Medtronic Heart Valves, Inc, Minneapolis, MN) combines zero
      pressure fixation, antimineralization properties of alpha-amino oleic acid (AOA),
      and a proven stent design. We tested the hypothesis that AOA treatment of Mosaic
      valves improves hemodynamics, antimineralization properties, and survival in a
      chronic ovine model. METHODS: Mitral valves were implanted in juvenile sheep with
      Mosaic valves with AOA treatment (n = 8) or without AOA treatment (non-AOA, n =
      8), or Hancock I (HAN, n = 4) tissue valves, and explanted at 20 postoperative
      weeks. RESULTS: Survival was equivalent in AOA and non-AOA (140 +/- 0.4 and 129
      +/- 30 days), but was significantly less in HAN (82 +/- 35). Leaflet calcium
      (microgCa/mg tissue) was less in AOA (9.6 +/- 13.9; p < 0.05 versus non-AOA and
      HAN) than non-AOA (96.3 +/- 63.8) and HAN (130.8 +/- 43.2). Explant valve orifice
      area (cm2) was significantly preserved in the AOA group compared with the non-AOA
      group (1.5 +/- 0.7 vs 0.8 +/- 0.3; p < 0.05 versus non-AOA and HAN). CONCLUSIONS:
      We conclude that AOA treatment of Mosaic valves reduces leaflet calcification and
      valve gradient in juvenile sheep, and that the Mosaic design and fixation
      features may offer survival advantages that must be confirmed in extended trials.

PMID- 11216818
TI  - Characterization of T cell receptor beta chains of accumulating T cells in
      chronic ongoing myocarditis demonstrated by heterotopic cardiac transplantation
      in mice.
AB  - Autoimmne mechanisms have been implicated in the pathogenesis of chronic ongoing
      mycarditis. An earlier study of murine chronic ongoing myocarditis reported that
      infiltrating T cells and macrophages were prominent in the normal donor heart, in
      a heterotopic cardiac transplantation model. It was demonstrated that myocarditis
      was transferred to a normal heart transplanted into a mouse with chronic
      myocarditis. The present study investigated an autoimmune link to the
      pathogenesis of chronic ongoing myocarditis by analyzing the T cell clonalities
      in the model. To characterize the accumulating T cells in the donor heart, the T
      cell receptor beta genes (TCRBG) were amplified by reverse transcriptase
      polymerase chain reaction (RT-PCR) from mRNA in the donor hearts and accumulating
      TCRBG clonotypes were contrasted with those from recipient hearts. Inbred 3-week
      old A/J mice were inoculated intraperitoneally with Coxsackievirus B3 (Nancy
      strain), 2 x 10(4) PFU, and housed for more than 60 days. Normal A/J mouse hearts
      were transplanted into the same strain of mice without myocarditis, as well as
      into the mice with chronic ongoing myocarditis. Both recipient and donor hearts
      were evaluated histologically 2 weeks after the transplantation. TCRBG were
      amplified by RT-PCR from mRNA of recipient and donor hearts and spleens. The
      specific accumulating TCRBG clonotypes were identified by their single strand
      conformation polymorphism. Multiple clonotypic accumulations occurred in the
      donor heart after cardiac transplantation. Distinct oligoclonal accumulation of
      TCR Vbeta1, 10, and 13 T cells was found in both recipient and donor hearts in 3
      of 4 mice. Moreover, these clonotypes were not observed in spleen cells of the
      recipient mice. T specific cells expanding clonotypes of TCRBG are responsible
      for transferring myocarditis to the donor heart. An autoimmune response may,
      therefore, play a key role in the progression of chronic ongoing myocarditis.

PMID- 11216819
TI  - Quantitative analysis of termination of vagally induced canine atrial
      fibrillation by mutual information.
AB  - Atrial fibrillation (AF) is often described as a disorganized phenomenon, but
      many features that qualitatively suggest an underlying order have recently been
      reported. The present study aimed to disclose this underlying order of AF in a
      quantitative manner, using a new method of mutual information (MI), which is a
      measure for gauging the general correlation between 2 time series. Frequency
      analysis and the MI method were used to analyze 5 epicardial potentials on both
      atria during AF induced by vagal stimulation (Vs) in 15 dogs. Unipolar electrodes
      were placed on the right atrial appendage (Rap), the high right atrium (HRA), and
      the left atrial appendage (Lap). The other 2 electrodes were placed equidistantly
      between HRA and Rap (RA1-RA2). The power spectrum of AF had a discrete peak
      around 17Hz during Vs. After Vs was stopped, the discrete peak shifted from 17Hz
      to 7 Hz on all epicardial leads. Taking RA2 as a reference, MI was calculated
      between RA2 and each of the other electrodes. The MI values (0.066+/-0.005) were
      greater than 0.047 (the critical value for correlated data) even during Vs. The
      MI values increased significantly from the highly active process of AF during Vs
      to the less active one (0.126+/-0.006) before termination of AF. In addition, the
      MI values increased more at the electrodes close to RA2 (RA1 and Rap) than at
      those far from it (HRA and Lap). These findings suggest that multiple wavelets,
      which are not random, progressively organize into a few major waves toward the
      termination of AF; therefore, AF is not a random phenomenon in this model.

PMID- 11216821
TI  - Angiographically documented coronary steal phenomenon evoked by the intracoronary
      infusion of bradykinin.
AB  - While studying flow-dependent coronary dilation using a Doppler flow velocity
      guidewire, total occlusion of a stenosed segment of the left circumflex artery
      during the intracoronary infusion of bradykinin was angiographically documented.
      Total occlusion was not demonstrated during intracoronary infusion of bradykinin
      after angioplasty. This is angiographic confirmation of the coronary steal
      phenomenon that has been previously described in the field of stress
      scintigraphy.

PMID- 11216820
TI  - Effect of hypercholesterolemia on macrophage infiltration after balloon injury to
      rabbit iliac artery.
AB  - Both hypercholesterolemia and vascular injury have been reported to induce
      macrophage infiltration, but their combined effect and the mechanism by which
      hypercholesterolemia enhances the infiltration remain to be clarified in vivo. To
      evaluate the effect of hypercholesterolemia on macrophage infiltration after
      vascular injury, the iliac arteries of hypercholesterolemic (HC) and
      normocholesterolemic (NC) rabbits were examined 2h, 1 day, 3 days, 7 days, and 14
      days after balloon injury using immunohistochemical staining for macrophages,
      intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule
      (VCAM)-1. Nuclear factor kappa-B (NF-kappaB) activation was also evaluated in
      fresh frozen iliac arteries using the electrophoretic mobility shift assay
      method. The fundamental difference between HC and NC was the amount of macrophage
      infiltration seen in HC from 7 days after balloon injury. Two out of 4 HC iliac
      arteries on the 7th day, and 3 out of 4 HC iliac arteries on the 14th day were
      positively stained with ICAM-1 in regenerated endothelium and neointima, whereas
      there were no positively stained NC iliac arteries. Neither HC nor NC tissues
      showed positive staining with VCAM-1. NF-kappaB was activated in HC 7 and 14 days
      after balloon injury, but not in NC. In conclusion, in vivo hypercholesterolemia
      induces macrophage infiltration after balloon injury and it is mediated by
      increased NF-kappaB activation promoting ICAM-1 expression.

PMID- 11216822
TI  - Cardiac dysfunction because of secondary hemochromatosis caused by congenital non
      spherocytic hemolytic anemia.
AB  - Most patients diagnosed with secondary hemochromatosis have had repeated blood
      transfusions. Cardiac failure accounts for approximately one-third of the deaths
      associated with hemochromatosis. Liver dysfunction or hormonal disorders such as
      diabetes generally precede cardiac failure. A 23-year-old woman with
      hemochromatosis had, despite significant left ventricular dysfunction, liver
      function within the normal range on biochemical evaluation. She was treated for
      congestive heart failure and given desferoxamine intravenously. She did not have
      primary hemochromatosis, and had not received multiple blood transfusions or iron
      supplement. As a child the patient had been diagnosed with congenital non
      spherocytic hemolytic anemia not requiring transfusion; thus, this is a unique
      case of secondary hemochromatosis.

PMID- 11216823
TI  - Transient but marked ST elevation in precordial leads caused by ischemia of the
      isolated right ventricular branch.
AB  - The present case is a 64 year-old man in whom transient but marked ST elevation
      was confirmed in the contralateral precordial leads (V1-3) during percutaneous
      transluminal coronary angioplasty (PTCA) of the proximal right coronary artery,
      suggesting that the patient had anteroseptal ischemia. The ST elevation persisted
      even after the balloon was deflated, and no changes in the left coronary artery
      were detected. In addition, blood flow in the affected area of the right coronary
      artery was favorable and there was a transient delay only in the right
      ventricular branch. Once blood flow in the right ventricular branch improved, ST
      returned to baseline, and when the right ventricular branch was again occluded by
      the balloon, ST elevation occurred in a reproducible manner. Hence, the
      electrocardiographic changes in the precordial leads were caused by occlusion of
      the right ventricular branch. It is rare to observe ST elevation caused by
      isolated right ventricular branch ischemia.

PMID- 11216824
TI  - Biventricular hypertrophic cardiomyopathy with right ventricular outflow tract
      obstruction associated with Noonan syndrome in an adult.
AB  - This report describes an adult patient with Noonan syndrome accompanied by
      biventricular hypertrophic cardiomyopathy causing isolated right ventricular
      outflow tract obstruction. Biventricular hypertrophic cardiomyopathy causing
      right- and/or left-side outflow tract obstruction, as well as valvular pulmonary
      stenosis, is relatively common in infants with Noonan syndrome. However, this
      condition without a dysplastic pulmonary valve, or indeed any polyvalvular
      dysplasia, is rare in adults with Noonan syndrome. Treatment with a beta
      adrenergic receptor blocking agent improved the patient's symptoms. Because
      neither the etiologic and prognostic relationship nor the genetic linkage between
      hypertrophic cardiomyopathy associated with Noonan syndrome and non-syndromic
      hypertrophic cardiomyopathy is clearly defined, clinicopathological findings and
      further follow-up may provide important evidence for the pathogenesis of
      hypertrophic cardiomyopathy.

PMID- 11216825
TI  - Tumor necrosis factor receptor superfamily 12 may destabilize atherosclerotic
      plaques by inducing matrix metalloproteinases.
AB  - Immunohistochemical staining of human atherosclerotic plaques revealed expression
      of the tumor necrosis factor receptor superfamily (TNFRSF) 12 in regions rich in
      macrophage/foam cells. The role of TNFRSF12 in the functioning of monocytes in
      relation to atherogenesis was investigated by analysis of cellular events after
      stimulation of TNFRSF12 in a human macrophage-like cell line, THP-1. Activation
      of the THP-1 cells on plates coated with monoclonal antibody against TNFRSF12
      induced the expression of matrix metalloproteinases (MMPs) -1, -9, and -13.
      Furthermore, the expression patterns of TNFRSF12 and the MMPs overlapped in
      atherosclerotic plaques. Signaling of TNFRSF12 may thus contribute to the
      induction of extracellular matrix degrading enzymes in macrophages.

PMID- 11216826
TI  - Relationship between terminal QRS distortion on the admission electrocardiogram
      and the time course of left ventricular wall motion in anterior wall acute
      myocardial infarction.
AB  - In order to clarify the time course of left ventricular (LV) wall motion in
      patients with anterior acute myocardial infarction (AMI) showing terminal QRS
      distortion on the admission electrocardiogram (ECG), the present study examined
      106 patients with their first anterior AMI (< or =6 h) who underwent emergency
      coronary arteriography and cardiac cathetherization at 1 and 6 months after the
      infarction. The patients were classified into 2 groups according to the presence
      (group A, n=23) or absence (group B, n=83) of terminal QRS distortion (emergence
      of the J point at > or =50% of the R-wave amplitude in leads with QR
      configuration and/or absence of S waves in leads with RS configuration) on the
      admission ECG. Group A had a lower LV ejection fraction and more reduced regional
      wall motion (RWM) in the infarct region at both 1 and 6 months after AMI than
      group B. The degree of improvement in RWM between 1 and 6 months after AMI was
      less in group A than in group B (-0.1+/-0.5 vs 0.4+/-0.6 SD/chord, p<0.01). This
      study indicates that patients with anterior AMI showing terminal QRS distortion
      on the admission ECG have more severely depressed LV wall motion and less
      improvement in RWM in the infarct region in the healing stage, suggesting that
      this sign is an indicator of severe myocardial damage.

PMID- 11216827
TI  - Relationship between myocardial damage and C-reactive protein levels immediately
      after onset of acute myocardial infarction.
AB  - The present study investigated the relationship between myocardial damage and C
      reactive protein (CRP) levels, with no increase in creatine kinase (CK) activity,
      immediately after the onset of acute myocardial infarction (AMI) in 85 patients
      with their first reperfused anterior AMI without CK elevation on admission and no
      ischemic events during hospitalization. Patients were classified into those with
      low levels (<0.3 mg/dl) of CRP (Group L; n=67) and those with high levels (> or
      =0.3 mg/dl) of CRP (Group H; n=18). Group H had a higher proportion of patients
      with a history of preinfarction angina (89 vs 55%, p<0.01), especially unstable
      angina. SigmaST in leads V1-6 on admission ECG was lower in Group H than in Group
      L (14+/-7 vs 21+/-13 mm, p<0.05). Predischarge left ventriculography showed that
      the left ventricular global ejection fraction (55+/-11 vs 48+/-10%, p<0.01) and
      SD/chord at the left anterior descending artery lesion (-1.7+/-0.9 vs -2.3+/-0.9,
      p<0.01) were better in Group H. Multivariate analysis demonstrated that both CRP
      on admission (p=0.011) and preinfarction angina (p=0.002) were independently
      associated with better regional wall motion (SD/chord >-2.0) before discharge.
      These results suggest that the clinical situation of elevated CRP immediately
      after onset is associated with less myocardial damage and better left ventricular
      function in reperfused anterior AMI.

PMID- 11216829
TI  - Risk stratification for sudden cardiac death in dilated cardiomyopathy using
      microvolt-level T-wave alternans.
AB  - Predicting sudden cardiac death (SCD) in patients with dilated cardiomyopathy
      (DCM) is difficult, so the present study evaluated the efficacy of microvolt
      level T-wave alternans (TWA) and compared it with conventional parameters for
      prospective risk stratification of SCD in patients with DCM. Eighty-two patients
      with DCM (53+/-15 years old, 67M/15F) underwent assessment of TWA, left
      ventricular end-diastolic diameter (LVDd), left ventricular ejection fraction
      (LVEF), signal-averaged ECG, and analysis of 24-h Holter monitoring and QT
      dispersion (QTd). The endpoint of the study was defined as either SCD or
      documented sustained ventricular tachycardia/ventricular fibrillation (SVT/VF)
      during the follow-up period. During an average follow-up period of 24 months, 1
      patient died suddenly and 9 patients had SVT/VF. Kaplan-Meier survival analysis
      showed that TWA, LVEF (< or =35%), nonsustained ventricular tachycardia, and QTd
      (>90ms) were significant univariate risk stratifiers (p<0.005, p<0.005, p<0.005,
      and p<0.05, respectively). Multivariate Cox regression analysis showed that TWA
      and the LVEF were statistically significant independent risk stratifiers (p<0.05
      and p<0.01, respectively). A combination of TWA and LVEF identified high risk DCM
      patients (p<0.01); TWA for the electrical substrate and the LVEF for the
      hemodynamic function.

PMID- 11216828
TI  - Expression of matrix metalloproteinases in patients with acute myocardial
      infarction.
AB  - This study investigated the clinical significance of matrix metalloproteinases
      (MMPs) in acute myocardial infarction (AMI) and the involvement of peripheral
      blood mononuclear cells (PBMCs), which are a possible source of MMPs in AMI.
      Forty patients with AMI were recruited. Plasma and PBMCs were isolated from
      peripheral blood on days 1, 7, 14 and 21 after the onset of AMI. Levels of MMP-1
      and MMP-2 were measured by enzyme-linked immunosorbent assay. The MMP-1 level in
      the culture medium of PBMCs after incubation for 24h was designated as 'PBMC-MMP
      1 level.' Plasma MMP-1 did not significantly change during the course of AMI, but
      the plasma MMP-2 levels increased gradually after the onset of AMI with maximum
      elevation on day 21 after onset. Plasma MMP-2 activity also became significantly
      elevated during the course of AMI. PBMC-MMP-1 levels in the patients were
      significantly higher than those in control subjects over the course of AMI.
      Significant positive correlations were observed between maximum PBMC-MMP-1 levels
      and maximum plasma C-reactive protein levels (r=+0.55, p<0.01) and left
      ventricular end-diastolic volume index (r=+0.63, p<0.001). In conclusion, plasma
      MMP-2 levels and activity and MMP-1 production by PBMCs are increased in patients
      with AMI. Inflammation after AMI may enhance production of MMP-1 by PBMCs. These
      changes may play an important role in the ventricular remodeling that occurs
      after AMI by promoting the degradation of the extracellular matrix.

PMID- 11216830
TI  - Nitric oxide-mediated vasodilatation is decreased in forearm resistance vessels
      in patients with coronary spastic angina.
AB  - It has been reported that coronary endothelial dysfunction is associated with the
      pathogenesis of coronary spasm, and that endothelial nitric oxide (NO) mediated
      vasodilatation was decreased in coronary epicardial arteries in patients with
      coronary spastic angina (CSA). However, there are few reports about the
      endothelial function in peripheral resistance vessels of patients with CSA, so
      the present study investigated the role of NO in forearm resistance vessels in
      such patients. The responses of forearm blood flow to acetylcholine (ACh; 8-24
      microg/min) and sodium nitroprusside (SNP; 0.4-1.2 microg/ml) infusions was
      examined using plethysmography, and subsequently the responses to ACh after an
      infusion of N(G)-monomethyl-L-arginine (L-NMMA; 4 micromol/min, for 5 min) in 17
      patients with CSA and 17 age- and sex- matched controls. The vasodilator
      responses to ACh and SNP were comparable between the 2 groups (p=NS). L-NMMA
      significantly suppressed the vasodilator responses to ACh in controls (p<0.05),
      but there was no significant difference in the responses to ACh before and after
      infusion of L-NMMA in patients with CSA (p=NS). These results indicate that
      endothelial NO-mediated vasodilatation is decreased in the forearm resistance
      vessels of patients with CSA.

PMID- 11216831
TI  - Effects of a two-week, hospitalized phase II cardiac rehabilitation program on
      physical capacity, lipid profiles and psychological variables in patients with
      acute myocardial infarction.
AB  - A new 2-week hospitalized phase II cardiac rehabilitation program has been
      designed and the present study sought to clarify whether the physical and
      psychological status of patients with acute myocardial infarction (AMI) improved
      after participation in the program. Fifty-one patients with AMI were enrolled in
      the rehabilitation program, which consisted of exercise training, education and
      counselling, and another 34 patients with AMI who did not participate in the
      program served as the control group. The physical and psychological status of the
      patients was evaluated before, at 1-month after the program, and at 6- and 12
      months follow-ups. The physical status was assessed by exercise tolerance and
      serum lipid profiles and the psychological status was assessed by the Spielberger
      State-Trait anxiety inventory questionnaire (STAI) and self-rating questionnaire
      for depression. Quality of life (QOL) was assessed using established and
      validated QOL scales. After participation in the program, the exercise tolerance,
      serum lipid profiles and STAI anxiety score of the patients were improved
      significantly and at the 6-month follow-up these parameters remained improved and
      regular physical activity was maintained. The QOL score also improved
      significantly. Even at the 12-month follow-up, lipid profiles remained improved
      and regular physical activity was maintained. The 2-week hospitalized phase II
      cardiac rehabilitation program improved the management of cardiac risk factors
      and psychological status in patients with myocardial infarction (MI). It provides
      beneficial effects on the patient's physical and psychological activities in the
      recovery phase and may also contribute to the secondary prevention of MI.

PMID- 11216832
TI  - Pulse infusion thrombolysis (PIT) for large intracoronary thrombus: preventive
      effect against the 'no flow' phenomenon in revascularization therapy for acute
      myocardial infarction.
AB  - Because large thrombus is a limitation for revascularization in acute myocardial
      infarction (AMI), the present study evaluated the effectiveness of pulse infusion
      thrombolysis (PIT) in patients with an AMI with a large (>15 mm) coronary
      thrombus, focusing on the occurrence of the 'no flow' phenomenon. The
      retrospective study compared patients treated before (1988-95; Group A, n=74) and
      after (1996-99; Group B, n=40) the use of PIT, using the following parameters:
      lesion success (<50% stenosis during 30-min observation), procedural success
      (lesion success plus TIMI grade 3 flow), procedural no flow (TIMI grade 0 flow
      during the procedure with 'back and forth movement' of contrast dye after lesion
      success), persistent no flow (consistent no flow without any flow improvement at
      the final visualization despite intensive treatment), reocclusion rate and in
      hospital death. Group B was significantly better than Group A in procedural
      success (90% vs 66%; p=0.005), procedural 'no flow' (51% vs 15%; p<0.001), and
      persistent 'no flow' (34% vs 10%; p<0.05). Subgroup comparison was performed
      among the following groups: Direct-BA group (n=44): treated with mechanical
      angioplasty alone; ICT-BA group (n=40): treated with prior intracoronary
      thrombolysis and angioplasty; and PIT-BA group (n=30): treated with PIT and
      angioplasty. There were no differences in thrombus length and lesion success
      among these 3 groups. Procedural success was best achieved in PIT-BA: 97% vs 52%
      for Direct-BA (p=0.003) and 68% for ICT-BA (p=0.009). Procedural 'no flow' was
      least in PIT-BA: 50% vs 3.3% for Direct-BA (p=0.003) and 25% vs 3.3% for ICT-BA
      (p=0.042). Persistent 'no flow' was less frequent in PIT-BA than Direct-BA: 32%
      vs 3.3% (p=0.009). However, the difference between ICT-BA and Direct-BA was
      insignificant: 13% vs 3.3% (p=0.53). There were no differences in reocclusion
      rate and in-hospital death among the 3 subgroups. And there were no differences
      between Direct-BA and ICT-BA in any parameters. PIT was effective in preventing
      'no flow' in the mechanical revasculalization for AMI especially those cases with
      a large thrombus.

PMID- 11216833
TI  - Thallium-201 single photon emission computed tomography (SPECT) in patients with
      duchenne's progressive muscular dystrophy: a histopathologic correlation study.
AB  - The pathomorphologic mechanism responsible for abnormal perfusion imaging during
      thallium-201 myocardial single photon emission computed tomography (201Tl-SPECT)
      in patients with Duchenne's progressive muscular dystrophy (DMD) was
      investigated. Hearts from 7 patients with DMD were evaluated histopathologically
      at autopsy and the results correlated with findings on initial and delayed
      resting 201Tl-SPECT images. The location of segments with perfusion defects
      correlated with the histopathologically abnormal segments in the hearts. Both the
      extent and degree of myocardial fibrosis were severe, especially in the
      posterolateral segment of the left ventricle. Severe transmural fibrosis and
      severe fatty infiltration were common in segments with perfusion defects. In
      areas of redistribution, the degree of fibrosis appeared to be greater than in
      areas of normal perfusion; and intermuscular edema was prominent. Thus, the
      degree and extent of perfusion defects detected by 201Tl-SPECT were compatible
      with the histopathology. The presence of the redistribution phenomenon may
      indicate ongoing fibrosis. Initial and delayed resting 201Tl-SPECT images can
      predict the site and progress of myocardial degeneration in patients with DMD.

PMID- 11216834
TI  - Enhanced luciferin entry causes rapid wound-induced light emission in plants
      expressing high levels of luciferase.
AB  - In-vivo imaging of transgenic tobacco plants (Nicotiana tobacum L.) expressing
      firefly luciferase under the control of the Arabidopsis phenylalanine
      ammonialyase 1 (PAL1)-promoter showed that luciferase-catalyzed light emission
      began immediately after the substrate luciferin was sprayed onto the leaves and
      reached a plateau phase after approximately 60 min. This luminescence could
      easily be detected for up to 24 h after luciferin application although the light
      intensity declined continuously during this period. A strong and rapid increase
      in light emission was observed within the first minutes after wounding of
      luciferin-sprayed leaves. However, these data did not correlate with luciferase
      activity analysed by an in-vitro enzyme assay. In addition, Arabidopsis plants
      expressing luciferase under the control of the constitutive 35S-promoter showed
      similar wound-induced light emission. In experiments in which only parts of the
      leaves were sprayed with luciferin solutions, it was shown that increased uptake
      of luciferin at the wound site and its transport through vascular tissue were the
      main reasons for the rapid burst of light produced by preformed luciferase
      activity. These data demonstrate that there are barriers that restrict luciferin
      entry into adult plants, and that luciferin availability can be a limiting factor
      in non-invasive luciferase assays.

PMID- 11216835
TI  - Phloem-specific expression of the pumpkin fruit trypsin inhibitor.
AB  - Vascular exudates of Cucurbita maxima (Duch.) contain a group of highly conserved
      serine proteinase inhibitors collectively called Pumpkin Fruit Trypsin Inhibitors
      (PFTIs) that prevent proteolytic activity of trypsin or chymotrypsin. Polyclonal
      antibodies raised against PFTIs were used to immunolocalize these low-molecular
      weight proteins within the phloem tissue and to study their developmental
      expression. The inhibitors were translocated throughout the transport phloem and
      were present in vascular exudates collected from both source and sink tissues
      throughout the plant. During the early stages of vascular development, PFTIs
      accumulated specifically in sieve element-companion cell complexes of the phloem
      tissue. Transcripts were initially detected by reverse transcription-polymerase
      chain reaction in seedlings 1 d after germination and the protein detected 24 h
      later. Pumpkin fruit trypsin inhibitors were present in both cell types of
      differentiating and translocating sieve element-companion cell complexes. The
      inhibitors were detected in the phloem of the bicollateral vascular bundles, but
      the protein was most consistently localized within the cortical and bundle
      associated extrafascicular phloem.

PMID- 11216836
TI  - Tracking individual wheat microspores in vitro: identification of embryogenic
      microspores and body axis formation in the embryo.
AB  - The development of isolated, defined wheat microspores undergoing in vitro
      embryogenesis has been followed by cell tracking. Isolated wheat (Triticum
      aestivum L.). microspores were immobilized in Sea Plaque agarose supported by a
      polypropylene mesh at a low cell density and cultured in a hormone-free, maltose
      containing medium in the presence of ovaries serving as a conditioning factor.
      Embryogenesis was followed in microspores isolated from immature anthers of
      freshly cut tillers or from heat- and starvation-treated, excised anthers. Three
      types of microspore were identified on the basis of their cytological features at
      the start of culture. Type- microspores had a big central vacuole and a nucleus
      close to the microspore wall, usually opposite to the germ pore. This type was
      identical to the late microspore stage in anthers developing in vivo. Microspores
      with a fragmented vacuole and a peripheral cytoplasmic pocket containing the
      nucleus were defined as type 2. In type-3 microspores the nucleus was positioned
      in a cytoplasmic pocket in the centre of the microspore. Tracking revealed that,
      irrespective of origin, type-1 microspores first developed into type 2 and then
      into type-3 microspores. After a few more days, type-3 microspores absorbed their
      vacuoles and differentiated into cytoplasm-rich and starch-accumulating cells,
      which then divided to form multicellular structures. Apparently the three types
      of microspore represent stages in a continuous process and not, as previously
      assumed, distinct classes of responding and non-responding microspores. The first
      cell division of the embryogenic microspores was always symmetric. Cell tracking
      also revealed that the original microspore wall opened opposite to a region in
      the multicellular microspore which consisted of cells containing starch grains
      while the remaining cells were starch grain-free. The starch-containing cells
      were located close to the germ pore of the microspore. In more advanced embryos
      the broken microspore wall was detected at the root pole of the embryo.

PMID- 11216837
TI  - NADH-stimulated, cyanide-resistant superoxide production in maize coleoptiles
      analyzed with a tetrazolium-based assay.
AB  - Using the tetrazolium salt XTT (Na,3'-[(phe-nylamino)-carbonyl]-3,4-tetrazolium]
      bis(4-methoxy-6-nitro)benzenesulfonic acid hydrate) as a sensitive and
      physiologically compatible probe for the determination of superoxide (O2*-)
      production in vivo, we have shown that maize (Zea mays L.) coleoptiles possess
      the capacity of generating O2*- in the apoplastic space. Our results are in
      agreement with the notion that this activity is localized at the plasma membrane
      and can be attributed to an O2*--synthesizing enzyme with catalytic and kinetic
      properties similar to that of the NADPH oxidase of mammalian phagocytes, with the
      important exception that it utilizes NADH instead of NADPH as electron donor.
      When applied to the apoplastic space, NADH strongly increased the O2*--producing
      activity of coleoptiles. The maize NADH-dependent O2*--synthase activity could
      clearly be differentiated from peroxidase-mediated O2*--synthesizing activity by
      its insensitivity to cyanide and azide, as well as by its much higher affinity to
      O2. Formation of O2*-, and concomitantly appearing H2O2, was preferentially
      localized in the outer epidermis of the coleoptile. The physiological
      significance of O2*- and H2O2 production in relation to the growth-controlling
      function of the epidermal cell wall is discussed.

PMID- 11216838
TI  - Gravitropic microtubule reorientation can be uncoupled from growth.
AB  - The causal relationship between gravitropic growth responses and microtubule
      reorientation has been studied. Growth and microtubule reorientation have been
      uncoupled during the gravitropic response of maize (Zea mays L.) coleoptiles.
      Microtubule orientation and growth were measured under three different
      conditions: (i) a gravitropic stimulation where the growth response was allowed
      to be expressed (intact seedlings were displaced from the vertical position by 90
      degrees), (ii) a gravitropic stimulation where the growth response was suppressed
      (coleoptiles were attached to microscope slides and kept in a horizontal
      position), (iii) suppression of growth in the absence of gravitropic stimulation
      (coleoptiles were attached to microscope slides and kept in a vertical position).
      It was found that (i) gravitropic stimulation can induce a microtubular
      reorientation from transverse to longitudinal in the upper (slower growing) flank
      of the coleoptile, and an inhibition of growth; (ii) the reorientation of
      microtubules precedes the inhibition of growth; (iii) the gravitropic response of
      microtubules is weaker, not elevated, when the inhibition of growth is
      artificially enhanced by attaching the coleoptiles to a slide; and (iv)
      artificial inhibition of growth in the absence of gravitropic stimulation cannot
      induce a microtubular response. Thus, the extent of microtubule reorientation is
      not correlated with the extent of growth inhibition. Moreover, these findings
      demonstrate that microtubules do not reorient passively after growth changes, but
      actively in response to gravitropic stimulation.

PMID- 11216839
TI  - Utilization of mutants to analyze the interaction between Arabidopsis thaliana
      and its naturally root-associated Pseudomonas.
AB  - A model system based on the Arabidopsis thaliana (L.) Heynh. Ws ecotype and its
      naturally colonizing Pseudomonas thivervalensis rhizobacteria was defined.
      Pseudomonas strains colonizing A. thaliana were found to modify the root
      architecture either in vivo or in vitro. A gnotobiotic system using bacteria
      labelled with green fluorescent protein revealed that P. thivervalensis exhibited
      a colonization profile similar to that of other rhizobacterial species. Mutants
      of A. thaliana affected in root hair development and possible hormone perception
      were used to analyze the plant genetic determinants of bacterial colonization. A
      screen for mutants insensitive to P. thivervalensis colonization yielded two
      mutants found to be auxin resistant. This further supports a proposed role for
      bacterial auxin in inducing morphological modifications of roots. This work paves
      the way for studying the interaction between plants and non-pathogenic
      rhizobacteria in a gnotobiotic system, derived from a natural association, where
      interactions between both partners can be genetically dissected.

PMID- 11216840
TI  - Brassinolide may control aquaporin activities in Arabidopsis thaliana.
AB  - It is usually assumed that aquaporins present in the cellular membranes could be
      an important route in the control of water flux in plants, but evidence for this
      hypothesis is scarce. In this paper, we report measurements of the osmotic
      permeability (P(os) of protoplasts isolated from hypocotyls of wild-type and
      mutant Arabidopsis thaliana (L.) Heynh. Mutants were affected in their growth and
      exhibited different sensitivities to the phytohormone, brassinolide. For the two
      mutants studied (cpd: constitutive photomorphogenesis and dwarfism; bril:
      brassinosteroid insensitive), hypocotyl length was correlated to P(os) for the
      protoplasts. Under experimental conditions where hypocotyl growth had ceased,
      restoration of root, hypocotyl and petiole growth by brassinolide was correlated
      with an increase in P(os) of the hypocotyl protoplasts. We consider that the
      increase in Pos of the hypocotyl cells was needed because these cells were part
      of the transcellular water pathway of the plant. This is the first time, to our
      knowledge, that brassinolide has been shown to be involved in the modification of
      the water-transport properties of cell membranes. Our results also emphasize the
      importance of aquaporins and the transcellular pathway in water transport under
      normal growth conditions.

PMID- 11216841
TI  - Characterisation of programmed cell death during aerenchyma formation induced by
      ethylene or hypoxia in roots of maize (Zea mays L.).
AB  - Aerenchyma is a tissue type characterised by prominent intercellular spaces which
      enhance flooding tolerance in some plant species by facilitating gas diffusion
      between roots and the aerial environment. Aerenchyma in maize roots forms by
      collapse and death of some of the cortical cells in a process that can be
      promoted by imposing oxygen shortage or by ethylene treatment. Maize roots grown
      hydroponically in 3% oxygen, 1 microl x l(-1) ethylene or 21% oxygen (control)
      were analysed by a combination of light and electron microscopy. Use of in-situ
      terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL)
      suggested internucleosomal cleavage of DNA. However, chromatin condensation
      detectable by electron microscopy was preceded by cytoplasmic changes including
      plasma membrane invagination and the formation of vesicles, in contrast to
      mammalian apoptosis in which chromatin condensation is the first detectable
      event. Later, cellular condensation, condensation of chromatin and the presence
      of intact organelles surrounded by membrane resembling apoptotic bodies were
      observed. All these events were complete before cell wall degradation was
      apparent. Therefore, aerenchyma formation initiated by hypoxia or ethylene
      appears to be a form of programmed cell death that shows characteristics in part
      resembling both apoptosis and cytoplasmic cell death in animal cells.

PMID- 11216842
TI  - The production of an inducible antisense alternative oxidase (Aox1a) plant.
AB  - Plant mitochondria contain an alternative oxidase (AOX) acting as a terminal
      electron acceptor of the alternative pathway in the electron transport chain.
      Here we describe the production of inducible antisense Aox1a plants of
      Arabidopsis thaliana (L.) Heynh. and the procedures used to determine the
      resulting alternative pathway activity. The Arabidopsis Aox1a cDNA sequence was
      cloned behind a copper-inducible promoter system in the antisense orientation.
      Arabidopsis thaliana (Columbia) plants were transformed by in-planta vacuum
      infiltration with Agrobacterium containing the antisense construct. Whole-leaf
      ethanol production was used as a measure to investigate alternative pathway
      activity in the presence of antimycin A. After 24 h, leaves from the copper
      induced, antisense line F1.1 produced up to 8.8 times more ethanol (via aerobic
      fermentation) than the non-induced and wild-type leaves, indicating effective
      cytochrome pathway inhibition by antimycin A and a decreased alternative pathway
      activity in induced F1.1 leaves. Transgene expression studies also revealed no
      expression in non-induced leaves and up until 24 h post-induction. Copper-induced
      transgenic leaves were less susceptible to alternative pathway inhibition than
      non-induced transgenic leaves, as seen via tissue-slice respiratory studies, and
      mitochondrial respiration, using F1.1 cell cultures, also supported this. These
      results demonstrate the successful production of a transgenic line of Arabidopsis
      in which the alternative pathway activity can be genetically manipulated with an
      inducible antisense system.

PMID- 11216843
TI  - Characterization and localization of a wound-inducible type I serine
      carboxypeptidase from leaves of tomato plants (Lycopersicon esculentum Mill.).
AB  - During the course of characterization of the wound-response related proteins from
      tomato (Lycopersicon esculentum Mill.) leaves, a serine carboxypeptidase (EC
      3.4.16.1) was identified. An increase in peptidase activity in response to
      wounding, and the isolation of a protein with carboxypeptidase (CP) activity from
      tomato leaves had been reported previously, but the mRNA coding for the enzyme
      was not identified. We now report the isolation of a tomato leaf type I serine-CP
      cDNA whose corresponding mRNA is induced by wounding, systemin and methyl
      jasmonate. The protein sequence deduced from the cDNA exhibits homology to tomato
      CP, and barley and rice type I CPs. Southern blot results indicated that the CP
      gene is probably a member of a small gene family. Tomato CP mRNA was detected
      within 3 h after wounding, or treatment with systemin or methyl jasmonate.
      Employing Western blot analysis, CP protein was shown to increase 12 h after the
      treatments. Using the tomato def1 mutant, we have demonstrated that a functional
      octadecanoid pathway is necessary for CP transcription in response to wounding.
      Carboxypeptidase protein was immunolocalized as protein aggregates within the
      central vacuoles of palisade mesophyll cells as well as in vascular parenchyma
      where it had previously been found. Double labeling using antibodies specific for
      CP and inhibitor II indicated that the two proteins are colocalized in the
      vacuolar aggregates. Tomato CP is a member of the "late wound-inducible genes"
      whose mRNAs increase 4-12 h following wounding, in contrast to several "early
      wound-inducible genes", whose mRNAs appear within 30 min. The data support a role
      for the enzyme in protein turnover that occurs systemically in leaf cells in
      response to wounding.

PMID- 11216844
TI  - Ultrastructure of minor-vein phloem and assimilate export in summer and winter
      leaves of the symplasmically loading evergreens Ajuga reptans L., Aucuba japonica
      Thunb., and Hedera helix L.
AB  - Minor-vein ultrastructure and sugar export were studied in mature summer and
      winter leaves of the three broadleaf-evergreen species Ajuga reptans var.
      artropurpurescens L., Aucuba japonica Thunb. and Hedera helix L. to assess
      temperature effects on phloem loading. Leaves of the perennial herb Ajuga
      exported substantial amounts of assimilates in form of raffinose-family
      oligosaccharides (RFOs). Its minor-vein companion cells represent typical
      intermediary cells (ICs), with numerous small vacuoles and abundant plasmodesmal
      connectivity to the bundle sheath. The woody plants Hedera and Aucuba
      translocated sucrose as the dominant sugar species, and only traces of RFOs.
      Their minor-vein phloem possessed a layer of highly vacuolated cells (VCs)
      intervening between mesophyll and sieve elements. Depending on their location and
      ontogeny, VCs were classified either as companion or parenchyma cells. Both cell
      types showed symplasmic continuity to the adjacent mesophyll tissue although at a
      lower plasmodesmal frequency compared to the Ajuga ICs. p
      Chloromercuribenzenesulfonic acid did not reduce leaf sugar export in any of the
      plants, indicating a symplasmic mode of phloem loading. Winter leaves did not
      show symptoms of frost injury, and the vacuolar pattern in ICs and VCs was
      equally prominent in both seasons. Starch accumulation as a result of reduced
      phloem loading was not observed to be triggered by low temperature. In contrast,
      high amounts of starch were found in mesophyll and bundle-sheath cells of summer
      leaves. Physiological data on season-dependent leaf exudation showed the
      maintenance of sugar export in cold-acclimated winter leaves.

PMID- 11216845
TI  - Beta-1, 3-glucanase and chitinase transgenes in hybrids show distinctive and
      independent patterns of posttranscriptional gene silencing.
AB  - Nicotiana sylvestris Speg. & Comes transformed with a tobacco class-I beta-1,3
      glucanase (GLU I ) cDNA driven by CaMV 35S RNA expression signals exhibits
      posttranscriptional gene silencing (PTGS) which is triggered between the
      cotyledon and two-leaf stages of seedling development and is postmeiotically
      reset to the high-expressing state during seed development. The incidence of GLU
      I PTGS in sibling plants differed for the two different transformants tested and
      increased with the number of T-DNA loci. Comparison of host class-I and class-II
      beta-1,3-glucanase gene expression suggests that a similarity of 60-70% in the
      coding-region is required for PTGS of the homologous host genes. The GLU I
      transformants exhibited a spatial gradient in PTGS, in which expression of the
      silent phenotype gradually increased in successive leaves toward the bottom of
      the plant. In contrast, transformants carrying an unrelated tobacco class I
      chitinase (CHN I) cDNA in the same expression vector exhibited discontinuous
      patterns of PTGS with adjacent high-expressing and silent leaves. The GLU I- and
      CHN I-specific patterns were maintained in hybrids homozygous for both T-DNA's
      indicating that two different transgenes present in the same genome can exhibit
      independent and distinctive patterns of PTGS. This implies that the nature of the
      transgene rather than a general pre-pattern of competence for PTGS or propagation
      of the silent state are important for pattern determination.

PMID- 11216846
TI  - Fructose 2,6-bisphosphate activates pyrophosphate: fructose-6-phosphate 1
      phosphotransferase and increases triose phosphate to hexose phosphate cycling in
      heterotrophic cells.
AB  - The aim of this work was to establish the influence of fructose 2,6-bisphosphate
      (Fru-2,6-P2) on non-photosynthetic carbohydrate metabolism in plants.
      Heterotrophic callus lines exhibiting elevated levels of Fru-2,6-P2 were
      generated from transgenic tobacco (Nicotiana tabacum L.) plants expressing a
      modified rat liver 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase. Lines
      containing increased amounts of Fru-2,6-P2 had lower levels of hexose phosphates
      and higher levels of 3-phosphoglycerate than the untransformed control cultures.
      There was also a greater redistribution of label into the C6 position of sucrose
      and fructose, following incubation with [1-13C]glucose, in the lines possessing
      the highest amounts of Fru-2,6-P2, indicating a greater re-synthesis of hexose
      phosphates from triose phosphates in these lines. Despite these changes, there
      were no marked differences between lines in the metabolism of 14C-substrates, the
      rate of oxygen uptake, carbohydrate accumulation or nucleotide pool sizes. These
      data provide direct evidence that physiologically relevant changes in the level
      of Fru-2,6-P2 can affect pyrophosphate: fructose-6-phosphate 1-phosphotransferase
      (PFP) activity in vivo, and are consistent with PFP operating in a net glycolytic
      direction in the heterotrophic culture. However, the results also show that
      activating PFP has little direct effect on heterotrophic carbohydrate metabolism
      beyond increasing the rate of cycling between hexose phosphates and triose
      phosphates.

PMID- 11216847
TI  - Cytosolic glutamine synthetase and not nitrate reductase from the green alga
      Chlamydomonas reinhardtii is phosphorylated and binds 14-3-3 proteins.
AB  - The nitrate reductase activity from Chlamydomonas reinhardtii was not altered
      when extracts were incubated with yeast 14-3-3 proteins in the presence of Mg
      ATP. However, the C. reinhardtii extracts contained 14-3-3 proteins capable of
      inhibiting the spinach nitrate reductase, raising the question of their
      physiological substrates. Two C. reinhardtii proteins of about 48 and 35 kDa were
      eluted from 14-3-3 affinity chromatography columns and bound to 14-3-3s in
      overlay assays. The 48-kDa protein corresponded to the cytosolic isoform of
      glutamine synthetase (GS1). The GSI was phosphorylated by a Ca2+-and calmodulin
      dependent protein kinase partially purified from the alga. However, neither
      phosphorylation nor 14-3-3 binding seemed to change GS catalytic activity.

PMID- 11216848
TI  - Expression and distribution of a vaculoar aquaporin in young and mature leaf
      tissues of Brassica napus in relation to water fluxes.
AB  - Recently, it has been shown that water fluxes across biological membranes occur
      not only through the lipid bilayer but also through specialized water-conducting
      proteins, the so called aquaporins. In the present study, we investigated in
      young and mature leaves of Brassica napus L. the expression and localization of a
      vacuolar aquaporin homologous to radish gamma-tonoplast intrinsic
      protein/vacuolar-membrane integral protein of 23 kDa (TIP/VM 23). In-situ
      hybridization showed that these tonoplast aquaporins are highly expressed not
      only in developing but also in mature leaves, which export photosynthates. No
      substantial differences could be observed between different tissues of young and
      mature leaves. However, independent of the developmental stage, an
      immunohistochemical approach revealed that the vacuolar membrane of bundle-sheath
      cells contained more protein cross-reacting with antibodies raised against radish
      gamma-TIP/VM 23 than the mesophyll cells. The lowest labeling was detected in
      phloem cells. We compared these results with the distribution of plasma-membrane
      aquaporins cross-reacting with antibodies detecting a domain conserved among
      members of the plasma-membrane intrinsic protein 1 (PIP1) subfamily. We observed
      the same picture as for the vacuolar aquaporins. Furthermore, a high density of
      gold particles labeling proteins of the PIP1 group could be observed in
      plasmalemmasomes of the vascular parenchyma. Our results indicate that gamma
      TIP/VM 23 and PIP1 homologous proteins show a similar expression pattern. Based
      on these results it is tempting to speculate that bundle-sheath cells play an
      important role in facilitating water fluxes between the apoplastic and symplastic
      compartments in close proximity to the vascular tissue.

PMID- 11216849
TI  - Functional characterisation of Nicotiana tabacum xyloglucan endotransglycosylase
      (NtXET-1): generation of transgenic tobacco plants and changes in cell wall
      xyloglucan.
AB  - To study the function of xyloglucan endotransglycosylase (XET) in vivo we
      isolated, a tomato (Lycopersicon esculentum Mill.) XET cDNA (GenBank AA824986)
      from the homologous tobacco (Nicotiana tabacum L.) clone named NtXET-1 (Accession
      no. D86730). The expression pattern revealed highest levels of NtXET-1 mRNA in
      organs highly enriched in vascular tissue. The levels of NtXET-1 mRNA decreased
      in midribs with increasing age of leaves. Increasing leaf age was correlated with
      an increase in the average molecular weight (MW) of xyloglucan (XG) and a
      decrease in the relative growth rates of leaves. Transgenic tobacco plants with
      reduced levels of XET activity were created to further study the biochemical
      consequences of reduced levels of NtXET-1 expression. In two independent lines,
      total XET activity could be reduced by 56% and 37%, respectively, in midribs of
      tobacco plants transformed with an antisense construct. The decreased activity
      led to an increase in the average MW of XG by at least 20%. These two lines of
      evidence argue for NtXET-1 being involved in the incorporation of small XG
      molecules into the cell wall by transglycosylation. Reducing the incorporation of
      small XG molecules will result in a shift towards a higher average MW. The
      observed reduction in NtXET-1 expression and increase in the MW of XG in older
      leaves might be associated with strengthening of cell walls by reduced turnover
      and hydrolysis of XG.

PMID- 11216850
TI  - Cinnamic acid is a precursor of benzoic acids in cell cultures of Hypericum
      androsaemum L. but not in cell cultures of Centaurium erythraea RAFN.
AB  - Benzoic acids are precursors of xanthone biosynthesis which has been studied in
      cell cultures of Hypericum androsaemum (Hypericaceae) and Centaurium erythraea
      (Gentianaceae). In both cell cultures, methyl jasmonate induces the intracellular
      accumulation of a new xanthone. Under these inductive conditions, feeding
      experiments were performed with [U-14C]L-phenylalanine, [7-14C]benzoic acid and
      [7-14C]3-hydroxybenzoic acid. All three precursors were efficiently incorporated
      into the elicited xanthone in H. androsaemum, whereas 3-hydroxybenzoic acid was
      the only precursor to be incorporated into xanthones in C. erythraea. In
      addition, an appreciable increase in phenylalanine ammonia-lyase activity
      occurred only in methyl-jasmonate-treated cell cultures of H. androsaemum.
      Benzoic acids thus appear to be formed by different pathways in the two cell
      cultures studied. In H. androsaemum, benzoic acid is derived from cinnamic acid
      by side-chain degradation. In C. erythraea 3-hydroxybenzoic acid appears to
      originate directly from the shikimate pathway.

PMID- 11216851
TI  - Specificity of the accumulation of mRNAs and proteins of the plasma membrane and
      tonoplast aquaporins in radish organs.
AB  - Plant aquaporins occur in multiple isoforms and are distributed in both plasma
      membrane and tonoplast. We cloned cDNAs for plasma-membrane aquaporins (PAQ1, 1b,
      1c, 2, 2b, and 2c) of radish (Raphanus sativus L.). The amino acid sequences of
      the PAQs showed on average 63% sequence identity. Their sequences were 23%
      identical to those of tonoplast aquaporins (gamma- and delta-VM23). A
      comprehensive investigation of the aquaporin mRNAs, including VM23, in seedlings,
      plants, flowers and seeds of radish showed a marked accumulation of all the mRNAs
      in hypocotyls and growing taproots. In other organs, the mRNA level of each
      isoform varied according to the organ. In petals, stamens, pistils and sepals of
      flowers, the levels of PAQ1, 1b, 1c and gamma-VM23 mRNAs were high, and mRNAs of
      all aquaporins except for delta-VM23 were detected at high levels in pericarps.
      The protein levels of aquaporins on the basis of the membrane protein were
      determined by immunoblotting. Proteins PAQ1 and VM23 were detected in every organ
      except for the mature petiole. The PAQ2 protein level was especially high in
      green cotyledons and leaves, but was extremely low in seedling cotyledons and
      hypocotyls. Proteins PAQ1, PAQ2 and VM23 were highly accumulated in growing
      pericarps, but not in the immature seeds. These results indicate that the gene
      expression of the aquaporin isoforms was individually regulated in an organ- and
      tissue-specific manner, and that the amounts of aquaporin protein, especially
      PAQ2, are regulated in certain tissues at the translational level and by the rate
      of protein turnover.

PMID- 11216852
TI  - A short-term exposure of cucumber plants to rising atmospheric CO2 increases leaf
      carbohydrate content and enhances nitrate reductase expression and activity.
AB  - Nitrate reductase (NR; EC 1.6.6.1) is the first enzyme of the nitrate
      assimilatory pathway and is regulated transcriptionally and post-translationally
      by several metabolic and environmental signals. To investigate whether NR is
      controlled by the rate of photosynthetic CO2 assimilation in cucumber (Cucumis
      sastivus L.), intact plants were exposed, after the dark period, to light under
      different atmospheric CO2 concentrations (100, 400 and 2,000 microL x L(-1)) for
      2 h. The in-vivo rates of net CO2 assimilation correlated with atmospheric CO2
      concentrations. The CO2-fixation rate under 2,000 microL x L(-1) CO2 was 2.4- and
      5.4-fold higher than under 400 and 100 microL x L(-1), respectively. Stomatal
      conductances and transpiration rates were almost identical after the 2-h light
      period under the various CO2 concentrations tested. Increasing atmospheric CO2
      concentrations caused concomitant increases in the contents of starch and soluble
      sugars in the leaves and a decrease in the nitrate content. The activity and
      activation state of NR were both higher under elevated CO2 than under low CO2.
      High CO2 also enhanced NR-gene expression in the leaves. Sugars were supplied via
      roots to intact carbohydrate-starved plants and NR mRNA levels were analysed
      after 7 h. Fructose markedly stimulated NR-gene transcription in both leaves and
      roots. It is concluded that, in cucumber plants, the rate of CO2 assimilation
      controls the rate of nitrate assimilation by modulation of NR expression and
      activity, and that sugars are presumably involved as regulatory metabolites.

PMID- 11216853
TI  - Regulation of inducible adhesion molecule expression in human endothelial cells
      by grape seed proanthocyanidin extract.
AB  - Altered expression of cell adhesion molecule expression has been implicated in a
      variety of chronic inflammatory conditions. Regulation of adhesion molecule
      expression by specific redox sensitive mechanisms has been reported. Grape seed
      proanthocyanidins have been reported to have potent antioxidant properties. We
      evaluated the effects of grape seed proanthocyanidin extract (GSPE) on the
      expression of TNFalpha-induced ICAM-1 and VCAM-1 expression in primary human
      umbilical vein endothelial cells (HUVEC). GSPE at low concentrations (1-5
      micrograms/ml), down-regulated TNFalpha-induced VCAM-1 expression but not ICAM-1
      expression in HUVEC. Such regulation of inducible VCAM-1 by GSPE was also
      observed at the mRNA expression level. A cell-cell co-culture assay was performed
      to verify whether the inhibitory effect of GSPE on the expression of VCAM-1 was
      also effective in down-regulating actual endothelial cell/leukocyte interaction.
      GSPE treatment significantly decreased TNFalpha-induced adherence of T-cells to
      HUVEC. Although several studies have postulated NF-kappaB as the molecular site
      where redox active substances act to regulate agonist-induced ICAM-1 and VCAM-1
      gene expression, inhibition of inducible VCAM-1 gene expression by GSPE was not
      through a NF-kappaB-dependent pathway as detected by a NF-kappaB reporter assay.
      The potent inhibitory effect of low concentrations of GSPE on agonist-induced
      VCAM-1 expression suggests therapeutic potential of this extract in inflammatory
      conditions and other pathologies involving altered expression of VCAM- 1.

PMID- 11216854
TI  - Induction of P-glycoprotein mRNA transcripts by cycloheximide in animal tissues:
      evidence that class I Pgp is transcriptionally regulated whereas class II Pgp is
      post-transcriptionally regulated.
AB  - P-glycoprotein (Pgp) are a small family of plasma membrane proteins capable of
      transporting substrates across cell membranes. Class I and class II Pgp are able
      to transport drugs and have been shown to mediate multidrug resistance (MDR).
      Class III Pgp is a long chain phospholipid transporter and does not mediate MDR.
      The expression and regulation of Pgp genes in animal tissues are not well
      understood. In this study, the protein synthesis inhibitor cycloheximide was used
      as a tool to understand Pgp gene expression and regulation in animal tissues. The
      sensitive RNase protection assay was used to detect changes in Pgp mRNA levels
      and nuclear run-on assay was used to determine whether transcription or post
      transcription is important. The results showed that cycloheximide significantly
      induced class II Pgp expression in all tissues examined. This was predominantly
      through post-transcriptional effect. In contrast, the relatively modest increase
      in class I Pgp expression by cycloheximide was found to be mainly due to
      increased transcriptional activity. On the other hand, cycloheximide induced
      class III Pgp expression in some tissues while caused decay of class III Pgp mRNA
      in other tissues. The transcriptional and post-transcriptional mechanisms exerted
      by cycloheximide on Pgp genes are discussed. These findings have implications for
      our understanding of gene regulation in animal tissues and MDR reversal
      strategies in vivo.

PMID- 11216855
TI  - Effects of sustained low-flow ischemia and reperfusion on Ca2+ transients and
      contractility in perfused rat hearts.
AB  - We investigated changes in cytoplasmic Ca2+ concentration ([Ca2+]i) and in left
      ventricular contractility during sustained ischemia and reperfusion in isolated
      beating rat hearts. Hearts from male Sprague-Dawley rats were perfused
      retrogradely and were loaded with 4 microM fura-2. Low-flow global ischemia was
      induced by reducing perfusion flow to 10% and by electric pacing. The hearts were
      exposed to ischemia for 10 min or 30 min and then reperfused. [Ca2+]i was
      measured by monitoring the ratio of 500 nm fluorescence excited at 340 and 380 nm
      while simultaneously measuring left ventricular pressure (LVP). To determine
      diastolic [Ca2+]i, background autofluorescence was subtracted. LVP rapidly
      decreased from 82.3+/-8.2 to 17.1+/-2.9 mmHg , whereas the amplitude of the Ca2+
      transient did not change significantly during the first 1 min of ischemia. After
      10 min of ischemia, the amplitude decreased to 60.8+/-10.6% (p < 0.05) and
      diastolic [Ca2+]i increased by 26.3+/-2.9% (p < 0.001) compared with the pre
      ischemic value (n = 8). When the hearts were reperfused after 10 min of ischemia,
      the amplitude of the Ca2+ transient and LVP recovered to 79.0+/-7.2% and 73.2+/
      7.5 mmHg, respectively. Whereas diastolic [Ca2+]i decreased to the preischemic
      value. In the hearts exposed to 30 min of ischemia (n = 10), diastolic [Ca2+]i
      increased even further by 32.7+/-5.3% at the end of ischemia and continued
      increasing during the 10 min of reperfusion by 42.6+/-15.6%. Six of 10 hearts
      developed ventricular fibrillation (VF) and intracellular Ca2+ overload after
      reperfusion. Recovery of LVP after reperfusion was significantly smaller in the
      hearts exposed to 30 min of ischemia than in the hearts exposed to 10 min of
      ischemia (58.9+/-11.7 vs. 97.2+/-3.0% of pre-ischemic value, p < 0.05). Diastolic
      [Ca2+]i also increased under hypoxic conditions (N2 bubbling) in this model.
      These results suggest that increases in diastolic [Ca2+]i might play an important
      role in myocardial contractile dysfunction and viability in ischemia-reperfusion
      injury.

PMID- 11216857
TI  - Mitochondrial ATP dependent potassium channels mediate non-ischemic
      preconditioning by tachycardia in dogs.
AB  - Brief episodes of tachycardia without myocardial ischemia prior to a coronary
      occlusion decrease myocardial infarct size in dogs. This non-ischemic
      preconditioning is mediated by adenosine. Because ischemic preconditioning is
      mediated through ATP dependent potassium channels, particularly the mitochondrial
      ones, we studied whether non-ischemic preconditioning is also mediated through
      these channels. In anesthetized dogs heart rate was kept constant at 120
      cycles/min and aortic pressure changes were damped. Myocardial infarction was
      induced by occlusion of the anterior descending coronary artery for 60 min and
      reperfusion for 270 min. In a control group the infarct size (necrotic
      volume/risk region volume x 100) was 15.8+/-1.5%. Preconditioning with five
      periods of tachycardia, 5 min in duration each at 213 cycles/min with intervening
      periods of 5 min of basal heart rate at 120 cycles/min, reduced the infarct size
      by 45.6% (p < 0.05) with respect to the control group. This effect was completely
      reverted by the blockade of ATP dependent potassium channels with glibenclamide
      or 5 hydroxydecanoate (a specific blocker of mitochondrial ATP dependent
      potassium channels) prior to preconditioning. These effects were not due to
      differences in collateral flow, risk region size or hemodynamic variables between
      the groups. These results show that mitochondrial ATP dependent potassium
      channels mediate non-ischemic preconditioning by tachycardia in dogs.

PMID- 11216856
TI  - Homocysteine stimulates the expression of monocyte chemoattractant protein-1 in
      endothelial cells leading to enhanced monocyte chemotaxis.
AB  - Hyperhomocysteinemia has been identified as an independent risk factor for
      atherosclerosis. The infiltration of monocytes into the arterial wall is one of
      the key events during atherogenesis. Monocyte chemoattractant protein-1 (MCP-1)
      is a potent chemokine that stimulates the migration of monocytes into the intima
      of the arterial wall. The mechanism by which increased monocyte infiltration
      occurs in atherosclerotic lesions in patients with hyperhomocysteinemia has not
      been delineated. The objective of the present study was to investigate the effect
      of homocysteine on MCP-1 production in endothelial cells. Cells were incubated
      with homocysteine. The secretion of MCP-1 protein was significantly increased
      (195% as compared to the control) in cells treated with pathological
      concentrations of homocysteine. Such effect was accompanied by an increased
      expression of MCP-1 mRNA (176% as compared to the control) in endothelial cells
      which resulted in enhanced monocyte chemotaxis. The p38 MAP kinase as well as
      other members of the p38 MAP kinase pathway, including MKK3, MKK6, ATF-2 and Elk
      1, were activated in homocysteine-treated cells. Homocysteine-induced MCP-1
      expression and subsequent monocyte chemotaxis were blocked by a p38 MAP kinase
      inhibitor (SB203580) suggesting that the p38 MAP kinase pathway might be involved
      in homocysteine-induced MCP-1 expression in endothelial cells. In contrast,
      staurosporine, a protein kinase C inhibitor, had no effect on homocysteine
      induced MCP-1 expression. In conclusion, our results indicate that homocysteine
      stimulates MCP-1 expression in endothelial cells leading to enhanced monocyte
      chemotaxis.

PMID- 11216858
TI  - Cardiac chamber-specific alterations of ANP and BNP expression with advancing age
      and with systemic hypertension.
AB  - The present study determined cardiac chamber-specific alterations of the
      expression of the atrial and brain natriuretic peptide (ANP and BNP) genes with a
      small increase in age beyond adulthood and with systemic hypertension of
      intermediate duration. The expression distributions of these genes was determined
      using in situ hybridization in the right and left atria (RA and LA), and the
      right and left ventricles (RV and LV) in Wistar Kyoto rats (WKY) and age-matched
      Spontaneously Hypertensive rats (SHR) at ages 6 months (adult) and 8 months
      (advanced-age beyond adulthood). In all rat groups, both genes were expressed
      (ANP > BNP) in the LA and LV, and were not expressed in the RA and RV. The genes
      were expressed in the LA in all rat groups; the ANP, but not the BNP, expression
      increased with advancing age and with superimposed hypertension. They were
      expressed in the LV of the advanced-age WKY, adult and advanced-age SHR, but not
      in the adult WKY. The ANP mRNA labeling in the LA was diffuse and interspersed
      with dense accumulations, whereas BNP labeling was diffuse. The labeling of both
      genes in the form of sparse clusters was seen in the LV of the advanced-age SHR.
      Our study showed that ANP and BNP expression in left heart chambers increased
      with a small increase in age, with hypertension of intermediate duration, and
      with modest left ventricular hypertrophy. The chamber-specific expression
      distribution could be due to special groups of cardiac cells, or to local chamber
      specific factors.

PMID- 11216859
TI  - Receptor-Ck regulates membrane-bound 125 kDa protein having affinity for genomic
      sterol regulatory sequence.
AB  - The study addressed, to resolve the role of Receptor-Ck activation in the
      proteolytic maturation of 125 kDa (membrane bound) sterol regulatory element
      binding protein (SREBP), revealed that Receptor-Ck dependent signalling is not
      only responsible for the proteoloytic cleavage of this 125 kDa SREBP resulting in
      the generation of an active 47 kDa factor but also Receptor-Ck protein has high
      binding affinity for both 125 kDa SREBP as well as its cleaved 47 kDa product.
      Based upon these coupled with our earlier findings, we propose that Receptor-Ck
      may be regulating genes, have sterol regulatory element (SRE) in their promoter
      region, through the proteolytic maturation of 125 kDa SREBP into an active 47 kDa
      transcription factor.

PMID- 11216860
TI  - Expression of thrombospondin-1 in human hepatocarcinoma cell lines and its
      regulation by transcription factor Jun/AP-1.
AB  - Thrombospondin-1 (TSP-1) is a homotrimeric glycoprotein synthesized in a variety
      of normal and transformed cells, and secreted into the extracellular matrix.
      Based on its known effects on the tumor and endothelial cells, TSP-1 was
      implicated in the tumor growth and metastasis. In the present study, we have
      demonstrated the expression of TSP-1 in the human hepatocarcinoma cell lines. TSP
      1 was detected in human hepatocarcinoma SK-HEP-1, Hep 3B and immortalized human
      liver Chang cells. Using two different cell lines, SK-HEP-1 and Hep 3B cells, we
      have studied effects of phorbol 12-myristate 13-acetate (PMA) on TSP-1
      expression. TSP-1 synthesis was stimulated by PMA in both cell lines. When the
      cells were treated with PMA, the TSP-1 mRNA started to increase at 30 min and
      reached the maximal level at 6 h. TSP-1 induction by PMA was completely inhibited
      by the pre-treatment of 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), a
      potent protein kinase C inhibitor. A TSP-1 promoter-luciferase reporter gene was
      transcriptionally activated by PMA, as well as by the expression of c-Jun. Among
      three putative AP-1 recognition sites on the TSP-1 promoter, a deletion of the
      1st and 2nd sites caused loss of PMA-induced upregulation, while the 3rd site
      deletion showed no effect. In subsequent experiments, both the recombinant c-Jun
      and nuclear proteins induced by PMA have a stronger binding affinity for the 2nd
      AP-1 recognition site than the 1st and 3rd ones. Our study demonstrated that TSP
      1 could be expressed and secreted by human hepatoma cell lines and its expression
      could be effectively regulated by PMA. We also suggest that AP-1 binding activity
      through the protein kinase C activation is a critical event for the TSP-1 gene
      expression and consequently affects production and processing of the protein.

PMID- 11216861
TI  - Cardiac myosin phenotype remodeling following chronic spinal transection.
AB  - Spinal transection results in profound neural and functional changes of the
      heart. However, phenotypic alterations in cardiac myosin heavy chains (MyHC) as a
      result of spinal transection have not been explored. Hearts were removed from 180
      day old rats who had their spinal cords transected between T6 and T9 (ST; n = 10)
      and intact controls (IN; n = 9). Myosin was isolated from the left and right
      ventricles and separated into its respective heavy chain components (designated
      as alpha and beta) by SDS-PAGE. The resulting gels were scanned with a laser
      scanning densitometer to obtain relative concentrations of these two heavy
      chains. The left ventricles of the ST rats had a significantly higher (p < 0.05)
      alpha to beta ratio (10.89) than the intact controls (4.20), while the right
      ventricle of the ST rats had a significantly lower (p < 0.05) alpha to beta ratio
      (7.49) relative to intact controls (13.62). The left and right ventricular weight
      to body weight ratios were not different in ST compared to IN. Additionally,
      there were significant within group differences (p < 0.05) between the alpha and
      beta MyHC ratios for the left and right ventricles. These data suggest that 1)
      spinal transection causes remodeling of the right and left ventricles and 2) the
      two ventricles do not remodel as a unit.

PMID- 11216862
TI  - Intramitochondrial pyruvate attenuates hydrogen peroxide-induced apoptosis in
      bovine pulmonary artery endothelium.
AB  - In the hydrogen peroxide (H2O2) apoptosis model of the murine thymocyte, redox
      reactant and antioxidant pyruvate prevents programmed cell death. We tested the
      hypothesis that such protection was mediated, at least in part, via pyruvate
      handling by mitochondrial metabolism. Cultured bovine pulmonary artery
      endothelial cells were incubated for 30 min with 0.5 mM H2O2 in the absence and
      presence of 0.5 mM alpha-cyano-3-hydroxycinnamate, as a selective inhibitor of
      the mitochondrial pyruvate transporter. In controls H2O2 decreased cell viability
      by 30% within 24 h; this was associated with apoptosis-like bodies, nuclear
      condensation, and biochemical DNA damage consistent with programmed cell death.
      Pyruvate (0.1-20 mM) enhanced cell viability in a dose-dependent manner, with >
      or = 85% viable cells at > or = 3 mM and no DNA laddering, no positive nick-end
      labeling (TUNEL), and no detectable Annexin V or propidium iodide staining. In
      contrast, using > or = 5 mM L-lactate as a cytosolic reductant or acetate as a
      redox-neutral substrate, cell death increased to approximately 40%, which was
      associated with intense DNA laddering, positive TUNEL and Hoechst 33258 assays.
      Alpha-cyano-3-hydroxycinnamate alone did not significantly decrease endothelial
      viability but reduced viability from 85+/-3 to 71+/-4% (p = 0.023) in presence of
      3 mM pyruvate plus H2O2; pathological cell morphology and DNA laddering under the
      same conditions suggested loss of pyruvate protection against apoptosis. Since
      alpha-cyano-3-hydroxycinnamate re-distributed medium pyruvate and L-lactate
      consistent with selective blockade of pyruvate uptake into the mitochondria, the
      findings support the hypothesis that pyruvate protection against H2O2 apoptosis
      is mediated in part via the mitochondrial matrix compartment. Possible mediators
      include anti-apoptotic bcl-2 and/or products of mitochondrial pyruvate metabolism
      such as citrate that affect metabolic regulation and anti-oxidant status in the
      cytoplasm.

PMID- 11216863
TI  - Selective impairment of protein kinase C isotypes in murine macrophage by
      Leishmania donovani.
AB  - Leishmania donovani, an obligate intracellular parasite resides and multiplies
      within macrophage of the reticuloendothelial system. The intracellular signalling
      mechanism involved in the impaired oxidative response in leishmaniasis has not
      yet been clearly established. Generation of superoxide anion (O2-) is supposed to
      be the first line of host defence during microbial invasion. We found a
      substantial inhibition of superoxide anion generation in parasitized macrophages,
      which was just the reverse in case of macrophages challenged with
      Lipophosphoglycan (LPG) deficient attenuated leishmanial parasite UR-6. The
      generation of O2- essentially needs the prior activation of protein kinase C
      (PKC) mediated phosphorylation events. Our study proposed that phosphorylation of
      67, 54, 47 and 36 kDa proteins was attenuated during infection. This was
      supported by PKC activity study, where Ca-dependent PKC activity was inhibited
      but, Ca-independent PKC activity was enhanced. This result was further confirmed
      by using isotype specific pseudosubstrate inhibitors of Ca-dependent PKC beta and
      Ca-independent PKC zeta. Application of beta-pseudosubstrate could not alter the
      Ca-dependent PKC activity but zeta-pseudosubstrate inhibited the Ca-independent
      PKC activity in infected macrophages. Our immunoblot analysis with specific
      antibody against PKC beta and PKC zeta isotypes showed down regulation of PKC
      beta-II expression with concomitant induction of PKC zeta. Such inhibition of Ca
      dependent PKC beta was reversed in macrophages treated with UR-6. Taken together,
      our observations revealed that infection with L. donovani selectively attenuates
      both the expression and activity of Ca-dependent PKC beta.

PMID- 11216865
TI  - Hypothalamic GABA receptor functional regulation and liver cell proliferation.
AB  - GABAergic alterations in hypothalamus during compensatory hyperplasia after
      partial hepatectomy (PH), lead nitrate (LN) induced direct hyperplasia and N
      nitrosodiethylamine (NDEA) induced neoplasia in liver were investigated. Serum
      GABA levels were increased in all 3 experimental groups compared with the
      control. GABA content decreased in hypothalamus of PH and NDEA treated rats,
      while it increased in LN treated rats. GABA(A) receptor number and affinity in
      hypothalamic membrane preparations of rats showed a significant decrease in PH
      and NDEA treated rats, while in LN treated rats the affinity increased without
      any change in the receptor number. The GABA(B) receptor number increased in PH
      and NDEA treated rats, while it decreased in LN treated rats. The affinity of the
      receptor also increased in NDEA treated rats. Plasma NE levels showed significant
      increase in PH and NDEA rats compared with the control while it decreased in LN
      treated rats. The results of the present study suggests that liver cell
      proliferation is influencing the hypothalamic GABAergic neurotransmission and
      these changes regulate the hepatic proliferation through the sympathetic
      stimulation.

PMID- 11216864
TI  - Short-term gemfibrozil treatment reverses lipid profile and peroxidation but does
      not alter blood glucose and tissue antioxidant enzymes in chronically diabetic
      rats.
AB  - In this study, we investigated the efficiency of short-term treatment with
      gemfibrozil in the reversal of diabetes-induced changes on carbohydrate and lipid
      metabolism, and antioxidant status of aorta. Diabetes was induced by a single
      injection of streptozotocin (45 mg/kg, i.p.). After 12 weeks of induction of
      diabetes, the control and diabetic rats were orally gavaged daily with a dosing
      vehicle alone or with 100 mg/kg of gemfibrozil for 2 weeks. At 14 weeks, there
      was a significant increase in blood glucose, plasma cholesterol and triglyceride
      levels of untreated-diabetic animals. Diabetes was associated with a significant
      increase in thiobarbituric acid reactive substances (TBARS) in both plasma and
      aortic homogenates, indicating increased lipid peroxidation. Diabetes caused an
      increase in vascular antioxidant enzyme activity, catalase, indicating existence
      of excess hydrogen peroxide (H2O2). However, superoxide dismutase (SOD) and
      glutathione peroxidase (GSHPx) activities in aortas did not significantly change
      in untreated-diabetic rats. In diabetic plus gemfibrozil group both plasma lipids
      and lipid peroxides showed a significant recovery. Gemfibrozil treatment had no
      effect on blood glucose, plasma insulin and vessel antioxidant enzyme activity of
      diabetic animals. Our findings suggest that the beneficial effect of short-term
      gemfibrozil treatment in reducing lipid peroxidation in diabetic animals does not
      depend on a change of glucose metabolism and antioxidant status of aorta, but
      this may be attributed to its decreasing effect on circulating lipids. The
      ability of short-term gemfibrozil treatment to recovery of metabolism and
      peroxidation of lipids may be an effective strategy to minimize increased
      oxidative stress in diabetic plasma and vasculature.

PMID- 11216867
TI  - Radiomodification of glyoxalase I in the liver and spleen of mice: adaptive
      response and split-dose effect.
AB  - Glyoxalase system, particularly glyoxalase I (Gly I) plays an important role in
      regulation of cell division and is considered to be a metabolic indicator of cell
      proliferation. The glyoxalase system is likely to have a close link with cellular
      radiosensitivity. Therefore, we have examined the effect of adaptive and split
      dose of y-rays on the activity of Gly I in the liver and spleen of mice. For the
      adaptive response studies, mice pre-treated with a conditioning dose of 0.5 Gy
      were given a challenging dose of 4 Gy at varying time intervals. In the split
      dose studies, a dose of 4 Gy was delivered into two equal fractions and spaced at
      different time intervals. The results show that pre-exposure to a conditioning
      dose or the fractionation of total dose decreased the specific activity of Gly I
      in the liver and spleen of mice. The decreased activity of Gly I was suggestive
      of protective action induced by the conditioning dose and fractionation of dose.
      The similar pattern of radiation response of Gly I probably supported the
      possibility of involvement of a common pathway in the radiation-induced adaptive
      and split-dose effect. From these observations a close link between the Gly I and
      the adaptive-response as well as the split-dose effect is speculated. Since, the
      glyoxalase system is vital for a variety of biological functions including cell
      division and repair, the present findings may have relevance in understanding the
      dose-fractionation as well as the biological defence induced by low doses of
      radiations.

PMID- 11216868
TI  - Brain plasma membrane Na+,K+-ATPase is inhibited by acetylated tubulin.
AB  - Membranes from brain tissue contain tubulin that can be isolated as a hydrophobic
      compound by partitioning into Triton X-114. The hydrophobic behavior of this
      tubulin is due to the formation of a complex with the alpha-subunit of Na+,K+
      ATPase. In the present work we show that the interaction of tubulin with Na+K+
      ATPase inhibits the enzyme activity. We found that the magnitude of the
      inhibition is correlated with: (1) concentration of the acetylated tubulin
      isoform present in the tubulin preparation used, and (2) amount of acetylated
      tubulin isoform isolated as a hydrophobic compound. In addition, some compounds
      involved in the catalytic action of Na+K+-ATPase were assayed to determine their
      effects on the inhibitory capability of tubulin on this enzyme. The inhibitory
      effect of tubulin was only slightly decreased by ATP at relatively low nucleotide
      concentration (0.06 mM). NaCl (1-160 mM) and KCl (0.2-10 mM) showed no effect
      whereas inorganic phosphate abolished the inhibitory effect of tubulin in a
      concentration-dependent manner.

PMID- 11216866
TI  - Bezafibrate induces acyl-CoA oxidase mRNA levels and fatty acid peroxisomal beta
      oxidation in rat white adipose tissue.
AB  - Rats treated with bezafibrate, a PPAR activator, gain less body weight and
      increase daily food intake. Previously, we have related these changes to a shift
      of thermogenesis from brown adipose tissue to white adipose tissue attributable
      to bezafibrate, which induces uncoupling proteins (UCP), UCP-1 and UCP-3, in rat
      white adipocytes. Nevertheless, UCP induction was weak, implying additional
      mechanisms in the change of energy homeostasis produced by bezafibrate. Here we
      show that bezafibrate, in addition to inducing UCPs, modifies energy homeostasis
      by directly inducing aco gene expression and peroxisomal fatty acid beta
      oxidation in white adipose tissue. Further, bezafibrate significantly reduced
      plasma triglyceride and leptin concentrations, without modifying the levels of
      PPARgamma or ob gene in white adipose tissue. These results indicate that
      bezafibrate reduces the amount of fatty acids available for triglyceride
      synthesis in white adipose tissue.

PMID- 11216870
TI  - L-asparaginase of Thermus thermophilus: purification, properties and
      identification of essential amino acids for its catalytic activity.
AB  - L-asparaginase EC 3.5.1.1 was purified to homogeneity from Thermus thermophilus.
      The apparent molecular mass of L-asparaginase by SDS-PAGE was found to be 33 kDa,
      whereas by its mobility on Sephacryl S-300 superfine column was around 200 kDa,
      indicating that the enzyme at the native stage acts as hexamer. The purified
      enzyme showed a single band on acrylamide gel electrophoresis with pI = 6.0. The
      optimum pH was 9.2 and the Km for L-asparagine was 2.8 mM. It is a thermostable
      enzyme and it follows linear kinetics even at 77 degrees C. Chemical modification
      experiments implied the existence ofhistidyl, arginyl and a carboxylic residues
      located at or near active site while serine and mainly cysteine seems to be
      necessary for active form.

PMID- 11216869
TI  - Post-transcriptional control of catalase expression in garlic-treated rats.
AB  - Regulation of catalase (CAT) expression, a major antioxidant enzyme that
      detoxifies H2O2, is very complex. Garlic is effective to prevent or ameliorate
      oxidative stress probably through its intrinsic antioxidant properties and/or to
      its ability to modify antioxidant enzyme expression. In this paper we studied the
      effect of a 2% garlic diet on the renal and hepatic CAT expression (mRNA levels,
      and enzyme activity, content, synthesis, and degradation). The study was made 2
      weeks after feeding rats with a 2% garlic diet. CAT activity and content were
      measured by a spectrophotometric method and Western blot, respectively. CAT mRNA
      levels and CAT synthesis (k(s)) and degradation (kD) in vivo were measured by
      Northern blot and kinetic of reappearance of CAT activity after aminotriazole
      injection, respectively. Garlic-treatment decreased CAT activity and content, and
      CAT mRNA levels were unchanged in both tissues. k(s) decreased and kD remained
      unchanged in kidney and liver. The decrease in k(s) without changes in kD and CAT
      mRNA levels could explain the low CAT expression in garlic-fed rats. In vivo H2O2
      generation in kidney and liver was markedly decreased in garlic-fed rats which
      could be due to a direct antioxidant effect of garlic. This may be the initial
      event in the garlic-fed rats that leads to the decreased CAT expression. Our data
      strongly suggest that the diminished renal and hepatic CAT expression in garlic
      fed rats is mediated by post-transcriptional changes (mainly low translational
      efficiency) which could be an adaptation to the low H2O2.

PMID- 11216871
TI  - Influence of breast-feeding on the production of cytokines.
AB  - PROBLEM: Recently, we reported increases in the production of interferon-gamma
      (IFN-gamma), interleukin-2 (IL-2), and IL-4 during the postpartum period. The
      present study was undertaken to investigate whether these increases might be
      explained by increased prolactin while breast-feeding. METHOD: Whole blood from
      41 women who were breast-feeding, 13 women not breast-feeding, and 31 healthy non
      pregnant women was stimulated with phorbol 12-myristate 13-acetate and ionomycin,
      and the levels of cytokines in the supernatant were measured by enzyme-linked
      immunosorbent assay. Their serum levels of prolactin were measured by enzyme
      immunoassay. RESULTS: Increases in IFN-gamma, IL-2, IL-4, and IL-10 production
      were observed in women who were breast-feeding but not in women who were not
      breast-feeding. Serum levels of prolactin correlated with the levels of IFN-gamma
      in culture supernatant. CONCLUSIONS: These results suggest that breast-feeding
      induces production of cytokines and that IFN-gamma production is enhanced by
      physiological concentrations of prolactin.

PMID- 11216872
TI  - HLA-G expression by tumors.
AB  - PROBLEM: It has been proposed that the expression of the non-classical MHC class
      I antigen, HLA-G, by trophoblast is one mechanism by which the placenta evades
      attack by maternal uterine NK cells. A similar mechanism is thought to be
      operative in the escape from immunosurveillance by tumor cells. However, data on
      the expression of HLA-G by tumor cells are highly conflicting. METHOD OF STUDY:
      In the present study, we have examined tissue sections from a wide variety of
      tumors by immunohistology and also several cell lines by flow cytometry and RT
      PCR. Whilst very faint bands were detected in three cell lines (hepG2, Mead,
      CaSki) by RT-PCR, no tumors or cell lines were observed to express HLA-G protein.
      Furthermore, we found that tumor deposits are not usually infiltrated by NK
      cells. CONCLUSION: Our observations, therefore, do not support the proposal that
      tumor cells express HLA-G in order to evade host NK cell cytolysis.

PMID- 11216874
TI  - Immunologic detection of placental lactogen during pregnancy in a mouse model: a
      preliminary report.
AB  - PROBLEM: To establish a rapid test differentiating ectopic from failed
      intrauterine gestation, using placental lactogen (PL) as a marker for placental
      cells. METHOD OF STUDY: Sixteen Swiss Webster mice had synchronized ovulation and
      were mated. Eight mice were unmated controls. Study and control mice were
      sacrificed at 5, 7, 9. and 11 days gestation. Uterine sections were tested for PL
      by immunofluorescent antibody assay, enzyme-linked immunosorbent assay, and dot
      blot analysis. Human endometrial samples from a missed abortion and a nonpregnant
      woman were also tested. RESULTS: Placental lactogen was detectable only in
      pregnant uterine samples (placental cells only) by all assays and was absent in
      the endometial glandular cells of nonpregnant uterine samples. CONCLUSION: Three
      methods detected placental lactogen in the pregnant mouse and human tissue. This
      is the first step towards developing a reliable clinical test for human
      endometrial samples from early pregnancy to differentiate early abortion from
      ectopic pregnancy.

PMID- 11216873
TI  - FAS/FAS ligand interaction at the placental interface is not required for the
      success of allogeneic pregnancy in anti-paternal MHC preimmunized mice.
AB  - PROBLEM: FAS ligand (FASL) induces apoptosis in FAS+ T cells. FAS-FASL
      interaction can explain tolerance of some types of allografts. Do similar
      interactions prevent rejection of the fetal allograft and transplacental passage
      of maternal T cells capable of causing GvH leading to runting? METHOD OF STUDY:
      We examined growth of subcutaneous EL-4 (H-2b) tumor cells in syngeneic
      MRL.lpr/lpr mice mated with syngeneic MRL.lpr/lpr or allogeneic C57/B1/6.lpr/lpr
      males. Lpr/lpr mice lack FAS and their T cells should remain effective at the
      fetomaternal interface. In some studies, the mice were preimmunized against
      C57B1/6 to enhance the likelihood of fetal rejection and/or runting. Cytotoxic
      lymphocyte (CTL) activity in the spleens was assessed using a 51Cr-release assay.
      Birth weights and weights at weaning were measured. RESULTS: Tumor rejection was
      delayed by about 3 days in allopregnant lpr/lpr females compared to syngeneic
      pregnant females occurred, but tumors were rejected and in a secondary fashion
      with minimal delay allopregnant females preimmunized to H-2b. CTL activity was
      present more in decidua than in spleen in preimmunized mice, and allopregnancy
      failed to reduce this activity. No neonates born to preimmunized or control
      lpr/lpr mothers developed runt disease. Indeed, the birth weight was greater for
      immunized females, but at 10 weeks, the difference compared to non-immunized
      females disappeared. CONCLUSIONS: FAS/FASL interaction between FAS+ T cells and
      FASL+ fetal trophoblasts at the fetomaternal interface is not mandatory for
      successful allopregnancy. The potential roles of other apoptosis-induction
      mechanisms at the fetomaternal interface, such as TNF/TRAIL, require critical
      testing before enthusiasm is merited. It maybe necessary to eliminate all such
      mechanisms to show a deleterious effect on pregnancy. Spontaneous deletion of all
      pathways seems a priori unlikely to occur, and hence, of dubious relevance to
      fetal loss.

PMID- 11216875
TI  - Localization and distribution of platelet activating factor receptors in the
      mouse ovary and oviduct during the estrous cycle and early pregnancy.
AB  - PROBLEM: This study determined platelet activating factor (PAF) binding to
      ovaries and oviduct tissues to identify the location of PAF tissue interaction.
      METHOD: Mouse ovaries and oviducts taken during the estrous cycle and days 1, 4
      and 7 post-conception (pc) were analyzed by [3H]PAF binding using frozen sections
      and autoradiography. RESULTS: For the outer epithelium of estrous and metestrous
      ovaries there was no significant difference in PAF binding (P>0.05); however,
      both stages were significantly different from proestrous (P<0.001). Ovarian
      stroma PAF binding was significantly higher (P<0.001) at estrous than metestrous,
      with no PAF binding at proestrous. Binding of PAF to estrous ovarian follicles
      was significantly greater (P<0.001) than at proestrous and metestrous. Estrous
      oviduct binding of PAF was significantly increased for stroma, inner epithelium
      and lumen (P<0.001 in all cases). At days 1 and 7 pc, all ovarian tissues had the
      greatest PAF binding with day 4 pc failing to bind PAF except for a significant
      decrease in corpora luteal binding (P<0.001). Oviduct binding of PAF was greatest
      at day 1 pc. CONCLUSION: Ovarian and oviduct PAF receptor expression corresponds
      to peak embryo PAF synthesis and establishes the basis for PAF PAF receptor
      mediated early pregnancy signaling system.

PMID- 11216876
TI  - Hypercoagulable thrombophilic defects and hyperhomocysteinemia in patients with
      recurrent pregnancy loss.
AB  - PROBLEM: Placental perfusion may be compromised by increased thrombosis that
      leads to pregnancy complications and recurrent pregnancy loss (RPL). Since
      heritable thrombophilic defects and hyperhomocysteinemia are associated with
      increased thrombosis, their prevalence was evaluated in RPL patients with special
      emphasis on combinations of the above pathologies. METHODS OF STUDY: Evaluation
      of the prevalence of heritable thrombophilic defects (protein S, protein C, anti
      thrombin III deficiency, and the mutations for factor V Leiden,
      methylenetetrahydrofolate reductase [MTHFR], and prothrombin gene),
      hyperhomocysteinemia. and combinations of these pathologies in 36 non-pregnant
      recurrent aborters compared with 40 parous women. RESULTS: We found a relatively
      high prevalence of deficiencies of plasma coagulation proteins in RPL patients
      compared with the controls. A non-significant different increase in factor V
      Leiden mutation was detected (6/36 [16%] compared with 2/40 [5%] in the control
      group, P = 0.14]. Hyperhomocysteinemia was found in 31% of the RPL patients.
      MTHFR mutation homozygosity was found in 6/36 (16%) of the aborting patients.
      Combinations of hyperhomocysteinemia and MTHFR mutation were found in three
      patients, with folate deficiency in two patients, and with B12 deficiency in
      three. CONCLUSIONS: Combinations of gene mutations, plasma protein deficiencies,
      and hyperhomocysteinemia, which are associated with an increased thrombotic risk,
      are more common in RPL patients compared with controls. Large-scale prevalence
      studies are needed in order to draw conclusions as to the causative relation of
      such a condition and RPL.

PMID- 11216877
TI  - The association between anti-thyroid antibodies and pregnancy loss.
AB  - The incidence of thyroid autoantibodies in women with recurrent fetal loss,
      infertility or women who miscarried appears to be increased compared with
      controls of reproductive age without previous abortions. There are few working
      hypotheses concerning the asociation between anti-thyroid antibodies and the
      increased risk for pregnancy loss. The first hypothesis suggests that women with
      high titers of anti-thyroid antibodies have underlying very mild thyroid "under
      function". Another theory views the anti-thyroid antibodies as simply secondary
      markers of a predisposition of autoimmune disease rather than the actual cause of
      pregnancy loss. An evolutionary explanation suggests that reproductive problems
      in women with high titers of autoantibodies exist in order to prevent the
      transmission of autoimmune genes to the next generation. The reason for the
      association between pregnancy loss and thyroid immunity is still not clear. The
      working hypotheses above supply multi-factorial explanations, which could act
      together, may even be in synergy, as the propulsion for the pregnancy loss. Until
      today the mechanism by which anti Tg are responsible for pregnancy loss is not
      clear. Induced animal models with high titier of anti Tg could provide direct
      evidence for the pathogenic role of anti-thyroid antibodies and the mechanism
      that is responsible for the pregnancy loss in autoimmune thyroiditis. In the
      current presentation we describe data concerning the association between anti
      thyroid antibodies and pregnancy loss, and hypothesis which explains this
      association.

PMID- 11216878
TI  - Differential expression and regulation of inducible nitric oxide synthase (iNOS)
      mRNA in human trophoblasts in vitro.
AB  - OBJECTIVES: To determine the expression of inducible nitric oxide synthase (iNOS)
      in human trophoblast and to examine the possible regulation of iNOS gene by
      cytokines. MATERIALS AND METHODS: Total RNA was isolated from: 1) homogenized
      placental tissue; from 2) isolated and purified cytotrophoblast cells; and 3)
      cytotrophoblast and syncytiotrophoblast cells treated with cytokines in vitro.
      RNA was reverse transcribed and amplified by polymerase chain reaction, using
      specific primers for iNOS. Trophoblast cells were treated in vitro by interferon
      gamma (IFN-gamma) in a dose of 10 ng/mL, Interleukin 1beta (IL-1beta) (4 ng/mL)
      and leukemia inhibitory factor (LIF) (1 ng/mL). Trophoblasts were also subjected
      to immunocytochemistry using iNOS-specific antibody to detect iNOS protein
      expression in these cells. RESULTS: The expression of iNOS mRNA was found both in
      placental tissue and isolated cytotrophoblast cells. In culture, the highly
      differentiated syncytiotrophoblast expressed more mRNA than cytotrophoblast
      cells. IFN-gamma and LIF, but not IL-1beta, induced iNOS mRNA expression in
      trophoblast cells in vitro. The effects of these cytokines on iNOS mRNA were only
      observed in syncytiotrophoblast cells, but not in cytotrophoblast cells.
      Immunocytochemical staining confirmed the trophoblast cells as a major source of
      the iNOS synthase production. CONCLUSIONS: 1) Human trophoblast cells are able to
      express the iNOS mRNA, hence suggesting a role for NO in placental growth and
      function. 2) LIF and IFN-gamma, but not IL-1beta, induce the iNOS mRNA expression
      in syncytiotrophoblast cells in vitro, suggesting possible similar regulatory
      mechanisms in vivo. 3) This study, for the first time, demonstrates the
      stimulating effect of LIF on iNOS gene expression in human tissue.

PMID- 11216879
TI  - Comparative effect of danazol and a GnRH agonist on monocyte chemotactic protein
      1 expression by endometriotic cells.
AB  - PROBLEM: Endometriosis is associated with a chronic inflammatory process, and the
      increased number of activated peritoneal macrophages is one of the major
      hallmarks of this process. The medical treatment of the disease, which is based
      on the creation of an hypoestrogenic milieu unfavorable to the growth of
      endometriotic lesions, is often associated with a reduced peritoneal
      inflammation. The aim of this study was to investigate the ability of current
      therapeutic agents to modulate, through a direct mechanism, the expression by
      endometriotic cells of monocyte chemotactic protein-1 (MCP-1), a chemokine
      endowed with the potent faculty of recruiting and activating macrophages. METHOD
      OF STUDY: Cells were stimulated with interleukin-1 beta (IL-1beta) to induce MCP
      1 expression. MCP-1 protein secretion and mRNA steady-state levels were evaluated
      by ELISA and northern blot, respectively. RESULTS: Our results show that danazol
      concentrations (10(-7) -10(-5) M), taking into account the therapeutic levels
      found in the plasma of treated patients, inhibited MCP-1 protein and mRNA steady
      state levels in endometriotic cells, whereas buserelin acetate (0.1-10 ng/mL), a
      GnRH agonist, had no significant effect. Dexamethasone, an anti-inflammatory
      glucocorticoid, used at concentrations varying between 10(-12) and 10(-6) M, also
      displayed a dose-dependent inhibitory action. CONCLUSIONS: These results put into
      prominence the capability of danazol to directly inhibit the expression of a
      potent monocyte chemotactic and activating factor by ectopic endometrial cells
      shedding more light on the mechanisms underlying the clinical effects of hormonal
      therapeutic agents used in the treatment of endometriosis.

PMID- 11216880
TI  - Human leukocyte antigen-G-expressing cells differently modulate the release of
      cytokines from mononuclear cells present in the decidua versus peripheral blood.
AB  - PROBLEM: To better understand the role of human leukocyte antigen (HLA)-G in
      regulating the T helper (Th)1/Th2 cytokine balance, one of key conditions in
      determining the fate of pregnancy, we asked whether the presence of HLA-G protein
      altered the release of cytokines from both decidual mononuclear cells and
      peripheral blood mononuclear cells (PBMCs). METHOD OF STUDY: The amounts of
      cytokines released from decidual mononuclear cells and PBMCs were compared in the
      presence or absence of HLA-G-expressing cells. RESULTS: When cocultured with HLA
      G-expressing cells, the amounts of tumor necrosis factor-alpha and interferon
      gamma released from decidual mononuclear cells and PBMCs were decreased, while
      the amounts of interleukin (IL)-4 from PBMCs was increased, with IL-4 release
      from decidual mononuclear cells being unchanged. CONCLUSIONS: Upon contact with
      HLA-G, decidual mononuclear cells, and PBMCs as well, modulate their ability to
      release cytokines in a way that may shift the Th1/Th2 balance towards relative
      Th2 dominance, suggesting a role for HLA-G in maintaining pregnancy.

PMID- 11216881
TI  - Semantic knowledge and episodic memory for faces in semantic dementia.
AB  - Previous studies have documented poor recognition memory for faces in patients
      with semantic dementia. Preserved face recognition memory was found in this
      study, however, so long as atrophy was confined predominantly to the left
      temporal lobe. Patients with structural damage to the right temporal lobe were
      typically impaired, with the status of the hippocampus and parahippocampal gyrus
      (including the perirhinal cortex) on the right being critical. Two single-case
      studies of patients with predominantly left temporal lobe pathology confirmed
      good recognition memory for famous faces, even if semantic knowledge about the
      celebrities depicted was severely degraded. An effect of semantic knowledge on
      recognition memory became apparent only when perceptually different photographs
      of the famous people were used at study and test. These results support the view
      that new episodic learning typically draws on information from both perceptual
      and semantic systems.

PMID- 11216883
TI  - Short-term memory for serial order in schizophrenia: a detailed examination of
      error types.
AB  - Cognitive deficits in schizophrenia have been associated with working memory
      problems. Schizophrenic patients (n = 24) and controls (n = 29) participated in
      simple short-term memory tasks, recalling a list of letters from the first to
      last item in the order of presentation. The authors hypothesized that deficient
      sequential representations would increase movement errors (e.g., ABCD being
      recalled as ABDC) or intrusion errors (e.g., ABCD being recalled as ABCX),
      whereas simple trace decay would lead to omission errors (e.g., ABCD being
      recalled as ABC_). Patients made disproportionately more omissions toward the end
      of 6-item lists. There were no group differences in movements or intrusions as a
      function of serial position. Schizophrenic patients' limited short-term memory
      span may be due to greater forgetting during recall and not to a selective
      deficit in the mechanisms responsible for maintaining serial order information.

PMID- 11216882
TI  - Neural substrates of mathematical reasoning: a functional magnetic resonance
      imaging study of neocortical activation during performance of the necessary
      arithmetic operations test.
AB  - Brain activation was examined using functional magnetic resonance imaging during
      mathematical problem solving in 7 young healthy participants. Problems were
      selected from the Necessary Arithmetic Operations Test (NAOT; R. B. Ekstrom, J.
      W. French, H. H. Harman, & D. Dermen, 1976). Participants solved 3 types of
      problems: 2-operation problems requiring mathematical reasoning and text
      processing, 1-operation problems requiring text processing but minimal
      mathematical reasoning, and 0-operation problems requiring minimal text
      processing and controlling sensorimotor demands of the NAOT problems. Two
      operation problems yielded major activations in bilateral frontal regions similar
      to those found in other problem-solving tasks, indicating that the processes
      mediated by these regions subserve many forms of reasoning. Findings suggest a
      dissociation in mathematical problem solving between reasoning, mediated by
      frontal cortex, and text processing, mediated by temporal cortex.

PMID- 11216884
TI  - The development of a quantitative electroencephalographic scanning process for
      attention deficit-hyperactivity disorder: reliability and validity studies.
AB  - The development of a quantitative electroencephalographic (QEEG)-based procedure
      for use in the assessment of attention deficit-hyperactivity disorder (ADHD) was
      examined through a series of studies investigating test reliability and
      validation issues. This process, involving a spectral analysis of the
      electrophysiological power output from a single, midline, central location (the
      vertex), was conducted in 469 participants, 6 to 20 years of age, classified as
      ADHD, inattentive type; ADHD, combined type; or control. The results indicated
      that the QEEG scanning procedure was reliable (r = .96), was consistent with the
      Attention Deficit Disorders Evaluation Scale (S. B. McCarney, 1995) and the Test
      of Variables of Attention (L. M. Greenberg, 1994; chi-square, p < .01), and
      differentiated participants with ADHD from a nonclinical control group (p <
      .001). The sensitivity of the QEEG-derived attentional index was 90%; the
      specificity was 94%.

PMID- 11216885
TI  - Olfactory-evoked regional cerebral blood flow in Alzheimer's disease.
AB  - Olfaction is impaired in Alzheimer's disease (AD). It was hypothesized that AD
      would reduce olfactory-evoked perfusion in mesial temporal olfactory (piriform)
      cortex, where neuropathology begins. Seven AD patients and 8 elderly controls
      (ECs) underwent olfactory threshold and identification tests and olfactory
      stimulation during positron emission tomography. Odor identification was impaired
      in AD, but threshold was not. Olfactory stimulation in ECs activated right and
      left piriform areas and right anterior ventral temporal cortex. AD patients had
      less activation in right piriform and anterior ventral temporal cortex but not in
      the left piriform area. Although orbital cortex did not activate in ECs, there
      was a significant between-groups difference in this area. Right piriform
      activation correlated with odor identification. Impaired odor identification
      likely reflects sensory cortex dysfunction rather than cognitive impairment.
      Given olfactory bulb projections to the mesial temporal lobe, olfactory
      stimulation during functional imaging might detect early dysfunction in this
      region.

PMID- 11216886
TI  - Is the dissociability of working memory systems for name identity, visual-object
      identity, and spatial location maintained in old age?
AB  - The dissociability of working memory for name identity (verbal information),
      visual objects, and spatial location was explored in 3 experiments. Consistent
      with previous results, the 3 working memory systems were dissociable in younger
      adults. Both younger and older adults showed involvement of name identity in an
      object identity task, and older adults showed this involvement in a spatial
      memory task. Results were interpreted as showing that the systems are generally
      separable but that involvement of 1 with another is possible and more likely in
      older adults. A 4th, correlational study showed that there is generalized decline
      in working memory systems in old age, with the age differences in memory mediated
      to a moderate extent by age-related differences in speed of processing. It was
      speculated that the specific, possibly strategic changes are independent of and
      take place against a backdrop of generalized loss of nervous system integrity.

PMID- 11216887
TI  - Impaired perception of facial emotions following bilateral damage to the anterior
      temporal lobe.
AB  - Two patients (E.P. and G.T.) were previously described with damage to amygdala
      and anterior temporal cortex (S.B. Hamann et al., 1996). Both rated emotions in
      facial expressions normally (the rating task) when the data analysis followed a
      method that had revealed an impairment in the well-studied patient S.M. The
      present study reports findings for a 3rd patient (G.P.) with the rating task and
      reexamines the data for E.P. and G.T. All 3 patients were also given a labeling
      task in which they selected, from a list of 6 words, which word they thought best
      described the emotion expressed by a face. All 3 patients were unmistakably
      impaired on both tasks. However, the impairment exhibited by these patients is
      different from S.M.'s impairment. The difference may depend on the etiology
      (congenital vs. adult-onset lesion) or the site of the damage (relatively
      selective amygdala damage vs. damage to amygdala as well as anterior temporal
      cortex).

PMID- 11216888
TI  - Differences between nouns and verbs after anterior temporal lobectomy.
AB  - To test the claim that lesions of left anterior and middle temporal cortical
      structures specifically impair processing of nouns but not verbs, 56 left
      hemisphere-language-dominant patients who had undergone anterior temporal
      lobectomy (ATL) completed tasks assessing confrontation naming of pictured
      objects and actions, generation of synonyms for nouns and verbs, and semantic
      lexical judgments about nouns and verbs. Compared with right ATL patients, left
      ATL patients were impaired across different tasks that assessed naming and
      comprehension of high-imageability as well as low-imageability nouns. These
      groups did not differ, however, in verb naming or comprehension on most tasks.
      Results are consistent with the hypothesized specialization of left temporal lobe
      structures for processing nouns and suggest that naming problems commonly seen
      after left ATL extend beyond difficulties with retrieving object names and may be
      related to subtle disturbances in comprehension of the meanings underlying
      nominal word forms.

PMID- 11216889
TI  - Memory for content and source in temporal lobe patients.
AB  - Left and right temporal lobectomy patients and normal controls were tested in a
      memory task for which the to-be-remembered items were simple actions involving
      small objects. Participants either performed the actions, perceived the
      experimenter performing the actions, or imagined themselves performing the
      actions. The patients were deficient relative to the controls at remembering the
      actions and at remembering whether the actions were performed, perceived, or
      imagined. These results are interpreted as suggesting that the temporal lobes are
      involved in memory for the source as well as the content of past experiences.

PMID- 11216890
TI  - Short-term memory for duration and distance in humans: role of the hippocampus.
AB  - Control participants and hypoxic participants with bilateral hippocampal damage
      were tested for short-term memory (STM) for presentation duration of a single
      object, STM for a single object, STM for spatial distance information, and time
      estimation. Delays of 1, 4, 8, 12, or 16 s were used for all the STM and time
      estimation tests. Results indicated that relative to controls, hypoxic
      participants were significantly impaired for STM for duration and distance
      information at the long but not short delays. Similarly, time estimation was
      accurate only to 8 s for hypoxic participants, but STM for a single object was
      only mildly affected. Results suggest that the hippocampus may be required for
      the processing of spatial and temporal STM information.

PMID- 11216891
TI  - H.M. revisits the Tower of Hanoi Puzzle.
AB  - To address the controversy of whether an intact procedural memory system alone
      can support the learning of the recursive strategy for solving the Tower of Hanoi
      Puzzle, the authors tested 2 amnesic patients, H.M. and P.N. Contrary to the
      report of N. J. Cohen, H. Eichenbaum, B. S. Deacedo, and S. Corkin (1985), both
      patients failed to master the recursive strategy under the active-interaction
      condition. In contrast, normal control participants were able to master the
      strategy under identical testing conditions. The failure of H.M. and P.N. could
      not be attributed to the differences between the original and current testing
      conditions. In addition, neither patient showed frontal lobe dysfunction or
      impairment in procedural memory. Together with evidence provided by theoretical
      analyses of this puzzle as well as studies on normal participants, the authors
      conclude that declarative memory plays a vital role in the acquisition of the
      recursive strategy for solving the Tower of Hanoi Puzzle.

PMID- 11216892
TI  - Reflective and reflexive action control in patients with frontal brain lesions.
AB  - Two types of action control derived from the model of action phases (H.
      Heckhausen & P. M. Gollwitzer, 1987) were analyzed in patients with frontal
      lesions, patients with nonfrontal lesions, and university students. In Study 1,
      reflective action control in terms of goal selection was assessed, and impaired
      deliberation was found in patients with frontal lesions. Study 2 assessed
      reflexive action control in terms of automatic action initiation as a result of
      forming implementation intentions (P. M. Gollwitzer, 1999). All participants sped
      up their responses to critical stimuli by forming implementation intentions.
      Moreover, lesion patients with weak performances on the Tower of Hanoi (TOH) task
      did worse than patients with strong TOH performances in Study 1 but better than
      control participants in Study 2. Findings are interpreted as a functional
      dissociation between conscious reflective action control and automatic reflexive
      action control.

PMID- 11216893
TI  - Human genetics in health care.
AB  - The Human Genome Project, the mapping of our 100,000 genes and the sequencing of
      all of our DNA, will have major impact on biomedical research and the whole of
      therapeutic and preventive health care. The tracing of genetic diseases to their
      molecular causes is rapidly expanding diagnostic and preventive options, while
      the increased insights into molecular pathways open tremendous perspectives for
      pharmacological and genetic therapies. The design of animal model systems for the
      functional study of disease and development and the use of bioinformatics and
      biostatistics to improve our pattern recognition abilities are greatly
      accelerating progress. However, the optimal value from the current explosion of
      'data mining' possibilities will only be gained when the basic data are made and
      kept publicly accessible, while at the same time safeguarding the protection of
      intellectual property arising from downstream inventions. This is one of the
      goals of the international Human Genome Organisation, established 10 years ago to
      assist coordinating data acquisition and exchange and societal implementation of
      the genome project. Additional points of major attention in this historic
      endeavour are the safeguarding of a worldwide balance in the contribution and
      benefits to countries and populations, the prevention of stigmatisation and
      discrimination of individuals and groups and the maintenance of respect for the
      diversity of our world's cultures and traditions. CONCLUSION: The acquisition and
      use of genomic information for health care benefit should be seen in the light of
      a worldwide improvement without prejudice.

PMID- 11216895
TI  - Methods in clinical molecular genetics.
AB  - Mutation detection is fundamental throughout biology, but especially so in
      medicine and medical research, particularly in gene discovery and cancer
      diagnostics. Current methods are unsatisfactory due to a range of reasons, but
      particularly due to cost and lack of convenience. The current methods are
      reviewed and their advantages and disadvantages discussed. The high profile chip
      technology whilst making an enormous impact in expression studies is more
      problematic for mutation detection, especially for unknown mutations and the
      problems are discussed. Finally, once mutations are discovered they need
      documenting accurately and the efforts of the Human Genome Organisation mutation
      database initiative due this direction are discussed. CONCLUSION: Current methods
      of mutation analysis, although unsatisfactory, are reviewed and the impact of new
      technologies assessed.

PMID- 11216894
TI  - Disease-causing mutations in the human genome.
AB  - A considerable number of gene mutations has now been reported in a total of more
      than 1000 different human genes. Data on these mutations and their associated
      phenotypes have been collated and are available online through two major
      databases: Online Mendelian Inheritance in Man in Baltimore and the Human Gene
      Mutation Database in Cardiff. Since the non-randomness of mutation is determined
      largely by the local DNA sequence environment, the study of mutation may not only
      yield information on underlying mechanisms but also lead to the optimization of
      mutation search strategies. CONCLUSION: There is a high frequency of CG to TG or
      CA mutations in the human genome due to deamination of 5' methyl-cytosine. The
      second most common type of mutations in human disorders is short deletions or
      insertions of less than 20 nucleotides.

PMID- 11216896
TI  - Bridging the gap between molecular genetics and metabolic medicine: access to
      genetic information.
AB  - Thanks to the World Wide Web, most results of research in genetics are made
      available in public databases. At the present time there are resources on genetic
      diseases, genes and their location, mutations of already cloned genes and on
      laboratories performing the mutation analysis. The main resources on phenotypes
      are On-line Mendelian Inheritance in Man (OMIM), Pedbase, GeneClinics, London
      Dysmorphology Database (LDDB) and Orphanet. The main resources on human genes
      are, in addition to OMIM, the Genome Database, Genatlas and Genecard. There are
      also two major sequence databases. All of them can be queried using the OMIM
      number of the disease. Central databases of mutations, as well as locus specific
      databases have been created. Their list is maintained at the Human Genome
      Organisation mutation database initiative website. Several initiative have been
      taken to integrate all these data and help the clinician to find out quickly what
      he/she needs. The website of the National Center for Biotechnology Information is
      the best example of such an effort with sections on diseases, a genome guide, and
      locus links. Several databases of genetic testing resources have been
      established. GeneTests is an on-line genetics resource that contains a directory
      of North American laboratories providing testing for heritable disorders.
      Orphanet is a similar database on French services which is in the process of
      becoming a European database. CONCLUSION: Even if clinicians do not have as many
      services at their disposal as the molecular geneticists, various useful databases
      already exist and should no longer be ignored in practice.

PMID- 11216897
TI  - Mutation screening for prenatal and presymptomatic diagnosis: cystic fibrosis and
      haemochromatosis.
AB  - Hereditary haemochromatosis (HH) and cystic fibrosis (CF) are the most common
      autosomal recessively inherited disorders in Caucasian populations. In its
      typical form, CF manifests during the first years of life, while the mean age of
      onset of organ damage is 54 years in HH. Both disorders can be diagnosed
      presymptomatically utilising biochemical and/or genetic testing. Since
      approximately 90% of mid-European HH patients are homozygous for only one
      specific mutation (C282Y) in the candidate gene for HH, genetic testing is simple
      and sensitive in HH. In CF, molecular testing is currently hampered by the large
      number (more than 800) of mutations in the CF transmembrane conductance regulator
      gene. Several studies have been initiated to investigate the potential benefits
      and the best time and mode of presymptomatic testing for HH and CF. CONCLUSION:
      Mutation analysis is widely recommended for presymptomatic diagnosis of cystic
      fibrosis and hereditary haemochromatosis because of the presumed benefit,
      although several medical, ethical, social and technical questions warrant further
      investigations. Prenatal mutation testing is commonly performed for cystic
      fibrosis but not for hereditary haemochromatosis. Informed consent of tested
      individuals and the availability of genetic counselling is a prerequisite for any
      mutation screening approach in either disease.

PMID- 11216898
TI  - Population-based genetic screening for reproductive counseling: the Tay-Sachs
      disease model.
AB  - Since 1970, more than 1.4 million individuals worldwide have been screened
      voluntarily to determine if they are carriers of the mutant gene for Tay-Sachs
      Disease (TSD). Employing both enzymatic and molecular methods (for optimal
      sensitivity and specificity) more than 1400 couples have been identified to be at
      risk for TSD in their offspring, i.e., both parents heterozygotes. Through
      prenatal testing of more than 3200 pregnancies, births of over 600 infants with
      this uniformly fatal neurodegenerative disease have been prevented. In the United
      States and Canada, the incidence of TSD in the Jewish population has been reduced
      by more than 90%. More that 100 mutations in the hexosaminidase A gene (the TSD
      locus) have been identified to date. Some are associated with later onset or more
      chronic forms of neuronal storage disease. Two mutations cause a carrier-like
      "pseudo-deficiency" when enzymatic testing is used (false positives). A number of
      practical, social, and ethical complexities have been identified in this
      prototypic population-based effort. Educational and counseling components must be
      provided both before and after screening. Issues of privacy and confidentiality
      of test results must be addressed. In certain cultures insurability and
      employment may be involved. The public perception of the biomedical community as
      advocates for wide-scale testing and screening may be interpreted, in some
      systems, as conflicts of interest on the part of entrepreneurial scientists,
      clinicians, and institutions. CONCLUSION: Many new opportunities for population
      based screening will be evident in this era of genome-related discovery.
      Accordingly, some of the experiences with Tay-Sachs disease prevention may be
      instructive.

PMID- 11216899
TI  - The molecular basis of ornithine transcarbamylase deficiency.
AB  - The ornithine transcarbamylase (OTC) gene is located on the short arm of the X
      chromosome and encodes the second enzyme of the urea cycle. OTC deficiency is an
      X-linked disorder that causes hyperammonemia leading to brain damage, mental
      retardation and death. The clinical and biochemical phenotype is extremely
      variable and can only partially be explained by the genotype. We identified
      mutations in the OTC gene of more than 150 patients with OTC deficiency. The
      "neonatal onset" group of patients has mutations that abolish enzyme activity,
      whereas the "late onset group" shows partial enzyme deficiency to variable
      degree. Of the mutations, 60% are associated exclusively with acute neonatal
      hyperammonemic coma while the remaining cause "late onset" disease. Several
      symptomatic and asymptomatic adults have now been identified to have deleterious
      mutations in the OTC gene leading to predisposition to hyperammonemia.
      CONCLUSION: The enlarging clinical, biochemical and molecular spectrum observed
      in patients with ornithine transcarbamylase deficiency suggests that this
      disorder behaves like a single gene disorder at one end of the spectrum and as a
      multi-factorial disease at the other.

PMID- 11216901
TI  - Galactosaemia and allelic variation at the galactose-1-phosphate
      uridyltransferase gene: a complex relationship between genotype and phenotype.
AB  - More than 160 different base changes have been described at the galactose-1
      phosphate uridyltransferase gene and most of these are associated with a disease
      phenotype. Q188R is the most common mutation in north European populations and
      those predominantly of European descent. K285N is much rarer but in some
      countries of east/central Europe it is the second most common mutation. In some
      populations of northern Europe these two mutations can be found on 70%-80% of
      mutant chromosomes. Both mutations appear to be associated with a complete loss
      in enzyme activity and thus, a more severe biochemical phenotype. A single amino
      acid substitution, N314D, is found on both Duarte 1 and Duarte 2 alleles.
      Additional base changes that are different on each distinguish D1 from D2
      alleles. Whether the differences in galactose-1-phosphate uridyltransferase
      enzyme activities are associated with the additional molecular changes that
      distinguish D1 and D2 alleles remains unclear. S135L is found almost exclusively
      in galactosaemic individuals of African origin. Despite early diagnosis and
      treatment and adherence to a lactose free diet neurological complications, poor
      growth and reduced fertility are frequently observed in affected individuals.
      CONCLUSION: Allelic variation at the galactose-1-phosphate uridyltransferase gene
      undoubtedly plays a role in defining the biochemical and clinical phenotype.
      However, clinical galactosaemia is a complex trait in which multiple
      developmental and metabolic pathways are involved. Ultimately the phenotype is
      beyond the control of the single gene itself.

PMID- 11216900
TI  - Inherited ion channel disorders.
AB  - The inherited ion channel disorders (channelopathies) are a group of disorders
      caused by mutations in genes encoding ion channels. Ion channel disorders can
      affect any tissue, but the majority affect skeletal muscle or the central nervous
      system. These disorders include skeletal muscle sodium channelopathies causing
      hyperkalaemic periodic paralysis, paramyotonia congenita and potassium-aggravated
      myotonia. Skeletal muscle calcium channelopathies can cause hypokalaemic periodic
      paralysis, malignant hyperthermia and central core disease. Skeletal muscle
      chloride channelopathies can cause Thomsen and Becker myotonia. A neuronal sodium
      channelopathy causes the generalised epilepsy febrile seizures plus syndrome.
      Neuronal potassium channelopathies can cause familial benign neonatal convulsions
      and episodic ataxia type 1. Finally, neuronal calcium channelopathies can cause
      episodic ataxia type 2, familial hemiplegic migraine and spinocerebellar ataxia
      type 6. CONCLUSION: The clinical features, aetiology and pathogenesis of
      inherited voltage-gated ion channel disorders affecting muscle and the central
      nervous system are reviewed here.

PMID- 11216902
TI  - Genetic determinants of hyperhomocysteinaemia: the roles of cystathionine beta
      synthase and 5,10-methylenetetrahydrofolate reductase.
AB  - Over the last decade mild hyperhomocysteinaemia has widely been recognised as a
      new risk factor for arteriosclerosis and thrombosis. Main regulating enzymes of
      homocysteine (Hcy) metabolism are cystathionine beta-synthase (CBS), methionine
      synthase and methylenetetrahydrofolate reductase (MTHFR). Early studies on
      patients with vascular disease described elevated Hcy concentrations after
      methionine loading and decreased CBS activity, resembling heterozygotes for CBS
      deficiency. Therefore, heterozygosity for CBS deficiency was proposed as the main
      cause of mild hyperhomocysteinaemia. However, more recent enzymatic and molecular
      genetic studies have demonstrated that heterozygosity for CBS deficiency is not
      or only a very minor cause of mild hyperhomocysteinaemia in vascular disease. We
      discovered two common genetic causes of mild hyperhomocysteinaemia, the 677C > T
      and the 1298A > C mutations in the coding region of MTHFR. The 677C > T mutation
      causes reduced enzyme activity with thermolabile protein properties, elevated Hcy
      and low-normal or decreased plasma folate levels. The 1298A > C mutation relates
      also to decreased enzyme activity, but not to thermolabile protein, and Hcy and
      folate levels are not influenced. However, compound heterozygosity for these two
      mutations, i.e. individuals with the 677CT/1298AC genotype, have elevated Hcy and
      decreased plasma folate levels. Gene-enviroment interactions between 677C > T and
      folate is demonstrated in individuals with the 677TT genotype. Those with low
      normal folate have elevated Hcy, whereas those with high-normal folate have
      normal Hcy concentrations. The elevated Hcy levels due to these mutations can be
      normalised by administration of folate, but whether folate reduces the risk of
      cardiovascular disease remains to be established. CONCLUSION: Heterozygosity for
      cystathionine beta-synthase deficiency is a minor cause of hyperhomocysteinaemia.
      The current data on mutations in the methylenetetrahydrofolate reductase gene do
      not tell us whether elevated plasma homocysteine plays a causal role in vascular
      disease. Low cellular vitamin status may be a possible cause and homocysteine may
      just be a marker for this situation.

PMID- 11216903
TI  - Prevalent mutations in fatty acid oxidation disorders: diagnostic considerations.
AB  - The mutational spectrum in a given disease-associated gene is often comprised of
      a large number of different mutations, of which a single or a few are present in
      a large proportion of diseased individuals. Such prevalent mutations are known in
      four genes of the fatty acid oxidation: the medium-chain acyl-CoA dehydrogenase
      (MCAD) gene; the short-chain acyl-CoA dehydrogenase (SCAD) gene; the long-chain 3
      hydroxy acyl-CoA dehydrogenase (LCHAD) gene and the carnitine-palmitoyl-CoA
      transferase II (CPT II) gene. In MCAD deficiency the analysis confirms the
      conventional wisdom that individuals carrying the prevalent 985A > G mutation are
      at risk of developing life-threatening attacks. In SCAD/ethylmalonic aciduria, on
      the other hand, the presence of the prevalent susceptibility variations, 625A and
      511T, in the SCAD gene seems to require additional genetic and cellular factors
      to be present in order to result in a phenotype. For the prevalent mutations in
      the LCHAD and CPT II genes further data are needed to evaluate the penetrance and
      risk of manifest disease when carrying these mutations. CONCLUSION: Assessment of
      the prevalence of a prevalent mutation in the mutation spectrum of the disease in
      question and determination of the carrier frequency in the general population may
      help in elucidating the penetrance of the genotype. This is exemplified in
      disorders of mitochondrial fatty acid oxidation.

PMID- 11216904
TI  - Mitochondrial DNA disorders.
AB  - Over 100 pathogenic point mutations and 200 deletions, insertions, and
      rearrangements have been identified since the first mitochondrial DNA mutations
      were described in 1988. About 60% of the point mutations affect mitochondrial
      tRNAs, 35% affect polypeptide subunits of the respiratory chain, and 5% affect
      mitochondrial ribosomal RNAs. The clinical phenotypes of mitochondrial tRNA
      disease span the spectrum of all known oxidative phosphorylation disorders and
      include MELAS, MERRF, Leigh syndrome, PEO, deafness, diabetes, sideroblastic
      anemia, myoclonus, skeletal myopathy, cardiomyopathy, and renal tubular acidosis.
      Mutations in respiratory chain proteins encoded by mtDNA result in phenotypes
      ranging from exercise intolerance to blindness, ataxia, dystonia, dementia, and
      Leigh syndrome. CONCLUSION: The primary disorders of oxidative phosphorylation
      are commonly associated with a delayed age of onset, organ selectivity, and an
      episodic, progressive course. Organ-specific, non-ATP related functions of
      mitochondria are discussed as important considerations in evaluating the
      pathogenesis of mitochondrial disease.

PMID- 11216905
TI  - Nuclear genes and oxidative phosphorylation disorders: a review.
AB  - Knowledge concerning the approximately 70 human nuclear genes creating the
      essential building-blocks of the five multi-protein subunit complexes of the
      oxidative phosphorylation (OXPHOS) system has been expanded greatly in the past
      few years. However, knowledge concerning the numerous human genes involved in the
      regulation of transcription, translation, post-translational modification,
      mitochondrial signalling, import, quality control, folding and assembly of the
      OXPHOS system is still rather scanty. It may be expected that this scenario, by
      the application of direct (candidate gene identification by comparison between
      known genes in lower species and the human expressed sequence tag database) and
      indirect genetic strategies (the chromosome transfer technique, linkage analysis
      and positional cloning) will rapidly change. By now, a limited number of
      structural and non-structural nuclear gene defects have been found. CONCLUSION:
      This review summarises the state of our current knowledge of nuclear gene
      mutations in oxidative phosphorylation disorders.

PMID- 11216906
TI  - Hereditary deafness: lessons for developmental studies and genetic diagnosis.
AB  - Hereditary deafness is highly heterogeneous genetically, with over 100 loci so
      far identified. Routine diagnostic mutation screening can be done only when a
      candidate gene has been identified, and preferably a candidate mutation. For
      syndromic forms of hearing loss it is often possible to predict the gene
      involved. Non-syndromic loss is much more intractable to diagnostic mutation
      screening because of the extensive locus heterogeneity. However, mutations in the
      connexin 26 (GJB2) gene and the mitochondrial m. 1555A > G mutation are
      sufficiently frequent in some populations to justify mutation testing.
      Identifying the genes mutated in syndromic hearing loss can help delineate
      developmental pathways. CONCLUSION: The example of Waardenburg syndrome is used
      to illustrate how unravelling developmental pathways can be more complicated than
      defining metabolic pathways through biochemical defects. Developmental genes tend
      to be organised into networks rather than linear pathways, and transcription
      factors act in a combinatorial manner. This makes developmental pathways harder
      to unravel genetically than metabolic pathways.

PMID- 11216907
TI  - Organelle disease: peroxisomal disorders.
AB  - Peroxisomes are virtually ubiquitous organelles involved in numerous catabolic
      and anabolic pathways. Interest in peroxisomes stems from an expanding group of
      genetic diseases in which there is either deficiency of a specific peroxisomal
      function (single protein defects) or failure to assemble the organelle resulting
      in defects of multiple peroxisome functions (peroxisome biogenesis disorders).
      The paradigm for the former is X-linked adrenoleukodystrophy caused by mutations
      in the adrenoleukodystrophy gene and, for the latter, Zellweger syndrome caused
      by mutations in peroxin genes. CONCLUSION: The identification and functional
      characterisation of the peroxisomal disease genes is proceeding at rapid pace
      helped immeasurably by work in various yeast model systems. The ultimate goal is
      to elucidate how the encoded proteins produce normal appearing and functioning
      peroxisomes. The achievement of this goal will lead to a better understanding of
      peroxisomal disorders, their pathogenesis and treatment.

PMID- 11216908
TI  - What has happened to gene therapy?
AB  - Trials have demonstrated the feasibility of gene therapy in correcting the gene
      defect in monogenic disorders such as severe combined immune deficiency and
      cystic fibrosis, but there are still obstacles and ethical issues to overcome.
      CONCLUSION: With appropriate research, better delivery strategies and adherence
      to good standard clinical research and practice, gene therapy research will lead
      to clinical implementation in monogenic and multifactorial disorders including
      cancer, neurodegenerative disorders and vascular disease.

PMID- 11216909
TI  - Mutation analysis in metabolic (and other genetic) disease: how soon, how useful.

PMID- 11216910
TI  - The potent antitumor effects of combined p16 gene and GM-CSF gene therapy through
      efficient induction of antitumor immunity.
AB  - PURPOSE: Tumor suppressor gene therapy and cytokine gene therapy have limited
      antitumor effects when used alone. Thus, in the present study, we investigated
      the antitumor potentials of the combined transfer of the p16 tumor suppressor
      gene and the murine granulocyte-macrophage colony-stimulating factor (GM-CSF)
      gene. METHODS: The adenovirus-harboring p16 gene (Adp16) and adenovirus-harboring
      GM-CSF (AdGMCSF) gene were utilized for the treatment of established tumors in
      vivo. The mice were inoculated s.c. with Renca renal carcinoma cells and 3 days
      later received an intratumoral injection of Adp16 in combination with AdGMCSF.
      RESULTS: The results demonstrated that tumor-bearing mice treated with Adp16 and
      Ad-GMCSF showed more potent inhibition of tumor growth and a prolonged survival
      period than mice treated with Adp16. AdGMCSF, adenovirus-expressing beta
      galactosidase or PBS (P<0.01). Treatments of the mice with Adp16 alone or AdGMCSF
      alone also showed obvious antitumor effects as compared with those mice treated
      with PBS (P<0.05). After combined p16 and AdGMCSF gene therapy, the expression of
      H2Kd and Fas molecules on freshly isolated tumor cells increased markedly, and
      more CD(4)+ T cells and CD(8)+ T cells infiltrated in the tumor sites. The
      cytotoxicity of natural killer cells and specific cytotoxic T lymphocytes
      increased more significantly after the combined therapy. CONCLUSIONS: Our results
      demonstrated that combination p16 gene and GM-CSF gene therapy could inhibit the
      growth of established tumors in mice more significantly through efficient
      induction of antitumor immunity.

PMID- 11216911
TI  - Allelic loss of cyclophilin 40, an estrogen receptor-associated immunophilin, in
      breast carcinomas.
AB  - PURPOSE: Cyclophilin 40 (CyP40) is an estrogen receptor-associated protein which
      appears to modify receptor function. The aim of this study was to determine the
      extent of allelic loss at the CyP40 locus in a panel of breast carcinomas using a
      newly characterized microsatellite marker located upstream of the CyP40 gene and
      then to correlate this with losses at chromosomal sites for cancer-associated
      genes. METHODS: Allelic loss at CyP40 was determined from patients' matched tumor
      and normal breast tissue using Genescan 672 software analysis of fluorescently
      labeled, PAGE-separated PCR products incorporating the marker. For each patient,
      allelic loss at CyP40 was then assessed and compared with losses at markers for
      various cancer-associated genes. RESULTS: Allelic loss was detected in 30% of
      breast carcinomas from patients heterozygous for the CyP40 marker. All carcinomas
      demonstrating allelic loss were grade II or III invasive ductal carcinomas and
      generally showed multiple losses at other sites near known cancer-associated
      genes. CONCLUSIONS: The polymorphic marker which we characterized was useful in
      determining allelic loss at the CyP40 locus in breast cancer patients and when
      applied in these studies in conjunction with various cancer-associated gene
      markers, suggests that deletions in the region of the CyP40 gene might be a late
      event in breast tumor progression.

PMID- 11216912
TI  - Computed direct magnification radiography of bone tumors.
AB  - The purpose of this study was to assess the diagnostic performance of computed
      direct magnification radiography in diagnosing bone tumors as compared with
      conventional radiography. Ninety-one patients with primary bone tumors and tumor
      like lesions were radiographed with conventional and magnification techniques.
      All radiographs were analyzed by one orthopedic surgeon and two radiologists and
      the findings were correlated with histopathology. Two microfocal X-ray units were
      used for computed direct magnification radiography with a focal spot size of 20
      130 microm. Using magnification versus conventional radiography, the diagnosis of
      benign and malignant lesions as well as the individual tumor diagnosis was
      obtained with higher accuracy (85% versus 71% and 69% versus 51%, respectively,
      P<0.01). Margins of destruction, periosteal reactions, and matrix patterns were
      evaluated with higher accuracy by all observers (P<0.01). We conclude that
      computed direct magnification radiography may improve evaluation and diagnosis of
      bone tumors.

PMID- 11216913
TI  - Pleural mesothelioma associated with indoor pollution of asbestos.
AB  - This case report concerns a 46-year-old woman, dying from histologically
      confirmed diffuse malignant mesothelioma after asbestos exposure, which was only
      caused by indoor pollution from crocidolite-containing spray asbestos in building
      materials. There was no other known occupational or environmental asbestos
      exposure during her life. The lung tissue fibre analysis by light microscopy
      showed significantly increased concentrations of ferruginous bodies (3162 FB per
      gram of wet lung tissue). By use of scanning transmission electron microscopy,
      clearly increased concentrations of amphibole fibres (8.6 x 10(6) fibres longer
      than 1 microm and 0.6 x 10(6) fibres longer than > or =5 microm per gram dry
      tissue), mainly classified as crocidolite, were observed. The disease was
      attributed to indoor exposure to sprayed asbestos, which occurred during her work
      as a decorator in the studio of a warehouse.

PMID- 11216914
TI  - Pegylated doxorubicin for primary cutaneous T-cell lymphoma: a report on ten
      patients with follow-up.
AB  - PURPOSE: Pegylated liposomal doxorubicin (PEG-DOXO) was found to be effective in
      primary cutaneous T-cell lymphomas (CTCL). The present observation reports on
      follow-up and relapse-free interval in patients with CTCL. METHODS: Ten patients
      (one female, nine male) aged 50-78 years (mean 66.7 years) with relapsing or
      recalcitrant CTCL, stage I b (n = 3), II a (2), II b (3), IV a (1), and IV b (1)
      were treated with PEG-DOXO 20 mg m(-2) once a month with an upper limit of 400 mg
      or eight infusions to induce a clinical response. There was one drop out after a
      single infusion because of a capillary leak syndrome. RESULTS: In nine patients
      with PEG-DOXO the best response was a complete response (CR) in five patients and
      a partial response (PR) in four patients. The final outcome was CR in six, PR in
      two, stable disease (SD) in one, and progressive disease (PD) in another patient.
      The overall response rate (CR + PR) was 80% (of ten patients). The follow-up was
      2-22 months (mean 12.8+/-7.1 months). The overall survival was calculated as
      19.8+/-7.4 months with eight out of ten patients still alive. Response duration
      was 15.2+/-3.9 months, disease-free survival 13.3+/-6.1 months, event-free
      survival 16.7+/-9.0 months, and progression-free survival 18.2+/-6.5 months. Four
      patients (stage I b and II b) achieved 12-19 months of disease-free survival. The
      follow-up after the first course with PEG- DOXO was 2-22 months (mean 12.8+/-7.1
      months). The survival rate after 12 months of follow-up was 80% (n = 5). One
      patient free of relapse died after 12 months because of pulmonary embolism not
      related to disease or treatment. Another patient died 1 month after a second
      course of PEG-DOXO in an advanced tumor stage of CTCL. The most frequent side
      effects of treatment were anemia and lymphopenia without the need of supportive
      treatment or dose-reduction. Only one patient developed toxicity of grade 4
      (anemia). CONCLUSIONS: These results indicate that patients with relapsing or
      recalcitrant CTCL can achieve an 80% response rate with PEG-DOXO and long-term
      remissions.

PMID- 11216915
TI  - CYP19 gene polymorphism in endometrial cancer patients.
AB  - PURPOSE: Initiation/promotion of endometrial cancer is known to be associated
      with estrogenic influence. Therefore, it is possible that some allelic
      polymorphisms of the genes involved in steroidogenesis or steroid metabolism
      contribute to endometrial cancer susceptibility. METHODS: Here, we compared CYP19
      (aromatase) gene polymorphism in 85 endometrial cancer patients and in 110 non
      affected women. RESULTS: The genotypes containing the longest alleles (A6 and A7)
      of CYP19 were found to be over-represented in patients as compared to controls.
      In addition, these genotypes demonstrated a tendency to be associated with
      increased concentrations of estradiol and testosterone in postmenopausal
      patients. CONCLUSIONS: Thus, CYP19 polymorphism might be one of the genetic risk
      factors for endometrial cancer development.

PMID- 11216916
TI  - Transition from suspension to adherent growth is accompanied by tissue factor
      expression and matrix metalloproteinase secretion in a small cell lung cancer
      cell line.
AB  - Small cell lung cancer (SCLC) is a very malignant tumor known to grow
      aggressively and to metastasize early. It is well established that metastasis
      generally involves both tumor cell adhesion and proteolytic degradation of the
      extracellular matrix. However, SCLC cells cultured in vitro, such as the classic
      SCLC cell line NCI-H69, grow in floating aggregates and express only negligible
      proteolytic activity. In this report, we show that NCI-H69 cells can be selected
      for adherent growth. In contrast to parental suspension cells, the adherent cells
      were found to express tissue factor as well as gelatinolytic activity,
      attributable to matrix metalloproteinases 2 and 9. Such a switch of tumor cell
      characteristics, if it could occur in SCLC patients, might add to the
      understanding of the steps involved in the spreading of this highly metastatic
      type of lung cancer.

PMID- 11216917
TI  - Epidemiological and molecular aspects of ovarian cancer risk.
AB  - In Western and Northern Europe, as well as in the United States, ovarian cancer
      represents the third most frequent cancer of the female genital tract with an
      estimated 191,000 newly diagnosed cases per year worldwide. Due to its insidious
      onset, the disease is diagnosed in 70% of cases in an advanced stage.
      Consequently, ovarian cancer is the fifth leading cause of cancer-related deaths
      in women. Epidemiological and molecular studies reviewed here have identified
      demographic, geographic, molecular, genetic, endocrine, dietary, and
      environmental factors, which affect the risk of developing ovarian cancer: ethnic
      background, tumor suppressor gene mutations in the germline, positive family
      history, number of full-term pregnancies [odds ratio (OR): 0.17; 95% confidence
      interval (CI): 0.05-0.54], time spent breast feeding, oral contraceptive use [OR:
      0.23; 95% CI: 0.1-0.50], unexplained infertility (OR: 2.64; 95% CI: 1.10-6.35),
      tubal ligation and prior hysterectomy (OR: 0.5; 95% CI: 0.2-0.9), dietary factors
      and obesity (OR: 1.7; 95% CI: 1.1-2.8). This knowledge provides the objective
      basis for an individual risk assessment for women, which should lead to
      sophisticated counseling and prevention. It should also help to individualize the
      therapeutic approach in the event that disease is diagnosed.

PMID- 11216918
TI  - Molecular genetics in acute and chronic leukemias.
AB  - The application of molecular biological techniques in malignant hematologic
      diseases, particularly leukemias, has led to a rapid increase in knowledge and a
      deeper insight into the pathobiology of these diseases. Leukemia is a very
      heterogeneous disease on the molecular level. Clonal chromosomal abnormalities
      can be found in the vast majority of cases. A broader understanding of the
      underlying molecular changes has enabled the development of risk-adapted therapy
      regimens with improved outcome. One example is the application of molecular
      genetic techniques for detecting small numbers of leukemia cells after therapy
      ("minimal residual disease"). This allows the early preclinical recognition and
      prevention of relapse. This study gives a short overview of the current status of
      molecular genetics in human leukemias and its implications for the therapy and
      prognosis of these diseases. The following topics are covered: generation of
      oncogenic fusion genes or dysregulation of protooncogenes by chromosomal
      translocations, detection of minimal residual disease based on clonally
      rearranged immunoglobulin or T-cell receptor genes or on leukemia-specific fusion
      genes, monitoring bone marrow chimerism after allogeneic transplantation by
      molecular genetic techniques, and the role of oncogenic herpesviruses and
      retroviruses in human hematologic malignancies.

PMID- 11216919
TI  - Chemotherapy for malignant brain tumors of astrocytic and oligodendroglial
      lineage.
AB  - To date, surgery and irradiation remain the standard therapies for anaplastic
      astrocytoma (AA, WHO grade III) and glioblastoma multiforme (GBM, WHO grade IV).
      Due to infiltrative tumor growth a complete surgical resection is never achieved
      and more than 90% of the tumors will recur within 2 cm of the primary tumor
      location. Postoperative radiotherapy prolongs survival but is not curative and
      prognosis remains poor with only a few patients being alive 2 years after
      diagnosis. Over the past decades multiple trials dealt with the question of
      whether chemotherapy (CT) may influence the outcome of malignant brain tumor
      patients. In general, the results have been disappointing with one exception:
      chemosensitivity and prolonged survival after CT have been demonstrated for
      tumors of oligodendrogial lineage. Drugs showing some activity in malignant brain
      tumors and therapeutic concepts will be discussed.

PMID- 11216920
TI  - A low dose of ionizing radiation increases luminal release of intestinal
      peptidases in rats.
AB  - PURPOSE: Mucosal inflammation in the small intestine is a potentially hazardous
      side effect of abdominal irradiation. In an effort to develop a quantitative
      method of evaluating mucosal damage, the luminal release of brush border enzymes
      in response to ionizing radiation was examined using two investigational
      strategies. METHODS: First, a 20 cm segment of the proximal jejunum was perfused
      in situ and enzymatic activities within the perfusates were evaluated. In a
      second approach, enzymatic activities were directly evaluated in isolated brush
      border membranes from the jejunal mucosa. RESULTS: Most of the peptidase
      activities measured were increased in the perfusates 1 day after irradiation and
      had returned to control levels at 4 days. In the brush border membranes, some
      enzyme activities decreased at 1 day and were, with the exception of
      leucineaminopeptidase (LAP), similar to control levels at 4 days. CONCLUSIONS:
      LAP is more strongly affected by radiation than the transmembranously bounded
      enzymes.

PMID- 11216921
TI  - Tuberculosis case fatality rates in high HIV prevalence populations in sub
      Saharan Africa.
AB  - BACKGROUND: Tuberculosis is a leading cause worldwide of morbidity and mortality
      among HIV-infected people. The HIV era has seen a dramatic increase of the
      tuberculosis case fatality rate (CFR) in high HIV prevalence populations.
      Providing care for HIV-infected people must include measures to tackle this high
      tuberculosis CFR. AIMS: To analyse the extent of the increased tuberculosis CFR
      in high HIV prevalence populations in sub-Saharan Africa, the reasons for this
      increase and the causes of death, in order to identify possible ways of tackling
      this problem. METHODS: References were obtained by searching the MEDLINE on
      'tuberculosis', 'HIV infection', and 'mortality' (MesH or textword). In addition,
      available data from National Tuberculosis Programme reports were reviewed.
      FINDINGS: Tuberculosis CFR is closely linked to HIV prevalence. Limited autopsy
      data suggest that death from HIV-related diseases other than tuberculosis is
      probably the main reason for the increased CFR in HIV-infected tuberculosis
      patients. Among HIV-infected tuberculosis patients, the higher tuberculosis CFR
      in sputum smear-negative and extrapulmonary than in sputum smear-positive
      tuberculosis cases can also be attributed to misdiagnosis of HIV-related diseases
      as tuberculosis. The adverse effect of the HIV/AIDS epidemic on general health
      service performance probably accounts for the higher tuberculosis CFR among HIV
      negative tuberculosis patients in high prevalence populations than that in low
      HIV-prevalence populations. CONCLUSION: Tackling the problem of the increased
      tuberculosis CFR in high HIV prevalence populations requires collaboration
      between tuberculosis control and HIV/AIDS programmes in implementing measures
      such as improved health services, tuberculosis and HIV control services,
      preventive treatment for HIV-related diseases and anti-HIV treatment.

PMID- 11216922
TI  - Should physicians withhold highly active antiretroviral therapies from HIV-AIDS
      patients who are thought to be poorly adherent to treatment?

PMID- 11216923
TI  - Chemokine/CD4 receptor density ratios correlate with HIV replication in lymph
      node and peripheral blood of HIV-infected individuals.
AB  - OBJECTIVES: Lymphoid tissue is a major reservoir for virus replication in HIV
      infected subjects. The relationship of CCR5 and CXCR4 coreceptor density and HIV
      replication in peripheral blood mononuclear cells (PBMC) and lymph node (LN)
      mononuclear cells (LNMC) of HIV-infected subjects was examined. METHODS: PBMC and
      cervical LNMC from 12 HIV-infected patients were examined for virological and
      immunological parameters including chemokine receptor density, HIV plasma and
      cellular viral load, coreceptor usage and CD38/HLA-DR expression. RESULTS: The
      number of CCR5 and CXCR4 molecules on CD4 lymphocytes in the LN were
      significantly higher than in PBMC. In contrast the number of CD4 molecules/CD4 T
      cell was higher in PBMC than in LNMC. The CXCR4/CD4 and CCR5/CD4 ratios in the LN
      were significantly higher than in the PBMC. This was associated with a cellular
      viral load in the LN that was approximately 110-fold higher than in PBMC. The
      absolute number of coreceptor molecules per cell did not correlate with the viral
      load. However, the CCR5/CD4 and CXCR4/CD4 ratios in the LN positively correlated
      with HIV cellular and plasma RNA. Characterization of the viral isolates
      suggested an association between clinical isolates using a distinct coreceptor
      and the upregulation of the corresponding chemokine receptor. CONCLUSIONS: The
      ratios of chemokine receptors to CD4 molecules in CD4 T cells from LN is higher
      than in PBMC and may account for the relative difference in cellular viral load
      in these compartments. Additionally, the coreceptor/CD4 ratios, particularly in
      the lymphoid tissue, were highly related to HIV replication.

PMID- 11216924
TI  - Novel mutations identified using a comprehensive CCR5-denaturing gradient gel
      electrophoresis assay.
AB  - BACKGROUND: Most mutations detected for the gene for CC chemokine receptor 5
      (CCR5) are either relatively specific to different population groups or rarely
      observed in Africans. OBJECTIVES: To develop a comprehensive mutation detection
      assay for the entire coding region of CCR5 and to identify novel mutations that
      may play a role in genetic susceptibility to HIV-1 infection, within the diverse
      South African population. DESIGN: The study cohort consisted of 103 HIV
      seropositive patients and 146 HIV-seronegative controls of predominantly African
      descent. METHODS: A mutation detection assay for the entire coding region of CCR5
      was designed; this included amplification of part of the coding region of CCR2.
      The assay was based on denaturing gradient gel electrophoresis (DGGE) and allowed
      the complete analysis of samples from 10 individuals per denaturing gel. RESULTS:
      The use of the CCR5-DGGE assay led to the identification of seven novel and six
      previously reported mutations. All novel mutations, including a common
      polymorphism at codon 35, occurred exclusively in non-Caucasians, indicating
      possible African origin. CONCLUSION: A comprehensive DGGE mutation detection
      assay has been developed for the entire coding region of CCR5. Application of
      this assay resulted in the identification of novel CCR5 mutations, which may have
      a significant effect on the normal functioning of CCR5 and thus contribute to
      host variability and susceptibility to HIV-1 infection and/or progression to AIDS
      within this population.

PMID- 11216925
TI  - Protease inhibitor-resistant HIV-1 from patients with preserved CD4 cell counts
      is cytopathic in activated CD4 T lymphocytes.
AB  - OBJECTIVE: To evaluate CD4 T-cell cytopathicity of protease inhibitor (PI)
      resistant isolates from patients with preserved CD4 cell counts after long-term
      virologic failure. METHODS: PI-resistant primary isolates from 14 patients with
      stable or increasing CD4 T-cell counts despite long-term virologic failure during
      continuous combination therapy were examined. Replication and cytopathicity were
      assessed in activated peripheral blood mononuclear cell cultures in the presence
      and absence of PI using titered stocks of primary HIV-1 isolates and during
      initial viral isolation. Also studied were PI-sensitive isolates from four of
      these patients after therapy discontinuation and reversion to PI-sensitive virus
      and from seven antiretroviral drug-naive patients. Coreceptor use, syncytia
      inducing (SI) phenotype and protease sequences were determined by standard
      methods. RESULTS: All isolates obtained during continued therapy showed genetic
      markers of PI resistance and decreased phenotypic susceptibility. PI-resistant SI
      isolates were highly to moderately cytopathic whereas non-syncytia-inducing
      isolates were moderately to weakly cytopathic. PI-susceptible and PI-resistant
      isolates obtained after discontinuation of therapy were equally cytopathic at
      similar replication levels. The cytopathicity of PI-resistant isolates was not
      altered by PI and was similar to that of isolates from untreated subjects.
      CONCLUSIONS: Primary isolates from patients showing virologic rebound without net
      CD4 T-cell loss during continued therapy are as cytopathic as PI-sensitive
      isolates with equivalent input infectious titer. As with PI-sensitive isolates,
      cytopathicity of PI-resistant viruses was determined primarily by coreceptor
      preference. These results suggest that the sustained immunologic response
      observed after failure of PI-containing regimens is not due to the emergence of
      PI-resistant strains that are intrinsically less cytopathic for activated
      peripheral CD4 lymphocytes.

PMID- 11216926
TI  - Reasons for modification and discontinuation of antiretrovirals: results from a
      single treatment centre.
AB  - OBJECTIVE: To describe the reasons for, and factors associated with, modification
      and discontinuation of highly active antiretroviral therapy (HAART) regimens at a
      single clinic. SUBJECTS: A total of 556 patients who started HAART at the Royal
      Free Hospital were included in analyses. Modification was defined as stopping or
      switching any antiretrovirals in the regimen, whereas discontinuation was defined
      as the simultaneous stopping of all antiretrovirals included in the initial
      regimen. Reasons were classified as immunological/virological failure (IVF) and
      toxicities and patient choice/poor compliance (TPC). RESULTS: The median CD4
      count at starting HAART was 171 x 10(6) cells/l and viral load 5.07 log
      copies/ml. During a median follow-up of 14.2 months, 247 patients (44.4%)
      modified their HAART regimen, 72 due to IVF (29.1%) and 159 due to TPC (64.4%)
      and a total of 148 patients (26.6%) discontinued HAART. Older patients were less
      likely to modify HAART [relative hazard (RH), 0.73 per 10 years; P = 0.0008], as
      were previously treatment-naive patients (RH, 0.65; P = 0.0050), those in a
      clinical trial (RH, 0.64; P = 0.027) and those who started nelfinavir (RH, 0.57;
      P = 0.035). Patients who started with four or more drugs (RH, 2.21, P < 0.0001),
      who included ritonavir in the initial regimen (RH, 1.41; P = 0.035) or who had
      higher viral loads during follow-up (RH per log increase, 1.51; P < 0.0001) were
      more likely to modify HAART. CONCLUSIONS: There was a high rate of modification
      and discontinuation of HAART regimens in the first 12 months, particularly due to
      toxicities, patient choice or poor compliance.

PMID- 11216927
TI  - Outcome of patients with HIV-1-related cognitive impairment on highly active
      antiretroviral therapy.
AB  - OBJECTIVE: To examine the impact of highly active antiretroviral therapy (HAART)
      on the outcome of HIV-1-related cognitive impairments using a neuropsychological
      (NP) battery to assess separately the psychomotor, executive function and memory
      fields. DESIGN: A longitudinal study of HIV-1-infected patients based on serial
      NP tests in a Paris University Hospital. METHODS: A group of 91 HIV-1-infected
      patients, of whom 47 were already taking HAART at their first NP examination,
      were initially categorized as cognitively impaired (n = 53) or non-impaired (n =
      38) and underwent one to six serial NP batteries (mean follow-up 12.3+/-8.3
      months). Generalized estimating equations (GEE) were used to evaluate performance
      in a given NP test according to the number of days on HAART. RESULTS: Despite a
      25% mortality rate among patients who had cognitive impairment at their first NP
      examination, GEE showed a positive relationship between the duration of HAART and
      cognitive performance. Performance in psychomotor tests (e.g. Purdue Pegboard
      dominant hand) improved continuously during the study period, while memory test
      performance (e.g. Grober and Buschke free recall) tended to reach a plateau.
      CONCLUSIONS: HAART improves subcortical cognitive functions during the first year
      of treatment. Distinct neuropathological mechanisms appear to underlie
      psychomotor and memory dysfunctions in AIDS.

PMID- 11216928
TI  - The use of and response to second-line protease inhibitor regimens: results from
      the EuroSIDA study.
AB  - OBJECTIVE: To describe the use of second line protease-inhibitor (PI) regimens
      across Europe and to determine factors associated with virological and
      immunological response. DESIGN: Analysis of data from 984 patients with a median
      follow-up of 21 months enrolled in EuroSIDA. Patients started their second PI
      containing regimen at least 16 weeks after starting the first PI-containing
      regimen and with viral load > 1000 copies/ml. METHODS: Virological response was
      defined as a viral load < 500 copies/ml and immunological response as an increase
      of 50 x 10(6)/l or more in CD4 lymphocyte count. RESULTS: The median CD4 cell
      count at starting the second PI was 171 x 10(6) cells/l; viral load was 4.45 log
      copies/ml. As a second PI regimen, 45% were using a dual PI, while of those on
      one PI, indinavir (42%) and nelfinavir (34%) were most common. In multivariate
      Cox models, a higher viral load at starting the second PI [relative hazard (RH),
      0.67 per 1 log higher; 95% confidence interval (CI), 0.58-0.77; P < 0.0001) and a
      lower CD4 cell count (RH, 1.15 per 50% higher; 95% CI, 1.06-1.26; P = 0.0014)
      were associated with a reduced probability of virological response. Those who had
      achieved viral suppression on the first PI-regimen were more likely to respond to
      the second (RH, 1.65; 95% CI, 1.30-2.10; P < 0.0001) as were those who added one
      or two new nucleosides to their second PI. CONCLUSIONS: Patients who initiate a
      second PI regimen at lower viral load, higher CD4 cell count or who added new
      nucleosides tended to be more likely to achieve a viral load < 500 copies/ml. The
      roles of cross-resistance and adherence in response to second-line regimens needs
      further investigation.

PMID- 11216929
TI  - Atovaquone suspension for treatment of Pneumocystis carinii pneumonia in HIV
      infected patients.
AB  - OBJECTIVE: To describe clinical experience with atovaquone suspension for the
      treatment of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients.
      DESIGN: A retrospective chart review. METHODS: The medical records of 54 HIV
      infected patients with PCP treated with atovaquone were examined. The outcomes of
      34 patients treated with atovaquone suspension (750 mg twice a day) were compared
      with those of 20 patients treated with atovaquone tablets (750 mg three times a
      day). RESULTS: The proportion of patients successfully treated was similar with
      the suspension (74%) and tablet (70%) formulations of atovaquone. The proportion
      of patients with an inadequate response to therapy was lower for patients treated
      with atovaquone suspension (15%) than tablets (30%). Both formulations were well
      tolerated. CONCLUSION: Atovaquone suspension is effective and well tolerated for
      the treatment of PCP.

PMID- 11216930
TI  - Long-term effect of preventive therapy for tuberculosis in a cohort of HIV
      infected Zambian adults.
AB  - OBJECTIVE: To determine the long-term effect of preventive therapy (PT) for
      tuberculosis on the rates of tuberculosis, mortality and HIV progression.
      METHODS: In a randomized controlled trial, 1053 HIV-positive Zambian adults
      received isoniazid (H) for 6 months, rifampicin plus pyrazinamide (RZ) for 3
      months, or a placebo. CD4 percentage, neopterin, absolute lymphocyte count and
      haemoglobin were measured from enrolment (absolute CD4 cell counts from 12 months
      after enrolment). Because PT reduced the incidence of tuberculosis, eligible
      placebo subjects were offered H. Here, tuberculosis and mortality rates are
      compared in the three original arms (intention to treat) using data beyond the
      end of the trial (average follow-up 3 years; maximum 7 years). RESULTS: There
      were 102 cases of tuberculosis and 281 deaths (rates 3.6 and 9.0/100 person
      years, respectively). There was no significant difference between the
      tuberculosis rates in the H and RZ groups at any time. The effect of H/RZ on
      tuberculosis diminished over time (P = 0.011) but the cumulative risk of
      tuberculosis in the first 2.5 years was significantly lower in the H/RZ group
      than the placebo group (rate ratio 0.55; 95% confidence interval 0.32-0.93; P =
      0.028). There was no significant effect of PT on mortality or progression
      markers. Tuberculosis was associated with an increased mortality (adjusted rate
      ratio 1.96; 95% confidence interval 1.21-3.18; P = 0.006). CONCLUSIONS: Both PT
      regimens protect against tuberculosis for at least 2.5 years but appear to have
      no effect on HIV progression or mortality. These results may be used in cost
      effectiveness models of PT.

PMID- 11216931
TI  - Herpes zoster and HIV-1 infection in a rural Ugandan cohort.
AB  - OBJECTIVE: To compare the rates and clinical features of herpes zoster in HIV
      positive and HIV-negative individuals in a cohort in rural Uganda; to report the
      incidence of herpes zoster in the HIV-positive group in relation to
      seroconversion and CD4 cell counts and to determine whether it is indicative of a
      more rapid progression to death. DESIGN: A prospective population-based cohort.
      METHODS: The cohort comprised 107 prevalent and 144 incident (with documented
      dates of seroconversion) participants with HIV infection and 231 HIV-negative
      controls who were reviewed routinely every 3 months. RESULTS: The mean rate of
      herpes zoster was 53.6/1000 person-years in HIV-positive and 4.4 in HIV-negative
      participants. The cumulative incidence of a first episode of herpes zoster was
      7.6% at 2 years, 12.6% at 4 years and 24.0% at 6 years after seroconversion; the
      incidence rate was 35.6/1000 person-years. There was no evidence of a significant
      effect of age, gender, period from seroconversion or CD4 cell count on this
      incidence rate. Herpes zoster was an indicator of HIV-1 infection in this
      population but not an indicator of more rapid progression to death after
      adjusting for CD4 cell count and age. CONCLUSIONS: The rates, including the
      cumulative incidence after seroconversion and the clinical presentation of herpes
      zoster, were similar to those reported from industrialized countries. Although an
      indicator of HIV-1 infection in this population, herpes zoster was unrelated to
      CD4 cell count or period from seroconversion and did not lead to a faster disease
      progression.

PMID- 11216932
TI  - Lipodystrophy-associated morphological, cholesterol and triglyceride
      abnormalities in a population-based HIV/AIDS treatment database.
AB  - OBJECTIVE: To provide population-based estimates of the prevalence of
      lipodystrophy syndrome and constituent symptoms and to identify correlates of
      prevalent symptomology. METHODS: Participants in a province-wide HIV/AIDS
      treatment programme reported morphological and metabolic abnormalities. Probable
      lipodystrophy was defined as self-report of at least one morphological
      abnormality or both high cholesterol and triglyceride levels. Explanatory
      variables investigated included: age; sex; ethnicity; transmission risk group;
      CD4 cell count; plasma viral load; AIDS diagnosis; duration of infection;
      alternative therapy use; past, current and duration of use of antiretroviral
      therapy (ART) by class and specific drug; total duration of ART; and current
      adherence. Stepwise logistic regression identified possible determinates of
      lipodystrophy. RESULTS: Of 1035 participants, 50% appeared to have probable
      lipodystrophy, with 36% reporting peripheral wasting, 33% abdominal weight gain,
      6% buffalo hump, and 10 and 12% increased triglyceride or cholesterol levels,
      respectively. In multivariate analysis, lipodystrophy was associated with older
      age (per year) (AOR 1.03; 95% CI 1.01, 1.04), the use of ingested alternative
      therapies (AOR 1.46; 95% CI 1.06, 2.01), having ever used protease inhibitors
      (PI) (AOR 2.63; 95% CI 1.89, 3.66), and duration of stavudine treatment (per
      year) (AOR 1.35; 95% CI 1.15, 1.58). In analysis limited to participants exposed
      to PI, after similar adjustment, the duration of lamivudine rather than stavudine
      treatment was associated with lipodystrophy (AOR 1.32; 95% CI 1.13, 1.53).
      CONCLUSION: Increased risk of abnormalities is associated with the use of PI, and
      the duration of stavudine and lamivudine treatment after adjustment for personal
      characteristics, clinical disease stage, duration of infection and detailed
      treatment history.

PMID- 11216933
TI  - Tolerance of efavirenz in children.
AB  - OBJECTIVE: To extend the limited knowledge of efavirenz tolerance in children.
      METHOD: An observational study of 33 children given efavirenz combined with
      various others agents and followed in a single institution. RESULTS: Fifteen
      (42%) of the children presented at least one clinically discernable side effect,
      cutaneous (n = 5), nervous system (n = 10), or both (n = 2). Intolerance led to
      treatment interruption in seven children but the main symptom was transitory
      dizziness or other signs similar to those observed in adults. CONCLUSION: Early,
      often transient nervous system side effects require careful preparation with the
      child and his family to avoid premature and inadequate withdrawal from treatment.

PMID- 11216934
TI  - An evaluation of a thicker versus a standard condom with gay men.
AB  - OBJECTIVES: Although thicker (stronger) condoms are advocated in western Europe
      for anal intercourse between men, empirical evidence supporting their greater
      efficacy is lacking. The present study aimed to determine whether a thicker
      condom is less likely to fail (break or slip off) than a standard (regular
      thickness) condom, and to establish factors associated with condom failure among
      gay men. DESIGN: A total of 283 homosexual couples participated in a double
      blind, randomized, controlled trial of a standard and a thicker condom. METHODS:
      Each couple was allocated nine of either condom type. Data were collected on user
      characteristics, and a questionnaire completed immediately after the use of each
      condom. The thicker and the standard condoms were used by 142 and 141 couples,
      respectively. RESULTS: No significant differences were found between the two
      condom types with respect to either clinical or non-clinical definitions of
      failure (breakage and slippage). With instances of inappropriate use removed,
      failure rates for the standard and the thicker condom were low at 2.5 and 2.3%,
      respectively. User characteristics associated with breakage were lower
      educational achievement, lack of confidence in condom use, and a history of
      condom breakage. Behaviours associated with breakage were unrolling the condom
      before fitting to the penis, longer penis length, absence of additional
      lubricant, the use of inappropriate lubricant, and longer duration of
      intercourse. CONCLUSION: Breakage and slippage rates were low for both condom
      types. There is no evidence from the present investigation to support the use of
      stronger (thicker) condoms over standard strength condoms among gay men. The
      appropriate use of additional lubricant should be encouraged.

PMID- 11216935
TI  - Cytomegalovirus seroconversion as a cofactor for progression to AIDS.
AB  - OBJECTIVE: To study the impact of cytomegalovirus (CMV) seroconversion on HIV-1
      disease progression. DESIGN: Follow-up of CMV-seronegative subjects enrolled in
      the French SEROCO/HEMOCO cohorts of HIV-infected subjects. METHODS: A total of
      290 subjects were CMV-seronegative at enrolment in the cohort. Serological
      testing for CMV infection was done at enrolment and then every 6 months in CMV
      seronegative subjects. The person-years method was used to calculate the
      incidence of CMV seroconversion. After adjustment for age, the CD4+ cell count at
      enrolment and the HIV exposure group in a Cox model, we studied CMV
      seroconversion as a time-dependent variable in progression to a CD4+ cell count
      below 200 x 10(6) cells/l and to clinical AIDS. RESULTS: Overall, 61 CMV
      seroconversions were observed. The overall incidence rate was 4.4 per 100 person
      years [95% confidence interval (CI), 3.3-5.5]. The risk of progression to a CD4+
      cell count below 200 x 10(6) cells/l was not increased in CMV seroconverters.
      However, the risk of progression to AIDS was increased two-fold in CMV
      seroconverters compared with subjects who remained CMV-seronegative [relative
      risk (RR) = 2.09; 95% CI, 1.16-3.74; P = 0.01]. CONCLUSION: This analysis of 61
      CMV seroconversions, the largest study in the literature, confirms the impact of
      recent CMV infection on progression to AIDS.

PMID- 11216937
TI  - Latex condoms, human behavior, and public health.

PMID- 11216936
TI  - Using phylogenetic analysis to trace HIV-1 migration among western European
      injecting drug users seroconverting from 1984 to 1997.
AB  - OBJECTIVE: To reconstruct the epidemiological relationships of the HIV epidemics
      among injecting drug users (IDU) in western Europe. METHODS: HIV env V3 sequences
      of and epidemiological data were obtained from 145 IDU who seroconverted in three
      sequential periods: 1984-1988, 1989-1992 and 1993-1997. The sequences were
      phylogenetically analysed and examined for signature patterns characteristic of
      northern European IDU, including the conserved GGC codon in the V3 loop. RESULTS:
      Subpopulations of genetically related HIV strains were observed in Italy, France,
      Scotland and Spain, in contrast to the Netherlands, Austria and Switzerland. This
      difference between the two groups of countries suggests that the HIV epidemics
      amongst IDU in the latter group was caused by multiple virus introductions. In
      Edinburgh and the surrounding area, most IDU were infected with the same GGC
      strain over the 12-year study period. The epidemic among IDU in north-western
      Europe started with GGC viruses, whereas in south-western Europe non-GGC viruses
      predominated. This geographical separation has faded during the course of the
      epidemic, most likely because of virus exchange among IDU populations.

PMID- 11216938
TI  - The HIV-associated lipodystrophy syndrome: research, results, yet more questions.

PMID- 11216939
TI  - Treatment interruption after one year of triple nucleoside analogue therapy for
      primary HIV infection.

PMID- 11216940
TI  - Need for increased dose of warfarin in HIV patients taking nevirapine.

PMID- 11216941
TI  - Equivalent osteopenia in HIV-infected individuals studied before and during the
      era of highly active antiretroviral therapy.

PMID- 11216943
TI  - Incidence of clinical lipodystrophy in HIV-infected patients treated during
      primary infection.

PMID- 11216942
TI  - Long-term remission of an AIDS-related primary effusion lymphoma with antiviral
      therapy.

PMID- 11216944
TI  - Compartmentalization of HIV-1 according to antiretroviral therapy: viral loads
      are correlated in blood and semen but poorly in blood and saliva.

PMID- 11216945
TI  - The role of social marketing in sexually transmitted diseases/HIV protection in
      4600 sexual contacts in urban Zimbabwe.

PMID- 11216946
TI  - Severe anaphylactic shock after rechallenge with abacavir without preceding
      hypersensitivity.

PMID- 11216947
TI  - Are 'buffalo hump' syndrome, Madelung's disease and multiple symmetrical
      lipomatosis variants of the same dysmetabolism?

PMID- 11216948
TI  - Liver transplantation for an HIV-positive patient in the era of highly active
      antiretroviral therapy.

PMID- 11216949
TI  - Epidemiology and natural history of atrial fibrillation: clinical implications.
AB  - With a substantial impact on morbidity and mortality, the growing "epidemic" of
      atrial fibrillation (AF) intersects with a number of conditions, including aging,
      thromboembolism, hemorrhage, hypertension and left ventricular dysfunction.
      Currently, the epidemiology and natural history of AF govern all aspects of its
      clinical management. The ongoing global investigative efforts toward
      understanding AF are also driven by epidemiologic findings. New developments, by
      affecting the natural history of the disease, could eventually alter the nature
      of decision making in patients with AF. The crucial issue of rate versus rhythm
      control awaits completion of the AF Follow-up Investigation of Rhythm Management
      trial. The processes of electrical and structural remodeling that perpetuate AF
      appear to be reversible. In the era of functional genomics, the molecular basis
      of this ubiquitous arrhythmia is in the process of being defined. Unraveling the
      molecular genetics of AF might provide new insights into the structural and
      electrical phenotypes resulting from genetic mutations and, as such, new
      approaches to treatment of this arrhythmia at the ion channel and cellular
      levels. Thus, current adverse trends are superimposed on a background of a
      rapidly developing knowledge base and potentially exciting new therapeutic
      options. Consequently, an understanding of the epidemiology and natural history
      of AF is crucial to the future allocation of resources and the utilization of an
      expanding range of therapies aimed at reducing the impact of this disease on a
      changing patient population.

PMID- 11216950
TI  - Utility of B-type natriuretic peptide in the diagnosis of congestive heart
      failure in an urgent-care setting.
AB  - OBJECTIVES: The goal of this study was to evaluate the utility of a rapid
      "bedside" technique for measurement of B-type natriuretic peptide (BNP) in the
      diagnosis of congestive heart failure (CHF) in an urgent-care setting.
      BACKGROUND: B-type natriuretic peptide is a protein secreted from the cardiac
      ventricles in response to pressure overload. One potential application of
      measurements of BNP in blood is distinguishing dyspnea due to CHF from other
      causes. METHODS: B-type natriuretic peptide concentrations were measured in a
      convenience sample of 250 predominantly male (94%) patients presenting to urgent
      care and emergency departments of an academic Veteran's Affairs hospital with
      dyspnea. Results were withheld from clinicians. Two cardiologists retrospectively
      reviewed clinical data (blinded to BNP measurements) and reached a consensus
      opinion on the cause of the patient's symptoms. This gold standard was used to
      evaluate the diagnostic performance of the BNP test. RESULTS: The mean BNP
      concentration in the blood of patients with CHF (n = 97) was higher than it was
      in patients without (1,076 +/- 138 pg/ml vs. 38 +/- 4 pg/ml, p < 0.001). At a
      blood concentration of 80 pg/ml, BNP was an accurate predictor of the presence of
      CHF (95%); measurements less than this had a high negative predictive value
      (98%). The overall C-statistic was 0.97. In multivariate analysis, BNP
      measurements added significant, independent explanatory power to other clinical
      variables in models predicting which patients had CHF. The availability of BNP
      measurements could have potentially corrected 29 of the 30 diagnoses missed by
      urgent-care physicians. CONCLUSIONS: B-type natriuretic peptide blood
      concentration measurement appears to be a sensitive and specific test to diagnose
      CHF in urgent-care settings.

PMID- 11216951
TI  - A rapid bedside test for B-type peptide predicts treatment outcomes in patients
      admitted for decompensated heart failure: a pilot study.
AB  - OBJECTIVES: The goal of this study was to determine if B-type natriuretic peptide
      (BNP) levels predict outcomes of patients admitted with decompensated heart
      failure. BACKGROUND: Treatment of decompensated congestive heart failure (CHF)
      has often been based on titration of drugs to relieve patient's symptoms, a case
      that could be made for attempting to also treat neurohormonal abnormalities.
      Because BNP reflects both elevated left ventricular pressure as well as
      neurohormonal modulation, we hypothesized that BNP might be useful in assessing
      outcomes in patients admitted with decompensated CHF. METHODS: We followed 72
      patients admitted with decompensated New York Heart Association class III to IV
      CHF, measuring daily BNP levels. We then determined the association between
      initial BNP measurement and the predischarge or premoribund BNP measurement and
      subsequent adverse outcomes (death and 30-day readmission). RESULTS: Of the 72
      patients admitted with decompensated CHF, 22 end points occurred (death: n = 13,
      readmission: n = 9). In these patients, BNP levels increased during
      hospitalization (mean increase, 233 pg/ml, p < 0.001). In patients without end
      points, BNP decreased (mean decrease 215 pg/ml). Univariate analysis revealed
      that the last measured BNP was strongly associated with the combined end point.
      In patients surviving hospitalization, BNP discharge concentrations were strong
      predictors of subsequent readmission (area under the receiver operator curve of
      0.73). CONCLUSIONS: In patients admitted with decompensated CHF, changes in BNP
      levels during treatment are strong predictors for mortality and early
      readmission. The results suggest that BNP levels might be used successfully to
      guide treatment of patients admitted for decompensated CHF.

PMID- 11216952
TI  - Endothelial dysfunction in patients with chronic heart failure: systemic effects
      of lower-limb exercise training.
AB  - OBJECTIVES: We sought to analyze the systemic effects of lower-limb exercise
      training (ET) on radial artery endothelial function in patients with chronic
      heart failure (CHF). BACKGROUND: Local ET has the potential to improve local
      endothelial dysfunction in patients with CHF. However, it remains unclear whether
      the systemic effects can be achieved by local ET. METHODS: Twenty-two male
      patients with CHF were prospectively randomized to either ET on a bicycle
      ergometer (ET group, n = 11; left ventricular ejection fraction [LVEF] 26 +/- 3%)
      or an inactive control group (group C, n = 11; LVEF 24 +/- 2%). At the beginning
      of the study and after four weeks, endothelium-dependent and -independent
      vasodilation of the radial artery was determined by intra-arterial infusion of
      acetylcholine (ACh-7.5, 15 and 30 microg/min) and nitroglycerin (0.2 mg/min). The
      mean internal diameter (ID) of the radial artery was assessed using a high
      resolution ultrasound system (NIUS-02, Asulab Research Laboratories, Neuchatel,
      Switzerland) with a 10-MHz probe. RESULTS: After four weeks of ET, patients
      showed a significant increase in the baseline-corrected mean ID in response to
      ACh (30 microg/min), from 33 +/- 10 to 127 +/- 25 microm (p < 0.001 vs. control
      group at four weeks). In the control group, the response to ACh (30 microg/min)
      remained unchanged. Endothelium-independent vasodilation was similar in both
      groups at the beginning of the study and at four weeks. In the training group,
      increases in agonist-mediated, endothelium-dependent vasodilation correlated to
      changes in functional work capacity (r = 0.63, p < 0.05). CONCLUSIONS: In
      patients with stable CHF, bicycle ergometer ET leads to a correction of
      endothelial dysfunction of the upper extremity, indicating a systemic effect of
      local ET on endothelial function.

PMID- 11216953
TI  - Modulation of alveolar-capillary sodium handling as a mechanism of protection of
      gas transfer by enalapril, and not by losartan, in chronic heart failure.
AB  - OBJECTIVES: We sought to compare the protective efficacy of enalapril and
      losartan on lung diffusion in chronic heart failure (CHF). BACKGROUND: In CHF,
      hydrostatic overload causes disruption of the alveolar-capillary membrane and
      depression of carbon monoxide diffusion (DCO); enalapril improves DCO through
      mechanisms still undefined; and saline infusion in the pulmonary circulation
      worsens DCO, putatively because of an upregulated sodium transport to the
      alveolar interstitium. We investigated whether enalapril modulates sodium
      handling and whether losartan shares the same properties. METHODS: In 29 patients
      with CHF, DCO, its membrane diffusion subcomponent (DM) and right atrial and
      pulmonary wedge pressures were monitored during saline infusion, in the control
      condition, during enalapril therapy (20 mg/day) for two weeks and after crossover
      to losartan (50 mg/day) for two weeks (first 20 patients), or after the
      combination of enalapril with aspirin (325 mg/day) for one week (last 9
      patients). RESULTS: Saline, 150 ml, lowered DCO (-7.9%; p < 0.01) and DM (-9.9%;
      p < 0.01) without hydrostatic variations. Responses to 750 ml of saline were
      qualitatively similar. After treatment with enalapril, baseline DCO (p < 0.01)
      and DM (p < 0.01) were augmented; after sodium loading, the percent reductions of
      DCO (p < 0.01) and DM (p < 0.01) were comparable to those before it, resulting in
      higher absolute values. This suggests that the greater the gas conductance
      improvement with enalapril, the lower the impedance with saline. Losartan was
      ineffective on gas transfer at rest and under salt challenge. Aspirin
      counteracted the benefits of enalapril. CONCLUSIONS: In CHF, enalapril protects
      lung diffusion, possibly through a prostaglandin-mediated modulation of sodium
      overfiltration to the alveolar interstitium; losartan does not share this
      ability.

PMID- 11216954
TI  - Dilated cardiomyopathy in dialysis patients--beneficial effects of carvedilol: a
      double-blind, placebo-controlled trial.
AB  - OBJECTIVES: The aim of this study was to investigate in dialysis patients with
      symptomatic heart failure New York Heart Association (NYHA) functional class II
      or III whether the addition of carvedilol to conventional therapy is associated
      with beneficial effects on cardiac architecture, function and clinical status.
      BACKGROUND: Congestive heart failure (CHF) in chronic hemodialyzed patients,
      particularly when associated with dilated cardiomyopathy, represents an ominous
      complication and is an independent risk factor for cardiac mortality. METHODS: We
      enrolled 114 dialysis patients with dilated cardiomyopathy. All patients were
      treated with carvedilol for 12 months in a double-blind, placebo-controlled,
      randomized trial. The patients underwent M-mode and two-dimensional
      echocardiography at baseline, 1, 6 and 12 months after the randomization. Each
      patient's clinical status was assessed using an NYHA functional classification
      that was determined after 6 and 12 months of treatment. RESULTS: Carvedilol
      treatment improved left ventricular (LV) function. In the active-treatment group,
      the increase in LV ejection fraction (from 26.3% to 34.8%, p < 0.05 vs. basal and
      placebo group) and the reduction of both LV end-diastolic volume (from 100 ml/m2
      to 94 ml/m2, p < 0.05 vs. basal and placebo group) and end-systolic volume (from
      74 ml/m2 to 62 ml/m2, p < 0.05 vs. basal and placebo group) reached statistical
      significance after six months of therapy, compared with baseline and
      corresponding placebo values, and they remained constant at one year of treatment
      (p < 0.05 vs. basal and placebo group). The clinical status of patients, assessed
      by NYHA functional classification, improved during the treatment period.
      Moreover, at the end of the trial, there were no patients in NYHA functional
      class IV in the carvedilol group, compared with 5.9% of the patients in the
      placebo arm. CONCLUSIONS: One year of therapy with carvedilol in dialysis
      patients with CHF and dilated cardiomyopathy reduces LV volumes and improves LV
      function and clinical status.

PMID- 11216955
TI  - Effect of beta-blockers on circulating levels of inflammatory and anti
      inflammatory cytokines in patients with dilated cardiomyopathy.
AB  - OBJECTIVES: This study was designed to evaluate the beneficial effect of beta
      blockers on circulating cytokine levels in patients with dilated cardiomyopathy
      (DCM). BACKGROUND: Elevated circulating levels of inflammatory cytokines have
      been reported in patients with DCM. However, alterations of the levels of
      inflammatory and anti-inflammatory cytokines in association with beta-blocker
      therapy are unknown. METHODS: We studied 32 patients with idiopathic DCM who had
      been treated with digitalis, diuretics and angiotensin-converting enzyme
      inhibitors. In addition to this combination therapy, beta-blockers were started
      in all patients. Serum levels of interleukin (IL)-10, tumor necrosis factor-alpha
      (TNF-alpha) and soluble TNF receptors (sTNF-R1 and R2) were measured at baseline
      and 12 weeks after the initiation of beta-blocker therapy. We also measured
      plasma levels of neurohumoral factors, as well as left ventricular (LV) size and
      function. Ten age-matched subjects with no cardiac disease served as the control
      group. RESULTS: Baseline levels of IL-10, TNF-alpha and sTNF-R2 were
      significantly higher in patients with DCM than in control subjects (p < 0.05).
      There was a significant positive correlation between IL-10 and TNF-alpha levels
      (r = 0.545, p = 0.029). The TNF-alpha/IL-10 ratio correlated well with plasma
      epinephrine levels (r = 0.677, p = 0.025), and the level of sTNF-R2 was closely
      related to LV size. Serum levels of IL-10, TNF-alpha and sTNF-R2 were
      significantly decreased during beta-blocker therapy (p < 0.005). CONCLUSIONS: Our
      findings indicate that beta-blockers have an important immunoregulatory role in
      modifying the dysregulated cytokine network in DCM. This effect of beta-blockers
      may be partly responsible for the efficacy of therapeutic drugs for heart
      failure.

PMID- 11216956
TI  - Autoantibodies against the second extracellular loop of beta1-adrenergic
      receptors predict ventricular tachycardia and sudden death in patients with
      idiopathic dilated cardiomyopathy.
AB  - OBJECTIVES: We sought to define the clinical and long-term prognostic
      implications of autoantibodies that act against the second extracellular loop of
      beta1-adrenergic receptors (ARs) in patients with idiopathic dilated
      cardiomyopathy (IDC). BACKGROUND: Although autoantibodies directed against
      various domains of beta-ARs are found in patients with IDC, only a subgroup
      against the second extracellular domain of beta1-ARs exerts intrinsic
      sympathomimetic-like actions on human beta-ARs. It is suggested that the
      autoantibodies take part in the pathophysiology of IDC and may affect long-term
      prognosis of patients with this disorder. METHODS: Sera from 104 patients with
      IDC were screened for autoantibodies that act against the second extracellular
      loop of beta1-ARs by enzyme-linked immunosorbent assay, using a synthetic peptide
      corresponding to the domain. Relations of the autoantibodies to clinical
      variables and long-term prognosis were assessed by multivariate analysis.
      RESULTS: Autoantibodies were detected in 40 patients (38%). Multifocal
      ventricular premature contractions (p < 0.01) and ventricular tachycardia (VT; p
      < 0.01) were more common in autoantibody-positive than in autoantibody-negative
      patients, although no differences in cardiac function or neurohormonal levels
      were demonstrated. The presence of autoantibodies (p = 0.001) and a low left
      ventricular ejection fraction (LVEF <30%; p = 0.02) were independent predictors
      of VT. Sudden death was independently predicted by the presence of autoantibodies
      (p = 0.03), as well as by LVEF <30% (p = 0.01), whereas total mortality was
      predicted only by LVEF <30% (p = 0.001). CONCLUSIONS: Autoantibodies directed
      against the second extracellular loop of beta1-ARs were closely related to
      serious ventricular arrhythmias in patients with IDC, and the presence of
      autoantibodies independently predicted sudden death. These autoantibodies may
      contribute to electrical instability in patients with IDC.

PMID- 11216957
TI  - Estrogen-induced small low density lipoprotein particles may be atherogenic in
      postmenopausal women.
AB  - OBJECTIVES: The purpose of this study was to investigate the susceptibility of
      estrogen-induced small low density lipoprotein (LDL) particles to oxidation.
      BACKGROUND: Estrogen replacement therapy in postmenopausal women has an
      antioxidant effect that opposes oxidation of LDL particles. Estrogen-induced
      increases in plasma triglyceride concentrations, however, decrease LDL particle
      size, which may act counter to this antioxdant effect. It has not been evaluated
      whether estrogen-induced small LDL particles are atherogenic. METHODS: In 24 lean
      and healthy postmenopausal women treated with conjugated equine estrogen (0.625
      mg daily) for three months, plasma lipid concentrations and diameter of LDL
      particles were measured before and after therapy. Susceptibility of LDL to
      oxidation was determined by measuring the concentration of thiobarbituric acid
      reactive substances (TBARS) after incubation with CuSO4. RESULTS: Estrogen
      significantly decreased plasma concentrations of total cholesterol, LDL
      cholesterol and apolipoprotein B, while increasing concentrations of
      triglyceride, high-density lipoprotein cholesterol and apolipoprotein A-I.
      Estrogen-induced changes in LDL particle diameter correlated negatively with
      changes in plasma triglyceride concentrations (r = -0.55, p < 0.005) and with
      changes in concentrations of LDL-derived TBARS (r = -0.49, p < 0.005). In
      subjects with substantial estrogen-induced plasma triglyceride increases,
      estrogen significantly reduced the diameter of LDL particles (p < 0.05) and
      significantly increased the concentration of LDL-derived TBARS (p < 0.05). In
      contrast, estrogen significantly reduced the concentration of LDL-derived TBARS
      (p < 0.05) and caused no significant change in LDL particle diameter in subjects
      whose plasma triglyceride concentration was unchanged with estrogen therapy.
      CONCLUSIONS: Because estrogen-induced plasma triglyceride increases may produce
      small LDL particles that are more susceptible to oxidation, antioxidant effects
      of estrogen might be offset in patients showing such a triglyceride increase.

PMID- 11216958
TI  - Estrogens, lipids and cardiovascular disease: no easy answers.

PMID- 11216959
TI  - Lipoprotein(a) further increases the risk of coronary events in men with high
      global cardiovascular risk.
AB  - OBJECTIVES: This prospective population study was conducted to assess the role of
      elevated lipoprotein(a) [Lp(a)] as a coronary risk factor. BACKGROUND: The role
      of elevated Lp(a) as a risk factor for coronary heart disease is controversial.
      In addition, little attention has been paid to the interaction of Lp(a) with
      other risk factors. METHODS: A total of 788 male participants of the Prospective
      Cardiovascular Munster (PROCAM) study aged 35 to 65 years were followed for 10
      years. Both Lp(a) and traditional cardiovascular risk factors (e.g., age, low
      density lipoprotein [LDL] cholesterol, high density lipoprotein [HDL]
      cholesterol, triglycerides, systolic blood pressure, cigarette smoking, diabetes
      mellitus, angina pectoris, and family history of myocardial infarction) were
      evaluated in 44 men who suffered from myocardial infarction, and in 744 men who
      survived without major coronary events or stroke. A multiple logistic function
      algorithm was used to estimate global cardiovascular risk by the combined effects
      of traditional risk factors. RESULTS: Overall, the risk of a coronary event in
      men with an Lp(a) > or =0.2 g/liter was 2.7 times that of men with lower levels
      (95% confidence interval [CI]: 1.4 to 5.2). This increase in risk was most
      prominent in men with LDL cholesterol level > or =4.1 mmol/liter (relative risk
      [RR]: 2.6; 95% CI: 1.2 to 5.7), with HDL cholesterol < or =0.9 mmol/liter (RR
      8.3; 95% CI: 2.0 to 35.5), with hypertension (RR 3.2; 95% CI: 1.4 to 7.2), or
      within the two highest global risk quintiles (relative risk: 2.7; 95% CI: 1.3 to
      5.7). CONCLUSIONS: Lp(a) increases the coronary risk, especially in men with high
      LDL cholesterol, low HDL cholesterol, hypertension and/or high global
      cardiovascular risk.

PMID- 11216960
TI  - Irbesartan, an angiotensin type 1 receptor inhibitor, regulates markers of
      inflammation in patients with premature atherosclerosis.
AB  - OBJECTIVES: This study assessed the role of angiotensin II type 1 (AT1) receptor
      antagonists on inflammatory mechanisms involved in atherogenesis. Specific
      inflammatory markers included solubilized tumor necrosis factor-alpha receptor II
      (sTNF-alphaRII), vascular cell adhesion molecule-1 (VCAM-1) and superoxide. In
      addition, the AT1 receptor blocker irbesartan was evaluated for its ability to
      suppress these markers in individuals with atherosclerosis. BACKGROUND:
      Mechanisms involved in the complex process of atherogenesis include alterations
      in the inflammatory responses. The use of compounds that suppress these responses
      may reduce the degree of damage seen in atherosclerosis. METHODS: With a cross
      sectional study design, 33 normotensive patients with stable coronary artery
      disease (CAD) were treated with irbesartan for a 24-week period. These patients
      were compared against a control population with no known coronary
      atherosclerosis. Marker levels were measured by enzyme-linked immunosorbent assay
      technique and lucigenin chemiluminescence assay and statistically evaluated by
      two-way repeated measures analysis of variance. RESULTS: All patients with
      coronary artery disease had increased levels of inflammatory molecules over those
      of control patients. Treatment with irbesartan in these patients significantly
      reduced levels of inflammatory molecules measured. Soluble VCAM-1 levels were
      reduced by 36%; soluble TNF-alpha levels were reduced by 54% and superoxide level
      decreased by 52%. Maximal suppression of inflammatory markers by irbesartan
      therapy in patients with CAD was seen at 12 weeks. CONCLUSIONS: The effect of
      irbesartan on each inflammatory marker is significant. Our results show that use
      of irbesartan may retard the inflammatory process seen in premature forms of
      atherosclerosis.

PMID- 11216961
TI  - Periodontal disease and risk of subsequent cardiovascular disease in U.S. male
      physicians.
AB  - OBJECTIVES: We sought to prospectively assess whether self-reported periodontal
      disease is associated with subsequent risk of cardiovascular disease in a large
      population of male physicians. BACKGROUND: Periodontal disease, the result of a
      complex interplay of bacterial infection and chronic inflammation, has been
      suggested to be a predictor of cardiovascular disease. METHODS: Physicians'
      Health Study I was a randomized, double-blind, placebo-controlled trial of
      aspirin and beta-carotene in 22,071 U.S. male physicians. A total of 22,037
      physicians provided self-reports of presence or absence of periodontal disease at
      study entry and were included in this analysis. RESULTS: A total of 2,653
      physicians reported a personal history of periodontal disease at baseline. During
      an average of 12.3 years of follow-up, there were 797 nonfatal myocardial
      infarctions, 631 nonfatal strokes and 614 cardiovascular deaths. Thus, for each
      end point, the study had >90% power to detect a clinically important increased
      risk of 50%. In Cox proportional hazards regression analysis adjusted for age and
      treatment assignment, physicians who reported periodontal disease at baseline had
      slightly elevated, but statistically nonsignificant, relative risks (RR) of
      nonfatal myocardial infarction, (RR, 1.12; 95% confidence interval [CI], 0.92 to
      1.36), nonfatal stroke (RR, 1.10; CI, 0.88 to 1.37) and cardiovascular death (RR,
      1.20; CI, 0.97 to 1.49). Relative risk for a combined end point of all important
      cardiovascular events (first occurrence of nonfatal myocardial infarction,
      nonfatal stroke or cardiovascular death) was 1.13 (CI, 0.99 to 1.28). After
      adjustment for other cardiovascular risk factors, RRs were all attenuated and
      nonsignificant. CONCLUSIONS: These prospective data suggest that self-reported
      periodontal disease is not an independent predictor of subsequent cardiovascular
      disease in middle-aged to elderly men.

PMID- 11216962
TI  - Correlation of coronary calcification and angiographically documented stenoses in
      patients with suspected coronary artery disease: results of 1,764 patients.
AB  - OBJECTIVES: This study correlated the electron beam computed tomographic (EBCT)
      calcium scores with the results of coronary angiography in symptomatic patients
      in order to assess its value to predict or exclude significant coronary artery
      disease (CAD). BACKGROUND: Electron beam computed tomography is a sensitive
      method to detect coronary calcium. However, it is unclear whether it may play a
      role as a filter before invasive procedures in symptomatic patients. METHODS: A
      total of 1,764 patients (1,225 men and 539 women) with suspected CAD from a
      single center were included in our study. All patients underwent calcium
      screening with EBCT (C150XP Imatron) and conventional coronary angiography.
      RESULTS: Fifty-six percent of men and 47% of women revealed significant coronary
      stenoses (> or =50%). Total exclusion of coronary calcium (14% of the study
      group) was associated with an extremely low probability of stenosis (<1%). With
      calcium scores > or =20th, > or =100th or > or =75th percentile of age groups,
      the sensitivity to detect stenoses decreased to 97%, 93% and 81%, respectively,
      in men and to 98%, 82% and 76%, respectively, in women. At the same time, the
      specificity increased up to 77% in men and women. There was a significant
      difference in coronary calcium between men and women in all age groups; however,
      receiver-operating characteristic curves indicated that the test can be performed
      with equal accuracy in all of these subgroups. CONCLUSIONS: Calcium screening
      with EBCT is a highly sensitive and moderately specific test to predict stenotic
      disease. Exclusion of coronary calcium defines a substantial subgroup of
      patients, albeit symptomatic, with a very low probability of significant
      stenoses.

PMID- 11216963
TI  - Enhanced detection of reversible perfusion defects by Tc-99m sestamibi compared
      to Tc-99m tetrofosmin during vasodilator stress SPECT imaging in mild-to-moderate
      coronary artery disease.
AB  - OBJECTIVES: We prospectively compared dipyridamole single-photon emission
      computed tomography (SPECT) imaging with Tc-99m sestamibi and Tc-99m tetrofosmin
      for the detection of reversible perfusion defects in patients with mild-to
      moderate coronary artery disease. BACKGROUND: Tc-99m tetrofosmin has a lower
      first-pass myocardial extraction fraction compared to Tc-99m sestamibi and thus
      could underestimate mild perfusion defects. METHODS: Eighty-one patients with 50%
      to 90% stenosis in one or two major epicardial vessels without previous
      myocardial infarction, and seven with <5% probability of coronary artery disease
      underwent dipyridamole SPECT imaging with both agents. The SPECT data were
      analyzed quantitatively. RESULTS: Tc-99m sestamibi detected reversible perfusion
      defects in a greater number of segments (total 363 and 285, p < 0.001, and mean
      +/- SD, 2.2 +/- 3.0 and 1.8 +/- 2.5 per patient, p = 0.008, for Tc-99m sestamibi
      and Tc-99m tetrofosmin, respectively), demonstrated a larger extent of perfusion
      defect (mean +/- SD, 15.8% +/- 12.3% and 12.0% +/- 11.4%, p < 0.03, for Tc-99m
      sestamibi and Tc-99m tetrofosmin, respectively) and more often correctly
      identified patients with disease in more than one coronary artery (p = 0.02).
      There was better defect contrast with Tc-99m sestamibi (defect/normal wall count
      ratios were 0.60 +/- 0.15 vs. 0.73 +/- 0.14 for Tc-99m sestamibi and Tc99m
      tetrofosmin, respectively, p = 0.01, for reversible defects seen in identical
      segments with both agents; and 0.73 +/- 0.16 vs 0.79 +/- 0.17, respectively, p
      <0.01, for reversible defects detected with either agent alone). There was no
      significant difference in diagnostic sensitivity or image quality. CONCLUSIONS:
      These differences between two commonly used tracers may have significant
      diagnostic and prognostic implications.

PMID- 11216964
TI  - Myocardial perfusion imaging findings and the role of adenosine in the warm-up
      angina phenomenon.
AB  - OBJECTIVES: This study examined the roles of myocardial perfusion and adenosine
      in warm-up angina. BACKGROUND: In warm-up angina, neither the role of an
      adenosine-mediated mechanism, as is found in experimental ischemic
      preconditioning, nor of increased myocardial perfusion is well defined. METHODS:
      In substudy A, a single-photon emission computed tomography (SPECT)-thallium-201
      exercise test was performed by 12 subjects with ischemic heart disease on three
      occasions one week apart. The third test was preceded by a warm-up test. The
      extent of the thallium deficit and its intensity on the third test were compared
      with the baseline tests controlling for the heart rate-systolic blood pressure
      product (RPP) at thallium injection. In substudy B, 12 similar subjects did two
      successive exercise tests at two separate sessions and received the adenosine
      antagonist, aminophylline (intravenous 5 mg/kg bolus and 0.9 mg/kg/h infusion) at
      one session, and equivalent saline at the other session. Change in ischemic
      threshold (RPP at 1 mm ST segment depression) and in maximum ST depression
      adjusted for RPP were analyzed. RESULTS: In substudy A, despite a significant
      attenuation of electrocardiogram indexes of myocardial ischemia between the
      baseline and third (warmed-up) tests, the thallium extent deficits (20.8 +/-
      15.1% and 16.8 +/- 12.4%) and intensity deficits (41.2 +/- 12.6% and 39.3 +/-
      12.6%) did not differ significantly. In substudy B, the increase in ischemic
      threshold on re-exercise was unaffected by aminophylline. Adjusted maximum ST
      depression even decreased to a greater extent on re-exercise with aminophylline
      (by 51 +/- 21%) than with saline (by 32 +/- 19%) (p = 0.012). CONCLUSIONS: While
      warm-up angina is associated with a significant attenuation of exercise
      electrocardiogram indexes of ischemia, it is unaccompanied by significant changes
      in SPECT perfusion and does not appear to be mediated by an adenosine-dependent
      mechanism since it is not blocked by aminophylline. Thus, its mechanism, which
      appears distinct from experimental ischemic preconditioning, remains
      unidentified.

PMID- 11216965
TI  - Reduction of exercise-induced myocardial ischemia during add-on treatment with
      the angiotensin-converting enzyme inhibitor enalapril in patients with normal
      left ventricular function and optimal beta blockade.
AB  - OBJECTIVES: We sought to study the effect of angiotensin-converting enzyme
      inhibition on exercise-induced myocardial ischemia. BACKGROUND: Although
      angiotensin-converting enzyme inhibitors have been shown to reduce ischemic
      events after myocardial infarction, few data are available regarding their direct
      anti-ischemic effects in patients with coronary artery disease. METHODS: We
      studied 43 patients (average age 63 +/- 8 years) with exercise-induced myocardial
      ischemia (> or =0.1 mV ST depression, despite optimal beta blockade) and normal
      left ventricular function (ejection fraction >0.50). In a double-blind, placebo
      controlled parallel design, patients were treated with angiotensin-converting
      enzyme inhibitor (enalapril 10 mg twice daily) or placebo. Assessments were made
      after three weeks (short-term) and 12 weeks (long-term). RESULTS: At baseline,
      the groups were well matched for all clinical characteristics. After three weeks,
      there was a slight but not significant increase in time to 0.1 mV ST depression
      in both groups (p = NS); rate pressure product (RPP = heart rate x systolic blood
      pressure) was also unaffected. After 12 weeks, however, time to 0.1 mV ST
      depression further increased in the enalapril group (5.6 +/- 1.9 min) but was
      unchanged in the placebo group (4.4 +/- 1.3 min; p < 0.05 between groups). In
      contrast, RPP was not affected. Concentrations of both atrial and brain
      natriuretic peptides at peak exercise tended to be lower by enalapril, if
      compared to placebo (p = NS). CONCLUSIONS: Angiotensin-converting enzyme
      inhibition may reduce exercise-induced myocardial ischemia in patients with
      normal left ventricular function. Further studies are needed to elucidate the
      mechanisms involved.

PMID- 11216966
TI  - Effects of long-term, moderate-intensity oral anticoagulation in addition to
      aspirin in unstable angina. The Organization to Assess Strategies for Ischemic
      Syndromes (OASIS) Investigators.
AB  - OBJECTIVES: We sought to evaluate whether oral anticoagulant (AC) therapy given
      for five months was superior to standard (control) therapy in patients with
      unstable angina receiving aspirin. BACKGROUND: The long-term risk of myocardial
      infarction (MI) or death remains high in patients with unstable angina, despite
      the use of aspirin. Therefore, additional treatments are necessary. METHODS: Of
      the 10,141 patients entering the main trial, 3,712 were randomized 12 to 48 h
      later to receive oral AC therapy (n = 1,848) or standard therapy (n = 1,864).
      RESULTS: One-hundred forty patients (7.6%) suffered from cardiovascular death, MI
      or stroke while receiving oral AC, compared with 155 patients (8.3%) on standard
      therapy (relative risk [RR] 0.90, 95% confidence interval [CI] 0.72 to 1.14; p =
      0.40). The rates of the primary outcomes plus refractory angina were 16.7% (n =
      308) versus 17.5% (n = 327) (RR 0.95, 95% CI 0.81 to 1.11; p = 0.53). Countries
      were divided into good or poor compliers (based on the use of oral AC above or
      below 70% at 35 days), without knowledge of results by country. In good-complier
      countries, oral AC was discontinued in only 10.4% of patients at seven days and
      in 23.6% by five months, compared with 27.6% and 44.9%, respectively, in poor
      complier countries. There were significant reductions in the risks of both the
      primary (6.1% vs. 8.9%; RR 0.68, 95% CI 0.48 to 0.95; p = 0.02) and secondary
      outcomes (11.9% vs. 16.5%; RR 0.70, 95% CI 0.55 to 0.90; p = 0.005) with oral AC
      in the good-complier countries. There was little difference in the poor-complier
      countries (9.0% vs. 7.8% for the primary and 21.3% vs. 18.5% for the secondary
      outcomes, tests for interactions comparing the RRs for the primary and secondary
      outcomes were p < 0.02 and p = 0.002, respectively, between the two sets of
      countries). In the overall study, there was an excess of major bleeding (2.7% vs.
      1.3%; p = 0.004), which was larger in the good-complier countries (RR 2.71)
      compared with the poor-complier countries (RR 1.58). There were also reductions
      in cardiac catheterization (RR 0.80; p = 0.004) and coronary revascularization
      procedures (RR 0.82; p = 0.06) in the good-complier countries, but not in the
      poor-complier countries (RR 0.98 and 1.06, respectively, p for interaction of
      0.06 and 0.04, respectively). CONCLUSIONS: Overall, oral AC led to a small,
      nonsignificant reduction in the risk of the primary and secondary outcomes.
      Stratifying the countries or centers by their rates of compliance to oral AC
      suggested that good compliance to oral AC could potentially lead to clinically
      important reductions in major ischemic cardiovascular events.

PMID- 11216967
TI  - Interaction between chemokines and oxidative stress: possible pathogenic role in
      acute coronary syndromes.
AB  - OBJECTIVES: We sought to study the relationships between chemokines and oxidative
      stress in acute coronary syndrome. BACKGROUND: In view of existing knowledge on
      the participation of leukocytes and oxidative stress in the pathogenesis of acute
      coronary syndrome, we hypothesized that chemokines may play a role in recruiting
      and activating leukocytes in this disorder. METHODS: The levels of chemokines and
      oxidative stress were studied in 38 patients with stable and 38 with unstable
      angina and in 20 controls. In separate in vitro experiments the effect of
      chemokines on reactive oxygen species in monocytes and the effect of antioxidants
      on chemokine levels in these cells were also studied. RESULTS: 1) Angina patients
      had raised serum levels of chemokines in both cross-sectional and longitudinal
      testing, with particularly high levels of interleukin (IL)-8, monocyte
      chemoattractant protein (MCP)-1 and macrophage inflammatory peptide (MIP)-1-alpha
      in unstable disease. 2) T cells, and particularly monocytes, seem to contribute
      to the raised IL-8, MCP-1 and MIP-1-alpha levels in unstable angina. 3)
      Concomitantly, and significantly correlated with MCP-1 and IL-8 levels, stable
      and particularly unstable angina patients had decreased plasma levels of
      antioxidants and increased lipid peroxidation, suggesting enhanced oxidative
      stress. 4) Monocyte chemoattractant protein-1 enhanced the generation of O2- in
      monocytes from unstable angina patients, and the antioxidant glutathione
      monoethyl ester suppressed the production of IL-8 and MCP-1 in these cells.
      CONCLUSIONS: Our findings suggest an interaction between chemokines and oxidative
      stress in unstable angina. This interaction may represent a vicious circle
      involved in the pathogenesis of acute coronary syndromes.

PMID- 11216968
TI  - Therapeutic value of eptifibatide at community hospitals transferring patients to
      tertiary referral centers early after admission for acute coronary syndromes.
      PURSUIT Investigators.
AB  - OBJECTIVES: We aimed to evaluate the benefits of the glycoprotein (GP) IIb/IIIa
      antagonist, eptifibatide, after patients with acute coronary syndromes (ACS) were
      admitted to hospitals that approach revascularization for ACS through early
      transfer to tertiary referral centers. BACKGROUND: Across a variety of hospital
      settings, GP IIb/IIIa inhibition, after patients were admitted to the hospital
      for non-ST segment elevation ACS, is associated with a reduction in death or
      myocardial infarction (MI) before and during a percutaneous coronary
      intervention. METHODS: The outcomes of 429 patients from 153 sites in the
      Platelet glycoprotein IIb/IIIa in unstable angina: Receptor Suppression Using
      Integrilin Therapy (PURSUIT) trial, who were transferred during study drug
      infusion ("transfer patients"), were compared with those of 1,987 patients who
      either remained in the hospital at those sites or were transferred after study
      drug termination ("nontransfer patients"). RESULTS: The baseline characteristics
      of transfer and nontransfer patients were similar. Patients receiving
      eptifibatide were transferred less frequently than those receiving placebo (16%
      vs. 20%, p = 0.014). Transfer patients underwent more procedures and experienced
      a greater 30-day incidence of death or MI, as compared with nontransfer patients
      (21% vs. 12%, p = 0.001). Eptifibatide was associated with a reduction in death
      or MI through 30 days, independent of transfer status (2.5% absolute reduction),
      as well as for those transferred (5.5% absolute reduction). CONCLUSIONS: For
      patients with ACS admitted to community hospitals, eptifibatide is associated
      with a reduced need for transfer and improved clinical outcomes.

PMID- 11216969
TI  - The effects of contemporary use of coronary stents on in-hospital mortality.
      Registry Committee of the Society for Cardiac Angiography and Interventions.
AB  - OBJECTIVES: This study was designed to determine the effect of coronary stents on
      in-hospital mortality. BACKGROUND: Despite extensive use of stents for
      percutaneous coronary interventions (PCIs), their effect on serious in-hospital
      events, especially mortality, is not well defined. METHODS: A cohort study was
      performed using 16,811 consecutive native-vessel PCI procedures performed on
      patients in the Society for Cardiac Angiography & Interventions Registry from
      July 1, 1996, through December 31, 1998. Patients undergoing balloon-only
      angioplasty were compared with those receiving a planned or unplanned stent.
      Procedures with other devices were excluded. Multivariable analyses adjusted for
      detailed clinical characteristics and for individual laboratory. RESULTS: Stents
      were associated with a significant reduction in in-hospital mortality (0.3%)
      compared with balloon procedures (0.6%; multivariable odds ratio [OR] 0.55; 95%
      confidence interval [CI] 0.34, 0.89; p = 0.014). The risk of emergency coronary
      bypass also was reduced by stenting (0.3% vs. 0.7%; multivariable OR 0.47; 95%
      CI: 0.29, 0.76; p = 0.002). Adjustment for the use of glycoprotein IIb/IIIa
      inhibitors did not change the results, and the effects of stenting relative to
      balloon procedures were similar in those procedures with and without glycoprotein
      IIb/IIIa blockade (p = 0.94). CONCLUSIONS: This study suggests that coronary
      stenting, compared with balloon procedures, reduces in-hospital mortality,
      independent of the clinical setting.

PMID- 11216970
TI  - Nitroglycerin withdrawal increases endothelium-dependent vasomotor response to
      acetylcholine.
AB  - OBJECTIVES: We sought to determine whether nitroglycerin (NTG) withdrawal
      contributes to worsening of endothelial dysfunction and development of the
      rebound phenomenon during intermittent transdermal NTG therapy. BACKGROUND:
      Intermittent transdermal NTG therapy is recommended to avoid the development of
      tolerance. However, this regimen may precipitate worsening angina in the NTG-free
      interval. METHODS: Twenty patients were randomized to intermittent transdermal
      NTG (0.6 mg/h; NTG group) or no treatment (control group) five days before
      angiography. The risk factors for endothelial dysfunction were similar in both
      groups. After diagnostic angiography, the patients underwent quantitative
      angiography before and after intracoronary acetylcholine (ACh), 10(-4) mol/liter.
      Immediately after the morning study, the patch was removed from the NTG group,
      and 3 h later, the ACh infusion was repeated in both groups. All patients had
      mild to moderate coronary artery disease (CAD). RESULTS: The diameter of the left
      anterior descending coronary artery at baseline was 2.0 +/- 0.1 mm in the control
      group and 2.6 +/- 0.1 mm in the NTG group (p < 0.05). Acetylcholine caused mild
      vasoconstriction in the control group in the morning and afternoon (2.7 +/- 5.3%
      and 2.4 +/- 3.9%, respectively; p = NS). The NTG group demonstrated mild
      vasoconstriction to ACh in the morning (3.2 +/- 2.8%; p = NS vs. control group).
      After patch removal, there was a significant increase in the magnitude
      ofvasoconstriction in the NTG group (11.6 +/- 3.9%, p = 0.04 vs. morning
      constriction). CONCLUSIONS: These results confirm that NTG withdrawal increases
      the coronary vasomotor response to ACh in patients with mild CAD and suggests
      that the rebound phenomena may be secondary to the development of endothelial
      dysfunction after discontinuation of NTG therapy.

PMID- 11216971
TI  - Platelet inhibitory effect of nitric oxide in the human coronary circulation:
      impact of endothelial dysfunction.
AB  - OBJECTIVES: We sought to determine whether coronary vascular nitric oxide (NO)
      release in vivo modulates platelet activation. BACKGROUND: Nitric oxide modulates
      vasodilator tone and platelet activity via the cyclic guanosine monophosphate
      (cGMP) pathway, but whether coronary endothelial dysfunction influences platelet
      activation in humans is unknown. METHODS: In 26 patients, we measured coronary
      blood flow, epicardial diameter and coronary sinus platelet cGMP content during
      intracoronary infusions of acetylcholine (ACH), L-NG monomethyl arginine (L-NMMA)
      and sodium nitroprusside. RESULTS: Acetylcholine increased platelet cGMP content
      (p = 0.013), but its magnitude was lower in patients with endothelial
      dysfunction; thus, patients with epicardial constriction with ACH had a 7 +/- 6%,
      p = ns change compared with a 32 +/- 13%, p = 0.05 increase in platelet cGMP in
      those with epicardial dilation. Similarly, patients with atherosclerosis or its
      risk factors had a smaller increase (9 +/- 6%) compared with those having normal
      coronary arteries without risk factors (51 +/- 22%, p = 0.019). L-NG monomethyl
      arginine decreased platelet cGMP content to a greater extent in patients with
      epicardial dilation with ACH (- 15 +/- 7%, p = 0.06) compared to those with
      constriction (+5 +/- 6% change, p = 0.5). Sodium nitroprusside produced a similar
      increase in platelet cGMP content in patients with and without endothelial
      dysfunction (p = 0.56). The effects of sodium nitroprusside, but not ACH or L
      NMMA, were reproduced in vitro. CONCLUSIONS: Platelet cGMP levels can be
      modulated by basal and stimulated release of NO. The platelet inhibitory effect
      of NO is reduced in patients with endothelial dysfunction, which may explain
      their increased risk from thrombotic events and the improved survival associated
      with strategies designed to improve vascular function.

PMID- 11216972
TI  - Vascular endothelial function and oxidative stress mechanisms in patients with
      Behcet's syndrome.
AB  - OBJECTIVES: We sought to test the hypothesis that vascular endothelial function
      is impaired in Behcet's syndrome and reflects increased levels of oxidative
      stress. BACKGROUND: Behcet's syndrome is a multisystem inflammatory disorder
      commonly complicated by vascular thrombosis and arterial aneurysm formation. The
      precise mechanisms underlying vascular disease in Behcet's syndrome are not
      known. METHODS: We studied 19 patients with Behcet's syndrome (18 to 50 years
      old, 9 men) and 21 healthy volunteers (18 to 50 years old, 10 men). Brachial
      artery flow-mediated dilation (endothelium-dependent), and nitroglycerin (NTG)
      induced dilation (endothelium-independent) were measured. To investigate
      oxidative stress mechanisms, vascular studies were repeated 1 h after
      administration of vitamin C (1 g, intravenous) in 12 patients and 12 control
      subjects. RESULTS: Flow-mediated dilation was reduced in patients with Behcet's
      syndrome as compared with control subjects (0.7 +/- 0.9% vs. 5.7 +/- 0.9%, p =
      0.001). In contrast, there were no significant differences in the brachial artery
      diameter (4.2 +/- 0.2 vs. 4.0 +/- 0.2 mm, p = 0.47) or NTG-induced dilation (19.7
      +/- 1.9% vs. 19.7 +/- 1.2%, p = 0.98). In regression analysis, Behcet's syndrome
      was associated with impaired flow-mediated dilation independent of age, gender,
      brachial artery diameter, blood pressure, cholesterol and glucose. Vitamin C
      increased flow-mediated dilation in Behcet's syndrome (0.2 +/- 0.7% to 3.5 +/-
      1.0%, p = 0.002), but not in control subjects (4.3 +/- 0.6% to 4.7 +/- 0.4%, p =
      0.51). In both groups, NTG-induced dilation and brachial artery diameter were
      unchanged after vitamin C treatment. CONCLUSIONS: Vascular endothelial function
      is impaired in Behcet's syndrome and can be rapidly improved by vitamin C
      treatment. Our results support a role for oxidative stress in the pathophysiology
      of Behcet's syndrome and provide a rationale for therapeutic studies aimed at
      reducing vascular complications in this disorder.

PMID- 11216973
TI  - Early mortality and morbidity of bilateral versus single internal thoracic artery
      revascularization: propensity and risk modeling.
AB  - OBJECTIVES: We examined whether bilateral internal thoracic artery (BITA)
      revascularization is associated with any increased in-hospital mortality and
      complications compared with single internal thoracic artery (SITA)
      revascularization. BACKGROUND: Despite proven long-term benefits, BITA
      revascularization has been slow to be adopted because of fear of increased early
      morbidity. METHODS: We evaluated 1,697 consecutive patients undergoing BITA (n =
      867) or SITA (n = 830) revascularization. We used propensity score analyses and
      adjusted risk models to address differences between arms. RESULTS: There were 20
      (2.3%) deaths in the BITA group versus 26 (3.1%) in the SITA group (odds ratio
      0.73, p = 0.30). Propensity analysis identified several parameters that affected
      the decision to use BITA. Adjusting for propensity score and all potential risk
      factors, the odds ratio for death with BITA versus SITA was practically 1.
      Bilateral internal thoracic artery revascularization did not increase the number
      of in-hospital complications with the possible exception of deep sternal wound
      infections (11 [1.3%] vs. 3 [0.4%], p = 0.057). In multivariate modeling BITA
      increased the risk of deep sternal wound infections only in emergent cases and in
      older patients; the excess risk was negligible among 1,206 patients (71.1% of
      total) who did not have emergent revascularization and were < or =70 years old
      (risk difference 0.3%, p = 0.74). There was no difference in length of stay after
      adjustment for propensity factors (mean 11.3 vs. 11.7 days, p = 0.66).
      CONCLUSIONS: Bilateral internal thoracic artery revascularization grafting
      confers no increased risk for early death and does not prolong hospital stay. The
      small increase in the risk of deep sternal wound infections does not affect the
      majority of patients.

PMID- 11216974
TI  - Coronary artery revascularization in patients with sustained ventricular
      arrhythmias in the chronic phase of a myocardial infarction: effects on the
      electrophysiologic substrate and outcome.
AB  - OBJECTIVES: The objective of this study was to analyze the influence of coronary
      artery revascularization in patients with ventricular arrhythmias. BACKGROUND:
      Coronary artery revascularization is an effective treatment for myocardial
      ischemia; however, its effect on ventricular arrhythmias not related to an acute
      ischemic event has not been carefully studied. METHODS: Sixty-four patients (58
      men, mean age 65 +/- 8 years old) with prior myocardial infarction, spontaneous
      ventricular arrhythmias not related to an acute ischemic event (55 ventricular
      tachycardia, 9 ventricular fibrillation) and coronary lesions requiring
      revascularization were studied prospectively. Electrophysiological study was
      performed before and after revascularization, and events during follow-up were
      analyzed. RESULTS: At initial study 61 patients were inducible into sustained
      ventricular arrhythmias. After revascularization, in 62 survivors, 52 out of 59
      patients previously inducible were still inducible (group A), and 10 patients
      were noninducible (group B). No differences were found in clinical, hemodynamic,
      therapeutic and electrophysiological characteristics between both groups. During
      32 +/- 26 months follow-up, 28/52 patients in group A (54%) and 4/10 patients in
      group B (40%) had arrhythmic events (p = 0.46). An ejection fraction <30%
      predicted recurrent arrhythmic events (p = 0.02), but not the presence of
      demonstrable ischemia before revascularization (p = 0.42), amiodarone (p = 0.69)
      or beta-adrenergic blocking agent therapy (p = 0.53). Total mortality was 10% in
      both groups. CONCLUSIONS: In patients with ventricular arrhythmias in the chronic
      phase of myocardial infarction, probability of recurrence is high despite
      coronary artery revascularization, but mortality is low if combined with
      appropriate antiarrhythmic therapy. Recurrences are related to the presence of a
      low ejection fraction but not to demonstrable ischemia before revascularization,
      amiodarone or beta-blocker therapy nor are they the results of
      electrophysiological testing after revascularization.

PMID- 11216975
TI  - Different patterns of atrial activation in idiopathic atrial fibrillation:
      simultaneous multisite atrial mapping in patients with paroxysmal and chronic
      atrial fibrillation.
AB  - OBJECTIVES: We aimed to evaluate: 1) the behavior of electrical activity
      simultaneously in different atrial regions during atrial fibrillation (AF); 2)
      the difference of atrial activation between paroxysmal and chronic AF; 3) the
      atrial refractoriness dispersion; and 4) the correlation between the effective
      refractory periods (ERPs) and the FF intervals. BACKGROUND: Little data exist on
      the electrophysiologic characteristics of the different atrial regions in
      patients with AF. A more detailed knowledge of the electrical activity during AF
      may provide further insights to improve treatment of AF. METHODS: Right and left
      atria were extensively mapped in 30 patients with idiopathic AF (18 paroxysmal
      and 12 chronic). In different atrial locations, we analyzed 1) the FF interval
      duration; and 2) the grade of organization and, in case of organized electrical
      activity, the direction of atrial activation. Furthermore, in patients with
      paroxysmal AF, we determined the atrial ERP, evaluated the ERP dispersion and
      assessed the presence of a correlation between the ERPs and the FF intervals.
      RESULTS: In patients with chronic AF, we observed a shortening of the FF
      intervals and a greater prevalence of disorganized activity in all the atrial
      sites examined. In patients with paroxysmal AF, a significant dispersion of
      refractoriness was observed. The right lateral wall showed longer FF intervals
      and more organized atrial activity and, unexpectedly, the shortest mean ERPs. In
      contrast, the septal area showed shorter FF intervals, greater disorganization
      and the longest mean ERPs. CONCLUSIONS: Electrical activity during AF showed a
      significant spatial inhomogeneity, which was more evident in patients with
      paroxysmal AF. The mean FF intervals did not correlate with the mean ERPs.

PMID- 11216976
TI  - Single oral loading dose of propafenone for pharmacological cardioversion of
      recent-onset atrial fibrillation.
AB  - The efficacy and safety of the single dose oral loading regimen of propafenone
      for pharmacological cardioversion of recent-onset atrial fibrillation (AFib) was
      evaluated by analyzing the trials on the subject identified through a
      comprehensive literature search. Most of the trials used a single dose of 600 mg
      for oral loading. The success rates ranged from 56% to 83%, depending on the
      duration of AFib and follow-up after drug administration. The conversion time
      ranged from 110 +/- 59 to 287 +/- 352 min, depending on the duration of
      observation after drug administration. The single dose oral loading regimen of
      propafenone was significantly more efficacious than placebo in the first 8 h
      after administration but not at 24 h. Compared with the intravenous regimen, the
      oral regimen resulted in fewer conversions in the first 2 h, but both regimens
      were equally efficacious afterward. The oral propafenone regimen was as
      efficacious as the single dose oral loading regimen of flecainide but was
      superior to those of quinidine and amiodarone. The adverse effects reported were
      transient arrhythmia, reversible QRS-complex widening, transient hypotension and
      mild noncardiac side effects. The transient arrhythmias were chiefly at the time
      of conversion and included appearance of atrial flutter, bradycardia, pauses and
      junctional rhythm. No life-threatening proarrhythmic adverse effects were
      reported. The single oral loading dose of propafenone appears to be highly
      effective for conversion of recent-onset AFib, with a relatively rapid effect
      within 2 to 3 h and freedom from serious adverse effects.

PMID- 11216977
TI  - Efficacy and safety of out-of-hospital self-administered single-dose oral drug
      treatment in the management of infrequent, well-tolerated paroxysmal
      supraventricular tachycardia.
AB  - OBJECTIVES: We tested the efficacy of two drug treatments, flecainide (F) and the
      combination ofdiltiazem and propranolol (D/P), administered as a single oral dose
      for termination of the arrhythmic episodes. BACKGROUND: Both prophylactic drug
      therapy and catheter ablation are questionable as first-line treatments in
      patients with infrequent and well-tolerated episodes of paroxysmal
      supraventricular tachycardia (SVT). METHODS: Among 42 eligible patients (13% of
      all screened for SVT) with infrequent (< or =5/year), well-tolerated and long
      lasting episodes, 37 were enrolled and 33 had SVT inducible during
      electrophysiological study. In the latter, three treatments (placebo, F, and D/P)
      were administered in a random order 5 min after SVT induction on three different
      days. RESULTS: Conversion to sinus rhythm occurred within 2 h in 52%, 61%, and
      94% of patients on placebo, F and D/P, respectively (p < 0.001). The conversion
      time was shorter after D/P (32 +/- 22 min) than after placebo (77 +/- 42 min, p <
      0.001) or F (74 +/- 37 min, p < 0.001). Four patients (1 placebo, 1 D/P, and 2 F)
      had hypotension and four (3 D/P and 1 F) a sinus rate <50 beats/min following SVT
      interruption. Patients were discharged on a single oral dose of the most
      effective drug treatment (F or D/P) at time of acute testing. Twenty-six patients
      were discharged on D/P and five on F. During 17 +/- 12 months follow-up, the
      treatment was successful in 81% of D/P patients and in 80% of F patients, as all
      the arrhythmic episodes were interrupted out-of-hospital within 2 h. In the
      remaining patients, a failure occurred during one or more episodes because of
      drug ineffectiveness or drug unavailability. One patient had syncope after D/P
      ingestion. During follow-up, the percentage of patients calling for emergency
      room assistance was significantly reduced as compared to the year before
      enrollment (9% vs. 100%, p < 0.0001). CONCLUSIONS: The episodic treatment with
      oral D/P and F, as assessed during acute testing, appears effective in the
      management of selected patients with SVT. This therapeutic strategy minimizes the
      need for emergency room admissions during tachycardia recurrences.

PMID- 11216978
TI  - Lack of efficacy of atenolol for the prevention of neurally mediated syncope in a
      highly symptomatic population: a prospective, double-blind, randomized and
      placebo-controlled study.
AB  - OBJECTIVES: This study was designed to evaluate the efficacy of atenolol for the
      long-term management of patients with vasovagal syncope. The primary hypothesis
      was that atenolol is not superior to placebo for the treatment of vasovagal
      syncope. BACKGROUND: There is no definitive well-controlled analysis of the
      efficacy of beta-adrenergic blocking agents in patients with recurrent vasovagal
      syncope. METHODS: This is a prospective, randomized, double-blind, placebo
      controlled study. Fifty patients with recurrent vasovagal syncope were included
      (at least two episodes in the last year). A baseline tilt test was performed.
      Twenty patients (40%) had a positive tilt test. Intravenous atenolol prevented a
      second positive tilt in five patients. The patients were randomized to receive
      either atenolol or a placebo (26 patients atenolol 50 mg/day, 24 patients
      placebo). The follow-up procedure lasted one year. The primary end point of the
      study was the time to first recurrence of syncope. RESULTS: In the intention-to
      treat analysis, the group treated with atenolol had a similar number of patients
      with recurrent syncopal episodes as the placebo group. The Kaplan-Meier actuarial
      estimates of time to first syncopal recurrence showed that the probability of
      remaining free of syncope drops similarly in both groups and that there was no
      statistical difference between both curves (patients treated with atenolol vs.
      the placebo) with a log-rank test p value of 0.4517. CONCLUSIONS: The recurrence
      of neurocardiogenic syncope in highly symptomatic patients treated with atenolol
      is similar to that of patients treated with placebo.

PMID- 11216979
TI  - Can we assess the efficacy of therapy in neurocardiogenic syncope?

PMID- 11216980
TI  - A founder mutation of the potassium channel KCNQ1 in long QT syndrome:
      implications for estimation of disease prevalence and molecular diagnostics.
AB  - OBJECTIVES: We took advantage of the genetic isolate of Finns to characterize a
      common long QT syndrome (LQTS) mutation, and to estimate the prevalence of LQTS.
      BACKGROUND: The LQTS is caused by mutations in different ion channel genes, which
      vary in their molecular nature from family to family. METHODS: The potassium
      channel gene KCNQ1 was sequenced in two unrelated Finnish patients with Jervell
      and Lange-Nielsen syndrome (JLNS), followed by genotyping of 114 LQTS probands
      and their available family members. The functional properties of the mutation
      were studied using a whole-cell patch-damp technique. RESULTS: We identified a
      novel missense mutation (G589D or KCNQ1-Fin) in the C-terminus of the KCNQ1
      subunit. The voltage threshold of activation for the KCNQ1-Fin channel was
      markedly increased compared to the wild-type channel. This mutation was present
      in homozygous form in two siblings with JLNS, and in heterozygous form in 34 of
      114 probands with Romano-Ward syndrome (RWS) and 282 family members. The mean (+/
      SD) rate-corrected QT intervals of the heterozygous subjects (n = 316) and
      noncarriers (n = 423) were 460 +/- 40 ms and 410 +/- 20 ms (p < 0.001),
      respectively. CONCLUSIONS: A single missense mutation of the KCNQ1 gene accounts
      for 30% of Finnish cases with LQTS, and it may be associated with both the RWS
      and JLNS phenotypes of the syndrome. The relative enrichment of this mutation
      most likely represents a founder gene effect. These circumstances provide an
      excellent opportunity to examine how genetic and nongenetic factors modify the
      LQTS phenotype.

PMID- 11216981
TI  - Risks and benefits of adding anti-platelet therapy to warfarin among patients
      with prosthetic heart valves: a meta-analysis.
AB  - OBJECTIVES: The objective of this study was to compare the effectiveness and
      safety of adding dipyridamole or aspirin to warfarin among patients with
      prosthetic heart valves using meta-analytic techniques. BACKGROUND: Patients with
      prosthetic heart valves are at increased risk for valve thrombosis and arterial
      thromboembolism. Oral anticoagulation alone, or the addition of antiplatelet
      drugs, has been used to minimize this risk. An important issue is the
      effectiveness and safety of the latter strategy. METHODS: A combined MEDLINE and
      manual search was made for relevant articles from 1966 to November 1999. Standard
      meta-analysis techniques were used. RESULTS: Ten studies involving 2,199 subjects
      met the inclusion criteria. Compared with anticoagulation alone, the addition of
      an antiplatelet agent reduced the risk of thromboembolic events (odds ratio [OR]:
      0.41, p < 0.001) and total mortality (OR: 0.49, p < 0.001). The risk of major
      bleeding was increased when antiplatelet agents were added (OR: 1.50, p = 0.033).
      For major bleeding, the comparison of trials performed before and after 1990 (OR:
      2.23 and 0.88, respectively) showed that the chi-square test for heterogeneity
      was significant (p = 0.025). The latter trials used low-dose aspirin, suggesting
      that the risk of bleeding may be lower with contemporary low-dose (100 mg daily)
      aspirin. CONCLUSIONS: Adding antiplatelet therapy, especially low-dose aspirin,
      to warfarin decreases the risk of systemic embolism or death among patients with
      prosthetic heart valves. The risk of major bleeding is slightly increased with
      antiplatelet therapy. Nonetheless, the risk of bleeding appears to have
      diminished with the lower doses of aspirin used in the more recent trials,
      resulting in a favorable risk-to-benefit profile.

PMID- 11216982
TI  - Reoperation for prosthetic aortic valve obstruction in the era of
      echocardiography: trends in diagnostic testing and comparison with surgical
      findings.
AB  - OBJECTIVES: We sought to: 1) identify trends in the diagnostic testing of
      patients with prosthetic aortic valve (AVR) obstruction who undergo reoperation
      and 2) compare diagnostic test results with pathologic findings at surgery.
      BACKGROUND: It is unclear whether Doppler transthoracic echocardiography (TTE)
      and transesophageal echocardiography (TEE) have reduced hemodynamic
      catheterization rates. METHODS: We reviewed 92 consecutive cases ofAVR
      reoperation at a single center from 1989 to 1998, comparing 49 cases of
      mechanical AVR obstruction (group A) to 43 cases of bioprosthetic obstruction
      (group B). Preoperative Doppler TTE was performed in all cases. RESULTS: In group
      A cases, there was a marginally significant trend towards lower catheterization
      rates for the Gorlin AVR area, from 36% in 1989 to 1990 to 10% in 1997 to 1998 (p
      = 0.07), but diagnostic TEE utilization (47% of cases) did not vary. The cause of
      mechanical AVR obstruction was pannus in 26 cases (53%), mismatch (P-PM) in 19
      (39%) and thrombosis in 4 (8%). The mechanism (pannus/thrombus vs. mismatch) was
      identified in 10% by TTE and 49% by TEE (p < 0.001). In group B cases,
      hemodynamic catheterization rates (21%) and diagnostic TEE utilization (21%) did
      not vary with time. Obstruction was caused by structural degeneration in 37 cases
      (86%), thrombosis in 3 (7%), mismatch in 2 (5%) and pannus in 1 (2%). The
      mechanism was correctly identified in 63% by TTE and in 81% by TEE (p = 0.18).
      CONCLUSIONS: Doppler TTE is the primary means to diagnose AVR obstruction;
      hemodynamic catheterization is not routinely needed. In unselected patients with
      mechanical AVR obstruction, TEE differentiation of pannus or thrombus from
      mismatch is challenging.

PMID- 11216983
TI  - Outcomes of late atrial tachyarrhythmias in adults after the Fontan operation.
AB  - OBJECTIVES: The purpose of this study was to compare the clinical and
      echocardiographic features of adults who developed atrial tachyarrhythmias (ATs)
      late after a Fontan procedure with those who have remained free of arrhythmias.
      BACKGROUND: Atrial tachyarrhythmias are a frequent complication of the Fontan
      operation. However, the outcomes in adult patients with AT who have had the
      Fontan operation have not been well defined. METHODS: We reviewed the outcomes of
      94 consecutive patients who underwent the Fontan operation between 1977 and 1994
      and were followed as adults at the University of Toronto Congenital Cardiac
      Centre for Adults. Sixty patients had an atriopulmonary connection, 21 patients
      had an atrioventricular connection, and 13 patients received a lateral tunnel
      connection. RESULTS: Thirty-nine patients (41%) had sustained AT (atrial
      fibrillation, atrial flutter or supraventricular tachycardia) after their Fontan
      procedure. Compared with patients who did not develop AT, those who did were more
      likely to develop heart failure (46% vs. 13%, p = 0.003) and right atrial
      thrombus (31% vs. 4%, p = 0.006), exhibit left atrial enlargement (mean [+/-SD]
      diameter: 44 +/- 10 vs. 37 +/- 9 mm, p = 0.002), exhibit right atrial enlargement
      (mean [+/-SD] volume: 139 +/- 149 vs. 76 +/- 54 ml, p = 0.040) and have moderate
      to-severe systemic valve regurgitation (31% vs. 7%, p = 0.010). The mean survival
      time was not significantly different between the arrhythmia group and the
      arrhythmia-free group (21.2 +/- 1.3 and 18.0 +/- 0.7 years, respectively; p =
      0.900). CONCLUSIONS: Systemic atrioventricular valvular regurgitation and
      biatrial enlargement are commonly observed in patients who develop AT after the
      Fontan procedure. These patients are more likely to develop right atrial thrombus
      and heart failure.

PMID- 11216984
TI  - Major coronary artery anomalies in a pediatric population: incidence and clinical
      importance.
AB  - OBJECTIVES: We sought to prospectively determine the incidence and clinical
      significance of major coronary artery anomalies in asymptomatic children using
      transthoracic two-dimensional echocardiography. BACKGROUND: Anomalous origins of
      the left main coronary artery (ALMCA) from the right sinus of Valsalva or
      anomalous origins the right coronary artery (ARCA) from the left sinus are rarely
      diagnosed in children and can cause sudden death, especially in young athletes.
      Because most patients are asymptomatic, the diagnosis is often made post mortem.
      No study to date has prospectively identified anomalous coronary arteries in
      asymptomatic children in the general population. METHODS: After serendipitously
      identifying an index case with ALMCA, we examined proximal coronary artery
      anatomy in children with otherwise anatomically normal hearts who were referred
      for echocardiography. In those diagnosed with ALMCA or ARCA, we performed further
      tests. RESULTS: Within a three-year period, echocardiograms were obtained in
      2,388 children and adolescents. Four children (0.17%) were identified with
      anomalous origin of their coronary arteries, and angiograms, exercise perfusion
      studies and/or stress tests were then performed. One ARCA patient had decreased
      perfusion in the right coronary artery (RCA) perfusion area and showed
      ventricular ectopy on electrocardiogram (ECG) at rest that diminished but did not
      resolve with exercise. A second patient with ALMCA had atrial tachycardia
      immediately after exercise, with inferior and lateral ischemic changes on ECG and
      frequent junctional and/or ventricular premature complexes both at rest and
      recovery. CONCLUSIONS: This study demonstrates that although anomalous origins of
      coronary arteries are rare in asymptomatic children, the prevalence is greater
      than that found in other prospective studies. Ischemia can occur with both ALMCA
      and ARCA even though patients remain asymptomatic. Because of the high risk of
      sudden cardiac death, aggressive surgical management and close follow-up are
      necessary.

PMID- 11216985
TI  - Congenital coronary artery anomalies in young patients: new perspectives for
      timely identification.

PMID- 11216986
TI  - Acute ethanol exposure fails to elicit preconditioning-like protection in in situ
      rabbit hearts because of its continued presence during ischemia.
AB  - OBJECTIVES: Is the timing of exposure critical for ethanol's ability to induce
      cardioprotection? BACKGROUND: Acute ethanol exposure has been reported to mimic
      ischemic preconditioning in vitro, but it failed to protect in situ. We
      hypothesized that these conflicting findings were related to ethanol's presence
      during ischemia in situ. METHODS: The effect on infarct size
      (triphenyltetrazolium chloride) of acute ethanol exposure (0.35, 0.7, and 1.4
      g/kg IV) 10 min before ischemia was measured in open-chest rabbits after 30 min
      of regional ischemia and reperfusion and was compared to ethanol's ability to
      reduce infarct size in isolated hearts in which the timing of ethanol exposure
      could be varied. RESULTS: Ethanol exposure in situ shortly before ischemia did
      not reduce infarct size. Moreover, ethanol abolished protection from both
      ischemic preconditioning and mitochondrial KATP channel activation. In contrast,
      in buffer-perfused hearts exposed to 10 to 50 mmol/liter ethanol for 5 min
      followed by washout before ischemia, infarct size was significantly reduced. When
      ethanol exposure was prolonged until the end of ischemia in isolated hearts,
      protection was abolished. Conversely, protection was seen when ethanol was
      infused in situ followed by removal of the heart and perfusion with ethanol-free
      buffer prior to ischemia in a Langendorff preparation. When 50 min were allowed
      to metabolize the ethanol prior to ischemia, protection could also be shown in
      situ. CONCLUSIONS: Ethanol exposure followed by washout or sufficient time to
      metabolize the alcohol prior to ischemia induces preconditioning-like myocardial
      protection. However, if present throughout ischemia, ethanol actually blocks all
      preconditioning-related protection.

PMID- 11216987
TI  - Hypercholesterolemia impairs myocardial perfusion and permeability: role of
      oxidative stress and endogenous scavenging activity.
AB  - OBJECTIVES: We intended to study the effect of hypercholesterolemia (HC) on
      myocardial perfusion and permeability response to increased cardiac demand.
      BACKGROUND: Hypercholesterolemia is associated with increased incidence of
      cardiac events and characterized by impaired coronary vascular function, possibly
      mediated partly through increased pro-oxidative conditions in plasma and tissue.
      However, it is yet unclear whether HC is also associated with impaired myocardial
      perfusion and vascular permeability responses in vivo. METHODS: For 12 weeks pigs
      were fed a normal, HC or HC diet supplemented daily with antioxidants (HC + AO,
      100 IU/kg vitamin E and 1 g vitamin C). Myocardial perfusion and vascular
      permeability were measured in vivo using electron beam computed tomography before
      and after cardiac challenge with intravenous adenosine. Plasma and tissue
      oxidative status was determined ex vivo. RESULTS: Plasma cholesterol increased in
      all cholesterol-fed pigs but was associated with increased markers of oxidative
      stress only in HC pigs. Myocardial perfusion increased in response to adenosine
      in normal and HC + AO (+37 +/- 13% and +58 +/- 22%, respectively, p < 0.05 vs.
      baseline) but not in HC, whereas vascular permeability index increased only in HC
      pigs (+ 92 +/- 25%, p = 0.002). In HC animals, tissue endogenous oxygen radical
      scavengers and antioxidant vitamins were depleted and LDL oxidizability enhanced,
      but both were normalized in HC + AO pigs. Myocardial perfusion response was
      directly, and permeability inversely, associated with plasma and tissue vitamin
      concentrations. CONCLUSIONS: This study demonstrates that experimental HC is
      associated with blunted myocardial perfusion and increased vascular permeability
      responses in vivo to increased cardiac demand, which may be partly mediated by a
      shift in oxidative status.

PMID- 11216988
TI  - Efficacy of intracoronary or intravenous VEGF165 in a pig model of chronic
      myocardial ischemia.
AB  - OBJECTIVES: We sought to optimize vascular endothelial growth factor (VEGF)
      treatment for therapeutic angiogenesis in myocardial ischemia, we explored the
      efficacy of five different regimens. BACKGROUND: Although VEGF165 is one of the
      most potent pro-angiogenic growth factors, VEGF165 treatment for myocardial
      ischemia has been hampered by low efficacy and dose-limiting hypotension after
      systemic or intracoronary delivery. METHODS: This study evaluated the effect of
      intravenous or intracoronary rhVEGF165 in the presence or absence of nitric oxide
      (NO) synthase inhibition in a porcine model of chronic myocardial ischemia. Forty
      two Yorkshire pigs with chronically occluded left circumflex coronary arteries
      were randomly assigned to receive 10 microg/kg of VEGF165: 1) rapid (40 min)
      intravenous VEGF165 0.25 microg/kg/min, 2) slow (200 min) intravenous VEGF165
      0.05 microg/kg/min, 3) rapid intracoronary VEGF165 0.25 microg/kg/min, 4) rapid
      intracoronary VEGF165 0.25 microg/kg/min + nitro-L-arginine methyl ester
      hydrochloride (L-NAME) or 5) rapid vehicle infusion. RESULTS: Intracoronary and
      intravenous VEGF165 induced hypotension. Intracoronary VEGF-induced hypotension
      was blocked by L-NAME. Coronary angiography three weeks after treatment showed
      improvement in collateral index in both intracoronary groups but not the
      intravenous VEGF165 groups. Likewise, myocardial blood flow and microvascular
      function in the ischemic territory improved in both intracoronary groups but not
      in the intravenous groups. Global and regional myocardial function showed no
      significant improvements in any groups. CONCLUSIONS: Intracoronary infusion of
      VEGF165 significantly improves blood flow to the ischemic myocardium. Concomitant
      administration of L-NAME inhibits VEGF-induced hypotension while most likely
      preserving VEGF-induced angiogenesis. Intravenous infusion of VEGF165 was not
      effective in augmenting either myocardial flow or function in this model.

PMID- 11216989
TI  - Quantitative assessment of myocardial perfusion during graded coronary artery
      stenoses by intravenous myocardial contrast echocardiography.
AB  - OBJECTIVES: The purpose of this study was to examine whether coronary stenoses of
      variable severity could be quantitatively assessed by analysis of myocardial
      perfusion as determined by intravenous (IV) myocardial contrast echocardiography.
      BACKGROUND: Recently, new contrast agents and imaging technology have been
      developed that may enable improved assessment of myocardial perfusion by IV
      contrast injection. METHODS: Variable obstruction of the left anterior descending
      (LAD) coronary artery in dogs was produced by a screw occluder. Coronary artery
      flow was measured with a transit time flowmeter during baseline, pharmacological
      vasodilation, a non-flow-limiting stenosis at rest in conjunction with
      vasodilation, a flow-limiting stenosis, and total occlusion. Myocardial contrast
      echocardiography was performed after IV injection of the contrast agent NC
      100100. Time-intensity curves were obtained off-line for the LAD risk area and
      the adjacent left circumflex (LCx) territory, and peak background-subtracted
      video intensity was determined. Fluorescent microspheres were injected at each
      intervention for determination of regional myocardial blood flow. RESULTS: During
      non-flow-limiting stenosis, flow limiting stenosis and total occlusion, LAD/LCx
      ratios of peak myocardial videointensity and blood flow decreased
      proportionately. Both LAD/LCx ratios of video intensity and blood flow identified
      the non-flow-limiting and the flow-limiting stenoses as well as total occlusion
      of the LAD artery. A significant correlation between LAD/LCx video intensity and
      blood flow ratios was observed (r = 0.83, p < 0.0001). CONCLUSIONS: The degree of
      blood flow mismatch between ischemic and normal myocardial regions during graded
      coronary stenoses can be estimated in the dog by quantitative assessment of
      myocardial perfusion produced by IV myocardial contrast echocardiography.

PMID- 11216990
TI  - Validation of a digital color Doppler flow measurement method for pulmonary
      regurgitant volumes and regurgitant fractions in an in vitro model and in a
      chronic animal model of postoperative repaired tetralogy of Fallot.
AB  - OBJECTIVES: The purpose of this study was to validate a digital color Doppler
      (DCD) automated cardiac flow measurement method for quantifying pulmonary
      regurgitation (PR) in an in vitro and a chronic animal model of the right
      ventricular outflow tract of postoperative tetralogy of Fallot (TOF). BACKGROUND:
      There has been no reliable ultrasound method that can accurately quantitate PR.
      METHODS: We developed an in vitro model of mild pulmonary stenosis and wide-open
      PR that mimics the patterns of flow seen in patients with postoperative TOF.
      Thirteen different forward and regurgitant stroke volumes (RSVs) across the
      noncircular shaped cross-sectional outflow tract flow area were estimated using
      the DCD method in two orthogonal planes. In six sheep with surgically created PR,
      24 different hemodynamic states with PR strictly quantified by electromagnetic
      probes were also studied. RESULTS: The RSVs and regurgitant fractions (RFs)
      obtained by the DCD method using average values from two orthogonal planes
      correlated well with reference values (RSV: r = 0.99, mean difference = 0.02 +/-
      0.39 ml/beat for in vitro model; r = 0.97, mean differences = 1.79 +/- 1.84
      ml/beat for animal model, RF: r = 0.98, mean difference = -1.10 +/- 4.34% for in
      vitro model; r = 0.94, mean difference = 2.73 +/- 6.75% for animal model).
      However, the DCD method using a single plane had limited accuracy for estimating
      pulmonary RFs and RSVs. CONCLUSIONS: The DCD method using average values from two
      orthogonal planes provides accurate estimation of RSVs and RFs and should have
      clinical importance for serially quantifying PR in patients with postoperative
      TOF.

PMID- 11216991
TI  - Mechanism of ischemic mitral regurgitation with segmental left ventricular
      dysfunction: three-dimensional echocardiographic studies in models of acute and
      chronic progressive regurgitation.
AB  - OBJECTIVES: This study aimed to separate proposed mechanisms for segmental
      ischemic mitral regurgitation (MR), including left ventricular (LV) dysfunction
      versus geometric distortion by LV dilation, using models of acute and chronic
      segmental ischemic LV dysfunction evaluated by three-dimensional (3D)
      echocardiography. BACKGROUND: Dysfunction and dilation-both mechanisms with
      practical therapeutic implications-are difficult to separate in patients.
      METHODS: In seven dogs with acute left circumflex (LCX) coronary ligation, LV
      expansion was initially restricted and then permitted to occur. In seven sheep
      with LCX branch ligation, LV expansion was also initially limited but became
      prominent with remodeling over eight weeks. Three-dimensional echo reconstruction
      quantified mitral apparatus geometry and MR volume. RESULTS: In the acute model,
      despite LV dysfunction with ejection fraction = 23 +/- 8%, MR was initially trace
      with limited LV dilation, but it became moderate with subsequent prominent
      dilation. In the chronic model, MR was also initially trace, but it became
      moderate over eight weeks as the LV dilated and changed shape. In both models,
      the only independent predictor of MR volume was increased tethering distance from
      the papillary muscles (PMs) to the anterior annulus, especially medial and
      posterior shift of the ischemic medial PM, measured by 3D reconstruction (r2 =
      0.75 and 0.86, respectively). Mitral regurgitation volume did not correlate with
      LV ejection fraction or dP/dt. CONCLUSIONS: Segmental ischemic LV contractile
      dysfunction without dilation, even in the PM territory, fails to produce
      important MR. The development of MR relates strongly to changes in the 3D
      geometry of the mitral apparatus, with implications for approaches to restore a
      more favorable configuration.

PMID- 11216992
TI  - Impact directly over the cardiac silhouette is necessary to produce ventricular
      fibrillation in an experimental model of commotio cordis.
AB  - OBJECTIVES: In an experimental model of sudden death from chest wall impact
      (commotio cordis), we sought to define the chest wall areas important in the
      initiation of ventricular fibrillation (VF). BACKGROUND: Sudden death can result
      from an innocent chest blow by a baseball or other projectile. Observations in
      humans suggest that these lethal blows occur over the precordium. However, the
      precise location of impact relative to the risk of sudden death is unknown.
      METHODS: Fifteen swine received 178 chest impacts with a regulation baseball
      delivered at 30 mph at three sites over the cardiac silhouette (i.e., directly
      over the center, base or apex of the left ventricle [LV]) and four noncardiac
      sites on the left and right chest wall. Chest blows were gated to the vulnerable
      portion of the cardiac cycle for the induction of VF. RESULTS: Only chest impacts
      directly over the heart triggered VF (12 of 78: 15% vs. 0 of 100 for noncardiac
      sites: p < 0.0001). Blows over the center of the heart (7 of 23; 30%) were more
      likely to initiate VF than impacts at other precordial sites (5 of 55; 9%, p =
      0.02). Peak LV pressures generated instantaneously by the chest impact were
      directly related to the risk of VF (p < 0.0006). CONCLUSIONS: For nonpenetrating,
      low-energy chest blows to cause sudden death, impact must occur directly over the
      heart. Initiation of VF may be mediated by an abrupt and substantial increase in
      intracardiac pressure. Prevention of sudden death from chest blows during sports
      requires that protective equipment be designed to cover all portions of the chest
      wall that overlie the heart, even during body movements and positional changes
      that may occur with athletic activities.

PMID- 11216993
TI  - Adventitial remodeling after angioplasty is associated with expression of
      tenascin mRNA by adventitial myofibroblasts.
AB  - OBJECTIVES: The purpose of this study was to determine the temporospatial
      expression of tenascin-C (TnC) in balloon-injured rat and porcine arteries.
      BACKGROUND: Recent studies suggest that cell migration, in addition to cell
      proliferation, is a critical component of neointima formation after vascular
      injury. We have previously shown that adventitial myofibroblasts synthesize
      growth factors that contribute to the formation of neointima after arterial
      injury. We have also shown that the extracellular matrix protein, TnC, regulates
      cell migration. Consequently, we investigated the temporospatial expression of
      TnC by myofibroblasts after vascular injury. METHODS: In situ hybridization and
      immunohistochemistry were used to investigate the temporospatial expression of
      TnC in injured arteries. Northern and Western blots were used to determine the in
      vitro expression of TnC. RESULTS: In situ hybridization revealed that the major
      site of TnC expression early after vascular injury was the adventitial
      myofibroblasts. Immunohistochemical staining demonstrated that TnC expression
      began in adventitial myofibroblasts three days after injury. Tenascin-C
      expression, however, did not persist in this region. Rather, it moved
      progressively across the vascular wall toward the luminal surface. By one week,
      TnC expression reached the developing neointima. In vitro, myofibroblasts did not
      express TnC mRNA under basal conditions. In contrast, angiotensin II and PDGF-BB,
      factors that have been implicated in remodeling of balloon-injured arteries,
      markedly upregulated TnC mRNA. CONCLUSIONS: Tenascin-C is expressed in response
      to balloon injury. Tenascin-C expression begins with adventitial myofibroblasts.
      Over a period of 7 to 14 days, expression moves progressively across the vessel
      wall to the neointima. We hypothesize that adventitial myofibroblasts are
      actively involved in the formation of neointima and that TnC facilitates
      migration of these cells during adventitial remodeling.

PMID- 11216994
TI  - Prevention of aortic and cardiac fibrosis by spironolactone in old normotensive
      rats.
AB  - OBJECTIVES: Because the synthesis of aldosterone is mainly modulated by
      angiotensin II through type I receptor stimulation and because converting enzyme
      inhibition (CEI) does not modify aortic extracellular matrix in old normotensive
      rats, the aim of the present study was to determine whether inhibition of
      aldosterone formation was able to prevent aortic fibrosis in old Sprague-Dawley
      normotensive rats. BACKGROUND: We have previously shown that long-term
      aldosterone antagonism prevents the age-related increase in aortic collagen
      accumulation in young spontaneously hypertensive rats, independent of blood
      pressure changes. In contrast, we reported that the positive effects of CEI in
      the prevention of aortic collagen accumulation were related to the inhibition of
      angiotensin II actions on angiotensin II type I receptors. METHODS: For this
      purpose, we studied the histomorphometric and stiffness (echo-tracking technique)
      changes of an eight-week treatment with the aldosterone antagonist spironolactone
      by comparison with placebo. RESULTS: At the end of treatment, spironolactone in
      conscious animals did not change intra-arterial blood pressure, aortic and
      carotid wall thickness, and cardiac weight. Cardiac collagen density and, to a
      lesser extent, carotid collagen and elastin densities and contents were
      significantly decreased in association with an increase of carotid
      distensibility. CONCLUSIONS: These results show that in old normotensive rats,
      spironolactone can markedly prevent cardiac and, to a lesser extent, arterial
      fibrosis and improve arterial stiffness, despite a lack of hypotensive effect.

PMID- 11216995
TI  - Soluble substances released from postischemic reperfused rat hearts reduce
      calcium transient and contractility by blocking the L-type calcium channel.
AB  - OBJECTIVES: This study was designed to investigate the effects of
      cardiodepressant substances released from postischemic myocardial tissue on
      myocardial calcium-regulating pathways. BACKGROUND: We have recently reported
      that new cardiodepressant substances are released from isolated hearts during
      reperfusion after myocardial ischemia. METHODS: After 10 min of global ischemia,
      isolated rat hearts were reperfused, and the coronary effluent was collected for
      30 s. We tested the effects of the postischemic coronary effluent on cell
      contraction, Ca2+ transients and Ca2+ currents of isolated rat cardiomyocytes by
      applying fluorescence microscopy and the whole-cell, voltage-clamp technique.
      Changes in intracellular phosphorylation mechanisms were studied by measuring
      tissue concentrations of cyclic adenosine monophosphate (cAMP) and cyclic
      guanosine monophosphate (cGMP), as well as activities of cAMP-dependent protein
      kinase (cAMP-dPK) and protein kinase C (PKC). RESULTS: The postischemic coronary
      effluent, diluted with experimental buffer, caused a concentration-dependent
      reduction of cell shortening and Ca2+ transient in the field-stimulated isolated
      cardiomyocytes of rats, as well as a reduction in peak L-type Ca2+ current in
      voltage-clamped cardiomyocytes. The current reduction resulted from reduced
      maximal conductance--not from changes in voltage- and time-dependent gating of
      the L-type Ca2+ channel. The postischemic coronary effluent modified neither the
      tissue concentrations of cAMP or cGMP nor the activities of cAMP-dPK and PKC.
      However, the effluent completely eliminated the activation of glycogen
      phosphorylase after beta-adrenergic stimulation. CONCLUSIONS: Negative inotropic
      substances released from isolated postischemic hearts reduce Ca2+ transient and
      cell contraction through cAMP-independent and cGMP-independent blockage of L-type
      Ca2+ channels.

PMID- 11216996
TI  - Redox regulation of MAPK pathways and cardiac hypertrophy in adult rat cardiac
      myocyte.
AB  - OBJECTIVES: We analyzed the regulatory function of reactive oxygen species (ROS)
      on the hypertrophic signaling in adult rat cardiac myocytes: BACKGROUND: The ROS
      regulate mitogenic signal transduction in various cell types. In neonatal rat
      cardiac myocyte, antioxidants have been shown to inhibit cardiac hypertrophy, and
      ROS are suggested to modulate the hypertrophic signaling. However, the conclusion
      may not reflect the situation of mature heart, because of the different natures
      between neonatal and adult cardiac myocytes. METHODS: Cultured adult rat cardiac
      myocytes were stimulated with endothelin-1 (ET-1) or phenylephrine (PE), and
      intracellular ROS levels, the activities of mitogen-activated protein kinases
      (MAPKs; ERK, p38, and JNK), and 3H-phenylalanine incorporation were examined. We
      also examined the effects of antioxidant pretreatment of myocytes on MAPK
      activities and cardiac hypertrophy to analyze the modulatory function of redox
      state on MAPK-mediated hypertrophic signaling. RESULTS: The ROS levels in ET-1-
      or PE-stimulated myocytes were maximally increased at 5 min after stimulation.
      The origin of ROS appears to be from NADH/NADPH oxidase, because the increase in
      ROS was suppressed by pretreatment of myocytes with NADH/NADPH oxidase inhibitor
      diphenyleneiodonium. Extracellular signal-regulated kinase (ERK) activity was
      increased by the stimulation of ET-1 or PE. In contrast, p38 and c-Jun-N-terminal
      protein kinase (JNK) activities did not change after these stimulations.
      Antioxidant treatment of myocytes suppressed the increase in ROS and blocked ERK
      activation and the subsequent cardiac hypertrophy induced by these stimuli.
      CONCLUSIONS: These data demonstrate that ROS mediate signal transduction of
      cardiac hypertrophy induced by ET-1 or PE in adult rat cardiac myocytes.

PMID- 11216998
TI  - President's page: patient satisfaction: a personal perspective.

PMID- 11216997
TI  - The family under attack.

PMID- 11216999
TI  - Vascular effect of insulin in endothelial dysfunction.

PMID- 11217000
TI  - Electron beam computed tomography in the diagnosis of obstructive coronary artery
      disease.

PMID- 11217001
TI  - Use of teleoptometry to evaluate acceptability of rigid gas-permeable contact
      lens fits.
AB  - BACKGROUND: Teleoptometry involves the transmission of digitized optometric
      information from a remote site for analysis by an expert. This project assessed
      computer compression of video data showing contact lens fitting relationships and
      the transmission of these data to a specialist for evaluation METHODS: Fifty-five
      sets of video clips showing dynamic fluorescein patterns of rigid gas-permeable
      lens fits, topographic corneal maps, and basic information on lens parameters
      were evaluated-live and again after digitization and electronic compression-by a
      contact lens specialist. The evaluator was asked to determine whether lens fit
      was acceptable and, if not, how the lens parameters should be changed. RESULTS:
      Comparison of lens evaluations made live versus compressed showed agreement on
      fit acceptability for approximately 80% of the subject/lens combinations. When
      the evaluator concluded for both presentations that the lens was unacceptable,
      the same change in lens parameters was recommended 67% of the time. DISCUSSION:
      Agreement for the majority of live and compressed video observations suggests
      that teleoptometric consultation on contact lens fitting is feasible. When
      technology advances to the point at which large files can be sent quickly via the
      Internet, it is likely the practice of transmitting video clips and other
      information to obtain fitting assistance will become commonplace.

PMID- 11217002
TI  - Effect of near-vision addition lenses on the accuracy of the accommodative
      response.
AB  - BACKGROUND: Addition lenses (adds) are frequently used to increase the accuracy
      of the near-vision focusing response, and may also play a role in the prevention
      or retardation of refractive error development. However, following the
      introduction of such a lens, if the accommodative response is reduced by an
      amount equal to the magnitude of the near add, then the resulting accommodative
      error (and degree of retinal defocus) would remain unchanged. METHODS: This study
      measured the accommodative response in 28 subjects while they viewed a near
      target binocularly, either through their distance refractive correction alone or
      this correction combined with a +0.75 D, +1.50 D, +2.00 D, or +2.50 D near add.
      RESULTS: The mean findings demonstrated a small (0.03 D) lead of accommodation to
      the near target through the distance correction, and monotonically increasing
      leads of accommodation with larger adds. Further, the additional lens power
      required to reduce the accommodative error to zero correlated significantly with
      the initial accommodative error. CONCLUSIONS: Near addition lenses may actually
      increase the degree of retinai defocus for individuals who manifest small
      accommodative errors.

PMID- 11217003
TI  - Optic disk edema in a patient with non-Hodgkin's lymphoma: is there a metastasis
      to the brain?
AB  - BACKGROUND: The manifestation of bilateral disk swelling raises the suspicion of
      papilledema and mandates that an etiology for increased intracranial pressure be
      discovered. This case report will present the manifestations and treatment of non
      Hodgkin's lymphoma and review the differential diagnoses of bilateral disk edema.
      CASE REPORT: A 51-year-old black man manifested symptoms of dizziness and
      intermittent loss of vision in the left eye for one week. Dilated funduscopy
      revealed early left optic disk edema; edema of the right optic nerve head was
      questionable. The patient had pulmonary nodules noted on a recent chest x-ray
      that were thought to be cancerous; this raised the suspicion of a metastasis to
      the brain or orbit. The patient did not return until about 10 weeks later, at
      which time he presented with a history significant for newly-diagnosed
      intermediate-grade non-Hodgkin's lymphoma. He had begun chemotherapy one month
      before the second examination at our clinic; methotrexate therapy for CNS
      metastasis had been provided at the time of the spinal taps. At the second visit,
      there was marked progression of the swelling of the left optic disk and mild
      swelling of the right disk. At the third visit, six weeks later, the disk edema
      had improved remarkably. The patient's disk swelling resolved completely by the
      end of his six months of chemotherapy. CONCLUSION: This is a unique presentation
      of a patient at high risk for brain metastasis, in which laboratory and
      radiologic studies failed to provide adequate supportive evidence for the
      conclusions drawn from clinic observations. Bilateral disk edema in a patient
      with a history of non-Hodgkin's lymphoma is strongly suggestive of a metastatic
      tumor to the brain causing increased intracranial pressure.

PMID- 11217004
TI  - Contact dermatitis.
AB  - BACKGROUND: Anatomically, the eyelid can be divided microscopically into (1)
      skin, which is made up of epidermis and dermis; (2) submucosa (3) muscular layer;
      (4) submuscular layer (dense connective tissue); (5) fibrous layer; and (6)
      palpebral conjunctiva. The thin nature of the eyelid makes it susceptible to
      inflammation resulting from allergy. Minimum levels of irritants contacting the
      adnexal area can penetrate the skin to initiate the allergic cascade. Allergic
      reactions that involve the eye may begin via contact to the skin, but often
      involve the conjunctiva. Eczema is the general term that describes the
      superficial inflammatory process involving the epidermis. Contact eczema is
      characterized by varying elements of epidermal erythema, papules, and vesicles.
      Allergic dermatoconjunctivitis connotes involvement of both the skin and
      conjunctiva. CASE REPORT: A 24-year-old man came to the clinic with a red,
      swollen left eye. Based on the history, the constellation of signs and symptoms
      (lack of diffuse or focal pain, presence of periorbital and conjunctival edema,
      absence of fever), and failed resolution after treatment with injectable
      antibiotics, the diagnosis of type IV delayed hypersensitivity reaction secondary
      to toxic/chemical exposure was made. Speedy resolution was accomplished using a
      sequenced therapy, which included oral antihistamines, topical cycloplegics,
      topical antibiotics, topical steroids, and palliative therapies. CONCLUSION:
      Optometrists should be familiar with the signs and symptoms of contact eczema and
      allergic dermatoconjunctivitis. Treatment includes management of the skin and
      adnexae, as well as the ocular manifestations.

PMID- 11217005
TI  - Safe exposure times for slit-lamp fundus biomicroscopy with high plus lenses.
AB  - PURPOSE: The purpose of this study was to calculate the retinal irradiance and
      maximum permissible exposure time (MPE) using high plus fundus biomicroscopy
      lenses. METHODS: Four Volk handheld condensing lenses (+78 D, +90 D, Superfield
      NC, and Super 66) were tested with biomicroscopes from three manufacturers
      (Nikon, Topcon, and Zeiss) on both high and medium illumination. Using the
      conservation of radiance theorem, the retinal irradiance was calculated and. with
      guidelines from the American National Standard Institute (ANSI). the maximum
      permissible exposure time was determined. RESULTS: The range of MPE time across
      all lenses and biomicroscopes was from 23 seconds to 74 seconds on high
      illumination setting. The average MPE times were: for the +78 D, 36 seconds; the
      Superfield NC, 57 seconds; the Super 66, 32 seconds; and the +90 D, 52 seconds.
      CONCLUSION: Retinal irradiances and safe exposure times are useful guidelines in
      both the clinical and academic setting. Fundus biomicroscopy with non-contact
      high plus condensing lenses produced calculated retinal irradiances and MPE times
      similar to those of other commonly used ophthalmic equipment. Awareness of the
      maximum permissible exposure time increases the safety of this valuable
      technique.

PMID- 11217006
TI  - Telecommunication-the challenge.

PMID- 11217007
TI  - Save Your Vision Month 2001 celebration guide.

PMID- 11217008
TI  - Ophthalmic telemedicine at the Alabama Institute for Deaf and Blind.
AB  - BACKGROUND: The University of Alabama at Birmingham School of Optometry and the
      Alabama Institute for Deaf and Blind have collaborated in development of
      electronic medical records, digital slit-lamp medical imaging, and ocular
      telemedicine between their two sites. METHODS: The telemedicine link uses the
      electronic medical record system (EMRS) called PEARL, and digitized slit-lamp
      images made with an MCV 4000 digital imaging unit attached to a Topcon SL4E slit
      lamp. RESULTS: These technologies allow remote physician access to medical
      records as well as remote triage of eye problems using transmitted digital images
      and telephone consultation. CONCLUSIONS: This implementation strategy can serve
      as a model for improvement of specialist access to remotely located sites. It is
      a unique pairing of a school of optometry and a residential institution for
      people with sensory impairment.

PMID- 11217009
TI  - A notational analysis of elite tennis strategy.
AB  - A notational analysis of singles events at all four Grand Slam tournaments
      between 1997 and 1999 was conducted to determine the influence of the sex of the
      player and court surface on elite tennis strategy. Rallies of 7.1 +/- 2.0 s in
      women's singles were significantly longer than those in men's singles (5.2 +/-
      1.8 s; P < 0.001). Rallies of 6.3 +/- 1.8 s at the Australian Open, 7.7 +/- 1.7 s
      at the French Open, 4.3 +/- 1.6 s at Wimbledon and 5.8 +/- 1.9 s at the US Open
      were recorded. Rallies were significantly longer at the French Open than at any
      other tournament (P< 0.05) and significantly shorter at Wimbledon than at any
      other tournament (P< 0.05). In women's singles, 52.8 +/- 12.4% of points were
      baseline rallies, significantly more than in men's singles (28.6 +/- 19%; P <
      0.001). The proportion of baseline rallies played at the French Open (51.9 +/-
      14.2% of points) was significantly greater than at the Australian Open (46.6 +/-
      12.5%), Wimbledon (19.7 +/- 19.4%) and the US Open (35.4 +/- 19.5%; P < 0.05).
      The results show that both the sex of the player and surface of the court have a
      significant influence on the nature of singles tennis at Grand Slam tournaments.

PMID- 11217010
TI  - Information--movement coupling: implications for the organization of research and
      practice during acquisition of self-paced extrinsic timing skills.
AB  - Information--movement coupling is a fundamental concept, integral to theorizing
      on the coordination of goal-directed activity in ecological psychology. In this
      paper, we examine the implications of this concept for the design of experimental
      research and the organization of practice during the acquisition of movement
      coordination in sport tasks. The task vehicle for our analysis is interceptive
      actions, in particular self-paced extrinsic timing tasks exemplified by serving
      in sports such as volleyball. Recent research highlighting the relevance of
      information--movement coupling for the process of practice in sport is discussed.
      We conclude that information--movement coupling represents an important principle
      for the structural organization of research and practice in self-paced extrinsic
      timing tasks and that further work is required to verify its significance across
      a range of sport movements.

PMID- 11217011
TI  - Home advantage in the Winter Olympics (1908-1998).
AB  - We obtained indices of home advantage, based on the medals won by competing
      nations, for each event held at the Winter Olympics from 1908 to 1998. These
      indices were designed to assess home advantage while controlling for nation
      strength, changes in the number of medals on offer and the performance of 'non
      hosting' nations. Some evidence of home advantage was found in figure skating,
      freestyle skiing, ski jumping, alpine skiing and short track speed skating. In
      contrast, little or no home advantage was observed in ice hockey, Nordic
      combined, Nordic skiing, bobsled, luge, biathlon or speed skating. When all
      events were combined, a significant home advantage was observed (P = 0.029),
      although no significant differences in the extent of home advantage were found
      between events (P > 0.05). When events were grouped according to whether they
      were subjectively assessed by judges, significantly greater home advantage was
      observed in the subjectively assessed events (P = 0.037). This was a reflection
      of better home performances, suggesting that judges were scoring home competitors
      disproportionately higher than away competitors. Familiarity with local
      conditions was shown to have some effect, particularly in alpine skiing, although
      the bobsled and luge showed little or no advantage over other events. Regression
      analysis showed that the number of time zones and direction of travel produced no
      discernible trends or differences in performance.

PMID- 11217012
TI  - Changes in short-term power output in 10- to 12-year-olds.
AB  - In this study, we used multi-level regression modelling to assess the influence
      of age, sex, body size, skinfold thicknesses, maturity, thigh muscle volume and
      isokinetic leg strength on the development of load- and inertia-adjusted peak (1
      s) and mean power (30 s) determined using the Wingate anaerobic test. Fifteen
      males and 19 females were measured twice, first aged 10.0 +/- 0.3 years and then
      aged 11.8 +/- 0.3 years. Initial models identified body mass and height as
      significant explanatory variables (P < 0.05) for peak power and mean power, with
      an additional age effect for the former. No significant differences between the
      sexes or maturity effects were observed for either peak or mean power (P > 0.05).
      The introduction of sum of skinfolds improved the fit of the model and rendered
      the height term non-significant for both peak and mean power (P> 0.05). An age
      effect became apparent for mean power. When isokinetic leg strength and thigh
      muscle volume were entered into the model, the latter exerted a significant
      effect on both peak and mean power (P< 0.05), whereas isokinetic leg strength was
      not a significant explanatory variable for either (P> 0.05). In conclusion, thigh
      muscle volume exerts a positive influence on young people's short-term power
      output, which is additional to the effects of body mass, sum of skinfolds and
      age.

PMID- 11217013
TI  - Kinematic and postural characteristics of sprint running on sloping surfaces.
AB  - The aim of this study was to identify the kinematic and postural characteristics
      associated with sprint running on uphill and downhill slopes of 3 degrees and on
      a horizontal surface. Eight male physical education students were filmed while
      sprinting maximally on an uphill-downhill platform under each of three
      conditions: (a) uphill at 3 degrees, (b) downhill at 3 degrees and (c)
      horizontal. Running speed, step rate, step length, step time, contact time,
      flight time and selected postural characteristics of the step cycle were
      analysed. Running speed was 9.2% faster (P < 0.05) during downhill and 3.0%
      slower (P < 0.05) during uphill compared with horizontal sprint running. During
      downhill and uphill sprint running, step length was the main contributor to the
      observed changes in running speed. It increased by 7.1% (P < 0.05) for downhill
      sprint running and was associated with significant changes in posture at
      touchdown and take-off. During uphill sprint running, step length decreased by
      5.2% (P < 0.05), which was associated with significant changes in posture and
      reduced flight distance. Given the interaction between the acute changes in step
      length and posture when sprinting on a sloping surface, our findings suggest that
      such changes in posture may detract from the specificity of training on such
      surfaces. The chronic effects of training on such slopes on the kinematics and
      posture of horizontal sprint running are currently unclear.

PMID- 11217014
TI  - Hormonal responses to exercise after partial sleep deprivation and after a
      hypnotic drug-induced sleep.
AB  - The aim of this study was to determine the hormonal responses, which are
      dependent on the sleep wake cycle, to strenuous physical exercise. Exercise was
      performed after different nocturnal regimens: (i) a baseline night preceded by a
      habituation night; (ii) two nights of partial sleep deprivation caused by a
      delayed bedtime or by an early awakening; and (iii) two nights of sleep after
      administration of either a hypnotic compound (10 mg zolpidem) or a placebo. Eight
      well-trained male endurance athletes with a maximal oxygen uptake of 63.5 +/- 3.8
      ml x kg(-1) x min(-1) (mean value +/- s(x)) were selected on the basis of their
      sleeping habits and their physical training. Polygraphic recordings of EEG showed
      that both nights with partial sleep loss led to a decrease (P< 0.01) in stage 2
      and rapid eye movement sleep. A delayed bedtime also led to a decrease (P < 0.05)
      in stage 1 sleep. Zolpidem had no effect on the different stages of sleep. During
      the afternoon after an experimental night, exercise was performed on a cycle
      ergometer. After a 10-min warm-up, the participants performed 30 min steady-state
      cycling at 75% VO(2-max) followed by a progressively increased workload until
      exhaustion. The recovery period lasted 30 min. Plasma growth hormone, prolactin,
      cortisol, catecholamine and lactate concentrations were measured at rest, during
      exercise and after recovery. The concentration of plasma growth hormone and
      catecholamine were not affected by partial sleep deprivation, whereas that of
      plasma prolactin was higher (P < 0.05) during the trial after an early awakening.
      Plasma cortisol was lower (P < 0.05) during recovery after both sleep deprivation
      conditions. Blood lactate was higher (P < 0.05) during submaximal exercise
      performed after both a delayed bedtime and an early awakening. Zolpidem-induced
      sleep did not affect the hormonal and metabolic responses to subsequent exercise.
      Our results demonstrate only minor alterations in the hormonal responses to
      exercise after partial sleep deprivation.

PMID- 11217015
TI  - Effects of external loading on power output in a squat jump on a force platform:
      a comparison between strength and power athletes and sedentary individuals.
AB  - The aim of this study was to determine the effects of external loading on power
      output during a squat jump on a force platform in athletes specializing in
      strength and power events (6 elite weight-lifters and 16 volleyball players) and
      in 20 sedentary individuals. Instantaneous power was computed from time-force
      curves during vertical jumps with and without an external load (0, 5 or 10 kg
      worn in a special vest). The jumps were performed from a squat position, without
      lower limb counter-movement or an arm swing. Peak instantaneous power
      corresponded to the highest value of instantaneous power during jumping. Average
      power throughout the push phase of the jump was also calculated. A two-way
      analysis of variance showed significant interactions between the load and group
      effects for peak instantaneous power (P< 0.01) and average power (P< 0.001). Peak
      instantaneous power decreased significantly in sedentary individuals when
      moderate external loads were added. The peak instantaneous power at 0 kg was
      greater than that at 5 and 10 kg in the sedentary individuals. In contrast, peak
      instantaneous power was independent of load in the strength and power athletes.
      Mean power at 0 kg was significantly lower than at 5 kg in the athletes; at 0 kg
      it was significantly higher than at 10 kg in the sedentary males and at 5 and 10
      kg in the sedentary females. In all groups, the force corresponding to peak
      instantaneous power increased and the velocity corresponding to peak
      instantaneous power decreased with external loading. The present results suggest
      that the effects of external loading on peak instantaneous power are not
      significant in strength and power athletes provided that the loads do not prevent
      peak velocity from being higher than the velocity that is optimal for maximal
      power output.

PMID- 11217016
TI  - Analytical methods to determine phosphonic and amino acid group-containing
      pesticides.
AB  - A comprehensive view on the possibilities of the most recently developed
      chromatographic methods and emerging techniques in the analysis of pesticides
      glyphosate, glufosinate, bialaphos and their metabolites is presented. The state
      of-the-art of the individual pre-treatment steps (extraction, pre-concentration,
      clean-up, separation, quantification) of the employed analytical methods for this
      group of chemicals is reviewed. The advantages and drawbacks of the described
      analytical methods are discussed and the present status and future trends are
      outlined.

PMID- 11217017
TI  - Direct separation of the stereoisomers of methoxytetrahydronaphthalene
      derivatives, new agonist and antagonist ligands for melatonin receptors, by
      liquid chromatography on cellulose chiral stationary phases.
AB  - Analytical HPLC methods using derivatized cellulose chiral stationary phases were
      developed for the direct separation of the stereoisomers of disubstituted
      tetralin derivatives with two chiral centers, new agonist and antagonist ligands
      for melatonin receptors. The separations were made using normal-phase methodology
      with a mobile phase consisting of n-hexane-alcohol (methanol, ethanol, 1-propanol
      or 2-propanol) in various proportions, and a silica-based cellulose tris-3,5
      dimethylphenylcarbamate (Chiralcel OD-H), or tris-methylbenzoate (Chiralcel OJ).
      The effects of concentration of various aliphatic alcohols in the mobile phase
      were studied. A better separation was achieved on cellulose carbamate phase
      compared with the cellulose ester phase. The effects of structural features of
      the solutes on the discrimination between the stereoisomers were examined.
      Baseline separation (Rs>1.5) was easily obtained in many cases.

PMID- 11217018
TI  - Thermosensitive copolymers of N-vinylimidazole as displacers of proteins in
      immobilised metal affinity chromatography.
AB  - Synthetic copolymers of N-vinylcaprolactam (VCL) and N-vinylimidazole (VI) were
      studied as thermosensitive, reusable displacers for immobilised metal affinity
      chromatography (IMAC) of proteins. The copolymer with weight-average molecular
      mass of 11700 g/mol prepared by free radical polymerisation at a 9:1 monomer
      molar ratio was separated into several fractions by IMAC and thermal
      precipitation. The fraction with an average VI content of 8.5% was most efficient
      as a reusable displacer for IMAC of ovalbumin, lysozyme and other proteins of egg
      white on Cu2+-IDA-Sepharose. The displacer exhibited a sharp breakthrough curve
      and binding capacity of 16-20 mg/ml gel, depending on the flow-rate. The recovery
      of egg white proteins in the course of displacement chromatography was >95%. The
      displacer could be removed quantitatively from the protein fractions by thermal
      precipitation at 48 degrees C. Co-precipitation of lysozyme with the displacer
      was minimal in the presence of 3% (v/v) acetonitrile, while the lysozyme
      enzymatic activity in the supernatant was completely retained. Addition of free
      imidazole to the mobile phase increased the rate of protein desorption and
      allowed better separation of egg white proteins and the displacer in the course
      of chromatography. The displacement profile of the egg white extract consisted of
      three zones with different distributions of individual proteins characterised by
      SDS-PAGE. Regeneration of the column was easily performed with 0.02 M EDTA in
      0.15 M sodium chloride, pH 8.0, followed by washing with distilled water and
      reloading with Cu2+. The displacer could also be regenerated by thermal
      precipitation at 48 degrees C and subsequent dialysis against dilute hydrochloric
      acid (pH 2.5).

PMID- 11217019
TI  - Monitoring of recombinant human insulin production by narrow-bore reversed-phase
      high-performance liquid chromatography, high-performance capillary
      electrophoresis and matrix-assisted laser desorption ionisation time-of-flight
      mass spectrometry.
AB  - An analytical scheme for monitoring recombinant human insulin (rhI) production is
      suggested. The scheme includes high-performance separation micro-techniques
      (narrow-bore RP-HPLC, HPCE) based on different separation mechanisms and matrix
      assisted laser desorption ionisation time-of-flight MS, and allows one to obtain
      unambiguous information about purity and primary structure of all intermediates
      of the rhI production. The use of this scheme at all production steps provided
      optimisation of certain technological parameters [conditions for a fusion protein
      (FP) refolding, temperature and duration of the FP cleavage with trypsin,
      conditions for carboxypeptidase B digestion of di-ArgB31-B32-insulin] and
      achievement of a high purity of the end-product. The proposed scheme may be used
      for solving various problems in monitoring production of other recombinant
      proteins.

PMID- 11217020
TI  - Membrane ion-exchange chromatography for process-scale antibody purification.
AB  - The large-scale production of recombinant monoclonal antibodies demands
      economical purification processes with high throughputs. The potential for ion
      exchange membrane adsorbers to replace traditional ion-exchange columns was
      evaluated. Breakthrough capacities of commercially available cation-exchange
      membranes were determined as a function of flow-rate and layer number. Due to
      economic and process restrictions, cation-exchange membranes may not currently be
      advantageous for process-scale antibody purification in a bind and elute mode.
      However, anion-exchange membranes in a flow-through mode may provide a reasonable
      alternative to columns for the removal of low levels of impurities such as DNA,
      host cell protein, and virus.

PMID- 11217021
TI  - Purification method for the isolation of monophosphate nucleotides from Champagne
      wine and their identification by mass spectrometry.
AB  - Monophosphate nucleotides are difficult to identify in Champagne wine because
      they are present in small concentrations in a complex mixture. A method for the
      isolation, separation and identification of reference compounds, which achieved
      on average 79% recovery (except for cytidine derivatives), was developed and
      applied to wine. Some monophosphate nucleotides were then isolated from a
      Champagne wine aged on lees for 8 years, by ultrafiltration followed by a semi
      preparative HPLC step using a strong anion-exchange column. The fraction obtained
      was subjected to HPLC in a reversed-phase column to remove the salt previously
      introduced, before identification of compounds by HPLC coupled to a mass
      spectrometer. For the first time in wine, 5'-IMP, 5'-AMP, 5'-CMP, 5'-GMP, 5'-UMP
      and the 3'- and/or 2'-isomers of the four latter compounds were identified by
      comparing their HPLC and electrospray ionization mass spectrometry data with
      those of reference nucleotides.

PMID- 11217022
TI  - Determination of alkylphosphonic acids by microcolumn liquid chromatography with
      gradient elution coupled on-line with flame photometric detection.
AB  - Microcolumn liquid chromatography with gradient elution and on-line flame
      photometric detection has been used for the selective and rapid determination of
      non-volatile alkylphosphonic acids, which are hydrolysis products of nerve
      agents, in aqueous samples. A make-up of water was used to maintain stable
      introduction of the eluent during a gradient run. The detection limits are
      strongly dependent on quenching, which is determined by the mass flow of methanol
      in the eluent. Large-volume injections of 100 microl of aqueous solutions of
      short- and long-chain alkylphosphonic acids resulted in detection limits in the
      range 6-800 ng/ml. The repeatability of the retention times and analyte response 
      peak area or peak height were 0.7-0.9% and 4-11%, respectively. The method was
      successfully applied to a local tap water sample and an aqueous soil extract.

PMID- 11217023
TI  - Reversed-phase high-performance liquid chromatography versus spectrophotometric
      assay for thimerosal in Cuban recombinant hepatitis B vaccine.
AB  - A reversed-phase liquid chromatographic method was applied to study the stability
      of thimerosal in Cuban recombinant hepatitis B vaccine samples stored under
      different temperature conditions. Salicylic acid was used as internal standard,
      it allowed one to determine the thimerosal in the presence of its degradation
      products. Good stability of the preservative was demonstrated in vaccine samples
      for as long as 6 years. The same results were obtained when the vaccine samples
      were incubated at 37 and 45 degrees C during 30 days. The results were in
      compliance with the microbiological test for determining the effectiveness of
      antimicrobial preservative in these samples.

PMID- 11217024
TI  - Quantitative determination of marine toxins associated with diarrhetic shellfish
      poisoning by liquid chromatography coupled with mass spectrometry.
AB  - Quantitative determination by liquid chromatography (LC) coupled with mass
      spectrometry (MS) was achieved for the following 10 toxins found in association
      with diarrhetic shellfish poisoning: okadaic acid (OA), dinophysistoxin-1 (DTX1),
      7-O-palmitoylokadaic acid (palOA), 7-O-palmitoyldinophysistoxin-1 (pa1DTX1),
      pectenotoxin-1 (PTX1), pectenotoxin-2 (PTX2), pectenotoxin-2 seco acid (PTX2SA),
      pectenotoxin-6 (PTX6), yessotoxin (YTX), and 45-hydroxyyessotoxin (YTXOH). Toxins
      in 2 g of the adductor muscle or the digestive glands of scallops, Patinopecten
      yessoensis, were extracted with 18 ml of methanol-water (9:1, v/v), freed of
      polar contaminants by partition between chloroform and water, and treated by
      solid-phase extraction on a silica cartridge column. Samples containing YTXOH
      were purified separately on a buffered reversed-phase column. Chromatographic
      separation was achieved by the following combinations of columns and mobile
      phases: a Symmetry C18 column with acetonitrile-0.05% acetic acid (7:3, v/v) for
      OA, DTX1, PTX6 and PTX2SA; a Develosil ODS column with the same mobile phase for
      PTX1 and PTX2; a Capcellpak column with methanol-2.5% acetic acid (98:2, v/v) for
      palOA and palDTX1; and an Inertsil ODS column with methanol-0.2 M ammonium
      acetate (8:2, v/v) for YTX and YTXOH. Carboxylic acid toxins were selectively
      monitored on [M-H]- ions, sulfated toxins on [M-Na]-ions, and neutral toxins on
      [M+NH4]+ ions. Average recoveries of the toxins spiked to tissue homogenates
      ranged from 70 to 134%. Detection limits in the muscle ranged from 5 to 40 ng/g
      and those in the digestive glands from 10 to 80 ng/g.

PMID- 11217025
TI  - Determination of trace alkaline earth metals in brines using chelation ion
      chromatography with an iminodiacetic acid bonded silica column.
AB  - The chromatographic behaviour of alkaline earth metals on iminodiacetic acid
      bonded silica was studied. It was found that the ionic strength of the eluent
      greatly affected both retention time and selectivity by controlling the extent to
      which either simple ion exchange or surface complexation was responsible for
      retention. With a 0.1 M KNO3 eluent, the retention order was Mg(II), Sr(II),
      Ca(II) and Ba(II), indicating a strong contribution to retention from ion
      exchange. However, when using a 1.5 M KNO3 eluent, Ba(II) was found to elute
      first, indicating complexation to be more dominant under these conditions (pH
      4.2). The effect of the ionic strength of the sample was also studied and it was
      found that by matching the eluent cation with that of the sample matrix,
      efficient separations of alkaline earth metals in 1.0 M NaCl and KCl brines could
      be obtained without matrix system peaks. Using post-column reaction with o
      cresolphthalein complexone, trace levels of Ca(II) and Mg(II) were determined in
      medicinal NaCl saline solution and laboratory-grade KCl.

PMID- 11217026
TI  - Influence of the carrier composition on thermal field-flow fractionation for the
      characterisation of sub-micron polystyrene latex particles.
AB  - A study on the influence of the carrier composition in a ThFFF system on the
      retention and thermal diffusion of sub-micron polystyrene latex particles has
      been carried out. Various factors that may influence retention were studied.
      These include: the type of electrolyte and surfactant, their respective
      concentrations, and the addition of an organic modifier. Particle retention is
      highly sensitive to small changes in the carrier composition. It is demonstrated
      that under the conditions applied, secondary effects, such as particle-wall and
      particle-particle interactions, are negligible. Addition of surfactants is
      required to minimise particle-wall interactions. Generally, retention increases
      at higher electrolyte concentration. Furthermore, the addition of acetonitrile
      (ACN) to an aqueous carrier leads also to an increased retention. The type of
      surfactant as well as its concentration is of influence on the retention time.
      The three surfactants that were studied, i.e., sodium dodecyl sulfate, Brij 35
      and cetyltrimethylammonium bromide, showed significant differences in particle
      retention behaviour. The observed differences in retention in the carriers can be
      attributed to actual changes in thermal diffusion. D(T) appears to be mainly
      determined by the interaction between the particle's surface and the carrier
      liquid, and is therefore highly sensitive to changes in the chemical composition
      of the particle surface and the carrier. Strong differences in size selectivity
      were found for different carrier compositions. This allows a relatively easy
      optimisation of the separation. On the other hand, it complicates the size and
      composition analysis of particles.

PMID- 11217027
TI  - How to increase precision in capillary electrophoresis.
AB  - This review surveys approaches on how to improve precision in capillary zone
      electrophoresis and micellar electrokinetic chromatography. Many different
      techniques have been employed successfully to improve instrument precision and to
      facilitate method transfer between instruments and laboratories. Operational
      parameters as well as theories will be discussed in detail.

PMID- 11217028
TI  - Application of solvent microextraction to the analysis of nitroaromatic
      explosives in water samples.
AB  - The application of solvent microextraction to the analysis of nitroaromatic
      explosives is presented. Extraction of 11 nitroaromatics was achieved by
      suspending 1 microl of organic solvent to the tip of a microsyringe in a stirred
      aqueous solution. Parameters such as extraction solvent, stirring rate, salt
      concentration and sampling time were studied and optimized. The limits of
      detection using bench-top quadrupole mass spectrometry and short extraction times
      (15 min) were found to be between 0.08 and 1.3 microg/l and the relative standard
      deviations ranged between 4.3 and 9.8%. Although precision and accuracy of
      quantification of the method are still needed, solvent microextraction proved to
      be a fast, simple and inexpensive tool for preconcentration and matrix isolation
      of nitroaromatics on a microscale.

PMID- 11217029
TI  - Extraction of thiodiglycol from soil using pressurised liquid extraction.
AB  - Thiodiglycol (TDG) is the predominant hydrolysis product of the chemical warfare
      agent sulfur mustard. The extraction of TDG was investigated using pressurised
      liquid extraction and the results compared for a variety of different solvents
      and soils. TDG was analysed underivatised by gas chromatography with flame
      photometric detection. A mixture of methanol-water (9:1), proved to be the most
      efficient extracting solvent for TDG at a temperature of 150 degrees C and 10
      MPa.

PMID- 11217030
TI  - Simple time weighted average level air-monitoring method for sulfur mustard in
      work places.
AB  - A simple air-monitoring method was developed and validated for vesicant sulfur
      mustard (HD) in the work place at time weighted average levels. XAD-2 adsorbent
      was used for the collection of HD vapours for 8 h followed by liquid desorption
      with carbon tetrachloride. The trace level analysis was carried out by gas
      chromatography-photoionization detection and was confirmed by gas chromatography
      mass spectrometric detection in the selected ion mode.

PMID- 11217031
TI  - Fast temperature programming in routine analysis of multiple pesticide residues
      in food matrices.
AB  - Flash gas chromatographic (GC) analysis of 15 organophosphorus pesticides
      commonly occurring in food crops was performed using the Thermedics Detection EZ
      Flash upgrade kit installed in the oven of a HP 5890 Series II Plus gas
      chromatograph. The temperature program and splitless time period were the main
      parameters to be optimized. In the first set of experiments wheat matrix-matched
      standards were analyzed both by: (i) the flash GC technique (resistive heating of
      a 5 m capillary column), and (ii) the conventional GC technique (moderate oven
      temperature programming of a 30 m capillary column). Using the flash GC
      technique, the analysis time was reduced by a factor of more than 10 compared to
      the conventional GC technique. Dramatically improved detectability of analytes
      was achieved due to much narrower peak widths. The flash GC technique was
      compared with another approach to faster GC analysis employing a 5 m column and
      fast temperature programming with a conventional GC oven. In comparison with this
      alternative, in the case of flash GC significantly better retention time
      repeatability was observed. The other superiority of resistive heating is very
      rapid cooling down (i.e., equilibration to the initial conditions) which
      contributes to the increased sample throughput.

PMID- 11217032
TI  - Supercritical fluid extraction and quantitative determination of organophosphorus
      pesticide residues in wheat and maize using gas chromatography with flame
      photometric and mass spectrometric detection.
AB  - An automated method using supercritical CO2 and clean-up by solid-phase
      extraction (SPE) using graphitized carbon black, has been developed for the
      quantitative determination of organophosphorus pesticide (OPP) residues in wheat
      and maize. Recoveries were as good as, or better than, those obtained using
      liquid extraction (LE) and gel permeation chromatography (GPC) for 10 OPP's
      spiked at levels equivalent to 0.05 and 0.50 microg/g. Lower limits of detection
      were possible using supercritical fluid extraction (SFE). Incurred residues were
      found in wheat and maize samples, and good agreement was obtained using SFE+SPE
      and LE+GPC. The SFE+SPE method required less analyst time and organic solvent,
      and hazardous waste was reduced.

PMID- 11217033
TI  - Solute-solvent interactions in micellar electrokinetic chromatography.
      Selectivity of lithium dodecyl sulfate-lithium perfluorooctanesulfonate mixed
      micellar buffers.
AB  - The solvation parameter model has been applied to the characterization of
      micellar electrokinetic chromatographic (MEKC) systems with mixtures of lithium
      dodecyl sulfate and lithium perfluorooctanesulfonate as surfactant. The variation
      in MEKC surfactant composition results in changes in the coefficients of the
      correlation equation, which in turns leads to information on solute-solvent and
      solute-micelle interactions. Lithium perfluorooctanesulfonate is more dipolar and
      hydrogen bond acidic but less polarizable and hydrogen bond basic than lithium
      dodecyl sulfate. Therefore mixtures of lithium dodecyl sulfate and lithium
      perfluorooctanesulfonate cover a very wide range of polarity and hydrogen bond
      properties, which in turn results in important selectivity changes for analytes
      with different solute properties.

PMID- 11217034
TI  - Optimisation of resolution in micellar electrokinetic chromatography by
      multivariate evaluation of electrolytes.
AB  - A novel approach to multivariate evaluation of separation electrolytes for
      micellar electrokinetic chromatography is presented. An initial screening of the
      experimental parameters is performed using a Plackett-Burman design. Significant
      parameters are further evaluated using full factorial designs. The total
      resolution of the separation is calculated and used as response. The proposed
      scheme has been applied to the optimisation of the separation of phenols and the
      chiral separation of (+)-1-(9-anthryl)-2-propyl chloroformate-derivatized amino
      acids. A total of eight experimental parameters were evaluated and optimal
      conditions found in less than 48 experiments.

PMID- 11217035
TI  - Fabrication of polyester microchannels and their applications to capillary
      electrophoresis.
AB  - Inexpensive and disposable polyester microchips were fabricated through
      photolithographic and wet-chemical etching procedure, followed by replication
      using an imprinting method at room temperature. Laboratory-scale laser-induced
      fluorescence equipment was employed as a detection system. The generation of
      electroosmotic flow (EOF) on the polyester channels was discussed in this paper.
      Surfactants in the running buffer had a significant effect on the EOF depending
      on their types. The epsilon potential of the electric double layer formed by
      adsorbing sodium lauryl sulfate molecules on the wall of polyester channels
      seemed to be constant within the buffer pH investigated. EOF could also be
      suppressed to zero by adding polyoxyethylene 23 lauryl ether into the running
      buffer. The separation of two laser dyes was obtained using polyester chips
      through both micellar electrokinetic chromatography and capillary zone
      electrophoresis. The polyester channels modified with 10-undecen-1-ol exhibited a
      dramatically high-separation efficiency compared with the conventional fused
      silica capillary tubes.

PMID- 11217036
TI  - Laser-induced fluorescence detection at 266 nm in capillary electrophoresis.
      Polycyclic aromatic hydrocarbon metabolites in biota.
AB  - The separation of five phenolic polycyclic aromatic hydrocarbon metabolites
      (hydroxy-PAHs) has been performed by cyclodextrin-modified micellar
      electrokinetic chromatography (CD-MEKC) using a 30 mM borate buffer (pH 9.0)
      containing 60 mM sodium dodecyl sulfate and varying concentrations of gamma
      cyclodextrin (gamma-CD). A concentration of 12.5 mM gamma-CD was found to provide
      a baseline separation of the five hydroxy-PAHs. We applied conventional
      fluorescence and laser-induced fluorescence (LIF) detection, using a new, small
      size, quadrupled Nd-YAG laser emitting at 266 nm. The best limits of detection,
      in the low ng/ml range, were achieved using LIF detection. For all analytes,
      linearity was observed up to ca. 100 ng/ml. As an application, conjugated pyrene
      metabolites in hepatopancreas samples from the terrestrial isopods Oniscus
      asellus and Porcellio scaber were separated and detected. Finally, flatfish bile
      samples from individuals exposed to polluted sediment or crude oil, which were
      part of an interlaboratory study, were analyzed by CD-MEKC with conventional
      fluorescence and LIF detection to determine the 1-hydroxypyrene concentrations.

PMID- 11217037
TI  - Determination of phenols in soil by supercritical fluid extraction-capillary
      electrochromatography.
AB  - A new analytical procedure is developed to couple supercritical fluid extraction
      with capillary electrochromatography (SFE-CEC) to extract and determine phenols
      in soil. Ten phenols consisting of phenol, methylphenols (p-cresol and o-cresol),
      dimethylphenols (3,5-xylenol, 3,4-xylenol and 2,6-xylenol), trimethylphenol,
      ethylphenols (p-ethylphenol and o-ethylphenol), and o-isopropylphenol are
      investigated. The use of supercritical CO2 with 10% methanol as the organic
      modifier was found to give satisfactory extraction of alkylphenols from soil at
      1200 p.s.i. and 50 degrees C for 45 min under a total extractant flow-rate of 0.2
      ml/min (1 p.s.i.=6894.76 Pa). Baseline resolution was achieved for the 10
      selected phenols under optimised CEC conditions at 20 kV in a mobile phase of
      acetonitrile-4 mM Tris, pH 7.0 (35:65) in a 45 cm (25 cm packed with 3 microm
      ODS) x 75 microm I.D. fused-silica capillary column. Using SFE with a 10-fold
      preconcentration factor, all alkyl-substituted phenols in soil can be determined
      with detection limits ranging from 0.0032 to 0.014 mg/kg and working range from
      0.019 to 2.72 mg/kg. The SFE-CEC procedure developed has been applied
      successfully to determine phenols extracted from real soil sample contaminated
      with medical disinfectant. It will provide a rapid method for the direct
      determination of phenol and alkyl-substituted phenol in soils, with capability
      for confirmation of unknown peaks.

PMID- 11217038
TI  - Trace analysis of gamma-cyclodextrin in a sample of beta-cyclodextrin by
      capillary electrophoresis.
AB  - A new capillary electrophoretic method for trace analysis of gamma-cyclodextrin,
      gamma-CD, in a sample of beta-CD has been developed, building on our recent work
      in which the tetraphenylborate ion, Ph4B-, was found to bind to gamma-CD three
      orders of magnitude more strongly than to beta-CD. The method involves
      measurement of the change of net electrophoretic mobility of Ph4B- and its CD
      complexes in a background electrolyte containing a fixed concentration of beta
      CD. Good linearity was found between 1/deltamu and 1/Cgamma where deltamu is the
      difference in the mobility of Ph4B- in the beta-CD solution at a given and at
      zero concentration of gamma-CD, and Cgamma the gamma-CD concentration. The limit
      of detection for gamma-CD in a beta-CD sample was found to be 0.020% (w/w), and
      high precision and accuracy were obtained.

PMID- 11217039
TI  - Development and validation of a capillary electrophoresis assay for the
      determination of 3,4-diaminopyridine and 4-aminopyridine including related
      substances.
AB  - A capillary electrophoresis (CE) assay has been developed for the quantitation
      and determination of the impurity profile of the potassium channel blockers 3,4
      diaminopyridine and 4-aminopyridine. The compounds were separated from related
      substances using a capillary of 30 cm effective length, a 50 mM phosphate buffer,
      pH 2.5 and an applied voltage of 25 kV. The assay was validated with respect to
      specificity, linearity, range, limits of quantitation and detection, precision
      and robustness. The method allows the detection and quantitation of impurities at
      the 0.05% level. The feasibility of the assay was demonstrated by analyzing a
      commercial sample of 3,4-diaminopyridine. All known related substances could be
      detected in this sample with the present CE method.

PMID- 11217040
TI  - Sulfur speciation and tetrathionate sulfitolysis monitoring by capillary
      electrophoresis.
AB  - Capillary electrophoresis (CE) with indirect detection was used to analyse
      mixtures of sulfur-containing compounds. An optimised electrolyte, composed of 2
      mM sulfosalicylic acid-0.5 mM Waters osmotic flow modifier OFM-OH, pH adjusted to
      7.00 with Bis-Tris, allowed the analysis of sulfide (H2S/HS-), thiosulfate
      (S2O(3)2-), tetrathionate (S4O(6)2-), trithionate (S3O(6)2-), sulfite (HSO3
      /SO(3)2-), sulfate (SO(4)2-), and peroxodisulfate (S2O(8)2-). Only sulfate showed
      a single-peak electropherogram that gives evidence of its stability in aqueous
      solutions. Thiosulfate, tetrathionate and peroxodisulfate showed an additional
      minor peak of sulfate that did not seem to be time-dependent and was supposed to
      be due to salt impurities. Sulfide and sulfite showed rapid conversion into their
      oxidation products in solutions exposed to air. Linear calibration curves were
      obtained for all these species, taking the oxidation process into account for
      sulfide and sulfite. Limits of detection were in the low- to mid-microM range,
      except for sulfide, for which the limit of detection was 10(-5) M. The identity
      of trithionate was not determined via standard solutions (not commercially
      available) but after the rearrangement of tetrathionate with sulfite that yields
      thiosulfate and trithionate. The time-dependence of the concentrations of both
      the reagents and products could be followed simultaneously by the proposed CE
      method and the reaction kinetics were found to be second order in the pH range 7
      to 11. A calibration curve for trithionate could be deduced from this study.

PMID- 11217041
TI  - Effect of liquid chromatography separation of complex matrices on liquid
      chromatography-tandem mass spectrometry signal suppression.
AB  - The effect of liquid chromatography separation on liquid chromatography-tandem
      mass spectrometry (LC-MS-MS) signal response for the characterization of low
      molecular-mass compounds in a complex matrix was investigated. Matrix induced
      signal suppression appears throughout the entire LC-MS-MS analysis of wheat
      forage extract, with greatest suppression occurring at early retention times.
      Experimental results show that co-elution of matrix components and analytes from
      the LC column may be most strongly attributed to column overloading rather than
      similar analyte and matrix retention behavior. As a result, two-dimensional (LC
      LC) separation can be a highly effective approach to address signal suppression
      effects for the quantitative LC-MS-MS analysis of complex matrix samples.

PMID- 11217042
TI  - High-speed counter-current chromatography separation and purification of
      resveratrol and piceid from Polygonum cuspidatum.
AB  - High-speed counter-current chromatography (HSCCC) was applied to the separation
      and purification of resveratrol and piceid from the dried roots (20.0 g) of
      Polygonum cuspidatium. The EtOAc extracts were separated with chloroform-methanol
      water (4:3:2, v/v). Resveratrol was identified in fraction 5. The water extracts
      were separated first with EtOAc-EtOH-water (10:1:10, v/v) and then with the same
      solvent system at the modified volume ratio of 70:1:70. Yields of resveratrol and
      piceid obtained were 2.18% and 1.07%. Chemical structures of the purified
      resveratrol and piceid were confirmed by electrospray ionization MS and 1H
      nuclear magnetic resonance spectroscopy.

PMID- 11217043
TI  - Corrections to moving chemical reaction boundary equation for weak reactive
      electrolytes under the existence of background electrolyte KCl in large
      concentrations.
AB  - In this report, the moving chemical reaction boundary (MCRB) was formed by the
      weak reaction electrolytes of NH3.H2O and CH3COOH under the existence of
      background electrolyte KCl in large concentrations, the experiments were compared
      with the predictions by the moving chemical reaction boundary equation (MCRBE)
      for weak reactive electrolytes. It was found that the experimental results are
      far from the predictions with the MCRBE. So the MCRBEs must be corrected under
      the given experimental conditions. The corrected MCRBEs are given for the MCRB
      formed with weak reactive electrolytes coupled with KCl at high concentrations.

PMID- 11217044
TI  - Recalculation of the temperature inside capillaries using high buffer
      concentrations.

PMID- 11217045
TI  - Joule heating calculations in capillary zone electrophoresis. Reply to
      "Recalculation of the temperature inside capillaries using high buffer
      concentrations" by Zhang et al.

PMID- 11217046
TI  - 4-(6,7-Dihydro-5,8-dioxothiazolo[4,5-g]phthalazin-2-yl)benzoic acid N
      hydroxysuccinimide ester as a highly sensitive chemiluminescence derivatization
      reagent for amines in liquid chromatography.
AB  - 4-(6,7-Dihydro-5,8-dioxothiazolo[4,5-g]phthalazin-2-yl)benzoic acid N
      hydroxysuccinimide ester was synthesized as a highly sensitive and selective
      chemiluminescence derivatization reagent for primary and secondary amines in
      liquid chromatography. Methyl-n-octylamine, n-nonylamine and n-decylamine were
      used as model compounds to optimize the derivatization, separation and
      chemiluminescence reaction conditions. This reagent reacts selectively with
      amines in the presence of triethylamine to give the highly chemiluminescent
      derivatives, which produce chemiluminescence by reaction with hydrogen peroxide
      in the presence of potassium hexacyanoferrate(III) in an alkaline medium. The
      chemiluminescent derivatives of the three amines can be separated within 20 min
      by reversed-phase liquid chromatography with isocratic elution, followed by
      chemiluminescence detection. The detection limits (signal-to-noise ratio=3) for
      primary and secondary amines are at sub-fmol levels for a 20-microl injection.
      Furthermore, this method was applicable to the determination of amantadine in
      human plasma.

PMID- 11217047
TI  - Chiral beta-cyclodextrin-based polymer supports prepared via ring-opening
      metathesis graft-polymerization.
AB  - A series of norborn-2-ene-derivatized beta-cyclodextrins (beta-CDs), 6-O-(norborn
      2-ene-5-carboxyl)-beta-CD (1), tetrakis(6-O-norborn-2-ene-5-carboxyl)-beta-CD
      (2), (3), 6-O-(6-norborn-2-ene-5-car-6-O-(7-oxanorborn-2-ene-5-carboxyl)-beta-CD
      bonylaminohexoyl)-beta-CD (4), 6-O-(norborn-2-ene-5-ylmethoxymethylsilyl)-beta-CD
      (5), tris(6-O-norborn-2-ene-5-ylmethoxymethylsilyl)-beta-CD (6), tetrakis(6-O
      norborn-2-ene-5-ylmethoxymethylsilyl)-beta-CD (7) and hexakis(6-O-norborn-2-ene-5
      ylmethoxymethylsilyl)-beta-CD (8), have been synthesized. Compounds 1-3 were
      prepared via reaction of beta-CD with norborn-2-ene-5-carboxylic chloride and 7
      oxanorborn-2-ene-5-carboxylic chloride, respectively; compounds 5-8 were
      synthesized from norborn-2-ene-5-yl-methyldichlorosilane and beta-CD,
      respectively. Compound 4 was accessible by reaction of norbom-2-ene-5
      carboxylaminohexoyl chloride with beta-CD. Compounds 1-8 were surface grafted
      onto norborn-2-ene-derivatized silica-based supports using ring-opening
      metathesis polymerization employing the ruthenium-based initiator
      bis(tricyclohexylphosphino)benzylideneruthenium dichloride [Cl2Ru(CHC6H5)(PCy3)2,
      Cy=cyclohexyl, 9]. Generally speaking, the resulting chiral stationary phases
      (CSPs) I-VIII may be prepared with high reproducibility and may be used within a
      pH of 2-10. Thus, relative standard deviations (sigman-1) of the mean resolution
      (Rs) are <7%. The CSPs were used for the enantioselective separation of beta
      blockers, N-dansyl-, N-3,5-dinitrobenzoyl- and Fmoc-protected amino acids and
      were characterized in terms of chemical stability, selectivity (alpha') and
      resolution (Rs). Additionally, the role of the spacer as well as influences of
      capacity and the degree of substitution of the beta-CD moiety on the separation
      characteristics were determined.

PMID- 11217048
TI  - Determination of the pore connectivity and pore size distribution and pore
      spatial distribution of porous chromatographic particles from nitrogen sorption
      measurements and pore network modelling theory.
AB  - The pore connectivity, pore size distribution and pore spatial distribution of
      the porous structure of native and silanized silica particles were determined by
      matching the experimental nitrogen sorption data with the theoretical results
      obtained from pore network model simulations. The agreement between theory and
      experiment is found to be good. The results clearly indicate that the deposition
      of the silane layer to the pore surfaces of the native silica particles produces
      a silanized silica particle with a mean pore diameter and pore connectivity
      smaller than that of the native silica particle. Furthermore, the evaluation of
      the pore diffusivity of ribonuclease under unretained conditions shows that the
      lower values of the pore connectivity found in the samples of silanized silica
      particles, when compared with the values of the pore connectivity obtained for
      the native silica particles, increase the diffusional mass transfer resistance
      within the porous structure of the silanized silica particles.

PMID- 11217049
TI  - Influences of surface chemistry on the separation behavior of stationary phases
      for reversed-phase and ion-exchange chromatography: a comparison of coated and
      grafted supports prepared by ring-opening metathesis polymerization.
AB  - A series of poly(norborn-2-ene) (poly-NBE), poly(7-oxanorborne-2-ene-5,6
      dicarboxylic acid) (poly-ONDCA), as well as poly(norborn-2-ene-co-7-oxanorborne-2
      ene-5,6-dicarboxylic acid) (poly-NBE-co-ONDCA) based silica supports were
      prepared via ring-opening metathesis polymerization (ROMP) using both coating and
      grafting techniques. Poly-NBE-grafted and poly-NBE-coated supports were used for
      the reversed-phase separation of phenols; poly-NBE, poly-ONDCA as well as poly
      NBE-co-ONDCA-grafted supports were used for comparative studies on the separation
      of a series of anilines and lutidines. As expected, grafted supports possess
      superior separation capabilities compared to their coated analogues. Compared to
      pure poly-NBE- and poly-ONDCA-grafted stationary phases, supports consisting of
      poly-NBE-co-ONDCA block-copolymers possess both hydrophobic and ion-exchange
      sites and represent optimum stationary phases for the separation of isomeric
      basic analytes.

PMID- 11217050
TI  - Bi-quadratic surface response for quantitative determination of analytes leading
      to partially overlapped chromatographic peaks.
AB  - A simple analytic approach is described for the accurate determination of the
      concentration of components which give rise to partially overlapped
      chromatographic peaks. This method requires neither deconvolution processes nor
      chromatographic separation of the peaks. From the empirical point of view a bi
      quadratic function has been found relating the area of an unresolved peak with
      the concentrations of the related analyte and of the interfering one. Such
      concentrations are then computed by solving the related non linear system of
      equations by the Newton-Raphson method.

PMID- 11217051
TI  - Molecularly imprinted polymer membranes for substance-selective solid-phase
      extraction from water by surface photo-grafting polymerization.
AB  - Hydrophilized polyvinylidene fluoride microfiltration membranes were surface
      modified in the presence of a template (terbumeton) in methanol with a graft
      copolymer of a functional monomer (2-acrylamido-2-methyl-1-propane sulfonic acid,
      AMPS, methacrylic acid, MAA, or acrylic acid, AA) and a cross-linker (N,N'
      methylene-bis-acrylamide) using UV irradiation and benzophenone as
      photoinitiator. As result, membranes covered with a thin layer of imprinted
      polymer selective to terbumeton were obtained. Blank membranes were prepared with
      the same monomer composition, but in the absence of the template. The membranes'
      capacity to adsorb terbumetone from aqueous solution was evaluated yielding
      information regarding the effect of polymer synthesis (type and concentration of
      functional monomer, concentration of cross-linker) on the resulting membranes'
      recognition properties. UV spectroscopic studies of the interactions with
      terbumetone revealed that AMPS forms a stronger complex than MAA and AA. In
      agreement with that finding, imprinting with AMPS gave higher affinities than
      with MAA and AA. The terbumeton-imprinted membranes showed significantly higher
      sorption capability to this herbicide than to similar compounds (atrazine,
      desmetryn, metribuzine). With the novel surface modification technology, the low
      non-specific binding properties of the hydrophilized microfiltration membrane
      could successfully be combined with the receptor properties of molecular
      imprints, yielding substance-specific molecularly imprinted polymer composite
      membranes. The high affinity of these synthetic affinity membranes to triazine
      herbicides together with their straightforward and inexpensive preparation
      provides a good basis for the development of applications of imprinted polymers
      in separation processes such as solid-phase extraction.

PMID- 11217053
TI  - A case of canine primitive neuroectodermal tumor (PNET).
AB  - A 2-year and 6 month-old, female, Golden Retriever showed circling behavior and
      seizure. By magnetic resonance imaging (MRI) examination, a mass was found on the
      surface of the left cerebral hemisphere, invading to the left temporal muscle.
      The skull bone between them was destroyed. The dog was euthanized and necropsied.
      Histologically, the mass contained a lot of undifferentiated anaplastic cells,
      forming Homer-Wright rosettes and pseudopalisading patterns. Thus, the case was
      diagnosed as primitive neuroectodermal tumor (PNET).

PMID- 11217052
TI  - Immunohistochemical analysis of cytokeratin expression in dog skin.
AB  - The expression of cytokeratins and involucrin was analyzed to identify the skin
      cells which compose the epidermis of dogs. The distribution of cytokeratins and
      involucrin in normal dog skin was immunohistochemically examined with 27
      commercial monoclonal antibodies for human use. Antibodies, No.4. OV-TL12/13,
      35betaH11, 4.1.18, CAM5.2, NCL5D3, Ks.13.1, Ks.18.04, Ks.19.1, 170.2.]4 and
      Ks.20.8 stained hair follicles and/or the sweat gland duct, but not the
      epidermis. Antibodies, 34betaB4, AE3, 34betaE12. LP34, RCK102, MNF116, AE1, KLI,
      DE-K10 and DE-K13 reacted with every layer of the epidermis, hair follicles and
      the sweat gland duct. These results were similar to those reported in the human
      skin. No positive staining, however, could be detected in the epidermis, hair
      follicles and the sweat gland duct with commercial antibodies, 6B10, Ks.7.18,
      Mu146-uc, E3, RCK108 and involucrin. Therefore, immunohistochemical investigation
      with these commercial antibodies developed for human skin examination might be
      available for investigating the origin of skin tumors in dogs.

PMID- 11217054
TI  - Pleomorphic rhabdomyosarcoma in a cow.
AB  - In a 5-year-old Holstein cow, a neoplasm composed of a large intramuscular mass
      and multiple metastases in the lungs and lymph nodes was diagnosed as a
      pleomorphic rhabdomyosarcoma. This neoplasm was characterized by marked variation
      in tumor cell size and giant cells with single bizarre nuclei. Although the
      presence of cross striations and myoglobin could be confirmed, expression of
      alpha-smooth muscle actin (SMA) was also recognized in a few cells. Neoplastic
      cells showing intense staining for desmin, vimentin and proliferating cell
      nuclear antigen irrespective of their size differed from those in an embryonal
      rhabdomyosarcoma that exhibited a wide spectrum of differentiation, reminiscent
      of normal skeletal myogenesis. The cellular pleomorphism and SMA expression
      seemed to be characteristic of deviation from normal muscle cells or satellite
      cells in adult muscle.

PMID- 11217055
TI  - Immunolocalization of gastrin-releasing peptide in the bovine uterus and
      placenta.
AB  - Gastrin-releasing peptide (GRP), a mammalian homologue of amphibian bombesin, has
      been suggested to be a novel regulatory peptide in the reproductive tract during
      pregnancy. In this study, the localization of GRP in the bovine uterus and
      placenta was demonstrated by immunohistochemistry. Uterine and placental samples
      were collected from nonpregnant and pregnant specimens, respectively. Tissue
      sampling was done from the caruncle and intercaruncle of the uterus, and from the
      placentome (caruncle and cotyledon) and intercotyledon of the placenta. In all
      the tissues examined, GRP was detected although its immunoreactivity was observed
      at various degrees. In the uterus, moderate immunoreactivity for GRP was observed
      in the uterine gland epithelial cells. In the placenta, strong immunoreactivity
      for GRP was demonstrated in the uterine gland epithelial cells; moderate in
      superficial epithelial cells; and weak in the trophoblasts, trophoblastic giant
      cells and cryptal epithelial hybrid cells. In both nonpregnant and pregnant
      animals, GRP was immunolocalized in the uterine gland secretions and was found
      predominantly in the supranuclear region of the uterine gland epithelial cells.
      These findings may suggest that GRP is secreted into the uterine lumen and
      regulates the intrauterine environment of both the nonpregnant and pregnant
      bovine by exocrine, autocrine and/or paracrine manner.

PMID- 11217056
TI  - Detection of babesia species from infected dog blood by polymerase chain
      reaction.
AB  - Polymerase chain reaction (PCR) was first applied to diagnosis of canine
      babesiosis in Japan. Blood samples from 13 dogs suffering from canine babesiosis
      were used for examination of specificity and sensitivity of the PCR diagnosis. Of
      the 13 dogs, three were experimentally infected, and ten were naturally infected
      with Babesia species in west part of Japan. We designed a nested PCR to amplify
      the babesial small subunit ribosomal RNA gene and found that only the nested PCR
      produced a visual band, which were not apparent by the first-round PCR to the
      positive samples. Specificity of the nested PCR was confirmed by amplification
      after the second-round PCR. Sensitivity of the nested PCR was examined by
      diluting the blood samples from infected and uninfected dogs. The nested PCR was
      found to show positive results on the most diluted blood at 0.0001% parasitemia.
      These results indicate that the nested PCR is highly sensitive and useful for
      diagnosis of canine babesiosis.

PMID- 11217057
TI  - Differentiation of stromal-vascular cells isolated from canine adipose tissues in
      primary culture.
AB  - A culture condition supporting adipocyte differentiation of stromal-vascular (S
      V) cells isolated from canine adipose tissues was established. Morphological
      observation and determination of glycerol-3-phosphate dehydrogenase (GPDH)
      activity were used as the criteria for adipocyte differentiation. After reaching
      confluence, the cells were able to undergo terminal adipocyte differentiation by
      treatment with 100 microM indomethacin, 10 microg/ml insulin and 0.5 mM 1-methyl
      3-isobutylxanthine (MIX) in medium supplemented with 5% fetal calf serum (FCS).
      In the absence of either indomethacin or insulin, the S-V cells did not undergo
      adipose conversion and GPDH activity was not increased, indicating that both
      indomethacin and insulin play essential roles in this culture system. The S-V
      cells from inguinal adipose tissues exhibited the greatest increase in GPDH
      activity among the four depots (inguinal > abdominal-subcutaneous > perirenal >
      omental). demonstrating that adipocyte differentiation was also intensely
      dependent on anatomic sites from which the S-V cells were derived. Interestingly,
      dimethylsulfoxide (DMSO) was found to accelerate adipocyte differentiation in
      combination with indomethacin and insulin. Under this condition, up to 90% of the
      cells displayed adipocyte phenotypes and the GPDH activity reached 1288 +/- 441
      mU/mg protein. This culture system may be useful for investigating other
      adipogenic factors as well as anti-adipogenic factors involved in the regulation
      of canine adipose tissue development.

PMID- 11217058
TI  - Effects of short photoperiod on the expression of smad2 and smad3 mRNA in Syrian
      hamster testis.
AB  - The testicular localization and expression of Smad2 and Smad3 mRNA involved in
      the intracellular signal transduction of activin, inhibin and transforming growth
      factor-beta (TGF-beta) were examined under the influence of long and short
      photoperiod in Syrian hamsters (Mesocricetus auratus). In situ hybridization
      detected both Smad2 and Smad3 mRNA in spermatogonia and premeiotic spermatocytes
      in the active testis exposed to a long photoperiod, as well as in the regressed
      testis exposed to a short photoperiod. Northern blots showed that Smad2 mRNA was
      expressed at all stages over long and short photoperiods, whereas Smad3 mRNA was
      expressed at high levels in the photoperiod-induced regressed testis. The
      photoperiodic condition would change the balance between Smad2 and Smad3
      transcripts in the testis. Thus, intracellular Smad2 and Smad3 might participate
      in transducing signals from activin, inhibin and TGF-beta in spermatogenetic
      cells.

PMID- 11217059
TI  - The cycle of the seminiferous epithelium in the greater Japanese shrew mole,
      Urotrichus talpoides.
AB  - Spermatogenesis and acrosomal formation in the greater Japanese shrew mole,
      Urotrichus talpoides, were studied by light microscopy. On the basis of acrosomal
      changes, morphology of spermatid head, nuclear shape, appearance of meiotic
      figures, location of spermatid and period of spermiation, the cycle of the
      seminiferous epithelium was classified into 12 stages, and developing spermatids
      could be divided into 15 steps. The mean relative frequencies of stages from I to
      XII were 10.9, 8.7, 9.8, 7.3, 8.5, 10.3, 12.5, 8.7, 5.8, 5.4, 5.1 and 7.1%,
      respectively. Similar to the case in the musk shrew, the spermatid nucleus of the
      greater Japanese shrew mole remained in the middle region of the seminiferous
      epithelium and only the acrosome extended towards the basement membrane. The
      elongation of the acrosome, however, was not prominent. The proacrosomal vesicle
      first appeared in stage II and then one large and round granule was seen in stage
      III. The acrosomal vesicle became flattened on the surface of the nucleus in
      stage IV. Spreading of the acrosomic system has been recognized from stage VII.
      In stage VII, spermiation occurred. In stage IX, the spermatid nucleus began to
      elongate. Elongation and condensation of the nucleus were clearly observed in
      stage X. In stage XII, pachytene spermatocytes divided into diplotene
      spermatocytes. In stage XII, meiotic figures and secondary spermatocytes were
      observed.

PMID- 11217060
TI  - Mechanisms of NO-resistant relaxation induced by acetylcholine in rabbit renal
      arteries.
AB  - The effects of K+ channel blockers and P2Y receptor agonist/antagonist on the
      vasorelaxation mediated by endothelium-derived hyperpolarizing factor (EDHF) were
      investigated in the rabbit renal artery. Acetylcholine (ACh, 1 nM-10 microM)
      induced endothelium-dependent relaxation of arterial rings precontracted with
      norepinephrine (NE, 1 microM) in a concentration-dependent manner. NG-nitro-L
      arginine (L-NAME. 0.1 mM), an inhibitor of NO synthase, partially inhibited the
      ACh-induced endothelium-dependent relaxation. The ACh-induced relaxation was only
      partially inhibited by L-NAME whereas combined addition of L-NAME and 30 mM KCl
      completely inhibited the relaxation. The ACh-induced relaxation observed in the
      presence of L-NAME was significantly reduced by a combination of iberiotoxin (0.1
      microM) and apamin (1 microM), and almost completely blocked by 4-aminopyridine
      (5 mM). The ACh-induced relaxation was antagonized by P2Y receptor antagonist,
      cibacron blue (10 and 100 microM) in a concentration-dependent manner.
      Furthermore, ADPbetaS, a potent P2Y agonist, induced the endothelium-dependent
      relaxation, and this relaxation was markedly reduced by either the combination of
      iberiotoxin and apamin or by cibacron blue alone. In conclusion, ACh may activate
      the release of ATP from endothelial cells which in turn activates a P2Y receptor
      on the endothelial cells followed by a release of EDHF, resulting in a
      vasorelaxation via a mechanism that involves activation of both the voltage-gated
      K+ channels and the Ca2+-activated K+ channels. EY WORDS: ATP, K+ channel, rabbit
      renal artery.

PMID- 11217061
TI  - Mechanisms of acetylcholine-induced vasorelaxation in high K+-stimulated rabbit
      renal arteries.
AB  - To characterize the mechanisms of acetylcholine (ACh)-induced vasorelaxation in
      rabbit renal arteries precontracted with high K+ (100 mM), muscle tension and
      cytosolic free Ca2+ concentration ([Ca2+]i) were measured simultaneously in the
      fura-2-loaded arterial strips. In the artery with endothelium, high K+ increased
      both [Ca2+]i and muscle tension. Addition of ACh (10 microM) during high-K+
      induced contraction significantly relaxed the muscle and induced additional
      increase in [Ca2+]i. In the presence of NG-nitro-L-arginine (L-NAME, 0.1 mM). ACh
      increased [Ca2+]i without relaxing the muscle. In the artery without endothelium,
      high K+ increased both [Ca2+]i and muscle tension although ACh was ineffective,
      suggesting that ACh acts selectively on endothelium to increase [Ca2+]i. 4-DAMP
      (10 nM) or atropine (0.1 microM) abolished the ACh-induced increase in [Ca2+]i
      and relaxation. However, pirenzepine (0.1 microM), AF-DX 116 (1 microM) and
      tropicamide (1 microM) were ineffective. The ACh-induced increase of [Ca2+li and
      vasorelaxation was significantly reduced by 3 microM gadolinium, 10 microM
      lanthanum or 10 microM SKF 96365. These results suggest that, in rabbit renal
      artery, ACh-evoked relaxation of 100 mM K+-induced contractions is mediated by
      the release of endothelial NO. ACh may stimulates the M3 subtype of muscarinic
      receptor in the endothelial cells, resulting in the opening of the nonselective
      cation channels followed by an increase of [Ca2+]i and stimulation of NO
      synthase.

PMID- 11217062
TI  - Dynamic changes in plasma concentrations of gonadotropins, inhibin, estradiol
      17beta and progesterone in cows with ultrasound-guided follicular aspiration.
AB  - To elucidate the effects of ultrasound-guided transvaginal follicular aspiration,
      plasma concentrations of FSH, LH, inhibin, estradiol-17beta and progesterone, and
      folliculogenesis were examined in Holstein cows. Four clinically healthy cows
      with regular estrous cycles were scanned by ultrasound per rectum once a week for
      9 weeks before the commencement of follicular aspiration. All visible follicles
      were divided into 3 categories based on their sizes (2 < or = small < 5 mm; 5 <
      or = medium < 10 mm, large > or = 10 mm). The follicular aspiration was started
      at random during the estrous cycle and conducted under epidural anesthesia
      induced with 5 ml of 2% lidocaine once a week for 6 weeks. The average number of
      total visible follicles > or = 2 mm in diameter at 7 days after aspiration (21.7
      +/- 7.4, n = 24) was similar to that before starting aspiration (26.7 +/- 10.5, n
      = 36). Plasma inhibin and estradiol-17beta declined and fell to a trough on 1.5
      days and returned to pre-aspiration values by 5 days after aspiration. Plasma
      concentrations of FSH increased and reached peak levels between 1 and 1.5 days
      after aspirations. Plasma concentrations of LH also increased and reached peak
      levels between 0.5 and 1.5 days after aspirations. Both plasma FSH and LH had
      returned to pre-aspiration levels by 5 days after aspirations. Plasma
      concentrations of progesterone did not change with the follicular aspiration.
      These results demonstrate that follicular aspiration decreases plasma
      concentrations of inhibin and estradiol-17beta, which in turn leads to a rise in
      plasma concentrations of FSH and LH. It is suggested that marked increases in
      plasma concentrations of FSH and LH after the aspiration stimulate the
      development and maturation of a new cohort of follicles within one week in cows.

PMID- 11217063
TI  - Effects of exposure of lactating female rats to polychlorinated biphenyls (Pcbs)
      on testis weight, sperm production and sertoli cell numbers in the adult male
      offspring.
AB  - To investigate the effects of intermittent and continuous exposure of lactating
      rats to Aroclor 1242 (a PCB congener), testis weight, daily sperm production
      (DSP) and Sertoli cell number per testis were examined in the adult male
      offspring. Thyroxine (T4) was also measured because of the well-documented
      effects of polychlorinated biphenyls (PCBs) on this hormone. In experiment 1.3
      groups of lactating female rats received daily subcutaneous injections of low
      (0.8 mg) or high (1.6 mg) doses of Aroclor 1242 in 0.1 ml corn oil from
      parturition to weaning of pups at 21 days. In experiment II, 3 groups of
      lactating rats received 2 subcutaneous injections per week of 0.8 or 1.6 mg
      Aroclor 1242, as in experiment 1. In both experiments, control rats received
      vehicle alone. Serum T4 was measured at 21 and 90 days of age, and testis weight,
      DSP and Sertoli cell numbers were examined at 90 days. In experiment I
      (continuous exposure), both the low (0.8 mg) and high (1.6 mg) doses suppressed
      T4 concentrations at 21 days of age. Testis weight was increased by 14.8% (LD)
      and 16.5% (HD) compared with controls. DSP was increased by 20.4% in the low dose
      and 25% in the high dose animals compared with controls. The number of Sertoli
      cells per testis was increased by 32.6 and 39.4% in low and high dose animals,
      respectively. A similar study in which the lactating females were only dosed
      twice per week (experiment 11) did not show any differences in these parameters.
      These results indicate that continuous exposure of lactating female rats to PCBs
      increases testis weight, sperm production and Sertoli cell numbers in the adult
      male offspring.

PMID- 11217064
TI  - Application of short-time magnetic resonance examination for intervertebral disc
      diseases in dogs.
AB  - The usefulness of magnetic resonance (MR) is already established, but it has a
      disadvantage of requiring a long scanning time. A short-time examination is more
      or less needed so as to be more practical in veterinary clinics. A protocol of
      the short-time MR examination was devised based on parameters determined, and
      validity of the protocol was assessed through the diagnosis of clinical cases
      with intervertebral disc diseases. With this protocol, it was possible to
      complete an MR examination for the spine within 15 min. The MR images and
      myelographic findings were correlated well in this study, suggesting the short
      time protocol of MR examination can be used in the clinical diagnosis of spinal
      diseases.

PMID- 11217065
TI  - Distribution of reticulocerebellar neurons in chicken reticular formation.
AB  - The distribution of reticulocerebellar (RC) neurons was examined by the
      retrograde transport of horseradish peroxidase (HRP) or wheat germ agglutinin
      bound to HRP (WGA-HRP) in 7 White Leghorn chickens. A large number of labeled
      cells were found in the nucleus reticularis pontis caudalis (RP) of the
      pontomedullary junction and in the nucleus reticularis gigantocellularis (Rgc),
      parvocellularis (Rpc), subtrigiminalis (Rst), paragigantocellularis (Rpg) and
      paramedianus (RpaM) in the medulla. Slightly ventral to the vestibulocochlear
      nerve were many large RC neurons arranged in a longitudinal manner along the
      lateral edge of the brainstem reticular formation (the Dorsolateral edge cells,
      DLe cells). RC neurons were most numerous in the Rgc and accounted for 31.9% of
      the total number of labeled cells, followed by RP (24.2%), Rpc (12.7%), Rpg
      (10.8%), RpaM (6.7%), DLe cells (6.3%) and Rst (4.9%). The great number of RC
      neurons was found around the levels of the vestibulocochlear nerve.

PMID- 11217066
TI  - Analysis by enzyme-linked immunosorbent assay and 2-dimensional electrophoresis
      of haptoglobin in the high-density lipoprotein fraction in cows.
AB  - Haptoglobin (Hp) is a hemoglobin (Hb)-binding acute-phase protein. Besides its
      relevance in inflammation, Hp is involved in the regulation of lipid metabolism.
      In cattle, in addition to the lipoprotein-deficient fraction, Hp is distributed
      in high-density lipoprotein (HDL) and very high-density lipoprotein (VHDL)
      fractions. The purpose of this study was to determine Hp concentrations in the
      lipoprotein fractions using an enzyme-linked immunosorbent assay (ELISA) based on
      the affinity with Hb, and also to detect structural differences of HDL Hp from
      that in the lipoprotein-deficient fraction using 2-dimensional electrophoresis.
      When purified Hp was used as the antigen for the ELISA, the detection limit was
      7.4 ng/ml and linearity was obtained from 14.8 to 475 ng/ml. The correlation
      coefficient between the ELISA and single radial immunodiffusion was 0.884. The
      ELISA was shown to be applicable to evaluate Hp concentrations in the lipoprotein
      fractions. Hp concentrations in the lipoprotein fractions were in the range of
      0.94 to 8.77 microg of Hp/ml (n = 4), and concentration ratios were 0.2 to 0.3%
      of whole serum Hp. Of the lipoprotein fractions, Hp was most abundant in HDL,
      moderate in VHDL and faint in chylomicrons, the very low-density lipoprotein
      fraction and low-density lipoprotein fraction. By 2-dimensional electrophoresis,
      alpha- and beta-chains of serum Hp were each separated into 5 spots, and their
      isoelectric point (pI) values were from 5.05 to 6.28 in the alpha-chain and from
      5.92 to 6.95 in the beta-chain. The pI values of HDL Hp were indistinguishable
      from those of serum Hp. These results indicate that the ELISA based on the
      affinity with Hb is useful for evaluating Hp concentrations in lipoprotein
      fractions, and also suggest that HDL Hp is structurally similar to that in the
      lipoprotein-deficient fraction.

PMID- 11217067
TI  - Effect of enrofloxacin-Na against pathogens related to the respiratory and
      alimentary diseases in suckling and weanling piglets.
AB  - A field trial was conducted to evaluate effect of enrofloxacin-Na against
      pathogens related to the respiratory and alimentary diseases in eighty suckling
      piglets (6-7 days old) and eighty weanling piglets (5-6 weeks old). Respective
      twenty of the suckling and weanling piglets were assigned to each of 4
      experimental groups; control (non-treated), clinical injection dose (CID), 2x
      clinical injection dose (2CID). and premix. A 0.05 ml (2.5 mg) of enrofloxacin-Na
      injection (5% solution, 1 ml) per kg body weight of piglets as CID was injected
      intramuscularly for 3 days and the clinical signs were observed for 9 days. The
      premix (150 ppm) of enrofloxacin-Na was administered with feed for 7 days ad
      libitum and the clinical signs were observed for 13 days. The enrofloxacin-Na
      treated piglets showed a higher increase in body weight and a lower feed per gain
      than the control piglets. In addition, the treatment of enrofloxacin-Na,
      regardless of the route of administration, decreased the incidence rate of
      diarrhea in suckling piglets and respiratory symptoms in weanling piglets. The
      isolation index of E. coli and Cl. perfringens during the treatment periods was
      also lowered by the enrofloxacin-Na treatment in both suckling and weanling
      piglets. The antibiotics was also evaluated as safe locally and whole bodily as
      treated by injection or feeding. These results indicate that the newly developed
      antibiotics, enrofloxacin-Na, is very useful for the prevention and therapy of
      swine diseases in the pig industry.

PMID- 11217068
TI  - The complete nucleotide sequences of L3 and S7 segments of Ibaraki virus encoding
      for the major inner capsid proteins, VP3 and VP7.
AB  - The complete nucleotide sequences of the genes encoding two of the major inner
      capsid proteins of Ibaraki virus (IBAV), belonging to epizootic hemorrhagic
      disease virus serotype 2 (EHDV-2) were determined. The L3 RNA segment is 2768
      nucleotides in length which encodes VP3 polypeptides of 899 amino acid residues
      (M.W. 103 kDa). The S7 RNA segment, which encodes the VP7 core protein, is 1162
      nucleotides in length and encodes 349 amino acids (M.W. 38 kDa). These RNA
      segments had the characteristic consensus motifs of Orbivirus RNA segments in
      termini, namely 5'-GUUAAA... and ...ACUUAC-3'. The comparison of the IBAV L3 and
      S7 sequences with those of other two EHDV-2 isolates revealed the higher
      homologies of 93% and 92% against EHDV-2 Australia isolate (EHDV-2AUS) and lower
      homologies of 80% and 81% against EHDV-2 North America isolate, respectively. The
      phylogenetic analysis based on L3 and S7 genes also indicated close relationships
      between IBAV and EHDV-2AUS.

PMID- 11217069
TI  - Seasonal rhinitis in a cat sensitized to Japanese cedar (Cryptomeria japonica)
      pollen.
AB  - A cat showing seasonal allergic symptoms of rhinitis was examined for
      reactivities to Japanese cedar (Cryptomeria japonica, CJ) pollen allergen by
      intradermal skin test (IDST), Prausnitz-Kustner (P-K) test, and lymphocyte
      blastogenic response. In IDST for 26 common allergens. the cat showed a positive
      reaction to CJ pollen allergen. P-K test using CJ pollen allergen also showed a
      positive reaction, indicating the presence of serum IgE specific to CJ pollen. In
      the lymphocyte blastogenic response, the stimulation index in the presence of CJ
      pollen allergen was 2.4. These data suggested that the seasonal rhinitis observed
      in the cat was caused by the sensitization to CJ pollen allergen.

PMID- 11217070
TI  - Effect of retinoids on growth inhibition of two canine melanoma cell lines.
AB  - Two new canine melanoma cell lines (CMM1 and CMM2) were established from the
      patients with oral malignant melanomas. Histopathological type of both CMM1 and
      CMM2 was a mixed cell type consisted of spindle-shaped cells, polygonal cells,
      and oval cells. Doubling time of CMMI and CMM2 were 18.4 +/- 1.96 hr and 21.0 +/-
      0.73 hr, respectively. The effect of two kinds of retinoids (all-trans retinoic
      acid and 9-cis retinoic acid) on the proliferation of these cells were examined
      by morphological changes, proliferation assay and apoptosis assay. However, the
      retinoids did not suppress growth rate of these cells. This result suggests that
      retinoids used in this study did not induce differentiation, apoptosis, and
      growth inhibition of the canine melanoma cell lines.

PMID- 11217072
TI  - Esophageal adenosquamous carcinoma in a cat.
AB  - Esophageal carcinoma was observed in an eight-year-old, castrated male, Japanese
      domestic cat. Histologically, this neoplasm consisted of two different growth
      patterns, squamous cell carcinoma and adenocarcinoma. The results of
      immunohistochemical examination supported the fact that the two kinds of
      neoplastic cells have different characteristics. The tumor was, therefore,
      diagnosed as adenosquamous carcinoma. Esophageal tumors in the cat are very rare
      and, if any, neither adenocarcinoma nor adenosquamous carcinoma has been reported
      up to the present.

PMID- 11217071
TI  - A case of pulmonary acariasis in lung of Japanese macaque.
AB  - A 20-year-old female Japanese macaque, weighing 8.7 kg, developed severe
      pulmonary acariasis. Numerous whitish nodules, 2-4 mm, were scattered throughout
      the lungs. Histologically multifocal granulomatous lesions consisting of a large
      number of eosinophils, epithelioid cells, foreign body type giant cells, and
      collagen fibers were aggregated around the mait bodies. Numerous mast cells were
      also detected in the lesions by toluidine blue staining, and tested positive for
      tryptase by immunohistochemistry. This may be the first reported case of severe
      pulmonary acariasis in a Japanese macaque.

PMID- 11217073
TI  - In addition to the high-density lipoprotein fraction, apolipoprotein C-III is
      detected in chylomicrons and the very low-density lipoprotein fraction from serum
      of normolipidemic cows.
AB  - Apolipoprotein (apo) C-III is a low-molecular-mass protein that is involved in
      the regulation of the triglyceride metabolism. Except for the hyperlipidemic
      calf, cattle apoC-III is mainly detected in the high-density lipoprotein (HDL)
      fraction, and the distribution in chylomicrons (CM) and the very low-density
      lipoprotein (VLDL) fraction has not yet been clarified. The purpose of the
      present study was to detect apoC-III in concentrated CM and VLDL fractions to
      examine whether apoC-III is distributed in the two fractions even in
      normolipidemic cattle. ApoC-III could be detected by immunoblot analysis in both
      concentrated cow CM and VLDL fractions, but not in the corresponding calf
      fractions. These results suggest that apoC-III is distributed in the CM and VLDL
      fractions, at least in cows, although the concentrations in these fractions are
      considerably lower than in the HDL fraction.

PMID- 11217074
TI  - A study of reproductive performance in pregnant, IL-2 receptor beta-chain
      overexpressed transgenic mice.
AB  - Relationships between female reproductive performance and uterine natural killer
      (uNK) cells were investigated in pregnant IL-2 receptor beta-chain overexpressed
      transgenic (Tg2Rbeta) mice. At 8 days of pregnancy, all fetuses were alive,
      suggesting that implantation normally occurred in these mice. However, 47% of
      fetuses were dead at 10 days of pregnancy and at 12 days all fetuses were
      resorbing, indicating that fetal loss progressed with the advance of pregnancy.
      The placenta of Tg2Rbeta mice gradually decreased in weight with the advance of
      pregnancy. At 10 days the placental labyrinth, decidua basalis, and metrial gland
      in Tg2Rbeta mice were poorly developed, and more uNK cells were found in Tg2Rbeta
      mice than in the control mice. We propose that Tg2RPbeta mice are the first and
      interesting model that uNK cells can cause abortion, to clarify the involvement
      of uNK cell function in female reproductive performance.

PMID- 11217075
TI  - Conditionally immortalized cell lines as a new in vitro model for the study of
      barrier functions.
AB  - Conditionally immortalized brain and retinal capillary endothelial and choroid
      plexus epithelial cell lines were established from a transgenic rat (Tg rat) and
      mouse (Tg mouse) harboring the temperature-sensitive simian virus 40 (ts SV 40)
      large T-antigen. These cell lines exhibit temperature-sensitive cell growth due
      to the expression of ts SV 40 large T-antigen. Mouse brain (TM-BBB) and rat brain
      (TR-BBB) and rat retinal (TR-iBRB) capillary endothelial cell lines appear to
      have a spindle-fiber shaped morphology and exhibit the typical endothelial
      markers, such as von Willebrand factor and acetylated low-density lipoprotein
      uptake. These cell lines express in vivo influx and efflux transporters, such as
      P-glycoprotein (P-gp) and GLUT1, which is capable of 3-O-methyl-D-glucose
      transport. TM-BBB cells are able to undergo efflux transport of cyclosporin A,
      which is a substrate for P-gp transport activity. They may also express oatp2 and
      exhibit dehydroepiandrosterone sulfate and digoxin uptake activity. TR-BBB cells
      express the mRNA of multidrug resistance associated protein 1 (MRP1) and a large
      neutral amino acid transporter, which consists of LAT1 and 4F2hc. TR-iBRB cells
      exhibit pH-dependent L-lactic acid transport activity and express the mRNA of
      monocarboxylate transporter (MCT) 1 and 2. The choroid plexus epithelial cell
      line (TR-CSFB) has polygonal cell morphology, expresses the typical choroid
      plexus epithelial cell marker, transthyretin, and has Na+, K+-ATPase located on
      the apical side. TR-CSFB cells also exhibit amino acid transport activity which
      has been observed in vivo. These barrier cell lines established from the Tg rat
      and Tg mouse have in vivo transport functions and are good in vitro models for
      drug transport to the brain and retina and as a screen for drugs which might be
      capable of delivery to the brain and retina.

PMID- 11217076
TI  - Characterization of a protease responsible for truncated actin increase in
      neutrophils of patients with Behcet's disease.
AB  - As described previously (Yamashita S. et al., Biol. Pharm. Bull., 23, 519-522
      (2000)), high levels of a truncated actin with an N-terminus of Met-44 were
      detected in neutrophils of patients with Behcet's disease. Since the increase of
      the truncated actin in neutrophils of patients may be important for understanding
      the pathology of Behcet's disease, the mechanism of the truncated actin formation
      was studied. First, to investigate the presence of a specific protease, which
      cleaves the actin at the site between Val-43 and Met-44, a peptide with a partial
      amino acid sequence of actin from the N-terminal Pro-38 to Asp-51 was synthesized
      as the protease substrate. The synthesized peptide was digested with cytosolic
      fractions of neutrophils from patients and healthy volunteers, and digestion
      products were analyzed by C18-reverse phase HPLC. The chromatograms of these
      samples showed that an endoprotease, which cleaved the peptide at a specific
      site, was present in cytosolic fractions of neutrophils from patients with
      Behcet's disease. Then, the effects of various kinds of protease inhibitors on
      the digestion of the peptide were investigated in order to identify the
      responsible endoprotease. The digestion of the peptide was suppressed by 4-(2
      aminoethyl) benzenesulfonylfluoride (AEBSF, a serine protease inhibitor) and N
      methoxysuccinyl-Ala-Ala-Pro-Val chloromethylketone (CMK, a polymorphonuclear
      (PMN)-elastase inhibitor) in the presence of EDTA. Furthermore, PMN-elastase was
      found to cleave the substrate peptide and actin at the site between Val-43 and
      Met-44. These results lead to the conclusion that the PMN-elastase is responsible
      for cleavage of actin at the N-terminal site between Val-43 and Met-44 in
      neutrophils from patients with Behcet's disease.

PMID- 11217077
TI  - Protective effect of fluvastatin on degradation of apolipoprotein B by a radical
      reaction in human plasma.
AB  - Fluvastatin, which is a synthetic 3-hydroxy-3-methylglutaryl coenzyme (HMG-CoA)
      reductase inhibitor, its metabolites (M2, M3 and M4) and trolox all inhibited the
      decrease of apolipoprotein B-100 (apoB) and alpha-tocopherol in a radical
      reaction of human plasma initiated by Cu2+. The concentrations of fluvastatin,
      M2, M3, M4 and trolox for 50% inhibition (IC50) of apoB fragmentation were 405,
      8.55, 1.75, 305, and 43.4 microM, respectively. The IC50 value of pravastatin,
      which is another HMG-CoA reductase inhibitor, was 2880 microM, showing that
      pravastatin is not an effective antioxidant. Although fluvastatin, its
      metabolites and trolox inhibited the decrease of alpha-tocopherol in a similar
      manner to that of apoB, pravastatin did not significantly inhibit the decrease of
      alpha-tocopherol. Since oxidation of low density lipopotein (LDL) is an important
      step in the initiation and progression of atherosclerosis, fluvastatin may reduce
      the risk of atherosclerosis not only by lowering plasma cholesterol but also by
      protecting LDL from oxidation.

PMID- 11217078
TI  - Experimental administration of estradiol on the colonization of lactobacillus
      fermentum and escherichia coli in the urogenital tract of mice.
AB  - The effect of estrogen on the microbial colonization of the urogenital tract is
      widely discussed, mainly in regard to women with a high incidence of Urinary
      Tract Infections (UTI). The aim of this work was to study the effect of estradiol
      on the microbial colonization of lactobacilli and E. coli in mice. Female BALB/c
      mice were intramuscularly (i.m.) treated with beta-estradiol (one or three
      doses). The next day, L. fermentum was inoculated intraurethrally with three
      doses of 10(7) CFU (Colony Forming Units). Later, mice were challenged with
      uropathogenic E. coli (1 x 10(8) CFU). The hormone levels in sera increased to
      values 10 times higher than in control animals. Increased differentiation of
      desquamated vaginal cells and keratinization of the vaginal surface were also
      observed. The hormonal treatment produced an increased E. coli colonization in
      the whole tract and a higher level of L. fermentum in kidneys on the 6th day. In
      mice treated with hormones and lactobacilli, one dose of estradiol was enough to
      protect animals against the challenge with E. coli. Three doses of estradiol
      produced a more pronounced protection with a lower number of E. coli. No
      histological modifications were produced by L.fermentum, while lymphocytic
      proliferation at submucosal level was observed in E. coli-challenged animals.

PMID- 11217079
TI  - Characterization of the mouse TFF1 (pS2) gene promoter region.
AB  - Trefoil peptides (TFFs) with a unique trefoil domain(s) are presumed to function
      in protection and repair of the gastrointestinal epithelial layer. Three peptide
      family members are differently distributed in the mouse gastrointestinal tract:
      TFF1/pS2 specifically in stomach, TFF2/SP mainly in stomach, pancreas and
      duodenum, and TFF3/ITF in intestine. We cloned and sequenced the mouse TFF1 gene
      5'-upstream region by means of the genomic walking procedure. The cloned region
      was ligated to the luciferase reporter gene and then introduced into mouse
      gastric surface mucous GSM10 cells which express TFF1 and TFF2. The minimum
      promoter was located in the region containing the TATA-box between -39 and the
      transcriptional start site. Further upstream regions stimulated (-2192-- -1630bp,
      -641-- -243bp, -137-- -39bp) and inhibited (-1630-- -641bp, -243-- -137 bp)
      luciferase gene expression. These regions as well as short segments conserved in
      the mouse and human 5'-upstream sequences may be important for modulation of the
      mRNA level of the TFF1 gene.

PMID- 11217080
TI  - Identification of the substrates for plasma hyaluronan binding protein.
AB  - Plasma hyaluronan biding protein (PHBP) is a novel serine protease, which has an
      amino acid sequence homology to that of hepatocyte growth factor activator
      (HGFA), and has a similar domain structure to that of urinary plasminogen
      activator (u-PA), found in human plasma. We searched the PHBP substrate in human
      plasma by measuring the digested protein bands on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE). The results showed that fibrinogen
      and fibronectin were the major substrates of PHBP. PHBP cleaved the alpha-chain
      at multiple sites and the beta-chain between lysine53 and lysine54 but not the
      gamma-chain of fibrinogen. Therefore, PHBP did not initiate the formation of the
      fibrin clot and did not cause the fibrinolysis directly. PHBP did not cleave
      (activate) prothrombin and plasminogen, but it converted the inactive single
      chain urinary plasminogen activator to the active two chain form.

PMID- 11217081
TI  - Identification of zinc finger proteins bound to a silencer region in the rat
      glutathione transferase P gene.
AB  - The rat glutathione transferase P (GST-P) gene is strongly induced during
      chemical hepatocarcinogenesis, whereas mRNA of this gene is rarely expressed in
      normal rat liver. We previously identified a silencer region in the promoter of
      this gene. This silencer has several DNA binding sites and at least three
      proteins (Silencer factor A, -B, and -C (SF-A, SF-B, and SF-C)) bind to these
      sites. We previously cloned and characterized the Nuclear Factor 1 (NF1) family
      and the CCAAT/enhancer-binding protein (C/EBP) family as SF-A and SF-B,
      respectively. However, SF-C which binds to GST-P silencer 2 (GPS2) remains to be
      cloned. By screening using yeast one-hybrid system, several zinc finger proteins
      were identified as a candidate of SF-C. The gel-mobility shift analyses showed
      that BTEB2, EZF, LKLF, TFIIIA, TIEG1, and novel zinc finger protein MZFP bound to
      GPS2 with different affinities. Several proteins of these are known to be
      transcriptional activators or repressors, suggesting that zinc finger proteins
      bind to GPS2 and regulate GST-P expression in the rat liver.

PMID- 11217082
TI  - Demonstration of inhibitory effect of oral shark cartilage on basic fibroblast
      growth factor-induced angiogenesis in the rabbit cornea.
AB  - Several angiogenic inhibitors have been obtained from shark cartilage, some of
      these are currently in clinical trials for assessment of safety and therapeutic
      efficacy in humans. Still, shark cartilage taken orally is commonly used in
      alternative and complimentary medicine for various ailments including serious
      diseases such as cancer. However, only few studies of oral shark cartilage have
      demonstrated pharmacological effects in experimental animals or patients, to
      indicate safe doses with sufficient bioavailability. In the present study we
      demonstrated the antiangiogenic properties of oral shark cartilage in the rabbit
      cornea model. Slow-release, polymethylmetacrylate pellets containing basic
      fibroblast growth factor (bFGF) were surgically implanted in the rabbit cornea to
      stimulate neovascularization scored by stereo microscopy. Powdered shark
      cartilage (PSC; commercial product) was tested orally along with a water-soluble
      fraction (WSF) of this cartilage product which was tested by local application.
      Animals were treated with oral dosages of 100 mg/kg PSC or 200 mg/kg thalidomide
      as positive control. Pellets containing WSF (50, 100 or 200 microg/pellet) or
      bFGF-inhibitor pentosan polysulfate were implanted adjacent to the bFGF pellet.
      Oral shark cartilage inhibited bFGF-induced angiogenesis, as did oral
      thalidomide, in this in vivo model. WSF and pentosan polysulfate was shown to
      block neovascularization in the cornea when applied locally. This study
      demonstrates that in the rabbit, oral shark cartilage appears to produce systemic
      levels of angiogenesis inhibitors that can exert their effect at the cornea.

PMID- 11217083
TI  - Mechanism of superoxide generation system in indomethacin-induced gastric mucosal
      injury in rats.
AB  - We studied the mechanism of the superoxide generation system in indomethacin
      induced gastric mucosal injury. First, 10 mM indomethacin had no direct effect on
      xanthine oxidase (XOD) activity. Next, we found that NADPH oxidase activity in
      polymorphonuclear leukocytes (PMN) of peripheral blood was significantly
      increased 6 h after administration of indomethacin. This phenomenon was inhibited
      by the injection of the NADPH oxidase inhibitor, diphenylene iodonium chloride
      (DIC). Activation of NADPH oxidase caused the component, p47phox to be
      translocated to the plasma membrane. Since indomethacin did not directly activate
      NADPH oxidase, we sought another route of activation of PMN. As IL-1 and TNF
      alpha play in the inflammation, we examined these cytokines in this study. TNF
      alpha was not detected but IL-1 was increased significantly 30 min after
      administration of indomethacin.

PMID- 11217084
TI  - Effects of two saponins extracted from the polygonatum Zanlanscianense pamp on
      the human leukemia (HL-60) cells.
AB  - Two saponins, methyl protodioscin and dioscin, were extracted from the root of
      Polygonatum Zanlanscianense Pamp. One of them, dioscin exerted significant
      inhibitory effects on the growth of the human leukemia cell HL-60, inducing
      differentiation and apoptosis. HL60 cells were induced mainly along the
      granulocytic lineage. In addition, we have found that dioscin affects many cancer
      cells. These studies may have important significance in treating related cancers.

PMID- 11217085
TI  - Effects of paint thinner exposure on serum LH, FSH and testosterone levels and
      hypothalamic catecholamine contents in the male rat.
AB  - We have investigated the effects of thinner inhalation on serum LH, FSH and
      testosterone levels together with changes in hypothalamic catecholaminergic
      system in the male rat. A control group inhaled normal air ventilation. The
      remaining animals were divided into two groups and exposed to paint thinner in a
      glassy cage for 15 or 30 d. Toluene concentration (the largest constituent in
      thinner, 66%) was set at 3000 ppm in the inhalation air. At the end, all animals
      were decapitated and blood samples obtained. Serum LH and FSH levels were
      measured by RIA and testosterone by enzyme immunoassay. Following removal of
      brains on dry ice, medial preoptic area, suprachiasmatic nucleus, median eminence
      and arcuate nucleus were isolated by micropunch technique. Noradrenaline, 3,4
      dihydroxyphenylglycol (DHPG) and dopamine concentrations of these hypothalamic
      areas were determined by HPLC-ECD. Fifteen-day thinner inhalation significantly
      suppressed serum LH and testosterone levels in parallel (p<0.001) compared to
      control group values (LH: 0.77+/-0.07; testosterone: 2.67+/-0.39). Thirty-day
      exposure markedly decreased LH levels (p<0.001), but surprisingly had no
      significant effect on testosterone. Serum FSH levels were not significantly
      altered in either group. Thinner inhalation for 15 or 30 d did not cause any
      significant change in noradrenaline, DHPG or dopamine concentrations in the
      hypothalamic regions examined (except in the arcuate nucleus). These results
      suggest that paint thinner has an anti-gonadotropic effect and may cause long
      term endocrine disturbances in the male. It is thought that the hypothalamic
      catecholaminergic system is not involved in thinner inhibition of LH and
      testosterone secretion.

PMID- 11217086
TI  - Savinin, a lignan from Pterocarpus santalinus inhibits tumor necrosis factor
      alpha production and T cell proliferation.
AB  - Two lignans were isolated from the heartwood of Pterocarpus santalinus by
      activity-guided fractionation and investigated for their biological properties
      and molecular mechanism of action. On the basis of their spectroscopic data,
      these compounds were identified as savinin (1) and calocedrin (2), dibenzyl
      butyrolactone-type lignan compounds having an alpha-arylidene gamma-lactone
      structure. These lignans significantly inhibited tumor necrosis factor (TNF)-a
      production in lipopolysaccharide (LPS)-stimulated RAW264.7 cells, and T cell
      proliferation elicited by concanavalin (Con A), without displaying cytotoxicity.
      The molecular inhibitory mechanism of compound 1 was confirmed to be mediated by
      the non-polar butyrolactone ring, according to a structure-relationship study
      with structurally related and unrelated compounds, such as arctigenin (a dibenzyl
      butyrolactone type lignan), eudesmin (a furofuran type lignan), isolariciresinol
      (a dibenzylbutane type lignan), and cynaropicrin (a sesquiterpene lactone). The
      results suggest that savinin may act as an active principle in the reported
      biological activities of P. santalinus, such as antiinflammatory effect, by
      mediation of the butyrolactone ring as a valuable pharmacophore.

PMID- 11217088
TI  - High-Performance liquid chromatographic analysis of lactone and hydroxy acid of
      new antitumor drug, DX-8951 (exatecan), in mouse plasma.
AB  - A sensitive high-performance liquid chromatographic (HPLC) method has been
      developed and validated for the determination of lactone and total drug (lactone
      plus hydroxy-acid) of DX-8951 in mouse plasma. Solid-phase extraction by C18
      cartridge separated lactone from total drug of DX-8951. Analysis was performed
      using a reverse-phase ODS column with a mobile phase consisting of
      acetonitrile/0.05 M potassium dihydrogen phosphate (pH 3) (18: 82, v/v) at a flow
      rate of 1 ml/min. The limits of quantitation of lactone and total drug were 3
      ng/ml in plasma and a linear range of determination were observed over the
      concentration of 3 to 500 ng/ml. This method was applied to pharmacokinetic study
      in male mice treated with a single intravenous administration of either lactone
      or hydroxy-acid of DX-8951. The plasma concentrations of lactone from 2 to 6 h
      after dosing were similar regardless of the form of DX-8951 administered.

PMID- 11217087
TI  - Suppressive effects of Perilla frutescens on mesangioproliferative
      glomerulonephritis in rats.
AB  - Leaves of Perilla frutescens var. crispa DECNE. (perilla, Labiatae) are used as a
      garnishing vegetable in East Asian countries as well as an herbal medicine
      prescribed in Kampo medicines such as Saiboku-to. A previous in vitro study
      revealed that a decoction of perilla leaves inhibits the proliferation of murine
      cultured mesangial cells. In the present study, we evaluated the in vivo anti
      proliferative effects of a perilla decoction using rat mesangio-proliferative
      glomerulonephritis induced by an intravenous injection of rabbit anti-rat
      thymocyte serum (ATS). Leaves of perilla were boiled, and the decoction was
      orally administered to the rats as drinking water at doses of 100 and 500 mg/kg/d
      from the day of ATS-injection (day 0) to day 8, when rats were sacrificed. In the
      histological evaluation, the total number of glomerular cells, proliferating cell
      nuclear antigen (PCNA) positive cells, and macrophage/monocyte antigen-positive
      cells in the glomerulus, was significantly decreased in perilla-treated rats. A
      significantly lower level of proliferation was induced by the serum of the
      perilla-treated rats than by that of the controls. These results suggest that the
      perilla decoction suppresses the proliferation of mesangial cells in vivo by an
      inhibition of the glomerular infiltration of macrophage/monocytes and of the
      production of circulating growth factors.

PMID- 11217090
TI  - Extract from Serenoa repens suppresses the invasion activity of human urological
      cancer cells by inhibiting urokinase-type plasminogen activator.
AB  - We used three human urological cancer cell lines, PC-3, LNCaP and SKRC-1, to
      investigate the effects of the extract from Serenoa repens (Palmae) on tumor cell
      invasion. The invasion activity of these cell lines was determined in vitro using
      a Transwell cell-culture chamber. The invasion activity of PC-3 cells into
      Matrigel was effectively suppressed by the extract at the concentration range of
      1-10 microg/ml, while that of LNCaP and SKRC-1 cells was unaffected by the
      extract. The extract did not affect the viability, adhesion ability, or motility
      of the cell lines. uPA is more strongly expressed on the membrane fraction of PC
      3 cells than that of LNCaP or SKRC-1 cells. The purified uPA activity is
      inhibited by the extract from S. repens in a dose-dependent manner, suggesting
      that the suppression of PC-3 cell invasion by the extract is based on an
      inhibition of the uPA activity which is necessary for tumor cell invasion. These
      data suggest that the extract from S. repens specifically inhibits the uPA
      activity and may therefore be useful for the therapeutic treatment of prostate
      cancer.

PMID- 11217089
TI  - Purification and characterization of antithrombotics from Syzygium aromaticum
      (L.) MErr. & PERRY.
AB  - Two antithrombotic polysaccharides with relatively high molecular weight (HMW)
      and low molecular weight (LMW) were isolated from the flower buds of Syzygium
      aromaticum (L.) MERR. & PERRY (clove) by anion-exchange chromatography,
      hydrophobic interaction column chromatography and size exclusion chromatography
      (LMW: EC-2B-IIIa-2, M.W. ca. 34000; HMW: EC-2C-Ia-2, M.W. ca. 103000). The LMW
      polysaccharide was mainly composed of Rha, Gal, GalA and Ara (molar %: 24.1,
      18.9, 18.0 and 17.9, respectively) with 10.8% of sulfate and 18.2% of protein.
      The HMW fraction consisted of Ara, Gal, Glc and Rha (molar %: 26.0, 23.7, 17.5
      and 12.4, respectively) with 15.4% of sulfate and 8.0% of protein. Both
      polysaccharides had the backbone of type I rhamnogalacturonan and the side chain
      of arabinan. Also, most of the sulfates were attached at the position 6 of 3
      linked galactosyl residues. Compared to the antithrombotic activity of the HMW
      fraction (plasma clotting time of 145 s in APTT assay), the LMW fraction
      displayed a slightly low activity (90 s). However, animal studies indicated that
      crude LMW polysaccharide did not show acute toxicity, while the acute LD50 of the
      HMW fraction was approximately 2-fold lower than that of heparin.

PMID- 11217091
TI  - Heparin-Affinity of human extracellular-superoxide dismutase in the brain.
AB  - Extracellular-superoxide dismutase (EC-SOD) is one of the three SOD isozymes in
      humans and has affinity for heparin-like sulfated glycosaminoglycans in the
      extracellular matrix. The C-terminal portion of EC-SOD is responsible for the
      heparin-affinity of this enzyme, but this portion should be a target of
      proteinases. Recently, Oury et al. reported that EC-SOD is localized within the
      cytoplasm of neuronal cells, while this enzyme is found in the extracellular
      matrix in most other tissues. It has been speculated that the heparin-binding
      domain of EC-SOD in the brain is sensitive to proteolysis, which may result in a
      loss of extracellular immunoreactivity. This study was performed to investigate
      the heparin-affinity of EC-SOD in the human brain. We found that human EC-SOD in
      brain tissue has high heparin-affinity similar to that in the umbilical cord.
      Moreover, heparin-affinity of EC-SOD in brain homogenate was not decreased by
      incubation at 37 degrees C for 72 h. The proteolytic activity in brain homogenate
      might be less than that in umbilical cord homogenates. The intracellular
      localization of EC-SOD could contribute to its slow clearance from the brain and
      maintenance of its physiological functions in the brain.

PMID- 11217092
TI  - Effects of Ninjin-to on levels of brain-gut peptides (motilin, vasoactive
      intestinal peptide, gastrin, and somatostatin) in human plasma.
AB  - We examined the effects of Ninjin-to, a traditional Chinese (Kampo) medicine, on
      the levels of brain-gut peptides (motilin, vasoactive intestinal peptide (VIP),
      gastrin, and somatostatin) in plasma from healthy subjects. A single oral
      administration of Ninjin-to, at a dose of 6.0 g, caused significant increases in
      plasma motilin levels at 40 to 90 min and somatostatin levels at 20 to 90 min,
      compared with a placebo treated group. Transient elevations of gastrin levels in
      the placebo group were inhibited by administration of Ninjin-to, but the medicine
      did not alter the levels of VIP. In conclusion, these results suggest that
      pharmacological effects of Ninjin-to on gastrointestinal functions closely relate
      to changes of motilin, gastrin, and somatostatin-immunoreactive substance levels
      in human plasma.

PMID- 11217093
TI  - Expression of a small heat shock protein 27 (HSP27) in mouse skin tumors induced
      by UVB-irradiation.
AB  - We investigated the expression of heat shock protein 27 (HSP27) at intermediate
      stages of a cutaneous tumor induced by UVB-irradiation stress (290-380 nm, max.
      312 nm) using an immunostaining method. After 15-20 weeks of chronic exposure to
      UVB irradiation at a dose of 2 kJ/m2, HSP27 was found in the upper cell layers of
      bowenoid multilayers of epidermis, in areas of the lesions where normal
      stratification seems to be conserved. After 25 weeks, HSP27 was weakly expressed
      in squamous cell carcinoma (SCC). The HSP27 distribution patterns during
      cutaneous tumor progression resemble that of cytokeratin 10, a differentiation
      marker in keratinocytes. In SCC, a low degree of HSP27 expression was detected in
      the well-differentiated carcinomatous areas, but not in the poorly differentiated
      areas. These results indicate that the level of HSP27 decreases significantly as
      epithelial carcinoma growth progresses upon UVB-exposure. The expression of HSP27
      may be associated with the onset of skin keratinocyte differentiation, but not
      with progression of SCC.

PMID- 11217094
TI  - Release of intermediate reactive hydrogen peroxide by macrophage cells activated
      by natural products.
AB  - By determining the hydrogen peroxide (H2O2) released in cultures of peritoneal
      macrophage cells from Swiss mice, we evaluated the action of 27 vegetable
      compounds (pristimerin, tingenone, jatrophone, palustric acid, lupeol,
      cladrastin, ocoteine, boldine, tomatine, yohimbine, reserpine, escopoletin,
      esculine, plumericin, diosgenin, deoxyschizandrin, p-arbutin, mangiferin, and
      others) using a 2 mg/ml solution of each compound (100 microg/well). Macrophages
      are cells responsible for the development of the immunological response reaction,
      liberating more than one hundred compounds into the extracellular environment.
      Among these are the various cytokines and the intermediate compounds of nitrogen
      (NO) and oxygen (H2O2). This coordinated sequence of biochemical reactions is
      known as the "oxidative burst." When we compared the results with those obtained
      with zymosan (an important stimulator of H2O2) we observed that the compounds
      showing the highest activity were substances 2 (tingenone), 16 (reserpine) and
      20. Other substances such as compounds 1, 4, 5, 6, 8, 12, 13, 14, 15, 17, 19, 23,
      24, 26, and 27 also showed a certain activity, but with less intensity than the
      aforementioned ones. Compounds 3, 7, 9, 10, 11, 18, 21, 22 and 25 presented no
      activity. These results suggest that natural products (mainly tingenone and
      reserpine and others) with different chemical structures are strong immunological
      modulators. However, further tests are needed to determine the 'oxidative burst'
      in future studies.

PMID- 11217095
TI  - Biodegradation and drug release of chitosan gel beads in subcutaneous air pouches
      of mice.
AB  - Chitosan (CS) gel beads were prepared in 10% amino acid solution (pH 9) and
      implanted into air pouches (AP) prepared subcutaneously on the dorsal surface of
      mice. No inflammatory response was observed, and degradation of the beads in the
      AP increased as their degree of deacetylation decreased. Degradation could be
      altered by changing the nature of the CS or by increasing the CS concentration.
      The release of prednisolone (PS) in vivo from CS gel beads was similar to the
      release in vitro. When a suspension of PS was injected into the AP, the PS had
      almost completely disappeared 24 h after injection. Retention of PS in the AP was
      not increased by using a viscous CS solution. Alginate (Alg) gel beads, which
      were not degraded, released PS slowly into the AP over 3d. The in vitro release
      profile of PS using 1% CS (deacetylation: 70% (7B) and 80% (8B)) and 1.5% CS
      (deacetylation: 90% (9B)) gel beads was similar to that with Alg gel beads.
      However, the in vivo release of PS was affected by the degradability of the gel
      beads. CS7B and 8B (1%) gel beads had released PS into the AP earlier than 3 d
      according to their rate of degradation. CS9B (1.5%) gel beads were not degraded
      after 3 d and went on to release PS into the AP for 3 d similar to the release
      profile of Alg gel beads. CS9B (2%) gel beads were also not degraded after 3 d
      and the release of PS from these beads into the AP was sustained; 76% and 27% of
      administered PS remained in the gel beads after 1 and 3 d, respectively.
      Therefore, degradation and drug release of CS gel beads can be controlled by
      changing the structure of the gel matrix, which appears to make these beads a
      promising biodegradable vehicle for sustained drug delivery.

PMID- 11217096
TI  - Formulation design of ointment base suitable for healing of lesions in treatment
      of bedsores.
AB  - We intended to develop a desired ointment base suitable for treatment of bedsores
      including the proliferation of granulation and epidermis. The main bedsore
      bacteria detected in our hospital were S. aureus in gram-positive coccus and P.
      aeruginosa in gram-negative bacillus. As the macrogol ointment (MO) was found to
      have bactericidal effects on these bacteria, MO was adopted as the base for the
      objective ointment. To improve the properties of the ointment base such as
      regulating the humidity of the exudation and controlling the release of
      antibiotics formulated in the ointment, co-formulating effects of various
      additives to MO were evaluated. The sustained release function of the ointment
      base was obtained by adding hydrophilic petrolatum (HP) to MO. However, the
      resultant ointment was found to have a poor humidity regulating property. On the
      other hand, MO containing 5% of hydroxypropyl cellulose (HPC) showed both the
      humidity regulating and the controlled drug releasing properties. It was
      considered that HPC particles dispersed in the ointment could be swelled by
      absorbing water to form a gel network. The curd tension meter tests for the
      ointments prepared with the various polymers showed that the MO-HPC base, which
      showed the highest sustained drug releasing property, was found to have the
      highest hardness. This result means that HPC formulated into the base forms the
      most rigid gel structure to resist the erosion of the ointment and to control the
      drug release.

PMID- 11217097
TI  - Preparation of rapidly disintegrating tablet using new types of microcrystalline
      cellulose (PH-M series) and low substituted-hydroxypropylcellulose or spherical
      sugar granules by direct compression method.
AB  - To decrease the sensation of roughness when a tablet, which is rapidly
      disintegrated by saliva (rapidly disintegrating tablet), is orally taken, we
      prepared rapidly disintegrating tablets using microcrystalline cellulose (Avicel
      PH-M series), a new type of pharmaceutical excipient that is spherical and has a
      very small particle size (particle size, 7-32 microm), instead of conventional
      microcrystalline cellulose (PH-102) used in the formulation of tablets containing
      acetaminophen or ascorbic acid as model drugs for tableting study. Tablets (200
      mg) prepared using spherical microcrystalline cellulose, PH-M-06, with the
      smallest particle size (mean value, 7 microm) had sufficient crushing tolerance
      (approximately, 8 kg) and were very rapidly, disintegrated (within 15 s) when the
      mixing ratio of PH-M-06 to low-substituted hydroxypropylcellulose (L-HPC) was
      9:1. Sensory evaluation by volunteers showed that PH-M-06 was superior to PH-102
      in terms of the feeling of roughness in the mouth. Consequently, it was found
      that particle size is an important factor for tablet preparation using
      microcrystalline cellulose. It is possible to prepare drugs such as acetaminophen
      and ascorbic acid (concentration of approximately 50%) in the tablet form using
      PH-NM-06 in combination with L-HPC as a good disintegrant at a low compression
      force (1-6 kN). To solve the problem of poor fluidity in the preparation of these
      tablets, we investigated the use of spherical sugar granules (Nonpareil, NP-101
      (sucrose and starch, composition ratio of 7:3), NP-103 (purified sucrose), NP-107
      (purified lactose) and NP-108 (purified D-mannitol)). Rapidly disintegrating
      tablets can be prepared by the direct compression method when suitable excipients
      such as fine microcrystalline cellulose (PH-M-06) and spherical sugar granules
      (NP) are used.

PMID- 11217098
TI  - Melt pelletization of a hygroscopic drug in a high shear mixer. Part 3. Effects
      of binder variation.
AB  - Melt pelletization experiments with sodium valproate as a hygroscopic drug were
      performed in a laboratory scale high shear mixer. In the current part, the effect
      of altering the binder liquid properties (using different binders, varying the
      temperature, or adding highly dispersed silicon dioxide to the molten binder) on
      the pellet size, size distribution and the growth rate was studied. Three
      meltable binders, namely glycerol monostearate (GMS), hydrated castor oil (HCO),
      and polyethylene glycol (PEG), were included in the study. Two series of
      experiments with GMS or HCO showed a higher granule growth rate with decreasing
      binder viscosity. Also, increases in the granule growth rate were observed for
      all meltable binders tested, when the binder amount and the impeller speed were
      increased. Factorial designs with all three binders were performed under the same
      conditions. In these experiments, no correlation existed between the granule
      growth rate and the viscosity of the different binders. The different granule
      growth rate, however, was mainly attributed to the different solubility of sodium
      valproate in the binder liquid used. Higher solubility increased the volume of
      the binder liquid and, accordingly, the granule growth rate. Taking the amount of
      dissolved drug into account, the granule growth rates of GMS and PEG were
      comparable. However, HCO displayed a lower granule growth rate, which might be
      related to its low adhesion tension. During melt pelletization in a high shear
      mixer the solubility of the drug in the molten binder strongly influences the
      pelletization process.

PMID- 11217099
TI  - A prodrug of NMDA/glycine site antagonist, L-703,717, with improved BBB
      permeability: 4-acetoxy derivative and its positron-emitter labeled analog.
AB  - 4-Acetoxy derivative (1) of L-703,717, a high-affinity (IC50=4.5 nM) antagonist
      for the glycine site of NMDA receptors, was synthesized and its brain uptake was
      examined using a carbon-11 labeled analog ([11C]1). Initial radioactivity in the
      brain after intravenous injection of [11C]1 was a 2-fold that of [11C]L-703,717
      in mice. Rapid bioconversion of [11C]1 into [11C]L-703,717 was demonstrated by
      metabolite analyses of rat brain after [11C]1 injection. Ex vivo autoradiography
      of [11C]1 in rat brain showed the same cerebellar localization of radioactivity
      as [11C]L-703,717. These results indicate that 1 is a promising pharmacological
      tool as a prodrug of L-703,717 with improved BBB permeability.

PMID- 11217100
TI  - Studies on the constituents of the leaves of Morus alba L.
AB  - Two novel prenylflavanes (1, 2) and a glycoside (3) of 1 were isolated along with
      six known compounds, isoquercitrin (4), astragalin (5), scopolin (6), skimmin
      (7), roseoside II (8) and benzyl D-glucopyranoside (9), from the leaves of Morus
      alba. The inhibitory activities of compounds 1, 2 and 3 on the oxidation of human
      low density lipoprotein (LDL) were investigated.

PMID- 11217101
TI  - Analgesic components of saposhnikovia root (Saposhnikovia divaricata).
AB  - By activity-oriented separation using the writhing method in mice, the analgesic
      components of Saposhnikovia root (Saposhnikovia divaricata Schischkin;
      Umbelliferae) were identified to be chromones, coumarins, polyacetylenes and 1
      acylglycerols. Two new components, divaricatol and (3'S)-hydroxydeltoin, were
      also isolated. The most potent analgesia was observed in chromones such as
      divaricatol, ledebouriellol and hamaudol, which inhibited writhing inhibition at
      an oral dose of 1 mg/kg in mice. Acylglycerols also showed inhibition
      significantly at a dose of 5 mg/kg. In some pharmacological tests using sec-O
      glucosylhamaudol, the compound showed analgesia by the tail pressure and the
      Randall & Selitto methods, and its writhing inhibition was not reversed by
      naloxone.

PMID- 11217102
TI  - Six new withanolide-type steroids from the leaves of Solanum cilistum.
AB  - Six new withanolide-type steroids, designated cilistols v, t, i, j, y and w (1-6,
      respectively), were obtained from the leaves of Solanum cilistum. Their
      respective structures were characterized by spectroscopic means as follows:
      Cilistol v (1) was (22R,24Z)-1alpha,3beta,22,26-tetrahydroxyergost-5,24-diene 26
      O-beta-D-glucopyranoside, which is regarded as the precursor of other withanolide
      type steroids included in this title plant. Cilistol t (2) was (22R,24S,25R,26S)
      24,25;22,26-diepoxy-1alpha,3beta,26-trihydroxyergost-5-ene 26-O-beta-D
      glucopyranoside, and cilistols j (3) and i (4) corresponded to the substances
      probably formed by the cleavage of the epoxy ring at C-24 and 25 of 2. Cilistol y
      (5) was 3-O-sulphonyl (22R,24S,25R,26R)-1-oxo-24,25; 22,26-diepoxy
      3beta,17alpha,26-trihydroxyergost-5-ene 26-O-beta-D-glucopyranoside, and cilistol
      w (6) corresponded to the substance obtained by the fission of the epoxy ring at
      C-24 and 25 of 5. The occurrence of these withanolide type steroids from Solanum
      genera is rare and worthy of note.

PMID- 11217103
TI  - Analysis of electron spin resonance spectra of alkyl spin labels in excised
      guinea pig dorsal skin, its stratum corneum, delipidized skin and stratum corneum
      model lipid liposomes.
AB  - The electron spin resonance (ESR) spectra of alkyl spin labels were observed in
      the excised guinea pig dorsal skin, its stratum corneum, delipidized skin and
      stratum corneum model lipid liposomes. The spectrum of 5-doxylstearic acid (5-NS)
      in the stratum corneum and order parameter obtained from the spectrum, indicated
      that the spin label was present in highly ordered lipid lamella. On the other
      hand, the spectrum of methyl ester of 5-NS (5-NMS) and its apparent rotational
      correlation time calculated from the spectrum, showed only a weakly immobilized
      component in the stratum corneum as well as in the whole excised skin. The ester
      spin label seemed to be scarcely present in the rigid lipid lamella, but mainly
      in the relatively fluid environment. On the other hand, cationic alkyl spin
      labels showed quite different spectra depending on their alkyl chain lengths.
      Long-chain 4-(N,N-dimethyl-N,-pentadecyl)ammonium-2,2,6,6-tetramethylpiperidine-1
      oxyl (CAT-15) seemed to be present in the protein region of the stratum corneum
      as we recently reported, whereas hydrophilic quaternary ammonium spin label 4
      trimethylammonium-2,2,6,6-tetramethylpiperidine-1-oxyl (CAT-1) seemed to be
      present in the bulk water of the skin, even in delipidized skin. These findings
      indicated that the different interaction and different localization of the alkyl
      spin labels depended on their electronic charge as well as their alkyl chain
      lengths.

PMID- 11217104
TI  - Preparation of a novel aggregate like sugar-ball micelle composed of
      poly(methylglutamate) and poly(ethyleneglycol) modified by lactose and its
      molecular recognition by lectin.
AB  - We report the preparation and characteristics of a novel micellar aggregate of an
      amphiphilic diblock copolymer, poly(methylglutamate) (PMG)-poly(ethyleneglycol)
      (PEG), whose terminus was modified by lactose lactone (LA). Due to the terminal
      LA moiety, this aggregate could be specifically recognized by RCA120 lectin. PMG
      PEG-LA was synthesized by polymerizing the N-carboxy anhydride of L-glutamic acid
      gamma-methyl ester with H2N-PEG-LA as a polymerization initiator. By applying a
      fluorescence method using pyrene as a probe molecule, we found that PMG-PEG-LA
      could form the aggregate in aqueous solution. Fluorescence measurements showed
      that the critical aggregation concentration (C.A.C.) was 1.1 x 10(-5) M. The
      average diameter of the aggregate was 220 nm at 25 degrees C, as determined by
      the dynamic light scattering method. Circular dichroism measurements for the
      aggregate solution showed that the PMG residue took an alpha-helical structure,
      and that they associated to constitute the hydrophobic core of the aggregate. By
      adding RCA120 lectin to the aggregate solution, the turbidity of the solution
      increased rapidly, due to association of the aggregates. This implies that the
      aggregate could be recognized by lectin, and also suggests that sugar residues
      locate at the surface of the aggregates. From these findings, we concluded that
      the PMG-PEG-LA molecules form an aggregate like a "sugar ball" micelle, whose
      surface is covered by the sugar moieties. Application of the present aggregate
      system as a drug carrier is briefly discussed.

PMID- 11217105
TI  - New antifungal 1,2,4-triazoles with difluoro(substituted sulfonyl)methyl moiety.
AB  - New 1,2,4-triazoles (2) having a difluoro(substituted sulfonyl)methyl moiety were
      designed and synthesized via alpha,alpha-difluoro-alpha-(substituted
      thio)acetophenones (3). Compounds (2) showed potent antifungal activities against
      C. albicans, C. krusei, A. flavus and A. fumigatus in vitro and against C.
      albicans in vivo for oral and i.v. administrations. Especially, (-)-2a, (-)-2b
      and (-)-2d showed potent antifungal activities.

PMID- 11217106
TI  - Triterpenes and lignans from Artemisia caruifolia and their cytotoxic effects on
      meth-A and LLC tumor cell lines.
AB  - One new triterpene, 3beta-hydroxy-29-norcycloart-24-one (1), and four new
      lignans, caruilignans (2-5), together with six known compounds were isolated from
      the aerial part of Artemisia caruifolia BUCH.-HAM. ex TOXB. Their structures were
      determined by various spectroscopic means. Most of the isolated lignans were
      moderately cytotoxic to Meth-A cells with ED50 values of 5-10 microg/ml, but not
      to Lowis lung carcinoma (LLC) cells. An oxime derivative of 1 showed more potent
      cytotoxic activity against Meth-A and LLC cells than the original triterpene 1.

PMID- 11217107
TI  - Phosphodiesterase 4 isoenzyme inhibitory activity of 3-phenylxanthines and 4
      pheny.
AB  - On the basis of our study on the structure-activity relationships of 1,3,7
      alkylxanthines and condensed-purines on cAMP-phosphodiesterase 4 (PDE 4)
      isoenzyme inhibitor, we investigated the synthesis and the inhibitory activity of
      3-phenylxanthine and 4-phenyl[i]condensed-purine derivatives. Xanthines and
      condensed-purines with the phenyl group exhibited potent and selective PDE 4
      inhibitory activity.

PMID- 11217108
TI  - Mechanistic studies on the biomimetic reduction of tetrahydroxynaphthalene, a key
      intermediate in melanin biosynthesis.
AB  - 1,3,6,8-Tetrahydroxynaphthalene (T4HN) is an aromatic polyketide, serving as a
      general precursor of fungal melanin. Melanin biosynthesis involves two
      consecutive deoxygenations of T4HN, consisting of the reduction of a phenolic
      carbon followed by dehydration. The first reduction to produce scytalone was
      studied in a biomimetic reduction with sodium borohydride. The reduction required
      a strong alkaline condition, leading to the tautomerization of T4HN to a reactive
      species whose structure was clarified by NMR spectroscopy.

PMID- 11217109
TI  - Geranylgeranyl diphosphate synthase from Scoparia dulcis and Croton sublyratus.
      Plastid localization and conversion to a farnesyl diphosphate synthase by
      mutagenesis.
AB  - cDNAs encoding geranylgeranyl diphosphate synthase (GGPPS) of two diterpene
      producing plants, Scoparia dulcis and Croton sublyratus, have been isolated using
      the homology-based polymerase chain reaction (PCR) method. Both clones contained
      highly conserved aspartate-rich motifs (DDXX(XX)D) and their N-terminal residues
      exhibited the characteristics of chloroplast targeting sequence. When expressed
      in Escherichia coli, both the full-length and truncated proteins in which the
      putative targeting sequence was deleted catalyzed the condensation of farnesyl
      diphosphate and isopentenyl diphosphate to produce geranylgeranyl diphosphate
      (GGPP). The structural factors determining the product length in plant GGPPSs
      were investigated by constructing S. dulcis GGPPS mutants on the basis of
      sequence comparison with the first aspartate-rich motif (FARM) of plant farnesyl
      diphosphate synthase. The result indicated that in plant GGPPSs small amino
      acids, Met and Ser, at the fourth and fifth positions before FARM and Pro and Cys
      insertion in FARM play essential roles in determination of product length.
      Further, when a chimeric gene comprised of the putative transit peptide of the S.
      dulcis GGPPS gene and a green fluorescent protein was introduced into Arabidopsis
      leaves by particle gun bombardment, the chimeric protein was localized in
      chloroplasts, indicating that the cloned S. dulcis GGPPS is a chloroplast
      protein.

PMID- 11217110
TI  - Compositional analysis of copoly (DL-lactic/glycolic acid) (PLGA) by pyrolysis
      gas chromatography/mass spectrometry combined with one-step thermally assisted
      hydrolysis and methylation in the presence of tetramethylammonium hydroxide.
AB  - Rapid and precise compositional analysis of copoly (DL-lactic/glycolic acid)
      (PLGA) was performed by pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS)
      combined with one-step hydrolysis and methylation in the presence of
      tetramethylammonium hydroxide (TMAH). Pyrolysis of PLGA with TMAH gave two
      characteristic products, derivatives of DL-lactic acid and glycolic acid, which
      directly reflect the average molar composition of PLGA. The analytical results
      for PLGA samples with various compositional ratios were in good agreement with
      those obtained by 1H-NMR spectrometry, and the precision was satisfactory.

PMID- 11217112
TI  - Radical cyclization in heterocycle synthesis. 12. Sulfanyl radical addition
      addition-cyclization (SRAAC) of unbranched diynes and its application to the
      synthesis of A-ring fragment of 1alpha,25-dihydroxyvitamin D3.
AB  - Sulfanyl radical addition-addition-cyclization (SRAAC) of unbranched diynes
      proceeded smoothly to give cyclized exo-olefins, while the sulfanyl radical
      addition-cyclization-addition (SRACA) of diynes having a quaternary carbon gave
      cyclized endo-olefins. This method was successfully applied to the synthesis of A
      ring fragment of 1alpha,25-dihydroxyvitamin D3.

PMID- 11217111
TI  - Asymmetric synthesis of a 3-acyltetronic acid derivative, RK-682, and formation
      of its calcium salt during silica gel column chromatography.
AB  - RK-682 was reported to be a potent protein tyrosine phosphatase inhibitor. We
      found that (R)-3-hexadecanoyl-5-hydroxymethyltetronic acid (1) was easily
      converted to its calcium salt during column chromatography on Silica gel 60, and
      this calcium salt was identical to RK-682 originally isolated from a natural
      source. Here we report details of the asymmetric synthesis of (R)-1 and its
      conversion to the calcium salt. Fast atom bombardment mass spectrometric (FAB-MS)
      analysis of the free and calcium salt forms of RK-682 is also reported.

PMID- 11217113
TI  - Antioxidative and 5-lipoxygenase inhibiting activities of novel bis(4-hydroxy
      2,3,5-trimethylphenoxy)alkyl derivatives.
AB  - Novel bis(4-hydroxy-2,3,5-trimethylphenoxy)alkyl derivatives were synthesized and
      evaluations were made of their inhibiting action on Fe3+-ADP induced lipid
      peroxidation in rat liver microsome and reducing action on alpha,alpha-diphenyl
      beta-picrilhydrazyl (DPPH), a stable radical, in addition to their inhibiting
      action on 5-lipoxygenase (5-LO), an enzyme that synthesizes leukotrienes. We
      performed a structure-activity correlation study on these derivatives. A strong
      Fe3+-ADP induced lipid peroxidation preventing activity was observed for the
      derivatives with an odd number of methylene groups including 1,3-bis(4-hydroxy
      2,3,5-trimethylphenoxy)propane (3b) and 3a. No change in the DPPH reducing
      activity was found with change in the number of methylene groups. 5-LO inhibiting
      activity among the derivatives was the highest for 1,6-bis(4-hydroxy-2,3,5
      trimethylphenoxy)hexane (3e). MM2 calculations were performed to find a stable
      steric structure for the derivatives, and 1,5-bis(4-hydroxy-2,3,5
      trimethylphenoxy)pentane (3d) showed a strong activity in both antioxidative
      action and 5-LO inhibiting action.

PMID- 11217114
TI  - Pharmacokinetics of acetaminophen from rapidly disintegrating compressed tablet
      prepared using microcrystalline cellulose (PH-M-06) and spherical sugar granules.
AB  - The aim of the present study was to evaluate the bioavailability of a drug from
      rapidly disintegrating tablets prepared using fine spherical crystalline
      cellulose (PH-M-06) and spherical sugar granules (Nonpareil, NP). Rapidly
      disintegrating tablets containing acetaminophen as the model drug in combination
      with a mixture of NP-108 (purified n-mannitol) and PH-M-06 were prepared. Plasma
      concentration profiles and pharmacokinetic parameters of acetaminophen in rabbits
      were investigated after oral administration of the prepared tablets. No
      significant difference in Cmax and AUC(0-infinity) of acetaminophen between
      rapidly disintegrating tablets and conventional tablets was observed after direct
      administration of these tablets into the stomach of rabbits. However, tmax (15
      min) of acetaminophen from rapidly disintegrating tablets was significantly
      (p<0.05) shorter than that from conventional tablets (130 min). The same tmax was
      observed for rapidly disintegrating tablets and solution. When suitable
      excipients such as fine spherical microcrystalline cellulose (PH-M series) and
      spherical sugar granules (NP series) were used, rapidly disintegrating tablets
      could be prepared by the conventional direct compression method. According to the
      results of moment analysis, the mean residence time (MRT) obtained between both
      rapidly disintegrating and conventional tablets indicates that the mean
      absorption time (MAT) from these tablets is approximately 60 and 90 min,
      respectively. This difference in MAT between the two tablets may be caused by the
      difference in the sum of the mean dissolution time (MDT) and the mean
      disintegration time (MDIT) of these tablets. Rapidly disintegrating tablets allow
      rapid absorption of the drug compared with conventional tablets.

PMID- 11217115
TI  - An efficient synthesis of N-tert-butoxycarbonyl-O-cyclohexyl-L-tyrosine.
AB  - A facile and efficient synthesis of N-tert-butoxycarbonyl-O-cyclohexyl-L-tyrosine
      [Boc-Tyr(Chx)-OH] is described. Boc-Tyr-OH was treated with NaH in
      dimethylformamide and then with 3-bromocyclohexene to give N-Boc-O-(cyclohex-2
      enyl)-L-tyrosine [Boc-Tyr(Che)-OH] in 70% yield. Hydrogenation of Boc-Tyr(Che)-OH
      over PtO2 afforded Boc-Tyr(Chx)-OH in almost quantitative yield. The highest
      yield was achieved when a side product in the synthesis of Boc-Tyr-OH, Boc
      Tyr(Boc)-OH, was not removed, because it was also converted to Boc-Tyr(Che)-OH
      without any additional manipulations. The new synthetic method described here is
      convenient for practical use, and would facilitate the widespread use of the Chx
      group for the hydroxy-protection of Tyr.

PMID- 11217116
TI  - Caffeic acid phenethyl ester (CAPE): synthesis and X-ray crystallographic
      analysis.
AB  - The structure of caffeic acid phenethyl ester [2-propenoic acid, 3-(3,4
      dihydroxyphenyl)-, 2-phenethyl ester] (I), C17H16O4 x 1/2C6H6, synthesized by
      base-catalyzed alkylation of caffeic acid salt with beta-bromoethylbenzene in
      HMPA (hexamethylphosphoramide) and recrystallized from benzene, was confirmed by
      single crystal X-ray diffraction. The crystals are triclinic, space group P1,
      Z=2, unit cell dimension a=5.8129 (9) A, b=11.122 (2) A, c=13.226 (2) A,
      alpha=97.080 (3) degrees, beta=101.467 (3) degrees, gamma=95.405 (3) degrees ,
      V=825.4 (2) A3, Dcalc=1.301 g/cm3, F(000)=342. The packing of the molecule is
      stabilized by intermolecular O1H...O4 (2.69 A) and O1...HO2 (2.82 A) hydrogen
      bonds.

PMID- 11217117
TI  - Latifolosides I and J, two new triterpenoid saponins from the bark of Ilex
      latifolia.
AB  - Two new triterpenoid saponins, latifoloside I (1), 3-O-alpha-L-rhamnopyranosyl-(1
      ->2)-beta-D-glucopyranosyl 3beta,21alpha,28-trihydroxy-urs-12-ene 21-O-beta-D
      glucopyranoside; latifoloside J (2), 3-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D
      glucopyranosyl-3beta,21alpha-dihydroxy-ursolic acid 21-O-beta-D-glucopyranoside,
      along with two known compounds, latifoloside C (3) and latifoloside E (4), were
      isolated from the bark of Ilex latifolia THUNB. Structure assignments were
      established on the basis of spectroscopic data and chemical evidence.

PMID- 11217118
TI  - Vibsane-type diterpenes from Taiwanese Viburnum odoratissimum.
AB  - Two new eleven-membered and three new seven-membered vibsane-type diterpenes,
      named vibsanin L (1) and 14-hydroxyvibsanin F (2), and vibsanin I (3), 14R*,15
      epoxyvibsanin C (4) and 14S*,15-epoxyvibsanin C (5) respectively, have been
      isolated from Viburnum odoratissimum collected in Taiwan. Their structures have
      been elucidated by spectroscopic analyses and comparison of Nuclear magnetic
      resonance method (NMR) data with those of the previously reported vibsane-type
      diterpenes. High performance liquid chromatography (HPLC) analyses indicated that
      the methanol extract of V. odoratissimum collected in Taiwan contained no
      neovibsanines, characteristic chemicals occurring in V. awabuki.

PMID- 11217119
TI  - Triterpene glycosides from the cultures of Phytolacca americana.
AB  - A new triterpene glycoside I was isolated together with the five known triterpene
      glycosides 2-6 from the cultures of Phytolacca americana. The structure of 1 was
      elucidated by analysis of spectroscopic data and comparison of its NMR data with
      those of 2-7 and chemical degradation.

PMID- 11217120
TI  - [Sentinel node: a revolution in breast cancer surgery?].

PMID- 11217121
TI  - [Congential thrombocytic hemorrhagic dystrophy].

PMID- 11217122
TI  - [Nail pathology].

PMID- 11217123
TI  - [Fungal and bacterial nail infections].
AB  - Fungal and bacterial infections are very common causes of nail deformity. The
      majority of fungal nail infections are caused by dermatophytes. Dermatophytosis
      result from a human contamination. A dermatophyte is always a pathogenic agent.
      Very effective drugs are available to treat dermatophyte nail infections. Yeasts
      of the genus Candida, notably C. albicans are the second most common cause of
      nail infection. The infections of nails due to Candida and bacteria are related
      with Candida sp and bacteria which are common commensals of the gastrointestinal
      tract, vagina or skin. Except C. albicans which is always a pathogen of skin, the
      other species of Candida and the bacteria could be a commensal of the skin, a
      colonizer of a dermatological disease or a true pathogen of nail. It is important
      to consider these different situations. More rarely, environmental moulds, most
      often known as saprophytic agents, can affect nails. They do not respond to
      conventional antifungal drugs. So, their diagnosis do not suffer any error. In
      order to evaluate properly the patient with possible fungal or bacterial
      infection of nails and also to choice an accurate therapy, the laboratory
      confirmation is essential. Clinical diagnosis is not sufficient to distinguish an
      infection of nails from a dermatological disease (psoriasis, traumatism) and to
      identify the responsible agent.

PMID- 11217124
TI  - [Nail localization of dermatoses].
AB  - The nail unit may reflect a dermatological disease by its own. Actually, its
      involvement may account for the existence of a skin disease that never showed
      before (i.e. lichen planus). But since the nail apparatus has a limited
      repertoire of clinical expressions (hyperkeratosis, onycholysis, paronychia...),
      the diagnosis may be sometimes difficult even for the most trained physician.
      Nail involvement may be however an additional clue in the diagnosis of an
      atypical skin disease. In that case, it might help in the final correct diagnosis
      provided that the physician did not forget that clinical examination of the nails
      is part of a dermatological examination.

PMID- 11217126
TI  - [Nail tumors].
AB  - The presenting sign associated with the tumours of the nail unit may involve: the
      colouration of the nail plate and/or the subungual tissue; the contour of the
      nail and the volume of the distal phalanx; the integrity of the nail (partial
      destruction or nail disappearance); abnormalities in the periungual tissues. The
      key for the early diagnosis of a nail tumour is a high index of suspicion of any
      non healing or recurrent condition in the area. Non-invasive studies such as X
      ray or MRI may be followed by the need of exploratory nail plate removal and
      adequate biopsy.

PMID- 11217125
TI  - [Nail manifestations of systemic diseases].
AB  - General diseases-associated nail disorders may be classified into 5 types
      according to their clinical impact. Type I refers to nail disorders considered as
      peculiar features among the various symptoms of general disease such as peri
      ungueal vascular dilatation, onycholysis, Beau lines, opaque nails or
      melanonychia. Type II refers to nail disorders with a strong clinical value such
      as Terry's nails, Muerhrcke's lines or koilonychia. Type III refers to nails
      disorders presenting as significant syndromes of several diseases such as yellow
      nail syndrome of subungueal splinter haemorrhages, and type IV to specific
      disorders considered as true keys for diagnosis such as digital hippocratism,
      Bazex's acrokeratosis, Koenen's tumor, or nail hypoplasia. In type V are included
      drug-induced nails disorders especially after chemiotherapy or antiretroviral
      therapy.

PMID- 11217127
TI  - [Pigmented lesions of the nail apparatus].
AB  - Linear pigmentation of the nail apparatus most reflects longitudinal
      melanonychia. It results either from simple activation of matrical melanocytes
      induced by various factors or from benign (lentigo or naevus) or malignant
      (melanoma) melanocyte hyperplasia. Hematomas and some fungal infections can
      falsely resemble linear pigmentation. Non-linear pigmented lesions of the nail
      bed are most often subungual hematoma or infections (fungal, or pyocyanic
      superfection of a loosened or separated nail). Opening the nail bed directs the
      diagnosis. A possible tumoral cause should be kept in mind, especially melanoma,
      or carcinoma.

PMID- 11217128
TI  - [Mechanical nail pathology].
AB  - Nails are submitted to a lot of trauma in the everyday life; their response to
      these traumatisms is various and they show themselves in misleading clinical
      manifestations leading often to misdiagnosis such onychomycosis or nail pathology
      of another origin. As for toenails dystrophies, repeated microtraumatisms in the
      shoes are the main cause and these dystrophies often reveal biomechanical
      disorders. As for fingernails, except the occupational pathology which is not
      related in this paper, nails dystrophies are particularly self-inflicted due to
      an obsessional-compulsive disorder. We are describing here the different nails
      dystrophies of mechanical aetiology, the different original factors and their
      mechanisms, as well as signs leading to the diagnosis.

PMID- 11217129
TI  - [Nail pathology in children].
AB  - In children the nail has physiologic characteristics that imply specific
      abnormalities. The most common dermatological localisation in psoriasis in the
      child; it is seen as trachyonychia, pitting, and occasionally pachyonychia.
      Ingrowth of the large toenail is a common problem, whether due to congenital
      hypertrophy of the lateral nail folds of the hallux in the newborn, to congenital
      malalignment of the nail of the big toe, or to a juvenile ingrown nail. Many
      other nail disorders are observed in the child: parakeratosis pustulosa, nail
      lichen, lichen striatus, melanonychia, dermatophyte onychomycosis, candida
      infection, herpes.... Aside from warts, tumours are rare.

PMID- 11217131
TI  - [Vaccinations. Immunological and microbiological bases, indications, contra
      indications, adverse effects, efficacy (schedule and mandatory character of
      excluded vaccinations].

PMID- 11217130
TI  - [Cosmetology and brittle nails].
AB  - The knowledge of manicure techniques and nail cosmetics compositions are a
      prerequisite to the understanding of their potential side effects. The brittle
      nail syndrome is a common problem that roughly affect 20% of women. We will
      review the etiologic hypothesis, describe the various presentations, and suggest
      a treatment for this perplexing problem.

PMID- 11217132
TI  - [Hospitalization requested by a third party and mandatory hospitalization,
      guardianship, trusteeship and legal protection].

PMID- 11217133
TI  - [Bronchial epidermoid cancers and adenocarcinomas. Epidemiology, pathology,
      etiology, diagnosis, evolution, treatment].

PMID- 11217134
TI  - [Extrauterine pregnancy].

PMID- 11217135
TI  - [Respiratory distress in the newborn].

PMID- 11217136
TI  - The JIM interview. Francois M. Abboud, MD.

PMID- 11217137
TI  - The future of clinical research: the role of genomics, informatics, and evidence
      based medicine.

PMID- 11217138
TI  - Perspectives on vascular biology and diabetes.

PMID- 11217139
TI  - Events at the vascular wall: the molecular basis of inflammation.

PMID- 11217140
TI  - Hepatic lipase as a focal point for the development and treatment of coronary
      artery disease.
AB  - Recent epidemiological evidence suggests that although lowering low-density
      lipoprotein (LDL) cholesterol is important in decreasing cardiovascular disease
      morbidity and mortality, it accounts only for part of the coronary artery disease
      (CAD) improvement with lipid-lowering therapy. In the last decade, it has become
      evident that the atherogenicity of LDL particles is associated not only with
      their plasma levels, but also with their size and density. The presence of small,
      dense LDL particles is associated with a three fold increase in CAD risk. Hepatic
      lipase (HL), a key enzyme in the formation of small, dense LDL particles,
      modulates their phospholipid and triglyceride contents. The higher the HL
      activity, the smaller, denser, and more atherogenic the resulting lipoprotein
      particle. It is, therefore, plausible to hypothesize that at least part of the
      CAD benefits observed in the recent CAD-prevention pharmacological trials, which
      are not accounted for by the decrease in LDL-C (LDL-cholesterol), might be
      explained by a pharmacological effect on LDL size and density, possibly mediated
      by changes in hepatic lipase activity. By studying patients with dyslipidemia and
      CAD, we have been able to provide strong evidence that regression of coronary
      atherosclerosis results from at least two independent effects of lipid-lowering
      therapy on lipoprotein metabolism: the well known one that leads to changes in
      LDL-C and apo B levels, and a new pathway of HL-mediated improvement in LDL
      buoyancy. Finally, HL activity and LDL density appear to be significantly
      affected by the presence of a common C-->T substitution at position -514 with
      respect to the transcription start site of the HL gene, raising the possibility
      that the -514 C-->T polymorphism may significantly contribute to differences in
      individual CAD response to lipid-lowering treatment, as seen in the recent major
      primary and secondary CAD-prevention clinical trials.

PMID- 11217141
TI  - Central role of the adipocyte in the metabolic syndrome.
AB  - Insulin resistance is associated with a plethora of chronic illnesses, including
      Type 2 diabetes, dyslipidemia, clotting dysfunction, and colon cancer. The
      relationship between obesity and insulin resistance is well established, and an
      increase in obesity in Western countries is implicated in increased incidence of
      diabetes and other diseases. Central, or visceral, adiposity has been
      particularly associated with insulin resistance; however, the mechanisms
      responsible for this association are unclear. Our laboratory has been studying
      the physiological mechanisms relating visceral adiposity and insulin resistance.
      Moderate fat feeding of the dog yields a model reminiscent of the metabolic
      syndrome, including visceral adiposity, hyperinsulinemia, and insulin resistance.
      We propose that insulin resistance of the liver derives from a relative increase
      in the delivery of free fatty acids (FFA) from the omental fat depot to the liver
      (via the portal vein). Increased delivery results from 1) more stored lipids in
      omental depot, 2) severe insulin resistance of the central fat depot, and 3)
      possible regulation of visceral lipolysis by the central nervous system. The
      significance of portal FFA delivery results from the importance of FFA in the
      control of liver glucose production. Insulin regulates liver glucose output
      primarily via control of adipocyte lipolysis. Thus, because FFA regulate the
      liver, it is expected that visceral adiposity will enhance delivery of FFA to the
      liver and make the liver relatively insulin resistant. It is of interest how the
      intact organism compensates for insulin resistance secondary to visceral fat
      deposition. While part of the compensation is enhanced B-cell sensitivity to
      glucose, an equally important component is reduced liver insulin clearance, which
      allows for a greater fraction of B-cell insulin secretion to bypass liver
      degradation, to enter the systemic circulation, and to result in hyperinsulinemic
      compensation. The signal(s) resulting in B-cell up-regulation and reduced liver
      insulin clearance with visceral adiposity is (are) unknown, but it appears that
      the glucagon-like peptide (GLP-1) hormone plays an important role. The integrated
      response of the organism to central adiposity is complex, involving several
      organs and tissue beds. An investigation into the integrated response may help to
      explain the features of the metabolic syndrome.

PMID- 11217142
TI  - Relationship of lipoprotein(a) to variables of coagulation in hypertensive
      subjects.
AB  - BACKGROUND: Coagulation factors are independent predictors of cardiovascular
      damage in the general population. The purpose of this study was to investigate
      the relationships between general cardiovascular risk factors, lipoprotein(a)
      (Lp(a)), and some hemostatic variables, and to characterize the isoforms of
      apolipoprotein(a) (apo(a)) in hypertensive subjects. METHODS: Plasma lipids,
      apolipoproteins, Lp(a), apo(a) isoforms, fibrinogen, and parameters that directly
      reflect the coagulation activation were measured in 389 untreated essential
      hypertensive patients recruited at a hypertension clinic. Hypertensive patients
      were compared with 323 normotensive controls. RESULTS: In normotensive subjects,
      Lp(a) concentrations were significantly correlated with fibrinogen (r = 0.138; P
      < 0.02) but not D-dimer (r = 0.074; not significant). In hypertensive subjects,
      log Lp(a) concentrations were significantly correlated with age (r = 0.127; P <
      0.02), apo-B (r = 0.128; P < 0.02), plasma fibrinogen (r = 0.193; P < 0.001), and
      fibrin D-dimer (r = 0.200; P < 0.001) levels, but not with body mass index, blood
      pressure, cholesterol, triglycerides, apo-AI, prothrombin fragment 1 + 2, and
      antithrombin III. The relationship of Lp(a) with fibrinogen (male: r = 0.198, P <
      0.002; female: r = 0.177, P < 0.01) and D-dimer (male: r = 0.211, P < 0.002;
      female: r = 0.188, P < 0.01) was significant in both sexes, whereas the
      relationship of Lp(a) with age and apo-B was found only in males. Multivariate
      analysis showed that both fibrinogen and D-dimer were independently related with
      Lp(a). Elevated fibrinogen, D-dimer, and Lp(a) levels were significantly and
      independently associated with clinical evidence of atherosclerotic disease.
      Apo(a) phenotypes were analyzed to investigate the genetic background of the
      relationships between Lp(a) and coagulation parameters. In both hypertensive and
      normotensive subjects, Lp(a) levels were inversely correlated with apo(a) isoform
      protein size, whereas fibrinogen and D-dimer concentrations were comparable in
      patients with apo(a) isoforms of different size. CONCLUSIONS: The relationship
      between Lp(a) and clotting variables is significantly stronger in hypertensive
      than in normotensive subjects, providing a compelling argument for accelerated
      progression of atherothrombosis in these patients.

PMID- 11217143
TI  - PPAR-gamma effects on the vasculature.

PMID- 11217144
TI  - Beneficial intervention of experimental colitis by passive cigarette smoking
      through the modulation of cytokines in rats.
AB  - BACKGROUND: Epidemiologic observations have indicated that cigarette smoking
      decreases the risk of ulcerative colitis, but the modes of action remain
      anonymous. The present study aimed to investigate the beneficial effects of
      passive cigarette smoking using an animal colitis model. We hypothesized that the
      underlying mechanisms may involve immunoregulation of cytokines. METHODS:
      Experimental colitis was induced in rats by enema administration of 2,4
      dinitrobenzene sulfonic acid (DNBS). Passive cigarette smoking by rats was
      performed for 1 hour once daily, from 3 days before DNBS enema until they were
      sacrificed on day 8. Other groups of DNBS-treated rats received therapeutic
      treatment of cyclosporin A or pentoxifylline, a tumor necrosis factor (TNF)-alpha
      inhibitor. Macroscopic and histologic damage were graded, and the colonic levels
      of different cytokines and the levels/activities of parameters related to
      neutrophil activation were also measured. RESULTS: DNBS-induced colonic damage
      was improved in passive-cigarette-smoking rats. This was accompanied by
      attenuation of the elevated colonic myeloperoxidase and inducible nitric oxide
      synthase activities and leukotriene B4 level. Likewise, the augmentation in
      colonic levels of TNF-alpha, interleukin (IL)-1 beta, and IL-6 in colitis rats
      was also alleviated by passive cigarette smoking. In contrast, the deprivation of
      colonic IL-10 during colitis was preserved in cigarette-smoking rats. These
      effects were similarly accomplished by pentoxifylline and, to some degree, by
      cyclosporin A. CONCLUSIONS: The results support the idea that the beneficial
      effects of passive cigarette smoking in experimental colitis involved
      immunoregulation of cytokines in colonic tissues.

PMID- 11217145
TI  - Circadian phase resetting in older people by ocular bright light exposure.
AB  - BACKGROUND: Aging is associated with frequent complaints about earlier bedtimes
      and waketimes. These changes in sleep timing are associated with an earlier
      timing of multiple endogenous rhythms, including core body temperature (CBT) and
      plasma melatonin, driven by the circadian pacemaker. One possible cause of the
      age-related shift of endogenous circadian rhythms and the timing of sleep
      relative to clock time is a change in the phase-shifting capacity of the
      circadian pacemaker in response to the environmental light-dark cycle, the
      principal synchronizer of the human circadian system. METHODS: We studied the
      response of the circadian system of 24 older men and women and 23 young men to
      scheduled exposure to ocular bright light stimuli. Light stimuli were 5 hours in
      duration, administered for 3 consecutive days at an illuminance of approximately
      10,000 lux. Light stimuli were scheduled 1.5 or 3.5 hours after the CBT nadir to
      induce shifts of endogenous circadian pacemaker to an earlier hour (phase
      advances) or were scheduled 1.5 hours before the CBT nadir to induce shifts to a
      later hour (phase delays). The rhythms of CBT and plasma melatonin assessed under
      constant conditions served as markers of circadian phase. RESULTS: Bright light
      stimuli elicited robust responses of the circadian timing system in older people;
      both phase advances and phase delays were induced. The magnitude of the phase
      delays did not differ significantly between older and younger individuals, but
      the phase advances were significantly attenuated in older people. CONCLUSIONS:
      The attenuated response to light stimuli that induce phase advances does not
      explain the advanced phase of the circadian pacemaker in older people. The
      maintained responsiveness of the circadian pacemaker to light implies that
      scheduled bright light exposure can be used to treat circadian phase disturbances
      in older people.

PMID- 11217146
TI  - Superoxide dismutase SOD1, encoded on chromosome 21, but not SOD2 is
      overexpressed in brains of patients with Down syndrome.
AB  - BACKGROUND: The antioxidant enzyme Cu/Zn-superoxide dismutase-1 (SOD1) gene is
      localized to chromosome 21q22.1 and catalyzes the dismutation of superoxide
      anions to hydrogen peroxide, which may lead to the increased production of active
      oxygen species in Down Syndrome (DS), trisomy 21. Although a number of studies
      have addressed this question, proposing the overexpression hypothesis, no
      specific protein-chemical data on SOD protein levels in the brains of patients
      with DS are available. METHODS: We therefore determined the protein SOD-1 and SOD
      2 levels in the brains of controls (n = 9) and adult patients with DS (n = 9) and
      Alzheimer disease (AD; n = 9). Two-dimensional electrophoresis followed by matrix
      assisted laser desorption/ionization-mass spectroscopy detection and
      identification was used for the analyses. RESULTS: We found significantly
      increased SOD-1 levels in DS temporal, parietal, and occipital cortex, whereas
      SOD-1 was decreased in the AD temporal cortex and SOD-2 was comparable between
      all groups. CONCLUSIONS: Increased SOD-1 levels in patients with DS may reflect
      the overexpression by the trisomic state, as a response to the oxidative stress,
      as has been proposed in DS by several authors. However, it well may be that glial
      proliferation, which is markedly increased in DS brain, may underlie the
      increased brain levels of this ubiquitous protein. The decrease of SOD1 in the
      temporal cortex of patients with AD may reflect an antiapoptotic mechanism or
      simply cell loss in the brain.

PMID- 11217147
TI  - Primate mammary gland insulin-like growth factor system: cellular localization
      and regulation by sex steroids.
AB  - BACKGROUND: Insulin-like growth factor 1 (IGF1) plays a critical role in estrogen
      induced uterine proliferation, but it is unclear whether this estromedin function
      occurs in other estrogen-sensitive tissues such as the mammary gland. To
      elucidate this possibility, we investigated the cellular localization and
      hormonal regulation of mRNAs for IGF1 and 2, their cognate receptors (IGF1R,
      IGF2R), and IGF binding proteins 2-5 (BPs 2-5) in the rhesus monkey mammary
      gland. METHODS: Ovariectomized monkeys were treated with placebo, estradiol (E2),
      and E2 plus progesterone (E2/P4) for 3 days, after which mammary tissue was
      harvested for in situ hybridization and immunohistochemical analyses. RESULTS:
      IGF1 and IGF2 mRNA levels were significantly increased and BP2 mRNA decreased by
      E2 and by E2/P4 treatment. IGF1R mRNA was increased by combined E2/P treatment
      but not by E2 alone. BP5 mRNA was decreased by E2/P4. No differences in IGF2R,
      BP3, and BP4 mRNA levels were detected in any treatment group. Mammary IGF1 and
      IGF2 mRNA levels were both positively correlated with local epithelial
      proliferation, assessed by immunodetection of the proliferation-specific antigen,
      Ki67.IGF1 and IGF1R expression were negatively correlated with local programmed
      cell death, as assessed by the in situ TUNEL method. In contrast, BP2 expression
      was negatively correlated with epithelial proliferation and positively correlated
      with programmed cell death. IGF2R, BP3, BP4, and BP5 levels were not
      significantly correlated with either proliferation or death. CONCLUSIONS: Thus,
      E2-induced proliferation is associated with upregulation of both IGF1 and IGF2
      expression and downregulation of BP2 expression. These data suggest that the
      local mammary IGF system is involved in sex steroid-induced mammary epithelial
      cell hyperplasia.

PMID- 11217148
TI  - Adenosine and hemodialysis in humans.
AB  - BACKGROUND: Infections and hypotension are serious complications that develop
      during hemodialysis (HD) treatment. Adenosine (ADO), a strong hypotensive and
      immunosuppressive agent, may participate in these two HD complications, because
      high concentrations of ADO metabolites are found in dialyzed human plasma. ADO,
      which is released by endothelial cells, is quickly transformed into inosine (INO)
      by plasmatic ADO deaminase (ADA) and mononuclear cell ADO deaminase (MCADA). In
      plasma, the degradation of ADO into INO and its uptake by red blood cells (RBC)
      are both very rapid, resulting in the short half-life of ADO in blood. METHODS:
      Using liquid chromatography, we evaluated ADO and INO plasma concentrations
      before and after HD session. RESULTS: Before the HD session, ADO and INO plasma
      concentrations were higher in hemodialyzed patients than in controls and in
      peritoneally dialyzed patients. At the end of the HD session, ADO plasma
      concentration was increased. ADO plasma concentration for the undialyzed patients
      was in the same range as that of the controls. Before HD, ADA activity was higher
      in hemodialyzed patients (559 +/- 349 IU) than in controls (219 +/- 48 IU), and
      the activity rose during the session (665 +/- 135 IU). ADA activity in the
      undialyzed patients (222 +/- 80 IU) was in the same range as that of the controls
      (219 +/- 48 IU). Before the HD session, the MCADA activity (247 +/- 144 IU) was
      lower than in controls (624 +/- 99 IU). HD did not modify ADO RBC uptake. ADO
      inhibited mononuclear cell proliferation and interferon-gamma production in
      humans. Finally, as much as 50 microM INO does not inhibit ADO uptake by RBC and
      does not modify ADA and MCADA activities. CONCLUSIONS: These data indicate that
      chronic HD inhibited MCADA activity and increased ADO plasma concentration. Both
      high ADO plasma concentration and low MCADA activity may be involved in dialysis
      induced immune system failure and thereby favor infectious diseases.

PMID- 11217149
TI  - Cigarette smoke and asbestos activate poly-ADP-ribose polymerase in alveolar
      epithelial cells.
AB  - BACKGROUND: Cigarette smoke augments asbestos-induced bronchogenic carcinoma in a
      synergistic manner by mechanisms that are not established. One important
      mechanism may involve alveolar epithelial cell (AEC) injury resulting from
      oxidant-induced DNA damage that subsequently activates poly (ADP-ribose)
      polymerase (PARP), an enzyme involved in DNA repair that can deplete cellular
      energy stores. We previously showed that whole aqueous cigarette smoke extracts
      (CSE) augment amosite asbestos-induced DNA damage and cytotoxicity to cultured
      AEC in part by generating iron-induced free radicals. We hypothesized that CSE
      increase asbestos-induced AEC injury by triggering PARP activation resulting from
      DNA damage caused by iron-induced free radicals. METHODS: Aqueous CSE were
      prepared fresh on the day of each experiment. PARP activity in WI-26 (a type I
      like cell line) and A549 (a type II-like cell line) cells was assessed by the
      uptake of labeled NAD over 4 hours and confirmed on the basis of the reduction of
      PARP levels in the presence of a PARP inhibitor, 3-aminobenzamide (3-ABA). Cell
      survival was assessed by trypan blue dye exclusion. RESULTS: Hydrogen peroxide
      (H2O2; 1-250 microM), CSE (0.4-10 vol%), and amosite asbestos (5-250
      micrograms/cm2) each caused PARP activation in WI-26 and A549 cells. The
      combination of asbestos (5 micrograms/cm2) and CSE (0.04-10%) induced WI-26 and
      A549 cell PARP activation without evidence of synergism. 3-ABA significantly
      attenuated WI-26 and A549 cell PARP activity and cell death after exposure to
      H2O2, CSE, and asbestos. Phytic acid, an iron chelator, catalase, and superoxide
      dismutase each decreased WI-26 cell PARP activation caused by asbestos and CSE.
      CONCLUSIONS: CSE and asbestos induced PARP activation in cultured AEC in a
      nonsynergistic manner. These data provide further support that asbestos and
      cigarette smoke are genotoxic to relevant lung target cells and that iron-induced
      free radicals in part cause these effects.

PMID- 11217150
TI  - Productivity of medical research in Switzerland.
AB  - BACKGROUND: Little evidence exists about what contributes to successful medical
      research, an increasingly important issue in an era of limited research budgets.
      This study examined predictors of productivity of Swiss medical research.
      METHODS: Principal investigators of clinical research projects funded by the
      Swiss National Science Foundation between 1990 and 1994 were surveyed by mail.
      They provided information about the research question, whether changes were made
      to the protocol and why, their assessment of the importance of results for
      science and for public health, and additional funding of the project. The amount
      of the grant and the project priority score were obtained from the Foundation.
      Indicators of scientific productivity were the number of peer-reviewed articles
      and the summed impact factor per grant. RESULTS: The size of the grant predicted
      scientific output (number of articles and summed impact factor), but the marginal
      return decreased with the total sum awarded. The award of a continuation grant by
      the same agency and additional funding from other sources were also positively
      linked with productivity. In addition, the initial priority rating of the project
      by the funding agency's scientific committee and the assessment of scientific
      importance of the results by the principal investigator were also independently
      associated with productivity. Finally, modifications of the initial research plan
      in response to new scientific opportunities were linked with greater
      productivity, whereas modifications induced by technical or other difficulties
      were associated with lower productivity. CONCLUSIONS: Productivity in medical
      research, measured by peer-reviewed articles produced, requires adequate
      resources and ability to respond to new scientific challenges, and it can be
      anticipated by peer-review.

PMID- 11217152
TI  - The debriefing "controversy" and crisis intervention: a review of lexical and
      substantive issues.
AB  - Despite a long and rich history as a specialty within applied mental health,
      crisis intervention has, within recent years, been the target of criticism.
      Singled out for specific criticism has been the intervention referred to as
      "debriefing." Some authors have not only challenged its effectiveness but have
      raised the specter that it may cause significant harm. While superficially such
      arguments appear to have merit, closer scrutiny reveals an antiquated
      interpretation of even the most fundamental of terms and concepts inextricably
      intertwined with research based upon applications contrary to the most recent
      principles, prescriptions, and protocols regarding clinical use. A review of
      research based upon more extant formulations reveals many crisis intervention
      practices, including the Critical Incident Stress Debriefing model of
      "debriefing" and the Critical Incident Stress Management (CISM) model of crisis
      intervention to be highly clinically effective, indeed. This paper will review
      the terms and concepts which serve as the foundation of the field of crisis
      intervention, while subsequently reviewing key research investigations addressing
      its efficacy. It may be that outcome research directed toward assessing the
      effectiveness of crisis intervention can prosper from following trails blazed by
      psychotherapy researchers. The parallels seem striking. It may be that outcome
      research in crisis intervention (and "debriefing") needs to now focus upon "who"
      does crisis intervention, to "whom," and in "what specific situations," so as to
      maximize outcome associated with this clinically effective tool [International
      Journal of Emergency Mental Health, 2000, 2(4), 211-225].

PMID- 11217151
TI  - Insulin receptor antibodies inhibit insulin uptake by the liver: in vivo 123I
      insulin scintigraphic scanning and in vitro characterization in autoimmune
      hypoglycemia.
AB  - BACKGROUND: Insulin receptor antibodies can induce severe hypoglycemia or insulin
      resistance in rare autoimmune syndromes. In vitro properties of these antibodies
      occasionally explain the clinical features of the syndrome, but direct evidence
      of their in vivo activity is poor. We studied a 58-year-old male with rheumatoid
      arthritis who presented with hypoglycemic coma. METHODS AND RESULTS: Antibodies
      were detected by inhibition of 125I-insulin binding to human insulin receptor-3T3
      cells by the patient's serum. By immunofluorescence, they were immunoglobulin G
      of all four subclasses, immunoprecipitated insulin receptors from biotin-labeled
      cells, and triggered phosphorylation of the beta subunit of the insulin receptor.
      Insulin binding on the patient's red blood cells was markedly reduced. A
      biodistribution study after intravenous 123I-Tyr A14 insulin showed a marked
      inhibition of tracer uptake by the liver, reaching 10% of the injected dose
      (controls, mean +/- SD, 21.1 +/- 1.7%; n = 10). Time activity curves generated on
      the liver and on the heart were parallel, with a T1/2 of 11.5 minutes for both,
      suggesting that no specific uptake occurred in the liver, where tracer activity
      represented only the blood pool. Clearance of insulin from the blood was indeed
      slower than in controls and mainly occurred through the kidneys. Analysis of
      plasma 123I-insulin immunoreactivity and trichloroacetic acid precipitate showed
      that insulin degradation did not occur as in normal controls. CONCLUSIONS: In
      this patient with hypoglycemic syndrome, insulin receptor antibodies with in
      vitro insulin-like activity are capable of blocking in vivo the access of insulin
      to the liver receptor compartment, as directly demonstrated by the markedly
      altered biodistribution of intravenously injected 123I-insulin.

PMID- 11217153
TI  - In defense of defending what may not be so obvious in the CISD/CISM efficacy
      debates.

PMID- 11217155
TI  - Past violence and substance use disorder and subsequent violence towards others:
      six year analysis of the Assaulted Staff Action Program (ASAP).
AB  - Recent research has begun to document evidence of associations between past
      violence toward others, untreated personal victimization, and substance use
      disorder and later acts of violence toward others. This appears true for many
      types of individuals, including psychiatric patients who have been victims of
      violence. This six-year retrospective study sought to evaluate these possible
      associations in assaultive psychiatric patients. Data were gathered in the
      context of the Assaulted Staff Action Program (ASAP), a crisis intervention
      program for staff victims of patient assault. Both histories of violence
      (violence toward others and/or personal victimization) and substance use disorder
      in assaultive psychiatric patients were individually and jointly examined and
      found to be associated with subsequent assaults by these patients. Increased
      levels of both past violence toward others, personal victimization, and substance
      use disorder were associated with the largest increased frequency of subsequent
      assault. The implications and possible links to emergency mental health services
      are discussed [International Journal of Emergency Mental Health, 2(4), 241-247].

PMID- 11217154
TI  - Predictors of secondary trauma in sexual assault trauma counselors.
AB  - This study evaluated psychological distress, secondary trauma intensity, and
      specific components of secondary trauma in 89 sexual assault trauma counselors
      (SATC). Results indicated that some SATC were experiencing secondary trauma based
      on measures of psychological distress and PTSD-like symptoms. The study also
      examined whether personal trauma history, greater counseling experience,
      emergency room work as primary client contact type, counseling satisfaction
      levels, and demographic variables significantly predicted self-reported
      psychological distress and PTSD-like symptoms. Results supported the hypothesis
      that personal trauma history and younger age significantly predicted self
      reported psychological distress. Results also supported hypotheses that personal
      trauma history, younger counselor age, and lower counseling satisfaction levels
      significantly predicted higher levels of secondary trauma intensity. Contrary to
      prediction, exposure to trauma survivors, emergency room work as primary client
      contact type, and education did not significantly predict psychological distress
      or secondary trauma intensity. Findings were robust even when SATC currently in
      psychotherapy or taking medication were conservatively excluded in follow-up
      analyses. Research and training implications are discussed [International Journal
      of Emergency Mental Health, 2000, 2(4), 229-240).

PMID- 11217156
TI  - The critical incident stress debriefing process for the Los Angeles County Fire
      Department: automatic and effective.
AB  - Los Angeles County Fire Department has one of the oldest Critical Incident Stress
      Management (CISM) programs in the country. One core component for the LACoFD has
      been the Critical Incident Stress Debriefing (CISD). Two important questions for
      the emergency managers are: 1) Do individuals find a significant difference in
      symptom reduction for events that were debriefed? 2) Does helpfulness of a
      debriefing for a specific individual correlate with recommending the process for
      others? A Department-wide evaluative survey was conducted in 1996 to determine
      the satisfaction and effectiveness of the debriefing program. Individuals
      reported a significant difference in the speed of symptom reduction for incidents
      that were debriefed versus incidents that were not debriefed. The majority of
      individuals would recommend the debriefing process to others regardless of
      whether they personally found the process helpful or not. Based on this, the
      recommendations are to continue the debriefing process for specific events and to
      make the process mandatory; furthermore, it is recommended that the term
      "mandatory" be changed to "automatic." By using the term "automatic," debriefings
      become standard operating procedures. By doing so, a method to protect the
      psychological welfare of emergency personnel becomes as automatic as putting on
      safety protection equipment [International Journal of Emergency Mental Health,
      2000, 2(4), 249-257].

PMID- 11217157
TI  - Posttraumatic stress symptomatology in patients with automatic implantable
      cardioverter defibrillators: nature and intervention.
AB  - With the advent of DSM-IV, medical illness may be considered a traumatic event.
      Yet there is evidence that a lifesaving intervention, the automatic implantable
      cardioverter defibrillator (AICD) may be associated with PTSD, as well. Crisis
      intervention is reviewed as a possible model to assist AICD patients in their
      adjustment to AICD discharge and its associated distress [International Journal
      of Emergency Mental Health, 2000, 2(4), 259-263].

PMID- 11217158
TI  - Disaster management and the Goteborg Fire of 1998: when first responders are
      blamed.
AB  - On Thursday, the 29th of October, 1998, Goteburg, Sweden experienced one of its
      greatest fire related catastrophes. Sixty-three people lost their lives in a
      Goteburg discotheque. This paper describes the events surrounding the fire, its
      effects upon firefighters and the city of Goteborg, and the emergency mental
      health activities implemented to support fire and rescue personnel. Of particular
      importance were the effects experienced by fire and rescue personnel as they
      became targets for community grief and anger. This paper discusses the lessons
      learned from organizational and personnel points of view [International Journal
      of Emergency Mental Health, 2000, 2(4), 267-273].

PMID- 11217159
TI  - [Treatment of infants with acute diarrhea in Hungary].
AB  - In the treatment of infants with acute diarrhoea complicated by mild to moderate
      dehydration, there is a great importance of rapid rehydration over 3-4 hours with
      oral rehydration solution containing 60 mmol/l sodium and then the rapid
      reintroduction of normal diet or breast feeding which should be continued all the
      time if possible. The pharmacological treatment of diarrhoea is not justified. In
      the present study which was part of a European multicentre survey using
      questionnaires the authors analysed how the recommendation of European Society of
      Pediatric Gastroenterology, Hepatology and Nutrition are followed in Hungary. It
      was evaluated 131 returned questionnaires, 80 of primary care and 51 of hospital
      based pediatricians. The overwhelming majority of pediatricians (92%) recommended
      the oral rehydration at the beginning of treatment. The four fifth of them use
      the ORS with recommended composition. Only 31% of them use rapid oral rehydration
      over 3-4 hours. Merely 10% of them suggest the early reintroduction of normal
      feeding after the oral rehydration, while more than half of the respondent
      pediatricians (52%) think that temporarily the use of lactose free formula is
      justified. It is a very favourable fact that 84% of doctors recommend the
      continuation of breast feeding. Some kind of drugs for the treatment of diarrhoea
      is suggested by 15% of repliers. On the base of results it is obvious that the
      guidelines for the treatment of acute diarrhoea in infancy is complied only
      partially in Hungary and the reintroduction of normal feeding is delayed.

PMID- 11217160
TI  - [The role of HDL in the prevention of cardiovascular events].
AB  - The Framingham and other epidemiological studies have shown HDL and triglyceride
      to be inversely correlated. An independent relationship between HDL cholesterol
      and CAD was observed in other studies and also suggested by interventional
      trials. Decreased HDL-C and mildly elevated LDL-C are common in patients with
      coronary artery disease. Identification of receptors involved in the metabolism
      of HDL has been the subject of intensive research. The HDL particle may be
      recognized by different receptors in various tissues. Niacin and fibrate have a
      remarkable effect on the reduction of triglyceride and elevation of HDL, while
      their LDL lowering effect is moderate. Statins are effective and safe drugs for
      CHD, and exert beneficial effects across the lipoprotein profile. Therefore, the
      effects of statins on HDL-C may contribute to reductions in coronary events.

PMID- 11217161
TI  - [Physical illness and suicidal behavior. Review of results at the Pecs Center of
      the WHO/EURO Multicenter Study of Parasuicide].
AB  - The authors examined the relation of physical illness, suicidal behaviour and
      help-seeking patterns among suicide attempters within the framework of the
      WHO/EURO Multicentre Study on Parasuicide. Until now 700 monitored suicidal
      events have been collected; 101 structured interviews and 50 follow-up cases have
      been conducted in this three years period. Physical and mental problems proved to
      be very frequent among suicide attempters and many of them took somatic and
      psychiatric drugs. It was shown that patients with acute or chronic physical and
      mental illness more often had been in contact with GPs. Authors pointed out that
      in addition to mental problems the somatic diseases are significant risk factors
      in suicidal behaviour. In many cases these factors were not recognised and thus
      patients could not get help. Authors emphasised the importance of training GPs,
      since complex diagnostic and therapeutic approach is essential to prevent
      suicide.

PMID- 11217162
TI  - [Combination, transition and degrees of severity of various syndromes].
AB  - Nowadays it is difficult to recognise and separate the various syndromes. The
      geneticists and the morphologists often change the classification of syndromes.
      The problem may be caused by a new case of a known syndrome, when new symptoms
      are described among the known ones. Then it is not sure, if a new syndrome
      discovered or it is a more complicated variation of an already known syndrome. To
      emphasise and exemplify the difficulties of syndrome identification 5 patients
      are presented and analysed: on with anadysplasia, two with cleidocranial
      dysplasia and a sibling pair with Larsen syndrome. It is concluded that no new
      syndrome could be described, and in a similar context, the definition of several
      new syndromes is not justified. The classification of syndromes based on bone
      disorders must be modified in order to fit the Genetic Classification easier and
      more clearly.

PMID- 11217163
TI  - [Olanzapine and pregnancy].
AB  - The appearance of psychosis during pregnancy means a challenge for clinicians,
      either untreated psychiatric disorders or pharmacological treatment of pregnant
      psychotic females increase risk of complications. Controlled clinical trials
      can't be evaluated because of ethical considerations, so case reports have higher
      scientific values than in other clinical issues. The authors inform about a
      delivery of a young psychotic female, who was treated with olanzapine (atypical
      antipsychotic) after the 25th weeks of her pregnancy. A healthy newborn was born
      in the observed case, the Apgar score was 7 at the first minute and 9 at fifth
      minute.

PMID- 11217164
TI  - [Contribution to the subject of scientific qualifications and leadership
      potential in medicine].

PMID- 11217165
TI  - [Continuing medical education in Hungary].

PMID- 11217166
TI  - Police reporting and professional help seeking for child crime victims: a review.
AB  - Most crimes with child victims are not reported to police, nor do child victims
      access other professional victim services, despite evidence that these yield
      positive outcomes. This article develops a conceptual framework about the
      barriers to such access: (a) the reluctance to define the crime episodes or their
      consequences as serious, criminal, harmful, or warranting intervention; (b) the
      extra authorities, including parents and schools, who mediate between victims and
      police or services; (c) developmental issues, such as concerns about autonomy;
      (d) attitudinal and emotional obstacles; and (e) time and expense factors. This
      article suggests the need for initiatives to stimulate reporting and help
      seeking, such as more publicity about the seriousness of juvenile victimization,
      more justice-system involvement with schools, more child and family friendly
      police services, and an emphasis on attractive outcomes such as justice and
      empowerment.

PMID- 11217167
TI  - Abusive early child rearing and early childhood aggression.
AB  - Childhood aggression is significant for children, their families, and the society
      because aggressive children often become violent adolescents. This article
      examines the relationship between maltreatment and early childhood aggression.
      Data are from a longitudinal study of maltreated and nonmaltreated children
      assessed as preschoolers and again at school age. The dependent variable is the
      child's teacher's rating of aggression at school age. The independent variables
      are from preschool and school age observations of the mother-child interaction
      and the mother's report of physical discipline practices. Using structural
      equation modeling, harshness of interaction at preschool age but not school age
      and severity of physical discipline at school age but not preschool age, relate
      to aggression at school age. Results suggest a difference in the developmental
      stage at which different features of harsh child rearing exert their influence.
      Strategies for intervening to prevent the development of childhood aggression are
      suggested.

PMID- 11217168
TI  - Evolution of a classification scale: medical evaluation of suspected child sexual
      abuse.
AB  - This article presents a revision of a system for classifying examination
      findings, laboratory findings, and children's statements and behaviors as to
      their possible relationship to sexual abuse. The revisions are based on published
      research studies and current recommendations from the American Academy of
      Pediatrics Committee on Child Abuse and Neglect, and the American Professional
      Society on the Abuse of Children. Part 1 of the classification system lists
      genital and anal findings that can be considered normal or nonrelated to abuse,
      nonspecific for abuse, concerning for abuse, and clear evidence of blunt force or
      penetrating trauma. Under Part 2, the overall classification of the likelihood of
      abuse is broken into four categories: no evidence of abuse, possible abuse,
      probable abuse, and definite evidence of abuse or penetrating trauma. Cautions in
      the use of the classification system, as well as controversies concerning a few
      medical findings, are discussed.

PMID- 11217169
TI  - Child Sexual Behavior Inventory: normative, psychiatric, and sexual abuse
      comparisons.
AB  - A normative sample of 1,114 children was contrasted with a sample of 620 sexually
      abused children and 577 psychiatric outpatients on the Child Sexual Behavior
      Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in
      children 2 to 12 years old. The CSBI total score and each individual item
      differed significantly between the three groups after controlling for age, sex,
      maternal education, and family income. Sexually abused children exhibited a
      greater frequency of sexual behaviors than either the normative or psychiatric
      outpatient samples. Test-retest reliability and interitem correlation were
      satisfactory. Sexual behavior problems were related to other generic behavior
      problems. This contributed to the reduced discrimination between psychiatric
      outpatients and sexually abused children when compared to the normative/sexually
      abused discrimination.

PMID- 11217170
TI  - Pediatric anogenital exam: a theory-driven exploration of anticipatory appraisals
      and affects.
AB  - Smith and Lazarus's 1990 and 1993 theory of cognition-emotion associations guided
      this exploration of individuals' pre-exam experiences. The study also tested the
      model's integrity during a stressful event and examined its downward extension to
      children. A total of 47 girls ages 8 to 14 (M = 11.57, SD = 2.14) and 109 adult
      guardians of female patients (all ages) completed a brief questionnaire about
      their pre-exam thoughts and feelings. The majority of participants viewed the
      impending exam as important and desirable, reported optimism and confidence in
      their ability to cope or adjust, and described mild-moderate anxiety as well as
      moderate-high hope/gladness. The majority of adults also reported relatively high
      levels of sadness. Data supported the model's cognition-emotion associations.
      This theory-driven research offers a richer understanding of children who may
      have been sexually abused and their supportive adult guardians and encourages
      more positive and realistic expectations for these individuals.

PMID- 11217171
TI  - The relationship between interview characteristics and accuracy of recall in
      young children: do individual differences matter?
AB  - The relationship between interview characteristics and accuracy of recall in
      young children, as mediated by child characteristics, was examined. The interview
      characteristics included preinterview instructions and level of questioning.
      Fifty-six children ranging from ages 3 to 6 years participated in a Circus Day
      event and were interviewed 10 days later. Following either instructions or filler
      questions, children were questioned about the event. Results indicated that based
      on several individual difference factors, young children varied significantly in
      the accuracy of their interviews and their ability to resist misleading
      questions. However, individual differences did not mediate children's ability to
      benefit from different question types or preinterview instructions. As a whole,
      children provided limited information to the most open-ended questions and more
      correct information to highly structured questions. In contrast to the research
      with older children, younger children did not benefit from preinterview
      instructions. Suggestions for future research and implications for investigative
      interviews in the field of child abuse are discussed.

PMID- 11217172
TI  - 'Giveback' legislation restores funding for Medicare, Medicaid programs.

PMID- 11217173
TI  - Final rule on health information privacy issued.

PMID- 11217174
TI  - Neurotoxins licensed as treatment for neck neuromuscular disorder.

PMID- 11217175
TI  - Certification now required for Texas pharmacy technicians.

PMID- 11217176
TI  - Development and implementation of a tobacco consultation program for managed care
      pharmacists.

PMID- 11217177
TI  - Rituximab: an innovative therapy for non-Hodgkin's lymphoma.
AB  - The epidemiology, etiology, classification, and treatment of non-Hodgkin's
      lymphoma (NHL) are reviewed, and rituximab, a newly available therapy, is
      discussed. NHL comprises a group of lymphoproliferative disorders the frequency
      of which continues to rise. Although many classification systems exist for
      identifying specific histological subtypes, NHL is generally divided into
      indolent (low-grade) and aggressive (intermediate- and high-grade) forms. Low
      grade NHL is characterized by a slowly progressive, continually relapsing course,
      with eventual transformation to a more rapidly progressive form that is usually
      fatal. Several options are available for the management of indolent NHL; none is
      curative. Rituximab, a human-mouse monoclonal antibody that targets the CD20
      antigen expressed in over 90% of B-cell NHLs, provides an alternative to
      conventional chemotherapy that is relatively safe and effective. In a Phase III
      trial involving 166 patients with relapsed or refractory low-grade B-cell NHL,
      rituximab produced an overall response of 48%, with 20 of 80 responders still in
      remission more than 36 months after treatment. Study results in patients with
      bulky disease and those requiring retreatment have also been encouraging. Most
      adverse effects associated with rituximab are mild to moderate. Infusion-related
      reactions occur more commonly during initial infusions and in patients with
      evidence of increased tumor burden but can be effectively managed with
      premedication, supportive care, and adjusted infusion rates. Hematologic effects
      are generally mild and transient, and adverse immune responses are rare.
      Rituximab is an alternative to conventional chemotherapy for the treatment of
      relapsed or refractory low-grade or follicular CD20-positive B-cell NHL.

PMID- 11217179
TI  - Stability of carmustine in polyvinyl chloride bags and polyethylene-lined
      trilayer plastic containers.

PMID- 11217178
TI  - Citywide pharmaceutical preparation for bioterrorism.
AB  - One community's efforts to become pharmaceutically prepared for an attack with
      biological agents is described. In response to recent bioterrorist activities,
      including a local scare in 1999 involving anthrax, the pharmacy department at
      Deaconess Medical Center in Spokane, Washington, was asked to develop a plan for
      bioterrorism preparedness. A literature search was conducted, and resources, such
      as the Centers for Disease Control and Prevention, were contacted. For each
      biological agent, information was compiled about symptom onset, treatment,
      postexposure prophylaxis, patient isolation precautions, and the availability of
      antidotes at local hospitals. A procedure was developed for obtaining antidotes
      that might not be available or stocked in sufficient quantities. After being
      reviewed by appropriate authorities, the information was presented to area
      hospitals and trauma centers, drug wholesalers, hospital risk-management
      personnel, and emergency management personnel. In May 2000 dozens of emergency
      and medical personnel attended a day-long program on domestic preparedness.
      Citywide cooperation was obtained on how to respond to a mass exposure to a
      bioterrorism agent. The job of a pharmacist during a bioterrorism strike is to
      rapidly disseminate antidotes and information, provide dosage and vaccination
      schedules for both treatment and prophylaxis, and counsel patients. Medical
      facilities in Spokane have cooperated to make the community more prepared for a
      bioterrorist attack.

PMID- 11217180
TI  - Reliability of an instrument for evaluating antimicrobial appropriateness in
      hospitalized patients.

PMID- 11217181
TI  - Use of a multidisciplinary continuous-quality-improvement process to investigate
      succinylcholine treatment failures.

PMID- 11217182
TI  - Evaluation of antimicrobial surgical prophylaxis with multiattribute utility
      theory.

PMID- 11217183
TI  - Gender differences in the associations of self esteem, stress and social support
      with functional health status among older adults with heart disease.
AB  - This study explored and compared the role of self esteem, stress and social
      support in maintenance or improvement in physical and psychosocial functioning
      over 12 months in older men and women with cardiovascular disease. Data from 502
      adults over 60 years of age showed that self esteem and stress were both
      significantly associated with functioning when demographic and clinical factors
      were controlled. Men were significantly more likely than women to maintain or
      improve in functioning. Self esteem, stress, compliance with medication regimens,
      and marital status were significantly associated with maintenance or improvement
      of functioning among women. Only age and stress were significantly associated
      with maintenance or improvement in functioning among men. Findings indicated
      that: (1) stress and self esteem were stronger predictors of functioning,
      especially among women, than demographic and clinical factors; and (2) women in
      the highest quartile of the self esteem distribution were approximately five
      times as likely to maintain or improve their functioning as women in the lowest
      quartile.

PMID- 11217184
TI  - Anticipatory caregiving anxiety among older women and men.
AB  - This study, based on a sample of 221 older women and men, explores factors
      associated with anticipatory caregiving anxiety using a scale developed by
      Cicirelli (1988). Results show that even the anticipation of providing care
      evokes anxiety. We find that women have higher levels of anxiety than men,
      individuals who have served as caregivers have higher levels of anxiety than
      individuals who have never provided care to family members, and that individuals
      who are in better health and have more income have lower levels of anxiety than
      those with less health or income. Implications for services to support caregivers
      and long-term care reform are discussed.

PMID- 11217185
TI  - A chronology of the study of older women's health: data, discoveries, and future
      directions.
AB  - Women have been traditionally ignored in health and medical research. Some
      reasons for this mentality include a fear of harming a woman's reproductive
      ability, fear that variations in the menstrual cycle could confound results, fear
      that a woman's body could not withstand the rigors of clinical research, and an
      assumption that male and female body chemistry is similar. Thankfully, these
      fears and assumptions are being challenged and several major data-bases, designed
      specifically to study women's health, have emerged. The purpose of this paper is
      to: (1) characterize the major longitudinal studies on women's health, (2)
      summarize the major discoveries from these studies that are relevant to older
      women, and (3) pose several future directions for research throughout the paper.

PMID- 11217186
TI  - Importance of fatalism in understanding mammography screening in rural elderly
      women.
AB  - This study examined the relationship between demographic factors and other
      correlates of fatalism, and assessed the impact of fatalistic beliefs on the
      participation in breast cancer screening in rural women. The subjects were 220
      women aged 50 and over recruited from 6 large rural counties in South Carolina.
      Data were collected using a demographic questionnaire and the revised Powe
      Fatalism Inventory. Results show significant associations between fatalism and
      increased age (p = 0.005), race (p = 0.0001), doctor recommendation (p = .0034)
      and decreased educational level (p = 0.001). Fatalism was associated with
      noncompliance with mammography screening in univariate analysis among African
      American women (OR = .362; 95% CI: 1.11, 11.8). After adjusting for possible
      confounders (age, education, and doctor recommendation), fatalism was not
      significantly associated with noncompliance with screening. These results
      illustrate age, race, and education may be important predictors of fatalism and
      that fatalism may be one barrier that has previously gone unmeasured and
      unchallenged in understanding screening behavior in older women.

PMID- 11217187
TI  - Aging, chronic illness and self-concept: a study of women with osteoporosis.
AB  - The coalescence of aging and chronic illness may alter the relationships between
      the meanings of aging and chronic illness and the self-concept. Using Rosenberg's
      conceptualization of self-concept (1979), a qualitative study was designed and
      data collected from twenty-eight women with osteoporosis. Three types of self
      concepts emerged from the data: the confident self, the contradictory self and
      the disparaged self. A description of these types is presented highlighting the
      reciprocal relationship among meanings of aging and chronic illness and self
      concept and including discussion of the strategies used to enhance, protect and
      maintain self-concept despite changes brought on by aging and chronic illness.

PMID- 11217188
TI  - [Precancerous lesions of the uterine cervix in cameroonian women. Cytological and
      epidemiological aspects of 946 cases].
AB  - OBJECTIVE: The aim of this study was to present the cytological and
      epidemiological aspects of precancerous lesions of the uterine cervix of women
      living in the two first cameroonian cities (Yaounde and Doubla). MATERIAL AND
      METHODS: The material was made of pap smears registrar of the Yaounde Central
      Hospital pathological laboratory and the reports of cervical cancer screening
      from Douala and Yaounde within a period of five years (1st January 1994 to 31st
      December 1998). We recruited all cases showing a precancerous lesion of the
      uterine cervix. For each case, we noted: the type of lesion, the age of the
      patient, the age at the first sexual intercourse, the age at the first delivery,
      the number of pregnancies, the parity, the marital status, the socioeconomical
      class. RESULTS: From a total of 13524 pap smears done, 946 (7%) have shown
      precancerous lesions. 70% of these were high grade while 30% were low grade.
      These lesions were observed at all age from the range of 11 to 15 years. All
      women showing these lesions had had sexual intercourse. 30% of these lesions were
      noted among women who have had their first sexual intercourses between 10 and 15
      years. 40% were observed among women who have had their first sexual intercourses
      between 16 and 18 years. 66% among women who have had their first delivery
      between 13 and 21 years. 92% are observed among women who have had more than five
      pregnancies, more than five parities; 54% among women who are married and 76%
      among bachelors and widows; 64% among women with low socioeconomical status; 9%
      among women with high socioeconomical status. CONCLUSION: Many cameroonian women
      are prone to cervical cancer.

PMID- 11217189
TI  - [Evaluation of cost of laparoscopic surgery in gynecology].
AB  - The objective of this work was to evaluate hospital and postoperative costs
      associated with gynecologic laparoscopic surgery for benign pathologies. Hospital
      costs were broken down into several categories: operating room, postoperative
      hospitalization, pharmacy, surgical instruments, sterilization of reused
      equipment, food and laundry, indirect costs. The mean total costs for the
      hospitalization time were 8547,2 francs. Medical charges in recovery time were
      calculated with the help of the Social Security. These charges represented less
      than 5% of the total cost associated with the procedure.

PMID- 11217190
TI  - [Breast cancer and its psychological approach: family, others, chance and...me].
AB  - Since several years already, the scientific literature evoked the psycho
      oncological perspective in the psychotherapeutic treatment of the patient
      suffering of a malignant mammary pathology. The objective of this article is to
      insist on some characteristics of personality inherent to the individual that
      suffers of a malignant mammary pathology. Comparing three groups of women
      (malignant mammary pathology--n = 51, benign mammary pathology--n = 71 and a
      group controls--n = 30), a set of questionnaires relating to locus of control and
      to the close circle--family and couple--has been managed. Results indicate that
      the woman suffering of a breast cancer is less "intern", consider that her health
      depends on factor "luck" and wish less cohesion and therefore more of distance
      within her couple and her family.

PMID- 11217191
TI  - [Pregnancy outcome and the status of the newborn infant after ICSI at La
      Conception Hospital in Marseille].
AB  - OBJECTIVE: To evaluate obstetric outcome of pregnancies and pediatric follow-up
      of children born after ICSI procedure. MATERIAL AND METHOD: Prospective study
      from october 1994 to September 1998 in medical assisted procreations center in La
      Conception hospital in Marseilles. Three hundred forty-two couples undergoing
      ICSI procedures. INTERVENTIONS: analysis of pregnancy rates, prematurity rates,
      obstetric outcome and frequency of congenital malformations. RESULTS: One hundred
      seventy-eight pregnancies have been obtained with 111 children. Multiple
      pregnancy rate arise 29.7%. The average term at birth in the singleton
      pregnancies (38.7 weeks) is higher than in the twins (35.7 weeks). The
      prematurity rate of delivery before 35 weeks of gestation is about 9.6%. Seven of
      111 neonates was born with a congenital malformation, no cardiovascular one. One
      of boys presents a bilateral cryptorchidism with severe bilateral hypotrophy.
      CONCLUSIONS: Our results are similar with those of others teams. Congenital
      malformation rates is near rates reported in others studies. However, no
      bilateral cryptorchidism with bilateral severe hypotrophy has been yet reported
      in literature.

PMID- 11217193
TI  - [Mastodynia].

PMID- 11217192
TI  - [From pathological diagnosis to ovulation induction. The case of ovarian
      insufficiency].
AB  - The incidence of premature ovarian failure (POF) is around 1 to 3%. This
      pathology occurs in young women, who often wish to become pregnant.
      Theoretically, two mechanisms could be involved: initial follicle depletion and
      follicle dysfunction. However, in some cases, mixed mechanisms are involved.
      Initially, PFO was considered irreversible. In fact, signs of intermittent
      ovarian function in normal karyotypically women have been described, but
      predicting the probability of spontaneous remission in a specific woman is
      impossible. Therefore, various treatments for ovulation induction have been
      proposed to these patients. Most of the pregnancies occur after hormone
      replacement therapy. The action of this treatment is unclear and the cause-and
      effect relation has not been proven by prospective, randomized studies. The
      benefit of suppressing endogen gonadotropins by GnRH agonists is not proven
      either. Estrogen supplementation and high-dose gonadotropin ovarian stimulation
      protocols have been proposed. Even so, this therapy cannot be recommended because
      of the lack of controlled studies. Finally, numerous case reports have described
      the return of ovarian function after using immunosuppressive therapies. The lack
      of particular criteria for the diagnosis of autoimmune mechanisms have lead to
      treat heterogeneous groups of patients. No randomized controlled studies with
      immunologic monitorage have been performed that could establish the success of
      this therapy. Therefore, in order to find effective treatments, basic
      pathophysiologic mechanisms must be better understood. For those women who want
      to become pregnant, the lack of prospective, randomized studies cannot lead to
      formal conclusions. Depending on the patients' age and history, it appears
      reasonable to attempt a corrective therapy based on defined etiology, before
      entering in a donor oocyte program.

PMID- 11217194
TI  - [Pelvimetry by scanography].

PMID- 11217195
TI  - [Serum markers in breast cancer and colorectal cancer (1997)].

PMID- 11217196
TI  - [Fibroma: surgical myomectomy or embolization or GnRH analogs? Intramural and sub
      serous fibroma: start with medical treatment!].

PMID- 11217197
TI  - [Fibroma: surgical myomectomy or embolization or GnRH analogs? Embolization of
      uterine fibroma: a new treatment].

PMID- 11217198
TI  - [Fibroma: surgical myomectomy or embolization or GnRH analogs? Does myomectomy by
      laparoscopy have a justifiable place in the therapeutic strategy today?].

PMID- 11217199
TI  - [The end of a French paradox].

PMID- 11217200
TI  - [First World War and the explosion of venereal disease morbidity. IV.
      Prophylaxis].

PMID- 11217201
TI  - [Breast cancer and pregnancy. Review of the literature].
AB  - INTRODUCTION: The pregnancy-associated breast cancer seems to have become
      increasingly common with a high frequency of advanced breast cancer with axillary
      node metastases and so associated with poor prognosis. MATERIALS AND METHODS:
      This review examines the diagnosis, prognosis, and management of cancer during
      pregnancy; both in terms of the cancer's effect on the pregnancy, and the
      pregnancy's effect on the cancer. RESULTS: Diagnostic procedures (breast
      sonography) and excisional biopsies are necessary to reduce the delay of several
      months or more after discovery of a mass and before treatment. No histological
      difference, between patients with pregnancy-associated breast cancer and patients
      with non-pregnancy-associated breast cancer, was diagnosed. CONCLUSION: The
      treatment is linked to the effects of adjuvant therapy on the fetus.

PMID- 11217203
TI  - Post-transplant immune serological markers may be predictive of chronic
      rejection.

PMID- 11217202
TI  - Pharmacological surrogates of allograft outcome.
AB  - Because virtually all of the currently available oral immunosuppressive agents
      show significant inter- and/or intrapatient variability, drug doses do not
      predict patient exposure, which is the critical parameter of efficacy versus
      toxicity. Therefore, at least for the critical-dose baseline immunosuppressive
      agents CsA and tacrolimus, all transplant centers use some sort of therapeutic
      drug monitoring. However, for CsA, Cminss values show a poor correlation with
      exposure and therefore are of limited use. Reliable therapeutic drug monitoring
      demands some measure of CsA absorption profiles with or without an estimate of
      clearance rates. The suggested methods include full AUC, limited sampling AUC,
      and a single 2- or 3-hour post-dose blood concentration. For tacrolimus, Cminss
      displays a reasonable correlation with systemic drug exposure as measured by AUC,
      however, there is little correlation between Cminss and clinical events within
      recommended therapeutic ranges. Sirolimus, which has been recently approved for
      use in kidney transplant recipients by the Food and Drug Administration in 2 or 5
      mg doses, also shows the behavior of a critical-dose drug and that therapeutic
      monitoring using trough levels correlate strongly with drug exposure and the
      occurrence of adverse events. However, there is no approved automated assay and
      thus LC estimates must be utilized to estimate exposure. Pharmacodynamic drug
      monitoring opportunities are available for calcineurin inhibitors, MMF and
      sirolimus, but none is currently available for clinical use; however, the field
      of transplant pharmacodynamics is progressing rapidly. In the coming decade it is
      likely that an array of pharmacodynamic tools will be developed to complement the
      available pharmacokinetic information and lead to the development of models that
      predict optimal concentrations at the target sites in order to maximize
      immunosuppression and minimize toxic effects.

PMID- 11217204
TI  - Post-transplant glomerular filtration rate as a marker for long-term outcome.

PMID- 11217205
TI  - Post-transplantation histology as surrogate marker for long-term kidney allograft
      outcome.

PMID- 11217206
TI  - Subclinical rejection--a potential surrogate marker for chronic rejection--may be
      diagnosed by protocol biopsy or urine spectroscopy.
AB  - Our studies of protocol biopsy studies have shown that normal allograft histology
      can not be assumed by crude tests of renal function such as the serum creatinine
      concentration, and that there is a high prevalence of subclinical rejection in
      the first 6 months post-transplant (7, 13-17). The apparent ability of urine MR
      and IR spectra to reliably identify patients with normal allograft histology, if
      confirmed in a larger database, will preclude the need for a protocol biopsy in
      approximately 20-50% of patients. Conversely, finding urine MR or IR spectra
      characteristic of subclinical rejection would provide the opportunity for early
      treatment. The clear separation between patients with normal histology from those
      with subclinical rejection can be attributed to the use of the whole urine
      spectrum to develop the classifiers. Additional advantages of using MR or IR
      spectra of urine as a diagnostic tool compared to the biopsy include simplicity
      (i.e. no processing is required), low cost, rapid turnaround (i.e. < 15
      minutes/sample), and, particularly, low risk, thus allowing for repetitive
      sampling. The ability to non-invasively diagnose acute inflammation in the kidney
      would be of great assistance in the post-transplant monitoring of renal
      transplant patients. Indeed, by following subclinical inflammation as detected in
      the MR/IR spectra it will be possible to tailor the intensity of the
      immunosuppression to the inflammatory status of the graft, thus minimising the
      risks of both insufficient and excessive immunosuppression. Furthermore, by
      following subclinical inflammation, as detected in the MR/IR spectra, it will be
      possible to test the hypothesis that subclinical rejection (i.e. persistence of
      its MR/IR spectral classifier) is a surrogate marker for the development of
      chronic rejection.

PMID- 11217207
TI  - Surrogate biomarkers of long-term outcome after kidney transplantation.

PMID- 11217208
TI  - Cellular immunology markers postransplantation predictive of long-term graft
      outcome.

PMID- 11217209
TI  - Cytokine profiles as marker for graft vascular disease after clinical heart
      transplantation.

PMID- 11217210
TI  - Surrogate markers of chronic allograft nephropathy.

PMID- 11217211
TI  - Colour cues for oviposition behaviour in Toxorhynchites moctezuma and
      Toxorhynchites amboinensis mosquitoes.
AB  - Gravid female Toxorhynchites moctezuma (Dyar and Knab) and Toxorhynchites
      amboinensis (Doleschall) were offered the choice of coloured (spray-painted)
      containers for oviposition in laboratory trials. Both species oviposited
      preferentially into black containers rather than into white, red, yellow, green,
      or blue containers. Black containers also acted as oviposition stimulants of Tx.
      moctezuma females, and black and red containers for Tx. amboinensis females.
      Absorption spectra were measured for the paints used, with red and black paints
      absorbing more light across most of the visible spectrum than the other colours.

PMID- 11217212
TI  - Differences in response to temperature and density between two strains of the
      mosquito, Culex pipiens molestus forskal.
AB  - Two strains of Culex pipiens molestus of different geographical origin were
      reared for more than five years under the same laboratory conditions in order to
      study to what extent the reactions of these strains to constant temperature and
      density become similar. Lower temperature and higher densities caused not only
      the prolongation of developmental time of preimaginal stages and increasing
      mortality of larvae and pupae in both strains but also the extension of the rate
      between the first and last emerging imago in both sexes of both strains. Absolute
      time spent in the preimaginal stage was also influenced by genetic factors. Both
      strains displayed different values, although both strains were for reared in the
      laboratory under identical conditions.

PMID- 11217213
TI  - Species composition and seasonal dynamics of mosquitoes in the Belek region of
      Turkey.
AB  - The species composition and seasonal population dynamics of mosquitoes trapped in
      the Belek Region of Turkey are described. Eight traps (four New Jersey light
      traps and four CO2 baited traps) were activated weekly at four different sampling
      sites (wooded area, open field, village, and road edge). Between May and
      December, 1997, 4,542 specimens representing seven species (Culex pipiens, Culex
      tritaeniorhynchus, Aedes caspius, Aedes cretinus, Aedes dorsalis, Aedes vexans,
      and Culiseta annulata) were collected. The most abundant species was Cx. pipiens
      (26.7% of total catch) followed by Cx. tritaeniorhynchus (23.8%), Ae. caspius
      (23.4%), Ae. cretinus (10.7%), Ae. dorsalis (8.7%), Cs. annulata (6.2%), and Ae.
      vexans (0.1%). This is the first record of Ae. cretinus in the area since 1984.
      The species was captured throughout the study period, although it was most
      abundant in late summer. Culex tritaeniorhynchus reached its highest density in
      August, while Cx. pipiens was found in high numbers throughout most of the study
      period.

PMID- 11217214
TI  - New records of the blacklegged tick, Ixodes scapularis (Acari: Ixodidae) in
      Minnesota.
AB  - The Minnesota distribution of the blacklegged tick, Ixodes scapularis, was
      studied during 1998 and 1999. The majority of tick collecting was done by grouse
      hunters, who sent in specimens collected during the fall of 1998 and 1999. I.
      scapularis specimens were received from 17 counties, including eight counties in
      northern and central Minnesota that previously had no reports of I. scapularis.
      This brings the number of Minnesota counties with reported populations of I.
      scapularis to 30, mostly in the east-central, central, and northern parts of the
      state.

PMID- 11217215
TI  - Landing periodicity of Aedes aegypti with implications for dengue transmission in
      Trinidad, West Indies.
AB  - The diel landing/biting periodicity of the Trinidad strain of Aedes aegypti (L.)
      was monitored using human-bait during January-August 1999. Hourly light
      intensities were measured both indoors and outdoors at both urban and rural
      sites. The periodicity of females was diurnal and nocturnal, with 90% arriving
      during daylight and twilight and 10% during the night. The pattern of landing was
      trimodal, with consistent peaks at 0700 h, 1100 h and 1700 h. The diel
      periodicities at indoor and outdoor urban sites were virtually identical. In
      contrast, the periodicities in rural areas differed, with no nocturnal activities
      being recorded at indoor and outdoor sites. At both urban and rural sites, larger
      numbers of adults were collected outside than inside houses. A significant
      correlation between light intensities and mosquito landing patterns was observed.
      The implications of the changing landing patterns of Ae. aegypti within urban
      areas are discussed in light of the epidemiology and control of dengue fever in
      Trinidad.

PMID- 11217216
TI  - A taxonomic review of the North American genus Orchopeas Jordan, 1933
      (Siphonaptera: Ceratophyllidae: Ceratophyllinae).
AB  - The 20 named taxa assigned to the North American flea genus Orchopeas Jordan,
      1933 are reviewed. Four of these are treated as junior synonyms and the fifth as
      a nomen dubium. These are: Orchopeas sexdentatus firemani Hubbard, 1955 =
      Orchopeas schisintus (Jordan, 1929); Orchopeas schisintus nevadensis (Jordan,
      1929) = Orchopeas schisintus agilis (Rothschild, 1905); Orchopeas howardi
      bolivari Barrera, 1955 = Orchopeas howardi (Baker, 1895); Orchopeas howardi
      texensis Eads, 1950 = Orchopeas fulleri Traub, 1950 and Orchopeas labiatus (nomen
      dubium). Six taxa originally assigned as subspecies of Orchopeas sexdentatus are
      elevated to the rank of full species and distribution and host preferences of all
      15 species are discussed. Illustrations of the diagnostic features of all the
      species are provided.

PMID- 11217217
TI  - Influence of nymphal Anax imperator (Odonata: Aeshnidae) on oviposition by the
      mosquito Culiseta longiareolata (Diptera: Culicidae) and community structure in
      temporary pools.
AB  - We assessed the overall (consumptive plus non-consumptive) and non-consumptive
      effects of nymphal Anax imperator (Aeshnidae: Odonata) on experimental pool
      communities by comparing three treatments: (1) control (no Anax); (2) free Anax
      (Anax was not constrained); and (3) caged Anax (Anax, enclosed within a cage,
      could not consume prey outside the cages, but could possibly influence them via
      perceived risk of predation). Fewer egg rafts of the mosquito Culiseta
      longiareolata were found in the free Anax treatment compared to the other two
      treatments. There was no statistically significant difference in the number of
      egg rafts between control and caged Anax pools. Thus, while Culiseta females
      apparently oviposit fewer egg rafts in the presence of unconstrained Anax, they
      did not respond to predation risk from the caged Anax. Larval Culiseta densities
      were drastically reduced by free Anax; there was nearly a 100% reduction in the
      number reaching metamorphosis (pupae) and a 100% reduction in emergence (pupal
      exuviae). There were no significant treatment effects on densities of
      crustaceans, Daphnia magna and Heterocypris sp., or on chironomid pupal exuviae.
      Ceratopogonid pupal abundance was higher in free Anax pools than in the other two
      treatments toward the end of the experiment. Free Anax caused a trophic cascade,
      presumably by strongly reducing the dominant periphyton grazer, Culiseta larvae;
      periphyton mass was greater in the free Anax treatment than in the control.
      However, there was no behavioral trophic cascade, i.e., no difference in
      periphyton abundance between the control and caged Anax treatment.

PMID- 11217218
TI  - Plasmodium vivax polymorphs and Plasmodium falciparum circumsporozoite proteins
      in Anopheles (Diptera: Culicidae) from Belize, Central America.
AB  - Eight species of Anopheles mosquitoes from indoor/outdoor human landing
      collections in Belize, Central America, were examined for human Plasmodium
      circumsporozoite protein (CSP) using an enzyme-linked immunosorbent assay
      (ELISA). A total of 14 of 9,104 females tested were positive from general surveys
      throughout Belize and three of 11,966 were positive from a longitudinal study in
      Caledonia, northern Belize. ELISA results, using pooled head-thorax preparations
      and species-specific monoclonal antibodies directed against the circumsporozoite
      proteins of Plasmodium falciparum and two Plasmodium vivax polymorphs (210 and
      VK247), found four species reactive: Anopheles vestitipennis (3 pools), Anopheles
      darlingi (2 pools), Anopheles albimanus (10 pools), and Anopheles gabaldoni (2
      pools). The minimum field infection rates (MFIR) for combined Plasmodium species
      from the general survey were 0.282% for An. vestitipennis, 0.271% for An.
      darlingi, 0.126% for An. albimanus, and 0.395% for An. gabaldoni. MFIRs for
      combined Plasmodium species from the longitudinal study in the village of
      Caledonia were 0.018% for both An. vestitipennis and An. albimanus and 1.66% for
      An. gabaldoni. Positive CSP pools were collected from the Cayo, Corozal, Orange
      Walk, Stann Creek, and Toledo political districts. No CSP positive pools were
      detected from collections in the Belize District. The study provides valuable
      information on the spatial distribution and species type of Plasmodium positive
      mosquitoes. This information, in combination with other vector data, suggest that
      An. vestitipennis and An. darlingi are commonly involved in malaria transmission.
      Additionally, these species appear to be much more efficient vectors than An.
      albimanus in Belize.

PMID- 11217220
TI  - Influence of sanitary conditions on the field performance of chlorpyrifos-based
      baits against American cockroaches, Periplaneta americana (L.) (Dictyoptera:
      Blattidae).
AB  - The role of sanitation in performance of insecticidal bait stations containing
      0.5% chlorpyrifos against the American cockroach, Periplaneta americana (L.), was
      investigated in residential premises. Test sites were chosen from three locations
      in Penang Island, Malaysia, and clustered according to their sanitary conditions.
      Results indicated that at 1-week post-treatment, houses with good sanitary
      conditions showed a significantly faster reduction (P > 0.05) in the number of
      cockroaches trapped (> 95%) than those with moderate and poor conditions. At 6
      weeks post-treatment, all houses treated with insecticidal baits showed no
      significant difference in terms of reduction rate of cockroach numbers (P >
      0.05), irrespective of sanitary condition. However, the bait performance in
      houses with poor sanitary conditions could not be sustained up to 12-week post
      treatment.

PMID- 11217219
TI  - The relationship between size and fecundity in Aedes albopictus.
AB  - Recent use of correlates of the intrinsic rate of increase and models to study
      population dynamics in mosquitoes has emphasized the need for species specific
      data on the relationship of morphological factors such as body size to life
      history parameters such as fecundity. Aedes albopictus is of concern because of
      its continued spread and population growth in the U.S. and the potential for
      virus transmission. We examined the relationships between pupal wet weight and
      adult female wing length and between female wing length and fecundity in the
      first gonotrophic cycle in U.S. strains of Ae. albopictus. There was a
      significant positive relationship between pupal wet weight and adult wing length.
      The relationship between wing length and fecundity was also significant and
      positive, but with lower correlation coefficients and higher variance indicating
      that other factors also affect fecundity. The regression coefficients for the
      fecundity-wing length equation did not differ between two strains of Ae.
      albopictus.

PMID- 11217221
TI  - Rodent ectoparasites from two locations in northwestern Florida.
AB  - From Feb.-Apr. 1999, 19 species of ectoparasitic arthropods (2 sucking lice, 4
      fleas, 4 ticks, 2 mesostigmatid mites, 5 chiggers, 2 fur mites) were recovered
      from 106 rodents belonging to 5 species (cotton mouse, Peromyscus gossypinus, n =
      64; cotton rat, Sigmodon hispidus, n = 23; eastern woodrat, Neotoma floridana, n
      = 9; golden mouse, Ochrotomys nuttalli, n = 9; eastern gray squirrel, Sciurus
      carolinensis, n = 1) at Tall Timbers Research Station, Leon County, Florida.
      During the same period, 13 species of ectoparasites (2 sucking lice, 1 flea, 3
      ticks, 3 mesostigmatid mites, 2 chiggers, 2 fur mites) were recovered from 57
      rodents belonging to 3 species (S. hispidus, n = 40; black rat, Rattus rattus, n
      = 16; S. carolinensis, n = 1) from Panama City, Bay County, Florida. Noteworthy
      ectoparasite records include Ixodes minor from both sites, which extends the
      known geographical range of this tick, and Stenoponia americana from Tall Timbers
      that represents the second documented Florida record of this flea. Potential tick
      vectors (Dermacentor variabilis and Ixodes scapularis) of zoonotic pathogens
      (Rickettsia rickettsii and Borrelia burgdorferi) were collected at both sites. On
      S. hispidus, fleas were more prevalent at Tall Timbers but sucking lice,
      chiggers, ticks, mesostigmatid and listrophorid mites all were more prevalent at
      the Panama City site. Arthropods recovered from arboreal nests (n = 3) of O.
      nuttalli at Tall Timbers included 3 species of ectoparasites (1 tick, 2 laelapid
      mites).

PMID- 11217222
TI  - Bacterial abundance in larval habitats of four species of Anopheles (Diptera:
      Culicidae) in Belize, Central America.
AB  - Numbers of free-living and attached bacteria were counted in surface waters from
      larval habitats of four species of Anopheles mosquitoes: Anopheles albimanus
      Wiedemann, An. darlingi Root, An. vestitipennis Dyar and Knab, and An.
      pseudopunctiopennis Theobald, using a direct count method and DAPI staining
      technique. Bacterial counts from larval habitats were compared to those from
      adjacent open water. Several additional variables such as total suspended solids
      (TSS), particulate organic carbon (POC), and dissolved organic carbon (DOC) were
      also recorded in order to establish possible relationships with bacterial
      characteristics. Our results showed that the waters from larval habitats were
      enriched with bacteria as well as POC and DOC compared to open water. The major
      component of all samples consisted of cocci, the proportion of rods was similar
      and there were significantly more attached rods in habitat samples than in open
      water samples. Anopheles vestitipennis habitats had the highest values of each of
      the categories of bacteria as well as of POC and DOC.

PMID- 11217223
TI  - Correlates of violent assault among young male primary care patients.
AB  - Correlates of violent assault (defined here as having been shot, stabbed, shot
      at, or beaten) were identified among young male primary care patients. Data were
      analyzed from a cohort of young men ages 17 to 29 during their initial visits to
      an urban primary care facility. Each underwent a clinical assessment, including a
      self-report health inventory and provider history. In multivariable analysis,
      history of incarceration (odds ratio [OR] = 6.29, 95 percent confidence interval
      [CI], 2.34-16.89), having children (OR = 3.06, 95 percent CI, 1.30-7.17), and a
      high school education or less (OR = 0.69, 95 percent CI, 0.50-0.96) were
      significantly associated with increased likelihood of violent assault. Patients
      reporting more serious traumatic experiences, such as incarceration, witnessing
      violence, or carrying a weapon, had the highest risk (OR = 9.91, 95 percent CI,
      4.0-24.57). These findings may help primary care physicians identify young men at
      risk for violence and foster better interventions.

PMID- 11217225
TI  - Health data issues for Hispanics: implications for public health research.
AB  - The limited availability of Hispanic health data has hampered the development of
      targeted public health policies. Hispanics represent 11.5 percent of the
      population and are projected to become the largest minority group in the United
      States by the year 2010. This paper explores current issues in Hispanic health
      data collection, examines methodological concerns, and presents recommendations
      for future Hispanic public health data collection. Data are derived from
      statistical reports of the U.S. Bureau of the Census, National Center for Health
      Statistics, Bureau of Labor Statistics, and other empirical studies.
      Recommendations include: collecting both race and ethnic-specific data by
      Hispanic subgroup, designing appropriate data collection instruments and
      approaches, and selecting referent groups for comparison purposes. The authors
      conclude that the renewed national focus on health disparities among underserved
      populations requires an increased commitment to adequately identify Hispanic
      subgroups.

PMID- 11217224
TI  - Is variation in quality of mammographic services race linked?
AB  - The purpose of this investigation was to (1) determine whether there was
      variability in the quality of services offered in mammography facilities across
      Connecticut and (2) determine whether African American women were more likely
      than white women to receive mammograms in facilities that offered substandard
      services. Since most facilities do not routinely record information on race, this
      investigation represents a unique opportunity to address the question of race
      linked variation in the quality of screening mammography. Information on
      equipment, personnel, and record keeping in mammography facilities was used to
      construct indices that represented separate domains of quality: technical
      attributes, educational practices, and tracking of clients. While some variation
      in the quality of mammography services was found, there were no significant
      differences between the two race categories in the mean scores for each of three
      quality indices. Thus, variation in quality of screening mammographic services
      does not appear to be race linked.

PMID- 11217226
TI  - Consumer participation in health policy decisions: empowerment or puffery?
AB  - Many consumers in today's society have increased access to information about
      health and medical care through books, videotapes, audiotapes, the Internet, and
      television programming. However, consumers often are excluded from involvement in
      health policy decision making because it is believed that they do not have the
      necessary expertise. In this paper, the following will be discussed: (1) the
      historic role of consumer involvement in health policy decision making, (2) an
      overview of major barriers that consumers have encountered in health policy
      decision making, and (3) strategies for overcoming these barriers so that
      consumer empowerment can be enhanced when they serve on health policy panels.

PMID- 11217227
TI  - Community cancer control in a rural, underserved population: the Appalachian
      Leadership Initiative on Cancer Project.

PMID- 11217228
TI  - Health care utilization among homeless adults prior to death.
AB  - This study characterizes health care utilization prior to death in a group of 558
      homeless adults in Boston. In the year before death, 27 percent of decedents had
      no outpatient visits, emergency department visits, or hospitalizations except
      those during which death occurred. However, 21 percent of homeless decedents had
      a health care contact within one month of death, and 21 percent had six or more
      outpatient visits in the year before death. Injection drug users and persons with
      HIV infection were more likely to have had contact with the health care system.
      This study concludes that homeless persons may be underusing health care services
      even when they are at high risk of death. Because a subset of homeless persons
      had extensive health care contacts prior to death, opportunities to prevent
      deaths may have been missed, and some deaths may not have been preventable
      through medical intervention.

PMID- 11217229
TI  - Utilizing patient satisfaction surveys to prepare for Medicaid managed care.
AB  - To prepare for Medicaid managed care, a community health center incorporated the
      business principle of continuous quality improvement, often used in the private
      sector to improve customer service, into its planning process. The initial
      endeavor was to create a patient satisfaction survey that was appropriate for the
      uniqueness of the community. The survey, taken monthly, resulted in both staff
      and patients making active improvements in the clinic environment. Staff showed
      more enthusiasm, and patients were more assertive in their attitudes toward the
      clinic. The empowerment of the patient to take ownership in the clinic will be
      coupled with the next step of the formalized plan, that of educating patients on
      the steps necessary to ensure that their Medicaid managed care facility will be
      the local community health center.

PMID- 11217230
TI  - Crossing the border for health care.
AB  - A survey was administered to adults attending a health fair in south Los Angeles
      County, approximately 140 miles from the U.S.-Mexico border. The survey revealed
      that 14 percent of respondents had crossed the border to seek medical care during
      the past year. Nearly 80 percent of respondents crossing the border for medical
      care were uninsured, while 70 percent reported the low cost of medical care
      obtained across the border as being the most common reason for seeking care
      there. Twenty-eight percent of respondents reported purchasing medication in
      Mexico, with antibiotics and pain medication being reported in highest frequency.
      Ninety percent of these respondents were uninsured. This study shows that the
      high cost of health care and lack of insurance compels the poor and uninsured to
      seek low-cost health care and medication in Mexico to meet their most urgent
      health care needs, despite the burden of cost and travel.

PMID- 11217231
TI  - Concentrated poverty and nursing home bed supply in Chicago.
AB  - This study explores whether poverty areas of Chicago have fewer nursing home beds
      and unique staffing patterns. Using 1990 census data and Illinois's 1994 Long
      Term Care Facility Survey, census tracts were compared by need for long-term
      care, bed supply, and nursing home characteristics. While facilities cluster on
      the north side, and the number of beds follow the elderly, the supply of beds per
      elderly is actually greater in tracts with high proportions of poverty,
      disability, and African American residents due, in part, to the predominance of
      larger facilities. Ironically, economic segregation may work together with
      Medicaid's policy of serving the poorest to increase the supply of beds to those
      who might otherwise remain unserved. Nursing homes in the poorest communities
      have high percentages of Medicaid residents, are larger, and employ fewer staff
      per resident; homes with a high Medicaid population are more likely to employ
      LPNs, which may reflect labor supply differences.

PMID- 11217232
TI  - A 5-year prospective study of Astra single tooth implants.
AB  - AIM: To evaluate the AstraTech Implant ST (Molndal, Sweden) for single tooth
      replacement clinically and radiographically after 5 years in function. SUBJECTS
      AND METHOD: Fifteen patients (age range 16 to 48) with missing maxillary anterior
      teeth (6 central incisors, 8 laterals, 1 bicuspid) had four 13 mm and eleven 15
      mm single tooth implants provided. All patients were seen at 4- to 6-monthly
      intervals for oral hygiene maintenance. Periapical radiographs using Rinn holders
      and a long cone technique were taken at the crown insertion and after 1 year, 3
      and 5 years. RESULTS: No implant losses were observed in 14 of the 15 patients
      available for evaluation. No abutment screw loosening or soft tissue problems
      were observed. At crown insertion the mean bone level was 0.46 +/- 0.55 to 0.48
      +/- 0.56 mm apical to the top of the implant neck and there were no statistically
      significant changes in the radiographic bone level over the 5 years of the study
      (0.36 +/- 0.37 to 0.43 +/- 0.46 mm at year 5). One crown was recemented after 18
      months in function and 1 crown was replaced because of a fracture to the
      porcelain incisal edge. CONCLUSION: The Astra Tech Implants ST were highly
      successful in single tooth replacement and bone levels during 5 years of function
      were stable.

PMID- 11217233
TI  - [Acute cell death of cultured rat hippocampal neurons due to mitochondrial
      disorders].

PMID- 11217235
TI  - [Drug donations: help or problem?].

PMID- 11217234
TI  - [How much tuberculosis do we want?].

PMID- 11217236
TI  - [Recommendations for the control of cholesterolemia in Spain].
AB  - A number of recommendations are provided regarding the detection, assessment and
      management in primary and secondary prevention, approaching hypercholesterolaemia
      from a multifactorial standpoint based on cardiovascular risk. Cardiovascular
      diseases are the leading cause of death in Spain. The major risks involved are
      coronary heart disease and cerebrovascular disease. The demographic, health
      related and social impact thereof will be increasing over the coming decades.
      Controlling hypercholesterolaemia, in conjunction with eradicating the smoking
      habit and controlling hypertension, diabetes, obesity and physical inactivity
      comprise one of the main strategies for preventing cardiovascular diseases.
      Breaking down the risk of individuals based on the major cardiovascular risk
      factors is essential, given that these factors condition the frequency with which
      these individuals must be monitored and the type and degree of treatment
      entailed. Based on this breakdown, the priorities have been set for taking steps
      to prevent cardiovascular disease. In primary prevention, the therapeutic
      objective in high-risk persons (20% risk or higher or those persons involving two
      or more risk factors) has been established as LDL-cholesterol < 130 mg/dl. In
      secondary prevention, drug treatment is indicated when LDL-cholesterol (130 mg/dl
      and the therapeutic objective is LDL-cholesterol < 100 mg/dl. Those patients
      having coronary heart disease must be included in secondary prevention programs
      that will ensure good, constant clinical and risk factor-related control.

PMID- 11217237
TI  - [Hepatitis B vaccination. Indications of the post-vaccine serologic test and
      booster doses].
AB  - The standard anti-HBV vaccination elicits protective anti-HBs levels (above 10
      UI/l) in most people. However, the effective duration of immunologic memory is
      not well-known. Consequently, the recommendations on the postvaccination follow
      up are not uniform: from vaccination with no follow-up blood test (anti-HBs
      levels) to regular follow-up blood tests for all vaccines. In unresponsive
      subjects a booster dose has been demonstrated to be effective. However, the
      optimal procedure for management depending anti-HBs levels has not been well
      established. Postvaccination antibody testing and regular testing for antibodies
      is recommended only to high-risk subjects, especially to health care workers and
      subjects with immunodeficiency. In these cases, the booster dose should be
      administered in nonresponders, and might include double doses. Unanimous
      consensus does not exist about to the appropriate timing for booster dose
      administration.

PMID- 11217238
TI  - [Efficiency in primary health care: a critical review of frontier measures].
AB  - The object of this paper is to review applied research on primary care efficiency
      in Spain performed using parametric and nonparametric production and cost
      frontiers. A review of the most important bibliographic databases showed 12
      applied papers that used frontier approach to measure primary care efficiency in
      Spain. The most part of these papers only used Data Envelopment Approach to
      measure technical efficiency scores. There is only one study that has employed a
      stochastic and nonparametric approach to obtain cost efficiency estimates.
      Activity measures such as number of visits are a usual measure of output and
      inefficiency sources are rarely analysed in this literature. Important
      methodological problems observed in this literature severely limit their
      practical utility. Future research should consider more accurate output measures,
      use available methods more appropriately, and shed light on the sources of
      inefficiency.

PMID- 11217239
TI  - [Legal framework and strategy of the tobacco industry in relation to tobacco
      advertising in Spain].
AB  - Publicity is legally regulated in Spain, in order to avoid its misuse. Tobacco
      publicity is also under those regulation, having had the companies operating in
      this sector to adapt themselves through new strategies. In this work, the legal
      restrictions existing in Spain regarding publicity are analyzed, together with
      some of the strategies developed by tobacco companies in order to elude them. In
      this sense, and despite of the existing legal framework, it should be noticed
      that tobacco companies are cleverly taking advantage of the existence of legal
      loopholes in tobacco publicity to promote their products.

PMID- 11217240
TI  - [Distribution and trends of tuberculosis by age groups and municipalities in La
      Habana City, Cuba (1986-1998)].
AB  - BACKGROUND: The province of Havana City, the capital and most densely populated
      city in Cuba, totals around 27% of the new cases of tuberculosis. This article is
      for the purpose of describing the distribution and trend of the tuberculosis
      cases rates from 1986 to 1998, by municipalities and age groups in this province.
      METHOD: A calculation was made of the rates and of the total percentage of
      deviation of these rates, in addition to the annual average deviation both
      throughout two time periods and between the two (1986-1993 and 1994-1998). The
      trends were calculated by simple linear regression. RESULTS: Throughout the 1986
      1993 period, the case rate for this province underwent a 6% increase. Throughout
      the 1994-1998 period, it dropped by 7.3%. The three most densely-populated cities
      showed a higher rate increase. Of the 15 municipalities, only La Lisa showed a
      drop in the rates throughout the entire period in question. The rates by ages
      were similar throughout all of the municipalities, being higher for individuals >
      65 years of age. Six tenths (0.6%) of the cases reported involved people under 15
      years of age. The infantile tuberculosis rates were very low for the time period
      under analysis. CONCLUSIONS: The differences among the municipalities in question
      make it necessary for different measures to be taken to achieve a greater impact
      and repercussion in Cuba. The drop in the rates detected over the last three
      years is indicative of the epidemic being brought under control and the national
      tuberculosis control program being reinstated.

PMID- 11217241
TI  - [Anisakiasis in fresh fish sold in the north of Cordoba].
AB  - BACKGROUND: Anisakiasis is a parasitic zoonosis caused by live larvae of the
      Anisakidae Family found located in the body cavities and in the muscular systems
      of osseous fish and cephalopod mollusks. Humons inadvertently ingest these larvae
      when eating raw or undercooked infested fish. Symptoms are characterized by
      gastrointestinal disorders. The purpose of this study is that of ascertaining the
      frequency of anisakid larvae parasite infestation in fresh fish marketed in
      northern section of the province of Cordoba. METHODS: Over a nine-month period,
      samples were taken of the species of sen fish sold to the greatest degree at all
      of the establishments in this sector. The parasite analysis was conducted at the
      Penarroya Public Health Laboratory by the dissection method. A total of 1,261
      samples of 18 different species were analyzed. RESULTS: The total frequency of
      parasite infestation was 15.8%. The species in which the most parasites were
      found was the blue whiting (Micromesistius poutassou) showing a 42% parasite
      infestation rate, and Anisakidos larvae were also found in: hake (Merlucius
      merlucius) (27.5%), whiting (Merlucius sp.) (26%), mackerel (Scomber scombrus),
      greater forkbeard (Phycis blennoides) (6.2%), anchovy (Engraulis encrasicolus)
      (5.6%) and pouting (Trisopterus luscus) (5.5%) of the samples in which parasites
      were found. The monthly spread of the results reveals an increase in parasite
      infestation during the spring months, declining progressively up to the last
      months of the year. CONCLUSIONS: There is a significant degree of Anisakidos
      infestation in the species marketed in the northern section of the province of
      Cordoba. Nevertheless, the difficulty of detecting this parasite, the vague
      assessment of the degree of parasite infestation tolerable or unacceptable as set
      forth under regulations, the fact that some traditional dishes made from raw fish
      require fresh or refrigerated products and, lastly, the lack or complete lack of
      health education on the part of the population make it advisable for this
      emerging problem to be approached with greater rigor.

PMID- 11217242
TI  - [Outbreak of cryptosporidiosis in Guadarrama (Autonomous Community of Madrid)].
AB  - BACKGROUND: In spring of 1998, an acute gastroenteritis outbreak, which mainly
      affected preschool children, took place in Guadarrama (Community of Madrid,
      Spain). METHODS: A descriptive and analytical (cases and controls) study of the
      outbreak was done. Stool samples of the cases were taken to microbiological
      investigation. The tap water getting system of the municipality was inspected and
      samples were collected to microbiological analysis. RESULTS: Twenty one children
      from 0 to 5 years-old had liquid diarrhea which lasted more than five days. A
      significant statistical association was found within tap water consumption and
      gastroenteritis [OR = 5.73 (1.18-43.30); p < 0.05]. It did not have association
      with other variables investigated. Cryptosporidium parvum (Cp) oocysts were
      detected in stool samples of eight cases. Deficiencies were observed in the tap
      water getting and treatment system of the municipality but no oocysts were found
      in the analysis of the water. CONCLUSIONS: The results of the epidemiological
      investigation support that the source of the gastroenteritis outbreak was tap
      water, likely contaminated with Cp. While this parasite was not detected in the
      analysis of the water, it is explainable for the difficulties which this
      technique involves. In our review similar descriptions of outbreaks have not been
      found in Spain, but it seems that this reports are not infrequent in neighbour
      countries. Therefore, Cp should be borne in mind in diagnostic and management of
      these situations.

PMID- 11217243
TI  - [Extent of law compliance and anti-smoking teaching at Spanish schools].
AB  - OBJECTIVE: Knowing the degree of fulfillment of the anti tobacco legislation in
      Spanish schools and the influence that this has on the percentage of smoking
      pupils. MATERIAL AND METHODS: A survey was carried out among 3050 headmasters of
      Spanish schools, who were asked about different aspects of the fulfillment of the
      antitobacco laws in their schools and about the main characteristics of tobacco
      consumption in their centers. RESULTS: A 80.9% of the headmasters claim that the
      fulfillment of the legislation is demanded in their centers, and only a 64.9% of
      them have posters in theirs schools that warn people about smoking ban. Anti
      tobacco teachings are imparted in a 82.2% of the schools where laws is demanded
      and only in a 64.8% where is not demanded. The percentage of teachers who, smoke
      in the presence of the pupils is of a 5.9% in the schools where anti tobacco
      legislation is demanded and a 12.9% where is not demanded. In the schools where
      anti tobacco teachings are imparted, a 29% of the pupils have tried tobacco,
      opposite a 31% who have tried in the schools where these teachings are not
      imparted. CONCLUSIONS: The, headmasters of the schools, as people in charge of
      watching over the fulfillment of the anti tobacco legislation in theirs schools,
      must demand the fulfillment of this one, because this measure is effective in
      order to improve the global functioning of the schools and to reduce the
      percentages of smoking pupils and teachers.

PMID- 11217244
TI  - [Cost-benefit of the pharmacologic treatment of cerebral palsy with spasticity in
      Mexico].
AB  - BACKGROUND: Cerebral palsy involving spasticity is a highly handicapping illness,
      especially among children, the treatment of which is limited to reducing the
      handicaps involved without any full cure. There is a drug treatment which affords
      the possibility of providing patients with a better quality of life, regarding
      which a cost effectiveness analysis is made, note being made of the individual
      achievements and social benefits. METHODS: This analysis is based on nationwide
      information from Mexico which was obtained from secondary sources. The base data
      is set out within the framework of trends in the growth of this health problem,
      and the calculations affording the possibility of sizing up this problem are
      employed in order to ascertain the benefits thereof based on the following
      indicators: relative impact of this disease and years of healthy life lost and
      gained, based on which the social and economic benefit entailed in the drug
      treatment under analysis is estimated. RESULTS: The data reveals that the drug
      treatment in question is directly beneficial, because it lowers the relative
      impact of this disease from 0.92 to 0.40. At the individual level, the greatest
      benefit takes the form of the improved quality of life among the afflicted
      children within the 6-12 age range, they having gone from 0.08 years to 0.60
      years of life in terms of quality. At the nationwide level, the 595,817 years of
      healthy life which would be lost without any treatment would be recouped. The
      monetary value involved in this treatment is that of 2,725.00 Mexican pesos (US
      $283.00) for administering the drug over a one-year period to each child
      suffering from this disability. CONCLUSIONS: This is a low-cost treatment,
      because it is currently impossible to reverse the neurological and physiological
      processes of cerebral palsy, this treatment therefore improving the quality of
      life of the children afflicted with this disease is the best possible benefit.
      The cost effectiveness analysis taking into account these indicators reveals a
      clear-cut relationship between the monetary values and the health benefits.

PMID- 11217245
TI  - [Outbreak of gastroenteritis at a home for the aged in Albacete].
AB  - BACKGROUND: We describe the investigation of an acute gastroenteritis outbreak
      with an explosive beginning, probably waterborne, that occurred in an nursing
      home in Albacete, in November 1999 and affected 104 inmates and 35 employees. The
      dominant symptoms were diarrhea and vomiting. METHODS: A case-control study was
      designed. We carried out a descriptive analysis of facts and crossing of
      variables with the help of simple tables. A multivariant analysis, by models of
      logistic regression, was conducted both for the explosive phase and for that of
      transmission person-to-person. RESULTS: The attack rate for inmates was 45.8% and
      for employees, 33.7%. An association was found between the use of the main dining
      room of the nursing home and the explosive beginning of the outbreak and between
      the previous presence of a case-patient in the shared bedrooms and the person-to
      person transmission. Norwalk-like virus was isolated from faeces samples of four
      cases. CONCLUSIONS: The analysis of the clinical and epidemiological findings as
      well as the laboratory results proved the implication of a Norwalk-like virus in
      this outbreak.

PMID- 11217246
TI  - [Horizontal transmission of tuberculosis in children at a day-care center].

PMID- 11217247
TI  - [Methodologic obsession].

PMID- 11217248
TI  - Information technology and ophthalmology.

PMID- 11217249
TI  - Ischaemic optic neuropathy.
AB  - Ischaemic optic neuropathy is of two types: anterior (AION) and posterior (PION),
      the first involving the optic nerve head (ONH) and the second, the rest of the
      optic nerve. Pathogenetically AION and PION are very different diseases. AION
      represents an acute ischaemic disorder of the ONH supplied by the posterior
      ciliary artery (PCA), while PION has no specific location in the posterior part
      of the optic nerve and does not represent an ischaemic disorder of any definite
      artery. The most important step towards a logical understanding of the underlying
      causes, clinical features, pathogenesis and rational management of AION, is to
      understand the basic scientific issues involved; these are discussed in some
      detail. AION clinically is of two types: (1) that due to giant cell arteritis
      (arteritic AION: A-AION) and (2) non-arteritic AION (NA-AION). NA-AION, the more
      common of the two, is one of the most prevalent and visually crippling diseases
      in the middle-aged and elderly, and is potentially bilateral. NA-AION is a
      multifactorial disease, with many risk factors collectively contributing to its
      development. Although there is no known treatment for NA-AION, reduction of risk
      factors is important in decreasing chances of involvement of the second eye and
      of further episodes. Our studies have suggested that nocturnal arterial
      hypotension is an important risk factor for the development and progression of NA
      AION. The role of nocturnal arterial hypotension in the pathogenesis of NA-AION
      and management of nocturnal hypotension is discussed. Potent antihypertensive
      drugs, when used aggressively and/or given at bedtime, are emerging as an
      important risk factor for nocturnal hypotension, and there is some evidence that
      NA-AION may be occurring as an iatrogenic disease in some individuals. A-AION, by
      contrast, is an ocular emergency and requires immediate treatment with systemic
      corticosteroids to prevent further visual loss. The clinical parameters which
      help to differentiate the two types of AION, and their respective management are
      discussed.

PMID- 11217250
TI  - Evaluation of children in six blind schools of Andhra Pradesh.
AB  - PURPOSE: 1. To determine the anatomical site and underlying causes of severe
      visual impairment and blindness in children in special education in Andhra
      Pradesh, India. 2. To compare the causes of blindness in two different regions in
      the state. 3. To evaluate improvement with correction of refractive error and low
      vision devices (LVDs). METHODS: Children in 6 schools for the blind and in 3
      integrated education programmes were examined by one ophthalmologist, and were
      refracted and assessed for LVDs by an optometrist. The major anatomical site and
      underlying aetiology of severe visual impairment and blindness (SVI/BL; < 6/60 in
      the better eye) were recorded using the standardised WHO reporting form. RESULTS:
      Two hundred and ninety one students under 16 years were examined, and after
      refraction, 267 (91.7%) were classified as being severely visually impaired or
      blind. The most common anatomical sites of SVI/BL were retina in 31.1% children;
      cornea in 24.3%; and whole globe in 20.2%. The aetiology was unknown in 38.2%,
      hereditary in 34.8% and childhood causes in 24%. 114 children (39.2%) had
      functional low vision (i.e. visual acuity < 6/18 to light perception with
      navigational vision). In this group, 36 children improved with spectacles and 16
      benefited by LVDs. 41 children (15.4%) were able to read N10 point though they
      were studying Braille. CONCLUSION: Overall 37.4% of children had "avoidable"
      causes of blindness. The major avoidable causes were vitamin-A deficiency and
      cataract. Vitamin-A deficiency and congenital anomalies were more common in the
      dry plateau areas of the state. One in seven children could read normal print
      with optical support.

PMID- 11217251
TI  - A retrospective study of low-vision cases in an Indian tertiary eye-care
      hospital.
AB  - PURPOSE: To obtain data on the characteristics of low-vision patients seen at a
      tertiary eye care hospital in India. METHODS: Records of 410 patients were
      retrospectively reviewed at the Centre for Sight Enhancement, L.V. Prasad Eye
      Institute, Hyderabad, India. Patient underwent a comprehensive clinical low
      vision examination. Data obtained included age, gender, consanguinity, visual
      acuity, visual fields, ocular conditions causing low vision and types of low
      vision devices and methods prescribed. RESULTS: Two hundred and ninety seven
      (72%) of 450 patients were male. One-fifth were in the 11-20 years age group
      (21%). Visual acuity in the better eye was < 6/18-6/60 in almost half these
      patients (49.3%). One hundred and twenty two patients (29.9%) referred with a
      visual acuity of > or = 6/18, either had difficulty in reading normal print or
      had restricted visual fields. The main causes for low vision were: retinitis
      pigmentosa (19%), diabetic retinopathy (13%), Macular diseases (17.7%), and
      degenerative myopia (9%). Visual rehabilitation was achieved using accurate
      correction of ametropia (174 patients), approach magnification (74 patients) and
      telescopes (45 patients) for recognising faces, watching television and board
      work. Spectacle magnifiers (187 patients), hand/stand magnifiers (9 patients),
      closed-circuit television (3 patients), overhead illumination lamp (143 patients)
      and reading stand (24 patients) were prescribed for reading tasks. Light control
      devices (146 patients) were used for glare control, and cane (128 patients) and
      flashlight (50 patients) for mobility. Patients were trained in activities to
      improve their daily living skills, (54 patients); counselled in environmental
      modification (144 patients) and ancillary care (63 patients) for educational and
      vocational needs. CONCLUSION: Data obtained from this study elucidates the
      characteristics of low-vision patients. This information is likely to help in the
      development of appropriate low vision services.

PMID- 11217253
TI  - Is pseudophakic astigmatism a desirable goal?
AB  - PURPOSE: To determine whether pseudophakic astigmatism is a desirable goal, and
      if so, which one is better: against-the-rule (ATR) or with-the-rule (WTR).
      METHOD: Eyes were included only if they had an uncorrected vision > or = 6/18 and
      N/18. Three groups, of 40 patients each were evaluated: group 1, pseudophakes
      with neutral astigmatism; group 2, with ATR and group 3, with WTR astigmatism
      Unaided distance and near visual acuity was recorded. Statistical analysis was
      performed using the chi-square test for independence. RESULTS: Unaided distance
      vision of > or = 6/7.5 was achieved in 19 eyes (47.5%) of group 1 (neutral), 12
      eyes (30%) in group 2 (ATR), and 5 eyes (12.5%) in group 3 (WTR) (p = 0.0133,
      significant). Unaided near vision of > or = N/9 was achieved in 17 eyes (42.5%)
      in group 1 (neutral), 34 eyes (85%) in group 2 (ATR), and 10 eyes (25%) in group
      3 (WTR) (P < 0.001, significant). Group 1 (neutral) fared the best for unaided
      distance visual acuity. Group 2 (ATR) was better than in group 3 (WTR) for
      distant vision. Group 2 (ATR) fared the best for unaided near vision. CONCLUSION:
      ATR astigmatism could be a desirable goal after cataract extraction in selected
      populations because the largest proportion of these cases achieved good unaided
      near vision with acceptable distant vision.

PMID- 11217252
TI  - Partial flap during laser in-situ keratomileusis: pathogenesis and timing of
      retreatment.
AB  - PURPOSE: To report the timing of retreatment and clinical outcomes in patients
      with a partial corneal flap during laser in-situ keratomileusis (LASIK), and to
      describe the causes of this complication. METHODS: Retrospective review of case
      records of four patients (4 eyes) who had a partial corneal flap during LASIK.
      RESULTS: The mean age of the four patients was 23 +/- 4.7 years, and mean
      preoperative spherical equivalent (SE) refraction was -9.1 +/- 3.1 D (range, -5.5
      to -13 D). A 160 microns corneal flap was attempted during the initial treatment.
      Retreatment with a 180 microns corneal flap was performed at a mean of 5.1 +/-
      1.6 weeks (range, 4 to 7.5 weeks) after the initial procedure. There were no
      intraoperative complications during retreatment. Post-LASIK mean SE refraction
      was -1.0 +/- 1.1 D (range, +0.38 to -2.0 D), after a mean follow up of 19 +/-
      15.7 weeks (range, 7 to 42 weeks). Best spectacle-corrected visual acuity
      decreased in one eye from 6/5 to 6/6 and was maintained in the others.
      CONCLUSION: LASIK retreatment can be performed as early as one month after a
      partial flap, if the refraction is stable and a thicker corneal flap is created.

PMID- 11217254
TI  - Nocardia Asteroides keratitis: report of seven patients and literature review.
AB  - PURPOSE: To describe clinical features and treatment outcomes in patients with
      advanced Nocardia asteroides keratitis. METHODS: Retrospective review of case
      records of 7 patients with culture-proven Nocardia keratitis. RESULTS: Corneal
      infection occurred after corneal trauma in two patients, cataract surgery in
      three patients, penetrating keratoplasty in one patient and was associated with a
      silicone buckle element infection in one patient. Mean duration of infection at
      presentation was 33.4 days (7-75 days), and five patients had received prior
      treatment with corticosteroids. Six of seven patients had deep corneal
      suppuration at the time of presentation, clinically suggestive of mycotic
      keratitis. In two patients who had received prolonged corticosteroid therapy (>
      or = 45 days), the eyes could not be salvaged. Complete resolution of infection
      was achieved in all 4 eyes treated with topical fortified cefazolin eye drops (50
      mg/ml).

PMID- 11217256
TI  - Management of anterior segment penetrating injuries with traumatic cataract by
      Pentagon approach in paediatric age group: constraints and outcome.
AB  - PURPOSE: To evaluate the efficacy of multiple combined procedure (Pentagon
      approach) as single-step secondary repair in cases of extensive keratolenticular
      trauma in paediatric age group. METHODS: Retrospective evaluation of 18 patients
      of penetrating injuries with sclerokeratolenticular trauma, who underwent
      multiple procedure as single-step secondary repair by a single team of two
      surgeons during a 4 year period. Surgical procedure included reconstruction of
      anterior segment, synechiolysis, excision of membrane, lensectomy, open sky
      vitrectomy, PC IOL implantation over frill and penetrating keratoplasty.
      Meticulous antiamblyopia measures were applied in all cases. RESULTS: Extensive
      vasoproliferative membrane, complicated cataract and anterior vitreous
      condensation were significant intra-operative hurdles. Moderate uveitis,
      secondary glaucoma, persistent epithelial defects were problems noted. Eleven
      (61.22%) patients attained good visual outcome. Regrafting was required in
      remaining cases due to delayed graft failure. CONCLUSION: Despite being a highly
      complex technique, Pentagon approach provides effective management profile in
      terms of graft success and functional outcome, especially in keratolenticular
      trauma, in children.

PMID- 11217255
TI  - Topical diclofenac sodium for treatment of postoperative inflammation in cataract
      surgery.
AB  - PURPOSE: To study the effect of a topical non-steroidal anti-inflammatory drug as
      an alternative to topical steroids for postoperative control of inflammation in
      cataract surgery. METHODS: The effect of diclofenac sodium 0.1% following
      cataract surgery was studied and compared to routine corticosteroid,
      dexamethasone phosphate 1% in a prospective, double-blind randomized study. Both
      groups were similar in baseline parameters. Postoperative inflammatory response,
      intraocular pressure and best-corrected visual acuity following standard
      extracapsular cataract extraction were assessed in both groups in the initial 21
      days and the severity of these parameters was graded. The severity of
      postoperative inflammatory response to the two drugs was graded at 1, 3, 7, 14
      and 21 days. Intraocular pressure and visual acuity at baseline and endpoint were
      compared and statistically analyzed. RESULTS: The two groups did not differ
      statistically in treatment effect for any of the variables including aqueous
      cells, flare, ciliary congestion, Descemet's folds, visual acuity and intraocular
      pressure (p < 0.001). However there seemed to be a trend towards quicker
      improvement with corticosteroid when cells in the anterior chamber were
      considered. There were no side effects from topical diclofenac, and it was well
      tolerated. CONCLUSION: Diclofenac sodium is as effective as topical
      corticosteroid and can be used as an alternative in routine postoperative
      treatment following uncomplicated cataract surgery.

PMID- 11217258
TI  - Unilateral pellucid marginal degeneration.
AB  - Pellucid marginal degeneration (PMD) is a rare and usually a bilateral condition.
      We report a case of typical PMD with a unilateral presentation.

PMID- 11217257
TI  - Lid swelling and diplopia as presenting features of orbital sarcoid.
AB  - Sarcoid is an idiopathic multisystem non-caseating granulomatous disease with
      protean clinical manifestations. In the eye, the common sites of involvement are
      the skin of eyelid, conjunctiva, uveal tract, retina, optic nerve and lacrimal
      gland.

PMID- 11217259
TI  - Phakic-pseudophakic bullous keratopathy following implantation of a posterior
      chamber IOL in the anterior chamber to correct hypermetropia.
AB  - There is an increasing demand for refractive surgery stemming from a heightened
      awareness among patients wearing spectacles or contact lenses. Cosmetic or
      occupational reasons prompt patients to seek the alternative option of refractive
      surgery.

PMID- 11217260
TI  - The impact of information technology on the practice of ophthalmology.
AB  - Information technology has had a tremendous impact on the outlook of our
      professional lives. The Internet has revolutionised the speed of access to
      information with touch of a button. This article discusses the various aspects of
      information technology which are changing and enhancing our professional lives.
      It provides tips to enable the busy practising clinician to use the available
      resources effectively. Problems such as reliability of information on the web and
      how to assess the quality of such matter are also discussed.

PMID- 11217261
TI  - Sample size for ophthalmology studies.
AB  - Knowledge and the usage of actual sample size formulae are a necessity as
      validity of the inferences from research studies is often dependent on this. This
      paper explains how sample sizes are calculated. The concept of sampling variation
      is explained to emphasize the need for its proper calculation. Sample size
      formulae are explained with examples to provide researchers with a means of
      calculating the sample sizes for the commonly used study designs. Ophthalmic data
      are used as examples. It is perceived that this will improve the quality of
      inferences drawn from ophthalmic research studies.

PMID- 11217262
TI  - Safety of oral methotrexate pulsed therapy.

PMID- 11217263
TI  - Hepatitis C infection and recent diagnostic modalities.

PMID- 11217264
TI  - Aspiration vs nonaspiration technique of cytodiagnosis--a critical evaluation in
      160 cases.
AB  - The two sampling techniques were studied in 160 randomly selected cases of
      superficial swellings in various sites of the body. They were sampled by fine
      needle aspiration (FNA) and by non-aspiration (NA) (a needle without application
      of aspiration pressure). Cell samples were cytologically assessed and critically
      evaluated using five objective parameters. Contamination with blood was more in
      lymphnode, thyroid and liver lesions in aspiration smears than NA smears and
      values were statistically significant. Similarly when compared for the degree of
      cellular trauma and cellular degeneration statistically significant better
      results were obtained by nonaspiration technique for lymphnode lesions. Regarding
      amount of cellular material obtained by FNA, statistical significant better
      results were found for breast lesions only. Statistically significant better
      maintenance of architecture was observed only for thyroid lesions by NA
      technique. Better average scores were observed by NA technique for lymphnode and
      thyroid only. Categorizing all the smears obtained by FNA & NA on the basis of
      their scores according to predetermined criteria, greater number of
      diagnostically adequate specimens were obtained by FNA than by NA but the number
      of diagnostically superior specimens obtained by NA technique was found to be
      more than that by FNA. The difference was found to be statistically significant.
      However the number of inadequate smears was also more by NA technique than by FNA
      technique.

PMID- 11217265
TI  - Sex cord-stromal tumours of the ovary. A clinicopathological spectrum.

PMID- 11217266
TI  - A study of lupus anticoagulant in unexplained fetal wastage.
AB  - Lupus Anticoagulant, first discovered in patients of SLE, is now known to be
      associated with a wide spectrum of diseases. The presence of LA is associated
      with adverse fetal outcome in an obstetric population. In the present series the
      incidence of LA was found to be 16.6% and 80% of LA positive subgroup had an
      unsuccessful outcome.

PMID- 11217267
TI  - DNA flow-cytometry on fine needle aspiration cytology of lymph node: how helpful
      is it?
AB  - The diagnostic value of DNA content analysis by flow cytometry (FCM) has rarely
      been evaluated in combination with fine needle aspiration cytology (FNAC). In
      this present study, the value of DNA FCM in distinguishing malignant lesions from
      benign enlarged lymph nodes on FNAC material has been investigated. DNA FCM was
      done from FNAC materials of 58 cases of lymph node swellings Becton Dickinson's
      flow cytometer (USA) along with 'Cell Quest' program was used for the analysis of
      DNA ploidy and S & G2-M phase cells. There were 16 cases of reactive lymphoid
      hyperplasia, 8 cases of metastatic carcinoma and 34 cases of non Hodgkins
      lymphoma (NHL). DNA FCM showed 12 aneuploid case and 46 diploid case. All the
      cases with DNA aneuploidy were malignant. None of the benign cases showed
      aneuploidy on DNA aneuploidy were malignant. None of the benign cases showed
      aneuploidy on DNA histogram. Out of the 46 diploid cases, 11 cases showed high S
      & G2-M Phase cells (> 10%). Nine out of these 11 cases were malignant on FNAC.
      The sensitivity and specificity of DNA FCM were 50% and 87.5% respectively. None
      of the low grade NHL was detected by DNA FCM. In conclusion, DNA aneuploidy and
      high G2-M phase cells (> 10%) are good indicators of malignancy in lymph node
      aspirate. However DNA FCM is relatively costly and thereby its role as an
      adjunctive technique needs careful re-evaluation.

PMID- 11217268
TI  - Collagenous spherulosis of breast: diagnosis by FNAB with review of literature.
AB  - Collagenous Spherulosis (CS) of breast is an innocuous but interesting uncommon
      morphological feature observed with a variety of benign and malignant breast
      lesions. We report a case of collagenous shperulosis associated with nodular
      sclerosing adenosis (Adenosis tumor) on fine needle aspiration (FNA) smears
      confirmed later by biopsy. The differential diagnosis of collagenous spherulosis
      is discussed.

PMID- 11217269
TI  - Multidrug resistant Salmonella typhi in Rourkela, Orissa.
AB  - Out of 5410 blood samples 715 samples were found positive for Salmonella typhi.
      Enteric fever was prevalent for last three years in Rourkela. In last two years,
      a number of multidrug resistant strains of Salmonella typhi was isolated which
      constituted almost 16.1% of the total isolates. In this study, chloramphenicol
      sensitivity was found quite high (86.5%) and ceftriaxone showed 100% sensitivity.
      Resistance to ciprofloxacin was found 2.5% which due to direct consequence of
      indiscriminate use of antibiotics, either singly or in combination.

PMID- 11217270
TI  - In vitro susceptibility testing of nonsporing anaerobes to ten antimicrobial
      agents.
AB  - Antibiotic Susceptibility was performed on sixty clinical isolates of nonsporing
      anaerobes against ten antimicrobial agents. The test was performed on Muller
      Hinton Agar and Wilkins Chalgren blood agar by preparing suspension of freshly
      isolated colonies in BHI broth. Apart from Metronidazole and Chloramphenicol
      newer antibiotics like Minocycline, Secnidazole, Tinidazole, Clarithromycin,
      Roxithromycin were also tried. Antimicrobial agents like metronidazole,
      Secnidazole, Tinidazole and Minocycline were 100% sensitive, followed by
      Chloramphenicol, Clarithromycin and Roxithromycin. These newer agents can be good
      alternatives for the treatment of non sporing anaerobes.

PMID- 11217271
TI  - Comparison of Vitek Yeast Biochemical Card with conventional methods for
      speciation of Candida.
AB  - The ability of the Vitek Yeast Biochemical Card to identify yeast isolates was
      compared with conventional methods. Of the fifty yeast isolates tested same
      species identification was obtained in thirty-four isolates. The Vitek yeast
      biochemical card identified 13 isolates which could not be identified by the
      conventional tests. Though the Vitek Yeast biochemical card gave a good rapid
      identification the high cost of each test severely limits its routine use in most
      of the laboratories.

PMID- 11217272
TI  - Gall stones and carcinoma gall bladder.
AB  - One hundred and fifty surgically resected gall bladder specimens were included in
      the study to evaluate the relationship between the prevalence of gall stones and
      histochemical alteration in sequential changes of metaplasia, dysplasia and
      neoplasia in gall bladder epithelium. Multiple sections were processed and
      stained with haematoxylin and eosin, Periodic acid Schiff's stain, Alcian blue
      (pH 2.5)/Periodic acid, Orcein/Alcian blue (pH 2.5) and Alcian Blue/Periodic
      acid/Potassium borohydride saponifications stains. Details of gall stones present
      were also noted. Prevalence of gall stones in gall bladders with metaplastic,
      dysplastic and neoplastic mucosal changes was significantly higher (P < 0.001)
      than those gall bladders which had no epithelial changes. Increase in sialomucin
      with a corresponding decrease in sulphomucin was observed from metaplasia to
      malignancy. Neutral mucin increased in metaplastic cells but was significantly
      reduced in neoplastic cells. Loss of O-acylation in sialmucin was also present in
      neoplastic cells. The histochemical changes suggest that chronic injury due to
      cholelithiasis induces appearance of neutral mucin positive metaplastic cells,
      which may further dedifferentiate to sialomucin containing dysplastic or
      neoplastic cells if the stimulation persists.

PMID- 11217273
TI  - Giant cell tumour of soft tissue--a case report.
AB  - Giant cell tumor is seen in late adolescence or in the third or fourth decade of
      life. It arises from epiphysis of long bones, the commonest site being the distal
      end of the demur and the proximal end of tibia. This paper presents a case report
      of giant cell tumor of soft tissue.

PMID- 11217274
TI  - Retroperitonial atypical lipomatous tumour--a case report.
AB  - We report a case of atypical lipomatous tumor-sclerosing type, a rare
      retroperitoneal soft tissue liposarcoma, presented with vague musculoskeletal
      symptoms. Patient was managed with complete resection of the tumor mass with
      adjuvant chemotherapy. The patient is doing well, with no evidence of recurrence
      22 months after the treatment.

PMID- 11217275
TI  - Primary intracranial chondrosarcoma--a case report.
AB  - Intracranial malignant cartilaginous tumors, not arising from the skull bones are
      a rare phenomenon, and few cases have been reported till date in literature. We
      hereby describe one such case treated by us.

PMID- 11217276
TI  - Histoplasma capsulatum in adrenal gland aspirate--a case report.
AB  - We report a case of disseminated histoplasmosis in a 60-year-old non
      immunocompromised patient who presented to us with fever and hepatosplenomegaly.
      Sonographic & CT examination of the abdomen showed bilateral adrenal masses.
      Cytological examination of the aspirated material from the mass showed yeast
      forms of H. capsulatum.

PMID- 11217277
TI  - Aeromonas caviae as a cause of cholecystitis.

PMID- 11217278
TI  - Epidemiology of epilepsy--recent achievements and future.
AB  - Epilepsy is a very common neurological disease. Reliable epidemiological data are
      of great importance for understanding the etiology and risk factors for its
      development. It is necessary to use standardized methodology for the results from
      epilepsy studies in different geographical regions to be comparable. Most of the
      epidemiological studies of epilepsy find an incidence rate of 20-70/100,000 per
      year (range 11-134/100,000). The state of the problem in Bulgaria and other
      countries of Eastern Europe is not adequately studied. It is considered that the
      figures are higher in the developing countries. Incidence is higher in men than
      in women and varies considerably with age--it is high in childhood, decreases in
      young people and rises again in the elderly. Only approximately 30% of the newly
      registered cases can be assigned to one of the diagnostic categories. The studies
      identify an etiological factor in only about one third of all cases. The most
      commonly reported etiological factors are: cerebro-vascular disease, tumors,
      alcohol, head injuries, congenital factors and neuroinfections. Most of the
      developed countries report prevalence of active epilepsy in the range of 4
      8/1000. The prevalence rates in Latin America and some African states are
      especially high. In Bulgaria by means of the system of regional
      psychoneurological dispensaries about 30,000 epilepsy patients are registered,
      but it may be assumed that their real number is over 60,000. Contemporary views
      on the prognosis of this disease are favorable--more than 70% of the diseased
      reach long-term remission. Different prognostic factors predicting the final
      outcome of epilepsy patients are described. Epilepsy patients exhibit more than 2
      times higher mortality rate than the expected rate for the corresponding
      population. It is necessary to conduct additional projects, based on the
      available standardized methodology for epidemiological monitoring of epilepsy in
      different geographical regions, including Bulgaria.

PMID- 11217279
TI  - A study of Helicobacter pylori infection in patients with pernicious anemia.
AB  - INTRODUCTION: Chronic atrophic gastritis presents with atrophy of the gastric
      mucosa, hypochlorhydria or achlorhydria and unstable gastrin level. Type A
      chronic atrophic gastritis associated with hypergastrinemia is regarded as the
      principle causative factor for pernicious anemia. AIM: The study aimed at
      evaluation of the incidence of H. pylori infection in patients with pernicious
      anemia and analyze its relation to the severity of gastritis. MATERIAL AND
      METHODS: Forty patients with pernicious anemia (group 1) were examined for
      presence of H. pylori infection. Sex- and age-matched patients with gastric ulcer
      (group 2) and chronic superficial gastritis (group 3) were used as controls.
      Three antral forceps biopsies were obtained from all patients during
      videogastroscopy. The presence of H. pylori was verified by urease test,
      histological and microbiological examination. RESULTS: All patients with
      pernicious anemia had chronic atrophic gastritis and several times lower
      incidence of H. pylori infection than the patients with gastric ulcer. Chronic
      atrophic gastritis was not diagnosed in group 3 patients. Statistically
      significant difference in Helicobacter pylori infection was found between groups
      1 and 2 (P < 0.001) but not between groups 1 and 3 (P > 0.05). CONCLUSIONS:
      Atrophic gastritis was diagnosed in all patients with pernicious anemia. These
      patients showed significantly lower incidence of H. pylori infection than the
      gastric ulcer patients. The patients with pernicious anemia had lower gastritis
      index and quantitatively less expressed infection than the other two groups.

PMID- 11217280
TI  - Influence of age, sex and body weight on renal osteodystrophy in predialysis
      patients with chronic renal failure.
AB  - The aim of the present investigation was to examine the influence of age, sex and
      body weight on osseous changes in pre-dialysis patients with chronic renal
      failure (CRF). 87 patients (44 males and 43 females) aged 18-60 years with CRF
      were studied. The levels of serum creatinine, total and ionized calcium,
      phosphorus, alkaline phosphatase, intact parathormone and serum osteocalcine were
      followed up. Body weight is presented as BMI. 47 of the patients were subjected
      to double X-ray absorptiometry of lumbar vertebra (Lunar) and 40 patients were
      examined by computed tomography osteometry. RESULTS: No reliable differences in
      the levels of biochemical parameters in male and female patients with the same
      degree of CRF were established. A tendency towards an increase in the level of
      intact parathormone and serum osteocalcine in women with both initial and
      advanced CRF was recorded. The BMI in patients with advanced CRF was lower as
      compared to those with initial CRF. Different stages of osseous changes were
      observed in 29 males (74.35%) and in 25 females (60.97%). A tendency for a higher
      frequency and severity of osseous changes in men aged up to 40 years was
      observed. After this age males and females were equally affected. A high positive
      correlation (r = 0.50) between BMI and the percentage of the normal Bone Mineral
      Density/Bone Mineral Content in females with CRF stage II and III was noticed.
      CONCLUSIONS: No significant difference in the frequency and severity of osseous
      changes in male and female uremic patients was observed. Bone changes were more
      frequent and pronounced in males up to 40 years of age, while this tendency
      reversed after the menopause. The higher body weight was beneficial for the
      osseous changes only in females with advanced CRF, while in all other patients no
      correlation with densitometric parameters was noticed.

PMID- 11217281
TI  - Low protein diet and ketosteril in predialysis patients with renal failure.
AB  - After a short review of the contemporary understanding of amino acid
      supplementation to low protein diets in patients with uremia we present the
      results of administration of ketosteril in 20 low-protein-diet patients on such a
      diet. MATERIAL AND METHODS: Twenty patients (10 men and 10 women) with stable II
      and III stage chronic renal failure were assigned to a low protein diet (protein
      up to 40 g/day). Ketosteril (6 tablets a day) were added to the diet. Some of the
      basic markers of protein metabolism and nitrogen balance were followed. RESULTS:
      No evidence of deteriorated protein synthesis was found in the therapy thus
      administered. Serum urea and creatinine values did not change and even tended to
      decrease. Glomerular filtration was found to increase insignificantly more
      markedly in the patients with renal failure in the early stages. CONCLUSIONS: A
      low protein diet with increased content of essential amino acids and their keto
      analogues does not deteriorate the nitrogen balance of patients with chronic
      renal failure. By adding essential amino acids and keto-analogues a normal
      protein metabolism is maintained in spite of the reduce intake of protein
      substances with the diet. Supplementation of the diet of chronic renal failure
      patients with essential amino acids and keto-analogues allows a considerable
      reduction of the protein intake to be achieved which brings about reduction of
      glomerular hyperfiltration which actually retards the progression of renal
      failure and improves its short-term prognosis.

PMID- 11217282
TI  - Cyclosporin A in the treatment of patients with nephrotic syndrome.
AB  - OBJECTIVE: To present our experience in the treatment of conventional therapy
      refractory nephrotic syndrome with cyclosporin A. MATERIAL AND METHODS: The study
      sample included 22 patients (12 men, 10 women, aged 40.43 +/- 5.93 years). Twenty
      one patients were diagnosed histologically: 11 were with different histologic
      variants of chronic gtlomerulonephritis, 7 with lupus nephritis and 3 with renal
      amyloidosis. Sandimmun Neoral-Sandoz was given orally in a dose of 2-5 mg/kg/24
      hours; mean duration of the course of treatment 41.4 +/- 12.4 days. In the course
      of treatment we followed quantitatively 24-hour proteinuria, diuresis,
      hematologic parameters, serum creatinine, transaminases, the fat profile, and
      creatinine clearance. RESULTS: The patients were allocated into 3 groups
      according to their response to treatment--in 5 patients (22.73%) it achieved
      complete clinical and laboratory remission, in 8 (36.36%)--partial remission and
      in 9 (40.91%) it failed. The 24-hour diuresis in the patients with complete and
      partial remission increased significantly during the third week of treatment
      (from 1212.5 +/- 114.7 to 2700 +/- 394.61, p < 0.05, t = 3.62). Proteinuria was
      reduced from 3.47 +/- 0.54 to 1.86 +/- 0.36 g/d (p < 0.05, t = 2.48) at the end
      of treatment. No substantial change in the antihypertensive therapy was necessary
      in any of the patients. There was no decline of the renal and liver functions.
      Neither allergic reactions nor serious side effects that may have caused
      discontinuation of treatment were observed. Complete or partial clinical and
      laboratory remission was achieved in 59.09% (13 patients) (confidence interval =
      39.2%-78.9%, odds ratio = 0.95). Cyclosporin A therapy is an appropriate
      alternative in the treatment of refractory nephrotic syndrome in some of the
      immunologic glomerulopathies. The types of glomerulopathy that are best affected
      are minimal-change glomerulonephritis, some of the mesangioproliferative
      glomerulonephritis cases and some forms of lupus nephritis. No effect whatsoever
      was found in cases with renal amyloidosis.

PMID- 11217283
TI  - Acute hemolytic anemia as an initial clinical manifestation of Wilson's disease.
AB  - Wilson's disease is an inherited disorder of copper transport in the organism,
      transmitted in autosomal recessive fashion. It is caused by dysfunction in
      homologous copper-transporting adenosine triphosphatases. The main clinical
      symptoms are usually due to hepatic (42%) or/and neurologic (34%) involvement,
      which is the reason for the name hepatolenticular degeneration. Described in this
      report are four cases--the first three demonstrate an unusual form of
      manifestation of Wilson's disease in clinical practice--glucose-6-phosphate
      dehydrogenase deficiency hemolytic anemia. The fourth case concerns acute
      intravascular hemolysis that was provoked by the disease and presented without
      erythrocyte enzyme disturbances. Hemolytic anemia is a recognized but rare (10
      15%) complication of the disease. Most often Coombs' negative acute intravascular
      hemolysis occurs as a consequence of oxidative damage to the erythrocytes by the
      higher copper concentration. A literature review with discussion of the possible
      mechanisms for the development of this phenomenon is done.

PMID- 11217284
TI  - Myoplasty in chronic osteomyelitis and other postoperative defects of the lower
      jaw.
AB  - BACKGROUND: Mandibular chronic osteomyelitis is a complicated therapeutical
      problem in the oral and maxillofacial surgery. While the principles of
      conservative and radical treatments are generally widely accepted by all authors,
      the repair of the defects by plastic surgery is inadequately developed. METHOD:
      Eleven patients with chronic osteomyelitis, odontogenic cysts and benign tumors
      of the mandible were treated by filling the osseous defect with a muscle flap
      from the adjacent m. masseter, m. buccinatorius and m. platysma. RESULTS: The
      clinical and X-ray examinations showed that a successful outcome without
      complications was achieved in all treated patients. There was no recurrence of
      the underlying disease in the five-year follow-up period. CONCLUSIONS: Use of
      muscle pedicle flaps for plastic reconstruction of osteomyelitic cavities and
      other osseous defects improves the effect of the treatment, shortens its duration
      and reduces the possibility of further recurrences of the disease.

PMID- 11217285
TI  - Undergraduate medical education: tendencies and requirements in a rapidly
      developing Europe.
AB  - This study pinpoints the necessity to constantly monitor local approaches in
      undergraduate medical education on an inter-European scale. Traditional
      undergraduate medical curricula need restructuring to account for the increasing
      amount of medical knowledge and rapid changes and developments in societies,
      nosology, therapy and IT. European undergraduate medical curricula should be
      harmonized not egalized, with a focus on inter-European sharing of resources,
      mobility, credit (allocation, accumulation and transfer), definition of European
      and trans-European mission statements, identification of quality metrics, advice
      on dealing with conflicting aims such as specialization and generalization, on
      communicating core knowledge instead of providing overabundance of information,
      and on introducing multifaceted teaching and learning methods, as well as
      providing strategies for life long learning. Sound medical education can no
      longer and nowhere be considered under the autonomous auspices of individual
      Medical Schools or national philosophies. It has to be perceived and structured
      as a competitive and flexible approach which promotes life long learning of
      teachers, students, physicians and other related staff with international
      awareness. It is stressed that student and staff mobility, as well as virtual
      mobility in the form of worldwide available teaching modules and expertise have
      to be incorporated into national medical curricula. This is to guarantee up-to
      date education in support of patient demands, future professionality and
      competitiveness of students, physicians and Public Health System institutions.
      The formal approaches of traditional subject related curricula as well as problem
      based learning must be linked with quality approved state of the art ODL,
      evaluated international CME strategies and training in the utilization of IT in
      preparation of lifelong learning. Strategies for the use of IT need updating on a
      regular basis to diminish the gap between undergraduate and postgraduate medical
      education. General European perspectives of medical education are discussed in
      relation to ECTS, ODL, compulsory credited and evaluated CME and relicensing of
      physicians. Prime features of ETM--the most reputed and well-known European
      medical CME initiative fostering quality assured international awareness are
      described and recommended for local and nationwide implementation. Specific links
      of the Bonn undergraduate medical curriculum with credited and evaluated CME and
      imminent European strategies are detailed. The authors conclude that European
      universities not adapting at least some of the outlined curricular necessities
      will rapidly lose their competitiveness compared to other national and
      international Medical Schools. Harmonized European ethical mission statements and
      consequent utilization of IT deserve special considerations in this context.

PMID- 11217286
TI  - Endonasal microscopic dacryocystorhinostomy: results and advantages.
AB  - BACKGROUND: The modern endonasal operative technique of functional fenestration
      of saccus lacrimalis in the middle nasal meatus (endonasal
      dacryocystorhinostomy), first described by West in 1910, has been gaining in
      significance over the past few years. At the VI National Congress of
      Otorhinolaryngology (1997) we presented for the first time in this country
      performance of endonasal microscopic dacryocystorhinostomy videotaped and started
      a routine use of this technique in our department. OBJECTIVE: We present the
      results of our 3-year experience with the technique. MATERIAL AND METHODS:
      Endonasal microscopic dacryocystorhinostomy was performed in 50 patients (57
      operations) without stenting. The effect of the surgery was assessed by comparing
      the results of control examinations with the preoperative findings using the
      following criteria: subjective complaints, and objective findings--palpatory
      test, irrigation according to Anell, endoscopy of the nasal cavities and the neo
      ostium. RESULTS: Statistically significant improvement of specific subjective
      symptoms was obtained in 78.9%-100%. In 6 cases the closure of the neo-ostium was
      proven endoscopically. CONCLUSION: Endonasal microscopic dacryocystorhinostomy
      preserves intact the normal function of the lacrimal pump, yields excellent
      cosmetic results and allows simultaneous management of the concomitant sino-nasal
      pathology. A neo-ostium under 2 mm in diameter can be conducive to postoperative
      epiphora. A congenital, untreated form of postsaccal stenosis with concomitant
      dacryocystitis as well as formation of synechiae are factors increasing the
      possibility of restenosis.

PMID- 11217287
TI  - Surgical correction of funnel chest.
AB  - AIM: To present our experience in surgical treatment of funnel chest. MATERIAL
      AND METHODS: Seven patients (6 males and 1 female) aged 13 to 18 years were
      treated in the Department using Rathke-Schlegel's modification of Ravitch
      operative technique. In 2 patients the corrected deformity status was maintained
      by 2 Kirschner's pins that were placed substernally and attached bilaterally to
      the adjacent ribs. In one patient a direct traction through the sternum was
      applied and in 4 patients the fixation was achieved by fastening the sternum with
      wire loops to an overlying AO plate. RESULTS: Very good results were achieved in
      4 patients (57.14%) and a good outcome was evaluated in 3 patients with 30%
      recurrence of the deformity. There was no lethal outcome. Three complications
      were encountered: in one patient hemothorax occurred that was cured by a single
      punction aspiration, in other patient one of the Kirschner's pins slipped into
      the thoracic cavity. The pin but did not injure intrathoracic organs and was
      promptly removed. In the third patient earlier removal of the plate was required
      because suppuration developed. CONCLUSION: The presented method for correction of
      chest deformity is successful if the implants are kept in place from 6 to 12
      months. This time is sufficient for formation of a solid callus that prevents
      recurrence of the deformity.

PMID- 11217288
TI  - Dynamics of potassium and nitrate ions release from polycarboxylate cement with
      5% KNO3.
AB  - Release of potassium and nitrate ions from polycarboxylate-cement blocks
      containing 5% KNO3, with different exposure in extragent aqua redestillata was
      studied. Using flame photometry we found increased concentration of eliminated
      potassium ions into the extragent after the 24th hour (0.90 +/- 0.03 mg/cm3)
      while the maximum quantity of released potassium ions was measured after the 14th
      day (336 h)--1.50 +/- 0.02 mg/cm3 (t = 60, P < 0.001). The concentration of the
      released nitrate ions was determined by spectrophotometry at l = 410 nm. The
      degree of extraction of nitrate ions from the model cement blocks progressively
      increased with time, but their concentration in the cement decreased after the
      14th day too, demonstrating a statistically significant difference: from 4.50 mg
      on the 20th minute to 2.60 mg on the 14th day (t = 115, P < 0.001).

PMID- 11217289
TI  - Mandibular fractures in children. A retrospective study.
AB  - This study reviews the treatment of mandibular fractures in children for the
      period 1986-1995. The sample included 107 children under 15 years of age, which
      were studied by age, sex, cause and type of fracture, method of treatment and
      complications. The children were divided into four groups according to the
      development of the dentition: 0-5 years, 6-9 years, 10-12 years and 13-15 years.
      Boys to girls ratio was 3.46:1 and the highest incidence was observed in boys
      over 13 years of age. Associated injuries were more common in younger children
      (56%). Most of the fractures were the results of traffic accidents (28.97%),
      games and sports (25.23%), beating (19.63%) or falls (15.88%). Unilateral
      fractures were more common (69.16%) than bilateral (30.84%). Intermaxillar
      fixation for 3 weeks was the method of treatment used in 84.12% of the patients.
      Complications appeared to be rare.

PMID- 11217290
TI  - Morphological changes in dental enamel after fluoride gel application in vitro.
AB  - INTRODUCTION: The investigations of in vitro models precede the clinical studies.
      Using these studied we can investigate the effect upon the enamel of different
      agents for local application. AIM: The purpose of this study was to investigate
      the ultrastructural changes in a normal and partially demineralized enamel after
      0.42% fluoride gel application in vitro using scanning electron microscopy.
      MATERIAL AND METHODS: The experiment was performed on 20 premolars extracted for
      orthodontic indications. Symmetrical specimens were prepared, as one half served
      as a control, while the other one was treated with fluoride gel. The specimens
      were examined with electron microscope at different magnifications. RESULTS: The
      findings show that fluoride gel applications affect the processes of
      mineralization and remineralization. CONCLUSIONS: This gives us the ground for
      applying fluoride gel in the clinical practice for prevention and treatment of
      caries incipiens.

PMID- 11217291
TI  - Caries incipiens prevalence of the permanent teeth by jaw regions in 7-, 12- and
      14-year-old children.
AB  - AIM: The purpose of the present study was to establish caries incipiens
      prevalence of the permanent teeth by dental surfaces (Is). Caries incipiens is
      examined totally and separately by macula cariosa alba and macula cariosa fusca
      by jaws and regions. MATERIAL AND METHODS: The sample is random and comprises 600
      children of 7, 12 and 14 years of age. Caries incipiens is diagnosed visually
      tactile by means of a probe and mirror. The data is analyzed statistically with
      Excel 7.0. Statistical significance was defined as 0.05, two-tailed. RESULTS:
      Caries incipiens prevalence is highest at 7 years and does not change
      considerably with increase of age. In all age groups macula cariosa fusca
      prevalence is higher than that of macula cariosa alba (P < 0.001). The highest
      prevalence of macula cariosa fusca is found occlusally in all age groups in both
      jaws. Overall compared to the upper jaw prevalence rates in the lower jaw are
      higher. CONCLUSION: The obtained results are of importance in designing and
      applying preventive programs.

PMID- 11217292
TI  - Gingivoperiosteoplasty in 3-to-5-year-old patients with cleft lip and palate: a
      preliminary communication.
AB  - Closure of the alveolar cleft and the oronasal fistulas was achieved by
      gingivoperiosteoplasty in 26 patients with unilateral or bilateral cleft of the
      lip and palate. They were divided in two groups according to whether or not
      functional cheiloplasty was previously performed (group I comprised 12 patients,
      group II--14 patients). No systemic pre- or post-surgical orthodontic treatment
      was administered in both groups. The malocclusions before and after
      gingivoperiosteoplasty, the postoperative fistulas and the speech were evaluated.
      Prior to gingivoperiosteoplasty malocclusions were found in 16 children (4 in
      group I and 12 in group II). After gingivoperiosteoplasty better occlusion was
      achieved in 6 patients of group II and in 3 of group I. Malocclusions remained in
      6 children of group II and in one of group I. Fistulas persisted in 3 children
      (group II--2, group 1--1). Rhinolalia was found in 7 children of group II and in
      none of group I. In conclusion, we think that gingivoperiosteoplasty can be
      performed successfully after eruption of the deciduous teeth, that is between 3
      and 5 years of age. The quality of the cheiloplasty and palatoplasty performed
      prior to it is of great significance. Gingivoperiosteoplasty should be included
      as a separate surgical stage in the management of total cleft lip and palate.

PMID- 11217293
TI  - The most frequently cited articles published in Social Biology, 1961-1999.

PMID- 11217294
TI  - The founding of the Behavior Genetics Association, 1966-1971.

PMID- 11217295
TI  - MMPs and TIMPs. An historical perspective.

PMID- 11217296
TI  - The matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase
      (TIMP) genes. Transcriptional and posttranscriptional regulation, signal
      transduction and cell-type-specific expression.

PMID- 11217297
TI  - Models for gain-of-function and loss-of-function of MMPs. Transgenic and gene
      targeted mice.

PMID- 11217298
TI  - Expression of MMPs and TIMPs in mammalian cells.

PMID- 11217299
TI  - Expression of recombinant matrix metalloproteinases in Escherichia coli.

PMID- 11217300
TI  - Expression of human collagenase I (MMP-1) and TIMP-1 in a baculovirus-based
      expression system.

PMID- 11217301
TI  - Expression of recombinant matrix metalloproteinases in yeast.

PMID- 11217302
TI  - Expression of recombinant membrane-type MMPs.

PMID- 11217303
TI  - Strategies for cloning new MMPs and TIMPs.

PMID- 11217304
TI  - Refolding of TIMP-2 from Escherichia coli inclusion bodies.

PMID- 11217305
TI  - Expression and refolding of full-length human TIMP-1.

PMID- 11217306
TI  - Purification of MMPs and TIMPs.

PMID- 11217307
TI  - Monitoring MMP and TIMP mRNA expression by RT-PCR.

PMID- 11217308
TI  - Measuring transcription of metalloproteinase genes. Nuclear run-off assay vs
      analysis of hnRNA.

PMID- 11217309
TI  - In situ hybridization for metalloproteinases and their inhibitors.

PMID- 11217310
TI  - Use of EIA to measure MMPs and TIMPs.

PMID- 11217311
TI  - Immunohistochemistry of MMPs and TIMPs.

PMID- 11217312
TI  - Detecting polymorphisms in MMP genes.

PMID- 11217313
TI  - Methods for studying activation of matrix metalloproteinases.

PMID- 11217314
TI  - Assay of matrix metalloproteinases against matrix substrates.

PMID- 11217315
TI  - Zymography and reverse zymography for detecting MMPs, and TIMPs.

PMID- 11217316
TI  - In situ zymography.

PMID- 11217317
TI  - Detection of focal proteolysis using Texas-red-gelatin.

PMID- 11217318
TI  - Antibodies to MMP-cleaved aggrecan.

PMID- 11217319
TI  - Structural studies on MMPs and TIMPs.

PMID- 11217320
TI  - Cartilage proteoglycan release assay.

PMID- 11217321
TI  - Immunoassay for collagenase-mediated cleavage of types I and II collagens.

PMID- 11217322
TI  - Collagen degradation assays.

PMID- 11217323
TI  - Invasion assays and matrix metalloproteinases. Quantification of cellular
      invasion using propidium iodide labeling and confocal laser scanning microscopy.

PMID- 11217325
TI  - Kinetic analysis of the inhibition of matrix metalloproteinases by tissue
      inhibitor of metalloproteinases (TIMP).

PMID- 11217326
TI  - Assaying growth factor activity of tissue inhibitors of metalloproteinases.

PMID- 11217324
TI  - Using fluorogenic peptide substrates to assay matrix metalloproteinases.

PMID- 11217328
TI  - Influence of polymer concentration and polymer composition on capillary
      electrophoresis of DNA.

PMID- 11217327
TI  - Matrix metalloproteinase substrate binding domains, modules and exosites.
      Overview and experimental strategies.

PMID- 11217329
TI  - Capillary coatings. Choices for capillary electrophoresis of DNA.

PMID- 11217330
TI  - Replaceable polymers for DNA sequencing by capillary electrophoresis.

PMID- 11217331
TI  - Sieving matrix selection.

PMID- 11217332
TI  - Parameters affecting capillary electrophoretic separation of DNA.

PMID- 11217333
TI  - DNA separation by capillary electrophoresis in lyotropic polymer liquid crystals.

PMID- 11217334
TI  - Capillary electrophoresis of DNA fragments using poly(ethylene oxide) as a
      sieving material.

PMID- 11217335
TI  - DNA capillary electrophoresis using block copolymer as a new separation medium.

PMID- 11217336
TI  - DNA analysis under highly denaturing conditions in bare fused silica capillaries.

PMID- 11217337
TI  - Capillary electrophoresis with glycerol as an additive.

PMID- 11217338
TI  - DNA separation mechanisms during electrophoresis.

PMID- 11217339
TI  - Capillary electrophoresis of DNA fragments with replaceable low-gelling agarose
      gels.

PMID- 11217341
TI  - The application of capillary electrophoresis for DNA polymorphism analysis.
AB  - CE fractions may also be collected and then subjected to additional analysis.
      Nanoliter fractions containing size or shape fractionated DNA fragments can be
      collected on moving affinity membranes (125) or into sample chambers (126). The
      exact timing of the collection steps is achieved by determining the velocity of
      each individual zone measured between two detection points near the end of the
      capillary. The DNA samples may subsequently be identified by probe hybridization,
      or by PCR-linked sequencing. Capillary fractions containing metabolites and
      derivatives of DNA and small DNA adducts can also be sampled, and then
      characterized directly by highly sensitive MALDI-TOF atomic analysis (112-118)
      and ESI-MS (118,119). The automation and integration of PCR and CE analysis (PCR
      CE) on a microchip (3-12,96) will also contribute greatly to its adoption as the
      analysis tool of choice. Significantly, these tools will be applied for DNA
      sequencing (75,108), for genome mapping (65) and genotyping (42-46), for improved
      certainty in disease detection (3-6,107,120) and for DNA mutation analysis (2
      12,27,58). Recent improvements in the design CAE arrays and associated equipment
      such as the radial CAE microplate and rotary confocal signal detection system
      (127) overcome some of the detection limitations of linear CAE and microchip
      devices and allow the parallel genotyping of 96 samples in about 120 s. The
      integration of microreactive capillary surface assays (128) and "in-capillary"
      analysis will also lead to further increases in the speed and sensitivity of CE
      based analysis. The recent announcement of the completion of the first draft
      sequence of the 90% of the entire human genome within 6 mo by Celera Genomics by
      sequencing random DNA fragments using several hundred ABI 3700 machines (129)
      illustrates the enormous efficiency realized through the automation of DNA
      sequencing by CAE. Sequencing was performed at an average rate of approximately 6
      x 10(9) bases/yr. The CAE machines will now be employed for a concerted
      resequencing of genome elements to create an extremely high-density polymorphism
      map of the entire genome (130). This map will be based principally on single
      nucleotide polymorphisms, and will catapult human medicine into a new era of
      closely detailed genetic trait mapping to identify the genetic basis of multi
      gene diseases.

PMID- 11217342
TI  - Pulsed-field capillary electrophoresis separation of large DNA fragments.

PMID- 11217340
TI  - Robust field inversion capillary electrophoretic separation of long DNA
      fragments.

PMID- 11217343
TI  - Collection of capillary electrophoresis fractions on a moving membrane.

PMID- 11217345
TI  - Quality control of nucleotides and primers for PCR.

PMID- 11217346
TI  - Analysis of modified oligonucleotides with capillary gel electrophoresis.

PMID- 11217344
TI  - Separation of supercoiled DNA using capillary electrophoresis.

PMID- 11217347
TI  - Use of capillary electrophoresis for concentration analysis of phosphorothioate
      oligonucleotides.

PMID- 11217348
TI  - Capillary electrophoresis separation of ribonucleosides.

PMID- 11217349
TI  - On-line preconcentration and separation of antisense oligonucleotides by ITP-CE
      in dextran-filled capillaries.

PMID- 11217350
TI  - Capillary electrophoresis-mass spectrometric analysis of DNA adducts.

PMID- 11217351
TI  - Analysis of environment-induced DNA damage by capillary electrophoresis.

PMID- 11217352
TI  - Assay for DNA damage using immunochemical recognition and capillary
      electrophoresis.

PMID- 11217353
TI  - Analysis of DNA damage using capillary zone electrophoresis and electrospray mass
      spectrometry.

PMID- 11217354
TI  - Purification methods for preparing polymerase chain reaction products for
      capillary electrophoresis analysis.

PMID- 11217355
TI  - Integration of phosphodiesterase-induced degradation of oligonucleotides with
      capillary polymer-sieving electrophoresis.

PMID- 11217356
TI  - Capillary electrophoresis of urinary normal and modified nucleosides of cancer
      patients.

PMID- 11217357
TI  - Analytical considerations for capillary electrophoresis. Quantitative
      measurements.

PMID- 11217358
TI  - Microchip-based capillary electrophoresis systems.

PMID- 11217359
TI  - DNA sequencing by capillary array electrophoresis.

PMID- 11217360
TI  - Determining dye-induced DNA mobility shifts for DNA sequencing fragments by
      capillary electrophoresis.

PMID- 11217361
TI  - Modulation of growth factor receptor expression by irradiation for immunotoxin
      targeting.

PMID- 11217362
TI  - Quantification of immunotoxin number for complete therapeutic response.

PMID- 11217363
TI  - In vitro studies of ricin A-chain-induced vascular leak syndrome.

PMID- 11217364
TI  - Immunotoxin treatment of brain tumors.

PMID- 11217365
TI  - Cytotoxins directed at interleukin-4 receptors as therapy for human brain tumors.

PMID- 11217366
TI  - CD7-specific single chain Fv immunotoxins. Design and expression.

PMID- 11217367
TI  - Bispecific monoclonal antibodies for the targeting of type I ribosome
      inactivating proteins against hematological malignancies.

PMID- 11217368
TI  - Tyrosine kinase inhibitors against EGF receptor-positive malignancies.

PMID- 11217370
TI  - Gene therapy with immunotoxins.

PMID- 11217369
TI  - Targeting tumor vasculature using VEGF-toxin conjugates.

PMID- 11217371
TI  - Effects of selective immunotoxic lesions on learning and memory.

PMID- 11217372
TI  - Targeting toxins to neural antigens and receptors.

PMID- 11217373
TI  - In vivo testing of anti-HIV immunotoxins.

PMID- 11217374
TI  - Development and activities of the BR96-doxorubicin immunoconjugate.

PMID- 11217375
TI  - Recombinant fusion toxins directed against the human granulocyte-macrophage
      colony stimulating factor (GM-CSF) receptor.

PMID- 11217376
TI  - Synthesis of monensin derivatives and their effect on the activity of ricin A
      chain immunotoxins.

PMID- 11217377
TI  - Purification and conjugation of type 1 ribosome-inactivating proteins.

PMID- 11217378
TI  - Comparison of immunotoxins bearing a single saporin molecule with multiple toxin
      conjugates.

PMID- 11217379
TI  - Propagation of wild-type and mutant SV40.

PMID- 11217380
TI  - Generation of recombinant SV40 vectors for gene transfer.

PMID- 11217381
TI  - Production of SV40 proteins in insect cells and in vitro packaging of virions and
      pseudovirions.

PMID- 11217382
TI  - Using retroviral vectors to express SV40 tumor antigens.

PMID- 11217383
TI  - Neoplastic transformation assays.

PMID- 11217384
TI  - Methods to assess inhibition of adipocyte differentiation by SV40 large T
      antigen.

PMID- 11217386
TI  - Propagation and assay of BK virus.

PMID- 11217385
TI  - SV40-mediated immortalization.

PMID- 11217387
TI  - Biology of p53 and SV40 large T association.

PMID- 11217388
TI  - Binding of SV40 large T antigen to the retinoblastoma susceptibility gene product
      and related proteins.

PMID- 11217389
TI  - In situ electroporation for the measurement of c-Ras activation by SVLT.

PMID- 11217390
TI  - Role of SV40 small t in cell lysis, transformation, and signaling.

PMID- 11217391
TI  - Cytotoxic T lymphocytes in SV40 infections.

PMID- 11217392
TI  - Detection of SV40 DNA sequences in human tissue.

PMID- 11217393
TI  - Guide to techniques in creating transgenic mouse models using SV40 T antigen.

PMID- 11217395
TI  - Methods for studying interactions between Simian virus 40 T-antigen and the viral
      origin of replication.

PMID- 11217394
TI  - Molecular methods for identification and genotyping of BK virus.

PMID- 11217396
TI  - Cell-free transcription of SV40.

PMID- 11217397
TI  - Quantitation and structural analysis of SV40 RNAs.

PMID- 11217398
TI  - Propagation and assay of the JC virus.

PMID- 11217399
TI  - Hantaviruses: history and overview.

PMID- 11217400
TI  - Clinical manifestations of New World hantaviruses.

PMID- 11217401
TI  - Clinical characteristics of hantavirus infections on the Eurasian continent.

PMID- 11217402
TI  - Replication of hantaviruses.

PMID- 11217403
TI  - Human immune response, host genetics, and severity of disease.

PMID- 11217404
TI  - Vaccines against hantaviruses.

PMID- 11217405
TI  - Hantavirus maturation.

PMID- 11217406
TI  - Virus evolution and genetic diversity of hantaviruses and their rodent hosts.

PMID- 11217407
TI  - Modeling hantavirus maintenance and transmission in rodent communities.

PMID- 11217408
TI  - Cellular receptors and hantavirus pathogenesis.
AB  - Hantaviruses cause two potentially lethal diseases, HPS and HFRS, and both
      diseases result in defects in vascular permeability and platelet function. Human
      beta 3 integrins confer cellular susceptibility to HPS- and HFRS-causing
      hantaviruses, a fact directly linking platelets, endothelial cells, and
      hantavirus diseases to the use of [figure: see text] cellular receptors that
      maintain capillary integrity and regulate platelet function. The role of
      vitronectin, PAI-1, uPAR, and complement cascades in hantavirus pathogenesis are
      unstudied but may contribute to specific disease syndromes effected by
      hantaviruses. The divergence of hantavirus surface glycoproteins and common beta
      3-integrin usage provides further insight into the interaction of hantaviruses
      with cells. G1 and G2 glycoprotein variation is likely to contribute to
      additional interactions that determine pathogenic responses to individual
      viruses. beta 3-integrin usage also suggests that common elements exist on G1 or
      the more highly conserved G2 surface glycoprotein, which mediate viral attachment
      to integrins. Although there is currently no data defining the virion attachment
      protein, the development of antibodies that recognize the hantavirus attachment
      protein and block integrin interactions is of interest since it is likely to
      provide an additional point for therapeutic intervention and vaccine development.
      There are a plethora of effects that could be elicited by hantavirus regulation
      of cellular beta 3 integrins and their ligands that are consistent with
      hantavirus diseases. Since beta 3 integrins are critical adhesive receptors on
      platelets and endothelial cells and regulate both vascular permeability and
      platelet activation and adhesion, the use of these receptors by hantaviruses is
      likely to be fundamental to hantavirus pathogenesis. The lack of an animal model
      for hantavirus pathogenesis has prevented a systematic analysis of immune and
      cellular responses to hantavirus infections, and it impedes our ability to study
      protective or therapeutic approaches to hantavirus diseases. However, recent
      findings suggest that human beta 3 integrins within transgenic mice may provide
      animal models of hantavirus pathogenesis and have the potential to radically
      alter the ability to investigate hantavirus disease.

PMID- 11217410
TI  - Physiology, regulation, and limits of the synthesis of poly(3HB).
AB  - The properties of poly(3-hydroxybutyrate) combined with the fact that it can be
      produced easily by numerous prokaryotes from renewable resources and even from
      potentially toxic waste products using well-known fermentation processes have
      generated keen interest in this biopolyester as a substitute for chemo-synthetic
      petroleum-derived polymers in many applications. However, the high price of
      poly(3HB) compared with the conventional synthetic materials currently in use has
      restricted its availability in a wide range of applications. If the economic
      viability of poly(3HB) production and its competitiveness are to be improved,
      more must be found out about the phenotypic optimization and the upper limits of
      bacterial systems as the factory of poly(3HB). In this chapter, two aspects of
      poly(3HB) are reviewed--poly(3HB) formation as a physiological response to
      external limitations and overcoming internal bottlenecks, and poly(3HB) as a
      commercially attractive polyester. From a physiological viewpoint, the ability to
      synthesize and degrade poly(3HB) is considered an investment in the future and
      provides organisms with a selective advantage. Poly(3HB) is presented as a
      strategic survival polymer, and it is shown that growth-associated synthesis is
      not as rare as reported. The influence of the efficiency and velocity of cell
      multiplication and product formation, of poly(3HB) content and of productivity on
      the overall yield, and finally on the economics of the whole process are
      discussed and evaluated from the technological or consumer's point of view. The
      specific production rate and poly(3HB) content appear to be more important than
      the yield coefficients.

PMID- 11217411
TI  - Production of microbial polyesters: fermentation and downstream processes.
AB  - Poly(3-hydroxyalkanoates) (PHAs) constitute a large and versatile family of
      polyesters produced by various bacteria. PHAs are receiving considerable
      attention because of their potential as renewable and biodegradable plastics, and
      as a source of chiral synthons since the monomers are chiral. Industrial PHA
      production processes have been developed for poly(3-hydroxybutyrate) (poly(3HB))
      and poly(3-hydroxybutyrate-co-3-valerate) (poly(3HB-co-3HV). More than 100 other
      poly(3HAMCL)s, characterized by monomers of medium chain length, have been
      identified in the past two decades. These monomers typically contain 6-14 carbon
      atoms, are usually linked via-3-hydroxy ester linkages, but can occasionally also
      exhibit 2-, 4-, 5-, or 6-hydroxy ester linkages. Such polyesters are collectively
      referred to as medium chain length PHAs poly(3HAMCL)s. The vast majority of these
      interesting biopolyesters have been studied and produced only on the laboratory
      scale. However, there have been several attempts to develop pilot scale
      processes, and these provide some insight into the production economics of
      poly(3HAMCL)s other than poly(3HB) and poly(3HB-co-3HV). These processes utilize
      diverse fermentation strategies to control the monomer composition of the
      polymer, enabling the tailoring of polymer material properties to some extent.
      The best studied of these is poly(3-hydroxyoctanoate) (poly(3HO)), which contains
      about 90% 3-hydroxyoctanoate. This biopolyester has been produced on the pilot
      scale and is now being used in several experimental applications.

PMID- 11217409
TI  - Polyesters in higher plants.
AB  - Polyesters occur in higher plants as the structural component of the cuticle that
      covers the aerial parts of plants. This insoluble polymer, called cutin, attached
      to the epidermal cell walls is composed of interesterified hydroxy and hydroxy
      epoxy fatty acids. The most common chief monomers are 10,16-dihydroxy C16 acid,
      18-hydroxy-9,10 epoxy C18 acid, and 9,10,18-trihydroxy C18 acid. These monomers
      are produced in the epidermal cells by omega hydroxylation, in-chain
      hydroxylation, epoxidation catalyzed by P450-type mixed function oxidase, and
      epoxide hydration. The monomer acyl groups are transferred to hydroxyl groups in
      the growing polymer at the extracellular location. The other type of polyester
      found in the plants is suberin, a polymeric material deposited in the cell walls
      of a layer or two of cells when a plant needs to erect a barrier as a result of
      physical or biological stress from the environment, or during development.
      Suberin is composed of aromatic domains derived from cinnamic acid, and aliphatic
      polyester domains derived from C16 and C18 cellular fatty acids and their
      elongation products. The polyesters can be hydrolyzed by pancreatic lipase and
      cutinase, a polyesterase produced by bacteria and fungi. Catalysis by cutinase
      involves the active serine catalytic triad. The major function of the polyester
      in plants is as a protective barrier against physical, chemical, and biological
      factors in the environment, including pathogens. Transcriptional regulation of
      cutinase gene in fungal pathogens is being elucidated at a molecular level. The
      polyesters present in agricultural waste may be used to produce high value
      polymers, and genetic engineering might be used to produce large quantities of
      such polymers in plants.

PMID- 11217412
TI  - Production of microbial polyester by fermentation of recombinant microorganisms.
AB  - Polyhydroxyalkanoates (PHAs) can be produced from renewable sources and are
      biodegradable with similar material properties and processibility to conventional
      plastic materials. With recent advances in our understanding of the biochemistry
      and genetics of PHA biosynthesis and cloning of the PHA biosynthesis genes from a
      number of different bacteria, many different recombinant bacteria have been
      developed to improve PHA production for commercial applications. For enhancing
      PHA synthetic capacity, homologous or heterologous expression of the PHA
      biosynthetic enzymes has been attempted. Several genes that allow utilization of
      various substrates were transformed into PHA producers, or non-PHA producers
      utilizing inexpensive carbon substrate were transformed with the PHA biosynthesis
      genes. Novel PHAs have been synthesized by introducing a new PHA biosynthesis
      pathway or a new PHA synthase gene. In this article, recent advances in the
      production of PHA by recombinant bacteria are described.

PMID- 11217413
TI  - Production of polyesters in transgenic plants.
AB  - Polyhydroxyalkanoates (PHAs) are bacterial polyesters having the properties of
      biodegradable thermoplastics and elastomers. Synthesis of PHAs has been
      demonstrated in transgenic plants. Both polyhydroxybutyrate and the co-polymer
      poly(hydroxybutyrate-co-hydroxyvalerate) have been synthesized in the plastids of
      Arabidopsis thaliana and Brassica napus. Furthermore, a range of medium-chain
      length PHAs has also been produced in plant peroxisomes. Development of
      agricultural crops to produce PHA on a large scale and at low cost will be a
      challenging task requiring a coordinated and stable expression of several genes.
      Novel extraction methods designed to maximize the use of harvested plants for
      PHA, oil, carbohydrate, and feed production will be needed. In addition to their
      use as plastics, PHAs can also be used to modify fiber properties in plants such
      as cotton. Furthermore, PHA can be exploited as a novel tool to study the carbon
      flux through various metabolic pathways, such as the fatty acid beta-oxidation
      cycle.

PMID- 11217414
TI  - In vitro biosynthesis of polyesters.
AB  - In vitro synthesis of polyesters using isolated enzymes as catalyst via non
      biosynthetic pathways is reviewed. In most cases, lipase was used as catalyst and
      various monomer combinations, typically oxyacids or their esters, dicarboxylic
      acids or their derivatives/glycols, and lactones, afforded the polyesters. The
      enzymatic polymerization often proceeded under mild reaction conditions in
      comparison with chemical processes. By utilizing characteristic properties of
      lipases, regio- and enantioselective polymerizations proceeded to give functional
      polymers, most of which are difficult to synthesize by conventional
      methodologies.

PMID- 11217415
TI  - Properties, modifications and applications of biopolyesters.
AB  - Poly(hydroxyalkanoates) (PHAs), of which poly(hydroxybutyrate) (PHB) is the most
      common, can be accumulated by a large number of bacteria as energy and carbon
      reserve. Due to their biodegradability and biocompatibility these optically
      active biopolyesters may find industrial applications. A general overview of the
      physical and material properties of PHAs, alongside with accomplished
      applications and new developments in this field is presented in this chapter. The
      properties of PHAs are dependent on their monomer composition and therefore it is
      of great interest that recent research has revealed that, in addition to PHB, a
      large variety of PHAs can be synthesized microbially. The monomer composition of
      PHAs depends on the nature of the carbon source and microorganism used. PHB is a
      typical highly crystalline thermoplastic whereas medium chain length PHAs are
      elastomers with low melting points and a relatively lower degree of
      crystallinity. By (chemical) modification of the PHAs, the ultimate properties of
      the materials can be adjusted even further, when necessary. Applications that
      have been developed from PHB and related materials (e.g. Biopol) can be found in
      very different application areas and cover packaging, hygienic, agricultural and
      biomedical products. Recent application developments based on medium chain length
      PHAs range from high solid alkyd-like paints to pressure sensitive adhesives,
      biodegradable cheese coatings and biodegradable rubbers. Technically, the
      prospects for PHAs are very promising. When the price of these materials can be
      further reduced, application of biopolyesters will also become economically very
      attractive.

PMID- 11217416
TI  - Microbial degradation of polyesters.
AB  - Polyesters, such as microbially produced poly[(R)-3-hydroxybutyric acid]
      [poly(3HB)], other poly[(R)-hydroxyalkanoic acids] [poly(HA)] and related
      biosynthetic or chemosynthetic polyesters are a class of polymers that have
      potential applications as thermoplastic elastomers. In contrast to poly(ethylene)
      and similar polymers with saturated, non-functionalized carbon backbones,
      poly(HA) can be biodegraded to water, methane, and/or carbon dioxide. This review
      provides an overview of the microbiology, biochemistry and molecular biology of
      poly(HA) biodegradation. In particular, the properties of extracellular and
      intracellular poly(HA) hydrolyzing enzymes [poly(HA) depolymerases] are
      described.

PMID- 11217417
TI  - Polyesters from microorganisms.
AB  - Bacterial polyesters have been found to have useful properties for applications
      as thermoplastics, elastomers, and adhesives and are biodegradable and
      biocompatible. Poly(3-hydroxyalkanoates) (PHAs) and poly(beta-malate) are the
      most representative polyesters synthesized by microorganisms. PHAs containing a
      wide variety of repeating units can be produced by bacteria, including those
      containing many types of pendant functional groups which can be synthesized by
      microorganisms that are grown on unnatural organic substrates. Poly(beta-malate)
      is of interest primarily for medical applications, especially for drug delivery
      systems. In this chapter, the bacterial production and properties of poly(3
      hydroxyalkanoates) and poly(beta-malate) are described with emphasis on the
      former.

PMID- 11217419
TI  - The history and biology of Marek's disease virus.

PMID- 11217418
TI  - Biochemical and molecular basis of microbial synthesis of polyhydroxyalkanoates
      in microorganisms.
AB  - Intensive research on the physiology, biochemistry, and molecular genetics of the
      metabolism of polyhydroxyalkanoates (PHA) during the last 15 years has revealed a
      dramatic increase of our knowledge on the biosynthesis of these polyesters in
      bacteria. This mainly very basic research has revealed several new, hitherto not
      described enzymes and pathways. In addition, many genes encoding the enzymes of
      these pathways and in particular the key enzyme of PHA biosynthesis, PHA
      synthase, were cloned and characterized at a molecular level. This knowledge was
      utilized to establish PHA biosynthesis in many prokaryotic and eukaryotic
      organisms, which were unable to synthesize PHAs, and to apply the methodology of
      metabolic engineering, thus opening new perspectives for the production of
      various PHAs by fermentation biotechnology or agriculture in economically
      feasible processes. This contribution summarizes the properties of PHA synthases
      and gives an overview on the genes for these enzymes and other enzymes of PHA
      biosynthesis that have been cloned and are available. It also summarizes our
      current knowledge on the regulation at the enzyme and gene level of PHA
      biosynthesis in bacteria.

PMID- 11217420
TI  - Genetic resistance to Marek's disease.

PMID- 11217421
TI  - The genomic structure of Marek's disease virus.

PMID- 11217422
TI  - Protein-coding content of the sequence of Marek's disease virus serotype 1.

PMID- 11217423
TI  - A complete genomic DNA sequence of Marek's disease virus type 2, strain HPRS24.

PMID- 11217424
TI  - Marek's disease virus latency.
AB  - MDV latency is defined as the persistence of the viral genome in the absence of
      production of infectious virus except during reactivation. A number of systems
      for studying MDV latency exist, and most involve the use of lymphoblastoid cells
      or tumors. It has been difficult to divorce latency and transformation.
      Understanding the relationship between these two states remains a major challenge
      for the MDV system. Based on their patterns of expression, the MDV LATs are apt
      to be important in the balance between latent and lytic infections. The LATs are
      a complex group of transcripts. The profile of gene expression that characterizes
      latency differs among all herpesviruses, and MDV is no exception. MDV LATs bear
      little resemblance to LATs of other alphaherpesviruses or to the LATs of other
      lymphotropic herpesviruses. LAT splicing patterns are complex and the
      relationships among various spliced species or between these species and the
      large 10-kb transcript are unknown. In addition, the existence of any protein
      gene products of significance is unknown at this time. More work is needed to
      further investigate the significance and function of these RNAs. Better
      technology to construct mutants in the MDV system is badly needed, since the
      analysis of mutants in the chicken is a powerful and unique advantage of the MDV
      system.

PMID- 11217425
TI  - Meq: an MDV-specific bZIP transactivator with transforming properties.

PMID- 11217426
TI  - Pathogenesis of Marek's disease virus infection.

PMID- 11217427
TI  - Polyvalent recombinant Marek's disease virus vaccine against poultry diseases.

PMID- 11217428
TI  - Protective efficacy of Marek's disease vaccines.

PMID- 11217430
TI  - [Differential diagnosis of primary lung tumors and pulmonary metastases].
AB  - The lungs are frequent metastatic targets for metastases of extrapulmonary cancer
      with or without known primary tumor. Metastases of extrapulmonary tumors are
      found in 20 to 50%. Metastatic carcinoma of unknown primary localizations
      contributes to about 4% of all diagnosed carcinomas. Within this group
      adenocarcinomas can be found in 60%, squamous cell carcinomas in 15%, unspecified
      tumors including small cell and undifferentiated tumors in 25% histogenetically.
      Due to overlapping histologic features a histopathological distinction of primary
      and secondary tumors might be difficult. Topography, size and form of pulmonary
      growth pattern are important aspects for the differential diagnosis. Primary lung
      tumors are mainly localized in upper lobes as singular nodules, metastases in
      lower lobes as multiple lesions. For the distinction of endobronchial primary or
      secondary squamous cell carcinomas findings of severe dysplasia and CIS of the
      bronchial epithelium are important. Stroma and vascularisation pattern of primary
      and secondary lung tumors differ in distribution, arrangement and extracellular
      matrix components. Pulmonary vascular changes in primary tumors are characterized
      by vascular infiltration, destruction and occlusion whereas in secondary tumors
      intravascular embolisation and extravasation predominate. Immunohistochemical
      techniques using different algorithms of antibodies (cyto-keratins,
      neuroendocrine markers, TTF-1, vimentin, HMB 45, LCA, oncogenes, tumor suppressor
      genes etc.) give vital clues as to the origin of the primary tumor. Metastases of
      thyroid or prostate carcinomas, melanomas, sarcomas, lymphomas etc. can be
      reliably differentiated. Molecular investigations are up to now only subject in
      research.

PMID- 11217429
TI  - Immune responses to Marek's disease virus infection.

PMID- 11217431
TI  - [Differential diagnosis and etiology of epitheloid cell granulomatosis of the
      lung].
AB  - Our knowledge on epithelioid cell granulomatosis of the lung has been extended in
      recent years. New entities have been added, like zirconiosis, others like
      tuberculosis, mycobacteriosis and sarcoidosis have gained new interest, because
      molecular techniques allowed new insight into their pathogenesis and a more rapid
      and species-specific diagnosis. Experimental work in addition has added a lot of
      information about the network of cytokines and other inflammatory mediators
      responsible for granuloma formation, however, our knowledge of this network is
      still incomplete. Three types of agents are now known to cause epitheloid cell
      granulomas: infectious organisms (bacteria, fungi, and parasites), products of
      plants and animals (pollen, sporangia, proteins), and metallic compounds. In
      addition there is still a group of epithelioid cell granulomatoses with unknown
      etiology. Sarcoidosis, one of these granulomatosis, has recently elicited an old
      controversy: By molecular techniques Mycobacteria and Corynebacterium acnes have
      been identified in sarcoid granulomas and a link to the aetiology of sarcoidosis
      has been proposed. If these bacteria induce some cases of sarcoidosis by an
      allergic mechanism, has still to be proven.

PMID- 11217432
TI  - [Value of bronchoalvoeolar lavage in the diagnosis of lung disease].
AB  - Bronchoalveolar lavage (BAL) is an important tool for evaluating interstitial
      lung diseases. It provides information on inflammatory cells which play an
      important role in the pathogenesis of such diseases and complements the
      information of the lung biopsy. The method is based on the observation, that the
      cells recovered by BAL reflect the population of cells in pulmonary parenchyma.
      In healthy subjects the main cells in the lavage fluid are macrophages (> or =
      80%), lymphocytes (10-20%), some few neutrophils (< or = 4%), eosinophils (< or =
      3%) and single mast cells. There are significant differences in the distribution
      of cell types in never-smokers, exsmokers and current smokers. Generally the
      increase in the number of lymphocytes is a hallmark of granulomatous and allergic
      lung diseases. Evaluation of the lymphocyte surface antigen phenotypos allows the
      recognition of sarcoidosis (increased proportion of T-helper lymphozytes) and
      extrinsic allergic alveolitis (increased proportion of T-suppressor lymphocytes).
      High neutrophil counts are characteristic of fibrosing processes or of
      occupational diseases caused by inhalation of inorganic dust. The evaluation of
      the diagnostic accuracy of the BAL is difficult because the final diagnosis of
      many symptomatically cured patients is not clear. Nevertheless, the evaluation of
      our cases showed a surprisingly high overall diagnostic accuracy (> 80%).
      However, the accuracy of negative diagnosis (exclusion of a certain disease) is
      slightly higher than this of the positive ones (diagnosis confirmed).

PMID- 11217433
TI  - [Tumorigenesis after intra-portal pancreatic islet transplantation in diabetic
      rats].
AB  - In a novel model of hepatocarcinogenesis, a low number of isologous pancreatic
      islets were transplanted via the portal veins into the livers of streptozotocin
      diabetic rats. The number of islets is chosen so low, that the diabetic state is
      only ameliorated by the islet transplantation. The permanent high blood glucose
      stimulates the beta-cells of the islet transplants to permanent maximal synthesis
      and secretion of insulin which causes hyper-insulinemia in the liver acini
      downstream of the transplants. The hepatocytes of these acini show alterations
      which are typical for insulin effects but also for glycogen storing foci of
      altered hepatocytes induced by different protocols of experimental
      hepatocarcinogenesis in different species, and which are also found in human
      preneoplastic liver foci. Indeed, the altered hepatocytes after low-number islet
      transplantation proceeded in long-term experiments to hepatocellular adenomas and
      hepatocellular carcinomas. Hyperplasia of islet cells developed in the
      transplanted islets, as a consequence of hyperglycemia which for the beta cells
      is not only a secretory, but also a proliferative stimulus. Six out of 33 animals
      between the 18th and the 24th month after islet transplantation changed from
      hyperglycemia to severe hypoglycemia, due to insulinomas which had developed in
      the liver from the transplanted islets. Development of hepatocellular tumors as
      well as insulinomas start in this model with alterations, which have been shown
      to be of preneoplastic nature. They can be understood as local pathological
      adaptative phenomena without the postulate of a primary genetic damage.

PMID- 11217434
TI  - [Monocytic B-cells represent a new cell population that is mainly recruited from
      unmutated polyconal naive B-cells].
AB  - Monocytoid B-cells appear as a distinct B-cell population in a number of
      lymphadenopathies but above all in Piringer's lymphadenopathy. Up until now,
      their assignment to a recognised B-cell subpopulation has not been conclusively
      achieved. Immunohistological studies have shown characteristics in common with
      the tumour cells of hairy cell leukemia and also with so-called splenic marginal
      zone cells. In order to unequivocally clarify their B-cell differentiation stage
      we have isolated single monocytoid B-cells from immunostained frozen sections and
      have analysed their immunoglobulin chain gene rearrangements. In addition we have
      studied the Ig-expression of monocytoid B-cells at both the RNA and protein
      levels.

PMID- 11217435
TI  - [Genetic and biological features define two types of follicular non-Hodgkin grade
      3 lymphoma].
AB  - In the REAL classification system, follicular lymphomas (FL) were subdivided into
      three grades depending on the number of blasts (6). In this study, we were
      interested in defining biological parameters possibly being important in the
      delineation of subgroups. Between 1990 and 1998, biological and cytogenetic
      investigations were performed on 91 FL. Clonal aberrations were found in all
      cases. The tumours were subclassified according to the blast content and the
      morphology of the centrocytes into 29 FL 1, 33 FL 2, 15 FL 3, and 14 FL 3 with a
      diffuse large B-cell lymphoma component (FL 3 + DLBL). They were characterised by
      classical cytogenetics, for their mitotic (MI) and proliferative (PI) indices,
      and CD10, bcl-2, and p53-expression. In contrast to FL 1 and FL 2, which showed a
      common genetic background with t(14;18), and only differed by their blast content
      and MI/PI, FL 3 (with or without associated DLBL) turned out to be an
      inhomogeneous group. 11 follicular lymphomas (with > 150 blasts/10HPF) still
      showed maturation to centrocytes. They were positive for CD10 and harboured the
      t(14;18) in 73%. These cases correspond to a "high grade" variant of
      centroblastic-centrocytic lymphoma according to the Kiel classification (FL 3a).
      In 18 cases with a follicular or follicular and diffuse growth pattern, the
      infiltrate consisted of centroblasts exclusively. These tumours were CD10+ in
      only 50% and were t(14;18)+ in only 22%. Secretory differentiation (clg+) was
      found in 44%. They were--with respect to primary and secondary chromosome
      aberrations--more comparable to a follicular variant of DLBL and hence,
      correspond to centroblastic lymphoma, follicular or centroblastic lymphoma,
      follicular and diffuse according to the Kiel classification (FL 3b). By
      histomorphological, biological and cytogenetic investigations, therefore, FL 3
      can be delineated into two different biological subgroups with obviously
      different transformation pathways.

PMID- 11217436
TI  - [Analysis of clonality of nephroblastomas in patients with Wilms tumors].

PMID- 11217437
TI  - [Morphologic response evaluation of neoadjuvant chemotherapy of gastric
      carcinoma].
AB  - A primary goal of the histopathologic evaluation of the gastric resection
      specimen is the determination of prognostically relevant factors, but it is not
      known whether, following neoadjuvant therapy, these factors have the same
      influence on prognosis. The goal of this study was to investigate prognostically
      relevant macroscopic and microscopic findings after neoadjuvant chemotherapy. The
      resection specimens of 36 patients with locally advanced gastric carcinoma who
      had been treated with Etoposide, Adriamycin and Cisplatin were investigated with
      respect to tumor size, Lauren type, ypTNM, UICC R-status, lymphangiosis, and
      degree of regression. On the basis of these factors, a prognosis score was
      developed that included both the degree of regression (grade 1-3), staging
      parameters (UICC T-category, R-status), tumor size and lymphatic vessel invasion.
      All of the parameters were weighted according to a score (1 point--best, 3 points
      -worst). The points were added for each individual case and the cases were
      divided into three prognosis groups, Group A: 5-7 points (n = 5), Group B: 8-10
      points (n = 15), and Group C: > or = 11 points (n = 16). When compared with
      survival by the Kaplan-Meier method, these three prognosis groups showed highly
      significant differences (p < 0.0001). These results demonstrate that it is
      possible to accurately predict survival using resection specimens following
      neoadjuvant chemotherapy, which could lead to the identification of subgroups for
      which additional, further adjuvant therapy might be useful.

PMID- 11217438
TI  - [beta-Catenin induces invasive growth by activating matrix metalloproteinases in
      colorectal carcinoma].
AB  - beta-catenin was shown to be a major oncoprotein in colon cancer development. Its
      oncogenic function as a transcriptional activator is upregulated by mutations in
      the APC tumor suppressor gene, leading to a constitutive activation of the
      proliferation-associated genes c-myc and cyclin D. The aim of this study was to
      demonstrate a role of APC-mutations and dysregulated beta-catenin also for the
      progression of colorectal cancer, by identifying new target genes of beta-catenin
      associated with tumor invasion and metastasis. Potential invasion genes regulated
      by beta-catenin and its DNA binding partner TCF4 were identified by a computer
      search for the consensus DNA binding sequence in relevant promoter regions.
      Specific DNA binding was confirmed by gel shift assays. Functional importance of
      beta-catenin for the activation of identified genes was determined by luciferase
      reporter assays. The significance was demonstrated by coexpression of nuclear
      beta-catenin and the identified target genes by immunohistochemistry. Among other
      invasion genes, we identified the matrix metallo proteinases MMP-7 and MMP-1
      activated by beta-catenin in the tumor cells. MMP-7 is an important factor for
      invasion and metastasis and overexpressed in 75% of colon carcinomas. The
      significance for human colon cancer development was demonstrated by a correlated
      overexpression of beta-catenin and the MMPs, beginning in large, severely
      dysplastic adenomas. Our results explain the high percentage of MMP-7
      overexpression in colorectal tumors and the resulting activation of invasive
      growth. Moreover by identifying dysregulated beta-catenin as a transcriptional
      activator of MMPs and other invasion factors, we demonstrated an important role
      of mutated APC not only for early steps but also for the progression of
      colorectal carcinogenesis.

PMID- 11217439
TI  - [beta-Catenine as a genomic target of high-grade microsatellite instability in
      colorectal cancer].
AB  - AIMS: Various inherited and acquired alterations affecting the genes and gene
      products of the WNT pathway appear to be involved in the different molecular
      routes leading to colorectal cancer (CRC). This study was initiated to
      investigate the prevalence of somatic mutations in the beta-catenin gene (CTNNB1)
      and the associated pathology in CRC with defective DNA mismatch repair. METHODS:
      Paraffin and/or frozen sections of 33 primary CRC (including any liver and lymph
      node metastases present) with high-grade microsatellite instability (MSI-H; i.e.
      with > or = 5 unstable microsatellite markers of 10 tested) were polytopically
      fractionated by microdissection. Genomic and c-DNA samples were sequenced across
      exons 2-4 of CTNNB1 and the expression patterns of beta-catenin (beta-C) analyzed
      by immunohistology and Western blotting. RESULTS: Seven somatic mutations
      affecting phosphorylation sites of exon 3 (2 deletions also encompassing parts of
      either intron 2 or exon 4 [delta X2/3 bzw. delta X3/4] and 5 missense mutations
      [2 x T41A, 2 x S45F, S45P]) were identified. Two mutations (delta X3/4 and S45F)
      were concordantly present in CRC primaries and their respective metastases
      whereas the S45P mutation was restricted to a hepatic metastasis. In the delta
      X2/3 CRC primary only a shortened 66 kD CTNNB1 gene product was present while its
      associated liver metastasis showed a total loss of beta-C expression.
      CONCLUSIONS: Both exon 3 and the entire locus coding for beta-C are somatically
      altered in approximately 20% of CRC with MSI-H at different stages of tumor
      progression. Thus CTNNB1 appears to be a genomic target for complex oncogenic
      mutations and deletional processes in a substantial fraction of this molecular
      subset of CRC.

PMID- 11217440
TI  - [New immunotherapeutic approaches for the treatment of anaplastic large cell
      lymphoma in a mouse model].
AB  - As there is still a high mortality of the large cell anaplastic non Hodgkin
      lymphoma (ALCL) (between 40-70%, depending on prognostic factors) there is a need
      for new therapeutic approaches. Therefore, we studied different strategies for
      cancer immunotherapy in an immunogenic ALCL tumor model system: A murine IL-9
      dependent T cell line was transfected with IL-9 cDNA, resulting in an autonomous
      growing T cell line designated G6BB, which had a high tumor incidence after
      injecting of as few as 10(4) cells subcutaneously into syngeneic C57Bl/6 mice.
      Tumor growth, dissemination, histology, and immunohistochemistry were similar to
      human ALCL. This mouse model provides an immunogenic in vivo system to
      investigate antitumor immunotherapies. In order to increase antigen recognition
      by T cells and T cell activation, we administered tumor bearing mice cell-based
      cancer vaccines with irradiated tumor cells alone or in combination with
      immunostimulating CpG-Oligonucleotides, a combination of Th1 cytokines and Th2
      cytokine antibodies (IL-12, IFN-gamma, GM-CSF, Anti-IL-10) (after detecting a Th2
      cytokine profile in G6BB), or the recall antigens diphtheria, pertussis, and
      tetanus.

PMID- 11217441
TI  - [CD143 expression in testicular germ cell tumors].
AB  - CD143 (angiotensin I-converting enzyme) occurs in two isoforms: a testicular form
      (tCD143) expressed during spermatogenesis, and a somatic form (sCD143) generally
      found in certain other cell types. To study these isoforms in normal and
      neoplastic germ cells of humans, we analyzed a broad collective of different
      testicular germ cell tumors (GCTs) of adults, adjacent intratubular germ cell
      neoplasms (IGCNs), and testicular tissues representing the regular germ cell
      development. Different techniques were employed on fresh frozen and formalin
      fixed, paraffin-embedded tissues: CD143-mRNAs were analyzed by RT-PCR on selected
      cells after UV-laser-assisted cell picking and by in-situ hybridization using
      cRNA probes; the proteins were analyzed by semi-quantitative immunohistochemistry
      using monoclonal antibodies to CD143, and to PLAP/GCAP as controls. In contrast
      to normal germ cells bearing only tCD143 during spermiogenesis, both mRNA and
      protein of sCD143 were detected in neoplastic cells of all IGCNs and in the
      majority of seminomas. sCD143 expression also was found during testicular
      development, but was differently regulated in fetal germ cells and in GCTs
      compared with PLAP/GCAP. Thus, our findings (i) demonstrate profound changes in
      the expression of both CD143 isoforms during regular germ cell development and
      maturation, (ii) suspect sCD143 being involved in the regulation of germinal stem
      cell proliferation, (iii) are in agreement with the concept of an 'embryonic
      state' of neoplastic germ cells, (iv) indicate a close molecular relationship
      between IGCN and seminoma and, finally, (v) suggest sCD143 as an appropriate
      marker in the diagnosis of seminomas in addition to PIAP/GCAP.

PMID- 11217442
TI  - [Rudolf Virchow Prize 2000 from the German Society of Pathology].

PMID- 11217444
TI  - [List of members].

PMID- 11217443
TI  - Tumor patterning: analogies of neoplastic morphogenesis with embryogenesis.
AB  - Patterning or pattern formation is a spatial and temporal process, by which
      ordered arrangements of cells and tissue structure are attained. The term is
      mostly applied to the morphogenesis in developmental biology, but it can also be
      useful for the neomorphogenesis in tumor biology. Despite increasing data on the
      proliferation and differentiation of tumor cells, processes of tumor patterning
      are rarely studied and poorly understood. A fundamental embryonic process of
      patterning is the gastrulation and a basic example of neoplastic patterning is
      the colonic adenoma-carcinoma sequence. Both processes exhibit distinct nuclear
      translocations and expressions of beta-catenin, which is considered to be a
      decisive transcriptional regulator. Our recent studies demonstrate striking
      analogies of patterning and nuclear beta-catenin expressions between the colonic
      adenoma-carcinoma sequence and the gastrulation steps. The shared patterns are
      dissociation, reassembly, tubular reconstruction and branching of neoplastic
      cells in association with nuclear beta-catenin expressions. These new findings
      establish patterning as a relevant concept for tumor biology and link the
      neoplastic morphogenesis with embryogenesis.

PMID- 11217446
TI  - Tumor cell-matrix interaction: pericellular matrix degradation and metastasis.
AB  - In order to determine key MMPs for invasion and metastasis in various human
      cancers, we examined the expression of ten MMPs (MMP-1, 2, 3, 7, 8, 9, 13 and
      MT1, 2, 3-MMPs) and tissue inhibitors of metalloproteinases (TIMP-1 and 2) in
      breast carcinomas, thyroid papillary carcinomas, endometrial carcinomas, ovarian
      carcinomas, gastric adenocarcinomas, oral squamous cell carcinomas and gliomas.
      Of the MMPs examined, the activation of proMMP-2 by MT1-MMP (membrane type 1-MMP)
      was commonly important for the invasion and metastasis of these cancers except
      for endometrial carcinomas. The MMP-2 and MT1-MMP were localized to the carcinoma
      cells and gelatinolytic activity was demonstrated within the carcinoma cell nests
      by in situ zymography. In endometrial carcinomas, production and activation of
      proMMP-7 were a key determinant of the lymph node metastasis. The activation of
      proMMP-2 in gliomas involved MT2-MMP as well as MT1-MMP, and a combination of
      decreased TIMP-2 production and enhanced MT1-MMP expression was important in the
      subarachnoidal dissemination of glioblastoma cells. Brevican, a major adult brain
      proteoglycan, was degraded with MMP-1, 2, 3, 7, 10 and ADAMTS4 (aggrecanase-1) by
      being cleaved at the MMP site (the Ala360-Phe361 bond) with the MMPs and ADAM
      site (the Glu395-Ser396 bond) with ADAMTS4. Since activated MMP-2 and ADAMTS4 are
      present in human glioma tissues, they may play a key role in the invasion of
      glioma cells through the brevican degradation. The data in the present study
      suggest that the extracellular matrix-degrading metalloproteinases acting
      probably on the cell membranes of cancer cells are essential to the invasion and
      metastasis of human cancers.

PMID- 11217445
TI  - Molecular aspects of adhesion-epigenetic mechanisms for inactivation of the E
      Cadherin-mediated cell adhesion system in cancers.
AB  - E-Cadherin and its undercoat proteins, alpha- and beta-Catenins, which connect
      cadherins to actin filaments and establish firm cell-cell adhesion, act as an
      invasion suppressor system. It was demonstrated that transcriptional inactivation
      of E-Cadherin expression occurred frequently in tumor progression, and that E
      Cadherin expression in human cancer cells was regulated by CpG methylation around
      the promoter region. In diffusely infiltrating cancers, mutations were found in
      the genes for E-Cadherin and alpha- and beta-Catenins. The E-Cadherin-mediated
      cell-adhesion system is inactivated by tyrosine phosphorylation of beta-Catenin
      at the invading front of cancers with high metastatic ability. An attempt was
      made to identify the kinases that participate in the aberrant tyrosine
      phosphorylation, and c-erbB-2 protein was found to be directly associated with
      beta-Catenin. Transfection of N-terminally deleted beta-Catenin, which binds to c
      erbB-2 but not to cadherin, markedly reduced peritoneal dissemination and
      hematogenous metastasis of gastrointestinal cancer cells in mouse inoculation
      models. Regulation of the E-Cadherin-mediated cell adhesion system by tyrosine
      phosphorylation of beta-Catenin is important in determining the biological
      properties of human cancers. Tumor cells are dissociated throughout the entire
      tumor masses of diffuse-type cancers, whereas those of solid tumors with high
      metastatic potentials are often focally dissociated or dedifferentiated at the
      invading fronts. Thus, both irreversible and reversible mechanisms for
      inactivating the E-Cadherin-mediated cell adhesion system well correspond to the
      pathological features of human cancers.

PMID- 11217447
TI  - [Opening address of the President. Molecular patholgy: challenge, risks and
      chance].

PMID- 11217448
TI  - Molecular aspects of invasion and metastasis of stomach cancer.
AB  - The scenario of multiple genetic and epigenetic alterations found in gastric
      carcinoma differs depending upon the two histological types, indicating that well
      differentiated or intestinal type and poorly differentiated or diffuse type
      gastric carcinomas have different genetic pathways. Cancer-stromal interaction
      through growth factor/cytokine receptor system which plays a central role in
      invasion and metastasis, is also different between the two types of stomach
      cancer. The majority of gastric carcinoma exhibit co-expression of IL-8 and its
      two receptors that evidently confer tumor angiogenesis. IL-8 increases the
      expression of EGF receptor, VEGF and IL-8 itself by tumor cells themselves,
      whereas IL-8 decreases expression of E-Cadherin, associated with increase in
      expression and activity of MMP-9 by tumor cells. These findings overall suggest
      that IL-8 produced by gastric cancer cells is used for sustained angiogenesis and
      tissue invasion and metastasis via autocrine/paracrine manners. On the other
      hand, co-expression of osteopontin (OPN) and CD44v9 in tumor cells correlates
      well with the degree of lyiphatic vessel invasion or long distant lymph node
      metastasis in diffuse type gastric carcinoma, indicating that mutual interaction
      between OPN and CD44v9 on the tumor cells is implicated in lymphogenous
      metastasis. In addition to these factors, tumor invasion and metastasis requires
      telomere maintenance regulated by telomerase activity. The human telomerase
      catalytic subunit, hTERT, is strongly expressed in almost all primary tumors and
      nodal metastasis.

PMID- 11217449
TI  - [Forms and nomenclature of gastrointestinal epithelial expansion: what is
      invasion?].
AB  - In the gastrointestinal (GI) glandular mucosa, the term invasion is ill defined
      until today. In order to standardize the nomenclature of the expansion of benign
      and early malignant tumors of the glandular epithelium, we tried to establish a
      new descriptive terminology: In adenomas, the first glands with neoplastic
      epithelium may be divided by gland fission before there is primary superficial
      lateral expansion, followed by luminal expansion in form of budding, glandular
      fission and minimal branching, and a secondary downward vertical intra- and
      intertubular expansion into the mucosa. The different growth types of GI adenomas
      differ in the proportion of these components which will be considered below. In
      contrast, mucosal carcinomas usually do not show superficial lateral expansion,
      but they are usually characterized by a primary midmucosal disorderly lateral
      intertubular expansion with irregular branching and fusion of neoplastic glands,
      with undermining of the surface epithelium, and with compression and destruction
      of neighbouring glands by lateral and downward expansion of the neoplastic
      epithelium, finally with secondary erosions. This pattern of lateral intertubular
      expansion is indicative for carcinomatous invasion in GI mucosal carcinomas. The
      permeation of basal membranes usually does not occur in well differentiated
      carcinomas, which form new basal membranes. With increasing loss of
      differentiation, there is tumor cell dissociation with permeation or no
      production of basal membranes up to the pure diffuse type carcinoma; this process
      of invasion across basal membranes is merely one, but not the only sign of
      invasion, in our view. A fibrous stromal reaction usually does not occur in the
      mucosa, but it is most intense in the submucosa and subserosa, and much less
      pronounced in the muscularis propria. This fibrous stromal reaction is also
      indicative for invasion. However, Japanese pathologists do not diagnose
      malignancy only from architectural signs of invasion but mainly from cytological
      criteria, which also have to be considered aside from structural criteria given
      above. In comparison, epithelial growth in metaplastic processes is restricted to
      intratubular expansion or glandular fission without superficial lateral
      expansion. Pseudoinvasions of cohesive and diffuse types have to be considered
      for differential diagnosis.

PMID- 11217450
TI  - [Morphology and biology of invasion with Barret's carcinoma as an example].
AB  - In order to determine the molecular genetic alterations associated with tumor
      invasion, Barrett's adenocarcinoma and its non-invasive precursor lesions were
      investigated by comparative genomic hybridization (CGH), fluorescence in situ
      hybridization (FISH), and loss of heterozygosity (LOH). Along the metaplasia
      dysplasia-carcinoma sequence in Barrett's adenocarcinoma gains on 7q, 8q, 20q,
      2p, 10q and 17q, and losses on Y, 4q, 5q, 9p 18q and 14q became steadily more
      frequent. FISH demonstrated increasing DNA copy of numbers of c-erbB-2, 20q13.2
      (AIB), c-myc and cyclin D1 during the development of Barrett's adenocarcinoma,
      and LOH confirmed DNA losses on 5q21 (APC) and 18q (DCC). Some of the chromosomal
      changes of the non-invasive precursor lesions were significantly different from
      the alterations detected in invasive carcinoma. Although molecular pathology may
      be used as diagnostic adjunct in future, the histopathological determination of
      invasion remains the most important diagnostic criterion of malignancy in
      Barrett's adenocarcinoma.

PMID- 11217451
TI  - [Cellular proteases and invasion].
AB  - Cellular proteases are those proteases that are localized in the cytoplasm and on
      the cell surface, but not those secreted into the extracellular matrix. Proteases
      localized on the cell surface play a specific role in the invasion process of
      malignant tumor cells. These are activated by a relatively complicated cascade in
      which different cathepsins, the plasminogen activator system, plasmin, and the
      matrix metalloproteinases, including the membrane-type matrix metalloproteinases,
      play a major role. This article places emphasis on the biologic function and
      oncologic significance of cathepsins B and L, as well as on the urokinase
      plasminogen activator and the membrane-type matrix metalloproteinases localized
      on the cell surface. Recent investigations on these factors revealed that they
      are dependent on each other, such that the upregulation or downregulation also
      causes alterations in the regulation of the other factors. This fact alone
      elucidates the complexity of this system. Moreover, there is growing evidence
      that other proteases hitherto known to have other functions, e.g. as signal
      proteases in the immunologic system, may be important for invasion provesses. To
      provide an example of this, we describe the invasive potential of aminopeptidase
      N (APN/CD13). These recent results, which shed light on the role of further
      proteases in invasion processes, clearly show the complexity of this proteolytic
      system. Against this biologic background, it seems not to be promising to
      establish single proteases as distinct parameters for the prognosis of the
      metastatic potential of malignant tumors.

PMID- 11217452
TI  - [The role of inflammation in tumor invasion].
AB  - While at first inflammatory reactions within the stroma of malignant tumors have
      been considered as a sign of immunological response to the tumor, there is now
      ample evidence that inflammation is able to promote tumor progression. It is now
      clear that tumor cells themselves direct the assembly of tumor stroma, using
      signalling pathways normally confined to inflammatory cells. By producing
      inflammatory mediators, tumor cells are able to recruit inflammatory cells to the
      tumor site, induce myofibroblasts and the production of extracellular matrix
      components. Paradoxically, the host reaction assists tumor progression by
      providing optimal conditions for growth and migration of tumor cells. In order to
      achieve a better understanding of malignant tumor progression, malignant tumors
      have to be regarded as a complex interactive microecosystem of tumor cells and
      stromal elements.

PMID- 11217453
TI  - [Pathology at Kiel University].

PMID- 11217454
TI  - [Detection of isolated tumor cells in bone marrow: methodological aspects. A
      critical re-appraisal and prospects].
AB  - Systemic dissemination of tumor cells occurring prior to the diagnosis or
      resection of the primary tumor is a prerequisite for relapse at distant sites and
      a major cause for death from cancer. Although detection of isolated tumor cells
      by sensitive immunocytochemical techniques is increasingly being considered as a
      clinically relevant prognostic factor, methodical objections including a
      questionable specificity of some of the antibodies applied, the heterogenity of
      the patient cohorts and the wide variation of the reported frequencies suggest
      that an independent prognostic impact of tumor cell detection in bone marrow at
      least for most of the tumor types still remains to be proven. When compared to
      non-morphological techniques immunocytochemistry is characterized by a lower
      false positive rate. So far a standarized application of this method still holds
      the most promise for clinical practice. Alternatively the genetic diagnosis of
      isolated tumor cells is hampered by a rather high false positive rate due to
      pseudogenes and illegitimate transcription. Appropriate negative controls in
      combination with a quantification of the PCR product are one possibility to
      overcome these difficulties. The clinical utility of genetic assays as a tool for
      the estimation of prognosis and management of cancer patients still remains an
      area of active investigation.

PMID- 11217455
TI  - Molecular pathology of lung cancer.
AB  - Our understanding of the molecular pathology of lung cancer is advancing rapidly
      with several specific genes and chromosomal regions being identified. Lung cancer
      appears to require many mutations in both dominant and recessive oncogenes before
      they become invasive. Several genetic and epigenetic changes are common to all
      lung cancer histologic types, while others appear to be tumor type specific. The
      identification of those specific genes undergoing such mutations and the sequence
      of cumulative changes that lead the neoplastic changes for each lung tumor
      histologic type remain to be fully elucidated. Recent findings in normal and
      preneoplastic bronchial epithelium from lung cancer patients and smoker subjects
      suggest that genetic changes may provide in this neoplasm new methods for early
      diagnosis, risk assessment and for monitoring response to chemoprevention.

PMID- 11217456
TI  - Analgesia and analgesic techniques.
AB  - In recent years, there has been a great increase in our understanding of pain
      mechanisms and our awareness of pain in small animals. Despite increased
      knowledge, many animals still go undertreated or untreated. Small exotic animals
      are a unique group of patients, and can prove challenging for the practitioner
      concerned with their welfare. This article reviews the process of nociception and
      how one can intervene in the pain pathway. Newer analgesic drugs are discussed,
      along with some novel administration techniques that can be adapted for small
      mammals. Ketamine has been regarded primarily as a chemical restraining agent,
      but new information reveals that it may have an important place in pain
      management.

PMID- 11217457
TI  - Crocodilian anesthesia.
AB  - With declining crocodilian populations worldwide, a greater interest in the
      conservation of these animals in the wild and in captivity is ongoing. This
      effort has created a demand for safe and effective ways to handle and immobilize
      crocodiles for transport and relocation. With the advent of new anesthetic
      protocols, working with crocodilians has now been made safer for both the animal
      and the handler. Unfortunately, current anesthetic protocols have been limited to
      a few species and further application of these protocols need to be undertaken
      with new species.

PMID- 11217458
TI  - Avian anesthesia.
AB  - Providing a safe anesthetic environment is the key to successful avian
      anesthesia. Knowledge and understanding the anatomic and physiologic differences
      between birds and mammals help to prevent most emergency situations and guide
      responses in critical situations. Thorough preanesthetic history and examination,
      correction of underlying conditions, and use of simple anesthetic protocols all
      optimize the outcome of the procedure. Finally, critical monitoring helps to
      anticipate most crises and reduces incidences of mortality and morbidity in avian
      anesthesia.

PMID- 11217459
TI  - Ferret, rabbit, and rodent anesthesia.
AB  - Ferrets, rabbits, and rodents are increasingly being presented to veterinarians
      for evaluation and treatment. The owners of these animals expect high-level
      medical and surgical care. Consequently, veterinarians are more often required to
      provide intensive anesthetic management of these animals. The variability of
      anesthetic agents used and patient responses are addressed. The consequences of
      size for anesthetic management are discussed. Successful small mammal anesthesia
      requires following general anesthetic principles, awareness of limitations, and
      maintenance of high standards of care.

PMID- 11217460
TI  - Fish, amphibian, and reptile analgesia.
AB  - Pain perception and appropriate behavioral responses are important for survival.
      The conservation of the opioid ligand and receptor suggests evolution of opioid
      receptors mediating antinociception throughout vertebrate phylogeny. Fish,
      amphibians, and reptiles have appropriate neurologic components, display the
      appropriate behavior in response to a painful stimulus, and possess
      antinociceptive mechanisms to modulate pain. Because pain perception in these
      species is therefore likely to be analogous to that of mammals, invasive and
      painful procedures should always be accompanied by appropriate analgesia and
      anesthesia. Although specific doses have not been established in clinical trials,
      clinicians should attempt to provide lower vertebrates with appropriate analgesia
      during painful procedures. Further experimental and clinical investigations are
      necessary to expand the current veterinary literature in the area of pain and
      analgesia in lower vertebrates such as fish, amphibians, and reptiles.

PMID- 11217461
TI  - Physical restraint techniques and immobilization equipment.
AB  - The art of safe and effective restraint of non-domestic patients can aid in their
      management and facilitate their health care delivery. This article discusses some
      of the strategies and basic equipment required in handling these unique patients
      more commonly seen by veterinary practitioners. These restraint procedures may
      offer an alternative to anesthesia for minor, less stressful procedures that do
      not involve pain.

PMID- 11217462
TI  - Marsupial, insectivore, and chiropteran anesthesia.
AB  - This article covers the manual restraint and anesthesia of marsupials,
      insectivores, and chiroptera. Marsupials commonly kept as pets in the U.S. [e.g.,
      eastern gray kangaroos (Macropus giganteus), Bennett's wallabies (Macropus
      rufogriseus), and sugar gliders (Petaurus breviceps)] are covered in detail.
      Marsupial species kept in zoological parks [e.g., Tasmanian devils, koalas
      (Phascolarctos cinereus), and common wombats (Vombatus ursinus)] are covered in
      less detail. Of the insectivores, only the African hedgehog (Atelerix
      albiventris) and the European hedgehog (Erinaceus europaeus) are commonly kept as
      pets and, consequently, the insectivore section concentrates on discussing these
      two species. The section on chiropteran anesthesia is divided into two broad
      categories: the megachiropterans (flying foxes and fruit bats) and the
      microchiropterans (insectivorous bats). Most of the information on the species
      covered in this article is anecdotal, and this should be kept in mind when using
      the anesthesia protocols described.

PMID- 11217463
TI  - Primate anesthesia.
AB  - This article provides an update on some of the recent advances in primate
      anesthesia. It focuses in particular on some of the newest information available
      regarding the effects of opioids and alpha-2 agonists in primates, and how these
      effects are different from what we might expect in other companion animals. It
      reviews the important properties of the latest induction and inhalation agents,
      and stresses the need for continuous monitoring of the anesthetized patient.

PMID- 11217464
TI  - Chemical immobilization of felids, ursids, and small ungulates.
AB  - Private ownership of wild animals is on the rise. With the advent of potent new
      sedative agents, many practitioners now receiving these cases have the means to
      increase the safety and effectiveness of chemical immobilization in many wildlife
      species. Chemical immobilization is actually the induction of anesthesia. In many
      cases, induction alone suffices to achieve some management or medical goal,
      whereas in other cases, maintenance anesthesia is required. One quickly realizes
      that once these species are induced, maintenance anesthesia is often familiar,
      based on experiences with domestic animals that bear close similarity to the
      species discussed in this chapter. Induction and recovery of wild animals
      requires special attention to details to prevent "fight or flight" responses from
      marring the success of a sedation procedure. Although potent novel drugs allow
      veterinarians to expand their practice horizons, it is vital to evaluate legal
      and safety issues thoroughly before engaging in the care of wildlife species on a
      regular basis.

PMID- 11217465
TI  - Avian analgesia.
AB  - Understanding behavioral indicators of pain and other assessment techniques can
      help one to recognize pain in birds and prompt us to treat birds with analgesics.
      An analgesic plan needs to include several modalities to help reduce pain in the
      avian patient. Analgesic therapy should be directed at treating the
      disease/injury in the periphery, and the changes that occur in the central
      nervous system (CNS). Both opioid and nonsteroidal anti-inflammatory drug (NSAID)
      therapeutics can be selected to provide analgesia for the avian patient.

PMID- 11217466
TI  - Analgesia of small mammals.
AB  - Small mammals receive analgesics much less frequently than more familiar species
      such as dogs and cats. This is probably related to the greater difficulty of
      recognizing pain in these species, and the uncertainty as to the most appropriate
      analgesic regimen to implement when the presence of pain is suspected. However,
      the same principles of pain assessment and analgesic use that are applied when
      dealing with other companion animals can be used to manage pain effectively in
      small mammals. All of the commonly used analgesic agents can be used safely and
      effectively in small mammals, although the size of many of these animals limits
      the use of techniques such as epidural administration or transdermal drug
      delivery systems. As with other species, it is important to integrate an
      analgesic regimen with the overall scheme of perioperative care, and to try to
      implement preemptive and multi-modal analgesic therapy.

PMID- 11217467
TI  - Invertebrate anesthesia.
AB  - One hundred years ago (January 5th, 1901), an article in the Veterinary Record
      declared: The use of chloroform by practitioners is now common, and the amount of
      pain and suffering prevented is enormous. By its aid we are enabled to perform
      operations with success which without it were seldom satisfactory. A century
      later, in an age of sophisticated veterinary medicine, those words seem quaint, a
      relic of a bygone age. Our understanding of anesthesia of invertebrates in 2000
      is very much at a comparable stage, however, and a great deal of research is
      needed to remedy this situation.

PMID- 11217468
TI  - Fish and amphibian anesthesia.
AB  - This article is designed to provide the veterinary practitioner with some basic
      information on how to anesthetize fish and amphibians. General guidelines
      regarding working with these aquatic animals are covered. Specific topics include
      methods of anesthetic delivery, anesthetic monitoring, and recovery. Various
      anesthetic regimes and dosages are presented both in the text and in table form.

PMID- 11217469
TI  - Reptile anesthesia.
AB  - Successful reptile anesthesia requires patience, planning, and understanding of
      normal anatomy and physiology in health and disease. Reptiles make good
      anesthetic patients because of their physiologic resilience. New drugs that are
      not only safe and efficacious, but also result in relatively short recovery
      times, have greatly enhanced the design of anesthetic regimens. Further studies
      are required to quantitatively evaluate the physiologic effects of drugs used and
      validate available monitoring modalities for use in a wide variety of reptiles.

PMID- 11217470
TI  - Video-assisted thoracic surgery--state of the art.
AB  - Video-assisted thoracic surgery (VATS) is one of the main medical revolutions of
      the past decade. For its satisfactory performance, the following prerequisites
      are essential: (1) knowledge and experience in thoracic surgery; (2) team of
      experienced anesthesiologists; (3) preoperative assessment of respiratory
      function; (4) adequate postoperative care; and (5) instruments specially designed
      for thoracoscopic surgery. VATS is routinely performed under general anesthesia
      with double lumen endotracheal intubation for separate control of each lung.
      Insufflation of carbon dioxide must not exceed 1-3 mm Hg. Too high pressure may
      cause harmful reduction of venous return and mediastinal shift with impairment of
      ventilation. Presence of adhesions should be determined by finger exploration of
      the pleural cavity. Operative ports should be placed carefully, avoiding damage
      to the intercostal nerves and vessels. The video technique can be used with
      efficiency for the following indications: pneumothorax, resection of pulmonary
      nodules, biopsies of lung, pleura and mediastinal structures, resection of
      mediastinal tumors, management of empyema, and hemostasis and closure of
      lacerations after trauma. Indications for esophageal procedures include
      esophagomyotomy for achalasia and resections of benign lesions. Repair of
      perforated esophagus is a matter of controversy, but in early stages it can be
      done thoracoscopically. Although video-pericardioscopy has been performed by some
      surgeons, this procedure can be done easier and faster using the direct approach
      without the video equipment. There are differences of opinion with regard to
      major pulmonary and esophageal resections for cancer. The apparent advantage of
      diminished pain is offset by inadequate resection, spread of malignant cells and
      potential damage to the resected specimen with loss of important information
      concerning pathology. Complications of VATS are few, and include prolonged air
      leak, dysrhythmia, respiratory failure, bleeding and infection. Due to progress
      over the past several years, VATS has become an inseparable part of thoracic
      surgery and should be included in the basic training of every thoracic surgeon.

PMID- 11217471
TI  - [Short- and long-term monitoring with high-resolution ultrasonography of
      postoperative thyroid residue. Personal experience with 200 thyroidectomies].
AB  - BACKGROUND: After having abandoned conservative operations of the thyroid
      (partial resection, enucleal resection) today total thyroidectomy and sub-total
      thyroidectomy and near total thyroidectomy are the operations of choice. Cause
      the frequent post-operative scintigraphic signs, on the 3rd month, of thyroidal
      residue of significative size, founded in our patients operated for sub-total
      thyroidectomy, we begun to study the echografical monitoring of the thyroidal
      recess. METHODS: From January 1995 to December 1997 we operated 200 patients for
      Thyroidectomy. The kinds of operations were: total thyroidectomy for 96 patients
      (48%), sub-total thyroidectomy for 64 patients (32%), and near total
      thyroidectomy for 40 patients (20%). We controlled all the patients by
      ecografical monitoring of the thyroidal recess to detect and to determinate the
      possible thyroidal residue, that it will be monitorized on the 7th day, on the
      1st month, on the 6th month and on the 12th month. We measured the thyroidal
      residual dimensions and volume. We recorded all the examinations by VCR or film
      and after we elaborated the results by exponential graphics. The patients that
      showed the thyroidal residues underwent to a scintigraphy. RESULTS: The thyroidal
      residuals were measured within the 7Th post-operative day. In the following
      controls we have noted a thyroidal residue hypertrophy. Multinodular goither was
      the disease with the highest degree of growth (until the 200% of the first
      measure of the residue). After an initial phase of growth almost all the patients
      showed a trend to the stabilization, with the exception only of the patient that
      suffered from multinodular goither. The scintigraphic examination was not
      realiable, in our experience, about the mathematic measurement of the thyroidal
      tissue, showing always an overvaluation of the residue. The best specificity was
      showed by US-HR. CONCLUSIONS: The patient that undergoes to total thyroidectomy
      needs an adequate suppressive and substitutive therapy. We identify the presence
      of several stimulating factors the growth of the residual thyroidal tissue that
      could arise to promote the hyperplasia and the hypertrophy of the parenchyma
      (EGF, TSG, TSI, PG). There are factors that are unidentified and are not subject
      to the suppression caused by substitutive therapy.

PMID- 11217472
TI  - [Difficulties in defining and diagnosing gastroesophageal reflux: practical
      implications in surgery].
AB  - Today, it is difficult to set a correct definition and diagnosis of
      gastroesophageal reflux disease. The attempt to define it on the basis of
      "typical" symptoms, like heartburn and regurgitation, or "atypical" symptoms,
      like chronic cough, asthma, hoarseness and thoracic pain, or on the basis of
      endoscopic esophagitis presents notable difficulties. Moreover, the problem of a
      correct definition is tightly tied up to the ability to set a correct and early
      diagnosis. There are many diagnostics tools, but none of them is the golden
      standard. Today, the trend is to emphasize the role of the 24-hour pH-monitoring
      in diagnosing the reflux in those symptomatic patients with no visible
      esophagitis. However, its limit is to underline only the acid, not the
      duodenogastric alkaline reflux, which is also very important in the genesis of
      the inflammatory esophageal lesions. The esophageal manometry, however, evaluates
      only the mechanical state of the lower esophageal sphincter and the peristaltic
      function of the esophageal body but does not provide any direct information about
      the exposure of the esophagus to the gastric juice. The aim of this study is to
      analyze the problems concerning the definition and the diagnosis of the
      gastroesophageal reflux disease with particular attention to the practical
      implications on the common surgical practice, and to review some solutions
      reported in the literature for the difficult clinical approach to the patient
      with this pathology.

PMID- 11217473
TI  - [Cell-mediated immunity after laparoscopic cholecystectomy].
AB  - Cell-mediated immunity (CMI) is temporarily decreased after major surgical
      procedures in relation to type of anaesthesia, length and severity of an
      intervention. In this study it has been evaluated CMI response in vivo, after
      laparoscopic (LC) and open cholecystectomy (OC). 5 healthy persons and 16
      patients with symptomatic and uncomplicated gallstones were studied. They were
      subdivided in two groups: 8 were treated by OC, 8 by LC. A skin test system
      (Multitest, IMC-Institute Merieux, Lyon, France) consisting of a plastic
      disposable multiple-puncture device capable of simultaneous application of seven
      delayed-type hypersensitivity antigens and a glycerin and saline diluent
      (negative control) was used. The test was performed 48 hours before and 24 hours
      after the surgical procedure. A diameter of 2 mm or more of the induration was
      considered as a positive response. A score expressed, as the sum in millimeters
      of all the mean diameters (DM) of positive reactions and as numbers of antigens
      (NA) positive was calculated. Statistics was assessed by Student's t test for
      comparison of averages. There was no difference of age, sex, anesthesiologic
      risk, length of the operation between the two groups. We observed a significative
      reduction of DM (P < 0.05) and of NA (P < 0.05) in patients in which OC was
      performed while there were no significant in the group treated by LC. Results
      show a significant suppression of the CMI after OC, no particular changes after
      LC according to other studies in vitro.

PMID- 11217474
TI  - [Complicated Spigelian hernia: our experience].
AB  - We present a case of complicated Spigelian hernia presented with symptoms of
      intestinal occlusion, in a 50 years old woman. Spigelian hernia represents 1-2%
      of all abdominal hernias and can occur anywhere along the semicircular line of
      Douglas. The patient underwent emergency surgery followed by polypropylene
      plastic repair. The postoperative course was uneventful and the patient was
      discharged on day 8 post intervention in good general conditions. The 2 years
      follow-up showed no recurrence of the disease. Clinical examination is the
      foundation of the diagnosis, whereas radiological findings (ultrasonography, TC)
      allow the exclusion of other pathologies in the differential diagnosis. The
      preoperative diagnosis is difficult, mainly because of the non-specificity of
      symptoms as well as the few cases reported in the literature. In conclusion, we
      remark that the surgery remains the most effective treatment of Spigelian Hernia.

PMID- 11217475
TI  - [Current trends in the treatment of rectal carcinoma].
AB  - Authors report their personal experience about 336 cases of curative surgery for
      rectal cancer. They describe technical surgical details universally accepted in
      Literature such as sharp total mesorectal excision, the extension of
      lymphadenectomy with high ligature of inferior mesenteritis artery while pelvic
      lymphadenectomy seems to be unuseful and burdened by high morbidity; finally they
      underline advantages offered by a colic pouch above all for lower incidence of
      anastomotic leakages. As adjuvant therapy is concerned, our actual tendency is a
      preoperative radiochemiotherapy of which we are still evaluating long-term
      results. Finally we analyzed correlations between cellular genetics and colo
      rectal cancer.

PMID- 11217476
TI  - [Results of laparoscopic bilateral varicocelectomy].
AB  - Left varicocele (LV) is a common clinical condition that is present in
      approximately 15% of the general male population. Bilateral varicocele (BV) is an
      association of clinical LV and subclinical or ultrasound diagnosed right
      varicocele. Recent diagnostic technology suggests that BV is much more common
      than previously suspected varying from 15 to 57%. The laparoscopic technique
      offers the possibility of planning bilateral varix ligation but only a few
      reports are currently available. The aim of this study was to evaluate the
      outcome of contemporary bilateral correction of BV on spermatogenesis. From 1992
      January to 1998 December a total of 207 patients with clinical left varicocele
      and a pathological sperm count were studied. Scrotal sonography was performed and
      in 96 patients (group A) subclinical right varicocele was diagnosed while 111
      patients (group B) only had LV. 84 patients were married and had tried
      unsuccesfully for a pregnancy for at least one year before evaluation. All
      patients underwent laparoscopic varicocelectomy, performed under general
      anesthesia with a three trocar technique with application of clips to the
      spermatic vein and resection. Patients with right reflux received bilateral varix
      ligation. Operating time averaged 28 minutes for unilateral cases and 42 minutes
      for bilateral legatures. No significant differences were found in age
      distribution or preoperative seminal paramenters between the two groups.
      Postoperative hospital stay was 1.2 and 1.3 days respectively. 168 patients
      underwent sperm count four to six months after surgery. Both groups showed
      improvements in number (group A 41 millions, group b 27 millions), 2nd hour
      motility (group A 32%, group B 19%) and morphology (group A 52%, group B 51%). 95
      patients achieved normalization of seminal parameters, 40 (63%) in group A and 37
      (30%) in group B, and there was a statistically significant difference between
      the two groups. The pregnancy rate was calculated on married population after one
      year; it was 41% in total. The role of the subclinical right varicocele
      associated to clinical left varicocele is uncertain and there are few papers
      concerning this argument. In this serie normalization of seminal parameters and
      the pregnancy rate were significantly higher in patients with bilateral
      correction of reflux. In conclusion our data confirm that subclinical right
      reflux also has a detrimental effect on spermatogenesis and we suggest that it
      must be corrected contemporary when associated with clinical left varicocele.

PMID- 11217477
TI  - [Post-traumatic diaphragmatic hernia with late diagnosis. Report of a clinical
      case].
AB  - Starting from the observation of a case of late diagnosed left-side hernia after
      traumatic rupture of diaphragma, the authors consider the increasing incidence of
      this pathology during the years. The increased frequency of thoraco-abdominal
      traumas and the more sophisticated diagnostic tools, permit an earlier diagnosis
      nowadays. In our patient the diagnosis was made late on the basis of the standard
      x-ray of the thorax. The CT scan of the thorax and of the abdomen gave more
      informations. Left thoracotomy enabled a wide exposure of the herniated viscera;
      the breakthrough of the diaphragm was repaired by means of interrupted suture and
      it was necessary to apply two prostheses of synthetic material.

PMID- 11217478
TI  - [Lymphangiomatosis of the spleen. Report of a clinical case].
AB  - Lymphangiomatosis confined to the spleen is a very are condition. The authors in
      this article describes one new case and briefly reviews the literature. In this
      case, after the exclusion of an hydatidosis of the spleen, a total splenectomy
      was performed. The histologic findings confirmed the lymphangiomatosis of the
      spleen. The authors emphasize the surgical strategy in splenic
      lymphangiomyomatosis, infact the total splenectomy is mandatory, because the
      splenic parenchyma is nearly completely substitute by the cysts. For this reason
      is preferably, before surgery, to perform the antibateric profilaxis against the
      OPSI.

PMID- 11217479
TI  - Malignant lymphoma complicating ulcerative colitis.
AB  - Carcinoma of the colon as a complication of chronic ulcerative colitis is
      relatively common, whereas malignant lymphoma is apparently rare. We report two
      cases of patients with malignant lymphoma complicating ulcerative colitis, a CD
      30 + T-cell lymphoma of the intestine and a low grade B-cell non-Hodgkin's
      lymphoma of MALT type. It is important to be aware of the possibility of
      malignant lymphoma in ulcerative colitis in order to evaluate correctly any
      lymphoid infiltrate seen in a biopsy, especially when anti-inflammatory treatment
      seems to be ineffective or when symptoms change.

PMID- 11217480
TI  - [Angiodysplasia of the large intestine: unusual rectal localization].
AB  - The authors report a case of lower gastrointestinal hemorrhage in a 69-year-old
      male, in which the sequence colonoscopy-angiography identified the source of
      bleeding as a rare Angiodysplasia (AD) of the rectum. Such vascular abnormalities
      are one of the most common causes of major lower gastrointestinal tract bleeding
      in the elderly and usually occurs predominantly in the right side of the colon.
      The clinical presentation of Angiodysplasia is varied and accurate diagnosis
      usually requires a combination of diagnostic techniques such as colonoscopy and
      angiography. The optimal management is uncertain and should be individualized for
      each patient depending on severity and rate of rebleeding. A conservative medical
      approach is indicated for many patients, while endoscopic treatment does not seem
      modify the risk of recurrent bleeding. In case of massive hemorrhage or recurrent
      bleeding surgery still represents the definitive treatment for Angiodysplasia.
      However the risk of rebleeding following surgery is a considerable problem and
      varies in literature from 5% to 30%.

PMID- 11217481
TI  - [Inguinal hernioplasty with calibrated prosthesis (personal modification of the
      Trabucco technique].
AB  - From January 1994 to December 1997, the authors operated on 636 patients with
      primary inguinal hernia, using an original modification of Trabucco's tension
      free and sutureless technique. The hernial defect is sized according to Gilbert's
      classification modified by Rutkow and Robbins and repaired with one or more plugs
      (up to four in the authors' experience) in relation to its extent. The posterior
      wall is reconstructed over the plugs encompassing the transversalis fascia and a
      wing of the plug superiorly and the iliopubic tract inferiorly. The double-layer
      polypropylene mesh is fashioned intraoperatively and the key-hole tailored to the
      variable distance between the spermatic cord and the pubic tubercle. All patients
      ambulated immediately after the operation, had a light meal two hours later and
      were discharged within one day of surgery. During a 3 months to 4 year follow-up
      only one recurrence has been recorded (0.16%). The proposed technique allows to
      perform a repair to measure ("calibrated") with minimal pain, immediate
      rehabilitation and early return to unrestricted activity.

PMID- 11217482
TI  - [Clinical manifestations of herpetic keratitis and uveitis].
AB  - Herpetic keratitis and uveitis probably represent two of the most under- and
      misdiagnosed diseases affecting the anterior eye segment despite their being
      major causes of blindness in developed countries. Recurrences are pathognomonic
      of herpetic eye disease and are responsible for the high socioeconomic costs of
      this affection. In recent years, the application of molecular biological methods
      and the results of long-term clinical studies have afforded us new insights into
      the pathophysiology of herpetic eye disease and have advanced our perception of
      how best to manage it. This article summarizes our current understanding of the
      pathophysiology of herpetic eye disease and, in the light of this wisdom,
      discusses specific conditions (epithelial and geographic keratitis, ulcerating
      and non-ulcerative stromal keratitis, disciform keratitis/endotheleitis, uveitis
      and metaherpetic keratitis) as well as contemporary therapeutic and prophylactic
      strategies. The possible mechanistic basis of recurrence is also dealt with, as
      is the sociomedical relevance of the disease. In addition to providing a
      documentation of typical clinical pictures, the article also furnishes
      information respecting the course of the disease, its diagnosis and treatment.

PMID- 11217483
TI  - [The role of HIV associated eye changes in the time of HAART (highly active
      antiretroviral therapy].
AB  - Choice of an appropriate treatment strategy in the handling of HIV infection has
      become problematical, owing to the very serious side effects that sometimes
      develop in conjunction with antiretroviral combination therapy (HAART). Indeed,
      the severity of these affections can assume such a magnitude as to render an
      abatement or even the interruption of treatment imperative in a not
      inconsiderable proportion of patients. In such individuals, HIV-associated
      opportunistic diseases thus constitute a major concern. As regards the ocular
      system, three diseases are regularly encountered: HIV-associated retinal
      microangiopathy, cytomegalovirus (CMV)-retinitis and immune-recovery uveitis, the
      latter being a recently recognized condition which is manifested after immune
      reconstitution in patients with a history of viral retinitis. Retinal
      microangiopathy assumes significance in that it signals uncontrolled replication
      of the retrovirus. Viral retinitis hallmarks an actual breakdown of the
      functional immune response and may be observed in patients undergoing HAART even
      if their CD4 counts are above 100 per microliter. The treatment of this condition
      is crucial for the prolongation of survival and in so far as its manifestation
      renders an estimation of when systematic recurrence prophylaxis should be
      interrupted extremely difficult. Furthermore, reactivated retinitis is sometimes
      difficult to distinguish from immune-recovery uveitis--an immune restoration
      reaction which is probably directed against persisting CMV antigens. This
      circumstance may account for the impaired visual function attributable to chronic
      macular edema and epiretinal membrane formation.

PMID- 11217484
TI  - [Age-related macular degeneration (AMD)--therapeutic possibilities and new
      approaches].
AB  - Age related macular degeneration (ARMD) is one of the leading causes of
      irreversible vision loss in patients over 65 years of age. Nearly 30 percent of
      persons over 75 years of age will suffer from ARMD. The etiology is not yet fully
      understood. Besides age, many risk factors such as gender, arterial hypertension,
      arteriolosclerosis, elevated serum lipids, smoking, alcohol abusus, and exposure
      to UV light are being discussed. Genetic factors are certainly involved as well;
      familiar predisposition is assumed in more than 50 percent of cases. White
      individuals are more affected than colored ones. Predisposing ocular signs are
      macular drusen, focal hyperpigmentation, and light eyes. In this review,
      anatomical, pathophysiological and fluorescein-angiographic features and the
      clinical classification of exudative and dry stages of ARMD are described.
      Concepts of management of ARMD include pharmacological measures, laser treatment,
      photodynamic therapy, and surgery including excision of submacular choroidal
      neovascular membranes and macular translocation. Success rates of any therapeutic
      method are very limited. Low vision aids are promising by improving quality of
      life in many cases.

PMID- 11217485
TI  - [Central retinal artery occlusion--etiology, clinical picture, therapeutic
      possibilities].
AB  - An occlusion of the central retinal artery (CRAO) leads to a unilateral acute
      painless loss of vision. The individual etiology remains unclear in many cases.
      Potential pathomechanisms are embolism, vasoobliteration and vascular
      compression. Emboli (calcified, thrombotic, myxomatous, bacterial or cholesterol)
      are of carotid or cardiac origin. Atherosclerotic plaques, giant-cell arteritis
      and other types of vasculitis may cause vasoobliteration. A retrobulbar mass
      (hematoma, neoplasms, retrobulbar injections) may lead to an optic nerve and
      central retinal artery compression. Funduscopic signs of CRAO are described. Late
      development of iris neovascularization and neovascular secondary glaucoma may
      occur in up to 15 percent of cases. The prognosis of CRAO has been poor. A
      spontaneous remission and recovery of visual function is rare. It has been shown
      experimentally that the retinal damage is irreversible after 100 minutes of non
      perfusion. The initial treatment should include an immediate paracentesis of the
      anterior chamber, digital massage of the globe, and i.v. administration of 500 mg
      azetazolamide in order to stimulate retinal reperfusion by lowering the
      intraocular pressure. This procedure is recommended for the first 6 (up to 24)
      hours after onset of CRAO. More promising success rates have recently be reported
      by a selective intra-arterial fibrinolysis with Urokinase (100,000-1,000,000 IU)
      or recombinant plasminogen activator (rtPA). In a personal series of 18 cases,
      intra-arterial fibrinolysis with Urokinase was performed. A final visual acuity
      of 6/10 to 6/6 was achieved in 30 percent of the cases.

PMID- 11217486
TI  - [Diabetic retinopathy--pathophysiological knowledge and modern treatment
      methods].
AB  - Diabetic retinopathy (DR) leads to visual impairment in the majority of patients
      suffering from diabetes mellitus for more than 20 years. Endothelial damage,
      capillary dropout, and vasoproliferative activity of various growth factors are
      some of the complex pathophysiologic events that lead to retinal damage.
      Insufficient blood glucose control and arterial hypertension are the leading risk
      factors for the progression of DR. Adequate therapeutic measures depend on timely
      and regular ophthalmologic examination. Laser photocoagulation prevents severe
      visual loss in about 50% of cases with proliferative DR and high risk factors as
      defined by the Diabetic Retinopathy Study Group. Dosage of laser treatment
      depends on the stage and severity of DR and requires appropriate experience of
      the surgeon. Introduction of modern vitreoretinal surgery has yielded
      considerable progress in the management of vitreous hemorrhages (VH) and
      tractional retinal detachment in advanced stages of proliferative DR. Results of
      vitrectomy in 765 cases with proliferative DR are presented. Visual loss can be
      prevented in over 70% of cases with simple VH without retinal detachment and
      limited neovascularization, but in only about 30% of cases of VH complicated with
      retinal traction detachment and extensive vasoproliferation.

PMID- 11217487
TI  - [Eye diseases in mitochondrial encephalomyopathies].
AB  - Mitochondria are the principal site of generation of energy in form of adenosine
      triphosphate (ATP). They contain the enzymes of the Krebs and fatty acid cycles
      and the respiratory pathway. Ocular tissues with high energy consumption and
      dependence on oxidative energy production like the optic nerve, the retina, and
      the pigment epithelium are often involved in mitochondrial diseases. This article
      reviews the genetic mitochondrial diseases involving the visual system. Their
      most important ocular findings include: acute or slowly progressive bilateral
      visual loss and visual field loss due to an optic neuropathy or retinal
      degeneration, bilateral progressive decreased ocular motility, and bilateral
      upper lid ptosis. The following diseases are discussed: Leber's Hereditary Optic
      Neuropathy (LHON); Kearns-Sayre Syndrom (KSS); Chronic Progressive External
      Ophthalmoplegia (CPEO); Autosomal Recessive Cardiomyopathy, Ophthalmoplegia
      (ARCO); Mitochondrial Encephalomyopathy, Lactic Acidosis, Stroke-Like Episodes
      (MELAS); Neuropathy, Ataxia, Retinitis Pigmentosa (NARP); Mitochondrial
      Neuropathy, Gastro-Intestinal Encephalomyopathy (MNGIE); Myoclonus Epilepsy,
      Ragged-Red-Fibers (MERRF); Wilson's disease; Friedreich's ataxia. Diagnosis of
      mitochondrial encephalomyopathies is established by screening for mutations in
      blood or muscle biopsy samples. No specific therapies which influence the course
      of mitochondrial encephalomyopathies are known. Drugs interacting with the
      mitochondria function, alcohol consumption and smoking should be avoided.

PMID- 11217488
TI  - [Surgical correction of refractive errors].
AB  - This article reviews operation techniques and indications for the surgical
      correction of ametropia. The author also explains and lists the anomalies of
      refraction. The limitations of the methods as well as open questions for the
      future are discussed.

PMID- 11217489
TI  - [Eye diseases in sleep apnea syndrome].
AB  - Sleep apnea syndrome is characterized by recurrent complete or partial upper
      airway obstructions during sleep and recognized as an important risk factor for
      cardiovascular and cerebrovascular diseases. Several eye diseases have been
      associated with sleep apnea syndrome. Due to floppy eyelids often a chronic
      conjunctivitis occurs. A leaking mask used for apnea treatment may also induce a
      conjunctivitis. The lids may show an upper lid ptosis, lower lid ectropium,
      blepharochalasis, or trichiasis. Corneal findings include infectious keratitis,
      dry eye, recurrent erosion, keratoconus, and progressive endotheliopathy. Several
      optic neuropathies also seem to be associated with sleep apnea syndrome.

PMID- 11217490
TI  - [Pharmacological therapy approaches in ocular traumatology].
AB  - Ocular trauma is the most common reason for unilateral blindness. In the last 15
      years tremendous advances in diagnostics (CT, MRI, ultrasound) and surgery (pars
      plana vitrectomy, phacoemulsification, intraocular lenses) have been made.
      Furthermore new medical therapies to sustain treatment of eye accidents have been
      developed. On the basis of various traumatic diseases (abrasio, chemical
      injuries, hyphema, cataract, photothermal retina lesion and optic neuropathy)
      appropriate of these medical therapies are to be discussed.

PMID- 11217491
TI  - Gender bias in families and its clinical implications for women.
AB  - Within the framework of feminist theory, this clinical study of 45 women with
      brothers explores family-based gender bias and elucidates its role in the lives
      of women. Bias is conceptualized along three dimensions: (1) devaluation--the
      woman perceives that she was less valued by her parents than a brother; (2) abuse
      without redress--the woman reports that she was abused by a brother and perceived
      herself as unable to get redress from her parents; and (3) deprivation--the woman
      perceives herself to have been deprived of resources or privileges that a brother
      had. The author identifies several legacies from the girlhood experience of
      gender bias that may be associated with depression in women: involvement in
      demeaning intimate relationships; self-doubt about competence in comparison with
      males; an isolating distrust of relationships; and the sacrifice of personal and
      relational development to serve parents and compensate for problematic brothers.
      Components of treatment are the therapist's self-awareness of internalized
      sexism; the questioning of client beliefs, based on sexist assumptions, that
      devalue women; and expanding women's perceived range of choice for improving
      their lives.

PMID- 11217492
TI  - Cultural and linguistic considerations in psychodiagnosis with Hispanics: the
      need for an empirically informed process model.
AB  - It is estimated that in the next century nearly half of the clientele seeking
      mental health services will be members of ethnic minority groups. Hispanics are
      the most rapidly growing population in the United States, and epidemiological
      evidence suggests that they present higher levels of psychiatric symptomatology
      and prevalence rates of disorder compared with other ethnic groups. Despite the
      unprecedented recognition of cultural considerations found in DSM-IV for
      rendering a psychiatric diagnosis, there is still surprisingly little empirical
      research examining cultural and linguistic factors influencing the diagnostic
      process. This article critically reviews this research and considers process
      variables that can inform social workers' culturally sensitive diagnosis of
      Hispanics.

PMID- 11217493
TI  - Reading social work.

PMID- 11217494
TI  - Beyond therapy: bringing social work back to human services reform.
AB  - Based on field interviews in a Chicago community development corporation and
      settlement houses in New York City and St. Louis, as well as interviews with
      leading social services innovators and social work educators, this article
      explores the intersection of current social work practice and human services
      innovation. The article offers a rationale and a blueprint for a reorientation of
      social work's "helping relationship," reviews a number of promising innovations
      and strategies that may help the profession make this reorientation operational,
      and explores forces restraining as well as driving such change.

PMID- 11217495
TI  - Complexities of coalition building: leaders' successes, strategies, struggles,
      and solutions.
AB  - Government and private funding initiatives are promoting coalitions,
      collaborations, and other interorganizational approaches to address complex
      community, social services, and health issues. Social work organizers and
      administrators are increasingly leading coalitions themselves or representing
      their organizations in collaborative planning and problem solving, often without
      understanding how to manage the complexities involved in interorganizational
      relationships. This article reports on aspects of a larger quantitative and
      qualitative research project that studied coalition dynamics, operations, and
      outcomes. Coalition leaders interviewed defined success in multiple ways.
      Competent leadership was the factor most often identified with coalition success.

PMID- 11217496
TI  - Targeting women donors: a response to "Women and human services giving".

PMID- 11217497
TI  - Response to Sun.

PMID- 11217498
TI  - Nature of work and future of the social work profession.
AB  - Social work practice and education long have been influenced by trends in the
      U.S. economy, particularly as these trends affected patterns of employment and
      unemployment. This article assesses the implications of recent changes in
      patterns of economic production and the nature of work for the social work
      profession. The authors conclude with recommendations on how schools of social
      work can address these implications in their curricula and their relationships
      with the communities in which they are located.

PMID- 11217499
TI  - Work first: reflections on the welfare-to-work movement in America.

PMID- 11217500
TI  - [After 1440].

PMID- 11217501
TI  - [Radon and domestic exposure].
AB  - Radon is a noble gas derived from the decay of radium, which itself is a decay
      product of uranium. The decay products of radon can collect electrostatically on
      dust particles in the air and, if these particles are inhaled and attach to
      bronchial epithelium, produce a high local radiation dose. Alpha particles can
      induce DNA double-strand breaks and the development of cancer. A causal relation
      between lung cancer and radon exposure and its progeny has been demonstrated in
      epidemiological studies of miners. Radon exposure became a public health issue
      almost 15 years ago. Most radon exposure occurs indoors, predominantly in the
      home. There is however, a wide range of radon concentration values in different
      countries. The highest level occurs in areas with granite and permeable soils.
      The risk for smoking, the leading cause of lung cancer, is far greater than for
      radon, the second leading cause. The estimates obtained from case-control studies
      of indoor radon are very contradictory. Scientific knowledge of effects of low
      levels of exposure to radon and the role of cigarette smoking, as a combined
      factor, must be studied. Smoking and radon probably interact in a multiplicative
      fashion.

PMID- 11217502
TI  - [Strategy for early diagnosis of lung involvement in systemic scleroderma].
AB  - Systemic sclerosis (SSc) is an autoimmune disorder characterized by accumulation
      of collagen in affected organs, mainly the skin and the lungs, associated with
      abnormalities of the arterioles and capillaries. There are two types of pulmonary
      involvement, which influence long term prognosis: infiltration of the lungs
      and/or pulmonary artery hypertension. Full investigations into possible lung
      involvement must be performed systematically when SSc is diagnosed and during
      follow-up. The double pathophysiology sometimes makes diagnosis difficult but it
      must be made as early as possible in order to decide on the optimal treatment.
      The aim of this study was to evaluate the usual explorations and to propose
      biological markers to identify patients requiring more detailed lung
      investigations, in order to establish a diagnostic approach to treatment and
      follow-up patients with SSc.

PMID- 11217503
TI  - [Postoperative complications after radiochemotherapy or chemotherapy for
      bronchial cancers].
AB  - OBJECTIVE: The purpose of this study was to evaluate the risk of lung cancer
      surgery, following induction chemo and/or radiotherapy. METHODS: This
      retrospective study included 69 patients treated from January 1990 to January
      1998 for a primary lung cancer in whom surgery had been performed after induction
      treatment. Surgery had not been considered initially for the following reasons:
      N2 disease (IIIA; n = 25), temporary functional impairment (2 stages IB and 2
      stages IIIA [N2]; n = 4); doubtful resectability (stage IIIB [T4]; n = 40). The
      medical regimen resulted in combined radio-chemotherapy in 43 patients who
      received 2 to 4 cycles of chemotherapy (average = 2.9 +/- 0.8 cycles) and 43 +/-
      8 Gy (20 to 60 Gy), or chemotherapy alone in 26 patients (3 +/- 0.7 cycles).
      RESULTS: Exploratory thoracotomy was performed in 4 patients (6%). The in
      hospital mortality was 9% (n = 6) from respiratory origin in all cases. There
      were 4 reoperations (6%): 3 for bronchial fistula and 1 for bleeding. Thirty five
      patients (51%) required blood transfusion (4.5 +/- 3.8 cell packs). The incidence
      of early and delayed bronchial fistula after pneumonectomy was 15%. Thirteen
      patients had a postoperative pneumonia (19%). CONCLUSION: Surgery for lung cancer
      after induction chemo and/or radiotherapy is associated with an increased risk.
      While the mortality seems "acceptable", the morbidity rate however is high.

PMID- 11217504
TI  - [Prognosis of asthmatic adolescents in adulthood].
AB  - Little is known about the long-term outcome of asthmatic adolescents. According
      to the literature, 20 to 50% of asthmatic adolescents become symptom-free when
      they become adults. We report 50 cases of asthmatic adolescents, 25 girls and 25
      boys, with a mean follow of 4.4 years (range 1-12 years). Only 4 patients (8%)
      became symptom-free, all 4 were stage I and II patients. One death occurred
      subsequent to penicillin allergy, but was not related to status asthmaticus. Nor
      remission was observed in stage III and IV patients, whereas 5.8% and 12% of
      stage II and II patients respectively grew out of their asthma. The factors
      predictive of persistent asthma in adulthood were severe asthma at the age of 13
      years, female gender, onset of asthma before the age of 7 years, no periodic
      rhinitis, and exercise induced asthma.

PMID- 11217505
TI  - [Malignant mediastinal lymph node tumors with unknown primary cancers].
AB  - PURPOSE: Malignant mediastinal lymph nodes with unknown primary tumor is a rare
      occurrence. The purpose of this study is to specify some characteristics of the
      patients presenting with this disease and to define an adequate therapeutic
      approach. MATERIAL AND METHODS: Between 1985 and 1997, we have operated on 54
      patients with isolated non-small cell malignancy to mediastinal lymph nodes.
      Forty-nine patients underwent surgical biopsy of the mediastinal mass, generally
      followed by radiation therapy and/or chemotherapy. A mediastinal lymph node
      resection was performed in 5 patients. RESULTS: Five patients were lost to follow
      up (9.3%). The 5-year survival rate and the median survival were 12.4 +/- 5% and
      7 months respectively. Four of the 7 patients who were still alive after follow
      ups ranging from 10 to 68 months had undergone a lymph node resection. During the
      follow-up, a primary tumor was discovered in only 5 patients (11.4%).
      CONCLUSIONS: Patients with isolated malignant lymph nodes of the mediastinum have
      a poor prognosis. In order to improve their survival, we recommend a more
      aggressive therapeutic approach comprising a chemotherapy and a mediastinal lymph
      node resection, associated in some cases with a lung resection. Radiation therapy
      of the mediastinum can be administered, principally in case of incomplete
      resection.

PMID- 11217506
TI  - [Dry cough in a 17 year old patient].
AB  - We present a case of mediastinal ganglioneuroma observed in a 17-year-old girl.
      Imaging suggested the diagnosis that was confirmed histologically on a
      peroperative specimen. Mediastinal ganglioneuroma is a highly uncommon tumor with
      characteristic imaging features that is quite difficult to resect.

PMID- 11217507
TI  - [Post-cardiac injury syndrome: an rare cause of pleurisy, value of  pleural fluid
      analysis].
AB  - The post-cardiac injury syndrome is an inflammatory process concerning the
      pericardium, the pleura and/or the pulmonary parenchyma, that develops after
      different kinds of cardiac aggression. The diagnosis can be evoked when some
      clinical and biological results are present but remains one of exclusion. We
      report a case of post-cardiac injury syndrome for which we demonstrate an
      immunologic involvement of the pleura. The antimyocardial antibodies and the low
      complement index found in the pleura strongly support an immunologic process, and
      this suggests that the analysis of the pleural fluid could be useful for the
      diagnosis of the post-cardiac injury syndrome.

PMID- 11217508
TI  - [Lemierre syndrome: clinical and radiological characteristics of a rare disease].
AB  - A benign oropharyngial infection without appropriate treatment can be complicated
      by a jugular vein thrombosis and disseminated septic embolies with deleterious
      pulmonary effects. This septic clinical picture most commonly known as Lemierre
      syndrome is attributed to Fusobacterium necrophorum, a Gram negative anaerobic
      bacilli. We describe a case of a young patient who has presented this syndrome
      accompanied by typical pulmonary manifestations. Adequate antibiotic treatment
      for 3 weeks associated with anticoagulant treatment for about 3 months duration
      have allowed a complete recovery without sequel.

PMID- 11217509
TI  - [Symptomatic hypothalamo-hypophyseal metastasis revealing a small-cell bronchial
      carcinoma. Study of two cases].
AB  - Metastases are an uncommon cause of tumor in the sellar region. We report two
      cases of small cell lung cancer presenting with visual loss and hypopituitarism
      resulting from metastasis to the pituitary area.

PMID- 11217510
TI  - [Massive hemoptysis during sarcoidosis].
AB  - Hemoptysis is a rare but often severe event in sarcoidosis. It usually occurs in
      patients with advanced, fibrotic lung disease. We herein report the case of a 36
      year old female patient with type II pulmonary sarcoidosis who presented with
      abundant hemoptysis very early during the course of her disease. Two attempts to
      embolize bronchial arteries remained unsuccessful and surgery was eventually
      required to stop the bleeding. Clinical, microbiological, radiological and
      pathological data indicate that haemoptysis was caused by systemic
      hypervascularization around sarcoidosis granuloma.

PMID- 11217511
TI  - [An unusual thoracic opacity].
AB  - We report a case of a paraspinal meningocele in a 37-year-old man with no other
      clinical manifestation. The diagnosis was established on the basis of the
      computed tomography and magnetic resonance imaging features.

PMID- 11217513
TI  - [Depression: from practical aspects to theories].

PMID- 11217512
TI  - [Indications for lung and heart -lung transplantation in adults. SPLF-SCTCVLF-EFG
      AFLM Lung Transplantation Group].

PMID- 11217514
TI  - [Major depression. Clinical case].

PMID- 11217515
TI  - [Major depression. Synthesis].

PMID- 11217516
TI  - [Depression in eating disorders].

PMID- 11217517
TI  - [Depression in the woman. Clinical case].

PMID- 11217518
TI  - [Depression in the woman. Synthesis].

PMID- 11217519
TI  - [Suicide with reference to age].

PMID- 11217520
TI  - [Risk of suicide. Clinical case].

PMID- 11217521
TI  - [Risk of suicide. Synthesis].

PMID- 11217522
TI  - [Risk taking: a depressive equivalent?].

PMID- 11217523
TI  - [The traps of neurotic depression].

PMID- 11217524
TI  - [Depression in adolescence. Clinical case].

PMID- 11217525
TI  - [Depression in adolescence. Synthesis].

PMID- 11217526
TI  - [Physiopathologic hypotheses of depression].

PMID- 11217527
TI  - [Depression after age 50. Clinical case].

PMID- 11217528
TI  - [Depression after age 50. Synthesis].

PMID- 11217529
TI  - [Evaluation methods of the efficacy of an antidepressive drug].

PMID- 11217530
TI  - [Modalities for prescribing and taking antidepressive drugs. Clinical case].

PMID- 11217531
TI  - [Modalities for prescribing and taking antidepressants. Synthesis].

PMID- 11217532
TI  - [Defense and illustration of single case design in psychiatry].

PMID- 11217533
TI  - [Prospective study of favorable factors in follow-up of drug addicted patients-
      apropos of 257 patients of the Cassini Center in Paris].
AB  - Assessing the effectiveness of treatment is one of the main concerns of any
      medical process. The different ways proposed for assuming the responsibility of
      drug addicts and their efficacy are greatly heterogeneous since drug-abusing
      takes on diverse forms. Thus, in order to closely target the request of drug
      addicts and adjust their follow-up, we undertook to study prospectively, for 3
      months, a population of drug addicts taking medical advice for the first time at
      the Cassini center in Paris, with the assumption that some predictors may
      forecast outcomes. METHOD: Data were obtained at the admission with a structured
      interview about socio-economic and demographic status, psychiatric disorders
      (assessed clinically according to DSM III-R and with HAD and MADRS scales),
      substance use and prior treatment history, environmental data (as well as
      familial substance use or support lending). Medical and paramedical referents
      have been interviewed after their first contact with the patient about his
      expectations and his motivation. Familial attendance at this first contact was
      noted as well as its implication in the programme. At the end of the study, we
      noted length of stay, regularity of follow up and clinical changes with a last
      interview of the staff. RESULTS: Half the time, patients' follow up doesn't last
      a month, drug abuse doesn't change in 6 out of 10 cases, and we only note 14% of
      durable abstinence. Polydrug abuse (over 80%) is not linked, here, with
      pejorative outcomes, in opposition to the usual literature. Heroin is the main
      substance used by our population (over 80%), other opiates, sedatives and alcohol
      are associated by more than 30% of these patients; cocaine is associated in a
      quarter of the cases. More than 10% of the patients are concerned by ecstasy and
      LSD. Cannabis use is common. Medical complaint (mainly viral diseases) at the
      beginning of the programme, concerns one of two patients. Only a few are
      initially known as being HIV positive, suggesting a great lack of information.
      Over forty percent of the patients are given a DSM III-R diagnosis at the end of
      the first medical advice, when a doubt subsists for a third of the other
      patients. Major depressive disorder for the first axis and borderline personality
      disorder for the second axis are the main disorders we founded. We also noted a
      large ratio (n = 13.5%) of schizophrenic disorders. Univariate analysis: length
      and regularity of the programmes are key factors of their efficacy. A long follow
      up is also required to improve patients' socio-economical status. Initial
      psychiatric disorders are linked, in our study as well as in literature, with
      longer stays in therapeutic programms. By revenge, psychiatric disorders at the
      third month (over 10%) are linked with poorer outcomes. We noted with interest
      that, in our sample, neither imprisonment in the past (over 40%, but we noted
      several imprisonments in a case out of two), or intraveinous route at any moment
      of the patient's life time (40%), or else a programm caused by a court (a quarter
      of the patients) are of wrong prognosis. Relatives' implication in the programm
      is linked with favorable outcomes. Multivariate analysis draws 3 independent
      clusters about the length of stay. One concerns patient's motivation as assessed
      by medical staff. An other one concerns patient's relatives' implication in the
      care. A third one is about the begining of the treatment: an initial medical
      prescrition and a psychological help are linked with favorable outcomes. About
      the efficacy, multivariate analysis isolates 4 independant clusters. Prior drug
      abuse programmes (one out of three patients) are associated with poorer outcomes,
      when, by revenge, familial relationship initially seen by the patient as (very)
      satisfying, patient's motivation, and, again, an initial medical prescription are
      linked with better outcomes. The study of those of the patients whose programme
      lasted more then 3 months but without any appreciable benefit shows that a long
      follow-up is successful when it is regular, when it provides a socio-economical
      status improvement and when the patient is given access to insight. For these
      patients, the (old) age is associated with better outcomes. By revenge, such a 3
      months follow-up is not able to reduce drug abuse when a psychiatric disorder
      exists at the third month. Patients whose treatment was referred by a court don't
      differ from the others: their length of stay and outcomes are the same.
      DISCUSSION: Our study confirms our initial hypothesis according to witch
      subgroups in our population of drug abusers should be isolated and that some
      predictors of outcomes should be described. Three points seem important to be
      discussed. First, a medical prescription appears to be important to initiate the
      relationship between the patient and his practicioner. We have never see any
      report about this particular point. (ABSTRACT TRUNCATED)

PMID- 11217534
TI  - "Postpsychotic depression" and residual schizophrenia in a mental health
      hospital.
AB  - Forty three patients, mean age 55.20 +/- 9.27 SD, affected by Schizophrenia
      Residual Type (DSM IV, RDC criteria) and treated with neuroleptic drugs for a
      mean of 25.42 years (+/- 4.12 SD) were included into the study. Clinical
      evaluation was cross-sectional assessed by BPRScale, SAPS, SANS, HRS-D, EPSE. ACS
      and MMSE. Seventy percent of patients presented a "postpsychotic depression"
      (42%, mild; 16%, moderate and 12% serious). "Postpsychotic depression" does not
      seem to be influenced by neuroleptics, but it seems to be a component of residual
      schizophrenia in patients with a long lasting permanence in a mental hospital.

PMID- 11217535
TI  - [Validation of the French translation and factorial structure of the Tiffany and
      Drobes Smoking Urge Questionnaire].
AB  - Over the past 10 years researches and clinicians have made substantial progress
      in understanding and treating nicotine dependence. To demonstrate the
      effectiveness of these treatments, reliable and sensitive measures of change and
      outcome must be used. In the nicotine dependence treatment literature numerous
      outcome have been used: frequencies drug use, problems associated with substance
      use, psychiatric comorbidity, withdrawal severity, and craving. The term craving
      reflects the subjective reports of addicts regarding their attempts to abstain
      from drug use and the state of their minds at the point at which they attempt to
      fail. Exposure to cues previously associated with nicotine play a role in
      precipitating relapse in eliciting a conditioned craving/withdrawal response and
      can be measures by the Questionnaire of Smoking Urge (QSU). OBJECTIVE OF THE
      STUDY: Validation in a French translated version of the QSU published in 1991 by
      Tiffany and Drobes. METHODOLOGY: 42 male and 62 female participated in the study
      with the translated questionnaire: mean age was 36.7 years, mean age at starting
      and mean duration of tobacco consumption was respectively 20.2 years old and 16.5
      years, daily consumption was 16.6 cigarettes per day. The French translation of
      the QSU was administered to smokers instructed to abstain from smoking one hour
      and a half to three hours. RESULTS: The back translation has been accepted by
      Tiffany because more than 85% of the items are similar to the original
      questionnaire. We founded the same factor analysis with two factors, "desire to
      smoke" and "intention to smoke" accounting for 34% and 11% of the items variance,
      respectively. These two factors were the same than those of the original
      questionnaire. CONCLUSION: The validation of the French translation of the QSU
      gives the opportunity to use a sensitive instrument to assess craving.

PMID- 11217536
TI  - [Sleep polygraphy: diagnostic value in depressive pseudo-dementia. Attempt to
      improve visual scoring by digital periodic analysis].
AB  - ARGUMENT: Pseudo depressive dementia is a common pathology for elderly patients.
      Classically, it is said that depression is taking the mask of dementia, but very
      often deterioration and depression are present at the same time. Sleep EEG can
      help the clinician to differentiate dementia and depression in pseudo depressive
      dementia. Slow Wave Sleep (SWS) is a good indicator of deterioration process. We
      tried to improve the sleep recording and analysis and our ability to
      differentiate SWS in this indication. We use a portable digital recording
      material (Hypnotrace). The signal is analysed by the association of a visual
      standard method to Digital Periodic Analysis (DPA) which is very sensitive to
      SWS. The visual analysis gives informations about the macroarchitecture of the
      night. The Digital Periodic Analysis gives at any moment the value of the wave
      frequency and thus informations about the microarchitecture. Our hypothesis is
      that this association helps to better recognise SWS and thus improves sleep EEG
      as a diagnostic tool in this indication. METHODS: 23 inpatients meeting both the
      criteria for major depression and dementia (DSM IV) have been recorded during two
      nights after 15 days of wash out and before antidepressant treatment. The
      recordings are analysed with the visual standard method and with the help of DPA.
      The patients are evaluated every 15 days during two months in order to define
      three groups based on the clinical evolution. RESULTS: The scoring with DPA is
      more sensitive to Slow Wave Sleep, particularly for the patients with good
      clinical evolution (with the strongest depressive component). Thus, this method
      could be a good diagnostic tool to differentiate dementia and depression in
      pseudo depressive dementia.

PMID- 11217537
TI  - [Cause of mortality in schizophrenic patients: prospective study of years of a
      cohort of 150 chronic schizophrenic patients].
AB  - Overmortality in schizophrenic patients in comparison to the reference population
      has been found. At the present time this over mortality is mainly due to suicide
      or certain natural causes such as respiratory, cardio-vascular and cerebro
      vascular diseases. In France there are not psychiatric cas registers that could
      allow us to study the mortality of psychiatric patients. The aim of the study was
      first to determine the standardized mortality ratio (SMR) in a group of 150
      chronic schizophrenics followed during 8 years and secondly to detect the
      variables that could predict this mortality. METHOD: The subjects filled out the
      RDC criteria for definite chronic schizophrenia and were included from 1991 to
      1995. The subjects were inpatients or outpatients and their evaluation was made
      by psychiatrist. The subjects were selected from the different departments of two
      psychiatric hospitals corresponding to two French geographic areas (the Somme and
      Oise, two French "departement"). At the initial assessment socio-demographic,
      clinical and psychometrical variables were collected: sex, age, educative level,
      number of hospitalizations, mean duration of the illness, scores on the Physical
      Anhedonia Scale, Brief Psychiatric Rating Scale (BPRS), Positive and Negative
      Syndrome Scale (PANSS). For the BPRS and PANSS, negative, positive and general
      subscales were extracted. In May 1999 all the subjects were contacted in order to
      know if they are alive or not and if they are death to know the date and the
      causes of their death. For the subjects that were still alive we used either
      direct assessment by interview of their psychiatrist or general practioner or
      indirect assessment by interview of their family. For the deceased subjects, we
      obtained informations about the date and the causes of the death by their
      psychiatrist or general practioner. If the patients were lost sight of we send a
      letter to the city of their place of birth in order to know if they are alive or
      not and if they are dead to know the date of their death. Moreover demographic
      data concerning the French and the Somme populations as well as the corresponding
      data concerning the mortality according to age and gender were obtained. A
      comparison of global mortality between patients and the French general or the
      Somme populations was made by the SMR. Moreover the deceased subjects and the
      survivors were compared by unidimensional statistical tests (chi 2 analyses for
      qualitative variables or Student's t test for quantitative variables) for the
      sociodemographic, clinical or psychometric variables. For each significant
      difference at p level < or = 0.05, the corresponding variable was retained for a
      multivariate step by step discriminant analysis. RESULTS: We found 13 deaths (10
      males, 3 females): 3 suicides, 3 cardiac diseases, 2 cancers, 1 respiratory
      disease, 1 car crash, 1 homicide, 1 infectious disease, 1 respiratory arrest. The
      mortality rate (without correction for age) were 1.08% for both sexes, 1.44% and
      0.6% for males and females respectively. The mortality rates (corrected for age)
      were 2.47% in our cohort and 0.988% in the Somme population. The corresponding
      SMR was 2.5. (chi 2 = 3.15, df = 1, p < 0.01). The overmortality was found only
      for males (chi 2 = 2.57, df = 1, p < 0.01) and not for females (chi 2 = 0.034, df
      = 1, p > 0.05). Concerning the comparisons between the deceased subjects and the
      survivors, there were five significant differences: gender, age, duration of the
      illness, neuroleptic dosage, negative symptoms (BPRS negative subscale). The
      deceased subjects were older, there was more men, the duration of the illness and
      the neuroleptic dosage were higher and the BPRS negative subscale was lower.
      These five variables were introduced in the discriminant analysis to explore
      notably their respecting weight. The corresponding power of the five variables
      were in decreasing order: neuroleptic dosage, negative symptoms, age, gender,
      duration of the illness. DISCUSSION: Our study confirm the overmortality in
      schizophrenic patients, this overmortality was especially explained by natural
      and non natural causes of death. The overmortality concerned only schizophrenic
      males patients whereas schizophrenic females did not have an overmortality. This
      negative result could be explain by a bias selection, the males being
      overrepresented in our cohort. Among the variables that were linked to the
      overmortality, the low level of negative symptomatology confirmed previous
      studies that have shown a low suicide rate in deficit schizophrenic. Moreover a
      high level of positive symptomatology could lead to high risk behaviors (suicide
      attempts, sexual disinhibition...). The neuroleptic dosage was the variable whom
      discriminate power was the highest. At least two explanations can be proposed.
      (ABSTRACT TRUNCATED)

PMID- 11217538
TI  - [Biological markers in schizotypal and borderline personality disorders].
AB  - A preliminary but growing body of evidence supports the existence of biological
      substrates in personality disorders. Based on a review of the literature, the
      article deals with the major biological markers: genetic, cognitive, biochemical,
      electrophysiological and organic markers, of schizotypal and borderline
      personality disorders. In addition, the article compares these findings in these
      two types of pathological personality. In the field of genetics, we notice
      several indices in favour of a relationship between schizotypal personality
      disorder (SPD) and chronic schizophrenia. In contrast, in borderline personality
      disorder (BPD), indices were lacking for such a relationship between this
      disorder and one of the axis I diagnosis, or a clear genetic transmission. In the
      field of cognitive tests, we can note in both SPD and BPD, that the abnormalities
      which would be at the level of temporal and frontal lobes, may be implicated in
      the observable cognitive troubles in these two disorders. In the field of
      neurobiochemistry, the dopaminergic and serotonergic systems seem to be
      implicated in the etiology of SPD while several data point out the fact that
      several neurotransmitter systems (dopaminergic, serotonergic, noradrenergic and
      cholinergic) seem to be involved in the etiology of BPD. Finally, in the field of
      electrophysiology, we notice that some of these tests observed in SPD (smooth
      pursuit eye movements, evoked potentials, modification of the electrodermic
      response) seem reinforcing the relationship between SPD and schizophrenia while
      those observed in BPD seem reinforcing either a relationship between BPD and
      depression (sleep studies), or a relationship between BPD and schizophrenia
      (evoked potentials, smooth pursuit eye movements).

PMID- 11217539
TI  - [Biological factors of post-traumatic stress: neuroendocrine aspects].
AB  - The core symptoms of post-traumatic stress disorder (PTSD) include persistent
      reexperiencing of the traumatic event, avoidance of stimuli associated with the
      trauma, and autonomic hyperarousal. Many neurotransmitter systems and
      neurobiologic mechanisms may account for these primary symptoms of PTSD. Severe
      psychological trauma results in the parallel activation of these systems,
      producing an array of adaptive behavioral and physiologic responses necessary for
      survival. The pathophysiology of PTSD may involve dysfunction of several brain
      structures, particularly the amygdala, locus coeruleus, and hippocampus, as well
      as noradrenergic system and hypothalamic-pituitary-adrenal (HPA) axis. The
      neuroendocrinology of PTSD, and specifically hypothalamic-pituitary-adrenal axis
      alterations, are ways of examining biologic heterogeneity following trauma and
      its possible clinical implications. The decreased levels of cortisol, the
      increased responsiveness of glucocorticoid receptors, the increased sensitivity
      of the HPA negative feedback inhibition and its progressive sensitization are the
      neuroendocrine alterations specifically associated with the development of PTSD.

PMID- 11217540
TI  - [Antipsychotic drugs and cardiovascular safety: current studies of prolonged QT
      interval and risk of ventricular arrhythmia].
AB  - Cardiovascular mortality is higher among schizophrenic patients than in the
      general population, and it is possible that most unexplained sudden deaths among
      these patients are due to ventricular arrhythmias for which antipsychotic drugs
      are either the cause or a predisposing factor. Most antipsychotic agents show
      electrophysiological effects resembling those of class 1a antiarrhythmic agents,
      and may be responsible for prolonging the QT interval, potentially going on to
      cause torsades de pointes. Some of the antipsychotic agents carry a high risk of
      arrhythmias, related to their effects on the QT interval. These include
      thioridazine, pimozide, sultopride, droperidol, and to a lesser extent
      haloperidol and chlorpromazine. In the case of the new atypical antipsychotic
      agents, it is possible to rank the risks of different drugs, with sertindole (now
      withdrawn from sale) having the highest risk, and ziprasidone somewhat lower,
      followed by risperidone and finally by quetiapine, clozapine and olanzapine which
      have negligible effects on the QT interval. A number of risk factors have been
      demonstrated, particularly: hypokalaemia and hypomagnesaemia, bradycardia,
      congenital long QT syndrome, and any underlying cardiac pathology. Lastly, the
      risk associated with any given antipsychotic agent is increased if it is combined
      either with any other drug known to prolong the QT interval and provoke torsades
      de pointes, or with any drug capable of inhibiting the hepatic metabolism of the
      antipsychotic agent. A list of such drugs is provided, together with advice on
      the action to be taken when prescribing an antipsychotic agent to a patient with
      a long QT interval.

PMID- 11217541
TI  - [Prospective follow-up over a 12 month period of a cohort of 155 patients with
      obsessive-compulsive disorder: phase III National DRT-TOC Study].
AB  - In the phase III of the french national study on OCD, 155 patients suffering from
      an OCD (full DSM III-R criteria, score on NIMH-OC > or = 7, not treated or
      undertreated) had entered a naturalistic follow-up of 12 months duration.
      Obsessions, compulsions, depression, anxiety, impulsivity and global functioning
      were assessed by using NIMH-OC, CPRS-OC2, MOCI, MADRS, HAD (-A, -D), BDS
      (Behavioral Dyscontrol Scale), CGI and GAS (DSM III-R). From the initial
      population (155 patients), 130 (84%) had been treated with drugs and were
      "completers" and assessed at M6 and M12; 18 (11.6%) were lost to follow-up and 7
      (4.5%) had dropped out because of treatment refusal, side-effect or improvement.
      Only 19% of patients had received a behavior therapy. In spite of selection of
      patients with severe and chronic OCD associated to depression (mean MADRS score =
      25), 85% of treated patients had been treated with one anti-OCD drug (105 with
      fluoxetine, 17 with clomipramine and 17 with other antidepressants), 4.5% needed
      a treatment substitution and 4.5% a bitherapy (combination of 2 anti-OCD drugs);
      84% of patients were considered as "good compliant" with visit agenda and
      treatment. At the end of follow-up, global improvement was observed in 77% of
      patients treated. Clinical improvement was assessed by different response
      criteria (final NIMH-OC score, 30% decrease on NIMH-OC, 35% decrease on MOCI,
      final GAF score > or = 70) which showed 4 patterns of response to treatment:
      "positive response on M6 and M12" = 43-64%; "only M12" (slow response) = 13-24%;
      "only M6" (escape or relapse) = 4-6%; "negative response on M6 and M12"
      (resistant OCD) = 19-33%. During 12 month treatment, 31 patients (22.5%) had
      presented an adverse effect in which 7 cases (5.1%) with "serious adverse event"
      and 5 cases (3.6%) who required treatment drop-out. Predictive factors of
      clinical response to anti-OCD drugs were explored: 1) "lack of insight" was the
      best factor to characterise the resistant group; 2) high base-line of
      "impulsivity" predict better response at M6; 3) important to severe slowness was
      associated with a longer delay to response (between M6 and M12). The results of
      the phase III from the french multi-site study will be compared to the
      international data on long-term treatment of OCD.

PMID- 11217542
TI  - [Apropos of using patient isolation in psychiatry: point of view of nurses].
AB  - Seclusion continues to be used in the care of acutely disturbed psychiatric
      patients despite often emotionally charged debate about its appropriateness
      within mental health services. Powerful legal and moral arguments about the use
      of seclusion emphasize an urgent need to critically examine its role in the care
      of mentally ill people. This paper examines the use of seclusion on psychiatric
      departments in the management of acutely disturbed patients: 36 psychiatric
      nurses working in 6 departments in a specialized hospital (the CHS de la Savoie,
      in Chambery) were interviewed in relation to their perceptions of the role of
      seclusion. Data were analysed using grounded theory methodology revealing the
      core conceptual category "controlling" and two sub-categories "watching out for"
      and "watching over". Seclusion was found to be used as an adjunctive treatment in
      the care of individuals considered to be "out of control". Clinicians expressed
      comfort with the use of seclusion, citing a strict protocol that provided
      parameters for its use. While expert therapeutic interventions were described by
      clinicians, they are contextualized within a framework of power and control--a
      framework that stands in stark contrast to contemporary philosophies of nursing
      care, providing impetus for a reconsideration of the use of constraining
      practices in the care of mentally ill people.

PMID- 11217543
TI  - [Weight gain and antipsychotic drug treatment].
AB  - Like the classical neuroleptic drugs, most of the new antipsychotic agents can
      cause weight gain in patients receiving long-term treatment. However, it remains
      difficult to rank the different compounds according to their propensity to cause
      this unwanted side-effect. Recent data suggest that weight gain appears to be
      essentially related to an increase in appetite in these patients. Thus, it is a
      fact that the patients' diet represents the main predictive factor for weight
      gain, independently of the antipsychotic compound prescribed. In contrast to the
      other and often more disabling side-effects of these treatments, overweight can
      be effectively prevented by simple hygienic and dietetic measures. It would
      therefore be advisable to discuss the possibility of this side-effect of
      antipsychotic treatment with the patient, and to suggest appropriate preventive
      measures, as part of the therapeutic partnership.

PMID- 11217544
TI  - [Varicocele in adolescents].
AB  - Varicocele is a frequent disease in adolescents (15%) and has a harmful effect on
      growth of the testis and spermatogenesis, which deteriorates with increasing
      exposure time to varicocele. However, only 15 to 20% of adults with varicocele
      are infertile. It is currently impossible to predict, among adolescents with a
      varicocele, those who will subsequently be infertile. Testicular hypotrophy
      reflects testicular repercussions, but its correlation with subsequent
      infertility is unknown at the present time. However, treatment of varicocele
      allows correction of testicular hypotrophy. Although the arguments are still only
      speculative, testicular hypotrophy, together with symptomatic and/or grade III
      varicocele, represents a logical indication for treatment of varicocele in
      adolescents. Many techniques can be used to occlude the varicocele in
      adolescents. Open retroperitoneal surgery is currently the reference method.

PMID- 11217545
TI  - [High intensity focused ultrasound (HIFU) in urology].
AB  - INTRODUCTION: Focused ultrasound is now well known to urologists in the context
      of its validated application in extracorporeal lithotripsy. High Intensity
      Focused Ultrasound (HIFU) represents a potential therapeutic modality for tissue
      destruction due to its very high energy and its capacity to precisely reach a
      target with a very short emission time. The authors review the current state of
      art of HIFU in urology at a time when its indication in prostate cancer is being
      defined. MATERIAL AND METHOD: After a brief description of the main physical
      principles of ultrasound and the main data determining focussing of high energy
      ultrasound, the main machines available (research and clinical) are described.
      The published clinical literature concerning the tissue destructive action in
      urology is reviewed. RESULTS: HIFU has been used in urology to treat renal,
      vesical, prostatic (BPH and cancer), and external genital organ lesions. Purely
      extracorporeal machines are gradually being replaced by intracorporeal
      procedures, especially transrectal techniques for prostatic lesions. The quality
      of ultrasound detection of the target still limits the use of this minimally
      invasive modality. The intervening tissues are spared with a good therapeutic
      efficacy on the target tissues, provided optimal firing parameters are used.
      CONCLUSION: HIFU has a demonstrated potential in the treatment of prostate cancer
      and studies conducted by several teams have defined the technique and its
      efficacy. Other indications have been studied, but must be validated by further
      clinical trials. The future will probably see the design of machines adapted to a
      specific target tissue rather than a single multidisciplinary extracorporeal
      machine.

PMID- 11217546
TI  - [Mechanisms of action of BCG: towards a new individualized therapeutic
      approach?].
AB  - A better knowledge of antitumour immunity and the mechanisms allowing the tumour
      to overcome the host's immune surveillance has led to progress in the
      understanding of the mechanisms of action of Bacille Calmette-Guerin (BCG), as
      the local intravesical immune response is intimately related to the interaction
      of three systems: the host (the patient), the BCG (mycobacteria) and the tumour.
      This interaction gives rise to a cascade of immunological events, some of which
      are essential to the protective action of BCG against relapse and tumour
      progression. The immune response to BCG is currently considered to comprise three
      phases. First of all, the BCG adheres to the urothelium and is then phagocytosed
      by antigen-presenting cells. This phase corresponds to early release of so-called
      inflammatory cytokines (IL1, IL6, IL8). These cytokines could be responsible for
      certain adverse effects, but could also participate in cytotoxic phenomena. The
      second phase consists of recognition of bacterial antigens by helper CD4
      lymphocytes, which mainly release IL2 and IFNg (Th1 response). This cellular
      activation leads to the third phase: amplification of cytotoxic populations
      capable of killing tumour cells: CD8, gd lymphocytes, macrophages, NK, LAK, BAK
      cells. All these cells also produce cytokines, which participate in regulation of
      the immune response. The understanding of these mechanisms of action, urinary
      cytokine assays, a better definition of cytotoxic cells and their role, molecular
      analysis of the tumour and probably certain genetic characteristics of the host
      will allow the elaboration of more effective immunization protocols by defining
      an individualized therapeutic approach.

PMID- 11217547
TI  - [Kidney harvesting in living donors with manually assisted laparoscopy: technique
      and results].
AB  - OBJECTIVE: To evaluate the feasibility and complications of manually assisted
      laparoscopic live donor kidney harvesting. MATERIAL AND METHOD: Since June 1999,
      all related live donor kidney harvests have been performed by manually assisted
      laparoscopy. The patient is placed in the lumbotomy position and an 8 cm midline
      periumbilical incision is made. The assistant's hand is introduced through a
      watertight port (HandPort). Three trocars are used. The assistant presents the
      structures to be dissected and controls the ureter. The artery is clipped and the
      vein is stapled or clipped, depending on its diameter. The kidney is extracted
      via the midline incision and washed. RESULTS: Five kidney harvests were performed
      (three right kidneys and two left kidneys) with a mean operating time of 220 +/-
      30 minutes. Conversion was necessary in one case following the intraoperative
      discovery of two right renal veins. Warm ischaemia lasted 5 minutes for the first
      patient and one to two minutes for the other four non-converted patients. Blood
      losses were minimal. The mean duration of major analgesia was 2.4 days and the
      mean length of hospital stay was 7.2 days. Complications were: bacteriuria in 2
      cases and prolonged lymphorrhoea in 1 case. One transplanted kidney had to be
      removed because of immediate thrombosis of the recipient iliac artery. With a
      mean follow-up of 6 months (1 to 12 months), no ureteric or venous complications
      have been observed in the 4 evaluable transplanted kidneys. CONCLUSION: An intra
      abdominal hand during laparoscopic live donor kidney harvesting simplifies
      dissection, ensures intraoperative security and allows rapid extraction of the
      kidney.

PMID- 11217548
TI  - [Balloon catheter parieto-renal dilatation in percutaneous kidney surgery].
AB  - OBJECTIVE: To compare two techniques of parieto-renal dilatation for percutaneous
      surgery: Alken dilators and balloon catheter. MATERIAL AND METHODS: This
      prospective, non-randomized study was conducted between July 1999 and April 2000
      in 20 patients undergoing percutaneous renal surgery. 10 patients were dilated
      with a balloon catheter (NephroMax, Boston Scientific) and the other 10 patients
      were dilated with Alken metal dilators. Statistical analysis was performed with
      the Mann-Whitney test. RESULT: The dilatation time and x-ray exposure time were
      shorter during balloon catheter dilatation (statistically significant difference)
      and the two techniques were associated with a comparable morbidity. CONCLUSION:
      Balloon catheter parieto-renal dilatation significantly decrease dilatation and x
      ray exposure times and very considerably simplifies this operative step,
      essential to the success of percutaneous surgery.

PMID- 11217549
TI  - [Cystine lithiasis: study of a series of 116 cases].
AB  - INTRODUCTION: Cystine stones is a rare disease, related to a genetic metabolic
      disease. Its management must treat both the stones and their complications, and
      prevent recurrences by controlling cystinuria. OBJECTIVE: The objective of this
      study was to define the natural history of cystine stones, identify reliable
      diagnostic criteria and propose a simple treatment regimen. MATERIAL AND METHOD:
      The authors studied the clinical, biochemical and radiological data of a
      retrospective series of 116 cases, treated by the same urologist between 1953 and
      1999. RESULTS: Cystinuria is often diagnosed in young adults on the basis of
      urine biochemistry (Brand's reaction, urinary cystine assay) or
      spectrophotometric analysis of the stones or urinary crystals. This assessment,
      not performed routinely, must be guided by a family history, recurrent stones or
      following failure of lithotripsy. The appearance of the stones, macroscopically a
      waxy yellow, radiologically only slightly opaque with a large component in the
      renal pelvis associated with a small round caliceal stones, is highly suggestive.
      Radiological assessment by IVU is generally sufficient. Treatment of the disease
      is medical and surgical: dietary measures, alkalinization of the urine and
      possibly drug treatments, are associated with extracorporeal lithotripsy or
      surgical treatment. These modalities eliminate cystine stones in 70% of cases.
      Recurrent stones are observed in 42% of cases followed for more than 5 years,
      mainly due to the presence of residual fragments (60% of recurrences).
      Surveillance and dietary measures must be maintained for life. Surveillance is
      based on biannual radiographic follow-up (plain x-rays +/- ultrasound) to detect
      and consequently treat small stones. A test for cystinuria must be proposed to
      all relatives of affected patients. CONCLUSION: This disease presents very
      polymorphic clinical features and clinical course. It can be responsible for
      impaired renal function and must therefore be investigated in the presence of
      suggestive clinical signs or history to avoid a delayed diagnosis, as treatment
      modalities are available to decrease the frequency of recurrence and which can
      potentiate treatment by surgical or lithotripsy. However, there are no predictive
      factors of deterioration of the disease, and biannual surveillance, for life, is
      essential to detect and treat small stones.

PMID- 11217550
TI  - [CT-guided percutaneous fine needle biopsy of solid tumors of the kidney].
AB  - OBJECTIVE: This study was designed to evaluate the reliability and the role of
      percutaneous needle biopsy in the diagnosis of renal masses. MATERIALS AND
      METHODS: 85 biopsies were performed in 74 patients (mean age: 62 +/- 14 years).
      The median tumour diameter was 4.44 +/- 2.53 cm. Biopsies were performed with an
      18G ASAP* needle with CT guidance. 2 to 4 cores were obtained per patients. All
      biopsies were performed as an outpatient procedure. RESULTS: Biopsies were
      uninterpretable in 15 cases (17%) (13 with normal or no renal tissue and 2
      necrotic samples). A benign lesion was detected in 8 cases (4 fibrous lesions, 4
      infectious lesions). In 3 cases, biopsies were suspicious of cancer, which was
      confirmed on definitive histology. In 59 cases, biopsies were neoplastic: 6
      benign tumours (4 oncocytomas, 1 angiomyolipoma, 1 cystadenoma), 42 renal cell
      carcinomas (RCC) (conventional: 32, chromophobe: 3, tubulopapillary: 7), 5
      urothelial carcinomas, 3 metastases, 2 lymphomas and 1 sarcoma. The median
      Furhman grade was 2. 30 RCC were operated. The correlation coefficient for the
      biopsy and pathology histological type was 0.90. The median pathological Furhman
      grade was 2. The biopsy results modified therapeutic management in 38% of cases.
      There was no morbidity, post-biopsy medical management was never required.
      CONCLUSION: Biopsy of renal masses is reliable for evaluation of the histological
      type. The introduction of the CT scope should increase the accuracy of biopsies.
      The morbidity is low compared to that of diagnostic surgery.

PMID- 11217551
TI  - [Hydroposturotherapy and residual lithiasis after lithotripsy].
AB  - OBJECTIVE: The authors report the results of hydroposturotherapy on elimination
      of residual stone fragments after extracorporeal lithotripsy. MATERIALS AND
      METHODS: 417 subjects with residual stone fragments after one or several
      lithotripsy sessions, who failed to eliminate any fragments over a period of 3 to
      6 months, or even 12 months, before starting treatment, were submitted to
      intensive water intake and appropriate daily hydrotherapy. Hydrotherapy was
      adapted to each case and, in the case of residual lower caliceal stones, the
      subjects were placed in the vertical position, head downwards with the feet in
      the air, to facilitate migration of stone fragments. RESULTS: The subjects
      examined their urine at each micturition and collected any fragments expelled.
      Overall, in the population of 417 subjects treated in this way for three weeks,
      partial or complete expulsion was obtained in 282 cases (67.6%). Stone expulsion
      was obtained in 218 of the 305 cases (71.5%) of residual lower caliceal stones
      and 64 of the 112 cases (57.1%) of middle or upper caliceal stones. Stone
      expulsion, when obtained, usually started by the first, second or third day of
      treatment. CONCLUSION: This study shows that hydroposturotherapy can improve the
      elimination of residual stone fragments following extracorporeal lithotripsy.

PMID- 11217552
TI  - [Ureteral lesions after surgery of the aortic bifurcation. Report of 6 cases].
AB  - OBJECTIVE: The objective of this study was to evaluate the management and current
      treatment options for ureteric complications after vascular surgery based on a
      series of 6 cases. PATIENTS AND METHOD: 6 patients were treated between 1990 and
      1998 (mean age: 64.7 years) for ureteric complications after aortic bifurcation
      surgery. The mean interval between vascular surgery and urological management was
      11.6 years (+/- 4.04). All patients were assessed by intravenous urography (IVU),
      and 4 patients were assessed by abdominal computed tomography (CT). These
      complications consisted of: 2 cases of ureteric stenosis, 1 case of inflammatory
      peri-ureteritis, 2 cases of chronic peri-ureteritis and 1 case of compression by
      a false aneurysm. The lesion was situated in the iliac ureter in every case.
      RESULTS: Treatment consisted of temporary double J stenting (n = 1), ureter
      release (n = 1), endoscopic dilatation (n = 1), psoas bladder reconstruction (n =
      1) and corticosteroid therapy (n = 2), with 4 successes, 1 failure
      (corticosteroid therapy), and 1 death from another cause. CONCLUSION: Ureteric
      lesion after vascular surgery is a rare complication, often discovered
      incidentally. The iliac ureter is predominantly affected. IVU and CT are the
      reference examinations. Treatment options primarily depend on the patient's
      general state.

PMID- 11217553
TI  - [In vitro study of the modulation of human ureteral tonus by nitric oxide and
      zaprinast, a phosphodiesterase inhibitor].
AB  - AIM OF THE STUDY: To assess the role of nitric oxide (NO) and its second
      messenger, cGMP, on the mechanisms underlying human ureteral smooth muscle
      relaxation. METHODS: Proximal segments of ureter were dissected from nephrectomy,
      then cut into rings and suspended in organ chambers. Isometric tone was recorded
      at baseline and after preincubation with KCl (120 mumol). The Increasing
      concentration (10-8-10-4 M) of NO donors, Sodium nitroprusside, (SNP) and
      molsidomine (SIN-1) and a type V phosphodiesterase inhibitor, Zaprinast were
      added to the organ chambers and a dose response curve was constructed from each
      experiment. RESULTS: Dose-dependent relaxation was seen with all compounds. This
      was, however, more pronounced with SNP as compared with SIN-1. Zaprinast alone
      had marginal relaxant effect but markedly potentiated the relaxing effect of the
      NO donor SNP (p < 0.05). Inhibition of NO synthesis by the arginine analogue L-NA
      increased electrical-induced contraction (98 +/- 4% vs 122 +/- 3%, p < 0.001).
      CONCLUSION: Activation of the soluble guanylate cyclase by NO donors markedly
      relaxed significantly human ureteral smooth muscle but inhibition of
      phosphodiesterase did not affect the in vitro relaxation. Our results suggest
      that cGMP is an important second messenger in the transduction signalling pathway
      leading to relaxation of human ureteral smooth muscle. By contrast, basal
      activity of phosphodiesterase seems to be marginal under physiological condition.

PMID- 11217554
TI  - [Pfannenstiel short horizontal laparotomy in retropubic radical prostatectomy].
AB  - OBJECTIVE: To evaluate the feasibility of the Pfannenstiel short horizontal
      laparotomy to perform retropubic radical prostatectomy and its consequences on
      postoperative analgesic consumption. MATERIALS AND METHODS: From December 1998 to
      February 2000, 62 radical prostatectomies were performed via a short horizontal
      suprapubic incision. The mean length of the incision in the lower abdominal fold
      was 10.2 cm (range: 8 to 14 cm). The mean duration of radical prostatectomy was
      130 minutes (range: 90 to 210 min). Double drainage (retropubic and
      subaponeurotic) was systematically maintained for an average of 48 hours.
      Postoperative narcotic analgesic consumption, and the modalities and duration of
      prescription were compared between 30 patients operated by this technique and 30
      patients previously operated via a midline infraumbilical incision. RESULTS: The
      abdominal wall opening and closing time was about 20 minutes. The operation was
      always performed via this incision, allowing excellent exposure of lymph node
      areas and the prostate. Postoperative complications related to this incision
      consisted of a single subaponeurotic haematoma, which was not drained. The mean
      dosage and duration of postoperative analgesic consumption decreased by 44%
      compared to the reference group. Postoperative assessment of the abdominal wall
      showed almost complete disappearance of the scar at 3 months and no secondary
      wound dehiscence. CONCLUSION: The Pfannenstiel short horizontal laparotomy is a
      simple and reproducible technique for retropubic radical prostatectomy. This
      feasibility study was accompanied by a reduction of postoperative analgesic
      consumption in the study group.

PMID- 11217555
TI  - [Vesico-uterine fistula. Report of 10 cases].
AB  - OBJECTIVE: To study the aetiopathogenics, diagnostic and therapeutic aspects of
      this pathology. MATERIALS AND METHODS: The authors report a series of 10 vesico
      uterine fistulas observed over a 10 years period. The mean age was 32 years(30
      40). The fistulas were secondary to cesarian section in 6 cases and to abnormal
      delivery in 4 cases. The symptomatology was an urinary leakage from the vagina in
      6 cases, an isolated cyclic hematuria in 3 cases and the association of the two
      signs in one case. The diagnostic was established on clinical examination in 8
      cases. Intraveinous urography was performed in all the patients and visualised
      the uterine cavity in only 8 cases. In the 2 remaining cases a retrograd
      cystography was performed and demonstrated the opacification of the uterine
      cavity. The treatment was surgical in 9 cases. One patient who had a menuria has
      refused the operation. RESULTS: The diagnostic of the vesico-uterine fistulas is
      often based on clinic examination but often necessitate recourse to complementary
      examinations mostly in the menouria forms. The intraveinous urography does not
      establish the diagnostic in all the cases but is an indispensable complementary
      investigation because it permits searching for an associated ureteral injury.
      With a mean recoil of one year the results judged on the disappearance of the
      clinic signs was good in all the patients. CONCLUSION: The vesico-uterine
      fistulas are often secondary to cesarian section or abnormal delivery. Their
      treatment is surgical but is above all preventive by the improvement of the
      obstetric taking care and avoiding the vesical injuries in the course of the
      cesarian section.

PMID- 11217556
TI  - [Assessment of hemorrhage risk of transvesical prostatectomy with bladder neck
      cerclage].
AB  - OBJECTIVE: Evaluation of blood loss and predictive factors of haemorrhagic
      complications of transvesical prostatectomy. MATERIAL AND METHODS: From January
      1994 to December 1998, 202 patients with a mean age of 70.5 +/- 7.4 years (range:
      46.6-89.3 years) were operated for benign prostatic hyperplasia with a mean
      prostate weight of 86 +/- 33 g. Transvesical prostatectomy was performed with
      bladder neck cerclage and suction drainage of the prostatectomy site for 48
      hours. 107 patients donated blood preoperatively (mean: 2.8 +/- 0.7 units) to
      allow possible autotransfusion. Blood losses were evaluated by determining
      haematocrit during hospitalisation, the quantity of blood collected
      intraoperatively and the presence of postoperative bleeding possibly requiring
      surgical revision. RESULTS: The calculated overall blood loss was 435 +/- 306 ml
      of RBC, i.e. 1783 ml for an haematocrit of 30%. A high ASA score was
      significantly related with higher blood loss and preoperative anticoagulant
      treatment. No predictive factor for intraoperative bleeding (mean: 519 +/- 327
      ml) was identified. Absence of the median lobe and a high ASA score were also
      predictive factors of postoperative bleeding. Age, operating time, prostate
      weight, recent urinary tract infection, preoperative drainage, preoperative
      haematocrit, and preoperative blood donation (autotransfusion) did not
      significantly influence the volume of blood loss. CONCLUSION: Apart from the ASA
      score, no predictive factor for the severity of bleeding associated with
      transvesical prostatectomy was defined in order to identify a group of patients
      at higher risk of severe bleeding.

PMID- 11217558
TI  - [Fluorodeoxyglucose (FDO) positron emission tomography (PET) in testicular germ
      cell tumors in adults: preliminary French clinical evaluation, development of the
      technique and its clinical applications].
AB  - OBJECTIVES: Metabolic positron emission tomography (PET) is a new imaging
      modality for the detection of tumours, which uses fluorodeoxyglucose (FDG) to
      demonstrate increased carbohydrate metabolism of malignant cells. The management
      of testicular germ cell tumours in adults raises three clinical problems poorly
      resolved by conventional imaging techniques: identification of suspected
      recurrences in a context of elevated circulating serum markers, initial staging
      assessment after orchidectomy, evaluation of the response to treatment. MATERIAL
      AND METHODS: The authors report the data obtained in 16 patients (6 cases of
      seminoma and 10 cases of non seminomatous germ cell tumour [NSGCT]), investigated
      in the Frederic-Joliot Department using a dedicated PET camera, 60 minutes after
      intravenous injection of 270 MBq of FDG. RESULTS: In 9 cases of assessment of
      elevated serum markers with no tumour identified by conventional examinations,
      PET demonstrated images likely to correspond to tumour sites in 7 patients (5
      true-positives [TP] and 2 false-positives [FP] due to postoperative inflammatory
      changes). PET was negative in 2 out of 9 patients, in whom subsequent follow-up
      showed spontaneous but delayed return to normal of tumour markers. In 3 of the 4
      cases of initial staging of the disease, PET excluded an extension suspected by
      conventional imaging and the 4th case was a FP for PET. In 3 cases of evaluation
      of the response to treatment, PET concluded on the absence of viable residual
      tumour mass, with a false-negative result in one case. CONCLUSIONS: These results
      are in line with those reported in the literature, which emphasize the diagnostic
      difficulties encountered in this disease. The significant contribution of FDG-PET
      should be confirmed by larger series of patients investigated by this new
      modality.

PMID- 11217557
TI  - [Prospective, multicentric, open, and controlled evaluation of the effectiveness
      of prostatron 2.5 in the treatment of prostatic benign hypertrophy: 1-year
      results].
AB  - OBJECTIVE: Evaluation of the efficacy at 1 year of the Prostatron 2.5 in the
      treatment of BPH weighing more than 40 grams. MATERIAL AND METHODS: 46 patients
      over the age of 50 years presenting with BPH > 40 grams responsible for a maximum
      flow rate (MFR) < 9 ml/s and a mean IPSS score of 18 were prospectively included
      without randomization, by 5 French Urological Centres. These patients were
      reviewed at 3, 6 and 12 months. Primary endpoint: MFR; secondary endpoints:
      Madsen score and IPSS. RESULTS: No major complications were observed. The mean
      postoperative catheterization time was 10 days, causing discomfort with a mean
      score of 5 on a visual analogue scale from 0 to 10.. Maximum flow rate waas 13.4
      ML/s at 3 months, 13.4 ml/s at 6 months and 14.7 ml/s at 12 months. The IPSS was
      improved by 75%. CONCLUSION: Treatment by Prostatron 2.5 improves the MFR and the
      patient's quality of life, which is maintained for at least 1 year after
      treatment.

PMID- 11217559
TI  - [Epidermoid cancer of the kidney pelvis].
AB  - Squamous cell carcinoma of the renal pelvis is a rare tumour, mainly occurring in
      elderly patients with neglected and secondarily infected pyelocaliceal stones. It
      has a poor prognosis. The authors report the case of a 74-year old man with a
      destroyed and painful kidney containing a staghorn calculus for 30 years. The
      preoperative diagnosis was pyonephrosis, but nephrectomy, justified by the
      symptoms, showed that the kidney was invaded by a squamous cell carcinoma of the
      renal pelvis invading the psoas. The patient died 1 month after the operation.
      Treatment is essentially preventive by removal of staghorn calculi and management
      of chronic urinary tract infections.

PMID- 11217560
TI  - [Urothelial tumor and colonic cancer in the context of a syndrome of hereditary
      predisposition to HNPCC colonic cancer].
AB  - The authors report the association of ureteric tumour and colon carcinomas in the
      context of hereditary predisposition to HNPCC colon cancer (hereditary non
      polyposis colon cancer). The recall the diagnostic criteria of HNPCC syndrome and
      emphasize the importance of guiding the clinical interview of patients with upper
      urinary tract tumours in order to detect a family history and the presence of
      gastrointestinal tumours.

PMID- 11217561
TI  - [Primary lymphoma of the bladder].
AB  - The authors report two cases of primary non-Hodgkin's malignant lymphoma of the
      bladder. In contra with secondary site, which are not rare, primary malignant
      lymphomas of the bladder wall are exceptional. Urinary symptoms are varied and
      nonspecific. These tumours cannot be distinguished from other bladder tumours on
      the basis of their radiological or endoscopic appearance. Only histology provides
      the diagnosis. The pathophysiological hypotheses are discussed. Treatment is
      mainly based on chemotherapy. Endoscopic drainage procedures are sometimes
      useful, as in one of the reported cases.

PMID- 11217562
TI  - [Rupture of the female urethra in pelvic fractures: report of 2 cases].
AB  - Urethral trauma after fracture of the pelvis is rare in women due to the mobility
      and short length of the urethra, which is consequently better protected in the
      case of trauma than the male urethra. Vaginal trauma is sometimes associated due
      to the intimate contact between the urethra and vagina. A pelvic and perineal
      examination must be systematically performed in all women presenting with pelvic
      trauma to avoid the morbidity resulting from late diagnosis of urethral trauma.
      Early surgical operation allows precise repair of the lesions, ensuring a good
      functional result.

PMID- 11217563
TI  - [Cancer of the female urethra. Report of 2 new cases].
AB  - Female urethral cancer is a rare urologic malignancy, it is about 0.02% of genito
      urinary cancer in woman. Prognosis remains poor and it depends of staging of
      disease. Applying combined modality treatment (radiation and surgery) may produce
      local control and increase the survival.

PMID- 11217564
TI  - [Primary mucinous carcinoma of the female ureter].
AB  - The authors report a new case of primary mucinous carcinoma of the urethral
      meatus in a 66-year-old patient, treated by simple excision. The patient is in
      very good general health one year after the diagnosis. Although primary mucinous
      carcinoma of the female urethra is very rare, this diagnosis should be considered
      in any case of macroscopically suspicious urethral polyp, after having eliminated
      a gastrointestinal, vesical or gynaecological origin. Only seventeen cases have
      been published in the literature. Unlike our case, most of the reported lesions
      involved all of the urethra at the time of diagnosis and frequently presented
      extension to periurethral tissues or adjacent organs. A very poor prognosis is
      reported in the literature, even despite treatment, based on surgery and/or
      radiotherapy.

PMID- 11217565
TI  - [Progression of stage I non-seminomatous germ cell tumors during surveillance.
      Role of positron emission tomography].
AB  - Surveillance is one of the options proposed in the management of stage 1 non
      seminomatous germ cell tumours when there is only a low risk of progression. No
      consensus has yet been reached concerning the modalities of this surveillance and
      several protocols are available, including the CCAFU protocol. The presence of
      recurrences in this population at low risk of progression, estimated to be 5%,
      accounts for the continuing research for more precise predictive factors of
      occult metastases. Although several studies appear to indicate a useful
      predictive value for some of these factors, their application in clinical
      practice still appears to be difficult. PET metabolic imaging (positron emission
      tomography) could constitute a new approach to staging of these tumours, allowing
      the detection of tumour sites by an increase of carbohydrate metabolism of
      malignant cells. However, no study is yet available to define the real place of
      this technique.

PMID- 11217566
TI  - [Unusual tumor: liposarcoma of the spermatic cord].
AB  - Spermatic cord liposarcoma is a rare tumour, as only 60 cases have been reported
      in the literature. They represent 7% of all malignant spermatic cord tumours. The
      authors report a new case of spermatic cord liposarcoma unusual by its
      inflammatory and fibrotic features, occurring in an 83-year-old man in poor
      general health. Treatment consists of surgical resection as widely as possible.
      Adjuvant radiotherapy is sometimes effective on local recurrences. Despite the
      slow rate of progression of this tumour, prolonged surveillance is required due
      to the high risk of late recurrence.

PMID- 11217567
TI  - [Paratesticular rhabdomyosarcoma].
AB  - The authors report a case of embryonal paratesticular rhabdomyosarcoma in a 9
      year-old child and discuss the treatment modalities in the light of data from the
      literature.

PMID- 11217568
TI  - [Malignant testicular non-Hodgkin's lymphoma in a young subject].
AB  - The authors report a rare case of testicular non-Hodgkin's malignant lymphoma
      (NHML) in a 21-year-old man with a fatal outcome. In the light of the literature,
      they analyse the clinical features, clinical course and treatment of this
      lymphoma.

PMID- 11217569
TI  - [Materials used in treatment of stress urinary incontinence with suburethral
      sling].
AB  - Suburethral sling is a classical method of surgical repair of female stress
      urinary incontinence (SUI). Initially reserved for SUI due to sphincter
      incompetence, this method now appears to be indicated for other types of SUI. A
      large number of organic and synthetic materials have been used in published
      series. The long-term functional results reported in the literature vary between
      65 and 98%, regardless of the materials used. Some of the complications observed
      are specific to the type of material. Synthetic slings appear to be associated
      with a higher complication rate. It is too early, based on data of the
      literature, to determine the real role of Prolene tape (TVT).

PMID- 11217570
TI  - [Extra-corporeal lithotripsy in children].
AB  - Extracorporeal shock-wave lithotripsy (ESWL) constitutes the reference treatment
      for renal and ureteric stones in adults, but its use and development in children
      have been accompanied by a certain degree of caution and reticence. A large
      number of paediatric series have been published since 1986, confirming the
      efficacy and minimally invasive nature of this technique. Modification of the
      nature of the shock waves and release onto the market of second and third
      generation apparatuses have simplified the management of urinary stones in
      children. However, several questions persist concerning the maximum number of
      impacts, the recommended interval between two sessions and the long-term effects
      of shock waves on the growing renal parenchyma. The objective of this study was
      to review the current state of ESWL in children based on a review of the
      literature, the GEUP report and our own experience.

PMID- 11217571
TI  - [Intent to treat].
AB  - Intent to treat methodology consists of keeping all patients included, in their
      initial group in the case of randomization, to perform final analysis of a study.
      This attitude is justified methodologically, as it preserves the validity of the
      statistical rationale, and clinically, as it more closely reproduces real
      prescribing conditions. In the light of a classical example, this review
      illustrates several clinical situations raising the problem of intent to treat.

PMID- 11217572
TI  - [Critical review of quality of life scales].
AB  - Methods of construction and required metrologic properties of quality of life
      scales are reviewed while looking for such tools in the field of urinary tract
      infections. To capture the subjectivity of patients, to reach a simple measure
      scale, to build a reliable tool, are conflicting aims. Although they appeared
      several years ago and are broadly spread in all medical fields, including
      urology, quality of life scales are still in early ages and are not always widely
      admitted. Quality of life scales can be criticized, but they capture specific
      data and are very useful in some fields. Today, there are no quality of life
      scales in the field of urinary infectiology.

PMID- 11217573
TI  - [Indication and strategy for further biopsies following the diagnosis of
      prostatic intra-epithelial neoplasia].
AB  - Prostatic Intraepithelial Neoplasia (PIN) lesions are characterized by
      proliferation of the epithelial cells lining prostatic ducts and acini. Only high
      grade PIN lesions (grades 2 and 3) should be reported on biopsy histology
      reports. The authors present a review of the literature. The clinical importance
      of demonstration of isolated PIN lesions on prostatic biopsies is based on the
      high risk of associated invasive cancer present in the prostatic gland in 22% to
      100% of cases, usually adjacent to the zone presenting PIN lesions. This risk
      increases as the grade of the PIN lesion increases, when there is a clinical
      (abnormal digital rectal examination) or laboratory suspicion (elevation PSA > 10
      ng/ml), or in elderly patients. Identification of a high grade PIN does not
      require any immediate treatment decision. PSA assays do not need to be repeated.
      A new series of biopsies is recommended after three months. The optimal strategy
      for the choice of the new biopsy sites has not been defined. In the case of a
      first series of sextant biopsies, a new series of biopsies is recommended,
      combining biopsies directed towards the site of PIN lesions (3 biopsies in the
      site of PIN lesions, 2 biopsies adjacent to this site) and systematized biopsies
      of the same side. In the case of a first series of non-systematized biopsies, a
      new series of systematized biopsies is recommended.

PMID- 11217574
TI  - [Prostatic biopsies: technical modalities and conditions of the test].
AB  - Histological examination of prostate biopsies is necessary for the diagnosis of
      prostate cancer. The technical modalities and examination conditions of prostate
      biopsies were evaluated in the light of a review of the literature and the
      conclusions are presented in the form of standards, options and recommendations.
      STANDARDS: The standard or modified protocol of 6 sextant biopsies, applied as
      first-line investigation in all cases of stage T1c or T2 prostate cancer is a
      standard procedure and remains a reproducible, effective and well tolerated
      method for diagnosis and staging. Rectal preparation by enema and prophylactic
      antibiotics before the examination decrease the risk of infectious complications.
      In its usual modality used for the majority of patients, biopsies are performed
      as an outpatient procedure, with or without local anaesthesia, with ultrasound
      guidance via a transrectal approach using an 18 Gauge needle (pink colour code),
      mounted on an automatic biopsy gun and especially sampling the posterior and
      lateral zone. The patient must be given written information explaining the risks
      and management of possible complications following this examination. OPTIONS:
      Local, regional or general anaesthesia may be necessary in a minority of cases,
      either in the context of a protocol of extensive systematized biopsies (more than
      10 biopsies), or in the case of repeated examination, or when preferred by the
      patient. Modified extensive protocols (sextant plus posterolateral zones or
      sextant plus anterior zones) applied to all cases as first-line procedure is a
      useful option, particularly when: 1) a first series of biopsies was negative 2)
      PSA is < or = 10 ng/ml and digital rectal examination is normal (sextant plus
      posterolateral zones) 3) the prostate is larger than 50 cm3 (sextant plus
      anterior zones). The transperineal approach is less reliable for detection and
      staging, and is used when the transrectal approach is contraindicated. When
      curative treatment is not considered (life expectancy < 10 years, patient's
      choice, stage T3, T4), the number of biopsies can be decreased. Transurethral
      resection of the prostate is not recommended as first-line procedure for the
      diagnosis of prostate cancer. RECOMMENDATIONS: Written information given to the
      patient during the visit prior to biopsy to explain the objectives, practical
      modalities and risks of prostate biopsies facilitates the patient's cooperation
      during the examination and increases its tolerance.

PMID- 11217575
TI  - [The legislator's position regarding research perspectives (concerning xenografts
      and the development of stem cell banks].
AB  - Analysis of the legislation concerning xenotransplantation and constitution of
      stem cell banks reveals an absence of status common to embryos and animals. They
      do not have any legal status, they are not assimilated to objects, but benefit
      from protective measures. Xenotransplantation is regulated by a set of rules,
      while embryo research is currently prohibited in France, but is regulated in
      other countries. Bioethical legislation raises difficulties related to the early
      stage of its development and its perverse effects. The consultation process prior
      to defining legislation must take into account the international dimension and
      the necessary progress of scientific research.

PMID- 11217576
TI  - [Acute intermittent porphyria: a new hypothesis to explain Jean-Jacques
      Rousseau's urinary disorders].
AB  - We present the main diagnosis concerning Rousseau's, with an emphasis on his
      urologic disorders.

PMID- 11217577
TI  - [Re: "The TVT seen from the other side" by Philippe Zimmern].

PMID- 11217578
TI  - [Re: "The TVT seen form the other side" by Philippe Zimmern].

PMID- 11217579
TI  - [Re: "The TVT seen from the other side" by Philippe Zimmern].

PMID- 11217580
TI  - A fluid issue.

PMID- 11217581
TI  - More about waterlines.

PMID- 11217582
TI  - Licensure.

PMID- 11217583
TI  - A flawed report on fractures?

PMID- 11217584
TI  - Mandatory or elective?

PMID- 11217585
TI  - Composites vs. Amalgams.

PMID- 11217586
TI  - Can tomatoes fight oral cancer?

PMID- 11217587
TI  - Are you now treating or have you ever treated indigent patients, either through a
      government program such as Medicaid or at a reduced our-of-pocket fee?

PMID- 11217588
TI  - Prevalence of carpal tunnel syndrome and median mononeuropathy among dentists.
AB  - BACKGROUND: The authors undertook a study to determine the prevalence in dentists
      of abnormal sensory nerve conduction and/or symptoms of carpal tunnel syndrome,
      or CTS, the most common nerve entrapment syndrome. METHODS: In a cross-sectional
      study, dentists (n = 1,079) were screened during the American Dental
      Association's Annual Health Screening Program in 1997 and 1998 by means of
      standard electrodiagnostic measures in the dominant hand and a self-reported
      symptom questionnaire. The authors diagnosed a median mononeuropathy from a 0.5-
      or 0.8-millisecond, or ms, prolongation of the median sensory-evoked peak latency
      compared to the ulnar latency. They diagnosed CTS if the subject also had
      accompanying symptoms of numbness, tingling or pain. RESULTS: Thirteen percent of
      screened dentists were diagnosed with a median mononeuropathy (using a 0.5-ms
      prolongation as the criterion), but only 32 percent of these had symptoms
      consistent with CTS (4.8 percent overall). When the 0.8-ms prolongation was used
      as the electrodiagnostic criterion, only 2.9 percent (overall) were diagnosed
      with CTS. People with diabetes, rheumatoid arthritis and obesity were more likely
      to have a median mononeuropathy. CONCLUSIONS: The prevalence of symptoms
      consistent with CTS in the dominant hand among dentists was higher than the
      prevalence in the general population. However, when electrodiagnostic
      confirmation is added, the prevalence of CTS was nearly the same as that among
      the general population. CLINICAL IMPLICATIONS: Early recognition of CTS can lead
      to more effective management. Education regarding ergonomic risk factors can be
      an effective preventive measure.

PMID- 11217589
TI  - Heart murmurs: are older male dental patients aware of their existence?
AB  - BACKGROUND: The American Heart Association recommends that patients with certain
      abnormal and prosthetic heart valves receive antibiotic prophylaxis before
      undergoing invasive dental treatment, owing to the risk of bacterial
      endocarditis, or BE. However, it is not known how many patients are aware that
      they have such conditions and understand such recommendations. METHODS: The
      authors conducted a study to determine how many male users of three U.S.
      Department of Veterans' Affairs ambulatory medical care centers denied having a
      heart murmur, even though a murmur was noted in their medical record. The authors
      asked 637 potential subjects a series of questions to identify those who had a
      heart murmur that might place them at risk of developing BE. The authors then
      reviewed each subject's medical records for documentation of a heart murmur.
      RESULTS: Four hundred ninety-seven dentate men (mean age: 61.0 years) denied
      having a heart murmur. Seventy (14.1 percent) of these men had documentation of a
      heart murmur in their medical records, and 13 (2.6 percent) had murmurs that were
      likely to be pathological. The failure to accurately report having a heart murmur
      and having a potentially pathological heart murmur were positively related to age
      (P = .001). Failure to accurately report having a heart murmur also was related
      to lower educational levels. CONCLUSIONS: These results indicate that a
      substantially larger number of older men than younger men were unaware that they
      had a heart murmur. Since some of these murmurs necessitate administration of
      antibiotic prophylaxis before dental procedures, this failure to communicate
      their correct medical status may put them at risk of developing BE. CLINICAL
      IMPLICATIONS: Dental health care providers should be aware that patient self
      report may not be a reliable indicator of cardiac status, particularly in older
      patients.

PMID- 11217590
TI  - Articaine hydrochloride: a study of the safety of a new amide local anesthetic.
AB  - BACKGROUND: Articaine is an amide local anesthetic introduced clinically in
      Germany in 1976 and subsequently throughout Europe, Canada and, in 2000, the
      United States. METHODS: The authors report on three identical single-dose,
      randomized, double-blind, parallel-group, active-controlled multicenter studies
      that were conducted to compare the safety and efficacy of articaine (4 percent
      with epinephrine 1:100,000) with that of lidocaine (2 percent with epinephrine
      1:100,000). RESULTS: A total of 1,325 subjects participated in these studies, 882
      of whom received articaine 4 percent with epinephrine 1:100,000 and 443 of whom
      received lidocaine 2 percent with epinephrine 1:100,000. The overall incidence of
      adverse events in the combined studies was 22 percent for the articaine group and
      20 percent for the lidocaine group. The most frequently reported adverse events
      in the articaine group, excluding postprocedural dental pain, were headache (4
      percent), facial edema, infection, gingivitis and paresthesia (1 percent each).
      The incidence of these events was similar to that reported for subjects who
      received lidocaine. The adverse events most frequently reported as related to
      articaine use were paresthesia (0.9 percent), hypesthesia (0.7 percent), headache
      (0.55 percent), infection (0.45 percent), and rash and pain (0.3 percent each).
      CONCLUSIONS: Articaine is a well-tolerated, safe and effective local anesthetic
      for use in clinical dentistry.

PMID- 11217591
TI  - Intralesional corticosteroid injection for treatment of central giant-cell
      granuloma.
AB  - BACKGROUND: The central giant cell granuloma, or CGCG, is a benign intraosseous
      lesion of the jaw. It is found predominantly in children and young adults. It is
      an asymptomatic lesion, which often becomes evident on routine radiographic
      examination. Giant cell lesions have been described as both nonaggressive and
      aggressive in nature, with recurrence noted in cases of aggressive lesions.
      Central giant cell lesions present as unilocular or multilocular radiolucent
      defects on radiographs. Multinucleated giant cells within a collagenous stroma
      are the characteristic histopathologic feature of CGCG. CASE DESCRIPTION: The
      authors describe a 10-year-old girl with an expansile lesion of the mandible. The
      panoramic radiograph showed a well-circumscribed mixed radiolucent-radiopaque
      lesion of the left mandibular body. An incisional biopsy of the lesion was
      performed to establish a histologic diagnosis. The specimen was submitted for
      frozen-section examination, and a diagnosis of CGCG was made. Serum calcium,
      parathyroid hormone and phosphorous levels were normal. The patient was treated
      successfully with intralesional corticosteroid injections. CLINICAL IMPLICATIONS:
      Central giant cell lesions have been treated surgically with aggressive
      curettage. More aggressive and recurrent lesions require resection, which leads
      to major defects of the jaws. This form of surgical treatment can be particularly
      disfiguring for a child or young adult. An alternative nonsurgical approach is
      the intralesional administration of corticosteroids, which have been effective in
      the treatment of CGCG. If a dentist suspects a patient may have CGCG, he or she
      should refer the patient to an oral surgeon for follow-up.

PMID- 11217592
TI  - Implant failures associated with asymptomatic endodontically treated teeth.
AB  - BACKGROUND: Endosseous root-formed implants occasionally fail to osseointegrate.
      Causes of failure include infection, overheating of the bone, habitual smoking,
      systemic disease, transmucosal overloading, excessive surgical trauma and implant
      placement adjacent to teeth demonstrating periapical pathology. CASE DESCRIPTION:
      In this article, the authors present another possible cause of implant failure.
      The cases of four patients who received endosseous root-formed implants are
      discussed. Each patient demonstrated signs of infection after initial implant
      placement. The common factor in each failing implant was its placement adjacent
      to an asymptomatic endodontically treated tooth with no clinical or radiographic
      evidence of pathology. CLINICAL IMPLICATIONS: These patients demonstrate the
      importance of evaluating and possibly retreating or extracting adjacent
      endodontically treated teeth before placing implants.

PMID- 11217593
TI  - Twenty-four-month clinical evaluation of different posterior composite resin
      materials.
AB  - BACKGROUND: In a 24-month clinical trial, the authors compared three brands of
      light-cured composite resins that were used to restore the posterior teeth of 38
      patients. METHODS: A total of 88 Class I and 32 Class II restorations were made
      using Z100 (3M Dental Products Div.), Clearfil Ray-Posterior (Kuraray Co. Ltd.)
      and Prisma TPH (Caulk/Dentsply). Quadrant impressions were taken using a
      polyvinyl siloxane impression material, and stone casts were obtained every six
      months for indirect evaluations of anatomical form and marginal adaptation. The
      restorations were evaluated directly by three clinicians using the Ryge criteria.
      RESULTS: The authors statistically evaluated parameters at each recall period,
      using a chi 2 test; compared baseline scores with the recall scores, using a
      McNemar test; and evaluated changes in the parameters, using the Cochran Q test.
      Color match, cavosurface margin discoloration and secondary caries remained
      unchanged at the end of the 24-month recall period for all materials (P > or =
      .05). A total of 11.5 percent of the Z100 restorations and 16.7 percent of the
      Prisma TPH restorations showed a slight crevice along the margin (P < or = .05).
      The surface texture was scored as Bravo only for Clearfil Ray-Posterior
      restorations at the end of the study (P < or = .05). The authors found that the
      indirect evaluation results were different from the direct evaluations for Z100
      and Prisma TPH. CONCLUSIONS: According to these findings, all the materials used
      are suitable for posterior restorations. The difference between the two
      evaluation methods can be attributed to the level of sensitivity. CLINICAL
      IMPLICATIONS: With the improvement in materials, careful case selection and
      application of the restorative techniques, posterior composites placed under
      appropriate conditions and monitored routinely can be expected to last 10 years
      or longer.

PMID- 11217594
TI  - The digital transformation of oral health care. Teledentistry and electronic
      commerce.
AB  - BACKGROUND: Health care is being changed dramatically by the marriage of
      computers and telecommunications. Implications for hospitals and physicians
      already have received extensive media attention, but comparatively little has
      been said about the impact of information technology on dentistry. This article
      illustrates how the digital transformation will likely affect dentists and their
      patients. CONCLUSIONS: Based on recent experiences of hospitals and medical
      practices, dentists can expect to encounter revolutionary changes as a result of
      the digital transformation. The Internet, the World Wide Web and other
      developments of the information revolution will redefine patient care, referral
      relationships, practice management, quality, professional organizations and
      competition. PRACTICE IMPLICATIONS: To respond proactively to the digital
      transformation of oral health care, dentists must become familiar with its
      technologies and concepts. They must learn what new information technology can do
      for them and their patients and then develop creative applications that promote
      the profession and their approaches to care.

PMID- 11217595
TI  - Understanding retirement finances. A challenge everyone faces.

PMID- 11217596
TI  - Community socioeconomic status and children's dental health.
AB  - BACKGROUND: Although a substantial decline in dental caries has occurred among
      U.S. children, not everyone has benefited equally. The first-ever surgeon
      general's report on oral health in America indicates that the burden of oral
      diseases is found in poor Americans. This study investigates the relationship
      between community socioeconomic status, or SES, and dental health of children.
      METHODS: An oral health survey of 17,256 children, representing 93 percent of
      children residing in 62 Tennessee communities, was conducted in public elementary
      schools during the 1996-1997 school year. Portable dental equipment was used for
      examinations, and data from each examination were entered directly into a laptop
      computer. The authors performed analyses of covariance to examine the
      relationship between community SES (low/medium/high) and dental health,
      controlling for community fluoridation. RESULTS: Community SES was significantly
      related to caries experience in the primary teeth, the proportion of untreated
      caries in the primary and permanent teeth, dental treatment needs, dental
      sealants and incisor trauma. Overall, dental health was significantly worse for
      low-SES communities than for medium- and high-SES communities. CONCLUSION: The
      authors conclude that all specific dental indexes used to measure children's
      dental health in this study, with the exceptions of caries experience in the
      permanent teeth and sealant presence, were inversely related to the communities'
      SES. The percentage of children with dental sealants was directly related to the
      community's SES. PRACTICE IMPLICATIONS: Further improvements in oral health will
      necessitate that community-based preventive programs and access to quality dental
      care be made available to children who are identified as being at highest risk of
      experiencing oral disease.

PMID- 11217597
TI  - Protecting your patients. Federal case on discharged employee centers on concerns
      about patient safety.

PMID- 11217598
TI  - Treatment of the edentulous mandible.

PMID- 11217599
TI  - An update on radiographic practices: information and recommendations.ADA Council
      on Scientific Affairs.

PMID- 11217600
TI  - Purification of kinesin from the brain.

PMID- 11217601
TI  - Assays for microtubule-destabilizing kinesins.

PMID- 11217602
TI  - Green fluorescent protein as a tag for molecular motor proteins.

PMID- 11217603
TI  - In vitro reconstitution of endosome motility along microtubules.

PMID- 11217604
TI  - Approaches to study interactions between kinesin motors and membranes.

PMID- 11217605
TI  - Microinjection methods for analyzing the functions of kinesins in early embryos.

PMID- 11217606
TI  - The use of dominant negative mutants to study the function of mitotic motors in
      the in vitro spindle assembly assay in Xenopus egg extracts.

PMID- 11217607
TI  - A dominant negative approach for functional studies of the kinesin II complex.

PMID- 11217608
TI  - Identification of kinesin-associated proteins.

PMID- 11217609
TI  - Expression cloning with pan kinesin antibodies.

PMID- 11217610
TI  - Assaying spatial organization of microtubules by kinesin motors.

PMID- 11217611
TI  - Crystallization of kinesin.

PMID- 11217612
TI  - Structural analysis of the microtubule-kinesin complex by cryo-electron
      microscopy.

PMID- 11217613
TI  - Expression of kinesin in Escherichia coli.

PMID- 11217615
TI  - Preparation of recombinant kinesin superfamily proteins using the baculovirus
      system.

PMID- 11217614
TI  - Plasmids for expression of chimeric and truncated kinesin proteins.

PMID- 11217616
TI  - Assays for kinesin microtubule-stimulated ATPase activity.

PMID- 11217617
TI  - An improved microscope for bead and surface-based motility assays.

PMID- 11217618
TI  - RT-PCR for the identification of developmentally regulated novel members of the
      kinesin-like superfamily.

PMID- 11217619
TI  - Use of photonic force microscopy to study single-motor-molecule mechanics.

PMID- 11217620
TI  - High group A streptococcal carriage in the Orthodox Jewish community of north
      Hackney.
AB  - BACKGROUND: General practitioners and the microbiologist serving north Hackney in
      north east London formed the impression, that of throat swabs sent to the
      laboratory, a disproportionate number of those positive for group A streptococcus
      appeared to come from Orthodox Jewish patients. AIM: To confirm the clinical
      impression that the pharyngeal carriage of group A streptococci was higher in the
      Orthodox Jewish population than in other members of the population in the same
      locality. DESIGN OF STUDY: A general practice questionnaire survey of all
      patients aged three years or over attending two practices that are about one
      kilometre apart, over a five-week period. SETTING: Two general practices in north
      London, one of which had a significant Orthodox Jewish patient list. METHODS:
      Throat swabs were taken from eligible patients who were invited to participate by
      completing a questionnaire and having a throat swab taken. RESULTS: Swabs were
      taken from 1223 people. After correction for age (child or adult) and history of
      recent sore throat, the Orthodox Jewish community had a significantly higher
      carriage rate of group A streptococci than the rest of the population (odds ratio
      = 5.0 [2.1 to 11.9]). The proportion of adults with group A streptococci with and
      without sore throats was 6.4% and 2.4% respectively in the Orthodox Jewish group
      and 0.45% and 1% respectively in the 'others' group. The proportion of children
      with group A streptococci with and without sore throats was 17.4% and 5.9%
      respectively and 3.4% and 0% respectively in the others. These differences were
      not explained by the larger family size and domestic overcrowding in the Orthodox
      Jewish group. CONCLUSIONS: Orthodox Jews in north London have a higher pharyngeal
      carriage rate of group A streptococci than the neighbouring population. These
      results may have implications for the diagnosis and treatment of acute sore
      throat in Orthodox Jewish patients, especially children.

PMID- 11217621
TI  - Detection of tongue cancer in primary care.
AB  - BACKGROUND: The incidence of tongue cancer is increasing, and survival has not
      improved since the majority of patients present at an advanced stage. Patient
      delay has remained the same over the years and is difficult to influence. Much
      less is known about the delay in diagnosis caused by physicians and dentists.
      AIM: To investigate the detection of tongue cancer in primary care in Northern
      Finland and to examine the consultation prevalence of oral symptoms in primary
      care in Finland. STUDY: Analysis of data from medical records of tongue cancer
      patients kept between 1 January 1974 and 31 December 1994 for the general health
      insurance scheme. SETTING: The two northernmost provinces of Finland (population
      of 700,000). METHOD: Data were collected on demographic and clinical variables
      and on the first medical visit on 75 tongue cancer patients. In addition, primary
      care physicians recorded all patient visits during four weeks in 25 health
      centres randomly selected throughout Finland in 1996. RESULTS: At the initial
      visit, the tongue cancer patient was correctly referred for further examinations
      in 49 (65%) cases. In 12 (16%) of cases the patient was not referred but was
      scheduled for a follow-up visit, and was neither referred nor followed-up in 14
      (19%). When compared with the referred patients the median professional delay was
      somewhat longer for the unreferred patients but increased dramatically if no
      follow-up was arranged (0.6 months [range = 0.1-2.4] versus 1.2 [range = 0.3-2.2]
      versus 5.2 [range = 0.7-18.2], P < 0.001). Compared with the referred patients
      the adjusted relative hazard of death for the non-referred followed-up patients
      was 1.4 (95% confidence interval [CI] = 0.31-6.5) and that for the non
      referred/not followed-up patients 6.3 (95% CI = 1.7-22.9). The high-risk patients
      included those who sought an early professional evaluation, those who made the
      appointment for a completely different reason and only mentioned the symptom
      suggestive of cancer incidentally, those that had a small ulcerative lesion, and
      blue-collar workers. Oral symptoms were a rare cause of visits (0.55% of all
      visits) in primary care in Finland. CONCLUSION: Misdiagnosis of tongue cancer at
      the initial professional evaluation often leads to a fatal delay if the patient
      is left without any follow-up.

PMID- 11217622
TI  - Childhood asthma: can computers aid detection in general practice?
AB  - BACKGROUND: Childhood asthma remains underdiagnosed in general practice.
      Computers with a patient interface have the potential to screen children for
      asthma in a time-efficient manner. AIM: To develop a concise, validated self
      report measure that calculates an 'asthma score' that predicts likelihood of
      asthma and its severity in childhood. DESIGN OF STUDY: Computerised questionnaire
      survey in general practitioners' (GPs') waiting rooms, followed by a written
      questionnaire and either bronchial challenge or skin allergy testing at the
      regional teaching hospital. SETTING: Children between 18 months and 18 years old
      accompanied by a parent or guardian in five group practices in Newcastle in New
      South Wales, Australia. METHOD: The responses from both the computerised
      questionnaire and the written questionnaire were compared with physician
      assessment of asthma, based on an existing validated questionnaire and clinical
      tests. RESULTS: Six items were identified to be independently and significantly
      associated (at P < 0.05) with the presence of asthma and its severity: parent or
      self-reported asthma, previous diagnosis, wheeze in the past year, physical
      activity affected by symptoms, night cough in the past year, and visits to a GP
      in the past year. From the regression model a linear score was derived that
      indicates whether a child is likely to have asthma and its likely severity.
      CONCLUSIONS: The asthma score is a valid indicator of asthma and its severity in
      children in general practice.

PMID- 11217625
TI  - Community hospitals for the new millennium.
AB  - There is a lack of basic information regarding the numbers of and facilities
      offered by community hospitals. This survey identified 471 community hospitals in
      the United Kingdom containing 18,579 beds with 20% of general practitioners
      having admitting rights. The majority of hospitals provide a comprehensive range
      of rehabilitation services and consultant outpatient clinics. Community hospitals
      are potentially an important resource in providing intermediate care in the
      community.

PMID- 11217624
TI  - The association between daytime attendance and out-of-hours frequent attendance
      among adult patients in general practice.
AB  - BACKGROUND: Frequent attenders (FAs) account for a large proportion of daytime
      consultations in general practice. However, no studies have so far been conducted
      to establish whether daytime FAs are also out-of-hours FAs. AIM: To analyse the
      association between daytime attendance and out-of-hours frequent attendance.
      DESIGN OF STUDY: A registry-based study of individual face-to-face contacts with
      general practice during daytime and out of hours, based on National Health
      Insurance files. SETTING: General practices in Aarhus County, Denmark (630,000
      inhabitants). METHOD: A total of 416,172 adults, i.e. all adults registered with
      a general practice during a 12-month period from November 1997 to October 1998
      were included. Odds ratios (OR) for frequent attendance out of hours were
      stratified for age, sex, and frequency of contacts during daytime were
      calculated. RESULTS: A strong association was observed between daytime level of
      attendance and out-of-hours level of attendance (OR = 2.9-6.3 among patients with
      low daytime attendance, OR = 33.7-99.8 among daytime FAs). Daytime FAs accounted
      for one-third of the daytime contacts, one-third of the out-of-hours contacts,
      and 42% of out-of-hours FAs. More than half of the daytime FAs did not attend out
      of hours. Two per cent of the out-of-hours FAs had no contacts during the
      daytime. CONCLUSION: Frequent attendance in daytime was very strongly associated
      with frequent attendance out of hours, and daytime FAs accounted for a large
      proportion of all contacts with general practice.

PMID- 11217623
TI  - The use of a screening questionnaire to identify children with likely asthma.
AB  - BACKGROUND: The theory that airway remodeling and possible fixed asthma may
      result from failure to treat asthma airway inflammation highlights the importance
      of the early identification of patients with likely asthma. AIM: To identify
      children with likely asthma whose condition is unknown to the medical services.
      STUDY: Postal questionnaire survey. SETTING: Children in two general practice
      populations in 1999. METHOD: Parents completed the postal questionnaire surveys.
      Two validated scoring systems were used to identify children with 'likely
      asthma': first, three or more positive responses to five key questions; second,
      three or more positive responses to the same five questions and one more severe
      symptom (e.g. exercise-induced wheeze). Questionnaire responses were linked to
      practice records to determine those with a recorded diagnosis of asthma (ever) or
      of inhaled medication (past 12 months). RESULTS: Using the first scoring system,
      22.5% of children were identified as having likely asthma; more than one-third of
      these (35.1%) had no corroborative evidence recorded in the practice records.
      With the second system, 15.5% had likely asthma, a quarter of whom had no
      corroborative evidence. Depending on the scoring system chosen, between 3.5% and
      8% of children in these practices had likely asthma but no corroborative evidence
      in their records. CONCLUSIONS: Children identified using either of these scoring
      systems would require full clinical assessment to determine their need for
      medical intervention. These findings have implications for the allocation of
      health care resources.

PMID- 11217626
TI  - Percutaneous endoscopic gastrostomies: attitudes of general practitioners and how
      management may be improved.
AB  - Percutaneous endoscopic gastrostomy (PEG) has replaced surgical gastrostomy in
      patients requiring long-term enteral nutrition. Increasing numbers of patients
      are being referred for PEG placement. Concern has been raised about patient
      selection and subsequent follow-up of these patients in the community. We report
      the views of Northern Ireland GPs to PEGs and how management may be improved.

PMID- 11217627
TI  - Consultations owing to adverse drug reactions in a single practice.
AB  - Data was collected over a six-month period on all patients presenting with a
      suspected adverse drug reaction. Analysis showed that this was a frequent reason
      for doctor-patient contact and that a large proportion of adverse reactions were
      owing to a small group of drugs.

PMID- 11217628
TI  - Treatment of acute otitis media: are children entered into clinical trials
      representative?
AB  - This study involved a meta-analysis of randomised control studies of the
      treatment of acute otitis media and judged the characteristics of these trials on
      the basis of methods, age groups, interventions, and outcomes. An investigation
      of the eight trials reported in the meta-analysis of clinical trials revealed
      that the number of children entered per doctor in all practices was low and that
      the recruitment rate was probably lower than 44%. Low recruitment rates indicate
      that the type of children entered into trials may only relate to those with mild
      to moderate symptoms and signs, which could explain why the results of these
      trials show that antibiotics are not essential in treating acute otitis media.

PMID- 11217630
TI  - GP use and views of an inner-city GP unit.

PMID- 11217629
TI  - A continuous curriculum for general practice? Proposals for undergraduate
      postgraduate collaboration.
AB  - The development of a seamless general practice 'spiral' curriculum, in which
      topics may be revisited at different levels of intensity and complexity during
      the learning process, has been discussed in the context of undergraduate
      postgraduate co-operation. Although the lifelong curriculum for all doctors
      contains a number of core competencies that aim to produce a 'stem' doctor,
      concerns remain about the effects of excessive reductionism. It is therefore
      essential that the content and delivery of the spiral curriculum ensure that
      intellectual interest is nurtured, by containing both taught theory and training
      in a hospital context. The opportunity for generalists to teach core competencies
      such that general practice is at the centre of the undergraduate curriculum-
      emphasising working within primary health care teams in teaching and training
      practices--is an ideal area for undergraduate-postgraduate co-operation. The use
      of the directly observed measures of performance would bring the undergraduate
      approach to assessment closer to that used in postgraduate general practice.
      However, supporting the tutors' network is crucial in undergraduate departments
      where much can be gained by joint working with postgraduate colleagues.

PMID- 11217631
TI  - What are GPs for?

PMID- 11217632
TI  - School students and the clinical arena.

PMID- 11217633
TI  - School students and the clinical arena.

PMID- 11217634
TI  - Little evidence of safe injecting.

PMID- 11217635
TI  - Birmingham's condom distribution scheme--an opportunity to promote sexual health
      in a primary setting.

PMID- 11217636
TI  - Proposed new law on manslaughter: implications for the NHS and doctors.

PMID- 11217637
TI  - Sexual health promotion--inner-city style.

PMID- 11217638
TI  - Rediscovering community hospitals.

PMID- 11217639
TI  - Improving the diagnosis of childhood asthma.

PMID- 11217640
TI  - Defining the appropriate use of community hospital beds.
AB  - BACKGROUND: Patients of GPs who have access to community hospitals (CHs) as well
      as district general hospitals (DGHs) tend to spend on average more days in
      hospital each year. Increasing attention is being paid to the efficient
      management of medical admissions; however, there has been no previous prospective
      study investigating the appropriateness of CH admissions. AIM: To develop a
      protocol to assess the clinical appropriateness of admission and length of stay
      of patients in CHs and to simultaneously compare the appropriateness of
      admissions to all DGHs and CHs in the county. DESIGN OF STUDY: A protocol named
      Community Hospital Appropriateness Evaluation Protocol (CHAEP) was developed to
      assess CH admissions through a process of consultation and a series of pilot
      studies. The appropriateness evaluation protocol (AEP) was also reviewed and used
      to assess DGH admissions. SETTING: A prospective cohort of 440 DGH admissions
      from five DGH sites and 440 CH admissions from nine CHs. METHODS: The admissions
      were assessed and followed for 28 days. If an admission failed to satisfy any of
      the criteria then the researcher interviewed the clinician to decide whether it
      was justified to override the protocol and still classify the admission as
      appropriate. To assess validity, a proportion of these 'clinical overrides' and
      the researcher's classifications were reviewed retrospectively by a clinical
      panel. The kappa statistic was used to assess the level of agreement. RESULTS:
      Applying the CHAEP, 82% of CH admissions satisfied a criterion for admission and
      a further 3% were given clinical overrides. A lower intensity of care was
      required for the majority of the remainder while three admissions required DGH
      care according to AEP criteria. Sixty-eight per cent of bed days satisfied day-of
      care criteria within CHAEP and only a further 2% were given clinical override.
      These results were similar to those found with the AEP at the DGHs where 75% of
      admissions (plus 16% given clinical override) and 55% of days-of-care (plus 20%
      given clinical override) satisfied the AEP criteria. The review panel generally
      did not agree with the clinician's use of the clinical override at the CHs.
      Agreement between research nurse and review panel was better for the AEP and DGH
      (kappa = 0.9, 95% confidence interval (CI) = 0.7-1.0) than for the CHAEP and CH
      (kappa = 0.37, 95% CI = 0.1-0.8). CONCLUSIONS: The CHAEP could be used to audit
      the appropriateness of admission and length of stay in CHs. Other health
      communities would need to review the CHAEP before it could be applied within
      their context.

PMID- 11217641
TI  - [Clinical management and nephrology: a train we have to catch?].

PMID- 11217642
TI  - [Molecular physiology of the urinary concentration mechanism, role of renal
      aquaporins].

PMID- 11217643
TI  - [Logistic regression: a versatile tool].

PMID- 11217644
TI  - [Malignant arterial hypertension and acute renal failure caused by cocaine use].

PMID- 11217645
TI  - [Inheritance and prevalence of hypercalciuria in the children from the island of
      La Gomera].
AB  - The urinary elimination of calcium has been studies in 549 school children from
      the island of La Gomera (Canary Islands) and in 100 children of a control group
      from the capital of the Canaries, Santa Cruz de Tenerife. The diet was not
      manipulated and it was proven that the water that they consumed was of
      characteristic equal. The 95th centile for the distribution of the
      calcium/creatinine index was 0.2 in the control group, we calculated the
      prevalence of hypercalciuria of this group (3.8%) and of the study group (16%).
      The prevalence was analyzed by areas of the island and it this showed that it was
      higher (28.4%) in those from isolated communities and therefore, with history of
      more inbreeding that in those with good communications (10.6%). It was observed
      that the risk of suffering hypercalciuria among the children that have four grand
      parents who are natives of the island of La Gomera is 2.85 times higher than in
      those that don't have any grand-father/mother coming from the island.
      Hypercalciuria siblings of children with hypercalciuria found in 50%.

PMID- 11217646
TI  - [Increase of tubular secretion of creatinine by L-arginine: mechanism of
      practical significance in the assessment of renal function based on creatinine
      clearance].
AB  - BACKGROUND: Tubular secretion of creatinine is increased by meat meals. This
      increment has been attributed to the formation of new creatinine from creatine
      contained in the cooked meals. However, no studies are available using amino acid
      infusions containing no creatine, which allow to further investigate the putative
      causes of increment in tubular creatinine secretion. METHODS: We performed a
      prospective, interventional study involving 34 individuals with normal renal
      function participating in a protocol on arterial hypertension. A continuous
      infusion of L-arginine (6%, i.v., in four 30 min periods at 50, 100, 200 and 300
      ml/h) was administered. Creatinine (CCr) and inulin (CIn) clearances were
      determined at baseline and during L-arginine infusion. We analyzed the effects of
      L-arginine on tubular secretion by comparing CCr and CIn and calculated tubular
      secretion of creatinine (TSCr). RESULTS: L-arginine infusion induced a
      significant increase in both CCr and CIn. CCr and CIn were respectively 117.9 +/-
      22.7 and 107.5 +/- 23, before and 170.3 +/- 23 and 144.2 +/- 47.8 after the
      infusion of L-arginine (both p < 0.01). This increase was simultaneous with an
      increment in TSCr from 1.12 +/- 0.4 to 1.43 +/- 0.6 (p < 0.01). CCr correlated
      significantly with CIn at baseline and at 60 min of infusion (r = 0.365, p =
      0.031 and r = 0.368, p = 0.038, respectively), but not at 120 min (r = 0.130, p =
      0.412), a time corresponding to the maximum increase in CIn and TSCr.
      CONCLUSIONS: L-arginine induces a substantial increase of CCr, which exceeds that
      expected from the increase in glomerular filtration rate measured by CIn and
      corresponds to an increment in TSCr. This phenomenon adds a new interpretation of
      the effect of amino acids on tubular handling of creatinine and has practical
      implications in the evaluation of renal function by means of creatinine
      clearance.

PMID- 11217648
TI  - [Is the correlation between adequate dialysis in peritoneal dialysis and
      nutritional parameters mathematical or biological? Influence of residual renal
      function and comorbidity].
AB  - The relationship between urea Kt/V and nPCR (nPNA) is partly due to a
      mathematical coupling and greatly depends on the residual renal function (RRF).
      On the other hand, albumin could be just a comorbidity marker. Our objective in
      this study was to verify whether dialysis dose in peritoneal dialysis (PD) is
      biologically related to the nutritional state measured by the mean values of
      several parameters not mathematically related while analyzing the influence of
      RRF and comorbidity (C). 101 stable PD patients, 60M and 41F with a mean age of
      59.3 +/- 14.3 years, were studied and followed up every six months for a mean
      time of 35.8 +/- 22.3 months (8-112). The variables studied were initial
      comorbidity, plasma albumin, normalized protein nitrogen appearance (nPNA), lean
      body weight % (LBW%) and fat-free mass index (FFMI) derived from creatinine, and
      RRF. In every study (n = 471) the 24 hours dialysate and urine volumes were
      collected and the total (T), dialytic (P) and renal (R) urea KT/V and normalized
      creatinine clearance (CCR) were determined and compared with the nutritional
      parameters. When starting PD 48 patients (47.5%) had some C and 34 (33.7%) were
      already anuric. The correlations of nPNA with T-KT/V and T-CCR (n = 101) were r =
      0.67 and 0.50 (p < 0.0005) while the correlations of LBW% with T-KT/V and T-CCR
      were r = 0.36 and 0.40 (p < 0.0005) respectively. The correlations of albumin
      with T, P and R KT/V and CCR did not reach significance. The nutritional state
      was better in patients with a higher RRF and albumin showed significant
      differences when related to morbidity. KT/V and CCR correlations with nutritional
      variables not mathematically related verify the hypothesis that dialysis dose is
      biologically associated with the nutritional state.

PMID- 11217647
TI  - [Diagnostic and clinical course features of lupus membranous glomerulonephritis].
AB  - BACKGROUND: Lupus membranous glomerulonephritis (LMG) is sometimes difficult to
      distinguish from idiopathic membranous glomerulonephritis (IMG) and little is
      known about its natural history. METHODS: We have performed a retrospective study
      of 16 patients with LMG, types Va ("pure" LMG) (8 patients) and Vb (mesangial
      proliferation) (8 patients). Analytical and clinical characteristics were
      analyzed in each case at the onset of the disease and during follow-up. RESULTS:
      At the time of diagnosis, 7 patients (43%) did not present any extrarenal
      manifestations of systemic lupus erythematosus (SLE). Nephrotic syndrome was the
      most common clinical presentation (81%). 14 patients (87%) showed positive
      antinuclear antibodies (ANA), but at low titres (< 1/300); anti-DNA antibodies
      were positive only in 3 cases (18%) and hypocomplementemia was observed in 2
      (12%). The most relevant histological findings were the presence of Clq deposits
      (83%) and subendothelial and mesangial deposits. Treatment consisted of
      corticosteroids, adding immunosuppression when no response was obtained in 2-3
      months. In recent years, an angiotensin-converting enzyme inhibitor (ACEI) was
      added before immunosuppression. At the end of the study, 6 patients (42%)
      developed chronic renal insufficiency and 8 (58%) renainea with normal renal
      function. Actuarial renal survival was 100% at 5 years and 75% at 10 years. The
      evolution towards a non-nephrotic range proteinuria throughout the follow-up was
      the only parameter significantly associated with a good prognosis. CONCLUSIONS:
      LMG can present without extra-renal symptoms of SLE and even with very poor
      expression of its serological markers. Almost half of the patients (42%)
      developed chronic renal insufficiency. The evolution towards a non-nephrotic
      range proteinuria correlated with the maintenance of a normal renal function.

PMID- 11217649
TI  - [Nutritional status, comorbidity, and inflammation in hemodialysis].
AB  - Low y serum albumin and high C-reactive protein (CRP) have been shown to be
      significant predictors of mortality in hemodialysis (HD) patients. Although
      hypoalbuminemia has been attributed to malnutrition, it has recently been
      recognized evidence of inflammation that predicts serum albumin concentration in
      dialysis patients. AIM: To establish, in our HD patients, the factors associated
      with malnutrition, hypoalbuminemia and elevated levels of C-reactive protein to
      determine its influence in the incidence and cause of death during a one year
      follow-up period. METHODS: A cross sectional study was performed in 64 patients
      (35 males, 13% diabetics; mean age 64 +/- 12), who had beep on HD for 64 +/- 58
      months. We assessed nutritional status by anthropometric and biochemical
      parameters and estimated protein and calorie intake by diet recall. The dialysis
      dose was measure by KT/V normalized for actual and ideal body weight (BW).
      Comorbidity (total and cardiovascular) were measured using a modified M. Charlson
      index. CRP was used as a marker of inflammation. During a one year follow-up
      period we determined the incidence and cause of death. RESULTS: According to
      Bilbrey index only seven patients (11%) were well nourished. The variables
      associated with malnutrition were civil status (not married) and dialysis dose
      estimated by KT/V normalized to ideal BW. Serum albumin (mean 4.1 +/- 0.3 g/dl)
      was associated with creatinine, comorbidity age and infection. 37.5% of the
      patients had CRP > 1 mg/dl and they had more cardiovascular comorbidity and lower
      serum albumin, and they used higher doses of erythropoietin (table III). Patients
      using modified cellulosic membranes had higher levels of CRP. Multivariate
      analysis showed that high global comorbidity, low serum cholesterol, and high
      level of CRP and hematocrit predicted death. The principal cause of mortality was
      infection. CONCLUSIONS: Malnutrition is a common problem in HD patients. Low
      dialysis dose is associated with malnutrition in some patients. We propose to
      normalize urea clearances to ideal body weight. Inflammatory activity is frequent
      in HD, probably as a result of intermittent activation of the acute phase
      response during the dialysis procedure. Low serum albumin in HD patients is
      principally associated with infection/inflammation but not with malnutrition. CRP
      is a sensitive marker of inflammation and an power predictor of mortality in HD
      patients.

PMID- 11217650
TI  - [Late hepatitis C virus seroconversion in a patient on hemodialysis].
AB  - We present a case of an exceptionally late HCV seroconversion in a hemodialysis
      patient. The clinical case illustrates the difficulty of appropriately and
      quickly isolating a HCV infected patient, and it demonstrates the necessity to
      consider all the dialysis patients as potentially infectious patients. The
      standard precautions in hemodialysis must be applied routinely to all the
      patients, because the diagnosis of the HCV infection is very often late, and on
      some occasions it is difficult to interpret correctly the results of the
      available diagnostic tests.

PMID- 11217651
TI  - [Non-convulsive status epilepticus secondary to adjusted cefepime doses in
      patients with chronic renal failure].
AB  - Fever is one of the most frequent causes of hospital admission in patients with
      end-stage renal disease. Lack of an identified source of infection and/or lack of
      clinical response to the first empirical antibiotic treatment favour the use of
      broader spectrum antibiotics. The availability of fourth-generation
      cephalosporins (e.g. cefepime) and the increasing incidence of bacterial
      resistances to classical antibiotics has increased their use in the clinical
      practice. We present two cases of non-convulsive status epilepticus in patients
      with advanced chronic renal failure who received cefepime at doses corrected for
      the degree of renal function according to the manufacturer's instrument as. The
      clinical symptoms included shouthough, processes, disorientation, loss of
      attention, and the later appearance of myoclonus. In both cases the
      electroencephalogram (EEG) was compatible with non-convulsive epileptic status.
      After cefepime withdrawal there was a clinical remission of symptoms and
      normalization of the EEG. It is concluded that cefepime treatment can induce a
      non-convulsive epileptic status in patients with advanced chronic renal failure.
      Pharmacokinetic studies are urgently needed to clearly define the appropriate
      dose of cefepime in patients with advanced chronic renal failure.

PMID- 11217652
TI  - [Hematoma of the anterior rectus abdominis muscle as the first manifestation of
      lymphoproliferative disease after renal transplantation].
AB  - Rectus sheath hematoma results from the rupture of rectus muscle vessels by
      trauma, coagulation disorders or anticoagulant therapy, but it can occur
      spontaneously too. Its prognosis is good. On the other hand, posttransplant
      lymphoproliferative disorders (PTLD) are serious and potentially fatal
      complications in transplant recipients. Patients with PTLD have a mononucleosis
      like syndrome or develop extranodal masses which involve various organs. We
      report the case of a renal transplant recipient who develop a rectus sheath
      hematoma as the first clinical feature of PTLD.

PMID- 11217653
TI  - [Ferritin and infection in hemodialysis. Evaluation of a treatment protocol with
      intravenous iron].

PMID- 11217654
TI  - [All you wanted to know about nephrology...].

PMID- 11217655
TI  - [Errors in bibliographic references of Nefrologia from 1981 to 1995. A quality
      control].
AB  - The accuracy of the reference list is considered an essential factor in
      determining the quality of a scientific publication, and has been reviewed and
      published in several medical journals. The rate of citation errors in NEFROLOGIA
      has not been published before. The aim of this study has been to examine the
      accuracy of the references citation in the numbers of the journal published for a
      period of 15 years, from the first issue in 1981 to the last one on 1995.
      MATERIAL AND METHODS: In this period 68 ordinary issues of the journal were
      published, with 520 original articles that constituted the data base, 87 articles
      were selected applying a table of random numbers with 5 references of each
      article selected to be reviewed with a total of 435. The accuracy of the name of
      the authors, title of the article, volume, initial and last page and year of
      publication were evaluated, accordingly with the NEFROLOGIA normative. Citation
      errors were considered major or minor depending on whether they prevented or not
      the immediate retrieval of the article listed. RESULTS: Of the 435 citations
      examined, 433 could be located, being impossible in 2 with the data supplied. In
      189 (43.45%) 237 errors were detected, with 13.50% of them being considered major
      and 86.50% minor, with the greatest percentage of errors occurring in the data
      about the authors of the articles referenced 96 (40.50%). CONCLUSIONS: The issues
      of NEFROLOGIA published in this period present a high number of bibliographic
      reference errors, being the rate similar to other evaluated scientific periodical
      journals. This fact should be improved, and authors and reviewers should
      thoroughly check their references in order to avoid these mistakes, as they
      affect the quality standard of the publication.

PMID- 11217656
TI  - [The scientific publication and its critical reading. Standards for the
      publication of a scientific article. The impact factor].

PMID- 11217658
TI  - [Arterial hypertension in Cuba. General overview of the past 25 years].
AB  - A general overview of hypertension as a major health problem in Cuba in the last
      25 years are presented. In the first period, 1974-1990 was created a National
      Hypertension High Commission by the Minister of Public and the First national
      program for prevention and Control of Hypertension in Cuba was launched. To
      define high blood pressure in adults 15 years and older the cut-off point was set
      at 160/95 mmHg. The prevalence found was 15% in urban areas and 7-8% in rural
      areas. The second period, 1991-1998 the original National program was re
      evaluated in 1990 and 1995. The new blood pressure cut-off point was set at
      140/90 mmHg. The prevalence increased to 30.6% in urban areas and 15% in rural
      areas and incidence of 2.5% annual. A total of 862,303 hypertensive patients were
      registry at the end of 1997 which represents less than 40% of the total number of
      possible hypertensive patients. A National Campaign was launched in 1998. In 9
      months the preliminary reports were: 25% increase in prevalence, registry and
      follow-up of hypertensive patients 15 years old and older (8.5% to 12.5%); 92.9%
      of primary care doctors and 89.5% of primary care nurses received training;
      improvement in public education and social support; improvement in risk factor
      awareness in general public and improvement of hypotensive drugs availability and
      splygmomanometers supplies.

PMID- 11217657
TI  - [Report on dialysis and transplantation of the Spanish Society of Nephrology for
      1998].

PMID- 11217659
TI  - Tuberculosis in children.

PMID- 11217660
TI  - The Bulletin in 2001.

PMID- 11217661
TI  - Cross-sectional study of sexual behaviour and knowledge about HIV among urban,
      rural, and minority residents in Viet Nam.
AB  - OBJECTIVE: A cross-sectional survey was conducted in three districts of Quang
      Ninh province, Viet Nam, to find out what proportion of the people who lived
      there engaged in behaviour that put them at risk of becoming infected with HIV,
      and to measure their knowledge about HIV infection and AIDS. METHODS: The survey
      was conducted in a rural district, Yen Hung; a mountainous district inhabited
      primarily by ethnic minority groups, Binh Lieu; and an urban district, Ha Long.
      Participants aged 15-45 years were randomly selected from the general population
      to be interviewed. FINDINGS: A total of 630 people from 707 households were
      interviewed; 8% were not home despite repeated visits and 3% refused to
      participate. The prevalence of premarital intercourse ranged from 9% to 16% among
      married men and 4% to 7% among married women. Among single men the proportion who
      had ever had intercourse ranged from 6% to 16%. Fewer than 3% reported having
      ever had sex with a sex worker. The median number of extramarital sex partners
      was 1. Knowledge about HIV/AIDS was high in the urban and rural areas but low in
      the mountainous area. Being male and being 20-29 years old were associated with
      having multiple sex partners. CONCLUSION: The low prevalence of individuals
      reporting that they had had intercourse with sex workers and partners other than
      their spouse may explain the low rates of HIV infection among the heterosexual
      population; these rates are in contrast to the high rates of HIV infection found
      among injecting drug users. The association between having extramarital partners
      and being a younger man suggests that the tendency to have more sexual partners
      may increase in the future. If this happens, the potential for HIV to be spread
      through heterosexual sex will increase.

PMID- 11217662
TI  - Homicide in children and adolescents: a case-control study in Recife, Brazil.
AB  - OBJECTIVE: The homicide rate for children and adolescents in Recife, Brazil,
      mostly caused by firearms, is one of the highest that has been reported. The
      present case-control study was designed to identify factors that were potentially
      modifiable through preventive interventions. METHODS: Cases were 255 homicide
      victims under 20 years of age, who had died in 1997 and been identified at the
      Institute of Forensic Medicine, Police Department, Recife, and whose relatives
      were interviewed by two community health workers when they claimed the corpse.
      The 255 controls were neighbours of the cases, paired by age and sex to them, and
      identified within one week of identification of each case, and whose relatives
      were interviewed by a third community health worker. FINDINGS: The overall
      homicide rate in Recife for under-20-year-olds in 1997 was 49 per 100,000; among
      males aged 15-19 years it was 324 per 100,000. Firearms were responsible for 97%
      of deaths. After multivariate logistic regression, history of personal police
      records (odds ratio (OR) = 18.65; 95% confidence interval (CI) = 1.91-182.50),
      use of illicit drugs (OR = 7.48; 95% CI = 1.86-30.17), tap water at home (OR =
      7.30; 95% CI = 1.80-29.59), and maternal age at birth over 26 years (OR = 3.98;
      95% CI = 1.79-8.84) were identified as risk factors, while higher education (OR =
      0.22; 95% CI = 0.11-0.43), religious practice (OR = 0.25; 95% CI = 0.10-0.65),
      and presence of the father in the household (OR = 0.28; 95% CI = 0.09-0.81) were
      protective factors. CONCLUSION: Public health authorities should plan preventive
      interventions based on the findings of this study and should control the
      acquisition, possession and carrying of firearms.

PMID- 11217663
TI  - The use of hospital-based nurses for the surveillance of potential disease
      outbreaks.
AB  - OBJECTIVE: To study a novel surveillance system introduced in Mpumalanga
      Province, a rural area in the north-east of South Africa, in an attempt to
      address deficiencies in the system of notification for infectious conditions that
      have the potential for causing outbreaks. METHODS: Hospital-based infection
      control nurses in all of Mpumalanga's 32 public and private hospitals were
      trained to recognize, report, and respond to nine clinical syndromes that require
      immediate action. Sustainability of the system was assured through a schedule of
      regular training and networking, and by providing feedback to the nurses. The
      system was evaluated by formal review of hospital records, evidence of the
      effective containment of a cholera outbreak, and assessment of the speed and
      appropriateness of responses to other syndromes. FINDINGS: Rapid detection,
      reporting and response to six imported cholera cases resulted in effective
      containment, with only 19 proven secondary cholera cases, during the two-year
      review period. No secondary cases followed detection and prompt response to 14
      patients with meningococcal disease. By the end of the first year of
      implementation, all facilities were providing weekly zero-reports on the nine
      syndromes before the designated time. Formal hospital record review for cases of
      acute flaccid paralysis endorsed the value of the system. CONCLUSION: The primary
      goal of an outbreak surveillance system is to ensure timely recognition of
      syndromes requiring an immediate response. Infection control nurses in Mpumalanga
      hospitals have excelled in timely weekly zero-reporting, participation at monthly
      training and feedback sessions, detection of priority clinical syndromes, and
      prompt appropriate response. This review provides support for the role of
      hospital-based nurses as valuable sentinel surveillance agents providing timely
      data for action.

PMID- 11217664
TI  - Home care of malaria-infected children of less than 5 years of age in a rural
      area of the Republic of Guinea.
AB  - OBJECTIVES: To assess the ability of mothers in a rural area of the Republic of
      Guinea to identify fever in their children, and to estimate the proportion of
      children who received antimalarial drugs. METHODS: Children under 5 years of age
      in 41 villages were selected by a two-step cluster sampling technique. During
      home visits we examined the children and questioned their mothers about the
      child's symptoms and treatment. FINDINGS: Of 784 children examined, 23% were
      febrile and more than half of them also had a positive smear result for
      Plasmodium. Mothers reported 63% of children with a temperature > or = 37.5
      degrees C as sick. Among all children reported as feverish by their mother, 55%
      had a normal temperature (< 37.5 degrees C). In contrast, a temperature > or =
      37.5 degrees C was found in 38% of children identified as sick but afebrile by
      their mother and in 13% of children considered healthy. Among febrile children,
      18% were given chloroquine at home or had consulted at the health centre or a
      dispensary. CONCLUSION: In areas where malaria is endemic, recognition of fever
      and its presumptive treatment with antimalarial drugs is an essential part of the
      strategy of the World Health Organization (WHO) to reduce the morbidity due to
      this disease. This population study shows that mothers often failed to identify
      fever in their children and to consult or to provide antimalarial treatment.
      Without great efforts to improve home care, it is unlikely that the morbidity and
      mortality due to malaria in young children will be greatly reduced.

PMID- 11217665
TI  - Maternal and congenital syphilis in Bolivia, 1996: prevalence and risk factors.
AB  - OBJECTIVES: The present study was carried out in seven maternity hospitals to
      determine the prevalence of maternal syphilis at the time of delivery and the
      associated risk factors, to conduct a pilot project of rapid syphilis testing in
      hospital laboratories, to assure the quality of syphilis testing, and to
      determine the rate of congenital syphilis in infants born to women with syphilis
      at the time of delivery--all of which would provide baseline data for a national
      prevention programme in Bolivia. METHODS: All women delivering either live-born
      or stillborn infants in the seven participating hospitals in and around La Paz,
      El Alto, and Cochabamba between June and November 1996 were eligible for
      enrolment in the study. FINDINGS: A total of 61 out of 1428 mothers (4.3%) of
      live-born infants and 11 out of 43 mothers (26%) of stillborn infants were found
      to have syphilis at delivery. Multivariate analysis showed that women with live
      born infants who had less than secondary-level education, who did not watch
      television during the week before delivery (this was used as an indicator of
      socioeconomic status), who had a previous history of syphilis, or who had more
      than one partner during the pregnancy were at increased risk of syphilis. While
      76% of the study population had received prenatal care, only 17% had syphilis
      testing carried out during the pregnancy; 91% of serum samples that were reactive
      to rapid plasma reagin (RPR) tests were also reactive to fluorescent treponemal
      antibody-absorption (FTA-ABS) testing. There was 96% agreement between the
      results from local hospital laboratories and national reference laboratories in
      their testing of RPR reactivity of serum samples. Congenital syphilis infection
      was confirmed by laboratory tests in 15% of 66 infants born to women with
      positive RPR and FTA-ABS testing. CONCLUSION: These results indicate that a
      congenital syphilis prevention programme in Bolivia could substantially reduce
      adverse infant outcomes due to this disease.

PMID- 11217666
TI  - Comparison of different culture media and storage temperatures for the long-term
      preservation of Streptococcus pneumoniae in the tropics.
AB  - OBJECTIVE: The preservation of Streptococcus pneumoniae by standard freezing
      methods for subsequent tests--such as serotyping and antibiotic susceptibility-
      is not possible or is difficult in many developing countries because of the high
      cost of equipment, inadequate equipment maintenance, and irregular power supply.
      We evaluated alternative low-cost methods, by comparing different culture media
      and storage temperatures. METHODS: Clinical isolates of five capsular types (1,
      5, 7, 19, and 23) of S. pneumoniae were preserved in rabbit blood, sheep blood,
      skimmed milk, or glycerol-chocolate broth, and stored at -20 degrees C or -70
      degrees C. The cultures were also preserved by lyophilization or sand
      desiccation, followed by storage at room temperature and 4 degrees C. The
      viability of the preserved cultures was determined by making serial colony counts
      on day 0 and after 1 week, 4 weeks, 4 months and 16 months. The viability of
      cultures preserved by sand desiccation and storage at 4 degrees C was also
      determined every 6 months for up to 68 months. FINDINGS: Irrespective of the
      media used, cultures maintained at -20 degrees C became nonviable by the fourth
      month, while those maintained at -70 degrees C were still viable at 16 months.
      Cultures preserved by lyophilization or sand desiccation lost their viability by
      the fourth month when maintained at local room temperature (30-42 degrees C), but
      remained viable when stored at 4 degrees C for up to 68 months. CONCLUSIONS: Our
      results confirm that freezing at -70 degrees C, or lyophilization and storage at
      4 degrees C are the ideal methods for the preservation of S. pneumoniae. In
      laboratories where lyophilization is not feasible, sand desiccation and storage
      at 4 degrees C offers an alternative low-cost method for the long-term
      preservation of S. pneumoniae.

PMID- 11217667
TI  - Community-based trials of sexually transmitted disease treatment: repercussions
      for epidemiology and HIV prevention.
AB  - This paper reviews the scientific basis for trials exploring the relation between
      sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)
      infection in Mwanza in the United Republic of Tanzania and Rakai and Masaka in
      the Republic of Uganda. The importance of a study's location and explanations for
      the divergent results of these trials are discussed. The modest effect on STDs
      seen in the trial of syndromic management in Mwanza, in contrast to the 38%
      reduction in the incidence of HIV, casts doubt on the underlying hypothesis that
      treating STDs alone slows the transmission of HIV-1. According to the Piot
      Fransen model, the trial in Rakai, which offered treatment of STDs to all
      subjects irrespective of symptoms ("mass" treatment), should have been more
      effective both in reducing the prevalence of STDs and the incidence of HIV.
      However, the Rakai trial was stopped because there was no difference in the
      incidence of HIV between the intervention and control arms. If Mwanza is seen as
      the trial that needs explaining, another paradigm becomes relevant. In rural East
      Africa, where all trials have been conducted, networks of concurrent sexual
      partnerships are a source of infection with both STDs and HIV. Because of their
      shorter latency periods, STDs may prompt attendance at a clinic before the early
      signs of HIV-1 infection appear. Part of the management of STDs is to recommend
      abstinence or the consistent use of condoms until treatment is completed. This
      recommendation may cover the earliest period of viraemia during primary HIV-1
      infection. This paradigm appears to explain the results from Mwanza and Rakai,
      emphasizing behavioural aspects of syndromic management.

PMID- 11217668
TI  - STI care: one of many necessary approaches for prevention of HIV infection.

PMID- 11217669
TI  - More community-based trials of STD control or more appropriate interventions:
      which is the priority for preventing HIV-1 infection in developing countries?

PMID- 11217670
TI  - The rationale for recommending fixed-dose combination tablets for treatment of
      tuberculosis.
AB  - There is considerable exigency to take all necessary steps to cure tuberculosis
      cases and prevent further emergence of drug-resistant tuberculosis. The most
      important of these steps is to ensure that the treatment, particularly of sputum
      smear-positive cases, is adequate and that patients adhere to their treatment by
      supervised, direct observation of drug-taking according to the standardized
      regimens. Use of fixed-dose combinations (FDCs) of tablets against tuberculosis
      is now being recommended by WHO and the International Union Against Tuberculosis
      and Lung Disease (IUATLD) as an additional step to ensuring proper treatment.
      FDCs simplify the prescription of drugs and the management of drug supply, and
      may also limit the risk of drug-resistant tuberculosis arising as a result of
      inappropriate drug selection and monotherapy. Only FDCs of proven quality and
      proven rifampicin bioavailability should be purchased and used. In most
      situations, blood levels of the drugs are inadequate because of poor drug quality
      rather than poor absorption. This is true irrespective of the human
      immunodeficiency virus (HIV) infection status of the tuberculosis patients (other
      than those with overt acquired immunodeficiency syndrome, with CD4 counts < 200
      cells/mm3). Currently, WHO, IUATLD and their partners are developing strategies
      for ensuring that only quality FDCs are used in tuberculosis programmes. A
      simplified and effective protocol for assessment of rifampicin bioavailability
      has been developed, and laboratories are being recruited to form a supranational
      network for quality assurance of FDCs. Standardization of FDC drug formulations
      has been proposed, which limits rifampicin-containing preparations to nine
      (including a four-drug FDC and three paediatric FDCs).

PMID- 11217671
TI  - Kochi's tuberculosis strategy article is a "classic" by any definition.

PMID- 11217672
TI  - Comparison of malaria control interventions.

PMID- 11217673
TI  - AIDS--dramatic surge in ex-Soviet Union, no respite worldwide, new data show.

PMID- 11217674
TI  - Experimental vaccine protects monkeys against Ebola virus.

PMID- 11217675
TI  - Pilot study of the use of community volunteers to distribute azithromycin for
      trachoma control in Ghana.
AB  - OBJECTIVE: To assess the skills of community health volunteers in diagnosing
      active trachoma and distributing azithromycin in the Northern Region of Ghana.
      METHODS: Six community health volunteers from Daboya were trained to diagnose
      trachoma and to treat the disease using azithromycin. They were also informed of
      the drug's possible side-effects. Under supervision, each volunteer then
      examined, and if necessary treated, 15 households. The dose of azithromycin was
      determined by weight; height was also measured. Tablets were given in preference
      to suspension when possible. RESULTS: The volunteers' diagnostic sensitivity for
      active trachoma was 63%; their specificity was 96%. At the household level, their
      "decision to treat" was correct in 83% of households. In 344 treatment episodes,
      volunteers planned a dose of azithromycin outside the range 15-30 mg/kg on only
      seven occasions (2.0% of all planned treatments). The volunteers' drug management
      skills were good, the response of the community was excellent, and adverse
      reactions were infrequent. Diagnosis of active trachoma, record-keeping skills,
      and knowledge of side-effects were found to need greater emphasis in any future
      education programme. Most people aged four years or older were able to swallow
      tablets. For those taking tablets, the correlation between the data gathered for
      height and weight shows that calculating azithromycin doses by height is a valid
      alternative to calculating it by weight. CONCLUSION: Trained community health
      volunteers have a potential role in identifying active trachoma and distributing
      azithromycin. To simplify training and logistics, it may be better to base dosage
      schedules on height rather than weight for those taking tablets, which included
      most people aged four years or more in the population studied.

PMID- 11217676
TI  - [Living donors in kidney transplantation. Renaissance by non-related donors?].
AB  - Renal Transplantation is hampered worldwide by the continuing lack of cadaveric
      organs. The discrepancy between the number of patients on the waiting list and
      the number of organs available is further compounded by the still unresolved
      problem of chronic transplant failure. Against this background, the arguments for
      increasing acceptance of the use of kidneys from living donors, both related and
      unrelated, are discussed. Initial reports on appreciably improved transplant
      survival rates of organs from unrelated living donors (85% survival after 3 years
      [19]) have since been confirmed by more recent studies. Our own results, in part
      obtained during a prospective study involving 103 patients (53 related, 50
      unrelated) done between October 1994 and April 1999, with strict psychological
      care/evaluation prior to and after transplantation, revealed a four-year
      transplant survival rate of 98% in both groups. So far, the higher rejection rate
      of 34% in unrelated, vs. 13.2% in related, donors has not led to any earlier
      chronic dysfunction of the transplant. The expanded use of living kidney donors
      is not only ethically justifiable, but also improves the outcome.

PMID- 11217677
TI  - [Intensified conventional insulin therapy in patients with type 2 diabetes
      mellitus. Positive long-term effects of insulin lispro on metabolic control and
      microalbuminuria].
AB  - AIMS: It was decided to demonstrate by the present observations to which extent
      beneficial long-term effects on metabolic control, body weight and
      microalbuminuria can be attained by applying intensive insulin therapy (IIT) to
      type 2 diabetic patients, particularly when using insulin lispro. METHODS: In our
      observational study, clinical data were evaluated during 6, 12 and 36 months
      after participation in our structured inpatient insulin treatment and teaching
      programme in 25 patients with conventional insulin therapy (CT), in 10 patients
      with IIT using human normal insulin and in 15 patients with IIT using insulin
      lispro who all could be followed for 3 years in our outpatient diabetic clinic.
      RESULTS: In the CT-treated patients, HbA1c decreased from 10.2 +/- 0.4% to 7.6 +/
      0.2% (average +/- SEM) after 3 years. Body weight increased from 27.8 +/- 0.9
      kg/m2 to 28.6 +/- 0.9 kg/m2, insulin dose increased from 29 +/- 3 U/day to 48 +/-
      5 U/day (all p < 0.05), urinary albumin concentration was only transiently
      reduced. In the IIT-treated patients using human normal insulin, HbA1c fell from
      10.6 +/- 0.8% to 7.9 +/- 0.5%, body weight increased from 27.8 +/- 1.4 kg/m2 to
      29.8 +/- 1.3 kg/m2, urinary albumin concentration was reduced from 26 +/- 10 mg/l
      to 13 +/- 3 mg/l (all p < 0.05). Insulin dose increased only slightly from 57 +/-
      6 U/day to 63 +/- 7 U/day. In the IIT-treated patients using insulin lispro HbA1c
      fell from 8.4 +/- 0.5% to 6.7 +/- 0.3%, body weight increased from 27.6 +/- 1.0
      kg/m2 to 28.7 +/- 1.3 kg/m2, insulin dose from 36 +/- 5 U/day to 50 +/- 7 U/day,
      urinary albumin concentration was reduced from 23 +/- 4 mg/l to 13 +/- 4 mg/l
      (all p < 0.05). Blood pressure remained uninfluenced by insulin therapy.
      CONCLUSION: In our patients, we observed a beneficial long-term effect on
      metabolic control of IIT-treatment using insulin lispro, which was evident over
      the complete 3-year observation period, together with an only moderate increase
      in insulin dose and a clinically acceptable increase in body weight, but a
      remarkable reduction of microalbuminuria. Thus, clinical outcome was superior to
      that in patients treated with CT or IIT using human normal insulin.

PMID- 11217678
TI  - [Dexketoprofen-trometamol and tramadol in acute lumbago].
AB  - BACKGROUND, METHOD: The analgesic efficacy and tolerability of dexketoprofen
      trometamol (DKPT) was compared with tramadolhydrochloride (TRAM) in a
      multicentre, randomised, double-blind, clinical trial in 192 Patients with acute
      low back pain. The initial pain at rest and on movement should be at least 50 mm
      on a 100 mm visual analogue scale. The daily dose during the 7 days' treatment
      was 50 mg TRAM t.i.d. (n = 95) or 25 mg DKPT t.i.d. (n = 97). The patients were
      allowed to take additional Paracetamol up to 4 x 500 mg per day as rescue
      medication. RESULTS: From the 4th day of treatment pain on movement decreased
      significantly (p = 0.044) in the DKPT-group in comparison with the TRAM-group.
      The nocturnal pain decreased during the treatments with a difference in therapies
      of 22.9% in favour of DKPT. Within the DKPT-group the patients required
      additional Paracetamol more often only during the 1st day of treatment whereas
      the patients of the TRAM-group required the additional rescue medication mainly
      during the first 3 days of treatment. This difference was statistically
      significant (p = 0.011). Under DKPT treatment patients experienced significantly
      less adverse events (with an at least "possible" causal relationship; p = 0.026).
      This can be explained by central nervous disturbances that occurred only in the
      TRAM group. The distribution of gastro-intestinal disorders was identical in both
      treatment groups. CONCLUSION: With this results DKPT in comparison with TRAM also
      showed to be a strong analgesic drug with a better risk-benefit relation due to
      its better tolerability.

PMID- 11217679
TI  - [Differential diagnosis of pain experience. Chronic pain and depression].
AB  - Chronic pain and depressive symptoms often occur together. The relationships
      between these two conditions are, however, still controversial. On the
      neurobiological level, features common to both disorders are to be found. Mental
      coping patterns favor the development of depressive symptomatology in patients
      suffering from pain, or of pain within the framework of a psychiatric illness.
      For the diagnostic work-up, the case history, exploration, organic investigations
      and, where indicated, psychological tests are employed. A well-proven strategy in
      the areas of diagnosis and therapy is interdisciplinary cooperation involving
      physicians, psychologists and--within relevant institutions--nursing staff.

PMID- 11217680
TI  - [Ginkgo special extract EGb 761 in tinnitus therapy. An overview of results of
      completed clinical trials].
AB  - In a systematic search of the literature 19 clinical trials investigating the
      effects of tinnitus treatment with Ginkgo biloba special extract EGb 761 were
      identified and evaluated. The results of eight controlled studies on tinnitus due
      to cerebrovascular insufficiency or labyrinthine disorders of varying genesis for
      the most part show a statistically significant superiority of treatment with the
      Ginkgo biloba special extract EGb 761 as compared with placebo or reference drugs
      applied of periods of one to three months. Open studies, too, some involving
      large numbers of patients, revealed appreciable improvements under ginkgo
      treatment. Therapeutic success was not directly correlated with either the
      genesis or the duration of tinnitus. However, investigations of prognostic
      factors revealed that short-standing disorders have a better prognosis, so that
      better results can be expected from early-onset treatment. The tolerability of
      Ginkgo biloba special extract EGb 761 was excellent, and in this respect the
      controlled clinical trials revealed little difference between drug-treated and
      control groups.

PMID- 11217681
TI  - [Normal and pathological aging of the brain].
AB  - The number of people of old age in western countries is growing, leading to an
      increased prevalence of degenerative brain diseases. These diseases are widely
      regarded as a limiting factor of quality of life in old age. The possibilities to
      maintain intellectual performance of the brain even in old age historically met
      with scepticism and diseases like Alzheimer's or Parkinson's disease were
      accepted as an inevitable consequence of aging. "The older, the sicker." However,
      during recent years new concepts were developed: The physiologic aging of the
      brain is distinct from diseases of the brain occurring during old age and
      pathogenesis of degenerative brain diseases is increasingly revealed. This
      results in novel, even neuroprotective, therapy strategies, implying that these
      diseases cannot only be seen as inevitable and incurable, but also as a target
      for prevention and symptomatic and causal therapy strategies.

PMID- 11217682
TI  - [Combined vaccine against tetanus, diphtheria and polio. A randomized controlled
      study of immunogenicity and tolerance].
AB  - BACKGROUND, METHOD: Given the worldwide distribution of infection and the
      mobility of large parts of the population immunizations against tetanus,
      diphtheria and polio remain a challenge. This is especially true for adolescents
      and adults since antibodies tend to wane once immunized children enter
      adolescence and adulthood. A new combination vaccine against tetanus, diphtheria
      and polio (Td-IPV) for booster immunizations was subjected to a randomized,
      controlled and single-blind trial. Non-inferiority had to be demonstrated with
      regard to efficacy (immunogenicity) and safety in comparison to separate Td and
      IPV injections. RESULTS: Almost 500 subjects from community practices and
      occupational/immunization clinics took part. Antibody titres were equivalent for
      all antigens. Local and systemic reactions were equal or even less marked in the
      intervention group. CONCLUSION: From a public health perspective the new vaccine
      can make an important contribution to ensure adequate protection against tetanus,
      diphtheria and polio in adolescent and adult populations.

PMID- 11217684
TI  - Bibliography. Current world literature. Neoplasms.

PMID- 11217683
TI  - [Prescribing of sildenafil by national insurance program physicians. What basic
      sexual medicine qualification is required?].
AB  - The role of sildenafil in the treatment of erectile dysfunction is discussed.
      Especially in primary care there is a necessity to weigh the individual cost
      benefit-ratio. Functional analysis of erectile dysfunction, exclusion of
      psychiatric and organic comorbidity, identification of sexual deviance and couple
      counseling about the advantages and disadvantages of sildenafil prescription are
      the core prerequisites of sildenafil application in primary care. The counseling
      model of PLIS-SIT is proposed as a guideline for counseling process. Current
      approaches of education for general practitioners are reviewed and the
      integration in a recently developed training for management of psychiatry and
      psychosomatic illness in general medical settings is proposed. Finally open
      questions for research and quality management are discussed.

PMID- 11217686
TI  - Bibliography. Current world literature. Metabolic disorders and neurotoxicology.

PMID- 11217685
TI  - Bibliography. Current world literature. Trauma and rehabilitation.

PMID- 11217687
TI  - [Guidelines of the DGVS. Complementary therapy. German Society of Digestive and
      Metabolic Diseases].

PMID- 11217688
TI  - [A 57-year-old woman with progressive disturbance of gait and mental
      deterioration].
AB  - We report a 57-year-old woman with progressive gait disturbance and mental
      deterioration. She was well until March 1995, when she was 54 years of the age.
      At that time she noted a gradual onset of tremor and difficulty using her hand.
      Similar symptoms appeared in her right hands, and she visited another hospital,
      where 300 mg of levodopa and 7.5 mg of bromocriptine were prescribed. These
      medication did not help her symptoms. In the summer of 1996, she became to fall
      down easily. In September of the same year, she started to repeat the same words
      many times. She was unable to stop it. She was hospitalized to our service on
      January 25, 1997. On admission, she was alert but demented moderately; her
      Hasegawa dementia scale was 15/30. She showed palilallia, logoclonia, and
      echolalia. She showed constructional apraxia and questionable left-right
      disorientation. She had marked vertical gaze palsy with preserved oculocephalic
      response. She had masked face and small voice. Her gait was wide based with small
      steps. No muscle atrophy or weakness was noted. She showed only mild rigidity in
      the neck, but no rigidity was noted in the limb. No tremor was noted. She was
      bradykinetic. Deep tendon reflexes were symmetric and within normal limits.
      Laboratory findings on admission was unremarkable. MRI showed atrophy of the
      brain stem as well as cerebral cortical areas, particularly in the fronto
      temporal region. Her hospital course was complicated with paralytic ileus and
      septicemia. She developed hypotension and pronounced dead on July 28, 1998. She
      was discussed in the neurological CPC. The chief discussant arrived at a
      conclusion that the patient had progressive supranuclear palsy and died of septic
      shock. All the participants wondered between PSP and CBD, but majority agreed
      with this diagnosis of the chief discussant. Only one thought that she might have
      had corticobasal degeneration rather than PSP, because of dementia, cortical
      atrophy in MRI, and lack of limb rigidity. Postmortem examination revealed
      cortical and brain stem atrophy. In the premotor cortex, marked astrocytosis and
      ballooned neurons were seen. Furthermore, astrocytic plaques were seen; this is
      considered to be pathognomonic for CBD. The substantia nigra showed marked
      neuronal loss and gliosis, but no neurofibrillary tangles or Lewy bodies were
      seen. Gliosis was also seen in the globus pallidus and in the medial thalamus.
      The pathologic diagnosis was corticobasal degeneration. This patient was very
      interesting case, in that the clinical manifestations appeared to be consistent
      with PSP, yet pathologic diagnosis was CBD. Lack of limb rigidity may be atypical
      for advanced PSP. In addition, palilalia appears to be more associated with CBD.

PMID- 11217689
TI  - Knowledge is not enough.

PMID- 11217690
TI  - Proposed design modifications to reduce risk of operating rotary field mowers.
AB  - The primary objective of this project was to reduce risk of injury associated
      with operating a rotary mower driven by a tractor power take-off (PTO) by
      developing and evaluating design improvements and determining their economic
      feasibility. Researchers have concluded that alteration of machinery design has a
      greater impact on the reduction of accidents than safety training. Implementation
      of an Operator Presence Sensing System (OPSS) and removal of the PTO are the two
      injury-reducing, engineering modifications evaluated by this research. Hydraulic
      power allows this to occur by providing dynamic braking, few moving parts
      (removal of the PTO), and controllable power. A hydraulic circuit was developed
      to power the mower and to enable an OPSS. Tractor hydraulics were simulated using
      a hydraulic training bench. Two mower configurations were tested: 6.55 cm3 rev(
      1) (0.4 in.3 rev(-1)) displacement motor with a 0.748 kg blade and 47.5 cm3 rev(
      1) (2.9 in.3 rev(-1)) displacement motor with a 9.4 kg blade. A PTO-driven rotary
      mower was not used to test the circuit due to spatial and safety limitations of
      the hydraulic training bench. Results from the first mower configuration verified
      the concepts behind the hydraulic circuit. The second configuration verified the
      OPSS and indicated the applicability of the circuit to a rotary mower.

PMID- 11217691
TI  - Dust in pig buildings.
AB  - It is well documented in the international scientific literature that airborne
      dust in pig houses can cause serious health problems for humans as well as for
      animals. Extensive research has been carried out in different countries during
      the last few decades to improve the scientific understanding of air quality
      issues related to intensive animal production. Research and review papers were
      presented at the international symposium on Dust Control in Animal Production
      Facilities, held in Denmark in 1999. Different techniques have been used in order
      to reduce dust burdens in pig confinement buildings, but up to date only the
      procedure of spraying oil or a mixture of oil and water has contributed to
      reducing the indoor dust concentrations significantly. This article summarizes
      the current level of understanding of dust issues in intensive animal production
      buildings, mainly on the basis of papers presented at the above-mentioned
      symposium.

PMID- 11217692
TI  - Dust levels and control methods in poultry houses.
AB  - This article summarizes information from the papers and posters presented at the
      international symposium on "Dust Control in Animal Production Facilities", held
      in Aarhus (Denmark) on 30 May-2 June 1999. Dust concentrations in poultry houses
      vary from 0.02 to 81.33 mg/m3 for inhalable dust and from 0.01 to 6.5 mg/m3 for
      respirable dust. Houses with caged laying hens showed the lowest dust
      concentrations, i.e., less than 2 mg/m3, while the dust concentrations in the
      other housing systems, e.g., perchery and aviary systems, were often four to five
      times higher. Other factors affecting the dust concentrations are animal
      category, animal activity, bedding materials and season. The most important
      sources of dust seem to be the animals and their excrements. Further studies on
      the effects of housing systems on dust sources and their compounds are desired
      for development of a healthier working environment in poultry production
      facilities. Adjustment of the relative humidity (RH) of the air in a broiler
      house to 75% will have an effect on inhalable dust, but not on respirable dust. A
      slight immediate effect on the respirable dust was observed after fogging with
      pure water or water with rapeseed oil. In an aviary system, a 50 to 65% reduction
      of the inhalable dust concentration was found after spraying water with 10% of
      oil and pure water, respectively. To obtain a higher dust reducing efficiency,
      improvement of techniques for application of droplets onto dust sources will be
      desired.

PMID- 11217693
TI  - Human health effects of dust exposure in animal confinement buildings.
AB  - Work in swine and poultry units is associated with exposure to significant levels
      of organic dust and endotoxins with the highest concentrations found in poultry
      houses, whereas values found in dairy and in cattle farming are much lower.
      Corresponding to this is an excess of work-related respiratory symptoms in swine
      farmers. A dose-response relationship exists between symptoms and number of
      working hours. Longitudinal studies have demonstrated an accelerated decline of
      lung function in swine farmers large enough to cause clinically significant
      disease in some farmers. Because of the large number of people needed in swine
      farming and the long working hours, swine farming has emerged as the major
      respiratory problem in farming. Experimental studies indicate that exposure has
      to be lowered substantially to avoid acute effects and longitudinal studies
      demonstrate that loss of lung function occurs in non-smoking swine farmers
      without respiratory symptoms and that accelerated decline in lung function occurs
      below endotoxin concentrations in dust (100 ng/m3) proposed as a safe threshold.

PMID- 11217694
TI  - Asthma and indoor air: the next epidemic.

PMID- 11217695
TI  - National Conference on Preventing Hearing Loss in Construction.

PMID- 11217696
TI  - Workers exposed to class B biosolids during and after field application. National
      Institute for Occupational Safety and Health.

PMID- 11217697
TI  - COLCHIC-occupational exposure to chemical agents database: current content and
      development perspectives.
AB  - Set up in 1987, COLCHIC is a database for occupational exposure to chemical
      agents. Eight French regional health insurance fund (Caisse Regionale d'Assurance
      Maladie-CRAM) interregional laboratories and the French national research and
      safety institute (Institut National de Recherche et de Securite-INRS)
      laboratories have stored results and information from chemical agent exposure
      measurements on this database. More than 10 years later, 400,000 measurement
      results of exposure to 600 substances are now stored on COLCHIC. Utilization of
      data from this base is limited by the quality and absence of certain information,
      so a working group has been formed to develop a new data retrieval system, which
      takes into account recommendations formulated by the AIHA-ACGIH and European
      working groups. Utilization of this new coding system should allow improved
      description of workplace exposure conditions in the near future. This data
      retrieval system is currently being validated and should be used by the
      laboratories concerned during the course of 2001.

PMID- 11217698
TI  - Recording of data of individual measurements of occupational exposure: guideline
      of the Dutch Society of Occupational Hygiene (October 1999).
AB  - Following the recommendations of the European Working Group on Exposure
      Databases, a Working Group (on Storage of Data of Measurements of Occupational
      Exposure) of the Dutch Occupational Hygiene Society has developed a Guideline
      which was presented at the International Symposium on Occupational Exposure
      Databases and Their Application for the Next Millennium, November 1-3, 1999,
      London. To establish the present situation, a small-scale telephone survey of
      monitoring practices and storage of data was done within the Society. The results
      of the telephone survey and the draft guidance document were discussed with the
      occupational hygienists and other stakeholders (e.g., authorities, industry,
      labor unions, and occupational physicians) in a society meeting. This meeting was
      used to gather ideas on the need and support for a guidance document and to get
      input for improving the draft guidance document and for implementation of the
      Guideline. After this meeting, the Guideline was further developed and published
      by the Dutch Occupational Hygiene Society. The Guideline concentrates on the data
      elements required when storing exposure data. The data elements presented are the
      minimum and should be stored minimally to ensure proper interpretation of results
      at present and in the future and definitions of the items used are given. The
      Guideline does not prescribe how the data should be stored, or which procedures
      need to be used to guarantee the quality of the recorded data elements.

PMID- 11217699
TI  - Development of a National Occupational Exposure Survey and Database associated
      with NIOSH hazard surveillance initiatives.
AB  - NIOSH pioneered hazard surveillance in the workplace by designing and conducting
      the 1972 to 1974 National Occupational Hazard Survey (NOHS), the 1981 to 1983
      National Occupational Exposure Survey (NOES), and the 1984 to 1989 National
      Occupational Health Survey of Mining (NOHSM). The databases developed from these
      three on-site surveys represent unique resources for associating potential
      chemical, physical and biological agents with industries and occupational groups.
      The data have been a primary source of information for NIOSH, regulatory
      agencies, health professionals, researchers, and labor organizations in
      establishing priorities for prevention strategies that include medical and
      engineering interventions, development of occupational standards, and the
      identification of research needs. Recognizing that the data from these surveys
      are becoming dated, a multidisciplinary team comprising members from various
      NIOSH research divisions was established to develop a hazard surveillance
      strategy for the Institute, including options for a national hazard surveillance
      survey and database. The proposed new hazard survey builds on lessons learned
      from the previous surveys, seeks opportunities to incorporate existing data from
      other sources, expands the scope of industries and hazards, and takes advantage
      of advances in data gathering, processing and dissemination technology. This
      article presents current considerations and recommendations for a new hazard
      survey and database.

PMID- 11217700
TI  - Development of an exposure database and surveillance system for use by practicing
      OSH professionals.
AB  - This report summarizes the development of an occupational exposure database and
      surveillance system for use by health and safety professionals at Rocky Flats
      Environmental Technology Site (RFETS), a former nuclear weapons production
      facility. The site itself is currently in the cleanup stage with work expected to
      continue into 2006. The system was developed with the intent of helping health
      and safety personnel not only to manage and analyze exposure monitoring data, but
      also to identify exposure determinants during the highly variable cleanup work.
      Utilizing a series of focused meetings with health and safety personnel from two
      of the major contractors at RFETS, core data elements were established. These
      data elements were selected based on their utility for analysis and
      identification of exposure determinants. A task-based coding scheme was employed
      to better define the highly variable work. The coding scheme consisted of a two
      tiered hierarchical list with a total of 34 possible combinations of work type
      and task. The data elements were incorporated into a Microsoft Access database
      with built-in data entry features to both promote consistency and limit entry
      choices to enable stratified analyses. In designing the system, emphasis was
      placed on the ability of end users to perform complex analyses and multiparameter
      queries to identify trends in their exposure data. A very flexible and user
      friendly report generator was built into the system. This report generator
      allowed users to perform multiparameter queries using an intuitive system with
      very little training. In addition, a number of automated graphical analyses were
      built into the system, including exposure levels by any combination of building,
      date, employee, job classification, type of contaminant, work type or task,
      exposure levels over time, exposure levels relative to the permissible exposure
      limit (PELS), and distributions of exposure levels. Both of these interfaces,
      allow the user to "drill down" or gradually narrow query criteria to identify
      specific exposure determinants. A number of other industrial hygiene processes
      were automated by the use of this database. Exposure calculations were coded into
      the system to allow automatic calculation of time-weighted averages and sample
      volumes. In addition, a table containing all the PELs and other relevant
      occupational exposure limits was built into the system to allow automatic
      comparisons with the current standards. Finally, the process of generating
      reports for employee notification was automated. The implementation of this
      system demonstrates that an integrated database system can save time for a
      practicing hygienist as well as provide useful and more importantly, timely
      information to guide primary prevention efforts.

PMID- 11217701
TI  - Retrospective collection of exposure data from industry: results from a
      feasibility study in the United Kingdom.
AB  - In the United Kingdom the Health and Safety Executive for some years has stored
      chemical exposure data in their National Exposure Database. However, it has been
      difficult to persuade industry and other organizations to contribute to this
      resource. The aim of this project was to devise a cost-effective method of
      obtaining occupational exposure data on chemicals from U.K. industry and other
      sources. Five strategies were used to identify data for three different
      substances: toluene, acrylonitrile, and ethylene oxide. In total, 810
      organizations were contacted and over 45 percent responded. However, only 40 had
      relevant exposure data. Almost equal numbers of acceptable measurements were
      identified for toluene and acrylonitrile (2,770 and 2,000 respectively) with
      lesser ethylene oxide data (800). These measurements were drawn from a wide range
      of industries and are probably representative of measurements made by U.K.
      industry, although most of the data were from companies employing more than 100
      people. During the second phase of the project, more than 3,000 measurements and
      associated contextual information were collected (499 for toluene, 1,516 for
      acrylonitrile, and 17 for ethylene oxide, with a further 1,004 measurements for 1
      of 27 substances collected simultaneously with one of the above). The costs of
      identifying and collecting exposure data ranged from l7 to l380 per valid
      measurement, depending on the source of the data. We suggest that, rather than
      trying to retrospectively collect data, it is likely to be more cost-effective to
      enlist a number of occupational hygiene consults and industrial organizations to
      prospectively provide anonymized exposure measurements for inclusion in the
      Health and Safety Executives National Exposure Database.

PMID- 11217703
TI  - Finnish occupational exposure databases.

PMID- 11217702
TI  - A task exposure database for use in the alumina and primary aluminium industry.
AB  - A task exposure database (TED) was developed to facilitate data collation for
      construction of a task exposure matrix (TEM) for Healthwise, a series of studies
      on cancer and respiratory morbidity in the alumina and primary aluminium
      industry. Following the construction of job classifications for the eight study
      sites, the site hygienists identified all historical air monitoring time-weighted
      average (TWA) data, from their respective sites. The earliest data were sampled
      in the late 1970s, and over 17,000 personal samples were recorded over the eight
      sites over a twenty-year period. TED, a Microsoft Access database, was developed
      for use by site occupational hygienists to collate these exposure data across the
      mines, refineries and smelters. All data conforming to strict criteria for use
      were recorded using TED and provided to the study group. Following the individual
      data point entry, a calculator program in TED systematically calculated the
      geometric means, arithmetic means, and maximum and minimum results at the task
      level. Other features of TED included fields for flagging "significant changes"
      and "stepwise changes" in exposure. TED established a standardised means of data
      collation that later formed the basis for the construction of a TEM for the
      study. A TEM is similar to a job exposure matrix (JEM) except that the basic unit
      of categorization is at the task level instead of at the job level. Both a TEM
      and JEM have been constructed independently for Healthwise. The possible
      reduction of exposure misclassification and improvement in validity of exposure
      characterization with the use of the TEM, is currently under investigation. The
      Healthwise TEM consists of annual TWA and peak data results for each site for
      various airborne contaminants, including fluorides, coal tar pitch volatiles,
      sulfur dioxide, inspirable dust, alumina dust, bauxite dust, and oil mist.
      Construction of the TEM for the Healthwise study was completed in late 1998 and
      consists of over 33,700 TWA years of task exposure data.

PMID- 11217704
TI  - MEGA-database: one million data since 1972.
AB  - MEGA is the chemical workplace exposure database of the Institute for
      Occupational Safety (BIA) of the German Berufsgenossenschaften (BG) (statutory
      accident institutions for insurance and prevention). On the legal basis of the
      social insurance law the inspectorates of the BGs conduct workplace measurements
      of chemical and biological agents. The BGs have cooperated with BIA within the
      Berufsgenossenschaftliches Messsystem Gefahrstoffe--BGMG since 1972: measurements
      are done by the BGs, analyses and data processing are the tasks of BIA. In 1999
      31,000 measurements with 68,000 analyses were taken in 4,000 enterprises. All
      data are stored in the MEGA-database with up to 150 pieces of information
      (describing type of workplace, working conditions, measured substances, sampling
      strategy, sampling duration, sampling and analytical method etc.), for each
      result. MEGA contains today about 1,000,000 measurements of more than 400
      substances starting in 1972. MEGA is used by BIA and the BGs for the following
      purposes: prevention (e.g., identification of hazards, efficiency of exposure
      reducing measures, determination of technical criteria for exposure limit
      values), epidemiological questions, and investigations of occupational diseases.
      In the framework of the measuring and inspection activities and tasks of the
      inspectorates of the BGs the locations for measurements are not randomly
      selected, but are based on criteria such as supposed critical exposure situations
      or testing the efficiency of exposure reducing measures. Nevertheless, a
      statistical appraisal of the data is possible for different purposes considering
      the specific determinants of the results, as, for example, classification of
      enterprises (sectors), workplaces (activities, tasks), used materials, and
      products. The MEGA-database will be further developed into a multifactorial
      exposure database with additional data on biological exposure to bacteria and
      funghi, but also noise and other data.

PMID- 11217705
TI  - Development and initial experience with the new "exposure database of the federal
      states".
AB  - The Workgroup of the State Measuring Authorities for Chemical Occupational Safety
      (ALMA) was established in 1987 by the State Committee for Occupational Safety and
      Safety Technology (LASI) for the purpose of exchanging experiences between the
      measuring institutes and authorities of the federal states supporting the
      commercial regulation authorities in the field of dangerous materials. A
      workgroup was assigned by ALMA in 1995 to determine the theoretical and practical
      basis for the establishment of an exposure database commonly available to the
      federal states. In the first stage, the theoretical data structure of the planned
      database was defined. The purpose of this was to ensure the exchange of exposure
      data between the federal states in the future and to allow common evaluation of
      the data. In the second stage, the practical benefits of the database were
      determined in a trial run. This database makes possible and simplifies the
      documentation of both the exposure measurements of the state measuring
      authorities and also those of external (private) measuring bodies.

PMID- 11217706
TI  - Dermal exposure: how to get information.
AB  - Risk assessment of chemical substances at the workplace requires information
      about intrinsic hazards and workers' exposure. At many workplaces health risks
      from both inhalative and dermal exposure to hazardous substances may occur.
      Exposure assessment therefore must include both modes of exposure. Very often,
      qualitative and quantitative information about dermal exposure is lacking.
      Measurement methods are of questionable quality when applied to monitoring dermal
      exposure at workplaces and the results are difficult to interpret. A
      questionnaire was designed for the description of dermal exposure situations
      taking into account the different factors influencing dermal exposure. In
      conjunction with an air monitoring survey in German car repair shops the
      questionnaire was applied by a hygienist. The hands of car mechanics are the most
      exposed parts of their bodies. The typical duration of tasks (and dermal
      exposure) was from either 5-10 minutes or up to about 1 hour. This corresponds to
      typical jobs in car repair shops like inspection and repair, respectively. In
      some cases other parts of the body are also exposed, for example, the face and
      forearms. Parts of the body may be covered by wetted or greasy clothes. Only in a
      few cases do mechanics clean their hands immediately after finishing a task.
      Normally, hands are cleaned at the end of a shift. The questionnaire was further
      developed for general application making use of multiple choice entries together
      with an explanatory manual. The questionnaire is still under development to be
      applied for a qualitative survey of dermal exposure as part of the European
      project RISKOFDERM.

PMID- 11217707
TI  - Lessons learned while compiling a quantitative exposure database from the
      published literature.
AB  - The published literature was reviewed and then a quantitative hydrocarbon solvent
      exposure database was compiled. The data was then analyzed to determine trends in
      documented worker exposures to hydrocarbon solvents. It was found that an all too
      common limitation of the published literature was the incomplete reporting of
      results by the authors.

PMID- 11217708
TI  - Exposure information in European industry: implications for future occupational
      research.
AB  - A survey has been carried out among European industry to investigate the
      collection and retention of records which might be used for epidemiological
      research. Exposure information results are reported. Approximately 1,000
      questionnaires focusing on exposure information were sent to seven countries,
      with a 42 percent response rate. Eighty-two percent of companies reported that
      exposure measurements were taken to comply with legal requirements. Measurements
      were most often made for noise (84%), with 48% of companies measuring chemicals,
      48 percent particulates but only 10 percent vibration. Measurements were most
      often taken for specific locations (73%), rather than for particular jobs (54%)
      or individual workers (50%). Eighty percent recorded location, sampling date,
      agents measured, and units of measurement, with about 70 percent recording job
      being sampled, sampling method, and duration and plant process, but less than 60
      percent recording environmental conditions or worker details. Overall, only 10
      percent of companies kept their exposure information forever, and 71 percent kept
      it for 10 years or less. Legislative requirements were most often cited as the
      reason for retention of records. The variation in the quantity and quality of
      measurements and the early destruction of records poses considerable problems for
      European research. Inaccuracy and misclassification of exposure limits the
      ability to establish causal relationships between effect and disease. Records
      should uniquely identify an individual worker and facilitate linkage to exposure
      and health effects information. Their format should be accessible, linkable, and
      secure. Data should be kept by an identifiable organization and there should be a
      secure chain of custody if a company goes out of business. Unless industry can be
      motivated to follow these guidelines the future of research into occupational
      causes of ill health, and in particular, the evaluation of exposure, will be
      limited.

PMID- 11217709
TI  - Do EASE scenarios fit workplace reality? A validation study of the EASE model.
      Estimation and Assessment of Substance Exposure.
AB  - Within the framework of European risk assessment of new and existing substances,
      the EASE model (Estimation and Assessment of Substance Exposure) is often applied
      to assess inhalative exposure at workplaces. To contribute to the validation of
      this model, single EASE scenarios were compared with independent measurement data
      on inhalative exposure to vapors and dusts. For this purpose, workplace
      measurements obtained in the areas of production, textile printing and coating,
      screen printing and offset printing, the rubber industry, and the plastics
      processing industry as well as flame spraying were used. A good correspondence
      between model estimates and measurement data was found in the case of exposure to
      vapors for the production of chemical substances in closed systems (EASE
      scenario: closed system without breaching) and for procedural control works at
      mainly automated printing workplaces (EASE scenarios: non dispersive use,
      segregation, low/medium volatility). For the handling of powdery substances
      measurement results obtained during weighing and filling works, in part
      semiautomatic, were compared with the EASE estimates for the scenario: dry
      manipulation, with/without local exhaust ventilation. Good correspondence was
      estimated if approx. 1 t to 200 t powdery substances were handled per shift. For
      the EASE scenarios "direct handling with natural ventilation/with local exhaust
      ventilation," high discrepancies exist between model prediction and measurement
      results obtained during manual screen printing or the preparation of printing
      inks.

PMID- 11217710
TI  - Use of rank-order analysis of ordinal exposure data: application to vinyl
      chloride exposure.
AB  - The University of Louisville currently maintains a database of work histories and
      exposure rankings for chemicals used in the production of polyvinyl chloride from
      the plant where the original angiosarcoma cases were identified. A 6-point
      ranking scale was used to characterize worker exposure to vinyl chloride by year,
      building, and job. Since this is ordinal data, non-parametric statistics have
      been used to evaluate exposure factors in case-control studies. Rank order
      analysis of vinyl chloride exposure and angiosarcoma shows a strong statistical
      association. In contrast, the method shows no association between vinyl chloride
      exposure and brain cancer. Exposure ranking is a reasonable alternative to
      estimation of actual dose. Rank order analysis allows for a rapid assessment of
      exposure-disease associations for case control studies.

PMID- 11217711
TI  - Integrating workplace exposure databases for occupational medicine services and
      epidemiologic studies at a former nuclear weapons facility.
AB  - We outline methods for integrating epidemiologic and industrial hygiene data
      systems for the purpose of exposure estimation, exposure surveillance, worker
      notification, and occupational medicine practice. We present examples of these
      methods from our work at the Rocky Flats Plant--a former nuclear weapons facility
      that fabricated plutonium triggers for nuclear weapons and is now being
      decontaminated and decommissioned. The weapons production processes exposed
      workers to plutonium, gamma photons, neutrons, beryllium, asbestos, and several
      hazardous chemical agents, including chlorinated hydrocarbons and heavy metals.
      We developed a job exposure matrix (JEM) for estimating exposures to 10 chemical
      agents in 20 buildings for 120 different job categories over a production history
      spanning 34 years. With the JEM, we estimated lifetime chemical exposures for
      about 12,000 of the 16,000 former production workers. We show how the JEM
      database is used to estimate cumulative exposures over different time periods for
      epidemiological studies and to provide notification and determine eligibility for
      a medical screening program developed for former workers. We designed an
      industrial hygiene data system for maintaining exposure data for current cleanup
      workers. We describe how this system can be used for exposure surveillance and
      linked with the JEM and databases on radiation doses to develop lifetime exposure
      histories and to determine appropriate medical monitoring tests for current
      cleanup workers. We also present time-line-based graphical methods for reviewing
      and correcting exposure estimates and reporting them to individual workers.

PMID- 11217712
TI  - Application of statistical models for secondary data usage of the US Navy's
      Occupational Exposure Database (NOED).
AB  - Many organizations around the world have collected data related to individual
      worker exposures that are used to determine compliance with workplace standards.
      These data are often warehoused and thereafter rarely used as an information
      resource. Using appropriate groupings and analysis of OSHA data, Gomez showed
      that such stored data can provide additional insight on factors affecting
      occupational exposures. Using data from the Occupational Exposure Database of the
      United States Navy, the usefulness of statistical models for defining
      probabilities of exposure above permissible limits for observed work conditions
      is examined. Analyses have highlighted worker Similar Exposure Groups (SEGs) with
      potential for overexposure to asbestos and lead. In terms of grouping data,
      Rappaport et al. defined the Within-Between Lognormal Model, a scale-independent
      measure for quantifying between-worker variability within a selected worker
      group: (B)R.95 = exp[3.92s(sB)], representing the ratio of arithmetic mean
      exposures received by workers in the 97.5th and 2.5th percentiles. To help search
      for groups, the Proportional Odds Model, a generalization of the logistic model
      to ordinal data, can predict probabilities for group exposure above the
      Occupational Exposure Limit (OEL), or the Action Level (AL), which is one-half of
      the OEL. Worker SEGs have been identified for asbestos workers removing friable
      asbestos ((B)R.95 = 11.0) and nonfriable asbestos ((B)R.95 = 6.5); metal cleaning
      workers sandingspecialized equipment ((B)R.95 = 11.3), and workers at target
      shooting ranges cleaning up lead debris ((B)R.95 = 10). Estimated probabilities
      for the categories <AL, AL-OEL, and >OEL support current understanding of work
      processes examined. Differences in probability noted between tasks and levels of
      ventilation validate this method for evaluating other available workplace
      exposure determinants, and for predicting probability of membership in categories
      that may help further define worker exposure groups, and determinants of
      excessive exposures. Thus, analyses of retrospective exposure data can help
      identify work site and work practice factors for efficient targeting of
      remediation resources.

PMID- 11217713
TI  - Assessing reasonable worst-case full-shift exposure levels from data of variable
      quality.
AB  - Exposure assessors involved in regulatory risk assessments often need to estimate
      a reasonable worst-case full-shift exposure level from very limited exposure
      information. Full-shift exposure data of very high quality are rare. A full-shift
      value can also be calculated from (short term) task-based values, either derived
      from measured data or from models. The most simple option is to use the task
      based exposure levels as the full-shift value. A second option is to calculate a
      time-weighted average (TWA), using (reasonable worst case) estimates of the
      duration and the exposure level of the relevant tasks. The third option is to use
      a Monte Carlo analysis with estimated input distributions for exposure level and
      duration of exposure. If an estimated distribution of respiratory volume is also
      included, this leads to a distribution of inhaled amounts. The 90th percentile of
      such a distribution is generally substantially lower than the fixed point
      estimates calculated using high end values for each parameter. This technique can
      thus prevent unnecessary conservative estimates in risk assessment. The output
      distribution can also be used as valuable input to the risk management process,
      because it provides information on probabilities of exposure levels, that can
      influence the cost-benefit analysis of the risk management process. Finally, the
      sensitivity analysis of Monte Carlo simulation can give guidance for further
      studies to increase the accuracy of the exposure assessment.

PMID- 11217715
TI  - What does "low exposure" mean? Exposure considerations in the testing of notified
      new substances.
AB  - In the notification procedure for new substances, the need to conduct further
      toxicity tests may arise if the outcome of a qualitative or quantitative risk
      assessment indicates relevant risks. Sometimes a quantitative assessment is not
      possible (e.g., if a no observed adverse effect level [NOAEL] is not available).
      A different approach is required for such substances. An approach based on the
      correlation of the classification of the substance (the possible outcome of
      testing) with the assumed tolerable exposure levels is presented here. It relates
      to the hazard band model developed by the Health and Safety Executive (HSE) of
      the United Kingdom. To aid decision-making, the assumed tolerable exposure level
      is compared with the estimated workplace exposure level by means of calculating
      the quotient of these two figures. The quotient is called the assumed margin of
      safety (AMOS). A quotient higher than 1 means that testing may be deferred. The
      approach is described for a powdery substance used as a pigment in the coloration
      of plastics and rubber. Depending on the exposure situation, the need for further
      testing to determine the repeated dose toxicity of the substance is discussed.

PMID- 11217714
TI  - Harmonization of future needs for dermal exposure assessment and modeling: a
      workshop report.
AB  - Dermal exposure assessment and modeling is still in early phases of development.
      This article presents the results of a workshop organized to harmonize the future
      needs in this field. Methods for dermal exposure assessment either assess the
      mass of contaminant that is transferred to the skin, or the transfer of
      contaminant through the skin. Models for dermal exposure are either knowledge
      based or deterministic. Any method or model should be transparent, validated, and
      open to further development. Some (partly) validated and standardized methods are
      available for measuring or modeling permeation of the skin or of personal
      protective equipment (PPE). Further validation and standardization is necessary.
      More research is needed on permeation of dusts and aerosols and more realistic
      tests should be developed and used for PPE. Several methods have been developed
      to measure contamination of surfaces or skin, but they are not validated or
      standardized. A number of non-validated models exist to assess dermal exposure. A
      clear need exists for more studies of dermal exposure, regarding measurement
      methods, models and actual exposure levels. A running four-year European study
      will greatly expand the knowledge in this field. Simple tools to assess and
      control the risks of dermal exposure in small and medium sized enterprises are
      also needed. Increasing the general knowledge of practitioners (e.g., safety
      professionals, occupational hygienists and physicians) in the field of dermal
      exposure is a first requirement. Available data, for example, on the permeation
      of PPE, should be made more readily available, using modern information
      technology. When information on dermal exposure is gathered and stored, the core
      information needs are partly the same as those for inhalation exposure. Some
      elements of process and activity, substance and product or worker, specific for
      dermal exposure, have been suggested by the workshop.

PMID- 11217716
TI  - The need for empirically derived permeation data for personal protective
      equipment: the death of Dr. Karen E. Wetterhahn.
AB  - Personal protective equipment (PPE) is an essential component in any occupational
      health and safety program. The appropriate selection and use of PPE can help
      prevent or limit exposure to hazardous materials. The inappropriate selection or
      use of PPE can lead to unnecessary exposure or --with extremely hazardous
      materials--serious harm including death. In 1997, Dr. Karen E. Wetterhahn died
      from mercury poisoning resulting from a single exposure to dimethylmercury almost
      a year before. Her death raised numerous questions as to how this tragedy
      occurred and what could be done to protect against a chemical as dangerous as
      dimethylmercury. This article provides a brief review of the case and discusses
      the glove permeation testing done during the course of the accident
      investigation. Using this case as an example, the author argues that all
      recommendations for PPE be based on empirical testing using accepted methods and
      that this information be readily available.

PMID- 11217717
TI  - Determinants of inhalable dust exposure in the European carbon black
      manufacturing industry.
AB  - A large study to investigate the respiratory health effects of occupational
      exposure to carbon black in the European carbon black manufacturing industry
      commenced in 1987. During the study, a large amount of personal occupational
      exposure data was collected. This article describes the empirical models used to
      study the determinants of inhalable dust exposure, using data from 16 factories
      collected in the third and last cross-sectional phase of this study. Information
      on activities during the measurements was collected using short job category
      specific questionnaires. In addition, questionnaires were completed by factory
      representatives on the implementation of control measures and changes in
      production process since the first cross-sectional phase. Mixed effects analyses
      of variance models were used to identify determinants of exposure, while taking
      into account the within- and between-worker (random) variance components. The
      results of these models show that, for any job category, factory is a strong
      predictor of exposure in this industry. These differences could not be explained
      entirely by factors such as age of the factory or the control measures
      implemented since the first phase of the study. Surprisingly, implementation of
      local exhaust ventilation systems had an effect that was counterintuitive; for
      example, in warehouses where local exhaust ventilation systems had been
      implemented, higher dust exposure levels were found compared to those where such
      control measures had not been installed since the first cross-sectional survey.
      Season appeared to have some effect on exposure for some job titles, with
      generally relatively low exposures being found in the summer. Finally, a number
      of activities were identified that caused higher levels of dust exposure, most
      notably "changing of filters" and "clean-up of carbon black spills."

PMID- 11217718
TI  - EUROPOEM, a predictive occupational exposure database for registration purposes
      of pesticides.
AB  - For registration of agricultural pesticides, the risks for humans, animals, and
      the environment must be determined. The risk assessment is based on an appraisal
      of the levels of exposure and the hazards of the active substance(s) in the plant
      protection product, that is, the agricultural pesticide. Funded by the European
      Commission (AIR3 CT93-1370), the EUROPOEM database has been developed by a group
      of experts, representing governments, industry, and academia. The currently
      available exposure database reflects exposure to operators (mixer/loaders and
      applicators). The EUROPOEM approach is based on a harmonized protocol for conduct
      of field studies of operator exposure (presently published as an Organization for
      Economic Cooperation and Development [OECD] Guidance Document) and a tiered
      approach to exposure and risk assessment. The database is constructed from
      exposure data obtained in representative field studies. These field studies are
      considered according to criteria reflecting the quality of documentation, study
      design, adequate methodology, number of replicates, and QA/QC elements, for use
      of the inhalation and dermal exposure data. The resulting exposure data were
      combined according to comparable use scenarios. From the resulting databases
      typical surrogate potential exposure values have been obtained, which are
      determined by their use for either acute or chronic health effects, and the size
      of the database. For large databases (over 50-100 data points), from many
      different field studies (10 or more), the 75th percentile is taken if the
      exposure is considered leading to chronic effects. For smaller databases, a more
      conservative 90th percentile is taken as surrogate value, or none at all for very
      small databases (15-20 or less data points from 3 or less different field
      studies). The choice for the 75th percentile is based on the assumed or observed
      lognormal distribution of the exposure data, as being the most relevant typical
      value for long-term effects, since the 75th percentile of log-normal
      distributions is nominally very similar to a calculated arithmetic mean (AM). The
      AM, as such however, is irrelevant for log-normal distributions.

PMID- 11217719
TI  - Misinterpretation and misuse of exposure limits.
AB  - Users of occupational exposure limits (OELs) often fail to distinguish between
      the complementary processes of risk assessment and exposure (risk) management.
      The former refers to those activities that lead to the selection of a reasonably
      protective exposure limit and often includes an analysis of exposure databases
      and an evaluation of group-based risk. The latter focuses on individual risk, and
      refers to those actions required of employers to ensure that each employee is
      unlikely to incur harm to health. This presentation focuses on how this failure
      to distinguish leads to misinterpretation and misuse of OELs. A typical OEL
      definition consists of at least three components: a concentration, an averaging
      time, and a target (usually the individual worker). OELs are occasionally
      improperly applied, resulting in a reduction of the expected level of protection.
      For example, sampling strategies proposed by the American Industrial Hygiene
      Association (AIHA) and Comite Europeen de Normalisation (CEN) permit workers to
      be aggregated into exposure groups. Under certain circumstances this practice can
      leave some workers unevaluated and unprotected. Protection is also reduced when
      the averaging time is extended from a single shift to multiple shifts.
      Frequently, OELs are misinterpreted as upper limits to exposures averaged over
      weeks, months, or even years, rather than a single shift. Much of this confusion
      can be traced to the desire of some to reconcile research (epidemiology) sampling
      strategies with compliance sampling strategies. But the two have fundamentally
      different goals and objectives. Others are simply attracted to alternative OEL
      interpretations that permit frequent overexposures (i.e., measurements that
      exceed the OEL), thus making compliance easier. Given the current limitations of
      industrial hygiene and occupational epidemiology, and the general unwillingness
      of employers to routinely collect exposure data, OELs should continue to be
      defined as upper limits for single shift exposures. The current OEL model, which
      permits the use of proximate risk management goals to realize long-range
      objectives, should be retained. There are, however, valid reasons for augmenting
      this model to include criteria for evaluating compliance with long-range
      objectives. The augmented OEL model would be applicable to future new and revised
      OELs. The author suggests that OEL setting organizations consider harmonizing
      definitions and statistical interpretations for both existing and new OELs, thus
      minimizing future misinterpretation and misuse.

PMID- 11217720
TI  - A practical approach to exposure assessment programs in the private sector: a
      partial validation study of a qualitative chemical exposure assessment model.
AB  - Utilizing a computer-based exposure assessment program, a United States-based
      chemical company was able to predict which chemicals and tasks presented the
      greatest probability of exposure in the workplace. The data generated by the
      model also enabled the company to prioritize these tasks for quantitative
      exposure monitoring. The assessment program addressed potential chemical exposure
      to workers in a cost-effective way. This assessment program reduced a facility's
      cost of complying with the Occupational Safety and Health Administration (OSHA)
      standard by about 90 percent. Overall, the program reduced the company's cost by
      about $700,000 when compared to traditional methods used for achieving compliance
      with these regulations. In addition, by utilizing a computer-based approach, a
      facility did streamline its chemical exposure assessment process. A comparative
      evaluation study was conducted in conjunction with a graduate research project.
      The purpose of the study was to compare the company's qualitative exposure
      assessment model with several other exposure assessment models. The project
      compared hazard rankings calculated from three exposure assessment models with
      actual exposure data for three work scenarios. Overall, the models appeared to be
      predictive of measured exposures. Therefore, they can be useful tools to help
      make decisions on which exposures have the highest potential to cause
      occupational illness to employees and therefore require additional monitoring and
      follow-up.

PMID- 11217721
TI  - Time trends in exposure measurements from OSHA compliance inspections of the pulp
      and paper industry.
AB  - Time trends in employee exposures to the air contaminants measured by the
      Occupational Safety and Health Administration (OSHA) during compliance
      inspections of pulp and paper manufacturing facilities conducted between 1979 and
      1997 were evaluated based on the measurement results stored in the OSHA
      Integrated Management Information System (IMIS) database. The IMIS database is
      among the largest sources of occupational exposure measurements available for
      occupational health research in the United States. The IMIS database contains the
      results of 3,568 personal time-weighted average (TWA) measurements for 171 air
      contaminants made at 524 establishments in Standard Industrial Classification
      (SIC) 26. An analysis of these measurements revealed an overall decrease in the
      total number of measurements made per year since 1991, and a decrease in the
      percentage of measurements by year that exceeded the OSHA permissible exposure
      limits (PELs). Linear regression analyses detected decreasing trends in the
      geometric mean concentrations by year for 33 of the 36 agents analyzed.

PMID- 11217722
TI  - Development of a paperless, Y2K compliant exposure tracking database at Los
      Alamos National Laboratory.
AB  - The Industrial Hygiene and Safety Group at Los Alamos National Laboratory (LANL)
      developed a database application known as IH DataView, which manages industrial
      hygiene monitoring data. IH DataView replaces a LANL legacy system, IHSD, that
      restricted user access to a single point of data entry needed enhancements that
      support new operational requirements, and was not Year 2000 (Y2K) compliant. IH
      DataView features a comprehensive suite of data collection and tracking
      capabilities. Through the use of Oracle database management and application
      development tools, the system is Y2K compliant and Web enabled for easy
      deployment and user access via the Internet. System accessibility is particularly
      important because LANL operations are spread over 43 square miles, and industrial
      hygienists (IHs) located across the laboratory will use the system. IH DataView
      shows promise of being useful in the future because it eliminates these problems.
      It has a flexible architecture and sophisticated capability to collect, track,
      and analyze data in easy-to-use form.

PMID- 11217723
TI  - Future need for development of occupational exposure databases in Hungary.
AB  - The data on the occupational exposure measured by the hygienic network
      laboratories in Hungary were collected during the last 20 years. The data refer
      to the air pollutant chemicals and to the biological monitoring. The structure of
      the database of occupational exposure that has been used in the last decade is
      intended to be changed according to the guideline of the European Working Group
      on Exposure Registers in Europe. The current databases on the occupational
      exposure contain data only related to the substances responsible for air
      pollution. It would be desirable to complement the database with data from the
      biological monitoring, which also characterize the occupational exposure. It
      would then be possible to harmonize two distinct databases, and the risk
      assessment of the employees would become more thorough. This practice would
      require close cooperation of several organizations. It is desirable to set
      minimum requirements against the measurement techniques, thus, giving results
      that are accepted in the exposure database. It is necessary to encourage the use
      of direct reading instruments in collecting the exposure data and to complement
      the requirements of the strategies of data collection and the system of
      evaluation.

PMID- 11217724
TI  - Cleanup worker exposures to hazardous chemicals at a former nuclear weapons
      plant: piloting of an exposure surveillance system.
AB  - Cleanup of former U.S. Department of Energy (DOE) nuclear weapons production
      facilities involves potential exposures to various hazardous chemicals. We have
      collaboratively developed and piloted an exposure database and surveillance
      system for cleanup worker hazardous chemical exposure data with a cleanup
      contractor at the Rocky Flats Environmental Technology Site (RFETS). A unique
      system feature is the incorporation of a 34-category work task-coding scheme.
      This report presents an overview of the data captured by this system during
      development and piloting from March 1995 through August 1998. All air samples
      collected were entered into the system. Of the 859 breathing zone samples
      collected, 103 unique employees and 39 unique compounds were represented.
      Breathing zone exposure levels were usually low (86% of breathing zone samples
      were below analytical limits of detection). The use of respirators and other
      exposure controls was high (87 and 88%, respectively). Occasional high-level
      excursions did occur. Detailed quantitative summaries are provided for the six
      most monitored compounds: asbestos, beryllium, carbon tetrachloride, chromium,
      lead, and methylene chloride. Task and job title data were successfully collected
      for most samples, and showed specific cleanup activities by pipe fitters to be
      the most commonly represented in the database. Importantly, these results
      demonstrate the feasibility of the implementation of integrated exposure database
      and surveillance systems by practicing industrial hygienists employed in industry
      as well as the preventive potential and research uses of such systems. This
      exposure database and surveillance system--the central features of which are
      applicable in any industrial work setting--has enabled one of the first
      systematic quantitative characterizations of DOE cleanup worker exposures to
      hazardous chemicals.

PMID- 11217726
TI  - The development of a prototype database for the voluntary reporting of
      occupational exposure data on chemicals.
AB  - A prototype occupational exposure database was developed as part of a study to
      retrospectively collect chemical exposure data from U.K. industry. The data
      dictionary for the database was constructed using existing recommendations on
      core data elements developed by working groups from the ACGIH and the European
      Union. The study also made use of existing job and workplace coding schemes. The
      practicalities of gathering the data by voluntary donation, its storage in a
      database, and the transfer of suitably anonymised data to the U.K. Health and
      Safety Executive's National Exposure Database system were investigated and
      assessed. Prior to the development, several existing exposure database systems
      were evaluated for their suitability to store the data from the study. Though of
      high quality, these were found to be insufficiently flexible for the diversity of
      datasets encountered and so the prototype exposure database was constructed using
      a leading database development package. The database was successfully used to
      gather data and forward it in a suitable format to the U.K. Health and Safety
      Executive. The published recommendations on occupational exposure databases and
      the associated coding schemes provided a very useful foundation for designing and
      implementing the prototype database. However, as data collection proceeded it
      became clear that the existing recommendations often were poorly understood and
      misinterpreted, or at least interpreted differently, by different database
      designers, data collectors, and other users of occupational exposure data. It is
      suggested that several items in the ACGIH and European Union core recommendations
      are ambiguous and need to be clarified. Once agreed, the improved database design
      criteria need to be widely promoted to foster a common understanding and to
      encourage their use by all those involved in collecting occupational exposure
      data. Beyond this, recommendations for exposure databases should be augmented to
      facilitate easy exchange of data between organizations.

PMID- 11217725
TI  - Development of an occupational illness and injury surveillance database for the
      electric energy sector.
AB  - Currently available occupational injury and illness data for electric energy
      companies provide only overall summary rates. Specific information about types of
      injury or illnesses, rates by occupational or work environments, and injury costs
      and severity are generally not readily available. Relevant data such as personnel
      and claims information are frequently not integrated into a comprehensive health
      and safety surveillance system suitable for epidemiologic and health and safety
      research purposes. Epidemiological methods are valuable for identifying key risk
      factors for work-related injuries and illnesses and assessing their magnitude, as
      well establishing priorities for health and safety research. Application of such
      methods can result in long-term reductions in injury and illness rates and their
      attendant costs. Aggregation of relevant health and safety data across companies
      improves statistical power for the assessment of rare (yet costly) injuries or
      illness or specific at-risk subgroups within the electric energy sector. A pilot
      occupational injury and illness database has been developed that can incorporate
      and standardize data across a spectrum of companies of differing sizes and
      configurations. In illustrative data analyses, injury trends were summarized by
      company size, occupation, and demographic factors, among others. Trends observed
      in these illustrative analyses were consistent with results previously reported
      in the epidemiological literature, however, results are considered preliminary
      pending development of the full database. This study shows that development of a
      standardized surveillance occupational injury and illness database across
      companies with different database configurations is feasible. This database will
      ultimately provide a stable and accurate occupational health and safety
      assessment tool not currently available for this sector.

PMID- 11217727
TI  - The European chemical industry's needs and expectations for workplace exposure
      data.
AB  - Current information on exposure data is characterized by its inconsistent quality
      and significant gaps. These are particularly apparent amongst small- and medium
      sized companies. The European Chemical Industry Council (CEFIC), through its Long
      Range Research Initiative (LRI), currently is developing a tool which aims, by
      virtue of it being seen as an integral part of business management software, to
      collect relevant exposure information across key sectors of the chemical
      industry.

PMID- 11217728
TI  - Workshop on harmonization of serving multiple needs with occupational exposure
      databases, session II.

PMID- 11217729
TI  - Workshop on harmonization of serving future needs with occupational exposure
      databases--inhalation modeling, session IIIA.
AB  - This workshop was one of several that took place at the International Symposium
      on Occupational Exposure Databases and Their Application for the Next Millennium
      held in London from November 1-3, 1999. About 30 delegates participated in the
      workshop. The agenda for the discussions was provided by a white paper prepared
      by the organizers. The workshop produced a conceptual outline for a general
      purpose prediction model for inhalation exposure, and constructed a list of
      important input variables for successful model development. Evaluation of
      prototype models was discussed in some detail, and the workshop concluded with
      suggestions for taking forward the ideas discussed and maintaining the momentum
      and interest generated during the symposium.

PMID- 11217730
TI  - Occupational exposure information needs for regulatory risk assessment of
      existing chemicals.

PMID- 11217731
TI  - Comparison of fluorescence and rinsing methods for assessing dermal exposure.
AB  - There are a number of methods of estimating dermal contamination. "Potential
      exposure" methods, such as patch and whole-body oversuit sampling, intercept the
      contaminant before it reaches the skin. "Actual exposure" measurements recover
      the contaminant from the skin by wiping, stripping, or rinsing, or, in the case
      of fluorescent tracer dye monitoring, assess it in-situ on the skin. These
      different methods can give rise to very different results. Comparison of methods
      is difficult, because they usually interfere within-subject. This presentation is
      a comparison of two compatible 'actual dermal contamination' measurement
      techniques. They are: (1) fluorescence monitoring of a tracer dye in-situ on the
      skin, using ultraviolet light and a video camera linked to an image processor;
      (2) rinsing of the skin to recover a metal tracer salt for later assay in
      solution. Several painting and spraying application tasks were carried out by a
      panel of volunteers who wore T-shirts, shorts, and open sandals. The exercises
      simulated domestic or nonoccupational tasks. Results showed excellent agreement,
      with discrepancies identified and explained. The good agreement of the two
      completely different, independent tracer methods for measuring skin contamination
      contributes to their mutual validation.

PMID- 11217732
TI  - Assessment of dermal exposure--empirical models and indicative distributions.
AB  - The Health and Safety Executive embarked upon a program of work to address the
      issue of exposure to nonagricultural pesticides in the United Kingdom. Early on
      it became clear that the primary route of exposure was via the skin. Empirical
      dermal exposure models have been developed which allow estimates of potential
      dermal exposure to be derived from distributions of rate of contamination with in
      use formulations during typical use conditions in the workplace. Estimates of
      actual dermal exposure (what gets onto the skin) may also be anticipated and used
      in quantitative risk assessment to inform product registration. The key
      interpreted data from the empirical models are presented. Data are presented for
      six models. Separate summary data are presented for exposure to the body, hands,
      and feet. In the case of hand exposure, data are presented, in some cases, for
      contamination arising from wearing used (previously worn, of unknown history) and
      clean protective gloves. This article proposes a mechanism for addressing
      exposure assessment where little or no direct dermal exposure data are available-
      the indicative distribution approach. The empirical distributions of rate of
      contamination have been studied to seek commonalities which may allow the
      construction of a universal tool for use in screening level risk assessment. A
      simple 12-box matrix is proposed.

PMID- 11217733
TI  - Data solutions for the 21st century: CEFIC's vision and intentions. The European
      Chemical Industry Council.
AB  - Information on workplace exposures to chemicals has a role and importance that
      goes beyond compliance with occupational exposure limits (OELs). In particular,
      the increasing use of exposure data in regulatory risk assessment processes
      places added demands on the need to collect such information. Industry's
      challenge is to respond to these developments in a manner that ensures data are
      obtained, archived, and analyzed to standards consistent with evolving
      stakeholder expectations.

PMID- 11217734
TI  - Research recommendations of the NORA exposure assessment methods team. National
      Occupational Research Agenda.

PMID- 11217735
TI  - Personal protective equipment and dermal exposure.
AB  - Personal protective equipment (PPE) should only be used as a control measure when
      other measures are inappropriate or are inadequate by themselves. The person
      undertaking a risk assessment must exercise his or her judgment to take into
      account the protection afforded by the PPE. There is, therefore, considerable
      scope for differences in approach and it would seem sensible to eliminate these
      differences and ensure consistency, where possible, by reaching agreement on the
      attenuating effect of PPE. However, there is growing evidence that the levels of
      protection indicated by laboratory-based tests may not be achieved in real use
      situations. Studies of workplace protection suggest that the spread of
      contaminants inside protective clothing, including gloves, is commonplace and
      significant. Insufficient attention may have been paid to the effect of factors
      such as temperature differentials on the permeation of chemical agents through
      protective materials. To investigate this, a test cell was designed and built to
      measure the breakthrough times and subsequent permeation rate of solvents through
      glove materials where the temperature inside and outside the glove was
      representative of those that can occur in the workplace. Two chemical solvents
      were tested against two different glove materials at three different temperature
      conditions. The differences between the breakthrough times and permeation rates
      were measured and compared to manufacturer's test data. The practical
      implications are considered for risk of health and safety to the wearer.

PMID- 11217736
TI  - A field evaluation of the effect of pulsed arc welding technique on reducing
      worker exposures.

PMID- 11217737
TI  - A software application for implementing an effective industrial hygiene program,
      assisting with exposure assessment, and validating management indicators and
      performance metrics.

PMID- 11217738
TI  - A multidimensional electrospray MS-based approach to phosphopeptide mapping.
AB  - A new, multidimensional electrospray MS-based strategy for phosphopeptide mapping
      is described which eliminates the need to radiolabel protein with 32P or 33P. The
      approach utilizes two orthogonal MS scanning techniques, both of which are based
      on the production of phosphopeptide-specific marker ions at m/z 63 and/or 79 in
      the negative ion mode. These scan methods are combined with liquid chromatography
      electrospray mass spectrometry and nanoelectrospray MS/MS to selectively detect
      and identify phosphopeptides in complex proteolytic digests. Low-abundance, low
      stoichiometry phosphorylation sites can be selectively determined in the presence
      of an excess of nonphosphorylated peptides, even in cases where the signal from
      the phosphopeptide is indistinguishable from background in the conventional MS
      scan. The strategy, which has been developed and refined in our laboratory over
      the past few years, is particularly well suited to phosphoproteins that are
      phosphorylated to varying degrees of stoichiometry on multiple sites. Sensitivity
      and selectivity of the method are demonstrated here using model peptides and a
      commercially available phosphoprotein standard. In addition, the strategy is
      illustrated by the complete in vitro and in vivo phosphopeptide mapping of Sic1p,
      a regulator of the G1/S transition in budding yeast.

PMID- 11217739
TI  - Enhancement of the quality of MALDI mass spectra of highly acidic
      oligosaccharides by using a nafion-coated probe.
AB  - Spectra of highly acidic oligosaccharides obtained by matrix-assisted laser
      desorption/ionization (MALDI) mass spectrometry (MS) can be greatly enhanced in
      quality by coating the MALDI probe surface with a film consisting of a
      perfluorosulfonated ionomer (Nafion) prior to the addition of the sample-matrix
      mixture. For comparison, three mixtures containing highly acidic oligo- and
      polysaccharides derived from partial acidic hydrolysis of alginate, pectin, or
      carboxymethyl cellulose (CMC) were analyzed by employing probes with an uncoated
      gold surface or a surface coated with a Nafion or nitrocellulose film. The
      negative ion-mode MALDI spectra of the oligouronates (oligomers containing
      mannuronic/guluronic and galacturonic acid residues) obtained using uncoated or
      nitrocellulose-coated probes consisted of a series of broad, multiple peaks.
      These multiple peaks were assigned to the molecular ions of the nondissociated [M
      - H]- and partially sodiated [MnNa - H]-, where n = 1, 2, or 3, oligomers. In
      contrast, the corresponding spectra obtained with Nafion-coated probes contained
      only a single series of sharp peaks originating from the molecular ions ([M - H]
      ) of nondissociated oligomers exhibiting chain lengths of as many as
      approximately 15 uronic acid residues. The Nafion coating was apparently capable
      of removing the sodium counterions remaining in the deposit of the sample-matrix
      mixture on the probe, thereby greatly enhancing the signal-to-noise ratios of the
      peaks in the spectra. In a similar manner, higher quality spectra could also be
      obtained by using Nafion-coated probes for analysis of the oligouronates and CMC
      oligomers by positive ion-mode MALDI-MS.

PMID- 11217740
TI  - In situ ATR-FT-IR kinetic studies of molecular transport and surface binding in
      thin sol-gel films: reactions of chlorosilane reagents in porous silica
      materials.
AB  - ATR-FT-IR spectroscopy was employed to study the kinetics of transport and
      binding within thin silica sol-gel films. Studies of transport of several
      nonbinding probe molecules n-heptane, toluene, and 2-propanol, showed that slow
      diffusion occurs within the micropores of the sol-gel films which could be
      modeled as a single-exponential accumulation in agreement with numerical models
      for diffusion in constricted pores. The rate of transport into the film was found
      to decrease for molecules that interact strongly with the silica surface, which
      is consistent with adsorption inhibiting the transport of molecules through the
      pores. In situ spectroscopic studies of surface reactions with
      diphenylchlorosilane (DP-SiCl) reveal that DPSiCl reacts quickly with surface
      water to form diphenylhydroxysilane (DPSiOH), the reactive species detected
      within the film. Analysis of the time-dependent infrared spectra reveals both
      transport and surface-binding steps in the reaction kinetics. From the magnitudes
      of the rate constants and the corresponding pure component spectra, it is
      determined that the surface-binding component is responsible for accumulation of
      most of the silane at the silica surface. Ex situ spectroscopic studies confirm
      that Si-O-Si bond formation occurs at room temperature in these sol-gel films.
      Studies of chlorosilane reactions at silica surfaces pretreated with
      triethylamine were conducted to investigate the influence of amines on this
      chemistry; it was determined that the amine enhances the transport of more
      reagent molecules to the silica surface while the intrinsic rate of the binding
      reaction is not significantly changed.

PMID- 11217741
TI  - Assessment of purity and screening of peptide libraries by nested ion mobility
      TOFMS: identification of RNase S-protein binders.
AB  - Combinatorial peptide synthesis in combination with affinity selection and high
      resolution ion mobility/time-of-flight mass spectrometry (IM/TOFMS) analysis has
      been used to investigate the binding of a series of 96 related eight-residue
      peptides (with the general sequence NH2-GX1X2FX3X4X5G-CO2H, where X1 = L, F, V,
      Y; X2 = N, F; X3 = E, V, T; X4 = V, L; X5 = V, L) to the ribonuclease S protein.
      A key advantage of this strategy is that the IM/ TOFMS approach allows the
      relative abundances of individual library components (including numerous sequence
      and structural isomers) to be characterized before and after screening. The
      relative binding interactions of different sequences are assessed by comparing
      IM/TOFMS data for those components that pass through the column (as well as those
      that bind) to data for the library prior to screening. The high-affinity
      sequences that are found in this study are compared with those selected from much
      larger combinatorial libraries. The results suggest that many expected sequences
      in the large libraries may be missing (e.g., due to issues such as failure of
      specific steps during the synthesis or differences in solubility). Comparison of
      the binding sequences obtained in these studies and those reported previously
      indicates that screening results from large libraries should be interpreted with
      caution.

PMID- 11217742
TI  - Alpha-cyano-4-hydroxycinnamic acid affinity sample preparation. A protocol for
      MALDI-MS peptide analysis in proteomics.
AB  - We present a new MALD1 sample preparation technique for peptide analysis using
      the matrix alpha-cyano-4-hydroxy-cinnamic acid (CHCA) and prestructured sample
      supports. The preparation integrates sample purification, based on the affinity
      of microcrystalline CHCA for peptides, thereby simplifying the analysis of crude
      peptide mixtures. Enzymatic digests can thus be prepared directly, without
      preceding purification. Prepared samples are homogeneous, facilitating automatic
      spectra acquisition. This method allows preparation of large numbers of samples
      with little effort and without the need for automation. These features make the
      described preparation suitable for cost-efficient high-throughput protein
      identification. Performance of the sample preparation is demonstrated with in
      situ proteolytic digests of human brain proteins separated by two-dimensional gel
      electrophoresis.

PMID- 11217743
TI  - A 384-well solid-phase extraction for LC/MS/MS determination of methotrexate and
      its 7-hydroxy metabolite in human urine and plasma.
AB  - A solid-phase extraction procedure, in a 384-well format, has been developed for
      methotrexate and its primary metabolite, 7-hydroxymethotrexate, in human urine
      and plasma. This format has not been utilized previously for solid-phase
      extraction of drugs from biological fluids. The 384-well plates contained a C-18
      stationary phase bonded to silica particles which are incorporated into a glass
      fiber membrane. Methotrexate and 7-hydroxymethotrexate have been quantified
      across the curve range of 1 to 50 microg/mL and 50 to 1000 ng/mL, respectively,
      in urine and from 5 to 250 ng/mL and 5 to 100 ng/mL, respectively, in plasma.
      Both analytes are quantified by linear regression using 20-microL sample
      aliquots. Experiments to evaluate the influence of particle size, elution volume,
      and injection volume on signal intensity were conducted and are reported, along
      with the results of experiments examining cross contamination between wells.
      Recovery was determined to be > or = 95% from urine. Results from a run of 384
      samples analyzed over a 14-h period indicate that 384-well SPE can be
      successfully utilized to increase analytical run sizes and sample throughput for
      LC/MS/MS determination of small drug molecules in biological samples.

PMID- 11217744
TI  - Chromatographic interactions between proteins and sulfoalkylbetaine-based
      zwitterionic copolymers in fully aqueous low-salt buffers.
AB  - Macroporous monoliths containing N,N-dimethyl-N-methacryloyloxyethyl-N-(3
      sulfopropyl)ammonium betaine (SPE) have been synthesized via in situ
      photopolymerization, yielding a stoichiometric balance between sulfur and
      nitrogen in the final polymer, which is indicative of a genuine strong/strong
      zwitterionic character. The chromatographic properties of these zwitterionic
      resins were evaluated with respect to the retention behavior of inorganic ions
      and proteins. The weak electrostatic nature of the interaction between the
      sulfobetaine monoliths and proteins provided a high selectivity between basic
      proteins and peptides. Elution was accomplished with low-ionic-strength fully
      aqueous mobile phases, whereby high recovery was obtained, even for hydrophobic
      proteins. Chaotropic ions such as perchlorate or thiocyanate were used as mobile
      phase modifiers to modulate the apparent ion exchange group density, thus
      introducing a route for the modulation of the ionic strength that is required to
      competitively elute the protein. The promising features of polymeric
      sulfoalkylbetaine interaction layers for separation and analysis of biological
      extracts was also manifested in an application involving purification of
      biologically active peptide-pheromone obtained from Enterococcus faecium.

PMID- 11217745
TI  - An inductively coupled plasma carbon emission detector for aqueous carbohydrate
      separations by liquid chromatography.
AB  - An inductively coupled plasma atomic emission spectrometer is used to detect
      carbon-containing compounds following separation by high-performance liquid
      chromatography. A calcium form ligand exchange column with distilled and
      deionized water as the mobile phase is used to separate carbohydrates. The
      eluting species are detected by monitoring the carbon atomic emission line at
      193.09 nm. The mass detection limits using a photomultiplier tube for sucrose and
      glucose are 50 ng, while that for fructose is 60 ng. The carbon emission detector
      should provide the same detection limit for any compound with a similar mass
      percent of carbon, whether or not the compound exhibits appreciable absorption
      characteristics. While the carbon emission detector will universally detect any
      organic compound, it will discriminate against species with high molar
      absorptivity that may be present at low concentration. Such species may act as
      interferences in chromatograms generated with conventional UV-visible absorption
      detectors. To demonstrate the utility of the carbon emission detector, three
      sugars (glucose, fructose, sucrose) are determined in apple, crangrape, and
      orange juice.

PMID- 11217746
TI  - Improved analysis of dissolved carbohydrates in stream water with HPLC-PAD.
AB  - This paper describes improvements made to the determination of dissolved
      carbohydrates in stream water with high-performance liquid chromatography and
      pulsed amperometric detection (HPLC-PAD). We eliminated interference from
      dissolved oxygen, separated xylose and mannose along with other molecules,
      reduced the chromatographic peak shift associated with carbonate accumulation in
      the column to less than 1% for all samples, and achieved an 8% increase in
      recovery of hydrolyzed carbohydrates by replacing ion-exchange desalting
      cartridges with evaporative removal of HCl under N2. These modifications lowered
      detection limits to less than or equal to 0.4 nM for 10 different monosaccharides
      and enhanced our ability to follow the dynamics of these molecules in stream
      ecosystems. In the determination of dissolved free monosaccharides, average
      relative precision was 1.3% and recovery ranged from 92 to 109%. For dissolved
      total saccharides, average relative precision was 3.3%. Concentrations were
      stable when filtered (0.2 microm) stream water was stored for 1 day at 22 degrees
      C, 1 week at 4 degrees C, or 1.5 months at -20 degrees C.

PMID- 11217747
TI  - Optical sensors for detection of bacteria. 1. General concepts and initial
      development.
AB  - The concept of using immobilized nucleic acid stains as detection chemistry to
      fabricate optical bacterial sensors is first demonstrated. SYTO 13 (a green
      fluorescent cell stain) is used as the molecular recognition element and
      fluorescent reporter in the sensor. The sensor responds to aqueous and
      aerosolized bacterial samples in 15 and 30 min, respectively. In addition, the
      sensor can discriminate a change in Pseudomonas aeruginosa (Pa) cell
      concentration of 1 order of magnitude or less and can detect down to 2.4 x 10(5)
      cells/mL of Pa cells. The utility of the sensor is demonstrated by monitoring the
      growth of a Pa cell culture over a period of 50 h.

PMID- 11217748
TI  - Enhanced detection of live bacteria using a dendrimer thin film in an optical
      biosensor.
AB  - Here we describe the detection of live Pseudomonas aeruginosa using a sensing
      film containing a fourth-generation hydroxy-terminated polyamidoamine (PAMAM)
      dendrimer (i.e., G4-OH) and SYTOX Green fluorescent nucleic acid stain. The films
      are configured on simple, disposable plastic coupons or optical fibers and are
      interrogated using a miniature fiber-optic spectrometer. SYTOX Green is generally
      considered a dead cell stain because it is not able to cross the membranes of
      live cells. In the presence of PAMAM-OH (G4-OH) in water, the bacterial cell
      becomes permeable to the SYTOX dye and the fluorescence is significantly
      enhanced. The fluorescence increases with the bacteria concentration, and the
      intensity at 5.4 x 10(7) cells mL(-1) is 350% higher than the liquid controls
      without PAMAM-OH. We also demonstrate that dendrimers stabilize the sensing film.
      After drying and desiccation, the SYTOX Green/PAMAM-OH films are still able to
      quantitatively detect P. aeruginosa in water. Incorporation of glucose into the
      SYTOX Green/ PAMAM-OH film may improve the homogeneity of the film and enhances
      the fluorescence signal an additional 11-25%.

PMID- 11217749
TI  - A quantitative assessment of heterogeneity for surface-immobilized proteins.
AB  - Many biotechnological applications use protein receptors immobilized on solid
      supports. Although, in solution, these receptors display homogeneous binding
      affinities and association/dissociation kinetics for their complementary ligand,
      they often display heterogeneous binding characteristics after immobilization. In
      this study, a fluorescence-based fiber-optic biosensor was used to quantify the
      heterogeneity associated with the binding of a soluble analyte, fluorescently
      labeled trinitrobenzene, to surface-immobilized monoclonal anti-TNT antibodies.
      The antibodies were immobilized on silica fiber-optic probes via five different
      immobilization strategies. We used the Sips isotherm to assesses and compare the
      heterogeneity in the antibody binding affinity and kinetic rate parameters for
      these different immobilization schemes. In addition, we globally analyzed kinetic
      data with a two-compartment transport-kinetic model to analyze the heterogeneity
      in the analyte-antibody kinetics. These analyses provide a quantitative tool by
      which to evaluate the relative homogeneity of different antibody preparations.
      Our results demonstrate that the more homogeneous protein preparations exhibit
      more uniform affinities and kinetic constants.

PMID- 11217750
TI  - Design and validation of portable SPME devices for rapid field air sampling and
      diffusion-based calibration.
AB  - The use of SPME fibers coated with porous polymer solid phases for quantitative
      purposes is limited due to effects such as interanalyte displacement and
      competitive adsorption. For air analysis, these problems can be averted by
      employing short exposure times to air samples flowing around the fiber. In these
      conditions, a simple mathematical model allows quantification without the need of
      calibration curves. This work describes two portable dynamic air sampling (PDAS)
      devices designed for application of this approach to nonequilibrium SPME sampling
      and determination of airborne volatile organic compounds (VOCs). The use of a
      PDAS device resulted in greater adsorbed VOC mass compared to the conventional
      SPME extraction in static air for qualitative screening of live plant aromas and
      contaminants in indoor air. For all studied air samples, an increase in the
      number of detected compounds and sensitivity was also observed. Quantification of
      aromatic VOCs in indoor air was also carried out using this approach and the
      PDAS/SPME device. Measured VOC concentrations were in low parts-per-billion by
      volume range using only 30-s SPME fiber exposure and were comparable to those
      obtained with a standard NIOSH method 1501. The use of PDAS/SPME devices reduced
      the total air sampling and analysis time by several orders of magnitude compared
      to the NIOSH 1501 method.

PMID- 11217751
TI  - Chemiluminescence imaging ELISA using an imprinted polymer as the recognition
      element instead of an antibody.
AB  - An imaging assay analogous to competitive enzyme immunoassays has been developed
      using a molecularly imprinted polymer instead of an antibody. The antigen 2,4
      dichlorophenoxyacetic acid (2,4-D) was labeled with tobacco peroxidase, and the
      chemiluminescence reaction of luminol was used for detection. Microtiter plates
      (96 or 384 wells) were coated with polymer microspheres imprinted with 2,4-D,
      which were fixed in place by using poly(vinyl alcohol) as glue. In a competitive
      mode, the analyte-peroxidase conjugate was incubated with the free analyte in the
      microtiter plate, after which the bound fraction of the conjugate was quantified.
      After addition of the chemiluminescent substrates, light emission was measured in
      a high-throughput imaging format with a CCD camera. Calibration curves
      corresponding to analyte concentrations ranging from 0.01 to 100 microg/mL were
      obtained.

PMID- 11217752
TI  - Lysing bacterial spores by sonication through a flexible interface in a
      microfluidic system.
AB  - Cell disruptions using ultrasonic energy transmitted through a flexible interface
      into a liquid region has limitations because the motion of the vibrating tip is
      not completely transferred into the liquid. To ensure that some degree of contact
      will be maintained between the ultrasonic horn tip and the flexible interface,
      the liquid must be pressurized. The pressure conditions that yield consistent
      coupling between the ultrasonic horn tip and the liquid region were explored in
      this study by using an analytical model of the system and test fixture
      experiments. The nature of the interaction between the horn tip and the flexible
      interface creates pulses of positive pressure rises, increase in temperature,
      streaming flow, and almost no cavitation in the liquid. There was sufficient
      energy to create a cloud of microspheres, or beads, that maintain a consistent
      pattern of ballistic motion in the liquid. The sonication was found to be
      repeatable by studying video recordings of bead motion and was shown to be
      statistically consistent using measurements of temperature rise. Sonication of
      bacterial spores to obtain measurements of released nucleic acid and SEM images
      of damaged spores were used to verify the effects of liquid pressure on the horn
      interface-liquid coupling.

PMID- 11217753
TI  - MicroITIES detection of nitrate by facilitated ion transfer.
AB  - A microITIES array, created by laser photoablation of a 12-microm polyester film,
      was used to investigate electroassisted anion transfer between two immiscible
      electrolyte solutions. Besides measuring directly the transfer of nitrate to the
      organic phase, the enhancement of transfer of the cation (K+) by facilitated
      anion (counterion) transfer was measured as well. In the presence of a triamide
      derived from tris(2-aminoethyl)amine (tren), which is known to function as a host
      for nitrate, the current responses for both nitrate and potassium transfer were
      monitored. The linear relationships between the current responses and nitrate
      concentration formed the basis of an anion sensor with a dynamic range from 0.1
      to 5 mM. A dual facilitated transfer mechanism is proposed to explain the
      enhancement phenomenon.

PMID- 11217754
TI  - Dispersion reduction in pressure-driven flow through microetched channels.
AB  - Fluid is often moved about microetched channels in lab-on-a-chip applications
      using electrokinetic flows (electrophoresis or electroosmosis) rather than
      pressure-driven flows because the latter result in large Taylor dispersion.
      However, small pressure gradients may arise unintentionally in such systems due
      to a mismatch in electroosmotic flow rates or hydrostatic pressure differentials
      along the microetched channel. Under laminar flow conditions, Doshi et al. (Chem.
      Eng. Sci. 1978, 33, 795-804) have shown that for a channel with rectangular cross
      section of width W and depth d, longitudinal diffusivities can attain values as
      large as approximately 8 K0 for small values of the aspect ratio d/W, where K0 is
      the value of the longitudinal diffusivity obtained by ignoring all variations
      across the channel. Microchannels in lab-on-a-chip geometries are often not
      rectangular in cross-section. Isotropic etching techniques, for example, lead to
      channels with quarter-circular ends. In this paper we examine the effect of this
      geometry on the magnitude of longitudinal dispersivity for pressure-driven flows
      and also investigate modifications to this design which may minimize such
      dispersion. Optimal channel profiles are shown to lead to dispersivities
      approaching K0, the theoretical minimum, for small values of d/W.

PMID- 11217755
TI  - Voltammetric determination of L-cysteine at conductive diamond electrodes.
AB  - Boron-doped diamond (BDD) electrodes were used to examine L-cysteine (CySH)
      oxidation in alkaline media. The results of the voltammetric and polarization
      measurements showed that at BDD electrodes the overall CySH oxidation reaction is
      controlled by the initial electrochemical step, i.e., the oxidation of the CyS-
      electroactive species. The same conclusion was supported by the results of a
      study of pH effects. Conversely, at glassy carbon (GC) electrodes, the same
      reaction is controlled by the desorption of the reaction products. These results
      account for the poor response for CySH determination at GC compared to BDD. It
      was found that BDD exhibits excellent behavior for CySH determination, clearly
      outperforming GC. The results demonstrate that measurement of the peak current
      for CySH oxidation can be used as a basis for simple method for determining CySH
      in the micromolar concentration range by the use of BDD electrodes.

PMID- 11217756
TI  - Bias assessment of current technologies used for the determination of low levels
      of moisture in mineral oil samples.
AB  - The problem in the current debate on the accuracy of Karl Fischer (KF) titrations
      lies in the fact that coulometry is being compared to volumetry on mineral oil
      samples for which the true moisture content is unknown. To clarify this point,
      dehydrated oil samples equilibrated under known temperature and relative humidity
      conditions and equilibrated oil samples containing known amounts of added
      moisture were used to assess the accuracy of the determinations. In addition, the
      measurements were extended to other techniques given that it is unlikely that
      they would be affected by the same phenomenon causing the KF systematic errors.
      The samples sent to different laboratories were analyzed by headspace/capillary
      gas chromatography, gas-phase H2 sensor, oil-phase or gas-phase RH sensors, KF
      coulometric titration with direct or indirect injection, and KF volumetric
      titration using a standard or NIST modified procedure. The laboratory comparison
      showed that with the exception of 4 techniques out of 10 that were tested, the
      measurements gave results in the expected concentration range. Considering the
      exceptions, two techniques based on volumetric titration yielded results tainted
      with an important positive bias for both sample types. This bias, tentatively
      associated with the high iodine end point concentration used by these systems,
      was estimated at approximately 22 ppm under the conditions applied by NIST. On
      the other hand, the two RH sensors showed a marked tendency to underestimate the
      value of the samples containing high moisture content. In this case, a loss of
      analyte through wall adsorption during the time required to achieve steady-state
      conditions in the measuring chamber seems to be at the origin of the negative
      biases.

PMID- 11217757
TI  - Phase-sensitive detection in potential-modulated in situ absorption and probe
      beam deflection techniques: theoretical considerations.
AB  - A mathematical framework is presented for the quantitative analysis of in situ
      potential modulation spectroelectrochemical techniques based on phase-sensitive
      detection for the study of solution-phase redox systems under strict diffusion
      control. In the case of arrangements in which the probing beam is parallel to the
      electrode surface, the phase of the optical signal with respect to the applied
      potential, assuming negligible double-layer charging currents, was found to be
      proportional to y(omega/2D)(1/2), where y is the distance normal to the
      electrode, omega is the frequency of the perturbating signal, and D is the
      diffusion coefficient of the species responsible for absorption or refraction.
      Good agreement was found between theoretical predictions and the few available
      experimental results for both absorption and probe beam deflection-type
      experiments. In particular, in the case of solutions containing the chromophore
      trianisylamine and nonabsorbing p-benzoquinone, the phase angle difference
      between absorption and diffraction calculated from theory and measured
      experimentally yielded a common value of approximately 30 degrees.

PMID- 11217758
TI  - Scanning electrochemical microscopy of membrane transport in the reverse imaging
      mode.
AB  - Scanning electrochemical microscopy (SECM), operated in reverse imaging mode
      (RIM), has been used to visualize the steady-state transport of molecules
      entering into porous membranes. RIM imaging is advantageous for investigating
      transport across biological membranes in situations where the SECM tip can access
      only the exterior membrane surface. Examples of RIM images of a synthetic
      membrane (mica with pores filled with the ion-selective polymer Nafion) and a
      biological membrane (hairless mouse skin) recorded during diffusive and
      iontophoretic transport, are reported. RIM imaging during diffusive transport
      allows visualization of the depletion of solute molecules in the solution
      adjacent to the pore openings. However, an accumulation of solute molecules above
      the pore opening is observed during iontophoresis, which is a consequence of the
      separation of the solute from the solvent (i.e., ultrafiltration). The separation
      results from differences in the rates of molecule transfer across the
      pore/solution interface when electroosmotic flow is operative. The results
      suggest that RIM imaging may be useful for measuring the kinetics of interfacial
      molecule transfer at biological membranes.

PMID- 11217759
TI  - The postdoc: an opportunity for learning and more.

PMID- 11217760
TI  - The problem of uniqueness of fit for viscoelastic films on thickness-shear mode
      resonator surfaces.
AB  - We describe a new strategy for interpreting frequency responses of thickness
      shear mode resonators loaded with spatially uniform viscoelastic films. This
      procedure leads to unambiguous extraction of the four parameters that
      characterize such a film: its thickness, density and shear modulus components
      (storage and loss moduli). The interpretational difficulty is that the
      experimental frequency response (impedance spectrum) can only provide two
      parameters; thus, the problem is underdetermined. Previous interpretations
      employed various approximations and assumptions for two (or more) film parameters
      to effectively reduce the problem to a two-parameter fit. Such approaches are
      clearly imperfect. Our new strategy splits the problem into two separate two
      parameter sub-problems, each of which is solved by the measurement of two
      different experimental responses. The result is a unique fit to the data without
      the need to make approximations or assumptions for film parameters. First, in the
      acoustically thin regime, measured frequency shift and film charge are combined
      to provide a unique solution for film thickness and density; shear moduli
      components do not affect the response in this regime. Second, film density is
      carried forward directly, and the film thickness-charge relationship is
      extrapolated into the acoustically thick regime. Third, with film density and
      thickness held fixed, crystal impedance data in the acoustically thick regime
      provide unambiguous shear modulus components. The method is generalized to any
      other (nonelectrochemical) probe that provides film thickness data and validated
      using crystal impedance data for poly(3-methylthiophene) films exposed to
      propylene carbonate.

PMID- 11217761
TI  - Noncontact electrochemical imaging with combined scanning electrochemical atomic
      force microscopy.
AB  - Combined scanning electrochemical atomic force microscopy (SECM-AFM) is a
      recently introduced scanned probe microscopy technique where the probe, which
      consists of a tip electrode and integrated cantilever, is capable of functioning
      as both a force sensor, for topographical imaging, and an ultramicroelectrode for
      electrochemical imaging. To extend the capabilities of the technique, two
      strategies for noncontact amperometric imaging-in conjunction with contact mode
      topographical imaging-have been developed for the investigation of solid-liquid
      interfaces. First, SECM-AFM can be used to image an area of the surface of
      interest, in contact mode, to deduce the topography. The feedback loop of the AFM
      is then disengaged and the stepper motor employed to retract the tip a specified
      distance from the sample, to record a current image over the same area, but with
      the tip held in a fixed x-y plane above the surface. Second, Lift Mode can be
      employed, where a line scan of topographical AFM data is first acquired in
      contact mode, and the line is then rescanned to record SECM current data, with
      the tip maintained at a constant distance from the target interface, effectively
      following the contours of the surface. Both approaches are exemplified with SECM
      feedback and substrate generation-tip collection measurements, with a 10-microm
      diameter Pt disk UME serving as a model substrate. The approaches described allow
      electrochemical images, acquired with the tip above the surface, to be closely
      correlated with the underlying topography, recorded with the tip in intimate
      contact with the surface.

PMID- 11217762
TI  - Oxidation kinetics of guanine in DNA molecules adsorbed onto indium tin oxide
      electrodes.
AB  - Oligonucleotides containing the guanine nucleobase were adsorbed onto ITO
      electrodes from mixtures of DMF and acetate buffer. Chronocoulometry and
      chronoamperometry were performed on the modified electrodes in both phosphate
      buffer and buffer containing low concentrations of the inorganic complex
      Ru(bpy)3(2+) (bpy = 2,2' bipyridine), which catalyzes guanine oxidation. The
      charge and current evolution with and without the catalyst were compared to the
      charge and current evolution for electrodes that were treated with identical
      oligonucleotides that were substituted at every guanine with the
      electrochemically inert nucleobase hypoxanthine. Chronocoulometry over 2.5 s
      shows that roughly 2 electrons per guanine were transferred to the electrode in
      both the presence and absence of Ru(bpy)3(2+), although at a slower rate for the
      uncatalyzed process. Chronoamperograms measured over 250 ms can be fit to a
      double exponential decay, with the intensity of the fast component roughly 6-20
      times greater than that of the slow component. First- and second-order rate
      constants for catalytic and direct guanine oxidation were determined from the
      fast component. The maximum catalytic enhancement for immobilized guanine was
      found to be i(cat)/i(d) = 4 at 25 microM Ru(bpy)3(2+). The second-order rate
      constant for the catalyzed reaction was 1.3 x 10(7) M(-1) s(-1), with an apparent
      dissociation constant of 8.8 microM. When compared to parallel studies in
      solution, a smaller value of the dissociation constant and a larger value of the
      second-order rate constant are observed, probably due to distortion of the
      immobilized DNA, an increase in the local negative charge due to the oxygen sites
      on the ITO surface, and redox cycling of the catalyst, which maintains the
      surface concentration of the active form.

PMID- 11217763
TI  - Death, taxes, and analytical chemistry.

PMID- 11217764
TI  - Single-molecule DNA amplification and analysis in an integrated microfluidic
      device.
AB  - Stochastic PCR amplification of single DNA template molecules followed by
      capillary electrophoretic (CE) analysis of the products is demonstrated in an
      integrated microfluidic device. The microdevice consists of submicroliter PCR
      chambers etched into a glass substrate that are directly connected to a
      microfabricated CE system. Valves and hydrophobic vents provide controlled and
      sensorless loading of the 280-nL PCR chambers; the low volume reactor, the low
      thermal mass, and the use of thin-film heaters permit cycle times as fast as 30
      s. The amplified product, labeled with an intercalating fluorescent dye, is
      directly injected into the gel-filled capillary channel for electrophoretic
      analysis. Repetitive PCR analyses at the single DNA template molecule level
      exhibit quantized product peak areas; a histogram of the normalized peak areas
      reveals clusters of events caused by 0, 1, 2, and 3 viable template copies in the
      reactor and these event clusters are shown to fit a Poisson distribution. This
      device demonstrates the most sensitive PCR possible in a microfabricated device.
      The detection of single DNA molecules will also facilitate single-cell and single
      molecule studies to expose the genetic variation underlying ensemble sequence and
      expression averages.

PMID- 11217765
TI  - MS/NMR: a structure-based approach for discovering protein ligands and for drug
      design by coupling size exclusion chromatography, mass spectrometry, and nuclear
      magnetic resonance spectroscopy.
AB  - A protocol is described for rapidly screening small organic molecules for their
      ability to bind a target protein while obtaining structure-related information as
      part of a structure-based drug discovery and design program. The methodology
      takes advantage of and combines the inherent strengths of size exclusion gel
      chromatography, mass spectrometry, and NMR to identify bound complexes in a
      relatively universal high-throughput screening approach. Size exclusion gel
      chromatography in the spin column format provides the high-speed separation of a
      protein-ligand complex from free ligands. The spin column eluent is then analyzed
      under denaturing conditions by electrospray ionization mass spectrometry (MS) for
      the presence of small molecular weight compounds formerly bound to the protein.
      Hits identified by MS are then individually assayed by chemical shift
      perturbations in a 2D 1H-15N HSQC NMR spectrum to verify specific interactions of
      the compound with the protein and identification of the binding site on the
      protein. The utility of the MS/NMR assay is demonstrated with the use of the
      catalytic fragment of human fibroblast collagenase (MMP-1) as a target protein
      and the screening of a library consisting of approximately 32 000 compounds for
      the identification of molecules that exhibit specific binding to the RGS4
      protein.

PMID- 11217766
TI  - A four-column parallel chromatography system for isocratic or gradient LC/MS
      analyses.
AB  - A novel approach to parallel liquid chromatography/ tandem mass spectrometry
      (LC/MS/MS) analyses for pharmacokinetic assays and for similar quantitative
      applications is presented. Modest modifications render a conventional LC/MS
      system capable of analyzing samples in parallel. These modifications involve the
      simple incorporation of three valves and four LC columns into a conventional
      system composed of one binary LC pumping system, one autosampler, and one mass
      spectrometer. An increase in sample throughput is achieved by staggering
      injections onto the four columns, allowing the mass spectrometer to continuously
      analyze the chromatographic window of interest Using this approach, the optimized
      run time is slightly greater than the sum of the widths of the desired peaks.
      This parallel chromatography unit can operate under both gradient and isocratic
      LC conditions. To demonstrate the utility of the system, atorvastatin, five of
      its metabolites, and their deuterated internal standards (IS) were analyzed using
      gradient elution chromatography conditions. The results from a prestudy assay
      evaluation (PSAE) tray of standards and quality control (QC) samples from
      extracted spiked human plasma are presented. The relative standard deviation and
      the accuracy of the QC samples did not exceed 8.1% and 9.6%, respectively, which
      is well within the acceptance criteria of the pharmaceutical industry. For this
      particular analysis, the parallel chromatography system decreased the overall run
      time from 4.5 to 1.65 min and, therefore, increased the overall throughput by a
      factor of 2.7 in comparison to a conventional LC/MS/MS analytical method.

PMID- 11217767
TI  - Exact mass measurements on-line with high-performance liquid chromatography on a
      quadrupole mass spectrometer.
AB  - Exact mass measurements were performed on-line with high-performance liquid
      chromatography on a quadrupole mass spectrometer. Compounds with molecular
      weights from 98 to 797, mainly aromatic sulfonates and sulfonamides, were
      analyzed with electrospray ionization in positive or negative mode. Internal mass
      calibration compounds were continuously added after separation. A Gaussian fit of
      the mass errors of 808 individual measurements (concentrations of 1-10 mg/L, 20
      200 ng absolute on column) resulted in a mean error of 0.1 mmu (0.45 ppm) and a
      standard deviation sigma of 1.5 mmu (5.4 ppm). The 99.7% confidence intervals
      (3sigma) were +/-4.5 mmu (+/-16.2 ppm) for single mass measurements. Averaging 10
      measurements further reduced the errors to less than +/-1.5 mmu (+/-5 ppm).
      Isobaric interferences with ions resulting from the mass calibrants were avoided
      by the use of complementary mass calibrants. The results were verified
      (differences below +/-4.5 mmu) with a LC/ oa-TOFMS. Limited mass range
      chromatograms were used to enhance selectivity in the analysis of mixtures. The
      method was applied to determine the elemental composition of a potential dye
      metabolite detected in anaerobically treated textile wastewater.

PMID- 11217768
TI  - Application of quantitative chemometric analysis techniques to direct sampling
      mass spectrometry.
AB  - This paper explores the use of direct sampling mass spectrometry coupled with
      multivariate chemometric analysis techniques for the analysis of sample mixtures
      containing analytes with similar mass spectra. Water samples containing varying
      mixtures of toluene, ethyl benzene, and cumene were analyzed by purge-and
      trap/direct sampling mass spectrometry. Multivariate calibration models were
      built using partial least-squares regression (PLS), trilinear partial least
      squares regression (tri-PLS), and parallel factor analysis (PARAFAC), with the
      latter two methods taking advantage of the differences in the temporal profiles
      of the analytes. The prediction errors for each model were compared to those
      obtained with simple univariate regression. Multivariate quantitative methods
      were found to be superior to univariate regression when a unique ion for
      quantitation could not be found. For prediction samples that contained unmodeled,
      interfering compounds, PARAFAC outperformed the other analysis methods. The
      uniqueness of the PARAFAC model allows for estimation of the mass spectra of the
      interfering compounds, which can be subsequently identified via visual inspection
      or a library search.

PMID- 11217769
TI  - Determination of low molecular weight silicones in plasma and blood of women
      after exposure to silicone breast implants by GC/MS.
AB  - A sensitive, one-step sample preparation method for detection of volatile, low
      molecular weight (LMW) cyclic silicones hexamethylcyclotrisiloxane (D3),
      octamethyl-cyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and
      dodecamethylcyclohexasiloxane (D6) in plasma and blood using gas chromatography
      coupled with mass spectrometry (GC/MS, SIM mode) is presented. In spiked
      experiments, extraction efficiencies for these siloxanes (100-20 000 ng/mL) were
      approximately 90% for plasma and approximately 80% for blood; only in the case of
      D3 was the recovery very low. Plasma and blood of women who are or were exposed
      to silicone gel-filled implants and of control subjects were analyzed for low
      molecular weight silicones. D3-D6 were not detectable in control plasma or blood.
      Although the investigated numbers of patients samples are very limited, and thus,
      no statistical analysis is possible, our data clearly show a general increase in
      the amount of LMW cyclic siloxanes in the bodies of women with silicone implants.
      In particular, several years after ruptured silicone implants were removed,
      siloxanes could still be found in blood samples from several women. Siloxane
      compound D3 varied between 6 and 12 ng/mL (plasma) and between 20 and 28 ng/mL
      (blood), whereas the concentration range of D4 was 14-50 ng/mL (plasma) and 79-92
      ng/mL (blood). D5 and D6, with one exception, could not be detected.

PMID- 11217770
TI  - Porous silicon as a versatile platform for laser desorption/ionization mass
      spectrometry.
AB  - Desorption/ionization on porous silicon mass spectrometry (DIOS-MS) is a novel
      method for generating and analyzing gas-phase ions that employs direct laser
      vaporization. The structure and physicochemical properties of the porous silicon
      surfaces are crucial to DIOS-MS performance and are controlled by the selection
      of silicon and the electrochemical etching conditions. Porous silicon generation
      and DIOS signals were examined as a function of silicon crystal orientation,
      resistivity, etching solution, etching current density, etching time, and
      irradiation. Pre-and postetching conditions were also examined for their effect
      on DIOS signal as were chemical modifications to examine stability with respect
      to surface oxidation. Pore size and other physical characteristics were examined
      by scanning electron microscopy and Fourier transform infrared spectroscopy, and
      correlated with DIOS-MS signal. Porous silicon surfaces optimized for DIOS
      response were examined for their applicability to quantitative analysis, organic
      reaction monitoring, post-source decay mass spectrometry, and chromatography.

PMID- 11217771
TI  - Genotyping of two mutations in the HFE gene using single-base extension and high
      performance liquid chromatography.
AB  - Currently, a major focus of human genetics is the utilization of single
      nucleotide polymorphisms for clinical diagnostics, whole-genome linkage
      disequilibrium screens to identify common disease genes such as Alzheimer
      disease, determination of the recent evolutionary history of a species, and the
      process of speciation. We have examined single-nucleotide extension coupled with
      high-performance liquid chromatography as a method to simultaneously genotype two
      SNPs occurring in the coding region of the HFE gene that produce clinical
      effects. This assay allows concurrent genotyping of the C282Y and H63D mutations
      in 11 min and is 100% concordant with current testing methods for both of these
      mutations.

PMID- 11217772
TI  - A solid sample preparation method that reduces signal suppression effects in the
      MALDI analysis of peptides.
AB  - Here we report on the application of a solid-solid (SS) sample preparation
      protocol for the MALDI analysis of peptides and multicomponent peptide mixtures.
      Our results with a series of model peptides indicate that a SS MALDI sample
      preparation protocol is useful for the analysis of peptides in the 1-3 kDa mass
      range. MALDI mass spectra recorded for peptides in this size range using a SS
      sample preparation were of a quality comparable to spectra recorded using a
      conventional dried-droplet (DD) sample preparation. Our results with several
      model peptide mixtures indicate that one advantage of a SS sample preparation
      protocol for the MALDI analysis of peptides is that it can significantly reduce
      signal suppression effects in multicomponent mixtures. MALDI results obtained
      using a SS sample preparation protocol are also more reproducible than results
      obtained using a conventional DD sample preparation protocol.

PMID- 11217773
TI  - Electrospray device for coupling microscale separations and other miniaturized
      devices with electrospray mass spectrometry.
AB  - A miniaturized ion sprayer device is described which is suitable for coupling
      with chip-based analytical separation devices, multiwell plates, or surfaces
      containing residues of prepared samples. Two versions of a similar device are
      described. A "microsprayer" device suitable for coupling to the terminal edge of
      a capillary electrophoresis (CE) chip is constructed from modified 1/16-in. HPLC
      fittings. This microsprayer employs a free-standing liquid junction formed via
      continuous delivery of a flow (2-6 microL/min) of suitable solvent which carries
      the CE effluent through a pneumatically assisted electrospray (ion spray) needle
      positioned in front of an atmospheric pressure ionization (API) mass
      spectrometer. A related but larger "minisprayer" device is also described which
      employs the same features as the microsprayer, but with an extended sampling
      capillary tube which can reach into the depths of 96-, 384-, and 1536-multiwell
      plates containing either sample solutions or dried sample residues. The
      minisprayer may be positioned in front of an API ion sampling orifice and the
      multiwell plate positioned stepwise from sample to sample for analysis of trace
      samples contained in the wells. The resulting infusion-ion spray mass
      spectrometric analyses can provide sequential analysis of previously prepared
      biological samples containing small drug compounds, proteins, and related
      compounds. This same device is also shown to be useful for sampling from a
      surface containing trace level compounds of biological interest. Results are
      shown that demonstrate microscale separations and selected ion monitoring (SIM)
      capillary electrophoresis/mass spectrometry (CE/MS) detection of berberine and
      palmatine using the microsprayer. SIM ion spray determination of a 2 ng/microL
      solution of berberine contained as a dry residue in the bottom of a 384-well
      plate as well as full-scan electrospray mass spectra for low-picomole levels of
      cytochrome c contained in a 1536-well microtiter plate are shown. The respective
      micro- and minisprayer devices provide a simple yet effective means of
      transferring trace-level samples either from a microscale or chip-based
      separation device as well as samples contained in multiwell plates which are
      increasingly employed in high-throughput applications in the pharmaceutical
      industry.

PMID- 11217774
TI  - Chip-based capillary electrophoresis/mass spectrometry determination of
      carnitines in human urine.
AB  - A chip-based capillary electrophoresis/mass spectrometry (CE/MS) system is
      described for the CE separation and on-line electrospray detection of carnitine
      and selected acylcarnitines from mixtures of analytical standards as well as
      extracts of fortified human urine. Chip-based CE/MS experiments in two different
      laboratories were carried out using a triple-quadrupole mass spectrometer and a
      quadrupole time-of-flight (QTOF) mass spectrometer, respectively. The glass chips
      used with both systems were comparably equipped with a microfabricated capillary
      electrophoresis (CE) channel but with different electrosprayers. The quadrupole
      chip-based CE/MS experiments employed a miniature coupled microsprayer, which
      allowed coupling of the microelectrospray process via a micro liquid junction at
      the exit of the CE capillary channel. Selected ion monitoring (SIM) CE/MS
      experiments were employed for all of the quadrupole CE/MS work. The QTOF CE/MS
      full-scan single MS and MS/MS experiments were carried out in another laboratory
      using accurate mass measurement TOF mass spectrometry techniques. The
      electrospray process that was employed with the QTOF system differed in that an
      inserted nanoelectrospray capillary needle was carefully affixed into a flat
      bottomed hole that was aligned with the CE channel exit orifice. SIM CE/MS using
      the described quadrupole system provided acceptable ion current electropherograms
      from fmole levels from analytical standard solutions of carnitine and
      acylcarnitines that were manually injected (loaded) onto the chip. In addition,
      the corresponding electropherograms for human urine fortified with the target
      carnitine and acylcarnitines at a 10-20 microg/mL (35-124 microM) level were
      obtained via SIM CE/MS techniques. The measured CE separation efficiency for the
      SIM CE/MS electropherograms was determined to be 2860 plates (peak width at half
      height method or N = 5.54(T/WO.5(2)), and carnitine and three acylcarnitines were
      separated in less than 48 s. In contrast, using quadrupole-TOF technologies, the
      same samples could be diluted by a factor of 2-4 to obtain a comparable detector
      response for the target compounds. In the full-scan, single mass analyzer mode
      (m/z 150-500), the CE separation efficiency was measured to be 2600 plates, but
      mass measurement accuracy was less than 5.0 ppm for the quaternary cations. In
      the CE/MS/MS mode, full-scan collision-induced dissociation (CID) mass spectra
      were obtained with a mass accuracy of < or =10 ppm for the higher mass ions and <
      or =27 ppm for the lower mass product ions. These results demonstrate the
      feasibility for on-chip CE separation and electrospray mass spectrometric
      detection for these important compounds in synthetic mixtures, as well as in
      human urine extracts.

PMID- 11217776
TI  - Bar codes for combinatorial libraries.

PMID- 11217775
TI  - Baseline mass resolution of peptide isobars: a record for molecular mass
      resolution.
AB  - Baseline resolution of two peptides, RVMRGMR and RSHRGHR, of neutral monoisotopic
      mass, approximately 904 Da, has been achieved by microelectrospray ionization
      Fourier transform ion cyclotron resonance mass spectrometry at a mass resolving
      power of approximately 3 300 000. The elemental compositions of these molecules
      differ by N40 vs. S2H8 (0.000 45 Da), which is less than one electron's mass
      (0.000 55 Da)! This result establishes a new record for the smallest resolved
      mass difference between any two molecules. This achievement is made possible by a
      combination of high magnetic field (9.4 T), large-diameter (4-in.) Penning trap,
      and low ion density. The implications for proteomics based on accurate mass
      measurements are discussed briefly.

PMID- 11217777
TI  - Negative-ion electrospray mass spectrometry of neutral underivatized
      oligosaccharides.
AB  - Negative-ion electrospray mass spectrometry (ES-MS) with collision-induced
      dissociation (CID) and MS/MS scanning on a quadrupole-orthoganal time-of-flight
      instrument provide a sensitive means for structural analysis of neutral
      underivatized oligosaccharides. Molecular mass information can be readily
      obtained from the dominant [M - H]- ions in the ES mass spectrum formed with
      subnanomole amounts of oligosaccharides, and similar sensitivity is available
      from CID-MS/MS to give structural details. The CID spectra of 14 oligosaccharides
      demonstrated that sequence and partial linkage information can be derived and
      isomeric structures can be differentiated. Series of C-type fragment ions give
      sequence information while the double glycosidic D-type cleavage of a 3-linked
      GlcNAc or Glc and the saccharide ring fragmentation of the 0,2A-type from 4
      linked GlcNAc or Glc can provide partial linkage information. The distinctive D-
      and A-cleavages are important for differentiation of oligosaccharide type 1 and
      type 2 chains and to define the blood group H, Le(a), Le(x), Le(b), and Le(y)
      determinants carried by their fucosylated analogues.

PMID- 11217778
TI  - Formation of natural pH gradients in a microfluidic device under flow conditions:
      model and experimental validation.
AB  - A new isoelectric focusing technique has been developed that incorporates natural
      pH gradient formation in microfluidic channels under flowing conditions. In
      conjunction, a one-dimensional finite difference model has been developed that
      solves a system of algebraic-ordinary differential equations that describe the
      phenomena occurring in the system, including hydrolysis at the electrodes,
      buffering effects of weak acids and bases, and mass transport due to both
      diffusion and electrophoresis. A quantitative, noninvasive, optically based
      method of monitoring pH gradient formation is presented, and the experimental
      data generated by this method are found to be in good agreement with model
      predictions. In addition, the model provides a theoretical explanation for
      initially unexpected experimental results. Model predictions are also shown to
      match well with experimental results of microfluidic isoelectric focusing of a
      single protein species. Accounting for the nonuniform velocity profile,
      characteristic of pressure-driven flow in microfluidic channels, is found to
      improve predictions of dynamic pH changes close to the electrodes and overall
      time required to reach steady state, but to reduce the accuracy of dynamic pH
      change predictions in other regions of the channel.

PMID- 11217779
TI  - Combined HPLC-MS and HPLC-NMR on-line coupling for the separation and
      determination of lutein and zeaxanthin stereoisomers in spinach and in retina.
AB  - The determination and unambiguous identification of carotenoid stereoisomers from
      biological tissues, avoiding isomerization and oxidation due to the extraction
      process, is still a major challenge. Particularly, the analysis of lutein and
      zeaxanthin stereoisomers is of great importance, as these are the main
      constituents of the macula lutea, the central part of the human retina, and act
      as possible agents in the prevention and treatment of age-related macular
      degeneration (AMD). By combining a mild and quick extraction technique such as
      matrix solid-phase dispersion together with high-performance liquid
      chromatography (HPLC), the extremely light and oxygen sensitive lutein and
      zeaxanthin stereoisomers are extracted, enriched, and separated directly from the
      solid plant or tissue samples, excluding preparation of artifacts. HPLC
      separations are performed with C30 phases due to their enhanced shape selectivity
      compared to C18 phases and on-line coupled to mass spectrometry (MS) and nuclear
      magnetic resonance (NMR) spectroscopy. By using HPLC-MS with atmospheric pressure
      chemical ionization, the lutein stereoisomers can be distinguished from the
      zeaxanthin stereoisomers within one chromatographic run in the upper picogram
      range, whereas HPLC-NMR coupling allows the unequivocal identification of each
      stereoisomer with a concentration in the upper nanogram range. This article
      provides an analytical method for the artifact-free determination of lutein and
      zeaxanthin stereoisomers directly from the solid biological tissue spinach as a
      source of carotenoids and retina as the sphere of activity for AMD. In addition,
      the structures of these stereoisomers were unambiguously elucidated by employing
      hyphenated analytical techniques.

PMID- 11217780
TI  - Aggregating K+ sensor.

PMID- 11217781
TI  - Increasing the number of analyzable peaks in comprehensive two-dimensional
      separations through chemometrics.
AB  - Comprehensive two-dimensional (2-D) separations are emerging as powerful tools
      for the analysis of complex samples. The substantially larger peak capacity for a
      given length of time relative to 1-D separations is a well-known benefit of
      comprehensive 2-D separation methods. Unfortunately, with complex samples, the
      probability of peak overlap in 2-D separations is still quite high. This is
      especially true if one desires to speed up the analysis by reducing the run time
      and, thus, by reducing the resolving power along the first dimension separation.
      Chemometric methods hold considerable promise to overcome the limitations brought
      upon by the likelihood of peak overlap. Thus, chemometric methods should be able
      to effectively extend the resolving power of 2-D separation methods. In this
      paper, the theoretical enhancement provided by application of the generalized
      rank annihilation method (GRAM) for the analysis of unresolved peaks in
      comprehensive 2-D separations is carefully modeled and critically evaluated.
      First, Monte Carlo simulations are used to determine the conditions where the use
      of GRAM results in the successful analysis of unresolved peaks. A wide range of
      experimental conditions and performance criteria are modeled, typical to many
      available 2-D separation methods, including analyte/interference peak height
      ratio, first- and second-dimension resolutions, signal-to noise ratio, injection
      volume reproducibility, and run-to-run retention time reproducibility.
      Essentially, a wide range of experimental conditions and performance criteria are
      found to provide reliable data amenable to GRAM analysis. The information gleaned
      from this first set of simulations is then used in conjunction with Monte Carlo
      simulations of comprehensive 2-D separations. For these simulated 2-D
      separations, the total number of analyzable peaks when using GRAM was determined
      and found to be substantially better than using only traditional quantitative
      methods such as peak integration or height. For example, it was determined that
      the use of GRAM increases the average number of analyzable peaks by a factor of 2
      for 2-D separations in which the peak capacity is 67% occupied by randomly
      distributed peaks. The results of the studies are general, and the use of GRAM
      should increase the number of analyzable peaks for all forms of comprehensive 2-D
      separations.

PMID- 11217782
TI  - Correlation of characteristic thermal constant and elution temperature in GC.
AB  - In a temperature-programmed analysis, the solutes that elute at higher
      temperatures have generally larger characterisitic thermal constants,
      theta(char). The change approximately matches the temperature-related increase in
      a carrier gas viscosity. Accounting for the effect allows reduction in the
      uncertainty of prediction of theta(char) by a factor or f approximately 2 and, in
      a constant-pressure mode, description of a linear heating ramp by the same
      dimensionless rate for all solutes.

PMID- 11217783
TI  - Synthesis of porous titania microspheres for HPLC packings by polymerization
      induced colloid aggregation (PICA).
AB  - Porous titania microspheres with a very narrow particle size distribution (PSD)
      were synthesized by polymerization-induced colloid aggregation (PICA). After
      being sintered, the titania microspheres that are obtained have an average
      diameter of 3.5 microm, a surface area of 36.7 m2/g, an average pore volume of
      0.30 mL/g, and an average pore diameter of 32.2 nm. The microspheres possess
      enough rigidity to withstand high packing pressure and are very useful as a new
      kind of chromatographic packing material for high performance liquid
      chromatography (HPLC).

PMID- 11217785
TI  - MALDI chip shot.

PMID- 11217786
TI  - On-line particle concentrator with upstream ultrafiltration in continuous SPLITT
      fractionation.
AB  - An upstream ultrafiltration (UU) method is employed for the on-line concentration
      of collected particle fraction and for the convenient regulation of flow rates in
      split-flow thin (SPLITT) fractionation. Concentration of the collected particle
      fraction is necessary to fractionate particles by smaller cutoff diameters in
      SPLITT fractionation. By introducing a simple device utilizing upstream
      ultrafiltration with tangential flow, particle solution collected at each SP

PMID- 11217784
TI  - Enzyme-amplified aequorin-based bioluminometric hybridization assays.
AB  - The sensitivity of aequorin-based bioluminometric hybridization assays was
      enhanced by introducing, enzymically, multiple aequorin labels per DNA hybrid.
      The target DNA was hybridized in microtiter wells with an immobilized capture
      probe and a digoxigenin-labeled detection probe. The hybrids were reacted with an
      anti-digoxigenin antibody conjugated to horseradish peroxidase. Peroxidase
      catalyzed the oxidation of digoxigenin-tyramine by hydrogen peroxide, resulting
      in the attachment of multiple digoxigenin moieties to the solid phase. Aequorin
      labeled anti-digoxigenin antibody was then allowed to bind to the immobilized
      digoxigenins. The bound aequorin was determined by its characteristic Ca2+
      triggered bioluminescence. As low as 20 fmol/L (1 amol/ well) target DNA was
      detected with a signal-to-background ratio of 2.7. A hybridization assay that
      used only aequorin-labeled anti-digoxigenin antibody without the peroxidase
      amplification step gave a signal-to-background ratio of 2 for 160 fmol/L target
      DNA. The signal enhancement of the amplified assay was in the range of 14-38
      times. The analytical range of the amplified assay extended up to 2600 fmol/L.
      The CVs were in the range of 5.5-7.3%.

PMID- 11217787
TI  - Determination of peptides and proteins in fats and oils.
AB  - A method for the determination of proteins in fats and oils is described.
      Proteins were sequentially precipitated with acetone and hydrolyzed, and the
      produced amino acids were fractionated and quantificated. This analysis protocol
      afforded a method of high sensitivity and specificity which was fully evaluated
      and validated. The data obtained showed good accuracy and linearity with
      excellent reproducibility and recovery. When the method was applied to 40 olive
      oils, all of them contained proteins in the range 10-50 microg/100 g of oil,
      suggesting that proteins are nonpreviously described minor components of these
      oils. In addition, the proteins precipitated were almost exclusively composed by
      one polypeptide of apparent 4600 molecular weight, which was isolated from olive
      drupes and partially characterized by amino acid analysis. Similar polypeptides
      were also detected in other seeds, suggesting that they may constitute a new
      class of polypeptides in plants with oleosin-like characteristics. Furthermore,
      the method was also applied to different fats and oils, and all the samples
      analyzed contained proteins, suggesting that natural fats and oils always contain
      polypeptides and/or proteins as minor components. These results also suggest that
      some peptides are soluble in lipid matrixes, where they might be playing unknown
      functions. The developed procedure provides a methodology for the determination
      of these components.

PMID- 11217788
TI  - Determination of naphthenic acids in crude oils using nonaqueous ion exchange
      solid-phase extraction.
AB  - A method is presented for the routine, rapid, and quantitative analysis of
      aliphatic and naphthenic acids in crude oils, based on their isolation using
      nonaqueous ion exchange solid-phase extraction cartridges. The isolated acid
      fractions are methylated and analyzed by gas chromatography and gas
      chromatography/mass spectrometry. The method is effective on both light and heavy
      oils and is capable of providing mechanistic information of geochemical
      significance on the origin of the acids in the oils. Analysis of oils that were
      solvent extracted from laboratory and field mesocosm marine sediment oil
      degradation studies indicate that this new method of analyzing the products of
      hydrocarbon biodegradation may be a useful tool for monitoring the progress of
      bioremediation of oil spills in the environment.

PMID- 11217790
TI  - Collaboration pays off for NCSR. National Centre for Sensor Research.

PMID- 11217789
TI  - Fully automated 96-well liquid-liquid extraction for analysis of biological
      samples by liquid chromatography with tandem mass spectrometry.
AB  - A fully automated high-throughput liquid-liquid extraction (LLE) methodology has
      been developed for preparation of biological samples using a 96-well LLE plate
      and a 96-channel robotic liquid handling workstation. The 96-well LLE plate is
      made of a 96-well filter plate filled with inert diatomaceous earth particles,
      allowing continuous and efficient extraction of analytes between the aqueous
      biological sample and the organic extraction solvent. Two carboxylic acid-based
      protease inhibitor compounds with high and low levels of plasma protein binding
      were chosen for the development and application of the automated methodology. The
      LLE extracts of the plasma samples of the two compounds were analyzed by high
      performance liquid chromatography with electrospray (ESI) tandem mass
      spectrometry (LC-MS/MS). The LC-MS/MS method was developed using a rapid gradient
      LC separation, followed by sample introduction through an ionspray interface in
      the negative ion mode and tandem mass spectrometric detection with selected
      reaction monitoring. In the optimized LLE method, a formate buffer solution was
      first loaded into a 96-well filter plate packed with inert diatomaceous earth
      material. Then crude plasma samples and a water-immiscible organic solvent,
      methyl ethyl ketone, were sequentially added to the LLE plate so that LLE would
      occur in the interface between the two liquid phases on the surface of individual
      particles in each well. The organic eluate containing extracted analytes was
      evaporated and reconstituted for LC-MS/MS analysis. This fully automated LLE
      methodology avoids several disjointed steps involved in a manual or semiautomated
      LLE method, leading to significantly reduced sample preparation time, increased
      sample throughput, and clean sample extracts for improved ESI-MS/MS detection.
      The automated LLE methodology is universal and can be employed for sample
      preparation of other biological fluids. The complete bioanalytical method, based
      on the automated LLE and fast gradient LC-MS/MS, was validated and successfully
      applied to the quantitative analysis of protease inhibitors in rat plasma.

PMID- 11217791
TI  - Estimating the precision of exact mass measurements on an orthogonal time-of
      flight mass spectrometer.
AB  - The combination of orthogonal TOF/ESI MS exact mass measurement and on-line
      chromatography represents a powerful analytical tool for identifying unknown
      components in complex mixtures and is being widely utilized. The precision of
      these mass data is often incorrectly estimated as the precision or mean deviation
      obtained for reference standards under standard conditions. But, the precision of
      a mass measurement is dependent on the number of ions sampled in the measurement
      and, thus, is likely to be different for every measurement. A simple procedure
      for correctly estimating the precision of a specific mass measurement is
      presented, the limits of the procedure are investigated, and the utility and
      validity of the procedure are demonstrated.

PMID- 11217792
TI  - Tailored chemosensors for chloroaromatic acids using molecular imprinted TiO2
      thin films on ion-sensitive field-effect transistors.
AB  - The SiO2 gate of an ion-sensitive field-effect transistor, (ISFET), is
      functionalized with a TiO2 film that includes imprinted molecular sites for 4
      chlorophenoxy acetic acid, (1), or 2,4-dichlorophenoxy acetic acid, (2). The
      functionalized devices that include the imprinted interfaces reveal an impressive
      selectivity in the sensing of the imprinted substrates Na+ -1 or Na+ -2. The
      detection limit for Na+ -1 is (5+/-2) x 10(-4) M, which corresponds to 38 mV x
      dec(-1) in the concentration range of 0.5 to 6 mM. The detection limit for the
      analysis of Na+ -2 is (1.0+/-0.2) x 10(-5) M, which corresponds to 28 mV dec(-1)
      in the concentration range 0.1-9.0 mM. The equilibration time of the devices is
      ca. 5 min.

PMID- 11217794
TI  - The water project: a "real-world" experience for the quantitative analysis
      laboratory.

PMID- 11217793
TI  - Detecting DNA hybridization and damage.

PMID- 11217795
TI  - Tracing the history of selective ion sensors.

PMID- 11217796
TI  - Top-of-the-line MS.

PMID- 11217797
TI  - FR191512, a novel anti-influenza agent isolated from a fungus strain No.17415. I.
      Taxonomy, fermentation, isolation, physico-chemical properties and structure
      elucidation.
AB  - In the course of our screening for anti-influenza agents of microbial origin,
      FR191512 was isolated from the cultured broth of fungus strain No. 17415 as
      colorless powder. The structure of FR191512 was determined by several
      spectroscopic experiments as a novel polyphenolic compound. This compound showed
      potent antiviral activity against influenza A virus.

PMID- 11217798
TI  - FR191512, a novel anti-influenza agent isolated from a fungus strain No.17415.
      II. Biological properties.
AB  - FR191512, a novel polyphenolic compound, inhibited the infectivity of influenza A
      virus in Madin-Darby canine kidney (MDCK) cells in vitro. Furthermore, FR191512
      showed good in vivo anti-influenza activity in a mouse model of intranasal
      infection with influenza A virus. The cytotoxic activity of FR191512 against MDCK
      cells was very weak.

PMID- 11217799
TI  - A potent seryl tRNA synthetase inhibitor SB-217452 isolated from a Streptomyces
      species.
AB  - A potent inhibitor of seryl tRNA synthetase, designated SB-217452 has been
      isolated from Streptomyces sp. ATCC 700974. The fermentation, isolation,
      structure elucidation and some properties are described. SB-217452 showed
      inhibitory activity against both Staphylococcus aureus and rat seryl tRNA
      synthetases, with similar IC50 values of approximately 8 nM. The inhibitor is the
      serine linked nucleoside moiety of the antibiotic albomycin delta2. In contrast
      to albomycin delta2, SB-217452 showed only very weak antibacterial activity
      against a limited range of microorganisms. The compound has not been previously
      reported as a naturally occurring metabolite. In addition to SB-217452, albomycin
      delta2 Fe3+ complex and the novel Al3+ complex were isolated from the
      fermentation. These complexes had no seryl tRNA synthetase inhibitory activity.

PMID- 11217800
TI  - Effects of nitrogen sources on cell growth and production of nystatin by
      Streptomyces noursei.
AB  - Cell growth and production of nystatin by Streptomyces noursei (ATCC 11455) were
      investigated on the three different nitrogen sources, ammonium sulphate, ammonium
      nitrate and sodium nitrate. S. noursei was able to utilise all of the three
      tested nitrogen sources for the growth and production of nystatin. High ammonium
      concentration had a negative effect on production of nystatin when phosphate and
      glucose was in excess. There was an increased production of nystatin when the
      cultures became ammonium limited. Cultivation with sodium nitrate as the nitrogen
      source resulted in a prolonged lag-phase for growth and about 50% lower final
      nystatin titres compared with cultures grown on nitrogen sources containing
      ammonium. Nystatin production was shown to be related to the specific growth
      rate, its production was increased at decreasing specific growth rates.

PMID- 11217801
TI  - Molecular cloning and sequencing of the edeine B1 amidinohydrolase gene of
      Bacillus brevis TT02-8 and its expression in Escherichia coli.
AB  - The gene encoding edeine B1 amidinohydrolase from Bacillus brevis TT02-8 was
      cloned into Escherichia coli and its nucleotide sequence was determined. An open
      reading frame was identified and was found to encode a polypeptide of 289 amino
      acid residues with a predicted molecular weight of 32,455, which was consistent
      with that previously calculated for edeine B1 amidinohydrolase purified from this
      bacterium. Comparison of the deduced amino acid sequence of this enzyme with
      other amidinohydrolases revealed the highest homology to B. subtilis agmatine
      ureohydolase. The enzymatic activity of the protein produced in Escherichia coli
      was analyzed. Three histidine residues, H-112, H-137 and H-151 in the edeine B1
      amidinohydrolase, which are highly conserved in amidinohydrolases, were changed
      to alanine by site-directed mutagenesis. Analysis of each of these mutants
      revealed that three histidine residues are important but not essential for the
      enzyme activity.

PMID- 11217802
TI  - Studies on the biosynthesis of epothilones: the biosynthetic origin of the carbon
      skeleton.
AB  - The biosynthetic origin of the epothilone skeleton was studied by the
      incorporation of 13C and radioactively labeled precursors by Sorangium cellulosum
      So ce90. The carbon atoms are derived from acetate, propionate, the methyl group
      of S-adenosyl-methionine, and cysteine which also introduces the sulfur and
      nitrogen atoms. Epothilone biosynthesis starts with the formation of the thiazole
      part from acetate and cysteine. The incorporation of acetate or propionate units
      results in the formation of epothilones A and B, respectively. To introduce the
      epoxide function of epothilones A and B molecular oxygen is used.

PMID- 11217803
TI  - Blasticidin A derivatives with highly specific inhibitory activity toward
      aflatoxin production in Aspergillus parasiticus.
AB  - Blasticidin A (1), an antibiotic, has strong inhibitory activity toward aflatoxin
      production by Aspergillus parasiticus. We prepared some derivatives of 1 and
      examined their biological activities. Among them, derivatives 3 and 4 without the
      tetramic acid moiety of 1 maintained inhibitory activity toward aflatoxin
      production, but did not show antifungal activity or toxicity. RT-PCR experiments
      indicated that derivatives 3 and 4 as well as 1 significantly reduced the
      expression of genes encoding aflatoxin biosynthetic enzymes (pksA, ver-1 and
      omtA) and a regulatory gene (aflR) in A. parasiticus. These results suggested
      that derivatives 3 and 4 can inhibit aflatoxin production more specifically than
      1 by inhibiting an early step prior to the expression of aflR in the pathway of
      aflatoxin biosynthesis.

PMID- 11217804
TI  - Synthesis of N-4909 analogs. Part I. A stimulant of apolipoprotein E secretion in
      human hepatoma G2 cells.
AB  - Analogs of N-4909 (1), which had a stimulating activity for apolipoprotein E (apo
      E) secretion in Human hepatoma Hep G2 cells, were prepared and their activities
      examined. Cyclic analogs which had different kinds of amino acids or different
      number of amino acids from N-4909 (1) showed less effect on apo E secretion from
      Hep G2 cells. The length of acyl chain was found to be an important factor for
      the activity. Shorter chain reduced the activity. Linear analogs were also
      prepared. One of their analogs, N-5849 (17), which had six amino acids was found
      to have strong activity.

PMID- 11217805
TI  - Novel triene-beta-lactone antibiotics, oxazolomycin derivative and its isomer,
      produced by Streptomyces sp. KSM-2690.

PMID- 11217806
TI  - Trichodion, a new bioactive pyrone from a Trichosporiella species.

PMID- 11217807
TI  - New pacidamycins produced by Streptomyces coeruleorubidus, NRRL 18370.

PMID- 11217808
TI  - Biosynthesis of IC202C, a new siderophore with immunosuppressive activity.

PMID- 11217809
TI  - Acetylation of aminoglycoside antibiotics with 6'-methylamino group, istamycin B
      and micronomicin, by a novel aminoglycoside 6'-acetyltransferase of actinomycete
      origin.

PMID- 11217810
TI  - Structures of fattiviracin family, antiviral antibiotics.

PMID- 11217811
TI  - Resistance to paromomycin is conferred by rpsL mutations, accompanied by an
      enhanced antibiotic production in Streptomyces coelicolor A3(2).

PMID- 11217812
TI  - Absence of cross-reactivity to myeloperoxidase of anti-thyroid microsomal
      antibodies in patients with autoimmune thyroid diseases.
AB  - BACKGROUND: Thyroperoxidase is the major antigen of the thyroid microsomal
      antibodies (TMA) detected in autoimmune thyroid diseases. Its amino acid sequence
      has 44% homology with myeloperoxidase (MPO), an enzyme present in the primary
      granules of neutrophils and one of the major antineutrophil cytoplasmic
      antibodies (ANCA) antigens. The objective of the present study was to investigate
      the presence of cross-reactivity to MPO of TMA. METHODS: We studied sera from 51
      patients with autoimmune thyroid diseases, all of them TMA-positive. The presence
      of ANCA was investigated by indirect immunofluorescence and by capture enzyme
      linked immunosorbent assay. RESULTS: ANCA were positive in 3.9% of the TMA
      positive sera and none of them reacted with MPO. In contrast, the ANCA-positive
      sera revealed antielastase activity. None of the ANCA-positive cases presented
      clinical signs of vasculitis. However, these 2 patients had been on prolonged
      treatment with propylthiouracil. CONCLUSIONS: We conclude that there is no cross
      reactivity to MPO of TMA in patients with autoimmune thyroid diseases, possibly
      because of difference in the spatial configuration of the immunodominant region.
      The presence of ANCA in patients with autoimmune thyroid diseases without
      evidence of vasculitis might result from propyIthiouracil-induced polyclonal
      activation.

PMID- 11217813
TI  - Reversible sequestration of nitric oxide by hemoglobin during hemodialysis in end
      stage renal disease.
AB  - BACKGROUND: During hemodialysis, patients whose plasma concentrations of nitric
      oxide (NO) products increase reportedly experience hypotension. Therefore,
      whether NO bound to hemoglobin (Hb) could contribute to various clinical and
      laboratory changes during hemodialysis was explored in patients with end-stage
      renal disease (ESRD). METHODS: Ten patients were studied during 3 hemodialysis
      treatments with samples of blood analyzed for RBC nitrosyl Hb (HbNO), L-arginine,
      asymmetric dimethylarginine (ADMA), plasma nitrite+nitrate (NOx), and buffy coat
      NO synthase (NOS) activities. RESULTS: HbNO before and during hemodialysis varied
      considerably. Those with higher predialysis levels had lower HbNO values during
      dialysis, whereas HbNO levels in those with lower levels before dialysis
      increased. Plasma NOx did not correlate with HbNO, but change in HbNO in the
      first hour and change in NOx in the first 2 hours correlated with drop in
      diastolic and systolic blood pressures (BP), respectively. HbNO concentrations
      increased in patients with >35% drop in systolic BP, whereas in those with <35%
      drop, HbNO concentrations decreased. HbNO levels adjusted by the hematocrit
      showed a drop in HbNO for the <35% group and a >3-fold increase in the >35%
      group. HbNO levels were higher in men than in women, and levels and changes
      correlated with the hematocrit, skin temperatures, plasma ADMA, arginine, and
      buffy coat NOS. CONCLUSIONS: In patients with >35% drop in systolic BP, NO was
      scavenged by Hb in the circulating RBCs, undoubtedly attenuating the degree of
      hypotension. These data indicate that the amount of NO that is scavenged or
      released by Hb in the circulating RBCS during dialysis is highly variable and
      reversible. Various predialysis factors relate to the concentration of HbNO
      before and during dialysis, which in turn influence clinical findings that occur
      during the interdialytic period.

PMID- 11217814
TI  - Acute respiratory distress syndrome as a major clinical manifestation of
      thrombotic thrombocytopenic purpura.
AB  - BACKGROUND: Although the classical triad of thrombocytopenia, microangiopathic
      hemolytic anemia, and neurological changes has been well recognized, thrombotic
      thrombocytopenic purpura (TTP) sometimes presents with atypical clinical
      features. Some cases of acute respiratory distress syndrome (ARDS) were suspected
      to be a manifestation of TTP. METHODS: We examined retrospectively the medical
      records of patients with known TTP from 1981 to 1998. The patients who developed
      ARDS simultaneously with TTP were identified. Clinical, laboratory, and other
      pertinent data were reviewed; the clinical outcome was documented. RESULTS: Seven
      out of 56 patients with an established diagnosis of TTP were identified as having
      ARDS. All 7 patients had progressive dyspnea, persistent hypoxemia with diffuse
      pulmonary infiltrates, and no evidence of localized pneumonia, pulmonary emboli,
      congestive heart failure, or other identifiable lung diseases. In addition to
      ARDS, 4 patients developed progressive neurological (mental) changes, 3 developed
      fever, and 2 developed renal failure. Six patients were treated with ventilatory
      support in the ICU. Upon establishing the diagnosis of TTP, 6 patients were
      treated with exchange plasmapheresis (EP) and 1 patient with an infusion of fresh
      frozen plasma. Within 2 days of initiation of EP, 4 patients showed marked
      respiratory improvement; shortly thereafter, mechanical ventilation was ended.
      Complete and long-lasting remission was achieved in all 4 patients. Three
      patients died because of delayed diagnosis and untimely employment of EP.
      CONCLUSION: Life-threatening ARDS can be associated with TTP. It is recommended
      that all patients with ARDS and unexplained thrombocytopenia be evaluated for
      unrecognized TTP. Early recognition of ARDS associated with TTP and timely EP is
      critical to a favorable outcome.

PMID- 11217815
TI  - Poly-L-lysine-based molecular conjugate vectors: a high efficiency gene transfer
      system for human progenitor and leukemia cells.
AB  - BACKGROUND: Targeted, specific receptor mediated gene transfer is a major goal of
      gene therapy research to accomplish gene transfer exclusively to the desired cell
      population. METHODS: First, the use of natural receptor for stem cell factor and
      transferrin receptor-targeted gene transfer using poly-L-lysine-based molecular
      conjugate vectors was evaluated in a panel of hematopoietic progenitor cell
      lines. Second, the ability of poly-L-lysine to enhance adenovirus mediated gene
      transfer efficiency was examined in different cell lines by using recombinant
      adenovirus-poly-L-lysine molecular conjugate conglomerates (recMCVEGFP). RESULTS:
      Despite effective ligand internalization receptor, gene expression amplification
      in receptor positive cell lines was not uniformly observed. Therefore, using a
      poly-L-lysine-based, receptor-targeted vector, neither transferrin nor natural
      receptor for stem cell factor mediated gene transfer can be considered a
      universally applicable procedure that exclusively depends on the presence of
      receptors on the cell surface; rather, it is a cell specific phenomenon. In our
      model, poly-L-lysine is the major contributor for gene transfer to hematopoietic
      progenitor cells, mediating the initial vector-cell binding. Human progenitor
      cell lines are poorly transduceable with recombinant adenovirus vectors. This new
      poly-L-lysine-modified, adenovirus-based vector could overcome virus tropism
      restrictions and consistently achieve very high transduction efficiency (>90%) in
      cells otherwise refractory to adenovirus gene transfer. CONCLUSIONS: Polylysine
      based adenovirus vectors may have promise for situations in which high-efficiency
      gene transfer with transient high level transgene expression in hematopoietic
      cells is needed, such as leukemia vaccine protocols or for purging strategies in
      leukemia cell contaminated stem cell preparations.

PMID- 11217816
TI  - Adrenal insufficiency in HIV infection: a review and recommendations.
AB  - Adrenal insufficiency is known to be a complication of HIV infection, although
      estimates of its prevalence and severity vary. Adrenal insufficiency is the most
      serious endocrine complication that occurs in persons with HIV infection.
      Patients with acquired immune deficiency syndrome (AIDS) are considered to be at
      high risk for primary or secondary adrenal insufficiency. We describe 3 patients
      with AIDS who had clinical features suggestive of adrenal insufficiency, but
      their corticotropin (ACTH) stimulation tests were normal. Repeat testing
      confirmed the diagnosis in one patient, and further testing with the overnight
      metyrapone test revealed evidence of secondary adrenal insufficiency in the other
      patients. Persistent clinical improvement was evident on subsequent
      glucocorticoid therapy. A normal response to the ACTH stimulation test can be
      dangerously misleading. Patients with AIDS and suspected adrenal insufficiency
      who have normal screening by the ACTH stimulation test should undergo further
      testing for secondary adrenal disease.

PMID- 11217817
TI  - Prevention in liver disease.
AB  - Prevention has become an important component of medical therapy for a variety of
      diseases. Preventive strategies in liver disease are relatively underdeveloped
      and have focused mainly on specific complications of chronic liver disease and
      vaccination for viral hepatitis. Although public health initiatives designed to
      prevent certain forms of liver disease are in place, they seem to be
      underutilized and their utility has not been evaluated. The development of a
      comprehensive approach using public health initiatives in conjunction with
      strategies by health care providers is important because of the potential for
      decreasing the human and health care costs associated with hepatic dysfunction.
      This article reviews the available literature regarding prevention for health
      care providers, includes a summary of ongoing public health initiatives, and
      suggests an approach to prevention in liver disease. It is intended to raise
      awareness and encourage implementation of preventive strategies in hepatology.

PMID- 11217818
TI  - A case report of olanzapine-induced hypersensitivity syndrome.
AB  - Hypersensitivity syndrome is defined as a drug-induced complex of symptoms
      consisting of fever, rash, and internal organ involvement. The hypersensitivity
      syndrome is well recognized as being caused by anticonvulsants. Olanzapine is an
      atypical antipsychotic agent whose side effects include sedation, weight gain,
      and increased creatinine kinase and transaminase levels. To date, there have been
      no reports of hypersensitivity syndrome related to this drug. A 34-year-old man
      developed a severe generalized pruritic skin eruption, fever, eosinophilia, and
      toxic hepatitis 60 days after ingestion of olanzapine. After termination of
      olanzapine treatment, the fever resolved, the skin rash was reduced, eosinophil
      count was reduced to normal, and the transaminase levels were markedly reduced.
      Clinical features and the results of skin and liver biopsies indicated that the
      patient developed hypersensitivity syndrome caused by olanzapine.

PMID- 11217819
TI  - Severe symptomatic hyponatremia during citalopram therapy.
AB  - Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic
      hormone (SIADH) is an uncommon complication of treatment with the new class of
      antidepressant agents, the selective serotonin reuptake inhibitors (SSRIs). Most
      of the reported cases were associated with fluoxetine; only 2 have previously
      been described in association with citalopram. We describe an elderly woman who
      presented with severe symptomatic hyponatremia caused by the SIADH during therapy
      with citalopram. Because the use of SSRIs is becoming more popular among elderly
      depressed patients, the present case and the other 2 reported previously
      emphasize the need for greater awareness of the development of this serious and
      potentially fatal complication also in association with citalopram therapy and
      suggest that serum sodium levels should be monitored closely in elderly patients
      during treatment with citalopram.

PMID- 11217820
TI  - For the want of a test..

PMID- 11217822
TI  - Science 'in crisis' says commission.

PMID- 11217821
TI  - Handling (mis?)appropriated data.

PMID- 11217823
TI  - Japan's ape sequencing effort set to unravel the brain's secrets.

PMID- 11217824
TI  - Japanese premier underlines opposition to human cloning.

PMID- 11217826
TI  - Germany targets international talent.

PMID- 11217825
TI  - Italian biologists left out in the cold.

PMID- 11217827
TI  - Greek plutonium haul raises smuggling fears.

PMID- 11217829
TI  - India struggles to cope with IT brain drain.

PMID- 11217828
TI  - Top research universities face up to gender bias.

PMID- 11217830
TI  - NASA celebrates as spacecraft homes in on asteroid.

PMID- 11217831
TI  - Australian leader pledges research boost before election.

PMID- 11217832
TI  - Tissue donations slump after revelations about misuse.

PMID- 11217833
TI  - Testing times for BSE.

PMID- 11217834
TI  - In search of a cure for CJD.

PMID- 11217835
TI  - Leaders need to realize that science can offer a route out of poverty.

PMID- 11217836
TI  - Secret behind Hungary's stellar intellects.

PMID- 11217837
TI  - Why didn't flood of print launch science in China?

PMID- 11217838
TI  - The harmonious hand. Marin Mersenne and the science of memorized music.

PMID- 11217839
TI  - Gained in the translation.

PMID- 11217840
TI  - The big picture.

PMID- 11217841
TI  - The dark side of aerosols.

PMID- 11217843
TI  - The age of the Universe.

PMID- 11217842
TI  - Diabetes. Dialogue between muscle and fat.

PMID- 11217845
TI  - The day the solar wind nearly died.

PMID- 11217844
TI  - Infectious speciation.

PMID- 11217846
TI  - Developmental biology. A macho way to make muscles.

PMID- 11217847
TI  - Dominant rams lose out by sperm depletion.

PMID- 11217848
TI  - Transgenic crops in natural habitats.

PMID- 11217849
TI  - Nanoscale control of chain polymerization.

PMID- 11217850
TI  - View of a mouse clock gene ticking.

PMID- 11217852
TI  - Measurement of stellar age from uranium decay.
AB  - The ages of the oldest stars in the Galaxy indicate when star formation began,
      and provide a minimum age for the Universe. Radioactive dating of meteoritic
      material and stars relies on comparing the present abundance ratios of
      radioactive and stable nuclear species to the theoretically predicted ratios of
      their production. The radioisotope 232Th (half-life 14 Gyr) has been used to date
      Galactic stars, but it decays by only a factor of two over the lifetime of the
      Universe. 238U (half-life 4.5 Gyr) is in principle a more precise age indicator,
      but even its strongest spectral line, from singly ionized uranium at a wavelength
      of 385.957 nm, has previously not been detected in stars. Here we report a
      measurement of this line in the very metal-poor star CS31082-001, a star which is
      strongly overabundant in its heavy elements. The derived uranium abundance,
      log(U/H) = -13.7 +/- 0.14 +/- 0.12 yields an age of 12.5 +/- 3 Gyr, though this
      is still model dependent. The observation of this cosmochronometer gives the most
      direct age determination of the Galaxy. Also, with improved theoretical and
      laboratory data, it will provide a highly precise lower limit to the age of the
      Universe.

PMID- 11217853
TI  - Generic mechanism for generating a liquid-liquid phase transition.
AB  - Recent experimental results indicate that phosphorus--a single-component system-
      can have a high-density liquid (HDL) and a low-density liquid (LDL) phase. A
      first-order transition between two liquids of different densities is consistent
      with experimental data for a variety of materials, including single-component
      systems such as water, silica and carbon. Molecular dynamics simulations of very
      specific models for supercooled water, liquid carbon and supercooled silica
      predict a LDL-HDL critical point, but a coherent and general interpretation of
      the LDL-HDL transition is lacking. Here we show that the presence of a LDL and a
      HDL can be directly related to an interaction potential with an attractive part
      and two characteristic short-range repulsive distances. This kind of interaction
      is common to other single-component materials in the liquid state (in particular,
      liquid metals), and such potentials are often used to describe systems that
      exhibit a density anomaly. However, our results show that the LDL and HDL phases
      can occur in systems with no density anomaly. Our results therefore present an
      experimental challenge to uncover a liquid-liquid transition in systems like
      liquid metals, regardless of the presence of a density anomaly.

PMID- 11217851
TI  - Functional annotation of a full-length mouse cDNA collection.
AB  - The RIKEN Mouse Gene Encyclopaedia Project, a systematic approach to determining
      the full coding potential of the mouse genome, involves collection and sequencing
      of full-length complementary DNAs and physical mapping of the corresponding genes
      to the mouse genome. We organized an international functional annotation meeting
      (FANTOM) to annotate the first 21,076 cDNAs to be analysed in this project. Here
      we describe the first RIKEN clone collection, which is one of the largest
      described for any organism. Analysis of these cDNAs extends known gene families
      and identifies new ones.

PMID- 11217854
TI  - Strong radiative heating due to the mixing state of black carbon in atmospheric
      aerosols.
AB  - Aerosols affect the Earth's temperature and climate by altering the radiative
      properties of the atmosphere. A large positive component of this radiative
      forcing from aerosols is due to black carbon--soot--that is released from the
      burning of fossil fuel and biomass, and, to a lesser extent, natural fires, but
      the exact forcing is affected by how black carbon is mixed with other aerosol
      constituents. From studies of aerosol radiative forcing, it is known that black
      carbon can exist in one of several possible mixing states; distinct from other
      aerosol particles (externally mixed) or incorporated within them (internally
      mixed), or a black-carbon core could be surrounded by a well mixed shell. But so
      far it has been assumed that aerosols exist predominantly as an external mixture.
      Here I simulate the evolution of the chemical composition of aerosols, finding
      that the mixing state and direct forcing of the black-carbon component approach
      those of an internal mixture, largely due to coagulation and growth of aerosol
      particles. This finding implies a higher positive forcing from black carbon than
      previously thought, suggesting that the warming effect from black carbon may
      nearly balance the net cooling effect of other anthropogenic aerosol
      constituents. The magnitude of the direct radiative forcing from black carbon
      itself exceeds that due to CH4, suggesting that black carbon may be the second
      most important component of global warming after CO2 in terms of direct forcing.

PMID- 11217855
TI  - Tropical climate changes at millennial and orbital timescales on the Bolivian
      Altiplano.
AB  - Tropical South America is one of the three main centres of the global, zonal
      overturning circulation of the equatorial atmosphere (generally termed the
      'Walker' circulation). Although this area plays a key role in global climate
      cycles, little is known about South American climate history. Here we describe
      sediment cores and down-hole logging results of deep drilling in the Salar de
      Uyuni, on the Bolivian Altiplano, located in the tropical Andes. We demonstrate
      that during the past 50,000 years the Altiplano underwent important changes in
      effective moisture at both orbital (20,000-year) and millennial timescales. Long
      duration wet periods, such as the Last Glacial Maximum--marked in the drill core
      by continuous deposition of lacustrine sediments--appear to have occurred in
      phase with summer insolation maxima produced by the Earth's precessional cycle.
      Short-duration, millennial events correlate well with North Atlantic cold events,
      including Heinrich events 1 and 2, as well as the Younger Dryas episode. At both
      millennial and orbital timescales, cold sea surface temperatures in the high
      latitude North Atlantic were coeval with wet conditions in tropical South
      America, suggesting a common forcing.

PMID- 11217856
TI  - Upper-mantle dynamics revealed by helium isotope variations along the southeast
      Indian ridge.
AB  - Helium isotope variations in igneous rocks are important for relating isotopic
      heterogeneity to convective mixing in the Earth's mantle. High 3He/4He ratios at
      many ocean islands, along with lower and relatively uniform values in mid-ocean
      ridge basalts (MORBs), are thought to result from a well mixed upper-mantle
      source for MORB and a distinct deeper-mantle source for ocean island basalts. At
      finer scales, 3He/4He variations along mid-ocean ridges have been related to
      underlying mantle heterogeneity, but relationships between the scales of
      geochemical segmentation and mantle convection remain enigmatic. Here we present
      helium isotope data for MORB glasses recovered along approximately 5,800 km of
      the southeast Indian ridge, and develop an approach to quantitatively relate
      spatial variations in geochemical and geophysical parameters at the Earth's
      surface. A point-to-point correlation analysis reveals structure in the helium
      isotope data at length scales of approximately 150 and approximately 400 km that
      appears to be related to secondary convection in the underlying mantle.

PMID- 11217857
TI  - Complete mitochondrial genome sequences of two extinct moas clarify ratite
      evolution.
AB  - The origin of the ratites, large flightless birds from the Southern Hemisphere,
      along with their flighted sister taxa, the South American tinamous, is central to
      understanding the role of plate tectonics in the distributions of modern birds
      and mammals. Defining the dates of ratite divergences is also critical for
      determining the age of modern avian orders. To resolve the ratite phylogeny and
      provide biogeographical data to examine these issues, we have here determined the
      first complete mitochondrial genome sequences of any extinct taxa--two New
      Zealand moa genera--along with a 1,000-base-pair sequence from an extinct
      Madagascan elephant-bird. For comparative data, we also generated 12 kilobases of
      contiguous sequence from the kiwi, cassowary, emu and two tinamou genera. This
      large dataset allows statistically precise estimates of molecular divergence
      dates and these support a Late Cretaceous vicariant speciation of ratite taxa,
      followed by the subsequent dispersal of the kiwi to New Zealand. This first
      molecular view of the break-up of Gondwana provides a new temporal framework for
      speciation events within other Gondwanan biota and can be used to evaluate
      competing biogeographical hypotheses.

PMID- 11217858
TI  - Wolbachia-induced incompatibility precedes other hybrid incompatibilities in
      Nasonia.
AB  - Wolbachia are cytoplasmically inherited bacteria that cause a number of
      reproductive alterations in insects, including cytoplasmic incompatibility, an
      incompatibility between sperm and egg that results in loss of sperm chromosomes
      following fertilization. Wolbachia are estimated to infect 15-20% of all insect
      species, and also are common in arachnids, isopods and nematodes. Therefore,
      Wolbachia-induced cytoplasmic incompatibility could be an important factor
      promoting rapid speciation in invertebrates, although this contention is
      controversial. Here we show that high levels of bidirectional cytoplasmic
      incompatibility between two closely related species of insects (the parasitic
      wasps Nasonia giraulti and Nasonia longicornis) preceded the evolution of other
      postmating reproductive barriers. The presence of Wolbachia severely reduces the
      frequency of hybrid offspring in interspecies crosses. However, antibiotic curing
      of the insects results in production of hybrids. Furthermore, F1 and F2 hybrids
      are completely viable and fertile, indicating the absence of F1 and F2 hybrid
      breakdown. Partial interspecific sexual isolation occurs, yet it is asymmetric
      and incomplete. Our results indicate that Wolbachia-induced reproductive
      isolation occurred in the early stages of speciation in this system, before the
      evolution of other postmating isolating mechanisms (for example, hybrid
      inviability and hybrid sterility).

PMID- 11217859
TI  - Evolutionary radiations and convergences in the structural organization of
      mammalian brains.
AB  - The sizes of mammalian brain components seem to be mostly related to the sizes of
      the whole brain (and body), suggesting a one-dimensional scale of
      encephalization. Previous multivariate study of such data concludes that
      evolutionary selection for enlargement of any one brain part is constrained to
      selection for a concerted enlargement of the whole brain. However, interactions
      between structurally related pairs of brain parts confirm reports of differential
      change in brain nuclei, and imply mosaic rather than concerted evolution. Here we
      analyse a large number of variables simultaneously using multi-dimensional
      methods. We show that the relative proportions of different systems of
      functionally integrated brain structures vary independently between different
      mammalian orders, demonstrating separate evolutionary radiations in mammalian
      brain organization. Within each major order we identify clusters of unrelated
      species that occupy similar behavioural niches and have convergently evolved
      similar brain proportions. We conclude that within orders, mosaic brain
      organization is caused by selective adaptation, whereas between orders it
      suggests an interplay between selection and constraints.

PMID- 11217860
TI  - Neurons derived from radial glial cells establish radial units in neocortex.
AB  - The neocortex of the adult brain consists of neurons and glia that are generated
      by precursor cells of the embryonic ventricular zone. In general, glia are
      generated after neurons during development, but radial glia are an exception to
      this rule. Radial glia are generated before neurogenesis and guide neuronal
      migration. Radial glia are mitotically active throughout neurogenesis, and
      disappear or become astrocytes when neuronal migration is complete. Although the
      lineage relationships of cortical neurons and glia have been explored, the clonal
      relationship of radial glia to other cortical cells remains unknown. It has been
      suggested that radial glia may be neuronal precursors, but this has not been
      demonstrated in vivo. We have used a retroviral vector encoding enhanced green
      fluorescent protein to label precursor cells in vivo and have examined clones 1-3
      days later using morphological, immunohistochemical and electrophysiological
      techniques. Here we show that clones consist of mitotic radial glia and
      postmitotic neurons, and that neurons migrate along clonally related radial glia.
      Time-lapse images show that proliferative radial glia generate neurons. Our
      results support the concept that a lineage relationship between neurons and
      proliferative radial glia may underlie the radial organization of neocortex.

PMID- 11217861
TI  - The gating mechanism of the large mechanosensitive channel MscL.
AB  - The mechanosensitive channel of large conductance, MscL, is a ubiquitous membrane
      embedded valve involved in turgor regulation in bacteria. The crystal structure
      of MscL from Mycobacterium tuberculosis provides a starting point for analysing
      molecular mechanisms of tension-dependent channel gating. Here we develop
      structural models in which a cytoplasmic gate is formed by a bundle of five amino
      terminal helices (S1), previously unresolved in the crystal structure. When
      membrane tension is applied, the transmembrane barrel expands and pulls the gate
      apart through the S1-M1 linker. We tested these models by substituting cysteines
      for residues predicted to be near each other only in either the closed or open
      conformation. Our results demonstrate that S1 segments form the bundle when the
      channel is closed, and crosslinking between S1 segments prevents opening. S1
      segments interact with M2 when the channel is open, and crosslinking of S1 to M2
      impedes channel closing. Gating is affected by the length of the S1-M1 linker in
      a manner consistent with the model, revealing critical spatial relationships
      between the domains that transmit force from the lipid bilayer to the channel
      gate.

PMID- 11217862
TI  - macho-1 encodes a localized mRNA in ascidian eggs that specifies muscle fate
      during embryogenesis.
AB  - Maternal information stored in particular regions of the egg cytoplasm has an
      important function in the determination of developmental fate during early animal
      development. Ascidians show mosaic development; such autonomous development has
      been taken as evidence that prelocalized ooplasmic factors specify tissue
      precursor cells during embryogenesis. Interest has been concentrated on the
      mechanisms underlying the formation of muscle cells in the tail, as yellow
      coloured myoplasm in eggs is preferentially segregated into muscle-lineage
      blastomeres. Here we show that maternal messenger RNA of the macho-1 gene is a
      determinant of muscle fate in the ascidian Halocynthia roretzi. The macho-1 mRNA
      encodes a zinc-finger protein, and the mRNA is localized to the myoplasm of eggs.
      Depletion of the mRNA specifically resulted in the loss of primary muscle cells
      in the tail, as shown by the expression of muscle-specific molecular markers. The
      myoplasm of macho-1-deficient eggs lost its ability to promote muscle formation.
      Injection of synthesized macho-1 mRNA caused ectopic muscle formation in non
      muscle-lineage cells. Our results indicate that macho-1 maybe both required and
      sufficient for specification of muscle fate, and that the mRNA is a genuine,
      localized muscle determinant.

PMID- 11217863
TI  - Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle
      and liver.
AB  - The earliest defect in developing type 2 diabetes is insulin resistance,
      characterized by decreased glucose transport and metabolism in muscle and
      adipocytes. The glucose transporter GLUT4 mediates insulin-stimulated glucose
      uptake in adipocytes and muscle by rapidly moving from intracellular storage
      sites to the plasma membrane. In insulin-resistant states such as obesity and
      type 2 diabetes, GLUT4 expression is decreased in adipose tissue but preserved in
      muscle. Because skeletal muscle is the main site of insulin-stimulated glucose
      uptake, the role of adipose tissue GLUT4 downregulation in the pathogenesis of
      insulin resistance and diabetes is unclear. To determine the role of adipose
      GLUT4 in glucose homeostasis, we used Cre/loxP DNA recombination to generate mice
      with adipose-selective reduction of GLUT4 (G4A-/-). Here we show that these mice
      have normal growth and adipose mass despite markedly impaired insulin-stimulated
      glucose uptake in adipocytes. Although GLUT4 expression is preserved in muscle,
      these mice develop insulin resistance in muscle and liver, manifested by
      decreased biological responses and impaired activation of phosphoinositide-3-OH
      kinase. G4A-/- mice develop glucose intolerance and hyperinsulinaemia. Thus,
      downregulation of GLUT4 and glucose transport selectively in adipose tissue can
      cause insulin resistance and thereby increase the risk of developing diabetes.

PMID- 11217864
TI  - Negative regulation of T-cell activation and autoimmunity by Mgat5 N
      glycosylation.
AB  - T-cell activation requires clustering of a threshold number of T-cell receptors
      (TCRs) at the site of antigen presentation, a number that is reduced by CD28 co
      receptor recruitment of signalling proteins to TCRs. Here we demonstrate that a
      deficiency in beta1,6 N-acetylglucosaminyltransferase V (Mgat5), an enzyme in the
      N-glycosylation pathway, lowers T-cell activation thresholds by directly
      enhancing TCR clustering. Mgat5-deficient mice showed kidney autoimmune disease,
      enhanced delayed-type hypersensitivity, and increased susceptibility to
      experimental autoimmune encephalomyelitis. Recruitment of TCRs to agonist-coated
      beads, TCR signalling, actin microfilament re-organization, and agonist-induced
      proliferation were all enhanced in Mgat5-/- T cells. Mgat5 initiates GlcNAc
      beta1,6 branching on N-glycans, thereby increasing N-acetyllactosamine, the
      ligand for galectins, which are proteins known to modulate T-cell proliferation
      and apoptosis. Indeed, galectin-3 was associated with the TCR complex at the cell
      surface, an interaction dependent on Mgat5. Pre-treatment of wild-type T cells
      with lactose to compete for galectin binding produced a phenocopy of Mgat5-/- TCR
      clustering. These data indicate that a galectin-glycoprotein lattice strengthened
      by Mgat5-modified glycans restricts TCR recruitment to the site of antigen
      presentation. Dysregulation of Mgat5 in humans may increase susceptibility to
      autoimmune diseases, such as multiple sclerosis.

PMID- 11217865
TI  - Crystal structure of photosystem II from Synechococcus elongatus at 3.8 A
      resolution.
AB  - Oxygenic photosynthesis is the principal energy converter on earth. It is driven
      by photosystems I and II, two large protein-cofactor complexes located in the
      thylakoid membrane and acting in series. In photosystem II, water is oxidized;
      this event provides the overall process with the necessary electrons and protons,
      and the atmosphere with oxygen. To date, structural information on the
      architecture of the complex has been provided by electron microscopy of intact,
      active photosystem II at 15-30 A resolution, and by electron crystallography on
      two-dimensional crystals of D1-D2-CP47 photosystem II fragments without water
      oxidizing activity at 8 A resolution. Here we describe the X-ray structure of
      photosystem II on the basis of crystals fully active in water oxidation. The
      structure shows how protein subunits and cofactors are spatially organized. The
      larger subunits are assigned and the locations and orientations of the cofactors
      are defined. We also provide new information on the position, size and shape of
      the manganese cluster, which catalyzes water oxidation.

PMID- 11217866
TI  - Emergence of methicillin-resistant Staphylococcus aureus with intermediate
      glycopeptide resistance: clinical significance and treatment options.
AB  - Methicillin-resistant Staphylococcus aureus is a pathogen that is associated with
      serious infections that pose a significant risk of morbidity and mortality
      because of their multidrug resistant nature. Until recently, therapeutic options
      were limited to vancomycin, making the use of this drug widespread.
      Unfortunately, the continued application of this drug has led to the emergence of
      glycopeptide intermediate susceptible S. aureus (GISA). By definition, these
      organisms demonstrated a vancomycin minimum inhibitory concentration (MIC) of >4
      mg/L and <32 mg/L. However, although the mechanism of resistance is not fully
      elucidated at this time, GISA strains have demonstrated thickened or aggregated
      cell walls, an increase in penicillin binding proteins and greater autolytic
      activity. At present, the overall number of reported cases of GISA is relatively
      low. In most cases, thus far, prolonged courses of vancomycin were reported. A
      few cases reported monitoring serum vancomycin concentrations but because of
      limited information, no association with outcome can be made. Whether these GISA
      strains will become more widespread or evolve into fully glycopeptide resistant
      strains is unknown at this time. Although there are a number of new agents that
      possess activity against these pathogens, there is no consensus regarding
      specific recommendations for treatment. Strict infection control practices,
      routine screening for resistance and controlled use of antibacterial agents,
      especially vancomycin, are critical steps in preventing the further development
      of resistance among staphylococci.

PMID- 11217868
TI  - The emerging roles of non-nucleoside reverse transcriptase inhibitors in
      antiretroviral therapy.
AB  - The availability of potent non-nucleoside reverse transcriptase inhibitor (NNRTI)
      based regimens for antiretroviral therapy and concerns regarding protease
      inhibitor (PI)-related metabolic disturbances have led to significant shifts in
      treatment practices in HIV infection. NNRTI-based regimens may have several
      advantages over PI-based therapy for initial or prolonged therapy, including more
      convenient administration regimens, lower tablet volume, fewer drug interactions,
      and central nervous system penetration. No data from prospective clinical trials
      currently exist comparing the 3 approved agents (efavirenz, nevirapine or
      delavirdine). Both efavirenz and nevirapine have been compared to triple therapy
      with the PI indinavir over 48 weeks as initial therapy, with similar responses
      being observed with nevirapine regimens and superiority observed with efavirenz.
      A smaller 24-week study has suggested nevirapine may be superior to the PI
      nelfinavir. Limited comparative data in patients with high viral loads treated
      with nevirapine- or delavirdine-based regimens currently exist. However, cohort
      data and selected patient data from clinical trials suggest comparable activity
      to PI-based regimens in these patients. The superiority of efavirenz over
      indinavir-based regimens has been observed in comparative data in a subset of
      patients with high viral loads. In treatment-experienced patients, available
      uncontrolled data suggest these agents contribute to regimen efficacy in NNRTI
      naive, treatment-experienced patients. Efavirenz has demonstrated superiority
      over nelfinavir in nucleoside-experienced patients, although combining these 2
      agents may represent the best approach in these circumstances. The tolerability
      of NNRTIs appears generally good with few individuals discontinuing in clinical
      studies as a result of adverse drug events. The majority of adverse events with
      NNRTIs occur within the first month, and are predictable and manageable without
      therapy interruption.

PMID- 11217869
TI  - Response to inhaled nitric oxide in premature and term neonates.
AB  - Inhaled nitric oxide (iNO) has emerged as a promising therapeutic agent in the
      treatment of persistent pulmonary hypertension of the newborn. Several theories
      exist regarding causes of both response and nonresponse to iNO. Clinical trials
      differentiate disease entities (primary vs secondary persistent pulmonary
      hypertension associated with meconium aspiration syndrome, pneumonia or
      congenital diaphragmatic hernia) and their specific response rates. iNO combined
      with high-frequency ventilation appears to be superior to inhalation of nitric
      oxide (NO) during conventional ventilation. Little is known regarding the role of
      the degree of lung expansion and its modification -- no matter what mode of
      ventilation is applied. Gestational age plays an important role in relation to
      the potential adverse effects of NO. Of particular concern in the premature
      neonate is the effect of NO on bleeding time and the inhibition of platelet
      aggregation. Those potentially hazardous effects need to be carefully weighed
      against early intervention with iNO at a comparably low oxygenation index in
      order to prevent the vicious cycle of hypoxaemia and subsequent increased right
      to-left shunting. Further studies are required to determine the optimal timing,
      mode of delivery and mode of ventilation used with iNO therapy in order to
      optimise the response of premature and term neonates.

PMID- 11217867
TI  - Olanzapine: an updated review of its use in the management of schizophrenia.
AB  - Olanzapine, a thienobenzodiazepine derivative, is a second generation (atypical)
      antipsychotic agent which has proven efficacy against the positive and negative
      symptoms of schizophrenia. Compared with conventional antipsychotics, it has
      greater affinity for serotonin 5-HT2A than for dopamine D2 receptors. In large,
      well controlled trials in patients with schizophrenia or related psychoses,
      olanzapine 5 to 20 mg/day was significantly superior to haloperidol 5 to 20
      mg/day in overall improvements in psychopathology rating scales and in the
      treatment of depressive and negative symptoms, and was comparable in effects on
      positive psychotic symptoms. The 1-year risk of relapse (rehospitalisation) was
      significantly lower with olanzapine than with haloperidol treatment. In the first
      double-blind comparative study (28-week) of olanzapine and risperidone,
      olanzapine 10 to 20 mg/day proved to be significantly more effective than
      risperidone 4 to 12 mg/day in the treatment of negative and depressive symptoms
      but not on overall psychopathology symptoms. In contrast, preliminary results
      from an 8-week controlled study suggested risperidone 2 to 6 mg/day was superior
      to olanzapine 5 to 20 mg/day against positive and anxiety/depressive symptoms (p
      < 0.05), although consistent with the first study, both agents demonstrated
      similar efficacy on measures of overall psychopathology. Improvements in general
      cognitive function seen with olanzapine treatment in a 1-year controlled study of
      patients with early-phase schizophrenia, were significantly greater than changes
      seen with either risperidone or haloperidol. However, preliminary results from an
      8-week trial showed comparable cognitive enhancing effects of olanzapine and
      risperidone treatment in patients with schizophrenia or schizoaffective disorder.
      Several studies indicate that olanzapine has benefits against symptoms of
      aggression and agitation, while other studies strongly support the effectiveness
      of olanzapine in the treatment of depressive symptomatology. Olanzapine is
      associated with significantly fewer extrapyramidal symptoms than haloperidol and
      risperidone. In addition, olanzapine is not associated with a risk of
      agranulocytosis as seen with clozapine or clinically significant
      hyperprolactinaemia as seen with risperidone or prolongation of the QT interval.
      The most common adverse effects reported with olanzapine are bodyweight gain,
      somnolence, dizziness, anticholinergic effects (constipation and dry mouth) and
      transient asymptomatic liver enzyme elevations. In comparison with haloperidol,
      the adverse events reported significantly more frequently with olanzapine in > or
      = 3.5% of patients were dry mouth, bodyweight gain and increased appetite and
      compared with risperidone, only bodyweight gain occurred significantly more
      frequently with olanzapine. The high acquisition cost of olanzapine is offset by
      reductions in other treatment costs (inpatient and/or outpatient services) of
      schizophrenia. Pharmacoeconomic analyses indicate that olanzapine does not
      significantly increase, and may even decrease, the overall direct treatment costs
      of schizophrenia, compared with haloperidol. Compared with risperidone,
      olanzapine has also been reported to decrease overall treatment costs, despite
      the several-fold higher daily acquisition cost of the drug. Olanzapine treatment
      improves quality of life in patients with schizophrenia and related psychoses to
      a greater extent than haloperidol, and to broadly the same extent as risperidone.
      CONCLUSIONS: Olanzapine demonstrated superior antipsychotic efficacy compared
      with haloperidol in the treatment of acute phase schizophrenia, and in the
      treatment of some patients with first-episode or treatment-resistant
      schizophrenia. The reduced risk of adverse events and therapeutic superiority
      compared with haloperidol and risperidone in the treatment of negative and
      depressive symptoms support the choice of olanzapine as a first-line option in
      the management of schizophrenia in the acute phase and for the maintenance of
      treatment response.

PMID- 11217870
TI  - Cholinesterase inhibitors for Alzheimer's disease.
AB  - Alzheimer's disease (AD) is the most common age-related neurodegenerative disease
      and has become an urgent public health problem in most areas of the world.
      Substantial progress has been made in understanding the basic neurobiology of AD
      and, as a result, new drugs for its treatment have become available.
      Cholinesterase inhibitors (ChEIs), which increase the availability of
      acetylcholine in central synapses, have become the main approach to symptomatic
      treatment. ChEIs that have been approved or submitted to the US Food and Drug
      Administration (FDA) include tacrine, donepezil, metrifonate, rivastigmine and
      galantamine. In this review we discuss their pharmacology, clinical experience to
      date with their use and their potential benefits or disadvantages. ChEIs have a
      significant, although modest, effect on the cognitive status of patients with AD.
      In addition to their effect on cognition, ChEIs have a positive effect on mood
      and behaviour. Uncertainty remains about the duration of the benefit because few
      studies of these compounds beyond one year have been published. Although ChEIs
      are generally well tolerated, all patients should be followed closely for
      possible adverse effects. There is no substantial difference in the effectivenes
      of the various ChEIs, however, they may have different safety profiles. We
      believe the benefits of their use outweigh the risks and costs and, therefore,
      ChEls should be considered as primary therapy for patients with mild to moderate
      AD.

PMID- 11217871
TI  - Treatments for androgenetic alopecia and alopecia areata: current options and
      future prospects.
AB  - Androgenetic alopecia and alopecia areata are common disorders of the hair
      follicle which may heavily influence self esteem and self image. Androgenetic
      alopecia is caused by the heightened sensitivity of scalp follicles to dihydro-
      testosterone whereas alopecia areata is induced by an autoimmune reaction.
      Current drug treatment approaches include the use of regrowth stimulators such as
      topical minoxidil and oral finasteride for androgenetic alopecia, as well as
      topical minoxidil, dithranol (anthralin), corticosteroids, contact sensitisers,
      and psoralen plus ultraviolet A irradiation (PUVA) therapy for alopecia areata.
      Combination regimens are also proposed. However, extreme cases of either type of
      alopecia do not generally respond well to these existing treatments. For this
      reason, new therapeutic strategies are directed towards both improving the
      targeting of existing agents, as well as the development of novel hypertrichotic
      modalities.

PMID- 11217872
TI  - Inhaled budesonide/formoterol combination.
AB  - Current evidence suggests that the addition of the long acting inhaled beta2
      agonist formoterol to low or moderate doses of the inhaled corticosteroid
      budesonide is effective in improving lung function and reducing the incidence of
      asthma exacerbations. Concurrent use of budesonide with formoterol does not
      result in any untoward interaction that affects the pharmacodynamic or
      pharmacokinetic profiles of the individual drugs, or their adverse effect
      profiles. The administration of combined budesonide/formoterol is effective in
      improving morning and evening peak expiratory flow rates in adults with
      persistent asthma. Control of asthma symptoms is also significantly improved. In
      children aged 4 to 17 years, combined budesonide/formoterol is effective in
      increasing both morning and evening peak expiratory flow rates and significantly
      improving forced expiratory volume in 1 second (FEV1). The most commonly
      encountered adverse effects in clinical trials with combination
      budesonide/formoterol therapy have been respiratory infection, pharyngitis and
      coughing. No adverse effects on pulse rate, blood pressure or serum potassium
      have been reported with combination therapy.

PMID- 11217873
TI  - Fluoxetine: a review of its therapeutic potential in the treatment of depression
      associated with physical illness.
AB  - Fluoxetine is a potent and selective inhibitor of neuronal serotonin (5
      hydroxytryptamine) reuptake. Fluoxetine reduces food, energy and carbohydrate
      intake and increases resting energy expenditure, which may account for the
      moderate and transient bodyweight loss observed with its use. Glucose tolerance
      and/or hypoglycaemia in patients with type 2 diabetes mellitus improve with
      fluoxetine therapy. The ability of fluoxetine to inhibit cytochrome P450 (CYP)
      isoenzymes (CYP2D6, CYP2C and CYP3A4), is potentially important for patients with
      physical illness who may be taking multiple concomitant medications. Fluoxetine
      was more effective than placebo in 2 double-blind, randomised trials, and
      according to limited data appears to be equally effective compared with other
      SSRIs and tricyclic antidepressants (TCAs), in the treatment of depression in
      patients with HIV/AIDS. The efficacy of fluoxetine is also superior to that of
      placebo in the treatment of depression in patients with diabetes mellitus and
      stroke as shown in double-blind randomised trials, although its efficacy relative
      to that of nortriptyline in stroke is uncertain. Fluoxetine had similar efficacy
      to that of desipramine in patients with cancer, with improved Hamilton Depression
      Rating Scale and quality-of-life scores from baseline; however, the drug was not
      more effective than placebo in a double-blind randomised trial. Medically healthy
      individuals tolerate fluoxetine well. Like other SSRIs, fluoxetine lacks the
      anticholinergic, cardiovascular, sedative and weight-increasing properties of
      TCAs, and is safer in overdose than TCAs and monoamine oxidase inhibitors. Rates
      of sexual dysfunction and suicidal ideation with fluoxetine appear similar to
      those seen with other SSRIs. CONCLUSION: Fluoxetine has shown superior efficacy
      compared with placebo in the treatment of depression in patients with HIV/AIDS,
      diabetes mellitus or stroke; however, it has not significantly improved
      depressive symptoms versus placebo in patients with cancer. The efficacy of
      fluoxetine appears similar to that of desipramine in patients with stroke, cancer
      or HIV, and is similar to that of sertraline or paroxetine in patients with
      HIV/AIDS; comparisons with nortriptyline give equivocal results. The potential
      for drug interactions with fluoxetine use should be carefully considered because
      most patients with comorbid physical illness will be receiving multiple
      comedications. Although fluoxetine has proved effective as an antidepressant in
      this population in several clinical trials, its drug interaction profile and long
      half-life are a potential limitation, and these properties should be carefully
      considered in relation to the status of each patient.

PMID- 11217874
TI  - The role of fluoroquinolones in tuberculosis today.
AB  - Tuberculosis is a growing international health concern; it is the leading
      infectious cause of death in the world today. The fluoroquinolones are the most
      recent class of drugs offering hope in the fight against this disease.
      Ciprofloxacin, ofloxacin, levofloxacin and sparfloxacin are currently the most
      commonly used agents used against Mycobacterium tuberculosis (TB), with in vitro
      minimum inhibitory concentrations (MICs) of 0.1 to 4 mcg/ml. Resistance in TB to
      fluoroquinolones may occur spontaneously or may be acquired, especially when
      these agents are used inappropriately. Cross-resistance among the
      fluoroquinolones has been shown in TB. The fluoroquinolones offer a favourable
      pharmacokinetic profile for the treatment of TB. Most demonstrate excellent oral
      bioavailability and achieve maximum (peak) serum concentrations well above the
      MIC. They are also distributed widely, including intracellularly. The
      fluoroquinolones are cleared renally and/or hepatically, with varying serum half
      lives. Fluoroquinolones are most effective when the peak concentration (Cmax) to
      MIC ratio is maximised. Fluoroquinolones such as ciprofloxacin and ofloxacin have
      been used in regimens for the prevention of TB, but have been poorly tolerated
      when used in combination with pyrazinamide. Favourable responses with
      fluoroquinolones in regimens used in the treatment of clinical TB disease have
      been seen. They, however, are not to be considered as equal replacements for
      isoniazid or rifampicin (rifampin) and should be used with at least 2 other
      antituberculous agents. Therapeutic drug monitoring of fluoroquinolones is
      beneficial in assuring that maximum Cmax to MIC ratios are being achieved,
      especially in patients at risk for malabsorption, such as those infected with
      HIV. Higher, once-daily doses of most fluoroquinolones are becoming more common
      in treating TB. Fluoroquinolones are generally well tolerated with long term use
      in treating TB, but rare, serious adverse effects have been reported with general
      fluoroquinolone use. The most common drug interactions with fluoroquinolones in
      TB therapy include the malabsorption interactions associated with multivalent
      cations and cytochrome P450 interactions with ciprofloxacin. An increased risk of
      central nervous system effects with concomitant cycloserine has been reported and
      seen clinically. When using fluoroquinolones to treat TB, careful consideration
      of individual susceptibility patterns, pharmacokinetic and toxicity profiles
      should be taken. The aid of a TB expert may also be warranted. The exact role of
      the fluoroquinolones in treating TB remains to be determined.

PMID- 11217875
TI  - Iterative optimal design of PET experiments for estimating beta-adrenergic
      receptor concentration.
AB  - To estimate in vivo myocardial beta-adrenergic receptor concentration with
      sufficient precision and to reduce the experimental complexities in positron
      emission tomography (PET), an iterative optimal design method is applied. An
      initial three-injection protocol, utilising [F-18]-labelled (R)- and (S)
      fluorocarazolol and unlabelled (S)-fluorocarazolol, is optimised for ligand
      dosages and administration times to maximise the precision of all model
      parameters using the D-optimal criterion. Using this experimental protocol, PET
      data are collected in porcine studies, and model parameters are estimated. All
      model parameters are identified with satisfactory precision. The in vivo
      myocardial beta-receptor concentration is 7.5+/-0.6 pmol x ml(-1), which
      corresponds to the in vitro result of 10.1+/-1.3 pmol x ml(-1). With more
      accurate parameter values, a simplified two-injection protocol is optimally
      designed, utilising only radiolabelled and unlabelled (S)-fluorocarazolol, based
      on a new criterion to maximise the precision of the beta-receptor concentration.
      This revised optimum design predicts that the in vivo beta-receptor concentration
      can be estimated with good precision but reduced experiment complexity.

PMID- 11217876
TI  - Measurement of femoral neck anteversion in 3D. Part 1: 3D imaging method.
AB  - Femoral neck anteversion is the torsion of the femoral head with reference to the
      distal femur. Conventional methods that use cross-sectional computed tomography
      (CT), magnetic resonance or ultrasound images to estimate femoral anteversion
      have met with several problems owing to the complex, three-dimensional (3D)
      structure of the femur. These problems include not only the difficulty of
      defining the direction of the femoral neck axis and condylar line but also the
      dependency upon patient positioning. In particular, the femoral neck axis, the
      direction of the femoral head, known as the major source of error, is difficult
      to determine from either a single or several two-dimensional (2D) cross-sectional
      images. A new method has been devised for the measurement of femoral anteversion
      using the 3D imaging technique. 3D reconstructed CT images from the femoral head
      and trochanter to the distal femur are used to measure the anteversion. It is
      necessary to remove the soft tissue from the CT images and extract just the bone
      part. Then, the femoral anteversion is measured from a computer-rendered femur
      image. The 3D imaging method is compared with both the conventional 2D method and
      the physical method using 20 dried femurs. For the physical method, which is used
      as a reference value, a special apparatus is devised. The average difference
      between the results of the physical method and those of the 2D CT method is 5.33
      degrees. The average difference between the results of the physical method and
      those of the 3D imaging method is 0.45 degrees. Seventy-four patients, who suffer
      from toe-in-gait disease, are tested to compare the 3D imaging method with the
      conventional 2D CT method. The average difference between the 2D and 3D methods
      is 8.6 degrees, and the standard is 7.43 degrees. This method provides a very
      accurate and reliable measurement of femoral anteversion, as it is virtually
      equivalent to the direct measurement of bisected dried femur in vitro.

PMID- 11217877
TI  - Measurement of femoral neck anteversion in 3D. Part 2: 3D modelling method.
AB  - Femoral neck anteversion is the torsion of the femoral head with reference to the
      distal femur. Conventional methods that use cross-sectional computed tomography
      (CT), magnetic resonance or ultrasound images to estimate femoral anteversion
      have met with several problems owing to the complex three-dimensional (3D)
      structure of the femur. A 3D imaging method has been developed that virtually
      measures femoral anteversion on the 3D computer space with continuous CT slices;
      this 3D method provides more accurate and reliable results than conventional 2D
      CT measurements. A 3D modelling method is devised for the measurement of femoral
      neck anteversion. This method has advantages over the 3D imaging method, such as
      shorter processing time, reduced number of slices and an objective result
      compared with the 3D imaging method. The results of the 3D modelling method are
      compared with the conventional CT methods (2D CT method and 3D imaging method)
      using 20 dried femurs.

PMID- 11217878
TI  - Analysis of postural sway using entropy measures of signal complexity.
AB  - A stochastic complexity analysis is applied to centre-of-pressure (COP) time
      series, by using different complexity features, namely the spectral entropy, the
      approximate entropy, and the singular value decomposition spectrum entropy. A
      principal component analysis allows an estimate of the overall signal complexity
      in terms of the ensemble complexity score; the difference in values between open
      eyes (OE) and closed-eyes (CE) trials is used for clustering purposes. In
      experiments on healthy young adults, the complexity of the mediolateral component
      is shown not to depend on the manipulation of vision. Conversely, the increase of
      the anteroposterior complexity in OE conditions can be statistically significant,
      leading to a functional division of the subjects into two groups: the Romberg
      ratios (RRs), namely the ratios of the CE measure to the OE measure, are: RR =
      1.19 +/- 0.15 (group 1 subjects), and RR = 1.05 +/- 0.14 (group 2 subjects).
      Multivariate statistical techniques are applied to the complexity features and
      the parameters of a postural sway model recently proposed; the results suggest
      that the complexity change is the sign of information-generating behaviours of
      postural fluctuations, in the presence of a control strategy which aims at
      loosening long-range correlation and decreasing stochastic activity when visual
      feedback is allowed.

PMID- 11217879
TI  - A method for turbulent noise estimation in voiced signals.
AB  - In this article a new acoustic parameter is introduced and it is shown that it
      may serve as an indicator of laryngeal function. It is termed the turbulent noise
      index (TNI) and is defined as 100(1 - Rmax), where Rmax is the mean value of the
      maximum correlation coefficient between each pair of consecutive glottal cycles
      in the voiced signal. A method for its calculation is described. Experiments with
      synthetic and natural voice signals show that TNI is almost independent of
      frequency modulation noise and amplitude modulation noise. TNI is compared with
      HNR (harmonic-to-noise ratio) and NNE (normalised noise energy) which require
      high stationarity of the voice signal and are substantially affected by slow
      changes of frequency and amplitude. When the parameters HNR and NNE are used to
      discriminate between normal and pathological voices, the overlap area contains
      21.5% and 23.5% of the total number of pathological voices, respectively. Using
      TNI, the normal and pathological voices overlap is 14.8% of the total number of
      pathological voices, i.e. compared to the other noise parameters TNI has a
      significant advantage as a diagnostic parameter.

PMID- 11217880
TI  - Analysis and decomposition of signals obtained by thigh-fixed uni-axial
      accelerometry during normal walking.
AB  - The use of piezo-resistive uni-axial accelerometer signals in gait analysis is
      complicated by the fact that the measured signal is composed of different types
      of acceleration. The aim of the study is to obtain insight into the signal from a
      tangential accelerometer attached to the thigh during walking. Six subjects walk
      with three different speeds. Simultaneous measurements are performed with
      accelerometers, footswitches and an opto-electronic system. The components of the
      accelerometer signal are calculated from the opto-electronic system. A clear
      relationship is found between the measured and calculated accelerometer signals
      (range RMS: 0.76-3.69 m x s(-2), range rms: 0.22-0.61). The most pronounced
      feature is a high positive acceleration peak (> 10 m x s(-2)) at the end of the
      cycle. The gravitational acceleration during one cycle is characterised by a
      sinusoidal shape, whereas the inertial acceleration contains higher-frequency
      components (up to 20 Hz). During the major part of the gait cycle, the
      gravitational and inertial acceleration make opposing contributions to the signal
      As a result, the gravitational acceleration influences the amplitudes of the
      measured acceleration signal, the shape and peaks of which are mainly determined
      by the inertial acceleration. Because the gravitational and inertial
      accelerations differ in frequency components, the application for gait analysis
      remains feasible.

PMID- 11217882
TI  - Adaptive wavelet filtering for analysis of event-related potentials from the
      electro-encephalogram.
AB  - A challenging task in psychophysiology is the extraction of event-related
      potentials (ERPs) from the background electro-encephalogram. The task is made
      more difficult by the properties of ERPs, which typically consist of multiple
      features of variable latency, localised in time and frequency. A novel technique
      is described for analysis of ERPs, adaptive wavelet filtering (AWF), which is
      proposed as an alternative to trial averaging. Band-limited detail
      representations of each trial are obtained using wavelet analysis. The Woody
      adaptive filter is then used to align trials with respect to the evoked response.
      In a simulation study, the AWF extracts 39% of higher-frequency signal variance
      from background noise, compared with less than 1% for standard averaging and the
      Woody filter. The AWF is applied to a data-set of 448 ERPs, comprising right
      finger button presses from eight subjects. Average split-half reliability of the
      AWF on scales up to 12 Hz was 0.51.

PMID- 11217881
TI  - Three-dimensional mapping of brainstem functional lesions.
AB  - The human brainstem is a highly complex structure where even small lesions can
      give rise to a variety of symptoms and outward signs. Localising the area of
      dysfunction within the brainstem is often a difficult task. To make localisation
      easier, a neural net system has been developed which uses 72 clinical and
      neurophysiological data inputs to provide a display (using 5268 voxels) on a
      three-dimensional model of the human brainstem. The net was trained by means of a
      back-propagation algorithm, over a pool of 580 example cases. Assessed on 200
      test cases, the net correctly localised 83.6% of the target voxels; furthermore
      the net correctly localised the lesions in 31 out of 37 patients. Because this
      computer-assisted method provides reliable and quantitative localisation of
      brainstem areas of dysfunction and can be used as a 3D interactive functional
      atlas, it is expected to prove useful as a diagnostic tool for assessing focal
      brainstem lesions.

PMID- 11217883
TI  - Isopower mapping of electrogastrograms in short-bowel syndrome.
AB  - Methods for making topographic or isopower electrogastrographic (EGG) maps and
      for obtaining maximum power foci (MPFs) by means of 27-channel EGG recordings are
      briefly described. The methods are applied to short-bowel syndrome (SBS). The
      gastro-intestinal tract is traced by videofluorograms after X-ray-opaque barium
      has been ingested. The MPFs are generally located on the trace of the gastro
      intestinal tract. The gastric area is occupied by 3 cycles x min(-1) (up to 28%
      of total MPFs) and 6 cycles x min(-1) MPFs (26%). The trace of the small
      intestine is occupied mainly by 8 cycles x min(-1) (39%) and 10 cycles x min(-1)
      (43%) MPFs. The trace of the colon is occupied almost evenly by all five spectral
      frequency groups, that is, by 1 (58%), 3 (53%), 6 (48%), 8 (57%) and 10 cycles x
      min(-1) (42%). Most interestingly, the numbers of 8-10 cycles x min(-1) power
      foci found on EGG maps (including MPFs and relatively higher power foci) are
      proportional to the remaining length at operation and to the length of the
      remaining small intestine in the long-term, over 6 years postoperatively. It is
      therefore possible to follow approximately the trace of the gastero-intestinal
      tract.

PMID- 11217884
TI  - Identification of post-myocardial infarction patients with ventricular
      tachycardia by time-domain intra-QRS analysis of signal-averaged
      electrocardiogram and magnetocardiogram.
AB  - A new time-domain analysis method, which quantifies ECG/MCG intra-QRS
      fragmentation, is applied to parts of the QRS complex to identify post-myocardial
      infarction patients with ventricular tachycardia. Three leads of signal-averaged
      electrocardiograms and nine leads of magnetocardiograms were band-pass filtered
      (74 Hz to 180 Hz). The filtered signals showed fragmentation in the QRS region,
      which was quantified by the number of peaks M and a score S, that is the product
      of M and the sum of the peak amplitudes. Both parameters were determined for the
      first 80 ms of the QRS complex and the total QRS complex in each channel. For
      classification, the mean-values of the parameters M and S of the three electrical
      leads and the nine magnetic leads were calculated. Late potential and late field
      analyses were performed for the same signals. 31 myocardial infarction patients
      were included, 20 of them with a history of documented ventricular tachycardia
      (VT). Identification of VT patients using the SAECG led to better results
      (sensitivity 95%, specificity 91%) considering the entire QRS complex than with
      the standard late potential analysis suggested by Simson (sensitivity 90%,
      specificity 73%). For the SAMCG and the entire QRS complex results using the
      parameters S and M are also better (sensitivity 95%, specificity 100%) than for
      the late field analysis (sensitivity 90% and specificity 100%). For the first 80
      ms, the performance of the parameters M and S is only slightly decreased.

PMID- 11217885
TI  - Risk evaluation of ventricular tachycardia using wavelet transform irregularity
      of the high-resolution electrocardiogram.
AB  - A new method for analysis of high-resolution ECG signals using a wavelet
      transform based on a modified Morlet function is presented. A polynomial filter
      is used to reduce low-frequency, high-amplitude noise components in the analysed
      signals. The method is tested on test ECG signals with simulated late potentials
      and finally verified on two post-infarction patient (PP) groups: 62 PPs with
      ventricular tachycardia and 44 PPs without arrhythmia. A new quantitative
      parameter, the irregularity factor, is proposed for discrimination between the
      study groups. The results show a significant difference in the parameter values
      for tachycardia patients compared with those for patients without arrhythmia. The
      sensitivity of the proposed method is 85%, and the specificity is 93%.

PMID- 11217887
TI  - Evaluation of renormalised entropy for risk stratification using heart rate
      variability data.
AB  - Standard time and frequency parameters of heart rate variability (HRV) describe
      only linear and periodic behaviour, whereas more complex relationships cannot be
      recognised. A method that may be capable of assessing more complex properties is
      the non-linear measure of 'renormalised entropy.' A new concept of the method,
      RE(AR), has been developed, based on a non-linear renormalisation of
      autoregressive spectral distributions. To test the hypothesis that renormalised
      entropy may improve the result of high-risk stratification after myocardial
      infarction, it is applied to a clinical pilot study (41 subjects) and to
      prospective data of the St George's Hospital post-infarction database (572
      patients). The study shows that the new RE(AR) method is more reproducible and
      more stable in time than a previously introduced method (p<0.001). Moreover, the
      results of the study confirm the hypothesis that on average, the survivors have
      negative values of RE(AR) (-0.11+/-0.18), whereas the non-survivors have positive
      values (0.03+/-0.22, p<0.01). Further, the study shows that the combination of an
      HRV triangular index and RE(AR) leads to a better prediction of sudden arrhythmic
      death than standard measurements of HRV. In summary, the new RE(AR) method is an
      independent measure in HRV analysis that may be suitable for risk stratification
      in patients after myocardial infarction.

PMID- 11217888
TI  - Preparation of a pure autologous biodegradable fibrin matrix for tissue
      engineering.
AB  - Parallel to the growing role of tissue engineering, the need for cell embedding
      materials, which allow cells to stabilise in a three-dimensional distribution,
      has increased. Although several substances have been tested, fibrin is thus far
      the only one that permits the clinical application of cultured tissue. To date,
      autologous fibrinogen has usually been polymerised with bovine thrombin, which
      can cause severe immunological side effects. The objective of this study was to
      explore the practicability of obtaining autologous thrombin from a single patient
      in an adequate concentration and amount. Fibrinogen was cryoprecipitated from 200
      ml of freshly-frozen plasma. Thrombin was isolated from the supernatant through
      ion-exchange chromatography. The thrombin was first bound to Sephadex A-50 and
      then eluated using 2 ml of a salt buffer (2.0 M NaCl in 0.015 M trisodiumcitrate,
      pH 7.0). The activity of the thrombin (51 NIH x ml(-1) to 414 NIH x ml(-1)
      reached levels comparable to those in commercially available fibrin glues (4-500
      NIH x ml(-1)). The study has shown that it is possible to obtain a sufficient
      amount of autologous thrombin from a single donor to create a fibrin matrix of
      high efficiency without the risk of immunological and infectious side effects.

PMID- 11217889
TI  - New model to characterise cell-substrate adhesion in the presence of osmosis.
AB  - A simple model of cell-substrate adhesion, in response to osmosis change, is
      derived to describe quantitatively the interrelationships between osmotic
      inflation, contact area and angle, membrane stretching and adhesion strength. As
      the cell inflates, the contact area shrinks in dimension, until the cell is
      eventually lifted off the substrate. The theoretical prediction is consistent
      with other published data.

PMID- 11217886
TI  - Increase in pulse transit time to the foot after epidural anaesthesia treatment.
AB  - Epidurally induced anaesthetic treatment is a routine treatment for pain relief
      during surgical procedure, based on blocking the sensory and sympathetic fibres
      that mediate pain. The epidural sympathetic block results in relaxation of the
      muscle walls in the lower limbs, which can be assessed by the resultant
      haemodynamic changes. In the current study, the difference tt,f in the transit
      time of the blood pressure pulses between the toe and the finger is measured by
      photoplethysmography (PPG). Fifteen patients are administered 10 ml 0.25% of
      bupivacaine, ten patients are administered 10 ml 0.5%, and 17 patients are
      administered 40 ml 0.0625%. tt,f decreases as a function of the patient's age and
      blood pressure, both before and after the sympathetic block, owing to the
      decrease in arterial compliance with age and blood pressure. The time delay tt,f
      increases after the epidural treatment by 10.1+/-7.0 and by 16.8+/-10.8 ms for
      the 0.25% and the 0.5% concentrations, respectively. The time delay increase for
      the lowest concentration is not statistically significant. The toe-finger time
      delay change is found to reflect the haemodynamic changes induced by the
      sympathetic block with higher reliability than the routine methods of skin
      temperature or arterial blood pressure.

PMID- 11217890
TI  - Resistance training enhances the stability of sensorimotor coordination.
AB  - Strategies for the control of human movement are constrained by the
      neuroanatomical characteristics of the motor system. In particular, there is
      evidence that the capacity of muscles for producing force has a strong influence
      on the stability of coordination in certain movement tasks. In the present
      experiment, our aim was to determine whether physiological adaptations that cause
      relatively long-lasting changes in the ability of muscles to produce force can
      influence the stability of coordination in a systematic manner. We assessed the
      effects of resistance training on the performance of a difficult coordination
      task that required participants to synchronize or syncopate movements of their
      index finger with an auditory metronome. Our results revealed that training that
      increased isometric finger strength also enhanced the stability of movement
      coordination. These changes were accompanied by alterations in muscle recruitment
      patterns. In particular, the trained muscles were recruited in a more consistent
      fashion following the programme of resistance training. These results indicate
      that resistance training produces functional adaptations of the neuroanatomical
      constraints that underlie the control of voluntary movement.

PMID- 11217891
TI  - In vivo behaviour of human muscle tendon during walking.
AB  - In the present study we investigated in vivo length changes in the fascicles and
      tendon of the human gastrocnemius medialis (GM) muscle during walking. The
      experimental protocol involved real-time ultrasound scanning of the GM muscle,
      recording of the electrical activity of the muscle, measurement of knee- and
      ankle-joint rotations, and measurement of ground reaction forces in six men
      during walking at 3 km h(-1) on a treadmill. Fascicular lengths were measured
      from the sonographs recorded. Musculotendon complex length changes were estimated
      from anatomical and joint kinematic data. Tendon length changes were obtained
      combining the musculotendon complex and fascicular length-change data. The
      fascicles followed a different length-change pattern from those of the
      musculotendon complex and tendon throughout the step cycle. Two important
      features emerged: (i) the muscle contracted near-isometrically in the stance
      phase, with the fascicles operating at ca. 50 mm; and (ii) the tendon stretched
      by ca. 7 mm during single support, and recoiled in push-off. The behaviour of the
      muscle in our experiment indicates consumption of minimal metabolic energy for
      eliciting the contractile forces required to support and displace the body. On
      the other hand, the spring-like behaviour of the tendon indicates storage and
      release of elastic-strain energy. Either of the two mechanisms would favour
      locomotor economy

PMID- 11217892
TI  - Small variations in multiple parameters account for wide variations in HIV-1 set
      points: a novel modelling approach.
AB  - Steady-state levels of HIV-1 viraemia in the plasma vary more than a 1,000-fold
      between HIV-positive patients and are thought to be influenced by several
      different host and viral factors such as host target cell availability, host anti
      HIV immune response and the virulence of the virus. Previous mathematical models
      have taken the form of classical ecological food-chain models and are unable to
      account for this multifactorial nature of the disease. These models suggest that
      the steady-state viral load (i.e. the set-point) is determined by immune response
      parameters only. We have devised a generalized consensus model in which the
      conventional parameters are replaced by so-called 'process functions'. This very
      general approach yields results that are insensitive to the precise form of the
      mathematical model. Here we applied the approach to HIV-1 infections by
      estimating the steady-state values of several process functions from published
      patient data. Importantly, these estimates are generic because they are
      independent of the precise form of the underlying processes. We recorded the
      variation in the estimated steady-state values of the process functions in a
      group of HIV-1 patients. We developed a novel model by providing explicit
      expressions for the process functions having the highest patient-to-patient
      variation in their estimated values. Small variations from patient to patient for
      several parameters of the new model collectively accounted for the large
      variations observed in the steady-state viral burden. The novel model remains in
      full agreement with previous models and data.

PMID- 11217893
TI  - The basic depression ratio of the host: the evolution of host resistance to
      microparasites.
AB  - The basic reproduction ratio R0 occupies a central position in the theory of host
      pathogen interactions. However, this quantity stresses the role of the pathogen.
      This paper proposes an additional, more host-centred char acterization using the
      basic depression ratio D0. This quantity is the number of host individuals per
      infected by which the infected host population is depressed below its uninfected
      level. This paper shows that a baseline criterion for the evolution of host
      resistance to microparasites is that resistance evolves to minimize D0. This
      parallels the result for pathogen virulence where R0 is maximized. The tension
      between these two criteria is noted. The framework established allows a
      discussion of trade-offs between aspects of the pathogen-free host biology and
      the host pathogen interaction. For certain linear and convex trade-offs it is
      shown that the strain with the lowest transmission parameter beta wins (despite
      the fact that it has the lowest intrinsic birth rate a). For corresponding
      concave trade-offs, either the strain with minimum beta and a or the strain with
      maximum beta and a wins. Finally the connection with the techniques of adaptive
      dynamics is made. Evolutionary singular points are shown to occur at extrema of
      D0. The evolutionary attainment of the results is discussed.

PMID- 11217894
TI  - Trade-offs in the evolution of virulence in an indirectly transmitted
      macroparasite.
AB  - The adaptive trade-off theory for the evolution and maintenance of parasite
      virulence requires that virulence be genetically correlated with other fitness
      characteristics of the parasite. Many theoretical models rely on a positive
      correlation between virulence and transmissibility. They assume that high
      parasite replication rates are associated with a high probability of transmission
      (and, hence, increased parasite fitness), but also with high levels of damage to
      the host (high virulence). Schistosomes are macroparasites with an indirect life
      cycle involving a mammalian and a molluscan host. Here we demonstrate, through
      the development of five substrains, a genetic basis for schistosome virulence. We
      used these substrains further in order to investigate the presence of parasite
      fitness traits that were genetically correlated with virulence. High virulence in
      the (mouse) definitive host was, as predicted, positively correlated with
      parasite replication. In contrast, in the (snail) intermediate host high
      virulence was associated with low parasite replication rates. Variation in
      infectivity to and parasite replication in the definitive host was suggested as a
      compensating mechanism for the maintenance of virulence in the snail host. This
      is the first report of a trade-off in parasite reproductive success across hosts
      in an indirectly transmitted macroparasite.

PMID- 11217895
TI  - Basis of the trade-off between parasitoid resistance and larval competitive
      ability in Drosophila melanogaster.
AB  - Drosophila melanogaster can be artificially selected for increased resistance
      against parasitoid wasps that attack the larvae. Lines selected for greater
      resistance are poorer larval competitors under conditions of resource scarcity.
      Here we investigated the mechanistic basis of this apparent trade-off. We found
      that resistant lines have approximately twice the density of haemocytes (blood
      cells) than that of controls. Haemocytes are involved in encapsulation, the chief
      cellular immune defence against parasitoids. We have previously shown that
      resistant lines feed more slowly than controls and hypothesize that limiting
      resources are being switched from trophic to defensive functions.

PMID- 11217896
TI  - Complex social structure, alliance stability and mating access in a bottlenose
      dolphin 'super-alliance'.
AB  - Large brain size in mammals has been related to the number and complexity of
      social relationships, particularly social alliances within groups. The largest
      within-group male alliance known outside of humans is found in a social network
      (> 400) of Indian Ocean bottlenose dolphins (Tursiops aduncus) in Shark Bay
      Western Australia. Members of this dolphin 'super-alliance' cooperate against
      other alliances over access to females. Males within the super-alliance form
      temporary trios and occasionally pairs in order to consort with individual
      females. The frequent switching of alliance partners suggests that social
      relationships among males within the super-alliance might be relatively simple
      and based on an equivalence rule', thereby allowing dolphins to form large
      alliances without taxing their 'social intelligence'. The equivalence model
      predicts that the 14 males in the super-alliance should not exhibit differences
      in alliance stability or partner preferences. However, data from 100 consortships
      do not support the equivalence hypothesis. The 14 males exhibited striking
      differences in alliance stability and partner preferences suggesting that the
      super-alliance has a complex internal structure. Further, within the super
      alliance, alliance stability correlates with consortship rate, suggesting that
      differentiated relationships within the super-alliance are based on competition
      for access to females.

PMID- 11217897
TI  - Unifying the relationships of species richness to productivity and disturbance.
AB  - Although species richness has been hypothesized to be highest at 'intermediate'
      levels of disturbance, empirical studies have demonstrated that the disturbance
      diversity relationship can be either negative or positive depending on
      productivity On the other hand, hypothesized productivity diversity relationships
      can be positive, negative or unimodal, as confirmed by empirical studies.
      However, it has remained unclear under what conditions each pattern is realized,
      and there is little agreement about the mechanisms that generate these diverse
      patterns. In this study, I present a model that synthesizes these separately
      developed hypotheses and shows that the interactive effects of disturbance and
      productivity on the competitive outcome of multispecies dynamics can result in
      these diverse relationships of species richness to disturbance and productivity
      The predicted productivity diversity relationship is unimodal but the
      productivity level that maximizes species richness increases with increasing
      disturbance. Similarly, the predicted disturbance diversity relationship is
      unimodal but the peak moves to higher disturbance levels with increasing
      productivity Further, these patterns are well explained by the opposite effects
      of productivity and disturbance on competitive outcome that are suggested by the
      change in community composition along these two environmental gradients: higher
      productivity favours superior competitors while higher disturbance levels favour
      inferior competitors.

PMID- 11217898
TI  - Coexistence under positive frequency dependence.
AB  - Negative frequency dependence resulting from interspecific interactions is
      considered a driving force in allowing the coexistence of competitors. While
      interactions between species and genotypes can also result in positive frequency
      dependence, positive frequency dependence has usually been credited with
      hastening the extinction of rare types and is not thought to contribute to
      coexistence. In the present paper, we develop a stochastic cellular automata
      model that allows us to vary the scale of frequency dependence and the scale of
      dispersal. The results of this model indicate that positive frequency dependence
      will allow the coexistence of two species at a greater rate than would be
      expected from chance. This coexistence arises from the generation of banding
      patterns that will be stable over long time-periods. As a result, we found that
      positive frequency-dependent interactions over local spatial scales promote
      coexistence over neutral interactions. This result was robust to variation in
      boundary conditions within the simulation and to variation in levels of
      disturbance. Under all conditions, coexistence is enhanced as the strength of
      positive frequency-dependent interactions is increased.

PMID- 11217899
TI  - Reaction norms with bifurcations shaped by evolution.
AB  - Two versions of a model for the evolution of seasonal polyphenism investigate the
      evolution of reaction norm bifurcation and branching. The first version is
      without a specific submodel for morphological development and the second has an
      explicit developmental map. Version 1 is evolutionarily relatively unconstrained:
      (i) reaction norms are specified by matrices containing the probabilities of
      occurrence of environment-phenotype combinations, (ii) all conceivable reaction
      norm matrices are reachable through a sequence of mutations, and (iii) small as
      well as large mutational effects occur. This version is used to find the
      evolutionarily stable strategy favoured by the population ecology that is
      characterized by stabilizing viability selection with a cyclically fluctuating
      selection optimum. When the strength of selection is large and when the lag
      between initiation of development and selection on mature phenotype is not a
      multiple of half the period of the environmental cycle, a branching reaction norm
      evolves. In the second model version, branching reaction norms occur for certain
      parameter combinations of the developmental submodel, but the evolution of this
      pattern is often constrained. The evolutionary trajectory becomes trapped in a
      local selective optimum for the parameters of the developmental system.
      Substantial developmental noise evolves, but mutations that produce a selectively
      advantageous branching pattern do not occur from there.

PMID- 11217900
TI  - Warmer springs disrupt the synchrony of oak and winter moth phenology.
AB  - Spring temperatures have increased over the past 25 years, to which a wide
      variety of organisms have responded. The outstanding question is whether these
      responses match the temperature-induced shift of the selection pressures acting
      on these organisms. Organisms have evolved response mechanisms that are only
      adaptive given the existing relationship between the cues organisms use and the
      selection pressures acting on them. Global warming may disrupt ecosystem
      interactions because it alters these relationships and micro-evolution may be
      slow in tracking these changes. In particular, such shifts have serious
      consequences for ecosystem functioning for the tight multitrophic interactions
      involved in the timing of reproduction and growth. We determined the response of
      winter moth (Operophtera brumata) egg hatching and oak (Quercus robur) bud burst
      to temperature, a system with strong selection on synchronization. We show that
      there has been poor synchrony in recent warm springs, which is due to an increase
      in spring temperatures without a decrease in the incidence of freezing spells in
      winter. This is a clear warning that such changes in temperature patterns may
      affect ecosystem interactions more strongly than changes in mean temperature.

PMID- 11217901
TI  - Deferred costs of compensatory growth after autumnal food shortage in juvenile
      salmon.
AB  - Growing animals are often able to offset the effects of periods of reduced food
      availability by subsequently undergoing a phase of elevated compensatory or
      'catch-up' growth. This indicates that growth rates are not normally maximized
      even when food is not limiting, suggesting that fast growth may be costly. Here,
      we show experimental evidence of a long-term deferred cost of compensatory growth
      after a period of food shortage. Juvenile salmon subjected to a short-lived low
      food regime in autumn subsequently entered a hyperphagic phase, leading to
      complete restoration of lipid reserves and partial recovery of lost skeletal
      growth relative to controls. However, several months later they entered a
      prolonged phase of poorer performance (despite food now being freely available),
      so that by the following spring they were substantially smaller than controls and
      had lower lipid reserves for their body size. The incidence of sexual maturation
      in males the following breeding season was also reduced. Salmon thus appear to
      trade off the benefits of short-term restoration of fat stores prior to winter
      against long-term performance.

PMID- 11217902
TI  - Microbial diversity, producer-decomposer interactions and ecosystem processes: a
      theoretical model.
AB  - Interactions between the diversity of primary producers and that of decomposers-
      the two key functional groups that form the basis of all ecosystems--might have
      major consequences on the functioning of depauperate ecosystems. I present a
      simple ecosystem model in which primary producers (plants) and decomposers
      (microbes) are linked through material cycling. The model considers a diversity
      of plant organic compounds and a diversity of microbial species. Nutrient
      recycling efficiency from organic compounds to decomposers is then the key
      parameter that controls ecosystem processes (primary productivity, secondary
      productivity, producer biomass and decomposer biomass). The model predicts that
      microbial diversity has a positive effect on nutrient recycling efficiency and
      ecosystem processes through either greater intensity of microbial exploitation of
      organic compounds or functional niche complementarity, much like in plants.
      Microbial niche breadth and overlap should not affect ecosystem processes unless
      they increase the number of organic compounds that are decomposed. In contrast,
      the model predicts that plant organic compound diversity can only have a negative
      effect or, at best, no effect on ecosystem processes, at least in a constant
      environment. This creates a tension between the effects of plant diversity and
      microbial diversity on ecosystem functioning, which may explain some recent
      experimental results.

PMID- 11217903
TI  - Testing demographic models of effective population size.
AB  - Due to practical difficulties in obtaining direct genetic estimates of effective
      sizes, conservation biologists have to rely on so-called 'demographic models'
      which combine life-history and mating-system parameters with F-statistics in
      order to produce indirect estimates of effective sizes. However, for the same
      practical reasons that prevent direct genetic estimates, the accuracy of
      demographic models is difficult to evaluate. Here we use individual-based,
      genetically explicit computer simulations in order to investigate the accuracy of
      two such demographic models aimed at investigating the hierarchical structure of
      populations. We show that, by and large, these models provide good estimates
      under a wide range of mating systems and dispersal patterns. However, one of the
      models should be avoided whenever the focal species' breeding system approaches
      monogamy with no sex bias in dispersal or when a substructure within social
      groups is suspected because effective sizes may then be strongly overestimated.
      The timing during the life cycle at which F-statistics are evaluated is also of
      crucial importance and attention should be paid to it when designing field
      sampling since different demographic models assume different timings. Our study
      shows that individual-based, genetically explicit models provide a promising way
      of evaluating the accuracy of demographic models of effective size and delineate
      their field of applicability.

PMID- 11217904
TI  - Genealogical portraits of speciation in montane grasshoppers (genus Melanoplus)
      from the sky islands of the Rocky Mountains.
AB  - Grasshoppers in the genus Melanoplus have undergone a radiation in the 'sky
      islands' of western North America, with many species originating during the
      Pleistocene. Despite their recent origins, phylogenetic analyses indicate that
      all the species exhibit monophyletic or paraphyletic gene trees. The objectives
      of this study were to determine whether the monophyletic genealogies are the
      result of a bottleneck at speciation and to investigate the extent to which the
      different phylogenetic states of eight species (i.e. monophyletic versus
      paraphyletic gene trees) can be ascribed to the effects of speciation. A
      coalescent simulation was used to test for a bottleneck at speciation in each
      species. The effective population sizes and demographic histories of species were
      compared across taxa to evaluate the possibility that the paraphyly versus
      monophyly of the species reflects differential rates of lineage loss rather than
      speciation mode. While coalescent analyses indicate that the monophyly of
      Melanoplus species might not be indicative of bottlenecks at speciation, the
      results suggest that the paraphyletic gene trees may reflect the demography of
      speciation, involving localized divergences in the ancestral species. With
      respect to different models of Pleistocene divergence, the data do not support a
      model of founder-effect speciation but are compatible with divergence in
      allopatric refugia.

PMID- 11217905
TI  - Genetic and morphometric differentiation between island and mainland southern
      elephant seal populations.
AB  - We compare genetic (both nuclear and mitochondrial) and morphometric measures
      between two putative populations of southern elephant seal (Mirounga leonina),
      and interpret the results in the context of data from mark-recapture and
      satellite-telemetric studies. One population is on the Argentine mainland, while
      the other is 2,400 km away on South Georgia island. We found pronounced
      differentiation at the mitochondrial DNA (mtDNA) control region that was distinct
      from the pattern of variation seen among island rookeries. Some morphometric
      characters and seven out of ten nuclear-DNA markers also showed differentiation
      between the island and mainland sites. Diversity at nuclear markers was high in
      both populations but mtDNA diversity was low in the mainland population,
      suggesting a founder event and little subsequent immigration of females.
      Morphological differences may suggest different selective environments at the two
      sites.

PMID- 11217906
TI  - Alpha1-antitrypsin Pi phenotypes S and Z in Spain: an analysis of the published
      surveys.
AB  - The aim of the present study was to review published surveys on allelic
      frequencies S and Z in Spanish populations to evaluate the validity of the
      reported data. Thirty-four studies published since 1965 were retrieved by
      MEDLINE, Index Medicus and consultations with experts. The criteria for studies
      selection were (i) sample size > or = 250 individuals; (ii) alpha-1-antitrypsin
      phenotyping determination performed by means of crossed antigen-antibody
      electrophoresis or isoelectrofocusing; (iii) S and Z reported outcomes with an
      upper 95% CI smaller than mean + 2 SD, a lower 95% CI smaller than mean - 2 SD,
      and the following ratio: 100 x (95%CI upper limit - 95%CI lower limit)/allelic
      frequency, for both S and Z, included in the mean +/- 2 SD interval. Thirteen out
      of 34 surveys retrieved complied with the proposed criteria for S gene frequency
      analysis and 11 fulfilled the criteria for Z. The greatest frequency for S type
      is in the north-west of the country (149 alleles per 1000 in Galicians natives),
      while frequencies in the rest of the country are approximately 100 alleles per
      1000. The greatest frequency for Z type has been reported in newborn infants from
      Valladolid (20.8) and in a randomly selected general population of Asturias
      (19.7). In the rest of Spain, Z frequencies range from 1.5 to 15 alleles per 1000
      genes.

PMID- 11217907
TI  - In patients with chronic bronchitis a four week trial with inhaled steroids does
      not attenuate airway inflammation.
AB  - Systemic corticosteroids have been recommended as a therapeutic option in
      patients with moderate to severe COPD. In an early stage of the disease, i.e.
      chronic bronchitis with mild or no airflow obstruction, a trial with inhaled
      steroids could reveal potential benefits, particularly in terms of a modulation
      of airway inflammation. We therefore investigated the effect of inhaled
      fluticasone (1000 microg day(-1)) on markers of airway inflammation in 19
      patients with chronic bronchitis (mean+/-SEM FEV1, 83.4+/-3.0% predicted;
      FEV1/VC, 67.5+/-2.4%) in a double-blind, cross-over, placebo-controlled manner.
      Visits were performed before and after two 4-week treatment periods. separated by
      a 4-week washout period. Lung function, the concentration of exhaled nitric
      oxide, differential cell counts in induced sputum and the number of cells
      positive for iNOS, as well as the levels of LDH, ECP, neutrophil elastase and IL
      8 in sputum supernatants were determined. Although the total cell number
      decreased significantly after fluticasone (geometric mean 12.3 vs. 7.7 x
      10(6)/ml; P<0.05) it was not significantly different from the change observed
      after placebo (14.2 vs. 10.6 x 10(6)/ml; n.s.). None of the other parameters
      showed statistically significant changes after fluticasone or placebo and the
      results did not depend on the presence of airway hyperresponsiveness. We conclude
      that in patients with chronic bronchitis short-term treatment with inhaled
      corticosterids did not improve lung function or inflammatory parameters to an
      extent which was statistically significant as compared to spontaneous
      variability.

PMID- 11217908
TI  - Sensitization and exposure to pet allergens in asthmatics versus non-asthmatics
      with allergic rhinitis.
AB  - In sensitized subjects with allergic rhinitis (AR) or asthma, allergen exposure
      provokes symptoms. Among non-asthmatics with AR, an association between allergen
      sensitization, pollen season and lower airway inflammation has been demonstrated.
      Our aims were to compare AR and asthma with regard to patterns of allergen
      sensitization, the degree of airway hyperresponsiveness (AHR) and levels of
      exhaled nitric oxide (ENO). Finally, we wanted to relate our findings to previous
      or current exposure to household pets. Four hundred and thirty-one adolescents
      with different clinical phenotypes were randomly selected from a large-scale
      epidemiological survey. They were investigated with allergy screening,
      measurements of ENO and a methacholine bronchoprovocation test. Sensitization to
      pet allergens (cat, dog and horse) was associated with increased AHR and ENO both
      in asthmatics and non-asthmatics with AR. The risk of being sensitized to cat
      allergens was significantly reduced in those who had kept cats vs. those who had
      never kept them. Keeping dogs or horses did not influence the risk of being
      sensitized to the respective allergens. Only in steroid-naive, non-smoking
      asthmatics, a trend towards increased ENO in those sensitized and exposed to cat
      or dog allergens was seen. Although sensitization towards pet allergens was
      associated with inflammation in the lower airways irrespective of clinical
      phenotype, keeping pets did not increase the risk of being sensitized to pet
      allergens.

PMID- 11217909
TI  - The ACE gene polymorphism and cough threshold for capsaicin after cilazapril
      usage.
AB  - Persistent dry cough is an occasional but clinically important adverse reaction
      to angiotensin I-converting enzyme (ACE) inhibitors (ACEI). Its reported
      incidence is variable, and why cough occurs in only certain individuals has been
      unclear. An insertion/deletion (I/D) polymorphism of the ACE gene is associated
      with serum ACE activity. We have previously shown that susceptibility to cough
      induced by ACEI is associated with this polymorphism such that patients with
      genotype II are more susceptible to cough than patients with other genotypes. In
      order to confirm and extend our previous observation, we conducted a randomized,
      placebo-controlled, double-blind, cross-over study in 10 healthy volunteers with
      genotype II and 10 with genotype DD. The cough threshold was determined by the
      concentration of inhaled capsaicin causing two or more coughs. After the usage of
      an ACEI, cilazapril, for 4 weeks, changes in the cough threshold in subjects with
      genotype II [before: 6.6+/-3.7 nM (mean+/-SD); after: 5.0+/-4.6 nM] significantly
      differed from those in subjects with genotype DD (before: 9.0+/-9.4 nM; after:
      9.3+/-9.1 nM). Skin responses to intradermal bradykinin, which is a substrate of
      ACE and tussigenic, were significantly increased in subjects with genotype II
      (before: 1.6+/-0.6 vs. after: 2.6+/-0.5 cm2, P<0.05) but not in subjects with
      genotype DD (before: 1.4+/-0.5 vs. after: 1.6+/-0.6 cm2, n.s.) after usage of
      cilazapril. By contrast, skin responses to intradermal substance P did not change
      in subjects with either genotype. These findings provide further evidence of a
      link between ACEI-induced cough and I/D polymorphism of the ACE gene and suggest
      that ACEIs induce cough by modulating the tissue level of bradykinin.

PMID- 11217910
TI  - Clinical equivalence of salmeterol/fluticasone propionate in combination (50/100
      microg twice daily) when administered via a chlorofluorocarbon-free metered dose
      inhaler or dry powder inhaler to patients with mild-to-moderate asthma.
AB  - This multi-centre, randomized, double-blind, double-dummy, parallel-group study
      was designed to investigate the hypothesis of equivalent efficacy and comparable
      safety of two inhaled presentations of salmeterol/fluticasone propionate
      combination product (SALM/FP) 50/100 microg administered twice daily to patients
      with mild-to-moderate asthma for 12 weeks. The delivery systems were a 25/50
      microg strength hydrofluoroalkane (HFA) metered-dose inhaler (MDI) and a Diskus
      inhaler (50/100 microg strength). A third group received FP 100 microg twice
      daily via a chlorofluorocarbon MDI (50 microg strength). A total of 497 patients
      aged 11-79 years with reversible airways obstruction who were symptomatic on
      inhaled corticosteroid (ICS) therapy and had room for improvement in lung
      function were randomized to treatment in a double-blind, parallel-group design
      (SALM/FP MDI: n=165; SALM/FP Diskus: n=167; FP MDI: n=165) for 12 weeks. A total
      of 383 patients completed the study according to the protocol. According to the
      primary efficacy variable, increase in mean morning PEF over weeks 1-12, the two
      inhaled presentations of SALM/FP were clinically equivalent (adjusted mean
      increases 43 and 46 l min(-1); treatment difference 3 l min(-1); 95% confidence
      interval: -6 to 11 l min(-1)). Equivalence was also demonstrated by all secondary
      efficacy measures. The SALM/FP MDI was significantly superior to the FP MDI for
      increase in mean morning PEF (treatment difference 19 l min(-1); P<0.001) and for
      all secondary measures except FEV1 and symptom-free nights. There was no
      significant difference between the groups with respect to adverse events and
      serum cortisol levels. These results demonstrate that the SALM/FP 25/50 microg
      HFA MDI (two inhalations twice daily) is clinically equivalent to the SALM/FP
      50/100 microg Diskus (one inhalation twice daily). Patients switching to SALM/FP
      from other MDI-based asthma treatments may now do so without a change of delivery
      device.

PMID- 11217911
TI  - Pseudomonas aeruginosa in cystic fibrosis: cross-infection and the need for
      segregation.
AB  - Evidence-based reasons for segregation of patients colonized with Pseudomonas
      aerugionsa in the outpatient setting are unclear. To clarify local decisions,
      Pseudomonas genotyping of the local environment, patients and patient contacts
      was undertaken in 1993. The hospital environment was re-swabbed in 1997.
      Pseudomonas genotyping of old and new patients attending the North Staffordshire
      cystic fibrosis clinic has subsequently been undertaken and more recently been
      repeated on an annual basis to assess whether the same Pseudomonas genotypes can
      be found in both the environment and in patients, and whether the same
      Pseudomonas genotype can be transferred from one patient to another. No
      Pseudomonas genotype found in the local environment in 1993 or in 1997 has been
      found in any of our patients. Nine children attending the same special school for
      many years and sharing the same physiotherapy facilities showed no evidence of
      cross-infectivity. Except for siblings living in the same household our cross
      infectivity rate is very low and where cross-infection has potentially occurred
      the level of contact between these patients has been minimal. This study does not
      support the suggestion that patients with cystic fibrosis attending the North
      Staffordshire clinic and colonized with Pseudomonas aeruginosa should be
      segregated from non-colonized patients.

PMID- 11217912
TI  - Increased nitric oxide in exhaled air after intake of a nitrate-rich meal.
AB  - Exhaled and nasal NO (ENO, NNO) have been suggested as markers for inflammation
      in lower and upper respiratory tract respectively. It is still unknown how a
      number of factors, apart from airway inflammation, can influence NO levels. The
      aim of this study was to determine the effect of a nitrate-rich meal on ENO and
      NNO. Sixteen healthy subjects were observed during 1 week on normal diet before a
      nitrate-restricted diet was introduced in the next. On day 3 of the second week
      they were made to ingest a nitrate rich meal. ENO, NNO, plasma nitrate and plasma
      L-arginine were followed before the meal and afterwards for 3 h. ENO and NNO as
      well as plasma nitrate and plasma L-arginine were significantly elevated after
      the nitrate-rich meal. The median maximal increase of ENO and NNO was 47% and 13%
      respectively. We found a moderate but significant correlation between the rise in
      plasma nitrate and ENO (r(s)=0.57, P=0.027) but none between plasma nitrate and
      NNO (r(s)=-0.02, P=0.95). As nitrate in the diet seems to substantially influence
      the levels of ENO it is important either to restrict or register the intake of
      nitrate-rich food prior to measuring ENO.

PMID- 11217913
TI  - Quality of life and health-related quality of life measures.

PMID- 11217914
TI  - Re: Dose proportionality of fluticosone proportionate hydrofluoroalkane
      pressurized metered dose inhalers (pMDIS) and comparability with
      chlorofluorocarbon pMDIS.

PMID- 11217915
TI  - Critical evaluation of guidelines for the treatment of lower respiratory tract
      bacterial infections.

PMID- 11217917
TI  - CoMFA-based comparison of two models of binding site on adenosine A1 receptor.
AB  - A set of 32 N6-substituted adenosines and 22 8-substituted xanthines with
      affinity for adenosine A1 receptors was subjected to three-dimensional
      quantitative structure-affinity relationship analysis using comparative molecular
      field analysis (CoMFA). The aim was to compare two modes of binding to the
      receptor--'N6-C8' and 'N6-N7'. Good models with high predictive power and
      stability were obtained. A comparison of these models gives the following
      results: (a) Inclusion of both steric and electrostatic fields in CoMFA generates
      better predictive models compared to models based on steric or electrostatic
      fields alone. (b) The 'N6-N7' CoMFA models are slightly better than the 'N6-C8'
      ones. (c) Steric restriction exists around the N6-H in the 'N6-N7' steric field
      map, which is absent in the 'N6-C8' steric field map. This report demonstrates
      that the 'N6-N7' mode of binding is a further development of the 'N6-C8' model
      with a slightly better predictive ability and more accurate steric and
      electrostatic overlaps between agonists and antagonists.

PMID- 11217916
TI  - A search for sources of drug resistance by the 4D-QSAR analysis of a set of
      antimalarial dihydrofolate reductase inhibitors.
AB  - A set of 18 structurally diverse antifolates including pyrimethamine,
      cycloguanil, methotrexate, aminopterin and trimethoprim, and 13 pyrrolo[2,3-d
      pyrimidines were studied using four-dimensional quantitative structure-activity
      relationship (4D-QSAR) analysis. The corresponding biological activities of these
      compounds include IC50 inhibition constants for both the wild type, and a
      specific mutant type of Plasmodium falciparum dihydrofolate reductase (DHFR). Two
      thousand conformations of each analog were sampled to generate a conformational
      ensemble profile (CEP) from a molecular dynamics simulation (MDS) of 100,000
      conformer trajectory states. Each sampled conformation was placed in a 1 A cubic
      grid cell lattice for each of five trial alignments. The frequency of occupation
      of each grid cell was computed for each of six types of pharmacophore groups of
      atoms of each compound. These grid cell occupancy descriptors (GCODs) were then
      used as a descriptor pool to construct 4D-QSAR models. Models for inhibition of
      both the 'wild' type and the mutant enzyme were generated which provide detailed
      spatial pharmacophore requirements for inhibition in terms of atom types and
      their corresponding relative locations in space. The 4D-QSAR models indicate some
      structural features perhaps relevant to the mechanism of resistance of the
      Plasmodium falciparum DHFR to current antimalarials. One feature identified is a
      slightly different binding alignment of the ligands to the mutant form of the
      enzyme as compared to the wild type.

PMID- 11217918
TI  - Comparative molecular field analysis (coMFA) study of epothilones-tubulin
      depolymerization inhibitors: pharmacophore development using 3D QSAR methods.
AB  - A three-dimensional quantitative structure-activity relationship (3D QSAR) study
      has been carried out on epothilones based on comparative molecular field analyses
      (CoMFA) using a large data set of epothilone analogs, which are potent inhibitors
      of tubulin depolymerization. Microtubules, which are polymers of the a/beta
      tubulin heterodimer, need to dissociate in order to form the mitotic spindle, a
      structure required for cell division. A rational pharmacophore searching method
      using 3D QSAR procedures was carried out and the results for the epothilones are
      described herein. One-hundred and sixty-six epothilone analogs and their
      depolymerization inhibition properties with tubulin were used as a training set.
      Over a thousand molecular field energies were generated and applied to generate
      the descriptors of QSAR equations. Using a genetic function algorithm (GFA)
      method, combined with a least square approach, multiple QSAR models were
      considered during the search for pharmacophore elements. Each GFA run resulted in
      100 QSAR models, which were ranked according to their lack of fit (LOF) scores,
      with a total of 40 GFA runs having been performed. The 40 best QSAR equations
      from each run had adequate fitted correlation coefficients (R from 0.813 to
      0.863) and were of sufficient statistical significance (F value from 7.2 to
      10.9). The pharmacophore elements for epothilones were studied by investigating
      the hit frequency of descriptors (i.e. the sampling probabilities of grid points
      from the GFA studies) from the set of the 4,000 top scoring QSAR equations. By
      comparing the frequency with which each grid point appeared in the QSAR
      equations, three candidate regions in the epothilones were proposed to be
      pharmacophore elements. Two of them are completely compatible with the recent
      model proposed by Ojima et al. [Proc. Natl. Acad. Sci. USA, 96 (1999) 4256],
      however, one is quite different and is necessary to accurately predict the
      activities of all 166 epothilone molecules used in our training set. Finally, by
      visualizing the 35 most probable grid points, it was found that changes related
      to the C6, C7, C8, C 12, S20, and C21 atoms of the epothilones were highly
      correlated to their activity.

PMID- 11217919
TI  - FILO (field interaction ligand optimization): a simplex strategy for searching
      the optimal ligand interaction field in drug design.
AB  - A method (FILO, Field Interaction Ligand Optimization) for obtaining the optimal
      molecular interaction field was developed on the basis of the Simplex
      optimization procedure applied to a matrix of interaction energies obtained by
      performing a GRID computation on a suitable data set. The FILO procedure was
      tested on a set of nine HIV-1 protease inhibitors with known crystal structures.
      The results of FILO consist of the optimal molecular interaction field of a
      putative new ligand with optimal binding affinity. The final FILO model yields R2
      and R2(CV) values of 0.993 and 0.936, respectively, and finds eight negative and
      four positive interaction nodes for the OH probe taken as an example. The eight H
      bonding interactions pointed out by FILO identified well the binding site AA
      residues Gly A27, Asp A29, water 501, Gly B48 and Asp A25 of HIV-1 protease.

PMID- 11217920
TI  - Structure-toxicity relationships of polycyclic aromatic hydrocarbons using
      molecular quantum similarity.
AB  - The establishment of quantitative structure-activity relationship (QSAR) models
      for the toxicity of polycylic aromatic hydrocarbons (PAHs) is described. Two
      properties, in vitro percutaneous absorption in rat skin and discrete levels of
      carcinogenic activity, are examined using molecular quantum similarity measures
      (MQSM). The results show that MQSM produces comparable, or even better, results
      than other approaches using physicochemical, topological and quantum-chemical
      molecular descriptors. Furthermore, a careful analysis puts into evidence that
      most of the information characterized by the original descriptors is in fact
      contained in the molecular density functions, the basis of MQSM. The present
      paper, together with several other reported by our laboratory, proves that MQSM
      might be appropriate theoretical tools for QSAR and computer-aided drug design,
      comparable to other highly predictive QSAR methodologies.

PMID- 11217921
TI  - SLATE: a method for the superposition of flexible ligands.
AB  - A novel program for the superposition of flexible molecules, SLATE, is presented.
      It uses simulated annealing to minimise the difference between the distance
      matrices calculated from the hydrogen-bonding and aromaticring properties of two
      ligands. A method for generating a molecular stack using multiple pairwise
      matches is illustrated. These stacks are used by the program DOH to predict the
      relative positions of receptor atoms that could form hydrogen bonds to two or
      more ligands in the dataset. The methodology has been applied to ligands binding
      to dihydrofolate reductase, thermolysin. H3 histamine receptors, alpha2
      adrenoceptors and 5-HT1D receptors. When there are sufficient numbers and
      diversity of molecules in the dataset, the prediction of receptor-atom positions
      is applicable to compound design.

PMID- 11217923
TI  - Pharmacokinetics of the ganciclovir implant in the silicone-filled eye.
AB  - PURPOSE: Ganciclovir (GCV) implants are highly effective in delaying the
      progression of cytomegalovirus (CMV) retinitis. Rhegmatogenous retinal
      detachments can occur in untreated eyes with CMV retinitis or in eyes treated
      with anti-CMV therapy, which may include placement of a GCV implant. The clinical
      management of CMV retinitis and associated retinal detachment often involves the
      concurrent use of silicone oil and GCV implants. The authors investigated the
      effect of silicone oil tamponade on intravitreal drug levels achieved with the
      GCV implant. METHODS: The authors performed gas compression vitrectomy in the
      right eyes of 29 New Zealand white rabbits. They then inserted a 5-mg GCV implant
      into the vitreous cavity through an inferotemporal sclerotomy. Saline (1 cc),
      silicone oil 0.5 cc, or silicone oil 1.0 cc was then injected into the
      midvitreous cavity of 9, 8, and 12 rabbits, respectively. On postoperative days
      21, 42, and 70, the rabbits were killed and the right eyes were immediately
      collected and stored at -70 degrees C until all samples were obtained. Vitreous
      was then isolated and drug levels were determined by high-pressure liquid
      chromatography. RESULTS: Vitreous GCV levels at days 21 and 42 were similar in
      both the saline-filled and silicone oil-filled eyes. At day 70, GCV levels in
      both the saline- and silicone-filled eyes were statistically significantly lower
      than at day 21 (P < 0.05 for all groups). In addition, at day 70, GCV levels in
      the saline-filled eyes were significantly lower than in silicone-filled eyes
      (saline versus 0.5 cc oil, P = 0.01; saline versus 1 cc oil, P = 0.09).
      CONCLUSIONS: Effective GCV levels are maintained in the aqueous phase of the
      vitreous cavity of eyes with silicone oil tamponade. Ganciclovir levels may be
      maintained longer in eyes with silicone oil tamponade than in those without.
      These results support the use of combined GCV implants and silicone oil tamponade
      in patients with CMV retinitis and associated retinal detachment.

PMID- 11217922
TI  - Immune recovery vitritis and uveitis in AIDS: clinical predictors, sequelae, and
      treatment outcomes.
AB  - PURPOSE: To determine 1) clinical predictors of an inflammatory syndrome
      associated with cytomegalovirus (CMV) retinitis (immune recovery vitritis or
      uveitis [IRV or IRU]); 2) clinical sequelae of IRV; and 3) the effect of
      corticosteroid treatment on visual acuity. METHODS: A cohort study from the AIDS
      Ocular Research Unit of the University of California, San Diego, and a case
      series from the Cleveland Clinic consisted of patients who had acquired
      immunodeficiency syndrome and inactive CMV retinitis who responded to highly
      active antiretroviral therapy (HAART) with CD4 T-lymphocyte levels >60 cells/mm3.
      The cohort was followed for a median of 13.5 months following increase in CD4
      count. The authors studied the occurrence of IRV, defined as symptomatic (vision
      decrease and/or floaters) vitritis of 1+ or greater severity associated with
      inactive CMV retinitis. Macular edema or epiretinal membrane formation was
      determined by clinical examination and fluorescein angiography. Five eyes were
      treated with sub-Tenon corticosteroid injections. RESULTS: In the cohort study,
      19 (63%) of 30 HAART responders developed IRV (26 eyes). The clinical spectrum of
      inflammation included vitritis, papillitis, macular edema, and epiretinal
      membranes. Eyes with CMV surface area >30% of the retina were at the highest risk
      (relative risk = 4.5) of developing IRV (P = 0.03). During follow-up,
      inflammation persisted without treatment for a median of 20 weeks and 14 patients
      (16 eyes) developed macular changes. Treatment resulted in vision improvement
      without reactivation of retinitis. Histology and immunohistochemistry of
      associated epiretinal membranes showed evidence of chronic inflammation with a
      predominant T-lymphocyte cell population. In the case series, 3 (38%) of 8 HAART
      responders developed IRV (4 eyes). All four eyes were treated and resulted in
      visual acuity improvement of one line. CONCLUSIONS: Symptomatic IRV or IRU
      develops in a significant number of patients with CMV retinitis following
      successful HAART. Eyes with CMV surface area >30% of the retina are at the
      greatest risk. Eyes with IRV respond favorably to antiinflammatory therapy
      without reactivation of retinitis. Immune recovery vitritis may be the result of
      an immunologic reaction to latent CMV antigens in the eye in which T-lymphocytes
      play a role.

PMID- 11217924
TI  - Surgery for idiopathic macular holes associated with extensive subretinal fluid.
AB  - PURPOSE: To study the baseline characteristics and outcomes of surgery for
      idiopathic macular holes associated with localized macular detachment. METHODS:
      In this case-control study, eight consecutive patients with idiopathic macular
      hole associated with localized macular detachment (cases) and 30 randomly
      selected patients with idiopathic macular hole not associated with macular
      detachment underwent macular hole surgery. RESULTS: The mean age (62.1 versus
      68.2 years; P = 0.086), mean refractive error (-0.13 versus +0.23 diopters; P =
      0.68), average duration of symptoms (5.9 versus 4.6 months; P = 0.47), and
      macular hole stage (P = 0.43) were similar in the cases and controls. The
      baseline visual acuity ranged from 20/50-20/80 (1 [13%] versus 1 [3%]) to 20/100
      20/200 (2 [25%] versus 24 [80.0%]) to < 20/200 (5 [63%] versus 5 [17%]) (P =
      0.10). Single-operation anatomic success was achieved in 2 (25%) cases and 24
      (80%) controls (P = 0.007). Visual acuity 3 months after the last macular hole
      surgery was worse in cases compared to controls: > or = 20/40 in 0 versus 6
      (20%), 20/50-20/80 in 1 (13%) versus 13 (43%), 20/100-20/200 in 4 (50%) versus 10
      (33%), and < 20/200 in 3 (38%) versus 1 (3%) (P = 0.003). The mean improvement in
      visual acuity was 0.2 logMAR units in cases versus 0.4 logMAR units in controls
      (P = 0.054). CONCLUSIONS: Surgical outcomes for idiopathic macular hole
      associated with a localized macular detachment compare poorly with the outcomes
      for macular hole not associated with extensive surrounding subretinal fluid.

PMID- 11217925
TI  - Endoscopic vitreoretinal surgery for complicated proliferative diabetic
      retinopathy.
AB  - PURPOSE: To evaluate the indication for endoscopic vitreoretinal surgery in
      proliferative diabetic retinopathy (PDR). METHODS: Chart review of consecutive
      cases of vitreoretinal surgery for PDR performed by one of the authors (Y.L.F.)
      over a 2-year period. RESULTS: Endoscopic vitreoretinal surgery was performed in
      8 of 41 (19.5%) eyes. The surgical indications were small pupil (3), hyphema (3),
      pseudophakia with fibrotic posterior capsule (1), and pars plana
      neovascularization with anterior tractional retinal detachment (6). CONCLUSION:
      Endoscopic vitreoretinal surgery, by enhancing the visualization of the
      retroirideal space, is a useful technique in PDR with opaque ocular media and/or
      neovascularization of the pars plana and ciliary body.

PMID- 11217927
TI  - Familial primary pulmonary hypertension and associated ocular findings.
AB  - BACKGROUND: Familial primary pulmonary hypertension (PPH) is a rare, fatal,
      autosomal dominant disease that results in right heart failure from idiopathic
      obliteration of the pulmonary arteries. Patients develop stagnation of venous
      blood flow and elevated venous pressure. METHODS: The authors retrospectively
      reviewed the clinical records of three patients diagnosed with PPH that was
      confirmed on the basis of physical examination, chest X-ray, electrocardiogram,
      and echocardiogram. Cardiac catheterization excluded cardiac shunt and other
      secondary causes of pulmonary hypertension. RESULTS: Two patients presented with
      a clinical picture resembling venous stasis retinopathy, and one with bilateral
      choroidal detachments. Two patients had delayed choroidal filling on fluorescein
      angiography, which was confirmed in one patient with indocyanine green
      videoangiography. CONCLUSIONS: Elevated venous pressure found in PPH is
      responsible for the delayed choroidal perfusion and the reduced venous blood
      outflow. This explains the clinical findings of venous stasis retinopathy and
      choroidal detachments seen in these patients.

PMID- 11217926
TI  - Matrix metalloproteinases in human diabetic and nondiabetic vitreous.
AB  - PURPOSE: To compare matrix metalloproteinase (MMP) activities in human vitreous
      samples from patients with diabetic retinopathy (DR) and other vitreoretinal
      diseases, and to investigate the factors influencing the MMP activities in human
      DR vitreous samples. METHODS: Thirty-one diabetic and 17 nondiabetic vitreous
      samples (from nine patients with macular holes and eight patients with epiretinal
      membranes) were examined. Samples collected at the time of pars plana vitrectomy
      were subjected to substrate zymography to conduct a quantitative analysis of MMP
      activity. Immunoblotting against antihuman MMP-1, 2, and 9 was performed to
      identify MMP in vitreous samples. The effects of posterior vitreous detachment
      (PVD), vitreous hemorrhage, proliferative membrane, traction detachment, and
      cystoid macular edema on MMP activities were investigated. RESULTS: All vitreous
      samples from both DR and non-DR patients showed a single band at the position of
      72 kD, corresponding to MMP-2. Another band at 99 kD, corresponding to MMP-9, was
      detected significantly more often in DR samples than in non-DR samples: 45.2% and
      0%, respectively (P = 0.0007). The number of samples showing a band from MMP-9
      was significantly higher in partial PVD samples than in complete PVD samples:
      66.7% and 15.4%, respectively (P = 0.001). CONCLUSION: The results indicated that
      MMP-9 may be involved in DR and that partial PVD may be related to the MMP-9
      activity in DR.

PMID- 11217928
TI  - Choroidal granulomas in systemic sarcoidosis.
AB  - PURPOSE: To evaluate the clinical course, including response to therapy, of
      patients with macular and peripapillary choroidal granulomas secondary to
      systemic sarcoidosis. METHODS: This is a retrospective case study and literature
      review. Nine patients with choroidal granulomas were identified. Eight patients
      had a tissue biopsy confirming sarcoidosis; one was diagnosed from clinical
      history and typical gallium scan. Ocular examinations included fundus
      examination, fluorescein angiography, and visual field examination. Eight
      patients had magnetic resonance imaging (MRI) scans looking for intracranial
      granulomas. Treatment consisted of oral prednisone in eight patients (one with
      concomitant subconjunctival triamcinolone); one patient received no treatment
      because of good vision and granuloma in the nasal retina. Variables studied
      included visual acuity (VA), response of granulomas to treatment, time to
      recurrence, and associated anterior segment findings. RESULTS: Eight of nine
      patients had a solitary lesion whereas one had multifocal involvement. The
      granulomas ranged in size from one half to four disk diameters. Eight patients
      had blurry vision; one was asymptomatic. All nine patients had hilar adenopathy
      and/or pulmonary parenchymal disease. No patient had nonocular neurologic
      symptoms and in eight patients who underwent MRI examination no intracranial
      granulomas were detected. Of the eyes that were treated (n = 8) all had decrease
      in the size of the choroidal mass at an average of 4 months of treatment. Two had
      complete resolution. Mean follow-up was 29.2 months. At the time of initial
      diagnosis only one patient had an active anterior uveitis. Five of nine patients
      had at least one recurrence. Mean time to recurrence was 7.6 months after
      discontinuing oral prednisone. The VA at presentation ranged from 20/30 to
      20/300. Final VA was 20/30 or better in all patients. CONCLUSIONS: Choroidal
      granulomas related to systemic sarcoidosis respond well to oral corticosteroids.
      They may recur but good vision can be maintained. They are not typically
      associated with concomitant iritis and also do not appear to be associated with
      intracranial granulomas.

PMID- 11217929
TI  - Methylprednisolone concentrations in the vitreous and the serum after pulse
      therapy.
AB  - PURPOSE: Intravenous (i.v.) pulse of corticosteroids has been used to treat
      severe eye inflammation from different origins. Whether such large doses result
      in vitreous levels that differ either in magnitude or duration from more
      conventional corticotherapy remain unsolved issues. The authors therefore
      determined levels of methylprednisolone hemisuccinate and methylprednisolone in
      the vitreous and serum of patients at different times after a single i.v.
      perfusion of methylprednisolone hemisuccinate. METHODS: Fifty patients scheduled
      for a first vitrectomy received an i.v. injection of 500 mg hemisuccinate
      methylprednisolone at different times before surgery (from 15-24 hours). Patients
      were divided into two groups: those with (n = 21) and without (n = 29) retinal
      detachment (RD). Pure vitreous samples were analyzed by high-pressure liquid
      chromatography. RESULTS: Both the ester and the nonester methylprednisolone forms
      were sampled in the vitreous, showing a slower rate of hydrolysis compared to the
      serum. On average, the highest concentration of total methylprednisolone in the
      vitreous was found at 2.5 hours and rapidly decreased for the group of patients
      with RD. In the group of patients without RD, the highest concentration was
      reached at 6 hours and then slowly decreased. The antiinflammatory potency in the
      nondetached retina eyes was approximately 500 times more than in the physiologic
      vitreous, but despite the route of administration (i.v. or oral), only 1/10 of
      the corticosteroid serum concentration was measured in the vitreous. CONCLUSION:
      High concentration of methylprednisolone is achieved by i.v. pulse therapy
      without changing the kinetic of entry in the vitreous of nondetached retina eyes
      when compared to conventional oral corticotherapy. Hydrolysis occurs in the
      vitreous resulting in high rate of active form. Pulse therapy could be considered
      in cases of severe ocular inflammation involving the posterior segment of the
      eye.

PMID- 11217930
TI  - Retinal fixation of traumatic retinal detachment with metallic tacks: a case
      report with 10 years' follow-up.
AB  - BACKGROUND: Retinal rupture and detachment caused by traumatic ocular perforation
      has a poor prognosis without extensive repair procedures. The authors describe
      the phases of treatment of a complex injury in a 21-year-old man with a traumatic
      retinal rupture in whom metallic tacks were used for retinal fixation. The report
      does not include histopathology. METHODS: Observational case report and
      literature review. The outcome of a 10-year follow-up is evaluated at the latest
      visit by determining the visual acuity (VA) and by observing the state of retina
      and tacks. RESULTS: A traumatic retinal rupture with detachment was treated with
      titanium tacks for retinal fixation. By inserting a total of 13 metallic tacks
      for the repair of a temporal postequatorial retinal rupture and adjacent retinal
      detachment a successful outcome was achieved. Two additional operations were
      performed to reattach the retina of nasal hemisphere in the same eye. One
      dislodged tack was removed at the final operation. Ten years later, at the last
      intervention, VA was 12/20 in the injured eye. The retina was completely
      attached, and the remaining 12 tacks were in place, although six of them were
      partially pushed up by an encircling band. Proliferative vitreoretinopathy (PVR)
      was absent, and a relatively narrow circumferential zone of scar tissue adjacent
      to the row of tacks was visible. The patient occasionally experienced glare in
      the affected eye, but was otherwise symptom-free. CONCLUSION: Reports of long
      term experiences with mechanical retinal refixation with metallic tacks are
      scarce. Especially in extended use, the tacks are claimed to cause several
      complications, including PVR. Although modern ophthalmic surgery offers a variety
      of methods for retinal reattachment, the complexity of the damage caused by
      trauma may lead to a dead end in refixation attempts. Nevertheless, retinal tacks
      may represent an adjunctive remedy in complex retinal detachment cases.

PMID- 11217931
TI  - Retinal thickness measurements with optical coherence tomography and the scanning
      retinal thickness analyzer.
AB  - PURPOSE: To assess the reproducibility of retinal thickness measurements in
      normal subjects and to compare foveal thickness using optical coherence
      tomography (OCT) and the scanning retinal thickness analyzer (RTA). METHODS: Two
      examiners performed foveal thickness measurements in 24 eyes of 12 healthy
      subjects using both OCT and the scanning RTA. Intraclass correlation coefficients
      (ICC) (intra-examiner and inter-examiner) were calculated for the paired foveal
      thickness measurements obtained with each instrument. RESULTS: The average foveal
      thicknesses measured with OCT and the scanning RTA were 155.1 +/- 14.9 microm and
      107.8 +/- 18.6 microm, respectively. The intra-examiner ICCs from the two
      sessions using the OCT and the scanning RTA were 0.99 and 0.78 and 0.89 and 0.99,
      respectively. The inter-examiner ICCs of the OCT and the scanning RTA were 0.99
      and 0.99, respectively. There was a significant correlation between the foveal
      thickness measurements with these two instruments (R2 = 0.629, P < 0.0001).
      CONCLUSION: The foveal thicknesses measured using OCT and the scanning RTA in
      healthy subjects agreed with the previously reported data on foveal thickness.
      Both instruments can reproducibly quantitate foveal thickness.

PMID- 11217932
TI  - Diagnostic and therapeutic challenges.

PMID- 11217933
TI  - Bilateral prepapillary loops with unilateral branch retinal artery occlusion
      following thrombus at the loop apex.

PMID- 11217934
TI  - Purtscher's retinopathy secondary to airbag injury.

PMID- 11217935
TI  - Surgical removal of a laser-induced choroidal neovascular membrane.

PMID- 11217936
TI  - Visual recovery from macular phototoxic injury following cataract surgery.

PMID- 11217937
TI  - Sector retinitis pigmentosa with bitemporal visual field defects and macular
      hole.

PMID- 11217938
TI  - Bilateral ocular ischemic syndrome in Takayasu disease.

PMID- 11217939
TI  - Epipapillary adenoma of retinal pigment epithelium.

PMID- 11217940
TI  - Optical coherence tomography and electrophysiology in X-linked juvenile
      retinoschisis associated with a novel mutation in the XLRS1 gene.

PMID- 11217941
TI  - Diabetic papillopathy with macular star mimicking clinically significant diabetic
      macular edema.

PMID- 11217942
TI  - Surgical management of combined traction and rhegmatogenous retinal detachment
      associated with persistent fetal vasculature.

PMID- 11217943
TI  - Central retinal vein occlusion associated with primary pulmonary hypertension.

PMID- 11217944
TI  - Neovascularization associated with cytomegalovirus retinitis.

PMID- 11217945
TI  - Retinal and choroidal vascular changes in heterozygous Fabry disease.

PMID- 11217946
TI  - A case of Alport's syndrome and retinal degeneration.

PMID- 11217947
TI  - Early versus late removal of retained intraocular foreign bodies.

PMID- 11217948
TI  - Fungal endophthalmitis after a single intravenous administration of presumably
      contaminated dextrose infusion fluid.

PMID- 11217949
TI  - Occurrence of retinoblastoma and uveal melanoma in the same period.

PMID- 11217950
TI  - Surgical techniques double-bent needle for intraocular injection.

PMID- 11217951
TI  - Fiberoptic illuminator assisted conventional retinal detachment surgery.

PMID- 11217952
TI  - Synthesis of novel ganglioside GM4 analogues containing N-deacetylated and
      lactamized sialic acid: probes for searching new ligand structures for human L
      selectin.
AB  - Novel ganglioside GM4 analogues, which contain N-deacetylated or lactamized
      sialic acid instead of usual N-acetylneuraminic acid, were synthesized in a
      highly efficient manner. (Methyl 4,7,8,9-tetra-O-acetyl-3,5-dideoxy-5
      trifluoroacetamido-D-glycero-alpha-D-galacto-2-nonulopyranosylonate)-(2-->3)-4,6
      di-O-acetyl-2-O-benzoyl-D-galactopyranosyl trichloroacetimidate was coupled with
      2-(tetradecyl)hexadecanol to give the desired beta-glycoside in high yield.
      Successive O- and N-deacylation, and saponification of the methyl ester group
      afforded the N-deacetylated sialyl derivative that was converted by treatment
      with 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride in Me2SO into
      the lactamized sialic acid-containing ganglioside GM4 analogue.

PMID- 11217953
TI  - The occurrence of internal (1 --> 5)-linked arabinofuranose and arabinopyranose
      residues in arabinogalactan side chains from soybean pectic substances.
AB  - CDTA-extractable soybean pectic substances were subjected to enzymatic digestion
      with arabinogalactan degrading enzymes yielding a resistant polymeric pectic
      backbone and arabino-, galacto-, and arabinogalacto-oligomers. The complex digest
      was fractionated using size-exclusion chromatography. Monosaccharide composition
      analysis, HPAEC fractionation and MALDI-TOF MS analysis of the resulting
      fractions showed that each contained a mixture of oligosaccharides of essentially
      the same degree of polymerisation, composed of only arabinose and galactose.
      MALDI-TOF MS analysis was used for molecular mass screening of oligosaccharides
      in underivatised HPAEC fractions. The monosaccharide sequence and the branching
      pattern of oligosaccharides (degree of polymerisation from 4 to 8) were
      determined using linkage analysis and ES-CID tandem MS analysis of the per-O
      methylated oligosaccharides in each of the HPAEC fractions. These analyses
      indicated the presence of common linear (1 --> 4)-linked galacto
      oligosaccharides, and both linear and branched arabino-oligosaccharides. In
      addition, the results unambiguously showed the presence of oligosaccharides
      containing (1 --> 4)-linked galactose residues bearing an arabinopyranose residue
      as the non-reducing terminal residue, and a mixture of linear oligosaccharides
      constructed of (1 --> 4)-linked galactose residues interspersed with an internal
      (1 --> 5)-linked arabinofuranose residue. The consequences of these two new
      structural features of pectic arabinogalactan side chains are discussed.

PMID- 11217954
TI  - Reactivity of some sugars and sugar phosphates towards gold(III) in sodium
      acetate-acetic acid buffer medium.
AB  - The kinetics of the oxidation of some aldoses and aldose phosphates have been
      studied spectrophotometrically in sodium acetate-acetic acid buffer medium at
      different temperatures. The reactions are first order with respect to [Au(III)]
      and [substrate]. Both H+ and Cl- ions retard the reaction. The reactions appear
      to involve different gold(III) species, viz. AuCl4-, AuCl3(OH2) and AuCl3(OH)- .
      The results are interpreted in terms of the probable intermediate formation of
      free radicals and Au(II). Aldoses react with gold(III) in the order: triose >
      tetrose > pentose > hexose. The sugar phosphates react with gold(III) at a faster
      rate than the parent sugars except glucose-1-phosphate, which reacts at slower
      rates than glucose. A tentative reaction mechanism leading to the formation of
      products has been suggested.

PMID- 11217955
TI  - Complexation of trivalent lanthanide cations by galactitol in the solid state.
      The crystal structure and an FT-IR study of 2NdCl3.galactitol.14H2O.
AB  - The crystal structure of 2NdCl3.galactitol.14H2O has been determined. The crystal
      system is triclinic, space group: -1, with unit-cell dimensions: a = 9.736(2), b
      = 10.396, c = 8.027 A; alpha = 108.05(3), beta = 92.68(3), gamma = 88.44(3)
      degrees, V= 771.6(3) A3, Z = 2. Each Nd atom is coordinated to nine oxygen atoms,
      three from the alditol and six from water molecules, with Nd-O distances from
      2.461 to 2.552 A. The seventh water molecule is hydrogen-bonded by the hydroxyl
      hydrogen on O-1 (O-1-H-ll...O-10, 2.639 A). The FT-IR spectra of
      2NdCl3.galactitol.14H2O and 2PrCl3.galactitol.14H2O are analogous, and show that
      Pr and Nd have the same coordination mode. The IR results are consistent with the
      crystal structures.

PMID- 11217956
TI  - Systematic analysis of oxidative degradation of polysaccharides using PAGE and
      HPLC--MS.
AB  - Oxidation of polysaccharides yields hydroxyaldehydes and hydroxycarboxylic acids.
      Aldehydes and carboxylic acids were separately conjugated to 8-aminonaphthalene
      1,3,6-trisulfonic acid (ANTS) or tyrosine t-butyl ester (TBT). The ANTS-labeled
      derivatives were separated by molecular size on PAGE gels and detected by
      fluorescence. TBT-labeled derivatives were separated by reverse phase
      chromatography on a C18-HPLC column and analyzed by positive ion electrospray
      mass spectroscopy (HPLC--MS). This combination of procedures allowed a systematic
      analysis of carbohydrate oxidation products.

PMID- 11217957
TI  - Studies on the synthesis of 1,2-cis pentofuranosides from S-glycofuranosyl
      dithiocarbamates, dithiocarbonates and phosphorodithioates.
AB  - The selectivity in the synthesis of 1,2-cis glycofuranosides from
      dithiocarbonates, dithiocarbamates and phosphorodithioates is improved by
      combined use of silver triflate and catalytic amount of hexamethylphosphoramide
      (HMPA) under mild conditions.

PMID- 11217958
TI  - X-ray diffraction and high-resolution NMR spectroscopic analysis of 2,4,7,8-tetra
      O-acetyl-3-deoxy-alpha-D-manno-2-octulopyranosono-1,5-lactone.
AB  - The X-ray diffraction and high-resolution 1H and 13C NMR spectral data are
      reported for 2,4,7,8-tetra-O-acetyl-3-deoxy-alpha-D-manno-2-octulopyranosono-1,5
      lactone.

PMID- 11217959
TI  - TEMPO-mediated oxidation of maltodextrins and D-glucose: effect of pH on the
      selectivity and sequestering ability of the resulting polycarboxylates.
AB  - Maltodextrins were oxidized to polyglucuronic acids with the ternary oxidation
      system: NaOCl-NaBr-2,2,6,6-tetramethylpiperidine-l-oxyl (TEMPO). The
      chemoselective oxidation at the primary alcohol groups was shown to be strongly
      pH dependent. Oxidation of polysaccharides was best achieved at pH 9.5 in order
      to minimize depolymerization, whereas oxidation of oligosaccharides required
      stronger alkaline conditions (pH 11-11.5). The resulting sodium polyglucuronates
      present interesting sequestering properties, the best of which being obtained
      from maltodextrins with the highest degrees of polymerization. The same oxidation
      process allowed the convenient conversion of D-glucose to D-glucaric acid in high
      yield (> 90%), under strongly basic conditions (pH > 11.5).

PMID- 11217960
TI  - Synthesis of 2-deoxy-2,3-didehydro-N-acetylneuraminic acid analogues modified at
      the C-4 and C-9 positions and their behaviour towards sialidase from influenza
      virus and pig liver membrane.
AB  - The synthesis of novel 2-deoxy-2,3-didehydro-N-acetylneuraminic acid analogues
      structurally varied at C-4 and C-9 by transformation from versatile key
      intermediates and their inhibitory activity against sialidase from influenza
      virus A and pig liver membrane are described.

PMID- 11217961
TI  - Contribution of the anomeric effect to the solution and crystal structure of
      [1S,2S,6S,7s]-1,6-diaza-4,9-dioxa-2,7-dimethoxycarbonylbicyclo[4.4.1]undecane, a
      condensation product of L-serine methyl ester with formaldehyde.
AB  - The reaction of L-serine methyl ester hydrochloride (1) with paraformaldehyde (2)
      in dichloromethane in the presence of triethylamine afforded a novel compound:
      [lS,2S,6S,7S]-1,6-diaza-4,9-dioxa-2,7-dimethoxycarbonylbicyclo[4.4.1]undecane (4)
      as a 2:3 adduct of 1 with 2. 1H and 13C NMR spectroscopy were unable to
      discriminate between two possible symmetrical structures. The latter was
      unambiguously proved by X-ray crystallography. The crystal structure established:
      (i) the existence of two identical seven-membered rings each containing a N-C-O
      grouping; (ii) the existence of a long C-O-C-N-C-N-C-O-C sequence in which each
      nitrogen belongs simultaneously to a N-C-O (oxazolidine) and to a N-C-N (aminal)
      motifs; (iii) the existence of a chair-like conformation for both seven-membered
      rings; (iv) the antiperiplanar geometry of pN-C-O and consequently the
      manifestation of a strong anomeric effect in both N-C-O groupings, whereas
      anomeric effect was virtually absent in the N-C-N sequence, as corroborated by
      bond distances and bond angles. Chemical shifts, coupling constants and NOE
      effects confirm that the conformational features of 4 are preserved in solution.

PMID- 11217962
TI  - Acid-catalyzed dehydrative cyclization of 4-(D-galacto -pentitol-1-yl)-2-phenyl
      2H-1,2,3-triazole. synthesis and anomeric configuration of D-lyxo-C-nucleoside
      analogs.
AB  - Dehydration of 4-(D-galacto-pentitol-1-yl)-2-phenyl-2H-1,2,3-triazole with 20%
      methanolic sulfuric acid afforded the anomeric pairs of nucleosides, 4-(alpha-D
      lyxopyranosyl)-2-phenyl-2H-1,2,3-triazole (major component) and its beta-anomer,
      as well as 4-(alpha-D-lyxofuranosyl)-2H-1,2,3-triazole and its beta-anomer. The
      four anomeric C-nucleosides were separated by chromatography, and their structure
      and anomeric configuration were determined by periodate oxidation, acylation, and
      NMR spectroscopy as well as mass spectrometry. The anomeric assignment from
      optical rotation was not in agreement with final structure assignment and
      represented a violation of the Hudson isorotation rules. NOE studies and X-ray
      diffraction measurements confirmed the anomeric configuration.

PMID- 11217963
TI  - Biosynthesis of lactosamine in bovine mammary gland.
AB  - Lactosamine (beta-D-Galp-(1-->4)-D-GlcN) was isolated from bovine milk sampled
      after intravenous infusion of glucosamine through the jugular vein of a lactating
      cow. The chemical structure was established by 2D NMR spectroscopy and
      electrospray ionisation mass spectrometry (ESIMS). Selected ion monitoring liquid
      chromatography-mass spectrometry (SIMLC-MS) of the perbenzoylated carbohydrate
      fraction showed the presence of the novel disaccharide in the milk sample after
      infusion, but not in the control bovine milk sample. The results showed the
      uptake of glucosamine in bovine mammary gland, and also indicated that a part of
      glucosamine was metabolised to the product lactosamine.

PMID- 11217964
TI  - Syntheses of the L-manno and some other analogs of the terminal determinants of
      the O-PS of Vibrio cholerae O:1.
AB  - Analogs of the methyl alpha-glycosides of the terminal residues of the O-specific
      polysaccharides (O-PS) of Vibrio cholerae O:1, serotype Inaba and Ogawa, have
      been prepared as probes to study their interaction with anti V. cholerae O:1
      antibodies. They differ from the termini of the respective O-PSs in anomeric or
      absolute configuration of perosamine, position of the O-methyl group in D
      perosamine, and nature of the N-acyl side chain.

PMID- 11217965
TI  - Expression and action pattern of Botryotinia fuckeliana (Botrytis cinerea)
      rhamnogalacturonan hydrolase in Pichia pastoris.
AB  - The cDNA sequence coding for the complete rhamnogalacturonan hydrolase (RGase) of
      Botryotinia fuckeliana (Botrytis cinerea) was introduced into Pichia pastoris and
      expressed under the control of the alcohol oxidase promoter. The RGase was
      secreted into the medium of the yeast driven by the alpha-factor secretion
      peptide and could be purified using the C-terminal His6-tag fusion. RGase
      activity was measured using a traditional reducing end assay with linseed
      rhamnogalacturonan (RG) as the substrate, or with an assay using a fluorescent RG
      oligomer as the substrate and detection and identification of hydrolysis products
      by capillary zone electrophoresis (CZE). Both methods showed the recombinant
      enzyme to have a specific activity of about ten units per milligram of protein.
      Since the CZE method allows identification of the hydrolysis products, it was
      used to show that the RGase lacks a multiple attack mechanism and needs at least
      five GalA-Rha repeating disaccharides to be active. This finding is contrary to
      the action pattern of the native RGase of Aspergillus aculeatus which has the
      same substrate length requirement, but exhibits multiple attack, leading to
      products containing only two and three Rha-GalA repeat units without the
      appearance of intermediate sized fragments. No plant cell wall degrading enzymes
      were detected in the culture medium of un-transformed P. pastoris, thus the
      recombinant enzyme, devoid of extraneous activities, can be applied for fine
      structural studies on cell walls.

PMID- 11217966
TI  - Structural studies of the O-specific polysaccharide of Vibrio cholerae O8 using
      solvolysis with triflic acid.
AB  - The O-specific polysaccharide (OPS) of Vibrio cholerae 08 was isolated by mild
      acid degradation of the lipopolysaccharide and studied by two-dimensional NMR
      spectroscopy, including NOESY and heteronuclear multiple-bond correlation (HMBC)
      experiments. The OPS was found to have a tetrasaccharide repeating unit with the
      following structure: --> 4)-beta-D-Glcp NAc3NAcylAN-(1 --> 4)-beta-D-Manp
      NAc3NAcAN-(1 --> 4)-alpha-L-Gulp NAc3NAcA-(1 --> 3) -beta-D-QuipNAc4NAc-(1 -->
      where QuiNAc4NAc is 2,4-diacetamido-2,4,6-trideoxyglucose, GlcNAc3NAcylAN is 2
      acetamido-3-(N-formyl-L-alanyl)amino-2,3-dideoxyglucuronamide, ManNAc3NAcAN is
      2,3-diacetamido-2,3-dideoxymannuronamide, and GulNAc3NAcA is 2,3-diacetamido-2,3
      dideoxyguluronic acid. The OPS was stable towards acid hydrolysis and solvolysis
      with anhydrous hydrogen fluoride, but could be cleaved selectively with
      trifluoromethanesulfonic (triflic) acid by the glycosidic linkages of beta
      QuiNAc4NAc and alpha-GulNAc3NAcA. The structures of the oligosaccharides obtained
      that were elucidated by electrospray ionization (ESI) MS and NMR spectroscopy,
      confirmed the OPS structure.

PMID- 11217967
TI  - Polysaccharides of green Arabica and Robusta coffee beans.
AB  - Two independent procedures for the quantitative determination of the
      polysaccharide content of Arabica Caturra (Coffea arabica var. Caturra) and
      Robusta ROM (Coffea canephora var. ROM) green coffee beans showed that they both
      contained identical amounts of polysaccharide. Cell wall material (CWM) was
      prepared from the beans and partial solubilisation of component polysaccharides
      was effected by sequential extraction with water, 1 M KOH, 0.3% NaClO2, 4 M KOH
      and 8 M KOH. The monosaccharide compositions of the CWMs were similar, although
      Arabica beans contained slightly more mannose than Robusta. In the latter, more
      arabinogalactan was solubilised during preparation of the CWM and the water
      soluble fraction of the CWM contained higher amounts of galactomannan than in
      Arabica. Linkage analysis indicated that the galactomannans possessed unbranched
      to branched mannose ratios between 14:1 and 30:1 which is higher than previously
      reported. No major difference in the structural features of the galactomannans
      between species was found. The arabinogalactans were heterogeneous both with
      regard to the degree of branching and the degree of polymerisation of their
      arabinan side-chains. Compared to Arabica, Robusta appeared to contain greater
      amounts of arabinogalactans with longer side chains. It is concluded that there
      was no detectable difference between the Arabica and Robusta varieties of this
      study in their absolute polysaccharide content or in the gross structural
      features of their galactomannans. Differences were apparent both in the
      structural features and ease of solubility of the arabinogalactans but a more
      detailed study of several varieties of Arabica and Robusta will be required to
      determine whether these differences occur consistently between species.

PMID- 11217968
TI  - Studies toward the site specific incorporation of sugars into proteins: synthesis
      of glycosylated aminoacyl-tRNAs.
AB  - A series of glycosylated serine derivatives was synthesized from peracetylated
      sugars and Fmoc-protected serine; these were chemically esterified with the tris
      (tetrabutylammonium) salt of pdCpA. The fully protected and deprotected
      glycosylated aminoacyl pdCpAs were ligated enzymatically to an abbreviated tRNA
      (tRNA-C(OH)) to provide the title compounds that are key intermediates in the
      elaboration of glycoproteins using readthrough of a nonsense codon.

PMID- 11217969
TI  - Syntheses and reactions of 5-O-acetyl-1,2-anhydro-3-O-benzyl-alpha-D-ribofuranose
      and beta-D-lyxofuranose, 5-O-acetyl-1,2-anhydro-3,6-di-O-benzyl- and 1,2-anhydro
      5,6-di-O-benzoyl-3-O-benzyl-beta-D-mannofuranose, and 6-O-acetyl-1,2-anhydro-3,4
      di-O-benzyl-alpha-D-glucopyranose and -beta-D-talopyranose.
AB  - The title compounds 5-O-acetyl-1,2-anhydro-3-O-benzyl-alpha-D-ribofuranose and 5
      O-acetyl-1,2-anhydro-3-O-benzyl-beta-D-lyxofuranose, and 6-O-acetyl-1,2-anhydro
      3,4-di-O-benzyl-alpha-D-glucopyranose and 6-O-acetyl-1,2-anhydro-3,4-di-O-benzyl
      beta-D-talopyranose, and 5-O-acetyl-1,2-anhydro-3,6-di-O-benzyl-beta-D
      mannofuranose and 1,2-anhydro-5,6-di-O-benzoyl-3-O-benzyl-beta-D-mannofuranose
      have each been synthesized from the corresponding 2-O-tosylate and 1-free
      hydroxyl intermediates by base-initiated intramolecular S(N)2 ring closure in
      almost quantitative yields. Acetyl and benzoyl groups were not affected in the
      ring closure reactions. Condensation of 6-O-acetyl-1,2-anhydro-3,4-di-O-benzyl
      alpha-D-glucopyranose and 5-O-acetyl-1,2-anhydro-3,6-di-O-benzyl-beta-D
      mannofuranose with 1,2:3,4-di-O-isopropylidene-alpha-D-galactopyranose in the
      presence of ZnCl2 as the catalyst afforded the 1,2-trans-linked 6-O-acetyl-3,4-di
      O-benzyl-beta-D-glucopyranosyl-(1-->6)-1,2:3,4-di-O-isopropylidene-alpha-D
      galactopyranose and 5-O-acetyl-3,6-di-O-benzyl-alpha-D-mannofuranosyl-(1-->6)
      1,2:3,4-di-O-isopropylidene-alpha-D-galactopyranose as the sole products in
      satisfactory yields, while condensation of 5-O-acetyl-1,2-anhydro-3-O-benzyl-beta
      D-lyxofuranose with 3-O-benzyl-1,2-O-isopropylidene-alpha-D-xylofuranose yielded
      the 1,2-trans-linked 5-O-acetyl-3-O-benzyl-alpha-D-lyxofuranosyl-(1-->5)-3-O
      benzyl-1,2-O-isopropylidene-alpha-D-xylofuranose as the sole product in a good
      yield. The 6-O-acetyl group in the glycosyl donor, 6-O-acetyl-1,2-anhydro-3,4-di
      O-benzyl-alpha-D-glucopyranose, did not influence the stereoselectivity of the
      ring-opening-coupling reaction.

PMID- 11217970
TI  - Regioselective and stereoselective benzoylation of 2-N-protected 4,6-O-ketal
      derivatives of D-glucosamines with 1-(benzoyloxy)benzotriazole.
AB  - A highly regioelective and stereoselective benzoylation of the 2-N-protected 4,6
      O-ketal derivatives of D-glucosamines with 1-(benzoyloxy)benzotriazole that
      affords the corresponding beta anomeric benzoates in excellent yields is
      described herein.

PMID- 11217971
TI  - Anomalous Zemplen deacylation reactions of alpha- and beta-D-mannopyranoside
      derivatives.
AB  - Reaction of mono-, di-, and trisaccharide derivatives of methyl beta-D- and octyl
      beta-D-mannopyranosides bearing ester groups at isolated and non-isolated
      positions on the same molecule, under Zemplen conditions (catalytic amount of
      sodium methoxide in methanol) gave partially deacylated compounds, in which the O
      acyl groups were retained at isolated sites. In the case of one disaccharide, all
      the benzoyl groups remained intact at the reducing end, while all the acetyl
      functions were removable from the nonreducing end. In another case, both isolated
      ester groups at positions 2 and 4 were retained at the reducing end. The isolated
      2-O-acyl groups on methyl alpha-D-mannopyranoside compounds were more labile than
      on the corresponding beta-mannosides under the same conditions. The mechanism of
      the reaction may be different for ester groups at isolated or non-isolated
      positions. In the latter case, acyl migration may take place and carry acyl
      groups into a less hindered position.

PMID- 11217972
TI  - Synthesis, analysis and reduction of 2-nitropropyl starch.
AB  - Granular 2-nitropropyl potato starch was synthesized by reaction with 2
      nitropropyl acetate in an aqueous suspension. Nitroalkylation occurs
      preferentially with the amylose fraction of potato starch, as was confirmed by
      leaching experiments and digestion of the modified starch with alpha-amylase. The
      2-nitropropyl substituent is a mixture of the nitroalkane and nitronic acid
      tautomer. Some grafting occurs and to a lesser extent additional reactions
      (formation of carbonyls and oximes) of the nitro group take place. After
      catalytic hydrogenation of water soluble 2-nitropropyl starch only a small amount
      of the nitro functionality was reduced to the corresponding amine. Reduction of
      granular 2-nitropropyl starch with sodium dithionite did not go to completion and
      led to a complex mixture of starting material, several intermediates and side
      products (for example sulfamates).

PMID- 11217973
TI  - Reactions of some 2- and 4-O-triflylglycopyranosides with MeLi, t-BuOK, and
      pyridine.
AB  - As an extension of our previous work on secondary triflates of carbohydrates [El
      Nemr, A.; Tsuchiya, T. Tetrahedron Lett. 1995, 36, 7665-7668. El Nemr, A.;
      Tsuchiya, T.; Kobayashi, Y. Carbohydr. Res. 1996, 293, 31-59. El Nemr, A.;
      Tsuchiya, T. Carbohydr. Res. 1997, 301, 77-87. El Nemr, A.; Tsuchiya, T.
      Carbohydr. Res. 1997, 303, 267-281], the reaction modes of several methyl 2- and
      4-O-triflyl-D-glycopyranosides with MeLi (strong base), t-BuOK (moderately strong
      base), and pyridine (weak base) have been studied. This paper describes the
      reactions of 3-O-benzyl-4,6-O-benzylidene-2-O-triflyl-D-gluco and 
      mannopyranosides with MeLi to give mainly the corresponding 2-C-methyl
      derivatives through alpha-elimination, with t-BuOK to give either the 2,3
      unsaturated compounds through beta-elimination or detriflyl 2-ols, and with hot
      pyridine to give the corresponding 2-pyridinium salts with inversion (except for
      the 2-O-triflyl-alpha-D-mannopyranoside (8)). 2,3,6-Tri-O-benzyl-4-O-triflyl
      alpha-D-gluco and -mannopyranosides were also examined similarly.

PMID- 11217974
TI  - Structures of the O4 and O18 antigens of Stenotrophomonas maltophilia: a case of
      enantiomeric repeating units.
AB  - The O-specific side-chain polymers of lipopolysaccharides from the reference
      strains for Stenotrophomonas maltophilia serogroups 04 and O18 are both
      xylosylated rhamnans. In the 04 polymer, both sugar components are the D isomers,
      whereas the O18 polymer contains only the L isomers. By means of NMR
      spectroscopy, methylation analysis and Smith degradation, the repeating unit of
      the 04 polymer was identified as a doubly-branched pentasaccharide of the
      structure shown below. The O18 polymer is based on the enantiomeric
      pentasaccharide, but the xylosyl substituent at the 4-position is apparently
      absent from some units. The polymers closely resemble the O antigens found in
      Xanthomonas campestris pathovars. [structure: see text]

PMID- 11217975
TI  - Chemical structure of the core oligosaccharide of aerotolerant Campylobacter
      jejuni O:2 lipopolysaccharide.
AB  - The structure of the core oligosaccharide of aerotolerant Campylobacter jejuni
      0:2 lipopolysaccharide was determined and found to contain 3-deoxy-D-manno
      octulosonic acid (Kdo), L-glycero-D-manno-heptose (LD-Hep), D-galactose, D
      glucose, and phosphorylethanolamine (PEtn). Based on 1H, 13C and 31P NMR
      spectroscopic studies including 2D COSY, TOCSY, ROESY and heteronuclear 1H-31P
      and HMQC experiments it was established that the oligosaccharide has the
      following structure: [structure: see text].

PMID- 11217976
TI  - Structure of an acidic polysaccharide from a marine bacterium Pseudoalteromonas
      distincta KMM 638 containing 5-acetamido-3,5,7,9-tetradeoxy-7-formamido-L-glycero
      L-manno-nonulosonic acid.
AB  - An acidic polysaccharide was obtained from the lipopolysaccharide of
      Pseudoalteromonas distincta strain KMM 638, isolated from a marine sponge, and
      found to contain D-GlcA, D-GalNAc, 2-acetamido-2,6-dideoxy-D-glucose (D-QuiNAc)
      and two unusual acidic amino sugars: 2-acetamido-2-deoxy-D-galacturonic acid (D
      GalNAcA) and 5-acetamido-3,5,7,9-tetradeoxy-7-formamido-L-glycero-L-manno
      nonulosonic acid (Pse5Ac7Fo, a derivative of pseudaminic acid). Oligosaccharides
      were derived from the polysaccharide by partial acid hydrolysis and mild alkaline
      degradation and characterised by electrospray ionisation (ESI) MS and 1H and 13C
      NMR spectroscopy. Based on these data and NMR spectroscopic studies of the
      initial and O-deacetylated polysaccharides, including quaternary carbon
      detection, 2D COSY, TOCSY, ROESY, H-detected 1H,13C HMQC and HMBC experiments,
      the following structure of the branched pentasaccharide repeating unit was
      established: [structure: see text].

PMID- 11217977
TI  - Physicochemical properties and structure of large, medium and small granule
      starches in fractions of normal barley endosperm.
AB  - Normal barley grain was milled to flour with a machine used to polish brewers'
      rice from the surface layer to the center. Large (18.4 microm, median size),
      medium (12.3 microm) and small (2.2 microm) granule starches were isolated from
      classified flours. Their physicochemical properties and fine structure were
      investigated. The percentage (w%) of large granules decreased from the surface
      layer to the center, while the amounts of medium and small granules increased.
      Although all the starch granules were an A-type crystal, the relative
      crystallinity varied from 22.0 to 27.4%. The DPn of the amyloses was around 1600
      and similar for all the samples. But the amylose content of the starches varied
      from 21.9 to 26.4%. Also, the amylopectins showed differences in DPn (around 5700
      7900) and chain-length distribution between granule size or fractions. The
      transition temperature ranges and the enthalpy values of the starch granules
      differed with granule size. The gelatinization properties showed no correlation
      with any of the parameters, except the enthalpy value and relative crystallinity
      (gamma = +0.73). The findings suggested that the structural characteristics of
      the starches in classified flours of normal barley differed essentially from
      those of waxy barley.

PMID- 11217978
TI  - Internal structure of the starch granule revealed by AFM.
AB  - Atomic force microscopy images of sectioned native corn starch granules show
      evidence of the well-known radial organisation of the starch macromolecules, with
      the less-ordered hilum region near to the centre. Native granules show blocks 400
      500 nm in size that span the growth rings. Lintnerised starch granules, where a
      mild acid hydrolysis has been used to remove the amorphous and less crystalline
      parts of the granule, clearly show smaller 'blocklets' within the rings
      approximately 10-30 nm in size. This level of organisation within the growth
      rings corresponds to the blocklet or superhelix structures that have been
      proposed in the literature for the association or clustering of amylopectin
      helices. Mechanical property imaging techniques have provided enhanced contrast
      to view this morphology, and shown the deformability of the starch structure
      under contact mode imaging conditions.

PMID- 11217979
TI  - Preparation of novel polysubstituted chiral cyclohexanone derivatives containing
      a quaternary carbon by Ferrier reaction.
AB  - 2-C- and 3-C-[(2'-chloro)pyrid-5'-yl]-hex-5-enopyranosides were synthesized from
      4,6-O-benzylidene acetals in three steps. By treatment with mercury or palladium
      salts, the corresponding cyclohexanones could be obtained. The stereochemistry of
      these reactions was highly dependent on the substitution pattern of the starting
      material and the nature and concentration of the catalyst.

PMID- 11217980
TI  - An efficient synthesis of methyl 2,3-anhydro-alpha-D-ribofuranoside.
AB  - An efficient synthesis of methyl 2,3-anhydro-alpha-D-ribofuranoside is reported.
      Its preparation is achieved via a four-step sequence from methyl 2,3,5-tri-O
      benzoyl-alpha-D-arabinofuranoside in 74% overall yield.

PMID- 11217981
TI  - Structural determination of the phytotoxic mannan exopolysaccharide from
      Pseudomonas syringae pv. ciccaronei.
AB  - The structural determination was performed of a mannan exopolysaccharide from the
      gram negative bacterium Pseudomonas syringae pv. ciccaronei, which is the
      pathogenic agent responsible for the leaf spots of carob plants. The structure,
      obtained by chemical, enzymatic and spectroscopic methods, consisted of a
      backbone of alpha-(1-->6)-linked mannopyranose units with 80% substituted at C-2
      by mono-, di- and trisaccharide side chains. In addition, terminal glucose units
      and phosphate groups were found to be present. This is, to the best of our
      knowledge, the first report of a mannan exopolysaccharide structure from a
      phytopathogenic bacterium. The pure polysaccharide showed phytotoxic effects,
      i.e., chlorosis and necrosis on tobacco leaves.

PMID- 11217982
TI  - Structure of the O16 antigen of Stenotrophomonas maltophilia.
AB  - A polysaccharide containing D-ribose, N-acetyl-D-glucosamine, and N-acetyl-D
      mannosamine was isolated from the phenol-soluble lipopolysaccharide extracted
      from defatted cell walls of the reference strain (560) for serogroup O16 of
      Stenotrophomonas maltophilia. The results of methylation analysis, chemical
      degradations, and NMR spectroscopy showed that the polysaccharide is based on a
      branched trisaccharide repeating-unit of the structure shown below. Although
      ribose was absent from about half of the units in the isolated polymer, the
      regularity and spacing of the ladder observed on SDS-PAGE of the parent
      lipopolysaccharide indicate that this was an artefact of the mild acid hydrolysis
      used to release the polymer. On the other hand, the effects of mild alkaline
      hydrolysis on the polymer indicated partial O-acetylation. [structure: see text]

PMID- 11217983
TI  - Isolation and NMR characterisation of a (4-O-methyl-D-glucurono)-D-xylan from
      sugar beet pulp.
AB  - Stable aqueous suspensions of purified and homogenised sugar beet pulp (SBP)
      cellulose were subjected to various TFA treatments which induced a flocculation
      of the suspension and the release of a number of polysaccharides. Among these, a
      4-O-methyl glucuronoxylan was isolated and characterized by 1H and 13C NMR
      spectroscopy. In this polysaccharide the molar proportions of D-Xyl and 4-O-Me-D
      GlcA were found to be 7:1. The presence of a glucuronoxylan at the surface of the
      cellulose microfibrils is very likely involved in the stability of the
      suspensions. To our knowledge, the presence of a 4-O-methyl-glucuronoxylan in the
      sugar beet cells has not been described previously.

PMID- 11217984
TI  - Is contact allergy in man lifelong? An overview of patch test follow-ups.
AB  - In contradistinction from certain strains of mice, contact allergy in man is
      hypothesized to be either lifelong or at least to last for years. We examined
      follow-up studies on contact allergy, as evaluated by patch testing, attempting
      to quantify its natural history. The allergens include colophonium, gold sodium
      thiosulfate, nickel, and cobalt. At present, due to technical limitations, we
      cannot state in quantitative terms whether contact allergy in man is lifelong and
      whether its clinical manifestations change. Thus, we list some criteria for
      future studies which may help resolve the above question.

PMID- 11217985
TI  - Modified short-term guinea pig sensitization tests for detecting contact
      allergens as an alternative to the conventional test.
AB  - The conventional adjuvant and patch test (APT) method of guinea pig sensitization
      testing was modified in 2 ways, s-APT and s-APT(2), in order to shorten the test
      period. These short-term test methods consist of 72-h closed application of test
      material with intradermal injection of emulsified Freund's complete adjuvant (E
      FCA) for 1st induction, 48-h closed application of test material with (s-APT) or
      without (s-APT(2)) intradermal injection of E-FCA on the 7th day for 2nd
      induction, and open application on the 14th day for challenge. They were compared
      with conventional APT by using 8 allergenic chemicals (formaldehyde, nickel
      sulfate, cobalt sulfate, ethyl-p-aminobenzoate (benzocaine), isoeugenol, 2
      mercaptobenzothiazole, 2,4-dinitrochlorobenzene (DNCB) and 1-phenylazo-2-naphthol
      (Sudan I)). The short-term methods gave similar results to those of conventional
      APT in terms of mean response, sensitization rate and sensitization potency
      (challenge concentration that induces a mean response equal to 1.0). Thus, our
      short-term methods, which are capable of evaluating skin sensitization within 17
      days, are sufficiently sensitive to detect potentially hazardous contact
      allergens.

PMID- 11217986
TI  - Another look at seasonal variation in patch test results. A multifactorial
      analysis of surveillance data of the IVDK. Information Network of Departments of
      Dermatology.
AB  - There is conflicting evidence concerning seasonal variability of patch test
      results and no evidence concerning the influence of season on weak-positive,
      possibly false-positive, irritant reactions, which was analysed in the present
      study. Data collected in the German Information Network of Departments of
      Dermatology (IVDK) 1992 to 1997 were combined with external environmental data on
      temperature and absolute humidity in Germany, and bivariate as well as logistic
      regression analyses performed concerning the association between reactivity to
      selected allergens and air temperature and absolute humidity on the respective
      days of patch testing. Between 39,239 and 41,629 patients had been tested with
      the 4 allergens considered here. Only formaldehyde exhibited a distinct increase
      in questionable or irritant as well as weak-positive reactions associated with
      dry, cold weather. Methylchloroisothiazolinone/methylisothiazolinone and lanolin
      alcohol showed only a weak, and epoxy resin no, association with climatic
      conditions. The results indicate that weak-positive reactions, at least to
      formaldehyde as a prototype of an allergen which is at the same time a marginal
      irritant, may sometimes be irritant rather than allergic. Patients showing these
      should be re-tested to improve the poor reproducibilty observed with this
      allergen.

PMID- 11217987
TI  - Occupational contact allergy to (meth)acrylates.
AB  - Among 13,833 patients suspected of contact dermatitis examined during the years
      1978-1999, occupational contact allergy to (meth)acrylates was diagnosed in 31
      patients. The 3 most common sensitizers were ethyleneglycol dimethacrylate (17
      positive patch tests), 2-hydroxyethyl methacrylate (14) and triethyleneglycol
      dimethacrylate (6). The aim of this report was to assess the different
      occupations and industries responsible for occupational sensitization to
      (meth)acrylates. 14 of the 31 patients work in the dental sector, either as a
      dentist or as a student of dental technology, where (meth)acrylate-containing
      dental prostheses and dental composites are mainly responsible for allergy to
      (meth)acrylates. An increasing trend in dermatological problems related to the
      expansion of the use of (meth)acrylates is clearly reflected in the patient
      population of our dermatology department.

PMID- 11217988
TI  - Nickel release from coins.
AB  - Nickel allergy is the most frequent contact allergy and is also one of the major
      background factors for hand eczema. The clinical significance of nickel release
      from coins was discussed when the composition of euro coins was decided. Current
      European coinage is dominated by cupro-nickel coins (Cu 75; Ni 25); other nickel
      containing and non-nickel alloys are also used. Nickel release from used coinage
      from the UK, Sweden and France was determined. It was shown that nickel ions are
      readily available on the surface of used coins. After 2 min in artificial sweat,
      approximately 2 microg of nickel per coin was extracted from cupro-nickel coins.
      Less nickel was extracted from non-nickel coins. Nickel on the surface was mainly
      present as chloride. After 1 week in artificial sweat approximately 30 microg/cm2
      was released from cupro-nickel coins: less nickel was released from coins made of
      other nickel alloys. Theoretically, several microg of nickel salts may be
      transferred daily onto hands by intense handling of high-nickel-releasing coins.

PMID- 11217989
TI  - Incidence of work-related hand eczema during apprenticeship: first results of a
      prospective cohort study in the car industry.
AB  - Data on the incidence and prevalence of occupational contact dermatitis (OCD) are
      scarce, and most of our knowledge about OCD is derived from clinical case reports
      or clinical studies of in-and out-patients. Therefore, we investigated in the
      epidemiological, prospective Audi cohort study (PACO study) the incidences of
      work-related hand eczema in different apprenticeships of Audi AG. In total, 2078
      apprentices were investigated at the start of their apprenticeship and
      systematically followed up over a 3-year period. At the end of the study,
      information on 2042 (98.2% follow-up) apprentices was available. The 1-year
      cumulative incidences of hand eczema were 9.2% (95%-confidence interval 7.8-10.7)
      in metalworkers, 8.8% (95%-CI 7.0-10.7) in other blue-collar workers, and 4.6%
      (95%-CI 2.3-8.1) in white-collar apprentices. The 3-year cumulative incidences of
      hand eczema were 15.3% (95%-CI 13.6-17.2) in metalworkers, 14.1% (95%-CI 11.8
      16.5) in other blue-collar workers, and 6.9% (95%-CI 4.0-10.9) in white-collar
      apprentices. In females, the cumulative incidence of hand eczema was higher
      compared to men (1-year incidence 10.1%, 95%-CI 7.7-13.0, versus 8.3%, 95%-CI 7.1
      9.5; 3-year incidence 16.1%, 95%-CI 13.1-19.5 versus 13.6%, 95%-CI 12.2-15.2). In
      some occupations, like cooks, tool mechanics, milling cutters and varnishers, the
      incidence of hand eczema was significantly increased. In those occupations,
      however, no job change was necessary, and no notifiable occupational contact
      dermatitis occurred. The incidence was not uniformly distributed over the 3-year
      period. Within the first 6 months, a particularly high rate of hand eczema
      occurred, which then declined and remained steady at a lower rate over the 2nd
      and the 3rd years. The results of our study give important suggestions for
      preventive measures at the workplace and effective occupational pre-employment
      advices.

PMID- 11217990
TI  - Contact allergy to Disperse Blue 106 and Disperse Blue 124 in German and Austrian
      patients, 1995 to 1999.
AB  - Between 1995 and 1999, 1986 patients were tested in the 31 participating centres
      of the Information Network of Departments of Dermatology (IVDK), all of them
      members of the German Contact Dermatitis Research Group, with a textile dyes
      series containing Disperse Blue (DB) 106 and 124, and since 1997 also with a mix
      of both. 86 patients (4.3%) reacted positively to DB 106 and/or DB 124; with good
      concordance between the 2 allergens (Cohen's weighted kappa 0.72), and the single
      allergens and the mix (kappa=0.75 in both cases), which had been tested in
      parallel in 969 and 975 patients, respectively. In contrast, concordance between
      DB 106/124 and p-phenylenediamine and p-aminoazobenzene, respectively, was poor.
      Some 70% of positive reactions to DB 106/124 had current clinical relevance.
      Furthermore, a significant increase in the proportion of DB 106/124-positive
      patients among those tested was found from 1995 to 1999. Hence, DB 106/124 are
      important allergens deserving close monitoring. The use of a mix of DB 106 and DB
      124 seems justified in view of the close chemical similarity of both compounds.
      If possible, the presence of the allergen(s) in individual textiles considered
      causative should be checked by thin layer or column chromatography.

PMID- 11217991
TI  - Allergic contact dermatitis caused by a nickel-containing headband.

PMID- 11217992
TI  - Contact dermatitis from organophosphorus pesticides.

PMID- 11217993
TI  - Type I allergy to natural rubber latex and Type IV allergy to rubber chemicals in
      children with risk factors.

PMID- 11217994
TI  - Phytodermatitis from Ranunculus damascenus.

PMID- 11217995
TI  - Occupational and systemic contact dermatitis with photosensitivity due to vitamin
      B6.

PMID- 11217996
TI  - Generalized eczema due to codeine.

PMID- 11217997
TI  - Occupational allergic contact dermatitis in hairdressers due to glutaraldehyde.

PMID- 11217998
TI  - Palmar contact dermatitis due to (meth)acrylates.

PMID- 11217999
TI  - Occupational allergic contact dermatitis from benzophenone-4 in hair-care
      products.

PMID- 11218000
TI  - Fixed-drug eruption caused by allylisopropylacetylurea.

PMID- 11218001
TI  - Sorbitan sesquioleate as an allergen.

PMID- 11218002
TI  - Allergic contact dermatitis from pharmaceutical grade BHA in Timodine, with no
      patch test reaction to analytical grade BHA.

PMID- 11218003
TI  - Allergic contact dermatitis from enoxolone.

PMID- 11218004
TI  - Occupational allergic contact dermatitis from ethylhexylzinc dithiophosphate and
      fatty acid polydiethanolamide in cutting fluids.

PMID- 11218005
TI  - Active sensitization by epoxy in Leica immersion oil.

PMID- 11218007
TI  - Drug eruption induced by cefcapene pivoxil hydrochloride.

PMID- 11218006
TI  - Allergic and irritant occupational contact dermatitis from Alstroemeria.

PMID- 11218008
TI  - Periorbital allergic contact dermatitis from oxybuprocaine.

PMID- 11218009
TI  - Primula dermatitis mimicking lichen planus.

PMID- 11218011
TI  - Epiploic appendagitis: color Doppler sonographic findings.
AB  - The aim of this study was to analyze the color Doppler sonographic findings in
      primary epiploic appendagitis. Color Doppler sonographic findings of ten patients
      with primary epiploic appendagitis were reviewed. The following sonographic
      features were analyzed: identification of a mass adjacent to the colonic wall;
      identification of spotty color areas with arterial flow in this mass and
      detection of abnormalities of the colonic wall adjacent to the infiltrated fatty
      tissue. A well-delineated hyperechoic mass adjacent to the colonic wall was
      detected in each patient with sonography. No colonic wall abnormalities were
      observed nor color Doppler signal in and around the hyperechoic area. Absence of
      flow at color Doppler sonography is an additional feature of epiploic
      appendagitis.

PMID- 11218010
TI  - Irritant contact dermatitis of the hands following thoracic sympathectomy.

PMID- 11218013
TI  - Mycobacterium genavense infection in AIDS: imaging findings in eight patients.
AB  - This retrospective study included eight HIV-positive patients with a M. genavense
      infection. Seven of these patients had a CT scan of the abdomen and a US
      examination, whereas one patient with pulmonary symptoms had conventional chest
      radiographs and thin-section CT scan of the thorax. Multiple large
      retroperitoneal and mesenteric lymph nodes were demonstrated in seven patients;
      low-attenuation centers within enlarged nodes were identified in two patients. On
      CT scans two cases showed circumferential wall thickening of the proximal small
      bowel with a deep ulceration in one of these patients. Additional findings
      included focal lesions in the liver (n = 1), spleen (n = 2), splenomegaly (n =
      6), and hepatomegaly (n = 4). The CT scans from the thoracic examination
      demonstrated multiple diffuse nodular infiltrates in both lungs. M. genavense
      infection should be considered in the differential diagnosis of AIDS patients
      with CD4 counts below 100 cells/mm3 presenting with abdominal lymphadenopathy,
      multinodular or homogeneous hepatosplenic enlargement and circumferential
      thickening of the small bowel wall.

PMID- 11218012
TI  - Off-site evaluation of liver lesion detection by Gd-BOPTA-enhanced MR imaging.
AB  - The aim of this study was to determine the efficacy of Gd-BOPTA-enhanced MRI in
      liver lesion detection in comparison with unenhanced MRI and dynamic CT. The
      image sets of 148 of 151 patients enrolled in a multicenter German phase-III
      trial were evaluated by two independent radiologists unaffiliated with the
      investigating centers. Patients underwent a routine MRI protocol comprising T2-
      and T1-weighted spin-echo and T1-weighted gradient-echo (GE) sequences pre and 1
      h post 0.1 mmol/kg Gd-BOPTA (Bracco-Byk Gulden, Konstanz, Germany). Additionally,
      a serial T1-weighted GE scan was performed after administration of the first half
      of the dose. All patients underwent dynamic contrast-enhanced CT. The evaluation
      was performed with regard to the number and size of lesions detected per patient
      by each modality or sequence. Furthermore, all pre CM and pre + post CM image
      sets were analyzed for number of lesions per patient. Both readers detected
      significantly more lesions in the contrast-enhanced image set compared with the
      unenhanced image set (32 and 39 %, respectively; p < 0.0001). While contrast
      enhanced CT detected a similar number of lesions to unenhanced MRI, it was
      clearly inferior to contrast-enhanced MRI (reader 1: p = 0.0117; reader 2: p =
      0.0225). Of the T1-weighted scans performed, the dynamic and late T1-weighted GE
      exams contributed most to the increased lesion detection rate (reader 1: p =
      0.0007; reader 2: p = 0.0037). The size of the smallest lesion detected by means
      of MRI was significantly larger in the pre-CM image sets than in the pre + post
      CM image sets (reader 1: p = 0.001; reader 2: p < 0.0001). Gd-BOPTA-enhanced MRI
      detected significantly smaller lesions than contrast-enhanced CT (reader 1: p =
      0.0117; reader 2: p = 0.0925). Gd-BOPTA-enhanced MR imaging improves liver lesion
      detection significantly over unenhanced MRI and dynamic CT.

PMID- 11218014
TI  - Helical CT without contrast in choledocholithiasis diagnosis.
AB  - The goal of this study was to determine the diagnostic value of the helical CT
      without contrast in suspected cases of choledocholithiasis, comparing this test
      with endoscopic retrograde cholangiopancreatography (ERCP). Forty patients with
      possible choledocholithiasis were studied prospectively. There were 23 women and
      17 men, ranging in age from 24 to 91 years. Helical CT was performed immediately
      before ERCP (time interval between the two procedures was less than 1 h). A
      biliary area previously selected was studied with a technique of pitch 1 and
      slice thickness of 3.2 mm. Average time was 30 s. Reconstruction with different
      increments and windows were made. Stone presence was evaluated in bile duct and
      Vater's ampulla. Biliary dilation was evaluated too. Endoscopic retrograde
      cholangiopancreatography found stones in 19 patients and absence of stones in 20.
      One case was failed, but stones in bile duct were demonstrated during
      intraoperative cholangiography. Helical CT demonstrated stones in 15 of the 19
      patients with positive ERCP. There were no false positives with CT. Patients
      without stones in ERCP were also negative in CT. The patient having the failed
      ERCP was considered positive in CT. The CT sensitivity was 80% and specificity
      was 100%, with an accuracy of 90%. Helical CT without contrast has sensitivity
      and specificity good enough to be used as a screening technique in patients with
      suspected choledocholithiasis.

PMID- 11218015
TI  - Focal nodular hyperplasia: imaging findings.
AB  - Focal nodular hyperplasia is an uncommon benign hepatic tumor that continues to
      pose diagnostic dilemmas. Imaging techniques are of great value in diagnosis of
      this tumor. In this article we present the US, CT, MR imaging, scintigraphy, and
      angiography findings. The demonstration of a central vascular scar is very
      helpful. Although the radiologic features may be diagnostic, many atypical cases
      must be differentiated from other benign or malignant hepatic tumors. In these
      cases excisional biopsy and histopathologic examination are necessary to
      determine a definite diagnosis.

PMID- 11218016
TI  - US and CT diagnosis of a twisted lipomatous appendage of the falciform ligament.
AB  - Pathologic conditions of the falciform ligament leading to surgical intervention
      are extremely uncommon. We report a case of twisted lipomatous appendage of this
      ligament, demonstrated by US and CT. To our knowledge, there have been no
      previous reports of this entity. The extraperitoneal nature of the lesion was
      found by realtime sonography, but CT only was able to characterize its lipomatous
      nature and relationship with the falciform ligament. This lesion should be
      considered in the differential diagnosis of intra-abdominal focal fat infarction
      (IFFI), a recent vocable essentially regrouping infarction of omentum and
      epiploic appendages.

PMID- 11218017
TI  - Gastrointestinal stromal tumor of the rectum.
AB  - Gastrointestinal stromal tumors (GISTs) are characterized by remarkable
      variability in their differentiation potential, but most of these lesions do not
      display convincing smooth muscle or neuronal differentiation. The GISTs arising
      from the rectum or anal canal are extremely uncommon. We present a case of
      immunohistochemically proven GIST of the rectum, which was characterized by
      homogenous isointensity mass without necrosis or hemorrhage on T2-weighted image
      and by enhancement on gadolinium-enhanced study.

PMID- 11218018
TI  - Imaging of the acute scrotum.
AB  - The scrotum is a superficial structure and clinical examination is frequently not
      enough for making a specific diagnosis. In acute scrotal pain US can confirm the
      presumptive clinical diagnosis and provide additional relevant information. In
      testicular torsion, color-Doppler imaging has a central role since it has become
      possible to identify it at early stage by showing absence of perfusion in the
      affected testis before any gray-scale abnormality. Scintigraphy remains a
      satisfactory alternative in evaluating testicular torsion and should be used when
      color Doppler is inadequate, raising doubts about the suspected torsion.
      Diagnosis of torsion of testicular appendages is particularly difficult. Ischemic
      infarction shows a characteristic pattern at gray-scale and color Doppler
      imaging, whereas hemorrhagic ischemia may require MRI. Inflammatory diseases of
      the scrotum can be easily investigated by echo color Doppler and conventional
      radiography, and CT can be particularly useful in the detection of gas bubbles.
      In scrotal trauma, scrotal hematoma, hematocele, intratesticular hematoma, and
      testicular rupture can be identified using gray-scale US with very good
      reliability. Magnetic resonance imaging is indicated when a small tear of tunica
      albuginea is suspected but not visualized on US.

PMID- 11218019
TI  - The value of endorectal MR imaging to predict positive biopsies in clinically
      intermediate-risk prostate cancer patients.
AB  - The aim of this study was to assess the effectiveness of endorectal MR imaging in
      predicting the positive biopsy results in patients with clinically intermediate
      risk for prostate cancer. We performed a prospective endorectal MR imaging study
      with 81 patients at intermediate risk to detect prostate cancer between January
      1997 and December 1998. Intermediate risk was defined as: prostatic specific
      antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20
      ng/ml but negative digital rectal examination (DRE) or PSA levels progressively
      higher (0.75 ng/ml year(-1)). A transrectal sextant biopsy was performed after
      the endorectal MR exam, and also of the area of suspicion detected by MR imaging.
      The accuracies were measured, both singly for MR imaging and combined for PSA
      level and DRE, by calculating the area index of the receiver operating
      characteristics (ROC) curve. Cancer was detected in 23 patients (28%). Overall
      sensitivity and specificity of endorectal MRI was 70 and 76%, respectively.
      Accuracy was 71% estimated from the area under the ROC curve for the total
      patient group and 84% for the group of patients with PSA level between 10-20
      ng/ml. Positive biopsy rate (PBR) was 63% for the group with PSA 10-20 ng/ml and
      a positive MR imaging, and 15% with a negative MR exam. The PBR was 43% for the
      group with PSA 4-10 ng/ml and a positive MR study, and 13% with a negative MR
      imaging examination. We would have avoided 63% of negative biopsies, while
      missing 30% of cancers for the total group of patients. Endorectal MR imaging was
      not a sufficient predictor of positive biopsies for patients clinically at
      intermediate risk for prostate cancer. Although we should not avoid performing
      systematic biopsies in patients with endorectal MR imaging negative results, as
      it will miss a significant number of cancers, selected patients with a PSA levels
      between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal
      MR imaging.

PMID- 11218020
TI  - Endorectal magnetic resonance imaging of prostatic cancer: comparison between fat
      suppressed T2-weighted fast spin echo and three-dimensional dual-echo, steady
      state sequences.
AB  - The aim of this study was to develop an endorectal MRI strategy for prostatic
      cancer. We evaluated the MR images from 44 consecutive prostatic cancer patients
      treated by radical prostatectomy. Each sequence from every examination was
      assessed separately with a specific tumor map drawn. Tumor localization, capsular
      penetration, and seminal vesicle invasion were marked on maps on the basis of T2
      and DESS (dual-echo steady-state) sequences. Thirty patients also had T1-weighted
      images, and these were assessed with regard to possible tumor outgrowth. The maps
      were compared with histopathological findings from radical prostatectomy
      specimens. According to our study, DESS equaled T2 in every respect. No
      statistically significant differences between the sequences were found with
      respect to detecting either tumor localization, outgrowth, or seminal vesicle
      invasion. DESS is a potential new sequence in prostatic MRI as it has been proven
      to parallel the routinely used T2-weighted imaging.

PMID- 11218021
TI  - Bilateral papillary renal cell carcinoma.
AB  - Papillary renal cell carcinoma is a subgroup of malignant renal epithelial
      neoplasms. We report the clinical and imaging findings of a case with multifocal
      and bilateral renal cell carcinoma which are nonspecific.

PMID- 11218022
TI  - Emphysematous cystitis in a patient presenting with paradoxical arterial embolism
      and intestinal mycobacteriosis without evidence of diabetes.
AB  - We describe the case of a 72-year-old woman who displayed massive multiple
      intramural gas collections of the bladder wall as an incidental finding on CT.
      The patient presented with critical ischemia of the left leg caused by
      paradoxical arterial embolism, raised corpuscular sedimentation rate, anemia by
      gastrointestinal blood loss, hypoproteinemia, diarrhea, malabsorption, and
      exudative enteropathia caused by mycobacterial ileocolitis. The patient had no
      dysuria and there was no evidence of diabetes. The intramural gas collections of
      the bladder wall, as shown by CT, were compatible with emphysematous cystitis.
      Urine samples proved infection by a multi-resistant strain of E. coli.
      Emphysematous cystitis is a rare form of bladder infection that can be diagnosed
      by plain-film radiograms or CT.

PMID- 11218023
TI  - MR features of peripheral nerve sheath tumors: can a calculated index compete
      with radiologist's experience?
AB  - The aims of this study were, firstly, to provide a formula (neurogenic index)
      based on MR characteristics used in daily routine for predicting whether a soft
      tissue tumor is neurogenic or not, secondly, to test prospectively the
      performance of this formula, and thirdly, to compare this performance with that
      of radiologists experienced in MR imaging of soft tissue tumors. Retrospectively,
      MR images of 70 neurogenic and 70 non-neurogenic soft tissue tumors were
      evaluated in random order by two teams of two observers each. A neurogenic index
      (NI) was calculated based on those MR parameters that showed no or minor
      interobserver variability. Subsequently, three investigators in concert used the
      NI in a validation group of 15 neurogenic and 22 nonneurogenic soft tissue
      tumors. The same team, based on their own experience, tried to differentiate in
      the same validation group neurogenic from non-neurogenic soft tissue tumors. This
      was expressed in a subjective score (SS). Sensitivity, specificity, and
      predictive values were calculated. NI comprised spread (intra- or
      extracompartmental), distribution, fluid-fluid levels, homogeneity on T2-weighted
      images (WI), highest signal intensity (SI) on T1WI, lowest SI on T2WI, and
      delineation on T2WI. In the validation group, NI had a sensitivity of 88.6%, a
      specificity of 52.0%, a positive predictive value (PPV) of 54.1%, and a negative
      predictive value (NPV) of 84.6% for neurogenic tumors. The subjective score SS
      was superior and had a sensitivity of 93.3%, a specificity of 77.2%, a PPV of
      73.7%, and a NPV of 94.4%. Our NI was less accurate than the SS; however, the low
      number of false-negative diagnoses for neurogenic tumors warrants continued
      efforts in development of neural networks.

PMID- 11218024
TI  - Indirect MR arthrography of the shoulder in detection of rotator cuff ruptures.
AB  - The aim of this study was to compare the efficacy of indirect MR arthrography
      images obtained following intravenous contrast injection and conventional MR
      imaging in the diagnosis of rotator cuff tears. Twenty-four patients with
      clinically suspected rotator cuff disease were examined. Conventional MR images
      and post-contrast indirect MR arthrography images were obtained. All images were
      evaluated in a blinded fashion by two musculoskeletal radiologist. Results were
      than analyzed depending on surgical output. The correlation coefficient (Spearman
      rank correlation test) and the kappa values for agreement between surgery and
      imaging techniques were calculated. The correlation coefficients between indirect
      MR arthrography and surgery for reader 1 and reader 2 were 0.9137 and 0.9773,
      respectively. Whereas the agreement between conventional MR imaging and surgery
      was moderate (n = 0.383-0.571), the agreement between indirect MR arthrography
      and surgery was excellent (n = 0.873-0.936). We suggest the use of indirect MR
      arthrography technique when conventional MR images are equivocal in diagnosis of
      rotator cuff disease.

PMID- 11218025
TI  - Height of lumbar discs measured from radiographs compared with degeneration and
      height classified from MR images.
AB  - The relation between height of lumbar discs (measured from lateral radiographic
      views) and disc degeneration (classified from MR images) deserves attention in
      view of the wide, often parallel or interchanged use of both methods. The time
      sequence of degenerative signs and decrease of disc height is controversial. To
      clarify the issue, this cross-sectional study documents the relation between disc
      degeneration and disc height in a selected cohort. Forty-three subjects were
      selected at random from a cohort examined for potential disc-related disease
      caused by long-term lifting and carrying. From each subject a lateral
      radiographic view of the lumbar spine as well as findings from an MR
      investigation of (in most cases) levels T12/L1 to L5/S1 were available; thus, n =
      237 lumbar discs were available for measurement and classification. Disc height
      was measured from the radiographic views with a new protocol compensating for
      image distortion and permitting comparison with normal, age- and gender
      appropriate disc height. Degeneration as well as disc height were classified
      twice from MR images by independent observers in a blinded fashion. Disc
      degeneration classified from MR images is not related to a measurable disc height
      loss in the first stage of degeneration, whereas progressive degeneration goes
      along with progressive loss of disc height, though with considerable
      interindividual variation. Loss of disc height classified from MR images is on
      average compatible with loss of disc height measured from radiographs. In
      individual discs, however, classification of height loss from MR images is
      imprecise. The first sign of disc degeneration (a moderate loss of nucleus
      signal) precedes disc height decrease. As degeneration progresses, disc height
      decreases. Disc height decrease and progress of degeneration, however, appear to
      be only loosely correlated.

PMID- 11218026
TI  - Stress-induced osteolysis of distal clavicle: imaging patterns and treatment
      using CT-guided injection.
AB  - Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated
      stress or microtrauma to the shoulder. This entity has clinical and radiological
      findings similar to post-traumatic ODC. We describe a case of successful
      treatment of stress-induced ODC with CT-guided injection of corticosteroid and
      anesthetic drug into the acromioclavicular joint.

PMID- 11218027
TI  - Desmoplastic fibroma in the thoracic spine: an unusual localization of a rare
      primary bone tumor.
AB  - A case of an intraspinal growing desmoplastic fibroma of the thoracic spine (T9
      T11) is reported. Desmoplastic fibroma is a rare tumor of connective tissue that
      shows a locally infiltrative and destructive growth. An affection of the thoracic
      spine is an extremely rare manifestation. Preoperative CT documents the extent of
      osseous destruction and tumor associated cortical erosion. In central tumor areas
      an inhomogeneous, intermediate to low signal is demonstrated by MRI using T1- and
      T2-weighted spin-echo and turbo-spin-echo sequences. Contrast-enhanced MRI shows
      marked enhancement in peripheral areas depicting the extraosseous and
      intramedullary extension.

PMID- 11218028
TI  - Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and
      subclassification of malignant lymphomas.
AB  - The objective of this study was to evaluate the sensitivity and specificity of
      percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and
      subclassification of malignant lymphomas. In a 1-year period 158 image-guided
      percutaneous core-needle biopsies of enlarged lymph nodes were performed on 149
      consecutive patients using a Tru-cut needle fired by a biopsy gun. In 135 cases
      the biopsy findings could be confirmed by histologic examination of additional
      tissue samples (n = 59) or by correlation with the patient's clinical and
      radiologic course (n = 76). The final diagnoses were malignant lymphoma in 65
      cases, leukemic nodal infiltration in 2, nodal metastases from a solid tumor in
      37 and benign changes or no evidence of malignancy in 31 cases. The core-needle
      biopsies correctly diagnosed 58 of 65 malignant lymphomas, corresponding to a
      sensitivity of 89% and a specificity of 97%. Fifty-five of the 58 (95%) correctly
      diagnosed malignant lymphomas could be subclassified on the basis of the core
      needle biopsy. Image-guided core-needle biopsy of enlarged lymph nodes with a Tru
      cut needle is a useful method for the diagnosis and subclassification of
      malignant lymphomas.

PMID- 11218029
TI  - DIMA enlargement mammography in microcalcifications: a prospective study with ROC
      analysis.
AB  - The purpose of this study was to investigate whether the four-fold magnification
      mammography (direct magnification, DIMA) technique would perform better than
      conventional 1.5-fold magnification mammography in the differentiation of breast
      microcalcifications into benign and malignant. Fifty patients with non-palpable
      microcalcifications detected by mammography were examined immediately prior to
      surgical biopsy using both a conventional (1.5-fold) and the DIMA (fourfold)
      magnification mammography techniques. The microcalcifications were classified by
      five experienced radiologists using morphological criteria. A receiver operating
      characteristics curve (ROC) analysis of the sensitivity and specificity of both
      techniques in assessing malignancy was then carried out. The DIMA mammography
      technique was slightly but non-significantly superior to the conventional method
      in detecting malignancy (p > 0.05). Coarse granular and pleomorphic
      calcifications were detected more frequently with the DIMA technique. Coarse
      calcifications were significantly more frequently associated with histologically
      benign findings, whereas fine granular calcifications were significantly more
      likely to be malignant lesions. Assessment of malignancy associated with
      microcalcifications using morphological criteria is not significantly improved by
      mammography techniques with higher magnification.

PMID- 11218030
TI  - A cavernous haemangioma of breast in male: radiological-pathological correlation.
AB  - Vascular tumours of the breast are especially rare in men, and a majority of them
      are angiosarcomas. In fact, we found only four cases of haemangioma in males in
      the literature. We present a case of cavernous haemangioma in a male aged 48
      years, and which commenced as a palpable mass. We performed differential
      diagnosis and radiological-pathological correlation. We established the correct
      classification of this case histologically, and decided on the definitive
      therapeutic approach.

PMID- 11218031
TI  - Preliminary experience with dynamic MR projection angiography in the evaluation
      of cervicocranial steno-occlusive disease.
AB  - The application of a contrast-enhanced, two-dimensional MR technique, which
      provides dynamic projection angiograms at a subsecond temporal frame rate for
      depiction of the cervical and intracranial arteries, was evaluated in three
      healthy volunteers and seven patients with various cervicocranial steno-occlusive
      diseases. Intra-arterial digital subtraction angiography (DSA) served as standard
      of reference for findings in the patients. Magnetic resonance projection
      angiography (MRPA) was performed on a standard 1.5-T clinical MR imaging system
      at intravenous injection of a single dose of contrast agent (0.1 mmol/kg GdDTPA
      BMA). Sixty consecutive images of the cerebral circulation were acquired at a
      temporal frame rate of 900 ms per image in the coronal plane. The collateral flow
      and the perfusion of the compromised vessel territory were readily assessed by
      MPRA in patients with occlusion of the internal cerebral artery (ICA) or middle
      cerebral artery (MCA). The leptomeningeal collateralisation of these patients was
      displayed in a dynamic fashion. Furthermore, quantitative perfusion measurement
      provided a difference between both MCA territories in the time to peak
      (deltaDTTP) of the contrast bolus of 1.12 +/- 0.28 s in five patients with severe
      stenosis or occlusion of the ICA (healthy volunteers 0.19 +/- 0.05 s). However,
      important pathological findings, such as the evaluation of carotid artery
      stenoses and the intracranial collateral flow pattern in patients with severe
      carotid stenoses, were not sufficiently assessable as compared with DSA. We
      conclude that the possibility of obtaining simultaneously information about
      morphology and perfusion dynamics of the cervicocranial vessels is unique in MPRA
      as compared with other MR techniques. However, in the applied form, the technique
      is not a reliable tool for the complete evaluation of the cervicocranial vessels
      in patients with steno-occlusive disease.

PMID- 11218032
TI  - Fluid-attenuated inversion-recovery MR imaging of gliomatosis cerebri.
AB  - Magnetic resonance imaging has been shown to be the most sensitive imaging
      modality in the assessment of gliomatosis cerebri. Recent studies have shown that
      fluid-attenuated inversion-recovery (FLAIR) is a valuable MR sequence in the
      delineation of cerebral pathologies including intra-axial tumors. However, no
      data are available about the role of this novel technique in the assessment of
      gliomatosis lesions. The purpose of this study was therefore to evaluate the
      diagnostic potential of FLAIR MR imaging in patients with suspected gliomatosis
      cerebri. Seven patients suspected of having lesions of gliomatosis cerebri were
      examined by T1-weighted spin echo (SE), T2-weighted fast spin echo (FSE), and
      FLAIR MR imaging with identical slice parameters. T1 and FLAIR were repeated
      after contrast media administration. Delineation and extent of gliomatosis were
      the primary parameters of the image analysis. The FLAIR imaging clearly
      delineated the extent of gliomatosis lesions in all patients. Due to the
      suppression of cerebrospinal fluid, the delineation was superior to conventional
      T2-weighted FSE images. Especially the detection and delineation of cortical
      spread and the infiltration of the corpus callosum was best seen on FLAIR images.
      The FLAIR MR imaging is a valuable diagnostic modality in the assessment of
      patients with gliomatosis cerebri. Due to its better delineation of tumor spread,
      it was found to be the imaging method of choice and should therefore be
      integrated into the MR imaging protocol of these patients.

PMID- 11218033
TI  - CT and MRI findings in gliomatosis cerebri: a neuroradiologic and neuropathologic
      review of diffuse infiltrating brain neoplasms.
AB  - The aim of the study was to develop objective criteria that might be helpful for
      the diagnosis of gliomatosis cerebri (GC) with the highest possible probability
      based on both the neuroradiological and histopathological findings. Imaging
      findings in 14 patients with diffuse infiltrating brain neoplasms were studied by
      two neuroradiologists. Computed tomography and MRI scans were compared with each
      other side by side. The extent and kind of disease were graded on a scale of 1-5.
      Interexamination agreement between the two methods was calculated using a kappa
      analysis. Neither of the neuroradiologists performed the examinations and both
      were blinded to the histopathological findings, which were also available for all
      patients, based on biopsy as well as follow-up CT and MRI studies. A
      neuroradiological-neuropathological correlation was performed. A score system
      helped to differentiate the findings in three categories: 1 = suggestive of GC; 2
      = GC cannot be excluded; and 3 = others. Both CT and MRI were performed in 14
      patients with clinical signs and symptoms of an intracerebral tumor. All
      examinations had diagnostic quality and showed the involvement of at least two
      brain lobes. Stereotactic biopsy was carried out in all patients. In 2 patients
      the neuropathological diagnosis was suggestive of GC, in 1 patient glioblastoma,
      in 2 patients astrocytoma, and in 5 patients nonspecific astrogliotic
      proliferation. In the remaining 4 cases anaplastic tumor infiltration was
      diagnosed. The neuroradiological findings in 5 cases were suggestive of GC; in 6
      cases a GC could not excluded; and in 3 patients only a slight probability of GC
      was found. In 2 cases was the neuropathological and the neuroradiological
      diagnosis of GC concordant. Magnetic resonance imaging is significantly more
      sensitive than CT in the diagnosis of GC. However, even with multiple, MRI-guided
      stereotactic biopsies in correlation with intraoperative analysis of the sample
      by smear preparations by a neuropathologist the antemortem diagnosis of GC is
      still difficult. Discussion of neuropathological and neuroradiological findings
      in each case in combination with a score system may help to resolve
      discrepancies.

PMID- 11218035
TI  - MRI of the brachial plexus.
AB  - Magnetic resonance imaging is the imaging method of first choice for evaluating
      the anatomy and pathology of the brachial plexus. This review discusses the used
      imaging techniques, the normal anatomy, and a variety of pathologies that can
      involve the brachial plexus. The pathology includes primary and secondary tumors
      (the most frequent secondary tumors being superior sulcus tumor and metastatic
      breast carcinoma), radiation plexopathy, trauma, thoracic outlet syndrome,
      neuralgic amyotrophy, chronic inflammatory demyelinating polyneuropathy (CIDP),
      and multifocal motor neuropathy (MMN).

PMID- 11218034
TI  - Temporal lobe changes following radiation therapy: imaging and proton MR
      spectroscopic findings.
AB  - Radiation therapy for nasopharyngeal carcinoma affects the temporal lobes. This
      paper characterizes proton MR spectroscopic findings of the temporal lobes and
      correlates them with imaging changes. Single-voxel proton MR spectroscopic
      examinations were acquired from 13 healthy adult volunteers (25 spectra) and 18
      patients (28 spectra). All patients had biopsy-confirmed nasopharyngeal carcinoma
      and were previously treated with radiation therapy. Six patients (33%) had a
      single treatment and 12 (67%) patients had two treatments. Point resolved
      spectroscopy (PRESS) method was used (TR = 3,000 ms, TE = 135 ms) and data
      processed automatically using the LCModel software package for metabolite
      quantification. Voxel size and geometry were adapted to the lesion to reduce
      skull-base lipid contamination. The metabolites were quantitated relative to
      water signal. For each location, an additional non-water-suppressed reference
      scan in fully relaxed conditions was performed. The imaging findings were divided
      into four categories: I, normal; II, edema only; III, contrast-enhancing lesions;
      and IV, cystic encephalomalacia. The N-acetyl-aspartate levels were reduced in 27
      (96%) spectra. Choline was increased in 3 (11%), normal in 4 (14%), and reduced
      in 21 (75%) spectra. The creatine level was normal in 8 (29%) spectra and reduced
      in 20 (71%) spectra. Imaging showed 4 (14%) spectra with category-I imaging
      findings; 5 (18%) spectra with category-II findings; 15 (54%) spectra with
      category-III findings; and 4 (14%) spectra with category-IV findings. Magnetic
      resonance spectroscopy showed reduced N-acetyl-aspartate in radiation-induced
      temporal lobe changes. Creatine levels were relatively more stable. Choline
      levels may be increased, normal, or reduced. Imaging findings ranged from normal
      to contrast-enhancing lesions and cystic encephalomalacia.

PMID- 11218036
TI  - Networks in the radiology department and the hospital.
AB  - Data networks are a basic technology with regard to an appropriate design of the
      information technology (IT) infrastructure for the hospital. Due to the
      distributed workflow within the hospital, an integrated Hospital Information
      System (HIS) is based mostly on a set of network applications facing specific
      items. Medical communication standards, i.e., HL 7, DICOM, and in the near future
      the migration towards XML, support the interoperability between the IT subsystems
      and pave the way to patient information systems with access to unified and
      complete electronic medical records (EMR). Furthermore, with standardized
      communication techniques, such as CORBAmed, an object-oriented design of
      Healthcare applications will be possible in the near future. The intent of this
      paper is to give an overview of which basic technologies are suitable for
      building comprehensive, flexible, and reliable hospital networks and which also
      meet the special demands of the radiology department.

PMID- 11218037
TI  - Angiographic pseudolesion in the liver in asymptomatic subacute cholecystitis.

PMID- 11218038
TI  - Antrochoanal polyps in children.

PMID- 11218039
TI  - Intralobar lung sequestration and surrounding hyperaeration.

PMID- 11218040
TI  - Quiz case of the month. Partially thrombosed aneurysm of the extracranial carotid
      artery.

PMID- 11218041
TI  - Comparative assessment of endocrine modulators with oestrogenic activity: I.
      Definition of a hygiene-based margin of safety (HBMOS) for xeno-oestrogens
      against the background of European developments.
AB  - A novel concept - the hygiene-based margin of safety (HBMOS) - is suggested for
      the assessment of the impact of potential endocrine modulators. It integrates
      exposure scenarios and potency data for industrial chemicals and naturally
      occurring dietary compounds with oestrogenic activity. An HBMOS is defined as a
      quotient of estimated daily intakes weighted by the relative in vivo potencies of
      these compounds. The Existing Chemicals Programme of the European Union provides
      Human and Environmental Risk Assessments of Existing Chemicals which include
      human exposure scenarios. Such exposure scenarios, along with potency estimates
      for endocrine activities, may provide a basis for a quantitative comparison of
      the potential endocrine-modulating effects of industrial chemicals with endocrine
      modulators as natural constituents of human diet. Natural phyto-oestrogens
      exhibit oestrogenic activity in vitro and in vivo. Important phyto-oestrogens for
      humans are isoflavones (daidzein, genistein) and lignans, with the highest
      quantities found in soybeans and flaxseed, respectively. Daily isoflavone
      exposures calculated for infants on soy-based formulae were in the ranges of 4.5
      8 mg/kg body wt.; estimates for adults range up to 1 mg/kg body wt. The Senate
      Commission on the Evaluation of Food Safety (SKLM) of the Deutsche
      Forschungsgemeinschaft has also indicated a wide range of dietary exposures. For
      matters of risk assessment, the SKLM has based recommendations on dietary
      exposure scenarios, implying a daily intake of phyto-oestrogens in the order of 1
      mg/kg body wt. On the basis of information compiled within the Existing Chemicals
      Programme of the EU, it appears that a daily human exposure to nonylphenol of 2
      microg/kg body wt. may be a worst-case assumption, but which is based on valid
      scenarios. The intake of octylphenol is much lower, due to a different use
      pattern and applications, and may be neglected. Data from migration studies led
      to estimations of the daily human uptake of bisphenol A of maximally 1 microg/kg
      body wt. On the basis of comparative data from uterotrophic assays in rats, with
      three consecutive days of oral applications involved, and taking the natural
      phyto-oestrogen daidzein as reference (= 1), relative uterotrophic activities in
      DA/Han rats follow the sequence: daidzein = 1; bisphenol A = 1; p-tertoctylphenol
      = 2; o, p'-DDT = 4; ethinyl oestradiol = 40,000. The derived values from exposure
      scenarios, as well as these relative potency values and bridging assumptions, led
      to calculations of HBMOS as a quantitative comparison of potential endocrine
      modulating effects of industrial chemicals with those of natural constituents of
      human diet. HBMOS estimates for nonylphenol ranged between 250 and 500, dependent
      on bridging assumptions, and around 1000 for bisphenol A. The derivations of
      HBMOS were in full support of the conclusions reached by the SKLM of the Deutsche
      Forschungsgemeinschaft. The estimated HBMOS values for the industrial chemicals
      (nonylphenol, bisphenol A) appear sufficiently high to ensure the absence of a
      practical risk to human health under the present exposure conditions.

PMID- 11218042
TI  - The relevance of physical activity for the kinetics of inhaled gaseous
      substances.
AB  - Inhalation is the most important route of absorption for many volatile
      substances. The inhaled chemical is distributed via the bloodstream into the
      organs and tissues. It is eliminated mainly unchanged by exhalation and also via
      metabolism. The blood concentration can be considered as a surrogate for the body
      burden of the chemical. It depends on the rate of uptake and on the rate of
      elimination. The rate of uptake by inhalation is determined by the blood:air
      partition coefficient of the gaseous compound, the actual concentration of the
      chemical already in the blood entering the lungs, the blood flow through the
      lungs, and the alveolar ventilation. The latter is greatly influenced by physical
      activity, which thus has a crucial impact on the rate of uptake. Consequently,
      the blood concentration of an inhaled chemical and the resulting alveolar
      retention, representing the rate of metabolism at steady-state, are dependent on
      the intensity of physical work. Both parameters can be calculated for steady
      state conditions using simple algebraic equations, if one assumes that the rate
      of metabolic elimination is limited by the blood flow through the metabolizing
      organs. This assumption is valid for many rapidly metabolized inhaled gases and
      vapours at low concentrations present under workplace conditions. The derived
      equations give the theoretical background for the observations presented from a
      series of experimental studies which demonstrate that physical activity can be a
      major determinant of the toxicokinetics of inhaled compounds. Practical examples
      illustrate the procedure. We conclude that workplace-related physical activity
      should be taken into account for compounds with blood:air partition coefficients
      above 6 in the determination of occupational limit concentrations in air.

PMID- 11218043
TI  - The disposition and metabolism of durene (1,2,4,5-tetramethylbenzene) in rats.
AB  - The organ and tissue distribution, excretion and metabolism of [3H]1,2,4,5
      tetramethylbenzene ([3H]durene) in male Wistar albino rats were investigated
      following a single i.p. administration (40 mg/kg) and within 9 days after five
      daily repeated administrations. Urine proved to be the main route of tritium
      excretion. Within the first 24 h after a single administration 69% of the
      radioactivity was excreted in the urine and only 9% in the feces. The highest
      level of tritium binding was found in the fat tissue, liver, kidneys and adrenal
      glands. The accumulation of tritium in the plasma proceeded with a kinetic
      constant of 0.49 h(-1), whereas the half-life of radioactivity decay amounted to
      about 6.3 h. In erythrocytes, the tritium level was found to be about three times
      lower than in blood plasma. The total amount eliminated during the 9 days
      following repeated administration was about 94% of the five doses given. The
      highest level of tritium was found in fat tissue and adrenal glands, followed by
      the liver, kidneys, sciatic nerve and muscle. A gradual decline in tritium levels
      was observed during the following 4 days in most tissues to reach about 2% of the
      dose given. The main urinary metabolites resulting from the administration of
      durene were 2,4,5-trimethylbenzyl alcohol (about 22%), 4,5-dimethyl-1,2
      benzdialdehyde (about 19%), 2,4,5-trimethylbenzaldehyde (about 19%) and 2,4,5
      trimethylbenzoic acid (about 16%). The oxygen-containing metabolites accounted
      for almost 80%, whereas sulphur-containing metabolites accounted for
      approximately 10% of the products of biotransformation. In conclusion, most of
      the durene administered has a relatively rapid turnover rate, with minor levels
      retained in the tissues for longer time periods.

PMID- 11218044
TI  - Hemoglobin adducts of epoxybutene in workers occupationally exposed to 1,3
      butadiene.
AB  - 1,3-Butadiene (BD) is an important chemical widely used in the synthetic rubber
      industry. Hemoglobin adducts of two of its reactive metabolites have been already
      investigated as possible parameters for exposure assessment. In this study
      hemoglobin adducts of epoxybutene (EB) were analyzed in blood samples from 17
      workers in a BD monomer production unit and 19 controls in a heat production unit
      of a petrochemical plant near Prague, Czech Republic. BD exposure was determined
      by personal air sampling. The median level of exposure was 440 microg/m3 (range <
      11-17 mg/m3) for the exposed workers and < 6 microg/m3 (< 5-150 microg/m3) for
      the controls. The adduct N-(2-hydroxy-3-butenyl)valine (HBVal) formed by the
      reaction of the N-terminal valine of globin with carbon-1 of EB was measured. The
      N-alkylated amino acid was analyzed by gas chromatography/mass spectrometry
      (GC/MS) after degradation by the modified Edman procedure. Using published
      methods problems arose with high background levels, especially in the negative
      ion chemical ionization (NCI) mode. In the present study a limit of detection of
      0.2 pmol/g globin was achieved by using 400 mg globin, a variation in extraction
      solvents, an additional purification step and a widely extended GC temperature
      program. The median hemoglobin adduct level of the Czech BD monomer production
      workers (0.7 pmol/g globin; n = 17) was significantly higher than that of the
      controls (0.2 pmol/g globin; n = 19; P<0.05). Smoking controls showed higher
      hemoglobin adduct levels than nonsmoking controls (P<0.1) and significantly
      higher BD exposure levels (P<0.01).

PMID- 11218045
TI  - Glutathione transferase activities in renal carcinomas and adjacent normal renal
      tissues: factors influencing renal carcinogenesis induced by xenobiotics.
AB  - In general, the biological activation of nephrocarcinogenic chlorinated
      hydrocarbons proceeds via conjugation with glutathione. It has mostly been
      assumed that the main site of initial conjugation is the liver, followed by a
      mandatory transfer of intermediates to the kidney. It was therefore of interest
      to study the enzyme activities of subgroups of glutathione transferases (GSTs) in
      renal cancers and the surrounding normal renal tissues of the same individuals (n
      = 21). For genotyping the individuals with respect to known polymorphic GST
      isozymes the following substrates with differential specificity were used: 1
      chloro-2,4-dinitrobenzene for overall GST activity (except GST theta); 7-chloro-4
      nitrobenzo-2-oxa- 1,3-diazole for GST alpha; 1,2-dichloro-4-nitro-benzene for GST
      mu; ethacrynic acid and 4-vinylpyridine for GST pi; and methyl chloride for GST
      theta. In general, the normal tissues were able to metabolize the test
      substrates. A general decrease in individual GST enzyme activities was apparent
      in the course of cancerization, and in some (exceptional) cases individual
      activities, expressed in the normal renal tissue, were lost in the tumour tissue.
      The GST enzyme activities in tumours were independent of tumour stage, or the age
      and gender of the patients. There was little influence of known polymorphisms of
      GSTM1, GSTM3 and GSTP1 upon the activities towards the test substrates, whereas
      the influence of GSTT1 polymorphism on the activity towads methyl chloride was
      straightforward. In general, the present findings support the concept that the
      initial GST-dependent bioactivation step of nephrocarcinogenic chlorinated
      hydrocarbons may take place in the kidney itself. This should be a consideration
      in toxicokinetic modelling.

PMID- 11218046
TI  - Evidence against a major role of plasmalogens in the resistance of astrocytes in
      lactic acid-induced oxidative stress in vitro.
AB  - Astrocytes are known to play a key role in buffering extracellular pH variations
      and, in addition, they are particularly resistant to oxidative stress and
      subsequent lipid peroxidation. This great resistance may be ascribed to the
      presence of high concentrations of certain antioxidants, but another explanation
      may be the presence of a high quantity of plasmalogens, which are a special group
      of glycerophospholipids characterized by a vinyl ether bond instead of an ester
      bond in the sn-1 position of the glycerol backbone. Plasmalogens are sensitive to
      free radical attack and acidity, and numerous works have supported the hypothesis
      that they may be antioxidant molecules that protect cells from oxidative stress.
      The aim of this work was to investigate, on astrocytes in lactic acid-induced
      oxidative stress (pH 5.5), the behavior of phospholipids and, in particular,
      plasmalogens. Two main techniques, based on the susceptibility of the vinyl ether
      bond to hydrolysis, were employed in this study to measure plasmalogen levels. In
      both cases, the sn-1 vinyl ether linkage was cleaved using mercuric chloride,
      producing a lysophospholipid that was assessed by phosphorus measurement or using
      HCl treatment, producing a long-chain fatty aldehyde assayed by gas
      chromatography/mass spectrometry. On astrocytes in culture, only
      plasmenylethanolamine (PlmEtn) was evidenced, representing 40% of
      glycerophosphoethanolamine lipids. When astrocytes were incubated with lactic
      acid, no modification in the amount of PlmEtn was seen. Furthermore, free
      aldehydes and aldehydes corresponding to the quantity of intact plasmalogens were
      similar to those observed on controls. In addition, the constancy of two lipid
      peroxidation markers, thiobarbituric acid reactive substances and polyunsaturated
      fatty acids, was clear evidence of the resistance of these cells in lactic acid
      conditions. In conclusion, our results fail to demonstrate a major role of
      plasmalogens in the resistance of astrocytes in lactic acid-induced oxidative
      stress.

PMID- 11218047
TI  - On the interactions between antimuscarinic atropine and NMDA receptor antagonists
      in anticholinesterase-treated mice.
AB  - Both organophosphate (OP) and carbamate pesticides may produce seizures and death
      commonly attributed to the inhibition of acetylcholinesterase (AChE) and
      subsequent excess of acetylcholine (ACh). The anticonvulsant and neuroprotective
      properties of N-methyl-D-aspartate (NMDA) receptor antagonists in animals
      encouraged us to investigate their effects on the toxic and convulsant properties
      of OP and carbamate pesticides. Adult Swiss mice were systemically injected with
      the OP pesticide, chlorfenvinphos (CVP), or the carbamate pesticide, methomyl
      (MET). Both CVP and MET induced dose-dependent seizure activity and death in
      mice. Pretreatment with the muscarinic antagonist, atropine (ATR), at a dose of
      1.8 mg/kg did not prevent seizures but decreased the lethal effects of CVP and
      MET. Pretreatment with the NMDA antagonists, dizocilpine (MK-801) at a dose of 1
      mg/kg or 3-((R,S)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP) at a
      dose of 10 mg/kg, influenced neither MET-induced seizures nor CVP- or MET-induced
      death. However, both MK-801 and CPP blocked CVP-induced seizures. Concurrent
      administration of ATR and the NMDA antagonists prevented seizures produced by
      CVP, but not those produced by MET. Nevertheless, both MK801 and CPP
      coadministered with ATR markedly enhanced its antilethal effects in CVP- and MET
      intoxicated mice. The antidotes had no influence upon brain AChE activities in
      mice treated with saline or CVP or MET. It seems that combined treatment with ATR
      and NMDA receptor antagonists might be of clinical relevance.

PMID- 11218048
TI  - Differential response of immature rat uterine tissue to ethinylestradiol and the
      red wine constituent resveratrol.
AB  - The stilbene derivative resveratrol (RES) is a phytoalexin of grapes, peanuts and
      other fruits. It is structurally related to stilbene estrogens and an estrogenic
      potential of RES has recently been demonstrated in a number of in vitro studies.
      In this investigation, the uterotrophic responses of immature Wistar rats to
      subcutaneous administration of RES (18, 58, and 575 mg/ kg) and the reference
      estrogen ethinylestradiol (EE2; 0.3, 1, 3, 30 microg/kg) on three consecutive
      days were determined. Uterine weight, histopathological changes,
      immunohistochemical expression of nuclear estrogen receptor-alpha (ERalpha) and
      progesterone receptor (PR) protein, gene expression of ERalpha and PR at the
      messenger ribonucleic acid (mRNA) level and peroxidase induction were examined.
      EE2 dose dependently increased uterine weight, enlarged the uterine lumen and
      induced hypertrophy of epithelial, stromal and myometrial cells. Expression of
      ERalpha protein in epithelial, stromal and myometrial nuclei and of PR protein in
      epithelial nuclei was reduced in EE2-treated rats, while PR protein in stromal
      and myometrial nuclei was increased in a dose-dependent manner. EE2 increased
      messenger ribonucleic acid (mRNA) levels of uterine PR and induced peroxidase
      activity. In contrast, RES rather mildly decreased uterine weight, while
      histology did not reveal differences between controls and RES-treated rats.
      Expression of nuclear ERalpha protein was dose dependently decreased in
      epithelial, stromal and myometrial cells of RES-treated rats, while nuclear PR
      protein content was similar in controls and RES-treated rats. Following
      administration of RES, a trend toward reduced levels of ERalpha and PR mRNA was
      found, while no peroxidase induction occurred. Plasma levels of RES, 45 min after
      the administration of a single subcutaneous dose of 500 mg/kg, were in the range
      1-2 microM. In summary, an estrogenic potential of RES could not be substantiated
      in this in vivo study, although the most effective route of administration and
      extremely high doses were used and plasma levels were in the range reported to be
      effective in vitro. Whether other pharmacological properties of RES could mediate
      the observed changes in RES-treated animals is discussed.

PMID- 11218049
TI  - Evidence of a no-effect level in silica-induced rat lung mutagenicity but not in
      fibrogenicity.
AB  - Exposure to silica can lead to fibrosis and the development of lung tumors in the
      rat. Based on these animal studies and on epidemiological data, silica has been
      classified as a human carcinogen. The initial mechanisms have not been finally
      clarified, but particle-induced tumor formation is at least closely associated
      with inflammation, the production of reactive oxygen species (ROS) and DNA
      damage. We investigated the dose-dependent effects of silica on the formation of
      the major DNA oxidation product 8-oxoguanine (8-oxo-Gua) in rat lung cells, on
      p53 (p53) and p53 mutant protein (p53 mut) synthesis, as well as on the amount of
      the surfactant phospholipids phosphatidylinositol (PI) and phosphatidylglycerol
      (PG) in the bronchoalveolar lavage fluids (BALF) as indicators of fibrotic
      processes in the lung. Rats were exposed by intratracheal instillation to various
      amounts of DQ12 quartz (0.15, 0.3, 0.6, 1.2, 2.4 mg/animal) and lungs were
      investigated after 21 and 90 days. PG decreased and PI increased quartz dose
      dependently. 8-oxoGua was significantly increased only after 1.2 and 2.4 mg
      quartz/animal. Cells expressing p53 protein were increased at 1.2 and 2.4 mg, p53
      mutant protein only at 2.4 mg/animal. This indicates a no-effect level for
      mutagenicity at a low, but still fibrogenic quartz exposure.

PMID- 11218050
TI  - Formation of DNA adducts from oil-derived products analyzed by 32P-HPLC.
AB  - The aim of this study was to investigate the genotoxic potential of DNA adducts
      and to compare DNA adduct levels and patterns in petroleum vacuum distillates,
      coal tar distillate, bitumen fume condensates, and related substances that have a
      wide range of boiling temperatures. An in vitro assay was used for DNA adduct
      analysis with human and rat S-9 liver extract metabolic activation followed by
      32P-postlabeling and 32P-high-performance liquid chromatography (32p-HPLC). For
      petroleum distillates originating from one crude oil there was a correlation
      between in vitro DNA adduct formation and mutagenic index, which showed an
      increase with a distillation temperature of 250 degrees C and a peak around a
      distillation point of approximately 400 degrees C. At higher temperatures, the
      genotoxicity (DNA adducts and mutagenicity) rapidly declined to very low levels.
      Different petroleum products showed a more than 100-fold range in DNA adduct
      formation, with severely hydrotreated base oil and bitumen fume condensates being
      lowest. Coal tar distillates showed ten times higher levels of DNA adduct
      formation than the most potent petroleum distillate. A clustered DNA adduct
      pattern was seen over a wide distillation range after metabolic activation with
      liver extracts of rat or human origin. These clusters were eluted in a region
      where alkylated aromatic hydrocarbons could be expected. The DNA adduct patterns
      were similar for base oil and bitumen fume condensates, whereas coal tar
      distillates had a wider retention time range of the DNA adducts formed. Reference
      substances were tested in the same in vitro assay. Two- and three-ringed
      nonalkylated aromatics were rather low in genotoxicity, but some of the three- to
      four-ringed alkylated aromatics were very potent inducers of DNA adducts.
      Compounds with an amino functional group showed a 270-fold higher level of DNA
      adduct formation than the same structures with a nitro functional group. The most
      potent DNA adduct inducers of the 16 substances tested were, in increasing order,
      9,10-dimethylanthracene, 7,12-dimethylbenz[a]anthracene and 9-vinylanthracene.
      Metabolic activation with human and rat liver extracts gave rise to the same DNA
      adduct clusters. When bioactivation with material from different human
      individuals was used, there was a significant correlation between the CYP 1A1
      activity and the capacity to form DNA adducts. This pattern was also confirmed
      using the CYP 1A1 inhibitor ellipticine. The 32P-HPLC method was shown to be
      sensitive and reproducible, and it had the capacity to separate DNA adduct
      forming substances when applied to a great variety of petroleum products.

PMID- 11218051
TI  - Topiramate in childhood epilepsy: past, present, and future.

PMID- 11218052
TI  - Topiramate in the catastrophic epilepsies of childhood.
AB  - Several epileptic syndromes that occur during childhood are characterized by
      severe treatment-resistant seizures, progressive loss of higher intellectual
      functions, and characteristic electroencephalographic abnormalities. These
      catastrophic epileptic syndromes include epileptic encephalopathy with diffuse
      slow spike waves (Lennox-Gastaut syndrome), West syndrome, progressive myoclonic
      epilepsies, and electrical status epilepticus during sleep. This article
      summarizes each syndrome and reviews the most recent information concerning the
      effectiveness of topiramate with respect to each condition. Suggestions are
      offered to help clinicians maximize topiramate's efficacy and tolerability in
      patients suffering with these syndromes. Overall, topiramate is a valuable
      antiepileptic medication in the treatment of catastrophic pediatric epileptic
      syndromes.

PMID- 11218053
TI  - Safety and tolerability of topiramate in children.
AB  - Three double-blind, randomized, placebo-controlled studies of topiramate that
      include children have been published and prospective but unblinded and
      retrospective reviews have been reported providing information regarding
      topiramate's safety and tolerability. These studies indicate that side effects
      tend to occur early in treatment with topiramate, especially in children
      receiving polypharmacy. Two classes of adverse events are commonly reported:
      central nervous system and anorexia/weight loss. Central nervous system effects
      include somnolence, difficulties with concentration, and behavior changes.
      Tolerance to these effects seems to develop in most children. When it occurs,
      weight loss has been noted in the first 12 to 18 months, after which normal
      weight gain resumes, without long-term impact on growth. As opposed to the
      experience in adults, aphasia and word-finding difficulties are not commonly
      seen, and parasthesiae are not reported by children. Renal calculi are rare. Life
      threatening idiosyncratic reactions have not been attributed to topiramate. While
      metabolic acidosis has been reported, no other clinically significant laboratory
      abnormalities have been associated with the use of topiramate in children.

PMID- 11218054
TI  - Pharmacokinetics and pharmacodynamics of topiramate.
AB  - In the treatment of children with epilepsy, the role of topiramate has been
      expanding gradually. The main factor that has contributed to this trend is the
      relatively large body of information that has accumulated on the clinical
      pharmacology of topiramate in children, including its broad-spectrum efficacy,
      pediatric pharmacokinetics, side-effect profile, and safety. It has also become
      increasingly apparent with time that topiramate, in contrast to other broad
      spectrum antiepileptic drugs used in children, does not seem to be associated
      with a significant risk of any serious or life-threatening adverse effects. The
      present review summarizes the available evidence related to the clinical
      pharmacology of topiramate in children and provides an update on its known
      mechanisms of action. Finally, available experimental data on the neuroprotective
      effect of topiramate are reviewed because of their considerable clinical
      potential in the treatment of children and newborns.

PMID- 11218055
TI  - Use of topiramate in localization-related epilepsy in children.
AB  - Topiramate has been shown to be safe and effective in refractory partial epilepsy
      in children. Pharmacokinetic studies show that the clearance of topiramate is
      greater in children than in adults; therefore, higher doses may be needed in
      children than adults. It is generally well tolerated, except for cognitive
      dysfunction. Weight loss and the risk of renal stones can be significant in some
      cases. However, when compared with other anticonvulsant medications, topiramate
      has few serious idiosyncratic reactions such as rash, hematologic reactions, and
      hepatotoxicity.

PMID- 11218056
TI  - Use of topiramate in childhood generalized seizure disorders.
AB  - Topiramate is a sulfamate derivative of the naturally occurring monosaccharide D
      fructose. It was initially approved in the United States as adjunctive therapy
      for partial seizures in 1997. However, there is increasing evidence that it is
      effective in the treatment of generalized seizures and epilepsy syndromes.
      Initially, open-label studies using topiramate as add-on therapy in children with
      refractory generalized seizure types were performed. These showed improvement in
      patients with the following generalized seizure types: typical and atypical
      absence, atonic, myoclonic, generalized tonic-clonic, and juvenile myoclonic
      epilepsy. Double-blind, placebo-controlled multicentered studies in patients with
      refractory primary generalized tonic-clonic seizures and epilepsy syndromes were
      performed. The median reduction in seizure frequency for primary generalized
      tonic-clonic seizures was 56.7% for topiramate and 9% for placebo. Additionally,
      13.6% of topiramate-treated patients were primary generalized tonic-clonic
      seizure free for the study period. In the topiramate-treated juvenile myoclonic
      epilepsy patients, primary generalized tonic-clonic seizures were reduced > 50%
      in 73% of patients. Open-label extension showed that primary generalized tonic
      clonic seizures were reduced >50% in 63% of topiramate-treated patients for > or
      = 6 months, and 16% were primary generalized tonic-clonic seizure free > or = 6
      months. Accumulating evidence suggests that topiramate has a broad spectrum of
      antiepileptic effect. Moreover, life-threatening organ toxicity has not been
      attributed to topiramate. Topiramate is an effective treatment for refractory
      generalized seizure types and epilepsy syndromes encountered in children.

PMID- 11218057
TI  - Parvalbumin and GABA in the developing somatosensory thalamus of the rat: an
      immunocytochemical ultrastructural correlation.
AB  - The calcium binding protein parvalbumin (PV) is widely distributed in the
      mammalian nervous system and its relationship with GABAergic neurons differs
      within thalamic nuclei and animal species. In the rat somatosensory thalamus PV
      immunoreactive (ir) neurons were found only in the GABAergic reticular thalamic
      nucleus (RT), while a dense PVir neuropil is present in the ventrobasal complex
      (VB). In this study the distribution and relationship of PV and GABA were
      investigated in RT and VB during postnatal development at electron microscopic
      level. The pre-embedding immunoperoxidase detection of PV was combined with the
      post-embedding immunogold localization of GABA. In RT, at all developmental ages,
      neuronal cell bodies, dendrites and rare axonal terminals were both PVir and
      GABAir. In VB during the first postnatal week several small vesicle-containing
      profiles were double-labelled and some of them were identifiable as synaptic
      terminals. From postnatal day 7 (P7) to P9 the medial part of VB was more
      intensely PVir than the lateral one and some differences in the sequence of
      maturation of PVir terminals were noted between these two VB subdivisions. Single
      labelled PVir profiles were first observed at P8, whereas single-labelled PVir
      terminals appeared at P12 and at P15 they became more frequent and larger,
      showing the typical morphology of ascending afferents described in adult VB.
      These results demonstrate the late expression of PV and acquisition of adult
      morphology in ascending terminals of rat VB during postnatal development in
      comparison with the innervation arising from the GABAergic RT.

PMID- 11218058
TI  - The distribution of NPY-like immunoreactivity in the chameleon brain.
AB  - The distribution of neuropeptide Y (NPY) immunoreactivity was studied in the
      brain of the chameleon. Cell bodies and fibers displaying NPY-like
      immunoreactivity were widely dispersed throughout the brain and at the highest
      density in the telencephalon and diencephalon. Immunolabeled cell bodies were
      numerous in the medial and dorsomedial cortex and in the dorsal ventricular
      ridge, while the striatum and basal telencephalon only contained sparsely
      scattered NPY-positive somata. Immunopositive neurons were densely distributed in
      the dorsal thalamus (particularly in the perirotundal belt), the area
      triangularis, the nucleus geniculatus lateralis pars dorsalis, the
      periventricular hypothalamus and the medial eminence. In the pretectum, NPY
      immunoreactive cell bodies were limited to the nucleus posterodorsalis, while in
      the mesencephalon immunolabeled somata were found in the stratum album centrale
      of the optic tectum and in the substantia nigra. Immunopositive fibers and
      terminals were particularly dense in the dorsomedial cortex, the periventricular
      hypothalamus, the nuclei accumbens, suprachiasmaticus and griseus tectalis, in
      the substantia nigra and in the torus semicircularis. These findings show that
      the NPY system in the chameleon has the same basic organization as in other
      vertebrate species, and indicate that this peptide could be also implicated in
      the regulation of several aspects of cerebral functions. In addition, and of
      particular interest, is the observation of numerous NPY-immunoreactive neurons
      and fibers in several visual nuclei, suggesting an important involvement of this
      substance in the visual function.

PMID- 11218059
TI  - Changing synaptic connections on cell bodies of growing identified spinal
      motoneurons of the eel, Anguilla.
AB  - As the target musculature they innervate grows throughout life, certain segmental
      motoneurons from the spinal cord of Anguilla, readily identified on the basis of
      their form and position, also increase in size. In doing so, they present a
      steadily increasing target to the spinal and supraspinal neurons that innervate
      them. How the afferent neurons respond was assessed by measuring features of
      their synaptic boutons contacting the motoneuronal perikarya, as seen with
      electron microscopy. About 60% of the perimeter of the perikaryal profile of each
      motoneuron was found to be covered with synaptic bouton profiles, a value that is
      independent of the size of the motoneuron. Furthermore, the distances between
      synaptic profiles, their contact sizes (measured as apposition length) and the
      number and size of the vesicles each profile contains were all found to be
      relatively constant and also independent of motoneuronal size. In contrast, the
      number of synaptic profiles contacting a motoneuron correlated well with its
      perikaryal size. Our findings indicate that the challenge of a growing neuronal
      target is met by a steady increase in the number of contacting boutons, the form
      and spacing of which are held relatively constant; this strategy will require
      continual synaptic realignment at the target.

PMID- 11218060
TI  - The apical ectodermal ridge, fibroblast growth factors (FGF-2 and FGF-4) and
      insulin-like growth factor I (IGF-I) control the migration of epidermal
      melanoblasts in chicken wing buds.
AB  - The role of the apical ectodermal ridge and of fibroblast growth factors FGF-2
      and FGF-4 and of the insulin-like growth factor I (IGF-I) in the control of the
      migration of epidermal melanoblasts was investigated using quail-chicken
      chimeras. Wing buds of a strain of unpigmented chicken were microsurgically
      modified in several ways (ablation, displacement or implantation of additional
      apical ectodermal ridges, implantation of grafts devoid of apical ectodermal
      ridges, ectopic application of growth factors) and received grafts containing
      quail neural crest cells. The distribution of the epidermal melanoblasts which
      had differentiated from the quail grafts revealed that both the apical ectodermal
      ridge and the growth factors invariably caused the migration of epidermal
      melanoblasts towards them. This leads to the conclusion that the presence of the
      apical ectodermal ridge is the sufficient condition to direct the migration of
      epidermal melanoblasts within the avian embryonic wing bud. Furthermore, FGF-2
      and IGF-I and to a lesser extent FGF-4 play a decisive role in directing the
      migration of epidermal melanoblasts within chicken wing buds and are likely to be
      involved in the molecular cascade by means of which the apical ectodermal ridge
      controls the migration of epidermal melanoblasts.

PMID- 11218061
TI  - Spatial and temporal expression patterns of the cyclin-dependent kinase (CDK)
      inhibitors p27Kip1 and p57Kip2 during mouse development.
AB  - The cyclin-dependent kinase (CDK) inhibitors p27Kip1 and p57Kip2 are thought to
      regulate progression of the cell cycle. We have previously shown that the
      phenotypes of p27-/- mice are substantially different from those of p57-/- mice,
      suggesting that spatial and temporal expression patterns of p27Kip1 and p57Kip2
      might be distinct. In this study, the roles of p27Kip1 and p57Kip2 in development
      were examined by characterizing their expression patterns during mouse
      embryogenesis by immunohistochemical analysis. Whereas certain organs and tissues
      (brain, lens, ganglion, lung, heart, liver, skin and kidney) expressed both
      proteins, others expressed only p27Kip1 (thymus, spleen, retina, testis and
      ovary) or only p57Kip2 (gut, palate, pancreas, cartilage and skeletal muscle). In
      addition, some organs expressed both p27Kip1 and p57Kip2 but showed mutually
      exclusive patterns of distribution among tissues. Thus, in the adrenal gland,
      p57Kip2 was expressed in the cortex but not in the medulla, whereas p27Kip1 was
      expressed in the medulla but not in the cortex. Whereas the expression of p57Kip2
      in most tissues was restricted to embryogenesis, expression of p27Kip1 in many
      tissues was maintained in adult animals. Double-label immunofluorescence staining
      with either anti-p27Kip1 or anti-p57Kip2 and anti-BrdU revealed that the
      expression of p27Kip1 and p57Kip2 was inversely correlated with cell
      proliferation, suggesting that p27Kip1 and p57Kip2 are expressed exclusively in
      postmitotic cells. These complex spatial and temporal patterns of expression are
      consistent with the phenotypes of mice deficient in p27Kip1 or p57Kip2, and they
      suggest that these proteins might play important roles in tissue development.

PMID- 11218062
TI  - Mitoses of existing corticotrophs contribute to their proliferation in the rat
      pituitary during the late fetal period.
AB  - We studied the proliferation of pituitary corticotrophs quantitatively by
      labeling the proliferating cells with bromodeoxyuridine (BrdU) and carrying out
      immunocytochemistry for ACTH in rat fetuses at 19.5 days of gestation. In
      addition to labeling proliferating cells with a single injection of BrdU, we used
      double BrdU administrations at 9:00 and 19:00 for a more sensitive detection of
      proliferating cells. With this double administration, the number of cells labeled
      with either BrdU or both BrdU and ACTH increased by 1.75 and 2.3 times,
      respectively, compared with the single BrdU injection. The labeled cells further
      increased when the sections were stained for the proliferating cell nuclear
      antigen (PCNA) instead of BrdU. The number of cells labeled with PCNA or both
      PCNA and ACTH was 1.37 and 1.68 times that of the cells labeled with either BrdU
      or both BrdU and ACTH, respectively. The ratio of BrdU/ACTH-labeled cells or
      PCNA/ACTH-labeled cells to all corticotrophs was 13.6% and 24.3%, respectively,
      much higher than the ratios in fetuses having a single BrdU injection (6.6%).
      These results indicate that the mitosis of existing corticotrophs contributes
      greatly to their increase during the late fetal period.

PMID- 11218063
TI  - Differential expression of calcium-binding proteins in the red nucleus of the
      developing and adult human brain.
AB  - The adult human red nucleus consists of two parts: (1) the parvocellular part,
      which is clearly separated from (2) the magnocellular part. The latter and its
      rubrospinal projection is known to be rudimentary in the adult human brain.
      Information concerning the fetal or neonatal features of the red nucleus is
      sparse. This study is aimed at providing a detailed account of the distribution
      of three calcium-binding proteins: calretinin (CR), calbindin (CB), and
      parvalbumin (PV), which are known to be expressed in distinct neuronal
      populations. Special attention has been paid to transient phenomena. CB was the
      most abundant protein in the magnocellular part in fetal and perinatal brains;
      immunoreactive (ir) neurons appeared numerous and densely packed. In the adult
      only few and widely spaced ir nerve cells were present. CR-expression largely
      corresponds to that of CB, except that fewer neurons were immunolabelled. In
      double-labellings the majority of neurons expressed both CB and CR; a moderate
      number of nerve cells solely expressing CR was present in the magnocellular part.
      PV-ir fibers and a moderate number of small cells were observed in the fetal,
      perinatal as well as the adult parvocellular part. A few PV-ir neurons were seen
      in the magnocellular part of the fetal and perinatal brains. Our results
      indicated that: (1) the magnocellular and parvocellular parts of the red nucleus
      were well-demarcated portions from fetal life onwards, thus a dominance of the
      parvocellular part over the magnocellular occurred during development; (2) the
      magnocellular part was more prominent in the fetal period than in adulthood; (3)
      neurons in the red nucleus were heterogeneous with respect to the
      immunoreactivities towards the three calcium-binding proteins examined; (4) the
      transient prominence of the magnocellular part might be a substrate for a
      specific transitory pattern of motor behaviour.

PMID- 11218064
TI  - Effects of K+ channel openers on I K(ATP) of human atrial myocytes at
      physiological temperatures.
AB  - The aim of this study was to investigate the effects of the potassium channel
      openers (PCOs) cromakalim and pinacidil on the ATP-dependent potassium current
      I(K)(ATP) in human atrial myocytes. Cells were isolated from the right atrial
      appendage obtained during cardiac surgery. Membrane currents were studied with
      the patch-clamp technique in the whole-cell recording mode at 36 degrees -37
      degrees C. Under physiological conditions (4.3 mmol/l ATP in the pipette
      solution, ATPi) I(K)(ATP) did not contribute to basal electrical activity. When
      ATPi was omitted from the pipette solution I(K)(ATP) activated with a time lag of
      4.92+/-0.92 min (n=6) and was completely inhibited by glibenclamide. Using 4.3
      mmol/l ATPi I(K)(ATP) at +30 mV was increased by 2.04+/-0.51, 7.24+/-1.65 and
      13.22+/-3.71 pA/pF (n=7) with 10, 30 and 100 micromol/l cromakalim, respectively,
      and by 3.24+/-0.98 (n=6), 4.07+/-0.48 (n=10) and 3.46+/-1.23 pA/pF (n=6) with 10,
      30 and 100 micromol/l pinacidil, respectively. Control current density was 5.39+/
      0.47 pA/pF (n=39). Using 1 mmol/l ATPi I(K)(ATP) showed a more pronounced
      activation (4.81+/-3.28, n=6; 9.78+/-2.60, n=7; and 15.1+/-4.18 pA/pF, n=6; with
      10, 30 and 100 micromol/l pinacidil, respectively). I(K)(ATP) activated by both
      compounds could be effectively inhibited by glibenclamide. Repetitive exposure to
      pinacidil (30 micromol/l at 4.3 mmol/l ATPi) caused a potentiation of I(K)(ATP).
      Current density at +30 mV was increased by 87% during the first and by 401%
      during the second pinacidil application (n=5). The data presented in this paper
      provide new information about electrophysiological characteristics of human
      atrial I(K)(ATP) and its modulation by the PCOs cromakalim and pinacidil and
      suggest species-dependent differences.

PMID- 11218065
TI  - Lack of evidence for histamine H3 receptor function in rat ileum and human colon.
AB  - The effects of histamine and the more selective H3 receptor agonist (R)alpha
      methylhistamine were investigated on contractile responses produced by electrical
      stimulation of the longitudinal and circular muscles of the rat ileum and the
      circular muscle of the human colon. Histamine (0.1-3.0 microM) and (R)alpha
      methylhistamine (0.1-3.0 microM) had no significant effect (P>0.05) on
      cholinergic nerve stimulation of either the longitudinal or circular muscle of
      the rat ileum nor the circular muscle of the human colon. Substance P (1 microM)
      and nicotine (0.1 microM), which both produce a contraction via activation of
      cholinergic nerves, were also unaffected by histamine (1 microM and 10 microM) or
      (R)alpha-methylhistamine (1 microM and 10 microM), in either tissue. Preliminary
      studies using in situ hybridisation histochemistry (ISHH) were performed in rat
      brain and ileum in an attempt to identify H3 receptor mRNA expression. This was
      done using 33P-labelled oligonucleotide-specific probes for rat H3 receptor mRNA.
      Unlike rat brain, where H3 receptor mRNA expression was found to be abundant in
      several regions, no H3 receptor mRNA expression could be detected in the rat
      ileum under the conditions used. These findings suggest H3 receptors have no role
      in the modulation of cholinergic neuronal function in the rat or human intestine
      unlike those in the guinea-pig. Furthermore, H3 receptors appear to be absent in
      the rat ileum.

PMID- 11218066
TI  - Differences between GABA levels in Alzheimer's disease and Down syndrome with
      Alzheimer-like neuropathology.
AB  - Down syndrome (DS) is a genetic disease with developmental brain abnormalities
      resulting in early mental retardation and precocious, age-dependent Alzheimer
      type neurodegeneration. Furthermore, non-cognitive symptoms may be a cardinal
      feature of functional decline in adults with DS. A number of amino acids
      [glutamate, aspartate, gamma-aminobutyrate (GABA), glycine, taurine, glutamine,
      serine, arginine] were investigated in post-mortem tissue samples from temporal,
      occipital cortex, thalamus, caudate nucleus, and cerebellum of adult patients
      with Down syndrome (DS) exhibiting Alzheimer-like neuropatholgy, Alzheimer's
      disease (AD) and from controls by use of high performance liquid chromatography
      (HPLC). In DS, no significant differences from control values could be observed
      in any of the brain regions. In AD, significant loss of GABA content was found in
      the temporal cortex (0.5+/-0.2 micromol/g vs. 1.3+/-0.8 micromol/g wet weight
      tissue, P<0.01), occipital cortex (0.8+/-0.2 micromol/g vs. 1.4+/-0.6 micromol/g,
      P<0.05) and cerebellum (1.1+/-0.3 micromol/g vs. 1.8+/-0.5 micromol/g, P<0.05).
      Glutamate and aspartate concentrations were significantly reduced in the caudate
      nucleus of AD subjects (glutamate: 6.1+/-3.4 micromol/g vs. 14.7+/-1.8
      micromol/g; aspartate: 1.5+/-0.3 micromol/g vs. 3.3+/-0.4 micromol/g, P<0.05).
      The results of this study confirm previous findings in late stage AD and provide
      further information with respect to DS which may be relevant to understanding
      different pathogenesis of cognitive and non-cognitive (behavioral) features in DS
      and AD.

PMID- 11218067
TI  - 5HT4(a) and 5-HT4(b) receptors have nearly identical pharmacology and are both
      expressed in human atrium and ventricle.
AB  - 5-Hydroxytryptamine (5-HT) increases human heart rate and atrial contractile
      force and hastens atrial relaxation through 5-HT4 receptors. Moreover, 5-HT may
      be arrhythmogenic and give rise to atrial fibrillation. It is not clear which
      splice variant(s) of the 5-HT4 receptor is expressed and mediates these effects
      of 5-HT in the human heart. Previous studies have indicated different
      pharmacological properties of 5-HT4 receptors in human heart and mouse colliculi
      neurones, possibly due to expression of different splice variants. We therefore
      cloned the human 5-HT4(b) receptor and compared its pharmacological properties
      with those of the cloned human 5-HT4(a) receptor and searched for the
      corresponding mRNA in human tissues. The primary structures of the two human 5
      HT4 receptor splice variants are identical except for divergent C-terminal tails
      of 28 and 29 amino acids in the 5-HT4(a) and 5-HT4(b) receptors, respectively.
      Reverse transcription-polymerase chain reaction (RT-PCR) analysis showed that
      both variants were coexpressed in various tissues, including cardiac atrium and
      ventricle. Additional bands suggested the presence of more than two human 5-HT4
      receptor splice variants. With cloned receptors stably expressed in HEK293 cells
      or transiently expressed in COS-7 cells, [3H]GR 113808 consistently showed
      slightly higher binding affinity to h5-HT4(b) than to h5-HT4(a) receptor (pKd 0.1
      0.2 log units higher). Competition of agonists, partial agonists and antagonists
      for [3H]GR113808 binding revealed no significant differences between the two
      receptors. For 5-HT4 receptor agonists and antagonists, their potencies in
      stimulating or inhibiting, respectively, 5-HT-stimulated adenylyl cyclase
      activity correlated well with their binding affinities. Tropisetron and SB207710
      showed partial agonist activity at high receptor expression levels for both
      isoforms. Cisapride and renzapride were both partial agonists at moderate
      receptor levels and full agonists at high receptor levels. Cisapride was more
      potent than renzapride while the converse was the case in human atrium, for which
      cisapride had lower affinity and agonist potency than at the recombinant
      receptors. The binding affinities and agonist potencies of ligands for both 5
      HT4(a) and 5-HT4(b) receptors correlated with the corresponding affinities and
      potencies in human atrium. The agonist potency of SB207710 was around 10 times
      lower than its binding and blocking affinity for both splice variants, suggesting
      that activation of adenylyl cyclase and blockade of 5-HT responses are mediated
      through different conformational states. The similar pharmacological properties
      of the two human 5-HT4 receptor splice variants together with their expression in
      human atrium would be consistent with mediation of the cardiostimulant effects of
      5-HT through both variants. However, the effects of cisapride appear either
      mediated through non-a and non-b splice variants of the 5-HT4 receptor or 5
      HT4(a) and 5-HT4(b) receptor expression in human atrial cells alters somewhat
      their pharmacological profile through still unknown mechanisms.

PMID- 11218068
TI  - Characterization of the locomotor activity-inhibiting effect of
      nociceptin/orphanin FQ in mice.
AB  - Nociceptin/orphanin FQ (NC) modulates spontaneous locomotor activity (LA) in
      mice. NC applied intracerebroventricularly (i.c.v.) has been reported to
      stimulate LA at low doses (0.001-0.01 nmol) while inhibiting LA at higher doses
      (1-10 nmol). In the present study, the effects of NC on LA in mice were evaluated
      and the receptor involved characterized using NC receptor (OP4) agonists and
      antagonists. No significant differences were found in the LA (30-min observation
      period) between non-injected mice, mice injected with saline (2 microl/mouse,
      i.c.v.), or with low doses of NC (0.001 nmol and 0.01 nmol). In the 0.1-10 nmol
      range, NC caused a dose-dependent, naloxone-insensitive reduction of LA. The
      effects of the natural peptide were mimicked by NCNH2 and NC(1-13)NH2 while
      shorter fragments were inactive (NC(1-12)NH2, NC(1-9)NH2). [Phe1psi(CH2
      NH)Gly2]NC(1-13)NH2 ([F/G]NC(1-13)NH2) was inactive at 0.1 nmol and 1 nmol, while
      causing a partial reduction of LA at 10 nmol. One nmol of the pseudopeptide also
      prevented the inhibitory effect of 1 nmol NC. Ten nmol [Nphe1]NC(1-13)NH2 did not
      modify LA per se, but fully prevented the inhibitory action of 1 nmol NC. Results
      indicate that [F/G]NC(1-13)NH2 and [Nphe1]NC(1-13)NH2 behave as a partial agonist
      and a pure antagonist of OP4 sites, respectively. Taken together, these data
      demonstrate that NC inhibits LA in mice by activating OP4 receptor sites.

PMID- 11218069
TI  - Differential effects of dofetilide, amiodarone, and class lc drugs on left and
      right atrial refractoriness and left atrial vulnerability in pigs.
AB  - OBJECTIVES: Antiarrhythmic drugs have been shown to prolong right atrial
      refractoriness while data on the left atrium are not available. In pigs we have
      observed shorter effective refractory periods (ERP) of the left compared with the
      right atrium associated with a much higher left atrial vulnerability for
      tachyarrhythmias. Since this could suggest a different distribution of
      repolarizing ion channels in left and right atrium, we investigated whether
      antiarrhythmic drugs blocking different ion channels have a differential effect
      on left and right atrial ERP and left atrial vulnerability. METHODS: In
      pentobarbital-anesthetized pigs (n=40) we measured and compared ERPs in both
      atria before and after different drugs with the S1-S2 extrastimulus method at
      three basic cycle lengths (BCL) and assessed the inducibility of atrial
      fibrillation/flutter (AF/AFL) by the premature S2 stimulus. RESULTS: At the three
      BCL tested (240/300/400 ms) baseline ERPs were shorter in left vs. right atrium
      (112+/-2/124+/-2/129+/-2 ms vs. 147+/-2/163+/-2/167+/-2 ms, P<0.001). Mostly non
      sustained AF/AFL induced by the S2 extrastimulus was very frequent in the left
      (68%) and nearly absent in the right atrium (3%). Only amiodarone, 5 mg/kg i.v.,
      which showed a balanced increase of left and right atrial ERP (29+/-5/33+/-4/35+/
      3% vs. 30+/-5/35+/-5/42+/-7%), decreased the inducibility of AF/AFL significantly
      (-72%, P<0.01). Dofetilide, 10 microg/kg i.v., had a stronger effect on right
      than left atrial ERP (36+/-4/39+/-5/46+/-10% vs. 23+/-2/22+/-7/22+/-5%, P<0.05),
      while flecainide, 1 mg/kg i.v., prolonged left more than right atrial ERP (58+/
      15/36+/-7/40+/-7% vs. 26+/-5/24+/-5/21+/-4%, P<0.05) similar to 1 mg/ kg of
      propafenone (46+/-5/45+/-7/32+/-10% vs. 17+/-4/21+/-5/ 25+/-8%, P<0.05).
      CONCLUSION: The shorter refractoriness of the left compared with the right atrium
      observed in pigs was associated with a high left atrial vulnerability for
      tachyarrhythmias, which was reduced only by amiodarone showing a balanced
      increase of left and right atrial ERP. Dofetilide was stronger on right atrial
      ERP, flecainide and propafenone on left atrial ERP. These differences suggest a
      differential distribution of repolarizing ion channels between left and right
      atrium with possible relevance for the antiarrhythmic efficacy of drugs.

PMID- 11218070
TI  - Differences in electromechanical coupling between bradykinin and the nonpeptide
      kinin B2 receptor agonist, FR 190997, in the circular muscle of guinea-pig colon.
AB  - We have compared the effect of bradykinin (BK) and the nonpeptide kinin B2
      receptor agonist, FR 190997, in producing changes in membrane potential and
      tension in the circular muscle of guinea-pig colon by the sucrose gap technique.
      In the presence of atropine (1 microM), S-ketoprofen (3 microM) and apamin (0.1
      microM), BK (1 microM for 20 s) induced a transient depolarization of the
      membrane with superimposed action potentials (spikes) and transient contraction.
      Nifedipine (1 microM) eliminated the spikes and markedly inhibited the BK-induced
      contractions. FR 190997 (3-10 microM for 20 s) induced a slowly developing
      sustained small depolarization associated with a slowly developing and sustained
      contraction but, contrary to BK, FR 190997 was unable to trigger spikes.
      Nifedipine had no effect on depolarization and contraction induced by FR 190997.
      In the presence of 1 microM nifedipine, the combined application of a blocker of
      receptor-operated cation channels, SKF 96365 (50 microM for 30 min), and of an
      inhibitor of sarcoplasmic reticulum calcium pump, cyclopiazonic acid (CPA 10
      microM for 30 min), reduced the BK-induced depolarization and contraction by
      about 45%-60%. The same treatment induced about 40% reduction of the sustained
      contraction induced by FR 190997, whereas the concomitant depolarization was not
      significantly affected. The tyrosine kinase inhibitor genistein (40 microM for 20
      min) had no effect on the BK- and FR 190997-induced depolarization and
      contraction in the presence of nifedipine. In radioligand binding experiments
      performed in membranes of colonic smooth muscle cells, both agonists displaced
      the [3H]BK specific binding with a pIC50 of 9.6 and 8.5 for BK and FR 190997,
      respectively. These findings indicate a substantial qualitative difference in
      mechanisms of excitation contraction coupling activated by BK and FR 190997 via
      B2 receptors in guinea-pig colon.

PMID- 11218071
TI  - Anticonvulsant and sodium channel blocking activity of higher doses of
      clenbuterol.
AB  - Clenbuterol, a lipophilic beta2-adrenoceptor agonist, was investigated in various
      seizure models of experimental epilepsy. In the maximal electroshock seizure
      threshold test, clenbuterol (> or =4 mg/kg i.p.) increased the electroconvulsive
      threshold for tonic seizures in mice. In the traditional maximal electroshock
      seizure (MES) test in mice, ED50 values of 11 mg/kg i.p. or s.c. were determined.
      In both models, the beta2-receptor antagonist ICI 118.551 did not antagonize the
      anticonvulsant activity of clenbuterol. Combinations of clenbuterol with standard
      antiepileptics revealed additive anticonvulsant effects. Repeated administration
      of clenbuterol (5 mg/kg s.c., twice daily for 14 days) to mice did not
      significantly influence its anticonvulsant potency or the effectiveness of
      phenobarbital in the MES test. In various chemically-induced seizure tests with
      tonic convulsions, clenbuterol inhibited or tended to suppress the tonic phase.
      However, this drug was not effective in preventing clonic seizures in the
      pentylenetetrazol (85 mg/kg s.c.) seizure threshold test. In the rotarod ataxia
      test (mice), a minimal "neurotoxic" dose (TD50) of 41 mg/kg i.p. was determined.
      In unrestrained rats with chronically implanted electrodes in the dorsal
      hippocampus, clenbuterol (2 mg/kg and 4 mg/kg i.p.) significantly reduced the
      duration of electrically evoked hippocampal afterdischarges. In amygdala-kindled
      rats, clenbuterol (5 mg/kg and 10 mg/kg i.p.) reduced the seizure severity to
      stage 3. Additional studies indicated that clenbuterol (6 mg/kg i.p.) increased
      the heart rate and decreased the blood pressure, but this drug did not alter the
      plasma level of the two tested antiepileptics phenobarbital and carbamazepine.
      Furthermore, in whole-cell voltage-clamp experiments on cultured neonatal rat
      cardiomyocytes, clenbuterol (1-100 microM) depressed the fast sodium current in a
      concentration- and frequency-dependent manner. In conclusion, the anticonvulsant
      effects of higher doses of clenbuterol against generalized tonic-clonic and
      complex partial seizures seem to be related to the inhibition of voltage
      dependent sodium channels and not to the modulation of beta-adrenoceptors.

PMID- 11218072
TI  - Sanguinarine induces K+ outflow from yeast cells expressing mammalian sodium
      pumps.
AB  - Sanguinarine, an alkaloid from Sanguinaria canadensis, has no effect on the yeast
      Saccharomyces cerevisiae at concentrations of up to 225 microM. Yeast cells
      become sensitive to sanguinarine and lose cytosolic K+ in a time- and
      concentration-dependent manner when they express the mammalian Na+,K+-ATPase
      (sodium pump). Dose-response studies show that sanguinarine induces K+ outflow
      from cells expressing wild-type sodium pumps with an EC50 of 29.3+/-1.2 microM. A
      similar effect with a comparable EC50) of 26.8+/-1.3 microM is obtained with
      cells expressing an Asp369Ala mutant of the sodium pump alpha1 subunit. Since
      this sodium pump mutant does not hydrolyze ATP, it can be excluded that the
      observed sanguinarine-induced outflow of K+ is an active ion transport process.
      Ouabain inhibits the sanguinarine effect at concentrations higher than 1 mM. In
      contrast, proscillaridin A inhibits the sanguinarine-induced K+ outflow from
      cells expressing the wild-type sodium pump with an IC50 of 48.9+/-1.3 microM. A
      similar IC50 of 52.2+/-3.0 microM is obtained with cells expressing the Asp369Ala
      mutant. These data, together with the fact that sanguinarine inhibits the binding
      of [3H]ouabain to microsomes prepared from yeast cells expressing the sodium pump
      with an IC50 of 94.5+/-4.3 microM, all indicate that sanguinarine specifically
      targets the sodium pump, and that the observed K+ outflow is tightly associated
      with the presence of the enzyme.

PMID- 11218073
TI  - Effects of repeated cocaine treatment on striatal dopamine release in alcohol
      preferring AA and alcohol-avoiding ANA rats.
AB  - Modulation of striatal dopamine (DA) release by acute or repeated cocaine
      treatment was studied in the nucleus accumbens and caudate-putamen of alcohol
      preferring (AA, Alko Alcohol) and alcohol-avoiding (ANA, Alko Non-Alcohol) rats.
      Cocaine (5-10 mg/kg i.p.) was administered daily for 4 days and the
      concentrations of extracellular DA measured by in vivo microdialysis on days 1
      and 4 in the freely moving rats. The first administration of cocaine increased DA
      concentration similarly in rats of both lines in both the nucleus accumbens and
      caudate-putamen. On the 4th day, the effect of cocaine was significantly larger
      in the nucleus accumbens of AA than in that of ANA rats, whereas no such enhanced
      effect of cocaine was found in the caudate-putamen of either line. The results
      suggest that mesolimbic DA release in response to cocaine is sensitized more
      readily in AA than in ANA rats, which would not only render the former more
      susceptible to alcohol, but to other drugs of abuse, and might explain our
      previous findings that AA rats are more susceptible to psychomotor sensitization
      than ANA rats.

PMID- 11218074
TI  - Troglitazone and rosiglitazone induce apoptosis of vascular smooth muscle cells
      through an extracellular signal-regulated kinase-independent pathway.
AB  - Recent evidence suggests that apoptosis may be involved in the control of
      vascular smooth muscle cell (VSMC) number in atherosclerotic lesions. The
      peroxisome proliferator-activated receptor gamma (PPARgamma) ligands
      thiazolidinediones have been reported to induce apoptosis in macrophages and in a
      variety of tumor cell lines. To evaluate whether these agents also induce
      apoptosis in VSMC, cultured rat VSMC were treated with increasing doses of the
      thiazolidinedione analogues troglitazone (TRO) and rosiglitazone (RSG). Both
      ligands induced cell death in a concentration-dependent manner (EC50 12.1+/-3.3
      microM and 1.43+/-0.39 microM, respectively), causing almost complete cell death
      at the highest concentrations (100 microM and 10 microM for TRO and RSG,
      respectively), along with an expected parallel decrease in [3H]thymidine uptake
      into cell DNA (EC50 6.7+/-2.4 microM and 0.75+/-0.19 microM, respectively). The
      cell count was determined by the coulter counter principle. Furthermore two
      apoptotic markers were measured, the caspase 3 activity and the cytoplasmic
      histone-associated DNA fragments, both of which were significantly increased when
      the aforementioned high concentrations were used. This indicates that apoptosis
      is involved in the TRO- and RSG-induced VSMC growth suppression. The same
      concentrations of TRO and RSG caused an unexpected stimulation of the
      extracellular signal-regulated response kinases 1 and 2 (ERK1/2) and stimulated
      the p38 mitogenic-activated protein (MAP) kinase as determined by Western
      blotting. In order to establish whether the proapoptotic effects of TRO and RSG
      are mediated through ERK1/2 activation, we used the selective MAP kinase kinase
      (MEK) inhibitor PD98059 (20 microM), which suppressed the TRO- and RSG-induced
      ERK1/2 activation but did not abolish their proapoptotic effects. We conclude
      that the thiazolidinedione analogues TRO and RSG induce cell death due to
      apoptosis in VSMC through an ERK1/2-independent pathway.

PMID- 11218075
TI  - Pharmacological characterisation of the decrease in 5-HT synthesis in the mouse
      brain evoked by the selective serotonin re-uptake inhibitor citalopram.
AB  - The selective serotonin re-uptake inhibitor (SSRI) citalopram decreases the
      synthesis of 5-hydroxytryptamine (5-HT) in the mouse brain in vivo. The
      underlying mechanism was studied by recording the accumulation of 5
      hydroxytryptophan (5-HTP) in hypothalamus and hippocampus after inhibition of the
      aromatic amino acid decarboxylase activity with m-hydroxybenzylhydrazine (NSD
      1015). Depletion of 5-HT with reserpine markedly reduced the citalopram-induced
      decrease of 5-HTP but not that evoked by the 5-HT1A receptor agonist 8-OH-DPAT,
      which indicates that the presence of endogenous 5-HT is necessary for full effect
      of citalopram. In contrast to the almost complete antagonism of the decrease in 5
      HT synthesis induced by 8-OH-DPAT, the 5-HT1A receptor antagonist WAY-100,635
      only slightly affected the citalopram-evoked decrease in 5-HT synthesis.
      Likewise, the 5-HT1B receptor antagonists NAS-181 and GR127935 only slightly
      antagonised the citalopram effect although they strongly inhibited the decrease
      in 5-HT synthesis induced by the 5-HT1B receptor agonist anpirtoline. Combined
      treatment with 5-HT1A and 5-HT1B receptor antagonists did not produce any
      additive antagonistic effect on the citalopram-induced decrease in 5-HT
      synthesis. The 5-HT2A/2C receptor antagonist ketanserin, the 5-HT3 receptor
      antagonist ondansetron and the 5-HT4 receptor antagonist RS-39604 had no effect
      on the citalopram-induced decrease in 5-HT synthesis. The same was found for
      several other non-selective 5-HT receptor antagonists, e.g. cyproheptadine,
      dihydroergotamine, methiothepin, methysergide, metergoline and mianserin. It is
      concluded that the citalopram-induced decrease in 5-HT synthesis differs in
      sensitivity from that mediated by 5-HT1A or 5-HT1B receptor agonists and
      citalopram also seems to require endogenous 5-HT for its full effect.

PMID- 11218076
TI  - Aspirin, but not the more selective cyclooxygenase (COX)-2 inhibitors meloxicam
      and SC 58125, aggravates postischaemic cardiac dysfunction, independent of COX
      function.
AB  - Inhibition of cyclooxygenase (COX) might favour non-enzymatic formation of
      cardiodepressive isoprostanes from arachidonic acid by radicals generated during
      reperfusion. This could explain deleterious effects of acetylsalicylic acid (ASA)
      on cardiac function. We examined the influence of COX inhibition on myocardial
      function after low-flow ischaemia and reperfusion, employing either ASA (100
      micromol/l), the partially selective COX-2 inhibitor meloxicam (0.3 micromol/l
      and 3.0 micromol/l), or the highly selective COX-2 inhibitor SC 58125 (1.0
      micromol/l and 3.0 microgmol/l). Isolated, buffer-perfused guinea pig hearts,
      performing pressure-volume work before and after consecutive low-flow ischaemia
      and reperfusion, were used for the study. Measurement of coronary and aortic
      flow, ejection time and heart rate served to calculate external heart work (EHW),
      before and after ischaemia. Additionally, release of prostacyclin and thromboxane
      A2, production of lactate, consumption of pyruvate and tissue concentration of
      the isoprostane 8-iso-PGF2alpha were measured. ASA significantly reduced recovery
      of EHW (46+/-18% vs. 82+/-15% for controls), whereas meloxicam and SC 58125 did
      not (64+/-15% and 74+/-13% recovery, respectively). Paradoxically, ASA increased
      reactive hyperaemia and consumption of pyruvate in the early reperfusion phase in
      comparison to all other groups, while lactate production did not differ.
      Prostacyclin production did not increase during reperfusion and was not
      significantly different between groups at any time point. In contrast,
      thromboxane A2 release increased about fivefold in the 2nd min of reperfusion
      under control conditions and in the presence of SC 58125, but was inhibited by
      ASA and by meloxicam in both concentrations. Isoprostane content of heart tissue
      was not detectably influenced under the mild reperfusion conditions used here. We
      conclude that ASA can aggravate postischaemic cardiac dysfunction, independent of
      COX inhibition. The deleterious effect in the present model might be due to
      uncoupling of mitochondrial oxidative phosphorylation rather than to direct
      effects of reduced eicosanoid release or radical induced formation of
      isoprostanes.

PMID- 11218077
TI  - Cannabinoid CB1-mediated inhibition of stress-induced gastric ulcers in rats.
AB  - The effect of cannabinoid drugs (i.p.) on cold/restraint stress-induced gastric
      ulcers was studied in rats. The cannabinoid receptor agonist (WIN 55,212-2, 0.1-1
      mg/kg), but not the less active isomer WIN 55,212-3 (1 mg/kg), reduced gastric
      ulceration. The protective effect of WIN 55,212-2 (1 mg/kg) was counteracted by
      the cannabinoid CB1 receptor antagonist SR141716A, but not by the cannabinoid CB2
      receptor antagonist SR144528. These results indicate that the antiulcer effect of
      the cannabinoid receptor agonist WIN 55,212-2 is mediated by cannabinoid CB1
      receptors.

PMID- 11218078
TI  - Linkage mapping in populations with karyotypic rearrangements.
AB  - A simulation study was used to examine the consequences of karyotypic
      rearrangements on molecular genetic map construction. Two groups of 50 datasets
      were created for F2 populations segregating for a reciprocal translocation of
      chromosomal segments or a reciprocal translocation and inversion. Multiple
      attempts were made to construct maps for each dataset using MapMaker/EXP. As
      expected, the markers from segments involved in the translocation formed one
      linkage group. Maps that corresponded to the known marker order within a segment
      could be constructed by the following method. The separation of markers distal to
      the translocation breakpoints into their respective segments could be made by
      constructing multiple maps, using distinct orders of marker entry, and observing
      the variances in intermarker distances: variances between pairs of markers from
      the same segment were an order of magnitude less compared to pairs where markers
      were from different segments. The order of markers within a segment could be
      determined from combining the pairwise linkage results from multiple maps, or
      from maps including all markers from a segment. No bias in map distances was
      observed. These results indicate that, under conditions similar to those tested,
      genetic maps corresponding to the segments conserved in translocations can be
      constructed.

PMID- 11218079
TI  - Integration of simple sequence repeat (SSR) markers into a molecular linkage map
      of common bean (Phaseolus vulgaris L.).
AB  - Microsatellite or simple sequence repeat (SSR) markers have been successfully
      used for genomic mapping, DNA fingerprinting, and marker-assisted selection in
      many plant species. Here we report the first successful assignment of 15 SSR
      markers to the Phaseolus vulgaris molecular linkage map. A total of 37 SSR primer
      pairs were developed and tested for amplification and product-length polymorphism
      with BAT93 and Jalo EEP558, the parental lines of an F7 recombinant inbred (RI)
      population previously used for the construction of a common bean molecular
      linkage map. Sixteen of the SSRs polymorphic to the parental lines were analyzed
      for segregation and 15 of them were assigned to seven different linkage groups,
      indicating a widespread distribution throughout the bean genome. Map positions
      for genes coding for DNAJ-like protein, pathogenesis-related protein 3, plastid
      located glutamine synthetase, endochitinase, sn-glycerol-3 phosphate
      acyltransferase, NADP-dependent malic enzyme, and protein kinase were determined
      for the first time. Addition of three SSR loci to linkage group B4 brought two
      separated smaller linkage groups together to form a larger linkage group.
      Analysis of allele segregation in the F7 RI population revealed that all 16 SSRs
      segregated in the expected 1:1 ratio. These SSR markers were stable and easy to
      assay by polymerase chain reaction (PCR). They should be useful markers for
      genetic mapping, genotype identification, and marker-assisted selection of common
      beans.

PMID- 11218080
TI  - Erwin Baur or Carl Correns: who really created the theory of plastid inheritance?
AB  - Historical reviews of the field of non-Mendelian genetics and many other
      publications credit Erwin Baur and Carl Correns equally for the development of
      the theory of plastid inheritance. However, a study of the original literature
      indicates that this conclusion is not correct. Analysis of the relevant articles
      leads to the conclusion that Baur alone deserves credit for the theory of plastid
      inheritance. In his classic article on the inheritance properties of white
      margined Pelargonium plants, Baur (1909) stated: (1) The plastids are carriers of
      hereditary factors which are able to mutate. (2) In variegated plants, random
      sorting-out of plastids is taking place. (3) The genetic results indicate a
      biparental inheritance of plastids by egg cells and sperm cells in Pelargonium.
      By contrast, Correns held the view that in variegated plants there is a
      maternally transmitted labile state of the cytoplasm which switches either to a
      permanently "healthy" state (allowing the "indifferent" plastids to become green
      chloroplasts) or to a permanently "diseased, ill" cytoplasmic state (causing
      white plastids and cells). Otto Renner supported Baur's theory and worked out
      important characteristics of plastid inheritance in the genus Oenothera. In the
      1930s Renner reported many more observations, which established plastid
      inheritance as a widely accepted genetic theory.

PMID- 11218081
TI  - Physical location of homoeologous groups 5 and 6 molecular markers mapped in
      Triticum aestivum L.
AB  - In situ hybridization was used to map 21 restriction fragment length polymorphism
      (RFLP) probes to linkage groups 5 and 6 of hexaploid wheat (Triticum aestivum L.
      em Thell.) in order to compare physical distances and genetic distances between
      adjacent markers. All 21 probes hybridized to the corresponding homoeologous
      chromosome arms. The linear order and linkage relationships among the DNA probes
      on the in situ-based physical maps were generally the same as those on the RFLP
      based genetic maps. However, significant differences were observed between the
      centiMorgan distances on a linkage map and the physical distances of the probes
      using in situ-based techniques. The results indicated a clustering of polymorphic
      RFLP markers in the middle of all of the homoeologous group 5 and 6 chromosome
      arms. This suggests that the available linkage maps do not completely cover the
      physical length of the chromosomes. As with the genetic maps, the physical map
      clearly showed the presence of nonhomoeologous rearrangements in the terminal
      regions of chromosome arms 5AL and 6BS. However, the physical mapping gave an
      indication of the physical size of the rearrangements as well as their arm
      location.

PMID- 11218083
TI  - A comparison of RAPD versus microsatellite DNA markers in population studies of
      the massasauga rattlesnake.
AB  - We compared genetic differentiation among populations of the threatened
      massasauga rattlesnake (Sistrurus c. catenatus) using two types of nuclear
      molecular markers: randomly amplified polymorphic DNA (RAPD) markers and
      microsatellites. Analyses of molecular variance (AMOVA) and G(ST) and F(ST)
      analyses indicated that levels of among-population differentiation between
      regional populations (>100 km) were comparable for both markers. However,
      microsatellites were superior in population assignment tests and at discerning
      fine-scale genetic differentiation between subpopulations separated by tens of
      kilometers. These results argue that both types of markers are suitable for
      defining broad-scale genetic structures in snake populations and can provide
      important inputs into conservation initiatives of focal taxa. However, our
      analyses suggest that microsatellites 3re better for detecting structure at
      limited spatial scales.

PMID- 11218082
TI  - Genetic diversity and population structure of 20 North European cattle breeds.
AB  - Blood samples were collected from 743 animals from 15 indigenous, 2 old imported,
      and 3 commercial North European cattle breeds. The samples were analyzed for 11
      erythrocyte antigen systems, 8 proteins, and 10 microsatellites, and used to
      assess inter- and intrabreed genetic variation and genetic population structures.
      The microsatellites BoLA-DRBP1 and CSSM66 were nonneutral markers according to
      the Ewens-Watterson test, suggesting some kind of selection imposed on these
      loci. North European cattle breeds displayed generally similar levels of
      multilocus heterozygosity and allelic diversity. However, allelic diversity has
      been reduced in several breeds, which was explained by limited effective
      population sizes over the course of man-directed breed development and
      demographic bottlenecks of indigenous breeds. A tree showing genetic
      relationships between breeds was constructed from a matrix of random drift-based
      genetic distance estimates. The breeds were classified on the basis of the tree
      topology into four major breed groups, defined as Northern indigenous breeds,
      Southern breeds, Ayrshire and Friesian breeds, and Jersey. Grouping of Nordic
      breeds was supported by documented breed history and geographical divisions of
      native breeding regions of indigenous cattle. Divergence estimates between
      Icelandic cattle and indigenous breeds suggested a separation time of more than
      1,000 years between Icelandic cattle and Norwegian native breeds, a finding
      consistent with historical evidence.

PMID- 11218084
TI  - Masculinization mechanism of hybrids in bitterlings (Teleostei: Cyprinidae).
AB  - The sex ratio of bitterling hybrids (subfamily: Acheilognathinae) is often likely
      to be biased toward males. Artificial hybridization was carried out in 10 species
      of bitterlings (three genera) in order to elucidate the masculinization mechanism
      of hybrids. Tanakia himantegus never produced viable F1 hybrids with other
      species, while hybrids of most other species were viable. In terms of sex ratio
      and fertility, hybrids were clearly divided into two groups: congeneric Tanakia
      hybrids and others. Both male and female congeneric Tanakia hybrids were fertile.
      The sex ratio was nearly 1:1 in all groups of Tanakia hybrids. Except for the
      congeneric Tanakia hybrids, sterile males appeared predominantly in groups of
      hybrids in which females were very rare but remained fertile. Sterile intersexes
      were also observed in five hybrid groups: T. lanceolata (female) x Acheilognathus
      cyanostigma (male), Rhodeus uyekii (female) x T. lanceolata (male), A. rhombeus
      (female) x T. lanceolata (male), A. rhombeus (female) x T. limbata (male), and A.
      tabira tabira (female) x A. cyanostigma (male). In the development of male
      predominant hybrids, although hybrid and control (parental species) hatching and
      survival rates do not differ, no females appeared in hybrids, contrary to the
      controls. Taking the female heterogametic sex-determining system (ZW) and the
      phylogenetic relationship of bitterlings into consideration, the masculinization
      mechanism of hybrids in bitterlings can be explained by the interaction of two
      sex chromosomes, derived from each parental species. The basic genetic sex in
      bitterlings is male (ZZ) and the derivative is female (ZW). When parental species
      are related, the sex phenotype of hybrids coincides with the genetic sex.
      However, when the parental species differ, the sex phenotype of the ZW genotype
      is reversed to become male by an abnormal interaction between the Z and W
      chromosomes. The rare appearance of females and intersexes in male-predominant
      hybrids might be due to complete or partial functional expression of the W
      chromosome.

PMID- 11218085
TI  - Genetic dissection of honeybee (Apis mellifera L.) foraging behavior.
AB  - We demonstrate the effects of a new quantitative trait locus (QTL), designated
      pln3, that was mapped in a backcross population derived from strains of bees
      selected for the amount of pollen they store in combs. We independently confirmed
      pln3 by demonstrating its effects on individual foraging behavior, as we did
      previously for QTLs pln1 and pln2 (Hunt et al. 1995). QTL pln2 is very robust in
      its effects on foraging behavior. In this study, pln2 was again shown to affect
      individual foraging behavior of workers derived from a hybrid backcross of the
      selected strains. In addition, pln2 was shown to affect the amount of pollen
      stored in combs of colonies derived from a wide cross of European and Africanized
      honeybees. This is noteworthy because it demonstrates that we can map QTLs for
      behavior in interstrain crosses derived from selective breeding and study their
      effects in unselected, natural populations. The results we present also
      demonstrate the repeatability of finding QTLs with measurable effects, even after
      outcrossing selected strains, suggesting that there is a relatively small subset
      of QTLs with major effects segregating in the population from which we selected
      our founding breeding populations. The different QTLs, pln1, pln2, and pln3,
      appear to have different effects, revealing the complex genetic architecture of
      honeybee foraging behavior.

PMID- 11218086
TI  - Inheritance of resistance in smooth bromegrass to the crown rust fungus.
AB  - Common smooth bromegrass (Bromus inermis Leyss.) is octoploid, 2n = 8x = 56, with
      a genome structure of AAAAB1B1B2B2. Tetrasomic inheritance patterns have been
      observed in smooth bromegrass, but disomic inheritance is also expected from
      cytologic observations. Smooth bromegrass is susceptible to the crown rust fungus
      (Puccinia coronata Corda.). The objective of this study was to determine the
      inheritance of smooth bromegrass resistance to P. coronata. Seven smooth
      bromegrass clones, three susceptible and four resistant, were selfed and crossed
      in a diallel with bulked reciprocals. Inoculations were made with a population of
      P. coronata from PL-BDR1 smooth bromegrass. Resistance of smooth bromegrass to
      this population of P. coronata is complex. At least three genes appear to be
      involved in this host-pathogen interaction, one tetrasomic dominant gene which
      determines susceptibility (S) and two dominant genes (R1 and R2) that may be
      complementary and could be inherited either tetrasomically or disomically. Other
      genes may be involved in the smooth bromegrass-P. coronata interaction, possibly
      accounting for the lack of fit to expected ratios of some progeny. Heterogeneity
      for avirulence phenotype in the pathogen population may also have contributed to
      lack of fit of some progeny. Multiple resistance genes were detected because a
      pathogen population, likely consisting of genotypes with different genes for
      virulence, was used to challenge the host.

PMID- 11218087
TI  - Isolation, mapping, and characterization of two barley multiovary mutants.
AB  - Mutations in homeotic genes disturb the spatial and temporal patterns of
      development, often leading to the appearance of tissues in abnormal locations.
      Many homeotic genes, involved in flower development, code for proteins with a
      highly conserved domain called the MADS box, which acts as a sequence-specific
      DNA binding protein. Two floral development mutants were isolated from a fast
      neutron irradiated M2 barley population. The phenotypes are multiovary, that is,
      stamens replaced with carpels, designated mo7a, and stamens replaced with carpels
      and lodicules converted to leaflike structures, designated mo6b. These phenotypes
      resemble the Arabidopsis mutants APETALA3 (AP3) and PISTILATA (PI). The mo6b and
      mo7a mutants were mapped to the centromeric region of chromosome 1 (7H) and to
      the telomeric region of chromosome 3 (3H), respectively.

PMID- 11218088
TI  - The Evergreen gene is essential for flower initiation in carnation.
AB  - One of the leading cut-flower crops in the world, the greenhouse carnation
      (Dianthus caryophyllus), has been subjected to intense breeding efforts for the
      past few hundred years. As an ornamental crop, flowering and flower architecture
      are major breeding targets that are constantly in demand. In an ongoing breeding
      program aimed at improving these characteristics, two mutants heterozygous for a
      mutation in a gene termed evergreen (e) were identified. In these mutants, spike
      like clusters of bracteoles subtend each flower. Genetic analysis of the mutants
      confirmed the semidominant nature of this nuclear mutation and that the two
      original mutants were allelic at the evergreen locus. In homozygous mutant
      plants, a more severe phenotype was observed. Flower formation was completely
      blocked and spikelike clusters of bracteoles did not subtend any flowers.
      Morphological characterization of mutant plants revealed that vegetative growth
      and inflorescence structure are not affected by the mutant allele. In plants
      heterozygous for the evergreen mutation, fertility, petal and pistil length,
      calyx diameter, and stamen number were not affected. However, flowers from these
      heterozygous plants had a reduced number of petals, suggesting an intriguing link
      between evergreen and the double flower (d) gene that determines petal number in
      carnation. The control by evergreen of bracteole formation, floral meristem
      initiation, and petal number in carnation is discussed in comparison to the
      recessive leafy (lfy) and floricaula (flo) mutants of Arabidopsis and
      Antirrhinum, respectively.

PMID- 11218089
TI  - Floral-color polymorphism in Ipomoea purpurea: biased inheritance of the dark
      allele is not a general explanation for its maintenance.
AB  - A previous investigation reported the existence in a single population of the
      morning glory (Ipomoea purpurea) of non-Mendelian inheritance at the W locus
      influencing flower color. In addition, it was shown that the magnitude of biased
      inheritance in that population was sufficient to maintain a floral-color
      polymorphism at that locus at frequencies approximating those observed in natural
      populations. The current investigation was undertaken to determine whether this
      biased inheritance was characteristic of other I. purpurea populations, and thus
      whether it provides a general explanation for maintenance of the polymorphism.
      The current study found no evidence for biased inheritance in two additional
      polymorphic populations examined. Non-Mendelian inheritance thus seems unlikely
      to constitute a general explanation for the maintenance of this floral-color
      polymorphism in l. purpurea.

PMID- 11218090
TI  - Genetic variability in the Iberian imperial eagle (Aquila adalberti) demonstrated
      by RAPD analysis.
AB  - RAPD analysis was used to estimate the genetic diversity in an Iberian imperial
      eagle (Aquila adalberti) population, one of the most threatened bird species in
      the world. Forty-five of 60 arbitrarily designed primers amplified 614 loci in 25
      individual eagles, 59.7% of which were polymorphic. In contrast to the
      traditional allozyme analysis performed in a previous study, the RAPD method has
      revealed a high level of heterozygosity in this species (H = 0.267+/-0.008). The
      genetic distances estimated between 25 eagles can serve to establish more
      adequate mating in order to preserve genetic variability. Conservation efforts
      being carried out in Spain in this species might be successful based on the
      results obtained in the present work.

PMID- 11218091
TI  - Genetic analyses of plumage color mutations on the Z chromosome of Japanese
      quail.
AB  - Genetic analyses were performed with four sex-linked plumage color mutations
      (roux, brown, imperfect albino, and cinnamon) in Japanese quail (Coturnix
      japonica). Roux and brown quail have similar plumage color, but plumage of roux
      quail is paler. Pure, F1 and F2 matings were carried out with roux and brown
      stocks, and 357, 338, and 273 progeny with either roux or brown plumage color
      were obtained from each mating type, respectively. These allelism tests showed
      that mutations for roux and brown colors were alleles (*R and *B) from the same
      locus BR, and that BR*B was dominant over BR*R. Two alleles at the AL locus, AL*A
      (imperfect albino) and AL*C (cinnamon) were used to estimate the recombination
      frequency between the BR and AL loci on the Z chromosome. It was estimated to be
      38.1+/-1.0% based on 4615 chicks from the test crosses.

PMID- 11218092
TI  - Fifty microsatellite markers for Japanese quail.
AB  - A Japanese quail genomic library enriched for (CA/GT)n simple sequence repeats
      was screened and positive clones were sequenced. Fifty original microsatellite
      sequences were isolated that consisted mainly of perfect repeats of the
      dinucleotide (CA/GT)n motif and a corresponding number of polymerase chain
      reaction (PCR) primer pairs complementary to unique DNA sequences flanking the
      microsatellite repeats were designed to detect the repeats. Forty-six percent (23
      of 50) of the markers revealed polymorphism in two unrelated quail individuals
      (one male and one female) randomly sampled from a population of wild quail
      origin. All 50 primer pairs were tested in the PCR for their ability to amplify
      chicken genomic DNA. Amplification products were obtained for 14 (28.0%) of the
      markers at the annealing temperature optimized for quail. These results provide
      an opportunity to begin characterizing the quail genome for the development of a
      genetic map for this economically valuable species and the eventual construction
      of a comparative genetic map in Phasianidae, which comprises a number of
      agriculturally important species of poultry.

PMID- 11218093
TI  - SIMCOAL: a general coalescent program for the simulation of molecular data in
      interconnected populations with arbitrary demography.

PMID- 11218094
TI  - SPAM (version 3.2): statistics program for analyzing mixtures.

PMID- 11218095
TI  - Linear and nonlinear analysis of the stability of gestural organization in speech
      movement sequences.
AB  - Recent procedures have been developed that allow the analysis of gestural
      stability across repetitions of phrase-length utterances by linearly normalizing
      aspects of the articulatory signal. This process produces an index of variability
      called spatiotemporal index, or STI (Smith, Goffman, Zelaznik, Ying, & McGillem,
      1995). Consistent findings that different STIs underlie changes in speaking rates
      in normally speaking adults have been found in subsequent studies by Smith and
      colleagues. However some researchers have raised concerns that linearly
      normalized data do not adequately account for the nonlinear aspects in the
      articulatory signal (Lucero, Munhall, Gracco, & Ramsey, 1997). The present study
      compared findings from linear and nonlinear normalization procedures in the
      analysis of lower-lip displacement of phrase-length utterances for a group of 8
      speakers and across three rates. Findings indicated that at a group level,
      gestural stability, although higher for each rate contingency, was similar to
      that found in earlier STI studies. However, variability was greater, and 4 of the
      8 subjects failed to consistently demonstrate greater stability at habitual rate,
      followed by fast and then slow rate. A nonlinearly normalized analysis of the
      same data produced significantly lower stability indices, and variability was
      also reduced. It is argued that a nonlinear normalization procedure based on
      lower-lip displacement holds advantages in the analysis of phrase-length speech
      data over both linear and alternative nonlinear normalization techniques.

PMID- 11218096
TI  - Acoustic comparison of vowel articulation in normal and reverse phonation.
AB  - Acoustic characteristics of the vowels /i,u,a/ produced by adult females and
      males during normal phonation were compared with the same vowels produced on
      deliberate ingressive airflow (i.e., "reverse" phonation). Results of the
      analysis revealed the average fundamental frequency (F0) of reverse phonation to
      be significantly higher than the corresponding normal phonations. There were no
      significant differences noted in the vocal tract resonance (F1 and F2 frequency)
      values for /i/ during normal and reverse phonation. However, the F1 values for
      /a/ were significantly lower, and the F2 values for /u/ significantly higher,
      during reverse phonation. The results are discussed with regard to differences in
      the articulatory control of the speech mechanism during reverse phonation as
      compared to normal expiratory phonation. Also discussed are the implications of
      using reverse phonation as a voice management technique.

PMID- 11218097
TI  - Respiratory markers of conversational interaction.
AB  - Respiratory movements were recorded from 10 dyads (20 subjects) during quiet
      breathing, reading aloud, spontaneous monologue, scripted dialog, and spontaneous
      conversation. Timing measures of inspiratory, expiratory, and total cycle
      duration were used to compare respiratory function during quiet breathing,
      listening, and speech. Cross-correlation analyses of the respiratory movements of
      conversational partners provided an index of conversational synchrony.
      Inspiratory duration was found to be the most consistent and sensitive measure
      for discriminating quiet breathing from speech breathing. In the scripted dialog
      and spontaneous conversation conditions, respiratory kinematics changed during
      listening to more closely resemble speech, and systematic changes were observed
      in anticipation of turn-taking speech onset. For the breathing cycles immediately
      surrounding turn changes and simultaneously produced vocal events, the kinematic
      signals of conversational partners were strongly correlated. Results are
      discussed in the context of similar findings concerning conversational
      interactions and motor preparation for speech.

PMID- 11218098
TI  - Time estimation by adults who stutter.
AB  - In view of the fact that stuttering involves time pressure in communicative
      contexts, the aim of this investigation was to study the effect of stuttering on
      time estimation. Two matching groups of 47 adults each, one consisting of
      stutterers and the other of fluent speakers, estimated the duration of four
      verbal tasks-two that involved speaking and two that did not. Two methods of time
      estimation were used: production and reproduction. In production, participants
      were required to perform a task, terminating it when they felt that the specified
      interval had elapsed. In reproduction, participants were asked to estimate the
      duration of a task immediately after being stopped by the experimenter. The
      results reveal that the differences in time estimation between adults who stutter
      and fluent speakers were task dependent, with the stutterers estimating time less
      accurately on oral verbal tasks. The conversation task in particular highlighted
      the inaccuracy of their time estimation. Furthermore, severe stutterers estimated
      time less accurately than mild stutterers. The greatest inaccuracy was displayed
      by severe stutterers when estimating the time of an oral task by the production
      method. The results are discussed in terms of cognitive models based on attention
      to time, method measurement, and mental workload. Clinical implications are also
      suggested.

PMID- 11218099
TI  - An alternate MLU calculation: magnitude and variability of effects.
AB  - This study investigated the effect of removing elliptical question responses,
      imitative utterances, and single-word Yes/No responses before calculating MLU.
      Forty-seven language samples from preschoolers with and without language
      impairment were analyzed. Initial MLUs ranged from 2.0 to 6.5 across both groups.
      The alternate calculation procedures resulted in an average 18% increase in the
      MLU index, with individual samples increasing as little as 3% or as much as 49%.
      The magnitude of the effect was primarily related to discourse properties,
      although in the SLI group there were secondary relationships to language level
      and proficiency. The observed variation in the discourse properties of language
      samples makes the alternate MLU index attractive to clinicians and researchers.

PMID- 11218100
TI  - Production of English finite verb morphology: a comparison of SLI and mild
      moderate hearing impairment.
AB  - The performance on production of finite verb morphology of 19 children (ages 5;9
      10;7) with mild-moderate sensorineural hearing impairment (SNH) was compared with
      that of 14 children with specific language impairment (SLI) (ages 7;2-10;9) and
      age-matched and language-matched control groups. On average, the SNH group
      outperformed the SLI group and was comparable to controls. However, a subset of
      the SNH group (n = 6) was impaired on one or both of these tasks. Degree of
      hearing loss or age of receiving hearing aids was not directly related to
      performance, but other language measures were. The subset was also significantly
      younger than the rest of the SNH group, suggesting that acquisition of finite
      verb morphology may be delayed in children with hearing impairments. Verb
      regularity had no effect on performance of any group, but word frequency and
      phonological complexity did exert an influence. The findings are discussed in
      relation to causative theories of SLI.

PMID- 11218101
TI  - Parental reports of spoken language skills in children with Down syndrome.
AB  - Spoken language in children with Down syndrome and in children in a normative
      group was compared. Growth trends, individual variation, sex differences, and
      performance on vocabulary, pragmatic, and grammar scales as well as MaxLU
      (maximum length of utterance) were explored. Subjects were 330 children with Down
      syndrome (age range: 1-5 years) and 336 children in a normative group (1;4-2;4
      years;months). The Swedish Early Communicative Development Inventory-words and
      sentences (SECDI-w&s) was employed. Performance of children with Down syndrome at
      ages 3;0 and 4;0 was comparable with that of children in the normative group at
      ages 1;4 and 1;8 respectively. In comparison with children in the normative group
      of similar vocabulary size, children with Down syndrome lagged slightly on
      pragmatic and grammar scales. The early development proceeded in most cases with
      exponential or logistic growth. This stresses the great potential of early
      intervention.

PMID- 11218102
TI  - The role of sequential stream segregation and frequency selectivity in the
      perception of simultaneous sentences by listeners with sensorineural hearing
      loss.
AB  - The purpose of this study was to determine the role of frequency selectivity and
      sequential stream segregation in the perception of simultaneous sentences by
      listeners with sensorineural hearing loss. Simultaneous sentence perception was
      tested in listeners with normal hearing and with sensorineural hearing loss using
      sentence pairs consisting of one sentence spoken by a male talker and one
      sentence spoken by a female talker. Listeners were asked to repeat both sentences
      and were scored on the number of words repeated correctly in each sentence.
      Separate scores were obtained for the first and second sentences repeated.
      Frequency selectivity was assessed using a notched-noise method in which
      thresholds for a 1,000 Hz pure-tone signal were measured in noise with spectral
      notch bandwidths of 0, 300, and 600 Hz. Sequential stream segregation was
      measured using tone sequences consisting of a fixed frequency (A) and a varying
      frequency tone (B). Tone sequences were presented in an ABA_ABA_... pattern
      starting at a frequency (B) either below or above the frequency of the fixed
      1,000 Hz tone (A). Initially, the frequency difference was large and was
      gradually decreased until listeners indicated that they could no longer
      perceptually separate the two tones (fusion threshold). Scores for the first
      sentence repeated decreased significantly with increasing age. There was a strong
      relationship between fusion threshold and simultaneous sentence perception, which
      remained even after partialling out the effects of age. Smaller frequency
      differences at fusion thresholds were associated with higher sentence scores.
      There was no relationship between frequency selectivity and simultaneous sentence
      perception. Results suggest that the abilities to perceptually separate pitch
      patterns and separate sentences spoken simultaneously by different talkers are
      mediated by the same underlying perceptual and/or cognitive factors.

PMID- 11218103
TI  - Beginning to talk at 20 months: early vocal development in a young cochlear
      implant recipient.
AB  - Early vocal development, consonant production, and spoken vocabulary were
      examined in a deaf toddler whose multichannel cochlear implant was activated at
      20 months. Parent-child interactions were recorded before implantation and at
      monthly intervals during the first year of implant use. The child's utterances
      were classified according to developmental levels from the Stark Assessment of
      Early Vocal Development. The emergence of consonant types and consonant features
      were documented through listener transcription. Parent reports were used to
      monitor oral vocabulary growth. A large increase in canonical and postcanonical
      utterances was observed after 5 months of implant use, and these advanced
      prelinguistic forms were dominant in all subsequent recording sessions. Increases
      in the diversity of consonant types and features suggested that auditory
      information was used to increase phonetic diversity. It was reported that the
      child understood almost 240 words and spoke approximately 90 words after one year
      of implant experience. The combination of cochlear implantation at a young age,
      family support, and regular intervention appeared to facilitate efficient early
      vocal development and gains in spoken vocabulary.

PMID- 11218104
TI  - Nonmainstream dialect use and specific language impairment.
AB  - Most work looking at specific language impairment (SLI) has been done in the
      context of mainstream dialects. This paper extends the study of SLI to two
      nonmainstream dialects: a rural version of Southern African American English
      (SAAE) and a rural version of Southern White English (SWE). Data were language
      samples from 93 4- to 6-year-olds who lived in southeastern Louisiana. Forty were
      classified as speakers of SAAE, and 53 were classified as speakers of SWE. A
      third were previously diagnosed as SLI; the others served as either age-matched
      (6N) or language-matched (4N) controls. The two dialects differed in frequency of
      usage on 14 of the 35 coded morphosyntactic surface patterns; speakers of these
      dialects could be successfully discriminated (94%) from each other in a
      discriminant analysis using just four of these patterns. Across dialects, four
      patterns resulted in main effects that were related to diagnostic condition (SLI
      vs. 6N), and a slightly different set of four patterns showed effects that were
      related to developmental processes (4N vs. 6N). More interestingly, the surface
      characteristics of SLI were found to manifest in the two dialects in different
      ways. A discriminant function based solely on SAAE speakers tended to misclassify
      SWE children with SLI as having normal language, and a discriminant function
      based on SWE speakers tended to misclassify SAAE unaffected children as SLI.
      Patterns within the SLI profile that cut across the two dialects included
      difficulties with tense marking and question formation. The results provide
      important direction for future studies and argue for the inclusion of contrastive
      as well as noncontrastive features of dialects within SLI research.

PMID- 11218105
TI  - Relative treatment effects of two prelinguistic communication interventions on
      language development in toddlers with developmental delays vary by maternal
      characteristics.
AB  - This paper tests whether two prelinguistic communication interventions have a
      differential effect on productive and receptive language development 6 and 12
      months after the end of treatment. We predicted that treatment effects on
      language development would vary as a function of pretreatment maternal
      responsivity or amount of mothers' formal education. Fifty-eight prelinguistic
      children with developmental delays and their mothers participated in the study.
      Children were randomly assigned to one of two staff-implemented treatments that
      were designed to increase intentional communication ability. Results confirmed
      the prediction that treatment effects on children's receptive and expressive
      language 6 and 12 months after the end of interventions vary as a function of
      pretreatment maternal responsivity and education level.

PMID- 11218106
TI  - A quantitative output-cost ratio in voice production.
AB  - A quantitative output-cost ratio (OCR) is proposed for objective use in voice
      production and is defined as the ratio of the acoustic output intensity to the
      collision intensity of the vocal folds. Measurement of the OCR is demonstrated in
      a laboratory experiment using 5 excised larynges and a transducer designed for
      use on human subjects. Data were gathered at constant fundamental frequency (150
      Hz). Subglottal pressure was varied from 1.0 to 1.6 kPa, and glottal width at the
      vocal processes was varied from a pressed condition to a 2-mm gap. The OCR was
      plotted as a function of glottal width. With no vocal tract, the excised larynx
      experiments yielded a broad maxima in the OCR curves, across all subglottal
      pressure conditions, at about 0.6 mm. Computer simulations indicate that sharper
      maxima may occur when the influence of the vocal tract is taken into account. The
      potential clinical utility of the OCR is discussed for treatment of a wide range
      of voice disorders, including those involving both hyper- and hypoadduction.

PMID- 11218107
TI  - Durational, proportionate, and absolute frequency characteristic of disfluencies:
      a longitudinal study regarding persistence and recovery.
AB  - The main objective of this study was to investigate developmental aspects of
      disfluencies over time as stuttering persists or ameliorates for 2 groups of
      preschool age children who stutter. Results indicated that the frequency, type,
      and duration of disfluencies remained relatively constant instead of increasing
      as expected in the persistent group over a 3-year period. In contrast, the
      recovered group's initially higher frequency of disfluency decreased over time,
      as did their number of repetition units and proportion of disrhythmic phonations,
      while the duration of silent intervals between repetition units and proportion of
      monosyllabic word repetitions increased.

PMID- 11218108
TI  - Enhanced speechreading in deaf adults: can short-term training/practice close the
      gap for hearing adults?
AB  - This study investigated effects of short-term training/practice on group and
      individual differences in deaf and hearing speechreaders. In two experiments,
      participants speechread sentences with feedback during training and without
      feedback during testing, alternating 10 times over six sessions spanning up to 5
      weeks. Testing used sentence sets balanced for expected mean performance. In each
      experiment, participants were adults who reported good speechreading and either
      normal hearing (n = 8) or severe to profound hearing impairments (n = 8). The
      experiments were replicates, except that in one participants received
      vibrotactile speech stimuli in addition to visible speech during training,
      testing whether vibrotactile speech enhances speechreading learning. Results
      showed that (a) training/practice did not alter the relative performance among
      individuals or groups; (b) significant learning occurred when training and
      testing were conducted with speechreading only (although the magnitude of the
      effect was small); and (c) there was evidence that the vibrotactile training
      depressed rather than raised speechreading scores over the training period.

PMID- 11218109
TI  - Effects of vowel height and vocal intensity on anticipatory nasal airflow in
      individuals with normal speech.
AB  - The purpose of this study was to determine the effects of vowel height and vocal
      intensity on the magnitude of anticipatory nasal airflow in normal speakers when
      producing vowel-nasal-vowel (VNV) sequences. Measurements of nasal and oral
      airflow were obtained from 15 men and 12 women with normal speech during
      production of the VNV sequences /ini/ and /ana/ at low, medium, and high
      intensity levels. Ratios of nasal to oral-plus-nasal airflow were calculated for
      the initial vowel of both utterances at each of the intensity levels. Analysis of
      variance (ANOVA) procedures indicated a significant main effect of intensity
      level and a significant vowel-by-sex interaction effect (p < .05) on the airflow
      ratios. Overall, the airflow ratio was reduced at high as compared to low
      intensity levels, regardless of sex of the speaker or vowel type. Female speakers
      exhibited greater airflow ratios during production of /ini/ than during
      productions of /ana/. Their airflow ratios were also greater during production of
      /ini/ than were those of male speakers. The results suggest that vocal intensity
      may affect velopharyngeal (VP) function in an assimilative nasal phonetic
      context. The results further suggest that anticipatory nasal airflow may be
      determined by the configuration of the oral cavity to a greater extent in women
      than in men. Theoretical and clinical implications are discussed.

PMID- 11218110
TI  - Perceptions of simulated stuttering and fluency.
AB  - This study explored multiple effects of listener perceptions of different levels
      of simulated stuttering and fluency. A single stuttered speech sample was
      modified to create four additional samples of stuttering and fluency. A sixth
      sample of a nonstuttered signal served as a comparative baseline. Each of 60
      independent listeners made quantitative and qualitative perceptual judgments upon
      hearing only one of the six randomly assigned samples. Results showed a broad
      spectrum of qualitative and quantitative listener perceptions of the various
      levels of stuttering and fluency studied. Likert scale data revealed that
      listeners gave lower ratings to samples with increased levels of stuttering.
      Listener commentaries revealed fewer positive comments with increased levels of
      stuttering and distinctive preferences between two 0% samples of stuttering where
      only prosodic features were modified. Additionally, specific perceptions of
      speaker competency, perceived ease in reading a passage, general comfort
      listening, and perceived effort in understanding the story appear to affect the
      global perceptions of a speaker's communication. Implications of these findings
      are discussed.

PMID- 11218111
TI  - Phonetic inventory development in young cochlear implant users 6 years
      postoperation.
AB  - Increases in the phonetic inventories of a group of 9 children in the fifth and
      sixth years of experience with a cochlear implant are reported, extending a
      previous 4-year study (T. A. Serry & P. J. Blamey, 1999). Thirty-six out of 44
      phones in Australian English reached the criterion of 50% correct in the
      conversational samples of 5 or more children. This level of performance
      corresponds to intelligible, but not completely natural, speech. The rate of
      improvement in the sixth year was slow, indicating a probable plateau in
      performance. The 8 phones that did not attain the 50% criterion in 5 or more
      children were /see text/. Potential reasons for the slow development or
      nondevelopment of these phones include very low frequency of occurrence for /see
      text/ and the perceptual and articulatory characteristics of /see text/. /see
      text/ is also subject to a high degree of allophonic variation in the fluent
      speech of normally hearing speakers, probably accounting for much of the
      variability in its articulation in the conversational samples.

PMID- 11218112
TI  - Relative kinematics of the rib cage and abdomen during speech and nonspeech
      behaviors of 15-month-old children.
AB  - Speech motor control emerges in the neurophysiologic context of widely
      distributed, powerful coordinative mechanisms, including those mediating
      respiratory function. It is unknown, however, whether developing children are
      able to exploit the capabilities of neural circuits controlling homeostasis for
      the production of speech and voice. Speech and rest breathing were investigated
      in eleven 15-month-old children using inductance plethysmography (Respitrace).
      Rib cage and abdominal kinematics were studied using a time-varying correlational
      index of thoracoabdominal coupling (i.e., reflecting the synchrony of movement of
      the rib cage and abdomen) as well as simple classification of the moment-to
      moment kinematic relationship of these two functional components (i.e.,
      concurrent expansion or compression, or oppositional movement). Results revealed
      markedly different patterns of movement for rest breathing and speech breathing,
      although within types of vocalization (nonspeech vocalization, babbling, true
      word production) no differences were apparent. Whereas rest breathing was
      characterized by tight coupling of rib cage and abdominal movement (average
      correlation coefficients usually exceeded .90), speech breathing exhibited weak
      coupling (the correlation coefficient ranged widely, but averaged about .60).
      Furthermore, speech production by these toddlers included the occurrence of both
      rib cage and abdominal paradoxing, which are observed infrequently in adult
      speakers. These results fail to support the suggestion that speech emerges from
      the extant coordinative organization of rest breathing. Rather, even in its
      earliest stages breathing for speech and voice exhibits kinematic properties
      distinct from those of other observed behaviors.

PMID- 11218113
TI  - Morphological analyses of the human tongue musculature for three-dimensional
      modeling.
AB  - Skilled movements of the tongue in speech articulation reflect complex formation
      of the tongue musculature, although its description in the anatomical literature
      is rather limited for developing a realistic computational model of the tongue.
      This study presents detailed descriptions of the muscular structure of the human
      tongue based on macroscopic and microscopic observations and provides three
      dimensional schemata of the tongue musculature. Histologic examination revealed
      that the tongue consists of five strata, stacked along the courses of the fibers
      of the genioglossus muscle in proximal-distal directions. This stratum structure
      exists in the entire tongue tissue, indicating that the lingual musculature can
      be divided into the inner and outer regions. The former consisted of the "stem"
      and "core," and the latter of the "cover" and "fringe." In gross dissection, the
      tongue was cut into wedge-like blocks along the course of the genioglossus muscle
      to examine muscle fiber arrangement. Using this approach, it was determined that
      serial repetitions of "structural units" composed the inner musculature of the
      tongue. Each unit consisted of a pair of thin muscle fiber laminae; one was
      composed of the genioglossus and vertical muscles, and the other of the
      transverse muscle. In the apex, the laminae lacked the fibers of the
      genioglossus. These findings have been incorporated in three-dimensional schemata
      of the tongue musculature.

PMID- 11218114
TI  - Theoretical study of the accuracy of the elution by characteristic points method
      for bi-langmuir isotherms.
AB  - The bi-Langmuir equation has recently been proven essential to describe chiral
      chromatographic surfaces and we therefore investigated the accuracy of the
      elution by characteristic points method (ECP) for estimation of bi-Langmuir
      isotherm parameters. The ECP calculations was done on elution profiles generated
      by the equilibrium-dispersive model of chromatography for five different sets of
      bi-Langmuir parameters. The ECP method generates two different errors; (i) the
      error of the ECP calculated isotherm and (ii) the model error of the fitting to
      the ECP isotherm. Both errors decreased with increasing column efficiency.
      Moreover, the model error was strongly affected by the weight of the bi-Langmuir
      function fitted. For some bi-Langmuir compositions the error of the ECP
      calculated isotherm is too large even at high column efficiencies. Guidelines
      will be given on surface types to be avoided and on column efficiencies and
      loading factors required for adequate parameter estimations with ECP.

PMID- 11218116
TI  - Automated normal-phase preparative high-performance liquid chromatography as a
      substitute for flash chromatography in the synthetic research laboratory.
AB  - An automated normal-phase preparative HPLC system was developed in order to omit
      time-consuming flash column chromatography in the synthetic research laboratory.
      The system is equipped with steel columns packed with spherical 12 microm silica
      and is able to separate samples in a range of 0.1-10 g depending on the column
      diameter and chromatographic problem. It was designed to be used as an open
      access instrument in the research department. The general users select from
      binary gradient programs after running an analytical TLC with the raw product.
      The HPLC instrument was fully controlled by the Chromeleon software from Dionex.
      A Gilson 215 robot served as injector/collector.

PMID- 11218115
TI  - Characterizing the performance of industrial-scale columns.
AB  - The performance of a large commercial chromatographic column was investigated
      using a short pulse of a tracer and an extension of the reverse-flow technique.
      This technique permits separate determination of the unavoidable irreversible
      microscopic processes and the reversible effects of flow maldistribution, and
      allows for the separation of flow maldistribution in the flow distributors from
      flow maldistribution inside the packed bed. This analysis was performed on a 0.44
      m Millipore IsoPak column using Cellufine GC 700, cellulosic-based media with an
      average particle diameter of 75 microm, for the stationary phase. The column
      efficiency was quantified by analysis of the effluent curve from a short pulse of
      a 5% aqueous acetone tracer. The study examined behavior of beds of different
      lengths (10-24 cm) and beds packed from different slurry concentrations (10-75%
      v/v). The slurry-packed columns were very uniform, and no significant macroscopic
      flow maldistribution was observed inside the column. The observed bed plate
      heights conformed to the predictions of available one-dimensional continuum
      models. Dispersion in the flow distributors was significant, corresponding to 15
      25% of the intracolumn dispersion when the full 24 cm available bed length was
      used and a proportionally larger increase for shorter bed lengths. Thus, the
      headers are shown to produce a significant increase in the observed plate height.

PMID- 11218117
TI  - Comparison of chromatographic ion-exchange resins. II. More strong anion-exchange
      resins.
AB  - A comparative study was performed on strong anion exchangers to investigate the
      pH dependence, titration curves, efficiency, binding strength, particle size
      distribution, and static and dynamic capacity of the chromatographic resins. The
      resins tested included Q Sepharose XL, UNO Q-1, Poros 50 HQ, Toyopearl QAE 550c,
      Separon HemaBio 1000Q, Q-Cellthru Bigbeads Plus, Q Sepharose HP and Toyopearl
      SuperQ 650s. Testing was performed with five different proteins: anti-Factor VII
      monoclonal antibody (immunoglobulin G), aprotinin, bovine serum albumin, lipolase
      and myoglobin. The dependence of pH on retention varies from generally low to
      very high for proteins with a low isoelectric point (pl). An unexpected binding
      at pH 7-8 of aprotinin with pI >11 was observed on Separon HemaBio 1000Q. No link
      between pH dependence on retention and titration curves of the different resins
      was observed. Efficiency results show the expected trend of higher dependence of
      the plate height with increasing flow-rate of soft resins compared to resins for
      medium- and high-pressure operation. No or a very small difference in particle
      size distribution was obtained between new and used resins. Binding to anion
      exchange resins as a function of ionic strength varies to some extent depending
      on the specific protein. Generally, binding and elution at high salt
      concentration may be performed with Q Sepharose XL, Toyopearl QAE 550c, Q
      Sepharose HP and Poros 50 HQ, while binding and elution at low salt concentration
      may be performed with Q-Cellthru Bigbeads Plus. A very high binding capacity was
      obtained with Q Sepharose XL. Comparison of static capacity and dynamic capacity
      at 10% breakthrough shows approx. 50-80% utilization of the total available
      capacity during chromatographic operation. A general good agreement was obtained
      between this study and data obtained by the suppliers. The results of this study
      may be used for selection of resins for testing in process development.

PMID- 11218118
TI  - Advances in process chromatography gradient elution using binary linear
      gradients.
AB  - A number of chromatography techniques utilize mobile phase gradients with
      changing buffer concentration to effect separation. At process scale the majority
      of gradients are stepwise or isocratic. There are a number of instances where
      process performance or economics indicate that linear gradients would deliver
      better theoretical performance. However, to date this process advantage has not
      been implemented due to concerns about the accuracy, reliability or
      reproducibility of equipment used to produce linear changes in gradient
      composition. In this manuscript, recent developments in simple feedforward
      control and data from the resultant process-scale performance are presented.
      Information is provided on the practical heuristics underlying the control
      strategy. The data presented in this paper illustrate how the feedforward control
      strategy has been implemented on a commercial system to achieve better than +/-
      2% accuracy of process-scale linear gradients.

PMID- 11218119
TI  - Performance comparison of suspended bed and batch contactor chromatography.
AB  - In some applications, the purification and recovery of biomolecules is performed
      via a cascade of batch adsorption and desorption stages using agitated contactors
      and related filtration devices. Suspended bed chromatography is a recent process
      scale innovation that is applicable to these separations. This hybrid technique
      exploits the benefits of combining batch adsorption in an agitated contactor with
      elution in an enclosed column system. To some extent, the process is similar to
      batch contactor chromatography but can be fully contained and significantly
      quicker. The process has two steps; first the fluid containing the sample is
      mixed with the adsorbent in a stirred tank. Second, the slurry suspension is
      transferred directly into a specialized column, such as an IsoPak column. The
      media with the adsorbed product is formed as a packed bed, whilst the suspension
      liquid is passed out of the column. The product is then eluted from the packed
      bed utilizing standard column-chromatography techniques. The performance of the
      suspended bed and the agitated contactor operations are demonstrated both by full
      scale experimental results and process simulations. The purification of ovalbumin
      from a hen-egg white feedstock by anion-exchange chromatography was used as a
      case study in order to prove the concept. With the availability of both pump
      packed systems and shear-resistant media, suspended bed chromatography is a
      better alternative for a range of applications than the traditional batch
      separations using agitated contactors.

PMID- 11218120
TI  - Control method for integrity of continuous beds.
AB  - Monoliths are considered to be the latest version of stationary phases for
      protein chromatography. They are now becoming popular since they exhibit reduced
      peak broadening due to low mass transfer resistances. A weak point of monoliths
      may be an inhomogeneous bed, especially when charged groups are present during co
      polymerization. This becomes apparent when a protein solution is loaded onto such
      a monolith. A biphasic breakthrough curve differing from the sigmoidal-shaped
      one, is observed. Two error functions were used to approximate the breakthrough
      curve. From these parameters an estimate of the fraction of flow passing through
      the homogeneously packed part of the bed as well as the inhomogeneously one was
      derived. This flow pattern was also confirmed by perfusing ferritin through an
      inhomogeneous monolith and comparing it to an intact one. Electron microscopy and
      mercury porosimetry did not indicate any abnormalities in the bed.

PMID- 11218121
TI  - Modification of a commercial chiral stationary phase influences on enantiomer
      separations using simulated moving bed chromatography.
AB  - Chromatographic enantiomer separations using high-performance chromatography and
      the simulated moving bed (SMB) principle have become a practically useful method
      for obtaining optical isomers. The carbamate derivatives of amylose coated onto
      silica particles are very effective chiral stationary phases (CSPs). Several lots
      of Chiralpak AS, and its successor, Chiralpak AS-V, were compared by laser
      diffraction, microscopic imaging and pulse injections with increasing amounts of
      various racemates in order to determine the loading capacity and the competitive
      adsorption isotherms. Software simulations allowed to assess the possible effects
      due to the observed variations between the CSPs on the performance of a pilot SMB
      unit. The obtained results were verified by two multi-kilogram separations
      performed under current good manufacturing principles (cGMP) guidelines employing
      the two CSPs. The results of the two production runs are discussed in the light
      of the recently introduced "triangle theory" which allows to account for the
      overload conditions prevailing under preparative chromatographic conditions and
      to predict optimal operating conditions. Under optimized conditions the
      enantiomer separation of 1.4 kg racemate/kg stationary phase per day with
      purities >99.6% for the target enantiomer have been achieved.

PMID- 11218122
TI  - Frontal analysis method to determine competitive adsorption isotherms.
AB  - In order to design and to optimise preparative separations, the knowledge of the
      underlying thermodynamic functions, i.e., the adsorption isotherms, is the most
      essential information. Usually these functions cannot be predicted and various
      methods have been suggested to determine them experimentally. In particular,
      dynamic methods are attractive regarding time requirements and reliability.
      Frontal analysis (FA) is frequently applied to measure single solute isotherms.
      The theoretical background of this method is offered by the classical equilibrium
      theory of adsorption. Although this theory also explains the shape of
      multicomponent breakthrough curves, FA is only seldom applied to determine
      competitive isotherms. In this work FA was used to measure adsorption isotherms
      of three components as single solutes and in binary and ternary mixtures in a
      reversed-phase system. The obtained equilibrium data were correlated using the
      competitive Langmuir isotherm equation, a bi-Langmuir model, the ideal adsorbed
      solution theory and the real adsorbed solution theory. No substantial improvement
      of the predictions was achieved using the more complex models instead of the most
      simple Langmuir model.

PMID- 11218123
TI  - Coupling of simulated moving bed chromatography and fractional crystallisation
      for efficient enantioseparation.
AB  - An optimised coupling of liquid chromatography and fractional crystallisation is
      suggested for efficient enantioseparation. As a first stage, a chromatographic
      separation, preferably simulated moving bed (SMB) chromatography, is applied to
      achieve an enantiomeric enrichment sufficient for a subsequent crystallisation.
      First results of the experimental and modelling work for the model system (+)-/(
      )-mandelic acid in an aqueous solution are described. Chromatographic
      investigations involve the estimation of adsorption isotherms on a suitable
      chiral stationary phase and the simulation and optimisation of a corresponding
      SMB process. From the ternary phase diagram measured for the (+)-/(-)-enantiomer/
      solvent system, the conditions required to crystallise a pure enantiomer from an
      asymmetric mixture can be derived. The productivity gains achievable from the
      combined process compared to the application of chromatography alone are
      discussed.

PMID- 11218124
TI  - Calculation of partition coefficient and hydrophobic moment of the secondary
      structure of lysozyme.
AB  - A method that permits a semiquantitative estimate of the partitioning of any
      solute between any two media is presented. As an example, the partition
      coefficients and hydrophobic moment of the secondary structure of lysozyme are
      calculated. Program GSCAP is written as a version of Pascal's solvent-dependent
      conformational analysis (SCAP) program. The dipole moments calculated for the
      helices are trebled with respect to that for the sheet. For helices, the main
      contribution to the water-accessible surface area is the hydrophobic term, while
      the hydrophilic part dominates in the sheet. Molecular globularity and the three
      studied partition coefficients differentiate between helices and sheet.

PMID- 11218126
TI  - Use of ion-exchange chromatography and hydrophobic interaction chromatography in
      the preparation and recovery of polyethylene glycol-linked proteins.
AB  - Cation- and anion-exchange chromatography can be used to purify a polyethylene
      glycol-linked protein dimer (PEG dimer) made with M, 20 000 PEG bis-vinylsulfone,
      even when there are no net charge differences between the components that are
      being separated. The retention time on ion-exchange generally is inversely
      proportional to the PEG:protein ratio (on a mass basis). One of the biggest
      challenges in developing the process for making this PEG dimer was the quality of
      the PEG linker. Reversed-phase HPLC can be used to determine both size
      heterogeneity and the degree of end-group activation of Mr 20 000 PEG bis
      vinylsulfone. In addition, we have found that hydrophobic interaction
      chromatography can be used make more size homogeneous preparations of Mr 20000
      PEG bis-vinylsulfone, which significantly increased the recovery of the PEG
      dimer.

PMID- 11218125
TI  - Direct isolation of monoclonal antibodies from tissue culture supernatant using
      the cation-exchange cellulose Express-Ion S.
AB  - The chromatography of the murine hybridoma cell C595/102 culture supernatant
      expressing the therapeutic monoclonal antibody C595, on the cation-exchange
      cellulose Whatman Express-Ion Exchanger S has been investigated. Initial method
      scouting studies using purified C595 in 1-ml mini columns demonstrated that
      binding capacity and binding efficiency were dependent not only on decreasing pH
      but also on the buffer salts used to prepare the mobile phase. Under optimised
      conditions of 0.1 M sodium acetate buffer, pH 5.0, we were able to separate
      purified C595 from BSA, the major contaminant in tissue culture fluid. Under
      these conditions immunoreactive C595 could be isolated directly from tissue
      culture supernatant. A scale-down study was carried out using a 25-ml column
      operated at a flow-rate of 150 cm/h which also yielded purified immunoreactive
      antibody. This procedure should now be suitable for scale-up.

PMID- 11218127
TI  - Continuous separation of green fluorescent protein by annular chromatography.
AB  - The concept of annular chromatography was tested by separation of a real protein
      solution used in biotechnology. Green fluorescent protein was expressed in S.
      cerevisiae and the extract was continuously separated by a pressurized annular
      chromatograph packed with a Superdex 200 prep grade size-exclusion chromatography
      medium. Purity was checked by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, Western blotting and fluorescent intensity. The continuous mode
      was compared to batchwise operation. Under the assumption that equivalent
      fractions are collected, both modes are comparable.

PMID- 11218128
TI  - Comparison of hydrophobic charge induction chromatography with affinity
      chromatography on protein A for harvest and purification of antibodies.
AB  - Efficient harvest and recovery of high-purity monoclonal antibodies was achieved
      using hydrophobic charge induction chromatography (HCIC). Both simple and complex
      feedstocks were studied, including protein-free cell culture supernatant and the
      clarified/concentrated milk of transgenic goats. Viral clearance studies
      demonstrated a 4-log reduction of MVM virus (minute virus of mice), along with
      substantial reduction of DNA content. Sorbent characterization studies confirmed
      that HCIC is based on the pH-dependent behavior of a dual-mode, ionizable ligand.
      Binding, based on hydrophobic interaction, was achieved under near-physiological
      conditions, and in the absence of lyotropic salt. Desorption was accomplished
      under mild conditions--pH 4.0. At this pH, both ligand and antibody carry a net
      positive charge, and desorption occurs on the basis of electrostatic charge
      repulsion. pH-based control of chromatographic function was demonstrated.
      Chromatography on this antibody-selective HCIC sorbent was evaluated as a cost
      effective, process-compatible alternative to affinity chromatography protein A
      sorbents.

PMID- 11218129
TI  - Separation of steroid compounds by overloaded preparative chromatography with
      precipitation in the fluid phase.
AB  - In order to gain a commercially acceptable yield compared to the adsorption
      capacity of the column, a rather large amount of sample is separated with
      preparative chromatography. During the competitive adsorption of the sample
      components, the species adsorbing better can force the rest out of the adsorbent
      phase. As a consequence, the concentrations of the later components may increase
      in the fluid phase to a level that those species start to precipitate. A
      mathematical model which takes the precipitation and dissolution into
      consideration is presented in this paper. Data calculated by this model are
      compared to that we obtained by using a previous mathematical model as well as
      the experimental results gained by a laboratory scale separation of steroid
      compounds on an organic polymer adsorbent. The equilibrium adsorption-desorption
      and equilibrium precipitation-dissolution is the first approximation of the
      complicated process mentioned above. In our next publication we are to extend the
      model with kinetic terms belonging to adsorption-desorption and precipitation
      dissolution process respectively.

PMID- 11218131
TI  - Flow microcalorimetric measurements for bovine serum albumin on reversed-phase
      and anion-exchange supports under overloaded conditions.
AB  - Heat of adsorption data using flow microcalorimetry is reported for the
      adsorption of bovine serum albumin (BSA) on C18 and C4 chromatographic supports.
      Exothermic heats were obtained in all cases. Data for the effect of salt indicate
      that conformational changes in adsorbed protein appear to be greatest in the
      absence of salt. Also, the specific surface area of the support was found to
      influence behavior more strongly than the length of the carbon ligand. Heats of
      adsorption of BSA on an ion-exchange support were also measured. Endothermic
      heats were obtained in all cases. The data indicate that the observed heat
      effects may be strongly influenced by the release of water from the surface.

PMID- 11218130
TI  - Purification of adipoyl-7-amino-3-deacetoxycephalosporanic acid from fermentation
      broth using stepwise elution with a synergistically adsorbed modulator.
AB  - Multicomponent adsorption data of a fermentation broth containing adipoyl-7-amino
      3-deacetoxycephalosporanic acid (adipoyl-7-ADCA), a cephalosporin precursor for 7
      ADCA, and two key impurities, alpha-hydroxyadipoyl-7-ADCA and alpha-aminoadipoyl
      7-ADCA were obtained from batch equilibrium and frontal chromatography tests.
      Amberlite XAD-1600 was chosen as the resin. A rate model was applied to simulate
      the chromatograms. An alkaline buffer, which by itself has no affinity for the
      resin, was used as the eluent. The widely used reversed-phase modulator model is
      inaccurate in explaining the stepwise elution data. A new model, the induced
      competition model, has been developed to account for apparent retention of the
      buffer in the presence of adsorbed species. Close agreement between the
      simulations and the data was achieved with the new model.

PMID- 11218132
TI  - Description of adsorption equilibria in liquid chromatography systems with binary
      mobile phases.
AB  - Adsorption of some simple compounds from pure and mixed solvents and of some
      solvents from mixed binary solvent mixtures on columns used in normal-phase,
      aqueous-organic and non-aqueous liquid chromatography was investigated. The
      distribution of the compounds between the liquid and the stationary phase is
      affected by the composition of the solvent mixture. Although preferential
      sorption of stronger solvents can often be described by the Langmuir isotherm,
      significant deviations are observed in some systems. A model was suggested
      accounting for the deviations from Langmuir isotherm by association on already
      adsorbed molecules. In most systems studied in this work, a simple competitive
      Langmuir isotherm did not provide a good fit to the experimental distribution
      data from mixed solvents when competition between the solute and the strong
      solvent for the adsorption sites was considered. A competitive isotherm taking
      into account possible association of solute on its own already adsorbed molecules
      and on the adsorbed molecules of strong solvent improves the fit to the
      experimental distribution data and enables description of the distribution data
      in dependence on the concentration of the strong solvent in mixed solvents in
      normal-phase, aqueous-organic and non-aqueous reversed-phase systems. Even though
      we need more data to prove the validity of the present model, we observe a good
      qualitative agreement of the experimental isotherm coefficients with the relative
      strength of the interactions expected in various chromatographic systems
      employing mixed solvents.

PMID- 11218134
TI  - Effect of the homogeneity of the column set on the performance of a simulated
      moving bed unit. I. Theory.
AB  - Although it is impossible to manufacture identical columns for use in a simulated
      moving bed (SMB) process, theoretical studies assume that all the columns in an
      SMB unit have identical characteristics. In practice, calculations in modeling
      and optimization studies are made with the average values of each column
      parameter set. In this report, the effects on SMB process performance caused by
      column-to-column fluctuations of the parameters are discussed. As a first step,
      we show how the differences in porosity of the columns may be taken into account
      with a revised set of separation conditions. Reductions in the purity of the
      extract and the raffinate streams are quantitatively related to the column-to
      column fluctuations of the retention times of the two components arising from
      these porosity differences. For the sake of simplicity, the discussion first
      addresses the case of a four-column SMB operating under linear conditions. Then,
      the scope is extended to the cases of SMB units incorporating several columns in
      each section and to SMB units operating under nonlinear conditions.

PMID- 11218133
TI  - Pore network modelling: determination of the dynamic profiles of the pore
      diffusivity and its effect on column performance as the loading of the solute in
      the adsorbed phase varies with time.
AB  - A three-dimensional pore network model for diffusion in porous adsorbent
      particles was employed in a dynamic adsorption model that simulates the
      adsorption of a solute in porous particles packed in a chromatographic column.
      The solution of the combined model yielded the dynamic profiles of the pore
      diffusion coefficient of beta-galactosidase along the radius of porous ion
      exchange particles and along the length of the column as the loading of the
      adsorbate molecules on the surface of the pores occurred, and, the dynamic
      adsorptive capacity of the chromatographic column as a function of the design and
      operational parameters of the chromatographic system. The pore size distribution
      of the porous adsorbent particles and the chemistry of the adsorption sites were
      unchanged in the simulations. It was found that for a given column length the
      dynamic profiles of the pore diffusion coefficient were influenced by: (i) the
      superficial fluid velocity in the column, (ii) the diameter of the adsorbent
      particles and (iii) the pore connectivity of the porous structure of the
      adsorbent particles. The effect of the magnitude of the pore connectivity on the
      dynamic profiles of the pore diffusion coefficient increased as the diameter of
      the adsorbent particles and the superficial fluid velocity in the column
      increased. The dynamic adsorptive capacity of the column increased as: (a) the
      particle diameter and the superficial fluid velocity in the column decreased, and
      (b) the column length and the pore connectivity increased. In preparative
      chromatography, it is desirable to obtain high throughputs within acceptable
      pressure gradients, and this may require the employment of larger diameter
      adsorbent particles. In such a case, longer column lengths satisfying acceptable
      pressure gradients with adsorbent particles having higher pore connectivity
      values could provide high dynamic adsorptive capacities. An alternative
      chromatographic system could be comprised of a long column packed with large
      particles which have fractal pores (fractal particles) that have high pore
      connectivities and which allow high intraparticle diffusional and convective flow
      mass transfer rates providing high throughputs and high dynamic adsorptive
      capacities. If large scale monoliths could be made to be reproducible and
      operationally stable, they could also offer an alternative mode of operation that
      could provide high throughputs and high dynamic adsorptive capacities.

PMID- 11218135
TI  - Application of equilibrium theory to ternary moving bed configurations
      (four+four, five+four, eight and nine zones) I. Linear case.
AB  - In this article, different ternary moving bed configurations are studied by
      determining the working flow-rates of the equivalent true moving bed at the low
      solvent consumption point using equilibrium theory. This method has been applied
      for linear adsorption isotherms. The simulated moving bed flow-rates can then be
      calculated and a final comparison between the performances of each process is
      given based upon two different objective functions.

PMID- 11218136
TI  - Application of the equilibrium theory to ternary moving bed configurations (4+4,
      5+4, 8 and 9 zones). II. Langmuir case.
AB  - In this article, the overall methodology used to determine the working flow-rates
      of a true moving bed (TMB) processing langmuirian isotherms compounds is
      explained. Then it is applied to different ternary configurations (4+4, 5+4, 8 or
      9 zones TMB) in order to characterize their performances. Finally the results
      obtained on all the configurations are compared on a given example. This
      comparison allows the choice of the more suitable configuration to be used for a
      given set of compounds.

PMID- 11218137
TI  - Determination of lewisite oxide in soil using solid-phase microextraction
      followed by gas chromatography with flame photometric or mass spectrometric
      detection.
AB  - A rapid, sensitive, and convenient method is described for determining Lewisite
      oxide in soil. Samples are initially fortified with phenylarsine oxide
      (surrogate), then both species are extracted using ascorbic acid solutions
      containing 1,3-propanedithiol (derivatizing reagent). The corresponding filtered
      supernatant is sampled using a solid-phase microextraction fiber. Collected
      analytes are thermally desorbed in a heated gas chromatographic inlet, separated
      using fused-silica capillary columns ("primary" and "confirmatory"), and detected
      with either a mass spectrometric (selected ion monitoring mode) or flame
      photometric (sulfur-selective mode) detector. Two independent statistically
      unbiased procedures were used to evaluate the detection limit for Lewisite oxide;
      the values range between 0.1 and 0.5 microg g(-1) soil.

PMID- 11218138
TI  - Application of on-site solid-phase microextraction in aquatic dissipation studies
      of profoxydim in rice.
AB  - The application of a manual operated solid-phase microextraction (SPME)-HPLC
      interface is discussed for the analysis of thermally labile analytes in aqueous
      matrices. The technique has been applied on-site at a flooded rice field to
      demonstrate its potential for real time extraction of the herbicide profoxydim.
      Thus, compounds which would otherwise easily degrade in the aqueous matrices
      within hours or days could be determined more accurately. The fibers were shipped
      back to the laboratory with express delivery where the target analyte was
      desorbed from the fiber and determined by HPLC-UV analysis. The SPME method was
      characterized by significant ruggedness where conventional techniques such as
      liquid-liquid extraction and solid-phase extraction require additional shipping
      and handling costs and time-consuming multiple sample preparation steps. In
      general, any delay in shipping the aqueous samples to the laboratory has the
      potential for sample degradation and a loss in accuracy when using non on-site
      extraction techniques. Fifty microm Carbowax-templated resin coatings were most
      suitable for coupling SPME to HPLC in order to achieve a high sensitivity for
      polar analytes. The SPME technique was characterized by a good sensitivity and a
      precision less than 10% RSD. The SPME-LC-UV method was linear over at least three
      orders of magnitude while achieving a limit of detection in the lower microg/l
      range. The on-site SPME method has shown significantly increased accuracy.
      Profoxydim was determined at concentrations of ca. 180 microg/l 3 h after an
      application on a flooded bare soil field.

PMID- 11218139
TI  - Combining membrane extraction with mobile gas chromatography for the field
      analysis of volatile organic compounds in contaminated waters.
AB  - A mobile gas chromatographic device (Airmobtx HC 1000 monitor manufactured by
      Airmotec, Germany), originally designed for the analysis of benzene, toluene,
      ethylbenzene and xylenes (BTEX) in air, was connected to a flow cell for dynamic
      membrane extraction. Volatile organic compounds (VOCs) diffuse out of a water
      stream through a hollow fibre, are enriched onto sorption tubes integrated in the
      mobile device, and are then thermally desorbed and analysed by gas chromatography
      flame ionisation detection. Battery operation of the device enables continuous on
      site analysis of VOCs. Influences of the water flow-rate on system response and
      memory effects were investigated. The linear range of the method depends on the
      flow-rate of the water sample and did not exceed two orders of magnitude. The
      detection limits for trichloroethene, chlorobenzene and the BTEX compounds were
      found to be between 0.1 and 1.0 microg/l using a water flow-rate of 30 ml/min.
      Dynamic membrane extraction combined with the mobile gas chromatographic device
      was used for the on-site analysis of contaminated waters in the area of Leipzig.

PMID- 11218140
TI  - Preparation and applications of polypyrrole films in solid-phase microextraction.
AB  - Polypyrrole (PPY) and poly-N-phenylpyrrole (PPPY) films were prepared and applied
      for solid-phase microextraction (SPME). The extraction properties of the new
      films to volatile organic compounds were examined using an SPME device coupled
      with GC-flame ionization detection. A PPY-coated capillary was applied for in
      tube SPME to evaluate its extraction efficiency towards less volatile compounds
      and ionic species. The porous surface structures of the films, revealed by
      scanning electron microscopy, provided high surface areas and allowed for high
      extraction efficiency. Compared with commercial SPME stationary phases, the new
      phases showed better selectivity and sensitivity toward polar, aromatic, basic
      and anionic compounds, due to their inherent multifunctional properties. In
      addition, PPY and PPPY films showed different selectivity to various groups of
      compounds studied, indicating that the selectivity of the films could be modified
      by introducing a new functional group (phenyl in PPPY) into the polymer. For in
      tube SPME, the PPY-coated capillary showed superior extraction efficiency to
      commercial capillaries for a variety of compounds, demonstrating its potential
      applications for a wide range of analytes when coupled with HPLC. The sensitivity
      and selectivity of the films for SPME could be tuned by changing the film
      thickness. These results are in line with both the theoretical expectations and
      the results obtained by other methods, which indicate not only that PPY films can
      be used as new stationary phases for SPME. but also that SPME method may provide
      an alternative tool for studying materials like polypyrrole.

PMID- 11218141
TI  - Detection of the cyclic nitramine explosives hexahydro-1,3,5-trinitro- 1,3,5
      triazine (RDX) and octahydro- 1,3,5,7-tetranitro- 1,3,5,7-tetrazine (HMX) and
      their degradation products in soil environments.
AB  - The cyclic nitramine explosives hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) and
      octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazine (HMX) were examined in field and
      microcosm soil samples to determine their patterns of degradation and
      environmental fates. A number of analytical techniques, including solid-phase
      microextraction with on-fiber derivatization, gas chromatography-mass
      spectrometry, gas chromatography with electron-capture detection, liquid
      chromatography-mass spectrometry, and micellar electrokinetic chromatography were
      required for the analyses. Two different classes of intermediates were detected,
      both of which lead ultimately to the formation of nitrous oxide (N2O) and carbon
      dioxide (CO2). The first class was identified as the nitroso derivatives formed
      by the sequential reduction of -NO2 functional groups. The second class of
      intermediates, which was favored at higher humidities and in the presence of
      anaerobic sludge amendments, consisted of ring cleavage products including bis
      (hydroxymethyl)-nitramine and methylenedinitramine. Rye-grass (Lolium perenne)
      present in field samples was found to extract and accumulate HMX from soil
      without further degradation. In all cases (excepting the plant samples), the
      indigenous microbes or amended domestic anaerobic sludge consortia degraded the
      cyclic nitramine explosives eventually to produce N2O and CO2.

PMID- 11218142
TI  - Development and application of immunoaffinity chromatography for the
      determination of the triazinic biocides in seawater.
AB  - The development of an immunoaffinity chromatography (IAC) procedure for the
      selective extraction of the anti-fouling agent Irgarol 1051 [2-(tert.-butylamino)
      4-(cyclopropylamino)-6-(methylthio)-1,3,5-triazine] from seawater is described.
      The anti-Irgarol 1051 antibodies were covalently bound to agarose-based beads
      support. IAC column capacities were higher than 400 ng and ethanol-water (70:30)
      was selected as eluting mixture. After percolation of 250 ml of water sample
      containing Irgarol 1051 at environmental levels (ng l(-1) ), the breakthrough
      volume was still not achieved. Other triazine herbicides percolated through the
      IAC column showed good recoveries. Thus, this IAC procedure may be useful to
      extract related compounds. The developed IAC column was applied to real seawater
      samples and compared with RP-C18 cartridges. The limit of detection (LOD) reached
      by using the IAC procedure was twenty times lower than the LOD achieved by the RP
      C 18 cartridges using the same detection system. Irgarol 1051 was detected at ng
      l(-1) levels in the Barcelona marina (northwestern Mediterranean Sea). An
      acceptable correlation between enzyme-linked immunosorbent assay and gas
      chromatography with nitrogen-phosphorus detection was observed, thus analysis of
      Irgarol 1051 can be performed by either one of the methods. In this work, further
      confirmation of the analyte identity for real samples was accomplished by gas
      chromatography-electron impact mass spectrometry.

PMID- 11218143
TI  - Alkyl diol silica: restricted access pre-column packings for fast liquid
      chromatography-integrated sample preparation of biological fluids.
AB  - A silica-based pre-column packed with a 'restricted access material' was used for
      fully automated solid-phase extraction of drugs and metabolites from untreated
      biological fluids via a simple valve-switching method. The bifunctional sorbent
      employed, alkyl diol silica, is characterised by a different chemical
      modification of the outer surface (diol groups) and the pore surface of the
      particles (alkyl chains: C4, C8 or C18). This allows for a fast and efficient
      clean-up of complex biological samples, such as blood, serum, urine or milk, with
      exclusion of the macromolecular matrix (proteins, nucleic acids) in less than 1.5
      min.

PMID- 11218144
TI  - Miniaturized solid-phase extraction with resin disks.
AB  - The properties and advantages of membrane disks for solid-phase extraction (SPE)
      are described. Miniaturization is a trend in SPE, as well as chemical analysis in
      general. A semimicro method is reviewed in which an extraction disk 4 mm in
      diameter is used for SPE. Even smaller scale separations are possible with a
      device in which a membrane 0.7 mm in diameter was incorporated into the needle of
      a 50-micro syringe. Aqueous samples containing 10 ppb of eight substituted
      benzenes were passed through the miniaturized-SPE syringe automatically using a
      single-syringe infusion pump. Elution volumes of 5 microl provided 500-fold
      concentrations and delivered average recoveries greater than 90% and an average
      relative standard deviation (RSD) of 4.6% for the analytes. Direct injection of
      the 5 microl eluate from the miniaturized-SPE syringe into a gas chromatograph
      also produced average recoveries greater than 90% and an average RSD of 6.2%.

PMID- 11218145
TI  - Liquid-phase microextraction and capillary electrophoresis of citalopram, an
      antidepressant drug.
AB  - A newly developed disposable device for liquid-phase microextraction (LPME) was
      evaluated for the capillary electrophoresis (CE) of the antidepressant drug
      citalopram (CIT) and its main metabolite N-desmethylcitalopram (DCIT) in human
      plasma. CIT and DCIT were extracted from 1 ml plasma samples through hexyl ether
      immobilised in the pores of a porous polypropylene hollow fibre and into 25
      microl of 20 mM phosphate buffer (pH 2.75) present inside the hollow fibre
      (acceptor phase). Prior to extraction, the samples were made strongly alkaline in
      order to promote LPME of the basic drugs. Owing to the high ratio between the
      volumes of sample and acceptor phase, and owing to high partition coefficients,
      CIT and DCIT were enriched by a factor of 25 to 30. In addition, sample clean-up
      occurred during LPME since salts, proteins and the majority of endogenic
      substances were unable to penetrate the hexyl ether layer. Since the extracts
      were aqueous, they were injected directly into the CE instrument. Limits of
      quantification (S/N= 10) for CIT and DCIT in plasma were 16.5 ng/ml and 18 ng/ml
      respectively, while the limits of detection (S/N=3) were 5 ng/ml and 5.5 ng/ml
      respectively. This enabled CIT (and DCIT) to be analysed within the therapeutic
      range by LPME-CE and detection limits were comparable with previously reported
      HPLC methods.

PMID- 11218146
TI  - In situ derivatisation using pressurized liquid extraction to determine phenols,
      sterols and carboxylic acids in environmental samples and microbial biomasses.
AB  - Pressurized liquid extraction was combined with in-situ derivatisation to extract
      polar analytes such as phenols (including chlorophenols) sterols and carboxylic
      acids from environmental and microbial samples. This one-step protocol uses
      acetic anhydride as an acetylation agent, N,O
      bis(trimethylsilyl)trifluoroacetamide (BSTFA) as an silylation agent, and boron
      trifluoride-methanol, phenyltrimethyl ammoniumhydroxide and trimethyl
      sulfoniumhydroxide as methylation agents. It results in faster extraction rates
      and better or comparable extraction efficiencies when compared to classical
      approaches. The addition of a silylation agent also facilitates the extraction
      kinetics of analytes not accessible to silylation (e.g. polycyclic aromatic
      hydrocarbons or alkylbenzenes). This may be attributed to a dissociative action
      of the agent to weaken analyte-matrix interactions.

PMID- 11218147
TI  - Leptin and leptin binding activity in the preovulatory follicle of polycystic
      ovary syndrome patients.
AB  - To investigate the clinical importance of leptin's intraovarian effects, we
      studied the concentration of leptin and leptin binding activity in the plasma and
      in the follicular fluid of PCOS patients (n=20; median BMI: 27.1 kg/m2, range
      19.7-36.3) undergoing controlled ovarian stimulation with long-term GnRH agonist,
      recombinant FSH, and in vitro fertilization. Follicular fluid and blood samples
      were collected during follicle aspiration for IVF. Total leptin concentration was
      measured by radioimmunoassay, and specific leptin binding activity was accessed
      by a gel filtration column assay. Follicular fluid and plasma leptin levels were
      similar (median 1135 pmol/l vs. 1409 pmol/l; p=0.81). Follicular fluid to plasma
      leptin ratio was independently associated with cumulative FSH dose (r=0.63;
      p=0.006) and insulin resistance index (r=-0.45; p=0.04). Specific leptin binding
      activity was higher in the plasma than in the follicular fluid [median 7.94% vs.
      3.49%; p<0.001]. When multivariate analysis was used to predict FSH consumption,
      only follicular fluid leptin levels were significantly associated with cumulative
      FSH dose (r=0.46; p=0.04). We infer that at least in part by increased
      intrafollicular leptin levels, obesity directly affects ovarian function in PCOS,
      and may induce a relative resistance to gonadotropin stimulation. This
      intraovarian effect of leptin can be even more profound because of low leptin
      binding activity in the preovulatory follicle of obese patients.

PMID- 11218149
TI  - Time-dependent diagnostic performance of a rapid troponin T version 2 bedside
      test in patients with acute coronary syndromes.
AB  - In a prospective trial, the diagnostic performance of the second version of the
      troponin T rapid assay (Trop T; cutoff 0.2 microg/L) was compared with the
      quantitative cardiac-specific troponin T assay (cTnT ELISA; cutoff 0.1 microg/L)
      and other established cardiac markers such as CK, CK-MB activity, CK-MB mass and
      myoglobin. Additionally, a 30-day follow-up was performed to determine the
      suitability of the Trop T assay and the reference markers for short-term risk
      stratification. Two-hundred-and-eighty-six consecutive patients with chest pain
      and suspected acute myocardial infarction (AMI) were enrolled in two CCU
      departments. Serial blood specimens were taken at admission and at 3, 6, 12, 24,
      48, 72 and 96 h after admission. According to the biochemical criterion CK-MB
      mass, the patients were classified as having AMI in 154 patients (54%), unstable
      angina (UAP) in 72 patients (27%) and no evidence for acute cardiac ischemia in
      55 patients (19%). Analytical method comparison of Trop T with cTnT ELISA (cutoff
      0.1 microg/L) showed a good agreement, Trop T yielded only 4% false-negative and
      3% false-positive results. The diagnostic performance of Trop T for the detection
      of AMI was only slightly inferior compared to cTnT ELISA. Beyond 12 h after
      admission, Trop T and cTnT ELISA maintained a sensitivity close to 100%, whereas
      the sensitivity of the other cardiac markers decreased sharply. The diagnostic
      sensitivity of Trop T for the detection of minor myocardial damage in UAP
      patients was the same as for cTnT ELISA. Death within 30 days' follow-up occurred
      only in AMI patients with a positive Trop T test result within the first 6 h
      after admission. The admission Trop T and cTnT ELISA were the only significant
      biochemical predictors of major cardiac events. In conclusion, these data show
      that Trop T has similar diagnostic sensitivity as cTnT ELISA and is a useful tool
      to confirm acute or subacute myocardial infarction. Trop T is an excellent marker
      in detecting minor myocardial damage in UAP patients and is suitable for short
      term risk stratification.

PMID- 11218148
TI  - Traditional and alternative nutrition--levels of homocysteine and lipid
      parameters in adults.
AB  - Values of homocysteine and lipid parameters were measured in groups of adults
      consuming alternative nutrition (vegetarians/lactoovo/, vegans) and compared with
      a group consuming traditional diet (omnivores, general population). Frequency of
      hyperhomocysteinemia was 53% in the vegans group, 28% in vegetarians vs. 5% in
      omnivores. In conditions of lower methionine intake (reduced content in plant
      proteins), the remethylation pathway of homocysteine metabolism prevails and it
      is vitamin B12 and folate-dependent. The intake of vitamin B12 is equal to zero
      in vegans; vegetarians consume 124% of the RDA vs. 383% in omnivores. Serum
      vitamin levels are significantly lower in subjects consuming alternative
      nutrition with deficiency observed in 24% of vegetarians, 78% of vegans vs. 0% in
      omnivores. Serum folate levels are within the reference range in all groups. Mild
      hyperhomocysteinemia in the groups consuming alternative diet is a consequence of
      vitamin B12 deficiency. Vegetarians and vegans meet the RDA for energy and fat,
      and have a favourable proportion of saturated, mono- and polyunsaturated fatty
      acids on total energy intake; the ratio of linoleic/alpha-linolenic acid in their
      diet corresponds with the recommendations. They have low cholesterol consumption
      and higher vitamin E and C intake. Optimal fat intake of correct composition is
      reflected in lower values of atherosclerosis risk factors (cholesterol, LDL
      cholesterol, atherogenic index, saturated fatty acids, triacylglycerols), and
      significantly higher levels of protective substances (linoleic acid, alpha
      linolenic acid, HDL-cholesterol, vitamin E, vitamin E/cholesterol, vitamin C).
      Low lipid risk factors but higher findings of mild hyperhomocysteinemia in
      vegetarians mean a diminished protective effect of alternative nutrition in
      cardiovascular disease prevention.

PMID- 11218150
TI  - Validation of inductively coupled plasma atomic emission spectrometry technique
      (ICP-AES) for multi-element analysis of trace elements in human serum.
AB  - The use of inductively coupled plasma atomic emission spectrometry (ICP-AES) for
      the simultaneous determination of Al, B, Ba, Be, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni,
      Pb, Se, Sr and Zn in human serum in a clinical laboratory was validated. Samples
      were digested and then analysed using yttrium as an internal standard and a serum
      matched calibration standard. The criteria used to assess the analytical
      performance of the ICP-AES were detection and quantification limits, linearity,
      sensitivity, recovery, interference from alkali and acid, trueness and precision.
      Detection limits were 0.002-0.003 micromol/L for Mn, Sr, Ba, and Cd; 0.014-0.07
      micromol/L for Co, Zn, Fe, Be, Li, Pb, Cu, Ni, and Cr; and 0.2-0.9 micromol/L for
      B, Se, and Al. Trueness, as controlled by analysis of bovine serum certified
      reference material, was acceptable for Co, Cu, Se and Zn, while Fe was 5.1% and
      Mn 6.2% below the lowest limit of the certified material interval. We conclude
      that ICP-AES can be used for multi-element analysis of B, Ba, Cu, Fe, Li, Se, Sr
      and Zn in serum. Serum levels of Al, Be and Co were below the detection limits
      while serum levels of Cd, Cr, Ni and Pb were below the quantification limits of
      the ICP-AES. These trace metals cannot be analysed as routine by the ICP-AES.
      However, in cases of intoxication with elevated serum concentrations mean
      recovery of 100+/-10% was obtained at an addition of 2.22 micromol/L for Al, 0.11
      micromol/L for Be, 0.03 micromol/L for Co, 0.39 micromol/L for Cr, 0.14
      micromol/L for Ni, and 0.12 micromol/L for Pb.

PMID- 11218152
TI  - Comparison of iohexol and lactulose-mannitol tests as markers of disease activity
      in patients with inflammatory bowel disease.
AB  - Increased intestinal permeability has been proposed as one aetiological factor
      for inflammatory bowel diseases (IBD). We have previously found that intestinal
      permeability of a water-soluble contrast medium, iohexol, correlates with disease
      activity. The objective was to compare the iohexol test with the lactulose
      mannitol ratio, which is a more extensively studied permeability marker, in
      patients with active IBD. Urinary excretion of iohexol was compared to the
      lactulose-mannitol ratio in 22 patients with an exacerbation of IBD and in 10
      healthy controls. Median intestinal absorption of iohexol was 0.64% (range 0.13
      3.8%) in the 22 patients and 0.3% (range 0.15-0.54%) in the controls (p = 0.016),
      whereas the median lactulose-mannitol ratio was 0.037 (range 0.01-0.260) in
      patients and 0.03 (range 0.004-0.063) in controls (N.S.). Correlation between
      urinary excretion of iohexol and lactulose-mannitol ratio was positive (R =
      +0.41, p = 0.018). The urinary excretion of iohexol correlated positively with
      endoscopic disease activity (R = +0.74, p < 0.001) and the modified Harvey
      Bradshaw index (R = +0.44, p = 0.04). The lactulose-mannitol ratio correlated
      positively with endoscopic disease activity (R = +0.44, p = 0.05), but
      correlations with clinical index or c-reactive protein were poor. In conclusion,
      the iohexol test is a superior activity marker compared to the lactulose-mannitol
      ratio which probably reflects, instead, some pathogenic property of IBD.

PMID- 11218151
TI  - Random C-peptide in the classification of diabetes.
AB  - OBJECTIVE: To clarify whether random C-peptide is a valuable test in the
      classification of diabetes. RESEARCH DESIGN AND METHODS: All C-peptide
      measurements conducted in the diabetic population of Skaraborg (280,539
      inhabitants and 3.2% diabetes) between 1995 and 1998 (3,115 samples) were
      considered, but only patients with well-defined diabetes type (1,449 samples from
      1,093 patients) were analyzed for the correlation between diabetes type and C
      peptide concentration. Serum C-peptide was measured after fasting over night
      (fCP), after glucagon stimulation (gCP), and randomly (rCP) without considering
      previous meals at an ordinary visit to the diabetic clinic (rCP). Receiver
      Operating Characteristic (ROC) curves were constructed to illustrate the power of
      the different C-peptide protocols and to determine the optimal cut-off values.
      RESULTS: Although all three tests had high discriminative power, the ROC curves
      demonstrated that rCP was superior to fCP and gCP in discriminating type 1 from
      type 2 diabetes. The optimal cut-off value for rCP was 0.50 nmol/L, for fCP 0.42
      nmol/L, and for gCP 0.60 nmol/L. CONCLUSIONS: rCP is more powerful than fCP and
      gCP in distinguishing type 1 from type 2 diabetes and can therefore be
      recommended as a classification tool, particularly in outpatients.

PMID- 11218153
TI  - A classification of circadian blood pressure profiles using a cumulative chi
      square technique.
AB  - Non-invasive ambulatory blood pressure monitoring has been used to assess
      circadian rhythms in blood pressure in a qualitative fashion. However, there are
      no established methods for assessing circadian changes in blood pressure in a
      quantitative fashion. In this study, we developed a quantitative method to
      evaluate the circadian rhythm based on profile analysis and a cumulative chi
      square technique. This method was used to analyse the circadian blood pressure
      variations in 100 normotensive volunteers and 127 hypertensive patients. Three
      blood pressure profiles were identified for the normotensive group, while four
      were identified for the hypertensive group. Furthermore, there was a relationship
      between the discriminate blood pressure profiles and the severity of
      hypertension. We conclude that profile analysis of 24-h ambulatory blood pressure
      monitoring may be used to stratify patients with regard to the risk of
      complications of hypertension.

PMID- 11218154
TI  - Biological variation and analytical imprecision of CA 125 in patients with
      ovarian cancer.
AB  - Despite the availability of serial data on CA 125 in ovarian cancer, the problem
      of interpreting a change over time is still unsolved. Changes in marker
      concentrations are due not only to patients improving or deteriorating but also
      to analytical imprecision and normal intra-individual biological variation. The
      aim of this study was to assess the analytical imprecision (CV(A)) and the intra-
      and inter-individual biological variation (CV(I) and CV(G), respectively) of CA
      125 in a group of 26 patients with clinically stable ovarian cancer. Furthermore,
      the critical difference for a change between two consecutive CA 125
      concentrations calculated as square root(2) x Z x (CV(A)2 + CV(I)2)(1/2) (Z =1.65
      for unidirectional and 1.96 for bidirectional changes, p < or = 0.05) and the
      index of individuality calculated as ((CV(A)2+CV(I)2)/CV(G)2)(1/2) were
      estimated. After the exclusion of outliers, CV(A) and the average CV(I) and CV(G)
      were 12.1%, 24.0%, and 43.1%, respectively. The index of individuality was 0.62
      and the critical difference calculated for unidirectional changes was 62.6%.
      CV(A) and CV(I) contribute considerably to the variation in serial results and
      should, therefore, be included in the criteria for serum tumor marker assessment
      during monitoring of patients with ovarian cancer. The cut-off value of CA 125 is
      of minor value in detecting unusual results for an individual subject, when
      previous measurements from an individual are available. These measurements should
      be preferred as reference for interpretation of new results.

PMID- 11218155
TI  - Short-term stimulation of vascular smooth muscle cells with platelet-derived
      growth factor (PDGF)-BB and angiotensin II induces.
AB  - Growth factors such as the platelet-derived growth factor (PDGF)-BB and
      angiotensin II (Ang II) have been shown to induce vascular smooth muscle cell
      (VSMC) proliferation after long stimulation periods. Little is known though,
      about the effects of PDGF-BB and Ang II on VSMC proliferation after short
      stimulation periods. The purpose of our study was to examine whether a short term
      (3-60 min) stimulation of VSMC with PDGF-BB or Ang II is sufficient to induce
      cell proliferation. Incubation of VSMC with Ang II (100 nM) or PDGF-BB (50 ng/ml)
      caused a significant increase in [3H]thymidine incorporation starting after a 3
      min stimulation, while the cell counts required 32 and 8 h of stimulation,
      respectively. Mitogen-activated protein kinase activation reached a maximum at 5
      10 min of PDGF-BB or Ang II stimulation. This study demonstrates that the growth
      promoting effects of PDGF-BB and Ang II are strongly dependent on the length of
      the stimulation period and that while prolonged stimulation periods (>8-32 h)
      result in VSMC proliferation, short ones (3-60 min) result only in [3H]thymidine
      incorporation without an increase in cell count, a fact of considerable
      pathophysiological significance, considering that the time kinetics of growth
      factors in the VSMC microenvironment have not as yet been clarified.

PMID- 11218156
TI  - Updating biological variation databases and selecting reasonably correct
      published values.

PMID- 11218157
TI  - The history of Crohn's disease.
AB  - Although it is likely that cases of what we know as granulomatous inflammatory
      bowel disease (Crohn's disease) may have been recorded as early as 1769, this
      illness is basically a disease of the 20th century. This historical review traces
      the development of our understanding of the disease and the evolution of its
      operative management.

PMID- 11218159
TI  - Crohn's disease of the foregut.
AB  - Historically, Crohn's disease of the esophagus, stomach, and duodenum has been
      reported only rarely. With more frequent use of upper endoscopy, however, upper
      gastrointestinal involvement has been found to be more common than previously
      suspected. The surgeon with an interest in Crohn's disease needs to be familiar
      with all areas that are potentially affected in this perplexing and sometimes
      devastating disease. This article examines the literature on foregut Crohn's and
      discusses the incidence, clinical manifestations, diagnosis, medical management,
      surgical indications, and operative techniques.

PMID- 11218158
TI  - Nutritional support for Crohn's disease.
AB  - This article reviews nutritional considerations that arise in the care of
      patients with Crohn's disease. The causes and presentation of malnutrition in
      these patients are discussed, and a rational method is presented for
      comprehensive nutritional assessment. The indications for nutritional
      intervention, either as supportive or primary therapy for Crohn's disease, are
      reviewed.

PMID- 11218160
TI  - Surgical pathology of Crohn's disease.
AB  - This article discusses the gross endoscopic and histologic features of Crohn's
      disease. Terms used to describe the pathologic features are defined, and possible
      mechanisms and implications of development are discussed. The gross endoscopic
      and histologic correlation and the roles of the pathologist and endoscopist in
      making the diagnosis of Crohn's disease are emphasized.

PMID- 11218161
TI  - Crohn's disease of the small bowel.
AB  - Crohn's disease of the small bowel frequently requires surgical intervention.
      While dealing with the disease complications that require intervention, treatment
      should be based on a long-term strategic plan that recognizes the likelihood of
      recurrent disease, repeat surgeries, and the possibility of a future ostomy.
      Resection forms the basis for surgical treatments, but strictureplasty, abscess
      drainage, intestinal and diversion bypasses also are used, selectively.

PMID- 11218162
TI  - Crohn's disease of the colon.
AB  - The surgical treatment of Crohn's disease of the colon is distinct from that used
      in treating ulcerative colitis. Crohn's disease often involves the small bowel
      and is not "cured" by colorectal resection. The popular ileo-anal pouch
      procedures used in the management of ulcerative colitis generally are not used
      for the treatment of Crohn's colitis, because of higher complication rates.
      Commonly performed operations include ileostomy, segmental colon resection,
      subtotal colectomy, and proctocolectomy. The general surgeon, therefore, is
      provided with many options when faced with complications of Crohn's colitis. This
      article examines the attributes of and results reported for each of these
      options.

PMID- 11218164
TI  - Intestinal stomas in Crohn's disease.
AB  - Stomal construction is as important as the establishment of hemostasis.
      Appropriate preoperative assessment and adherence to accepted construction
      techniques usually will avoid stomal complications. In patients who suffer
      adverse consequences, accurate assessment and appropriate management principles
      are essential to properly address the problem.

PMID- 11218163
TI  - Anorectal Crohn's disease.
AB  - Anorectal disease affects many patients with Crohn's disease. Clinical
      manifestations vary from asymptomatic skin tags to severe, debilitating perineal
      destruction and sepsis. Surgical management needs to be conservative and must
      focus on draining septic sites, preserving sphincter function, and palliating
      symptoms. Medical management has had some success in improving symptoms, but as
      yet, it has not been able to ameliorate most perianal complaints quickly and
      enduringly. Many new and exciting treatment modalities are being investigated
      with the hope that more effective approaches to these complex and difficult
      problems can be realized.

PMID- 11218165
TI  - Urologic complications of Crohn's disease.
AB  - Crohn's disease frequently can affect the genitourinary system, mainly in the
      form of urinary fistulae and urolithiasis. Diagnostic evaluation of fistulae
      associated with Crohn's disease has improved with the increasing use of computed
      tomography and MR imaging, along with other diagnostic modalities. Resective
      surgery is the main treatment in this group of patients. Kidney stones are common
      because of metabolic derangements and dehydration; however, these can be treated
      adequately with minimally invasive procedures, such as extracorporeal shock-wave
      lithotripsy, ureteroscopy, and percutaneous surgery. In addition, medical
      therapies can prevent recurrent stones.

PMID- 11218166
TI  - Laparoscopic surgery in Crohn's disease.
AB  - Laparoscopic surgeons attempting to treat Crohn's disease must have experience
      working with inflammatory bowel disease and advanced laparoscopic skills.
      Nonetheless, laparoscopy is dramatically changing all aspects of gastrointestinal
      surgery and inflammatory bowel disease, including Crohn's disease, is likely to
      benefit, as well. This article defines the role of laparoscopy in treating
      Crohn's disease and outlines surgical therapy.

PMID- 11218167
TI  - Psychosocial aspects of Crohn's disease.
AB  - In clinical practice, significant discrepancies occur between disease activity
      and severity, and the patient's symptom experience and behavior. Discrepancies
      cannot be explained by biologic or morphologic findings, and usually are
      considered to be related to psychosocial factors. Recent advances in the
      scientific understanding of the relationship between environmental stress and the
      neural, endocrine, and immune systems, combined with new methodologies in
      clinical research, provide a challenging opportunity for clinicians and
      researchers to establish a more comprehensive understanding of Crohn's disease.
      This article reviews the important relationship of psychosocial factors,
      pathogenesis, clinical expression, response to treatment, and outcome of Crohn's
      disease, and presents a comprehensive model of illness, disease, and ways to
      integrate psychosocial factors with diagnosis and patient care.

PMID- 11218168
TI  - Molecular genetics and Crohn's disease.
AB  - This article reviews basic molecular genetics and summarizes recent work in the
      genetics of Crohn's disease. Family studies are summarized, and candidate genes
      are described. The current state of knowledge and the implications of possible
      inheritance of Crohn's disease for patient care are discussed.

PMID- 11218169
TI  - Radiologic and endoscopic diagnosis of Crohn's disease.
AB  - This article reviews the radiologic and endoscopic diagnosis of Crohn's disease.
      Radiographic and endoscopic findings of Crohn's disease are discussed; a
      practical approach to the selection of radiologic modalities is presented; and
      the role of endoscopy in diagnosis and treatment is explained.

PMID- 11218170
TI  - Medical therapy for Crohn's disease: the state of the art.
AB  - Various medications are used to control the symptoms of Crohn's disease. This
      article reviews the traditional medical therapies of Crohn's disease, including
      aminosalicylates and corticosteroids, and the broad armamentarium of immune
      modulators and biologic agents that are becoming increasingly important in the
      management of Crohn's disease.

PMID- 11218171
TI  - Monitoring health reform: a report card approach.
AB  - During the past several years, budget cuts have forced hospitals in several
      countries to change the way they deliver care. Gilson (Gilson, L. (1998).
      DISCUSSION: In defence and pursuit of equity. Social Science & Medicine, 47(12),
      1891-1896) has argued that, while health reforms are designed to improve
      efficiency, they have considerable potential to harm equity in the delivery of
      health care services. It is essential to monitor the impact of health reforms,
      not only to ensure the balance between equity and efficiency, but also to
      determine the effect of reforms on such things as access to care and the quality
      of care delivered. This paper proposes a framework for monitoring these and other
      indicators that may be affected by health care reform. Application of this
      framework is illustrated with data from Winnipeg, Manitoba, Canada. Despite the
      closure of almost 24% of the hospital beds in Winnipeg between 1992 and 1996,
      access to care and quality of care remained generally unchanged. Improvements in
      efficiency occurred without harming the equitable delivery of health care
      services. Given our increasing understanding of the weak links between health
      care and health, improving efficiency within the health care system may actually
      be a prerequisite for addressing equity issues in health.

PMID- 11218172
TI  - Competitive health policies and community health.
AB  - Since 1992 there have been fundamental changes in health care policy in Victoria,
      Australia, as the state government moves to competitive market models of service
      delivery and the measurement of service provision through output based funding.
      The introduction of competitive relationships to the public health system has had
      a major impact in the primary health care sector, particularly on community
      health centres. Most community health centres in Victoria have traditionally been
      semi-independent agencies controlled by community based committees of management.
      Such policies have had huge implications for the management and organisation of
      these agencies, as they have led to different patterns of service delivery and
      different models of management practice, often devaluing traditional
      philosophical perspectives of 'primary health care practice'. Although many
      agencies have embraced change as providing opportunities for growth and
      development and to have more influence in the provision of mainstream public
      health care, primary health care models of practice should be supported for their
      intrinsic and increasing value.

PMID- 11218173
TI  - Networks and tuberculosis: an undetected community outbreak involving public
      places.
AB  - After decades of decline in developed countries, there was a resurgence of
      tuberculosis in the mid-1980s accompanied by increased recognition that this
      infectious disease has long remained a major public health problem at the global
      level. New methods from molecular biology, in particular DNA 'fingerprinting' (of
      Mycobacterium tuberculosis), made it clear that current transmission and recent
      infection (in contrast to reactivation of earlier, latent infection) were much
      more significant than previously believed. Studies of tuberculosis outbreaks
      using these new tools pointed to complex networks through which infection was
      spreading and highlighted the need for new approaches to outbreak investigation
      and disease control. In the study reported here a new approach--combining methods
      from molecular biology, epidemiology and network analysis--was used to examine an
      outbreak of tuberculosis in Houston, Texas. Initial investigation using
      conventional strategies revealed few contacts among 37 patients with identical
      (six-band) DNA (IS6110-based) fingerprints but subsequent research uncovered over
      40 places (including many gay bars) to which patients in this outbreak could be
      linked. Network methods were used to reconstruct an outbreak network and to
      quantify the relative importance (here, 'betweenness' centrality) of different
      actors (persons and places) playing a role in the outbreak. The multidisciplinary
      work provides the basis for a new approach to outbreak investigation and disease
      control.

PMID- 11218174
TI  - Primary care as intersecting social worlds.
AB  - An enhanced role for primary health care (PHC) is currently a matter of political
      priority in the UK. This higher profile is drawing attention to a range of
      unresolved challenges and issues, relating to both the structure and content of
      provision, which currently permeate the system. Running in parallel with this is
      a recognition that: to date, PHC has been under-researched; that, as a result,
      our understanding of it is frequently poor; and that, as a consequence, fresh
      perspectives are needed in order to effectively research this uncertain, evolving
      and increasingly important healthcare sector. In this paper we argue that social
      worlds theory (SWT) provides, albeit in a suitably modified form, an ideal
      conceptual framework for the analysis of contemporary primary care. SWT is an
      approach which assumes complexity and constant evolution, and its core concepts
      are directed towards unravelling the consequences of encounters between different
      interest groups--something which is of particular utility at this time given the
      increasing attention to user participation, and an ongoing questioning of
      established patterns of professional authority. It is an approach which has
      rarely been employed empirically, even beyond medicine. In order to illustrate
      the wide relevance of the approach, we discuss how it can facilitate research at
      all levels of PHC: i.e., in relation to aspects of medical practice (the case of
      medically unexplained symptoms); shifts in service organisation (changing
      professional roles and the introduction of policy reforms); and issues which
      straddle both organisation and content (the increasing use of complementary
      medicine in primary care). In each case the approach is able to embrace the
      complexity of situations characterised by the intersection of professional and
      lay social worlds and is able to provide the conceptual tools through which
      resultant processes can be tracked and investigated.

PMID- 11218175
TI  - The social construction of male 'homosexuality' in India: implications for HIV
      transmission and prevention.
AB  - Over the past 20 years, there has been a growing recognition of the relativity of
      sexual norms and of the difficulties of exporting Western conceptions of
      sexuality to different socio-cultural settings. This view has been most clearly
      articulated in studies of men who have sex with men (MSM) which suggest that the
      ways in which male-male sexual activity is shaped and constituted vary
      significantly from place to place. Despite this, 'homosexuality' continues to be
      treated as an unproblematic category in HIV/AIDS discourse, epidemiological
      studies of and HIV prevention strategies for MSM in widely different contexts
      being based on the North American/West European example of gay men. This paper,
      which draws upon ethnographic research in Madras, highlights important
      differences between India and the West, not only in the sexual identities and
      circuits of MSM, but in their sexual partnerships and practices. These
      differences, it is argued, are not only significant to the epidemiology of HIV
      transmission, but have important implications for the development and
      implementation of HIV prevention strategies.

PMID- 11218176
TI  - Implementing AIDS policy in post-apartheid South Africa.
AB  - In common with the rest of the Southern African sub-continent. South Africa is
      currently experiencing a serious HIV epidemic. When it came into power in 1994,
      the new, Mandela-led government immediately mobilised funds and adopted a far
      reaching AIDS Plan for the country. However, the implementation of AIDS policy in
      the first four years after 1994 has been characterised by a lack of progress and
      a breakdown of trust and co-operation, both within government and between
      government and NGOs. This paper outlines the political context which shaped the
      development of the AIDS Policy, then examines the difficulties of implementing a
      comprehensive response to AIDS in a country undergoing restructuring at every
      level. It questions the notion of "inadequate political will" as an explanation
      for lack of progress. Involvement by politicians has, in fact, been experienced
      as a double-edged sword in South Africa, with inappropriate, "quick-fix" actions
      creating conflict and hampering a more longer-term, effective response. The paper
      also highlights the importance of groupings outside of government in promoting
      effective policy actions, and the types of leadership required to mobilise a
      broad range of actors around a common vision. It concludes by emphasising the
      need to develop approaches to policy implementation rooted in the possibilities
      and constraints of the local situation, rather than relying on universal blue
      prints developed out of context.

PMID- 11218177
TI  - Relationship dynamics and teenage pregnancy in South Africa.
AB  - Teenage pregnancy is extremely common in South Africa. Whilst its 'problematic'
      nature is a subject of debate, it reflects a pattern of sexual activity which
      puts teenagers at risk of HIV. Currently one in five pregnant teenagers is
      infected with the virus. This creates a new imperative to understand teenage
      pregnancy and the pattern of high risk sexual activity of which it is one
      consequence. This was an exploratory study undertaken to investigate factors
      associated with teenage pregnancy amongst sexually active adolescents in an urban
      and peri-urban context. The study used a matched case control design, with 191
      cases and 353 school or neighbourhood, age-matched controls. Subjects were under
      19 years and recruited from township areas of Cape Town. A structured
      questionnaire was used to obtain information on socio-economic factors,
      contraceptive knowledge and use, and sexual behaviour. Conditional logistic
      regression was used to analyse the relationship between teenage pregnancy and the
      factors investigated. The results presented focus on relationship dynamics and
      their association with the risk of pregnancy. Both groups of teenagers had been
      dating for a mean of two and a half years and about half were still with their
      first sexual partner. The partners of the pregnant teenagers were significantly
      older, less likely to be in school and less likely to have other girlfriends. The
      pregnant teenagers were significantly more likely to have experienced forced
      sexual initiation and were beaten more often. They were much less likely to have
      confronted their boyfriend when they discovered he had other girlfriends.
      Multiple modelling shows that both forced sexual initiation and unwillingness to
      confront an unfaithful partner are strongly associated with pregnancy and also
      related to each other. We argue that the associations are mediated through
      unequal power relations within the relationship which are reinforced by violence.
      We further discuss indicators of greater intimacy within relationships of the
      pregnant teenagers which may suggest that more of the pregnancies were wanted
      than was suggested. Both of these conclusions pose critical challenges for health
      promoters.

PMID- 11218178
TI  - China's one-child policy: the economic choices and consequences faced by pregnant
      women.
AB  - This paper addresses the important issue of the effect of China's one-child
      policy on prenatal and obstetric care utilization. The paper provides the first
      detailed empirical approach to this question, exploiting a unique high quality
      household survey. China officially codified a set of rules and regulations in
      1979 governing the approved size of Chinese families, commonly known as the one
      child policy. The policy imposed economic and social costs on families failing to
      adhere to the family size limits. In particular, the policy raised the price of
      obstetric medical services for unapproved pregnancies in comparison to approved
      pregnancies and imposed fines on families with unapproved births. Using data from
      an eight-province longitudinal household survey (The China Health and Nutrition
      Survey), we investigate whether or not the one-child policy's financial penalties
      were associated with the avoidance of obstetric care by pregnant Chinese women
      with unapproved pregnancies. The one-child policy variables of particular
      interest were a dichotomous measure of the approval status of the pregnancy, a
      continuous measure of the fine imposed upon families with unapproved births, and
      a continuous measure of the prices of prenatal care and delivery services net of
      any subsidy available for approved births. The results partially confirm the
      hypotheses that the one-child policy's economic and social costs caused women to
      forego seeking modern obstetric care services. The fine was found to be a
      significant deterrent to the utilization of prenatal care. Additionally, the
      unapproved-status of a pregnancy was strongly negatively associated with "the use
      of obstetric care. However, higher prices were not consistently found to be a
      significant deterrent to the use of obstetric care.

PMID- 11218179
TI  - Dimensions of social inequality in the health of women in England: occupational,
      material and behavioural pathways.
AB  - This paper examines the role of behavioural and psychosocial risk and protective
      factors in explaining social inequalities in the general self-assessed health of
      women. Using path analysis, data from the Health Survey for England (1993) are
      used to demonstrate how different dimensions of social position (working
      conditions, general social advantage and material deprivation) have distinct
      pathways to ill-health. Smoking, diet, alcohol consumption, exercise, social
      support and job strain were all related to poorer health, but not always in the
      predicted direction. The effects of social position on health were not fully
      mediated through these risk and protective factors. Each dimension of social
      position had unique pathways to ill-health via other unidentified mechanisms.
      Furthermore, the salience of the three dimensions of social position differed
      according to the level of labour market attachment. Different path models are
      required to fit the data for women at home or in full-time or part-time work.

PMID- 11218180
TI  - "It's some kind of women's empowerment": the ambiguity of the female condom as a
      marker of female empowerment.
AB  - The female condom is the latest in a series of sexual and reproductive
      technologies to be imported into the third world, following the contraceptive
      pill, the Depo-Provera injection, the latex male condom, and others. It is an
      example of "traveling technology", which accrues different meanings and
      connotations in the different settings into which it is introduced in its journey
      through the circuits of international technological diffusion, from the
      headquarters of international NGOs and bilateral aid programs, through the
      bureaucracies of national ministries of health to the communities in urban and
      rural settings where the condoms are distributed. The female condom almost always
      carries connotations of women's empowerment, and the possibility of greater
      sexual autonomy for women. This association is a result of the female condom
      being the first new "post-Cairo" technology, the diffusion of which was spurred
      by the consensus reached at the 1994 International Conference on Population and
      Development in Cairo, at which the need to promote women's empowerment was moved
      to the center of international family planning and population movements. However,
      I demonstrate that "empowerment" is an ambiguous term, interpreted in different
      ways in different contexts. I illustrate this through interviews conducted in
      1998 and 1999 with stakeholders in the female condom in Cape Town, Nairobi, and
      in rural western Kenya. These stakeholders range from directors of US-based
      development programs to heads of national AIDS-prevention efforts to community
      based distributors and primary health care nurses at the village level. I argue
      that three different notions of empowerment are being articulated with respect to
      the female condom--two which correspond to Maxine Molyneux's typology of
      strategic and practical gender interests, and a third in which women's
      empowerment is conceived of as something which diminished the power of men. I
      argue further that the disjunctures between these three different notions of what
      "empowerment" means will pose a challenge for people at all levels which are
      seeking to make the female condom more widely accessible to women at risk of
      HIV/AIDS.

PMID- 11218181
TI  - African Americans' views on research and the Tuskegee Syphilis Study.
AB  - The participation of African Americans in clinical and public health research is
      essential. However, for a multitude of reasons, participation is low in many
      research studies. This article reviews the literature that substantiates barriers
      to participation and the legacy of past abuses of human subjects through
      research. The article then reports the results of seven focus groups with 60
      African Americans in Los Angeles, Chicago, Washington, DC, and Atlanta during the
      winter of 1997. In order to improve recruitment and retention in research, the
      focus group study examined knowledge of and attitudes toward medical research,
      knowledge of the Tuskegee Syphilis Study, and reactions to the Home Box Office
      production, Miss Evers' Boys, a fictionalized version of the Tuskegee Study, that
      premiered in February, 1997. The study found that accurate knowledge about
      research was limited; lack of understanding and trust of informed consent
      procedures was problematic; and distrust of researchers posed a substantial
      barrier to recruitment. Additionally, the study found that, in general,
      participants believed that research was important, but they clearly distinguished
      between types of research they would be willing to consider participating in and
      their motivations for doing so.

PMID- 11218182
TI  - Low incidence of hereditary nonpolyposis colorectal cancer syndrome in a selected
      area of the Lombardy Cancer Registry.
AB  - AIMS AND BACKGROUND: Epidemiological investigations on the frequency of
      hereditary nonpolyposis colorectal cancer (HNPCC) syndrome are few and have shown
      a variable worldwide incidence ranging from 1% to 7% of all colorectal cancers
      (CRCs). In Italy, relevant differences have been observed: 2.8-3% of all CRCs in
      northern regions and less than 1% in southern regions. The aim of the present
      study was to investigate the HNPCC incidence in a selected area of northern Italy
      belonging to the Lombardy Cancer Registry. METHODS AND STUDY DESIGN: We analyzed
      197 consecutive patients with newly diagnosed CRCs, histologically verified, and
      resident in two areas of the Lombardy Cancer Registry. For each case, genetic
      counseling with at least three generations pedigree reconstruction, HNPCC
      classification according to Amsterdam criteria, molecular analysis for
      microsatellite instability and immunohistochemistry for hMLH1 and hMSH2 were
      performed. RESULTS: A very low frequency (0.5%) of HNPCC fulfilling the Amsterdam
      criteria was found in comparison to the other Italian areas. Such an incidence
      seems to be due to actual population differences and reflects a genetic
      heterogeneity. CONCLUSIONS: The data underline the importance of a precise
      knowledge of actual HNPCC incidence in different populations in order to optimize
      effectiveness and efficiency of screening programs for the disease.

PMID- 11218183
TI  - Histopathologic interobserver agreement on the diagnosis of melanocytic skin
      lesions with equivocal dermoscopic features: a pilot study.
AB  - AIMS AND BACKGROUND: Dermoscopy (dermatoscopy, skin surface microscopy,
      epiluminescence microscopy) has been increasingly employed in recent years for
      the preoperative detection of cutaneous melanoma, and dermatoscopic features of
      pigmented skin lesions have been previously defined using histopathology (HP) as
      the "key to the code". The aim of the present study was to evaluate the
      interobserver agreement on the HP diagnosis in a series of epiluminescence
      microscopy equivocal melanocytic skin lesions. STUDY DESIGN: Ten melanocytic skin
      lesions were selected on the basis of diagnostic disagreement of at least 2 out
      of 9 epiluminescence microscopy observers. The histologic specimens from the 10
      lesions were examined by 9 HP observers. The agreement of the HP diagnoses was
      calculated by means of Fleiss' k statistics. RESULTS: The overall HP agreement
      was less than excellent (k = 0.5). When considering the prevailing
      epiluminescence microscopic and HP diagnoses, 2 cases were shown to be
      epiluminescence microscopy false-negative melanomas. Virtually no agreement was
      found among epiluminescence microscopy observers in 4 cases (40%) or among HP
      observers in 3 cases (30%). However, only one pigmented skin lesion remained
      unclassifiable on epiluminescence microscopy as well as HP. CONCLUSIONS: When at
      least 2 epiluminescence microscopy experts disagree in the evaluation of a given
      melanocytic skin lesion, even HP consultations may give equivocal results. The
      need to establish more reliable epiluminescence microscopic and HP criteria by
      performing an improved and meticulous clinicopathologic correlation, e.g. by
      using telecommunication via Internet, is emphasized.

PMID- 11218184
TI  - Ovarian germ cell cancer: clinicopathologic analysis and outcome of 31 cases.
AB  - AIMS: The aim of the study was to evaluate some clinicopathologic characteristics
      and the outcome of patients with ovarian germ cell cancer (OGCC) treated with
      cisplatin-based chemotherapy. METHODS: It was a clinical retrospective study. The
      clinical charts of 31 patients with OGCC assisted at the Department of Obstetrics
      and Gynecology of the State University of Campinas, Brazil, from January 1986 to
      June 1997 were reviewed. RESULTS: Ten patients had dysgerminoma and 21 patients
      nondysgerminomatous tumors. Women with dysgerminoma and nondysgerminomatous
      tumors did not present differences regarding surgical staging, age, ascites or
      residual tumor after the initial surgery. Frozen section, performed in 16
      patients, showed some discrepancy with paraffin histology diagnosis in 8
      patients. Platinum-based chemotherapy was used in 5/10 patients with dysgerminoma
      and in 17/21 patients with nondysgerminomatous tumors, with a 5-year survival of
      100% for the dysgerminoma and 53% for the nondysgerminomatous group. CONCLUSIONS:
      Women with dysgerminoma and nondysgerminomatous tumors did not present
      differences regarding clinicopathologic characteristics. The prognosis for
      patients with dysgerminoma was better than for those with nondysgerminomatous
      tumors. Frozen section had a high error rate in diagnosing OGCC intraoperatively.

PMID- 11218185
TI  - Detection of false-negative Pap smears using the PAPNET system.
AB  - AIMS AND BACKGROUND: False-negative cytological diagnoses represent the critical
      point of a screening program for early detection of cervical cancer. Computer
      assisted reading using neural network technology has been suggested as a possible
      approach to manage the problem. The study assessed the performance and the cost
      outcome ratio of computer-assisted versus conventional manual Pap smear reading.
      METHODS: One thousand routine smears, seeded with 81 false-negative smears, were
      independently interpreted by two readers by conventional and PAPNET-assisted
      reading. Results of both readings were compared in terms of: a)sensitivity for
      false-negative smears, b)specificity, and c) cost-outcome (cost per CIN2+ lesion
      detected). RESULTS: PAPNET-assisted reading showed a small increase in
      sensitivity only for one reader. Including the cost of PAPNET, the cost per
      detected lesion would be $7,543 and the cost per additional detected lesion would
      be $25,748. CONCLUSIONS: The present study provides further evidence that PAPNET
      assisted screening may allow the detection of a few extra cases of CIN2+ lesions
      with respect to conventional reading, though at a very high cost.

PMID- 11218186
TI  - Cellular and clinical pharmacokinetic/pharmacodynamic basis for lack of efficacy
      of 21-day continuous topotecan in patients with untreated advanced adenocarcinoma
      of the pancreas.
AB  - BACKGROUND: In a phase II study, topotecan was evaluated for response and
      toxicity in patients with advanced pancreatic carcinoma at the schedule of 0.7
      mg/m2/day q 21 days q 28 days. METHODS: Responses were assessed after at least 2
      courses using WHO criteria, and toxicity was evaluated after each course
      according to the CTC-NCI standards. Between December 1995 and September 1997, 15
      assessable patients (median age, 55 years; range, 36-74; median ECOG performance,
      1; range, 0-3) were included in the study. All had biopsy-proven and measurable
      disease, a life-expectancy of at least 3 months, and normal bone marrow, liver,
      and renal function. None of the patients had undergone prior cytotoxic or
      radiation therapy, and 10 were initially treated by surgery. Twenty-five cycles
      were assessable for toxicity. Plasma was collected from 7 patients who had
      received a total of 10 cycles and was, after extraction with methanol at -20
      degrees C, analyzed for total topotecan by an HPLC method. The thus determined
      steady-state concentrations were assessed for their capacity to affect growth and
      DNA integrity in the BxPC-3 human pancreatic carcinoma cell line after 21 days of
      continuous exposure. For these purposes, we used a sulforhodamine B staining
      assay, and agarose gel electrophoresis, respectively. RESULTS: Grades 3-4
      leukopenia, thrombocytopenia, granulocytopenia, and anemia occurred in 8, 6, 8
      and 8 cycles, respectively. Other mild to moderate side effects (grades 1-2)
      included malaise, nausea and vomiting, anorexia, and alopecia. No objective tumor
      response was documented. HPLC analysis of patients' plasma showed the attainment
      of constant steady-state levels of 1.0+/-0.1 ng/mL during the entire infusion
      period. At such a concentration, topotecan did not significantly affect growth or
      DNA integrity in the BxPC-3 cells. Fifty percent cell growth inhibition and
      appreciable oligonucleosomal DNA fragmentation were only evident with 21 days
      topotecan > or = 50 ng/mL. CONCLUSIONS: Our data suggest that the lack of
      clinical activity of 0.7 mg/m2 daily topotecan for 21 days q 28 days in patients
      with advanced pancreatic carcinoma might be partially attributed to the
      achievement of non-tumoricidal plasma drug concentrations.

PMID- 11218187
TI  - The value of oxaliplatin in combination with continuous infusion +/- bolus 5
      fluorouracil and levo-folinic acid in metastatic colorectal cancer progressing
      after 5FU-based chemotherapy: a GISCAD (Italian Group for the Study of Digestive
      Tract) cancer phase II trial.
AB  - AIMS AND BACKGROUND: The phase II trial was designed to evaluate the activity of
      combined oxaliplatin (L-OHP), continuous infusion (CI) +/- bolus 5-fluorouracil
      (5FU) and levo-folinic acid (I-FA) in patients with metastatic colorectal cancer
      progressing after one or more lines of 5FU-based chemotherapy. PATIENTS AND
      METHODS: We designed two contemporary studies: in the former we enrolled patients
      previously treated with 1 line of chemotherapy, and in the latter, patients
      previously treated with 2, 3 and 4 lines. Seventy-six consecutive patients were
      enrolled: 45 received L-OHP (85 mg/m2 i.v. 2 h on day 1) + I-FA (100 mg/m2 i.v. 2
      h on days 1 and 2) + 5FU i.v. bolus (400 mg/m2 days 1 and 2) + 5FU (600 mg/m2 CI
      22 h days 1 and 2 (FOLFOX 4); 31 received L-OHP (100 mg/m2 i.v. 2 h on day 1) + I
      FA (250 mg/m2 i.v. 2 h on days 1 and 2), followed by 5FU (1500 mg/m2 Cl 24 h days
      1 and 2 (FOLFOX 2). The treatment was recycled every 2 weeks and continued until
      progression and/or unacceptable toxicity or patient preference. The primary end
      point was activity (tumor growth control [TGC]: partial response [PR] + stable
      disease [SD]); the secondary end points were time to progression (TTP), overall
      survival (OS) and toxicity. RESULTS: Forty-five patients in 2nd line (22 FOLFOX
      4, 23 FOLFOX 2), 23 (17 FOLFOX 4, 6 FOLFOX 2) in 3rd, 4 in 4th and 1 in 5th line
      were assessable; 3 were lost to follow-up. In 15 patients (11 FOLFOX 4, 4 FOLFOX
      2), disease involved the liver only. A total of 533 courses were administered
      with a range of 1-14 in FOLFOX4 and 1-12 in FOLFOX2; dose intensity was 92.85%,
      and the total dose of the administered L-OHP was 98.29%. As a 2nd line treatment,
      FOLFOX 4 achieved TGC in 72.8% of the patients (PR, 18.2%; SD, 54.6%), with a
      median TTP of 6 months and a median OS of 7 months, whereas in the FOLFOX 2 group
      these figures were 78.3% (PR 21.8%, SD 56.5%), and 5 and 9 months. As a 3rd line
      treatment, FOLFOX 4 produced TGC in 41.1% of patients (PR 23.5%, SD 17.6%), with
      a median TTP of 5 months and median OS of 7+ months, whereas FOLFOX 2 obtained
      respective values of 50% (PR 16.7%, SD 33.3%), 7 and 9 months. As a 4th line of
      treatment, TGC was achieved in 2 patients (1 PR, 1 SD); the patient in 5th line
      therapy obtained a SD. With "de Gramont" as the first-line regimen, patients
      assessable were 24 in FOLFOX 4 and 18 in FOLFOX 2. In the former population, TGC
      was 70.8% (PR 37.5%, SD 33.3%), with a TTP of 6 months and OS of 10 months,
      whereas with FOLFOX2 these values were 61.1% (PR 5.6%, SD 55.5), 5 and 7 months.
      In patients with liver involvement only, FOLFOX 4 obtained TGC in 63.6% of cases
      (with a TTP of 7 months and OS of 6+ months), FOLFOX 2 in 100% (with a TTP of 9.5
      months and OS of 13.5+ months). Both schedules exhibited an acceptable toxicity:
      neurologic, hematologic and hepatic grade 3 side effects occurred in a limited
      number of patients, with a higher frequency in the FOLFOX 2 group. CONCLUSIONS:
      Treatment with L-OHP, CI +/- bolus 5FU and I-FA was well tolerated. The activity
      in terms of TGC was interesting and comparable with results reported in the
      literature for the standard treatment for 2nd line, i.e. irinotecan alone.
      Treatment was effective in 2nd line and in patients previously treated with more
      than two chemotherapy lines; in particular, treatment was active in patients with
      hepatic disease only. Although the two schedules seemed to achieve the same
      benefit with the same tolerance, we could not define from the study the better
      regime.

PMID- 11218188
TI  - Prognostic effects of lymph node micrometastases in patients undergoing curative
      gastrectomy for cancer.
AB  - AIMS & BACKGROUND: It is not known whether the presence of micrometastases in the
      regional lymph nodes has an impact on the oncologic outcome of patients
      undergoing a curative (R0) gastrectomy for cancer. The aim of the study was to
      assess the effects of the presence of micrometastases on survival. METHODS: We
      reviewed 29 patients operated on for curative (R0) gastrectomy, with a final
      diagnosis of pN0, 16 or more lymph nodes in the specimen, and a follow-up of at
      least 4 years. The original hemotoxylin and eosin slides were reviewed, and a new
      section was cut from the lymph nodes and immunostained with a pool of antibodies
      against different types of cytokeratins. Micrometastases were detected in 5
      patients (27.5% of the series) and 11 lymph nodes (1.51% of all removed lymph
      nodes). RESULTS: Mortality due to cancer progression occurred in 3 patients from
      the pN0 group (14.2%) and 1 patient from the pN1 group (12.5%). CONCLUSIONS:
      There was no suggestion from the data that the presence of micrometastases
      carries an ominous prognosis in terms of survival.

PMID- 11218189
TI  - Clinical management of a case of recurrent apocrine gland carcinoma of the scalp:
      efficacy of a chemotherapy schedule with methotrexate and bleomycin.
AB  - Apocrine carcinoma of the skin is a rare tumor. Wide surgical excision with
      complete removal of the neoplasm is the standard therapy and this appears to
      offer the best chance of cure. Radiotherapy may be used in case of local relapse
      or regional lymph node involvement. Systemic chemotherapy has not proved to be
      effective in the treatment of this tumor. We report on a 46-year-old woman with a
      recurrent apocrine carcinoma of the scalp that had previously been treated with
      surgery, radiotherapy and chemotherapy (Al-Saraff schedule). The patient was
      responsive to a second-line systemic chemotherapy regimen consisting of a weekly
      combination of methotrexate and bleomycin, and achieved long-term progression
      free survival.

PMID- 11218190
TI  - Intra-arterial liver chemotherapy and hormone therapy in malignant insulinoma:
      case report and review of the literature.
AB  - BACKGROUND: Malignant insulinoma is a rare tumor. Metastatic disease confined to
      the liver can be treated with various locoregional treatments. CASE REPORT: We
      report a case of a young woman who developed liver metastases twelve years
      following resection of a pancreatic insulinoma positive to anti-insulin
      antibodies. With five cycles of intra-arterial locoregional chemotherapy
      (fluorouracil and epirubicin) to the liver and monthly hormone therapy
      (octreotide) the patient obtained a clinical complete response. After twelve
      months she is still disease free. CONCLUSION: Locoregional therapy for insulinoma
      metastatic to the liver might represent the treatment of choice; hepatic intra
      arterial chemotherapy is an interesting therapeutic approach which deserves
      attention. The role of somatostatin analogs is limited to symptom control.

PMID- 11218191
TI  - Testicular plasmacytoma in a patient with the acquired immunodeficiency syndrome.
AB  - Clinical, laboratory, and pathologic findings from a case of primary
      extramedullary plasmacytoma of the testis and sinuses in a patient with acquired
      immunodeficiency syndrome (AIDS) are presented. To our knowledge this is the
      first case in the English literature of a primary testicular plasmacytoma in an
      HIV-infected patient. The findings in this report and those of others confirm the
      difference in the pattern of plasma cell tumor (PCT) presentation in patients
      infected with AIDS from those in non-infected individuals, suggesting that these
      tumors should be considered in the differential diagnosis of AIDS-associated
      malignancies.

PMID- 11218192
TI  - Two episodes of ifosfamide-related neurotoxicity in the same patient following
      different schedules and doses of the drug. A case report.
AB  - We report the first case of recurrent ifosfamide-related neurotoxicity in the
      same patient following two distinct administrations of the drug at different
      doses and schedules and with a long interval between the two episodes.
      Remarkably, the first event was characterized by confusion and hallucinations,
      while the second, 29 months later, was characterized by partial and generalized
      seizures. Between the two episodes the patient had received high-dose
      cyclophosphamide, an oxazophoshorine agent closely related to ifosfamide, without
      any neurological side effects. We briefly discuss the diagnosis and management of
      ifosfamide-related encephalopathy.

PMID- 11218193
TI  - A young female patient with an androgen-secreting tumor: a rare malignant
      disease.
AB  - A 23-year-old female patient presented with hirsutism and fatigue nine months
      after delivery. Endocrine assessment showed high testesterone, DHEA-S and
      androstenedione levels. Abdominal computed tomography and ultrasonography
      revealed the presence of a large tumor in the right renal region. Right
      adrenalectomy was performed resulting in a diagnosis of a functional adrenal
      tumor. Pathological examination showed a steroidogenically active tumor. Adjuvant
      chemotheraphy was administered postoperatively. At three months following surgery
      all endocrinological tests normalized, but liver metastases were detected by
      abdominal CT. Eight months after the operation the patient died of hepatic and
      renal failure. Androgen-secreting adrenal tumors are seen very rarely, yet the
      prognosis is poor due to their agressive nature.

PMID- 11218194
TI  - Intrathoracic desmoid tumor of the posterior mediastinum with transdiaphragmatic
      extension. Report of a case.
AB  - We report on a de novo desmoid tumor of the posterior mediastinum with
      transdiaphragmatic extension in a 40-year-old man. The tumor was inoperable
      because of its location and the invasion of adjacent structures. Although
      extremely rare, desmoid tumors of the posterior mediastinum should be considered
      in the differential diagnosis of posterior mediastinal masses.

PMID- 11218195
TI  - Primary non-Hodgkin's lymphoma of the liver (case report).
AB  - Primary non-Hodgkin's lymphoma of the liver is very uncommon, and fewer than 100
      cases have been reported in the literature. Most reports describe either solitary
      or multiple mass lesions in the liver. A diffuse lesion without nodule formation
      is a relatively rare form of the disease. The histologic feature of the disease
      is a predominantly large cell lymphoma of B-cell lineage. We report a case of
      primary B-cell non-Hodgkin's lymphoma which had diffusely infiltrated the liver
      without nodule formation.

PMID- 11218196
TI  - The role of outbreaks in developing food safety policy: population based
      surveillance of salmonella outbreaks in Wales 1986-98.
AB  - In developing public policy on food safety, systematic identification and
      thorough investigation of all general outbreaks is necessary in order to avoid
      bias towards highly publicised outbreaks. In Wales, from 1986 to 1998, 87 general
      foodborne outbreaks of salmonellosis were identified. Most outbreaks occurred at
      functions or were associated with small catering outlets such as bakeries and
      sandwich bars. In 50 outbreaks, a vehicle of infection was confirmed
      microbiologically and/or epidemiologically. The most common food vehicles were
      those containing shell eggs. Salmonella enteritidis outbreaks were significantly
      more likely than outbreaks of other serotypes to be associated with vehicles
      containing shell eggs, suggesting that eggs were also the source of infection in
      many outbreaks. The routine use of analytical epidemiological studies to identify
      vehicles in outbreaks is recommended.

PMID- 11218197
TI  - Emerging antibiotic resistance in Salmonella typhimurium in Norway.
AB  - The antimicrobial resistance of 809 Salmonella Typhimurium isolates collected
      from humans in Norway between 1975 and 1998 was studied. The material was
      subdivided into domestic and foreign isolates according to whether the patient
      had recently travelled abroad or not. In imported isolates the largest increase
      in resistance was in 1996 when 35% of the isolates were multi-resistant. The
      first multi-resistant isolate acquired in Norway appeared in 1994, but already in
      1998 23% of the isolates domestically acquired were multi-resistant, and a
      majority were S. Typhimurium DT104. We found no ciprofloxacin resistance in
      domestically acquired isolates. Amplified fragment length polymorphism analysis
      was performed on selected multi-resistant isolates. The method discriminated well
      between different multi-resistant isolates, but not between DT104 isolates.
      Resistant and multi-resistant S. Typhimurium were until 1998 essentially
      recovered from patients who had travelled abroad, but multi-resistant isolates,
      mainly DT104, are now also being transmitted within the country.

PMID- 11218198
TI  - Usefulness of genetic typing methods to trace epidemiologically Salmonella
      serotype Ohio.
AB  - Different genetic typing procedures were applied in an epidemiological study of
      Salmonella serotype Ohio. Isolates that generated identical DNA fingerprints
      (HinclI ribotypes, ERIC and RAPD profiles) were clustered into the same lineage,
      and the addition of data from plasmid, integron and resistance profiles was used
      to differentiate types. Results led to the determination of the endemic and the
      emergent epidemic types at specific times, and to ascertain the clinical and
      epidemiological impact of each type. In the series analysed (47 clinical isolates
      and 3 non-clinical isolates) 11 lineages and 32 types were found. Two lineages
      were considered prevalent and endemic, and during an epidemiological alert
      (Spain, 1998) a re-emergence and spread of organisms mainly from the most
      frequent lineage had occurred. The combination of H-ribotype with ERIC profile,
      as primary markers, and resistance profile with plasmid profile, as secondary
      markers, was shown to be the most useful tool to trace epidemiologically Ohio.

PMID- 11218199
TI  - Initially unrecognized distribution of a commercially cooked meat product
      contaminated over several months with Salmonella serotype Infantis.
AB  - An outbreak of salmonellosis occurred among 63 wedding participants. The outbreak
      was investigated through cohort, laboratory, and environmental studies.
      Consumption of rice-dressing made from a commercially cooked, meat-based, rice
      dressing mix was strongly associated with illness. Nineteen patient isolates, six
      company/grocery store isolates cultured from the rice-dressing mix, and one
      environmental isolate from a pump in the production line were of an identical
      outbreak strain of Salmonella Infantis characterized by pulsed-field gel
      electrophoresis. In the production line, cooked rice-dressing mix tested negative
      for S. Infantis before and positive after contact with the contaminated pump. The
      dressing-mix had an estimated 200 colony-forming units of salmonella per gram of
      product, and > 180,000 pounds were distributed in 9 states for > or = 2 months
      before contamination was recognized. Food manufacturers should be required to use
      systematic, hazard analysis critical control point risk management practices for
      all processed meat products, validated by periodic microbiologic monitoring of
      the end product.

PMID- 11218200
TI  - A community waterborne outbreak of gastro-enteritis attributed to Shigella
      sonnei.
AB  - An outbreak of gastro-enteritis occurred in a community of 2213 persons located
      near the city of Ioannina, in North-western Greece. Two hundreds and eighty-eight
      inhabitants of the village of Eleoussa, suffered from gastro-enteritis between 11
      and 22 October. The peak of the epidemic occurred during the first 3 days (11-13
      October). The highest risk of developing gastro-enteritis was observed in the age
      group 0-14 years (41.4%) and decreased significantly with age (P < 0.01).
      Patients over 65 years were more frequently hospitalized than those in other age
      groups (P < 0.05). Shigella sonnei was isolated from both, water samples and
      faeces of patients. Control measures were implemented on the second day of the
      outbreak. Environmental conditions suggest that contaminationof the water system
      occurred by groundwater.

PMID- 11218201
TI  - Health burden in the Netherlands due to infection with thermophilic Campylobacter
      spp.
AB  - Infection with thermophilic Campylobacter spp. usually leads to an episode of
      acute gastroenteritis. Occasionally, more severe diseases may be induced, notably
      Guillain Barre syndrome and reactive arthritis. For some, the disease may be
      fatal. We have integrated available data in one public health measure, the
      Disability Adjusted Life Year (DALY). DALYs are the sum of Years of Life Lost by
      premature mortality and Years Lived with Disability, weighted with a factor
      between 0 and 1 for the severity of illness. The mean health burden of
      campylobacter-associated illness in the Dutch population in the period 1990-5 is
      estimated as 1400 (90% CI 900-2000) DALY per year. The main determinants of
      health burden are acute gastroenteritis (440 DALY), gastroenteritis related
      mortality (310 DALY) and residual symptoms of Guillain-Barre syndrome (340 DALY).
      Sensitivity analysis demonstrated that alternative model assumptions produced
      results in the above-mentioned range.

PMID- 11218202
TI  - An epidemiological study of Plesiomonas shigelloides diarrhoea among Japanese
      travellers.
AB  - Plesiomonas shigelloides is often regarded as a non-pathogenic bacterial species
      that is occasionally isolated from patients with diarrhoea. However, a review of
      travellers returning to Japan with diarrhoeal illness through Kansai Airport
      revealed that the incidence of P. shigelloides from microbiologically confirmed
      cases increased from 23.2% in 1987 to 77.8% in 1999. We carried out a descriptive
      epidemiological study to identify patterns associated with diarrhoea due to this
      organism. Selected P. shigelloides isolates from this patient group were compared
      by pulsed-field gel electrophoresis of SpeI total chromosomal DNA digests to
      determine their genetic heterogeneity. Over the study period (whole of 1996 and
      first 2 months of 1999), 1149 of 1659 (69.3%) patients with microbiologically
      confirmed gastroenteritis yielded P. shigelloides. Infection was characterized by
      watery diarrhoea five times per day that persisted for 3 days. No statistically
      significant association was found between factors such as age, gender,
      destination, length of trip, but multivariable logistic regression analysis
      revealed an association between additional symptoms (vomiting, fever, abdominal
      pain) age and gender. The molecular fingerprints of a selection of 39 isolates
      and 3 reference strains of P. shigelloides were highly variable and each had a
      unique profile. We conclude that although P. shigelloides infections are usually
      mild and self-limiting, this organism may contribute to a significant proportion
      of travellers' diarrhoea in the Orient. The species is characterized by great
      heterogeneity at the DNA level.

PMID- 11218203
TI  - Infection with verocytotoxin-producing Escherichia coli O157 during a visit to an
      inner city open farm.
AB  - Two cases of Escherichia coli O157 infection occurred in children after visiting
      an inner city open farm. Subsequently faecal samples collected from animal pens
      and samples of composted mixed animal manure and vegetable waste were examined
      for E. coli O157 by enrichment culture, immunomagnetic separation and culture of
      magnetic beads to cefixime tellurite sorbitol MacConkey agar. Strains of E. coli
      O157 were characterized by hybridization with DNA probes for VT1, VT2 and eaeA,
      plasmid profile analysis, phage typing and pulsed field gel electrophoresis
      (PFGE). Verocytotoxin-producing E. coli O157 strains were isolated from faecal
      samples from a cow, a horse, 3 breeds of pigs, 2 breeds of sheep and 2 breeds of
      goats and from 2 samples of compost which had been processed for 3 months. All
      strains were phage type 21, hybridized with probes for VT2 and eaeA but not with
      one for VT1, harboured 92 and 2 kb plasmids and gave indistinguishable banding
      patterns with PFGE. Although only two culture-confirmed cases of infection had
      been identified, the farm had over 100,000 visitors per year and so it was closed
      as a precaution both to allow a thorough investigation and to prevent further
      cases. The investigation identified many factors which may have contributed to
      transmission of E. coli O157 infection. Most of these were readily resolved by
      appropriate corrective measures and as there were no further cases associated
      with the farm during the ensuing 4 weeks it then re-opened. These cases highlight
      the risk, especially to young children, of acquiring zoonotic infections during
      visits to open farms and emphasize the need for adequate guidance and supervision
      before and during such visits.

PMID- 11218204
TI  - Genomic fingerprinting of shigatoxin-producing Escherichia coli (STEC) strains:
      comparison of pulsed-field gel electrophoresis (PFGE) and fluorescent amplified
      fragment-length polymorphism (FAFLP).
AB  - For epidemiological studies of shigatoxin-producing Escherichia coli (STEC)
      infections, rapid, reproducible and highly discriminative methods are required.
      In this study, we examined the performance of the fluorescent amplified-fragment
      length polymorphism (FAFLP) technique for epidemiological fingerprinting of STEC
      isolates and compared it to the acknowledged fingerprinting method pulsed-field
      gel electrophoresis (PFGE). A total of 88 STEC isolates, including 82 of serotype
      O157:H7 or O157:H-, were subjected to fingerprinting by both PFGE and FAFLP. The
      isolates included sporadic and epidemiologically related strains of both animal
      and human origin from widespread geographical locations. The FAFLP fingerprint
      patterns confirmed the clonal nature of STEC O157 strains. Among the 82 O157:H7/H
      isolates belonging to 49 distinct groups of epidemiological unrelated isolates,
      24 FAFLP profiles and 51 PFGE patterns were obtained. Thus, PFGE had a higher
      discriminatory power than FAFLP and overall correlated better to available
      epidemiological data. Consequently, the PFGE technique remains the method of
      choice in epidemiological investigations of STEC infections.

PMID- 11218205
TI  - Population-based surveillance for bacterial meningitis in the Dominican Republic:
      implications for control by vaccination.
AB  - Quantifying the local burden of disease is an important step towards the
      introduction of new vaccines, such as Haemophilus influenzae type b (Hib)
      conjugate vaccine. We adapted a generic protocol developed by the World Health
      Organization for population-based surveillance of bacterial meningitis. All
      hospitals that admit paediatric patients with meningitis in the National
      District, Dominican Republic were included in the system and standard laboratory
      methods were used. The system identified 111 cases of confirmed bacterial
      meningitis. Hib was the leading cause of bacterial meningitis, followed by group
      B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case
      series, this population-based system was able to calculate incidence rates. The
      incidence of Hib meningitis was 13 cases per 100,000 children < 5 years old. The
      data from this study were used by the Ministry of Health to support the
      introduction of routine Hib vaccination and will be used to monitor its
      effectiveness.

PMID- 11218206
TI  - Determinants of case fatality rates of meningococcal disease during outbreaks in
      Makkah, Saudi Arabia, 1987-97.
AB  - We studied case-fatality rates (CFRs) among cases of meningococcal disease (MCD)
      admitted to Makkah (Saudi Arabia) hospitals during the period 1988-97. Of 483
      cases, 431 (89.2%) were due to strains of serogroup A, 31 (6.4%) to serogroup
      W135, 16 (3.3%) to serogroup C, and 5 (10%) to serogroup B. Eighty-one patients
      died (case fatality rate (CFR)) 16.8%, 95% CI 13.5%, 20.4%). The CFR in
      infections due to serogroup A strains was 14.8%, and for other serogroups it was
      32.7% (95% CI 20.3%, 47.1%). The CFR of MCD due to N. meningitidis serogroup A
      increased steadily with age (P<0.05). Seeking first medical help at a foreign
      Hajj medical mission and being treated in a non-specialized hospital were
      associated with a higher case fatality rate.

PMID- 11218207
TI  - Serotypes/groups distribution and antimicrobial resistance of invasive
      pneumococcal isolates: implications for vaccine strategies.
AB  - Based on the invasive pneumococcal isolates referred to reference laboratories in
      Scotland in 1988-99, we identified the distribution of serotypes/groups and their
      antimicrobial resistance patterns in order to evaluate the coverage of
      polysaccharide and the new pneumococcal conjugate vaccines. A total of 5659
      invasive isolates were included. Of these, 5124 (90.5%) were blood isolates, 308
      (5.5%) were CSF isolates, 143 (2.5%) were blood and CSF and 84 (1.5%) were other
      normally sterile isolates. The most prevalent 11 serotypes/groups were 14, 9, 19,
      6, 23, 1, 3, 4, 7, 8 and 18, in numerical order. These accounted for 84% of total
      serotypes/groups. The serotypes/groups included in the 23 and 14-valent
      polysaccharide vaccines accounted for 96% and 88% of all isolates. Both vaccines
      accounted for 98% of penicillin non-susceptible and 100% of erythromycin non
      susceptible isolates. The 7, 9, and 11-valent conjugate vaccines covered 61, 68
      and 80% of invasive isolates respectively. The coverage of these vaccines was
      substantially higher in youngest age group with 84, 86 and 93% of invasive
      isolates in children < 2 years included in the 7, 9 and 11-valent conjugate
      vaccines compared with 58, 64 and 77% in adults > or = 65 years of age. The
      serotype/group distribution of invasive isolates in Scotland varied from year to
      year over the period 1993-9. The coverage of the 23-valent vaccine remained above
      95% in each year but the coverage of the 7, 9 and 11-valent conjugate vaccines
      showed more marked fluctuation with coverage as low as 53, 60 and 75% in some
      years. Continued surveillance of invasive pneumococcal isolates is required to
      inform the development of appropriate vaccine strategies to prevent pneumococcal
      disease in Scotland.

PMID- 11218208
TI  - The prevalence and clonal diversity of penicillin-resistant Streptococcus
      pneumoniae in Kuwait.
AB  - Penicillin-resistant Streptococcus pneumoniae (PRSP) is widespread all over the
      world, including countries previously free of PRSP. This study was undertaken to
      determine the prevalence, the common serotypes and the clonality of PRSP isolated
      over a period of 1 year, from various clinical samples from three major hospitals
      in Kuwait. Strains were identified by standard methods and their antibiotic
      susceptibility was determined by the agar dilution method. The clonality of the
      isolates was determined by repetitive extragenic palindromic sequence polymerase
      chain reaction (REP-PCR) genomic profiling and pulsed field gel electrophoresis
      (PFGE). Serotyping was done by Quellung reaction using specific antisera. We
      found that 55% of the S. pnuemoniae were resistant to penicillin (46% and 9%
      exhibited intermediate and full resistance, respectively). Nearly 41% were
      resistant to sulfamethoxazole-trimethoprim, 9% to cefotaxime and ceftriaxone, 15%
      to amoxycillin-clavulanate, 17% to cefuroxime, 77 % to cefaclor, and 14% to
      clindamycin. The commonest serotypes among the PRSPs were 6A, 6B, 14, 19F, 23F
      and nontypable. PFGE and REP-PCR patterns showed a large diversity of genetic
      clones of the PRSP. Serotypes 6B, 14, 19F and 23F were more clonally related than
      the others. Our data showed that the prevalence of PRSP was high, the serotypes
      were diversified and different genetic clones make up the population of
      circulating PRSP in Kuwait.

PMID- 11218209
TI  - Dynamics of natural immunity caused by subclinical infections, case study on
      Haemophilus influenzae type b (Hib).
AB  - Natural immunity to Haemophilus influenzae type b (Hib) is based primarily on
      antibodies that are thought to develop in response to subclinical infections.
      Wide use of conjugated Hib vaccines could lead to decreases in circulating Hib
      bacteria, thereby diminishing antibody levels in the unvaccinated. We applied a
      statistical model to estimate the duration of natural immunity to Hib under
      different forces of infection. Prior to the introduction of conjugated Hib
      vaccines, new Hib infections were estimated to occur once in 4 years and the
      antibody concentration to stabilize at a level around 1 microg/ml. In the absence
      of new stimuli, i.e. infection, 57% of the unvaccinated population would become
      susceptible to invasive disease (antibody levels < 0.15 microg/ml) in 10 years.
      Due to an interaction between the force of infection and the duration of
      immunity, in some situations numbers of invasive infections could increase in
      unvaccinated cohorts. This theoretical scenario has yet to be observed in
      practice.

PMID- 11218210
TI  - Serodiagnosis of human plague by an anti-F1 capsular antigen specific IgG/IgM
      ELISA and immunoblot.
AB  - Plague is a re-emerging disease endemic in at least 24 countries. Non-endemic
      countries should be able to confirm plague to prevent outbreaks due to imported
      cases. We established a combination of a IgG/IgM screening ELISA and a
      confirmation immunoblot employing F1 capsular antigen (CA) for the serodiagnosis
      of plague in countries where yersiniosis is present. The ELISA and the immunoblot
      assay showed a specificity of 96.1% and 100% among sera from healthy German blood
      donors. This group had a seroprevalence of 39% of anti-yersinia outer protein
      (YOP) antibodies obviously caused by previous Y. enterocolitica infection. The
      ELISA detected anti-F1 CA antibodies in 22 and the immunoblot in 20 out of 26
      sera of plague vaccinees. Five control sera from bacteriologically confirmed
      plague cases from Madagascar reacted positively. It can be concluded that anti
      YOP antibodies do not affect assays based on purified F1 CA.

PMID- 11218211
TI  - Strengths and limitations of molecular subtyping in a community outbreak of
      Legionnaires' disease.
AB  - An epidemiological and microbiological investigation of a cluster of eight cases
      of Legionnaires' disease in Los Angeles County in November 1997 yielded
      conflicting results. The epidemiological part of the investigation implicated one
      of several mobile cooling towers used by a film studio in the centre of the
      outbreak area. However, water sampled from these cooling towers contained L.
      pneumophila serogroup 1 of another subtype than the strain that was recovered
      from case-patients in the outbreak. Samples from two cooling towers located
      downwind from all of the case-patients contained a Legionella strain that was
      indistinguishable from the outbreak strain by four subtyping techniques (AP-PCR,
      PFGE, MAb, and MLEE). It is unlikely that these cooling towers were the source of
      infection for all the case-patients, and they were not associated with risk of
      disease in the case-control study. The outbreak strain also was not
      distinguishable, by three subtyping techniques (AP-PCR, PFGE, and MAb), from a L.
      pneumophila strain that had caused an outbreak in Providence, RI, in 1993.
      Laboratory cross-contamination was unlikely because the initial subtyping was
      done in different laboratories. In this investigation, microbiology was helpful
      for distinguishing the outbreak cluster from unrelated cases of Legionnaires'
      disease occurring elsewhere. However, multiple subtyping techniques failed to
      distinguish environmental sources that were probably not associated with the
      outbreak. Persons investigating Legionnaires' disease outbreaks should be aware
      that microbiological subtyping does not always identify a source with absolute
      certainty.

PMID- 11218212
TI  - Lack of serological evidence for Mycoplasma fermentans infection in army Gulf War
      veterans: a large scale case-control study.
AB  - Mycoplasma firmentans is suspected in the development of 'Gulf War illness' in
      veterans of Operation Desert Storm. We conducted a matched case-control study for
      the prevalence of M. firmentans-specific antibodies before and after the
      operation, as well as seroconversion rates in veterans with and without
      complaints of 'Gulf War illness'. Cases consisted of Gulf War veterans, who
      complained of various illnesses and were enrolled in the second phase of the
      health evaluation by the Army Comprehensive Clinical Examination Program (CCEP).
      Controls were selected from Gulf War veterans who did not participate in the
      registry and did not request a health evaluation by the CCEP. Before operation
      deployment, 34 out of 718 of the cases (48%) and 116 out of 2233 of the controls
      (5.2%) tested positive for M. fermentans-specific antibodies. There was no
      difference in rates of seroconversion between cases and controls (1.1 vs. 1.2%)
      to M. fermentans during Operation Desert Storm. Thus, there is no serological
      evidence that suggests infectionby M. fermentans is associated with development
      of 'Gulf War illness'.

PMID- 11218213
TI  - Modelling rubella in Europe.
AB  - The prevention of congenital rubella syndrome (CRS), as a complication of rubella
      infection during pregnancy, is the main aim of rubella vaccination programmes.
      However, as vaccination of infants leads to an increase in the average age at
      which those who were not immunized become infected, certain rubella vaccination
      programmes can lead to an increase in the incidence of CRS. In this paper we use
      a mathematical model of the transmission dynamics of rubella virus to investigate
      the likely impact of different vaccination policies in Europe. The model was able
      to capture pre- and post-vaccination patterns of infection and prevalence of
      serological markers under a wide variety of scenarios, suggesting that the model
      structure and parameter estimates were appropriate. Analytical and numerical
      results suggest that endemic circulation of rubella is unlikely in Finland, the
      United Kingdom, The Netherlands, and perhaps Denmark, provided vaccine coverage
      is uniform across geographical and social groups. In Italy and Germany vaccine
      coverage in infancy has not been sufficient to interrupt rubella transmission,
      and continued epidemics of CRS seem probable. It seems unlikely that the
      immunization programmes in these countries are doing more harm than good, but
      this may be partly as a result of selective immunization of schoolgirls. Indeed,
      in both these countries, selective vaccination of schoolgirls with inadequate
      vaccination histories is likely to be an important mechanism by which CRS
      incidence is suppressed (unlike the other countries, which have had sufficiently
      high infant coverage rates to withdraw this option). Reducing inequalities in the
      uptake of rubella vaccine may bring greater health benefits than increasing the
      mean level of coverage.

PMID- 11218214
TI  - The pre-vaccination epidemiology of measles, mumps and rubella in Europe:
      implications for modelling studies.
AB  - Data on the pre-vaccination patterns of infection for measles, mumps and rubella
      are collated from a number of European countries in order to compare the
      epidemiology of the three viruses. Key epidemiological parameters, such as the
      age-specific force of infection and the basic reproduction number (R0) are
      estimated from case notification or serological data using standard techniques. A
      method is described to compare force of infection estimates derived from
      serological data. Analysis suggests that the pre-vaccination patterns of measles
      and mumps infection in the different countries were similar. In contrast, the
      epidemiology of rubella was highly variable between countries. This suggests that
      it may be acceptable to use parameter values estimated from other countries to
      model measles and mumps transmission, but that this approach to modelling rubella
      transmission requires more caution. Estimates of R0 depend on underlying mixing
      assumptions. Constraints were placed on R0 estimates by utilising knowledge of
      likely mixing patterns. The estimates for R0 were highest for measles,
      intermediate for mumps, and generally lowest for rubella. Analysis of within- and
      between-age-group transmission rates suggested that mumps transmission tends to
      be more concentrated within young children than the other two viruses. The
      implications for the design of immunization programmes are that mumps may be the
      easiest to control via infant immunization since it is predominantly transmitted
      between the very young and the variability in rubella epidemiology requires that
      careful consideration of the possible effects of vaccination options should be
      made using local data when planning rubella immunization programmes.

PMID- 11218215
TI  - Modelling the impact of immunization on the epidemiology of varicella zoster
      virus.
AB  - The objective of this study was to develop and apply a dynamic mathematical model
      of VZV transmission to predict the effect of different vaccination strategies on
      the age-specific incidence and outcome of infection. To do so a deterministic
      realistic age-structured model (RAS) was used which takes account of the
      increased potential for transmission within school aged groups. Various vaccine
      efficacy scenarios, vaccine coverages and vaccination strategies were
      investigated and a sensitivity analysis of varicella incidence predictions to
      important parameters was performed. The model predicts that the overall (natural
      and breakthrough) incidence and morbidity of varicella would likely be reduced by
      mass vaccination of 12-month-old children. Furthermore, adding a catch-up
      campaign in the first year for 1-11 year olds seems to be the most effective
      strategy to reduce both varicella incidence and morbidity (in the short and long
      term), though with the possible detrimental effect of increasing the incidence of
      zoster.

PMID- 11218216
TI  - Serological and virological evidence of non-sexual transmission of human
      herpesvirus type 8 (HHV8).
AB  - To evaluate whether or not human herpesvirus 8 (HHV8) can be transmitted through
      a non-sexual route a serological survey was carried out in a group of 51 catholic
      nuns. The seroprevalence rate and the geometrical mean antibody titre to anti
      latent HHV8 antigen were similar in nuns and in a group of 60 women, matched by
      age, in the general population (27 vs. 24%; 1028 vs. 1575, respectively).
      Moreover, by using nested polymerase chain reaction (PCR), HHV8 DNA sequences
      were detected in 7 of 16 (43.8%) saliva and peripheral blood mononuclear cells
      (PBMC) from patients with classical Kaposi's sarcoma (KS) and in 3 out of 7 (42%)
      AIDS-KS patients. None of 5 HIV positive persons who did not have KS tested
      positive for HHV8 DNA. HHV8 DNA sequences were also detected in 2 of 12 (17%)
      saliva and 1 PBMC sample out of 12 healthy HHV8 positive individuals (age range:
      30-80 years old). This paper suggests that non-sexual transmission of HHV8 is
      operating in our geographical setting and saliva may be a potential source of
      HHV8 spreading in the general population.

PMID- 11218218
TI  - Herpes simplex virus type-2 antibodies in pregnant women: the impact of the stage
      of pregnancy.
AB  - In this study the impact of pregnancy duration on the measured level of HSV-2
      antibodies was assessed. The study population comprised 35,940 pregnant women in
      Norway, in 1992-4, followed during pregnancy. A random sample of 960 women was
      selected. A mean of 2.6 serum samples from each woman were analysed for HSV-2
      specific IgG antibodies at different times in pregnancy. Crude and adjusted odds
      ratios were estimated in logistic regression models taking all observations per
      women into account. Twenty-seven percent of the pregnant women had antibodies
      against HSV-2 in the first trimester. The adjusted odds ratio of being HSV-2
      antibody positive decreased during the pregnancy and was 0.5 (0.2-0.9, 95%
      confidence interval) in the 40th as compared to the 10th week of pregnancy. About
      50% of initially HSV-2 positive women did not have detecable antibodies by the
      end of the pregnancy. This may be explained by haemodilution during pregnancy.
      Our findings have diagnostic implications and should encourage further studies.

PMID- 11218217
TI  - Incidence, seasonality and serotypes of rotavirus in Gipuzkoa (Basque Country),
      Spain. A 14-year study.
AB  - Over a 14-year period (1984-97) the presence of rotavirus in stool samples from
      children under 15 years with acute gastroenteritis was studied by
      enzymoimmunoanalysis. Serotyping (G1-G4) was performed using monoclonal
      antibodies. A total of 17,348 children under 15 were investigated. Rotavirus was
      detected in 3637 (21.0%) specimens, 74.6% of which were from children younger
      than 2 years old. G1 and G4 were the most frequent serotypes. In 1991-7, the
      minimum incidence of rotavirus gastroenteritis in children under 4 years of age
      was 21.7 cases/1000 children/year. By the age of 5 years, at least 1 out of 11.3
      children and probably 1 out of every 5-6 children in this area had experienced an
      episode of rotavirus gastroenteritis that required medical care. In the 1984-90
      period a clear seasonality was not observed but in the second period of the study
      (1991-7), seasonality was marked, with peak activity in winter.

PMID- 11218219
TI  - A severe and explosive outbreak of hepatitis B in a rural population in Sirsa
      district, Haryana, India: unnecessary therapeutic injections were a major risk
      factor.
AB  - Most outbreaks of viral hepatitis in India are caused by hepatitis E. This report
      describes an outbreak of hepatitis B in a rural population in Haryana state in
      1997. At least 54 cases of jaundice occurred in Dhottar village (population 3096)
      during a period of 8 months; 18 (33.3%) of them died. Virtually all fatal cases
      were adults and tested positive for HBsAg (other markers not done). About 88%
      (21/24) of surviving cases had acute or persistent HBV/HCV infections; 54%
      (13/24) had acute hepatitis B. Many other villages reported sporadic cases and
      deaths. Data were pooled from these villages for analysis of risk factors. Acute
      hepatitis B cases had received injections before illness more frequently (11/19)
      than those found negative for acute or persistent HBV/HCV infections (3/17) (P =
      0.01). Although a few cases had other risk factors, these were equally prevalent
      in two groups. The results linked the outbreak to the use of unnecessary
      therapeutic injections.

PMID- 11218220
TI  - Prevalence of hepatitis B anti-core antibody in the Republic of Ireland.
AB  - The aim of this study was to estimate the prevalence of hepatitis B exposure in
      the population of the Republic of Ireland, by measuring the prevalence of
      hepatitis B anti-core antibody in oral fluid collected by postal survey. A random
      multi-stage stratified sample of Irish households was obtained, using the Irish
      electoral register as the sampling frame. A total of 962 households were
      selected, and a household response rate of 60.4% was achieved. Oral fluid
      specimens totalling 1714 were tested for antibody to hepatitis B core antigen
      (anti-HBc), using an Immune Capture Enzyme Immuno-Assay. Five specimens (0.29%)
      were found to contain anti-HBc. Adjusting for study design, the estimated anti
      HBc prevalence in the Republic of Ireland is 0.51%. This study demonstrates that
      self-collection of oral fluid samples is acceptable to the public, and based upon
      the data generated, that the Republic of Ireland has a low prevalence of
      hepatitis B infection.

PMID- 11218221
TI  - The prevalence and genetic diversity of hepatitis C infection in antenatal clinic
      attenders in two regions of England.
AB  - The prevalence and genetic diversity of hepatitis C infection in women attending
      antenatal clinics in two regions of England was investigated to inform future
      surveillance and control measures. Women booking into antenatal care are
      routinely offered a test for immunity to rubella. Serum residues from these tests
      were unlinked, anonymized and archived as part of the Unlinked Anonymous
      Prevalence Monitoring Programme (UAPMP). The serum specimens were tested for anti
      HCV using a cost-effective pooling strategy. After taking into account
      differential sampling from the UAPMP serum archive, the adjusted overall
      prevalence of anti-HCV was 0.43% (95% CI: 0.32-0.53) in London and 0.21% (95% CI:
      0.14-0.28) in the Northern and Yorkshire region. Restriction fragment length
      polymorphism of amplified HCV RNA identified type 3a as the most common HCV
      genotype in these antenatal women. The prevalence of anti-HCV in antenatal women
      in the UK is low and consistent with that expected from injecting drug use.

PMID- 11218222
TI  - Modelling the impact of prior immunity, case misclassification and bias on case
      control studies in the investigation of outbreaks of cryptosporidiosis.
AB  - Cryptosporidiosis is the most common cause of outbreaks of disease linked to
      mains water supply in the United Kingdom and the second commonest in the United
      States. Recent evidence has suggested that prior population immunity may have an
      impact on the epidemiology of waterborne outbreaks and in particular prior
      immunity may reduce the power of case-control studies for demonstrating
      association between disease and water consumption behaviour. However, the degree
      of impact of prior immunity on the power of epidemiological studies is not yet
      clear. This paper reports the results of some simple mathematical models of
      outbreaks of waterborne disease in populations with varying levels of immunity
      due to prior water and non-water exposure. The basic outbreak model was run on a
      spreadsheet. To determine the impact of prior immunity on case-control studies,
      further analysis was done using a Monte Carlo method to simulate sampling from
      cases and controls. It was found that moderate degrees of prior immunity due to
      water associated disease could markedly reduce the relative risk of water
      consumption on illness in waterborne outbreaks. In turn this would reduce the
      power of case-control studies. In addition, this model was used to demonstrate
      the impact of case misclassification and recall bias on case-control studies.
      Again it was found that within the model, the results of case-control studies
      could be significantly affected by both these sources of error. Anyone conducting
      epidemiological investigations of potentially waterborne outbreaks of disease
      should be aware of the epidemiological problems. Mistakes from case-control
      studies will be minimized if the outbreak team pays considerable attention to the
      descriptive phase of the investigation and if case-control studies are conducted
      as soon as possible after an outbreak is detected.

PMID- 11218223
TI  - The prevalence of viral antibodies during a large population fluctuation of house
      mice in Australia.
AB  - We studied the seroprevalence of three viruses (mouse cytomegalovirus (MCMV),
      minute virus of mice (MVM), and mouse parvovirus (MPV)) in house mice (Mus
      domesticus) in 1995 7. In the first year average mouse density was less than 1
      mouse/ha. From November 1995 to May 1996 the population increased at an average
      rate of 7% per week, a doubling time of about 10 weeks. From August 1996 to May
      1997 the population increased at an average rate of 10% per week, a doubling time
      of about 7.5 weeks. From a peak around 250 mice/ha in May 1997, the mouse
      population fell 19% per week to 5 mice/ha in October 1997. The seroprevalence for
      all three viruses varied dramatically over time. MCMV had the highest
      seroprevalence (61.7%), followed by MVM (8.5%) and MPV (18.4%). Time series data
      indicated that MCMV spread rapidly through the population of mice once trap
      success was greater than 14% (40-100 mice/ha). By contrast MVM and MPV
      seroprevalence occurred with a 2-3 month and 3-4 month time lag, respectively.
      The current study supports the contention that MCMV would be a good carrier for
      an immunocontraceptive vaccine for controlling field populations of mice.

PMID- 11218224
TI  - Genetic analysis of foot-and-mouth disease virus type O isolates responsible for
      field outbreaks in India between 1993 and 1999.
AB  - Partial nucleotide sequence at the 3' end of ID (VP1-encoding) gene of 90 foot
      and-mouth disease virus type O isolates recovered from field outbreaks in India
      between 1993-9 were determined. The sequences were compared with each other and
      reference viruses. The published sequences of 15 type O isolates recovered from
      different parts of Asia and one isolate (O1BFS) from Europe and one from Egypt
      (O1/Sharquia/Egypt/72) were also included in the analysis for comparison. On the
      basis of phylogenetic analysis the viruses could be grouped into four distinct
      genotypes (genotypes I-IV). All 90 isolates from India were genotype-I, as were
      the reference isolates from Bangladesh, China, Egypt, Iran, Saudi Arabia, Syria
      and Turkey. Genotype-I isolates were further subdivided into 16 sub-genotypes.
      The Indian isolates were found to be extremely heterogeneous in nature and
      clustered into 12 different genetic groups. In genotype-I, the nucleotide
      sequence difference seen between the isolates was 0-11.6%, while among the Indian
      isolates it is 0-8.8%. Viruses of similar genetic groups are circulating in
      India, Bangladesh and countries of the Middle East. Genotype-II and -III are
      represented by isolates from Lebanon (O1/South Lebanon) and Europe (O1-BFS),
      respectively. Genotype-IV is formed by isolates from China, Hong Kong and Taiwan.
      The present study reveals the occurrence of viruses belonging to multiple genetic
      groups over a short period of time and persistence of single genetic group in the
      same geographical area over several years. This is consistent with the endemic
      nature of the disease in the country.

PMID- 11218225
TI  - Interaction of procedural factors in human performance on yoked schedules.
AB  - The differential effects of reinforcement contingencies and contextual variables
      on human performance were investigated in two experiments. In Experiment 1, adult
      human subjects operated a joystick in a video game in which the destruction of
      targets was arranged according to a yoked variable-ratio variable-interval
      schedule of reinforcement. Three variables were examined across 12 conditions:
      verbal instructions, shaping, and the use of a consummatory response following
      reinforcement (i.e., depositing a coin into a bank). Behavior was most responsive
      to the reinforcement contingencies when the consummatory response was available,
      responding was established by shaping, and subjects received minimal verbal
      instructions about their task. The responsiveness of variable-interval subjects'
      behavior varied more than that of variable-ratio subjects when these contextual
      factors were altered. Experiment 2 examined resistance to instructional control
      under the same yoked-schedules design. Conditions varied in terms of the validity
      of instructions. Performance on variable-ratio schedules was more resistant to
      instructional control than that on variable-interval schedules.

PMID- 11218226
TI  - Drug discrimination: stimulus control during repeated testing in extinction.
AB  - Rats were trained, under a two-lever drug-discrimination procedure, to respond
      differentially depending upon whether lorazepam (1.0 mg/kg) or no injection had
      been administered before the session. Responses on the appropriate lever produced
      a food pellet under a modified fixed-ratio (FR) 10 schedule, in which the 10
      responses had to be emitted consecutively. In reinforcement tests, completing an
      FR 10 on either lever produced a pellet. In extinction tests, stimulus changes
      paired with reinforcement occurred but no pellet was delivered. Training sessions
      were conducted between test sessions. Each of four extinction phases consisted of
      six tests preceded by one stimulus (e.g., lorazepam). Repeated exposures to
      extinction reduced response rates for all rats, but stimulus control, as inferred
      from either percentage of total responses or percentage of total FR 10s on the
      drug-appropriate lever, remained high. The percentage of total FR 10s measure was
      less subject to skewing under low-rate conditions than was the percentage of
      total responses measure and provided an evaluation of stimulus control in terms
      of meeting the consecutive response contingency. These results demonstrate a
      level of independence between response rate and stimulus control in drug
      discrimination, which has positive implications for the validity of interpreting
      discriminative effects of novel test conditions in well-trained animals, even
      when overall response rates are low.

PMID- 11218227
TI  - Effect of drugs on response-duration differentiation VII: response-force
      requirements.
AB  - Rats were trained to press a lever for at least 1 s but for less than 1.3 s. The
      force required to press the lever was then increased or decreased by 10, 15, or
      20 g. Increases in the force requirements for lever pressing decreased timing
      accuracy, but decreases in the force requirement had the opposite effect.
      Accuracy decreases at increasing force requirements were characterized by an
      increase in the relative frequency of responses that were too short to meet the
      reinforcement criterion. In contrast, increases in accuracy when the force
      requirements were decreased were characterized by increases in response durations
      that met the reinforcement criterion and decreases in the relative frequency of
      responses that were too short to produce the reinforcer. Phencyclidine (PCP) and
      methamphetamine produced dose-dependent decreases in accuracy that were
      associated primarily with increases in the relative frequency of short response
      durations, although methamphetamine also produced increases in long response
      durations at some doses. When the effects of PCP were determined with the force
      requirement increased by 10 g or decreased by 15 g, the cumulative response
      duration distribution shifted toward even shorter response durations. When the
      effects of methamphetamine were determined with the force requirement on the
      lever increased by 10 g, the cumulative frequency distribution was shifted toward
      shorter response durations to about the same extent as it had been before force
      requirements increased; however, when the force required to press the lever was
      decreased by 15 g, these shifts toward shorter response durations almost
      completely disappeared. These results show that increases and decreases in the
      force requirements for lever pressing have different effects on the accuracy of
      temporal response differentiation.

PMID- 11218228
TI  - Choice, changing over, and reinforcement delays.
AB  - In three experiments, pigeons were used to examine the independent effects of two
      normally confounded delays to reinforcement associated with changing between
      concurrently available variable-interval schedules of reinforcement. In
      Experiments 1 and 2, combinations of changeover-delay durations and fixed
      interval travel requirements were arranged in a changeover-key procedure. The
      delay from a changeover-produced stimulus change to a reinforcer was varied while
      the delay between the last response on one alternative and a reinforcer on the
      other (the total obtained delay) was held constant. Changeover rates decreased as
      a negative power function of the total obtained delay. The delay between a
      changeover-produced stimulus change had a small and inconsistent effect on
      changeover rates. In Experiment 3, changeover delays and fixed-interval travel
      requirements were arranged independently. Changeover rates decreased as a
      negative power function of the total obtained delay despite variations in the
      delay from a change in stimulus conditions to a reinforcer. Periods of high-rate
      responding following a changeover, however, were higher near the end of the delay
      from a change in stimulus conditions to a reinforcer. The results of these
      experiments suggest that the effects of changeover delays and travel requirements
      primarily result from changes in the delay between a response at one alternative
      and a reinforcer at the other, but the pattern of responding immediately after a
      changeover depends on the delay from a changeover-produced change in stimulus
      conditions to a reinforcer.

PMID- 11218229
TI  - Behavior analysis and revaluation.
AB  - Revaluation refers to phenomena in which the strength of an operant is altered by
      reinforcer-related manipulations that take place outside the conditioning
      situation in which the operant was selected. As an example, if lever pressing is
      acquired using food as a reinforcer and food is later paired with an aversive
      stimulus, the frequency of lever pressing decreases when subsequently tested.
      Associationist psychology infers from such findings that conditioning produces a
      response-outcome (i.e., reinforcer) association and that the operant decreased in
      strength because pairing the reinforcer with the aversive stimulus changed the
      value of the outcome. Here, we present an approach to the interpretation of these
      and related findings that employs neural network simulations grounded in the
      experimental analysis of behavior and neuroscience. In so doing, we address some
      general issues regarding the relations among behavior analysis, neuroscience, and
      associationism.

PMID- 11218230
TI  - Criticisms of the satiety hypothesis as an explanation for within-session
      decreases in responding.
AB  - The authors of four papers recently reported that satiation provides a better
      explanation than habituation for within-session decreases in conditioned
      responding. Several arguments question this conclusion. First, the contribution
      of habituation to within-session changes in responding seems clearly established.
      Information that is consistent with habituation, but that is difficult to
      reconcile with satiation, is not adequately addressed. Second, the limited
      evidence offered in support of satiation is ambiguous because the results are
      just as compatible with habituation as with other satiety variables. Finally, the
      term satiation is used in an intuitive way that is sometimes contradicted by
      research about the termination of ingestion. Use of the technical term satiation
      in a way that differs from its conventional usage will only isolate operant
      psychology from other areas of psychological research.

PMID- 11218231
TI  - Experimental analysis of human vocal behavior: applications of speech-recognition
      technology.
AB  - Recent developments in speech recognition make it feasible to apply the
      technology to study vocal behavior. The present study illustrates the use of this
      technology to establish functional stimulus classes. Eight students were taught
      to say nonsense words in the presence of arbitrarily assigned sets of symbols
      consistent with three three-member experimenter-defined stimulus classes.
      Computer-controlled speech-recognition software was used to record, analyze, and
      differentially reinforce vocal responses. When the stimulus classes were
      established, students were taught to say a new nonsense word in the presence of
      one member of each stimulus class. Transfer of function was tested subsequently
      to determine if the novel stimulus names transferred to the remaining stimulus
      class members. Most subjects required two iterations of the training and testing
      procedures before transfer occurred. The data illustrate the usefulness of
      recording vocal behavior during stimulus control procedures and demonstrate the
      use of speech-recognition technology. The paper also describes the current state
      of speech-recognition technology and suggests several other areas of research
      that might benefit from using vocal behavior as its primary datum.

PMID- 11218232
TI  - Pulse oximetry saturation levels during routine unsedated diagnostic upper
      gastrointestinal endoscopy.
AB  - BACKGROUND: Diagnostic procedures account for over 90% of all upper
      gastrointestinal endoscopies. Pulse oximetry saturation (SpO2) levels were
      assessed in patients attending for routine unsedated diagnostic gastroscopy to
      identify factors associated with oxygen desaturation. METHODS: Three hundred and
      thirty unsedated patients were monitored with continuous pulse oximetry. A
      further 154 patients who requested sedation prior to endoscopy were studied as a
      positive control group. RESULTS: SpO2 levels were lower in sedated compared to
      unsedated patients (P < 0.0001). Six unsedated patients (2%) desaturated to 90%
      or less during endoscopy compared to 32 sedated patients (21%) (P < 0.0001). SpO2
      levels in unsedated patients were not related to patient sex, age, cigarette
      smoking, endoscope diameter, basal SpO2 levels or duration of endoscopy. In
      contrast, examination of the pharyngeal area and epiglottis (P = 0.0002) and a
      longer intubation time (P = 0.0002) were associated with lower SpO2 levels. The
      lowest SpO2 level recorded during unsedated endoscopy was 88%. CONCLUSION: Pulse
      oximetry is not a prerequisite to performing routine unsedated diagnostic
      gastroscopy in patients without severe systemic disease.

PMID- 11218233
TI  - Ascites caused by brucellosis: a report of two cases.
AB  - Brucellosis is a zoonosis still endemic in developing areas of the world. Focal
      complications of Brucellosis are well known and often troubling in the
      differential diagnosis. Gastrointestinal complications of Brucellosis are
      randomly reported, ascites being particularly rare, and usually in the context of
      a predisposing condition such as cirrhosis. We describe two cases of ascites
      attributed to Brucellosis, one in a previously healthy patient with an
      accompanying clinical picture of acute Brucellosis, in whom ascites reflected the
      response of the peritoneal mononuclear phagocytic system, and one in a HBsAg
      positive, but not cirrhotic, patient, in whom Brucellosis seemed to act as a
      trigger effect for the development of ascites. Both cases of ascites were of an
      effusion type, with a predominantly lymphocytic cell count, and exhibited an
      excellent response to treatment with tetracycline and rifampicin.

PMID- 11218234
TI  - Involvement of cyclic GMP in nitric-oxide-induced gastric relaxation Comparison
      of the actions of cyclic GMP and cyclic AMP.
AB  - BACKGROUND: Smooth muscle relaxation induced by various agents that increase the
      cellular levels of cyclic nucleotides (cAMP and cGMP) is accompanied by a
      decrease in intracellular Ca2+ concentration. However, little is known about the
      differences between the inhibitory effects of cAMP and cGMP on the contraction of
      smooth muscle. OBJECTIVE: To compare the effects and underlying mechanisms of
      cAMP and cGMP on the inhibition of gastric smooth muscle contraction, cyclic
      nucleotide promoting agents, as well as cell membrane permeable cyclic
      nucleotides were used. METHODS: Isometric contraction was measured from circular
      muscle strips prepared from the fundus of cat stomach in a cylinder-shaped
      chamber filled with Krebs-Ringer solution (pH 7.4, temperature 36 degrees C)
      bubbled with 5% CO2 in O2. The level of inositol phosphates (IPs) was measured.
      RESULTS: Forskolin and sodium nitroprusside significantly inhibited acetylcholine
      (ACh)-induced gastric smooth muscle contraction and increased the cellular levels
      of cAMP and cGMP, respectively. Direct application of 8-Br-cAMP and 8-Br-cGMP
      also significantly inhibited ACh-induced contraction. Both verapamil and TMB-8
      inhibited ACh-induced contraction. The combined inhibitory effect of verapamil
      and TMB-8 was significantly greater than the effect of either one, separately.
      Forskolin or sodium nitroprusside similarly augmented the effect of verapamil.
      However, the inhibitory effect of TMB-8 was augmented only by 8-Br-cGMP or sodium
      nitroprusside but not by 8-BrcAMP or forskolin. Forskolin and 8-Br-cAMP
      significantly inhibited the formation of inositol phosphates stimulated by ACh.
      CONCLUSIONS: cAMP inhibits the contraction mechanism associated with
      intracellular Ca2+ mobilization as well as extracellular Ca2+ influx, while cGMP
      inhibits contraction by inhibiting the mechanism associated with extracellular
      Ca2+ influx.

PMID- 11218235
TI  - A critical review of epidemiological studies in inflammatory bowel disease.
AB  - This review addresses the difficulty in interpreting the results of
      epidemiological studies in IBD and in making meaningful comparisons between
      studies. Both ulcerative colitis and Crohn disease appear to be more common in
      some industrialized countries such as Scandinavia, United Kingdom, North America
      and less common in Central and Southern Europe, Asia and Africa. Given data
      showing an increased incidence of ulcerative colitis in the United Kingdom, it is
      crucial that more studies be conducted in developing countries. While the
      incidence of Crohn disease has increased strikingly in many areas, the incidence
      of ulcerative colitis has remained fairly stable in most. This could be due to
      the rising number of community-based studies, as well as the improved accuracy in
      diagnosing Crohn disease. Although, the incidence of IBD among Blacks in Africa
      is low, infection rates are high, life expectancy is lower than in developed
      countries. Data from the USA suggest that rates are similar in Afro-American and
      Caucasian populations. Rates for Jewish populations may be slightly higher than
      in non-Jewish populations but this also varies geographically. Careful attention
      to genetic, environmental, and socioeconomic factors must be accounted for in
      these studies. There is no strong evidence to support that IBD is more common in
      urban than in rural settings and migration towards more accessible health care
      has not been adequately addressed. Recent epidemiological studies suggest that
      mortality rates for IBD are similar to that of the general population for the
      majority of patients. However, older patients with IBD and newly diagnosed cases
      with severe diseases are at increased risk of dying. Epidemiological studies
      remain important in assisting with health policy planning and in hypothesis
      testing of etiological factors. As better diagnostic techniques become widely
      available and public health registries are increasingly used, it is possible that
      geographic differences will diminish. International collaborative studies will be
      better equipped to answer research questions addressing risk factors and disease
      natural history. We have summarized in Table V the essential criteria to conduct
      a sound epidemiological study, which would permit future testing of hypotheses
      among different populations.

PMID- 11218236
TI  - Decreased expression of epidermal growth factor receptor and mRNA of its ligands
      in Helicobacter pylori-infected gastric mucosa.
AB  - BACKGROUND: Epidermal growth factor (EGF) and TGF-alpha play a central role in
      maintaining gastric mucosal integrity. Little is known about the regulative role
      of the four other widely expressed epidermal growth factor receptor ligands,
      heparin-binding EGF, amphiregulin, betacellulin and cripto in the gastric mucosa.
      METHODS: Nineteen patients with Helicobacter pylori-positive gastritis and 32
      healthy controls were investigated. Mucosal mRNA expression of EGF receptor
      ligands was determined by quantitative PCR before and after H. pylori
      eradication. PCR products were analyzed by soft laser scanning densitometry.
      Moreover, the effect of chronic active gastritis on EGF receptor expression was
      assessed by [125I] EGF receptor autoradiography. Immunohistochemistry was
      performed for TGF-alpha to localize growth factor expression. RESULTS: Antral and
      oxyntic biopsies showed strong mRNA expressions for TGF-alpha, amphiregulin and
      heparin binding EGF, but not for EGF, cripto and betacellulin. mRNA expression
      was significantly reduced down to 50% in H. pylori infection, significantly lower
      compared to normal gastric mucosa, and increased after eradication therapy.
      Moreover, chronic gastritis was associated with decreased antral EGF receptor
      binding compared to healthy controls, possibly reflecting reduced autoinduction.
      Immunohistochemical analyses localized TGF-alpha in the cytoplasma of gastric
      epithelial cells and revealed its increased expression after H. pylori
      eradication. CONCLUSIONS: The data presented suggest that amphiregulin, heparin
      binding EGF and TGF-alpha are important EGF receptor ligands in the gastric
      mucosa. H. pylori infection apparently suppresses their mRNA as well as receptor
      expression that is reversed by H. pylori eradication. This deficiency of the
      gastroprotective EGF system may contribute to the gastric pathogenicity of H.
      pylori infection.

PMID- 11218237
TI  - Motor and sensory function of the rectum in different subtypes of constipation.
AB  - BACKGROUND: It is not known whether evaluation of motor and sensory function of
      the rectum using a barostat may help to distinguish subtypes of constipation.
      METHODS: Motor and sensory function of the rectum have been evaluated using a
      barostat in 14 patients with slow transit constipation (STC), 12 patients with
      constipation-predominant irritable bowel syndrome (IBS) and 18 healthy controls.
      First minimal distending pressure was determined, after which spontaneous
      adaptive relaxation of the rectum was monitored. Then a step-wise isobaric
      distension procedure was performed, during which symptom perception was
      determined. The distension was followed by a 90-min barostat procedure: for 30
      min in the basal state followed by ingestion of a semi-liquid meal (postprandial
      state). RESULTS: Minimal distending pressure was not different between both
      patient groups and controls, neither was compliance different between constipated
      patients and controls. The degree of spontaneous adaptive relaxation was in the
      same range in all groups. During distensions with high pressures, the perception
      of urge was significantly reduced in STC patients compared to IBS and controls,
      while the perception of pain was significantly increased in IBS versus STC and
      controls. Postprandially, a small decrease of rectal volume was only observed in
      the control group, but not in the patients. CONCLUSIONS: Rectal motor
      characteristics are not different between patients with constipation-predominant
      IBS, patients with STC and healthy controls while during isobaric distensions,
      sensations of urge were reduced in STC and sensations of pain were increased in
      IBS. Rectal visceroperception testing may help distinguish groups of patients
      with different subtypes of constipation.

PMID- 11218238
TI  - Programmed cell death in rat intestine: effect of feeding and fasting.
AB  - BACKGROUND: The regulation of intestinal cell death by luminal factors is poorly
      understood. The objectives of this study were to determine whether a diurnal
      rhythm of intestinal apoptosis exists, and to determine the role that feeding and
      fasting play in this process. METHODS: Mucosal apoptotic death was measured in
      fed and 24-h fasted rats and at various times after feeding by DNA fragmentation
      and in situ immunohistochemical staining (TUNEL). RESULTS: In 24-h fasted rats,
      32% of total mucosal DNA was fragmented as compared to 9% in fed animals. In both
      jejunal and ileal segments, the fragmented DNA exhibited characteristic apoptotic
      DNA ladders on agarose gels. Immunohistochemical staining revealed significant
      location of apoptotic cells at the upper third of the intestinal villus. In the
      duodenum, DNA fragmentation at 6-12 h post feeding was 20% and decreased to 4% at
      24 h. In comparison, DNA fragmentation in the jejunum and ileum was low from 0 to
      6 h post feeding (2%-9%) and significantly increased at 12 h (18% versus 12%) and
      24 h (30% versus 32%), respectively. These results are consistent with a temporal
      relationship between percent fragmented DNA and time after feeding with greater
      cell death at longer fasting period. A postprandial rhythm of DNA fragmentation
      was evident in the jejunum and ileum, in which fragmentation was at a peak
      between 0900 h and 1200 h. CONCLUSION: Collectively, the data show that
      initiation of apoptosis in apical enterocytes is coincident with cessation of
      feeding and commencement of fasting, and is consistent with a rhythm of
      programmed cell death in these cells that parallels the cyclical pattern of
      feeding and fasting.

PMID- 11218239
TI  - Effect of high-dose growth hormone and glutamine on body composition, urine
      creatinine excretion, fatty acid absorption, and essential fatty acids status in
      short bowel patients: a randomized, double-blind, crossover, placebo-controlled
      study.
AB  - BACKGROUND: Positive effects of high dose growth hormone and glutamine (GH + GLN)
      on body composition in short bowel patients have been described. Lack of effects
      on intestinal absorption found in some studies has been ascribed to concomitant
      essential fatty acid (EFA) deficiency. This study describes changes in body
      weight (BW) and composition, 24-h urine creatinine excretion, intestinal fatty
      acid absorption (total, saturated, unsaturated and EFA), and EFA status in
      relation to treatment with GH + GLN in 8 short bowel patients. METHODS: A double
      blind, crossover study between placebo and growth hormone (mean, 0.12 mg/kg/day)
      plus oral (mean, 28 g/day) and parenteral glutamine (mean, 5.2 g/day) for 28
      days. Body composition was measured by dual-energy absorptiometry (DEXA) scans.
      Intestinal fatty acid absorption was evaluated in balance studies, and EFAs were
      measured in plasma phospholipids by gas liquid chromatography. RESULTS: Active
      treatment did not increase BW, lean body mass (LBM), fat mass (FM) and bone mass
      significantly compared with placebo treatment, but BW increased 1.03 kg (1.7%, P
      < 0.05), LBM 2.93 kg (8.7%, P < 0.001) and FM decreased 2.41 kg (10.6%, P <
      0.001) in comparison with baseline. Twenty-four-hour urine creatinine excretion
      did not differ between study periods. No changes in intestinal absorption of
      fatty acids were seen, and no changes in EFAs measured in plasma phospholipids
      were observed. Only 1 of 8 patients, who did not receive parenteral lipids, had a
      Holman index above 0.2, indicative of EFA deficiency. All developed peripheral
      oedema. CONCLUSIONS: Combined high dose growth hormone and glutamine administered
      for 4 weeks, did not improve absorption of fatty acids or EFA status in short
      bowel patients. No changes in BW or composition were seen when comparing
      treatment to placebo periods. The increase in LBM measured by DEXA scan,
      comparing treatment and baseline periods, was not accompanied by an increase in
      the 24-h urinary creatinine excretion and is suspected to be associated with an
      accumulation in extracellular fluids.

PMID- 11218240
TI  - Effects of inhibition of PAF, ICAM-1 and PECAM-1 on gut barrier failure caused by
      intestinal ischemia and reperfusion.
AB  - BACKGROUND: The role of cell adhesion molecules and transmigration of PMNs
      through the endothelial barrier is probably essential in intestinal ischemia and
      reperfusion (I/R)-induced gut barrier dysfunction. Although cytokines are
      released in I/R, it is unclear whether cytokines directly increase permeability
      or if this phenomenon requires both expression of cell adhesion molecules and PMN
      adhesion-activation. Endothelial barrier dysfunction plays an important role in
      the pathogenesis of multiple organ dysfunction syndrome, inducing gut barrier
      failure, but the mechanisms are not fully understood. The purpose of this study
      was to evaluate the potential therapeutic value of inhibition of platelet
      activating factor (PAF), intercellular adhesion molecule-1 (ICAM-1), and platelet
      endothelial cell adhesion molecule-1 (PECAM-1) in gut barrier dysfunction induced
      by intestinal I/R. METHODS: A PAF antagonist (lexipafant, BB-882) and monoclonal
      antibodies against rat ICAM-1 (anti-ICAM-1-MAb) and PECAM-1 (anti-PECAM-1-MAb)
      were used in a model of gut barrier dysfunction caused by intestinal ischemia for
      40 min and concomitant reperfusion for 12 h in the rat, and endothelial
      permeability, myeloperoxidase activity, interleukin-1beta and protease inhibitor
      levels were evaluated. RESULTS: The endothelial permeability and tissue leukocyte
      recruitment in the distal small intestine significantly increased in rats with
      I/R treated with saline. Proteolytic activity in plasma was evident by low levels
      of the three measured plasma protease inhibitors. These changes were, to
      different degrees, reduced by treatment with lexipafant, anti-ICAM-1-MAb, or anti
      PECAM-1-MAb. Alterations in systemic levels of interleukin-1beta paralleled the
      changes found in gut barrier permeability and leukocyte trapping. CONCLUSIONS:
      Our results suggest that treatment with the PAF inhibitor lexipafant and
      monoclonal antibodies against ICAM-1 or, seemingly most efficient, PECAM-1
      reduces the severity of I/R-associated intestinal dysfunction, associated with a
      decrease in systemic concentrations of IL-1beta local leukocyte recruitment, and
      partly restoring plasma protease inhibitor levels.

PMID- 11218241
TI  - Mycophenolate mofetil reduces tissue damage and inflammation in an experimental
      model of colitis in rats.
AB  - BACKGROUND: Lymphocytes are widely believed to be responsible for persistent
      intestinal inflammation in inflammatory bowel diseases. Mycophenolate mofetil
      (MMF) is a potent immunosuppressant that inhibits lymphocyte proliferation and
      has been shown to be effective in preventing allograft rejection after organ
      transplantation. The purpose of this study was to assess the modulating effects
      of MMF on intestinal inflammation in an experimental model of colitis in rats.
      METHODS: Colitis was induced by rectal instillation of trinitrobenzenesulfonic
      acid (TNBS) in ethanol in male Sprague-Dawley rats. One group of rats (n = 10)
      was treated with MMF i.p. (25 mg/kg b.w.) daily for 1 week starting 24 h after
      induction of colitis. A second group of rats (n = 10) was treated with MMF at the
      same dose 2 days, I day and 1 h prior to induction of colitis. Control animals (n
      = 10) received vehicle only. After being killed, colonic tissue was
      macroscopically evaluated for necrosis and microscopically for ulcerations.
      Sections were stained and examined for the presence of granulocytes. RESULTS:
      Administration of MMF after induction of TNBS colitis reduced macroscopic injury
      by 62% compared to control animals (P = 0.01). Microscopic ulcerations were
      reduced by 64% compared to controls (P = 0.009). In addition, posttreatment
      significantly reduced the number of granulocytes. MMF pretreatment did not
      significantly prevent macroscopic or microscopic tissue damage, or change the
      number of granulocytes. CONCLUSION: Systemic administration of MMF significantly
      ameliorates tissue damage in a model of experimental colitis in rats suggesting
      that this compound may play an important role as an immunosuppressant in the
      therapy of inflammatory bowel diseases.

PMID- 11218242
TI  - Therapeutic drug monitoring of azathioprine and 6-mercaptopurine metabolites in
      Crohn disease.
AB  - BACKGROUND: 6-Mercaptopurine (6-MP) and its prodrug azathioprine (AZA) have
      proven efficacy in the treatment of Crohn disease (CD). The immunosuppressive
      properties of AZA/6-MP are mediated by the intracellular metabolism of 6-MP into
      its active metabolites, 6-thioguanine nucleotides (6TGN) and
      6methylmercaptopurine (6-MMP). Preliminary studies have suggested that the red
      blood cell concentration of 6TGN (RBC 6TGN) is a potential guide to therapy. The
      aims of the study were to evaluate the RBC 6TGN concentrations in adult patients
      with CD under long-term AZA/6-MP therapy and to correlate it with response to
      treatment and haematological parameters. METHODS: Twenty-eight CD patients
      treated for at least 3 months with AZA/6-MP were prospectively studied. Patients
      were separated into three main groups: group 1 (n = 19), corresponding to
      quiescent CD receiving AZA (dose: 2.05 +/- 0.4 mg/kg/day for a mean of 28.6 +/-
      25 months) or 6-MP (dose: 1.4 +/- 01 mg/kg/day for a mean of 7.5 +/- 3.5 months)
      alone; group 2 (n = 6), corresponding to quiescent CD treated by AZA (dose: 2.14
      +/- 0.5 mg/kg/day for a mean of 29.5 +/- 22 months) with oral steroids; and group
      3 (n = 3), corresponding to active CD on AZA (dose: 1.94 +/- 0.6 mg/kg/day for a
      mean of 31.3 +/- 35 months) as the only treatment. An assessment was also made by
      merging groups 1 and 2 forming a larger group of patients (n = 25) defined by
      clinical remission and groups 2 and 3 forming a larger group of patients (n = 9),
      non-complete responders with AZA/6-MP alone. Crohn disease index activity (CDAI),
      blood samples for full blood count and differential white cell count and
      measurement of RBC 6TGN and 6-MMP concentrations were evaluated at inclusion and
      at 6 months (n = 17). RBC 6TGN were measured using high performance liquid
      chromatography (HPLC) on heparinized blood. RESULTS: The baseline characteristics
      of the three groups of patients were similar. There was no significant difference
      among the three groups of patients regarding the dose and the duration of
      immunosuppressive treatment. There was no significant difference between groups
      according to various parameters tested. Particularly, the median RBC 6TGN
      concentration at inclusion was similar in the three groups of patients (166 (105
      688), 183 (90-261) and 160 (52-194) pmol/8 x 10(8) RBC, respectively). The
      majority of patients had no detectable level of 6-MMP metabolite, except for 3
      patients. There was also no difference between merging groups. Furthermore, there
      was no significant correlation between RBC 6TGN concentrations and the various
      biological parameters tested except for the mean erythrocyte volume. At 6 months,
      all patients of group 1 remained in remission and median RBC 6TGN concentration
      remained stable. No side effects were observed. CONCLUSIONS: There is, contrary
      to preliminary studies, a broad overlap in RBC 6TGN levels as well as for
      haematological parameters in patients in remission or not and responders or not
      to AZA/6-MP therapy. This suggests, beside a variability in the metabolism of
      these drugs, the existence of complex mechanisms of action. Nevertheless, beside
      the use of RBC 6TGN determination to confirm compliance to therapy, this dosage
      could be useful in non-responding patients, allowing, in absence of leukopenia,
      to increase the dose of AZA/6-MP safely.

PMID- 11218243
TI  - Validation of the inflammatory bowel disease questionnaire in Swedish patients
      with ulcerative colitis.
AB  - BACKGROUND: The Inflammatory Bowel Disease Questionnaire (IBDQ) is a disease
      specific health-related quality of life (HRQOL) questionnaire including four
      dimensions and a sum score. The aim of this study was to assess the internal and
      external validity, reliability, and sensitivity of a Swedish version of the IBDQ.
      METHODS: Three hundred consecutive patients with ulcerative colitis completed the
      IBDQ and three other health-related quality of life questionnaires (the Rating
      Form of IBD Patient Concerns (RFIPC), the Short Form-36 (SF-36) and the
      Psychological General Well-Being (PGWB) index). Disease activity was evaluated
      using a 1-week symptom diary, blood tests and rigid sigmoidoscopy. One hundred
      and fourteen patients filled in the questionnaire a second time, of whom 75 had
      been in stable remission for over 6 months and 39 had a significant clinical
      change in disease activity. RESULTS: Factor analysis of the 32 IBDQ items did not
      support the four dimensional scores. The dimensional scores had sufficient
      convergent validity, but low discriminative validity and homogeneity. The
      homogeneity was also low for the sum score. The inter-dimensional correlations
      were high. The concurrent validity was supported by correlations between the
      dimensional scores and other measures of disease activity and HRQOL. Patients in
      relapse scored significantly less on the sum score and the four dimensions
      compared to patients in remission. The test-retest correlations for the
      dimensional scores were 0.40-0.76. Patients with a change in disease activity
      during the 6-month follow-up period had a significant change in IBDQ scores not
      found in those who remained in remission. CONCLUSIONS: The Swedish version of the
      IBDQ had external validity and was shown to be a reliable and sensitive measure
      of HRQOL in ulcerative colitis, though there are some concerns regarding the
      internal validity. The use of a sum score was not supported and the questionnaire
      may benefit from a redivision of items into dimensions with better homogeneity
      and discriminative validity.

PMID- 11218244
TI  - Proliferation of alpha-smooth muscle actin-containing stromal cells
      (myofibroblasts) in the lamina propria subjacent to intraepithelial carcinoma of
      the esophagus.
AB  - BACKGROUND: The lamina propria of the digestive tract is the space containing
      vessels, myofibroblasts, and other interstitial components. The present study was
      undertaken to elucidate the relationships between the proliferation of
      myofibroblasts within this space and other histological features such as
      inflammatory cell infiltration and proliferation of blood vessels. METHODS:
      Thirty-eight cases in total-comprising 19 cases of early and 19 cases of advanced
      esophageal squamous cell carcinoma with intraepithelial extension (the former
      including 10 lesions of carcinoma in situ and 15 lesions of carcinoma with
      invasion only into the lamina propria)-were examined using H&E staining, Azan
      Mallory staining, and immunostaining for the characterization of mesenchymal
      cells in the lamina propria against alpha-smooth muscle actin (alphaSMA), desmin,
      vimentin, factor VIII, collagen type IV, laminin, or inflammatory cells (L26,
      UCHL1, Kp1, and c-kit). The proliferative potential of myofibroblasts was
      evaluated by measuring the total length of the bundles of myofibroblasts per
      case. RESULTS: Proliferation of alphaSMA-containing stromal cells: i) occurred in
      the lamina propria subjacent either to intraepithelial carcinomas (64%) or to the
      intraepithelial extension of carcinoma tissue (47%), and ii) showed a significant
      correlation with both the degree of mononuclear cell infiltration (mostly UCHL1
      positive T cells) and the total length of the carcinoma tissue in each case.
      CONCLUSIONS: Proliferation of alphaSMA-containing stromal cells in the lamina
      propria may be involved in altering the endoscopic features of the esophagus in
      cases with intraepithelial carcinoma or an intraepithelial extension of carcinoma
      tissue.

PMID- 11218245
TI  - Small intestinal bacterial overgrowth versus antimicrobial capacity in patients
      with spontaneous bacterial peritonitis.
AB  - BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a serious infection in
      cirrhotic patients with ascites. Both defects in the host defense mechanisms and
      the enhancement of the offensive factor (small intestinal bacterial overgrowth
      (SIBO)) may contribute to the development of SBP. Therefore, the aim of this
      study was to evaluate the role of SIBO versus various antimicrobial capacities in
      the pathogenesis of SBP in cirrhotic patients. METHODS: Forty-five cirrhotic
      patients were enrolled in this study. Bacterial overgrowth was evaluated by
      breath hydrogen test (BH2T). The hepatic reticuloendothelial system phagocytic
      index (HRESPI) was measured by intravenously injected colloid suspensions.
      RESULTS: The Child-Pugh scores in the SBP group were higher than in the non-SBP
      group (10.5 +/- 2.0 versus 8.0 +/- 1.8, P < 0.01). The ascitic protein
      concentration was significantly lower in the SBP group than in the non-SBP group
      (897 +/- 425 mg/l versus 1,325 +/- 453 mg/l, P < 0.01). Furthermore, the serum C3
      concentration was lower in the SBP group than in the non-SBP group (43.1 +/- 13.6
      ng/dl versus 73.2 +/- 26.4 ng/dl, P < 0.01). The serum C4 concentration was also
      lower in the SBP group than in the non-SBP group (12.4 +/- 4.0 ng/dl versus 16.9
      +/- 6.6 ng/dl, P < 0.05). The incidence of SIBO was higher in the SBP group than
      in the non-SBP group (68.2% versus 17.4%, P < 0.01). HRESPI values were
      significantly higher in the two groups of cirrhotic patients than in the normal
      reference. However, there were no statistical differences in HRESPI between the
      two groups (8.4 +/- 2.8 min in the SBP group versus 7.9 +/- 2.8 min in the non
      SBP group). CONCLUSIONS: The results of this study showed that the hepatic
      reticuloendothelial function is impaired in cirrhotic patients, but the degree of
      impairment does not differ between patients with and without previous history of
      SBP. Lower ascitic total protein, lower serum C3 and C4 concentrations, and
      presence of SIBO are all risk factors for SBP. Based on the results of our study,
      defects in the host defense mechanisms and the enhancement of the offensive
      factor (SIBO) may act in concert for the development of SBP.

PMID- 11218247
TI  - [What is your diagnosis? Lung metastases of hypopharyngeal carcinoma].

PMID- 11218246
TI  - Sustained virological response in chronic hepatitis C patients after a 6- and a
      36-month interferon-alpha2b treatment schedule: a multicenter, randomized,
      controlled study.
AB  - BACKGROUND: In patients with chronic hepatitis C (HCV) Interferon-alpha (IFN)
      treatment for 12-18 months is more effective than 6 months in inducing a
      sustained virological response. METHODS: In a multicenter, randomized, controlled
      trial, 88 patients with chronic HCV were enrolled (47 treated with IFN-alpha2b
      and 41 constituted an untreated control group). Treatment consisted of 5 million
      units (MU) IFN thrice a week (tiw) for 8 weeks and subsequently 2.5 MU IFN tiw
      for 16 weeks ('standard treatment'). After week 24 ('long-term treatment'), in
      virological non-responders treatment was continued using 5 MU IFN tiw for up to
      week 156, whereas in virological responders IFN was discontinued. In case of a
      virological relapse, treatment with 5 MU IFN tiw was restarted and continued up
      to week 156. RESULTS: Sustained virological response rate was 6/47 (13%) after
      standard treatment and increased to 19/47 (40%) after long-term treatment
      (McNemar paired test; P = 0.002). Of the 18 patients with a breakthrough or
      relapse during or after standard treatment, 14 (78%) became sustained virological
      responders upon long-term treatment. Of the 4 patients who did not have a
      sustained virological response after long-term treatment, 3 did not receive
      complete treatment due to side effects and/or non-compliance. In patients who
      failed to respond to standard treatment, no virological response was observed
      during long-term treatment. In the control group, no spontaneous clearance of HCV
      was observed. CONCLUSIONS: Long-term IFN (re)treatment enhanced the virological
      sustained response rate significantly and was particularly effective in patients
      with a breakthrough or relapse following standard treatment.

PMID- 11218248
TI  - Child abuse and neglect: the dental assistant's role in prevention.
AB  - Child abuse and neglect are growing at ever increasing rates in the U.S. It is
      not only within the purview of dental practice to identify and report suspected
      cases, it is also required by state law. An appropriate child abuse and neglect
      protocol in your dental practice is the best defense children may have to prevent
      these problems. Talk about abuse and neglect at your staff meetings. Be aware of
      the warning signs, know what to consider when you see an injury, and know how to
      make a report. When you see a child that may be a victim, remember that everyone
      else in the dental office has seen the same child and may have useful
      information. Talk privately among yourselves about what you see and hear.
      Encourage your dentist to fulfill his or her legal obligation to report suspected
      cases, but understand that anyone can make a report, whether specified as a
      mandated reporter or not. Remember that breaking the cycle of child abuse and
      neglect not only can make your patient happier and healthier, it may save a
      child's life.

PMID- 11218249
TI  - Arsenic and heavy metals in leachate from a real landfill and a laboratory
      landfill.
AB  - A preliminary study, based particularly on Arsenic and some heavy metals
      determination (Cd, Cr, Hg and Pb) in three leachate tipologies produced from
      municipal waste landfill plant, lab-scale aerobic landfill, lab-scale anerobic
      landfill was undertaken. Leachate was collected and analysed monthly; samples
      were homogenized and then, all heavy metals were determined after mineralization,
      except for Hg, determined before mineralization, due to his high volatility. In
      all samples pH was measured. In general we can say that low concentrations of the
      elements analyzed were found in all kinds of landfills considered; in particular,
      in the lab-scale anaerobic reactors, where low pH values have been found, we have
      a more considerable mobilization of As and the others heavy metals, moreover due
      to the behaviour of these elements.

PMID- 11218250
TI  - Assessment of the metals contamination of the low Sebou sediments (Morocco).
AB  - The heavy metals contamination of the lower Sebou sediments was studied to
      determine the average degree of contamination and to assess the extent of
      anthropogenic contamination. The spatial and temporal distribution of these
      metals and the results of the contamination indices showed very serious metallic
      contamination principally of Cr, Pb and Hg. However accurate analysis of the
      situation in the river mouth was complicated by the fact that the metals could be
      moved by the tides and currents.

PMID- 11218251
TI  - Determination of metals in thoracic fraction of ambient air particulate matter.
AB  - The present work deals with the optimization and validation of a method for the
      quantitative simultaneous ICP determination of metals in ambient air particulate
      matter. The attention has been focused on the thoracic fraction (PM10) and twelve
      different metals were chosen on the basis of their toxicity and of their possible
      use as chemical tracers. The microwave acidic digestion of the samples has been
      performed in the presence of different reagents and under different conditions
      and particular attention has been paid to the optimization of the whole
      analytical procedure and to the evaluation of accuracy and precision related to
      the single operative steps. The interferences due to the reagents and to the
      sampling supports have also been evaluated. In addition, the analytical procedure
      has been checked by examining the equivalence of results related to parallel
      sampled filters pairs.

PMID- 11218252
TI  - Changes in copper, lead and zinc concentrations in plants from paper mill sludge
      treated soils.
AB  - Effects of paper mill sludge addition on the availability of metals were studied
      on different soils both laboratory and naturally polluted; copper, lead and zinc
      concentrations were determined in Hordeum Distichum plants grown on the untreated
      and on sludge-treated soils. In some case a decrease of metal concentration is
      observed on sludge-treated soils; these results are consistent with the reduction
      of metal mobile forms in the soil, before plant growth. The decrease of metal
      availability in sludge-treated soils may be related with the pH value of the soil
      after sludge addition.

PMID- 11218253
TI  - Civilian and military uses of depleted uranium: environmental and health
      problems.
AB  - Depleted uranium is a by-product of the process of enrichment of natural uranium
      and is classified as a toxic and radioactive waste; it has a very high density
      (approximately 19 g cm-3), a remarkable ductility and a cost low enough to be
      attractive for some particular technical applications. Civilian uses are
      essentially related to its high density, but the prevailing use is however
      military (production of projectiles). From the radioactive point of view, the
      exposure to depleted uranium can result from both external irradiation as well as
      internal contamination. The associated risks are however mainly of chemical
      toxicological kind and the target organ is the kidney. In the present note the
      recent military uses and the possible effects of its environmental diffusion are
      discussed.

PMID- 11218254
TI  - Assessment of ground water quality in a fractured aquifer under continue
      wastewater injection.
AB  - Experimental studies have been carried out in a fractured coastal aquifer of the
      Salento Region (Nardo (Le), Italy), subject since 1991 to injection of 12,000
      m3/d of treated municipal wastewater in a natural sink. The analytical parameters
      of ground water sampled in monitoring wells, have been compared before and after
      the injection started. The mound of water table (1.5 m), the reduction of
      seawater extent of 2 km and the spreading of pollutants injected were evaluated
      by means of mathematical model results. After ten years operation, the volume of
      the available resource for agricultural and drinking use has been increased,
      without notable decrease of the preexistent ground water quality. Moreover for
      preserving such resource from pollution, the mathematical model allowed the
      standards of wastewater quality for recharge to be identified. Around the sink, a
      restricted area was also defined with prohibition of withdrawals, to avoid
      infection and other risks on human health.

PMID- 11218255
TI  - Soil decontamination at the Montevecchio-Levante mine site with experimental
      washing and leaching techniques.
AB  - The soils in the neighbourhood of the Rio Montevecchio-Sitzerri, a stream that
      flows in the valley below the tailings pond of the Montevecchio-Levante mineral
      processing plant (SW Sardinia, Italy) are severely contaminated by heavy metals,
      to the extent that traditional land uses are compromised. Consequently urgent
      measures are needed both to abate the pollution at source and rehabilitate the
      contaminated land. This paper is concerned with the problem of soil
      decontamination using washing and leaching techniques. Laboratory experiments
      have been conducted in mechanically agitated reactors, using citric acid and
      acetic acid solutions and brine of hydrochloric acid and calcium chloride. The
      influence of both reagent concentration and solid-to-liquid ratio has been
      assessed, and in the most significant cases, the attack kinetics has been
      determined. The tests showed the brine to be the most effective for removing
      metals from the soils. Based on the findings of the investigations, the
      possibility of decontamination by heap leaching has been simulated in the
      laboratory using the column technique.

PMID- 11218256
TI  - The impact of lead pollution on the environment of Rabat-Sale' (Morocco).
AB  - There are numerous possible vectors of industrial lead poisoning in unprotected
      work environments and the areas surrounding industrial sites. In the Rabat-Sale
      region, ceramics is the industry which uses most lead. Galena (PbS) is used in
      the fabrication of some types of pottery, and other lead-based compounds are used
      as glaze. A second source of lead pollution is the production of some fuels, in
      which lead is used as an anti detonator. In order to evaluate the impact of lead
      contamination on the environment, our investigation is focused on the lead
      concentration in the atmosphere, soil and vegetation at five stations in the
      Rabat-Sale region. We found concentrations of lead higher than those published
      for any other country in the atmosphere and vegetation near the ceramics
      factories of Rabat-Sale. These concentrations decreased significantly as we moved
      away from urban areas.

PMID- 11218257
TI  - Cadmium chronic administration to lactating ewes: reproductive performance,
      cadmium tissue accumulation and placental transfer.
AB  - 20 lactating ewes were allotted to two groups: 10 subjects received orally 100
      mg/day of CdCl2 for 108 consecutive days, and the remaining 10 acted as control.
      Reproductive performance in ewes and cadmium tissue accumulation, both in ewes
      and their lambs, were investigated. The results showed that in ewes: 1) the
      regular cadmium intestinal intake negatively influences all reproductive
      parameters; 2) cadmium is particularly accumulated in kidney and liver, but also
      in mammary gland, although at a distinctly lower level; 3) chronic administration
      does not increase cadmium placental transfer in lactating pregnant subjects.

PMID- 11218258
TI  - Genotoxic effects of cadmium chloride on human amniotic fluid cells cultured in
      vitro.
AB  - In this study we report the results of cytogenetic tests, namely a search for
      chromosome aberrations (CA) and sister chromatid exchanges (SCEs), performed on
      human amniotic fluid cells cultured and treated with Cadmium chloride. The cells
      from primary cultures were exposed to CdCl2 at 1 microM and 10 microM for 24 h.
      At the higher dose, no metaphases were scored and at the lower dose (1 microM) no
      effects were evident on cell proliferation, and no chromosome aberrations were
      found. In the subsequent experiments we used cells from subcultures exposed to 1
      microM and 5 microM CdCl2. At the 5 microM dose was evident the induction of
      chromatid breaks, while the frequency of sister chromatid exchanges shows a small
      increase, not statistically significant at the dose of 1 microM. In this study we
      positively demonstrated that amniotic fluid cells grown in vitro are reliable for
      testing various mutagenic or teratogenic substances. With regard to cadmium
      treatment results, it is evident a clastogenic effect of cadmium chloride but not
      a significant induction of SCEs.

PMID- 11218259
TI  - Model for the study of the impact of atmospheric heavy metals on soil microbial
      biomass.
AB  - In the Castelporziano (Rome) protected area the inputs of atmospheric heavy
      metals on the soil-plant system were evaluated by the analysis of stem-flowing
      water from Quercus ilex L. The heavy metals detected in the soil under the
      canopies exhibited higher concentrations near to the tree trunks, highlighting
      the tree's capacity to concentrate such polluting substances. Microbial biomass,
      its specific respiration and the biomass calculated as a percentage of total soil
      organic matter, were utilised as indicators of the state of the soil and
      consequently also its quality with respect to heavy metal contamination.

PMID- 11218260
TI  - Methodological approach for an integrated environmental monitoring system
      relative to heavy metals from an incineration plant.
AB  - The use of an Integrated Environmental Monitoring System is an innovative and
      very important approach for the determination of environmental impacts due to a
      contamination source. In the present work, the methodological approach is
      described and applied to the case study of a MSW incineration plant. Heavy metals
      were chosen as Environmental Indicators. Gaseous emissions were measured and
      correlated to wet and dry depositions, soil and vegetation samples. Results show
      a good correlation between stack emissions and atmospheric depositions; less with
      soil and vegetation, but these results are important in order to design a
      standard procedure for an Integrated Monitoring System.

PMID- 11218261
TI  - Effects of fire on the state of several elements in some soils of Sardinia.
AB  - In order to individuate the modifications induced in the soil by fires relatively
      to the mobility of metals and rare earth three soils of Sardinia which differ in
      their mineralogical and physico-chemical characteristics were sampled. The
      analytical results obtained on the samples drawn at different depths (0-5 and 10
      30 cm) three months after a fire and on the tests indicate that only the surface
      layer underwent significant modifications. The dynamics of metals and the
      distribution of the rare earths were found to depend, besides the amount and
      quality of the burned material, on the different behaviour of elements towards
      leaching. The diffractometric analysis showed that the soil surface layer of all
      the samples did not exceed 400 degrees C.

PMID- 11218262
TI  - Heavy metals contents in organic amendments based on beached Posidonia oceanica.

PMID- 11218263
TI  - Propofol sedation in general dental practice: the first 100 patients.
AB  - Experience is presented of the treatment of 100 patients for routine dentistry in
      general dental practice under propofol (Diprivan) sedation, delivered by
      continuous infusion. The infusion rates were set manually according to patients'
      responses. There were no differences in dental treatment or propofol requirements
      according to gender. Propofol requirements in some cases exceeded the upper limit
      of the recommended dose ranges and reasons why this may have occurred are
      discussed. A most useful feature of propofol sedation was the associated rapid
      recovery, with no patients needing to remain in the surgery for the purposes of
      recovery. The technique met with patients' approval, as all responses returned
      indicated a willingness to undergo the same type of sedation in future. Propofol
      sedation is not appropriate for the single operator/sedationist.

PMID- 11218264
TI  - Management of molar teeth with periodontal disease.
AB  - Over the years patients' attitudes towards maintaining a functional and aesthetic
      masticatory apparatus have improved, and their expectations of delivery of care
      by the dental professional have risen. With the advance of new techniques and
      materials, the periodontist can now offer an ever-expanding range of treatments
      in the management of molar teeth with periodontal disease. This paper considers
      such treatment in relation to the levels of disease present and within the
      overall context of adult restorative dental healthcare.

PMID- 11218265
TI  - Implant complications and failures: the single-tooth restoration.
AB  - The single-tooth implant restoration appears to be an ideal method of replacing
      missing natural teeth in a healthy dentition. Most follow-up studies report a
      high success rate. The restoration is seen by many clinicians as a relatively
      straightforward technique easily adapted to general dental practice and popular
      with patients, although it is not without complications. The purpose of this
      paper is to look at common problems following the placement of root-formed
      endosseous dental implants. A number of implant systems are reviewed and the
      results of the authors' clinical experiences reported.

PMID- 11218266
TI  - Orofacial disease: update for the dental clinical team: 11. Cervical
      lymphadenopathy.
AB  - By far the most common causes of lumps in the neck are swollen lymph nodes. The
      most common cause of cervical lymphadenopathy is infection in the area of
      drainage (virtually anywhere in the head and neck). Most frequent of all is an
      enlarged jugulodigastric (tonsillar) lymph node, inflamed secondary to a viral
      upper respiratory tract infection. Enlarged cervical lymph nodes may also be a
      manifestation of systemic infection (e.g. HIV/AIDS), or related to malignant
      disease in the drainage area (e.g. carcinoma) or elsewhere (e.g. leukaemia or
      lymphoma). These and less common causes are discussed in this, the last article
      in this series.

PMID- 11218267
TI  - Strategies for dental clinic infection control.
AB  - The application of proper infection control procedures helps to protect
      practitioners, patients and the community. The goal is to minimize the spread of
      potentially pathogenic micro-organisms and to remove and/or kill organisms that
      have contaminated objects and surfaces. Dental practitioners are aided in this
      process by the generation of rules, guidelines and recommendations by regulatory
      agencies and professional organizations. Ideally, each office/clinic would
      generate and maintain a written set of infection control procedures.

PMID- 11218268
TI  - A case report of pre-eruptive coronal resorption in a mandibular canine.

PMID- 11218269
TI  - Orofacial disease: update for the clinical team: 9. Orofacial pain.

PMID- 11218270
TI  - A forgotten entity: 'broken needle while inferior dental block'.

PMID- 11218271
TI  - 'Sweetie-free' policy.

PMID- 11218272
TI  - Ethics in aesthetics?

PMID- 11218273
TI  - Parkinson's disease and oral care.
AB  - Parkinson's disease is a relatively common, progressive, neurological disorder.
      Its key features of resting tremor, bradykinesia, akinesia, restricted mobility
      and postural instability militate against independence for daily living,
      mobility, good nutrition and oral health. The successful management of the
      disease requires a multi-disciplinary approach in which the dietician, speech
      therapist, nurse and dental staff are pivotal members of the care team.

PMID- 11218274
TI  - Economic evaluation and dentistry.
AB  - This article is a brief guide to economic evaluation and dentistry. It outlines
      the most common methods such as cost-effectiveness analysis and cost-benefit
      analysis; discusses how and when they should be used; gives some dental examples;
      and outlines important issues that need to be borne in mind when interpreting
      them. It also corrects one or two common misunderstandings about economic
      evaluation.

PMID- 11218275
TI  - Diver's mouth syndrome: a field study.
AB  - Reports of clinical presentations of diver's mouth syndrome and prevalence of at
      least one of its symptoms in many successive Joint Service (JS) diving
      expeditions prompted the author (who is an advanced diving instructor and an
      Armed Forces dental surgeon and has been present on, or organized, at least six
      JS diving expeditions in regions from cold temperate to tropical) to construct
      customized diving mouthpieces and investigate their effectiveness during
      intensive use in the field.

PMID- 11218276
TI  - A comparison of written and multimedia material for informing patients about
      dental implants.
AB  - A study was undertaken to compare the effectiveness of an information leaflet
      with a multimedia program in informing potential implant patients attending a
      dental hospital. The results show that both methods of presenting information are
      effective in informing patients; however, where the information to be presented
      is visual in nature, a multimedia presentation can have a more positive short
      term effect than an equivalent leaflet.

PMID- 11218278
TI  - An overview of the prevention of oral cancer and diagnostic markers of malignant
      change: 1. Prevention.
AB  - The incidence of oral cancer appears to be on the increase, with patients
      presenting at an earlier age. An overview of the prevention of this important
      condition is given in this article, and diagnostic markers will be discussed in a
      later presentation. Greater awareness of the aetiological agents involved in the
      development of oral cancer, and their avoidance, should help reduce the number of
      cases. General dental practitioners have an important role to play in advising
      patients on healthier lifestyles (primary prevention), the detection of
      potentially malignant disease before it becomes malignant (secondary prevention)
      and screening for field changes in patients with a history of oral cancer. The
      role of chemoprevention (defined here as tertiary prevention) is also considered.

PMID- 11218277
TI  - Dentine bonding systems: 1. Mode of action.
AB  - The achievement of a reliable bond to dentine has been more difficult than
      bonding to enamel, due principally to the anatomy of the dentine substrate. The
      mechanisms of bonding are now much better understood than a decade ago and
      clinically-viable bond strengths to dentine are now achieved with many dentine
      bonding systems.

PMID- 11218279
TI  - Thoughts on the atraumatic restorative treatment (ART) technique.

PMID- 11218280
TI  - Antimycotic agents in oral candidosis: an overview: 1. Clinical variants.
AB  - The advent of the human immunodeficiency virus and the increasing prevalence of
      immunocompromised individuals in the community have resulted in a resurgence of
      opportunistic infections, including oral candidoses. Despite the availability of
      a number of effective antimycotics for the management of oral candidoses,
      therapeutic failure is not uncommon. Further, the presence of many clinical
      variants of oral candidosis, both new and old, may confound the unwary clinician
      and complicate its management. These problems have been partly circumvented by
      the introduction of the triazole group of antimycotics, which initially appeared
      to be highly effective. However, an alarming increase in organisms resistant to
      triazoles has been reported recently. In this paper we provide an overview of
      clinical variants of oral candidosis. A second paper will discuss recent advances
      in the usage of antimycotics in the management of this condition.

PMID- 11218281
TI  - The atraumatic restorative treatment (ART) technique: does it have a place in
      everyday practice?
AB  - The ART technique was introduced in the early 1990s. It involves the removal of
      carious tooth tissue with hand instruments followed by restoration with an
      adhesive material (glass-ionomer cement). Local anaesthetic is not always
      required for treatment and the technique has helped to bridge the gap in the
      provision of treatment to rural communities, senior citizens and dental phobic
      patients. This article looks at the development of the technique, its performance
      and potential areas of application.

PMID- 11218282
TI  - Dentine bonding systems: 2. Clinical uses.
AB  - As the reliability of dentine bonding agents has improved, the clinical uses of
      these systems has increased and now include the bonding of directly and
      indirectly constructed restorations, amalgam bonding and treatment of dentinal
      sensitivity. Areas of potential use which require further evaluation include pulp
      capping and the attachment of fractured tooth fragments.

PMID- 11218283
TI  - Malignant lymphoma of the maxillary sinus masquerading as an odontogenic
      infection: report of a case.
AB  - The dental surgeon can play an important role in the early referral of malignancy
      of the maxillary sinus, and should be familiar with the signs and symptoms of
      disease of the paranasal sinuses. Here we report a case of a 71-year-old male
      patient diagnosed with high-grade B-cell lymphoma of the maxillary sinus that was
      initially thought to be an odontogenic infection. We discuss the signs and
      symptoms of lymphomas and malignancy of the maxillary sinus.

PMID- 11218284
TI  - Modified apically repositioned flap in the treatment of unerupted maxillary
      central incisors.
AB  - The successful management of labially unerupted maxillary central incisors
      requires a coordinated surgical, orthodontic and general practitioner approach.
      The key to achieving maximal eruption of these teeth is their surgical exposure,
      central to which is the philosophy that the surgeon must provide a functional
      width of attached gingiva on the labial surface. This case describes the
      incorporation of palatal mucosa into an apically repositioned flap, resulting in
      the successful establishment of an attached gingival margin, where routine flap
      design would have seriously compromised the eventual outcome.

PMID- 11218285
TI  - Inhalation sedation with nitrous oxide: a review.
AB  - The General Dental Council guidelines regarding the use of general anaesthesia in
      general practice have changed; inhalation sedation with nitrous oxide has been
      shown as a safe alternative to general anaesthesia for many patients and is a
      technique particularly suited to the practice environment.

PMID- 11218286
TI  - An overview of the prevention of oral cancer and diagnostic markers of malignant
      change: 2. Markers of value in tumour diagnosis.
AB  - Earlier diagnosis of oral cancer should lead to an improvement in prognosis.
      This, the second part of a two-part overview, is concerned with the various
      cellular markers available for diagnosis of oral cancer. Traditionally diagnosis
      has relied upon the histomorphological interpretation of a tissue section
      following biopsy. The application of advances in various laboratory techniques
      for the identification of different cellular markers is briefly reviewed. In
      addition, although it is currently only a research tool, the potential role of
      oral exfoliative cytology in screening is considered.

PMID- 11218287
TI  - Adhesive solutions: report of a case using multiple adhesive techniques in the
      management of enamel hypoplasia.

PMID- 11218289
TI  - The anatomy of a firing. When you finally act, it's often later than you think.

PMID- 11218288
TI  - A fresh look at effective telephone screening. Part 1: General guidelines.

PMID- 11218290
TI  - Impact of fluoride on dental health.

PMID- 11218291
TI  - Commit to being the best.

PMID- 11218292
TI  - Billing a patient's medical insurance.

PMID- 11218293
TI  - E-mail. 20 reasons why you should have it in your dental office.

PMID- 11218294
TI  - [Unexplained weight loss in the elderly: role of gastric fibroscopy, study of a
      cohort of 77 patients with a 13-month follow-up].
AB  - PURPOSE: In case of unexplained weight loss, chest X-ray, abdominal
      ultrasonography and gastroscopy are usually recommended. However, gastroscopy is
      not usually performed in elderly patients. METHODS: We evaluated 77 patients
      (mean age: 80 +/- 8 years) hospitalized in our geriatric unit between January
      1995 and May 1997 for unexplained weight loss. All patients underwent chest X
      ray, abdominal ultrasonography and gastroscopy. RESULTS: These investigations led
      to diagnosis in respectively 17, 15 and 46 patients. The etiology of weight loss
      was unique in 47 patients, while in 30 other patients at least two or three
      causes could be described. Gastroscopy appeared to be the most useful test, as it
      allowed description of eight cases of cancer, 29 cases of peptic ulcer, two cases
      of candidosis, and one case of actinomycosis in patients who did not present any
      clinical sign. CONCLUSION: Sixty-five patients were followed-up for a mean period
      of 13 +/- 21 month; 33 patients died. The condition of 23 patients improved
      either slightly or definitely. Simple investigations led to diagnosis in 95% of
      the cases. However, 42% of the patients died within 3 months. Gastroscopy appears
      to be the most valuable test, leading to diagnosis in more than half of the
      cases. With adapted treatment, the condition of 75% of the patients with gastro
      intestinal lesions improved.

PMID- 11218295
TI  - [Small intestine bacterial overgrowth: six case reports and literature review].
AB  - INTRODUCTION: Small intestinal bacterial overgrowth syndrome (SIBOS) has various
      clinical and biological presentations. Six observations are described in this
      review which is aimed at reporting recent data on SIBOS and proposing diagnosis
      and therapeutic attitudes. CURRENT KNOWLEDGE AND KEY POINTS: Chronic diarrhea,
      malabsorption syndrome and exsudative enteropathy are the main criteria of
      diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis,
      with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of
      malabsorption consequences, reduction of intestinal bacterial overgrowth, and
      surgical correction of intestinal stasis. In the absence of consensus,
      norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15
      days) seem the more appropriate antibiotics. When possible, surgery represents
      the primary treatment of SIBOS recurrences. FUTURE PROSPECTS AND PROJECTS:
      Diagnosis of small intestinal bacterial overgrowth syndrome must be evoked on the
      basis of either surgical or medical context, i.e., the existence of chronic
      diarrhea, malabsorption syndrome (complete or not), and exsudative enteropathy.
      This review reports essential factors for diagnosis and treatment.

PMID- 11218296
TI  - [Risk factors for irreversible cerebral ischemia complications from Horton's
      disease: prospective study of 178 patients].
AB  - PURPOSE: To search for risk factors of developing irreversible cranial ischemic
      complications (ICIC) in patients with giant cell arteritis (GCA) and to explore
      whether two subsets of patients (high risk and low risk of developing ICIC) can
      be defined. METHODS: One-hundred seventy-eight consecutive patients with temporal
      arteritis (149 biopsy-proven) were diagnosed and followed up in a department of
      Internal Medicine between 1976 and 1999. The patients were separated into two
      groups, according to the presence or absence of ICIC, with comparison of 17
      clinical and biological parameters prospectively recorded for each patient using
      a pre-established comprehensive questionnaire. RESULTS: ICIC occurred in 25
      patients (14%), with amaurosis in 22 cases. Suggestive symptoms and/or signs of
      temporal arteritis were present in 92% of the patients, lasting 50 days (median)
      before the onset of ICIC. Forty-three patients (24%) complained of transient
      visual ischemic symptoms (TVIS), which preceded acute blindness in 11 cases. A
      multivariate logistic regression, from which 28 cases with upper limb artery
      involvement were excluded for technical reasons (no CCII in any case, thus
      predicting perfectly the lack of ischemic risk, P = 0.02), indicated that the
      only independent variables associated with the ischemic risk were: a history of
      TVIS (P = 0.05), the lack of signs of polymyalgia rheumatica (PMR; P = 0.02),
      lower blood levels of fibrinogen (P = 0.024) and higher mean blood platelets
      levels (P = 0.006). However, these five variables predicted only 30% of the
      variability of the model. Sensitivity, specificity, positive and negative
      predictive values of the model reached respectively 36, 96, 64 and 88%. Overall,
      86% of the cases were correctly classified with respect to the ischemic risk.
      CONCLUSION: The rate of ICIC should be reduced by an earlier recognition of the
      usual signs of temporal arteritis. Several independent risk factors of ICIC have
      been identified. However, the logistic model failed to predict accurately the
      ischemic risk in 14% of the cases, indicating that as yet unrecognised factors
      probably exist that play a role in the occurrence of ICIC. Nevertheless,
      regarding the strong association between platelet levels and ICIC, patients with
      thrombocytosis should receive initially both corticosteroids and antiplatelet
      agents.

PMID- 11218297
TI  - [Current antiretroviral therapy].
AB  - INTRODUCTION: Advances in HIV/AIDS therapy have been rapid and profound. CURRENT
      KNOWLEDGE AND KEY POINTS: In developed countries the epidemic infection has
      stabilized and there are dramatic decreases in morbidity and mortality resulting
      from the use of intensive but expensive therapies. HIV patients who have
      detectable viral loads and/or evidence of immunologic dysfunction should be
      treated with a potent combination antiretroviral regimen. Currently, this
      consists of two nucleoside reverse transcriptase inhibitors with at least one
      protease inhibitor, or a non-nucleoside reverse transcriptase inhibitor, or
      another combination with adequate potency. Current therapies do have limitations,
      including side effects, cross-resistance, adherence challenges, and drug
      interactions. FUTURE PROSPECTS AND PROJECTS: Drug resistance is a major factor
      contributing to the failure of antiretroviral therapy: the ability to predict
      clinical response to therapy on the basis of genotype and/or phenotype depends on
      knowledge of appropriate data for defining drug resistance. Moreover, careful
      selection and monitoring of combination drug therapy along with individualized
      rather than standard dosage regimens may minimize the pharmacological problems
      and help ensure optimum antiviral activity. Further developments include new
      drugs, vaccine, cytokine-, and gene therapy-based treatment strategies.

PMID- 11218298
TI  - [Thalidomide: the revival].

PMID- 11218299
TI  - [What is current opinion of antiviral therapy for the flu in 2001?].
AB  - INTRODUCTION: The availability of new neuraminidase inhibitors which interact on
      the influenza A and B viruses could be the start of a new approach to flu
      treatment. Until now, vaccination has been the principal medical treatment,
      except in the case of a pandemic caused by antigenic shifts. In this article the
      authors will answer the following questions: Potentially, is there room for
      antiviral drugs and why? Are these drugs efficient and according to which
      criteria? Who are they for? And what indications must be followed? Are they well
      tolerated? Do they induce any viral resistance? M2 protein inhibitors (i.e.,
      amantadine and rimantadine) are compared with neuraminidase inhibitors (i.e.,
      zanamivir and oseltamivir). CURRENT KNOWLEDGE AND KEY POINTS: Neuraminidase
      inhibitors prescribed during the first 48 h have a medical curative effectiveness
      on non-complicated forms carried by healthy patients--symptoms last no longer
      than 1 to 3 days and their severity is reduced. This efficiency could potentially
      concern unexpected complications due to the diminution of antibiotics absorption.
      The inhibitors seem to induce little resistance and are responsive to influenza B
      as opposed to the M2 protein inhibitors. They seem to be well-tolerated by
      patients and they are also efficient when it comes to prophylaxis measures.
      FUTURE PROSPECTS AND PROJECTS: It is assumed that these treatments are used in a
      curative and preventive manner in order to give them their full strategic
      importance (their use is currently forbidden in France). This importance will
      require that physicians and the population be well aware of the epidemic and that
      responsive physicians who know the medical indications quickly implement the
      treatment. It is necessary to carry out surveys with those at risk who are
      seriously ill with the flu in order to measure ratios such as cost efficiency.
      The use of these treatments will have to be evaluated, bearing special attention
      on the risks of the emergence of resistant viruses and on the impact on
      vaccination.

PMID- 11218300
TI  - [Testicular seminoma and multifocal aseptic osteonecrosis following
      chemotherapy].
AB  - INTRODUCTION: Multifocal osteonecrosis has a wide variety of etiologies, but in
      the cancer patient several risk factors could have a synergic effect
      (chemotherapy, radiotherapy, corticosteroid, metabolism disorder). EXEGESIS: A
      patient with testicular seminoma receiving cisplatin-based chemotherapy and short
      term corticosteroid developed multifocal osteonecrosis. Early diagnosis of
      osteonecrosis is important to prevent orthopedic complications. CONCLUSION:
      Cisplatin could represent one of the possible etiologies of multifocal
      osteonecrosis. Magnetic resonance imaging has a high sensitivity and specificity
      in the diagnosis of osteonecrosis and should be used when this condition is
      suspected.

PMID- 11218301
TI  - [Dilated cardiomyopathy and panuveitis as presenting symptoms of Lyme disease.
      General review of one case].
AB  - INTRODUCTION: The clinical expression of Lyme disease is highly variable. If a
      patient presents clinical findings consistent with a systemic Lyme borreliosis,
      this disease must be considered in an endemic area because of its favorable
      outcome with adequate treatment. EXEGESIS: The authors report and discuss the
      case of a patient with an unusual history of dilated cardiomyopathy and
      supraventricular fibrillation followed by bilateral panuveitis. Enzyme-linked
      immunosorbent assay and Western blot were positive for Borrelia burgdorferi
      antigens. The diagnosis of Lyme disease was made after other infectious,
      inflammatory and autoimmune disorders were excluded by clinical, instrumental and
      biological investigations. The treatment by ceftriaxone and amoxicillin resolved
      the ophthalmologic manifestations and improved the cardiac condition. CONCLUSION:
      This report underlines the possibility of an unusual presentation of Lyme
      disease. Ophthalmologic and cardiac involvement should be known by clinicians.

PMID- 11218302
TI  - [McDuffie hypocomplementemic urticarial vasculitis. Two cases and review of the
      literature].
AB  - INTRODUCTION: Hypocomplementemic urticarial vasculitis (HUV) described by
      McDuffie is a rare entity recently individualized among vasculitis. We report two
      new cases. EXEGESIS: Case 1: a 41-year-old woman presented in 1994 with
      inflammatory polyarthralgia, diffuse urticaria, fever, and weight loss. Biology
      showed proteinuria, positive rheumatoid factor with hypocomplementemia and
      negative immunological tests. Skin and renal biopsies showed leukocytoclastic
      vasculitis and extramembranous glomerulopathy, respectively. Outcome within
      steroid therapy was marked by alternating clinical improvement and relapses. Case
      2: a 39-year-old woman presented in 1994 with inflammatory polyarthritis, diffuse
      urticaria, Raynaud phenomenon, cough and dyspnea. Chest x-rays and CT scan showed
      interstitial fibrosis and echocardiography revealed pericarditis. Biology showed
      positive rheumatoid factor with hypocomplementemia and negative antinuclear
      antibodies. Skin biopsy showed leukocytoclastic vasculitis. Corticosteroids and
      cyclophosphamide improved the patient's condition. McDuffie HUV is a disease with
      varied systemic manifestations. Its existence is still contested by some authors.
      Treatment is still empirical and depends on the clinical features. It is based
      primarily on corticosteroids. CONCLUSION: McDuffie HUV is a defensible entity
      among urticarial vasculitis because of its particular clinical and biological
      features.

PMID- 11218303
TI  - [Primary Neisseria meningitidis arthritis of the knee without meningitis:
      contribution of synovial fluid culture in blood-culture vial].
AB  - INTRODUCTION: Primary meningococcal arthritis is a rare form of meningococcal
      disease. It occurs as an isolated acute purulent arthritis without meningitis,
      and presence of Neisseria meningitidis in articular fluid. We report a new case
      of typical primary meningococcal arthritis. EXEGESIS: A previously healthy 23
      year-old female patient was admitted for purpuric lesions of the legs. At
      admission, conscience was normal and symptoms of meningitis were absent. During
      the 2nd day of hospitalisation, a warm and painful effusion in the right knee
      appeared. Aspiration from the right knee yielded a purulent fluid. N.
      meningitidis was isolated from a blood-culture vial inoculated with the synovial
      fluid, while blood cultures remained sterile. Anti-biotherapy was initiated as
      soon as microbiological diagnosis was established. The patient was symptom-free 1
      month later. CONCLUSION: We emphasize the fact that agar cultures of the synovial
      fluid remained sterile, while N. meningitidis grew in a blood-culture vial. We
      suggest that diagnosis of primary meningococcal arthritis may be underestimated
      when inappropriate culture media are used.

PMID- 11218304
TI  - [WHen interrogation permits appraisal of the mouth...].

PMID- 11218305
TI  - [Interactions between corticosteroids and oral anticoagulants: a real problem].

PMID- 11218306
TI  - [Two faces of Kikuchi disease].

PMID- 11218307
TI  - [A cause of unexplained hyperkalemia: trimethoprim-sulfamethoxazole].

PMID- 11218308
TI  - [A potential etiology of elevated ferritin: hyperferritinemia-cataract syndrome].

PMID- 11218309
TI  - [Unilateral exophthalmia revealing orbital myositis associated with metastatic
      cutaneous melanoma].

PMID- 11218310
TI  - [Disseminated candidiasis in drub abusers: report of a case revealed by the
      presence of Candida-related pustules].

PMID- 11218311
TI  - [Lymphedema and Paget's disease of the scrotum].

PMID- 11218312
TI  - [Physicopathologic mechanisms and methods of analysis of cellular apoptosis].
AB  - Apoptosis is a normal process occurring during development and in various tissues
      in humans. It appears that the mechanisms responsible for apoptosis are
      implicated in many aspects of human diseases. The apoptotic answer is in fact the
      integration of multiple different and complex signalization pathways which
      communicate, bifurcate and self-regulate. The mitochondria take an essential
      place in the description of programmed cell death and its regulation mechanisms.
      Caspases are the effector of apoptotic cell death. The methods of identification
      of the apoptosis pathways are: morphological modifications observed in
      microscopy, the evaluation of the difference of the mitochondrial membrane
      potential, the measurement of the DEVDase activity, the labelling of the
      phosphatidylserines by the annexin V on the cell surface, and the Western blot
      allowing the identification of the activated caspases. Apoptosis is implicated in
      many pathologies. A better understanding of the mechanisms of apoptosis and
      tissue specificity of the caspases make it possible to consider in the future the
      development of synthetic inhibitors as serious candidates for a therapeutic
      intervention.

PMID- 11218313
TI  - [Report on evaluation of clinical laboratory examination of GFR and urinary
      protein].

PMID- 11218314
TI  - [Immunohistochemical analysis of protein gene product 9.5, a new marker for
      parietal epithelial cells of Bowman's capsules, in anti-glomerular basement
      membrane(GBM) antibody induced glomerulonephritis of WKY rats].
AB  - Protein gene product 9.5(PGP 9.5) is expressed specifically in neuroendocrine
      cells and considered to be one of the neuroendocrine markers. Recently, we
      reported that PGP 9.5 is localized in the parietal epithelial cells(PECs) of
      Bowman's capsules as well as in neural tissues. In the present study,
      immunohistochemical analysis of PGP 9.5 as a specific marker of the PECs of
      Bowman's capsules, synaptopodin as a podocyte-specific marker, and ED-1 as a
      specific marker of monocytes/macrophages was performed in the cellular crescents
      in anti-GBM antibody induced glomerulonephritis of WKY rats using serial renal
      sections. In the acute phase of anti-GBM antibody induced glomerulonephritis, and
      the expression of PGP 9.5 and ED-1 was observed diffusely in proliferating cells
      of cellular crescents. However, in most part of cellular crescents, PGP 9.5
      positive areas did not overlap with the ED-1 positive areas. Synaptopodin was
      constantly detected along the glomerular tufts compressed by the crescents. In
      the chronic phase of this disease, PGP 9.5 was observed in the cells covering the
      surface of fibrous crescents or scattered within fibrocellular crescents.
      Synaptopodin was partially detected in such cells. It appears that cellular
      crescents are composed mainly of proliferating PECs and macrophages in rat anti
      GBM antibody-induced glomerulonephritis.

PMID- 11218316
TI  - [A case of congenital nephrogenic diabetes insipidus accompanied by
      hypertension].
AB  - Congenital nephrogenic diabetes insipidus is a rare disorder in which the kidney
      is insensitive to the antidiuretic hormone, vasopressin. In most cases, a
      mutation in the vasopressin type 2(V2) receptor gene is the genetic cause of the
      disease. So far, few cases of congenital nephrogenic diabetes insipidus with
      hypertension have been reported. We report one male case of congenital
      nephrogenic diabetes insipidus accompanied by hypertension. The patient was a 24
      year-old man who had suffered from polyuria and polydipsia since infancy and had
      been found to have hypertension at about 16 years. He was admitted to hospital in
      May 2000 for investigation of polyuria and hypertension with a high plasma level
      of renin activity of 10.4 ng/ml/hr. On physical examination, the blood pressure
      was 150/90 mmHg and the daily urinary output was 18.5 l. There was no change in
      urine volume and urine osmolality after an intramascular injection of vasopressin
      and water deprivation. The blood pressure and plasma renin activity were
      increased from 127/73 mmHg to 146/87 mmHg and from 4.9 ng/ml/hr to 6.1 ng/ml/hr,
      respectively, by a 4-hour dehydration test. He was found to have a C-to-T
      transition at nucleotide position 675 by sequencing analysis of the V2 receptor
      gene. After administration of hydrochlorothiazide, both the blood pressure and
      urine volume were reduced. Consequently, it was suggested that activation of the
      renin-angiotensin system by dehydration, at least in part, contributed to high
      blood pressure in this case.

PMID- 11218315
TI  - [Renal hemodynamic effect of angiotensin II type 2 receptor].
AB  - In the present study, the role of the angiotensin II type 2 receptor in the
      regulation of medullary blood flow in conscious Spontaneous Hypertensive
      Rats(SHR) was investigated. We tested the hypothesis that AT2 receptor activation
      may exert the opposite effects of AT1 receptors in terms of renal hemodynamics.
      Mean arterial pressure(MAP), daily sodium balance, cortical blood flow(CBF), and
      medullary blood flow(MBF) were measured over a 10-day protocol in several groups
      of rats in which optical fibers for laser-Doppler flowmetry had been implanted
      and which received the following drug combinations: the AT1 receptor antagonist
      CV11976(CV) alone and CV plus AT2 receptor antagonist PD123319 (PD). In the CV
      alone group, the renal interstitial administration of CV decreased MAP, caused
      sodium diuresis, and increased MBF significantly. In the CV plus PD group, the
      renal interstitial administration of PD prevented sustained hypotension, sodium
      diuresis, and increased medullary blood flow during CV administration. These data
      indicated that AT2 receptor activation leads to vasodilation in the renal medulla
      and an antihypertensive effect in SHR. AT2 receptors play an important role in
      the renal medullary blood flow.

PMID- 11218317
TI  - [A case of paroxysmal nocturnal hemoglobinuria combined with focal segmental
      glomerular sclerosis].
AB  - A 81-year-old woman was admitted to our hospital because of edema and massive
      proteinuria on September 26, 1995. On admission, the palpebral conjuctiva were
      slightly anemic, and edema of the eyelids and legs was observed. Laboratory
      findings were as follows, urine protein(3+), occult blood(3+), WBC
      2,600/microliter, Hgb 10.0 g/dl, reticulocytes 20@1000, TP 5.0 g/dl, Alb 2.7
      g/dl, T-Cho 376 mg/dl, TG 194 mg/dl, LDH 763 U/l, haptoglobin < 93 mg/dl, Ham's
      test(+), sugar water test(+), and indirect coombs (+). The erythrocytes of this
      patient showed a negative population consisting of double negative erythrocytes
      evaluated by flow cytometric two-color analysis using monoclonal antibodies
      specific to CD55 and CD59. From these findings, the diagnosis of paroxysmal
      nocturnal hemoglobinuria(PNH) was made. The patient showed nephrotic syndrome and
      a renal biopsy was performed. The histological findings of renal biopsy showed
      focal and segmental sclerosis and adhesion of glomerular tufts. Interstitial
      fibrosis with atrophic tubules and lymphocyte infiltration were also observed.
      There was no specific staining of immunoglobulins and complement by
      immunofluorescence. The diagnosis of focal segmental glomerular sclerosis(FSGS)
      was made. There have been only three case reports of glomerular disease in
      patients with PNH, such as purpura nephritis, IgA nephropathy and membranous
      nephropathy. The complication of FSGS and PNH is every rare and there has been no
      report of FSGS in a case with PNH. The onset of PNH resulted from the loss of
      CD55 and CD59, which was critical in the onset of FSGS in the present case.

PMID- 11218318
TI  - [Two cases of episodic angioedema associated with eosinophilia].
AB  - We experienced two cases of limb edema of unknown pathogenesis. No evidence was
      found concerning involvement of the kidneys, heart of other visceral organs. Case
      1 was 22-year-old woman. Her white blood cell count increased to
      13,100/microliter with 65.0% eosinophils. Case 2 was a 27-year-old woman. Her
      white blood cell count increased to 23,300/microliter with 67.0% eosinophils. In
      these cases, extensive diagnostic evaluations revealed no evidence of atopy,
      neoplasms, collagen-vascular disease, or parasitic infestation. We diagnosed
      these cases as episodic angioedema with eosinophilia. In both cases, the
      angioedema improved gradually in parallel with a decrease in the white blood cell
      count. This disorder is very rare, but it is very important to consider it in
      differential diagnosis especially for nephrologists.

PMID- 11218319
TI  - A primary care intervention for depression.
AB  - To assess a guideline-based intervention's impact on depression care provided in
      rural vs. urban primary care settings, 12 community primary care practices (four
      rural, eight urban) were randomized to enhanced (i.e., intervention) and usual
      care study conditions. The study enrolled 479 depressed patients, with 432 (90.2
      percent) completing telephone follow-up at six months. Multilevel analytic models
      revealed that rural enhanced care patients had 2.70 times the odds (P = 0.02) of
      rural usual care patients of taking a three-month course of antidepressant
      medication at recommended dosages in the six months following baseline; urban
      enhanced care patients had 2.43 times the odds compared with their urban usual
      care counterparts (P = 0.007). Rural enhanced care patients had 3.00 times the
      odds of rural usual care patients of making eight or more visits to a mental
      health specialist for counseling in the six months following baseline (P = 0.03).
      Comparisons of patients in enhanced care practices showed that rural enhanced
      care patients had 2.00 times the odds (P = 0.12) of urban enhanced care patients
      of making at least one visit to a mental health specialist for counseling in the
      six months following baseline and had comparable odds to urban enhanced care
      patients (odds ratio [OR] = 1.06, P = 0.77) of making eight or more visits to
      such specialists during that interval. The study's intervention improved the care
      received by both rural and urban depressed primary care patients. Moreover, the
      intervention's effect appears to have been greater in rural settings,
      particularly in terms of increasing depressed rural patients' use of mental
      health specialists for counseling.

PMID- 11218320
TI  - Why rural residents migrate for family physician care.
AB  - Several studies have examined why rural residents bypass local hospitals, but few
      have explored why they migrate for physician care. In this study, data from a
      random mail survey of households in rural Iowa counties were used to determine
      how consumers' attitudes about their local health system, health beliefs, health
      insurance coverage and other personal characteristics influenced their selection
      of local vs. nonlocal family physicians (family physician refers to the family
      practice, internal medicine or other medical specialist providing an individual's
      primary care). Migration for family physician care was positively associated with
      a perceived shortage of local family physicians and use of nonlocal specialty
      physician care. Migration was negatively associated with a highly positive rating
      of the overall local health care system, living in town, Lutheran religious
      affiliation and private health insurance coverage. By understanding why rural
      residents prefer to bypass local physicians, rural health system managers,
      physicians and policy-makers should be better prepared to design innovative
      health organizations and programs that meet the needs of rural consumers.

PMID- 11218321
TI  - Utilization of preventive medical services in the United States: a comparison
      between rural and urban populations.
AB  - Differences between rural and urban residents in their utilization of three
      clinical preventive services--Papanicolaou screening tests (Pap smears) for women
      aged 18 to 65, mammograms for women aged 50 to 69 and flu shots for people aged
      65 or older--were examined using a nationally representative sample from the 1994
      U.S. National Health Interview Survey. Eighty-two percent of urban women and 79
      percent of rural women (P = 0.11) had Pap smears. Sixty-eight percent of urban
      women and 61 percent of rural women (P = 0.01) had mammograms. Flu shots were
      received by 55 percent of urban and 58 percent of rural elderly residents (P =
      0.11). Of women aged 50 to 69 who had a high school education or whose annual
      household income was between $15,000 and $34,999, significantly fewer rural than
      urban women had mammograms (P < 0.01). However, the proportion of rural women
      receiving mammograms was not significantly different from that of urban women
      after adjusting for their education, household income and health insurance
      status. Education level, house-hold income and health insurance coverage were
      positively associated with utilizing mammograms. These results suggest that
      differences in the utilization of preventive services between rural and urban
      women vary by services. Improving socioeconomic status and health insurance
      coverage of rural women may reduce the disparity in mammogram use between rural
      and urban women. Mechanisms of how a woman's socioeconomic status affects her
      utilization of mammograms needs further study.

PMID- 11218322
TI  - The role of critical access hospital status in mitigating the effects of new
      prospective payment systems under Medicare.
AB  - This article examines rural hospitals that potentially qualify as critical access
      hospitals (CAH) and identifies facilities at substantial financial risk as a
      result of Medicare's expansion of prospective payment systems (PPS) to nonacute
      settings. Using Health Care Financing Administration (HCFA) cost reports from the
      federal year ending Sept. 30, 1996, combined with county-level sociodemographic
      data from the Area Resource File (ARF), characteristics of potential CAHs were
      identified and their finances analyzed to determine whether they could benefit
      from the cost-based reimbursement rules applicable to CAH status. Rural hospitals
      were identified as potential CAHs if they met a combination of federal and state
      criteria for necessary providers. Rural facilities were classified as "at risk"
      if they had poor financial ratios in conjunction with high levels of dependence
      on outpatient, home-care or skilled nursing services. Almost 30 percent of all
      rural hospitals were identified as potential CAHs. Ninety percent of potential
      CAH facilities were identified as "at risk" by at least one of five possible risk
      criteria, and one-third were identified by at least three. Of those classified
      "at risk," 48 percent might not benefit from conversion to CAH because their
      inpatient Medicare reimbursement would likely be less under CAH payment rules
      than under their current PPS payment rules. Many potential CAHs were doing well
      under inpatient PPS because they were sole community hospitals (SCH) and were
      therefore eligible for special adjustments to the PPS rates. The Rural Hospital
      Flexibility Act would be more beneficial to the population of isolated rural
      hospitals if those eligible for both CAH and SCH status were given the option of
      retaining their SCH inpatient payment arrangements while still qualifying for
      outpatient cost-based reimbursement.

PMID- 11218323
TI  - Moving from medical student placement to a community-academic partnership with a
      rural community.
AB  - This article explains a partnership-based community education model, which uses
      as an example a partnership between the Center for Healthy Communities in the
      Department of Family and Community Medicine at the Medical College of Wisconsin
      (MCW) and the rural Marion area of central Wisconsin. MCW is similar to other
      medical schools in that it has a strong history and philosophy of placing
      students in communities for educational purposes. This article describes how the
      Center for Healthy Communities is moving beyond student placement to true
      partnership building. The center followed four stages of development as it built
      a partnership with this rural Wisconsin community: (1) establish and build
      relationships, (2) develop common goals, (3) develop and implement programs and
      (4) maintain and expand progress. The center also applied a set of principles in
      developing the partnership. By following the stages and applying the principles,
      the center found that two elements were key to building a partnership for medical
      student education and community health improvement: long-term commitment and
      ability and willingness to spend time in the community. As a result, a
      meaningful, ongoing partnership developed that benefits both the community and
      MCW.

PMID- 11218324
TI  - Implementing the latest "guidelines" may not be easy.

PMID- 11218325
TI  - If we want to change unfair Medicare payment, there may never be a better
      opportunity.

PMID- 11218326
TI  - Rift Valley Fever, Yemen (update).

PMID- 11218327
TI  - Recommended composition of influenza virus vaccines for use in the 2001 influenza
      season.

PMID- 11218328
TI  - Malaria research.

PMID- 11218329
TI  - Ebola, Uganda.

PMID- 11218330
TI  - Human plague in 1998 and 1999.

PMID- 11218331
TI  - Integrated global effort against malaria.

PMID- 11218332
TI  - Oral poliovirus vaccine (OPV) and intussusception.

PMID- 11218333
TI  - Legionnaires' disease, Europe, 1999.

PMID- 11218334
TI  - Malaria risk for travellers to Africa.

PMID- 11218335
TI  - Circulation of a type 2 vaccine-derived poliovirus, Egypt.

PMID- 11218336
TI  - Chiangmai declaration on dengue/dengue haemorrhagic fever. Strengthening efforts
      to control dengue in the new millennium.

PMID- 11218337
TI  - BCG in immunization programmes.

PMID- 11218338
TI  - Cognitive, perceptual-speed, and psychomotor determinants of individual
      differences during skill acquisition.
AB  - The authors describe a series of experiments that explore 3 major ability
      determinants of individual differences in skill acquisition in the context of
      prior theory (e.g., P.L. Ackerman, 1988) and subsequent empirical and theoretical
      research. Experiment 1 assessed the predictability of individual differences in
      asymptotic skill levels on the Kanfer-Ackerman Air Traffic Controller (ATC) task.
      Experiment 2 provided an exploration of the construct space underlying perceptual
      speed abilities. Experiment 3 concerned an evaluation of theoretical predictions
      for individual differences in performance over skill development in a complex air
      traffic control simulation task (TRACON) and the ATC task, with an extensive
      battery of general and perceptual-speed measures, along with a newly developed PC
      based suite of psychomotor ability measures. Evidence addressing the
      predictability of individual differences in performance at early, intermediate,
      and asymptotic levels of practice is presented.

PMID- 11218339
TI  - Exploring the effects of icon characteristics on user performance: the role of
      icon concreteness, complexity, and distinctiveness.
AB  - Because icons, signs, and symbols are now widely used to communicate information,
      it is essential for system designers to know what makes them easy to use and
      interpret. The authors report a series of studies that examine characteristics
      considered central to icon usability. After quantifying the properties of icon
      concreteness, complexity, and discriminability, the authors assessed each
      property's effects on user performance when user experience, task demands, and
      presentation context were systematically varied. Findings indicated that the
      effects of icon concreteness were primarily associated with the initial grasp of
      meaning, whereas complexity effects were found to persist longer and to be
      associated with search efficacy. The effects of icon distinctiveness were
      complex, but distinctiveness was enhanced by using both semantic and visual
      contrasts. The implications of these findings for interface design are discussed.

PMID- 11218340
TI  - Individual differences in spatial learning from computer-simulated environments.
AB  - A multivariate study examined relationships between the following factors: paper
      and-pencil assessments of verbal and spatial ability, ability to form an accurate
      spatial representation of a large real-world environment, gender, computer
      attitudes and experience, proficiency with the navigational interface of a
      virtual environment (VE), and the ability to acquire and transfer spatial
      knowledge from a VE. Psychometrically assessed spatial ability and proficiency
      with the navigational interface were found to make substantial contributions to
      individual differences in the ability to acquire spatial information from a VE.
      Gender influenced many VE-related tasks, primarily through its relationship with
      interface proficiency and spatial ability. Measures of spatial knowledge of a VE
      maze were highly predictive of subsequent performance in a similar real-world
      maze, suggesting that VEs can be useful for training people about real-world
      spaces.

PMID- 11218341
TI  - Milliseconds matter: an introduction to microstrategies and to their use in
      describing and predicting interactive behavior.
AB  - Interactive behavior is constrained by the design of the artifacts available
      (e.g., a mouse and button) as well as by the ways in which elementary cognitive,
      perceptual, and motor operations can be combined. Any 2 basic activities, for
      example, (a) moving to and (b) clicking on a button, can be combined to yield a
      limited number of microstrategies. The results of an experimental study suggest
      that alternative microstrategies can be deployed that shave milliseconds from
      routine interactive behavior. Data from a usability study are used to explore the
      potential of microstrategies for (a) bracketing the range of individual
      performance, (b) profiling individual differences, and (c) diagnosing mismatches
      between expected and obtained performance. These 2 studies support the arguments
      that the microstrategies deployed can be sensitive to small features of an
      interface and that task analyses at the millisecond level can inform design.

PMID- 11218342
TI  - Illusory correlations in graphological inference.
AB  - The authors investigate the illusory correlation phenomenon as a possible
      contributor to the persistence of graphology's use to predict personality.
      Participants unfamiliar with graphology inspected handwriting samples paired with
      fabricated personality profiles. In Experiment 1, handwriting samples and
      personality profiles were randomly paired. In Experiment 2, discernible
      correlations near unity were set between targeted handwriting-feature-personality
      trait pairs in a congruent or incongruent direction with graphologists' claims.
      In both experiments, participants' judgments of the correlation between
      designated handwriting-feature-personality-trait pairs agreed with graphologists'
      claims, even after controlling for their actual statistical association. Semantic
      association between words used to describe handwriting features and personality
      traits was the source of biases in perceived correlation. Results may partially
      account for continued use of graphology despite overwhelming evidence against its
      predictive validity.

PMID- 11218344
TI  - The supply side initiative as an international collaboration to study alcohol
      supply, drinking, and consequences: current knowledge, policy issues, and
      research opportunities.

PMID- 11218343
TI  - Preference between onset predictable and unpredictable administrations of 20%
      carbon-dioxide-enriched air: implications for better understanding the etiology
      and treatment of panic disorder.
AB  - Predictability of aversive events impacts the development and maintenance of
      anxiety, particularly panic disorder. Although animal studies typically have
      found a preference for signaled (predictable) over unsignaled (unpredictable)
      aversive events, results of research with human participants have been less
      clear. Using a panic-relevant paradigm, the authors examined predictability
      preference with humans as a function of anxiety sensitivity and gender during
      repeated administrations of 20% carbon-dioxide-enriched air. Participants
      preferred predictable administrations, with high-anxiety individuals showing
      greater preference than low-anxiety individuals and women showing greater
      preference than men. In addition to providing information to better understand
      human predictability preference for panic-related events, results also may aid in
      determining the applicability of predictability to the cognitive-behavioral
      treatment of panic disorder.

PMID- 11218345
TI  - Applying commodity chain analysis to changing modes of alcohol supply in a
      developing country.
AB  - Development sociology has used global commodity chains as one way of analyzing
      the dynamics of power and profit-taking in globalized production networks made up
      of multiple firms and occurring in multiple national settings. A substantial
      portion of the alcohol supply in developing countries is now produced through
      such production networks. Particularly in the beer and spirits trade, a small
      number of transnational firms control networks of local producers, importers,
      advertisers and distributors. These networks serve to embed transnational or
      transnationally backed brands in the local culture, using the tools of market
      research, product design and marketing to influence local drinking practices.
      Case materials from Malaysia's beer industry help to illustrate how the
      transnational firms dominate in those links of the commodity chain in which
      monopoly or oligopoly control is most likely to be found: the design/recipe and
      marketing/advertising nodes. Their control of the commodity chains and extraction
      of monopoly or oligopoly profits from them places substantial resources and
      influence over drinking settings and practices in foreign hands. The impact of
      this influence on state efficacy and autonomy in setting alcohol policy is an
      important subject for future research on the creation and implementation of
      effective alcohol policies in developing societies.

PMID- 11218346
TI  - International issues in the supply of tobacco: recent changes and implications
      for alcohol.
AB  - This paper reviews international issues in the supply of tobacco and tobacco
      products, including trade liberalization and globalization. The paper begins with
      a brief discussion of the theoretical foundations for trade and trade
      restrictions. This is followed by a description of the treatment of tobacco and
      tobacco products in recent multi-lateral, regional and bilateral trade
      agreements, as well as a short discussion of the recent globalization of the
      tobacco industry. Included in this description is a review of the empirical
      evidence on the impact of trade liberalization on tobacco use. The implications
      of two recently proposed international agreements--the Multilateral Agreement on
      Investments and the Framework Convention for Tobacco Control--are then discussed.
      The paper concludes by summarizing the theoretical and empirical evidence that
      shows clearly that trade liberalization has significantly increased tobacco use,
      particularly in low and middle-income countries, and follows this with a
      discussion of the lessons learned from tobacco for controlling alcohol supply.

PMID- 11218347
TI  - Impacts of international trade, services and investment treaties on alcohol
      regulation.
AB  - There is an underlying incompatibility between government efforts to minimize the
      harm associated with alcohol, particularly by regulating its supply, and
      international commercial treaties that promote the freer flow of goods, services
      and investment. These treaties have already forced changes to many government
      measures affecting alcohol availability and control, primarily by constraining
      the activities of government alcohol monopolies and by altering taxation regimes.
      The North American Free Trade Agreement and the World Trade Organization
      agreements open new avenues for challenges against alcohol control measures. Some
      of these agreements extend beyond trade, border measures and differential
      taxation and allow challenges that intrude into areas of non-discriminatory
      domestic regulation affecting market access, intellectual property, investment
      and services. Effective protection from these agreements for vital public health
      measures has rarely been obtained, although it is increasingly essential. The WTO
      "services" agreement, basically unknown to the public, is currently being re
      negotiated and poses the gravest new challenge to policies designed to influence
      patterns of alcohol use and minimize alcohol-related harm. In future, these
      international agreements will probably affect adversely those alcohol approaches
      considered to be the most effective or promising. These include: maintaining
      effective state monopolies, restricting the number and locations of retail
      outlets, taxing and regulating beverages according to alcohol strength,
      restricting commercial advertising, and maintaining and enhancing public alcohol
      education and treatment programs. These effects can, in turn, be expected to
      increase the availability and access to alcohol, to lower alcohol taxes, and to
      increase advertising and promotion, resulting in increased alcohol consumption
      and associated health problems. Until more balanced international rules are
      developed, the challenge facing alcohol policy researchers is to defend national
      and local alcohol measures from further erosion. This will require greater
      coordination with researchers in other affected sectors, intervention with
      government representatives in health and related areas and the promotion of
      alternative approaches to current international commercial agreements.

PMID- 11218348
TI  - The supply of alcoholic beverages in transitional conditions: the case of Central
      and Eastern Europe.
AB  - Three periods are distinguished and applied to describe the dynamics of changes
      in the system of supply of alcoholic beverages in Central and Eastern Europe
      since 1980. The distinction of these three periods is based on changes in the
      regulation of the supply. The period of the old regulation ended in most
      countries around the 1990s. A deregulation took place in the early 1990s. The
      first steps toward a reregulation were visible in attempts to create a new order
      in the alcohol market in the last years of the 1990s. The analysis builds mainly
      on developments in Poland and Russia, with more scattered information from other
      countries. In each period the role of different actors (the state, the
      enterprises, organized crime, civil organizations and individuals), different
      interests (economic development, state finances, political order, public order,
      public health and various symbolic interests) and different public measures to
      regulate the supply (licensing, taxation and preventive actions and treatment)
      are considered. The analysis shows how the state lost its dominant position to
      private firms and is slowly regaining it again, how interest in state finances,
      overall economic development and later in profit-making dominate all three
      periods, and how the old system of regulations was ruined, to become rebuilt in
      very small steps with many conflicts and complications. Public health interests
      and also civil society interests were weak in comparison with economic interests.
      From the public health perspective, changes in the supply system have had
      significant consequences, but a more comprehensive regulation of supply does not
      necessarily lead to diminished alcohol-related harm.

PMID- 11218349
TI  - The ambiguous role of alcohol in economic and social development.
AB  - An increased and industrialized alcohol supply in a developing society is usually
      assumed to have positive effects on economic development, although it may be
      recognized that the effects on public health and order will be negative. There
      has been little attention to the potential for negative effects on the economic
      side. This paper directs attention to such factors as unemployment for cottage
      producers (often female heads of household) and reduced industrial employment as
      highly-automated "turnkey" brewers are installed. On the other hand, changes in
      the mode of production of alcoholic beverages may have little impact on the much
      larger work-force involved in serving or selling alcohol in retail trade. The net
      contribution of an increased and industrialized alcohol supply in terms of
      economic development is unclear, but industrialization and development bring with
      them increased demands for attention and sobriety, e.g. in motorized traffic and
      on the production line, which increased drinking may undercut. Decisions by
      international development agencies on investment in alcohol production and
      distribution should take account of both the positive and negative impacts on
      economic development as well as on public health. In line with this, the World
      Bank has recently decided to invest in alcohol industry projects only when there
      is a strong positive development impact and the project is "consistent with
      public health issues and social policy concerns".

PMID- 11218350
TI  - Local and global alcohol supply: economic and geographic models of community
      systems.
AB  - This paper discusses how economic and geographic distributions of local supply
      affect patterns of alcohol problems in state and community settings. It is argued
      that characteristics of local supply directly affect the economic and social
      behaviors of consumers when purchasing and using alcohol. For example, although
      taxes may be raised in order to lower alcohol use, the manner in which tax
      increases are translated into price increases, and the way consumers respond to
      price increases through alterations in purchase patterns, may strongly mitigate
      price effects. Similarly, although overall alcohol availability may be reduced in
      order to lower alcohol use, the tendency for greater numbers of outlets to be
      focused in low-income areas and the manner in which consumers bundle alcohol
      purchases with other routine activities (e.g. shopping) may also strongly
      mitigate such effects.

PMID- 11218351
TI  - Unrecorded alcohol consumption: its economics and its effects on alcohol control
      in the Nordic countries.
AB  - The starting point of this paper is the fact that no country has complete records
      of alcohol consumption. In addition to being a matter or statistical accuracy,
      unrecorded alcohol also plays an important role in alcohol policy discussions.
      Furthermore, its quantity is bound to basic economic laws. These latter two
      aspects are the main interest in this paper, which discusses, first, what is
      really meant by unrecorded alcohol consumption and what kind of categories are
      included in it. The next task is to discuss the economics of different categories
      of unrecorded alcohol and the mechanisms which lead to increases or decreases in
      them. The examples in this part of the paper come from the Nordic countries.
      Arguments about increased smuggling and illegal distilling have always been used
      against alcohol policy restrictions in the Nordic countries. Recently the level
      of travellers' alcohol imports and border trade have also been used for the same
      purpose. In the European Union the task to harmonize alcohol excise taxes is
      partly given to increased travellers' duty-free allowances and market forces.
      This policy has already led to reductions in alcohol taxation both in Denmark and
      Sweden.

PMID- 11218352
TI  - The influence of economic interests on alcohol control policy: a case study from
      Finland.
AB  - Finland's participation in the European Union has meant that Finnish markets have
      been opened to international competition and that the traditional alcohol policy
      decision-making that revolved around Alko, the state alcohol monopoly company,
      has become impossible. The influence of private commercial interests increased in
      the 1990s but not in a straightforward manner. They had their biggest influence
      in the mid-1990s when the 1994 Alcohol Act was drafted and accepted. After that
      the influence of commercial interests has declined, and nowadays the alcohol
      question is again discussed in terms of public health and safety and drinking
      among young people. Integration did not lead to the expected deregulation of
      alcohol control but to new forms of regulation, where EU authorities such as the
      Commission and the EU Court also play an important role. Alcohol policy-making is
      now more transparent, and free trade and competition without interference are
      much more stressed than previously. These are the new frames of public
      intervention in the alcohol question, both in the trade of alcoholic beverages
      and in the taking care of individuals harmed by the use of alcohol.

PMID- 11218353
TI  - Roles of commercial interests in alcohol policies: recent developments in North
      America.
AB  - This paper examines recent developments in Canada and the United States and the
      role of commercial interests in alcohol-related policies bearing on taxes, outlet
      density, advertising, counter-advertising, health messages and prevention. Case
      study material is drawn from published papers, project reports, government
      documents and newspaper accounts. The main focus is at the federal level, with
      some reference to provincial, state and local experience. Alcohol industries have
      as their primary agenda that of maintaining and expanding their markets and
      maximizing profits. In order to achieve this they typically oppose restrictions
      on access to alcohol, tax increases, controls on marketing and some counter
      advertising campaigns. They are powerful in influencing policy in both countries,
      at national and regional levels, and their efforts impact policy agenda and
      outcome of government deliberations. Their prevention efforts, which tend to be
      oriented to information and education, are mainly individualistic in focus and
      typically not supportive of environmentally based policy reforms. Governments
      appear to have a declining interest in policy issues, due partly to resistance by
      the industries to alcohol control policies. Governments are encouraged to apply
      an evidence-based orientation to funding prevention, and facilitate evaluation of
      industry-sponsored prevention efforts. Greatest attention and resources should be
      directed to interventions that are most likely to have the greatest impact in
      reducing drinking-related problems, and funding for prevention from alcohol
      industries should involve arms-length arrangements. Alcohol industries are
      encouraged to consider strategies that do not increase access to alcohol but
      rather reduce drinking-related risks.

PMID- 11218354
TI  - Marketing alcohol to young people: implications for industry regulation and
      research policy.
AB  - This paper focuses on the marketing of alcohol to young people in the United
      Kingdom, but the lessons that emerge have international significance. Alcohol is
      a global enterprise and recent consolidation means that it is controlled by a
      decreasing number of expanding multi-nationals. Alcohol companies are able to
      allocate significant resources to researching consumer preferences, developing
      new products and promoting them on an international level. Recent years have seen
      a growth in the value that youth culture attaches to brand labels and symbols and
      a move away from the healthy-living ethos. The alcohol industry's response to
      these trends has been to design alcoholic beverages that appeal to young people,
      using well-informed and precisely targeted marketing strategies. This has led to
      growing concerns about the implications for public health and a demand for
      tighter controls to regulate alcohol marketing practices. In the United Kingdom,
      controls on alcohol are piecemeal and reactive and the current system of
      voluntary regulation appears ineffective. This paper argues for more research to
      establish current industry practice and inform the development of a comprehensive
      regulatory structure and system of monitoring.

PMID- 11218355
TI  - Alcopops in Sweden--a supply side initiative.
AB  - This paper describes the introduction of alcopops and sweet ciders in Sweden in
      1996, as a result of the membership of the European Union. Special attention is
      given to its effect on youth drinking. Surveys of young people show that alcopops
      and sweet ciders are perceived to be easy to drink and to have a sweet and
      pleasant taste, which tends to conceal the taste of alcohol. These results
      suggest that alcopops and sweet ciders should be regarded as one category of
      drinks. Alcopops and sweet ciders have penetrated the youth market rapidly. The
      introduction of these beverages accounted for approximately half of the increase
      in alcohol consumption by 15-16-year-old boys from 1996 to 1999, and two-thirds
      of the increase among girls, according to the surveys. A large proportion of the
      youth answered that alcopops and ciders did not replace any other alcoholic
      beverage. The paper also describes the public debate on alcopops and cider. The
      introduction of alcopops was criticized by the media and the responsible
      minister. Prominent spokesmen of the alcohol industry put themselves at a
      distance from these, primarily imported, products. The sales of alcopops have
      been declining since 1997. Sweet ciders, on the other hand, which in reality are
      synonymous with alcopops, have continued to increase during the whole period
      since 1996, and have not been subject to the same public criticism.

PMID- 11218356
TI  - The alcohol supply: its importance to public health and safety, and essential
      research questions.
AB  - This paper seeks to identify the main questions which have emerged from the
      preceding papers concerning the supply side of alcohol. On any rational analysis
      these issues are of thoroughly legitimate concern to public health researchers.
      We list them under seven headings: (1) what drives the alcohol supply side? (2)
      What is the impact of alcohol supply on demand? (3) What are the benefits and
      risks to health and safety stemming from deregulation and what are the
      possibilities to avoid negative effects? (4) What is the size and significance of
      the alcohol supply which may derive from other than the officially approved
      channels? (5) Who are the important actors in the alcohol supply system? (6) What
      are local influences on alcohol supply and its distribution throughout
      communities? (7) What is to be learned from tobacco and other risky commodities
      about the importance of supply? Finally, we outline a series of possible next
      steps for a supply side initiative.

PMID- 11218357
TI  - Professional ethics and marketing of treatment.

PMID- 11218358
TI  - UROD: an antipodean therapeutic enthusiasm.

PMID- 11218359
TI  - Large claims obstruct progress.

PMID- 11218360
TI  - Dissemination of current treatment research findings to the profession, policy
      makers and patients--whose responsibility is it?

PMID- 11218361
TI  - Our ethical responsibility.

PMID- 11218362
TI  - Warning label: this treatment approach may cause claims of a magic cure.

PMID- 11218363
TI  - Overvalued ideas about alcoholism and schizophrenia.

PMID- 11218364
TI  - The co-occurrence of schizophrenia and alcoholism: comments on Michael Soyka's
      editorial.

PMID- 11218365
TI  - Injectable methadone: cautious interest.

PMID- 11218366
TI  - Naloxone distribution: remembering hepatitis C transmission as an issue.

PMID- 11218367
TI  - Putting thiamine in beer: comments on Truswell's editorial.

PMID- 11218368
TI  - Alcoholism treatment and the importance of economic analysis: comment on Holder
      et al.

PMID- 11218369
TI  - When commercial interests differ from public health interests: comments on Sato
      et al.

PMID- 11218370
TI  - Conflict of trade versus health: problems and prospects.

PMID- 11218371
TI  - Use of race and ethnicity in epidemiologic research: concepts, methodological
      issues, and suggestions for research.

PMID- 11218372
TI  - Molecular epidemiology of vitamin D receptor gene variants.

PMID- 11218373
TI  - HLA-DQ locus of the human leukocyte antigen complex and type 1 diabetes mellitus:
      a HuGE review.

PMID- 11218374
TI  - Review of organizational factors related to care offered to women with breast
      cancer.

PMID- 11218375
TI  - Perinatal sex hormones and risk of breast and prostate cancers in adulthood.

PMID- 11218376
TI  - Reproductive problems among women health care workers: epidemiologic evidence and
      preventive strategies.

PMID- 11218377
TI  - Epidemiology of gestational weight gain and body weight changes after pregnancy.

PMID- 11218378
TI  - Birth weight in offspring of women with epilepsy.

PMID- 11218379
TI  - Helicobacter pylori: epidemiology and routes of transmission.
AB  - H. pylori is a common bacterium, and approximately 50 percent of the world's
      population has been estimated to be infected (198). Humans are the principal
      reservoir. The prevalence of H. pylori infection varies widely by geographic
      area, age, race, ethnicity, and SES. Rates appear to be higher in developing than
      in developed countries, with most of the infections occurring during childhood,
      and they seem to be decreasing with improvements in hygiene practices. H. pylori
      causes chronic gastritis and has been associated with several serious diseases of
      the gastrointestinal tract, including duodenal ulcer and gastric cancer. Since
      its "discovery" in 1982 by Warren and Marshall (1), H. pylori has been the topic
      of extensive research. A number of studies have used questionnaire components to
      investigate factors possibly related to the etiology of H. pylori infection. The
      majority of recent studies have not found tobacco use or alcohol consumption to
      be risk factors for H. pylori infection. Adequate nutritional status, especially
      frequent consumption of fruits and vegetables and of vitamin C, appears to
      protect against infection with H. pylori. In contrast, food prepared under less
      than ideal conditions or exposed to contaminated water or soil may increase the
      risk. Overall, inadequate sanitation practices, low social class, and crowded or
      high-density living conditions seem to be related to a higher prevalence of H.
      pylori infection. This finding suggests that poor hygiene and crowded conditions
      may facilitate transmission of infection among family members and is consistent
      with data on intrafamilial and institutional clustering of H. pylori infection.
      Understanding the route of H. pylori transmission is important if public health
      measures to prevent its spread are to be implemented. Iatrogenic transmission of
      H. pylori following endoscopy is the only proven mode. For the general
      population, the most likely mode of transmission is from person to person, by
      either the oral-oral route (through vomitus or possibly saliva) or perhaps the
      fecal-oral route. The person-to-person mode of transmission is supported by the
      higher incidence of infection among institutionalized children and adults and the
      clustering of H. pylori infection within families. Also lending support to this
      concept is the detection of H. pylori DNA in vomitus, saliva, dental plaque,
      gastric juice, and feces. Waterborne transmission, probably due to fecal
      contamination, may be an important source of infection, especially in parts of
      the world in which untreated water is common. Recent studies in the United States
      have linked clinical H. pylori infection with consumption of H. pylori
      contaminated well water. This area of research is worthy of further
      investigation. Although H. pylori has been isolated in domestic cats, additional
      research has suggested that H. pylori is probably uncommon in domestic cats and
      thus is probably not a major concern for cat owners. Several studies have
      suggested sheep as a possible source of H. pylori transmission, a hypothesis that
      deserves additional investigation. The most recent reservoir suggested for H.
      pylori transmission is the housefly. However, evidence is lacking that H. pylori
      can be transmitted to humans from flies that have been in contact with H. pylori
      infected feces. Nevertheless, the hypothesis is appealing since flies are known
      to carry many other infectious diseases. Knowledge of the epidemiology and mode
      of transmission of H. pylori is important to prevent its spread and may be useful
      in identifying high-risk populations, especially in areas that have high rates of
      gastric lymphoma, gastric cancer, and gastric ulcer.

PMID- 11218380
TI  - Differential diagnosis of acute flaccid paralysis and its role in poliomyelitis
      surveillance.

PMID- 11218382
TI  - [Isolation of methicillin-resistant Staphylococcus aureus from nasopharyngeal
      swabs on admission to a ward for pediatric patients: comparison between 1992-1993
      and 1997-1998].
AB  - We studied 2,176 nasopharyngeal swabs obtained from 1,891 children on admission
      to the pediatric ward at Asahikawa Kosei Hospital from January 1997 to December
      1998, and compared the results with the same study from January 1992 to December
      1993. Fifty strains of Methicillin-resistant Staphylococcus aureus (MRSA) were
      isolated from 46 patients. The ages of these patients ranged from 7 days to 17
      years and 24 patients were younger than 1 year. Six patients were diagnosed as
      MRSA infection; acute otitis media in 3, osteomyelitis and bacteremia in 1,
      staphylococcal scalded skin syndrome in 1, and inflammation in umbilical region
      in 1. The ratio of MRSA positive to the total specimens significantly increased
      from 1.25% in 1992-1993 to 2.30% in 1997-1998 (p = 0.011). The ratio of MRSA
      positive to the total S. aureus positive specimens significantly increased from
      10.7% in 1992-1993 to 20.3% in 1997-1998 (p = 0.003). These findings demonstrated
      that prevalence of MRSA carriers among children is increasing.

PMID- 11218381
TI  - [Susceptibility testing of clinical strains of Legionella spp. isolated in
      Japan].
AB  - We determined antimicrobial susceptibilities of 23 strains of Legionella spp.
      clinically isolated in Japan, between September 1994 through November 1999 by
      using Etest. The MICs of all isolates against macrorides, fluoroquinolones and
      rifampicin showed 1 microgram/ml or less. Especially rifampicin showed the most
      potent activity, of which the MICs of all isolates showed 0.064 microgram/ml or
      less. Although we could not find resistant strains against any antibiotics tested
      in this study, we think it is important to follow up the susceptibilities of
      clinical isolates of Legionella.

PMID- 11218383
TI  - [Experimental study on the influence of alginate induced immune complex on BALF
      cells].
AB  - Immune complex containing alginate and antialginate antibodies plays an important
      role in the disease-progress of chronic airway infection with mucoid-alginate
      producing strains. For the purpose of clarifying the immune-pathogenic influence
      of the alginate induced immune complex (alg-IC) on inflammatory cells in
      bronchoalveolar lavage fluid (BALF), an experimental study was performed. The
      alginate immunized mice were injected through the trachea with alg-IC extracted
      from the immunized mouse serum in advance, and the changes in BALF-cells, such as
      macrophage, neutrophil, lymphocyte, CD16/32 positive neutrophil, CD4+ lymphocyte,
      CD4+CD45+ lymphocyte, CD8+ lymphocyte, CD8+CD11b- lymphocyte were investigated
      along with the passage of time as compared with those of the non-immunized mice.
      1) On the 2nd day after intratracheal injection, the time which was chosen as an
      acute phase, the total count of macrophages, neutrophils, lymphocytes were
      increased in both groups. However CD16/32 positive neutrophil (with the
      expression of Fc-gamma recepter on it) was significantly decreased in the
      immunized group. 2) On the 5th day being chosen as the resolving phase of acute
      inflammation, the number of the increased inflammatory cells tended to recover to
      the base line value in both groups. But the continuous decrease in CD16/32
      positive cell and the significant increase in CD4+CD45+ lymphocytes were found in
      only the immunized group. 3) On the 16th day being chosen as the beginning of the
      chronic phase, all inflammatory cells investigated in the non-immunized group
      recovered to the base line level. In the immunized group, however, significantly
      higher values of neutrophil-count still remained, in spite of the decrease in CD
      16/32 positive neutrophils. Also, CD4+CD45+, CD8+, CD8+CD11b- lymphocytes were
      significantly at a higher level. 4) Histological findings in the lung tissue was
      supported the above findings. 5) From the above, in the alginate immunized group,
      the scavenging function of neutrophils for the alg-IC deposited in lung tissue
      would be suppressed resulting from the decrease in CD16/32 positive neutrophils,
      in spite of the increase in total count of neutrophils. Consequently, long term
      deposition of alg-IC in the lung would induce an accumulation of cytotoxic CD8+ T
      lymphocyte or other lymphocytes as one of the cell-mediated immune responses.
      This indicates that such a harmful immune reaction induced by alg-IC leads the
      chronic infection with mucoid-alginate producing pathogens to be more
      intractable.

PMID- 11218384
TI  - [Clinical significance of eosinophilic cationic protein in serum and
      bronchoalveolar lavage fluid of adult patients with mycoplasmal pneumonia].
AB  - Pathogenic mechanisms of mycoplasmal pneumonia is not fully understood at present
      though some kind of cell-mediated hypersensitivity is closely related to its
      mechanisms. Though eosinophilia in peripheral blood are sometimes revealed in
      patient with mycoplasmal pneumonia, it is not unclear whether eosinophils related
      to its pathogenesis, or not. We evaluated the clinical significance of ECP in
      serum and BAL fluid in patients with mycoplasmal pneumonia. The diagnosis of
      mycoplasmal pneumonia was confirmed both by serological diagnosis from paired
      serum and by the polymerase chain reaction (PCR) methods using specific primers
      of the Mycoplasma pneumoniae for detecting specific DNA from bronchial washing
      fluids. ECP level in serum were measured in 27 patients (11 male, 16 female,
      average age 31.7 yo) with mycoplasmal pneumonia by ELISA methods. ECP level in
      BALF were also measured in ten of all patients. The level of ECP in serum was
      high in 17 cases (63%) of the total cases. In addition the level of ECP in BALF
      was also high in all tested patients (10 cases). There was a correlation between
      serum ECP level and days from onset. There was also a correlation between serum
      ECP level and WBC counts, the degree of PaO2. These results suggested that ECP
      derived from activated eosinophils in the lung might in part play a role in the
      pathogenesis of mycoplasmal pneumonia.

PMID- 11218385
TI  - [Comparison of community-acquired pneumonia in relation to influenza A and RS
      virus infections].
AB  - We experienced 142 cases with community-acquired pneumonia between April 1998 and
      March 2000. By measuring the titers of respiratory viruses for these cases, we
      were able to identify acute phase infections of influenza A virus in 10 cases and
      RS virus in 6 cases and determined that there was an increase in community
      acquired pneumonia during both winter seasons. Thereafter we compared the
      clinical features of community-acquired pneumonia with regard to these two types
      of virus infection by dividing the patients into two groups, both of which
      frequently included in the elderly. In the influenza virus group, such general
      symptoms as high fever, headache and general fatigue were dominant. Common
      bacteria were isolated in nine cases with mixed infection; four of them with
      Streptococcus pneumoniae. In the RS virus group, there were fewer general
      symptoms and common bacteria were isolated in four cases with mixed infection;
      three with Haemophilus influenzae. The severity of the illness was greater in the
      Influenza virus group; i.e.) three cases required mechanical ventilation and two
      of these three cases died. In the RS virus group, on the other hand, the
      prognosis was good because no mechanical ventilation was required and there were
      no deaths. Influenza vaccination is especially important for the elderly, because
      the epidemiology of the influenza virus groups showed none had a history of
      influenza vaccination in this study.

PMID- 11218387
TI  - [Detection of spotted fever group rickettsiae DNA from ticks in Kanagawa, Shimane
      and Kochi Prefectures].

PMID- 11218386
TI  - [Two cases of typhoid fever with reduced susceptibility to fluoroquinolones].
AB  - Two separate febrile Indian patients who reside in Japan and had recently
      returned from their country were diagnosed as suffering from typhoid fever.
      Fluoroquinolone therapy was clinically ineffective and the addition of a third
      generation cephalosporin was required in each case. Each strain of Salmonella
      Typhi was resistant to nalidixic acid in vitro and also showed higher minimal
      inhibitory concentration to other quinolones than usual susceptible strains.
      Similar cases of typhoid fever responding poorly to quinolone treatment have been
      observed in the Indian subcontinent, south-east Asia and central Asia since the
      early 1990s, and potential spread by travelers into Japan is of serious concern.
      Although quinolones still remain the drugs of choice for treatment of typhoid
      fever, physicians should be aware of the possibility and implications of clinical
      treatment failure.

PMID- 11218388
TI  - [Detection of mupirocin resistant staphylococci from patients treated with
      mupirocin].
AB  - Susceptibility testing of mupirocin (MUP) was performed by an agar dilution
      method according to the National Committee for Clinical Laboratory Standard
      (NCCLS) to detect the MUP resistance. A total of 434 isolates of methicillin
      resistant staphylococci were examined and all of 205 isolates of methicillin
      resistant Staphylococcus aureus (MRSA) from 43 hospitals nationwide in 1993 were
      sensitive to MUP. However, MUP resistance emerged among 228 isolates [185
      isolates (88 cases) of MRSA and 43 isolates (28 cases) of methicillin-resistant
      coagulase negative staphylococci (MR-CNS)] from nasal swabs of patients with MUP
      treatment between Sep 1996 and Feb 2000 in the Nagoya University Hospital. The
      high-level MUP resistance (MIC > or = 512 micrograms/mL) was isolated from two
      patients, one isolate of MRSA and four of S. hominis, respectively. Low-level MUP
      resistance (MIC 8-128 micrograms/mL) was isolated from three patients, 11
      isolates of MRSA, one of S. chromogenes and five of S. epidermidis, respectively.
      The mupA which encodes the MUP resistant isoleucyl-tRNA synthetase (IRS) were
      investigated by PCR in these MUP resistant isolates. The mupA was detected only
      in high-level MUP resistant S. hominis, but not detected in high-level MUP
      resistant MRSA and low-level MUP resistant isolates. We also investigated the
      characteristics of the patients with MUP resistance. All of MUP resistant
      staphylococci were isolated after initiation of MUP treatment. Four patients with
      MUP resistant MRSA and low-level MUP resistant MR-CNS had MRSA infectious disease
      and MUP resistant strains were successfully eradicated with vancomycin treatment
      in two patients. MUP high-level resistant S. hominis, has emerged after MUP
      treatment for eradication of MRSA. Clinical guidelines for the prudent use of MUP
      should be generally adopted with careful monitoring of emergence of MUP
      resistance.

PMID- 11218389
TI  - [Progress of molecular bacteriological studies on Helicobacter pylori].
AB  - To understand pathogenesis of H. pylori in stomach diseases including gastric
      cancer, molecular bacteriological studies are important. The studies are greatly
      advanced by information of the whole genome sequence of this bacterium in 1997.
      Various methods of gene manipulation to identify the genes involved in
      pathogenesis are now available such as transformation followed by construction of
      knockout mutants, complementation using H. pylori-E. coli shuttle vectors, random
      insertion mutagenesis, and RT-PCR or proteome analysis of in vivo-expressed
      genes. The molecular mechanism of persistent infection of H. pylori is discussed
      in light of recent findings on molecular mechanisms of bacterial attachment and
      colonization as well as on gastric physiology.

PMID- 11218391
TI  - [Epidemiology of H. pylori infection].
AB  - Prevalence rates and risk factors for H. pylori infection have been reported in
      many countries over the past year. Infection patterns in developed and developing
      countries are very different. Very high infection rates in developing countries
      with high incidence of gastric cancer were described, however, African enigma is
      still under controversy. The main risk factors for H. pylori infection are fecal
      oral and oral-oral spread because H. pylori has not been detected to any extent
      in the environment. Recently, in childhood, main risk factors for transmission
      may be the contact with own father with H. pylori infection in Japan. Re
      infection are very rare in adults, but not uncommon in childhood. Prevalence of
      H. pylori infection is reviewed.

PMID- 11218390
TI  - [Virulence gene of H. pylori].
AB  - H. pylori is a well-recognized pathogen that infects up to 50% of humans in the
      world. H. pylori lives for decades in the hostile environment of the human
      stomach. H. pylori is closely associated with histologic gastritis, gastric
      ulceration, duodenal ulceration, gastric cancer and MALT lymphoma. These various
      clinical outcomes are considered by 1) different virulence, 2) host response, 3)
      other environmental factors, and their interactions. Since the whole genome was
      sequenced in 1997, the virulence genes have been investigated in molecular
      genetic aspects. The cag pathogenicity island (cagPAI) is a complex of virulence
      genes, which code approximately 30 proteins. The cagPAI acquired by horizontal
      transfer and is coding for type 4 secretion machinery system. Via this system,
      many virulence gene products or other interactive proteins are transferred into
      the host cells.

PMID- 11218392
TI  - [Causal relationship between Helicobacter pylori infection and upper
      gastroduodenal diseases].
AB  - Helicobacter pylori infection causes chronic gastritis (nonatrophic gastritis),
      which progresses to atrophic gastritis and intestinal metaplasia over a period of
      decades. Atrophy may result from inflammation and apoptosis caused by H. pylori
      infection. H. pylori is an important risk factor for peptic ulcer disease.
      Duodenitis in the gastric metaplasia of the duodenum, hypergastrinemia, and
      impaired proximal duodenal mucosal bicarbonate secretion are considered causal
      factors for duodenal ulcer disease. Low-grade B-cell gastric lymphoma of mucosa
      associated lymphoid tissue (MALT) develops in response to H. pylori infection.
      Studies of Mongolian gerbil model demonstrated that H. pylori had an initiator or
      promoter effect on gastric carcinogenesis.

PMID- 11218393
TI  - [Recent guidelines for the management of Helicobacter pylori infection].
AB  - The guidelines for the diagnosis and treatment of H. pylori infection have been
      developed in Europe, United States, Asia, and Japan. Each guideline is
      characteristic in recommended indication, diagnostic method, and eradication
      regimen, because it depends on different background of medical situation. Two
      guidelines were reported in 2000. One is Maastricht 2-2000 consensus report,
      another is the guideline of Japanese Society for Helicobacter Research. In this
      article, European and Japanese recent statement for the management of H. pylori
      infection were introduced to reveal the differences in indication, diagnosis, and
      treatment between both guidelines.

PMID- 11218394
TI  - [Triple site biopsy under endoscopy].
AB  - Triple site biopsy specimens were taken from antrum, corpus, and supraangle
      simultaneously in 3002 Japanese cases to compare the differences among the biopsy
      sites for the evaluation of mucosal atrophy and inflammation. The prevalence of
      H. pylori infection was almost same in biopsy specimens from the different sites,
      but the detective rates for mucosal atrophy and intestinal metaplasia were
      remarkably higher in the supraangle. Our results indicate that the antral and the
      corpal biopsy are suitable for the evaluation of inflammation and H. pylori
      infection, but the supraangular biopsy is more reliable for the recognition of
      mucosal atrophy and intestinal metaplasia than the antral and the corpal biopsy.

PMID- 11218395
TI  - [Serological diagnosis of Helicobacter pylori infection].
AB  - H. pylori gastritis elicits both a local and a systemic immune response. Although
      multiple invasive tests are available for the diagnosis of H. pylori infection,
      serum testing for anti-H. pylori antibodies is a minimally invasive test
      available to diagnose this infection. Latex agglutination is available, but most
      kits use ELISA. The sensitivities and specificities of many commercial kits were
      more than 90%. However, most of these serologic detection kits were made in
      Western countries. There might been the influence of geographical differences on
      test results. Recently, serological test has been reported about of usefulness in
      monitoring after eradication therapy at long-term period.

PMID- 11218396
TI  - [13C-urea breath test].
AB  - A 13C-urea breath test(13C-UBT) is known to be a good diagnostic method for
      detecting H. pylori infection since it is non-invasive, simple and accurate. Its
      diagnostic capability in determining H. pylori eradication has been studied using
      153 patients (who underwent the H. pylori eradication therapy) as subjects at two
      times: 6-8 weeks after the end of administration (at the time of determination of
      eradication) and 6 months afterwards. When determination was made, the
      sensitivity and specificity of 13C-UBT compared to culture and histology were
      100% and 95.1%, respectively. Seven inconsistent cases were positive according to
      13C-UBT and negative according to two other methods. After 6 months, both
      sensitivity and specificity were 100% and 4 of the 7 inconsistent cases became
      positive according to all three methods. These results indicate that the 13C-UBT
      is superior in terms of sensitivity and specificity to culture and histology and
      recognize the failure eradication earlier than ether two methods. Re-examination
      of inconsistent cases should be performed after 6 months. After covered by
      insurance, the H. pylori eradication therapy will become a general form of
      treatment of peptic ulcers. 13C-UBT in particular has proven most useful for
      diagnosis of eradication.

PMID- 11218397
TI  - [Rapid urease test].
AB  - The rapid urease test is a simple, sensitive, and highly specific test that
      enables the endoscopist to diagnose Helicobacter pylori infection in the
      endoscopy room. Determination of the infection status of Helicobacter pylori by
      biopsies from the gastric body had a significantly higher sensitivity than antral
      biopsies. A false-negative reaction by rapid urease test occurred the use of
      antibiotics (correlates with clearance of the bacteria) and the use of proton
      pump inhibitor or a part of mucosal protective agents(correlates urease
      inhibitory effect) and in the case of non-urease producing Helicobacter pylori.
      The rapid urease test satisfactory overall sensitivity before eradication
      treatment. However, the sensitivity of these rapid urease tests was lower after
      eradication than before eradication.

PMID- 11218398
TI  - [Diagnosis of H. pylori infection by PCR].
AB  - Because of its high sensitivity, polymerase chain reaction (PCR) method can be
      used to detect the presence of very few numbers of H. pylori organisms in gastric
      biopsy materials or gastric juice samples. PCR has also been applied to the
      detection of H. pylori organisms in the oral cavity, in stools, and in the
      environment. RT-PCR is useful to study the expression of H. pylori pathogenic
      genes and gene expression of gastric mucosal cells in response to H. pylori
      infection. Other PCR-based techniques, such as PCR-RFLP or real-time quantitative
      PCR, are now providing important information on H. pylori and pathophysiology of
      H. pylori infection.

PMID- 11218399
TI  - [Genetic diagnosis of H. pylori strains].
AB  - Helicobacter pylori strains are divided into two broad families, type I and type
      II, based on whether or not they possess the cag pathogenicity island (cagPAI).
      It has been suggested that cagPAI is inherited by horizontal transfer from an
      unknown microorganism, and the genes of cag are thought to be encoded by a
      putative type IV secretory system. In addition, CagA may be delivered from
      attached H. pylori into the host crytoplasm by this system and is tyrosine
      phosphorylated in gastric epithelial cells. The phosphorylated CagA may play a
      crucial role in promoting the inflammatory responses of gastric mucosa. These
      findings suggest that type I H. pylori is a pathogenic H. pylori.

PMID- 11218400
TI  - [Antimicrobial resistant test of H. pylori].
AB  - The resistance of Helicobacter pylori (H. pylori) to antibiotics leaves great
      influence on treatment outcome. Agar and broth dilution techniques are difficult
      to perform and not practical. E-test has the advantage of allowing visualization
      of resistant subpopulations of bacteria within zones of inhibitions. We studied
      point mutation of 23s-rRNA gene for H. pylori strains. (74 clarithromycin (CAM)
      resistant, 6 CAM-susceptible) The results of these assays were well correlated
      with these of E-test. The cure rate of triple therapy with metoronidazole (MTZ)
      for CAM-resistant H. pylori is 100%(11/11), and that with CAM for MTZ-resistant
      H. pylori is 94.4% (17/18). It is very difficult to eradicate CAM and MTZ
      resistant H. pylori.

PMID- 11218401
TI  - [Morphological investigation of H. pylori and its culture method].
AB  - H. pylori plays important roles in the pathogenesis of active gastritis, peptic
      ulcer, and gastric cancer. Culture of H. pylori from suspicious materials is one
      of gold standard methods for the diagnosis of its infection. H. pylori has two
      types of morphological manifestation, spiral (mobile) and coccoid (immobile)
      forms. Morphological conversion from spiral to coccoid form and its reversion may
      be important role in its pathophysiology including bacterial properties,
      pathogenicity, and etiology. However, the mechanism and significance of such
      transformation of H. pylori have remained unknown. In this chapter, we introduce
      the conventional and new culture methods of H. pylori and review the current
      knowledge regarding both two types of morphological manifestation and
      pathophysiological significance of such transformation.

PMID- 11218402
TI  - [Indication of H. pylori eradication therapy--who should be treated?].
AB  - With increased evidence of H. pylori infection being deeply related with various
      gastric diseases, its curative therapy will be approved by social security
      foundation soon also in Japan. Japanese Society of Helicobacter reported a
      guideline for H. pylori diagnosis and treatment in July 2000. In the guideline,
      only peptic ulcers and low grade MALT lymphomas are recommended as an indication
      of H. pylori eradication and other diseases such as atrophic gastritis, post EMR
      state for early gastric cancer and post-operated stomach due to gastric cancer,
      hyperplastic polyps and non-ulcer dyspepsia, were not included. It is speculated
      that while benefit of eradication therapy for peptic ulcers and low grade MALT
      lymphomas has been supported by much clinical evidence, that for other diseases
      was judged not to be enough. Especially as to atrophic gastritis, eradication
      therapy might be considered in aspect of decreasing gastric cancer risk in Japan.
      Since accumulated epidemiological and experimental data strongly support its
      positive correlation with cancer risk, patients in high risk group for gastric
      cancer could be included for a target eradication therapy. In present, indication
      of the therapy should be clinically and socially decided according to individual
      patient.

PMID- 11218403
TI  - [Selection of antibiotics and planning of eradication for H. pylori infection].
AB  - There is general agreement that H. pylori should be eradicated in patients with
      peptic ulcers. But the optimal therapeutical regimen to be used still remains a
      matter for many investigations. An increase in the prevalence of antibiotic
      resistant H. pylori strains has been reported recently. The recommended drugs for
      the eradication in Japan are clarithromycin (CAM) and amoxicillin (AMPC) because
      metronidazole (MNZ) is anti-parasites drug in Japan. A total of 392 H. pylori
      strains in the last twelve years were tested for sensitivity to CAM, MNZ, and
      AMPC. The Primary resistance of H. pylori to CAM, MNZ, and AMPC were found in
      10.2%, 26.5%, and 0.3% strains, respectively. The resistant strains to CAM were
      gradually increasing in the last few years. The eradication therapies which do
      not increase antibiotics resistant strains after eradication failure were
      reported. The recommendation for eradication in patients with peptic ulcer
      disease includes those with bleeding ulcers. The pretreatment with proton pump
      inhibitors (PPI) does not influence the success of PPI-based triple therapy in
      eradicating H. pylori.

PMID- 11218404
TI  - [Usefulness of new triple therapy containing PPI].
AB  - The guideline on the management of H. pylori was developed by the Japanese
      Society for Helicobacter Research in 2000, and new triple therapy with
      lansoprazole, amoxicillin and clarithromycin is recommended. At first, we
      determined the eradication ratio and the frequency of adverse effects,
      considering difference of genetic polymorphism in metabolizing enzyme of PPI,
      CYP2C19. No significant difference was shown among the groups of different
      metabolizing activity in the two points of view. Next, resistance to antibiotics
      of H. pylori were determined in the eradication-failure cases and compared before
      and after the therapy. The result did not showed that strains newly acquired the
      resistance during the therapy. We emphasis that the new triple therapy can be
      performed without considering the genetic difference or antibacterial resistance
      until now and that we should examine how eradication is completely performed.

PMID- 11218405
TI  - [How and when should we check Helicobacter pylori infection after eradication
      therapy?].
AB  - In Japan, The new triple therapy was opened for Helicobacter pylori (HP)
      eradication from Nov. 1, 2000. The Japanese Society for Helicobacter Research
      presented a guideline for HP eradication. It recommended that HP infection should
      be checked at least 4 weeks after the treatment for peptic ulcer and HP infection
      using HPIgG antibody, rapid urease test, urea breath test, histology and/or
      culture. However, it did not state the best way and suitable timing to check HP
      infection after the eradication therapy. In this study, we investigated the
      accuracy of PyloriTek test(a 1-h rapid urease test) and tried to establish the
      suitable timing for checking HP infection after eradication therapy. In
      conclusion, when patients are examined more than 4 months after eradication
      therapy, the use of PyloriTek alone may be sufficient for correctly diagnosing HP
      infection.

PMID- 11218407
TI  - [Anti-ulcer therapy after eradication of Helicobacter pylori].
AB  - Helicobacter pylori (H. pylori) infection is the cause of the frequent relapse of
      peptic ulcer disease. Successful eradication therapy of H. pylori is associated
      with a decline in the recurrence of peptic ulcer. In this paper, we discussed the
      significance of anti-ulcer therapy after H. pylori eradication therapy. In
      patients with duodenal ulcer, maintenance therapy for preventing ulcer recurrence
      is not necessary because the rate of ulcer recurrence after eradication therapy
      is very low. However, in patients with gastric ulcer, the rate of ulcer relapse
      and reflux esophagitis ranges between 5-10% in the Japanese population even after
      successful eradication therapy; therefore, maintenance therapy for 1 year may be
      permissible in patients with gastric ulcer even after successful eradication
      therapy.

PMID- 11218406
TI  - [A strategy for second-line anti-Helicobacter pylori therapy in patients with
      previously failed treatment].
AB  - Highly effective H. pylori eradication therapies are currently used in Japan.
      However, eradication failures still appear in a considerable proportion of cases.
      In such refractory cases, several second-line eradication therapies and
      therapeutic efficacies have been only exceptionally studied. Our aims were to
      analyze the reasons and evaluate the second-line therapies when first-line
      eradication therapies fail. We make a strategy for second-line anti-H. pylori
      therapy in patients with previously failed treatment.

PMID- 11218408
TI  - [Occurrence of upper gastrointestinal tract disease after Helicobacter pylori
      eradication].
AB  - Helicobacter pylori (H. pylori) infection is recognized to be a pathogen of
      various gastro-duodenal disease. Eradication therapy of H. pylori reduces the
      recurrence of gastro-duodenal ulcer, improves gastritis histologicaly, and is
      suggested to act an certain role in protection against gastric carcinogenesis.
      Although, several studies show uncomfortable results arise after H. pylori
      infection was cured. These studies suggest that gastro-esophageal reflux disease
      (GERD) and gastro-doudenal erosion may increase after successful eradication of
      H. pylori. Recently, adenocarcinoma of the gastric cardia and esophagus increase
      in incidence. Reflux esophagitis and Barrett's esophagus are recognized as
      precancerous lesion of esophageal adenocarcinoma. It is uncertain the association
      of newly occurrence of GERD after H. pylori eradication and increase of
      esophageal adenocarcinoma. Although GERD may lead to adenocarcinoma, long term
      observations is necessary after H. pylori eradication.

PMID- 11218409
TI  - [Epidemiology and clinical role of childhood Helicobacter pylori infection].
AB  - Colonization of Helicobacter pylori depends on virulence factors of the organism,
      host factors and environmental factors. The prevalence of H. pylori differs
      between developing and Western developed countries, suggesting that the
      socioeconomic status influences the acquisition of the infection. The prevalence
      of Japanese children has been almost equal to that of Western countries. Although
      a main mode of transmission remains unclear, childhood is critical for
      acquisition of the infection. H. pylori causes gastritis (especially nodular
      gastritis) and duodenal ulcers in children but rarely gastric ulcers. No
      pediatric cases with H. pylori-associated gastric cancer have been reported.
      However, precancerous lesions including mucosal atrophy can develop in the
      infected children. Further studies in children are needed on strategy for H.
      pylori infection including prophylaxis of gastric cancer.

PMID- 11218410
TI  - [Gastric mucosal immunity induced by H. pylori infection].
AB  - H. pylori infection induces various humoral and cellular immunities in gastric
      mucosa. Some reports indicate predominant CD4+ cells infiltrate in H. pylori
      infected gastric mucosa, and these cells express the T helper 1 phenotype. Local
      humoral immunity is also induced. Gastric plasma cells produce anti-H. pylori
      antibodies, however, their protective immunity is not enough to eradicate
      bacteria in human. We found heat shock protein 60 kDa (hsp60) may be closely
      associated with pathogenesis in MALT lymphoma. IgG1 antibodies to hsp60 were
      significantly correlated with the antibodies to H. pylori whole cell in patients
      with MALT lymphoma. CD40-CD40L dependent B cell proliferation was induced by
      cytokine and/or hsp60 stimulations in those patients. Cytotoxicity of gastric
      epithelial cells which is associated with host immunity induced by H. pylori
      infection is still unclear. We found that lymphocytes from patients with peptic
      ulcer showed cytotoxicity to gastric cell line HGC-27 in vitro. Cytotoxicity was
      enhanced by cytokine stimulus to T-lymphocytes and by heat stress and/or
      patients' antibodies treatment of HGC-27 cells. The pathogenicity of H. pylori
      may involve not only bacterial virulence factor but also host immunity. Studies
      of mucosal local immunity will help explain the mechanisms of H. pylori induced
      gastrodoudenal diseases.

PMID- 11218411
TI  - [The role of Helicobacter pylori infection and effect of eradication in
      experimental animal models of gastric carcinogenesis].
AB  - Helicobacter pylori (Hp) was concluded to be 'a definite carcinogen' by WHO/IARC
      in 1994. We have demonstrated that Hp infection enhances chemical carcinogen
      induced stomach carcinogenesis in Mongolian gerbils (MGs) using N-methyl-N'-nitro
      N-nitrosoguanidine or N-methyl-N-nitrosourea. Not only well-differentiated but
      also poorly differentiated and signet ring cell types of cancers are observed,
      mimicking the human case. Eradication of Hp was found to be effective of
      preventing enhancing effects. Hp infection alone, without chemical carcinogens,
      caused submucosal proliferating lesions, but not gastric carcinomas, in contrast
      to reports that Hp infection alone may act on a complete carcinogen. Precise
      pathological assessment is required to solve this controversy. Here we
      demonstrate alleviation of Hp induced gastric lesions with eradication in MGs.

PMID- 11218412
TI  - [Treatment of gastric MALT lymphoma by H. pylori eradication].
AB  - Strong evidence exists for the efficacy of H. pylori eradication in achieving
      gastric low-grade MALT lymphoma (L-MALT) regression when the bacteria present.
      Besides histological evaluation, the appearance of endoscopic finding such as
      'discolored mucosa-like atrophy' after treatment may be useful for the prediction
      of its outcome (endoscopic evaluation). However, a reliable marker for molecular
      evaluation is not obtained so far. On the other hand, long-term control of L-MALT
      with H. pylori eradication therapy is uncertain and there still remains a subset
      of patients with no evidence of H. pylori or who fail H. pylori eradication
      therapy. Therefore, the optimal non antibiotic therapy for these patients has
      been studied. According to the recent report, radiation therapy appears to be
      well tolerated and effective for patients with gastric L-MALT.

PMID- 11218413
TI  - [Intestinal metaplasia and Helicobacter pylori infection, their relationship and
      effects of eradication therapy].
AB  - Intestinal metaplasia is characterized by Goblet cells and Peneth cells in
      histological examination. It is frequently observed in gastric mucosa with
      atrophic gastritis and easily diagnosed using Methylene blue stain in endoscopy.
      Intestinal metaplasia is seemed to occur during the progression of atrophic
      gastritis. From our prospective endoscopic follow-up study over 8 years,
      progression of intestinal metaplasia in gastric body is observed in 44.4% out of
      27 H. pylori positive patients. Progression of atrophy is also observed in 37.0%
      of cases. Development of intestinal metaplasia is also assured in other clinical
      investigations and experimental studies using Mongolian Gerbils. However,
      reversibility of intestinal metaplasia after H. pylori eradication is under
      discussion still now. In our study, we can not observe the regression of
      intestinal metaplasia even 2 years after successful H. pylori eradication.

PMID- 11218415
TI  - [The perspectives of upper GI tract diseases].
AB  - Recently, most of the upper GI tract diseases, peptic ulcer, chronic gastritis,
      gastric cancer as well as MALT lymphoma, have been explained by the infection of
      Helicobacter pylori (H. pylori). However, it is not evident whether or not
      gastric cancer is induced solely by the bacterial infection at this stage. On the
      other hand, it is reported that the eradication of H. pylori might evoke the
      reflux esophagitis as well as esophageal and fundic cancer. These important
      issues remain to be elucidated for the investigation of upper GI tract in the
      21st century. The development of new endoscopic technology may be another
      promising field of upper GI tract.

PMID- 11218414
TI  - [Mechanism of drug resistance in Helicobacter pylori].
AB  - Clarithromycin is one of the most important antibiotics for H. pylori
      eradication. However, 5-10% was reported to be resistant. It has been shown that
      one point mutation in the 23S rRNA gene is associated with resistance to
      clarithromycin. To detect H. pylori infection and the mutation simultaneously, we
      have designed PCR primers specific for H. pylori, and established assays of PCR
      RFLP and PCR-preferential homo-duplex formation (PHFA). Using this assay, we can
      detect mixed infections with wild and mutant-strains. The prevalence of mutant
      infection increased through clarithromycin-based eradication. However, the
      existence of mutant strains had been confirmed before therapy in most cases who
      'converted' to mutant after therapy. Metronidazole is also one of the most
      important antibiotics for eradication. However, 5-50% was reported to be
      resistant. It has been shown that rdx gene mutation is associated with
      resistance. It is reported that inactivation of the rdx gene is frequently, but
      not always, associated with resistance to metronidazole. Amoxicillin resistant
      strains were rare (1.2% in Japanese strains). It is reported that penicillin
      binding protein might play a role in the resistance. By detecting of the
      resistance based on the molecular mechanism, patients can be treated with
      adequate antibiotics with information about resistance.

PMID- 11218416
TI  - [The Cochrane Collaboration: the present and the future].
AB  - The Cochrane Collaboration has developed in response to the call for systematic,
      up-to-date reviews of all relevant randomized controlled trials (RCTs) of health
      care. Both evidence-based medicine (EBM) and the Cochrane Collaboration have been
      gaining attention of healthcare professionals in Japan recently. Ways for
      Japanese people to contribute to the Cochrane Collaboration are as follows:
      participating in a collaborative review group as a reviewer; increasing registry
      number of Japanese RCT articles; and Japanese translation of their outputs and
      its dissemination. Establishment of Japan Cochrane Center will integrate and
      promote the related activities. Furthermore, the positive recognitions for the
      Cochrane Collaboration and EBM among Japanese people can improve environments for
      conducting clinical trials and epidemiological studies in Japan.

PMID- 11218417
TI  - Demonstrating effectiveness of passive radon-resistant new construction.
AB  - Fifty percent of homes tested for radon in Rock Island County, IL, have radon
      levels above the U.S. Environmental Protection Agency (EPA) action guideline of 4
      picoCuries per liter (pCi/L) of air. Therefore, the county is classified by the
      EPA as Zone 1 on the EPA's Map of Radon Potential. Radon-resistant new
      construction (RRNC) strategies for new homes are recommended by the EPA in Zone 1
      areas. One city in the county, East Moline, reduced the cost of building permits
      for contractors volunteering to build new homes incorporating modified passive
      RRNC. Forty-six of 124 new homes built with passive RRNC in the city were tested
      during this study. Only 27 of the homes tested were below 4-pCi/L, justifying the
      importance of testing the system to ensure levels are below the action guideline.
      To provide additional support to an argument in favor of changing city building
      codes to the required RRNC, 23 of the homes were also tested with the systems
      deactivated. After systems were deactivated, 73% of the homes had radon levels
      above the action guideline. Four homes were sampled for bioaerosols to evaluate
      if passive RRNC might impact other indicators of poor indoor air quality (IAQ).
      The results of the research will be discussed here.

PMID- 11218418
TI  - Comparison of real-time instruments used to monitor airborne particulate matter.
AB  - Measurements collected using five real-time continuous airborne particle monitors
      were compared to measurements made using reference filter-based samplers at
      Bakersfield, CA, between December 2, 1998, and January 31, 1999. The purpose of
      this analysis was to evaluate the suitability of each instrument for use in a
      real-time continuous monitoring network designed to measure the mass of airborne
      particles with an aerodynamic diam less than 2.5 microns (PM2.5) under wintertime
      conditions in the southern San Joaquin Valley. Measurements of airborne
      particulate mass made with a beta attenuation monitor (BAM), an integrating
      nephelometer, and a continuous aerosol mass monitor (CAMM) were found to
      correlate well with reference measurements made with a filter-based sampler. A
      Dusttrak aerosol sampler overestimated airborne particle concentrations by a
      factor of approximately 3 throughout the study. Measurements of airborne
      particulate matter made with a tapered element oscillating microbalance (TEOM)
      were found to be lower than the reference filter-based measurements by an amount
      approximately equal to the concentration of NH4NO3 observed to be present in the
      airborne particles. The performance of the Dusttrak sampler and the integrating
      nephelometer was affected by the size distribution of airborne particulate
      matter. The performance of the BAM, the integrating nephelometer, the CAMM, the
      Dusttrak sampler, and the TEOM was not strongly affected by temperature, relative
      humidity, wind speed, or wind direction within the range of conditions
      encountered in the current study. Based on instrument performance, the BAM, the
      integrating nephelometer, and the CAMM appear to be suitable candidates for
      deployment in a real-time continuous PM2.5 monitoring network in central
      California for the range of winter conditions and aerosol composition encountered
      during the study.

PMID- 11218419
TI  - Oxidation of gas mixtures containing dimethyl sulfide, hydrogen sulfide, and
      methanethiol using a two-stage biotrickling filter.
AB  - A biofiltration technique was developed for removing a mixture of hydrogen
      sulfide (H2S), methanethiol (MeSH), and dimethyl sulfide (Me2S) from waste gases.
      Since H2S, especially at high concentrations, disturbs the removal of Me2S, two
      biotrickling filters with different microbes and operating pH levels were
      connected in series to create a two-stage system. Different loads of these gases
      were studied in order to determine their impact on the removal capacity of the
      system. The microbial consortia for these filters were enriched from the sludge
      of a Finnish refinery with bubbling H2S or Me2S. Acclimation for Me2S took 2
      weeks, though no acclimation time was needed for the other gases. The first
      filter, at a pH of 2, removed most of the H2S and some of the MeSH and Me2S. The
      second filter, at a pH of approximately 6.5, removed the rest of the MeSH and
      most of the Me2S. The total maximum loads of the whole two-stage biotrickling
      filter were 1150 g/m3/day for H2S-S (suffix S indicates the results are counted
      as sulfur amounts), 879 g/m3/day for Me2S-S, and 66 g/m3/day for MeSH-S treated
      in a gas mixture. The average removal efficiencies for all gases tested were 99%
      or higher.

PMID- 11218420
TI  - Observations and model simulations of carbon monoxide emission factors from a
      California highway.
AB  - A series of twelve intensively monitored 1-hr CO dispersion studies were
      conducted near Davis, CA, in winter 1996. The experimental equipment included
      twelve CO sampling ports at elevations up to 50 m, three sonic anemometers, a
      tethersonde station, aircraft measurements of wind and temperature profile aloft,
      and a variety of conventional meteorological equipment. The study was designed to
      explore the role of vehicular exhaust buoyancy during worst-case meteorological
      conditions, such as low winds oriented in near-parallel alignment with the road
      during a surface-based nocturnal inversion. From the study, field estimates of
      the CO emission factor (EF) from a California vehicle fleet were computed using
      two different methods. The analysis suggests that the CT-EMFAC/EMFAC (EMission
      FACtor) models currently used to conduct federal conformity modeling
      significantly overpredict CO emissions for high-speed, free-flowing traffic on
      California highways.

PMID- 11218421
TI  - Personal exposure levels and microenvironmental concentrations of formaldehyde
      and acetaldehyde in the Helsinki metropolitan area, Finland.
AB  - Personal 48-hr exposures to formaldehyde and acetaldehyde of 15 randomly selected
      participants were measured during the summer/autumn of 1997 using Sep-Pak DNPH
      Silica cartridges as a part of the EXPOLIS study in Helsinki, Finland. In
      addition to personal exposures, simultaneous measurements of microenvironmental
      concentrations were conducted at each participant's residence (indoor and
      outdoor) and workplace. Mean personal exposure levels were 21.4 ppb for
      formaldehyde and 7.9 ppb for acetaldehyde. Personal exposures were systematically
      lower than indoor residential concentrations for both compounds, and ambient air
      concentrations were lower than both indoor residential concentrations and
      personal exposure levels. Mean workplace concentrations of both compounds were
      lower than mean indoor residential concentrations. Correlation between personal
      exposures and indoor residential concentrations was statistically significant for
      both compounds. This indicated that indoor residential concentrations of
      formaldehyde and acetaldehyde are a better estimate of personal exposures than
      are concentrations in ambient air. In addition, a time-weighted exposure model
      did not improve the estimation of personal exposures above that obtained using
      indoor residential concentrations as a surrogate for personal exposures.
      Correlation between formaldehyde and acetaldehyde was statistically significant
      in outdoor microenvironments, suggesting that both compounds have similar sources
      and sinks in ambient urban air.

PMID- 11218422
TI  - Semi-volatile species in PM2.5: comparison of integrated and continuous samplers
      for PM2.5 research or monitoring.
AB  - Fine particles in urban atmospheres contain substantial quantities of semi
      volatile material [e.g., NH4NO3 and semi-volatile organic compounds (SVOCs)] that
      are lost from particles during collection on a filter. Several diffusion denuder
      samplers have been developed for the determination of both NO3- and organic semi
      volatile fine particulate components. The combination of technology used in the
      BOSS diffusion denuder sampler and the Harvard particle concentrator has resulted
      in the Particle Concentrator-Brigham Young University Organic Sampling System (PC
      BOSS) for the 24-hr (or less) integrated collection of PM2.5, including NH4NO3
      and semi-volatile organic material. Modification of the BOSS sampler allows for
      the weekly determination of these same species. Combination of BOSS denuder and
      tapered element oscillating microbalance (TEOM) monitor technology has resulted
      in the real-time ambient mass sampler (RAMS) for the continuous measurement of
      PM2.5, including the semi-volatile components. Comparison of the results obtained
      with the BOSS and with each of the newly developed modifications of the BOSS
      indicates that the modified versions can be used for the continuous, daily, or
      weekly monitoring of PM2.5, including semi-volatile species, as appropriate to
      the design of each sampler.

PMID- 11218423
TI  - Assessment of opacimeter calibration according to International Standard
      Organization 10155.
AB  - This paper compares the calibration method for opacimeters issued by the
      International Standard Organization (ISO) 10155 with the manual reference method
      for determination of dust content in stack gases. ISO 10155 requires at least
      nine operational measurements, corresponding to three operational measurements
      per each dust emission range within the stack. The procedure is assessed by
      comparison with previous calibration methods for opacimeters using only two
      operational measurements from a set of measurements made at stacks from pulp
      mills. The results show that even if the international standard for opacimeter
      calibration requires that the calibration curve is to be obtained using 3 x 3
      points, a calibration curve derived using 3 points could be, at times, acceptable
      in statistical terms, provided that the amplitude of individual measurements is
      low.

PMID- 11218424
TI  - An assessment of the impact of California's Phase 2 Reformulated Gasoline on
      ozone air quality.
AB  - California's Phase 2 Reformulated Gasoline (CaRFG), introduced early in 1996,
      represents an important step toward attainment of ozone standards. Studies of
      vehicle emissions and ambient air quality data have reported substantial
      reductions of ozone precursors due to CaRFG. This study uses daily measurements
      of regional ozone and meteorology to estimate the effect of CaRFG on ozone
      concentrations in three areas of California. In each area, a regression model was
      used to partially account for the daily effects of meteorology on area-wide ozone
      maxima for May-October. The statistical models are based on combinations of air
      temperature aloft (approximately 5000 ft), surface air temperatures, and surface
      wind speeds. Estimated ozone benefits were attributed to CaRFG after accounting
      for meteorology, which improved the precision of the estimates by approximately
      37-57% based on a resampling analysis. The ozone benefits were calculated as the
      difference in ozone times the proportion of the reductions of hydrocarbons and
      nitrogen oxides attributed to CaRFG by the best available emission inventories.
      Ozone benefits attributed to CaRFG (with approximately 90% confidence) are 8-13%
      in the Los Angeles area, -2-6% in the San Francisco Bay area overall with greater
      benefits in two major subregions, and 3-15% in the Sacramento area.

PMID- 11218425
TI  - Theory and laboratory study of a tall passive chamber for measuring gas fluxes at
      soil surface.
AB  - A tall passive flux chamber with a height significantly greater than its
      horizontal dimensions is proposed for measuring fluxes of volatile organic
      compounds (VOCs) at the soil surface. The main feature of this tall chamber is
      the presence of a vertical concentration gradient of the target gas in the
      chamber. The emission and transport behavior of the target gas in the soil
      chamber system are analyzed using the diffusion theory. A mathematical model is
      developed to estimate the flux from the soil into the tall chamber, providing the
      target gas establishes a detectable vertical concentration gradient in the
      chamber. To obtain the data required for calculating flux, only two gas
      concentrations (C1 and C2) at two heights (h1 and h2) within the chamber need to
      be measured at the end of a short chamber placement time (tp). To evaluate the
      applicability of the tall chamber for measuring flux, several laboratory tests
      have been conducted, using CH2Cl2 and CH3Br as the target gases. The results
      indicate that the proposed tall chamber has promising potential as a method for
      measuring fluxes of VOCs at the soil surface.

PMID- 11218426
TI  - The MMT bag for emission source sampling: design and evaluation.
AB  - This paper presents the design and evaluation results for a metal-coated
      multilayer Tedlar (MMT) bag that was developed for the collection of source
      emissions. The applicability of the MMT bag was evaluated for a number of
      important greenhouse relevant gases: CO, CO2, CH4, N2O, and total hydrocarbons
      (THCs). The bag was tested for durability and stability for a range of
      concentrations of the tested compounds using both laboratory-prepared samples and
      real source samples. The results show that all tested compounds were more stable
      when stored in the MMT bag than when stored in a regular Tedlar bag. These
      compounds can be stored at room temperature for at least 3 months without
      significant changes in concentration. When properly packed, the MMT bag is
      durable and may be shipped by air. The MMT bag is lower in cost, lighter in
      weight, and easier to clean, and it requires less devices during the subsequent
      laboratory analysis compared with a stainless steel canister, which is often used
      to collect air and source samples.

PMID- 11218427
TI  - Analysis of moisture findings in the interior spaces of Finnish housing stock.
AB  - A grading system was developed to rate the moisture damage profile of dwellings
      and to study the relationship between moisture-induced indoor air problems and
      occupant health. A total of 630 randomly selected houses and apartments, built
      between 1950 and 1989, were visually inspected. Moisture observations were
      standardized into three damage levels. Thus, a system to classify the homes into
      three grades was devised. The two grades of homes associated with the highest
      levels of damage were graded as index homes. Overall, 51% of the sample had some
      kind of moisture fault in them and one in every three homes (33%) was classified
      as an index home. The mean number of damage incidents in the index dwellings
      varied from 1.4 to 2.6. The mean number of damage incidents in the reference
      homes was 0.28. Prevalence of index dwellings was significantly higher (p < 0.01)
      in houses (38%) than in apartments (26%). There was no major difference in the
      prevalence of index buildings in houses built in any particular decade (30-35%).
      Moisture was observed in 28% of bathrooms, in 10% of kitchens, and in 17% of
      other spaces. Indoor relative humidity (RH) levels were low in most homes.

PMID- 11218428
TI  - A procedure for use in estimating human exposure to particulate matter of ambient
      origin.
AB  - Modern epidemiology has shown that fluctuations of mortality data are
      statistically significantly correlated with fluctuations of ambient particulate
      matter (PM) concentration data. This relation cannot be confounded by exposure to
      PM of indoor origin because the concentrations of ambient PM are not correlated
      with concentrations of PM of indoor origin. It has been suggested, given the
      above understanding, that modern PM exposure measurements and analysis should
      create separate estimates of exposure to all PM of ambient origin and exposure to
      all PM of nonambient origin (primarily of indoor origin), and not exposure to
      total PM. This paper reviews the developments of the form of the general
      microenvironmental mass balance equation that can be utilized for estimating
      human exposure to PM of ambient origin and for estimating the portion of total PM
      exposure that is attributable to nonambient origin PM. The equation is perfectly
      general and can be applied to conditions of time-varying factors that influence
      exposure, such as rapidly changing air-exchange rates in a home as doors and
      windows are opened and closed, and turning on and off air cleaners in a home. It
      is suggested that this procedure be applied in exposure assessment studies and
      validated using independent techniques of estimating exposure to PM of ambient
      origin available in the literature.

PMID- 11218430
TI  - Forecasting generation of urban solid waste in developing countries--a case study
      in Mexico.
AB  - Based on a study of the composition of urban solid waste (USW) and of
      socioeconomic variables in Morelia, Mexico, generation rates were estimated. In
      addition, the generation of residential solid waste (RSW) and nonresidential
      solid waste (NRSW) was forecasted by means of a multiple linear regression (MLR)
      analysis. For residential sources, the independent variables analyzed were
      monthly wages, persons per dwelling, age, and educational level of the heads of
      the household. For nonresidential sources, variables analyzed were number of
      employees, area of facilities, number of working days, and working hours per day.
      The forecasted values for residential waste were similar to those observed. This
      approach may be applied to areas in which available data are scarce, and in which
      there is an urgent need for the planning of adequate management of USW.

PMID- 11218429
TI  - Development and performance of an alternative biofilter system.
AB  - Step tracer tests were carried out on lab-scale biofilters to determine the
      residence time distributions (RTDs) of gases passing through two types of
      biofilters: a standard biofilter with vertical gas flow and a modified biofilter
      with horizontal gas flow. Results were used to define the flow patterns in the
      reactors. "Non-ideal flow" indicates that the flow reactors did not behave like
      either type of ideal reactor: the perfectly stirred reactor [often called a
      "continuously stirred tank reactor" (CSTR)] or the plug-flow reactor. The
      horizontal biofilter with back-mixing was able to accommodate a shorter residence
      time without the usual requirement of greater biofilter surface area for
      increased biofiltration efficiency. Experimental results indicated that the first
      bed of the modified biofilter behaved like two CSTRs in series, while the second
      bed may be represented by two or three CSTRs in series. Because of the flow
      baffles used in the horizontal biofilter system, its performance was more similar
      to completely mixed systems, and hence, it could not be modeled as a plug-flow
      reactor. For the standard biofilter, the number of CSTRs was found to be between
      2 and 9 depending on the airflow rate. In terms of NH3 removal efficiency and
      elimination capacity, the standard biofilter was not as good as the modified
      system; moreover, the second bed of the modified biofilter exhibited greater
      removal efficiency than the first bed. The elimination rate increased as
      biofilter load increased. An opposite trend was exhibited with respect to removal
      efficiency.

PMID- 11218431
TI  - Measurements of sulfur dioxide and formaldehyde in Taipei using a differential
      optical absorption spectrometer.
AB  - Taipei, the capital city of Taiwan, lies in a basin, and its topography prevents
      the dispersion of pollutants in the city. As a continuation of our air quality
      study, from February 1999 through June 1999, we measured the concentrations of
      SO2 at six different locations and of formaldehyde at five locations using a
      differential optical absorption spectrometer (DOAS). The average concentration of
      SO2 varied from 3.5 to 6.6 ppb. The average concentration was highest at Toucheng
      because of its proximity to point sources. The level in Hsientien was close to
      that in Toucheng, with Hsinyu showing the lowest concentrations. The DOAS and the
      Taiwan Air Quality Monitoring Network (TAQMN) measurements for SO2 were highly
      correlated (r2 > 0.9) for Toucheng, Panchiao, and Hsientien. However, DOAS SO2
      concentrations were 2 times higher for Hsientien and slightly lower for Panchiao
      than the TAQMN concentrations were. The average concentration of formaldehyde
      varied from 7 to 10 ppb. Diurnal variation of formaldehyde closely followed the
      variation of ozone, especially when the 1-hr peak ozone concentration was > 60
      ppb. Photochemical formation accounted for the ambient levels of formaldehyde in
      Taipei. Concentration of formaldehyde became significant on days when O3
      concentration was high. Our results indicate that DOAS can replace conventional
      measurement techniques.

PMID- 11218432
TI  - The early management of the burn wound and observations on hypertrophic scarring.
      With special reference to the deep dermal level and hypertrophic scarring.
AB  - Much confusion about the management of the burn wound still exists in many a
      clinician's mind. This is an attempt to clarify the problem and create a better
      understanding of the importance of assessing the various depths of penetration of
      the thermal agent. The treatment varies from the use of minimal bland dressings
      left undisturbed to aggressive early tangential excision and skin grafting. This
      is discussed together with the rationale for this approach and some problems
      associated with it. A 'critical depth' of penetration at the deep dermal level,
      which spares the acini of the sweat glands, is suggested as the factor initiating
      later development of hypertrophic scarring. This can be prevented by early
      excision and skin grafting.

PMID- 11218433
TI  - Post-decompression gallbladder haemorrhage in obstructive jaundice. A report of 2
      cases.
AB  - Two cases of massive haemorrhage from the gallbladder in patients suffering from
      common bile duct obstruction are described. Sudden operative decompression of the
      massively distended gallbladder was the probable cause of the bleeding.

PMID- 11218434
TI  - Uterine actinomycosis associated with an enterocutaneous fistula. A case report.
AB  - A postmenopausal woman with suppurative actinomycotic uterine infection
      complicated by an enterocutaneous fistula is reported. It occurred against a
      background of prolonged use of an intra-uterine contraceptive device.

PMID- 11218435
TI  - Abdominal tuberculosis. A report of 3 cases.
AB  - Three patients admitted to the surgical wards of Johannesburg Hospital in whom
      abdominal tuberculosis was suspected are presented. In every case difficulties
      were encountered in diagnosis and treatment. Each case presentation is followed
      by a short commentary on relevant aspects of abdominal tuberculosis.

PMID- 11218436
TI  - Candidiasis in an intensive care unit.

PMID- 11218437
TI  - GP anaesthetists.

PMID- 11218438
TI  - Do abnormal hemipelvic bone stresses contribute to loosening and migration of
      screw-threaded cups?
AB  - Excellent long-term results have been reported with the Charnley low-friction
      arthroplasty. Failure of the cemented acetabular component has been identified as
      a problem in the longer term, while cemented hip replacements in active young
      patients have exhibited a disconcerting incidence of early clinical or
      radiological failure. This resulted in the development of the cementless
      arthroplasty. Bone responds favourably to an optimal stress window and reacts
      dynamically to metal implants that have a greatly differing modulus of
      elasticity. This study represents a comparative qualitative analysis of the peri
      acetabular hemipelvic stresses after loading two cementless (press-fit and screw
      threaded) acetabular components inserted into identical bone models. A simplified
      model of the artificial hip joint was constructed and the very sensitive stress
      analysis technique of holographic interferometry was used for the investigation.
      Peri-acetabular stress concentrations were noted with the screw-threaded cup.
      This may predispose to bone resorption and it is suggested that these could be
      implicated in the migration of these cups described in published reports.

PMID- 11218439
TI  - Humidification in intensive care.
AB  - The normal physiological function of the upper respiratory tract is to filter and
      humidify inspired air. In intensive care units the upper respiratory tract is
      frequently bypassed. The importance of humidifying and warming the dry, cold,
      piped gas is well documented. The results of lack of adequate humidification
      include endotracheal tube obstruction, impairment of the mucociliary elevator and
      altered pulmonary function. Optimal levels of humidification are as yet undefined
      and useful clinical markers of adequate humidification are not available. As a
      result there is a bewildering array of humidification devices available at
      present, the most recent of which are heat and moisture exchangers with or
      without specific filtration properties. This article reviews available data on
      these humidification devices, and recommends an approach to their appropriate
      use, based on the probable physiological needs of individual patients.

PMID- 11218440
TI  - Tension pneumoperitoneum aggravating respiratory failure. A case report.
AB  - A case of tension pneumoperitoneum secondary to barotrauma is reported. Any
      patient needing high pressures for ventilation and oxygenation is prone to this
      complication. The important respiratory and haemodynamic implications are
      discussed. It is suggested that drainage of a tension pneumoperitoneum is easy
      and safe and has major beneficial effects on the respiratory and cardiovascular
      systems.

PMID- 11218441
TI  - Esmolol in a case of severe tetanus. Adequate haemodynamic control achieved
      despite markedly elevated catecholamine levels.
AB  - A patient with severe tetanus, who had a sympathetic crisis while sedated with 30
      mg/h diazepam and 30 mg/h morphine, is described. Satisfactory control of the
      haemodynamic crisis was achieved with bolus doses of esmolol to a total of 180
      mg. A disturbing finding was that although there was adequate control of the
      tachycardia and hypertension, arterial catecholamine levels remained markedly
      elevated. Adrenaline levels of 531 pg/ml (normal 10-110 pg/ml) and noradrenaline
      levels of 1,036 pg/ml (normal 100-500 pg/ml) were recorded when the patient had a
      systolic arterial pressure of 110 mmHg and a heart rate of 97/min. The
      implications of this finding are discussed.

PMID- 11218442
TI  - The Department of Surgery, Baragwanath Hospital--the early days.

PMID- 11218443
TI  - Traumatic haemothorax--experience of a protocol for rapid turnover in 1,845
      cases.
AB  - Incomplete or prolonged drainage of the pleural cavity for haemothorax may lead
      to the development of empyema, with long-term morbidity. Using a protocol based
      on vigorous physiotherapy and early withdrawal of the thoracostomy tube (average
      drainage time 27.1 hours), hospital stay in 1,845 patients with traumatic
      haemothorax was 48 hours or less in 81.8% of patients. In all, 152 haemothorax
      patients (8.1%) required either early or late thoracotomy, 46 of which were for
      associated cardiac injury. Prophylactic antibiotics were not given routinely.
      Severe complications occurred in 40 patients (2.2%); 15 developed empyema (0.8%)
      and 25 died (1.4%), mainly from ongoing haemorrhage. The early identification of
      patients needing operative or other intervention minimises the hospital stay and
      complications associated with residual blood in the pleural cavity. This study
      shows that the short-period drainage protocol used gives very acceptable results
      in the treatment of traumatic haemothorax.

PMID- 11218445
TI  - Forensic dentistry: a process of elimination.

PMID- 11218444
TI  - Carcinoma of the head of the pancreas. Morbidity and mortality of surgical
      procedures.
AB  - This retrospective study analyses the peri-operative morbidity and mortality of
      165 patients presenting with carcinoma of the head of the pancreas over a 5-year
      period. Patients clinically fit for surgery (84%) were subdivided into three main
      groups, namely: group I (6%) underwent pancreaticoduodenal resection; group II
      (42%) had locoregionally advanced disease; and group III (36%) with metastatic
      disease. The latter group was subdivided into groups IIIa (22%) without ascites
      and IIIb (14%) with ascites. In the palliative groups (II and III), 61% underwent
      operative biliary drainage procedures, 33% a combined biliary drainage and a
      duodenal bypass procedure and 5% a duodenal bypass only. Obstructive jaundice
      recurred in 3% of cases after operative biliary drainage. Only 7% of patients
      required a duodenal bypass during follow-up. The mortality rates after surgery
      were 22% following pancreaticoduodenectomy (group I), 1.5% for the palliative
      procedures in group II, but 17% in group IIIa patients with metastatic disease
      without ascites and 83% when ascites was present (group IIIb). This study
      demonstrates that patients with ascites, although clinically fit for surgery, had
      a prohibitively high operative mortality rate and represented a subgroup of
      patients better treated by non-operative methods. Surgical drainage of the
      biliary system in all other cases had acceptably low morbidity and mortality
      rates. A prophylactic duodenal bypass is not mandatory.

PMID- 11218446
TI  - Dental infection control at the year 2000. Accomplishment recognized.
AB  - OVERVIEW: Health care providers have strived to address the many elements
      necessary to achieve effective infection control. Historical progress in
      microbiology and hospital asepsis provided the foundation for advances in dental
      preventive practices. Evidence supporting the application of current practices
      includes a long history of scientific and clinical investigations, technological
      advances in equipment and materials, and periodic publication of updated
      recommendations by professional health care organizations. CLINICAL IMPLICATIONS:
      The routine application of precautions such as multiple aseptic procedures, latex
      gloves, masks, protective eyewear, clinic coats, automated instrument
      decontamination devices, time-efficient heat sterilization modalities, chemical
      disinfectants, waste management procedures and single-use disposable items have
      created a safer environment for dental personnel and patients alike.

PMID- 11218447
TI  - 10 steps to shape your future.

PMID- 11218448
TI  - Rx to adjust to change.

PMID- 11218449
TI  - Chips.

PMID- 11218450
TI  - Corporate dentistry--a 2020 vision.

PMID- 11218451
TI  - Antimycotic agents in oral candidosis: an overview: 2. Treatment of oral
      candidosis.
AB  - As both humans and fungi are eukaryotic organisms, antifungal agents affect their
      cellular metabolism. Thus, a relatively few antifungals with minimal toxicity and
      side-effects are available compared with a plethora of antibacterials. These
      agents currently prescribed in dentistry belong to two major groups, the polyenes
      (nystatin and amphotericin B) and the azoles (imidazoles and triazoles). A newly
      recognized phenomenon known as the post-antifungal effect implies that
      antifungals, even at sub-therapeutic concentrations, may suppress the virulent
      attributes of yeasts, especially intra-orally where topical drug levels fluctuate
      dramatically during dosing intervals.

PMID- 11218452
TI  - Investigation and treatment of patients with teeth affected by tooth substance
      loss: a review.
AB  - Tooth substance loss, an increasing problem, may result from erosion, abrasion
      and attrition, often with more than one of these acting together. Investigation
      requires a detailed history and examination. The aim of treatment may be
      prevention of further damage in less affected cases. The treatment of severe
      tooth substance loss may be complex, especially in view of the reduced amounts of
      tooth substance which may be available and the need to find space because of the
      compensatory over-eruption of worn teeth.

PMID- 11218453
TI  - A synopsis of the adult dental health survey: oral health in the United Kingdom
      1998.

PMID- 11218454
TI  - Extensive temporal bone pneumatization: incidental finding in a patient with TMJ
      dysfunction.
AB  - An 18-year-old male presented with symptoms of temporomandibular joint
      dysfunction. A panoramic radiograph revealed slight erosion of the condylar
      heads, and an incidental finding of multilocular radiolucencies in the zygomatic
      processes of the right and left temporal bones. CT scans were undertaken to
      exclude any sinister cause. The radiolucencies were shown to be extensive
      bilateral pneumatization of the temporal bones. Conservative management relieved
      the symptoms of TMJ dysfunction.

PMID- 11218455
TI  - Oral midazolam for adults with learning disabilities.
AB  - This paper demonstrates how oral midazolam can be employed as an alternative
      method of behaviour management to general anaesthesia for the dental treatment of
      people with learning disabilities. A range of treatments, from scaling to root
      canal therapy, can be carried out successfully using the sedation technique
      outlined. The advantages of sedation include reduced morbidity and mortality.
      Treatment outcomes are also likely to be improved as root canal therapy and
      periodontal care can be carried out over a number of visits rather than a single
      treatment session under general anaesthesia. Oral sedation with midazolam should
      improve the scope of dental treatment available to patients with disabilities.

PMID- 11218456
TI  - Enamel microabrasion.
AB  - A significant number of patients complain of discoloured teeth. The enamel
      microabrasion technique described in this article is a simple conservative method
      for improving the appearance of discoloured enamel.

PMID- 11218457
TI  - The use of hypnosis in dentistry: a review.
AB  - Hypnosis is a valuable technique in patient management. With appropriate
      training, general dental practitioners can widen the treatment options they can
      offer to patients, especially those who are dentally anxious. This article
      provides a brief theoretical and historical overview, and a review of the
      literature pertaining to the clinical uses of hypnosis in dentistry.

PMID- 11218458
TI  - First response.

PMID- 11218459
TI  - Walmsley's Web Watch.

PMID- 11218460
TI  - Sex and dentistry.

PMID- 11218461
TI  - The Lifelong Learning Scheme.

PMID- 11218462
TI  - Immediate anterior tooth replacement using fibre-reinforced composite.
AB  - The loss of anterior teeth can be psychologically and socially damaging to the
      patient the trauma of which can be minimized by immediate replacement of the
      teeth, preferably using a fixed prosthesis. This paper describes the immediate
      replacement of a lateral incisor using a fibre-reinforced composite with the
      natural tooth as the pontic. The abutment teeth can be conserved with minimal or
      no preparation, thus keeping the technique reversible, and can be completed at
      the chairside thereby avoiding laboratory costs. It can be used as an interim
      measure or as a definitive prosthesis. The advantages of this technique over
      other methods are also discussed.

PMID- 11218464
TI  - Periodontal splinting in general dental practice.
AB  - Splinting periodontally involved teeth is a technique that has been in use for
      centuries. This article gives a brief history and review of the literature
      concerning periodontal splinting and outlines the rationale and indications for
      the correct application of periodontal splinting in modern dental practice. The
      common types of splint and clinical techniques involved are described, addressing
      some of the clinical problems.

PMID- 11218463
TI  - Dentine caries: take it or leave it?
AB  - In modern dentistry the primary aim when excavating carious dentine is to
      eradicate only the highly infected, irreversibly demineralized and denatured
      biomass in order to allow effective restoration of the cavity, restoration of the
      surface anatomy of the tooth and to prevent disease progression. However, the
      boundary between this superficial zone of dentine requiring excavation and the
      deeper, affected but repairable tissue is not always obvious either in the clinic
      or in the research laboratory. The inherent subjectivity in detecting this
      excavation boundary can result in clinically significant differences in the
      quality and quantity of dentine removed by different operators and makes the in
      vitro comparison of newer excavation techniques more difficult. This article
      discusses the rationale behind carious dentine excavation and the criteria
      available to the dentist, both clinical and laboratory, to help identify the
      dentine requiring removal.

PMID- 11218466
TI  - Transcultural oral health care and the Chinese--an invisible community.
AB  - The Chinese, a 'silent minority', are the most scattered, but neglected,
      community in the UK. Most dentists will have at least a few Chinese people in
      their community. This paper describes the health beliefs, dental knowledge,
      attitudes and behaviours of the Chinese. Implications for general dental
      practitioners are discussed.

PMID- 11218467
TI  - Presentation of case reports.

PMID- 11218465
TI  - Oral cancer: 2. Clinical presentation and use of new knowledge about the biology
      of cancer to establish why tumours may recur.
AB  - This article describes the clinical presentations of oral cancer, and the
      development of a new generation of ultra-sensitive diagnostics to identify occult
      tumour and precancer, despite seemingly adequate treatment.

PMID- 11218468
TI  - Thrombophilia and dental surgery: a report of dental extraction in a patient with
      protein S deficiency.
AB  - Most patients with thrombophilia are asymptomatic. A case is presented here of a
      young woman with protein S deficiency, one of the thrombophilias, who required
      dental extraction. Protein S deficiency predisposes a very small number of those
      affected to life-threatening thromboses and emboli, for which they are required
      to take lifelong prophylactic anticoagulation. This report emphasizes the need to
      liaise closely with haematology departments when deciding whether heparinization
      is required for patients already taking warfarin. The role of low-molecular
      weight heparins is highlighted, a brief review of thrombophilia is given and the
      management of patients who are taking warfarin and need dental surgery is
      discussed.

PMID- 11218469
TI  - Name changes of drugs.

PMID- 11218470
TI  - A forgotten entity: 'broken needle while administering inferior dental block'.

PMID- 11218471
TI  - The atraumatic restorative treatment (ART) technique: does it have a place in
      everyday practice?

PMID- 11218472
TI  - C4 dispatches.

PMID- 11218473
TI  - Medical emergencies in the dental office.

PMID- 11218474
TI  - Dry mouth symptoms of Sjogren's syndrome.

PMID- 11218475
TI  - Latex allergy: ignorance and avoidance are not bliss.

PMID- 11218476
TI  - ADAA's answers to the most frequently asked questions about dental assisting
      professionalism. Interview by Jennifer Blake.

PMID- 11218477
TI  - A pat on the back?

PMID- 11218478
TI  - The occlusal management of maxillary anterior single-unit implant-supported
      restorations.
AB  - This paper, with the aid of clinical examples, highlights some of the common
      occlusal problems that can be associated with maxillary anterior single-unit
      implant-supported restorations. The authors stress the importance of thorough pre
      operative planning to identify any likely occlusal problems. This allows patients
      to be fully informed of the impact of any necessary clinical compromise and of
      the need for and nature of modifications to the natural dentition.

PMID- 11218479
TI  - Take two dentists: a tale of root caries.
AB  - Take two dentists, whose practices are about as different as they could possibly
      be, who both have a healthy respect for root caries. Our paper will start by
      describing these two practices and then review the literature to show what is
      known about the management of root caries. The paper ends by returning to the two
      dentists, who describe how the research reviewed in the literature may affect
      their work.

PMID- 11218480
TI  - An oral 'follicular' choristoma presenting in the anterior floor of the mouth.
AB  - A 46-year-old Asian man presented with hair growing from the anterior floor of
      his mouth. The diagnosis of this lesion was an oral choristoma of a 'follicular'
      variety. A choristoma is defined as an overgrowth of normal tissue at an abnormal
      site. Only one other case of this particular lesion has been reported to date.
      This article proposes mechanisms as to the aetiology of this lesion, and its
      inclusion in the classification of oral choristomas.

PMID- 11218481
TI  - Forget the sailboard--let's go whiteboarding!
AB  - This paper describes the electronic whiteboard, and discusses its potential as a
      clinical communication tool and its possible use in dental education.

PMID- 11218482
TI  - Oral cancer: 1. The genetic basis of the disease.
AB  - This article is in two parts. The first describes recent advances in our
      understanding of the biology of oral cancer and the potential to utilize this new
      information to make better predictions about outcome and devise new treatments.
      The second part describes the clinical presentation and the development of a new
      generation of ultra-sensitive diagnostics to identify occult tumour and
      precancer, to investigate why cancer may recur.

PMID- 11218483
TI  - The orthodontic restorative management of the peg-lateral.
AB  - There are usually two orthodontic options in dealing with the peg-lateral. First,
      the lateral incisor can be extracted and the resultant space closed. However,
      this will often give a narrow unaesthetic smile. The canine is too yellow and the
      gingival margin is too high. The second, preferred, option is often to open the
      space mesial and distal to the peg-lateral and create a proper space for a normal
      sized lateral incisor. The restorative dentist has to build up the peg-lateral to
      simulate a normal-sized lateral incisor.

PMID- 11218484
TI  - Walmsley's Web watch.
AB  - The ADEE site serves as a portal to other educational sites around the world. The
      address can be book-marked and used as a focus to explore and use the Web in a
      constructive way without becoming overwhelmed with the large amount of
      information that is present. There are, of course, many other sites that act as a
      resource and contain links to other web pages. This site is simple to use,
      contains links to web pages that are of high quality and will prove useful to
      people wishing to update their current knowledge.

PMID- 11218485
TI  - A fresh look at effective telephone screening. Part 2: Handling specific types of
      calls.

PMID- 11218486
TI  - Surface barriers.

PMID- 11218487
TI  - How dental assistants can avoid common problems found in panoramic images.

PMID- 11218488
TI  - A 2-year clinical study of composite and ceramic inlays.
AB  - Objective long-term clinical data are necessary to evaluate the performance of
      dental restorations. This prospective clinical trial evaluated composite and
      ceramic inlays for clinical acceptability as restorative materials in posterior
      teeth and provided 2-year results. The study involved 7 student operators placing
      47 composite inlays (Tetric, blend-a-lux, Pertac) and 24 ceramic inlays (Empress)
      under the supervision of an experienced dentist. Clinical assessment of 56 inlays
      (78.9%) was performed after 2 years with modified USPHS criteria and
      statistically analyzed using the Mann-Whitney U test and Fisher's exact test. All
      the ceramic inlays and 90% of the composite inlays were considered clinically
      excellent or acceptable. During the first year 3 composite inlays failed and
      during the second evaluation period 1 had to be replaced. Ceramic inlays produced
      significantly better "anatomic form of the surface" (P = 0.038) and "integrity of
      the restoration" values (P = 0.043). Inlays in small cavities exhibited superior
      "marginal integrity" (P = 0.026) and "marginal discoloration" values (P = 0.034).
      Fisher's test revealed a significantly higher failure rate in molars than in
      bicuspids (P = 0.034). Posterior tooth-colored inlays exhibited a success rate of
      100% for ceramic inlays and 90% for composite inlays even if placed by relatively
      inexperienced but supervised student operators.

PMID- 11218489
TI  - Retrospective clinical study and survival analysis on partial ceramic crowns:
      results up to 7 years.
AB  - The purpose of the present study was to determine retrospectively the clinical
      performance of 42 all-ceramic partial crowns (PCCs) placed during the past 7
      years. All patients (n = 25) with partial ceramic crowns (n = 49) placed by one
      experienced dentist between 1992 and 1999 were asked to take part in a clinical
      study, and 22 patients with 42 restorations agreed to do so. All partial ceramic
      crowns studied were fabricated using the IPS-Empress I all-ceramic system
      (Vivadent). The following luting composites were used for placing the
      restorations: 20 (47.6%) Variolink high viscosity (Vivadent), 3 (7.1%) Variolink
      ultra (Vivadent), 17 (40.5%) Dual Zement (Vivadent), and 2 (4.8%) Compolute
      (Espe). The partial ceramic crowns were examined clinically using the modified
      USPHS criteria. Of the 42 restorations, 40 (95.2%) were still in function without
      any need of replacement. One restoration (2.4%) had failed before starting the
      clinical study, and another one (2.4%) fractured during the study. Twenty-eight
      (66.7%) of the partial ceramic crowns evaluated were rated Alpha with respect to
      marginal adaptation. Twelve (28.6%) restorations were rated Bravo, no Charlie
      ratings were found and 2 (4.7%) restorations were rated Delta. The Kaplan-Meier
      analysis was used to calculate the survival rate. The probability of survival
      (95% confidence interval) for 7 years was 81% (66-96%). These data indicate that
      partial ceramic crowns may provide successful esthetic restorations in posterior
      teeth.

PMID- 11218490
TI  - Relation between mercury concentrations in saliva, blood, and urine in subjects
      with amalgam restorations.
AB  - The aim was to determine the relationship between mercury content of resting and
      stimulated saliva, and blood and urine. Eighty subjects participated; 40 of them
      attributed their self-reported complaints to dental amalgam (patients), the
      others were matched with respect to age, sex and amalgam restorations (controls).
      Serum, 24-h urine, resting and chewing stimulated saliva were analyzed for
      mercury using the ASS-technique. Quality, number, surfaces and total area of
      amalgam fillings were recorded clinically and using study models. Median (range)
      mercury levels in serum were 0.67 (0.1-1.52) microgram/l for patients and 0.60
      (0.1-1.3) for controls. In urine levels were found to be 0.77 (0.11-5.16) and
      0.94 (0.17-3.01) microgram/g creatinine respectively. No significant differences
      were found between the groups. Resting saliva contained 2.97 (0.10-45.46)
      micrograms/l in patients and 3.69 (0.34-55.41) in controls (not significant).
      Chewing mobilized an additional amount of 16.78 (-6.97 to 149.78) micrograms/l in
      patients and 49.49 (-1.36 to 504.63) in controls (P < or = 0.01). Only a weak
      correlation was found between mobilized mercury in saliva and serum (r = 0.27; P
      < or = 0.05) or urine (r = 0.47; P < or = 0.001). For resting saliva the
      respective values were r = 0.45 (P < or = 0.001) and r = 0.60 (P < or = 0.001).
      Saliva testing is not an appropriate measure for estimating the mercury burden
      derived from dental amalgam.

PMID- 11218491
TI  - Site-specific association between supragingival plaque and bleeding upon probing
      in young adults.
AB  - The aim of the present study was to consider supragingival plaque as a risk
      factor for gingivitis in a group of young adults without destructive periodontal
      disease. A total of 127 subjects, 17 to 30 years of age, participated.
      Periodontal probing depth, clinical attachment level as well as bleeding upon
      probing and supragingival plaque was assessed at 6 sites of every tooth present.
      The individual odds ratios between plaque and bleeding ranged between 0.237 and
      66.6. 23% volunteers had an odds ratio of below 1.2. Only 15% individuals
      presented with an attributable risk of supragingival plaque for bleeding upon
      probing of 50% or more. Overall, the odds of bleeding, adjusted for periodontal
      probing depth, was increased by 67% in the presence of plaque. Large differences
      were observed at different teeth with the highest odds ratio at mandibular
      premolars with 2.557 (95% confidence interval 2.033-3.216) and the lowest at
      maxillary molars with 1.355 (1.161-1.732). It was concluded that there was high
      interindividual and intraindividual variation of the relative risk for bleeding
      in the presence of plaque. The observed low overall relative risk has important
      consequences in educational and health care programmes since the risk of
      supragingival plaque which is actually attributable for the observed bleeding on
      probing may be rather small.

PMID- 11218492
TI  - Compatibility of resorbable and nonresorbable guided tissue regeneration
      membranes in cultures of primary human periodontal ligament fibroblasts and human
      osteoblast-like cells.
AB  - The purpose of this study was (a) to evaluate the cytocompatibility of three
      resorbable and nonresorbable membranes in fibroblast and osteoblast-like cell
      cultures and (b) to observe the growth of those cells on the various barriers by
      scanning electron microscopy (SEM). Primary human periodontal ligament
      fibroblasts (HPLF) and human osteoblast-like cells (SAOS-2) were incubated with
      nonresorbable polytetrafluoroethylene (ePTFE) barriers and resorbable polylactic
      acid as well as collagen membranes. Cytotoxic effects were determined by XTT
      (mitochondrial metabolic activity) and sulforhodamine B assays (cellular protein
      content). In addition, HPLF and SAOS-2 grown for 21 days on the investigated
      barriers were evaluated by SEM. Data were analyzed statistically by ANOVA using
      the Wilcoxon-Mann-Whitney test (P < 0.05). No changes were established in the
      periodontal ligament fibroblasts and human osteoblast-like cells after incubation
      with the collagen membrane. Cytotoxic effects, however, were induced by the
      polylactic acid barrier which slightly inhibited cell metabolism of the
      periodontal fibroblasts (XTT: 90.1% +/- 3.6 of control value). Moderate cytotoxic
      reactions were caused by the nonresorbable ePTFE membrane in HPLF-cultures (XTT:
      82.7% +/- 3.5) and osteoblast-like cell monolayers (XTT: 80.0% +/- 0.6%).
      Mitochondrial activity in both cell cultures was significantly reduced by ePTFE
      barriers in comparison to non-incubated control cells (P = 0.028). SEM analysis
      of cell behavior on barriers demonstrated the differences between these
      materials: collagen barriers were densely populated with HPLF and SAOS-2, whereas
      only few or no cells were seen to adhere to the ePTFE and polylactic acid
      membranes. Our findings indicate that the collagen barrier investigated is very
      cytocompatible and may be integrated into connective tissue well. On the
      contrary, the ePTFE and polylactic acid membranes induced slight to moderate
      cytotoxic reactions which may reduce cellular adhesion. Thus, gap formation
      between the barrier surface and the connective tissue may be promoted which may
      facilitate epithelial downgrowth and microbial accumulation. Consequently, these
      effects may reduce the potential gain in periodontal attachment.

PMID- 11218494
TI  - An in vitro study of fluoride release from a resin-modified glass ionomer cement
      after exposure to toothpaste slurries of different pH.
AB  - The aim of the study was to evaluate the fluoride release from an aged resin
      modified glass ionomer (Vitremer) after exposure to five toothpaste slurries with
      different pH values. Cylindrical specimens of the material were leached in de
      ionized water for 3 months and then exposed for 30 min daily for 10 days to three
      dentifrice slurries (20 specimens/group) containing 0.05% fluoride with pH values
      of 2.6, 5.7 and 8.3 and two non-fluoridated slurries with pH values of 2.5 and
      5.7. A neutral NaF solution (0.05% F) was used as a control. During the 30 min
      exposure time, the fluoride concentration was gradually decreased in order to
      imitate the clinical situation. Thereafter, specimens were immersed individually
      in de-ionized water and the fluoride release determined. After the first day of
      exposure, all groups except one without fluoride (pH 5.7) showed significantly (P
      < 0.05) increased fluoride release. After exposure to the fluoridated toothpaste
      slurry with pH 5.7, significantly (P < 0.05) more fluoride was released compared
      to the toothpaste slurry with pH 8.3. Low pH (2.5 or 2.6) of the slurry resulted
      in a significantly (P < 0.05) higher fluoride release, regardless of whether it
      was fluoridated or not. The total amount of fluoride released after exposure to
      the more acidic fluoride toothpaste slurry was greater than that released from
      the more acidic non-fluoride toothpaste and the less acidic fluoride toothpaste.
      Our data indicate that the fluoride release from the resin-modified glass ionomer
      studied may be increased after treatment with an acidified NaF-toothpaste.

PMID- 11218493
TI  - Oral Chlamydia trachomatis in patients with established periodontitis.
AB  - Periodontitis is considered a consequence of a pathogenic microbial infection at
      the periodontal site and host susceptibility factors. Periodontal research
      supports the association of Actinobacillus actinomycetemcomitans, Porphyromonas
      gingivalis, Prevotella intermedia, and Bacteroides forsythus, and periodontitis;
      however, causality has not been demonstrated. In pursuit of the etiology of
      periodontitis, we hypothesized that the intracellular bacteria Chlamydia
      trachomatis may play a role. As a first step, a cross-sectional study of dental
      school clinic patients with established periodontitis were assessed for the
      presence of C. trachomatis in the oral cavity, and in particular from the lining
      epithelium of periodontal sites. C. trachomatis was detected using a direct
      fluorescent monoclonal antibody (DFA) in oral specimens from 7% (6/87) of the
      patients. Four patients tested positive in specimens from the lining epithelium
      of diseased periodontal sites, one patient tested positive in healthy periodontal
      sites, and one patient tested positive in the general mucosal specimen. In
      conclusion, this study provides preliminary evidence of C. trachomatis in the
      periodontal sites. Planned studies include the use of a more precise periodontal
      epithelial cell collection device, the newer nucleic acid amplification
      techniques to detect C. trachomatis, and additional populations to determine the
      association of C. trachomatis and periodontitis.

PMID- 11218495
TI  - An attempt to explain why Tanzanian children drinking water containing 0.2 or 3.6
      mg fluoride per liter exhibit a similar level of dental fluorosis.
AB  - The aim of this study was to identify factors that might explain the similar
      level of prevalence and severity of dental fluorosis in two neighboring areas in
      Tanzania: Kibosho; 0.2 mg fluoride/l, n = 96 and Arusha; 3.6 mg fluoride/l in
      drinking water, n = 80. Subjects aged 8-16 years were examined for dental
      fluorosis using the Thylstrup and Fejerskov Index (TFI). Based on the score on
      the upper left central incisor, the prevalence was not significantly different
      between the communities (TFI > or = 1). The severity, however, was significantly
      higher in Arusha. The areas had different food habits, e.g., type of weaning food
      used, and the use of magadi, a fluoride containing salt. In Arusha, 99% of the
      children had been given lishe, which is a magadi-free weaning food. Conversely in
      Kibosho, 61% used lishe while 39% used the magadi-containing weaning food
      kiborou. Magadi was used as food tenderizer in 'adult food' by 98% in Kibosho and
      45% in Arusha. Residential area and use of magadi explained 5% of the variance in
      TFI scores in inter-area analyses. In intra-area analyses, weaning food in
      Kibosho and use of magadi in Arusha had a significant effect, but the total
      explained variance was only 5 and 4%, respectively. Apart from fluoride in the
      drinking water, other sources of fluoride such as use of magadi in weaning food
      (kiborou) and in the adult food may partly explain the high prevalence and
      severity of dental fluorosis in the community with 0.2 mg fluoride per liter in
      the drinking water.

PMID- 11218496
TI  - The bicarbonate concentration in human saliva does not exceed the plasma level
      under normal physiological conditions.
AB  - Depending on the secretion rate and nature of the stimulus applied, the
      bicarbonate concentration ([HCO3-]) in human saliva has been shown to vary from 1
      to 60 mM, with the highest values obtained in secretions from the parotid and
      submandibular glands. We conducted the present study on five healthy young males,
      in order to determine whether human saliva [HCO3-] can exceed the plasma level
      under normal physiological conditions, and applied a strategy in which we
      measured the secretory response to various stimulus intensities. Whole saliva
      stimulation was initiated by chewing paraffin (50-100 chewing cycles/min),
      parotid saliva stimulation by citric acid taste (0.2-4% citric acid solutions),
      and both secretions were also collected during systemic medication using
      pilocarpine (5 mg). Our results showed that the parotid and whole saliva flow
      rates were closely correlated to the intensity of the secretion-inducing stimulus
      applied (taste, chewing, and pilocarpine). This was also the case for saliva
      [HCO3-], all of which was present in the form of physically dissolved CO2, H2CO3,
      and HCO3-. The highest mean [HCO3-] (i.e. 37.75 mM) was found in parotid saliva
      after stimulation by pilocarpine in combination with 4% citric acid taste. Under
      normal physiological conditions (i.e. without pilocarpine) the saliva [HCO3-] was
      similar to or below the plasma level in both secretions.

PMID- 11218498
TI  - Bone sialoprotein-induced reparative dentinogenesis in the pulp of rat's molar.
AB  - Bone sialoprotein (BSP), an osteogenic protein (OP), mixed with a carrier, was
      implanted in the pulp of rat first upper molars (OP group). Cavities were
      prepared with dental burs and pulp perforation was carried out by pressure with
      the tip of a steel probe. After 8, 14, and 30 days, the rats were killed and the
      pulps of the OP group were compared with (1) a sham group (S group), (2) a group
      where the carrier was implanted alone (C group), and (3) capping with calcium
      hydroxide (Ca group). After 8 days, a few inflammatory cells were seen, mostly
      located at the pulp surface near the perforation. In the Ca group, a dentin
      bridge started to form, in contrast to the other groups. After 15 days, globular
      structures were seen in the pulps of the S and C groups. A reparative osteodentin
      bridge isolated the pulp from the cavity in the Ca group. Variable reactions were
      seen in the OP group, with some evidence of cell and matrix alignments or plugs
      of osteodentin in continuity with an inner layer of reparative dentin. After 30
      days, irregular osteodentin formation was observed in the pulps of the S and C
      groups, with a tendency for globular structures to merge, but with interglobular
      spaces filled by pulp remnants. In the Ca group, osteodentin was observed in the
      mesial part of the pulp chamber. In the BSP-implanted group, the osteogenic
      protein stimulated the formation of a homogeneous dentin-like deposit occupying
      most of the mesial part of the pulp. Apparently, BSP stimulates the
      differentiation of cells which secrete an organized extracellular matrix more
      efficiently than any other capping material used so far. Altogether, the results
      reported here support that bone sialoprotein displays novel bioactive properties
      and is capable of stimulating in 1 month's time the development of a thick
      reparative dentinal tissue in the pulp, occluding the perforation and filling the
      mesial third of the pulp chamber.

PMID- 11218499
TI  - Emdogain--periodontal regeneration based on biomimicry.
AB  - Biomimicry has been introduced as a term for innovations inspired by nature [1].
      Such innovations may appear in almost every part of modern society. This review
      on the effects of enamel matrix proteins on the formation of cementum and the
      development of emdogain for regeneration of periodontal tissues lost due to
      periodontitis shows an example of biomimicry in dentistry. Findings from clinical
      and laboratory investigations are summarized and the biological basis for enamel
      matrix-induced periodontal regeneration is discussed.

PMID- 11218497
TI  - Terminal end of the human odontoblast processes.

PMID- 11218500
TI  - Tools for tissue engineering of mineralized oral structures.
AB  - This paper presents a short review of three groups of tools which can be or are
      used for the tissue engineering of mineralized oral structures: growth factor
      delivery systems (GFDS) and surface bioactivation with covalent bound peptides or
      with nanomechanically linked proteins. According to the reported personal
      experience of the authors, GFDS have to face the following challenging issue
      before being used routinely in dentistry, e.g., as a tool for reparative
      dentinogenesis or bone healing: adaptation of the GFDS design to the tissue where
      it will be implanted in order to deliver the right dose of growth factor (GF) at
      the right time. The bioactivation of surfaces, for example of dental implants,
      with covalent bound peptides or nanomechanically linked proteins represents a
      second innovative way to improve dental health in the future. Here we report on
      the experimental use of cyclic RGD peptides grafted on polymethylmethacrylate to
      improve osteoblast adhesion. Furthermore, we show the potential advantage of
      immobilizing and incorporating collagen I on titanium implant surfaces. These
      techniques or a combination of them will help to create improvements, for
      example, of dental implants in the near future. They will also help to promote
      bone and dentin regeneration.

PMID- 11218501
TI  - Basic research meets dentistry.

PMID- 11218502
TI  - Ehlers-Danlos type VIII. Review of the literature.
AB  - Ehlers-Danlos type VIII is a rare disorder characterized by soft, hyperextensible
      skin, abnormal scarring, easy bruising, and generalized periodontitis with early
      loss of teeth. To illustrate the clinical dermatological and dental features, we
      present the case history of a 20-year-old patient who has suffered from poor
      healing of wounds at the shins and knees since childhood, which have developed
      into hyperpigmented atrophic scars. In the course of orthodontic treatment during
      the last 3 years, severe apical root resorption, gingival recession, and loss of
      alveolar bone were observed. Family history was noncontributory for any skin or
      tooth disorders. The typical clinical signs confirmed the diagnosis of Ehlers
      Danlos syndrome type VIII. As there is no specific treatment for the disorder,
      management is limited to the symptomatic treatment of the dental disease. It
      seems advisable to consider carefully the indications for orthodontic treatment
      in patients with Ehlers-Danlos type VIII syndrome.

PMID- 11218504
TI  - Clinical evaluation of removable partial dentures 10 years after insertion:
      success rates, hygienic problems, and technical failures.
AB  - The aim of this retrospective study was to examine the condition and success rate
      of various designs of removable partial dentures 10 years after placement.
      Seventy-four patients treated with 101 mainly conical crown-retained dentures
      (CCRDs), clasp-retained removable partial dentures (RPDs), or a combination of
      conical crown and clasp-retained dentures (CRPDs) were reexamined. Prosthetic
      findings were compared to baseline values at insertion and checked for factors
      that may affect them. Overall, 36.6% of the prostheses were regarded as
      successes, 23.8% as partial successes, and 39.6% as failures. Also, only one
      third of the prostheses showed neither hygienic problems nor technical failures.
      The statistical analysis identified no single parameter as significantly
      affecting the success rate of the partial dentures. Prostheses supported by
      several abutment teeth had improved success, and RPDs had a higher failure rate
      (66.7%) than CCRDs (33.3%) and CRPDs (44.8%); however, because of the limited
      number of RPDs these differences were not statistically significant. Although the
      prostheses were unsupervised in service, the 60.4% overall success rate of the
      dentures was somewhat higher than in other studies on precision-retained
      prostheses.

PMID- 11218503
TI  - Clinical and antibacterial effect of tea tree oil--a pilot study.
AB  - The aim of this clinical pilot study was to compare the effect of tea tree oil
      with the effect of water and chlorhexidine on supragingival plaque formation and
      vitality. Eight subjects were asked to refrain from any kind of mechanical oral
      hygiene for 4 days after professional tooth cleaning (day 0), and to rinse with
      water instead for 1 week, with chlorhexidine in a second and tea tree oil in a
      third test week. The plaque index (PI), which was evaluated daily (days 1-4),
      served as a clinical control parameter. On the last day of the study (day 4), the
      plaque covering the front teeth was stained, photographed, and therefrom the
      plaque area (PA; %) was estimated using a digital measuring system. Each day of
      the study (days 1-4), the sampled plaque was examined using a vital fluorescence
      technique. Tea tree oil reduced neither the clinical parameters (PI and PA) nor
      the vitality of the plaque flora significantly. Within the limitations of the
      study design, it was determined that a solution with tea tree oil--utilized as
      ordinary mouthwash--has no positive effect on the quantity or quality of
      supragingival plaque.

PMID- 11218505
TI  - Effect of transcutaneous electrical nerve stimulation on pain perception
      threshold of human teeth: a double-blind, placebo-controlled study.
AB  - In this double-blind, placebo-controlled study, we studied the effect of three
      different transcutaneous electrical nerve stimulation (TENS) devices with extra-
      and intraoral electrodes on the pain perception thresholds of 234 unrestored,
      caries-free human teeth of 66 healthy individuals subjected to stimulation with
      an electric pulp tester. A placebo control collective of 64 healthy subjects
      received no electrical stimulation, since an inactive TENS device was used. In
      all tooth types tested (maxillary and mandibular incisors and premolars), the use
      of the active TENS devices resulted in an increase of 16.3-32.5% versus baseline
      in the pain perception threshold. The differences between active TENS and
      baseline were statistically significant for both TENS devices using extraoral
      electrodes (P < 0.05). No statistically significant differences were found
      between the different devices tested (P > 0.05). In the placebo collective, the
      increase in the pain perception threshold ranged between 6.4% and 10.3% versus
      baseline. There were no significant differences between placebo TENS and baseline
      on the one hand and between placebo TENS and the active TENS devices on the other
      hand (P > 0.05). The findings suggest that, as an alternative to local
      anesthetics, TENS seems not to be useful in the case of painful dental
      interventions, since it offered only minor advantages over a placebo.

PMID- 11218506
TI  - Technical failure rates of double crown-retained removable partial dentures.
AB  - Removable partial dentures (RPD) can be retained using conical crowns or parallel
      sided telescopic double crowns. The purpose of this study was to evaluate and
      compare the technical failure rate of the two retainer systems. One hundred
      seventeen dentures made by dentists of the medical school were included. Seventy
      four RPD were retained with parallel-sided crowns (n = 251) and 43 with conical
      crowns (n = 160). Following the medical report follow-ups from January 1992 to
      December 1998, technical RPD failures were noted and analyzed. Technical problems
      occurred during the observation time in 48.8% of the conical retained dentures
      and 34.2% of the parallel-sided retained dentures. In both cases, loss of
      cementation was most frequently noted, while loss of the facings occurred only
      with conical crowns. Other technical failures did not depend on the type of
      retainer system used. These were most frequently problems with the denture base,
      e.g., fracture of artificial teeth or the metal framework. We conclude that there
      were different technical failures of both double crown retainer systems. These
      problems were not insignificant in number but treatable.

PMID- 11218507
TI  - Power toothbrushes, gender, and dentin hypersensitivity.
AB  - Power toothbrushes require less force for plaque removal than manual brushes. In
      addition, in vitro studies have indicated that brushing with low force could
      occlude patent dentin tubules by formation of a smear layer. Hence, lessening the
      force necessary to remove plaque may reduce dentin hypersensitivity. However, it
      was recently suggested that the use of an oscillating/rotating power toothbrush
      could decrease tooth sensitivity as compared to a sonic power toothbrush.
      Therefore, the objective of the present research was to compare the effect on
      dentin hypersensitivity of two different types of power brushes, the Optiva
      Sonicare and the Braun Oral B Ultra Plaque Remover. The null hypothesis was
      tested in an 8-week, randomized, parallel group, examiner-blind clinical trial.
      Fifty-nine subjects with a history of dentin hypersensitivity participated.
      Dentin hypersensitivity-associated pain was elicited using tactile and
      evaporative stimuli and assessed using a visual analog scale (VAS) instrument.
      Clinical examinations were carried out at screening and baseline and repeated
      after 8 weeks of twice daily use of the power brushes. Data analysis was
      performed on VAS scores obtained at the final visit following adjustment for
      group differences at baseline. A 35% to 40% reduction in pain as compared to
      baseline was observed in both treatment groups. Treatment-related differences
      were not statistically significant. A gender-related effect on dentin
      hypersensitivity was observed using the tactile stimulus and may merit further
      investigation.

PMID- 11218508
TI  - The effect of splinting of teeth in combination with reconstructive periodontal
      surgery in humans.
AB  - The purpose of this study was to evaluate the effect of splinting teeth on the
      results of periodontal reconstructive surgery using a specific carbonate bone
      replacement graft (BRG) material. Forty-five patients were randomly treated with
      a periodontal surgery approach. Natural coral calcium BRG was utilised in 33
      patients. This 33-patient group was divided into three equal groups. In the
      presplint group, teeth were splinted to at least two rigid teeth before surgery,
      in the postsplint group, teeth were splinted at suture removal, and in the
      nonsplint group, the treated teeth were not splinted at all. In 12 patients,
      teeth were treated with surgical debridement (DEBR) alone and not splinted.
      Periodontal probing depth (PPD), clinical probing attachment level (CPAL), and
      tooth mobility were measured using desmodontometry (DDM) and periotest (PTV) with
      reproducible methods before surgery and at various periods up to 1 year
      afterwards. A decrease in PPD (5.4 mm, SD 1.4 mm) and tooth mobility (DDM
      horizontal 257 microns, SD 60 microns) and a gain of CPAL (5.1 mm, SD 1.4 mm)
      were seen following the use of BRG in presplint teeth. In the same group, PPD and
      tooth mobility were significantly reduced compared to nonsplint teeth. DEBR alone
      showed reductions in tooth mobility and PPD and a significantly smaller gain in
      CPAL than in presplint teeth treated with BRG. The less favourable improvement in
      periodontal function of postsplint or nonsplint teeth seemed to be due to the
      loss of BRG material caused by tooth mobility. These results indicate that an
      undisturbed wound healing process using BRG together with tooth stability is
      beneficial to overall clinical success.

PMID- 11218509
TI  - Inserts--megafillers in composite restorations: a literature review.
AB  - Modern insert systems have been available on the dental market since the late
      1980s. In general, two major systems can be distinguished: those with and those
      without preparation instruments in combination with matching standardized
      inserts. It is claimed that one of the advantages of insert systems is the better
      marginal adaptation of insert/composite restorations compared to mere composite
      restorations: the integration of inserts reduces the polymerization shrinkage
      stress and lowers the overall coefficient of thermal expansion. In vitro data
      indicate that adapting the insert size to the most precise fit produces a quality
      of marginal adaptation comparable to that of ceramic inlays. Inserts also
      facilitate the establishment of a proximal contact. With respect to wear, no
      significant differences are detected between composite and insert restorations.
      The bond between insert and composite is susceptible to contamination during
      operative procedures. Short-term clinical investigations confirm in vitro
      findings regarding improved marginal adaptation and increased wear resistance.
      Long-term controlled clinical studies are in progress, but data are not yet
      available. Based upon the present in vitro and in vivo data it can be concluded
      that the insert technology shows promising results, but further investigations
      regarding, for example, stability of the insert/composite bond, fracture
      resistance of the overall restoration, and wear behavior are necessary to predict
      the clinical success of this alternative restoration procedure.

PMID- 11218510
TI  - Time dependent failure rate and marginal bone loss of implant supported
      prostheses: a 15-year follow-up study.
AB  - This study deals with 4971 implants (Branemark system) installed in 1315
      patients, either fully or partially edentulous, and followed from implant
      installation up to the last control. A predominance of female patients (61%) and
      a nearly equal number of upper and lower jaws characterised the study group.
      Patients were scheduled each 6-12 months for recall. The observation time varied
      from 0.5 to 15 years (mean 5.1). The whole cohort was split up into compromised
      (n = 59) and non-compromised (n = 1256) patients. The former are defined as
      grafted (autologous bone) and patients irradiated in the head and neck area. In
      the compromised patients 24 out of 59 patients (40.6%) showed failures, in whom
      59 out of 310 (19%) implants failed. In the non-compromised patients, implant
      failures were observed in 11.6% of the patients, which corresponds to 5.9% of the
      installed implants, excluding iatrogenic failures. Failures were further divided
      chronologically into early (up to 1 year after abutment connection) and late
      failures. There were early implant failures in 12.5% of the compromised patients
      and in 3.4% of the others. Late implant failures occurred in 7.4 and 2% of the
      two patients groups, respectively. While gender did not affect the failure rate,
      implant lengths, corresponding to the available bone height did, since a 21.5%
      failure rate for the 7-mm implants contrasts with 4.1 and 3.8% for 13- and 15-mm
      implants, respectively. Early as well as annual late failures are more frequently
      found in the maxilla. Implant fractures only occurred in the fixed (both partial
      and full) prosthesis group but never surpassed the 0.2% annual level. Marginal
      bone loss, exceeding the third screw thread occurred in 1.8% of the implants at
      the last control. It appears that this type of implant configuration offers a
      high long-term predictability. Failures occur before, at or during the first year
      after abutment connection and in very short implants. Marginal bone as a whole is
      very stable over the years.

PMID- 11218511
TI  - Salivary arginase in patients with adult periodontitis.
AB  - Human saliva has been shown to possess enzymatic activities, one of which is
      derived from arginase. Arginase is known to be an arginine-depleting enzyme
      belonging to the L-arginine/nitric oxide pathway. The aim of this study was to
      examine the possible role of arginase activity of saliva in the pathogenesis of
      periodontal disease. Mixed saliva samples were collected from 20 adult
      periodontitis patients and 15 systemically and periodontally healthy subjects.
      Salivary arginase and total protein contents were determined by using
      spectrophotometrical enzyme analysis and salivary arginase was expressed as
      specific activity. Periodontal disease status was determined by clinical
      periodontal assessments including probing pocket depth, clinical attachment
      level, plaque index and gingival index. While the increase in total protein was
      not statistically significant, arginase levels in the patient group were
      significantly higher than the controls. All periodontal indices were found to be
      significantly higher in the periodontitis group, but no meaningful correlation
      was observed between the biochemical and periodontal variables in both groups.
      Furthermore, no significant correlation existed between the amount of arginase
      and total protein. In conclusion, it was suggested that salivary arginase
      activity in periodontitis along with the arginine-nitric oxide pathway may be
      involved in the disease process by using the common substrate L-arginine and
      inhibiting nitric oxide production.

PMID- 11218512
TI  - Comparison of failure rates of adhesive-fixed partial dentures for in vivo and in
      vitro studies.
AB  - The objective was to investigate associations between the results of an in vitro
      and an in vivo study using an artificial mouth and a study of adhesive fixed
      partial dentures (AFPD) begun in 1985 [1]. Twenty extracted human molars and 20
      human upper incisors were inserted into PMMA resin, 6 mm apart to represent a
      gap. Two preparation methods (identical to those in in vivo conditions) were
      used: a retentive preparation technique (posterior) and a non-retentive
      preparation technique (anterior). The frameworks of the bridges consisted of CoCr
      alloy with a ceramic veneered pontic to replace the missing tooth. The bonding
      surfaces of the posterior AFPDs were conditioned with a tribochemical system,
      while the anterior AFPDs were sandblasted. All AFPDs were inserted using a dual
      curing composite cement. During thermal-cycling and mechanical loading (TCML:
      6000 x 5 degrees C, 1.2 x 10(6) x 50 N, 1.66 Hz) in an artificial environment,
      the frequency and type of failures were observed. The above mentioned loading
      parameters were hypothesized to represent a period of 5 years under oral
      conditions. The results were compared to those of similar bridge-types in the in
      vivo study. The Kaplan-Meier estimations showed similar graphs for in vivo and in
      vitro with both types of AFPDs. In vivo and in vitro, the retentively prepared
      AFPDs were markedly more successful. With regard to the failure types, the
      simulation-parameters seemed to represent a loading stress that was comparable to
      in vivo conditions.

PMID- 11218513
TI  - Fluoride concentration in plaque in adolescents after topical application of
      different fluoride varnishes.
AB  - The aim of the study was to measure the fluoride (F) concentration in plaque
      after a single topical application of different fluoride varnishes with
      contrasting levels of F. Thirty adolescents (12-17 years) with fixed orthodontic
      appliances were randomly assigned to one of three groups: Bifluoride (6% F),
      Duraphat (2.23% F) and Fluor Protector (0.1% F). The varnishes were applied after
      professional cleaning in one upper quadrant, leaving the opposite quadrant
      untreated according to the split-mouth technique. Pooled plaque samples from each
      quadrant were collected at baseline and 3 days, 7 days and 30 days after the
      varnish treatment, and fluoride was analysed by microdiffusion. All fluoride
      varnishes increased the fluoride concentration in plaque compared with baseline,
      and the mean values varied between 23 and 138 ng F/mg after 3 days, depending on
      varnish F concentration. Compared with the control quadrant, statistically
      significant elevations were recorded for Bifluoride after 3 days and 7 days and
      Duraphat after 3 days, while no significant differences were revealed in the
      Fluor Protector group. The fluoride concentration in plaque was back to baseline
      levels for all participants in the Duraphat group after 7 days, while some
      individuals in the Bifluoride and Fluor Protector groups still registered
      slightly increased levels after 30 days. The results suggest that fluoride
      varnish treatments resulted in elevated fluoride levels in plaque adjacent to
      fixed orthodontic appliances for a period of up to 1 week, although different
      patterns was disclosed for the various brands.

PMID- 11218514
TI  - Infection of primary human gingival fibroblasts by Porphyromonas gingivalis and
      Prevotella intermedia.
AB  - Adhesion and penetration of clinical isolates of Porphyromonas gingivalis and
      Prevotella intermedia in human gingival fibroblast monolayers were studied by
      transmission electron microscopy (TEM). Fibroblasts were cultured from biopsies
      of human healthy gingiva. Porphyromonas gingivalis and Prevotella intermedia were
      isolated from patients with periodontitis. Fibroblasts were incubated with
      microorganisms in an antibiotic-free medium for 24 h. Then cultures were washed
      to remove nonadherent bacteria. Consecutively, infected cultures were grown for
      another 24 h. Thereafter, the treated monolayers were prepared for TEM
      investigations. Internalized Porphyromonas gingivalis and Prevotella intermedia
      were visible after 24 h of incubation. Prevotella intermedia showed only division
      in cytoplasm of fibroblasts after 24 h and 48 h incubations. Infected fibroblasts
      revealed various morphological alterations such as extensive vacuolization and
      breakdown of mitochondria. These findings demonstrate that Porphyromonas
      gingivalis and Prevotella intermedia may invade human gingival fibroblasts and
      thus may damage these cells directly or due to the release of microbial cytotoxic
      components.

PMID- 11218515
TI  - Influence of a high-speed polymerization method on the marginal integrity of
      composite fillings in Class-II cavities.
AB  - The aim of this study was to evaluate the effect of a rapid photopolymerization
      method on the marginal integrity of composite fillings. Ninety two-surface
      cavities were prepared in extracted human molars using the SonicSys preparation
      system. All cavities were bonded with one bonding agent (Syntac) and filled with
      a microfilled composite (Herculite XRV), a heavy filled composite (Z100 MP), and
      an Ormocer (Definite) in two increments. Each increment had a thickness of
      approximately 1.5 mm and was polymerized using either halogen light or the plasma
      light of Apollo 95 E. In this process, six trial groups each containing 15
      fillings were created. After replicas were made, the test teeth were subjected to
      a thermocycling process of 2000 temperature cycles (5 degrees C/55 degrees C)
      followed by a wear simulation of 50,000 stress cycles each with 50 N. This was
      followed by the creation of a second set of replicas, quantitative margin
      analysis, and dye penetration. A significant (P < 0.05) influence of the
      thermomechanical stress and a significant (P < 0.05) influence of the factor
      "material" were shown for the margin criterion "continuous margin" using MANOVA.
      The factor "light source" produced no significant influence (P = 0.57) on the
      amount of continuous margin. During the dye penetration, no significant
      differences between the polymerization methods could be established with the
      materials Herculite XRV and Z100 MP (H-test according to Kruskall and Wallis).
      Only with the material Definite was a significantly higher dye penetration
      observed at the occlusal measuring point in the plasma light group. A rapid
      polymerization with high light intensity had no adverse effects on the margin
      quality within the limitations of this in vitro study. However the marginal
      integrity might have been influenced by the chosen adhesive system/composite
      resin combination, which does not represent the respective product line.
      Additionally, further studies ought to show which exposure time is necessary for
      a sufficient degree of conversion.

PMID- 11218516
TI  - Healing of fenestration-type defects following treatment with guided tissue
      regeneration or enamel matrix proteins. An experimental study in monkeys.
AB  - The aim of the present study was to evaluate histologically in monkeys the
      healing in acute fenestration-type defects following treatment with guided tissue
      regeneration (GTR) or enamel matrix proteins (EMD). Standardized "critical size"
      fenestration-type defects were produced surgically at the vestibular aspect of
      teeth 13, 23, 33, 43 in three monkeys (Macaca fascicularis). The vestibular bone
      plates were removed and the root surfaces were debrided by means of hand
      instruments in order to completely remove the root cementum. Following root
      conditioning with ethylenediaminetetraacetate (EDTA), the defects were treated
      using one of the following therapies: (1) GTR, (2) EMD, or (3) control (coronally
      repositioned flaps). After 5 months the animals were killed and perfused with 10%
      buffered formalin for fixation. Specimens containing the defects and surrounding
      tissues were dissected free, decalcified in EDTA, and embedded in paraffin. Eight
      micrometer-thick step serial histological sections were cut in a vestibulo-oral
      direction, stained with hematoxylin and eosin or oxone-aldehyde-fuchsin-Halmi,
      and subsequently examined under the light microscope. The results showed that, in
      the defects treated with GTR, a new connective tissue attachment (i.e., new
      cementum with inserting collagen fibers) and new bone formation had consistently
      occurred, whereas, in the defects treated with EMD or with coronally repositioned
      flaps, new attachment and new bone reformed to a varying extent. The quality of
      the cementum did not differ after EMD, GTR, or flap surgery. It was concluded
      that GTR treatment with bioresorbable membranes seems to predictably promote new
      attachment and new bone formation, whereas the application of EDTA or EMD may
      also enhance periodontal healing to a certain extent. Further studies with higher
      numbers of animals and defects are needed in order to definitely clarify the
      effect of root surface conditioning with EDTA and EMD on periodontal healing.

PMID- 11218517
TI  - Dental variables associated with differences in severity of fluorosis within the
      permanent dentition.
AB  - The aim of this study was to assess the influence of age at start, duration, and
      completion of enamel formation, as well as of tooth-eruption age and enamel
      thickness on the severity of dental fluorosis within the permanent dentition. The
      material comprised Ugandan children (n = 219), aged 10-14 years, with 28 teeth
      and at least 1 tooth with fluorosis. The children were permanent residents in
      districts with either 0.5 mg or 2.5 mg fluoride/l in the drinking water.
      Fluorosis was assessed on the vestibular surfaces of all teeth using the modified
      Thylstrup and Fejerskov (TF) index. In order to relate fluorosis to the dental
      variables, the material was divided into a test group (n = 103), with fluorosis
      on all teeth, and a reference group (n = 116), with fluorosis on up to 27 teeth.
      The reference group was used to confirm or refute the findings in the test group.
      Paired comparisons showed significantly higher median TF scores for the late than
      for the early mineralizing and erupting teeth. In multiple regression analyses,
      the age at start, duration, and completion of enamel formation as well as tooth
      eruption was significantly related to the severity of fluorosis after controlling
      for enamel thickness (P < 0.05, n = 14). The effect (R2change) of the dental
      variables on the variation in severity of fluorosis within the dentition was in
      decreasing order: the duration of enamel formation, age at completion of enamel
      formation, tooth-eruption age, and the start of enamel formation.

PMID- 11218518
TI  - Acid formation in sucrose-exposed dental plaque in relation to caries incidence
      in schoolchildren.
AB  - The aim was to investigate the composition and concentration of organic acids
      produced by plaque bacteria in vivo and its possible relation to caries
      development in schoolchildren. Sucrose-exposed pooled plaque from 25 healthy
      teenagers was collected and the levels of Streptococcus mutans and lactobacilli
      were estimated. The acid anions were analysed with isotachophoresis. The
      prevalence and incidence of dental caries during a 2-year period was recorded.
      Depending on the amount of plaque collected, the subjects were divided into a low
      (n = 12) and a high (n = 13) plaque weight group. The dominating anions in
      sucrose exposed plaque were lactate, acetate and propionate. For the entire study
      group, no association was found between the total acid concentration and caries
      development but for the participants with low plaque weight a positive
      relationship (P < 0.01) was disclosed. No correlation was found between the
      concentrations of acids and the number of lactobacilli or Streptococcus mutans.
      The present results did not suggest that the acidogenicity of sugar-exposed
      pooled plaque samples was a suitable indicator of caries activity in teenagers.

PMID- 11218519
TI  - From black to white?

PMID- 11218520
TI  - The management of occupational exposures to blood and saliva in dental practice.
AB  - Accidental injuries when handling sharp or rotating instruments can allow
      inoculation of a dental team member by the patient's blood or saliva. The risk of
      transmission of HIV from occupational exposure among dental workers is low and to
      date no occupational exposure has resulted in HIV transmission. However,
      hepatitis B and C have a high morbidity and mortality and are more infectious
      than HIV. This paper demonstrates how occupational exposures to blood and saliva
      could be managed in general dental practice and outlines the legal
      responsibilities of a dentist in the management of these exposures.

PMID- 11218522
TI  - Current practice in endodontics.
AB  - The aim of this series of six articles is to improve the quality of endodontic
      treatment in general dental practice by considering what is currently being
      taught in dental schools. This first article considers the rationale behind
      endodontic treatment, what we are aiming to achieve and why. It looks at the
      dental and medico-legal issues which dictate the standards of our practice, and
      sets out the programme for the series.

PMID- 11218521
TI  - Contemporary resin-based composite materials for direct placement restorations:
      packables, flowables and others.
AB  - Resin-based composite (RBC) materials are composed of principal and diluent
      monomers, fillers, coupling agents and other components. These materials have
      been developed in recent years to produce packable and flowable materials, and
      materials which may release ions under specific conditions and which may contain
      fibres. Materials which are organic-inorganic copolymers have also become
      available. Long term clinical trial data are not available for the most recently
      introduced materials.

PMID- 11218523
TI  - Diagnosis of acromegaly in orofacial pain: two case reports.
AB  - Acromegaly is an uncommon condition, with an annual incidence in the UK of three
      per million. The gradual onset of the clinical features mean that often friends
      and relatives are unaware of the underlying pathology. In view of the morbidity,
      and indeed mortality, arising from undiagnosed cases, general dental
      practitioners and other healthcare workers should routinely take note of systemic
      as well as intra-oral changes occurring in their patients when seen on review.
      The association of paraesthesia, anaesthesia and pain with acromegaly is well
      documented. However, there appear to be few reports linking acromegaly with
      orofacial pain or dysaesthesia. This paper describes two such cases.

PMID- 11218524
TI  - Transcultural oral health care: 2. Developing transcultural oral health
      promotional materials.
AB  - This paper discusses the common problems involved in developing transcultural
      oral health promotional materials, and describes the best ways to avoid them.
      Translation errors and poor illustrations are by far the most frequently
      encountered problems followed by cultural incompatibility, inadequate
      information, and text and layout mistakes.

PMID- 11218525
TI  - Selection of materials for post cementation.
AB  - Many types of cement are available for post cementation, each with advantages and
      disadvantages. For posts with adequate mechanical retention, zinc phosphate is a
      good choice for patients for whom fluoride release is not considered essential.
      Posts with compromised mechanical retention benefit from use of a resin-modified
      glass-ionomer cement, which also releases fluoride. Composite resin cements
      should be reserved for rare cases where mechanical retention is so compromised
      that use of a resin-modified glass-ionomer cement provides inadequate retention.
      Great care is required when using composite resin cements to ensure optimum
      performance and avoid the creation of difficult-to-remove excess cement.
      Clinicians should be aware that posts cemented with resin-modified glass ionomer
      or composite resin cements may be difficult or impossible to remove if access to
      the root canal system is subsequently required.

PMID- 11218526
TI  - Periodontal signs and symptoms associated with vertical root fracture.
AB  - This report describes the clinical presentation of three cases of vertical root
      fractures in adult patients where an initial diagnosis of localized periodontitis
      had been considered. Loss of the affected tooth occurred in all of these
      patients. The effects of endodontic therapy and the provision of post-retained
      restorations are considered in relation to their potential effect of weakening
      the root and predisposing the tooth to vertical fracture. The last case presents
      an unrestored molar tooth with a complete vertical root fracture.

PMID- 11218527
TI  - More dental health.

PMID- 11218528
TI  - Modern thoughts on fissure sealants.
AB  - It has long been known that fissure sealants are an important part of the
      prevention and control of dental caries in pits and fissures. However, their
      usage is still sporadic and generally not related to evidence-based guidelines.
      Caries prevalence has changed since sealants were introduced and this has
      significant implications for the criteria on which to select patients who would
      most benefit from their usage. The clinical technique for successful fissure
      sealant application is very moisture and operator sensitive. However, there is
      accumulating evidence that use of fissure sealants can be extended, given
      suitable investigation, to the early carious lesion as a 'preventive resin
      restoration'.

PMID- 11218529
TI  - An alternative putty/wash impression technique.
AB  - Conventionally, custom trays have been made in the laboratory on casts
      constructed from preliminary impressions. A spaced tray made in this way allows a
      uniform thickness of impression material of approximately 2 mm which is said to
      enhance the accuracy of the impression-taking procedure. A technique is described
      to fulfill this criterion without the need for a primary impression, by
      constructing a spaced putty custom tray inside the mouth.

PMID- 11218530
TI  - Hormonal factors in periodontal disease.
AB  - This article discusses the effects of sex steroid hormones, glucocorticoids and
      insulin deficiency on periodontal tissues, and the possible consequences on
      periodontal disease progression. The androgens and oestrogens have predominantly
      anabolic functions in stimulating matrix synthesis, which is applicable to
      periodontal repair and medication-induced gingival overgrowth. Oestrogen and
      progesterone can contribute to pregnancy gingivitis; long-term use of hormonal
      contraceptives can accelerate progression of periodontal disease. Higher levels
      of circulating cortisol, associated with stress, can influence the onset of acute
      necrotic ulcerative gingivitis. Gingivitis and periodontal disease are reported
      to be more prevalent in type 1 and type 2 diabetes mellitus (periodontal disease,
      particularly in older, less well controlled subjects) than in non-diabetic
      individuals.

PMID- 11218531
TI  - It ain't what you say.... legibility and clarity of treatment records.
AB  - The content of treatment records is irrelevant if it cannot be understood. This
      is a report of a clinical audit project that aimed to assess the readability of
      records, and set standards to be maintained throughout the practice for
      handwriting and use of abbreviations.

PMID- 11218533
TI  - Transcultural oral health care: 3. Dental care and treatment during the fast of
      Ramadan.
AB  - The aim of this paper is to highlight issues that may affect dental treatment and
      care of Muslim patients when they are fasting during Ramadan. Recommendations are
      provided on how to provide culturally sensitive oral health care for this
      community. By taking into account the beliefs and wishes of the individual,
      dentists will provide a service that is acceptable and appropriate to both the
      Muslim community and individual Muslims.

PMID- 11218532
TI  - Current practice in endodontics: 2. Diagnosis and treatment planning.
AB  - The aim of this series of six articles is to improve the quality of endodontic
      treatment in general dental practice by considering what is currently being
      taught in dental schools. This second article considers the accurate diagnosis of
      endodontic lesions, which frequently present as emergencies requiring prompt,
      rapid and efficient attention. The paper then presents the treatment normally
      indicated once a correct and accurate diagnosis has been made.

PMID- 11218534
TI  - A case of sialolithiasis in a young female patient.
AB  - This paper describes the examination, diagnosis and treatment of a swelling that
      appeared in the floor of the mouth of a healthy 15-year-old girl. A sialith
      (stone) is not the first thing one considers when dealing with oral swellings in
      childhood but it does occur. Theories for its formation are described, as are the
      radiographic and clinical details of the case.

PMID- 11218535
TI  - A chemomechanical method for caries removal.
AB  - Over recent years the dental profession has shifted towards practising preventive
      dentistry and adopting more conservative and tooth-preserving procedures. Such
      progression is considered to be a response to the decline in the level of dental
      caries and advances in materials science. This shift in caries management will no
      doubt continue over the coming decades, based on rational clinical and scientific
      principles. Chemomechanical caries removal involves the application of a solution
      that selectively softens the carious dentine, thus facilitating its removal. This
      limits the removal of sound tooth structure, the cutting of open dentinal
      tubules, pulpal irritation and pain compared with conventional mechanical
      methods.

PMID- 11218536
TI  - The role of the general dental practitioner in detection and prevention of oral
      cancer: a review of the literature.
AB  - Over the last two decades little progress appears to have been made in reducing
      the incidence and number of deaths associated with oral cancer. The most recently
      available Scottish data indicate a steady rise in both incidence of, and
      mortality rates from, tongue and 'mouth' cancer, supporting previous observations
      of a steady rise in the incidence of oral cancer since the mid 1970s. Very little
      improvement in 5-year survival rates for oral cancer has been observed in England
      and Wales and, over the last 30 years, survival rates in Scotland have actually
      declined. Although many dentists are committed to examining the mouth for oral
      cancer, the majority still feel uncomfortable with involvement in patient
      education. Clearly scope exists for dental practitioners to improve patient
      awareness of both oral cancer itself and the risk factors associated with the
      disease. Dental teams should be aware of the opportunities within dental practice
      to contribute to preventive initiatives--such as smoking cessation.

PMID- 11218537
TI  - Enamel microabrasion.

PMID- 11218538
TI  - The occlusal management of maxillary anterior single-unit implant-supported
      restorations.

PMID- 11218539
TI  - AIDS and STD knowledge, condom use and HIV/STD infection among female sex workers
      in Bali, Indonesia.
AB  - The objectives of this paper were to examine changes in AIDS/STD knowledge and
      behaviour from 1992-1998, current levels of STD infection and psychosocial and
      demographic determinants of condom use and STD infection among female sex
      workers. Data for the study were drawn from cross-sectional surveys of female sex
      workers conducted in 1992, 1994 and 1997-8. For each survey, women participated
      in a face-to-face interview in the brothel complexes. Survey questions included
      information on AIDS/STD knowledge, demographics, sexual history and psychosocial
      factors related to condom use. After the last survey, women were offered a
      vaginal exam for STD diagnosis and treatment. Sera were tested for HIV infection
      (anonymous, Elisa/Western blot) and syphilis (TYPHA, RPR). Cervical mucous was
      tested for chlamydia (LcX), gonorrhea (LCx), herpes (pcr) and HPV (pcr).
      Knowledge of AIDS and awareness of STDs has increased tremendously in this
      population since 1992. Reported condom use has also increased substantially
      (69.9%). Perceived susceptibility toward HIV infection remains low. Ineffective
      preventive strategies such as medication use continue to be common. HIV infection
      remains very low in this population (0.2%), although the prevalence of other STDs
      such as gonorrhea (60.5%), chlamydia (41.3%) and HPV (37.7%) were very high. STD
      knowledge and self-efficacy were significantly related to condom use as were the
      sex workers' perceived susceptibility to STD and HIV infection. Women with a
      larger number of partners were more likely to be infected with gonorrhea,
      chlamydia and HIV. Women who had come to Bali recently were more likely to be
      infected with HIV and gonorrhea.

PMID- 11218540
TI  - Psychosocial and economic aspects of HIV/AIDS and counselling of caretakers of
      HIV-infected children in Uganda.
AB  - The knowledge that her child is infected puts a heavy emotional burden on a
      mother. Despair or depression lead to difficulties in reacting to the options and
      advice given by health workers. The compliance of the mother also is largely
      dependent on her acceptance of the HIV status of the child. Additionally, the
      belief that the child might die any moment may cause her not to take proper care
      of the child anymore. Worries of the caretakers are frequently related to
      poverty. Counselling of caretakers at the health centre could and should be an
      important element in care for HIV-infected children. Psychological and material
      support and advice concerning HIV infection, proper childcare and material
      problems may empower the caretakers. This may lead to a better follow-up of the
      child by health care workers and to increased compliance of and better care by
      the caretaker, which will improve life and survival of an infected child.

PMID- 11218542
TI  - HIV/AIDS-related services for women and the rural community context.
AB  - Rural communities present a different context for HIV/AIDS than urban
      communities, particularly for women. Theory, research and care and prevention
      practices for women in urban contexts are not necessarily easily applied to women
      in rural communities. This paper identifies several important characteristics of
      the rural community context and discusses how they may impact the development of
      HIV/AIDS-related care and prevention services for women. A social ecological
      perspective, with its emphasis on the relationship between individual-level
      behaviour and experience and different levels of the social environment, is
      presented as a useful approach to the study of the HIV/AIDS care and prevention
      service needs of rural women. Finally, recommendations for research are provided,
      consistent with a social ecological perspective, that can address the current
      lack of information regarding rural women's HIV/AIDS care and prevention service
      needs.

PMID- 11218541
TI  - African and European HIV-positive women: psychological and psychosocial
      differences.
AB  - The objectives were to study and compare the psychosocial and psychopathological
      aspects of HIV infection in African and European HIV-positive women living in
      France. All women included were seen in a semi-structured interview to assess
      personal history, history of their HIV infection, social and family
      relationships, preoccupation with childbearing and concerns about HIV infection
      and its prognosis. The comparison of psychological and psychosocial factors
      between HIV-positive African and European women showed certain significant
      differences. The demographic characteristics did not differ, except for current
      professional activity, with more African women being unemployed. The medical
      aspects of the HIV infection were similar to those described in the literature
      for the two populations. The most interesting findings were on the disclosure of
      HIV-positive status to family and friends, with significantly more European women
      informing friends and family, and on the desire to have children, which was much
      greater in African women; while they already had significantly more children,
      they still wanted to have even more. All these differences emphasize the need to
      adapt medical and psychosocial care to gender and to the ethnic and cultural
      background of the person.

PMID- 11218543
TI  - Trauma, coping, and depression among women with HIV/AIDS in New York City.
AB  - Among 230 HIV-positive women in New York City, we examined the association of
      retrospective self-reports of sexual and physical abuse, current coping
      strategies and depressive symptomatology (CES-D scores). Results revealed a high
      prevalence of abuse in childhood (50%) and adulthood (68%); 7% reported physical
      assault or rape in the last 90 days. As expected, childhood abuse was
      significantly correlated with both adult and recent trauma, and each type of
      trauma correlated with CES-D scores. Childhood abuse also positively correlated
      with the frequency of current adaptive and avoidant coping strategies, although
      avoidant coping had a stronger (negative) association with CES-D scores.
      Hierarchical regression analyses revealed the association between childhood abuse
      and CES-D scores persisted even after controlling for relevant demographic
      variables, more recent trauma and coping strategies. Implications for improving
      the psychological functioning of women living with HIV/AIDS are discussed.

PMID- 11218544
TI  - Use of female controlled microbicidal products for HIV risk reduction.
AB  - Many over-the-counter microbicidal contraceptive methods reduce the risk of
      acquiring sexually transmitted diseases. This pilot project compared the use of
      female controlled barrier methods in an extremely high-risk population of low
      income drug abusing women following an intervention designed to promote HIV risk
      reduction and barrier use. An HIV transmission risk reduction interactive
      intervention emphasizing self-esteem, assertiveness and sexual negotiation was
      offered to 41 drug dependent women. Participants were randomly assigned to one of
      two conditions, a male and female condom condition or a male and female condom
      plus N-9 products (vaginal suppositories, film, gel) condition. Results from the
      three-month follow-up period suggest that there may be a synergistic effect of
      availability of multiple protective methods on the overall rate of protective
      behaviours. The use of the male condom for penile/vaginal sex increased from 19%
      at study entry to 27% during the three-month follow-up period. The total
      protected sexual episode rate, calculated to include use of the other protective
      barriers distributed, was 60%. Thus, the condom use rate was not found to
      decrease because of the availability of alternative methods of protection. Future
      research should address the use of microbicidal products to empower women to
      prevent STD/HIV transmission.

PMID- 11218545
TI  - Introducing the female condom through the public health sector: experiences from
      South Africa.
AB  - The successful implementation of new public health policy is influenced by
      provider preparedness and user acceptability of the new intervention. This paper
      describes the development and implementation of a participatory Training of
      Trainers (TOT) programme as a precursor to launch the South African government's
      female-initiated HIV prevention strategies in public health clinics. Three
      hundred peer-trainees from throughout South Africa were trained through a
      comprehensive, modular and interactive three-day workshop. The workshop content
      included: HIV/AIDS knowledge, beliefs and attitudes; values clarification
      regarding HIV infection and sexuality; sexual desensitization; 'hands-on'
      training in the use of and introduction of the female condom; and counselling,
      communication and programme planning skills. The TOT generated a cadre of
      knowledgeable health care workers for training others and provided a support
      structure at the service delivery level for ensuring potential users' access to
      the female condom within each province. Qualitative assessments of the training
      and trainer debriefing sessions suggest that the training was successful in
      increasing knowledge and promoting positive attitudes about female condoms. In
      addition, the expanded repertoire of problem-solving approaches left providers
      feeling confident about recommending this method to clients.

PMID- 11218546
TI  - A gender-specific intervention for at-risk women in the USA.
AB  - Women are the fastest growing group in the USA to become infected with HIV. Also,
      the mode of transmission is changing with heterosexual behaviour being the
      predominant source. As these changes occur, HIV infection becomes more common in
      women who have not typically been considered at high risk. This paper describes
      an intervention designed to decrease unsafe sexual encounters and to focus on a
      highly meaningful concern in the lives of these women: relationships with men.
      The sessions encouraged making decisions, choice, partner selection, sexual
      rights, refusal of any unwanted sex, female controlled methods and other elements
      of empowerment. An eight-session and a four-session curriculum were created to
      assess dose factors as well.

PMID- 11218547
TI  - Coping strategies and emotional wellbeing among HIV-infected men and women
      experiencing AIDS-related bereavement.
AB  - AIDS influences the psychological coping not only of the person with the disease
      but also those close to that individual. Following a death from AIDS, family
      members and friends may experience atypical bereavement. Bereavement coping
      challenges can be especially difficult and pronounced for persons who are
      themselves HIV-positive. The prevalence of AIDS-related bereavement and
      psychosocial predictors of grief severity were examined in an ethnically diverse
      sample of 199 HIV-infected men and women. Eighty per cent of HIV-positive
      respondents had experienced the loss of someone close to AIDS, the majority of
      whom had sustained multiple and repetitive losses. Two-thirds of the participants
      who had experienced an AIDS-related loss reported grief symptoms in the past
      month. Hierarchical regression analyses revealed that grief was most closely
      associated with emotional suppression and avoiding coping strategies, with
      residual variance related to depression. Interventions for AIDS-related
      bereavement that reduce distress and maladaptive ways of coping are needed in
      order to meet the secondary prevention needs of bereaved people living with
      HIV/AIDS.

PMID- 11218548
TI  - Counsellors' perspectives on the experience of providing HIV counselling in Kenya
      and Tanzania: the Voluntary HIV-1 Counselling and Testing Efficacy Study.
AB  - Demand for HIV counselling services is increasing in developing counties, but
      there have been few previous studies that describe counsellors' roles and
      experiences providing HIV-related counselling in developing countries. Such
      information can be used to better supervise and support counsellors and thereby
      improve counselling services. As a sub-study of the Voluntary Counseling and
      Testing Efficacy Study, we conducted focus groups and individual interviews with
      11 counsellors and counselling supervisors providing HIV counselling services in
      Kenya and Tanzania. Counsellors told us that their jobs were both rewarding and
      stressful. In addition to their obligations in the counselling relationship
      (providing information, protecting confidentiality and being non-judgemental),
      they perceived pressure to provide information and be good role models in their
      communities. Additional stresses were related to external (economic and
      political) conditions, 'spillover' of HIV issues from their personal lives and
      providing counselling in a research setting. Counsellor stress might be reduced
      and their effectiveness and retention improved by (1) allowing work flexibility;
      (2) providing supportive, non-evaluative supervision; (3) offering alternatives
      to client behaviour change as the indication of counsellor performance; (4)
      acknowledging and educating about 'emotional labour' in counselling; (5)
      providing frequent information updates and intensive training; and (6)
      encouraging counsellor participation in the development of research protocols.

PMID- 11218549
TI  - Perceived support in newly registered HIV/AIDS clinic outpatients.
AB  - This study compares levels of perceived social support in newly registered
      outpatients attending an HIV/AIDS clinic to those reported in a reference sample
      of other ambulatory medical populations. Perceived availability of four types of
      functional support is assessed: tangible, affectionate, positive social
      interaction and emotional-informational. Other elements of patients' support
      networks that might be associated with perceived support are also examined. In
      general, functional support levels in the outpatient PHA population were found to
      be similar to those of the MOS-SSS reference sample. Patient factors including
      age, gender, family awareness of HIV/AIDS diagnosis, time elapsed since
      diagnosis, employment status, physical health indicators, antiretroviral
      treatment history and support network size showed no relationship to functional
      support. Network composition factors significantly associated with higher social
      support ratings included the presence of a partner (all dimensions of functional
      support) and a greater proportion of close friends as opposed to close family
      members (emotional-informational support). Requesters of clinic support services
      tended to exhibit lower emotional-informational support scores compared to non
      requesters. Implications for the provision of support services to people living
      with HIV/AIDS are discussed.

PMID- 11218550
TI  - Barriers to social support for persons living with HIV/AIDS.
AB  - The purpose of this study was to test a barrier theory of perceived social
      support to HIV-positive gay men. The proposed model was tested for friends and
      family separately in order to investigate the uniqueness each provided. In both
      models, it was hypothesized that the presence of barriers to social support
      (availability, intimacy and disclosure) diminished acquisition of social support.
      The influence of barriers on the relationship between social support and health
      outcome (i.e. depression, t-cell count) for both friend and family models was
      also investigated. In general, data from HIV-positive gay men support barrier
      theory premises for both family and friends. Implications for helping
      professionals and researchers are proposed.

PMID- 11218551
TI  - Relationships of perceived stress to coping, attachment and social support among
      HIV-positive persons.
AB  - The purpose of this study was to examine the relationships of coping, attachment
      style and perceived social support to perceived stress within a sample of HIV
      positive persons. Participants were 147 HIV-positive persons (80 men and 67
      women). Multiple regression analysis was used to examine the relationships of the
      demographic variables, AIDS status, three coping styles, three attachment styles
      and perceived quality of general social support with total score on the Perceived
      Stress Scale (PSS). PSS score was significantly associated with less income,
      greater use of behavioural and emotional disengagement in coping with HIV/AIDS,
      and less secure and more anxious attachment styles. These results indicate that
      HIV-positive persons who experience the greatest stress in their daily lives are
      those with lower incomes, those who disengage behaviourally/emotionally in coping
      with their illness, and those who approach their interpersonal relationships in a
      less secure or more anxious style.

PMID- 11218553
TI  - WHO global AIDS statistics.

PMID- 11218552
TI  - Relationship between quality of life, social support and disease-related factors
      in HIV-infected persons in Venezuela.
AB  - This study examines the relationships among health-related quality of life
      (HRQL), social support, sociodemographic factors and disease-related factors in
      persons infected with the human immunodeficiency virus (HIV) living in Venezuela.
      A sample of 118 HIV-infected persons living in Caracas, Venezuela, was surveyed
      using a written questionnaire that included a Spanish translation of the
      Interpersonal Support Evaluation List (ISEL) developed for this study, the
      Medical Outcomes Study Short Form-36 (SF-36) and a symptom inventory. All three
      instruments showed good internal consistency reliability. Multiple regression
      analyses were used to model SF-36 sub-scale scores as a function of symptoms,
      social support, HIV-status and use of antiretroviral drugs. The models explained
      between 16 and 39% of the variance in the different HRQL domains. Controlling for
      other variables in the model, level of symptomatology was significantly
      associated with all HRQL domains except social functioning and role-emotional
      scores. Social support was significantly associated with all HRQL domains except
      physical functioning and bodily pain. The use of antiretroviral drugs was
      significantly associated with social functioning. The study indicates the
      importance of social support to the quality of life of HIV-infected individuals
      in this culture.

PMID- 11218554
TI  - The 2000 Frieda Fromm-Reichmann Lecture. The current relevance of Fromm
      Reichmann's works.

PMID- 11218555
TI  - Impoverished counterfactual thinking is associated with schizophrenia.
AB  - Counterfactual thoughts are mental representations of alternatives to past
      events. Recent research has shown counterfactual thinking to be a pervasive
      cognitive process in normal populations and has linked it to effective problem
      solving and decision-making. The present research demonstrates that
      counterfactual thinking is impaired in schizophrenia patients relative to normal
      control subjects; this impairment was evident using measures of counterfactual
      thoughts as well as counterfactual-derived inferences. Furthermore, this
      impoverished counterfactual thinking partly mediated impaired social functioning
      experienced by schizophrenia patients. Given the convergence of
      neuropsychological evidence showing counterfactual deficits in frontal lobe
      patients and the documented frontal deficits in schizophrenia patients, future
      studies investigating a specific relationship between counterfactual thinking and
      frontal lobe function in schizophrenia patients would be a logical next step in
      this line of research.

PMID- 11218556
TI  - Counterfactual thoughts about conterfactual thinking.

PMID- 11218557
TI  - Some reflections on social-cognitive research in schizophrenia.

PMID- 11218558
TI  - Forgiveness: toward an integration of theoretical models.
AB  - Studies on forgiveness have only recently emerged in the psychological
      literature. Despite evidence that forgiveness is associated with positive
      therapeutic outcomes, the concept has received little theoretical consideration
      in mainstream psychology. Existing definitions and models of forgiveness differ
      widely, and little attempt has been made to integrate these diverse approaches.
      Based on a review of the Medline and Psychlit databases, the present article
      evaluates current conceptualizations of forgiveness in the psychological
      literature. The values and limitations of each approach are discussed with
      reference to two case studies: a close interpersonal relationship and a human
      rights violation presented to the Truth and Reconciliation Commission in South
      Africa. A new theoretical model, integrating the most valuable aspects of
      existing approaches, is proposed.

PMID- 11218560
TI  - Cultural psychiatry and minority identities in Japan: a constructivist narrative
      approach to therapy.
AB  - Clinical work with minorities in Japan is a relatively new and rapidly growing
      field. An influx of migrants from the 1970s has required psychiatrists to work
      with culturally different patients, yet few are experienced or trained in this
      area. With an even more radical population change imminent, skills in working
      with people of diverse cultural backgrounds are becoming a pressing need. While
      psychiatry in Japan has long been concerned with culture, only very recently has
      this concern involved differences among Japanese. Psychotherapy with both new
      migrants and individuals from more traditional minority backgrounds involves
      issues of acculturation and identity. A clinical approach based on a theoretical
      orientation of constructivistic narrative therapy can be usefully applied to
      multicultural situations. A case is presented in which this approach is employed
      in assisting a Korean-Japanese youth to deal with identity struggles.

PMID- 11218559
TI  - Posttraumatic stress two years after the Oklahoma City bombing in youths
      geographically distant from the explosion.
AB  - This article describes Posttraumatic Stress Disorder (PTSD) symptomatology in 69
      sixth-grade youths who resided within 100 miles of Oklahoma City at the time of
      the 1995 bombing of the Alfred P. Murrah Federal Building. These youths neither
      had any direct physical exposure nor personally knew anyone killed or injured in
      the explosion. A survey conducted two years after the bombing assessed exposure,
      PTSD symptoms, and functioning. PTSD symptom frequency was measured with the
      Impact of Event Scale--Revised. Our BCD criteria for defining PTSD caseness was
      modeled after DSM-IV B, C, and D criteria requiring one reexperiencing, three
      avoidance/numbing, and two arousal symptoms for diagnosis. Those who met our BCD
      criteria had significantly higher PTSD symptom scores than those who did not.
      Both increased mean PTSD symptom score and meeting our caseness definition were
      associated with increased functioning difficulties. Media exposure and indirect
      interpersonal exposure (having a friend who knew someone killed or injured) were
      significant predictors of symptomatology. These findings suggest that children
      geographically distant from disaster who have not directly experienced an
      interpersonal loss report PTSD symptoms and functional impairment associated with
      increased media exposure and indirect loss.

PMID- 11218561
TI  - VEOS in a six year old girl: premorbid state, onset, course and therapy.

PMID- 11218562
TI  - [Analysis of the proportion of women at different qualification levels in
      departments of human medicine in Germany].
AB  - BACKGROUND AND OBJECTIVE: In Germany leadership positions in medicine are
      characterized by an almost complete lack of women. The goal of this study was to
      determine the representation of women among different career ranks during medical
      school, residency and academic advancement during the past 20 years. METHODS: The
      annual reports of the German Federal Statistic Office in Wiesbaden were checked
      for the numbers of medical students, dissertations, physicians, internists,
      fellows and trainees at universities, habilitations and professorships. RESULTS:
      Among medical students, final examination, dissertation, physicians, internists
      and trainees at universities a proportion of women can be found nowadays which is
      at a 15% higher percentage level than 20 years ago. Among assistant professors
      and habilitations at universities there is a very low proportion of women, which
      did increase only slightly from 5 to 10% during the past 20 years. Within the
      same period of time the total number of professors and the proportion of female
      professors were nearly unchanged. Reunification of East and West Germany led to
      an increase of the representation of women among all levels of qualification
      which is due to the much higher proportion of female physicians in the former
      GDR. CONCLUSIONS: The lack of women in leadership positions in medicine in
      Germany is not due to a general lack of women in medicine. Among all other career
      ranks the proportion of women increased by 15%. The completely unchanged number
      and composition of the professors during the past 20 years suggests that the lack
      of women among this professional group has to do with conservatism which is an
      inherent trait of university professors in Germany.

PMID- 11218563
TI  - [Frequency-dependent rise in absolute threshold during DDD-R stimulation-
      clinical consequences].
AB  - HISTORY AND ADMISSION FINDINGS: A 65-year-old female patient had been supplied
      with a rate-adaptive DDD-R pacemaker system because of symptomatic sick sinus
      syndrome with insufficient rate increase one year ago (first implantation of a
      DDD-system had taken place 14 years ago). In addition she had coronary
      atherosclerosis without relevant haemodynamic changes. Now she was taken into
      hospital because of dizziness and dyspnoea on exertion, without loss of
      consciousness. The physical examination showed normal results concerning heart,
      lungs and vessels. INVESTIGATIONS: During pacemaker control a significant rate
      dependent stimulation threshold increase was found (stimulation rate 70-160/min).
      Similar results were seen in threshold measurements during operation as well as
      for the ventricular lead implanted in 1982, and for the new electrode just placed
      in the right ventricle. Several pacemaker controls within 6 months after
      implanting the new lead showed a significant increase in pacing threshold.
      TREATMENT AND COURSE: Because of a new rate-dependent increase of pacing
      threshold the implantation of a further ventricular lead became necessary. Again
      a rate dependent threshold increase during and immediately after surgery was
      detected. This time the programming of the pacemaker allowed a good safety
      interval because of a generally low stimulation threshold. CONCLUSIONS: This case
      report demonstrates a rate-dependent rise in threshold on DDD-R stimulation. It
      clearly shows that this rise occurred more often at high than at low rates of
      stimulation, but there were marked individual differences. There was no clear
      correlation between cycle length and the interval from implantation to the
      investigation. Further investigations including stimulation with various cycle
      lengths should be carried out in patients at high risk. Furthermore, the
      development of modern pacemaker systems with autocapture might help to solve this
      problem.

PMID- 11218564
TI  - [Fulminant course of falciparum malaria].
AB  - HISTORY AND ADMISSION FINDINGS: A 57-year-old white man had been travelling in
      Kenya for vacation until 14 days before admission. Due to apprehension about side
      effects, the patient had refused any malaria prophylaxis. Ten days before
      admission he developed low grade temperatures and suffered from pain in the
      limbs, from nausea and vomiting. A new episode of tachyarrhythmia was diagnosed
      two days before admission and was treated by his general practitioner. Finally he
      was admitted to our hospital because of high temperatures, chills and progressive
      clinical deterioration. Autopsy revealed prominent congestion of liver, spleen
      and cerebral vessels as well as subdural and subarachnoidal hemorrhage.
      INVESTIGATIONS: In both thin and thick peripheral blood smears Plasmodium
      parasites were demonstrated in approximately 30% of the eryhthrocytes and the
      diagnosis of Plasmodium falciparum was immediately confirmed by an immunological
      test. TREATMENT AND COURSE: Due to the fulminant clinical and neurological
      deterioration with progressive hypoxaemia, the patient required ventilator
      therapy already one hour after admission. Therapy with chinine and doxycycline
      was initiated and exchange transfusion was considered. However, due to
      hyperkalaemia and cardiac arrest, the patient died 4 hours after admission due to
      parasitic hemolysis. CONCLUSIONS: Severe Plasmodium falciparum infection in non
      immunized patients is a medical emergency and requires immediate diagnosis and
      treatment. Malaria should always be considered in the differential diagnosis in
      persons who have travelled to endemic areas and presenting not only with
      temperatures, but also with non-specific clinical signs, like cardiac
      arrhythmias. Although never entirely effective, chemoprophylaxis is highly
      recommended.

PMID- 11218565
TI  - [Diagnostic significance of autoantibodies in bullous dermatoses].

PMID- 11218566
TI  - [Meaningful and meaningless hygienic measures in internal medicine].

PMID- 11218567
TI  - [Venous catheter-associated infections in patients with neutropenia].

PMID- 11218569
TI  - [Subcutaneous magnesium pump in a patient with combined magnesium transport
      defect].

PMID- 11218568
TI  - [Aortic rupture in idiopathic Gsell-Erdheim medionecrosis].

PMID- 11218570
TI  - [BSE (bovine spongiform encephalopathy) and the new variant of Creutzfeldt-Jakob
      disease].

PMID- 11218571
TI  - Synthesis and immunotropic properties of 5-substituted 1,5-benzodiazepin-2-ones
      derivatives in cultures of human peripheral blood cells, Part III.
AB  - The reaction of 4-methyl-(A) and 3-methyl-1H-2,3,4,5-tetrahydro-1,5-benzodiazepin
      2-one (B) with selected alpha,beta-unsaturated acid chlorides: crotonoyl,
      cinnamoyl, and 4-nitrocinnamoyl is described. We have also characterized
      immunotropic activities of these compounds in the proliferative response of human
      lymphocytes to phytohemagglutinin A (PHA) or to allogeneic cells in one-way mixed
      lymphocyte reaction (MLR), as well as their action on tumor necrosis factor alpha
      (TNF-alpha) and interleukin 6 (IL-6) production in peripheral blood mononuclear
      cells (PBMC) and mixed lymphocyte cultures (MLC). Some of the compounds exhibited
      regulatory activities in the proliferative response of cells to PHA depending on
      the reactivity of cells to PHA. The MLR induced proliferation of lymphocytes was
      moderately inhibited by two selected compounds. The compounds showed also
      inhibitor properties with regard to lipopolysaccharide (LPS)- and MLR-induced TNF
      alpha production. Structure-activity relationship was discussed.

PMID- 11218572
TI  - Synthesis and antinociceptive activity of (2-benzazolon-3-yl)propionamide
      derivatives.
AB  - The syntheses of (2-benzothiazolinon-3-yl)propionamide and (2-benzoxazolinon-3
      yl)propionamide derivatives are reported. The structures of these compounds are
      elucidated by their IR and 1H-NMR spectral data, as well as by elemental
      analysis. The compounds were tested for antinociceptive activity by hot plate,
      tail flick, tail clip, and modified Koster tests. Compounds 6b and 7d were found
      to be the most promising compounds among the substances investigated.

PMID- 11218573
TI  - Synthesis of 5-substituted pyrrolo[1,2-b]pyridazines with antioxidant properties.
AB  - 5-Substituted pyrrolo[1,2-b]pyridazines have been prepared by cyclisation of
      pyridazine with diphenylcyclopropenone followed by further functionalisations in
      the pyrrolo[1,2-b]pyridazine 5-position. Several compound exhibit profound
      inhibition of lipid peroxidation in vitro. Lipid peroxidation of boiled rat liver
      microsomes was induced by ascorbic acid/FeSO4 and the peroxidation was determined
      by measuring the thiobarbituric acid reactive material.

PMID- 11218574
TI  - Benzolactam derivatives and their affinity for alpha 1- and alpha 2
      adrenoreceptors.
AB  - A series of benzolactam derivatives has been evaluated for their affinity for
      alpha 1 and alpha 2-adrenoreceptors. The influence of terminal amine and amide
      fragments on the affinity and selectivity has been investigated. It has been
      found that derivatives containing 1,2,3,4-tetrahydroisoquinoline (THIQ) as the
      basic component can form potent alpha 1 and/or alpha 2 ligands, and that their
      alpha 1/alpha 2 selectivity depends on the benzolactam fragment.

PMID- 11218575
TI  - Studies on the structural variations of pentosan polysulfate sodium (NaPPS) from
      different sources by capillary electrophoresis.
AB  - Commercial pentosan polysulfate sodium salts (NaPPS) are highly sulfated
      polysaccharides derived from beechwood hemicellulose by sulfate esterification
      with a Mrel range of 1500-6000. The polysaccharide backbone of NaPPS consists of
      repeating linear units of 1-4 linked beta-D-xylopyranose with laterally
      substituted 4-methylglucopyranosyluronic acid units glycosidically linked to the
      2 position of the main chain at every 10th xylopyranose unit on average. For many
      years NaPPS has been used for antithrombotic prophylaxis in Europe and
      interstitial cystitis in the USA and Australia. More recently NaPPS has found
      veterinary application for the treatment of osteoarthritis and related conditions
      in domestic animals and is registered for this use in Australia, New Zealand,
      Canada, UK, Eire, and several Scandanavian countries. At present the use of NaPPS
      for human disorders is confined to material manufactured by one company. However,
      for veterinary applications, NaPPS from three manufactures have been described.
      Since it is well known that the biological activities of sulfated polysaccharides
      are dependent on their molecular structures we considered it important to
      characterise these various NaPPS preparations using an established method of
      analysis. Unfortunately, traditional analytical techniques such as TLC, OR,
      UV/Vis spectroscopy, and size exclusion chromatography were incapable of
      providing structural information which would distinguish these NaPPS preparations
      from each other. In contrast, a capillary zone electrophoresis (CZE) method
      facilitated characterisation of the different NaPPS by a highly reproducible
      fingerprint, using a benzene-1,2,4-tricarboxylic acid buffer (8.75 mmol/L, pH =
      4.9) with indirect UV detection (lambda = 217 nm) and a special capillary pre
      treatment (1 M NaOH for 1 h at 25 degrees C, then running buffer for 120 min at
      25 degrees C applying -20 kV). In the present study more than 20 batches of NaPPS
      from the three manufacturers have been investigated and compared. Minor batch
      variations were observed to exist for each manufacturer's product however
      significant differences were detected between NaPPS synthesised by the different
      manufacturers. Moreover, some preparations showed fingerprint profiles that
      indicated a more heterogeneous mixture, probably containing other polysaccharides
      as well.

PMID- 11218576
TI  - Synthesis and antiproliferative activity in vitro of novel 1,5-benzodiazepines.
      Part II.
AB  - The reaction of 2,2,4-trimethyl-1H-2,3-dihydro-1,5-benzodiazepine (1) with
      cinnamoyl chloride leading to the formation of 1-cinnamoyl derivative 2 is
      described. Two novel benzodiazepines, 2,2,4-trimethyl-1H-2,3,4,5-tetrahydro-1,5
      benzodiazepine (3) and 1-cinnamoyl-2,2,4-trimethyl-1H-2,3,4,5-tetrahydro-1,5
      benzodiazepine (4), were synthesized by the reduction of 1 and 2 using NaBH4 in i
      PrOH and two other derivatives 5 and 6 were obtained by reaction of 4 with
      equimolar and dimolar quantity of cinnamoyl chloride, respectively. The
      structures of 1-6 were confirmed by analytical and spectral data (IR, 1H NMR, and
      MS). 7-Carboxy-2,2,4-trimethyl-1H-2,3-dihydro-1,5-benzodiazepine (7) was
      synthesized and its crystals were subjected to X-ray analysis. Benzodiazepines 1
      6 were evaluated for antiproliferative activity in vitro. Among the compounds
      tested, 4-6 exhibited cytotoxic activity against human cancer cell lines, namely
      SW707 (colon cancer), MCF-7 (breast cancer), A549 (lung cancer), and HCV29T
      (bladder cancer).

PMID- 11218577
TI  - [Lysis of atrial thrombus with in situ injection of rt-PA].

PMID- 11218578
TI  - [Management of gastroesophageal reflux in children with severe encephalopathy].

PMID- 11218579
TI  - [Is the motivation to use dangerous drugs associated with the number of drugs
      used? Survey among 840 adolescent students].

PMID- 11218580
TI  - [Sexually transmitted diseases in young children in Lome (Togo). Role of sexual
      abuse].
AB  - OBJECTIVE: The purpose of this study was to determine the importance of sexual
      abuse in young children with sexually transmitted diseases (STD) in Lome (Togo).
      METHODS: This transversal study consisted of documenting all cases of STD in
      young children (up to 11 years of age) diagnosed during 20 months (May 1997 to
      December 1998) in the dermatovenereology unit of the Lome teaching hospital.
      Syphilitic (TPHA-VDRL) and HIV serologies were carried out in all children. These
      serologies were repeated two weeks and three months later in sexually abused
      children. RESULTS: During this period, 33 cases of STD were diagnosed. There were
      16 cases of anogenital warts (13 females, three males; mean age: 5.6 +/- 2.4
      years); 13 cases of gonorrhoea (all were females; mean age: 7.2 +/- 1.8 years);
      and four cases of genital trichomoniasis (four females; mean age: 6.2 years). In
      12 of 13 cases of gonorrhoea, sexual abuse was noted with identification of the
      alleged contaminators in ten cases. In eight of 16 cases of anogenital warts (all
      observed in females; mean age: 6.1 +/- 1.9 years), and two of four cases of
      genital trichomoniasis (mean age: six years) sexual abuse was observed.
      Syphilitic serology was negative in all children, but one ten-year-old girl had
      HIV infection with identification of the alleged contaminator. CONCLUSION: The
      results of this study confirm that sexual abuse in children is not uncommon in
      black Africa and that the STD, like condylomata acuminata and gonorrhoea, are
      good indicators of this phenomenon. The classical consequences of such sexual
      abuses are aggravated in Africa by the high prevalence of HIV infection observed
      in the majority of countries, mainly in urban areas.

PMID- 11218581
TI  - [Early cardiovascular effects of corticotherapy for bronchopulmonary dysplasia].
AB  - OBJECTIVES: The aim of this study was to analyze the time course of
      cardiovascular effects in glucocorticoid-treated premature infants with
      bronchopulmonary dysplasia (BPD). METHODS: In a retrospective case study, 63
      ventilator-dependent very-low-birth-weight neonates (mean gestational age = 27.9
      +/- 2 weeks and mean birth weight = 920 +/- 275 g) treated with dexamethasone
      (52%) or betamethasone (48%) were studied. The average value for each study day
      was calculated for systolic arterial blood pressure and heart rate. RESULTS: At
      initiation of treatment, blood pressures increased significantly from pre
      treatment to day 1 and continued to increase during the first week: as a
      percentage of pre-treatment baseline the mean increase for systolic arterial
      blood pressure was 19% (95% confidence interval [CI] = 16, 22) on day 2 (P <
      0.001). The maximum amplitude of variation was observed before day 2 for 75% of
      the study group. As a group as a whole, the heart rate value significantly
      decreased on day 1 (mean difference = -14.6 beats/min; 95% CI = -16.5, -12.6; P <
      0.001), and then reached pre-treatment value within one week. Cardiovascular
      response was independent of gestational age, birth weight and postnatal age at
      the beginning of treatment. CONCLUSION: During postnatal steroid therapy a rise
      in blood pressure is a common side effect, but bradycardia is mentioned very
      occasionally. The present study shows a marked increase in blood pressure during
      the first 48 hours concomitant with a decrease in heart rate. The inverse
      relationship between systolic arterial blood pressure and heart rate suggests a
      baroreflex response.

PMID- 11218582
TI  - [Colonization by Ureaplasma urealyticum and chronic lung disease in premature
      newborn infants under 32 weeks of gestation].
AB  - Colonization of the respiratory tract of premature newborn infants by genital
      mycoplasma is suspected to be associated with chronic lung disease. METHODS AND
      PATIENTS: We prospectively determined the prevalence of genital mycoplasma
      colonization with nasopharyngeal or endotracheal culture in preterm neonates
      younger than 32 weeks gestation and its possible association with the development
      of chronic lung disease in a prospective study. RESULTS: Fifty-nine infants were
      enrolled and 11 (19%) were colonized with Ureaplasma urealyticum. In the subgroup
      of 45 ventilated infants, seven of seven U. urealyticum-positive infants
      developed chronic pulmonary disease versus ten of 38 (26%) of U. urealyticum
      negative infants (relative risk [RR] = 3.8; 95% confidence interval [CI] 2.2 to
      6.5, P < 0.001). U. urealyticum-colonized infants had a lower median birth weight
      (760 vs 1,083 g, P = 0.04), a lower gestational age (26 vs 28 weeks, P = 0.03),
      and a higher incidence of symptomatic patent ductus arteriosus (P = 0.03). These
      potential confounding factors may partially explain the association between U.
      urealyticum and chronic pulmonary disease. However, this association remained
      statistically significant when the analysis was restricted to infants with birth
      weight of 1,000 g or less (RR = 2.3; 95% CI 1.3 to 4, P = 0.02) or to infants
      with a patent ductus arteriosus (RR = 2; 95% CI 1.3 to 3.1, P = 0.02).
      CONCLUSION: Colonization with U. urealyticum in ventilated preterm neonates
      younger than 32 weeks gestation is a significant risk factor of developing
      chronic pulmonary disease.

PMID- 11218583
TI  - [Collagen gastritis, an unusual cause of anemia in children. Report of 2 cases].
AB  - When a child presents a severe anemia or resistant to iron supplementation, an
      upper gastrointestinal endoscopy has to be realized to find special causes. CASE
      REPORTS: We report observations of two patients, respectively 11 and 12 years
      old, who were admitted to hospital for a severe microcytic, hypochromic,
      aregenerative anemia (hemoglobin less than 50 g/L) due to an iron deficiency. The
      two children's history did not reveal a deficient diet, gastrointestinal tract
      disorder, ingested toxic or gastrotoxic drugs, or exteriorized hemorrhage. Upper
      gastrointestinal endoscopy showed a macroscopic pattern of gastritis. The stomach
      biopsies revealed subepithelial collagenous deposits. CONCLUSION: The collagenous
      gastritis involves lesions similar to those described in the small intestine
      (collagenous sprue) and colon (collagenous colitis). The pathogenic factors of
      the three entities are presently unknown, but they are often associated with
      autoimmune pathology. These two observations are the third and the fourth
      pediatric cases described.

PMID- 11218584
TI  - [Acute rhabdomyolysis disclosing polymyositis in children].
AB  - Traumatic and non-traumatic rhabdomyolysis have been mostly reported in adults.
      Polymyositis rarely leads to rhabdomyolysis. CASE REPORT: We report the case of a
      13-year-old girl with rhabdomyolysis. Full recovery was observed after
      symptomatic treatment. Nine months later she developed polymyositis. CONCLUSION:
      Long-term follow-up is necessary for rhabdomyolysis, even in those cases with an
      isolated occurrence caused by viral infection.

PMID- 11218585
TI  - [Esophageal duplication in children. Report of 7 cases].
AB  - Esophageal duplications represent 10 to 20% of esophageal malformations and 15 to
      20% of digestive duplications. METHODS: The authors report a series of seven
      cases observed between 1985 and 1999. RESULTS: The sex ratio was 2.5. The
      diagnosis was made before the age of six months in five cases. The clinical
      presentation included respiratory signs in six cases and digestive signs in five
      cases. The diagnosis was made on the association of a mediastinal mass behind
      vertebral malformation in five cases. The duplication was cystic in five cases
      and tubular in two. A perforation in the pleura occurred in one case of tubular
      duplication. The intervention consisted of total excision of the duplication in
      four cases and subtotal resection in two cases. For the seventh patient, who
      presented a perforation of the duplication in the pleura, the operation comprised
      a thoracic drainage associated to feeding gastrostomy. The histologic examination
      of the six operative specimens confirmed the diagnosis of esophageal duplication.
      Six patients survived and have favorable evolution with an average follow-up of
      four years. DISCUSSION: Esophageal duplications represent 15 to 20% of digestive
      duplications. Their clinical presentations are variable. Their diagnosis is often
      made before the age of two years, when a posterior mediastinal mass is associated
      with vertebral malformations. Apart from the tubular form, which is rare,
      diagnosis is confirmed by the histologic study of the operative specimen.
      CONCLUSION: Esophageal duplications are rare and often pose a problem of positive
      diagnosis. Their treatment is surgical and should be undertaken before the
      appearance of complications.

PMID- 11218587
TI  - [Breastfeeding and hepatitis C virus (HCV): the need for a careful appraisal].
AB  - We review the available data on the possible role of breast-feeding in hepatitis
      C virus (HCV) transmission to infants of HCV-RNA-positive mothers. Current
      knowledge about HCV excretion through breast milk, HCV infection of breast-fed
      infants by mothers contaminated after delivery, and vertical transmission risk to
      infants breast-fed by chronic HCV viremic mothers are presented. Vertical
      transmission risk by breast-feeding HCV-RNA-positive mothers is unclear: no study
      has been performed with the aim and the required methodology to evaluate HCV
      transmission risk related to breast-feeding duration. Recommendations to HCV-RNA
      positive mothers who wish to breast-feed their infant are discussed in light of
      present knowledge about HCV secretion in breast milk, mother-to-infant HCV
      transmission, and historical records on vertical transmission of other viruses to
      infants breast-fed by their viremic mothers.

PMID- 11218586
TI  - [Anemia and limping in a vegetarian adolescent].
AB  - A vegan diet in the child and adolescent can induce severe bone sequelae by
      rickets and osteomalacia and megaloblastic anemia by cobalamin deficiency. CASE
      REPORT: A 15-year-old adolescent was hospitalized because of lameness and pallor.
      The lameness was explained by femoral epiphysiolysis caused by rickets with
      severe hypocalcemia. The pallor, jaundice and splenomegalia were due to cobalamin
      deficiency megaloblastic anemia. A prolonged supplemental diet with calcium,
      vitamins D and B12 as well as orthopedic treatment stabilized the bone lesions.
      The megaloblastic anemia was cured by parenteral cobalamin. The adolescent and
      his brother were victims of a diet imposed by a cult and a lack of care due to
      their parents refusing that a vegan diet was the cause of the deficient
      pathology. Penal proceedings led to the incarceration of the parents and to the
      placement of the children. COMMENTS: Deficiencies in calcium and vitamins D and
      B12 may be severe in a child's development with a vegan diet. This case report
      reveals the social and legal problems of an inappropriate diet in infancy imposed
      by parents who are followers of a fundamentalist church. Beyond the management of
      children in cults, health professionals have to prevent, screen and supplement
      the deficient diet.

PMID- 11218588
TI  - [Obesity in children: a disease that risks the vital prognosis].
AB  - Drug consumption by adolescents causes social and health problem. OBJECTIVE: This
      prospective study was designed to examine reasons for and against using
      substances such as tobacco, alcohol, and marijuana and to discover whether or not
      motives to use drugs vary with the number of drugs used. METHOD: The participants
      were 886 adolescents from a suburban high school (Nancy, France), who answered a
      self-report questionnaire. RESULTS: The response rate was 95% (655 males and 175
      females, mean age 17.5 +/- 2.5 years).  The prevalence of current tobacco use,
      former tobacco use and never used was 40.7, 21.3 and 31.7%, respectively.  For
      alcohol consumption, the results wre 85.8, 3.5 and 0.7% respectively and for
      marijuana consumption 34.4, 18.3 and 47.3%, respectively.  Ecstasy had already
      been used by the respondens.  The main reasons given by the adolescents to
      explain why they did or did not use these substances varied with the mumber of
      drugs used. CONCLUSION: This work shows an increasing deterioration of youths'
      social relations (with his/her parents and with him/herself) that seem to depend
      onthe number of drugs used.  Further research is necessary to improve these
      results.

PMID- 11218589
TI  - [Home artificial nutrition in children. Indications and organization].
AB  - Home enteral and parenteral nutritions are logical alternatives to long-term
      hospitalization when a long-term nutritional support is required. They are
      effective and safe methods, compatible with a good quality of life. Major cost
      savings have been demonstrated as a result of home nutrition rather than
      hospitalization. Nevertheless, one must not underestimate the importance of the
      families' teaching and the medical follow-up to prevent somatic and psychological
      complications. The quality of home nutrition programmes depends on the
      organization of the nutrition support teams based on close collaboration between
      the various involved professionals.

PMID- 11218590
TI  - [Identification of language disorders in children. A contribution to the
      prevention of illiteracy].
AB  - Early identification of disorders of oral and written language development is
      essential for effective action before the vicious circle of educational failure
      and established psychosocial consequences. There has been growing awareness among
      health and education professionals that the means of recognizing, treating and
      teaching children with specific oral and written language disorders are
      inadequate. There is still a limited number of diagnostic tools that have not
      been fully evaluated. Nevertheless, considerable effort has been made in recent
      years to develop instruments for early detection and precise diagnostic
      evaluation. Developments in cognitive neuropsychology provide new approaches for
      the management of these disorders.

PMID- 11218592
TI  - Allergic to dentistry?

PMID- 11218591
TI  - [Jargon of the neonatal intensive care unit].
AB  - Jargon, the specialized vocabulary and idioms, is frequently used by people of
      the same work or profession. The neonatal intensive care unit (NICU) makes no
      exception to this. As a matter of fact, NICU is one place where jargon is
      constantly developing in parallel with the evolution of techniques and
      treatments. The use of jargon within the NICU is very practical for those who
      work in these units. However, this jargon is frequently used by neonatologists in
      medical reports or other kinds of communication with unspecialized physicians.
      Even if part of the specialized vocabulary can be decoded by physicians not
      working in the NICU, they do not always know the exact place that these
      techniques or treatments have in the management of their patients. The aim of
      this article is to describe the most frequent jargon terms used in the French
      NICU and to give up-to-date information on the importance of the techniques or
      treatments that they describe.

PMID- 11218593
TI  - The NHS dental plan--key points for the busy practitioner.

PMID- 11218594
TI  - Osteogenic distraction within the craniofacial complex.
AB  - Osteogenic distraction is a method of increasing bone length, and was developed
      by orthopaedic surgeons. It is now being used in the craniofacial region. This
      paper outlines some of the suggested uses: mandibular distraction can be used to
      correct hypoplasia and asymmetry in both children and adults; maxillary
      distraction can bring the midface forward, and holds potential for people with
      cleft lip and palate; augmentation of alveolar ridges and regeneration of
      mandibular tissue following tumour resection show considerable promise. The
      complex spatial dimensions of the craniofacial bones present considerable
      challenges for this developing technique.

PMID- 11218596
TI  - Current practice in endodontics: 3. Access is success, and rubber dam is easy.
AB  - The prime aim of this series of articles is to improve the quality of endodontic
      treatment in general dental practice by considering what is currently being
      taught in dental schools. This, the third article, offers guidance and hints to
      ease the use of rubber dam, which should be mandatory for root canal therapy. It
      also considers the shape, position and extent of access cavities. The access
      cavity can make all the difference in success or failure of endodontic treatment.

PMID- 11218595
TI  - Allergy to a common component of resin-bonding systems: a case report.
AB  - Allergies to materials routinely used in dentistry are becoming more prevalent.
      The hydrophilic resin 2-hydroxyethyl methacrylate is a common constituent of
      systems designed to bond resin-based restorative materials to dentine. It has
      been considered to have a high sensitizing potential, although dental patient
      related allergies to the resin appear to be rare. This report presents details of
      a patient who has such an allergy, which, it is suspected, manifested as an intra
      oral lichenoid reaction to the closely approximating anterior restorations.

PMID- 11218597
TI  - Fibre-reinforced materials.
AB  - This paper considers the role of fibres in the reinforcement of composite
      materials, and the significance of the form the fibre takes and the material from
      which it is made. The current dental applications of fibre reinforcement,
      including dental cements and splints, fibres made into structures for use in
      composites, denture bases and the contemporary use of fibres in fixed partial
      dentures, are reviewed. Their role in biomedical implants is surveyed and their
      future forecast.

PMID- 11218598
TI  - Transcultural oral health care: 4. Dental medication for Muslim patients.
AB  - The aim of this paper is to provide a guide for general dental practitioners who
      may need to prescribe medication to Muslim patients, particularly during the
      month of Ramadan. An understanding and appreciation of the patient's religious
      background will aid treatment compliance and allow dentists to provide a
      culturally sensitive service for their Muslim patients. Drug therapy compliance
      is important, but it is likely to be poor among Muslim patients during the month
      of Ramadan, when fasting and religious practices may cause problems. The authors
      provide guidelines on good clinical practice and prescribing regimens for general
      dental practitioners treating Muslim patients, particularly during Ramadan.

PMID- 11218600
TI  - Adapting crown preparations to adhesive materials.
AB  - Traditional approaches to crown preparation for replacement crowns or teeth with
      short clinical crowns are often overly destructive of tooth tissue. Adhesive
      cements or composites combined with dentine bonding agents provide the clinician
      with some flexibility in treatment planning and should be considered when more
      destructive techniques would otherwise be necessary.

PMID- 11218599
TI  - The long-term management of patients with tooth surface loss treated using
      removable appliances.
AB  - The causes of tooth surface loss are multi-factorial and hence can be difficult
      to eradicate. This paper identifies the problems that may be anticipated during
      the long-term management of patients where tooth surface loss has been treated
      using removable appliances, where the number of teeth is often reduced. Wear and
      tear are inevitable and patients should therefore be made fully aware of the
      possibility of the gradual deterioration and failure of restorative work.
      Treatments should be planned, which would enable the dentist to recover the
      situation, with minimal inconvenience to the patient.

PMID- 11218601
TI  - Presenting the dental assisting professional in the year 2000.

PMID- 11218602
TI  - How to determine a fair & equitable salary for dental auxiliaries.

PMID- 11218603
TI  - Next patient please.

PMID- 11218604
TI  - Environmental surface disinfection.

PMID- 11218605
TI  - Lost dentists.

PMID- 11218606
TI  - The York review of water fluoridation--key points for the busy practitioner.

PMID- 11218607
TI  - The Cartwright Prize. Caries removal and the pulpo-dentinal complex.

PMID- 11218609
TI  - Current practice in endodontics: 4. A review of techniques for canal preparation.
AB  - The prime aim of this series is to improve the quality of endodontic treatment in
      general dental practice by considering what is currently being taught in dental
      schools. This article reviews the development of today's endodontic techniques
      and suggests alternative methods of obtaining a clean and shaped canal, in
      keeping with the varying requirements of practitioners of differing backgrounds
      and abilities, while keeping in mind the established aims and objectives of
      endodontic treatment.

PMID- 11218608
TI  - Strength of a 'no-bottle' adhesive system bonded to enamel and dentine.
AB  - Existing bonding systems permit effective bonding to enamel or dentine. Bonding
      to dentine is mainly achieved through the hybridization of dentine with resin.
      However, despite their success, the 'three-bottle' systems do have drawbacks--the
      large number of steps involved may be confusing and prone to errors of
      application, as well as being time consuming. Recently developed systems have
      significantly reduced the number of steps and the total treatment time, but
      deliver a reliable outcome.

PMID- 11218610
TI  - Multiple Stafne bone cavities: a diagnostic dilemma.
AB  - Salivary gland inclusions in the mandible are relatively uncommon. If defects
      occur they are generally unilateral, although bilateral cases have been reported.
      This article describes an unusual case in which the dental panoramic tomogram
      revealed three radiolucent areas in the mandible. The diagnosis of the two
      posterior radiolucencies was confirmed as Stafne's bone cavities but a definite
      diagnosis for the parasymphyseal lesion remained elusive, even after surgery.
      However, Stafne's bone cavities are known to occur in this region and this
      diagnosis remains the most probable.

PMID- 11218612
TI  - Rhinoliths presenting during routine radiography: two cases.
AB  - Rhinoliths are calcified masses found within the nasal cavity. They are an
      uncommon finding and usually present to ENT surgeons. This article presents two
      cases where rhinoliths have been recognized in the dental setting, and discusses
      their management and treatment.

PMID- 11218611
TI  - Transcultural oral health care: 5. Diet and minority ethnic groups in the United
      Kingdom.
AB  - Dietary behaviours of minority ethnic groups vary considerably, not only between
      groups but also within communities and families. The aim of this article is to
      consider the information on diet and eating habits of members of minority ethnic
      groups, especially with regard to sugar consumption.

PMID- 11218613
TI  - The early management of Class III malocclusions using protraction headgear.
AB  - Class III malocclusions affect approximately 3% of Caucasians. Treatment options
      include; growth modification, dental camouflage and, once growth has ceased,
      orthognathic surgery. Originally, Class III malocclusions were thought to arise
      primarily from an overdevelopment of the mandible, but it is now known that
      maxillary retrusion contributes in up to 60% of cases. Maxillary retrusion is
      best treated with a combination of protraction headgear and rapid maxillary
      expansion, preferably before the age of 9 years. This article provides an
      overview of the management of skeletal Class III cases using protraction headgear
      with particular guidance for the general dental practitioner on when and how to
      treat.

PMID- 11218614
TI  - Immediate auto-bridge.

PMID- 11218615
TI  - Caution with oral midazolam.

PMID- 11218616
TI  - Dentine caries: take it or leave it?

PMID- 11218617
TI  - Transcultural oral health care and the Chinese.

PMID- 11218618
TI  - Transcultural oral health care of the Chinese.

PMID- 11218619
TI  - Long-term relapses of breast cancer: questions, interpretations and hypotheses.
AB  - The author has demonstrated in previous publications that the consistent
      characteristic of long-term relapses of carcinoma after more than 8 years from
      surgery is hormone dependence, since long-term relapses occur almost exclusively
      in hormone-dependent tumors such as carcinoma of the breast, prostate,
      endometrium and thyroid. Such publications presented a series of 237 long term
      relapses of breast cancer that occurred at no less than 8 years from the
      mastectomy, which proved that all the patients were estrogen-receptor positive.
      Estrogen-negative cases who did not relapse after 8 years from surgery should be
      considered cured, as is found for cases of non-hormone-dependent tumors.
      Therefore, the study demonstrates that breast cancer, without the presence of
      hormone receptors (which influence clinical behavior) is similar to neoplasms
      that arise in all parts of the body. The author herein presents a personal
      hypothesis relative to the possibility that the presence of receptors indirectly
      conditions the formation of antimitotic factors up to determining in some cases
      the phenomenon of long-term relapses. Such factors are presumably physiological,
      and the possibility that such a hypothesis can also serve to explain the results
      obtained with hormone therapy of breast cancer is examined.

PMID- 11218620
TI  - Peripheral neuropathy without cryoglobulinemia in patients with hepatitis C virus
      infection.
AB  - BACKGROUND: An association between essential mixed cryoglobulinemia and hepatitis
      C virus infection has been documented by many reports. Some clinical
      manifestations such as purpura, arthralgia, vascular lesions and peripheral
      neuropathies are also connected with the presence of detectable cryoglobulins.
      The association between HCV infection, the presence of mixed cryoglobulinemia and
      peripheral neuropathy is well documented. The aim of this study was to define the
      possible presence of peripheral neuropathy in HCV patients without detectable
      cryoglobulins and the possible association with the different genotypes. METHODS:
      Twenty patients (11 females, 9 males) with chronic HCV hepatitis and without
      detectable cryoglobulins were submitted to neurological and electrophysiological
      studies to detect a possible peripheral neurological involvement. In all patients
      the HCV infection was assumed by the presence of antibodies to HCV with ELISA
      assay and then confirmed with recombinant immunoblot assay. HCV genotyping was
      obtained by INNO LIPA in 15 out of 20 patients. In 4 patients a sural nerve
      biopsy was possible. RESULTS: Genotype 1b was present in 80% of patients, while
      1a in 13.3% and 4 in 6.6%. Thirteen patients had positive neurological anamnesis
      (65%), while neurological examination was positive in 40% of the cases.
      Electromyographic study was positive in 50% of subjects. The sural nerve biopsies
      agreed with axonal degeneration in amyelinated fibres. CONCLUSIONS: Our results
      suggest a possible peripheral neurological system involvement in patients with
      HCV infection without cryoglobulins.

PMID- 11218621
TI  - Role of monocytes in the early phase of acute myocardial infarction.
AB  - BACKGROUND: In acute myocardial infarction peripheral leucocytosis occurs early
      and fibrinogen levels increase in response to the tissue injury, expressed by the
      enhanced enzyme plasma levels. The aim of the present study has been to
      investigate if a unifying link between these modifications might be found.
      METHODS: In 325 patients, 246 men and 79 women, 61.46 +/- 11.00 and 70.03 +/-
      11.30 years mean age respectively, at admission for myocardial infarction and
      before treatment, we simultaneously measured plasma fibrinogen (FBG),
      hemochromocytometric parameters and plasma enzyme aspartate and alanine
      transaminase (AST and ALT), lactate dehydrogenase (LDH) and creatine
      phosphokinase (CPK). The statistical analysis was performed by using standard
      multiple regression for dependent variable FBG and for the variables white blood
      cells (WBC), monocyte number, large unstained cells (LUC) and CPK. RESULTS: The
      results showed that FBG was significantly correlated with monocyte (p < 0.001)
      and LUC (p < 0.05) counts; assumed as dependent variable, further on with FBG,
      monocyte number was correlated with WBC count, LUC and CPK; further on with
      monocyte number, WBC with neutrophile and lymphocyte counts, LUC with CPK, CPK
      with LDH. CONCLUSIONS: The study seems to show that monocyte modifications occur
      already in the early phase of myocardial infarction. These modifications are
      directly related to damage extension, as deducible from CPK levels, and seem to
      mainly modulate FBG and WBC, since the cytokines and hematopoietic growth factors
      production by activated monocytes.

PMID- 11218622
TI  - Seroprevalence of Helicobacter pylori infection in a group of hospitalized
      geriatric patients.
AB  - BACKGROUND: In recent years several epidemiological surveys have reported the
      association between Helicobacter Pylori (HP), chronic ischemic heart disease
      (CHD) and cerebrovascular disease (CVD). None involved the geriatric population
      in which these diseases are prevalent. METHODS: We investigated the HP
      seropositivity prevalence in a group of over 75-year-old subjects recruited among
      all patients consecutively admitted for various diseases in an Internal Medicine
      Department during a period of 9 months. INTERVENTION: We measured HP IgG
      antibodies employing a commercially available kit based on reverse flow
      chromatography highly feasible and simple to perform and we investigated all
      patients for past or present CHD/CVD. RESULTS: From our data, the prevalence of
      seropositivity to Hp does not differ from other wider age stratified studies;
      more in detail; in the over 90-year-old patients we found the same HP
      seropositivity prevalence as in younger group but were not able to confirm the
      progressive lowering or seroprevalence in extreme geriatric age. CONCLUSIONS: No
      clear correlation between HP seroprevalence and CHD and CVD was found, but a link
      with CHD seems possible for the determinant (age) is common to both conditions.

PMID- 11218623
TI  - Association of alpha-interferon and acetyl cysteine in patients with chronic C
      hepatitis.
AB  - BACKGROUND: Numerous experimental findings have underlined the relationships
      between liver damage and production of oxygen-derived free radicals during
      inflammation. In chronic hepatitis C liver disease this damage may be attributed
      to altered oxide-reductive balance and glutathione (GSH) depletion. Moreover, it
      may be linked to chronic inflammation provoked by the replicative activity of the
      hepatitis C virus and its relationships with immune system cells. Our aim was to
      assess the effects of combined IFN + NAC treatment to compare the effects of
      interferon alpha-n1 associated with N-acetyl cysteine treatment with the results
      observed using interferon therapy alone. METHODS:  EXPERIMENTAL DESIGN:
      prospective randomised study. SETTING: Ambulatory and hospitalised care.
      PATIENTS: 77 selected patients affected by chronic C hepatitis. INTERVENTIONS:
      our patients were investigated by laboratory tests (ALT values, RIBA test, HCV
      RNA, oxide-reductive balance), liver biopsy and liver US. The recruited subjects
      were treated with interferon and N-acetyl cysteine or with interferon alone.
      RESULTS: Our findings confirmed the presence of oxidative stress in patients with
      chronic hepatitis C and showed earlier relapse in patients treated with
      interferon alone. The difference between the results in patients treated with
      interferon and N-acetyl cysteine and those on interferon alone was significant.
      CONCLUSIONS: The good results and absence of side effects in patients treated
      with interferon + N-acetyl cysteine recommend wider use of this association.

PMID- 11218624
TI  - The use of intravenous immunoglobulin in sine causa or alloimmune recurrent
      spontaneous abortion (RSA).
AB  - BACKGROUND: Recurrent spontaneous abortion (RSA) has an incidence of 0.5%-1%. It
      is thought that immune reaction disorders in the mother may evolve in unexplained
      RSA, which has a higher incidence in women over 40 years old. METHODS: Twenty
      three patients with recurrent spontaneous abortion of unknown origin and two
      autoimmune cases were treated with intravenous specific immunoglobulins at the
      5th-6th week of pregnancy and fifteen days later. RESULTS: After treatment,
      nineteen patients brought their pregnancy to term, five aborted, one is pregnant
      at present. CONCLUSIONS: The use of immunoglobulins seems to be efficacious in
      recurrent spontaneous abortion of unknown origin. Our results support the theory
      that this treatment is able to passively transfer the sparking off factor that
      allows the pregnancy to evolve.

PMID- 11218625
TI  - Azithromycin in the treatment of Plasmodium falciparum gametocytes. Preliminary
      observation.
AB  - BACKGROUND: Treatment of malaria represents a problem as antimalarial drugs are
      relatively few, and because of the increasing widespread resistance of Plasmodium
      falciparum to most of these drugs. A partial efficacy of azithromycin against Pl.
      falciparum hepatic stage and against trophozoytes in the erythrocytic stages of
      the disease has been demonstrated. No data concerning the activity against
      gametocytes are available, and primaquine stands as the only therapy against Pl.
      falciparum gametocytes. Primaquine causes haemolysis in patients with glucose-6
      phosphate dehydrogenase (G6PD) deficiency, so primaquine therapy is usually
      avoided. A better tolerated therapy against gametocytes would be useful to reduce
      malaria transmission. We present the results of a study concerning the efficacy
      of azithromycin in the treatment of P. falciparum gametocytes. METHODS: A
      prospective study was performed: 4 patients with Pl. falciparum gametocytes (3
      children, 1 adult) were treated with azithromycin for concomitant bacterial
      infections; in the meantime two children with gametocytes were taken as control.
      Azithromycin was administered as recommended. RESULTS: Gametocytes were
      detectable in children thick blood smears after 8, 5 and 6 days respectively
      after the beginning of azithromycin therapy, while they were undetectable in the
      adult thick blood smear 5 days after the beginning of the therapy. The
      gametocytes spontaneously disappeared in the two controls 4 to 6 days after the
      beginning of observation. CONCLUSIONS: These data suggest that azithromycin seems
      ineffective against Pl. falciparum gametocytes. Further studies are needed in
      order to determine whether azithromycin treated gametocytes are infective to
      mosquitoes or not, and to confirm this first observation.

PMID- 11218626
TI  - Local recurrences and primary surgery in rectal carcinoma.
AB  - BACKGROUND: The authors analyze retrospectively a consecutive series of rectal
      carcinomas operated on with different surgical strategies at Third Surgical
      Department of "La Sapienza" University of Rome, between January 1985 and December
      1997, by one expert surgeon (GDM), and report the incidence of the local
      recurrence correlated to the surgical technique development. METHODS: In most
      recent groups of patients treated for extraperitoneal neoplasm from January 1992
      with curative (R0) total mesorectal excision (TME) and nerve sparing technique
      (NST) (Group C, n = 47) and with curative TME plus lateral pelvic lymphadenectomy
      (LPL) and NST (Group D, n = 7), sacrificing the pelvic autonomic nervous system
      only in case of neoplastic infiltration, the local recurrence was 8.5% (4 cases,
      with mean interval of 30.5 months) and 0 respectively at mean follow-up of 44.9
      and 55 months. RESULTS: In none of the local recurrences of the Group C a re
      resection (neither curative nor palliative) was possible and the survival was 50%
      at 14 months from the diagnosis of relapse. Instead, in local recurrences of
      rectal carcinoma in patients who underwent a first anterior resection with less
      extended dissection in other Department (Group E), a re-resection was possible
      for 3 cases out of 4 (R0, R1 and R2 operations); re-resected patients are now
      alive at mean follow-up of 33.6 months (82, 12 and 7 months, respectively). In
      Group A patients, treated between January 1985 and December 1988 with partial
      mesorectal excision (R0) also for extraperitoneal localization, the incidence of
      local relapses is 21.9% (9/41 cases) vs 11.2% (11/98 cases) in Group B patients,
      treated from January 1989 with curative TME for extraperitoneal tumors.
      CONCLUSIONS: The incidence of local recurrences of extraperitoneal rectal cancer
      can be reduced by total mesorectal excision. The total sparing of pelvic
      autonomic nervous system in advanced rectal carcinoma doesn't increase the
      incidence of local recurrences.

PMID- 11218627
TI  - Patient's needs in substitutive dialysis treatment. Some psycho-social and
      organizational considerations.
AB  - BACKGROUND: The observations here presented come from an action-research project
      carried out at the Dialysis Centre of Ivrea. The work is focused on the
      articulation between subjective (the felt experience) and objective variables
      (the structure and intervention typology) with the aim of understanding patient's
      needs from an organizational point of view. METHODS: A questionnaire to evaluate
      the needs of dialytic patients and the burden that these have on the health
      service and staff, was formulated by the nurses. RESULTS: The results showed how
      the patient's clinical history indicate, significantly, not only personal and
      subjective aspects (e.g. interpersonal relationships), but also how they
      construct their relationships with the hospital and its services (including the
      hospital staff). CONCLUSIONS: Data open up certain reflections on what role
      communication and information play within the hospital structure. Efficient
      communication contributes both to reduce the anxiety level and to improve the
      organizational climate therefore influencing service quality.

PMID- 11218628
TI  - Effects of acute normovolaemic haemodilution and partial exchange transfusion on
      blood product utilization, haemostasis and haemodynamics in surgery of the
      thoracoabdominal aorta. A cohort study in consecutive patients.
AB  - BACKGROUND: This paper outlines the technique of acute normovolaemic
      haemodilution with partial exchange transfusion (ANHPET) in surgery of the
      thoracic and thoracoabdominal aorta. Perioperative coagulation parameters and
      patterns of blood product utilization observed with this technique are described
      and compared with results for historical controls treated without ANHPET.
      METHODS: During thoracoabdominal aneurysm repair, acute normovolaemic
      haemodilution with partial exchange transfusion (ANHPET) was used to withdraw of
      up to 3 L of blood. This was returned to the patient at the end of the
      reconstruction. Albumin 5% and stored packed red cells (PRC) were used for
      replacement. Seven patients underwent surgery with ANHPET, and fifteen without.
      Univariate and multivariate analysis of variance was used to examine differences
      between these groups. RESULTS: No differences were observed between the two
      groups for estimated blood loss, PRC transfused, and postoperative haemoglobin
      concentration. The ANHPET group received fewer platelets (8 vs 22 units, p =
      0.0004), cryoprecipitate (0 vs 13 units, p = 0.02), and desmopressin or epsilon
      aminocaproic acid (0 of 7 vs 4 of 15 patients, p = 0.04). FFP use was not
      significantly different (11 vs 17 units). Postoperatively, PTT values were less
      prolonged (26 vs 34 sec, p = 0.05) and platelet concentration higher (218 vs 169
      x 109/L, p = 0.01) in the ANHPET group. A significant reduction in the total of
      blood products transfused was observed in the ANHPET group (30 vs 68 units, p =
      0.003). Control of hypertension was facilitated by phlebotomy so that
      nitroglycerine was necessary in low doses only (0.25-1.0 microgram/kg/min).
      CONCLUSIONS: ANHPET reduced blood product transfusion, improved postoperative
      haemostatic parameters and simplified the management of cross-clamping
      hypertension.

PMID- 11218630
TI  - A new method of repair for quadriceps tendon ruptures. A case report.
AB  - Rupture of the quadriceps tendon is an uncommon injury observed predominantly in
      subjects over 40 years old. Multiple surgical techniques have been employed to
      repair fresh and neglected ruptures; methods that make use of allograft and
      augmentation with tissues harvested from around the knee have been reported. We
      describe a case of surgical repair of a tendon-bone junction rupture in a 64-year
      old patient by use of suture anchors to attach the tendon to bone and improve
      fixation of the soft tissue elements. Clinical diagnosis of rupture was confirmed
      radiographically and echographically. Surgical repair was performed within 24
      hours of injury. Active movement of the knee started after 3 weeks and the
      patient was permitted to walk without weight-bearing with a knee cage. Three
      weeks later, he was permitted to walk with full weight-bearing unassisted by
      crutches; the knee cage was removed 6 weeks after surgery. At his most recent
      follow-up 24 months postoperative, quadriceps strength was equal to that of the
      controlateral knee and the patient has returned to sports and daily activities.
      The surgical method presented here provides a suture of the tendon ends without
      putting excess stress on the suture line during the period of early knee
      mobilization. Advantages over other techniques include reduced operative time,
      easy access to the implantation site, and better resistance of the suture
      material: the patient is thus able to initiate physical therapy earlier and more
      aggressively.

PMID- 11218629
TI  - Latex allergy. History, diagnosis and prevention.
AB  - During the past 10 years the incidence of natural rubber latex (NRL) allergy has
      dramatically increased. It occurs predominantly in certain high risk group:
      health care workers, latex industry workers, immune compromised individuals (such
      as children with spina bifida) and persons with positive risk factors (such as
      multiple surgeries). The epidemiology, history, mechanism, clinical symptoms and
      signs, and diagnosis of latex allergy are presented briefly. The subject of this
      review is to understand the importance in reducing the prevalence of latex
      allergy: reducing exposure, using appropriate work practices, training and
      educating workers, monitoring symptoms and substituting non latex products when
      appropriate.

PMID- 11218631
TI  - Bilo-pancreatic Ascaris Lumbricoides infestation. Endoscopic discovery and
      removal.
AB  - Ascaris Lumbricoides infestation is relatively rare in industrialized countries,
      and it occurs mainly in conditions in which hygiene is lacking. We describe here
      a case of a 39-year-old female from ex-Jugoslavia affected by recurrent hepatic
      colic. At entry ultrasonography revealed microlithiasis in the gallbladder and
      widening of the pancreatic head. The subsequent ERCP showed slight filling
      defects in the choledochus and an inflammation-like stricture of the papilla of
      Vater, and after endoscopic sphincterotomy we saw an outflow of dense bile and
      microlitholits. Thus, a standard surgical cholecystectomy was carried out and the
      patient was dismissed on the 3rd postoperative day without any symptoms. However,
      the patient was admitted again after four days for a new coliky pain attack. An
      upper endoscopy showed a 23 cm long mobile parasite in the duodenum: it was
      caught with the polypectomy loap, extracted and identified as A. Lumbricoides.
      The patient's symptoms disappeared after the endoscopic removal of the worm and
      she was dismissed the day after the worm's removal. No recurrence of symptoms was
      noted during a 1-year follow-up. This case showed that A. Lumbricoides
      infestation of the biliary tree should be considered when biliary and/or
      pancreatic symptoms recur, especially in patients coming from undeveloped
      countries. At the same time we showed that endoscopic removal is a safe and
      effective treatment for this infestation.

PMID- 11218632
TI  - Micrococcus luteus: a putative cause of hepatic abscess?
AB  - Micrococcus luteus was repeatedly isolated in blood cultures during a prolonged
      feverish syndrome in a patient who presented with multiple hepatic abscesses as
      well. In contrast to the literature, this case is not related to prosthetic
      devices; an untreated limb wound may have been the site of microbial entry.

PMID- 11218633
TI  - Trauma sites and clinical features associated with acute hyperextension spinal
      cord injury without bone damage--relationship between trauma site and severity.
AB  - To elucidate whether a relationship exists between the site of trauma and
      severity of acute hyperextension spinal cord injury without bone damage, we
      examined the clinical features of 25 male and 10 female patients aged 13 to 88
      years. None of the patients had vertebral damage such as fracture and
      dislocation. The site of impact was classified as the buccal, forehead, or
      mandibular region. The neurological findings were assessed according to Frankel's
      classification at admission and at follow up after 3 months or more to assess
      outcome. Eleven patients suffered trauma in the buccal region, one patient in
      Frankel's grade B, three in grade C, and seven in grade D at admission. All 11 of
      these patients showed an improvement of one grade or more to an outcome of C in
      one patient, D in one, and E in nine. Trauma occurred at the forehead region in
      18 patients, four in grade B, 10 in grade C, and four in grade D. Improvement was
      seen at follow up by one grade or more to C in one patient, D in 10, and E in
      seven. Trauma occurred at the mandibular region in six patients, four in grade B
      and two in grade C. Four of these patients showed improvement of one grade or
      more to grade B in one, grade C in four, and grade E in one. Overall, seven
      patients had poor outcomes, five of whom suffered trauma to the mandibular
      region, indicating that impact to the mandibular region tends to have an
      unfavorable clinical outcome. Our findings indicate that the site of trauma
      greatly influences the severity of hyperextension spinal cord injury.

PMID- 11218634
TI  - Relationship between stroke and asymptomatic minute hemorrhages in hypertensive
      patients.
AB  - Asymptomatic small hemorrhages were identified in hypertensive patients by T2*
      weighted gradient echo magnetic resonance (MR) imaging to investigate the
      relationship between hypertensive intracerebral hemorrhage and asymptomatic
      minute hemorrhages. Forty-eight patients with hypertensive intracerebral
      hemorrhage or cerebral infarction with hypertension (these diseases were defined
      as stroke) were treated in National Defense Medical College from April 1998 to
      February 2000. All patients had no past history of stroke or head injury,
      underwent MR imaging within 6 months of the stroke attack, were aged from 40 to
      80 years, and had no diagnosis of aneurysm, angioma, or moyamoya disease.
      Patients were divided into the infarction group and hemorrhage group. All foci
      over 2 mm in size appearing as hypointense on T2*-weighted MR imaging and
      unrelated to stroke areas were defined as minute hemorrhages. There were no
      significant differences between the two groups with respect to sex, age, and
      history of diabetes mellitus. The incidence of minute hemorrhages in the
      hemorrhage group (21/26) was greater than in the infarction group (9/22, p <
      0.01). The incidence of minute hemorrhages in the basal ganglia (18/26) was
      greater in the hemorrhage group than in the infarction group (4/22, p < 0.001).
      Symptomatic intracerebral hemorrhage may be preceded by asymptomatic minute
      hemorrhage.

PMID- 11218635
TI  - Organized chronic subdural hematoma requiring craniotomy--five case reports.
AB  - Two child and three elderly patients underwent craniotomy for organized and/or
      partially calcified chronic subdural hematomas (CSHs). The characteristic feature
      of magnetic resonance imaging was a heterogeneous web-like structure in the
      hematoma cavity. Both children had undergone one side subduroperitoneal shunt for
      bilateral CSHs when infants. As a result, the opposite hematoma cavities
      persisted and developed into calcified CSHs after a couple of years. All three
      elderly patients with senile brain atrophy showed various systemic complications
      such as cerebral infarction, diabetes mellitus, leg ulceration, cirrhosis, and
      bleeding tendency. Craniotomy for removal of the hematoma and calcification
      achieved good results in all patients. Subdural space created by shunt,
      craniotomy, or brain atrophy and persisting for a certain period, and additional
      various brain damage such as microcirculatory disorder, meningitis, encephalitis,
      or premature delivery may be important in generating calcified or organized CSH.

PMID- 11218636
TI  - Successful treatment of a ruptured enlarged infundibular widening of the
      posterior communicating artery--case report.
AB  - A 67-year-old female with a history of hypertension and cerebral infarction
      presented with subarachnoid hemorrhage (SAH) (Hunt and Kosnik grade 4). Brain
      computed tomography (CT) revealed a clot dominantly on the right (Fisher's
      classification Group 4). Cerebral angiography showed funnel-shaped widenings at
      the origins of the bilateral posterior communicating arteries. The maximum
      diameter of the widening was greater than 3 mm, so this widening was called an
      enlarged infundibular widening. Angiography showed a small bulge protruding
      posterolaterally from the wall of the right enlarged infundibular widening, and
      the right posterior communicating artery arose from the apex of the enlarged
      infundibular widening. Based on the findings of the brain CT and cerebral
      angiography, the diagnosis was SAH due to rupture of the right enlarged
      infundibular widening. Approximately 12 hours after the onset, the clot was
      evacuated through the right pterional approach. Bleeding from the small bulge of
      the right enlarged infundibular widening occurred intraoperatively, so a right
      angled ring clip was applied parallel to the right internal carotid artery to
      obliterate the rupture point. Postoperatively, she was discharged without
      neurological deficit, and follow-up CT showed no other new infarction. We
      recommend clipping rather than wrapping or coating for similar cases of ruptured
      enlarged infundibular widening.

PMID- 11218637
TI  - Kissing mirror image anterior communicating artery aneurysms--case report.
AB  - A 45-year-old male presented with an extremely rare case of symmetrical kissing
      aneurysms located at the both ends of the anterior communicating artery.
      Angiography and three-dimensional computed tomography (3D-CT) angiography clearly
      showed the relationship of the kissing aneurysms. The aneurysms were clipped
      through the right pterional approach. Temporary clipping of the anterior cerebral
      arteries for 5 minutes was required to gain enough operative space. The patient
      was discharged without neurological deficits. 3D-CT angiography, magnetic
      resonance angiography, or rotatory digital subtraction angiography may be useful
      for detecting kissing aneurysms, but the most important issue is awareness of
      this unusual condition.

PMID- 11218638
TI  - Serial neuroimaging of a growing thrombosed giant aneurysm of the distal anterior
      cerebral artery--case report.
AB  - An 81-year-old female presented with a giant aneurysm of the distal anterior
      cerebral artery (A3) which grew from a small saccular aneurysm to a huge aneurysm
      within 36 months before manifesting as a mass lesion. The thrombosed portion of
      the aneurysm showed growth, whereas the aneurysmal cavity did not change in size.
      Computed tomography and magnetic resonance imaging showed new bleeding in the
      thrombosed portion. Hemorrhage into the thrombus and/or aneurysmal wall might
      have caused the aneurysmal growth. She refused surgery and was discharged with no
      deficits. Distal anterior cerebral artery aneurysm which shows neuroimaging signs
      of growth requires regular follow up as such lesions may become giant before
      manifesting clinical symptoms.

PMID- 11218639
TI  - Moyamoya disease and coronary artery disease--case report.
AB  - A 26-year-old female with idiopathic moyamoya disease developed chest pain with
      concomitant ST depression on electrocardiography. Coronary angiography detected
      no stenotic lesions in the epicardial coronary arteries. The clinical diagnosis
      was vasospastic angina pectoris. She was medicated with calcium antagonists,
      which reduced the frequency of chest pain episodes. Angina pectoris is a rare
      occurrence in young patients with moyamoya disease. Coronary artery disease and
      moyamoya disease may have common etiological factors.

PMID- 11218640
TI  - Bone defect associated with middle meningeal arteriovenous fistula treated by
      embolization--case report.
AB  - A 57-year-old male presented with a frontal bone defect associated with a middle
      meningeal arteriovenous fistula (AVF) manifesting as headache. The patient had a
      history of head injury 19 years previously. Skull radiography and computed
      tomography demonstrated a left frontal bone defect. Left external carotid
      angiography demonstrated a middle meningeal AVF at the frontal region, at the
      same location as the bone defect. The AVF was fed by the bilateral middle
      meningeal and left deep temporal arteries, and drained by the superior sagittal
      and ipsilateral cavernous sinuses. The minor feeding artery, the left deep
      temporal artery, was embolized with polyvinyl alcohol particles, then 0.4 ml of a
      1:3 mixture of n-butyl cyanoacrylate and lipiodol was injected from the left
      middle meningeal artery. Follow-up angiography 3 months after the embolization
      revealed complete obliteration of the fistula. The bone defect may have been
      caused by erosion of the frontal bone by the pulsating effect of the feeding and
      draining vessels of the fistula, or by inadequate nutrition to the bone tissue
      because of the arteriovenous shunt.

PMID- 11218641
TI  - Neurosarcoidosis without systemic sarcoidosis--case report.
AB  - A 20-year-old male presented with symptoms of isolated neurosarcoidosis including
      epilepsy. Magnetic resonance imaging disclosed multiple enhanced right temporal
      and frontal lesions. Cerebrospinal fluid examination identified mild lymphocytic
      pleocytosis, and histological examination of a stereotactic brain biopsy specimen
      demonstrated noncaseating granulomas, so fungal or other inflammatory or
      granulomatous diseases were excluded. The diagnosis was cerebral sarcoidosis,
      despite the absence of systemic manifestations. Corticosteroid therapy improved
      his neurological state and radiological findings. Neurosarcoidosis is a well
      recognized occurrence in systemic sarcoidosis, but diagnosis may be difficult in
      the absence of extracerebral manifestations.

PMID- 11218642
TI  - High incidence of arterial dissection associated with left vertebral artery of
      aortic origin.
AB  - The incidences of arterial dissection of the vertebral artery (VA) of aortic
      origin and VA of subclavian artery origin were determined. The origins of the
      left and right VAs were confirmed by angiography in 860 and 717 patients,
      respectively. Left VA of aortic origin was found in 21 patients (6 females and 15
      males) but no right VA of aortic origin was found. Left VA of left subclavian
      artery origin was found in 837 patients and right VA of right subclavian artery
      origin in 717 patients. Arterial dissection of the VA occurred in 17 patients (6
      females and 11 males), four patients with left VA of aortic origin, seven with
      left VA of left subclavian artery origin, four with right VA of right subclavian
      artery origin, and two with bilateral VAs of subclavian artery origin. Left VA of
      aortic origin (4 of 21 patients) was associated with a significantly higher
      incidence of VA dissection than left VA of left subclavian artery origin and
      right VA of right subclavian artery origin (p < 0.001). Left VA of aortic origin
      is associated with a predilection for VA dissection in comparison to VA of
      subclavian artery origin.

PMID- 11218643
TI  - Investigation of connexin gene expression patterns by in situ hybridization
      techniques.

PMID- 11218645
TI  - Expression and imaging of connexin-GFP chimeras in live mammalian cells.

PMID- 11218644
TI  - Biochemical analysis of connexon assembly.

PMID- 11218646
TI  - Analysis of connexin expression in brain slices by single-cell reverse
      transcriptase polymerase chain reaction.

PMID- 11218647
TI  - Use of retroviruses to express connexins.

PMID- 11218648
TI  - Spatiotemporal depletion of connexins using antisense oligonucleotides.

PMID- 11218649
TI  - Transfection and expression of exogenous connexins in mammalian cells.

PMID- 11218650
TI  - Assaying the molecular permeability of connexin channels.

PMID- 11218651
TI  - Applying the Xenopus oocyte expression system to the analysis of gap junction
      proteins.

PMID- 11218652
TI  - Mutagenesis to study channel structure.

PMID- 11218653
TI  - Dual patch clamp.

PMID- 11218654
TI  - Determining ionic permeabilities of gap junction channels.

PMID- 11218655
TI  - Fluorescence recovery after photobleaching.

PMID- 11218656
TI  - Capture of transjunctional metabolites.

PMID- 11218657
TI  - Sodium dodecyl sulfate-freeze-fracture immunolabeling of gap junctions.

PMID- 11218658
TI  - The study of connexin hemichannels (connexons) in Xenopus oocytes.

PMID- 11218659
TI  - Exploring hemichannel permeability in vitro.

PMID- 11218660
TI  - Inducing de novo formation of gap junction channels.

PMID- 11218661
TI  - Recording and analysis of putative direct electrical interactions in the
      mammalian brain.

PMID- 11218662
TI  - Intercellular calcium signaling and flash photolysis of caged compounds. A
      sensitive method to evaluate gap junctional coupling.

PMID- 11218663
TI  - Biochemical analysis of connexin phosphorylation.

PMID- 11218664
TI  - How to close a gap junction channel. Efficacies and potencies of uncoupling
      agents.

PMID- 11218665
TI  - Purification of gap junctions.

PMID- 11218666
TI  - Culturing of mammalian cells expressing recombinant connexins and two-dimensional
      crystallization of the isolated gap junctions.

PMID- 11218667
TI  - Connexins/connexons. Cell-free expression.

PMID- 11218668
TI  - HBV-DNA detection in hepatitis B infection.

PMID- 11218669
TI  - Histopathology of skin lesions in chronic arsenic toxicity--grading of changes
      and study of proliferative markers.
AB  - Chronic arsenic toxicity (CAT) manifests predominantly as cutaneous lesions in
      the form of melanosis, keratosis and neoplastic changes. We have studied skin
      biopsies from 42 patients of CAT. Histological study of H/E stained sections
      showed--hyperkeratosis in 13, parakeratosis in 13, acanthosis in 12,
      papillomatosis in 24, elongation of reteridges in 21, increased basal
      pigmentation in 27 and dysplastic changes in 8 cases. Squamous cell carcinoma was
      present in 2, basisquamous in 1 and basal cell carcinoma in 1 case. Changes of
      skin lesions after drug DMSA and DMPS therapy compared to placebo were studied.
      The result was inconclusive. Proliferative activity of skin lesions in CAT were
      studied by AgNOR stain to assess the biological behaviour of the lesions. AgNOR
      score showed--normal control 1.08, benign changes (e.g. Hyperkeratosis,
      parakeratosis, acanthosis, papillomatosis etc.) without dysplasia--1.35, mild to
      moderate dysplasia--1.735, severe dysplasia--3.0 and carcinoma--3.56. Thus, AgNOR
      score gives some idea on the biological behaviour of CAT lesions. It is suggested
      that AgNOR staining should be done regularly along with H&E staining for proper
      assessment of the cases.

PMID- 11218670
TI  - DNA aneuploidy in invasive carcinoma of the uterine cervix.
AB  - Forty cases of squamous cell carcinoma and twenty cases of adenocarcinoma of the
      cervix were subjected to DNA ploidy analysis to find out the frequency of
      aneuploid DNA pattern in different types of invasive carcinoma of the uterine
      cervix and their possible correlation with the clinical stage and age of the
      patients. From the DNA analysis an increasing trend of DNA aneuploidy was
      observed from well differentiated (63.6%) to moderately differentiated (70.8%) to
      poorly differentiated squamous cell carcinoma (83.3%). However, 85%
      adenocarcinomas of endocervix showed aneuploid DNA pattern. It indicates that
      aneuploidy increases with tumour dedifferentiation and further confirms the
      importance of DNA ploidy as a high risk indicator.

PMID- 11218671
TI  - Correlations between apoptotic and proliferative indices in cervical
      intraepithelial neoplasia and carcinoma.
AB  - Aims of the present paper was to study cell death by apoptosis and cell
      proliferation in normal cervical biopsies, cervical intraepithelial neoplasms
      (CIN) and squamous cell carcinomas of cervix (CaCx). There were each seven cases
      of normal cervical biopsy, CIN1 and CIN2 along with 10 cases of CIN3 and 14 cases
      of CaCx. Percentage of apoptotic cells and bodies (i.e. apoptotic index, AI) and
      mitoses (i.e. mitotic index, MI) and turnover index (TI - AI + MI) were counted
      in formalin fixed, paraffin embedded, haematoxylin and eosin stained slides.
      AgNOR stain was done and mean AgNOR dots per cell was also estimated. AI, MI and
      TI were correlated with histology grade of CIN and invasive carcinoma cervix.
      Mean AI, MI, TI and AgNOR count increased from lower to higher grades of CIN. AI,
      MI & TI raised significantly from CIN3 to carcinomas; AI, TI & AgNOR count raised
      significantly from CIN1 to combined CIM2 & 3; TI & AgNOR count were high in CIN1
      to CIN2; AI & TI were significantly raised in normal to CIN1. In conclusion, TI
      is probably more important for cell kinetic analysis of CIN and carcinoma of
      cervix because it reflects the frequency of two important events i.e. mitosis and
      cell death. Sudden increase of AI, MI, TI count from CIN3 to CaCx may indicate
      the possibility of genetic alteration of cells of CIN3 which induces a frank
      malignant transformation from CIN3 to CaCx.

PMID- 11218672
TI  - Isolated right ventricular infarction.
AB  - Rare occurrence of isolated right ventricular infarction is reported in four
      patients, three of whom were elderly. The causes of infarction were due to
      pulmonary thromboembolism and dissection of non-dominant right coronary artery.
      None of the hearts had right ventricular hypertrophy and significant coronary
      atherosclerosis.

PMID- 11218673
TI  - In vitro susceptibility testing of nonsporing anaerobes to ten antimicrobial
      agents.
AB  - Antibiotic susceptibility was performed on sixty clinical isolates of nonsporing
      anaerobes against ten antimicrobial agents. The test was performed on Muller
      Hinton Agar and Wilkins Chalgren blood agar by preparing suspension of freshly
      isolated colonies in BHI broth. Apart from Metronidazole and Chloramphenicol
      newer antibiotics like Minocycline, Secnidazole, Tinidazole, Clarithromycin,
      Roxithromycin were also tried. Antimicrobial agents like Metronidazole,
      Secnidazole, Tinidazole and Minocycline were 100% sensitive, followed by
      Chloramphenicol, Clarithromycin and Roxithromycin. These newer agents can be good
      alternatives for the treatment of non sporing anaerobes.

PMID- 11218674
TI  - Expression of CXCR4 in the brain of feline immunodeficiency virus infected cat.
AB  - Advances in understanding the mechanisms of human immunodeficiency virus (HIV)-1
      entry have revealed that the cell surface CD4 expression alone is insufficient
      and needs an additional molecule on its surface for the viral entry. These are G
      protein coupled seven transmembrane (7-TM) family molecules (chemokine receptor)
      and amongst them one is CXCR4. Feline homologue of CXCR4 acting as a co-receptor
      for feline immunodeficiency virus (FIV) entry is already reported for the Crandle
      feline kidney cells strain (CrFK) of FIV. An experiment was carried out to search
      the expression of CXCR4 retrospectively in FIV (CrFK) infected cat brain tissues
      using immunohistochemically in the formalin fixed paraffin sections against 12G5,
      a mouse monoclonal antibody to CXCR4. We observed the expression of this receptor
      in feline neurons, astrocytes and in some vascular endothelial cells. The study
      of expression of CXCR4 in the brain, which is one of the many chemokine receptors
      in the central nervous system, may provide further insight into the interactions
      between brain cells, pathogens, and the immune system, and help understand the
      pathogenesis of HIV dementia.

PMID- 11218675
TI  - Identification of Pneumocystis carinii in induced sputum of AIDS patients in
      Chennai (Madras).
AB  - Induced sputum samples were collected from 32 AIDS patients with respiratory
      ailments. Pneumcystis carinii was demonstrated in 9 out of 32 AIDS cases by
      Indirect Immunofluorescence technique (HF). Four cases were positive by all the
      three techniques namely Giemsa staining, Toluidine blue staining and IIF, three
      were positive by both toluidine blue and IIF, and two were positive only by IIF.
      Among other microbial pathogens, acid fast bacilli was demonstrated in all the P
      carinii positive cases and Candida albicans in 53% AIDS cases from the induced
      sputum sample.

PMID- 11218676
TI  - Clinical spectrum of Glanzmann's thrombasthenia.
AB  - Glanzmann's thrombasthenia is a well defined inherited disorder of platelet
      function characterized by qualitative and qualitative defect in cytoadhesive
      membrane protein, glycoprotein IIb-IIIa (the platelet fibrinogen receptor). From
      January 1990 to October, 1999, five patients who presented with mucocutaneous
      bleeding were detected to have Glanzmann's thrombasthenia. Clinical and
      laboratory spectrum of this rare disorder was studied which revealed
      heterogeneity of disease with respect to nature and severity of bleeding
      unpredictable by laboratory findings.

PMID- 11218677
TI  - Cytohistological study of urinary bladder neoplasms.
AB  - Eighty patients presenting with painless hematuria and 24 patients of
      transitional cell carcinoma bladder coming for follow up were included in this
      study to assess the role of exfoliative (voided urine) and lavage (saline lavage)
      cytology in initial diagnosis and follow up of the patient with carcinoma
      bladder. Freshly voided urine samples and saline lavage bladder washing samples
      were collected. A thorough cystoscopic examination was done and biopsy was taken
      from any apparent growth. Cytological smears were stained with hematoxylene and
      eosin and PAP's stain, histology sections were stained with hematoxylene and
      eosin. A statistically significant correlation (p < 0.001) was observed between
      the increasing grade of malignancy and cytopositivity. A good association was
      observed between histology and two methods of cytology (p < 0.01). The
      sensitivity, specificity and overall diagnostic accuracy of lavage cytology was
      more as compared to exfoliative cytology (71.05%, 56.0%, 78.85% Vs 47.37%, 41.18%
      and 61.54%). Cystopositivity was more with single large sessile tumour as
      compared to multiple small pedunculated tumours. Cytohistological discrepancy was
      observed in patients of transitional cell carcinoma with recurrence. It is
      concluded that cytology may act as a good adjuvant to histology in picking up
      early flat lesions and/or follow up of patients with transitional cell carcinoma.

PMID- 11218678
TI  - Fatal complications of systemic lupus erythematosus--an autopsy study from north
      India.
AB  - Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with
      varied clinical manifestations and outcome. It may prove fatal due to disease
      activity or intercurrent infections. In recent years, earlier diagnosis and
      better treatment modalities have resulted in a change in the pattern of organ
      involvement and mode of death in the west. This aspect of the disease is unknown
      in India. Hence, in this autopsy series of SLE, the organ involvement and cause
      of death have been studied. Twenty five cases of clinically diagnosed SLE have
      been analysed retrospectively. Renal involvement was invariably present (96%)
      with class IV being the commonest lesion in 60% cases. Disease activity was noted
      in 60% cases. Pleuro pulmonary lesions were seen in 92% cases with infection
      being the commonest. Pulmonary infections included bacterial pneumonias (13),
      disseminated tuberculosis (3), pulmonary mucormycosis (1) and aspergillosis (1).
      Massive pulmonary haemorrhage in 5 cases and acute lupus pneumonitis in one,
      contributed to the demise of the patient. Vasculitis was evident in single organ
      in 9 cases, in two or more organs in 3 cases with systemic vasculitis
      significantly attributing to morbidity in 1 case. Active disease was the cause of
      death in 60% cases and infection in 40%.

PMID- 11218679
TI  - Prothrombotic factors in nephrotic syndrome.
AB  - Nephrotic syndrome is a hypercoagulable state with variable prevalence of
      clinical thrombosis. The role of platelet aggregation, fibrinogen and
      antithrombin III and protein S levels in the pathogenesis of hypercoagulable
      state in these patients is controversial. Since no study on Indians is available,
      the clinical and laboratory profile of 22 patients of nephrotic syndrome (age 18
      35 years with an MF ratio of 4:3), have been studied. The coagulation profile
      revealed a prolonged APTT in 12 patients (54.5%), and a prolonged TT in four
      (18.1%). In the rest APTT and TT were normal. PT was raised in two patients.
      Fibrinogen, an acute phase reactant was raised in five patients (22.7%).
      Antithrombin III levels were reduced in 19 patients (86.4%), normal in one and
      raised in two patients. Free Protein S levels were high in 12(54.5%), normal in
      seven and decreased in three patients. Platelet aggregation with adrenaline and
      adenosine diphosphate was raised in 6 patients. Ultrasonographically detected
      deep vein thrombosis was seen in one patient only (4.5%) who had ATIII levels of
      48%. This low incidence can be explained by elevated protein S levels which was
      found to be raised in 12(54.5%) cases, protein S being an anticoagulant factor.
      This low level of clinical thrombosis in Indian patients of nephrotic syndrome
      may be an ethnic variable factor. It is thus concluded that although patients
      with nephrotic syndrome have a hypercoagulable state, clinical thrombosis is
      rarely seen in Indian patients with nephrotic syndrome.

PMID- 11218680
TI  - Serum lactate dehydrogenase in diagnosis of megaloblastic anaemia.
AB  - The present study was carried out in 75 patients of macrocytic anaemia
      categorised on bone marrow examination (into megaloblastic and non-megaloblastic
      anaemia) to evaluate the efficacy of total serum LDH levels and LDH isoenzyme
      pattern in the diagnosis of megaloblastic anaemia. 25 healthy adults were taken
      as controls. From this study it can be concluded that total serum LDH levels more
      than 3000 IU/L are diagnostic of megaloblastic anaemia. Reversed LDH isoenzyme
      pattern (LDH1 > LDH2) by chloroform inhibition test is an adjuvant in the
      diagnosis where total serum LDH levels are between 451-3000 IU/L and it will also
      differentiate megaloblastic anaemia from haemolytic anaemia.

PMID- 11218681
TI  - Evaluation of leukergy test as an indicator of infection in hip joint in
      children.
AB  - This new blood test (leukergy) for infection is based on the fact that white
      cells agglomerate in peripheral blood of patients with inflammatory diseases. We
      evaluated leukergy in 25 children with proven septic arthritis of hip. It was
      found to be the efficient and earliest indicator of septic arthritis than the
      erythrocyte sedimentation rate (ESR), total leucocyte count (TLC), polymorphs and
      C-reactive protein (CRP). It also correlated well with the clinical severity of
      infection and the prognosis of disease. Thus leukergy is a simple, rapid and
      inexpensive slide test which was found as the best indicator profile for the
      presence of septic arthritis.

PMID- 11218682
TI  - Leptospirosis in the causation of hepato-renal syndrome in and around Pune.
AB  - Fifty cases of hepato-renal dysfunction of unknown etiology were studied over a
      two-year period. Urine samples were examined microscopically and cultured for
      Leptospira. Serum samples were examined for antibodies against Leptospira by the
      Macroscopic slide agglutination test (MSAT). Seventeen out of fifty patients
      (34%) showed evidence of Leptospiral infection by at least two diagnostic
      techniques used. 15/17 i.e. 88.2% were positive by dark ground microscopy, 7/17
      were diagnosed by culture technique and 16/17 i.e. 94% were confirmed by
      serology. There was a good correlation between Microscopic agglutination test
      (MAT) and MSAT. Thus Leptospires seem to play a major role in the causation of
      hepato-renal dysfunction in and around Pune, Maharashtra.

PMID- 11218683
TI  - Rapid identification of fluconazole resistance using Chromagar Candida.
AB  - Although extremely rare 10 years ago, antifungal drug resistance is becoming a
      major problem in certain populations, especially in those infected with HIV. This
      study was undertaken to study the resistance of Candida species isolated in our
      hospital to Fluconazole using Chrom agar Candida. The Candida strains which were
      routinely isolated from clinical specimens like blood, urine, sputum, pus, fluid
      and homograft isolates were included in the study. 142 Candida isolates were
      tested by using Chrom agar Candida incorporated with fluconazole. 16 strains were
      found to be resistant to Fluconazole and 126 strains sensitive to Fluconazole.
      Nine were C tropicalis, 3 C krusei, 2 C guillermondii, 1 Geotrichum candidum and
      one was an unidentified strain of Candida. The MIC of the 16 strains were done
      using RPMI 1640 medium by macro broth dilution method. MIC of 9 strains was 64 &
      > 64 micrograms/ml of 6 strains 32 micrograms/ml and 1 strain 16 micrograms/ml.

PMID- 11218684
TI  - Congenital infantile fibrosarcoma of the upper extremity.
AB  - Congenital-infantile fibrosarcoma is an unusual childhood tumor that occurs
      mainly in children under 5 years of age. More than 300 cases have been reported
      in the literature so far, very few of them at birth. A distinction must be made
      between it and its adult counterpart because of differences in their clinical
      behaviour. We report here a case of congenital fibrosarcoma in a 4-day-old female
      infant.

PMID- 11218685
TI  - Intrapericardial teratoma--a report of two cases.
AB  - Two rare cases of intra-pericardial teratoma in infants are reported. The
      presenting symptoms were either due to pericardial effusion and cardiac tamponade
      or due to compression of the tracheo-bronchial tree. The tumors were well
      encapsulated and were attached to the ascending aorta. Histologically, they were
      composed of derivatives of the three germ cell layers.

PMID- 11218686
TI  - Giant cell tumour of soft tissue--a case report.
AB  - Giant cell tumor is seen in late adolescence or in the third or fourth decade of
      life. It arises from epiphysis of long bones, the commonest site being the distal
      end of the femur and the proximal end of tibia. This paper presents a case report
      of giant cell tumor of soft tissue.

PMID- 11218687
TI  - Hairy polyp of nasopharynx--a case report.
AB  - A specific subtype of teratoid tumour occurring in nasopharynx and oropharynx has
      been mentioned as 'hairy polyp'. This is a rare lesion and is to be
      differentiated from true teratomas. A case of hairy polyp of nasopharynx in a 12
      year old girl is reported.

PMID- 11218688
TI  - Pleomorphic xanthoastrocytoma--a clinicopathological study.
AB  - Six cases of Pleomorphic Xanthoastrocytoma of central nervous system are
      presented. One case presented with recurrent refractory seizures and others as
      intracranial space occupying lesions. They were located in temporal/parietal
      lobes, were partly cystic and partly solid on CT scan, enhancing with contrast.
      Histopathology was characterized by pleomorphic giant cells and cells with
      vacuolated cytoplasm. Glial fibrillary acidic protein was strongly positive in
      all the cases.

PMID- 11218689
TI  - Breast filariasis--a case report.
AB  - An unusual presentation of filariasis as a breast lump simulating breast
      carcinoma, in a 50 year old woman residing in Pokhara, Nepal. The case was
      reported on Fine Needle Aspiration Cytology and also evaluated by histopathology.
      Morphology of the nematode is that of Brugia species which is unusual in Nepal.

PMID- 11218690
TI  - Metastatic carcinoma in hepatic hemangioma.
AB  - Metastasis into the hepatic hemangioma is a rare occurrence. We report a unique
      case of metastasis of intestinal carcinoma into hepatic hemangioma in a case of
      65 year old male who presented with anorexia, weakness and headache. The
      postmortem examination revealed adenocarcinoma in the ileocaecal region. The
      liver showed a subcapsular hemangioma of 1.5 cms. diameter which on microscopic
      examination revealed metastasis of adenocarcinoma. The is the first documentation
      of metastasis in hepatic hemangioma. Such cases may pose problems of diagnostic
      difficulties and thus may result in mismanagement.

PMID- 11218692
TI  - Chediak-Higashi syndrome--a case report.
AB  - Chediak Higashi anomaly is a very rare disorder in which patients suffer frequent
      and severe pyogenic infections that are secondary to abnormal functions of
      polymorphonuclear leukocytes, associated with albinism and bleeding tendency.
      Blume RS and Wolff SM (1972) reported that only 59 cases were diagnosed after the
      first description of Chediak-Higashi Syndrome in 1943 by Cesar AB (cited by
      Wintrobe MM Clinical Haematology). As per recent literature available (Internet)
      last case was reported on 16th July, 1997.

PMID- 11218691
TI  - MALT lymphoma of the intestine. A clinicopathological study over a period of 13
      years.
AB  - Clinicopathological features of 14 patients with histologically confirmed primary
      intestinal Non-Hodgkin lymphoma were analysed. Patients were mostly young males
      with median age of 27.2 years. Main presenting features was intestinal
      obstruction. Diffuse large cell lymphoma was the commonest histological type. All
      cases were found to be B cell type in immunohistochemistry.

PMID- 11218693
TI  - Hepatitis C virus: biology and diagnosis.

PMID- 11218694
TI  - Unverified rumours of viral haemorrhagic fever, Democratic Republic of the Congo.

PMID- 11218696
TI  - Dracunculiasis, Yemen.

PMID- 11218695
TI  - Onchocerciasis (river blindness).

PMID- 11218697
TI  - [A one-month combined use of selective adrenergic beta 1- and alpha 1-agonists
      for postprandial hypotension in patients with autonomic failure].
AB  - In 1993, we reported the pathophysiology of postprandial hypotension (PPH) in
      patients with sympathetic dysfunction: a fall of BP resulted from both excess
      systemic vasodilation and lack of compensatory increase of cardiac output and
      vascular resistance in the leg arteries. In that article, we showed the
      beneficial results of combined oral administration of denopamine (a selective
      beta 1-agonist) and midodrine HCI (a selective alpha 1-agonist) on this
      condition. The present study was undertaken to further evaluate the efficacy and
      safety of this agonist combination in autonomic failure (AF) patients with PPH.
      This was a one-month trial. A total of 13 chronic AF patients received orally 30
      mg of denopamine and 12 mg of midodrine three times a day, 30 minutes before each
      meal. We measured brachial BP every 10 min in the daytime and every 15 min in the
      nighttime, using a 24-h indirect BP recorder. The combined use of these agonists
      produced a significant improvement in PPH and maintained a near-normal BP level.
      In conclusion, the combined administration of denopamine and midodrine three
      times a day is a well-tolerated and efficacious treatment for PPH.

PMID- 11218698
TI  - [Serological diagnostic trial of the causative virus of Bell's palsy by anti
      herpes virus antibodies in the paired sera].
AB  - Substantial evidence obtained through polymerase chain reaction techniques
      strongly supports that reactivation of latently infected herpes simplex virus
      (HSV) in geniculate ganglia is the main cause of Bell's palsy. However, serum
      antibody titers to HSV rarely increase in patients with this disease. This
      discrepancy may result from the difficulty in detecting a small increase in
      antibody titers by conventional serological analysis. To detect such a small
      increase in antibody titer, we defined the significant increase in IgG antibody
      titers more precisely, and examined the association of HSV or varicella-zoster
      virus (VZV) with Bell's palsy. From 40 patients with Bell's palsy, paired sera
      were obtained within the 4th disease day and 2 weeks later. IgG antibodies to
      HSV, VZV, cytomegalovirus (CMV), or measles virus (MsV) were measured with solid
      phase enzyme immunoassay (EIA). IgM antibodies were measured with captured EIA.
      Each antibody titer was expressed as an EIA-value, which was quantitatively
      measured by using a calibration curve prepared from the samples containing known
      titers to the virus in proportion to the logarithm of its titer. An EIA-value
      ratio (EVR) between paired sera and a corrected EVR was calculated according to
      the formulae: EVR = [EIA-value in the second serum]/[EIA-value in the first
      serum]; corrected EVR = [EVR to HSV, VZV or CMV]/[EVR to MsV]. The association
      with a virus was determined to be positive when the corrected EVR of the virus
      was beyond the normal range (the logarithmical mean +/- 3 SD of corrected EVRs
      among 24 healthy controls) while the corrected EVR of the other viruses were
      within it. Using the corrected EVR, 6 patients were positive: 4 for HSV, 2 for
      VZV. On the other hand, the conventional serological analysis, which confirms
      positivity by a 4-fold increase in IgG antibody titer or a demonstration of IgM
      antibody, disclosed only 2 positive patients (1 for HSV, 1 for VZV). EIA is a
      very sensitive method of detecting antibodies. Corrected EVRs can exclude a
      decrease in antibody titers induced by corticosteroids, which are generally used
      for therapy of Bell's palsy. Moreover, the normal range of corrected EVRs can be
      defined more precisely than in conventional serological analyses. Our results
      indicate that some sensitive analysis, such as the corrected EVR method, may make
      it possible to serologically detect the causative virus of Bell's palsy.

PMID- 11218699
TI  - [A case of myasthenia gravis following sarcoidosis and Hashimoto's thyroiditis].
AB  - Here, we report on an elderly woman with sarcoidosis and Hashimoto's disease who
      later developed myasthenia gravis. She was 68-year-old with a long history of
      Hashimoto's disease who had a clinical diagnosis of sarcoidosis with uveritis at
      the age of 66 years. On laboratory examination, angiotensin-converting enzyme,
      lysozyme and gamma-globulin were elevated and there was bilateral hilar
      lymphoadenopathy. She was admitted to our hospital because of left blepharoptosis
      and mild fatigability in the proximal muscles at the age of 68 years. Myasthenia
      gravis, type IIa, was confirmed by elevated titer of anti-acetylcholine receptor
      antibody in serum (0.8 nmol/l, normal < 0.6), positive edrophonium test and
      decremental EMG response. Oral prednisolone therapy was effective. Her muscle
      biopsy revealed HLA ABC-positive fibers in all fascicles, and HLA-DR positive
      fibers in the perifascicular areas. Myasthenia gravis complicated by sarcoidosis
      and Hashimoto's thyroiditis is extremely rare, suggesting that the common
      underlying immunological abnormalities for the three disorders such as a certain
      defective cellular immunity are responsible for the pathomechanism to induce the
      patient condition.

PMID- 11218700
TI  - [An autopsied case of progressive spinal muscular atrophy showing tremor and
      choreiform movement].
AB  - A 42-year-old man without family history of neurologic disease developed muscle
      weakness, and wasting associated with tremor and choreiform movement. He died at
      age 75 with 33 years of total duration of illness. Autopsy revealed neuronal loss
      and gliosis in the anterior horns of the spinal cord, hypoglossal nuclei, caudate
      nuclei, putamen, globus pallidus, and substantia nigra. Bunina bodies or Lewy
      bodies were not seen. Several similar cases with motor neuron disease, dementia
      and parkinsonism have been reported in the literature. However, this pattern of
      chronic spinal neostriato-pallido-nigral degeneration has not been reported.

PMID- 11218701
TI  - [A case of left third nerve palsy and contralateral vertical gaze palsy with
      medial midbrain infarction].
AB  - An 81-year-old man developed oculomotor nerve palsy of the left eye and vertical
      gaze palsy of the right eye due to left medial midbrain infarction. His left
      eyelid was ptotic and the pupil was dilated. His right eye showed normal
      horizontal movement and Bell's phenomenon was preserved although the
      oculocephalic reflex was incomplete. There were no other abnormal neurological
      findings. The brain MRI revealed a high-intensity lesion in left medial midbrain
      on T2 weighted image. This lesion involved the oculomotor nerve nucleus, the
      interstitial nucleus of Cajal, and the rostral intersititial nucleus of the
      medial longitudinal fasciculus (riMLF). We thought that upward gaze palsy of the
      right eye was resulted from the infarction of the left riMLF or disruption of the
      axonal collateral of upward gaze fibers in the left oculomotor nucleus. Downward
      gaze palsy was resulted from the damage of the downward gaze fibers before their
      decussation, or the damage of the left interstitial nucleus of Cajal. This case
      provides evidence that unilateral lesion of the midbrain could cause
      contralateral vertical gaze palsy.

PMID- 11218702
TI  - [A case of Ondine curse associated with a medullary tumor].
AB  - A 49-year-old woman with 6 months history of body weight loss, muscle weakness,
      and dysarthria, was found with respiratory arrest and resuscitated in the morning
      of January 1999. An MRI brain scan revealed diffuse swelling and T2/FLAIR high
      signal intensity with mild Gadolinium enhancement in the lower pons and medulla
      oblongata. Although the histological diagnosis could not be obtained, glioma
      (astrocytoma) was suspected. In the morning of July 3rd she presented sweating
      and cyanosis. Her arterial oxygen saturation was 18%. When we asked her to
      breathe more, she kept breathing and oxygen saturation was normalized. However,
      she could not breathe at all when she fell asleep without stimulation. She was
      kept under respiratory support for 2 months. Her symptoms improved with
      fluctuating course after 70 Gy of radiation therapy. Ondine curse is one type of
      sleep apnea syndrome, defined as the selective disturbance of autonomous
      breathing. Surgical operation and stroke are the reported causes of this
      syndrome. Brainstem tumor is relatively common cause for children's Ondine curse.
      On the other hand, it rarely causes adult's Ondine curse as a main symptom.

PMID- 11218703
TI  - [A case of chorea-acanthocytosis with dilated cardiomyopathy and myopathy].
AB  - We report a patient of chorea-acanthocytosis (CA), presenting with dilated
      cardiomyopathy and myopathy. The patient, 40-year-old male, was seen in our
      clinic because of progressive gait disturbance. Neurologically, he had chorea,
      tic, dystonia, diminished tendon reflexes and mild muscular atrophy and weakness.
      Serum creatine kinase level was elevated to 5.514 IU/l, MRI study showed atrophy
      of the putamen and caudate nucleus. Peripheral nerve involvement was confirmed
      pathologically and electrophysiologically. Acanthocytosis was found after
      repeated blood examinations. Furthermore, he had dilated cardiomyopathy on
      echocardiogram and cardiac muscle biopsy, and his muscle biopsy taken from
      gastrocnemius indicated myopathic changes with fiber necrosis. From these
      clinical and laboratory data, he was suspected to have McLeod syndrome (McS).
      However, he had normal expression of Kell antigens, and direct sequence of XK
      gene from genomic DNA sample showed no mutations. Accordingly, he was diagnosed
      as having CA. As CA shares the similar clinical and laboratory features with McS
      except Kell antigens, the evaluation of Kell blood system is crucial for
      differential diagnosis. As seen in our patient, blood sampling should be repeated
      for identification of acanthocytosis, because the finding is not always clearly
      present.

PMID- 11218704
TI  - [Acquired immunodeficiency syndrome-associated progressive multifocal
      leukoencephalopathy treated with highly active anti-retroviral therapy].
AB  - We reported a patient with acquired immunodeficiency syndrome (AIDS)-associated
      progressive multifocal leukoencephalopathy (AIDS-PML), whose condition improved
      after highly active anti-retroviral therapy (HAART). A 70-year-old man was
      admitted to our hospital because of worsening left hemiplegia and disturbance of
      consciousness. During the past 30 years, he frequently traveled to the United
      States and southeast Asia. On neurological examination, he was somnolent and left
      hemiplegia with severe rigospasticity was present. The deep tendon reflexes
      showed hyper-reflexes with extensor plantar responses. Laboratory studies showed
      pancytopenia and positive HIV-1 antibodies. The CD4 cell count was 38/mm3 and his
      HIV viral RNA load in the blood was 9,500 copies/ml. T2-weighted magnetic
      resonance imaging (MRI) of the brain revealed asymmetrical high intensity white
      matter lesions in the right fronto-parietal, and left frontal regions and in the
      cerebellar hemisphere. The cerebrospinal fluid (CSF) protein elevated to 91 mg/dl
      with a normal cell count. The diagnosis of PML was confirmed by the detection of
      JC virus DNA in the CSF using a nested polymerase chain reaction assay. Three
      weeks after starting HAART with zidovudine, lamivudine, and indinavir, he was
      able to respond to simple commands. Two months later, the HIV viral RNA load
      decreased to less than 400 copies/mm3, and no JC virus DNA was detected in the
      CSF, with an increase of the CD4 cell count to 285/mm3 in the blood. A follow-up
      MRI of the brain showed a reduction in the cerebellar and cerebral white matter
      lesions. The recovering immune function by decreasing of the HIV load after HAART
      might suppress JC virus replication. It was suggested that HAART would become a
      beneficial treatment for patients with AIDS-PML.

PMID- 11218705
TI  - [A novel adult case of acute necrotizing encephalopathy of childhood with
      bilateral symmetric thalamic lesions].
AB  - This report describes a 46-year-old Japanese woman with bilateral symmetric
      thalamic necrosis. The unusual radiologic findings are discussed in relation with
      acute necrotizing encephalopathy (ANE) of childhood, a rare disease proposed by
      Mizuguchi et al. ANE affects young children and the incidence is highest between
      6 and 18 months of ages. There is only one report of an adult case. The acute
      stage pathology in ANE can be summarized as acute edema and necrosis involving
      both gray and white matter by local breakdown of the blood-brain barrier. The
      radiologic findings in our case were similar to those in ANE of childhood. Though
      the pathogenesis between our adult case and ANE of childhood might be different,
      severe hypoalbuminea in our case could cause the alteration of permeability of
      the thalamic vessels, which might accelerate breakdown of the blood-brain barrier
      in the thalamus.

PMID- 11218706
TI  - [Midbrain infarction presenting isolated inferior rectus nuclear palsy].
AB  - We presented a patient of isolated inferior rectus muscle palsy from midbrain
      lacunar infarction involving the oculomotor nucleus. The patient noticed sudden
      onset diplopia gazing to the right side, especially to the right-lower direction.
      He did not have any other symptom, and neurological examination revealed no other
      findings. Brain MRI documented the focal hyperintense lesion on T2-weighted
      images in the right-median midbrain ventral to the aqueduct at the level of the
      superior colliculus. This lesion involved the right oculomotor nucleus,
      especially the dorso-lateral subnucleus extend to the inferior rectus muscle. The
      oculomotor nuclear complex consists of one unpaired subnucleus and four paired
      subnuclei. Among them, the inferior rectus subnucleus lies dorso-laterally. So
      nucleus lesion may cause isolated weakness of one of muscles innervated by the
      oculomotor nerve. Among them the isolated inferior rectus muscle palsy can occur
      relatively.

PMID- 11218707
TI  - [A case of acute motor sensory axonal polyneuropathy after Haemophilus influenzae
      infection].
AB  - A 47-year-old woman developed consciousness disturbance, and experienced
      hallucinations while traveling abroad, and then went into critical condition. She
      was placed in the critical care unit, and had flaccid tetraparesis requiring
      mechanical ventilation. Haemophilus influenzae was cultured from the sputum. The
      level of protein of the cerebrospinal fluid was elevated to 114 mg/dl, nerve
      conduction study showed findings of pure axonal damage, and the sural nerve
      biopsy revealed severe axonal degeneration. She improved gradually by plasma
      exchange. The diagnosis of acute motor sensory axonal polyneuropathy (AMSAN)
      based on autoimmune mechanism was made. We speculate that H. influenzae infection
      may have elicited AMSAN in this case.

PMID- 11218708
TI  - [Progressive paralysis of divergence in an adult with midbrain angioma].
AB  - A 37-year-old woman was admitted to the hospital with the complaint of
      progressive horizontal diplopia of six years' duration when viewing distant
      objects. On admission she had a slight left convergent strabismus. Homonymous
      diplopia was present beyond 50 cm and increased on distance fixation. Both eyes
      were fully mobile in the horizontal plane with a mild decrease in the velocity of
      horizontal eye movement to the left, and slight impairment of upward eye
      movement. The left eye did not fully adduct during convergence. The right pupil
      was slightly larger than the left. Prism cover test showed 6 delta esophoria at
      30 cm and 14 delta esophoria at 5 m. The Hess chart showed a convergent
      deviation. MRI revealed a small right-side paramedian lesion of the midbrain
      tegmentum lying ventral to the aqueduct of Sylvius, at the level between the
      superior colliculi and the intercollicular area. A venous angioma with
      arteriovenous shunts in the right midbrain was diagnosed by angiography. We
      suggest that lesions that damage the divergence neurons in the tegmentum of the
      midbrain and also interrupt the supranuclear fibers having an inhibitory effect
      on the convergence neurons may produce homonymous diplopia on distant fixation
      combined with the esotropia.

PMID- 11218709
TI  - [Sudden bilateral hearing loss with vertigo due to vertebral artery occlusion].
AB  - We report a case of sudden bilateral hearing loss associated with an occlusion of
      the right vertebral artery. A 66-year-old man was admitted to hospital suffering
      from sudden onset vertigo, deafness, and vomiting. He could not walk due to
      truncal ataxia. There was positional nystagmus to the right; spontaneous and gaze
      evoked nystagmus were absent. He had no facial nerve palsy, dysarthria, pyramidal
      tract signs, limb ataxia, and sensory impairment. Pure tone audiometry
      demonstrated a profound sensorineural deafness of both ears. A tentative
      diagnosis of sudden deafness was made. He was treated with intravenous infusion
      of corticosteroid; hearing loss of the left ear slightly improved. Cranial MR
      imaging demonstrated fresh small infarcts in the right cerebellar tonsil, the
      left cerebellar medulla, and the left middle cerebellar peduncle. MR angiography
      demonstrated an occlusion of the right vertebral artery. It is possible that
      reduced perfusion of the anterior inferior cerebellar arteries and internal
      auditory arteries on both sides resulted in multiple "border zone" infarcts and
      damage to the inner ear. Clinicians should be aware of the possibility of
      vertebrobasilar occlusive disease in case of sudden bilateral hearing impairment,
      even when brainstem or cerebellar signs are absent.

PMID- 11218711
TI  - Sexual dimorphism of the motoneurons in the human spinal cord.
AB  - There have been few morphometric studies on the size of the motoneurons of the
      human spinal cord. The purpose of the present study is to report the differences
      in the size of the motoneurons between males and females in the human spinal
      cord. We examined numbers and transverse cell body areas of the motoneurons of
      the anterior horn using 16 male and 21 female human spinal cords at levels C5 and
      L3. The sizes of the motoneurons were larger in males than in females, but their
      numbers were practically the same. These results can be of great importance in
      setting standard values for the understanding of morphological and functional
      correlations.

PMID- 11218710
TI  - Morphology of the dorsal lingual papillae in the bush dog (Speothos venaticus).
AB  - The dorsal lingual surface of a bush dog (Speothos venaticus) was examined by
      scanning electron microscopy (SEM). The tongue was about 7 cm in length.
      Filiform, fungiform and vallate papillae were found. The filiform papillae were
      distributed over the entire dorsal surface of the tongue. Each filiform papillae
      on the apical surface of the tongue had several conical processes, in the
      midportion were larger than those on the apex in size. In the region of the
      vallate papillae, the filiform papillae had not the conical processes and more
      larger than those on the midportion of the tongue. The fungiform papillae were
      present rounded bodies and more densely distributed on the tip of the lingual
      apex. There were 5 vallate papillae on both sides. The vallate papillae were
      located on both sides of the posterior end of the lingual body. Each papilla was
      surrounded by a groove and a crescent pad. In the dorsal surfaces of the
      papillae, small conical papillae were observed.

PMID- 11218712
TI  - Supraclavicular artery in Japanese: an anatomical basis for the flap using a
      pedicle containing a cervical, non-perforating cutaneous branch of the
      superficial cervical artery.
AB  - We investigated the morphology of the non-perforating cervical cutaneous branch
      in the lateral cervical triangle using 65 (130 sides) donated cadavers. We found
      the branch in 104 of the entire 130 sides (80.0%). In the majority (72.1%), the
      cutaneous branch did not cross the clavicle or acromion but supplied the
      dorsolateral cervical area. The branch was originated from the superficial
      cervical artery close to the posterior belly of the omohyoideus muscle and
      immediately lateral to the external jugular vein. The comitant vein, if present,
      drained into the external jugular vein. Our observations and measurements (length
      and diameter) suggested that the non-perforating cutaneous branch is useful for a
      pedicle of the dorsolateral cervical flap in Japanese people. However, detailed
      morphologies differ from the previous studies published in western countries.

PMID- 11218713
TI  - Anatomy and histology of the lacrimal fluid drainage system.
AB  - Five human specimens of the lacrimal canaliculus and sac were examined by light
      and scanning electron microscopy. The superior and inferior lacrimal canaliculi
      are lined with stratified squamous epithelium that is non-keratinized and non
      mucin-producing. The common canaliculus is also lined with stratified squamous
      epithelium, but its lumen is much narrower than the lumen of the superior and
      inferior canaliculi. The common canaliculus opens into an ample space called the
      vestibule, where the epithelium changes to high pseudostratified columnar and
      then low pseudostratified columnar. The vestibule continues to the infundibulum
      of the lacrimal sac. The infundibulum is formed by several epithelial folds that
      radiate from the vestibular opening to the lacrimal sac. The vestibule and
      infundibulum are consistent transitional structures from the common canaliculus
      to the lacrimal sac. The connective tissue of the lamina propria from the common
      canaliculus to the lacrimal sac has two histological characteristics: numerous
      free cell aggregates (= lymphoid structure) and numerous venules and capillaries
      (= cavernous structure).

PMID- 11218714
TI  - Morphological evaluation of the baboon hind limb muscles based on relative
      weight.
AB  - Morphological features of the hind limb muscles reflect the muscular function
      correlating with the locomotion. In this study, the muscles of the baboon hind
      limb were weighed and the relative muscle weights were compared with those of the
      human lower extremity. In the baboon, the biceps femoris was the largest (11.60%)
      and the vastus lateralis (10.67%) was placed second. The gluteus medius (8.55%)
      among the hip muscles and the gastrocnemius (4.38%) among the leg muscles were
      predominant in each segment. The relative weights of the gluteus medius and the
      biceps femoris were especially larger in the baboon than in the human, while the
      gluteus maximus and the soleus were larger in the human. The baboon gluteus
      medius and biceps femoris chiefly generate the propulsive power during
      quadrupedal locomotion and the human soleus is essential for the erect
      bipedalism.

PMID- 11218715
TI  - Fiber arrangement of the rat splenic capsule with special reference to elastic
      fibers.
AB  - The fiber arrangement of the rat splenic capsule was examined under scanning
      electron microscope (SEM) after selective removal by chemical maceration of
      capsule components, in conjunction with examination of thin sections using a
      transmission electron microscope (TEM). TEM findings were compared to those of
      the guinea-pig, mouse and dog. Serosal cells of the rat splenic capsule showed
      labyrinthic channels that consisted of expanded intercellular spaces and tunnel
      like spaces or slits in the basal cytoplasm. The channels contained fascicles of
      collagenous fibrils, forming a loose net on an underlying elastic lamina of
      densely aggregated elastic fibers. The fibrous tunica was an intermingled layer
      of elastic and collagenous fibers and sparse interstitial cells. The fibrous
      components were arranged more densely in the external layer than in the internal
      layer of the capsule. The elastic lamina comprised the outermost layer of the
      fibrous tunica in the intertrabecular region, but was situated deep in the
      trabecular region. Outward branches of the lamina in the trabecular region were
      arranged in a spiral. Intrachannel fibrillar fascicles were continuous, via
      fenestrations in the elastic lamina, with thick fascicles of collagenous fibers.
      The elastic lamina may play a role in effective contraction of whole spleen. In
      the guinea-pig, mouse and dog, elastic fibers were fragmented and not arranged in
      laminae. Typical smooth muscle cells were abundant in the dog. The channel spaces
      in the serosal tunica are discussed from the viewpoint of extravascular lymphatic
      flow for circulation of the peritoneal serous fluid.

PMID- 11218717
TI  - [For establishing geriatric medicine of the 21st century].

PMID- 11218716
TI  - The effects of prenatal X-irradiation on hypoglossal nucleus: a GFAP
      immunohistochemical study.
AB  - The effects of prenatal X-irradiation on hypoglossal (XII) nucleus were
      investigated in the rat. Pregnant animals were exposed to a single whole body X
      irradiation on day 11 and 16 of gestation at a does of 1.3 Gy. The offspring were
      killed at 7-14 days of age for the histological and immunohistochemical
      observations. Nissl staining revealed no significant changes of XII motoneurons
      in these experimental animals. In the control case it was of interest that
      expression of glial fibrillary acidic protein-immunoreactivity (GFAP-IR) is
      largely confined to the dorsomedial region including the XII nucleus at the level
      caudal to the obex. Exposure of X-irradiation on day 16 of gestation led to
      similar expression of GFAP-IR in the nucleus at the same level. However, exposure
      on day 11 of gestation apparently led to strong expression of GFAP-IR in the XII
      nucleus at the level caudal to the obex and the expression was observed to extend
      rostrally. The GFAP-IR cells showed hypertrophy of cell bodies and longer
      cytoplasmic processes. Horse-radish peroxidase (HRP) injection into the tip of
      the tongue including the intrinsic muscles resulted in retrograde labeling in the
      ventromedial portion of the XII nucleus bilaterally from +0.30 to -1.25 mm. The
      present study would indicate that motoneurons of the XII nucleus supplying mainly
      the intrinsic and partly the extrinsic tongue muscles are more sensitive to X-ray
      exposure before the formation of the XII nucleus.

PMID- 11218718
TI  - [Perspectives of the aging science in the 21st century].

PMID- 11218719
TI  - [Geriatric medicine of the 21st century--perspectives for the practice,
      education].

PMID- 11218721
TI  - [Preventive geriatric standpoint of view for reducing the elderly people with
      disabilities].

PMID- 11218720
TI  - [Basic concepts and strategies for the management of the elderly in the new era].

PMID- 11218722
TI  - [Clinical stage of dementia of Alzheimer's type].

PMID- 11218723
TI  - [Effective assessment and planning services for disabled older people].

PMID- 11218724
TI  - [Care for the incurable elderly].
AB  - The goals of medicine encompass the relief of pain and suffering, the promotion
      of health and the prevention of disease, and the cure of disease when possible
      and the care of those who can not be cured. Today, closely affiliated with
      various establishments, medicine sustains an influential but strange subculture
      in our society. Because of its insistent ideology for cure, medicine is blamed
      for futility, a misuse of modern technology. The root of the problem lies in the
      abandonment of the human soul when medicine in the 19th century joined the new
      sprung science which identified objectivity as a leading principle forbidding
      "cogito ergo sum". Accordingly, modern medicine neglected patients for whom the
      care of the mind is essential and failed to care for those with uncurable
      conditions. Curiously, the development of life sciences dictates the human soul
      as a final product of an evolution through a trade-off with aging and death. The
      human soul and its dignity must be revived at the heart of medicine, and the art
      of dying must be sought to enable a peaceful death. The concept of Tenju gann or
      "natural-end cancer", an example for blessed longevity followed by a peaceful
      death is an ideal goal of palliative care, developing the art of dying for every
      patient, irrespective of age or disease. Palliative care begins at the
      irreversible stage of diseases or when treatment impairs the dignity of a dying
      patient. With public disclosure physicians must be selected by aged patients and
      their families to promote the art of dying.

PMID- 11218725
TI  - [Discovery of cis-preference of aromatic N-methylamides and its application to
      molecular constructions].
AB  - Aromatic secondary amides such as benzanilide (1) exist in a trans-amide form
      both in the crystal and in the solution, whereas N-methylbenzanilide (2) exists
      in cis form in the crystal, and predominantly in a cis form in the solution.
      Similar cis conformational preferences were observed in aromatic N,N'
      dimethylated ureas and guanidines, in which two aromatic rings are located face
      to face. The cis preferences of N-methylated amides, ureas and guanidines could
      be utilized to construct interesting aromatic architecture. N,N',N"-Trimethyl
      N,N',N"-triphenyl-1,3,5-benzenetricarboxamide (20) and a cyclic triamide (24)
      have crystal structures in which three N-phenyl groups direct to the same
      orientation (syn conformation). 1,2-Bis(N-benzoyl-N-methylamino)benzene (22),
      which have no fixed asymmetric center, afforded chiral crystals by simple
      recrystallization. Furthermore, aromatic multi-layered structures could be built
      and applied to obtain aromatic molecules which have potent DNA-binding ability.

PMID- 11218726
TI  - [Cytokine balance in the pathogenesis of rheumatoid arthritis].
AB  - Rheumatoid arthritis (RA) is a common, frequently severe, chronic inflammatory
      disease. Although the cause of RA remains unknown, recent advances in
      understanding its pathogenesis have been substantial. Despite the use of a
      variety of medications, the treatment of RA is not fully effective in most
      patients. A T-helper type 1 (Th1)/T-helper type 2 (Th2) cytokine imbalance has
      been suggested to be of pathogenic importance in several diseases. In this
      review, the information of cytokine balance in both the experimental model of
      arthritis and patients with arthritis were summarized. Furthermore, to
      characterize the cytokine balance at a single cell level, we analyzed the
      subtypes of cytokine-secreting cells in an experimental model of arthritis using
      a dual color enzyme-linked immunospot assay (Stardust assay) which we newly
      developed. These information including our findings might provide us the clue for
      diagnosis and therapy of arthritis.

PMID- 11218727
TI  - [The amount of the loss of cyclosporine A dose correlated with the amount of
      leaching di (2-ethylhexyl) phthalate from polyvinyl chloride infusion tube].
AB  - An interaction between cyclosporine A (CyA) injection and infusion tubes were
      examined. We used polyvinyl chloride (PVC) and polybutadiene (PB) tubes. CyA
      injection (Sandimmun) was diluted (0.495 mg CyA/ml) with saline and dripped
      through infusion tubes. The amounts of unsolved substances, loss of CyA dose and
      leached di (2-ethylhexyl) phthalate (DEHP) during the drip study were compared.
      CyA was not lost into the PB tube and no DEHP was leached. Therefore, using PVC
      tube, 11.9 mg of CyA were lost with in 24 h after the beginning of the
      administration, and the concentration of leached DEHP amounted to 93.6
      micrograms/ml at 12 h. We also investigated the effects of the component of the
      einfusion solution on the loss of CyA into PVC tube using saline, electrolyte
      maintenance solution, 5% glucose and 10% maltose. Sugar-containing solutions were
      found to have less effects than other solutions on the loss of CyA dose and DEHP
      leaching. The leaching of DEHP may be a major factor for the generation of
      unsolved substances and the loss of CyA dose. In the clinical use of CyA
      injection, PB tube is the best selection and the sugar-containing solution is a
      second selection when PB infusion tubes are hard to obtain.

PMID- 11218728
TI  - [The trend of the drug eruptions in the last fifteen years].
AB  - The drug eruptions are known to often become more severe by the readministration
      of causative drugs. It is an important theme to prevent the relapse of the drug
      eruptions. We have been monitoring drug adverse reactions at our hospital since
      October, 1980. We divided fifteen years from October, 1980 to September, 1995
      into three periods; the first period (Oct., 1980-Sep. 1985), the second period
      (Oct., 1985-Sep., 1990), and the third period (Oct., 1990-Sep., 1995), and
      discussed the trend of the drug eruptions appeared among these three periods. The
      number of the drug eruptions increased. But the proportion to the total drug
      adverse reactions and to the number of patients slightly decreased. The eruptions
      in women much increased and in the patients of forties or older generations also
      increased. But in patients of thirties or younger generations decreased. While
      nonsteroidal anti-inflammatory drugs (NSAIDs) other than pyrines, antibiotics
      other than penicillins and cephalosporins and drugs affecting the cardiovascular
      system and the metabolism tend to increase, pyrines, penicillins, iodic and
      biliary contrast media tend to decrease. The incubation period before the
      eruption appeared is less than three days in most antibiotics and anti
      inflammatory drugs. But it is more than four days in most drugs for chronic
      diseases. Other symptoms such as nausea, fever and liver dysfunction were shown
      in 9.2% of the drug eruptions. In 8.9% of the drug eruptions a relapse of
      allergic reactions included eruptions were also found. In some cases the drug
      eruptions exacerbate by re-administration of beta-lactam antibiotics. In the case
      of administration of drugs, it is necessary to pay attention to dermatitis caused
      by the drugs. And we recognized the importance of the system for the prevention
      of the relapse of drug eruptions including injections.

PMID- 11218729
TI  - Effects of sho-saiko-to (xiao chai hu tang), a Chinese traditional medicine, on
      the gastric function and absorption of tolbutamide in rats.
AB  - This study was carried out to investigate the effects of Sho-saiko-to (Xiao Chai
      Hu Tang), a Chinese traditional medicine, on the gastric function including the
      gastric emptying rate (GER) and intragastric pH in rats. Additionally, the
      effects of the GER and intragastric pH on tolbutamide absorption after oral
      administration were examined. The GER measured at 40 min after dosing was reduced
      to about 70% by the pretreatment of Sho-saiko-to (500 mg/kg). The plasma
      tolbutamide concentration in the rats treated with a 250 mg/kg dose of Sho-saiko
      to was significantly lower than that in the control group. Plasma tolbutamide
      concentrations increased along with the GER in the group co-administered Sho
      saiko-to, and there were significant correlations between the GERs and plasma
      levels in both time points at 20 and 40 min after administration. In the study
      using pylorus-ligated rats, Sho-saiko-to significantly elevated the intragastric
      pH, but induced no change in the concentrations of tolbutamide dissolved in the
      gastric content. Additionally, Sho-saiko-to did not change the area under the
      plasma concentration-time curve (AUC) of tolbutamide up to 60 min after
      administration into the stomach loop, and gastric absorption has been considered
      to minimally contribute to whole absorption of tolbutamide in the
      gastrointestinal tract. These results indicate that Sho-saiko-to has an
      inhibitory effect on the function of gastric emptying in rats. The reduced
      gastric emptying could affect gastrointestinal absorption, resulting in the lower
      plasma concentration of tolbutamide after oral administration. Furthermore, it is
      suggested that Sho-saiko-to can raise the intragastric pH but affect neither the
      intragastric dissolution nor the gastric absorption of tolbutamide.

PMID- 11218730
TI  - [Enhancing effect of switching iontophoresis on transdermal absorption of
      glibenclamide].
AB  - Glibenclamide(GLI) is widely used as an oral hypoglycemic drug in the treatment
      of non-insulin dependent diabetes mellitus (NIDDM). We investigated The enhancing
      effect of switching iontophoresis on the transdermal absorption and reduction of
      skin irritation to develop a transdermal dosage form of GLI. The 0.1% of Gli
      suspensions in 0.2 M tris-HCl buffer of pH 7.4, 8.0 and 8.5 were prepared as
      donor solutions. We examined drug permeation through the excised rat abdominal
      skin, drug absorption in rats and reduction of skin irritation after application
      of switching iontophoresis for 1 h using DC 10 V. The solubility of GLI in 0.2 M
      tris-HCl buffer increased with a rise in pH. In the permeation study, GLI was
      permeated continuously and the cumulative amount of permeated GLI increased using
      an alkaline donor solution. In the drug absorption study, the application group
      of pH 8.5 gave higher plasma concentration levels than those of pH 7.4 and 8.0
      groups. The skin irritation evoked by the application of iontophoresis was
      pathologically studied. A total irritation score (TIS) was estimated as a judging
      standard for the skin damage. The TIS value increased dependently with a rise in
      pH. However, it was considered that the skin irritations were not serious and
      small matters. The results demonstrate the possibility of iontophoretic
      transdermal administration of GLI and the effect of drug solubility in the donor
      solution on the absorption of GLI.

PMID- 11218731
TI  - [Inhibition effect of Amaryllidaceae alkaloids, lycorine and lycoricidinol on
      macrophage TNF-alpha production].
AB  - We previously demonstrated that Amaryllidaceae alkaloids, lycorine and
      lycoricidinol, inhibit induction of apoptosis by calprotectin derived from
      neutrophils, and that the latter alkaloid showed suppression in rat adjuvant
      induced arthritis model. These findings suggest that the alkaloids have a
      modulating activity against inflammatory reaction. To explore further the
      mechanism of the suppression for inflammation, we studied the effect of the
      alkaloids on macrophage tumor necrosis factor (TNF-alpha) production in vitro,
      since TNF-alpha is recognized as a pivotal cytokine to regulate inflammation. As
      a result of this study, lycorine and lycoricidinol inhibited TNF-alpha production
      of murine macrophages stimulated with lipopolysaccharide (ID50 were 0.2
      microgram/ml and 0.002 microgram/ml, respectively). The inhibition was also
      observed in macrophages treated by Gram-positive bacteria, Enterococcus faecalis.
      Both lycorine and lycoricidinol reportedly have inhibitory activity for protein
      biosynthesis. Although the inhibition of TNF-alpha production by lycoricidinol
      was mainly due to the inhibition of protein biosynthesis, lycorine showed
      inhibition against TNF-alpha production at lower concentrations than the case
      that they inhibited 35S-Cysteine/35S-Methionine incorporation into macrophages.
      These facts suggest that the inhibition of TNF-alpha production is not due to the
      inhibitory activity against protein translation at least at lower concentrations.
      From these results, it was concluded that these alkaloids exert inhibitory
      effects not only on neutrophil apoptosis-inducing protein, calprotectin, but also
      on macrophage TNF-alpha production.

PMID- 11218733
TI  - Evaluation of the effective drugs for the prevention of nausea and vomiting
      induced by morphine used for postoperative pain: a quantitative systematic
      review.
AB  - Postoperative nausea and vomiting (PONV) with morphine therapy develops in more
      than 60% of patients after surgery, markedly reducing patient QOL. The
      prophylactic effect of several antiemetics has already been studied, but
      evaluations, and even those using the same drug, are not uniform. The present
      research involved a meta-analysis of randomized controlled trials on prophylactic
      drug therapy for PONV in patients receiving morphine for the treatment of
      postoperative pain. The efficacy of the prophylactic administration of the drugs
      was examined. As a result, meta-analysis of five drugs was possible and the
      evidence of efficacy was shown for three drugs ranked in order of an increasing
      odds ratio (OR) and confidence interval (CI): dexamethasone (OR: 0.23, 95% CI:
      0.15-0.35, p < 0.00001), droperidol (OR: 0.27, 95% CI: 0.21-0.34, p < 0.00001),
      and metoclopramide (OR: 0.48, 95% CI: 0.30-0.75, p < 0.001). These results
      suggest that the three drugs are effective in prophylactic treatment for PONV. Of
      them, dexamethasone used as a prophylactic drug for PONV provided the best
      results. Dexamethasone was shown to reduce the incidence of PONV from 66-80% to
      16-50% with a dose of 1.25 to 10 mg and to be suitable as a first drug of choice.

PMID- 11218732
TI  - [The effects of kampo-formulation and the constituting crude drugs, prescribed
      for the treatment of peptic ulcer on H,K-ATPase activity].
AB  - We studied the effects of 17 kinds of Kampo-formulations prescribed for the
      treatment of peptic ulcer on H,K-ATPase activity. The activity was strongly
      inhibited by San-o-shashin-to ([symbol: see text], IC50 = 82 micrograms/ml),
      Bukuryo-in ([symbol: see text], IC50 = 110 micrograms/ml), Shakuyaku-kanzo-to
      ([symbol: see text], IC50 = 170 micrograms/ml), Hange-koboku-to ([symbol: see
      text], IC50 = 290 micrograms/ml), Dai-saiko-to ([symbol: see text], IC50 = 340
      micrograms/ml), Irei-san ([symbol: see text], IC50 = 380 micrograms/ml) than
      other Kampo-formulations. Among the 17 kinds of crude drugs contained in these
      Kampo-formulation, Rhei Rhizoma, Coptidis Rhizoma, Glycyrrhiza Radix, Cinnamomi
      Cortex, and Poria have notable inhibitory effects (IC50 = 19-57 micrograms/ml).
      H,K-ATPase activity was inhibited by sennoside A (Rhei Rhizoma), sennoside B
      (Rhei Rhizoma), ergosterol (Poria), coptisine (Coptidis Rhizoma), glycyrrhizin
      (Glycyrrhiza Radix), glycyrrhetic acid (Glycyrrhiza Radix), gallic acid
      (Cinnamomi Cortex) in the 21 components of these crude drugs (IC50 = 1.6-7.9 x
      10(-4) M). The inhibition of San-o-shashin-to and Bukuryo-in is considered to be
      mainly attributed to Rhei Rhizoma and Poria, respectively. The anti-gastric ulcer
      effects of San-o-shashin-to and Bukuryo-in may be ascribed to the inhibition of
      H,K-ATPase activity.

PMID- 11218734
TI  - Medication management skill and regimen compliance are deteriorated in the
      elderly even without obvious dementia.
AB  - We investigated whether regimen comprehension deteriorated in the elderly
      patients who did not suffer from obvious dementia. Eligible patients were
      ambulatory elderly patients who did not show any signs of dementia and could
      visit our outpatient clinic by themselves. 138 patients (age: 43-89, 75 males and
      63 females, underlying diseases: hypertension, hyperlipidemia, arrhythmia etc.)
      were tested with a regimen comprehension scale (RCS: Jpn J Geriat 1997; 34: 209
      214). The differences in scores among individuals increased with age. Scores of 5
      or less in the RCS were recorded in 10 out of 69 patients aged 65 or more, but no
      such scores were recorded in younger patients (p < 0.01). The 60 patients who
      scored less than full marks were classified into two groups, the T-group (tutored
      by pharmacists), and a Non Tutored group. RCS was tested again in both groups.
      Only in the T-group (n = 28), did the second scores increase significantly (from
      7.2 +/- 0.9 to 8.6 +/- 2.0 (m +/- SD); p < 0.01) after tutorial by pharmacists.
      Comparing the 7 patients who obtained an RCS score of 5 or less and age- and
      gender-matched controls who got full marks, there was no difference in the HDS-R
      test. These results suggest that even in elderly patients who did not show any
      signs of dementia, the regimen comprehension deteriorated with age, and tutorials
      in medication protocols were considered to be effective.

PMID- 11218736
TI  - [Approaches to sella turcica in endoscopic pituitary surgery].
AB  - Recent advances in endoscopic sinus surgery suggested the potential for its
      surgical application to pituitary surgery. A number of institutions have reported
      the advantage of endoscope use in pituitary surgery, which is now widely
      accepted, but approaches to the sella vary in the literature. We retrospectively
      studied sella approaches in endoscopic pituitary surgery as rhinologists.
      Subjects included 6 cases of pituitary adenoma and 2 cases of Rathke's cleft
      cyst. A both-nostril transnasal transsphenoidal approach, our standard technique,
      was used in 6 cases. This approach consisted of elevation of mucoperiosteal
      flaps, resection of the vomer and sphenoid anterior wall, and opening of the
      sellar floor. Elevated mucoperiosteal flaps were used to close of the sella after
      tumor resection. All tumors were removed and no significant postoperative
      complications occurred. We found the both-nostril transnasal approach to be easy
      and time-saving and provided surgeon with a broad surgical field necessary to
      treat large tumors and accidental cases. Postoperative observation of the sella
      was easy for wide opening of the anterior wall of the sphenoid sinus. In our
      experience with reoperation, we quickly accessed the sella and easily removed
      tumors in the second operation. Our technique therefore has an advance in
      treatment of recurrence. The both-nostril transnasal approach involves the same
      procedures as median drainage of the sphenoid sinus, so our technique may have
      advantages in preventing mucocele of the sphenoid sinus as a late complication of
      transsphenoidal surgery. The transnasal transsphenoidal approach via both
      nostrils is preferable rhinologically.

PMID- 11218735
TI  - [Micelle-mediated extraction for concentrating conjugated bilirubin in urine].
AB  - An extraction method based on the phase separation of aqueous micellar solutions
      of n-octyl-beta-D-thioglucoside (OTG) was applied to the concentrating conjugated
      bilirubin in urine. The analyte in sample solutions could be efficiently
      concentrated into a small volume of surfactant-rich phase, while hydrophilic
      matrix components including urinary protein, ascorbic acid, and saccharide
      remained in the aqueous phase. The concentrated OTG negligibly affected the diazo
      reaction and the subsequent spectrophotometric detection. Conjugated bilirubin
      was successfully determined in the concentration range from 0.05 microgram/ml to
      5 micrograms/ml with a 96-well microplate reader absorption spectrophotometer.

PMID- 11218737
TI  - [Congenital rubella syndrome developing after a 1987-1988 epidemic in Japan].
AB  - Since vaccination legislation was revised in 1994, rubella vaccination has been
      changed from application to all junior high school girls with no history of
      clinical rubella to application to individual infants and junior high school
      students. This may decrease the vaccination acceptance rate and increase the
      chance of pregnant women's infection with rubella causing congenital rubella
      syndrome (CRS). We studied 5 children with CRS developed after a 1987-1988
      epidemic in Japan to determine how their mothers were infected, and reviewed
      auditory findings. They were CRS-confirmed or CRS-compatible cases who met CRS
      diagnostic criteria formulated by the U.S. Center for Disease Control (CDC) in
      1983. Two mothers had not been vaccinated because this was not legislated when
      they were in junior high school. Three were eligible for vaccination at 14, but 2
      were not vaccinated. The children were born in 1991-1997. Complications were low
      birth weight in 3, delay in neck stabilization in 2, and cataract in 1. No case
      was serious. Ages at first ENT examination ranged from 3 months to 1 year and 8
      months. ABR showed hearing loss of > or = 90 dBnHL. They started using hearing
      aids at 6 months to 1 year and 10 months. Tsumori mental development tests showed
      delays in developmental age in 2 who started auditory training after ages of 1
      year and 6 months. Findings indicated that infants, students, and potentially
      pregnant women should be vaccinated. Complete serologic testing are important in
      pregnant women and fetal rubella infection should be diagnosed early by PCR.

PMID- 11218739
TI  - [Clinical features of benign paroxysmal positional vertigo].
AB  - Our understanding of the pathomechanism of benign paroxysmal positional vertigo
      (BPPV) has improved dramatically. A type of BPPV featuring mixed torsional and
      vertical nystagmus induced by the Dix-Hallpike maneuver involves the posterior
      semicircular canal (P-BPPV). The other type of BPPV featuring horizontal
      nystagmus induced by spine-to-lateral head positioning involves the horizontal
      canal BPPV (H-BPPV). In complaints of vertigo or dizziness, 619 patients visited
      our department last year. Of these, 142 (23%) was had positional nystagmus
      consistent with a diagnosis of BPPV, 118 (19%) had no nystagmus but were
      suspected of BPPV due to vertigo episodes. BPPV was the most frequent diagnosis.
      H-BPPV was not rare, but accounted for 30% of BPPV. Of H-BPPV, 73% featured
      direction changing geotropic nystagmus, and 27% direction changing apogeotropic
      nystagmus. H-BPPV resolved faster than P-BPPV. Most cases caused by head trauma
      were P-BPPV. Transition between P- and H-BPPV was found in 6 cases. Women
      outnumbered men by about 3 to 2 in both P- and H-BPPV. Peak incidence was found
      in the those in their 60s and 70s, suggesting that the etiologies of both types
      of BPPV are essentially the same.

PMID- 11218740
TI  - [Radiation therapy for head and neck cancer].
AB  - Radiation therapy is the first choice of treatment for most of the early squamous
      cell carcinoma of the head and neck. Conventional radiotherapy however,
      contributes to the high local control rates only for carcinoma of the glottic
      larynx and the nasopharynx. Squamous cell carcinoma of the other sites cannot be
      sterilized easily only by external beam radiation therapy alone.
      Chemoradiotherapy, conformal three-dimensional radiotherapy and multi-daily
      fractionation are introduced clinically to improve local control and/or survival
      for radioresistant tumor. In this review, consensus report of radiation therapy
      for carcinoma of the larynx and pharynx, which was reached an agreement in JASTRO
      meeting in 1998, is introduced. The role of radiation therapy in the management
      of head and neck cancer in present and near future is also discussed.

PMID- 11218738
TI  - [Evaluation of nasal valve by CT imaging].
AB  - The nasal valve was studied using coronal scans by computed tomography (CT).
      SUBJECTS: Coronal images were 5 mm thick obtained from 133 subjects 93 men and 40
      women averaging 46 years of age. METHODS: The valvular area was studied in 2
      slices containing nasal valve, anterior and posterior slices 5 mm apart. After
      defining standard points for evaluation, breadth, height and area were evaluated
      using NIH Image Version 1.59 from left and right as an unit. RESULTS: Results
      were follows: 1. The breadth of the nasal valvular area is larger in men than in
      women, and the height greater. The angle of valvular area is similar in both. 2.
      A comparison of anterior and posterior slices showed the smallest breadth of
      valvular area in the anterior slice to be smaller than in the posterior slice.
      The breadth of the vestivular area below the valvular area is larger in the
      anterior than posterior slice. The angle in the anterior slice is larger than
      that in the posterior slice. The area of valvular area in the anterior slice is
      smaller than that in the posterior slice.

PMID- 11218741
TI  - [Evaluation of computer-assisted diagnosis of small pulmonary nodules using
      contrast-enhanced dynamic helical CT].
AB  - Dynamic helical computed tomography(DH-CT) was performed to examine 45 lesions(23
      lung cancers, 2 pulmonary metastasis, and 20 benign nodules) as an application of
      computer-assisted qualitative analysis of small pulmonary nodules. Based on the
      three-dimensional(3D) CT image data, the internal structure of the nodule was
      assessed quantitatively and temporal changes were evaluated. The entire lesion
      was examined by helical scanning with a beam width of 2 mm(pitch of 1) before
      contrast enhancement and 2 and 4 minutes after contrast enhancement. Using the
      digital CT data, the pixels inside the nodules were quantified based on a
      combination of CT values and 3D curvature in order to differentiate between
      benign(BN) and malignant nodules (MN). (The numeral score abovementioned was
      calculated.) The average scores for BN 2 and 4 minutes were -5.72 and -12.8,
      respectively, and those for MN were 5.51 and 12.0, respectively(p < 0.01).
      Assuming that a score of 0 or higher indicates a MN based on the CT data 4
      minutes. In conclusion, 3D computer-assisted analysis of the internal structure
      of small pulmonary nodules using contrast-enhanced DH-CT was found to be
      effective for differentiating between benign and malignant nodules.

PMID- 11218742
TI  - [Usefulness of transradial angiography and interventional angiography for
      abdominal diseases: comparison with transfemoral or transbrachial approach].
AB  - Transradial angiography has recently emerged as an alternative to the
      transfemoral or transbrachial approach, especially for coronary or cerebral
      procedures. However, there are few such studies regarding abdominal angiography.
      In our institution, we performed abdominal angiography and intervention by the
      transradial arterial method in 42 cases using a 120-cm-long 4 Fr catheter and
      compared the results with the transfemoral or transbrachial arterial method and
      examined the usefulness of this technique. Puncture was successfully carried out
      in 42 cases, whereas failure occurred in one case, in which the transbrachial
      method was adopted because of weak pulse. Selective catheter insertion was
      successful in all cases, after the shape of the catheter had been improved. No
      serious or dangerous complications occurred during the examinations. In addition,
      many patients chose the radial arterial method for subsequent examinations on a
      questionnaire survey we gave patients on the day after we did abdominal
      angiography by the transradial arterial method. We consider that the transradial
      arterial method can be used generally in angiography and interventional
      angiography for abdominal diseases.

PMID- 11218743
TI  - [Development and assessment of real cardiac motion simulation phantom].
AB  - To evaluate cardiac images obtained by multi-slice CT, assessments of the
      temporal resolution and reconstruction algorithm are essential. For these
      purposes, we have designed and developed a cardiac motion phantom. Using suitable
      driver sequences, the phantom allowed for modeling of real left ventricular
      motion, which was characterized by fast pumping, slow pumping, fast filling and
      slow filling. Our phantom seems to be useful for use in the fundamental
      assessments and researches of cardiac CT.

PMID- 11218744
TI  - [Significance of CT findings and catecholamine determination in peripheral blood
      of asymptomatic pheochromocytoma and paraganglioma].
AB  - The purpose of this study was to assess the CT findings and significance of
      hormone determination in the peripheral blood of asymptomatic patients with
      pheochromocytoma and paraganglioma. CT findings in 29 patients with surgically
      proven pheochromocytoma(n = 19) and paraganglioma(n = 10) were reviewed. Nine
      patients(31%) were symptomatic and 20 (69%) were asymptomatic. Tumor size ranged
      from 39 mm to 114 mm(mean: 60 mm) in symptomatic patients and 11 mm to 100
      mm(mean: 50 mm) in asymptomatic ones. Of the 9 symptomatic patients and 18
      asymptomatic patients, a homogeneous solid pattern was seen in 4 and 4, mixed
      pattern in 2 and 6, and massive necrotic pattern in 3 and 8 patients,
      respectively, on CT scans. The CT attenuation values in symptomatic cases ranged
      from 30 HU to 50 HU(mean: 41 HU) on precontrast CT scans and 60 HU to 111
      HU(mean: 77 HU) on postcontrast CT scans, while those in asymptomatic cases
      ranged from 15 HU to 48 HU(mean: 33 HU) on precontrast CT scans and 66 HU to 133
      HU(mean: 95 HU) on postcontrast CT scans. There were no statistically significant
      differences in tumor size, homogeneity, or CT attenuation values between
      symptomatic and asymptomatic patients. All symptomatic patients and 17(89%) of 19
      asymptomatic cases showed elevated levels of catecholamine (epinephrine) or
      norepinephrine in the peripheral blood. Our study showed that the CT findings in
      asymptomatic patients were similar to those in symptomatic patients, and 89% of
      asymptomatic patients showed elevation of catecholamine in the peripheral blood.
      Determination of catecholamine level in the peripheral blood is recommended for
      preoperative diagnosis in patients suspected of having asymptomatic
      pheochromocytoma or paraganglioma on CT scans.

PMID- 11218746
TI  - [Diagnostic imaging in the congenital and developmental disorders: before and
      after advancement of molecular genetics].
AB  - In this review, a general approach to the congenital and genetic disorders is
      presented. Differentiation between deformation and malformation is practically
      important to triage congenial or developmental abnormalities. The disease
      distribution along arterial supply or sclerotome is more suggestive of
      developmental or acquired disorder, either in utero or in early infancy. Newly
      developed genetic analysis of bone dysplasia is an important subject, and this
      review focuses on collagen abnormalities, systemic disorders associated with
      neoplasms and receptor disorders. Owing to the progress of molecular genetics and
      gene therapy, the approach to hereditary conditions will dramatically change.
      Although most of these diseases are relatively uncommon, the role of diagnostic
      radiologist may become more important for early institution of treatment planning
      and estimating prognosis.

PMID- 11218745
TI  - [Visualization of abdominal arteries by super-high-flow venous injection using
      multidetector helical CT].
AB  - The purpose in this study was to compare the ratio of visualization of upper
      abdominal arteries using MDHCT between the super-high-flow injection method
      (Group A) and the conventional injection method (Group B). The subjects ects were
      200 patients who were randomly divided into Group A (100 patients) and Group B
      (100 patients). In Group A, visualization of the large arteries, including the
      CE, SMA, HA and LGA, was possible at a rate exceeding 96%, and that of the small
      arteries, including the DPA, SPDA, RGA and Cyst A, was more than 79%.
      Visualization of upper abdominal arteries was markedly improved by the super high
      flow injection technique.

PMID- 11218749
TI  - [Tracing of analysis and prophylaxis on medical malpractice in Japan].
AB  - The role of drugs, especially injectables, in medical treatment is extremely
      important. In Japan, accidents associated with injections were not uncommon. Post
      injection neuroparalysis of the radial nerve and sciatic nerve was associated
      with problems in textbooks, which described injection sites at the regions of
      neural passage. Then, in the 1970s, quadriceps femoral muscle contracture and
      deltoid muscle contracture became a social problem. When the author examined the
      osmotic pressure of various injectables, some injectables were found to deviate
      from the physiological range. When 335 injectables were evaluated for the
      potential to cause hemolysis, many injectables marketed for intramuscular
      injection gave strong hemolytic reaction, which attracted attention. Next, 89
      types of injectables were tested for the potential to cause muscle damage by
      injecting into the femoral muscle of rabbits, and severe muscular damages were
      observed with antipyretics, analgesics, and antibiotics. The group lawsuit of
      Yamanashi Prefecture was settled at the Tokyo High Court in 1989, with the
      pharmaceutical company agreeing to pay over 2.95 billion yen as settlement.
      Giving drugs to patients occupies an important place among medical act. Medical
      disputes concerning accidents of wrong drugs and wrong usage are common.
      Obviously health care workers should exercise great caution in their duties, but
      without measures taken against medical equipment and drugs, such as containers
      and seals, this type of accidents will not be reduced. Through giving numerous
      speeches and lectures on medical accidents throughout the years, the author had
      felt strongly the need for teaching materials such as video tapes that can be
      used for self-learning. In 1999, the video entitled "Medical Accident-Learning
      from Actual Cases-" was finally completed, which consists of 6 parts (1. General
      consideration, 2. Blood transfusion, 3. Drug administration, 4. Surgery, 5.
      Examinations, 6. Management). For each area, typical incidents are presented as
      reproduced video taping. Then the criminal responsibility, civil responsibility
      and administrative responsibility of the doctor or nurse concerned are questioned
      in the form of questionnaires. Subsequently, the author also published a
      commentary book for the video that provides commentaries of the cases.

PMID- 11218748
TI  - [Studies on distribution of H type 1-H type 4 antigens of ABO system and on FUT2
      polymorphism].
AB  - I have examined the immunohistochemical distribution of H type 1-H type 4
      antigens of the ABO system in human submandibular gland using either of the three
      anti-H monoclonal antibodies specific for H type 1, H type 2 and H type 3/4. I
      have clearly identified cell types expressing H type 1, H type 2 and H type 3/4:
      H type 1 in mucous cells and duct cells, H type 2 in duct cells, and H type 3/4
      in serous cells of the submandibular gland. The expression of H type 1 and H type
      3/4 in the human submandibular gland is regulated by the Se enzyme. The FUT2
      encodes Secretor type alpha(1,2) fucosyltransferase (Se enzyme), which regulates
      the expression of ABH antigens in the gastrointestinal tract and secretions.
      Molecular analysis of the FUT2 polymorphism of various populations have indicated
      the ethnic specificity of null alleles: the null allele se428 is a common Se
      enzyme deficient allele in Africans and Caucasians but does not occur in Asians,
      whereas the null allele se357,385 is specific to Asians. The gene frequency of
      se428 or se357,385 is about 0.5 in each respective population. Why the se428 is
      absent in Asians is of interest.

PMID- 11218747
TI  - [Colonic varices; a case report].
AB  - Colonic varices is a rare entity that is caused by portal hypertension in most
      instances. In the case reported here, barium enema and colonoscopy showed
      multiple tortuous polypoid lesions with intact mucosal surface. Inferior
      mesenteric angiography showed arteriovenous malformation in the sigmoid colon,
      complete obstruction of the inferior mesenteric vein, and tortuous dilated
      marginal veins. We assume that the colonic varices of this case was secondary to
      complete obstruction of the inferior mesenteric vein following AVM of the sigmoid
      colon. Close follow-up should is warranted in cases of colonic varices because of
      the risk of bleeding.

PMID- 11218750
TI  - [From medicolegal toxicology to forensic toxicology].
AB  - The importance of forensic toxicology has been increasing until now, because of
      the increasing numbers of toxic substances and poisoning incidents. In Japan, a
      special translational word "houi-chudoku-gaku" has been used for the forensic
      toxicology especially in the field of legal medicine. The Japanese word, however,
      does not seem appropriate for translation of forensic toxicology, because it
      covers medicine, pharmacy and police sciences interdisciplinary. In 1980,
      Emeritus Prof. Hidetoshi Yoshimura created an appropriate word "hochudoku-gaku"
      for translation of forensic toxicology. In 1982, Prof. Yoshimura and his friends
      established the Japanese Association of Forensic Toxicology, consisting of people
      from legal medicine, pharmacy and police institutes. This Association enabled
      lively discussions among different fields and greatly contributed to advances of
      forensic toxicology in Japan. We started studies of forensic toxicology using gas
      chromatography (GC)/mass spectrometry (MS) in 1979. Until now, we delt with solid
      phase extraction (1987-1994), surface ionization GC (1989-1997), negative ion
      chemical ionization MS (1981-now), solid-phase microextraction (1994-now),
      cryogenic oven trapping GC (1997-now), surface ionization organic MS (1998-now)
      and high-performance liquid chromatography/tandem MS (1998-now). In this review,
      the author presents some details of solid-phase microextraction, negative ion
      chemical ionization MS, cryogenic oven trapping GC and surface ionization organic
      MS. Unprecedented poisoning terrorism by use of sarin took place in Matsumoto and
      Tokyo in 1994 and 1995, respectively. On July 25, 1998, a curry poisoning
      incident using arsenious acid occurred in Wakayama, resulting in the death of 4
      people and injury of 63 people. Since then, more than 30 imitative poisoning
      cases have been reported by mass communication within 1 year. In spite of the
      above continuing poisoning cases, almost no effective measures have been taken by
      the administration of our country and local governments. Many serious problems
      concerning poisoning and drug abuse are accumulating in Japan. In this review,
      the problems are also made manifest, and some proposals are presented to solve
      the problems.

PMID- 11218751
TI  - [The dynamics of cytokines and their related substances in skin wounds].
AB  - Molecular-pathological study on cytokines and their related substances in skin
      wound healing was performed from the view points of forensic pathology; 1. The
      dynamics of inflammatory cytokines such as interleukin (IL)-1 alpha, IL-1 beta,
      IL-6 and tumor necrosis factor-alpha (TNF alpha) during murine wound healing was
      examined at the levels of protein and mRNA. As for the results, the production of
      those inflammatory cytokines could be considered as one of the local vital
      reactions after wounding, and it was clarified that those inflammatory cytokines
      were one of the biological markers for forensic wound age determination.
      Practically, our immunohistochemical and morphometrical study with human skin
      wounds with different wound ages suggested that the ratios of IL-1 alpha-positive
      cells, considerably exceeding 30%, indicated a postinfliction interval of 1 day
      or less. 2. In mouse skin incision, a significant increase in IL-10 mRNA occurred
      between 30 and 180 min. The increased expression of IL-10 mRNA could be
      considered a vital reaction in skin wounds. Furthermore, it was clarified that IL
      10 may have an important regulatory role in limiting the extent and duration of
      inflammatory response during skin wound healing. 3. Fas and Fas ligand (Fas L)
      were immunohistochemically detectable on macrophages and fibroblasts in skin
      wound healing process. Morphometrically, the number of cell expressing Fas and/or
      Fas L reached a peak at 6 days after wounding. Therefore, it is considered that
      apoptosis through Fas and Fas L may play an important role for reducing the
      cellularity during proliferative phase of wound healing in mice.

PMID- 11218752
TI  - [Membrane disorder and free radical].
AB  - The aim of this study is to confirm cholesterol-derived hydroperoxides in
      membrane lipids as indices of free radical or active oxygen-induced membrane
      disorder or pathological changes at legal medicine. First, 7 alpha- and 7 beta
      hydroperoxycholesterol (7 alpha-OOH and 7 beta-OOH) were synthesized. Then, these
      were identified in lipids from human fatty liver by liquid chromatography-mass
      spectrometry. Secondly, the method for quantifying 7 alpha-OOH and 7 beta-OOH by
      high-performance liquid chromatography with chemiluminescent detection (HPLC-CL)
      was developed. Finally, the following membrane disorders were examined based on
      lipid peroxidation. Elevated lipid peroxidations were found in erythrocyte
      membranes of alcoholic patients, in alcoholic fatty liver, and in muscle of
      alcohol dosed rats. Enhanced lipid peroxidation was induced in rat kidney by
      paraquat. In addition, lipid peroxidation was increased in brains of senile
      dementia as well as in atheroscleroic plaque. Thus, we confirm 7
      hydroperoxycholesterol as a marker of free radical-induced oxidative stress.

PMID- 11218753
TI  - [Forensic pathological significance of iNOS with regard to brain and myocardial
      damage].
AB  - Inducible nitric oxide synthase (iNOS) does not express within cells under normal
      conditions. But, it is induced by inflammatory cytokines and the activity of iNOS
      is independent of elevated Ca2+. It is implied that nitric oxide (NO) produced by
      iNOS has a close relation with pathological conditions as a mediator of cell
      damages. We aimed at the crucial property of iNOS, therefore we have searched the
      expression of iNOS for the purpose to establish forensic pathological
      significance in the cases with damages of neuronal cells or cardiomyocytes. At
      first, we examined induction and expression of iNOS in the human brains whose
      causes of death was traumatic brain injury (TBI). These findings demonstrated
      prolonged induction of iNOS in neutrophils, microglia/macrophages, and vascular
      smooth muscle cells in traumatized brain. Such a response may indicate that iNOS
      could play a crucial role on cerebrovascular disturbances and secondary brain
      injury subsequent to TBI. Secondly, we evaluated the induction and expression of
      iNOS in the human hearts with myocardial cell damage. The expressions of iNOS
      were localized to the following areas, the cardiomyocytes in the zone adjacent to
      the infarcted area, the preserved cytoplasm of infarcted cardiomyocytes, the
      endothelial cells in arteriolar walls and macrophages in viable myocardium. These
      findings have led to the speculation that the NO might play a significant role
      during myocardial ischemia and reperfusion. Furthermore, representative
      expression of iNOS was identified in coronary artery, that is the portion of
      shoulder and broken part of coronary atherosclerotic plaque. These findings may
      indicate that the iNOS might have a close relation to the coronary
      atherosclerotic lesion. The physiopathological mechanism of iNOS might involve in
      the close relation with inflammatory cytokines. The precise elucidation of this
      participation may make it possible to explicate the presumed time of injury in an
      earlier stage, and to clarify the forensic pathological significance of these
      inflammatory factors.

PMID- 11218754
TI  - [The role of heat shock proteins on the disordered tissues: implication for the
      pathogenesis and diagnostics in the forensic practice].
AB  - There are many problems in identifying the cause of death from the early acute
      myocardial infarction and hypothermia in the field of forensic medicine, because
      there are no clear findings to identify without details of circumstances. It was
      caused complexly by many factors such as health condition, age, surroundings,
      weather, alcohol drinking, drugs poisoning, etc., and unfortunately the early
      acute myocardial infarction and hypothermia invasion almost never show the vital
      reactions. A variety stresses especially ischemia and temperature induce the
      expression of heat shock proteins (Hsp), and previous reports have documented the
      function and regulation of Hsp expression. Hsp are currently classified into five
      groups on the basis of size. Of these, the 70 Kd Hsp (Hsp70 family) are regarded
      as most important proteins because they are most often highly induced in stressed
      cells. In the field of medical science, various diseases induce the expression of
      Hsp and especially Hsp70 family are well related to some diseases. Of course,
      previous report in the field of forensic medicine demonstrated that
      hypoxic/ischemic neuronal damage induced the expression of Hsp70 in the brain of
      forensic autopsy cases and suggested that investigation of Hsp70 could be
      effective for diagnosing hypoxic/ischemic neuronal damage during process of
      death. So we investigated the expression of Hsp70 induced by the lethal ischemia
      and hypothermia in the experimental rat model and practical autopsy cases. The
      present study suggests that the lethal ischemia induce the expression of Hsp70 in
      the heart and the lethal hypothermia induce the expression of Hsp70 in the
      cerebral cortex, and these inductions are one clear findings contributing to the
      estimate the cause of death from the acute myocardial infarction or lethal
      hypothermia in the forensic autopsy cases.

PMID- 11218755
TI  - [Significance of product documents (tenpubunsho) cited in judicial precedents in
      the field of anesthesiology].
AB  - The significance of the product documents (Tempubunsho) was mentioned in 21 out
      of 94 medical malpractice cases published in several laws reports 1963-97. The
      number of such cases has been increasing in recent years. Among the items
      described in the product documents, the precautions for use were most frequently
      mentioned (12 cases) followed by the instructions for administration and dosage
      (3 cases). In most cases, the judgment was against the medical institution
      involved due to the violation of legal obligations with respect to the contents
      of the product documents. Product documents will be taken much more seriously in
      future lawsuits. Attention should be focused on the contents of the product
      documents, especially when revised. When the administration of a drug deviates
      from the contents of the product document, medical evidence is required to
      support this deviation.

PMID- 11218756
TI  - [Genotyping of blood-groups by denaturant gradient gel electrophoresis (DGGE)].
AB  - The denaturant gradient gel electrophoresis (DGGE) method was used in order to
      simultaneously estimate the genotypes of different factors in a gel plate
      consisting of one sheet. A genotype analysis of the blood groups (MN, Duffy, Kidd
      type) and serotype (Gc system) was carried out. DNA samples extracted from the
      leucocytes of volunteers, whose blood group had already been proven, were used.
      The PCR amplification fragments were amplified from the gene which controlled
      each blood group. The primers were designed in order to analyze genotypes with
      from 1-3 base substitutions in the amplification product. The concentration of
      the denaturant most suitable for the DGGE method to detect each genotype of the
      blood groups (MN, Duffy, Kidd type and Gc system) was calculated using a computer
      simulation method. The denaturant concentration limit of the gel which was
      suitable for performing a DGGE analysis was determined to range from 15-36%.
      Electrophoresis was performed at 60 degrees C and with 100 V using this gel on
      each amplification fragment for 3 hours. The gel after electrophoresis was
      treated in ethidium bromide in order to detect the DNA band. The genotype (M/M,
      M/N and N/N) of the MN blood group, the genotype (Fya/Fya, Fya/Fyb and Fyb/Fyb)
      of the Duffy blood group, the genotype (Jka/Jka, Jka/Jkb and Jkb/Jkb) of the Kidd
      blood group and each allele (GC*1S, GC*1F and GC*2) of the Gc system were all
      simultaneously distinguished in one plate. As a result, it was possible to
      estimate multiple gene polymorphism, while substituting bases 1-3, by PCR, DGGE
      and ethidium bromide staining. The polymorphic results obtained using this DGGE
      method is very useful for cases in which a multiple gene analysis is required
      such as for the personal identification.

PMID- 11218757
TI  - [Survey on postmortem examination to police surgeons and emergency physicians.
      Possibility of physicians' assist in mass-disaster].
AB  - We conducted a questionnaire survey of police surgeons and emergency physicians,
      inquiring about their experience of medicolegal investigation of death and their
      willingness to join a death investigation team in a major disaster. The
      questionnaire also asked about their knowledge about and interest in the forensic
      specialist system established by the Japanese Society of Legal Medicine. Police
      surgeons were generally willing to join an investigation team only if a disaster
      occurred in or close to their hometown, because they could not afford more than
      several days away from patient care. Although many of the emergency physicians
      were willing to join a death investigation team, they had difficulty in doing so
      without permission or orders from their employer or the authorities concerned.
      The survey found that the percentage of aged police surgeons was increasing among
      those surveyed. This fact, in combination with the current emphasis of
      postgraduate education on specialty training, threatens to cause a substantial
      lack of physicians available for medicolegal investigation of death. Therefore,
      it is urgently necessary to establish a system of training resident and emergency
      physicians in medicolegal investigation of death. In addition to providing
      postgraduate training in medicolegal investigation of death to prospective
      trainees who are emergency physicians at major hospitals in potential disaster
      stricken areas, the medical school should incorporate forensic medicine in
      postgraduate training programs so that they can actively perform death
      investigation on disaster victims dying before or after arrival at their
      hospitals. Furthermore, the forensic community should make every effort to
      increase the number of autopsies in each department of forensic medicine and to
      expand the medical examiner system throughout Japan that is currently in practice
      only in the Metropolis of Tokyo and Yokohama, Nagoya, Osaka and Kobe Cities in
      order to incorporate forensic training in the postgraduate clinical training
      programs that will become compulsory in 2004.

PMID- 11218758
TI  - [Effects of the expression of the expert opinion on prosecution].
AB  - We carried out a questionnaire survey on judicial apprentices with a case died of
      subarachnoid hemorrhage to examine whether the expression of the text and
      supplementary explanation of the expert opinion affect judicial decisions and
      findings of facts. The survey results suggest that both the expressions of the
      text and the supplementary explanation may have an effect on the decision. That
      is, judicial apprentices who read the text expressed that "it was not clear
      whether the subarachnoid hemorrhage was traumatic or not" with the explanation
      are less likely to indict for injury resulting in death than those who read the
      text expressed that "it was not contradictory that the subarachnoid hemorrhage
      was traumatic" without the explanation. Additionally, we found that these two
      factors affected the reader's findings of fact. Particularly, the text expressed
      that "it was not contradictory" without a supplementary explanation is prone to
      give a conclusive conviction to readers. These results suggest that how a medical
      diagnosis would be legally interpreted in court depend to some extent upon the
      expression and the supplementary explanation of the expert opinion. The text of
      an expert opinion should be expressed to report the medical diagnosis exactly.
      When autopsy cannot determine the definitive cause of the death, detailed
      explanation should be supplemented lest the expert opinion give a conclusive
      conviction. Moreover, we suggest that it is necessary to standardize the form and
      expression of the expert opinion hereafter.

PMID- 11218759
TI  - [mRNA detection of beta-myosin heavy chain gene in the autopsy cases of
      hypertrophic cardiomyopathy].
AB  - A known trigger of sudden cardiac death, hypertrophic cardiomyopathy (HCM) is
      associated with a point mutation in or overexpression of MYH7, which encodes the
      sarcomere protein beta-myosin heavy chain. We used nested RT-PCR to detect MYH7
      mRNA in left ventricular myocardial tissue. We extracted total RNA from tissue
      samples that had been obtained after autopsy of 8 people who had died from HCM
      related sudden death and that had been fixed in 10% formalin solution for as long
      as 4 years. The abundance of total RNA extracted from the 100 mg samples of
      cardiac muscle ranged from 10 to 24 mg/ml. The products of the nested RT-PCR were
      electrophoresed on a denaturing 8% polyacrylamide gel, and the MYH7 mRNA product
      was detected as a 424 bp band. MYH7 mRNA was easier to detect in tissue that had
      been fixed for shorter rather than longer periods. In addition, the greater the
      cardiac weight, the higher was the yield of the MYH7 mRNA product. Although mRNA
      had been detected by using RT-PCR on formalin-fixed paraffin-embedded tissue, no
      one previously had identified by using RT-PCR or nested RT-PCR on formalin-fixed
      tissue. By using nested RT-PCR, we were able to detect MYH7 mRNA in myocardial
      tissue that had been fixed in formalin solution for 4 years. Our results are
      applicable to retrospective examination into the cause of death in cases of
      sudden cardiac failure.

PMID- 11218760
TI  - [Creating language model of the forensic medicine domain for developing a autopsy
      recording system by automatic speech recognition].
AB  - For the purpose of practical use of speech recognition technology for recording
      of forensic autopsy, a language model of the speech recording system, specialized
      for the forensic autopsy, was developed. The language model for the forensic
      autopsy by applying 3-gram model was created, and an acoustic model for Japanese
      speech recognition by Hidden Markov Model in addition to the above were utilized
      to customize the speech recognition engine for forensic autopsy. A forensic
      vocabulary set of over 10,000 words was compiled and some 300,000 sentence
      patterns were made to create the forensic language model, then properly mixing
      with a general language model to attain high exactitude. When tried by dictating
      autopsy findings, this speech recognition system was proved to be about 95% of
      recognition rate that seems to have reached to the practical usability in view of
      speech recognition software, though there remains rooms for improving its
      hardware and application-layer software.

PMID- 11218761
TI  - [Detection of methamphetamine in a severely burned cadaver--a case report].
AB  - We report an autopsy case of a severely burned cadaver in which methamphetamine
      (MA) and amphetamine (A) were detected. A severely burned cadaver was found in a
      burned-out car on the seashore. At the autopsy, the drug screening test in the
      urine using Triage system gave positive result for MA and/or A. Qualitative
      analysis by gas chromatography/mass spectrometry (GC/MS) confirmed the presence
      of MA and A. The concentrations of MA and A (mumol/100 g) were 1.66 in the thermo
      coagulated blood, 16.3 in the urine, 4.60 in the cerebrum, 4.11 in the lung, 7.84
      in the liver, 0.94 in the skeletal muscle and 0.54 in the bone marrow. From these
      results, we concluded that the man had been under the moderate MA and A
      intoxication. The cause of death was diagnosed as the death of fire on the basis
      of autopsy findings, and the cadaver was identified as the owner of the car by
      the DNA typing. This case indicated the importance of drug screening tests in
      autopsy cases. Furthermore, the qualitative and quantitative analysis of MA and A
      should be successfully performed by GC/MS even in the case of severely burned
      cadaver.

PMID- 11218762
TI  - [Restoration of motor function by functional electrical stimulation].

PMID- 11218764
TI  - [Transsphenoidal surgery assisted by navigation system].
AB  - Microneurosurgical technique combined with precise localization of lesions, can
      minimize the invasiveness of neurosurgical procedures. This report describes the
      usefulness of the neuronavigation system in transsphenoidal surgery. Nineteen
      transsphenoidal operations for sellar lesions including pituitary adenoma, clival
      chordoma, Rathke's cleft cyst and suprasellar germinoma were assisted by the
      optical tracking system (OTS). Operations were performed either through the
      sublabial or the endonasal approach using an operative microscope and, to a
      certain extent, the endoscope. All five microadenomas were totally removed. The
      tumors could be precisely localized by the navigation system. Four out of seven
      macroadenomas were totally removed. The operations were assisted effectively by
      the excellent guidance to the lateral margin of the tumors and the internal
      carotid arteries provided by the navigation system. The endonasal approach, in
      which the surgeon looks through a nostril at the sellar floor obliquely, was
      especially facilitated by the three-dimensional view provided by the system. The
      navigation system, however, was not useful in estimating the amount of the
      suprasellar residual tumor because of the dislocation that occurred during the
      tumor removal.

PMID- 11218763
TI  - [Continuous intrathecal administration of nicardipine using a portable infusion
      pump system for management of vasospasm after subarachnoid hemorrhage].
AB  - We studied the feasibility of intrathecal nicardipine administration using a
      portable infusion pump system in five cases (two males and three females) of
      subarachnoid hemorrhage (SAH). All of the five cases manifested severe SAH of
      Hunt & Kosnic grade 3 or 4, and Fisher CT group 3. Aneurysmal sites of five cases
      were as follows: three internal carotid-posterior communicating artery (IC-PC)
      aneurysms and two anterior communicating artery (Acom) aneurysms. The container
      of the infusion pump system was filled with 105 ml of nicardipine-saline solution
      (2:1), and this system was connected to the cisternal tube. The solution was
      continuously injected at a daily dose of 12 ml (8 mg of nicardipine). This
      therapy was continued for 14 days, and new nicardipine solution was supplied only
      once at 8 days after the operation during this therapy. No postural restraint of
      patients was necessary, even during physical movement for rehabilitation.
      Postoperative angiography was performed in three of five cases at one week after
      the operation. No angiographic vasospasm was observed in any of the three cases.
      Symptomatic vasospasm was observed in one case of right IC-PC aneurysm as a
      transient total aphasia and right hemiplegia, which recovered within several
      hours due to induced hypervolemia and hypertension therapy. Mild meningitis at 14
      days after the operation complicated this treatment in one case, but it improved
      in a few days after the cisternal tube was removed. It was speculated that
      meningitis was caused by cerebrospinal fluid leakage from the scalp exit site of
      the cisternal tube. All of the five cases had obtained good recovery at three
      months after the operation. These results show that, although this method
      involves a risk of infection, it has the advantage of easiness and convenience
      over conventional methods. Though further improvement of this method is required,
      this preliminary stage is potentially useful for delivering not only nicardipine,
      but also for other drugs which may be used in intrathecal administration therapy.

PMID- 11218765
TI  - [Relationship of postoperative residual air and recurrence in chronic subdural
      hematoma].
AB  - The possibility exists that residual air after surgery is one cause of recurrence
      of chronic subdural hematoma. We have devised a new simple method which decreases
      postoperative residual air, using external drainage and an endoscope. First, we
      make endoscopic observations of the inner aspect of the hematoma cavity. Then, we
      insert external drainage apparatus into the most frontal area of the hematoma
      cavity, we regard this location as the most appropriate place to ensure most
      effective drainage. The present study included 37 chronic subdural hematomas in
      32 patients who had been treated between January and December, 1999. Their ages
      ranged from 48 to 86 years old, with an average of 72 years. Insertion of
      external drainage in the most frontal area of the hematoma cavity was
      successfully achieved in 27 (73%, Group I) out of 37 cases and resulted in no
      recurrence. In the remaining 10 hematomas (27%, Group II), external drainage was
      not able to be inserted in the most frontal area, and four hematomas (40%) had
      recurrence (p < 0.01 vs Group I). Insertion in the most frontal area of the
      hematoma cavity decreases residual air after surgery, and may be effective for
      the prevention of recurrence of chronic subdural hematoma.

PMID- 11218766
TI  - [Preliminary results of PET activation study in cerebral arteriovenous
      malformation (AVM), using C15O2 and 18F-FDG].
AB  - The authors applied PET activation study to two patients with arteriovenous
      malformation (AVM) to localize primary motor cortex before surgery or
      embolization. The change in regional cerebral blood flow (rCBF) was measured
      during foot movements in Case 1 who had a 2-cm AVM located in the post-central
      gyrus. Superimposed PET/MRI images revealed that the rCBF increase was located in
      the pre-central gyrus. Its validity was confirmed by intraoperative cortical
      mapping using electrical median nerve stimulation. The patient safely underwent
      total removal of AVM. The change in regional cerebral metabolic rate for glucose
      (rCMRglc) was measured during hand movements in Case 2 who had a huge AVM over
      the central sulcus. Superimposed PET/MRI images revealed that hand movements
      significantly increased rCMRglc in the frontal cortex, which was separated from
      the original primary motor area. The patient safely underwent partial
      embolization, although he suffered transient weakness of the face after
      embolization. The preliminary results strongly suggest that PET activation study
      is useful to localize precisely cortical functions of the patients with AVM, thus
      reducing morbidity after treatment. The results also suggest that cortical
      functions may undergo translocation when huge AVM involves the eloquent area.

PMID- 11218767
TI  - [A case of the spinal subdural hematoma formation following ventriculoperitoneal
      shunting for von Recklinghausen's disease associated with aqueductal stenosis].
AB  - Von Recklinghausen's disease associated with hydrocephalus due to non-tumoral
      aqueductal stenosis is rare. Furthermore the formation of subdural hematoma
      within the spinal canal is also a very rare complication of ventriculoperitoneal
      shunt. We presented a case of spinal subdural hematoma formation following
      ventriculoperitoneal shunting for von Recklinghausen's disease associated with
      aqueductal stenosis. A 10-year-old girl with von Recklinghausen's disease was
      referred to our hospital for gait disturbance during the previous 8 months.
      Magnetic resonance imaging (MRI) revealed hydrocephalus due to non-tumoral
      aqueductal stenosis, and ventriculoperitoneal shunt was instituted. Three months
      later, the patient developed lumbar pain and paraplegia. MRI revealed subdural
      hematoma in the lumbosacral spinal canal, and bilateral intracranial subdural
      hematoma were shown on computerized tomography (CT) scans. Subdural hematoma in
      the lumbosacral spinal canal was evacuated by laminectomy. Improvement of her
      neurological deficit was obtained postoperatively, and intracranial subdural
      hematomas disappeared spontaneously. Spinal subdural hematoma is assumed to be
      formed by the migratory movement of intracranial subdural hematoma under the
      influence of gravity. A characteristic finding of MRI is that such a subdural
      hematoma in the lumbosacral canal is located around the cauda equina.

PMID- 11218769
TI  - [Simultaneous carotid and coronary artery surgery in asymptomatic carotid artery
      stenosis--report of three cases].
AB  - Some patients with coronary artery disease are diagnosed as having additional
      carotid artery disease. This subset of patients has been identified as a high
      risk group for cardiac and cerebral complications following surgical
      intervention. Three patients who underwent combined CEA/CABG for coexistent
      asymptomatic carotid occlusive disease are reported. Case 1: A 69-year-old female
      who suffered chest pain on exertion. Her coronary angiogram showed severe
      stenosis of three vessels. Her carotid angiogram showed 98% stenosis of the right
      internal carotid artery and poor collateral circulation. The severe stenosis of
      her carotid artery was considered as a risk factor for perioperative cerebral
      stroke. Intraoperatively, CEA preceded the CABG. Postoperative course was
      uneventful. Case 2: A 64-year-old male. Intermittent claudication was his initial
      symptom. His coronary angiogram showed stenosis in three vessels and carotid
      angiogram showed 75% stenosis in the right carotid artery. Simultaneous CABG and
      CEA was performed. His postoperative course was uneventful. Case 3: A 62-year-old
      male whose ECG indicated ischemic heart disease, although he had no symptoms. His
      coronary angiogram showed stenosis in three vessels, and 80% stenosis of his
      right carotid artery was observed by carotid angiogram. He underwent simultaneous
      surgery, and had an uneventful postoperative course. It has been reported that
      1.5-8.7% of CABG patients have severe carotid artery stenosis, and perioperative
      cerebral stroke occurs in 0.9-16%. Simultaneous surgery was successful in our
      three patients who had asymptomatic carotid artery stenosis. Using this surgical
      approach for critical coexistent disease may minimize the incidence of
      perioperative cerebrovascular complications in patients undergoing CABG.

PMID- 11218768
TI  - [Systemic non-Hodgkin lymphoma initially presented with visual disturbance due to
      intrasellar lymphoma--a case report].
AB  - A case with systemic non-Hodgkin lymphoma involving the sella turcica and kidney
      is reported. A 69-year-old man presented with a progressive two month history of
      visual disturbance and headache. Neurological examination revealed bilateral
      visual disturbance and right optic atrophy. MRI showed a contrast-enhancing mass
      in the sella turcica. The tumor extended to the right optic nerve. Without
      extensive studies for systemic disease, the patient immediately underwent
      transsphenoidal surgery. The slightly firm, fibrous and vascular-rich tumor was
      subtotally removed. The histopathological examination revealed a malignant
      lymphoma, diffuse-large-cell type with B-cell phenotype. The postoperative course
      was uneventful and the patient's symptoms subsided gradually. The patient
      received radiation therapy and the tumor disappeared. Postoperative CT
      examinations of the abdomen and pelvis revealed a large mass at the upper portion
      of the left kidney. Ga-scan also suggested the mass to be consistent with the
      abdominal CT. However, the patient suddenly died of acute heart failure with
      unknown cause just before starting chemotherapy for systemic lymphoma. Patients
      presenting primary central nervous system lymphoma (PCNSL) may have systemic non
      Hodgkin lymphoma. To exclude systemic non-Hodgkin lymphoma, systemic
      investigation is essential for the initial management of patients presenting
      PCNSL.

PMID- 11218770
TI  - [Serial angiographical changes of a ruptured dissecting vertebral aneurysm].
AB  - A 54-year-old woman presented a subarachnoid hemorrhage from a ruptured
      dissecting aneurysm on the right vertebral artery. A right vertebral angiogram
      revealed a fusiform dilatation distal to the right posterior inferior cerebellar
      artery and "pseudo lumen" was observed in a delayed arterial phase. Conservative
      treatment was carried out, and the patient condition gradually improved. An
      angiographical examination for planned endovascular treatment 46 days after the
      onset, revealed the normalization of the formerly dilated caliber of the right
      vertebral artery with only a minor luminal irregularity. However, 83 days after
      the onset, right vertebral angiogram showed reappearance of the fusiform
      dilatation. The right vertebral angiogram obtained 204 days after the onset
      showed that the dilated segment of the dissecting aneurysm had become normalized
      to a slight degree. The serial angiographical changes of the dissecting site
      might have been due to regression and organization following transient thrombosis
      of intramural hematoma. Such drastic changes within a short period have not been
      reported yet. In conclusion, careful repeated follow-up is recommended in
      monitoring aneurysmal formation during the early to chronic phase after rupture
      of a dissecting aneurysm. The repetition of angiography is important, because
      later, if angiography has been performed only once, aneurysmal dilatation may be
      overlooked. One has to be aware of such changes, because such changes may alter
      the clinician's decision about treatment, as they did in our case.

PMID- 11218771
TI  - [Brain stem hemorrhage associated with venous angioma: report of two cases].
AB  - The incidence of hemorrhage associated with venous angioma has been considered to
      be rare. We here report two cases of brain stem venous angioma which also showed
      brain stem hemorrhage. Case 1; a 15-year-old female had experienced weakness in
      the left upper extremity 8 months prior to admission. She developed dysfunction
      of the left cranial nerves, and magnetic resonance imaging (MRI) showed a huge
      enlarging hematoma in the pons. Cerebral angiography showed venous angioma
      penetrating through the pons. Evacuation of the hematoma was performed through
      the fourth ventricle and many small vessels were found in the hematoma. Although
      all symptoms were partially resolved after the operation, a re-hemorrhage
      occurred 1 month after the operation. Case 2; a 50-year-old man had suddenly
      developed headache and vertigo several days prior to admission. Computed
      tomography (CT) and MRI showed a small hematoma in the lesion with venous angioma
      adjacent to the hematoma. All symptoms gradually resolved with conservative
      therapy.

PMID- 11218772
TI  - [A case of recurrent convexity meningioma with malignant transformation 26 years
      after total tumor removal].
AB  - Meningiomas are common intracranial tumors, the majority of which are considered
      benign. However, they sometimes show altered biologic behavior, associated with
      local aggressiveness and late distant metastasis. We report a patient with a
      convexity meningioma, which recurred as a malignant transformation 26 years after
      a total tumor removal. A 75-year-old man was transferred to a local hospital
      because of general convulsions and left hemiparesis. The patient had had an
      operation for the total removal of a right frontal convexity meningioma at the
      age of 46 and had been free of its effects until the age of 72. Brain magnetic
      resonance imaging (MRI) showed a recurrent tumor located in the anterior area of
      the previous craniotomy. Over the following two and a half years, MRI revealed
      rapid enlargement and infiltration of the tumor into the brain parenchyma. The
      primary tumor was nodular, macroscopically well demarcated from the surrounding
      brain tissue and, histologically, was a transitional type of meningioma without
      any atypical features. In contrast, the recurrent tumor, whose border was ill
      defined, had invaded the neighboring brain. A histological specimen of the
      recurrent tumor showed highly malignant features such as necrosis, intracerebral
      infiltration, dense cellularity, and high proliferating activity as demonstrated
      by a cell kinetic study using the MIB 1 staining index. We should be mindful that
      recurrence from common benign type meningiomas may occur as malignant
      transformations after more than two decades.

PMID- 11218773
TI  - [Why do you express the artery as carotid and the vein as juglar though they are
      all the same neck vessels?].

PMID- 11218774
TI  - [Fewer complications--earlier discharge--shorter convalescence].

PMID- 11218775
TI  - [Legionella infections: diagnostic and therapeutic challenges].

PMID- 11218776
TI  - [Accelerated surgical stay programs. A professional and administrative
      challenge].
AB  - Accelerated surgical stay programs represent a multi-modal, multi-disciplinary
      concept to reduce postoperative morbidity, hospitalisation and convalescence
      based upon recent advantages in surgical pathophysiology and pain treatment.
      Preliminary data from a variety of surgical procedures suggest major improvements
      in quality of surgical care and cost reduction and call for further controlled or
      large-size multi-center studies.

PMID- 11218777
TI  - [Trends in dietary habits in Denmark and Sweden since the 1960s].
AB  - Dietary habits in Denmark and Sweden are compared during the period 1965-1998
      based on data from Food Balance Sheets. Common trends are an increase in
      consumption of vegetables, fruits, berries and meat and a decrease in consumption
      of fats. In the latest ten years percentage of energy from fat has also
      decreased. Denmark has a higher consumption of fats and meat and a lower
      consumption of fruits, berries and fish. These differences contribute to a higher
      percentage of energy from fat in the Danish diet compared to the Swedish. Data
      consequently indicate that dietary habits in Sweden are healthier than in
      Denmark. Differences in dietary habits may have contributed to differences in
      life expectancy between the countries. Disparities in dietary habits are seen in
      both countries. The tendency is greater social differences in Denmark.

PMID- 11218778
TI  - [Cancer and prevention].
AB  - INTRODUCTION: The aim of the study was to estimate the preventable potential of
      various types of cancer in Denmark on the basis of present knowledge. MATERIAL
      AND METHODS: The well-documented factors in lifestyle and environment causing
      cancer in Denmark were identified from the IARC Monograph series. The population
      attributable risk per cent (PAR%) and the annual number of preventable cancers
      were calculated for each aetiology and cancer type around the year 2000. RESULTS:
      A large proportion of the cancers occurring in the lungs, larynx, upper digestive
      tract, skin, lower urinary tract, and the uterine cervix is potentially
      avoidable, whereas only a small proportion of breast and colorectal cancers is
      preventable on the given knowledge. The main causative factors include active and
      passive smoking, alcohol intake, exposure to asbestos and other occupational
      carcinogens, solar and ionising radiation, obesity, human papillomavirus
      infection in the female genital tract, and infection with Helicobacter pylori.
      More than 5000 cancers in men and almost 3500 in women annually in Denmark could
      have been avoided by eliminating exposure to these known carcinogens. This is
      equivalent to 39% and 23% of all cancers occurring respectively in men and women,
      around the year 2000. Smoking habits account for more than half of these
      avoidable cases. DISCUSSION: The incidence of cancer could be greatly reduced
      through primary prevention, especially of tobacco smoking, which is the major
      single factor. A large proportion of the cancers occurring in the lungs, larynx,
      upper digestive tract, skin, lower urinary tract, and the uterine cervix are
      potentially avoidable. More research in the field of aetiological factors causing
      female breast cancer and colorectal cancer is much needed in order to be able to
      prevent these types of cancer.

PMID- 11218779
TI  - [Cancer treatment in Skane and in Sjaelland. Do differences concerning
      examination and treatment explain reduced survival among Danish cancer
      patients?].
AB  - INTRODUCTION: Danish cancer patients generally have a poorer survival than
      Swedish cancer patients. The difference is most pronounced for certain tumour
      types, e.g. common types such as lung, breast, colorectal, and prostate cancer.
      The reasons are not clear. The present article examines if differences in the
      diagnostic workup and treatment can explain some of this variation. MATERIAL AND
      METHODS: Aspects of the diagnostic workup and treatment of the above mentioned
      four cancer types are examined using data from cancer registry analyses and
      official reports. These data are seen in the context of counts of trained
      personnel and equipment in cancer diagnostics and treatment in the two countries.
      RESULTS: With regard to lung and breast cancer, the data seem to indicate that
      Danish patients are diagnosed later, and that Denmark lags behind in treatment
      capacity. With regard to rectal cancer, the data seem to indicate that
      concentrating operations in fewer hospitals, and improvements in operation
      technique have been introduced earlier in Sweden than in Denmark. With regard to
      prostate cancer, however, the data seem to indicate that many more indolent cases
      that do not need treatment are diagnosed in Sweden than in Denmark. The total
      capacity for oncologic treatment, both in terms of trained personnel and
      equipment, seen in relation to the size of the population, is considerably larger
      in Southern Sweden than in Eastern Denmark. DISCUSSION: The data for some of the
      common cancer types seem to indicate that problems in the areas of sufficient
      capacity for diagnostic workup and treatment may explain some of the difference
      in survival between Danish and Swedish cancer patients.

PMID- 11218780
TI  - [An unusual complex of debut symptoms in Wegener's granulomatosis].
AB  - We report an unusual case of Wegener's granulomatosis in a patient presenting
      with stridor and tracheal narrowing as the initial manifestation of the disease.

PMID- 11218781
TI  - [Deadly indoor climate].

PMID- 11218782
TI  - [Do more women lose their breast after screening?].

PMID- 11218783
TI  - [Colorectal cancer].

PMID- 11218784
TI  - [Long-term results after cemented total hip alloplasty in the treatment of
      primary hip arthrosis].

PMID- 11218785
TI  - [Cigarettes are and remain the great killer].

PMID- 11218786
TI  - [Five outbreaks of human ascariasis caused by pig ascaris?].

PMID- 11218787
TI  - [Gabapentin--yet another antiepileptic agent for the treatment of neuropathic
      pain?].
AB  - Gabapentin is a recently introduced anti-epileptic drug used as an adjuvant in
      partial and secondarily generalised tonic-clonic seizures. Its mechanism of
      action has not been fully elucidated, but it seems that gabapentin may regulate
      voltage-dependent calcium channels, presumably on a spinal level, in the
      nociceptive system. Two large, controlled clinical trials of painful diabetic
      neuropathy and postherpetic neuralgia have demonstrated its analgesic efficacy.
      The adverse effects associated with gabapentin treatment are relatively harmless,
      mild to moderate in severity, and usually transient, with tolerance developing 2
      3 weeks after start of treatment. Gabapentin and tricyclic antidepressants are
      efficacious in the treatment of painful diabetic neuropathy and postherpetic
      neuralgia.

PMID- 11218788
TI  - [Tramadol and oxazepam. Effect on pulmonry function in elderly patients with
      chronic obstructive lung disease].
AB  - Many patients with chronic obstructive pulmonary disease (COPD) suffer from
      osteoporotic pain as a result of glucocorticoid treatment and nervous symptoms
      partly related to their lung disease. There seems to be som reluctance to treat
      these patients with an opioid or benzodiazepine. Upon request, the Drug
      Information Centre in Odense made an extensive literature search on the subject.
      No documentation was found that tramadol additionally depresses the respiration
      in patients with COPD, nor has oxazepam in clinically relevant doses been found
      to exacerbate their lung disease. The clinical effect is subject to large
      interindividual variability, and the use of these drugs should, to a greater
      extent, rest on experience with the individual patient. There seems to be no
      reason to maintain a priori this rigoristic reluctance to use tramadol and/or
      oxazepam in patients with COPD.

PMID- 11218789
TI  - [Tirofiban (Aggrastat). A non-peptide glycoprotein IIb/IIIa receptor inhibitor].
AB  - Platelet aggregation and thrombus formation on a ruptured atherosclerotic plaque
      plays an important role in the pathogenesis of acute coronary syndromes.
      Activation of glycoprotein IIb/IIIa receptors (GP-receptors) on the surface of
      platelets is the final common pathway which leads to the binding of fibrinogen
      and crosslinking of platelets to form the white thrombus. Antiplatelet therapy
      reduces the risk of ischaemic complications in patients with acute coronary
      syndromes. Recently, the GP-receptor antagonists have been introduced. They
      inhibit the binding of fibrinogen to the GP-receptors and thus prevent platelet
      aggregation. Tirofiban is a low molecular, intravenously administered GP-receptor
      antagonist, which in combination with unfractionated heparin in several
      controlled studies has been shown to decrease morbidity and mortality in patients
      with unstable angina pectoris and non-Q-wave infarction and, in patients
      subsequently undergoing percutaneous coronary intervention.

PMID- 11218790
TI  - [Therapeutic, activated charcoal to pediatric poisoning patients].

PMID- 11218791
TI  - [Eptifibatide (Integrilin)].
AB  - Eptifibatide (Integrilin) is a specific blocker of the glycoprotein IIb/IIIa
      receptor and an effective inhibitor of platelet aggregation. It reduces coronary
      events in patients with acute coronary syndromes and no elevation in the
      electrocardiographic ST segment. The present summary discusses the indications
      for the use of eptifibatide/Integrilin based on recent clinical trials and cost
      benefit analyses.

PMID- 11218792
TI  - [Abciximab (ReoPro) in the treatment of acute coronary syndromes].
AB  - Platelet activation plays a major role in the pathophysiology of acute coronary
      syndromes (ACS). Inhibition of platelet function is the basic pharmacological
      treatment of ACS. Platelet membrane glycoprotein IIb/IIIa inhibitors, a new class
      of potent antiplatelet agents, have been used in the treatment of ACS and in the
      prevention of complications after percutaneous coronary interventions (PCI).
      Several large clinical trials have demonstrated the effectiveness of this class
      of agents. The first of these agents to show beneficial effects after coronary
      interventions was the mouse/human chimeric Fab fragment antibody c7E3 abciximab
      (ReoPro). The purpose of this article is to describe the pharmacology of
      abciximab and to review the results of the clinical trials carried out with the
      drug in patients with ACS, treated either with or without acute/elective PCI.

PMID- 11218793
TI  - [Diagnosis. Pneumocystis carinii].

PMID- 11218794
TI  - The elections and health care: an opportunity for bipartisan progress?

PMID- 11218796
TI  - Learning from the pros. Health plans go to customer satisfaction school.

PMID- 11218795
TI  - A day in the life of managed care. Blue Cross and Blue Shield of Georgia's Jay
      Kulkin, MD.

PMID- 11218797
TI  - Putting members first is top initiative at Blue Cross and Blue Shield of
      Massachusetts.

PMID- 11218798
TI  - Exporting American-style managed care: what works and what doesn't.

PMID- 11218799
TI  - Communicating from the brink.

PMID- 11218800
TI  - Health plans take steps to implement new federal standards for electronic
      transactions.

PMID- 11218802
TI  - Reducing tobacco use: health plans take an active role.

PMID- 11218801
TI  - Major HIPAA compliance efforts underway, despite uncertainty.

PMID- 11218803
TI  - Getting physicians online.

PMID- 11218804
TI  - By the numbers. Poll finds voters prefer external review to lawsuits.

PMID- 11218806
TI  - Correlation and modulation of Ehrlich ascites tumor growth with tumor-plasma IgA.
AB  - Plasma IgA level of Ehrlich ascites tumor bearing mice showed correlation with
      progress of tumor growth. In PAGE analysis total plasma IgA separated into 3
      major bands corresponding to mol. wt. > or = 669,000 daltons, identical to
      443,000 daltons and between 443,000 and 150,000 daltons. All the three bands
      increased gradually with progress of tumor growth upto day 14 and then declined
      on day 16. Total plasma IgA isolated by anti-IgA affinity chromatography when
      adoptively transferred to mice inhibited tumor growth. Affinity-purified plasma
      IgA separated into three major peak fractions after Sephadex G-200 column
      chromatography which corresponded with the bands of IgA on PAGE analysis. Three
      Sephadex G-200 IgA fractions when adoptively transferred to tumor-bearing mice
      showed effect different from total IgA. High mol. wt. IgA fraction (> or =
      669,000 daltons) inhibited tumor growth whereas medium mol. wt. fraction
      (identical to 443,000 daltons) enhanced tumor growth. The low mol. wt. IgA
      fraction (< 443,000 and > 150,000 daltons) had no significant effect on tumor
      growth. The high mol. wt. IgA fraction enhanced tumor killing ability of
      peripheral blood lymphocytes (PBL) and peritoneal macrophages of tumor bearer in
      vitro. Medium mol. wt. IgA fraction inhibited tumor-killing ability of PBL in
      vitro but had no significant effect on peritoneal macrophages. The low mol. wt.
      IgA fraction showed a mild enhancing effect on tumor-killing ability of PBL but
      had no significant effect on peritoneal macrophages. The results established
      importance of IgA in tumor growth regulation and its therapeutic potentiality.
      The results indicated that tumor growth modulation by tumor plasma IgA is also
      mediated by its effect on cellular anti-tumor immune factors of the host.

PMID- 11218805
TI  - Immunology of gangliosides.
AB  - This review discusses the immunology of gangliosides from the perspective of
      tumor, neuronal and general immunology. Antiganglioside antibodies in human sera
      are invariably IgM and are found in healthy individuals. Their titers decline
      with age. Persistent high titer of IgM is associated with several diseases,
      particularly neuropathies. Membrane-bound gangliosides are important tumor
      associated antigens and targets for immune attack. Cells enriched with
      gangliosides can be used as cancer vaccines. Efficacy of these vaccines depends
      on the viability of whole cells, integrity of the cell membranes, adjuvants and
      topography of the tumor-associated antigens. The role of antiganglioside IgM is
      to eliminate the immunosuppressive gangliosides shed from tissues during ageing,
      degeneration of neural and extraneural tissues, and tumor growth and necrosis. In
      addition, in vitro observations with human and murine monoclonal antibodies
      suggest that they are capable of complement dependent cytotoxicity and apoptosis.

PMID- 11218807
TI  - Effect of feeding protein deficient diet on phospholipid turnover and protein
      kinase C mediated protein phosphorylation in rat brain.
AB  - Feeding of protein deficient diet is known to alter the transmembrane signalling
      in brain of rat by reducing total protein kinase C (PKC) activity. Phospholipid
      metabolism regulates the activation of PKC through generation of second
      messengers and the extent of PKC activation accordingly influences the magnitude
      of phosphorylation of its endogenous substrate proteins. Thus it was speculated
      that ingestion of protein deficient diet may modify the turnover rate of membrane
      phospholipids and magnitude of phosphorylation of endogenous substrate proteins
      of PKC. The experiments were conducted on rats fed on three different types of
      laboratory prepared diets viz. casein (20% casein), deficient (4% protein, rice
      flour as source of protein) and supplemented (deficient diet supplemented with L
      lysine and DL-threonine) for 28 days. The metabolism of phosphoinositides (PIs)
      and phosphatidyl choline (PC) was studied by equilibrium labeling with [3H] myo
      inositol and [14C methyl] choline chloride respectively. The phosphorylation of
      endogenous substrate proteins of PKC was studied by using 32P-gamma-ATP followed
      by SDS-PAGE and autoradiography. The results suggest that in deficient group,
      there is an increased incorporation of [3H] myo inositol in PIs and inositol
      phosphate pool in comparison to the casein group. The phosphatidyl inositol (PI)
      turnover reduced, although there was a marginal increase in the phosphatidyl
      inositol monophosphate (PIP) and phosphatidyl inositol bis phosphate (PIP2).
      Supplementation of diet showed a reversal of the pattern towards control to a
      considerable extent. In the deficient group, PC metabolism showed an increased
      incorporation of [14C methyl] choline in choline phospholipids but decreased
      incorporation in phosphoryl choline in comparison with the casein group. The
      increase in total PC contents was significant but marginal in residue contents.
      The turnover rate of PC increased only marginally and that of residue declined.
      Supplementation of diet reduced the total contents of PC and residue, but the
      turnover rate of PC and residue remained still higher. Phosphorylation of
      endogenous proteins showed four different proteins of 78, 46, 33 and 16 kDa to be
      the substrates of PKC in casein group. In deficient group, phosphorylation of
      these proteins increased markedly while supplementation of diet had a reversing
      effect rendering the values to be intermediate between casein and the
      supplemented group. The changes in phospholipid metabolism and in phosphorylation
      of endogenous substrate proteins of PKC suggest that dietary protein deficiency
      causes alterations in transmembrane signalling mechanism in rat brain. These
      effects are partially reversed by improving the quality of proteins in the diet.

PMID- 11218808
TI  - Studies on anticonvulsant actions of L-deprenyl.
AB  - L-Deprenyl (Selegeline) introduced for use in parkinson's disease, is implicated
      to show beneficial effects in epilepsy, alzheimer's disease, cognition,
      depression and other age related neurological diseases. In this study, we
      investigated the CNS effects of L-deprenyl with special reference to epilepsy,
      anxiety and cognition and memory in mice. L-deprenyl (10, 20 and 40 mg/kg) showed
      a significant anticonvulsant activity against pentylenetetrazole (PTZ)-induced
      convulsions. Combination of L-deprenyl (10 mg/kg) with the sub-protective dose of
      diazepam (1 mg/kg) showed potentiation of the anticonvulsant effect. In the
      maximal-electroshock (MES)-induced convulsions, L-deprenyl (10 mg/kg)
      significantly delayed the onset and decreased the duration of extensor phase. Its
      combination with the lower dose of phenytoin (10 mg/kg) showed potentiation in
      response compared to the per se effect of both the drugs. However, L-deprenyl did
      not show any protective effect in lithium-pilocarpine induced status epilepticus.
      Acute treatment with L-deprenyl had no effect on learning and memory. In chronic
      treatment, L-deprenyl per se showed no effect on learning and memory but did
      improve the condition in mice with scopolamine induced memory deficit. L-Deprenyl
      per se was anxiogenic though in combination with diazepam (1 mg/kg) it
      potentiated the antianxiety effect of the latter. The above observations suggest
      that in epilepsy, L-deprenyl might be acting partially by influencing the
      GABAA/benzodiazepine mechanism in the brain (similar to diazepam and phenytoin),
      and in cognition enhancing effect, the cholinergic system might be playing a
      role. Thus, L-deprenyl could prove to be an adjuvant in the antiepileptic therapy
      and beneficial in dementia associated with epilepsy.

PMID- 11218809
TI  - Pre-clinical toxicity evaluation of leaf-stalk extractive of Piper betle Linn. in
      rodents.
AB  - Studies on pre-clinical toxicity were undertaken to determine the haematological
      and biochemical changes after administration of alcoholic extract of leaf-stalk
      of P. betle in rats and mice. Acute and chronic toxicity experiments were
      performed on mice and rats according to WHO protocol. Different doses of plant
      extractive were administered for toxicity studies on short and long term basis.
      Haematological, biochemical profiles and enzymatic studies (transaminases and
      phosphatases) indicated that the drug (plant extractive) was devoid of toxicity.

PMID- 11218810
TI  - Anxiolytic activity of Indian Abies pindrow Royle leaves in rodents: an
      experimental study.
AB  - Putative anxiolytic activity of ethanolic extract of Indian A. pindrow Royle leaf
      was investigated in rats using various experimental paradigms of anxiety viz.
      open field exploratory behaviour, elevated plus maze (EPM) and elevated zero maze
      (EZM) tests. Pilot studies indicated that single dose administration of extract
      had little to no acute behavioural effects, hence the extract was administered
      orally at different dose levels once daily for three consecutive days, while
      lorazepam (LR) (0.5 mg/kg, i.p.) was administered acutely. Ethanolic extract of
      A. pindrow (AP) leaves (50 and 100 mg/kg, p.o.) showed significant anxiolytic
      effects on all the paradigms of anxiety. The results indicate that AP and LR
      induced a significant increase in open field ambulation and slight increase in
      rearings and activity in center, whereas grooming and faecal droppings remain
      unchanged. In EPM, significant augmentation of open arm entries, and time spent
      on open arms was noted in AP treated rats. In EZM test, significant increase in
      time spent on open arms and entries in open arms was observed, whereas slight
      increase in head dips and stretched attend postures was also observed. The AP
      extract showed consistent and significant anxiolytic activity in all the tests.
      The effects induced by ethanolic extract of AP were less marked than those of
      lorazepam were.

PMID- 11218811
TI  - Effect of pentoxifylline on cyclosporine-induced nephrotoxicity in rats.
AB  - Effect of unique hemorrheologic agent pentoxifylline (PTX) was investigated on
      cyclosporine (CsA) induced nephrotoxicity in rats. Compared to saline control,
      CsA produced significant increase in blood urea and serum creatinine.
      Pentoxifylline treatment prevented the CsA-induced rise in blood urea and serum
      creatinine. Creatinine clearance (Ccr) and lithium clearance (Licr) was decreased
      with CsA. PTX treatment prevented the CsA-induced decrease in Ccr and Licr.
      Malondialdehyde (MDA) was increased with CsA compared to saline treated animals.
      PTX prevented the CsA-induced MDA rise. Kidney form CsA treated rat showed marked
      vacuolar degeneration of tubular epithelium with excess of microcalcification.
      Severity of the lesions was markedly reduced in rats treated with PTX plus CsA.
      The results indicate that PTX reduces CsA-induced renal toxicity in rats.

PMID- 11218812
TI  - Efficacy of dietary protein in alleviating toxicity of monocrotophos in rats.
AB  - Monocrotophos administration at intervals induced variable responses in
      phosphatases, transaminases and aldolase of liver and plasma. Hepato-toxicity was
      aggravated under protein deficient state. A weak resistance to toxicity was
      observed in rats on low protein diet (5%). However, animals fed on protein
      enriched diet (20%) indicated an elevation in tissue defense mechanism and were
      able to combat toxic stress of monocrotophos, though partially. A higher protein
      level may prove efficient and significant for alleviating pesticide toxicity.

PMID- 11218813
TI  - Salmonella. typhi OMPs induced immunomodulation in peritoneal macrophages.
AB  - The immunomodulatory properties of outer membrane proteins (OMPs) from S. typhi
      Ty2 were studied in mouse model at 72 hr and 20 days post-infection. Inspite of
      reduction in the number of macrophages and their protein content observed in the
      immunized group vis-a-vis infected group, OMPs activated macrophages showed
      significant upregulation of NO. At 20 days post infection, the level remained
      almost the same suggesting the prolonged cytotoxic and cytostatic activity due to
      the long lasting effects of OMPs activated macrophages. Higher activity of SOD in
      these aged cells pointed out towards the protective efficacy of OMPs to keep the
      macrophages themselves away from the noxious effects of O2-. Lower level of acid
      phosphatase in the macrophages from immunized mice group indicated the
      involvement of oxygen dependent rather than oxygen independent killing process.
      The enhanced uptake of organisms and their killing could be related to the
      production of oxygen and nitrogen radicals in the OMPs immunized group.

PMID- 11218814
TI  - Isolation and characterisation of legumin promoter sequence from chickpea (Cicer
      arietinum L.).
AB  - Seed specific promoters are useful for expression of foreign genes in the seeds.
      We have isolated a Cicer arietinum legumin promoter from lambda EMBL genomic
      library and subcloned in pBluescript II KS (-) in Eco RV and Pst I site. The
      2.762 kb Hind II Pst I fragment was sequenced completely by dideoxy chain
      termination method by creating a set of unidirectional deletions of the inserts
      in pAKKIII. The insert contains mainly upstream sequence (2240 bps) and only a
      part of structural gene (522 bps) sequence. The 522 bps of the structural gene
      shows approximately 80% homology with pea legumin A and this is almost the same
      as chickpea legumin in its sequence. The amino acid sequence derived from the
      part of the structural gene was similar to the chickpea 5' part of the legumin
      structural gene with a few variations. A 21 amino acid signal peptide was also
      deduced like many other legumes. Transcription start site (CAT) was located at 55
      bp upstream of the initiation codon ATG. One codon downstream to ATG codon Hind
      III site was present. TATA box was observed at -30 position, with a consensus of
      CCTATAAATAACC. The consensus CATGCAAG, a part of legumin box was noticed at -110
      bp position. At -295 to -265 bp upstream AGGA box like sequences were observed
      and a 56 bp perfect repeat was located between -913 bp and -972 bp. Strong
      homology with pea promoter sequence near the CAT sequence was noticed which
      gradually decreased towards the upstream region. Thus the cloned fragment
      contains a full length promoter which can be utilised for expression of foreign
      genes in seeds of chickpea.

PMID- 11218815
TI  - Analogue-resistant mutants of Azotobacter chroococcum derepressed for nitrogenase
      activity and early ammonia excretion having potential as inoculants for cereal
      crops.
AB  - Spontaneous mutants resistant to methionine sulfoximine (Msx), methyl alanine
      (Mal) and methyl ammonium chloride (Mac) were derived from A. chroococcum strain
      A103. Msx and Mal-resistant mutants expressed 1.73 to 10.98% of the fully
      derepressed nitrogenase activity when grown in Burk's medium containing ammonium
      acetate. Mac-resistant mutants did not express nitrogenase activity in ammonium
      acetate supplemented medium. The mutants excreted ammonia even after 2 days of
      growth and some mutants excreted more ammonia as compared to the parent. Selected
      mutants were inoculated on wheat (Triticum aestivum) and barley (Hordeum vulgare)
      under field conditions. Majority of the derepressed mutants increased grain yield
      of wheat and barley varying from 1.2 to 33.3%. However, host-dependent effects on
      grain yield were observed with different mutants. Two mutants, Mal 27 and Mac 19
      showed significant increase in grain yields of both the crops. The results
      suggest that metabolic analogue-resistant mutants of Azotobacter have potential
      for use as a biofertilizer for cereal crops.

PMID- 11218816
TI  - Effects of stress and food deprivation on catfish, Heteropneustes fossilis
      (Bloch).
AB  - No significant changes in plasma cortisol and plasma osmolarity (the indicators
      of primary and secondary response respectively) were observed when the blood
      samples were obtained from unanaesthetized, anaesthetized and stressed catfish,
      H. fossilis. The results suggest that the catfish is fairly hardy and not easily
      susceptible to stress by routine laboratory handling. The sustained plasma
      glucose levels and decreased liver and muscle glycogen concentrations during
      cessation of feeding of the catfish suggest that during period of food
      deprivation, it draws its energy through glycogenolysis. Hence, in any study
      dealing with carbohydrate metabolism, the catfish needs to be fed during
      acclimation and experimental periods.

PMID- 11218817
TI  - Influence of culture parameters on paper mill effluent decolourization by a white
      rot fungus Ganoderma lucidum.
AB  - Efficacy of a white rot fungus G. lucidum for reduction of colour of paper mill
      effluent under various growth conditions was evaluated. G. lucidum cultured in
      IBME medium supported maximum colour reduction on 18th day of fungal growth. The
      optimization of growth parameters further improved colour reduction. The 18 day
      old culture at 4 g/l inoculum concentration resulted in maximum decolourization
      (89%) of the effluent with pH adjusted to 6.5 at 35 degrees C along with maximum
      reduction in biological oxygen demand and chemical oxygen demand. Relative
      contribution of lignin peroxidase and laccase to the decolourization of paper
      mill effluent by G. lucidum was also observed.

PMID- 11218818
TI  - Effect of naloxone on GnRH-induced LH and FSH release in buffalo, Bubalus
      bubalis.
AB  - The effect of naloxone on GnRH-induced LH and FSH release was measured in
      buffaloes in luteal phase of estrous cycle. Animals were administered
      intravenously, naloxone/saline (50 mg/injection) every 15 min for 3 hr followed
      by GnRH (100 micrograms). Peripheral plasma LH and FSH concentrations were
      measured in blood samples collected at 15 min intervals from 1 hr prior to
      beginning of naloxone/saline treatment up to 3 hr post GnRH administration and
      every 30 min for the subsequent 3.5 hr. Between the animals of Group I
      administered naloxone and those of Group II given saline, GnRH-induced peak LH
      and FSH concentrations, the total LH and FSH released in response to GnRH, and
      the time to peak LH and FSH concentrations were not significantly different. The
      results of the present study suggest the absence of a direct effect of naloxone
      on pituitary responsiveness to GnRH.

PMID- 11218819
TI  - Changes of haemolymph protein profile in the larva of Pericallia ricini
      (Fabricius) parasitised by the Braconid Wasp, Apanteles taragamae Viereck
      (Hymenoptera: Braconidae).
AB  - Parasitism by the braconid wasp, A. taragamae caused alterations in the
      haemolymph polypeptides of woolly bear larvae of P. ricini. Analysis of
      haemolymph proteins by SDS-PAGE and densitometry showed that the quantities of
      haemolymph proteins were reduced dramatically in the parasitised larvae.
      Simultaneously, parasitism induced large amount of 95 kDa polypeptides in the
      haemolymph of the parasitised larvae. Also, a remarkable induction of 43 and 45
      kDa polypeptides which are not detectable in non-parasitised larvae appeared in
      the parasitised larvae.

PMID- 11218820
TI  - X-ray microanalysis of elements of VA mycorrhizal and non-mycorrhizal Pennisetum
      pedicellatum roots.
AB  - Chemical composition of inter and intracellular hyphae was elucidated in
      Pennisetum pedicellatum roots colonized by Gigaspora margarita by employing
      energy dispersive X-ray microanalysis. Maximum amount of phosphate was estimated
      in polyphosphate granules present in the roots. Amount of phosphate was low in
      fungal hyphae, arbuscular trunks and degenerated arbuscules. Elements S, K and Ca
      were present in the hyphae, arbuscular trunk and degenerated arbuscules.

PMID- 11218821
TI  - Effect of light intensity on in vitro multiple shoot induction and regeneration
      of cotton (Gossypium hirsutum L. cv Khandawa-2).
AB  - Cotyledonary nodes taken alongwith shoot apex from seedlings of cotton (G.
      hirsutum) proliferated into shoots on nutrient agar medium supplemented with
      cytokinins. In the presence of optimal plant growth regulators, low light
      intensity enhanced the number of shoots initiated per explant in cotton. An
      average of 33.5 +/- 2.9 shoots were obtained from a single explant cultured for 8
      weeks which is about four fold higher than the values reported in earlier
      protocols. The isolated shoots were rooted on nutrient agar medium supplemented
      with alpha-naphthalene acetic acid and transferred to soil after acclimatization.
      Regenerated plants were morphologically identical to the seed-germinated plants
      and were fertile.

PMID- 11218822
TI  - Tolerance of Oscillatoria isolates to agrochemicals and pyrethroid components.
AB  - Four isolates of Oscillatoria sp from an Indian paddy field have been tested for
      their tolerance to agrochemicals and pyrethroid components. The isolates
      possessed considerable tolerance to agrochemicals and reduced toxicity of
      pyrethroid components towards fish.

PMID- 11218823
TI  - Size dependent bioaccumulation of heavy metals by Mytilopsis sallei (Recluz) at
      Visakhapatnam harbour.
AB  - Relationship between body size and bioaccumulation of copper, zinc, lead and
      cadmium in the fouling bivalve, M. sallei (Recluz) in Visakhapatnam harbour was
      studied. While concentration of copper, zinc and lead decrease with increasing
      size, no such relationship is observed for cadmium.

PMID- 11218824
TI  - Protective antioxidant effect of vitamins C and E in streptozotocin induced
      diabetic rats.
AB  - We have investigated the protective effect of vitamin C and E together
      supplementation on oxidative stress and antioxidant enzyme activities in the
      liver of streptozotocin-induced diabetic rats, unsupplemented diabetic and
      control rats. We also determined the levels of both the vitamins and oxidative
      stress in plasma. Vitamin supplementation in diabetic rats lowered plasma and
      liver lipid peroxidation, normalised plasma vitamin C levels and raised vitamin E
      above normal levels. In liver, the activity of glutathione peroxidase was raised
      significantly and that of glutathione-S-transferase was normalised by vitamin
      supplementation in diabetic rats. The levels of lipid peroxidation products in
      plasma and liver of vitamin-supplemented diabetic rats and activities of
      antioxidant enzymes in liver suggest that these vitamins reduce lipid
      peroxidation by quenching free radicals.

PMID- 11218825
TI  - Motor and electrographic response of refractory experimental status epilepticus
      in rats and effect of calcium channel blockers.
AB  - Effects of various calcium channel inhibitors have been studied in lithium
      pilocarpine model of status epilepticus. Status epilepticus was induced by
      administration of lithium chloride (3 meq/kg) followed 21 hr later by pilocarpine
      (30 mg/kg). Diltiazem (5 and 10 mg/kg) was not effective in delaying onset of
      convulsions. Verapamil (20 mg/kg) showed protection against lithium-pilocarpine
      induced convulsions. The dihydropyridine nifidepine (2.5 and 5 mg/kg) did not
      show any protection in this model. Amlodipine (5 and 10 mg/kg) as partially
      protective. Flunarizine (10 and 20 mg/kg) delayed the onset of forelimb clonus
      and rearing and only 60% of the rats underwent status in the 20 mg/kg group. Pre
      treatment of MK-801 led to a potentiation of the antiseizure activity of calcium
      channel inhibitors. The percent increase in amplitude at various time points with
      amlodipine pretreatment was significant only at the 30th min recording, and at
      the rest of the time frames was practically similar as the controls. It can be
      concluded that the anticonvulsant action of MK-801 can be enhanced by centrally
      acting calcium channel inhibitors.

PMID- 11218826
TI  - Prolonged release biodegradable vesicular carriers for rifampicin--formulation
      and kinetics of release.
AB  - An attempt has been made to design suitable liposome and niosome-encapsulated
      drug delivery system for rifampicin and evaluated the same in vitro and in vivo.
      A modified lipid layer hydration method was employed to prepare these vesicular
      carriers. The formulated systems were characterized in vitro for size
      distribution analysis, drug entrapment, drug release profiles and vesicular
      stability at different conditions of storage. In vivo drug kinetics was evaluated
      in normal, healthy albino rats for niosomal formulation upon subcutaneous
      injection and various pharmacokinetic parameters were determined. Niosomes and
      liposomes exhibited mean diameter of 9.73 and 11.87 microns with entrapment
      efficiencies of 30.5 and 34.2% respectively. Both the products exhibited
      sustained release characteristics in vitro with zero order drug release kinetics
      up to initial 10 hr. Stability evaluation indicated that both formulations were
      not significantly leaky over a period of one month. Niosomal formulation elevated
      plasma elimination half life and decreased elimination rate constants for
      rifampicin in vivo suggested that encapsulation retarded the removal of the drug
      from circulation compared to free drug due to slow drug release into systemic
      circulation. A five-fold increase in the area under plasma rifampicin
      concentration-time curve for niosomal rifampicin as compared to free drug
      indicated better bioavailability of encapsulated drug. It is evident from this
      study that niosomes and liposomes could be promising delivery systems for
      rifampicin with prolonged drug release profiles and reasonably good stability
      characteristics.

PMID- 11218827
TI  - Adaptogenic activity of Siotone, a polyherbal formulation of Ayurvedic rasayanas.
AB  - Siotone (ST) is a herbal formulation comprising of Withania somnifera, Ocimum
      sanctum, Asparagus racemosus, Tribulus terristris and shilajit, all of which are
      classified in Ayurveda as rasayanas which are reputed to promote physical and
      mental health, improve defence mechanisms of the body and enhance longevity.
      These attributes are similar to the modern concept of adaptogenic agents, which
      are, known to afford protection of the human physiological system against diverse
      stressors. The present study was undertaken to investigate the adaptogenic
      activity of ST against chronic unpredictable, but mild, footshock stress induced
      perturbations in behaviour (depression), glucose metabolism, suppressed male
      sexual behaviour, immunosuppression and cognitive dysfunction in CF strain albino
      rats. Gastric ulceration, adrenal gland and spleen weights, ascorbic acid and
      corticosterone concentrations of adrenal cortex, and plasma corticosterone
      levels, were used as the stress indices. Panax ginseng (PG) was used as the
      standard adaptogenic agent for comparison. Additionally, rat brain levels of
      tribulin, an endogenous endocoid postulated to be involved in stress, were also
      assessed in terms of endogenous monoamine oxidase (MAO) A and MAOB inhibitory
      activity. Chronic unpredictable footshock induced marked gastric ulceration,
      significant increase in adrenal gland weight and plasma corticosterone levels,
      with concomitant decreases in spleen weight, and concentrations of adrenal gland
      ascorbic acid and corticosterone. These effects were attenuated by ST (50 and 100
      mg/kg, p.o.) and PG (100 mg/kg, p.o.), administered once daily over a period of
      14 days, the period of stress induction. Chronic stress also induced glucose
      intolerance, suppressed male sexual behaviour, induced behavioural depression
      (Porsolt's swim despair test and learned helplessness test) and cognitive
      dysfunction (attenuated retention of learning in active and passive avoidance
      tests), and immunosuppression (leucocyte migration inhibition and sheep RBC
      challenged increase in paw oedema in sensitized rats). All these chronic stress
      induced perturbations were attenuated, dose-dependently by ST (50 and 100 mg/kg,
      p.o.) and PG (100 mg/kg, p.o.). Chronic stress-induced increase in rat brain
      tribulin activity was also reversed by these doses of ST and by PG. The results
      indicate that ST has significant adaptogenic activity, qualitatively comparable
      to PG, against a variety of behavioural, biochemical and physiological
      perturbations induced by unpredictable stress, which has been proposed to be a
      better indicator of clinical stress than acute stress parameters. The likely
      contribution of the individual constituents of ST in the observed adaptogenic
      action of the polyherbal formulation, have been discussed.

PMID- 11218828
TI  - Organogenesis and tissue regeneration of fallopian tube: a desired metaplastic
      transformation of mesodermal stem cells in live animal models (dogs).
AB  - The capacity of stem cells of peritonium of mesodermal origin to undergo
      metaplastic transformation and form different tissues developed from mesoderm
      germ layer is exploited with ulterior motive to use it in the management of human
      diseases. The excised fallopian tube was replaced with a tube on a stent
      constructed from autogenous peritoneum from a suitable donor site. The effect of
      the surroundings environment of the new tissue system to which the peritoneum
      stem cells are now exposed was studied for 3, 6 and 12 months period in live
      animal models. The gross and histological studies revealed development of all the
      component of the wall of the fallopian tube. The lumen of the constructed
      peritoneal tube was well preserved in its whole length including the anastomotic
      sites. The scientific rationale of the working hypothesis on which the work is
      based, is discussed.

PMID- 11218830
TI  - A method for large-scale multiplication of Curculigo orchioides through bulbil
      formation from leaf explant in shake flask culture.
AB  - An efficient method has been developed for large-scale multiplication of
      Curculigo orchioides (Hypoxidaceae), an endangered medicinal plant, through
      direct bulbil formation from leaf explants in shake flask cultures. Leaf-segments
      (7 x 10 mm) were cultured in B5 liquid medium containing KNO3 (200 mgNL-1),
      (NH4)2SO4 (50 mgNL-1), benzyl adenosine (2.2 microM), adenine (0.11 mM), indole
      butyric acid (1.0 microM) and polyvinyl pyrrolidone (250 mgL-1). About 95% of
      explants produced maximum number of bulbils (546/flask at 6 weeks growth) in the
      medium. Shake flask cultures yielded 2737 bulbils/L medium whereas static
      cultures yielded 624 bulbils/L medium. Germination of bulbils was maximum
      (90.62%) on agar-gelled B5 medium containing benzyl adenosine (2.2 microM) and
      gibberellic acid (3.5 microM). Plantlets developed in vitro were successfully
      transferred to soil with a high rate of survivability (90%) and were comparable
      to natural population in growth and vigour.

PMID- 11218829
TI  - RH-5992--an ecdysone agonist on model system of the silkworm Bombyx mori.
AB  - RH-5992 is a novel synthetic non-steroidal ecdysteroid agonist with a high
      selectivity towards Lepidopteran species. The effect of ecdysone agonist RH-5992
      on larval period, larval weight, silk gland weight and haemolymph protein profile
      were examined in the model organism, the larvae of silkworm, Bombyx mori. The
      LD50 values were found to be 16.21 and 12.01 micrograms/larva for 72 and 96 hr
      respectively. In the present study, three sublethal concentrations of 1/5th,
      1/10th and 1/20th of LD50 at 72 hr were selected and applied on the mid-dorsal
      line of the silkworm B. mori. The maximum mortality of 35% was observed in the
      group which received the highest (3.2 micrograms/larva) concentration of RH-5992.
      The mortality rate was found to be dose dependent as well as time dependent.
      Interesting results were observed in haemolymph profile of the RH-5992 treated
      larvae as staining intensity of 30 kDa protein decreased significantly whereas
      the effect was not marked on other major proteins like storage proteins and
      vitellogenin polypeptides. From the results, it is confirmed that RH-5992 causes
      changes in larval characters and protein profile of silkworm B. mori. It is
      proposed that RH-5992 may cause negative effect specifically on reproductive
      characters like development of ovary and egg production due to decrease in 30 kDa
      protein.

PMID- 11218831
TI  - Micropropagation of terrestrial orchids, Anoectochilus sikkimensis and
      Anoectochilus regalis.
AB  - Two horticulturally important jewel orchids of the genus Anoectochilus were
      successfully micropropagated. Isolated nodes of A. sikkimensis collected from
      Sikkim in Eastern Himalayas and subsequently reared under nursery conditions and
      A. regalis collected from Western Ghats in Southern India were cultured for 12
      weeks on Woody Plant Medium (WPM) to produce a maximum of 4.8 and 5.6 callus-
      free axillary shoots respectively at 95 and 98% efficiency. During reculture of
      the explants from in vitro raised shoots under the same conditions, the total
      number of shoots obtained from the nodes (21.4) and shoot tips (8.2) of A.
      regalis were significantly higher than those hardy and slow growing shoots of A.
      sikkimensis (12.3 and 4.3) respectively. Shoots (4-6 cm) were rooted in medium
      containing NAA (2.70 microM) and activated charcoal (0.2%). The rooted plants
      established at 95-98% rate in community pots after hardening. After 6 months,
      green house adapted community potted plants of A. regalis were transferred to
      natural forest habitat locally with 95 and 70% survival respectively after 12
      months. The plants, established in community pots and native forest habitat were
      free from any morphological and growth defects.

PMID- 11218832
TI  - Non-cellulosic mixed linkage beta-D-glucan in sorghum, Sorghum bicolor (L.)
      Moench--localization and biological activity studies.
AB  - Fluorescence of Calcofluor and Congo Red was observed in stained sections of
      sorghum grain (Sorghum bicolor (L.) Moench), especially in the sub-aleurone cells
      indicating the presence of mixed linkage beta-D-glucan. Relatively less
      fluorescence intensity was observed in the single layered (approximately 20
      microns thick) aleurone. Alkali extracted beta-D-glucan (fraction 2) of sorghum
      showed 30% activation of rat peritoneal macrophages (in vitro) at 100 micrograms
      ml-1 concentration in 10 min. This activation was found mediated mainly through
      PLA2 pathway. A phagocytic index k of 0.102 +/- 0.008 was observed in vivo carbon
      clearance test in mice in the group treated with fraction 2. Accumulation of
      colloidal carbon particles in spleen and liver of mice was moderate in this
      group, compared to control.

PMID- 11218833
TI  - Validity of mechanism of gene transfer in the process called conjugation in
      bacteria.
AB  - We have attempted a new evaluation of the process of conjugation in bacteria,
      because of some basic dissimilarities observed between this and that of
      eukaryotes, or plants and animals. Reference donor and recipient strains, widely
      used to prove conjugation in bacteria, were chosen; addition of DNase during the
      conjugation process, led to an unexpected but highly reproducible increase in the
      transconjugant colony counts (TCC; ca. > or = 1 log), when compared with that of
      the controls without DNase. Transconjugants were also obtained when the same live
      donors were substituted with the UV-killed ones although the TCC was very low
      initially. Contrarily, donors treated with DNA-intercalating agents, e.g.
      acridine orange or ethidium bromide, resulted in a complete failure to produce
      transconjugants. There was a quantitative relationship between the DNase used on
      donors and levels of DNA sugars/nucleotides/DNA, which possibly resulted from
      interaction between the DNase and DNA being present/produced on the donor
      surface. This may be indicative of what may actually happen in the donor
      recipient mixtures in the conjugation test proper, where the recipient DNase may
      activate a donor DNA production cycle. The evidences presented did not suggest
      that the donor DNA in the conjugation process is actually vestibuled through any
      intercellular conjugation passages, and is susceptible to the action of DNase or
      the intercalating dyes.

PMID- 11218834
TI  - Development of a computer software for analysis of SDS-PAGE protein fingerprints
      of bacterial isolates.
AB  - Protein fingerprinting is a widely used technique in epidemiological studies for
      typing bacterial strains. This study reports the development of a computer based
      gel analysis system. The system has the capability to analyse SDS-PAGE whole-cell
      protein profiles using digital image processing techniques. The software
      incorporates spatial and frequency domain operators for image enhancement,
      support for geometric correction of images and new algorithms for identification
      of strain tracks and protein bands. The system also provides facilities for
      correcting imaging defects for inter-gel comparison, similarity analysis,
      clustering and pictorial representation of results as a dendrogram. The software
      is highly interactive, user-friendly and can produce accurate results for
      differentiation of bacterial strains with minimal overhead of time.

PMID- 11218835
TI  - Bidder's organ extract induced anaphylaxis in experimental animals.
AB  - Bidder's organ (BO, a vestigeal organ), present in toad Bufo melanostictus
      (Schenider), is a characteristic feature of all male bufo. Its possible
      anaphylactic properties are investigated on experimental animals. BO extract
      produced both in vivo and in vitro anaphylactic reaction in guineapig. Dyspnoea
      and bronchoconstriction was a major cause of anaphylactic death. Blood histamine
      level was significantly increased in the anaphylactic animals. BO extract
      significantly released histamine from chopped lung preparation, an action
      antagonised by disodium chromoglycate. BO extract degranulated peritoneal mast
      cell in vitro. Passive cutaneous anaphylactic reactions were enhanced by BO
      extract and were significantly inhibited by disodium chromoglycate. Anaphylotoxin
      (identity not known) present in bidder's organ is probably involved in toad
      defence.

PMID- 11218836
TI  - Hypoglycaemic activity of extracts from soft corals of Andaman and Nicobar coasts
      in rats.
AB  - The ethylacetate extract of soft corals collected from Andaman and Nicobar Coasts
      were screened for hypoglycaemic activity in fasting rats. Rats were divided into
      5 groups. Group I received 0.5 ml of 5% gum acacia suspension (control). Group II
      received the extract of Cladiella australis (CAS), at a dose of 250 mg/kg. Group
      III received the extract of Sinularia new species (SNS), at a dose of 75 mg/kg.
      Group IV received the extract of Lamnalia new species (LNS), at a dose of 400
      mg/kg and Group V received the extract of 250MF-CBR-13 at a dose of 250 mg/kg.
      All extracts were administered orally. Blood samples, collected before the
      administration of test extracts and also at 2, 4, 6, and 8 hr after treatment,
      were analysed for glucose content. The percentage blood glucose reduction from
      that of control was also calculated. A very promising hypoglycaemic activity was
      observed in rats with CAS at 8 hr (42.3%), with SNS at 4 hr (28.34%) and 6 hr
      (40.6%), with LNS at 6 hr (32.38%) and with MF-CBR-13 at 6 hr (20.25%).

PMID- 11218837
TI  - Antinociceptive pattern of flavone and its mechanism as tested by formalin assay.
AB  - Flavone, dextrose and long swim stress exhibited antinociception. Degree of
      antinociception was greater with long swim stress as compared to flavone or
      dextrose. Combination of these treatments resulted in potentiation of
      antinociception. Naloxone (opioid antagonist; 5 mg/kg i.p.) antagonised flavone
      or long stress induced antinociception showing opioid medicated mechanism,
      however, failed to reverse the potentiated antinociceptive component recorded in
      long stressed animals which received flavone and dextrose. Antinociceptive
      activity of flavone, dextrose and long swim stress which was documented by acetic
      acid assay has been confirmed in the present study. Role for opioid system in
      this action has been demonstrated. Therefore, formalin test can also be
      considered as an useful assay procedure for testing flavonoids. However, like
      acetic acid assay this assay procedure also has the limitation that it is unable
      to detect minor changes in the degree of antinociception produced by
      physiological interventions such as long swim and dextrose.

PMID- 11218839
TI  - Effect of fumigation and juvenile hormone on oxygen consumption of the larvae of
      Corcyra cephalonica (Stainton).
AB  - Reduced effect of JH-I, JH-II and JH-III on oxygen consumption of II-V instars
      and increased effect on the oxygen consumption of VI instar larvae suggested that
      control of corcyra with juvenile hormones could be brought about only when
      applied to just emerged VI instar larvae. Similarly fumigation of juvenile
      hormone treated larvae could prove beneficial only at VI instar stage. The
      possibility of enhancing the effect of fumigant with pretreatment of JH will be
      futile as even only JH treated VI instar larvae develop into abnormal individuals
      which die later.

PMID- 11218840
TI  - Stress responses in two genotypes of mulberry (Morus alba L.) under NaCl
      salinity.
AB  - Changes in biomass yield rates, cell membrane stability (CMS), malondialdehyde
      (MDA) content and in the levels of physiological stress markers such as proline
      and glycine betaine in two high yielding genotypes (S1 and ATP, salt tolerant and
      salt sensitive, respectively) of mulberry under NaCl salinity were studied.
      Biomass yield rates and CMS were significantly decreased in both the genotypes
      under stress conditions. Per cent of decrease in biomass yield rate and CMS was
      relatively less in S1 than in ATP. Salt stress results a significant increase in
      the accumulation of proline, by 6-fold in S1 and 4-fold in ATP. Glycine betaine
      content was also increased significantly in stressed plants. However, the per
      cent increase was more in S1 than in ATP. The level of lipid peroxidation as
      indicated by MDA formation was greater in ATP than in S1. These results clearly
      support the better salt tolerant nature of S1 compared to ATP genotype.

PMID- 11218838
TI  - Purification and differentiation of three avian adenoviruses by restriction
      endonuclease analysis.
AB  - A rapid method of ultracentrifugation pelleting of avian adenovirus (AAV) from
      small volume of chloroform treated infected cell culture fluid or allantoic fluid
      was adapted for isolation of adenoviral DNA. The viral DNA extracted from
      semipurified viruses was found to be intact on agarose gel and pure enough
      (A260/280 = 1.85-1.92) for restriction enzyme analysis. Restriction endonuclease
      analysis of Indian strain of AAV serotype 1, AAV serotype 4 (group I AAVs) and
      egg drop syndrome-76 (EDS-76) virus genomes (group III AAV) with Hind III enzyme
      differentiated these viruses. The AAV serotype 1 and serotype 4 strain exhibited
      identical Hind III profile to European viral strains belonging to same serotypes
      however, the EDS-76 virus gave similar but not identical profile. The calculated
      genomic lengths for AAV serotype 1 and EDS-76 virus were approximately found to
      be 33.9 and 44.4 Kb, respectively.

PMID- 11218841
TI  - Ribosomal DNA repeat unit polymorphism in some pulses.
AB  - Restriction fragment length polymorphism (RFLP) of nuclear ribosomal RNA genes
      (rDNA) was carried out in some pulse species such as Lablab purpureus, Dolichos
      tribolus, Vigna bournii, V. grahmiana, V. unguiculata and V. wightii. Restriction
      endonuclease digestion and Southern blot analysis with wheat probe pTa 71
      revealed a bewildering diversity. The fragment patterns produced by different
      enzymes such as Dpn II, Hind III, EcoRI and Bam H1 already illustrate
      considerable polymorphism.

PMID- 11218843
TI  - The effects of alcoholic compounds on the stability of type I collagen studied by
      differential scanning calorimetry.
AB  - The interaction between bovine tendon collagen and a series of homologous
      alcohols were investigated using a differential scanning calorimetry. For all
      alcoholic substances, as well as 2-hydroxyethyl methacrylate (HEMA), the
      concentration dependence of the denaturation temperature of collagen was
      observed, which showed a minimum at 30%. Clearly there are two opposing actions
      on the stabilization of the collagen structure; destabilization dominates over
      stabilization at lower concentrations, and vice versa at higher concentrations.
      The concentration dependence became greater for longer chain alcohols, while it
      was suppressed by the increased number of OH groups. The chain length-dependent
      surface tension may be related, which controls the permeation of the additives
      through the collagen fibers. Overall hydrophobicity, indicated by the hydrophile
      lipophile balance (HLB) numbers, suggests the importance of the hydrophobic
      effect in the interaction of collagen and alcoholic substances, including
      adhesive monomers such as HEMA.

PMID- 11218844
TI  - Effect of binary and ternary filler mixtures on the mechanical properties of
      composite resins.
AB  - The mechanical strength of experimental light cure composites containing binary
      filler mixtures with various combinations of irregular and spherical macrofillers
      in various mixes, and the microfilled ternary system fillers were measured. The
      compressive strength of the binary mixtures between different shaped fillers was
      not related to mixing ratios, although it significantly increased as the filler
      size decreased. The mixing ratio was immaterial within the irregular filler
      mixture. The compressive strength of the binary mixtures within the spherical
      fillers increased as the mixing ratio increased while the filler size was
      relatively large, then the mixing ratio became insignificant as the filler size
      decreased under 1.4 microns. The compressive strength of the microfilled ternary
      fillers increased with the decrease in the macrofiller size and with the increase
      in the mixing ratio. A large diametrical tensile strength was found in several
      microfilled ternary mixtures containing different shaped macrofillers.

PMID- 11218842
TI  - Mercury evaporation from amalgams with varied mercury contents.
AB  - This study examined the relationship between mercury content and mercury
      evaporation from amalgams during setting. Two different types of commercial high
      copper amalgams (single composition and admixed types) were used. Cylindrical
      specimens of each amalgam were prepared with five different mercury contents
      according to ADA Specification No.1. Specimens were also prepared by hand
      condensation. Mercury evaporation from amalgam specimens maintained at 37 degrees
      C was measured using a gold film mercury analyzer from 10 min after the end of
      trituration until the mercury concentration in air reached an undetectable level.
      The mercury content more clearly influenced the mercury evaporation from the
      admixed type amalgam specimens when the mercury content decreased below the
      manufacturers' recommended trituration conditions. Triturating with less mercury
      than the manufacturers' recommended amount cannot lower the evaporation of
      mercury from freshly made amalgam. Proper condensing procedures can minimize the
      mercury evaporation from the amalgam surface.

PMID- 11218845
TI  - Estrogenic activity of dental materials and bisphenol-A related chemicals in
      vitro.
AB  - Twenty-eight chemicals used as dental materials and bisphenol-A related chemicals
      were diluted with DMSO to concentrations ranging from 10(-7) to 10(-3) M and
      tested for estrogenicity. Bisphenol-A (BPA), bisphenol-F (BPF) and bisphenol-A
      bischloroformate (BPACF) showed estrogenic activity using the yeast two-hybrid
      system, and BPA, BPF, BPACF and bisphenol-S (BPS) showed estrogenic activity
      using the fluorescence polarization system. However, none of the remaining
      chemicals and none of the dental materials showed any activity at concentrations
      between 10(-7) and 10(-3) M. Although BPA, BPF, BPACF, bisphenol-A-dimethacrylate
      and BPS showed estrogenic activity in the E-screen test, the remaining chemicals
      did not. Thus, most of the chemicals showed consistent results, either positive
      or negative, by the three testing methods, while two chemicals showed conflicting
      results. Further studies, together with in vivo and epidemiological examinations,
      are required. Elucidation of the structure-activity relationships of these
      chemicals is also needed to estimate the estrogenicity of a chemical from its
      structure.

PMID- 11218846
TI  - Analysis of major components and bisphenol A in commercial Bis-GMA and Bis-GMA
      based resins using high performance liquid chromatography.
AB  - The purpose of this study was to examine the quality of commercially available
      Bis-GMA because concerns about Bis-GMA and Bis-GMA-based resins have been
      recently expressed in dentistry. Four major components and bisphenol A, which is
      a compound of recent controversy, were quantitatively analyzed using high
      performance liquid chromatography (HPLC) in three commercial Bis-GMA and six Bis
      GMA-based composite resins. The contents of genuine Bis-GMA, Iso-bis-GMA, Bis-GMA
      H, and Bis-GMA-M as well as the total content of the four monomers were 45.7
      57.5%, 19.9-26.2%, 1.8-5.0%, 0.6-15.0% and 83.7-85.6% in the commercial Bis-GMAs,
      or 3.8-9.1%, 1.7-4.3%, 0.1-0.5%, 0.1-2.0% and 5.8-14.0% in composite resins,
      respectively. There were some differences in the composition of the major
      components between domestic and foreign materials. Bisphenol A contents in the
      unpolymerized composite resins were 1.5-10.2 micrograms/g resin.

PMID- 11218847
TI  - Corrosion resistance of the Pt-Fe-Nb magnets for dental-casting.
AB  - Magnetic attachments have been used in clinical dental practice, but there is
      some difficulties associated with removable bridges. One possible solution is to
      make whole bridges of Pt-Fe magnet alloys and its abutment out of magnetic
      stainless steel by casting. In terms of castability and magnetic properties, the
      promising composition of the Pt-Fe-Nb magnet alloy is Pt-30.0 mass% Fe-0.6 mass%
      Nb and Pt-30.0 mass% Fe-0.5 mass% Nb-0.03 mass% Si. In the present study, the
      corrosion resistance of these alloys was investigated based on the elusion test,
      electrochemical behavior and surface characterization by EPMA analysis. The
      released elements from the Pt-Fe-Nb magnets were mainly Fe ions in quantities
      similar to that of stainless steel for biomedical use, and the Pt-Fe-Nb magnet
      alloy, the Pt-Fe-Nb-Si magnet alloy and platinum resembled each other in
      electrochemical behavior. The present findings suggest, that the Pt-Fe-Nb magnet
      alloy provides excellent corrosion resistance and has important clinical dental
      applications.

PMID- 11218850
TI  - New partition technique for two-chamber pressure casting unit for titanium.
AB  - Although titanium has been widely used in prosthetic appliances, such as cast
      removable partial denture frameworks, high quality castings are still difficult
      to obtain. This study proposes a new partition technique using a metal foil for
      improving castability of a two-chamber pressure casting unit. The metal foil was
      formed beforehand to bring it in contact with the mold crucible wall so that no
      clearance was left behind it. Using this formed foil, the mold cavity can be
      completely isolated from the upper chamber and can be maintained in a vacuum even
      after the rupture of the foil. Accordingly, a large casting force is generated
      very quickly, and as a result, castability is expected to be significantly
      improved. This expectation was confirmed by the experiments using wax patterns
      including thin plate and mesh plate.

PMID- 11218848
TI  - Study of resin-bonded calcia investment: Part 1. Setting time and compressive
      strength.
AB  - This study was carried out to develop a new titanium casting investment
      consisting of calcia as the refractory material and a cold-curing resin system as
      the binder. The setting time of the investment was investigated under different
      N,N-dimethyl-p-toluidine (DMPT) contents in methyl methacrylate monomer (MMA) and
      benzoyl peroxide (BPO) contents in calcia without any sintering agent. The
      effects of the sintering agents, which were calcium fluoride (CaF2) and calcium
      chloride (CaCl2), on the compressive strength of the investments were
      investigated at room temperature before and after heating to two different
      temperatures. The shortest setting time (68 minutes) of the investment was
      obtained at 0.37 DMPT/BPO (1.5 vol% /1.0 mass%) ratio by mass. The highest
      strength (16.5 MPa) was obtained from the investment which contained 2 mass% CaF2
      and was heated to 1,100 degrees C. It was found that the developed calcia
      investment containing 2 mass% CaF2 has a possibility for use in titanium
      castings.

PMID- 11218849
TI  - Development of Ag-Pd-Au-Cu alloy for multiple dental applications. Part 1.
      Effects of Pd and Cu contents, and addition of Ga or Sn on physical properties
      and bond with ultra-low fusing ceramic.
AB  - Ag-Pd-Au-Cu quaternary alloys consisting of 30-50% Ag, 20-40% Pd, 10-20% Cu and
      20% Au (mother alloys) were prepared. Then 5% Sn or 5% Ga was added to the mother
      alloy compositions, and another two alloy systems (Sn-added alloys and Ga-added
      alloys) were also prepared. The bond between the prepared alloys and an ultra-low
      fusing ceramic as well as their physical properties such as the solidus point,
      liquidus point and the coefficient of thermal expansion were evaluated. The
      solidus point and liquidus point of the prepared alloys ranged from 802 degrees C
      to 1142 degrees C and from 931 degrees C to 1223 degrees C, respectively. The
      coefficient of thermal expansion ranged from 14.6 to 17.1 x 10(-6)/degrees C for
      the Sn- and Ga-added alloys. In most cases, the Pd and Cu contents significantly
      influenced the solidus point, liquidus point and coefficient of thermal
      expansion. All Sn- and Ga-added alloys showed high area fractions of retained
      ceramic (92.1-100%), while the mother alloy showed relatively low area fractions
      (82.3%) with a high standard deviation (20.5%). Based on the evaluated
      properties, six Sn-added alloys and four Ga-added alloys among the prepared
      alloys were suitable for the application of the tested ultra-low fusing ceramic.

PMID- 11218851
TI  - WDX study of resin-dentin interface on wet vs. dry dentin.
AB  - The purpose of the present study was to determine the resin-dentin Interface
      conditions in Wet vs. Dry Dentin. Dentin disks were prepared from extracted human
      premolars. Sectioned dentin surfaces were used for SEM studies of wet vs. dried
      acid-etched dentin. These specimens were cut perpendicular to the surface into
      two equal halves. One-half of the sectioned specimen was observed by SEM in three
      treatment groups and the other half was observed for micromorphological
      differences in the resin-dentin interface using Wavelength Dispersive X-ray
      Spectrometer (WDX). SEM photomicrographs of the dentin surface showed the
      collapse of collagen fibrils in the demineralized layer and enlargement of the
      tubule orifices. A collagen rich layer approximately 8-10 microns thick (WDX) was
      observed at the resin-dentin interface when treated with the conventional dry
      bonding technique. Dentin surfaces treated by the wet-bonding technique (SB), as
      observed by SEM, showed an uncollapsed collagen layer, while the collagen-rich
      layer was approximately 1-2 microns thick (WDX). The present findings suggest
      that moist bonding is required for optimum infiltration of adhesive resin into
      the demineralized layer.

PMID- 11218852
TI  - [Effects of isoprenaline on apoptosis related gene expression in rat myocardium
      cells].
AB  - AIM: To study the relationship between acute myocardial ischemia rat induced by
      isoprenaline (Iso) and expression of some apoptosis related genes in myocardium.
      METHODS: Acute myocardial ischemic rat model was induced by subcutaneous
      injection of large doses of Iso. The myocardial expression of apoptosis related
      genes, Fas, CPP32, Bcl-2 and Bax, were detected with RT-PCR method. The
      influences of aloperine (Alo, 20 mg.kg-1) and propranolol (Prop, 2 mg.kg-1) on
      apoptosis related genes were also investigated by the same method. RESULTS:
      Myocardial expression of Fas, CPP32 and Bcl-2 were increased in acute myocardial
      ischemic rats, but no significance was detected in Bax expression. Both Alo and
      Prop were shown to decrease the expression of Fas and CPP32, and increase
      expression of Bcl-2. Prop also showed down regulated effect on expression of Bax.
      CONCLUSION: Subcutaneous injection of large doses of Iso was shown to induce
      expressions of apoptosis related genes in rat myocardium, which were also
      influences by Alo and Prop.

PMID- 11218853
TI  - [The effect of melatonin on enhancing immune function and inhibiting the ability
      of NO over-release in morphine dependent mice].
AB  - AIM: To observe the effects and mechanism of melatonin (MT) on the immune
      function of morphine dependent mice. METHODS: A physical dependent mice model was
      established by repeated subcutaneous injection of morphine. The intensity of
      morphine withdrawal syndrome was evaluated according to the weight of immune
      organs, the proliferation reaction of stimulated splenic lymphocytes by Con A,
      the phagoindex of blood primed macrophages and the content of NO induced in the
      peritoneal macrophage (pM phi). RESULTS: MT reversed the inhibitory effect of
      morphine on the proliferation ability of splenic lymphocytes and enhanced the
      phagocytosis of macrophages of morphine dependent mice obviously and prevented
      the over-release of NO from pM phi. The enhancing effects of MT on the
      phagocytosis can be prevented by naloxon. CONCLUSION: MT can significantly
      enhance the immune function of morphine dependent mice and inhibit NO excessive
      release from pM phi.

PMID- 11218854
TI  - [Expression of FAS and FASL genes in brain and effect of flunarizine on these
      expressions in rats after global ischemia-reperfusion].
AB  - AIM: To explore the expression of Fas and FasL genes after ischemia-reperfusion
      in rats and the effect of flunarizine. METHODS: Ischemia was induced by four
      vessel occlusion for 30 min following reperfusion in rats. The biopsy tissues
      from brain were immunohistochemically assayed with Fas and FasL genes polyclonal
      antibody. RESULTS: The expression of Fas was increased as early as 6 h after the
      onset of reperfusion. The peak of the expression of Fas occurred 24-48 h after
      ischemia-reperfusion. The expression of FasL was observed 12 h after ischemia
      reperfusion and peaked at 48-72 h. The expression of Fas and FasL gene was quite
      obvious in the cortex and hippocampus CA1, the more sensitive areas to ischemic
      injury. Flunarizine i.p. 10 mg.kg-1 and 20 mg.kg-1 obviously inhibited the
      expression of Fas and FasL in dose-dependent manner. CONCLUSION: Expression of
      Fas and FasL in cerebral cortex and hippocampus can be induced by global ischemia
      reperfusion. Flunarizine significantly inhibited the expression of Fas and FasL
      genes following ischemia-reperfusion.

PMID- 11218855
TI  - [Effect of heparinoid derived from porcine duodenum on the proliferation of
      cultured smooth muscle cells].
AB  - AIM: To study the antiproliferative effect of haparinoid derived from porcine
      duodenum (heparinoid) on cultured vascular smooth muscle cells. METHODS: Cultured
      bovine aortic smooth muscle cells (BASMCs) of 5-10 passages were seeded into 24
      and 72-well cluster culture plates and were synchronized by 48 h serum
      deprivation. Then, the cells were re-stimulated by serum repletion with or
      without heparinoid. The antiproliferative effect of heparinoid was evaluated by
      crystal violet staining and MTT assay 72 h after serum repletion. To study the
      drug action on cytomorphological changes, three kinds of cells [quiescent cells,
      cells treated with 10% fetal calf serum (FCS) with or without heparinoid] were
      observed by transmission electron microscopy. After synchronized and re
      stimulated as above, BASMCs were treated with heparinoid 0.8 mg.mL-1 at selected
      points during serum repletion. The cells were harvested at specified times after
      serum repletion, then cellular DNA contents (to estimate the proportions of cells
      in different phases of the cell cycle) and the contents of alpha-actin, c-myc and
      c-fos proteins were measured by flow cytometry. RESULTS: Heparinoid was shown to
      inhibit the proliferation of BASMCs induced by 10% FCS. The inhibitory effect was
      weakened when heparinoid was added 2 h after serum repletion, and there was no
      antiproliferative effect when heparinoid was added 12 h after serum repletion.
      Electron micrographs showed that cells treated with 10% FCS and heparinoid
      expressed a contractile phenotype, while cells treated with 10% FCS only
      expressed a synthetic phenotype. Flow cytometry study showed remarkable increase
      of alpha-actin, and decrease of c-myc and c-fos proteins in the cells treated
      with heparinoid. CONCLUSION: Heparinoid was found to inhibit the proliferation of
      BASMCs. The antiproliferative effect occurred at the early phase of the cell
      cycle. It might be due to the drug's influence on cell phenotype modulation and
      the down regulation of c-myc and c-fos proto-oncogenes expression.

PMID- 11218857
TI  - [New triterpenoid saponins from Anemone begoniifolia].
AB  - AIM: To study the triterpenoid saponins in the whole plants of Anemone
      begoniifolia Levl. et Vant. METHODS: Methanol extraction, normal and reversed
      phase silica gel column chromatography and various spectral analysis were used to
      isolate and determine the structures of the triterpenoid saponins. RESULTS: Four
      triterpenoid saponins were idenetified as: 3-O-beta-D-glucopyranosyl(1-->2)-alpha
      L-arabinopyranosyl oleanolic acid 28-O-alpha-L-rhamnopyranosyl (1-->4)-beta-D
      glucopyranosyl (1-->6)-beta-D-glucopyranoside (1), 3-O-beta-D-glucopyranosyl (1-
      >3)-alpha-L-arabinopyranosyl oleanolic acid 28-O-alpha-L-rhamnopyranosyl (1-->4)
      beta-D-glucopyranosyl (1-->6)-beta-D-glucopyranoside (2), 23-O-methyl malonyl
      hederagenin 28-O-alpha-L-rhamnopyranosyl (1-->4)-beta-D-glucopyranosyl (1-->6)
      beta-D-glucopyranoside (3) and 3-O-methyl malonyl hederagenin 28-O-alpha-L
      rhamnopyranosyl (1-->4)-beta-D-glucopyranosyl (1-->6)-beta-D-glucopyranoside (4).
      CONCLUSION: Compunds 2, 3 and 4 are new compounds and named as begoniifolides A,
      B and C, respectively.

PMID- 11218858
TI  - [Studies on the chemical constituents of Murraya kwangsiensis].
AB  - AIM: To investigate the chemical constituents of Murraya kwangsiensis. METHODS:
      Compounds were isolated by silica gel column chromatography and TLC method,
      respectively. Structures of compounds were elucidated by spectral (UV, IR, MS,
      1HNMR and 13CNMR) analysis. RESULTS: Five carbazole alkaloids and two other
      compounds were isolated and identified. Six of them are known compounds:
      murrayafoline A, murrayanine, koenine, isomahanine, palmitic acid and beta
      sitosterol. One is a new alkaloid, named kwangsine. CONCLUSION: A new alkaloid,
      named kwangsine, was isolated from Murraya kwangsiensis Var. Six known compounds
      were isolated from this plant for the first time.

PMID- 11218856
TI  - [One-pot synthesis of dl-naproxen by rearrangement].
AB  - AIM: To synthesize dl-naproxen by rearrangement method. METHODS: dl-Naproxen was
      synthesized by halogenation, ketalization, rearrangement and hydrolysis, using
      cupric halide as halogenation agent. RESULTS: Total yields were 74.0%-92.6% based
      on 6-methoxy-2-propionyl naphthalene. CONCLUSION: Total yield was higher by one
      pot rearrangement approach.

PMID- 11218859
TI  - [Studies on metabolite of beta-elemene in rat bile].
AB  - AIM: To study the metabolite of beta-elemene in the bile of rat. METHODS: After
      i.v. 100 mg.kg-1 beta-elemene, the metabolite in rat bile was extracted by ether.
      Mass spectrometry, nuclear magnetic resonance, infrared spectrometry and
      ultraviolet spectrometry were used to analyze the metabolite of i.v. beta-elemene
      in rat bile. RESULTS: It was confirmed by nuclear magnetic resonance that the
      methyl of No. 11 carbon connecting with No. 10 carbon of a metabolite in rat bile
      was oxidized to be aldehyde. The molecular weight of the metabolite was 218 which
      detected by mass spectrometry. Infrared spectrometry and ultraviolet spectrometry
      proved that the aldehyde existed in the metabolite. The structure of the
      metabolite in bile of rat was identified, that was 1-methyl-1-ethenyl-2
      isopropenyl-4-isopropenyl aldehydohexamethylene. CONCLUSION: The
      biotransformation of beta-elemene exists in vivo.

PMID- 11218860
TI  - [Foundational study of subcritical water chromatography].
AB  - AIM: To study the subcritical water chromatographic discipline of compounds with
      medium and high polarity on the capillary and packed column. METHODS: A packed
      and capillary subcritical water chromatography-FID detection system was built up.
      Six alcohols were well separated on a C18 column and the influence of temperature
      on chromatographic behavior of alcohols with different polarity was studied. The
      influence of temperature and pressure on chromatographic behavior of benzoic acid
      and gensenoside Rg1 on a SE-54 capillary column were also studied. RESULTS:
      Increasing temperature resulted in the decreasing polarity of mobile phase,
      shortened retention times of components separated, narrowed peak shape and
      improved tailing as well. CONCLUSION: Temperature programming could be used
      successfully to separate compounds with various polarity selectively.
      Thermostable capillary column could enlarge the range of temperature even more.

PMID- 11218861
TI  - [Pharmacokinetics of topically applied in-situ-forming gels of fluconazole in
      rabbit eyes].
AB  - AIM: To study the pharmcokinetics of fluconazole (FCZ) in the aqueous humors and
      tears of New Zealand white rabbits following topically applied in-situ-forming
      gels of 0.5% FCZ (ISG-FCZ) and 0.5% FCZ eye drops to rabbit eyes. METHODS: The
      rabbit tears and aqueous humors were obtained and quantified at different times
      after topically applying single dose of ISG-FCZ and FCZ eye drops to the rabbit
      eyes. The drug levels were assayed by megabore capillary gas-liquid
      chromatography with nitrogen-selective detector. The pharmacokinetic parameters
      were calculated with nonlinear least square method with computer. RESULTS: FCZ
      concentrations in rabbit tears within 180 min after applying ISG-FCZ were found
      to be significantly higher compared with those of FCZ eye drops. The FCZ levels
      in the aqueous at 10, 30, 60, 90 and 120 min after applying ISG-FCZ are
      significantly higher compared with FCZ eye drops. The time for arriving peak
      concentration (Tmax) and the area under concentration (AUC)-time curve as well as
      the half-life (T1/2) of FCZ in rabbit aqueous humors were markedly higher after
      application of ISG-FCZ. The peak levels in the aqueous humors showed no
      difference between the two groups. CONCLUSION: The ISG-FCZ, which upon exposure
      to physiological conditions will shift the gel phase, can significantly extend
      FCZ release and increase the precorneal residence time of the drug, thus enhance
      ocular bioavailability compared with FCZ eye drops.

PMID- 11218862
TI  - [Analysis of phenylethanoid glycosides in the extract of herba Cistanchis by
      LC/ESI-MS/MS].
AB  - AIM: To analyze the phenylethanoid glycosides in Cistanche deserticola Y. D. Ma
      and its alternatives. METHODS: An HPLC/MS/MS method has been developed for the
      analysis of seven kinds of phenylethanoid glycosides in Cistanche deserticola Y.
      D. Ma, C. salsa (C. A. Mey) G. Beck and C. tubulosa (Schenk) R. Wight. The [M -
      H]- ions were observed for five standards and Cistanche extracts. The glycosidic
      linkages, the core, and the attached sugar (s) of the phenylethanoid glycosides
      can be determined from the collision-induced dissociation spectra of the
      molecular. RESULTS: Seven kinds of phenylethanoid glycosides (echinacoside,
      acteoside, cisacteoside, isoacteoside, 2'-acetylacteoside, cistanoside A,
      osmanthuside B) in Cistanche deserticola Y. D. Ma, six kinds (echinacoside,
      acteoside, cisacteoside, isoacteoside, 2'-acetylacteoside and cistanoside A) in
      C. salsa (C. A. Mey) G. Beck and five kinds (echinacoside, acteoside,
      cisacteoside, isoacteoside and 2'-acetylacteoside) in C. tubulosa (Schenk) R.
      Wight were detected. CONCLUSION: The difference of the relative distribution of
      these phenylethanoid glycosides in each extract was found out. Phenylethanoid
      glycosides are the specific constituents in Cistanchis, which can be used to
      distinguish different species in Genus Cistanchis.

PMID- 11218863
TI  - [Use of high-field nulear magnetic resonance spectroscopy for the analysis of
      stereoselective metabolites of ibuprofen (R)-enantiomer in rat urine].
AB  - AIM: To study the metabolic chiral inversion and chiral metabolites of R-(-)
      ibuprofen. METHODS: Following administration of R-(-)-ibuprofen (250 mg.kg-1),
      analysis was performed on rat urine purified extracts obtained by solid phase
      extraction onto C-18 bonded silica gel, then the metabolites of ibuprofen were
      detected and identified by 1HNMR spectroscopy. RESULTS: Except for a little
      ibuprofen, there were 2'-hydroxy-ibuprofen and its glucuronide, 1'-carboxy
      ibuprofen glucuronide and ibuprofen glucuronide in rat urine. 2'-hydroxy
      ibuprofen is the main metabolite. 1'-carboxy-ibuprofen glucuronide and ibuprofen
      glucuronide were diastereoisomers. CONCLUSION: There was the phenomenon of
      metabolic chiral inversion, whereby the R-enantiomer is transformed in vivo to
      its active S-antipode via an unusual process.

PMID- 11218864
TI  - [Detection of impurities in DNA samples by using the convolution spectrum
      method].
AB  - AIM: To detect the presence of phenol, amino acids and endotoxin in DNA
      preparations. METHODS: By using the convolution curve transformation technology,
      correlation coefficient discriminant which was put forward by spectrum space
      theory and computer information process technology, impurities in DNA samples
      were detected. RESULTS: The convolution spectrum method compared with A260/A280
      ratio method and second-derivative absorption spectrum method could be used for
      the semiquantitative determinations of impurities in DNA samples and the results
      were satisfactory. CONCLUSION: The method was simple, convenient, fast and
      valuable to the biochemical analysis.

PMID- 11218865
TI  - [Study on preparation and pharmacodynamics of insulin-loaded polyester
      microparticles].
AB  - AIM: To investigate the possibility of using poly (epsilon-caprolactone-block-D,
      L-lactide) (PLCA) as a kind of materials to prepare the microparticles drug
      carrier. METHODS: PCLA-MP (microparticle, MP) was prepared by double
      emulsification solvent evaporation method. Its morphology was examined by
      scanning electron microscope. Its size diameter was examined by particle
      analyser. Insulin (INS), as a model drug, was then encapsulated into PCLA-MP (INS
      PCLA-MP). HPLC method was established for determining INS in INS-PCLA-MP. An
      "antibody-capture" procedure was devised for investigating encapsulation
      mechanism. The in vitro release behaviour of INS-PCLA-MP was determined in
      phosphatic buffer solution (pH 7.4). The diabetic rat model was established and
      blood glucose levels were measured using glucose oxidase (GOD-PAP) method to
      evaluate the hypoglycaemic effects after subcutaneous administration of INS-PCLA
      MP. The pharmacological bioavailability (PBA) of INS-PCLA-MP was calculated from
      the area above the curve (AAC) in contrast with INS-solution. RESULTS: The mean
      diameter of INS-PCLA-MP was 1.9 microns, while the encapsulation ratio of INS
      reached to 76.46%. Only 18.25% encapsulated INS was on the surface of the
      microparticles, it could be measured by "antibody-capture" experiment. The in
      vitro release curve of INS-PCLA-MP consists of initial rapid release stage
      followed by slower exponential stage. In pharmacodynamic studies, after
      subcutaneous administration of INS-PCLA-MP 12 u.kg-1, the hypoglycaemic effect
      was significant. The PBA of INS-PCLA-MP was 123.08%. CONCLUSION: PCLA might
      become a new drug carrier material in the future.

PMID- 11218866
TI  - [Study on preparation and biodistribution of PEG-immunoliposomes with active
      carboxylic terminals].
AB  - AIM: In order to accumulate into its target specifically, the immunoliposomes
      must possess two characteristics: specific target efficiency to its target cells
      and prolonged circulation in blood. A new type of polyethylene glycol (PEG)
      immunoliposomes carrying monoclonal antibodies at the distal end of PEG chains
      should be developed. METHODS: A dipalmitoylphosphatidylethanolamine (DPPE)
      derivative of PEG with carboxyl group (DPPE-PEG3000-COOH) was newly synthesized.
      Small unilamellar liposomes were prepared from egg phosphatidyl choline and
      cholesterol (5:4, mol/mol) containing 6 mol% DPPE-PEG3000-COOH using reverse
      phase evaporation method followed with bath sonication. Monoclonal antibody of
      human bladder cancer cell (BDI-1), which is highly specific to human bladder
      cancer cell, was conjugated to PEG-liposomes as well as mouse IgG at the distal
      end of polyethylene glycol chain. Doxorubicin was entrapped into these
      immunoliposomes by remote (NH4)2SO4 gradient loading method. The specific
      targeting efficiency of these immnoliposomes was tested by cytotoxicity test in
      vitro, enzyme-linked immune sorbent assay (ELISA) and indirect fluorescent
      immunoassay. Its biodistribution was carried out in mice. RESULTS: The specific
      targeting efficiency of BDI-1 immunoliposomes (BDI-1-IML) to EJ cells has been
      demonstrated, in contrast to the nonspecific human colon carcinoma cells (LOVO).
      PEG-liposomes linked with mouse IgG (mouse-IgG-immunoliposomes, IgG-IML)
      displayed lower reticulo-endothelial systems (RES) uptake and longer circulation
      time than liposomes without PEG after intravenous injection. CONCLUSION: The long
      circulation of these PEG-immunoliposomes in vivo, combined with its specific
      targeting efficiency demonstrated in vitro, guarantees the positive targeting
      efficiency of these immunoliposomes to its target carcinoma in vivo.

PMID- 11218867
TI  - [Antifungal effect of three natural products on the genetic substance of
      Saccharomyces cerevisiae GL7 and Prototheca wickerhamii].
AB  - AIM: To investigate the antifungal effect of three natural products on the
      genetic substance of Saccharomyces cerevisiae GL7 and Prototheca wickerhamii.
      METHODS: The normal and treated cells were observed by confocal laser scanning
      microscope (CLSM) and image analysis to quantitatively described the cell
      morphology, area, DNA and RNA content. RESULTS: The morphology, area, DNA and RNA
      contents were changed greatly in the treated cells. CONCLUSION: Solasodine, 4'
      hydroxy-3, 5-dimethoxystilbene and dictamnine directly or indirectly interfered
      the synthesis and function of genetic substance in S. cerevisiae and P.
      wickerhamii.

PMID- 11218868
TI  - [Selective isolation of isopsoralen from crude extract of Psoralea corylifolia. L
      by using inclusion method of host-guest molecules].
AB  - AIM: To isolate the chemical components from extracted crude of Psoralea
      corylifolia L. METHODS: Applicate the function of molecular recognition in
      supramolecular chemistry, use 1,1,6,6-tetraphenylhexa-2,4-diyne-1,6-diol as the
      host molecule and chemical components in extracted crude of Psoralea corylifolia
      L. as guest molecules, which represent different from either in sort, quantity
      and sites of function groups or in structural topological character, 1,1,6,6
      tetraphenylhexa-2,4-diyne-1,6-diol could selectively form inclusion compound with
      component endowed with interactional complementarity and isolate as crystalline
      from the extracted crude of Psoralea corylifolia L. RESULTS: The isopsoralen as
      guest molecule is selectively included by 1,1,6,6-tetraphenylhexa-2,4-diyne-1,6
      diol in inclusion crystal and removed by acetone from the inclusion compound and
      total yield is 0.18%. Isopsoralen is determined by UV, IR, 1HNMR and MS and its
      inclusion compound is determined by means of IR, powder XRD and single crystal
      XRD. The isolation effect is analyzed by GC/MS. CONCLUSION: The method is simple
      and selective for isolation isopsoralen from extracted crude of Psoralea
      corylifolia L.

PMID- 11218870
TI  - [Comparison between colorimetry and HPLC on the stability test of roxithromycin].
AB  - AIM: To compare the stability of roxithromycin in solutions of different pH.
      METHODS: Roxithromycin solutions of different pH were prepared with water,
      simulate intestinal fluid (SIF) and simulate gastric fluid (SGF) shown to be the
      stability of these solutions were tested by colorimetry and HPLC. RESULTS:
      Roxithromycin was stable in water, SGF and SIF determined by colorimetry.
      However, it was found to be stable only in water and SIF but unstable in SGF as
      determined by HPLC. CONCLUSION: Roxithromycin is unstable in acidic medium like
      SGF. The metabolite of roxithromycin showed unfavorable interference on the assay
      of roxithromycin when colorimetry was used. Colorimetry can not be used for the
      determination and assay of roxithromycin in acidic solution like SGF.

PMID- 11218869
TI  - [Determination of ecdysterone in Achyranthes bidentata Bl. and its activity
      promoting proliferation of osteoblast-like cells].
AB  - AIM: To study the activity of ecdysterone from Achyranthes bidentata Bl. (AB)
      promoting proliferation of osteoblast-like (OB-like) UMR106 cells and to
      determine its content in AB by HPLC method. METHODS: Ecdysterone isolated from AB
      was cultured with OB-like cells UMR106 together in vitro and the proliferation of
      OB-like cells was determined by MTT assay. The chromatographic conditions for
      determining ecdysterone included an ODS column (250 mm x 4.6 mm, 5 microns), a
      mobile phase consisting of a mixture of water-acetontrile-tetrahydrofuran
      (86:11:3), detection wavelength of 243 nm, and column temperature of 27 degrees
      C. Phenacetin was used as the internal standard. RESULTS: The ecdysterone from AB
      had significant activity promoting proliferation of OB-like cells, the
      proliferation was promoted by 41% (n = 3). The average recovery of ecdysterone
      was 96.2% (RSD = 2.1%), the calibration was linear in the range of 30-300
      micrograms.mL-1 (gamma = 0.9998). CONCLUSION: Ecdysterone was screened quickly by
      cultivating with OB-like cells together in vitro. The HPLC method is accurate,
      fast and reproducible for the determination of ecdysterone in AB.

PMID- 11218871
TI  - [Progress in studies on small molecule cytokine mimetics].

PMID- 11218872
TI  - [Evaluation of immune prophylaxis of recombinant urease subunit of Helicobacter
      pylori].
AB  - OBJECTIVE: To evaluate the immune prophylaxis of recombinant urease subunit A or
      B (rUreA or rUreB). METHODS: The BALB/C mice were divided into seven groups:
      negative control group, control group with CTB, control group with rUreA, control
      group with rUreB, experimental group with rUreA + CTB and experimental group with
      rUreB + CTB, experimental group with sonicate + CTB, which were gastrically
      inoculated with 150 ml PBS, 5 micrograms CTB, 50 micrograms rUreA, 50 micrograms
      rUreB, 50 micrograms rUreA + CTB, 5 micrograms rUreB + CTB and 400 micrograms
      sonicate + 5 micrograms CTB, respectively. Two weeks later, the mice were
      gastrically infected with H. pylori (10(7)-10(8) CPU per time). 4, 8 and 12 weeks
      later, the mice were killed and the immune protection of PBS, CTB, rUreA, rUreB,
      rUreA + CTB, rUreB + CTB and sonicate + CTB were evaluated by the presence of H.
      pylori in gastric tissue stained with Giemsa by microscopy. The mice in the side
      effecting groups of rUreA + CTB and rUreB + CTB were not infected with H. pylori.
      12 weeks later, the mice in the two groups were killed, and the side effects of
      rUreA + CTB and rUreB + CTB were evaluated by the infiltration of inflammation
      cells in gastric tissue stained with HE by microscopy. RESULTS: The mice
      gastrically inoculated with CTB, rUreA or rUreB had significantly less H. pylori.
      The immune protective effect of rUreA, rUreB or sonicate of H. pylori combined
      with CTB was stronger than that of rUreA, rUreB or sonicate of H. pylori alone.
      The immune protective effect of rUreA + CTB occurred later than that of rUreB +
      CTB or sonicate of H. pylori + CTB. The mice immunized with rUreA + CTB, rUreB +
      CTB or sonicate of H. pylori + CTB were not completely protected against H.
      pylori infection. The mice immunized with rUreA + CTB, rUreB + CTB or sonicate of
      H. pylori + CTB were less infected with H. pylori, and had mild inflammation of
      gastric tissue. CONCLUSION: Mice immunized with rUreA + CTB, rUreB + CTB or
      sonicate of H. pylori + CTB could not be completely protected against H. pylori
      infection and have alleviated inflammation of gastric tissue.

PMID- 11218874
TI  - [Evaluation and comparison of the Helicobacter pylori stool antigen test and the
      gastric mucosal antigen test].
AB  - OBJECTIVE: To evaluate the reliability of an enzyme-linked immunosorbent assay by
      the Helicobacter pylori (H. pylori) stool antigen test for the detection of H.
      pylori infection. METHODS: Stool specimens were collected from 224 patients who
      received upper gastrointestinal endoscopic examination for gastrointestinal
      symptoms. H. pylori status was evaluated by five different tests: culture,
      histology, biopsy rapid urease test, H. pylori stool antigen test, and H. pylori
      gastric active mucosal antigen test (parts of the patients). A commercial kit
      using an enzyme-linked immunosorbent assay was used to examined H. pylori antigen
      in the stool or in the gastric active mucosa. H. pylori status was defined as
      positive when two of the three tests (culture, histology and biopsy rapid urease
      test) were positive. RESULTS: 137 patients were diagnosed as H. pylori-positive.
      The H. pylori stool antigen test was positive in 143 patients and negative in 81
      patients. The sensitivity and specificity were 96.4% and 87.4%, respectively. The
      overall accuracy was 92.9%. 39 patients were examined H. pylori antigen in the
      gastric active mucosa, and 27/39 were diagnosed as H. pylori-positive. The H.
      pylori gastric active mucosal antigen test was positive in 28 patients and
      negative in 11 patients. The H. pylori stool antigen test was positive in 30
      patients and negative in 9 patients. The corresponding rate between gastric
      active mucosa and stool was 94.9%. CONCLUSION: The H. pylori stool antigen test
      is a simple, non-invasive method for accurate diagnosis of H. pylori infection.

PMID- 11218873
TI  - [The evaluation of cagA and other vaccine candidate proteins of Helicobacter
      pylori on T cell apoptosis mediated by Fas/Fas ligand interaction].
AB  - OBJECTIVE: To evaluate the effect of several surface proteins of Helicobacter
      pylori (H. pylori) on inducing apoptosis of T cells through the modulation of
      Fas/Fas ligand (FasL) interaction and to provide information on the screen of
      safe and effective immunogen for H. pylori vaccine. METHODS: T cell apoptosis
      induced by cagA+ and isogenic cagA knockout strain, recombinant urease, HpaA and
      outer membrane proteins, Hop25, Hop35 and Hop38 was detected by JAM assay. Flow
      cytometry was used to evaluate the increase in FasL expression on T cells under
      the stimulation of these bacterial proteins. Metalloprotease inhibitor, 1, 10
      Phenanthroline (PHE) and protein synthesis inhibitor, emetine, were used to
      change the activity of FasL to confirm the association of FasL with H. pylori
      mediated killing toward T cells. RESULTS: The effect of cagA+ H. pylori was
      stronger in both the induction of apoptosis and FasL expression of T cells than
      that of cagA knockout strain. H. pylori urease could not kill T cell, while Hop38
      had the strongest effect among the tested H. pylori proteins on the induction of
      T cell apoptosis through increasing FasL expression. Metaloprotease inhibitor
      could increase the killing of T cells induced by H. pylori because of its ability
      to prevent the cleavage of membrane-bound FasL protein. On the other hand,
      emetine could decrease H. pylori mediated killing by inhibiting of FasL synthesis
      on T cells. CONCLUSION: cagA and Hop38 protein might be involved in the negative
      regulation of T cell growth through upregulating FasL expression urease and other
      Hop proteins tested might be safe and effective to be used as the antigens for H.
      pylori vaccine.

PMID- 11218875
TI  - [Variable number of tandem repeats as an evidence of engraftment status after
      allogeneic peripheral blood stem cell transplantation].
AB  - OBJECTIVE: To evaluate engraftment status of patients after allogeneic peripheral
      blood stem cell transplantation (allo-PBSCT) based on red blood cell type,
      karyotype and variable number of tandem repeats (VNTR). METHODS: Amplification of
      3 loci of VNTR in vitro by polymerase chain reaction (PCR) was preformed to
      detect the polymorphism of 15 patients post-PBSCT. Furthermore, analysis of
      karyotype in 7 sex-mismatched patients and red blood cell antigen switching in 3
      ABO blood type mismatched patients were also employed. RESULTS: VNTR analysis in
      15 patients revealed complete chimerism in 11 patients and mixed chimerism in 4.
      In the 7 sex-mismatched patients, karyotype analysis showed types of their
      donors. As for blood type analysis, it was after 2 months that the first patient
      transformed to his donor's type. One patient showed mixed status 7 months after
      transplantation. CONCLUSION: Amplification of VNTR loci by PCR for documenting
      engraftment status after allo-PBSCT is simple and sensitive. This technology is
      especially suitable for patients who have received stem cells with the same sex,
      same blood type and identical HLA type. Examination with several different VNTR
      loci will improve the power of discrimination.

PMID- 11218876
TI  - [Histological and ultrastructural characteristics of interface membrane around
      aseptically loosened prostheses].
AB  - OBJECTIVE: To investigate the effect of wear particles on prosthetic loosening by
      analyzing the histological and ultrastructural characteristics of interface
      membrane around aseptically loosened prostheses. METHODS: Slices of interface
      membranes around aseptically loosened hip prostheses of 51 cases were stained
      with HE, Safranin O-Briliant green and CD68 Mab immunohistochemical technique
      respectively. The histological structure of the membranes and the kinds of wear
      particles and their distribution characters were observed. The size of particles
      and the number of CD68 positive cells were measured. Ultrastructure of cells in
      the membrane and the characters and size of the particles phagocytozed by M phi
      were also observed and measured. RESULTS: Interface membrane consisted of
      fibromatrix, fibroblasts, M phi[CD68 positive, occupying (23 +/- 5)% (x +/- s)],
      and foreign body giant cells. In the membranes at the site of osteolysis, great
      amount of UHMWPE particles, PMMA particles and Ti alloy or CoCr alloy particles
      collected at the side attaching to the implant and caused chronic foreign body
      inflammatory reaction. Most of the particles outside M phi were less than 15
      microns while that inside M phi were less than 1 micron. Different kinds of wear
      particles could exist in the lysosomes of one M phi. No particles but cartilage
      like tisses appeared in the membranes at the site without osteolysis. CONCLUSION:
      Wear particles in the interface membrane have relations with osteolysis and
      fibrous tissue proliferation at bone-implant interface, which plays an important
      role in aseptic loosening.

PMID- 11218877
TI  - [The expression of platelet-derived endothelial cell growth factor in liver
      cancer].
AB  - OBJECTIVE: To investigate the expression of platelet-derived endothelial cell
      growth factor (PD-ECGF) in liver cancer and explore its related intervention with
      Capecitabine for the growth and metastasis of liver cancer. METHODS: The protein
      level of PD-ECGF was determined using immunohistochemical method in 61 HCC
      samples and the mRNA level was detected using Northern blot analysis.
      Capecitabine was administered orally in 24 nude mice bearing LCI-D20 tumor. All
      treatments lasted 3 weeks. The tumor size was calculated by the following
      formula: V = a x b2 x 0.5. Lung metastasis was evaluated by HE staining in lung
      samples. RESULTS: The PD-ECGF expression rate in 61 HCC and paratumoral liver
      tissues was 70.5% and 47.5%, respectively. The rate was higher in HCC tissues
      with advanced TNM stage than in those with early TNM stage (81.1% vs 54.2%, P <
      0.05). The mRNA level of PD-ECGF was related well to its protein expression. The
      tumor size on day 3 after last treatment measured in the control, and low dose
      (1.05 mmol.kg-1.day-1), moderate dose (2.10 mmol.kg-1.day-1) and high dose (3.15
      mmol.kg-1.day-1) of Capecitabine treatment groups was 447 mm3 +/- 159 mm3, 414
      mm3 +/- 97 mm3, 240 mm3 +/- 119 mm3 and 209 mm3 +/- 150 mm3, respectively. High
      doses of Capecitabine increased the inhibitory effect on the growth and lung
      metastasis of HCC implant. CONCLUSION: PD-ECGF is highly expressed in HCC and
      correlates with the TNM staging. Capecitabine may inhibit the growth and
      metastasis of HCC.

PMID- 11218878
TI  - [Prospective study on the relationship between treatment duration of antithyroid
      drug and remission rate of Graves' disease].
AB  - OBJECTIVE: To compare the potential benefits of 36-month treatment with 6- and 18
      month treatment of antithyroid drug in patients with hyperthyroidism due to
      Graves' disease (GD). METHODS: 183 GD patients were studied prospectively. All
      patients received methimazole (MMI) at decreasing doses for 6, 18 or 36 months.
      The relapse rates 18 months after MMI withdrawal were compared between the three
      therapy groups. RESULTS: The relapse rate 18 months after the discontinuation of
      treatment was higher in patients treated for 6 months than in those treated for
      18 or 36 months. There was no significant difference between 18-month and 36
      month treatment groups. At the end of therapy, serum thyroid stimulating antibody
      (TSAB) and TSH receptor antibody (TRAB) titers were greater in patents treated
      for 6 months (320 +/- 191 for TSAB and 8.72 +/- 5.23 for TRAB) and 18 months (165
      +/- 87 and 4.55 +/- 4.17) than in those treated for 36 months (126 +/- 77 and
      2.19 +/- 2.64), but no statistical difference was found between the three groups
      before MMI treatment. TSAB and TRAB titers were higher in patients who relapsed
      after discontinuation of MMI (287 +/- 94 and 6.14 +/- 2.37, respectively)
      compared with those who remained euthyroid through the 18-month follow-up period
      (144 +/- 61 and 1.97 +/- 1.06). CONCLUSIONS: Negative TSAB or TRAB at the end of
      antithyroid therapy is a good indicator for a long-term remission after treatment
      withdrawal. However, treatment duration greater than 18 months does not improve
      remission rate of GD.

PMID- 11218879
TI  - [Genetic polymorphism analysis of apoE intron 1 enhancer in patients with
      coronary heart disease and the association with serum lipid level].
AB  - OBJECTIVE: To investigate the association between the polymorphism of
      apolipoprotein E (apoE) intron 1 enhancer (IE1) and the level of serum lipid in
      patients with coronary heart disease (CHD). METHODS: ApoE IE1 genotypes of 81
      patients with CHD and 108 healthy subjects were detected by polymerase chain
      reaction and restriction fragment length polymorphism. RESULTS: The frequency of
      G/G genotype in patients with CHD was significantly higher than that in control
      group (P < 0.05). The frequency of G allele was significantly higher in patients
      than in control group (P < 0.05). The gene polymorphism of apoE IE1 obviously
      influenced the serum lipid levels. The concentrations of TC, and LDL-C among
      different genotype groups were significantly different, and the level in G/G
      group was higher than that in C/C group (P < 0.05). CONCLUSION: ApoE IE1 gene
      polymorphism is closely related to serum lipid, and G/G genotype of apoE IE1 may
      be a risk factor of coronary heart disease in Han Chinese.

PMID- 11218880
TI  - [Selected CD34+ cells transplantation: a primary clinical report].
AB  - OBJECTIVE: CD34+ is an immunophenotype of hematopoietic stem cells/progenitors.
      CD34+ cells selection in vitro may deplete T-cells 4-5 logs and tumor cells 3-4
      logs. It will benefit to mismatched related donor allo-transplantation and
      autologous transplantation of tumor diseases. METHODS: 19 patients aged 29 (5-52)
      years were treated by allo- (n = 5) or auto-PB CD34+ cells transplantation (n =
      14). Grafts from fifteen patients with various disorders (3 lymphomas, 6 multiple
      myelomas, 2 SLE, 1 Sjogren's syndrome, 2 breast cancer and 1 medulloblastoma) and
      five haploidentical donors for leukemia patients (1 ALL-CR2, 2 AML-rel, 1 CML-CP
      and 1 MDS-RAEB) were isolated using magnetic-activated cell sorting (CliniMACS,
      Milteny Biotech, Germany). RESULTS: After separation, purity of CD34+ cells was >
      97%. Depletion of CD34 negative cells was extensive: CD3+ 2.6-4.6 logs, CD4+ > 5
      logs, CD8+ 4.6-> 5 logs, and CD19+ 1.2-3.1 logs. 19 patients who received
      selected CD34+ cells transplantation (CD34+ CT) were followed up for 11(1-20)
      months. Overall survival(OS) was 13/19 (68.4%) cases. 1/5 patients with
      haploidentical transplant had disease free survival for 19 months. 12/14(85.7%)
      auto-CD34+ CT achieved overall survival(OS). CONCLUSION: Selected CD34+ cells
      transplantation significantly decreases the incidence of > II GVHD and depletes
      tumor cell contamination. This approach may be useful to haploidentical or
      unrelated donor transplantation. It also benefits autologous transplant in
      various tumor disorders.

PMID- 11218883
TI  - [Diagnosis and treatment of neoplasms involving the cranio-orbital region].
AB  - OBJECTIVE: To study the diagnosis and microneurosurgical treatment of neoplasms
      involving the cranio-orbital region. METHODS: Clinical manifestations,
      neuroradiological features, operative technique and postoperative complications
      in 16 cases of cranio-orbital region neoplasms were reviewed. RESULTS: Total
      resection was achieved in 5 cases, and subtotal resection in 8 cases. No
      operative death was observed. CONCLUSION: The neoplasms involving the cranio
      orbital region are uncommon. Total resection is difficult in most cases.
      Postoperative complications are severe and should be avoided if possible.

PMID- 11218882
TI  - [Influence of mannitol on early enlargement of hematoma in hypertensive cerebral
      hemorrhage].
AB  - OBJECTIVE: To probe into the influence of mannitol on early enlargement of
      hematoma in hypertensive cerebral hemorrhage, and to discuss how to use mannitol
      correctly. METHODS: 93 patients with hypertensive supratentorial non-thalamic
      cerebral hemorrhage and light intracranial hypertension, and with less than 30 ml
      of hematoma volume determined by cranial CT within 6 h after the onset were
      randomly divided into a group in which mannitol was used (n = 46) or a group in
      which mannitol was not used (n = 47) within 24 h. Cranial CT was redone at 48 h.
      If the volume of hematoma increased by 33%, it was named early enlargement of
      hematoma. The influence of using mannitol within 24 h after the onset on early
      enlargement of hematoma was analyzed. RESULTS: 14(14/46) patients in the group in
      which mannitol was used within 24 h after the onset had early enlargement of
      hematoma, yet 4(4/47) patients in the group without mannitol had hematoma
      enlargement. There was significant difference between them (P < 0.01). No
      significant difference was seen between the integral of nerve function defect in
      the two groups when CT was done at the first time (P > 0.05). When CT was redone,
      the integral of nerve function defect in the group with mannitol used within 24 h
      was markedly higher than that in the group without mannitol (P < 0.05). 5(5/46)
      patients died in the former group and 1(1/47) in the latter. CONCLUSION: Improper
      use of mannitol within 24 h after the onset may increase the incidence of early
      enlargement of hematoma in patients with hypertensive cerebral hemorrhage, and
      exacerbate the patient's condition. For patients with hypertensive cerebral
      hemorrhage with light intracranial hypertension, especialy those within 24 h
      after the onset, mannitol should not be used blindly, in case that it enlarges
      the hematoma and exacerbates patient's condition.

PMID- 11218881
TI  - [Signal transduction and biological function of IL-6 in a human myeloma cell line
      XG-7].
AB  - OBJECTIVE: To investigate the relationship between IL-6 signal transduction and
      its biological function on a human IL-6-dependent myeloma cell line-XG-7.
      METHODS: Electrophoretic mobility shift (EMSA) and immunopeipitation were used
      respectively to detect the activation of transcription factors (STAT3 and NF-IL
      6) and protein kinases (JAK1 and ERK) in the two IL-6 signal transduction
      pathways by IL-6 in XG-7 cells. Then the cells were transfected with the sense or
      anti-sense expression plasmids of the transcription factors, which could up- or
      down-regulate the activation of the signal transduction pathways specially, the
      changes of the biological function of IL-6 on XG-7 cells was shown by cell number
      counting and MTT. RESULTS: IL-6 can promote the proliferation of XG-7 cells and
      activate one of the IL-6 signal transduction pathway-Ras/NF-IL-6; but Jak/STAT
      signal transduction pathway was not activated at the same conditions. When the
      activation of Ras/NF-IL-6 pathway was up- or down-regulated, the growth effect of
      IL-6 on XG-7 cells was strongthened or weakened. CONCLUSIONS: The proliferation
      of XG-7 cells in the presence of IL-6 is mediated by the activation of Ras/NF-IL
      6 signal transduction pathway.

PMID- 11218884
TI  - [The expression of CD15 mRNA CD44v6 mRNA and nm23H1 mRNA in breast cancer and
      their clinical significance].
AB  - OBJECTIVE: To study the relationship of the expression of CD15 mRNA and its
      protein, CD44v6 mRNA and nm23H1 mRNA with the clinical pathology parameter and
      prognosis of breast cancer, and to investigate the correlation of the expression
      of CD15 mRNA with CD44v6 mRNA and nm23H1 mRNA. METHODS: Catalyzed signal
      amplification (CSA) method of in situ hybridization and immunohistochemistry were
      used to detect the expression of CD15 mRNA and its protein, CD44v6 mRNA and
      nm23H1 mRNA in 94 cases of breast cancer. RESULTS: The overexpression of CD15
      mRNA and its protein and CD44v6 mRNA and the low expression nm23H1 mRNA were
      correlated with the grading, clinical stage, lymph node metastasis, recurrence
      and prognosis of breast cancer. Patients who had overexpression of CD15 mRNA and
      CD44v6 mRNA and low expression of nm23H1 mRNA had a higher lymph node metastatic
      rate and a lower survival rate. CONCLUSION: The expression of CD15 mRNA has a
      synergistic action in positive and negative regulation with that of CD44v6 mRNA
      and nm23H1 mRNA. Combining detection of the expression of these three mRNA is a
      reliable index to evaluate the metastasis, recurrence and prognosis of breast
      cancer.

PMID- 11218885
TI  - [Inhibition of human glioma growth in nude mice by local secretion of angiostatin
      K(1-3)].
AB  - OBJECTIVE: To discuss the feasibility of human glioma therapy by the local
      secretion of angiostatin K(1-3)[AK(1-3)]. METHOD: AK(1-3) cDNA with secretive
      signal was inserted into polylinker sites of eukaryotic expression vector pcDNA3
      to construct pcDNA-SAK(1-3); The vector was transfected into human glioma SHG44
      cells by lipofectamine and the positive clone was screened by G418. The
      biological characters of glioma cells were examined with electron microscopy and
      FCM. The activity of AK(1-3) protein expressed by the SHG44 cells was examined by
      the endotheliocyte inhibition assay and immunofluorescence assay. When the tumor
      cells were implanted into nude mice, the tumor necrosis and micrangium was
      calculated by immunohistochemistry and electron microscopy in order to determine
      the influence of AK(1-3) protein to the human glioma growth. RESULTS: The pcDNA
      SAK(1-3) vector was successfully constructed and transfected into glioma cells
      that could express AK(1-3) protein. The tumorigenesis and angiogenesis of glioma
      cells in nude mice were greatly reduced (tumour end volume, experiment group 170
      mm3, control group 8 120 mm3, P < 0.01; Blood vessel counting, experimental group
      5.4, control group 12.2, P < 0.01). CONCLUSION: The human glioma angiogenesis and
      growth were inhibited by the local secretion of AK(1-3). It can be further used
      in the treatment of other solid tumors.

PMID- 11218887
TI  - [Study on COL7A1 gene mutation in a epidermolysis bullosa pruriginosa family].
AB  - OBJECTIVE: To identify gene mutation of a epidermolysis bullosa pruriginosa
      family. METHODS: Polymerase chain reaction (PCR), DNA sequencing, multiplex PCR
      using allele-specific oligonucleotide primers. RESULTS: A G6100A transition of
      COL7A1 was found in patients, resulting in G2034R substitution in type VII
      collagen. The mutation was not found in control normal individuals. CONCLUSION:
      The mutation of G2034R is the underlying cause of epidermolysis bullosa
      pruriginosa in this family, not common polymorphism.

PMID- 11218886
TI  - [A study of human breast carcinoma xenografts in nude mice].
AB  - OBJECTIVE: To study the spontaneous metastasis and the genetic stability of human
      breast carcinoma xenografts in nude mice and its micrometastasis. METHODS: The
      intact tissue of surgical specimens from breast carcinoma were xenografted into
      nude mice and transplanted from generation to generation. Cells from the
      xenografts were cultured in vitro and retransplanted into nude mice.
      Microsatellite DNA in genome of human breast carcinoma, xenotransplanted tumors
      and metastases in nude mice were analysed at three microsatellite loci. RESULTS:
      The tumorigenicity of orthotopic xenotransplantation was 88.6%(31/35) with a
      metastasis rate of 41.9%(13/31). Cells from the xenografts were cultured in vitro
      successfully, both the take rate of retransplantation into nude mice and the
      spontaneous lung metastasis rate were 100%(10/10). Microsatellite DNA sequences
      in genome of the xenotransplanted tumors and metastases in nude mice were
      identical with that of the original human breast carcinoma at the three
      microsatellite loci. CONCLUSIONS: The tumorigenicity and metastasis potential can
      be improved in human breast carcinoma xenograft using the intact fresh tumor
      tissue and orthotopic graft. The xenotransplanted tumors and their passaged
      tumors maintained the genetic stability. The detection of microsatellite DNA may
      discover micrometastasis in the nude mice model.

PMID- 11218888
TI  - [Neutrophil activation in pathogenesis of preeclampsia].
AB  - OBJECTIVE: To investigate the effect of neutrophil activation on pathogenesis of
      preeclampsia. METHODS: In 22 pregnant women with preeclampsia and 21 normal
      pregnant women at third trimester, neutrophil activation was examined by flow
      cytometry to assess the CD11b expression, and the levels of plasma endothelin-1
      (ET-1) and serum NO2- were also measured with no-equilibrium radio-immunoassay
      and with Griess assay respectively. RESULTS: The expression of neutrophil CD11b
      was significantly elevated in women with preeclampsia compared with that of
      normal pregnant women at third trimester [the mean fluorescence index of CD11b
      were 439.1 +/- 169.1 and 321.2 +/- 166.3 respectively, P < 0.05], the plasma ET-1
      level and serum NO2- concentration in preeclampsic women [(61.4 +/- 48.2) ng/L
      and (20.4 +/- 5.2) mumol/L, respectively] were both significantly increased
      compared with those in the normal pregnancy women [(29.3 +/- 20.9) ng/L and (15.5
      +/- 4.8) mumol/L, respectively], (P < 0.01). The mean fluorescence index of CD11b
      was significantly correlated with plasma ET-1 level and serum NO2- concentration
      (r = 0.312 and 0.382, respectively, P < 0.05). But the correlation between the
      plasma ET-1 level and serum NO2- concentration was not found (r = 0.227, P >
      0.05). CONCLUSIONS: The neutrophil CD11b expression is significantly elevated in
      preeclampsia. The increased neutrophil activation may cause the damage of
      vascular endothelium and result in compensatory increase of NO release in
      endothelial cells. It suggests that the neutrophil activation may play a key role
      in pathogenesis of preeclampsia.

PMID- 11218889
TI  - [Clinical significance of beta-hCG and human placental lactogen in serum of
      normal pregnancies and patients with pregnancy induced hypertension].
AB  - OBJECTIVE: To examine the level of beta-hCG and Human Placental Lactogen (HPL) in
      maternal serum of normal pregnancies and patients with pregnancy induced
      hypertension (PIH) and to study the clinical significance and effects of them on
      the pathogenesis of the disease. METHODS: Serum levels of beta-hCG and HPL of 142
      normal pregnant women and 43 patients with PIH (16 mild, 12 moderate and 15
      severe) were determined by radioimmunossay. RESULTS: (1) Serum levels of beta-hCG
      in all PIH subgroups [(25.33 +/- 17.80) micrograms/L in mild, (33.12 +/- 4.91)
      micrograms/L in moderate, (42.19 +/- 17.47) micrograms/L in severe] were
      significantly higher than the normal pregnant group [(12.33 +/- 7.92)
      micrograms/L; P < 0.001]. There is positive correlation between levels of beta
      hCG and degrees of PIH (r = 0.677, P < 0.05). (2) Serum levels of HPL in all PIH
      subgroups [(14.73 +/- 3.26) mg/L in mild, (11.44 +/- 4.02) mg/L in moderate,
      (12.73 +/- 4.18) mg/L in severe] did not show significant difference when
      compared with that of normal pregnant group [(12.78 +/- 4.67) mg/L; P > 0.05].
      Furthermore, there was no correlation between levels of HPL and degrees of PIH (r
      = -0.300, P > 0.05). CONCLUSIONS: Serum beta-hCG could reflect the degree of
      functional imbalance of the placental trophoblasts on PIH and it may be used as a
      clinical detecting index of PIH. On the other hand, HPL is not such a useful
      factor.

PMID- 11218890
TI  - [Clinical study on morphological characteristics of placenta in severe pregnancy
      induced hypertension].
AB  - OBJECTIVE: To study morphological characteristics of placenta in severe pregnancy
      induced hypertension (SPIH) and its relationship to pregnant outcome. METHODS:
      Morphological changes were observed by light microscopy; Blood biochemical
      analyses were used to predispose pregnant outcome. RESULTS: Difference in
      pathological changes of placental bed between normal term pregnancy (NTP) and
      SPIH groups was significant: the placental weight, proliferation of
      cytotrophoblasts, numbers of the placental villi with syncytial knots, thickness
      of basal lamina, fibrinoid necrosis and deposition of matrix, stromal edema and
      fibrosis of villi, the vascular numbers of villi, stasis; lack of physiologic
      changes in decidual spiral arteries. Clinical examination showed that the rate of
      anemia, thrombocytopenia, blood concentration, hypoproteinemia, ascites, eye
      ground artery spasm in SPIH were higher in NIT. CONCLUSIONS: Pathological changes
      of placenta play important roles in development of SPIH, and the pathological
      changes are paralleled with the severity of the disease.

PMID- 11218891
TI  - [Study on hepatitis B virus infection status in placentas of hepatitis B surface
      antigen positive pregnant women during middle and late period of pregnancy].
AB  - OBJECTIVE: To investigate Hepatitis B Virus (HBV) infection status in placentas
      of Hepatitis B Surface Antigen (HBsAg) positive pregnant women during middle and
      late period of pregnancy. METHODS: One hundred and sixty-seven placentas from
      HBsAg positive pregnant women were collected, including 158 term placentas and 9
      aborted second-trimester placentas. HBsAg and hepatitis B core antibody (HBcAg)
      in placental cytotypes were detected by immunohistochemistry. RESULTS: Of the 158
      term placentas, HBV infection rates in decidual cells (DC), trophoblastic cells
      (TC), villous mesenchymal cells (VMC) and villous capillary endothelial cells
      (VCEC) were 66.46% (105/158), 58.23% (92/158), 27.22% (43/158) and 12.66%
      (20/158), respectively. The HBV infection rates gradually decreased from maternal
      side to fetal side of placentas. Both HBsAg and HBcAg were mainly located in the
      cytoplasm of infected cells. The positive cells were mostly in focal
      distribution. One out of 9 aborted second-trimester placentas was infected.
      CONCLUSIONS: HBV infection was found in different cells of term placentas. The
      positive rates for HBsAg and HBcAg in placentas were gradually decreased from
      maternal side to fetal side. The positive rate was low in aborted second
      trimester placentas.

PMID- 11218892
TI  - [Effects of tumor necrosis factor-alpha on proliferation and intracellular free
      calcium concentration in endothelium of human umbilical vein endothelial cells].
AB  - OBJECTIVE: To Observe the effects of tumor necrosis factor-alpha (TNF-alpha) on
      cell proliferation and Intracellular free calcium concentration ([Ca2+]i) in
      endothelium of human umbilical vein endothelial cells (HUVEC) and investigate the
      pathogenesis of pregnancy induced hypertension syndrome (PIH). METHODS: Confluent
      monolayer of HUVEC was directly incubated with TNF-alpha at following final
      concentrations: 500, 1,000, 2,000 U/ml for 24 hours. The percentages of different
      cellcycles and [Ca2+]i were measured by flow cytometry and
      fluorospectrophotmetry. RESULTS: Incubated with TNF-alpha, the endothelial cells
      were elongated and transformed into fibroblast-like cells. Border of nucleus was
      sharp, clarity, and cells were in regular shape. But there were abnormal granules
      in cytoplasma and some cells detached at the concentrotion of 2,000 U/ml of TNF
      alpha. Stimulated by TNF-alpha, the percentage of cellcycles from phase G0 + G1
      to S and G2 + M decreased significantly and it was dose-dependent [Ca2+]i
      increased significantly and dose-dependent as well. CONCLUSION: TNF-alpha may
      injure endothelium directly and inhibit its proliferation and repair through the
      changes of [Ca2+]i level. It may play an important role in the pathogenesis of
      PIH.

PMID- 11218893
TI  - [Clinical study on postpartum depression and its related factors].
AB  - OBJECTIVE: The prevalence rate, related factors and clinical characteristics of
      postpartum depression were studied in order to promote obstetrician's
      understanding of the disease, and resort to preventive and therapeutic measure
      earlier. METHODS: Two hundred and ten puerpera were selected from September to
      November 1998 for mood study by self-rating depression scale, self-rating anxiety
      scale, Hamilton depression scale, and self-made questionnaires. RESULTS: The
      prevalence rate of postpartum depression was 37.14% (78/210), of which, 91.03%
      (71/78) was mild, and 8.97% (7/78) moderate. In addition, 10.48% (22/210) of
      women got anxiety after delivery. The symptoms, including decreased activity,
      difficulty in thinking, problems in decision-making, difficulty in doing things,
      feeling of uselessness and hopelessness were chief complaints of postpartum
      depression patients. Bad social behavior and mood controlling, inadequate
      psychological preparation for delivery, lack of knowledge of delivery were
      closely correlated to the onset of postpartum depression, which are the risk
      factors of postpartum depression. CONCLUSIONS: Postpartum depression is a
      spiritual and psychological obstacle with relatively high prevalence rate. Bad
      social psychological factors can bring out and aggravate postpartum depression.
      It is important to carry out prenatal psychological care and to propagate the
      knowledge of delivery, to find out and cure of postpartum depression as soon as
      possible.

PMID- 11218894
TI  - [Treatment of intrauterine growth retardation with magnesium sulfate].
AB  - OBJECTIVE: To study the relationship between magnesium level in umbilical vein
      and mother's peripheral blood with intrauterine growth retardation (IUGR) and
      fetal weight. METHODS: 39 pregnant women with IUGR were randomly divided into 3
      groups: Group 1 (n = 14): The patients were treated with 10% glucose 500 ml +
      danshen compound 14 ml + low molecular weight dextran 500 ml i.v.; Group 2 (n =
      14): in addition to the same treatment as in group 1, 25% magnesium sulfate 20 ml
      in 5% glucose 500 ml i.v. was given; Group 3 (n = 11): no treatment was given;
      and another 12 normal term delivery women were served as control. Magnesium
      concentration levels were determined in both maternal peripheral blood and their
      fetal umbilical vein. RESULTS: Maternal serum magnesium level was higher in Group
      2 (1.06 +/- 0.09) mmol/L than that in Group 1 (0.69 +/- 0.05) mmol/L (P < 0.05),
      while there was no significant difference between Group 1 and Group 3. The serum
      magnesium levels in both mother and fetal umbilical vein of normal pregnancy and
      of Group 2 were significantly higher than those of Group 1 and 3 (P < 0.01), so
      did the birth weight of their newborns (P < 0.05). CONCLUSION: Magnesium
      deficiency might be one of the causes of IUGR, and magnesium sulfate treatment
      was effective.

PMID- 11218895
TI  - [Clinical analysis of 25 cases of malignant transformation of endometriosis of
      the ovary].
AB  - OBJECTIVE: To study clinicopathologic characteristics, treatment and prognostic
      factors of malignant transformation of endometriosis of the ovary. METHODS: From
      1981 to 1999, a total of 25 patients with malignant transformation of
      endometriosis of the ovary were retrospectively analyzed. RESULTS: The main
      symptoms were pelvic masses, abdominal pain, abdominal distension and abnormal
      vaginal bleeding or discharge. Histological type: of the 25 cases, 14 were
      endometrioid carcinomas, 2 were clear-cell carcinomas, 2 were adenoacanthoma, 1
      was serous papillary adenocarcinomas, 6 were mixed epithelium tumor of ovary. The
      exact area of histologic transition from benign to malignant epithelium was
      observed in 25 patients. Stage: stage I 14, stage II 7, stage III 3, stage IV 1.
      The actual 5-year survival rate was 77.7%. CONCLUSIONS: The exact incidence and
      prevalence of malignant transformation in endomertriosis is unknown. Radical
      tumor resection combined with chemotherapy is the main therapeutic approach for
      malignant transformation of endometriosis of the ovary.

PMID- 11218896
TI  - [Expression of vascular endothelial growth factor receptor kinase inser domain
      containing receptor in human cervical carcinoma].
AB  - OBJECTIVE: To observe the expression of vascular endothelial growth factor
      receptor (KDR) in human cervical carcinomas, to clarify the relationship between
      the expression and invasion, metastasis, prognostic value in human cervical
      carcinoma. METHODS: KDR was stained immunohistochemically in 80 cases of human
      cervical carcinoma. RESULTS: The expression of KDR in the endothelial cells of
      tumor vasculature is: the high KDR expression rate of clinical cancer stages < or
      = I b and II a-III a was 21.4% and 60.6% (P < 0.01). The high KDR expression rate
      of the high, middle and low pathohistologic grading was 7.7%, 27.8% and 84.1%
      respectively (P < 0.01). The high KDR expression rate of adenocarcinoma and
      squamous-cell carcinoma was 0/5 and 57.3% (P < 0.05). The high KDR expression
      rate of the cases with lymphonodus metastasis and without lymphonodus metastasis
      was 77.8% and 46.8% respectively (P < 0.05). The survival rate of patients with
      high KDR expression tumors was significantly lower than that of patients with low
      KDR expression (P < 0.05). CONCLUSION: KDR is highly related to growth, invasion
      and metastasis of human cervical carcinoma, it may be one of the predictors for
      the biological behavior of human cervical carcinoma.

PMID- 11218898
TI  - [Study of mdr1 antisense oligodeoxynucleotides on reversal of multidrug
      resistance in ovarian carcinoma cell line SKOV3].
AB  - OBJECTIVE: To investigate the effect of mdr1 antisense oligodeoxynucleotides
      (ASON) on reversal of multidrug resistance in ovarian carcinoma cells. METHODS:
      Drug resistance ovarian carcinoma cells SKOV3/mdr1 transducted with human
      multidrug resistance gene (mdr1) were served as models. The positive rate and
      function of the mdr1 gene product P-glycoprotein (P-gp) in SKOV3/mdr1 cells after
      mdr1-ASON (250 micrograms/ml) treatment were determined by flow cytometry and
      rhodamine 123 efflux trial. Drug resistance of SKOV3/mdr1 cells was also observed
      by cell colony culture. RESULTS: P-gp positive rate of SKOV3/mdr1 cells after
      mdr1-ASON treatment was decreased from 38.9% to 21.3% (P < 0.01). Intracellular
      rhodamine retension in SKOV3/mdr1 cells after mdr1-ASON treatment was increased
      from 32.1% to 50.7% (P < 0.01). Under effect of Taxol 5 ng/ml, the relative
      percents of drug-resistant colony in mdr1-ASON treated SKOV3/mdr1 cells and in
      SKOV3/mdr1 cells was 8% and 63%, respectively, (P < 0.01). Under effect of
      Doxorubicin 100 ng/ml, the relative percents of drug-resistant colony in mdr1
      ASON treated SKOV3/mdr1 cells and in SKOV3/mdr1 cells was 34% and 79%,
      respectively, (P < 0.01). CONCLUSION: mdr1-ASON can reverse multidrug resistance
      of ovarian carcinoma cell in a certain extent so as to increase chemotherapeutic
      sensitivity of ovarian carcinoma cells.

PMID- 11218897
TI  - [Prognostic factors in granulosa cell tumor of the ovary].
AB  - OBJECTIVE: To study the effect of clinical and pathologic factors on prognosis
      for granulosa cell tumor of the ovary. METHODS: The clinical records and tumor
      sections of 100 patients with granulosa cell tumors of the ovary between 1958 and
      1995 were reviewed. The relationship between age, stage, mitosis and the adjuvant
      therapy for early stage (stage I) were analyzed retrospectively. Patients with
      recurrent tumors were compared with patients who remained without disease,
      patients with early recurring tumors were compared with late recurring tumors.
      RESULTS: The overall 5 and 10 year survival rates were 80% and 72%. There were no
      significant difference between ages and survival (P > 0.05). The survival rates
      in stage I were 98% and 96% after 5 and 10 years, respectively, and in stages II
      were 70% and 60%, after 5 and 10 years, all of 4 patients with stage III-IV were
      dead of recurrent disease in 1 year. The frequency of observed mitosis influenced
      the survival rate: with less 5/10 high-power fields (HPF) the survival were 96%
      both at 5 and 10 years, with more or equal 5/10 HPF the 5 and 10 year survival
      rates were 58% and 36%, respectively (P < 0.01). No significant correlation could
      be established between the adjuvant therapy and 5 and 10 years survival in 56
      stage I patients. There were 44 patients with recurrent disease in this group,
      median time to recurrence was 53 months. Late recurrence appeared in 8 cases. The
      significant differences in stage and abdominal mass were noted between the
      recurrent tumors and the group without disease (P < 0.05). When early and late
      recurring tumors were compared, statistically significant differences were again
      noted: early recurring tumors had higher mitotic rates and late stage, and late
      recurring tumors had lower mitotic rages and early stage. Patients without
      recurrent tumors were similar to the patients with early recurring tumors.
      CONCLUSIONS: Tumor stage and mitotic rate are the clinical and pathologic
      prognosticators in granulosa cell tumor. It is difficult to predict late
      recurrences using these clinical and pathologic parameters.

PMID- 11218899
TI  - [Long-term effects of low-dose combined norethisterone and combined 18-metayl
      norethisterone on lipid metabolism in healthy women].
AB  - OBJECTIVE: To assess the long-term effects of combined oral contraceptive pills
      use on the mean of serum TG, TC, HDL-C, LDL-C, ApoA1, ApoB and Lp(a). METHODS:
      The study was carried out in 446 women grouped as combined norethisterone
      containing ethinylestradiol (EE) 35 micrograms and norethisterone 625 micrograms;
      combined 18-metayl-norethisterone (norgestrel) containing EE 30 micrograms and 18
      metayl-norethisterone 300 micrograms for using 5-25 years, and control subjects
      wearing IUD for the corresponding period. The three groups were similar in age,
      body mass index (BMI), continued period of contraceptives use and income.
      RESULTS: The data showed that changes of varying degree of lipid and lipoprotein
      parameters were obvious in women of long-term taking low-dose combined
      norethisterone and norgestrel, compared with the control. The mean of TG, HDL-C,
      ApoA1 were significantly increased simultaneously (P < 0.05, P < 0.01), indicated
      multiple effects of two low-dose Chinese COCs on lipid lipoprotein parameters. In
      addition, A significant increase (P < 0.05) in Lp(a), an independent risk factor
      for cardiovascular disease, was found in norgestrel group. Further more, the
      results of stratified analysis to duration of contraceptives use showed that the
      mean of TC, LDL-C, in the combined norethisterone use less than 15 years, after
      the adjusting for age, were significantly lower (P < 0.05, P < 0.01) and the
      ratio of LDL-C/HDL-C was improved (P < 0.05), compared with the Norgestrel; at
      the same time, the mean of ApoA1 was markedly higher (P < 0.05) in combined
      norethisterone; the ratio of ApoA1/ApoB (1.87 +/- 0.58) in the combined
      norethisterone group was superior to the ratio value (1.68 +/- 0.55) in
      norgestrel group. CONCLUSIONS: These beneficial effects on lipid metabolism have
      been considered indicators of potential cardiovascular protective effect of the
      combined norethisterone for taking pill less than 15 years, but these protective
      effects would be reduced with adverse change in lipid and lipoprotein parameters
      for taking combined norethisterone more than 15 years. In contrast, the mean of
      TC, LDL-C, two known risk factors for cardiovascular system, in the norgestrel
      use less than 15 years, after the adjusting for age, were significantly increased
      (P < 0.05, P < 0.01), and adverse changes in the TC/HDL-C ratio (P < 0.05) and
      ASI value, compared with the combined norethisterone; Lp(a) level was markedly
      higher in the norgestrel group than that in the control group (P < 0.05). These
      adverse effects on lipid metabolism have been considered indicators of potential
      cardiovascular harmful effect of low-dose norgestrel.

PMID- 11218900
TI  - Joint Commission improves accreditation process.

PMID- 11218901
TI  - Maintain a high census, or "how to keep your beds filled".

PMID- 11218902
TI  - Assisted living comes of age: a bright future lies ahead for the popular senior
      care alternative.

PMID- 11218903
TI  - Healthcare facilities must act affirmatively to prevent sexual harassment.

PMID- 11218904
TI  - Illinois nursing homes develop successful programs to promote comfort during end
      of-life care.

PMID- 11218905
TI  - Celebrate long-term care administrators week. March 19-25, 2001.

PMID- 11218906
TI  - Twenty ways to motivate yourself.

PMID- 11218907
TI  - Congress fixes Medicare reimbursement rate glitches.

PMID- 11218908
TI  - Taking stock of the eldercare market.

PMID- 11218909
TI  - Benign tumors of the liver.
AB  - Benign tumors of the liver, less commonly encountered than metastatic or primary
      liver tumors, may present clinically with symptoms due to mass effect, or may be
      discovered incidentally during radiographic evaluation or surgical exploration
      for other clinical indications. Many of the lesions that result in a benign liver
      mass are true neoplasms, while others result from reactive proliferation of
      hepatocytes, biliary cells, mesenchymal or inflammatory cells. The premalignant
      nature or potential for malignant transformation is of concern in some of the
      benign tumors or tumor-like masses of the liver. In this article, benign tumors
      and tumor-like masses involving the adult liver are discussed with a focus on
      histopathology, histogenesis, and clinical significance of these interesting and
      unusual lesions.

PMID- 11218910
TI  - Screening for cancer in viral hepatitis.
AB  - Early diagnosis of HCC is possible because certain risk factors for this tumor
      are known and because sensitive and relatively inexpensive diagnostic tools are
      available. Early diagnosis of HCC is also possible because of the long phase of
      asymptomatic tumor growth and the tumor's tendency to grow as a solitary mass in
      many patients. In two consensus development conferences held in Anchorage, Alaska
      and in Milan, Italy, chronic carriers of HBsAg, patients with cirrhosis, patients
      with rare metabolic liver diseases, and individuals with family histories of HCC
      were identified as patients at high risk for HCC and therefore as candidates for
      periodic screening. At the Anchorage conference, it was recommended that healthy
      carriers have at least yearly determinations of serum AFP and that carriers with
      additional risk factors (e.g., cirrhosis) be screened every 6 months by abdominal
      US scans and determination of serum AFP levels. No specific recommendations were
      released for HBsAg-negative patients with chronic liver disease. At the Milan
      conference, it was recommend that patients with cirrhosis or with certain
      congenital metabolic conditions known to be at risk for HCC should be screened by
      AFP determination and US scan twice a year. It was also recommended that HBsAg
      carriers older than 35 years or with family histories of HCC should be screened
      for HCC by determinations of serum AFP levels and aminotransferase levels once a
      year.

PMID- 11218911
TI  - Radiologic diagnosis of hepatocellular carcinoma.
AB  - Substantial recent technologic improvements in CT scanning, US scanning, and MR
      imaging, together with advances in the understanding of the optimal application
      of contrast administration techniques, have facilitated advances in radiologic
      imaging detection for HCC diagnosis. Despite a large number of earlier
      publications reporting a high sensitivity for imaging detection of HCC, more
      recent screening studies of large cirrhotic populations confirm that only 37% to
      45% of HCC tumor nodules are detected by CT scanning, US scanning, or MR imaging.
      Future investigation will include efforts to improve the detection of small
      tumors and to characterize with greater specificity the spectrum of nodular
      changes that occur with cirrhosis. Although several small series have attempted
      to characterize cirrhotic nodules by evaluating the relative arterial or portal
      blood supply, these preliminary results require substantiation with larger
      series. Continued technologic advances such as multidetector helical CT scanning
      and new US and MR contrast agents under investigation may improve the imaging
      characterization of cirrhotic nodules.

PMID- 11218912
TI  - The role of serum alpha-fetoprotein estimation in the diagnosis and management of
      hepatocellular carcinoma.
AB  - Forty years after its discovery, estimation of serum AFP remains a useful test
      for clinicians involved in management of patients with HCC or chronic liver
      disease. The test, when used with the conventional cut-off point of 500 ng/mL,
      has a sensitivity of about 50% and a specificity of more than 90% in detecting
      the presence of HCC in a patient with coexisting liver disease. New tests that
      can significantly increase the specificity at lower levels (i.e., between 10 and
      500 ng/mL) are available but have, to date, been too complex to be widely applied
      in clinical practice. Serum AFP estimation may also be useful in monitoring
      response to therapy, particularly as more effective systemic regimens are
      becoming available. Indeed, there is preliminary evidence that changes in serum
      AFP may be a more accurate and sensitive way of determining the degree of
      response to treatment than conventional imaging procedures that rely on physical
      determination of tumor size. It may, perhaps, be time to add changes in serum AFP
      to the conventional imaging criteria for assessing response in clinical trials.

PMID- 11218913
TI  - Locoregional management of hepatocellular carcinoma. Surgical and ablation
      therapies.
AB  - The selection of an appropriate treatment strategy for patients with HCC depends
      on careful tumor staging and assessment of the underlying liver disease (Fig. 5).
      All patients with localized HCC (involvement of one single lobe, no vascular
      invasion or extrahepatic disease) should be evaluated for the potentially
      curative therapeutic options of partial hepatectomy or OLT. Candidates for
      partial hepatectomy must have no liver disease or Child's A cirrhosis, normal
      portal pressure, and normal serum bilirubin. For patients not meeting these
      criteria, OLT should be considered if there is a solitary lesion smaller than 5
      cm in diameter or fewer than three lesions smaller than 3 cm. Local ablative
      therapies such as PEI, RFA, and TACE offer palliation for patients for whom
      surgical approaches are contraindicated. Percutaneous alcohol injection and RFA
      are minimally invasive and can be used on an outpatient basis, usually for tumor
      nodules smaller than 3 cm. When these therapies are used for small tumors, the
      survival rates can be similar to those achieved by partial hepatectomy.
      Transcatheter [figure: see text] arterial chemoembolization may be used as an
      interim treatment for patients waiting for OLT. Although TACE is often used for
      the palliation of large tumors, significant survival benefits have not yet been
      demonstrated for this indication.

PMID- 11218914
TI  - Benign focal lesions of the liver.
AB  - This article focuses on the origin, diagnosis, and management of focal benign
      lesions of the liver. The most common lesions include cavernous hemangioma, focal
      nodular hyperplasia, hepatic adenoma, and nodular regenerative hyperplasia. A
      number of less frequent occurring lesions are also discussed. In general, the
      common lesions can be diagnosed by radiologic imaging, but occasionally biopsies
      are required, and surgical removal is often needed.

PMID- 11218915
TI  - Nonsurgical treatment of hepatocellular carcinoma.
AB  - Given the poor prognosis of HCC and the therapeutic challenge posed by underlying
      liver cirrhosis, efforts and resources must be directed towards preventive
      strategies. Return on the investment in such research is likely to be greater
      than can be expected from treatment of advanced disease.

PMID- 11218916
TI  - Cholangiocarcinoma.
AB  - Despite overall advances in the ability to diagnose and treat patients with
      cholangiocarcinoma, the prognosis for patients with this malignancy remains poor.
      Further improvements in the survival of patients with cholangiocarcinoma will
      come with the early diagnosis of these lesions. New molecular techniques should
      improve the ability to screen high-risk patients, such as those with primary
      sclerosing cholangitis, hepatolithiasis, choledochal cysts, and ulcerative
      colitis. Improvements in imaging will continue, and spiral CT scanning, duplex
      ultrasonography, MR imaging and, perhaps, PET scans will improve the ability to
      stage patients with cholangiocarcinoma noninvasively. Complete surgical resection
      remains the only curative treatment for malignancies of the biliary tract.
      Aggressive surgical approaches are likely to continue, and the challenge remains
      in being able to perform these procedures safely in jaundiced and sometimes
      septic patients. For patients with unresectable lesions, the optimal form of
      palliation, whether surgical or nonsurgical, remains to be defined. Finally,
      multicenter, prospective, randomized trials of chemoradiation need to be
      performed to delineate an effective adjuvant therapy more precisely, and to
      improve the overall prognosis of patients with cholangiocarcinoma.

PMID- 11218917
TI  - Mesenchymal tumors of the liver.
AB  - Primary angiosarcoma of the liver accounts for up to 2% of all primary liver
      tumors and is the second most common primary malignant neoplasm of the liver.
      Approximately 10 to 20 new cases are diagnosed every year in the United States
      and the prevalence varies from 0.14 to 0.25 per million. In an autopsy series
      from Chicago, one hepatic angiosarcoma was noted for every 30 cases of
      hepatocellular carcinoma.

PMID- 11218918
TI  - Hepatic tumors in children.
AB  - Although they account for only 1% to 4% of solid tumors in children, hepatic
      tumors and pseudotumors offer a diagnostic challenge to the clinician seeing only
      an occasional case. Metastatic lesions such as neuroblastoma, Wilms' tumor, and
      lymphoma are the most common neoplasm seen in the liver, but 10 distinct primary
      tumors and pseudotumors of the liver occur with some regularity, and a few others
      may be seen rarely, including leiomyosarcoma, rhabdoid tumor, and endodermal
      sinus tumor. Five of these neoplasms--hepatoblastoma, infantile hemangio
      endothelioma, mesenchymal hamartoma, undifferentiated embryonal sarcoma, and
      embryonal rhabdomyosarcoma of the biliary tree--occur only in children and are
      the major focus of the article.

PMID- 11218919
TI  - Animal models of hepadnavirus-associated hepatocellular carcinoma.
AB  - Animal models of hepatitis B virus infection have been valuable for determining
      the mechanisms of hepadnavirus replication, for studies of pathogenesis, and for
      investigations of viral hepatocarcinogenesis. The woodchuck model also seems to
      be useful in the discovery and development of antiviral drugs to treat HBV
      infection and for testing new forms of immunotherapy. In particular, the
      woodchuck seems to be ideal for studying the effect of antiviral treatment and
      immunotherapy on the outcome of hepadnavirus infection and on survival. The
      median life expectancy of experimentally infected, chronic WHV carriers is
      approximately 29 months, and almost all develop HCC. New types of prophylaxis or
      therapy can be evaluated under controlled experimental conditions, in a relevant
      animal model, and within a reasonable time frame.

PMID- 11218920
TI  - Pathogenesis of hepatocellular carcinoma.
AB  - The pathogenesis of HCC is poorly understood at present. There is insufficient
      understanding to propose a robust general model of hepatic carcinogenesis, partly
      because pathogenic host and environmental factors show significant regional
      variation, making such generalization difficult. Figure 4 is a model based on
      data presented in this article. Multiple risk factors for HCC have been
      identified, including cirrhosis, male gender, increasing patient age, toxins,
      chronic viral hepatitis, and other specific liver diseases. The understanding of
      how the individual risk factors result in genetic changes is rudimentary, and
      there is even less understanding about interactions between risk factors. Future
      studies should acknowledge the geographic origin of the HCCs studied and consider
      the effects of cirrhosis, gender, and age. A more rigorous approach to these
      factors may help explicate the interaction with specific liver diseases so that a
      comprehensive model of hepatic carcinogenesis can be developed.

PMID- 11218921
TI  - Epidemiology of hepatocellular carcinoma.
AB  - The epidemiology of hepatocellular carcinoma (HCC) is characterized by marked
      differences between genders, ethnic groups, and geographic regions. These
      variations are explained by the nature, frequency, and time of acquisition of the
      major risk factors for cirrhosis--namely hepatitis B virus, hepatitis C virus
      (HCV), and alcoholic cirrhosis. The incidence and mortality of HCC has been
      rising in the US over the last two decades and is progressively affecting younger
      persons. The evidence indicates that HCV infection is responsible for the current
      trends.

PMID- 11218922
TI  - Influence of a scheduled-waiting task on EMG reactivity and oral habits among
      facial pain patients and no-pain controls.
AB  - Recent research has strongly implicated the role of psychological stress in the
      development of temporomandibular disorders (TMD). It is widely reported that oral
      habits (e.g., teeth grinding) probably provide a behavioral link between stress
      and the development of TMD symptomatology. Extrapolation of research in the field
      of adjunctive behavior to the TMD disorders suggests that oral behaviors may
      develop conjointly with fixed-time (FT) stimulus presentation. The current
      experiment extended previous research examining this possibility by assessing the
      influence of experimental stress on masseter EMG and oral habits among persons
      who met broadband criteria for TMD and no-pain controls. Oral habit activity was
      assessed via self-report questionnaire whereas masseter muscle activity was
      measured continuously via electromyography across four phases (Adaptation, Free
      Play, Scheduled-Play, Recovery). The Scheduled-Play phase was designed as a
      stress-reactivity task that included an FT schedule. Results indicated that,
      consistent with the stress-reactivity model, the Scheduled-Play phase resulted in
      a significant increase in masseter EMG levels relative to Free-Play and
      Adaptation, and that this effect was significantly larger for the TMD group
      relative to controls. The results suggest an adjunctive behavior effect although
      the effect was not specific to those with facial pain. Oral habit data showed a
      significant phase effect with oral habits that was significantly higher during
      the Scheduled-Play phase relative to Adaptation. The findings are the impetus for
      further study regarding the mechanisms whereby oral habits are developed and
      maintained despite their painful consequences.

PMID- 11218923
TI  - Oxygen consumption and respiration following two yoga relaxation techniques.
AB  - The present study was conducted to evaluate a statement in ancient yoga texts
      that suggests that a combination of both "calming" and "stimulating" measures may
      be especially helpful in reaching a state of mental equilibrium. Two yoga
      practices, one combining "calming and stimulating" measures (cyclic meditation)
      and the other, a "calming" technique (shavasan), were compared. The oxygen
      consumption, breath rate, and breath volume of 40 male volunteers (group mean +/-
      SD, 27.0 +/- 5.7 years) were assessed before and after sessions of cyclic
      meditation (CM) and before and after sessions of shavasan (SH). The 2 sessions
      (CM, SH) were 1 day apart. Cyclic meditation includes the practice of yoga
      postures interspersed with periods of supine relaxation. During SH the subject
      lies in a supine position throughout the practice. There was a significant
      decrease in the amount of oxygen consumed and in breath rate and an increase in
      breath volume after both types of sessions (2-factor ANOVA, paired t test).
      However, the magnitude of change on all 3 measures was greater after CM: (1)
      Oxygen consumption decreased 32.1% after CM compared with 10.1% after SH; (2)
      breath rate decreased 18.0% after CM and 15.2% after SH; and (3) breath volume
      increased 28.8% after CM and 15.9% after SH. These results support the idea that
      a combination of yoga postures interspersed with relaxation reduces arousal more
      than relaxation alone does.

PMID- 11218924
TI  - Electromyographic (EMG) biofeedback in the comprehensive treatment of central
      pain and ataxic tremor following thalamic stroke.
AB  - Peripheral pain and ataxic tremor can appear suddenly following thalamic stroke
      and can significantly alter a patient's psychological, social, and physical
      functioning. The present paper reports the case of a 70-year-old Caucasian female
      who sustained an acute left posterior cerebral artery infarction involving the
      thalamus and left mesiotemporal regions. She subsequently developed Central
      Poststroke Pain and ataxic movement of her right arm and hand in addition to a
      significant right-side claudication. She was treated over 16 weeks (6 weeks of
      EMG biofeedback and 10 weeks of psychotherapy) with a combination of EMG
      biofeedback, progressive muscle relaxation, behavioral pain coping skills
      training, Forced Use Therapy, and Cognitive Behavioral Therapy 7 years after her
      initial cerebral accident. The case demonstrates the utility of biofeedback when
      combined as part of a comprehensive treatment program to address the multiple
      complications associated with thalamic stroke.

PMID- 11218925
TI  - Stress and human spirituality 2000: at the cross roads of physics and
      metaphysics.
AB  - Although stress is defined as a perceived threat, the implications of stress go
      well beyond physical well-being. In the words of Carl Jung, "Every crisis is a
      spiritual crisis." Western science, so strongly influenced by the Cartesian
      Principle of Reductionism, has ignored the essence and significance of human
      spirituality in the health and healing process. Holistic healing honors the
      integration, balance, and harmony of mind, body, spirit, and emotions, where the
      whole is greater than the sum of the parts. Stress (unresolved issues of anger
      and fear) chokes the human spirit, the life force of human energy, which
      ultimately affects the physical body. From the perspectives of both physics and
      metaphysics, stress is a disruption in the state of coherence between the layers
      of consciousness in the human energy field. The emerging paradigm of health
      reunites mind, body, and spirit, and considers health as a function of coherence
      among the energy levels of these components.

PMID- 11218926
TI  - Partnership contributes to the success of the AORN Journal team.

PMID- 11218927
TI  - Perioperative preparation of the adolescent surgical patient.
AB  - The perioperative preparation of adolescents for surgery provides a challenge to
      nurses and other health care providers because of the wide diversity in
      adolescents' age, physical maturation, and cognitive and psychosocial
      development. Perioperative issues, informed consent, and assent differ
      considerably depending on the age and developmental level of each adolescent.
      This article provides information about adolescent growth and development and
      approaches to managing adolescent surgical patients.

PMID- 11218928
TI  - Treating benign colon disorders using laparoscopic colectomy.
AB  - Laparoscopic bowel surgery is a recent application of minimally invasive
      videoscopic techniques. Understanding the anatomy and physiology of the bowel,
      the background of bowel disorders and their treatment, signs and symptoms of
      bowel disease, and the patient selection process can help perioperative nurses
      better care for patients diagnosed with colon polyps, diverticulitis, and
      inflammatory bowel disease.

PMID- 11218930
TI  - Implementing a nonlatex surgical glove study in the OR.
AB  - Sterile surgical gloves are used to protect patients and health care workers
      (HCWs) from infection during surgery and to shield HCWs from exposure to
      bloodborne pathogens. Based on increased reports of latex allergy, many HCWs now
      use nonlatex surgical gloves as a substitute for natural rubber gloves. Little is
      known, however, about the performance of nonlatex gloves in surgery. This article
      describes a study that currently is being performed to test the barrier
      performance of nonlatex surgical gloves after they have been used in surgery and
      to determine HCW satisfaction. To date, 12,703 latex and nonlatex gloves from all
      surgical services have been collected and tested for barrier quality. This
      article describes the project and challenges encountered by the collaborative
      team of perioperative staff members and nurse researchers as they collect data.

PMID- 11218931
TI  - A creative process for reinforcing aseptic technique practices.
AB  - Issues in aseptic technique challenge every perioperative practitioner. Equally
      challenging for educators is how to creatively present information to large
      groups of staff members in a way that facilitates learning. This article
      describes the process used to address practice issues in aseptic technique and to
      present educational inservice programs to a large number of staff members. Two
      clinical educators formed a work group comprising staff RNs and surgical
      technologists to address this topic. Work group members then planned and
      presented a two-part education session to review these issues with surgical staff
      members.

PMID- 11218929
TI  - Comparison of different regimens for surgical hand preparation.
AB  - Twenty surgical staff members participated in a clinical trial to compare the
      microbiology and skin condition of hands when using a traditional surgical scrub
      (TSS) with a detergent-based antiseptic containing 4% chlorhexidine gluconate
      (CHG) and a short application without scrub of a waterless hand preparation (HP)
      containing 61% ethyl alcohol, 1% CHG, and emollients. The HP was associated with
      less skin damage (P = .002) and lower microbial counts postscrub at days five (P
      = .002) and 19 (P = .02). The HP protocol had shorter contact time (HP mean [M] =
      80.7 seconds; TSS M = 144.9 seconds; P < .0001), and more subjects preferred the
      HP regimen (P = .001). The HP performed better than the TSS, was less costly, and
      should be evaluated in larger trials and considered for widespread
      implementation.

PMID- 11218932
TI  - Needlestick Safety and Prevention Act.

PMID- 11218933
TI  - Preoperative assessment and discharge planning for older adults undergoing
      ambulatory surgery.
AB  - Based on this survey, the prevalence of chronic illness and disability in older
      adult patients with respect to current ambulatory surgery practices is worrisome,
      especially the fragmentation of patients' care as they progress from the decision
      to undergo procedures, to preoperative assessment, to postoperative discharge.
      Ambulatory surgery unit nurses, case managers, surgeons, and office staff members
      must work together to better optimize time and resources. As baby boomers age,
      the number of older adults undergoing ambulatory surgery will increase. It is
      essential for ASU staff members to be cognizant of the special needs of older
      adult patients. Timeliness, patient education, and appropriate coordination and
      follow-up of care are important ingredients to successfully plan care for older
      adult patients undergoing ambulatory surgery. Nurses can play a pivotal role in
      this success.

PMID- 11218934
TI  - Recommended practices for maintaining a sterile field.

PMID- 11218935
TI  - Sampling for qualitative research.

PMID- 11218936
TI  - Update on Medicare reimbursement for certified RN first assistants.

PMID- 11218937
TI  - Helping patients (and their doctor) survive retirement.

PMID- 11218938
TI  - Too much energy to retire.

PMID- 11218939
TI  - Your career guide. Winding down, bowing out. Eager to quit? Be careful what you
      wish for.

PMID- 11218940
TI  - When bad news might make patients sicker.

PMID- 11218941
TI  - Medicare gave you a raise. Have you noticed?

PMID- 11218942
TI  - Sorry, doc, your Rolex isn't deductible.

PMID- 11218943
TI  - Your career guide. Winding down, bowing out. Leaving practice, but not the
      profession.

PMID- 11218944
TI  - The role of free radicals, oxidative stress and antioxidant systems in diabetic
      vascular disease.
AB  - Recent experimental findings suggest that overproduction of reactive oxygen and
      nitrogen species (ROS/RNS), lowered antioxidant defense and alterations of
      enzymatic pathways in humans with poorly controlled diabetes mellitus can
      contribute to endothelial, vascular and neurovascular dysfunction. Over the past
      decade, there has been substantial interest in oxidative stress and its potential
      role in diabetogenesis, development of diabetic complications, atherosclerosis
      and associated cardiovascular disease. Consequences of oxidative stress are
      damage to DNA, lipids, proteins, disruption in cellular homeostasis and
      accumulation of damaged molecules. This review summarizes recent knowledge on the
      pathomechanism of ROS/RNS in vascular oxidative stress and Maillard reactions.
      Evidence suggests that Maillard reactions act as amplifier of oxidative damage in
      aging and diabetes. Furthermore, results of experimental observations with
      antioxidant systems and antioxidant pharmacotherapy in the treatment of diabetes
      mellitus are discussed. These data indicate that the targeting therapy to
      specific macromolecules, tissues and organs of diabetics by specific antioxidants
      or combined drug preparates could become a relevant adjuvant pharmacotherapy with
      improved glycaemic control, blood pressure control and management of dyslipidemia
      for the treatment or prevention of progression of micro- and macrovascular
      diabetic complications. Supplementation with antioxidants as a promising
      complementary treatment can exert beneficial effects in diabetes. Some
      antidiabetic drugs may have antioxidant properties independently of their main
      role on glycaemia control. Therapeutic potential of inhibitors of AGEs formation
      for delaying of diabetic complications is now intensively studied in several
      laboratories. Furthermore, for functional outcomes of the intervention with
      antioxidants is also important development of accurate and sensitive methods for
      early detection of oxidative damage in diabetes. (Tab. 6, Fig. 3, Ref. 117.)

PMID- 11218945
TI  - [Serum neopterin levels in oncology patients in intensive care].
AB  - BACKGROUND: Elevated neopterin serum levels are associated with diseases that
      stimulate the cellular immune response. This includes viral infections,
      autoimmune diseases, transplant rejection and dissemination of certain types of
      cancer. T-helper lymphocytes and macrophages play a key role in neopterin
      synthesis. The degree of activation of Th1-lymphocytes is responsible for the
      production of interferon-gamma and interleukin-2, which stimulate neopterin
      production in human macrophages. DESIGN AND METHODS: We have designed a
      prospective observational study to assess the dynamics of serum neopterin levels
      in 75 oncological patients during post-surgery period. We measured serum
      neopterin by means of RIA method (radioimmunoassay) in 50 uncomplicated surgery
      patients (group A), in 15 complicated surgery patients (group B--abdominal
      sepsis, peritonitis, ileus) and 10 medical ICU patients (group C). Serum levels
      of neopterin were measured in 5 consecutive periods: before surgery, after
      surgery, and on the 1st, 2nd, 3rd postoperative days. RESULTS: In all groups, we
      observed gradual elevation of serum neopterin. The lowest values of neopterin
      were measured in group A in patients with uncomplicated course following surgery:
      6.75 nmol/l, 7.67 nmol/l, 8.9 nmol/l, 10.82 nmol/l and 13.66 nmol/l. A
      significant increase in serum neopterin levels was measured in group B in
      patients with septic complications during perioperative period: 18.9; 23.2;
      26.82; 29.53 and 27.32 nmol/l. High values of neopterin were also measured in
      medical ICU patients with disseminated cancer and sepsis during ICU stay: 26.1;
      58.1; 28.7 and 22.5 nmol/l. We concluded that serum neopterin levels were
      increased during the post-surgery period. We observed a significant increase in
      serum neopterin in patients with severe systemic infection or sepsis or in
      patients with cancer progression or dissemination (more than 15-20 nmol/l).
      Neopterin is a simple, reliable and sensitive parameter of cell-mediated
      immunity, suitable for early diagnosis of viral, autoimmune and transplantant
      rejection diseases. Neopterin can be used also for non-specific laboratory
      monitoring of cancer progression and/or dissemination. (Tab. 3, Fig. 4, Ref. 7.)

PMID- 11218946
TI  - [Variation in the localization of NADPH-d positive neurons in the gray matter of
      the spinal cord in different species].
AB  - The presence of NADPH-diaphorase (NADPH-d) activity was investigated in the
      thoracic part of rat, rabbit and pheasant spinal cords. Histochemical method for
      visualization of NADPH-d was used in this study. The comparison between all
      spinal cord regions (laminae) in three experimental species revealed marked
      differences. Especially in the ventral horn, the presence of NADPH-d activity was
      different. While the pheasant ventral horn possessed number of scattered
      intensively stained neurons, the rat and rabbit showed no NADPH-d activity in
      this region. Pericentral area (lamina X), intermediate zone (lamina VII) and
      dorsal horn revealed the presence of NADPH-d positive neurons in all examinated
      species although they differed in the distribution of NADPH-d activity. In
      summary, it can be suggested that the observed differences in the presence and
      distribution of NADPH-d activity among species may reflect their different
      phylogenetic development. As a consequence, different NO function in spinal cord
      of various species can be presumed. (Fig. 10, Ref. 28.)

PMID- 11218947
TI  - [Correction of measurement errors in the ELISA test].
AB  - The authors followed the influence of the arrangement of measured and control
      samples on microtitration plate on the ELISA test results by quantitative
      evaluation of rabies antibodies titres in human blood serum. They performed the
      test under identical conditions in all microtitration plate wells. They
      calculated the result according to five calibration curves--four of them were
      obtained by different positioning of the control positive and negative sera and
      the fifth curve was obtained from average values. The results from the four
      various positional calibration curves were significantly statistically different
      from the average. However, the average calibration curve--obtained from four
      measurements--led to identical value of rabies antibodies in cases with different
      dilutions of sera. The authors propose to follow some principles of measured and
      control samples arrangement on microtitration plates in order to minimalize the
      errors, caused by their dishomogeneity. (Tab. 2, Fig. 3, Ref. 10.)

PMID- 11218948
TI  - [Diabetic angiopathy--etiopathogenesis and clinical manifestations (hypersyndrome
      X)].
AB  - Diabetic angiopathy is a generalised systemic disease of the vascular system
      which afflicts both distribution vessels (diabetic macroangiopathy) and
      microcirculation (diabetic microangiopathy). The diabetic angiopathy, as well as
      other angiostenotic diseases (obliterations, obstructions, occlusions) result in
      one common consequence--ischaemia. This study is based on an analysis of a large
      group of patients (71,662 angiologic consultant examinations which took place
      during the 25-year period of the existence of the Comenius University Faculty
      Hospital). The author indicates that the clinical course of angio-organic
      ischaemic syndromes determined by diabetic angiopathy is multiform, remarkably
      severe and unfavourable. The author has suggested the term "X hypersyndrome"
      referring to cases with simultaneous occurrence of various pathophysiologic
      abnormalities and clinical units which finally increase the risk of origin and
      development of diabetic angiopathy. (Tab. 7, Ref. 47.)

PMID- 11218949
TI  - [Treatment of salivary gland tumors in the past and at the present time at the
      1st and 2nd Stomatology Clinics of the Charles University Medical School in
      Bratislava].
AB  - The retrospective study analyzes a group of 1021 patients (484 men and 537 women)
      with salivary gland tumours treated at the 1st and 2nd Departments of Stomatology
      in Bratislava within the years 1951-1996. This time period is divided into the
      past (1951-1980) and recent (1981-1996) periods. The trends in the diagnosis and
      treatment with the main emphasis on surgical procedures are mentioned. The most
      common operation were lateral parotidectomy (409 cases = 40.1%) and conservative
      parotidectomy (105 cases = 10.2%), enucleations were indicated rarely. Authors
      stress the necessity of team approach and cooperation of maxillofacial surgeons,
      radiologists, histopathologists, otorhinolaryngologists and oncologists. (Tab. 1,
      Fig. 2, Ref. 6.)

PMID- 11218950
TI  - [Diabetic nephropathy: new findings on pathogenesis and therapy].
AB  - The authors describe the new factors (genetic, haemodynamic and metabolic) which
      are involved in the pathogenesis and therapy of diabetic nephropathy. The
      treatment must be based especially on strict control of glycaemia, decrease in
      arterial blood pressure, beneficial effect of low-protein diet, reduction of body
      weight and smoking prevention. The combination of the presented therapeutic
      procedures can slow down the progression of nephropathy and approximate it to the
      process of natural ageing.

PMID- 11218951
TI  - [Renal hypertension: pathogenesis and therapy].
AB  - The kidney is both the source and target of high blood pressure. The pathogenesis
      of renal parenchymatous hypertension is significantly affected by sodium
      retention, inappropriate activity of vasopressoric systems and other factors.
      Drugs inhibiting the renin-angiotensin system are the treatment of choice in
      diabetic and non-diabetic nephropathies. The nephroprotective effect of long
      acting dihydropyridine calcium channel blockers as well as of other compounds is
      currently under investigation.

PMID- 11218952
TI  - [Diabetic nephropathy].
AB  - Low-protein diet decreases hyperfiltration and albuminuria, and slows down the
      decrease in glomerular filtration in diabetic patients with incipient diabetic
      nephropathy (DN). The patients with incipient DN are recommended to intake 0.6
      0.8 g of proteins per kg of body weight with a sufficient amount of essential
      amino acids. A high occurrence of urologic infections was found in risk groups of
      diabetic patients, namely in those with ketoacidosis, urinary bladder dysfunction
      in urogenital forms of autoimmune neuropathy, and in pregnant diabetic patients.
      Each symptomatic infection of renal parenchyma and urinary tract should be
      urgently treated. The cases with relapses of urinary tract infection should be
      subdued to a long-term prophylactic antimicrobial treatment.

PMID- 11218953
TI  - [Reconstruction of the gastrointestinal tract after esophagogastrectomy].
AB  - The authors deal with the problems of reconstruction of gastrointestinal
      continuity after esophagectomy. They present the advantages of the stomach which
      is an especially good mediastinal as well as retrosternal substituent. One case
      of restoration of gastrointestinal continuity after both esophagectomy and
      gastrectomy by a jejunal loop with anastomosis on the neck is also presented.

PMID- 11218954
TI  - Health-status of the Slovak Republic population in comparison with countries of
      Central Europe and European Union.
AB  - The Central Europe (CE) countries are probably to become members of the European
      Union (EU) in a few years' time. This overview compares the health trends of
      Slovak Republic (SK) population in comparison with Central Europe countries
      (Czech Republic (CZ), Poland (PL) and Hungary (H)) and with the weighed mean of
      EU. The life expectancy of males and females at birth is significantly higher in
      EU, and this difference is not caused by substantially different infant mortality
      rate. Total premature mortality is significantly higher in CE and the differences
      in mortality due to cardiovascular diseases are the main cause of this gap.
      Cancer mortality in males, but not in females is the second most important
      difference. Breast cancer mortality rates in SK, CZ and PL are even lower than
      the EU average. Male mortality due to external causes is the third most important
      difference between EU and CE. The differences in mortality due to infectious
      diseases and due to diseases of respiratory system are not very great. After the
      political changes in 1989/90, the decline in cardiovascular mortality, mortality
      due to external causes and due to respiratory system diseases were observed in
      CE. Unfortunately, this is not true with cancer mortality. The rank of health
      status of four CE countries is as follows: the CZ is in the best situation,
      followed by SK and PL. There is an evident gap between these 3 countries and
      Hungary. The differences between EU and CE at the end of the 20th century are
      still relatively great, but in CZ, SK and PL there is the tendency to overcome
      this gap in the first 10-15 years of the next century. (Tab. 2, Fig. 6, Ref. 18.)

PMID- 11218955
TI  - The function of the cerebrospinal fluid space and its expansion.
AB  - In addition to its nutritive and protective effects, the basic function of the
      cerebrospinal fluid space resides in dynamic equilibration of pressure
      fluctuations caused by volume changes in three compartments contained within the
      rigid skull cavity: brain tissue, blood and cerebrospinal fluid. An increase in
      volume in one of them brings about a compliant withdrawal in volume in the other
      two. The degree of cerebrospinal fluid compliance can be expressed by means of
      the pressure/volume index which is directly proportional to this compliance. On
      the other hand an expansion of fluid space which forces the brain to withdraw its
      tissue, brings about the dilatation of brain ventricles. The degree of their
      dilatation depends on the effective pressure of cerebrospinal fluid which
      counteracts with the resistance of brain venous collectors. The blood in the
      venous network of the brain and cerebral extracellular fluid play a reversible
      role in cerebral mass restoration and reduction. These facts explain the reason
      why, from the physical point of view, the brain is considered to represent a
      viscous and elastic spongious matter. (Ref. 21.)

PMID- 11218956
TI  - ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale)--validation of
      the Slovak version.
AB  - BACKGROUND: ADAS was designed to measure the severity of the most important
      symptoms of Alzheimer's disease (AD). Its subscale ADAS-cog is the most popular
      cognitive testing instrument used in clinical trials of nootropics. It consists
      of 11 tasks measuring the disturbances of memory, language, praxis, attention and
      other cognitive abilities which are often referred to as the core symptoms of AD.
      AIM: The aim of the study is to verify the Slovak adaptation of ADAS-cog and its
      ability to distinguish patients with AD from those with depressive disorders
      (DD). SUBJECTS AND METHODS: The study sample consists of 29 psychiatric
      inpatients divided into 2 groups: the AD group of 14 patients (4 males, 10
      females, mean age 73.9 +/- 7.3 yrs) fulfilling NINCDS-ADRDA criteria of probable
      AD and the DD group of 15 subjects (6 males, 9 females, mean age 74.3 +/- 6.5
      yrs) without any cognitive impairment. In all patients the ADAS-cog and SMMSE
      were administered. We compared the group in: total scores in both scales, task
      scores in the ADAS-cog and the scores of 3 ADAS-cog factors--memory, language and
      praxis. RESULTS: Both methods distinguished the patients with the AD from DD (p <
      0.001 for both scales). Also other variables (task and factor scores of ADAS-cog)
      reflect the worse results of the AD group. The most evident differences between
      the diagnostic groups were found in the orientation and constructive praxis. The
      education level did not affect the scores of the ADAS-cog in the AD patients but
      it did in SMMSE scores in the DD group (p < 0.05). CONCLUSIONS: The Slovak
      version of ADAS-cog has distinguished the patients with the AD from those with
      DD. The most evident differences between the groups were found in orientation and
      visuo-constructive praxis. In DD patients, the risk of false positive findings in
      subjects with lower education is higher than in the AD patients. In comparison
      with the SMMSE, ADAS-cog seems to be more helpful in early diagnostics of AD.
      (Tab. 6, Fig. 3, Ref. 14.)

PMID- 11218957
TI  - [Influenza and influenza-like acute respiratory diseases in Slovakia in the 1999
      2000 season].
AB  - BACKGROUND: Acute respiratory infections (ARI) represent the most frequent cause
      of morbidity. Their epidemic outbreaks become a severe problem not only in
      healthcare, but also in economical and social spheres. OBJECTIVE: Presentation of
      epidemiological and virologic characteristics of the 1999-2000 influenza season
      in Slovakia; their comparison with the same Influenza season in other European
      countries, as well as with the situation during the preceding season in Slovakia.
      METHODS: The epidemiological analysis of Influenza and influenza-like diseases is
      based on the duty of attending physicians to report the number of new cases,
      complications, cases of working inability due to disease, and death cases. The
      reports are required on a compulsory weekly basis, and the reported cases are
      structured into 4 age groups. The laboratory diagnosis is based on virus
      isolation, rapid detection of antigen and serological tests. RESULTS: The
      outbreak of Influenza spread through Slovakia during the period between the 4th
      and 8th calendar weeks with its peak appearing during the 6th calendar week, when
      its incidence reached 2821 cases/100,000. The age group mostly afflicted by
      morbidity during the entire investigated season were children at the age of 0-5,
      while during the outbreak, the highest morbidity was reported among school
      children at the age of 6-14. The epidemic broke out on the entire territory of
      the Slovak Republic at the same time. 5 death cases were reported. Complicated
      cases were reported in 6.1% of the diseased. 34.1% of the group at the age from
      15 to 59 were reported to be unable to work due to disease. 25 isolates of
      influenza virus were obtained from 505 nasopharyngeal swabs. 2 strains were found
      to be atigenetically similar to the vaccine strain A(H3N2)/Sydney 5/97 and
      A(H3N2)/Moscow 10/99. Regarding ARI aetiology, influenza viruses were
      serologically confirmed in 1356 samples; out of which type A(H3N2) was confirmed
      in 930 cases, A(H1N1) in 143 cases, type B in 283 cases; adenoviruses were
      detected in 467 samples; RS viruses in 779 samples; and Mycoplasma pneumoniae in
      859 samples. Mixed infection caused by two viruses was diagnosed in 27 cases.
      DISCUSSION: The outbreak which hit Slovakia in the 1999/2000 season was a part of
      the European epidemic wave. As to its extent, it was a mild epidemic outbreak. It
      was significantly low as to its incidence among children. During autumn months,
      ARI aetiology was dominated by M. pneumoniae, viruses of type A(H3N2) prevailed.
      CONCLUSION: The identification of strains isolated during the investigated season
      confirmed that strains of influenza virus similar to strain A(H3N2)/Sydney 5/97
      which is contained within the vaccine which has been assessed for this season,
      circulated in Slovakia during the past two subsequent seasons. Similar experience
      was reported from the majority of European countries involved in the
      international WHO programme of influenza Surveillance. These facts explain the
      mild extent of the investigated epidemic outbreak. (Tab. 5, Fig. 7, Ref. 8.)

PMID- 11218959
TI  - [Skin manifestations of Lyme borreliosis--occurrence, diagnosis, therapy].
AB  - Eight genotypes of Borrelia burgdorferi are known currently. In Slovakia
      (Carpathian Euroregion) the most frequent genotypes are B. garini, B. afzelii, as
      well as B. valaisiana and B. lusitaniae. Infestation of the vector Ixodes ricinus
      is 3-30%. The most frequent early skin manifestation is erythema migrans (60
      70%). Borrelia burgdorferi is suggested to be the causative agent in sclerodermia
      circumscripta, lichen sclerosus et atrophicus, maybe also in urticaria chronica,
      granuloma anulare, erythema anulare, erythema nodosum. It can be the causative
      agent also in neurological diagnoses as e.g. chronic oligosymptomatic
      encephalopathy, "sclerosis multiplex-like" syndrome and fatigue syndrome,
      arthralgia, myalgia, seronegative indifferentiated oligoarthritis and
      fibromyalgies. The serological diagnosis has to be coincide with clinical
      findings. Used serological examinations are ELISA, Immunoblot, indirect
      immunofluorescence examination. PCR is an important contribution in examination
      of synovial fluid (85% detection) and cerebrospinal liquor (24-100%). The
      importance of PCR is stressed in cases with mixed infections by several borrrelia
      genotypes. The first line treatment includes doxyciclin, amoxicilin, and
      erythromycin. The second line includes macrolides, cephalosporines. New
      perspectives are ascribed to active immunisation with recombined antigen OsA
      (LYMErix, ImuLyme).

PMID- 11218958
TI  - [Induction of autoimmune phenomena in lymphoproliferative diseases].
AB  - The association of lymphoma with the positivity of antinuclear antibodies is
      unclear. The predisposition to neoplasma in the group of patients with systemic
      autoimmune diseases is known. Our case report contains steps of the differential
      diagnostic procedure leading from the diagnosis of systemic lupus erythematosus
      to the final assessment of non-Hodgkin lymphoma. (Ref. 11.)

PMID- 11218960
TI  - [Current views on seborrheic dermatitis].
AB  - Seborrhoeic dermatitis is a common polyaethiological chronic disease affecting
      mainly the skin of face and scalp. The paper informs about aetiopathogenetic
      factors and clinical signs of SD. It review the contemporary methods of both
      external and internal treatments. Topical antimycotic treatment focused on
      Pityrosporum ovale, which could be the main causative agent, is considered to be
      the most important approach.

PMID- 11218962
TI  - [Cardiovascular diseases at the turn of the millenium].
AB  - The coronary disease of the heart (CDH) will be the most frequent cause of
      mortality and inability to work in the 21st century not only in industrially
      advanced countries but also in the developing countries. This unfavourable,
      assumedly paradoxical tendency persevering despite the significant progress in
      diagnosis and therapy is caused by two circumstances: ageing of population
      (prolonged mean life expectancy) and the increase in the number of individuals
      afflicted with (CDH) and living up to high age. In result of this development,
      the rapid increase in the prevalence of heart failure, especially in the aged,
      becomes the main cause of mortality, morbidity and hospitalisation.

PMID- 11218961
TI  - [Clinical and pharmacologic aspects of mitochondrial nephropathy].
AB  - Mitochondrial diseases, rated as rarities in paediatrics and neurology, become to
      be more and more frequently diagnosed in various body systems, including the
      kidneys. In nephrology, mitochondrial defects play an important role in the
      pathogenesis of tubular syndromes, interstitial nepohritis, focal and segmental
      glomerulosclerosis.

PMID- 11218963
TI  - [Diabetic neuropathy].
AB  - Author in his article shortly describe pathogenetic mechanisms, clinical
      manifestations, diagnostic procedures and screening possibilities (which are very
      easy to perform), and also therapeutic methods of diabetic neuropathy.

PMID- 11218964
TI  - [Somatic and functional profiles of members of the Slovak karate team].
AB  - The exercise load in karate is prevailingly of anaerobic character, the fact of
      which is evident by the increase in heart frequency and the levels of blood
      lactate. During competition, the heart frequency achieved the values of 180-199
      beats per minute and the level of blood lactate following the competition was 4.5
      6.5 mmol/l. The values of lactate were substantially higher during the training
      unit (at the time of chronometric measurement) when exercise was more intensive
      5.8-12.5 mmo/l at the heart frequency of 180-200 or even more beats per minute,
      than during competition. The aim of this work was to find out the basic
      morphologic and functional profiles in the representatives of the National Karate
      Team on the basis of laboratory methods.

PMID- 11218965
TI  - [Association of type I diabetes mellitus with HLA alleles].
AB  - Insulin-dependent diabetes mellitus is a chronic autoimmune disease characterised
      by a loss of tolerance towards own antigene structures beta-pancreatic cells. The
      destruction of cells subsequently leads to the loss of insulin production. There
      are more factors which trigger the autoimmune response in susceptible
      individuals, however, they are only partially known so far. One of the
      predisposing factors is the genotype, while the main role is ascribed to genes of
      the main histocompatible complex (HLA). Out of extensive genetic and
      epidemiological studies, the Caucasoid population is known to have a significant
      association of insulin-dependent diabetes mellitus with the increased frequencies
      of haplotypes HLA-DRB1*04-DQA1*0301-DQB1*0302 and DRB1*0301-DQA1*0501-DQB1*0201.

PMID- 11218967
TI  - [Telemedicine: something more than just "long-distance medicine"]].

PMID- 11218966
TI  - Anatomy into the future.
AB  - The necessary increase in the clinical components of the medical curriculum has
      created pressure to reduce the amount of time spent on basic science,
      particularly the detailed learning of anatomy. Methods of learning must be re
      evaluated, but departments will be constrained by resources available. The
      clinical aspects of anatomy should form the principles of a core course, with a
      limit to the wider anatomical knowledge required. Feedback from the students is
      recommended as an initial form of monitoring the course. (Ref. 13.)

PMID- 11218968
TI  - [Adolescents and sources of sex information: preferences and perceived
      usefulness].
AB  - OBJECTIVES: To find adolescents' assessment of the information received at their
      school on questions relating to sexuality. To discover their main sources of
      information on sexuality, the perceived utility of these and their preferences.
      DESIGN: Observational study. SETTING: Province of Cordoba. MEASUREMENTS AND MAIN
      RESULTS: 955 adolescents at secondary schools were chosen through multistage
      randomised sampling. Anonymous health questionnaire. Average age was 16.62% were
      girls. 545 valued as a lot or sufficient the AIDS information received (57%; 54.3
      59.6), more than when asked about STD (29%; 25.4-31.9), contraceptives (33%; 29.7
      35.2), sexual relations (22%; 19.5-24.1) or pregnancy (22%; 19.3-24.2). They were
      able to talk openly about sexuality, firstly with friends (90.8%) and girl/boy
      friend (80.5%), and least with teachers (18.7%), parents (17.4%) or priests
      (8.9%). Sexual information came basically from friends (26%) and magazines (24%),
      and least from doctors (7%) and parents (6%). The most useful source for
      adolescents was magazines (21%) and teachers (21%), with parents and cinema/T.V.
      in the last positions. When adolescents were asked from whom they would prefer to
      receive information, they chose firstly parents (34%) and doctors (33%).
      CONCLUSIONS: Adolescents perceived a centering of the information received at
      their school on AIDS. Their preferred sources of information did not coincide
      with what was most accessible. Despite considering doctors as a preferred source,
      they have received little information from us. The usefulness given to magazines
      is worthy of note.

PMID- 11218969
TI  - [Cost-effectiveness of atorvastatin against simvastatin as hypolipemic treatment
      in hypercholesterolemic patients in primary care].
AB  - OBJECTIVE: To perform an economics evaluation of lipid-lowering therapy with
      atorvastatin and simvastatin in patients with hypercholesterolemia in primary
      care setting. DESIGN: Cost-effectiveness analysis (CEA) has been carried out by
      means of an open, random, prospective, "real world" study, with
      hypercholesterolemic patients (total cholesterol [TC] > 240 mg/dl and cLDL > 160
      mg/dl). PATIENTS: A total of 92 patients were included (44.8% males), with a mean
      age of 64.9 +/- 9.4 years old (mean +/- standard deviation). 41.4% were
      diabetics, 62.1% hypertensives and 16.1% smokers. INTERVENTIONS: Patients were
      allocated to simvastatin 20 mg/day (44) and atorvastatin. 10 mg/day (48) for 6
      months. ASSESSMENT AND MAIN RESULTS: Both therapies reduced significantly cLDL,
      TC and triglycerides at the end of the study. Atorvastatin reduced lipids faster
      than simvastatin at 3 months (p < 0.05), but significant differences could not be
      observed at 6 months. Atorvastatin reduced cLDL levels by 21.5 +/- 13.2% and 23.8
      +/- 13.9% at 3 and 6 months, respectively, versus 16.4 +/- 14.2% and 22.8 +/-
      10.8% with simvastatin. By these reductions, 54.2% of patients treated with
      atorvastatin and 50.0% of those allocated to simvastatin reached therapeutic
      goals of cLDL control. Atorvastatin 10 mg was more cost-effective than
      simvastatin 20 mg; 95,406 versus 101,335 pts per patient reaching therapeutic
      goals, respectively, which means that simvastatin need an extra cost of 24,833
      pts per patient reaching therapeutic goals to be as efficient as atorvastatin.
      Sensitivity analysis to control for uncertainty confirmed the results of cost
      effectiveness analysis. CONCLUSIONS: Both statins were effective as lipid
      lowering agents. However, atorvastatin 10 mg was more efficient than simvastatin
      20 mg due to a better cost-effectiveness ratio.

PMID- 11218970
TI  - [Motives for consultation and demographic characteristics of a community of
      "undocumented" immigrants in the district of Usera-Villaverde (Madrid)].
AB  - OBJECTIVE: The objectives of the present study are to describe to the social
      particularizations, reasons for consultation and diagnoses conducted in the adult
      immigrants without regularizing that they went to this doctor's office in the
      district of Villaverde-Usera (Madrid), excluding the data from obstetrics
      gynecology and pediatric. DESIGN: One is a descriptive observational study, based
      on the registry of the daily activity of the consultation from 1996 to 1999.
      SETTING: Primary level of attention in the area of influence of the municipal
      districts of Villaverde-Usera. PARTICIPANTS: 1496 consultations to immigrants
      without regularizing adults, taken care of in our consultation are described in
      the mentioned period. MEASUREMENTS AND RESULTS: By means of the registry of daily
      activity social and demographic variables took shelter, of reason and type of
      consultation, as well as of the main diagnosis that brought to them to the
      consultation, en 1496 consultations of illegal immigrants (533 people). 31% of
      the consultations were new and a 14% of absences to the citation were registered.
      67% of the consultations made women, the average age was of 34.9 years and in a
      76% it referred like South America origin. The diseases that more consultations
      generated were acute respiratory infection 18%, depressives disorders 11% and the
      backache with also a 11%. The 48% the reasons for the consultation were acute and
      60% took place to free demand. CONCLUSIONS: The group of consultations taken care
      of responds to the profile of a young South American woman, that fundamentally
      consults by acute respiratory infections, and very in proximity by depressive
      anxious upheavals and lumbar affections, problems very in relation to his
      situation of immigrant. The irregularity adds to a risk when making difficult the
      access, most of the consultations are precise, failing in elevated occasions to
      the programmed consultation.

PMID- 11218971
TI  - [Secondary prevention of ischemic heart disease in primary care (PRESENCIAP)].

PMID- 11218972
TI  - [Women's attitudes to menopause and predictive variables].
AB  - OBJECTIVE: To find what women's attitudes to the menopause are and how these
      attitudes relate to certain personal variables. DESIGN: Multi-centre, transversal
      study. SETTING: 5 clinics at three urban and teaching health centres in Granada.
      PARTICIPANTS: A systematic randomised sample of women = 18 who attended on demand
      in June 1998: alpha = 0.05, accuracy = 3 and standard deviation from the scale of
      attitudes (SA), found through prior sampling, was 15.4. N = 101 women.
      INTERVENTIONS: Questionnaire through interview after consultation. MEASUREMENTS
      AND MAIN RESULTS: Dependent variable: scale of attitudes to the menopause with 29
      items. INDEPENDENT VARIABLES: age, marital status, educational qualifications,
      work situation, cultural group, religion, continuity with her doctor,
      utilisation, menopausal status, perception of autonomy, opinion of the menopause,
      feelings towards the menopause, perceived health. ANALYSIS: homogeneity and
      validity of SA. Descriptive, univariate analysis of SA with independent
      variables. Multiple linear regression: we found 7 factors that explained 66.5% of
      variance. Age 43.4 +/- 17.5. 50.5% had not reached the menopause; 10.9% were in
      the peri-menopause; and 37.6% in the menopause. 70.3% had feelings of relief or
      were neutral; 54.5% had a positive view; and 21.8% expressed no opinion. The
      variables explaining attitudes were feeling, continuity, opinion, utility,
      autonomy and perceived health. CONCLUSIONS: Women had positive or neutral
      feelings and opinions about the menopause. Their attitudes to it were related to
      these variables and not to other social or demographic variables or to their
      menopausal status.

PMID- 11218973
TI  - [Pharmacologic interactions in chronic treatments: corrective measures for its
      prevention in a basic area of rural health].
AB  - OBJECTIVES: To identify the pharmacological interactions of clinical relevance
      (PICR) in the medication authorization cards (MAC) of the chronically ill and to
      establish strategies to minimise their appearance. DESIGN: Cross-sectional
      descriptive study. SETTING: Rural primary care centre. PATIENTS: Random sample of
      626 MAC out of a total of 1306. MEASUREMENTS AND MAIN RESULTS: In December 1998,
      the following was gathered for every MAC with more than one drug treatment: age,
      sex, number of drugs, intrinsic value, drugs prescribed, daily dose and
      pharmacological interactions (PI), classified (using the scale of Hansten 1996)
      into light and clinically relevant. STATISTICAL ANALYSIS: Mantel-Haenszel (alpha
      = 0.05). Patients' mean age was 69.1 (95% CI, +/- 1.2). Mean number of drugs per
      MAC was 4 (95% CI, +/- 0.2). 341 PI affecting 197 patients (31.5%, 95% CI, +/-
      3.6) were identified. 24.9% (95% CI, +/- 4.5) were PICR, detected in 11.7% (95%
      CI, +/- 2.5) of the MAC. The existence of PI was related to the number of drugs
      prescribed to each patient (p < 0.01). There were 26 PI with drugs of low
      intrinsic value (7.6%; 95% CI, +/- 2.8). 74.1% (95% CI, +/- 9.3) of the total
      PICR could be avoided by simple recommendations; and the remaining 25.9% (95% CI,
      +/- 9.3) by monitoring and follow-up of patients. CONCLUSIONS: It is important to
      identify the medications most commonly involved in the PICR so as to establish
      corrective measures to minimise the risks arising from multiple medication. Four
      educational messages advise on over 60% of the PICR detected.

PMID- 11218974
TI  - [Effectiveness of preventive activities at 8 years of their introduction in a
      general medicine practice in a health center].
AB  - OBJECTIVES: Main: to assess the change in coronary risk (CR) in adults after 8
      years of their involvement in the Programme of Preventive Activities and Health
      Promotion (PAPPS). Secondary: to determine the level of anti-tetanus vaccination
      reached and patients' compliance with activities. DESIGN: "Before and after"
      intervention study without random allocation. SETTING: A general medical clinic
      at a health centre. PATIENTS: 429 patients (204 men, 225 women) between 30 and 65
      monitored for 8 years, recruited by active search for cases at daily
      consultations. INTERVENTIONS: Blood pressure, cholesterol, weight, tobacco habit,
      alcohol intake, anti-tetanus vaccination state, CR calculation at 10 years on the
      Framingham scale, and degree of compliance with activities were all determined at
      the start, at 4 years and at 8 years. Data was obtained from the clinical notes.
      RESULTS: Total population: a 0.8 drop in CR (CI difference: 0.4-1.2), equivalent
      to 8.5% of the initial figure. 64.4% increase in correct anti-tetanus vaccination
      (CI difference: 59.9-69). Compliance with activities at the start and after eight
      years: pressure 100%, 71%; tobacco consumption 99.5%, 71%; cholesterol
      determination 89%, 64%. Initially high CR sub-group: 6.7 drop of CR at 8 years
      (CI difference: 4.9-8.5), equivalent to 24.8% of the initial figure. CONCLUSIONS:
      In the total population, the CR drop found was not clinically significant,
      whereas in the initially high CR sub-group the drop was. There should probably be
      an active search made for patients with high CR and action taken on them.

PMID- 11218975
TI  - [Factors conditioning prescription in primary care].

PMID- 11218976
TI  - [CUIDA'L: a clinical trial evaluating the effectiveness of an intervention in
      care givers].

PMID- 11218977
TI  - [Applications of telemedicine in primary care].

PMID- 11218978
TI  - [Family medicine and emergency medicine].

PMID- 11218979
TI  - [Health economy and its application to evaluation].

PMID- 11218980
TI  - [Users complaints].

PMID- 11218983
TI  - [Feet on the ground and nothing grandiose].

PMID- 11218982
TI  - [Care, professional career and teaching units].

PMID- 11218981
TI  - [Treatment and control of arterial hypertension in the elderly].

PMID- 11218984
TI  - [Traveling to the world of osteoporosis].

PMID- 11218985
TI  - [Double-blind study on the efficacy of long-term intermittent nasal elcatonin in
      recent postmenopausal women].
AB  - FUNDAMENTALS: Continuous treatment with calcitonin (CT) has caused an increase of
      bone mineral density for the first 18 months, followed by a partial decrease of
      it. In order to obtain a better result in a two year follow-up, it is proposed a
      schedule treatment during 50% to 66% of the time in recent postmenopausal women.
      METHODS: Pilot, double-blind, randomised, two years follow-up study. 60 women
      with osteopenia less than 5 years from menopause received 40 U of intranasal
      elcatonin (ELC) or placebo (PL) 2 months ON, one month OFF. Compliance, safety,
      pain and the degree of incapacity were evaluated at baseline and every 3 months.
      At the start and every six months lumbar and femoral BMD were assessed with DXA.
      RESULTS: 41 patients completed the study (21 ELC and 20 PL). There were no basal
      differences. The treatment was actually used during 59% of the follow-up time in
      the ELC group and during 58% of the time in the PL group. Basal T-scores were 
      2.29 SD in the PL group and -2.42 SD in the ELC group. Bone densitometry showed
      an increase of BMD in the group of patients treated with ELC up to 18 months
      (lumbar and femoral) but a loss in those patients that received PL. CONCLUSION:
      40 U of nasal elcatonin for more than 50% of the observation time prevents in the
      long-term (2 years) the progressive loss of bone mineral density in recent
      postmenopausal women.

PMID- 11218986
TI  - [Fibronectin as a diagnostic marker in several determined neurological diseases].
AB  - OBJECTIVE: To determinate if fibronectin in CSF can be a useful parameter in the
      diagnosis of some neurologic illnesses. MATERIAL AND METHODS: We have studied 30
      patients, subdivided in four groups, depending on the type of neurologic illness.
      We have chosen as control a 10-patient group, which came to the Emergency Service
      and were diagnosed as a suspicious of neurologic illness, but after this it was
      discarded. In the whole group we practiced a lumbar puncture, with cytology,
      systematic, biochemistry, cultures, immunoglobulins determination and fibronectin
      quantification by ELISA. RESULTS: We want to emphasize the increase in
      fibronectin levels in CSF in both the patients with bacterial meningitis and the
      multiple sclerosis groups, when it's compared with the control group. CONCLUSION:
      For this, the determination of fibronectin levels in CSF might be a useful
      parameter in the diagnosis of some neurologic illnesses.

PMID- 11218987
TI  - [Evaluation of the functional component underlying the frequent attendance to a
      hospital emergency service and its economic consequences].
AB  - OBJECTIVE: To analyse the psychosocial characteristics of frequent emergency
      department (ER) users with a relevant non-organic component and estimate the
      generated costs. METHODS: Retrospective-descriptive study (Jan 1996-Jun 1997)
      about overusers (OU) defined as > = 3 visits/6 months during at least two 6
      months periods, coming to our hospital's emergency department. Reviewing their
      medical records and making a psychiatric interview we identified Non-organic OU
      (NOU). Subsequently we estimated the cost generated by discharge visits during
      the first six months of 1997. RESULTS: Sixty six out of 220 OU were identified as
      NOU. The mean consultation rate was 11.3 +/- 9.4. Clinician-psychiatrist
      agreement on non-organicity was 72.7%. The most frequent diagnoses were:
      personality disorders (37.5%) and depression-anxiety (35%). Psychiatric OU were
      significantly younger (51.7 vs 62.5 years) and attended more often (17.6 vs. 9.9
      times). In six months only one of 240 ER consultation cause admission. The mean
      cost of each discharge episode was 8682.9 +/- 6633.8 pta (25.06% due to variable
      costs). The cost per minute of emergency room stay was 19.26 ptas. Overall NOU
      attention cost during the six month period studied was 1,903,775 ptas (0.36% of
      overall ER costs). CONCLUSIONS: Compared with the rest of users, NOU entail a
      higher burden for the ER. Mentally-ill patients are younger and consult more
      frequently than the rest of OU. Only 25% of the cost per consultation is due to
      treatments, tests or diets.

PMID- 11218988
TI  - [Echography evaluation of Morton's neuroma].
AB  - OBJECTIVE: We have carried out a study to evaluate diagnostic usefulness of
      ultrasound in Morton's neuroma. METHODS: Twenty five patients with symptoms
      suggestive of Morton's neuroma underwent ultrasound examination of the forefoot.
      All patients subsequently had surgical treatment. RESULTS: Nineteen patients had
      sonographic evidence of neuroma which were confirmed surgically and later by
      histological exams. One patient had sonographic evidence of a neuroma that was
      not confirmed surgically. The remaining five patients did not have sonographic or
      surgical evidence of neuroma in spite of clinical signs and symptoms. No adjacent
      neuromas were appreciated. Ultrasound accurately predicted the location of the
      neuroma in 96.7%. Ultrasound demonstrated a sensitivity of 100% and a specificity
      of 83.3%. CONCLUSION: We conclude that ultrasound is a highly accurate technique
      in the diagnosis of the presence and location of Morton's neuromas.

PMID- 11218989
TI  - [Diagnosis of hemochromatosis with magnetic resonance].
AB  - Hemochromatosis is a disorder of parenchymal iron overload. The diagnosis is
      based upon clinical manifestations, laboratory findings and iron concentration in
      liver. Magnetic resonance imaging (MRI) shows a decrease in liver signal
      intensity. Its role has not been already defined. Nonetheless, ratio of liver to
      muscle proton density (LMPD) shows a significant correlation with hepatic iron.
      One patient with a long-standing cirrhosis with data of hemochromatosis whose
      coagulation study did not allow to perform a liver biopsy was diagnosed with this
      method. Hepatic iron concentration was calculated based upon: microgram/g of
      hepatic iron = (-5.174* LMPD) + 9.932. MRI can be useful in the evaluation of
      hemochromatosis among patients who refuse or have contraindication to liver
      biopsy.

PMID- 11218991
TI  - [Meningeal carcinomatosis as first manifestation of carcinoma of the bladder:
      report of 2 cases].
AB  - Meningeal carcinomatosis may occur in 0.8-8% of patients with solid tumors. The
      most common tumors associated with that condition are breast and small cell lung
      cancer. Meningeal carcinomatosis from urothelial cancer is rare, and it appears
      described in advanced stages of disease, generally, after chemotherapy. Two cases
      of meningeal carcinomatosis as the first manifestation of bladder cancer were
      reported. In the first case, a 46-year-old man presented signs and symptoms
      indicative of involvement of the spinal roots, subsequently neurologic
      dysfunction of the brain and cranial nerves appeared. In the second case, a 68
      year-old man was admitted to our hospital with a history compatible with
      panhypopituitarism and pulmonary lymphangitic carcinomatosis from cancer of
      unknown primary site. Follow-up revealed a transitional cell carcinoma of the
      bladder and hydrocephalus due to cerebrospinal fluid outflow obstruction. We
      emphasize in the polymorphic presentation of meningeal carcinomatosis and the
      necessity to consider the bladder as primary tumor localization.

PMID- 11218990
TI  - [Nocardiosis in 2 immunocompetent patients].
AB  - Two diagnosed clinical cases of nocardiosis in immunocompetent patients are
      presented, different in their clinical aspects, evolution and treatment. We
      report a 55 years-old man with disseminated nocardiosis and a 32 years-old man
      with splenectomy diagnosed of pulmonary nocardiosis. The medical literature is
      reviewed and emphasis is placed on the different illness and treatment of the
      nocardiosis.

PMID- 11218992
TI  - [Gastric anisakiasis diagnosed with endoscopy].
AB  - Anisakiasis is a parasitic infestation, infrequent in Spain, due to ingestion of
      raw or underdone by Anisakis larvae. Also it can appear after consumption of
      smoked, salted or dried salt fish. The disease can show under different clinical
      forms, depending on the part of the gastrointestinal tract where the larva
      settles. We report two cases of anisakiasis diagnosed in Valladolid. Both
      patients were women that had eaten some days before anchovies marinated with
      vinegar. The diagnosis was made by endoscopic examination and the problem was
      solved by extraction of the parasite. It worthy to note that both cases appeared
      in a short time interval, showing perhaps some seasonal character. Finally some
      hygienic-dietetic measures are proposed for combating the disease.

PMID- 11218993
TI  - [Diffuse T-cell lymphoma of the cervix uteri: an unusual localization of an
      infrequent tumor].
AB  - Non-Hodgkin lymphomas are frequent tumors. However, extraglandulary forms are
      very unusual, and the location in the uterine cervix is also extraordinary. A
      case of an elderly woman with symptoms not related with the tumor, in whom the
      diagnosis was made from the incidental finding of a distended obstructive bladder
      is presented. Pelvic mass is one of the forms of presentation of primary
      malignant lymphomas of the uterine cervix. Diagnosis was made in this case by
      transvaginal biopsy under general anesthesia. Biopsy showed a diffuse T-cell
      lymphoma, a very rare finding considering that most of published cases are B-cell
      type. The importance of distinguishing malignant lymphoma from undifferentiated
      carcinoma or sarcoma is emphasized since cervical malignant lymphoma can be
      successfully treated with irradiation.

PMID- 11218994
TI  - [Chemotherapy and palliation in patients with advanced cancer].
AB  - Chemotherapy shows antitumoral activity in several advanced cancers. However,
      toxicity is frequent and may even overwhelm the clinical benefit of
      antineoplastic activity. To recommend such a treatment, we need to know the
      sensibility of cancer to therapy, its toxic effects and the clinical benefit we
      are looking for, expressed as: symptoms relief or delay in its presentation,
      improvement in quality of life, increase in overall survival and reduction in
      tumor volume. We need also to evaluate the performance status and functional
      status of each patient, its prognosis, the severity of symptoms and its interest
      to receive any antitumor treatment. According to these parameters we can
      individualize each therapy to select those patients whose expected benefit from
      this palliative chemotherapy is higher.

PMID- 11218995
TI  - [Acute pancreatitis complicated by a tubercular abscess].

PMID- 11218996
TI  - [Hepatic epithelioid hemangioendothelioma: presentation of a case].

PMID- 11218997
TI  - [Symptomatic hypocalcemia in an adenocarcinoma of the prostate with osteoblastic
      metastasis].

PMID- 11218998
TI  - [Toxic epidermal necrolysis in relation with nevirapine].

PMID- 11218999
TI  - [Massive rhabdomyolysis after an overdose of intravenous drugs complicated by
      acute acute renal failure and generalized compartment syndrome].

PMID- 11219000
TI  - [Pellagra: manifestations of a disease. . . not forgotten?].

PMID- 11219002
TI  - [Leishmaniasis in the cellular block of bone marrow aspirate].

PMID- 11219001
TI  - [Acute adrenal insufficiency secondary to a bilateral adrenal hemorrhage].

PMID- 11219003
TI  - [Pneumonitis in a 73-year-old woman].

PMID- 11219004
TI  - [Xanthogranulomatous pyelonephritis with fistula in the gluteal region].

PMID- 11219005
TI  - Peptide bond characteristics.

PMID- 11219006
TI  - Synthetic Cu(II) and Ni(II) peptidases.

PMID- 11219007
TI  - Palladium(II) and platinum(II) complexes as synthetic peptidases.

PMID- 11219008
TI  - Protease activity of 1,10-phenanthroline-copper systems.

PMID- 11219009
TI  - Specific protein degradation by copper(II) ions.

PMID- 11219010
TI  - Artificial iron-dependent proteases.

PMID- 11219011
TI  - Lanthanide ion-mediated peptide hydrolysis.

PMID- 11219012
TI  - Hydroxyl radical footprinting of proteins using metal ion complexes.

PMID- 11219013
TI  - Nickel- and cobalt-dependent oxidation and crosslinking of proteins.

PMID- 11219014
TI  - Effects of metal ions on the oxidation and nitrosation of cysteine residues in
      proteins and enzymes.

PMID- 11219015
TI  - Protein cross-linking mediated by metal ion complexes.

PMID- 11219016
TI  - Ferrocenoyl amino acids and peptides: probing peptide structure.
AB  - Recent studies clearly show the utility of the carbodiimide protocol to attach
      the redox-active Fc moiety to the N-terminal side of amino acids and peptides
      under mild conditions, resulting in stable and often crystalline products that
      afford themselves to structural analysis by X-ray crystallography.
      Electrochemical studies of Fc-peptides show that there is a significant influence
      of the redox potential depending on the amino acid sequence. The Fc moiety is
      sensitive to structural changes that occur in the peptide to which it is
      attached. For helical Fc-oligoprolines, the redox potential of the Fc group makes
      it easier to oxidize as the oligoproline chain increases in length. Nonhelical
      peptides, having a similar primary but different secondary structure, give rise
      to very different redox potentials. The ramifications of these findings to
      biological systems are significant in that they provide further evidence that the
      redox properties of a metal center are influenced by factors that go beyond the
      primary ligand sphere and thus for the involvement of long-range interactions.
      The Fc group is clearly sensitive to the shape of the peptide. These effects are
      currently under more detailed investigation [45] in order to gain further insight
      into the electronic structure of these ferrocenoyl peptides. Although we are not
      yet in a position to distinguish between "sensing" coordination or "sensing"
      conformation changes, this effect is of interest because it may allow the
      development of peptidic sensors.

PMID- 11219018
TI  - Co(III)-promoted hydrolysis of amides and small peptides.

PMID- 11219017
TI  - Synthetic analogs of zinc enzymes.

PMID- 11219019
TI  - Mimicking biological electron transfer and oxygen activation involving iron and
      copper proteins: a bio(in)organic supramolecular approach.

PMID- 11219020
TI  - Soft papules on the forearm. Lesions that can be compressed are often benign and
      do not require surgery.

PMID- 11219022
TI  - How to predict your patient's future.

PMID- 11219021
TI  - Hypertension. Update on use of angiotensin II receptor blockers.
AB  - Hypertension is the most common of the cardiovascular risk factors. Although its
      risks have been known for decades, hypertension remains inadequately diagnosed
      and undertreated. Better understanding of the pathophysiology of hypertension,
      including the role of the renin-angiotensin system, has led to the development of
      new approaches for patient management. Compared with traditional antihypertension
      treatments, angiotensin II receptor antagonists may offer more effective
      treatment and an improved side effect profile. These agents also may have an
      important treatment role in other cardiovascular conditions for which ACE
      inhibitors are commonly prescribed. As clinical trial data are showing, the full
      potential of these drugs has yet to be determined.

PMID- 11219023
TI  - Prescribing. Keys to maximizing benefit while avoiding adverse drug effects.
AB  - When prescribing for older patients, some physicians are overly cautious, and
      this strategy can result in a less than optimal treatment outcome. The reluctance
      to treat aggressively is understandable because the geriatric population is
      susceptible to adverse drug reactions. The key to maximizing therapy lies in
      individualizing it as much as possible. There are a number of steps physicians
      can take to ensure that their patients are not being undertreated. These steps
      include regular reevaluations of dosages and plasma drug concentrations,
      recognition and understanding of drug side effects, and avoidance of certain
      agents. Close monitoring allows physicians to minimize risks, maximize benefits,
      and get the most out of what modern medications can do to help older patients.

PMID- 11219024
TI  - Prostate cancer Tx. Therapeutic options based on tumor grade, life expectancy,
      and patient preferences.
AB  - Cancer of the prostate is the most common malignancy in American men. Its
      incidence is associated with age, race, family history, and life style factors,
      such as high-fat diets. Some men develop prostate cancer before age 55, but 80%
      of tumors occur in men older than age 65. For organ-confined prostate cancers,
      treatment options include observation, radical prostatectomy, external beam or
      interstitial radiation, and cryoablation. The appropriate therapeutic decision is
      based on analysis of multiple factors by the physician and the individual
      patient. Advanced prostate cancer remains incurable, but hormonal manipulation
      and newer chemotherapeutic regimens offer palliation in later stages of the
      disease.

PMID- 11219025
TI  - Treatment of impulsivity and aggression in a patient with vascular dementia.
AB  - This case illustrates how treatment with divalproex sodium, an agent approved for
      use as an anticonvulsant and mood stabilizer, led to a reduction in overt
      aggression, diminished impulsivity, and improved functional status in a patient
      with vascular dementia. Improved receptivity to care and reduced hostility also
      led to an increased quality of life for the family caregivers. The daughter also
      benefited greatly from participation in a family support group.

PMID- 11219026
TI  - Iasis plans IPO. Hospital company hopes to woo investors with new management
      team.

PMID- 11219027
TI  - The watchdogs are biting. State attorneys general asserting authority over not
      for-profit hospitals.

PMID- 11219028
TI  - Hardly a sense of closure. N.Y. ambulatory center closes, blames move on
      hospital's tactics.

PMID- 11219029
TI  - New kids on the block. Here comes the next generation of workers: they have Gen
      Xers' energy and skills, with a new attitude.

PMID- 11219030
TI  - Casting a net via the Net. More healthcare organizations turn to online
      recruiting; results mixed.

PMID- 11219031
TI  - Web survey. December survey results: a look at 2001.

PMID- 11219032
TI  - Behind in the count. Purchase of money-losing hospital puts Ty Cobb health system
      in a slump.

PMID- 11219033
TI  - The PPO accreditation contest. Competition among the big guns may hamper
      universal standards.

PMID- 11219034
TI  - What would make your day perfect?

PMID- 11219035
TI  - Treating the underserved: you call this an incentive?

PMID- 11219036
TI  - Compliance plans: how optional, really?

PMID- 11219037
TI  - Prompt-pay laws are finally getting teeth.

PMID- 11219038
TI  - Moving on, moving up. Your career guide. Stuck midstream? Change horses.

PMID- 11219039
TI  - Making good use of a sabbatical.

PMID- 11219040
TI  - Back to college, at 49.

PMID- 11219041
TI  - Moving on, moving up. Your career guide. Some are meant to lead. Maybe you.

PMID- 11219042
TI  - "Perfect is the enemy of good".

PMID- 11219043
TI  - The ion chromatographic separation of high valence metal cations using a neutral
      polystyrene resin dynamically modified with dipicolinic acid.
AB  - A neutral polystyrene resin column, dynamically loaded with dipicolinic acid at a
      concentration of 0.1 mM in 1 M potassium nitrate eluent, was investigated for the
      separation characteristics of a number of high valence metal cations over the pH
      range 0-3. The metal species studied were Th(IV), U(VI), Zr(IV), Hf(IV), Ti(IV),
      Sn(IV), V(IV) and V(V), Fe(III) and Bi(III), of which Ti(IV), Sn(IV), V(IV) and
      Fe(III) did not show any retention. For the remaining metal ions, significant
      retention was obtained with good peak shapes, except for Th(IV), which moved only
      slightly from the solvent front with some tailing. The retention order at pH 0.3
      was Th(IV) < V(V) < Bi(III) < U(VI) < Hf(IV) < Zr(IV). A notable feature of this
      separation system was the high selectivity shown for uranium, zirconium and
      hafnium, the last two being nearly resolved in 15 min on the relatively short 10
      cm column.

PMID- 11219044
TI  - Ion chromatographic analysis of hydronium ion using ODS modified with
      dodecylsulfate as the stationary phase.
AB  - The hydronium ion (H3O+), the most essential species to every field of chemistry,
      was successfully separated from other cations. This major goal was achieved by a
      HPLC approach in which a reversed-phase ODS which had been initially modified
      with dodecylsulfate was used as the stationary phase and an aqueous KNO3 solution
      was used as the mobile phase. Of all tested monovalent cations (analyte ions),
      the hydronium ion (H3O+) showed the highest affinity towards the stationary
      phase, followed by NH4+, Na+, and then Li+. The hydronium ion, after the
      separation, was directly detected using conductivity and the detection signal
      (conductivity) was in linear proportion (linear range 7.8 x 10(-4)-0.45 M;
      injection volume, 100 microL) to the concentration of the acid species of the
      tested sample. This proposed HPLC method was applicable to separate/detect H3O+
      from both strong and weak acidic samples.

PMID- 11219045
TI  - Alloy electrodes with high hydrogen overvoltage for analytical use in
      voltammetry. Some preliminary results.
AB  - Liquid mercury and liquid diluted mercury amalgams have been the major electrode
      systems employed in voltammetry and related methods. This is mainly due to their
      high overvoltage to hydrogen, which enables the determination of heavy metals
      (zinc, nickel, cobalt, etc.) and other species with high negative half-wave
      potentials; the toxicity of mercury and liquid diluted mercury leads to ever
      increasing restrictions in their use. The use of such systems may even be
      forbidden in the future, at least in online systems for work in the field. Recent
      work, carried out in our laboratory, has demonstrated that a non-toxic solid
      dental amalgam may be used as the electrode material, conveniently replacing
      mercury. An extension of this work has shown that electrode materials comprising
      a metal or a compound with low hydrogen overvoltage change their hydrogen
      overvoltage properties substantially when contaminated with even small amounts of
      metals or compounds which show high hydrogen overvoltage. This extends greatly
      the range of potentially available electrode systems and thereby analytical
      possibilities of voltammetry. This new discovery also makes it possible to
      produce solid electrodes that have high overvoltage to hydrogen without any use
      of mercury.

PMID- 11219046
TI  - Assessment of growth of Fusarium solani by cyclic voltammetry and possible
      bioanalytical applications.
AB  - Fusarium solani, the fungus isolated from polyurethane waste scraps, was studied
      for its voltammetric response. The peak current values were obtained for
      different days and were plotted against time. This electrochemical method based
      on the voltammetric response showed all the four phases of the growth of the
      fungus. The growth curve obtained matched well with the conventional methodology,
      which is obtained by assessing the increase of dry weight of the organisms
      against time. The electrochemical method is more advantageous than the
      conventional method because the conventional method is very time consuming and
      difficult to work with. Further, the electrochemical method clearly shows the
      decline phase, which is generally not very well defined in the conventional
      method of assessment of the growth curve. It was confirmed by further experiments
      that the metabolites were responsible for the anodic peak and not the fungal
      biomass. Identification of the metabolites that are responsible for the anodic
      peak is presently being studied.

PMID- 11219047
TI  - A dual electrochemical sensor for nitrite and nitric oxide.
AB  - Nafion/lead-ruthenate pyrochlore chemically modified electrode (NPyCME) showed a
      remarkable dual sensing activity toward NO2- oxidation and NO reduction as
      demonstrated by cyclic voltammetry (CV), ac-impedance spectroscopy and flow
      injection analysis (FIA). The mechanistic parameters of current function, charge
      transfer resistance and exchange current for the NPyCME, GCE and Nafion-coated
      GCE were evaluated and compared. The disproportionation reaction of NIIIO2- into
      NIVO3- + NIIO in acidic solution was used as a model system for testing the dual
      sensing ability of the NPyCME. The obtained crossover peak response for NO2-
      oxidation and NO reduction in pH 1.65 buffer solution gave the direct proof for
      the applicability of the NPyCME in the dual electrocatalytic action. By flow
      injection analysis, under optimized conditions, the calibration curve was linear
      in the range of 100 nM-100 microM and 800 nM-63.3 microM and the detection limit
      (S/N = 3) was 4.8 nM and 15.6 nM for NO2- and NO, respectively.

PMID- 11219048
TI  - Refractometric discrimination of void-space filling and swelling during vapour
      sorption in polymer films.
AB  - Thin polymeric films have been deposited as upper cladding layers on a new
      integrated optical interferometer fabricated from layers of silicon oxynitride on
      a silicon wafer. The evanescent field of the probing waveguide mode transduces
      refractive index changes in the polymer layer into the measured phase changes in
      the device. Real-time measurement of index change and its sign is obtained. Upon
      exposure to humid air, we record water sorption by films of poly(vinyl
      pyrrolidone) by a rapid positive index change for void-space filling followed by
      a slow negative index change for swelling. Sorption of water vapor into a thin
      film of the viscous liquid polymer polyethylenimine shows only swelling mode
      behaviour and a simple constitutive model can be applied to give the fractional
      water occupied volume.

PMID- 11219049
TI  - mRNA isolation in a microfluidic device for eventual integration of cDNA library
      construction.
AB  - mRNA isolation for the purpose of cDNA library construction was performed in a
      microfluidic chip device using paramagnetic oligo-dT beads. The simple Y
      intersection flow design mixes beads and sample on-chip, and uses magnetic
      trapping to capture, then release the beads. The capillary gel electrophoresis
      (CGE) detection of the total unamplified mRNA isolated on-chip, and of a reverse
      transcription-polymerase chain reaction (RT-PCR) amplified rare gene indicated
      that mRNA could be captured by oligo-dT beads on-chip, had very good integrity
      and was suitable for constructing a cDNA library. The limit of detection for the
      rare bicoid gene of Drosophila Melanogaster corresponded to the capture of
      approximately 2.8 ng of total mRNA from 0.85 microgram of total RNA (TRNA) within
      the microchip. As much as 34 ng of total mRNA was estimated to be captured from
      10 micrograms of TRNA.

PMID- 11219050
TI  - Chromatographic methods for the determination of the logL16 solute descriptor.
AB  - A squalane packed column and two open-tubular columns coated with an immobilized
      stationary phase film of poly(dimethylsiloxane) or poly(methyloctylsiloxane) are
      evaluated as surrogate chromatographic systems for the determination of the
      logL16 solute descriptor by gas chromatography. Retention on the squalane column
      is dominated by gas-liquid partitioning with a significant temperature-dependent
      contribution from interfacial adsorption at the liquid-solid interface. Using the
      gas-liquid partition coefficient as the dependent model variable allows logL16 to
      be estimated to +/- 0.026 log units over the temperature range 60-120 degrees C.
      Without correction for interfacial adsorption a single column estimation of
      logL16 with phase loadings of 8 to 20% (m/m) over the temperature range 80-120
      degrees C is possible for compounds with moderate hydrogen-bond basicity. The
      poly(dimethylsiloxane) stationary phase is both dipolar and hydrogen-bond basic
      and less suitable than the poly(methyloctylsiloxane) stationary phase, which is
      less cohesive and has similar dipolarity but no hydrogen-bond basicity. The
      determination of logL16 on the poly(methyloctylsiloxane) column requires prior
      knowledge of the solute dipolarity/polarizability descriptor to avoid significant
      errors in the measurement of logL16 for polar compounds. In such circumstances a
      single column estimation of logL16 over the temperature range 60-140 degrees C
      with an error of +/- 0.05-0.09 log units is possible.

PMID- 11219051
TI  - High accuracy isotope dilution analysis for the determination of ethanol using
      gas chromatography-combustion-isotope ratio mass spectrometry.
AB  - A procedure was established for the determination of ethanol in water samples by
      isotope dilution analysis. After spiking the sample with labelled [13C2]ethanol,
      it was analysed by gas chromatography-combustion-isotope ratio mass spectrometry.
      Results are reported for two certified reference materials and also ethanol
      solutions prepared for a CITAC (Co-operation on International Traceability in
      Analytical Chemistry) interlaboratory comparison. The certified reference
      materials were certified using the dichromate titration method at nominal levels
      of 80 and 200 mg per 100 mL. The CITAC solutions were prepared gravimetrically at
      nominal levels of 50, 80 and 200 mg per 100 mL. The results of the analysis agree
      well to within 0.5% of the gravimetric values of the different samples. The
      relative expanded standard uncertainties (with a coverage factor equal to 2)
      associated with the results varied between 0.18 and 0.37%, a range that
      encompassed the gravimetric values for the different samples. A complete
      uncertainty budget was also drawn up so that the different contributions could be
      identified and quantified. The main contributions were due to variations in the
      measured isotope amount ratios and a 'between' blend component introduced to
      quantify the contribution of factors such as the degree of matching of the
      isotope amount ratios between standards and samples used in the isotope dilution
      analysis.

PMID- 11219052
TI  - A rapid method for the determination of lasalocid in animal tissues and eggs by
      high performance liquid chromatography with fluorescence detection and
      confirmation by LC-MS-MS.
AB  - A simple and rapid method has been developed for the extraction of lasalocid from
      chicken muscle, eggs and liver and kidney from chicken, pig, sheep and calf. This
      method allows the screening of a large number of samples, i.e. 30-40 within a
      working day, and has an overall analysis time of 90 min. Lasalocid standard
      solution can be detected at 1 ng ml-1 by both HPLC-fluorescence (HPLC-F) and LC
      MS-MS; the limit of quantification in fortified samples by the described method
      is 1 ng g-1. Results show good repeatability and mean 'spiked' recoveries by HPLC
      F in the range of 10 to 200 ng g-1 (ppb) of 103, 87, 107, 97, 97, 103, 93, 109
      and 100% in chicken muscle, chicken liver, egg, pig liver, pig kidney, sheep
      liver, sheep kidney, calf liver and calf kidney, respectively. For concentrations
      between 1 and 6 ng g-1 of spiked lasalocid in eggs and chicken liver by LC-MS-MS,
      the average recoveries were 76 and 59%, respectively.

PMID- 11219054
TI  - Cross-referenced combinatorial libraries for the discovery of metal-complexing
      ligands: library deconvolution by LC-MS.
AB  - N-Acylthioureas are excellent ligands for a variety of heavy metals, but their
      metal selectivity is highly dependent on the precise nature of the substituents
      present. In this paper we show how combinatorial chemistry techniques can be used
      to establish relative affinities for copper within a mixture of 100 such
      thioureas. Following a straightforward synthesis, and copper extraction using
      standard liquid-liquid extraction techniques, LC-MS was used to identify the
      ligands which bind most strongly to the copper ions. Among the 100 ligands
      XC(O)N(Z)C(S)NHY, the most important substituent is the Y group bound to the NH:
      only aromatic Y substituents give strong binding to copper. The acyl X
      substituents are invariably aromatic, and an electron-rich X group is best; the
      affinity for copper seems to be less dependent on the Z substituent, although a
      large group such as benzyl disfavours copper binding. The five ligands from the
      library which bind copper most strongly have been clearly identified by a series
      of experiments: they all have aromatic groups in the Y position, but the X and Z
      substituents can be more varied. This is a very convincing demonstration of the
      power of combinatorial methods: to have found the same information by
      conventional methods would have required a lengthy and repetitive series of
      syntheses and investigations. In addition, our results give some preliminary
      evidence for synergistic binding of two different ligands, but this requires
      further investigation.

PMID- 11219053
TI  - Simultaneous quantitative determination of norgestrel and progesterone in human
      serum by high-performance liquid chromatography-tandem mass spectrometry with
      atmospheric pressure chemical ionization.
AB  - A selective, reliable and rapid method for the simultaneous determination of
      progesterone and norgestrel concentrations in human serum after taking oral
      contraceptive tablet has been developed using high-performance liquid
      chromatography-tandem mass spectrometry (HPLC-MS-MS) with atmospheric pressure
      chemical ionization (APCI) interface. The norethisterone was used as the internal
      standard. Selected transitions of m/z 313/245 for norgestrel, m/z 315/97 for
      progesterone and m/z 299/109 for norethisterone were monitored using multiple
      reaction monitoring (MRM) mode for quantitation. The assay was linear over the
      concentration range of 0.2-50 ng mL-1 for norgestrel and progesterone. The lower
      level of quantitation in human serum was obtained at 0.2 ng mL-1 for both
      norgestrel and progesterone using optimum tuning parameters. The intra-assay
      precision and inter-assay precision do not exceed 10 and 9%, respectively. The
      method has been applied to the determination of norgestrel and progesterone in
      serum of female volunteers.

PMID- 11219055
TI  - Automated in-tube solid phase microextraction coupled with HPLC-ES-MS for the
      determination of catechins and caffeine in tea.
AB  - A polypyrrole (PPY) coated capillary and several commercially available
      capillaries (capillary GC columns) were used to evaluate their extraction
      efficiencies for catechins and caffeine. Compared with commercial capillaries
      that were currently used for in-tube solid phase microextraction (SPME), the PPY
      coated capillary showed better extraction efficiency for all of the compounds
      studied. Electrospray mass spectrometric (ES-MS) detection conditions were also
      investigated. After optimization of the extraction and detection conditions, a
      method for the sensitive and selective determination of catechins and caffeine
      was developed by coupling the PPY coated capillary in-tube SPME with HPLC-ES-MS.
      Catechins could be determined in both positive and negative ion detection modes.
      The detection limit (S/N = 3) for each of the studied catechins was < 0.5 ng mL
      1. Caffeine could only be determined under positive ES-MS detection conditions
      and its detection limit was 0.01 ng mL-1. Caffeine and the five catechins in
      several tea samples were determined using the developed method. Small amounts of
      catechins were also detected in grape juice and wine samples.

PMID- 11219056
TI  - Metal distribution patterns in the mussel Mytilus edulis cytosols using size
      exclusion chromatography and double focusing ICP-MS detection.
AB  - In order to estimate metal distribution patterns in biomolecules of different
      sizes and their possible relationship with environmental heavy metal
      contamination, multi-elemental distributions in different fractions of the
      cytosols of mussels were studied. To do so, samples were collected from natural
      populations of two coastal regions in Spain: a wild (uncontaminated) coast and an
      industrialised (contaminated) area in Asturias. Moreover, some commercial mussels
      from the Galicia coast were also investigated for comparison. Aliquots of the
      mussel cytosol extracts from each sample were applied to a calibrated Sephadex G
      75 column (100 x 1 cm) and forty 3 ml fractions were obtained. After suitable
      dilution, 18 trace metals were determined by double focusing inductively coupled
      plasma mass spectrometry (DF-ICP-MS). The use of DF-ICP-MS detection allowed the
      resolution of several spectral interferences that cannot be resolved by
      quadrupole ICP-MS. Accurate results for ultratrace elements at basal levels are
      possible even after sample dilution to prevent matrix effects. After biomolecule
      metal association pattern has been established, quantitative analysis of mussel
      cytosols from the three coastal areas was carried out, using external aqueous
      calibration plus standard additions to correct for possible matrix effects.
      Results showed that total metal contents increased following the expected order:
      wild coast < Galicia coast < industrial area coast. Speciation of Cu, Zn, Ca, U,
      Ni, Mo, Mn, Cr, V, Cd, Al and Sb showed a similar distribution pattern among
      cytosolic ligands for all the studied samples. Conversely, Fe, Pb, Sn, Co, Hg and
      Ag were found to exhibit different speciation patterns when samples from
      industrialised (contaminated) and non-industrialised areas were compared.

PMID- 11219057
TI  - Determination of three anabolic compounds in calf urine by liquid chromatography
      with photodiode-array detection.
AB  - A method for the determination of three anabolic hormones (diethylstilbestrol,
      dienestrol and trenbolone) in calf urine is described. After enzymatic
      hydrolysis, the samples were cleaned up by C18 solid-phase extraction. Drugs were
      extracted with hexane and analyzed by isocratic elution on a Discovery RP-Amide
      C16 5 microns column with photodiode-array detection at 240 and 347 nm. Both
      retention time and UV spectra were used for identification. Detection limits for
      the HPLC system were calculated to be 0.3 ng injected for all analytes in the
      standard mixture. However, for urine samples these limits increased because of
      the presence of unidentified matrix components. After extraction from urine, the
      limits of detection for the whole analytical procedure were 5 and 10 ng injected
      for trenbolone and stilbenes, respectively. The average recoveries of the
      hormones from spiked samples were in the range 53.1-56.7% with RSD between 11.3
      and 14.5% for the whole procedure in the concentration range 25-2.5 ng ml-1.

PMID- 11219058
TI  - Comparative study of capillary zone electrophoresis and micellar electrokinetic
      capillary chromatography for the separation of naphthalenedisulfonate isomers.
AB  - We investigated the separation of a test mixture of nine substituted and
      unsubstituted naphthalenedisulfonate isomers by capillary electrophoresis with a
      UV diode array detector. In particular, we focused on how the composition of the
      running buffer affected the separation selectivity. When capillary zone
      electrophoresis was carried out, the best results were obtained when organic
      solvents such as ethanol or propan-2-ol were added. Eight peaks were baseline
      separated but in no case were all the unsubstituted isomers separated. Therefore,
      capillary electrophoretic separation of the compounds was examined in the
      presence of micellar agents, such as sodium dodecyl sulfate, polyethylene glycol
      dodecyl ether (Brij 35) and cetyltrimethylammonium bromide. All the substituted
      isomers and two of the unsubstituted isomers were well resolved within 20 min by
      micellar electrokinetic capillary chromatography when Brij 35 was used as
      micellar agent. Separations were reproducible, in terms of peak area and
      migration time, under these conditions.

PMID- 11219059
TI  - Rejection of capillary wall background light in an on-column confocal
      fluorescence detector.
AB  - Minimization of the background arising from the capillary wall is of extreme
      importance in laser induced fluorescence on-column detection for capillary
      electrophoresis. A sensitive confocal fluorescence detection scheme is described.
      The intense capillary wall background light was effectively rejected by an
      adjustable precision slit in a confocal configuration. Rhodamine 640 was used as
      a standard fluorophore. Detection linearity was demonstrated over four orders of
      magnitude of concentration and the concentration detection limit was 3.38 x 10(
      11) M.

PMID- 11219060
TI  - An electrospray ionization ion trap mass spectrometric (ESI-MS-MSn) study of
      dehydroascorbic acid hydrolysis at neutral pH.
AB  - The hydrolysis of dehydroascorbic acid (DAAH) at neutral pH and 27 degrees C was
      investigated by direct infusion electrospray ionisation ion trap mass
      spectrometry (ESI-MS). This approach permitted derivatisation and elution
      procedures to be avoided, reducing to the minimum extent sample manipulation and
      allowing a rapid and direct observation of the species involved in the reaction.
      Six main peaks, related to hydrated dehydroascorbate (HyDAA-) and diketogulonate
      (HyDKG-) anions, were observed in the mass spectra of DAAH solutions at different
      times of incubation and were characterised by MSn experiments. The relevant
      signal intensities changed with time and a model, based on the irreversible
      pseudo-first order HyDAA(-)-->HyDKG- conversion, fitted successfully the data
      obtained for dehydroascorbate. The kinetic constant of the process was (3.2 +/-
      0.5) x 10(-2) min-1. The influence of metal ion traces on the hydrolysis rate was
      also checked, performing experiments in the presence of EDTA, and was found to be
      negligible.

PMID- 11219061
TI  - Enantioselective uptake of amino acid with overoxidized polypyrrole colloid
      templated with L-lactate.
AB  - An overoxidized polypyrrole colloid, which can recognise enantiomers of amino
      acids has been prepared by a newly developed molecular imprinting technique. A
      polypyrrole colloid, which had been polymerised from a mixture of pyrrole
      (monomer), polyvinylpyrrolidone (steric stabiliser), peroxodisulfate (oxidant)
      and L-lactate (dopant), was overoxidized to create a dopant-complementary cavity.
      The enantioselectivity of the overoxidized colloid was evaluated by comparing the
      uptake of L-alanine and L-cysteine with that of the respective D-enantiomers. The
      L/D uptake ratios for these amino acids were about 2, while phenylalanine showed
      suppressed uptake for both the enantiomers. The absence of phenylalanine uptake
      can be explained in terms of the molecular size, which is too large to be
      accommodated by the cavity created by L-lactate. In contrast, a colloid templated
      with L-phenyllactate took up L-phenylalanine with a higher enantioselectivity of
      about 7. A colloid templated with L-lactate was applied to surface chirality
      analysis through enantioselective adsorption on cysteine-modified gold surfaces.
      Quartz microbalance experiments and scanning electron microscope observation of
      the gold surface revealed that the colloidal particle has higher affinity to a
      surface modified with L-cysteine than to one modified with D-cysteine.

PMID- 11219062
TI  - Enzymatic hydrolysis of conjugated steroid metabolites: search for optimum
      conditions using response surface methodology.
AB  - The optimum conditions for hydrolysing conjugated metabolites of steroid hormones
      in bovine urine were performed with Helix pomatia juice, beta-glucuronidase from
      bovine liver and preparations of limpets and abalone entrails using response
      surface methodology. The experimental design and empirical modelling used allowed
      us to assess the main effects of factors (time, temperature, pH and enzyme
      quantity) and to predict the optimum conditions for each enzyme preparation.
      Confirmatory experiments were applied to check the predicted values and to
      validate the model. The comparison of the enzyme preparation efficiency for
      various conjugate steroids and the study of possible by-product synthesis led us
      to select abalone entrails to hydrolyse natural dehydroepiandrosterone,
      etiocholanolone, epitestosterone; 17 alpha-estradiol and estrone in bovine urine.
      The optimum conditions were found to be 20 h at 42 degrees C with the pH adjusted
      to 5.2 and using 12,000 units of enzyme preparation.

PMID- 11219063
TI  - A novel mimetic enzymatic fluorescence immunoassay for hepatitis B surface
      antigen by using a thermal phase separating polymer.
AB  - Iron tetrasulfonatophthalocyanine (FeTSPc), a peroxidase mimic, was used as a
      labeling reagent and poly(N-isopropylacrylamide) (PNIP) as the separation support
      of the immune complex for the mimetic-enzymatic immunoassay of hepatitis B
      surface antigen (HBsAg). PNIP was precipitated from aqueous solution when the
      ambient temperature was higher than its lower critical solution temperature of 31
      degrees C. In a sandwich immunoassay, the antigen (HBsAg) first reacted with
      mouse anti-human HBsAg antibody immobilized on PNIP (PNIP-antibody) and then
      further reacted with FeTSPc-labeled mouse anti-HBsAg antibody (antibody-FeTSPc)
      at room temperature in a homogeneous format. After changing the temperature to
      separate the PNIP-antibody-HBsAg-antibody-FeTSPc conjugate moiety, it was re
      dissolved and determined by coupling with the fluorogenic reaction of hydrogen
      peroxide and p-hydroxyphenylpropionic acid. The sensitivity of this method (3 ng
      mL-1) was close to that of the traditional ELISA using the same reactants.
      However, the assay was much faster (the assay time decreased from 100-120 to 45
      min). This method was applied to determine HBsAg in human serum with satisfactory
      results.

PMID- 11219064
TI  - Point-of-need diagnosis of cystic fibrosis using a potentiometric ion-selective
      electrode array.
AB  - The novel approach of using a micro-sensor array of miniaturised solid-state ion
      selective electrodes to analyse sweat samples for sodium, potassium and chloride
      simultaneously is described. The array, incorporated into a miniature flow cell
      which is linked to a portable PC for data acquisition, constitutes a small,
      portable, and simple to use analytical instrument. Samples are passed through the
      flow cell and over the array and an immediate potentiometric response is
      obtained, which can be equated to the concentrations of sodium, chloride,
      potassium and other parameters in the sweat sample. Used here in conjunction with
      a Wescor Macroduct sweat sampling unit, it promises a much simplified, much less
      expensive procedure for sweat analysis than the procedures currently in common
      use.

PMID- 11219065
TI  - Disposable, low cost, silver-coated, piezoelectric quartz crystal biosensor and
      electrode protection.
AB  - The use of a commercial, silver-coated, piezoelectric quartz crystal as a
      disposable, low cost and reliable immunosensor is presented. The protection of
      the silver electrode from undesirable oxidation was achieved by polystyrene or
      carboxy-poly(vinyl chloride) (PVC-COOH) modification. In addition to serving as
      protection for the electrode, polymer films provided a substrate for antibody
      immobilization by either physical adsorption or covalent linkage. Polystyrene
      modification showed an additional advantage of improvement of surface smoothness.
      The atomic force microscope (AFM) and scanning electron microscope (SEM) were
      used to evaluate the morphologies of polymer films obtained by dip or drop
      coating techniques. It was found that drop coating provided more significant
      improvement in surface smoothness than dip coating, and the resulting sensor
      surfaces were more suitable for in situ liquid phase assay. Although PVC-COOH
      modified sensors were not suitable for liquid phase assay because of the high
      surface roughness, the covalent linkages (amide bonds) between antibodies and 
      COOH groups in the polymer film offered better sensor performance in ex situ
      assay in terms of a higher antibody binding capacity and better antigen detection
      sensitivity.

PMID- 11219066
TI  - Disposable potentiometric enzyme sensor for direct determination of
      organophosphorus insecticides.
AB  - A potentiometric disposable enzyme sensor for the direct and fast determination
      of organophosphorus (OP) insecticides was developed by using an organophosphorus
      hydrolase (OPH) immobilized on an ion-selective electrode. The disposable screen
      printed transducer was based on double matrix membrane technology which allows
      easy mass production. The potentiometric device consisted of a H(+)-sensitive
      electrode with integrated Ag/AgCl reference electrode. The electrodes were
      prepared with N,N-dioctadecylmethylamine as H(+)-sensitive ionophore and pH
      calibration resulted in slopes of 55 mV decade-1 over a pH range from 11 to 6.
      OPH was isolated from recombinant Escherichia coli DH5 alpha and immobilized
      within poly(carbamoyl sulfonate) prepolymer on the surface of the H(+)-sensitive
      electrode without any further fixation membrane. OPH catalyzes the hydrolytic
      cleavage of OP compounds which releases protons in a concentration proportional
      to hydrolyzed substrate. Sensor performance was investigated with regard to
      enzyme load, concentration, pH and temperature of the measuring buffer using
      paraoxon as analyte. Best sensitivity and response time were obtained with
      sensors prepared with 250 U of OPH and measuring at 37 degrees C in 1.0 mM HEPES
      buffer, pH 9.3, containing 100 mM NaCl. The enzyme sensor exhibited a linear
      calibration range of 0.01-0.15 mM chlorpyrifos, 0.05-0.35 mM diazinon, 0.05-0.4
      mM paraoxon and 0.007-0.05 mM parathion, respectively. For all these analytes
      response times to reach 95% of maximum change in potential did not exceed 5 min.
      Sensors stored under dry conditions at 4 degrees C still showed 60% of initial
      hydrolytic rate after 70 d. The sensors even when stored dry were ready for
      measurements after 5 min incubation in measuring buffer. A range of putative
      interfering substances did not influence sensor response, and suitability of
      measuring OPs in soil extracts was ascertained.

PMID- 11219067
TI  - A mediator-type biosensor as a new approach to biochemical oxygen demand
      estimation.
AB  - A novel biosensor for the determination of biochemical oxygen demand (BOD) was
      developed using potassium hexacyanoferrate(III) [HCF(III)] as a mediator. The
      sensor element consists of a three-electrode system, with both working and
      counter electrodes compactly integrated as a disposable using etching and
      electroplating processes. Pseudomonas fluorescens biovar V (isolated from a
      wastewater treatment plant) was immobilized on the surface of the working
      electrode using poly(vinyl alcohol)-quaternized stilbazol (PVA-SbQ) photopolymer
      gel. Synthetic wastewater described by the Organization for Economic Cooperation
      and Development (OECD) was used as a standard solution instead of glucose
      glutamic acid synthetic wastewater. The conditions of amperometric measurement
      were optimized at +600 mV (vs. Ag/AgCl) operating potential, namely 40 mM
      HCF(III) in a 0.1 M phosphate buffer (pH 7.0) at 20 degrees C. The sensor
      response was linear from 15 up to 200 mg O l-1 BOD. The response time was 15 min
      at 200 mg O l-1 BOD. To demonstrate the wide metabolic range of activity of the
      sensor, the sensor response to 14 substances in four categories of organic
      compounds was investigated. Further, it was shown that the response of this BOD
      sensor was not influenced in samples with low concentrations of dissolved oxygen
      under the measuring conditions used. For real wastewaters, the BOD values were
      determined using the sensor and compared favorably with those determined by the
      conventional BOD5 method.

PMID- 11219068
TI  - Bismetalloporphyrin-based ISE sensitive to fluoroborate.
AB  - Several mu-oxo-bismetalloporphyrin complexes were synthesized for preparing
      fluoroborate sensors. The electrode based on mu-oxo-bis[tetra(p
      chlorophenyl)porphinatomanganese(III)] with an optimized membrane composition
      shows a potentiometric response towards fluoroborate ion over the concentration
      range from 4.3 x 10(-7) to 1.0 x 10(-1) mol l-1 with a Nernstian slope, a wide
      working pH range from 5.5 to 12.0 and a fast response time of 30 s. The electrode
      shows anti-Hofmeister selectivity towards BF4- with respect to common co-existing
      ions, which is an improvement over methods reported so far. As electroactive
      materials, several mu-oxo-bismetalloporphyrins with different substituents on the
      benzene rings were compared for potentiometric response characteristics. The
      interaction between BF4- and bismetalloporphyrin was investigated using UV/VIS
      spectrophotometry. The electrode was applied to the determination of fluoroborate
      in electroplating solutions.

PMID- 11219069
TI  - Mathematical analysis for impedance change with proteolytic digestion of gelatin.
AB  - A mathematical analysis is proposed to demonstrate an inter-relationship between
      the proteolytic digestion of gelatin on the surface of an interdigitated gold
      electrode and the resulting rate of impedance change, at different collagenase
      concentrations, in a biosensor used to detect protease in solution. The impedance
      change due to digestion of the gelatin layer by collagenase for the overall
      digestion process was expressed in two different stages: an initial exponential
      period where the rate of impedance change with enzymic digestion was slow,
      leading to a critical thickness; after which there was a greater change in
      impedance associated with subsequent dissolution of the layer and partial or
      complete uncoating of the digits on the electrode surface. An inter-relationship
      between the rate of impedance change and collagenase concentration within the
      range 0.2-0.6 mg ml-1 was predicted for the early stages of the digestion
      process. A kinetic theory for the rapid rate of impedance change with collagenase
      concentrations could not be developed owing to the rate remaining almost constant
      for all concentrations of collagenase, after the critical thickness had been
      reached. An inter-relationship between the rate of impedance change and stirrer
      speed was also demonstrated.

PMID- 11219070
TI  - The enhanced electrogenerated chemiluminescence of Ru(bpy)3(2+) by glutathione on
      a glassy carbon electrode modified with some porphine compounds.
AB  - It has been found that the electrochemical activity of glutathione was increased
      greatly at the glassy carbon electrodes modified with 5,10,15,20
      tetraphenylporphine ruthenium(II) carbenyl (RuTPP), meso-tetraphenylporphine
      copper(II) complex (CuTTP) and hemin. It has been also found that glutathione
      would enhance the electrogenerated chemiluminescence (ECL) of Ru(bpy)3(2+) at a
      hemin glassy carbon electrode; the enhanced ECL intensity was linear with the
      concentration of glutathione in the range of 1 x 10(-7)-1 x 10(-4) mol l-1, based
      on which method for determination of glutathione has been developed. The
      detection limit of glutathione was 2 x 10(-8) mol l-1, and the relative standard
      deviation for 1 x 10(-6) mol l-1 glutathione was 2.7%. The mechanism for this ECL
      system has been proposed.

PMID- 11219071
TI  - Study of the electrochemical behavior of mitoxantrone and its determination at a
      Co-C modified ultramicroelectrode.
AB  - In 0.005 mol dm-3 Tris-0.05 mol dm-3 NaCl buffer solution (pH 7.10), the
      electrochemical behavior of mitoxantrone was studied by linear-sweep voltammetry
      and cyclic voltammetry at a Co-carbon fiber ion implantation modified
      ultramicroelectrode. A sensitive reduction peak was obtained. The peak potential
      was -0.798 V (vs. SCE), the peak current was proportional to the concentration of
      mitoxantrone over the range of 2.0 x 10(-7)-6.0 x 10(6) mol dm-3 and the
      detection limit was 4.2 x 10(-8) mol dm-3. This method was applied to the direct
      determination of mitoxantrone in urine. Recoveries were in the range 95.4-105.8%.
      The reduction process was quasi-reversible with absorptive characteristics at a
      Co-C ultramicroelectrode. According to Laviron's theory, the electrode reaction
      rate constant ks and the electron transfer alpha of mitoxantrone were 4.4 s-1 and
      0.48, respectively. The composition and depth distribution of elements on the
      surface of the Co-C ultramicroelectrode were determined by Auger electron
      spectroscopy. The experiments showed that Co was implanted into the surface of
      the carbon fiber, and the Co-C ultramicroelectrode had good stability and
      reproducibility.

PMID- 11219072
TI  - A PARAFAC algorithm using penalty diagonalization error (PDE) for three-way data
      array resolution.
AB  - A modified parallel factors analysis (PARAFAC) algorithm with the penalty
      diagnolization error (PDE) was developed. This algorithm can overcome the slow
      convergence problem of the traditional PARAFAC method and is insensitive to the
      number of components, i.e., it is much faster than PARAFAC and insensitive to
      overestimation of the dimensionality of the model. The characteristic performance
      was demonstrated by treating simulated and real excitation-emission fluorescence
      data for samples of naphthalene, 1-naphthol and 2-naphthol with satisfactory
      results.

PMID- 11219073
TI  - Polymorphic analysis of a pharmaceutical preparation by NIR spectroscopy.
AB  - A method for the characterization and determination of the crystalline from
      present in the amorphous miokamycin of a pharmaceutical preparation using near
      infrared spectroscopy (NIRS) is proposed. The study leading to the development of
      the proposed method involved both qualitative (classification by residual
      variance analysis) and quantitative aspects (the determination of both total
      miokamycin and its crystalline form using multivariate calibration). Samples
      containing less than 5% of the total amount of miokamycin in its crystalline form
      can be accurately classified. Partial least-squares regression (PLSR) allows low
      contents of the crystalline form to be determined with absolute errors less than
      1.5%, which is comparable to the limit of detection of the X-ray diffraction
      technique used as reference. Also, the total miokamycin content is determined by
      NIRS with errors less than 1%. The simplicity, expeditiousness and robustness of
      the proposed method make it an effective tool for determining both total and
      crystalline miokamycin in solid dosage forms.

PMID- 11219074
TI  - Monitoring the melt-extrusion transesterification of ethylene-vinylacetate
      copolymer by self-modeling curve resolution analysis of on-line near-infrared
      spectra.
AB  - The transesterification of molten ethylene-vinylacetate (EVA) copolymers by
      octanol with sodium methoxide as catalyst in an extruder has been monitored by on
      line near infrared (NIR) spectroscopy. A total of 60 NIR spectra were acquired
      for 37 min with the last spectrum recorded 31 min after the addition of octanol
      and catalyst was stopped. The experimental spectra show strong baseline
      fluctuations which are corrected for by multiplicative scatter correction (MSC).
      The chemometric methods of the orthogonal projection approach (OPA) and
      multivariate curve resolution (MCR) were used to resolve the spectra and to
      derive concentration profiles of the species. The detailed analysis reveals the
      absence of completely pure variables which leads to small errors in the
      calculation of pure spectra. The initial estimation of a concentration that is
      necessary as an input parameter for MCR also presents a non-trivial task. We
      obtained results that were not ideal but applicable for practical concentration
      control. They enable a fast monitoring of the process in real-time and resolve
      the spectra of the EVA copolymer and the ethylene-vinyl alcohol (EVAL) copolymer
      to be very close to the reference spectra. The chemometric methods used and the
      decomposed spectra are discussed in detail.

PMID- 11219075
TI  - Spectrofluorimetric determination of moxifloxacin in tablets, human urine and
      serum.
AB  - A spectrofluorimetric method to determine the antibiotic moxifloxacin is proposed
      and was applied to pharmaceuticals, human urine and serum. The fluorimetric
      method allows the determination of 30-300 ng mL-1 moxifloxacin in aqueous
      solution containing phosphoric acid-phosphate buffer (pH 8.3) with lambda exc =
      287 nm and lambda em = 465 nm. Detection and quantification limits were 10 and 30
      ng mL-1, respectively, with a relative standard deviation (n = 10) of 2%. This
      method was applied to the determination of moxifloxacin in three Spanish
      commercial pharmaceutical formulations. Another variant of the method in micellar
      medium allows the direct measurement of moxifloxacin in human serum and urine by
      standard additions. The enhanced fluorescence of moxifloxacin in 8 mM sodium
      dodecyl sulfate (SDS) solution at pH 4.0 (acetic acid-acetate buffer) for lambda
      exc = 294 nm and lambda em = 503 nm shows the same linear range as the aqueous
      method with a 25% lower slope (with detection and quantification limits of 15 and
      60 ng mL-1, respectively, and a relative standard deviation of 1.3%), but permits
      the background fluorescence for urine and serum blanks to be minimized. Hence,
      sufficient sensitivity is reached to determine therapeutic concentrations of the
      drug in urine (average recovery 102 +/- 2%) and serum (average recovery 105 +/-
      2%) samples.

PMID- 11219077
TI  - Sensitive fluorimetric determination of formaldehyde by the co-quenching effect
      of formaldehyde and sulfite on the fluorescence of tetra-substituted amino
      aluminium phthalocyanine.
AB  - A novel and sensitive fluorimetric method was developed for the determination of
      formaldehyde based on the co-quenching effect of formaldehyde and sulfite on the
      fluorescence of tetra-substituted amino aluminium phthalocyanine. Formaldehyde in
      the concentration range 0.040-1.19 micrograms ml-1 can be determined with a limit
      of detection of 7.5 ng ml-1. The relative standard deviation for nine replicate
      measurements of 80.0 ng ml-1 formaldehyde is 1.8%. The method was applied to the
      analysis of real samples with satisfactory results.

PMID- 11219076
TI  - Determination of trace selenium in human plasma and hair with ternary inclusion
      compound-fluorescent spectrophotometry.
AB  - A method for determination of selenium in plasma and hair with ternary inclusion
      compound-fluorescent spectrophotometry has been developed. The determination of
      selenium in plasma and hair can be performed directly in aqueous solution. Blood
      and hair samples were destroyed by oxygen flask combustion. The linear range was
      10-500 ng mL-1 for plasma and 10-100 ng mL-1 for hair. Within-day and day-to-day
      precisions for plasma ranged from 5.4% to 9.3% (n = 7) and from 3.5% to 14.5% (n
      = 7), respectively. Within-day precisions for hair ranged from 0.6% to 6.2% (n =
      7). Recoveries ranged from 91.0% to 97.8% for plasma and from 95.0% to 102.0% for
      hair. The blood samples from 15 Hans and 20 Uygurs in Xinjiang Uygur automatic
      region and 23 Hans in Liaoning province were collected and determined. It was
      indicated that no statistically significant difference in plasma selenium
      concentration of the Hans between Xinjiang and Liaoning was found (F = 1.36, P >
      0.05). However, there were statistically significant differences between the Hans
      and the Uygurs in Xinjiang (F = 1.01, P < 0.01) and between males and females in
      the two areas (P < 0.01). There was a low correlation between plasma selenium
      concentration and hair selenium concentration. The ratio of hair selenium
      concentration to plasma selenium concentration was 2.17, with a range of 1.63
      2.88.

PMID- 11219078
TI  - Derivative spectrophotometry in the analysis of mixtures of phenols and
      herbicides.
AB  - Derivative spectrophotometry (zero-crossing technique) was applied to the
      determination of selected phenols and herbicides in two-component mixtures.
      Methyl- and chlorophenols (3-methylphenol, 2,3- and 3,4-dimethylphenol, 2,5-, 2,6
      and 3,4-dichlorophenol and 2,4,5-trichlorophenol) and triazine, uracil and urea
      herbicides (simazine, propazine, hexazinone, bromacil and metoxuron) were
      examined. The RSD values ranged between 0.05 and 4% and the recoveries obtained
      were between 97 and 110%. The developed derivative spectrophotometric method was
      also applied as a complementary technique for the separation of overlapping peaks
      of sample compounds obtained by HPLC with diode-array detection. Metoxuron and 3
      methylphenol, metoxuron and 2,5-dichlorophenol and simazine and 2,6
      dichlorophenol were determined simultaneously by this method at the level of 1 x
      10(-3) g l-1.

PMID- 11219079
TI  - Determination of titanium dioxide in foods using inductively coupled plasma
      optical emission spectrometry.
AB  - Titanium dioxide is a common food additive of increasing interest in dietary
      intake studies and dietary exclusion studies. Food labelling for titanium dioxide
      is imprecise so a method was developed for its rapid determination in foods using
      acid digestion and inductively coupled plasma optical emission spectrometry
      (ICPOES). Twenty-five foods thought to contain titanium dioxide were obtained.
      Based on preliminary digestion studies, samples (500 mg) were digested in 18 mol
      l-1 H2SO4 at 250 degrees C for 1 h and then diluted to 5.9 mol l-1 H2SO4 before
      determination of titanium by ICPOES at 336.121 nm. Emission intensity was
      suppressed by H2SO4 so standards were matched for acid concentration. Titanium
      dioxide embedded in gelatine was used to assess accuracy. A standard reference
      material of known titanium concentration and six foods of known titanium dioxide
      content were used as external reference materials. Limits of detection were 2-7.5
      ppb, depending on spectral integration times, and the signal was linear up to 5
      ppm. Results for all control samples were in good agreement with the expected
      values. Twelve of the foods contained detectable titanium, ranging from 0.001 to
      0.782% by weight, but only eight indicated this on their labels, four being
      exempt under food labelling regulations. Based on food portion sizes, an
      individual's daily intake of titanium dioxide could exceed 200 mg from just one
      of these products. This method may facilitate future studies on titanium dioxide
      intake, given the present limitations of food labelling.

PMID- 11219080
TI  - Determination of metals in lubricating oils by flame atomic absorption
      spectrometry using a single-bore high-pressure pneumatic nebulizer.
AB  - The behaviour of a single-bore high-pressure pneumatic nebulizer (SBHPPN) as a
      tool for the analysis of lubricating oils by flame atomic absorption spectrometry
      (FAAS) was investigated. The effects of the sample oil content [from 10% to 100%
      (w/w) oil in 4-methylpentan-2-one, IBMK] and the carrier nature (IBMK and
      methanol) on the characteristics of the aerosols generated, on the analyte
      transport efficiency and on the analytical figures of merit in FAAS were studied.
      A pneumatic concentric nebulizer (PCN) was used for comparison. Increasing the
      oil content increases the viscosity of the sample. With the PCN this gives rise
      to coarser aerosols, making it impossible to nebulize samples with an oil content
      higher than 70% (w/w). Using the SBHPPN, the viscosity of the sample scarcely
      affects the characteristics of the primary aerosols. Hence, the SBHPPN is able,
      by using the appropriate carrier, to nebulize pure lubricating oils. Among the
      carriers tested, IBMK is the most advisable because it is fully miscible with all
      the oil samples. The SBHPPN provides higher sensitivities and lower limits of
      detection than the PCN. Compared with a method based on organic dilution, the use
      of the SBHPPN for the direct analysis of lubricating oils by FAAS makes it
      possible, in addition to increasing the analysis throughput, to detect elements
      at lower concentrations. Moreover, the SBHPPN provides similar results to those
      obtained using a previous acid digestion step.

PMID- 11219081
TI  - Thiosalicylic acid-immobilized Amberlite XAD-2: metal sorption behaviour and
      applications in estimation of metal ions by flame atomic absorption spectrometry.
AB  - Thiosalicylic acid (TSA)-modified Amberlite XAD-2 (AXAD-2) was synthesized by
      coupling TSA with the support matrix AXAD-2 through an azo spacer. The resulting
      chelating resin was characterized by elemental analyses, thermogravimetric
      analysis (TGA) and infrared spectra. The newly designed resin quantitatively
      sorbs CdII, CoII, CuII, FeIII, NiII and ZnII at pH 3.5-7.0 when the flow rate is
      maintained between 2 and 4 ml min-1. The HCl or HNO3 (2 mol l-1) instantaneously
      elutes all the metal ions. The sorption capacity is 197.5, 106.9, 214.0, 66.2,
      309.9 and 47.4 mumol g-1 of the resin for cadmium, cobalt, copper, iron, nickel
      and zinc, respectively, whereas their preconcentration factor is between 180-400.
      The breakthrough volume of HCl or HNO3 for elution of these metal ions was found
      to be 4-8 ml. The limit of detection (LOD) for CdII, CoII, CuII, FeIII, NiII and
      ZnII was 0.48, 0.20, 4.05, 0.98, 1.28 and 3.94 micrograms l-1, respectively, and
      the limit of quantification (LOQ) was found to be 0.51, 0.29, 4.49, 1.43, 1.58
      and 4.46 micrograms l-1, respectively. The loading half time, t1/2, for the
      cations was found to be less than 2.0 min, except for nickel for which the value
      was 13.1 min. The determination of each of these six cations is possible in the
      presence of other five, if their concentration is up to 4 times. All six metals
      were determined in river water (RSD approximately 0.7-7.7%) and tap water samples
      (RSD approximately 0.3-5.7%). The estimation of Co was made in the samples of
      multivitamin tablets (RSD < 2.3%). The results agree with those quoted by
      manufacturers.

PMID- 11219082
TI  - Development of an automated method for determining oil in water by direct aqueous
      supercritical fluid extraction coupled on-line with infrared spectroscopy.
AB  - A direct aqueous supercritical fluid extraction (SFE) system was developed which
      can be directly interfaced to an infrared spectrometer for the determination of
      oil in water. The technique is designed to provide an environmentally clean,
      automated alternative to established IR methods for oil in water analysis which
      require the use of restricted organic solvents. The SFE-FTIR method involves
      minimum sample handling stages, with on-line analysis of a 500 ml water sample
      being complete within 15 min. Method accuracy for determining water samples
      spiked with gasoline, white spirit, kerosene, diesel or engine oil was 81-100%
      with precision (RSD) ranging from 3 to 17%. An independent evaluation determined
      a 2 ppm limit of quantification for diesel in industrial effluents. The results
      of a comparative study involving an established IR method and the SFE-FTIR method
      indicate that oil levels calculated using an accepted equation which includes
      coefficients derived from reference hydrocarbon standards may result in
      significant errors. A new approach permitted the derivation of quantification
      coefficients for the SFE-FTIR analyses which provided improved results. In
      situations where the identity of the oil to be analysed is known, a rapid off
      line SFE-FTIR system calibration procedure was developed and successfully applied
      to various oils. An optional in-line silica gel clean-up procedure incorporated
      within the SFE-FTIR system enables the same water sample to be analysed for total
      oil content including vegetable oils and selectively for petroleum oil content
      within a total of 20 min. At the end of an analysis the SFE system is cleaned
      using an in situ 3 min clean cycle.

PMID- 11219083
TI  - A robust multisyringe system for process flow analysis. Part II. A multi-commuted
      injection system applied to the photometric determination of free acidity and
      iron(III) in metallurgical solutions.
AB  - A new software-controlled volume-based system for sample introduction in process
      flow injection analysis was developed. By using a multi-syringe burette coupled
      with one or two additional commutation valves, the multi-commuted injection of
      precise sample volumes was accomplished. Characteristics and performance of the
      injection system were studied by injecting an indicator in a buffered carrier.
      Three configurations were implemented in order to achieve two different tasks:
      the single injection of a sample in a two- or three-channels manifold, and the
      dual injection into different streams. The two channel flow system using the
      single injection was applied to the determination of free acidity in diluted
      samples containing high levels of iron(III), by employing the single point
      titration methodology. The precipitation of ferric hydroxide was prevented using
      the ammonium and sodium salts of oxalate and acetate as buffer titrant. Methyl
      Red was employed as indicator. The procedure allows determination of acid
      concentration in solutions with a Fe(III)/H+ molar ratio up to 0.2. Samples with
      higher Fe(III)/H+ molar ratios were spiked with a known strong acid at dilution.
      The three-channel configuration was applied to the determination of ferric ions,
      using, as reagent, a merging mixture of sulfuric acid and potassium thiocyanate.
      The double injection system was implemented in series in a single (three-channel)
      manifold in such a way that a different injection volume and a changed reagent
      were used for each analyte. It was applied to the separated or sequential
      determination of free acidity and ferric ions. In this configuration, iron(III)
      was determined using 0.5-0.7% (w/v) sodium salicylate solution as reagent. The
      systems can operate at up to 100, 84 and 78 injections per hour, respectively.
      Determinations on synthetic and process samples compared well with the reference
      values and procedures. Recoveries of 95-102% with a maximum RSD value of 5.4%
      were found for acidity. The respective values obtained for iron determinations
      were 96-105% and 4.3%.

PMID- 11219084
TI  - Sensitive determination of diquat by a kinetic method using the stopped-flow
      mixing technique.
AB  - A simple, sensitive, selective, fast and inexpensive assay for the determination
      of diquat is proposed. The method is based on the reduction of the herbicide to a
      strongly fluorescent monocation radical with sodium dithionite. The initial rate
      of this reaction is directly proportional to the diquat concentration. The
      stopped-flow mixing technique was used because the kinetic data can be obtained
      in only 7 s, meaning that the method can be automated. The calibration graph is
      linear over the range 5-500 ng ml-1 and the precision (RSD) is close to 1.2%. The
      applicability of the method was demonstrated by determining the herbicide in
      different kinds of samples.

PMID- 11219085
TI  - Flow injection analysis of fluoride: optimization of experimental conditions and
      non-linear calibration using artificial neural networks.
AB  - This paper deals with the application of artificial neural networks (ANNs) to two
      common problems in spectroscopy: optimization of experimental conditions and non
      linear calibration of the result, with particular reference to the determination
      of fluoride by flow injection analysis (FIA). The FIA system was based on the
      formation of a blue ternary complex between zirconium(IV), p
      methyldibromoarsenazo and F- with the maximum absorption wavelength at 635 nm.
      First, optimization in terms of sensitivity and sampling rate was carried out by
      using jointly a central composite design and ANNs, and a neural network with a 3
      7-1 structure was confirmed to be able to provide the maximum performance.
      Second, the relationship between the concentration of fluoride and its absorbance
      was modeled by ANNs. In this process, cross-validation and leave-k-out were used.
      The results showed that good prediction was attained in the 1-4-1 neural net. The
      trained networks proved to be very powerful in both applications. The proposed
      method was successfully applied to the determination of free fluoride in tea and
      toothpaste with recoveries between 96 and 101%.

PMID- 11219086
TI  - Side-effects of dental materials reported in Scandinavian countries.
AB  - Dental treatment usually involves a wide range of materials which continue to
      grow in number and complexity. During the last decade there has been an
      increasing demand for safety evaluation and control of dental materials. Since it
      is the members of the dental staff who handle the materials in their most
      reactive states they constitute the main risk category. Bearing this in mind
      reported side-effects in both patients and dental personnel in Scandinavia are
      presented. Data from the only two existing national registers for side-effects of
      dental materials, i.e. those in Norway and Sweden, are thus elucidated.
      Furthermore, recent mainly Scandinavian publications dealing with the side
      effects of dental materials are presented. It can be concluded that a national
      register on the side-effects of dental materials, apart from revealing
      information regarding their frequency and nature, may detect changes in the
      profiles of adverse reactions and also serve as a tool for the post-marketing
      surveillance of dental materials.

PMID- 11219087
TI  - Surface composition and structure of titanium polished with aqueous slurry of
      ferric oxide.
AB  - Cast plates were prepared from commercial titanium. The plates were polished with
      a slurry of fine ferric oxide powder. The surface composition and structure were
      investigated by electron probe microanalysis (EPMA) and X-ray photoelectron
      spectroscopy (XPS). In the high pressure-polished surface, iron was non-uniformly
      distributed but oxygen was mostly uniformly distributed, while in a light
      pressure-polished surface, iron and oxygen were uniformly distributed though at
      lower and higher concentrations, respectively. EPMA state analysis and XPS
      suggested that the iron might exist as Fe2+ in the outermost surface, while it
      might be in a metallic state in the inner surface layer.

PMID- 11219088
TI  - Microfracture mechanisms of composite resins containing prepolymerized particle
      fillers.
AB  - The effect of prepolymerized particle fillers on fracture toughness of four
      commercial composite resins was studied. The ground surface morphology was
      examined with a field emission scanning electron microscope. Fracture toughness
      was determined by using single edge notched specimens. Acoustic Emission (AE),
      which is the elastic wave due to the release of energy from the localized sources
      of material, was detected by sensors of a high-sensitivity and low-noise
      resonance type during the fracture toughness test. Acoustic Emission signals
      detected were analyzed for parameters such as amplitude and energy. Fracture
      surfaces were examined with a scanning electron microscope. The fracture
      toughness values, AE releasing patterns during fracture toughness test, and the
      fracture surface findings were analyzed to understand the fracture behavior of
      composite resins containing prepolymerized particle fillers. A microfracture
      model and fracture mechanisms to increase the fracture toughness of this type of
      composite resins are proposed.

PMID- 11219089
TI  - Corrosion characteristics of ferric and austenitic stainless steels for dental
      magnetic attachment.
AB  - The corrosion behaviors of four ferric stainless steels and two austenitic
      stainless steels were examined in a simulated physiological environment (0.9%
      NaCl solution) to obtain basic data for evaluating the appropriate composition of
      stainless steels for dental magnetic attachments. The corrosion resistance was
      evaluated by electrochemical techniques and the analysis of released metal ions
      by atomic absorption spectrophotometry. The surface of the stainless steels was
      analyzed by X-ray photoelectron spectroscopy (XPS). The breakdown potential of
      ferric stainless steels increased and the total amount of released metal ions
      decreased linearly with increases in the sum of the Cr and Mo contents. The
      corrosion rate of the ferric stainless steels increased 2 to 6 times when they
      were galvanically coupled with noble metal alloys but decreased when coupled with
      commercially pure Ti. For austenitic stainless steels, the breakdown potential of
      high N-bearing stainless steel was approximately 500 mV higher than that of
      SUS316L, which is currently used as a component in dental magnetic attachments.
      The enriched nitrogen at the alloy/passive film interface may be effective in
      improving the localized corrosion resistance.

PMID- 11219090
TI  - Influence of different elastic moduli of dowel and core on stress distribution in
      root.
AB  - This study was carried out to investigate the influences of elastic moduli of the
      dowel-core combination on the stress distribution in the root by the use of 2
      dimensional finite element analysis. The peak stress at the dowel-cement
      interface was influenced strongly by a change of elastic modulus of the post
      (from 20,000 kg/mm2 as a hard prefabricated post to 8,000 kg/mm2 as a custom cast
      post) for both vertical and 45 degree oblique loading (rho > 90%). Peak dentinal
      stress adjacent to the luting cement layer depended only on the post material for
      vertical loading (rho [symbol: see text] 99%). In contrast, the post and core
      materials (from 8,000 kg/mm2 as cast core to 300 kg/mm2 as composite resin core)
      acted in cooperation on the stress magnitude for oblique loading, but the
      influence of the core material was stronger than that of the post (rho of core
      [symbol: see text] 41% and rho of post [symbol: see text] 26%). On the other
      hand, at the marginal region the effect of the core material contributed more
      than 86% to the peak stress value for both loadings, and the post material
      affected at most about 11% of the bending resistance.

PMID- 11219092
TI  - Detection of bisphenol-A in dental materials by gas chromatography-mass
      spectrometry.
AB  - The xenoestrogenic substance bisphenol-A is widely used as a synthetic precursor
      of resin monomers, such as bisphenol-A diglycidyl methacrylate. Reports
      describing the release of bisphenol-A from polymerized resin into saliva have
      aroused considerable concern regarding exposure to xenoestrogen by dental
      treatment. The purpose of the present study was to demonstrate a reliable
      methodology of detecting the trace amounts of bisphenol-A in dental materials.
      Bisphenol-A was separable from bisphenol-A diglycidyl methacrylate, which is
      often employed as the principal dimethacrylate monomer, by selective extraction
      with a Sep-Pak C18 cartridge. Using this extraction method in combination with a
      gas-chromatography mass-spectrometry, we have obtained evidence that all
      unpolymerized materials used in this study were contaminated with bisphenol-A.
      Quantitative analysis using a deuterium-labeled compound as an internal standard
      revealed bisphenol-A contents in commercial dental materials ranging from < 1
      microgram/g material to about 20 micrograms/g material. The polymerized dental
      materials released up to 91.4 ng bisphenol-A/g material into phosphate buffered
      saline during 24-h incubation. These results indicate that bisphenol-A can be
      released from dental materials, however the leachable amount would be less than
      1/1000 of the reported dose (2 micrograms/kg body weight/day) required for
      xenoestrogenisity in vivo.

PMID- 11219091
TI  - Addition of antibacterial agents to MMA-TBB dentin bonding systems--influence on
      tensile bond strength and antibacterial effect.
AB  - To produce a bonding system which has both high bond strength and antibacterial
      properties, an antibacterial agent (vancomycin: VCM or metronidazol: MN) was
      added to the PMMA powder of 4-META/MMA-TBB resin (CB). The influence of the
      addition of an antibacterial agent on tensile bond strength to dentin and the
      antibacterial effect were investigated in this study. Forty-seven freshly
      extracted bovine first or second incisors were used to measure the tensile bond
      strength to dentin. The bond strengths to bovine dentin were not significantly
      decreased by addition of VCM (1%, 2%, 5%), or MN (1%) to CB (p < 0.05). The
      antibacterial effect of CB containing antibacterial agent on six strains of
      bacteria was investigated by the agar plate diffusion method, analyzing the
      appearance of the inhibition zone around a resin disk following anaerobic
      culturing. The resin disks containing VCM showed antibacterial effects on all of
      the strains examined; the widths of the inhibition zones were 4-15 mm. The resin
      disks containing MN showed antibacterial effects on three strains; the widths of
      the inhibition zones were 0-4 mm. It was thus possible to produce a bonding
      system with both antibacterial effect and high tensile bond strength by addition
      of VCM to PMMA powder.

PMID- 11219093
TI  - Application of high resolution microfocus X-ray CT for the observation of human
      tooth.
AB  - The calcification degree of extracted human teeth was observed by using high
      resolution microfocus X-ray CT. As samples, upper and lower first premolars
      extracted from a 21-year-old female were used. The computed tomograms were
      produced by high resolution microfocus X-ray CT with a open vacuum X-ray source,
      rotating sample stage, and image sensor. The distinction between enamel and
      dentin was very clear, and the shape of the pulp cavity was also clearly
      identified. The secondary dentin was visible in the circumpulpal dentin. The
      color map displays showed the heterogeneity of the calcification degree not only
      in the dentin but also in the enamel. The enamel was divided into three layers
      according to the calcification degree. High resolution microfocus X-ray CT was
      very useful for the observation of the internal structure of human teeth without
      destroying the samples.

PMID- 11219094
TI  - Elution of bisphenol A from composite resin: a model experiment.
AB  - To understand the leaching characteristics of bisphenol A (BPA) from composite
      resins, we prepared experimental composite resins containing known amounts of BPA
      and examined the BPA elution from the resins in water and methanol at 37 degrees
      C. The concentration of BPA in each eluate was determined by high performance
      liquid chromatography. Cumulative BPA release was calculated and plotted against
      extraction time. The elution of BPA was rapid during a 6-hr period for both
      solvents, and then declined and continued steadily. Plots of square root of the
      amount of BPA leached against logarithm of extraction time produced good linear
      relationships from a 6-hr period thereafter. Extrapolation of the relationship
      enabled prediction of the amount of BPA to be leached in the long term. The
      present results suggested that little or no estrogenic effect due to long-term
      elution of BPA from commercial Bis-GMA-based resins is expected in practice.

PMID- 11219095
TI  - Acid and base-catalyzed hydrolysis of bisphenol A-related compounds.
AB  - In order to ascertain whether an estrogenic bisphenol A is produced from
      bisphenol A-related monomers by chemical-induced hydrolysis and to clarify their
      hydrolytic mechanisms, bisphenol A dimethacrylate (Bis-DMA) and bisphenol A
      bis(glycidyl methacrylate) (Bis-GMA) were reacted with phosphoric acid,
      hydrochloric acid, and sodium hydroxide in methanol or methanol/water mixed media
      at 37 degrees C. Amounts of monomethacrylate intermediates as well as bisphenol A
      (BPA) were determined by the use of high-performance liquid chromatography
      (HPLC), and time-conversion curves of hydrolytic products were prepared. BPA and
      bisphenol A monomethacrylate were produced by acid-catalyzed hydrolysis of Bis
      DMA. Bis-GMA was partly converted into monomethacrylate by phosphoric acid and
      into monomethacrylate and 2,2-bis[4-(2,3-dihydroxypropoxy) phenyl]propane (BHP)
      by hydrochloric acid. Hydrolytic reactions by sodium hydroxide were completed
      almost within 1 day, resulting in the production of BPA from Bis-DMA, and BHP
      from Bis-GMA. No BPA was formed from Bis-GMA by chemical-induced hydrolysis. The
      hydrolytic behaviors of these monomers were discussed.

PMID- 11219096
TI  - Effect of the adhesive layer thickness on the fracture toughness of dental
      adhesive resins.
AB  - We investigated how the thickness of an adhesive layer between two Co-Cr alloy
      plates affected the mode I fracture toughness of dental adhesive resin by varying
      the type of resin using a double cantilever beam (DCB) test. Two typical adhesive
      resins (PV and SB) were used. The adhesive layers of the DCB test specimens were
      20, 100 and 200 microns thick. The fracture modes of PV differed with the
      thickness of the adhesive layer, such as interface fracture at 20 microns
      thickness, and similar cohesive fracture at 100 and 200 microns thickness. In the
      case of SB, crack-propagating areas were observed as cohesive fractures in all
      test specimens with different adhesive layer thickness, and the surfaces of these
      areas became remarkably rougher as the thickness of the adhesive layer increased.
      The fracture toughness of PV was not affected by the differences in thickness
      between the 100 and 200 microns adhesive layers, but there was a notable decrease
      in fracture toughness when the adhesive layer decreased to a thickness of 20
      microns. That of SB showed a tendency to increase as the adhesive layer became
      thicker.

PMID- 11219097
TI  - New initiation system for resin polymerization using metal particles and 4-META.
AB  - Fifteen kinds of metal particles were examined to establish whether they could
      induce the setting of UDMA-based monomer containing BPO without amine under the
      presence of 4-META at room temperature. FT-IR spectra of the resultant set
      samples and the monomer were analyzed to see if the setting was caused by the
      polymerization. The effects of 4-META and BPO concentrations on the setting time
      were also studied using the metal particles that induced the setting very
      effectively. As-received Cu, Zn, Mo, Sn, Co, and In particles could initiate the
      polymerization of the monomer in combination with BPO and 4-META when they were
      moistened with water. All the three kinds of silver alloy particles examined also
      could initiate the polymerization, although pure silver metal particles could
      not. The presence of 4-META drastically shortened the setting time of the mixture
      of Cu particles and the monomer containing BPO, while higher concentration of BPO
      in the monomer significantly shortened the setting time.

PMID- 11219098
TI  - Polymerization of UDMA using zinc particles and 4-META with and without BPO.
AB  - The polymerization phenomena of zinc particles moistened with a small amount of
      water, 4-META, and UDMA without amine in the presence and absence of BPO were
      investigated. The effects of 4-META and BPO on the setting time and the degree of
      conversion (DC) were studied. Moreover, the effect of zinc ion amount on the
      setting time was investigated. As-received zinc particles could induce the
      polymerization either with or without BPO. A higher concentration of 4-META
      shortened the setting time and increased DC when BPO was absent. However, the
      presence of BPO generally retarded the setting time and decreased DC, although
      its effect was dependent on the 4-META concentration. A higher amount of zinc ion
      retarded the setting reaction in the presence of 4-META. The zinc particles mixed
      with 10% zinc sulfate and acetic acid solutions could induce the polymerization
      of UDMA containing BPO when the amine and 4-META were absent.

PMID- 11219099
TI  - Development of metal-resin composite restorative material. Part 3. Flexural
      properties and condensability of metal-resin composite using Ag-Sn irregular
      particles.
AB  - Powder-liquid type metal-resin composites, using Ag-Sn irregular particles as the
      filler, 4-META as coupling agent and UDMA + TEGDMA as resin matrix, were
      experimentally prepared under 9 different conditions (three different particle
      sizes and three different filler contents). The flexural strength and flexural
      modulus were measured. Three different irregular particle size MRCs without redox
      initiator at 94% filler content, as well as amalgam, conventional hybrid
      composite and Ag-Sn spherical particle MRC were evaluated for condensability. The
      flexural strength of the Ag-Sn irregular particle MRC was significantly
      influenced by both the filler particle size and filler contents (p < 0.01). It
      increased when either the filler content increased or the particles size
      decreased. The highest flexural strength (97.6 MPa) was obtained from the
      condition of particles size < 20 microns and 94% filler content. The flexural
      modulus was significantly influenced by filler content and it increased with
      increasing filler content. The condensability of the Ag-Sn irregular particle MRC
      was lower than that of amalgam but much higher than presently available
      conventional composites and spherical particle MRC.

PMID- 11219100
TI  - Genetic potential of interfacial guided osteogenesis in implant devices.
AB  - The purpose of this review is to summarise recent advances in the design and
      composition of bioactive surface layers of implantabile biomaterials, and thus
      the genetic potential of osteoprogenitor cells to recognize and respond to these
      diverse implanted biomaterials. Changes applied to a biomaterial's surface, in
      general, could improve its biocompatibility, osseointegration and durability
      properties, which are required for long-term implantation in the living body. In
      this review, the implant-bone interface was evaluated and interpreted on the
      basis of osteoblast cell cultures, i.e., on the genetic potential of osteoblasts
      to express different phenotype markers depending on the type of biomaterials
      used. The interface formed by in vitro-grown osteoblasts may be used to identify
      components of the in vivo implant-bone interface. Over the years, a large number
      of implant systems consisting of many different biomaterials have been introduced
      in dentistry and orthopaedics. This paper discusses the performance of currently
      used metals and other biomaterials, by focusing on the events which occur
      immediately after implantation and on their impact on the bone-implant interface.
      The review demonstrates that continuous improvements in composition, surface
      modality and design of implants may benefit osseointegration and clinical
      longevity of such implants. No load-bearing conditions or clinical status are
      discussed. Titanium (Ti) and calcium phosphate ceramics are regarded as the most
      biocompatible synthetic substances known to be used in hard tissue implantation.
      These biomaterials are osteoconductive, and do not induce ectopic bone formation.
      Nonetheless, they provide a physical matrix which is suitable for the deposition
      of new bone and may guide both the growth and extension of the bone. Comparative
      investigation evaluated that Ti implant systems appear to be apposed by more bone
      than ceramic systems, although alternatives concerning the type of Ti alloy and
      bioactive surface layer engineering, generate extremely diverse osseointegration
      results. Manufacturers have created an extensive range of inorganic or ceramic
      coatings on Ti implants in order to achieve better bone healing and
      osteoconduction. Biologically active molecules, added to the implant surface,
      represent breakthroughs in guided interfacial osteogenesis. This methodology
      offers an enormous potential of genetic controlling and promoting osteogenesis.
      The bone growth factors are not fully understood, but most researchers agree that
      the contact between the bioactive surface layer of the implant and bone is not
      static but dynamic and that the above factors may maximise the implant
      osseointegration.

PMID- 11219101
TI  - [The bone and joint decade].

PMID- 11219102
TI  - [The motivated conversation].

PMID- 11219103
TI  - [Investigation of demented patients. New possibility for improved quality in
      cooperation between general practice and hospitals].

PMID- 11219104
TI  - [Echinococcus multifocal. Epidemiology, clinical findings and treatment].
AB  - Infection with the fox dwarf tapeworm, Echinococcus multilocularis, has for the
      first time been found in a fox in Denmark, and E. multilocularis infection is
      therefore now a possible diagnosis in Danish patients. This paper reviews the
      life cycle, epidemiology, clinical symptoms, diagnosis, and treatment of E.
      multilocularis infections.

PMID- 11219105
TI  - [Can ultrasonography replace arteriography in arteriosclerosis of the lower
      limb?].
AB  - Arteriography is the imaging modality of choice before lower limb
      revascularization, because it allows pinpointing of the diseased arteries and
      planning of the treatment strategy, be it PTA or bypass grafting. However, a 2-3%
      risk of complications, makes assessment of non-invasive alternatives mandatory.
      Insufficient contrast filling of infrapopliteal arteries distal to severe lesions
      have also challenged the status of arteriography as the gold standard before
      revascularisation. The use of duplex arterial mapping is a promising alternative,
      as it has the highest agreement in the femoral segment and the lowest in the
      infra-popliteal segment. Duplex arterial mapping is a reliable means of
      predicting whether patients will require a bypass graft or an endovascular
      procedure, and, if surgery is required, in predicting the actual location of both
      anastomoses.

PMID- 11219106
TI  - [Risk factors for low back pain among 1.389 pupils in the 8th and 9th grade. An
      epidemiologic study].
AB  - INTRODUCTION: The aim of this study was to investigate the frequency and severity
      of low back pain (LBP) in 13-16-year-old pupils in relation to selected factors,
      such as anthropometry, physical activity, smoking, hypermobility, and tightness
      of hamstring muscles. METHODS: The study was designed as a cross-sectional
      questionnaire-based survey and all the pupils were examined by the school doctor
      for height, weight, mobility of joints, and general health status. RESULTS: The
      lifetime prevalence of non-specific LBP was 58.9% and the one-year prevalence was
      50.8% with no differences between the sexes. Recurrent/continuous LBP in a
      moderate to severe degree was recorded in 19.4% of the school children (182 F, 88
      M). This was positively correlated to a female gender, a BMI of more than 25
      kg/square meter, competitive sports for boys, poor physical fitness, daily
      smoking, heavy jobs in leisure time, increased use of the health system, and
      reduced life quality. DISCUSSION: Stepwise logistic regression analysis indicates
      that a female gender, daily smoking, and heavy jobs are important associated
      factors for severe LBP in adolescents, with an observed probability of 46% if all
      factors are present. We do not know yet whether these factors have any causal
      importance for the development of severe LBP.

PMID- 11219107
TI  - [Glucagon-like peptide 2, a neurotransmitter with a newly discovered role in the
      regulation of food ingestion].
AB  - We report here that glucagon-like peptide 2(GLP-2) and its receptor constitute a
      distinct projection system connecting the nucleus of the solitary tract with the
      dorsomedial hypothalamic nucleus (DMH). The DMH contains a dense plexus of GLP-2
      immunoreactive fibres and is the only hypothalamic nucleus expressing GLP-2
      receptor mRNA. Consistent with this, central application of GLP-2 activates the
      expression of neurones solely in the DMH. Furthermore, central administration of
      GLP-2 causes a dose-related, a pharmacologically and behaviourally specific
      inhibition of food intake in rats. Surprisingly, the alleged GLP-1 receptor
      antagonist, Exending (9-39), proved a functional antagonist of centrally applied
      GLP-2. These data implicate GLP-2 as an important neurotransmitter in the
      regulation of food intake and likely bodyweight. Our data therefore point to the
      DMH as a crossroad for endocrine and visceral information affecting feeding
      behaviour.

PMID- 11219108
TI  - [Laparoscopic fundoplication. A prospective assessment of 100 operations for
      gastroesophageal reflux].
AB  - INTRODUCTION: Laparoscopic fundoplication was assessed in a prospective study.
      METHOD: One hundred patients with gastroesophageal reflux (GORD) were treated by
      a 360 degrees fundoplication. The number of operations completed as a
      laparoscopic procedure, the complication rate, the length of hospital stay and
      time of work and the effect on GORD symptoms were used as endpoints. RESULTS: The
      operations could be performed as a laparoscopic procedure in 97 cases.
      Complications were few: A left-sided pneumothorax in two patients. Median
      operating time was 100 min and postoperative hospital stay two days. Sufficient
      reflux control was obtained in 93 patients. Only minor side effects were
      encountered in three patients (dysphagia two, flatulence one). At three-month
      control 91 were satisfied. After 3-49 mo (median 19 mo) two have needed a re
      operation for dysphagia (one due to tight suture and one for a rotated
      fundoplication). One patient had the fundoplication taken down for embarrassing
      flatulence in spite of successful reflux control. CONCLUSION: Laparoscopic
      fundoplication offers a good immediate control of GORD during a short
      hospitalization with few complications or side effects. No long term results are
      available at present.

PMID- 11219109
TI  - [Endogenous retroviruses in multiple sclerosis].
AB  - INTRODUCTION: In recent years, it has been suggested that human endogenous
      retroviruses (HERVs) may play a role in autoimmune diseases. HERVs represent both
      putative susceptibility genes and putative pathogenic viruses in multiple
      sclerosis (MS). Initially, our objective was to characterize a retrovirus
      produced by MS derived cell lines and to investigate this association in vivo.
      METHODS: The retrovirus was identified by RT-PCR on virion RNA purified from RT
      positive retroviral particles from the MS cell lines, and from blood samples from
      MS patients. Wistar rats were immunized with purified virions and serological
      responses analyzed by ELISA. RESULTS: Sequence variants highly homologous to the
      HERV-H family were found. The same sequences were specifically found in the
      particulate fraction of a series of MS patient plasma samples and were absent in
      controls. A database search demonstrated HERV-H copies in several chromosome
      regions implied in MS susceptibility. Virion-immunized rats developed a specific
      serological response towards HERV-H peptides indicating that immunogenic virion
      proteins are encoded by HERV-H. DISCUSSION: Activation of normally replicatively
      quiescent HERVs may be causally involved in MS.

PMID- 11219110
TI  - [Malignant neuroleptic syndrome or serotonergic syndrome].
AB  - The malignant neuroleptica syndrome (MNS) and the serotonin syndrome (SS) can be
      impossible to differentiate. This case history describes clinical symptoms
      compatible with either MNS or SS in a 59-year-old schizophrenic male patient, who
      had been heavily medicated with antipsychotics for several years in close
      relation to initiation of new treatment with a SSRI compound. The case shows that
      it is important to have both syndromes in mind when chronically ill patients are
      treated with several medicaments.

PMID- 11219111
TI  - [Picture of the month: aspiration of a foreign body].

PMID- 11219112
TI  - [Drug therapy of heart insufficiency guided by hormone measurements].

PMID- 11219113
TI  - [What does the FRISC II study say about the treatment of unstable coronary
      disease, especially non-Q-wave myocardial infarction?].

PMID- 11219114
TI  - [Name confusion].

PMID- 11219115
TI  - [Chronic subdural hematoma as a differential diagnosis to apoplexy].

PMID- 11219116
TI  - Standards in evidence.

PMID- 11219117
TI  - The working practices of the police in relation to mentally disordered offenders
      and diversion services.
AB  - A research study was undertaken to examine the working practices of four
      bridewells in Hampshire in relation to mentally disordered offenders (MDOs) and
      diversion services. A consecutive sample of individuals detained in cells and not
      identified by the police as having a mental disorder were screened for the
      presence of mental disorder and their suitability for diversion. Custody and
      detention staff were observed and interviewed to elicit their views and working
      practices in relation to MDOs. The findings revealed that in bridewells with
      diversion schemes an average of about 7% of detained individuals had mental
      disorders who were suitable for diversion but were not detected by the police. In
      the bridewell without a diversion scheme the figure was 14%. Conversely, many
      individuals without a formal mental disorder were inappropriately referred to
      diversion schemes. The effectiveness of screening processes by custody staff was
      variable. Facilities in the bridewells were not suitable for containing disturbed
      individuals. Delays in obtaining mental health assessments caused considerable
      concern for police officers and prolonged the discomfort of vulnerable
      individuals. Further preparation and training of custody staff is needed to
      improve screening procedures. Reception and detention facilities for mentally
      disordered individuals should be reviewed and response times for approved social
      workers (ASWs) and psychiatrists would benefit from improvement.

PMID- 11219119
TI  - Medical help-seeking by motor vehicle accident claimants.
AB  - The assessment of general psychiatric damages in personal injury cases is partly
      determined by evidence that the claimant has attempted to mitigate their losses
      by seeking medical help. However, there is no evidence that seeking medical help
      for a psychiatric injury is typical behaviour. The general practice consultation
      behaviour of 100 claimants with chronic physical and psychiatric injury with an
      onset at the time of a motor vehicle accident, was assessed over a 12-month
      period after the injury. GP consultations for physical and psychiatric symptoms
      were compared. At 12 months after the accident 53 (95% CI 42.7, 63.3) had
      consulted their GP with psychiatric symptoms and 94 (95% CI 88.8, 99.2) had
      consulted their GP with physical symptoms. Neither the sex, age or a pre-accident
      history of help-seeking for psychological symptoms was significantly predictive
      of post-accident help seeking for psychiatric injury. The results from this study
      provide information about the weight that should be given to medical help-seeking
      as a factor in assessing the value of claims for general psychiatric damages in
      personal injury cases.

PMID- 11219118
TI  - Pedestrian deaths following collisions with heavy goods vehicles.
AB  - Pedestrian fatalities following collisions with heavy goods vehicles ('lorries')
      in south-east Scotland were studied between 1992 and 1998. Data sources included
      police and ambulance reports, forensic medicine records, hospital casenotes and
      the Scottish Trauma Audit Group database. All injuries were scored according to
      the Abbreviated Injury Scale, yielding Injury Severity Scores (ISS). Sixteen
      pedestrians (mean age 60.2 years) died after being hit by a lorry. Actions of
      pedestrians were implicated in causing all the collisions--four of which appeared
      to be suicides. Four of the apparently accidental deaths involved pedestrians
      with significant blood alcohol levels. Thirteen pedestrians were dead when found.
      Ten pedestrians had an ISS of 75, having a total of 13 injuries acknowledged to
      be unsurvivable (Abbreviated Injury Scale = 6), largely to the head and chest.
      The unsurvivable injuries reflect huge forces, explaining why only a small
      proportion of the pedestrians survived to hospital. There is little potential to
      reduce the number of deaths by improving hospital treatment, rather the focus
      needs to be directed towards injury prevention. Although pedestrians appeared to
      be responsible for the collisions, the results suggest it may be more feasible
      and effective to direct injury prevention measures towards lorry drivers.

PMID- 11219120
TI  - Early outcomes of supervised discharge.
AB  - We have previously described the generally positive initial experiences of
      Supervised Discharge (SD) in a large Mental Health Trust serving a mixed inner
      city, suburban and rural population. This paper seeks to extend our earlier
      findings by reporting a longitudinal cohort study examining hospitalization
      before and after SD for the original sample. The main outcome measures were:
      renewal of SD; time spent out of hospital; survival to readmission or the end of
      the study period (1 April 1999). Of the 22 patients commenced on SD orders
      between April 1996 and October 1997, by 1 April 1999: 12 patients were still
      subject to supervised discharge; 15 had not been readmitted to hospital; survival
      out of hospital was longer--717 days, compared with 607 days in the same period
      before SD (p = 0.037); survival to readmission was also longer than before SD (p
      = 0.023). Contrary to early professional expectations patients subject to SD seem
      to survive for longer periods in the community. Although not always effective,
      its wider use should at least be considered as part of the care package for
      detained patients with a history of non-compliance with care packages leading to
      relapse and readmission.

PMID- 11219121
TI  - Trends in admissions to a regional secure unit (1983-1997).
AB  - Admissions and discharges from a 30-bed regional secure unit (RSU) were surveyed
      over a 15-year period. In the last five years there has been a significant
      increase in the average length of stay of patients and a marked decrease in the
      number of admissions and discharges. The reasons for this 'silting up' of the RSU
      by longer-term patients and the consequences for an effective forensic
      psychiatric service are discussed.

PMID- 11219122
TI  - Sudden death and intussusception in infancy and childhood--autopsy
      considerations.
AB  - Search of the autopsy files of the Department of Histopathology at the Women's
      and Children's Hospital (WCH), Adelaide, Australia for cases of intussusception
      from January 1961 to December 1995 revealed two deaths due to intussusception out
      of a total of 4,384 autopsies (0.05%). Both cases occurred in infants (aged five
      months and six months respectively) who had only non-specific and apparently
      minor manifestations of illness, until precipitate deterioration occurred. The
      intussusceptions were ileo-ileal and ileocaecal in location, respectively. A
      total of 204 cases of intussusception were found in a search of 28,123 surgical
      pathology cases (0.73%) at the WCH over the 20-year period from 1976 to 1995.
      Mesenteric lymphadenopathy was found in 16 cases (including one with possible
      Yersinia infection), Meckels diverticulum in 14, isolated gastric/pancreatic
      heterotopia in two, cystic fibrosis in two and Henoch-Schonlein purpura in one.
      Although it has been shown that unexpected death is more likely to occur in older
      children with purely small intestinal intussusception, the current cases
      demonstrate that unexpected death may occur at any age, with intussusception at
      any level. The autopsy assessment of deaths due to intussusception requires
      careful evaluation of cases for evidence of local or systemic disease,
      particularly given the hereditary nature of certain predisposing conditions.
      Careful review of the presenting history is also required to assess the quality
      of care received by the child in the time preceding death.

PMID- 11219124
TI  - Fit to be interviewed by the police--an aid to assessment.
AB  - The assessment of a suspect's fitness to be interviewed by the police is becoming
      an increasingly important part of a police surgeon's workload. This paper
      discusses the assessment in terms of the various factors that may render a person
      prone to providing an involuntary or false confession and proposes an aide
      memoire to assist the examining doctor.

PMID- 11219123
TI  - Death of a psychiatric patient during physical restraint. Excited delirium--a
      case report.
AB  - We report the case of a young man with a diagnosis of paranoid schizophrenia and
      multiple drug abuse who died in hospital following a period of prolonged physical
      restraint. The literature is reviewed, possible factors contributing to death
      discussed and measures which may reduce the incidence of such deaths in the
      future highlighted.

PMID- 11219125
TI  - Arsonists in maximum security: mental state at time of firesetting and
      relationship between mental disorder and pattern of behaviour.
AB  - Seventy-nine arsonists were identified in a Special Hospital. Sixty-eight had a
      clinical interview which included an analysis of symptoms present at the time of
      the most recent fire. Mentally ill arsonists did not differ from Psychopathic
      Disorder arsonists in their self-report of symptoms at the time of firesetting,
      the major difference was in the time course of their behaviour. Mentally ill
      arsonists lit their first fire on average eight years later than did Psychopathic
      Disorder patients. Further analysis indicates that PD women have a distinct group
      of current symptoms and behaviours.

PMID- 11219127
TI  - Survey of the use of the interim hospital order in Scotland (1985-94).
AB  - A retrospective case note review was undertaken of all admissions to the State
      Hospital under an Interim Hospital Order between 1985 and 1994 (n = 73). This
      represented 89 per cent of all Interim Orders made by the Scottish courts during
      this time period. Thirty-one per cent of patients received a non hospital
      disposal at the end of the assessment. Seventy-eight per cent of the interim
      hospital orders were for a period of three months of less. The demographic,
      illness and offense backgrounds of the group is presented. In addition, the
      outcome of the assessment is discussed in the light of current legislative
      changes.

PMID- 11219128
TI  - The place and point of 'true crime'.

PMID- 11219126
TI  - A prospective study using the Monroe Dyscontrol Scale as a measure of impulsivity
      in referrals to a forensic psychiatry service.
AB  - Many people referred to a forensic psychiatry service will have displayed
      impulsive aggression. There are few validated tests to allow a quantitative
      measurement of such behaviour. The Monroe Dyscontrol Scale (MDS) arose from work
      that recognized certain symptoms in people who had impulsive aggression, the so
      called 'episodic dyscontrol syndrome'. This study uses the MDS in two groups of
      people who were referred to a forensic psychiatry service. One was a group of
      'mentally disordered' in-patients, and the other comprised consecutive referrals
      to the service. The groups were compared and certain features noted. The most
      interesting feature was that a family history of epilepsy was common, and
      associated with high scores on the MDS. The value of the MDS, and the importance
      of a family history of epilepsy, are discussed.

PMID- 11219129
TI  - Cutaneous burns from CS incapacitant spray.
AB  - A case of a superficial burn following exposure to CS incapacitant spray is
      reported. This is followed by a summary of the properties and effects of CS and
      the other agents which occur in the incapacitant spray. CS is relatively safe,
      but it does have unwanted effects, especially on skin exposure. Possible
      contributing factors to the production of a skin burn are discussed.

PMID- 11219130
TI  - Two cases of death due to plastic bag suffocation.
AB  - Deaths due to plastic bag suffocation or plastic bag asphyxia are not reported in
      Malaysia. In the West many suicides by plastic bag asphyxia, particularly in the
      elderly and those who are chronically and terminally ill, have been reported.
      Accidental deaths too are not uncommon in the West, both among small children who
      play with shopping bags and adolescents who are solvent abusers. Another well
      known but not so common form of accidental death from plastic bag asphyxia is
      sexual asphyxia, which is mostly seen among adult males. Homicide by plastic bag
      asphyxia too is reported in the West and the victims are invariably infants or
      adults who are frail or terminally ill and who cannot struggle. Two deaths due to
      plastic bag asphyxia are presented. Both the autopsies were performed at the
      University Hospital Mortuary, Kuala Lumpur. Both victims were 50-year old married
      Chinese males. One death was diagnosed as suicide and the other as sexual
      asphyxia. Sexual asphyxia is generally believed to be a problem associated
      exclusively with the West. Specific autopsy findings are often absent in deaths
      due to plastic bag asphyxia and therefore such deaths could be missed when some
      interested parties have altered the scene and most importantly have removed the
      plastic bag. A visit to the scene of death is invariably useful.

PMID- 11219131
TI  - The reconstruction: a useful tool in forensic sciences.
AB  - The intervention of a forensic pathologist may be required at any stage of a
      judicial investigation. Clearly, he or she plays an important role at a crime
      scene and later on during the examination of the body. But the forensic
      pathologist's contribution is equally important during reconstruction, which is
      most frequently called for in cases of violent deaths, homicides in particular.
      However, reconstruction may also be very useful in cases of less importance in
      terms of criminal law. It requires little investment and can provide precious
      evidence. In the two cases presented here we were able to exclude, respectively,
      the presumption of the adulteration of a blood sample taken for alcohol dosage
      and the accidental origin of an attempted murder. In fact, reconstruction may be
      a valuable procedure in any event requiring the participation of a forensic
      expert.

PMID- 11219132
TI  - Deaths among psychiatric patients: future considerations.

PMID- 11219134
TI  - [Ehlers-Danlos syndrome associated with acute pancreatitis].
AB  - Ehlers-Danlos syndrome is an inherited connective tissue disease characterized by
      articular laxity, hyperelastic skin and tissue fragility. The syndrome is
      genetically, biochemically and clinically heterogeneous and several well-defined
      subtypes have been identified. We describe a patient with the type IV variant of
      this syndrome who developed acute spontaneous pancreatitis.

PMID- 11219133
TI  - [Assessment of the PCR-Southern blot technique for the analysis of viremia in
      patients with acute hepatitis A].
AB  - Assessment of viremia in hepatitis A virus (HAV) infection is not frequently
      performed with conventional methods because the techniques used are laborious,
      have low sensitivity are usually performed in feces. The aims of this study were
      to develop a polymerase chain reaction (PCR) and Southern blot technique to
      detect HAV-RNA in the serum of patients with acute HAV infection and to determine
      the relationship between HAV-RNA and anti-HAV IgM and alanine aminotransferase
      (ALT) levels. The presence of HAV-RNA was studied in 26 serum samples from 21
      patients with acute hepatitis A. We also studied 11 samples from patients with
      acute hepatitis B and 15 samples from patients with non-A, non-E hepatitis. HAV
      RNA was detected in 10 (38%) of the 26 serum samples from patients with acute
      hepatitis A. Simple PCR was positive in 5 samples and PRC-Southern blot was
      positive in 10. All the serum samples obtained during the first week of onset
      were HAV-RNA positive and 50% of those obtained during the second week were
      positive. None of the serum samples obtained after the second week of onset were
      HAV-RNA positive. None of the serum samples from the 11 patients with acute
      hepatitis B or from the 15 patients with non-A, non-E acute hepatitis were
      positive for HAV-RNA. No significant relationship was detected between HAV-RNA
      detection and an IgM anti-HAV or ALT positive result. In conclusion, the presence
      of HAV-RNA in acute hepatitis A is frequent but the PCR Southern blot technique
      is required for detection, which is transitory during the first weeks after
      onset.

PMID- 11219136
TI  - [The intestinal brain].

PMID- 11219135
TI  - [Macromolecular creatinine kinase in patients diagnosed with ulcerative colitis].
AB  - Macromolecular creatinine kinase (macro-CK) type 1 is a macroenzyme formed by the
      union of an immunoglobulin with a creatinine kinase (CK) enzyme. Its presence in
      the blood may lead to misdiagnosis of heart disease. This macromolecule has been
      described in various diseases and is relatively more frequent those with
      autoimmune etiology. We describe three cases of ulcerative colitis that presented
      elevated MB-isoenzyme of CK activity greater than the total CK quantified by the
      immunoinhibition method. Electrophoresis revealed an atypical band that
      corresponded with the presence of a type 1 macroenzyme. Detection of this
      macromolecule could be useful in cases of ulcerative colitis when results of
      blood testing lead to suspicion of ischemic disease.

PMID- 11219137
TI  - [Clinical approach for the patient requiring non-steroid anti-inflammatory
      agents: role of COX-2 inhibitors].

PMID- 11219138
TI  - [Consensus on spontaneous bacterial peritonitis in liver cirrhosis: diagnosis,
      treatment, and prophylaxis].

PMID- 11219139
TI  - [Fulminant infection caused by varicella herpes zoster in patient with Crohn
      disease undergoing treatment with azathioprine].

PMID- 11219140
TI  - [Multifocal hepatic steatosis and Crohn disease].

PMID- 11219141
TI  - [Helicoidal CT and choledocholithiasis].

PMID- 11219142
TI  - [Efficacy of fecal detection of Helicobacter pylori with the HpSA technique in
      patients with upper digestive hemorrhage].
AB  - BACKGROUND: The rapid urease test is the most commonly used test in the diagnosis
      of Helicobacter pylori infection in patients with upper gastrointestinal
      hemorrhage. However, some studies have suggested that results of this test are
      frequently false negative when blood is present. An effective new enzyme
      immunoassay for determining H. pylori antigens in stools has recently begun to be
      used. AIM: To determine the efficacy of the H. pylori stool antigen test (HpSAT)
      in patients with upper gastrointestinal hemorrhage. PATIENTS AND METHODS: Thirty
      two patients with upper gastrointestinal hemorrhage were prospectively studied
      from November 1998 to April 1999. In all patients the following tests were
      performed in the first 72 hours after onset of bleeding and 24 hours after
      hospital admission: upper gastrointestinal endoscopy, biopsy samples for the
      rapid urease test and histological study, blood samples for serology, stool
      samples for HpSAT, and the 13C urea breath test. Criteria for infection was a
      positive result in at least two of the four diagnostic techniques, except in the
      case of HpSAT. Sensitivity, specificity, positive predictive value (PPV) and
      negative predictive value (NPV) were calculated. RESULTS: Of the 32 patients, 23
      (71.8%) were infected. The results of four HpSAT (12.5%) were negative and 28
      were positive (87.5%). HpSAT showed high sensitivity (95.6%) but low specificity
      (33.3%). The PPV and NPV were 78.5% and 75% respectively. Of the 32 HpSAT, 25
      (78.1) were performed in melenic stools: 22 were positive and 3 were negative.
      Seventy-five percent of negative HpSAT and 78.5% of positive HpSAT corresponded
      to melenic stools. CONCLUSIONS: HpSAT is a rapid, non-invasive technique that
      does not appear to be influenced by the presence of blood. Consequently, it can
      be applied in patients with upper gastrointestinal hemorrhage. The rapid urease
      test showed high sensitivity, specificity and PPV and should remain the first
      line test in patients with upper gastrointestinal hemorrhage. HpSAT is
      appropriate as a second-line technique and is useful when the rapid urease test
      is negative and infection is strongly suspected, when no samples for the rapid
      urease test have been taken and when endoscopy cannot be performed. The result
      obtained in the present study should be confirmed in future studies with larger
      samples.

PMID- 11219143
TI  - [Tolerance to and colon cleansing with 2 preparations. Polyethylene glycol or
      sodium phosphate].
AB  - OBJECTIVE: To compare colon cleansing and tolerance with two preparations:
      polyethylene glycol 4-liters (PEG) and sodium phosphate (FS). MATERIAL AND
      METHODS: Prospective randomized study of 100 consecutive patients who underwent
      endoscopy after taking PEG (Bohm lavage solution) or FS (Fosfosoda). All patients
      were evaluated for the presence of adverse effects, degree of discomfort of the
      preparations (1: mild, 2: moderate, 3: severe) and the degree of cleansing with
      the products (1: poor, 2: fair, 3: good, 4: excellent). RESULTS: Age, sex, depth
      of insertion and surgical history were similar for both groups. Discomfort in the
      FS group was mild in 37, moderate in 11 and severe in 2 (mean score 1.30 +/-
      0.54); in the PEG group it was mild in 28, moderate in 15 and severe in 7 (mean
      score 1.58 +/- 0.73). Colon cleansing was poor or fair in 11 (22%) patients in
      the PEG group and in 8 (16%) patients in the FS group and was good or excellent
      in 39 (78%) in the PEG group in comparison with 42 (84%) in the FS group. Among
      the 50 patients who took the FS preparation, 12 had previously taken the PEG
      preparation and 11 of these preferred the FS preparation. Among the 50 patients
      who took the PEG preparation, 10 had previously taken preparations: 4 had used
      enemas (considering the present PEG to be worse) and 6 had taken the same PEG as
      that used in the present study (p < 0.005). One patient in the FS group and four
      in the PEG group did not complete the preparation because of vomiting. The
      adverse effects of both preparations were similar. CONCLUSIONS: The adverse
      effects and degree of colon cleansing were similar for FS and PEG. Tolerance and
      patient comfort were greater with FS than with PEG.

PMID- 11219144
TI  - [Therapy of HIV infection: how early and how intensive?].
AB  - Three men aged 53, 25 and 34 years and 2 women aged 39 and 34 years with HIV
      infection had different courses with and without highly active antiretroviral
      therapy (HAART). Medication regimes were often complicated and adverse events
      occurred frequently, which led to adjustment of treatment. Since the introduction
      of HAART for treatment of HIV infection, a tremendous progress has been achieved,
      resulting in reduction of HIV related events and in reduction of fatality due to
      AIDS. However, besides the positive effects of this therapy, there is also a
      negative side of HAART. In addition to the complexity and adverse events, the
      medication has to be taken lifelong while non-compliance might result in
      resistance-mutation. If HAART might be indicated, it is necessary to weigh the
      pros and contras before starting with medication.

PMID- 11219146
TI  - [Physical diagnosis--pain elicited by percussion in the kidney area].
AB  - Percussion of the kidney as a diagnostic method was first described by John
      Benjamin Murphy (1857-1916). The test is rapidly elicited, but can cause severe
      pain. Considering acute pyelonephritis or acute renal colic, it is common
      practice to perform fist percussion of the kidney, yet its diagnostic value is
      unknown. Finnish study results in 1998 suggest that in acute renal colic loin
      tenderness and erythrocyturia are more significant signs than renal tenderness.
      There is no scientific evidence for determining renal tenderness in diagnosing
      urinary tract infections and urolithiasis.

PMID- 11219145
TI  - [Effect of aldosterone antagonism in heart failure: pharmacotherapeutic options].
AB  - Aldosterone escape during chronic angiotensin-converting enzyme (ACE) inhibition
      may contribute to the high mortality among patients with heart failure.
      Aldosterone exerts several detrimental effects in the pathophysiology of heart
      failure. Spironolactone, an aldosterone antagonist, has proved beneficial when
      added to ACE inhibitors in patients with severe heart failure. However,
      spironolactone has substantial side effects mostly due to anti-androgen and anti
      progestagen actions. This may limit its use in less severe heart failure.
      Recently, more selective aldosterone antagonists have been developed, which
      appear to have the same potential as spironolactone with fewer side effects.
      Trials to assess efficacy of these drugs in hypertension and mild heart failure
      are now being started.

PMID- 11219148
TI  - [Diagnostic image (23). Congenital lobar emphysema].
AB  - A 6-months-old-boy failed to thrive. Congenital emphysema of the left upper lobe
      of the lung was diagnosed, and lobectomy was performed, with good results.

PMID- 11219147
TI  - [CBO-guideline 'Bacterial meningitis'].
AB  - Neisseria meningitidis and Streptococcus pneumoniae are the most frequent causes
      of bacterial meningitis. The incidence of Haemophilus meningitis in the
      Netherlands is low due to successful Haemophilus influenzae type b vaccination.
      This implies that there is no need to take account into this microorganism in
      using initial empiric antimicrobial therapy for bacterial meningitis. Vomiting
      (especially children), headache, fever, and a stiff neck characterize acute
      bacterial meningitis. However, even without these signs a patient may still have
      acute bacterial meningitis. The characteristics in neonates are less specific. An
      emergency lumbar puncture should be performed in all patients with meningeal
      irritation or other signs of bacterial meningitis. Examination of the CSF is not
      indicated for convulsive children (between the ages of 6 months and 6 years) who
      do not exhibit other clinical signs. In patients who respond adequately to the
      treatment, it is not necessary to examine the CSF again. Papilloedema or focal
      neurological symptoms contraindicate a lumbar puncture in patients with bacterial
      meningitis, until CT results justify that it can be performed safely. Antibiotic
      treatment should not be delayed until after the CT. General practitioners should
      treat their patients with suspected meningococcus infection by admitting them to
      the hospital without first injecting antibiotics. In the Netherlands, patients
      with suspected pneumococcus meningitis may still be treated with
      benzylpenicillin. Patients with bacterial meningitis have no fluid restrictions;
      only in case of the syndrome of inadequate secretion of antidiuretic hormone is
      fluid reduction indicated. The physician is responsible for prescribing
      prophylaxis to family members. The Regional Health Services organize
      chemoprophylaxis for classmates. The latter is only indicated if at least 2
      related cases occur in one month.

PMID- 11219149
TI  - [Teaching to inhale: better utilization of powder inhalators after counseling and
      instruction].
AB  - OBJECTIVE: To study the effect of instruction of patients who used an dry powder
      device on the correct performance of the inhalation technique and whether the
      effect lasts. DESIGN: Prospective. METHOD: A number of patients who used at least
      one drug by the dry powder devices Diskhaler or Diskus/Accuhaler were asked to
      demonstrate their inhalation technique in the outpatient clinic, Department of
      Pulmonary Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. On a
      score list the receptionist recorded the correctness of every step of use of the
      device. Then information and instruction on the correct performance of the
      inhalation technique were supplied by the same receptionist until the patient
      mastered the inhalation technique. A simple instruction card was handed to the
      patient. At the next outpatient visit the effect of the instruction was measured
      by means of the same score list registered by the same or another receptionist.
      RESULTS: Data from 97 patients could be evaluated; 42 men and 55 women, with a
      mean age of 58 years (range: 16-84). The percentage of patients who performed all
      essential actions correctly increased from 12 to 62. Almost all actions were
      performed better at the second than at the first visit. Better inhaling technique
      was observed in the 53 patients who paid their second visit within 30 days as
      well as in the 44 who came later (mean: 96 days; range: 34-352). CONCLUSION: The
      performance of the inhalation technique with the Diskhaler and the
      Diskus/Accuhaler was poor. By means of instruction the inhalation technique
      improved. This improvement was also seen in the group checked after an average of
      3 months.

PMID- 11219150
TI  - [Acute schistosomiasis: fever and eosinophilia, with or without urticaria, after
      a trip to Africa].
AB  - Despite treatment for malaria two travellers who acquired fever in Africa
      continued to have complaints: a 25-year-old Dutch woman and a 25-year-old
      Australian man. On questioning they appeared to have swum in Lake Malawi and a
      diagnosis of acute schistosomiasis was made, confirmed by serological tests. This
      syndrome, also called Katayama fever, is characterized by fever, oedema,
      urticaria and eosinophilia. The aetiology is not fully elucidated but it is
      supposed to be caused by immune complexes initiated by maturing worms and eggs.
      Patients who acquired fever in an endemic area must be questioned about contact
      with fresh water. Serological tests are important for the diagnosis. Treatment is
      with praziquantel but it is advised to treat only after the acute phase. During
      the acute manifestations corticosteroids may be necessary. Prevention is by
      avoiding contact with infected water. There is no vaccine. The role of
      artemisinin drugs in prevention is currently being studied.

PMID- 11219151
TI  - [Acute delirium, probably precipitated by clarithromycin].
AB  - Clarithromycin is a relatively new antibiotic with many applications. Its
      frequent use explains why side-effects previously reported seldom now become
      clear. Two patients, a man aged 74 and a woman aged 56 years, developed delirium
      after treatment with clarithromycin as part of eradication treatment of
      Helicobacter pylori, presumably as a result of an ideosyncratic reaction to the
      clarithromycin. Preclinical and clinical investigations did not reveal side
      effects on the central nervous system. By now the appearance of a delirium
      presumably related to the use of clarithromycin has been described in several
      patients. Furthermore some patients had a positive rechallenge. Finally, 17
      reports on psychiatric side effects, of which 7 were delirium, after the use of
      clarithromycin reached the Netherlands Pharmacovigilance Foundation (Lareb). This
      combination of facts makes a causal relationship probable.

PMID- 11219152
TI  - [Ethical shortcomings of skeletal age determination to establish minority for
      single young asylum seekers].
AB  - Each year tens of thousands of asylum seekers from all over the world come to the
      Netherlands. Amongst them are minors who come alone. They are eligible for a
      separate, less severe, admittance procedure than for adults and their under-age
      children. Because of abuse of this procedure by adults an X-ray age examination
      of the claviculae and hand-wrist has been introduced to determine minority. A
      person who claims to be a minor but appears to be an adult is invited to submit
      to the examination on a 'voluntary' basis. The selection procedure, the informed
      consent, the voluntariness and the technical aspects of the age measurement
      suffer from ethical shortcomings. An ethical committee should ensure that the
      procedures conform to the generally accepted Dutch ethical principles laid down
      in the Dutch Medical Treatment Act. In addition, the selection of asylum seekers
      for age determination should be carried out by specialized officials (an
      alternative would be to subject all single minor asylum seekers to age
      measurement). The waiting time for age measurement should be reduced to prevent
      the medial clavicular epiphyseal disc from closing during the waiting time. Age
      should not be judged on the basis of a partially closed epiphyseal disc, as this
      is controversial. It is recommended that the age for the single minor asylum
      seeker regulation be reduced from 18 to 16 years.

PMID- 11219153
TI  - [Good medical care at the borderline of mental incompetence].

PMID- 11219154
TI  - [Bizarre advertisements by hospitals in the Dutch Journal of Medicine].

PMID- 11219155
TI  - [Cholesterol-lowering therapy; a recommendation from the Health Council].

PMID- 11219156
TI  - [Fabry disease: data from 4 families].

PMID- 11219157
TI  - [Link between prenatal exposure to the 'Winter of Famine' and long-term medical
      consequences].

PMID- 11219158
TI  - [Acquired medical condition and driving ability].

PMID- 11219159
TI  - [Primary osteomyelitis of sternum].

PMID- 11219160
TI  - [Primary osteomyelitis of sternum].

PMID- 11219161
TI  - Folate and intrauterine growth retardation.
AB  - The objectives of this case-control study were to compare the levels of folate in
      cord and maternal blood of 315 mothers who had intrauterine growth-retarded
      (IUGR) babies and 321 mothers who had appropriate-for-gestational-age (AGA)
      babies, to evaluate the correlation between cord and maternal folate and to
      assess the prevalence of folate deficiency. Mothers were recruited from the four
      largest hospitals in Campinas city, south-east Brazil. The gestational ages of
      the newborns were evaluated by the Capurro method. They were classified as being
      IUGR according to the Lubchenco birthweight-for-gestational-age standard. Red
      blood cell (RBC) folate was measured by radio-immunoassay. Slightly more IUGR
      (25.7%) than AGA babies (19.9%) had cord folate levels < or = 226.5 nmol/l (100
      ng/ml) (p = 0.05) and similar percentages of IUGR (32.1%) and AGA (29.9%) mothers
      had folate levels < or = 226.5 nmol/l. Mean cord folate levels in IUGR and AGA
      babies were 10% higher than mean folate levels in the two groups of mothers (p <
      0.001). There were weak correlations between maternal and cord folate in IUGR (r
      = 0.31) and AGA (r = 0.35) (p < 0.001) mother/baby groups. In this population,
      35% of mothers were folate-deficient although it was not associated with IUGR.
      Nevertheless, it would be important to give Brazilian women folate tablets during
      pregnancy and to investigate the effect on concentrations of homocysteine and on
      the prevalence of birth defects.

PMID- 11219162
TI  - No strong long-term effect of vitamin A supplementation in infancy on CD4 and CD8
      T-cell subsets. A community study from Guinea-Bissau, West Africa.
AB  - The World Health Organization recommends that 100,000 IU of vitamin A be given to
      infants between 6 and 12 months of age at the same time as measles vaccination in
      order to prevent vitamin A deficiency. In the present study, our aim was to
      assess the effect of vitamin A supplementation on T-cell subsets in a randomized
      factorial design, seeking a possible modifying effect of measles vaccination.
      Three hundred children were allocated either to two doses of measles vaccine at 6
      and 9 months of age or to poliomyelitis vaccine at age 6 months and measles
      vaccine at age 9 months. Within each group, infants were to receive two doses of
      vitamin A or two doses of placebo at 6 and 9 months of age. We found no
      significant effect of vitamin A supplementation on CD4 and CD8 T-cell subsets at
      3 and 9 months after supplementation. We found no effect of measles vaccine and
      no interaction between vitamin A supplementation and measles vaccine. Based on
      these observations, vitamin A supplementation does not seem to have a strong long
      term effect on CD4 and CD8 T-cell subsets in infants without clinical vitamin A
      deficiency.

PMID- 11219163
TI  - Independent indicators of outcome in severe paediatric malaria: maternal
      education, acidotic breathing and convulsions on admission.
AB  - Severe malaria is an important cause of death in hospitalized children in
      Mozambique, but the risk factors for this remain unclear. The objectives of the
      study were to define simple clinical criteria to identify on admission the
      children most at risk of dying. We studied prospectively 559 children admitted
      with severe malaria to the Department of Paediatrics of the Central Hospital of
      Maputo, Mozambique between March 1995 and August 1996. The case fatality rate was
      3.6%. In a multiple logistic regression model, mothers' education (RR = 9.6, 95%
      CI 1.2-76.0), acidotic breathing (RR = 4.3, 95% CI 1.3-13.8) and convulsions in
      the emergency room (RR = 8.1, 95% CI 2.6-25.1) were associated with outcome.
      Together they predicted 97% of outcomes but only 33.3% of deaths.

PMID- 11219164
TI  - Comprehensive community effectiveness of health care. A study of malaria
      treatment in children and adults in rural Burkina Faso.
AB  - Malaria is one of the most important causes of morbidity and mortality in
      children in sub-Saharan Africa, yet community effectiveness of treatment is not
      well understood. This study presents a quantitative estimate of community
      effectiveness of malaria treatment in Burkina Faso, based on population surveys,
      observational studies of health services and user surveys. Analysis of seven
      steps in the process of treating malaria reveal the following: (1) 21% of people
      with malaria attend health centres; (2) 31% of them have a sufficient history
      taken; (3) 69% receive a complete clinical examination; (4) 81% receive the
      correct dosage of drugs prescribed; (5) 91% purchase the drugs; (6) 68% take the
      drugs as prescribed; (7) the drugs are estimated to be 85% effective. Taking all
      the steps into account, overall community effectiveness is estimated to be 3%.
      Statistically significant differences in age and gender are seen in some steps.
      Quinine is prescribed too frequently. Critical issues in educating health care
      workers include complete history-taking and clinical examination, rational
      indication for quinine and adjusted drug dosages for children. We identify
      utilization and diagnostic quality as offering the greatest potential for
      improvement in overall community effectiveness.

PMID- 11219165
TI  - Cystic fibrosis in Arabs: a prototype from Jordan.
AB  - Cystic fibrosis is believed to be rare in Arabs. We report 202 cases (114 boys
      and 88 girls) diagnosed in Jordan over a period of 9 years. The mean age at
      diagnosis was 2.9 years. Classical presentation with growth failure,
      malabsorption and respiratory symptoms occurred in 75.4% of cases. Eighteen
      (10.8%) presented with hepatomegaly, 12 (7.2%) with meconium ileus and 11 (6.6%)
      had Pseudo-Bartter syndrome. Thirty-eight (23%) children died, most below the age
      of 1 year which may reflect a more severe disease in our population.
      Consanguineous marriage was present in 69% of cases. Genetic screening of 84
      children and 66 parents revealed 24 different CFTR mutations with a DF508
      mutation accounting for only 7.4%. Among the mutations detected, six were alleles
      identified for the first time. The fact that boys outnumber girls might reflect
      more deaths in girls due to the observed gender gap in CF mortality. It is
      possible that the low incidence of the DF508 mutation is due to a confounding
      effect and the high mortality in those carrying this mutation. The large number
      of different mutations reflects the ethnic diversity of the Jordanian population
      and the complex history of the country.

PMID- 11219166
TI  - Prognostic aspects of cystic fibrosis in Brazil.
AB  - Selected prognostic factors were assessed in a cohort of 111 Brazilian children
      with cystic fibrosis diagnosed between 1 June 1970 and 31 December 1994 and
      followed in the Pediatric Pulmonology Unit of the Federal University of Minas
      Gerais Hospital. A standardized protocol was used to collect information
      retrospectively from medical charts which included date of birth, age at
      diagnosis, gender, ethnic group, predominant mode of presentation, duration of
      follow-up, status on 31 December 1994, date of death or date of the last clinical
      evaluation. The risk of death (univariate and multivariate) was assessed using
      Cox's proportional hazard model. Mean age at death was higher in males (5.10
      years), when the diagnosis was made before the age of 12 months (3.10 years),
      when clinical presentation was other than respiratory (4.01 years old) and in
      'non-whites' (4.86 years old). Age at diagnosis was the only factor associated
      with death in this population, with both Cox's univariate (RH: 19.4) and
      multivariate analyses (RH: 17.6; 95% CI: 4.8-64.1). The increased risk of dying
      in children diagnosed before 12 months of age found in our analysis indicates
      that they should receive differentiated and intensive multi-professional care.

PMID- 11219167
TI  - Cerebrospinal trypanosomiasis masquerading as pulmonary infectious disease in a 1
      year-old boy.
AB  - A 1-year-old boy with cerebrospinal trypanosomiasis presented with severe
      respiratory symptoms, hepatosplenomegaly and no neurological signs of
      trypanosomiasis. Agitation and high fever on the 2nd day in hospital prompted a
      lumbar puncture and trypanosomes were recovered from the cerebrospinal fluid.

PMID- 11219168
TI  - Typhoid fever, ciprofloxacin and growth in young children.
AB  - Typhoid fever remains a significant public health problem in Southern Asia,
      particularly with the emergence of multi-resistant strains of Salmonella typhi in
      the late 1980s. Use of ciprofloxacin in children, although discouraged, is
      increasing and we aimed to assess whether its use affects growth or the
      prevalence of joint symptomology. Children under 6 years of age diagnosed as
      typhoid fever on the basis of a positive Widal test were recruited in the
      outpatient department of a paediatric teaching hospital after treatment had been
      initiated. During 6 months follow-up, prevalences of arthritis/arthralgia and
      ponderal, linear and knemometric growth were recorded. Seventy-five children were
      recruited (mean age 32 months, mean weight-for-height Z-score--1.3, mean height
      for-age Z-score 1.4) and 29 (39%) of them received ciprofloxacin. No significant
      adverse effects on ponderal, linear or knemometric growth, or on the incidence of
      arthritis/arthralgia were found to be associated with the use of ciprofloxacin.
      Knemometric and ponderal catch-up growth was demonstrable 30 days after diagnosis
      but linear growth was still declining 3 months after diagnosis with catch-up
      growth demonstrable only after 6 months. We conclude that ciprofloxacin is
      commonly used in typhoid fever and has no adverse effects on growth or joint
      symptomology.

PMID- 11219169
TI  - Childhood immunization in rural Malawi: time of administration and predictors of
      non-compliance.
AB  - A cohort of 760 newborns was followed prospectively for 2 years to ascertain the
      time of administration of childhood vaccinations in rural Malawi and to study
      predictors of non-compliance with national vaccination recommendations. At 1 year
      of age, 99% of the infants were fully vaccinated against tuberculosis, 91%
      against polio, 90% against diphtheria, pertussis and tetanus and 64% against
      measles. At 2 years, the corresponding vaccination coverages were 99%, 93%, 93%
      and 84%. On average, all vaccinations were given 1-3 months later than
      recommended. Many of the delayed measles vaccinations were given during a
      separate vertical campaign, during which 25% of previously unvaccinated 21-23
      month-old children were identified and immunized. Non-compliance with vaccination
      recommendations was associated with living in villages with no access to mobile
      vaccination teams, birth between April and June and birth at home. In this rural
      Malawian area, most vaccination services were functioning well. To increase
      measles vaccination coverage, regular outreach activities should be encouraged.

PMID- 11219170
TI  - Levels and avidity of antibodies to tetanus toxoid in children aged 1-15 years in
      Dar es Salaam and Bagamoyo, Tanzania.
AB  - A study was undertaken to determine the serological response in children (aged 1
      15 years) immunized with diphtheria-pertussis-tetanus vaccine (DPT) alone or with
      a tetanus toxoid (TT) booster dose under the Expanded Programme on Immunization
      in Dar es Salaam and Bagamoyo, Tanzania. Using an ELISA technique, serum levels
      of anti-TT antibody, antibody avidity and anti-TT IgG subclasses were determined
      in 138 apparently healthy children. Our findings revealed that 94.7% and 98% of
      children aged 1-5 years in Dar es Salaam and Bagamoyo, respectively, had anti-TT
      antibody levels above that considered protective (> or = 0.1 IU/ml). Among 6-15
      year-old children, 53.3% in Dar es Salaam and 55% in Bagamoyo had anti-TT
      antibody levels > or = 0.1 IU/ml. The avidity index of anti-TT antibodies was
      high in most of the younger children, 84.2% in Dar es Salaam and 92% in Bagamoyo.
      Significantly fewer older children in Dar es Salaam and Bagamoyo (53.3% and 50%,
      respectively) had high avidity index antibodies. The predominant anti-TT IgG
      subclasses were IgG1 and IgG3. It is concluded that the current DPT immunization
      schedule provides adequate tetanus immunity for children under 5. However, about
      half of the older children had no protection against tetanus.

PMID- 11219171
TI  - Neonatal neurological testing in resource-poor settings.
AB  - The aim of the study was to design and test a neurological examination for
      newborns that could be performed reliably by paramedical staff in resource-poor
      settings. The examination was adapted from a method established by Dubowitz et
      al., the latest version of which includes an optimality score. The final items in
      the test were chosen because they were culturally acceptable, could be elicited
      according to strict but easily comprehensible instructions and because the
      expected responses could be scored by the descriptions given or by diagrams in
      the proforma. The shortened examination was easily taught to paramedical staff
      who achieved a high degree of inter-observer reliability. This shortened version
      of the examination was piloted by comparing newborns from a Karen refugee camp on
      the western border of Thailand and from a large maternity hospital in Bangkok
      with a standardized cohort of newborns in London. The modified shortened version
      of the test was sufficiently sensitive to identify a number of differences
      between the cohorts, notably the poor vision performance and markedly reduced
      tone of the Karen newborns. In conclusion, the test can be used very reliably by
      paramedical staff and is a useful, simple and portable tool for the neurological
      assessment of newborn babies where resources are limited.

PMID- 11219173
TI  - Short stays in hospice. A review & update.
AB  - Despite the proven benefits and popularity of hospice, the average hospice
      patient receives only one month of services before death. Advanced progression of
      a patient's disease at admission contributes to short lengths of stay, and
      precludes patients from receiving the full benefit of hospice services. This
      article uses the results of the literature review to articulate reasons for
      delayed enrollment and to advance suggestions for ameliorating the problem of
      short stay in hospice.

PMID- 11219172
TI  - Incidence and spectrum of congenital heart disease in Oman.
AB  - We analysed the incidence and spectrum of congenital heart disease (CHD) in the
      Sultanate of Oman from 1994 to 1996. CHD was detected in 992 of 139,707 live
      births (incidence 7.1/1000 live births). The common CHDs were ventricular septal
      defect (24.9%), atrial septal defect (14.4%) and patent ductus arteriosus
      (10.3%). The frequency of atrioventricular septal defects (5.9%) was higher than
      reported from other countries. Age at diagnosis was under 1 month in 38% and 1-12
      months in 40%. Cyanotic CHD was found in 21.7% of the whole group and 35% of
      neonates. Although this was a hospital-based study, we believe we included almost
      all the infants and children with CHD in the country. The incidence and pattern
      of CHD in Oman were similar to those reported from developed countries in Europe
      and America, except for a higher frequency of atrioventricular septal defects.
      The high prevalence of consanguinity in the country did not affect the overall
      incidence of CHD.

PMID- 11219174
TI  - Talbot Hospice Foundation. A successful community endeavor.
AB  - Since it opened its doors 20 years ago, the Talbot Hospice Foundation, located in
      Talbot County, Maryland, has grown to be one of the most highly respected service
      organizations in the county. A professional, non-medical staff of about five full
      time employees manages some 800 volunteers who offer free hospice services to
      anyone in the community. It is dedicated to the concept that dying is not just a
      medical event, and that trained community lay people can play a significant role
      in providing practical and emotional support to their neighbors. The Foundation
      is supported completely by donations and receives no reimbursement from Medicare
      or other insurers.

PMID- 11219175
TI  - Completing the continuum of care. The growth of a pediatric hospice program.
AB  - This article examines the process of integrating a pediatric program into an
      existing hospice organization. It also discusses the five phases a child and
      family experience, from entering hospice through grieving the loss of the child.

PMID- 11219176
TI  - Intimacy and the telephone.
AB  - While the opportunities for touch are absent, the opportunities for intimacy with
      an individual patient and caregiver are not, thanks to Hospice of Northern
      Virginia's telephone triage department. Achieving this intimacy across telephone
      lines is not happenstance; rather, it is a careful blending of home care and
      triage practice. The result is continuity of care and successful patient/family
      interactions.

PMID- 11219177
TI  - Volunteer Hospice Network. A grass-roots model for community coalitions.
AB  - In 1995, the Hospice Association of America established the Volunteer Hospice
      Network to promote the growth, diversity, and development of volunteer
      organizations that serve those who are dealing with life-threatening illness and
      those who are grieving. Partnerships between these volunteer hospices and
      Medicare-certified hospices may possibly be a part of the answer to the future of
      the hospice movement.

PMID- 11219179
TI  - The challenges & rewards of a hospice volunteer program.
AB  - This overview of a hospice volunteer program discusses the many aspects of
      running such a program, including finding volunteers, providing training and
      education, keeping volunteers motivated, and offering bereavement education.

PMID- 11219178
TI  - Love matters. A profile of Connecticut Hospice.
AB  - After 25 years, America's first hospice looks back at its past challenges and
      successes, and looks forward to continuing its mission into the 21st century.

PMID- 11219180
TI  - Preparing for the new hospice cost report.
AB  - All certified hospice providers are required to file cost reports for all cost
      report periods beginning on or after April 1, 1999. In addition, if the hospice
      cost report is filed late and/or is incomplete, Hospice Medicare payments will be
      withheld from the provider. Thus, it is imperative that agencies understand how
      to prepare for and complete the report properly.

PMID- 11219181
TI  - Honoring America's heroes.

PMID- 11219182
TI  - End-of-life issues.
AB  - In the Western world we have not fully accepted the fact that dying is indeed
      part of the process of living. Even today in the 21st century, physicians who
      have historically been taught to diagnose and treat disease with the expectation
      of cure, still regard death as a failure. We need to be reminded of the 15th
      century definition of medical care, "To cure sometimes, to relieve often, to
      comfort always." We must realise that we cannot defy death and that every
      individual on earth has no choice but to travel the journey, be it long or short,
      from birth to ultimate death.

PMID- 11219183
TI  - [Capacity limitation and intellectual ability].
AB  - In a study examining the influence of cognitive capacity limitation on
      intellectual ability, 124 university students were subjected to 7 computer-based
      tests in which cognitive demands were manipulated by varying the number of
      required ordering, arithmetic, and memory operations, respectively. Intelligence
      data were obtained by forming a composite score from Raven's Advanced Progressive
      Matrices and the Berlin Intelligence Structure Test. Increases in cognitive
      demands led to increases in reaction times and number of errors as well as to
      increases in common variance and in correlations between intelligence and number
      of errors in 5 and 2 (of 5) comparisons, respectively, while correlations between
      intelligence and reaction time were found to decrease with increasing task
      demands in 3 comparisons. All correlations were reduced considerably when storage
      capacity and coordination efficiency were partialled out. These findings suggest
      a relationship between capacity limitation and intellectual ability.

PMID- 11219184
TI  - [Object-related action: use of recall in anticipation and performance].
AB  - Consideration of the course of everyday actions during which real objects are
      manipulated would suggest that the sequence of individual activities should be
      represented in the memory not as a chain but as a network with specific
      characteristics. These characteristics would appear to indicate that activities
      which directly change parts of the environment are more memorable than shifts of
      attention during the performance of the action. The results of Experiment 1
      support this view. Furthermore, it may be supposed that complex actions are not
      anticipated in their entirety before being performed, but only partially.
      Hypotheses concerning the temporal order of the parts of the anticipation process
      were tested in Experiment 2, the results supporting the hypotheses. Altogether,
      the results obtained confirm certain basic assumptions relating to the memory
      model Net of Recallable Action.

PMID- 11219185
TI  - [Structure and intensity of surprise].
AB  - Two experiments investigated the multicomponent theory of emotion intensity
      proposed by Frijda, Ortony, Sonnemans, and Clore (1992) in the case of surprise
      and compared it with the more traditional "feeling element" approach to emotion
      intensity. In both experiments the participants performed a choice reaction time
      task for a certain number of trials. In the last trial they were surprised by an
      unexpected change of appearance of the stimuli. In Experiment 1 the change
      concerned either an action-relevant or an action-irrelevant, affectively neutral
      stimulus. In Experiment 2 the change concerned either an affectively positive or
      an affectively negative stimulus. Response delay in the surprise trial served as
      the index of the interruption of ongoing processes caused by surprise.
      Immediately after the surprise trial the participants completed a surprise
      intensity questionnaire that was an adaptation of the general emotion intensity
      questionnaire used by Sonnemans and Frijda (1994). In contrast to the findings of
      Sonnemans and Frijda (1994), the present findings were consistently better in
      line with the traditional feeling element approach to emotion intensity than with
      the multicomponent theory. Possible reasons for the failure to support the
      multicomponent theory of emotion intensity for the case of surprise are
      considered.

PMID- 11219186
TI  - [Effect of personal priorities on magnitude of stimulus preference: initial
      empirical findings].
AB  - This study examines whether setting priorities in personal life-investment is
      reflected in a heightened sensitivity towards thematically related stimuli. Two
      groups of adults (N = 47; M = 30 years; 53% female) were compared: (1)
      participants with a parallel goal structure (n = 12) who feel equally committed
      to the work and the family domain, both in the present and in the future, and (b)
      participants with a sequential goal structure (n = 24), who currently feel more
      involved in the work domain, but expect to be more engaged in the family domain
      in the future. Five tasks were used to assess preference, all of them
      simultaneously presenting work- and family-related stimuli. As hypothesized,
      individuals with a sequential goal structure showed a stronger preference for
      work-related stimuli than individuals with a parallel structure. There were clear
      differences in word detection, in the elaboration of work-related statements, and
      in the choice between work-related and family-related reading material. Results
      are discussed primarily in reference to models of action-regulation.

PMID- 11219188
TI  - Role of blood coagulation factor XIII in vascular diseases.

PMID- 11219187
TI  - Evaluation of certain veterinary drug residues in food.
AB  - This report presents the conclusions of a Joint FAO/WHO Expert Committee convened
      to evaluate the safety of residues of certain veterinary drugs and to recommend
      maximum levels for such residues. The first part of the report considers an
      approach to assessing the safety of antimicrobial drug residues and their effects
      on the human intestinal microflora and general issues relating to the
      recommendation of Maximum Residue Levels (MRLs) for veterinary drug residues in
      food. A summary follows of the Committee's evaluations of toxicological and
      residue data on a variety of veterinary drugs: one beta-adrenoceptor-blocking
      agent (carazolol), one anthelminthic agent (doramectin), four antimicrobial
      agents (dihydrostreptomycin, streptomycin, neomycin and thiamphenicol), two
      insecticides (deltamethrin and phoxim), four production aids (estradiol-17 beta,
      progesterone, testosterone and porcine somatotropins) and one tranquillizing
      agent (azaperone). Annexed to the report are a summary of the Committee's
      recommendations on these drugs, including Acceptable Daily Intakes and MRLs, and
      other information required.

PMID- 11219189
TI  - CD14 expression on monocytes and TNF alpha production in patients with septic
      shock, cardiogenic shock or bacterial pneumonia.
AB  - OBJECTIVES: In patients with septic shock, circulating monocytes become
      refractory to stimulation with microbial products. Whether this hyporesponsive
      state is induced by infection or is related to shock is unknown. To address this
      question, we measured TNF alpha production by monocytes or by whole blood
      obtained from healthy volunteers (controls), from patients with septic shock,
      from patients with severe infection (bacterial pneumonia) without shock, and from
      patients with cardiogenic shock without infection. MEASUREMENTS: The numbers of
      circulating monocytes, of CD14+ monocytes, and the expression of monocyte CD14
      and the LPS receptor, were assessed by flow cytometry. Monocytes or whole blood
      were stimulated with lipopolysaccharide endotoxin (LPS), heat-killed Escherichia
      coli or Staphylococcus aureus, and TNF alpha production was measured by bioassay.
      RESULTS: The number of circulating monocytes, of CD14+ monocytes, and the
      monocyte CD14 expression were significantly lower in patients with septic shock
      than in controls, in patients with bacterial pneumonia or in those with
      cardiogenic shock (p < 0.001). Monocytes or whole blood of patients with septic
      shock exhibited a profound deficiency of TNF alpha production in response to all
      stimuli (p < 0.05 compared to controls). Whole blood of patients with cardiogenic
      shock also exhibited this defect (p < 0.05 compared to controls), although to a
      lesser extent, despite normal monocyte counts and normal CD14 expression.
      CONCLUSIONS: Unlike patients with bacterial pneumonia, patients with septic or
      cardiogenic shock display profoundly defective TNF alpha production in response
      to a broad range of infectious stimuli. Thus, down-regulation of cytokine
      production appears to occur in patients with systemic, but not localised, albeit
      severe, infections and also in patients with non-infectious circulatory failure.
      Whilst depletion of monocytes and reduced monocyte CD14 expression are likely to
      be critical components of the hyporesponsiveness observed in patients with septic
      shock, other as yet unidentified factors are at work in this group and in
      patients with cardiogenic shock.

PMID- 11219191
TI  - Transposition of great arteries and single coronary artery: a new surgical
      technique for the arterial switch operation.
AB  - A single coronary artery can complicate the surgical technique of arterial switch
      operations, impairing early and late outcomes. We propose a new surgical
      approach, successfully applied in a 2.1 kg neonate, aimed at reducing the risk of
      early and late compression and/or distortion of the newly constructed coronary
      artery system.

PMID- 11219190
TI  - The HMG-CoA reductase inhibitor simvastatin inhibits IFN-gamma induced MHC class
      II expression in human vascular endothelial cells.
AB  - HMG-CoA reductase inhibitors, or statins, are lipid-lowering agents that have
      been shown to effectively decrease severe rejection periods and development of
      transplant coronary artery disease after heart transplantation. Precise
      regulation of major histocompatibility complex class II (MHC class II) gene
      expression plays a pivotal role in control of the immune response after
      transplantation. The aim of this study was to evaluate the potential role of HMG
      CoA reductase inhibitors in regulating the immune response. We have examined the
      effects of simvastatin on MHC class II expression in primary human endothelial
      cells. Using RNAse protection assay and flow cytometry, we observed that
      simvastatin dose-dependently reduced interferon-gamma (IFN-gamma) induced MHC
      class II expression (mRNA and protein). In contrast, simvastatin did not affect
      the expression of MHC class I, pointing to specific actions in the MHC class II
      signalling cascade. The transcriptional coactivator CIITA is the general
      regulator of both constitutive and inducible MHC class II expression. After
      stimulation with IFN-gamma, the CIITA gene is selectively activated via one
      (promotor IV) of its four promoters. Interestingly, mRNA levels of CIITA were
      decreased after treatment with simvastatin. In addition, using transient
      transfections of promoter-reporter constructs we observed that the activity of
      CIITA promoter IV was decreased by simvastatin. In conclusion, simvastatin
      selectively decreases IFN-gamma-induced MHC class II expression in human primary
      endothelial cells through actions on the CIITA promoter IV. Thus, the beneficial
      effects of statins reported after heart transplantation may result from this
      immunosuppressive action, suggesting possible therapeutic use for other
      immunological disorders as well.

PMID- 11219192
TI  - Increased plasma adrenomedullin in patients undergoing percutaneous transluminal
      coronary angioplasty.
AB  - OBJECTIVES: Adrenomedullin (ADM) production and secretion have been reported in
      endothelial cells. The present study was designed to assess whether coronary
      angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) affect
      plasma ADM levels. DESIGN AND METHODS: We measured plasma concentrations of ADM
      using a specific radioimmunoassay method in patients undergoing coronary
      angiography or PTCA before and after a 5-minute procedure. Patients were divided
      into three groups; group I: normal coronary angiography group (11 males, 10
      females; mean age 55.90 +/- 11.03 yrs), group II: coronary artery disease (CAD),
      only coronary angiography performed (14 males, 8 females; mean age 60.95 +/- 9.80
      yrs), group III: PTCA performed in patients with CAD (35 males, 11 females; mean
      age 55.89 +/- 10.41 yrs). RESULTS: The plasma ADM levels and left ventricular end
      diastolic pressures measured before the procedure were similar in the three
      groups (p > 0.05). Plasma ADM levels were 13.98 +/- 2.26, 15.59 +/- 6.70, 17.15
      +/- 8.47 pg/ml respectively. ADM levels measured after CA showed no significant
      difference in group I (13.75 +/- 1.75 pg/ml) or group II (16.50 +/- 7.18 pg/ml)
      (p > 0.05). A marked elevation was observed in group III with ADM levels of 27.31
      +/- 12.27 pg/ml after PTCA (p < 0.01). The ADM levels observed in group III after
      PTCA were significantly higher than those of group I and group II after coronary
      angiography (p < 0.001). CONCLUSION: The results of our study show an increase of
      ADM after PTCA but not after coronary angiography in patients with or without
      CAD. We think that the increase of ADM levels may be due to cardiac secretion
      from endothelial and smooth muscle cells following balloon injury.

PMID- 11219193
TI  - Severe envenoming by a Gaboon viper (Bitis gabonica).

PMID- 11219194
TI  - Retirement Confidence Survey 2000 including results from the RCS Minority Survey
      and the Small Employer Retirement Survey.
AB  - The year 2000 represents the 10th anniversary of the Retirement Confidence Survey
      (RCS), and the third year for the Minority RCS and Small Employer Retirement
      Survey (SERS). Key RCS findings over the past 10 years include: The fraction of
      workers saving for retirement has trended upward, and today 80 percent of
      households report that they have begun to save. The fraction of workers who have
      attempted to calculate how much they need to save for retirement has risen
      noticeably over the past several years. Today, 56 percent of households report
      that they have attempted the calculation. One-half of workers who have attempted
      such a calculation report that it has changed their behavior, such as saving more
      and/or changing where they invest their retirement savings. Workers who have done
      the calculation appear to be in better shape regarding their retirement finances.
      Worker confidence in the ability of Social Security to maintain benefit levels
      bottomed out in 1994 and 1995. Workers today are just as confident as they were
      in 1992, although the majority remain not confident in Social Security. Regarding
      overall retirement confidence, Hispanic-Americans tend to be the least confident
      among the surveyed minority groups that they will have enough money to live
      comfortably throughout their retirement years. Key SERS findings include: While
      cost and administrative issues do matter to small employers, they are not the
      primary reasons for low plan sponsorship rates. Employee-related reasons are most
      often cited as the most important factor for not offering a retirement plan.
      Business-related reasons, such as profitability, are also a main decision-driver.
      It is important to note what small employers without plans do not know about plan
      sponsorship. Small employers that do sponsor a retirement plan report that
      offering a plan has a positive impact on both their ability to attract and retain
      quality employees and the attitude and performance of their employees. The survey
      results indicate that many small company nonsponsors may not be aware of such
      potential business benefits from plan sponsorship. In addition, many nonsponsors
      are unaware of the plan options available to them, in particular the ones created
      specifically for small employers, such as SIMPLE and SEP retirement plans.
      Therefore, some small employers may be making a premature decision not to sponsor
      a plan based on incomplete information.

PMID- 11219195
TI  - [The epidemiological approach and the good of the single individual].

PMID- 11219196
TI  - [The Assessor is grateful].

PMID- 11219198
TI  - [Our criticism is constructive].

PMID- 11219199
TI  - [The WTO and asbestos: commerce above all].

PMID- 11219200
TI  - [How difficult it is to measure the quality of life].

PMID- 11219201
TI  - [Survival from neoplastic diseases and planning for oncological care].

PMID- 11219203
TI  - [Health status indicators: features of the economic approach].
AB  - Quality of Life (QoL) instruments are often considered similar, since they all
      concern subjective health state valuations. Actually, among the set of QoL
      scales, it is possible to distinguish two approaches, different in terms of both
      goals and tools. The clinical approach elicits functional limitations as
      perceived by patients, the economic approach is aimed at solving allocation
      problems generated by scarsity of resources. The major goal of this article is to
      analyse the economic approach to health state subjective valuation. By using QoL
      questionnaires, economists attempt to set up quantitative indexes which can value
      any kind of health outcome. Thus the economic approach seems to be more ambitious
      than the clinical one. However, the results so far achieved are quite
      disappointing, especially if compared to those of the clinical approach. In
      particular, economic scales still suffer a general lack of validation, due to the
      scarcity of studies conducted on relevant samples. Accordingly, indexes now
      available seem to require substantial revision. In general, further significant
      efforts seem necessary to improve the methodology inside the field of HRQoL
      measures. Integrating the two approaches, as recently attempted, could be a sound
      strategy.

PMID- 11219202
TI  - [Identification and mortality of Italian emigrants returning to Italy after
      having worked in the crocidolite mines at Wittenoon Gorge, Western Australia].
AB  - The crocidolite mine at Wittenoom Gorge, Western Australia, has been active from
      1943 to 1966, and managed by Australian Blue Asbestos Ltd (ABA). Migrants
      constituted the large majority of workers. The list of workers is composed of
      6,911 subjects (6,501 males). In it we identified 1,102 Italians (1,069 males)
      and completed the follow up for those previously lost, remained in Australia or
      returned to Italy. Up to 1997, 302 subjects (301 males) definitively resettled in
      Italy, almost always returning to their community of origin. The median length of
      work at Wittenoom for those resettled was 17.8 months. The resettled subjects are
      spread around Italy, and 112 subjects (37%) already died. We compared the
      mortality rates of those returned to Italy to the rates of the male Italian
      population. Migrants were subjected to a strong selection before departure and
      were the target of a surveillance program during work at Wittenoom: however, for
      those resettled, instead of a healthy migrant effect, we observed an
      overmortality, mainly due to deaths from penumoconiosis (10 deaths vs 0.38
      expected), from respiratory tumours (3 deaths from pleural mesothelioma and 4
      from primary peritoneal tumours; an excess of lung cancers, SMR 1.28, 95% CI 0.72
      2.11, and an excess of undefined caused of deaths (SMR 6.29, 95% CI 2.52-12.96).
      The study suggests that asbestos-related diseases and deaths have been observed
      among those resettled to Italy. In order to increase the precision of the follow
      up of the Wittenoom cohort, a search outside Australia should be carried out in
      some European countries for workers whose vital status was unconfirmed. Survivors
      in Italy are suffering from asbestosis, jeopardizing their life, and are at risk
      of cancer, but few have received information, actions aimed at reducing the
      accumulated risk, or compensation. Italy had a multi-million number of migrants
      for work, and an important percentage of migrants is returned to Italy: the
      effects of occupational exposures to adverse agents should be expected, but this
      topic has received up to now little attention.

PMID- 11219204
TI  - The "De morbis artificum diatriba" editions since 1700 and their legacy.

PMID- 11219206
TI  - [What is your diagnosis? Relative hypergonadotrophic ovarian insufficiency after
      chemotherapy for Hodgkin disease].

PMID- 11219205
TI  - [Bernardino Ramazzini. Ante litteram epidemiologist].
AB  - Bernardino Ramazzini, born in Carpi in 1633 and deceased in Padua in 1714, is
      universally renowned father and founder of occupational health. This paper will
      present Bernardino Ramazzini under a different perspective, and will show that
      during his scientific career he continuously maintained the attitude of a modern
      epidemiologist. Reviewing all his scientific papers, and many papers commenting
      his activity, we present four major areas in which Ramazzini expressed in a
      direct and convincing way his epidemiologic culture: the epidemiologic
      constitutions and the work done mainly on physical subjects while he was in
      Modena; the general architecture of his most important book (De Morbis Artificum
      Diatriba); the first full description of an episode of environmental pollution
      which occurred in Finale Emilia in 1689 (in his book this episode is reported in
      the chapter describing the diseases of chemicals); the opening lectures of some
      academic years he gave while he was teaching, mainly, in Padua. To our knowledge
      the epidemiological attitude of Bernardino Ramazzini is not recognized yet in
      epidemiology textbooks.

PMID- 11219207
TI  - [General practice and home blood pressure measurement with fully automated device
      in long-term comparison].
AB  - In this prospective cohort study on 43 patients, the blood pressure patterns
      measured fully automatically in the doctor's practice and at home were compared
      over an average period of eight months. In total, a highly significant
      correlation was found between professional and patient measurements for both
      systolic and diastolic values. However, over the entire study period, the values
      obtained in the doctor's practice were higher than the patient's measurements
      (systolic +17 mmHg, diastolic +9 mmHg). The values obtained in the practitioner's
      office exhibited a much greater fluctuation than the patient's measurements. The
      majority of the values measured in the practice were above the mean of the home
      measurements (65% systolic and 67% diastolic). On therapy, 28 percent of the
      patients showing hypertensive values in the practice measured normal pressures at
      home. In conclusion, the study shows a minor fluctuation and a better
      reproducibility of the patient's own measurements versus those taken in the
      practitioner's office.

PMID- 11219208
TI  - [Endoluminal, cardiovascular radiotherapy: a new standard].
AB  - The treatment for cardiovascular disease, especially the treatment of coronary
      stenosis, has been continuously improving during the last decades. Routine use of
      angioplasty was improved by the use of coronary stenting further reducing cardiac
      morbidity. However, the incidence of restenosis after cardiovascular angioplasty
      remains high. The restenosis process is mainly explained by neointimal
      proliferation. Therefore, the utility of ionizing radiation has been
      systematically investigated in order to reduce proliferation of the neointimal
      tissue. Radiation therapy turns out to be a very efficient approach in reducing
      the rate of both de novo lesions as well as of instant restenosis. Recent
      clinical data from randomized trials confirm the utility of intracoronary
      radiation therapy and change the treatment standards in interventional
      cardiology.

PMID- 11219209
TI  - [Using diffusion and perfusion imaging of the brain with magnetic resonance
      tomography].

PMID- 11219210
TI  - [Penile metastasis of carcinoma of the urinary bladder].

PMID- 11219211
TI  - [Heracl'eum mantegazzi'anum: photosensitization].

PMID- 11219212
TI  - [Multiple morbidity in a patient (87 years old)].
AB  - The group of aged people--in particular of highly aged persons--increases and
      with it also the risk of polymorbidity. Atherosclerosis often occurs in the
      elderly population; it is not astonishing that atherosclerosis also increasingly
      affects the renal arteries. Another problem in this age group is chronic back-
      and leg pain. Considering a medicine that respects the patient's attitude and is
      reasonable and cost-effective, the care and therapy of a polymorbid patient
      offers a special challenge in the modern evidence-based medicine.

PMID- 11219213
TI  - Politics for dentists and dentistry--a grassroots view.
AB  - A Regent of the College who is involved in county government explains how he
      became involved in local politics and why participation at this level matters.

PMID- 11219214
TI  - Above all, check your references.

PMID- 11219215
TI  - Dentists serving their communities and states.
AB  - An orthodontist from Utah describes the motives and rewards for public service at
      the city and state level. Timing, a desire to give back to the community, and
      good advice all play a role.

PMID- 11219216
TI  - A commitment to community.
AB  - Retiring Republican Member of Congress for the 48th District of California, Dr.
      Ron Packard reflects on the qualities of success that are common in dentistry and
      politics and stresses the importance of community.

PMID- 11219217
TI  - From private practice to public policy.
AB  - A dentist describes her journey from private practice to legislative assistant.
      Beginning with work in the ADA's Government Relations Office and then through the
      American Dental Association's Congressional Fellowship, Dr. Skoulas has now taken
      a full-time position monitoring and developing legislation for Congressman Edward
      J. Markey.

PMID- 11219218
TI  - Reflection, introspection, and communication: a psychologist's view of dental
      ethics.
AB  - A psychologist with experience teaching ethics in dentistry observes that ethical
      practice involves three skills: reflection (to understand the ethical issue),
      introspection (to discover the forces for action), and communication (to carry
      ethics into action). Several short cases are presented showing how ethical
      communication can be difficult. Direct communication (what psychologist call
      confrontation) is recommended and some tips are offered.

PMID- 11219220
TI  - Will you accept this responsibility?

PMID- 11219219
TI  - Advertising, commercialism, and professionalism: a history of the ethics of
      advertising in dentistry.
AB  - The authors "read" the historical dental codes prohibiting advertising and the U.
      S. Supreme Court decision striking down prohibitions against advertising by
      lawyers in Arizona, and by extension, professional advertising generally. The
      arguments presented in defense of prohibiting professional advertising and the
      court's responses to each are presented in detail. The current ADA code is
      analyzed in this context.

PMID- 11219221
TI  - Having your say.
AB  - Effectiveness in speaking at meetings is more a matter of fit with the emerging
      image the group has of itself than the persuasiveness of the speaker. In addition
      to rhetorical messages, people speak at meetings to confirm their right to
      membership, obtain or exercise status, achieve social goals, and provide or
      reinforce the structural and procedural needs of the group. Persuasive speeches
      should fit the flow of the meeting, state the desired result of the speech, and
      give a reason. Style points are also mentioned.

PMID- 11219222
TI  - Stress-induced hormonal alterations.
AB  - The hormonal alterations observed during critical illness are extremely diverse,
      being both adaptive and maladaptive. Central and peripheral mechanisms are at
      play depending on the duration and severity of the insult. Perturbations in the
      endocrine axes are exacerbated by endogenous mediators and by pharmacologic
      intervention. The emergence of the concept of the wound, or inflammatory lesion,
      as an endocrine organ introduces new potential mechanisms of stress physiology
      and possible interventional strategies. Whether the physiology of the wound can
      be manipulated to heighten organism resistance to stress either emergently or
      electively is theoretically appealing and supported by animal models. Currently,
      however, it remains a subject of ongoing controversy and research.

PMID- 11219223
TI  - Stress-induced hyperglycemia.
AB  - Stress hyperglycemia is common and likely to be associated with at least some of
      the same complications as hyperglycemia in true diabetes mellitus, such as poor
      wound healing and a higher infection rate. The predominant cause is the intense
      counterregulatory hormone and cytokine responses of critical illness, often
      compounded by excessive dextrose administration, usually as TPN. Although
      randomized data suggesting benefit of controlling hyperglycemia in hospitalized
      patients are paltry, prospective controlled trials are feasible and should be
      initiated. In the interim, the practice at the authors' institution is to use
      insulin to lower plasma glucose concentrations to a safe range of 150 mg/dL to
      200 mg/dL in all patients.

PMID- 11219224
TI  - Syndromes of excess antidiuretic hormone release.
AB  - Hyponatremia, particularly that due to the syndrome of inappropriate antidiuretic
      hormone secretion (SIADH), is common in patients seen in the critical care
      setting. Because of aging-associated changes in the hormonal and renal systems
      involved in regulation of water and sodium balance, older persons are at higher
      risk than the young. The high prevalence of disease states and drug use in the
      elderly can affect water and sodium conservation and further contribute to the
      risk of hyponatremia in this population. The approach to management is dependent
      both on the severity of hyponatremia-related symptoms and the rapidity with which
      hyponatremia has developed. Careful monitoring of serum sodium during treatment
      is essential to produce prompt resolution of symptoms while avoiding the
      development of central pontine myelinolysis. Several therapeutic modalities are
      available for the longterm management of chronic hyponatremia.

PMID- 11219225
TI  - Cerebral salt wasting syndrome.
AB  - There is significant evidence to show that many patients with hyponatremia and
      intracranial disease who were previously diagnosed with SIADH actually have CSW.
      The critical difference between SIADH and CSW is that CSW involves renal salt
      loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or
      hypervolemic condition. Attention to volume status in patients with hyponatremia
      is essential. The primary treatment for CSW is water and salt replacement. The
      mechanisms underlying CSW are not understood but may involve ANP or other
      natriuretic factors and direct neural influence on renal function. Future
      investigation is needed to better define the incidence of CSW in patients with
      intracranial disease, identify other disorders that can lead to CSW, and
      elucidate the mechanisms underlying this syndrome.

PMID- 11219226
TI  - Hypocalcemic syndromes.
AB  - Hypocalcemia is common in the ICU and is a marker of poor prognosis. The
      mechanisms behind the low calcium levels include extravasation, increased
      chelation, intracellular overload of calcium, and an altered parathyroid hormone
      (PTH) secretion. Hypocalcemia and an altered PTH secretion seem to be related to
      systemic inflammation, but it is not known today if this response is appropriate
      or not. Therefore, a general supplementation with calcium in these patients
      cannot be recommended at this stage.

PMID- 11219227
TI  - Hypomagnesemic disorders.
AB  - Adequate magnesium stores are vitally important for life. Critically ill patients
      will almost always have diminished levels of circulating magnesium, and this
      predisposes them to a variety of adverse effects, some life threatening. The
      causes of hypomagnesemia are many and varied, but in the critically ill, losses
      from the kidneys, often secondary to medications and from the gastrointestinal
      (GI) tract, predominate. The measurement of magnesium is not straightforward,
      although many clinicians are now switching to the use of ionized magnesium from
      ion selective electrodes. The use of supplemental magnesium in acute flares of
      asthma has some support in medical literature, especially for those patients with
      severe disease who fail traditional therapy. Magnesium holds the preeminent
      position in the treatment of pre-eclampsia and eclampsia in the minds of most
      obstetricians, who have decades of experience showing it to be both effective and
      safe. Magnesium is clearly useful for certain types of ventricular tachycardia,
      and probably assists in the treatment of several types of supraventricular
      tachycardia. Its role in acute myocardial ischemia is less certain, although
      there is no benefit once reperfusion therapy has already been carried out.
      Finally, the role of magnesium in the treatment of acute cerebral insults is an
      exciting area of active investigation with initial studies suggesting much
      promise.

PMID- 11219228
TI  - Cardiovascular actions of magnesium.
AB  - Intracellular magnesium is an important modulator of calcium and potassium
      channels in cardiac myocytes. Hypomagnesemia is common in hospitalized patients
      and may contribute significantly to cardiac morbidity and mortality, particularly
      in states associated with myocardial ischemia. Therefore, it is important to
      maintain the plasma magnesium concentration within the normal range in
      asymptomatic patients and in patients with cardiac disease as prophylaxis against
      the occurrence of significant arrhythmias.

PMID- 11219229
TI  - Management of the obese critically ill patient.
AB  - The management of the morbidly obese critically ill patient is a challenging and
      formidable task. A better understanding of the pathophysiologic changes that
      occur with obesity and the complications unique to this group of patients may
      improve their outcome.

PMID- 11219230
TI  - Lipid modulation and systemic inflammation.
AB  - N-6 and n-3 PUFAs from the diet are absorbed and reach the cell where they
      interact with fatty acid binding proteins within cell membranes and cytoplasm.
      They are processed in the endoplasmic reticulum (desaturation-elongation
      reactions, lipid synthesis, eicosanoid and epoxide production) and in peroxisomes
      (beta-oxidation, synthesis, oxidation products). They interact with receptors,
      ion channels, and nuclear elements; the result is modulation of gene expression.
      PUFA-induced alterations result in modulation of local and systemic inflammation
      and inflammatory disease activity.

PMID- 11219231
TI  - Cytopathic hypoxia. Mitochondrial dysfunction as mechanism contributing to organ
      dysfunction in sepsis.
AB  - Several lines of evidence support the notion that cellular energetics are
      deranged in sepsis, not on the basis of inadequate tissue perfusion, but rather
      on the basis of impaired mitochondrial respiration and/or coupling; that is,
      organ dysfunction in sepsis may occur on the basis of cytopathic hypoxia. If this
      concept is correct, then the therapeutic implications are enormous. Efforts to
      improve outcome in patients with sepsis by monitoring and manipulating cardiac
      output, systemic Do2, and regional blood flow are doomed to failure. Instead, the
      focus should be on developing pharmacologic strategies to restore normal
      mitochondrial function and cellular energetics.

PMID- 11219232
TI  - Oxidants and antioxidant therapy.
AB  - The nature of organ injury during critical illness would suggest that antioxidant
      therapy might be effective as prophylaxis and therapy. To date, the results of
      human trials with these agents have yielded somewhat disappointing results.
      Future trials using better-defined primary endpoints for outcome and newly
      developed agents and modes of administration may result in successes in this
      field.

PMID- 11219233
TI  - Hypothalamic-pituitary-adrenal insufficiency.
AB  - Adrenal insufficiency is a common and underdiagnosed disorder that develops in
      critically ill patients. Most forms are acquired and will resolve with treatment
      of the underlying disease. Hypotension that is refractory to fluids and requires
      vasopressors is the most common presentation of adrenal insufficiency in the ICU.
      It is important to make the diagnosis of adrenal insufficiency, because current
      data suggest that treatment with glucocorticoids improves outcome. Diagnosis
      usually can be made on the basis of a stress cortisol level. Occasionally, when
      the level of stress is uncertain, the low-dose corticotropin stimulation test
      will be required for definitive diagnosis. A therapeutic trial with
      hydrocortisone should be started in patients with suspected adrenal insufficiency
      pending results of diagnostic testing.

PMID- 11219234
TI  - Thyroid function in the intensive care unit setting.
AB  - In sum, there is no convincing evidence yet published supporting the utility of
      T4 or T3 administration in patients with nonthyroidal illness. The authors
      recognize that evidence accrued in one disease state may not be applicable to
      others and that, although these studies are difficult to perform, further large
      scale prospective studies need to be performed. The issue of T3 treatment will
      not be resolved satisfactorily until more definitive data are available. Until
      that time, there may be rare circumstances when a clinician may think it best to
      treat an individual patient with T4 or T3. For the majority of patients, however,
      there will be little indication for the administration of thyroid hormones until
      the potential benefits can be shown to outweigh the risks.

PMID- 11219235
TI  - Management of hypothyroidism and hyperthyroidism in the intensive care unit.
AB  - Thyroid storm and myxedema coma are uncommon problems in the ICU, but both
      usually present with typical findings, and when recognized early, are treatable.
      Thus, rapid recognition with early institution of therapy may be life saving. It
      is always important to search diligently to determine the underlying cause of the
      decompensation and to treat that aggressively.

PMID- 11219236
TI  - Management of decompensated diabetes. Diabetic ketoacidosis and hyperglycemic
      hyperosmolar syndrome.
AB  - DKA and HHS represent two extremes in the spectrum of decompensated diabetes
      mellitus. Their pathogenesis is related to absolute or relative deficiency in
      insulin levels and elevations in insulin counterregulatory hormones that lead to
      altered metabolism of carbohydrate, protein, and fat and varying degrees of
      osmotic diuresis and dehydration, ketosis, and acidosis. In DKA, insulin
      deficiency and ketoacidosis are the prominent features of the clinical
      presentation, and insulin therapy is the cornerstone of therapy. In HHS,
      hyperglycemia, osmotic diuresis, and dehydration are the prominent features, and
      fluid replacement is the cornerstone of therapy. As many as one-third of patients
      may have mixed features of both DKA and HHS. Because the three-pronged approach
      to therapy for either DKA or HHS consists of fluid administration, intravenous
      insulin infusion, and electrolyte replacement, mixed cases are managed using the
      same approach. The therapeutic regimen is tailored according to the prominent
      clinical features present. In adult patients with mixed features, fluids may be
      administered more rapidly than they would be in younger patients, or in patients
      with DKA alone, because the risk for fatal cerebral edema in adults is low and
      the consequences of undertreatment include vascular occlusion and increased
      mortality. In younger patients with mixed features, rapid correction of metabolic
      abnormalities and, consequently, of hyperosmolarity by administration of
      hypotonic fluids and insulin should be avoided to decrease the risk for
      precipitating cerebral edema. In addition, if ketoacidosis has been a prominent
      feature in a mixed case, the patient may have type 1 diabetes with no residual
      pancreatic islet beta cell secretion and may subsequently need ongoing, life-long
      insulin therapy after resolution of the acute episode of decompensated diabetes.
      ICU admission is indicated in the management of DKA, HHS, and mixed cases in the
      presence of cardiovascular instability, inability to protect the airway,
      obtundation, the presence of acute abdominal signs or symptoms suggestive of
      acute gastric dilatation, or if there is not adequate capacity on the floor unit
      to administer the intravenous insulin infusion and to provide the frequent and
      necessary monitoring that must accompany its use.

PMID- 11219237
TI  - Postcoital contraception.

PMID- 11219238
TI  - Vaginal ring hormone delivery systems in contraception and menopause.

PMID- 11219240
TI  - Adolescent contraception and the clinician: an emphasis on counseling and
      communication.

PMID- 11219239
TI  - Mechanisms of pregnancy loss in antiphospholipid syndrome.
AB  - Antiphospholipid antibodies are associated with intrauterine fetal growth
      retardation and fetal distress leading to premature birth or fetal death. These
      complications are caused by uteroplacental insufficiency that is the result of
      multiple placental thromboses, infarcts, and spiral artery vasculopathy, which
      are almost certainly provoked by the hypercoagulable state induced by aPL
      antibodies. Available data indicate that the thrombogenic function of aPL
      antibodies involves their general effect on platelets, endothelial cells,
      anticoagulant mechanisms, and fibrinolytic pathways, as well as their local
      effect on trophoblasts and villi cells, leading to reduction of annexin V
      (placental anticoagulant protein-I) production and inhibition of its
      anticoagulant function.

PMID- 11219241
TI  - New contraceptive options.
AB  - New contraceptive modalities that are being introduced into the US marketplace
      reflect many changes in the delivery of existing steroidal products. These
      products are available now not only as oral medications but also as transdermal,
      intravaginal, intrauterine, and implantable or injectable devices. Each of these
      has its own unique profile and enhances the ability of consumers to pick and
      choose the product that is most acceptable to them. However, development of new
      barrier contraceptives, particularly those that have the potential to reduce the
      heterosexual transmission of HIV or to reduce a bacterial infection such as
      Chlamydia or Neisseria gonorrhea, continues to be moving forward in clinical
      trials. These products can have a lower efficacy compared with the steroidal
      products but, because of their other benefits, may be of significant medical use.

PMID- 11219242
TI  - Obstetric implications of antiphospholipid antibodies: pregnancy loss and other
      complications.

PMID- 11219243
TI  - Management of antiphospholipid syndrome during pregnancy.

PMID- 11219244
TI  - Antiphospholipid antibodies and infertility.

PMID- 11219245
TI  - Management of thrombosis in women with antiphospholipid syndrome.
AB  - 1) Antiphospholipid antibody syndrome may be associated with unusual sites of
      thrombosis. 2) Laboratory evaluation involves testing for antiphospholipid
      antibodies: lupus anticoagulant and anticardiolipin antibodies. 3) Acute
      management of thrombosis involves immediate anticoagulation. Low-molecular-weight
      heparins are as safe and effective as unfractionated heparin in this setting.
      Arterial events may require emergent thrombolytic therapy. Monitoring of the APTT
      with unfractionated heparin in the presence of a lupus anticoagulant is
      ineffective; these patients require monitoring of antifactor Xa levels or the use
      of LMWH, which does not require monitoring. 4) The pharmacokinetics of LMWH
      change in pregnancy, resulting in a shorter plasma half-life and larger volume of
      distribution. Monitoring of antifactor Xa levels is necessary. 5) Chronic
      anticoagulation is best achieved with warfarin, with significantly decreased
      rates of recurrent events when the INR is > or = 3.0. Long-term, if not life
      long, anticoagulation is often necessary. Warfarin is teratogenic, and
      individuals desiring pregnancy will need to convert to therapeutic, not
      prophylactic, doses of either unfractionated heparin or LMWH. 6) As part of
      optimal management of thrombosis in APS, additional risk factors for thrombosis
      should be eliminated or reduced. These include comorbid illnesses such as
      hypertension and hyperlipidemia, as well as smoking. 7) Tamoxifen, raloxifene,
      oral contraceptives, and hormone replacement therapy are all associated with an
      increased risk of DVT in the general population. In APS patients receiving
      therapeutic anticoagulation, the addition of these drugs should not increase
      thrombosis risk. In APS patients not receiving anticoagulant therapy, these
      hormonal therapies may increase the thrombosis risk.

PMID- 11219246
TI  - Testing for antiphospholipid antibodies: problems and solutions.
AB  - The first aCL test was developed in 1983 and subsequently standardized. Although
      new and more specific tests have become available, the aCL ELISA and the LA tests
      are still the first choice to be used in diagnosis of APS. Newer tests such as
      the anti beta 2 GP1 ELISA and the APhL ELISA Kit (Louisville APL Diagnostics) use
      somewhat different antigens and likely provide a more specific (and possibly more
      reliable) diagnosis of APS while retaining good-to-excellent sensitivity. Other
      tests, such as ELISA for prothrombin antibodies and annexin V antibodies, are
      still undergoing development and will require standardization and extensive
      evaluation. We thank Dr Isabel Abreu and Dr Mittermeyer B. Santiago for
      performing some of the studies reported in this review.

PMID- 11219247
TI  - Oral contraceptives: current status.
AB  - During the past four decades, oral contraceptives have remained a safe and
      effective method of birth control. Reductions in the estrogen and progestin
      dosages have significantly decreased the incidence of cardiovascular
      complications. The association between oral contraceptives and breast cancer
      appears to be primarily because of detection bias or possibly a promotional
      effect. Despite the changes in formulation, the problems related to side effects
      have not been totally solved. Because compliance and successful use is strongly
      affected by side effects, improvement in this area is probably the biggest
      challenge faced by developers of oral contraceptives. It is also clear that there
      are a growing number of significant noncontraceptive benefits that accrue in oral
      contraceptive users. Unfortunately, many women do not know about these benefits.
      Thus, one of the issues that providers need to continue to address is how to
      provide better information about oral contraceptives and contraception in general
      to patients.

PMID- 11219248
TI  - Injectable long-acting contraceptives.

PMID- 11219249
TI  - Norplant and other implantable contraceptives.
AB  - Implantable contraception represents a safe, reversible form of long-term family
      planning with distinct advantages. It does not contain estrogen, thus avoiding
      many of it contraindications. Importantly, it is extremely effective, has high
      continuation rates, and is well tolerated. The main side effects of Norplant are
      irregular menstrual bleeding and the occasional difficult removal. Although
      recent high-profile litigation has severely diminished enthusiasm for Norplant,
      the FDA has reaffirmed its safety and efficacy. Norplant remains a viable family
      planning option for carefully selected women. New contraceptive implants may soon
      be available accentuating the advantages of Norplant while minimizing the
      disadvantages.

PMID- 11219250
TI  - What health consumers want from online resources.

PMID- 11219251
TI  - Prophetic ministry in a new century. Prophets--lest we forget--are often
      unpopular in their own communities.

PMID- 11219252
TI  - CHA's refugee initiative.

PMID- 11219253
TI  - Non-heart-beating organ donation. Designing an ethically acceptable protocol.

PMID- 11219254
TI  - Organ donation and prudential deliberation. The opinions of physicians, other
      caregivers, and the public at large should be taken into consideration.

PMID- 11219255
TI  - Catholic systems: two years later. Two authors revisit strategic planning issues
      raised in a 1998 Health Progress article.

PMID- 11219256
TI  - 21st century strategic thinking. Five insights for boards of trustees.

PMID- 11219257
TI  - "Living our Promises, Acting on Faith". Year two update of CHA's performance
      improvement project in health ministry.

PMID- 11219258
TI  - The hiring process. Quality staff selection generates positive business results.

PMID- 11219259
TI  - Cutting costs in surgery. Rationalizing the use of surgical instruments can help
      hospitals stay competitive.

PMID- 11219260
TI  - Community networks. Partnerships between Catholic charities and Catholic health
      care organizations. Behavioral Health Care, Richmond, VA.

PMID- 11219261
TI  - The contemplative approach in the workplace.

PMID- 11219262
TI  - New collaboration aids refugees.

PMID- 11219264
TI  - Beyond the gift shop: making hospital retailing profitable.

PMID- 11219263
TI  - Enhancing relationships with local employers.

PMID- 11219265
TI  - Hospitals need to watch the viability of firms supplying content to their Web
      sites.

PMID- 11219266
TI  - The era of knowledge in health care.

PMID- 11219267
TI  - Health plan CEO offers tips on what hospitals need to do to serve seniors
      effectively.

PMID- 11219268
TI  - Health systems need to rethink post-acute care strategies in aftermath of BBA,
      PPS.

PMID- 11219269
TI  - Sleep disorders create growing opportunities for hospitals.

PMID- 11219270
TI  - Changing dynamics of integrated health care reports on major changes over five
      years.

PMID- 11219271
TI  - HIPAA is new weapon and career opportunity.

PMID- 11219272
TI  - New York, Florida, lead nation in AIDS rates, North Dakota has lowest rates.

PMID- 11219273
TI  - [New breast cancer diagnosis. False positive findings should become less frequent
      (interview by Petra Eiden)].

PMID- 11219274
TI  - [BSE-cattle in Germany. Must we soon also count on vCJK patients?].

PMID- 11219275
TI  - [Primary prevention of coronary heart disease. Exercise for life)].

PMID- 11219276
TI  - [Homocysteine--CRP--lipoprotein (a). When do you evaluate the "new" risk
      factors].
AB  - Homocysteine, inflammatory markers (e.g. CRP), hemostatic factors (fibrinogen,
      PAI-1, factor VII and factor VIII) and lipoprotein (a) are independent risk
      factors for atherosclerotic disease. Although the association between these
      factors and atherosclerosis is clear, it is uncertain whether this signals a
      causal relationship, or whether the parameters simply represent markers of
      atherosclerosis. Currently, there are no reports on interventional studies
      demonstrating a benefit from correcting these risk factors. The determination of
      homocysteine, fibrinogen and lipoprotein should therefore be restricted to
      certain situations, such as atherosclerosis or a family history of the disease
      without classical risk factors, or uncertainty about the need for primary
      pharmacological prevention. An increase in these parameters should prompt the
      early use of lipid-lowering drugs or aspirin. In exceptional cases only
      (homocysteine), correction of the risk factors should be considered.

PMID- 11219277
TI  - [Primary prevention in atherosclerosis. Properly assessing the risk of your
      patient].

PMID- 11219279
TI  - [Detecting fungi in the intestines. Sometimes it pays off!].

PMID- 11219280
TI  - [Tinnitus. Ways out of the diagnostic jungle in the direction of targeted
      therapy].

PMID- 11219278
TI  - [Preventing coronary heart disease by physical activity. How much exercise is
      necessary?].
AB  - The value of general measures, in particular physical exercise, for the
      prevention of cardiac disease has been unequivocally demonstrated. Meta-analyses
      done to investigate the preventive character of exercise have shown that the
      coronary risk of physically active persons is lower by a factor of 2 to 3. This
      reduction in risk is independent of the presence of other risk factors, and is
      not due to the better health awareness of those who are physically active.
      However, the amount or intensity of such training actually required remains
      uncertain. A number of studies report a protective effect only for intensive
      physical effort, while others claim a risk reduction independent of training
      intensity. In the last resort, however, any form of exercise is better than none
      at all, when it comes to lowering the coronary risk. Not only endurance sports,
      but also other types of sport, such as tennis, or daily activities, can be
      recommended.

PMID- 11219281
TI  - [Detection of disseminated tumor cells after cancer surgery. Indication of
      recurrence?].

PMID- 11219282
TI  - [Diagnostic quiz. Increasing dyspnea after bypass operation. Interstitial lung
      disease].

PMID- 11219284
TI  - [Sequlae of "silent rationing". Substantial deficits in drug management].

PMID- 11219285
TI  - [Comprehensive anti-adrenergic therapy. It can save the weak heart].

PMID- 11219283
TI  - [Orange peel skin provides business in the billions. But what really helps your
      patients?].

PMID- 11219286
TI  - [30-year-old diabetic patients mostly have type 2 diabetes. "Mature" diabetics
      are becoming increasingly younger].

PMID- 11219287
TI  - [Anti-inflammatory asthma therapy. Effectiveness depends on compliance].

PMID- 11219288
TI  - [SERM-therapy in postmenopause. Protection of bone and breast].

PMID- 11219289
TI  - [Best method against cellulite. Liposuction and freezing! (interview by Waldtraud
      Paukstadt)].

PMID- 11219290
TI  - [An innovative treatment reported on television. Gene therapy against
      arthrosis?].

PMID- 11219291
TI  - [15. Pathological liver values--alcohol is not always the problem!].

PMID- 11219292
TI  - Appropriate antibiotic use: reducing the emergence and dissemination of
      resistance.

PMID- 11219293
TI  - Risk stratification for patients with community-acquired pneumonia.
AB  - Community-acquired pneumonia (CAP) is a common medical illness with a prognosis
      that ranges from rapid complete recovery to severe medical complications and
      death. Approximately 4 million adults are diagnosed with CAP in the US each year;
      with more than 600,000 (15%) hospitalised. An estimated $4 billion is expended
      annually on patients with CAP, with inpatient therapy costing as much as 20 times
      that of outpatient antimicrobial therapy. Determining severity of illness and
      using this information to risk-stratify patients with CAP is important from
      several perspectives. Clinically, understanding prognosis can assist physicians
      in the initial site of treatment decision (home versus hospital) and can be used
      to communicate expected outcomes to patients. From a research perspective, risk
      stratification can be used to select appropriate patient subgroups for clinical
      trials and to provide severity-adjusted outcomes comparisons. From a policy
      perspective, severity-adjusted outcomes can be used as a proxy for quality of
      medical care.

PMID- 11219294
TI  - Community-acquired pneumonia.

PMID- 11219295
TI  - Outpatient management of infectious diseases.

PMID- 11219297
TI  - Changes in drug resistance of bacteria in China.

PMID- 11219296
TI  - International outpatient parenteral antimicrobial therapy.
AB  - On an international basis, outpatient parenteral antimicrobial therapy (OPAT)
      varies greatly. There are cultural as well as economic issues which make it
      different in every country. In general, the duration of hospital stay varies with
      the outpatient resources available and the economic base for them. In some
      countries, there may not be money available for any intravenous antibiotics, even
      in the hospital. In addition, there are great differences in outpatient
      intravenous therapy, with infusion clinics proliferating in China, yet these are
      scarce in the UK. There is also considerable variation in the use of
      intramuscular compared with intravenous therapies. In Italy, intramuscular
      ceftriaxone is used more often than intravenous therapy. While ceftriaxone use is
      high in the US, its use is surpassed on a per capita basis by Italy, and it is
      most interesting that the rate of antimicrobial resistance is lower in Italy than
      in most other European countries. Whether this relates to outpatient use,
      parenteral use or other unknown factors is unclear. Obviously, further studies
      are necessary.

PMID- 11219298
TI  - Bioterrorism.

PMID- 11219300
TI  - History and future of pneumonia.

PMID- 11219299
TI  - Are we ready for emerging strains of pandemic influenza?

PMID- 11219301
TI  - Staphylococcus aureus small colony variants: formation and clinical impact.
AB  - S. aureus small-colony variants are a naturally occurring subpopulation which
      grow slowly and produce small colonies on routine media. They also demonstrate a
      number of other characteristics that are atypical for S. aureus including reduced
      alpha-toxin production and delayed coagulase activity. The connection of S.
      aureus SCVs with persistent and relapsing infections has been defined over the
      past decade, especially in patients with chronic osteomyelitis and in cystic
      fibrosis patients as demonstrated by prospective studies. While the studies with
      clinical isolates of SCVs suggested a link between electron transport-defective
      strains and persistent infections, a defined hemB mutant with the SCV phenotype
      provided strong additional evidence for these connections. The hemB mutant was
      phagocytosed by cultured endothelial cells, but did not lyse these cells, because
      the mutant produced very little alpha-toxin. The intracellular location may
      shield the SCVs from host defenses and antibiotics, thus providing one
      explanation for the difficulty in clearing S. aureus SCVs from host tissues.

PMID- 11219302
TI  - Otitis media--10 days versus 5 days versus none.

PMID- 11219303
TI  - New and emerging pathogens.

PMID- 11219304
TI  - The changing epidemiology of food-borne disease.

PMID- 11219305
TI  - Glycopeptide-resistant Staphylococcus aureus.

PMID- 11219306
TI  - Changing epidemiology of HIV.

PMID- 11219307
TI  - New rickettsial pathogens.

PMID- 11219308
TI  - Update on vancomycin resistance.

PMID- 11219309
TI  - Update on cross-resistance of fluoroquinolones.

PMID- 11219310
TI  - Is there still a role for penicillins and cephalosporins in the treatment of
      bacterial infections?

PMID- 11219311
TI  - Identifying priority patients for coronary angiography.
AB  - We conducted an open observational study with blinded endpoint evaluation to
      validate the use of the Duke treadmill score in identifying patients likely to
      require coronary intervention. We studied 101 consecutive patients referred for
      coronary angiography from a cardiology clinic. All patients had a Bruce protocol
      exercise test. A 70% stenosis was regarded as significant. Patients were referred
      for percutaneous transluminal coronary angioplasty (PTCA) or coronary artery
      bypass grafting (CABG) surgery, if indicated. The Duke score was calculated as
      follows: exercise time (min) - (5 x ST segment deviation [mm]) - (4 x angina
      index [text]). Patients were classified into low, medium and high risk. The
      patients at high risk are more likely to have a significant stenosis (53/58 vs
      30/43: p = 0.01 [OR 4.59 95% CI 1.34-16.6]) and require CABG or PTCA (47/58 vs
      16/43: p < 0.001 [OR 7.21 95% CI 2.69-19.8]) than those at medium/low risk.
      Multiple logistic regression analysis, including ST segment depression, exercise
      time and symptoms shows that the score independently predicts a significant
      stenosis (p = 0.002) and the need for coronary intervention (p = 0.001).
      Introducing the score can help to identify those patients who need priority
      investigation.

PMID- 11219312
TI  - The Foley catheter in the management of epistaxis.
AB  - The Foley urinary catheter has been used in the management of epistaxis for many
      years, yet it has never been designed or licensed for this purpose. We performed
      a telephone questionnaire of senior house officers in 90 ENT departments in
      England and Wales. The aim was to determine how many departments used the Foley
      catheter for epistaxis management, whether licensed nasal balloon devices were
      available and if there had been any complications associated with their use.
      Eighty-three (92%) ENT departments in the study used the Foley catheter for
      epistaxis management and 44 (49%) departments had licensed balloon devices
      available. Only 22% of ENT senior house officers questioned were aware that the
      Foley catheter was not licensed for use in the nose. Most complications
      associated with the use of nasal balloon devices appear to be due to Foley
      catheters.

PMID- 11219314
TI  - Conservative management of low back pain.
AB  - Back pain is prevalent worldwide, but back pain disability has reached epidemic
      proportions in many industrialised societies. Few patients have serious medical
      pathology or direct neurological involvement requiring surgery. Although the
      causes remain unclear, physical stress and its consequences on discs, facet
      joints and supporting soft tissues at work or leisure are important, sometimes
      aggravated by adverse psychosocial factors. Modern management emphasises the role
      of self-care, beginning in primary care with the first episode. Without root
      compression, bed rest should not exceed 48 hours. Emphasis is on encouraging a
      rapid return to physical fitness and other activities, including employment,
      acknowledging that returning to a normal life may require working through pain.
      Medication facilitates this. No one should remain in pain beyond six weeks
      without being referred to a specialist service for a physical and psychosocial
      assessment by appropriately trained professionals and with consultant support for
      investigation, pain management and rehabilitation when needed.

PMID- 11219313
TI  - What influences outcome of stroke--pyrexia or dysphagia?
AB  - To investigate the significance of pyrexia and dysphagia as risk factors for
      mortality at 90 days in patients admitted with an acute stroke when controlled
      with other confounding factors, 202 stroke patients admitted to acute medical
      wards were prospectively studied for demographic and neurological details, stroke
      syndromes and pathology. A number of other factors were recorded within three
      days of admission, including pyrexia and dysphagia. Cox's proportional hazards
      model was used to identify the effect of 10 factors on mortality at 90 days; 59
      (29%) patients had died by 90 days. Univariate analysis revealed pyrexia and
      dysphagia to be independently and significantly associated with indices of stroke
      severity and 90 day mortality (p < 0.001 for both). Cox's proportional hazards
      model, however, revealed that stroke mortality was associated with dysphagia
      (relative risk 2.6, 95% CI 1.2-5.4; p = 0.009), pre-existing diabetes mellitus
      (2.4, CI 1.2-4.5; p = 0.006), higher age > 75 years (1.8, CI 1.0-3.1), ischaemic
      heart disease (2.1, CI 1.1-4.2, p = 0.025), total anterior circulation syndromes
      (2.8, CI 1.5-5.2) and previous stroke (1.8, CI 1.0-3.2, p = 0.028). Pyrexia was
      not a significant factor (p = 0.50). Although both pyrexia and dysphagia are
      associated with higher mortality in acute stroke patients, dysphagia was a
      significant variable predicting death at 90 days when controlled for other
      factors known to influence stroke mortality. Pyrexia is not significant when
      other variables are considered.

PMID- 11219315
TI  - Lessons to be learned--the blame culture.

PMID- 11219317
TI  - How do we prioritize patients on the waiting list for coronary angiography?

PMID- 11219316
TI  - Considerations for drug therapy in hypertension.
AB  - Both the Joint National Committee and the British Hypertension Society recommend
      b-blockers and diuretics as first-line therapy in the treatment of uncomplicated
      hypertension. As a result, many clinicians will also prescribe these drugs in the
      treatment of patients with hypertension and coexistent disease (unless they are
      specifically contraindicated), even though they may not always be the most
      beneficial choice. This review aims to examine factors that should be taken into
      consideration when choosing appropriate antihypertensive therapy. Particular
      attention is given to treatment options in two special patient groups, the
      elderly and patients with co-morbid diabetes, as these groups have an increased
      risk of developing cardiovascular complications. In response to the increasing
      evidence base from large-scale trials, the article concludes that cardiovascular
      risk factors, coexisting disease, concomitant medication and age should all be
      taken into account when choosing antihypertensive therapy.

PMID- 11219318
TI  - Consensus for the pharmacological management of insomnia in the new millennium.
AB  - Insomnia, a common symptom throughout the world, is characterised by difficulty
      initiating or maintaining sleep or non-restorative sleep and is associated with
      significant morbidity. A comprehensive medical and sleep history and physical
      examination are necessary before treating patients with insomnia; the presence of
      co-morbidities, including medical and psychiatric disorders, or the possible use
      of substances that may contribute to sleeplessness should be thoroughly
      investigated. Non-pharmacological approaches include correction of sleep hygiene
      as well as behavioural treatments. Pharmacotherapy includes benzodiazepine
      receptor agonists, which are the drugs of choice for this disorder. They can be
      subdivided into classic benzodiazepines and non-benzodiazepines. Although many
      agents in these classes have been prescribed, potential shortcomings include
      residual sedation, rebound insomnia, and psychomotor and memory impairment. Novel
      pharmacological strategies that address limitations of the traditional treatment
      approach, combined with proven modes of behavioural therapy, offer the most
      successful results in the management of insomnia. These advances provide the
      opportunity to establish these current recommendations for the optimal management
      of insomnia. This report from the XXII Collegium Internationale Neuro
      Psychopharmacologicum Consensus Workshop outlines recommendations to serve as the
      foundation for developing a therapeutic plan for each patient.

PMID- 11219319
TI  - Verapamil SR and trandolapril combination therapy is safe and effective in
      hypertensive patients with metabolic disorders.
AB  - Verapamil SR (180 mg) plus trandolapril (2 mg) is a potent antihypertensive
      combination but the efficacy and safety of this treatment has not been studied
      fully in hypertensive patients with metabolic disorders. We enrolled 298 patients
      with mild to moderate hypertension who had at least one of the following
      disorders: diabetes mellitus, hypercholesterolaemia or mild renal failure. The
      sitting systolic pressure and diastolic blood pressures were significantly
      decreased after 12 weeks of treatment. Blood pressure was inadequately controlled
      in only 24 patients (8.8%). Progressive decreases in blood glucose, total
      cholesterol, low-density lipoprotein and triglyceride levels were observed during
      the study. There was no significant change in blood urea nitrogen, creatinine and
      transaminase levels (p > 0.05). There was a significant decrease in
      microalbuminuria levels. There was no significant change in glycosylated
      haemoglobin levels in diabetic patients. Verapamil SR plus trandolapril is an
      effective drug combination in the treatment of hypertension. It may be used
      safely in patients with diabetes mellitus, hyperlipidaemia and mild renal
      failure.

PMID- 11219320
TI  - The pharmacology underlying pharmacotherapy for tobacco dependence: a focus on
      bupropion.
AB  - Tobacco dependence remains the major preventable cause of early mortality and
      morbidity in the developed world. The primary reinforcer of the dependence is the
      nicotine present in tobacco smoke and, for many smokers, successful treatment
      depends upon breaking this dependence. Until recently, the only specific
      pharmacotherapy available for tobacco dependence was nicotine replacement therapy
      (NRT). Although this approach does significantly increase long-term cessation
      rates, it is by no means a panacea for the many smokers who require help to quit.
      Recently, a new drug, bupropion (Zyban), has been licensed as an additional
      pharmacological aid for smoking cessation. This commentary discusses the
      mechanisms that may account for its efficacy in this indication and considers the
      impact its introduction may have on the approach of healthcare systems to the
      treatment of tobacco dependence.

PMID- 11219321
TI  - Linezolid.
AB  - Multiple antibiotic resistance is increasing worldwide in Gram-positive bacteria,
      especially in hospitals. Problem organisms include multiply resistant strains of
      pneumococci, Staphylococcus aureus and enterococci; for many of these the
      glycopeptide vancomycin has become the treatment of last resort. This situation
      has been made worse by the emergence of vancomycin-resistant enterococci and
      vancomycin-intermediate S. aureus. Fortunately, several compounds active against
      resistant Gram-positive bacteria are in active development. One of these is
      linezolid, the first of the oxazolidinones, a new class of antibacterial.
      Linezolid is a synthetic agent which is active against all the clinically
      important Gram-positive bacteria, including multiply resistant strains. It has
      good pharmacokinetics, with equal bioavailability by both oral and intravenous
      routes and no need for dose adjustment in patients with renal impairment. The
      drug has a good safety profile and clinical trials have given excellent results
      in a variety of skin and soft tissue, respiratory and bloodstream infections.
      Linezolid is a promising drug, which, together with prudent antibiotic use and
      the prevention and control of hospital infection, will help in the battle against
      multiply antibiotic resistant Gram-positive bacteria.

PMID- 11219322
TI  - A case of voluminous diarrhoea with hypokalaemic acidosis.
AB  - We describe a patient presenting with voluminous diarrhoea, hypokalaemic acidosis
      and hypercalcaemia who was found to have a vasoactive intestinal polypeptide
      producing tumour. His diarrhoea was initially mild and intermittent requiring no
      medical attention.

PMID- 11219323
TI  - Acute spontaneous haematoma of the rectum.
AB  - Gastrointestinal haematomata occur usually in the small intestine and may be
      secondary to anticoagulation. Spontaneous intramural haematoma of the rectum is
      rare. We report such a case which presented as acute abdominal pain and which was
      treated by simple drainage.

PMID- 11219324
TI  - Glossal palpation of the eustachian tube cushion: an unusual cause of globus
      sensation.
AB  - Globus sensation, the sensation of a lump in the throat, is a common symptom
      which, in its chronic form, accounts for 4% of first-patient visits to ENT
      clinics. We describe a rare cause of globus sensation and stress the importance
      of thorough investigation to exclude any possible organic causes.

PMID- 11219325
TI  - Cardiogenic shock following a single therapeutic oral dose of verapamil.
AB  - Cardiogenic shock and apnoea appeared in a 78-year-old woman with a history of
      biventricular heart failure, following ingestion of a single 80 mg verapamil
      tablet. She was resuscitated with artificial ventilation, dobutamine,
      norepinephrine and calcium gluconate. Toxicological analysis revealed
      unexpectedly high plasma verapamil concentration, which was attributed to the
      patient's liver failure. In patients with advanced heart failure a single oral
      therapeutic dose of verapamil may have a severe toxic effect.

PMID- 11219326
TI  - Coeliac disease and chronic fatigue syndrome.

PMID- 11219327
TI  - Implications of hypnotic flexibility on patterns of clinical use.
AB  - Insomnia is common among the primary care patient population, 1.3 times more
      common in women than men, and the prevalence increases with age. Until recently,
      benzodiazepines (BZs) were the only first-line hypnotics, but with the
      availability of non-BZ sleep agents, the management of insomnia is changing.
      Zolpidem and zopiclone have adverse-effect profiles similar to BZs but lack next
      day residual effects with bedtime dosing. Zaleplon is a fast-onset, rapidly
      eliminated medication that allows for dosing at bedtime or during the night with
      minimal concern for residual effects. In addition, the BZ-associated problems of
      tolerance and rebound effects are not evident with long-term zaleplon use. The
      pharmacokinetic profile of zaleplon has the potential to allow for the treatment
      of symptoms of sleeplessness when they occur, an approach that could replace the
      standard practice of always treating in anticipation of a problem.

PMID- 11219328
TI  - New perspectives on the pharmacologic management of insomnia.

PMID- 11219330
TI  - The relationship between psychiatric diseases and insomnia.
AB  - Sleep difficulties affect about one-third of American adults, yet these symptoms
      are not often addressed by patients and their physicians. Unresolved insomnia
      that impairs daytime function may be associated with significant psychiatric
      morbidity, predominantly major depression. Clinicians who are aware that these
      disorders frequently co-exist will be able to facilitate prompt diagnosis and
      initiate appropriate pharmacotherapeutic intervention. Antidepressant therapies
      may interfere with sleep quality; therefore, the management of insomnia in
      depressed patients should be addressed separately. Traditionally, benzodiazepines
      have been prescribed to treat sleep disturbances, but certain drugs in this class
      have limited benefits due to residual sedative effects that impair cognitive
      function, memory and general daytime performance. Zaleplon, a new, quick-acting,
      non-benzodiazepine sleep medication, may be clinically advantageous in promoting
      sleep without residual impairment.

PMID- 11219329
TI  - Individualizing therapy for early, middle-of-the-night and late-night insomnia.
AB  - Many patients with insomnia describe their sleep problems as an inability to
      remain asleep throughout the night, resulting in next-day fatigue that may
      adversely affect daytime functioning. To be most effective, insomnia treatment
      should be tailored to resolving underlying causes of the condition and managing
      specific sleep complaints. Therefore, hypnotic therapy administered prior to
      bedtime, as is currently recommended for most compounds, is not appropriate for
      all insomnia patients. Ideally, behavioral interventions should be combined with
      a rapid-acting agent that can be administered at virtually any time during the
      night without producing residual effects the following day. Zaleplon, a new non
      benzodiazepine sleep medication, provides the clinician with an effective and
      safe pharmacotherapeutic option for insomnia management. Its rapid rates of
      absorption and elimination allow for treatment of symptoms when they occur,
      either at bedtime or later at night, without incurring significant risk for the
      development of next-day impairment of psychomotor and cognitive functioning.

PMID- 11219331
TI  - Efficacy and safety of zaleplon at peak plasma levels.
AB  - Zaleplon is a non-benzodiazepine sleep medication that shows efficacy as a sleep
      inducer comparable to that of other hypnotics but with significantly fewer
      residual effects. In addition, evaluations of psychomotor or memory function at
      zaleplon peak plasma levels show much less impairment than noted with other
      hypnotics, suggesting an improved benefit-to-risk profile for zaleplon compared
      with older available agents. Thus, zaleplon can be used to treat symptoms of
      insomnia when they occur without the concern of next-day psychomotor or memory
      impairment, whether administered at bedtime or later during the night. Such an
      approach permits physicians to reformulate their strategies for safe and
      effective management of sleeplessness.

PMID- 11219339
TI  - The significance of surveillance and reporting on the prevention and control of
      equine diseases.
AB  - Examples of equine disease surveillance at the local, regional, national and
      international level are discussed in this article. Reporting systems at each
      level are also considered, and the increasing importance of laboratory confirmed
      diagnoses is emphasized. The need to develop national disease reporting systems
      is addressed, particularly with respect to conforming to international trading
      standards.

PMID- 11219340
TI  - Equine protozoal myeloencephalitis.
AB  - Recent advances in the understanding of the parasite life cycle, epidemiology,
      clinical signs, diagnosis, treatment, and prevention of EPM are reviewed. The
      NAHMS Equine '98 study and a controlled retrospective study from The Ohio State
      University College of Veterinary Medicine identified a number of risk factors
      associated with development of the disease. The national annual incidence of EPM
      was 1% or less depending on the primary use of the animals. Increased disease
      risk was associated with age (1-5 and > 13 years of age), season (lowest in
      winter months and increasing with ambient temperature), previous stressful
      events, the presence of opossums, the use of nonsurface water drinking systems,
      and failure to restrict wildlife access to feed. Horses that received treatment
      were 10 times more likely to improve, and those that improved were 50 times more
      likely to survive. A number of recent studies confirmed that horses can be
      experimentally infected with S. neurona; however, large numbers of sporocysts are
      apparently necessary to achieve infection, and clinical signs and abnormal CNS
      histology are only seen inconsistently. Results suggest that CNS infection and
      positive CSF immunoblot findings may be transient phenomena among naturally
      infected horses. Although immunosuppression may be involved in the development of
      EPM, some element of the immune response seems to be necessary for the
      development of clinical signs. Use of the standard immunoblot test for the
      detection of anti-S. neurona antibodies in CSF continues to provide the most
      useful adjunct to a detailed neurologic examination for the diagnosis of EPM.
      Test sensitivity and specificity were 89% in 295 horses euthanatized because of
      neurologic disease, of which 123 were confirmed cases of EPM. The PPV was 85%,
      and the NVP was 92%. A number of promising new EPM treatments are under
      investigation. In addition to standard SDZ/PYR therapy, toltrazuril, ponazuril,
      diclazuril, and NTZ have shown promise as possible alternatives.

PMID- 11219341
TI  - West Nile encephalitis.
AB  - WNV encephalitis in horses, previously reported in Africa, Asia, and Europe,
      occurred for the first time in the Western Hemisphere in 1999. The causative
      agent, WNV, is a flavivirus maintained in nature by a bird-mosquito cycle. The
      disease in horses is manifested primarily by ataxia of variable severity.
      Outbreaks of encephalitis may have a case fatality rate in excess of 40%,
      although this virus infection is inapparent in some horses. Early evidence
      indicates that WNV has overwintered in the northeastern United States and poses a
      threat for future disease occurrences in horses. No vaccine is available to
      protect against WNV infection in horses; disease control is predicated on
      mosquito abatement.

PMID- 11219342
TI  - Emergent causes of placentitis and abortion.
AB  - The clinical signs, laboratory findings, diagnosis, epidemiology, treatment, and
      prevention and control of two emerging causes of placentitis and abortion in
      horses are described in this article. Leptospirosis has been reported as a
      significant cause of fetal loss in horses in Kentucky, Northern Ireland, and
      England. Most abortions result from infection by serovars kennewicki or
      bratislava. Nocardioform placentitis has become the most common cause of
      placentitis in central Kentucky horses. Nocardioform placentitis is associated
      with infection by unnamed, gram-positive, filamentous, branching bacteria, and is
      characterized by distinctive changes in the placental membranes.

PMID- 11219343
TI  - Vesicular stomatitis and other vesicular, erosive, and ulcerative diseases of
      horses.
AB  - Physical trauma, dietary factors, certain toxins, immune mediated disorders, and
      vesicular stomatitis virus (VSV) infection are known causes of stomatitis in
      horses. There is evidence that some outbreaks of equine stomatitis are caused by
      as yet unidentified infectious agents. It remains to be determined whether
      stomatitis is an emerging equine infectious disease, or if the increase in
      reported cases is simply the result of greater public awareness as a consequence
      of widespread outbreaks of VSV in the southwestern United States in recent years.
      Focused laboratory and epidemiological studies are necessary to more adequately
      define non-VS related infectious and noninfectious causes of equine stomatitis.

PMID- 11219345
TI  - Ehrlichial diseases.
AB  - Equine granulocytic and monocytic ehrlichiosis caused by Ehrlichia equi and E.
      risticii, respectively, are seasonal diseases in horses that occur throughout the
      United States E. equi is transmitted by lxodes ticks and causes high fever,
      depression, anorexia, limb edema, petechiation, icterus, ataxia, and stiffness in
      gait. E. risticii, also known as the agent of Potomac horse fever, causes a
      febrile illness with a colitis of variable severity. Its occurrence is associated
      with aquatic habitats. The natural route of transmission is oral, through the
      ingestion of E. risticii infected trematode stages either free in water or in an
      intermediate host, such as aquatic animals.

PMID- 11219344
TI  - Clostridial enterocolitis.
AB  - Equine clostridial enterocolitis is being recognized with increasing frequency.
      It has been identified in foals with diarrhea, antibiotic-associated
      enterocolitis, or nosocomial enterocolitis. The sporadic occurrence of
      clostridial enterocolitis, the variety of types of clostridia involved, and the
      difficulty of experimentally reproducing the disease suggest that it is a poorly
      defined multifactorial syndrome. The risk factors associated with susceptibility
      to colonization and progressive infection are largely based on anecdotal
      observations and extrapolation from human studies. Quantitative studies are
      needed to decipher the complex interactions between host and indigenous
      microflora that provide for and maintain a healthy colonization resistance
      environment. It seems that such studies might be more beneficial in furthering
      our understanding of the pathogenesis of clostridial enterocolitis than
      attempting to implicate another agent or toxin as the sole cause of the disease
      in equids. Treatment protocols that interrupt the pathogenesis of the disease
      need to be devised and critically evaluated to complement the present protocols
      emphasizing supportive care. Perhaps it is time to consider clostridial
      enterocolitis as yet another consequence of the use of antimicrobials analogous
      to the selective pressures that result in the emergence of multiple drug
      resistant pathogens.

PMID- 11219346
TI  - Larval cyathostomiasis.
AB  - Over the past few years, cyathostomiasis has become increasingly recognized as a
      clinical problem of horses in the United States. Clinical cyathostomiasis has
      been reported frequently in Europe for a considerable time. This clinical
      syndrome is usually related to the sudden release of large numbers of the larval
      stages of small strongyles from the mucosa of the large intestine. Typical
      clinical signs include diarrhea, ventral abdominal edema, pyrexia, colic, weight
      loss, and poor body condition. Hypoalbuminemia and the presence of large numbers
      of small strongyles being passed in the feces are also characteristic features of
      the disease. The disease may occur seasonally in late winter and early spring or
      after drug treatment to remove the luminal stages of small strongyles. Two
      commercially available drugs, moxidectin and fenbendazole, have been shown to be
      effective against the encysted larval stages of the parasites. Drug resistance of
      small strongyles to all classes of currently available antiparasitic compounds
      except the macrocyclic lactones (ivermectin and moxidectin) is a limiting factor
      in controlling these parasites and may result in an increased prevalence of
      clinical cyathostomiasis over time.

PMID- 11219347
TI  - Antimicrobic and anthelmintic resistance.
AB  - Antimicrobial and anthelmintic resistance are growing issues for the equine
      practitioner. The development of antimicrobial or anthelmintic resistance is a
      source of significant concern because of increased frequency of treatment
      failures and increased treatment costs. In addition, antimicrobial resistance may
      have important consequences for public health. Only through judicious use can the
      efficacy of antimicrobials and anthelmintics be prolonged. This article discusses
      the development of resistance and suggestions for control.

PMID- 11219348
TI  - Factors influencing the international spread of equine diseases.
AB  - In an era of increasing globalization, the risk of spread of infectious diseases
      in humans and animals, including equids, has never been greater. International
      movement of equids and trade in semen are the most important factors responsible
      for the dissemination of various equine pathogens. Other factors that can or do
      have the potential to influence the global distribution of equine infectious
      diseases include: multinational trade agreements, emergent diseases, mutation of
      pathogens, climate related phenomena, migration of amplifying/reservoir hosts or
      vectors, availability of new vectors, vaccine contamination and agroterrorism.
      The relative importance of each of these factors is considered in relation to the
      spread of equine diseases.

PMID- 11219349
TI  - Venezuelan equine encephalomyelitis.
AB  - The emergence of epidemic VEE viruses has been reported ever since the virus was
      first described; this phenomenon is likely to continue to occur because of the
      high mutation rate of these RNA viruses. A vaccine that was first developed by
      the US Military for human use has proved helpful in curtailing the spread of VEE
      virus during epizootics of the disease in equids but not during human epidemics.
      It has not, however, eliminated the source of these highly pathogenic and
      transmissible viruses. Occurrences of VEE in equids in Mexico in recent years
      suggest that the present vaccine is not effective in interrupting transmission of
      new epizootic viruses arising from what were previously known as avirulent
      enzootic cycles. Future vaccines against VEE should be based on immunogens
      derived from enzootic viruses to interrupt VEE virus transmission at the source
      itself rather than waiting for virulent phenotypes of VEE virus to emerge.

PMID- 11219350
TI  - Japanese encephalitis.
AB  - Japanese encephalitis (JE) virus is a mosquito-borne flavivirus that can cause
      encephalitis and death in horses and humans. It is an emerging disease of
      international concern because it has been spreading into previously nonendemic
      areas. Major epidemics may occur where the virus moves into new areas, but many
      infections are subclinical. This article presents information on the virus, its
      epidemiology, and what little information has been published on the disease in
      horses. The methods available for the diagnosis and control of JE are described
      and issues raised, particularly for those countries faced with the threat of
      imminent incursions as the virus extends its range.

PMID- 11219351
TI  - Borna disease in horses.
AB  - Borna disease is a sporadically occurring, progressive viral
      polioencephalomyelitis that primarily affects horses and sheep. The etiological
      agent, Borna disease virus (BDV), is an enveloped, single-stranded RNA virus that
      has been classified in the new virus family Bornaviridae within the order
      Mononegavirales. Serological evidence of BDV infection has been found in an
      increasing number of countries throughout the world. After an incubation period
      lasting a few weeks to several months, BDV infection can cause locomotor and
      sensory dysfunction followed by paralysis and death. Borna disease is the result
      of a virus-induced immunopathological reaction. BDV-specific antibodies and viral
      RNA have been found in humans with various psychiatric disorders.

PMID- 11219352
TI  - Hendra and Nipah virus infections.
AB  - The most important clinical and pathological manifestation of Hendra virus
      infection in horses and humans is that of severe interstitial pneumonia caused by
      viral infection of small blood vessels. The virus is also capable of causing
      nervous disease. Hendra virus is not contagious in horses and is spread by close
      contact with body fluids, such as froth from infected lungs. Diagnosis should be
      based on the laboratory examination of blood, lung, kidney, spleen, and, if
      nervous signs are present, also of the brain. Evidence of infection with the more
      recently identified and related Nipah virus was found in the brain of one horse
      in which there was inflammation of the meningeal blood vessels. Fruit bats,
      especially Pteropus s., have been incriminated as the natural and reservoir hosts
      of both Hendra and Nipah viruses.

PMID- 11219353
TI  - Getah virus as an equine pathogen.
AB  - Getah virus is a member of the genus Alphavirus in the family Togaviridae and has
      been frequently isolated from mosquitoes. Seroepizootiologic studies indicate
      that the virus is mosquito-borne and widespread, ranging from Eurasia to
      southeast and far eastern Asia, the Pacific islands, and Australasia. The natural
      host animal of the virus was not known until the first recognized occurrence of
      Getah virus infection among racehorses in two training centers in Japan in 1978.
      Outbreaks of clinical disease due to Getah virus infection occur infrequently,
      and only one outbreak has been reported outside Japan; this was in India in 1990.
      Clinical signs of the disease are mild and nonlife-threatening and are
      characterized by pyrexia, edema of the hind limbs, swelling of the submandibular
      lymph nodes, and urticarial rash, as reported in the 1978 epizootic. The
      morbidity was 37.9% (722 of 1903 horses) in one training center, with 96% of 722
      affected horses making a full clinical recovery within a week without any
      significant sequelae. Antibodies against Getah virus were detected in 61.2% (172
      of 281) and 55.8% (254 of 455) of horses at two training centers, respectively.
      Virus isolation can be attempted in VERO, RK-13, BHK-21, and many other cell
      lines as well as in suckling mouse brain. Blood plasma collected from suspect
      cases of infection at the onset of pyrexia is the specimen of choice. A diagnosis
      of Getah virus infection can also be confirmed serologically based on testing
      acute and convalescent phase sera by using SN, CF, HI, and ELISA tests. An
      inactivated vaccine is available for the prevention and control of Getah virus
      infection in horses in Japan.

PMID- 11219354
TI  - Venerable or vulnerable? Ageism in health care.

PMID- 11219355
TI  - Cost analysis of a hospital-at-home initiative using discrete event simulation.
AB  - OBJECTIVES: To examine whether, from a National Health Service (NHS) and local
      authority social services' viewpoint, a hospital-at-home service was cost saving
      compared with conventional inpatient care. METHODS: The subjects of this part
      retrospective and part-prospective cost analysis were 51 elderly medical and
      orthopaedic surgical patients assessed at Hillingdon Hospital, West London, as
      being suitable for hospital-at-home care. Thirty patients received hospital-at
      home care, provided for up to 14 days, while 21 patients remained in hospital and
      received standard inpatient care. All direct costs to the NHS hospital, community
      health services' provider and social services' department during the initial
      episode of care and the three months after discharge were collected for each
      group of patients. Costs and clinical event data were entered in a discrete event
      simulation model which generated baseline results. Uncertainty surrounding the
      model's parameters was explored using sensitivity analysis. RESULTS: The baseline
      simulation performed with 1000 patients in each group showed the mean cost per
      patient for hospital-at-home care and three-month follow-up to be around three
      fifths the mean cost per patient of inpatient care and follow-up. Most of the
      excess cost in the inpatient group was attributable to the initial period of
      hospitalisation. Under all assumptions used in the sensitivity analysis, the
      hospital-at-home service was less costly. CONCLUSIONS: For elderly patients
      assessed as needing no more than 14 days of hospital care, hospital-at-home care
      is cost saving to health and social care agencies when compared with conventional
      inpatient care.

PMID- 11219357
TI  - It ain't what you do but the way that you do it.

PMID- 11219356
TI  - Implementation of evidence-based medicine: evaluation of the Promoting Action on
      Clinical Effectiveness programme.
AB  - OBJECTIVES: To evaluate the Promoting Action on Clinical Effectiveness (PACE)
      programme, which sought to implement clinically effective practice in 16 local
      sites. METHODS: 182 semi-structured interviews, usually by telephone, with
      project team members, clinicians, and senior managers and representatives from
      the Department of Health and the King's Fund. RESULTS: The most influential
      factors were strong evidence, supportive opinion leaders and integration within a
      committed organization; without these factors, projects had little chance of
      success. Other factors (context analysis, professional involvement and good
      project management) emerged as important, supporting processes; their presence
      might be an additional help, but on their own they would not be enough to
      initiate change. A serious problem with any of them could have a strong adverse
      impact. CONCLUSIONS: Although there is no simple formula for the factors that
      ensure successful implementation of research-based improvements to clinical
      practice, certain principles do seem to help. Time and resource need to be
      devoted to a period of local negotiation and adaptation of good research evidence
      based on a careful understanding of the local context, in which opinion leader
      influence is an important component of a well managed and preferably well
      integrated process of change.

PMID- 11219358
TI  - Can simulation be used to reduce errors in health care delivery? The hospital
      drug distribution system.
AB  - OBJECTIVES: To construct a simulation model of the hospital drug distribution
      system, to evaluate the effects of different changes to the system on
      unavailability-related medication administration errors (U-MAEs), to test the
      most promising system in a controlled trial and to explore the model's validity.
      METHODS: A discrete-event simulation model of the drug distribution system was
      constructed, using data collected on a vascular surgery ward and a renal medicine
      ward as model inputs. The model's output was the U-MAE rate. The model was used
      to explore the effects on U-MAEs of different changes to the system. One of the
      changes predicted to reduce U-MAEs, a patients' own drugs scheme, was introduced
      on each study ward; U-MAE rates were measured using observations before and after
      its introduction and compared with those predicted by the model. RESULTS: The
      model predicted that the introduction of a patients' own drugs system would
      reduce unavailability-related errors on each ward; in practice, there was a
      slight decrease on the medical ward but an increase on the surgical ward. Reasons
      for these findings were explored and four contributing factors identified. Three
      of these related to failure to follow hospital procedures, the fourth to an issue
      for which no policy existed. If these factors had been taken into account, the
      error rates predicted by the model would have been similar to those observed.
      CONCLUSIONS: Simulation modelling is a potentially useful approach to the study
      of U-MAEs, although care must be taken to ensure that such models reflect actual
      practice rather than stated policy.

PMID- 11219359
TI  - Developing appropriate measures of the benefits of complementary and alternative
      medicine.
AB  - Complementary and alternative medicine (CAM) is growing in popularity and
      consumes increasing amounts of resources. Economic evaluations such as cost
      effectiveness analyses (CEAs) are intended to inform decision-makers about the
      relative efficiency of different interventions, including CAM. To be
      generalizable, economic evaluations should use the same metric to assess health
      benefits--e.g. quality-adjusted life years (QALYs). However, the recurrent
      conditions for which CAM is typically used suggest that the health benefits of
      CAM will manifest themselves primarily as quality-of-life improvements that
      appear in CEA as 'utilities' attached to health states. Therefore, appropriate
      utility measures will be critical to the production of valid CEAs of CAM
      therapies. Some economists assert that the process of health care, as well as its
      outcome, can contribute to patient utility. This essay argues that process
      utility is especially relevant to CAM; accurate assessment of process utility
      will be important to valid economic evaluations of CAM; existing utility
      assessment methods do not directly account for process utility; and, therefore,
      techniques such as qualitative analysis that can inform more appropriate and
      complete assessments of the benefits of CAM should be explored. The heterogeneity
      of CAM modalities suggests that the arguments made in this essay will apply with
      similar force to economic evaluation of conventional therapies with which CAM is
      likely to be compared.

PMID- 11219361
TI  - Roemer's effect reconsidered.

PMID- 11219360
TI  - Impact of payment method on behaviour of primary care physicians: a systematic
      review.
AB  - OBJECTIVE: To review the impact of payment systems on the behaviour of primary
      care physicians. METHODS: All randomised trials, controlled before and after
      studies, and interrupted time series studies that compared capitation, salary,
      fee-for-service or target payments (mixed or separately) that were identified by
      computerised searches of the literature. Methodological quality assessment and
      data extraction were undertaken independently by two reviewers using a data
      checklist. Study results were qualitatively analysed. RESULTS: Six studies met
      the inclusion criteria. There was considerable variation in the quality of
      reporting, study setting and the range of outcomes measured. Fee-for-service
      resulted in a higher quantity of primary care services provided compared with
      capitation but the evidence of the impact on the quantity of secondary care
      services was mixed. Fee-for-service resulted in more patient visits, greater
      continuity of care, higher compliance with a recommended number of visits, but
      lower patient satisfaction with access to a physician compared with salary
      payment. The evidence of the impact of target payment on immunisation rates was
      inconclusive. CONCLUSIONS: There is some evidence to suggest that how a primary
      care physician is paid does affect his/her behaviour but the generalisability of
      these studies is unknown. Most policy changes in the area of payment systems are
      inadequately informed by research. Future changes to doctor payment systems need
      to be rigorously evaluated.

PMID- 11219362
TI  - Does it matter who owns health facilities?
AB  - The rhetoric of governments 'steering not rowing' and of purchaser-provider
      splits is still part of the language of public sector reform throughout the
      world, despite some retreat in the National Health Service in the UK.
      Implementation of separation of purchaser and provider roles has often been
      associated with suggestions that the private sector is better able to manage
      hospitals. The evidence for this assertion is mixed, especially when possible
      quality differences are also considered. This essay suggests that the ownership
      question is a second-order issue and that policy-makers should ensure that
      existing public hospitals are funded in a way that encourages efficiency.

PMID- 11219364
TI  - Alcoholism and schizophrenia.

PMID- 11219363
TI  - Inequality in the geographical distribution of general practitioners in England
      and Wales 1974-1995.
AB  - OBJECTIVES: To compare geographical inequality in the distribution of general
      practitioners (GPs), other resources and mortality around 1995 in England and
      Wales; to measure trends between 1974 and 1995 in inequality of GP distribution;
      to examine the implications of different need adjustments and inequality measures
      on the degree of geographic inequality; and to analyse the impact of policies
      (increased supply, area inducements and entry regulation) on inequality. METHODS:
      Measurement of relative inequality (decile ratio, Gini coefficient, Atkinson
      index) and absolute inequality (standard deviation) in the ratio of GPs to need
      adjusted population in former Family Practitioner Committee/Family Health
      Services Authority areas each year from 1974 to 1995; and relative inequality
      across areas in the distributions of income, other resources and standardised
      mortality ratios (SMRs) around 1995. Regression of 1995 GP/population ratios on
      1974 ratios. Application of equalising net advantages location model to GP
      distribution. RESULTS: Inequality in the distribution of GPs in 1995 was less
      than inequality in other primary care resources, but greater than inequalities in
      disposable income, SMRs, primary school expenditure, and hospital and community
      health services expenditure. The decile ratio shows little change between 1974
      and 1995. Gini and Atkinson inequality indices indicate some reduction in
      inequality between 1974 and 1980, but little change thereafter. The standard
      deviation of need-adjusted provision increased over the period. Areas that had
      the lowest GP provision in 1974 tended to have the lowest in 1995. CONCLUSIONS:
      The choice between relative and absolute inequality measures and, to a lesser
      extent, the method of adjusting for need affect conclusions about the trend in
      inequality. Both types of measure and most need adjustments suggest that the
      policies adopted did not lead to a reduction in inequality over the period.
      Interactions between policies may reduce their overall effectiveness.

PMID- 11219365
TI  - Drug use and young people: why is co-morbidity research so important?

PMID- 11219366
TI  - The effects of adolescent cannabis use on educational attainment: a review.
AB  - This paper reviews research examining the link between cannabis use and
      educational attainment among youth. Cross-sectional studies have revealed
      significant associations between cannabis use and a range of measures of
      educational performance including lower grade point average, less satisfaction
      with school, negative attitudes to school, increased rates of school absenteeism
      and poor school performance. However, results of cross-sectional studies cannot
      be used to determine whether cannabis use causes poor educational performance,
      poor educational performance is a cause of cannabis use or whether both outcomes
      are a reflection of common risk factors. Nonetheless, a number of prospective
      longitudinal studies have indicated that early cannabis use may significantly
      increase risks of subsequent poor school performance and, in particular, early
      school leaving. This association has remained after control for a wide range of
      prospectively assessed covariates. Possible mechanisms underlying an association
      between early cannabis use and educational attainment include the possibility
      that cannabis use induces an 'amotivational syndrome' or that cannabis use causes
      cognitive impairment. However, there appears to be relatively little empirical
      support for these hypotheses. It is proposed that the link between early cannabis
      use and educational attainment arises because of the social context within which
      cannabis is used. In particular, early cannabis use appears to be associated with
      the adoption of an anti-conventional lifestyle characterized by affiliations with
      delinquent and substance using peers, and the precocious adoption of adult roles
      including early school leaving, leaving the parental home and early parenthood.

PMID- 11219368
TI  - Lethal methadone intoxications in Geneva, Switzerland, from 1994 to 1998.
AB  - AIMS: To estimate the number of methadone lethal intoxications in Geneva from
      1994 to 1998, where the number of patients in methadone treatment has more than
      doubled since 1990. DESIGN: Retrospective study of all toxicological, autopsy and
      clinical data. SETTING: The Geneva Department of Forensic Medicine. PARTICIPANTS:
      All suspected overdose deaths in Geneva from 1994 to 1998. Cases were selected on
      the basis that the only cause of death was a potentially lethal drug
      concentration in the postmortem blood sample. MEASUREMENT: Toxicology and autopsy
      findings, clinical and drug history. FINDINGS: There were 106 lethal drug
      intoxications over the period. The overall number of drug intoxication deaths
      went from 33 in 1994 to nine in 1998. Thirty-six cases had methadone identified
      in their blood. All the 36 cases but one had medications or other drugs used
      illicitly present in the blood or urine. Of these 36 cases, 21 were attributed to
      methadone lethal intoxication. Only seven of these 21 decedents were enrolled in
      a methadone programmes. The number of deaths attributed to methadone intoxication
      ranged from three to five per year. CONCLUSION: Most lethal methadone
      intoxication is due to diverted or illegal methadone in association with
      medications or other drugs used illicitly. Furthermore, the increase in methadone
      prescription under strict medical control with health measures aimed at drug
      abuse prevention did not lead, in our study, to an increase of methadone lethal
      intoxication and may have been partly responsible for the large decrease of
      overall drug intoxication deaths during the time of our study.

PMID- 11219367
TI  - Randomized trial of supervised injectable versus oral methadone maintenance:
      report of feasibility and 6-month outcome.
AB  - AIM: To assess the feasibility of a randomized clinical trial of supervised
      injectable versus oral methadone maintenance and to assess medium-term treatment
      outcomes. DESIGN: Randomized clinical trial of supervised injectable versus
      supervised oral methadone maintenance treatment (MMT). Trial participants were
      dependent illicit opiate injectors allocated at intake to supervised injectable
      or oral methadone maintenance treatment. SETTING: Specialist addictions treatment
      centre in South London. SUBJECTS: Forty dependent illicit opiate injectors
      seeking methadone maintenance treatment. INTERVENTIONS: Daily supervised
      injectable and oral methadone maintenance, delivered at the treatment centre.
      MAIN OUTCOME MEASURES: Frequency of illicit heroin use and frequency of illicit
      drug injecting during 30 days before intake to treatment and prior to 6-month
      follow-up. SECONDARY OUTCOME MEASURES: frequency of use of illicit methadone,
      crack cocaine, benzodiazepines and alcohol, physical and psychological health
      symptoms and acquisitive crime. RESULTS: Injectable and oral MMT were both
      generally acceptable to the study participants: there was a high level of
      agreement to enter the randomized trial, and subsequent retention in treatment
      was good. The average number of days of illicit heroin use reduced from 22.2 to
      7.6 for the injectable MMT group and from 22.4 to 8.7 for the oral MMT group. The
      average number of days of illicit injecting reduced from 25.7 to 10.8 days for
      the injectable group and from 20.1 to 11.9 days for the oral group. Patients'
      physical and psychological health symptoms and involvement in acquisitive crime
      also reduced in both groups. Treatment satisfaction ratings at follow-up were
      higher among patients in the injectable MMT group. The ratio for the actual
      medication costs between injectable and oral MMT was 6.8:1, and for the direct
      operational costs was 4.7:1. There was some evidence of a differential patient
      response with greater reductions in heroin use occurring among patients who were
      daily illicit injectors and had poorer psychological and physical health (at
      entry) who were allocated to injectable MMT. CONCLUSIONS: Conduct of the trial
      has demonstrated that it is feasible to implement supervised injectable methadone
      maintenance treatment in the context of (although separate from) a specialist
      oral methadone maintenance service. Patients assigned to receive either
      supervised injectable or oral MMT had broadly equivalent, positive during
      treatment outcomes at 6-month follow-up. Future studies should seek to identify
      patient characteristics which are linked to good outcome in injectable MMT.
      Practical evidence-based guidance to physicians about determining which patients
      are more suitable for injectable MMT is urgently needed.

PMID- 11219369
TI  - Increased use of marijuana and other illicit drugs at US colleges in the 1990s:
      results of three national surveys.
AB  - AIMS: To examine rates and patterns of marijuana and other illicit drug use among
      different types of students and colleges in 1999, and changes in use since 1993.
      DESIGN: Self-administered mail survey (Harvard School of Public Health College
      Alcohol Study). SETTING: One hundred and nineteen nationally representative US 4
      year colleges. PARTICIPANTS: A representative sample of 15,403 randomly selected
      students in 1993, 14,724 students in 1997 and 14,138 students in 1999.
      MEASUREMENTS: Self-reports of marijuana and other illicit drug use in the past 30
      days and in the past year, cigarette use, drinking behavior, and age of
      initiation of smoking, drinking and using marijuana. FINDINGS: The prevalence of
      past 30-day marijuana use rose from 12.9% to 15.7% between 1993 and 1999, an
      increase of 22%. Almost all of this change occurred by 1997. An increase was
      observed at 66% of the 119 colleges. The prevalence of 30-day and annual
      marijuana use increased in nearly all student demographic subgroups except for
      Hispanic students, and at all types of colleges except for colleges with low
      binge drinking rates. Rates of illicit drug use in the past 30 days increased
      slightly for other illicit drugs in the 4-year interval except for LSD. Nine out
      of 10 students (91%) who used marijuana in the past 30 days used other illicit
      drugs, smoked cigarettes and/or engaged in binge drinking. Of students who used
      any other illicit drug in the past 30 days, 87% used another substance or binge
      drank. Twenty nine per cent of past 30-day marijuana users first used marijuana
      and 34% began to use marijuana regularly at or after the age of 18, when most
      were in college. CONCLUSIONS: Use of marijuana and other illicit drugs has
      increased on campuses across the United States in most student subgroups and all
      types of colleges. This may reflect earlier increases in middle schools and
      secondary schools among this cohort. However, nearly one-third of students
      initiated marijuana use in college and one of three began to use it regularly.
      Intervention efforts should be directed at college students, as well as secondary
      school students.

PMID- 11219370
TI  - The respiratory effects of cannabis dependence in young adults.
AB  - AIM: To evaluate the relationship between cannabis dependence and respiratory
      symptoms and lung function in young adults, while controlling for the effects of
      tobacco smoking. SETTING AND PARTICIPANTS: Nine hundred and forty-three young
      adults from a birth cohort of 1037 subjects born in Dunedin, New Zealand in
      1972/1973 were studied at age 21. MEASUREMENTS: Standardized respiratory symptom
      questionnaires were administered. Spirometry and methacholine challenge tests
      were undertaken. Cannabis dependence was determined using DSM-III-R criteria.
      Descriptive analyses and comparisons between cannabis-dependent, tobacco-smoking
      and non-smoking groups were undertaken. Adjusted odds ratios for respiratory
      symptoms, lung function and airway hyper-responsiveness (PC20) were measured.
      FINDINGS: Ninety-one subjects (9.7%) were cannabis-dependent and 264 (28.1%) were
      current tobacco smokers. After controlling for tobacco use, respiratory symptoms
      associated with cannabis dependence included: wheezing apart from colds, exercise
      induced shortness of breath, nocturnal wakening with chest tightness and early
      morning sputum production. These were increased by 61%, 65%, 72% (all p < 0.05)
      and 144% (p < 0.01) respectively, compared to non-tobacco smokers. The frequency
      of respiratory symptoms in cannabis-dependent subjects was similar to tobacco
      smokers of 1-10 cigarettes/day. The proportion of cannabis-dependent study
      members with an FEV1/FVC ratio of < 80% was 36% compared to 20% for non-smokers
      (p = 0.04). These outcomes occurred independently of co-existing bronchial
      asthma. CONCLUSION: Significant respiratory symptoms and changes in spirometry
      occur in cannabis-dependent individuals at age 21 years, even although the
      cannabis smoking history is of relatively short duration.

PMID- 11219371
TI  - Initiation and progression of cannabis use in a population-based Australian
      adolescent longitudinal study.
AB  - AIMS: To examine predictors of cannabis use initiation, continuity and
      progression to daily use in adolescents. DESIGN: Population-based cohort study
      over 3 years with 6 waves of data collection. PARTICIPANTS: 2032 students,
      initially aged 14-15 years, from 44 secondary schools in the state of Victoria,
      Australia. MEASUREMENTS: Self-report cannabis use was categorized on four levels
      (none, any, weekly, daily) and summarized as mid-school (waves 2/3) and late
      school (waves 4/5/6) use. Background, school environment, mid-school peer use and
      individual characteristics were assessed. FINDINGS: Peer cannabis use, daily
      smoking, alcohol use, antisocial behaviour and high rates of school-level
      cannabis use were associated with mid-school cannabis use and independently
      predicted late-school uptake. Cannabis use persisted into late-school use in 80%
      of all mid-school users. Persisting cannabis use from mid- to late-school was
      more likely in regular users (odds ratio (OR) 3.4), cigarette smokers (OR any
      smoking: 2.0, daily smoking: 3.3) and those reporting peer use (OR 2.1). Mid
      school peer use independently predicted incident late-school daily use in males
      (OR 6.5) while high-dose alcohol use (OR 6.1) and antisocial behaviour (OR 6.6)
      predicted incident late-school daily use in females. CONCLUSIONS: Most cannabis
      use remained occasional during adolescence but escalation to potentially harmful
      daily use in the late-school period occurred in 12% of early users. Transition
      was more likely in males, for whom availability and peer use were determinants.
      In contrast, females with multiple extreme behaviours were more likely to become
      daily users. Cigarette smoking was an important predictor of both initiation and
      persisting cannabis use.

PMID- 11219372
TI  - Further validation and development of a screening instrument for the assessment
      of substance misuse in adolescents.
AB  - AIM: The aim of this study was to investigate the validity of the Substance
      Misuse in Adolescence Questionnaire, which has been proposed as a screening
      instrument for problem drug use in adolescents. PARTICIPANTS AND SETTING: The
      participants in the study were 4544 11-16-year-olds attending eight secondary
      schools located in the north-west midlands of England. PROCEDURE: Participants
      completed an anonymous self-report questionnaire that incorporated a modified
      version of the SMAQ (the Assessment of Substance Misuse in Adolescence: ASMA),
      together with other questions relating to substance use and associated issues.
      RESULTS: The ASMA showed good reliability, both within the overall sample of
      respondents, and in a drug-using subsample. Principal-components analysis
      returned a single factor when applied either to the whole sample or to the drug
      using subsample; 1.4% of respondents met a criterion equivalent to that proposed
      by Swadi (1997) for 'problem drug use' (ASMA > 12). A further 6.4% reached a
      threshold for potentially problematic drug use (ASMA > 8) and could be considered
      'at risk'. In regression analyses, ASMA scores were predicted by drug-related
      variables, and by low resistance to peer influence (RPI), but not by alcohol
      related variables. The highest ASMA scores and lowest levels of RPI were found in
      heroin users. Respondents' perceptions of their future risk of drug or alcohol
      problems were predicted by RPI and by frequency of drug use and drunkenness.
      CONCLUSIONS: The ASMA may be a useful screening instrument for identifying
      problem drug use in adolescents unknown to treatment services.

PMID- 11219373
TI  - Joint heavy use of alcohol, cigarettes and coffee and the risk of suicide.
AB  - AIMS: To estimate the relationship between joint heavy use of alcohol, cigarettes
      and coffee, and the risk of suicide in a general population with high rate of
      suicide. DESIGN: Prospective cohort analyses. SETTING: Finland. PARTICIPANTS:
      Data from 36,689 adult (age range 25-64 years) men and women who participated in
      the population surveys between 1972 and 1992. MEASUREMENTS: The mortality of the
      cohort was monitored for a mean of 14.4 years, which yielded 169 suicides.
      Criteria for heavy use of each psychoactive substance were defined as follows:
      alcohol (> 120 g/week), cigarettes (> or = 21/day) and coffee (> or = seven
      cups/day). FINDINGS: About half the men and 80% of the women did not use any of
      the psychoactive substances heavily. Every third man and every fifth woman used
      one substance heavily, and the prevalence for those who exceeded criteria for
      joint heavy use of two substances was 9% for men and 1% for women. Joint heavy
      use of all three substances was rare. The adjusted relative risk of suicide
      increased linearly with increasing level of joint heavy use of alcohol,
      cigarettes and coffee. Among subjects with heavy use of one substance the risk
      was 1.55 (95% CI = 1.10, 2.18), with joint heavy use of two substances 2.22 (95%
      CI = 1.37, 3.61), and with joint heavy use of all three substances 3.99 (95% CI =
      1.80, 8.84) compared with no heavy use. CONCLUSIONS: Clustering of the heavy use
      of alcohol, cigarettes and coffee could serve as a new marker for increased risk
      of suicide.

PMID- 11219374
TI  - Indigenous Australians and liquor licensing restrictions: comments.

PMID- 11219375
TI  - Indigenous Australians and liquor licensing--some additional comments.

PMID- 11219376
TI  - The risk of injury and alcohol consumption.

PMID- 11219377
TI  - DUI risk screening instruments.

PMID- 11219378
TI  - Does working without theorizing make life endurable?

PMID- 11219379
TI  - An excellent springboard.

PMID- 11219380
TI  - Testing CBT mechanisms of action: humans behave in a more complex way than our
      treatment studies would predict!

PMID- 11219381
TI  - Coping skills and Tiger Woods.

PMID- 11219382
TI  - Human genome row draws in journals.

PMID- 11219383
TI  - Tracing Nightingale's steps.

PMID- 11219384
TI  - Human science research in public health: the contribution and assessment of a
      qualitative approach.

PMID- 11219385
TI  - Bibliography. Current world literature. Arrhythmias.

PMID- 11219386
TI  - New functions for Cox-2 in health and disease: report of "The Third International
      Workshop on Cox-2", Ka'upelehu, Kona, Hawaii, USA, 30 August to 2 September 1999.

PMID- 11219387
TI  - Web reports.

PMID- 11219388
TI  - The Arthritis Research non-peer-review depository.

PMID- 11219389
TI  - Clonal expansion is a characteristic feature of the B-cell repetoire of patients
      with rheumatoid arthritis.
AB  - The present study was designed to analyze the level of B-cell clonal diversity in
      patients with rheumatoid arthritis by using HCDR3 (third complementarity
      determining region of the rearranged heavy chain variable region gene) length as
      a marker. A modified immunoglobulin VH gene fingerprinting method using either
      genomic DNA or complementary (c)DNA derived from B cells of the peripheral blood,
      synovial fluid, and tissues of several rheumatoid arthritis patients was
      employed. These assays permitted the detection and distinction of numerically
      expanded B-cell clones from activated but not numerically expanded B-cell clones.
      The present data suggest that B-cell clonal expansion is a common and
      characteristic feature of rheumatoid arthritis and that it occurs with increasing
      frequency from the blood to the synovial compartments, resulting in a narrowing
      of the clonal repertoire at the synovial level. These clonal expansions can
      involve resting, apparently memory B cells, as well as activated B cells.
      Furthermore, some of these individual expansions can persist over extended
      periods of time. These findings support the hypothesis that a chronic ongoing
      (auto)immune reaction is operative in rheumatoid arthritis and that this
      reaction, at least at the B-cell level, may be unique to each individual joint. A
      determination of the targets of these autoimmune reactions may provide valuable
      clues to help understand the immunopathogenesis of this disease

PMID- 11219390
TI  - Activation of synovial fibroblasts in rheumatoid arthritis: lack of Expression of
      the tumour suppressor PTEN at sites of invasive growth and destruction.
AB  - AIMS: PTEN is a novel tumour suppressor which exhibits tyrosine phosphatase
      activity as well as homology to the cytoskeletal proteins tensin and auxilin.
      Mutations of PTEN have been described in several human cancers and associated
      their invasiveness and metastatic properties. Although not malignant, rheumatoid
      arthritis synovial fibroblasts (RA-SF) exhibit certain tumour-like features such
      as attachment to cartilage and invasive growth. In the present study, we analyzed
      whether mutant transcripts of PTEN were present in RA-SF. In addition, we used in
      situ hybridization to study the expression of PTEN messenger (m)RNA in tissue
      samples of RA and normal individuals as well as in cultured RA-SF and in the
      severe combined immunodeficiency (SCID) mouse model of RA. Synovial tissue
      specimens were obtained from seven patients with RA and from two nonarthritic
      individuals. Total RNA was isolated from synovial fibroblasts and after first
      strand complementary (c)DNA synthesis, polymerase chain reaction (PCR) was
      performed to amplify a 1063 base pair PTEN fragment that encompassed the coding
      sequence of PTEN including the phosphatase domain and all mutation sites
      described so far. The PCR products were subcloned in Escherichia coli, and up to
      four clones were picked from each plate for automated sequencing. For in situ
      hybridization, digoxigenin-labelled PTEN-specific RNA probes were generated by in
      vitro transcription. For control in situ hybridization, a matrix
      metalloproteinase (MMP)-2-specific probe was prepared. To investigate the
      expression of PTEN in the absence of human macrophage or lymphocyte derived
      factors, we implanted RA-SF from three patients together with normal human
      cartilage under the renal capsule of SCID mice. After 60 days, mice were
      sacrificed, the implants removed and embedded into paraffin. RESULTS: PCR
      revealed the presence of the expected 1063 base pair PTEN fragment in all (9/9)
      cell cultures (Fig.1). No additional bands that could account for mutant PTEN
      variants were detected. Sequence analysis revealed 100% homology of all RA
      derived PTEN fragments to those from normal SF as well as to the published
      GenBank sequence (accession number U93051). However, in situ hybridization
      demonstrated considerable differences in the expression of PTEN mRNA within the
      lining and the sublining layers of RA synovial membranes. As shown in Figure 2a,
      no staining was observed within the lining layer which has been demonstrated to
      mediate degradation of cartilage and bone in RA. In contrast, abundant expression
      of PTEN mRNA was found in the sublining of all RA synovial tissues (Figs 2a and
      b). Normal synovial specimens showed homogeneous staining fo PTEN within the thin
      synovial membrane (Fig. 2c). In situ hybridization using the sense probe gave no
      specific staining (Fig. 2d). We also performed in situ hybridization on four of
      the seven cultured RA-SF and followed one cell line from the first to the sixth
      passage. Interestingly, only 40% of cultured RA-SF expressed PTEN mRNA (Fig. 3A),
      and the proportion of PTEN expressing cells did not change throughout the
      passages. In contrast, control experiments using a specific RNA probe fo MMP-2
      revealed mRNA expression by nearly all cultured cells (Fig. 3B). As seen before,
      implantation of RA-SF into the SCID mice showed considerable cartilage
      degradation. Interestingly, only negligible PTEN expression was found in those RA
      SF aggressively invading the cartilage (Fig. 3c). In situ hybridization for MMP-2
      showed abundant staining in these cells (Fig. 3d). DISCUSSION: Although this
      study found no evidence for mutations of PTEN in RA synovium, the observation
      that PTEN expression is lacking in the lining layer of RA synovium as well as in
      more that half of cultured RA-SF is of interest. It suggests that loss of PTEN
      function may not exclusively be caused by genetic alterations, yet at the same
      time links the low expression of PTEN to a phenotype of cells that have been
      shown to invade cartilage aggressively. It has been proposed that the tyrosine
      phosphatase activity of counteracting th actions o protein tyrosine kinases. As
      some studies have demonstrated an upregulation of tyrosine kinase activity in RA
      synovial cells, it might be speculated that the lack of PTEN expression in
      aggressive RA-SF contributes to the imbalance of tyrosine kinases and
      phosphatases in this disease. However, the extensive amino-terminal homology of
      the predicted protein to the cytoskeletal proteins tensin and auxilin suggests a
      complex regulatory function involving cellular adhesion molecules and phosphatase
      mediated signalling. The tyrosine phosphatase TEP1 has been shown to be identical
      to the protein encoded by PTEN, and gene transcription of TEP1 has been
      demonstrated to be downregulated by transforming growth factor (TGF)-beta.
      Therefore, it could be hypothesized that TGF-beta might be responsible for the
      downregulation of PTEN. Low expression of PTEN may belong to the features that
      distinguish between the activated phenotype of RA-SF and the sublining,
      proliferating but nondestructive cells.

PMID- 11219391
TI  - Mast cell activation and its relation to proinflammatory cytokine production in
      the rheumatoid lesion.
AB  - INTRODUCTION: Increased numbers of mast cells (MCs) are found in the synovial
      tissues and fluids of patients with rheumatoid arthritis (RA), and at sites of
      cartilage erosion. MC activation has been reported for a significant proportion
      of rheumatoid specimens. Because the MC contains potent mediators, including
      histamine, heparin, proteinases, leukotrienes and multifunctional cytokines, its
      potential contributions to the processes of inflammation and matrix degradation
      have recently become evident. Proinflammatory cytokines are important mediators
      of inflammation, immunity, proteolysis, cell recruitment and proliferation.
      Tumour necrosis factor (TNF) reportedly plays a pivotal role in the pathogenesis
      o RA, especially its ability to regulate interleukin (IL)-1beta expression, this
      being important for the induction of prostanoid and matrix metalloproteinase
      production by synovial fibroblasts and chondrocytes. IL-15 has been assigned
      numerous biological effects and has been assigned numerous biological effects and
      has been implicated as an important factor in TNF-alpha expression by
      monocyte/macrophages. Some in vitro studies have placed IL-15 upstream from TNF
      alpha in the cytokine cascade, suggesting an interdependence between TNF, IL-1
      and IL-15 for the promotion of proinflammatory cytokine expression in the
      rheumatoid joint. AIMS: To examine the in situ relationships of TNF-alpha, IL
      1beta and IL-15 in relation to MC activation in rheumatoid tissues by use of
      immunolocalization techniques; and to compare quantitatively the proinflammatory
      cytokine production by specific cell cultures and rheumatoid synovial explants
      with and without exposure to a MC secretagogue. MATERIALS AND METHODS: Samples of
      rheumatoid synovial tissue and cartilage-pannus junction were obtained from
      patients (n=15) with classic late-stage RA. Tissue sections were immunostained
      for MC (tryptase) and the proinflammatory cytokines IL-1, TNF-alpha and IL-15.
      Rheumatoid synovial tissue explants were cultured in Dulbecco's modified Eagles
      medium (DMEM) containing either the MC secretagogue rabbit antihuman
      immunoglobulin (Ig)E, or control rabbit IgG. Primary rheumatoid synovial cell
      cultures, human articular chondrocytes, synovial fibroblasts and synovial
      macrophages were prepared as described in the full article. Conditioned culture
      media from these cultures were collected and assayed for IL-1beta, TNF-alpha and
      IL-15 using enzyme-linked immunosorbent assay methodology. RESULTS:
      Immunohistological studies of rheumatoid synovial tissues have demonstrated local
      concentrations of MCs in most specimens of the rheumatoid lesion. Sites of MC
      activation were associated with localized oedema, and TNF-alpha, IL-1alpha and IL
      1beta production by a proportion of mononuclear inflammatory cells. By contrast,
      no evidence was found for IL-15 production in tissue sites containing either
      intact or activated MCs, and IL-15 expression, when observed, bore no relation to
      tissue sites where TNF-alpha and IL-1beta were evident. The immunodetection of IL
      15 was restricted to microfocal sites and was not typical of most junctional
      specimens, but was associated with a proportion of articular chondrocytes in a
      minority of junctional specimens. MC activation within synovial explant cultures
      was induced by the addition of polyclonal antibody to human IgE. MC activation
      significantly reduced the levels of TNF-alpha and IL-1beta released into the
      medium, this representing approximately 33% of control values. By contrast, MC
      activation had little effect of the levels of IL-15 released into the culture
      medium, the average value being very low in relation to the release of TNF-alpha
      and IL-1beta. Thus, induced MC activation brings about changes in the amounts of
      released tryptase, TNF-alpha and IL-1beta, but not of IL-15. Four preparations of
      primary rheumatoid synovial cell cultures produced more IL-1beta than TNF-alpha,
      with only modest values for IL-15 production, indicating that all three cytokines
      are produced and released as free ligands by these cultures. Of specific cell
      types that produced IL-15 in vitro, macrophages produced more than fibroblasts,
      which in turn produced more than chondrocytes. This demonstrates that all three
      cell types have the potential to produce IL-15 in situ. DISCUSSION: The
      biological consequences of MC activation in vivo are extremely complex, and in
      all probability relate to the release of various combinations of soluble and
      granular factors, as well as to the expression of appropriate receptors by
      neighbouring cells. The subsequent synthesis and release of cytokines such as TNF
      alpha and IL-1 may well follow at specific stages after activation, or may be an
      induced cytokine response by adjacent macrophagic or fibroblastic cells. However,
      because no IL-15 was detectable either in or around activated or intact MCs, and
      the induced MC activation explant study showed no change in IL-15 production, it
      seems unlikely that the expression of this cytokine is regulated by MCs. The
      immunohistochemistry (IHC) demonstration of IL-15 at sites of cartilage erosion,
      and especially by some chondrocytes of articular cartilage, showed no spatial
      relationship with either T cells or neutrophils, and suggests other functional
      properties in these locations. The lack of evidence for an in situ association of
      IL-15 with TNF and IL-1 does not support a role for IL-15 in a proinflammatory
      cytokine 'cascade', as proposed by other in vitro experiments. We believe that
      sufficient evidence is available, however, to suggest that MC activation makes a
      significant contribution to the pathophysiological processes of the rheumatoid
      lesion.

PMID- 11219393
TI  - Ninth Asia Pacific League of Associations for Rheumatology (APLAR) Congress,
      Beijing, China, 21-26 May, 2000.
AB  - The Congress covered the broad field of rheumatology, with participants from
      China, the Asia Pacific League of Associations of Rheumatology (APLAR) region and
      the rest of the world. The programme consisted of a mix of plenary lectures,
      concurrent symposia, workshops, free paper sessions and poster presentations.
      Basic sciences were well represented, with the general theme of inflammatory
      cytokines being of particular interest. One plenary lecture and a number of other
      presentations addressed the problem of atherosclerosis and rheumatic diseases.
      Diseases prominent in the region, such as Behcet's disease and Takayasu's
      disease, were represented with large series. Other areas of interest were
      musculoskeletal infections in HIV-positive patients and the management of
      spondyloarthritis. Although the use of the most recently developed drugs is
      restricted in the APLAR region because of cost factors, there were symposia on
      the latest pharmacological advances such as COX-2 technology, leflunomide and
      anti-tumour necrosis factor (TNF) therapy.

PMID- 11219394
TI  - Cell contact interactions in rheumatology, The Kennedy Institute for
      Rheumatology, London, UK, 1-2 June 2000.
AB  - The intricate interactions that regulate relationships between endogenous tissue
      cells and infiltrating immune cells in the rheumatic joint, particularly in
      rheumatoid arthritis (RA), were the subject of the meeting. A better
      understanding of these interactions might help to define intervention points that
      could be used to develop specific therapies. The presentations and discussions
      highlighted the fact that, once chronic inflammation is established, several
      proinflammatory loops involv9ing tumour necrosis factor (TNF)-alpha and
      interleukin (IL)-1beta can be defined. Direct cellular contact with stimulated T
      lymphocytes induces TNF-alpha and IL-1beta in monocytes which in turn induce
      functions in fibroblast-like synoviocytes. The latter include the production of
      stromal cell-derived factor-1alpha (SDF-1alpha) which enhances the expression of
      CD40L in T cells, which stimulates SDF-1alpha production in synoviocytes, which
      in turn protects T and B cells from apoptosis and enhances cell recruitment thus
      favoring inflammatory processes. IL-1beta and TNF-alpha also induce IL-15 in
      fibroblast like synoviocytes, which induces the production of IL-17 which in turn
      potentiates IL-1beta and TNF-alpha production in monocyte-macrophages. This
      underlies the importance of TNF-alpha and IL-1beta in RA pathogenesis, and helps
      explain the efficiency of agents blocking the activity of these cytokines in RA.
      Factors able to block the induction of cytokine production (such as
      apolipoprotein A-I [apo A-I] and interferon [IFN]-beta) might interfere more
      distally in the inflammatory process. Furthermore, stimulated T lymphocytes
      produce osteoclast differentiation factor (ODF), which triggers erosive functions
      of osteoclasts. Therefore, factors capable of affecting the level of T lymphocyte
      activation, such as IFN-beta, IL-15 antagonist, or SDF-1alpha antagonist, might
      be of interest in RA therapy.

PMID- 11219392
TI  - Interferon-gamma production in response to in vitro stimulation with collagen
      type II in rheumatoid arthritis is associated with HLA-DRB1(*)0401 and HLA-DQ8.
AB  - INTRODUCTION: Despite much work over past decades, whether antigen-specific
      immune reactions occur in rheumatoid arthritis (RA) and to what extent such
      reactions are directed towards joint-specific autoantigens is still questionable.
      One strong indicator for antigenic involvement in RA is the fact that certain
      major histocompatibility complex (MHC) class II genotypes [human leucocyte
      antigen (HLA)-DR4 and HLA-DR1[ predispose for the development of the disease [1].
      In the present report, collagen type II (CII) was studied as a putative
      autoantigen on the basis of both clinical and experimental data that show an
      increased frequency of antibodies to CII in RA patients [2-4] and that show that
      CII can induce experimental arthritis [5]. It is evident from the literature that
      RA peripheral blood mononuclear cells (PBMCs) respond poorly to antigenic
      stimulation [6-8], and in particular evidence for a partial tolerization to CII
      has been presented [9]. The strategy of the present work has accordingly been to
      reinvestigate T-cell reactivity to CII in RA patients, to relate it to the
      response to commonly used recall antigens and to analyze interferon (IFN)-gamma
      responses as an alternative to proliferative responses. AIMS: To study cellular
      immune reactivity to CII in patients with RA and in healthy control individuals
      and to correlate this reactivity to HLA class II genotypes and to the presence of
      antibodies to CII in serum. METHODS: Forty-five patients who met the 1987
      American college of Rheumatology classification criteria for RA [10] and 25
      healthy control individuals of similar age and sex were included. Twenty-six of
      these patients who had low levels of anti-CII in serum were randomly chosen,
      whereas 19 patients with high anti-CII levels were identified by enzyme-linked
      immunosorbent assay (ELISA)-screening of 400 RA sera. Heparinized blood was
      density gradient separated and PBMCs were cultured at 1 x 10(6)/ml in RPMI-10%
      fetal calf serum with or without antigenic stimulation: native or denatured CII
      (100 microgram/ml), killed influenza virus (Vaxigrip, Pasteur Merieux, Lyon,
      France; diluted 1:1000) or purified protein derivative (PPD; 10 microgram/ml).
      CII was heat-denatured in 56 degrees C for 30 min. Cell supernatants were
      collected after 7 days and IFN-gamma contents were analyzed using ELISA. HLA-DR
      and HLA-DQ genotyping was performed utilizing a polymerase chain reaction-based
      technique with sequence-specific oligonucleotide probe hybridization.
      Nonparametric statistical analyses were utilized throughout the study. RESULTS:
      PBMCs from both RA patients and healthy control individuals responded with IFN
      gamma production to the same degree to stimulation with native and denatured CII
      (Fig. 1a), giving median stimulation indexes with native CII of 4.6 for RA
      patients and 5.4 for health control individuals, and with denatured CII of 2.9
      for RA patients and 2.6 for healthy control individuals. RA patients with
      elevated levels of anti-CII had a weaker IFN-gamma response to both native and
      denatured CII that did healthy control individuals (P-).02 and 0.04,
      respectively). Stimulation with the standard recall antigens PPD and killed
      influenza virus yielded a median stimulation index with PPD of 10.0 for RA
      patients and 51.3 for healthy control individuals and with influenza of 12.3 for
      RA patients and 25.7 for healthy, control individuals. The RA patients displayed
      markedly lower responsiveness to both PPD and killed influenza virus than did
      healthy control individuals (Fig. 1b). IFN-gamma responses to all antigens were
      abrogated when coincubating with antibodies blocking MHC class II. The low
      response to PPD and killed influenza virus in RA patients relative to that of
      healthy control individuals reflects a general downregulation of antigen-induced
      responsiveness of T cells from RA patients [6-8]. That no difference between the
      RA group and the control group was recorded CII-induced IFN-gamma production
      therefore indicates that there may be an underlying increased responsiveness to
      CII in RA patients, which is obscured by the general downregulation of T-cell
      responsiveness in these patients. In order to address this possibility, we
      calculated the fraction between individual values for the CII-induced IFN-gamma
      production and the PPD-induced and killed influenza virus-induced IFN-gamma
      production and the PPD-induced and killed influenza virus-induced IFN-gamma
      production, and compared these fractions. A highly significant difference between
      the RA and health control groups was apparent after stimulation with both native
      CII and denatured CII when expressing the response as a fraction of that with PPD
      (Fig. 2a). Similar data were obtained using killed influenza virus-stimulated IFN
      gamma values as the denominator (Fig. 2b).When comparing the compensated IFN
      gamma response to denatured CII stimulation between RA patients with different
      HLA genotypes, highly significant differences were evident, with HLA-DRB1*0401
      patients having greater CII responsiveness than patients who lacked this genotype
      (Fig. 3a). HLA-DQ8 positive patients also displayed a high responsiveness to CII
      as compared with HLA-DQ8 negative RA patients (Fig. 3b). These associations
      between the relative T-cell reactivity to denatured CII and HLA class II
      genotypes were not seen in healthy control individuals. Similar results were
      achieved using influenza as denominator (P = 0.02 for HLA-DRB1*0401 and P = 0.01
      for HLA-DQ8). DISCUSSION: No reports have previously systematically taken the
      general T-cell hyporesponsiveness in RA into account when investigating specific
      T-cell responses in this disease. In order to address this issue we used the T
      cell responses to PPD and killed influenza virus as reference antigens. This was
      made on the assumption that exposure to these antigens is similar in age-matched
      and sex-matched groups of RA patients and healthy control individuals. The
      concept of a general hyporesponsiveness in RA T cells has been documented in
      several previous reports, in which both nominal antigens [6,7,8] and mitogens
      [11,12,13] have been used. The fact that a similar functional downregulation in
      RA PBMCs was obtained with both PPD and killed influenza virus as reference
      antigens strengthens the validity of our approach. We identified an association
      between the IFN-gamma response to CII and HLA-DRB1*0401 and HLA-DQ8 in the RA
      patient group, which is of obvious interest because both these MHC class II
      alleles have been associated with high responsiveness to CII in transgenic mice
      that express these human MHC class II molecules [14,15]. There was no association
      between high anti-CII levels and shared epitope (HLA-DRB1*0401 or HLA-DRB1*0404).
      CONCLUSION: CII, a major autoantigen candidate in RA, can elicit an IFN-gamma
      response in vitro that is associated with HLA-DRB1*0401 and HLA-DQ8 in RA
      patients. This study, with a partly new methodological approach to a classical
      problem in RA, has provided some additional support to the notion that CII may be
      a target autoantigen of importance for a substantial group of RA patients.
      Continued efforts to identify mechanisms behind the general hyporesponsiveness to
      antigens in RA, as well as the mechanisms behind the potential partial anergy to
      CII, may provide us with better opportunities to study the specificity and
      pathophysiological relevance of anti-CII reactivity in RA.

PMID- 11219395
TI  - Re: Orthodontic treatment with fixed appliances in the General Dental Service in
      Scotland.

PMID- 11219396
TI  - Web alert.

PMID- 11219397
TI  - Web alert.

PMID- 11219399
TI  - Web alert. Rheumatology.

PMID- 11219398
TI  - Web alert.

PMID- 11219400
TI  - [Prevention using new media. Well packaged half-thruths are counterproductive].

PMID- 11219401
TI  - [2 platelet inhibitors administered at the same time. Improved prognosis in
      myocardial infarct?]].

PMID- 11219403
TI  - [Use of the Appropriateness Evaluation Protocol in inpatient ENT practice].
AB  - BACKGROUND AND OBJECTIVE: Determination of inappropriate hospital use is of
      increasing importance due to limited resources in health care. The
      Appropriateness Evaluation Protocol (AEP) serves as an instrument to identify
      this inappropriate hospital use. It was designed in the USA in 1981 for use in
      Internal Medicine and General Surgery and consists of criteria items to assess
      the appropriateness of hospital admissions and days of care. PATIENTS/METHODS:
      The present study aims to examine the practicability of the AEP in
      Otorhinolaryngology. The charts of all patients hospitalized in the ENT
      Department at that particular day were surveyed on 4 consecutive Wednesdays.
      Three reviewers each reviewed 196 charts. RESULTS: The overall level of
      inappropriate use was 41.5%. Presuming that the day preoperative to elective
      surgery was appropriate, the level was 23.1%. CONCLUSIONS: The critical
      comparison between this result and the actual reasons for hospital admissions and
      days of care showed, that the present German version of the AEP is less suitable
      for use in Otorhinolaryngology. Based on the experiences with the AEP an AEP
      adjusted to Otorhinolaryngology (AEP-ENT) is proposed.

PMID- 11219402
TI  - H3 receptor-mediated inhibition of intestinal acetylcholine release:
      pharmacological characterization of signal transduction pathways.
AB  - The present study investigates the mechanisms through which prejunctional
      histamine H3 receptors modulate intestinal cholinergic neurotransmission. The
      experiments were performed on longitudinal muscle-myenteric plexus preparations
      of guinea pig ileum, preincubated with [3H]choline, superfused with physiological
      salt solution containing hemicholinium-3, and subjected to electrical field
      stimulation. The stimulation-induced outflow of radioactivity was taken as an
      index of endogenous acetylcholine release. The electrically induced
      [3H]acetylcholine release was inhibited by histamine (EC50)=33.5 nM) or the H3
      receptor agonist R-alpha-methylhistamine (EC50=41.6 nM), whereas it was not
      affected by pyridylethylamine (H1 agonist), impromidine (H2 agonist), pyrilamine
      (H1 antagonist), cimetidine (H2 antagonist), thioperamide or clobenpropit (H3
      antagonists). The inhibitory effects of histamine or R-alpha-methylhistamine were
      antagonized by thioperamide (pKd= 8.31 and 8.53, respectively) or clobenpropit
      (pKd=9.44 and 9.32, respectively), but not by pyrilamine or cimetidine. The
      modulatory action of histamine on the evoked tritium outflow was attenuated by
      pertussis toxin and abolished by N-ethylmaleimide, two selective blockers of
      Gi/Go proteins. Tetraethylammonium or 4-aminopyridine, acting as inhibitors of
      voltage-dependent K+ channels, enhanced the evoked tritium outflow when tested
      alone, and apparently counteracted the inhibitory effect of histamine. However,
      the blocking actions of tetraethylammonium and 4-aminopyridine were no longer
      evident when their enhancing actions were compensated by appropriate reductions
      of Ca2+ concentration in the superfusion medium. Histamine-induced inhibition of
      evoked tritium output was enhanced by omega-conotoxin, a selective blocker of N
      type Ca2+ channels, or low Ca2+ concentration, whereas it was not modified by
      nifedipine, an antagonist of L-type Ca2+ channels. In addition, the inhibitory
      effect of histamine was not significantly affected by forskolin (activator of
      adenylyl cyclase), 8-bromo-cyclic AMP (a stable analog of cyclic AMP), rolipram
      (a selective blocker of type IV phosphodiesterase), phorbol myristate acetate
      (activator of protein kinase C), H-89 (N-(2-[p-bromocinnamylamino]ethyl)-5
      isoquinolinesulfonamide, inhibitor of protein kinase A), Ro-31-8220 (2-(1-[3
      (amidinothio)propyl]-1H-indol-3-yl)-3-(1-methylindol-3-yl)-maleimide, inhibitor
      of protein kinase C), KT5823 (N-methyl-(8R*,9S*,11S*)-(-)-9-methoxy-9
      methoxycarbonyl-8-methyl-2,3,9,10-tetrahydro-8,11-epoxy-1H,8H,11H-2,7b,11a
      triazadibenzo [a,g]cycloocta[c,d,e]-trinden-1-one, inhibitor of protein kinase
      G), or lavendustin A (inhibitor of tyrosine kinase). The present results indicate
      that histamine inhibits intestinal cholinergic neurotransmission through
      presynaptic H3 receptors coupled to Gi/Go proteins. It is suggested that adenylyl
      cyclase, serine-threonine protein kinase and tyrosine kinase pathways are not
      implicated in this regulatory action, and that Gi/Go proteins modulate the
      activity of N-type Ca2+ channels through a direct link, thus causing a reduced
      availability of extracellular Ca2+ at the level of ileal cholinergic nerve
      terminals.

PMID- 11219404
TI  - [2000 Nobel Prize in Medicine. Communicating nerve cells].

PMID- 11219405
TI  - [Orbital space-occupying lesions. Practical aspects of imaging].
AB  - During the period 1992-1998,we diagnosed orbital tumors in 23 cases at the MLU
      Halle-Wittenberg. In the intraconal compartment we mostly saw cavernous
      hemangiomas and neurogenic tumors. Lymphomas and a primary meningioma were
      located in the extraconal space. Beneath the periosteum, bony processes, tumors
      of the sinuses, dermoid-and epidermoid-cysts normally occur, but we only observed
      metastases and hematomas. Furthermore,tumors of the lacrimal gland and
      inflammatory lesions were diagnosed. Orbital tumors are uncommon lesions, whose
      location in the orbit gives an important hint to differential diagnosis, because
      a high percentage of various pathologies is located in special compartments of
      the orbit. According to our results,the MRI-scan is usually sufficient for
      differentiation and for preoperative planning in order to reduce the X-ray dose
      of the lens. CT-scans with contrast are sometimes necessary for examining bone
      destroying processes and for planning the surgical approach to removing the
      tumor. X-rays of the skull widely lost their importance in the exact diagnostic
      of orbital tumors. B-scan ultrasonic imaging is reserved for screening and follow
      up examination. Despite the use of MRI and CT scanning, the histological
      examination remains necessary.

PMID- 11219406
TI  - [Neurofeedback in therapy of tinnitus].
AB  - BACKGROUND AND OBJECTIVE: Biofeedback is known as a possibility to control
      physiologic processes like body temperature or heart frequency. Neurofeedback is
      a form of biofeedback linked to aspects of the electrical activity of the brain
      such as frequency, location or amplitude of specific EEG activity. It has been
      successfully used in patients with closed head injury, hyperactivity disorder or
      epilepsy. PATIENTS/METHODS: In this study 40 patients with tinnitus were treated
      with neurofeedback.They trained to upregulate the amplitude of their alpha
      activity and downregulate the amplitude of beta-activity during muscle relaxation
      and acoustic orientation on sounds or music in order to suppress their tinnitus.
      RESULTS: After 15 sessions of training 24 patients with a duration of their
      tinnitus for an average of 1 year showed significant increase of alpha-amplitudes
      while 16 patients with duration of their tinnitus on an average of 7 years showed
      a decrease of beta-amplitudes without any change in alpha-activity. After the
      training all patients had a significant reduction of the score in the tin
      nitusquestionaire of Gobel and Hiller. In a control-group of 15 persons without
      tinnitus we didn't see any changes of alpha- or beta-amplitudes during the same
      training. CONCLUSIONS: In conclusion neurofeedback is a new therapy for patients
      with tinnitus. Patients get the possibility of selfcontrol and therefore of
      influence on their disease.

PMID- 11219407
TI  - [Warming inhaled air in the nose].
AB  - BACKGROUND AND OBJECTIVE: The purpose of this study was to determine whether the
      temperature at the end of inspiration is the same as the temperature a few
      seconds after breathing stops at the end of inspiration to study if the nasal
      mucosa are capable of providing heat during a cessation of breathing.
      PATIENTS/METHODS: Fifteen healthy volunteers were included in the study. The
      temperature at the end of inspiration was compared to the temperature obtained 5
      s after cessation of breathing at the end of inspiration and at the end of
      expiration. Intranasal temperature measurements were taken at three locations in
      the nose with a miniaturized thermocouple. RESULTS: The temperature increased
      during cessation of breathing at all locations. The highest temperature
      differences between the end of inspiration and 5 s later (breathing at rest)
      could be observed at the nasal valve area. The lowest temperature difference was
      found in the nasopharynx. At the end of expiration,the temperature decreased only
      slightly from the nasopharynx to the nasal valve area. CONCLUSIONS: The anterior
      part of the nose in particular is capable of heating the inspired air. This is
      also important for humidification. Heating of inspired air requires special
      anatomical conditions of the anterior nasal segment.

PMID- 11219408
TI  - [Prevention of endocarditis within the scope of ENT interventions. Current
      recommendations].

PMID- 11219410
TI  - [Voice change and laryngeal obstruction caused by a median thyroglossal duct
      cyst].
AB  - Thyroglossal duct cysts are common primary neck tumors, resulting from remnants
      of the ductus thyroglossus. They can occur at any point along the migratory path
      of the thyroid gland anlage until the 2nd or 3rd decade of life. The usual
      symptoms leading to the diagnosis are painless midline neck masses orfistulas.
      Despite their close proximity, the cysts normally do not affect the larynx. We
      report on the eighth case mentioned in the world literature of a thyroglossal
      duct cyst invading the larynx in a 62-year-old patient. Preoperatively, the voice
      of the patient sounded metallic, and the frequency of the voice field was
      reduced. Postoperatively, the voice onset was physiological, and the voice
      increased by an octave in the higher frequencies. The intonation of the voice was
      steady. The analysis of formants of the vowels "a" and "i" showed that the fourth
      formant of the vowel "i" was lower in frequency postoperatively.

PMID- 11219409
TI  - [Clinical aspects of tracheopathia osteoplastica].
AB  - Tracheopathia osteoplastica is a rare condition of the tracheobronchial tree
      characterized by the formation of multiple osseous or cartilaginous submucosal
      nodules which protrude into the lumen. Clinical features, pathological
      anatomical, and radiological findings are described and discussed on the basis of
      three recent cases and a literature review.Two female patients (age 56 and 62
      years) and one male (age 44 years) presented with recurrent tracheobronchitis, a
      "difficult intubation" at the time of an emergency situation requiring
      tracheostomy. The diagnosis was confirmed by tracheoscopy. CT scans showed
      radiodense nodular thickening of the tracheal wall compromising the lumen in all
      patients, whereas plain chest radiography revealed scalloped linear calcification
      in only one case. Histologically the nodules consisted of lamellar-type bone
      covered by normal mucosa. None of the patients needed therapeutic measures as
      there was no impairment of ventilatory function. The long-term observations (>15
      years) of a few authors suggest that the disease is of benign course and does not
      deteriorate.

PMID- 11219411
TI  - [Degenerative changes in parapharyngeal schwannoma "ancient schwannoma". Case
      report and review of the literature].
AB  - Schwannomas are rare, slow-growing, benign neoplasms derived from the schwann
      cells of the nerve sheath of peripheral nerves. Extracranial schwannomas are most
      frequently localized within the extremities or the head and neck region. For
      example, they are common in the skull base, the carotid sheath, and the
      parapharyngeal space. Beneath several histological variants, schwannomas showing
      prominent degenerative changes (so-called,,ancient schwannomas") are exceedingly
      rare. Histopathological features, such as degenerative changes and nuclear
      atypias in ancient schwannomas, may be easily confused with malignant mesenchymal
      neoplasm.We present the case of a 32-year-old female who required surgery for a
      parapharyngeal neoplasm. Histological examination revealed features of an ancient
      schwannoma.

PMID- 11219412
TI  - [Radiation-induced malignant fibrous histocytoma of the oropharynx].
AB  - Malignant fibrous histiocytoma is a rare sarcoma. This is the report of a
      radiation-induced histiocytoma of the right tonsillar region. Because of squamous
      cell carcinoma of the left tonsil, a 64-year-old woman was treated with primary
      surgery and postoperative radiotherapy. Six years later, a histiocytoma was
      diagnosed histologically within the former field of radiation. This second
      primary tumor was resected radically. Clinical, radiological, and histological
      findings are presented, and the importance of this very rare malignant tumor,
      especially when it is radiation-induced, is discussed.

PMID- 11219413
TI  - [Current aspects on diagnosis of sleep-related breathing disorders].
AB  - Various diagnostic procedures are available to diagnose sleep-related breathing
      disorders. The present review examines the amount of diagnostics necessary for
      daily routine. Concerning taking patients' history, the medical examination and
      nasal parameters, no new recommendations derive from this review. On the other
      hand,the detection of the site of pharyngeal obstruction seems to have become
      less important than it was a couple of years ago.Today, the upper airway is
      considered to be a complex, functional unit. The classification of the
      obstruction site into retropalatal and retrolingual seems to be oversimplified. A
      fully attended, complete polysomnography in the sleep laboratory no longer seems
      to be necessary in every case of suspected sleep-related breathing disorders.
      Under certain conditions, ambulatory recording units provide cost-effective
      alternatives.

PMID- 11219414
TI  - [Communication and personality. Markers for successful leadership].

PMID- 11219415
TI  - [Acute healing loss with subsequent cranial nerve paralysis. Wegener
      granulomatosis].

PMID- 11219416
TI  - [Digital photo- and video-documentation. 2].

PMID- 11219417
TI  - Quality of life for long-term survivors of cancer: influencing variables.
AB  - The study's purpose was to describe the relations among self-esteem, learned
      resourcefulness, and social support, and to show how they predict health-related
      quality of life (HRQL) for long-term survivors of cancer. With advances in
      oncology and increased survival, variables influencing the HRQL of long-term
      survivors of cancer must be explored. The design was descriptive and
      correlational. Five instruments were sent to 456 long-term survivors in southern
      California. Data were analyzed for 62 of 111 consenting individuals, most of whom
      were married, retired, white, college-educated, female survivors of breast cancer
      older than 60 years of age treated by radiation and surgery. Subjects with higher
      self-esteem reported higher HRQL (r = 0.69; p = 0.00). Learned resourcefulness
      had a significant negative relation with HRQL (r = -0.32; p = 0.01). Social
      support was operationalized as functional components, network properties, and
      recent loss. Only the loss component of social support had a significant negative
      relation with HRQL (r = -0.38; p = 0.00). Together, the three variables explained
      more than half of the variance (R2 = 0.53) of HRQL, with self-esteem being the
      strongest predictor. The HRQL of long-term survivors of cancer may increase with
      interventions such as both survivor- and nurse-led support groups aimed at
      supporting and improving self-esteem. In addition, education to anticipate social
      support losses may further enhance HRQL.

PMID- 11219418
TI  - Predictors of quality of life in rural patients with cancer.
AB  - Quality of life (QOL) as an outcome for cancer treatment has been studied
      primarily in urban populations. Yet, descriptions of rural dwellers suggest that
      their perception of QOL may differ from that of their urban counterparts. The
      purpose of this study was to examine QOL in people with a cancer diagnosis of at
      least 1 month duration in two similar rural northeastern states. The Functional
      Assessment of Cancer Therapy General (FACT G) scale was completed by 344
      respondents. The mean QOL score was 89.41 +/- 16.55. State of residence, gender,
      known recurrence, and marital status were significant predictors of QOL,
      explaining 18.3% of the variance in this study. Age, education level, income,
      type of cancer, living arrangements, and time since diagnosis were not
      predictive. The QOL scores in this rural sample were higher than those reported
      earlier for predominantly urban dwellers. Future research is needed to understand
      these differences.

PMID- 11219419
TI  - Hospice nursing: the specialty.
AB  - The purpose of this study was to identify and delineate what experienced hospice
      nurses perceive as the knowledge and skills base essential to their practice of
      hospice nursing as a specialty. Little of this specialty is taught in basic
      nursing programs, so another purpose was to determine the methods hospice nurses
      use for knowledge and skills acquisition. The qualitative study method of focused
      ethnography was used. This method allowed the researcher to examine hospice
      nurses in the context of their own community-based agency, enter the research
      arena with specific questions, describe the topic from the viewpoint of the
      participants, use multiple data sources, and begin data analysis concurrently
      with data collection, which continued until saturation was reached. During data
      analysis, 11 categories emerged. Four of these categories involved skills: (a)
      assessment skills, (b) communication skills, (c) technical skills, and (d)
      management skills; and seven categories primarily involved knowledge: (a) end
      stage disease process, (b) signs of impending death, (c) palliative therapeutics,
      (d) collaboration between disciplines, (e) advocacy, (f) philosophy and ethics of
      hospice care, and (g) family dynamics. Of these 11 categories, the one discussed
      and observed most often was that of assessment skills. It was found that the
      hospice nurses learned their specialty by doing it. However, the need for
      graduate education in hospice nursing became apparent.

PMID- 11219420
TI  - Caregivers' descriptions of patients with advanced breast cancer in connection
      with supervision sessions in a surgical ward.
AB  - The purpose of this study was to describe the content of caregivers' (health care
      professionals') presentation of care situations as told at supervision sessions.
      For 1 year, 21 caregivers in a surgical ward of a county hospital in the middle
      of Sweden participated in a clinical supervision session 2 hours every third
      week. The participants in the supervision sessions were divided so as to form
      three mixed groups composed of registered nurses, practical nurses,
      physiotherapists, and physicians. The purpose of the supervision sessions was to
      give caregivers the opportunity to reflect on different care situations in a way
      that contributed to the development of patient care. The 38 supervision sessions
      were tape-recorded and transcribed verbatim. The transcripts were analyzed using
      a qualitative content analysis. The caregivers described difficult care
      situations focusing on the feelings of patients, relatives, and caregivers, with
      an emphasis on the caregivers' being dominant. Difficult care situations were
      described as giving caregivers feelings of discomfort, powerlessness, and reduced
      self-esteem. These feelings were described as arising in connection with caring
      for women with advanced breast cancer and other seriously ill patients in an
      organization lacking clear goals and rules. This study found that supervision
      sessions offering an opportunity to reflect on the difficult care situations are
      important for caregivers. These sessions seem therefore to be of vital importance
      for the future development of cancer care on the surgical ward.

PMID- 11219421
TI  - African American women and breast cancer: notes from a study of narrative.
AB  - Survival after breast cancer and after all cancers is significantly worse for
      African American women than for others. Although many reasons have been proposed,
      no studies have explored the reception of messages about breast cancer by African
      American survivors of this disease, and how public images and discourses about
      breast cancer affects both their perceived risk for this disease and their
      experiences of illness. Narrative accounts of their lived experiences with breast
      cancer were collected from 23 African American survivors of breast cancer. Three
      themes have emerged: (a) Breast cancer is perceived to be a white woman's
      disease; (b) cancer is caused by experiences of repeated traumatic heartbreak;
      and finally, (c) there is a perceived lack of social support and understanding
      for the unique life experiences of the African American survivor of breast
      cancer. Nurses are on the front line of patient care. In the context of the
      managed care environment, they spend more time with patients than other health
      care providers and are soundboards for many patient concerns. As such, they can
      use the information provided in this study to inform high-risk women, current
      patients, partners, and other individuals in the medical community of how African
      American women might inaccurately access their personal risks for breast cancer,
      despite the public emphasis on this disease. Through the use of culturally
      sensitive pamphlets, nurses and other medical practitioners can also open
      discussions with underserved and minority patients as a means of realistically
      addressing some of these women's fears about breast cancer. These fears are
      barriers to effective cancer prevention because these individuals may consciously
      or unconsciously link a diagnosis of breast cancer, or even behaviors related to
      cancer prevention, to a potential death sentence.

PMID- 11219422
TI  - The Breast Cancer Distance Education Program: development and evaluation of a
      course for specialist breast care nurses.
AB  - The Breast Cancer Distance Education Program is the first tertiary-based
      education program for specialist breast care nurses in Australia. The program
      covers current treatment options, psychosocial issues, and professional
      development issues relating to breast cancer nursing. For the first two student
      intakes (n = 53), precourse, postcourse, and 3-month follow-up surveys were
      conducted to assess the perceived value of the course, identify any limitations,
      and note changes in practice that arose. Before taking the course, most of the
      students had experience in breast cancer nursing, but lacked confidence and hoped
      to learn more about responding effectively to psychosocial issues through
      communication, counseling, and provision of support to patients and their carers.
      After taking the course, the students were very positive about the course
      content, resources, and teaching support. They reported learning new skills for
      addressing psychosocial issues and symptom management arising from a diagnosis of
      breast cancer, stating a desire to implement these new skills. Comparison between
      results from the three surveys indicated that students' confidence in providing
      breast cancer support increased significantly in most areas of practice, and was
      maintained at 3-month follow-up survey. Results suggest that students met the
      course objectives successfully, and in most cases subsequently translated their
      knowledge into improved practice.

PMID- 11219423
TI  - Relationship issues of women with breast cancer.
AB  - This in-depth, qualitative pilot study explored the impact of breast cancer on
      specific dimensions of the relationships and roles of women. It included
      interaction within the partner relationship as well as with family, friends, and
      colleagues. Data were obtained by individual and group interviews from 10 women
      with a diagnosis of breast cancer and 5 male partners. Both partnered and single
      women participated. There were four major findings seldom discussed in the
      literature, which have important implications for preventive intervention. First,
      partner relationships troubled before the diagnosis as well as those
      characterized by mutual caring faced challenges and negative changes. Second, in
      an effort to protect each other, communication within the partner dyad became
      less open, and there were changes in the usual manner of conflict resolution.
      Third, unpartnered women appeared to be more vulnerable to problems of negative
      adjustment, largely because of relationship issues. Fourth, participants
      confirmed the need for a comprehensive intervention to facilitate coping with
      issues relative to relationships, intimacy, and sexuality. Although the sample
      was small, in-depth data were obtained that provide a basis for specific areas in
      which further empirical investigation is needed, and they indicate that
      preventive intervention may well be warranted.

PMID- 11219424
TI  - The needs of children and adolescents with cancer for information and social
      support.
AB  - Research has indicated that information and social support may have helped
      children and adolescents with cancer to cope with their illness and lead normal
      lives. However, recent researchers have reported that youths with cancer express
      a clear interest in receiving more information and social support. This study
      reviewed research on information and social support for children and adolescents
      with cancer to understand their needs. Young patients with cancer showed high
      uncertainty about cancer. Besides, adolescents with cancer were more in conflict
      with their parents than healthy youths. Discussions on future plans or death are
      difficult for young people with cancer. They also are frequently absent from
      school over time. Moreover, they want to make healthy friends. To fulfill the
      needs of these youths, nurses should be aware not only of individualized
      information and social support, but also of these factors from an ecologic
      perspective. Further qualitative research is required to identify the needs of
      youths with cancer and resolve these issues.

PMID- 11219425
TI  - Chinese women's experiences and images of the Pap smear examination.
AB  - Cervical cancer remains a significant cause of mortality and morbidity in Chinese
      women, despite the efficacy of the screening procedure for the disease. This
      article focuses on specific gender and culturally related experiences of Chinese
      women presenting for Papancolaou (Pap) tests. The first phase of a descriptive
      exploratory study involved the administration of a questionnaire to a total
      population of female Hong Kong Chinese clerical and technical staff working in
      academic departments of a tertiary institution. The second phase consisted of in
      depth semistructured interviews with a purposive sample of women to explore
      experiences of Pap smear screening. Of these women, 68.2% associated pain with a
      Pap smear. In addition, 78.6% of the women associated a Pap smear with
      embarrassment. Older women were more likely to experience pain and embarrassment
      during the procedure. In the qualitative data, women's personal images and
      experiences reflected four subthemes including pain, sexual connotations of the
      procedure, vulnerability, and diminished embarrassment after childbirth. The
      second substantive theme, characteristics of the practitioner, highlighted the
      importance of procedural, interpersonal, and culturally sensitive skills,
      particularly in respect to information-giving and interaction with women. The
      conclusion outlines the nursing implications for Chinese women presenting for Pap
      smears in terms of cultural sensitivity as a means of enhancing attendance
      patterns.

PMID- 11219427
TI  - Correlations between theoretical and experimental determination of heat of
      formation of certain aromatic nitro compounds.
AB  - Heats of formation of energetic materials can be obtained either experimentally
      or theoretically. In order to compare the results of the two methods, some
      correlation methods were proposed in this study. The molecular structures and
      heats of formation of nitrobenzenes, nitrotoluenes, nitroanilines, and
      nitrophenols were calculated by Dewar's AMI and Stewart's PM3 methods.
      Correlations of heats of formation between the theoretical calculations and
      experimental results were evaluated by using the multivariable linear regression
      method. Results indicate that there are very precise correlations. Based on these
      correlations, heats of formation of some aromatic nitro compounds can be
      predicted at 95% predictive interval without experimental analysis.

PMID- 11219428
TI  - Prediction of programmed-temperature retention values of naphthas by wavelet
      neural networks.
AB  - The wavelet neural network (WNN) was used to predict the programmed-temperature
      retention values of naphthas. In WNN, a Morlet mother wavelet was used as a
      transfer function, and the convergence speed was faster than other neural
      networks. Sixty-four compounds (selected randomly from 94) were used as a
      training set, and the 30 remaining compounds were used as a test set. A very
      satisfactory result was obtained only after about 8000 training epochs. The other
      two methods, the artificial neural network (ANN) and the Simpson integral method,
      were also used for this study. The comparison of results obtained from three
      methods showed that the WNN is the most suitable tool in predicting programmed
      temperature retention values of naphthas, consequently this method can be used to
      provide reliable data for the petrochemical industry.

PMID- 11219429
TI  - Evaluation of Spartan semi-empirical molecular modeling software for calculations
      of molecules on surfaces: CO adsorption on Ni(111).
AB  - This paper reports the use of the PM3(tm) semi-empirical method in the Spartan
      molecular modeling software to optimize geometries and calculate vibrational
      frequencies for increasingly complex transition metal- and carbon monoxide (CO)
      containing systems, culminating in calculations of CO adsorbed on a Ni(111)
      surface. Mononuclear and dinuclear transition metal carbonyl molecular species
      were used to establish the level of accuracy that could be expected for
      vibrational frequencies to provide a context for the results from the adsorbed
      molecule calculations. One to four CO molecules adsorbed on the (111) face of a
      22-atom-nickel crystal were then modeled, and the accuracy of the adsorption
      geometry and vibrational frequency was evaluated. The calculated CO stretching
      vibrational frequencies were within 8% larger than the gas phase experimental
      values for the molecular species and were approximately 10% larger than the range
      of experimental values for CO on the nickel surface. The geometry optimization
      predicted that the CO molecules on the Ni(111) surface occupy three-fold hollow
      sites with no preference for sites over Ni atoms, in agreement with recent
      structural data and other theoretical calculations. The software was less
      successful in calculating the CO bond angle to the surface and the distance of
      the CO molecules from the surface, but the calculation did produce a reasonable
      distance between CO molecules on the surface. In general, the PM3(tm) method in
      Spartan shows promise for predicting adsorption sites and vibrational frequencies
      of molecules on metal surfaces.

PMID- 11219430
TI  - Stepwise assembling of polypeptide chain energy distributions.
AB  - The principles and application of conformational analysis software that makes use
      of a new algorithm are described. It is known that the existence of a local
      energy minimum in the energy landscape is in general related to the clustering of
      polypeptide chain conformations near that energy value or, in other words, to a
      high density of states. A criterion based on this principle is part of an
      algorithm employed to select subsets of polypeptide chain conformations in broad
      energy ranges. Chain fragments belonging to these subsets are then combined to
      build larger polypeptide chains and the corresponding energy distributions. The
      functionality of the various operations employed in the process is described and
      the FORTRAN 77 source code that defines the algorithm is listed. The methodology
      is illustrated with a calculation involving three chain fragments belonging to
      the cellular prion protein (PrP(C)).

PMID- 11219431
TI  - Visualization methods in analysis of detailed chemical kinetics modelling.
AB  - Sensitivity analysis, principal component analysis of the sensitivity matrix, and
      rate-of-production analysis are useful tools in interpreting detailed chemical
      kinetics calculations. This paper deals with the practical use and communication
      of the sensitivity analysis and the related methods are discussed. Some
      limitations of sensitivity analysis, originating from the mathematical concept
      (e.g. first-order or brute force methods) or from the software-specific
      implementation of the method, are discussed. As supplementary tools to the
      current methods, three novel visual tools for analysis of detailed chemical
      kinetics mechanisms are introduced: (a) scaled sensitivity analysis which is
      especially suited for studying initiation reactions where the span of reaction
      rates is high; (b) automated generation of reaction pathway plots which provides
      an immediate graphical illustration of the chemical processes occurring; (c)
      explorative (or chemometric) analysis of accumulated rate of progress matrices
      which assist in the identification of reaction subsets. The application of these
      tools are demonstrated by analysing NOx enhanced oxidation of methane at 700-1200
      K.

PMID- 11219426
TI  - Screening the molecular surface of human anticoagulant protein C: a search for
      interaction sites.
AB  - Protein C (PC), a 62 kDa multi-modular zymogen, is activated to an anticoagulant
      serine protease (activated PC or APC) by thrombin bound to thrombomodulin on the
      surface of endothelial cells. PC/APC interacts with many proteins and the
      characterisation of these interactions is not trivial. However, molecular
      modelling methods help to study these complex biological processes and provide
      basis for rational experimental design and interpretation of the results. PC/APC
      consists of a Gla domain followed by two EGF modules and a serine protease
      domain. In this report, we present two structural models for full-length APC and
      two equivalent models for full-length PC, based on the X-ray structures of Gla
      domainless APC and of known serine protease zymogens. The overall elongated shape
      of the models is further cross-validated using size exclusion chromatography
      which allows evaluation of the Stokes radius (rs for PC = 33.15 A; rs for APC =
      34.19 A), frictional ratio and axial ratio. We then propose potential binding
      sites at the surface of PC/APC using surface hydrophobicity as a determinant of
      the preferred sites of intermolecular recognition. Most of the predicted binding
      sites are consistent with previously reported experimental data, while some
      clusters highlight new regions that should be involved in protein-protein
      interactions.

PMID- 11219432
TI  - A QSPR model for the prediction of the gas-phase free energies of activation of
      rotation around the N-C(O) bond.
AB  - A novel approach to predict the gas-phase rotational activation energies of
      amides is presented. The quantitative structure property relationship (QSPR)
      treatment, using the statistical package, comprehensive descriptors for
      structural and statistical analysis (CODESSA), resulted in a three-parameter
      equation with R2 = 0.982 for the deltaG(double dagger)gas, of a set of 24 N,N
      dialkylamides.

PMID- 11219433
TI  - Implementation of similarity model in the CSB system for chemical reaction
      predictions.
AB  - A new algorithm for predicting the course of chemical reactions, implemented in
      the CSB system is presented. It allows to use of four various models for reaction
      generation, that lead to create different solution space according to the needs
      of the user. Depending on the chosen model one can expect solutions featuring
      great completeness or great reliability.

PMID- 11219434
TI  - ChromWin--a computer program for the determination of enantiomerization barriers
      in dynamic chromatography.
AB  - The software program ChromWin simulates interconversion profiles in dynamic
      chromatography (rearrangements, isomerizations, epimerizations,
      diastereomerizations and, notably, enanatiomerizations) on a personal computer in
      a user-friendly environment. ChromWin is especially suited for systems involving
      large plate numbers, e.g. gas chromatography (GC) and capillary electrophoresis
      (CE, CEC, MEKC), and first or pseudo-first order reactions. ChromWin (1)
      simulates the elution profiles of interconverting enantiomers by different models
      and yields the rate constant, (2) allows automation of the 'find
      enantiomerization barrier' function, (3) helps to optimise separation parameters
      by visualization of the separation process and (4) provides other useful tools
      for chromatography. In addition to the theoretical plate and the stochastic model
      a modified and improved stochastic model has been developed and implemented in
      the program.

PMID- 11219435
TI  - QSPR studies of PCBs by the combination of genetic algorithms and PLS analysis.
AB  - A hybrid approach that combines genetic algorithms (GA) with PLS analysis is
      proposed, and a modified cross-validation correlation coefficient (MCVR2) is used
      as fitness function. The method is applied to QSPR studies of PCBs, in comparison
      with class regression, and many better models are obtained for each property
      studied. By MCVR2, not only can the low dimensional PLS models be obtained, but
      also the best multiple least squares regression (MLS) models. Moreover, the
      results show the WHIM descriptors that contain information about the whole 3D
      molecular structure are excellent descriptors for molecular modeling, but by
      adding some common molecular parameters representing total molecular properties
      the quality of the models is still improved slightly.

PMID- 11219436
TI  - High order spatial discretisations in electrochemical digital simulation. 2.
      Combination with the extrapolation algorithm.
AB  - The application of fourth order discretisations of the second derivative of
      concentration with respect to distance from the electrode, in electrochemical
      digital simulations, is examined. In the bulk of the diffusion space, a central
      five-point scheme is used, and six-point asymmetric schemes are used at the
      edges. In this paper, the scheme is applied to the extrapolation technique, based
      on the backward implicit (BI) algorithm for temporal integration, which (with
      extrapolation) allows higher orders in time as well. The method is found to be
      stable, using both the von Neumann and matrix methods. Exceptional efficiency is
      obtained both for Cottrell and chronopotentiometry simulations, requiring as few
      as 3-5 steps in time, starting at the dimensionless time t = 0 to gain four
      decimal accuracy at t = 1.

PMID- 11219437
TI  - Individually measured feed intake characteristics and growth performance of group
      housed weanling pigs: effects of sex, initial body weight, and body weight
      distribution within groups.
AB  - Feed intake characteristics of 192, 27-d-old weanling pigs housed in groups and
      given ad libitum access to feed and water were measured individually with the use
      of computerized feeding stations. The groups were either homogeneous or
      heterogeneous as to BW distribution; pigs of three defined initial BW classes
      were used (mean BW of 6.7, 7.9, or 9.3 kg). The effects of BW distribution, BW
      class, and sex were studied with regard to average performance traits, latency
      time (interval between weaning and first feed intake), initial feed intake
      (intake during the first 24 h following first feed intake), and daily increase in
      feed intake during the interval between first feed intake and the day on which
      energy intake met or exceeded 1.5 times the maintenance requirement. Homogeneous
      and heterogeneous groups had similar latency times, initial feed intakes, and
      daily increases in feed intake. For the period 0 to 34 d after weaning, ADFI and
      ADG were also similar for homogeneous and heterogeneous groups, but gain:feed
      ratio was greater (P < 0.05) in the homogeneous groups. Gilts had higher (P <
      0.05) initial feed intakes than barrows and also had greater (P < 0.05) ADFI and
      ADG during the period 0 to 13 d after weaning. Pigs with average BW of 6.7 kg had
      higher (P < 0.05) initial feed intakes than their counterparts with average BW of
      7.9 kg and 9.3 kg, but the daily increase in feed intake was similar for the
      three groups. The lighter pigs had more daily visits and a lower feed intake per
      visit and tended to have a shorter postweaning latency to the onset of feeding
      than the heavier pigs. This study indicates that the high variability in early
      feeding behavior among group-housed weanling pigs may be related to BW and sex.

PMID- 11219438
TI  - Effectiveness of GnRH plus prostaglandin F2alpha for estrus synchronization in
      cattle of Bos indicus breeding.
AB  - Postpartum and lactating crossbred cows containing a percentage of Bos indicus
      breeding at three locations were studied to determine the efficacy of GnRH +
      PGF2alpha combinations for synchronization of estrus and(or) ovulation. Cows were
      equally distributed to each of three treatments by body condition score at the
      start of the experiment (d 0). All cows received 100 microg of GnRH on d 0 and 25
      mg of PGF2alpha 7 d later. The three insemination protocols included 1) AI 12 h
      after exhibiting estrus during d 7 to 12 of the experiment (Select-Synch; n =
      197); 2) timed-AI + 100 microg of GnRH on d 9 of the experiment (CO-Synch; n =
      193); 3) AI 12 h after exhibiting estrus during d 7 to 10 of the experiment. Cows
      not exhibiting estrus by d 10 were timed-AI and injected with 100 microg of GnRH
      on d 10 of the experiment (Hybrid-Synch; n = 200). The percentage of cows
      exhibiting estrus during d 7 to 12 of the experiment was lower (P < 0.05) for CO
      Synch (17.6%) cows than for Select-Synch or Hybrid-Synch (45.2 and 33.0%,
      respectively) cows, which did not differ (P > 0.05). For the Select-Synch and
      Hybrid-Synch cows that exhibited estrus during d 7 to 10 of the experiment and
      were artificially inseminated, conception rates were similar across treatments
      (50.5%). Pregnancy rates were greater (P < 0.01) for CO-Synch and Hybrid-Synch
      (31.0 and 35.5%, respectively) cows than for Select-Synch (20.8%) cows. A greater
      (P < 0.01) percentage of cycling cows became pregnant (34.5%) than noncycling
      cows (25.9%) across all treatments. The CO-Synch and Hybrid-Synch synchronization
      protocols resulted in greater pregnancy rates compared with the Select-Synch
      protocol in postpartum and lactating crossbred cows containing a percentage of
      Bos indicus breeding.

PMID- 11219439
TI  - Interactions in postweaning production of F1 cattle from Hereford, Limousin, or
      Piedmontese sires.
AB  - A 2-yr study was conducted to evaluate the interactions of castration, feeding
      length, and dietary CP on growth and carcass characteristics of male cattle
      (bulls and steers) that vary in expression of muscular hypertrophy. Crossbred
      cows were bred by AI to Hereford, Limousin, or Piedmontese bulls, which
      represented genotypes with normal, moderate, and hypermuscularity, respectively,
      but with similar mature weights. Male calves (131 in yr 1 and 120 in yr 2) were
      placed in pens with individual electronic feeding gates. Calves were fed growing
      diets until they reached 386 kg BW and then were individually switched to
      finishing diets for 90 or 132 d. Interactions were observed among sire breed,
      gender, and feeding length on carcass composition. Bulls were more efficient than
      steers in producing live weight gain. Length of finishing period accounted for a
      larger source of variation than gender for weight characteristics, whereas gender
      was the larger source of variation for carcass composition. Concentration or
      degradability of dietary CP influenced rate of gain from weaning to 386 kg.
      Interactions resulting from varying management on carcass characteristics among
      calves of different sire breeds indicate that unique strategies may be beneficial
      for the production of meat from these breeds.

PMID- 11219441
TI  - Comparison of threshold vs linear and animal vs sire models for predicting direct
      and maternal genetic effects on calving difficulty in beef cattle.
AB  - This study compared the accuracy of several models for obtaining genetic
      evaluations of calving difficulty. The models were univariate threshold animal
      (TAM), threshold sire-maternal grandsire (TSM), linear animal (LAM), and linear
      sire-maternal grandsire (LSM) models and bivariate threshold-linear animal
      (TLAM), threshold-linear sire-maternal grandsire (TLSM), linear-linear animal
      (LLAM), and linear-linear sire-maternal grandsire (LLSM) models for calving
      difficulty and birth weight. Data were obtained from the American Gelbvieh
      Association and included 84,420 first-parity records of both calving difficulty
      and birth weight. Calving difficulty scores were distributed as 73.4% in the
      first category (no assistance), 18.7% in the second, 6.3% in the third, and 1.6%
      in the fourth. Included in the animal models were fixed sex of calf by age of dam
      subclasses, random herd-year-season effects, and random animal direct and
      maternal breeding values. Sire-maternal grandsire models were similar to the
      animal models, with animal and maternal effects replaced by sire and maternal
      grandsire effects. Models were compared using a data splitting technique based on
      the correlation of estimated breeding values from two samples, with one-half of
      the calving difficulty records discarded randomly in the first sample and the
      remaining calving difficulty records discarded in the second sample. Reported
      correlations are averages of 10 replicates. The results obtained using animal
      models confirmed the slight advantage of TAM over LAM (0.69 vs 0.63) and TLAM
      over LLAM (0.90 vs 0.86). Bivariate analyses greatly improved the accuracy of
      genetic prediction of direct effects on calving difficulty relative to univariate
      analyses. Similar ranking of the models was found for maternal effects, but
      smaller correlations were obtained for bivariate models. For sire-maternal
      grandsire models, no differences between sire or maternal grandsire correlations
      were observed for TLSM compared to LLSM, and small differences were observed
      between TSM and LSM. The threshold model offered advantages over the linear model
      in animal models but not in sire-maternal grandsire models. For genetic
      evaluation of calving difficulty in beef cattle, the threshold-linear animal
      model seems to be the best choice for predicting both direct and maternal
      effects.

PMID- 11219440
TI  - The effects of grazing, liquid supplements, and implants on feedlot performance
      and carcass traits of Holstein steers.
AB  - In each of 2 yr, 20 Holstein steers (185+/-7 kg initial BW) were allocated to
      each of three treatments: pastured for 4.5 mo on grass/legume pastures and then
      fed 80% corn diets (DM basis) until slaughter; pastured for 4.5 mo on
      grass/legume pastures with ad libitum access to molasses-based protein
      supplements and fed 80% corn diets until slaughter; and placed in a feedlot and
      fed only 80% corn diets until slaughter (FEEDLOT). Half of the steers in each
      treatment were initially implanted with Revalor-S and not reimplanted.
      Supplemented steers on pasture had greater (P < 0.05) ADG than unsupplemented
      steers, and FEEDLOT steers gained faster and were fatter (P < 0.05) after 4.5 mo.
      Implanted steers had greater (P < 0.05) ADG with no significant treatment x
      implant status effect. Supplement intake was variable and related to ambient
      temperature. During the feedlot phase, steers previously on pasture had greater
      DMI and ADG (P < 0.05) but were not more efficient than FEEDLOT steers.
      Percentage of USDA Choice carcasses, fat thickness, dressing percentage, yield
      grade, and final weight were greater (P < 0.05) for FEEDLOT steers than for
      steers on other treatments. Implanting increased ADG of all steers but did not
      affect carcass traits, carcass composition, or feedlot performance during the
      finishing phase. Holstein steers consuming supplemented and unsupplemented
      pasture before slaughter will be leaner, have lower carcass weights, and have
      generally lower quality grades than those fed exclusively in a feedlot when
      slaughtered at similar ages.

PMID- 11219442
TI  - Genetic correlations for litter weight weaned with growth, prolificacy, and wool
      traits in Columbia, Polypay, Rambouillet, and Targhee sheep.
AB  - Total litter weight weaned at 120 d postpartum per ewe lambing is often believed
      to be a measure of range ewe productivity. Genetic correlations for litter weight
      weaned at 120 d with prolificacy, growth, and wool traits for Columbia, Polypay,
      Rambouillet, and Targhee sheep were estimated using REML with animal models.
      Observations per breed ranged from 5,140 to 7,083 for litter weight weaned, from
      5,140 to 7,095 for prolificacy traits, from 7,750 to 9,530 for growth traits, and
      from 4,603 to 18,443 for wool traits. Heritability estimates for litter weight
      weaned were low and ranged from 0.02 to 0.11. Fraction of variance due to
      permanent environmental effects averaged 0.05 and, due to effects of mates,
      averaged 0.01. Estimates of genetic correlations with litter weight weaned varied
      from breed to breed. The ranges were as follows: 0.42 to 0.65 with litter size
      born, 0.80 to 0.99 with litter size weaned, -0.22 to 0.28 with birth weight, 
      0.07 to 0.23 with average daily gain to weaning, -0.56 to 0.19 with fleece
      weight, -0.15 to 0.02 with fleece grade, and -0.11 to 0.08 with staple length.
      Results suggest that, if selection were practiced on litter weight weaned, the
      average correlated responses would be expected to be favorable or neutral for
      prolificacy, growth, and wool traits although responses might vary from breed to
      breed.

PMID- 11219443
TI  - Associations of heart and adipocyte fatty acid-binding protein gene expression
      with intramuscular fat content in pigs.
AB  - Intramuscular fat content is a major determinant of meat quality in pigs.
      Previously, polymorphisms in the adipocyte and heart fatty acid-binding protein
      genes, A-FABP and H-FABP, have been significantly associated with genetic
      variation of intramuscular fat content in a Duroc pig population. Further support
      for the role of H-FABP but not for A-FABP was found in a Meishan crossbred
      population. However, the effect of closely linked genes could not be excluded in
      these analyses. To validate the role of A-FABP and H-FABP in intramuscular fat
      accretion, 153 pigs of a crossbred genotype were evaluated for the A-FABP and H
      FABP polymorphisms, mRNA, and protein expression levels of both FABP genes and
      intramuscular fat content in the longissimus lumborum muscle. For H-FABP,
      statistical analyses showed significant differences in mRNA but not protein
      expression levels between H-FABP HaeIII PCR-RFLP genotype classes. Between these
      genotype classes, significant differences in intramuscular fat content were found
      within barrows but not in gilts. Moreover, H-FABP mRNA but not protein expression
      levels were significantly related to intramuscular fat content. For A-FABP
      genotype classes, no significant differences in mRNA and protein expression
      levels were found. However, a significant difference in intramuscular fat content
      was found within barrows but not in gilts. In addition, a significant
      relationship between A-FABP mRNA but not protein expression levels and
      intramuscular fat content was found. In conclusion, variation of intramuscular
      fat content could not be explained by differences in A-FABP and H-FABP mRNA and
      protein expression levels. However, this may be due to limitations of the assays
      used and(or) the inappropriateness of the time of sampling. Finally, results
      suggest that A-FABP and H-FABP expression are translationally rather than
      transcriptionally regulated.

PMID- 11219444
TI  - Breed effects on growth performance, carcass characteristics, fatty acid
      composition, and palatability attributes in finishing steers.
AB  - Crossbred steers (n = 136) were used to assess breed differences in growth
      performance, carcass characteristics, fatty acid composition (total lipids and
      phospholipids), and palatability attributes of longissimus muscle. A multiple
      regression model was applied to crossbreeding data to estimate genetic
      differences between Simmental and Red Angus at the same level of backfat finish
      (10 mm). Simmental spent 71 more (P < 0.001) days on feed to acquire the same
      degree of backfat thickness as Red Angus, had heavier (P < 0.001) slaughter
      weights, larger (P = 0.002) longissimus muscle area, and increased (P = 0.023)
      lean yield. Average daily gain did not differ (P = 0.297) between breeds.
      Simmental were less (P = 0.012) efficient in converting feed to gain than Red
      Angus. Generally, there were few breed differences in palatability attributes for
      longissimus and semitendinosus muscles, with the exception of increased (P <
      0.05) beef flavor scores for Simmental beef vs Red Angus beef across both
      muscles. For total lipids, concentrations of myristoleic acid (14:1), palmitoleic
      acid (16:1), and vaccenic acid (18:1n-7), along with n-6 to n-3 fatty acid (n-6:n
      3) ratio, were greater (P < 0.05) in Simmental than Red Angus. In contrast,
      concentrations of margaric acid (17:0), eicosapentaenoic acid (20:5n-3), and
      total n-3 polyunsaturated fatty acids (n-3 PUFA) were greater (P < 0.05) in Red
      Angus than Simmental. For phospholipids, Simmental had lower (P < 0.05) amounts
      of 20:5n-3, docosahexaenoic acid (22:6n-3), and n-3 PUFA, with a greater (P =
      0.017) n-6:n-3 ratio. Activity of delta9-desaturase enzyme in the conversion of
      palmitic acid (16:0) to 16:1 was greater (P = 0.001) in total lipids from
      Simmental as compared with Red Angus. A genetic basis for fatty acid differences
      is suggested, although the biological and practical significance needs to be
      demonstrated.

PMID- 11219445
TI  - Inbreeding and effective population size of Japanese Black cattle.
AB  - The objective of this research was to estimate the amount of inbreeding and
      effective population size of the Japanese Black breed using pedigree records from
      bulls and heifers registered between 1985 and 1997. Inbreeding was quantified by
      three F-statistics: actual inbreeding, inbreeding expected under random mating,
      and inbreeding due to population subdivision. During the period of 1985 to 1997,
      the inbreeding expected under random mating increased from 2.3% to 5.0%, whereas
      the increase of actual inbreeding was more gradual (from 4.7% to 5.4%). The
      inbreeding due to population subdivision decreased almost linearly and reached
      0.5% in 1997, indicating that genetic subdivision of the Japanese Black cattle
      population has essentially disappeared. The effective size of the breed was
      estimated from the increasing rate of inbreeding expected under random mating. In
      the earlier half of this period (1986 to 1990), the breed maintained an effective
      size of approximately 30. However, after 1991 the effective size sharply
      decreased and the harmonic mean between 1993 and 1997 was only 17.2. The main
      cause of this reduction of the effective size was considered to be the intensive
      use of a few prominent sires. To increase the effective size, an upper limit in
      the use of AI semen per sire should be imposed.

PMID- 11219446
TI  - Enterocyte digestive enzyme activity along the crypt-villus and longitudinal axes
      in the neonatal pig small intestine.
AB  - Our objective was to examine the distribution of enterocyte digestive enzyme
      activity along the crypt-villus and longitudinal axes of the small intestine in
      formula-fed neonatal pigs between the ages of 14 and 18 d. The distended
      intestinal sac method was used to isolate 12 sequential fractions (F1 through
      F12) of epithelial cells. Enterocyte migration rate was measured in the proximal
      and distal intestine using in vivo bromodeoxyuridine labeling. Specific
      activities of representative villus cell marker enzymes of alkaline phosphatase,
      aminopeptidase N, sucrase, and lactase increased 6- to 17-fold from F12 (crypt
      cells) to F1 (villus cells), whereas the crypt cell marker [3H]thymidine
      incorporation increased 8- to 18-fold from F1 (villus cells) to F12 (crypt
      cells). Enterocyte migration rate was similar (3.2 vs 3.0 microm/h), whereas the
      villus height (547.4 vs 908.5 microm) and enterocyte life span (4.7 vs 10.2 d)
      were markedly lower (P < 0.05) in the proximal than in the distal segments,
      respectively. In general, the specific activities of all enzymes were lowest in
      the crypt fractions (F9 through F12) but increased markedly (ranging from 8- to
      17-fold) from F12 to F1. The activity of aminopeptidase N was higher and that of
      sucrase was lower in the distal than in the proximal segment. The activities of
      the remaining enzymes were similar in the proximal and the distal segments. Our
      results suggest that the enterocyte life span in the distal small intestine is
      approximately twice as long as in the proximal small intestine. However, despite
      the difference in life span, the patterns of enzyme activities along the crypt
      villus axis were generally similar in the proximal and the distal regions.

PMID- 11219447
TI  - Muscle glycogen stores and meat quality as affected by strategic finishing
      feeding of slaughter pigs.
AB  - The aim of the present study was to investigate whether muscle glycogen stores in
      slaughter pigs could be decreased through strategic finishing feeding before
      slaughter. Moreover, preliminary meat quality traits were measured to see whether
      such a regulation of muscle glycogen stores affected ultimate pH, color, and
      tenderness in the meat. The strategic finishing feeding was carried out the last
      3 wk prior to slaughter. Seven experimental groups with eight animals per group
      were fed diets low in digestible carbohydrates. A control group with four animals
      was fed a traditional grower-finishing diet. The muscle glycogen stores were
      reduced in longissimus muscle (LM) 11 to 26% at the time of slaughter in pigs
      that were fed the experimental diets compared with the control group. Meat
      quality measured as ultimate pH and color on LM muscle in half the pigs 24 h
      postmortem showed that ultimate pH in LM was not affected by the reduction in
      glycogen stores in the muscles from pigs fed any of the experimental diets.
      However, the meat from pigs fed the experimental diets was darker than the meat
      from pigs that were fed the control diet with two of the experimental diets,
      resulting in significantly lower L* values. Activities of key enzymes in the
      glycolytic pathway, glycogen phoshorylase a and b, phosphofructokinase, and the
      fatty acid oxidative pathway, beta-hydrozyacyl-CoA-dehydrogenase, were not
      affected by the strategic feeding. In contrast, the activity of the proteolytic
      enzyme calpain as well as its inhibitor calpastatin was influenced by the
      strategic feeding. Lower activity of mu-calpain and greater activity of
      calpastatin in the muscle samples from the strategically fed pigs indicate a
      lesser muscle protein degradation in the muscles compared with muscles of control
      animals. The present study showed that the muscle glycogen stores in slaughter
      pigs can be reduced at the time of slaughter through strategic finishing feeding
      with diets low in digestible carbohydrate without compromising growth rate.

PMID- 11219448
TI  - The influence of ultimate pH and intramuscular fat content on pork tenderness and
      tenderization.
AB  - Intramuscular fat (IMF) and ultimate pH (pHu) influence tenderness, but their
      roles have not been conclusively determined. Length of storage also affects
      tenderness and may interact with IMF and pHu. We evaluated the effects of pHu,
      IMF, and storage time on the tenderness of pork longissimus muscle and determined
      whether the contribution of the various factors was dependent on genetic line. To
      obtain variation in IMF, Berkshire (B), Duroc (D) and Hampshire (H) boars were
      crossed with Yorkshire-Landrace sows. In four trials, a total of 176 pigs were
      used. To obtain a range in pHu, half of the pigs were deprived of feed before
      slaughter. Warner-Bratzler shear force (WBS) of each loin was assessed after 2,
      7, and 14 d of storage at 0 to 2 degrees C. Warner-Bratzler shear force decreased
      (P < 0.05) from 4.89 kg at d 2 to 4.16 kg at d 7 to 3.52 kg at d 14. The H pork
      (n = 62) had a lower (P < 0.05) WBS than the other pork at d 2. After 7 d of
      storage, this difference had disappeared. Based on glycolytic potential, 30 of
      the H pigs were carriers of the Rendement Napole (RN) gene. When these pigs were
      excluded from the analysis, there was no difference in tenderness or
      tenderization of H, D, and B pork. The correlation between IMF and WBS was -0.11
      at d 2, -0.21 at d 7, and -0.19 at d 14. In D pork, the relationship between IMF
      and WBS was linear, and IMF accounted for 47% of the differences in WBS. In H and
      B pork, the relationship between IMF and WBS was not significant. For each cross,
      the relationship between pHu and WBS was different; in D pork it was quadratic,
      in H pork WBS increased linearly, and in B pork there was no significant
      relationship between WBS and pHu. The 30 kDa/actin ratio, a measure of
      myofibrillar degradation, increased (P < 0.05) during storage. Differences in 30
      kDa/actin ratio did not explain differences in pork tenderness or tenderization.
      Further research on determinants and mechanisms of pork tenderness and pork
      tenderization is needed before production of consistently tender pork will be
      possible.

PMID- 11219449
TI  - The calpain system in three muscles of normal and callipyge sheep.
AB  - Activities of mu- and m-calpain and of calpastatin were measured at four
      different times during postmortem storage (0, 1, 3, and 10 d) in three muscles
      from either callipyge or noncallipyge (normal) sheep. The weights of two muscles,
      the biceps femoris and the longissimus, are greater in the callipyge phenotype,
      whereas the weight of the infraspinatus is not affected. The activity of m
      calpain was greater (P < 0.05) in the biceps femoris and longissimus from
      callipyge than in those from normal sheep, but it was the same in the
      infraspinatus in the two phenotypes. The extractable activity of m-calpain did
      not change (biceps femoris and infraspinatus) or decreased slightly (longissimus)
      during postmortem storage. Extractable activity of mu-calpain decreased to zero
      or nearly zero after 10 d postmortem in all muscles from both groups of sheep.
      The rate of decrease in mu-calpain activity was the same in muscles from the
      callipyge and normal sheep. At all time points during postmortem storage,
      calpastatin activity was greater (P < 0.05) in the biceps femoris and longissimus
      from the callipyge than from the normal sheep, but it was the same in the
      infraspinatus from callipyge and normal sheep. Calpastatin activity decreased (P
      < 0.05) in all three muscles from both phenotypes during postmortem storage; the
      rate of this decrease in the callipyge biceps femoris and longissimus and in the
      infraspinatus from both the callipyge and normal sheep was slow, especially after
      the first 24 h postmortem, whereas calpastatin activity in the biceps femoris and
      longissimus from the normal sheep decreased rapidly. During postmortem storage,
      the 125-kDa calpastatin polypeptide was degraded, but the 80-kDa subunit of mu
      calpain was cleaved only to 76- and 78-kDa polypeptides even though extractable
      mu-calpain activity declined nearly to zero. Approximately 50 to 60% of total mu
      calpain became associated with the nonextractable pellet after 1 d postmortem.
      The myofibril fragmentation index for the biceps femoris and longissimus from
      normal sheep increased significantly during postmortem storage. The fragmentation
      index for the infraspinatus from the callipyge and normal sheep increased to an
      intermediate extent, whereas the index for the biceps femoris and longissimus
      from the callipyge did not change during 10-d postmortem storage. The results
      suggest that postmortem tenderization is related to the rate of calpastatin
      degradation in postmortem muscle and that calpastatin inhibition of the calpains
      in postmortem muscle is modulated in some as yet unknown manner.

PMID- 11219450
TI  - Dietary phosphorus and an inflammatory challenge affect performance and immune
      function of weanling pigs.
AB  - Ninety-six 3-wk-old pigs (6.3+/-0.12 kg initial BW) were allotted to one of eight
      treatments based on BW and litter origin to determine the effect of dietary
      phosphorus and an inflammatory challenge on performance and immune function. Four
      corn-soybean meal-based treatment diets were formulated to contain 0.16, 0.24,
      0.32, or 0.40% available P. Monocalcium-dicalcium phosphate was used as the
      supplemental P source. The Ca:available P ratio was maintained at 2:1. To
      challenge the pigs, half of the pigs in each dietary treatment were injected i.m.
      with E. coli lipopolysaccharide (200 microg/kg of BW) on d 7 and 14. This
      resulted in a 2 x 4 factorial arrangement of treatments. Average daily gain for
      the 35-d study was increased linearly (P < 0.01) by increasing supplemental P.
      Average daily gain and ADFI were decreased (P < 0.05) by lipopolysaccharide
      injection. Serum P concentrations increased linearly (P < 0.01) with increasing
      supplemental P. Antibody titers to the injection of sheep red blood cells and
      ovalbumin on d 21 decreased linearly (P < 0.10) by increasing supplemental P. In
      vitro blastogenic response of lymphocytes to phytohemagglutinin (PHA) on d 25 was
      increased linearly (P < 0.05) by increasing supplemental P. Blastogenic response
      of lymphocytes to pokeweed mitogen on d 25 was not affected. On d 31, skinfold
      thickness 6 h following an intradermal injection of PHA was increased
      quadratically (P < 0.07) by increasing supplemental P. There were no P x
      lipopolysaccharide interactions for any immune response measure. In conclusion,
      increasing supplemental P increased ADG and enhanced cell-mediated immune
      response but decreased humoral immune response.

PMID- 11219451
TI  - Effects of postweaning dietary energy source on reproductive traits in
      primiparous sows.
AB  - An experiment was conducted to study the effects of major dietary energy source
      fed from weaning to ovulation or from ovulation to d 35 of pregnancy on
      reproductive traits in primiparous sows. Dietary energy sources were used to
      manipulate the plasma insulin concentration. One hundred thirteen sows were used
      in a split-plot design. From weaning to ovulation sows were fed at two times
      maintenance either a diet with tallow (Fat) or maize starch plus dextrose
      (Starch) as the major energy source. From ovulation onward, sows within each
      dietary group were alternately reassigned to either the Fat or the Starch diet
      and were fed at 1.25 times maintenance. Estrus detection was performed three
      times a day from d 3 to 9 after weaning and sows were inseminated each day of
      standing estrus. On d 35 of pregnancy, the sows were slaughtered and their
      reproductive tracts were removed. Plasma insulin concentration was higher in sows
      fed the Starch-rich diet than in sows fed the Fat-rich diet on d 4 after weaning
      (1.30 vs 0.97 ng/mL, P = 0.08) and on d 32 of pregnancy (1.20 vs 0.51 ng/mL, P <
      0.001). Plasma glucose and IGF-I concentration on d 4 after weaning and d 32 of
      pregnancy did not differ between sows on the two dietary energy sources. The
      percentage of sows exhibiting estrus within 9 d after weaning was 52 and 67% for
      the Fat and Starch diet before ovulation, respectively (P = 0.11), whereas the
      weaning-to-estrus interval was 134 vs 123 h, respectively (P = 0.12). Survival
      analysis showed that sows fed the Fat-rich diet had a 1.6 times higher risk to
      remain anestrous until d 9 after weaning than sows fed the Starch-rich diet (P =
      0.04). No effect of dietary energy source, either before or after ovulation, on
      uterine, placental, or embryonal development on d 35 of pregnancy was found. It
      can be concluded that the dietary energy source provided after weaning can affect
      the risk of sows to remain anestrous but does not affect uterine, placental, or
      embryonic traits.

PMID- 11219452
TI  - Liquid diets accelerate the growth of early-weaned pigs and the effects are
      maintained to market weight.
AB  - Piglets (n = 240, 11.0+/-0.1 d old, 3.93+/-0.05 kg) were allotted to one of four
      treatments in a 2 x 2 factorial arrangement to examine the effects of diet
      physical form and nursery environment during the first 14 d after weaning on
      growth to market weight. During the treatment period, pigs were housed (10 pigs/
      pen) in either a conventional hot nursery (30 degrees C) or a segregated
      temperature nursery (cool ambient temp. of 24 degrees C, with enclosed hot-box
      hovers at 32 degrees C). Pigs in each environment were fed nutritionally
      identical diets in either liquid or dry-pellet form for 14 d. Subsequently, all
      pigs were fed identical dry diets and were housed in common grower-finisher
      facilities (penned by sex, five pigs/pen). At the end of the treatment period (d
      14), pigs fed the liquid diet were 21% heavier than pigs fed the dry pellet diet
      (9.22 vs 7.60 kg; P < 0.001). Similarly, gain, feed intake, and gain/feed of
      liquid-fed pigs were 44%, 18%, and 22% greater, respectively, than observed for
      pigs fed the dry pellet diet. No main effect of environment was observed (P >
      0.10); however, an interaction with diet physical form occurred during the early
      nursery period (P < 0.01). Pigs fed the liquid diet showed better performance in
      the conventional nursery, whereas pigs fed the dry pellet diet were favored in
      the segregated-temperature nursery. No major differences in growth performance or
      in ultrasound carcass measurements were detected during the growing-finishing
      period; however, the advantage in body weight of liquid-fed pigs gained during
      the first 2 wk postweaning was maintained to the end of the trial (113.9 vs 110.6
      kg; P < 0.05). Pigs that were fed the early-nursery diet in liquid form reached
      market weight (110 kg) 3.7 d sooner than the dry-fed controls (P < 0.01).
      Estimates of lean gain (calculated from live ultrasound data) were unaffected,
      suggesting that composition of growth was not altered. Collectively, these
      results show that liquid feeding during early life can markedly accelerate piglet
      growth performance and that the growth advantage is maintained to market weight,
      with no evidence of compensatory gain in the dry-fed control pigs.

PMID- 11219453
TI  - In vitro fermentation characteristics of native and processed cereal grains and
      potato starch using ileal chyme from dogs.
AB  - Two in vitro experiments were conducted to evaluate the ability of small
      intestinal bacteria of dogs to ferment native and extruded cereal grains and
      potato starch and cereal grain and potato flours. Substrates included barley,
      corn, potato, rice, sorghum, and wheat. In addition to testing native grains and
      flours, extruded substrates also were tested. Substrates were extruded at low
      temperatures (LT; 79 to 93 degrees C) and high temperatures (HT; 124 to 140
      degrees C) using a Wenger extruder (model TX-52). Substrates varied widely in
      concentrations of rapidly digestible starch (RDS), slowly digestible starch
      (SDS), resistant starch (RS), and total starch (TS). Extrusion of most substrates
      at HT vs LT resulted in increased RDS and decreased RS concentrations. Organic
      matter disappearance (OMD) values attributed to microbial fermentation for a 5-h
      period were as high as 27% for native extruded substrates (LT potato starch) and
      39% for potato flour. Average OMD was higher for cereal and potato flours than
      for native extruded substrates (29.9 vs 25.4%). Average molar percentages of
      short-chain fatty acids produced from all substrates fermented for 5 h were 73,
      14, and 13% (acetate, propionate, and butyrate, respectively). Average lactate
      production for substrates ranked as follows: flours > native and extruded cereal
      grains and potato starch (0.33 and 0.18 mmol/g OM, respectively). In vitro
      microbial fermentation of starches by ileal bacteria can be substantial and is
      affected by differences in starch source, fraction, and processed form.

PMID- 11219455
TI  - Effects of the perfusion of beta-, beta2-, or beta3-adrenergic agonists or
      epinephrine on in situ adipose tissue lipolysis measured by microdialysis in
      underfed ewes.
AB  - The effects of isoproterenol (ISO, a non-selective beta-agonist), terbutaline
      (TER, a selective beta2-agonist), CL316243 (CL, a selective beta3-agonist), and
      epinephrine (EPI, beta- and alpha2-agonist) on in situ lipolytic response of s.c.
      adipose tissue were investigated in vivo, using a microdialysis method to measure
      glycerol release, in 12 adult nonlactating and ovariectomized, underfed Lacaune
      ewes. All the adrenergic compounds were perfused for 120 min at 10(-6), 10(-5),
      and 10(-4) M. They had no lipolytic effect at 10(-6) M. Isoproterenol and EPI at
      10(-5) and 10(-4) M enhanced, in the same way, maximal response and area under
      the concentration curve (AUC) of dialysate glycerol, thus suggesting that
      involvement of alpha2-adrenoceptors in the control of in situ lipolysis is of
      minor importance in underfed ewes. Terbutaline had only a slight lipolytic effect
      at 10(-5) M. This low effect could be due to a lower affinity of TER than of ISO
      for the beta2-adrenoceptors. The beta3-agonist, CL, had no lipolytic effect
      whatever the concentration perfused. Further studies are needed to prove the
      putative presence of beta3-adrenoceptors and their possible role in the ovine
      adipose tissue.

PMID- 11219456
TI  - The influence of the phase of the estrous cycle on sheep endometrial tissue
      response to lipopolysaccharide.
AB  - The effect of lipopolysaccharide on ovine endometrial tissue was examined at
      estrus (follicular phase) and during the luteal phase. Endometrial tissues were
      cultured with 0, 1, or 10 microg/mL lipopolysaccharide. After 24 h, culture
      supernates were harvested and analyzed for PGF2alpha, PGE2, 6-keto-PGF1alpha,
      thromboxane B2 (TXB2), and cysteinyl-leukotrienes (leukotrienes) using EIA.
      Homogenates of endometrial tissue were analyzed for prostaglandin endoperoxidase
      1 (PTGS-1), and -2 (PTGS-2) as well as Type-I, -II, and -III nitric oxide
      synthase (NOS) by Western analysis. Follicular phase tissue produced more
      PGF2alpha (P < 0.001), TXB2 (P < 0.001), and leukotrienes (P < 0.02) than luteal
      tissue. Lipopolysaccharide increased PGE2 (P < 0.001) and TXB2 (P < 0.02)
      production by endometrial tissue. Elevations in these eicosanoids were likely due
      to the measured increases in PTGS-2 (P = 0.002) because no changes in PTGS-1 (P =
      0.54) or Type-I, -II, or -III NOS (P > or = 0.20) occurred in endometrial tissue
      following lipopolysaccharide exposure. These data suggest that the phase of the
      estrous cycle regulates prostaglandin production by immune-challenged endometrial
      tissue.

PMID- 11219454
TI  - Effects of recombinant ovine leptin on in vitro lipolysis and lipogenesis in
      subcutaneous adipose tissue from lactating and nonlactating sheep.
AB  - Direct effects of recombinant ovine leptin on adipose metabolism in sheep were
      investigated. Lipolytic and lipogenic rates were assessed following preincubation
      of subcutaneous adipose tissue explants with recombinant ovine leptin. Leptin had
      no consistent effect on the basal (unstimulated) lipolytic rate in adipose tissue
      from wethers. Lipolytic rate measured in the presence of combinations of
      adenosine deaminase, isoprenaline, and N6-phenylisopropyl adenosine was
      unaffected by pretreatment with leptin. In lactating ewes, there was no
      relationship between increasing concentrations of leptin and basal lipolytic
      rate. Leptin had no effect on basal (unstimulated) lipogenesis, or on insulin
      stimulation or growth hormone inhibition of lipogenesis in adipose tissue from
      wethers. Lipogenesis in adipose tissue from lactating ewes was also unaffected by
      preincubation with leptin; however, at supraphysiological concentrations of
      leptin, there was a small reduction in the rate of insulin-stimulated
      lipogenesis. Leptin failed to induce phosphorylation of the signal transducers
      and activators of transcription, STAT 3 and STAT 5, in sheep adipocytes. These
      results suggest that leptin does not have a direct physiological effect on
      subcutaneous adipose tissue metabolism in sheep.

PMID- 11219457
TI  - Genetic variation in stimulated GH release and in IGF-I of young dairy cattle and
      their associations with the leucine/valine polymorphism in the GH gene.
AB  - Genetic variations in plasma GH concentrations before and following thyrotropin
      releasing hormone (TRH) stimulation and in IGF-I concentrations were studied in
      11-mo-old Polish Friesian cattle (104 heifers and 110 bulls). A possible
      association between stimulated GH release, IGF-I, and the polymorphism in the GH
      gene causing substitution of leucine-Leu to valine-Val at amino acid position 127
      of the protein was also investigated. The GH concentrations were determined in
      serial plasma samples collected every 15 min from 15 min before to 135 min after
      intravenous administration of 0.15 microg TRH/kg live weight. The analysis was
      performed on three variables: baseline (mean of samples at -15 and 0 min), peak
      (sample at 15 min after injection) and rate (peak minus sample at 60 min, divided
      by 45 min). The IGF-I concentrations were measured in plasma samples taken before
      the TRH stimulation. Additionally, first lactation records from the 75 cows
      earlier tested for GH release and IGF-I were used to study a possible association
      of milk production traits with GH genotypes. The data were analyzed by
      multivariate mixed linear models. The heritability of IGF-I reached a higher
      value (0.35) than variables baseline, peak, and rate (0.02, 0.14, and 0.14,
      respectively). The GH variables were positively genetically correlated with each
      other (0.22 to 0.93), whereas they had negative genetic correlations with IGF-I (
      0.26). The Val/Val genotypes reached the highest peak value compared with other
      GH genotypes (P > 0.01), whereas the Leu/Leu genotypes had the highest IGF-I
      concentrations (P < or = 0.05). Moreover, the Leu/Val heterozygotes were superior
      to others in milk and protein yields, whereas the Leu/Leu homozygotes reached the
      highest fat yield (P > or = 0.01). We conclude that GH peak, GH rate, and IGF-I
      are heritable traits in young dairy cattle and are affected by the Leu/Val
      polymorphism in the GH gene.

PMID- 11219458
TI  - Influence of intraduodenally infused olive and coconut oil on postprandial
      exocrine pancreatic secretions of growing pigs.
AB  - The effect of dietary vegetable oils differing in fatty acid composition that
      were infused directly into the duodenum on exocrine pancreatic secretions in pigs
      has not previously been studied. The objective of the present study was to
      determine the acute response of the exocrine pancreas to vegetable oils with
      various fatty acid profiles under prandial conditions. Six growing pigs (BW 13.2
      kg) were surgically prepared with pancreatic duct catheters and duodenal
      reentrant T-cannulas. The animals were fed twice a day (1000 and 1600) a
      commercial weaner diet at a rate of 2% of BW. Beginning with the morning feeding,
      olive oil, coconut oil, or saline as a control were infused in boluses every 5
      min in total 0.1% of BW over a period of 1 h directly into the duodenum according
      to a 3 x 3 Latin square design. Pancreatic juice was collected over a period of 4
      h, beginning 1 h preprandially (0900) until 3 h postprandially (1300). A time
      effect was observed after the infusion of olive oil on the volume of secretion,
      on protein contents and outputs, as well as on lipase contents and outputs and on
      colipase contents. The infusion of saline and coconut oil changed the runs of the
      curves for lipase and colipase outputs. No time x treatment interactions were
      observed regarding volume of secretion, protein contents and outputs, trypsin
      contents and outputs, and lipase outputs. The runs of the curves for lipase
      contents were different between the olive oil and saline treatment and between
      the olive oil and coconut oil treatment. The runs of the curves for the olive oil
      and saline treatment differed from each other regarding colipase contents. Pooled
      values of colipase outputs were elevated after coconut oil treatment, and a
      positive correlation between trypsin and colipase contents was found. Under
      prandial conditions, the exocrine pancreas responds differently in its acute
      secretion to different vegetable oils due to the differences in the fatty acid
      profiles.

PMID- 11219459
TI  - Genetic and phenotypic parameters for dietary selection of mountain big sagebrush
      (Artemisia tridentata Nutt. ssp. vaseyana.
AB  - The heritability of diet selection for mountain big sagebrush (Artemisia
      tridentata Nutt. ssp. vaseyana [Rydb] Beetle) by grazing sheep was estimated from
      fecal samples collected from 549 Rambouillet ewes. Fecal samples were collected
      in September and October during 1996 and 1997 from free-grazing ewes on
      intermountain sagebrush-bunchgrass rangelands at the U.S. Sheep Experiment
      Station in Idaho. The total number of fecal samples was 1,949. Fecal samples were
      evaluated for composition of big sagebrush by near-infrared spectroscopy.
      Percentage of sagebrush in the diet was less in September than in October (21.6
      vs 31.7%, respectively). Single-trait and bivariate derivative-free REML analyses
      were performed to genetically compare percentage of sagebrush in the diet in
      September and October. Heritability estimates were similar between September and
      October measurements (0.25 and 0.28, respectively). The genetic correlation
      between September and October percentages of sagebrush in the diet was high
      (0.91), implying that there is strong genetic similarity between September and
      October measurements and that an annual measurement may be sufficient for
      selection. These results contribute to a greater understanding of dietary
      preferences in freely grazing sheep, and suggest opportunities to improve
      production efficiency and forage management through selection for dietary
      preferences.

PMID- 11219460
TI  - Performance of light vs heavy steers grazing Plains Old World bluestem at three
      stocking rates.
AB  - Live weight gains of light and heavy calves grazing Plains Old World bluestem at
      three stocking rates were evaluated during the summers of 1997 and 1998. Initial
      weights of mixed-breed light-weight steers (LHT) were 141 SD = 17 kg (n = 214) in
      1997 and 160 SD = 23 kg (n = 193) in 1998. Initial weights of mixed-breed heavy
      steers (HWT) were 265 SD = 17 kg (n = 115) in 1997 and 248 SD = 13 kg (n = 126)
      in 1998. Initial stocking rates for both sizes of steers were as follows: light,
      392 kg of live weight/ha; moderate, 504 kg of live weight/ha (increased to 616 kg
      live weight/ha in 1998); and heavy, 840 kg of live weight/ ha. Averaged gain and
      gain/hectare are reported as stocking rate by steer type within year. Heavy
      steers had greater ADG than LHT steers during both years. Forage intake,
      expressed as a percentage of BW, was greater (P = 0.05) for LHT (3.1%) than for
      HWT (2.8%) calves. Grazing time (min/d; 1998 only) was greater (P = 0.05) for LHT
      (665) than for HWT (624) steers. Forage CP and in vivo digestible organic matter
      (DOM) were slightly greater (P < 0.05) in pastures grazed by HWT vs LHT cattle.
      Gain/hectare was greater (P < 0.05) for LHT than for HWT calves at all three
      stocking rates during both years. A linear decline in ADG was observed (P < 0.07)
      as stocking rates increased for HWT steers in 1997 and LHT steers in 1998.
      However, ADG did not decline with increasing stocking rate for LHT calves during
      1997 or HWT calves during 1998. Forage intake was not different among stocking
      rates in either 1997 or 1998. Grazing time was greatest (P < 0.05) for steers in
      the moderate and heavy stocking rates. Forage in vivo DOM decreased (P < 0.05) as
      stocking rate increased. Both LHT and HWT steers had lower (P < 0.05) ADG at all
      three stocking rates during 1998 compared with 1997. Despite lower ADG, LHT
      steers had greater gain/hectare than HWT steers during both 1997 and 1998.

PMID- 11219461
TI  - Hydrolyzable carbohydrates in pasture, hay, and horse feeds: direct assay and
      seasonal variation.
AB  - Carbohydrates may be hydrolyzed or fermented in the digestive tract, and this
      distinction is important for the evaluation of the diet of herbivores. Both
      hydrolyzable and fermentable carbohydrates are included in the nonstructural
      carbohydrate (NSC) fraction as estimated by difference using proximate analysis.
      Our objectives were to measure hydrolyzable carbohydrates in forages and
      concentrates, to compare these values with nonstructural carbohydrate, to test
      for prediction of hydrolyzable carbohydrate concentration in forages from its
      near-infrared spectrum, and to examine seasonal variation of carbohydrates in
      pasture. Samples of forages (107) and concentrates (25) were collected, dried,
      ground, and analyzed for NSC (calculated as 100 - water - CP - fat - ash - NDF),
      hydrolyzable carbohydrate (CHO-H, direct analysis), and rapidly fermentable
      carbohydrate (NSC minus CHO-H). Hydrolyzable carbohydrate accounted for 97% or
      more of the NSC in the concentrates but only 33% in pasture and hay. A two-term
      polynomial equation fit all the data: CHO-H = 0.154 x NSC + 0.00136 x NSC2, R2 =
      0.98, P < 0.0001, n = 132. In 83 pasture samples, CHO-H concentrations were
      predicted by near-infrared spectra with a calibration R2 of 0.97, a mean of 48
      g/kg, and a SE of calibration of 3.5 g/kg DM. In pasture samples collected
      between September 1995 and November 1996, the coefficient of variation was 31%
      for both CHO-H and rapidly fermentable carbohydrate (CHO-FR); the largest
      increments were 31 g/kg of CHO-H from September to October and 41 g/kg of CHO-FR
      from February to March. The increased risk of certain diseases, such as laminitis
      and colic, that have been previously associated with an abrupt overload of NSC
      may be more precisely attributed to CHO-H in grain concentrates, and to CHO-H as
      well as CHO-FR in pastures.

PMID- 11219462
TI  - Retention time of macerated alfalfa hay and silage in sheep.
AB  - Fresh alfalfa was mowed and conditioned mechanically at four levels: a control
      (rubber rolls), macerated once (a single passage through three finely corrugated
      rolls set at 1-mm clearance), macerated twice (two passages), and macerated
      thrice (three passages). Alfalfa was then field-wilted either for 45 h and
      conserved as chopped silage at 30% dry matter (DM) or for 94 h and stored as
      baled hay at 85% DM. The eight forage treatments (four mechanical conditioning
      levels x two conservation systems) were fed to 24 sheep (three replications per
      treatment) during 5 wk. At the beginning of wk 5, a 15-g sample of chromium
      mordanted forage (3.5% Cr) was fed to each sheep, and feces samples were
      collected at 30 different times over 7 d, between 10 h and 168 h after Cr
      ingestion. Four models were used to estimate the passage rates, the time delay,
      and the mean retention time (MRT). A two-compartment time-dependent model and a
      multicompartment model produced the best fit (average r2 of 0.96) to represent
      the Cr concentration in the feces over time. When compared with alfalfa hay,
      alfalfa silage had a higher (P < 0.01) time-dependent turnover rate (0.0949 vs
      0.0733/h), a lower (P = 0.03) time delay (9.1 vs 11 h), and a lower (P = 0.04)
      MRT (57.8 vs 64.4 h). Maceration did not affect significantly (P > 0.10) the time
      delay or the MRT. However, the MRT of macerated alfalfa hay tended to be higher
      than the MRT of control hay. Experimental data based on marker concentration in
      the feces can be used satisfactorily to assess differences in MRT between
      treatments, but they should be used with caution to estimate the partition of
      retention time within the gastrointestinal tract.

PMID- 11219464
TI  - The amino acid profiles of the whole plant and of four plant residues from
      temperate and tropical forages.
AB  - This study compared the amino acid (AA) profile of five residues (original
      forage, borate-phosphate buffer residue (BPR), neutral detergent fiber residue
      with (NDF+) and without (NDF-) sodium sulfite, and acid detergent fiber residue
      (ADF). Fourteen grasses and legumes from tropical and temperate regions were used
      in this study. The use of sodium sulfite did not affect the NDF concentration,
      but the NDF insoluble protein was lower (P < 0.05) in the NDF+ than in the NDF-
      (3.9 vs 4.5% DM, respectively). For all of the amino acids tested, the amino acid
      content, expressed as a percentage of CP, was lower in the ADF residue than in
      the original forage. There were no differences in the amino acid concentrations
      of the NDF- and NDF+ extracts (P > 0.05). Only in the case of methionine was
      there a difference in the amount of amino acid when the original forage was
      compared with the BPR (1.84 vs 1.45 % CP). When the AA profile of each residue
      was corrected for the AA content of the ADF, no difference was observed between
      the AA profile of the original forage and of the BPR (P > 0.05). Similar to the
      result without correction for the amino acids in ADF, the AA profiles of the NDF+
      and NDF- fractions were similar (P > 0.05). From this result, we infer that the
      sodium sulfite had similar effects on all AA in the NDF residue that we tested.
      There were differences in amino acid concentrations in the original forage and
      the NDF residues for several amino acids (Met, Cys, Lys, Thr, Arg, Ile, Leu, and
      Phe) (P < 0.05). When the amino acid values of the original forage and the BPR
      were used with animal data in the Cornell Net Carbohydrate and Protein System
      model, few differences in animal predicted performance were evident. These
      findings suggest that the AA profile of the original forage can be used to
      predict the AA profile of the undegraded intake protein instead of using the
      borate-phosphate buffer residue for amino acid analyses. This would simplify
      obtaining feed amino acid values for use in the Cornell Net Carbohydrate and
      Protein System.

PMID- 11219463
TI  - Fermentation characteristics and ruminal ciliate protozoal populations in cattle
      fed medium- or high-concentrate barley-based diets.
AB  - Fermentation characteristics were measured and numbers and distribution by genera
      of ciliate protozoa were determined in ruminal fluid samples collected from 10
      ruminally cannulated steers during the first 30 d of their being fed barley-based
      diets containing 62% (Medium Barley) or 95% (High Barley) barley grain (DM
      basis). Ruminal samples were collected at 5-d intervals over the 30-d periods
      beginning after adaptation (i.e., at the first full feeding of each diet).
      Ruminal pH and ammonia concentrations were lower (P < 0.001) with the High Barley
      than with the Medium Barley diet. Concentrations of total VFA and propionate and
      amylase activity of ruminal fluid were higher (P < 0.001) on High Barley than on
      Medium Barley. Total protozoal numbers in ruminal fluid were 42% lower (P < 0.05)
      on High Barley (470 x 10(3)/mL) than on Medium Barley (804 x 10(3)/mL). On Medium
      and High Barley diets, respectively, Entodinium spp. made up 89 and 91% of the
      ciliate protozoal populations. With the Medium Barley diet, relative proportions
      of Dasytricha, Ophryoscolex, Ostracodinium, Diplodinium, and Metadinium spp. in
      the total ciliate population were 4.5, 0.4, 0.5, 0.7, and 0.3%, respectively.
      When the High Barley diet was fed, these genera were not detected. In a
      subsequent survey, ruminal samples were collected from 200 finishing cattle at
      slaughter. Average protozoal population was 328 x 10(3)/mL, and Entodinium spp.
      constituted 97% of the total. These data demonstrate that a large population of
      Entodinium spp. can persist in the rumen of cattle fed high barley grain-based
      finishing diets.

PMID- 11219465
TI  - Effect of ruminal protein degradability on growth and N metabolism in growing
      beef steers.
AB  - The objective of two experiments was to correlate plasma levels of urea N (PUN)
      and the percentage of urine N in the form of urea (UUN) to weight gain in
      response to different dietary protein regimens for growing Angus steers. In Exp.
      1, 60 steers (302 kg BW) were assigned to various levels of dietary N (control
      plus supplemental N to provide from 100 to 400 g more crude protein daily) within
      two sources of supplemental N (soybean meal [SBM] or a mixture of two parts corn
      gluten meal:one part blood meal [CGM:BM]). In Exp. 2, 27 steers (229 kg BW) were
      fed two levels of SBM, and half of the steers received growth-promoting implants.
      Steers were housed in groups of 12 and fed individually for 84 d in both
      experiments. Corn silage was fed at a restricted rate to minimize orts. Jugular
      blood and urine samples were collected during the experiments. In Exp. 1, maximal
      ADG of steers fed SBM (1.0 kg) was reached with 671 g/d total crude protein, or
      531 g/d metabolizable protein. Maximal ADG of steers fed CGM:BM (0.91 kg) was
      reached with 589 g/d total crude protein, or 539 g/d metabolizable protein. The
      DMI was higher (P < 0.07) for steers fed SBM (6.37 kg/d) than for steers fed
      CGM:BM (6.14 kg/d). Increasing ruminal escape protein from 36% (SBM) to 65%
      (CGM:BM) of CP decreased (P < 0.05) endogenous production of urea, as evidenced
      by lower concentrations of urea in blood and lower UUN. In Exp. 2, increasing
      supplemental protein from 100 to 200 g/d increased (P < 0.05) ADG and PUN.
      Implants lowered (P < 0.05) UUN, particularly at the higher level of supplemental
      protein. Protein supplementation of growing steers can be managed to maintain
      acceptable ADG yet decrease excretion of urea in the urine.

PMID- 11219466
TI  - Ergot alkaloid transport across ruminant gastric tissues.
AB  - Ergot alkaloids cause fescue toxicosis when livestock graze endophyte-infected
      tall fescue. It is generally accepted that ergovaline is the toxic component of
      endophyte-infected tall fescue, but there is no direct evidence to support this
      hypothesis. The objective of this study was to examine relative and potential
      transport of ergoline and ergopeptine alkaloids across isolated gastric tissues
      in vitro. Sheep ruminal and omasal tissues were surgically removed and placed in
      parabiotic chambers. Equimolar concentrations of lysergic acid, lysergol,
      ergonovine, ergotamine, and ergocryptine were added to a Kreb's Ringer phosphate
      (KRP) solution on the mucosal side of the tissue. Tissue was incubated in near
      physiological conditions for 240 min. Samples were taken from KRP on the serosal
      side of the chambers at times 0, 30, 60, 120, 180, and 240 min and analyzed for
      ergot alkaloids by competitive ELISA. The serosal KRP remaining after incubation
      was freeze-dried and the alkaloid species quantified by HPLC. The area of ruminal
      and omasal tissues was measured and the potential transportable alkaloids
      calculated by multiplying the moles of transported alkaloids per square
      centimeter of each tissue type by the surface area of the tissue. Studies were
      conducted to compare alkaloid transport in reticular, ruminal, and omasal tissues
      and to determine whether transport was active or passive. Ruminal tissue had
      greater ergot alkaloid transport potential than omasal tissue (85 vs 60 mmol)
      because of a larger surface area. The ruminal posterior dorsal sac had the
      greatest potential for alkaloid transport, but the other ruminal tissues were not
      different from one another. Alkaloid transport was less among reticular tissues
      than among ruminal tissues. Transport of alkaloids seemed to be an active
      process. The alkaloids with greatest transport potential were lysergic acid and
      lysergol. Ergopeptine alkaloids tended to pass across omasal tissues in greater
      quantities than across ruminal tissues, but their transport was minimal compared
      to lysergic acid and lysergol.

PMID- 11219467
TI  - Rapid communication: Microsatellites isolated from BAC clones containing v-akt1
      murine thymoma viral oncogene homolog 1 and bradykinin receptor B2 assigned to
      sheep chromosome 18 by linkage analysis.

PMID- 11219468
TI  - Rapid communication: Nucleotide sequences of two isoforms of porcine micromolar
      calcium-activated neutral protease 1 cDNA.

PMID- 11219469
TI  - Rapid communication: Linkage mapping of the porcine micromolar calcium-activated
      neutral protease 1 (mu-calpain) gene on SSC2.

PMID- 11219470
TI  - Rapid communication: Genetic linkage and physical mapping of the porcine
      lipopolysaccharide-binding protein (LBP) gene.

PMID- 11219472
TI  - The new administration and Medicare reform.

PMID- 11219471
TI  - Comparison of 26-week efficacy and tolerability of telmisartan and atenolol, in
      combination with hydrochlorothiazide as required, in the treatment of mild to
      moderate hypertension: a randomized, multicenter study.
AB  - OBJECTIVE: This study was undertaken to compare the efficacy and tolerability of
      telmisartan, a novel antihypertensive agent, and atenolol, a well-established
      beta-blocker, in the treatment of mild to moderate hypertension. METHODS: This 26
      week, multicenter, randomized, double-blind, double-dummy, parallel-group,
      titration-to-response study compared doses of telmisartan (40 mg titrated to 80
      mg titrated to 120 mg) with atenolol (50 mg titrated to 100 mg) required to
      achieve diastolic blood pressure (DBP) control (< or = 90 mm Hg or a decrease
      from baseline of > or = 10 mm Hg). Open-label hydrochlorothiazide (HCTZ) 12.5 or
      25 mg was added if needed according to a prespecified titration rule. Men and
      women aged > 18 years with mild to moderate hypertension (morning mean supine DBP
      [SDBP] > or = 95 mm Hg and < or = 114 mm Hg) were eligible to participate.
      Patients with significant cardiovascular, metabolic, hepatic, or renal
      dysfunction or chronic obstructive pulmonary disease were excluded. The primary
      efficacy end point was trough SDBP response at 26 weeks; secondary efficacy end
      points included changes from baseline at trough in both standing and supine DBP
      and systolic blood pressure (SBP), and heart rate after 4, 8, 16, and 26 weeks;
      SBP control (reduction from baseline of > or = 10 mm Hg); normalization of supine
      SDBP to < or = 90 mm Hg; and the need for add-on HCTZ. Changes in quality of life
      were also examined. Adverse events were obtained from spontaneous reporting and
      recorded. Serious adverse events were reported to the sponsor according to
      predefined timelines. RESULTS: A total of 533 patients from 49 centers
      participated. Patients' mean age was 57.9 years (range, 22-79 years); 55.9%
      (298/533) of the population was male and 98.1% (523/533) was white. Of the 533
      patients randomly assigned to treatment and included in the safety analysis, 520
      (97.6%) were included in the efficacy analysis; 346 received telmisartan and 174
      received atenolol. A total of 489 patients (91.7%) completed the study (325
      [93.9%], telmisartan; 164 [94.2%], atenolol). Full SDBP response (trough SDBP <
      or = 90 mm Hg and/or a reduction from baseline of > or = 10 mm Hg) was observed
      in 84% and 78% of telmisartan- and atenolol-treated patients, respectively; this
      difference was not statistically significant. Final SBP/DBP reductions of
      20.9/14.4 mm Hg were observed for the telmisartan regimen versus 16.7/13.3 mm Hg
      for the atenolol regimen; only the difference in SBP was significant (P = 0.005).
      Reduction from baseline in SBP of > or = 10 mm Hg was achieved by 80% of
      telmisartan-treated and 68% of atenolol-treated patients (P = 0.003). Adverse
      events were reported by 52.7% of patients given telmisartan and 61.2% of patients
      given atenolol; this difference was not statistically significant. Most events
      were mild or moderate. Although fatigue and male impotence were more common in
      atenolol-treated patients (3.4% and 4.0%, respectively), the incidence of these
      adverse events was too low to differentiate statistically. CONCLUSIONS:
      Telmisartan appears to be at least as effective as atenolol in the treatment of
      mild to moderate hypertension and may be better tolerated.

PMID- 11219473
TI  - Treatment satisfaction, functional status, and health-related quality of life of
      migraine patients treated with almotriptan or sumatriptan.
AB  - BACKGROUND: Patient-reported outcomes, such as treatment satisfaction, functional
      status, and health-related quality of life (HRQOL) are essential components of
      migraine research. Almotriptan is a new selective serotonin 1B/1D agonist triptan
      migraine treatment. OBJECTIVE: The purpose of this double-blind, multicenter,
      randomized, parallel-group study was to compare treatment satisfaction,
      functional status, and HRQOL of patients treated with oral almotriptan versus
      sumatriptan, the leading triptan on the market. METHODS: Migraine patients, aged
      18 to 71 years, took equivalent oral doses of 12.5 mg almotriptan or 50 mg
      sumatriptan for the abortive treatment of a migraine headache. Treatment
      satisfaction differences between study groups were assessed using a 6-item
      measure to determine patients' satisfaction with pain relief and satisfaction
      with side effects 48 hours after drug administration. Functional status was
      assessed by analyzing the change in patients' ability to perform normal
      activities during the course of the migraine. HRQOL was compared between
      treatment groups at 24 hours using the Migraine Quality of Life Questionnaire.
      End points were assessed using entries from patients' 48-hour diaries. RESULTS: A
      total of 1173 patients were treated with almotriptan or sumatriptan. There were
      no significant differences between the 2 treatment groups in terms of
      satisfaction with pain relief; however, patients in the almotriptan group were
      significantly more satisfied (less bothered) with side effects than those
      receiving sumatriptan (P = 0.016). Functional status and HRQOL outcomes were not
      significantly different between groups. CONCLUSIONS: In this study, migraine
      patients treated with almotriptan were significantly more satisfied with the side
      effect profile of the drug than patients treated with sumatriptan. The results of
      this study may help inform practicing physicians and neurologists about the
      potential treatment satisfaction advantages of almotriptan.

PMID- 11219474
TI  - Ovarian carcinoma: care and survival in a community-based population.
AB  - BACKGROUND: Previous studies of the management and costs of ovarian cancer have
      been based on data from oncology practices. Such studies may exclude patients who
      are not candidates for treatment and may not account for costs incurred during
      diagnosis or primary treatment. OBJECTIVE: The purpose of this study was to
      describe the epidemiology, management, and costs of care of ovarian cancer in a
      geographically defined population to better reflect the total spectrum of the
      disease and its care. METHODS: We conducted a retrospective review of the medical
      records of all residents of Olmsted County, Minnesota, who received a first
      diagnosis of epithelial ovarian carcinoma (including postmortem diagnoses)
      between 1985 and 1997. RESULTS: Of the 107 women with a new diagnosis of ovarian
      cacinoma, 42 (39%) had stage I or II tumors at the time of diagnosis. The mean
      age of the patients at the time of diagnosis was 64.7 years, and 20% were
      nulliparous. The diagnostic assessment for ovarian carcinoma was initiated by a
      family physician or internist in 50% of cases and by an obstetrician or
      gynecologist in 16% of cases. One hundred two patients (95%) underwent surgical
      treatment, and 80 (75%) received primary chemotherapy. The 5-year survival rate
      was 88% in those with stage I or II tumors and 17% in those with stage III or IV
      tumors. The mean charges for secondary care were higher than those for primary
      care ($36,110 vs $32,367; P < 0.05) in those receiving both types of therapy.
      Fifty percent of those dying of ovarian cancer received hospice care for a mean
      of 39.0 days before death. CONCLUSIONS: Most assessments leading to a diagnosis
      of ovarian carcinoma were initiated by primary care physicians. In this community
      based population, early-stage and low-grade tumors were common (> or = 30%) and
      were associated with lower costs of care and higher 5-year survival rates. Total
      treatment costs for those requiring secondary therapy were approximately twice
      the costs for those requiring primary treatment only, with approximately 50% of
      costs associated with inpatient care.

PMID- 11219475
TI  - Delphi panel study of current hypertension treatment patterns.
AB  - OBJECTIVE: The purpose of this study was to assess whether, and to what extent,
      usual practice in the management of patients with mild to moderate hypertension
      differs from that recommended in the Sixth Report of the Joint National Committee
      on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC
      VI). The results were used as input for a clinical decision analytic model to
      assess the cost-effectiveness of a new treatment for hypertension. METHODS: A
      Delphi panel survey of general practitioners and cardiologists in the United
      States was conducted to determine current strategies for the treatment of mild to
      moderate uncomplicated hypertension. The purpose of the panel survey was to reach
      consensus on 3 key facets of the JNC-VI guidelines and how they relate to the
      respondents' clinical practices: (1) the definition of mild to moderate
      hypertension, (2) the treatment that adult patients with uncomplicated mild to
      moderate hypertension should receive, and (3) the management of patient follow
      up. RESULTS: Of the 20 physicians contacted for the survey, 10 responded to both
      rounds of the questionnaire. There was considerable variation in the responses
      for defining the ranges of healthy, acceptable, unacceptable, and serious blood
      pressure. In general, the Delphi panel respondents cited higher limits than
      stated in the JNC-VI guidelines. Physicians followed the guidelines approximately
      60% of the time. Primary determinants of initial drug choice among the panelists
      were comorbid conditions and the severity of hypertension; patients' age, race,
      and sex were secondary determinants. Follow-up typically occurred 1 month after
      therapy initiation. Panelists reported titrating the dose of new therapies upward
      once or twice before discontinuing the drug for lack of efficacy. Once adequate
      blood pressure control was achieved, patient follow-up was reported to occur
      every 3 to 4 months. CONCLUSIONS: This Delphi panel study highlights the
      differences between clinical practice and the JNC-VI guidelines in the treatment
      of hypertension. The results were used as a basis for defining a structure for a
      cost-effectiveness model and provided the management practice and prescribing
      practice patterns required by the model.

PMID- 11219476
TI  - The importance of health-related quality-of-life data in determining the value of
      drug therapy.
AB  - BACKGROUND: The rapid evolution of outcomes research during the last decade has
      led to increasing emphasis on measures of health-related quality of life (HRQOL).
      However, the relatively recent advent of these measures makes it difficult to
      decide how much weight to attribute to them in decisions about the value of drug
      therapy. OBJECTIVE: The aim of this article is to discuss the factors that affect
      the relative importance of HRQOL data in determining the value of drug therapy.
      CONCLUSIONS: The relative importance of HRQOL data depends on the type of
      condition and the type of treatment. In chronic conditions, HRQOL may be
      considered a primary measure of efficacy. In acute conditions, HRQOL is not
      likely to be a primary efficacy measure, although excluding HRQOL measures may
      lead to an underestimation of treatment effects. Measures of HRQOL are also
      likely to be important in the assessment of palliative treatments and, to some
      extent, preventive treatments (primarily in the measurement of adverse effects).
      HRQOL measures will be less important in the assessment of curative treatments
      because these types of treatment are most relevant in acute conditions.

PMID- 11219477
TI  - Sildenafil citrate: a therapeutic update.
AB  - BACKGROUND: Since its approval by the US Food and Drug Administration in March
      1998, sildenafil citrate has been used by millions of men for the treatment of
      erectile dysfunction. Recent studies and consensus reports have expanded our
      understanding of its efficacy, safety, contraindications, and drug interactions.
      OBJECTIVE: This paper reviews recent studies of the efficacy of sildenafil, its
      adverse effects and drug interactions, and socioeconomic factors involved in its
      use, with a focus on specific patient populations (prostate cancer, diabetes
      mellitus, ischemic heart disease, spinal cord injuries, neurologic disorders).
      METHODS: Clinical studies, case reports, and commentaries and editorials
      concerning sildenafil published in the international literature between January
      1999 and August 2000 were identified through searches of MEDLINE, PREMEDLINE, and
      International Pharmaceutical Abstracts, using the terms sildenafil, Viagra, and
      erectile dysfunction. RESULTS: Sildenafil has demonstrated effectiveness in men
      with erectile dysfunction associated with prostatectomy, radiation therapy,
      diabetes mellitus, certain neurologic disorders, and drug therapy (eg, selective
      serotonin reuptake inhibitors [SSRIs]). It has not been as effective in women
      with sexual dysfunction, with the exception of SSRI-associated sexual
      dysfunction. Some disorders unrelated to sexual dysfunction (eg, esophageal
      motility dysfunction) may also respond to sildenafil. In the general population,
      sildenafil is considered to have an acceptable tolerability profile; however,
      patients with moderate to severe cardiovascular disease or those taking nitrate
      therapy are at increased risk for potentially serious cardiovascular adverse
      effects with sildenafil therapy. In addition, patients taking drugs that inhibit
      the cytochrome P450 3A4 isozyme, which metabolizes sildenafil, may experience
      increased drug concentrations and possible toxicity from normal doses of
      sildenafil. CONCLUSIONS: Sildenafil is an effective first-line therapy for
      erectile dysfunction in men. The decision to prescribe this agent should include
      such considerations as the cost-risk-benefit balance, patient access, drug
      distribution pathways, and prescription drug coverage.

PMID- 11219478
TI  - Quinupristin/dalfopristin: a therapeutic review.
AB  - BACKGROUND: The proliferation of multidrug-resistant gram-positive bacteria,
      including methicillin-resistant Staphylococcus aureus and vancomycin-resistant
      Enterococcus faecium (VREF), has created a pressing need for effective
      alternative antibiotics. Quinupristin/dalfopristin is a new combination
      streptogramin product with a selective spectrum of antibacterial activity, mainly
      against gram-positive aerobic bacteria. It has been assessed primarily in
      emergency-use protocols, in hospitalized patients with skin and skin-structure
      infections, and in patients with VREF bacteremia. OBJECTIVES: The objectives of
      this review were to summarize important results of in vitro microbiologic
      studies; to provide information on relevant pharmacokinetic parameters, drug
      interactions, and Y-site compatibility; and to assess efficacy and safety data
      from clinical studies of quinupristin/dalfopristin. METHODS: Articles included in
      this review were identified by a MEDLINE search of the literature published
      between 1966 and September 2000 using the terms Synercid, quinupristin, and
      dalfopristin. Additional articles were retrieved from the reference lists of
      articles identified in the MEDLINE search. RESULTS: In vitro analysis of the
      spectrum of activity of quinupristin/dalfopristin has confirmed its relatively
      selective coverage of gram-positive aerobic bacteria. Both quinupristin and
      dalfopristin undergo hepatic metabolism and are extensively excreted in the
      feces. Combination quinupristin/dalfopristin inhibits the cytochrome P450 3A4
      pathway, and caution is warranted with concomitant use of other medications
      eliminated via this pathway. In trials in patients with VREF infections,
      treatment success with quinupristin/dalfopristin varied depending on the site of
      infection, ranging from 51.9% in bacteremia of unknown origin to 88.9% in urinary
      tract infections. The results of comparative clinical trials suggest that
      quinupristin/dalfopristin has similar efficacy to that of commonly used
      antibiotics, including cefazolin, oxacillin, and vancomycin, in patients with
      skin and skin-structure infections or nosocomial pneumonia. The most frequently
      reported adverse effects with administration of quinupristin/dalfopristin were
      infusion-site inflammation, pain, and edema; other infusion-site reactions; and
      thrombophlebitis. Arthralgia, myalgia, nausea, diarrhea, vomiting, and rash
      occurred in 2.5% to 4.6% of patients and were the most frequently reported
      systemic adverse events. CONCLUSIONS: Outcomes data from clinical trials indicate
      that quinupristin/dalfopristin has the potential to play an important role in the
      treatment of bacteremia, complicated skin and skin-structure infections, and
      nosocomial pneumonia caused by VREF. Issues of bacterial resistance to
      quinupristin/dalfopristin and other appropriate uses of this combination agent
      remain to be elucidated.

PMID- 11219480
TI  - Pharmacokinetics of levormeloxifene in young versus elderly postmenopausal women.
AB  - BACKGROUND: Physiologic changes of aging may affect processes of drug absorption
      and distribution, in some cases necessitating age-dependent dose adjustment.
      OBJECTIVE: The possibility of age dependence in the pharmacokinetic behavior and
      tolerability of levormeloxifene was investigated in a single-center, open-label
      study. METHODS: The study comprised 2 groups of healthy postmenopausal women:
      group A included younger subjects (50-60 years) and group B included elderly
      subjects (> or = 66 years). All subjects received a single 40-mg tablet of
      levormeloxifene base. Blood samples were collected immediately before drug intake
      and at several points after administration, through day 34. Peak plasma
      concentration, time to maximum plasma concentration, area under the plasma
      concentration-time curves from zero to the last quantifiable value and to
      infinity, and terminal half-life were calculated for levormeloxifene and compared
      between age groups. RESULTS: Of 29 subjects enrolled, 28 (15 group A, 13 group B)
      completed the study. The ages of the women in group A ranged from 50 to 58 years
      and in group B from 66 to 79 years. No serious adverse events were reported. Ten
      subjects experienced 17 adverse events, of which 2 (abdominal pain and vaginal
      hemorrhage) were judged to be possibly related to study drug. There was no
      noticeable difference between age groups in the frequency of adverse events or
      laboratory abnormalities. The plasma concentration-time curves of levormeloxifene
      were indistinguishable between age groups up to 48 hours after dosing. From 72
      hours onward, the mean plasma concentration-time curve was approximately 20%
      higher and the area under the curve was approximately 19% greater in the older
      subjects compared with the younger subjects. However, no statistically
      significant differences were observed between groups in any of the
      pharmacokinetic parameters, except for the elimination rate constant. The
      difference in mean elimination half-life was 25 hours (group A, 126 hours; group
      B, 151 hours). CONCLUSION: The findings suggest that it is not necessary to
      adjust the dose of levormeloxifene on the basis of age in postmenopausal women.
      However, these results need confirmation in a multiple-dose setting under steady
      state conditions--that is, as the drug is intended to be used clinically.

PMID- 11219479
TI  - Comparison of the efficacy and tolerability of fluvastatin extended-release and
      immediate-release formulations in the treatment of primary hypercholesterolemia:
      a randomized trial.
AB  - BACKGROUND: A new extended-release (ER) formulation of fluvastatin 80 mg has been
      developed for once-daily treatment of primary hypercholesterolemia. OBJECTIVE:
      The purpose of this study was to compare the lipid-lowering efficacy and
      tolerability of fluvastatin ER (80 mg once daily) versus fluvastatin immediate
      release (IR) (40 mg once or twice daily). METHODS: Following a 4-week
      placebo/dietary run-in period, patients with primary hypercholesterolemia type
      IIa or IIb (low-density lipoprotein cholesterol ILDL-C] > or = 160 mg/dL and
      triglycerides [TG] < or = 400 mg/dL) were randomized (2:1:1) to receive
      fluvastatin ER 80 mg once daily at bedtime (QPM), fluvastatin IR 40 mg QPM, or
      fluvastatin IR 40 mg BID for 24 weeks. Patients who had homozygous familial
      hypercholesterolemia; type I, III, IV, V, or secondary hyperlipoproteinemia;
      diabetes; or evidence of liver or renal impairment were excluded. At weeks 0, 2,
      4, 8, 12, 16, 20, and 24 of the active-treatment period, levels of LDL-C, high
      density lipoprotein cholesterol (HDL-C), TG, and total cholesterol (TC) were
      measured. RESULTS: Of the 1183 patients enrolled, 695 were randomly assigned to
      treatment--346 to fluvastatin ER 80 mg QPM, 174 to fluvastatin IR 40 mg QPM, and
      175 to fluvastatin IR 40 mg BID. Patients were well matched between groups, with
      a mean age of approximately 56 years and body mass index of 27 kg/m2; 56.0% of
      patients (389/695) were female and 97.7% (679/695) were white. Fluvastatin ER 80
      mg QPM lowered LDL-C levels significantly more than did fluvastatin IR 40 mg QPM
      (33.7% vs 24.4%; P < 0.001) and as effectively as fluvastatin IR 40 mg BID
      (33.9%). More than half of the patients administered fluvastatin ER 80 mg QPM and
      IR 40 mg BID achieved reductions in LDL-C levels of > or = 35%; more than half of
      those administered fluvastatin IR 40 mg QPM experienced reductions in LDL-C
      levels of > or = 25%. The mean reductions in LDL:HDL ratio, TC, and
      apolipoprotein B levels in the fluvastatin ER 80 mg QPM group were significantly
      greater than the reductions in the IR 40 mg QPM group (P < 0.001). In patients
      with mixed dyslipidemia, fluvastatin ER 80 mg reduced triglycerides by 21.8%
      (median 28%) and increased HDL-C by 14.5%. Fluvastatin ER 80 mg QPM was well
      tolerated, with incidences of clinically notable elevations in alanine
      aminotransferase, aspartate aminotransferase, and creatine kinase levels and
      musculoskeletal adverse events comparable to those in the IR 40 mg QPM group.
      CONCLUSION: The ER 80-mg formulation of fluvastatin is effective and well
      tolerated as a once-daily starting and maintenance treatment for primary
      hypercholesterolemia.

PMID- 11219481
TI  - Comparison of the efficacy of extended-release clarithromycin tablets and
      amoxicillin/clavulanate tablets in the treatment of acute exacerbation of chronic
      bronchitis.
AB  - BACKGROUND: Clarithromycin has established efficacy and safety in the treatment
      of respiratory infections. OBJECTIVE: This study examined the efficacy and safety
      of a new extended-release formulation of clarithromycin compared with
      amoxicillin/clavulanate in the treatment of acute exacerbation of chronic
      bronchitis (AECB). METHODS: This phase IIIB, multicenter, randomized, parallel
      group, investigator-blinded study in patients with AECB and productive cough with
      purulent sputum compared treatment with extended-release clarithromycin (two 500
      mg tablets once daily for 7 days) and amoxicillin/clavulanate (one 875-mg tablet
      twice daily for 10 days). Assessments were performed before treatment, between
      study days 10 and 12 (or within 48 hours after premature discontinuation), and
      between study days 17 and 21 (test of cure). RESULTS: Of 287 patients randomized
      and treated, 270 were clinically evaluable (137 clarithromycin, 133
      amoxicillin/clavulanate). Treatment groups were well matched in terms of
      demographic characteristics, medical condition, and history. Among clinically
      evaluable patients at test of cure, 85% and 87% of clarithromycin- and
      amoxicillin/clavulanate-treated patients, respectively, demonstrated clinical
      cure (as defined in 1998 draft US Food and Drug Administration guidelines); among
      clinically and bacteriologically evaluable patients, 92% versus 89%,
      respectively, demonstrated bacteriologic cure. Overall pathogen eradication rates
      were similar in the 2 groups (88% clarithromycin, 89% amoxicillin/clavulanate).
      Rates of premature discontinuation of study drug for any reason differed between
      treatments: 3% (4/142) of clarithromycin-treated patients versus 12% (17/145) of
      amoxicillin/clavulanate-treated patients (P = 0.005). One percent (2/142) and 6%
      (8/145) of the respective treatment groups discontinued study drug because of
      adverse events. Adverse events generally occurred with a similar frequency in the
      2 groups; however, taste alteration was more common with clarithromycin (9/142
      [6%]) than with amoxicillin/clavulanate (1/145 [1%]; P = 0.01). Mean severity
      scores for gastrointestinal adverse events showed a significant difference
      between groups (1.16 for clarithromycin-treated patients and 1.58 for
      amoxicillin/clavulanate-treated patients: P = 0.016). CONCLUSIONS: The results of
      this study demonstrate the clinical and bacteriologic equivalence and improved
      gastrointestinal tolerability of a 7-day course of once-daily extended-release
      clarithromycin relative to a 10-day course of twice-daily amoxicillin/clavulanate
      in the treatment of AECB.

PMID- 11219482
TI  - Blood pressure control in patients with mild to moderate essential hypertension
      switched from nifedipine gastrointestinal therapeutic system (GITS) 30 mg to
      nifedipine GITS 20 mg.
AB  - BACKGROUND: Nifedipine gastrointestinal therapeutic system (GITS) is a once-daily
      formulation of nifedipine that provides sustained plasma nifedipine
      concentrations throughout the 24-hour dosing interval. OBJECTIVE: This study was
      undertaken to determine if adult patients with mild to moderate essential
      hypertension whose blood pressure had been controlled for > or = 3 months with
      nifedipine GITS 30 mg could be successfully switched to a 20-mg daily dose with
      continued antihypertensive efficacy. METHODS: This was a randomized, double
      blind, parallel-group study. Patients entered a 1-week run-in period during which
      they continued to receive their usual antihypertensive medication, including
      nifedipine GITS 30 mg. After baseline assessment, patients entered a 6-week
      treatment period during which they were randomly assigned to receive nifedipine
      GITS 30 or 20 mg. Men and women were eligible to participate if they were > or =
      55 years of age, had received a diagnosis of mild to moderate essential
      hypertension (sitting diastolic blood pressure [DBP] 95-114 mm Hg), and had
      exhibited good blood pressure control (sitting DBP < or = 90 mm Hg) while taking
      nifedipine GITS 30 mg once daily for > or = 3 months. Systolic blood pressure
      (SBP), DBP, and heart rate were recorded at baseline and after 1, 3, and 6 weeks
      of treatment. Adverse events were reported by patients. The responder rate was
      defined as the percentage of patients whose sitting DBP was < 95 mm Hg at the
      final study assessment. Results were based on the intent-to-treat analyses, which
      included data for all patients who received > or = 1 dose and had 1 postbaseline
      blood pressure assessment. Statistical significance was set at P < 0.05. RESULTS:
      Seventy-five patients entered the 1-week run-in period; 71 patients (94.7%) were
      randomized to treatment. Twenty-four patients received nifedipine GITS 30 mg for
      43.0 +/- 3.3 days, and 47 patients received nifedipine GITS 20 mg for 42.5 +/-
      6.7 days. Both groups exhibited a sustained decrease in blood pressure throughout
      the study; minor variations were not statistically significant. End-point SBP and
      DBP for the 30- and 20-mg groups were 135.5 +/- 9.8/81.7 +/- 5.4 mm Hg and 138.6
      +/- 11.8/82.9 +/- 7.6 mm Hg, respectively. Changes from baseline in end-point SBP
      and DBP did not differ significantly between groups. At the end of treatment,
      goal DBP (< 95 mm Hg) was achieved by 24 of 24 patients (100%) receiving the 30
      mg dose and 45 of 47 patients (95.7%) receiving the 20-mg dose. Blood pressure
      control (sitting DBP < 90 mm Hg) was achieved by 21 of 24 (87.5%) patients in the
      30-mg group and 35 of 47 (74.5%) patients in the 20-mg group. The most commonly
      reported adverse event was headache; 2 patients discontinued the study because of
      adverse events. Overall, 9 of 24 patients (37.5%) in the 30-mg group and 14 of 47
      patients (29.8%) in the 20-mg group experienced > or = 1 treatment-related
      adverse event. CONCLUSIONS: Patients whose mild to moderate essential
      hypertension is controlled with nifedipine GITS 30 mg once daily may be able to
      switch to 20 mg once daily with continued antihypertensive efficacy. In addition
      to safety and economic advantages, such a switch may be a reasonable alternative
      in patients with lower body weight or as an adjunct to existing antihypertensive
      therapy.

PMID- 11219483
TI  - Comparison of 5-day, short-course gatifloxacin therapy with 7-day gatifloxacin
      therapy and 10-day clarithromycin therapy for acute exacerbation of chronic
      bronchitis.
AB  - BACKGROUND: The ideal duration of antibiotic therapy for acute exacerbation of
      chronic bronchitis (AECB) remains controversial. OBJECTIVE: This study compared
      short-course, 5-day gatifloxacin treatment with standard 10-day clarithromycin
      treatment in patients with AECB; 7-day gatifloxacin therapy was a secondary
      comparator. METHODS: This was a multicenter, prospective, randomized, double
      blind study in which adult outpatients with AECB were randomized to 1 of 3
      treatment groups: 5 days of gatifloxacin, 7 days of gatifloxacin, or 10 days of
      clarithromycin. Clinical cure and microbiologic eradication rates were determined
      7 to 14 days after the completion of antibiotic treatment. RESULTS: A total of
      527 patients with AECB were enrolled and treated with study drug (174,
      gatifloxacin 5-day; 175, gatifloxacin 7-day; 178, clarithromycin 10-day). Most
      patients (82%) had type 1 (severe) exacerbations, and a bacterial pathogen was
      isolated from pretreatmer, sputum samples in 59% of patients. The overall
      clinical cure rates among clinically evaluable patients were comparable between
      groups: 89% (135/151 patients) in the gatifloxacin 5-day group; 88% (136/154) in
      the gatifloxacin 7-day group; and 89% (145/163) in the clarithromycin 10-day
      group. The 95% CIs for the differences in response rates were -6.1 to 7.0 for
      gatifloxacin 5-day versus clarithromycin, -8.9 to 5.0 for gatifloxacin 7-day
      versus clarithromycin, and -5.5 to 8.0 for gatifloxacin 5-day versus 7-day. These
      observations did not appear to be affected by use of corticosteroids or smoking
      status, type of exacerbation, or duration of current episode. The microbiologic
      eradication rate among microbiologically evaluable pathogens was >90% in all
      treatment groups. No clinically meaningful differences were noted in the
      incidence of drug-related adverse events. CONCLUSION: Short-course, 5-day
      gatifloxacin therapy in patients with AECB resulted in clinical cure and
      microbiologic eradication rates comparable to those of standard 7- and 10-day
      therapies.

PMID- 11219484
TI  - The role of the clinical pharmacologist in the management of adverse drug
      reactions.
AB  - The classical definition of clinical pharmacology is the study or the knowledge
      of the effects of drugs in humans. The activities of a clinical pharmacologist
      can vary from country to country, usually ranging from involvement in clinical
      trials, especially fundamental pharmacodynamic studies, to studies of
      pharmacokinetics and drug metabolism, to pharmacogenetics. Most clinical
      pharmacologists outside industry are in hospitals or university hospitals and
      research centres. In addition to research, this implies teaching of clinical
      pharmacology, and interacting with other medical staff: in the field of research,
      giving advice on clinical trials methodology and often managing a therapeutic
      drug monitoring centre. Some clinical pharmacologists have clinical departments
      with beds or consulting offices. Can there be another role for the clinical
      pharmacologist that would increase his or her usefulness for the medical
      community? Adverse drug reactions (ADRs) are remarkably complex events, related
      to drug effects, patient characteristics (background diseases, genetics), and
      drug/disease interactions. Evaluation of ADRs requires understanding of drug
      mechanisms and interactions, and of disease diagnostics, especially in the
      discussion of alternative diagnoses. This implies expertise as a pharmacologist
      and a clinician. In addition, because not all adverse reactions or interactions
      are in the Summary of Product Characteristics, and because problems arise long
      before they report in the literature, it is necessary for the clinical
      pharmacologist to have knowledge of ongoing regulatory processes, in addition to
      having access to the published literature. Helping clinicians cope with
      individual patient problems will also improve the clinical pharmacologist's
      integration into the healthcare process.

PMID- 11219485
TI  - Anticancer drug-induced kidney disorders.
AB  - Nephrotoxicity is an inherent adverse effect of certain anticancer drugs. Renal
      dysfunction can be categorised as prerenal uraemia, intrinsic damage or postrenal
      uraemia according to the underlying pathophysiological process. Renal
      hypoperfusion promulgates prerenal uraemia. Intrinsic renal damage results from
      prolonged hypoperfusion, exposure to exogenous or endogenous nephrotoxins,
      renotubular precipitation of xenobiotics or endogenous compounds, renovascular
      obstruction, glomerular disease, renal microvascular damage or disease, and
      tubulointerstitial damage or disease. Postrenal uraemia is a consequence of
      clinically significant urinary tract obstruction. Clinical signs of
      nephrotoxicity and methods used to assess renal function are discussed.
      Mechanisms of chemotherapy-induced renal dysfunction generally include damage to
      vasculature or structures of the kidneys, haemolytic uraemic syndrome and
      prerenal perfusion deficits. Patients with cancer are frequently at risk of renal
      impairment secondary to disease-related and iatrogenic causes. This article
      reviews the incidence, presentation, prevention and management of anticancer drug
      induced renal dysfunction. Dose-related nephrotoxicity subsequent to
      administration of certain chloroethylnitrosourea compounds (carmustine, semustine
      and streptozocin) is commonly heralded by increased serum creatinine levels,
      uraemia and proteinuria. Additional signs of streptozocin-induced nephrotoxicity
      include hypophosphataemia, hypokalaemia, hypouricaemia, renal tubular acidosis,
      glucosuria, aceturia and aminoaciduria. Cisplatin and carboplatin cause dose
      related renal dysfunction. In addition to increased serum creatinine levels and
      uraemia, electrolyte abnormalities, such as hypomagnesaemia and hypokalaemia, are
      commonly reported adverse effects. Rarely, cisplatin has been implicated as the
      underlying cause of haemolytic uraemic syndrome. Pharmaceutical antidotes to
      cisplatin-induced nephrotoxicity include amifostine, sodium thiosulfate and
      diethyldithiocarbamate. Dose- and age-related proximal tubular damage is an
      adverse effect of ifosfamide. In addition to renal wasting of electrolytes,
      glucose and amino acids, Fanconi syndrome, rickets and osteomalacia have occurred
      with ifosfamide treatment. High dose azacitidine causes renal dysfunction
      manifested by tubular acidosis, polyuria and increased urinary excretion of
      electrolytes, glucose and amino acids. Haemolytic uraemia is a rare adverse
      effect of gemcitabine. Methotrexate can cause increased serum creatinine levels,
      uraemia and haematuria. Acute renal failure is reported following administration
      of high dose methotrexate. Urinary alkalisation and hydration confer protection
      against methotrexate-induced renal dysfunction. Dose-related nephrotoxicity,
      including acute renal failure, are reported subsequent to treatment with
      pentostatin and diaziquone. Acute renal failure is a rare adverse effect of
      treatment with interferon-alpha. Haemolytic uraemic syndrome occurs with
      mitomycin administration. A mortality rate of 50 to 100% is reported in patients
      developing mitomycin-induced haemolytic uraemic syndrome. Capillary leak syndrome
      occurring with aldesleukin therapy can cause renal dysfunction. Infusion-related
      hypotension during infusion of high dose carmustine can precipitate renal
      dysfunction.

PMID- 11219486
TI  - Nephrotoxicity and hepatotoxicity of histamine H2 receptor antagonists.
AB  - The extensive use of selective histamine H2 receptor antagonists provides a
      unique opportunity to describe very rare adverse drug reactions. Although mild
      elevation of serum creatinine level following the administration of cimetidine is
      relatively common, acute interstitial nephritis (AIN) is a rare hypersensitivity
      reaction. There have been 25 published reports of AIN associated with H2
      antagonist therapy and we also identified 16 cases from the Australian Adverse
      Drug Reaction Advisory Committee (ADRAC) database. AIN was reported most commonly
      following cimetidine administration. AIN was supported by renal biopsy in 28
      patients and by rechallenge in 6. H2 antagonist-induced AIN was more commonly
      reported in men older than 50 years. In the majority of cases the onset was
      within 2 weeks of initiation of therapy (1 day to 11 months). The clinical
      manifestations were nonspecific including sterile pyuria, elevated erythrocyte
      sedimentation rate, fatigue, proteinuria and leucocytosis whereas rash,
      arthralgia and flank pain were rarely reported. There were 170 cases of
      hepatotoxicity following H2 antagonist administration reported to ADRAC. These
      were more common following ranitidine and included cholestatic, hepatocellular
      and mixed reactions. Hepatotoxicity was proven following liver biopsy in several
      cases published in the literature and in 15 cases reported to ADRAC.
      Hepatotoxicity recurred upon rechallenge in 6 cases. Generally, renal and hepatic
      adverse effects resolved quickly after cessation of H2 antagonist therapy and did
      not require specific treatment. Nephrotoxicity and hepatotoxicity following
      administration of an H2 antagonist is rare and a high index of suspicion is
      necessary for early detection. Now that many H2 antagonists are available over
      the counter, awareness of these conditions and early detection with cessation of
      H2 antagonist therapy would appear paramount.

PMID- 11219489
TI  - Potent antitumor effects of intra-arterial injection of fibroblasts genetically
      engineered to express IL-12 in liver metastasis model of rat: no additional
      benefit of using retroviral producer cell.
AB  - Interleukin-12 (IL-12) mediates significant antitumor effects in animal models
      but associated with dose-dependent toxicity in human. To achieve local expression
      of IL-12 at the tumor site without systemic toxicity, we performed intra-arterial
      administration of fibroblasts genetically engineered to produce IL-12 protein
      with or without retrovirus (CRIP- IL-12 or 3T3-IL-12) in liver metastasis model.
      Rat breast cancer cells ( MADB - 106) were injected into the portal vein of
      syngeneic Fisher rats on day 0, and fibroblasts were injected into the hepatic
      artery on day 7. On day 21, liver weight and number of liver tumors were
      examined. As controls, CRIP cells expressing retrovirus carrying lacZ marker gene
      (CRIP-lacZ) or saline (Hanks balanced salt solution, HBSS) were injected.
      Administration of CRIP-IL-12 significantly reduced tumor metastasis in liver
      measured by number of foci (CRIP- IL-12: 45.2 +/- 36.7, CRIP-lacZ: >250, HBSS:
      >250, P<.05) and by liver weight (CRIP-IL-12: 13.0+/-2.5 g, CRIP-lacZ: 30.4+/-8.5
      g, HBSS: 26.0+/-7.6 g, P<.05). 3T3-IL-12, which produced only IL-12 protein but
      not IL-12 retrovirus, also had significant antitumor effects equivalent to CRIP
      IL-12. Intra-arterial injection of IL-12--producing fibroblasts into the liver
      may be an effective therapy for liver tumors reducing systemic toxicity, and
      could be developed for clinical application.

PMID- 11219490
TI  - Suppression of mammary carcinoma growth in vitro and in vivo by inducible
      expression of the Cdk inhibitor p21.
AB  - Mammary carcinomas that develop in C3 (1)/SV40 T- antigen (TAg) transgenic mice
      have lost the p53-mediated induction of p21, leading to increased cellular
      proliferation and significant elevations of cyclins and Cdks. To test whether p21
      could serve as a target for anticancer therapy for this mammary cancer model, a
      retroviral delivery system for the inducible expression of p21 was developed. We
      demonstrate that overexpression of p21 in C3(1)/TAg mammary tumor cells using the
      retroviral inducible p21 expression system results in increased apoptosis,
      reduced cell proliferation in vitro and reduced tumor growth in vivo associated
      with reduced expression of cyclins D1 and E, and Cdks 2, 4, and 6. Reciprocal
      changes in the expression of p21 and p27(Kip1), another cell-cycle regulator,
      were also observed. Because reduced p21 expression occurs frequently in human
      breast cancer, restoration of the Cdk inhibitor p21 by gene therapy approaches
      may provide a method for inhibiting mammary tumor progression.

PMID- 11219487
TI  - Bodyweight gain with atypical antipsychotics. A comparative review.
AB  - The atypical antipsychotics have been shown to have superior efficacy compared
      with typical antipsychotics such as haloperidol, particularly in the treatment of
      negative symptoms of schizophrenia. Furthermore, they induce less extrapyramidal
      effects. However, following clinical use, marked bodyweight gain has been
      frequently observed with some of the atypical antipsychotic drugs. In order to
      examine and compare the frequency, amount and conditions of bodyweight gain
      during treatment with atypical antipsychotics, studies concerning bodyweight gain
      with these agents were identified through a MEDLINE search from 1966 to March
      2000. Although comparison is limited by the different designs and recruitment
      procedures of the reviewed studies, the available data support the notion that
      the frequency as well as the amount of bodyweight gain is high in patients
      treated with olanzapine (average bodyweight gain 2.3 kg/month), clozapine (1.7
      kg/month), quetiapine (1.8 kg/month), and possibly also zotepine (2.3 kg/month).
      Moderate changes in bodyweight have been observed in the treatment with
      risperidone (average bodyweight gain 1.0 kg/month). Ziprasidone seems to induce
      only slight bodyweight changes (0.8 kg/month). Bodyweight gain most frequently
      occurs in the first 12 weeks of treatment. Patients who were underweight at the
      beginning of treatment are at highest risk of gaining bodyweight. The underlying
      pathomechanism still remains largely unclear. The relative receptor affinities of
      the atypical antipsychotics for histamine H1 receptors as well as the ratio of
      their affinity for serotonin 5-HT2 and dopamine D2 receptors appear to be the
      most robust correlate of bodyweight gain. Furthermore, the induction of leptin
      secretion may have an important impact on bodyweight gain in patients treated
      with atypical antipsychotics. Although many questions concerning the pathogenesis
      of bodyweight gain remain unresolved, this adverse effect has to be taken into
      consideration when prescribing the atypical antipsychotics, particularly in view
      its affect on compliance during long term treatment and the long term effects of
      obesity on mortality and morbidity.

PMID- 11219488
TI  - NSAID-induced nephrotoxicity from the fetus to the child.
AB  - In this review we report data available from the literature on the use of
      nonsteroidal anti-inflammatory drugs (NSAIDs) and the development of
      nephrotoxicity in the fetus, neonates and children. Up to the present day,
      several cases of severe and sometimes irreversible renal insufficiency have been
      described in neonates exposed to indomethacin prenatally or in the first days of
      life for treatment of patent ductus arteriosus (PDA). Until now, very few studies
      have been carried out on alternative treatments for PDA in preterm infants;
      ibuprofen has been shown to be as effective as indomethacin in closing the ductus
      in this patient group without affecting renal function. In children, NSAID
      induced renal failure is a rare event and is usually reversible after
      discontinuation of the drug. However, caution should be taken when NSAIDs are
      administered to individuals with preexisting renal problems or with other
      potentially nephrotoxic drugs. In these situations, new approaches such as cyclo
      oxygenase-2 selective inhibitors or prostanoid receptor selective antagonists
      could lead to alternative therapies for use in paediatrics.

PMID- 11219491
TI  - Substantially improved in vivo radiosensitization of rat glioma with mutant HSV
      TK and acyclovir.
AB  - We recently demonstrated in vitro that a mutant HSV-TK (mutant 75) expressed from
      an adenovirus (AdCMV-TK75) radiosensitized rat RT2 glioma cells significantly
      better than wild type HSV-TK (AdCMV-TK) in combination with acyclovir (ACV). To
      examine whether a similar improvement could also be observed in vivo, we tested
      these viruses in a syngeneic rat glioma tumor model (RT2/Fischer 344). First, we
      demonstrate that treatment with AdCMV-TK and ACV significantly radiosensitizes
      implanted gliomas and roughly doubles the mean survival time to 37 days, compared
      to 20 days for control animals implanted with Adbetagal-transduced cells (P<.02).
      Second, it was important to first examine the effect of AdCMV-TK75 and ACV on
      survival without any irradiation. We found that AdCMV-TK75 appeared to sensitize
      gliomas more efficiently than AdCMV-TK, although this difference was not
      significant ( P= .19 ). Third, and most importantly, in combined HSV-TK, ACV and
      irradiation experiments, we demonstrate that AdCMV-TK75 is superior over AdCMV-TK
      and significantly (P<.005) prolonged the survival of treated animals. Our results
      suggest that AdCMV-TK75 is far more efficient than AdCMV-TK in radiosensitizing
      rat glioma when administered in combination with ACV.

PMID- 11219493
TI  - Adenovirus-mediated delivery of antiangiogenic genes as an antitumor approach.
AB  - Based on the observation that the growth of solid tumors is dependent on the
      formation of new blood vessels, therapeutic strategies aimed at inhibiting
      angiogenesis have been proposed. A number of proteins with angiostatic activity
      have been described, but their development as therapeutic agents has been
      hampered by difficulties in their production and their poor pharmacokinetics.
      These limitations may be resolved using a gene therapy approach whereby the genes
      are delivered and expressed in vivo. Here we compared adenoviral delivery of
      endostatin, proliferin-related protein (PRP), and interferon-inducible protein 10
      (IP10) genes. Recombinant adenoviruses carrying the three angiostatic genes
      express biologically active gene products as determined in vitro in endothelial
      cell proliferation and migration assays, and in vivo by inhibition of
      neoangiogenesis in rat chambers. Eradication of established tumors in vivo, in
      the murine B16F10 melanoma model in immunocompetent mice, was not achieved by
      intratumoral injection of the different vectors. However, the combination of
      intravenous plus intratumoral injections allowed rejection of tumors. Ad-PRP or
      Ad-IP10 were significantly more efficient than Ad-endostatin, leading to complete
      tumor rejection and prolonged survival in a high proportion of treated animals.
      These data support the use of in vivo gene delivery approaches to produce high
      circulating and local levels of antiangiogenic agents for the therapy of local
      and metastatic human tumors.

PMID- 11219492
TI  - Targeting the replication of adenovirus to p53-defective thyroid carcinoma with a
      p53-regulated Cre/loxP system.
AB  - In this article, we evaluated the feasibility of the restricted replication
      competent adenoviruses for treatment of anaplastic thyroid carcinomas (ATCs),
      which are very aggressive and difficult to treat. Because ATCs very often harbor
      p53 mutations, we used wt-p53 as a regulatory factor to restrict virus
      replication and cytopathic effect to p53-mutated cells. The recently reported
      "gene inactivation strategy" using p53-regulated Cre/loxP system was employed;
      this system consists of two recombinant adenoviruses. One has an expression unit
      of the synthetic p53 - responsive promoter and the Cre recombinase gene
      (Axyp53RECre), and another contains two expression units; the first consists of
      E1A gene flanked by a pair of loxP sites downstream of the constitutive CAG
      promoter and the second E1B19K gene under the control of the CMV promoter
      (AdCALE1AL). We expected that coinfection of these two adenoviruses into the
      cells with wt-p53 would lead to expression of the Cre, which excises E1A gene and
      switches off E1A expression resulting in no virus replication, whereas in the
      cells with mutant p53 E1A could be expressed that leads to virus replication and
      cell lysis. Our in vitro data demonstrate that although infection of AdCALE1AL
      alone led to E1A expression, viral replication and cytolysis in all the thyroid
      cells examined irrespective of their p53 status, the double infection did so in
      FRO cells (p53-null ATC) but not in FRO cells stably expressing wt-p53 and normal
      thyroid cells with wt-p53. These data indicate that our double infection method
      may have a potential for treatment of ATC and probably also other p53-defective
      cancer cells.

PMID- 11219494
TI  - Fusogenic activity of vesicular stomatitis virus glycoprotein plasmid in tumors
      as an enhancer of IL-12 gene therapy.
AB  - We have characterized the fusogenic activity of a plasmid expression system
      encoding vesicular stomatitis virus G protein (VSVG) in vitro and in vivo. Over
      70% of murine colon and renal carcinoma cells (MC38 and Renca, respectively)
      transfected with VSVG plasmid in vitro fused and formed polykaryons upon
      incubation with pH 5.5 media. Using a plasmid expression system encoding VSVG and
      bacterial green fluorescent protein (GFP) formulated in a polyvinyl pyrrolidone
      (PVP) delivery system, diffusion of GFP throughout the VSVG-induced syncytia was
      shown in vivo in MC38 and Renca tumors. Moreover, tumor-bearing mice showed tumor
      growth inhibition following in vivo transfection with VSVG plasmid at an optimal
      dose of 48 microg. We have previously shown that direct injection of interleukin 
      12 (IL -12) plasmid complexed with PVP into tumors induces a strong immune
      response. In the current study, we assessed the ability of VSVG to elicit an
      antitumor response by enhancing cytokine gene delivery within the tumor mass.
      Tumor-bearing mice treated intratumorally with both VSVG/PVP and IL-12/PVP (48
      and 24 microg, respectively) showed increase in tumor rejection when compared to
      IL- 12 plasmid alone (75% vs. 50%, respectively). These data suggest that VSVG
      gene therapy can be used in combination with other therapeutic genes to induce an
      antitumor response in vivo by enhancing the expression of the gene of interest.

PMID- 11219495
TI  - Antitumor activity of recombinant adenoviral vectors expressing murine IFN-alpha
      in mice injected with metastatic IFN-resistant tumor cells.
AB  - Recent studies have shown that gene therapy with type I interferon (IFN) in an
      adenovirus vector is a powerful tool to suppress the growth of human tumors
      transplanted in immune-deficient mice. However, in these studies the host immune
      mediated effects, which may be important in mediating the long-term control of
      tumor growth by these cytokines, was not studied. In this paper, we evaluate the
      antitumor efficacy of different adenoviral vectors containing mouse IFN-alpha
      genes (i.e., a first-generation replication-defective vector containing IFN
      alpha1 and two different second-generation vectors containing IFN-alpha2) in
      immunocompetent DBA/2 mice transplanted with highly metastatic Friend leukemic
      cells resistant in vitro to type I IFN. We found that injection of all the
      different adenovirus vectors containing mouse IFN-alpha( genes resulted in a
      marked antitumor response in mice transplanted either subcutaneously or
      intravenously with IFN-resistant Friend leukemic cells compared to tumor-bearing
      animals inoculated with a control vector. Tumor growth inhibition after injection
      of IFN-adenovirus vectors was associated with a prolonged presence of high IFN
      levels in the sera of the injected mice. Suppression of metastatic tumor growth
      was also observed after a single injection of the IFN--adenovirus recombinant
      vectors, whereas a comparable antitumor response generally required several
      injections of high doses of IFN. Altogether, these results demonstrate that IFN-
      adenoviral vectors can efficiently inhibit metastatic tumor growth by host
      mediated mechanisms and suggest that adenovirus-mediated IFN-alpha gene therapy
      may represent an attractive alternative to the conventional clinical use of this
      cytokine, which generally requires multiple injections of high IFN doses for a
      prolonged period of time.

PMID- 11219496
TI  - Postoperative immuno-gene therapy of murine bladder tumor by in vivo
      administration of retroviruses expressing mouse interferon-gamma.
AB  - The murine MBT-2 bladder tumor model in syngeneic C3H/HeN mice was used to
      investigate the feasibility of gene therapy based on the delivery of interferon
      gamma (IFN-gamma) in vivo by retroviral vectors. We constructed a recombinant
      retroviral vector pRUFneo/IFN-gamma, which was transfected into a retroviral
      packaging cell line psiCRE, to produce psiCRE/pRUFneo/IFN-gamma cells. The
      expressions of the neo and IFN-gamma genes were verified by reverse transcription
      polymerase chain reaction and IFN-gamma was detected in the culture supernatant
      from psiCRE/pRUFneo/IFN-gamma cells. After receiving MBT-2 cells admixed with
      retroviral pRUFneoIFN-gamma supernatant, C3H/HeN mice exhibited lower tumor
      incidence, lower tumor mass, and higher survival rate, as well as higher
      antitumor responses compared to those injected with MBT-2 cells admixed with
      control retroviral supernatant. Moreover, the retroviral pRUFneoIFN-gamma
      supernatant was able to suppress the growth of rechallenged tumors in
      postoperated mice. Although the IFN-gamma protein secreted from
      psiCRE/pRUFneo/IFN-gamma cells partly contributes to the antitumor effect of
      retroviral pRUFneoIFN-gamma supernatant, the retroviruses carrying the IFN-gamma
      gene transduced MBT-2 cells in vivo, which may result in enhancing local IFN
      gamma production from tumor cells. Because bladder is suitable for the
      intravesical instillation of therapeutic agents, in vivo administration of
      retroviral vectors encoding IFN-gamma may be explored for the treatment of
      bladder cancer.

PMID- 11219497
TI  - Successful immunogene therapy using colon cancer cells (colon 26) transfected
      with plasmid vector containing mature interleukin-18 cDNA and the Igkappa leader
      sequence.
AB  - IL-18 is a novel cytokine that induces interferon (IFN)-gamma secretion and plays
      an important role in antitumor immunity. In the present study, we constructed
      plasmid vectors encoding the murine mature IL-18 cDNA linked with the Igkappa
      leader sequence and the pro-IL-18 cDNA to estimate the efficacy of the mature IL-
      18 vector and to evaluate IL-18--producing tumor cells as a tumor vaccine. Colon
      26 cells were transfected with the abovementioned vectors or with vector alone
      (mock). Reverse transcription-polymerase chain reaction analysis showed increased
      expression of murine IL-18 cDNA in both mature IL-18 and pro-IL-18 transfectants
      in comparison to that in mock transfected cells. The ability of the culture
      supernatants of mature IL-18 transfectants to induce IFN-gamma secretion was
      extremely high (40-140 pg/10(6) cells) in comparison to that of pro-IL-18
      transfectants (4-18 pg/10(6) cells). When injected into syngeneic BALB/c mice,
      the growth of mature IL-18 transfectants, but not pro-IL-18 transfectants, was
      significantly less than that in mock transfected cells ( P< .01, by ANOVA and
      analysis of covariance). In addition, injection of colon 26 or Meth-A cells into
      mice immunized with a mature IL-18 transfectant revealed acquired immunity.
      Depletion of natural killer cells did not affect the growth of transfectants.
      However, the growth inhibitory effects were partially abrogated following
      treatment with anti-CD4+ and anti-CD8+ antibodies. These data suggest that the
      rejection of mature IL-18/colon 26 cells was mediated through T-cell activation.
      Gene therapy using mature IL-18 transfectants containing a plasmid vector and the
      Igkappa leader sequence may be a useful tumor vaccine.

PMID- 11219498
TI  - The relationship between aerobic fitness and recovery from high intensity
      intermittent exercise.
AB  - A strong relationship between aerobic fitness and the aerobic response to
      repeated bouts of high intensity exercise has been established, suggesting that
      aerobic fitness is important in determining the magnitude of the oxidative
      response. The elevation of exercise oxygen consumption (VO2) is at least
      partially responsible for the larger fast component of excess post-exercise
      oxygen consumption (EPOC) seen in endurance-trained athletes following intense
      intermittent exercise. Replenishment of phosphocreatine (PCr) has been linked to
      both fast EPOC and power recovery in repeated efforts. Although 31P magnetic
      resonance spectroscopy studies appear to support a relationship between endurance
      training and PCr recovery following both submaximal work and repeated bouts of
      moderate intensity exercise, PCr resynthesis following single bouts of high
      intensity effort does not always correlate well with maximal oxygen consumption
      (VO2max). It appears that intense exercise involving larger muscle mass displays
      a stronger relationship between VO2max and PCr resynthesis than does intense
      exercise utilising small muscle mass. A strong relationship between power
      recovery and endurance fitness, as measured by the percentage VO2max
      corresponding to a blood lactate concentration of 4 mmol/L, has been
      demonstrated. The results from most studies examining power recovery and VO2max
      seem to suggest that endurance training and/or a higher VO2max results in
      superior power recovery across repeated bouts of high intensity intermittent
      exercise. Some studies have supported an association between aerobic fitness and
      lactate removal following high intensity exercise, whereas others have failed to
      confirm an association. Unfortunately, all studies have relied on measurements of
      blood lactate to reflect muscle lactate clearance, and different mathematical
      methods have been used for assessing blood lactate clearance, which may
      compromise conclusions on lactate removal. In summary, the literature suggests
      that aerobic fitness enhances recovery from high intensity intermittent exercise
      through increased aerobic response, improved lactate removal and enhanced PCr
      regeneration.

PMID- 11219500
TI  - Physiological and cardiovascular changes associated with deep water running in
      the young. Possible implications for the elderly.
AB  - The increased number of people taking part in deep water running (DWR) is
      attributable to the weight-independent characteristic of this form of exercise.
      Deep water runners should, however, be aware of the respiratory and
      cardiovascular repercussions that result from exercising in water. It has been
      well documented that water immersion (WI) alone results in decrements in
      respiratory and cardiovascular parameters in young individuals immersed in water
      to the neck. These decrements become more pronounced with exercise, such that
      maximal oxygen consumption and heart rate (HR) are lower during DWR compared with
      running on land. Age also seems to influence these parameters; Derion et al.
      found little to no change in cardiac output, stroke volume and HR during WI in
      older individuals compared with the decrease experienced in younger individuals.
      In contrast, gender appears to have no effect on WI or DWR response. Although
      differences in acute metabolic responses have been observed in numerous studies,
      training studies examining the effectiveness of using a DWR training programme
      found that DWR produced equivocal training responses when compared with fit and
      highly trained individuals running on land. Less convincing evidence has been
      provided for untrained individuals seeking benefits from a DWR training
      programme, as some studies showed significant improvements while others did not.
      There is a current lack of knowledge regarding the use of this form of exercise
      by frail elderly individuals and/or those with osteoporosis.

PMID- 11219499
TI  - Interval training for performance: a scientific and empirical practice. Special
      recommendations for middle- and long-distance running. Part I: aerobic interval
      training.
AB  - This article traces the history of scientific and empirical interval training.
      Scientific research has shed some light on the choice of intensity, work duration
      and rest periods in so-called 'interval training'. Interval training involves
      repeated short to long bouts of rather high intensity exercise (equal or superior
      to maximal lactate steady-state velocity) interspersed with recovery periods
      (light exercise or rest). Interval training was first described by Reindell and
      Roskamm and was popularised in the 1950s by the Olympic champion, Emil Zatopek.
      Since then middle- and long- distance runners have used this technique to train
      at velocities close to their own specific competition velocity. In fact, trainers
      have used specific velocities from 800 to 5000m to calibrate interval training
      without taking into account physiological markers. However, outside of the
      competition season it seems better to refer to the velocities associated with
      particular physiological responses in the range from maximal lactate steady state
      to the absolute maximal velocity. The range of velocities used in a race must be
      taken into consideration, since even world records are not run at a constant
      pace.

PMID- 11219503
TI  - Controlled cell deformation produces defined areas of contact between cells and
      ligand-coated surfaces.
AB  - A method which allows precise control of the time of initiation and the area of
      contact of T cells with immobilized ligands has been developed. Cells are trapped
      in an asymmetric film that can be quantitatively thinned by reducing the film's
      capillary pressure. Ligands adsorbed to the base of the apparatus are forced into
      close contact with the cells as the air-liquid interface is drawn down. Using
      interference microscopy and microbeads to indicate the film height, the amount of
      thinning can be controlled to within 1 microm. In this study, this system was
      used to produce contact areas of 182 and 356 microm2 between T cells and anti-CD3
      coated surfaces. These contact areas were measured using fluorescent dye
      exclusion microscopy. This apparatus can be used for quantitative studies of T
      cell activation, as is reported in Patrick et al., J. Immunol. Method. 24:97-108,
      2000.

PMID- 11219501
TI  - Alterations in energy metabolism during exercise and heat stress.
AB  - Much of the research that has examined the interaction between metabolism and
      exercise has been conducted in comfortable ambient conditions. It is clear,
      however, that environmental temperature, particularly extreme heat, is a major
      practical issue one must consider when examining muscle energy metabolism. When
      exercise is conducted in very high ambient temperatures, the gradient for heat
      dissipation is significantly reduced which results in changes to thermoregulatory
      mechanisms designed to promote body heat loss. This can ultimately impact upon
      hormonal and metabolic responses to exercise which act to alter substrate
      utilisation. In general, the literature examining metabolic responses to exercise
      and heat stress has demonstrated a shift towards increased carbohydrate use and
      decreased fat use. Although glucose production appears to be augmented during
      exercise in the heat, glucose disposal and utilisation appears to be unaltered.
      In contrast, glycogen use has been consistently demonstrated to be augmented
      during exercise in the heat. This increase in glycogenolysis is observed via both
      aerobic and anaerobic pathways. Although several hypotheses have been proposed as
      mechanisms for the substrate shift towards greater carbohydrate metabolism during
      exercise and heat stress, recent work suggests that an augmented sympatho-adrenal
      response and intramuscular temperature may be responsible for such a phenomenon.

PMID- 11219504
TI  - A parametric approach to measuring cerebral blood flow autoregulation from
      spontaneous variations in blood pressure.
AB  - Autoregulation maintains cerebral blood flow (CBF) almost constant in the face of
      changes in arterial blood pressure (ABP). Tests for impairment of this process
      using only spontaneous fluctuations in ABP, without provoking large variations,
      are of great clinical interest, and a range of different approaches have
      previously been applied. Extending earlier work based on linear filters, we
      propose a simple parametric method using a first order finite impulse response
      filter. We evaluate the method on ABP and CBF velocity [(CBFV), from trancranial
      Doppler ultrasound] signals collected in 60 patients with stenosis or occlusion
      of the carotid arteries. Data were collected during the inspiration of ambient
      air, a 5% CO2/air mixture, and finally the return to ambient air. Equivalent data
      were collected in 15 normal subjects. The filters estimated from the data
      segments with constant inspiratory pCO2 showed the expected high-pass
      characteristic, which was reduced during hypercapnia and also in patients. Highly
      significant correlation between the filter parameters and cerebrovascular
      reactivity (percent increase in CBFV per unit change in end-tidal pCO2) gives
      further evidence that the filters reflect autoregulation. The method allows
      simple parametrization of the dynamic autoregulatory responses in CBFV, and the
      analysis of short (1 min) data segments.

PMID- 11219502
TI  - Fast pitch softball injuries.
AB  - The popularity of fast pitch softball in the US and throughout the world is well
      documented. Along with this popularity, there has been a concomitant increase in
      the number of injuries. Nearly 52% of cases qualify as major disabling injuries
      requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75%
      of injuries occur during away games and approximately 31% of traumas occur during
      nonpositional and conditioning drills. Injuries range from contusions and
      tendinitis to ligamentous disorders and fractures. Although head and neck traumas
      account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of
      all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of
      injuries occur when the athlete collides with another individual or object. Other
      factors involved include the quality of playing surface, athlete's age and
      experience level, and the excessive physical demands associated with the sport.
      Nearly 24% of injuries involve base running and are due to poor judgement,
      sliding technique, current stationary base design, unorthodox joint and extremity
      position during ground impact and catching of cleats. The increasing prevalence
      of overtraining syndrome among athletes has been attributed to an unclear
      definition of an optimal training zone, poor communication between player and
      coach, and the limited ability of bone and connective tissue to quickly respond
      to match the demands of the sport. This has led routinely to arm, shoulder and
      lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and
      time loss injuries in 45% of pitching staff during a single season. Specific
      attention to a safer playing environment, coaching and player education, and
      sport-specific training and conditioning would reduce the risk, rate and severity
      of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as
      well as minimising use of indoor facilities, is suggested to decrease the number
      of collision injuries. Coaches should be cognisant of overtraining, vary day-to
      day training routines to decrease repetitive musculoskeletal stress, focus on
      motor skills with equal emphasis on speed and efficiency of movement, and use
      drills that reinforce sport-specific, decision making processes to minimise
      mental mistakes. Conditioning programs that emphasise a combination of power,
      acceleration, flexibility, technical skill, functional capacity and injury
      prevention are recommended. Due to the limited body of knowledge presently
      available on this sport, a greater focus on injury surveillance would provide a
      clearer picture of injury causation and effective management procedures, leading
      toward safer participation and successful player development.

PMID- 11219505
TI  - Short-Term biomechanical adaptation of the rat carotid to acute hypertension:
      contribution of smooth muscle.
AB  - The biomechanical adaptation of the arterial wall to hypertension has been
      studied extensively in recent years; however, the exact biomechanical
      contribution of vascular smooth muscle cells (VSMCs) during the adaptation
      process in conduit vessels is not known. We induced hypertension in 8 wk old
      Wistar rats by total ligation of the aorta between the two kidneys. Mean blood
      pressure increased from 92 +/- 2 (mean +/- SE) mm Hg to approximately 150 mmHg.
      Rats were sacrificed 2, 4, and 8 d after surgery and the left common carotid
      artery was excised for analysis. Wall thickness increased by 18% in 8 d and the
      opening angle by 32% in 4 d. The elastic properties were measured under normal
      VSMC tone (i.e., the amount of VSMC tone under normal conditions also called
      basal VSMC tone or normal resting VSMC tone), under maximally contracted VSMC
      (NE, 5 x 10(-7) mol/L) and under totally relaxed VSMC conditions (papaverine, 10(
      4) mol/L). The most pronounced modifications were the changes in elastic
      properties related to normal VSMC tone. The functional contraction ratio at 100
      mm Hg, defined as the relative contraction under normal conditions (normal VSMC
      tone), increased by 439% 4 d after the induction of hypertension. The total
      contraction capacity of the VSMC increased by 38% within 8 d. The changes in
      normal VSMC tone led to important changes in the mechanical properties of the
      arterial wall. Under normal VSMC conditions, compliance at mean pressure (148 mm
      Hg) increased by 159% within 8 d, whereas in the absence of VSMC tone, compliance
      did not increase significantly. We conclude that in conduit vessels, the VSMC,
      which is the sensing and effecting element of the adaptation process, is
      subjected to large-scale changes during the early phase of arterial adaptation to
      acute hypertension.

PMID- 11219506
TI  - Wave front-obstacle interactions in cardiac tissue: a computational study.
AB  - An understanding of wave front-obstacle interactions will greatly enhance our
      knowledge of the mechanisms involved in cardiac arrhythmias and their therapy.
      The goal of this computational study is to examine the interactions between wave
      fronts and various obstacles in a two-dimensional sheet of myocardium. The
      myocardium is modeled as an isotropic sheet with Luo-Rudy I membrane kinetics. An
      examination is conducted of wave front interactions with nonconductive and
      passive-tissue obstacles. Simulations were performed either in environments of
      reduced myocardial excitability, or with rapid stimulation via a line electrode.
      The shape of the obstacles and their ability to withdraw current from the active
      tissue greatly influence wave front-obstacle interactions in each of these
      environments. The likelihood of wave front detachment from an obstacle corner
      increases as the curvature of the obstacle corner is increased. A passive-tissue
      obstacle promotes wave front-obstacle separation in regions of depressed
      excitability. Under rapid pacing, the presence of the passive obstacle results in
      wave fragmentation, while the insulator obstacle promotes wave front detachment.
      The results of this study reveal the importance of obstacle composition and
      geometry in wave front interactions with cardiac obstacles.

PMID- 11219507
TI  - An experimentalist's approach to accurate localization of phase singularities
      during reentry.
AB  - A phase variable that uniquely represents the time course of the action potential
      has been used to study the mechanisms of cardiac fibrillation. A spatial phase
      singularity (PS) occurs during reentrant wave propagation and represents the
      organizing center of the rotating wave. Here, we present an error analysis to
      investigate how well PSs can be localized. Computer simulations of rotating
      spiral waves scaled appropriately for cardiac tissue were studied with various
      levels of noise added. The accuracy in identifying and localizing singularities
      depended on three factors: (i) the point chosen as the origin in state space used
      to calculate the phase variable; (ii) signal to noise ratio; and (iii)
      discretization (number of levels used to represent data). We found that for both
      simulation as well as experimental data, there existed a wide range for the
      choice of origin for which PSs could be identified. Discretization coupled with
      noise affected this range adversely. However, there always existed a range for
      choice of the origin that was 20% or more of the action potential amplitude
      within which the accuracy of localizing PSs was better than 2 mm. Thus, a precise
      determination of origin was not necessary for accurately identifying PSs.

PMID- 11219508
TI  - Compartmental analysis of breathing in the supine and prone positions by
      optoelectronic plethysmography.
AB  - Optoelectronic plethysmography (OEP) has been shown to be a reliable method for
      the analysis of chest wall kinematics partitioned into pulmonary rib cage,
      abdominal rib cage, abdomen, and right and left side in the seated and erect
      positions. In this paper, we extended the applicability of this method to the
      supine and prone positions, typically adopted in critically ill patients. For
      this purpose we have first developed proper geometrical and mathematical models
      of the chest wall which are able to provide consistent and reliable estimations
      of total and compartmental volume variations in these positions suitable for
      clinical settings. Then we compared chest wall (CW) volume changes computed from
      OEP(deltaVCW) with lung volume changes measured with a water seal spirometer (SP)
      (deltaVSP) in 10 normal subjects during quiet (QB) and deep (DB) breathing on
      rigid and soft supports. We found that on a rigid support the average differences
      between deltaVSP and deltaVCW were -4.2% +/- 6.2%, -3.0% +/- 6.1%, -1.7% +/-
      7.0%, and -4.5% +/- 9.8%, respectively, during supine/QB, supine/DB, prone/QB,
      and prone/DB. On the soft surface we obtained -0.1% +/- 6.0%, -1.8% +/- 7.8%,
      18.0% +/- 11.7%, and 10.2% +/- 9.6%, respectively. On rigid support and QB, the
      abdominal compartment contributed most of the deltaVCW in the supine (63.1% +/-
      11.4%) and prone (53.5% +/- 13.1%) positions. deltaVCW was equally distributed
      between right and left sides. In the prone position we found a different chest
      wall volume distribution between pulmonary and abdominal rib cage (22.1% +/- 8.6%
      and 24.4% +/- 6.8%, respectively) compared with the supine position (23.3% +/-
      9.3% and 13.6% +/- 13.0%).

PMID- 11219510
TI  - Potential of the genetic algorithm neural network in the assessment of gait
      patterns in ankle arthrodesis.
AB  - The aim of this study was to develop an empirical model of parameter-based gait
      data, based on an artificial neural network and a genetic algorithm, for the
      assessment of patients after ankle arthrodesis. Ground reaction force vectors
      were measured by force platforms during level walking. Nine force parameters
      expressed in percentage of body weight and their chronologic incidence of
      occurrence expressed in percentage of stance phase period were used in modeling.
      Ten healthy persons and ten patients who had solid arthrodesis of the ankle were
      recruited in this study for developing the model. By applying the genetic
      algorithm neural network, the percentage of correct classification was 98.8% and
      the subset of discriminant parameters was be reduced to 9 out of 18. These key
      parameters were mainly related to the loading response and propulsive phase. This
      indicates that there was a reduction in the abilities in cushion impact and push
      off in the patients after ankle arthrodesis. Finally, the relative distance (Dr)
      was defined in this study and used in two new patients' examinations to
      demonstrate its clinical utility.

PMID- 11219509
TI  - Transfer impedance of the respiratory system by forced oscillation technique and
      optoelectronic plethysmography.
AB  - To estimate the transfer impedance of the respiratory system (Ztr), we applied
      pressure forcing at the mouth from 1 to 24 Hz in eight healthy subjects and used
      optoelectronic plethysmography (OEP) to measure volume changes of the chest wall
      and its different compartments: pulmonary rib cage (RCp), abdominal rib cage
      (RCa) and abdomen (AB). Spectral analysis allowed assessment of input impedance
      (Zin) and total (Ztr) and compartmental (ZRCP, ZRCa, and ZAB) transfer
      impedances. As expected, averaged values of Zin and Ztr were similar at low
      frequencies (< 8 Hz) while they progressively differed at high frequencies. The
      percentage contributions of ZRCp, ZRCa , and ZAB to Ztr were, respectively, 35.3
      +/- 1.4SD, 13.8 +/- 1.4, and 50.8 +/- 2.8 at low frequencies (< 8 Hz) and 63.1 +/
      5.5, 20.7 +/- 5.2, and 16.2 +/- 2.3 at higher frequencies (> 10 Hz). The
      validation of our approach was based on the comparison with a physical model
      comprised of a rubber membrane stretched over and attached to the lip of a bowl.
      We conclude that the combination of forced oscillations with OEP provides the
      simultaneous assessment of Zin and Ztr, it does not require the use of a
      plethysmographic chamber and it allows the separation between the different rib
      cage-abdominal pathways.

PMID- 11219512
TI  - A new algorithm for autoregression moving average model parameter estimation
      using group method of data handling.
AB  - A new algorithm for autoregresive moving average (ARMA) parameter estimation is
      introduced. The algorithm is based on the group method of data handling (GMDH)
      first introduced by the Russian cyberneticist, A. G. Ivakhnenko, for solving high
      order regression polynomials. The GMDH is heuristic in nature and self-organizes
      into a model of optimal complexity without any a priori knowledge about the
      system's inner workings. We modified the GMDH algorithm to solve for ARMA model
      parameters. Computer simulations have been performed to examine the efficacy of
      the GMDH and comparison of the GMDH is made to one of the most accurate and one
      of the most widely used algorithms, the fast orthogonal search (FOS) and the
      least-squares methods, respectively. The results show that in some cases with
      noise contamination and incorrect model order assumptions, the GMDH performs
      better than either the FOS or the least-squares methods in providing only the
      parameters that are associated with the true model terms.

PMID- 11219511
TI  - On the use of optical flow methods with spin-tagging magnetic resonance imaging.
AB  - Magnetic resonance imaging (MRI) is a versatile noninvasive tool for achieving
      full-field quantitative visualization of biomedical fluid flows. In this study,
      two MRI velocimetry techniques (spin tagging and phase contrast) are used to
      obtain velocity measurements in a Poiseuille flow for Reynolds numbers below
      1,000. Spin-tagging MRI velocimetry supplies the displacement of tagged grids of
      nuclear spins from which the velocity field can be inferred, while phase contrast
      MRI velocimetry directly provides velocity data for every pixel in the field of
      view. Although the phase contrast method is more accurate for this flow, this
      technique is more sensitive to errors from magnetic susceptibility gradients,
      higher order motions, and has limited dynamic range. Spin-tagging MRI velocimetry
      is a viable alternative if automatic methods for extracting velocity fields from
      the tags can be found. Optical flow, a technique originally developed for machine
      vision applications, is proposed here as a postprocessing step to obtain two
      dimensional velocity fields from spin-tagging MRI images. Results with
      artificially generated grids demonstrate the robustness of the optical flow
      algorithm to noise and indicate that a 7%-10% average error can be expected from
      the optical flow calculations alone, independent of MRI image artifacts.
      Experiments on spin-tagging MRI images for a Re=230 Poiseuille flow gave an
      average error of 6.41%, which was consistent with the measurement error of the
      generated (synthetic) images with the same level of random noise superimposed.

PMID- 11219513
TI  - Twenty-year report of the first auditory brain stem nucleus implant.
AB  - We present the 20-year case report of an auditory implant placed on the dorsal
      cochlear nucleus with long-term electrical stimulation in a patient with
      neurofibromatosis 2. The patient has continued to use her implant daily for 20
      years, and it has greatly enhanced her quality of life. There have been no
      adverse sequelae.

PMID- 11219514
TI  - Hearing improvement after therapy for hyperlipidemia in patients with chronic
      phase sudden deafness.
AB  - Hearing in patients with chronic-phase sudden deafness and associated
      hyperlipidemia tends to improve with therapy for hyperlipidemia. We studied 12
      patients with unilateral sudden deafness and hyperlipidemia in whom more than 1
      month had elapsed since the onset of the hearing disturbance. The disturbance was
      considered to be irreversible without therapy. The 4 men and 8 women ranged in
      age from 32 to 73 years, with a mean age of 54.3 years. The hearing disturbance
      was evaluated by measuring the air conduction thresholds at 125 to 8,000 Hz with
      pure tone audiometry. Hyperlipidemia was diagnosed when the total blood
      cholesterol level was 230 mg/dL or greater. The therapy for hyperlipidemia
      consisted of diet therapy and the administration of antilipemic agents. The
      hearing level was measured both before therapy and when the total blood
      cholesterol level had decreased to less than 230 mg/dL. After therapy, the mean
      hearing level had improved significantly (Wilcoxon's test, p < .05) at each of
      125, 250, 500, and 2,000 Hz, but the changes in the level were not significant at
      1,000, 4,000, or 8,000 Hz. Our results suggest that with therapy for
      hyperlipidemia, hearing tends to improve in patients with chronic-phase sudden
      deafness and associated hyperlipidemia, even when more than 1 month has elapsed
      since the onset of the presumably otherwise-irreversible hearing disturbance.

PMID- 11219515
TI  - Effects of exposing the opened endolymphatic sac to large doses of steroids to
      treat intractable Meniere's disease.
AB  - To enhance the effect of treatment for intractable Meniere's disease, we exposed
      the opened endolymphatic sac to high concentrations of steroids. This technique-
      endolymphatic sac drainage and steroid instillation surgery--involves the
      application of a mass of prednisolone followed by absorbable gelatin sponges
      soaked in a high concentration of dexamethasone into a sac lumen opened and
      expanded with a bundle of absorbable gelatin film. These sponges are also placed
      around the sac and coated with biochemical adhesive so that the medicine is
      slowly delivered into the sac over a prolonged period of time by means of a
      natural sustained-release vehicle. The short-term results (6 to 14 months) in 12
      patients with Meniere's disease, including those in stage IV, treated by the
      above techniques showed that definitive spells were completely controlled in all
      cases. Hearing was improved, and annoyance due to tinnitus was decreased in all
      cases except one.

PMID- 11219516
TI  - Inner ear fluid volumes and the resolving power of magnetic resonance imaging:
      can it differentiate endolymphatic structures?
AB  - Magnetic resonance imaging (MRI) can accurately recognize minute volumes as small
      as 1 mm3. The volumes of the utricle and saccule of the inner ear are within the
      resolving power of MRI, but these structures cannot be recognized because the
      endolymph and perilymph signals are identical. To clarify the interpretation and
      description of inner ear structures on MRI, we measured and calculated the
      volumes of the perilymphatic and endolymphatic spaces of the human ear. We found
      the total volume of the bony labyrinth to be approximately 192.5 mm3 (endolymph,
      34.0 mm3; perilymph, 158.5 mm3).

PMID- 11219517
TI  - Poly(adenosine diphosphate-ribose) synthetase inhibitor 3-aminobenzamide
      alleviates cochlear dysfunction induced by transient ischemia.
AB  - The present study was undertaken to determine the possible deleterious role
      played by poly(adenosine diphosphate-ribose) synthetase (PARS) in cochlear
      ischemia-reperfusion injury. Transient ischemia of the cochlea was induced in
      albino guinea pigs for 15, 30, or 60 minutes by pressing the labyrinthine artery
      at the porus acusticus internus. The animals were given intravenous 3
      aminobenzamide (a PARS inhibitor) or physiological saline solution I minute
      before the onset of reperfusion. The compound action potential thresholds were
      measured before the onset of ischemia and 4 hours after the onset of reperfusion.
      A statistically significant reduction in the postischemic compound action
      potential threshold shift was observed in the animals treated with 3
      aminobenzamide after 15 or 30 minutes of ischemia, whereas no statistical
      difference was found after 60 minutes of ischemia. These results suggest that
      excessive activation of PARS exerts deleterious effects on the cochlear injury
      induced by transient ischemia.

PMID- 11219518
TI  - Changes in permeability of strial vessels following vibration given to auditory
      ossicle by drill.
AB  - We produced drill-induced damage of the auditory ossicles of guinea pigs to study
      changes over time in the permeability of the blood vessels of the stria
      vascularis to horseradish peroxidase (HRP). In group A, the stimulus was applied
      for 10 seconds after intravenous injection of HRP. In group B, it was applied for
      30 seconds, and in group C, for 60 seconds. The cochlea was fixed with 2%
      glutaraldehyde perfused through the round window, and the guinea pigs were then
      decapitated. The stria vascularis of the basal and third turns was examined. The
      leakage of HRP from the blood vessels of the stria vascularis significantly
      increased in relation to the duration of the stimulus in both the basal and third
      turns. The damage to intermediate cells also tended to be in relation to the
      duration of the stimulus. Extravascular permeation of HRP took place through the
      tubules in the endothelial cytoplasm. The vibratory stimulation presumably opened
      channels that are not normally open.

PMID- 11219519
TI  - Vestibular findings in professional divers.
AB  - The purpose of the present study was to investigate possible inner ear changes
      related to professional diving, by the documentation of auditory and vestibular
      function in 13 asymptomatic professional divers and 12 nondiver controls. A
      higher average pure tone hearing threshold, although of no clinical significance,
      was found in the study group (8.53 +/- 4.85 versus 6.67 +/- 3.54 dB hearing
      level, p = .04). In the vestibular evaluation, the smooth harmonic acceleration
      test phase leads for 0.01, 0.02, and 0.04 Hz were significantly lower in the
      divers (0.01 Hz, 38.46 degrees +/- 7.15 degrees versus 45.83 degrees +/- 9.02
      degrees, p = .02; 0.02 Hz, 21.08 degrees +/- 5.19 +/- versus 25.17 degrees +/- 
      5.78 degrees, p = .05: 0.04 Hz, 12.38 degrees +/- 3.69 degrees versus 14.25
      degrees +/- 3.14 degrees, p = .05). We suggest that the lower smooth harmonic
      acceleration phase values found in the professional divers, reflecting longer
      vestibulo-ocular reflex primary time constants and enhancement of the velocity
      storage mechanism, are the result of a habituation process that augments the low
      frequency response of the canal-ocular system.

PMID- 11219520
TI  - Immortalization of rat middle ear epithelial cells by adeno 12-SV40 hybrid virus.
AB  - Rat middle ear epithelial cells were infected with the adeno 12-SV40 hybrid
      virus. The cell line thus obtained displays features of primary cultured
      epithelial cells in both light microscopic and ultrastructural examinations. The
      immortalized cells have been in continuous proliferation for 40 passages and more
      than 17 months. Immunohistochemical analysis of the immortalized cells was
      positive for the SV40 T antigen and the tumor suppressor protein p53. The cells
      also stained positive for cytokeratin, an epithelial cell marker, and negative
      for vimentin, a fibroblast marker. These results, together with karyotype
      analysis, indicate that this cell line originated from rat middle ear epithelial
      cells and retains the characteristics of epithelial cells. This cell line will be
      useful for studying the normal cellular biology of middle ear epithelial cells,
      as well as the cellular and molecular mechanisms involved in the bacteria-middle
      ear epithelial cell interaction.

PMID- 11219521
TI  - Long-term study of endonasal duraplasty and review of the literature.
AB  - Many different techniques have been proposed to repair frontobasal dura mater
      lesions. Because of its low morbidity and high success rate, the endonasal
      approach has become a preferred route for treating cerebrospinal fluid fistulas
      of the anterior skull base. This article presents a retrospective evaluation of
      136 endonasal duraplasties (126 patients) performed between July 1980 and May
      1998 at a tertiary care facility. Follow-up consisted of clinical examinations
      including nasal endoscopy, objective measures, and telephone interviews. The
      following measures were used to evaluate the results of these duraplasties:
      postoperative nasal fluorescein endoscopy in 71 cases, computed tomographic
      cisternography in 2, nasal fluorescein endoscopy with computed tomographic
      cistemography in 19, magnetic resonance imaging in 6, and nasal fluorescein
      endoscopy with magnetic resonance imaging in 1. Tight closure was accomplished in
      129 dural lesions (94.9%) on the first attempt. In 3 cases, recurrence of
      cerebrospinal fluid leakage was treated successfully by 1 endonasal revision, and
      in 1 case, a tight duraplasty was achieved after 2 endonasal revisions. Its high
      success rate, low rate of morbidity, and good long-term results recommend
      endonasal duraplasty as a primary treatment modality for frontobasal dural
      lesions. For extended frontobasal dural lesions, for which intracranial dural
      repair is the preferred approach, the endonasal approach should be used to close
      additional dural leaks of the sphenoid sinus.

PMID- 11219522
TI  - Correlation between microbiology and previous sinus surgery in patients with
      chronic maxillary sinusitis.
AB  - Aspirates of 108 chronically inflamed maxillary sinuses were processed for
      aerobic and anaerobic bacteria. There were 295 bacterial isolates: 109 aerobic
      and facultative, and 186 anaerobic. The predominant aerobic isolates were
      Staphylococcus aureus (17 isolates), alpha-hemolytic streptococci (14),
      Pseudomonas aeruginosa (12), Moraxella catarrhalis (10), and Haemophilus spp (8).
      The predominant anaerobes were Peptostreptococcus spp (61), Prevotella spp (45),
      Fusobacterium spp (15), and Propionibacterium acnes (14). Analysis of the medical
      histories revealed a correlation only between the microbial results and previous
      sinus surgery. Pseudomonas aeruginosa and gram-negative aerobic bacilli (GNAB)
      were more often isolated in patients who had surgery (9 of 33 patients had P
      aeruginosa and 17 had GNAB) than in patients who did not have surgery (3 of 75
      had P aeruginosa and 7 had GNAB; p < .001). Anaerobes were isolated more often in
      patients who did not have surgery (69 of 75 patients) than in those who had
      previous surgery (21 of 33 patients; p < .001). These findings illustrate the
      unique microbiological features of chronic maxillary sinusitis that persist after
      sinus surgery.

PMID- 11219523
TI  - Loss of secondary esophageal peristalsis is not a contributory pathogenetic
      factor in posterior laryngitis.
AB  - Secondary esophageal peristalsis helps prevent the entry of gastric acid into the
      pharynx by clearing the refluxed gastric contents back into the stomach. Because
      the loss of this mechanism may contribute to the pathogenesis of reflux-induced
      laryngeal disorders, our aim was to study the frequency of stimulation and
      parameters of secondary esophageal peristalsis in patients with posterior
      laryngitis (PL). We studied 14 patients (45 +/- 5 years) with PL documented by
      videolaryngoscopy and 11 healthy controls (46 +/- 6 years). The upper esophageal
      sphincter (UES) pressure was monitored by a sleeve assembly incorporating an
      injection port 5 cm distal to the sleeve. The esophageal body and lower
      esophageal sphincter (LES) pressures were measured by an LES sleeve assembly.
      Primary esophageal peristalsis was induced by 5-mL water swallows. Secondary
      esophageal peristalsis was induced by abrupt injection of volumes of air,
      incrementally increased by 5 mL, into the esophagus. Secondary esophageal
      peristalsis could not be elicited by injection of any volume (up to 60 mL) in 3
      PL patients and 2 controls. These 5 subjects had normal primary peristalsis. The
      threshold volume of air required to stimulate secondary esophageal peristalsis in
      PL patients (median, 15 mL) was similar to that of controls (median, 10 mL). The
      parameters of the secondary esophageal peristaltic pressure wave were similar in
      both groups, and in both groups, they were similar to those of primary
      peristalsis. The UES response to the injection of the threshold volume that
      induced secondary esophageal peristalsis in PL patients was contraction in 58% of
      the trials, partial relaxation in 3%, and no response in 39%. The findings were
      similar to those in the controls. The LES response to injection of the threshold
      volume was complete relaxation in both the PL patients and the controls. We
      conclude that the integrity of secondary esophageal peristalsis is preserved in
      PL patients.

PMID- 11219524
TI  - Thyroarytenoid muscle: functional subunits based on morphology and muscle fiber
      typing in cats.
AB  - Using parvalbumin immunohistochemistry to determine the distribution of muscle
      fiber types in the feline thyroarytenoid muscle (TA), we clearly distinguished
      the vocalis (with predominance of "slow" type 1 fibers) from the external TA (in
      which "fast" type 2 fibers predominated, especially in its rostral part).
      Reconstruction of serial frontal sections of the TA allowed the stereoscopic
      study of each division. The existence of a rudimentary laryngeal ventricle
      separating the true and false vocal folds in cats was demonstrated anatomically
      and histologically, and its relationships to each division of the TA were
      established. Our results suggest that the vocalis, fitted for enduring
      activities, is suited for voice control. The fast, rostral part of the external
      TA seems suited to laryngeal sphincteric demands, while its caudal counterpart
      may act in both functions. The anatomic individualization of the divisions of the
      TA may suggest that they play distinct physiological roles and may imply that
      they should not be considered a single functional unit.

PMID- 11219525
TI  - Retropharyngeal autologous fat transplantation for congenital short palate: a
      nasometric assessment of functional results.
AB  - Seventeen patients (4 to 24 years old; mean, 9.7 years) with mild velopharyngeal
      insufficiency were treated in our department during the period 1996 to 1999 with
      augmentation of the posterior pharyngeal wall with autologous fat. The main
      disorder was a congenital short palate without a cleft, in most cases revealed by
      adenoidectomy. Four patients had previously undergone pharyngoplasty, and 1 had
      already been injected in the posterior pharyngeal wall with Teflon paste. All
      patients had been exhaustively treated with speech therapy, and the result
      remained unsatisfactory. The functional outcome of the surgical procedure was
      quantified by acoustic nasometry. The decrease of the nasalance percentage for a
      standardized spoken passage was significant 1 to 3 months after the fat
      transplantation, and there was a slight tendency to further reduction of nasality
      at the late follow-up visit, more than 6 months (average, 9.4 months) after the
      intervention. The mean value of the nasalance score for the "normal passage"
      (running speech) then reached the limit of normal values. A long-term follow-up
      (average, 24.3 months) by telephone questionnaire confirmed the persistence of
      the beneficial results. Autologous fat seems an excellent alternative for Teflon
      in this indication. Acoustic nasometry allows a precise quantitative assessment
      of functional velopharyngeal surgery.

PMID- 11219527
TI  - Quantitative assessment of the pharyngeal airway by dynamic magnetic resonance
      imaging in obstructive sleep apnea syndrome.
AB  - Dynamic changes in the pharyngeal airway of patients with obstructive sleep apnea
      syndrome (OSAS) were evaluated by quantitating the findings of real-time imaging
      performed during wakefulness and spontaneous sleep by means of dynamic magnetic
      resonance imaging (MRI). Six patients with OSAS and 3 non-OSAS subjects, selected
      prospectively and randomly, underwent polysomnography and dynamic MRI. The cross
      sectional areas of the soft palate and oropharynx and the anterior-posterior
      airway dimensions seen during wakefulness and spontaneous sleep were calculated
      by US National Institutes of Health imaging software. On the basis of a case
      control study, comparisons were made with age-matched and body mass index-matched
      obese non-OSAS snorers. Spontaneous sleep caused significant obstruction and
      narrowing of various sites of the pharyngeal airway in the OSAS patients, but not
      in the non-OSAS subjects. During wakefulness, the non-OSAS subjects showed no
      marked narrowing of the pharyngeal airways, whereas a transient but significant
      narrowing was observed in the OSAS patients. The mean values of both the cross
      sectional area and the anterior-posterior diameter at the soft palate were
      significantly reduced by spontaneous sleep in the OSAS patients. Dynamic MRI in
      awake OSAS patients shows promise as a routine diagnostic tool for localizing the
      upper airway collapse for appropriate selection of surgical therapy.

PMID- 11219528
TI  - Effect of cigarette smoking on gastropharyngeal and gastroesophageal reflux.
AB  - Gastropharyngeal reflux appears to be associated with various otolaryngological
      complaints. Cigarette smoking is known to affect adversely the defense mechanisms
      against reflux of acid gastric contents into the esophagus. To study the
      relationship between gastropharyngeal, as well as gastroesophageal, reflux and
      cigarette smoking, 15 subjects underwent 24-hour double-probe pH monitoring while
      smoking their daily amount of cigarettes. The percentage of time the pH was below
      4 during the smoking period was significantly higher than the percentage of time
      the pH was below 4 during the nonsmoking period, proximal, at the level of the
      upper esophageal sphincter, as well as distal, above the lower esophageal
      sphincter. These findings demonstrate that smoking increases gastropharyngeal and
      gastroesophageal reflux. Smokers with complaints and disorders caused by reflux
      should therefore be advised to stop smoking in order to reduce reflux.

PMID- 11219526
TI  - Comparison of the microanatomical distributions of macrophages and dendritic
      cells in normal and diseased tonsils.
AB  - The palatine tonsils play an important role in immunologic surveillance and
      resistance to infection in the upper aerodigestive tract. Dendritic cells and
      macrophages function to capture and process antigen and present it to T
      lymphocytes, a critical step in the early immune response. Few studies have
      characterized the distribution and phenotype of those antigen-presenting cells in
      the normal palatine tonsil, or determined how those parameters change with
      disease. Immunohistochemical analysis was performed to determine the
      microanatomical distribution, quantity, morphology, and phenotype of macrophages
      and dendritic cells in both normal and diseased tonsils. Differences were
      observed in macrophage and dendritic cell distribution, quantity, and phenotype
      in the surface and crypt epithelium. The number of macrophages was significantly
      increased in all compartments in all disease groups (p < .05), although the
      number of macrophages that expressed phenotypes of maturity and/or activation was
      not concomitantly increased. In the surface epithelium, Langerhans and
      interdigitating cells decreased significantly with disease (p < .05). Chronic
      infection may impose an immunosuppressive effect on responses within tonsil
      tissue, affecting the immunologic factors responsible for macrophage maturation
      and activation.

PMID- 11219529
TI  - Bifid epiglottis associated with Joubert's syndrome.
AB  - This report presents the case of a 2-year-old boy who had a bifid epiglottis
      associated with Joubert's syndrome. He had episodic tachypnea and apnea,
      inspiratory stridor, aspiration, and growth and mental retardation. Direct
      laryngoscopy demonstrated agenesis of the right half of the epiglottis and
      hypertrophied mucosa over the arytenoid cartilage. After the hypertrophied mucosa
      was partially vaporized with a CO2 laser, the inspiratory stridor soon improved
      and the aspiration was alleviated. Brain magnetic resonance imaging showed
      cerebellar vermian agenesis and enlargement of the fourth ventricle.

PMID- 11219530
TI  - Epiglottic tuberculosis: differential diagnosis and treatment. Case report and
      review of the literature.
AB  - A case of a 40-year-old man with tuberculous involvement of the epiglottis
      suffering from unsuspected pulmonary tuberculosis is described. The laryngeal
      lesions were primarily considered to be highly suspicious for a neoplastic
      process rather than an infectious one. After diagnosis, the patient was treated
      according a standard protocol and followed up for a period of 2 years. He is
      still free of disease. The clinical presentation, diagnosis, pathological
      findings, and therapy of the condition are described. The differential diagnosis
      and management of epiglottic tuberculosis are reviewed and discussed. Even though
      these cases are rare, otorhinolaryngologists should keep in mind the possibility
      of tuberculosis in the differential diagnosis of laryngeal tumors, as the
      incidence of tuberculosis in developed countries is steadily increasing.

PMID- 11219532
TI  - Nuclear energy's debutante.

PMID- 11219531
TI  - Chondrosarcoma of the nasal septum.

PMID- 11219533
TI  - The second international in-vivo monitoring intercomparison program for whole
      body counting facilities by Canadian and United States agencies.
AB  - The Canadian National Calibration Reference Centre for In-Vivo Monitoring and the
      United States Department of Energy collaborated to offer a second international
      in vivo intercomparison program to whole body counting facilities in 1996. This
      program used a Reference Female phantom shell filled with radioactive tissue
      substitute polyurethane to simulate a uniform fission-product distribution in
      soft tissues. The nuclides used were 137Cs and 60Co. The phantom also contained
      40K homogeneously distributed in an amount similar to a Reference Female to
      produce a representative Compton background in the resulting spectra.
      Participants were asked to identify the nuclides and report activities for all
      except 40K. They were also asked to measure the precision of counting and supply
      the MDA for 137Cs and 60Co. The bias results were in the range of -30% to +80%
      with most facilities falling inside the range of -25% to +50% (Canadian and U.S.
      acceptable performance criteria). Results indicated that there was no measurable
      size dependency for this phantom. All reported precisions were less than 5% but
      NaI detector based systems seemed to have a systematic uncertainty in addition to
      Poisson variability. Contrarily, this was not found for Ge detector based
      systems. MDA data was scattered (14-3,500 Bq for 137Cs and 9-460 Bq for 60Co) and
      only suggested that lengthening the counting time improves MDA.

PMID- 11219534
TI  - An evaluation of the ethical principles of the ICRP's radiation protection
      standards for workers.
AB  - After reviewing international recommendations and national standards for
      occupational radiation exposures, the article summarizes the major ethical
      theories so as to analyze which theories various ICRP principles presuppose. It
      also shows how proponents of each ethical theory would support or criticize
      various radiation principles and practices. Finally the article discusses four
      ethical issues crucial to the debate over workplace standards for radiation: (1)
      how to respond to the uncertainty over effects of low-dose exposures; (2) the
      conditions under which worker consent legitimates higher exposures; (3) whether
      there ought to be a double standard for worker, vs. public, exposures; and (4)
      whether ethics allows money-for-health tradeoffs in radiation protection. The
      article concludes with several recommendations about how to make occupational
      exposure to radiation more ethically defensible.

PMID- 11219535
TI  - In-vivo thyroid 125I monitoring method using imaging plate.
AB  - A new in vivo thyroid monitoring system was devised with radioluminography using
      an imaging plate. The counting features of the system were investigated by using
      a neck-thyroid phantom. A clear thyroid image was obtained at thin prethyroid
      tissue thicknesses and short distances between IP and neck surface. The
      characteristic 125I thyroid image made it possible to visually confirm that the
      thyroid definitely accumulated 125I. The counting efficiency in 100xcps Bq(-1) of
      the imaging plate system was determined by setting a region of interest on the
      thyroid image resulting in a maximum efficiency of 0.5%. The higher efficiency
      was obtained for thinner tissue thickness overlaying the thyroid, smaller
      thyroids, and shorter distances between the imaging plate and neck surface. The
      imaging plate thyroid monitoring system was sensitive to thyroid 125I. Its
      minimum detection limit of 23 Bq for a 10-min measurement was considerably lower
      than the annual thyroid burden limit of 300 kBq.

PMID- 11219536
TI  - Age- and sex-specific relative thyroid radiation exposure to 131I in Ukraine
      after the Chernobyl accident.
AB  - The age- and sex-dependence of the 131I induced count rates is determined for the
      measurements performed in Ukraine after the Chernobyl accident on the thyroids of
      over 60,000 persons. For this, the individual measurements are scaled in such a
      way that the mean values over age and sex on one side and the mean values over
      measurement series on the other side are normalized to one. The resulting
      distribution of all scaled measurements is roughly log-normal. Half of them lie
      within a factor 1.6 of the median. 131I induced count rates have a minimum at
      birth year 1986, about half the value of adults. The maximum count rates with
      about 30% above adults are reached for males around age 16 y. The count rates are
      up to about 40% (at age 14-17 y) higher for males than for females. The results
      are within statistical uncertainties independent of the geographical area and the
      urban or rural nature of the settlements. Starting from the relative count rates,
      the age- and sex-dependence is calculated for the thyroid activities 1 mo after
      the accident for the integrated activities and for the doses. The dose of young
      children is a factor of about 6.5 higher than that of adults. Uncertainties are
      estimated throughout.

PMID- 11219538
TI  - Solubility of airborne uranium compounds at the Fernald Environmental Management
      Project.
AB  - The in vitro solubility of airborne uranium dusts collected at a former uranium
      processing facility now undergoing safe shutdown, decontamination, and
      dismantling was evaluated by immersing air filters from high volume samplers in
      simulated lung fluid and measuring the 238U in sequential dissolution fractions
      using specific radiochemical analysis for uranium. X rays and photons from the
      decay of uranium and thorium remaining on the filter after each dissolution
      period were also directly measured using a planar germanium detector as a means
      for rapidly evaluating the solubility of the uranium-bearing dusts. Results of
      these analyses demonstrate that two distinct types of uranium-bearing dusts were
      collected on the filters depending upon the location of the air samplers. The
      first material exhibited a dissolution half-time much less than 1 d and was most
      likely UO3. The dissolution rate of the second material, which was most likely
      U3O8, exhibited two components. Approximately one-third of this material
      dissolved with a half time much less than 1 d. The remaining two-thirds of the
      material dissolved with half times between 230 +/- 16 d and 1,350 +/- 202 d. The
      dissolution rates for uranium determined by radiochemical analysis and by gamma
      spectrometry were similar. However, gamma spectrometry analysis suggested a
      difference between the half times of 238U and its initial decay product 234Th,
      which may have important implications for in vivo monitoring of uranium.

PMID- 11219537
TI  - Calculation of the air concentrations of serially decaying nuclides--a new method
      applied to radon progeny.
AB  - A new calculation method is presented for determining the air concentrations of
      any serially decaying nuclides. This new method is easily incorporated into a
      Basic or spreadsheet program that is used to record the decay data. Specifically,
      the measurements were designed to illustrate radon progeny from a filter sample
      that is gross-alpha counted. The method is based on regressing the decay data,
      recorded in 1-min intervals, on the time after the end of sampling with an
      equation that describes the alpha activity as a function of the decay
      exponentials, e-lambdat. The results from both generated data and experimental
      filter samples were compared to the results obtained by two other well-known
      methods. All the methods give comparable estimates for the progeny air
      concentrations; non-linear regression and weighting by variances produces the
      smallest error estimates with the method presented here.

PMID- 11219539
TI  - Deconstructing radiation hormesis.
AB  - This paper explores some factors that may explain why the possibility of hormesis
      has not been embraced by the radiation protection community. If shown to be
      sustainable, hormesis might ameliorate several serious issues plaguing radiation
      protection including the high economic cost of environmental regulatory
      compliance and public fear of radiation exposure. Some but not all analyses of
      data from various sources, including the Japanese survivors of the atomic bombs
      and residential radon studies, suggest that low levels of ionizing radiation may
      be beneficial to human health. The evidence, however, has not been viewed as
      compelling for the following reasons: (1) Data in support of radiation hormesis
      in human populations is limited and much of it is based on re-evaluation of
      selected epidemiological data that has been used to test a different hypothesis;
      (2) Hormetic effects are weak and inconsistent, and are subject to large
      statistical uncertainties as is the case for carcinogenic effects at small doses;
      (3) A consensus is lacking on how hormesis should be defined and quantified; and
      (4) It is unclear how hormesis can be incorporated into the regulatory framework
      when beneficial health effects exceed the requirement for protection of health.

PMID- 11219540
TI  - Urinary uranium concentrations in an enlarged Gulf War veteran cohort.
AB  - Depleted uranium was first used on a large scale as a major component of
      munitions and armaments employed by the U.S. armed forces during the Gulf War in
      1991. In response to concern that exposure to depleted uranium may have been a
      cause of health problems suffered by returning veterans of that war, an already
      existing surveillance program following depleted uranium "friendly fire" victims
      was enlarged to assess the wider veteran community's exposure to depleted
      uranium. Between August 1998 and December 1999, 169 Gulf War veterans submitted
      24-h urine samples for determination of urinary uranium concentration and
      questionnaires describing their potential exposures to depleted uranium while in
      the Gulf War theatre. Depleted uranium exposure assessment was determined from 30
      separate questionnaire items condensed into 19 distinct exposure scenarios.
      Results of urine uranium analysis were stratified into high and low uranium
      groups with 0.05 microg uranium/g creatinine being the cut point and approximate
      upper limit of the normal population distribution. Twelve individuals (7.1%)
      exhibited urine uranium values in the high range, while the remaining 157 had
      urine uranium values in the low range. A repeat test of urine for 6 of these 12
      produced uranium results in the low range for 3 of these individuals. Exposure
      scenarios of the high and low uranium groups were similar with the presence of
      retained shrapnel being the only scenario predictive of a high urine uranium
      value. Results emphasize the unlikely occurrence of an elevated urine uranium
      result and consequently any uranium-related health effects in the absence of
      retained depleted uranium metal fragments in the veterans.

PMID- 11219541
TI  - Evaluation of body mass index for a reference Pakistani man and woman.
AB  - To strengthen the radiation protection infrastructure, a pilot study on physical
      characteristics for Reference Asian Man was carried out in Pakistan. Physical
      data on height and weight of Pakistani men and women were collected and compiled
      for all age groups to establish a Reference Pakistani Man/Woman which contributed
      toward the Reference Asian Man/Woman. A correlation between Age and Body Mass
      Index (BMI) of Pakistani MALES (i.e., rm = +0.89) and FEMALES (i.e., rf = +0.71)
      was observed. Average BMI of Pakistani males and females for the age group of 20
      50 y was found to be 21.95 kg m(-2) and 21.20 kg m(-2), respectively. From recent
      literature and work of others BMI for Reference Asian Male (RAM) and Reference
      Asian Female (RAF) has been found to be 20.79 kg m(-2) and 20.81 kg m(-2).
      Results of our study fall within BMI ranges for male/female adults of Asian
      countries, i.e., 19.14-22.98 kg m(-2) and 19.38-22.71 kg m(-2), respectively.
      However, no significant sex specific difference has been noted.

PMID- 11219543
TI  - Comment on "are public dose limits necessary?".

PMID- 11219542
TI  - Technical procedures for the evaluation of different radiation detection systems
      at the entrance of a waste incinerator plant.
AB  - To protect a new waste incinerator plant and the population against the
      accidental introduction of radioactive material in the furnace, in 1998 the
      Municipal Service Corporation of the city of Brescia decided to acquire a
      radiation detection portal system. However, the performance of such instruments
      is not sufficiently specified in this type of application, so ASM asked the
      Nuclear Engineering Department of the Polytechnic of Milan to draw up a test
      protocol and to lead the following experimental campaign. A truck trailer and a
      source container were prepared ad hoc, and three different systems underwent a
      sensitivity and a false alarm test. On the basis of the final results, the
      performance characteristics of various monitoring systems in this particular
      application were established with the correct degree of accuracy.

PMID- 11219545
TI  - IAEA D.G. on shutdown on Chernobyl.

PMID- 11219544
TI  - UNSCEAR 2000 published. United Nations Scientific Committee on the Effects of
      Atomic Radiation.

PMID- 11219546
TI  - An overview of fungal infections.
AB  - The incidence of fungal infections is increasing at an alarming rate, presenting
      an enormous challenge to healthcare professionals. This increase is directly
      related to the growing population of immunocompromised individuals, resulting
      from changes in medical practice such as the use of intensive chemotherapy and
      immunosuppressive drugs. HIV and other diseases which cause immunosuppression
      have also contributed to this problem. Superficial and subcutaneous fungal
      infections affect the skin, keratinous tissues and mucous membranes. Included in
      this class are some of the most frequently occurring skin diseases, affecting
      millions of people worldwide. Although rarely life threatening, they can have
      debilitating effects on a person's quality of life and may in some circumstances
      spread to other individuals or become invasive. Most superficial and subcutaneous
      fungal infections are easily diagnosed and readily amenable to treatment.
      Systemic fungal infections may be caused by either an opportunistic organism that
      infects an at-risk host, or may be associated with a more invasive organism that
      is endemic to a specific geographical area. Systemic infections can be life
      threatening and are associated with high morbidity and mortality. Because
      diagnosis is difficult and the causative agent is often confirmed only at
      autopsy, the exact incidence of systemic infections is difficult to determine.
      The most frequently encountered pathogens are Candida albicans and Aspergillus
      spp. but other fungi such as non-albicans Candida spp. are increasingly
      important.

PMID- 11219549
TI  - Clinical experience with itraconazole in systemic fungal infections.
AB  - The broad spectrum antifungal itraconazole is an effective and well tolerated
      agent for the prophylaxis and treatment of systemic fungal infections. The recent
      development of an itraconazole oral solution and an intravenous itraconazole
      solution has increased the options for the use of this drug and increased the
      oral bioavailability in a variety of at-risk patients. Reliable absorption of the
      itraconazole oral solution has been demonstrated in patients with HIV infection,
      neutropenic patients with haematological malignancy, bone marrow transplant
      recipients and neutropenic children. In clinical trials, itraconazole oral
      solution (5 mg/kg/day) was more effective at preventing systemic fungal infection
      in patients with haematological malignancy than placebo, fluconazole suspension
      (100 mg/day) or oral amphotericin-B (2 g/kg/day) and was highly effective at
      preventing fungal infections in liver transplant recipients. There were no
      unexpected adverse events with the itraconazole oral solution in any of these
      trials. In addition, intravenous itraconazole solution is at least as effective
      as intravenous amphotericin-B in the empirical treatment of neutropenic patients
      with systemic fungal infections, and drug-related adverse events are more
      frequent in patients treated with amphotericin-B. A large proportion of patients
      with confirmed aspergillosis also respond to treatment with intravenous
      itraconazole followed by oral itraconazole. The new formulations of itraconazole
      are therefore effective agents for prophylaxis and treatment of most systemic
      fungal infections in patients with haematological malignancy.

PMID- 11219547
TI  - Current management of fungal infections.
AB  - The management of superficial fungal infections differs significantly from the
      management of systemic fungal infections. Most superficial infections are treated
      with topical antifungal agents, the choice of agent being determined by the site
      and extent of the infection and by the causative organism, which is usually
      readily identifiable. One exception is onychomycosis, which usually requires
      treatment with systemically available antifungals; the accumulation of
      terbinafine and itraconazole in keratinous tissues makes them ideal agents for
      the treatment of onychomycosis. Oral candidiasis in immunocompromised patients
      also requires systemic treatment; oral fluconazole and itraconazole oral solution
      are highly effective in this setting. Systemic fungal infections are difficult to
      diagnose and are usually managed with prophylaxis or empirical therapy.
      Fluconazole and itraconazole are widely used in chemoprophylaxis because of their
      favourable oral bioavailability and safety profiles. In empirical therapy, lipid
      associated formulations of amphotericin-B and intravenous itraconazole are safer
      than, and at least as effective as, conventional amphotericin-B (the former gold
      standard). The high acquisition costs of the lipid-associated formulations of
      amphotericin-B have limited their use.

PMID- 11219548
TI  - Pharmacology of itraconazole.
AB  - Itraconazole is a triazole antifungal agent that has a broad spectrum of activity
      and is well tolerated. Itraconazole is highly efficacious, particularly because
      its main metabolite, hydroxy-itraconazole, also has considerable antifungal
      activity. The original capsule formulation of itraconazole may lead to
      variability in absorption and the plasma concentration. For the treatment of
      superficial fungal infections, this is not problematical because itraconazole
      accumulates at the infection site, making consistently high plasma concentrations
      unnecessary -- a characteristic that has been exploited in the development of a
      pulse regimen. Because consistent plasma concentrations are critical for the more
      serious systemic fungal infections, variable absorption of itraconazole from the
      capsules limits their application. Moreover, underlying disease processes and
      medical interventions can reduce absorption from the capsules in some patients
      with systemic fungal infections. To widen the beneficial application of
      itraconazole to include such patients, an oral solution and an intravenous
      formulation were developed. These formulations combine lipophilic itraconazole
      with hydroxypropyl-beta-cyclodextrin, a ring of substituted glucose molecules,
      which improves the solubility of itraconazole. The enhanced absorption and
      bioavailability of itraconazole from these new formulations make them ideal for
      the treatment of systemic fungal infections in a wide range of patient
      populations. The additional flexibility offered by the different routes of
      administration also means that itraconazole can be used in patients at high risk,
      such as children or those requiring intensive care, for whom the capsule
      formulation may be impractical.

PMID- 11219551
TI  - Should breech babies be delivered vaginally or by planned cesarean delivery?

PMID- 11219552
TI  - Are there adverse maternal and neonatal outcomes associated with induction of
      labor when there is no well-accepted indication?

PMID- 11219550
TI  - The cost of treating systemic fungal infections.
AB  - The increasing incidence of systemic fungal infections and rising medical costs
      have highlighted the need for an economic appraisal of antifungal agents to
      determine the most cost-effective therapeutic option. Cost savings derived from
      the prophylactic or empirical use of antifungal agents have been difficult to
      estimate because of the lack of information on the costs of systemic fungal
      infections. Fluconazole is effective in prophylaxis and represents a direct cost
      saving compared with polyenes. However, itraconazole oral solution, an effective
      and widely used antifungal prophylactic agent, has not been analysed for cost
      effectiveness. In empirical therapy, the development of new formulations of
      existing agents has prompted a number of cost comparisons. In particular, the
      cost of treatment with conventional amphotericin-B has been compared with the
      costs of the new lipid-associated formulations of amphotericin-B or the new
      intravenous (IV) formulation of itraconazole. The acquisition costs of lipid
      associated amphotericin-B and IV itraconazole are higher than the cost of
      conventional amphotericin-B; however, these costs appear to be offset by
      reductions with both these agents in the cost for increased length of hospital
      stay and treating adverse events seen with conventional amphotericin-B. In
      neutropenic patients and bone marrow transplant recipients, IV itraconazole may
      be the most cost-effective option for empirical therapy.

PMID- 11219553
TI  - Is mometasone furoate aqueous nasal spray (MFNS) effective in reducing symptoms
      in acute recurrent sinusitis?

PMID- 11219554
TI  - What is the risk of venous thromboembolism (VTE) among women taking third
      generation oral contraceptives (OCs) in comparison with those taking
      contraceptives containing levonorgestrel?

PMID- 11219555
TI  - Clinical inquiries. When should we stop mammography screening for breast cancer
      in elderly women?

PMID- 11219556
TI  - Clinical inquiries. Is there any benefit to Papanicolaou (Pap) test screening in
      women who have had a hysterectomy for benign disease?

PMID- 11219557
TI  - Care of the secondary patient in family practice. A report from the Ambulatory
      Sentinel Practice Network.
AB  - BACKGROUND: Care of a secondary patient (an individual other than the primary
      patient for an outpatient visit) is common in family practice, but the content of
      care of this type of patient has not been described. METHODS: In a cross
      sectional study, 170 volunteer primary care clinicians in 50 practices in the
      Ambulatory Sentinel Practice Network reported all occurrences of care of a
      secondary patient during 1 week of practice. These clinicians reported the
      characteristics of the primary patient and the secondary patient and the content
      of care provided to the secondary patient. Content of care was placed in 6
      categories (advice, providing a prescription, assessment or explanation of
      symptoms, follow-up of a previous episode of care, making or authorizing a
      referral, and general discussion of a health condition). RESULTS: Physicians
      reported providing care to secondary patients during 6% of their office visits.
      This care involved more than one category of service for the majority of visits
      involving care of a secondary patient. Advice was provided during more than half
      the visits. A prescription, assessment or explanation of symptoms, or a general
      discussion of condition were provided during approximately 30% of the secondary
      care visits. Secondary care was judged to have substituted for a separate visit
      60% of the time, added an average of 5 minutes to the visit, and yielded no
      reimbursement for 95% of visits. CONCLUSIONS: Care of a secondary patient
      reflects the provision of potentially intensive and complex services that require
      additional time and are largely not reimbursed or recognized by current measures
      of primary care. This provision of secondary care may facilitate access to care
      and represent an added value provided by family physicians.

PMID- 11219558
TI  - Routine screening for postpartum depression.
AB  - BACKGROUND: Postpartum depression (PPD) is a common and often overlooked
      condition. Validated screening tools for PPD exist but are not commonly used. We
      present the 1-year outcome of a project to implement universal PPD screening at
      the 6-week postpartum visit. METHODS: Universal screening with the Edinburgh
      Postnatal Depression Scale (EPDS) was implemented in all community postnatal care
      sites. One-year outcome assessments (diagnosis and treatment of PPD) were
      completed for a sample of the women screened using medical record review of all
      care they received during the first year postpartum. RESULTS: Sixty-eight (20%)
      of the 342 women whose medical records were reviewed had been given a documented
      diagnosis of postpartum depression, resulting in an estimated population rate of
      10.7%. Depression was diagnosed in 35% of the women with elevated EPDS scores (>
      or =10) compared with 5% of the women with low EPDS scores (<10) in the first
      year postpartum. Treatment was provided for all women diagnosed with depression,
      including drug therapy for 49% and counseling for 78%. Four women were
      hospitalized for depression. Some degree of suicidal ideation was noted on the
      EPDS by 48 women but acknowledged in the chart of only 10 women, including 1 with
      an immediate hospitalization. The rate of diagnosis of postpartum depression in
      this community increased from 3.7% before the routine use of EPDS screening to
      10.7% following screening. CONCLUSIONS: A high EPDS score was predictive of a
      diagnosis of postpartum depression, and the implementation of routine EPDS
      screening at 6 weeks postpartum was associated with an increase in the rate of
      diagnosed postpartum depression in this community.

PMID- 11219559
TI  - The quality of physician-patient relationships. Patients' experiences 1996-1999.
AB  - BACKGROUND: Our objective was to examine how patients of primary care physicians
      are responding to a changing health care environment. The quality of their
      relationship with their primary care physicians and their experience with
      organizational features of care were monitored over a 3-year period. METHODS:
      This was a longitudinal observational study (1996-1999). Participants completed a
      self-administered questionnaire at baseline and at follow-up. The questionnaires
      included measures of primary care quality from the Primary Care Assessment Survey
      (PCAS). We included insured adults employed by the Commonwealth of Massachusetts
      who remained with one primary care physician throughout the study period
      (n=2383). The outcomes were unadjusted mean scale score changes in each of the 8
      PCAS over the 3 years and associated standardized difference scores (effect
      sizes). The 8 PCAS scales measured relationship quality (4 scales: communication,
      interpersonal treatment, physician's knowledge of the patient, patient trust) and
      organizational features of care (4 scales: financial access, organizational
      access, visit-based continuity, integration of care). RESULTS: There were
      significant declines in 3 of the 4 relationship scales: communication (effect
      size [ES] = -0.095), interpersonal treatment (ES = -0.115), and trust (ES = 
      0.046). Improvement was observed in physician's knowledge of the patient (ES =
      0.051). There was a significant decline in organizational access (ES = -0.165)
      and an increase in visit-based continuity (ES = 0.060). There were no significant
      changes in financial access and integration of care indexes. CONCLUSIONS: The
      declines in access and 3 of the 4 indexes of physician-patient relationship
      quality are of concern, especially if they signify a trend.

PMID- 11219561
TI  - What patients want.

PMID- 11219560
TI  - Switching doctors: predictors of voluntary disenrollment from a primary
      physician's practice.
AB  - BACKGROUND: Our objective was to evaluate 8 interpersonal and structural features
      of care as predictors of patients' voluntary disenrollment from their primary
      care physician's practice. METHODS: We performed a longitudinal observational
      study in which participants completed a validated questionnaire at baseline
      (1996) and follow-up (1999). The questionnaire measured 4 elements of the quality
      of physician-patient relations (communication, interpersonal treatment,
      physician's knowledge of the patient, and patient trust) and 4 structural
      features of care (access, visit-based continuity, relationship duration, and
      integration of care). Study participants were insured adults who reported having
      a regular personal physician at baseline and who completed both baseline and
      follow-up questionnaires (n=4108). The outcome measured was voluntary
      disenrollment from the primary physician's practice between baseline and follow
      up. RESULTS: One fifth of the patients voluntarily left their primary physician's
      practice during the study period. When tested independently, all 8 scales
      significantly predicted voluntary disenrollment (P <.001), with somewhat larger
      effects associated with the 4 relationship quality measures. In multivariable
      models, a composite relationship quality factor most strongly predicted voluntary
      disenrollment (odds ratio [OR]=1.6; P<.001), and the 2 continuity scales also
      significantly predicted disenrollment (OR=1.1; P<.05). Access and integration did
      not significantly predict disenrollment in the presence of these variables.
      CONCLUSIONS: These findings highlight the importance of relationship quality in
      determining patients' loyalty to a physician's practice. They suggest that in the
      race to the bottom line medical practices and health plans cannot afford to
      ignore that the essence of medical care involves the interaction of one human
      being with another.

PMID- 11219562
TI  - Enhancing smoking cessation of low-income smokers in managed care.
AB  - BACKGROUND: Although office-based and telephone support services enhance the rate
      of smoking cessation in managed care systems, it is not clear whether such
      services are effective for very low-income smokers. We evaluated the comparative
      effectiveness of usual care (physician-delivered advice and follow-up) and usual
      care enhanced by 6 computer-assisted telephonic-counseling sessions by office
      nurses and telephone counselors for smoking cessation in very low-income smokers
      in Medicaid managed care. METHODS: A randomized clinical trial comparing the 2
      approaches was conducted in 3 Michigan community health centers. All clinicians
      and center staff received standard training in usual care. Selected nurses and
      telephone counselors received special training in a computer-assisted counseling
      program focusing on relapse prevention. RESULTS: The majority of the study
      population (233 adult smokers with telephones) were white (64%) women (70%) with
      annual incomes of less than $10,000 (79%) and with prescriptions of nicotine
      replacement therapy (>90%). At 3 months, quit rates (smoke-free status verified
      by carbon monoxide monitors) were 8.1% in the usual-care group and 21% in the
      telephonic-counseling group (P=.009) by intention-to-treat analysis. Special
      tracking methods were successful in maintaining participants in treatment.
      CONCLUSIONS: Smoking cessation rates are enhanced in a population of very low
      income smokers if individualized telephonic-counseling is provided. State and
      Medicaid managed care plans should consider investing in both office-based nurse
      and centralized telephonic-counseling services for low-income smokers.

PMID- 11219563
TI  - Opioids for chronic nonmalignant pain. Attitudes and practices of primary care
      physicians in the UCSF/Stanford Collaborative Research Network. University of
      California, San Francisco.
AB  - BACKGROUND: We hoped to determine the attitudes and practices of primary care
      physicians regarding the use of opioids to treat chronic nonmalignant pain
      (CNMP). We also examined the factors associated with the willingness to prescribe
      opioids for CNMP. METHODS: A survey was mailed to primary care physicians in the
      University of California, San Francisco/Stanford Collaborative Research Network.
      This survey contained questions regarding treatment in response to 3 case
      vignettes, the use of opioids for CNMP in general, and the demographic
      characteristics of the physicians. RESULTS: Among 230 physicians surveyed, 161
      (70%) responded. Two percent of the respondents were never willing to prescribe
      schedule III opioids (eg, acetaminophen with codeine) as needed for patients with
      CNMP that persisted unchanged after exhaustive evaluation and attempts at
      treatment. Thirty-five percent were never willing to prescribe schedule II
      opioids (eg, sustained-release morphine) on an around-the-clock schedule for
      these patients. The most significant predictor of willingness to prescribe
      opioids for patients with CNMP was a lower level of concern about physical
      dependence, tolerance, and addiction. CONCLUSIONS: Primary care physicians are
      willing to prescribe schedule III opioids as needed, but many are unwilling to
      use schedule II opioids around the clock for CNMP. Individual prescribing
      practices vary widely among primary care physicians. Concerns about physical
      dependence, tolerance, and addiction are barriers to the prescription of opioids
      by primary care physicians for patients with CNMP.

PMID- 11219564
TI  - Meeting the challenge of chronic pain.

PMID- 11219565
TI  - The role of gynecologists in providing primary care to elderly women.
AB  - BACKGROUND: Federal legislation has recently been proposed to designate
      obstetrician-gynecologists (OBGs) as primary care physicians. The Institute of
      Medicine identifies care unrestricted by problem or organ system as an essential
      characteristic of primary care. We examined the degree to which OBGs in the state
      of Washington offer this aspect of primary care to their elderly patients by
      investigating the type and amount of nongynecologic care they provide. METHODS:
      Using 1994 Part B Medicare claims data for Washington residents, we identified
      visits made by women aged 65 years and older to OBGs (N=10,522) and 9 other types
      of specialists. Diagnoses were classified as in or out of the domain of care
      traditionally provided by each specialty. Visit volumes, proportion of out of
      domain visits, and the frequency of diagnoses were reported. RESULTS: Of the
      patient visits to obstetrician-gynecologists, 12.2% had nongynecologic diagnoses.
      The median percentage of nongynecologic visits for individual OBGs was 6.7%.
      Patients who saw OBGs received 15.4% of their overall health care from an OBG;
      patients who saw family physicians received 42.9% of their total health care from
      a family physician. CONCLUSIONS: In 1994, a small amount of the care that
      Washington OBGs provided to their elderly patients was for nongynecologic
      conditions. Studies are needed to evaluate how the practices of OBGs have changed
      since the 1996 implementation of a primary care requirement in obstetrics
      gynecology residencies, and if adopted, how legislation designating OBGs as
      primary care physicians affects the health care received by elderly women.

PMID- 11219566
TI  - Evaluation of the patient with suspected deep vein thrombosis.

PMID- 11219567
TI  - Does the increased sensitivity of the new Papanicolaou (Pap) tests improve the
      cost-effectiveness of screening for cervical cancer?

PMID- 11219568
TI  - What is the optimal strategy for managing acute migraine headaches?

PMID- 11219569
TI  - Do back-up antibiotic prescriptions for the treatment of common respiratory
      symptoms alter fill rates and patient satisfaction?

PMID- 11219570
TI  - Is cilostazol more effective than pentoxifylline in the treatment of symptoms of
      intermittent claudication?

PMID- 11219571
TI  - Ultrasound-assisted physical examination.

PMID- 11219572
TI  - Childhood vaccinations.

PMID- 11219573
TI  - Chlorophyll is not the primary photoreceptor for the stimulation of P-type H+
      pump and growth in variegated leaves of Coleus x hybridus.
AB  - There has been persisting controversy over the role of photosynthesis in the
      stimulation of the plasma membrane H+-ATPase and growth of dicotyledonous leaves
      by light. To investigate this, we compared the effects of light on growth, H+ net
      efflux and membrane potential (Vm) of strips which contained either only
      chlorophyll-free (white) mesophyll cells or chlorophyll-containing (green) cells
      cut from variegated Coleus leaves. White mesophyll cells responded to white, blue
      and red light with a hyperpolarization of Vm, an acidification of the apoplast
      and a promotion of growth, all of which began after a lag of 2-7 min. In
      contrast, green mesophyll cells showed a biphasic light response in which the
      hyperpolarization and the acidification were preceded by a rapid depolarization
      of Vm and an alkalinization of the apoplast. Nevertheless, green and white
      tissues showed comparable growth promotions in response to light. The light
      response of the leaf mesophyll is a composite of two separate photosystems. The
      initial depolarization and alkalinization are mediated by photosynthesis and
      blocked by 3-(3,4-dichlorophenyl)-1,1-dimethylurea. The slower hyperpolarization,
      acidification and growth response, on the other hand, are clearly in response to
      light absorption by pigments other than chlorophyll.

PMID- 11219574
TI  - Thermodynamic analysis of diffusion of non-electrolytes across plant cuticles in
      the presence and absence of the plasticiser tributyl phosphate.
AB  - Solute mobility in cuticular membranes (CMs) of 14 plant species (Citrus
      aurantiumn L., Citrus grandis L., Hedera helix L., Ilex aquifolium L., Ilex
      paraguariensis St.-Hil., Malus domestica Borkh. cv. Golden Delicious, Populus
      alba L., Prunus laurocerasus L., Pyrus communis L. cv. Bartlett, Conference and
      Gellerts Butterbirne, Pyrus pyrifolia (Burm. f.) Nakai, Schefflera actinophylla
      (Endl.) Harms and Strophanthus gratus Baill.) was measured over the temperature
      range 25-55 degrees C. The five organic model compounds differed in size (130-349
      cm3 mol(-1)) and cuticle/water partition coefficient (18-10(8)). For all
      individual CMs (n = 297), the data were plotted according to the thermodynamic
      relationship between the preexponential factor (which is proportional to entropy)
      of the Arrhenius equation and the activation energy (enthalpy) of diffusion (ED).
      A strict linear correlation was obtained, providing evidence that the five
      compounds diffused along the same lipophilic diffusion path in all plant species
      tested. Extracting cuticular waxes from CMs of four plant species (Hedera, Pyrus,
      Schefflera and Strophanthus) had no effect on the slope of the plot but a
      parallel displacement towards higher entropy was observed with these polymer
      matrix (MX) membranes. This displacement is interpreted as a temperature
      independent tortuosity factor directly related to entropy. The influence of the
      plasticiser tributyl phosphate on solute mobility at various temperatures was
      measured for CM and MX membranes. The plasticiser increased solute mobility and
      ED was reduced drastically for both membrane types. This plasticiser effect was
      almost completely reversible, when tributyl phosphate was desorbed from the
      membranes. For both, plasticised CM and MX, the thermodynamic correlation exists
      whereby all data points lie on the same line. The data are used to characterise
      the lipophilic pathway across plant cuticles in terms of the free-volume theory.

PMID- 11219575
TI  - Calcium chloride penetrates plant cuticles via aqueous pores.
AB  - Penetration of calcium chloride across astomatous cuticular membranes (CMs)
      isolated from leaves of Pyrus communis L. has been studied. Penetration was a
      first-order process when calcium chloride concentrations ranged from 2 gl(-1) to
      10 gl(-1). Rate constants were increased 10-fold by adding wetting agents but
      they did not depend on temperature. The accelerators tributyl phosphate and
      diethyl sebacate had no effect on rates of penetration. Increasing humidity over
      the salt residue on the CMs from 50 to 90% increased rate constants by about 2
      fold. Extracting cuticular waxes from pear leaf CMs increased rate constants by
      factors of 2 to 3, depending on humidity. Leaf CMs from Malus domestica Borkh.,
      Populus aelha L., Stephanotis floribunda Brongn. and Schefflera actinophylla
      (Endl.) Harms were also permeable to CaCl2. Highest rate constants were observed
      with poplar CMs while Schefflera CMs exhibited the lowest permeability. By
      comparing these results with the well established transport properties of the
      lipophilic pathway it is concluded that calcium chloride hexahydrate penetrated
      cuticular membranes via aqueous pores.

PMID- 11219576
TI  - 3-hydroxy-3-phenylpropanoic acid is an intermediate in the biosynthesis of
      benzoic acid and salicylic acid but benzaldehyde is not.
AB  - Stable-isotope-labelled (2H6, 18O) 3-hydroxy-3-phenylpropanoic acid, a putative
      intermediate in the biosynthesis of benzoic acid (BA) and salicylic acid (SA)
      from cinnamic acid, has been synthesized and administered to cucumber (Cucumis
      sativus L.) and Nicotiana attenuata (Torrey). Analysis of the products by gas
      chromatography-mass spectrometry revealed incorporation of labelling into BA and
      SA, but not into benzaldehyde. In a separate experiment, 3-hydroxy-3
      phenylpropanoic acid was found to be a metabolite of phenylalanine, itself the
      primary metabolic precursor of BA and SA. These data suggest that cinnamic acid
      chain shortening is probably achieved by beta-oxidation, and that the proposed
      "non-oxidative" pathway of side-chain degradation does not function in the
      biosynthesis of BA and SA, in cucumber and N. attenuata.

PMID- 11219577
TI  - Studies on water transport through the sweet cherry fruit surface: characterizing
      conductance of the cuticular membrane using pericarp segments.
AB  - Water conductance of the cuticular membrane (CM) of mature sweet cherry fruit
      (Prunus avium L. cv. Sam) was investigated by monitoring water loss from segments
      of the outer pericarp excised from the cheek of the fruit. Segments consisted of
      epidermis, hypodermis and several cell layers of the mesocarp. Segments were
      mounted in stainless-steel diffusion cells with the mesocarp surface in contact
      with water, while the outer cuticular surface was exposed to dry silica (22 +/- 1
      degrees C). Conductance was calculated by dividing the amount of water transpired
      per unit area and time by the difference in water vapour concentration across the
      segment. Conductance values had a log normal distribution with a median of 1.15 x
      10(-4) m s(-1) (n=357). Transpiration increased linearly with time. Conductance
      remained constant and was not affected by metabolic inhibitors (1 mM NaN3 or 0.1
      mM carbonylcyanide m-chlorophenylhydrazone) or thickness of segments (range 0.8
      2.8 mm). Storing fruit (up to 42 d, 1 degrees C) used as a source of segments had
      no consistent effect on conductance. Conductance of the CM increased from cheek
      (1.16 +/- 0.10 x 10(-4) m s(-1)) to ventral suture (1.32 +/- 0.07 x 10(-4) m s(
      1)) and to stylar end (2.53 +/- 0.17 x 10(-4) m s(-1)). There was a positive
      relationship (r2=0.066**; n=108) between conductance and stomatal density. From
      this relationship the cuticular conductance of a hypothetical astomatous CM was
      estimated to be 0.97 +/- 0.09 x 10(-4) m s(-1). Removal of epicuticular wax by
      stripping with cellulose acetate or extracting epicuticular plus cuticular wax by
      dipping in CHCl3/methanol increased conductance 3.6- and 48.6-fold, respectively.
      Water fluxes increased with increasing temperature (range 10-39 degrees C) and
      energies of activation, calculated for the temperature range from 10 to 30
      degrees C, were 64.8 +/- 5.8 and 22.2 +/- 5.0 kJ mol(-1) for flux and vapour
      concentration-based conductance, respectively.

PMID- 11219578
TI  - A cDNA encoding 3-deoxy-D-manno-oct-2-ulosonate-8-phosphate synthase of Pisum
      sativum L. (pea) functionally complements a kdsA mutant of the Gram-negative
      bacterium Salmonella enterica.
AB  - Recombinant plasmids encoding 3-deoxy-D-manno-oct-2-ulosonate-8-phosphate (Kdo-8
      P) synthase (KdsA; EC 4.1.2.16) were identified from a cDNA library of Pisum
      sativum L. (pea) by complementing a temperature-sensitive kdsA(ts) mutant of the
      Gram-negative bacterium Salmonella enterica. Sequence analysis of several inserts
      revealed a central open reading frame encoding a protein of 290 amino acids with
      a high degree of amino acid sequence similarity to bacterial KdsA. The cDNA was
      confirmed by amplifying a 1,812-bp DNA fragment from the chromosome of pea that
      encoded four exons around the 5'-end of kdsA. The recombinant enzyme was
      subcloned, overexpressed and characterized to synthesize Kdo-8-P from D-arabinose
      5-phosphate and phosphoenolpyruvate. The pH optimum was 6.1 and the activity of
      the enzyme was neither stimulated by the addition of divalent cations nor
      inhibited by EDTA. The cDNA of kdsA could not complement Escherichia coli K-12
      strain AB3257, which is defective in all three isoenzymes (AroFGH) of 3-deoxy-D
      arabino-hept-2-ulosonate-7-phosphate (Dha-7-P) synthase (EC 4.1.2.15), and
      neither D-erythrose-4-phosphate nor D-ribose-5-phosphate could substitute for D
      arabinose-5-phosphate in vitro. Thus, plant cells possess a specific enzyme for
      the biosynthesis of Kdo-8-P with remarkable structural and functional
      similarities to bacterial KdsA proteins.

PMID- 11219579
TI  - Barley Mla and Rar mutants compromised in the hypersensitive cell death response
      against Blumeria graminis f.sp. hordei are modified in their ability to
      accumulate reactive oxygen intermediates at sites of fungal invasion.
AB  - The pathogenesis-related accumulation of superoxide radical anions (O2*-) and
      hydrogen peroxide (H2O2) was comparatively analyzed in a barley line (Hordeum
      vulgare L. cv Sultan-5) carrying the powdery mildew (Blumeria graminis f.sp.
      hordei, Speer, Bgh) resistance gene Mla12, and in susceptible mutants defective
      in Mla12 or in genes "required for Mla12-specified disease resistance" (Rar1 and
      Rar2). In-situ localization of reactive oxygen intermediates was performed both
      by microscopic detection of azide-insensitive nitroblue tetrazolium (NBT)
      reduction or diaminobenzidine (DAB) polymerization, and by an NBT-DAB double
      staining procedure. The Mla12-mediated hypersensitive cell death occurred either
      in attacked epidermal cells or adjacent mesophyll cells of wild-type plants.
      Whole-cell H2O2 accumulation was detected in dying cells, while O2*- emerged in
      adjacent cells. Importantly, all susceptible mutants lacked these reactions. An
      oxalate oxidase, which is known to generate H2O2 and has been implicated in
      barley resistance against the powdery mildew fungus, was not differentially
      expressed between the wild type and all mutants. The results demonstrate that the
      Rar1 and Rar2 gene products, which are control elements of R-gene-mediated
      programmed cell death, also control accumulation of reactive oxygen intermediates
      but not the pathogenesis-related expression of oxalate oxidase.

PMID- 11219580
TI  - Celery (Apium graveolens L.) parenchyma cell walls examined by atomic force
      microscopy: effect of dehydration on cellulose microfibrils.
AB  - Atomic force microscopy (AFM) was used to image celery (Apium graveolens L.)
      parenchyma cell walls in situ. Cellulose microfibrils could clearly be
      distinguished in topographic images of the cell wall. The microfibrils of the
      hydrated walls appeared smaller, more uniformly distributed, and less enmeshed
      than those of dried peels. In material that was kept hydrated at all times and
      imaged under water, the microfibril diameter was mainly in the range 6-25 nm. The
      cellulose microfibril diameters were highly dependent on the water content of the
      specimen. As the water content was decreased, by mixing ethanol with the bathing
      solution, the microfibril diameters increased. Upon complete dehydration of the
      specimen we observed a significant increase in microfibril diameter. The
      procedure used to dehydrate the parenchyma cells also influenced the size of
      cellulose microfibrils with freeze-dried material having larger diameters than
      air-dried material.

PMID- 11219581
TI  - The distribution of caprylate, caprate and laurate in lipids from developing and
      mature seeds of transgenic Brassica napus L.
AB  - The composition and positional distribution of lipids in developing and mature
      transgenic Brassica napus seeds accumulating up to 7 mol% of caprylate (8:0), 29
      mol% caprate (10:0) or 63 mol% of laurate (12:0) were examined. The accumulation
      of 8:0 and 10:0 resulted from over-expression of the medium-chain-specific
      thioesterase (Ch FatB2) alone or together with the respective chain-length
      specific condensing enzyme (Ch KASIV). Seeds containing high levels of 12:0 were
      obtained from plants expressing bay thioesterase (BTE) alone or crossed with a
      line over-expressing the coconut lysophosphatidic acid acyltransferase (LPAAT),
      an enzyme responsible for the increase in acylation of 12:0 at the sn-2 position.
      In all instances, 10:0 and 12:0 fatty acids were present in substantial amounts
      in phosphatidylcholine during seed development with a drastic decrease of 80-90%
      in mature seeds. At all stages of seed development however, 8:0 was barely
      detectable in this membrane lipid. Altogether, these results indicate that these
      transgenic seeds exclude and/or remove the medium-chain fatty acids from their
      membrane and that this mechanism(s) is more effective with the shorter-chain
      fatty acids. Furthermore, seeds of 8:0- and 10:0-producing lines had only
      negligible levels of these fatty acids present in the sn-2 position of the
      triacylglycerols. In contrast, all 12:0-producing seeds had a substantial amount
      of this fatty acid in the sn-2 position of the triacylglycerols, suggesting that
      the endogenous LPAAT is able to acylate 12:0 if no other acyl-CoA species are
      available.

PMID- 11219582
TI  - Characterization and expression of the Douglas-fir luminal binding protein
      (PmBiP).
AB  - The endoplasmic reticulum (ER) molecular chaperone, BiP, plays a role in the
      cotranslational translocation and subsequent folding and assembly of newly
      synthesized proteins targeted to the ER and secretory pathway. The sequence
      encoding a Douglas-fir (Pseudotsuga menziesii [Mirb] Franco) BiP homologue
      (PmBiP) was identified by differential screening of a seedling cDNA library.
      Southern blotting indicated that PmBiP is most likely present as a single copy.
      The deduced amino acid sequence of PmBiP contains an HEEL tetrapeptide sequence
      which functions to retain PmBiP in the ER and is different from HDEL commonly
      found in angiosperm plant BiPs. Amino acid sequence alignment and phylogenetic
      analysis show that PmBiP is highly similar to other plant BiPs yet forms a
      distinct phylogenetic subgroup which is separate from the angiosperm BiPs.
      Northern and western blotting revealed that PmBiP is subject to developmental
      regulation during seed development, germination, and early seedling growth and is
      seasonally regulated in needles of young seedlings.

PMID- 11219583
TI  - Regulation of protoporphyrin IX biosynthesis by intraplastidic
      compartmentalization and adenosine triphosphate.
AB  - Subplastidic preparations from cotyledons of cucumber (Cucumis sativus L.) were
      tested for their ability to synthesize protoporphyrin IX from the substrate 5
      aminolevulinic acid. Envelope or thylakoid membranes failed to synthesize
      protoporphyrin IX from the substrate 5-aminolevulinic acid. Stromal preparations
      synthesized a very low amount of protoporphyrin IX. In a reconstitution
      experiment using stroma + envelope membranes, protoporphyrin IX synthesis from 5
      aminolevulinic acid was enhanced by 660% over that of stroma alone. However, when
      thylakoids were added to the stroma + envelope mixture, protoporphyrin IX
      synthesis from 5-aminolevulinic acid was completely inhibited. In the
      reconstituted stroma + envelope membrane mixture, the reducing agent
      dithiothreitol enhanced the protoporphyrin IX-synthesizing ability and completely
      abolished the inhibition of protoporphyrin IX synthesis by thylakoids. This
      suggested that the oxidizing agents usually associated with the thylakoid
      membranes inhibited protoporphyrin IX biosynthesis and the inhibition was
      alleviated by the reducing power of dithiothreitol. This study exposes the
      weakness of in vitro reconstitution experiments in mimicking the in vivo
      conditions. Addition of ATP stimulated protoporphyrin IX synthesis by 50% in the
      supernatant fraction of chloroplast lysate. This ATP-induced stimulation of
      protoporphyrin IX synthesis was due to the enhancement of the activities of
      uroporphyrinogen decarboxylase and protoporphyrinogen oxidase, involved in
      tetrapyrrole biosynthesis. The ATP-induced stimulation of porphyrinogen oxidase
      activity was an energy-dependent reaction.

PMID- 11219585
TI  - Effect of heat stress on the inhibition and recovery of the ribulose-1,5
      bisphosphate carboxylase/oxygenase activation state.
AB  - Experiments were conducted to determine the relative contributions of ribulose
      1,5-bisphosphate carboxylase/oxygenase (Rubisco; EC 4.1.1.39) activation state
      vis-a-vis Rubisco activase and metabolite levels to the inhibition of cotton
      (Gossypium hirsutum L.) photosynthesis by heat stress. Exposure of leaf tissue in
      the light to temperatures of 40 or 45 degrees C decreased the activation state of
      Rubisco to levels that were 65 or 10%, respectively, of the 28 degrees C control.
      Ribulose-1,5-bisphosphate (RuBP) levels increased in heat-stressed leaves,
      whereas the 3-phosphoglyceric acid pool was depleted. Heat stress did not affect
      Rubisco per se, as full activity could be restored by incubation with CO2 and
      Mg2+. Inhibition and recovery of Rubisco activation state and carbon dioxide
      exchange rate (CER) were closely related under moderate heat stress (up to 42.5
      degrees C). Moderate heat stress had negligible effect on Fv/Fm, the maximal
      quantum yield of photosystem II. In contrast, severe heat stress (45 degrees C)
      caused significant and irreversible damage to Rubisco activation, CER, and Fv/Fm.
      The rate of Rubisco activation after alleviating moderate heat stress was
      comparable to that of controls, indicating rapid reversibility of the process.
      However, moderate heat stress decreased both the rate and final extent of CER
      activation during dark-to-light transition. Treatment of cotton leaves with
      methyl viologen or an oxygen-enriched atmosphere reduced the effect of heat
      stress on Rubisco inactivation. Both treatments also reduced tissue RuBP levels,
      indicating that the amount of RuBP present during heat stress may influence the
      degree of Rubisco inactivation. Under both photorespiratory and non
      photorespiratory conditions, the inhibition of the CER during heat stress could
      be completely reversed by increasing the internal partial pressure of CO2 (Ci).
      However, the inhibition of the CER by nigericin, a K+ ionophore, was not
      reversible when the Ci was increased at ambient or high temperature. Our results
      indicate that inhibition of photosynthesis by moderate heat stress is not caused
      by inhibition of the capacity for RuBP regeneration. We conclude that heat stress
      inhibits Rubisco activation via a rapid and direct effect on Rubisco activase,
      possibly by perturbing Rubisco activase subunit interactions with each other or
      with Rubisco.

PMID- 11219584
TI  - Molecular cloning and characterization of a tomato cDNA encoding a systemically
      wound-inducible bZIP DNA-binding protein.
AB  - Localized wounding of one leaf in intact tomato (Lycopersicon esculentum Mill.)
      plants triggers rapid systemic transcriptional responses that might be involved
      in defense. To better understand the mechanism(s) of intercellular signal
      transmission in wounded tomatoes, and to identify the array of genes systemically
      up-regulated by wounding, a subtractive cDNA library for wounded tomato leaves
      was constructed. A novel cDNA clone (designated LebZIP1) encoding a DNA-binding
      protein was isolated and identified. This clone appears to be encoded by a single
      gene, and belongs to the family of basic leucine zipper domain (bZIP)
      transcription factors shown to be up-regulated by cold and dark treatments.
      Analysis of the mRNA levels suggests that the transcript for LebZIP1 is both
      organ-specific and up-regulated by wounding. In wounded wild-type tomatoes, the
      LebZIP1 mRNA levels in distant tissue were maximally up-regulated within only 5
      min following localized wounding. Exogenous abscisic acid (ABA) prevented the
      rapid wound-induced increase in LebZIP1 mRNA levels, while the basal levels of
      LebZIP1 transcripts were higher in the ABA mutants notabilis (not), sitiens
      (sit), and flacca (flc), and wound-induced increases were greater in the ABA
      deficient mutants. Together, these results suggest that ABA acts to curtail the
      wound-induced synthesis of LebZIP1 mRNA.

PMID- 11219587
TI  - Alpha-expansins in the semiaquatic ferns Marsilea quadrifolia and Regnellidium
      diphyllum: evolutionary aspects and physiological role in rachis elongation.
AB  - To investigate the evolutionary history of expansins and their role in cell
      elongation in early land plants, we isolated two alpha-expansin genes, Mq-EXP1
      and Rd-EXP1, respectively, from the semiaquatic ferns Marsilea quacdrifolia L.
      and Regnellidium diphyllum Lindm. The deduced amino acid sequences of the fern
      expansins exhibit a high degree of identity to those of seed plants, showing that
      expansin genes were conserved during the evolution of vascular plants. Gel-blot
      analysis of M. quadrifolia and R. diphyllum genomic DNA indicated that, in both
      ferns, alpha-expansins are encoded by multigene families. Expression of alpha
      expansin genes probed with Mq-EXP1 was confined to the elongating region of the
      Marsilea rachis. Cell-wall proteins of M. quadrifolia induced in-vitro extension
      of acidified cucumber cell walls. In R. diphyllum, expression of Rd-EXP1
      increased when elongation of the rachis was enhanced by submergence or ethylene.
      These results indicate that alpha-expansins act as wall-loosening proteins in
      ferns, as has been proposed for angiosperms. In addition, Rd-EXP1 may play a role
      in mediating elongation of the rachis in submerged plants.

PMID- 11219586
TI  - Cellular compartmentation of cadmium and zinc in relation to other elements in
      the hyperaccumulator Arabidopsis halleri.
AB  - The cellular compartmentation of elements was analysed in the Zn hyperaccumulator
      Arabidopsis halleri (L.) O'Kane & Al-Shehbaz (=Cardaminopsis halleri) using
      energy-dispersive X-ray microanalysis of frozen-hydrated tissues. Quantitative
      data were obtained using oxygen as an internal standard in the analyses of
      vacuoles, whereas a peak/background ratio method was used for quantification of
      elements in pollen and dehydrated trichomes. Arabidopsis halleri was found to
      hyperaccumulate not only Zn but also Cd in the shoot biomass. While large
      concentrations of Zn and Cd were found in the leaves and roots, flowers contained
      very little. In roots grown hydroponically, Zn and Cd accumulated in the cell
      wall of the rhizodermis (root epidermis), mainly due to precipitation of Zn/Cd
      phosphates. In leaves, the trichomes had by far the largest concentrations of Zn
      and Cd. Inside the trichomes there was a striking sub-cellular compartmentation,
      with almost all the Zn and Cd being accumulated in a narrow ring in the trichome
      base. This distribution pattern was very different from that for Ca and P. The
      epidermal cells other than trichomes were very small and contained lower
      concentrations of Zn and Cd than mesophyll cells. In particular, the
      concentrations of Cd and Zn in the mesophyll cells increased markedly in response
      to increasing Zn and Cd concentrations in the nutrient solution. This indicates
      that the mesophyll cells in the leaves of A. halleri are the major storage site
      for Zn and Cd, and play an important role in their hyperaccumulation.

PMID- 11219588
TI  - Light-induced pH and K+ changes in the apoplast of intact leaves.
AB  - The K +-sensitive fluorescent dye benzofuran isophthalate (PBFI) and the pH
      sensitive fluorescein isothiocyanate dextran (FITC-Dextran) were used to
      investigate the influence of light/dark transitions on apoplastic pH and K+
      concentration in intact leaves of Vicia faba L. with fluorescence ratio imaging
      microscopy. Illumination by red light led to an acidification in the leaf
      apoplast due to light-induced H+ extrusion. Similar apoplastic pH responses were
      found on adaxial and abaxial sides of leaves after light/dark transition.
      Stomatal opening resulted only in a slight pH decrease (0.2 units) in the leaf
      apoplast. Gradients of apoplastic pH exist in the leaf apoplast, being about 0.5
      1.0 units lower in the center of the xylem veins as compared with surrounding
      cells. The apoplastic K+ concentration in intact leaves declined during the light
      period. A steeper light-induced decrease in apoplastic K+, possibly caused by
      higher apoplastic K+, was found on the abaxial side of leaves concentration.
      Simultaneous measurements of apoplastic pH and K+ demonstrated that a light
      induced decline in apoplastic K- concentration indicative of net K+ uptake into
      leaf cells occurs independent of apoplastic pH changes. It is suggested that the
      driving force that is generated by H+ extrusion into the leaf apoplast due to H+
      ATPase activity is sufficient for passive K+ influx into the leaf cells.

PMID- 11219589
TI  - The role of growth rate, redox-state of the plastoquinone pool and the trans
      thylakoid deltapH in photoacclimation of Chlorella vulgaris to growth irradiance
      and temperature.
AB  - The long-term photoacclimation of Chlorella vulgaris Beijer (UTEX 265) to growth
      irradiance and growth temperature under ambient CO2 conditions was examined.
      While cultures grew at a faster rate at 27 than at 5 degrees C, growth rates
      appeared to be independent of irradiance. Decreases in light-harvesting
      polypeptide accumulation, increases in xanthophyll pool size and changes in the
      epoxidation state of the xanthophyll cycle pigments were correlated linearly with
      increases in the relative reduction state of QA, the primary quinone receptor of
      photosystem II, when estimated as 1-qP under steady-state growth conditions.
      However, we show that there is also a specific temperature-dependent component,
      in addition to the redox-state of the QA, involved in regulating the content and
      composition of light-harvesting complex II of C. vulgaris. In contrast,
      modulation of the epoxidation state of the xanthophyll pool in response to
      increased 1-qP in cells grown at 5 degrees C was indistinguishable from that of
      cells grown at 27 degrees C, indicating that light and temperature interact in a
      similar way to regulate xanthophyll cycle activity in C. vulgaris. Because C.
      vulgaris exhibited a low-light phenotype in the presence of 3-(3,4
      dichlorophenyl)-1,1-dimethylurea (DCMU), but a high-light phenotype upon addition
      of 2,5-dibromo-6-isopropyl-3-methyl-1,4-benzoquinone, we conclude that the
      plastoquinone pool acts as a sensor regulating the accumulation of light
      harvesting polypeptides in C. vulgaris. However, concomitant measurements of non
      photochemical fluorescence quenching (qN) and the epoxidation state of the
      xanthophyll pool appear to indicate that, in addition to the redox-state of the
      plastoquinone pool, the trans-thylakoid deltapH may also contribute to sensing
      changes in irradiance and temperature that would lead to over-excitation of the
      photosynthetic apparatus. We suggest that sink capacity as reflected in
      photosynthate utilization and cell growth ultimately regulate photoacclimation in
      C. vulgaris.

PMID- 11219590
TI  - Early pregnancy failure--current management concepts.
AB  - Approximately one in four women will experience a miscarriage during her
      lifetime. For more than 50 years, the standard management of early pregnancy
      failure has been a dilatation and curettage (D & C). Typically, the procedure is
      performed in an operating room, which significantly increases cost. There is
      little objective information in the modem literature to prove that a D & C for
      all patients will lower morbidity or improve emotional well being. Treatment
      options include expectant management, D & C in an outpatient setting, and medical
      management with misoprostol (not approved by the U.S. Food and Drug
      Administration for treatment of early pregnancy failure). The medical literature
      supports that expectant management may result in more complications, including
      the need for "emergent" curettage, if clinicians do not understand the true
      normal course of expectant management. In general, women prefer some form of
      active management. Dilatation and curettage can be performed safely in the office
      or other outpatient setting using manual vacuum aspiration. Vaginal misoprostol
      will cause expulsion in 80% to 90% of women up to 13 weeks' uterine size or
      gestation, including patients who have a gestational sac present. However, these
      data come from only three trials involving a total of 42 subjects treated with
      vaginal misoprostol, and another study of 42 women who received vaginal
      misoprostol for "missed abortion" before a scheduled D & C. There is a
      significant lack of information from large-scale studies about when treatment is
      necessary and the relative efficacy, rates of side effects, and acceptability of
      these various treatment options for early pregnancy failure.

PMID- 11219591
TI  - Anesthesia and analgesia for newborn circumcision.
AB  - Newborn circumcision is likely the most common elective surgical procedure
      performed in children, yet a sizable portion of these procedures is performed
      without anesthesia or analgesia. This review discusses methods and techniques of
      analgesia and anesthesia for newborn circumcision. Behavioral, pharmacological,
      and regional block techniques are described. Ideally, the use of a combination of
      local anesthesia and behavioral techniques are most beneficial to newborns that
      undergo this painful procedure.

PMID- 11219592
TI  - A guest editorial: a pragmatic approach to gestational diabetes.

PMID- 11219593
TI  - Laparoscopic presacral neurectomy: a review.
AB  - Dysmenorrhea can be a severe and debilitating symptom in many women. Although
      most women may find adequate relief of symptoms from pharmacological approaches,
      there remain a few with resistant pain. Presacral neurectomy, although
      technically challenging, may be offered after other approaches are unsuccessful.
      The operation is now performed increasingly by the laparoscopic approach, which
      has revived this operation in some centers. The anatomy, technique, and
      indications as well as a review of the literature supporting this operation are
      reviewed. The potential complications of this operation are discussed also.

PMID- 11219594
TI  - Non-invasive assessment of graft patency using transcutaneous Doppler
      echocardiography for the validation of functional improvement after PTCA of the
      LAD via internal thoracic artery graft.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) of a native coronary artery
      via internal thoracic artery (ITA) graft after bypass surgery is a relatively
      rare procedure. Our current study evaluates the flow velocity patterns of the
      graft before and after PTCA. After intervention the mean diastolic flow velocity
      increased under rest and stress conditions. In addition, the graft patency was
      proved not before control angiography after 6 months. It could be verified that
      the measurement of flow velocity patterns under rest and stress conditions is a
      useful non-invasive procedure for monitoring long-term patency and PTCA-results
      of this vessel.

PMID- 11219595
TI  - Enhanced methods for visualizing myocardial perfusion with peripheral venous
      injection of levovist: application of triggered harmonic imaging and triggered
      harmonic power Doppler imaging techniques.
AB  - OBJECTIVES: The purpose of this study was to determine whether triggered harmonic
      imaging (THI) or triggered harmonic power Doppler imaging (THPDI) could obtain
      the myocardial contrast enhancement using peripheral venous injection of a first
      generation echocardiographic contrast agent, Levovist. METHODS: In a phantom
      model, we examined the influence of an acoustic power, harmonic filters,
      transmitted frequencies and focus positions of transducer on Levovist. Then
      fundamental, harmonic or harmonic power Doppler imaging were performed with ECG
      triggered imaging in eight closed-chest dogs using bolus injection of Levovist.
      RESULTS: In a phantom model, the highest transmission power (Mechanical index
      1.6), a medium harmonic filter and a focus position (6 cm) resulted in the best
      enhanced contrast in both THI and THPDI. Furthermore, higher pulse repetition
      frequency (5500 Hz) of harmonic power Doppler made clearer enhancement. In animal
      models, we could not observe the apparent myocardial contrast using triggered
      fundamental imaging, and the intensity of each region of interest (ROI) of
      myocardium had not changed significantly. However, homogeneous myocardial
      contrast could be obtained using THI, which was conditioned on the highest
      transmission power, a medium harmonic filter same as the phantom model, at a
      lower transmitted frequency (1.8 MHz) and a focus position, which were located in
      the middle portion of the left ventricle. The peak intensity of each ROI
      increased significantly in a gray level. Furthermore, THPDI caused emphasized
      myocardial contrast visually. CONCLUSIONS: These results indicate that THI and
      THPDI produce obvious MCE using peripheral venous injection of Levovist.

PMID- 11219596
TI  - Anatomical M-mode: A novel technique for the quantitative evaluation of regional
      wall motion analysis during dobutamine echocardiography.
AB  - Recognition of abnormal wall motion during dobutamine echocardiography requires
      an expert observer. Anatomical M-mode echocardiography may offer a novel
      quantitative approach to interpretation, amenable to less expert readers. We
      studied the application of this new modality to 124 patients (80 with known
      coronary anatomy and 44 patients at low probability of coronary disease) who
      underwent dobutamine echocardiography, using a standard protocol. Wall motion was
      interpreted by an experienced reader, using digitally stored 2-dimensional
      echocardiographic images at rest and peak stress. Percentage of systolic
      thickening was measured offline using anatomical M-mode echocardiography in the
      basal and mid segments at rest and peak dose, and compared with wall motion
      scores and coronary angiography. Of 729 segments, wall motion was identified as
      normal in 449, ischemic or viable in 171 and showed resting WM abnormalities only
      in 109 segments. After exclusion of the apex, anatomical M-mode measurements were
      feasible in 729 of 960 possible basal- and mid-zone segments (76%). Measurement
      of systolic thickening at peak dose was reproducible within (r2 = 0.83) and
      between observers (r2 = 0.93). Systolic thickening was significantly greater in
      segments with normal wall motion (37 +/- 2%) compared with ischemic or viable
      segments (30 +/- 2%, p < 0.001), and scar segments (23 +/- 3%, p < 0.001). There
      was an increment of thickening from rest to stress in normal and viable segments,
      no change in scar, and a decrement in ischemic segments. Significant coronary
      artery disease (defined by stenoses >70% diameter) was present in 59 patients.
      Systolic thickening showed significant variation between segments interpreted by
      wall motion scoring and angiography as true and false positive and true and false
      negative (p < 0.05). Measurement of systolic thickening using anatomical M-mode
      echocardiography offers an objective method to quantify systolic thickening at
      dobutamine echocardiography but has limited clinical feasibility.

PMID- 11219597
TI  - Comparison of methods of fractional area change for detection of regional left
      ventricular dysfunction.
AB  - Three methods for assessment of fractional area change (FAC) and conventional
      versus cross-sectional segmentation were compared under conditions known to occur
      frequently during stress echocardiography. Quantitative analysis of 80
      echocardiograms obtained from healthy subjects, patients with left ventricular
      (LV) dysfunction and after coronary artery bypass grafting included segmental and
      cross-sectional FACs by the centroid method with fixed and floating reference and
      a method with floating external reference. All segmental and cross-sectional FACs
      were equally sensitive to LV dysfunction, and segmental FACs failed to accurately
      predict the location of coronary lesions. The centroid method with floating
      reference and cross-sectional FACs were the least affected by surgery induced
      intrathoracic heart motion. In moderate to severe LV dysfunction FAC by the
      centroid method with floating reference and cross sections were rarely within
      normal limits. Cross-sectional FACs may prove to be useful in stress
      echocardiography. For viability studies segmental FAC by fixed reference appears
      to be the method of choice.

PMID- 11219599
TI  - Laser to the heart in coronary artery disease.

PMID- 11219598
TI  - Evaluation of the long-term functional outcome assessed by myocardial perfusion
      scintigraphy following excimer laser angioplasty compared to balloon angioplasty
      in longer coronary lesions.
AB  - OBJECTIVES: Evaluation of the long-term functional outcome assessed by exercise
      myocardial perfusion imaging following excimer laser angioplasty compared to
      balloon angioplasty in coronary lesions > 10 mm in length. BACKGROUND: Previous
      randomized studies evaluating the effect of coronary interventions mainly focused
      on the long-term clinical and angiographic outcome. The functional outcome,
      assessed by myocardial perfusion scintigraphy, has not been evaluated in a
      randomized setting. METHODS: A total of 308 patients with stable angina and a
      longer coronary lesion (> 10 mm) were randomized to excimer laser angioplasty or
      balloon angioplasty. A 99mTechnetium-2-methoxy isobutyl isonitrile (MIBI) single
      photon emission computed tomography (SPECT) study was performed in 139 patients
      before the initial angioplasty procedure and at 6 months follow-up (73 patients
      in the laser group versus 66 patients in the balloon group, respectively).
      Exercise tolerance at follow-up was compared to baseline values by means of
      exercise duration and double product at peak exercise. Myocardial perfusion of
      the randomized vascular bed was assessed semi-quantitatively on the MIBI SPECT
      images. The reversible defects were graded as mild, moderate or severe.
      Myocardial perfusion at follow-up was expressed as a percentage reduction in
      incidence and grading of the reversible defects compared to baseline values.
      RESULTS: Forty-four (61%) patients assigned to laser angioplasty were
      asymptomatic at 6 months follow-up compared to 34 (52%) patients assigned to
      balloon angioplasty (p = NS). Improvement in exercise duration and double product
      were 0.7 +/- 2.1 min and 4.3 +/- 6.2 min/mmHg/l,000, respectively, in the laser
      group, versus 0.3 +/- 2.5 min and 3.1 +/- 5.5 min/mmHg/1,000, respectively, in
      the balloon group (both p = NS). The percentage reduction of reversible defects
      was 23% in patients assigned to laser angioplasty vs. 29% in patients assigned to
      balloon angioplasty (Relative risk [RR]: 0.79, 95% confidence interval [CI]: 0.40
      1.57; p = 0.50). The mild, moderate and severe reversible defects improved in
      44.4, 63.6 and 66.6%, respectively, in the laser angioplasty group vs. 66.6, 53.8
      and 90%, respectively, in the balloon angioplasty group. None of the comparisons
      were significantly different. CONCLUSION: Excimer laser angioplasty compared to
      balloon angioplasty in coronary lesions > 10 mm in length yields a similar long
      term functional outcome assessed by anginal status, exercise tolerance and
      myocardial perfusion.

PMID- 11219600
TI  - Comparison between segmental wall motion and wall thickening in patients with
      coronary artery disease using quantitative gated SPECT software.
AB  - This study was performed to evaluate regional wall motion (WM) and wall
      thickening (WT) using gated myocardial perfusion single photon emission computed
      tomography (SPECT) and to determine their similarity and disparity in patients
      with coronary artery disease (CAD). A total of 44 patients underwent 1 day
      stress/rest (MIBI) gated SPECT. Commercially available quantitative analysis of
      gated SPECT (QGS) software was used to generate 3D surface display and cine-mode
      SPECT display. Left ventricle was divided into nine segments to score WM and WT
      from 0 (no abnormality) to 4 (severe abnormality) by six independent observers.
      Finally a mean score was calculated for each segment from the scores of six
      observers. There was fairly good correlation between WM and WT of individual
      segments (r = 0.62, p < 0.0001). Concordance rate (IWM - WTI < 1) was 85%. A
      large difference between WM and WT (WM - WT > or = 2) was observed in 15
      segments, including 12 segments with greater WM abnormalities and 3 segments with
      greater WT abnormalities (lateral and inferior walls). Greater WM abnormalities
      were most commonly observed in anteroseptal segments especially in post coronary
      artery bypass grafting (CABG) patients. In conclusion, WM and WT showed
      similarity on QGS studies. However, these two parameters may be determined
      separately in gated SPECT studies for comprehensive and robust evaluation of the
      functional status of myocardium. Analyses based on WM assessment alone may lead
      to erroneous results especially in septal regions.

PMID- 11219601
TI  - A systematic analysis of factors which may impact upon tomographic perfusion
      imaging measurements: implications for the use of Tc-99m sestamibi in acute
      myocardial infarction.
AB  - BACKGROUND: The use of acute Tc-99m sestamibi imaging has provided a valuable
      methodology to assess myocardium at risk and collateral blood flow. OBJECTIVE:
      The purpose of this study was to determine the impact of physical, physiologic,
      and reconstruction factors on the extent and severity of Tc-99m sestamibi images
      in a porcine model of coronary occlusion and reperfusion. METHODS AND RESULTS:
      Eleven pigs underwent 40 min of coronary occlusion using a balloon catheter
      followed by reperfusion. Radiolabeled microspheres were injected during occlusion
      for blood flow determination and 20-30 mCi of Tc-99m sestamibi was injected
      intravenously for cardiac imaging. Each animal underwent four modes of gamma
      camera imaging: a cardiac and respiratory gated SPECT study, an ungated SPECT
      study, a post-mortem SPECT study and an ex-situ study where the heart was sliced
      into five short axis slices and directly imaged. All animals had extensive wall
      motion abnormalities at the time of imaging. Myocardial risk area by ex-situ
      imaging was 32 +/- 9% LV and did not significantly change with the addition of a
      chest cavity and tomographic reconstruction (post-mortem and gated imaging) or
      cardiac and respiratory motion (ungated imaging). Defect severity was
      significantly underestimated with the addition of a chest cavity and tomographic
      reconstruction but was unaltered by cardiac and respiratory motion. CONCLUSIONS:
      The assessment of risk area acutely by SPECT Tc-99m sestamibi imaging is
      unaffected by cardiac motion obviating the necessity for gated imaging. Estimated
      defect severity (which has been used as a measure of collateral flow) is
      significantly reduced by the chest wall and tomographic acquisition and
      reconstruction suggesting a role for scatter and attenuation algorithms for this
      measure.

PMID- 11219602
TI  - Eustachian valve mimicking a right atrial cystic tumor.
AB  - We report the case of a 65-year-old patient referred to our hospital for stroke.
      In the course of the diagnostic procedure, a transesophageal echocardiography was
      performed and showed at first sight a mass attached to the right aspect of the
      interatrial septum and mimicking a cystic tumor. But after performing multiple
      views, it was in fact demonstrated a large Eustachian valve with its extremity
      attached to the right aspect of the interatrial septum. The increasing use of
      transesophageal echocardiography to evaluate patients makes it important for
      echocardiographers to recognize this anatomic entity and its normal variants.

PMID- 11219603
TI  - Macromolecular dynamics in living cell nuclei revealed by fluorescence
      redistribution after photobleaching.
AB  - Regulation and structural requirements of vital nuclear processes such as DNA
      replication, transcription, RNA processing and DNA repair inside the eukaryote
      nucleus are as yet poorly understood. Although a wealth of evidence exists
      pointing to a considerable degree of spatial organisation of chromatin and
      nuclear processes, there are still questions concerning the dynamics and
      interaction of nuclear proteins that remain unanswered. The cloning of the gene
      encoding the green fluorescent protein (GFP) has revolutionised the study of
      proteins in living cells. The expression of recombinant cDNA fusion plasmids of
      GFP and proteins of interest currently enables the investigation of those
      proteins in living cells. Time-lapse confocal microscopy as well as quantitative
      fluorescence methods such as fluorescence redistribution after photobleaching
      (FRAP) and fluorescence resonance energy transfer are widely applied to living
      cells expressing GFP fusion proteins. This review gives an overview of the
      current state of knowledge of nuclear structure and function. In particular, the
      different applications of FRAP technology to study the dynamics of GFP-tagged
      nuclear proteins will be summarised.

PMID- 11219605
TI  - Methods for visualizing RNA processing and transport pathways in living cells.
AB  - Recent advances in fluorescence microscopy, imaging, and probe technology
      provided possibilities to study the spatial and temporal distribution of RNA
      species in living cells. While some methods have been developed to localize all
      nascent or poly (A) containing transcripts others have been developed to study
      the in vivo distribution of specific RNA species. Irrespective of the method that
      has been used, the results of these studies provided important information
      concerning the localization and the cellular transport pathways of RNAs. Also,
      the picture emerges that RNA molecules travel through the nucleus at much faster
      speed, equaling that of free diffusion, than previously anticipated. Still, a
      major challenge proves to be the development of a microscopic detection technique
      that allows specific, in vivo, detection of low levels of RNA species by
      fluorescence in situ hybridization, without interfering fluorescent background
      signals derived from non-hybridized probe sequences and autofluorescent cell
      components. By applying photoactivatable caged fluorochrome-, molecular beacon-,
      or fluorescence resonance energy transfer (FRET)-based detection methods an
      important step in the future of living cell analysis has already been made.

PMID- 11219604
TI  - Illuminating the human genome.
AB  - The identification and analysis of novel genes and their encoded protein products
      remains a vigorous area of research in biology today. Worldwide genomic and cDNA
      sequencing projects are now identifying new molecules every day and the need for
      methodologies to functionally characterise these proteins has never been greater.
      The distinct compartmental arrangement of eukaryotic cells helps define the
      processes which occur within or in proximity to these membranes, and as such
      provides one means of inferring protein function. We describe here some of the
      methods recently reported in the literature, which use the subcellular
      localisation of proteins as a first step towards their further characterisation.

PMID- 11219606
TI  - In vivo imaging of the mammalian nervous system using fluorescent proteins.
AB  - The recent development of fluorescent proteins has rapidly and radically altered
      the way cell biology is performed by allowing simple, non-invasive imaging of
      cellular processes in real time. The special properties of the nervous system,
      such as synaptic morphology, axonal/dendritic maturation, and neuronal migration
      are especially amenable to investigation using fluorescent proteins. This review
      focuses on the various genetic and viral vectors used to express fluorescent
      proteins in vivo and in slice culture, and the strengths and limitations
      associated with them.

PMID- 11219607
TI  - Long-term expression of foreign genes in normal human epidermal keratinocytes
      after transfection with lipid/DNA complexes.
AB  - Normal human epidermal keratinocytes were isolated and cultivated in serum-free
      medium. The expression of the integrin subunits alpha6 and beta1 indicated that a
      high number of keratinocytes from the stem cell system was present. These cells
      were transfected with complexes made of different cationic lipids and marker
      genes. Effectene showed a 20-fold higher transfection efficiency, compared to
      Lipofectin and Lipofectamine, and a similar low toxicity. The transfection
      protocol was optimised. A DNA/lipid ratio of 0.133 showed the highest
      transfection efficiency. Keratinocytes expressed the marker gene luciferase for
      20 days. The maximum expression occurred after 3-4 days, where individual patches
      of fluorescent keratinocytes were detected. Transfected keratinocytes, cultivated
      at the air-liquid interface, expressed the marker gene beta-galactosidase for at
      least 7 weeks.

PMID- 11219608
TI  - The color of mice: in the light of GFP-variant reporters.
AB  - The mouse currently represents the premier model organism for mammalian genetic
      studies. Over the past decade the production of targeted and transgenic lines of
      mice has become commonplace, with current technology allowing the creation of
      mutations at base pair resolution. Such genome modifications are becoming
      increasingly elaborate and often incorporate gene-based reporters for tagging
      different cellular populations. Until recently, lacZ, the bacterial beta
      galactosidase gene has been the marker of choice for most studies in the mouse.
      However, over the past 3 years another valuable reporter has emerged, and its
      attractiveness is reflected by an explosion in its use in mice. Green fluorescent
      protein (GFP), a novel autofluorescent genetic reporter derived from the
      bioluminescent jellyfish Aequorea victoria, currently represents a unique
      alternative to other gene-based reporters in that its visualization is non
      invasive and so can be monitored in real-time in vitro or in vivo. It has the
      added advantage that it can be quantified by, for example, flow cytometry,
      confocal microscopy, and fluorometric assays. Several mutants of the original
      wild-type GFP gene that improve thermostability and fluorescence have been
      engineered. Enhanced GFP is one such variant, which has gained popularity for use
      in transgenic or targeted mice. Moreover, various GFP spectral variants have also
      been developed, and two of these novel color variants, enhanced yellow
      fluorescent protein (EYFP) and enhanced cyan fluorescent protein (ECFP), can also
      be used in mice. Since the spectral profiles of the ECFP and EYFP color variants
      are distinct and non-overlapping, these two reporters can be co-visualized, and
      are therefore ideal for in vivo double-labeling or fluorescent energy transfer
      analyses. The use of GFP and its color variants as reporters provides an
      unprecedented level of sophistication and represents the next step in mouse
      genome engineering technology by opening up the possibility of combinatorial non
      invasive reporter usage within a single animal.

PMID- 11219609
TI  - Green fluorescent protein (GFP) fusion constructs in gene therapy research.
AB  - The history of green fluorescent protein (GFP) as a marker is less than 10 years
      old, but it has already made a major impact on many areas of natural sciences,
      especially on cell biology and histochemistry. GFP can be detected in living
      cells without selection or staining and it can be fused to other proteins to
      yield fluorescent chimeras. The potential of GFP has also been recognised by gene
      therapy researchers and various GFP-tagged therapeutic proteins have been
      constructed. These chimeric proteins have been used to determine the expression
      level, site and time course of the therapeutic gene, or the correlation between
      gene transfer rate and therapeutic outcome. This review summarises the status of
      the applications of GFP fusions in gene therapy research.

PMID- 11219611
TI  - Cutaneous gene therapy--an update.
AB  - In this paper we review various strategies for gene transfer into the skin, their
      applications and show some of our own examples. The skin is the most accessible
      somatic tissue. Inherited skin diseases, such as epidermolysis bullosa and
      ichthyosis, and various systemic metabolic disorders are under investigation as
      potential candidate diseases for cutaneous gene transfer. Research is directed
      against genetic therapy of wounds and malignancies as well. So far, cutaneous
      gene transfer only has been used experimentally, but several clinical trials are
      under preparation.

PMID- 11219610
TI  - Tumor structure and extracellular matrix as a possible barrier for therapeutic
      approaches using immune cells or adenoviruses in colorectal cancer.
AB  - In this article we report about the role that tumor structure and extracellular
      matrix (ECM) may play in immunotherapy and in gene therapy using adenoviruses. We
      performed studies in a rat model for colorectal cancer, CC531, and in specimens
      of human colorectal cancer. The tumors were composed of two compartments, tumor
      cell nests surrounded by stromal cells. ECM proteins were expressed in the
      stromal part, where the blood vessels were also located. Furthermore, in several
      tumors, the tumor cell nests were surrounded by basal membrane-like structures.
      Therefore, in vascular approaches to treat cancer, therapeutic agents on their
      route to tumor cells may be hampered by ECM to reach tumor cells. We found that
      immune cells were abundantly present in tumors from colorectal origin. These
      cells were, however, not found in direct contact with tumor cells, but mainly in
      the stromal part of the tumor. Adenoviruses, when intravascularly injected, did
      not reach tumor cells in the CC531 rat model. Tumor cells were only infected, and
      even then in limited numbers, in cases of intratumoral injection. We hypothesize
      that ECM in a tumor is a barrier both for immune cells and for adenoviruses to
      make direct contact with these tumor cells, and thus limits colorectal tumor
      therapy.

PMID- 11219613
TI  - Outcomes after selective dorsal rhizotomy for spastic cerebral palsy.
AB  - OBJECT: The purpose of this article was to review the published outcomes after
      selective dorsal rhizotomy (SDR) for treatment of spastic cerebral palsy.
      METHODS: A literature search identified all articles related to outcomes after
      SDR. The outcomes were reviewed according to a paradigm developed by the National
      Center for Medical Rehabilitation Research (NCMRR). The quality of the evidence
      for each outcome was assessed using Sackett's criteria and the classification
      system developed by the Brain Trauma Foundation and the American Association of
      Neurological Surgeons. RESULTS: There is very strong evidence for benefits of SDR
      in the impairment domain of the NCMRR classification. SDR has been shown
      conclusively to decrease lower limb spasticity and increase lower limb range of
      motion. There is strong, but not as conclusive evidence that SDR has a positive
      impact in the functional limitation dimension, with improvements in motor
      function, and in particular the Gross Motor Function Assessment (GMFM). There is
      a moderate degree of certainty that SDR results in improvements in the disability
      dimension, as evidenced particularly by improvements in the Functional
      Independence Measure for Children (WeeFIM) and Pediatric Evaluation of Disability
      Inventory (PEDI). There is a moderate degree of certainty that SDR results in
      positive suprasegmental effects, especially related to upper limb function and
      cognition. There is weak evidence that SDR may reduce the need for orthopedic
      procedures in patients with spastic cerebral palsy, and the impact on hip
      subluxation relative to the natural history of this problem is unclear.
      CONCLUSIONS: This information could help to define the role of SDR in the
      management of the child with spastic cerebral palsy, in the light of alternative
      therapies, such as intrathecal baclofen and botulinum toxin, which have been
      introduced more recently. It also reveals the need for further studies,
      particularly dealing with quality of life and economic impact.

PMID- 11219612
TI  - Novel mutant Semliki Forest virus vectors: gene expression and localization
      studies in neuronal cells.
AB  - Semliki Forest virus vectors (SFV) are suitable for high-level transgene
      expression in neuronal tissue, both in vitro and in vivo. Cortical and
      hippocampal primary neurons in culture are efficiently infected resulting in 75
      95% of GFP-positive cells, and injection of SFV vectors into hippocampal slice
      cultures revealed a highly neuron-specific expression pattern with more than 90%
      of the infected cells being neurons. Here, we present novel SFV vector mutants
      and describe their infection patterns obtained in cultures of baby hamster kidney
      (BHK) cells, dissociated hippocampal neurons, and organotypic hippocampal slices.
      A less cytotoxic vector SFV(PD), carrying two point mutations in the nsP2 gene,
      showed much higher GFP expression levels in primary hippocampal neurons compared
      to the wild-type SFV vector. A triple mutant vector SFV(PDE153) demonstrated a
      temperature-sensitive phenotype in both BHK cells and primary neurons. In
      hippocampal slices cultured at 36 degrees C, SFV(PDE153) showed a remarkably
      higher (ca 250-fold) preference for expression in interneurons rather than in
      pyramidal cells as compared to wild-type SFV. The quadruple mutant SFV(PDTE) led
      to substantially increased and prolonged GFP expression in primary neurons.
      Relative to SFV(PDE153), a more pronounced temperature-sensitive phenotype was
      found resulting in no virus production and no GFP expression at the non
      permissive temperature (36-37 degrees C) in BHK cells, in dissociated neurons,
      and in organotypic hippocampal slices. The described novel SFV vectors will be
      useful for several specific applications in neurobiology.

PMID- 11219615
TI  - Double ependymoma of the filum terminale.
AB  - Myxopapillary ependymoma of the filum terminale and conus medullaris are
      relatively common spinal intradural neoplasms in adults, only 8-14% affecting
      children. We describe a case of a 15-year-old girl with two myxopapillary
      ependymomas of the filum terminale. Although cases of two such tumours have been
      described in adults, we have not found any similar paediatric cases in the
      literature.

PMID- 11219614
TI  - Multicentric glioma with unusual clinical presentation.
AB  - Multiple glioma is a well-recognized but uncommon entity. They are grouped in two
      categories: multifocal and multicentric gliomas. Multifocal gliomas grow through
      dissemination along an established route, spreading through commissural pathways,
      CSF channels, or the blood or by local extension through satellite formation; at
      the opposite end of the spectrum, multicentric gliomas are widely separated
      lesions whose simultaneous presence cannot be attributed to any of the above
      pathways. Reports in the literature refer to single cases or small series of
      multicentric gliomas, almost always in adult patients, their occurrence in
      children being even less frequent. We report the case of a 12-year-old boy with
      multicentric glioma, atypical acute clinical onset and fast growth of three other
      tumors in 8 months, and then discuss the problems of diagnosis and therapy.

PMID- 11219616
TI  - Intramedullary spinal teratoma with spina bifida.
AB  - Spinal intramedullary teratoma is a rare tumor. We report a case of
      intramedullary teratoma of the conus medullaris with spina bifida. A 5-year-old
      boy was admitted to our hospital for removal of a lumbosacral tumor sited in an
      intramedullary location at the conus medullaris, which was totally resected with
      neuroendoscopic assistance. The pathological diagnosis was mature teratoma
      consisting of three germ cell layers. The pathogenesis of spinal intramedullary
      teratoma is discussed with special reference to spina bifida.

PMID- 11219617
TI  - Inadvertent insertion of a nasogastric tube in a patient with head trauma.
AB  - This is a report of a 3-year-old boy with intracranial penetration of a
      nasogastric tube causing brain damage in the left frontal lobe. A computed
      tomography (CT) showed passage of the nasogastric tube via a fracture of the
      cribriform plate into the intracranial cavity. The tube was manually removed
      under antibiotic prophylaxis. The patient then underwent dural repair for
      rinorrhoea and was discharged in good health.

PMID- 11219618
TI  - The curly tail mouse model of human neural tube defects demonstrates normal
      spinal cord differentiation at the level of the meningomyelocele: implications
      for fetal surgery.
AB  - The paralysis associated with lumbosacral meningomyelocele has been attributed
      both to myelodysplasia and to degeneration of the exposed neural tissue.
      Surgically created dysraphism shows that exposure of an intact spinal cord in a
      genetically normal animal results in degeneration of the normal nervous tissue
      and subsequent paralysis. Our objective was to study neuronal differentiation in
      the curly tail mouse mutant model, which develops lumbosacral meningomyelocele
      naturally and is a phenocopy of nonsyndromic human neural tube defects. Prenatal
      repair of meningomyelocele assumes that the normal neuronal differentiation
      program occurs despite failure of neurulation. Here we demonstrate that this most
      suitable animal model has normal differentiation of neuronal structures at the
      level of the meningomyelocele. TuJ1, an antibody to neuronal specific class III
      beta-tubulin, an early marker of neuronal differentiation, was used to stain
      paraffin-embedded sections of curly tail mouse embryo meningomyelocele. Embryos
      were examined at embryonic day 13.5 (E13.5). The inbred mouse strain, C57BL6/J,
      which is genetically similar to the curly tail mouse, was used as a control in
      these studies. We show that early neuronal differentiation appears intact within
      the meningomyelocele. TuJ stains structures within the open neural tube. Motor
      neurons are present in the ventral horn and ventral roots. Dorsal root ganglia
      are present and of similar size to controls. The staining pattern is similar to
      that seen in the C57BL/6J control mouse, although dorsal structures are laterally
      displaced in the curly tail meningomyelocele. Based on this model, fetal surgery
      to repair human meningomyelocele may preserve neurological function in those
      cases where there is not an inherent genetic defect of the neural tissue.

PMID- 11219619
TI  - Ependymoma in children and young adults (0-19 years): report of 25 consecutive
      cases.
AB  - The objective of this retrospective study was to evaluate the relative effect of
      surgery and radiotherapy (RT) on the survival of 25 consecutive children and
      young adults treated for ependymoma [18 in the posterior fossa (PF), 2 in
      supratentorial locations (ST) and 5 in intraspinal locations (IS)]. Five-year
      survival rates for patients with PF, ST and IS tumors were 28%, 0% and 100%,
      respectively. Total tumor resection was a positive prognostic factor in the case
      of PF tumors. No patients with subtotal removal of a PF tumor survived for longer
      than 5 years. The effect of RT on survival of patients with PF ependymomas in
      this series was uncertain. No patients with PF ependymoma had disseminated
      disease at diagnosis, and all tumor recurrences were local. Based on these
      observations, we see no indications for craniospinal RT of PF ependymomas, except
      in rare cases of disseminated disease. If RT is given, it should only be targeted
      to the tumor site. The two patients with ST ependymoma died within 3.8 years
      after primary treatment. Our series of ST ependymomas does not allow any specific
      treatment recommendations. One patient with IS ependymoma was cured by surgery
      alone. Four patients with IS ependymoma had documented residual tumor after
      surgery. RT induced remission in these patients. For IS ependymomas we recommend
      no RT if total tumor removal can be documented. In patients with subtotal removal
      of IS ependymomas local RT is effective and should be given.

PMID- 11219620
TI  - Cerebellar gliomas in infants: specificity, pathology, and outcome.
AB  - Cerebellar gliomas (CGs) in children are generally associated with a favorable
      outcome; however, data regarding these tumors in very young children are scarce.
      We report on our experience with CGs in children less than 3 years old at
      surgery, compared with a second group older than 3 years. From 1991 to 1996, we
      operated on 7 children with CGs in the first group and 43 in the second.
      Psychomotor delay and regression were the first symptoms in 3 cases, and 3 had
      macrocrania. The tumor was totally removed in all cases. One child died
      intraoperatively of air embolism and subdural bleeding. Three had malignant
      tumors (grade 3 or 4). There was no operative mortality or malignancy in the
      second group of patients. With a mean follow-up of 33 months, all survivors in
      the first group are disease-free, with no or minimal symptoms, and attend normal
      schools. The clinical, surgical, and pathological features suggest that children
      under 3 years of age represent a specific subgroup of CGs.

PMID- 11219621
TI  - Cerebral aneurysms in childhood.
AB  - OBJECTS: The aim of this work was to ascertain any clinical and anatomical
      factors allowing differentiation between aneurysms of childhood and those
      occurring in adults by comparing both groups. METHODS: Results obtained in a
      total of 17 children and adolescents aged up to 18 who had been operated on for
      cerebral aneurysm in our department from 1989 to 1997 (3% of all patients treated
      for subarachnoid haemorrhage resulting from ruptured cerebral aneurysm in this
      period) were compared with those in the adult group operated on in our
      department. In contrast to the situation in adults, there was a male predominance
      in our population. In children we found only 1 case of middle cerebral aneurysm
      and 1 case of multiple aneurysms. We also found a high rate of rebleeding in the
      paediatric group. CONCLUSIONS: We suggest that the very good outcome (100% very
      good results in patients operated on early) obtained and the high risk of
      rebleeding in children with cerebral aneurysm allow the recommendation of early
      surgery in children with ruptured cerebral aneurysms.

PMID- 11219622
TI  - Spontaneous regression of a symptomatic pineal cyst after endoscopic third
      ventriculostomy.
AB  - With the advent of modern diagnostic tools for neuroimaging, the incidental
      detection of pineal cysts in asymptomatic subjects has increased. Only rarely do
      pineal cysts present with the clinical signs and symptoms of increased
      intracranial pressure or with neurological deficits in relation to compression
      and distortion of the adjacent nervous structures and cerebrospinal fluid
      pathways. While asymptomatic cysts are considered to be normal variants for which
      no further investigations are usually required, surgical treatment is suggested
      for symptomatic cysts, with the goal of eliminating the block in the
      cerebrospinal fluid circulation and/or the mass effect exerted by the lesion. In
      this report we describe a pediatric case of symptomatic pineal cyst, revealed by
      repeated episodes of headache caused by secondary obstructive hydrocephalus.
      Following an endoscopic third-ventriculostomy, serial magnetic resonance imaging
      studies demonstrated that not only had the ventriculomegaly resolved but also
      that the pineal cyst had regressed over time. A to-and-fro movement of fluid
      through the cyst wall, the direction of which depends on the equilibrium existing
      between the inner pressure of the cyst and the outer cerebrospinal fluid
      pressure, is suggested as a possible mechanism accounting for this unexpected
      result--to our knowledge, the first reported in literature.

PMID- 11219623
TI  - Primary intervention for posthemorrhagic hydrocephalus in very low birthweight
      infants by ventriculostomy.
AB  - The objective of our study was to determine the efficacy of ventriculostomy as
      the primary treatment for posthemorrhagic hydrocephalus in premature infants.
      Within a period of 4 years, 20 very low birthweight (VLBW) infants (birthweight
      median 1,135 g, range 650-1,470 g) were treated for progressive posthemorrhagic
      hydrocephalus (PHHC) by right parietal ventriculostomy (Salmon Rickham) at a mean
      age of 21 days. Serial tapping of the subcutaneous reservoir was performed for
      temporary drainage until conversion to a permanent ventriculoperitoneal (VP)
      shunt or spontaneous resolution of hydrocephalus. A total of 1,402 punctures
      (median 71/infant, range 13-168) was performed. The results showed that only 1/20
      patients developed a cerebrospinal fluid (CSF) infection, accounting for a 5%
      patient-related and 0.07% procedure-related infection rate. Major complications
      such as skin defects, subdural hygroma, or CSF leaks occurred in three patients
      (15%). A permanent shunt was needed in 17 patients (85%). We concluded that, as
      an effective alternative to serial or lumbar puncture, there should be early
      implantation of ventriculostomy reservoirs for serial taps to control
      intracranial pressure in PHHC of VLBW infants until a permanent shunt can be
      placed because of the low incidence of infections and technical complications.

PMID- 11219624
TI  - Pressure compensation in shunt-dependent hydrocephalus with CSF shunt
      malfunction.
AB  - This study is a retrospective analysis of intracranial pressure (ICP) and
      cerebral perfusion pressure (CPP) data from 56 children with active hydrocephalus
      and cerebrospinal fluid (CSF) shunt malfunction. The pressures were measured from
      a separately sited CSF access device placed in the frontal horn of the lateral
      ventricle. Of the patients, 79% had an elevated ICP (mean 20+/-12 mmHg). A
      subgroup of patients demonstrated ten different forms of CSF-filled swelling.
      This group had significantly lower ICP recordings (P=0.000075) with a mean ICP of
      8.5 mmHg compared with the remainder (22.9 mmHg). This pressure 'compensation'
      was because of additional nonphysiological accommodation of CSF volume. Overall
      the CPP was normal in 35% of cases despite normal ICP occurring in only 11% of
      cases. The CPPs were not significantly different in those with and without
      compensation. Measurement of ICP may not always be a reliable indicator of shunt
      malfunction in shunt-dependent children who present with compensatory CSF-filled
      spaces.

PMID- 11219626
TI  - Sagittal synostosis: results of surgical treatment in 210 patients.
AB  - From 1977 to 1996, 210 patients suffering from scaphocephaly, have been operated
      on in our institutions. The surgical technique depended on the patients age.
      Single wide sagittal synostectomy was performed in 155 babies aged less than 3
      months, obtaining good cosmetic results. Patients older than 3 months needed more
      complex and aggressive procedures to achieve similar results. The conclusions is
      that sagittal suturectomy is the proper treatment in younger patients under 3
      months of age, and that a greater effort must be made to diagnose and treat these
      patients early.

PMID- 11219625
TI  - Hyponatraemia in children with acute CNS disease: SIADH or cerebral salt wasting?
AB  - Hyponatraemia in patients with an acute central nervous system disease can be
      caused by two different mechanisms: (1) retention [corrected] of free water, i.e.
      the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and (2)
      excessive sodium retention [corrected], i.e., the cerebral salt wasting syndrome
      (CSW). Although the concept of CSW is well known in adult medicine, it is still
      not established in child neurology. We conducted a retrospective analysis of
      electrolyte disturbances in 195 children with various acute CNS diseases. In 20
      children (10.3%) hyponatraemia with plasma sodium below 130 mmol/l was
      identified. On the basis of clinical and laboratory data 7 of these 20 children
      were diagnosed as having SIADH, and the other 9 children, as having CSW. Our data
      suggest that hyponatraemia attributable to CSW is at least as frequent in
      children as SIADH. Because of their different pathophysiological mechanisms,
      which require diametrically opposed therapeutic regimens, early differential
      diagnosis is mandatory if the correct treatment is to be given.

PMID- 11219627
TI  - Cervical disc prolapse in childhood associated with Klippel-Feil syndrome.
AB  - Klippel-Feil syndrome is characterized by a variable degree of congenital fusion
      of the cervical spine. It can exist in association with other mesodermal
      deformities affecting several systems. Symptomatic cervical disc prolapse in the
      context of the syndrome is well documented in young adults. We present a case of
      a 5-year-old girl with the syndrome, who presented with mild motor developmental
      delay and cervical cord compression from a prolapsed C3/4 intervertebral disc,
      seen on MR scan. She also had posterior elements fused from C-2 to C-4. She
      improved after cervical discectomy. The presence of degenerative disc disease at
      such a young age and at a level mechanically protected by posterior element
      fusion indicates a congenital primary defect, rather than mechanical stress
      fatigue.

PMID- 11219628
TI  - Seizure outcomes after anterior callosotomy in patients with posterior-dominant
      and with anterior-dominant epileptiform discharges.
AB  - OBJECTS: We wished to find whether there was any difference in the postoperative
      seizure outcome between patients with bisynchronous anterior-dominant and those
      with posterior-dominant EDs after anterior callosotomy. METHODS: Seizure outcomes
      after anterior callosotomy in 7 patients with bisynchronous posterior-dominant
      epileptiform discharges and in 54 patients with anterior-dominant seizures were
      compared. All 61 cases had been followed up for more than 2 years after
      operation. One patient (14.3%) had become seizure free. Two patients (28.6%) had
      more than 50% reduction in seizure frequency, but 4 patients (57.2%) showed no
      improvement at all. The percentage of cases with significant improvement (more
      than 50% reduction of seizure frequency) was 43% (3 in 7), which is lower than in
      the patients with bisynchronous anterior-dominant EDs (64.8%). CONCLUSIONS: Our
      preliminary results suggest that anterior partial callosotomy could still be
      helpful in cases with bisynchronous posterior-dominant epileptiform discharges
      but the prognosis may be less optimistic than for those with anteriorly located
      discharges.

PMID- 11219629
TI  - Hydrocephalus and epilepsy.
AB  - Since the introduction of ventriculo-atrial and/or ventriculo-peritoneal shunting
      for hydrocephalic patients, controversies have developed regarding the likelihood
      of epileptic seizures developing as a result of the shunting itself and/or its
      complications. On the other hand, hydrocephalus is not commonly recognized as a
      cause of seizures in general, although epilepsy is reported to be frequently
      associated with shunt-treated hydrocephalus, especially in children. Several
      authors have reported an increased risk of epileptic seizures after shunt
      placement, but the underlying mechanisms are still controversial. The insult to
      the brain at the time of ventricular catheter insertion, the presence of the
      shunt tube itself as a foreign body, the burr hole location, the number of shunt
      revisions after malfunction, associated infection, the etiology of hydrocephalus,
      and associated mental retardation are thought to be related to the risk of
      epilepsy. Age at the time of initial shunt placement also seems to be an
      important factor. Early shunting is a well-known determinant of risk in shunt
      obstruction, and children less than 2 years old are consequently at a higher risk
      of developing epilepsy than older ones. It is reported that antiepileptic drug
      treatment is not so reliable as might be expected. Conscientious and more
      sophisticated EEG recording in those children may be beneficial during follow-up.
      The incidence of seizures in shunted children is reported to be quite high,
      ranging from 20% to approximately 50%, so that neurosurgeons should pay more
      attention to the issue of epilepsy in hydrocephalic children. Although ventriculo
      extracranial shunts have been the standard treatment for hydrocephalus for
      decades, the long-term morbidity, including postshunt epileptic seizures, has to
      be taken seriously. The use of neuroendoscopic techniques when indicated may
      ameliorate this problem a great deal in the future.

PMID- 11219630
TI  - Application of finite element analysis in neurosurgery.
AB  - With the rapid development of computer equipment, approximation by analytical
      solutions has become popular in mathematical modeling. Finite element (FE)
      analysis uses numerical methods to solve problems with physical phenomena, and
      these can be applied to various geometrically complex materials, such as brain.
      The FE formulation can provide such diverse domains as heat conduction, torsion
      of elastic material, diffusion and fluid flow, and it can view different objects
      of study in the neurosurgical field. In this article, the various applications of
      FE methods are introduced to illustrate the usefulness of the technique and the
      link between the external biomechanical aspect and internal phenomena in brain
      research.

PMID- 11219631
TI  - Dermoid cyst in the posterior fossa accompanied by Klippel-Feil syndrome.
AB  - OBJECTS: Dermoid cysts accompanied by Klippel-Feil syndrome are uncommon, and the
      coincidence of these two rare diseases suggests an interesting idea about the
      pathogenesis of a dermoid cyst, which the authors consider with reference to an
      actual case. A posterior fossa dermoid cyst with dermal sinus and Klippel-Feil
      syndrome are reported in the same patient. A 23-year-old woman was admitted to
      hospital with progressive headaches. METHODS: Cervical radiography demonstrated
      C4-5 vertebral fusion, and magnetic resonance imaging revealed a large cystic
      mass in the midline of the posterior fossa. The cystic lesion was totally removed
      along with the accompanying dermal sinus. It was histopathologically diagnosed as
      a dermoid cyst. CONCLUSION: The rare coincidence of a dermoid cyst and Klippel
      Feil syndrome suggests the possibility that a disturbance in the mesoderm before
      the fourth week of gestation might play an important part in the causation of
      dermoid cyst.

PMID- 11219632
TI  - The sartorial specter of viscocanalostomy.

PMID- 11219633
TI  - Effect of timolol on anterior optic nerve blood flow in patients with primary
      open-angle glaucoma as assessed by the Heidelberg retina flowmeter.
AB  - PURPOSE: To evaluate the effect of 0.5% timolol maleate on the capillary
      circulation of the anterior optic nerve head in patients with primary open-angle
      glaucoma and to compare the results with those obtained in a healthy control
      group. PATIENTS AND METHODS: Twelve patients with nonprogressive glaucoma and 12
      age- and sex-matched healthy volunteers were included in this prospective study.
      Optic nerve head perfusion was examined by the Heidelberg Retina Flowmeter (HRF)
      in both groups. A 3-week washout period preceded the baseline measurement in the
      glaucoma group, and ONH blood flow was assessed again after 3 weeks of bilateral
      topical timolol treatment and 2 hours after timolol application. RESULTS:
      Intraocular pressure decreased significantly with timolol (P < 0.001). The HRF
      flow values for patients with glaucoma were comparable to those for a control
      group at baseline (P = 0.25), 3 weeks after timolol therapy (P = 0.09), and 2
      hours after timolol instillation (P = 0.15). The glaucoma group showed no
      statistically significant change in the HRF parameter flow as compared with
      baseline, either after 3 weeks of timolol treatment or 2 hours after timolol
      instillation (P = 0.40). The heart rate and arterial systolic and diastolic blood
      pressure values showed no alteration after timolol therapy. CONCLUSIONS: Patients
      with nonprogressive glaucoma seem not to have an altered optic nerve blood flow
      as assessed by the HRF, and timolol treatment does not seem to alter the latter
      blood flow parameter in such patients.

PMID- 11219634
TI  - Diurnal variation of episcleral venous pressure in healthy patients: a pilot
      study.
AB  - PURPOSE: To study diurnal episcleral venous pressure (EVP) and its relation to
      intraocular pressure (IOP) in healthy patients. The influences of supine position
      and lid closure on EVP were also studied. DESIGN: Experimental observational
      study. PARTICIPANTS AND METHODS: Twelve healthy patients with no eye disease had
      their IOP and EVP measured at 16h00, 22h00, 22h30, 06h00, 06h30, 09h00, 12h00,
      and 16h00. Measurements at 22h30, 06h00, and 06h30 were performed on supine
      patients, and the measurement at 06h00 was with the eye that had been closed for
      the whole night. In a second experiment, EVP was measured on patients who were
      lying supine from 22h30 to 16h00 with one eye closed during the day. MAIN OUTCOME
      MEASURES: Episcleral venous pressure and IOP at varying time points during a 24
      hour period. RESULTS: Episcleral venous pressure was relatively constant
      throughout the day except for a slight reduction at 22h00. After lying down, the
      EVP increased by 3.6 mm Hg and remained increased as long as the patient remained
      in this position. Eyelid closure did not affect EVP. IOP measured with the Tono
      Pen closely followed the variations in EVP. CONCLUSION: Episcleral venous
      pressure remains relatively constant throughout the day. It increases in the
      supine position with a corresponding increase in IOP. Lid closure does not
      influence EVP or IOP.

PMID- 11219635
TI  - Caffeine and intraocular pressure in a Nigerian population.
AB  - PURPOSE: Caffeine is widely consumed as kola nuts and in other products in sub
      Saharan Africa. We examined the acute effect of caffeine on the intraocular
      pressures of healthy Nigerian volunteers between the ages of 20 and 27 years.
      METHODS: Intraocular pressure and blood pressure were measured 0, 30, 60, and 90
      minutes after the ingestion of coffee by two groups of participants, namely the
      experimental (caffeinated coffee) and control (decaffeinated coffee) groups.
      RESULTS: The result showed that ingested caffeine increases intraocular pressure
      and that the elevation, though variable across patients, is sustained for several
      minutes. The mean increase across patients rises monotonically with the
      postingestion time and by almost 4 mm Hg. There was also a corresponding increase
      in systolic and diastolic blood pressure of the caffeinated group. There was
      relatively no change in intraocular pressure or blood pressure with time in the
      control group. The difference between both groups was statistically significant
      (P < 0.05). CONCLUSIONS: The results suggest the need for more glaucoma
      screenings and proper patient education, particularly in Nigerian populations in
      which the consumption of caffeine, contained in kola nuts and in other raw and
      processed products, is endemic and long-term.

PMID- 11219636
TI  - Intraocular pressure after homologous penetrating keratoplasty.
AB  - PURPOSE: To evaluate intraocular pressure (IOP) changes after homologous central
      penetrating keratoplasty in a noncomparative interventional case series. METHODS:
      The study included 245 patients undergoing homologous central penetrating
      keratoplasty for keratoconus (n = 77), herpetic corneal scars (n = 29),
      nonherpetic corneal scars (n = 46), Fuchs endothelial dystrophy (n = 24), and
      secondary corneal endothelial decompensation caused by preceding intraocular
      operations (n = 69). Mean follow-up time was 30.4 +/- 18.7 months (range, 12.1
      111.6 months). The same surgeon operated on all patients, and a peripheral
      iridotomy was routinely performed. RESULTS: On the first postoperative day, IOP
      was significantly (P = 0.02) higher than that before keratoplasty. Taking the
      whole study group and taking the study groups separately, IOP measurements
      determined on the third postoperative day (P = 0.57), 1 week after surgery (P =
      0.55), or later (P > 0.50) were not significantly different from the preoperative
      values. Eyes undergoing keratoplasty with cataract surgery and eyes undergoing
      keratoplasty without additional intraocular procedures did not vary significantly
      (P > 0.10) in IOP measurements. IOP did not differ significantly (P > 0.50)
      between eyes with an immunologic graft reaction (n = 29) and eyes without a
      reaction (n = 216). Acute angle-closure glaucoma was not detected in any of the
      patients. IOP measurements were statistically independent of suture type (P >
      0.10), age (P > 0.05), preoperative and postoperative refractive error (P >
      0.05), preoperative and postoperative corneal astigmatism (P > 0.10),
      preoperative and postoperative visual acuity (P > 0.10), diameter of graft and
      trephine (P > 0.15), and oversize of the graft (P > 0.50). Postoperative IOP
      measurements were significantly (P < 0.01) correlated with preoperative IOP
      values. CONCLUSIONS: In eyes with a peripheral iridotomy performed during
      surgery, homologous central penetrating keratoplasty usually does not markedly
      change IOP. The main risk factor for postoperatively increased IOP is increased
      IOP before surgery.

PMID- 11219637
TI  - Intraocular pressure and medication control after clear corneal
      phacoemulsification and AcrySof posterior chamber intraocular lens implantation
      in patients with filtering blebs.
AB  - PURPOSE: To determine whether clear corneal phacoemulsification and the
      implantation of a copolymer acrylic (AcrySof, Alcon, Fort Worth, TX) intraocular
      lens will maintain the intraocular pressure (IOP) and number of medications in
      patients with a previous filtering bleb. PATIENTS AND METHODS: This retrospective
      analysis included 69 consecutive patients with previous trabeculectomy who had a
      copolymer acrylic intraocular lens implanted during cataract surgery between 1995
      and 1999 by a single surgeon (A.C.S.C.). RESULTS: Mean IOP significantly
      decreased from 26.03 mm Hg (range, 14.5-70 mm Hg; n = 69) before trabeculectomy
      to 13.58 +/- 3.98 mm Hg (range, 5-24 mm Hg; n = 69) before the cataract
      extraction. After cataract extraction, the mean IOP increased significantly by
      1.49 mm Hg (n = 67; P = 0.0013), by 1.85 mm Hg (n = 57; P = 0.0005), and by 1.01
      mm Hg (n = 67; P = 0.042) after 6 months, after 1 year, and at the patient's last
      appointment, respectively. When patients whose pressures were purposely increased
      during cataract surgery were not included (n = 5), the mean increase at the last
      appointment was not significantly increased (0.54 mm Hg; n = 62; P = 0.25). The
      average number of antiglaucoma medications decreased from 2.93 (range, 1-5; n =
      69) before trabeculectomy to 0.36 (range, 0-2; n = 69) before cataract surgery.
      This mean decreased to 0.34 (range, 0-2; n = 67; P = 0.8366) 6 months after
      cataract surgery and increased to 0.49 (range, 0-3; n = 57; P = 0.1029) and 0.62
      (range, 0-3; n = 67; P = 0.0006) after 1 year and at the last appointment,
      respectively. Of the total study population, two (2.9%) patients required
      additional glaucoma surgery and 14 (20.3%) patients required additional
      antiglaucoma medications as compared with their precataract levels. CONCLUSIONS:
      Clear corneal phacoemulsification and the implantation of a copolymer acrylic
      (AcrySof, Alcon) posterior chamber intraocular lens statistically increased the
      number of medications and IOP of patients in our study. These increases, although
      statistically significant, did not cause a clinically significant deterioration
      in IOP control.

PMID- 11219638
TI  - Intraocular and interocular symmetry in normal retinal capillary perfusion.
AB  - PURPOSE: To investigate retinal capillary perfusion in different areas of the
      posterior pole (intraocular symmetry) and to compare capillary perfusion between
      the right and left eyes (interocular symmetry). METHODS: The study consisted of
      52 clinically healthy patients between the ages of 45 and 74 years. Good quality
      images were obtained in 30 patients. By using scanning laser Doppler flowmetry
      with the Heidelberg Retina Flowmeter, three 10 degree scans were obtained from
      the fovea and superior and inferior retina of the study eye (for intraocular
      symmetry) and from the fovea of the fellow eye (for interocular comparison).
      Values of volume, flow, and velocity were recorded from each of these areas.
      Repeated measures analysis of variance, with Bonferroni correction, was used for
      groupwise comparison between areas in the study eye. Paired t tests, with
      Bonferroni correction, were used to compare nonfoveolar perfusion between the
      right and left eyes for each patient. RESULTS: Capillary volume in the foveola
      was significantly less than that in areas superior and inferior and 3 degrees
      nasal and temporal, and it was found to increase with eccentricity in the macular
      region. Only 2 of 30 patients had significant interocular differences between the
      extrafoveolar areas. CONCLUSION: Significant differences in retinal capillary
      perfusion were found across the macular region and corresponded with the increase
      in capillary beds. The Heidelberg Retina Flowmeter also measured the expected
      decrease in volume at the foveolar avascular zone. There were no significant
      interocular differences in perfusion. Eye movements, media opacities, and poor
      tear film quality had a deleterious effect on image quality.

PMID- 11219639
TI  - Bleb window cryopexy for the management of oversized, misplaced blebs.
AB  - PURPOSE: To describe a new technique for revising oversized blebs after
      trabeculectomy. METHODS: A chart review of consecutive patients undergoing bleb
      window cryopexy was conducted. Patients with symptomatic oversized blebs were
      candidates for the technique, regardless of the intraocular pressure. Under
      topical anesthesia, the bleb was incised and a 3 mm x 3 mm conjunctival window
      was removed using 0.12 forceps and Vannas scissors. Light cryotherapy was applied
      to the sclera through the window. A soft bandage contact lens was then placed for
      compression, and a patch was applied. All patients were given antibiotic drops
      the first day after surgery. Topical corticosteroid drops were used to minimize
      postoperative inflammation. Outcome measures included relief of symptoms,
      adequate control of intraocular pressure, and restoration of filtering bleb
      function without further antiglaucoma medication or surgical bleb revision.
      RESULTS: Nine patients met the inclusion criteria. All patients had flattening of
      the bleb with symptomatic relief within 2 weeks. No loss of bleb function
      occurred. One patient developed aqueous misdirection after the procedure.
      CONCLUSION: Early results showed that bleb window cryopexy is safe and effective.
      This minimally invasive technique can be useful for selected patients with large.
      symptomatic, overhanging blebs.

PMID- 11219640
TI  - Silicone oil glaucoma.

PMID- 11219641
TI  - How does nonpenetrating glaucoma surgery work? Aqueous outflow resistance and
      glaucoma surgery.
AB  - Histologic, experimental, and theoretical studies of the aqueous outflow pathways
      point toward the juxtacanalicular region and inner wall of Schlemm's canal as the
      likely site of aqueous outflow resistance in the normal eye. At least 50% of the
      aqueous outflow resistance in the normal eye and the bulk of the pathologically
      increased resistance in the glaucomatous eye resides in the trabecular meshwork
      and the inner wall of Schlemm's canal. The uveoscleral, or uveovortex, pathway,
      which accounts for perhaps 10% of the aqueous drainage in the healthy aged human
      eye, can become a major accessory route for aqueous drainage after pharmacologic
      treatment. Surgeries designed to incise or remove the abnormal trabecular
      meshwork of glaucoma address the pathologic problem of the disease. Surgeries
      that unroof Schlemm's canal or expand the canal, such as viscocanalostomy,
      probably cause inadvertent ruptures of the inner wall and juxtacanalicular
      tissue, thus relieving the abnormal outflow resistance of glaucoma. This review
      is a summary of current thought on the pathophysiology of aqueous outflow
      resistance in glaucoma and, in light of this, provides an interpretation of the
      mechanism of pressure reduction created by these new surgeries.

PMID- 11219643
TI  - The sixth annual Optic Nerve Rescue and Regeneration Think Tank: developmental
      genetics in glaucoma.

PMID- 11219642
TI  - Retrograde infusion of fluorescein to confirm location and patency of a glaucoma
      drainage device.
AB  - BACKGROUND: During surgical revision of a glaucoma drainage device, the status of
      the implant tube can be in question. We report two cases in which retrograde
      infusion of fluorescein-stained balanced salt solution was used to confirm the
      patency and location of the tube. METHODS: Fluorescein-stained balanced salt
      solution was made by dipping a sterile fluorescein strip into a 3-mL syringe of
      balanced salt solution until the fluid was visibly yellow. A 30-gauge canula was
      inserted into the tube at the reservoir end, and fluorescein-stained balanced
      salt solution was infused into the eye. RESULTS: Retrograde infusion of
      fluorescein-stained balanced salt solution confirmed the location and patency of
      the glaucoma drainage device implant tube, obviating the need for more extensive
      surgical intervention in these two cases. Neither patient experienced an adverse
      event. CONCLUSION: Retrograde infusion of fluorescein-stained balanced salt
      solution is a useful adjunctive technique for surgical revision of glaucoma
      drainage devices.

PMID- 11219644
TI  - Sex differences on a computerized mental rotation task disappear with computer
      familiarization.
AB  - The area of cognitive research that has produced the most consistent sex
      differences is spatial ability. Particularly, men consistently perform better on
      mental rotation tasks than do women. This study examined the effects of
      familiarization with a computer on performance of a computerized two-dimensional
      mental rotation task. Two groups of college students (N=44) performed the
      rotation task, with one group performing a color-matching task that allowed them
      to be familiarized with the computer prior to the rotation task. Among the
      participants who only performed the rotation task, the 11 men performed better
      than the 11 women. Among the participants who performed the computer
      familiarization task before the rotation task, how ever, there were no sex
      differences on the mental rotation task between the 10 men and 12 women. These
      data indicate that sex differences on this two-dimensional task may reflect
      familiarization with the computer, not the mental rotation component of the task.
      Further research with larger samples and increased range of task difficulty is
      encouraged.

PMID- 11219645
TI  - Quality of life of people with epilepsy following temporal lobectomy: a
      preliminary report.
AB  - This is a preliminary report of the quality of life of 9 people, 5 men and 4
      women, in Hong Kong who underwent temporal lobectomy for seizure control. The
      Chinese version of World Health Organization Quality of Life Measure Abbreviated
      Version, validated in Hong Kong, was used as the outcome measure. Analysis
      suggested that the quality of life of these participants after successful
      temporal lobectomy was poorer than that of 157 healthy controls in the physical
      and psychological domains as measured. This suggests that other factors in
      addition to achieving complete seizure control play significant roles in
      promoting the quality of life of such patients.

PMID- 11219646
TI  - A psychometric investigation of the Clinical Instruction Analysis Tool--Athletic
      Training II.
AB  - To identify clinical instructors', students', and patients' behaviors during
      athletic training clinical education, the Clinical Instruction Analysis Tool
      Athletic Training II was developed and used by two trained observers to assess
      interobserver agreement, which was 95.4%.

PMID- 11219648
TI  - Effects of hypnosis on flow states and golf performance.
AB  - This study examined the effects of an hypnotic intervention on flow states and
      golf-chipping performance of 3 participants. The study utilized an ideographic
      ABA single-subject design combined with a procedure to assess the participants'
      internal experience (Wollman, 1986). The intervention involved relaxation,
      imagery, hypnotic induction, hypnotic regression, and trigger control procedures
      over 5 wk. and 7 trials. Analysis indicated the 3 participants increased their
      mean golf-chipping performance from the trials in Baseline 1 to intervention,
      with 2 returning to Baseline 1 performance after the intervention phase at
      Baseline 2. The intensity of flow experienced by the participants during the
      performance trials was measured using Jackson and Marsh's 1996 Flow State Scale.
      Two participants experienced higher flow during the intervention phase and much
      lower flow during Baselines 1 and 2. Finally, participants indicated the
      intervention seemed useful in keeping them confident, relaxed, and in control.
      These results support the hypothesis that an hypnotic intervention can improve
      golf-chipping performance and increase feelings and cognitions associated with
      flow.

PMID- 11219647
TI  - Comparison of eye-movement patterns in schizophrenic and normal adults during
      examination of facial affect displays.
AB  - Patients with schizophrenia are known to have deficits in facial affect
      recognition. Subjects were 25 schizophrenic patients and 25 normal subjects who
      were shown pairs of slides of laughing faces and asked to compare the intensity
      of laughter in the two slides. Eye movements were recorded using an infrared
      scleral reflection technique. Normal subjects efficiently compared the same
      facial features in the two slides, examining the eyes and mouth, important areas
      for recognizing laughter, for a longer time than other regions of the face.
      Schizophrenic patients spent less time ex amining the eyes and mouth and often
      examined other regions of the face or areas other than the face. Similar results
      were obtained for the number of fixation points. That schizophrenic patients may
      have employed an inefficient strategy with few effective eye movements in facial
      comparison and recognition may help to explain the deficits in facial recognition
      observed in schizophrenic patients.

PMID- 11219649
TI  - Relationship between attentional orientation and associative learning.
AB  - This study presents experimental evidence for a relationship between attentional
      orientation and associative learning. Learning to establish contingencies between
      warning signals and subsequent task stimuli is a phenomenon which we know from
      previous studies to be more associated with the left hemisphere. We investigated
      how hemispheric priming, i.e., activating one hemisphere by directing attention
      towards the contralateral hemispace, affected both the rate and the extent of
      associative and nonassociative learning. When attention was directed towards the
      right while perceiving a discrimination task stimulus, the rate of learning
      through contingency formation was increased since the relative activation of the
      left hemisphere was increased. Such a relationship was not found for relative
      activation of the right hemisphere following leftward orientation of attention.

PMID- 11219650
TI  - Sidedness preference as an index of organization of laterality.
AB  - A rightward bias to all forms of sidedness seems to be particularly human and
      perhaps characteristic of every human society. However, this phenomenon has been
      studied mainly in relation to lateralization of handedness and language. This
      study investigated the consistency of right- and nonright-handed individuals in
      prefer ring the same side for foot, eye, and ear using Coren's Lateral Preference
      Inventory. The sample of 194 students, 91 boys and 103 girls, ranging in age from
      11.5-14.5 years (M age 13.2 yr.) was recruited from public junior high schools in
      a rural area in Greece on the island of Rhodes. Despite the dominance of the
      right side observed in handedness, footedness, eyedness, and earedness, this
      tendency was not equally strong in all four indexes of lateral preference, with
      handedness showing comparatively the strongest tendency and earedness showing
      comparatively the weakest tendency. Moreover, the strength of preference for the
      same side for foot, eye, and ear was significantly weaker in nonright-handed
      individuals compared to right handed individuals. These results agree with the
      hypothesis that nonright-handers may have reduced rath er than reversed
      asymmetry.

PMID- 11219651
TI  - Random number generation deficit in schizophrenia characterized by oral vs
      written response modes.
AB  - To characterize the deficit in random number generation in schizophrenia with
      respect to control of sensory information processing, the present study employed
      a random number generation task using 10 digits (0 to 9) and compared two
      response modes (oral and written) with different amounts of sensory availability
      about the previous choices of the subject. Analysis indicated that the increased
      availability of previous information in the written response mode may exacerbate
      an aspect of the deficit in random number generation in schizophrenia reflecting
      the disturbance in control of sensory information processing. The comparison of
      performance in written and oral response modes may be useful in assessing
      schizophrenic psychopathology.

PMID- 11219652
TI  - Manipulations of sensory information: a test of the hypothesis of redundancy of
      knowledge of results.
AB  - The hypothesis of redundancy in knowledge of results was examined by manipulating
      the amount and location of sensory information available to participants
      performing a coincident anticipation timing task. Either the last 8 lights or the
      last 16 lights of the visual display were visible to 48 participants. Following
      an acquisition phase, learning was tested over immediate (5-min.) and delayed (24
      hr.) retention intervals. The main finding was that performance was better when
      knowledge of results was present, regardless of the amount of sensory information
      available; therefore, knowledge of results was not redundant information for
      learning this task.

PMID- 11219653
TI  - Psychological factors and sex differences in acceptance of monovision.
AB  - 49 participants, adapted to using contact lenses, completed a battery of
      psychological tests to examine differences between persons who were successful in
      wearing monovision lenses for presbyopia and those who were unsuccessful.
      Although visual performance and requirements strongly affect participants'
      satisfaction with monovision lenses, personality characteristics and visual
      processing styles appear to in fluence the percentage of full-time wear. Of the
      participants, 41% (20 of 49) ultimately rejected monovision for a variety of both
      visual and psychological reasons. Sex differences were evidenced in the
      psychological variables correlated to monovision lens wear. Analysis indicated
      that men scoring as introverts rejected monovision while women with difficulty
      perceiving a visual pattern against visual background noise had difficulty
      adapting to monovision and exhibited shorter wearing times.

PMID- 11219654
TI  - A comparison of predictions and data for a model of two automatic responses in
      stimulus-response compatibility.
AB  - Effects of stimulus-response compatibility and position of hands have previously
      been reported to be additive or interactive. It has been assumed in a recent
      model that, in some particular experimental paradigms, the presentation of the
      stimulus would activate two automatic responses. In the present study three
      theoretical limit cases of this model are investigated. The different sets of
      experimental data are consistent with the predicted values.

PMID- 11219655
TI  - Relations of empathy and social responsibility to guilt feelings among
      undergraduate students.
AB  - Empathy and social responsibility as related to guilt feelings were investigated
      among undergraduate students. Subjects (337 men and 353 women) were assessed for
      guilt feelings, empathy, and social responsibility. The Guilt Inventory was used
      to assess guilt feelings. Analysis indicated that scores on the two empathy
      subscales, Fantasy and Personal Distress, were related to rated Trait Guilt and
      State Guilt, whereas Social Responsibility scores were associated with those on
      Moral Stan dards of the Guilt Inventory.

PMID- 11219656
TI  - Parental attribution of artistic ability in talented children.
AB  - Attributed talent is a powerful construct that can have important consequences
      for the lives of children. Parents and schools often provide special programs to
      support talented children, and attributed talent can influence children's
      behavior. The purpose of this study was to examine how the parents of children in
      a program for gifted and talented students explain the artistic capabilities of
      their children. Analysis indicated parents attributed the artistic capabilities
      of the children primarily to innate talent and intrinsic motivation. However,
      estimates of accumulated hours of involvement in art showed that the children had
      similar patterns of involve ment in art as did individuals with strong records of
      achievement in other domains. Alternative explanations for achievement, including
      deliberate practice theory, are discussed.

PMID- 11219657
TI  - Automatic auditory processing and event-related brain potentials in persons with
      mental retardation.
AB  - Measuring event-related brain potentials, this study examined automatic auditory
      processing in adults with and without mental retardation. Using an auditory
      oddball paradigm under an inattentive condition, we anticipated that an enhanced
      negative potential would be followed by a relatively small positive potential.
      The former was considered as the mismatch negativity and the latter as the P3a.
      Retarded adults (1 woman, 6 men, defined as a range of moderate to profound
      retardation) and 8 nonretarded (2 women, 6 men) adults participated. The mismatch
      negativity showed smaller amplitudes and greater latencies for retarded persons
      than those for nonretarded adults, whereas the P3a for the groups was comparable.
      The results may suggest malfunction of automatic auditory change-detection of the
      brain in mentally retarded persons.

PMID- 11219658
TI  - Study of anticipatory postural adjustments in an air pistol-shooting task.
AB  - A segmental teleokinetic movement performed from an upright standing position is
      usually preceded by a sequence of postural movements having the goal of
      counteracting the imbalance which will be caused by the forthcoming movement.
      This study had two aims, (1) to verify whether the postural component was
      programmed in the same way as that of the teleokinetic component and (2) to
      verify whether the postural component was specific to the direction and speed of
      the movement. 12 participants performed a pistol-shooting task involving a rapid
      arm-raising movement. Three directions, two time deadlines, and three types of
      cue were manipulated. This study showed that the postural component was sensitive
      to the cue effects, the characteristics of anticipatory postural adjustments were
      specific to the direction of the movement, and the characteristics of the
      postural muscle EMG burst were the same whether the participants programmed or
      deprogrammed and reprogrammed their movements for a given direction. The speed
      parameter did not seem to have any significant influence on the characteristics
      of the anticipatory postural adjustments.

PMID- 11219659
TI  - Visual search for single and combined features by children and adults: possible
      developmental inferences.
AB  - Visual search time was measured in four groups of children 4 to 10 years of age
      and in young adults, as a function of display size for both target present and
      target-absent conditions. The slopes of regression lines in a simple search
      (search for ? within /) were compared with those obtained in within-dimension
      conjunction target searches, within either homogeneous (search for the inverted T
      within Ts) or heterogeneous distractors (search for arrow within Ys and inverted
      Ys). Analysis indicated that simple search was always preattentive (slopes near
      0) after 5 years of age and serial (with positive slopes) before this age.
      Searching within heterogeneous distractors apparently involved element-by-element
      scrutiny and focal attention in all groups whereas searching within homogeneous
      distractors required distributed attention, perhaps based on parallel grouping of
      distractors in adults, though distractors were focally attended to by children.

PMID- 11219660
TI  - Sex and skill differences in translation of English color words by Chinese
      students.
AB  - The present study investigated sex and skill differences in color-word
      translation by Chinese-speaking students in university English classes. A
      questionnaire was administered to estimate the correlation between subjects'
      performance and their color-related hobbies. To conceptualize the issue better,
      two more groups of correlated parameter (academic achievements plus demographic
      factors) were introduced in this research as well. 40 English majors (20 women,
      20 men), ranging in education from level one to level four, were randomly drawn
      from a metropolitan university and tested in the experiments as subjects. These
      university students were asked to provide Chinese equivalents for a list of 33
      elaborated English color terms chosen from a thesaurus by mapping on the 11 color
      tone categories defined by basic color theory. The results confirm the findings
      in relevant studies that used native speakers as subjects by observing that (1)
      women possessed a richer color vocabulary both in their source language and in
      their target language, (2) women also provided more elaborated Chinese
      equivalents to the color words used as stimuli, and finally, (3) women showed a
      superiority in accuracy in this color-lexicon matching or translating task. As a
      whole, the effects of skill and age were not significant. A significant
      correlation was found between the learners' proficiency in English and
      performance in translation of color words, but this relationship was rather weak
      and only true for the men. Color-related hobbies did not significantly correlate
      with the color-decoding performance of these language learners. Neither did the
      demographic factors. Taken together, it is sensible to state that differences
      reported here were affected primarily by the sex of the learn er. conditionally
      by language proficiency, and presumably by the cognitive and perceptual sex
      differences as well. These findings further indicate that the process of color
      codability is a complicated but unstudied issue in language learning and that sex
      should be treated as an independent variable in this area of research.

PMID- 11219661
TI  - Self-perception of breath odor: role of body image and psychopathologic traits.
AB  - Oral malodor is a common complaint in Western society and is an important reason
      why adults seek dental counsel. In the present study, an attempt was made to
      evaluate the contribution of psychopathologic traits and of body-image char
      acteristics on participants' self-perception of breath odor. 60 participants
      without any specific complaint concerning breath odor (55% men: M age 35.5 yr.,
      SD= 10) were evaluated. Variables included self-evaluation of participants' own
      breath odor (gener ally and current), an organoleptic evaluation of an impartial
      judge of odor, measurement of the volatile sulfide level in the oral cavity, and
      questionnaires referring to psychopathologic symptoms and body-image
      characteristics. Stepwise regression analysis showed that in addition to
      impartial measurements, self-perception of breath odor among noncomplaining
      subjects can be predicted by their feelings and attitudes toward the body and by
      their hostility.

PMID- 11219662
TI  - The tau and anti-tau effects in successively presented stimuli.
AB  - It was confirmed by the reproduction method with 20 adults that (a) the tau
      effect, i.e., the greater the temporal separation between successively presented
      stimuli with a constant spatial interval, the greater the apparent spatial
      interval, occurred, especially in the situation in which the participants were
      assumed to form a set easily using temporal interval as the cue for spatial
      interval estimation, and (b) the anti-tau effect occurred in the special
      situation in which the participants were assumed to form a set using speed of an
      imaginary movement as the cue for it. These findings supported the hypothesis of
      "cue-selection sets."

PMID- 11219663
TI  - Examination of force-production properties during static explosive grip based on
      force-time curve parameters.
AB  - The present study attempts to clarify the properties of force-time curves in the
      force-development phase during static explosive grip exertion and to determine
      force-time parameters in relation to static explosive strength. 80 healthy young
      males (age 17.8 +/- 2.5 yr.) exerted maximal isometric force as fast and
      forcefully as possible. In total, 21 variables, e.g., time to fixed level,
      integrated area, average force, integrated area to fixed time, force at the
      maximal rate of force development, and maximal rate of force development, were
      selected as force-time parameters. Good reliability was obtained for average
      force in force levels above 90% of maximal strength (.64-.93), integrated area to
      a fixed time of 1.0-2.0 sec. (.86-.93), force at the maximal rate of force
      development (.67), and maximal rate of force development (.73). In addition,
      these values correlated closely with maximal grip strength (r= .65-.93). Further,
      significant differences in maximal grip strength, average force in force levels
      above 90% of maximal strength, integrated area to fixed time, and force at the
      maximal rate of force development were found among three groups categorized by
      average force in force levels of maximal strength. These results suggested that
      individual differences were present in the force-time curve patterns during the
      force-development phase of static explosive grip exertion and that the average
      force in force levels of maximal strength might be a valuable tool for evaluating
      static explosive strength.

PMID- 11219664
TI  - Field dependence and verbalized strategies on the portable rod-and-frame test by
      depressed outpatients and normal controls.
AB  - This study examined the relationships between scores on the cognitive style of
      field dependence-independence and verbalized strategies on the Portable Rod-and
      Frame Test for normal and psychopathological outpatients. We attempted to verify
      (a) Manning's hypothesis (1991) of a correspondence between scores on field
      dependence and external strategies (reference to the visual field) and scores on
      field independence and internal strategies (reference to the body) on perceptual
      tasks, and (b) a tendency of depressed persons to score as field dependent, and
      (c) use of external verbalized strategies. A total of 50 depressed outpatients
      and 50 normal controls were administered the test and requested to report the
      strategy they had employed to solve the problem. Contrary to Manning's findings,
      no significant relationship was found between cognitive style and verbalized
      strategies in the total sample. Depressed outpatients classified as internal
      scored significantly higher on the Group Embedded Figures Test but appeared more
      field dependent on the Rod-and-Frame Test. Moreover, only for the former test did
      depressed outpatients score more field-dependent than controls. Finally, no
      significant relationship was found between the diagnosis of depression and use of
      external strategies; however, field dependence and the use of external strategies
      on the Rod-and-Frame Test were associated with more severe depressive symptoms
      measured by the D scale of the MMPI-2. Further research is needed to assess the
      role of premorbid personality structures of depression in subjective and
      objective aspects of Rod-and-Frame Test performance.

PMID- 11219665
TI  - Changes in eye-head-body movements during maze learning.
AB  - Investigation of the relationship between visual search (eye movement) and
      walking (head and body movement) during way-finding through a maze by each of 6
      subject pedestrians who wore an eye camera showed patterns of sight lin, head
      movement, body movement, and changes of coordination between eye-head-body
      movement during the process of comprehension of the pathways were revealed.

PMID- 11219666
TI  - Factor structure and internal consistency of the Greek version of the Flow State
      Scale.
AB  - The present study tested the internal consistency and the factor struc ture of a
      translated version of the Flow State Scale with Greek sport participants. Sport
      psychology literature is not conclusive regarding sex differences and the type of
      sport in flow. The sample was comprised of 144 women from interactive sports
      (volleyball and handball) who were drawn from the second division of the first
      national category. Athletes completed the scale immediately after a game. Values
      of Cronbach alpha were used to estimate the internal consistency of the scale and
      confirmatory factor analysis to examine the model. The results showed acceptable
      psychometric prop erties of the scale and suggest a need for improvement of the
      problematic items.

PMID- 11219667
TI  - Training in lingual awareness during production of isolated syllables of English.
AB  - The purpose of this preliminary investigation was to determine the effects of
      training on lingual awareness during the production of isolated syllables of
      English. 60 subjects were selected for this investigation. They were placed into
      two groups of 30 individuals each. Group one (Trained) consisted of individuals
      who had received training in articulation and phonetics (M age=22.7) Group two
      (Untrained) consisted of individuals who had not received training in
      articulation and phonetics (M age= 18.8). The subjects in the Trained group were
      majors in speech-language pathology. The procedure involved asking subjects to
      imitate the production of a syllable, then describe where the tongue was located
      during that production. Following this request, subjects were given four multiple
      choice questions to answer regarding (a) tongue height (high to low), (b) tongue
      position (front to back), (c) contact with the teeth, and (d) contact with other
      structures within the oral cavity. Mean scores ranged from 1.87 to 3.2 (on a
      scale of 4.0) for the group of Trained subjects versus 1.5 to 2.4 for the
      Untrained subjects. The Trained subjects had significantly higher test scores on
      all phonemes (p<.05) with the exception of r and sh (p>.05). For both groups of
      subjects, the phonemes, r, sh, and l, were the most difficult to describe, while
      the phoneme t was described most accurately.

PMID- 11219668
TI  - Formation and decomposition of chloroaromatic compounds in chlorine-containing
      benzene/oxygen flames.
AB  - Premixed chlorine-containing, fuel-rich, low-pressure benzene/oxygen flames were
      analysed for the formation of (oxygenated) chloroaromatic compounds and their
      radicals by means of the condensation/radical-scavenging method (Hausmann, M.,
      Homann, K.-H., 1995. Ber. Busenges. Phys. Chem. 99, 853-862). Several chlorinated
      organic compounds (methyl chloride, t-butyl chloride, chlorobenzene, chloroform)
      were used as additives within a maximum concentration of 10% of total fuel.
      Product identification and quantification were performed by GC/MS. The extent of
      formation of chloroaromatic compounds in these flames was largest in the cases of
      chlorobenzene and chloroform as additives. For chlorobenzene, 12 different
      chloroaromatics could be analysed in between C7H7Cl and C12H9Cl. Their formation
      is mainly due to conversion of initial chlorobenzene into substituted or oxidised
      derivatives, or growth products. Additional chlorination of aromatics is shown to
      be of minor importance in chlorobenzene-containing flames. Three isomeric (o/m/p)
      scavenging products could be identified for the chlorophenyl radical. In the
      chloroform case, 15 chloroaromatics could be analysed in between C6H5Cl and
      C14H9Cl. The weak C-Cl bond in chloroform is responsible for the high extent of
      chloroaromatics formation, either by Cl abstraction from the additive or by
      chlorination reactions via Cl radicals. Additionally, specific pathways to
      (di)chloroaromatics and chlorinated fulvene-type structures are outlined via
      CHCl2 and CCl2 radicals.

PMID- 11219669
TI  - Flamelet modeling of NO formation in laminar and turbulent diffusion flames.
AB  - The applicability of the laminar flamelet concept for the formation and
      destruction of nitric oxides in laminar and turbulent diffusion flames has been
      studied. In a first step, temperatures and species concentrations in an
      axisymmetric laminar diffusion flame have been calculated (i) by solving the
      detailed conservation equations and (ii) by applying the laminar flamelet
      concept. The main purpose of this step was the identification of differences
      between results from both approaches. It turned out that for highly temperature
      sensitive or relatively slow chemical processes, the inclusion of the full range
      of the prevailing scalar dissipation rates plays a major role for the calculated
      species concentrations. This behavior is obvious from the concept of the laminar
      flamelet model, where the scalar dissipation rate can be discussed in terms of
      the reciprocal of a residence time for attaining chemical equilibrium. In a
      second step, flamelet modeling of NOx formation was extended to a turbulent
      hydrogen diffusion flame. In both the steps, the flow fields of the flames were
      calculated by solving the Navier-Stokes equations in axisymmetric formulation
      using the SIMPLER algorithm. For the turbulent flow, Favre-averaged equations
      have been used and turbulence was modeled with the standard k-epsilon model
      including a correction term for axisymmetric systems. The averaging of the
      species concentrations was accomplished with presumed shape probability density
      functions (pdfs). The pdf of the mixture fraction was described with a beta
      function whereas that of the scalar dissipation rate was assumed to be log
      normal. Buoyancy effects have been taken into account. The calculated
      temperatures and concentrations were compared with data from different
      experiments.

PMID- 11219670
TI  - A modeling evaluation of the effect of chlorine on the formation of particulate
      matter in combustion.
AB  - The effect of chlorine on the fuel-rich oxidation of hydrocarbons and on the
      molecular weight growth of aromatics is analyzed by simulating experiments
      featuring a model chlorinated additive CH3Cl in a jet-stirred/plug-flow reactor
      and premixed flames. The kinetic model used in this work emphasizes the role of
      resonantly stabilized radicals in the formation and growth of aromatics, and
      considers soot inception as the net effect of molecular weight growth and
      graphitization of aromatic structures. Chlorinated hydrocarbons decompose at
      temperatures significantly lower than hydrocarbons, producing reactive Cl-atoms,
      which have a strong tendency to go to HCl. The HCI, tying up the H-atoms,
      inhibits hydrocarbon oxidation. The model is able to predict not only the levels
      but the shape of the experiments quite well and also the surprising finding of an
      increased soot formation associated with lower PAH levels found in rich flames
      with significant levels of chlorine. Based on reaction kinetic analysis, chlorine
      addition to the fuel enhances soot formation by promoting the formation of
      aromatic-ring compounds and accelerating the abstraction of aromatic H-atoms from
      stable PAH molecules. This process activates the transformation of aromatics to
      soot.

PMID- 11219671
TI  - Health risk of combustion products: toxicological considerations.
AB  - Combustion of organic material produces an almost uncountable number of products
      among which are many chemicals known to have toxic properties. A pertinent
      example is the diesel engine emission. There is concern about the possible health
      effects and we would like to know what risk is associated with the exposure. If
      risk is defined as the probability that a certain health effect occurs within a
      defined time span or as a result of a certain strain (Royal Society Study Group)-
      and it is important to emphasize the quantitative aspect of this definition--we
      must admit that we do not know a good answer. The example of diesel exhaust is
      used to demonstrate the toxicological approach to risk characterization in
      general and the possible improvement of exposure assessment with nitroarenes as
      indicators for environmental contaminations in particular.

PMID- 11219672
TI  - A flexible and stable numerical method for simulating the thermal decomposition
      of wood particles.
AB  - The objective of this paper is to present a flexible and stable simulation method
      to predict the thermal conversion of wood particles. A combination of several
      subprocesses such as heating-up, drying, pyrolysis, gasification and combustion
      of fuel particles of different properties and sizes represents the global process
      of thermal conversion. This approach allows for simultaneous processes e.g.
      reactions in time and covers the entire range between transport-limited
      (shrinking core) and kinetically limited (reacting core) reaction regimes. Thus,
      the model is applicable to simulate sufficiently accurate the thermal
      decomposition of each particle in a packed bed, of which the entire conversion is
      regarded as the sum of all particle processes. Effects such as fragmentation,
      swelling, homogeneous reactions e.g. ignition outside a particle are excluded as
      a tradeoff between complexity and calculation time. However, a description of the
      particle processes by one-dimensional and transient differential conservation
      equations for mass and energy is feasible to represent the above mentioned
      subprocesses. The particles are coupled to the gas phase by heat and mass
      transfer taking into account the Stefan correction due to the gas outflow during
      conversion. A general formulation of the conservation equations allows the
      geometry of a fuel particle to be treated as a plate, cylinder or sphere. In
      order to achieve a high degree of flexibility, the method distinguishes between
      data, such as kinetics or material properties and the conversion process, for
      which relevant data are stored in a data base for easy access and extension. The
      resulting modules of this subdivision are encapsulated into separate software
      units cast in a hierarchy of well-defined classes in Tools of Object-oriented
      Software for Continuum-Mechanics Applications (TOSCA) by object-oriented
      techniques.

PMID- 11219673
TI  - Nitrogen oxides from waste incineration: control by selective non-catalytic
      reduction.
AB  - An experimental study of the selective non-catalytic reduction (SNCR) process was
      carried out to determine the efficiency of NOx removal and NH3 mass balance, the
      NOx reducing reagent used. Experimental tests were conducted on a full-scale SNCR
      system installed in a hospital waste incineration plant. Anhydrous NH3 was
      injected at the boiler entrance for NOx removal. Ammonia was analyzed after each
      flue-gas treatment unit in order to establish its mass balance and NH3 slip in
      the stack gas was monitored as well. The effective fraction of NH3 for the
      thermal NOx reduction was calculated from measured values of injected and
      residual NH3. Results show that a NOx reduction efficiency in the range of 46.7
      76.7% is possible at a NH3/NO molar ratio of 0.9-1.5. The fraction of NH3 used in
      NOx removal was found to decrease with rising NH3/NO molar ratio. The NH3 slip in
      the stack gas was very low, below permitted limits, even at the higher NH3
      dosages used. No direct correlation was found between the NH3/NO molar ratio and
      the NH3 slip in the stack gas since the major part of the residual NH3 was
      converted into ammonium salts in the dry scrubbing reactor and subsequently
      collected in the fabric filter. Moreover, another fraction of NH3 was dissolved
      in the scrubbing liquor.

PMID- 11219674
TI  - Hazardous air pollutants formation from reactions of raw meal organics in cement
      kilns.
AB  - Thermally induced chlorination, condensation, and formation reactions of raw meal
      organic surrogates were investigated on different types of surfaces. The System
      for Thermal Diagnostic Studies provided a powerful tool to study these reactions
      under defined reaction conditions, which were related to typical conditions in
      the preheater zone of cement kiln. Experiments were conducted with benzene and
      benzene/myristic acid (C6H6/C13H27COOH) mixtures in a quartz reactor containing
      different chlorinating catalysts/reagents over a temperature range of 300-500
      degrees C. Reaction products were trapped in-line and analyzed by GC-MS. A
      mixture of chlorides of calcium, potassium, aluminium and iron was highly
      effective for chlorination/condensation reactions of benzene and benzene/myristic
      acid mix at temperatures above 300 degrees C. The same behavior was observed only
      when calcium chloride and potassium chloride were used as chlorinating
      catalyst/reagent. This result showed that transition metal chlorides like FeCl3
      are not necessary for chlorination/condensation of organics under post-combustion
      conditions. Methylene chloride was the major chlorinated product followed by
      chloroform and various other C1, C2 and C6 chlorinated products. Yields of
      chlorinated aliphatics were highest at 400 degrees C for both benzene and
      benzene/myristic acid mix. C6 products were mainly mono- to hexa-chlorinated
      benzenes with trace amounts of chlorinated phenols. The major chlorinated
      products observed in this study (i.e., methylene chloride, chloroform,
      chloroethanes and monochlorobenzene) were also present as major chlorinated
      hydrocarbons in the cement kiln field emission data.

PMID- 11219675
TI  - Identification of surrogate compounds for the emission of PCdd/F (I-TEQ value)
      and evaluation of their on-line real-time detectability in flue gases of waste
      incineration plants by REMPI-TOFMS mass spectrometry.
AB  - Correlations between products of incomplete combustion (PIC), e.g.,
      chloroaromatic compounds, can be used to characterise the emissions from
      combustion processes, like municipal or hazardous waste incineration. A possible
      application of such relationships may be the on-line real-time monitoring of a
      characteristic surrogate, e.g., with Resonance-Enhanced Multiphoton Ionization
      Time-of-Flight Mass Spectrometry (REMPI-TOFMS). In this paper, we report the
      relationships of homologues and individual congeners of chlorinated benzenes
      (PCBz), dibenzo-p-dioxins (PCDD), dibenzofurans (PCDF) and phenols (PCPh) to the
      International Toxicity Equivalent (I-TEQ) of the PCDD/F (I-TEQ value) in the flue
      gas and stack gas of a 22 MW hazardous waste incinerator (HWI). As the REMPI
      detection sensitivity is decreasing with the increase of the degree of
      chlorination, this study focuses on the lower chlorinated species of the
      compounds mentioned above. Lower chlorinated species, e.g., chlorobenzene (MCBz),
      1,4-dichlorobenzene, 2,4,6-trichlorodibenzofuran or 2,4-dichlorophenol, were
      identified as I-TEQ surrogates in the flue gas. In contrast to the higher
      chlorinated phenols, the lower chlorinated phenols (degree of chlorination <4)
      were not reliable as surrogates in the stack gas. The identified surrogates are
      evaluated in terms of their detectability by REMPI-TOFMS laser mass spectrometry.
      The outcome is that MCBz is the best suited surrogate for (indirect) on-line
      measuring of the I-TEQ value in the flue gas by REMPI-TOFMS. The correlation
      coefficient r of the MCBz concentration to the I-TEQ in the flue gas was 0.85.

PMID- 11219676
TI  - Combustion of brominated flame retardants and behavior of its byproducts.
AB  - The substance flow rate of PBDDs/DFs into flue gas and incineration residues from
      incineration of three types of waste samples containing brominated flame
      retardants were examined. The samples used consisted of PBDEs (a typical
      retardant), used TV casing materials (actual waste materials), and waste printed
      circuit boards. PBDDs/DFs concentrations in the experimental samples of PBDEs/PE,
      waste TV casing materials and printed circuit boards ranged between 3000 and
      130,000 ng/g. These values are very high when compared to other investigations.
      The increase of chlorine concentration in input sample reduced the ratio of
      PBDDs/DFs in flue gas and raised the ratio of PCDDs/DFs. With adequate combustion
      control and flue gas treatment, the amount of PBDDs/DFs released from the
      incineration of resin containing brominated flame retardants was lower than the
      input amount. The presence of PBDDs/DFs in incineration residues dominated the
      total amount of dioxins released. When PBDDs/DFs, PCDDs/DFs and PXDDs/DFs were
      considered as a total, the total amount released was lower than the total amount
      input.

PMID- 11219677
TI  - Fate of antimony in municipal solid waste incineration.
AB  - The average antimony concentration in municipal solid waste is estimated to be
      about 10-60 ppm. Thermodynamical models predict a volatile behavior for antimony
      compounds, yet literature mass balances show that about 50% of the antimony input
      remains in the grate ashes. This fact can be explained by the formation of
      thermally stable antimonates in the fuel bed due to interactions with alkali or
      earth-alkali metals. Thermogravimetric experiments revealed an increased thermal
      stability for antimony oxide in presence of oxygen and calcium oxide. Spiking
      experiments on the test incinerator TAMARA showed that chlorination processes
      have a strong effect on antimony volatilization whereas high fuel-bed
      temperatures and addition of antimony oxide only have a moderate effect. In the
      grate ashes, antimony shows a pH-depending leaching property, which is typical
      for anionic species. This fact supports the thesis that antimony is present in
      the grate ashes in an anionic speciation.

PMID- 11219678
TI  - Reduction of combustion by-products in WTE plants: O2 enrichment of underfire air
      in the MARTIN SYNCOM process.
AB  - The SYNCOM process involves oxygen enrichment of underfire air, recirculation of
      flue gas and a combustion control system using infrared thermography of the waste
      layer on the grate. At the demonstration plant in Coburg, operational reliability
      and plant availability using SYNCOM could be proven under real disposal
      conditions with a waste throughput of 7 t/h. Oxygen enrichment of the underfire
      air promotes the destruction of pollutants due to the high oxygen partial
      pressures and temperatures. This is then reflected in very low residual amounts
      of organic combustion by-products in the bottom ash and flue gas from the SYNCOM
      unit. The flue gas concentrations of organic pollutants are reduced, as compared
      with conventional operation, by over 35% (for CO, total hydrocarbons and PCDD/F)
      at the boiler outlet. As the flue gas flow is reduced by oxygen enrichment and
      flue gas recirculation, the resulting reduction in terms of kg of pollutant per
      Mg of waste is even higher. In the bottom ash, the level of organic residues is
      reduced, by 45% in the case of loss on ignition and by 55% in the case of TOC and
      dioxins (I-TE of PCDD/F). This is due to the higher oxygen partial pressures and
      the fuel bed temperature which is increased by 135 to 1200 degrees C. Other
      important features of the process include more intense sintering and thus
      improved immobilization of the bottom ash, as well as reduced flue gas and fly
      ash flows.

PMID- 11219679
TI  - Comparison of dioxin-like-response in vitro and chemical analysis of emissions
      and materials.
AB  - Samples from industrial and domestic emissions and materials were investigated by
      using in vitro assays for dioxin-like-response (DLR) and chemical analysis. The
      results show a small part of persistent bioaccumulative toxicants (PBT) to be
      responsive in vitro. Clean-up procedures directed to persistence decrease the
      amount of inducing toxicants substantially. The comparison of biological in vitro
      (B) and chemical (A) analysis show ratios between B and A below 10 for DLR of
      persistent inductors. The consideration of PAH improved the knowledge about
      unknown less persistent agonists.

PMID- 11219680
TI  - Transient puffs of trace organic emissions from a batch-fed waste propellant
      incinerator.
AB  - Emissions data have been obtained from a waste propellant incinerator. The
      incinerator is a dual fixed hearth, controlled air incinerator equipped with acid
      gas and particulate scrubbing. "Puffing" has been evident in this waste
      propellant incinerator by spikes in the CO concentration. Transient puffs of
      organics may travel down the combustion chambers and lead to stack emissions. The
      major conclusions from this study are that (1) transient puffs are formed due to
      the semi-batch feed nature of the combustion process (causing a local oxygen
      deficiency) and high water content of the desensitized propellant; (2) in batch
      fed combustors, puffs can contribute to most of the organic emissions (which are
      relatively low) measured with US EPA sampling and analytical methods; (3) it is
      estimated that batch-fed combustion contributes up to 7-18 times more emissions
      than steady-state combustion will generate; (4) by applying dispersion analyses
      to determine the amount of oxygen deficiency in the flame zone, the combustion
      zone concentration of CO during batch-fed operation could be as high as 160,000
      ppm, compared to a measured peak stack concentration of 1200 ppm CO; and (5) an
      organic sample is collected and averaged over at least a 2-h period that smooths
      out the transient peaks of organics emissions during batch-fed operation. For
      emissions that are associated with long-term potential health impacts, this is an
      appropriate sampling method. However, if a compound has a short-term potential
      health impact, it may be important to measure the time-resolved emissions of the
      compound.

PMID- 11219681
TI  - Kinetic studies of the reaction of hydroxyl radicals with trichloroethylene and
      tetrachloroethylene.
AB  - Rate coefficients are reported for the gas-phase reaction of the hydroxyl radical
      (OH) with C2HCl3 (k(1)) and C2Cl4 (k2) over an extended temperature range at
      740+/-10 Torr in a He bath gas. These absolute rate measurements were
      accomplished using a laser photolysis/laser-induced fluorescence (LP/LIF)
      technique under slow flow conditions. The simple Arrhenius equation adequately
      describes the low temperature data for k1 (<650 K) and the entire data set for k2
      and is given by (in units of cm3 molecule(-1) s(-1)): k1(291 - 650 K) = (9.73+/
      1.15) x 10(-13) exp (158.7+/-44.0)/T, k2(293 - 720 K ) = (1.53+/-0.14) x 10(-12)
      exp (-688.2+/-67.5)/T. Error limits are 2sigma values. The room temperature
      values for k1 and k2 are within +/-2sigma of previous data using different
      techniques. The Arrhenius activation energies for k1 and k2 are a factor of 2-3
      lower than previously reported values. The experimental measurements for both k1
      and k2 in conjunction with transition state and variation transition state theory
      calculations infer an OH addition mechanism. The lack of a measurable kinetic
      isotope effect for k1 is consistent with this mechanism. Insight into the
      subsequent reactions of the chemically activated intermediate are presented in
      the form of potential energy diagrams derived from ab initio calculations.

PMID- 11219682
TI  - The role of copper(II) chloride in the formation of organic chlorine in fly ash.
AB  - In the de-novo synthesis and formation of PCDD/PCDF, the transfer of inorganic
      chlorine to the carbonaceous material of fly ash plays an important role. Here,
      copper acts as a catalyst in the chlorination reaction. In experiments in the
      range of 250-350 degrees C under helium, we determined the stoichiometry of the
      chlorination reaction with model systems. Therefore, it was necessary to develop
      a method to quantify the copper(II) and copper(I) ions. In a combination of solid
      electron paramagnetic (spin) resonance spectroscopy (EPR) for Cu(I), and X-ray
      fluorescence spectroscopy (XRFA) analysis for Cu (total), we found a way for the
      quantification of copper(I) and (II). With these experiments, we can show that
      the chlorination reaction is relatively fast and comes to a stop under helium,
      after the copper(II) is reduced. The ratio between the organic chlorine formed
      and copper(II) reduced is, at the end of the reaction, 0.5, which is in agreement
      with the following reaction: 2CuCl2 + R-H-->2CuCl + R-Cl + HCl.

PMID- 11219684
TI  - Thermal destruction of benzene.
AB  - The thermal destruction of benzene in methane/air flue gas is studied
      experimentally using an atmospheric laminar flow reactor in laboratory scale. The
      reactor is operated at four different fuel equivalent ratios (phi = 0.06,
      0.1,0.5, 3.7), and temperatures in the range from 850 to 973 K and realises a
      residence time of 5 s. Stable-species concentrations are measured by gas
      chromatography (GC) and high-pressure liquid chromatography (HPLC), where phenol,
      acetylene, formaldehyde, acrolein, methane and acetaldehyde are the major
      hydrocarbon products besides CO and CO2. The augmentation of the temperature from
      850 to 973 K increases the benzene conversion rate from 55% to 99%. The
      experimental results for one fuel equivalent ratio (phi = 0.5) are compared to
      the benzene model proposed by Emdee et al. (J. Phys. Chem. 92 (1992) 2151-2161).
      A fair agreement is observed for the benzene consumption and the CO production
      throughout the temperature range considered here. The small hydrocarbons are not
      very well matched, which requires further research on the sub-models. Our
      experimental results on laboratory scale provide a database for the modelling of
      benzene oxidation in waste incinerators.

PMID- 11219683
TI  - Formate species in the low-temperature oxidation of dimethyl ether.
AB  - The oxidation of dimethyl ether (DME, 340 ppm in 10% O2) has been studied
      experimentally in an atmospheric pressure laminar flow reactor in the temperature
      range from 240 degrees C to 700 degrees C for residence times in the range 2-4 s.
      The influence of nitric oxide additions up to 620 ppm to the feed gases has also
      been investigated. Products of reaction were determined by FTIR. In the absence
      of NO, reaction is first detected at about 260 degrees C. The products in the low
      temperature region include formaldehyde (HCHO), and formic acid (HCOOH). The
      addition of NO leads to the appearance of methyl formate (CH3OCHO). While the
      overall behaviour of the system can be explained qualitatively in terms of
      typical low-temperature hydrocarbon ignition, recently published chemical kinetic
      models for DME ignition do not allow for the formation of these formate species.
      We find no experimental evidence for the formation of hydroperoxymethyl formate
      (HPMF, HOOCH2OCHO) which is predicted by the models to be a significant stable
      intermediate at temperatures below 350 degrees C. Since both formic acid and
      methyl formate have potentially harmful health effects, these observations may
      have significant implications for use of DME as a diesel fuel.

PMID- 11219685
TI  - Main products and kinetics of the thermal degradation of polyamides.
AB  - The thermal degradation of the polyamides (PA) 6, 12, 66 and 612 was investigated
      by means of thermal analysis/mass spectrometry (TA-MS) and pyrolysis in a german
      standard oven. Sample masses were about 20 and 40 mg. The heating rates used in
      the dynamic studies were 1, 5 and 10 K min(-1). Both air and nitrogen atmospheres
      were utilized. The kinetic parameters were calculated from the TA-MS measurements
      and the main decomposition products were registered online. The evolved products
      from the pyrolysis oven were captured and analyzed off-line by GC/MS.

PMID- 11219686
TI  - Numerical studies of the heterogeneous combustion of char using detailed
      chemistry.
AB  - The oxidation of graphite is used as a model system for the combustion of char.
      In order to understand this oxidation process a stagnation-point flow of an
      oxygen stream on a graphite surface is investigated numerically. The chemical
      reactions in the gas phase as well as on the surface are modelled by a series of
      elementary steps. The surface reactions take into consideration the different
      surface complexes formed, the influence of the geometry of the graphite surface
      and the interaction of gas-phase molecules with surface complexes. The rate
      coefficients used are estimated by applying methods of the microkinetic analysis
      of heterogeneous catalytic reactions. The mechanism is used to simulate the
      combustion rate of a graphite surface and the ratio of CO to CO2 formed on the
      surface. The simulation results are compared with experimental data and a good
      agreement is achieved. Furthermore, the fraction of char-bound nitrogen converted
      to N2 and N2O is calculated.

PMID- 11219687
TI  - Removal of dioxins and related aromatic hydrocarbons from flue gas streams by
      adsorption and catalytic destruction.
AB  - The dioxin removing capacity of the shell dedioxin system (SDDS-a Ti/V oxidative
      type catalyst) has been tested using the Umea lab-scale incinerator over the
      temperature range 100-230 degrees C and at space velocities of 8000 and 40,000 h(
      1). Other analogous organic compounds, such as PCBs, PAHs, chlorobenzenes and
      chlorophenols have also been investigated. Results show a high degree of dioxin
      removal already at 100 degrees C (82%), which occurs mainly by adsorption. When
      the temperature is raised a transition towards destruction is seen and at 150
      degrees C, gas hour space velocity (GHSV) 8000 and at 230 degrees C, GHSV 40,000
      virtually all removal is by destruction. High PCDD/F destruction efficiencies are
      reported (> 99.9%, based on I-TEQ); the other dioxin-related species and PAHs are
      also removed and destroyed to a significant extent. The SDDS has proved to be an
      effective means of destroying organic compounds in the gas phase, particularly
      dioxins, at temperatures as low as 150 degrees C.

PMID- 11219688
TI  - Aromatic hydrocarbon growth from indene.
AB  - Aromatic hydrocarbon growth from indene (C9H8), which contains the five-membered
      ring cyclopentadienyl moiety, was investigated experimentally in a 4 s flow
      reactor over a temperature range 650-850 degrees C. Major products observed were
      three C18H12 isomers (chrysene, benz[a]anthracene and benzo[c]phenanthrene), two
      C17H12 isomers (benzo[a]fluorene and benzo[b]fluorene), and two C10H8 isomers
      (naphthalene and benzofulvene). Reaction pathways to these products are proposed.
      Indenyl radical addition to indene produces a resonance-stabilized radical
      intermediate which further reacts by one of two routes. Rearrangement by
      intramolecular addition produces a bridged structure that leads to the formation
      of C17H12 and C10H8 products. Alternatively, beta scission produces biindenyl,
      which leads to the formation of C18H12 products by a ring condensation mechanism
      analogous to that proposed for cyclopentadiene-to-naphthalene conversion.
      Temperature dependencies of both the partitioning between these two routes and
      the product isomer distributions are consistent with thermochemical modeling
      using semi-empirical molecular orbital methods. The results further illustrate
      the role of resonance-stabilized radical rearrangement in aromatic growth and
      condensation of systems with cyclopentadienyl moieties.

PMID- 11219689
TI  - A detailed numerical study of the evolution of soot particle size distributions
      in laminar premixed flames.
AB  - In this work, two numerical techniques, viz. the method of moments and a discrete
      h-p-Galerkin method, have been applied for numerical simulation of soot formation
      in a laminar premixed acetylene/oxygen/argon flame. From the evolution of the PAH
      and the soot particle size distributions, new insight into the different
      processes of soot formation is provided. For this, the single submodels have been
      examined with respect to their influence on the PAH and the soot particle size
      distributions. The particle inception step was studied in detail by comparing the
      simulated PAH size distributions with experimental results. Additionally, an
      estimation of the interaction energy of layered PAH dimers was performed by
      quantum chemical calculations. From these results, some evidence for the particle
      inception model employing coalescence of PAH molecules has been found. The
      numerical results for the gas phase chemical species, the particle number
      densities and volume fractions of soot as well as for the soot particle size
      distributions are compared with experimental data. Thereby, the consistency of
      the entire model is demonstrated.

PMID- 11219690
TI  - Investigation of soot by two-colour four-wave mixing.
AB  - A novel technique has been used for the temporally resolved investigation of the
      interaction of laser radiation and soot in a flame. Based on established soot
      vaporisation models we developed a framework to calculate the two-colour four
      wave mixing signal obtained in an acetylene/air diffusion flame at atmospheric
      pressure. The signal comprises a contribution due to soot and, depending on the
      wavelength of the probe laser, a contribution because of C2, which is generated
      by vaporising soot. For both parts of the signal we found a good agreement
      between measured and calculated power dependency. Furthermore, we measured
      spatial profiles of the signal in a Wolfhard-Parker slot burner. By analysing the
      different signal contributions we found that depending on the location within the
      flame there are particles with different C2 yield.

PMID- 11219692
TI  - Characterization of biomass pyrolysis vapors with molecular beam, single photon
      ionization time-of-flight mass spectrometry.
AB  - A single photon ionization, molecular beam sampling, reflectron time-of-flight
      mass spectrometer (SPI/MBTOFMS) has been developed and used to study pyrolysis
      products from a selection of biomass materials. Spectra are characterized by high
      resolution and decreased fragmentation compared to electron-impact ionization
      mass spectra from related molecular beam mass spectrometer systems equipped with
      quadrupole mass analyzers.

PMID- 11219691
TI  - Excimer laser fragmentation-fluorescence spectroscopy as a method for monitoring
      ammonium nitrate and ammonium sulfate particles.
AB  - Excimer laser fragmentation-fluorescence spectroscopy (ELFFS) is shown to be an
      effective detection strategy for ammonium nitrate and ammonium sulfate particles
      at atmospheric pressure and room temperature. Following photofragmentation of the
      ammonium salt particle, fluorescence of the NH fragment is observed at 336 nm.
      The fluorescence signal is shown to depend linearly on particle surface area for
      laser intensities varying from 1.2 x 10(8) to 6 x 10(8) W/cm2. The 100 shot (1 s)
      detection limits for ammonium nitrate range from 20 ppb for 0.2 microm particles
      to 125 ppb for 0.8 microm particles, where these concentrations are expressed as
      moles of ammonium ion per mole of air. For ammonium sulfate, the 100 shot (1 s)
      detection limits vary from 60 ppb for 0.2 microm particles to 500 ppb for 1
      microm particles. These detection limits are low enough to measure ammonium salt
      particles that form in the exhaust of combustion processes utilizing ammonia
      injection as a nitric oxide control strategy.

PMID- 11219693
TI  - UV-visible spectroscopy of organic carbon particulate sampled from ethylene/air
      flames.
AB  - A systematic comparison of spectra obtained with extra and in situ diagnostics in
      the soot preinception region of rich, premixed ethylene air flames suggests that
      combustion generated organic carbon (OC) particulate can be extracted from flames
      and isolated from other flame material for further chemical analysis. Both the
      trend with height above the burner and the form of UV fluorescence and absorption
      spectra from extra situ sampled material captured in water agree with those
      measured in situ. These results show that the OC particulate formed in flames is
      partially water soluble. However, the collection efficiency can be increased
      using less polar solvents, like acetonitrile and dichloromethane. The
      fluorescence spectra from the water samples are comprised both a naphthalene-like
      component and a broad band UV fluorescence component similar to that observed in
      situ which is attributed to flame generated OC particulate. The broad band UV
      fluorescence centered around 320 nm is also observed very early in flames and
      does not change considerably with increasing flame residence time. These results
      support previous hypotheses that the UV broad band fluorescence is from
      carbonaceous material comprised two-ring aromatics, formed earlier than soot in
      the flame, and is still present along with soot at higher heights or flame
      residence times.

PMID- 11219694
TI  - Semi-volatile and particulate emissions from the combustion of alternative diesel
      fuels.
AB  - Motor vehicle emissions are a major anthropogenic source of air pollution and
      contribute to the deterioration of urban air quality. In this paper, we report
      results of a laboratory investigation of particle formation from four different
      alternative diesel fuels, namely, compressed natural gas (CNG), dimethyl ether
      (DME), biodiesel, and diesel, under fuel-rich conditions in the temperature range
      of 800-1200 degrees C at pressures of approximately 24 atm. A single pulse shock
      tube was used to simulate compression ignition (CI) combustion conditions.
      Gaseous fuels (CNG and DME) were exposed premixed in air while liquid fuels
      (diesel and biodiesel) were injected using a high-pressure liquid injector. The
      results of surface analysis using a scanning electron microscope showed that the
      particles formed from combustion of all four of the above-mentioned fuels had a
      mean diameter less than 0.1 microm. From results of gravimetric analysis and fuel
      injection size it was found that under the test conditions described above the
      relative particulate yields from CNG, DME, biodiesel, and diesel were 0.30%.
      0.026%, 0.52%, and 0.51%, respectively. Chemical analysis of particles showed
      that DME combustion particles had the highest soluble organic fraction (SOF) at
      71%, followed by biodiesel (66%), CNG (38%) and diesel (20%). This illustrates
      that in case of both gaseous and liquid fuels, oxygenated fuels have a higher SOF
      than non-oxygenated fuels.

PMID- 11219695
TI  - On-line real-time measurements at incineration plants: PAHs and a PCDD/F
      surrogate compound at stationary combustion conditions and during transient
      emission puffs.
AB  - Laser mass spectrometry has been applied for on-line monitoring of traces of
      aromatic compounds from flue gas of incineration plants. The experiments have
      been carried out at two sampling sites in an industrial hazardous-waste
      incinerator. With laser mass spectrometry resonance-enhanced multiphoton
      ionization (REMPI) with time-of-flight mass spectrometry (TOFMS) (REMPI-TOFMS),
      using the group selective multi-component monitoring approach, aromatic compounds
      are selectively ionized from the complex flue-gas matrix. In this case, the
      result of an REMPI-TOFMS on-line measurement is a distinct pattern of aromatic
      compounds. These patterns are dependent on: (i) the point of measurement, (ii)
      the incineration plant, (iii) the temperature, and (iv) the fuel. This
      contribution focuses on the fuel dependence of the pattern. The most transient
      behavior can be observed when containers filled with hazardous waste are burnt,
      leading to puffs. Real-time monitoring results of puffs are given. Furthermore,
      as an approach towards on-line monitoring of the TEQ (PCDD/F toxicity
      equivalent), REMPI-TOFMS on-line analysis results of chlorobenzene are presented.

PMID- 11219696
TI  - Reactions of 2,4,6-trichlorophenol on model fly ash: oxidation to CO and CO2,
      condensation to PCDD/F and conversion into related compounds.
AB  - Thermal treatment of 2,4,6-trichlorophenol on a magnesium silicate-based model
      fly ash in the temperature range between 250 degrees C and 400 degrees C leads
      predominantly to carbon monoxide and carbon dioxide. The fraction of 2,4,6
      trichlorophenol which is oxidized to CO and CO2 increases from 3% at 250 degrees
      C to 75% at 400 degrees C. Further products are polychlorinated benzenes, dibenzo
      p-dioxins, dibenzofurans and phenols. The homologue and isomer patterns of the
      chlorobenzenes suggest chlorination in the ipso-position of the trichlorophenol.
      The formation of PCDD from 2,4,6-trichlorophenol and 2,3,4,6-tetrachlorophenol on
      municipal solid waste incinerator fly ashes and model fly ash were compared and
      the reaction order calculated.

PMID- 11219697
TI  - An experimental and numerical study of the thermal oxidation of chlorobenzene.
AB  - A combustion-driven flow reactor was used to examine the formation of chlorinated
      and non-chlorinated species from the thermal oxidation of chlorobenzene under
      post-flame conditions. Temperature varied from 725 to 1000 K, while the
      equivalence ratio was held constant at 0.5. Significant quantities of chlorinated
      intermediates, vinyl chloride and chlorophenol, were measured. A dominant C-Cl
      scission destruction pathway seen in pyrolytic studies was not observed. Instead,
      hydrogen-abstraction reactions prevailed, leading to high concentrations of
      chlorinated byproducts. The thermal oxidation of benzene was also investigated
      for comparison. Chemical kinetic modeling of benzene and chlorobenzene was used
      to explore reaction pathways. Two chlorobenzene models were developed to test the
      hypothesis that chlorobenzene oxidation follows a CO-expulsion breakdown pathway
      similar to that of benzene. For the temperatures and equivalence ratio studied,
      hydrogen abstraction by hydroxyl radicals dominates the initial destruction of
      both benzene and chlorobenzene. Chlorinated byproducts (i.e., chlorophenol and
      vinyl chloride) were formed from chlorobenzene oxidation in similar quantities
      and at similar temperatures to their respective analogue formed during benzene
      oxidation (i.e., phenol and ethylene).

PMID- 11219698
TI  - Temperature dependence of DCDD/F isomer distributions from chlorophenol
      precursors.
AB  - The temperature dependence of the gas-phase, rate-limited formation of
      dichlorodibenzo-p-dioxin (DCDD) and dichlorodibenzofuran (DCDF) isomers from 2,6
      dichlorophenol and 3-chlorophenol, respectively, has been studied experimentally
      in an isothermal flow reactor over the range 300-900 degrees C under pyrolytic,
      oxidative and catalytic conditions and computationally using semi-empirical
      molecular orbital methods. At high temperatures, distributions of sets of DCDD/F
      condensation products are consistent with the calculated thermodynamic
      distributions, indicating that the relative rates of formation are governed by
      differences in symmetry and steric hindrance present in the isomer product
      structures. At low temperatures, however, this is not the case. In the case of
      1,6- and 1,9-DCDD formed from 2, 6-dichlorophenol via Smiles rearrangement, the
      1,6 isomer is favored at low temperatures more than thermodynamically predicted.
      This result appears to be consistent with kinetic effects of either the expansion
      of the five-membered ring Smiles intermediate or a lower activation energy six
      membered ring intermediate pathway that produces only the 1,6 isomer. For
      formation of 1,7-, 3,7- and 1,9-DCDF from 3-chlorophenol, the 1,7 isomer fraction
      increases at low temperatures whereas thermodynamics predicts a decrease. This
      result can be attributed to steric effects in alternative "sandwich-type"
      approach geometries of phenoxy radicals to form the o,o'-dihydroxybiphenyl (DOHB)
      intermediate via its keto-tautomers. Higher level molecular theory (ab initio) is
      needed to provide a more quantitative description of these kinetics.

PMID- 11219699
TI  - Dioxins from thermal and metallurgical processes: recent studies for the iron and
      steel industry.
AB  - In thermal metallurgical processes such as iron ore sintering and metal smelting
      operations, large flows of off-gases are generated. Mainly due to residue
      recycling in such processes, chlorine and volatile organics are always present in
      the feed. As a consequence of "de novo" formation, the off-gases from such
      processes typically contain dioxins in the range 0.3-30 ng I-TEQ/Nm3. So far
      there are only very few studies about the mechanisms of dioxin formation and
      destruction in these metallurgical processes. In an European Union (EU) research
      project "Minimization of dioxins in thermal industrial processes: mechanisms,
      monitoring and abatement (MINIDIP)", integrated iron and steel plant has been
      selected as one of the industrial sectors for further investigation. A large
      number of particulate samples (feed, belt siftings, electrofilter) were collected
      from the iron ore sintering installations from various steel plants and analyzed
      for their organochlorocompound contents. Measurable amounts of PCDD/F, PCBz, PCB
      were found for all samples. The various parameters influencing their de novo
      synthesis activity were also evaluated in laboratory experiments, and such
      activity was found to be moderate for samples from the ore sinter belt, but
      extremely high for some ESP dusts. Fine dust is active in a wide range of
      temperatures starting at 200 degrees C and declining above 450 degrees C; the
      optimal temperature for de novo synthesis was found to be around 350 degrees C;
      some inhibitors, such as triethanolamine, may reduce de novo activity by 50%, and
      lowering the O2 concentration in the gas stream leads to a much lower amount of
      PCDD/F formation. On the basis of their relative mass, typical operating
      conditions and specific activity of the different samples, the regions in the
      sintering plant where de novo synthesis may take place were tentatively
      established.

PMID- 11219700
TI  - PCDD/F inhibition by prior addition of urea to the solid fuel in laboratory
      experiments and results statistical evaluation.
AB  - The objectives of this work were to study the effect of urea addition to the fuel
      before the combustion on the suppression of PCDD/F emissions, to examine the
      influence of urea to PCDD/F isomer patterns by employing statistical analysis
      techniques and to determine the most effective method of urea addition. Urea in
      the form of powder and as an aqueous solution was mixed with RDF and the fuel
      mixtures were incinerated in a lab-scale reactor at 1000 degrees C. PCDD/F
      emitted during combustion experiments were collected in a quartz wool filter
      downstream the reactor unit. Analysis and quantification of PCDD/F showed that
      urea significantly affected PCDD/F emissions. Combustion of RDF containing 10%
      w/w urea resulted in PCDD/F emissions lower than 8 I-TEQ ng/g RDF, while the
      corresponding average value from single RDF combustion was 17 I-TEQ ng/g RDF. The
      PCDD/F prevention capacity of urea was independent from the method of urea
      addition to the fuel, as similar results were obtained after the addition of urea
      in the solid and in the aqueous phases. Results assessment by statistical methods
      showed that isomer patterns remained almost stable and were not affected by the
      method of urea addition.

PMID- 11219701
TI  - Hazardous air pollutant emissions from gas-fired combustion sources: emissions
      and the effects of design and fuel type.
AB  - Air emissions from gas-fired combustion devices such as boilers, process heaters,
      gas turbines and stationary reciprocating engines contain hazardous air
      pollutants (HAPs) subjected to consideration under the federal clean air act
      (CAA). This work presents a recently completed major research project to develop
      an understanding of HAP emissions from gas-fired boilers and process heaters and
      new HAP emission factors based on field emission tests of gas-fired external
      combustion devices used in the petroleum industry. The effect of combustion
      system design and operating parameters on HAP emissions determined by both field
      and research tests are discussed. Data from field tests of gas-fired petroleum
      industry boilers and heaters generally show very low emission levels of organic
      HAPs. A comparison of the emission data for boilers and process heaters,
      including units with and without various forms of NOx emission controls, showed
      no significant difference in organic HAP emission characteristics due to process
      or burner design. This conclusion is also supported by the results of research
      tests with different burner designs. Based on field tests of units fired with
      natural gas and various petroleum industry process gases and research tests in
      which gas composition was intentionally varied, organic HAP emissions were not
      determined to be significantly affected by the gas composition. Research data
      indicate that elevated organic HAP emission levels are found only under extreme
      operating conditions (starved air or high excess air combustion) associated with
      poor combustion.

PMID- 11219702
TI  - Research and development to improve naval shipboard waste management using a
      compact closed-loop-controlled waste incinerator.
AB  - Research has been conducted into the application of forced acoustics for
      enhancing the performance of a pyrolyzed waste afterburner configured as a dump
      combustor. Subscale studies showed that acoustic forcing of an air jet entering a
      dump chamber could trigger the formation of coherent vortices generated by
      entrainment of ambient gases. Subsequent studies showed that combustible gases
      could be introduced into the coherent vortices, and with additional modulation
      this configuration would lead to an enhanced combustion rate with low emissions
      of pollutants. The acoustically forced burner concept was scaled up to practical
      levels and tested as an afterburner on a commercial waste incinerator operating
      in pyrolysis mode. Results show that the afterburner can promote both
      compactness, due to the rapid combustion rate, and low pollutant emissions
      resulting from enhanced mixing prior to combustion.

PMID- 11219703
TI  - PAH and soot emissions from burning components of medical waste:
      examination/surgical gloves and cotton pads.
AB  - This is a laboratory investigation on the emissions from batch combustion of
      representative infectious ("red bag") medical waste components, such as medical
      examination latex gloves and sterile cotton pads. Plastics and cloth account for
      the majority of the red bag wastes by mass and, certainly, by volume. An
      electrically heated, horizontal muffle furnace was used for batch combustion of
      small quantities of shredded fuels (0.5-1.5 g) at a gas temperature of
      approximately 1000 degrees C. The residence time of the post-combustion gases in
      the furnace was approximately 1 s. At the exit of the furnace, the following
      emissions were measured: CO, CO2, NOx, particulates and polynuclear aromatic
      compounds (PACs). The first three gaseous emissions were measured with continuous
      gas analyzers. Soot and PAC emissions were simultaneously measured by passing the
      furnace effluent through a filter (to collect condensed-phase PACs) and a bed of
      XAD-4 adsorbent (to capture gaseous-phase PACs). Analysis involved soxhlet
      extraction, followed by gas chromatography-mass spectrometry (GC-MS). Results
      were contrasted with previously measured emissions from batch combustion of
      pulverized coal and tire-derived fuel (TDF) under similar conditions. Results
      showed that the particulate soot) and cumulative PAC emissions from batch
      combustion of latex gloves were more than an order of magnitude higher than those
      from cotton pads. The following values are indicative of the relative trends (but
      not necessarily absolute values) in emission yields: 26% of the mass of the latex
      was converted to soot, 11% of which was condensed PAC. Only 2% of the mass of
      cotton pads was converted to soot, and only 3% of the weight of that soot was
      condensed PAC. The PAC yields from latex were comparable to those from TDF. The
      PAC yields from cotton were higher than those from coal. A notable exception to
      this trend was that the three-ring gas-phase PAC yields from cotton were more
      significant than those from latex. Emission yields of CO and CO2 from batch
      combustion of cotton were, respectively, comparable and higher than those from
      latex, despite the fact that the carbon content of cotton was half that of latex.
      This is indicative of the more effective combustion of cotton. Nearly all of the
      mass of carbon of cotton gasified to CO and CO2 while only small fractions of the
      carbon in latex were converted to CO2 and CO (20% and 10%, respectively). Yields
      of NOx from batch combustions of latex and cotton accounted for 15% and 12%,
      respectively, of the mass of fuel nitrogen indicating that more fuel nitrogen was
      converted to NOx in the former case, possibly due to higher flame temperatures.
      No SO2 emissions were detected, indicating that during the fuel-rich combustion
      of latex, its sulfur content was converted to other compounds (such as H2S) or
      remained in the soot.

PMID- 11219704
TI  - Laboratory study on the high-temperature capture of HCl gas by dry-injection of
      calcium-based sorbents.
AB  - This is a laboratory study on the reduction of combustion-generated hydrochloric
      acid (HCl) emissions by in-furnace dry-injection of calcium-based sorbents. HCl
      is a hazardous gaseous pollutant emitted in significant quantities by municipal
      and hazardous waste incinerators, coal-fired power plants, and other industrial
      furnaces. Experiments were conducted in a laboratory furnace at gas temperatures
      of 600-1000 degrees C. HCl gas diluted with N2, and sorbent powders fluidized in
      a stream of air were introduced into the furnace concurrently. Chlorination of
      the sorbents occurred in the hot zone of the furnace at gas residence times
      approximately 1 s. The sorbents chosen for these experiments were calcium formate
      (CF), calcium magnesium acetate (CMA), calcium propionate (CP), calcium oxide
      (CX), and calcium carbonate (CC). Upon release of organic volatiles, sorbents
      calcine to CaO at approximately 700 degrees C, and react with the HCl according
      to the reaction CaO + 2HCl <=> CaCl2 + H2O. At the lowest temperature case
      examined herein, 600 degrees C, direct reaction of HCl with CaCO3 may also be
      expected. The effectiveness of the sorbents to capture HCl was interpreted using
      the "pore tree" mathematical model for heterogeneous diffusion reactions. Results
      show that the thin-walled, highly porous cenospheres formed from the pyrolysis
      and calcination of CF, CMA, and CP exhibited high relative calcium utilization at
      the upper temperatures of this study. Relative utilizations under these
      conditions reached 80%. The less costly low-porosity sorbents, calcium carbonate
      and calcium oxide also performed well. Calcium carbonate reached a relative
      utilization of 54% in the mid-temperature range, while the calcium oxide reached
      an 80% relative utilization at the lowest temperature examined. The data matched
      theoretical predictions of sorbent utilization using the mathematical model, with
      activation energy and pre-exponential factors for the calcination reaction of
      17,000 K and 300,000 (g gas/cm2/s/atm gas), respectively. Thus, the kinetics of
      the calcination reaction were found to be much faster (approximately 500 times)
      than those of the sulfation reaction examined previously in this laboratory.

PMID- 11219705
TI  - Mechanistic studies on the role of PAHs and related compounds in PCDD/F formation
      on model fly ashes.
AB  - Model fly ashes containing Florisil, CuCl2.2H2O and PAHs with structures similar
      to dibenzo-p-dioxin or dibenzofuran were heated at 250 degrees C in He/O2 with
      regard to a supposed intramolecular reaction mechanism for oxygen incorporation.
      Highest reactivities in PCDF formation could be found for model compounds
      containing a biphenyl structure, while condensed pi-systems lead to a decrease in
      reactivity for such compounds. Biphenyl is almost completely converted to
      dibenzofuran. PCDD formation from six-membered rings like xanthene/9,10
      dihydroanthracene is of minor importance. 18O-labeling of gaseous oxygen reveals
      no common reaction step for oxygen incorporation using 9-fluorenone, xanthene,
      diphenyl ether and diphenyl-2-carboxylic acid as model compounds. Pre-existing
      oxygen in reactants is a major source for ether groups in PCDD and PCDF.
      Determination of labeled and unlabeled CO and CO2 besides He/O2 reflects higher
      reactivities towards oxidation for model compounds containing ether groups than
      for compounds with carbonyl groups.

PMID- 11219707
TI  - Pressure effect on soot formation in turbulent diffusion flames.
AB  - Soot formation in a methane air turbulent jet diffusion flame is investigated
      numerically using a semi-empirical model. The temperature, density and species
      (the soot precursor C2H2) fields are calculated using detailed chemical kinetic
      mechanism based on the flamelet library approach. The influence of pressure on
      the soot formation and the behavior of the semi-empirical model in different
      flame situations are investigated. It is found that the flame shape and the flame
      temperature can be well predicted by the flamelet library approach. The
      calculated soot yield is mostly sensitive to the soot surface growth rate and the
      increase of pressure. The increase of pressure leads to the increase of soot
      surface growth rate and therefore to the increase of soot volume fraction. By
      adjusting a model constant in the soot surface growth rate, the soot emissions in
      both pressure p = 1 atm and p = 3 atm are properly simulated by the current semi
      empirical soot model.

PMID- 11219706
TI  - Adsorption of PCDD/F on MWI fly ash.
AB  - The removal of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) from
      waste incinerator off-gas is a costly task, because a considerable part of the
      PCDD/F may exist in the gas phase (often 50-100% around 200 degrees C). The
      volatile fraction passes the particle filter and the subsequent gas cleaning
      equipment, so that an additional unit is needed to remove the gaseous PCDD/F from
      the flue gas. Moreover, dioxins and furans can accumulate in some parts of the
      equipment in a way that they can act as a latent source. In this work, we
      investigate the possibility to adsorb the PCDD/F at the fly ash particles and to
      remove them during the filtration. The gas/particle partitioning of the PCDD/F
      depends on the temperature, the vapor pressure, the particle size, the particle
      number density and on the physical and chemical properties of the particle
      surface. These relationships are investigated by model calculations and by pilot
      scale experiments (500 Nm3/h) which employ one selected hexachlorinated dioxin
      congener. At room temperature, approx. 90% of the HxCDD are found in the
      particulate phase, while at 135 degrees C that portion is only 10%. This means
      that at ambient temperatures, the gas/particle partitioning of the dioxin
      corresponds well to the sublimation equilibrium. At higher temperatures, it is
      much different from the sublimation equilibrium and the apparent adsorption
      enthalpy is smaller than the enthalpy of sublimation. This observation is in
      agreement with literature data. From the above experiments and from similar
      literature data, the efficiency of fly ash particles as a sink for PCDD/F can be
      evaluated. The data suggest that the adsorption rate is not the limiting factor
      for the transfer into the particulate phase. The important factors appear to be
      the chemical composition of the fly ash and the temperature.

PMID- 11219708
TI  - Evidence for the contribution of methane in the formation of aromatics and soot
      in fuel-rich pre-mixed combustion.
AB  - Experimental results from an isothermal laminar flow reactor at atmospheric
      pressure are presented on the chemical composition in the post-oxidative region
      of two sooting fuel-rich pre-mixed mixtures diluted in nitrogen. A base case
      composed of n-heptane and O2 in N2 at 1425 K with a C/O of 2.85 was perturbed by
      substituting 10% of the carbon in n-heptane with carbon as CH4. While these
      changes would intuitively reduce aromatics and soot formation by increasing H2
      and decreasing C2H2 concentrations, we observe the opposite. The concentrations
      of individual aromatic species are observed to actually increase by up to 50% and
      the soot yield increases by 80%.

PMID- 11219709
TI  - Analysis of exhausts emitted by i.c. engines and stationary burners, by means of
      u.v. extinction and fluorescence spectroscopy.
AB  - Optical investigations of the exhausts emitted by internal combustion (i.c.)
      engines and a stationary burner were performed, in order to assess their relative
      role as sources of organic matter to the atmosphere. Extinction spectra of air
      diluted exhausts in the 200-400 nm u.v. band reveal the expected existence of
      gaseous trace-species (NO, NO2 and SO2) and carbonaceous particulate matter
      (soot). In addition, after subtracting the absorption contribution from known
      species, a strong residual absorption band remains below 250 nm, which is
      attributed to organic aromatic matter, involving no more than two aromatic rings.
      A set of ex situ extinction and laser induced fluorescence (LIF) experiments were
      carried out on condensed combustion-water samples. Extinction measurements from
      the water samples show absorption spectra similar to those observed from air
      diluted samples, which are attributed to low volatility organic compounds, as
      they are trapped in the condensed phase. Combining the indications of extinction
      data for both air-diluted and condensed samples, it is suggested that the
      absorbing species might be molecular clusters of one/two aromatic rings. LIF
      spectra from condensed samples evidence two fluorescence bands, centered above
      300 and 400 nm, respectively, whose intensities correlate with the combustion
      regimes. Analogous optical analysis on rain samples, collected in an urban area,
      showed that rain absorption and fluorescence spectra are similar to those found
      in condensed exhaust samples, which is consistent with the prevailing
      contribution of i.c. engines to the urban air pollution. The combined
      experimental data suggest that the absorbing and fluorescent species trapped in
      the condensed samples are organic (aromatic) compounds, involving mostly one two
      aromatic rings structural units, since they do not absorb above 250 nm. The
      overall molecular weight of the trapped material is likely heavy as they show low
      volatility.

PMID- 11219710
TI  - Fluorescence spectroscopy of aromatic species produced in rich premixed ethylene
      flames.
AB  - The fluorescence spectra of the condensed species (CS) collected in the soot
      inception region of a rich premixed laminar ethylene/oxygen flame have been
      measured by excitation in the UV at 266 and 355 nm excitation wavelength. The
      contribution of the most abundant polycyclic aromatic hydrocarbons (PAH) to the
      CS fluorescence has been evaluated in order to attribute the CS fluorescence at
      different emission wavelengths to specific aromatic structures. The fluorescence
      peaks detected in the UV region of the CS fluorescence spectrum was found to be
      mainly due to a typical PAH like fluorene, that is, the most fluorescent one
      among the PAH analyzed in the CS by chromatographic analysis. The CS exhibited
      the larger emission in the visible where the PAH contribution has been shown to
      be negligible and other fluorescing aromatic species, not identified by
      chromatographic analysis of the CS, have to be considered responsible for the
      visible fluorescence. Laser induced fluorescence (LIF) flame measurements excited
      at 266 nm and detected at two selected wavelengths (310 and 410 nm) have been
      performed along the flame axis and compared with the CS fluorescence intensity.
      The LIF and CS fluorescence signals show quite similar axial trends demonstrating
      that the LIF signals are related to CS fluorescence. In particular, the LIF
      fluorescence signals detected in the UV could be attributed to the PAH
      fluorescence whereas the unidentified species contained in the CS can be followed
      by LIF detection in the visible region.

PMID- 11219712
TI  - Characterization of emissions during the heating of tyre contaminated scrap.
AB  - In order to characterize the compounds (type and quantities) emitted during
      melting of organic contaminated scrap and to investigate the mechanism of their
      formation, an experimental set-up has been designed and built to study precisely
      the influence of temperature and gas atmosphere in the conditions of an electric
      arc furnace. These experiments lead to the determination of mass balances (C, H,
      O, S) and to the quantification of unburnt compounds (tars, carbon monoxide,
      volatile organic compounds (VOCs), benzene, toluene, ethylbenzene and xylenes
      (BTEX), polyaromatic compounds (PAHs)). Degradation conditions (gas atmosphere
      and temperature) corresponding to different areas in the electric furnace have
      also been investigated. Such experiments lead to a better understanding of
      degradation mechanisms; this interpretation is not possible from investigations
      performed in an industrial furnace since there are many uncontrolled parameters
      (large dispersion of the results).

PMID- 11219711
TI  - Identification of oxygenated compounds in combustion systems.
AB  - An attempt for the spectroscopic identification of oxygenated compounds produced
      in combustion processes under different environmental conditions is reported in
      this paper. A deeper knowledge about presence and evolution of such species in
      dependence of the operating conditions of practical burner represents a
      fundamental hint to the objective of an advancement of the control of combustion
      process and reduction of pollutant emissions. This paper mainly focuses on
      species characterized by the presence of carbonyl functionality since aldehydes,
      ketones and diketones are among the principal intermediate species and products
      of hydrocarbon oxidation. They are by themselves to be considered atmospheric
      pollutants and are also indicators of actual pathways followed during the
      chemical reactions occurring in the combustion process. For these reasons they
      are most suitable for the exploitation of the above indicated objectives. In this
      paper, a classification of spectroscopic features and markers of these classes of
      carbonyl compounds is presented on the basis of both literature and spectra
      collected from sample species. This interpretative scheme is then used for the
      attribution of fluorescence signals collected from a tetradecane spray in
      different environmental conditions.

PMID- 11219713
TI  - Evaluation of combustion by-products of MTBE as a component of reformulated
      gasoline.
AB  - Methyl tertiary-butyl ether (MTBE) is a gasoline oxygenate that is widely used
      throughout the US and Europe as an octane-booster and as a means of reducing
      automotive carbon monoxide (CO) emissions. The combustion by-products of pure
      MTBE have been evaluated in previous laboratory studies, but little attention has
      been paid to the combustion by-products of MTBE as a component of gasoline. MTBE
      is often used in reformulated gasoline (RFG), which has chemical and physical
      characteristics distinct from conventional gasoline. The formation of MTBE by
      products in RFG is not well-understood, especially under "worst-case" vehicle
      emission scenarios such as fuel-rich operations, cold-starts or malfunctioning
      emission control systems, conditions which have not been studied extensively.
      Engine-out automotive dynamometer studies have compared RFG with MTBE to non
      oxygenated RFG. Their findings suggest that adding MTBE to reformulated gasoline
      does not impact the high temperature flame chemistry in cylinder combustion
      processes. Comparison of tailpipe and exhaust emission studies indicate that
      reactions in the catalytic converter are quite effective in destroying most
      hydrocarbon MTBE by-product species. Since important reaction by-products are
      formed in the post-flame region, understanding changes in this region will
      contribute to the understanding of fuel-related changes in emissions.

PMID- 11219714
TI  - Ionically crosslinked alginate hydrogels as scaffolds for tissue engineering:
      part 1. Structure, gelation rate and mechanical properties.
AB  - Alginate gels have been used in both drug delivery and cell encapsulation
      applications in the bead form usually produced by dripping alginate solution into
      a CaCl2 bath. The major disadvantages to these systems are that the gelation rate
      is hard to control; the resulting structure is not uniform; and mechanically
      strong and complex-shaped 3-D structures are difficult to achieve. In this work
      controlled gelation rate was achieved with CaCO3-GDL and CaSO4-CaCO3-GDL systems,
      and homogeneous alginate gels were formulated as scaffolds with defined
      dimensions for tissue engineering applications. Gelation rate increased with
      increasing total calcium content, increasing proportion of CaSO4, increasing
      temperature and decreasing alginate concentration. Mechanical properties of the
      alginate gels were controlled by the compositional variables. Slower gelation
      systems generate more uniform and mechanically stronger gels than faster gelation
      systems. The compressive modulus and strength increased with alginate
      concentration, total calcium content, molecular weight and guluronic acid (G)
      content of the alginate. MC3T3-E1 osteoblastic cells were uniformly incorporated
      in the alginate gels and cultured in vitro. These results demonstrated how
      alginate gel and gel/cell systems could be formulated with controlled structure,
      gelation rate, and mechanical properties for tissue engineering and other
      biomedical applications.

PMID- 11219715
TI  - Effects of heparin immobilization on the surface characteristics of a biological
      tissue fixed with a naturally occurring crosslinking agent (genipin): an in vitro
      study.
AB  - Heparinized biomaterials have been used to manufacture blood-contacting
      prostheses. The present study was intended to characterize the surface properties
      of a genipin-fixed biological tissue immobilized with heparin using the methods
      of ionic binding (the /h-i tissue) or covalent binding via multi-point attachment
      (the /h-m tissue) or end-point attachment (the /h-e tissue). The surface
      characteristics of test tissues evaluated were water contact angle, surface
      tension, protein adsorption, platelet adhesion, and cellular compatibility.
      Nonheparinized and the glutaraldehyde-fixed counterparts were used as controls.
      It was found that immobilization of heparin on the glutaraldehyde- and genipin
      fixed tissues increased their hydrophilicity and surface tension and suppressed
      their mole ratio of adsorbed fibrinogen to adsorbed albumin and the amount of
      platelets adhered. Among the heparinized tissues, the /h-m tissue was more
      hydrophobic and had a higher mole ratio of adsorbed fibrinogen to adsorbed
      albumin and a greater amount of platelets adhered than the /h-i and /h-e tissues.
      In general, the surface characteristics of the /h-i tissue were comparable to the
      /h-e tissue. However, it is known that the ionically immobilized heparin may be
      displaced from the surface by an ion-exchange mechanism when exposed to blood.
      There were no significant differences in hydrophilicity, surface tension, the
      mole ratio of adsorbed fibrinogen to adsorbed albumin, and the amount of platelet
      adhesion between the glutaraldehyde- and genipin-fixed tissues in comparison with
      their respective counterparts. However, the cellular compatibility of the genipin
      fixed tissues with or without heparinization was significantly superior to its
      glutaraldehyde-fixed counterparts.

PMID- 11219717
TI  - Study of cell-material interaction by estimating NF-kappaB activation in HeLa S3
      cells adhered onto hydrophilic substrates.
AB  - In order to interpret how cells recognize biomaterials, nucleic factor-kappa B
      (NF-kappaB) activation in the attached HeLa S3 cells on various substrates was
      evaluated. As substrates, materials of hydrophilic nature (cellulose,
      poly(acrylamide)-grafted poly(ethylene) (PAAm-g-PE), and lipids films) were used.
      The contemporary assay method for NF-kappaB was modified to fit our system. As a
      result, NF-kappaB activation varied depending on the substrates. The NF-kappaB
      outcome was induced significantly in the HeLa S3 cells that had adhered onto the
      lipid films in a short time. On the other hand, high levels of NF-kappaB
      induction were observed in the HeLa cells adhered to the celluose and PAAm-g-PE
      after a 24 h incubation period. The induction of NF-kappaB by cell-material
      interaction is discussed from the point of view of biocompatibility.

PMID- 11219716
TI  - Synthesis and characterization of N-isopropyl, N-methacryloxyethyl methacrylamide
      as a possible dental resin.
AB  - In this study, N-isopropyl, N-methacryloxyethyl methacrylamide (NIMM) is proposed
      as a possible reactive diluent in place of triethylene glycol dimethacrylate
      (TEGDMA) for dental resin mixtures. Real-time infrared spectroscopy was used to
      monitor the double-bond conversion as a function of irradiation time, and
      mixtures of 50/50wt% bis-GMA/NIMM were found to reach final conversions (95%)
      that were 1.5 times greater than bis-GMA/TEGDMA (65%) under visible light
      irradiation. In addition, samples cured to these conversions were tested with
      dynamic mechanical analysis. The bis-GMA/NIMM mixture (100% converted) was found
      to have a higher glass transition temperature and modulus at body temperature
      than a comparable bis-GMA/TEGDMA mixture (60% converted). Finally, the water
      sorption and solubility of bis-GMA/NIMM were determined to be higher than the
      bisGMA/TEGDMA comparison, but the values were still within the range of the ISO
      9000s standard. These results suggest that bis-GMA/NIMM mixtures are a viable
      alternative to conventional dental resins since a greater degree of monomer
      conversion is obtainable without sacrificing physical and mechanical properties.

PMID- 11219718
TI  - Potassium ion release from a glass ionomer cement matrix.
AB  - Glass ionomer was mixed with water alone and with water containing two levels of
      potassium ion, added as potassium chloride. The dimensions of the specimens
      varied; discs, cylinders and a rectangular bar were used. Release of potassium
      was measured until it ceased. A little potassium was released from cement mixed
      with water but could be accounted for by traces present in the glass. Release
      took 2 months for the lower level and 1.5 years for the higher level of addition.
      For some specimen groups not all the potassium added was subsequently released.
      Potassium release tended towards the pattern found for fluoride release naturally
      occurring from glass ionomer cements in being proportional to t 1/2 but was less
      certain at the lower addition. Release was not related to the dimensions of the
      sample as has been shown for release of intrinsic fluoride.

PMID- 11219719
TI  - Bone reactions to nacre injected percutaneously into the vertebrae of sheep.
AB  - We have studied the osteogenic effects of nacre (mother of pearl) placed in
      experimental cavities prepared in the lumbar vertebrae of sheep. Some of cavities
      were filled with nacre, some with PMMA, and some were left empty. The vertebrae
      were removed 1, 8, 12 weeks after surgery, and assessed histologically and
      morphometrically. The nacre particles in the bone cavity and the surrounding
      intertrabecular spaces gradually dissolved beginning at 8 weeks after surgery.
      There were layers of newly formed bone, both woven and lamellar, in various
      stages of maturation in contact with or adjacent to the dissolving nacre.
      Quantitative assessment of the activation of bone formation adjacent to the
      cavities filled with nacre indicated significant activation of bone formation,
      which continued until week 12. There was also increased mineralization of the
      host bone at this time. There was no new bone formation in the empty cavities, or
      in those filled with PMMA. PMMA also caused necrosis of surrounding bone cells
      with a change in bone architecture and significant reductions in bone formation
      and mineralization. This study demonstrates that nacre stimulates bone-forming
      cells in vertebrae and appears to result in new bone formation.

PMID- 11219720
TI  - In vivo-in vitro study of biodegradable methadone delivery systems.
AB  - Three one-week controlled-release methadone formulations: polylactic acid
      microspheres (F-PLA) and poly(lactide-co-glycolide) microspheres (F-PLGA) with 24
      and 30% methadone content, respectively, and an implant of 50:50 poly(lactide-co
      glycolide): methadone, were evaluated in vitro and in vivo. The implant released
      the total amount of methadone in vitro while microsphere formulations released
      the methadone incompletely, 63% from F-PLA and 85% from F-PLGA in a week.
      Methadone release in vivo was estimated by deconvolution, F-PLGA giving a
      bioavailability >99% (methadone was totally released in 48h), while the estimated
      bioavailability of F-PLA was lower than expected. The bioavailability of the
      implant by deconvolution was around 60%, but absence of methadone in the implant
      indicated its complete release. These differences are due to an increase in
      methadone clearance after 72 h of the in vivo experimental period had passed,
      disturbing a good in vivo-in vitro correlation. A linear correlation between in
      vitro methadone release and in vivo release calculated from the amount of drug
      remaining within the implant, was found until the drug was completely released.

PMID- 11219721
TI  - A study of HAp/PLLA composite as a substitute for bone powder, using FT-IR
      spectroscopy.
AB  - Chemically synthesized hydroxyapatite/poly-L-lactide (HAp/PLLA) composite
      biomaterial was studied in vivo. The biocomposite was implanted into Balb/c
      Singen mice and after 1 and 3 weeks removed from their organisms and analyzed by
      the FT-IR spectroscopy. After 1 week of testing in vivo the implanted sample gave
      a spectrum in which absorption bands arising from newly formed functional groups
      of amine and peptide can be seen. After 3 weeks, a spectrum with pronounced
      absorption bands at 3420 and 1650cm(-1) assigned to newly generated collagen, a
      component of the extracellular connective-tissue matrix, was registered. Also,
      decrease of the intensity absorption band at 1760cm(-1) originating from the C=O
      group of PLLA indicates bioresorption of the PLLA used. Analysis of the
      microstructure of the sample surface by scanning electron microscopy before and
      after implantation revealed bioresorption of the PLLA polymer phase and
      generation of collagen fibers at the sites of implanted bioresorptive PLLA. A
      mixture of autologous bone powder and HAp/PLLA biocomposite was also examined.
      After implantation, the same final products as in the case of HAp/PLLA composite
      biomaterial used alone were found.

PMID- 11219722
TI  - Calcium phosphate invert glass-ceramic coatings joined by self-development of
      compositionally gradient layers on a titanium alloy.
AB  - A glass-ceramic layer containing beta-Ca3(PO4)2 crystals could be joined easily
      with a new type of titanium alloy (Ti-29Nb-13Ta-4.6Zr) consisting of a beta
      titanium phase by heating the metal, on which glass powders with a composition of
      60CaO x 30P2O5 7Na2O x 3TiO2 were placed, at 800 degrees C in air. Measurement of
      tensile bonding strength revealed that the joining between the coating layer and
      the substrate is very strong. Even after the large deformation (e.g.,
      approximately 90 degrees in bending angle) of the titanium alloy, the coating
      layer was not peeled off from the substrate. A compositionally gradient layer in
      the TiO2-P2O5-Na2O-CaO system is developed automatically on the titanium alloy
      during the heating, resulting in the formation of the strong joining. By soaking
      in simulated body fluid at 37 degrees C, hydroxyapatite phase was formed newly on
      the surface of the coating layer.

PMID- 11219723
TI  - Fabrication of hydroxyapatite bodies by uniaxial pressing from a precipitated
      powder.
AB  - Hydroxyapatite (OHAp) has been obtained by using a precipitation method. Thermal
      stability of the precipitated powder has been checked to define an appropriate
      working range to process ceramic bodies without the appearance of odd phases.
      Pellets of hydroxyapatite have been manufactured by means of uniaxial pressing
      and convenient thermal treatments have been investigated to achieve high density
      OHAp bodies. Finally, factors that could affect the ultimate mechanical
      properties of the sintered bodies prepared by uniaxial pressing have been
      discussed.

PMID- 11219724
TI  - Influence of sol and stage of spinnability on in vitro bioactivity and
      dissolution of sol-gel-derived SiO2 fibers.
AB  - The ability of the sol-gel-derived green state silica fibers to induce the
      formation of bone-like calcium phosphate (HCA) on their surfaces has not been
      studied earlier. Bioactive silica fibers provide alternatives for the design of
      novel products, e.g., as implants used in tissue guiding or bone repairs. In this
      study, dry spinning was used to prepare the sol-gel fibers. Different fibers with
      different bulk structures were prepared by changing the composition and
      controlling the stage of spinnability. Additionally, the influence of the aging
      time of the fibers on the bulk structure of the samples was investigated.
      Furthermore, the ability to form calcium phosphate was investigated in vitro in
      the simulated body fluid (SBF). Transmission electron microscopy was used to
      illustrate the bulk structure of the green state fibers and scanning electron
      microscopy to illustrate the formed calcium phosphate layer on the fibers. The
      fibers were additionally characterized by measuring the dissolution of the silica
      in the SBF. In vitro bioactive silica fibers were successfully prepared. The
      calcium phosphate layer was formed within 1-5 days in the best case. The
      structural stability and the in vitro bioactivity varied with the aging time
      expect in one case where practically stable fibers could be prepared. The
      concentration of silica released in the SBF had no direct connection with the HCA
      formation. The silica-rich gel layer was not observed on the fibers, but the
      structure of the fibers was suggested to have an important role in the HCA
      formation.

PMID- 11219725
TI  - Surface analysis of Ti-15Zr-4Nb-4Ta alloy after implantation in rat tibia.
AB  - A new Ti-15Zr-4Nb4Ta alloy without V was implanted in rat tibiae for 6-48 weeks.
      The new bone formation surrounding the Ti implant in bone marrow, surface
      analysis of the Ti alloy after implantation, and metal concentrations in dried
      bone tissue containing new bone were investigated. New bone was well formed
      around the Ti-15Zr-4Nb-4Ta alloy implanted in bone marrow. The mean thickness of
      the new bone increased up to 24 weeks after implantation, and changes in the mean
      thickness thereafter, up to 48 weeks. were very small. The number of corrosion
      pits observed in the Ti-6Al-4V extra low interstitial (ELI) alloy surface tended
      to be slightly more than that of the Ti-5Zr-4Nb-4Ta alloy implant. The
      concentrations of metal elements in the bone tissue containing the new bone
      tended to increase slightly more than in bones without the implant.

PMID- 11219727
TI  - The effects of scaffold thickness on tissue engineered cartilage in
      photocrosslinked poly(ethylene oxide) hydrogels.
AB  - The thickness of human articular cartilage has been reported to vary from less
      than 0.5 up to 7 mm. Hence, tissue engineered cartilage scaffolds should be able
      to span the thickness of native cartilage to fill defects of all shapes and
      sizes. In this study, we demonstrate the potential for using photopolymerization
      technology to encapsulate chondrocytes in poly(ethylene oxide) hydrogels, which
      vary in thickness from 2 to 8 mm. Chondrocytes, encapsulated in an 8 mm thick,
      photocrosslinked hydrogel and cultured in vitro for 6 weeks, remained viable and
      produced cartilaginous tissue throughout the construct comparable to a 2 mm thick
      gel as seen both histologically and biochemically. In addition, the total
      collagen and glycosaminoglycan contents per wet weight of the 8 mm thick cell
      polymer construct were 0.13 +/- 0.01 and 0.25 +/- 0.03%, respectively, and did
      not vary significantly as a function of spatial position in the construct. The
      histological evidence and the biochemical content were similar in all constructs
      of varying thickness. The results suggest that photocrosslinked hydrogels are
      promising scaffolds for tissue engineering cartilage as cell viability is readily
      maintained; uniform cell seeding is easy to achieve: and the biochemical content
      of the extracellular matrix is not compromised as the scaffold thickness is
      increased from 2 to 8 mm.

PMID- 11219726
TI  - Thermal compression and characterization of three-dimensional nonwoven PET
      matrices as tissue engineering scaffolds.
AB  - Nonwoven fibrous matrices have been widely used as scaffolds in tissue
      engineering, and modification of microstructure of these matrices is needed to
      organize cells in three-dimensional space with spatially balanced proliferation
      and differentiation required for functional tissue development. The method of
      thermal compression of nonwoven polyethylene terephthalate (PET) fabrics was
      developed and key parameters of temperature, pressure, and compression duration
      were evaluated in this study. The permanent deformation was obtained at elevated
      temperature under pressure and the viscoelastic compressional behaviors were
      observed, characterized by a distinct apparent modulus change in glass transition
      temperature region. A liquid extrusion method was further employed to analyze
      both pore size and its distribution for matrices with porosity ranging from 84 to
      93%. It is also found that a more uniformly distributed pore size was resulted
      from thermal compression and the isotropic nature of nonwoven fabrics was
      preserved because of the proportional reduction of the pore by compression. The
      thermally compressed fabric matrices with two different pore sizes (15 and 20
      microm in pore radius) were used to culture human trophoblast ED27 and NIH 3T3
      cells. It was found that cells cultured in the different pore-size PET matrices
      had different cell spatial organization and proliferation rates. The smaller
      pores in the matrix allowed cells to spread better and proliferate faster, while
      cells in the larger pores tended to form large aggregates and had lower
      proliferation rate. The thermal compression technique also can be applied to
      other synthetic fibrous matrices including biodegradable polymers used in tissue
      engineering to modify the microstructure according to their viscoelastic
      properties.

PMID- 11219728
TI  - Lysis of Gymnodinium breve by cultures of the green alga Nannochloris eucaryotum.
AB  - Laboratory cultures of Florida's red tide organism, Gymnodinium breve, were
      killed by the green alga Nannochloris eucaryotum. Studies involved organism
      organism interaction as well as organism-cell-free culture (N. eucaryotum)
      interaction. Both studies demonstrated that N. eucaryotum adversely affected
      Florida's red tide organism. The lysis has been attributed to compounds called
      APONINs (apparent oceanic naturally occurring cytolins). N. eucaryotum crude
      APONIN was extracted from cell-free cultures, partially purified and
      fractionated. The fractions were bioassayed against G. breve, and 'fingerprints'
      of the deleterious fractions were obtained.

PMID- 11219729
TI  - A strategy for the identification of T-cell epitopes on Leishmania cysteine
      proteinases.
AB  - In this study computational analysis was used to compile sequence alignments,
      construct a dendrogram and calculate physical data in order to predict potential
      T-cell epitopes of the Leishmania cysteine proteinase. Using multiple alignment
      of human and Leishmania proteinase sequences deposited on data bank sequences, it
      was possible to predict that the extreme C-terminus of cysteine proteinase
      (Cyspep, 355-444) contained three peptides (pI 361-370, pII 415-422 and pIII 431
      444) with charge score, hydrophobicity and isoelectric points compatible for
      human leucocyte-associated antigen (HLA) class II binding. The prediction was
      confirmed in vitro through the ability of synthetic peptides corresponding to the
      predicted regions to stimulate peripheral blood mononuclear cells of patients
      with leishmaniasis.

PMID- 11219730
TI  - Altered expression of keratins during abnormal wound healing in human skin.
AB  - Keloids and hypertrophic scars are a result of aberrations of the normal wound
      healing processes of the skin. The expression of keratins, the proteins of an
      intermediate filament supergene family, closely parallel the
      division/differentiation of epithelial cells and therefore offer excellent
      molecular markers to examine wound healing. In this study, the expression of
      K5/K14, proliferation specific keratin polypeptides in normal skin, keloids and
      hypertrophic scars was analysed. Results indicated that unlike normal wounds and
      hypertrophic scars, keloid epidermis displayed increased expression of K5 and K14
      at both the translational and transcriptional levels. The molecular mechanisms in
      the pathogenesis of keloids appear to be different from those of hypertrophic
      scars.

PMID- 11219731
TI  - Recovery of gravitropic response during regeneration of root caps does not
      require developed columella cells and sedimentation of amyloplasts.
AB  - Correlations between regeneration of the root cap and recovery of a gravitropic
      response were studied using primary roots of Phaseolus vulgaris. After removal of
      various lengths of the root tip a gravistimulus was continuously given to the
      root. The statistical analysis of data showed that recovery of the gravitropic
      response was gradually delayed as the length of the tips removed increased. This
      suggested that the columella cells of the root cap were involved in gravitropism.
      When the root cap was completely removed, the roots did not respond to
      gravistimuli for the first 15 h and began to reorient their growth direction at
      20 h. At this time, the columella cells had just begun to regenerate and had
      immature amyloplasts which did not sufficiently form a sediment. These results
      suggest that other systems of perception exist in plant cells in addition to the
      amyloplast-based model of graviperception.

PMID- 11219732
TI  - Sex bodies and synaptonemal complexes of Balb/C mice: antioxidant intervention of
      oxyradical insult.
AB  - Spermatogenesis is inhibited in Balb/C mice as a result of oxyradical insult.
      However, mammalian spermatocytes and synaptonemal complexes retain their
      structure and function after oxyradical insult due to protection afforded by the
      antioxidant vitamin E. Control groups were compared with experimental groups
      which were fed various vitamin E-deficient diets and subjected to varying times
      in an humidified 100% oxygen (hyperoxia) chamber. Measurements were made of sex
      body volume (SBV), nuclear envelope aberrations (NEA), and synaptonemal complex
      structure in spermatocytes during pachytene of meiosis prophase I. Changes in the
      volume of the sex body were positively correlated with increased oxyradical
      insult. The structure of the synaptonemal complex was not altered in any of the
      experimental groups which is a significant observation. It is suggested that
      vitamin E affords antioxidant protection and inhibits the alteration of membranes
      and sex chromosomes in mice during meiosis.

PMID- 11219733
TI  - Glucose sensor with improved haemocompatibilty.
AB  - A new biocompatible copolymer has been synthesised and used in an electrochemical
      enzyme-based glucose sensor. The copolymer incorporates three segments including
      a monomer with an electrically neutral phosphorylcholine head group that is able
      to reject protein adsorption and two segments that increase the affinity to
      polyurethane substrate. Peel and solution circulation tests showed that this
      material has high attachment to polyurethane. With the new copolymer as the
      outermost layer and the polyurethane as the diffusion-limiting membrane, the
      sensor showed extended linearity up to 50 mM glucose and stable output in bovine
      serum for 70 h. During in vivo tests, the sensor exhibited a steady current
      signal and a rapid transient response when the glucose concentration was raised.
      These results imply that the haemocompatibility of the glucose sensor coated with
      the new copolymer has been improved, which is crucial for a sensor used for
      clinical real-time monitoring. The material may also be suitable for application
      to other implantable devices.

PMID- 11219734
TI  - Parameters important in tuning the response of monolayer enzyme electrodes
      fabricated using self-assembled monolayers of alkanethiols.
AB  - Enzyme electrodes were observed experimentally to have a broad dynamic range,
      high sensitivity and excellent reproducibility. The theoretically predicted
      response of the monolayer enzyme electrodes was in good agreement with that
      observed experimentally over the broad range of experimental conditions tested.
      The response is limited by the rate of enzyme turnover by a mediating species
      rather than mass transport. As a consequence of this limitation, the response was
      very sensitive to the enzyme loading and the concentration of mediator in the
      sample solution but insensitive to mass transport variables such as solution
      stirring or the diffusion coefficients of the substrate or cosubstrate.

PMID- 11219735
TI  - Quantification of nisin in flow-injection immunoassay systems.
AB  - A monoclonal-antibody-based, sequential competitive-flow-injection immunoassay
      system in expanded-bed mode has been developed for the determination of nisin.
      The system allows the determination of nisin in the presence of suspended
      particles without any significant interference, illustrating its potential for on
      line monitoring of fermentation processes or the analysis of food matrices. The
      dose response range of the system when operated in expanded-bed mode was 6-90
      microM. The detection limit under packed-bed conditions was 3 microM. The results
      correlated well with the results from conventional ELISA in the analysis of
      samples of processed cheese. When milk samples, fermentation samples and buffer
      were spiked with nisin, the mean recoveries were 86% for milk samples, 96% for
      fermentation samples and 98% for buffer solution.

PMID- 11219736
TI  - Diagnosis of diabetes by image detection of breath using gas-sensitive LAPS.
AB  - Gaseous respiratory acetone detection using LAPS (Light Addressable
      Potentiometric Sensors) is proposed as a supplementary method for the diagnosis
      of diabetes. First, electric simulation of the LAPS system is studied to obtain
      the optimum sensitivity of tested odours. Gas phase chromatography is used to
      obtain correlations between blood sugar levels and acetone from the breath. Then
      several experiments are carried out to obtain the 2-dimension static and dynamic
      images of respiratory acetone and air. All experimental results show that the
      LAPS can be very useful for the detection of respiratory odours, especially the
      diagnosis of diabetes.

PMID- 11219737
TI  - Development of a disposable ethanol biosensor based on a chemically modified
      screen-printed electrode coated with alcohol oxidase for the analysis of beer.
AB  - A disposable amperometric biosensor for the measurement of ethanol has been
      developed. It comprises a screen-printed carbon electrode doped with 5% cobalt
      phthalocyanine (CoPC-SPCE), and coated with alcohol oxidase; a permselective
      membrane on the surface acts as a barrier to interferents. The measurement of
      ethanol is based on the signal produced by H2O2, the product of the enzymatic
      reaction. Optimisation studies were performed using amperometry in stirred
      solution and the magnitude of the signal was found to be dependent on pH, enzyme
      loading, type of membrane and applied potential. The same technique was used to
      evaluate the biosensor for the determination of ethanol in samples. The results
      obtained compared well with the manufacturers specifications. In order to test
      the possibility of using the devices in the field, chronoamperometry was also
      used to determine ethanol in the same beer samples. The precision and recovery
      data again indicated that the biosensor should give reliable results under the
      conditions described.

PMID- 11219738
TI  - Screen-printed amperometric microcell for proline iminopeptidase enzyme activity
      assay.
AB  - A microfabricated amperometric microcell was designed and used for the
      determination of proline iminopeptidase (PIP) enzyme activity in 2-10-microl
      samples. The measurements were made in the range of 10.3-841.5 mU/ml enzyme
      activities. The sensitivity of the determinations was between - 0.0195 and -
      0.0203 microA ml/mU per min. The coefficient of variation of the determined
      values ranged between 2.8 (at 561.2 mU/ml) and 24.1% (at 10.3 mU/ml). The
      microcell was manufactured on an alumina substrate using screen-printed graphite
      working and Ag/AgCl reference electrodes. Elevated PIP activity in the vaginal
      fluid is a biochemical indicator of bacterial vaginosis. The method is
      appropriate to differentiate between normal (66+/-145 mU/ml) and elevated,
      diseased (704+/-145 mU/ml), values.

PMID- 11219739
TI  - Materials and techniques for electrochemical biosensor design and construction.
AB  - New developments in biosensor design are appearing at a high rate as these
      devices play increasingly important roles in daily life. This review aims to
      highlight recent developments in materials and techniques for electrochemical
      biosensor design and construction. Rapid growth in biomaterials, especially the
      availability and application of a vast range of polymers and copolymers
      associated with new sensing techniques have led to remarkable innovation in the
      design and construction of biosensors, significant improvements in sensor
      function and the emergence of new types of biosensor. Nevertheless, in vivo
      applications remain limited by functional deterioration due to surface fouling by
      biological components. However, new copolymers based upon biomembrane mimicry
      have been extensively investigated during the last two decades, raising hopes
      that the problems related to interactions between foreign surfaces and biological
      fluids and tissues may soon be solved.

PMID- 11219740
TI  - High sensitivity waveguide grating sensor based on radiative losses.
AB  - A scheme of a waveguide sensor utilizing an output grating coupler with the
      grating length less than the coupling length is analyzed. This is the new method
      for the evaluation of average thickness of the adsorbed layer. This method, based
      on measurements of radiation loss coefficients, is proposed. Sensitivity limits
      of such a scheme are discussed. The new scheme has strong response on formation
      on the adsorbed layer and relatively weaker response on the fluctuations of
      temperature and analyte concentration. New possibilities for multiparameter
      sensing are shown.

PMID- 11219741
TI  - Electrochemical genosensor design: immobilisation of oligonucleotides onto
      transducer surfaces and detection methods.
AB  - The present report reviews immobilisation techniques of purified oligonucleotides
      on electrochemical transducers and their corresponding detection techniques. Most
      of the literature reviewed was published in the 1990s. The immobilisation
      techniques of a DNA probe to the surface of an electrochemical transducer made
      from carbon, gold, platinum or polypyrrole, ranged from simple adsorption to
      covalent bonding. Recent efforts to couple the recognition layer containing the
      immobilised nucleic acid recognition layer with the electrochemical signal
      transducer are discussed. Special attention is given to hybridisation biosensing
      based on electroactive indicators.

PMID- 11219742
TI  - Detection of protease activity in the wetted surface of gelatin-coated electrodes
      in air by AC impedance spectroscopy.
AB  - As a step towards developing a biosensor which can detect airborne protease
      droplets, a biosensor which had previously been developed to detect protease in
      solution is shown to be capable of detecting different concentrations of protease
      in liquid films on the sensor surface in air. The biosensor measured impedance
      change due to proteolytic digestion of its gelatin coating. In saturated air
      there was a rise in impedance, with a loss in weight of the gelatin, in
      proportion to collagenase concentration. The addition of glycerol to the gelatin
      caused a lower impedance response and smaller loss in weight. A critical
      thickness of the gelatin layer prior to a more rapid change in the rate of
      impedance was noted, with and without the addition of glycerol. In low air
      humidity (40%), with gelatin, all collagenase concentrations produced a very
      similar rapid increase in impedance. However, with glycerol-enhanced gelatin,
      there was a clear distinction between the extent of impedance change with
      different collagenase concentrations. The application of these findings for use
      in the field of bioaerosol sampling is discussed.

PMID- 11219743
TI  - Colloidal gold as an electrochemical label of streptavidin-biotin interaction.
AB  - A new electrochemical method to monitor biotin-streptavidin interaction, based on
      the use of colloidal gold as an electrochemical label, is investigated.
      Biotinylated albumin is adsorbed on the pretreated surface of a carbon paste
      electrode (CPE). This modified electrode is immersed in colloidal gold
      streptavidin labelled solutions. Adsorptive voltammetry is used to monitor
      colloidal gold bound to streptavidin, obtaining a good reproducibility of the
      analytical signal (R.S.D. = 3.3%). A linear relationship between peak current and
      streptavidin concentration from 2.5 x 10(-9) to 2.5 x 10(-5) M is obtained when a
      sequential competitive assay between streptavidin and colloidal gold-labelled
      streptavidin is carried out. On the other hand, the adsorption of streptavidin on
      the electrode surface was performed, followed by the reaction with biotinylated
      albumin labelled with colloidal gold. In this way, a linear relationship between
      peak current and colloidal gold labelled biotinylated albumin concentration is
      achieved with a limit of detection of 7.3 x 10(9) gold particles per ml (5.29 x
      10(-9) M in biotin).

PMID- 11219745
TI  - Current awareness in biosensors & bioelectronics.

PMID- 11219744
TI  - A micro flow injection electrochemical biosensor for organophosphorus pesticides.
AB  - We describe a disposable, amperometric micro flow injection electrochemical
      biosensor that can be applied to the identification and quantification of highly
      toxic organophosphorus (OP) compounds in the environment, on the spot and in a
      short time. The system traces very small quantities of OP by monitoring the
      enzymatic reaction of acetylcholine esterase (AChE) and its inhibition. The
      sensor is sensitive, rapid, small, inexpensive, disposable and can be operated by
      non-professional technicians. The electrochemical cell consists of screen-printed
      electrodes covered with an enzymatic membrane and placed in a home-made flow
      cell. The electrodes are connected to a computer-controlled potentiostat. We
      quantitatively detected the OP compound, dimethyl 2,2-dichlorovinyl phosphate
      (DDVP), by monitoring the OP induced decrease in enzymatic degradation of the
      substrate, acetylthiocholine chloride (ATCh), to thiocholine and acetic acid.
      Thiocholine reacts with hexacyanoferrate ion in the working solution and the
      reduction of [Fe(CN)6](-3) to [Fe(CN)6](-4) and its subsequent reoxidization by
      the electrode generates very sharp, rapid and reproducible electric signals. The
      ability to detect low quantities is extremely important when dealing with
      hazardous environmental pollutants.

PMID- 11219746
TI  - An intelligent rapid odour recognition model in discrimination of Helicobacter
      pylori and other gastroesophageal isolates in vitro.
AB  - Two series of experiments are reported which result in the discrimination between
      Helicobacter pylori and other bacterial gastroesophageal isolates using a newly
      developed odour generating system, an electronic nose and a hybrid intelligent
      odour recognition system. In the first series of experiments, after 5 h of growth
      (37 degrees C), 53 volatile 'sniffs' were collected over the headspace of complex
      broth cultures of the following clinical isolates: Staphylococcus aureus,
      Klebsiella sp., H. pylori, Enterococcus faecalis (10(7) ml(-1)), Mixed infection
      (Proteus mirabilis, Escherichia coli, and E. faecalis 3 x 10(6) ml each) and
      sterile cultures. Fifty-six normalised variables were extracted from 14
      conductive polymer sensor responses and analysed by a 3-layer back propagation
      neural network (NN). The NN prediction rate achieved was 98% and the test data
      (37.7% of all data) was recognised correctly. Successful clustering of bacterial
      classes was also achieved by discriminant analysis (DA) of a normalised subset of
      sensor data. Cross-validation identified correctly seven 'unknown' samples. In
      the second series of experiments after 150 min of microaerobic growth at 37
      degrees C, 24 volatile samples were collected over the headspace of H. pylori
      cultures in enriched (HPP) and normal (HP) media and 11 samples over sterile (N)
      cultures. Forty-eight sensor parameters were extracted from 12 sensor responses
      and analysed by a 3-layer NN previously optimised by a genetic algorithm (GA). GA
      NN analysis achieved a 94% prediction rate of 'unknown' data. Additionally the
      'genetically' selected 16 input neurones were used to perform DA-cross validation
      that showed a clear clustering of three groups and reclassified correctly nine
      'sniffs'. It is concluded that the most important factors that govern the
      performance of an intelligent bacterial odour detection system are: (a) an odour
      generation mechanism, (b) a rapid odour delivery system similar to the mammalian
      olfactory system, (c) a gas sensor array of high reproducibility and (d) a hybrid
      intelligent model (expert system) which will enable the parallel use of GA-NNs
      and multivariate techniques.

PMID- 11219747
TI  - Designing an amperometric thick-film microbial BOD sensor.
AB  - Thick film oxygen electrodes manufactured by screen print method have been used
      as a transducer for a biochemical oxygen demand (BOD) sensor. The kinetics of the
      immobilized yeast, Arxula adeninivorans (Arxula) has been studied. The apparent
      KM of immobilized Arxula (> 100 microM) is higher than free cells of Arxula (70
      microM). The increase in KM caused by the effect of immobilization extends the
      linear range of the sensor. End-point measurement and quasi-kinetic measurement
      have been studied comparatively as measurement procedures with a good
      correlation. The Vmax for end-point measurement is 790.7 microM/s and that for
      quasi-kinetic measurement is 537.3 microM/s. The limit of detection is calculated
      1.24 mg/l BOD. Using the quasi-kinetic measurement, instead of end-point
      measurements, the measuring time can be reduced from 5-30 min to 100 s. The
      sensor layer thickness or increase in the layer of covering gel can increase the
      KM that is accompanied with the extension of the linear range of the sensor.
      Nevertheless, increase in the layer of covering gel will not increase the
      saturation signal. Domestic wastewater was checked by the thick film BOD sensor
      and the results are satisfactory.

PMID- 11219748
TI  - Effect of incident angle of light on sensitivity and detection limit for layers
      of antibody with surface plasmon resonance spectroscopy.
AB  - The effect of the incident angle of light on sensitivity and the detection limit
      for surface-plasmon resonance spectroscopy were examined. The sensitivities and
      the detection limit were experimentally measured using an antibody as a modeled
      analyte in the incident angles of a light region of 66-76 degrees. The results
      showed that the sensitivity of a smaller incident angle was higher than that of a
      larger one. For instance, the sensitivity of a 66 degree incident angle was three
      times higher than that of a 76 degree incident angle. The detection limit with a
      66 degree incident angle was one-tenth of that with a 76 degree incident angle.
      These sensitivities and detection limits were compared with those of a
      commercially produced surface-plasmon resonance instrument. This comparison
      demonstrated that a wavelength resolution of the order of less than 10(-2) nm was
      necessary to obtain satisfactory sensitivities and detection limits. In addition,
      the refractive index and thickness of the antibody layer formed on a sensor
      surface was proposed by experimental results and theoretical calculation.

PMID- 11219749
TI  - Coupling of a DNA piezoelectric biosensor and polymerase chain reaction to detect
      apolipoprotein E polymorphisms.
AB  - In this paper we report the coupling of the Polymerase Chain Reaction (PCR) with
      a piezoelectric biosensor to detect a point mutation in a human gene.
      Biotinylated 23-mer probes were immobilised on the streptavidin coated gold
      surface of a quartz crystal; streptavidin was covalently bound to the
      thiol/dextran modified gold surface. The hybridisation of the immobilised probes
      with a short sequence (23 mer) complementary, non-complementary and mismatched
      DNA was investigated: the device was able to distinguish the different synthetic
      oligonucleotides. Many cycles of measurements can be performed on the same
      crystal surface regenerating the single strand of DNA with 1 mM of HCl. The same
      hybridisation reaction was then performed using real samples of human DNA
      extracted from blood and amplified by PCR, following a standard procedure for
      genetic detection of the polymorphism of the apolipoprotein E (apoE) gene. The
      procedure was able to distinguish the sequences present in the different samples,
      which differ only in one base: in this way it was possible distinguish between
      different groups of genotypes with apoE typing. Experiments with 'blank' samples
      confirmed the absence of adsorption or non-specific effects on the quartz crystal
      treated with the reported procedure.

PMID- 11219750
TI  - Optical fiber biosensor for the determination of low biochemical oxygen demand.
AB  - An optical fiber biosensor was developed for the evaluation of low Biochemical
      Oxygen Demand (BOD) values in river waters. Artificial wastewater (AWW) solution
      was employed as standards for the calibration of the BOD sensor. The response
      time of the sensor was 15 min, and the optimal BOD response was observed at 30
      degrees C, pH 7.0. A linear relationship was obtained between the output voltage
      and BOD5 values, and the range of determination was 1-10 mg l(-1) BOD. The sensor
      response was almost not influenced by chloride ion up to 1000 mg l(-1), and also
      not affected by heavy metal ions (Fe3+, Cu2+, Mn2+, Cr3+, Zn2+). The BOD of river
      waters was estimated by using the optical fiber biosensor, and good correlation
      between the sensor and BOD5 test was obtained (r2 = 0.971).

PMID- 11219751
TI  - Enzyme kinetic assays with surface plasmon resonance (BIAcore) based on
      competition between enzyme and creatinine antibody.
AB  - A procedure is described which allows the characterization of enzyme by a hybrid
      approach using an enzyme and an antibody. The presented method is related to the
      affinity determination of antibodies by the 'affinity in solution' procedure for
      BlAcore. The antibody is used as an indicator for the concentration of substrate,
      which is also the antigen. A mixture of enzyme, substrate and antibody is
      incubated, and an aliquot of this solution is injected periodically into a
      flowcell containing immobilized substrate, which is bound by the antibody, but
      not cleaved by the enzyme. The chosen initial concentration of substrate inhibits
      the binding of antibody to the immobilized substrate by 90%. During the enzymatic
      reaction, increased amounts of antibody bind to the surface, as the substrate
      concentration is decreased. With this method, the cleavage of creatinine with
      creatinine iminohydrolase (6 mU/ml) was monitored for up to 11 h. A recently
      developed monoclonal antibody against creatinine was used as the indicating
      protein. For the calculation of enzyme activity, the signals were compared with a
      calibration curve for inhibition of antibody binding to the chip by creatinine in
      solution.

PMID- 11219752
TI  - Drug evaluations using neuronal networks cultured on microelectrode arrays.
AB  - We used spontaneously active neuronal networks derived from dissociated embryonic
      murine spinal cord and auditory cortex and grown on substrate-integrated thin
      film microelectrodes to determine characteristic responses to the cannabinoid
      agonists anandamide (AN) and methanandamide (MA). AN and MA reversibly inhibited
      spike and burst production in both tissue types. Responses of 21 cultures ranging
      in age from 23 to 111 days in vitro (d.i.v.) showed high intra- and inter-culture
      reproducibility at all ages. However, responses were tissue and substance
      dependent. AN and MA were equipotent in cortical cultures and terminated bursting
      and spiking at 2.5 +/- 0.9 microM (n = 10). Spinal cultures were shut-off by 1.3
      +/- 0.7 microM (n = 15) AN, but required 5.8 +/- 1.2 microM MA for activity
      cessation. MA, but not AN, demonstrated a biphasic influence: excitation at 0.25
      3.5 microM and suppression at 4-7.1 microM. Palmitoylethanolamide, a related
      lipophilic molecule with no reported binding to the CBI receptor (to which AN and
      MA bind in the central nervous system), did not affect network activity at
      concentrations up to 6.5 microM. Irreversible cessation of activity was observed
      after 30 min applications of AN or MA at > 7 microM.

PMID- 11219753
TI  - Silica sol-gel composite film as an encapsulation matrix for the construction of
      an amperometric tyrosinase-based biosensor.
AB  - An amperometric tyrosinase enzyme electrode for the determination of phenols was
      developed by a simple and effective immobilization method using sol-gel
      techniques. A grafting copolymer was introduced into sol-gel solution and the
      composition of the resultant organic-inorganic composite material was optimized,
      the tyrosinase retained its activity in the sol-gel thin film and its response to
      several phenol compounds was determined at 0 mV vs. Ag/AgCl (sat. KCl). The
      dependences of the current response on pH, oxygen level and temperature were
      studied, and the stability of the biosensor was also evaluated. The sensitivity
      of the biosensor for catechol, phenol and p-cresol was 59.6, 23.1 and 39.4
      microA/mM, respectively. The enzyme electrode maintained 73% of its original
      activity after intermittent use for three weeks when storing in a dry state at 4
      degrees C.

PMID- 11219754
TI  - Increasing the sensitivity of piezoelectric odour sensors based on molecularly
      imprinted polymers.
AB  - The molecular imprinting technique has been used to create sensors with a
      predetermined selectivity for molecules in the gas phase. Based on previous
      results, piezoelectric quartz crystals were first coated with a layer of nylon,
      to provide increased sensitivity, and then a layer of a polymer imprinted with 2
      methylisoborneol (MIB) was applied to endow the device with selectivity. The
      response of the 'imprinted' sensor was significantly higher than the response of
      the 'non-imprinted' sensor at MIB concentrations above 10 ppb. Our new sensor is
      thus 20 times more sensitive than our previous device. At concentrations greater
      than 10 ppb, the response of the 'non-imprinted' sensor to geosmin, another
      odorant often accompanying MIB, was significantly higher than the response of the
      'imprinted' sensor. A number of other odorants were examined and, as in our
      previous work, the responses of the 'non-imprinted' sensors were found to be to
      greater than the responses of the 'imprinted' sensors.

PMID- 11219755
TI  - Surface plasmon resonance based pesticide assay on a renewable biosensing surface
      using the reversible concanavalin A monosaccharide interaction.
AB  - A competitive immunoassay based on surface plasmon resonance (SPR) for the
      detection of the pesticide 2,4-dichlorophenoxyacetic acid (2,4-D) is reported.
      The novelty of the assay is based on the regeneration of the chip surface by the
      reversible interaction between monosaccharide (D-glucose) and lectin
      (Concanavalin A). Concanavalin A-2,4-D conjugate was chemically synthesized,
      purified and used for binding to the SPR chip modified with covalently bound
      alpha-D-glucose. The interaction between anti-2,4-D antibody and the surface
      bound concanavalin A-2,4-D conjugate was monitored by surface plasmon resonance
      and the response was used for the quantification of 2,4-D. The dynamic range of
      the calibration curve was between 3 and 100 ng/ml. The demonstrated principle of
      surface regeneration based on the reversible sugar-lectin interaction may be of
      more general applicability in immunoassays.

PMID- 11219756
TI  - A liquid crystal pixel array for signal discrimination in array biosensors.
AB  - A new optical design uses a liquid crystal pixel array (LCPA) to discriminate
      multiple fluorescence signals on a two-dimensional biosensor array. The LCPA can
      selectively control the transmission of fluorescence generated from multiple
      biosensing elements on a planar waveguide. This device sequentially acquires the
      fluorescence data from the substrate by making multiple individual measurements
      of the sensing elements on the waveguide. The biosensing elements are patterned
      according to the pixel layout of the LCPA and optically aligned so that each
      electronically driven pixel can either transmit or filter out the fluorescence
      signal as specified by the user. The primary advantage of this system is that a
      single detection channel (i.e. photomultiplier tube (PMT)) can be used to measure
      multiple fluorescence signals from a two-dimensional substrate while the LCPA
      provides for spatial resolution. We evaluate the performance of the LCPA by
      testing the optical homogeneity of the liquid crystal pixels and linear dynamic
      range for transmitting light. The LCPA is also used with well-developed
      biosensing chemistry modified for this optical format.

PMID- 11219757
TI  - Simplified subjective workload assessment technique.
AB  - Although the subjective workload assessment technique (SWAT) has been widely
      used, it has two main problems: it is not very sensitive for low mental workloads
      and it requires a time-consuming card sorting pretask procedure. In this study
      are presented five variations of SWAT in an effort to overcome the limitations.
      Four of the variants used the continuous SWAT subscales while one used the
      discrete SWAT subscale. Fifteen subjects participated in the experiment. The
      scales were compared with the original SWAT scale in terms of sensitivity and
      pretask procedure completion time when performing arithmetic tasks. The results
      show that all four variants are more sensitive than the conventional SWAT scale
      and that the pairwise comparison procedure takes significantly less pretask
      completion time compared with the original SWAT scale. Thus, the conventional
      pretask procedure can be replaced by a simple unweighted averaging to yield a
      scale of high sensitivity.

PMID- 11219758
TI  - Effect of strenuous live-fire drills on cardiovascular and psychological
      responses of recruit firefighters.
AB  - The study examined the effects of repeated strenuous live-fire drills on
      cardiovascular and psychological responses of male recruit firefighters (n = 7).
      Participants performed three trials of a standardized set of tasks while inside a
      training structure containing several live fires. Measurements of heart rate,
      aortic blood flow, perceived exertion, respiratory and thermal distress, reaction
      time, and error rate were obtained before testing, after each trial and during
      recovery. Heart rate increased significantly during each of the trials, reaching
      age-predicted maximal values. Stroke volume was significantly lower after trial 3
      versus trial 1 and prevalues. Perceived exertion, respiratory distress, and
      thermal distress all increased, indicating greater stress following firefighting
      activities. Reaction time and error rate did not change significantly, but there
      was a tendency for more errors following trials 2 and 3 versus trial 1. The
      training drills resulted in considerable physiological and psychological strain,
      which has the potential to impair cognitive function. Firefighters are encouraged
      to take all possible steps to mitigate the extent of the cardiovascular strain.

PMID- 11219759
TI  - A critical examination of perceptual and cognitive effects attributed to full
      spectrum fluorescent lighting.
AB  - Full-spectrum fluorescent lighting (FSFL) has been credited with causing dramatic
      improvements in vision, perception and cognitive performance as compared with
      other fluorescent lamp types. These effects are hypothesized to occur because of
      similarity between FSFL emissions and daylight, which is said to have
      evolutionary superiority over other light sources. This review, covering 1945-98,
      critically considers the evidence for these claims. In general, poor-quality
      research has resulted in an absence of simple deterministic effects that can be
      confidently attributed to fluorescent lamp type. Promising avenues for lighting
      behaviour research include investigations of cognitive mediators of lighting
      behaviour relationships, and flicker rates and colour rendering effects on visual
      processing, appearance judgements and affect. Good lighting solutions are more
      complex than lamp type specification.

PMID- 11219760
TI  - Low back joint loading and kinematics during standing and unsupported sitting.
AB  - The aim was to examine lumbar spine kinematics, spinal joint loads and trunk
      muscle activation patterns during a prolonged (2 h) period of sitting. This
      information is necessary to assist the ergonomist in designing work where posture
      variation is possible -- particularly between standing and various styles of
      sitting. Joint loads were predicted with a highly detailed anatomical
      biomechanical model (that incorporated 104 muscles, passive ligaments and
      intervertebral discs), which utilized biological signals of spine posture and
      muscle electromyograms (EMG) from each trial of each subject. Sitting resulted in
      significantly higher (p<0.001) low back compressive loads (mean +/- SD 1698 +/-
      467 N) than those experienced by the lumbar spine during standing (1076 +/- 243
      N). Subjects were equally divided into adopting one of two sitting strategies: a
      single 'static' or a 'dynamic' multiple posture approach. Within each individual,
      standing produced a distinctly different spine posture compared with sitting, and
      standing spine postures did not overlap with flexion postures adopted in sitting
      when spine postures were averaged across all eight subjects. A rest component (as
      noted in an amplitude probability distribution function from the EMG) was present
      for all muscles monitored in both sitting and standing tasks. The upper and lower
      erector spinae muscle groups exhibited a shifting to higher levels of activation
      during sitting. There were no clear muscle activation level differences in the
      individuals who adopted different sitting strategies. Standing appears to be a
      good rest from sitting given the reduction in passive tissue forces. However, the
      constant loading with little dynamic movement which characterizes both standing
      and sitting would provide little rest/change for muscular activation levels or
      low back loading.

PMID- 11219761
TI  - Dynamic biomechanical model of the hand and arm in pistol grip power handtool
      usage.
AB  - The study considers the dynamic nature of the human power handtool operator as a
      single degree-of-freedom mechanical torsional system. The hand and arm are,
      therefore, represented as a single mass, spring and damper. The values of these
      mechanical elements are dependent on the posture used and operator. The apparatus
      used to quantify these elements measured the free vibration frequency and
      amplitude decay of a known system due to the external loading of the hand and
      arm. Twenty-five subjects participated in the investigation. A full factorial
      experiment tested the effects on the three passive elements in the model when
      operators exerted maximum effort for gender, horizontal distance (30, 60, 90 cm),
      and vertical distance (55, 93, 142 190 cm) from the ankles to the handle. The
      results show that the spring element stiffness and mass moment of inertia changed
      by 20.6 and 44.5% respectively with vertical location (p<0.01), and 23.6 and
      41.2% respectively with horizontal location (p<0.01). Mass moment of inertia and
      viscous damping for males were 31.1 and 38.5% respectively greater than for
      females (p<0.01). Tool handle displacement and hand force during torque build-up
      can, therefore, be predicted based on this model for different tool and workplace
      parameters. The biomechanical model was validated by recalling five subjects and
      having them operate a power handtool for varying horizontal distances (30, 60, 90
      cm), vertical distances (55, 93, 142 cm), and two torque build-up times (70, 200
      ms). Tool reaction displacement was measured using a 3D-motion analysis system.
      The predictions were closely correlated with these measurements (R = 0.88),
      although the model underpredicted the response by 27%. This was anticipated since
      it was unlikely that operators used maximal exertions for operating the tools.

PMID- 11219762
TI  - Surface electromyography analysis in long-term recordings: application to head
      rest comfort in cars.
AB  - Analysis of long-term surface electromyographic (SEMG) signals has many
      applications in ergonomics when related to muscle fatigue. The present work
      proposes a set of processing methods reporting SEMG modifications during long
      term driving tests in various situations (with or without head rest). A
      segmentation/classification algorithm allows signal splitting into homogeneous
      parts (postural activity and EMG bursts) and an efficient artefact suppression.
      Postural activity modifications are evaluated from time-varying amplitude
      probability density function (TAPDF) parameters. EMG burst analysis is achieved
      taking into account the relationships of these bursts with accelerometric events.
      This segmentation/classification procedure improves repeatability but does not
      significantly modify the overall results obtained before segmentation, as far as
      the analysis of head rest influence is concerned.

PMID- 11219763
TI  - A study of the discriminability of shape symbols by the foot.
AB  - An experiment to test the discriminability of shape symbols using the shod foot
      was performed with 38 blind people (aged 23-72 years). Ten shape symbols which
      were 5 mm thick and fitted into a 30.5 cm2 tile were presented to subjects to
      identify by using only their feet. Each subject had 20 trials in which to
      discriminate the symbols. In each trial, a symbol was selected randomly and
      presented to the subject in randomized orientation. The subject was instructed to
      step on the symbol and to identify it using their own method. Time to
      discriminate a symbol and the accuracy of identification were recorded. A very
      high accuracy (93% on average) was obtained, which is comparable to the accuracy
      of tactile symbol discrimination using the hands. Average time to discriminate a
      symbol was 16 s with a standard deviation of 12.15 s, which indicated the high
      variability of the results. Owing to the high accuracy of identification, tactile
      foot-discriminable symbols have great potential as landmarks for blind people and
      if applied to a tactile guide path they could provide information for orientation
      and navigation.

PMID- 11219764
TI  - Trapezius muscle activity as a risk indicator for shoulder and neck pain in
      female service workers with low biomechanical exposure.
AB  - Electromyographic activity of the upper trapezius muscles was recorded over the
      workday for two groups of service workers, shopping centre (n = 22) and
      healthcare workers (n = 44), both with low observed biomechanical exposure.
      Static and median EMG activity level, number of EMG gaps and gap time were
      determined. The variability of these variables over the workday was examined by
      calculating the coefficient of variation (CV) and the intraclass correlation
      coefficient (ICC) of 1-h consecutive recording periods. All variables except gap
      time showed acceptable reliability (ICC = 0.69-0.78), i.e. the largest fraction
      of variance in the data set was due to intersubject variance, despite relatively
      large hour-to-hour variation (CV = 0.21 0.62). The EMG activity level in the
      trapezius muscles was low (static activity level < 1% EMGmax), despite the high
      prevalence of shoulder and neck pain for both groups of workers. In addition to
      the work recordings, tests were performed to determine intersubject variation in
      muscle activity when adopting a standardized resting posture, and in a dynamic
      muscle activity pattern during paced arm movement. Neither the EMG variables from
      the work recordings nor the tests with EMG recording indicated higher trapezius
      EMG activity levels for workers with pain in the shoulders and neck in this
      study. The low EMG levels are interpreted to indicate a low risk of developing
      shoulder and neck complaints due to biomechanical exposure for both groups of
      workers. The possibility of pain-initiating mechanisms, associated with stress
      and not mediated through muscle activity, is considered in the discussion.

PMID- 11219765
TI  - High-risk human papillomavirus is sexually transmitted: evidence from a follow-up
      study of virgins starting sexual activity (intercourse).
AB  - Genital human papillomavirus (HPV) infection is generally considered to be
      sexually transmitted. However, nonsexual spread of the virus has also been
      suggested. The goal of this study was to assess: (a) the role of sexual
      intercourse in the transmission of HPV; (b) the determinants for seroconversion;
      and (c) the correlation between HPV DNA, abnormal cervical cytology, and
      serological response to HPV16. One hundred virgins and 105 monogamous women were
      randomly selected from a population-based cohort study in Copenhagen, Denmark, in
      which the women were examined twice with 2-year interval (interview, cervical
      swabs, Pap smear, blood samples). The presence of HPV DNA was determined by
      GP5+/6+ primers based HPV-PCR-EIA. HPV 16 virus-like particles (VLP) antibodies
      were detected by ELISA. All of the virgins were both HPV DNA negative and
      seronegative to VLP16, except for one woman who was weakly HPV 6 DNA positive.
      Only those virgins who initiated sexual activity became HPV DNA positive and/or
      VLP16 positive. The most important determinant of HPV DNA acquisition was the
      number of partners between the two examinations. The only significant risk factor
      for HPV 16 VLP seroconversion among women acquiring HPV DNA was HPV type. Our
      results show that sexual intercourse is important in the transmission of HPV, and
      that HPV 16 VLP seroconversion and the development of cervical lesions only occur
      after HPV transmission. Remarkably, no cervical lesions were found in HPV 16 DNA
      positive women who had seroconverted. Although based on small numbers, this may
      suggest that the development of antibodies had a protective effect.

PMID- 11219766
TI  - Screening markers for chronic atrophic gastritis in Chiapas, Mexico.
AB  - Intestinal-type gastric adenocarcinomas usually are preceded by chronic atrophic
      gastritis. Studies of gastric cancer prevention often rely on identification of
      this condition. In a clinical trial, we sought to determine the best serological
      screening method for chronic atrophic gastritis and compared our findings to the
      published literature. Test characteristics of potential screening tests
      (antibodies to Helicobacter pyloni or CagA, elevated gastrin, low pepsinogen,
      increased age) alone or in combination were examined among consecutive subjects
      enrolled in a study of H. pylori and preneoplastic gastric lesions in Chiapas,
      Mexico; 70% had chronic atrophic gastritis. English-language articles concerning
      screening for chronic atrophic gastritis were also reviewed. Sensitivity for
      chronic atrophic gastritis was highest for antibodies to H. pylori (92%) or CagA,
      or gastrin levels >25 ng/l (both 83%). Specificity, however, was low for these
      tests (18, 41, and 22%, respectively). Pepsinogen levels were highly specific but
      insensitive markers of chronic atrophic gastritis (for pepsinogen I <25 microg/l,
      sensitivity was 6% and specificity was 100%; for pepsinogen I:pepsinogen II ratio
      <2.5, sensitivity was 14% and specificity was 96%). Combinations of markers did
      not improve test characteristics. Screening test characteristics from the
      literature varied widely and did not consistently identify a good screening
      strategy. In this study, CagA antibodies alone had the best combination of test
      characteristics for chronic atrophic gastritis screening. However, no screening
      test was both highly sensitive and highly specific for chronic atrophic
      gastritis.

PMID- 11219767
TI  - Familial occurrence of nonmedullary thyroid cancer: a population-based study of
      5673 first-degree relatives of thyroid cancer patients from Norway.
AB  - The purpose of this study was to estimate the occurrence of familial nonmedullary
      thyroid cancer (FNMTC) in a large population-based study. Of the 5274 cases of
      thyroid cancer on record in the Norwegian Cancer Registry between 1960 and 1995,
      a total of 1025 patients could be identified with verified thyroid cancer, a
      unique personal identification number, and a link to at least one parent. For
      patients with nonmedullary carcinoma, 5457 first-degree relatives in 970 families
      were found, compared with 216 first-degree relatives in 37 families for the
      medullary cancers. A standardized incidence ratio (SIR) was calculated among the
      relatives based on rates from the Cancer Registry of Norway. A significantly
      increased risk of thyroid cancer was found among the 5457 relatives of
      nonmedullary index cases, both for males [SIR, 5.2; confidence interval (CI), 2.1
      10.7; 7 cases] and females (SIR, 4.9; CI, 3.0-7.7; 19 cases). All of these 26
      thyroid cancer cases were of the nonmedullary type. Furthermore, an increased
      risk was found among 4282 relatives of papillary index cases, for both males
      (SIR, 5.8; CI, 2.1-12.6; 6 cases) and females (SIR, 4.0; CI, 2.1-7.1; 12 cases).
      The 36 familial papillary thyroid cancer patients had an average age at diagnosis
      of 43 years. Genetic influence is probably only modest for the familial
      nonmedullary cases and clearly weaker than for the classic familial type of
      medullary thyroid cancer.

PMID- 11219769
TI  - DNA repair gene XRCC1 polymorphisms, smoking, and bladder cancer risk.
AB  - Bladder cancer is the sixth most common cancer in the United States. The main
      identified risk factor is cigarette smoking, which is estimated to contribute to
      up to 50% of new cases in men and 20% in women. Besides containing other
      carcinogens, cigarette smoke is a rich source of reactive oxygen species (ROS)
      that can induce a variety of DNA damage, some of which is repaired by the base
      excision repair (BER) pathway. The XRCC1 gene protein plays an important role in
      BER by serving as a scaffold for other repair enzymes and by recognizing single
      strand DNA breaks. Three polymorphisms that induce amino acid changes have been
      found in codon 194 (exon 6), codon 280 (exon 9), and codon 399 (exon 10) of this
      gene. We tested whether polymorphisms in XRCC1 were associated with bladder
      cancer risk and whether this association was modified by cigarette smoking.
      Therefore, we genotyped for the three polymorphisms in 235 bladder cancer cases
      and 213 controls who had been frequency matched to cases on age, sex, and
      ethnicity. We found no evidence of an association between the codon 280 variant
      and bladder cancer risk [odds ratio (OR), 1.2; 95% confidence interval (CI), 0.6
      2.6]. We found some evidence of a protective effect for subjects that carried at
      least one copy of the codon 194 variant allele relative to those homozygous for
      the common allele (OR, 0.59; 95% CI, 0.3-1.0). The combined analysis with smoking
      history suggested a possible gene-exposure interaction; however, the results were
      not statistically significant. Similarly, for the codon 399 polymorphism, our
      data suggested a protective effect of the homozygous variant genotype relative to
      carriers of either one or two copies of the common allele (OR, 0.70; 95% CI, 0.4
      1.3), and provided limited evidence, albeit not statistically significant, for a
      gene-smoking interaction.

PMID- 11219770
TI  - Differential interactions between GSTM1 and NAT2 genotypes on aromatic DNA adduct
      level and HPRT mutant frequency in lung cancer patients and population controls.
AB  - We have studied the influence of GSTM1 and NAT2 genotypes on aromatic DNA adduct
      level (AL) and HPRT mutant frequency (MF) in smokers with newly diagnosed lung
      cancer and matched population controls. AL was analyzed in relation to genotypes
      in 170 cases and 144 controls (113 current/recent smokers and 201 former/never
      smokers), and MF in 157 cases and 152 controls (155 ever smokers and 154 never
      smokers). Both genotypes exhibited the a priori expected effects on AL and MF
      among controls only, especially among smoking controls [significantly lower pack
      years (a pack-year is defined as 1 pack of cigarettes/day for 1 year) than among
      cases]. Among the 42 currently smoking controls, the NAT2 slow genotype [odds
      ratio (OR), 7.5; 95% confidence interval (CI), 1.5-38.4], in particular in
      combination with the GSTM1 null genotype (OR, 19.3, 95% CI, 1.1-338.6 for
      null/slow versus positive/rapid) was strongly associated with high AL. The
      null/slow combination was also significantly associated with high MF among ever
      smokers (cases and controls pooled) with lower pack-years (OR, 3.7; 95% CI, 1.3
      10.7 versus all of the other genotypes; OR, 5.1; 95% CI, 1.2-22.4 versus
      positive/rapid). In contrast, an antagonistic gene-gene interaction was seen
      among smoking cases for both AL and MF. Only currently smoking cases with the
      combined GSTM1 null and NAT2 rapid genotype showed a positive correlation between
      InAL and InMF (r, 0.64; P = 0.1), and an increase of AL with both age and daily
      cigarette use. This genotype combination was also associated with high MF among
      ever-smoking cases (OR, 4.0; 95% CI, 0.9-17.7 versus positive/rapid). There was a
      significant interaction between NAT2 genotype and pack-years of smoking among
      cases, so that the rapid genotype was associated with high MF among ever-smoking
      cases diagnosed at higher pack-years, whereas the slow genotype was associated
      with high MF at lower pack-years. These findings suggest that the influence of
      NAT2 genotype on AL and MF and its interaction with GSTM1 genotype may be dose
      dependent. The NAT2 slow genotype, in particular when combined with the GSTM1
      null genotype, may confer increased susceptibility to adduct formation, gene
      mutation, and lung cancer when the smoking dose is low.

PMID- 11219768
TI  - Polymorphisms of the DNA repair gene XRCC1 and lung cancer risk.
AB  - We explored the association between polymorphisms of the DNA repair gene XRCC1
      (codons 194, 280, and 399) and lung cancer risk in a case-control study nested
      within a cohort of tin miners. Cases were those diagnosed with lung cancer over 6
      years of follow-up (n = 108). Two controls, matched on age and sex, were selected
      for each case by incidence density sampling. Of the three polymorphisms, only the
      XRCC1 Arg280His allele was associated with increased lung cancer risk (odds
      ratio, 1.8; 95% confidence interval, 1.0-3.4) after adjustment for radon and
      tobacco exposure. In addition, individuals with the variant Arg280His allele who
      were alcohol drinkers seemed to be at higher risk for lung cancer compared with
      those with the homozygous wild-type genotype. Conversely, individuals with the
      variant Arg194Trp allele who were alcohol drinkers seemed to be at lower risk for
      lung cancer compared with those with the homozygous wild-type genotype.
      Polymorphisms of XRCC1 appear to influence risk of lung cancer and may modify
      risk attributable to environmental exposures.

PMID- 11219771
TI  - Mammographic density changes during the menstrual cycle.
AB  - The ability to detect small tumors is impaired in dense mammograms. It has been
      suggested that the sensitivity of mammograms could be lower in mammograms
      obtained during the luteal phase of the menstrual cycle. We examined the change
      in mammographic density from the follicular to the luteal phase of the menstrual
      cycle in 11 women. Although the average increase in densities was quite small
      (1.2%; P = 0.08), six women had clinically significant increases (1.4-7.8%),
      suggesting that premenopausal women should undergo mammographic examinations in
      the follicular part of the menstrual cycle.

PMID- 11219772
TI  - Hepatocellular carcinoma and aflatoxin exposure in Zhuqing Village, Fusui County,
      People's Republic of China.
AB  - Hepatocellular carcinoma (HCC) is a common cause of cancer morbidity and
      mortality in Asia and Africa. Epidemiological studies have found that dietary
      exposure to aflatoxin B1 (AFB1) and chronic infection with hepatitis B virus are
      two major risk factors for HCC. We have collated the incidence and mortality data
      of malignant tumors from 1973 to 1999 in Zhuqing Village, Fusui County, an area
      with very high HCC rates, and found that this cancer accounted for 64% of the
      total cancer incidence. Dietary intake of AFB1 was monitored for 1 week in a
      study group consisting of 15 males and 14 females from different households in
      this village. Four of 29 participants (13.8%) and 3 of 15 (20%) male participants
      were hepatitis B virus surface antigen positive. AFB1 was detectable in 76.7% (23
      of 30) of ground corn samples (range, 0.4-128.1 ppb), 66.7% (20 of 30) of cooking
      peanut oil samples (range, 0.1-52.5 ppb), and 23.3% (7 of 30) of rice samples
      (range, 0.3-2.0 ppb) collected from each household. Mean levels of serum AFB1
      albumin adducts in this group were 1.24 +/- 0.31 pmol/mg of albumin at the
      beginning of the study and 1.21 +/- 0.19 pmol/mg of albumin at the end of the
      period. Urinary AFB1 metabolites were detectable in 88.9% (24 of 27) samples
      (range, 0.9-3569.7 ng/24-h urine). These data provide the exposure and disease
      risk information for establishing intervention studies to diminish the impact of
      aflatoxin exposure in this high-risk population.

PMID- 11219773
TI  - Levels of 5-hydroxymethyl-2'-deoxyuridine in DNA from blood of women scheduled
      for breast biopsy.
AB  - Systemic oxidative stress is thought to contribute to risk of various cancers,
      including breast cancer. DNA repair ability also has been associated with breast
      cancer risk. In this work, we examined levels of oxidative DNA damage as an
      indication of breast cancer risk in women because oxidative DNA damage levels
      should reflect the net balance of oxidative stress and DNA repair ability. Levels
      of 5-hydroxymethyl-2'-deoxyuridine, one form of oxidative DNA damage, were
      measured in DNA from blood of women scheduled for breast biopsy. The blood
      samples analyzed included women whose biopsy results indicated invasive breast
      cancer, high-risk lesions (atypical hyperplasia or carcinoma in situ), or benign
      lesions. Mean levels of 5-hydroxymethyl-2'-deoxyuridine were significantly higher
      in blood of women who had high risk or invasive breast lesions versus women with
      benign lesions. If atypical hyperplasia or carcinoma in situ are precursor
      lesions for breast cancer, then these results suggest that oxidative DNA damage
      may be involved in the cancer process before invasive cancer develops.

PMID- 11219774
TI  - NAT2 and NQO1 polymorphisms are not associated with adult glioma.

PMID- 11219775
TI  - No increased Ki67 expression in ductal carcinoma in situ associated with invasive
      breast cancer.

PMID- 11219776
TI  - Germ-line p53 mutations predispose to a wide spectrum of early-onset cancers.
AB  - Germ-line p53 mutations are associated with dominantly inherited Li-Fraumeni
      syndrome (LFS), which features early-onset sarcomas of bone and soft tissues,
      carcinomas of the breast and adrenal cortex, brain tumors, and acute leukemias.
      However, carriers of germ-line p53 mutations may also be at increased risk of
      other cancers. To clarify the tumor spectrum associated with inherited p53
      mutations, we examined cancer occurrences among our series of 45 families, plus
      140 other affected cases and kindreds reported in the literature. The analyses
      included all cancers in patients with a germ-line p53 mutation and their first
      degree relatives with nearly 50% likelihood of being a carrier. Data were
      abstracted on tumor types and ages at diagnosis in eligible family members, and
      duplicate reports were excluded. Among 738 evaluable cancers, 569 (77%) were the
      six tumor types (breast and adrenocortical carcinomas, sarcomas of the bone and
      soft tissues, brain tumors, and leukemias) associated with LFS. The remaining 169
      (23%) cancers included diverse carcinomas of the lung and gastrointestinal tract,
      lymphomas, and other neoplasms that occurred at much earlier ages than expected
      in the general population. Unusually early ages at diagnosis are characteristic
      of hereditary cancers and suggest that carriers of germ-line p53 mutations are at
      increased risk of a wide range of neoplasms. Future studies addressing age
      specific penetrance and site-specific cancer risks can increase the utility of
      LFS as a model for understanding the role of p53 alterations in carcinogenesis
      and for designing diagnostic and preventive interventions for the broad array of
      neoplasms in this syndrome.

PMID- 11219778
TI  - Evaluation of self-collected cervicovaginal cell samples for human papillomavirus
      testing by polymerase chain reaction.
AB  - As human papillomavirus (HPV) becomes accepted as the central cause of cervical
      cancer, longitudinal studies are shifting focus away from causality to a more
      detailed investigation of the natural history of HPV infections. These studies
      commonly require repeated samples for HPV testing over several years, usually
      collected during a pelvic exam, which is inconvenient to the participants and
      costly to the study. To alleviate the inconvenience and cost of repeated clinic
      visits, it has been proposed that women collect cervicovaginal cells themselves,
      hopefully increasing participation in the natural history studies. We evaluated
      the technical feasibility of self-collection of cervicovaginal cells using a
      Dacron swab for HPV DNA detection. We compared the self-collected swab sample and
      two clinician-administered swab samples (one from the endocervix and another from
      the ectocervix) from a total of 268 women participating in a case-control study
      of adenocarcinoma and squamous cell carcinomas of the uterine cervix (111 cases
      and 157 controls). HPV DNA was detected and genotyped using an L1 consensus PCR
      assay. The overall agreement between the clinician- and self-collected swabs was
      excellent [88.1%; kappa = 0.73 (95% confidence interval (CI), 0.61-0.85)]. The
      correlation was highest between the two clinician-administered swabs [kappa =
      0.81 (95% CI, 0.69-0.93)] but was still excellent when comparing either clinician
      administered swab to the self-administered sample [kappa = 0.75 (95% CI, 0.63
      0.87) and 0.67 (95% CI, 0.55-0.79) for ectocervix and endocervix, respectively].
      The type-specific agreement between samples was higher for high-risk, or cancer
      associated, HPV genotypes than for low risk, noncancer-associated HPV genotypes
      when comparing the self-administered swab sample to the clinician-administered
      swab sample (kappa = 0.78 for high-risk versus 0.66 for low-risk HPV infections,
      t = -1.45, P = 0.15). The decrease in agreement for low risk types was largely
      attributable to an increased detection of these types in the self-administered
      sample (McNemar's chi2 = 6.25, P = 0.01 for clinician- versus self-administered
      swab comparisons). The agreement did not vary significantly by age, menopausal
      status, case status, or clinic center. We have demonstrated that a self-collected
      Dacron swab sample of cervicovaginal cells is a technically feasible alternative
      to clinician-administered cervical cell collection in natural history studies of
      HPV and cervical cancer.

PMID- 11219779
TI  - Defining moments in medicine. Pathology.

PMID- 11219777
TI  - Sulfotransferase 1A1 polymorphism, endogenous estrogen exposure, well-done meat
      intake, and breast cancer risk.
AB  - Sulfotransferase (SULT) 1A1 is involved in the inactivation of estrogens and
      bioactivation of heterocyclic amines and polycyclic aromatic hydrocarbons. A G--
      >A transition at codon 213 (CGC/Arg to CAC/His) of the SULT1A1 gene was reported
      recently, and individuals homozygous for the His allele have a substantially
      lower activity of this enzyme than those with other genotypes. We hypothesized
      that the His allele may be a risk factor for breast cancer, particularly among
      women who had risk factors related to higher endogenous estrogen exposure. This
      hypothesis was investigated in a case-control study conducted in a cohort of
      postmenopausal Iowa women who completed a mailed questionnaire in 1986 on
      lifestyle factors including information on major breast cancer risk factors. DNA
      samples and information related to well-done meat intake were obtained from
      breast cancer cases diagnosed between 1992 and 1994 and a random sample of cancer
      free cohort members. Multivariate analysis was performed on data from 156 cases
      and 332 controls who donated a blood sample. The frequency of the His allele was
      41.6% in cases and 34.1% in controls (P = 0.03), and the risk of breast cancer
      was increased with the number of His alleles (P for trend = 0.02). Compared with
      women with the Arg/Arg genotype, an 80% elevated risk was observed among women
      homozygous for the His allele (95% confidence interval, 1.0-3.2; P = 0.04). This
      positive association was more pronounced among women who drank alcohol and had a
      high body mass index, early age at menarche, and late age at menopause, factors
      related to high endogenous estrogen exposure, than among those who did not have
      these risk factors. The risk of breast cancer was elevated with increasing
      doneness level of red meat intake among women with the Arg/Arg genotype (P for
      trend, 0.01) or the Arg/His genotype (P for trend, 0.10), whereas this
      association was not evident for women with the His/His genotype. The results from
      this study suggest that homozygosity for the SULT1A1 His213 allele may be a risk
      factor for breast cancer, and its effect may be modified by the exposure level of
      endogenous estrogens and heterocyclic amines.

PMID- 11219780
TI  - Defining moments in medicine. Surgery.

PMID- 11219782
TI  - Defining moments in medicine. Radiology.

PMID- 11219781
TI  - Defining moments in medicine. Obstetrics and gynaecology.

PMID- 11219783
TI  - Defining moments in medicine. Paediatrics.

PMID- 11219784
TI  - Defining moments in medicine. Anaesthesia.

PMID- 11219785
TI  - Defining moments in medicine. Psychiatry.

PMID- 11219786
TI  - Death, disease and diversity in Australia, 1951 to 2000.
AB  - There has been a substantial decline in mortality in Australia during the 20th
      century, with a major improvement in life expectancy. There has been a broad
      "health transition", from a pattern of high mortality from infectious diseases to
      one of lower overall mortality from non-communicable diseases and injury. From
      1951, trends in death rates from major causes were evident, with the rise and
      partial fall of two epidemics (coronary heart disease and stroke, and lung
      cancer). This overall picture masks significant inequalities in health for
      Indigenous people and the socioeconomically disadvantaged.

PMID- 11219787
TI  - Expansion and diversification of medical education in Australia, 1951-2000.
AB  - Australia's present diverse and dynamic medical education environment has been
      shaped by: university funding increases by governments in the 1960s and 70s to
      promote Australia as a "clever" country; the Karmel Report's recommendations of
      increases in student numbers, new medical schools and a community focus for
      medical education; the successful innovations in entrance requirements and
      curricula of the most recent medical schools -Newcastle and Flinders; the
      formation of the Australian Medical Council, with a mandate to replace the
      British General Medical Council's accreditation of and restrictions on Australian
      medical school courses; the Doherty Report, which identified the close
      relationship between medical education, funding and workforce issues; the change
      to graduate entry and a four-year course for several Australian medical schools;
      and changing patterns of healthcare delivery, the imperative for increasing
      access to healthcare in rural areas, and the communication revolution made
      possible by information technology.

PMID- 11219788
TI  - A half-century of Australian health and medical research.
AB  - In 1951, the Journal published an overview of medical research in Australia since
      Federation. This concluded that, with a few notable exceptions, discoveries were
      few and research funding was paltry. In contrast, in 2001, Australia has become a
      significant contributor to international medical research. Three Australians have
      been awarded Nobel Prizes for research performed in Australia, and others have
      received international awards. Research growth has been driven by the development
      of the tertiary education sector and independent medical research institutes.
      Nevertheless, there is no room for complacency.

PMID- 11219789
TI  - Celebrating the centenary of Federation.

PMID- 11219790
TI  - Half a century of healthcare in Australia.

PMID- 11219791
TI  - A short history of vaccination in Australia.
AB  - It is almost 50 years since infant vaccination for diphtheria, pertussis and
      tetanus became routine in Australia. Since then, the incidence of vaccine
      preventable diseases has declined dramatically. We have used existing records and
      the recollections of experts to compile a history of vaccination in Australia,
      focusing on vaccines in the current childhood schedule.

PMID- 11219794
TI  - Fifty years of medical specialisation: from foundation to fragmentation.
AB  - The past 50 years of medicine have been dominated by revolutions in biological
      sciences and clinical therapeutics. No less dramatic have been changes in our
      healthcare systems, with medical specialisation playing a leading role. The
      middle of the century saw the rapid development of the teaching hospital as the
      centre of professional education, collegiate identity, medical specialisation and
      clinical research. By contrast, the past 20 years have seen dramatic shifts in
      response to the demands of a more diverse community.

PMID- 11219793
TI  - The growth of ethics in medicine over the past 50 years.

PMID- 11219795
TI  - Pharmacotherapeutics: what a difference five decades makes!
AB  - Our ability to prevent, cure or modify disease, as compared with relieving
      symptoms, has changed beyond recognition in the past half century. With the
      completion of the Human Genome Project and rapid advances in understanding of
      molecular biology and in technologies, our ability to target disease mechanisms
      and optimise an individual's responses will improve exponentially.

PMID- 11219796
TI  - Women in medicine: two generations.

PMID- 11219797
TI  - Medical themes on Australian coins.

PMID- 11219798
TI  - Preoccupations of the medical profession in Australia 100 years ago.

PMID- 11219799
TI  - On the writing and reading of obituaries.

PMID- 11219801
TI  - A golden age defined.

PMID- 11219802
TI  - Defining moments in medicine. General practice.

PMID- 11219803
TI  - Defining moments in medicine. Internal medicine.

PMID- 11219804
TI  - Global phytochemistry: the ethnobotanist view.

PMID- 11219805
TI  - Investigation of avenacin-deficient mutants of Avena strigosa.
AB  - The biosynthesis of cyclic triterpenoids in ten saponin-deficient (sad) mutant
      varieties of the diploid oat Avena strigosa is reported. Two mutants were found
      to be deficient in 2,3-oxidosqualene:beta-amyrin cyclase (OSbetaAC) (EC 5.4.99)
      and thus unable to produce the beta-amyrin necessary for the production of
      avenacins. The other mutants studied had post beta-amyrin lesions. 2,3
      Oxidosqualene:cycloartenol cyclase (OSCC) (EC 5.4.99.8) needed for sterol
      formation was present in all ten mutants.

PMID- 11219806
TI  - The study of a monocotyledon abscission zone using microscopic, chemical,
      enzymatic and solid state 13C CP/MAS NMR analyses.
AB  - We have investigated distinguishing features in cells of the abscission zone of a
      monocotyledon fruit, the oil palm Elaeis guineensis. The cell walls of the
      abscission zone and the subtending mesocarp and pedicel have been analysed by
      light and transmission electron microscopy, by chemical methods and by solid
      state 13C CP/MAS NMR spectroscopy. Results show that these abscission zone cells
      have specific characteristics which include high levels of unmethylated pectin in
      the walls and an inducible (x35) polygalacturonase enzyme expression. Together
      these findings help to explain the localised precision of cell separation events.

PMID- 11219807
TI  - The ABC-like vacuolar transporter for rye mesophyll flavone glucuronides is not
      species-specific.
AB  - In many cases, the vacuolar uptake of secondary metabolites has been demonstrated
      to be strictly specific for a given compound and plant species. While most plants
      contain glycosylated secondary substances, few cases are known where flavonoids
      may also carry negative charges, e.g. as glucuronide conjugates. Vacuolar
      transport of glucosylated phenylpropanoid derivatives has been shown to occur by
      proton substrate antiport mechanisms (Klein, M., Weissenbock. G., Dufaud, A.,
      Gaillard, C., Kreuz, K., Martinoia, E., 1996. Different energization mechanisms
      drive the vacuolar uptake of a flavonoid glucoside and a herbicide glucoside. J.
      Biol. Chem. 271, 29,666-29,671). In contrast, flavone glucuronides appearing
      specifically in rye mesophyll vacuoles are taken up by direct energisation
      utilising MgATP, strongly arguing for the presence of an ATP-binding cassette
      (ABC) transporter belonging to the subfamily of multidrug resistance-associated
      proteins (MRP) on the rye vacuolar membrane (Klein, M., Martinoia, E., Hoffmann
      Thoma, G., Weissenbock, G., 2000. A membrane-potential dependent, ubiquitous ABC
      like transporter mediates the vacuolar uptake of rye flavone glucuronides
      regulation of glucturonide uptake by glutathione and its conjugates. Plant
      Journal 21, 289-304). MRPs are known to transport negatively charged organic
      anions. Results presented here suggest that the vacuolar directly energised MRP
      like glucuronate pump for plant-specific flavone glucuronides is ubiquitously
      present in diverse plant species since rye flavone glucuronides are taken up into
      vacuoles isolated from the barley mesophyll or from the broccoli stalk parenchyma
      representing two species which do not synthesise glucuronidated secondary
      compounds. According to the transport characteristics and inhibition profile
      observed we propose the existence of a high-capacity, uncoupler-insensitive
      vacuolar ABC transporter for flavone glucuronides and possibly other negatively
      charged organic compounds -- plant-born or xenobiotic -- irrespective of the
      plant's capability to endogenously produce glucuronidated compounds.

PMID- 11219808
TI  - In vitro inhibition of Sphaeropsis sapinea by natural stilbenes.
AB  - The effects of pinosylvin, pinosylvin monomethyl ether, pinosylvin dimethyl
      ether, and resveratrol on the fungal shoot blight and canker pathogen of conifers
      Sphaeropsis sapinea were examined in vitro. Effects of compounds, isolates, and
      concentrations on both conidial germination and mycelial growth were significant
      (values of P < 0.001), indicating inhibitory activity of these compounds.

PMID- 11219809
TI  - Bioactive humulene derivatives from Asteriscus vogelii.
AB  - The bioactive fractions obtained from the extract of Asteriscus vogelii afforded
      a new humulene derivative, the 8-oxo-6,7,9,10-tetrahydrohumulen-1,12-olide (1),
      in addition to the known asteriscunolides A (2), C (3) and D (4), and the acids 8
      oxo-alpha-humula-6Z,9Z-dien-12-oic acid (5), 8-oxo-alpha-humula-6E,9Z-dien- 12
      oic acid (6) and 8-oxo-alpha-humula-6E,9E-dien-12-oic acid (7), characterized as
      their methyl esters. Evaluation of their phytotoxic and cytotoxic activities was
      accomplished. Compounds 3 and 4 gave the highest inhibition of plant cell
      cultures and of the plant Lemna paucicostata. Compound 4 was also the most active
      against P-338 lymphoma in mice, A-549 carcinoma of human lung, HT-29 carcinoma of
      human colon and MEL-28 human melanoma.

PMID- 11219810
TI  - A new triterpenoid from the fern Adiantum lunulatum and evaluation of
      antibacterial activity.
AB  - A new triterpenoid, 22,29xi-epoxy-30-norhopane-13beta-ol (1) was isolated
      together with six known compounds viz., fern-9(11)-en-6alpha-ol. fern-9(11)-ene,
      fern-9(11)-en-25-oic acid, fern-9(11)-en-28-ol, filicenol-B, adiantone and
      oxidation product of fern-9(11)-en-6alpha-ol obtained as 6-oxofern-9(11)-ene from
      the whole plant of Adiantum lunulatum, and their structures were elucidated by
      means of spectroscopic analysis and antibacterial evaluation of these compounds
      were conducted.

PMID- 11219812
TI  - Further glucosides of lichens' acids from Central Asian lichens.
AB  - Eight compounds isolated from an extract of Central Asian lichens comprised new
      glucosides having murolic, protoconstipatic and allo-murolic acids as the
      aglycones and a saccharide moiety linked at C-18 made up of four glucoses. The
      structures were elucidated using extensive spectroscopic analysis (1D and 2D NMR,
      MS, IR, UV and CD) and by chemical methods.

PMID- 11219811
TI  - Diterpenoids from Azorella yareta and their trichomonicidal activities.
AB  - Diterpenoids with trichomonicidal activity were isolated from the aerial parts of
      Azorella yareta Hauman. One was 13beta-hydroxyazorellane, together with the known
      constituents mulinolic acid, mulin-11,13-dien-20-oic acid, azorellanol and
      13alpha-hydroxyazorellane. Their structures were determined by spectroscopic and
      chemical methods.

PMID- 11219813
TI  - Polyphenolic compounds from Geranium pratense and their free radical scavenging
      activities.
AB  - Two new polyphenolic compounds, myricetin 3-O-(2"-O-galloyl)-beta-D
      glucopyranoside and (-)-6-chloroepicatechin, were isolated from the aerial parts
      of Geranium pratense subsp. finitimum (Woronow) Knuth, along with three known
      polyphenolic compounds [quercetin 3-O-(2"-O-galloyl)-beta-D-glucopyranoside,
      quercetin 3-O-(2"-O-galloyl)-beta-D-galactopyranoside, methyl gallate] and
      tryptophan. Quercetin 3-O-beta-D-glucopyranoside, quercetin 3-O-beta-D
      galactopyranoside, quercetin 3-O-(2"-O-galloyl)-beta-D-glucopyranoside and
      quercetin 3-O-(2"-O-galloyl)-beta-D-galactopyranoside were found to be effective
      against free radical induced impairment of endothelium-dependent relaxation in
      isolated rat aorta.

PMID- 11219814
TI  - Synthesis, characterisation and water sorption properties of pectin
      dehydrogenation polymer (lignin model compound) complex.
AB  - Coniferyl alcohol was polymerised in the presence of pectin and a pectin-DHP
      complex was isolated. Characterisation of the complex has demonstrated that DHP
      (20% wt) was covalently linked by ester bonds to the pectin. The water sorption
      behaviour of the pectin-DHP complex was determined at several relative vapour
      pressures and compared with those obtained on pectin, DHP and a blend of both
      polymers in the same proportion as in the complex. The complex exhibited a lower
      hydrophilicity resulting from three associated phenomena: grafting, pectin-DHP
      interactions and the formation of a chemical network.

PMID- 11219815
TI  - Terpenoids from Guarea rhophalocarpa.
AB  - Four new terpenes including, two sandaracopimaradiene diterpenoids, ent-8(14),15
      sandaracopimaradiene-2alpha,18-diol, and ent8(14),15-sandaracopimaradiene
      2beta,18-diol, and two lanostane triterpenoids, 23-hydroxy-5alpha-lanosta
      7,9(11),24-triene-3-one, and 5alpha-lanosta-7,9(11),24-triene-3alpha,23-diol,
      were isolated from the methanolic extract prepared from the leaves of G.
      rhopalocarpa together with the known steroid stigmasterol and the coumarin,
      scopoletin. The isolates showed weak antiprotozoal activity against Leishmania
      donovani promastigotes, and Trypanosoma brucei brucei blood stream
      trypomastigotes, and were devoid of interesting activity towards Plasmodium
      falciparum. The isolates did not show significant cytotoxic activity against KB
      cells.

PMID- 11219816
TI  - What is your diagnosis? Gas-filled anal glands: normal variant mimicking a
      disease.

PMID- 11219817
TI  - Dental disease in chinchillas in the UK.
AB  - Dental abnormalities are common in chinchillas, although knowledge of the lesions
      responsible for the clinical signs is incomplete. Animals bred in the UK were
      examined to gain further knowledge of dental disease in this chinchilla
      population. Dental abnormalities, particularly those related to tooth elongation,
      were detected on careful external examination of 35 per cent of apparently
      healthy chinchillas. Incisor abnormalities were seen on clinical examination in
      55 per cent of chinchillas presented because of clinical illness. In all but one
      case, this occurred secondarily to crown elongation of the cheek teeth or to the
      absence of opposing teeth, rather than being a primary skeletal problem. Clinical
      signs commonly attributed to malocclusion, such as ventral mandibular swelling,
      weight loss, dysphagia, altered chewing pattern and changed food preferences,
      were not specific to malocclusion, being seen associated with coronal spike
      formation, root elongation and advanced periodontal lesions. Caries and
      resorptive lesions rarely caused clinical signs in this population, but were
      identified during 37 per cent of postmortem examinations. Congenital absence of
      teeth, skeletal malocclusion and pathological loss of teeth all resulted in
      significant clinical signs, but were rare. It is concluded that provision of a
      diet with physical properties more closely matching that of wild chinchillas
      should improve the dental health of captive animals.

PMID- 11219818
TI  - Aortic body chemodectoma causing pulmonary oedema in a cat.
AB  - A seven-year-old male domestic shorthaired cat was presented with persistent
      dyspnoea. Thoracic radiography and echocardiography revealed pulmonary oedema and
      a mass at the base of the heart. At necropsy the mass was found to be an aortic
      body chemodectoma that had metastasised to the sternal lymph node. This is a rare
      tumour in the cat, the third reported case where there was evidence of
      metastasis, and only the second reported case where there was evidence of
      lymphocytic infiltration of the primary tumour. Pulmonary oedema is an unusual
      presentation of this tumour in the cat.

PMID- 11219819
TI  - Dyskinesia in an adult bichon frise.
AB  - Dyskinesias are disorders of the central nervous system that result in
      involuntary movements in a fully conscious individual. This report describes a
      disorder in a five-year-old male neutered bichon frise characterised by episodic
      involuntary skeletal muscle activity with normal levels of consciousness that
      bears some similarity to the previously described movement disorder in boxer
      puppies and to the human condition descriptively referred to as paroxysmal
      dystonic choreoathetosis. The disorder was differentiated from partial motor
      seizure activity by the character of the episodes, absence of identifiable
      preceding aura, absence of autonomic signs and the fact that multiple limbs were
      affected in a varying pattern without generalisation and loss of consciousness.
      Movement disorders are a well documented group of disorders in human neurology,
      but only rarely described in the veterinary literature. The purpose of this
      report is to contribute to an increased awareness of movement disorders within
      veterinary practice.

PMID- 11219820
TI  - Intrathoracic lipoma in a Labrador retriever.
AB  - Pyrexia, granulocytosis and hyperglobulinaemia were the main clinical findings in
      an unusual case of intrathoracic lipoma in a 12-year-old male Labrador retriever.
      The response to antibiotic and anti-inflammatory treatment was poor, prompting
      further investigation. Survey radiographs and ultrasonography revealed a
      cavitated, fluid-filled soft tissue mass in the right hemithorax, which was
      successfully removed resulting in rapid resolution of clinical signs. Lipomas are
      rare intrathoracic extrapulmonary tumours. Previously reported clinical signs are
      dyspnoea and coughing, attributed to the mass effect of the lipoma. The unusual
      presentation in this case was caused by necrosis of the lipoma, probably owing to
      torsion of the pedicle attaching it to the cranial mediastinum.

PMID- 11219821
TI  - Magnetic resonance imaging in the diagnosis and treatment of a canine spinal cord
      injury.
AB  - A nine-year-old female crossbred dog was presented with tetraplegia following a
      fall. No vertebral abnormalities were detectable on plain radiographs of the
      cervical spine. Magnetic resonance imaging scans revealed absence of
      extraparenchymal compression and an area of oedema within the cervical spinal
      cord, suggesting a favourable prognosis. Following nursing care and
      physiotherapy, the dog recovered the ability to walk, although mild neurological
      deficits persisted in the left limbs.

PMID- 11219822
TI  - Resolution of dysphagia following cricopharyngeal myectomy in six young dogs.
AB  - Six young dogs were presented with a history of dysphagia and nasal regurgitation
      since birth. Following cranial nerve examination and assessment of swallowing
      with fluoroscopy, a diagnosis of cricopharyngeal achalasia was made in each case.
      In four dogs, concomitant aspiration pneumonia was present. Sectioning and
      removal of part of the cricopharyngeal muscle resulted in immediate and continued
      resolution of all signs of dysphagia and nasal regurgitation over follow-up
      periods of two to eight years. Postoperative complications were not seen in any
      case. In five of the six dogs, the cricopharyngeal muscle was approached
      laterally, a technique not previously described.

PMID- 11219823
TI  - Practice in the year 2020: the shape of things to come?

PMID- 11219824
TI  - Immunosuppression in bitches with pyometra.
AB  - The function of the immune system was studied in 34 bitches affected by pyometra.
      The mean age of the animals was 8.1 +/- 2.8 years. Samples of peripheral blood
      were examined using a battery of immunological tests. Data obtained from four
      sets of animals, grouped according to the severity of their disease, were
      compared. Leucocytosis (neutrophilia and partial monocytosis) and lymphopenia
      were detected in 62 per cent and 35 per cent of the bitches, respectively. The
      increase in the number of leucocytes was higher in the severely affected bitches.
      Inhibition of mitogen-driven lymphocyte proliferation was the characteristic
      feature of the immunological profile in bitches affected by pyometra, and this
      corresponded with the impairment of the general state of health. Sera from
      bitches showing functional inhibition of lymphocytes suppressed the activity of
      lymphocytes isolated from normal dogs. Sera from bitches affected by pyometra
      also had higher levels of immunoglobulins, lysozyme and circulating immune
      complexes. It can be concluded that pyometra is associated with an inflammatory
      response, but also with a marked suppression of immune system activity.

PMID- 11219825
TI  - Double orthopaedics at Congress 2001.

PMID- 11219826
TI  - WSAVA links up with pet web site.

PMID- 11219827
TI  - Somatic cell hybrids of the Djungarian hamster: malignancy and evolution of the
      karyotype.
AB  - Djungarian hamster somatic cell hybrids were obtained by fusing malignant SV40
      transformed fibroblasts (line DM15, HGPRT-), and normal male lymphoid cells.
      Tumorigenicity, growth in soft agar and karyotype changes of 10 independent
      hybrid clones were studied. All hybrids grew as tumors after injection of new
      born hamsters with 1 x 10(6) cells. A total of 313 tumors occurred in 523
      hamsters. The hybrids proliferated in soft agar as well. No correlation was noted
      between the ability of hybrids to grow in vivo and to form colonies in soft agar.
      The total chromosome number in hybrid cells was usually less than the expected
      sum of the parental chromosome sets. G-banding analysis showed that, in vitro,
      hybrids lost chromosomes of the normal parent, whereas marker chromosomes of the
      malignant parent were retained. In the majority of hybrid tumors the chromosome
      set was reduced to the diploid range. In tumors with a slightly reduced karyotype
      one or two homologues of chromosomes #4 and #8 were, as a rule, eliminated.

PMID- 11219829
TI  - A method to separate the geographical components of temporal change in cancer
      mortality rates.
AB  - This communication sets forth and illustrates a method to isolate local changes
      in cancer mortality rates from national and regional components. The method is
      suggested as a means of identifying note-worthy places for case control and other
      local studies from large data bases with temporal and geographical dimensions.

PMID- 11219830
TI  - Metabolism of benzo[a]pyrene in human epidermal keratinocytes in culture.
AB  - The metabolism of benzo[a]pyrene (BP) in cultured human epidermal keratinocytes
      was investigated using thin layer chromatography, high pressure liquid
      chromatography and cell-mediated mutagenesis assay. Epidermal keratinocytes were
      obtained from skin of normal subjects and all experiments were performed on
      primary cultures. Human epidermal keratinocytes were shown to metabolize BP.
      Analysis of BP metabolites by high pressure liquid chromatography indicated that
      epidermal keratinocytes metabolize BP preferentially at non-K-regions such as
      positions 7, 8, 9 and 10, forming a moderate amount of BP-7,8-dihydrodiol, a
      precursor of the ultimate metabolite, BP-7,8-dihydrodiol-9,10-epoxide. Conjugate
      formation was examined by treating the medium with beta-glucuronidase and
      arylsulfatase. No appreciable amount of conjugates was formed by epidermal
      keratinocytes, except in one culture which gave small peaks eluted in the phenol
      regions after beta-glucuronidase treatment. The metabolic activity of human
      epidermal keratinocytes on BP was further demonstrated by a cell-mediated assay,
      in which V79 Chinese hamster cells were cultured on top of sheets of
      keratinocytes and treated with BP for 48 h. Mutation of the V79 cells,
      demonstrated as ouabain resistance, was induced in a dose-related fashion. The
      extent of induced mutation was higher than that observed using rat embryo cells
      as the activating layer, although the shape of the dose-response curves was
      different.

PMID- 11219828
TI  - N-acetoxy-2-acetylaminofluorene induced unscheduled DNA synthesis of
      granulopoietic precursor cells in chronic myeloid leukemia.
AB  - Studies on N-acetoxy-2-acetylaminofluorene (NA-AAF) induced unscheduled DNA
      synthesis (UDS) of granulopoietic cells were performed in patients with chronic
      myeloid leukemia (CML). Sequential studies were carried out in some patients.
      Both biochemical and autoradiographic methods demonstrated that [3H]dT was
      incorporated into nonreplicating DNA of immature granulopoietic cells after NA
      AAF damage and the 2 methods significantly correlated to each other (r = 0.63, n
      = 19). NA-AAF induced DNA synthesis was lower for myeloblasts than promyelocytes
      and myelocytes. Biochemically determined NA-AAF induced UDS was higher for
      immature granulopoietic cells in blood than in marrow. Sequential studies on
      granulopoietic blood cells suggested that phases of accelerated leukocytosis in
      CML can be preceded by increases of NA-AAF induced UDS. Whether increases in NA
      AAF induced UDS relates to an amplification of repair enzymatic capacity closely
      correlated to the cellular replication capacity, or whether it reflects an
      increased sensitivity to DNA damage induction and the consequences thereof, was
      not resolved in this study. Nevertheless these results are consistent with the
      hypothesis that increases in NA-AAF induced UDS signal the evolution during
      chronic phase CML of cell populations of increasing malignancy which escape
      growth control.

PMID- 11219831
TI  - Uptake and binding of 1-methyl-1-nitrosourea (MNU) and 1-methyl-3-nitro-1
      nitrosoguanidine (MNNG) by the isolated guinea pig pancreas.
AB  - 1-Methyl-1-nitrosourea (MNU) and 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) are
      carcinogens which methylate nucleic acids and proteins and covalently modify
      proteins by carbamoylation (MNU) or guanidination (MNNG). Using MNU and MNNG
      labeled with carbon-14 in the individual carbon positions, the above reactions
      were quantitated in the isolated guinea pig pancreas, an organ susceptible to
      tumorigenesis by MNU. Freshly prepared pancreatic lobules were incubated with the
      labeled drugs (0.03, 0.3 and 1.0 mM) for one hour at 37 degrees C. Alkylated
      purines from hydrolyzed DNA were separated on Sephadex G10 and acid-soluble
      nuclear proteins were extracted and separated on polyacrylamide gels. Total
      uptake of all four labels into lobules was linear with concentration. Acid
      insoluble radioactivity also increased linearly except for MNNG methylation which
      plateaued between 0.3 and 1.0 mM. 7-Methylguanine formation by both compounds was
      approximately ten fold greater than 06-methylation. However, DNA modification by
      MNU exceeded that by MNNG, especially at the higher drug concentrations. No
      carbamoylation or guanidination of DNA was detected. Total binding (methylation
      plus carbamoylation/guanidination) to acid-extractable chromatin proteins was
      equivalent to DNA modification on a molar basis (approximately 0.35 and 0.08
      pmol/microg for exposure to 1.0 mM MNU and MNNG, respectively). All histones were
      labeled by all drug preparations, with H2A being the principal site of
      methylation and H2B, H3 and H1 being the major targets of carbamoylation and
      guanidination. H4 was the least modified histone. Drug binding to cytoplasmic
      organelles also occurred. These results show a broad spectrum of nuclear and
      cytoplasmic modification of pancreatic cells by MNU and, to a smaller extent,
      MNNG.

PMID- 11219832
TI  - Selective inhibition of rat liver nuclear RNA polymerase II by actinomycin D in
      vivo.
AB  - It is well known that actinomycin D, a carcinogen, inhibits DNA-dependent RNA
      synthesis. The interpretation of this inhibition has been that this carcinogen
      binds specifically to the deoxyguanosine moiety of a DNA molecule, and thus
      blocks the template function. This paper presents evidence which suggests that
      this single mechanistic interpretation of actinomycin D action may not be
      adequate in eukaryotic cells. Thirty minutes after actinomycin D injection (250
      microg/100 g body weight), rat liver nuclear RNA synthesis was inhibited by 81%
      and nucleolar RNA synthesis was inhibited by 98%. In order to determine whether
      this inhibition is due to an inhibition of DNA template function or of the RNA
      polymerase activity, the total nuclear free and engaged RNA polymerases were
      solubilized and the individual RNA polymerase species were partially purified by
      DEAE-Sephadex column chromatography. It was found that while the overall enzyme
      activities of RNA polymerase I and III were not affected, there was a selective
      inhibition of RNA polymerase II activity (42%). This result suggests that
      actinomycin D, like aflatoxin B1 and N-hydroxy-2-acetylaminofluorene, inhibits
      nuclear RNA synthesis at multiple sites; it inhibits nucleolar RNA synthesis by
      blocking the nucleolar DNA template function, and it inhibits messenger RNA
      synthesis by inhibiting at least partially the enzyme RNA polymerase II activity
      per se.

PMID- 11219833
TI  - Mutagenicity and toxicity of chromyl chloride and its vapours.
AB  - Chromyl chloride (CC), a liquid Cr6+ compound suspected of carcinogenic activity,
      was assayed for mutagenicity in the Ames reversion test. Due to its high
      volatility and toxic and corrosive properties, handling of CC required particular
      precautions. The liquid phase of CC elicited dose-related mutations in Salmonella
      typhimurium, strain TA100, although it had a limited range of activity because of
      its toxicity to the bacteria. The mutagenic potency and the toxic activity were
      of the same order of magnitude as all the water-soluble Cr6+ compounds so far
      tested. Toxic and mutagenic activities could also be clearly detected by using a
      variety of modifications of the Ames test in CC vapours which indicates the
      particular danger of this chromium compound. In analogy with the other Cr6+
      compounds previously tested in this laboratory, all the effects observed were
      decreased in the presence of S-9 mix containing rat liver post-mitochondrial
      fractions.

PMID- 11219834
TI  - Tumorigenic action of N-n-butyl-N-formylhydrazine in mice.
AB  - Continuous administration of 0.04% N-n-butyl-N-formylhydrazine (BFH) in drinking
      water to 6-week-old randomly bred Swiss mice for life produced tumors of the
      lungs, preputial and clitoral glands. The tumor incidences in these three tissues
      of the treated animals were 87, 66, and 10%, whereas in the untreated controls
      they were 25, 0, and 0%, respectively. Histopathologically, the tumors were
      classified as adenomas and adenocarcinomas of the lungs, squamous cell papillomas
      and carcinomas, angio-, fibro-, and myxo- sarcomas of preputial glands and
      squamous cell papillomas and carcinomas of clitoral glands. N-n-Butyl-N
      formylhydrazine is a structural homologue of the carcinogenic N-methyl-N
      formylhydrazine and N-ethyl-N-formylhydrazine. These studies are integral parts
      of structure activity relationship inquiries.

PMID- 11219835
TI  - A comprehensive quantitative analysis of methylated and ethylated DNA using high
      pressure liquid chromatography.
AB  - Methods were developed for the efficient routine degradation and fractionation of
      ethylated and methylated DNA. Alkylated DNA was hydrolyzed by a neutral thermal
      method to yield 3- and 7- alkylpurines and O2-alkylcytosines. The partially
      apurinic DNA was separated from the bases by precipitation in 0.1 N HCl. Portions
      of the DNA precipitate were further hydrolyzed either by 0.1 N HCl to yield
      purine bases, or by enzymes to yield nucleosides and phosphotriesters. The
      chemical and enzymic digests were fractionated by a combination of high pressure
      liquid chromatography systems to yield quantitative estimates of the following
      products from methylated or ethylated DNA: 1-, 3-, and 7-alkyladenines, O2
      alkylcytosines, 3-, O6-, and 7- alkylguanines and O2-, 3-, and O4-alkylthymines.
      N6-Alkyladenines, 1-alkylguanines and N2-alkylguanines were not detected and the
      3- alkylcytosines were detected but not quantified. Phosphotriesters were
      estimated from the amounts of recovered alkyl phosphotriesters of thymidylyl (3'
      5') thymidine. Using these methods, it was possible to account for 98, 81, 98,
      and 92% of the DNA bound alkyl groups obtained from DNA reacted with [14C]methyl
      methanesulfonate, [3H]ethyl methanesulfonate, N-[3H]-methyl-N-nitrosourea, and N
      [14C]ethyl-N-nitrosourea, respectively. The methods described provide
      reproducible and quantitative methods of analysis for all the known methylated or
      ethylated products in a single DNA sample.

PMID- 11219836
TI  - Induction of mouse epidermal ornithine decarboxylase activity and skin tumors by
      7,12-dimethylben.
AB  - Application of a single large dose (3.6 micromol) or smaller weekly repeated
      doses (0.2 micromol) of 7,12-dimethylbenz[a]anthracene (DMBA) to the skin of CD-1
      mice led to a 20 to 50-fold increase in epidermal ornithine decarboxylase (ODC)
      (EC 4.1.1.17) activity as well as tumor formation. Retinoic acid (0.17-68 nmol),
      a potent inhibitor of both the induction of ODC activity and tumor formation by
      the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA), failed to inhibit
      both the induction of ODC activity and tumor formation by DMBA. In contrast, 7,8
      benzoflavone (367 nmol), which did not inhibit the induction of ODC activity by
      TPA, effectively inhibited the induction of ODC activity as well as the formation
      of skin tumors caused by DMBA. These results indicate that (a) the mechanism of
      the induction of ODC activity and tumor formation by a complete carcinogen
      appears to be different from that of the tumor promoter TPA, (b) DMBA-induced ODC
      activity may be an important component of the mechanism of DMBA carcinogenesis,
      and (c) the protective effect of retinoic acid on skin carcinogenesis is not
      universal; it inhibits skin tumor formation by some agents and not by others.

PMID- 11219837
TI  - Manganese inhibition of sarcoma induction by benzo[a]pyrene in rats.
AB  - The effects of Mn and Cr dusts upon carcinogenesis by polycyclic aromatic
      hydrocarbons were tested in male Fischer 344 rats. In Experiment I, rats were
      given i.m. injections of benzo[a]pyrene (BP, 1.2 mg), Mn dust (4.4 mg), and Cr
      dust (4.4 mg), alone, and in various combinations. By 100 weeks, sarcomas
      occurred at the injection site in 17/20 rats that received BP alone, versus 10/19
      rats that received BP plus Mn dust (P < 0.05). The sarcoma incidences were 0/20
      in 3 control groups that received the vehicle, Mn dust alone, or Cr dust alone,
      and 20/20 in rats that received BP plus Cr dust. In Experiment II, rats were
      given i.m. injections of BP (0.6 mg), 7,12-dimethylbenz[a]anthracene (DMBA, 0.6
      mg), Mn dust (4.4 mg), and Cr dust (4.4 mg), alone, and in various combinations.
      Local sarcomas occurred in 17/20 rats that received BP alone, versus 5/17 rats
      that received BP plus Mn dust (P < 0.001). Sarcoma induction was not inhibited
      when BP was injected in the right thigh and Mn dust in the left thigh (sarcoma
      incidence = 16/20). The sarcoma incidences were 0/19 in a vehicle control group;
      0/18 in 2 control groups that received Mn dust or Cr dust alone; 18/20 in rats
      that received BP plus Cr dust; 14/20 in rats that received DMBA alone; 17/19 in
      rats that received DMBA plus Mn dust; and 13/18 in rats that received DMBA plus
      Cr dust. These experiments show that Mn dust inhibits the carcinogenicity of BP
      when the Mn dust and BP are administered to rats by a single i.m. injection.
      Under identical conditions, Mn dust does not affect the carcinogenicity of DMBA;
      Cr dust does not affect the carcinogenicity of BP or DMBA.

PMID- 11219838
TI  - Detection of unscheduled DNA synthesis in hepatocytes isolated from rats treated
      with genotoxic agents: an in vivo- in vitro assay for potential carcinogens and
      mutagens.
AB  - An assay is described for the measurement of chemically-induced DNA repair in
      cultures of primary rat hepatocytes following in vivo treatment with genotoxic
      agents. Rats were exposed to chemicals then primary hepatocytes were isolated by
      liver perfusion and cultured with [3H]-thymidine. DNA repair was measured as
      unscheduled DNA synthesis (UDS) by quantitative autoradiography. Cells from
      control animals consistently ranged from -2 to -6 net grains (NG). Treatment of
      rats with 10, 1 or 0.1 mg/kg dimethylnitrosamine (DMN), i.p., yielded 36.6, 6.4
      and -0.9 NG, respectively; 10 mg/kg DMN, per os (p.o.), produced 22.2 NG. Oral
      doses of 50 or 5 mg/kg acetylaminofluorene (AAF) yielded 14.0 and 6.4 NG,
      respectively. Carbon tetrachloride (CCl4) at 100 or 10 mg/kg, p.o., yielded -3.2
      and -5.1 NG, respectively. Thus, dose-related increases in UDS were observed for
      the hepatocarcinogens DMN and AAF while vehicle controls and the hepatotoxin CCl4
      produced no response. An examination of the time-course of DNA repair following
      DMN treatment shows a linear decline in UDS during the first 24 h post-treatment
      followed by a slower decline from 24 to 48 h. These results indicate that this
      assay is a potentially useful system for assessing the genotoxic and potential
      carcinogenic activity of chemicals in the whole animal.

PMID- 11219839
TI  - The tumour promoter TPA does not affect mutation to ouabain resistance in L5178Y
      mouse lymphoma cells.
AB  - Following treatment with ultraviolet light or ethyl methane-sulphonate mouse
      lymphoma L5178Y cells were cultured for different periods in the presence of non
      toxic levels of the tumour promoter 12-O-tetra-decanoylphorbol-13-acetate (TPA).
      There were no significant changes in either the spontaneous or induced
      frequencies of ouabain-resistant variants recovered after TPA treatment. These
      results confirm that any effect of TPA on mutagenesis may be by modifying
      metabolic cooperation and the recovery of resistant cells.

PMID- 11219840
TI  - Effect of methyl substitution on mutagenicity of 2-aminodipyrido.
AB  - The mutagenicities of 2-aminodipyrido [1,2-a:3',2'-d] imidazole (Glu-P-2, a
      mutagen obtained from pyrolysate of glutamic acid) and six methyl substituted
      derivatives of Glu-P-2 were tested with Salmonella typhimurium TA98 and TA100
      with S-9 mix. Glu-P-1 (6-Me-Glu-P-2) was the strongest mutagen to TA98 and TA100.
      3-Me-Glu-P-2 was weakest. The presence of a methyl group, and its position were
      shown to affect the mutagenicity significantly.

PMID- 11219841
TI  - The effect of dietary lactulose on experimental large bowel cancer.
AB  - The hypothesis that feeding of lactulose might reduce large bowel tumour
      development was tested in an animal model. One hundred rats were divided into
      groups fed either a standard rat diet with water 'ad libitum', or the same diet
      but with 3.3% lactulose added to the drinking water. Large bowel tumours were
      induced by weekly injections of 1,2 dimethylhydrazine (DMH). There was no
      significant difference between the number of tumours found in the standard diet
      or the lactulose-treated groups. This result does not seem to support the colonic
      flora - bile salt theory of large bowel carcinogenesis.

PMID- 11219842
TI  - Circular dichroism and proton magnetic resonance studies of dApdG modified with 2
      aminofluorene and 2-acetylaminofluorene.
AB  - The conformational properties of 2'-deoxyadenylyl-(3'-5')-2'-deoxyguanosine
      (dApdG) modified by the covalent binding of the carcinogens 2-acetylaminofluorene
      (AAF) and 2-aminofluorene (AF) have been investigated, utilizing circular
      dichroism and proton magnetic resonance spectroscopy. The attachment of AF
      residues to the C-8 position of guanosine introduced smaller changes in the
      circular dichroism spectra of dApdG than the binding of AAF residues. Similarly,
      binding of AF residues caused lower up-field shifts for the H-2 and H-8 protons
      of adenine than the AAF residues. These results suggest that AF residues are less
      stacked with the neighboring A base in dApdG than AAF. Thus, AF residues bound on
      the C-8 position of guanine might induce less distortion in conformation of the
      modified regions than AAF residues.

PMID- 11219843
TI  - Investigation of covalent aflatoxin B1-DNA adducts formed in vivo in rainbow
      trout (Salmo gairdneri) embryos and liver.
AB  - The formation of covalent aflatoxin-DNA adducts has been studied in embryo and
      yearling stages of the rainbow trout (Salmo gairdneri). A linear relationship was
      found between the amount of aflatoxin B1 (AFB1) absorbed into 21-day-old eggs and
      the level of covalent modification of embryo DNA after exposure to 0.25 to 0.5
      p.p.m. aqueous solutions of AFB1 for 1 h; higher concentrations resulted in
      absorption of a greater proportion of AFB1. The principal covalent product,
      identified after acid and enzymatic hydrolysis of isolated embryo DNA, was
      chromatographically identical to 2,3-dihydro-2-(N7-guanyl)-3-hydroxy aflatoxin
      B1. Additional AFB1 derivatives which were present are believed to be formed by
      chemical transformation of this product in DNA producing an aflatoxin
      formamidopyrimidine adduct and the metabolic activation of other aflatoxin
      metabolites, such as aflatoxin M1 and aflatoxin P1. Although the eggs were
      exposed to AFB1 for a short time, covalent modification of DNA was evident over
      an extended period. The highest level of covalent products was present at
      approximately 24 h after exposure to 0.5 p.p.m. AFB1. Ninety-six hours later,
      this level had decreased slightly; however, the distribution of covalent adducts
      had changed: formamidopyrimidine adducts now represented up to 50% of the
      hydrolyzed aflatoxin derivatives. A similar pattern of covalent aflatoxin
      derivatives was found in the liver DNA of yearling trout 10 h after the
      administration of 0.3 mg/kg AFB1.

PMID- 11219844
TI  - Some factors affecting mutant numbers in the Salmonella/microsome assay.
AB  - An examination has been made of some of the parameters which can affect mutant
      numbers in the Salmonella/microsome assay. The type of minimal media plates used
      for the assay and the concentration of glucose-6-phosphate, one of the co-factors
      necessary for mono-oxygenase action, had no effect on mutant numbers. Increases
      in mutated bacteria resulted from the use of (1) log-phase bacteria, (2) higher
      NADP concentrations than those normally recommended, and (3) higher phosphate
      buffer concentrations. Six mutagens, i.e., 2-acetylaminofluorene (AAF), 3,3'
      dichlorobenzidine (3,3'-DCB), cyclophosphamide (CY), aflatoxin B1 (AFB1), 3
      methylcholanthrene (3MC) and benzo[a]pyrene (BP), all requiring mono-oxygenase
      activation, were studied with two Salmonella typhimurium strains, TA98 and TA100,
      and liver preparations from rats given different inducing agent treatments using
      optimum conditions. Phenobarbitone induction was generally superior to Aroclor
      1254 in converting these substrates to mutagens except for the polycyclic
      hydrocarbon substrates. A comparison of 3-methylcholanthrene, Aroclor-1254, beta
      naphthoflavone or phenobarbitone as inducing agents revealed the first three of
      these to be equally effective in activating BP or 3MC to mutagens, whereas
      phenobarbitone was less active. Dual administration of 3-methylcholanthrene and
      phenobarbitone to rats did not result in an additive mutagenic effect using AAF,
      AFB1 or 3,3'-DCB as substrates, the numbers of mutant bacteria obtained being
      only equal to that seen with 3-methylcholanthrene alone. These differences were
      not due to there being different liver protein optima for the various inducing
      agent treatments. The foregoing results are discussed in relation to attempts to
      draw up a rigid protocol for mutagenicity testing.

PMID- 11219845
TI  - Mutagenicity of cimetidine in nitrite-enriched human gastric juice.
AB  - A mutagenic response was obtained in the Salmonella/microsome reversion test by
      preincubating sodium nitrite and cimetidine in human gastric juice from untreated
      individuals, or even by adding nitrite to gastric juice samples from patients
      receiving cimetidine. Both base-pair substitutions (strains TA1535 and TA100)
      and, though very weakly, also frameshift errors (TA1537, TA1538 and TA98) were
      induced by such reaction. Mutagenicity was not affected by S-9 mix containing rat
      liver homogenates, neither in the sense of activation nor of deactivation. The
      optimal reaction occurred at high equimolar concentrations of the two precursor
      compounds, under physiological pH and temperature conditions and within a short
      time of contact. Ascorbic acid was efficient in preventing the formation of
      mutagenic nitrosoderivative(s).

PMID- 11219847
TI  - The metabolism of the 10,11-dihydrodiol of benz[a]-anthracene to a vicinal diol
      epoxide that is not involved in metabolic activation.
AB  - Benz[a]anthracene-10,11-diol, a major metabolite of benz[a]anthracene, is
      metabolized by a rat-liver microsomal system to form anti-BA-10,11-diol 8, 9
      oxide (t-10,r-11-dihydroxy-t-8,9-oxy-8,9,10,11 -tetrahydrobenz[a]anthracene) and,
      to a lesser extent, syn-BA-10,11-diol 8,9-oxide (t-10,r-11-dihydroxy-c-8,9-oxy
      8,9,10,11-tetrahydrobenz[a] anthracene). However, when benz[a]anthracene is
      incubated with DNA in a rat-liver microsomal system, anti-BA-10,11-diol 8,9-oxide
      does not contribute to the covalent binding of this hydrocarbon to DNA.

PMID- 11219846
TI  - The relationship between alkylation of specific DNA bases and induction of sister
      chromatid exchange.
AB  - The mechanism of induction of sister chromatid exchange (SCE) was investigated by
      treating Chinese hamster V-79 cells with two ethylating and two methylating
      mutagens at doses, taken from linear response curves, that produced 30 SCE/cell.
      Concentrations of the DNA alkylation products were measured or calculated at 11
      DNA base sites and at the phosphodiester bond. Ethyl methanesulfonate, N-methyl-
      and N-ethyl-N-nitrosourea produced comparable concentrations (3.3 to 3.5 micromol
      product/mol DNA phosphate) of O6-alkylguanine. Hence, alkylation at O6 of guanine
      appears relevant to SCE induction for these mutagens. Since alkylation at O6 of
      guanine has been positively correlated with mutagenesis in V-79 cells, these
      findings support the suggestion that SCE and mutagenesis can result from a common
      DNA lesion. Methyl methanesulfonate (MMS) produced very little O6-methylguanine,
      but did produce 3-methylthymine and 3-methyladenine, either of which might
      account for the MMS-induced SCE. Thus, for a series of mutagens, induction of SCE
      does not necessarily result from a single specific DNA lesion. Therefore, SCE can
      be considered a qualitative indicator of potential mutagenic events.

PMID- 11219848
TI  - Fluorescence spectral evidence that benzo[a]pyrene is activated by metabolism in
      mouse skin to a diol-epoxide and a phenol-epoxide.
AB  - Hydrolysates of DNA that had been isolated from mouse skin treated with 3H
      labelled benzo[a]pyrene were subjected to chromatography on Sephadex LH20. Two
      major products were eluted in the region expected for deoxyribonucleoside
      hydrocarbon adducts and these were purified further by h.p.l.c. The fluorescence
      emission and excitation spectra of one of the adducts were identical to that of
      the adduct obtained from DNA that was treated with BP-7,8-diol 9,10-oxide (r-7,t
      8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahydrobenzo[a] pyrene). The fluorescence
      emission and excitation spectra of the other adducts were identical to the
      published spectra of 9-OHBP-4,5-diol (4,5-dihydro-4,5,9-trihydroxy
      benzo[a]pyrene) and of the deoxyribonucleoside-hydrocarbon adduct obtained from
      DNA that had been incubated with 9-OHBP (9-hydroxybenzo[a] pyrene) in the
      presence of a rat-liver microsomal system. The metabolic activation of
      benzo[a]pyrene in mouse skin, a target tissue for carcinogenesis by this
      hydrocarbon, thus appears to involve the formation of adducts derived from both
      BP-7,8-diol 9,10-oxide and 9-OHBP 4,5-oxide (9-hydroxybenzo-[a]pyrene 4,5-oxide),
      although quantitatively, the adduct derived from 9-OHBP 4,5-oxide is a minor
      product.

PMID- 11219849
TI  - Tumor promoter produces anchorage independence in mouse epidermal cells by an
      induction mechanism.
AB  - The irreversible shift in anchorage independence by phorbol ester responsive
      mouse epidermal cell lines appears to occur not by a mechanism involving
      selection of preexisting transformants but by induction of a new phenotype.

PMID- 11219850
TI  - Sensitivity of the conformation of deoxyguanosine to binding at the C-8 position
      by N-acetylated and unacetylated 2-aminofluorene.
AB  - The conformation of N-(deoxyguanosin-8-yl)-2-acetylaminofluorene and N
      (deoxyguanosin-8-yl)-2-aminofluorene was investigated by 1H n.m.r. spectroscopy.
      There was rotation about the glycosyl bond and preference for either the anti or
      syn conformation depended on whether or not the 8-arylamino nitrogen was
      acetylated. The unacetylated adduct existed preferentially in the anti form and
      the acetylated adduct existed preferentially in the alternate syn form. There was
      also rotation about the backbone C4' -C5' bond. The unacetylated adduct was
      mainly in the gauche-gauche conformation about C4'-C5', while the acetylated
      adduct was mainly in the alternate gauche-trans/trans-gauche form. Using space
      filling models with the conformation of the unacetylated adduct conserved in the
      helix, a possible structure of modified DNA was proposed which had less
      perturbation of the helix than that of the acetylated adduct. This was consistent
      with single strand endonuclease hydrolysis data. The acetylated and unacetylated
      adducts may cause entirely different types of local conformational changes in DNA
      because of major differences in interactions between the base and the sugar
      moiety at the modified nucleoside level.

PMID- 11219851
TI  - Antibodies to N-hydroxy-2-aminofluorene modified DNA as probes in the study of
      DNA reacted with derivatives of 2-acetylaminofluorene.
AB  - Antibodies were elicited in rabbits immunized with a mixture of methylated bovine
      serum albumin and N-hydroxy-2-aminofluorene reacted DNA (DNA-AF). These
      antibodies were used in competition radioimmunoassays (RIA) with [3H]DNA-AF as
      radioactive antigen and different N-acetoxy-2-acetylaminofluorene (N-AcO-AAF) and
      N-hydroxy-2aminofluorene (N-OH-AF) reacted DNAs, deoxyguanosine, dGMP, dGpA and
      dApG as inhibitors. Based on the results of RIA it is concluded that the binding
      sites of the two residues, -AF and -AAF, to guanosine in DNA, are essentially the
      same. Moreover, the same sites seem to be reactive also in the direct reaction of
      N-AcO-AAF with dGMP. Circular dichroism measurements of modified DNA confirm the
      RIA results.

PMID- 11219852
TI  - Alteration by phenobarbital of membrane-associated enzymes including gamma
      glutamyl transpeptidase in mouse liver neoplasms.
AB  - Administration of phenobarbital for 5 to 7.5 weeks to aged C3HfB/HeN mice with
      spontaneous liver tumors produced an enhancement of gamma glutamyl transpeptidase
      activity in the tumors and a decrease in glucose-6-phosphatase and adenosine
      triphosphatase activity. Discontinuation of phenobarbital feeding for 5.5 weeks
      resulted in the loss of gamma glutamyl transpeptidase activity in tumors. These
      findings of alterations in three membrane-associated enzymes indicate that
      phenobarbital produces substantial changes in the composition of cellular
      membranes which may be related to its promoting activity.

PMID- 11219853
TI  - Hydroxyurea: protection of KB cells against the toxic effect of N-methyl-N'-nitro
      N-nitrosoguanidine.
AB  - This report shows that hydroxyurea (HU) protected KB cells specifically against
      the toxic effect of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). It appears
      unlikely that this action was due to stimulation of DNA repair since HU neither
      protected the cells when added after removal of MNNG, nor shielded them against
      the toxicity of other DNA damaging agents. Similarly, it seems difficult to
      account for HU protection by its specific effect as an inhibitor of DNA
      synthesis, because cell protection was found to be maximal when the proliferative
      activity of the cultures was minimal, and because much higher doses of HU were
      required to ensure cell protection than to inhibit DNA synthesis. In fact, the
      shift of the MNNG dose-response curves in the presence of increasing HU
      concentrations suggests that HU might interfere with the MNNG-molecule. This was
      confirmed by our finding that HU enhanced the decomposition rate of MNNG, as did
      other substances like cysteine or ascorbic acid, which also appeared able to
      protect the cells against the toxic effect of MNNG.

PMID- 11219854
TI  - Monooxygenase, epoxide hydrolase, and glutathione-S-transferase activities in
      human lung. Variation between groups of bronchogenic carcinoma and non-cancer
      patients and interindividual differences.
AB  - Activities of microsomal monooxygenases (MO) and epoxide hydrolase (EH) and
      cytoplasmic glutathione-S-transferases (GST) will contribute to controlling the
      pool of reactive intermediates, enzymatically derived from polynuclear aromatic
      hydrocarbons (PAH) within the cells of target organs such as the human lung.
      Therefore, we studied what interindividual differences exist in these enzyme
      activities and whether there is a correlation between the activities of these
      epoxide forming and metabolizing enzymes in preparations from peripheral lung
      samples and the occurrence of bronchogenic carcinomas in smokers and non-smokers.
      57 samples obtained from surgery were studied. Among them were 12 samples from
      non-smoking patients without cancer as a control group. It is not known whether
      this control group behaves, with respect to the investigated parameters,
      identically to fully healthy people, since in all cases indications existed which
      justified the removal of lung biopsies. Using very sensitive standard assays with
      benzo[a]pyrene, biphenyl, 7-ethoxyresorufin and 7-ethoxycoumarin as substrates,
      MO activity could only be determined as O-deethylation of 7-ethoxycoumarin and
      only after modification of the assay method. Evidence was obtained for the
      presence of a diffusible, but not dialysible, MO inhibitor in human lung
      microsomes. The MO activity (substrate: 7-ethoxycoumarin) in this fraction was
      extremely low in human (100-fold lower than in rat lung preparations), whereas EH
      (substrate: benzo[a]pyrene 4,5-oxide) was slightly (about 2-fold) higher in human
      and GST (substrate: 2,4-dinitrochlorobenzene) had similar activities in both
      species. Interindividual variations of enzyme activities in human lung were
      considerable: MO, 40-fold: EH, 5-fold; GST 10-fold. Compared to the control group
      (non-smokers without cancer) MO activities were slightly but significantly higher
      in lungs from bronchogenic carcinoma patients whether they were smokers (170% of
      controls, p < 0.0005) or non-smokers (320% of controls p < 0.025). MO activities
      of smokers without cancer were only very slightly elevated (140%) of controls, p
      < 0.05). Specific EH activities compared to the control group were slightly but
      significantly increased in smokers without cancer (160% of controls, p < 0.0125)
      and in bronchogenic carcinoma patients whether they used tobacco products (130%
      of controls, p < 0.005) or not (140% of controls, p < 0.05). Specific GST
      activities showed no significant differences (p > 0.1) between the various groups
      studied. The substrate specificity of human lung EH, which was studied using five
      K-region epoxides of various PAH as substrates, corresponded to that in human and
      rat liver and in human, mouse and rat skin and to the pure enzyme isolated from
      rat liver. In contrast to rat liver hepatoma preparations, where EH had been
      shown to be increased in the tumor tissue and had been identified as a
      preneoplastic antigen, EH activity in lung microsomal preparations from samples
      of peripheral squamous cell carcinomas of two subjects had in the tumor tissue
      only one third of the activity of non-diseased areas of the same lung.

PMID- 11219855
TI  - Cleavage of lambda repressor and induction of recA protein synthesis elicited by
      aflatoxin B1 metabolites in Escherichia coli.
AB  - In Escherichia coli lambda lysogens incubated with activated aflatoxin B1, the
      rate of synthesis of RecA protein is markedly increased while lambda repressor is
      cleaved, but not that of the non-inducible mutant lambdacIind-. Following a 10
      min lag period, lambda repressor is almost totally cleaved within 40 min of
      incubation. Cleavage of lambda repressor is inhibited by chloramphenicol.
      Synthesis of RecA protein and cleavage of lambda repressor are two characteristic
      processes induced in E. coil by DNA damaging agents such as u.v. light or
      mitomycin C. Our results favour the idea that in aflatoxin B1-treated lysogens,
      DNA lesions activate RecA protein to cleave LexA protein, the repressor of the
      recA gene, and lambda repressor. DNA damage, which may represent a relatively
      small fraction of the total cellular lesions, promotes the derepression of
      specific genes that control epigenetic as well as genetic processes in bacteria.

PMID- 11219856
TI  - Reaction of N-n-butyl-N-nitrosourea with DNA in vitro.
AB  - N-n-[1-14C]Butyl-N-nitrosourea was synthesized from n-[1-14C]butanol and
      incubated at physiological conditions (pH 7.2; 37 degrees C) with calf thymus DNA
      in vitro. Following mild acid hydrolysis, purine bases were separated by Sephadex
      G-10 and cation exchange chromatography. 3-n-Butyladenine, 7-n-butylguanine and
      O6-n-butylguanine were identified as major reaction products. The O6-/7
      butylguanine ratio was 0.69, indicating that the relative extent of oxygen
      alkylation by n-butylnitrosourea is similar to that produced by ethylnitrosourea.

PMID- 11219857
TI  - Metabolic activation of 3-methylcholanthrene in mouse skin: fluorescence spectral
      evidence indicates the involvement of diol-epoxides formed in the 7,8,9,10-ring.
AB  - Hydrolysates of DNA that had been isolated from mouse skin treated with 3H
      labelled 3-methylcholanthrene were subjected to chromatography on Sephadex LH20
      columns and 3H-labelled products that eluted in the region expected for
      nucleoside-hydrocarbon adducts were purified further by high pressure liquid
      chromatography; eight major and one minor products were resolved and their
      fluorescence spectra were determined using photon-counting
      spectrophotofluorimetry. The fluorescence spectra of six of the major products
      are anthracene-like and are similar to the previously-reported spectrum of
      7,8,9,10-tetrahydro-3-methylcholanthrene, a result that is consistent with
      metabolic activation involving diol-epoxide formation in the 7,8,9,10-ring of 3
      methylcholanthrene. The fluorescence spectra of the other two major products are
      also anthracene-like, but their maxima are shifted to longer wavelengths relative
      to the maxima in the spectrum of 7,8,9,10-tetrahydro-3-methylcholanthrene. The
      minor product possesses a fluorescence spectrum that is not anthracene-like and
      that is dissimilar from the spectra of products formed from 3-methylcholanthrene
      11,12-oxide.

PMID- 11219858
TI  - Preferential methylation of target organ DNA by the oesophageal carcinogen N
      nitrosomethylbenzylamine.
AB  - Male Wistar rats received a single i.v. injection of the oesophageal carcinogen N
      nitroso[methyl-14C]-methylbenzylnitrosamine (2.5 mg/kg body weight). Rapid
      distribution of the carcinogen occurred, with highest initial concentrations in
      liver and kidney. Within 10 min after the injection, 14C-labelled metabolites
      accounted for 50% of the total radioactivity present in the oesophagus, for
      approximately 25% in liver and forestomach, and for less than 20% in all other
      organs investigated. Decay of the carcinogen in rat serum followed first-order
      kinetics with a half-life of 35 min. Of the total radioactivity administered, 49%
      was exhaled as 14CO2 within 10 h and an additional 5-10% was excreted via urine
      and faeces. Four hours after a single i.v. injection of N-nitroso-[methyl
      14C]benzylnitrosamine methylation of purine bases in DNA was most extensive in
      the oesophagus, followed by liver, lung and forestomach DNA. In the remaining
      tissues, DNA methylation was either considerably less (kidney, glandular stomach,
      spleen) or not at all detectable (ileum, colon, brain). At this time the
      concentration of the promutagenic base O6-methylguanine in oesophageal DNA was
      six times higher than in lung and nine times higher than in hepatic DNA. These
      data suggest that in the rat the selective induction of oesophageal tumours by N
      nitrosomethylbenzylamine and related asymmetrical nitrosamines is mediated by a
      preferential bioactivation of the carcinogen in the target organ.

PMID- 11219859
TI  - Mutagenicity in Salmonella typhimurium of N-3-methylbutyl-N-1-methyl-acetonyl
      nitrosamine and N-methyl-N-benzylnitrosamine, N-nitrosation products isolated
      from corn-bread contaminated with commonly occurring moulds in linshien county, a
      high incidence area for oesophageal cancer in Northern China.
AB  - Two synthetic N-nitrosamines (N-3-methylbutyl-N-1-methyl acetonylnitrosamine and
      N-methyl-N-benzylnitrosamine), previously isolated from corn-bread which had been
      inoculated with moulds occurring in Linshien county, Northern China and
      subsequent nitrosation by sodium nitrite, were tested in Salmonella typhimurium
      strains TA1535 and TA100 in the presence of a liver postmitochondrial supernatant
      from Aroclor-treated rats. A concentration-dependent increase in the number of
      mutant colonies in both bacterial strains was observed when N-3-methylbutyl-N-1
      methylacetonyl-nitrosamine was assayed in liquid suspension and N-methyl-N
      benzylnitrosamine in plate incorporation assays. Our finding that mutagenic N
      nitrosamines are present in foodstuffs that may be consumed in Linshien county
      are discussed in relation to the possible etiological role of these compounds in
      cancer of the oesophagus in that area.

PMID- 11219860
TI  - Metabolic activation of benzo[a]pyrene by a human hepatoma cell line.
AB  - The liver-derived human cell line, Hep G2, has high benzo[a]pyrene-metabolizing
      activity and converts benzo[a]pyrene to intermediates that are mutagenic and that
      bind to DNA. This cell line will be useful for studying metabolic activation of
      polycyclic aromatic hydrocarbons and other xenobiotics by human tissue and as an
      activation system in short-term screening assays for identifying compounds with
      carcinogenic potential for humans.

PMID- 11219861
TI  - Correlation of nucleic acid binding by metabolites of trans-4-aminostilbene
      derivatives with tissue specific acute toxicity and carcinogenicity in rats.
AB  - The reaction with macromolecules was determined in various tissues of female
      Wistar rats 24 h following a single oral administration of [3H]-trans-4
      dimethylamino- and [3H]-trans-4-acetylaminostilbene. Total binding to proteins
      was 4-9 times greater than to nucleic acids in most tissues. Binding to RNA and
      DNA was very similar and greatest in liver, about 1/4 in kidney and 1/8 - 1/10 in
      lung, glandular stomach (target tissue for acute toxicity), bladder, mammary
      glands and Zymbal glands (target tissue for carcinogenicity). The target tissues,
      therefore, appear not to be notably exposed to reactive metabolites. The pattern
      of adducts was analyzed by Sephadex LH20 chromatography of RNA and DNA
      hydrolysates from liver, glandular stomach, lung and kidney. It was found to be
      very similar qualitatively. DNA-bound metabolites were very persistent in the non
      target tissues liver and kidney, t 1/2 being 34 and 60 days, respectively. Some
      of the major adducts in liver were not eliminated at all within 4 weeks. It thus
      appears that aminostilbene derivatives represent examples of strong and genotoxic
      carcinogens for which the extent and persistence of primary DNA lesions are not
      correlated with the biological effect.

PMID- 11219862
TI  - Retinoids inhibit 2,3,7,8-tetrachlorodibenzo-p-dioxine-induced activity of
      benzo[a]pyrene metabolizing enzymes in human diploid fibroblasts.
AB  - Retinoids are known to inhibit the substrate mediated enzyme induction of
      benzo[a]pyrene metabolizing enzymes. Consequently, the effect of two retinoids on
      the induction of benzo[a]pyrene metabolizing enzymes by the more potent inductor
      2,3,7,8-tetrachlorodibenzo-p-dioxine (TCDD) was investigated. The studies were
      performed with human diploid fibroblasts in culture. Vitamin A palmitate and all
      trans-retinoic-acid were found to prevent the TCDD induced increase of
      benzo[a]pyrene metabolism in a dose-dependent manner. The fact that this effect
      was immediately reversible makes it unlikely that it was due to non-specific
      toxic effects. The data suggest that retinoids cause a preferential inhibition of
      the de novo synthesis of benzo[a]pyrene metabolizing enzymes.

PMID- 11219863
TI  - The influence of occupation on health--some results from a study in the UK oil
      industry.
AB  - This study describes the patterns of mortality of 35,000 male employees, with a
      minimum of 1 year's continuous service, who worked at 8 refineries in the UK in
      the period 1.1.50-31.10.75. The trace rate of those involved was 99.8%. Overall
      the ratio of observed to expected deaths was 0.84 (O = 4406, E = 5259.9, P <
      0.00001). The numbers of deaths for many of the chronic degenerative diseases
      were lower than 'expected'. The number of observed deaths from all cancers was
      appreciably less than expected (O = 1147, E = 1286.4, O/E = 0.89, P = 0.00006).
      Lung cancer was particularly reduced (O = 416, E = 532.7, O/E = 0.78, P <
      0.00001); there was no excess of leukaemia (in workers including some exposed to
      benzene). Other comparable studies have suggested an excess of gastrointestinal
      cancer. In the present study deaths from oesophageal, stomach, intestinal and
      rectal cancer were slightly raised for all workers (O = 346, E = 328.6, O/E =
      1.05, P < 0.4); this was particularly noticeable for those joining before 1950
      with long service and with increased latent interval. There were also excesses
      based on small numbers of deaths from nasal cancer (O = 7, E = 3.1, O/E = 2.24, P
      < 0.05), and melanoma (O = 14, E = 6.5, O/E = 2.16, P 0.01).

PMID- 11219864
TI  - Studies on a new case of xeroderma pigmentosum (XP3BR) from complementation group
      G with cellular sensitivity to ionizing radiation.
AB  - XP3BR is a fibroblast strain derived from a xeroderma pigmentosum patient
      exhibiting severe mental retardation in addition to the typical changes in the
      skin. No tumours have been observed by 6 years of age. Cells from this patient
      had no detectable excision repair of u.v. damage. The defect in daughter strand
      repair was also characteristic of excision-defective XP's. The material was
      assigned to complementation group G and is the second (unrelated) example from
      this group. XP3BR cells were more sensitive than normal cells to the lethal
      action not only of u.v. but also of gamma irradiation, in contrast to all other
      XP cells tested to date including XP2BI, the other representative of
      complementation group G. The u.v. sensitivity was similar to that of strains from
      complementation groups A and D, confirming the correlation between extreme u.v.
      sensitivity and the presence of neurological defects. Following treatment with
      u.v., XP3BR, and other XPs gave more 6-thioguanine resistant mutants than normal
      cells whether the comparison was made per unit of dose or per lethal event. After
      low doses of gamma irradiation XP3BR cells were more mutable than normal or XP2BI
      cells.

PMID- 11219865
TI  - Carcinogenicity of the isomeric, N-nitroso-delta3-and N-nitroso-delta2
      piperidines in rats and the in vivo isomerization of the delta3-to the delta2
      isomer.
AB  - N-Nitroso-1,2,3,6-tetrahydropyridine (N-nitroso-delta3-piperidine), N-nitroso
      1,2,3,4-tetrahydropyridine (N-nitroso-delta2-piperidine) and N-nitroso-3,4
      epoxypiperidine were tested for carcinogenicity in Fischer 344 rats. The
      unsaturated nitrosamines were administered in drinking water (100 mg/l). The
      epoxide was administered by gavage in corn oil (11.5 mg/ml, 0.2 ml twice a week).
      Both of the unsaturated nitrosamines were potent carcinogens (most of the animals
      died by the 35th week), and both produced many esophageal tumors, a property
      which they have in common with the parent compound, N-nitrosopiperidine. The
      spectrum of the other tumors formed, however, was different. The delta3-isomer
      produced hemangioendothelial sarcomas in the liver, which were absent in the
      tumor spectrum of the delta2-isomer and N-nitrosopiperidine. The delta2-isomer,
      on the other hand, produced tumors of the forestomach and the oropharynx, which
      were essentially absent in the rats treated with the delta3-isomer. N-nitroso-3,4
      epoxypiperidine was a toxic compound (8 deaths in the first 5 weeks), but most of
      the remaining animals survived to 40 weeks. Of these, 8 animals died of induced
      tumors (esophagus and liver). The delta2- and the delta3-isomers were
      administered by gavage to groups of rats and the blood of these animals was
      withdrawn at timed intervals. Analysis of the serum revealed that both of the
      nitrosamines were cleared rapidly from circulation but that at the same time the
      delta3-isomer was being isomerized to the delta2. The reverse transformation did
      not occur in vivo.

PMID- 11219866
TI  - Sister chromatid exchanges and chromosome aberrations in V79 cells induced by
      aflatoxin B1, B2, G1 and G2 with or without metabolic activation.
AB  - Cells from Chinese hamster cell line V79 were pulse treated for one hour with
      aflatoxin (AF) B1, B2, G1 and G2 at various doses with or without the metabolic
      activation system-S9 mix. With metabolic activation, all these toxins caused
      significant increases of frequencies of sister chromatid exchanges (SCE) in a
      dose-dependent manner. Based on the rate of SCE induction, the relative order of
      potency was established as AFB1 > G1 > G2 > B2. Without metabolic activation, all
      four toxins had no or very little effect over the same dose ranges used for SCE
      induction with activation. Induction of chromosome aberrations in V79 cells after
      a one hour pulse treatment with AFB1 and G1 plus S9 mix was also studied. A dose
      and time dependent increase of aberrations was observed for both compounds. AFB1
      again is a more potent aberration inducer than AFG1.

PMID- 11219867
TI  - Polycyclic hydrocarbons induction of diphtheria toxin-resistant mutants in human
      cells.
AB  - Stable spontaneous mutants resistant to diphtheria toxin are present in the human
      cell line (EUE) at a frequency of 0-8 x 10(-6). Mutation increases by a number of
      polycyclic hydrocarbons have been used as an estimate of their carcinogenic
      potency. Eight polycyclic hydrocarbons of decreasing carcinogenic potency were
      assayed: 7,12-dimethylbenz[a]anthracene, 3-methylcholanthrene, benzo[a]pyrene,
      benz[a]anthracene, dibenz[a,c]anthracene, dibenz[a,h]anthracene, chrysene,
      anthracene, and a well known mutagenic substance, ethyl methanesulfonate. In our
      system, which does not require an exogenous source for metabolic activation, the
      most potent hydrocarbons, 7,12-dimethylbenz[a]anthracene, 3-methylcholanthrene
      and benzo[a]pyrene revealed a strong mutagenic effect, whereas three non
      carcinogenic hydrocarbons, anthracene, benz[a]anthracene and chrysene were not
      mutagenic. Our results indicate that there is a relationship between mutagenesis
      and carcinogenic potency for the tested polycyclic hydrocarbons. The maximum
      recovery of diphtheria toxin mutants was observed after an expression time of
      three weeks, corresponding to 10 cell generations.

PMID- 11219868
TI  - Repair of ethylnitrosourea-induced DNA damage in the newborn rat. I. Alkali
      labile lesions and in situ breaks.
AB  - The extreme sensitivity of the developing rat brain to tumor induction by N-ethyl
      N-nitrosourea (ENU) has been ascribed to the relatively inefficient repair of the
      presumed promutagenic lesion O6-ethylguanine from brain DNA. We have compared the
      brain of the newborn rat with liver, kidney and lung with respect to the repair
      of other types of DNA lesions that ENU induces, namely single strand breaks and
      alkali-labile lesions. The induction and repair or loss of these lesions has been
      analysed by alkaline sucrose gradient sedimentation using both mild as well as
      strong alkaline hydrolysis conditions. We found that ENU induces few lesions in
      the DNA of various organs that are detectable as breaks after mild alkaline
      hydrolysis. 24 h after ENU treatment such lesions are no longer detectable in
      brain DNA, while they are detectable in the DNA from other organs up to 10 days
      after ENU treatment. The number of ENU-induced lesions, detectable as breaks
      after strong alkaline hydrolysis, is far larger. These lesions were persistent in
      kidney DNA, disappeared slowly from liver DNA (t(1/2) = about 10 days), and more
      rapidly from brain and lung DNA (t(1/2) = 2-3 days). The latter result seems to
      be in contradiction with various reports that a large fraction of the ENU-induced
      alkali-labile lesions are stable in vivo. This difference between our results and
      those of others might be due to a difference between proliferating and non
      proliferating cells. Whether the alkali-labile lesions are removed from brain and
      lung DNA by a specific repair mechanism or by other causes remains to be
      investigated.

PMID- 11219869
TI  - Induction of sister chromatid exchanges by carcinogens mediated through cultured
      rat liver epithelial cells.
AB  - A cloned, untransformed rat liver cell-line, LNRL (with the normal diploid
      karyotype and epithelial morphology) was tested for use as the metabolizing
      component in a co-cultivation system for carcinogen-screening using sister
      chromatid exchanges (SCE) as the criterion. The well characterized early cultures
      of LNRL cells were co-cultivated with Chinese hamster ovary (CHO) cells, the
      target commonly used for the induction of SCE, and exposed to different
      concentrations of various chemicals for 24 h. Two polycyclic hydrocarbons, 7,12
      dimethylbenz[a]anthracene and benzo[a]pyrene did not produce any SCE in CHO cells
      cultured alone, but produced a significant number of SCE in CHO co-cultivated
      with LNRL. The aromatic amine, 2-acetylaminofluorene, and the potent carcinogenic
      mycotoxin, aflatoxin B1, induced SCE to a limited extent even in CHO cells
      cultivated alone, but in the presence of liver cells the SCE frequency was
      greatly increased. Aflatoxin G2, the least potent of the aflatoxins, also
      produced a response in the co-cultivation system. These results indicate that
      cultured liver cells can be used as the metabolizing cells in co-cultivation
      systems for carcinogen-screening. The advantages of this assay over those
      employing liver microsomal fractions are discussed.

PMID- 11219870
TI  - A high pressure liquid chromatography study on the removal of DNA-bound aflatoxin
      B1 in rat liver and in vitro.
AB  - Following intraperitoneal administration of [3H] aflatoxin B1 (AFB1) to young
      adult male rats, there is rapid uptake of the carcinogen by the liver, the target
      organ for carcinogenesis, leading to DNA covalent binding. Acid hydrolysis of
      this DNA shows that after 2h, the major DNA adduct is trans 8,9-dihydro-8-(7
      guanyl)-9-hydroxy AFB1 (AFB1-gua). By 24h after AFB1 administration the major DNA
      adduct is no longer AFB1-gua but a product with the identical retention time on
      h.p.l.c. to 8,9-dihydro-8-(N5-formyl-2',5',6' triamino-4' oxo-N5-pyrimidyl)-9
      hydroxy AFB1 (AFB1-triamino-Py). 48h after carcinogen administration, only a
      small amount of AFB1-gua remains and the major product is AFB1-triamino-Py. The
      half-life of removal of AFB1-gua is 22h, while AFB1-triamino-Py is much more
      persistent. In vitro incubation studies on DNA isolated from rats treated 2h
      previously with [3H] AFB1 show that at pH 7.4 AFB1-gua is the major product
      released from the DNA with some release of 8,9-dihydro-8,9-dihydroxy AFB1, (AFB1
      diol). If more extensively reacted AFB1-DNA is used than that obtained from in
      vivo administration, then the rate of AFB1-diol release is enhanced while that of
      AFB1-gua is reduced. It would appear, therefore, that much of the release of AFB1
      from DNA in vivo within the first 24h is probably not through a DNA repair
      process but through chemical release arising from the positively charged N7
      guanine. There is considerable conversion of AFB1-gua to AFB1-triamino-Py on in
      vitro incubation of DNA as well as AFB1-gua and AFB1-diol release. By 24h
      approximately 66% of the bound AFB1 is in the form of AFB1-triamino-Py and after
      48h the conversion is complete. The complex pattern of AFB1-release from DNA may
      have important consequences in both the induction of mutations and in tumour
      initiation.

PMID- 11219871
TI  - Evidence for the involvement of lesions other than O6-alkylguanine in mammalian
      cell mutagenesis.
AB  - Marked differences between the mutagenic efficiency of N-methyl-N-nitrosourea
      (MNU), a potent carcinogen, methyl methane sulphonate (MMS) and dimethyl sulphate
      (DMS), both weak carcinogens, have been reported at the hypoxanthine-guanine
      phosphoribosyltransferase (HGPRT) and ouabain loci in V79 cells. Differences in
      levels of O6-guanine methylation produced by these alkylating agents, has been
      interpreted as indicating that O6-methylguanine is the DNA lesion specifically
      responsible for their mutagenic and carcinogenic effects. Because of the
      heterogeneity of molecular events which can result in forward mutation this
      conclusion seems unjustified. The development and characterisation of a reverse
      assay from 6-thioguanine resistance and HAT medium sensitivity (TG(R) and
      HAT(S)), to 6-thioguanine sensitivity and HAT medium resistance (TG(S) and
      HAT(R)) HGPRT(-)-->HGPRT+ in V79 cells, has allowed us to test the above
      hypothesis in a more specific way. Ethyl methane sulphonate, a weak carcinogen
      and MNU, both of which produce significant levels of O atom alkylation, were
      similarly effective mutagens in the reverse direction. At equitoxic doses, DMS
      was 40-60 fold less efficient. There was however, no quantitative correlation
      between numbers of revertants induced and measured levels of O6-alkylguanine.
      From these and other observations it is concluded that O6-alkylguanine is not the
      only potentially mutagenic lesion in mammalian cells.

PMID- 11219872
TI  - Comparative activity of 4,4'-diaminobiphenyl (benzidine) and its terphenyl
      analogue, 4,4'-diaminoterphenyl, in two in vitro assays for potential
      carcinogenicity.
AB  - The carcinogen 4,4'-diaminobiphenyl (benzidine) has been compared in vitro with
      its terphenyl analogue 4,4''-diaminoterphenyl using the Salmonella reverse
      mutation assay and the BHK cell-transformation assay. The responses observed,
      taken together with a consideration of chemical structures, indicate that the
      terphenyl compound is a potential carcinogen. These findings may contribute to an
      understanding of the mechanism of action of benzidine as a carcinogen.

PMID- 11219873
TI  - Metabolism of the bay-region trans-1,2-dihydrodiol of benz[a]anthracene in rat
      liver microsomes occurs primarily at the 3,4-double bond.
AB  - The bay-region hydroxyl groups of benz[a]anthracene (+/-)trans-1,2-dihydrodiol
      are known to be exclusively in quasi-axial conformations. This dihydrodiol was
      stereoselectively metabolized in rat liver microsomes to form two optically
      active 1,2,3,4-tetrahydrotetrols as the predominant products. Thus, the bay
      region axial hydroxyl groups of benz[a]anthracene trans-1,2-dihydrodiol do not
      direct metabolism away from the vicinal 3,4-double bond.

PMID- 11219874
TI  - Evidence-based clinical guidelines for palliative care: the work of the APM
      Science Committee.

PMID- 11219875
TI  - Using bisphosphonates to control the pain of bone metastases: evidence-based
      guidelines for palliative care.
AB  - This work was undertaken by the Science Committee of the Association for
      Palliative Medicine of Great Britain and Ireland (APM) as a demonstration project
      in developing clinical guidelines relevant to palliative care from a pragmatic
      approach to literature review and grading of clinical evidence. CANCERLIT and
      Embase were searched for relevant papers written in English, published since
      1980. Each study identified was rated against agreed criteria for levels of
      evidence. Most studies were not specifically designed to define speed of
      response, and were not undertaken in palliative care patients. Thus, careful
      reading and grading of each study was necessary. Sufficient evidence was
      identified to make recommendations for clinical practice in a palliative care
      population of patients, and areas for future research have been identified.
      Bisphosphonates appear to have a role in managing pain from metastases which has
      been refractory to conventional analgesic management and where oncological or
      orthopaedic intervention is delayed or inappropriate.

PMID- 11219876
TI  - Identifying attitudinal barriers to family management of cancer pain in
      palliative care in Taiwan.
AB  - The purpose of this study was threefold: (1) to examine attitudes held by
      Taiwanese family caregivers of hospice inpatients with cancer that serve as
      barriers to cancer pain management; (2) to determine the relationship of
      attitudinal barriers to family caregiver hesitancy to report pain and to
      administer analgesics; and (3) to determine the relationship of attitudinal
      barriers to the adequacy of analgesics used by the patient. A total of 80 pairs
      of palliative care inpatients and their primary family caregivers participated in
      this study. Family caregivers completed the Barriers Questionnaire-Taiwan (BQT)
      form and a demographic questionnaire. The instruments completed by patients
      consisted of the Brief Pain Inventory-Chinese version and a demographic
      questionnaire. The data revealed that Taiwanese family caregivers of palliative
      care patients with advanced cancer had concerns about reporting pain and
      administering analgesics, particularly as they related to disease progression,
      side-effects and p.r.n. analgesics. Older and less-educated family caregivers
      scored significantly higher on the BQT than did their younger, more educated
      counterparts. Family caregivers' concerns measured by the BQT were related to
      family caregivers' reluctance to administer analgesics to their patients.
      Implications for a broader understanding of analgesics in the advancement of pain
      management in palliative care in Taiwan are discussed.

PMID- 11219877
TI  - Nonwhite ethnicity and the provision of specialist palliative care services:
      factors affecting doctors' referral patterns.
AB  - The aim of this paper was to examine the use of palliative care services by
      members of black/minority ethnic communities. Referral patterns of hospital
      consultants and general practitioners (GPs) to Birmingham St Mary's Hospice were
      examined. Semistructured interviews were carried out to explore doctors'
      perceptions of the benefits and limitations of hospice services for their
      black/minority ethnic patients and to identify potential barriers to referral. In
      total, 27 doctors were interviewed: 15 hospital consultants and 12 GP. The GPs
      were selected according to size of practice within areas of Birmingham with
      significant black/minority ethnic populations. Referrals received by the hospice
      for the period April 1996 to November 1997 were collected from the Hospice's
      computerized database. Results show that, compared to white Europeans, there was
      an underutilization of day care and inpatient hospice services by members of
      black/minority ethnic communities. Doctors did, however, refer their
      black/minority ethnic patients for hospice home-care services: 8.5% of referrals
      received by the hospice were for nonwhite patients. This referral rate increased
      to 19.3% in specific postcode areas known to have significant black/minority
      ethnic communities. Further research is needed to establish levels of awareness,
      explore attitudes towards palliative care services and assess the demand for
      specific services within various black/minority ethnic communities.

PMID- 11219878
TI  - Common threads? Palliative care service developments in seven European countries.
AB  - Since the late 1960s hospice and palliative care services have been developing in
      many European countries. Although attention has been given to patterns of
      development in specific national contexts, so far we lack a comparative
      understanding of how these services are organized and delivered. Such a
      comparison poses certain practical and methodological difficulties. It does,
      however, allow a wider view of the current provision of palliative care in
      Europe, together with a consideration of implications for the future. We report
      on an analysis of palliative care developments in seven European countries which
      gave attention to early origins, patterns of provision, and structural and policy
      integration. We conclude that, despite different processes of development, the
      emergent discipline of palliative care now finds its most congenial home within
      the structures of the formal health care system. Accordingly, inequities between
      the seven countries can be more clearly identified, posing continuing challenges
      to policy makers and planners who operate with a European perspective.

PMID- 11219879
TI  - Dimensions of the role of the social worker in palliative care.
AB  - There has been very little research focusing on the role of the social worker in
      a specialist palliative care service. A qualitative research methodology was used
      which sought to capture the essence of that role, as perceived by those carrying
      it out, rather than simply to approach it as a series of tasks. A specialist
      palliative care social worker was asked to describe her role in selected cases
      that she had worked with. The interviews were taped and transcribed. The data
      were then analysed for themes using the techniques of constant comparative
      analysis. The themes were grouped into six categories and a conceptual framework
      developed. This was then validated with four other experienced social workers.
      Integrating categories in the framework were knowing and working with limits and
      values and valuing. The four other categories, a family focus, being a team
      member, managing the environment and managing anxiety related to the everyday
      activities of the social worker. The results are discussed in relation to social
      work in other specialties and in relation to other professional roles in
      specialist palliative care. Further research is needed to add the perspective of
      the social worker's client to understanding of the role.

PMID- 11219881
TI  - Inter-rater reliability of formally trained and self-trained raters using the
      Edmonton Functional Assessment Tool.
AB  - The primary objective of this study was to determine the inter-rater reliability
      of the revised version of the Edmonton Functional Assessment Tool (EFAT-2). A
      second objective was to determine whether both formally trained and self-trained
      therapists had an acceptable level of inter-rater reliability. The EFAT-2 was
      administered to consenting palliative care patients by one of two independent
      physical therapist rater pairs; one pair self-trained (R1, R2) and the other
      formally trained (R3, R4). The intraclass correlation [ICC (1,1)] for R1, R2 was
      0.97 [95% confidence interval (CI) 0.94-0.99] and for R3, R4 was 0.95 (95% CI
      0.90-0.98). The standard error of measurement was 1.09 and 1.44, respectively.
      The Kappa statistic for the rater pairs on individual EFAT items ranged from 0.17
      to 0.96. The results suggest that both formally trained and self-trained
      therapists obtain an acceptable level of inter-rater reliability when using the
      EFAT-2.

PMID- 11219880
TI  - Death anxiety in brain tumour patients and their spouses.
AB  - When a person is diagnosed with a severe disease, it seems plausible that
      existential questions and death anxiety are easily intensified. The aims of this
      study were to explore whether this is the case, to what extent patients and their
      next of kin experience death anxiety, and how these experiences are expressed.
      Following a purposive sampling technique, 20 patients with brain tumours and 15
      of their next of kin took part in interviews. A content and context analysis were
      performed using a hermeneutic approach, in order to identify and analyse main
      categories. Six main categories common to patients and their next of kin emerged
      during the process: (1) emotional reactions that could be related to death
      anxiety and included general anxiety, anguish, sadness, hope and despair; (2)
      existential fear, existential anxiety and existential pain; (3) contradictions;
      (4) trigger situations; (5) coping strategies related to death anxiety; and (6)
      new values for life. Besides these categories, a further category emerged,
      experiences characteristic of the next of kin. The study shows that both the
      patients and their next of kin are preoccupied with existential thoughts and
      death anxiety. The problems are easily overlooked as the death anxiety is not
      always expressed directly. Staff need to be more aware of these situations in
      order to provide existential support.

PMID- 11219882
TI  - Using videoconferencing in palliative care.
AB  - Recent technological advances and reducing costs have meant that
      videoconferencing is a possible new medium for health-care teams. The IMPaCT
      (Interactive Multimedia Palliative Care Training) project began in 1997 with the
      aims of assessing the practicalities of videoconferencing in palliative care and
      assessing its educational effectiveness. The use of videoconferencing was closely
      evaluated during the first 2 years of the project and this paper presents the
      results of that monitoring. Twenty-two sites were linked worldwide, reaching 136
      professionals without the costs or time needed to travel. The savings on travel
      and time within the UK alone would have paid for the equipment in 1 year. Sites
      only continued with videoconferencing if they reached a point where their
      organization saw the advantages of videoconferencing. Links were easy to
      establish and rarely failed regardless of distance. Users rapidly adapted to the
      new medium, and links could be used in a variety of settings and audiences,
      including journal clubs and expert workshops. Videoconferencing offers a new and
      unique way of supporting palliative care professionals while reducing time and
      costs for both tutors and learners.

PMID- 11219883
TI  - The use of pilocarpine in opioid-induced xerostomia.

PMID- 11219884
TI  - Met and unmet needs in hospital-based home care: qualitative evaluation through
      open-ended questions.

PMID- 11219885
TI  - Teaching palliative care in east Asia.

PMID- 11219886
TI  - The effects of patients' and practitioners' preferences on randomized clinical
      trials.

PMID- 11219887
TI  - Palliative medicine undergraduate education detailed in university prospectuses
      and websites.

PMID- 11219889
TI  - Pets and animal-assisted therapy.

PMID- 11219888
TI  - The importance of low magnesium in palliative care.

PMID- 11219890
TI  - Challenges of decision making for families of children with single or multiple
      chronic conditions.
AB  - When a child is diagnosed with a chronic illness, families begin a constant cycle
      of decision making. Many of these decisions surround health care treatment. These
      families can be divided into two groups: those with children newly diagnosed with
      a chronic condition and those with children who have a preexisting illness. If a
      new diagnosis represents a family's entrance into the medical community, the
      decision-making process can be confusing and difficult. For the family of a child
      with a preexisting condition, making repeated decisions about treatments can be
      additionally stressful and anxiety provoking because of their medical history.
      How do families with a child with a preexisting medical condition differ in their
      decision making? What factors affect their decisions? The nurse practitioner has
      a critical role interacting with both types of families and guiding the decision
      making process. Therefore, understanding the family and their previous experience
      is crucial to determine how nurse practitioners can best tailor interventions to
      promote effective decision making.

PMID- 11219891
TI  - Assessing parental concerns of children with diabetes.
AB  - This study assesses levels of parental concern in a group of families who had a
      young child diagnosed with type 1 diabetes. Despite high levels of concern for
      hypoglycemia and hyperglycemia, the parents reported that they managed their
      child's diabetes as recommended by the health care providers. No correlation was
      found between the concern ratings and level of glycemic control or incidence of
      severe hypoglycemic events.

PMID- 11219892
TI  - Children with chronic conditions: the importance of growth assessment.
AB  - Growth assessment is crucial in the evaluation of all children. The growth of
      children with chronic conditions is often inadequately assessed by subspecialty
      services because of the following beliefs: (1) short stature is secondary to the
      disorder and therefore the cause is known, (2) poor growth is caused by a
      syndrome and is untreatable, and (3) growth is assessed adequately by the
      children's primary care providers. In reality, growth failure in children with
      chronic conditions may be caused by other factors and may be treatable. In
      addition, growth is often inadequately assessed by primary health care providers.
      Growth abnormalities should never be ignored or minimized in populations of
      children having other significant health care problems.

PMID- 11219893
TI  - Nurse practitioner intervention to improve the use of metered-dose inhalers by
      children with asthma.
AB  - Metered-dose inhalers (MDIs) have become a mainstay of maintenance therapy for
      various allergic and respiratory conditions. When used correctly, MDIs are as
      effective as nebulized medications. Patients use MDIs incorrectly in many cases
      because of poor instruction and lack of spacer devices. Nurses and physicians
      often teach the technique improperly. Nurse practitioners can have a positive
      impact in improving care through better patient and staff teaching and the use of
      spacer devices with MDIs.

PMID- 11219894
TI  - A school-based asthma clinic: a partnership model for managing childhood asthma.
AB  - Childhood asthma is a major public health problem. It is the leading cause of
      childhood hospitalizations and school absences despite recent advances in
      management. Current standards of care call for client education as partners in
      disease management. In pediatrics, this calls for shared decision making between
      health care provider, parent, and child. Traditional care delivery systems often
      fall short of meeting this standard. This article describes a nurse practitioner
      run school-based asthma clinic, designed as a pilot study, to fill these gaps.
      Characteristics of the community that affected outcomes are described.

PMID- 11219895
TI  - Perinatally acquired human immunodeficiency virus infection in infants: updated
      guidelines for prevention, diagnosis, and initiation of treatment.
AB  - Perinatally acquired human immunodeficiency virus (HIV) infection can be
      prevented through education and, for women with HIV and their babies,
      administration of chemoprophylaxis during the perinatal period. When perinatally
      acquired HIV infection occurs, early intervention can promote the quality and
      duration of the infant's life. This report updates and consolidates current
      recommendations related to the prevention of perinatally acquired HIV infection,
      as well as recommendations for the management of perinatally exposed and infected
      infants through the first year of life.

PMID- 11219896
TI  - Reporting medical neglect effectively: a guide for nurse practitioners working
      with child protective services.
AB  - Health care providers who suspect or observe medical neglect of chronic health
      problems in children are obligated to report the findings to Child Protective
      Services (CPS). Such reporting results in uneasiness for clinicians, who may
      jeopardize their therapeutic relationships with the patient and family, or worse,
      provoke them to withdraw from treatment. To the contrary, reporting medical
      neglect and discussing it openly and empathetically with the family can foster
      more cohesive teamwork and prompt families to address their problems. Knowing
      your state's child abuse laws, how to effectively report medical neglect, and how
      to communicate and collaborate with CPS caseworkers may result in the provision
      of therapeutic services to families. Enhancing family functioning can result in
      increased efforts toward caring for their child's medical problem.

PMID- 11219897
TI  - Discontinuing treatment in children with chronic, critical illnesses.
AB  - Decisions about optimal treatment for critically ill children are qualitatively
      different from those related to adults. Technological advances over the past
      several decades have resulted in myriad treatment options that leave many
      children chronically, critically ill. These children are often technology
      dependent. With new technologies and new patient populations comes the
      responsibility to understand how, when, and why these technologies are applied
      and when technology should not be used or should be withdrawn. Much has been
      written about ethical decision making in the care of chronically, critically ill
      adults and newborns. In this article, relevant factors about the care of children
      older than neonates are described: standards, decision makers, age of the child,
      and pain management. A case study is used as a mechanism to explore these issues.
      Dimensions of futility, discontinuing aggressive treatment, and a consideration
      of benefits and burdens are integrated throughout the discussion to inform nurse
      practitioner practice.

PMID- 11219898
TI  - Home care considerations for chronic and vulnerable populations.
AB  - Conducting a predischarge home assessment can provide important information to
      the hospital care team for discharge planning and postdischarge care. In
      addition, a predischarge home visit assists the family in preparing for the
      infant or child's care needs. This report describes an Environmental Assessment
      Guide initially developed and subsequently used in two nursing research studies.
      Anecdotal information from advanced practice nurse care records is provided to
      illustrate issues relating to predischarge assessment.

PMID- 11219899
TI  - [Hemorrhagic and hypoxic-ischemic brain lesions in premature infants on
      artificial ventilation].
AB  - Major intraventricular hemorrhage (IVH) and cystic leucomalacia (PVL) are major
      causes of mortality and neurologic morbidity in premature infants that are
      strongly associated with long-term neurodevelopmental sequelae. Preterm babies
      ventilated by intermittent positive pressure ventilation are in higher risk for
      this type of lesion. We studied incidence of major intraventricular bleeding
      (with ventricular dilatation and parenchymal involvement) and cystic
      periventricular leucomalacia in 79 preterm babies who required mechanical
      ventilation for respiratory-distress syndrome (RDS), admitted on Department of
      Neonatology of the Pediatric University Hospital in Sarajevo from February 1999.
      to May 2000. Thirty-five babies were classified as less than 32 weeks of
      gestation. Major intraventricular hemorrhage and cystic leucomalacia were
      documented in 5 babies (10.2%) of 49 survivors. Two babies developed
      posthemmoragic hydrocephalus and required shunting. Severe brain damage was more
      common in ventilated infants with gestational age with (32 weeks of gestation
      (23.5%) compared with the babies > 32 weeks of gestation (2.9%). The severity of
      RDS also correlated with an increased risk of severe IVH.

PMID- 11219900
TI  - [Incidence of respiratory distress syndrome in premature twins].
AB  - Respiratory distress syndrome (RDS) is a syndrome of respiratory malfunction
      occurring in pre-term newborns. Twin pregnancy is a risk factor for the
      occurrence of RDS. The objective of our study is to analyse RDS incidence in pre
      term twins and to determine the mortality in this group of newborns compared to
      single pregnancy pre-term babies. The study is based on the data collected in
      Clinic for Gynaecology and Obstetrics, Neonatology Department in the year 1999.
      RDS was diagnosed on the basis of clinical status and radiology findings. In the
      course of the test period, 544 pre-terms were born, 91 (16.7%) of them being from
      twin pregnancies. RDS developed in 132 newborns from single pregnancies (29.1%),
      in 28 newborns from twin pregnancies with RDS developed in both twins (30.7%) and
      in 19 babies whose twin siblings did not have RDS. If we consider gestation age,
      RDS developed in 28.6% twins born between 32nd and 36th gestation week and in
      20.45% single newborns of the same age. The results were similar in younger
      gestation age. Mortality rate in the tested group was 17.8% and 9% in the control
      group. These results lead us to the conclusion that pre-term newborns from twin
      pregnancies tend to develop RDS, a more difficult clinical status, have more
      complications and higher mortality rate than the newborns from single
      pregnancies.

PMID- 11219901
TI  - [Pulmonary complications during mechanical ventilation in the neonatal period].
AB  - The pulmonary complications (PC) during mechanical ventilation were caused by
      barotrauma, infection, oxygen toxicity and excessive pulmonary extravascular
      fluid. The most frequent manifestations are: pneumothorax, pulmonary haemorrhage
      and lobar or segmental athelectasis. This is a retrospective study conducted
      between 1.1.1990 till 31.8.2000. The aim of this study was to evaluate the
      frequency of the pulmonary complications during mechanical ventilation in 163
      ventilated neonates, as well as the relation towards gestational age, birth
      weight, primary disease and the outcome. The most common causes for mechanical
      ventilation were: hyaline membrane disease in 95 (58.3%) preterm babies,
      perinatal asphyxia in 26 (16%) and less frequent conditions such as: apnea,
      congenital heart diseases, neonatal infections and surgical cases. 25/163 (15.3%)
      ventilated pts have developed pneumothorax, 29 (17.7%) athelectasis and 14 (8.5%)
      pts had pulmonarly haemorrhage. The pulmonary complications were more frequent in
      preterm newborns with significant influence at the duration of the ventilation
      and the outcome. However, pulmonary complications could not be completely avoid,
      so we would like to underline the importance of preventive measures with the aim
      of decreasing PC incidence.

PMID- 11219902
TI  - [TORCH infections in mothers as a cause of neonatal morbidity].
AB  - When possible, diseases by expectant mothers and newborns, like long-term
      disabilities also, should be prevented by establishing early diagnoses,
      evaluation and implementation adequate therapy. The major goal of medical care is
      prevention of disorders with provision of adequate prenatal care for the
      expectant mother and precautions regarding the exposure to teratogenic
      infections. The range of pathological conditions produced by infections agents is
      wide, and the difference between maternal and fetal effects caused by any one
      agent is also important. Some maternal infections, especially during the early
      gestation, can result in fetal loss or malformation because the ability of the
      fetus to resist infectious organisms is limited and the fetal immunologic system
      is unable to prevent the disemination of infectious organisms to the various
      tissues. These infections are responsible for significant congenital neonatal
      morbidity as for as compromises a child's quality of life and infertility and
      sterility. One group of microbial agents--generally known as TORCH infections can
      cause remarkably similar manifestations, and is uncommon to test all when a
      prenatal infection is suspected. We analysed the practice of TORCH analyses with
      our patients and their mothers during last year (1999th) at the Pediatric Clinic
      and Clinic of Gynecology and Obstetrition-UCC Tuzla. At this time there were
      5.028 deliveries. Out of short figure 544 or 10.8% newborns were early born and
      245 or 4.8% were hypotrophic and 62 were still-born or 12.3 from 1000 deliveries.
      TORCH infection was analysed only in few cases. In the same period there were
      3.457 children treated at the Pediatric Clinic in Tuzla. Only in 20 cases or
      0.58% TORCH was made. Three or 15% were with remarkable sequeles like
      microcephaly, cerebrospinal liquid abnormality, seizures, hepatomegaly, cirrosis
      etc. TORCH analysis was made with all mothers. Only one was serologic CMV
      positive and we started with the therapy. History of four mothers or 20% have
      data about spontaneous abortions, and in other four or 20% we found data about
      early deliveries. The prevention of conatal infections was not made by any one.
      In our small group we made TORCH because of evident problems that were suspected
      of conatal infections. We concluded that there is a big risk of untreated
      maternal infections with women in fertile age in Bosnia and Herzegovina. This
      problem is not enough present in our medical practice.

PMID- 11219903
TI  - [Convulsions in the early neonatal period].
AB  - Convulsions are relatively frequent in neonatal population. They are also the
      most dramatic sign of a disorder of the central nervous system. Clinical signs of
      convulsive seizures in neonatal period differ greatly from those occurring in a
      later stage. Our study involves a five year period, in the course of which we
      analysed all newborns with convulsions occurring in the early neonatal period.
      The objective of the study was to determine the incidence, aetiology and time of
      occurrence of convulsions, to determine the mortality rate in this group of
      newborns and to assess risk factors for the development of convulsions. In 29.423
      newborns tested in the course of the study at our Clinic, convulsions were found
      in 38 (0.13%) of them. Regarding the gestation age, 68.4% of the cases of
      convulsion occurred in at term newborns. The most frequent aetiology factor was a
      perinatal damage, in 60.4%, and the majority of convulsive seizures occurred in
      the period between the 2nd and 7th day (84.3%). Five of the tested newborns died
      (13.5%), three of them having suffered from convulsions in the first 24 hours.
      The authors came to the conclusion that many factors influence the development of
      convulsions, and that the occurrence of convulsions in the first 24 hours and
      heavy perinatal brain damage give bad prognostics for survival.

PMID- 11219904
TI  - [Use of prostaglandins in neonatal cardiology].
AB  - The current trend in neonatal cardiology assumes the administration of
      prostaglandins. Prostaglandins are indicated as a palliative and not definitive
      therapeutic medicament in neonates with duct dependent congenital heart
      anomalies. The aim of this study is to evaluate the medicament Prostaglandin,
      first time administrated to neonatal cardiac patients, in Bosnia and Hercegovina.
      During December 1997 till June 2000. at the Neonatal department of Pediatric
      Clinic in Sarajevo 1162 pts were admitted, of which 17 (1.4%) with congenital
      heart disease have received prostaglandin therapy, with the mean age of 4.5 days
      (45 minutes till 20 days). 13/17 (76.5%) pts were boys and 4/17 (23.5%) girls,
      with mean body weight of 3.125 gr (range: 1.250 g to 4.100 g), mean gestational
      age 40 weeks (range 34 to 42). The patients were admitted for: cyanosis,
      breathing difficulties or fatigue. Central cyanosis was evident at admission in
      15/17 pts, whose oxygen saturation at admission was from 21% up to 76%. The
      diagnosis of congenital cyanotic heart anomalies was made in 15/17 pts (88%) by
      clinical examination, X ray, ECG and ultrasound examination and acyanotic duct
      dependent on 2/17 (12%) pts. The administration of prostaglandin's was necessary
      and of vital importance for life maintenance of these pts till the surgical
      correction of these congenital heart anomalies. Prostaglandin E1 (PGE1) was
      administrated by infusion pump with the mean doses of maintenance: 0.023
      mcg/kg/min in 11/17 (65%), and Prostaglandin E2 PGE2 in 6 (35%) pts, maintenance
      doses of 0.38 mcg/kg/hour. The duration of the prostaglandin application was from
      7 hrs up to 30 days, mean 12 days. Five (29.5%) pts were intubatued during the
      application of this medicament. The side effects of this therapy were present in
      13 pts (76.4%): hyperpyrexis in 8, apnea in 2 and apnea + hyperpyrexis in 3 pts.
      8/17 (47%) pts were operated and corrected abroad, they are now in good
      condition, and 9/17 (53%) pts died. The death causes were a part of complex
      congenital heart disease: impossibility of performing the heart surgery in the
      country when needed, impossibility of pts evacuation to the foreign
      cardiosurgical center on time, sepsis or persistent pulmonary hypertension.
      CONCLUSION: In pts with congenital heart disease whose survival is duct
      dependent, the availability is compulsory and the application of prostaglandins
      as a palliative medicament. The prostaglandins have made a revolution in saving
      children's lives in neonatal cardiology.

PMID- 11219905
TI  - [Obstetrical injuries of the brachial plexus].
AB  - Although birth-related brachial plexus injury (BPI) was first described more than
      two centuries ago, it still represents therapeutic dillemma. Incidence is 0.37
      2.0 per 1000 live births. The most frequent etiologic cause is extreme lateral
      traction and excessive fundal pressure in a case of shoulder dystocia. However,
      in last decade there are reports that cite of BPIs occurring prior to delivery in
      up to 46% cases--intrauterine maladaptation. In 1998. and 1999. at the
      Rehabilitation Department of Pediatric Hospital, Clinical University Center in
      Sarajevo 32 children with BPI were treated. The incidence is 2.67 per 1000 live
      births. There were 21 cases of Erb's palsy (65.63%), 2 cases of Klumpke's palsy
      (6.25%). Total plexus palsy was present in 9 children (28.63%), and Horner's
      Syndrome in 1 case. In 25.77% of cases (8 children) there was-no evidence of
      shoulder dystocia at delivery. Treatment of the brachial plexus injuries in
      newborn is still controversial. Proper immobilization in first 7-15 days is of
      great importance. In this study 25 children (78.13%), in average age of 4.6 days,
      were brought for examination with improper immobilization. The role of widely
      applied electrotherapy is controversial. Complete recovery is expected in about
      one half, and in this study it was achieved in 75% of cases (24 children).
      Consensus about timing od surgical approach does not exist still. However, there
      is strong agreement that decision about eventual surgical treatment should be
      based on clinical motor testing and that MRI should precede the surgery. Although
      the electrodiagnostic studies have proven to be of limited prognostic value in
      the evaluation of children with acute obstetrical brachial plexus injuries,
      electromyography should be performed prior the surgery in the aim of later
      comparison of the results. According to our data, at this particular moment in
      BiH surgical treatment in this age is not available, as well as use of MRI in
      diagnostics of BPIs.

PMID- 11219906
TI  - [Tetralogy of Fallot: postoperative monitoring of patients].
AB  - In 25 patients, 13 boys and 12 girls, median age 5.5 years, in 1990-2000,
      surgical reparation of their heart defects were performed. Median age of
      diagnostic Tetralogy of Fallot was 3.2 months, range 1 day-2 years. Anoxic spells
      were present in three patients. Ten patients (median age 3 years, range 3 months
      10 years) initially palliated with a modified Blalock-Taussig shunt, underwent a
      reparation at a median of 4.5 years after palliation. Median follow up was 4.2
      years, range 3 months-10 years. The 30-day mortality rate was 16%. Mean right
      ventricular outflow tract gradient on echocardiography was 20.20 +/- 4.78, and
      mean oxygen saturation was 96% +/- 1.3. Two patients had non significant residual
      ventricular septal defect with left to right shunt, 7 right ventricular
      enlargement and almost all mild pulmonary regurgitation. Also two patients had
      Blalock-Taussig shunt's thrombosis. Before surgical reparation, one boy showed
      pulmonary valve's endocarditis. Complete atrioventricular block has been
      developed on one girl. No patient required reintervention during follow up and
      there was no late mortality. Almost all of our patients were asymptomatic, had
      normal activity, regularly exercised and some of them participated in school
      sport programs. Complete correction of Tetralogy of Fallot showed good results
      with normal life expectancy for the patients.

PMID- 11219907
TI  - [Review of patients with congenital heart anomalies treated at the University
      Clinical Center in Sarajevo 1997-2000].
AB  - During April 1997 to October 2000, 65 children (61.5% female and 38.5% male) have
      been operated at KCU Sarajevo at the Hospital for Cardiac surgery. Diagnostic
      procedures, preoperative and postoperative treatment have been carried out at
      Pediatric hospital, Clinical center University of Sarajevo. The average age of
      establishing the diagnosis was 20 months and 4.5 years was the average age of
      surgical treatment. The most frequent defects were: Atrial septal defect 27.69%,
      Tetralogy of Fallot 16.92%, Patent ductus arteriosus 16.92%, Coarctatation of the
      aorta 7.69%, combination of more simple defects 7.69%, Atrioventricular septal
      defects 6.15%, Ventricular septal defect 4.61%, Pulmonary stenosis 4.61%,
      Anomalous pulmonary venous connection 4.61% and the other complex defects 3.07%.
      Among all cases 10.76% were associated with some of the syndromes. In 86.13% of
      cases total correction have been performed and palliative in 13.84% of cases.
      Death rate was 10.76%, and postoperative complications 21.53%. Catheterizations
      was performed on 14 patients (21.53%), and three of them had therapeutic
      interventional cardiac catheterization (coil, umbrella, balloon dilatation). The
      average timing of: preoperative procedures was 3.5 days, postoperative following
      7.5 days and intensive care 2.2 days.

PMID- 11219909
TI  - [Ictal automatisms during partial complex seizures in 36 children].
AB  - Partial complex seizures are relatively frequent type of epileptic seizures.
      These attacks are having aura in 60% of cases, that can be vegetative, motor,
      sensor or psychological one. Important is aura in the form of uncinatus seizures
      (unpleasant odor), because we must exclude tumor of temporal region in these
      patients. Altered consciousness comes after aura, patient has opened eyes, face
      can be pale or red, and automatism appear, in the form of different movements.
      These automatisms are often considered insignificant by parents or eyewitnesses.
      There is often misdiagnosis of this type of seizures, because only about 20% of
      standard EEG recordings find specific epileptic grapho-elements. Therapy of these
      seizures is difficult, with the success in only 50% of cases. Ictal automatisms
      were tested in the group of 36 children with partial complex seizures aged 4 to
      17 years. Duration of epilepsy was 1 to 5 years. All patients had proved
      diagnosis of partial complex seizures, clinically and on electroencephalography,
      CT scan and MRI in medically intractable seizures. Eleven patients were
      videotaped during the attack. All patients had questionnaire filled by parents,
      about automatisms. Thirty-four patients (94.4%) had ictal automatisms, and 2 with
      epileptic focus in frontal region did not. Some patients had different types of
      automatisms. Most frequent ones were mimicking (15.19%), sitting-standing up
      (10.76%), swinging (8.23%), swallowing (7.59%) etc. It can be concluded that
      automatisms are almost obligatory part of partial complex seizure, and their
      registration is essential for correct diagnosis and treatment of these seizures.

PMID- 11219908
TI  - [Prognosis in vesicoureteral reflux].
AB  - OBJECTIVES: To emphasise the importance of early diagnosis of Vesicoureteric
      Reflux (VUR) in prevention of renal failure. METHODS: General testing of children
      was followed by micturating cystourethrography (MCGU) for those with the
      diagnosis of urinary-tract infection. In cases where high level of VUR was
      determined, satic nuclear medicine scanning was performed using an isotope
      labeled substance (e.g. DMSA). RESULTS: 31 nephrology department patients were
      followed: 29 girls, 2 boys ages 0-15. MCGU showed 33 kidneys with reflux. 13 of
      the patients had reflux in the first or second degree. 7 patients showed reflux
      of the 2-3 degree while 13 had a high degree of reflux. Among the children under
      7 years of age, total of 16 kidneys, DMSA showed various degrees of damage to the
      paranhaim and the development of scars. CONCLUSION: After the VUR has been
      diagnosed, it is difficult to predict whether scarring will take place. The
      possibility of scarring is higher among younger children when appropriate
      therapeutic modalities are not identified.

PMID- 11219910
TI  - [Birth asphyxia as a cause of cerebral palsy].
AB  - Birth asphyxia is O2i CO2 exchange disorder during the labour, with consequent
      hypoxia and ischemia. The term "asphyxia" has been used unprecisely quite often.
      The most frequently used criteria for birth asphyxia have been: fetal
      bradycardia, meconium stained amniotic fluid, fetal acido-base status with
      umbilical artery pH value below 7.10, low Apgar score and need for endotracheal
      intubation. The correct Apgar score quantification depends on the examiner. Fetal
      acido-base status measured in umbilical artery could be useful biochemical
      parameter of birth asphyxia. Only if the fetal oxygen supply during the labour is
      severe and long enough disturbed, the neurological abnormalities will develop
      later. Our study has enrolled 70 children with various degree of motor
      impairment, detected during neonatal period and/or infancy. They have been
      followed up till 24 months chronological age for term neonates and 24 months
      corrected age for prematures. 34 children out of them have developed clear
      clinical signs of cerebral palsy. Birth asphyxia as a possible cause of cerebral
      palsy has been documented in 10 cases, e.g. 29.4%. The criteria for birth
      asphyxia have been low Apgar score, meconium stained amniotic fluid and clinical
      signs of hypoxic-ischemic encephalopathy. Fetal blood gas and acido-base
      measurements obtained from umbilical artery at delivery have been an important
      parameter of intrapartal asphyxia. Those measurements should be introduced as a
      routine method in our practice, in the cases of fetal heart deceleration, to
      asses the extent of fetal acidosis.

PMID- 11219911
TI  - [Hypochromic anemia in children with affective breath-holding spells].
AB  - Breath holding attacks are most common in children aged 6 months to 6 years, in
      76% of cases between 6 and 18 months of age. Very often they are misinterpreted
      as tonic epileptic seizures. They are provoked by frustration, anger or sudden
      injury. Child starts to cry, then holds the breath at the end of expirium. After
      a few seconds it becomes cyanotic, and losses consciousness. It is usually
      floppy, but sometimes stiffness, and clonic seizures can be present, and child
      can be diagnosed as having epilepsy. The form in which child is pale is less
      frequent, and crying is usually brief or even absent in this type. Breath holding
      attacks usually do not last more then one to three minutes. Good heteroanamnesis
      is essential for diagnosis, revealing provoking factors for each attack.
      Interictal EEG registration is usually normal. Attacks often spontaneously cease
      after 5 or 6 years of age, and do not require any medical treatment. In more
      severe cases behavioral therapy has shown good results. It has been noticed that
      those children in adolescence have syncope more frequent then rest of population.
      Seventeen children (12 male and 5 female) were investigated at Pediatric Hospital
      in Sarajevo as breath holding attacks in period from June 1997 to June 2000. Age
      of patients was between 5 months and 5.5 years (median was 11 months).
      Hypochromic anemia was present in 12 patients (76%), with average hemoglobin
      value of 8.2 g/dl (5.9-11.0 g/dl). All children had normal EEG recording. Iron
      therapy gave positive response in 8 out of 9 patients that were followed (88.9%).
      Three patients had not come for follow up. It is concluded that hypochromic
      anemia is often a part of clinical presentation of breath holding attacks in
      children, and iron therapy can stop them.

PMID- 11219912
TI  - [Magnetic resonance and magnetic resonance angiography in the diagnosis of
      vascular anomalies in childhood].
AB  - The aim of this study is to demonstrate the accuracy of MRI and MR angiography,
      using 3D and 2D TOF sequences to diagnose vascular malformation in children with
      non-traumatic intracranial hemorrhage (subarachnoid or intracerebral hemorrhage).
      PATIENTS AND METHODS: In two years period 7 children, 4 boys and 3 girls range
      age 8 to 14 years with non-traumatic intracranial hemorrhage were examined on 1.0
      TMR unit, using T1,PD,T2 WI and 3D and 2D TOF MR angiography with MIP
      reconstruction. RESULTS: In the group of 7 children, 2 were with aneurysms, 2
      with AV malformation, and 1 with cavernous angioma. The results of these were
      correlated with those of IA DSA. The results were in agreement regarding the
      presence, location and size of aneurysms, the presence, vasculation and drenage
      of AV malformation. CONCLUSION: MRI with MR angiography is rapid and non-invasive
      examination which can confirm the diagnosis of vascular anomalies in children and
      to follow them up.

PMID- 11219913
TI  - [Peripheral insertion of central catheters in the treatment of pediatric patients
      with leukemia].
AB  - In this paper we analyzed group of patients with leukemias in which was implanted
      peripherally inserted central catheters (PICC), which is safe and permanent
      intravenous line necessary for treatment in these patients. MATERIAL AND METHODS:
      In the period from January 1999. to September 2000. at the Oncology Department on
      Pediatric Clinic in Sarajevo we placed PICC in 18 patients with leukemia.
      Catheters were introduced through vena cubitalis and EMLA was used like local
      anestetic, All these manipulations were done with respect to asepsa rules. Tip of
      the catheter had to be situated in vena cava superior and its right position was
      checked by ultrasound. Management of catheter included everydays heparinisation,
      according strictly ordered rules and respect asepsa rules. RESULTS: PICC was
      placed in 18 patients with average of 6.5 years. According sex there were 61.1%
      males, and 38.9% females. Average period of using catheter was 2.7 months. In
      44.4% cases catheter was taken out after finished treatment, but in 22.2% cases
      we had mechanical complications (spontaneous breakage of catheter or stop in it).
      In 33.3% patients catheter is still in function. CONCLUSION: Using PICC in
      patients with leukemia made significantly easier their treatment regarding
      decreasing of their traumatisation, regarding simplier vein access and reduction
      of the infection. In our investigated group we had not infection what was very
      important fact for outcome of this serious disease.

PMID- 11219914
TI  - [Helicobacter pylori and gastroduodenal disease in our patients: 2-year
      experience].
AB  - Primary gastritis, duodenitis, peptic ulcer of stomach and duodenum are no longer
      considered to be disorders of the balance of secretion of acid and immune
      responses of the gastric mucose but it is thought to be caused by Helicobacter
      pylori infection. One of the most important factor causign the malignant gastric
      diseases such as carcinoma and non-Hodgkins MALT Lymphoma is an early infection
      by this spiral gram-negative bacterium. We performed byopsi of the gastric mucose
      in 80 of our patients. Endoscopic and histological results showed that 74
      patients had gastritis 6 others had normal results. The highest incidence of
      disease was found in children of 11 to 14 years of age because 67.4% were girls
      and 22.4% were boys of this age. Ethiological analysis of patients with gastritis
      showed that Helicobacter pylori was isolated in bioptic material of 46 patients
      while results of other 28 patients were negative.

PMID- 11219915
TI  - [Clinical assessment of occult infections in children].
AB  - Children's occult infections are characterised presenting pathogenic bacteries in
      blood of children in age 3 to 36 months, but they are good general aspect and
      orderly immunologic status and they don't have signs of focal infection.
      Manifestation of occult infections determined: age of child, increasing bodies
      temperature, testsphysical observance and clinical-biochemistry tests. Prevalence
      of manifestation occult infections is 3-8%, but they manifest ni a form occult
      bacteremia, occult pneumonia nad occult urinary infection. Methodic, systematic
      admission and adequate clinical-biochemical monitoring, we minimise sequeles of
      occult infections. Risk of serious sequeles at occult infections is importantly
      decreasing by epidemiological changes that it rises by using vaccination against
      Haemophilus influenzae and Streptococcus pneumoniae is leading ethiological
      source. Many contraversal opinions are presented in glance of therapeutic
      strategy at children's occult infection. Future of solutions at many hesitations
      ni context diagnosis and therapy of occult infections is established in using
      recent detectional tests /pneumococcus PCR, plasmas tumor reaction, interleukin
      la/ and preventive intervetions activities /conjugated pneumococcus vaccination/.

PMID- 11219916
TI  - [High-frequency ventilation in neonates with pulmonary hemorrhage].
AB  - The high-frequency ventilation (HFV) has been in use in the World since early
      70s, on patient (RDS, MPH, PPHN, etc.) who did not respond well as it was
      expected, on conventional mechanical ventilation (IPPV/IMV). At our Clinic we
      started to use this type of ventilation two months ago, and throw this work it
      was presented our first experience. In case report was showed massive pulmonary
      hemorrhage (MPH) in premature newborn 30 GW, where we applied HFV. Immediately
      after the bird conventional mechanical ventilation has been applied with positive
      pressure (IPPV) and surfactant has been given because RDS. After the MPH appeared
      we successfully applied HFV.

PMID- 11219917
TI  - [Cat-scratch disease].
AB  - We report a case of fourteen years old boy with cat scratch disease. He was
      treated at Pediatric Clinic in January and February 2000. Cat scratch disease is
      benign infectious chronic disease which appears in all ages. It begins after
      contact with cat and its scratch. Yearly incidence of this disease for whole
      population is 0.77-0.86/100.000. The cause is bacillus Bartonella which is also
      called genus Rochalimaea. It is Gram negative, mobile, aerobe bacillus with ten
      flagellas on one pole. Our patient was admitted at hospital because of high
      temperature, paleness, fatigue, bad appetite and pains in his joint. Ultrasound
      and magnet resonance scans of liver and spleen showed enlarged but regulary
      contured liver and two focal changes with diameter 16 mm, 12 mm and 7 mm in
      spleen. All those focal changes were described as abscesses. Diagnose was set up
      according increasing titre of IF-Bartonella hensalae IgG 1:256 (positive). This
      diagnostic test was performed at Institute for microbiology and Immunology at
      Medical Faculty in Ljubljana. Disease had long lasting course, and was cured by
      antibiotics without surgical intervention.

PMID- 11219918
TI  - [Hypoparathyroidism].
AB  - Hypoparathyreoidism of different etiology is the most common disorder of
      parathyreoidea. Symptoms caused by hypocalcemia are dominant and they are sign of
      disturbed neuromuscular balance. Alopecia is frequent disorder which occurs in
      the course of the illness. We report a case of five year old girl sent from
      Mostar because seizures incurable by phenobarbitone. Total alopecia was obvious.
      At admission total serum calcium level was 1.23 mmol/l. The level of parathormon
      was measured two times, and both results were under lowest value of normal range
      (< 10 pg/ml). After introducing calcitriol (Rocaltrol) in therapy, serum calcium
      level was almost normal and child was without symptoms.

PMID- 11219920
TI  - [Information model of activities of medical service headquarters in peacetime].

PMID- 11219921
TI  - [Methodological approaches to organization of paid medical services].

PMID- 11219919
TI  - [The blue sclera syndrome (Van der Heave syndrome)].
AB  - Authors in this paper present two cases of Van der Heave syndrome, congenital
      disease of connective tissues and myopia with astigmatismus. There are usually
      other problems, affecting different systems. We tried treatment with soft torus
      contact lenses, with improved visual acuity at the follow up.

PMID- 11219922
TI  - [Medical consequences of earthquakes and organization of their liquidation
      (Communication II)].
AB  - The main factor determining the size of sanitary losses (SL) and the share of
      injuries with different degree of severity is intensity of earthquake. At the
      same time dependence of SL structure on the types of populated area (including
      the peculiarities of their building) and the character of population allocation
      at the moment of earthquake is rather small. It allows to substantiate the common
      medical-and-evacuation indices of the casualties for the given intensity of
      earthquake. The normative indices given in the article are of reference
      significance and depending on concrete situation require closer definition.

PMID- 11219923
TI  - [Use of immunoenzyme test systems for diagnosis of syphilis in the troop unit of
      a medical service].

PMID- 11219924
TI  - [Surgical approaches in acute pancreatitis].

PMID- 11219925
TI  - [Standards in antibacterial therapy of hospital pneumonia].

PMID- 11219926
TI  - [Current problems in medical support for provision of radiation and chemical
      safety in the Armed Forces].
AB  - The events and changes of the last decade, appearance of new factors determining
      the character of professional activities of military doctors have become the
      cause of displace of some accents in organization of medical support of RF AF
      radiation and chemical security. The possibility to use chemical and radiation
      factors for military ends as well as wide spread of chemical substances and
      sources of ionizing radiation in human everyday activities during peacetime allow
      to confirm that protection of subject, society and state is closely connected
      with support of radiation and chemical security. Considerable widening of class
      of problems standing before medical service and their increased complexity make
      impossible medical support of radiation and chemical security of the RF AF staff
      with forces and means of specialists working only in one field (toxicologists
      radiologists). Such complex problem requires the conduction of scientifically
      well-founded, effective measures based on the knowledge of specific effects of
      radiation and chemical factors on human body.

PMID- 11219927
TI  - [Thrombogenesis and its prophylaxis].

PMID- 11219928
TI  - [Local myoplasty with microsurgical tissue transplantation in treatment of
      calcaneus chronic osteomyelitis].

PMID- 11219929
TI  - [Pharmacoeconomic estimation of cost of community acquired pneumonia therapy].

PMID- 11219930
TI  - [Modern carried medical kits for military paratroopers].

PMID- 11219931
TI  - [Treatment of pseudotuberculosis in military personnel (scientific basis and
      practical recommendations)].
AB  - The efficiency of 22 schemes of etiotropic therapy including treatment courses of
      different duration and new methods was studied basing on the results of
      examination of 1376 patients and retrospective analysis of 2008 cases of
      pseudotuberculosis in servicemen. Critical review of literature dealing with this
      problem was conducted. The causes of contradictory literary data have been
      revealed. Specificity of military service and pseudotuberculosis pathogenesis
      influencing on disease course and efficiency of its treatment has been shown.
      Taking into account our own investigations and analysis of literature there was
      developed the scheme of differentiated etiopathogenetic therapy of
      pseudotuberculosis with the use of original approaches including the method of
      two-stage intermittent antimicrobial therapy, stepped (parenteral-oral)
      etiotropic therapy, antihypoxants, gg-ABA-ergic and nootropic agents,
      adaptogenes, dose increase of physical load, new physiotherapeutic methods,
      endolymphatic administration of antibiotics.

PMID- 11219932
TI  - [Passive orthostatic test in evaluation of efficiency of medical rehabilitation
      of flying personnel].

PMID- 11219933
TI  - [Assessment of the health of the salvaging personnel at the Chernobyl Nuclear
      Power Plant: findings of the Russian Federal Interdepartmental Expert Committee
      for 1999].

PMID- 11219934
TI  - [Prognosis of oncologic morbidity among the salvaging personnel at the Chernobyl
      Nuclear Power Plant].

PMID- 11219935
TI  - [Radiologic diagnosis of stomach cancer. Critical analysis of deeply rooted
      misconceptions].

PMID- 11219936
TI  - [Current problems of dose-time correlation in delayed radiotherapy of cancer].

PMID- 11219937
TI  - [Comparison of diagnostic significance of bone and bone marrow scintigraphy in
      patients with Hodgkin disease].
AB  - Diagnosis of skeletal tumors in patients with Hodgkin's disease is of paramount
      importance for precise staging of tumor process, prognosis and choice of optimal
      treatment. At present, according to the International Union Against Cancer
      (UICC), scintigraphy of bones and bone marrow is not regarded as a standard
      examination procedure for this pathology. We believe, however, that the
      sensitivity, specificity and overall accuracy of this procedure for bone marrow
      examination are 91.4; 94.8 and 92.9%, while those of osteoscintigraphy--49.1; 97
      and 80.6%, respectively. According to our statistics (based on chi-square-test),
      the sensitivity and overall accuracy of osteoscintigraphy were significantly
      lower (p < 0.05) than those of bone marrow scintigraphy. The specificity (100%)
      of bone marrow trepanobiopsy is beyond doubt. However its sensitivity (36%) and
      overall accuracy (70.7%) were significantly lower (p < 0.05) than those of bone
      marrow scintigraphy (based on chi-square-test). Therefore, since the results of
      bone marrow scintigraphy are comparable to those of MRT which, like bone marrow
      trepanobiopsy, is a component of the diagnostic standard procedure approved by
      the UICC, bone marrow scintigraphy should be recommended for assaying the extent
      of involvement in Hodgkin's disease.

PMID- 11219938
TI  - ["Interventional radiology" in breast examination].
AB  - The data on such highly-effective invasive diagnostico-therapeutic procedures as
      ductography, sclerosing-solution cystography, X-ray-controled puncture biopsy,
      stereotactical computer technique, sonography and preoperative maging of
      nonpalpable lesions were analyzed following a complex mammographic examination of
      20,000 patients with different breast pathologies. Advantages offered by complex
      breast examination are discussed. Among them were the use of optimal effects of
      each invasive procedure, an accuracy of preoperative diagnosis reaching 95-98%
      (nonpalpable breast lesions included) and a significantly reduced extent of
      breast surgery.

PMID- 11219939
TI  - [The role of computerized tomography in the diagnosis of primary lung cancer].
AB  - A CT-examination of 87 patients with various types of central cancer of the lung
      was carried out. Computed-tomography scanning is a highly-sensitive method of
      radiodiagnosis which detects respiratory system lesions, stage, predominant area
      of involvement and condition of adjacent tissues. On the basis of CT-related
      features of tumor, type and stage can be identified to choose optimal therapy and
      follow-up.

PMID- 11219940
TI  - [Postoperative computerized tomography of thoracic organs in lung cancer
      patients].
AB  - The report discusses the data on the complex radiation examination of 40 lung
      cancer patients at different stages of postoperative follow-up. Standard X-ray
      procedures and CT of thoracic organs were carried out. Considerable advantages
      offered by CT were recorded in the assessment of the pleural cavity, the
      remaining part of the lung and mediastinal organs. CT evidence played an
      important role in making differential diagnosis of relapse and other
      postoperative changes.

PMID- 11219941
TI  - [Invasive radiology in the diagnosis and treatment of benign breast diseases].
AB  - 100% of cases of cystic breast disease were effectively diagnosed using high-tech
      complex examination procedures. The most efficient invasive methods of diagnosis
      and therapy are discussed. Surgery was reduced to 88% due to application of
      sclerosing-solution techniques for conservative treatment of breast cysts.

PMID- 11219942
TI  - [Problems in the radiologic diagnosis of osteogenic sarcoma].
AB  - Osteogenic sarcoma showing the signs of acute osteolytic process were hardest to
      diagnose. Since-reliable diagnosis depended on detection of neoplastic
      osteogenesis in involved bone, tomography proved to be of vital importance.
      Differential diagnosis was instrumental in dealing with osteolytic giant-cells
      and osteomyelitis. Diagnosis cannot be considered complete until histological
      examination is carried out. Whenever neoplastic osteogenesis is suspected,
      samples must be taken from relevant sites.

PMID- 11219943
TI  - [Conservative therapy for early-stage breast cancer].
AB  - An evaluation of the data on the treatment of 298 cases of breast cancer (stages
      IIa and IIb) showed that a reduced frequency of loco-regional recurrences, after
      post-operative irradiation as a component of conservative therapy, was followed
      by improvement in quality of life. This was particularly apparent in patients
      with pT2pN1 tumors. It was also found that after extended dissection of axillary
      lymph nodes at all three levels, a dose of 50 Gy was sufficient without
      additional irradiation of the cicatrix. Nor was it necessary to expose the
      axillary area in cases of three or less lymph node recurrences provided that at
      least 6 resected nodes were studied histologically. Following conservative
      therapy, 5-year survival was 97%, while relapse-free survival--82%.

PMID- 11219944
TI  - [Thermotherapy for laryngeal cancer].
AB  - An analysis of the data on the treatment of 91 cases of advanced cancer of the
      larynx showed that local UHF-hyperthermotherapy is more efficient than the SHF
      one as a component of radiotherapy. Use of the latter procedure was followed by a
      higher rate of late-onset radiation injuries. Moreover, combined application of
      hyper-fractionated irradiation and UHF-hyperthermotherapy involved practically no
      grave complications while 5-year survival increased.

PMID- 11219945
TI  - [Automated radiotherapy in the combined treatment of locally advanced and
      disseminated ovarian cancer].
AB  - The paper deals with the results of treatment of 110 patients with advanced
      ovarian cancer showing signs of tumor progression following polychemotherapy with
      two regimens which included radiotherapy. Variants of distant and contact
      irradiation individually-tailored to suit the types of tumor are discussed.
      Details of single and repeated courses of chemoradiation are presented. Such
      beneficial effects as longer survival and better quality of life were registered
      in 76%.

PMID- 11219946
TI  - [Experience with and perspectives of an extended radical regimen of radiotherapy
      for Hodgkin's disease with prophylactic irradiation of the liver and the lungs].
AB  - The end-results of extended radical radiotherapy for stage II-III Hodgkin's
      disease with apparent factors of risk of relapse in the lung and/or liver are
      presented. The procedure included prophylactic irradiation of both organs. Ten
      year relapse-free survival in the lung-irradiation group was 85.9%, overall 10
      year survival--94.0%; the liver-irradiation group--90.0 and 94.7%, respectively.
      Preventive irradiation was shown to significantly decrease the influence of such
      risks as extended lesions of the mediastinum and spleen. Relapse in the lung was
      recorded in one case (1.6%) only, with no tumor progression defected in the
      liver. Significant increase in 5- and 10-year relapse-free survival was
      established in the lung-irradiation group, as a result of a comparison of the
      study group and that of controls who showed characteristic signs of intrathoracic
      risk. Significant difference in overall survival was recorded for the first three
      years only. As far as the liver-irradiation factor is concerned, the rise in both
      categories of survival was significant for the 10 years. It is suggested that
      patients with stage II-III Hodgkin's disease receive prophylactic irradiation
      whenever they reveal significant signs of risk of relapse in the lung and/or
      liver.

PMID- 11219947
TI  - [Radiotherapy for brain stem neoplasms in children].
AB  - The immediate and short-term results of radiotherapy of brain stem tumors in 24
      children were evaluated. All the patients were able to sustain treatment due to
      adjuvant support with dehydrating and hormonal drugs, and beneficial clinical
      effect was recorded in 80%. However, MRT showed no decrease in tumor size. Tumor
      growth relapsed 3-8 months after radiotherapy. Although total dose ranged 60-72
      Gy in 19 patients, there was clinical evidence of radiation injury.

PMID- 11219948
TI  - [From a mammographic station to the organization of the Federal Mammologic
      Center].
AB  - The history of radiation application for breast cancer diagnosis in Russia is
      illustrated by an experience gained at the Center. It was concerned with
      designing specialized X-ray equipment as well as development of Standards to be
      used at mammographic stations. Teaching programs were devised for training X-ray
      diagnosis specialists with all necessary qualification to operate high-tech
      equipment of a mammographic station and to use a wide range of radiation and
      invasive procedures.

PMID- 11219949
TI  - [Some prognostic factors in the combined therapy of locally advanced breast
      cancer].
AB  - A relationship between the dynamics of growth and pathological response of tumor
      cells and the number of neoadjuvant chemotherapy courses was established. As a
      result, there was no correlation between increase in overall and disease-free
      survival, on the one hand, and stage, on the other. An interval between
      neoadjuvant chemotherapy and surgery longer than 4 weeks had a negative effect on
      overall tumor response and duration of disease-free period.

PMID- 11219950
TI  - [Role of induction chemo- and radiotherapy in the treatment of locally advance
      breast cancer].
AB  - 336 patients with locally-advanced breast cancer underwent neoadjuvant
      chemotherapy or chemoradiotherapy. Increase in T- and N-indices (change of stage
      after neoadjuvant chemotherapy) proved an important prognostic factor. Survival
      rates correlated with clinical effect and dropped as it diminished. This tendency
      was clear in both groups. There was no relationship between stage and overall and
      disease-free survival rates at early stages but later they declined as T- and N
      indices decreased.

PMID- 11219951
TI  - [Correlation of clinical effect, pathological response of tumor cells and the end
      results of combined treatment of locally advanced breast cancer].
AB  - A correlation was established between the end-results of neoadjuvant chemotherapy
      for locally-advanced breast cancer and pathological response of tumor cells.
      Also, the end-results correlated with CR or PR and pathological response. Only a
      small proportion of patients with tumor progression were registered as stage III
      or IV of pathological response (0.6 and 0.8%, respectively).

PMID- 11219952
TI  - [Diagnosis and therapy of cancer of Vater's ampulla].

PMID- 11219953
TI  - [The use of therapeutic/prophylactic dragee "honey laminolact" in radiotherapy of
      uterine tumors].
AB  - The study deals with the effect of a newly-developed food product--Honey
      Laminolact, containing live lactic acid bacteria, amino acids, trace elements,
      fruit pectine and immunomodulators-on the degree of response to radiation in 44
      patients who received radiotherapy for uterine tumors. It was shown to lower
      response of the intestinal tract to radiation when the small pelvis was exposed.

PMID- 11219954
TI  - Regularity effects in word naming: what are they?
AB  - In a word-naming experiment, word-body consistency was crossed with grapheme-to
      phoneme regularity to test predictions of current models of word recognition. In
      the latency and error data, a clear effect of consistency was observed, with the
      influence of regularity somewhat weaker. In addition, simulation data from three
      contemporary models of word recognition were obtained for the stimuli used in the
      experiment in order to compare the models' latencies with those of humans. The
      simulations showed that the human latency data are most consistent with the
      parallel-distributed-processing model of Plaut, McClelland, Seidenberg, and
      Patterson (1996), less so with the dual-process model (Zorzi, Houghton, &
      Butterworth, 1998), and least so with the dual-route-cascaded model (Coltheart &
      Rastle, 1994).

PMID- 11219955
TI  - Morphological priming: dissociation of phonological, semantic, and morphological
      factors.
AB  - Previous experiments based on a masked-priming paradigm revealed robust
      morphological priming effects induced by two derivational morphemes in Hebrew:
      the root and the verbal pattern. However, considering the special characteristics
      of the masked-priming paradigm, the possible contributions of phonological and/or
      semantic factors to these morphological effects could not be firmly assessed. In
      the present study, the role of these factors in morphological priming was
      examined, using cross-modal presentation. Experiment 1 revealed that priming
      between morphologically related words in Hebrew is determined by higher level
      linguistic characteristics and cannot be reduced to phonological overlap.
      Experiment 2 confirmed that morphological priming occurs in Hebrew even when
      primes and targets are not semantically related but, nevertheless, increases with
      semantic similarity. The results support the claim that morphological priming
      cannot be accounted for by considering semantic and phonological factors alone,
      and they exemplify the potential of using both masked and cross-modal priming to
      examine morphological processing.

PMID- 11219957
TI  - Syntactic priming in spoken production: linguistic and temporal interference.
AB  - Current evidence about the persistence of syntactic priming effects (Bock, 1986)
      is equivocal: Using spoken picture description, Bock and Griffin (2000) found
      that it persisted over as many as 10 trials; using written sentence completion,
      Branigan, Pickering, and Cleland (1999) found that it dissipated if even a single
      sentence intervened between prime and target. This paper asks what causes it to
      be long lasting. On one account, the rapid decay evidenced by Branigan et al.
      occurs because the task emphasizes conceptual planning; on another account, it is
      due to the written nature of their task. If conceptual planning is the cause,
      this might relate to planning the prime sentence or planning an intervening
      sentence. Hence we conducted an experiment with spoken sentence completion,
      contrasting no delay, an intervening sentence, and a pure temporal delay. The
      results indicated that strong and similar priming occurred in all three cases,
      therefore lending support to the claim that spoken priming is long lasting.

PMID- 11219956
TI  - Orthography plays a critical role in cognate priming: evidence from
      French/English and Arabic/French cognates.
AB  - A series of three experiments was carried out in order to better characterize the
      representations that support long-term cognate priming. In Experiment 1, robust
      priming was obtained between orthographically similar French/English cognates in
      bilingual speakers, and this priming was mediated, in part, by orthographic
      codes, given that priming for these items was dramatically reduced following a
      study-test modality shift. In Experiment 2, no priming was obtained between the
      same set of French/English cognates in monolingual English speakers. Finally, in
      Experiment 3, priming for orthographically unrelated Arabic/French cognates was
      no larger than cross-modal priming, suggesting that these effects were mediated
      by nonorthographic representations. The role of orthography in supporting cognate
      priming is discussed.

PMID- 11219958
TI  - Task demands and representation in long-term repetition priming.
AB  - The effects of task demands on the representation of letter strings in long-term
      repetition priming (LTRP) were explored in two lexical decision experiments. The
      stimuli in both experiments were words and nonwords, some presented horizontally
      and some vertically. The only difference between the two experiments was the
      response required by the participant. In Experiment 1, the participants pressed
      one of two buttons, indicating whether or not a given stimulus was a word. In
      Experiment 2, the participants pressed one of four buttons, indicating both the
      lexical status and the orientation of a given stimulus. The results were that in
      Experiment 1, LTRP was not disrupted by a change in stimulus orientation, whereas
      in Experiment 2 it was, suggesting that the nature of the stimulus representation
      utilized in LTRP is partially dependent on the demands of the task.

PMID- 11219959
TI  - Temporal and spatial distance in situation models.
AB  - In two experiments, we investigated how readers use information about temporal
      and spatial distance to focus attention on the more important parts of the
      situation model that they create during narrative comprehension. Effects of
      spatial distance were measured by testing the accessibility in memory of objects
      and rooms located at differing distances from the protagonist's current location.
      Before the test probe, an intervening episode was inserted in the narrative.
      Story time distance was manipulated by stating that the intervening episode
      lasted for either minutes or hours. Discourse time--that is, time spent reading
      from prime to test--was manipulated by describing the intervening episode either
      briefly or at length. Clear effects of story time distance and spatial distance
      on accessibility were found, whereas discourse time distance did not affect
      accessibility. The results are interpreted as supporting constructionist theories
      of text comprehension.

PMID- 11219960
TI  - Learning artificial grammars: no evidence for the acquisition of rules.
AB  - Two experiments investigated whether there is evidence for acquisition of rules
      in implicit artificial grammar learning (AGL). Two different methods were used in
      meeting this goal, multiple regression analysis and analysis of receiver
      operating characteristics (ROCs). By means of multiple regression analysis,
      several types of knowledge were identified that were used in judgments of
      grammaticality, for example, about single letters and about larger stimulus
      fragments. There was no evidence for the contribution of rule knowledge. The ROCs
      were in accord with a similarity-based account of AGL and thus did not support
      the notion that rule knowledge is acquired in AGL either. Simulations with a
      connectionist model corroborated the conclusion that the results were in accord
      with a similarity-based, associative account.

PMID- 11219961
TI  - Sex differences in duration judgments: a meta-analytic review.
AB  - We quantitatively reviewed human sex differences in the magnitude and variability
      of duration judgments. Data from 4,794 females and 4,688 males yielded 87 effect
      size estimates of magnitude and 28 of variability. The overall sex difference in
      duration judgment magnitude was small but statistically significant. It was
      moderated by whether study participants knew in advance (prospective paradigm) or
      only later (retrospective paradigm) that they would be required to judge
      duration. Although prospective judgments showed no overall sex effect, some
      levels of moderator variables showed a small but statistically significant
      effect. Retrospective judgments showed a larger subjective-to-objective duration
      ratio for females than for males, and several variables moderated this effect.
      Females' judgments also showed more intersubject variability than did males'
      judgments. Relative to males, females sustain attention to time more in the
      prospective paradigm and have better episodic memory in the retrospective
      paradigm.

PMID- 11219962
TI  - Predicting individual false alarm rates and signal detection theory: a role for
      remembering.
AB  - The relationships between hit, remember, and false alarm rates were examined
      across individual subjects in three remember-know experiments in order to
      determine whether signal detection theory would be consistent with the observed
      data. The experimental data differed from signal detection predictions in two
      critical ways. First, remember reports were unrelated, or slightly negatively
      related, to the commission of false alarms. Second, both response types
      (remembers and false alarms) were uniquely related to hit rates, which
      demonstrated that the hit rate cannot be viewed as the result of a single
      underlying strength process. These results are consistent with the dual-process
      signal detection model of Yonelinas (1994), in which performance is determined by
      two independent processes--retrieval of categorical context information
      (remembering) and discriminations based on continuous item strength. Remember and
      false alarm rates selectively tap these processes, whereas the hit rate is
      jointly determined. Monte Carlo simulations in which the dual-process model was
      used successfully reproduced the pattern in the experimental data, whereas
      simulations in which a signal detection model, with separate "old" and "remember"
      criteria, was used, did not. The results demonstrate the utility of examining
      individual differences in response types when one is evaluating memory models.

PMID- 11219964
TI  - On the locus of the semantic satiation effect: evidence from event-related brain
      potentials.
AB  - The present study sought to determine whether semantic satiation is merely a by
      product of adaptation or satiation of upstream, nonsemantic perceptual processes
      or whether the effect can have a locus in semantic memory. This was done by
      measuring event-related brain potentials (ERPs) in a semantic word-detection task
      involving multiple presentations of primes and critical related and unrelated
      words in three experiments involving visual (Experiment 1) and auditory
      (Experiments 2A and 2B) stimuli. Primes varied in their type case (Experiment 1)
      or pitch (Experiment 2B) in order to discourage sensory adaptation. Prime
      satiation and relatedness of the primes to the critical word had interacting
      effects on ERP amplitude to critical words, particularly within the time-window
      of the N400 component. Because numerous studies have indicated a role for the
      N400 in semantic processing, modulation of the N400 relatedness effect by prime
      satiation (with little or no contribution from perceptual adaptation) suggests
      that semantic memory can be directly satiated, rather than the cost to semantic
      processing necessarily resulting from impoverishment of perceptual inputs.

PMID- 11219965
TI  - The role of salience in conceptual combination.
AB  - The present study investigated three factors that affect the interpretation of
      novel noun-noun (N-N) combinations: simple feature salience, ontological
      category, and assessed similarity. Participants read and defined a series of
      novel N-N combinations in which the feature salience of N1 and N2 was
      manipulated. Participants also rated the combinations for similarity. The
      combinations were constrained to be within ontological category. All
      interpretations were scored in terms of the strategies (property mapping vs.
      relation linking) used to produce the given interpretations. Highly salient
      features drove property-mapping interpretations based on those features. Natural
      kinds produced more property-mapping interpretations than did artifacts. There
      was no correlation between the proportion of property-mapping interpretations and
      the assessed similarity of the N-N combinations. These results are discussed as
      an extension of Estes and Glucksberg's (2000) interactive theory of conceptual
      combination and argue for the importance of feature salience as a factor in
      conceptual combination.

PMID- 11219963
TI  - Acute effects of triazolam on false recognition.
AB  - Neuropsychological, neuroimaging, and electrophysiological techniques have been
      applied to the study of false recognition; however, psychopharmacological
      techniques have not been applied. Benzodiazepine sedative/anxiolytic drugs
      produce memory deficits similar to those observed in organic amnesia and may be
      useful tools for studying normal and abnormal memory mechanisms. The present
      double-blind, placebo-controlled repeated measures study examined the acute
      effects of orally administered triazolam (Halcion; 0.125 and 0.25 mg/70 kg), a
      benzodiazepine hypnotic, on performance in the Deese (1959)/Roediger-McDermott
      (1995) false recognition paradigm in 24 healthy volunteers. Paralleling previous
      demonstrations in amnesic patients, triazolam produced significant dose-related
      reductions in false recognition rates to nonstudied words associatively related
      to studied words, suggesting that false recognition relies on normal memory
      mechanisms impaired in benzodiazepine-induced amnesia. The results also suggested
      that relative to placebo, triazolam reduced participants' reliance on memory for
      item-specific versus list-common semantic information and reduced participants'
      use of remember versus know responses.

PMID- 11219966
TI  - Attribute centrality and imaginative thought.
AB  - Participants' representations of the concept human were examined to differentiate
      three types of associations between concepts and their component attributes: the
      capacity of concepts to cue attributes (attribute accessibility), the capacity of
      attributes to cue concepts (instance accessibility), and the extent to which
      attributes are thought of as central to concepts (attribute centrality). The
      findings provide information about the concept human itself and, more generally,
      about the functionally distinct roles those different attribute-concept
      associations play in guiding imaginative thought. College students listed
      attributes that differentiate humans from other animals, rated the centrality of
      those attributes, and listed animals that possess those attributes. Other
      students drew and described extraterrestrials that possessed some of the
      attributes that were found to vary across those listing and rating tasks. Rated
      centrality was the most important determinant of an attribute's impact on
      imaginative generation. When the imagined extraterrestrials were supposed to
      possess attributes that had been rated as central to humans (intelligence,
      emotional complexity, or opposable thumbs), participants projected more aspects
      of human form onto them than when the creatures were supposed to possess less
      central attributes or when attributes were unspecified.

PMID- 11219967
TI  - Levels-of-processing effects on Chinese character completion: the importance of
      lexical processing and test cue.
AB  - The levels of processing (LoP) effect was studied in Chinese character completion
      tasks. The same stem cue, either graphemically or semantically related to the
      target character, was used to generate either a perceptual or a conceptual test.
      Participants received either direct or indirect instructions, so that the same
      stem cue also produced either an explicit or an implicit test of memory. This
      allowed us to examine simultaneously the roles of perceptual versus conceptual
      test and retrieval intentionality in the LoP effect. No LoP effects were found
      when the memory test was implicit. LoP effects were also not found for stems and
      characters related graphemically (perceptually), but were found for stems and
      characters related semantically (conceptually) when the memory test was explicit.
      The results are discussed in terms of the importance of lexical processing for
      character completion tests and the importance of reinstatement of the study
      process during retrieval for explicit memory tests.

PMID- 11219968
TI  - Effects of hearing words, imaging hearing words, and reading on auditory implicit
      and explicit memory tests.
AB  - In four experiments, we examined the degree to which imaging written words as
      spoken by a familiar talker differs from direct perception (hearing words spoken
      by that talker) and reading words (without imagery) on implicit and explicit
      tests. Subjects first performed a surface encoding task on spoken, imagined as
      spoken, or visually presented words, and then were given either an implicit test
      (perceptual identification or stem completion) or an explicit test (recognition
      or cued recall) involving auditorily presented words. Auditory presentation at
      study produced larger priming effects than did imaging or reading. Imaging and
      reading yielded priming effects of similar magnitude, whereas imaging produced
      lower performance than reading on the explicit test of cued recall. Voice changes
      between study and test weakened priming on the implicit tests, but did not affect
      performance on the explicit tests. Imagined voice changes affected priming only
      in the implicit task of stem completion. These findings show that the sensitivity
      of a memory test to perceptual information, either directly perceived or
      imagined, is an important dimension for dissociating incidental (implicit) and
      intentional (explicit) retrieval processes.

PMID- 11219969
TI  - The ability of familiarity, disruption, and the relative strength of
      nonenvironmental context cues to explain unreliable environmental-context
      dependent memory effects in free recall.
AB  - The ability of environmental-context (EC) familiarity, movement disruption, and
      the relative strength of memory cues to explain unreliable EC-dependent free
      recall memory effects was examined in two experiments. Experiment 1 replicated
      Smith's (1979, Experiment 1) results confirming that familiarity and disruption
      cannot account for free-recall EC-reinstatement effects. In Experiment 2, a level
      of processing manipulation varied stimulus item memory cue strengths, and memory
      was again assessed by free recall. Contrary to Murnane and Phelps's (1995) and
      Dougal and Rotello's (1999) recognition findings, an EC-reinstatement effect was
      observed with low, but not high, levels of processing. However, comparisons
      across the two experiments revealed inconsistencies with the relative cue
      strength hypothesis. Consequently, a variant of the relative cue strength
      hypothesis that highlights the role of retrieval processes was proposed to
      explain the interaction between the levels of processing and the EC-reinstatement
      effect.

PMID- 11219970
TI  - Deeper processing at target selection increases the magnitude of negative
      priming.
AB  - Do deeper levels of processing produce equivalent priming effects at all stages
      of task performance? In Experiment 1, we varied the level of processing
      factorially across two task stages--target selection and response selection. Each
      stage required perceptual (e.g., color) or conceptual (e.g., friendliness)
      processing of stimulus items (i.e., animal names). Negative priming was
      substantially greater when deeper processing was required at the target selection
      stage, but it was unaffected by the level of processing at the response selection
      stage. In contrast, positive priming was greater when deeper processing was
      required at the response selection stage, but it was unaffected by processing at
      the target selection stage. In Experiment 2, we generalized this finding using a
      task in which numeric targets were selected on the basis of their parity. As in
      Experiment 1, the deeper level of processing at the target selection stage
      produced a larger negative priming effect. These results illuminate the role of
      target selection demands in modulating the strength of negative priming.

PMID- 11219971
TI  - The Stroop effect: it is not the robust phenomenon that you have thought it to
      be.
AB  - Five experiments demonstrate that context has a powerful effect on the ease with
      which people can name (Experiments 1-3) or categorize (Experiments 4-5) a
      stimulus while ignoring another stimulus, irrelevant or conflicting with the
      target. Selectivity of attention to the target dimension was gauged through
      Stroop and Garner effects. When the stimulus values along the target dimension
      and the to-be-ignored dimension were correlated over the experimental trials,
      large effects of Stroop and Garner influenced performance. However, when random
      allocation of values created zero dimensional correlation, the Stroop effects
      vanished. These results imply that when the nominally irrelevant dimension is in
      fact correlated with the relevant dimension, participants then attend to the
      irrelevant dimension and thus open themselves up to Stroop interference. Another
      variable of context, the relative salience of the constituent dimensions, also
      affected performance with the more discriminable dimension disrupting selective
      attention to the less discriminable dimension. The results demonstrate the
      importance of context in engendering the failure of selective attention and
      challenge traditional automaticity accounts of the Stroop effect.

PMID- 11219972
TI  - Biochemical modulation of 5-FU in systemic treatment of advanced colorectal
      cancer.
AB  - Randomized studies have tested a variety of strategies to improve the activity of
      5-fluorouracil (5-FU) in colorectal cancer patients. Results from 14 randomized
      trials comparing 5-FU administered via intravenous (i.v.) bolus either as a
      single agent or modulated by leucovorin indicate a significantly higher response
      rate with 5-FU/leucovorin (25% vs 13% of assessable patients). Sequential
      methotrexate followed by i.v. bolus 5-FU is associated with a higher response
      rate. Continuous infusion schedules also produce superior response rates compared
      to bolus 5-FU alone. Published meta-analyses indicate a small, but statistically
      significant, survival advantage for methotrexate/5-FU and infusional 5-FU, but
      not for leucovorin-modulated 5-FU. Although the incidence of hand-foot syndrome
      is higher with protracted infusional 5-FU, the incidence of other toxicities
      including myelosuppression, diarrhea, and mucositis is low. Oral administration
      of 5-FU may simulate infusional schedules while avoiding catheter-related
      complications.

PMID- 11219973
TI  - Clinical implications of dihydropyrimidine dehydrogenase on 5-FU pharmacology.
AB  - Dihydropyrimidine dehydrogenase (DPD) is the initial rate-limiting enzyme in the
      catabolism of 5-fluorouracil (5-FU), accounting for catabolism of over 85% of an
      administered dose of 5-FU. DPD plays an important role in regulating the
      availability of 5-FU for anabolism. DPD also accounts for much of the variability
      observed with the therapeutic use of 5-FU. This includes variable 5-FU levels
      over 24 hours during a continuous infusion; the widely reported variability in
      the pharmacokinetics of 5-FU; the observed variable bioavailability that led to
      the recommendation that 5-FU not be administered as an oral agent; and lastly,
      the observed variability in both toxicity and drug response (resistance) after
      identical 5-FU doses. Knowledge of the DPD level, as well as the levels of other
      potentially important molecular markers (e.g., thymidylate synthase), may permit
      adjustments or modulation of the 5-FU dose that can result in an increase in the
      therapeutic efficacy of 5-FU.

PMID- 11219974
TI  - Oral chemotherapy for colorectal cancer: some economic considerations.
AB  - In the formal medical curriculum, little has been provided to prepare the
      clinician for an understanding of the economics of health care. The questions are
      often far more complicated than they initially appear to be, and the techniques
      and terminology used in evaluation of these questions are often foreign to many
      health-care providers. This brief essay, written by an author who confesses to
      being an economic layman, will attempt to discuss and clarify some terms and
      techniques used in the economic analysis of health care. In that context, and
      recognizing the limitations of the techniques available, an attempt will be made
      to address the question of the economic impact of oral fluorinated pyrimidines on
      the management of colorectal cancer.

PMID- 11219975
TI  - Patient selection for oral chemotherapy.
AB  - Oral chemotherapy has evolved with several new agents such as capecitabine and
      UFT in active clinical trials or already approved for use in the western world.
      Several distinct issues, apart from the usual criteria for selecting patients for
      intravenous chemotherapy, dictate patient selection for these drugs. This article
      discusses these issues, which include patient preference, selection, and
      compliance.

PMID- 11219976
TI  - Nursing strategies for patients on oral chemotherapy.
AB  - Oncology nurses play a pivotal role in educating the cancer patient who is about
      to commence oral chemotherapy. Increasing numbers of patients are receiving oral
      chemotherapy at home, and with this move to oral self-administration, there has
      been a critical shift in responsibility of management from the provider to
      patient. Oral regimens pose new challenges in patient selection and education.
      Recognition of factors that affect patient compliance will be particularly
      important with oral chemotherapy. Strategy tools for the patient and provider
      will need to be developed to ensure optimal compliance and safety.

PMID- 11219978
TI  - UFT in the treatment of colorectal and breast cancer.
AB  - UFT and leucovorin (Orzel) is a combination of tegafur and uracil in a molar
      ratio of 1:4. Tegafur, a prodrug of 5-fluorouracil (5-FU), is converted to 5-FU
      by the hepatic cytochrome P450 pathway, whereas uracil enhances the half-life of
      converted 5-FU leading to prolonged exposure and higher intracellular
      concentration of 5-FU by inhibiting dihydropyrimidine dehydrogenase (DPD), a rate
      limiting enzyme in 5-FU catabolism. UFT has broad antitumor activity against
      colorectal and breast cancer, and has been studied extensively worldwide. Trials
      conducted in the United States have mainly focused on the combination of UFT and
      leucovorin. Compared with an intravenous 5-FU plus leucovorin regimen in advanced
      colorectal cancer treatment, UFT plus leucovorin appears to have equivalent
      antitumor efficacy with less toxicity. UFT may also provide a more convenient
      protracted treatment method with fewer complications, compared to intravenous
      programs. The application for FDA approval of UFT with leucovorin as a first-line
      treatment regimen for advanced colorectal cancer is pending. Administered as a
      single agent or in combination with other chemotherapy agents and hormones, UFT
      may also be effective in treating breast cancer, either as a primary adjuvant
      treatment or as palliative treatment for metastatic disease.

PMID- 11219977
TI  - Capecitabine in colorectal cancer.
AB  - Capecitabine (Xeloda) is the first orally available fluoropyrimidine approved for
      use in patients with cancer. It was initially approved for use in metastatic
      breast cancer, but significant data also support its use in the management of
      metastatic colorectal cancer. Capecitabine relies on a series of metabolic steps,
      the last of which occurs primarily within cancer cells. This results in selective
      activation of the compound within cancer cells, thereby reducing systemic
      toxicities and allowing for greater dose intensity. This article reviews selected
      phase I, phase II, and phase III clinical trials conducted in patients with
      colorectal cancer that document the metabolic activation of this compound and
      support its use in patients with advanced colorectal cancer.

PMID- 11219979
TI  - Oral eniluracil/5-FU for advanced colon and breast carcinomas.
AB  - 5-fluorouracil (5-FU) is irreversibly catabolized to dihydrofluorouracil, an
      inactive metabolite, by the enzyme dihydropyrimidine dehydrogenase (DPD). This
      catabolic pathway is a critical step in determining 5-FU availability for
      conversion to nucleotides and eventual incorporation into either RNA or DNA.
      Inactivation of DPD, therefore, is an approach to enhance the availability of 5
      FU for potential improved therapeutic effect. Preclinical animal and human
      studies have demonstrated that eniluracil is an effective inactivator of DPD.
      Phase I studies have been completed showing the tolerability of two dosing
      schedules, including (1) a chronic schedule with twice-daily administration of
      eniluracil plus oral fluorouracil (5-FU) (10:1 ratio) for 28 days, and (2) a
      schedule of eniluracil administered daily on days 1-7 with oral 5-FU once daily
      on days 2-6. The phase I trials have demonstrated limited toxicities including
      diarrhea, mucositis, and neutropenia. Follow-up clinical trials have targeted
      colon and breast cancers in particular.

PMID- 11219980
TI  - Other fluorinated pyrimidines in the treatment of solid tumors.
AB  - Researchers, primarily in Japan, Europe, and the United States, have evaluated
      several new fluorinated pyrimidines in recent years. Most of these drugs are
      orally active prodrugs of fluorouracil (5-FU), and some also contain modulators
      of its pharmacological properties. S-1 is a rationally developed combination of
      tegafur, a prodrug of 5-FU; CDHP, an inhibitor of 5-FU catabolism; and potassium
      oxonate, an inhibitor of 5-FU-induced diarrhea. S-1 underwent phase I and II
      trials in Japan, where it is now approved for use in the treatment of advanced
      gastric cancer. Two phase I studies conducted recently in Europe and the United
      States identified diarrhea as the dose-limiting toxicity of S-1. BOF-A2, which
      contains a 5-FU prodrug and CNDP, an inhibitor of 5-FU catabolism, demonstrated
      clinical activity in preliminary studies in Japan. This article summarizes the
      preclinical and clinical development of S-1 and BOF-A2.

PMID- 11219981
TI  - Clinical status of capecitabine in the treatment of breast cancer.
AB  - New treatment strategies for advanced breast cancer have focused on both the
      development of new molecular targets in breast cancer cells, as well as improving
      the therapeutic index of presently available therapy. The development of
      capecitabine (Xeloda), a new oral fluoropyrimidine, is an example of a
      chemotherapy drug that has single-agent activity in heavily pretreated patients
      with advanced breast cancer, with the added convenience of good oral
      bioavailability. Capecitabine is an excellent treatment option for patients who
      require symptom palliation and who prefer oral medications. The discussion that
      follows reviews the clinical data on the use of capecitabine in advanced breast
      cancer.

PMID- 11219982
TI  - Perspectives on fluorinated pyrimidine use in gastrointestinal and breast
      oncology.

PMID- 11219983
TI  - Oral fluoropyrimidine-based combination therapy in gastrointestinal cancer.
AB  - Significant emphasis has been placed recently on designing more effective
      fluorouracil (5-FU)-based combination protocols for gastrointestinal cancer.
      Promising results were seen with 5-FU/leucovorin in combination with irinotecan
      (Camptosar) or oxaliplatin (Eloxatin), especially in colorectal cancer. Clinical
      trials of UFT, with or without leucovorin, demonstrate the safety of this regimen
      and an efficacy comparable to that of bolus 5-FU/leucovorin in the treatment of
      gastrointestinal tumors. Two large randomized phase III trials of capecitabine
      (Xeloda) showed that capecitabine also offers a convenient alternative to bolus 5
      FU/leucovorin with a superior safety profile and at least equivalent antitumor
      activity.

PMID- 11219984
TI  - Public perception of science. Part 1.

PMID- 11219985
TI  - In space, the past can be recast but not the present.
AB  - We address the relationship between perception and spatial, working memory.
      Specifically, we argue that perceptual experience following the creation of a
      representation of target location affects it in a systematic way. We designed a
      motor task in which observers had to point to the initial or final position of a
      horizontally drifting target embedded in a vertically drifting background. The
      target was perceived as having an illusory motion component in a direction
      opposite that of the inducer dots [Duncker, 1938, Source Book of Gestalt
      Psychology (London: Kegan Paul, Trench, Trubner and Co)]. For both positions,
      there was an identical time delay before the observer could respond. Nonetheless,
      estimates of the initial target position were significantly biased by the
      illusion in a direction opposite the perceived target motion, and both bias and
      variability were significantly greater than those of the target's final position.
      In prior studies on positional accuracy with induced displacement, a delay before
      a pointing response led to an unbiased position estimate obtained without delay
      to become biased, leading investigators to argue for a long-lasting, inaccurate
      cognitive system that overrules an accurate, nonetheless transient, motor one
      (Bridgeman et al, 1997, Perceptual Psychology 59 456-469). Since the same motor
      task with identical delay on either position yielded different outcomes, a
      hypothesis based on distinct motor and cognitive representations of visual space
      is untenable here. Instead, we argue that an online representation of the
      target's original position is updated in an ongoing fashion in order to reconcile
      the perceived illusion with the veridically perceived present (current target
      location).

PMID- 11219986
TI  - Manipulation of colour and shape information and its consequence upon recognition
      and best-likeness judgments.
AB  - Previous forays into the study of recognition have revealed an advantage for line
      drawn and photographic shape caricatures of faces in reaction-time paradigms.
      When a presentation-time technique was used, photographs with enhanced colour
      intensity and saturation were also found to provide superior recognition accuracy
      to veridical images. This has provided strong evidence that distinctive
      information can produce a recognition advantage for famous faces in both colour
      and shape domains. Such a presentation-time paradigm allows the display of
      stimuli over a range of brief display periods. Using this paradigm, subjects
      recognised photorealistic target faces caricatured in shape with greater accuracy
      than veridical images, consistent with previous findings when reaction time was
      used as a measure. Subjects were also asked to identify the best likeness for
      individuals using photorealistic stimuli and an interactive paradigm with shape
      caricature, colour caricature, and contrast control varied by the user in real
      time. The best likeness with shape manipulation was a slight anticaricature,
      while with colour-caricature and contrast-control images a mildly exaggerated
      image was selected as the best likeness. Thus, although images caricatured
      substantially in colour or shape (+40%) induce superior recognition compared to
      veridical images, such substantial exaggerations are not necessarily seen as best
      likenesses under prolonged exposure.

PMID- 11219987
TI  - Perceiving binocular depth with reference to a common surface.
AB  - A common surface is a spatial regularity of our terrestrial environment. For
      instance, we walk on the common ground surface, lay a variety of objects on the
      table top, and display our favorite paintings on the wall. It has been proposed
      that the visual system utilizes this regularity as a reference frame for coding
      objects' distances. Presumably, by treating the common surface as such--i.e. an
      anticipated constant--the visual system can reduce its coding redundancy, and
      divert its resources to representing other information. For intermediate-distance
      space perception, it has been found that absolute distance judgment is most
      accurate when a common ground surface is available. Here we explored if the
      common surface also serves as the reference frame for the processing of binocular
      disparity information, which is a predominant cue for near-distance space
      perception. We capitalized on an established observation where the perceived
      slant of a surface with linear binocular-disparity gradient is underestimated.
      Clearly, if the visual system utilizes this incorrectly represented slant surface
      as a reference frame for coding the objects' locations, the perceived depth
      separation between the objects will be adversely affected. Our results confirm
      this, by showing that the depth judgment of objects (two laterally separated
      vertical lines) on, or in the vicinity of, the surface is underestimated.
      Furthermore, we show that the impact of the common surface on perceived depth
      separation most likely occurs at the surface-representation level where the
      visual surface has been explicitly delineated, rather than at the earlier
      disparity-processing level.

PMID- 11219988
TI  - The effects of age upon the perception of depth and 3-D shape from differential
      motion and binocular disparity.
AB  - The ability of younger and older adults to perceive the 3-D shape, depth, and
      curvature of smooth surfaces defined by differential motion and binocular
      disparity was evaluated in six experiments. The number of points defining the
      surfaces and their spatial and temporal correspondences were manipulated. For
      stereoscopic sinusoidal surfaces, the spatial frequency of the corrugations was
      also varied. For surfaces defined by motion, the lifetimes of the individual
      points in the patterns were varied, and comparisons were made between the
      perception of surfaces defined by points and that of more ecologically valid
      textured surfaces. In all experiments, the older observers were less sensitive to
      the depths and curvatures of the surfaces, although the deficits were much larger
      for motion-defined surfaces. The results demonstrate that older adults can
      extract depth and shape from optical patterns containing only differential motion
      or binocular disparity, but these abilities are often manifested at reduced
      levels of performance.

PMID- 11219989
TI  - Mapping the zone of eye-height utility for seated and standing observers.
AB  - In a series of experiments, we delimited a region within the vertical axis of
      space in which eye height (EH) information is used maximally to scale object
      heights, referred to as the "zone of eye height utility" (Wraga, 1999b Journal of
      Experimental Psychology, Human Perception and Performance 25 518-530). To test
      the lower limit of the zone, linear perspective (on the floor) was varied via
      introduction of a false perspective (FP) gradient while all sources of EH
      information except linear perspective were held constant. For seated (experiment
      1a) observers, the FP gradient produced overestimations of height for rectangular
      objects up to 0.15 EH tall. This value was taken to be just outside the lower
      limit of the zone. This finding was replicated in a virtual environment, for both
      seated (experiment 1b) and standing (experiment 2) observers. For the upper limit
      of the zone, EH information itself was manipulated by lowering observers' center
      of projection in a virtual scene. Lowering the effective EH of standing
      (experiment 3) and seated (experiment 4) observers produced corresponding
      overestimations of height for objects up to about 2.5 EH. This zone of
      approximately 0.20-2.5 EH suggests that the human visual system weights size
      information differentially, depending on its efficacy.

PMID- 11219990
TI  - Emmert's law in the dark: active and passive proprioceptive effects on positive
      visual afterimages.
AB  - The relationship between apparent size and apparent distance is given by Emmert's
      law, which states that a retinal image is proportional in size to the distance of
      the surface it is projected upon. This principle also applies to retinal
      afterimages in that they, too, will change in apparent size if distance cues
      suggest that the location of the object onto the retinal image has been altered.
      It has also been known for some time that non-retinal cues can produce
      quantitative and qualitative effects on an afterimage when it is viewed in the
      dark. In the present two studies, positive afterimages of an observer's hand, as
      well as objects held by that hand, were used as targets to investigate the
      effects on size-constancy scaling of moving the hand to and fro along the line of
      sight for different distances in the dark. Results show that, when observers
      focus on a held object, the changes in size predicted by Emmert's law occur in
      response to both active and passive proprioceptive or haptic cues. The most
      intriguing result consisted of the finding that, when only the hand is the
      target, there appears to be a limit to the decrease in apparent hand size. It
      appears that the visual system 'refuses' to size-scale the hand below a limit it
      accepts as representative or acceptable of 'its' hand.

PMID- 11219992
TI  - Near the zone of totality: an eclipse observed.

PMID- 11219991
TI  - The multiple-faces phenomenon: some investigate studies.

PMID- 11219993
TI  - [Clinical nutrition: a science in evolution].

PMID- 11219994
TI  - [Nutrition and chronic renal failure].
AB  - The causes of malnutrition in chronic terminal kidney failure are reviewed in the
      situation both before and after dialysis, as are the malnutrition rates in both
      circumstances and their treatment. Malnutrition has a high prevalence in terminal
      kidney patients, partly as a result of the therapeutic restriction on calories
      and proteins, but also due to the metabolic reactions typical of the disease and
      to anorexia. In patients subjected to dialytical methods, certain other
      mechanisms are added. In addition to malnutrition, there are alterations in the
      metabolism of calcium, phosphorus and potassium, as well as lipids, thus limiting
      nutritional therapy's ability to restore the nutritional status to normal. An
      awareness of energy expenditure in chronic terminal kidney failure and the
      consequences of malnutrition have led to new challenges in nutritional therapy,
      both in the dose and quality of the proteins, with a debate raging over the
      advantages of ketoanalogues, and also in the methods for providing nutrients. The
      ideal nutritional method for repletion is oral administration, but this can be
      enhanced with artificial support such as oral supplements, parenteral nutrition
      during dialysis or such alternatives as enteral nutrition at home in the case of
      chronic kidney problems in children, using percutaneous endoscopic gastrostomy
      (PEG), in order to nourish the patients and minimize growth disorders.

PMID- 11219995
TI  - [Parenteral nutrition in hematologic patients treated with hematopoietic stem
      cell transplantation].
AB  - The transplant of haematopoyetic parent cells is on common way of treating
      haematological neoplasias and other types of immunological and tumoural
      disorders. The aggressive nature of the treatment, leading to peculiar
      nutritional and metabolic conditions in these patients, as well as the notable
      incidence of complications, have meant that nutritional support is included in
      the therapeutic armoury. As in other clinical situations, we are currently able
      to go beyond merely ensuring the necessary nutritional support. We can also
      influence the progress of the illness by means of the provision of specific
      substrates which interfere in a positive manner with the disturbed intermediate
      metabolism. Even more, in some of these substrates we can find a nutrient drug
      action.

PMID- 11219996
TI  - [Multiple trauma and burns].
AB  - Patients with multiple injuries and burns are the paradigm of critically-ill
      patients. Their cases are acute, severe and, fortunately, reversible in a large
      number of situations. The severe aggressions leading to this kind of condition is
      the rigger for a maelstrom of inflammatory mediators, metabolic and neuro
      endocrinal response, leading to an acceleration in the combustion of the injured
      organ. This "internal combustion" process takes nourishment from organic
      reserves, using them up and thus producing dysfunctions in various organs. This
      is where nutritional support has a role, always remedying the metabolic response
      to inflammation and attempting to modify it. For this reason, nutritional support
      plays an undisputed part in the treatment of such patients. This nutritional
      support, so necessary in situations with a high degree of stress, must be
      individually tailored in terms of quantity and quality to the process and to the
      patient in question. Thus, adapting the support to requirements appears as a
      priority of nutritional assessment. While it is important to provide nourishment
      to needy patients, it is just as important if not more so to avoid over
      nourishment. Indirect calorimetry continues to be the most accurate indicator for
      determining the needs of each patient and, in view of the lack of knowledge of
      this technique mainly as a result of economic factors, many different methods and
      formulas have been proposed to attempt to carry out these adjustments. The
      characteristics and distribution of the macronutrients will be connected with the
      pathologies to be treated. And finally, the route for providing this nourishment
      seems ever more clearly to be as prompt first-line administration through the
      digestive tube. There are situations in which parenteral support will complement
      or replace the enteral route when the latter is insufficient or unavailable; in
      certain circumstances, the parenteral route even seems to be superior to enteral
      support, as in the case of pure head injury. As these patients are particularly
      prone to suffer from infections, another aspect of increasing interest in the
      nutritional support of these patients is the use of immunity-modulating diets,
      where a better response can be expected. The components of the immunity
      modulating diets have been shown to be able to modify the immune response in
      different ways, sometimes favouring the replication of lymphocytes and at other
      times stimulating the production of certain types of cytokines and attenuating
      the release of others, in short balancing the inflammatory response.

PMID- 11219997
TI  - [Nutrition and gene expression].
AB  - The genetic information stored in the DNA is transmitted to an RNA molecule
      through transcription and protein molecules are obtained from the RNA using
      translation techniques. Each of the processes forming part of this chain is the
      object of complex regulation (gene expression regulation). Some nutrients may
      affect gene expression by taking part in these regulatory mechanisms, such as
      sterols, glucose, vitamins A, D and B12, various fatty acids or some components
      of dietary fibre. These phenomena may have come about through the adaptation of
      the primitive beings to the various changes in the nourishment available. The
      successive changes over centuries have led to the determination of individuals'
      phenotypes not only by their genotype but also by environmental factors such as
      diet. Our genes have adapted to the changing sources of nourishment surrounding
      our ancestors; modern diets are, however, very different from those of the past.
      The inability of our genetic store to adapt to modern diets may be the reason for
      the appearance of certain chronic diseases in developed countries. One well
      analyzed case is that of the thrifty genotype which provided evolutionary
      advantages in the past, but may now be contributing to obesity and diabetes.
      Further examples of genotype interaction with various environmental factors to
      produce different phenotypes are provided by the apolipoproteins: some mutations
      in the genes of these proteins, in combination with different diet types, are
      associated with altered lipid levels and the risk of various cardiovascular
      diseases. These diet-genotype interactions mean that it is fundamentally
      important to take into account the genetic variability of individuals before
      recommending dietary measures to prevent the so-called "first-world" diseases.

PMID- 11219998
TI  - [Nutritional recommendations in gynecology].
AB  - In pregnant women, appropriate eating habits has a key role to play in the
      development of the foetus and is also related with the amount of labour at
      delivery, helping to avoid complications. In addition, correct nutrition is also
      necessary during the puerperium to encourage breast feeding and provide the new
      born child with an adequate nutritional status without leading to any deficits in
      the mother.

PMID- 11220000
TI  - [Nutrition and physical exercise].
AB  - The principles of a good diet and proper nutrition are the same for people
      practising sports and for non-athletes. The main difference lies in the amount of
      energy that sportsmen and women need to carry out a more intense physical
      activity and to keep an appropriate weight to allow greater performance. The
      relationship between nutrition and physical exercise has often been shrouded in
      confusion and conjecture, so certain products or supplements turn into real myths
      through attempts to achieve better athletic results, despite the fact the
      information available on the true effect of a particular substance or food on
      athletic performance is, quite limited and disputed. This paper attempts to
      clarify the scientific information available on this subject.

PMID- 11219999
TI  - [Antioxidant micronutrients and human pathology].
AB  - The harmful oxidation by free radicals has been implicated in the pathogenesis of
      many illnesses, including, as the most significant from the epidemiological
      standpoint, cardiovascular disease and cancer. This paper reviews the physio
      pathological foundations of this relationship and describes the possible
      usefulness of anti-oxidant therapy in these and other conditions.

PMID- 11220001
TI  - [Clinical ethics and nutritional support].
AB  - Artificial nutrition is a modern technique enjoying a great boom of late.
      Regulations on the use of important clinical and technological advances in
      connection with nutritional support in certain groups of patients represent one
      of the ethical problems most often posed in daily medical practice. Terminal
      patient and those with irreversible neurological damage are population groups at
      risk of these ethical problems when it comes to the prescription, withdrawal or
      omission of artificial nourishment and hydration. The establishment of certain
      guidelines in order to resolve the ethical problems arising seems to be a complex
      process. So far, no consensus has been reached among doctors, with no clear legal
      framework and no universally accepted ethical principles. It is necessary to
      ensure the consideration of all the circumstances and parties coming into
      conflict in order to find the best solution for all concerned by means of shared
      decision-making.

PMID- 11220002
TI  - [Oral nutritional supplements. Are they useful?].
AB  - Oral nutritional supplements are products included in enteral nutrition,
      preferably used in hospital settings, although their use in the community is
      gradually increasing and in the United Kingdom has doubled in the last seven
      years, with prescriptions covering a wide range of the population from children
      to the elderly, and different pathologies affecting their nutritional status.
      There is, however, no consensus on the usefulness of oral nutritional supplements
      among these patients, so we do not have any recommendations for use. In this
      paper we have reviewed the various studies available in the literature in order
      to clarify the usefulness of these supplements in different contexts or
      pathologies.

PMID- 11220003
TI  - [Dietetics principles. The food pyramid. Disease-nutrition relationship].
AB  - Dietetics is a largely unknown discipline among medical professionals as it is
      not common for them to receive any training in the matter. Nonetheless, this
      group very often needs to give dietary counselling and even to draw up diets for
      patients, more often indeed than nutrition specialists. This paper attempts to
      review some of the basic concepts of dietetics and study in a general way the
      relationship between illness and nutritional status without going into too much
      detail as many of the points mentioned here are referred to more fully in other
      articles in the same monograph.

PMID- 11220004
TI  - [Diabetes and nutrition].
AB  - Diabetes mellitus is one of the most frequent metabolic syndromes found in our
      hospitals, occurring at around 10%. There are basically two types: the most
      common is Type 2, associated with obesity in almost 80% of cases and family
      groupings, and then, far behind, comes Type 1 which requires insulin
      administration for life. Furthermore, there is a condition known as "stress
      hyperglycaemia" in which a patient without a prior history of diabetes mellitus
      responds to stress with a syndrome comprising hypermetabolism, hyperglycaemia,
      hyperlactacidaemia and protein catabolism. The desirable pre-prandial levels of
      glycaemia in an outpatient are between 80 and 120 mg/dl (under 100 mg/dl is
      normal) and between 100 and 140 mg/dl before retiring (levels of 110 mg/dl are
      normal). In patients with artificial nutrition, whether parenteral or enteral,
      the control of glycaemia is not so strict and the recommendation is for a level
      of around 150-200 mg/dl in the acute stress phases, falling to 100-150 mg/dl in
      stable patients. The ideal enteral formula for diabetic patients has been a bone
      of contention for years and has still not been satisfactorily resolved. The
      discussion centres on the replacement of saturated fatty acids by mono
      unsaturated fatty acids (MUFA) or by carbohydrates. The studies of patients
      undergoing prolonged treatments with MUFA-rich enteral diets have shown a greater
      control of glycaemia with these diets than with those rich in carbohydrates, so
      Type 2 diabetics and in stress hyperglycaemia with enteral nutrition, there is an
      ever stronger proposal to use MUFA rich formulas, whereas in Type 1 diabetics and
      in Type 2 patients with high prior requirements of insulin, it would be more
      recommendable to use diets with a more intermediate composition. With regard to
      parenteral nutrition, there is a consensus on increasing the amount of fatty
      acids to the detriment of carbohydrates, but the use of carbohydrates other than
      glucose is not so clear. The use of fast-acting insulin, either intravenously or
      subcutaneously, is recommended in the acute stages of the underlying condition
      because any instability in the patient makes it difficult to plan the required
      dose of intermediate-acting NPH insulin. The use of metformin or acarbose is not
      recommended. In parenteral nutrition, the subcutaneous administration of NPH
      insulin is often required at doses of 30% of the home dosage as the basal insulin
      therapy in addition to fast-acting insulin in the nutrition bag and a regimen of
      subcutaneous fast-acting insulin every 6 hours depending on glycaemia.

PMID- 11220005
TI  - [New nutrients in enteral nutrition].
AB  - 1. Medical and surgical stress (major surgery, sepsis, injuries,...) increases
      requirements of certain essential nutrients and others considered non-essential
      or semi-essential. 2. Some nutrients such as glutamine, arginine, omega 3 fatty
      acids nucleotides, ... have a considerable influence on the immune function
      (delayed hypersensitivity, lymphocyte sub-population counts, immunological
      tests,..) and improve certain metabolic and nutritional indices (nitrogen
      balance, medium and short life proteins,...). For this reason, they are called
      "immunonutrients" or "immunity regulators". 3. The supply of special enteral
      formulas for situations of immunological compromise, with the addition of one or
      more of the nutrients considered today as "immunity regulators" has increased
      since 1988 in both absolute and percentage terms. 4. These nutrient-enriched
      enteral formulas improve the rate of infections, reduce the number of days on
      ventilator equipment, the length of hospital stays for critical patients, with a
      more marked effect on surgical patients. 5. The evidence seems today to support
      the use of enriched formulas with critical patients. Nonetheless, some caution
      must be maintained as it has not been possible to show any reduction in the
      mortality of the cases studied nor, in short, in the prognosis of patients
      affected by situations of hypercatabolism and reduced immunity. 6. We feel that
      their use should, therefore, be carried out in accordance with the protocols and
      in patients expected to survive, where the evolution reveals severe catabolism
      unhindered by conventional therapy.

PMID- 11220006
TI  - [Early enteral nutrition and immunonutrition].
AB  - The repercussions of nutrition on the immunological system are described. The
      current situation is discussed with regard to the handling of the immuno
      inflammatory response to aggression and the improvement of the immune response.
      The goal pursued by nutritional manipulation of the immune system is to improve
      the prognosis and reduce the complications in critical patients subjected to
      surgical or traumatic aggression or sepsis. The following points are reviewed:
      the importance of preserving the axis from the liver to the digestive tract, the
      advantages of particularly early enteral nutrition over parenteral nutrition, the
      substances currently considered as immunonutrients and the available clinical
      evidence on their use, with a series of conclusions for current decisions and
      future developments.

PMID- 11220007
TI  - [Nutritional support in pancreatitis].
AB  - Pancreatitis is an illness that can bring about nutritional changes in connection
      with the underlying cause, the metabolic reaction to stress or the limitations
      that this pathology may represent for the processes of digesting and absorbing
      nutrients or for tolerating the diet. Although nutritional support is well
      accepted as a therapeutic measure in patients with severe acute pancreatitis,
      there is some dispute over the route of administration. In patients with mild
      pancreatitis, the use of parenteral nutrition may be accompanied by an increase
      in complications, particularly due to catheter-related sepsis, but in severe
      cases, early parenteral nutrition has been associated with a lower incidence of
      complications and a drop in mortality. Although parenteral nutrition is the
      preferred conventional method for the nutritional support of patients with
      pancreatitis, enteral nutrition offers the advantages of being more
      physiological, safer and less costly, at the same time as it seems to have a
      favourable influence on the progress of the pancreatitis. For this reason, the
      current recommendations suggest the use of enteral nutrition via the jejunum in
      those cases where the severity of the pancreatitis indicates nutritional support.
      Further research is, however, necessary in this field to clarify the group of
      patients in which the benefits of nutritional support would be most evident, the
      most appropriate type of diet, and the role of enteral nutrition on the
      evolution, both locally and systemically, of the changes brought about by the
      inflammation of the pancreas.

PMID- 11220008
TI  - [Nutrition and respiratory insufficiency].
AB  - Unlike other pathologies, not much attention has been paid to the relationship
      between nutrition and respiratory disease. This is probably because some of these
      diseases, such as cancer and chronic obstructive pulmonary disease, are closely
      associated with smoking while others that could be more directly linked with
      nutrition such as cystic fibrosis and emphysema are not directly caused by
      nutrition disorders. Not all patients with chronic obstructive pulmonary disease
      are undernourished. When malnutrition is present in these patients it is because
      of multiple reasons and is associated with an increase in both mortality and
      morbidity. In patients with acute respiratory insufficiency, malnutrition is
      often secondary to a heightened catabolic state leading to the severe fundamental
      illness. We also know that nutritional treatment may not only correct
      malnutrition but also help in improving the respiratory function. This
      nutritional therapy is not normally easy to comply with. It must be accompanied
      by other non-pharmacological therapies such as rehabilitation. Renourishment may
      also entail risks for patients with respiratory diseases so it is very important
      to know as closely as possible their nutritional requirements and to focus on
      specific actions.

PMID- 11220009
TI  - Casebook: microscopic haematuria.

PMID- 11220011
TI  - The kidney in hypertension.

PMID- 11220012
TI  - The orals--a chance to make the right impression.

PMID- 11220013
TI  - The challenge of finding donors.

PMID- 11220010
TI  - Dialysis patients: the GP's role.

PMID- 11220014
TI  - A homeless teenager who may be pregnant.

PMID- 11220015
TI  - Homeopathy: let likes be cured by likes, Part II.

PMID- 11220016
TI  - Urinary incontinence in women: assessment and management in the primary care
      setting.
AB  - Urinary incontinence, the unwanted loss of urine, is a condition that affects
      millions of women and yet is often not addressed by the primary care provider.
      The unfortunate consequence of this ignorance is that, if correctly diagnosed and
      managed 80% of these patients could have marked improvement in clinical symptoms.
      The intent of this report is to familiarize the reader with a systematic approach
      to the assessment, diagnosis, and management strategies for urinary incontinence
      in the outpatient setting.

PMID- 11220018
TI  - Mastalgia: evaluation and management.
AB  - Mastalgia, defined as breast pain, is a common, often distressing complaint among
      women. It is the most common breast-related complaint in primary care clinics,
      with a prevalence in working women of approximately 66%. An underlying fear of
      breast cancer is what prompts these patients to seek health care. A comprehensive
      history and thorough clinical breast exam is essential to evaluation. Once
      significant breast disease is ruled out, the majority of these patients respond
      to simple reassurance.

PMID- 11220017
TI  - A case study approach to evaluation of cardiac disease in women.
AB  - Women rarely consider coronary heart disease as a health concern despite the fact
      that it is the leading cause of death in women in the United States. We have just
      recently begun to appreciate the gender and age differences related to coronary
      heart disease presentation and management in women. Management challenges often
      relate to the unusual or atypical disease presentation and course, and are
      frequently misunderstood by the practicing clinician. Comorbidities and
      prevention strategies in the female patient must be carefully considered. Early
      risk reduction and counseling should be incorporated into every well-woman exam
      so that women receive the timely and appropriate care they need and deserve.

PMID- 11220019
TI  - Decreased libido in postmenopausal women.
AB  - As baby boomers age, the health issues of postmenopausal women have gained
      increasing media attention. Sexual well-being is an important health component
      for these women. The estimated rate of female sexual dysfunction in the United
      States is an astounding 25% to 63% with the most prevalent age group being
      postmenopausal women. Decreased libido is a major complaint of postmenopausal
      women, and many seek medical consultation for this problem. Unfortunately,
      current female sexuality research for this population is clearly deficient.
      Additionally, medical providers tasked with managing postmenopausal sexual
      dysfunction often lack training, experience, and the confidence necessary to
      handle sexuality concerns. Nurse practitioners, as superior counselors, are in a
      prime role to address this issue. The purpose of this report is to focus on the
      multifaceted problem of decreased libido in postmenopausal women, with management
      strategies to assist practitioners in managing and addressing this problem in the
      clinical setting. The report will investigate several physical, hormonal, and
      psychosocial factors impacting decreased libido in these women. Current and past
      research into this area will be analyzed to better define the current
      professional consensus on managing decreased libido in postmenopausal women.

PMID- 11220020
TI  - Hormone replacement therapy.
AB  - By the year 2020, more than 45 million American women will be over the age of 50.
      Many of these women will wrestle with decisions concerning the use of hormone
      replacement therapy. This report presents a history of hormone replacement
      therapy use. The report then addresses the benefits, risks, and relative and
      absolute contraindications associated with hormone therapy. Concluding sections
      of the report discuss hormone replacement options which are currently available
      as well as provider considerations when tailoring a therapy regimen to the needs
      of the patient.

PMID- 11220021
TI  - Clinical challenges in menopausal management: a case study approach.
AB  - Selecting an appropriate hormone replacement regimen can pose many challenges to
      the clinician and the patient. This report offers 4 case studies and clinical
      considerations illustrating both scientific and clinical considerations when
      collaborating with women to find an acceptable method to manage menopausal
      symptoms. Both traditional and complementary therapies are considered.

PMID- 11220022
TI  - Travel and expatriate health: an overview.

PMID- 11220023
TI  - Recent trends in infectious diseases for travellers.
AB  - In the early 1970s medicine was considered to have conquered infectious diseases.
      The following three decades have shown this optimism to be misplaced, with both
      traditional infections increasing in prevalence and novel diseases appearing.
      Many of these diseases have become major problems in developing countries, and
      coupled with the exponential growth in international traffic now pose a
      significant risk to the traveller. The threat to the package tourist differs
      greatly from that to the businessman, soldier or backpacker. The latter groups
      may have little control over their food and water supplies and be exposed to
      vector-borne and zoonotic infections normally restricted to remote locations.
      However the package holidaymaker may be involved in mass outbreaks of food
      poisoning with novel pathogens or acquire unusual infections from close proximity
      to other tourists. All groups may be susceptible to diseases transmitted during
      travel, and these may be more common than is presently recognised. The common
      factor is that all such infections may be transported around the world within
      their incubation period, and that any disease can now present to any doctor.
      Today more than ever before it is incumbent on any practitioner to ask not only
      'where have you been?' but also 'what were you doing there?'

PMID- 11220024
TI  - The assessment of fitness to travel.
AB  - The majority of health problems encountered in association with travel stem from
      pre-existing, perhaps latent, illness in the individual which may be exacerbated
      by the rigours and hazards of travel. It is essential that the advising physician
      understands the hazards that are likely to be encountered during travel in order
      that they may develop informed decisions regarding fitness for travel and give
      appropriate advice. In an occupational health setting, the employer has a
      responsibility to safeguard the health of their employees whilst travelling on
      behalf of the organisation and will also have to fund any treatment abroad or the
      cost of repatriation. The dictating factor in determining fitness to travel will
      often be fitness to travel by air, consequent to the reduced partial pressure of
      oxygen and pressure changes in-flight. The majority of significant health
      problems encountered during travel are attributable to coronary heart disease and
      detailed guidance exists to determine fitness for travel. For many health
      problems little if any evidence based guidance exists and decisions will
      therefore have to be based on an understanding of the hazards likely to be
      encountered during travel. Access to appropriate standards of medical care abroad
      and the difficulties and expense of repatriation, should this be necessary, are
      also important factors to consider in addition to the basic determination of
      fitness for travel itself. This paper outlines the main factors to be considered
      when assessing fitness to travel and also examines available guidance for some of
      the more commonly encountered conditions.

PMID- 11220025
TI  - Medical aspects of expatriate health: health threats.
AB  - The globalisation of business activity can lead to the movement of key employees
      and their dependants from country to country. In their host country these
      expatriates often face health hazards not experienced at home. This paper
      describes the range of health issues of relevance to expatriates.

PMID- 11220026
TI  - Medical aspects of expatriate health.

PMID- 11220027
TI  - Assessment of the returned traveller.
AB  - The occupational health physician is in a unique position to provide total care
      for the returned traveller. In a sense, the physician packs and unpacks with the
      patient and ensures that other carers consider a wider range of disease
      possibilities than may be found in the home country. Follow-up tests and
      examinations are comparatively simple and where necessary specialist advice
      should be sought.

PMID- 11220028
TI  - Occupational respiratory symptoms in New Zealand hairdressers.
AB  - BACKGROUND: A study of occupational respiratory symptoms in hairdressers was
      carried out in 26 salons in New Zealand. METHODS: A questionnaire was
      administered to 100 hairdressers and 106 office and shop workers, recording
      respiratory symptoms, demographic data, and smoking habits. Pulmonary function
      was measured before each shift. RESULTS: Hairdressers had a higher prevalence of
      asthma symptoms, diagnosed asthma, and asthma attacks in the previous 12 months,
      but these differences reduced markedly when adjusted for age, gender and smoking.
      Hairdressers had a significantly lower pulmonary function, even after adjustment
      for smoking, but this difference was entirely due to differences between
      hairdressers and office workers and there were no such differences between
      hairdressers and shop workers. CONCLUSIONS: The excess symptom prevalence in
      hairdressers was largely due to the high smoking rates. Mean pulmonary function
      was lower in hairdressers but this finding requires further study.

PMID- 11220030
TI  - Occupational skin conditions in the food industry.
AB  - The study presents the findings of a questionnaire survey of skin conditions in a
      selective sample of the UK food industry, covering companies who employ
      occupational physicians. The mean incidence of skin conditions in food
      manufacturing operations was 2103 per million employees per annum. The mean
      incidence in retail or catering organizations was 1414 per million employees per
      annum.

PMID- 11220029
TI  - Psychological and occupational predictive factors for back pain among employees
      of a university hospital in southern Spain.
AB  - OBJECTIVES: To identify the individual and occupational factors that are
      predictors for low back pain among the employees of a university hospital in
      southern Spain. METHODS: A transverse study was conducted in which the population
      used was the hospital employees who volunteered to participate. The information
      was obtained by using a questionnaire, which included demographic and
      anthropometric variables, habits, characteristics of the work done, and of any
      pain experienced. The mental health condition of subjects was measured using the
      GHQ-28, using a score of > or = 6 as the cut-off point. To study the variables
      associated with pain, crude odds ratios (ORs) were calculated (+/- 95% CI) and
      adjusted according to a logistic regression model. RESULTS: One thousand one
      hundred and four subjects participated in the study but only 890 of these
      completed the questionnaire in full (rate of response, 35.7% of total employees).
      The population studied was notable for the high proportion of women, for subjects
      > 41 years of age, and subjects who undertook little or no physical exercise. In
      addition, according to the GHQ-28 test, 29.9% of the total were 'probable
      psychiatric cases'. The crude ORs were high in all the occupational categories in
      comparison with the doctors, with the exception of the maintenance, cleaning, and
      catering group. They were also higher among women, among subjects with poor
      mental health, and among women with one or more children. The adjusted ORs showed
      that having a GHQ-28 score of > or = 6, and belonging to the auxiliary technician
      category, were independent risk factors for suffering low back pain. Being older
      than 41 years and in temporary employment were protective variables. CONCLUSIONS:
      The presence of probable mental illness is the variable most strongly associated
      with the presence of low back pain in the population studied. Its diagnostic
      confirmation and appropriate treatment could contribute to reducing the
      prevalence of vertebral pains in this occupational group.

PMID- 11220031
TI  - An investigation of the validity of 'simulated' work related tasks in relation to
      'real-life' situations in the fire service training environment.
AB  - Many researchers have developed work simulated tasks that can successfully
      predict fitness for work. In the fire service there are few tests available to
      make such predictions. This study was designed to evaluate the validity of four
      simulated fire-fighting tasks developed by Manchester Fire Service. Twenty-seven
      subjects each performed, in random order, three repeats of four simulated and
      four real-life tasks: under-running a 9 m ladder, dead lift, placing a 13.5 m
      ladder on an appliance and hauling an extended line. Comparisons between real and
      simulated tasks were assessed by measuring total time and amount of muscle
      activity. Recommendations were made to reduce the weight and to revise the
      lifting and grip positions for the 13.5 m ladder and dead lift, respectively,
      whereas the simulated 9 m ladder and hauling an extended line simulated tasks
      were sufficiently similar to the real-life activities to not warrant any change.

PMID- 11220032
TI  - Gender differences in musculoskeletal health of computer and mouse users in the
      Swedish workforce.
AB  - The objectives of the study were to explore the musculoskeletal health of
      computer users in the Swedish workforce with regard to gender and psychosocial
      factors, and to describe gender differences between the occupational groups. A
      subset was chosen from a large survey of 12,462 individuals representing the
      workforce of Sweden, performed by Statistics Sweden. Included in the subset were
      2044 subjects who worked for at least half their working hours with personal
      computers, or an equivalent device, and also used a computer mouse. All
      occupational groups had prevalence ratios (women/men) > 1. When using regression
      models, the variables 'learn and develop' and 'involved in planning your work'
      were health factors, and 'too much to do' was a risk factor for upper body
      symptoms for both women and men. For women 'PC duration 100' was a risk factor
      and 'support from superiors' was a health factor. Age seemed to be a stronger
      risk factor for men than for women.

PMID- 11220033
TI  - The prevention of tuberculosis in prison staff.
AB  - The Joint Tuberculosis Committee of the British Thoracic Society (BTS) recommends
      that all new prison staff be screened for tuberculosis (TB) as 'at risk' health
      workers. This study of prisons in the West Midlands area of England shows that
      there are considerable variations in the practice of TB control amongst prison
      staff and that the recommendations of the BTS committee are not routinely
      implemented. The study highlights the need for a routine and robust system of TB
      surveillance and prevention amongst prison staff which can be applied nationwide.

PMID- 11220034
TI  - Effects of exposure to very high frequency radiation on six engineers in two
      separate incidents.

PMID- 11220035
TI  - How do you manage dermatitis after exposure to the causative agent has ceased.

PMID- 11220036
TI  - The influences of stimulus wavelength and eccentricity on short-wavelength
      pathway isolation in automated perimetry.
AB  - The aim of the study was to determine whether the suggested stimulus and
      background parameters employed in commercially available short-wavelength
      sensitive perimetry (SWAP) are clinically appropriate. Threshold versus intensity
      curves were measured using a modified Humphrey Field Analyser. The reduction in
      background luminance was achieved using aperture stops in order to avoid changes
      in the chromaticity of the background. Short-wavelength thresholds were
      determined for 440, 450 and 460 nm stimuli and were corrected for pre-receptoral
      absorption. Short-wavelength sensitive pathway isolation was approximately 1.5
      log units and decreased with increases in eccentricity and in stimulus
      wavelength. It would seem that the use of a 450 nm narrowband stimulus filter
      would offer a compromise between both the physiological requirements and the
      physical properties of the stimulus. Such an approach would reduce some of the
      inherent between-subject normal variability associated with SWAP.

PMID- 11220037
TI  - Validation of grading scales for contact lens complications.
AB  - The validity of use of two artist-rendered and two photographic sets of grading
      scales (grading 'systems') designed for gauging the severity of contact lens
      related ocular pathology was assessed in terms of precision and reliability.
      Thirteen observers each graded 30 images--by interpolation or extrapolation to
      the nearest 0.1 increment--of each of the three contact lens complications
      (corneal staining, conjunctival redness and papillary conjunctivitis) that were
      common to all four grading systems. This entire procedure was repeated
      approximately two weeks later, yielding a total data base comprising of 9360
      individual grading estimates. Analysis of variance revealed statistically
      significant differences in both precision and reliability between systems,
      observers and conditions (p < 0.03 for system reliability; p = 0.0001 for all
      other combinations). The artist-rendered systems generally afforded lower grading
      estimates and better grading reliability than the photographic systems. Corneal
      staining could be graded less reliably than conjunctival redness and papillary
      conjunctivitis. Grading reliability was generally unaffected by the severity of
      the condition being assessed. Notwithstanding the above differences, all four
      grading systems are validated for clinical use and practitioners can initially
      expect to use these systems with average 95% confidence limits of +/- 1.2 grading
      scale units (observer range +/- 0.7 to +/- 2.5 grading scale units). In view of
      the significant between-system differences revealed in this study, it is
      advisable to consistently use the same grading system. It may be possible to
      reduce between-observer differences by applying personalised correction factors
      to normalise grading estimates.

PMID- 11220038
TI  - Clinical grading of corneal staining of non-contact lens wearers.
AB  - To distinguish normal from pathological corneal fluorescein staining requires
      knowledge of background levels of staining among otherwise healthy individuals.
      Corneal staining of 102 non-contact lens wearing subjects was assessed using a
      photographic grading scale that uses a generic (0 to 4) scale to score corneal
      staining. Some degree of corneal staining was found on 79% of the corneas. Low
      inter-observer variability suggests that the corneal staining grading scale can
      be used successfully with decimal rather than integer scale increments.

PMID- 11220040
TI  - Why do we still not know whether refractive error causes headaches? Towards a
      framework for evidence based practice.
AB  - In this paper, we systematically review the available experimental and clinical
      evidence concerning the causation of headache by refractive error. Despite the
      apparent belief of both medical and optometric professionals that provision of an
      appropriate correction may alleviate various types of headache, there is little
      if any robust evidence in support of this position. We identify four serious
      methodological and theoretical difficulties with studies to date, which currently
      render it impossible to assess the relationship between refractive error and
      headache. The provision by the International Headache Society of the diagnostic
      category "headache associated with refractive error" is called into question.
      Five research questions are posited in the form of a framework for the
      development of evidence-based practice in optometry and the treatment of
      headache.

PMID- 11220039
TI  - Randomised controlled trial of an integrated versus an optometric low vision
      rehabilitation service for patients with age-related macular degeneration: study
      design and methodology.
AB  - A number of studies have measured the outcomes of low vision care but these have
      usually been longitudinal case series, thus constituting very low quality of
      evidence for effectiveness. To date, there have been no randomised controlled
      trials (RCTs) which have evaluated the effectiveness and cost effectiveness of
      different models of care in low vision. The size of the low vision population and
      the paucity of systematic evaluation have created a pressing need for evidence
      about cost-effectiveness in order to inform service developments for low vision
      rehabilitation. This paper describes the study design and methodology of a three
      arm RCT currently under way in Manchester. The baseline population recruited is
      also described. A traditional hospital-based optometric service is being compared
      with an integrated service (comprising the addition of community-based
      rehabilitation officer input) and with more generic community input (which is non
      integrated and is not vision specific). A wide range of outcome measures are
      being assessed at recruitment and 12 months post-intervention, including low
      vision specific and generic quality of life measures, patterns of low vision aid
      use, and task performance. The rationale for the trial is discussed and the main
      study outcomes are described.

PMID- 11220041
TI  - Analysis of discrimination threshold on the tritan axis.
AB  - Discrimination thresholds on the tritan axis were obtained for an extensive group
      of 66 stimuli: in some of the stimuli, S-cone trolands were held constant by
      keeping the product of the S-cone excitation level and the luminance unchanged,
      while in others only the luminance was changed to establish various S-cone
      troland values. These thresholds depended clearly on the S-cone value of the
      stimuli, while they remained almost constant against the retinal illumination.
      Thus, we noted that the excitation of the L - 2M channel had practically no
      influence over the discrimination threshold on the tritan axis, although this
      independence of delta S from L - 2M was not so obvious when the S value was high.
      With our data, we performed different fits, and found that the fit including the
      terms S, (L - 2M) and (L + M) adapted better to our results.

PMID- 11220042
TI  - General binocular disorders: prevalence in a clinic population.
AB  - The purpose of this paper was to study the prevalence of nonstrabismic
      accommodative and binocular dysfunctions in a clinical population. We examined
      265 symptomatic patients who were chosen from an optometric clinic. We performed
      several tests to diagnose any form of refractive, accommodative or binocular
      dysfunction. Of the 265 subjects examined, 59 patients (22.3%) had some form of
      accommodative or binocular dysfunction and required not just the correction of
      the refractive error but a specific treatment for each of the problems diagnosed.
      The remaining subjects were classed as having refractive anomalies. The frequency
      of binocular dysfunctions was 12.9%, and 9.4% for accommodative anomalies.
      Convergence excess (4.5%) was more prevalent than convergence insufficiency
      (0.8%) and accommodative excess (6.4%) more prevalent than accommodative
      insufficiency (3%).

PMID- 11220043
TI  - Nearwork distances in children.

PMID- 11220044
TI  - Changes in the static accommodation response with age.
AB  - A transverse study of the monocular, steady-state accommodation response/stimulus
      curves for 49 normal subjects with ages between 17 and 49 years shows that the
      slope of the curve reduces only slowly with age up to about 40 years and then
      declines rapidly as complete presbyopia is approached. Such behaviour appears to
      result from the accommodation system changing its characteristics with age to
      make optimal use of the available objective amplitude of accommodation and the
      depth-of-focus of the eye.

PMID- 11220045
TI  - Effect of oral contraceptives on tear physiology.
AB  - Variations in sex hormones due to the menstrual cycle (and oral contraceptives)
      were evaluated for their effect on tear physiology. Subjects were 18 females
      taking oral contraceptives or their age matched controls (no medication), aged 21
      33 years. Symptoms of ocular discomfort (visual analog scale), tear film
      structure (TearScope), non-invasive tear thinning time (HirCal grid), evaporation
      rate (ServoMed evaporimeter), osmolality (Nanolitre Osmometer), tear turnover
      rate, tear volume (Fluorotron Master), and tear protein levels (HPLC) were
      measured around day 2 (D2), actually day 1-4 and day 19 (D19) actually day 18-21
      of the cycle. No significant differences were found for any tear parameters
      between D2 and D19 for either pill users or controls alone, or in the comparison
      of pill users with controls. No effect on tear physiology was found for serum
      hormone changes induced by oral contraceptive use or by normal cyclic variations
      in healthy young females.

PMID- 11220046
TI  - Homeopathy: let likes be cured by likes.

PMID- 11220047
TI  - First pelvic examination in the adolescent.
AB  - The first pelvic examination is often an emotionally charged and stressful event
      in the adolescent patient. The female adolescent patient has many unique health
      care needs, which if not met, can negatively impact future gynecologic health.
      History taking and physical examination techniques specific to the adolescent
      female patient are discussed. Indications for pelvic examination along with
      practice tips in communicating with the adolescent female patient are reviewed.
      Methods of reducing patient anxiety and empowering the adolescent to take charge
      of her health are discussed.

PMID- 11220048
TI  - Exploration of facilitators and barriers to prenatal care among military women.
AB  - Early and regular prenatal care has been shown to decrease the incidence of
      adverse pregnancy outcomes; however, little research has examined it
      experientially from the mother's perspective. The purpose of this qualitative
      study was to explore the experience of prenatal care from the military mother's
      perspective. Using purposive sampling, 16 women who had recently given birth were
      interviewed. The data were analyzed using a qualitative descriptive research
      methodology to elicit categories of substantive concepts, ideas, or themes. Data
      explored in this study included availability, use and satisfaction with prenatal
      care services, and barriers, preferences, and recommendations.

PMID- 11220049
TI  - Major depressive illness in women: assessment and treatment in the primary care
      setting.
AB  - Depressive illness in women carries with it a tremendous price to the woman's
      sense of well-being and health. Primary care providers who have frequent and
      continuous contact with women at risk for developing a depressive disorder are in
      an excellent position to diagnose and treat depression.

PMID- 11220050
TI  - Smoking cessation and low-income women: theory, research, and interventions.
AB  - There is a growing body of evidence indicating women's experiences with smoking
      and cessation may be unique from those of men. Advanced practice nurses (APNs) in
      primary care are ideally suited to assess and intervene with this complex
      addiction. APNs must be competent in interventions that address cigarette
      smoking. This article will summarize the literature on smoking cessation
      interventions with an emphasis on women smokers.

PMID- 11220051
TI  - HIV risk reduction strategies for low-income African American women.
AB  - Intervention strategies from the Health Education Reaching Out into the Community
      project that can be used in the clinical setting to assist low-income African
      American women adopt sexual behavior that is low risk for human immunodeficiency
      virus are discussed. These strategies include allocation of adequate time, the
      nurse practitioner's acceptance of the client, the use of adult learning
      principles, and active client participation through discussion, return
      demonstration, role play, and promotion of the client's ownership of the
      information learned.

PMID- 11220052
TI  - Physical activity stages of change in African American women: implications for
      nurse practitioners.
AB  - We examined stages of change in the physical activity in African American women
      aged 17 to 64 years (N = 104) who obtain primary health care. Forty-seven percent
      of the women had at least 1 chronic health problem that required treatment.
      Overweight or obesity was found in 66% of the women. The majority of women were
      in the precontemplation (21%) and contemplation (19%) stages of change; 27% were
      preparing to become active. Forty percent were classified as very low active;
      34%, low active; and only 26% were moderate or high active. Simple logistic
      regressions showed that women who were inactive during adolescence were 6 times
      more likely than other women to be in an early stage of change in physical
      activity (precontemplation or contemplation stage). Women who were self-motivated
      to be physically active, had support of friends and family, and enjoyed physical
      activity were more likely than other women to be in maintenance stage of
      activity. This article provides information on ways to use the stages of change
      and associated factors to move patients from inactivity to activity and help them
      remain active in the long term.

PMID- 11220053
TI  - Preventing injuries to infants of adolescent mothers.
AB  - Infant injury prevention is an important issue for practitioners who work with
      adolescent mothers. Data are presented to examine the association between having
      a young mother and being injured as an infant. Prevention messages need to take
      into account that parents in general tend to minimize the magnitude of injury
      risk to their children. With careful documentation, using External Cause of
      Injury Codes, practitioners may be able to estimate the cost savings of
      prevention initiatives.

PMID- 11220054
TI  - Discipline across generations.
AB  - The objective of this qualitative research was to understand how parents decide
      which discipline practices they will repeat from their childhoods. Participants
      chose not to repeat punishment practices when a strong, negative effect was
      remembered. However, some parents repeated physical punishment practices even
      when a strong, negative effect was remembered if they believed the practices were
      effective or culturally valued, if they were under stress, or if the parents
      lacked alternative strategies.

PMID- 11220055
TI  - Cardiovascular risk among middle school children: implications for primary care.
AB  - Cardiovascular risk reduction programs for school-aged children are based
      primarily in schools. Primary care providers, however, have not routinely
      included active cardiovascular risk reduction efforts in their practice. The
      research reported here supplies providers with evidence that can readily guide
      interventions augmenting cardiovascular risk reduction information and skills
      that children may be learning in schools.

PMID- 11220056
TI  - Cost analysis: a tool for measuring the value of nurse practitioner practice.
AB  - The survival of nurse-managed centers and their ability to provide practice
      opportunities for advanced practice nurses depends on combining sound business
      practices and active financial management with clinical excellence. Using cost
      analysis methodologies, this study examined the operational costs of 2 academic
      based nursing centers and analyzed the practices that resulted in profitability
      for 1 and questionable survival for the other.

PMID- 11220057
TI  - Peripheral neuropathy: alternative and complementary options.

PMID- 11220058
TI  - More than personal change: effective elements of symptom management.
AB  - Symptoms are the most common reason people seek health care. Although the
      menstrual cycle, a normative process, is not a chronic illness, about 10% to 15%
      of women experience severe recurring symptoms associated with the menstrual cycle
      that can be considered a chronic illness. Severe perimenstrual symptoms, although
      distressing for some women, provide a model for understanding complex gender
      specific conditions that include biological, psychosocial, and cultural factors,
      and have application to other women's health problems such as stress-related
      conditions (heart disease, arthritis, immune system disorders), psychiatric
      disorders, or normative menstrual cycle transitions (menarche, postpartum,
      menopause). The Perimenstrual Symptom Management Program, developed by the
      author, was evaluated to determine the short-term and long-term effectiveness of
      a multimodal, nonpharmacological treatment package aimed at relieving the symptom
      and stress experience as well as increasing health behaviors. Selected results
      from this longitudinal clinical trial will be presented along with examples of
      effective elements of personal and environmental strategies for symptom
      management and health promotion. Recommendations for clinical application of
      these research findings will be presented with a focus on both patient outcomes
      and intervention processes for personal and environmental therapeutic change.

PMID- 11220059
TI  - Herbal remedies: efficacy in controlling sleepiness and promoting sleep.
AB  - Difficulties with sleep and daytime sleepiness are common complaints among adults
      in the United States. During the past decade, the use of herbal preparations
      among adults increased from 2.5% to 12.4%. This article presents relevant aspects
      of the 1994 Dietary Supplements Health and Education Act that stimulated the
      proliferation of herbal medicinals and reviews the pharmacological properties of
      the most commonly available herbal wake-promoting and sedating products. Given
      the rapid increase in use of herbals, health care professionals need to educate
      themselves and their patients about the use of these preparations.

PMID- 11220060
TI  - Homocysteine--a novel risk factor for vascular disease.

PMID- 11220061
TI  - Continuous fetal heart rate monitoring: is there a conflict between confidential
      enquiry findings and results of randomized trials?

PMID- 11220062
TI  - Strong opioids for cancer pain.

PMID- 11220063
TI  - Screening for lung cancer.

PMID- 11220064
TI  - Instrumental psychosis: the Good Soldier Svejk syndrome.
AB  - The possession of severe mental illness, mainly schizophrenia and affective
      psychosis, may be perceived in positive terms. We have identified a group of
      patients, most of them with a history of previous psychotic disorder, who present
      with deliberately created symptoms and behaviour, and who are defined as having
      instrumental psychosis. Because most such patients have had a psychotic disorder
      in the past the symptoms are very like those of a real psychosis. A parallel is
      drawn with the fictional anti-hero of the Czech nation, the Good Soldier Svejk,
      who demonstrated both real and instrumental psychosis. A rating scale, the
      'pseudopsychosis inventory', was devised to identify the main components of this
      disorder and was applied in 15 consecutive patients presenting with putative
      psychotic disorders in whom assessment could be made by two raters within five
      days. The inter-rater reliability of the items of the scale was good (intra-class
      correlation coefficient 0.68). An epidemiological study with this scale in 45
      patients with a putative psychotic disorder suggested the presence of
      instrumental psychosis in 2.

PMID- 11220065
TI  - Recovery from chronic fatigue syndrome associated with changes in neuroendocrine
      function.

PMID- 11220066
TI  - Vascular Ehlers-Danlos syndrome undiagnosed during life.

PMID- 11220067
TI  - Acute abdomen after cardiac surgery: three cases, one fatal.

PMID- 11220068
TI  - Remission of precapillary pulmonary hypertension in systemic lupus erythematosus.

PMID- 11220070
TI  - Common iliac aneurysm rupture with sinus bradycardia.

PMID- 11220069
TI  - Sarcomatoid renal cell carcinoma metastatic to right ventricle.

PMID- 11220071
TI  - Subclinical presentation of massive retropharyngeal abscess.

PMID- 11220073
TI  - John Hunter's teachings on gunshot wounds.

PMID- 11220072
TI  - Leechcraft in nineteenth century British medicine.

PMID- 11220074
TI  - Expedition health and safety.

PMID- 11220075
TI  - Why doctors get angry in Crown courts.

PMID- 11220076
TI  - Reversible dementia in Paget's disease.

PMID- 11220077
TI  - Management of colorectal liver metastases.

PMID- 11220078
TI  - Knowledge and the Internet.

PMID- 11220079
TI  - Research as part of routine care.

PMID- 11220080
TI  - Management of explicit and tacit knowledge.

PMID- 11220081
TI  - [Homocysteine, endothelial dysfunction and cardiovascular risk: pathomechanisms
      and therapeutic options].
AB  - Elevated homocyst(e)ine plasma concentrations are an independent risk factor for
      cardiovascular disease. Hyperhomocyst(e)inaemia is common in patients with
      peripheral arterial occlusive disease, coronary heart disease, cerebrovascular
      disease, carotid artery stenosis and venous thromboembolism. Endothelial
      dysfunction may be one underlying cause leading to proatherogenic effects
      associated with hyperhomocyst(e)inaemia. However, the mechanisms which lead to
      impaired endothelial function in hyperhomocyst(e)inaemia are not fully
      understood. Recent evidence suggests that homocyst(e)ine may interact with
      physiological mediators of the endothelial matrix. Oxidative mechanisms and
      decreased biological activity of endothelium-derived nitric oxide (NO) may also
      contribute to homocyst(e)ine-associated endothelial dysfunction. B vitamins are
      essential cofactors in the metabolism of homocyst(e)ine to methionine via the
      remethylation-pathway (vitamin B12, folic acid) and to cystathionine via the
      transsulphuration-pathway (vitamin B6). Dietary deficiencies of folic acid,
      vitamin B12, and vitamin B6 appear to be common among elderly people in the
      western world and represent one pathogenic factor related to the incidence of
      hyperhomocyst(e)inaemia. Several studies have demonstrated that dietary
      supplementation with folic acid and the vitamins B12 and B6 is an efficient means
      to decrease plasma homocyst(e)ine. No clinical studies are available to date to
      prove whether reducing homocyst(e)ine levels to the normal range by supplementary
      B vitamins will also beneficially affect vascular function or cardiovascular
      risk. Furthermore it is unknown whether moderately elevated homocyst(e)ine
      concentrations per se may predispose to development of vascular disease, or
      whether homocyst(e)ine is an indirect marker of cardiovascular disease. Further
      investigations will be necessary to elucidate the causal relationship between
      elevated homocyst(e)ine plasma concentrations and the incidence of cardiovascular
      events, especially since the therapeutic strategies in hyperhomocyst(e)inaemia
      would differ depending on the underlying pathophysiological mechanisms.

PMID- 11220082
TI  - [Standardized findings in echocardiography using WWW: EchoBefundSystem].
AB  - As a non-invasive imaging system, ultrasound echocardiography has a very high
      impact on modern diagnosis and is widely used in clinical routine but without any
      structured and standardized documentation of the results. Thus, quality
      management (QM), statistics and comparison of the results are difficult.
      Therefore, a working group of the German Cardiac Society issued a consensus
      proposal. For evaluation and wide public distribution, we have developed the
      first internet-based application covering the full proposal: EchoBefundSystem.
      The EchoBefundSystem is a web based client-server application for standardized
      documentation of echocardiography results right at the workplace. The software
      leads the examiner by means of a user interface design and stored medical
      knowledge. The level of detail is scaled automatically to the ongoing
      examination. Every day clinical routine is performed on only two pages, one for
      general patient data and a second one covering the complete minimal data set
      called "minimum finding" in the standard. As the examiner discovers more and more
      special findings or might even enter a complete medical study, the interface
      offers more and more fields and checkboxes. One data set can contain up to 600
      values and findings. The structured user interface reflects the organ structure
      as well as examination methods familiar to the examiner. Automatically calculated
      fields speed up the examination. Judgements, diagnoses, values and ranges are
      interrelated. If there is a difference between the entered data and the medical
      knowledge base, a warning will be issued but the doctor's decision is
      authoritative. Some values may be gathered by different methods and even
      different units are converted automatically. The final doctor's letter is
      generated automatically in clear text but still editable and can be given out to
      the patient right after the examination without any further delay. Beside the
      minimal data set, all abnormal findings will appear and findings will be
      summarized wherever possible. The report is intended for the referring general
      practitioner, your own documentation, expert witness as well as clinical studies.
      Interested examiners may test the full version online at http://echo.ma.uni
      heidelberg.de

PMID- 11220083
TI  - [Exclusion of coronary calcium with electron beam tomography: an effective filter
      before invasive diagnosis in symptomatic patients?].
AB  - Electron beam computed tomography (EBCT) is the most sensitive and accurate
      method of measuring coronary calcium which indicates coronary atherosclerosis. We
      performed a prospective study in 1764 symptomatic patients who were referred to
      our hospital for coronary angiography because of suspected coronary artery
      disease. In all of these patients cardiac catheterization and coronary calcium
      scanning was performed within 3.2 +/- 4 days. 454/1225 men (37.0%) and 165/539
      women (30.6%) had significant coronary stenoses > or = 75%. Only two men (0.4%)
      and no single woman (0.0%) with stenoses > or = 75% and only 3/323 patients
      (0.9%) with moderate stenoses (50-75%) did not exhibit coronary calcium. Coronary
      angiography excluded stenoses in 822 patients. Of these patients 261 (29.4%) did
      not reveal coronary calcium. In younger patients (< 60 years) without stenosis
      exclusion of coronary calcium was a frequent finding: 31% of men and 55.8% of
      women were free of coronary calcium. Thus, exclusion of coronary calcium with
      electron beam tomography defines a substantial subgroup of patients who have an
      extremely low risk of significant coronary stenosis despite suspected coronary
      artery disease in history and non-invasive testing. Determination of coronary
      calcium might, therefore, be an effective filter before invasive angiography in
      selected groups of symptomatic patients.

PMID- 11220084
TI  - [Determination of right ventricular ejection fraction by thermodilution catheter
      technique during exercise: a comparison with radionuclide ventriculography].
AB  - Since the development of a Swan-Ganz Thermodilution Ejection Fraction Catheter,
      several studies have been published which compare this technique for obtaining
      right ventricular ejection fraction (RVEFTD) with alternative methods. However,
      the reliability of RVEFTD measurements under exercise conditions remains
      undetermined. Therefore, the aim of the present study was to evaluate RVEFTD with
      the Gated Blood Pool method (RVEFGBP) under exercise conditions. Twenty patients
      with different cardiac diseases (coronary artery disease, valvular incompetence,
      cardiomyopathy) underwent right heart catheterization, including RVEFTD and
      simultaneous RVEFGBP determination at rest and during supine bicycle exercise.
      Cardiac index at rest-/exercise was 2.9 +/- 0.8/5.7 +/- 2.2 l/min/m2, mean
      pulmonary artery pressure was 15 +/- 5/25 +/- 8 mmHg, RVEFTD was 38 +/- 6/41 +/-
      11% and RVEFRNV was 39 +/- 6/43 +/- 8%. Linear regression analysis showed a
      significant correlation between RVEFTD and RVEFGBP at rest (r = 0.72, p < or =
      0.0005) and during exercise (r = 0.72, p < or = 0.0005). It is concluded that the
      Thermodilution Ejection Fraction Catheter is a useful device for reliable,
      repetitive and safe RVEF measurements, not only at rest but also under exercise
      conditions. This is clinically important, because RVEF, as a sensitive parameter
      of primary or secondary right ventricular dysfunction, can be determined in the
      course of standard right heart catheterization.

PMID- 11220085
TI  - [Is brain blood supply affected by changes in cardiac volume? Measurements of
      brain blood supply in healthy subjects during volume overload and in patients
      with artificial pacemaker by changing the pacing rate].
AB  - A constant cerebral blood flow (CBF) in the presence of systemic blood pressure
      changes and cardiac output (CO) alterations during physiological conditions are
      postulated by the mechanism of cerebral autoregulation. The aim of the present
      study is the analysis of CBF in pacemaker (PM) patients with unspecific
      neurological symptoms. CBF was measured in 9 controls and 23 pacemaker patients
      with 133xenon, CO using Doppler echocardiography or impedance cardiography. Mean
      and individual CBF in controls remained unchanged when a CO increase of 28%
      induced by volume overload was observed. In PM patients a mean CO increase of 38%
      induced by an increase of basic pacing rate caused different effects of CBF. CBF
      increased or decreased by about 10% or remained constant. In summary, the data
      suggest an impairment of cerebrovascular function in those patients with
      concomittant CBF changes due to CO alterations (15/23 approximately equal to
      65%). Thus, the analysis of brain perfusion in PM patients with unspecific
      neurological symptoms is possibly a new diagnostic feature in the future. It can
      be discussed whether or not indication and optimizing of pacemaker therapy has to
      be additionally analyzed by determination of endorgan perfusion.

PMID- 11220086
TI  - [Detection of circulating cerebral microemboli by transcranial Doppler
      ultrasonography].
AB  - Thromboembolic events represent a major complication of cardiovascular diseases
      and interventions. Although general risk factors and predictors for
      thromboembolic events are well known from population-based studies, hardly any
      therapeutic consequences for the individual patient can be drawn, e.g. for a well
      balanced therapy with anticoagulants. A new approach towards an optimised therapy
      adapted to the individual risk of each patient may be based on the detection of
      circulating microemboli by transcranial Doppler sonography. With this technique,
      gaseous or solid microparticles circulating in the blood can noninvasively be
      detected. Due to their small size, they do not induce thromboembolic events
      themselves. However, several studies demonstrate that they indicate an increased
      thromboembolic activity and correlate directly with manifest stroke or emboli.
      From a transcranial Doppler probe positioned on the temporal plane at the
      patient's skull, the middle cerebral artery's blood flow is recorded and is
      analysed acoustically and optically for circulating microemboli. This technique
      has already been used for risk stratification of high-risk patients and
      therapeutic decision-making in neurologic routine, e.g. for the indication to
      anticoagulate the patient or for carotis surgery. Data to evaluate its value in
      cardiology are limited and based on few clinical studies. In this review, the
      basic principles and the methodological and technical background for the
      detection of microemboli, as well as current limitations, are discussed.
      Furthermore, clinical studies and their results evaluating this technique in
      patients with cardiological diseases and during cardiovascular interventions are
      reviewed.

PMID- 11220087
TI  - [Acute thrombosis of pelvic and leg veins in agenesis of the renal segment of the
      inferior vena cava].
AB  - A 19-year-old, otherwise asymptomatic man presented to the hospital of
      orthopaedic surgery with acute severe pain like lumbago. Symptomatic treatment
      was performed after extensive orthopaedic diagnostic procedures. On the third day
      after admission he showed clinical signs of deep vein thrombosis with painful
      swelling and livid discoloration of both legs. Colour duplex ultrasound revealed
      complete thrombosis of the leg and pelvic veins bilaterally, but the cranial
      extent was not clear. Contrast-enhanced helical computer tomography of the
      abdomen and the pelvis confirmed deep pelvic vein thrombosis and showed extension
      into the inferior vena cava. Moreover, the study revealed the agenesis of the
      renal segment of the inferior vena cava with collateral flow through dilated
      lumbar veins to enlarged azygous and hemiazygous, through vertebral and
      paravertebral venous plexus. The renals were drained via dilated capsular veins.
      The agenesis of renal vena cava is a very rare anomaly causing acute thrombosis
      of the deep leg and pelvic veins. Other risk factors of thromboembolic disease
      were not found. The patient was treated successfully with systemic thrombolysis.
      Therefore we used ultra-high streptokinase infusion (9 million units over 6
      hours). Colour duplex ultrasound revealed good flow into deep leg and pelvic
      veins after three cycle of lysis. Magnetic resonance angiography of the abdomen
      and pelvis was performed to evaluate the successful fibrinolysis with complete
      recanalisation of the pelvic veins and to demonstrate the venous anatomy.
      Permanent oral anticoagulation with phenprocoumon is indicated to decrease the
      high rate of recurrent thrombosis. Compression stockings were prescribed. To
      prevent thrombosis, additional risk factors like smoking, immobilization and
      unusual physical activity should be strictly avoided.

PMID- 11220088
TI  - [Cardiopathia fantastica: case report and literature review].
AB  - We describe the case of a 71-year old medical technician, who was treated for
      instable angina pectoris in 29 different hospitals 38 times over 9 years.
      Dramatically presented retrosternal pain regularly started in crowded places,
      such as bus or railway stations or directly in front of the hospital. Ultrasound
      and ECG gave evidence of an old inferior myocardial infarction. Invasive
      diagnostic procedures were rejected by the patient because of an alleged allergy
      for contrast media. The single, retired patient never admitted former cardiac
      hospitalizations and restrained the physicians from contacting his local doctor.
      The patient mostly left the hospital against medical advice and achieved
      hospitalization in another clinic sometimes the same day. Because of his
      personality structure, the dramatic presentation of his complaints and the
      numerous hospitalizations in various hospitals with self-discharge, we made the
      diagnosis of a cardiac Munchausen syndrome, a so-called cardiopathia fantastica,
      in the presence of an accompanying coronary heart disease. In the literature we
      found 52 cases of cardiopathia fantastica since the first description of this
      phenomenon in the year 1953. Interestingly enough, mostly men were identified.
      Angina pectoris is by far the most frequent symptom of cardiopathia fantastica.
      In 8 of 53 patients (15%) an additional cardiac manifestation was present in
      addition to cardiopathia fantastica. Cardiopathia fantastica on the one hand is
      an important differential diagnosis of coronary heart disease; on the other hand
      it may develop in the presence of an underlying cardiac disease.

PMID- 11220089
TI  - [Molecular genetic diagnosis in cardiology].
AB  - Within the next few years the "book of life" will be written, i.e., the sequence
      of the human genome will be completely assembled. This knowledge will open new
      avenues for the understanding and treatment of diseases. Causal relationships
      between mutated genes and disease states have been established for a number of
      single gene disorders. Although molecular genetic tests are not yet feasible for
      routine clinical practice in most cases, faster and, eventually, less expensive
      technologies for the identification of mutations are on the horizon. Clinical
      guidelines also apply to molecular genetics with diagnostics test being performed
      only in those individuals who may benefit from it.

PMID- 11220091
TI  - ["Trust is good, ... is control better?"].

PMID- 11220090
TI  - [Endovascular stent-graft prosthesis in aortic aneurysm].
AB  - Descending thoracic and abdominal aortic aneurysms represent a potential life
      threatening situation. Resection and graft replacement of the pathologically
      altered aorta used to be the preferred method of treatment. Although progress has
      been achieved during the past decades in the management of patients with thoracic
      aortic aneurysms by new surgical techniques, intraoperative monitoring of
      somatosensory-evoked potentials, and spinal cord fluid drainage, postoperative
      morbidity and mortality rates still remain high. The afflicted population is
      usually of older age and present at the time of operation with various
      comorbidities such as hypertension, obstructive pulmonary disease, coronary heart
      disease, all of which with significant impact on surgical outcome. Postoperative
      complications, such as paraplegia, renal and pulmonary disease, contribute to
      prolonged hospital stay and higher medical cost. In this review we report on a
      promising alternative approach to the surgical treatment of thoracic and
      abdominal aortic aneurysms, namely the currently emerging utilization of the
      endovascular stent-graft prosthesis in both thoracic and abdominal aneurysm.

PMID- 11220092
TI  - [Pathohistological findings in liver metastases].
AB  - Metastatic tumors are the most common malignancies of the liver. The frequency
      distribution of the primary tumor location site closely resembles the frequency
      distribution of primary cancers in general. Yet, due to the liver's filter
      function of the portal blood-stream, metastatic tumors of the gastrointestinal
      tract are overrepresented. Most metastatic tumors show a nodular growth pattern
      with a demarcation of the tumor by inflammatory or fibrous reactive tissue; a
      diffuse metastatic tumor spread within the sinusoids is uncommon. Metastatic
      liver tumors may be the first clinically detectable manifestation of an unknown
      primary tumor. In these cases, the histological and immunohistochemical pattern
      of the metastatic tumor cells may give a clue of the location of the
      corresponding primary tumor.

PMID- 11220093
TI  - [Basic principles and general practice of digital photo- and video-documentation.
      2].

PMID- 11220094
TI  - [Improvement in diagnosis of liver metastases with the multi-detector CT].
AB  - The introduction of multidetector computed tomography in clinical routine creates
      a new dimension of increased spatial and temporal resolution in CT scanning. On
      the basis of the very short acquisition time, the whole liver can now be scanned
      within one breathhold. Multidetector-CT allows the examination of the liver with
      nearly isotropic data sets. This is the prerequisite for the optimal assessment
      of very small liver lesions in all planes and excellent enhancement of liver
      lesions in defined organic perfusion phases. The speed of multidetector-CT can
      either be used to reduce the time to cover a given volume, or to use narrower
      beam collimation to increase the resolution of details along the z-axis and to
      reduce volume averaging. We report our clinical experiences in hepatic
      multidetector-CT examinations and optimized examination protocols in the
      assessment of hepatic metastases. Multidetector-CT and the use of interactive
      multiplanar reconstructions improve the detection and characterization of liver
      metastases. However, new problems in data management may arise from the large
      amount of data generated by multidetector-CT.

PMID- 11220095
TI  - [Contrast medium enhanced magnetic resonance tomography of liver metastases:
      positive versus negative contrast media].
AB  - The development in oncologic liver surgery as well as modified interventional
      therapy strategies of the liver have resulted in improved diagnostic imaging. The
      evolution of contrast agents for MR imaging of the liver has proceeded along
      several different paths with the common goal of improving liver-lesion contrast.
      In MRI contrast agents act indirectly by their effects on relaxation times.
      Contrast agents used for hepatic MR imaging can be categorized in those that
      target the extracellular space, the hepatobiliary system, and the
      reticuloendothelial system. The first two result in a positive enhancement, the
      last one in a negative enhancement. Positive enhancers allow a better
      characterization of liver metastases using dynamic sequence protocols. Detection
      rate of liver metastases is increased using hepatobiliary contrast-enhanced MRI
      compared to unenhanced MRI. Negative enhancers, iron oxide particles,
      significantly increase tumor-to-liver contrast and allow detection of more
      lesions than other diagnostic methods. Iron-oxide enhanced MRI enables
      differential diagnosis of liver metastases comparing morphologic features using
      T2 and T1-weighted sequences.

PMID- 11220096
TI  - [Indications and outcome of liver metastases resection].
AB  - Liver resection with curative intent for metastastic disease can be performed at
      low operative morbidity and mortality (< 3%). Most data relate to colorectal
      metastases. Five year survival following primary and repeat liver resection is
      consistently reported as 25-30% and has not been improved by adjuvant
      chemotherapy. Options for improvement of prognosis by purely technical means
      appear limited. Instead, future strategies should aim at increasing the number of
      patients amenable to potentially curative liver resection. This could be achieved
      by earlier diagnosis, by combination of surgical resection with neoadjuvant
      treatment or thermoablation, by selective portal embolisation as well as further
      surgical specialisation. The search for effective adjuvant therapy should
      continue.

PMID- 11220097
TI  - [Thermal ablation of liver metastases. Current status and prospects].
AB  - PURPOSE: To present thermal ablation of liver metastases via laser induced
      thermotherapy. MATERIAL AND METHODS: Different technical procedures of thermal
      ablation and online monitoring are used, as there are the MR-guided laser induced
      thermotherapy (LITT) and the radiofrequency ablation thermotherapy (RF). RESULTS:
      In a prospective non randomized study 606 patients with liver metastases were
      treated via MR-guided laser induced thermotherapy. Inclusion criteria were the
      exclusion of extrahepatic tumor spread and a number of metastases lower than 5
      and a size lower than 50 mm in diameter. The local tumor control rate in the 3
      month and 6 month control study was 98.3%, the complication rate 3.5% (clinically
      relevant: 1.2%). The mean survival rate was 40.9 months for all patients with
      liver metastases without statistically relevant differences for various
      primaries, like colorectal carcinoma, breast cancer and various other tumors.
      Results for radiofrequency are so far limited with incidence of a higher local
      tumor recurrence rate versus LITT. CONCLUSION: MR-guided LITT results in a high
      local tumor control rate with improved survival.

PMID- 11220098
TI  - [MRI-assisted brachytherapy of nonresectable liver metastases. Preliminary
      technical and clinical experiences].
AB  - PURPOSE: To evaluate the feasibility and efficacy of MR-guided interstitial
      brachytherapy of non-resectable liver metastasis. METHODS: Liver metastases (0.8
      5.2 cm in diameter) were treated during a prospective phase I/II study using an
      open 0.2 Tesla MR system (Magnetom Open Viva, Siemens, Erlangen). MR-compatible
      brachytherapy applicators were placed percutaneously under MR-guidance in an open
      0.2 Tesla MR system (Magnetom Open Viva, Siemens, Erlangen) using fast T1
      weighted sequences. Pretreatment and follow-up studies were performed using a 1.5
      Tesla MR system. RESULTS: Preliminary results of an unpublished prospective study
      are discussed exemplary on 2 selected patients. The median procedure time was 4.9
      h. No major complications were observed and late effects were acceptable. In
      large symptomatic metastases only a temporary relief of pain was achieved. In
      smaller metastases (DM 3 cm) a tumor control was observed. CONCLUSION: MR-guided
      brachytherapy is feasible and has the potential to ablate liver metastases with
      diameter of less than 3 cm. Further developments are necessary.

PMID- 11220099
TI  - [Stereotactic irradiation of liver metastases].
AB  - PURPOSE: A number of minimal-invasive methods have been developed for the
      treatment of non-resectable liver metastases. A focused high dose can be
      delivered to a liver tumor with sparing of surrounding normal liver tissue using
      non-invasive stereotactic techniques. METHODS: Sixty-six metastases were treated
      stereotactically in 43 patients during a phase 2 trial. RESULTS: There were no
      major side effects observed. The actuarial local control was 82% after 18 months.
      The median actuarial survival was 24 months. However, there was a significantly
      improved survival in patients without additional extrahepatic tumor manifestation
      at the time of treatment compared to those, who were treated in palliative
      intention (87% vs. 24% after 18 months, p = 0.001 (log-rank). CONCLUSION:
      Stereotactic single dose irradiation is a non-invasive and safe treatment option
      for patients with inoperable liver metastases. Phase III studies will further
      evaluate this new approach.

PMID- 11220100
TI  - [Radiofrequency ablation of liver metastases. Technique and initial results].
AB  - Primary and secondary malignant hepatic tumors are the most common tumors with a
      much more higher incidence of hepatic metastases. Chemotherapy and radiation
      therapy are in general ineffective. Therefore, surgical resection is considered
      the method of choice in the treatment of malignant hepatic lesions. Due to
      systemic disease, general medical or procedure-related reasons hindering surgery,
      only 25 to 45% of the patients with metastatic disease of the liver are suitable
      for a curative surgical therapy. In resectable lesions thermoablative methods can
      offer an alternative to the surgical therapy. The most experience exists in
      radiofrequency ablation techniques. Technique, indications, contraindications,
      and limitations of the radiofrequency ablation will be discussed together with a
      presentation of own cases and a review of the literature. In 37 patients the
      primary technical success rate of the ablation was 97.3% (72 of 74 lesions). In 4
      cases a hematoma of the liver capsule occurred. One of these had to be treated
      interventionally. During the limited follow-up period of 9 months no local
      recurrency was seen, however 4 patients developed new hepatic metastases. Beside
      differences in practicability it is not yet clarified if there are differences in
      the therapeutic efficacy of the different thermoablation methods. Nevertheless,
      the results of the ablation therapy may parallel the results of the surgical
      resection. Interstitial thermotherapy can provide a valuable contribution to
      local tumor control. However, the final significance of the thermoablation
      techniques within oncological therapy regimens has to be evaluated in further
      multidisciplinary studies.

PMID- 11220101
TI  - [MRI-controlled percutaneous cryotherapy of liver metastases].
AB  - The prognosis for patients with liver metastases depends on the therapeutic
      options regarding the treatment of the primary tumor, co-existing extrahepatic
      metastases and the extent and treatment possibilities of the hepatic metastases
      themselves. Numerous curative or palliative oncological therapeutic concepts have
      been introduced in case of non-resectable liver metastases to prolong survival
      while maintaining a highest possible quality of life. Cryotherapy, which can be
      performed percutaneously and under magnetic resonance guidance, is one of these
      manifold therapeutic modalities, combining the inherent advantages of MRI with
      minimal invasiveness. Excellent visualization of the frozen liver tissue, precise
      tumor ablation, as well as an almost painless intervention due to the analgetic
      effect of the ice are implicating percutaneous cryotherapy as an attractive
      alternative to other ablation techniques. First clinical results are promising.
      However, meticulous and extensive long-term evaluation on a broad clinical scale
      is required.

PMID- 11220102
TI  - [Ultrasound diagnosis of liver metastases with liver-specific contrast media].
AB  - In recent years sonographic contrast agents which can be used for liver imaging
      have become available. Some of these agents (e.g. Levovist, Schering AG, Berlin)
      display a liver-specific late phase. Visualisation of this late phase requires
      contrast-specific imaging techniques such as phase or pulse inversion. When
      scanned in phase inversion during the late phase, normal liver parenchyma shows
      strong enhancement. This enhancement spares metastases which stand out as echo
      poor or almost echo-free enhancement defects. This improves the conpicuity of
      metastases markedly. The technique increases the number of detectable metastases
      in up 45% of patients in comparison to unenhanced sonography. In a multi-centre
      study on 128 patients the sensitivity in the detection of individual metastases
      was increased from 71% to 88% and specificity improved from 59% to 88%. Contrast
      enhanced sonography thus represents a promising alternative to other cross
      sectional imaging modalities in the diagnosis of hepatic metastases.

PMID- 11220103
TI  - [Transarterial chemoembolization (TACE) of liver metastases. A palliative
      therapeutic approach].
AB  - Metastatic involvement of the liver determines the treatment. Hepatic artery
      chemoembolization (TACE) represents a safe palliative treatment for patients with
      unresectable liver metastases. Technical treatment, indication and results of the
      TACE are reported. The results of TACE depend on primary cancer, size and
      vascularisation of the hepatic tumors. Our results with out patient treatment of
      245 patients prove that TACE results in a extremely low rate of side effects.
      Combination of TACE with local ablative treatment may present potentially
      curative treatment option for unresectable tumors.

PMID- 11220104
TI  - [Radiation exposure of the patient by intraoperative imaging of intramedullary
      osteosyntheses].
AB  - MATERIAL AND METHOD: 39 patients with pertrochanteric femur fracture (n = 32) or
      lower leg fracture (n = 7) were treated with closed intramedullary nailing. The
      related radiation exposure of the patients was calculated. RESULTS:
      Osteosynthesis of pertrochanteric fractures took less fluoroscopic time than
      osteosynthesis of lower leg fractures. The effective dose was 14 mSv for nailing
      osteosynthesis of proximal pertrochanteric fractures and less than 0.1 mSv for
      osteosynthesis of distal lower leg fractures. CONCLUSION: Radiation exposure of
      the patient due to intraoperative fluoroscopic imaging during osteosynthesis can
      be estimated based on the data given above. Intraoperative observations imply,
      consequent application of radiation protection by the orthopaedic surgeons may
      reduce intraoperative radiation exposure even more.

PMID- 11220105
TI  - [Puzzling liver findings. Peliosis hepatis].

PMID- 11220106
TI  - Me and Max: a misalliance of goals.

PMID- 11220107
TI  - Thinking, talking, playing: the peculiar goals of psychoanalysis.

PMID- 11220108
TI  - Reflections on the goals of psychoanalysis, the psychoanalytic process, and the
      process of change.

PMID- 11220109
TI  - Life goals and psychoanalytic goals from a historical perspective.

PMID- 11220110
TI  - No search or getting down to business?

PMID- 11220112
TI  - The patient's experience of therapeutic benefit.

PMID- 11220111
TI  - "Butterflies caught in the network of signifiers": the goals of psychoanalysis
      according to Jacques Lacan.

PMID- 11220114
TI  - When the fruit ripens: alleviating suffering and increasing compassion as goals
      of clinical psychoanalysis.

PMID- 11220113
TI  - The treatment of affects: an interdisciplinary issue.

PMID- 11220115
TI  - Expanding psychological possibilities.

PMID- 11220116
TI  - Psychoanalysis and life.

PMID- 11220117
TI  - Psychoanalytic goals: new and old paradoxes.

PMID- 11220118
TI  - The goals of clinical psychoanalysis: notes on interpretation and psychological
      development.

PMID- 11220119
TI  - Survival analysis within one year of first acute myocardial infarction:
      comparison between non-Q and Q wave myocardial infarction.
AB  - BACKGROUND: Non-Q wave Myocardial Infarction (non-Q AMI) is related
      pathophysiologically to Q wave AMI, as each represents different stages of plaque
      rupture and thrombosis. Post-hospital re-infarction and recurrent angina are more
      frequent in non-Q AMI than in Q wave AMI, offsetting the higher early risk with Q
      wave AMI, with one-year survival rates similar in the two types of MI.
      OBJECTIVES: 1--Evaluation of early (< or = 28 days) and one-year total mortality
      from first non-Q AMI in comparison to QMI. 2--Analysis of recurrent acute
      ischaemic events (non-fatal reinfarction and unstable angina) in both types of MI
      in the same periods of time. POPULATION AND METHODS: A retrospective study of
      1146 patients, mean age 65 +/- 13 years, 65% male, admitted at CCU with a first
      MI, from January 1988 to December 1997 (minimum follow-up period of one year,
      mean follow-up 42 +/- 37 months). We compared the baseline demographics and
      clinical characteristics (coronary risk factors, previous angina, MI evolution,
      recurrent cardiac events, 28 day mortality and one year mortality) of patients
      with non-Q AMI (NQ group = 239) and Q wave AMI (Q group = 907). RESULTS: The NQ
      group patients were significantly older (mean age: 67 +/- 12.6 vs 65 +/- 12.5
      years; p < 0.05), included fewer smokers (29% vs 43%; p < 0.001) and were more
      symptomatic before the index infarction (stable angina: 40% vs 30%; p < 0.05;
      unstable angina: 16% vs 6%; p < 0.001), when compared to the Q group patients.
      There were no significant differences in MI evolution, in Killip-Kimbal class >
      or = 2, recurrent angina and in-hospital mortality (Q-12% vs NQ-9%; ns), although
      there was a higher combined risk of arrhythmias and AV conduction disturbances in
      patients with QMI (Q-34% vs NQ-26%; p < 0.05). The combined risk of unstable
      angina and reinfarction at one year was significantly higher in group NQ (NQ-13%
      vs Q-8.1%; p < 0.05). The NQ group showed no significant difference in 28 day
      total mortality (NQ-14% vs Q-17%; ns) or at one year follow-up (NQ-24% vs Q-26%;
      ns) when compared to the Q group. CONCLUSION: 1--Despite a lower severity of non
      Q AMI in the acute phase, 28 day and one year total mortality were similar in the
      two groups. 2--Patients with non-Q AMI showed a higher incidence of recurrent
      ischemic events at one year follow-up.

PMID- 11220120
TI  - Role of autonomic nervous system and hemodynamics in cardiovascular homeostasis
      after orthostatic stress.
AB  - Autonomic control of hemodynamics is crucial to maintaining cardiovascular
      homeostasis after orthostasis. Our goal was to assess the effect of passive
      orthostatic stress on cardiovascular hemodynamics regulation by analysis of the
      autonomic nervous system (ANS) and gender influence on the variables. We used a
      passive 70 degrees tilt test as an orthostatic maneuver. For SNA measurements we
      used FFT for HRV and SBPV, temporal sequences and alpha index to calculate
      baroreceptor gain. Hemodynamic data was calculated non-invasively by modelflow.
      Orthostatic stress induces a rise in heart rate (+15%), total peripheral
      resistance (+28%), sympathetic tonus (LF_nu: +32%; LF_pas: +64%) and a reduction
      in cardiac output (-28%), systolic volume (-43%), and vagal activity both tonic
      (HF_nu:-115%) and reflex (BRG:-103%). Females had higher vagal activity
      regardless of position. We concluded that the autonomic nervous system plays a
      crucial role in cardiovascular hemodynamics control to maintain homeostasis after
      orthostatic stress.

PMID- 11220121
TI  - [Acute effects of tobacco and vascular risk modulated by genetic factors].
AB  - Most studies regarding the acute effects of cigarette smoking refer to the higher
      sympathetic and adrenomedullary activity as a result of sympathetic ganglia and
      adrenal medulla nicotinic receptor activation. Although it is reasonable to
      suppose that the renin-angiotensin system might be activated, this possible
      effect of nicotine has not been studied. We have studied the effects of cigarette
      smoking on blood pressure, cardiac output, pulse pressure, renin-angiotensin
      system, kinins-NO, oxidative stress and insulin. Also, we have investigated if
      the variability of the biochemical parameters was dependent on genetic
      polymorphisms of the angiotensin converting enzyme and the acute phase protein
      haptoglobin. 39 normotensive individuals, 18 males and 21 females, of mean age
      35.4 +/- 8.9 years were included in this study. Oxidative stress was dependent on
      the ACE I/D and Hp1/2 polymorphisms, with the ACE DD genotype and the Hp2-2
      phenotype not showing variation in the anti-oxidant defense systems, and the ACE
      II-ID genotypes and Hp1-1 + 2-2 phenotypes showing a higher anti-oxidant
      response, hence a lower cardiovascular risk being predictable in the latter
      individuals.

PMID- 11220122
TI  - [Effect of programming different AV intervals on mitral insufficiency in patients
      with DDD pacemaker].
AB  - OBJECTIVE: To study the effect of programming three different atrioventricular
      intervals (AVI) on mitral insufficiency (MI) in patients with permanent pacemaker
      due to complete atrioventricular block. METHODS: We included 9 patients (mean age
      62 +/- 11 years; 6 men), with permanent DDD pacemaker, isolated MI and normal
      ventricular function. We evaluated MI (in a quantitative way) and cardiac output
      (CO) through echocardiographic examination with three different AVI (100, 150 and
      200 ms). RESULTS: We observed a reduction in the severity of MI with the
      reduction of the AVI (best results obtained with AVI of 100 ms). We also observed
      an increase in the CO in 4 patients (those with MI of greater degree) with AVI of
      100 ms. CONCLUSIONS: We observed a correlation of longer AVI with greater degree
      of MI; our results point to the possibility of increasing the CO of patients with
      greater degrees of MI with shortening of the AVI (probably due to a partial
      recovery of the regurgitant volume).

PMID- 11220123
TI  - [Interatrial electromechanic resynchronization by dual atrial pacing in the
      prevention of paroxysmal atrial fibrillation --report of a case].
AB  - We presented the case of a 78 year old woman who five years ago underwent
      myectomic surgery, and aortic valvular replacement, for obstructive
      cardiomyopathy and valvular aortic stenosis. After surgery, the aortic
      transvalvular gradient was insignificant (20 mm/Hg). In spite of this she suffers
      from frequent AF crises, (3 times a month), with a cardiac frequency of 140
      150/min. She was in sinus bradycardia (40-45/min), which was a clear counter
      indication for the use of antiarrhythmic drugs. Her ECG showed sinusal
      bradycardia with 45/min, a two-phase P-wave (positive-negative) in DII, DIII aVF,
      and bimodal P-wave in DI. Furthermore, she showed a 1st degree auriculo
      ventricular block with complete left-branch block. In her echocardiogram there
      was concentric left ventricular hypertrophy, with diastolic disfunction and left
      atrial dilatation. In the auricular IEGM we observed a slowed-down interauricular
      conduction (right atrium-left atrium = 120 msecs); The A-wave was fragmented. The
      auriculo-ventricular Wenckbach point was at 90/min. In view of these findings we
      proceeded with the implantation of a DDD-pacemaker with biauricular stimulation,
      as follows: 1. We used two auricular electrodes, one with an active fixation to
      the crista terminalis of the right atrium and the other (having in mind the
      stimulation of the left atrium) applied to the proximal coronary sinus. These two
      electrodes were connected to the auricular pin of the pacemaker by means of an
      "Y"--type Biotronick adaptor. 2. The right ventricular stimulation was done with
      a normal, bipolar ventricular electrode, on the apex of the ventricle. After
      biauricular, simultaneous, stimulation, we proceeded with interauricular re
      synchronization. After this procedure, the A-wave no longer appeared fragmented,
      and the right auricular--left auricular waves were then simultaneous and with two
      phase morphology. Three months later the interauricular resynchronization
      procedure was induced and without any antiarrhythmic drugs, the Holter showed no
      cardiac arrhythmias, there is no auricular fibrillation. The morphology of the P
      wave has changed. The patient has an improved exercise capacity and a better
      quality of life.

PMID- 11220124
TI  - [Numbers needed for treatment and their respective confidence intervals: useful
      tools to assess clinical significance and uncertainty associated with medical
      interventions].
AB  - This is a narrative review of a concept--number needed to treat (NNT). The
      proprieties of NNTs are described. Furthermore NNTs as important tools for
      medical decision are discussed. In particular, conditions that make calculus and
      the interpretation of NNTs somewhat more complex are commented. Namely, we
      consider situations where the results are not primarily binary or are expressed
      as "time to event" or come from a meta-analysis. The inconsistencies that might
      occur when NNTs are calculated from meta-analysis are discussed in some detail.
      Definitions for parameters derived from NNTs, as numbers needed to harm (NNH),
      unqualified success (NNTUS) and unmitigated failure (NNHUF) are given. Finally
      the usefulness of NNTs and absolute risk reductions to communicate risk to
      individual patients are considered. It is concluded that despite NNTs being
      powerful tools for medical decision, in the case of communicating risks to the
      individual patient absolute risks might be preferable.

PMID- 11220125
TI  - [Certification in interventional electrophysiology].

PMID- 11220127
TI  - [Effect of folic acid and antioxidant vitamins on endothelial dysfunction in
      patients with coronary artery disease].

PMID- 11220126
TI  - Anomalous origin of the left coronary artery from right coronary artery ostium.

PMID- 11220128
TI  - [State and problems of health resort construction in the Caucasian Mineral Waters
      Region].
AB  - Although the requirement of population in recreation and rehabilitation services
      is increasing, the number of Russians using spa treatment at institutions of
      Caucasian Mineral Water Health Resort is now 3.5 times less than at the end of
      the eighties. The author suggests approaches to and methods for solution of
      problems of health resorts and their institutions, which should serve as
      landmarks for managing actions at regional and local levels.

PMID- 11220129
TI  - [Organization and evaluation of activities of a diagnostic center].
AB  - Sums up the 12-year activities of Territorial Diagnostic Center in Krasnodar.
      Offers for discussion the key problems in improving the efficiency of such
      centers.

PMID- 11220130
TI  - [Role of various sources of financing in the activities of a consultation and
      diagnosis center].

PMID- 11220131
TI  - [Effects of information media on population health].
AB  - Analysis of sociohygienic statistical values brought the author to a conclusion
      that deterioration of health of the Russian population and increased mortality,
      particularly from causes associated with information, is directly (increased
      morbidity and disability caused by mental disorders) and indirectly
      (cardiovascular diseases) determined by unfavorable information media of Russia,
      and deterioration of population health in general is indicative of negative
      effects of information on population health in Russia.

PMID- 11220133
TI  - [Compensation for expenditures of municipal public health institutions in health
      resort regions].
AB  - Analyzes and suggests a mechanism for compensation of expenditures of medical
      institutions of health resort regions for services rendered to visitors to these
      regions through insurance system.

PMID- 11220132
TI  - [Health care of workers of industrial enterprises in Ukraine].
AB  - Presents the conceptual basis for recreating the system of primary health care of
      workers of industrial enterprises under modern conditions. Organization of
      medical care under modern economic conditions is shown as exemplified by a
      specially designed model of medical care of workers of atomic power station.

PMID- 11220134
TI  - [Methods of management of sanatoria for patients with urologic diseases].
AB  - Presents experience gained in development and introduction of managing
      technologies in organization of spa and health resort rehabilitation of
      urological patients--a population relatively new for the Black Sea health
      resorts.

PMID- 11220135
TI  - [Current problems in the formation of a system of monitoring health status of
      children and adolescents].
AB  - Discusses obviously limited potentialities of obtaining systematized analytical
      data by organs and institutions of social sphere. Such potentialities are
      particularly low in public health, specifically pediatric research and practice,
      where analytical materials would help improve the development of strategic
      programs of maternity and childhood protection and adopt adequate managing
      solutions at all levels. One of the constructive decisions aimed at the formation
      of a system of sociohygienic monitoring of children's health and ensuring
      integration of efforts of all responsible organs is creation of Federal Center of
      Social prevention for Children and Adolescents. The Center will ensure economy
      and rational utilization of finances and staff at the state and territorial
      level. Its purpose is to unite the interests of all profile organs and
      institutions for ensuring social well-being of children and adolescents.

PMID- 11220136
TI  - [Evaluation of the quality of hospital care of prisoners (results of sociological
      interviews)].
AB  - Interregional hospital attached to administration of prisons renders specialized
      care to prisoners. Anonymous sociological questionnaires distributed among 815
      patients treated at the hospital showed that the patients were satisfied with
      organization of medical care and communal provision and demonstrated serious
      problems in organization of hospital care rendered to prisoners.

PMID- 11220137
TI  - [Organizational and legal problems of medical care of traffic safety].
AB  - Medical aspects of driving safety are discussed. Legal problems in first care of
      victims of accidents and evaluation of fitness to driving are analyzed. The paper
      is addressed to specialists in public health management.

PMID- 11220138
TI  - [Restructuring of hospital care in a large city].

PMID- 11220139
TI  - [Prevention in the formation of a regional model of public health].

PMID- 11220140
TI  - [Systems of payment for medical care].

PMID- 11220141
TI  - [Experience in the analysis of intake and distribution of finances in sanatorium
      spa institutions].

PMID- 11220142
TI  - [Pre-history of preparing the "Supplemental enactment concerning the Medical
      Department of the Imperial Moscow University". II].

PMID- 11220143
TI  - [Zemstvo medicine in the Kazan province].

PMID- 11220144
TI  - [Health insurance in the Far East in the twenties].

PMID- 11220145
TI  - [History of public health in the railroad transport in Russia].

PMID- 11220146
TI  - [Medicine of the medieval Russia. IV].

PMID- 11220147
TI  - [Role of the family in the prevention of diseases of the oral cavity in
      children].
AB  - Sociohygienic studies of hygienic knowledge with regard to prevention of dental
      diseases in children were carried out in 456 mothers and their 15-year-old
      schoolchildren in Ufa. The respondents were interviewed using specially designed
      questionnaires. The results allowed the authors characterize the performance of
      medical functions by parents from families differing by well-being and their role
      in hygienic upbringing of children.

PMID- 11220148
TI  - Mechanisms of G-protein coupled receptor regulation.
AB  - It has been realized recently that the enhanced or lowered activation of a
      certain receptor type brings about changes not only in the sensitivity (or
      density) of this particular receptor type in cell membranes by producing its
      desensitization or sensitization, down- or up-regulation (i.e. homologous
      regulation), but also it could change the function (or density) of other
      receptors (cross-regulation). This review is focused on mechanisms of the
      homologous regulation (changes in the pathway activated by the appropriate type
      of receptor) and possible mechanisms of cross-regulation (changes in pathway
      activated by other type of receptor).

PMID- 11220149
TI  - [Role of protein phosphorylation in the development of tumors].
AB  - Phosphorylation is one of the most important ways of posttranslational
      modification of proteins that enables regulation of many cell physiological
      processes (transport, proliferation, differentiation). This reversible and very
      fast process is involved in all phases of cell division: in transition from G1 to
      S phase, progression of cells during S phase and entry into M phase. The
      physiological function of oncoproteins and tumor suppressor proteins that are
      involved in gene expression and replication are also regulated by
      phosphorylation. Many growth factors and their receptors are encoded by oncogenes
      which are mutated or overexpressed in a variety of human tumors. Mutation or
      overexpression of these oncogenes leads to uncontrollable cell division and
      transformation of normal cells to malignant. Cancer can be considered as a
      disease of the signalling pathways.

PMID- 11220150
TI  - Seizures in sleep apnea patients: occurrence and time distribution.
AB  - A retrospective survey of consecutive 480 adult patients (394 men, 96 women, mean
      age 50.3, SD +/- 10.4 years) with sleep apnea syndrome (SAS) was made in attempt
      to find out among them the patients with epilepsy. In total 19 subjects (17 men,
      2 women, average age 55.8 +/- 8.7 years) representing 4.0% experienced at least
      two seizures in adult age. The average age at the first seizure was 48.4 +/- 16.1
      years. Ten subjects suffered from primarily generalized tonic-clonic seizures,
      seven from secondarily generalized tonic-clonic seizures, one had complex partial
      seizures and one simple partial seizures. In 15 subjects (78.9%) the seizures
      occurred exclusively during sleep. Two patients (11.1%) had seizures exclusively
      during vigilance and in remaining two subjects the seizures occurred during sleep
      and vigilance. The findings of high proportion of subjects with epilepsy among
      SAS subjects, of late seizure onset and of predominantly sleep occurrence of
      seizures suggest that sleep apnea and hypopnea can facilitate epileptic seizures.

PMID- 11220151
TI  - The influence of traumatic brain lesion on sleep architecture.
AB  - The authors deal with sleep changes in patients after brain injury. Ten patients
      were examined with the use of daytime routine EEG and night polysomnography. The
      amount of REM sleep is most sensitive to brain damage and is reduced in all
      patients with nonspecific epileptiform changes in the EEG. Changes in deep
      synchronous sleep are less frequent and are not in correlation with the
      prevalence of epileptiform changes. Thus the reduction of REM sleep seems to be a
      sensitive marker of development of epileptiform EEG-changes and perhaps could
      play a predictive role of development of post-traumatic epilepsy.

PMID- 11220152
TI  - Influence of hemodialysis on selenium blood levels.
AB  - Selenium (Se) is considered an essential and very important trace element for
      humans. Blood Se levels in chronic hemodialysis (HD) patients are frequently
      reported to be lower than in controls. The aim of this study was to evaluate
      these lower Se blood levels with respect to the basic renal disease, duration of
      dialysis treatment, type of the membrane and dialysis solution used. We tried
      also to use the polynomial curve as a graphical method for rapid evaluation of a
      large number of Se blood levels. Se blood levels were measured before and after
      HD in 95 patients on chronic hemodialysis and in a control group of 20 healthy
      volunteers. Se blood levels were measured by atomic absorption spectrophotometry.
      Statistically significant increases of Se blood levels were found after HD (p <
      0.001). During HD, the relatively high Se blood levels decreased and low levels
      increased but remained below the range of physiological values. These levels were
      lower than those of the control group (p < 0.001). Of the different dialysis
      membranes used, the greatest changes in Se blood levels were measured after HD
      with cuprophan membranes (p < 0.001). No significant difference in Se blood level
      in respect to the underlying kidney disease (chronic glomerulonephritis,
      tubulointerstitial nephritis, polycystic kidney disease, diabetic nephropathy)
      was revealed. No association of predialytic Se blood levels and the length of
      dialysis treatment was found. Concluding our results suggests low selenium
      content in dialysis solution and show that, in respect to the importance of Se
      for humans, its substitution is desirable.

PMID- 11220154
TI  - Obstruction of common bile duct caused by liver fluke--Fasciola hepatica.
AB  - Three cases of obstruction of the common bile duct by Fasciola hepatica with two
      of the patients presenting jaundice are reported. The authors have reviewed
      several publications concerning common bile duct obstruction by liver fluke, a
      quite rare complication of fascioliasis. Only nineteen cases of common bile duct
      obstruction caused by Fasciola hepatica have been reported in a review of medical
      publications during last ten years. Clinical presentation, diagnostic methods and
      considerations, types of surgery are fairly uniform in all of the reported cases.
      Almost all of patients reviewed, had the history, symptoms and signs
      characteristic for cholelithiasis including recurrent colic pain in right
      hypochondriac area, fever or subfebrile temperature, fluctuating or stabile
      jaundice, and palpable painful gallbladder. The laboratory findings in all cases
      reviewed had shown leucocytosis, eosinophilia, high or slight elevated serum
      bilirubin. Echographically commonly revealed dilated intra- and extrahepatic bile
      ducts containing one or more hyperechogenic elements with or without casting an
      acoustic shadow. All patients underwent open surgery, comprised with
      choledochotomy and if possible extraction of the fluke. Only two postoperative
      cases were of necessity followed by ERCP. In all of our cases the primary pre
      operative diagnosis was choledocholithiasis, with diagnose of fascioliasis
      established at the operation. According to the literature this uncertainty in
      diagnosis is common because of difficulties in differentiation of fascioliasis
      versus choledocholithiasis. Considerations for making the differential diagnosis-
      a history of origin or visiting in endemic area of infection, history of eating
      of aquatic vegetables, laboratory findings including eosinophilia, fasciola eggs
      in stool, sonography and radiological imaging results and enzyme-linked
      immunosorbent essay (ELISA) which has been shown to be rapid, sensitive and
      quantitative. In all three cases we have observed intraoperative significant
      signs for liver fascioliasis to include surface scarring of the left lobe on the
      liver--tracks caused by subcapsular migration and location of the hepatic lesions
      (these findings were also seen by two authors in literature) with resemblance to
      Japanese letters. The most effective drug for treatment of fascioliasis according
      to our experience and literature reviewed is bithionol.

PMID- 11220153
TI  - Our experiences with combination of enzyme therapy and laser therapy in
      enthesopathies.
AB  - The present communication brings a contribution to the confrontation of two
      treatment methods in enthesopathies (painful overload syndromes). In group A, 26
      patients were treated by a combination of systemic enzyme therapy (SET) and non
      invasive laser therapy. In group B, 13 persons were treated only by therapeutic
      laser. The average age in group A and B was of 39.3 and 41.8 years, respectively.
      The representation of men and women in the two groups was almost identical. The
      intensity of the pain prior to the treatment and after the treatment, specified
      by each patient with the help of a ten-grade scale, was evaluated by the variance
      analysis. The combined treatment by the SET and therapeutic laser was
      statistically significantly more efficient (p = 0.02). On the other hand, there
      was also a significant difference between the two groups in baseline values of
      average pain intensities. These values were of 7.0 and 5.2 in groups A and B,
      respectively. The average value of the pain intensity in all the 39 patients was
      of 6.6 prior to the treatment and it was reduced to 3.5 after the treatment.

PMID- 11220155
TI  - [Comparison of the effectiveness of crystalloid and warm blood cardioplegia in
      patients with significant left ventricular dysfunction].
AB  - In a group of 84 patients undergoing elective coronary artery bypass surgery and
      with the ejection fraction lower than 40% two types of myocardial protection were
      studied. Group I (41 cases) was given intermittent cold crystalloid cardioplegia
      and group II (43 patients) was given intermittent warm blood cardioplegia
      followed by normothermic reperfusion. Preoperative, intraoperative and
      postoperative data were retrospectively collected. There were no differences
      between the two groups except more rhythm disturbances in group I and higher
      incidence of neurological complications in group II. CONCLUSIONS: Warm blood
      cardioplegia is an effective, cheap and practical myocardial protection
      technique.

PMID- 11220156
TI  - [A nontraditional method of surgical treatment of an aortocaval fistula. Case
      report].
AB  - Unusual method of aortocaval fistula and venous aneurysm repair is discussed and
      possible advantages of this type of surgery are cleared up. The aortoiliac
      prosthetic substitution and exclusion of the region, where aorta and inferior
      vena cava communicate without direct suture of the fistula makes the operation
      safer and lowers the risk of postoperative bleeding. In authors' opinion, this
      method is effective even in acutely rising aortocaval fistulas.

PMID- 11220157
TI  - [Aneurysm of the descending aorta causing destruction of vertebral bodies. Case
      report].
AB  - A case report of 59-year-old woman with combined lesion of the aneurysm of the
      descending thoracic aorta and the destruction of vertebral bodies is presented.
      Considering the infectious aetiology of the whole lesion and the possibility of
      the future orthopaedic intervention we use the less usual operative approach and
      technique in this case. Only indirect method to prevent the spinal cord injury
      was used and the aneurysm was repaired with bypass and exclusion. The only
      postoperative complication requiring future surgery was the dissection and
      thrombosis of the right superficial femoral artery used for blood pressure
      monitoring. We perform, in local heparinization, the proximal femoropopliteal
      prosthetic bypass. The latter postoperative course was uneventful. Follow-up
      digital angiography of the aorta 12 month later showed good filling of the
      prostheses and normal anastomosis, X-ray film and CT scans one, three and five
      years after operation showed almost complete reconstruction of the vertebral
      bodies. This article also discusses the technical and tactical aspects of the
      thoracic aortic aneurysm repair and also analyses the diagnostic and therapeutic
      chance to influence the spinal cord ischaemia.

PMID- 11220158
TI  - Humanities having been taught on the First Medical Faculty of Charles University
      last 10 years.

PMID- 11220159
TI  - Polyclonal antibodies for immunochemical determination of human pepsinogens.
AB  - The human gastric mucosa contains two main groups of aspartic proteinases, pepsin
      (EC 3.4.23.1) and gastricsin (EC 3.4.23.3), which differ by their structural,
      kinetic and immunological characteristics. The ratios between human aspartic
      proteases are important from the diagnostic point of view. Rabbit polyclonal
      antisera against human pepsinogen A and pepsinogen C (progastricsin) were
      obtained and tested for clinical purposes. Immunoblotting procedure seems to be a
      simple and sufficiently sensitive method for qualitative determination of
      pepsinogens in human gastric mucosa.

PMID- 11220160
TI  - [Effect of growth hormone on the structure of bone spongiosa in rats].
AB  - Changes in bone spongiosa, which follow after administration of growth hormone
      (GH) are described differently. Histomorphometrically processed value of bone
      trabecular volume is found higher or lower than normal. In this study, changes of
      rat bone spongiosa after administration of GH or bisphosphonate pamidronate were
      followed. The authors found statistically significant widening of
      histomorphometric parameter of trabecular thickness, but histomorphometrically
      assessed values of trabecular bone volume were not statistically different from
      normal rat bones. The structure of spongiosa is changed, the density of
      trabecular bone is diminished. The hypothesis of trabecular bone increase after
      GH administration together with resorption blocking agent (pamidronate) was not
      confirmed. GH causes widening of bone trabeculae. Pamidronate has no influence on
      bone histomorphometry in this case.

PMID- 11220161
TI  - [Personality changes in patients after voluntary alcoholism therapy from the
      aspect of the Rogers method].
AB  - The research deals with patients dependent on alcohol (F 10.2) who were treated
      on a voluntary basis by psychotherapeutic and sociotherapeutic methods in seven
      hospitals. For ethical, legal as well as professional reasons it was impossible
      to form a control group. Sixty six patients (28 women, 38 men) were put to the
      Regensburg inventory analysis of incongruities, its statistical evaluation was
      done by SPSS. The aim of the research was to detect personally changes in
      patients induced most probably by their hospital stay. As statistically
      significant (t-test, u-test, alpha adjustment, effect size), we detected positive
      changes in the following personality variables: the patient's self-confidence (p
      < 0.001, ES = 1.11), favourable self concept including the ability to tolerate
      and manage their inner incongruities (p < 0.001, ES = 0.48), an increase of self
      congruent experiences (p < 0.001, ES = 0.45) and a decrease of insufficiency
      feelings (p < 0.001, ES = 0.40). We consider our findings as preliminary and it
      is necessary to prove them by further research.

PMID- 11220163
TI  - [50 years' of the Institute of Sports Medicine at the Charles University Medical
      School on the 650th anniversary of its founding].
AB  - In an agreeable shadow of the great 650th anniversary of Charles University
      foundation (1348-1998), arising of the first Institute of Sports Medicine round
      the world on Medical Faculty in Prague (1948-1998) was commemorated by scientific
      session. Since J. E. Purkyne (1850) have gone idea of favourable effect of body
      training for human health by representatives of Prague Medical Faculty, till
      Doctor J. Kral, who started lectures for medical students in this discipline in
      1933. Rise of Institute of Sports Medicine was approved in 1934, but its
      realization thanks to Professor Kral, was performed after 2nd World War in 1948.
      From the beginning, students have lectures within the framework of daily study of
      whole wide of the branche, including practical exercises and closing examine.
      First text book of sports medicine and first book about clinic in sports medicine
      was written (J. Kral). Members of Institute lectured on many foreign universities
      and scientific congresses and published more than 2,500 scientific works, some of
      them have world priority. For example first wireless transmission of heart
      frequency (V. Seliger, V. Kruta), cardiologic observations during big sports load
      (J. Kral, Z. Hornof), discoveries at biochemical laboratory (J. Kral, A.
      Zenisek), at medical functional anthropologic laboratory (V. Novotny),
      introducing of remedial exercises in clinical practice (L. Schmid, M. Zintlova,
      J. Chrastek) etc. In the set out choice of literary citation it is put on only
      fragment of publications which document scientific activity of jubileeing
      Institute. For period of duration of Institute more than hundred thousand
      patients were examined--both sportives and non-sportives, young and old.
      Contemporary trend goes from classic care about sportsmen towards preventive
      medicine. Attention is focused first of all to testing of middle aged and older
      patients in sense of prevention of cardiovascular and metabolic diseases and
      indication for specific movement load. In 650 years history of pedagogic and
      scientific success of Charles University, 50-year activity of Institute of Sports
      Medicine means only tiny part. In view of healthy risks, which brings modern life
      style and in view of worsening of environment, an important task stand before the
      discipline with new prevention conception.

PMID- 11220162
TI  - [Aenigma sensorii or the mystery of human consciousness].

PMID- 11220164
TI  - [Thoughts on the infrastructure of modern pathologic physiology].
AB  - Contemporary pathophysiology is essentially based upon three principal pillars of
      support: First the experimental method (formulated by Cl. Bernard); second
      experimental design (proposed by R. A. Fisher); and finally, present-day
      information resources, which are easily accessible in sophisticated databases,
      following the so-called information explosion. These three underlying principles,
      sensitively interrelated, should be employed appropriately when engaging in
      pathophysiological research or education. Three points of support invariably
      offer stable equilibrium, as does a tripod, and it would be an error a priori to
      attempt to support research work exclusively on high-tech methodology, or
      overreliance on statistical software, or pseudo-abundance of citations from
      journals enjoying a high impact factor, whilst lacking significant balancing
      support from either of the other two legs of the tripod--or indeed other sources
      altogether. If pathophysiology in Czechoslovakia is to achieve international
      esteem and acknowledgement, then our undergraduate and postgraduate biomedical
      courses must be soundly based on this tripartite infrastructure, as a starting
      point for our intellectual methodology in pathophysiology. (This speech was
      presented at June 20th, 1989 at the opening session of the Tenth Czechoslovak
      Congress of Pathophysiology held in Prague June 20th-23rd 1989. The text still
      valid, ten years after its oral presentation, is now published in this form at
      the occasion of the tenth anniversary of the Congress.

PMID- 11220165
TI  - Studies on agenesis of third molars amongst populations of different origin.
AB  - This study contains information on the occurrence of agenesis of one to four
      third molars among the population and ethnic groups of Europe, North America,
      Africa and Asia (Japan), based on the results of investigations carried out by
      dozens of authors. Recent discoveries have been supplemented with corresponding
      data concerning the skeletal remains of the jaws of individuals living from the
      ice age to the middle ages. The results show unbelievably large diversities as
      regards the frequency of agenesis of third molars in different populations from
      practically zero (Tasmania) to nearly 100% (Mexican Indians). This remarkable
      fact is not, however, the only reason why the problem of third molars remains a
      major concern for anthropologists, anatomists and stomatologists. Indeed,
      agenesis of third molars present only one of the most important anomalies which
      characterizes this tooth. It is necessary to look for the roots of the said
      variability in the remarkably complicated phylogenetic development undergone by
      the third molar from the time of our predecessors to the present day. Most of
      today's authors are of the opinion that although significant involution changes
      have occurred in third molars, that with the advent of hominization the number of
      teeth in individuals has stabilized at eight for every quadrant of dentition. For
      this reason it is not possible to regard agenesis of third molars as the
      manifestation of the phylogenetic reduction in the number of teeth, but as the
      developmental anomaly which is the result of a mutation and selection process
      based on heredity. The results are completed with an analysis of the value of
      agenesis of one to four third molars according to the individual quadrants and
      gender. A knowledge of these indicators is necessary in order to study the
      relationship between agenesis of third molars and hypodontia of the other teeth.

PMID- 11220167
TI  - Drugs in sport: a new approach.

PMID- 11220166
TI  - The effects of apomorphine on attentional processing in Parkinson's disease.
AB  - To ascertain whether variations in central dopaminergic transmission can
      differentially affect motor and cognitive processing, we studied the effects of
      apomorphine (APO) in 9 patients with Parkinson's disease (PD). The UPDRS motor
      scores and auditory event-related potentials (ERPs) obtained in the 'odd-ball'
      (OB) and in the 'covert orientation of attention' (COA) tasks were studied in the
      'off' and in the 'on' state after an injection of APO. Although APO injection
      improved patients' motor status, it induced a significant increase in the
      latencies of the P2 and P3 ERP components in the OB. In the COA task, right-hand
      reaction times (RTs) were markedly shortened in the 'on' state while left hand
      RTs remained unchanged. The contrasting effects of dopaminergic stimulation on
      the motor performance and on some aspects of cognitive processing suggest the
      existence of complex interactions within pre- and postsynaptic brain dopamine
      receptors, and an intervention of segregated basal ganglia-prefrontal cortex
      loops in motor and cognitive behaviour.

PMID- 11220168
TI  - A Muslim woman with infertility.

PMID- 11220169
TI  - A rational approach to managing back pain.

PMID- 11220170
TI  - Key developments in rheumatology.

PMID- 11220171
TI  - The patient with cervical disc prolapse.

PMID- 11220172
TI  - Casebook: acute knee injuries.

PMID- 11220173
TI  - Mouth conditions in the elderly: Part 2.

PMID- 11220174
TI  - Passing the MRCGP: a practical approach to the MCQ.

PMID- 11220175
TI  - Trust me--I'm a patient.

PMID- 11220176
TI  - Consecutive geoelectric measurements reveal the downward movement of an oxidation
      zone.
AB  - An investigation program for monitoring pyrite oxidation on a conveyer bridge
      dump used geoelectric measurement for monitoring the progress of pyrite oxidation
      within the dump. The results of the geoelectric measurement show that low soil-pH
      and high pore water conductivity correlate with low soil resistivity values. The
      soil resistivity values are dominated by high pore water conductivity. The
      influence of changes in water saturation on resistivity was comparably low. An
      increase in pyrite oxidation was observed in areas with high porosity due to low
      dump density. Consecutive geoelectric measurements revealed locally
      differentiated downward movement of an oxidation zone caused by dump
      heterogeneity.

PMID- 11220177
TI  - Chemical investigations of aquifers affected by pyrite oxidation in the
      Bitterfeld lignite district.
AB  - In a large area around the former open-pit lignite mines near Bitterfeld,
      Germany, groundwater taken from wells was analyzed for the major cations, anions,
      and trace elements. Quaternary and Tertiary sediments were collected from
      aquifers exposed on the sides of the pits and from boreholes outside the mines
      and analyzed for major and trace elements, as well as for carbonate, pyritic
      sulfur and total organic carbon. The pH and electrical conductivity of the
      sediments in suspension were measured. Significant differences were determined
      between the Tertiary sediments of the aquifers that were exposed to atmospheric
      oxygen during the lowering of the groundwater table and those outside the cone of
      depression. The greatest differences were found in the pyrite content, the pH
      values, and the electrical conductivity. In order to map the degree to which the
      mining of the lignite has affected the quality of the groundwater in the study
      area, the water samples were divided into six classes on the basis of their
      sulfate content. The neutralization potential was calculated to estimate the
      potential for acidification. Prediction of future groundwater quality is based on
      both (i) the present composition of the groundwater, surface water, and
      Quaternary and Tertiary aquifer sediments and (ii) the present and future
      groundwater flow directions. These studies have shown which parameters are
      important for future groundwater monitoring.

PMID- 11220178
TI  - Large-scale experiments for microbiological evaluation of measures for
      safeguarding sulfidic mine waste.
AB  - In the framework of a German-Romanian scientific cooperation, experiments were
      performed to evaluate feasible and cheap techniques for the safe storage of mine
      waste to prevent acid rock drainage (ARD). A large four-chamber percolator (4CP)
      was installed in a waste heap at Ilba Mine, Romania, to test the effect of
      biocides and alkaline layers on the bacteria causing acid rock drainage (ARD).
      The 4CP consisted of four chambers each containing 65 m3 of sulfidic waste
      material. The 4CP enabled the transfer of laboratory results to a technical
      scale. The detergent sodiumdodecylsulfate (SDS) was proved to be active against
      the leaching bacteria. Organotrophic micro-organisms were not effected by the SDS
      application. The alkaline layers caused an increase of pH, however, a decrease of
      cell numbers was measured only in adjacent ore layers, but not in the whole ore
      body. A rapid evaluation of the effects of these countermeasures on ARD formation
      became possible by microcalorimetric activity measurements for bioleaching.

PMID- 11220179
TI  - Soil properties and water regime of reclaimed surface dumps in the North Bohemian
      brown-coal region--a field study.
AB  - This paper attempts to characterise the water regime of reclaimed surface dumps
      in connection with their soil physical properties. The results of a research
      project based on field measurements of moisture content and hydraulic
      conductivity, supported by analyses of undisturbed soil samples, led to
      recommendations regarding technological procedures for such dumps. A dielectric
      soil moisture meter, in an improved version, was successfully used for field
      monitoring and further evaluation of moisture content. Hydraulic conductivity was
      also measured in the field (by repeated borehole infiltration) using the Guelph
      permeameter method. Laplace-Gardner analysis was used for evaluating the field
      saturated hydraulic conductivity results.

PMID- 11220180
TI  - Stabilisation of bank slopes that are prone to liquefaction in ecologically
      sensitive areas.
AB  - A consequence of lignite stripping in the Lusatia mining district (East Germany)
      is the backfilling of dumps that mainly consist of low-compacted fine and medium
      grained sands. When the ground-water table, which had been lowered while
      stripping the coal, is rising again, these dumps might be affected by a
      settlement flow due to the liquefaction of soils. Common methods for
      stabilisation as, for instance, blasting or vibrator-jetting deep compaction, are
      not very useful in ecologically sensitive areas, where dumps have been afforested
      and embankment areas of residual lakes have developed into highly valuable
      biotopes. A new so-called air-impulse method in combination with directional
      horizontal drilling has been developed, which does not have a considerably
      negative impact on the vegetation during compaction. The experience gained during
      the first employment of this method at the lake "Katja", a residual lake of
      lignite stripping, is presented in this paper.

PMID- 11220181
TI  - Deep soil compaction as a method of ground improvement and to stabilization of
      wastes and slopes with danger of liquefaction, determining the modulus of
      deformation and shear strength parameters of loose rock.
AB  - For the stabilization of dumps with the construction of hidden dams and for
      building ground improvement, for instance for traffic lines over dumps, nearly
      all applied compaction methods have the aim to reduce the pore volume in the
      loose rock. With these methods, a homogenization of the compacted loose rock will
      be obtained too. The compaction methods of weight compaction by falling weight,
      compaction by vibration and compaction by blasting have been introduced, and
      their applications and efficiencies have been shown. For the estimation of the
      effective depth of the compaction and for a safe planning of the bearing layer,
      respectively, the necessary material parameters have to be determined for each
      deep compaction method. Proposals for the determination of these parameters have
      been made within this paper. In connection with the stabilization of flow-slide
      prone dump slopes, as well as for the improvement of dump areas for the use as
      building ground, it is necessary to assess the deformation behavior and the
      bearing capacity. To assess the resulting building ground improvement,
      deformation indexes (assessment of the flow-prone layer) and strength indexes
      (assessment of the bearing capacity) have to be determined with soil mechanical
      tests. Forster and Lersow, [Patentschrift DE 197 17 988. Verfahren, auf der
      Grundlage last- und/oder weggesteuerter Plattendruckversuche auf der
      Bohrlochsohle, zur Ermittlung des Spannungs-Verformungs-Verhaltens und/oder von
      Deformationsmoduln und/oder von Festigkeitseigenschaften in verschiedenen Tiefen
      insbesondere von Lockergesteinen und von Deponiekorpern in situ; Forster W,
      Lersow M. Plattendruckversuch auf der Bohrlochsohle, Ermittlung des Spannungs
      Verformungs-Verhaltens von Lockergestein und Deponiematerial Braunkohle--Surface
      Mining, 1998;50(4): 369-77; Lersow M. Verfahren zur Ermittlung von
      Scherfestigkeitsparametern von Lockergestein und Deponiematerial aus
      Plattendruckversuchen auf der Bohrlochsohle. Braunkohle--Surface Mining,
      1995;51(1):39-47] improved a direct procedure, the so-called plate-loading test.
      With this improved procedure, it is possible to produce profiles of deformation
      parameters and shear-strength parameters of the loose rock. On this basis the
      settlement behavior and the bearing behavior of the ground can be described. The
      PDV-BS cone-penetration test and the pressiometer test are compared and the
      reliability of the soil mechanical indexes are assessed critically. The PDV-BS
      can be used as a calibration test for cone penetration tests as well as for the
      calibration of pressiometer tests. With the application of a PDV-BS and a
      pressiometer test in combination in a testing field, the anisotropy properties of
      the loose rock can be proved.

PMID- 11220182
TI  - Cover design for radioactive and AMD-producing mine waste in the Ronneburg area,
      eastern Thuringia.
AB  - At the former uranium mining site of Ronneburg, large scale underground and open
      pit mining for nearly 40 years resulted in a production of about 113,000 tonnes
      of uranium and about 200 million cubic metres of mine waste. In their present
      state, these materials cause risks to human health and strong environmental
      impacts and therefore demand remedial action. The remediation options available
      are relocation of mine spoil into the open pit and on site remediation by
      landscaping/contouring, placement of a cover and revegetation. A suitable
      vegetated cover system combined with a surface water drainage system provides
      long-term stability against erosion and reduces acid generation thereby meeting
      the main remediation objectives which are long-term reduction of radiological
      exposure and contaminant emissions and recultivation. The design of the cover
      system includes the evaluation of geotechnical, radiological, hydrological,
      geochemical and ecological criteria and models. The optimized overall model for
      the cover system has to comply with general conditions as, e.g. economic
      efficiency, public acceptance and sustainability. Most critical elements for the
      long-term performance of the cover system designed for the Beerwalde dump are the
      barrier system and its long-term integrity and a largely self-sustainable
      vegetation.

PMID- 11220184
TI  - Biogeochemical and ecological considerations in designing wetland treatment
      systems in post-mining landscapes.
AB  - Although wetlands have gained acceptance as important components of ecosystems in
      post-mining landscapes in the past decade, their roles in contaminant
      retention/removal have not been well integrated into the designing of restoration
      programs. This paper describes the integration of sediment microbial activities
      and natural precipitation processes, along with approaches to defining the
      contaminant load from the mine wastes. The contaminant removal rates, which can
      be expected by a wetland sediment, are summarized and how they need to be
      reflected in the wetland size required, and the carbon supply which is needed.
      Contaminant loading from mining wastes can be balanced by wetland ecological
      processes, including wetland primary production and microbial mineralization in
      the sediment. This ecological engineering approach is demonstrated using case
      studies on hard-rock mining waste in Canada.

PMID- 11220183
TI  - Relocation of net-acid-generating waste to improve post-mining water chemistry.
AB  - Acidic drainage and metal leaching are long-term environmental liabilities that
      can persist for many decades to millennia. One technique to improve the water
      chemistry and ecology of post-mining landscapes is to relocate and submerge net
      acid-generating mine materials in a lake or water-retaining impoundment. One
      example of a carefully executed relocation of waste rock took place at the Eskay
      Creek Mine in Canada. Pre-relocation studies included an empirical relationship
      that related (1) the amount of acidity retained by the waste rock during past
      oxidation to (2) the amount of lime needed in each truckload for neutralization
      of the acidity and for suppression of metal release. During relocation, thousands
      of rinse pH measurements indicated net acidity varied significantly over short
      distances within the waste rock and that acidic rock could not be reliably
      segregated from near-netural rock. After relocation, water from the watershed
      continued to be acidic for a few years, then returned to near-neutral pH and near
      background concentrations of metals. The chemistry of the lake where the waste
      rock was submerged remains near background conditions. Therefore, with careful
      planning and implementation, the relocation and submergence of net-acid
      generating materials can greatly improve post-mining water chemistry.

PMID- 11220186
TI  - Injury prevention rounds out public health review.

PMID- 11220185
TI  - Treatment of acid lignite mine flooding water by means of microbial sulfate
      reduction.
AB  - During and after mining activities acidic waters containing high amounts of heavy
      metals and sulfate often occur. In addition to precipitation processes, water
      purification is also possible with the help of sulfate-reducing bacteria (SRB). A
      mixed culture of SRB was adapted to methanol as a cheap carbon source. In order
      to receive high sulfate-reduction rates immobilization on porous materials proved
      to be advantageous. Continuous laboratory experiments based on immobilized SRB
      were carried out with original water from a lignite mining site reaching sulfate
      reducing rates up to 132 mg SO4(2-)/(1 h). Based on these results a process for
      the treatment of such waters was designed. Heavy metals are removed by recycling
      sulfide containing effluent, excess sulfide can be oxidized to elemental sulfur
      by addition of hydrogen peroxide. The plant with a 3.9 m3 bioreactor with
      immobilized SRB was constructed at the mine site. This pilot plant was operated
      successfully for some months. The removal of heavy metals was close to 100%, the
      pH of the acidic water increased from 3.0 to 6.9. The sulfate-reducing rate again
      reached 134 mg SO4(2-)/(1 h). The production of sulfur from the excess sulfide is
      possible.

PMID- 11220188
TI  - The injury epidemic: where do we stand?

PMID- 11220187
TI  - A current evaluation of injury programs in Wisconsin.

PMID- 11220189
TI  - Community-based injury prevention programs: toward a safer Wisconsin.
AB  - Community-based injury prevention programs are an important approach to the
      reduction of the burden of injury in all age groups. These programs may focus on
      education and behavioral change, increasing access to safer products, creating a
      safer environment, and passing and enforcing legislation. This article reviews
      some of the community-based injury prevention programs in Wisconsin that focus on
      the prevention of home- and transportation-related injuries. Community
      participation in the design and implementation of these programs will increase
      the likelihood of adopting safer behaviors on a community level. We are hopeful
      that physicians and other health care providers will be actively involved in
      community-based injury prevention activities in their locale.

PMID- 11220190
TI  - Trends in motor vehicle deaths in Wisconsin, 1986-1996: a decade of progress?
AB  - Motor vehicle-related injuries are a major cause of death and economic burden in
      Wisconsin. We examined motor vehicle-related mortality trends in Wisconsin from
      1986 to 1996. During this time, overall mortality decreased by 12% and Wisconsin
      has met its year 2000 goal. However, mortality rates did not improve for women
      and non-whites. In addition, mortality rates increased in persons over 75 years.
      There are several explanations that may account for the overall mortality rate
      decline, but the reasons for the differences between age, racial, and gender
      groups are unclear.

PMID- 11220191
TI  - Graduated driver licensing in Wisconsin: a new law for teens and parents.
AB  - The final components of Wisconsin's graduated driver licensing (GDL) statute
      [Biennial state budget act 1999 Wisconsin Act 9] went into effect on September 1,
      2000. The GDL system seeks to reduce the number of teen motor vehicle collisions
      and fatalities by gradually introducing young drivers to all driving situations,
      beginning with the easiest and progressing to the more difficult. The stages of
      licensing are defined by the degree of risk involved. When teen drivers
      demonstrate the ability to drive safely in a restricted setting with high levels
      of supervision, they "graduate" to the next licensing level with fewer
      restrictions. Numerous factors are associated with the high rate of teen motor
      vehicle crashes and fatalities. Such factors include driver inexperience and easy
      distractibility, alcohol use and lack of seat belt use. The GDL addresses all of
      these risk factors. This article reviews the injury prevention strategies
      incorporated in the GDL and outlines the basic components of Wisconsin's law.

PMID- 11220192
TI  - Fatal injuries in adolescents.
AB  - Injuries are a major cause of morbidity and mortality among adolescents.
      Adolescents routinely experiment with high-risk behaviors, increasing their risk
      of injury. Major modes of injury in adolescents include motor vehicle collisions,
      drowning, suicide and homicide. This article reviews the risk factors for fatal
      injuries in adolescents and discusses current prevention strategies. Previous
      research identifies many risk factors associated with adolescent injuries.
      Practitioners can help prevent teen injuries by screening all adolescent patients
      and identifying those at high risk of injury. Patients at high risk need
      preventive counseling and evaluation for possible referral to other services.
      Current strategies are useful in preventing many injuries; however, further
      research is needed to evaluate these strategies and to design new prevention
      programs.

PMID- 11220193
TI  - Preventing animal bites in children.
AB  - Domesticated animals have become an increasingly important part of our human
      experience. Children today are likely to experience daily interactions with
      animals within their neighborhoods and homes. These animals can provide children
      with companionship, the opportunity to learn responsibility and respect for life.
      Yet they can also present children with the potential for injury under certain
      conditions. Almost half of all children will suffer an animal bite at some time
      during their childhood, and over 15% of these bites will require medical care.
      This article will discuss the circumstances leading to most domesticated animal
      bites, provide advice to the practitioner in helping families choose kid-friendly
      pets and provide guidance in promoting safe interactions with animals. A future
      article will review the management of animal bites, including wound care,
      antimicrobial prophylaxis and the treatment of infected bite wounds. Doctor
      Corden's article in this issue (p. 43) addresses the role for rabies prevention
      in animal bites.

PMID- 11220194
TI  - Too many treatments for Parkinson's disease: yet another look.

PMID- 11220195
TI  - Prevention of choking, strangulation, and suffocation in childhood.
AB  - Choking, suffocation and strangulation are important causes of unintentional
      injury and death in young children. Choking on food and toys, suffocation from
      plastic bags and strangulation from strings on children's items are common causes
      of mechanical airway obstruction. An effective prevention plan must include
      education, product labeling, and product and container modification. Health care
      providers can play an important role in the dissemination of prevention
      information to caregivers and manufacturers in order to reduce the incidence of
      these injuries in young children. In the United States, mechanical airway
      obstruction from choking, suffocation and strangulation is the leading cause of
      unintentional injury that results in death of children less than 1 year. It ranks
      fourth as a cause of death in children 1 to 9 years, surpassed only by motor
      vehicle injuries, drowning/submersion, and fire/burns. Many of these deaths are
      preventable. Prevention of death from mechanical airway obstruction has long been
      a concern of health care providers, whose role may involve education of parents,
      other caregivers and manufacturers about the risks and the prevention of choking,
      suffocation and strangulation in children. Choking is the interruption of
      respiration by internal obstruction of the airway, usually by food or small toys
      in young children. Suffocation is obstruction of the airway from an external
      object that blocks the nose and mouth, such as a plastic bag. Strangulation also
      results from external compression of the airway from an object, such as a string
      that becomes caught around the neck.

PMID- 11220196
TI  - Rabies prevention.
AB  - Rabies is an almost uniformly fatal encephalomyelitis with no treatment option
      other than supportive care for those who contract the illness. Mortality
      worldwide is estimated to be 40,000-70,000 people annually. Fortunately, public
      health measures begun in the 1940s and 1950s regarding vaccination and control of
      domestic animals in this country and the availability of safe and effective
      rabies postexposure prophylaxis treatment (RPEP) for humans has made rabies a
      rare disease in the United States. Community healthcare providers continue to
      play a pivotal role in the prevention of this devastating disease. This article
      emphasizes the challenges that the evolving epidemiology of rabies presents to
      our healthcare system, especially regarding international travel, the importance
      of domestic animal vaccination against rabies, the use and cost of RPEP, recent
      rabies epizootics in wildlife populations and the role of bats in disease
      transmission.

PMID- 11220197
TI  - Farm injuries in children: a review.
AB  - Farming is one of the most dangerous occupations in the United States.
      Unfortunately, risk of injury and death extends not only to adults, but to
      children that live, play, and work on the farm. This article reviews the
      epidemiology, pathogenesis and prevention of farm injury in children and
      adolescents. In Wisconsin 39 children were killed in the agricultural setting
      between 1995 and 1999. Nationwide, over 100 children per year are killed and
      27,000 injured on farms. The age distribution of injury in children is bimodal,
      with one peak at 3-4 years of age and a second peak at 13-16 years. Boys are much
      more likely to be injured on the farm than girls. Of the agents associated with
      the injury of children, tractors are most commonly implicated and are the most
      deadly. Drownings, injury by cows and horses, and other farm implements and
      machinery make up the remainder of most farm accidents. The head and face are the
      sites involved in preschoolers whereas the limbs are more likely to be injured in
      older children. Poor supervision, unreasonable expectations, financial
      difficulties and lack of safety devices are associated with risk of injury.
      Prevention or injury involves patient and family education, regulation and safety
      devices. Important resources are available for farm families and health care
      providers to prevent farm accidents in children.

PMID- 11220198
TI  - Injury data changes the debate over firearms.

PMID- 11220199
TI  - New guidelines published for managing community-acquired pneumonia.

PMID- 11220200
TI  - Strong SMS/DPH partnership needed.

PMID- 11220201
TI  - I was saved by a seat belt... would my 5 year old have been so lucky?

PMID- 11220202
TI  - [Relationship among VIP plasma levels, esophageal dysfunction, and
      microcirculation in systemic sclerosis].
AB  - BACKGROUND: Recent studies suggest that esophageal dysmotility occurring in
      systemic sclerosis might be caused by neurotransmitter levels decrease. The aim
      of the present study is to value VIP plasma levels, and to relate them with the
      pressure of the inferior esophageal sphincter (IES) and the capillaroscopy score
      in a group of patients affected by Systemic Sclerosis (SSc). METHODS: Eleven
      subjects affected by SSc (eight male and three female, age from 30 to 72 years
      old) have been studied through esophageal manometry, capillaroscopy and VIP
      plasma levels evaluation. Fifteen healthy volunteers, as control group, have been
      enlisted. RESULTS: Our results show a decrease of VIP plasma levels in patients
      with SSc compared with control group. The difference between two groups has
      statistical significance (p < 0.01). Capillaroscopy has shown remarkable
      microcirculatory impairment and the esophageal manometry proved a decreased IES
      pressure. The scores of capillaroscopy, VIP plasma levels and pressures of IES
      have been compared and it has been observed that there is a relationship between
      VIP plasma level and pressure of IES. CONCLUSIONS: VIP plasma levels decrease
      enhances the role of the autonomic disorder in SSc and may contribute to produce
      the alteration of vascular tone as well as the gastroenteric musculature
      dysfunction.

PMID- 11220203
TI  - [Psoriasis complicated with severe mutilating psoriatic osteoarthropathy.
      Clinical case and review of the literature].
AB  - Aim of this paper is to discuss, on the basis of an extensive critical review of
      the recent literature, the case of a 56-yr-old male patient who suffered from
      cutaneous psoriasis and psoriatic arthritis mutilans (PA) (polyarticular,
      symmetric, destruent and erosive) with involvement of the hands, feet and spine,
      associated with android obesity and mild type 2 diabetes mellitus. HLA typing of
      the patient showed the HLA-A3-Ax, B14-B63 and Cw4-Cw6 haplotypes, some of which
      are associated or correlated with susceptibility to PA. Cutaneous psoriasis is a
      chronic inflammatory dermatitis, with onset at any age and affecting
      approximately 2% of the western populations. In 5-7% of patients, it is
      associated with articular manifestations or true arthritis. PA is a chronic,
      inflammatory, seronegative arthropathy which may develop in some psoriasis
      patients, may involve peripheral and axial (spondarthritis) joints and may lead
      to severe joint destruction. Genetic, immunologic and environmental (i.e.,
      infectious agents or trauma) factors seem to play an important role in the onset
      and clinical appearance of PA. Although PA is a clinically monomorphic disease,
      it may show different heterogenous subgroups with differences in their
      etiopathogenesis. When PA is suspected, it is mandatory to analyze carefully the
      patient's familiar history, search attentively for the specific skin features,
      exclude a septic arthritis (especially if the involvement is monoarticular) and,
      in the cases of fulminant disease, consider always the possible coexistence of an
      acquired immunodeficiency syndrome. PA can occasionally be an aggressive,
      disfigurating and disabling disease and the treatment (incisive and precocious)
      should be similar to that for rheumatoid arthritis. At present, a definitive
      therapy does not yet exist, but the majority of PA patients can lead a fairly
      normal life and they do not show increased mortality rates (excluding the severe
      cases of erythrodermic or pustulosis psoriasis). However, as a result of the
      various problems of occupation and morbidity it causes, PA is a disease with
      great social involvement.

PMID- 11220204
TI  - Abnormal vaginal flora, cervical length and preterm birth.

PMID- 11220205
TI  - High immunocontent of S100 beta protein in amniotic fluid of pregnancies with
      Down syndrome.

PMID- 11220206
TI  - Ambiguity of 'ambiguity'.

PMID- 11220207
TI  - Change blindness in the absence of a visual disruption.
AB  - Findings from studies of visual memory and change detection have revealed a
      surprising inability to detect large changes to scenes from one view to the next
      ('change blindness'). When some form of disruption is introduced between an
      original and modified display, observers often fail to notice the change. This
      disruption can take many forms (e.g. an eye movement, a flashed blank screen, a
      blink, a cut in a motion picture, etc) with similar results. In all cases, the
      changes are sufficiently large that, were they to occur instantaneously, they
      would consistently be detected. Prior research on change blindness was predicated
      on the assumption that, in the absence of a visual disruption, the signal caused
      by the change would draw attention, leading to detection. In two experiments, we
      demonstrate that change blindness can occur even in the absence of a visual
      disruption. In one experiment, subjects actually detected more changes with a
      disruption than without one. When changes are sufficiently gradual, the visible
      change signal does not seem to draw attention, and large changes can go
      undetected. The findings are discussed in the context of metacognitive beliefs
      about change detection and the strategic decisions those beliefs entail.

PMID- 11220208
TI  - Hearing by eye: how much spatial degradation can be tolerated?
AB  - In the McGurk effect (McGurk and MacDonald, 1976 Nature 264 746-748), illusory
      auditory perception is produced if the visual information from lip movements is
      discrepant from the auditory information from the voice. A study is reported of
      the tolerance of the effect to varying levels of spatial degradation (videotaped
      images of a speaker's face were quantised by a mosaic transform). The illusory
      effect systematically decreased with an increase in the coarseness of the spatial
      quantisation. However, even with the coarsest level (11.2 pixels/face) the
      illusion did not completely disappear. In addition, those participants who did
      not experience the illusion nevertheless showed the effects of auditory-visual
      interaction in their clarity ratings of the auditory stimulus. It is concluded
      that auditory-visual interaction in visible speech perception is based on
      relatively coarse-spatial-scale information.

PMID- 11220209
TI  - Color appearance of surfaces viewed through fog.
AB  - How do the colors of surfaces seen through fog depend on the chromatic properties
      of the fog? Prior work (e.g. Chen and D'Zmura, 1998 Perception 27 595-608) shows
      that the colors of surfaces seen through a transparent filter can be described by
      a convergence model. The convergence model takes into account color shift and
      change in contrast. Whether the convergence model can also be applied to fog was
      tested experimentally with an asymmetric matching task. In computer graphic
      simulation, observers adjusted the color of a surface seen through fog in order
      to match the color of a surface seen in the absence of fog. The convergence model
      fits the data well. The results suggest that the color constancy revealed in this
      task with fog is described best by a model that takes into account both shift in
      color and change in contrast.

PMID- 11220210
TI  - The spatial spread of attentional modulation of the motion aftereffect.
AB  - The spatial spread of attentional modulation of selective adaptation was
      investigated in four experiments in which the duration of the movement
      aftereffect (MAE) was measured with and without processing of intermittently
      changing digits at the fixation point. In the first experiment, the effects of
      diverting attention on MAE duration were found to reduce as the distance between
      the fixation digits and the inner edge of the surrounding adapt/test grating was
      increased. A second experiment suggested that eye movements were unlikely to
      underlie the attentional effects. In experiment 3, the attentional effect stayed
      constant as the outer diameter of the adapt/test gratings was increased. In
      experiment 4 (as in experiment 1) the modulatory effects of attention were larger
      the closer the adapt/test gratings were to the locus of attention, when the area
      of the grating was held constant but its eccentricity varied. In experiments 1
      and 4, an intermittently changing fixation digit was found to reduce MAE
      durations more than an unchanging digit, even when subjects were not required to
      process it, suggesting that exogenous as well as endogenous attentional processes
      modulate early motion processing.

PMID- 11220211
TI  - Speed perception is affected by the Ebbinghaus-Titchener illusion.
AB  - We examined whether the apparent extent of motion affects speed perception. On
      the first presentation of each trial, a light dot travelled horizontally across a
      central circle of one of the Ebbinghaus configurations (with either small or
      large inducing elements). On the second presentation, observers adjusted the
      speed of a dot moving within the central circle alone so as to match the speed
      perceived in the first presentation. For all stimulus speeds (1.3, 2.1, and 5.5
      deg s-1), the matched speed with small inducing circles was systematically less
      than that with large inducing circles. The findings indicate that the perceived
      speed depends on the apparent extent of motion: the larger the apparent size of a
      frame, the slower the apparent speed. These results are consistent with the
      predictions of transposition effects in visual motion.

PMID- 11220212
TI  - Variations on the Hermann grid: an extinction illusion.
AB  - When the white disks in a scintillating grid are reduced in size, and outlined in
      black, they tend to disappear. One sees only a few of them at a time, in clusters
      which move erratically on the page. Where they are not seen, the grey alleys seem
      to be continuous, generating grey crossings that are not actually present. Some
      black sparkling can be seen at those crossings where no disk is seen. The
      illusion also works in reverse contrast.

PMID- 11220213
TI  - Curvature biases in stereoscopic vision: a nasotemporal asymmetry.
AB  - The reliability of curvature judgments for linear elements was studied, with
      stereograms that contained a binocular arc with curvature in depth, and either a
      binocular frontoparallel arc or a monocular one, on a background representing a
      hemiellipsoid. The subjects made about 15% errors on binocular arcs with
      curvature in depth, and 60%-80% of these occurred when both the hemiellipsoid and
      the arc were convex, the arc being perceived as concave, by transparency through
      the hemiellipsoid. There were also about 15%-30% errors on frontoparallel arcs,
      but spread among all situations, with a small prevalence of concave judgments.
      Curvature in depth was assigned to the monocular stimuli in more than 60% of the
      cases. There was a curvature bias when the monocular arcs were on the nasal side,
      and were viewed against a concave background. Assuming parallel viewing, nasal
      ingoing arcs were usually perceived as concave, and nasal outgoing arcs usually
      perceived as convex, in agreement with geometrical likelihood. Nasal-side
      elements captured by one eye are, in general, those with the highest likelihood
      of having matching elements in the other eye. Then the observed nasal bias effect
      suggests that the matching process in stereopsis could be driven from the nasal
      sides of the projections in the two cerebral hemispheres.

PMID- 11220214
TI  - From image segmentation to anti-textons.
AB  - We apply the 'patchwork engine' (PE; van Tonder and Ejima, 2000 Neural Networks
      forthcoming) to encode spaces between textons in an attempt to find a suitable
      feature representation of anti-textons [Williams and Julesz, 1991, in Neural
      Networks for Perception volume 1: Human and Machine Perception Ed. H Wechsler
      (San Diego, CA: Academic Press); 1992, Proceedings of the National Academy of
      Sciences of the USA 89 6531-6534]. With computed anti-textons it is possible to
      show that tessellation and distribution of anti-textons can differ from that of
      textons depending on the ratio of texton size to anti-texton size. From this we
      hypothesise that variability of anti-textons can enhance texture segregation, and
      test our hypothesis in two psychophysical experiments. Texture segregation
      asymmetry is the topic of the first test. We found that targets on backgrounds
      with regular anti-textons segregate more strongly than on backgrounds with highly
      variable anti-textons. This neatly complements other explanations for texture
      segregation asymmetry (e.g. Rubenstein and Sagi, 1990 Journal of the Optical
      Society of America A 7 1632-1643). Second the relative significance of textons
      and anti-textons in human texture segregation is investigated for a limited set
      of texture patterns. Subjects consistently judged a combination of texton and
      anti-texton gradients as more conspicuous than texton-only gradients, and judged
      texton-only gradients as being more conspicuous than anti-texton-only gradients.
      In the absence of strong texton gradients the regularity versus irregularity of
      anti-textons agrees with perceived texture segregation. Using PE outputs as anti
      texton features thus enabled the conception of various useful tests on texture
      segregation. The PE is originally intended as a general image segmentation method
      based on symmetry axes. With this paper we therefore hope to relate anti-textons
      with visual processing in a wider sense.

PMID- 11220215
TI  - A neuro-cognitive visual system for object recognition based on testing of
      interactive attentional top-down hypotheses.
AB  - We propose an extension of a systemic model for object recognition formulated by
      Rybak et al (1998 Vision Research 38 2387-2400) which is based on the functional
      organisation of the visual systems in primate brains. In contrast to the learning
      and recognition scheme of Rybak et al we do not assume a behavioural paradigm,
      i.e. a visuomotor programmed scanpath that determines the sequence of foveation
      on the different parts of the object. As in the basis architecture of Rybak et
      al, the system modules are separated into 'what'-like subsystems corresponding to
      the ventral occipito-inferotemporal visual path and 'where'-like complexes
      analogous to the dorsal occipito-parietal visual path. The 'what' system analyses
      local features in the actual foveation as in Rybak et al. But, in our case, the
      'where' memory, instead of programming a behavioural scanpath, scores the spatial
      relationship between successive fixation and the spatial relationship between the
      associated main edges. The recognition is based on the identification of parts
      and their spatial relationship. This gives the learning and recognition
      mechanisms more flexibility in the sense that, for recognising an object, several
      different fixation sequences may be accepted.

PMID- 11220216
TI  - The Leaning Tower of Pisa effect: an illusion mediated by colour, brightness, and
      motion.
AB  - We report a novel, easily observed, and extraordinarily striking optical illusion
      mediated by interactions of colour, brightness, form, and motion perception--the
      Leaning Tower of Pisa (LTOP) illusion. Under some circumstances, the perception
      of orientation of coloured forms is radically altered by rotary movement. We
      demonstrate that this kinetic effect--easily reproduced with a common record
      turntable--is optimised by particular colour and brightness differences between
      foreground and background with an illusory tilt of 8 degrees and more. The
      described illusions can be easily studied at home by downloading the colour
      figures from www.perceptionweb.com/perc1000/ditzinger, printing them on a common
      colour printer and placing them on a rotating record turntable.

PMID- 11220217
TI  - Medical Infobahn for Europe. Proceedings of the MIE2000 and GMDS2000 Congress.
      Hannover, Germany, 2000.

PMID- 11220218
TI  - Routine periodic acid-Schiff staining of nail plate fragments in fungal cultures
      for onychomycosis: a method to increase the sensitivity of diagnosis.
AB  - We propose the routine staining of nail plate fragments with periodic acid-Schiff
      stain to increase diagnostic accuracy in diagnosing onychomycosis. The advantages
      of this method, including increasing diagnostic yield after contaminant growth,
      confirmation of negative culture, and low cost, are reviewed.

PMID- 11220219
TI  - [Reptiles from Cerro Colorado and its surroundings, Cumana, Sucre State,
      Venezuela].
AB  - An inventory of the reptiles that inhabit in Cerro Colorado and its surroundings,
      was performed from March, 1994 to March, 1995. There were reported 8 species of
      snakes and 7 of lizards enclosed in 4 and 5 families repectively. Aspects
      observed were ecolology as habitat, activity, reproduction and relative
      abundance. The more abundant species of lizards were: Cnemidophorus femniscatus,
      Ameiva bifrontata, (Teiidae), Tropidurus hispidus (Tropiduridae), Gonatodes
      vittatus and Hemidactylus mabouia (Gekkonidae) and the ophidians: Leptodeira
      annulata and Mastigodryas amarali (Colubridae). It is believed that the changes
      occurred in the zone influenced the increase of the relative abundance of the
      species Leptotyphlops goudotii (Leptotyphlopidae) arid Gymnophthalmus
      speciosus(Gymnophthalmidae) and perhaps in the disappearance of others that have
      been reported at the xerophitic or semixerophitic zones of the Sucre State of
      Venezuela.

PMID- 11220220
TI  - [Directed trees and its application to social sciences].
AB  - Directed trees are special graphs usually employed as illustrative device of
      numerical methods applied in evolutionary biology. The present note explores its
      possible application in social sciences. Its utility as classificatory method in
      a classical anthropological study of cultural exchanges is exemplified.

PMID- 11220221
TI  - [Leaf anatomy study in Solanaceae of Venezuela. V. leaf anatomy of eleven species
      of Cestrum L] .
AB  - Leaf anatomy of the following eleven species: C. buxifolium Kunth, C. humboldtii
      Francey, C. lindenii Dunal, C. mariquitense Kunth, C. megalophyllum Dunal, C.
      olivaceum Francey, C. pariense Steyerm., C petiolare Kunth, C. scandans Vahl, C.
      strigilatum Ruiz et Pavon and C. tomentosum L.f. is described. Transverse
      sectioning, bruise and clearing according to the classical methods for optical
      microscopy were made. The species studied show dissimilitude in relation to a)
      fohar blade: thickness and sinuosity of epidermal cell walls; type, density and
      presence of trichornes, leaf type according the position of the stomata,
      thickness of both palisade and spongy parenchy-ma, number of spongy parenchyma
      layers, occurrence or not of paranchymatous sheath and sclerifled cells in
      mesophyll, tmbeculae or projection walls b) Midvein: degree of development and
      arrangement of the parenchyma and collenchyma, c) Petiole: size and form in
      transverse section, presence of ornamented cuticle, peridermis and degree of
      development of the sclerenctiyma next to vascular bundles.

PMID- 11220222
TI  - [Anatomic and morphological studies on the initiation of somatic embryos obtained
      from meristematic apexes of Musa sp.
AB  - The origin of somatic embryos obtained from meristematic apexes of the Musa (AAA)
      clone "Gran enano" was analyzed through histological and morphological studies
      during the various development phases of the process. The research point out that
      somatic embryos developed directly from perivascular parenchyma cells of the
      leaves. Histological sections of globular embryos showed a radial disposition to
      cell and the existence of an epidermal layer that surrounds the embryo
      completely. When citocinine (Z or BA) was added, some embryos remained in
      globular stage with mild signs of enlargement but with no later development of
      invagination. Other's embryos reached the invagination stage; and some reached
      the enlargement stage with active photosynthetic tissues. However there were no
      to generation of complete plant regardless of additional treatment, such as
      "osmotic shock" or the additions of GA3--At present do not have an explanations
      for this results. Therefore, additional experiment should be in early,
      intermediate and later stages of somatic embryogenesis, in order to understand
      the mechanisms underlying the lack of development of plants from somatics
      embryos.

PMID- 11220223
TI  - [Morphology and anatomy of the fruit development of Ocotea puberula (Rich.) Nees
      and Nectandra megapotamica (Spreng.) Mez (Lauraceae)].
AB  - The morphology and anatomy of the fruit development of Ocotee puberula (Rich.)
      Nees and Nectandra megapotamica (Spreng.) Mez (Lauraceae) was studied in flowers
      and fruits collected in secondary forests of Maringa, Parana State, Brazil. The
      fruits of the species are drupes, with epidermic exocarp, parenchymatous mesocarp
      and endocarp which consists of macrosclereids. The origin of endocarp is the
      internal epidermis of ovary. The exalbuminous seeds develop from the anatropous
      ovules and they have testa and tegmen with parenchymatous cells frequently
      compressed. In the hilum region these teguments show sciereids in radial
      arrangement. The straight embryo has thick cotyledons which contain reserve
      substances such as starch and oil. The plumule and hypocotyl-radicle axis are
      reduced.

PMID- 11220224
TI  - [Massive multiplication of coffee (Coffee arabica L. cv. Catimor) through
      embryogenic cell suspension culture].
AB  - Cell suspensions offer several advantages as a system for massive propagation
      because of the high rates of multiplication, the higher homogeneity in the
      culture conditions and the possibility of automatization. In this study,
      different experimental conditions were analyzed to establish embryogenic cell
      suspension cultures of coffee. The best conditions to establish the embryogenic
      cell suspension cultures of coffee were as follows: coffee leaf sections were
      cultivated during 12 weeks (Stage I) in a solid medium with the Murashige and
      Skoog salts, 2 mg/l kinetin and 0.5 mg/l 2,4-dichlorophenoxiacetic acid (medium
      1). Under these conditions the explants formed a callus tissue that was
      transferred to a liquid medium containing 5 mg/l of 6-benzylamlno-purine (medium
      2). After 12 days in a shaking liquid medium (Stage II), the cultures were sieved
      and were maintained In the same media, which was renewed every eight days (Stage
      III). This method yielded 1884 embryos in 50 ml; placing the embryos under
      conditions for germination yielded plantlets of normal appearance.

PMID- 11220225
TI  - [Spatial and temporal variation of the fish community inhabiting the Laguna
      Grande de Obispo, Gulf of Cariaco, Sucre State, Venezuela].
AB  - The monthly species composition and the spatial and temporal variation of fish
      community of Laguna Grande de Obispo, Gulf of Canaco, Sucre State, Venezuela were
      analyzed. The samples were collected using two beach seines of different size
      from December 1995 to November 1996. A cluster analysis for stations inside the
      lagoon and time of capture showed 4 major groups, defined principally with
      ecological parameters of each area. Fishing with large seine in and outside the
      lagoon showed two large groups which were divided into 10 subgroups in function
      of station and time, while an inverse analysis of the same sample differentiated
      into 8 groups of species. based on distribution, dominance, and occurrence.
      Xenomeianiris brasiliensis, Mugil curema and Eucinostomus argenteus were the most
      abundant species in both time and space. An analysis of conglomerate on the whole
      fish community of the sampling period indicated the existence of two groups: i)
      the first half of the year including December 1995 and October 1996 and ii) the
      second half of the year. The distribution of fishes in relation to ecological
      factors is discussed.

PMID- 11220226
TI  - Investigation of an outbreak of endemic coccidioidomycosis in Brazil's
      northeastern state of Piaui with a review of the occurrence and distribution of
      Coccidioides immitis in three other Brazilian states.
AB  - An outbreak of coccidioidomycosis is described that involved three individuals
      and eight of their dogs, who had engaged in a successful hunt for nine-banded
      armadillos (Dasypus novemcinctus) in the environs of Oeiras, a community in
      Brazil's north eastern state of Piaui. Diagnosis was based on clinical,
      serological and cultural findings. Four of 24 soil samples collected in and
      around the burrow of an armadillo yielded cultures of Coccidioides immitis, thus
      establishing the endemicity of that mould in the state of Piaui. A literature
      review revealed that C. immitis, aside from that state, is endemic in three other
      Brazilian states--Bahia, Ceara and Maranhao. These four contiguous states have
      semi-arid regions where climatic conditions and their flora are similar to those
      that exist in C. immitis's endemic regions in North, Central and South America.

PMID- 11220227
TI  - Leprosy research at the new millennium. Proceedings of a workshop. 26-28 June
      2000. Paris, France.

PMID- 11220229
TI  - Absolute income and life expectancy.

PMID- 11220228
TI  - Proceedings of the European Society of Surgery 4th Annual Meeting. Krakow,
      December 3-6, 2000.

PMID- 11220231
TI  - [News from the HAUTARZT to the dermatologist].

PMID- 11220230
TI  - Fractured neck of the femur in the elderly patient.

PMID- 11220232
TI  - [Recommendations for carrying out quality assurance in dermatological histology.
      Recommendations of the Working Group "Quality Assurance in Dermatological
      Histology" of the Committee for Dermatological Histology (ADH) of the DDG].

PMID- 11220233
TI  - [Epiluminescent microscopy aspects of initial cutaneous melanoma metastases].
AB  - BACKGROUND AND OBJECTIVE: Especially small and initial cutaneous melanoma
      metastases (CMMs) are tumours with inconspicuous clinical and sometimes
      histological features which may be difficult to differentiate from other
      melanocytic lesions. The present study was performed to determine whether
      epiluminescence microscopic (ELM) criteria could increase the accuracy in
      preoperative evaluation of CMMs. PATIENTS/METHODS: Thirty photographed and
      histologically verified CMMs were examined retrospectively using ELM in order to
      visualize a multitude of morphological features permitting the recognition of
      malignancy. The colour slides obtained by the photography were subjected to a
      secondary 30-80 fold magnification in order to conduct a visual analysis. The 50
      naevi in the control group were all histologically benign. RESULTS: Five of the
      15 features studied were shown to differ significantly between the two groups.
      Polymorphic angiectatic base pattern and vascular aneurysms, areas of polymorphic
      and horizontally dilated capillaries, peripheral erythema, saccular pattern and a
      light brown halo had a specificity of 90-98% and a sensitivity of 40-46% for CMMs
      (p<0.001). Peripheral grayish patches, lesions surrounded by gray streaks and
      microscopic ovoid blood lakes were absent in the benign group. CONCLUSIONS: The
      prevalence of distinct ELM criteria in CMMs enhances the diagnostic accuracy of
      malignancy in melanocytic skin lesions.

PMID- 11220234
TI  - [Evaluation of a telemedicine pilot project].
AB  - BACKGROUND AND OBJECTIVE: Rapid progress in computer and information technologies
      has led to an increased interest in the use of telemedicine during the past few
      years. Thus it should be clarified, whether teledermatology can achieve
      comparable results to conventional specialist examination and advice.
      PATIENTS/METHODS: We initiated a pilot study, comparing teledermatology with
      conventional examination in a dermatology outpatient setting. 60 patients were
      included. RESULTS: Out of 60 teledermatological examinations, remote clinicians
      were in agreement with face-to-face clinicians in 90%. Teledermatology was unable
      to make a useful diagnosis in 6 patients, however further diagnostic procedures
      were ordered, enabling teledermatologists to achieve correct diagnoses. Regarding
      need for further diagnostic tests, there was no difference between
      teledermatology and conventional examination. CONCLUSIONS: Teledermatology
      appears suitable to transfer a dermatologist's expertise over large distances.

PMID- 11220235
TI  - [Phylloid hypomelanosis and mosaic trisomy 13: a new etiologically defined
      neurocutaneous syndrome].
AB  - The term phylloid hypomelanosis is proposed to denote a new etiologically defined
      neurocutaneous syndrome. The hallmark of this trait is a pattern of
      hypopigmentation consisting of round or oval lesions, large asymmetrical areas
      reminiscent of the leaves of a begonia, as well as pear-shaped areas or oblong
      macules. The term phylloid pattern is derived from Greek phyllon=leaf and
      eidos=form. In 5 out of 6 cases in which cytogenetic findings were reported, a
      mosaic trisomy 13 or translocation trisomy 13 was found. All patients showed CNS
      defects with mental retardation. In addition, absence of corpus callosum,
      conductive hearing loss, choroidal and retinal coloboma,cranio-facial defects as
      well as brachydactyly,clinodactyly, camptodactyly and other skeletal anomalies
      were reported. In contrast to hypomelanosis of Ito which is associated with many
      different forms of genetic mosaicism, phylloid hypomelanosis most likely
      represents a cytogenetically rather uniform neurocutaneous phenotype.

PMID- 11220237
TI  - [Molluscum contagiosum: treatment with pulsed dye laser].
AB  - BACKGROUND AND OBJECTIVE: There is a wide variety of methods for the treatment of
      mollusca contagiosa. Especially with anxious children, most of them are not
      applicable because they are often invasive, painful, time intensive or difficult
      to conduct (e.g. if a stay in hospital is necessary). In order to verify the
      existing case reports, this paper evaluates the application of the pulsed dye
      laser as a possible therapy alternative in cases of mollusca contagiosa.
      PATIENTS/METHODS: In a prospective study 20 patients with mollusca contagiosa
      were treated with the pulsed dye laser. RESULTS: The therapy was well tolerated;
      no scars or pigment anomalies were observed. 95.9% of the lesions healed after
      the first treatment, the other 4.1% after the second. This larger study verifies
      the positive findings indicated in case studies. CONCLUSIONS: For exposed sites,
      difficult cases or if other treatment methods have failed, the pulsed dye laser
      is an effective, quick, bloodless and elegant therapeutic alternative for
      mollusca contagiosa with a low rate of side effects.

PMID- 11220236
TI  - [Treatment of endemic scabies with allethrin, permethrin and ivermectin.
      Evaluation of a treatment strategy].
AB  - BACKGROUND AND OBJECTIVE: Ectoparasitic cutaneous infestations are still common
      problems in countries of Western Europe. Scabies is a highly contagious disease
      of the skin caused by Sarcoptes scabiei variatio hominis. It has a world-wide
      distribution and affects all ages with no specific gender predisposition. Scabies
      is of profound public health interest because certain environment factors such as
      overcrowding, poor hygiene, delayed treatment of primary cases and lack of public
      enlightenment are conducive to its spread. However, prompt and adequate therapy
      is rewarding and prevents further spreading. Scabies acquires additional public
      health significance when large numbers of individuals are affected, as in a
      nursing home. Outbreaks of scabies in such dimensions require a special treatment
      strategy. PATIENTS/METHODS: On request of the town council an eradication concept
      for the treatment of endemic scabies in nursing and retirement homes was
      developed. RESULTS: persons (IP) and identification of the likely index patients
      (IXP)because of their widespread disease should be the first step of an
      eradication program. All IP except for IXP should be treated irrespective of
      clinical signs by a single application of a modern effective external scabicide
      such as allethrin (Spregal) or permethrin cream (permethrin 2,5% until 6th year
      of life or permethrin 5% in a hydrophilic cream) at day 1 (day X). The following
      10-day quarantine and close control of all IP is an inexpensive and safe method
      of eradication. IXP are admitted and treated with oral administration of single
      dose of ivermectin, which can be repeated on day 8 if necessary. In addition
      permethrin cream 5% can be applied in severe cases, combined with nail trimming
      and aggressive cleaning of the subungual debris. Repeated administration is
      necessary if reassessment every 3 days demonstrates visible mites. (Note: none of
      this is mentioned in German.) The staff is instructed to wear gloves during all
      patient contact. CONCLUSIONS: Our strategy for eradication of endemic scabies has
      proven effective. Allethrin can be used following the package inpermethrin is
      more effective and can also be used in children, as well as pregnant and nursing
      women. Ivermectin is particularly useful in treating crusted scabies. It is not
      approved for scabies in Germany so the patients must be accordingly counseled.
      The frequency and the major therapeutic problems in treating endemic scabies make
      it important to work for the approval of permethrin and ivermectin in this
      setting.

PMID- 11220238
TI  - [Multiple mantleomas in Birt-Hogg-Dube syndrome: successful therapy with CO2
      laser].
AB  - Birt-Hogg-Dube-syndrome, first described 20 years ago, is an autosomal dominant
      inherited disease, characterized by the occurrence of multiple cutaneous
      hamartomas with adnexal differentiation. An association with intestinal neoplasms
      has been mentioned repeatedly. Recently, the cutaneous lesions in this syndrome
      have been interpreted as different developmental stages of one single hamartoma
      with sebaceous differentiation, called mantleoma. Numerous dermatohistopathologic
      studies contribute to the certain diagnosis of Birt-Hogg-Dube-syndrome. In
      contrast, little information is available on the therapy of the multiple skin
      lesions. A father and his daughter with Birt-Hogg-Dube-syndrome were treated with
      the CO2 laser, producing satisfactory results.

PMID- 11220239
TI  - [Pyoderma gangrenosum: successful topical therapy with tacrolimus (FK506)].
AB  - Pyoderma gangrenosum is a distinct clinical entity characterized by chronic,
      recurring, destructive ulcerations. Although the pathogenesis of pyoderma
      gangrenosum is unknown, immunologic aberrations of neutrophil granulocytes seem
      to be important. Systemic steroids and macrolide lactones such as cyclosporin A
      and tacrolimus have been reported to be useful in the clinical management of
      disease. Pyoderma gangrenosum has been found to be associated with several
      systemic diseases. The association with chronic ulcerative colitis is well known,
      but the diagnosis may be complicated by early administration of systemic
      steroids. Therefore, local immunosuppression with topically applied agents could
      be an efficient therapeutic alternative especially for mild or early cutaneous
      lesions.We describe the successful topical treatment of a patient with multiple
      lesions of pyoderma gangrenosum with 0,1% tacrolimus (FK506) ointment which is
      known to have better dermal penetration and higher immunosuppressive potency than
      topical cyclosporin A. In addition, other indications for topical tacrolimus are
      discussed.

PMID- 11220240
TI  - [Trichorhinophalangeal syndrome. Case report and biophysical study of hair shaft
      parameters].
AB  - In 1956 Klingmuller first described the trichorhinophalangeal syndrome (TRPS),
      which was named by Giedion ten years later. The syndrome includes a combination
      of typical hair, facial and bone abnormalities with variable expression allowing
      the further distinction of three subtypes. In a 37-year old patient with TRPS
      type I who reportedly had reduced hair growth length, clinically fine and brittle
      hair were found. Scanning electron microscopy revealed widely spaced cuticular
      scales. Quantitative measurement of the biomechanical properties of the hair
      showed a significant increase in the viscous parameter. This could be a result of
      decreased disulfide bridges and increased halogen bonds in the keratin matrix of
      the hair. In dermatological practice patients with TRPS often present because of
      hair abnormalities. Because of premature arthrosis due to skeletal abnormalities,
      occupational counseling is advised.Congenital heart problems, kidney
      abnormalities and endocrinological problems are rare, but should be sought in the
      symptomatic individual. Apart from mild hair care and avoidance of additional
      physical or chemical injuries due to hair cosmetic procedures,there is no
      treatment for the hair defects.

PMID- 11220241
TI  - [Bullous scabies and scabies-triggered bullous pemphigoid].
AB  - Two patients were admitted to our hospital with tense blisters on an erythematous
      base, typical for bullous pemphigoid. In both patients an infestation with
      Sarcoptes scabiei was diagnosed by dermatoscopy as well as histological
      examination. In one patient the clinical diagnosis of bullous pemphigoid could be
      confirmed by immunofluorescence microscopy, histopathology and a clinical relapse
      of bullous pemphigoid without scabies infestation. In the other patient no
      evidence for an autoantibody-mediated autoimmune blistering disease was found. We
      postulate that bullous scabies could develop after long persistency of the
      parasites leading to a specific immune response with activation of T helper type
      2 (Th2) cells causing high levels of the cytokine interleukin 5 and then
      consecutively eosinophilia. Secretion of proteolytic enzymes near the basal
      membrane zone might explain the development of intraepidermal, often suprabasal
      blisters. In contrast, in the first patient the scabies infestation might have
      triggered a flare up of the underlying autoimmune disease. Comparison of our two
      patients demonstrates two entities: bullous pemphigoid triggered by scabies as a
      Koebner phenomenon and a bullous subtype of scabies mimicking bullous pemphigoid.
      Therefore both, scabies infestation triggering bullous pemphigoid and bullous
      pemphigoid-like scabies should be included in the differential diagnosis of
      vesicles, tense blisters and erythema, especially at an early clinical stage.

PMID- 11220242
TI  - [Clinical aspects and therapy of anogenital warts and papillomavirus-associated
      lesions].
AB  - There is a series of different therapies for the treatment of anogenital warts.
      Home therapy should be reserved only for initial therapy of simple cases. Such
      approaches include podophyllotoxin solution, podophyllotoxin cream,imiquimod
      cream and adjuvant interferon gel. Recurrent disease and disseminated disease
      must be treated by the physician. Choice of therapy depends on the morphology,
      the extent of the disease and also on the immunological status of the patient.
      Therapy should be discussed between the physician and the patient. Whatever
      therapy will be chosen, HPV DNA can persist latently in surrounding tissue and
      may lead to recurrence of visible lesions. Long-standing warts can undergo
      malignant conversion; intraepithelial neoplasias such as Bowen's disease,
      erythroplasia of Queyrat and bowenoid papulosis are especially prone to develop
      into squamous-cell carcinoma. Thus adequate therapy and thorough follow-up are
      mandatory in such cases. In the future therapies directed against HPV
      specifically will be available. They should lead both to destruction and complete
      clearance of visible lesions and also should prevent recurrences. Ideally HPV
      should be eliminated completely from the treated tissue.

PMID- 11220243
TI  - [Inhibitory effects of sunscreens on the development of skin cancer].

PMID- 11220244
TI  - [A medical student discovers onychomycosis].
AB  - When G. Meissner discovered the tactile bodies of the skin, he earned early fame.
      Yet he made further contributions to dermatology which have been forgotten such
      as the first description of onychomycosis. This took place when he was still a
      student in Gottingen. The circumstances of this discovery are told in the context
      of the medical history of that time, paying special attention to certain
      epidemiological aspects. Finally, a detailed account is given of Meissner's
      academic career.

PMID- 11220246
TI  - [A new modern domicile for the Clinic and Polyclinic of Dermatology of the FU
      Berlin].

PMID- 11220245
TI  - [Extensive anal ulcerations in a 19-year-old patient].

PMID- 11220247
TI  - [The yeast fungus Malassezia: pathogen, pathogenesis and therapy].

PMID- 11220248
TI  - [Reducing the dosage by new technology].

PMID- 11220249
TI  - [Minoxidil: more than an antihypertensive].

PMID- 11220250
TI  - [Proven and promising for the future].

PMID- 11220251
TI  - [Quantification of blood loss. How precise is visual estimation and what does its
      accuracy depend on?].
AB  - Estimation of blood loss is a difficult task. Apart from measuring the volume of
      the suctioned blood the anaesthetist has to make a visual estimate of blood shed
      on the floor, spread in the surgeons' gowns and gloves and hidden in drapes and
      sponges at nearly every operation. We were interested in how exact visual
      estimation of blood loss can be and what factors influence accuracy and precision
      of the visual estimate. In one OR we simulated typical blood loss scenes
      occurring during a mock hip joint replacement, using our normal customary
      equipment of drapes, sponges and containers. More than 8 litres of blood from
      autologous whole blood donations were partitioned with a graduated measure and
      syringes and were distributed around the OR in 22 locations in typical ways. 36
      members of staff entered the OR one by one and all gave their 22 estimates.
      Results were analysed by repeated measures analysis of variance. Bias (accuracy)
      and variation error (precision) were calculated for individuals and groups of
      individuals. We found a broad deviation of the visual estimates and little
      coincidence with the actual values. Over- and underestimations by 2 or even 3
      were rather common; underestimations were more frequent. We found a significant
      trend to overestimate diluted blood, even though these certain sites were known
      to exhibit diluted blood. On the other hand laparotomy pads and sponges fully
      saturated with blood as well as the simulation of the operative site were grossly
      underestimated. Age, sex and professional experience (!) did not influence the
      magnitude of estimation errors, but the professional groups'estimates differed:
      anaesthetists estimated slightly but significantly more than orthopedic or
      general surgeons. Obviously our capability to estimate lost blood volumes is more
      influenced by our belonging to a professional group than by our professional
      experience. Do we not learn by experience? Diluted blood is overestimated,
      whereas in some other typical scenes blood loss is grossly underestimated.
      Simulations such as this one may improve our estimation capabilities and thus
      result in better patient care in the OR.

PMID- 11220252
TI  - not app.

PMID- 11220253
TI  - [Neural networks and pain processing. New insights from imaging techniques].
AB  - Imaging techniques with high spatial and temporal resolution (PET,fMRI, MEG)
      provide detailed information about the brains' processing of pain. Structures
      detected by these techniques are not understood as pain centers but as nodal
      points of a dynamic network which is influenced by physiological and
      psychological input. Imaging techniques can be used for the investigation of
      different pain components. The neuronal network that encodes sensory
      discriminative information consists of the primary and secondary somatosensory
      cortex which receive input from lateral thalamic nuclei. Information for the
      affective pain component reach the anterior cingulate cortex, insula and
      prefrontal cortex via medial thalamic nuclei. Until now only little is known
      about cortical structures mediating the cognitive pain component. In chronic pain
      the cortical and subcortical processing of nociceptive input is presumably
      modified. Reorganization in the primary somatosensory cortex is presented as an
      example of neuronal plasticity induced by chronic pain.

PMID- 11220254
TI  - [Cardiovascular stress protection following anesthesia induction. Comparison of
      clonidine and esmolol].
AB  - Alpha-2-adrenoceptor-agonists as well as cardioselective betareceptor-antagonists
      have been shown to blunt stress response due to tracheal intubation. The purpose
      of our study was to investigate,whether clonidine or esmolol is more efficient to
      attenuate stress response due to intubation.44 patients were randomly assigned to
      receive either clonidine (n=22; 3 microg/kg) or esmolol (n=22; 2 mg/kg)
      immediately prior to a standardized induction of anaesthesia. Heart rate,
      arterial blood pressure, cardiac output, epinephrine and norepinephrine plasma
      concentrations were measured before,during and 10 min after intubation. Blood
      pressure was measured invasively and cardiac output was determined by
      transthoracic echocardiography. Absolute values and increase of mean arterial
      pressure and norepinephrine plasma concentrations were significantly less in the
      clonidine group (p<0,05). Clonidine (3 microg/kg) is more efficient than esmolol
      (2 mg/kg) in blunting stress response due to endotracheal intubation.

PMID- 11220255
TI  - [Danaparoid (Orgaran) as an antiocoagulant for mechanical autotransfusion with
      Cell Saver 5 (Hemonetics)].
AB  - We investigated Danaparoid Sodium (Orgaran) as anticoagulant using three
      different concentrations (9, 4,5 or 3 U/ml anticoagulant solution) for the use in
      the autotransfusion device Cell Saver 5 (Haemonetics). Fresh units of whole blood
      packs were mixed in the reservoir in a proportion of 5:1 with the anticoagulant
      solution. Having started the Cell Saver 5 in the automatic mode, the amount of
      Danaparoid in the retransfusion blood was determined (chromogenic Antifactor-Xa
      test). The lowest concentration of the anticoagulant was applied in 4 patients
      with Heparin-induced Thrombocytopenia Type II undergoing total hip arthroplasty.
      There was a correlation between the concentration in the reservoir and in the
      retransfusion blood. None of the patients showed a disturbance of his coagulation
      system. One of them had slight clotting in the reservoir. We recommend the use of
      the lower concentrations tested: 4,5 U/ml or, particularly for patients with
      renal insufficiency or low body weight or expected high retransfusion volumes, 3
      U/ml as anticoagulant concentrations. If the autotransfusion device is used
      according to the manufacturer's instructions there may be virtually no risk of
      clotting in the Cell Saver or of inhibition of the coagulation system in the
      patient.

PMID- 11220256
TI  - [Acute Leriche's syndrome in a patient undergoing coronary artery bypass grafting
      with extracorporeal circulation].
AB  - We are reporting a case of an acute thromboembolic obstruction of the aortic
      bifurcation in a 66-year-old patient undergoing coronary artery bypass grafting
      with extracorporeal circulation. After declamping of the aorta, the arterial
      pressure measured in the femoral artery suddenly dropped, whereas the pressure
      measured in the aortic cannula and in both radial arteries stayed normal.
      Transoesophageal echocardiography was performed to exclude an acute aortic
      dissection. While the patient always had a constant sinus rhythm, an angiography
      following the end of surgery, showed a complete obstruction of the abdominal
      aorta. Subsequent embolectomy through bifemoral arteriotomies was performed and a
      histologically fresh embolus (6,5 g in weight) was extracted. Neither the pre-
      and intraoperative echocardiography, nor the preoperative ventriculography showed
      signs of an intracardiac thrombus. Insufficient anticoagulation and a lack of
      inhibitor potential were almost excluded. Considering the histological findings,
      we assumed that the embolus was formed intraoperatively. Without further
      complications the patient left our department on the 8th postoperative day.

PMID- 11220257
TI  - [Massive acute hypotonic hyperhydration following arthroscopic synovectomy].
AB  - We report the case of a 4 year old boy who developed a massive water intoxication
      as a complication during knee arthroscopy. The sodium plasma concentration
      dropped to 100 mmol/l postoperatively. This complication may be triggered by
      prolonged surgery time, excessive intra-articular pressure, capsular tears and
      low body weight. To prevent massive incorporation of hypoosmolar fluid, the
      inflation of a tourniquet as well as the use of NaCl 0,9% as irrigation fluid
      seems to be of advantage. The guidelines for replacing sodium in hyponatremia are
      discussed according to literature. In general, hyponatremia should be corrected
      in the same amount of time as it took for it to develop.

PMID- 11220258
TI  - [Epileptoform EEG activity: occurrence under sevoflurane and not during propofol
      application].
AB  - In a 62-year-old female patient without a history of epileptic seizures EEG
      monitoring (EEG monitor: Narcotrend) was routinely performed during
      propofol/remifentanil and during sevoflurane/remifentanil/nitrous oxide
      anaesthesia. In the first course of anaesthesia after a bolus of propofol 1% a
      continuous EEG slowing was followed by a burst suppression pattern without
      occurrence of epileptiform activity throughout this sequence. During the second
      course of anaesthesia the sevoflurane concentration was increased from 2 to 8 %
      by volume. After 5 min epileptiform activity appeared in the EEG at an endtidal
      concentration of 5.9% by volume.

PMID- 11220259
TI  - [Nosocomial pneumonia. Epidemiology, pathogenesis and diagnosis].

PMID- 11220260
TI  - [Intrascalene block].

PMID- 11220262
TI  - [New diagnostic possibilities and macular diseases].

PMID- 11220261
TI  - [Colloids in intensive care].

PMID- 11220263
TI  - [Autofluorescence imaging of the macula].
AB  - Visualization of the retinal pigment epithelium (RPE) in vivo has proven
      difficult for various reasons, including the optical properties of the eye and
      the small size of the cellular elements, forming a single layer between the
      neurosensory retina and Bruch's membrane. With the advent of scanning laser
      ophthalmoscopy it is now possible to image topographic distribution and intensity
      fundus autofluorescence derived from accumulations of lipofuscin granules in RPE
      cells. Excessive lipofuscin storage in the RPE cytoplasm occurs not only in
      association with age but also with many hereditary and degenerative retinal
      diseases including age-related macular degeneration, Stargardt disease, Best
      disease, and pattern dystrophies. Lipofuscin in the RPE derives mainly from
      incomplete degradation of phagocytosed distal segments of photoreceptor outer
      segments, and is composed of various biomolecules including lipids, protein, and
      retinoids. Some of its constituents have recently been shown to possess toxic
      properties in vitro and may play a pathophysiological role in diseases such as
      age-related macular degeneration.Visualizing lipofuscin in vivo may help to
      better understand the significance of these metabolic alterations in the
      pathogenesis of retinal disorders. In addition,fundus autofluorescence imaging
      can be useful in the preclinical diagnosis of hereditary retinal disease. Dynamic
      alterations of intrinsic RPE fluorescence change may be applicable for monitoring
      effects at the level of the RPE of novel therapeutic modalities. Furthermore,
      identification of high-risk characteristics in patients with age-related macular
      degeneration with this technique may be helpful for indicating and adjusting
      future therapies.

PMID- 11220264
TI  - [Bilateral progressive choroid neovascularization in a 38-year-old patient.
      Ocular histoplasmosis syndrome].

PMID- 11220266
TI  - [Multifocal electroretinography in diagnosis of macular diseases].

PMID- 11220265
TI  - [Neuroprotection in retinal diseases. Myth or reality?].

PMID- 11220268
TI  - [Fundus-controlled functional evaluation in macular diseases with the scanning
      laser ophthalmoscope].
AB  - Exact functional testing in macular diseases still presents a challenge for the
      ophthalmologist in detecting both small (para)central scotomas and changes in
      fixation habits. The recent development of scanning laser ophthalmoscopy has
      enabled functional testing with simultaneous observation of the fundus. In
      addition to automatic static threshold fundus perimetry, kinetic fundus
      controlled perimetry and special fixation tasks can be applied. This method also
      allows the examination of reading performance combined with the exact observation
      of fixation and has been increasingly integrated into clinical routine. This
      allows more exact observations concerning macular function for diagnostic
      purposes, in evaluating new treatment methods, and as expertises in simulation or
      aggravation in patients with macular diseases.

PMID- 11220267
TI  - [Optical coherence tomography].
AB  - Optical coherence tomography has become an established method for imaging retinal
      diseases. It is now an accepted method for making quantitative measurements in
      studies on the cause and course of macular holes, vitreoretinal traction, pigment
      epithelial detachment, macular edema, and diabetic retinopathy. Its potential
      benefit in the evaluation of age-related macular degeneration and a variety of
      other diseases is currently under investigation. In clinical practice optical
      coherence tomography images add information to the biomicroscopic findings and
      results of other imaging techniques or functional testing and can significantly
      help in making critical decisions. Its future role in routine clinical practice
      will depend on further technical development and the results of long-term
      studies.

PMID- 11220269
TI  - [Erbium:YAG laser vitrectomy. Initial clinical results].
AB  - BACKGROUND: Much interest has been expressed in recent years in the use of
      erbium:YAG lasers in ophthalmology, particularly for vitrectomy and
      phacoemulsification. PATIENTS AND METHODS: We performed 54 operations (49
      primary, 5 secondary) for pars plana vitrectomy on 53 eyes of 53 patients using
      the Phacolase erbium:YAG laser at a frequency of 10-100 Hz single-pulse energy of
      5-50 mJ. RESULTS: The operation was successful in 51 cases,while in three we had
      to resort to mechanical vitrectomy due to initial technical problems. CONCLUSION:
      Erbium:YAG laser vitrectomy was generally fast and caused little mechanical
      stress to the retina. Complications were only those known from mechanical
      vitrectomy.The handpiece showed good properties for removing vitreous but not for
      cutting membranes, although new handpieces specifically for the cutting of
      membranes are under development.

PMID- 11220270
TI  - [Retinal nerve fiber layer thickness and peripapillary blood flow in glaucoma
      patients and healthy probands].
AB  - BACKGROUND: In progressive glaucoma there is increasing loss of retinal nerve
      fibers and therefore decreasing nerve fiber layer thickness. As measurements of
      capillary blood flow have been reported to depend on nerve fiber layer thickness,
      this could result in incorrectly high blood flow measurements in patients with
      advanced glaucoma. METHODS: In 33 healthy controls and 59 glaucoma patients we
      measured retinal nerve fiber layer thickness by laser polarimetry and relative
      capillary blood flow by scanning laser doppler flowmetry three times on the nasal
      and temporal peripapillary retina. For statistical analysis a regression analysis
      was used. RESULTS: The correlation coefficients for volume, velocity, and flow
      with nerve fiber layer thickness at the same location were 0.02/-0.03/-0.02 in
      the temporal retina and -0.22/-0.07/-0.19 in the nasal retina (all correlations
      nonsignificant). CONCLUSION: No correlation was found between nerve fiber layer
      thickness and capillary blood flow. Measurement of capillary blood flow in
      glaucoma patients thus does not appear to be affected by decreasing nerve fiber
      layer thickness.

PMID- 11220271
TI  - [Laser flare in combined cataract and glaucoma surgery].
AB  - BACKGROUND: We used a laser-flare meter to compare inflammation of the anterior
      chamber in combined cataract and glaucoma surgery with that in pure filtering
      surgery. MATERIALS AND METHODS: In 34 consecutive patients with primary chronic
      open-angle glaucoma (PCOG) we combined glaucoma surgery and cataract extraction
      with phacoemulsification and implantation of a foldable intraocular lens via the
      same incision. We compared the results with those in 32 PCOG patients receiving a
      single goniotrephination and in 45 PCOG patients receiving cataract extraction
      via clear cornea with implantation of a foldable lens. RESULTS: The increase in
      the flare in the first 2 days was significant in those receiving combined
      cataract and glaucoma surgery and in those receiving single goniotrephination but
      not in those receiving a single cataract extraction. After 3 weeks there was no
      significant difference to the preoperative value in any of the groups. The
      highest flare values were in patients after combined surgery, significantly
      higher than after cataract extraction in the first days and higher than in the
      goniotrephination patients 3 weeks after the operation. CONCLUSION: The highest
      flare on the first day was in combined cataract and glaucoma surgery. This may
      explain the more frequent scarring of the filtering bleb in combined surgery.
      Postoperatively the intraocular pressure and number of drugs used for glaucoma
      did not differ in patients with combined and single goniotrephination.

PMID- 11220272
TI  - [Modeling corneal topography with a subdivision scheme in keratoconus].
AB  - BACKGROUND: Videokeratoscopy is often unable to obtain complete data sets in
      cases of irregular or asymmetric corneal topography. Subdivision schemes are very
      common in computer graphics for completion and smoothing of surfaces. Based on a
      network of triangular facets a smooth and complete surface in a standard
      coordinate system can be derived from topographic raw data. PATIENTS AND METHODS:
      We examined 88 patients with keratoconus and 40 normal controls. Polygons and
      polyhedra were defined from videokeratoscopic height data, and a surface was
      modeled using a modified butterfly subdivision scheme for a nonuniform sampled
      grid. To assess the model quality topographic raw data were changed to missing
      values centrally (at the apex of the cone) and in four midperipheral quadrants.
      The target value was the root mean square error, comparing the remodeled value of
      the subdivision scheme to the raw data at the position of the missing values for
      each group. RESULTS: Due to the nonuniform mesh of our Placido-based topographer
      we used a dynamic adaptive model and the governing dynamic differential equation.
      With a single missing value, no difference was detected between normals and
      patients with keratoconus. For a missing area consisting of 13 raw data points,
      the remodeling error was significantly higher in patients with keratoconus than
      in normals. With the neighborhood of 13 missing data points, the apex of the cone
      was remodeled in both groups of patients with less precision than with the
      peripheral missing data. CONCLUSION: The locality of the equation systems to be
      solved and the easy calculation of explicit formulas for the normals may simplify
      ray-tracing techniques and make subdivision attractive for large datasets in
      corneal topography even with irregular patterns.

PMID- 11220273
TI  - [Photorefractive/photo-astigmatic refractive keratectomy in low myopia and myopic
      astigmatism. Broad beam versus scanning spot laser technology].
AB  - PURPOSE: The results of photorefractive/photoastigmatic refractive keratectomy
      (PRK/PARK) were compared between two patient groups treated consecutively with
      either broad-beam or scanning-spot technology. PATIENTS AND METHODS: PRK/PARK was
      performed with a broad-beam excimer laser VISX 20/20 in 46 eyes and with the
      scanning-spot laser system Keracor 217 in 49 eyes. Preoperative spherical
      equivalent (subjective manifest refraction) was < or =-6.0 diopter in both
      groups. Safety, efficacy, predictability, stability, and complications were
      investigated after 1,4 and 12, months postoperatively. RESULTS: In the broad-beam
      laser group no eye lost two or more lines of best-corrected visual acuity;in the
      scanning-spot laser group one eye lost two lines 12 months postoperatively.
      Efficacy, predictability, and stability were comparable between the two groups.
      CONCLUSIONS: Both the broad-beam and the scanning-spot laser provided good
      results after PRK/PARK for low myopia and myopic astigmatism. This study found no
      fundamental differences between the two laser systems.

PMID- 11220274
TI  - [The efferent lacrimal ducts of the human. Morphological and biochemical
      studies].
AB  - PURPOSE: Infections occur frequently in the region of the efferent tear ducts.
      Exact knowledge of the anatomical structure and of cellular defense mechanisms is
      necessary to understand the pathological processes. This study analyzed the
      efferent tear ducts with regard to physiological function and possible defense
      mechanism against infections. MATERIALS AND METHODS: We used histological,
      immunohistochemical and electronmicroscopic techniques to investigate the
      lacrimal systems from 31 body donors aged 54-88 years. RESULTS: The efferent tear
      ducts are lined by a double-layered epithelium resting on a broad basement
      membrane. These cells contain many lipid droplets and secretory vacuoles in their
      apical part. Inside the epithelium cells are arranged partly in cell groups
      forming mucous glands, which morphologically resemble goblet cells of the tarsus
      palpebrae. The secretory products of these cells contain various carbohydrates
      including sialic acid. Lymphocytes and macrophages are found in the submucosa
      partly penetrating the epithelium. CONCLUSIONS: Lipids and mucins of epithelial
      and goblet cells form a specialized protective layer on the epithelium of the
      tear ducts which enables easy drainage of tear fluid into the inferior meatus of
      the nose. Together with immunocompetent cells the protective layer prevents
      invasion of pathogenetic agents.

PMID- 11220275
TI  - [Rehabilitation of anophthalmic patients. Results of a survey].
AB  - BACKGROUND: We surveyed ocularists' views on orbital implants, secondary surgical
      procedures, patient satisfaction, and cooperation between ophthalmologists and
      ocularists. METHOD: A 14-item questionnaire was sent to all 29 ocularists working
      in Germany all 4 in the Netherlands. RESULTS: Primary implants are generally
      recommended, preferably dermofat grafts and ,,baseball" implants. Outcome depends
      crucially upon surgical procedure and postoperative course. Scepticism is common
      toward secondary surgical procedures, with the success rate estimated at 70%.
      Cooperation between ocularists and ophthalmologists is generally regarded as
      unsatisfactory, also the information provided to the patients by the
      ophthalmologist after enucleation. CONCLUSIONS: The ocularists demand best
      possible enucleation techniques including the use of primary implants. However,
      they are critical toward secondary procedures for correcting postenucleation
      socket syndrome. Cooperation between ocularists and ophthalmologists need to be
      improved in providing patient care.

PMID- 11220276
TI  - [Electrophysiological studies in breast carcinoma patients with tamoxifen
      retinopathy].
AB  - PURPOSE: Crystalline plaques in the cornea or the retinal nerve fiber layer are
      well-known side effects of tamoxifen therapy. We investigated whether
      electrophysiological methods for determining the function of the retinal nerve
      fiber layer and retinal pigment epithelium demonstrate changes in tamoxifen
      retinopathy. PATIENTS AND METHODS: We compared the right eyes of four women with
      breast cancer and mono- or bilateral tamoxifen retinopathy to ten right eyes of
      age-matched, eyehealthy patients who had not received tamoxifen by means of
      electrophysiological investigations (e.g., pattern-reversal electroretinography,
      flash electroretinography for the maximal combined response, electrooculography;
      ISCEV standard conditions). RESULTS: No significant differences were observed
      between patients with tamoxifen retinopathy and controls regarding mean visual
      acuity, basal level of the electro-oculographic standing potential, basal level
      on the Arden index, or any of the other electrophysiological potentials.
      CONCLUSIONS: Pattern-reversal electroretinographic measurements revealed no
      damage of retinal ganglion cells in the presence of crystalline plaques in the
      retinal nerve fiber layer. Electro-oculography did reveal differences, but these
      were not statistically significant, possibly due to the small number of cases.

PMID- 11220277
TI  - [Dynamic MRI imaging of orbital diseases and ocular motility disorders].
AB  - High temporal and spatial resolution has recently been achieved by rapid magnetic
      resonance imaging techniques. This offers the opportunity to perform dynamic
      magnetic resonance imaging in addition to topographic imaging and tissue
      analysis. Using sequences obtained by turbo-fast low-angle shot imaging we have
      reduced temporal resolution to 1 s per image.

PMID- 11220278
TI  - [3-D ultrasound. Initial experiences in various eye diseases].
AB  - BACKGROUND: Studies have confirmed three-dimensional (3-D) ultrasound as a
      practical diagnostic tool in examining the eye and orbit and suggest its routine
      clinical use. MATERIALS AND METHODS: 3-D ultrasound was prospectively performed
      in 46 patients (46 eyes) with various ocular diseases. In six large choroidal
      melanomas the tumor volume were measured by 3-D ultrasound and compared to that
      measured by MRI and to that calculated by a theoretical formula. To assess the
      reproducibility of volumetry by 3-D ultrasound the volumes of such three
      intraocular tumors were measured ten times using ten different virtual sectioning
      planes and a section thickness of 0.5 mm and/or 1.0 mm. RESULTS: 3-D ultrasound
      allows the precise assessment of complex three-dimensional structures. Choroidal
      melanoma volumes measured by 3-D ultrasound, MRI, and theoretical calculation
      were in the same range. CONCLUSION: Intraocular tumor volume can be measured well
      by 3-D ultrasound,which may be of clinical importance in follow-up examinations.

PMID- 11220279
TI  - [Implant in Schlemm's canal. A new method for regulating intraocular pressure in
      patients with primary open-angle glaucoma?].
AB  - BACKGROUND: A surgical technique was developed using a Schlemm's canal implant to
      bypass the obstruction of outflow of the juxtacanalicular trabecular meshwork in
      patients with primary open-angle glaucoma. The implant device should also bridge
      healing processes after trabeculotomy and laser techniques. PATIENTS AND METHODS:
      An 8- to 15-mm-long silicone tube was implanted in each of two human autopsy eyes
      connecting the anterior chamber directly with Schlemm's canal. Serial sectioning
      was performed at two sections of 1-mm length. RESULTS: Implantation of the tube
      was technically uneventful. Histological examination showed no evidence of
      mechanical disruption of the endothelial lining of the inner wall of Schlemm's
      canal. CONCLUSION: These preliminary results demonstrate the possibility of
      shunting aqueous directly into Schlemm's canal using a silicone tube. A clinical
      study in a selected group of patients is planned.

PMID- 11220280
TI  - [Accommodative lens implant].
AB  - PROBLEM: To date, approaches to restore accommodation following cataract surgery
      have been based on the principle of a liquid or solid implant that moves within
      the capsular bag and thereby changes the optical characteristics of the eye.
      However, these implants have been associated with shrinking and fibrosis of the
      capsular bag, a problem that will not be solved in the foreseeable future.
      APPROACH: If accommodation is effected by shifting the whole capsule including
      its contents on the optical axis, capsular fibrosis will virtually no longer play
      a role. In order to execute this shift via the neuronal feedback mechanisms of
      the ciliary muscle in a controlled way, radial zonular forces or movements must
      be transformed into axial ones, which is possible by means of tiny permanent
      magnets. This paper describes the basic aspects of such an implant. The
      dependence of accommodation on all relevant parameters is quantified in a
      computer simulation. CONCLUSION: The implant described appears to be practicable
      with justifiable technical and surgical efforts.

PMID- 11220281
TI  - Relative Lewis basicities of six AI(ORF)4- superweak anions and the structures of
      LiA.
AB  - The relative Lewis basicities of six Al(ORF)4- ions, Al[OC(CH3)(CF3)2]4-,
      Al(OC(CF3)3]4-, Al(OCPh(CF3)2]4-, Al[OC[4-C6H4(tBu)](CF3)2]4-, Al(OC(Cy)(CF3)2]4
      , and Al(OCPh2(CF3)]4-, have been determined by measuring their relative
      coordinating abilities towards Li+ in dichloromethane. The relative Li- Lewis
      basicities of the Al(ORF)4- ions are linearly related to the aqueous pKa values
      of the corresponding parent HORF fluoroalcohols. The Lewis basicity of
      Al[OCH(CF3)2]4- could not be measured because two of these anions can coordinate
      to one Li+ cation. The structures of LiAl[OCH(CF3)2]4 and [1-Et-3-Me-1,3
      C3H3N2][Li[Al[OCH(CF3)2)4]2] were determined.

PMID- 11220282
TI  - Biotransformation of diterpenes and diterpene derivatives by Beauveria bassiana
      ATCC 7159.
AB  - The biohydroxylation of stemodin and stemodinone by Beauveria bassiana ATCC 7159
      gave exclusively 2alpha,13,18-trihydroxystemodane and 13,18-dihydroxystemodan-2
      one respectively. Stemarin was converted to the novel 1beta,13,19
      trihydroxystemarane and 13-hydroxystemarane-19-carboxylic acid. The synthesis and
      biotransformation of various derivatives of stemodin have also been studied.

PMID- 11220283
TI  - Insulin resistance: the fundamental trigger of type 2 diabetes.
AB  - Type 2 diabetes is a heterogeneous condition that is not attributable to a single
      pathophysiological mechanism. In general, both insulin resistance and impaired
      insulin secretion are required for the disease to become manifest. Thus, as long
      as the pancreatic beta cells can compensate for the degree of insulin resistance,
      glucose tolerance remains normal. Clustering of type 2 diabetes in certain
      families and ethnic populations points to a strong genetic background for the
      disease. However, environmental factors such as obesity and a sedentary lifestyle
      are usually required to unmask the genes. Impaired insulin-stimulated glucose
      metabolism (particularly non-oxidative) in skeletal muscle represents a key
      feature of type 2 diabetes and is observed early in the pre-diabetic state. It is
      not clear, though, whether this represents an inherited defect in muscle or
      whether it develops secondarily, for example, to abdominal obesity. In favour of
      the latter hypothesis are findings that abdominal obesity and a low metabolic
      rate seem to precede the development of insulin resistance in offspring of type 2
      diabetic patients. According to the thrifty gene hypothesis, individuals living
      in an environment with an unstable food supply could increase their probability
      of survival if they could maximize storage of surplus energy, for instance, as
      abdominal fat. Exposing this energy-storing genotype to the abundance of food
      typical of westernized societies is detrimental, causing insulin resistance and,
      subsequently, type 2 diabetes. There are a number of potential thrifty genes,
      including those that regulate lipolysis or code for the beta3-adrenergic
      receptor, the hormone-sensitive lipase, and lipoprotein lipase. Type 2 diabetes
      develops as a consequence of a collision between thrifty genes and a hostile
      affluent environment. Insulin resistance is a key trigger for the disease, and
      optimal management of type 2 diabetes should therefore aim to ameliorate insulin
      resistance early.

PMID- 11220284
TI  - The association between insulin resistance and endotheliopathy.
AB  - Vascular endothelium is involved in the regulation of vascular tone, vessel
      permeability, and angiogenesis. Vessel tone is determined by the balance of
      various paracrine vasodilatory and vasoconstrictor factors, most notably nitric
      oxide (NO) and endothelin-1. Not surprisingly, endothelial dysfunction is
      believed to be crucial in the development of the chronic vascular complications
      of diabetes. Endothelial dysfunction, which may be examined by studying
      endothelial-dependent vasodilatation in humans, is also disturbed by many of the
      individual features of the insulin resistance syndrome including hypertension,
      dyslipidaemia, and hyperglycaemia. Therefore, it may be possible that endothelial
      dysfunction could be closely associated with, or even a common antecedent of, the
      insulin resistance syndrome (IRS). There is emerging evidence that impaired
      endothelial-dependent vasodilatation is present in populations at future risk of
      diabetes and even in children of low birth weight, who may exhibit features of
      the insulin resistance syndrome in later life. Endothelial dysfunction is an
      obvious therapeutic target if the vascular pathology associated with insulin
      resistance and type 2 diabetes is to be ameliorated.

PMID- 11220285
TI  - Insulin resistance: an independent risk factor for cardiovascular disease?
AB  - Population-based studies have shown that patients with type 2 diabetes have a
      higher cardiovascular morbidity and mortality and an increased all-cause
      mortality compared with non-diabetic subjects. In non-diabetic subjects,
      hyperinsulinaemia not only has been associated with an increased cardiovascular
      risk, but is also related with a number of other cardiovascular risk factors-
      hyperglycaemia, hypertension, dyslipidaemia, and a central body fat distribution-
      that constitute the insulin resistance syndrome and are also characteristic of
      type 2 diabetes. After 23 years of follow-up in the Paris Prospective Study, both
      fasting and 2-h insulin concentrations were related with all-cause mortality in a
      U-shaped fashion, with low and high concentrations being associated with an
      increased risk, independently of other risk factors; in contrast, while high
      insulin levels carried an increased risk for cardiovascular and coronary heart
      disease mortality, this was not independent of other risk factors.

PMID- 11220286
TI  - Effects of current therapeutic interventions on insulin resistance.
AB  - Although diet and exercise remain the cornerstones of type 2 diabetes therapy,
      attempts at lifestyle changes seldom result in the achievement of glycaemic
      control. As a result, the addition of pharmacological agents is usually
      necessary. Currently available treatment options improve glycaemic control in the
      short term; however, maintaining long-term glycaemic control, halting disease
      progression, and preventing the complications of type 2 diabetes have all proven
      to be elusive therapeutic goals. For more than 30 years, sulphonylureas (SUs)
      have been first-line therapy for the management of type 2 diabetes. These
      compounds control hyperglycaemia by stimulating insulin release from pancreatic
      beta cells, and thus their benefits are limited to patients with preserved beta
      cell function. Despite historic reliance on these agents to treat type 2
      diabetes, long-term use of SUs may desensitize beta cells. The meglitinides (e.g.
      repaglinide) are a new class of non-sulphonylurea secretagogues that bind to a
      different receptor on the beta cell. Repaglinide has a short duration of action
      and may be useful for the treatment of postprandial hyperglycaemia. The
      biguanides (e.g. metformin) represent another class of antidiabetic agents and
      improve glycaemic control primarily by decreasing hepatic glucose output.
      Metformin and SUs provide similar glucose-lowering effects, and, in combination,
      may provide additional benefits in some patients. Reducing the rate of glucose
      absorption with alpha-glucosidase inhibitors (e.g. acarbose) has been explored as
      an alternative approach to the management of postprandial hyperglycaemia, but
      these agents do not address the primary defect in type 2 diabetes. Eventually,
      prolonged overproduction of insulin to compensate for hyperglycaemia leads to
      dramatically reduced beta-cell function, and exogenous insulin therapy is
      required.

PMID- 11220287
TI  - Promising new approaches.
AB  - Insulin resistance in liver and muscle tissue, together with beta-cell secretory
      defects, leads to overt type 2 diabetes mellitus. In the early stages of this
      progressive disorder, glycaemic control can be established through diet and
      exercise alone. Indeed, in some patients, marked weight reduction can lead to
      normalized fasting blood glucose. As a consequence, pharmacological approaches to
      weight loss have been investigated as a new option for the management of type 2
      diabetes in obese patients. The serotonin- and noradrenaline-reuptake inhibitor
      sibutramine has emerged as the most promising agent in the treatment of obesity,
      although it appears to be less effective in diabetic patients than in non
      diabetic patients. Other weight-reducing agents of potential benefit include
      noradrenergic anorexiants, orlistat, leptin, and beta3-agonists. Insulin and
      insulin secretagogues, the oldest available antidiabetic drugs, have been used to
      compensate for beta-cell secretory defects in patients with type 2 diabetes.
      Repaglinide, a new, fast-acting insulin secretagogue with a short duration of
      action, reduces postprandial hyperglycaemia when taken shortly before meals.
      Other novel antidiabetic agents are currently under development, including
      pramlintide (an amylin analogue) and glucagon-like peptide. Pramlintide slows
      gastric emptying and delays glucose absorption, and glucagon-like peptide is the
      most potent endogenous stimulator of glucose-induced insulin release. Recent
      advances in type 2 diabetes therapy have seen the development of the
      thiazolidinediones (troglitazone, rosiglitazone, and pioglitazone), which improve
      insulin resistance in patients whose diabetes is poorly controlled by diet and
      exercise therapy. Thiazolidinediones bind to peroxisome proliferator-activated
      receptor-gamma (PPAR-gamma) and act through a process involving gene regulation
      at a transcriptional level. Troglitazone, the first approved drug in the class,
      has been shown to decrease plasma glucose levels as monotherapy but is more
      effective in combination with sulphonylureas, metformin, or insulin. However,
      despite its generally good safety profile, troglitazone has been associated with
      severe idiosyncratic hepatocellular injury. There have been more than 150
      spontaneous reports of serious hepatic events, including at least 25 instances in
      which patients died or required a liver transplant. Rosiglitazone, the most
      potent thiazolidinedione, is still in clinical development, as is pioglitazone.
      To date, rosiglitazone has been shown to have no reported cases of idiosyncratic
      drug reactions leading to jaundice or liver failure and no clinically significant
      drug interactions with cytochrome P450 3A4-metabolized drugs such as nifedipine.
      Although the available data for pioglitazone are limited to the results of short
      term studies, it is reported to be safe and well tolerated. Combination therapy
      is increasingly important in type 2 diabetes management following failure of
      monotherapy because complementary mechanisms of action of the different classes
      of oral agents demonstrate synergistic effects when used in combination. Oral
      agents may also be used as adjuncts to insulin for achieving glycaemic control.

PMID- 11220290
TI  - Proceedings of Worldwide Insulin Resistance Editorial Board Meeting, 14 July
      1998, Stockholm, Sweden.

PMID- 11220289
TI  - The relation between insulin resistance and cardiovascular complications of the
      insulin resistance syndrome.
AB  - It has been known for years that cardiovascular disease frequently precedes the
      development of type 2 diabetes, and that atherosclerosis might not be a
      complication of type 2 diabetes, but rather the consequence of common genetic and
      environmental factors (the common soil' hypothesis). The insulin resistance
      syndrome (IRS) is a cluster of closely associated and interdependent
      abnormalities, including insulin resistance, hyperinsulinaemia, android fat
      distribution, progressive glucose intolerance, dyslipidaemia (increased
      triglycerides, decreased HDL, increased small dense LDL), increased prothrombotic
      and antifibrinolytic factors, and hypertension. Many of these abnormalities are
      risk factors for type 2 diabetes, and most of them explain the predilection for
      atherosclerosis to occur in conjunction with IRS. Insulin resistance is a key
      feature of IRS, and has been suggested to be the common pathophysiological basis
      of atherosclerosis and type 2 diabetes. The term 'insulin resistance' denotes
      resistance to insulin-mediated glucose uptake into skeletal muscle, which can be
      measured by the glucose clamp technique. There are, however, other less
      understood sites of abnormal insulin action that may also be relevant in IRS.
      These include liver, adipose, and kidney tissue, and systems such as muscle
      perfusion, antilipolysis, lipoprotein lipase activity, and cation transport. The
      development of clinical cardiovascular end-points in a patient with insulin
      resistance is complex, as it includes the degree of the defect, its associated
      abnormalities, its consequences, and the ability to compensate for the underlying
      defect. It is therefore more appropriate to consider the different facets and
      risk factors of IRS in aggregate, rather than seeking 'independent' effects.
      Accordingly, treatment of insulin resistance per se has not yet been shown to
      reduce the incidence of cardiovascular complications. At the cellular level,
      excess insulin is involved in various elements of atherogenesis. It interacts
      with cytokines and growth factors in a cross talk among vascular wall cells and a
      variety of mediators that play a role in the establishment of atheroma. Excess
      insulin also plays an important role in concert with lipoproteins when they
      exhibit an abnormal pattern and become modified by oxidation and glycation. It is
      therefore currently hoped that the introduction of a new class of insulin
      sensitizing agents, the thiazolidinediones, may attenuate these processes. The
      thiazolidinediones act through ligand activation of a nuclear transcription
      factor, the peroxisomal proliferator-activated receptor-gamma (PPARgamma).
      Although this receptor was initially linked to lipid and glucose metabolism,
      recent data suggest that PPARgamma is also involved in the differentiation of
      mononuclear phagocytes, their inflammatory reactions, and macrophage conversion
      to foam cells. Thus, PPARgamma ligands may also be important regulators of
      monocyte/ macrophage gene expression during atherogenesis.

PMID- 11220291
TI  - The polycystic ovary syndrome: treatment with insulin sensitizing agents.

PMID- 11220292
TI  - Physiological and pharmacological regulation of insulin release: insights offered
      through exploitation of insulin-secreting cell lines.

PMID- 11220293
TI  - Sudden death in type 1 diabetes.

PMID- 11220294
TI  - Non-enzymatic glycation of lens proteins and haemoglobin-inhibition by pyruvate:
      an in-vivo study.
AB  - AIM: Previous studies have demonstrated that pyruvate can prevent protein
      glycation and oxidative stress under in-vitro conditions. The aim of this study
      was to examine the in-vivo effectiveness of this metabolite against glycation of
      lens crystallins and haemoglobin in galactosemic rats. METHODS: Sprague-Dawley
      rats were maintained on a 30% or 50% galactose-containing diet in the absence or
      presence of 2% or 5% pyruvate in food and water, respectively. The animals were
      killed subsequently and the extent of glycation of lens crystallins and
      haemoglobin was determined using an affinity column chromatograpic technique.
      RESULTS: Maintenance of rats on the high galactose diet resulted in a significant
      increase in glycation of both the proteins. The increase was faster and more
      substantial in the animals maintained on the 50% galactose diet than that in the
      animals fed a 30% galactose diet. The increase in the latter was also very
      significant. Supplementation with pyruvate inhibited the process. CONCLUSION: The
      inhibition is attributable to a competitive binding of pyruvate to the protein
      NH2 groups as well as to the antioxidant effect of the compound. The studies
      therefore suggest that this and other alpha-keto-acids may be physiologically
      useful in minimizing glycation and oxidative stress induced tissue pathology by
      the hyperglycaemic conditions, such as diabetes and galactosemia. The results are
      also considered pharmacologically significant.

PMID- 11220296
TI  - Glucose and fatty acid metabolism in type 2 diabetes mellitus: an assessment
      using low-dose insulin infusion and the hyperinsulinaemic euglycaemic clamp.
AB  - AIM: To assess whether resistance to the effects of insulin on lipid metabolism
      in type 2 diabetes mellitus parallels that demonstrated for glucose metabolism.
      METHODS: Thirteen patients with type 2 diabetes were studied (mean age 56.2
      years, mean body mass index (b.m.i.) 28.7 kg m(-2)). The hyperinsulinaemic
      euglycaemic clamp (2 mU insulin kg(-1) min(-1)) and a low-dose insulin infusion
      technique were used in order to assess insulin effects on both glucose and lipid
      metabolism. RESULTS: Using the low-dose insulin infusion there were significant
      correlations between measures of insulin sensitivity for glucose metabolism and
      those for NEFA (r = 0.82, p < 0.01) and glycerol (r = 0.73, p < 0.01). Mean clamp
      glucose disposal was 33.4 micromol kgb.w.(-1) min(-1). There was no correlation
      between clamp glucose disposal and insulin sensitivity derived from the low-dose
      insulin infusion. CONCLUSIONS: At low insulin concentrations, insulin's effects
      on glucose metabolism (mainly suppression of hepatic glucose output) mirror those
      on inhibition of lipolysis. At the high insulin concentrations seen during the
      clamp, stimulation of glucose uptake provides a measure of maximal insulin action
      which does not parallel its physiological effects shown at lower concentrations.

PMID- 11220295
TI  - Rosiglitazone monotherapy improves glycaemic control in patients with type 2
      diabetes: a twelve-week, randomized, placebo-controlled study.
AB  - AIM: Rosiglitazone is the most potent of the thiazolidinediones, a novel class of
      oral antidiabetic agents that reduce blood glucose levels by sensitizing
      peripheral tissues to insulin. This study was designed to identify doses of
      rosiglitazone that would lower fasting plasma glucose (FPG) in patients with type
      2 diabetes. METHODS: In this 12-week, double-blind, multicentre study, 380
      patients with FPG values > or =7.8 mmol/L (140 mg/dL) and < or =13.3 mmol/L (240
      mg/dL) were randomly assigned to receive treatment with placebo or rosiglitazone,
      0.05, 0.25, 1.0, or 2.0 mg twice daily. The primary efficacy parameter was
      changed in FPG from baseline after 12 weeks of treatment. Secondary endpoints
      were changes in HbA1c, fructosamine, C peptide, insulin, lipid levels, and body
      weight (b.w.). Safety monitoring included clinical laboratory evaluations,
      electrocardiography, and echocardiography. RESULTS: Rosiglitazone 1.0 and 2.0 mg
      b.i.d. produced significant decreases in FPG (p=0.0001). Fructosamine also
      decreased in patients treated with these two dosages (p=0.003 in the 2.0 mg
      b.i.d. group). Rosiglitazone 2.0 mg b.i.d. significantly reduced plasma insulin
      levels (p=0.0044) and free fatty acids (p=0.0014) compared with placebo. Total
      cholesterol (p=0.0001), HDL (p=0.0009), and LDL (p=0.0001) increased in the
      rosiglitazone 2.0 mg b.i.d. group, but there was no significant change in the
      total cholesterol/HDL ratio or triglyceride levels in any rosiglitazone treatment
      group. Clinically insignificant dose-dependent increases in b.w. were observed in
      the rosiglitazone 1.0 and 2.0 mg b.i.d. treatment groups. CONCLUSIONS: Twelve
      weeks of treatment with rosiglitazone 2.0 mg b.i.d. significantly decreases
      fasting plasma glucose, fructosamine, plasma insulin, and free fatty acids in
      patients with type 2 diabetes. Longer studies using higher doses will be needed
      to assess the efficacy and safety of rosiglitazone in patients with type 2
      diabetes mellitus.

PMID- 11220297
TI  - Possible liver damage by biosynthetic human insulin.

PMID- 11220298
TI  - Anticipated US approval for rosiglitazone and pioglitazone.

PMID- 11220299
TI  - Bacterial sources and sinks of isoprene, a reactive atmospheric hydrocarbon.

PMID- 11220300
TI  - Preferential occurrence of diazotrophic endophytes, Azoarcus spp., in wild rice
      species and land races of Oryza sativa in comparison with modern races.
AB  - Several diazotrophic species of Azoarcus spp. occur as endophytes in the pioneer
      plant Kallar grass. The purpose of this study was to screen Asian wild rice and
      cultivated Oryza sativa varieties for natural association with these endophytes.
      Populations of culturable diazotrophs in surface-sterilized roots were
      characterized by 16S rDNA sequence analysis, and Azoarcus species were identified
      by genomic fingerprints. A. indigens and Azoarcus sp. group C were detected only
      rarely, whereas Azoarcus sp. group D occurred frequently in samples of flooded
      plants: in 75% of wild rice, 80% of land races of O. sativa from Nepal and 33% of
      modern cultivars from Nepal and Italy. The putatively endophytic populations of
      diazotrophs differed with the rice genotype. The diversity of cultured
      diazotrophs was significantly lower in wild rice species than in modern
      cultivars. In Oryza officinalis (from Nepal) and O. minuta (from the
      Philippines), Azoarcus sp. group D were the predominant diazotrophic putative
      endophytes in roots. In contrast, their number was significantly lower in modern
      cultivars of O. sativa, whereas numbers and diversity of other diazotrophs, such
      as Azospirillum spp., Klebsiella sp., Sphingomonas paucimobilis, Burkholderia sp.
      and Azorhizobium caulinodans, were increased. In land races of O. sativa, the
      diazotrophic diversity was equally high; however, Azoarcus sp. was found in high
      apparent numbers. Similar differences in populations were also observed in a
      culture-independent approach comparing a wild rice (O. officinalis) and a modern
      type O. sativa plant: in clone libraries of root-associated nitrogenase (nifH)
      gene fragments, the diazotrophic diversity was lower in the wild rice species.
      New lineages of nifH genes were detected, e.g. one deeply branching cluster
      within the anf (iron) nitrogenases. Our studies demonstrate that the natural host
      range of Azoarcus spp. extends to rice, wild rice species and old varieties being
      preferred over modern cultivars.

PMID- 11220301
TI  - Desulfotomaculum genus- and subgenus-specific 16S rRNA hybridization probes for
      environmental studies.
AB  - Based on comparative analysis of 16S rRNA sequences and the recently established
      phylogeny of the genus Desulfotomaculum, a set of phylogenetically nested
      hybridization probes was developed and characterized. A genus-specific probe
      targets all known Desulfotomaculum species (with the exception of
      Desulfotomaculum acetoxidans), and five specific probes target subclusters within
      the Desulfotomaculum genus. The dissociation temperature of each probe was
      determined experimentally. Probe specificities were verified through
      hybridizations with pure culture rRNA isolated from a wide variety of target and
      non-target organisms and through an evaluation of probe 'nesting' using samples
      obtained from four different environments. Fixation and hybridization conditions
      for fluorescence in situ hybridizations were also optimized. The probes were used
      in quantitative membrane hybridizations to determine the abundance of
      Desulfotomaculum species in thermophilic anaerobic digesters, in soil, in human
      faeces and in pig colon samples. Desulfotomaculum rRNA accounted for 0.3-2.1% of
      the total rRNA in the digesters, 2.6-6.6% in soil, 1.5-3.3% in human faeces and
      2.5-6.2% in pig colon samples.

PMID- 11220302
TI  - 'Clay hutches': a novel interaction between bacteria and clay minerals.
AB  - Biofilm formation on a low-energy substratum floating on the surface of a water
      column overlying a polychlorinated biphenyl (PCB)-contaminated sandy clay soil
      was followed by light and electron microscopy. The biofilms that developed
      consisted of a dense lawn of clay aggregates, each one of which contained one or
      more bacteria, phyllosilicates and grains of iron oxide material, all held
      together by bacterial extracellular polysaccharides (EPS). The clay leaflets were
      arranged in the form of 'houses of cards' and gave the aggregates the appearance
      of 'hutches' housing the bacteria. Interestingly, although the soil is poor in
      carbon, and the weakly bioavailable PCBs constitute the principal source of
      carbon in this system, the bacteria contained electron-transparent structures
      presumed to be carbon storage granules. These, and the EPS material present in
      the hutches, indicate that carbon is not limiting in this system and, as PCBs
      have been found associated with the clay mineral fraction of the floating
      substratum, the clay particles may serve as carbon shuttles. The interesting
      possibilities that the 'clay hutches' may represent a 'soil microhabitat', a
      'minimal nutritional sphere' and an 'effective survival unit' for autochthonous
      bacteria are noted. The formation of clay hutches by bacteria would seem to merit
      further investigation, particularly regarding their roles in bacterial processes
      in soil and in geological processes.

PMID- 11220304
TI  - Ecological study of a bioaugmentation failure.
AB  - A nitrifying sequencing batch reactor was inoculated twice with the aerobic
      denitrifying bacterium Microvirgula aerodenitrificans and fed with acetate. No
      improvement was obtained on nitrogen removal. The second more massive inoculation
      was even followed by a nitrification breakdown, while at the same time,
      nitrification remained stable in a second reactor operated under the same
      conditions without bioaugmentation. Fluorescent in situ hybridization with rRNA
      targeted probes revealed that the added bacteria almost disappeared from the
      reactor within 2 days, and that digestive vacuoles of protozoa gave strong
      hybridization signals with the M. aerodenitrificans-specific probe. An overgrowth
      of protozoa, coincident with the disappearance of free-living bacteria, was
      monitored by radioactive dot-blot hybridization only in the bioaugmented reactor.
      Population dynamics were analysed with a newly developed in situ quantification
      procedure of the probe-targeted bacteria. The nitrifying groups of bacteria
      decreased in a similar way in the bioaugmented and non-bioaugmented reactors.
      Other bacterial groups evolved differently. The involvement of different
      ecological parameters are discussed separately for each reactor. These results
      underline the importance of predator-prey interaction and illustrate the
      undesirable effects of massive bioaugmentation.

PMID- 11220303
TI  - Regulation of urease gene expression by Streptococcus salivarius growing in
      biofilms.
AB  - The metabolism of urea by urease enzymes of oral bacteria profoundly influences
      oral biofilm pH homeostasis and oral microbial ecology. The purpose of this study
      was to gain insight into the regulation of expression of the low pH-inducible
      urease genes in populations of Streptococcus salivarius growing in vitro in
      biofilms and to explore whether urease regulation or the levels of urease
      expression in biofilm cells differed significantly from planktonic cells. Two
      strains of S. salivarius harbouring urease promoter fusions to a chloramphenicol
      acetyltransferase (cat) gene were used: PurelCAT, containing a fusion to the full
      length, pH-sensitive promoter; or Pureldelta100CAT, a constitutively derepressed
      deletion derivative of the urease gene promoter. The strains were grown in a
      Rototorque biofilm reactor in a tryptone-yeast extract-sucrose medium with or
      without pH control. Both CAT and urease activities in biofilms were measured at
      'quasi-steady state' and after a 25mM glucose pulse. The results showed that CAT
      expression in PurelCAT was repressed at relatively neutral pH values, and that
      expression could be induced by acidic pH after carbohydrate challenge. Biofilms
      of PurelCAT grown at low pH, without buffering, had about 20-fold higher CAT
      levels, and only a modest further induction could be elicited with carbohydrate
      pulsing. The levels of CAT in biofilms of PurelCAT grown in buffered medium were
      slightly higher than those reported for planktonic cells cultured at pH 7.0, and
      the levels of CAT in Purel-CAT growing at low pH or after induction were similar
      to those reported for fully induced planktonic cells. CAT activity in
      Pureldelta100CAT was constitutively high, regardless of growth conditions.
      Interestingly, urease activity detected in biofilms of the parent strain, S.
      salivarius 57.1, could be as much as 130-fold higher than that reported for fluid
      chemostat cultures grown under similar conditions. The higher level of urease
      activity in biofilms was probably caused by the accumulation of the stable urease
      enzyme within biofilm cells, low pH microenvironments and the growth phase of
      populations of cells in the biofilm. The ability of S. salivarius biofilm cells
      to upregulate urease expression in response to pH gradients and to accumulate
      greater quantities of urease enzyme when growing in biofilms may have a
      significant impact on oral biofilm pH homeostasis and microbial ecology in vivo.
      Additionally, S. salivarius carrying the pH-sensitive urease gene promoter fused
      to an appropriate reporter gene may be a useful biological probe for sensing
      biofilm pH in situ.

PMID- 11220305
TI  - Changes in community composition during dilution cultures of marine
      bacterioplankton as assessed by flow cytometric and molecular biological
      techniques.
AB  - Dilution cultures are a common technique for measuring the growth of
      bacterioplankton communities. In this study, the taxonomic composition of marine
      bacterioplankton dilution cultures was followed in water samples from Plymouth
      Sound and the English Channel (UK). Bacterial abundances as well as protein and
      DNA content were closely monitored by flow cytometry. Denaturing gradient gel
      electrophoresis (DGGE) of polymerase chain reaction (PCR)-amplified 16S rDNA
      fragments and fluorescence in situ hybridization (FISH) were applied directly to
      the water samples and to cells sorted from the dilution cultures based on their
      protein and DNA content. As expected, a rapid activation of bacteria occurred.
      However, molecular techniques showed that the community developed in the dilution
      culture within 1 day was significantly different from that in the original water
      samples. Whereas in the original samples, cells detectable by FISH were dominated
      by members of the Cytophagal Flavobacterium (CF) cluster, in dilution cultures,
      gamma-proteobacteria accounted for the majority of cells detected, followed by
      alpha-proteobacteria. An actively growing and an apparently non-growing
      population with average cellular protein contents of 24 and 4.5 fg respectively,
      were sorted by flow cytometry. FISH indicated mostly gamma- (64%) and alpha
      proteobacteria (33%) in the first active fraction and 78% members of the CF
      cluster in the second fraction. Sequencing of DGGE bands confirmed the FISH
      assignments of the latter two groups. The data presented clearly show that even
      relatively short-term dilution experiments do not measure in situ growth, but
      rather growth patterns of an enrichment. Furthermore, it was demonstrated that
      the combination of flow cytometric analysis and sorting combined with FISH and
      DGGE analysis presented a fairly rapid method of analysing the taxonomic
      composition of marine bacterioplankton.

PMID- 11220306
TI  - hexA of Erwinia carotovora ssp. carotovora strain Ecc71 negatively regulates
      production of RpoS and rsmB RNA, a global regulator of extracellular proteins,
      plant virulence and the quorum-sensing signal, N-(3-oxohexanoyl)-L-homoserine
      lactone.
AB  - The soft-rotting bacterium, Erwinia carotovora ssp. carotovora (E. c.
      carotovora), produces an array of extracellular enzymes (= exoenzymes), including
      pectate lyase (Pel), polygalacturonase (Peh), cellulase (Cel) and protease (Prt),
      as well as HarpinEcc, the elicitor of hypersensitive reaction (HR). The
      production of these exoenzymes and HarpinEcc responds to plant products and the
      quorum-sensing signal [N-(3-oxohexanoyl)-L-homoserine lactone; OHL] and is
      subject to both transcriptional and post-transcriptional regulation. hexA of E.
      c. carotovora strain Ecc71 (hereafter hexA71), like that of another E. c.
      carotovora strain, negatively controls the production of exoenzymes, OHL and
      virulence in E. c. carotovora strain Ecc71. In addition to exoenzymes, HexA71
      negatively regulates the expression of hrpNEcc, the structural gene for
      HarpinEcc. Exoenzyme overproduction is abolished by OHL deficiency in a HexA- and
      Ohll- double mutant, indicating that HexA and OHL are components of a common
      regulatory pathway controlling exoenzyme production. HexA71 negatively affects
      RpoS, as the levels of this alternative sigma factor are higher in the HexA-
      mutant than in the HexA+ strain. However, a HexA- and RpoS double mutant produces
      higher levels of exoenzymes and transcripts of pel-1, peh-1 and celVgenes than
      the HexA- and RpoS+ parent. Thus, the elevated levels of RpoS protein in the HexA
      mutant do not account for exoenzyme overproduction. The following evidence
      associates for the first time the phenotypic changes in the HexA mutant to
      overproduction of rsmB RNA, a global regulator of exoenzymes, HarpinEcc, OHL and
      secondary metabolites. Analyses of rsmB transcripts and expression of an rsmB
      lacZoperon fusion in E. c. carotovora strain Ecc71 revealed that HexA71
      negatively regulates transcription of rsmB. Multiple copies of hexA71+ DNA
      suppress various phenotypes, including exoenzyme production in E. c. carotovora
      strain Ecc71, and concomitantly inhibit the production of rsmB, pel-1, peh-1,
      celV and hrpNEcc transcripts. Multiple copies of rsmB+ DNA, on the other hand,
      stimulate exoenzyme production by relieving the negative effects of a chromosomal
      copy of hexA+. The occurrence of hexA homologues and the negative effect of the
      dosage of hexA71 DNA on rsmB transcripts were also detected in other E. c.
      carotovora strains as well as Erwinia carotovora atroseptica and Erwinia
      carotovora betavasculorum. Extrapolating from the findings with LrhA, the
      Escherichia coli homologue of HexA, and the presence of sprE homologues in E.
      carotovora subspecies, we propose that HexA71 controls several regulatory
      pathways in E. carotovora including rsmB transcription and the production of
      SprEEcc which, in turn, affects RpoS levels. A model is presented that integrates
      the findings presented here and our current knowledge of the major regulatory
      network that controls exoprotein production in soft-rotting Erwinia carotovora
      subspecies.

PMID- 11220307
TI  - Matching molecular diversity and ecophysiology of benthic cyanobacteria and
      diatoms in communities along a salinity gradient.
AB  - The phylogenetic diversity of oxygenic phototrophic microorganisms in hypersaline
      microbial mats and their distribution along a salinity gradient were investigated
      and compared with the halotolerances of closely related cultivated strains.
      Segments of 16S rRNA genes from cyanobacteria and diatom plastids were retrieved
      from mat samples by DNA extraction and polymerase chain reaction (PCR), and
      subsequently analysed by denaturing gradient gel electrophoresis (DGGE). Sequence
      analyses of DNA from individual DGGE bands suggested that the majority of these
      organisms was related to cultivated strains at levels that had previously been
      demonstrated to correlate with characteristic salinity responses. Proportional
      abundances of amplified 16S rRNA gene segments from phylogenetic groupings of
      cyanobacteria and diatoms were estimated by image analysis of DGGE gels and were
      generally found to correspond to abundances of the respective morphotypes
      determined by microscopic analyses. The results indicated that diatoms accounted
      for low proportions of cells throughout, that the cyanobacterium Microcoleus
      chthonoplastes and close relatives dominated the communities up to a salinity of
      11% and that, at a salinity of 14%, the most abundant cyanobacteria were related
      to highly halotolerant cultivated cyanobacteria, such as the recently established
      phylogenetic clusters of Euhalothece and Halospirulina. Although these organisms
      in cultures had previously demonstrated their ability to grow with close to
      optimal rates over a wide range of salinities, their occurrence in the field was
      restricted to the highest salinities investigated.

PMID- 11220308
TI  - Diversity and community structure within anoxic sediment from marine salinity
      meromictic lakes and a coastal meromictic marine basin, Vestfold Hilds, Eastern
      Antarctica.
AB  - 16S rDNA clone library analysis was used to examine the biodiversity and
      community structure within anoxic sediments of several marine-type salinity
      meromictic lakes and a coastal marine basin located in the Vestfolds Hills area
      of Eastern Antarctica. From 69 to 130 (555 total) 16S rDNA clones were analysed
      from each sediment sample, and restriction fragment length polymorphism (RFLP)
      and sequence analysis grouped the clones into 202 distinct phylotypes (a clone
      group with sequence similarity of >0.98). A number of phylotypes and phylotype
      groups predominated in all libraries, with a group of 10 phylotypes (31% of
      clones) forming a novel deep branch within the low G+C Gram-positive division.
      Other abundant phylotypes detected in several different clone libraries grouped
      with Prochlorococcus cyanobacteria, diatom chloroplasts, delta proteobacteria
      (Desulfosarcina group, Syntrophus and Geobacterl Pelobacter/Desulphuromonas
      group), order Chlamydiales (Parachlamydiaceae) and Spirochaetales (wall-less
      Antarctic spirochaetes). Most archaeal clones detected (3.1% of clones) belonged
      to a highly diverged group of Euryarchaeota clustering with clones previously
      detected in rice soil, aquifer sediments and hydrothermal vent material. Little
      similarity existed between the phylotypes detected in this study and other clone
      libraries based on marine sediment, suggesting that an enormous prokaryotic
      diversity occurs within marine and marine-derived sediments.

PMID- 11220309
TI  - Microbes and metals.

PMID- 11220310
TI  - TRAP--transformation and its connection to pathogenicity and antibiotic
      resistance.

PMID- 11220311
TI  - A new sample preparation technique for organochlorines in cod liver oil combining
      SPE and NP-HPLC with HRGC-ECD.
AB  - The analysis of semivolatile organochlorines (polychlorinated biphenyls and
      chlorinated pesticides) in less polluted biomaterials requires specific
      strategies in controlling the blank in sample preparation. The procedure
      described here allows to decrease significantly the level of contamination during
      the clean-up step of fish oil. Solid-phase-extraction (SPE) on LiChrolut EN and
      normal phase HPLC in the normal- and the backflush-mode were used to reduce the
      amount of solvents needed and the analysis time compared to established clean-up
      procedures. With a certified reference material (BCR-CRM 349; Cod Liver Oil) the
      precision and effectiveness of the new method were validated. Recovery rates of
      the Internal Standards (PCB 103 and TCN) lay between 75% and 90% at the microg/kg
      lipid level. The quantitative analyses were carried out by high resolution gas
      chromatography with electron capture detector (HRGC-ECD).

PMID- 11220312
TI  - Surface characterization of commercial fibers for solid-phase microextraction and
      related problems in their application.
AB  - The surfaces of commercially available polydimethylsiloxane (PDMS) and Carboxen
      PDMS fibers for solid-phase microextraction (SPME) were investigated by optical
      and electron microscopy. Damage to the coating as well as contamination of new
      fibers and a highly variable number of pores in Carboxen-PDMS coatings were
      observed. Together with the contamination of the fibers during their use with
      metallic particles originating from the SPME fiber holder they are possible
      explanations for the problems encountered in the analysis of organolead,
      organotin and organosulfur compounds, such as artifact formation and low
      repeatability.

PMID- 11220313
TI  - Automized procedures for the determination of ozone and ammonia contents in air
      by using the chromatomembrane method for gas-liquid extraction.
AB  - Chromatomembrane cells (CMC) operate as unique manifolds for extraction and
      preconcentration procedures in computer controlled flow-injection-analysis (FIA).
      By coupling to an ion chromatograph and to a conductometer, respectively,
      instrumentation is obtained that allows the pretreatment and the detection of
      ozone- and ammonia-containing samples after absorption of the gaseous
      constituents of air inside a chromatomembrane cell. The analysis of air even in
      the presence of liquid aerosols is discussed.

PMID- 11220314
TI  - Transport processes through track-etch membrane filters in a reagent delivery
      cell.
AB  - A reagent delivery cell with a track-etch membrane filter for on-line dilution of
      concentrated salt solutions is described. The influence of several system
      parameters such as concentration of the stock solution, temperature.
      transmembrane pressure and the dependence on the diffusion coefficients of
      several salt components on the dilution was evaluated. As an application example,
      the use of the reagent delivery cell for on-line calibration of an atomic
      absorption spectrometer was studied. Fluxes through the membrane filter of 10 to
      50 nL mm(-2) min(-1) with relative standard deviations of 0.8% within a day and
      1.9% from day to day were achieved. The permeation experiments with the track
      etch membrane filter for the dilution of aqueous solutions of several chlorides
      and sodium salts confirm a diffusion process. Flux rates can be estimated
      mathematically using Fick's first law with an agreement between measured and
      calculated dilution factors within 86 to 113%.

PMID- 11220315
TI  - Spacer-modified stationary phases for anion chromatography: alkyl- and
      carbonylalkylspacers--a comparison.
AB  - A comparison of two separation columns for high-capacity anion chromatography is
      presented. The distinctive feature of both packing materials is the structure of
      the alkyl-chain (spacer-group) between the polymer-backbone and the functional
      group. All other parameters, e.g. exchange capacity, functionality and length of
      the spacer-arm, are identical. The retention behavior of the so-called standard
      anions is investigated on both columns under identical chromatographic conditions
      using an experimental design technique in the course of which the composition of
      the elution system applied is varied. The statistical treatment of the retention
      data offers the possibility to explain the different chromatographic behavior of
      both stationary phases, at least qualitatively.

PMID- 11220316
TI  - New stationary phase based on beta-cyclodextrin for normal-phase HPLC group
      separation of organic nitrates.
AB  - The synthesis of a beta-cyclodextrin-silica normal-phase (NP)-liquid
      chromatography (LC) stationary phase is reported. Silica gel was modified with (3
      bromopropyl)trimethoxysilane to a 3-bromopropyl-silica that was reacted with beta
      cyclodextrin, resulting in a beta-cyclodextrin-silica. To prove its usefulness in
      group-separation of organic nitrates among others, a mixture of three groups of
      organic nitrates was separated. The results are compared with those obtained on a
      nitrated polyol-silica that has recently been reported. The alkyl dinitrates
      exhibt higher retention relatively to alkyl mononitrates on the new phase. This
      allows to cut the LC fractions in a way that the alkyl mononitrates and
      phenylalkyl nitrates appear in one fraction and the dinitrates in a second one
      without any overlap of the two fractions.

PMID- 11220317
TI  - Influence of column geometry on the ion chromatographic separation of aluminium
      species.
AB  - The dependence of the degree of disintegration and therefore the applicability of
      ion chromatography for the speciation of aluminium fluoride species was examined
      for two different column geometries, a standard bore and a microbore column.
      Besides mathematical calculations, the temperature of the separation column was
      varied between -5 and 50 degrees C for the observation of a temperature-dependent
      decomposition of the species. All species were detected by UV photometry after
      post-column reaction with Tiron. The results showed that the disintegration of
      the higher coordinated Al fluoride species (AlFn with n >2) could be dramatically
      reduced utilizing the microbore technique. In contrast to the standard bore
      technique the column temperature is of minor importance. The agreement between
      speciation data experimentally determined by microbore chromatography and those
      calculated using stability constants is quite good. The standard bore technique
      showed bigger differences between calculated and experimentally determined
      species distributions.

PMID- 11220318
TI  - Comparison of sodium tetraethylborate and sodium tetra(n-propyl)borate as
      derivatization reagent for the speciation of organotin and organolead compounds
      in water samples.
AB  - The influence of pH on the propylation with sodium tetra(n-propyl)borate of butyl
      and phenyltins as well as for trimethyl- and triethyllead was investigated.
      Ethylation and propylation with tetraalkylborates were compared with regard to
      derivatization yields and figures of merit for organotin compounds in real water
      samples. Similar results for limit of detection (3-12 ng/L as tin),
      derivatization yield (40-100%) and relative standard deviation of the method (3
      10%) were achieved for derivatization with the two tetraalkylborates. Propylation
      is thus the preferred method for the simultaneous determination of
      environmentally relevant organotin and organolead compounds. The handling of the
      hygroscopic and air sensitive reagents NaBEt4 and NaBPr4 was simplified by
      dissolving them in tetrahydrofurane. The reagent solutions in tetrahydrofurane
      can be stored for at least one month at 4 degrees C in the dark without observing
      any decrease in the derivatization efficiency.

PMID- 11220319
TI  - Spectrophotometric and direct-reading methods for the analysis of gas phase
      peroxyacetic acid.
AB  - A new method for the determination of peroxyacetic acid (PAA) in gas phase
      samples is described. It is based on the oxidation of ABTS (2,2'-azino-bis(3
      ethylbenzothiazoline)-6-sulfonate) by PAA with formation of a radical cation
      which is characterized by four strong absorption maxima between 405 nm and 810
      nm. These allow for sensitive spectrophotometric determination of the peracid.
      The selectivity of the method towards hydrogen peroxide is strongly dependent on
      the sampling method used. Impinger sampling and sampling based on the use of
      coated solid sorbents (test tubes) was performed. Limits of detection are 10(-8)
      mol, limits of quantification are 5 x 10(-8) mol, the linear range consists of
      1.5 concentration decades in both cases. Using ABTS-coated test tubes above 1 x
      10(-7) mol, direct reading of the results is possible and may be used as rapid
      screening method for the PAA concentration.

PMID- 11220320
TI  - Analysis of halogenated C1/C2-trace compounds in marine atmosphere.
AB  - Patterns of volatile ECD-active substances in marine air at the ultra trace level
      were investigated. The protocol used carbon based adsorbents, thermodesorption
      and thick film HRGC-ECD together with a second ECD in line with oxygen doped make
      up gas. The latter ECD mode leads to an increased sensitivity for chloromethane.
      dichloromethane, and other important chlorinated substances with an otherwise low
      response at an ECD driven with oxygen-free nitrogen or argon/methane. The
      experimental set-up is easily to employ. Air samples were taken on two cruises of
      the German research vessel R/V "Polarstem" in the Atlantic Ocean to determine the
      background pattern of all volatile halocarbons from CF3Cl to CHI3 in marine air.

PMID- 11220321
TI  - Direct observation of the formation of aromatic pollutants in waste incineration
      flue gases by on-line REMPI-TOFMS laser mass spectrometry.
AB  - On-line REMPI-TOFMS laser mass spectrometry (Resonance Enhanced Multi-Photon
      Ionization-Time-Of-Flight Mass Spectrometry) was used to monitor combustion and
      pyrolysis byproducts from industrial combustion processes, including polycyclic
      aromatic hydrocarbons (PAH) and monochlorobenzene in the flue gas of an
      industrial 22 MW hazardous waste incineration plant. Sampling at different places
      in the flue gas stream revealed the complexity of the processes responsible for
      the formation of the different chemical species, while time resolved measurements
      depicted the emission dynamics.

PMID- 11220322
TI  - Analysis of the cancerogenic heterocyclic aromatic amines in fried meat.
AB  - Heterocyclic aromatic amines (HAs) are potential cancerogens found in heated meat
      and fish. From the precursors creatin/ine amino acids and carbohydrates the HAs
      are formed in very complex reactions at high temperatures. The concentration in
      meat is very low and the analysis especially the clean-up is critical due to the
      complex meat matrix. The concentrations in heated meat are in the low ng/g range.
      With increasing time of heating and the temperature the concentration of the HAs
      (MeIQx, IQ, 4,8-DiMeIQx, PhIP) can increase from 0 to 5 ng/g at 140 degrees C for
      15 min to 20 to 40 ng/g at 220 degrees C for 35 min. MeIQ is formed at a
      significant lower amount.

PMID- 11220323
TI  - Analysis of anthocyane glycosides in human serum.
AB  - Anthocyanins, natural food antioxidants, can be identified in human blood plasma
      using a restricted access phase for removal of the proteins and enrichment of the
      anthocyanins. In preliminary studies the spray dried elderberry juice was shown
      to have antioxidant activities in vitro. From the four known anthocyanins present
      in elderberry (Sambucus nigra) the two main components could be analysed
      quantitatively enabling their analysis in blood. Using a restricted access phase
      and a column switching set-up the injection of high volumes of concentrated
      protein solutions is possible. Additional, by using high injection volumes the
      sensitivity is increased due to a concentration of the analytes on the restricted
      access phase. The limit of quantification reached was 0.5 ng/mL. In this
      experiment the maximum concentration in blood (35 mg/mL) was observed after 1 h
      with a quick decay.

PMID- 11220324
TI  - Quantification of beta-trace protein and detection of transferrin isoforms in
      mixtures of cerebrospinal fluid and blood serum as models of rhinorrhea and
      otorrhea diagnosis.
AB  - Different mixtures from a serum pool and a cerebrospinal fluid (CSF) pool were
      used as models to study CSF contamination in secretions by determining two CSF
      specific proteins: beta-trace protein (beta-TP) and the asialo-transferrin (a-Tf)
      band which was detected by isoelectric focusing (IEF) with Tf specific
      immunofixation. Beta-TP and total Tf were measured immunonephelometrically.
      Secretion/serum ratios of beta-TP content > 2.0 indicated CSF contaminations with
      > or = 5% (v/v) CSF; this was confirmed by detecting the a-Tf band by IEF.
      Reliable a-Tf bands were only revealed with secretion/serum rations of Tf
      contents < 0.1, indicating an interference of major sialo-Tf fractions with the a
      TF band detection in the sample. For CSF detection in rhinorrhea and otorrhea,
      complementary use of beta-TP assay and a-Tf assay is recommended.
      Preanalytically, dilution or concentration of the sample as well as denaturation
      of Tf and beta-TP should be prevented by optimizing sample collection.

PMID- 11220326
TI  - Determination of endogenous and exogenous estrogens in effluents from sewage
      treatment plants at the ng/L-level.
AB  - An analytical method for the determination of the major endogenous and exogenous
      estrogenic steriods in effluent water samples of sewage treatment plants (STPs)
      with a LOQ down to 1 ng/L and below has been developed. The exogenous estrogen
      17alpha-ethynylestradiol, frequently used as estrogenic component in oral
      contraceptives, and the endogenous estrogen 17beta-estradiol show the highest
      estrogenic potential, therefore they were part of our target compounds. In
      addition, the content of the synthetic gestagen levonorgestrel, also often
      administered in oral contraceptives, was determined. A solid-phase extraction
      system for high volume sampling of water up to 25 L was implemented. Two types of
      adsorbent, Amberlite XAD 2 and a mixture of LiChrolut EN/Bondesil C-18,
      respectively, were tested for their extraction efficiency of these polar
      analytes. Recovery rates with LiChrolut EN/Bondesil C-18 ranged up to 94%,
      whereas sampling on XAD 2 led only to poor recoveries below 40%. After a liquid
      chromatographic clean-up step on silicagel the steroids were converted into their
      trimethylsilyl-ethers by the reaction with MSTFA/TMSI (N-methyl-N-trimethylsilyl
      2,2,2-trifluoroacetamide, trimethylsilyliodide) and were then determined by
      HRGC/MS in the selected ion mode. A limit of quantification over the whole
      procedure of at least 1 ng/L was reached for all analytes. In several effluent
      samples the input of estrogens by the STP of the cities Ulm and New Ulm into the
      river Danube was characterised. The concentrations commonly found ranged from 1
      ng/L up to 13 ng/L, depending on the respective steroid.

PMID- 11220325
TI  - Comparison of ion chromatographic methods based on conductivity detection, post
      column-reaction and on-line-coupling IC-ICP-MS for the determination of bromate.
AB  - An established method for the determination of the disinfection by-product
      bromate is ion chromatography (IC). This paper presents a comparison of three IC
      methods based on either conductivity detection (IC-CD), a post-column-reaction
      (IC-PCR-VIS) or the on-line-coupling with inductively coupled plasma mass
      spectrometry (IC-ICP-MS). Main characteristics of the methods such as method
      detection limits (MDL), time of analysis and sample pretreatment are compared and
      applicability for routine analysis is critically discussed. The most sensitive
      and rugged method is IC-ICP-MS, followed by IC-PCR-VIS. The photometric detection
      is subject to a minor interference in real world samples, presumably caused by
      carbonate. The lowest sensitivity is shown by the IC-CD method as slowest method
      compared, which, in addition, requires a sample pretreatment. The highest amount
      of information is delivered by IC-PCR-VIS, which allows the simultaneous
      determination of the seven standard anions and bromate.

PMID- 11220327
TI  - Determination of acetaldehyde in tobacco smoke using N-methyl-4-hydrazino-7
      nitrobenzofurazan and liquid chromatography/mass spectrometry.
AB  - A liquid chromatography/mass spectrometry (LC/MS) method for the determination of
      carbonyl compounds based on derivatization with N-methyl-4-hydrazino-7
      nitrobenzofurazan (MNBDH) has been developed. Atmospheric pressure chemical
      ionization (APCI) in the positive mode proved the most versatile ionization
      technique for MNBD-hydrazones. APCI/MS spectra were recorded and the detection
      limits were determined for [M+H]+, 13C2 acetaldehyde MNBD-hydrazone has been
      synthesized and characterized. It is applied as internal standard for the
      quantification of acetaldehyde. Tobacco smoke has been investigated concerning
      its carbonyl content. Acetaldehyde was identified as main product and quantified
      by LC/MS using internal standardization. The result is in good agreement to
      quantification data obtained with UV/vis detection.

PMID- 11220328
TI  - Investigating the potential of high-performance liquid chromatography with
      atmospheric pressure chemical ionization-mass spectrometry as an alternative
      method for the speciation analysis of organotin compounds.
AB  - Liquid chromatography with atmospheric pressure chemical ionization-mass
      spectrometry (LC-APCI-MS) was applied for the determination of butyl- and
      phenyltin compounds. Chromatography was performed on a 30 x 2 mm, 3 microm C18
      column, enabling the separation of mono-, di- and trisubstituted butyl- and
      phenyltin compounds in less than 10 min using a water/1% trifluoroacetic
      acid/methanol gradient. While satisfactory retention and resolution is achieved
      for the di- and trisubstituted butyl- and phenyltin compounds, monobutyltin and
      monophenyltin cannot be resolved chromatographically. Depending on the parameter
      values of the interface, APCI-MS detection allows both specific detection of the
      molecular ion or cluster ion at low to intermediate fragmentor voltages or quasi
      element specific detection of the Sn+ ion released from the organotin compounds
      at high fragmentor voltages. The sensitivity of MS detection is similar for butyl
      and phenyltin compounds, but varies largely from mono- to trisubstituted
      organotin compounds with tributyl- and triphenyltin being the most sensitively
      detectable compounds. Detection limits are in the 20-65 pg (abs.) range in SIM
      mode and in the 750-2000 pg (abs.) range in the scan mode for tributyl- and
      triphenyltin and for dibutyl- and diphenyltin, respectively. Monobutyl- and
      monophenyltin can be detected with much lower sensitivity which, together with
      their unfavorable chromatographic behavior, accounts for the fact that they
      cannot be analyzed at environmentally relevant concentrations. Although LC-APCI
      MS is generally less sensitive than comparable GC methods, it is applicable to
      the analysis of environmental samples as demonstrated by the analysis of the PACS
      2 sediment certified reference material. Although the derivatization of the ionic
      organotin compounds, which particularly in real samples is a potential source of
      error, is circumvented when LC-APCI-MS is used, the extraction step is still
      critical and may lead to underestimation when quantitation is not done by the
      method of standard addition.

PMID- 11220329
TI  - On-line and in-situ detection of polycyclic aromatic hydrocarbons (PAH) on
      aerosols via thermodesorption and laser-induced fluorescence spectroscopy.
AB  - A fiber optical sensor system for the determination of polycyclic aromatic
      hydrocarbons (PAH) on aerosols by laser-induced, time-resolved fluorescence is
      combined with a thermodesorption device. The sensor system is based on an aerosol
      flow cell, which is fibre-optically coupled to a pulsed nitrogen laser for
      excitation and the detection system. Time-resolved fluorescence emission spectra
      are detected by a monochromator equipped with a photomultiplier and a fast
      digital storage oscilloscope. The analytical figures of merit of the
      thermodenuder are reported for benzo[a]pyrene, benzo[b]fluoranthene, and
      benzo[ghi]-perylene on ultrafine soot and NaCl aerosols. By thermodesorption of
      the PAH, problems due to quenching of the PAH fluorescence by the bulk aerosol
      material or excimer formation on the aerosol surface were avoided. For the PAH
      under study, the sensitivity was improved considerably and detection limits
      between 110 and 850 ng m(-3) were attained, while a response time of 2-3 min was
      achieved with the thermodenuder. A calibration for PAH on ultrafine soot and NaCl
      aerosols was established independent of the aerosol substrate.

PMID- 11220330
TI  - Mercury as a Global Pollutant--the fifth international conference.

PMID- 11220331
TI  - Assessing the contribution of natural sources to the global mercury cycle: the
      importance of intercomparing dynamic flux measurements.
AB  - In order to constrain the contribution of natural sources of mercury to the
      global atmospheric cycle we need to: 1. assess the methods used to measure
      mercury flux, 2. characterize those factors most important in controlling
      emissions, 3. develop a database of emissions from representative locations, and
      4. develop a means of scaling up measured emissions to estimate fluxes on a
      regional basis. This paper describes how an international multi-collaborator
      project, the Nevada SToRMS Project, held September 1997 in Reno, Nevada, USA,
      contributed to our ability to constrain natural source mercury emissions. This
      study entailed a field intercomparison of those methods typically applied to
      measure mercury flux from substrate combined with evening workshops and round
      table discussions. The project was unique in that it focused on assessing our
      ability to measure the flux of an environmental contaminant. This is more
      difficult than measurement of the concentration of a contaminant because of the
      number and nature of the variables which influence the field flux measurements,
      including experimental design, spatial heterogeneity, and temporally changing
      environmental conditions. As a result of the Nevada SToRMS Project, rapid and
      significant advances in our understanding of how to constrain emission fluxes
      from large areas of mercury enrichment were realized. Because this
      intercomparison was a multi-investigator project, the results and implications of
      the project have been broadly circulated. The sincere scientific collaboration
      that evolved amongst those working on the study has led to significant
      advancements in our understanding of the fate and transport of mercury in the
      environment.

PMID- 11220332
TI  - Improved determination of gaseous divalent mercury in ambient air using KCl
      coated denuders.
AB  - An improved method for the determination of gaseous divalent mercury (GDM) in
      ambient air using KCl coated denuders has been developed and tested. GDM
      collected in the KCl coated denuders can be quantitatively desorbed at 450
      degrees C in 10 min. After being complete thermally reduced to Hg0 at 900 degrees
      C, all mercury released from the denuder is pre-concentrated on the analytical Au
      trap, and detected by cold vapor atomic fluorescence spectrometry (CVAFS). The
      absolute detection limit of the method is less than 3 pg. Preliminary data of GDM
      concentration in ambient air from different sampling stations show that GDM
      concentrations in the urban air of Goteborg are much higher than in rural air
      (Rorvik and Sasetta), which indicates the anthropogenic origin of GDM.

PMID- 11220333
TI  - Mercury measurements in ambient air near natural gas processing facilities.
AB  - Natural gas from gas fields around the globe often contains mercury, along with a
      large number of other harmful substances (CO2, H2S, RSH, COS, etc). Mercury's
      potentially harmful effect on humans and on the ecological system as a whole as
      well as the technological risk regarding very sophisticated and expensive process
      equipment and catalysts make its removal imperative. There is a need for the
      highest efficiency for mercury removal and for permanent improvement and
      enhancement of technological and control procedures, including analytical
      instruments and measurements. Mercury concentration measurements in the ambient
      air performed during natural gas processing confirm that the design of the system
      at the Molve gas plant is adequate to meet the mercury removal objectives. The
      obtained results also illustrate in an excellent way the use of the portable
      instrument to identify and prevent potential mercury generated hazards linked to
      specific industrial processes.

PMID- 11220335
TI  - Analysis and stability of mercury speciation in petroleum hydrocarbons.
AB  - Raw petroleum and natural gas often contain high concentrations of mercury, which
      can be damaging to the metal components of production facilities, as well as to
      the environment. Various Hg species have different properties in terms of
      mobility, reactivity and bioavailability. Thus, for cost-effective decisions
      regarding plant design, Hg extraction, and pollution control, speciation
      information must be available at the production facility. In this paper, a
      simple, wet chemical speciation method, which provides data on Hg(o), dissolved
      and particulate total Hg, Hg(II), and methyl Hg is presented. The method
      incorporates species-specific extraction and separation procedures, followed by
      cold vapor atomic fluorescence spectrometry (CVAFS). For each species, detection
      limits of approximately 0.1 ng/g were obtained. Storage experiments in various
      containers showed that organo-mercury species were stable for at least 30 days in
      all containers except those made of polyethylene; and Hg(o) was stable in all
      containers except those made of stainless steel or polyethylene. Hg(II) was
      rapidly lost from all containers except those made of aluminum, which rapidly
      converted it to Hg(o), which was stable. In general, most of the total Hg in
      petroleum products was particulate Hg, followed by dissolved Hg(II) and Hg(o).
      Sub-ng/g concentrations of methyl-Hg were observed in most samples.

PMID- 11220334
TI  - Clean conditions for the determination of ultra-low levels of mercury in ice and
      snow samples.
AB  - Laboratory facilities and methods are presented for the determination of ultra
      low levels of mercury (Hg) in ice and snow samples originating from polar ice
      caps or temperate regions. Special emphasis will be given to the presentation of
      the clean laboratory and the cleaning procedures. The laboratory is pressurized
      with air filtered through high efficiency particle filters. This first filtration
      is not enough to get rid of contamination by Hg in air. Experiments are conducted
      in a clean bench, especially built for Hg analysis, equipped with both particle
      filter and activated charcoal filter. It allows to obtain very low levels of
      atmospheric Hg contamination. Ultrapure water is produced for cleaning all the
      plastic containers that will be used for ice and snow samples and also for the
      dilution of the standards. Hg content in laboratory water is about 0.08+/-0.02
      pg/g. A Teflon system has been developed for the determination of Hg in ice and
      snow samples based on Hg(II) reduction to Hg(0) with a SnCl2/HNO3 solution
      followed by the measurement of gaseous Hg(0) with a Hg analyzer GARDIS 1A+ based
      on the Cold Vapor Atomic Absorption Spectroscopy method. Blank determination is
      discussed.

PMID- 11220336
TI  - Gold electrodes from recordable CDs for mercury quantification by flow injection
      analysis.
AB  - The development of a new methodology for the construction of very efficient flow
      cells for mercury detection by potentiometric stripping analysis, employing the
      thin gold layer of recordable CDs as working electrode is reported. This new
      source of electrodes (CDtrodes) show very attractive performance, similar to that
      obtained with commercial gold electrodes, with superior versatility. The low cost
      of this new source of "gold electrodes" allows a frequent replacement of the
      electrode, avoiding cumbersome clean-up treatments. Various experimental
      parameters have been optimized to yield low detection limits (0.25 ng/mL of
      mercury for 5 min deposition at 0.3 V) and good precision (standard deviation of
      1.9% was obtained for 15 repetitive measurements using 10 ng/mL of mercury).
      Standard curves were found to be linear over the range of 0.5-100 microg L(-1) of
      mercury. The flow cells developed were used for the quantification of mercury in
      oceanic and tap water.

PMID- 11220337
TI  - Analytical validity of the determination of mercury in whole blood and urine-
      results of the German external assurance programme for toxicological analysis in
      biological materials.
AB  - The determination of mercury concentrations in blood and urine is currently the
      best way of monitoring individual uptake of organic and inorganic mercury. In
      Germany these determinations must be carried out under the conditions of an
      external quality assurance programme. The German performance evaluation, based on
      reference values established by reference laboratories yields success rates in
      percent for the participants in the intercomparison programme of about 60%. A
      Canadian evaluation system based on two evaluations scores, yields success rates
      of 25-50% for "good performance" and of 65-80% for "acceptable performance". The
      determination of mercury in blood and urine is at present not carried out with
      the necessary reliability.

PMID- 11220338
TI  - A methodological study of mercury speciation using dogfish liver CRM (DOLT-2).
AB  - The purpose of the study was to optimise analytical methods for determination of
      the chemical speciation of mercury in studies of protective mechanisms of
      selenium. Optimisation of the methods was performed using CRM DOLT-2 (Dogfish
      liver), both in its original form and after separation of various fractions. The
      sample was homogenised with 10 mM Tris-HCl buffer (pH 7.6) and ultracentrifuged.
      The soluble phase obtained was applied to a size exclusion chromatography column
      (Sephadex G-75 column) for separation of various protein fractions. Total mercury
      (total Hg), monomethyl mercury (MeHg) and selenium (Se) were determined in whole
      dogfish liver tissue and its soluble and insoluble phases (pellet). Different
      approaches for determination of total Hg and MeHg were compared. Simultaneous
      determination of MeHg and inorganic mercury (Hg2+) was based on alkaline
      dissolution and/or acid leaching, followed by ethylation, room temperature
      precollection, isothermal gas chromatography (GC), pyrolysis and detection with
      cold vapour atomic fluorescence spectrometry (CVAFS). The sum of MeHg and Hg2+
      was compared to total Hg results obtained by acid digestion and CVAAS detection.
      The accuracy of MeHg determination was checked by its determination using acid
      leaching at room temperature, solvent extraction, back extraction into Milli-Q
      water, ethylation, GC and CVAFS detection. For the insoluble phase it is
      recommended to use solvent extraction for MeHg and acid digestion CVAAS for total
      Hg. For determination of MeHg and Hg2+ in the lyophilised sample and water
      soluble fractions containing low concentrations of mercury species, the
      simultaneous measurement of MeHg and Hg2+ after alkaline dissolution is the most
      appropriate method.

PMID- 11220339
TI  - A low-cost non instrumental method for semiquantitative determination of mercury
      in fish.
AB  - A non instrumental method for the semiquantitative determination of mercury in
      fish is described. The sample is acid digested and the mercury vapor released
      after chemical reduction with SnCl2. The mercury vapor is then collected on a
      detecting paper covered with an emulsion of Cu2I2, 3% carboxymethylcellulose and
      MgCl2 as moistener agent. The colored Cu2[HgI4] complex is formed and the color
      intensity is proportional to the mercury concentration in the original sample.
      Parameters such as sample mass/digestion solution volume ratio, emulsion
      composition, paper covering technique, carrier gas flow were investigated.
      Comparative studies using CVAAS and digital color analysis after scanning the
      papers confirmed the applicability of the method to real samples.

PMID- 11220340
TI  - Determination of methylmercury in fish tissue by gas chromatography with
      microwave-induced plasma atomic emission spectrometry after derivatization with
      sodium tetraphenylborate.
AB  - The detection of methylmercury species (MeHg) in fish tissue was investigated.
      Samples were digested with KOH-methanol and acidified prior to extraction with
      methylene chloride. MeHg was back-extracted from the organic phase into water. An
      aliquot of this aqueous solution (buffered to pH 5) was subjected to
      derivatization with sodium tetraphenylborate (NaBPh4) and then extracted with
      toluene. The organic phase containing MePhHg was injected into a gas
      chromatograph (GC) which is on-line with a microwave-induced plasma atomic
      emission spectrometer (MIP-AED). The quantification limit was about 0.6 microg/g
      and 0.1 microg/g of MeHg (as Hg) for 0.08 g of freeze-dried fish powder and 0.5 g
      of fresh samples, respectively. Two certified reference materials, CRM 464 (tuna
      fish) from Community Bureau of Reference-BCR and DORM-2 (dogfish muscle) from
      National Research Council Canada-NRC were selected for checking the accuracy of
      the method. This methodology was applied to the determination of MeHg in some
      kinds of fish from the Carmo river with alluvial gold recovery activities
      ("garimpos") in Mariana, Minas Gerais, Brazil.

PMID- 11220341
TI  - Discovery of a transalkylation mechanism--identification of ethylmercury+ at a
      tetraethyllead-contaminated site using sodiumtetrapropylborate, GC-AED and HPLC
      AFS.
AB  - Although organolead as a gasoline additive is banned in most countries,
      contamination by organolead compounds is still present. Little is known about
      transformation reactions of organolead compounds and especially transalkylation
      reactions with other metals. Laboratory experiments to clarify transalkylation
      reactions between organolead and inorganic mercury, and investigations of sites,
      where organolead compounds were emitted, are reported. Under laboratory
      conditions, inorganic mercury is ethylated to ethylmercury+ in presence of
      tetraethyllead. These transalkylations take place very fast and almost
      completely. In soil samples from an industrial site contaminated with organolead
      compounds and inorganic mercury, EtHg+ was clearly identified in high
      concentrations (up to 46 mg Hg/kg dw). Furthermore, methylmercury+ was found in
      concentrations up to 27 mg Hg/kg dw. It is the first time, that a transethylation
      of an organolead compound to an organomercurial compound in the environment is
      reported. It must be assumed, that this transalkylation takes place at sites,
      where organolead compounds occur and Hg2+ is available. Thus, it will be
      necessary to assess the risk of these sites.

PMID- 11220342
TI  - Optimization of HPLC-ICP-AES for the determination of arsenic species.
AB  - High performance liquid chromatography coupled to ICP-AES detection provides a
      rapid, reliable and sensitive method for arsenic speciation. The separation of
      As(III), As(V), DMA and MMA was achieved with ion exchange chromatography coupled
      to an axially-viewed sequential ICP-AES. After optimization of the
      chromatographic parameters (pH and concentration of the mobile phase), a careful
      study of the interface was conducted. Five nebulizers associated to three spray
      chambers were tested. Response of the ICP to each arsenic species was strongly
      affected by the selection of the nebulizer and spray chamber, however similar
      responses were obtained for each arsenic species. Best signal-to-noise ratios
      were obtained by using a microconcentric nebulizer and a cyclone spray chamber
      and did not affect the chromatographic resolution. Detection limits better than
      10 microg L(-1) were obtained for As(III), DMA, MMA and 20 microg L(-1) for
      As(V), which is a significant improvement over previously published results.

PMID- 11220343
TI  - Fiber-optic microsensor for high resolution pCO2 sensing in marine environment.
AB  - A fast responding fiber-optic microsensor for sensing pCO2 in marine sediments
      with high spatial resolution is presented. The tip diameter varies typically
      between 20 and 50 microm. In order to make the pH-indicator 8-hydroxypyrene-1,3,6
      trisulfonate soluble in the ethyl cellulose matrix, it was lipophilized with
      tetraoctylammonium as the counterion [HPTS-(TOA)4]. The microsensor was tuned to
      sense very low levels of dissolved carbon dioxide which are typically present in
      marine systems. The detection limit is 0.04 hPa pCO2 which corresponds to 60 ppb
      CO2 of dissolved carbon dioxide. A soluble Teflon derivative with an
      extraordinarily high gas permeability was chosen as a protective coating to
      eliminate interferences by ionic species like chloride or pH. Response times of
      less than 1 min were observed. The performance of the new microsensor is
      described with respect to reproducibility of the calibration curves, dynamic
      range, temperature behavior, long term stability and storage stability. The
      effect of hydrogen sulfide as an interferent, which is frequently present in
      anaerobic sediment layers, was studied in detail.

PMID- 11220344
TI  - Analysis of low molecular weight organic acids in water with capillary zone
      electrophoresis employing indirect photometric detection.
AB  - A capillary zone electrophoretic method for the analysis of low molecular weight
      carboxylic acids in water was developed. The application uses the chromophore
      trimellitic acid that allows for indirect photometric detection at 254 nm.
      Selectivity control by the addition of Ca2+ to the carrier electrolyte made
      possible a baseline resolved separation of 14 carboxylic acids. Good linearity
      and repeatability were obtained for both electrokinetic and hydrostatic injection
      modes. The usefulness of the method is demonstrated by the analysis of a snow
      sample.

PMID- 11220345
TI  - Determination of Al, Cu, Li and Mn in spruce seeds and plant reference materials
      by slurry sampling graphite furnace atomic absorption spectrometry.
AB  - An ultrasonic slurry sampling graphite furnace AAS method was developed for the
      determination of Al, Cu, Li and Mn in spruce seeds, NBS SRM 1575 pine needles and
      GBW CRM 07602 bush branches and leaves. The only sample preparation was grinding
      in a Mixer Mill before preparing a slurry by adding 0.14 mol/L nitric acid to a
      small sample aliquot. Cryogenic grinding was used for the spruce seeds to solve
      the problem of agglomerating during grinding at room temperature. A modified
      sample tray was applied allowing the use of both the commercial 1.5 mL vials and
      home-made 15 mL vials. With optimal conditions for ultrasonic agitation the
      homogeneity and particle size distributions in the slurries prepared in the two
      different vials were similar. Several aspects of the slurry sampling approach are
      discussed and data of important parameters are given, including the total number
      of particles injected into the graphite furnace, densities of the materials and
      percentage of analyte extracted into the liquid phase of the slurry. The density
      of the materials was determined by two methods; by using a Coulter particle
      analyser and by using a gravimetric method. The two methods gave similar accuracy
      and precision. The concentration ranges of the elements (in microg g(-1)) were:
      80-2100 for Al, 3-15 for Cu, 0.06-2.5 for Li and 50-700 for Mn. External
      calibration with aqueous standards was employed. Chemical modifiers were not
      found to be necessary. The relative standard deviations were in the range 1.7-7%.
      Analyses of the two certified plant reference materials confirmed the accuracy of
      the method. In addition no significant difference was found for analyses of
      digested and slurried spruce seeds. The detection limit was 10 ng g(-1) for Li
      and 170 ng g(-1) for Cu. The characteristic mass (area measurements) was 4.4 pg
      for Li and 11 pg for Cu. For Al and Mn less sensitive wavelengths were used.

PMID- 11220346
TI  - Cationic cyanine as a near-infrared fluorescent probe for the determination of
      nucleic acids.
AB  - A new method with a cationic near-IR cyanine as fluorescent probe was developed
      for the determination of nucleic acids. The near-IR cyanine shows maximum
      excitation and emission wavelengths at 765 and 790 nm, respectively, in aqueous
      solution. The method is based on the fluorescence decrease of near-IR cyanine in
      the presence of nucleic acids. Under optimal conditions, the ratio of
      fluorescence intensity in the absence and presence of nucleic acids was
      proportional to the concentration of nucleic acids over the range 0.10-1.2
      microg/mL for CT (calf thymus) DNA or SM (salmon sperm) DNA, and 0.10-1.6
      microg/mL for yeast RNA. The detection limits were 30 ng/mL for CT DNA, 25 ng/mL
      for SM DNA and 70 ng/mL for yeast RNA. The relative standard deviation (n = 6)
      was 2.1% for 500 ng/mL CT DNA, 2.4% for 500 ng/mL SM DNA and 2.7% for 500 ng/mL
      yeast RNA, respectively.

PMID- 11220347
TI  - New strategy for the determination of microcystins and diarrhetic shellfish
      poisoning (DSP) toxins, two potent phosphatases 1 and 2A inhibitors and tumor
      promoters.
AB  - A new analytical strategy was established to improve the determination and
      identification performance during analyses of microcystins and diarrhetic
      shellfish poisoning (DSP) toxins in different matrices. Automated high
      performance size exclusion chromatography (gel permeation chromatography, SEC)
      was applied for the clean-up of raw extracts from algae and mussel tissue
      containing either microcystins or DSP toxins. The cleaned raw extracts are well
      suited for the direct determination of microcystins and DSP toxins by HPLC/MS.
      The analyses of cleaned raw extracts containing microcystin by HPLC and UV/diode
      array detection (DAD) revealed chromatograms without interfering peaks.
      Additionally, methods for the identification of unknown microcystins and those
      not available as standards were developed and established. The proposed strategy
      is exemplarily demonstrated for the analyses of a natural algae community from a
      lake in Slowakia and a naturally contaminated mussel from Portugal.

PMID- 11220348
TI  - HOPE for diabetes in the new millennium. Heart Outcomes Prevention Evaluation.

PMID- 11220350
TI  - Sulphonylurea dose-response relationships: relation to clinical practice.

PMID- 11220349
TI  - Is there a role for endothelin antagonists in diabetic renal disease?

PMID- 11220351
TI  - Effects of inhibition of the renin-angiotensin system on the cardiovascular
      actions of insulin.

PMID- 11220352
TI  - Treatment of familial hypertriglyceridaemia with acarbose.
AB  - AIM: The evaluation of serum triglyceride levels has played an important role as
      an independent method for assessing the risk factor for coronary atherosclerosis.
      Fibrates, nicotinic acid, and omega-3 polyunsaturated fish oils are the
      pharmacological tools most used today against hypertriglyceridaemia. Acarbose is
      a pseudotetrasaccharide of microbial origin which exerts a competitive, selective
      and reversible inhibition of the intestinal alpha glucoside-hydrolase. We
      evaluated the efficacy and side-effects of acarbose as a new and alternative drug
      in the treatment of hypertriglyceridaemia in non-diabetic patients. METHODS: We
      enrolled 30 non-diabetic patients (18 men, 12 women; mean age 59.23 +/- 6.27
      years) without a family history of diabetes mellitus affected by familial
      hypertriglyceridaemia. The study covered a total period of 6.5 months: half of
      the patients were on 1.5 months of 'run in' diet only followed by 5 months of
      therapeutic diet plus acarbose; and half were on the therapeutic diet plus
      placebo. We gave 30 dividable pills to all patients. The administration was as
      follows: half a pill before lunch and half a pill before dinner while on the 'run
      in' diet. Fifteen patients (group A) took acarbose while the reminder (group B)
      took a placebo (50 mg of starch); these were distributed randomly and the test
      was double blind. The 20 weeks of study were divided in five 4-week periods.
      Fasting serum concentrations of total cholesterol, triglycerides, HDL-cholesterol
      (HDL-c), LDL-cholesterol (LDL-c) and glucose were determined at the starting of
      the study and after each treatment cycle. Glucose values were determined 2 h
      after lunch at the beginning of the study and at the end of the first, third and
      fifth month of treatment. All parameters assessed have been analysed by anova.
      RESULTS: The serum total cholesterol, LDL-c levels observed in the two groups did
      not change during the course of treatment. We observed a noteworthy progressive
      reduction of mean baseline triglyceride levels until the fourth month (p < 0.05)
      in acarbose-treated patients, with an increase in HDL-c (p < 0.008). CONCLUSIONS:
      We maintain that acarbose may be a useful therapeutic tool in addition to the
      diet in order to reduce triglyceride serum levels in non-diabetic patients.

PMID- 11220353
TI  - Factors associated with nocturnal hypoglycaemia among patients with type 2
      diabetes new to insulin therapy: experience with insulin lispro.
AB  - AIM: To identify factors associated with nocturnal hypoglycaemia in patients with
      type 2 diabetes who were new (< 2 months therapy) to insulin therapy. METHODS: A
      randomised, multicentre, 12-month parallel open-label study compared the clinical
      safety and efficacy of insulin lispro with regular human insulin. A cohort of
      North American patients completed a health-related quality of life (HRQOL)
      questionnaire which included questions related to the Health Beliefs Model (HBM).
      Measurements of hypoglycaemia rate and short-and long-term glucose control
      assessed clinical safety and efficacy. Three hundred and sixty-five type 2
      diabetic patients were enrolled in the study, and 195 North American patients
      completed the HRQOL questionnaire. RESULTS: After adjustment for demographic and
      psychological factors, the study population demonstrated lower nocturnal
      hypoglycaemia risk with insulin lispro. Higher nocturnal hypoglycaemia risk was
      associated with reduced body mass index (b.m.i.), lower age, and basal ultralente
      insulin therapy. The associated hypoglycaemia risk was lower with increased
      alcohol consumption. Patients who completed the HRQOL survey demonstrated higher
      risk for nocturnal hypoglycaemia if they: (1) had more troublesome hyperglycaemia
      symptoms in the week before starting insulin; (2) were more confident in their
      ability to control their diabetes; or (3) thought that diabetes control did not
      offer a clear health benefit. Nocturnal hypoglycaemia risk was inversely
      associated with fear of hypoglycaemia. CONCLUSIONS: Type 2 diabetic patients new
      to insulin therapy demonstrated lower risk of nocturnal hypoglycaemia with
      insulin lispro. Practitioners should consider patient characteristics and
      psychological factors that may predispose type 2 diabetes patients to nocturnal
      hypoglycaemia when initiating insulin therapy.

PMID- 11220354
TI  - Time-course changes in plasma endothelin-1 and its effects on the mesenteric
      arterial bed in streptozotocin-induced diabetic rats.
AB  - AIM: To examine the mechanisms underlying the elevated plasma endothelin-1 (ET-1)
      in diabetes and its vascular effects. RESULTS: Relationships between the plasma
      ET-1 level and the levels of other plasma constituents (glucose, cholesterol, and
      triglyceride) were found in 10-week streptozotocin (STZ)-induced diabetic rats.
      In contrast, at 1 week after the STZ injection only plasma ET-1 and glucose
      levels were elevated, suggesting that the hyperglycaemia might trigger the excess
      production of ET-1. Incubation with high glucose promoted the release of ET-1
      from the isolated mesenteric arterial bed. In STZ-induced diabetic rats, the
      maximum contractile response of the mesenteric arterial bed to ET-1 was
      significantly reduced, and the vasoconstriction and vasodilation induced by the
      ET(B)-receptor agonist IRL-1620 in this bed were significantly impaired. The
      vascular responses induced by these ET receptor agonists were restored to normal
      by chronic treatment of diabetic rats with insulin for 7 or 4 weeks. CONCLUSIONS:
      These results suggest: (1) that the marked increase in plasma glucose in STZ
      induced diabetic rats elevates the plasma ET-1; and (2) that the decreased
      contractile and vasodilator responses of the mesenteric arterial bed to ET-1
      receptor agonists may be due to desensitization of not only ET(A), but also ET(B)
      receptors, an effect secondary to the elevation of plasma ET-1.

PMID- 11220355
TI  - Dissociation between Fas expression and induction of apoptosis in human islets of
      Langerhans.
AB  - There is increasing evidence that inappropriate induction of apoptosis in
      pancreatic beta-cells may precede the development of type 1 diabetes in animal
      models and in man. One mechanism by which this has been proposed to occur
      involves up-regulation of the death receptor Fas on beta-cells, resulting in
      apoptosis of the Fas-bearing beta-cells upon ligation of the receptor. We have
      examined this hypothesis in isolated human islets of Langerhans and show that--in
      contrast to data obtained with rodent beta-cells--expression of Fas per se is not
      sufficient to allow induction of apoptosis upon addition of agonistic anti-Fas
      serum.

PMID- 11220356
TI  - Near-syncope and abnormal T waves in a young woman.

PMID- 11220357
TI  - Delirium: a barometer for quality of hospital care.

PMID- 11220358
TI  - Current management of rheumatoid arthritis.

PMID- 11220359
TI  - Eating disorders: 1. anorexia nervosa.
AB  - Although many of the factors that contribute to anorexia nervosa are not within
      the physician's control, early detection and prompt initiation of treatment may
      improve patient outcome. A high level of suspicion and a willingness to address
      the issue can serve our patients well.

PMID- 11220360
TI  - New perspectives on pneumococcal meningitis.

PMID- 11220361
TI  - Verapamil block of large-conductance Ca-activated K channels in rat aortic
      myocytes.
AB  - The effects of verapamil on the large conductance Ca-activated K (BK) channel
      from rat aortic smooth muscle cells were examined at the single channel level.
      Micromolar concentrations of verapamil produced a reversible flickering block of
      the BK channel activity. Kinetic analysis showed that verapamil decreased
      markedly the time constants of the open states, without any significant change in
      the time constants of the closed states. The appearance of an additional closed
      state-specifically, a nonconducting, open-blocked state--was also observed, whose
      time constant would reflect the mean residence time of verapamil on the channel.
      These observations are indicative of a state-dependent, open-channel block
      mechanism. Dedicated kinetic (group) analysis confirmed the state-dependent block
      exerted by verapamil. D600 (gallopamil), the methoxy derivative of verapamil, was
      also tested and found to exert a similar type of block, but with a higher
      affinity than verapamil. The permanently charged and membrane impermeant
      verapamil analogue D890 was used to address other important features of verapamil
      block, such as the sidedness of action and the location of the binding site on
      the channel protein. D890 induced a flickering block of BK channels similar to
      that observed with verapamil only when applied to the internal side of the
      membrane, indicating that D890 binds to a site accessible from the cytoplasmic
      side. Finally, the voltage dependence of D890 block was assessed. The
      experimental data fitted with a Langmuir equation incorporating the Woodhull
      model for charged blockers confirms that the D890-binding site is accessed from
      the internal mouth of the BK channel, and locates it approximately 40% of the
      membrane voltage drop along the permeation pathway.

PMID- 11220362
TI  - An integrated view of the kinetics of glucose and phosphate transport, and of
      glucose 6-phosphate transport and hydrolysis in intact rat liver microsomes.
AB  - The dynamics of the glucose 6-phosphatase system were investigated in intact rat
      liver microsomes using a fast-sampling, rapid-filtration apparatus. Glucose and
      phosphate transport followed single exponential kinetics, appeared to be
      homogeneous, was unaffected by unlabeled substrate concentrations up to 100 mM,
      proved insensitive to various potential inhibitors, and demonstrated similarly
      low energies of activation. The extent of tracer accumulation from glucose 6
      phosphate depended on which of the glucose or phosphate moieties was the labeled
      species in the parent molecule. The rates of tracer equilibration reflected those
      of glucose or phosphate transport but similar initial rates of uptake were
      observed for the glucose and phosphate products of hydrolysis. However, the
      latter accounted for only 12-13% of the steady-state rate of total glucose
      production. It is concluded that tracer uptake cannot represent substrate
      transport, that labeled glucose 6-phosphate at best represents a tiny fraction of
      the intramicrosomal glucose or phosphate pools, and that glucose 6-phosphate
      transport is not an obligatory prerequisite to its hydrolysis. The latter
      conclusion invalidates a major postulate of the substrate transport-catalytic
      unit concept but proves compatible with a conformational model whereby glucose 6
      phosphate transport and hydrolysis are tightly coupled processes while glucose
      and phosphate share, along with water and a variety of other organic and
      inorganic solutes, a common porelike structure for their transport through the
      microsomal membrane.

PMID- 11220363
TI  - Characterization of the ryanodine receptor-Ca2+ release channel from the thoracic
      tissues of the lepidopteran insect Heliothis virescens.
AB  - The existence of invertebrate forms of the RyR has recently been confirmed
      (Takeshima et al., 1994, Puente et al., 2000). However, information on the
      functional properties of this insect RyR is still limited. We report the
      functional characterization of a RyR from the thoracic muscle of H. virescens
      (Scott-Ward et al., 1997). A simple purification protocol produced membranes from
      homogenized prefrozen H. virescens thoracic muscle with a [3H]-ryanodine binding
      activity of 1.19 +/- 0.21 pmol/mg protein (mean +/- SE; n = 4). [3H]-Ryanodine
      binding to the H. virescens receptor was dependent on the ryanodine concentration
      in a hyperbolic fashion with a KD of 3.82 nM (n = 4). [3H]-ryanodine binding was
      dependent on [Ca2+] in a biphasic manner and was stimulated by 1 mM ATP.
      Millimolar caffeine did not stimulate [3H]-ryanodine binding to H. virescens
      membranes in the presence of either nanomolar or micromolar Ca2+. A protein of at
      least 400 KDa was recognized in H. virescens membrane proteins by a specific anti
      H. virescens RyR antibody. Discontinuous density sucrose gradient fractionation
      of microsomal membranes produced vesicles suitable for single-channel studies.
      Ca2+-sensitive, Ca2+-permeable channels were successfully inserted into
      artificial lipid bilayers from H. virescens membrane vesicles. The H. virescens
      RyR-channel displayed a Ca2+ conductance of approximately 110 pS and underwent a
      persistent and characteristic modification of ion handling and gating following
      addition of 100 nM ryanodine. The gating of H. virescens channels was sensitive
      to ATP and ruthenium red in a manner similar to mammalian RyR. This is the first
      report to describe the single channel and [3H]-ryanodine binding properties of a
      native insect RyR.

PMID- 11220364
TI  - Functional asymmetry of the sodium-D-glucose cotransporter expressed in yeast
      secretory vesicles.
AB  - The sodium-D-glucose cotransporter (SGLT1) was expressed in a yeast mutant strain
      NY 17 (sec6-4) that accumulates secretory vesicles at a nonpermissive temperature
      because of a block in the delivery of these vesicles to the plasma membrane. By
      differential centrifugation a microsomal fraction enriched in secretory vesicles
      was prepared with a high specific activity of the vanadate-sensitive H+-ATPase
      and invertase. In this membrane fraction one protein band of an apparent
      molecular weight of 55 kDa representing the nonglycosylated SGLT1 protein could
      be detected by immunochemical analysis. In addition, higher molecular weight
      protein bands probably representing dimers and aggregates were found. In
      transport studies with the microsomes D-glucose fluxes showed asymmetric
      properties: efflux experiments revealed the typical properties of the SGLT1 such
      as sodium dependence, inhibition by phlorizin and potential dependence. Influx of
      D-glucose showed no dependence on sodium and was not inhibited by phlorizin.
      Furthermore, the transporter exhibited a striking asymmetry with regard to the D
      glucose affinity and the sugar specificity. These results suggest that the
      orientation of the SGLT1 expressed in yeast secretory vesicles is, indeed,
      inverted with regard to its configuration in the plasma membrane of epithelial
      cells. Moreover, there are striking functional differences between the
      periplasmic and cytoplasmic face of the transporter.

PMID- 11220365
TI  - Cloning and function of the rat colonic epithelial K+ channel KVLQT1.
AB  - KVLQT1 (KCNQ1) is a voltage-gated K+ channel essential for repolarization of the
      heart action potential that is defective in cardiac arrhythmia. The channel is
      inhibited by the chromanol 293B, a compound that blocks cAMP-dependent
      electrolyte secretion in rat and human colon, therefore suggesting expression of
      a similar type of K+ channel in the colonic epithelium. We now report cloning and
      expression of KVLQT1 from rat colon. Overlapping clones identified by cDNA
      library screening were combined to a full length cDNA that shares high sequence
      homology to KVLQT1 cloned from other species. RT-PCR analysis of rat colonic
      musoca demonstrated expression of KVLQT1 in crypt cells and surface epithelium.
      Expression of rKVLQT1 in Xenopus oocytes induced a typical delayed activated K+
      current, that was further activated by increase of intracellular cAMP but not
      Ca2+ and that was blocked by the chromanol 293B. The same compound blocked a
      basolateral cAMP-activated K+ conductance in the colonic mucosal epithelium and
      inhibited whole cell K+ currents in patch-clamp experiments on isolated colonic
      crypts. We conclude that KVLQT1 is forming an important component of the
      basolateral cAMP-activated K+ conductance in the colonic epithelium and plays a
      crucial role in diseases like secretory diarrhea and cystic fibrosis.

PMID- 11220366
TI  - Cell surface area regulation and membrane tension.
AB  - The beautifully orchestrated regulation of cell shape and volume are central
      themes in cell biology and physiology. Though it is less well recognized, cell
      surface area regulation also constitutes a distinct task for cells. Maintaining
      an appropriate surface area is no automatic side effect of volume regulation or
      shape change. The issue of surface area regulation (SAR) would be moot if all
      cells resembled mammalian erythrocytes in being constrained to change shape and
      volume using existing surface membrane. But these enucleate cells are anomalies,
      possessing no endomembrane. Most cells use endomembrane to continually rework
      their plasma membrane, even while maintaining a given size or shape. This
      membrane traffic is intensively studied, generally with the emphasis on targeting
      and turnover of proteins and delivery of vesicle contents. But surface area (SA)
      homeostasis, including the controlled increase or decrease of SA, is another of
      the outcomes of trafficking. Our principal aims, then, are to highlight SAR as a
      discrete cellular task and to survey evidence for the idea that membrane tension
      is central to the task. Cells cannot directly "measure" their volume or SA, yet
      must regulate both. We posit that a homeostatic relationship exists between
      plasma membrane tension and plasma membrane area, which implies that cells detect
      and respond to deviations around a membrane tension set point. Maintenance of
      membrane strength during membrane turnover, a seldom-addressed aspect of SA
      dynamics, we examine in the context of SAR. SAR occurs in both animal and plant
      cells. The review shows the latter to be a continuing source of groundbreaking
      work on tension-sensitive SAR, but is principally slanted to animal cells.

PMID- 11220367
TI  - Review of medical prevention of vasospasm after aneurysmal subarachnoid
      hemorrhage: a problem of neurointensive care.
AB  - Cerebral vasospasm remains a devastating medical complication of aneurysmal
      subarachnoid hemorrhage (SAH). It is associated with high morbidity and mortality
      rates, even after the aneurysm has been secured surgically or radiologically. A
      great deal of experimental and clinical research has been conducted in an effort
      to find ways to prevent this complication. The literature includes extensive
      coverage of in vivo animal model studies of SAH and vasospasm. These experimental
      studies have contributed to tremendous advances in the understanding of the
      mechanisms leading to cerebral vasospasm. Most of the experimental settings,
      however, have demonstrated varying levels of ability to predict accurately what
      occurs in human SAH. Therefore, although animal models have been developed to
      test new therapies, most of the treatment effects have been shown to be less
      compelling when trials have been conducted in clinical settings. The
      interpretation of current literature is complicated further by the imprecise
      estimation of the incidence of cerebral vasospasm, which is due to various
      degrees of clinical expression, ranging from the absence of symptoms in the
      presence of increased blood flow velocities at transcranial Doppler or vessel
      diameter reduction at angiography to neurological manifestations of severe
      ischemic deficits. In addition, a change over time in the incidence pattern of
      human SAH and vasospasm, possibly related to improved surgical techniques and
      overall patient management, may have occurred. This topic review collects the
      relevant literature on clinical trials investigating prophylactic therapies for
      cerebral vasospasm in patients with aneurysmal SAH and emphasizes the need for
      large clinical trials to confirm the results derived from clinical experience. In
      addition, it points out some experimental therapies that may hold promise in
      future clinical trials to prevent the occurrence of vasospasm.

PMID- 11220368
TI  - Pallidotomy: a comparison of responders and nonresponders.
AB  - OBJECTIVE: We reviewed a prospective series of 32 unilateral, large-volume,
      microelectrode-guided posteroventral pallidotomies to determine the differences
      between responsive and nonresponsive patients. METHODS: Our patients underwent
      extensive pre- and postoperative evaluations. One year postoperatively, we
      correlated the outcomes of 25 patients with their histories, physical findings,
      neuropsychological assessments, and lesion characteristics to further understand
      the indications, limitations, and pitfalls of unilateral pallidotomy. Our group
      judged responsiveness by comparing the preoperative total Unified Parkinson's
      Disease Rating Scale off-state scores with those obtained 1 year postoperatively.
      A score indicating greater than 20% improvement at 1-year follow-up was rated a
      good outcome; improvement of greater than 40% was rated an excellent outcome.
      RESULTS: Although most patients sustained long-term benefits, some demonstrated
      little or no improvement. Patient and lesion factors influenced outcome. Younger
      age (<60 yr), tremor, unilateral predominance, L-dopa responsiveness, motor
      fluctuations with dyskinesia, and good lesion placement predicted a good response
      to unilateral pallidotomy. Advanced age (>70 yr), absence of tremor, increased
      duration of disease, reduced responsiveness to L-dopa, frontal behavioral
      changes, prominent apraxic phenomena, and improper lesion placement predicted a
      poor response. CONCLUSION: Unilateral, large-volume pallidotomy with precise
      lesion control provides long-lasting benefits for carefully selected patients.

PMID- 11220369
TI  - Quantitative and qualitative outcome measures after thalamic deep brain
      stimulation to treat disabling tremors.
AB  - OBJECTIVE: We studied outcome measures after unilateral and bilateral thalamic
      stimulation to treat disabling tremor resulting from essential tremor and
      Parkinson's disease. The surgical technique, qualitative and quantitative tremor
      assessments, stimulation parameters, locations of active electrodes,
      complications, and side effects are described and analyzed. METHODS: Forty-one
      patients with essential tremor or Parkinson's disease underwent implantation of
      56 thalamic stimulators. Preoperative qualitative and quantitative tremor
      measurements were compared with those obtained after unilateral and bilateral
      surgery, with activated and deactivated stimulators. Stimulation parameters and
      stimulation-related side effects were recorded, and outcome measures were
      statistically analyzed. RESULTS: Qualitative measurements demonstrated
      significant improvement of contralateral upper-limb (P < 0.001), lower-limb (P <
      0.01), and midline (P < 0.001) tremors after unilateral surgery. Ipsilateral arm
      tremor also improved (P < 0.01). No differences were observed with the Purdue
      pegboard task. Quantitative accelerometer measurements were correlated with
      qualitative assessments and confirmed improvements in contralateral resting (P <
      0.001) and postural (P < 0.01) tremors and ipsilateral postural tremor (P <
      0.05). Activities of daily living improved after unilateral surgery (P < 0.001)
      and additionally after bilateral surgery (P < 0.05). Adjustments of the pulse
      generator were required more frequently for tremor control than for amelioration
      of side effects. Bilateral thalamic stimulation caused more dysarthria and
      dysequilibrium than did unilateral stimulation. Stimulation-related side effects
      were reversible for all patients. Stimulation parameters did not change
      significantly with time. A significantly lower voltage and greater pulse width
      were used for patients with bilateral implants. CONCLUSION: Unilateral thalamic
      stimulation and bilateral thalamic stimulation are safe and effective procedures
      that produce qualitative and quantitative improvements in resting, postural, and
      kinetic tremor. Thalamic stimulation-related side effects are mild and
      reversible.

PMID- 11220370
TI  - Long-term tumor control and functional outcome in patients with cavernous sinus
      meningiomas treated by radiotherapy with or without previous surgery: is there an
      alternative to aggressive tumor removal?
AB  - OBJECTIVE: We report the long-term follow-up of 31 patients with cavernous sinus
      meningiomas who were treated either with surgery and radiotherapy (RT) or with RT
      alone. This retrospective review was undertaken to compare long-term efficacy and
      morbidity of RT with or without previous surgery versus complete, aggressive
      surgical removal. METHODS: Between 1980 and 1997, we performed a retrospective
      study of 31 patients harboring cavernous sinus meningiomas. The patient group
      comprised 25 women and 6 men. Patients were divided into two therapeutic
      categories: patients treated with surgery and RT (Group I, 17 patients) and
      patients treated with RT alone (Group II, 14 patients). Twenty-five patients (14
      in Group I and 11 in Group II) were treated for primary tumors, and 6 patients (3
      in Group I and 3 in Group II) were treated for recurrent disease. All three
      patients who were treated by RT alone at the time of recurrent disease had had
      previous surgery as initial treatment. Tumor control, treatment morbidity, and
      functional outcomes were evaluated for all patients. Twenty-eight patients were
      alive at the time of analysis, with a median follow-up period of 6.1 years.
      RESULTS: The progression-free survival rate was 92.8% at 10-year follow-up. Only
      two patients exhibited tumor progression after initial treatment. One of the
      patients who experienced tumor regrowth 4 years after surgery and RT benefited
      from additional conventional external beam radiation, and this patient exhibited
      no evidence of tumor progression at the last follow-up examination 6 years later.
      Two patients experienced cranial nerve impairment after surgery, and no patients
      developed late radiation toxicity. Follow-up status as measured by the Karnofsky
      Performance Scale deteriorated in 7% of patients and was the same or improved in
      93% of patients. CONCLUSION: The results of combined surgery and RT or RT alone
      indicated a high rate of tumor control and a low risk of complications. Complete
      aggressive surgical removal of cavernous sinus meningiomas is associated with an
      increased incidence of morbidity and mortality and does not demonstrate a better
      rate of tumor control. Conventional external beam radiation seems to be an
      efficient and safe initial or adjuvant treatment of these lesions, and these
      findings should serve as a basis for evaluating new alternatives such as
      radiosurgery or stereotactic RT.

PMID- 11220371
TI  - Secretory meningiomas: clinical and immunohistochemical observations.
AB  - OBJECTIVE: Secretory meningiomas are a rare histological subtype of these benign
      intracranial tumors. Few reports have been published regarding their tendency to
      develop peritumoral edema. METHODS: Between July 1994 and February 1999, 11
      patients with secretory meningiomas underwent operations in the Department of
      Neurosurgery, University of Kiel, Kiel, Germany. The clinical notes and
      radiological data (computed tomographic and magnetic resonance imaging scans)
      were reviewed. Immunohistochemistry was used to examine the expression of
      carcinoembryonic antigen and epithelial membrane antigen as well as progesterone
      and estrogen receptors. RESULTS: Secretory meningiomas were found in 11 (5%) of
      214 patients with intracranial meningiomas who were operated on in that period.
      All 11 patients were women. These patients' mean age was 65 years (range, 51-87
      yr). The localization of these tumors was at the convexity in seven patients, at
      the sphenoid ridge in two patients, and in the olfactory groove and petroclival
      region in one patient each. Two meningiomas had no edema surrounding them, two
      meningiomas had a small amount of edema, two had moderate edema, and five had
      severe edema. No recurrences were observed during the mean follow-up period of 26
      months (range, 8-65 mo). Immunohistochemically, all tumors contained
      pseudopsammoma bodies and reacted with epithelial membrane antigen and
      carcinoembryonic antigen. The MIB-1 antibody staining index showed a mean of 2%
      (range, 0-7%). CONCLUSION: Secretory meningiomas are rare tumors, and they are
      mainly localized at the frontal convexity and the sphenoid ridge. They are
      surrounded by more edema than usual. The preponderance of female patients with
      this presentation is striking. The expression of carcinoembryonic antigen and
      epithelial membrane antigen is a characteristic feature of secretory meningiomas.
      These meningiomas are also positive for progesterone receptors, which has been
      shown to be a good prognostic factor.

PMID- 11220372
TI  - Choroid plexus tumors in children: significance of stromal invasion.
AB  - OBJECTIVE: A group of choroid plexus tumors fit the cellular criteria for choroid
      plexus papilloma (CPP) except for invasion into the adjacent parenchyma, with
      associated loss of the normal villus architecture at the site of invasion. These
      tumors retain a benign cellular appearance. In the existing literature, it is
      unclear whether these tumors are classified as choroid plexus carcinomas or as
      CPPs. In our experience, although evidence of invasion is present, these tumors
      tend to exhibit benign behavior. We suggest that stromal invasion of this type
      remains consistent with a benign clinical course, although surgical results may
      demonstrate higher morbidity rates, given the invasive nature of the tumors. The
      failure to classify these tumors as CPPs may explain some of the variability in
      outcomes reported for various studies. METHODS: To study this question, clinical
      and histological data for children diagnosed with CPPs (either with or without
      stromal invasion) between 1985 and 1995 were examined. Only cases with pre- and
      postoperative magnetic resonance imaging data were included in the series.
      RESULTS: A total of 12 patients with CPPs were identified, with 4 tumors being
      notable for stromal invasion. After gross total tumor removal, none of the eight
      children with CPPs received adjuvant therapy at our institution; all are alive
      without evidence of tumor recurrence after surgical excision (mean, 108 mo). Of
      the four patients with stromal invasion, three underwent gross total resection.
      The one patient who underwent subtotal resection received chemotherapy at another
      facility. All four of these patients are alive, after a mean of 100 months of
      follow-up monitoring. CONCLUSION: It is recommended that CPPs with a benign
      cellular appearance but with evidence of local parenchymal invasion and loss of
      the normal villus architecture at the site of invasion be classified as CPPs.
      Patients with these tumors respond to surgical therapy alone, without the need
      for adjuvant treatment.

PMID- 11220373
TI  - Prodromal signs and clinical factors influencing outcome in patients with
      intraventricular rupture of purulent brain abscess.
AB  - OBJECTIVE: To elucidate prodromal signs and clinical factors influencing the
      prognosis in patients with intraventricular rupture of brain abscess (IVROBA) to
      prevent and manage this catastrophic condition. METHODS: In this study, 33
      consecutive patients with IVROBA diagnosed by computed tomography (CT) were
      treated. Basic and therapeutic parameters were evaluated as independent
      predictive factors of a poor prognosis by using univariate analysis. The factors
      were statistically analyzed based on the interval between initial symptoms and
      IVROBA. RESULTS: Patients with a good outcome were younger (<21 yr old) (P <
      0.003) and had fewer complications after IVROBA (P < 0.03). For the most part,
      these patients had undergone aspiration for brain abscess with ventricular
      drainage combined with the immediate administration of appropriate intravenous
      and intrathecal antibiotics (P < 0.02). In just a short time, abscesses located
      in the parieto-occipital region ruptured into the ventricle (P < 0.004), and
      those with nonsterile cultures (P < 0.01) developed into IVROBA. Just before
      IVROBA, patients had severe headaches, signs of meningeal irritation, and a
      rapidly deteriorating clinical condition within 10 days after the signs of
      meningeal irritation developed. A CT scan obtained before IVROBA ascertained
      localized enhancement of the ventricular wall adjacent to the abscess.
      CONCLUSION: Our findings suggest that signs of meningeal irritation and localized
      enhancement of the ventricular wall adjacent to the abscess, as observed on CT
      scans, preceded IVROBA. To decrease the mortality rate associated with purulent
      brain abscesses, signs forewarning of IVROBA should be recognized, and aggressive
      management of IVROBA should be initiated. Aggressive CT-guided aspiration of deep
      seated abscesses, particularly in the parieto-occipital region, at the time
      forewarning signs of IVROBA are observed lead to the prevention of IVROBA and an
      improvement in outcome.

PMID- 11220374
TI  - Utility of three-dimensional computed tomographic angiography for assessment of
      relationships between the vertebrobasilar system and the cranial base.
AB  - OBJECTIVE: The optimal surgical exposure for basilar tip aneurysms is dictated by
      the relationship of the basilar bifurcation to the cranial base. This study was
      designed to evaluate three-dimensional computed tomographic angiography as a
      means of obtaining detailed anatomic information on the basilar artery and the
      surrounding cranial base in individual patients before surgery. METHODS: We
      studied 30 patients using three-dimensional computed tomographic angiographic
      reconstructions from 1-mm computed tomographic slices. Detailed anatomic
      measurements were performed to define the relationship between the basilar artery
      and the cranial base. Particular attention was paid to the height of the dorsum
      sellae and its relationship to the basilar bifurcation. RESULTS: The heights of
      the basilar apex and the vertebrobasilar junction, relative to the cranial base,
      were extremely variable. Considerable asymmetries in the heights of the left and
      right posterior clinoid processes were identified; in one case, this difference
      was more than 1 cm (mean difference in height, 0.9 mm; range, 0-10.3 mm). The
      heights of the posterior clinoid processes above the sellar floor ranged from 5.8
      to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of
      the pterional/orbitozygomatic, middle fossa/ anterior petrosal, and presigmoid
      retrolabyrinthine approaches to an individual basilar bifurcation. We also
      estimated the amount of bone removal required and determined the operative
      distances via those approaches. CONCLUSION: Three-dimensional computed
      tomographic angiography is a useful tool for assessing critical anatomic
      relationships and represents an adjunct to conventional angiography in the
      planning of individualized, precisely tailored, cranial base approaches to the
      vertebrobasilar system.

PMID- 11220375
TI  - Effect of carotid endarterectomy on chronic ocular ischemic syndrome due to
      internal carotid artery stenosis.
AB  - OBJECTIVE: We evaluated the effect of carotid endarterectomy on chronic ocular
      ischemic syndrome due to internal carotid artery stenosis by use of data obtained
      from ophthalmic artery color Doppler flow imaging. METHODS: We examined 11
      patients with ocular ischemic syndrome due to internal carotid artery stenosis
      (>70% stenosis) who were being treated by carotid endarterectomy. Ophthalmic
      artery color Doppler flow imaging indicated ophthalmic artery flow direction and
      peak systolic flow velocity and was performed before and at 1 week, 1 month, and
      3 months after surgery. RESULTS: We assessed the ophthalmic arteries of 11
      patients via color Doppler flow imaging. Before undergoing carotid
      endarterectomy, five patients showed reversed ophthalmic artery flow. In the
      other six patients who experienced antegrade ophthalmic artery flow, the average
      peak systolic flow velocity was 0.09 +/- 0.05 m/s (mean +/- standard deviation).
      Preoperative reversed flow resolved in each patient 1 week after undergoing
      surgery. All patients showed antegrade ophthalmic artery flow. The average peak
      systolic flow velocity in the patients who had preoperative antegrade flow rose
      significantly, to 0.21 +/- 0.14 m/s (P < 0.05). There was no significant change
      as compared with findings at 1 week after surgery. During the follow-up period
      (mean, 32.4 mo), no patients complained of recurrent visual symptoms. At the end
      of the study period, visual acuity had improved in five patients and had not
      worsened in the other six patients. CONCLUSION: Carotid endarterectomy was
      effective for improving or preventing the progress of chronic ocular ischemia
      caused by internal carotid artery stenosis.

PMID- 11220376
TI  - Anterior lumbar microdiscectomy and interbody fusion for the treatment of
      recurrent disc herniation.
AB  - OBJECTIVE: To demonstrate the feasibility of anterior lumbar microdiscectomy in
      patients with recurrent, sequestered lumbar disc herniations. METHODS: Between
      1997 and 1999, six patients underwent a muscle-sparing "minilaparotomy" approach
      and subsequent microscopic anterior lumbar microdiscectomy and fragmentectomy for
      recurrent lumbar disc extrusions at L5-S1 (n = 4) or L4-L5 (n = 2). A
      contralateral distraction plug permitted ipsilateral discectomy under microscopic
      magnification. Effective resection of the extruded disc fragments was
      accomplished by opening the posterior longitudinal ligament. Interbody fusion was
      performed by placing cylindrical threaded titanium cages (n = 4) or threaded
      allograft bone dowels (n = 2). RESULTS: There were no complications, and blood
      loss was minimal. Follow-up magnetic resonance imaging revealed complete
      resection of all herniated disc material. Plain x-rays revealed excellent
      interbody cage position. Radicular pain and neurological deficits resolved in all
      six patients (mean follow-up, 14 mo). CONCLUSION: Anterior lumbar microdiscectomy
      with interbody fusion provides a viable alternative for the treatment of
      recurrent lumbar disc herniations. Recurrent herniated disc fragments can be
      removed completely under direct microscopic visualization, and interbody fusion
      can be performed in the same setting.

PMID- 11220377
TI  - Nuances of middle cerebral artery aneurysm microsurgery.
AB  - Middle cerebral artery aneurysms, a common source of subarachnoid hemorrhage,
      occur predominantly at the main bifurcation of the middle cerebral artery.
      Microsurgical clipping is the most effective treatment of these aneurysms because
      of their peripheral location, wide necks, and straightforward surgical anatomy.
      Despite the moderate technical requirements of this type of surgery, patients
      with ruptured aneurysms often have poor outcomes because of the high incidence of
      intracerebral hematomas. Although several different surgical approaches can be
      used, we favor a lateral-to-medial transsylvian approach for most aneurysms. This
      description of our surgical technique stresses minimizing retraction to avoid
      injury to the brain and preparing broad-based middle cerebral artery aneurysms
      for clipping. Management of outcomes when using these techniques also is
      presented.

PMID- 11220378
TI  - Transorbital keyhole approach to anterior communicating artery aneurysms.
AB  - OBJECTIVE: The transorbital keyhole approach to anterior communicating artery
      aneurysms was developed as a minimally invasive method for safe control of the
      anterior communicating artery complex. This approach does not necessitate
      resection of the gyrus rectus. METHODS: The technique is described in detail. The
      transorbital keyhole approach provides more ventral access than the supraorbital
      approaches, and the anterior communicating artery complex can be controlled by
      splitting the basal aspect of the interhemispheric fissure. RESULTS: Since late
      1998, the authors have used the transorbital keyhole approach routinely. During
      the initial experience with 33 patients, the only observed complication specific
      to this approach was transient diplopia in one patient. At follow-up examinations
      2 to 15 months after surgery, the cosmetic results were favorable as compared
      with those of standard pterional craniotomy. CONCLUSION: We have designed a
      small, custom-tailored approach to the anterior communicating artery complex for
      routine use. The small orbitocranial approach is a step toward the ideal of
      purely extra-axial safe control of anterior communicating artery aneurysms. The
      orbitocranial keyhole approach seems to be substantially better than the
      craniotomy, although it requires additional effort and time.

PMID- 11220379
TI  - Intratumoral arteriovenous shunting in malignant gliomas.
AB  - OBJECTIVE: Intratumoral arteriovenous shunting in glioblastomas has been
      suspected but neither proven nor quantified. METHODS: Using a previously
      described technique of selective intra-arterial intratumoral injection of 99mTc
      labeled microparticles (macroaggregated albumin), we measured the amount of
      radioactivity, by cerebral and pulmonary scintigraphy, in seven patients with
      malignant gliomas (six with glioblastomas and one with an anaplastic
      oligodendroglioma). The pulmonary shunt index was calculated as a percentage from
      the pulmonary/pulmonary plus cerebral radioactivity ratio. RESULTS: The results
      revealed a mean pulmonary shunt index of 67% (range, 47-89%), indicating that
      most of the microparticles injected into the tumor via the arterial route
      bypassed the tumor and reached the lungs. The measured arteriovenous shunting was
      greater when the injection was performed in an artery exclusively perfusing the
      tumor. CONCLUSION: Important intratumoral arteriovenous shunting exists in
      glioblastomas. The potential consequences of this finding for intra-arterial
      treatment strategies are discussed.

PMID- 11220380
TI  - Expression of endothelial cell angiogenesis receptors in human cerebrovascular
      malformations.
AB  - OBJECTIVE: To further understand the role of angiogenic growth factors in the
      development of cerebral cavernous malformations (CCMs) and arteriovenous
      malformations (AVMs), we investigated endothelial cell (EC) expression of
      receptors for vascular endothelial growth factor (VEGF) and angiopoietin systems
      in patients with surgically resected lesions. METHODS: Paraffin-embedded sections
      of five AVMs, CCMs, and normal control brain tissue samples were stained
      immunohistochemically with antibodies to von Willebrand factor and CD31 (to
      characterize ECs) and angiogenesis growth factor receptors Flt-1 (VEGF-R1), Flk-1
      (VEGF-R2), Tie-1, and Tie-2. We counted large and small vessels in each specimen,
      assessed each specimen's immunoexpression of each antigen, and analyzed
      differences between CCMs, AVMs, and the normal control brain tissue samples.
      RESULTS: The ECs of CCMs, AVMs, and normal control brain tissue samples expressed
      the von Willebrand factor uniformly, but the ECs of CCMs were largely negative
      for CD31 (P < 0.05). Flk-1, Flt-1, and Tie-2 were not expressed in the control
      brain tissue samples. The proportion of immunopositive vessels to VEGF receptors
      Flk-1 and Flt-1 was significantly greater in AVMs and CCMs than in the control
      brain tissue samples (P < 0.05). Tie-2 in AVMs and CCMs was expressed in a higher
      percentage of immunopositive vessels than in the control brain tissue samples,
      but the difference was not statistically significant. Tie-1 was expressed in rare
      vessels of all lesion types and control brain tissue samples. CONCLUSION: ECs of
      CCMs do not seem to express CD31 to the same extent that AVMs and normal brain
      tissue do. AVMs and CCMs show greater expression of VEGF receptors, but not of
      angiopoietin receptors, than normal brain tissue does.

PMID- 11220381
TI  - Transcranial Doppler identification of changing autoregulatory thresholds after
      autoregulatory impairment.
AB  - OBJECTIVE: Transcranial Doppler (TCD) flow velocity (FV) assessment may provide a
      useful index of autoregulatory impairment after severe head injury. It may define
      a therapeutic end point against which cerebral perfusion pressure (CPP) can be
      titrated. This study examines the relationship between cerebral blood flow (CBF)
      and TCD FV indices in a laboratory model before and after autoregulatory
      impairment. METHODS: CPP, CBF, and middle cerebral artery TCD FV were measured
      continuously in nine anesthetized and ventilated sheep. CPP was decreased by
      hemorrhagic hypotension. The process was repeated after impairment of
      autoregulation by cisternal infusion, which maintained CPP at 0 mm Hg for 15
      minutes. Points of significant change (i.e., breakpoints) from baseline values
      for each of the measured flow parameters were identified by using a ratio of
      variance technique. RESULTS: Before any significant change in CBF or systolic
      TCD, diastolic TCD FV decreased (mean breakpoint, 69 mm Hg; range, 56-78 mm Hg)
      as CPP was reduced. This divergence of diastolic and systolic TCD FV, which
      occurred before autoregulatory failure, was associated with an increasing TCD
      pulsatility index (mean breakpoint, 63 mm Hg; range, 53-70 mm Hg). At diastolic
      TCD FV congruent with 10 cm/s, systolic TCD FV (mean breakpoint, 48 mm Hg; range,
      46-53 mm Hg) and CBF (mean breakpoint, 49 mm Hg; range, 47-51 mm Hg) decreased
      rapidly, indicating autoregulatory failure. After autoregulatory impairment, the
      breakpoints for all four indices shifted to higher CPP values (mean, 16 mm Hg).
      CONCLUSION: TCD FV assessment identified two CPP thresholds of autoregulatory
      loss. Before autoregulatory failure, an earlier phase of autoregulatory
      disturbance may be detected by divergent systolic and diastolic TCD FVs. It is
      important to note that this phase may be detected before CBF decreases. These TCD
      FV breakpoints depend on the state of autoregulatory impairment and may provide
      potential targets for CPP-directed therapy.

PMID- 11220382
TI  - Carbon dioxide reactivity and pressure autoregulation of brain tissue oxygen.
AB  - OBJECTIVE: To describe the normal relationships between brain tissue oxygen
      tension (PbrO2) and physiological parameters of systemic blood pressure and CO2
      concentrations. METHODS: Licox Clark-type oxygen probes (GMS mbH, Kiel, Germany)
      were inserted in the frontal white matter of 12 swine maintained under general
      anesthesia with a 1.0 fraction of inspired oxygen (FiO2). In seven swine,
      alterations in end-tidal carbon dioxide (ET-CO2) concentration (range, 13-72 mm
      Hg) were induced via hyperventilation or instillation of CO2 into the ventilation
      circuit. In nine swine, mean arterial pressure (MAP) (range, 33-200 mm Hg) was
      altered; phenylephrine was used to induce hypertension, and a nitroprusside
      esmolol combination or systemic hemorrhage was used for hypotension. Quantitative
      cerebral blood flow (CBF) was measured in two animals by using a thermal
      diffusion probe. RESULTS: Mean baseline PbrO2 was 41.9 +/- 11.3 mm Hg. PbrO2
      varied linearly with changes in ET-CO2, ranging from 20 to 60 mm Hg (r2 = 0.70).
      The minimum PbrO2 with hypocarbia was 5.9 mm Hg, and the maximum PbrO2 with
      hypercarbia was 132.4 mm Hg. PbrO2 varied with MAP in a sigmoid fashion
      suggestive of pressure autoregulation between 60 and 150 mm Hg (r2 = 0.72). The
      minimum PbrO2 with hypotension was 1.4 mm Hg, and the maximum PbrO2 with
      hypertension was 97.2 mm Hg. In addition, CBF correlated linearly with PbrO2
      during CO2 reactivity testing (r2 = 0.84). CONCLUSION: In the uninjured brain,
      PbrO2 exhibits CO2 reactivity and pressure autoregulation. The relationship of
      PbrO2 with ET-CO2 and MAP appears to be similar to those historically established
      for CBF with ET-CO2 and MAP. This suggests that, under normal conditions, PbrO2
      is strongly influenced by factors that regulate CBF.

PMID- 11220383
TI  - The effect of streptozotocin-induced diabetes on the release of excitotoxic and
      other amino acids from the ischemic rat cerebral cortex.
AB  - OBJECTIVE: Hyperglycemic stroke results in increased neuronal damage, the exact
      mechanism of which is unknown. Lactic acidosis has been implicated; however,
      increases in the excitotoxic amino acid glutamate, which correlate with increased
      neuronal damage, may be the cause for the increased damage seen in hyperglycemic
      stroke. METHODS: Ten Sprague-Dawley rats were treated with streptozotocin (STZ;
      50 mg/kg), and 12 normoglycemic rats were used as controls. Using a four-vessel
      occlusion model, global ischemia was assessed at 5 to 7 days after treatment in
      five animals (acute STZ group) or at 4 to 6 weeks after treatment in five animals
      (chronic STZ group). The cortical cup model was used to collect superfusates
      under basal, ischemic, and reperfusion conditions and analyzed for nine different
      amino acids using high-performance liquid chromatography. RESULTS: Plasma glucose
      levels were significantly higher in the acute and chronic STZ groups as compared
      with the control group. Plasma lactate levels were higher in the acute STZ group
      as compared with the control or chronic STZ groups. Extracellular cortical
      glutamate levels were significantly reduced during reperfusion in the acute STZ
      group and during ischemia/reperfusion in the chronic STZ group as compared with
      the controls. Levels of extracellular gamma-aminobutyric acid were significantly
      reduced in the acute and chronic STZ groups as compared with the controls.
      CONCLUSION: A chronic state of hyperglycemia results in reduction in
      extracellular brain glutamate levels during ischemia/reperfusion and therefore
      does not appear to be responsible for the increased neuronal damage seen in
      diabetic stroke. Chronic hyperglycemia also causes decreased extracellular gamma
      aminobutyric acid levels, which, because of the loss of the inhibitory effects of
      this neurotransmitter, could contribute to the increased damage observed in
      hyperglycemic stroke.

PMID- 11220384
TI  - L-buthionine sulfoximine potentiates the antitumor effect of 4
      hydroperoxycyclophosphamide when administered locally in a rat glioma model.
AB  - OBJECTIVE: L-buthionine sulfoximine (BSO) inhibits glutathione synthesis and may
      modulate tumor resistance to some alkylating agents, but it has not been proven
      effective in the treatment of intracranial neoplasms. To evaluate this drug for
      the treatment of brain tumors, we studied the use of BSO for potentiating the
      antineoplastic effect of 4-hydroxyperoxycyclophosphamide (4-HC) in the rat 9L
      glioma model. METHODS: The survival of male Fischer 344 rats with intracranial 9L
      gliomas was measured after implantation of controlled-release polymers containing
      one of the following: no drug, BSO, 4-HC, or both BSO and 4-HC. The efficacy of
      intracranial 4-HC treatment was assessed with and without serial systemic
      intraperitoneal BSO injections. Tissue glutathione levels were measured in the
      brains, tumors, and livers of animals treated with intraperitoneal injections or
      local delivery of BSO. RESULTS: The median survival of animals treated with
      intracranial polymers containing 4-HC was 2.3 times greater than that of
      controls. This survival benefit was doubled by local delivery of BSO. In
      contrast, systemic BSO therapy did not improve survival time. In animals that
      were treated systemically, both liver and tumor glutathione levels were
      significantly lower than they were in control animals. In the locally treated
      animals, glutathione levels were reduced in the brain tumor but not in the liver.
      CONCLUSION: These results demonstrate that local but not systemic delivery of BSO
      enhances the antineoplastic effect of 4-HC in this rat 9L glioma model. In
      addition, because local delivery of BSO within the brain did not deplete
      glutathione levels systemically, this method of treatment may be safer than
      systemic administration of BSO.

PMID- 11220386
TI  - The fatal wound of Hector, according to a drawing by Peter Paul Rubens designed
      for tapestry weaving.
AB  - According to the Iliad(Chapter XXII, Verses 322-329), Hector, while fighting his
      last duel, was almost entirely protected by bronze armor, with only a small area
      "where the clavicle marks the boundary between neck and thorax" exposed. It was
      precisely into this area, "the shorter way to death," that Achilles thrust his
      lance. This fatal wound, although covering Hector with blood, allowed the victim
      to pronounce a few words. In designing the Story of Achilles, his fourth and last
      series of drawings especially designed for tapestry weaving, Rubens depicted
      Achilles stabbing Hector near the midline of his neck. There is evidence that
      Rubens was always well acquainted with the literary sources of his pictures. It
      is also likely that he became familiar with contemporary editions of the Iliad
      that were enhanced with commentaries. Realizing that the wound depicted in his
      original drawing should have prevented Hector from speaking, Rubens altered the
      scene, then showing the lance piercing the cervical vascular bundle. The careful
      scrutiny for literary accuracy that was typical of Rubens' artistic behavior did
      not prevent an additional minor imprecision in the final tapestry. Nevertheless,
      his outstanding expressive power enabled him to give form to a gigantic baroque
      representation of the death of Hector in masterly fashion.

PMID- 11220385
TI  - Elective trepanation for acute epidural hematoma by Dr. Nicolaes Tulp (1593
      1674).
AB  - The improved knowledge of human anatomy in the 16th century led to an increase in
      the practice of cranial trepanation in clinical cases, and detailed definitions
      of indications for performing this operation were provided by several authors. It
      was not until the 18th century, however, that detailed data on patient selection,
      decision making, and the postoperative course of this surgical procedure became
      available through individual case reports. In this historical context, a report
      written in 1641 by the Dutch physician Dr. Nicolaes Tulp is remarkable. This
      report, one of the first individual commentaries on the surgical treatment of an
      acute epidural hematoma, has not yet gained international recognition.

PMID- 11220387
TI  - Historical perspective on the Department of Neurosurgery at the Henry Ford
      Hospital.
AB  - The Henry Ford Hospital (HFH) was founded in 1915 as a philanthropic gift from
      Henry Ford, the automobile magnate and inventor of the Model T. The hospital and
      its organizational structure represented a nonsectarian facility that would
      provide care for all members of society. The system was patterned after the
      newest and most modern medical centers at the time in Europe, Canada, and the
      United States, including the German Krankenhauser, the Johns Hopkins Hospital,
      the Mayo Clinic, and the Peter Bent Brigham Hospital in Boston. The HFH grew into
      the Henry Ford Health System in the 1970s to 1990s, with the acquisition of other
      hospitals, the development of a multiple-region-based clinic system through
      southeastern Michigan, and the development of comprehensive, vertically
      integrated health care systems. The Division of Neurosurgery at HFH was
      established by Albert Crawford in 1926. The tradition of training residents in
      neurosurgery began in 1946, and the residency training program was accredited by
      the American Board of Neurosurgery in 1954. In 1970, the Division of Neurosurgery
      of the Department of Surgery was combined with the Division of Neurology to
      create the joint Department of Neurology and Neurosurgery. A separate Department
      of Neurosurgery was established in 1981. Four individuals have served as chairmen
      of the Department of Neurosurgery at HFH, i.e., Albert Crawford (1926-1952),
      Robert Knighton (1952-1978), James Ausman (1978-1991), and Mark Rosenblum (1992
      to the present). During the 1980s and 1990s, HFH evolved into the vertically
      integrated, regionally distributed Henry Ford Health System. Under the current
      direction of Dr. Rosenblum, the Department of Neurosurgery at HFH has grown to
      include 11 full-time neurosurgeons, 2 neuro-oncologists, and 3 investigators with
      Ph.D. degrees and has recently expanded into three additional hospitals in
      southeastern Michigan, paralleling the growth of the system. The faculty annually
      treats more than 2,000 cases in all neurosurgical subspecialties, ranging from
      neuro-oncological surgery, cranial base surgery, radiosurgery, cerebrovascular
      surgery, epilepsy surgery, treatment of movement disorders, pain and spasticity
      surgery, pediatric neurosurgery, and neurotrauma treatment to complex
      instrumentation of the spine. This article chronicles the history of the Henry
      Ford Health System and the Department of Neurosurgery, its research endeavors,
      and its residency training program.

PMID- 11220388
TI  - Primary intradural classic chondrosarcoma: case report and literature review.
AB  - OBJECTIVE AND IMPORTANCE: The exact origin of rare intradural chondrosarcomas
      remains obscure. We present a case report of an intradural classic chondrosarcoma
      (a very rare subtype of chondrosarcoma in this location), with a review of the
      literature, in an attempt to clarify the histogenesis of these tumors. CLINICAL
      PRESENTATION: A 48-year-old man presented with a 12-month history of progressive
      right hemiparesis. Computed tomography and magnetic resonance imaging
      demonstrated a left parietal space-occupying lesion. INTERVENTION: The patient
      underwent an image-guided, left parietal parasagittal craniotomy. An extrinsic
      tumor, which seemed to arise from the dura, was macroscopically removed. There
      was no bone involvement. The histological examination revealed a Grade II classic
      chondrosarcoma with tumor infiltration into the dura. Adjuvant radiotherapy was
      administered. CONCLUSION: Intradural chondrosarcomas are rare tumors, the
      majority of which are mesenchymal. Classic chondrosarcomas in this location are
      much rarer. Their histogenesis is uncertain. In this case, the origin seems to be
      from the dura. Because of the malignant potential of these tumors, radical
      extirpation whenever possible, followed by radiotherapy, is indicated.

PMID- 11220389
TI  - Malignant giant-cell tumor of the parietal bone: case report and review of the
      literature.
AB  - OBJECTIVE AND IMPORTANCE: Giant-cell tumors (GCTs) are primary bone tumors that
      involve long bones in 75 to 90% of patients. They seldom develop in the cranium
      and are very rare in patients older than 60 years of age. A GCT rarely occurs
      with Paget's disease; when it does, however, it is most commonly associated with
      the polyostotic form and tends to involve the craniofacial bones. Pagetic GCTs
      are less aggressive than GCTs that are not associated with Paget's disease.
      CLINICAL PRESENTATION: We report the case of an 81-year-old woman with a painless
      left parietal mass and asymptomatic monostotic parietal Paget's disease.
      INTERVENTION: Surgical resection was performed, and histological examination of
      the lesion demonstrated Paget's disease with a malignant GCT. An incidental, low
      grade, small-cell lymphocytic lymphoma also was noted. The patient experienced
      local recurrence of the malignant GCT and eventually died after developing
      pulmonary metastases of the malignant GCT. CONCLUSION: This case is the first
      reported example of a patient with a malignant GCT of the cranium associated with
      monostotic Paget's disease. It provides evidence that not all pagetic GCTs in the
      cranium are benign, as has been reported.

PMID- 11220390
TI  - Congenital reactive myofibroblastic tumor of the petrous bone: case report.
AB  - OBJECTIVE AND IMPORTANCE: Myofibroblastic tumors are members of a diverse
      spectrum of neoplastic and quasineoplastic lesions that occur most commonly
      during childhood and typically involve soft tissues. We present a case of a
      congenital reactive myofibroblastic tumor of the petrous bone (i.e., cranial
      fasciitis) that was successfully treated with surgical excision. CLINICAL
      PRESENTATION: A newborn girl with congenital right facial palsy and deafness was
      noted during imaging evaluation to have a large enhancing mass that was
      destroying the right petrous bone and extending into the posterior and middle
      cranial fossae. INTERVENTION: After embolization, an open biopsy was performed,
      which revealed a moderately cellular, spindle cell neoplasm without mitosis or
      necrosis, with scattered lymphocytes, eosinophils, and multinucleated giant
      cells. The spindle cells demonstrated strong immunoreactivity for vimentin,
      muscle-specific actin, and alpha-smooth muscle actin, with prominent reticulin
      staining between individual cells. Staining for CD68, a histiocyte marker, was
      positive within the multinucleated giant cells and many of the spindle cells;
      CD34, S-100, and desmin staining was absent. On the basis of these findings, the
      lesion was classified as a reactive myofibroblastic tumor, consistent with a
      cranial variant of nodular fasciitis. Because of the large size and significant
      mass effect of the tumor, a resection was performed several days later, using a
      combined supra- and infratentorial approach. Dense adherence of the mass to the
      walls of the sigmoid sinus and the carotid artery precluded complete resection
      without sacrifice of these vessels, which was not performed because of the known
      potential of these tumors to remain stable or regress after extensive subtotal
      resection. The presumed residual tumor subsequently regressed, and the patient
      has exhibited no detectable residual disease in 2 years of follow-up monitoring.
      CONCLUSION: Reactive myofibroblastic tumors of the calvarium are uncommon lesions
      that superficially resemble sarcomas. Recognition of this diagnostic entity is
      important, to avoid unnecessary treatment with intensive adjuvant therapy.
      Although the management of these tumors relies predominantly on surgical
      resection, surgical decision-making should take into account the fact that small
      areas of residual disease can regress spontaneously.

PMID- 11220392
TI  - Stereotactic radiosurgery for recurrent central neurocytoma: case report.
AB  - OBJECTIVE AND IMPORTANCE: Neurocytomas are typically benign tumors that have high
      local control rates after gross total resection. Nevertheless, tumor recurrence
      is possible, and some patients have aggressive tumors. CLINICAL PRESENTATION: A
      26-year-old woman had a recurrent, asymptomatic neurocytoma 3 years after gross
      total resection. INTERVENTION: The patient underwent stereotactic radiosurgery
      for the tumor recurrence. Thirty-four months later, the patient remained
      neurologically intact, and the tumor had decreased significantly in size.
      CONCLUSION: Radiosurgery may be a viable treatment option for patients with
      recurrent neurocytomas or for patients whose tumor resections were subtotal.

PMID- 11220391
TI  - Reversal of focal misery perfusion after intracranial angioplasty: case report.
AB  - OBJECTIVE AND IMPORTANCE: The presence of reduced blood flow and increased oxygen
      extraction fraction (OEF) (misery perfusion) in the hemisphere distal to an
      occluded carotid artery is a proven risk factor for subsequent stroke. Whether
      angioplasty of intracranial stenosis is sufficient to reverse this condition has
      not been documented. CLINICAL PRESENTATION: A 67-year-old man exhibited
      progressive right hemispheric ischemic symptoms despite maximal antiplatelet and
      antithrombotic therapy. Angiography demonstrated focal 80% stenosis of the
      supraclinoid segment of the ipsilateral internal carotid artery. TECHNIQUE: 15O
      positron emission tomographic measurements of cerebral blood flow and OEF were
      made before and after transfemoral percutaneous angioplasty. OEF values measured
      before angioplasty were elevated in the middle cerebral artery distal to the
      stenosis. Angioplasty reduced the degree of luminal stenosis to 40% (linear
      diameter). OEF values measured 36 hours after angioplasty were normal.
      CONCLUSION: Angioplasty of intracranial stenosis can restore normal cerebral
      blood flow and oxygen extraction, despite mild residual stenosis after the
      procedure. Hemodynamic measurements may be useful for the identification of
      patients with the greatest potential to benefit from angioplasty.

PMID- 11220394
TI  - Preservation of large bridging veins of the cranial base: technical note.
AB  - OBJECTIVE: Sacrifice of a bridging vein in the cranial base occasionally may
      cause significant postoperative morbidity. We report a simple method for
      preserving large bridging veins of the cranial base by reflecting the dura when a
      subtemporal or transsylvian approach is used. METHODS: In the subtemporal
      approach, when a larger bridging vein enters the dura attached to the bone of the
      temporal base before it empties into the dural sinus, the dura is dissected
      widely from the bone and is cut vertically toward the medial side of the temporal
      base in front of the entrance of the vein into the dura. The dura, which includes
      part of the entrance and interdural course of the vein, is reflected and
      retracted over the brain. In the transsylvian approach, when the bridging segment
      of the superficial sylvian vein becomes taut because of retraction of the
      temporal lobe, the dura is incised along the sphenoid ridge and is dissected and
      freed from the sphenoid bone. RESULTS AND CONCLUSION: This dura-reflecting
      technique facilitates brain retraction without exerting tension on the bridging
      vein of the cranial base and is expected to help avoid injury to bridging veins
      during neurosurgical procedures.

PMID- 11220393
TI  - Intraoperative reduction of locked facets in the cervical spine by use of a
      modified interlaminar spreader: technical note.
AB  - OBJECTIVE: Facet dislocations commonly require intraoperative reduction after
      closed reduction with traction has failed. Reduction should be performed in a
      gradual, controlled fashion to prevent additional inadvertent spinal cord
      compromise. METHODS: We describe a new technique for safe and simple dorsal
      reduction of facet dislocations by use of a modified interlaminar spreader. This
      technique requires only minimal controlled manipulation of the spine. RESULTS: We
      have used this technique in 52 consecutive patients with no complications or
      failures related to its use in open reduction. This technique increases the
      stability of the cervical spine after reduction because it limits bone removal
      from the facet joints. CONCLUSION: This technique provides a feasible and
      reliable approach to open reduction of cervical facet dislocations via the
      posterior approach.

PMID- 11220395
TI  - Temporalis muscle resuspension using titanium miniplates and screws: technical
      note.
AB  - OBJECTIVE: To describe the technique for and results of using titanium miniplates
      and screws for resuspension of the temporalis muscle after osseous detachment
      during cranial procedures requiring exposure of and access to the
      frontotemporoparietal region. METHODS: Thirty-four patients, who were being
      treated with various cranial procedures, underwent resuspension of the dissected
      temporalis muscle, using 1.5-mm or 1.3-mm titanium plates and screws, after bone
      flap replacement. RESULTS: The temporalis muscle was successfully and securely
      resuspended in all cases, using the plates and screws. There were no infections,
      muscle tears, dislodgement, fractures, or temporal hollowing in any of the cases.
      In four cases that required re-exploration, the muscle was observed to be rigidly
      fixated and scarred to the bone. CONCLUSION: The use of titanium plates and
      screws is a safe, simple, successful alternative for reattachment of temporalis
      muscles for patients undergoing cranial procedures.

PMID- 11220396
TI  - Effects of radiation on cerebral vasculature: a review.

PMID- 11220397
TI  - Cerebral infarction after neuroendoscopic third ventriculostomy: case report.

PMID- 11220398
TI  - Limits of intermittent jugular bulb oxygen saturation monitoring in the
      management of severe head trauma patients.

PMID- 11220399
TI  - Advanced surgical approach for selective amygdalohippocampectomy through
      neuronavigation.

PMID- 11220400
TI  - Program requirements for residency/fellowship education in neuroendovascular
      surgery/interventional neuroradiology: special report on graduate medical
      education.

PMID- 11220401
TI  - Methylmethacrylate insufficiently fixes deep brain stimulator lead position.

PMID- 11220402
TI  - Vitamin K in neonates: how to administer, when and to whom.
AB  - Vitamin K-dependent factors are lower in neonates than in adults, and these
      anomalies are more prevalent in preterm neonates and in breast-fed infants.
      Vitamin K deficiency can account for vitamin K deficiency bleeding (VKDB) which
      occurs in 3 forms--early, classic and late. Vitamin K should be administered to
      all neonates at birth or immediately afterwards. However, the protocols for
      administration (route of administration, dosage, number of doses) remain a
      subject of discussion. Oral administration of a single dose of vitamin K protects
      against classical and early VKDB, but is less effective than intramuscular (IM)
      prophylaxis for the prevention of late VKDB. Although an increased risk of solid
      tumour, associated vitamin K administration, can be definitively excluded, a low
      potential risk of lymphoblastic leukaemia in childhood can not be ruled out. For
      formula-fed neonates without risk of haemorrhage, a 2 mg oral dose of vitamin K
      at birth, followed by a second 2 mg oral dose between day 2 and 7, is probably
      sufficient to prevent VKDB. For infants who are exclusively or nearly exclusively
      breast-fed, weekly oral administration of 2mg (or 25 microg/day) vitamin K after
      the initial 2 oral doses is justified at completion of breast-feeding. For
      neonates at high risk of haemorrhage (premature, neonatal disease, birth
      asphyxia, difficult delivery, any illness which will delay feeding, known hepatic
      disease, maternal drugs inhibiting vitamin K activity), the first dose must be
      administered by the IM or slow intravenous route. Doses should be repeated,
      particularly in premature infants, by a route of administration decided for each
      dose according to the clinical state of the infant. For infants of mothers
      treated with drugs inhibiting vitamin K activity, antenatal maternal prophylaxis
      (10 to 20 mg/day orally for 15 to 30 days before delivery) prevents early VKDB.
      After neonatal prophylaxis, as for infants at high risk of haemorrhage, doses
      need to be repeated at a rate and route of administration decided for each dose,
      according to the clotting factor profile specific for each infant.

PMID- 11220403
TI  - The ethics of drug research in children.
AB  - The obligation of society to improve the welfare of its members requires the
      conduct of paediatric drug trials. Nevertheless, research activities must satisfy
      obligations to individual participants. The obligation to protect the welfare of
      children requires that nontherapeutic research procedures generally involve no
      more than minimal risk. It also requires that randomisation occurs only when the
      relative merits of therapeutic procedures remain unsettled among the relevant
      community of experts. The duty to respect the developing autonomy of children
      requires that they be included in decision-making about research participation in
      a manner consistent with the level of their decision-making capacity. However,
      when children lack mature decision-making capacities, the duty of parents to
      protect their welfare may properly constrain their choices. Justice requires that
      the benefits and burdens of research be distributed in a manner that assures
      equal opportunity for all children. Vulnerable children should receive special
      protection against the burdens of nontherapeutic research procedures. The
      benefits of participating in clinical trials should be available to all children
      with serious illnesses for which current treatment is unsatisfactory. Justice
      also requires that initiatives be undertaken to rectify current shortcomings in
      the scope of paediatric drug research. Striking an appropriate balance between
      obligations to conduct research and to protect the interests of participants is
      essential to the moral integrity of paediatric drug research.

PMID- 11220405
TI  - Caffeine citrate: a review of its use in apnoea of prematurity.
AB  - Apnoea of prematurity is a common condition in neonates born at less than 37
      weeks' gestational age; it affects approximately 90% of premature neonates
      weighing under 1000 g at birth, and 25% of infants with a birthweight of less
      than 2500 g. Caffeine, a methylxanthine which occurs naturally in many plants,
      has been used for over 20 years to treat apnoea of prematurity. In a recent
      double-blind, placebo-controlled trial, apnoea was eliminated or reduced by at
      least 50% in significantly more neonates receiving caffeine citrate as first-line
      treatment than those receiving placebo. In a nonblind trial, caffeine citrate was
      more effective at reducing apnoeic episodes when compared with neonates receiving
      no treatment. Caffeine as first-line treatment demonstrated similar efficacy to
      theophylline or aminophylline (theophylline ethylenediamine) in 4 small
      randomised studies. Caffeine citrate was generally well tolerated in short term
      clinical trials, with very few adverse events reported. Caffeine was associated
      with fewer adverse events than theophylline in randomised trials. No differences
      in the incidence of individual adverse events were reported between caffeine
      citrate and placebo in a double-blind, randomised trial. Long term tolerability
      data are not yet available. CONCLUSIONS: Caffeine citrate was generally well
      tolerated by neonates in clinical trials and it decreased the incidence of apnoea
      of prematurity compared with placebo. It has demonstrated similar efficacy to
      theophylline, but is generally better tolerated and has a wider therapeutic
      index. Caffeine citrate should, therefore, be considered the drug of choice when
      pharmacological treatment of apnoea of prematurity is required.

PMID- 11220404
TI  - Immunosuppressive drugs in paediatric liver transplantation.
AB  - Orthotopic liver transplantation is established treatment for children with acute
      and chronic liver failure. Despite advances in pre- and postoperative management,
      innovative surgical techniques and new immunosuppressive drugs, acute and chronic
      rejection remains a problem. In addition, well established adverse effects of
      commonly used immunosuppressive drugs are no longer accept able. More potent, but
      less toxic, immunosuppressive agents have been developed and some novel compounds
      are now entering routine practice. Cyclosporin was the cornerstone of
      immunosuppressive therapy until the introduction of its novel pharmaceutical form
      (Neoral) with improved bioavailability, lower inter- and intraindividual
      pharmacokinetic variability and improved graft survival. Recently, tacrolimus, a
      macrolide drug with a similar mode of action, but much higher potency, was
      introduced and, at present, is the only agent which can successfully replace
      cyclosporin as a first-line immunosuppressive drug. Mycophenolate mofetil has
      recently been approved for use in adult and paediatric renal transplant
      recipients. It has a similar mode of action to cyclosporin and tacrolimus, but
      acts at a later stage of the T cell activation pathway. Administration with
      standard immunosuppressive drugs reduces the incidence of acute rejection and
      enables cyclosporin and tacrolimus dose reduction, thus reducing the risk of
      associated toxic effects. Phase I and II trials with sirolimus (rapamycin), a
      macrolide antibiotic, have shown comparable immunosuppressive action, when
      administered in conjunction with standard immunosuppressants. Further clinical
      trials need to be carried out to establish efficacy, tolerability and
      pharmacokinetics in paediatric transplant recipients. Monoclonal antibody therapy
      (daclizumab and basiliximab) is an exciting new development whereby T cell
      proliferation is inhibited by selective blockade of interleukin (IL)-2 receptors.
      Preliminary results, when used in combination with a standard immunosuppressive
      regimen, are good with respect to incidence of acute graft rejection, host immune
      response and adverse effects. FTY720 is a novel synthetic immunosuppressive
      compound which induces a reduction in peripheral blood lymphocyte count through
      apoptotic T cell death or accelerated trafficking of T cells into lymphatic
      tissues. Experimental animal studies demonstrated synergistic action in
      combination with low dose cyclosporin or tacrolimus, potentiating their
      immunosuppressive effects. Further studies are being carried out to determine its
      potential for application in organ transplantation. Despite this rapid
      development of novel compounds, it will take many years before they may become
      part of standard protocols in paediatric transplantation medicine. Further
      development and research of efficacy and tolerability of existing drugs is,
      therefore, vital.

PMID- 11220407
TI  - Introduction: infections in the intensive care unit.

PMID- 11220406
TI  - Management of sepsis and septic shock in infants and children.
AB  - Sepsis and septic shock constitute an important cause of morbidity and mortality
      in critically ill children. Thus, the systemic response to infection and its
      management remains a major challenge in clinical medicine. Apart from antibiotic
      administration, the majority of available therapies are limited to supportive
      strategies, although considerable efforts are being undertaken to devise
      innovative approaches that modulate host inflammatory responses. In suspected
      sepsis, 2 or 3 days' empiric antibiotic therapy should begin immediately after
      cultures have been obtained without awaiting results. Antibiotics should be re
      evaluated when the results of the cultures and susceptibility tests are
      available. The initial antibiotic (combination) is determined by the likely
      causative agent, susceptibility patterns within a specific institution, CNS
      penetration, toxicity, and the patient's hepatic and renal function. The likely
      offending micro-organism in turn depends primarily on the patient's age,
      coexistence of any premorbid condition leading to impaired immune response, and
      the presenting signs and symptoms. Close attention to cardiovascular,
      respiratory, fluid and electrolyte, haematological, renal and
      metabolic/nutritional support is essential to optimise outcome. Fluid
      resuscitation is of utmost importance to overcome hypovolaemia on the basis of a
      diffuse capillary leak. Monitoring and normalisation of the heart rate is
      essential. In case of nonresponse to fluid resuscitation, inotropic and
      vasoactive agents are commonly used to increase cardiac output, maintain adequate
      blood pressure and enhance oxygen delivery to the tissue. Because respiratory
      distress syndrome is seen in about 40% of critically ill children with septic
      shock, increased inspired oxygen is essential. To provide optimal relief from
      respiratory muscle fatigue and facilitate the provision of positive airway
      pressure, early intubation and mechanical ventilation should be considered. Renal
      support is essential to avoid prolonged renal shutdown in hypoperfusion states.
      Haematological support comprises replacement therapy of clotting factors to
      overcome disseminated intravascular coagulation. Metabolic support may include
      glucose support, extraction of ammonia from the body and recognition of liver
      dysfunction. Nutritional support may modify the inflammatory host response, and
      early enteral feeding can improve outcome in critical illness. To date,
      glucocorticoid and non-glucocorticoid anti-inflammatory agents have not shown
      significant benefit in septic patients.

PMID- 11220408
TI  - Intravascular catheter-related infections: a preventable challenge in the
      critically ill.
AB  - In modem medicine, central venous catheters (CVCs) have a pivotal role in the
      management of critically ill patients. The most serious complication of effective
      CVC placement is catheter-related bloodstream infection (CRBSI). Microbial
      colonization and CRBSI are the byproducts of the interaction of 4 factors: (1)
      microbial factors (hydrophobicity and exopolysaccharide production), (2) host
      factors (such protein adhesins as fibrin and fibronectin that attach to the
      catheter surface), (3) catheter material (hydrophobicity, surface charges,
      thrombogenicity), and (4) iatrogenic factors (total parenteral nutrition,
      interleukin-2). The organisms most frequently associated with CRBSI are
      Staphylococcus epidermidis, Staphylococcus aureus, and Candida spp. CRBSIs were
      traditionally diagnosed through semiquantitative or quantitative cultures of the
      catheter tip. However, the diagnosis can be achieved without catheter removal
      through cultures of blood specimens collected simultaneously though the CVC and a
      peripheral vein. Currently, the most effective method of preventing a CRBSI is
      the use of a CVC coated with antimicrobial agents. Intravenous administration of
      vancomycin for 7 days is adequate for an uncomplicated CRBSI caused by coagulase
      negative staphylococci, and at least 10 days of therapy with beta-lactams is
      required for an uncomplicated infection caused by methicillin-sensitive S.
      aureus. CRBSI caused by Candida albicans or Candida parapsilosis can be treated
      with at least 14 days of therapy with fluconazole or amphotericin B. In the case
      of Candida krusei, only amphotericin B is effective.

PMID- 11220409
TI  - Ventilator-associated pneumonia: incidence, risk factors, and microbiology.
AB  - Ventilator-associated pneumonia (VAP) is a pulmonary infection that occurs after
      at least 48 hours of mechanical ventilation (MV). The incidence depends on
      several factors, although the most important are those related to the host and
      duration of MV. VAP can be differentiated into early-onset (<5 days) and late
      onset types (> or =5 days). The overall incidence of VAP varies between 9% and
      70% (average, 20% to 25%), and the majority of episodes occur within the first 5
      days. Risk factors for VAP include prolonged MV, older age, supine body position,
      and type of comorbidity. Oropharyngeal colonization appears to be a risk factor
      for early-onset pneumonia, whereas prolonged MV and antibiotic pretreatment,
      especially with broad-spectrum drugs, increase the risk for late-onset VAP
      Microaspiration of colonized oropharyngeal secretions is a major cause of early
      onset VAP, most frequently caused by community-type pathogens. After 5 days of
      MV, pathological colonization with gram-negative bacteria may occur, and late
      onset VAP is more likely to be attributable to this group of microorganism.
      Incidence, risk factors, and microbiology depend strongly on the time frame in
      which the episode develops. However, initial and pathological colonization during
      the intensive care unit stay can modify this concept.

PMID- 11220410
TI  - Trauma, head injury, and neurosurgery infections.
AB  - Patients with multiple trauma and head injuries are high-risk populations for
      developing nosocomial infections, which are the first cause of death after 3
      weeks of admission. Pneumonia caused by methicillin-sensitive Staphylococcus
      aureus is the most frequent infection in patients with a decreased level of
      consciousness. Nevertheless, after 7 days of ventilation, Pseudomonas aeruginosa
      is the most frequently isolated microorganism in ventilator-associated pneumonia.
      Central nervous system infections represent only 4% of those experienced by
      trauma patients; however, if cerebrospinal fluid (CSF) leakage exists, the
      incidence increases to 50%. The diagnosis of meningitis is difficult because CSF
      biochemical data are not specific. Patients with spinal cord injuries are at
      greater risk for developing infections caused by multiresistant microorganisms
      because of their prolonged hospital stay.

PMID- 11220411
TI  - Problem pathogens (Pseudomonas aeruginosa and Acinetobacter).
AB  - A number of factors have been suspected of or identified as increasing the risk
      for pneumonia or colonization of the lower respiratory tract by Pseudomonas
      and/or Acinetobacter spp. in the intensive care unit (ICU), including advanced
      age, chronic lung disease, immunosuppression, surgery, use of antimicrobial
      agents, presence of such invasive devices as endotracheal and gastric tubes, and
      type of respiratory equipment. However, there is little doubt that of all these
      factors, extended ICU care because of severe underlying disease, prolonged
      respiratory therapy with mechanical ventilation, and prior antimicrobial therapy
      are the most important. Because the only factor amenable to prevention in this
      setting is antimicrobial therapy, avoiding unnecessary antibiotics should be a
      high priority in the management of such patients. Crude mortality rates of 30% to
      75% have been reported for nosocomial pneumonia caused by Pseudomonas and/or
      Acinetobacter spp., with the highest rates reported in ventilator-dependent
      patients. It is therefore clear that the prognosis associated with this type of
      infection is considerably worse than that associated with infection caused by
      other gram-negative or gram-positive bacteria. Because bactericidal synergy
      against Pseudomonas and Acinetobacter spp. has been shown when carbenicillin and
      an aminoglycoside are combined, the use of an effective beta-lactam
      (piperacillin, ticarcillin, ceftazidime, or imipenem) and aminoglycoside
      combination remains the preferred therapeutic approach when possible. Future
      research efforts should also aim to improve our ability to diagnose and exclude
      infection in the ICU setting to avoid administering unnecessary antibiotics to
      patients without true pulmonary infection.

PMID- 11220412
TI  - Extended-spectrum beta-lactamases.
AB  - Resistance to broad-spectrum cephalosporins among Klebsiella pneumoniae has
      increased significantly, particularly in the intensive care unit setting, in the
      past decade. The problem has been noted not only in the United States, but around
      the world. A major mechanism responsible for this is the emergence of extended
      spectrum beta-lactamases (ESBLs). These plasmid-mediated beta-lactamases confer
      resistance to broad-spectrum beta-lactam antibiotics, including third- and fourth
      generation cephalosporins, aztreonam, and extended-spectrum penicillins. Other
      resistances, such as aminoglycoside and trimethoprim-sulfamethoxazole resistance,
      are often cotransferred on the same plasmid. Fluoroquinolone resistance is also
      frequently associated, resulting in an organism resistant to most broad-spectrum
      options. The carbapenems are currently considered the drug of choice for these
      pathogens. Prevention and control measures are important because of the
      multiresistant nature of these pathogens. Such traditional infection control
      measures as contact precautions are recommended. In addition, because this type
      of antimicrobial resistance appears to be particularly influenced by antibiotic
      use, antibiotic control measures may also be a very important intervention in
      controlling the spread of ESBLs.

PMID- 11220413
TI  - Staphylococcal infections in the intensive care unit.
AB  - Staphylococcus aureus and coagulase-negative staphylococci are among the most
      common causes of nosocomial infections in the intensive care unit (ICU). The
      clinical presentation of staphylococcal device-related infections, pneumonias, or
      surgical wound infections is not unique. However, treatment of these infections
      is increasingly problematic because of the resistance of clinical isolates to a
      widening number of antimicrobial agents. The confluence of critically ill
      patients and the need for multiple invasive procedures, as well as the use of
      broad-spectrum antimicrobial agents in the ICU, set the stage for the emergence
      of these multidrug-resistant staphylococci. In the past 10 years, there has been
      a progressive increase in the overall resistance of staphylococci to
      antimicrobial agents. Conventional infection control measures, such as
      handwashing and isolation precautions, to prevent the spread of staphylococcal
      infections in the ICU setting remain of critical importance. New approaches,
      including the prophylactic use of topical antistaphylococcal agents to eliminate
      nasal colonization in high-risk ICU patients and the development of
      antistaphylococcal vaccines, are currently being investigated.

PMID- 11220414
TI  - Vancomycin-resistant enterococci.
AB  - Over the last 2 decades, enterococci, formerly viewed as organisms of minimal
      clinical impact, have emerged as important hospital-acquired pathogens in
      immunosuppressed patients and intensive care units (ICUs). Vancomycin resistance
      in enterococci is increasing steadily. Vancomycin-resistant enterococci (VRE)
      composed 26% of nosocomial enterococci in 1999, a 47% increase from 1994 to 1998.
      More that 25% of ICU enterococci are resistant to vancomycin. Antimicrobial
      therapy is problematic for all VRE, but particularly when bactericidal activity
      is necessary. Quinipristin-dalfopristin and linezolid are 2 new approved
      antimicrobials for the treatment of recalcitrant infections caused byVRE. Control
      of the transmission of VRE, although successful in preventing infections, is
      neither simple nor inexpensive, and VRE has become endemic in many hospitals.
      However, endemicity poses serious risks to the health of current and future
      patients, and of itself, is expensive. Data on the cost-effectiveness of VRE
      prevention programs are currently lacking and urgently needed; however, because
      the added cost of a single VRE infection far exceeds those of gowns, gloves, and
      screening, it seems likely that such control programs represent significant cost
      savings for those hospitals willing to undertake them.

PMID- 11220415
TI  - Infection control in intensive care units and prevention of ventilator-associated
      pneumonia.
AB  - Ventilator-associated pneumonia (VAP) is considered the most frequent infection
      in the intensive care unit (ICU), although incidence rates depend on the
      diagnostic methods. Because VAP has been associated with increased mortality and
      greater costs for medical care, prevention remains an important goal for
      intensive care medicine. Selective digestive decontamination (SDD), the most
      frequently studied method of infection prevention, is still controversial despite
      more than 30 prospective randomized trials and 6 metaanalyses. SDD reduces the
      incidence of VAP diagnoses, but beneficial effects on duration of ventilation or
      ICU stay, antibiotic use, and patient survival have not been shown unequivocally.
      Although recent metaanalyses suggest a 20% to 40% decrease in ICU mortality for
      SDD used with systemic prophylaxis, this benefit should be confirmed in a large,
      prospective, randomized study, preferably with a cost-benefit analysis. Selection
      of pathogens resistant to the antibiotics used in SDD remains the most important
      drawback of SDD, rendering SDD contraindicated in wards with endemic resistant
      problems. Other methods of infection prevention that do not create a selective
      growth advantage for resistant microorganisms may be more useful. Among these are
      the use of endotracheal tubes with the possibility of continuous aspiration of
      subglottic secretions, oropharyngeal decontamination with antiseptics, or the
      semirecumbent treatment position of patients. Although these methods were
      successful in single studies, more data are needed. Notwithstanding the potential
      benefits of these interventions, such classic infection control measures as
      handwashing remain the cornerstone of infection prevention.

PMID- 11220416
TI  - Diagnostic case study: radiographic findings in pulmonary blastomycosis.

PMID- 11220417
TI  - Pre-emptive analgesia: importance of timing.

PMID- 11220418
TI  - Why should we teach medical students?

PMID- 11220419
TI  - Gastric air tonometry during laparoscopic cholecystectomy: a comparison of two
      PaCO2 levels.
AB  - PURPOSE: Pneumoperitoneum can cause disturbances in acid-base balance and
      splanchnic perfusion. We studied the effect of ventilation on acid-base balance
      and gastric mucosal tonometric values in patients undergoing laparoscopic
      cholecystectomy. METHODS: Twenty-four patients (ASA I-II) were randomly allocated
      into two groups. In the fixed ventilation group, ventilation was constant
      allowing free increase in PCO2, while in the constant CO2 group end-tidal PCO2
      was fixed with ventilatory adjustment. Intraabdominal pressure was limited to 12
      mmHg. Arterial acid-base balance, automated air tonometric variables and gastric
      mucosal to arterial PCO2 gap were determined frequently from anesthesia induction
      until three hours postoperatively. RESULTS: During pneumoperitoneum, in the fixed
      ventilation group arterial PCO2 changed from 5.0 +/- 0.2 to 6.6 +/- 0.4 kPa and
      pH from 7.43 +/- 0.03 to 7.33 +/- 0.04, tonometric PCO2 from 5.1 +/- 0.5 to 6.9
      +/- 0.4 and pH from 7.44 +/- 0.04 to 7.33 +/- 0.04. In the constant CO2 group
      these variables remained at control levels (P < 0.01 between groups). The PCO2
      gap remained unchanged without any differences between the groups. In the
      recovery room all measured variables were within normal range in both groups.
      CONCLUSION: Despite inter-group differences in arterial and tonometric PCO2 and
      pH values during CO2 pneumoperitoneum, the patients did not develop splanchnic
      hypoperfusion detectable by air tonometric method, as indicated by normal PCO2
      gap in both groups throughout the study.

PMID- 11220420
TI  - Impact of the initial doses of rocuronium and pancuronium on subsequent
      maintenance for neuromuscular block.
AB  - PURPOSE: To determine the impact of the neuromuscular blocking agent given for
      intubation on the duration of effect of multiple maintenance doses of pancuronium
      and rocuronium. METHODS: Seventy-eight subjects were randomly assigned to receive
      one of four dosing combinations for intubation and neuromuscular maintenance:
      rocuronium for intubation and maintenance, rocuronium for intubation and
      pancuronium for maintenance, pancuronium for intubation and rocuronium for
      maintenance, or pancuronium for both. Each time that the first twitch response
      returned to 25% of the baseline value, the duration of the dose was determined
      and another maintenance dose was administered. The duration of action of the
      maintenance doses was compared between the groups. RESULTS: Twitch suppression
      from the first maintenance dose was shorter for subjects who received rocuronium
      for both doses (Group RR) compared with that for subjects that received
      pancuronium (Groups PR & PP) as their intubation dose (17.6 vs 34 & 59.8 min,
      respectively, P < 0.05). Subjects who received rocuronium followed by pancuronium
      (Group RP) showed a shorter duration of twitch suppression after the first
      maintenance dose than the group that received pancuronium for both doses (Group
      PP) (21.3 vs 59.8 min, P < 0.05). By the third maintenance dose, the influence of
      the intubating dose on the maintenance dose duration had essentially diminished.
      CONCLUSIONS: For combinations of rocuronium and pancuronium, the duration of
      twitch suppression after a maintenance dose is only dependent on the first agent
      given for the first two maintenance doses administered.

PMID- 11220421
TI  - High concentrations of isoflurane do not block the sympathetic nervous system
      activation from desflurane.
AB  - PURPOSE: The volatile anesthetic desflurane has been associated with
      neurocirculatory responses that have been relatively refractory to adjuvant
      treatment. We have employed desflurane to evaluate the integrity of the
      sympathetic nerve recording after establishment of the anesthetized state with
      another anesthetic agent. This retrospective evaluation of data from volunteers
      determined if higher concentrations of isoflurane that were sufficient to block
      the neurocirculatory response to laryngeal and tracheal stimulation would abolish
      the neurocirculatory response to desflurane. METHODS: Data from eight, healthy,
      young volunteers met our criteria for inclusion. They had been anesthetized with
      propofol or thiopental and intubated after neuromuscular blockade. Each subject
      was monitored with radial artery blood pressure (BP), heart rate (HR)(ECG), and
      sympathetic microneurography. Isoflurane had been administered to achieve a
      steady state concentration of 1.5 MAC (minimum alveolar concentration) while
      oxygenation and carbon dioxide were monitored with pulse oximetry and infrared
      spectrometry, respectively. A deep level of anesthesia was confirmed when
      laryngoscopy and endotracheal tube movement failed to elicit a neurocirculatory
      response. A brief exposure to 11% desflurane in the inspired gas was then
      provided. RESULTS: The responses to desflurane included significant increases in
      HR, range 32-84 b/min, and BP, range 15-72 mm Hg (P < 0.05). Sympathetic nerve
      activity increased substantially in the three volunteers with functional nerve
      recordings. CONCLUSION: In healthy volunteers receiving 1.5 MAC isoflurane, which
      was sufficient to block the neurocirculatory response to laryngoscopy and
      tracheal stimulation, there were striking increases in sympathetic outflow, HR
      and BP when 11% desflurane was substituted for isoflurane.

PMID- 11220422
TI  - Medication errors in anesthetic practice: a survey of 687 practitioners.
AB  - PURPOSE: The objectives of this study were to determine: 1) if anesthesiologists
      had experienced a medication error and 2) to identify causal factors. The
      perceived value of a Canadian reporting agency for medication errors and improved
      standards for labels on drug ampoules was also investigated. METHODS: A self
      reporting survey was mailed to members of the Canadian Anesthesiologists' Society
      (n = 2,266). Respondents provided free-text descriptions of medication errors and
      answered fixed response questions. RESULTS: Surveys from 687 anesthesiologists
      (30% response rate) revealed that 85% of the participants had experienced at
      least one drug error or "near miss". Although most errors (1,038) were of minor
      consequence (98%), four deaths were reported. The commonest error involved the
      administration of muscle relaxants instead of a reversal agent. "Syringe swaps"
      (70.4%) and the misidentification of the label (46.8%) were common contributing
      factors. Anesthesiologists (97.9%) reported that they read the ampoule label
      "most of the time" although the label colour was an important secondary cue.
      Approximately half of the participants would report the error if a reporting
      program existed and 84% agreed that improved standards for drug labels would
      reduce the incidence of error. CONCLUSIONS: Most anesthesiologists experienced at
      least one drug error. The commonest error was a "syringe swap" that involved a
      muscle relaxant. Most errors were of minor consequence, however, serious
      morbidity and mortality resulted from clearly preventable events. These results
      support the development of improved standards for drug labels and the
      establishment of a Canadian reporting program for medication errors.

PMID- 11220423
TI  - The role of anesthesiologists in Canadian undergraduate medical education.
AB  - PURPOSE: To examine the current role of anesthesiologists in Canadian
      undergraduate medical education (UME). METHODS: A 93-item questionnaire was
      mailed to the undergraduate course chairs/coordinators for anesthesia at the 16
      medical schools in Canada. RESULTS: Of the faculty anesthesiologists in Canada,
      1.7%, 4.9%, and 4.9% teach pre-clerkship lectures, seminars, and PBL tutorials,
      respectively. Annually, anesthesiologists teach an average of 3.3 hr (range: 0 to
      15) of pre-clerkship lectures and 12.8 hr (range: 0 to 48) of pre-clerkship
      seminars at each medical school. The topics most commonly taught by
      anesthesiologists in pre-clerkship lectures and seminars are pharmacology and
      perioperative patient assessment, respectively. An anesthesia rotation during
      clerkship is mandatory at 13 schools, with an average duration of 9.6 dy (range:
      5-20 dy). Clerkship teaching methods vary: ten schools provide seminars, eight
      use videos, six use computers, six use an airway skills laboratory, and four use
      an anesthesia simulator. The most common topics taught in clerkship anesthesia
      seminars are airway management and fluid therapy. CONCLUSION: A very small
      proportion of faculty anesthesiologists participate in Canadian UME at the pre
      clerkship level. Considerable variation exists in the amount and format of
      teaching by anesthesiologists among the Canadian undergraduate curricula,
      particularly at the pre-clerkship level. However, our results indicate that
      anesthesiologists are assuming a more important teaching role during clerkship.
      Our findings may suggest that Canadian medical schools are overlooking the
      advantages that anesthesiologists offer to UME at the pre-clerkship level, or
      that many anesthesiologists are reluctant to assume pre-clerkship teaching
      responsibilities.

PMID- 11220424
TI  - Patient satisfaction with anesthesia services.
AB  - PURPOSE: The evaluation of services by patients is an essential component of
      continuous quality improvement in anesthesiology. Little is known, however, about
      how to achieve this objective. Our goal was to conduct a systematic review of all
      available studies on patient satisfaction with anesthesia services, thereby
      ascertaining the present level of knowledge in this field and suggesting ways of
      improving current measurement methodologies. SOURCE: We reviewed relevant major
      data banks--Medline, Dissertation Abstract, Psyclit and Cochrane--between 1980
      and 2000 and bibliographies from primary sources. We used the following keywords
      for our search: quality improvement, anesthesia, quality, patient perceptions,
      consumer satisfaction, continuous quality improvement, outcome measures.
      PRINCIPAL FINDINGS: The review yielded 14 pertinent studies. Studies were divided
      into two groups (A & B), according to the quality of the psychometric evaluation
      (tests performed to verify the reliability and validity of an instrument). While
      all studies reported high levels of patient satisfaction with anesthesia
      services, many used methods of questionable value. None of the 14 studies
      controlled for any confounding variables, such as social desirability. Four
      studies had seriously biased their data collection and the majority of the
      studies lacked rigour in the development of the instrument used to measure
      patient satisfaction. Only one study presented a definition of the concept
      measured, and none provided a conceptual model of patients' satisfaction with
      anesthesia services. CONCLUSION: The currently available studies of patient
      satisfaction are of questionable value. Only rigorous methods and reliable
      instruments will yield valid and clinically relevant findings of this important
      issue in anesthesiology.

PMID- 11220425
TI  - Timing of pre-emptive tenoxicam is important for postoperative analgesia.
AB  - PURPOSE: In this prospective randomized study, a comparison was made between the
      efficacy of 20 mg tenoxicam, administered either, 30 min preoperatively or at
      induction of anesthesia, for the relief of postoperative pain in patients
      undergoing ambulatory breast biopsy. METHODS: Seventy-three patients were
      recruited and all received a standard anesthetic consisting of induction with 2
      mg x kg(-1) propofol followed by 5 microg x kg(-1) alfentanyl. No premedication
      was administered and at the end of the procedure the wounds were infiltrated with
      10 ml of bupivacaine (0.5%). Patients were randomized to receive 20 mg tenoxicam
      intraveneously either 30 min before surgery or at induction of anesthesia.
      RESULTS: Demographic criteria were similar in both groups. There were differences
      in pain scores at 30, 60, 120 and 240 min postoperatively (VAS at 30 min 3.2 +/-
      1.2 vs 5.5 +/- 1.8; P < 0.001: VAS at 60 min 1.8 +/- 1.2 vs 3.7 +/- 1.9; P <
      0.001: VAS at 120 min 0.9 +/- 0.9 vs 1.7 +/- 1.0; P = 0.003: VAS at 240 min 0.5
      +/- 0.5 vs 1.1 +/- 0.8; P < 0.001: Expressed as mean +/- SD). There was a
      difference in the number of patients requiring additional analgesia, in the first
      four hours postoperatively (12 (33%) vs 27 (73%); P = 0.001) and a difference in
      the time to additional analgesia in these patients (87.5 +/- 32.5 vs 55.0 +/-
      26.8 min; P = 0.002). CONCLUSION: Early administration of pre-emptive tenoxicam
      30 min before induction of anesthesia improves postoperative analgesia in
      patients undergoing ambulatory breast biopsy.

PMID- 11220427
TI  - Patient-controlled intravenous analgesia using remifentanil in the parturient.
AB  - PURPOSE: To show the use of the short acting opioid remifentanil for labour
      analgesia when epidural analgesia is considered to be contraindicated. CLINICAL
      FEATURES: After Ethics Committee approval and informed consent, six patients (36
      40 wk gestation), in whom epidural analgesia was considered contraindicated
      (women refusing regional analgesia, presenting with coagulation or platelet
      abnormalities or sepsis) benefited from patient-controlled intravenous analgesia
      (PCIA) with remifentanil. The Abbott Lifecare patient-controlled analgesia (PCA)
      pump with remifentanil 50 microg x ml(-1) was set to deliver remifentanil
      continuous background infusion of 0.05 microg x kg(-1) x min(-1) and 25 microg
      boluses with a five minutes lockout period. The PCIA was started when the
      parturients experienced regular painful contractions (cervical dilatation of at
      least 4 cm) and stopped just before delivery (cervix fully dilated). Maternal
      monitoring included non-invasive blood pressure measurements, heart rate,
      percutaneous arterial oxyhemoglobin saturation and respiratory rate. Percutaneous
      fetal heart rate was continuously monitored. All patients remained alert or
      sleepy but easily arousable and were satisfied with their analgesia. No
      particular side effects have been noticed. Apgar scores were between 6 and 10.
      CONCLUSION: Remifentanil PCIA combining low continuous background infusion and
      small bolus doses is an alternative when epidural analgesia in labour is
      contraindicated. Under careful anesthesia monitoring, the technique seems to be
      safe for both mother and baby, at least when delivery occurs at or near the
      normal term of pregnancy.

PMID- 11220426
TI  - Dextromethorphan attenuation of postoperative pain and primary and secondary
      thermal hyperalgesia.
AB  - PURPOSE: To determine the effect of 90 mg dextromethorphan (DM) p.o. vs placebo
      90 min preoperatively, on the immediate and delayed postoperative course.
      METHODS: Thirty patients undergoing laparoscopic cholecystectomy or inguinal
      hernioplasty under general anesthesia were studied. Half (DM) received 90 mg
      dextromethorphan and half received placebo 90 min before anesthesia. Intravenous
      Patient Controlled Aanalgesia with morphine was available for two hours within a
      six-hour observation period; 75 mg diclofenac i.m. prn was given later in PACU
      and on-ward (24 hr). Pain was assessed using the visual analogue scales. Thermal
      thresholds for cold and hot sensation and for pain (by limit method) were
      evaluated at the site of skin incision (primary-) and distantly (secondary
      hyperalgesia). Von Frey filaments were applied testing touch sensation. Sedation
      level and morphine consumption were also assessed in PACU. RESULTS: Demographic,
      surgical and perioperative parameters were similar; no untoward effects were
      encountered. Pain intensity and sedation were lower, and the feeling of well
      being was greater, in the DM patients: one vs five (median), two vs five, five vs
      two, respectively, P <0.01 (90 min time-point). Thermal application revealed
      absence of primary and secondary hyperalgesia only in the DM patients; von Frey
      filaments induced similar pain sensation in both groups. Mean morphine/group,
      morphine/weight and diclofenac injection rates were approximately 55% lower in
      the DM group: 2.1 +/- 1.2 (SD) vs 4.7 +/- 2.3, 0.03 +/- 0.02 vs 0.07 +/- 0.03,
      1.0 +/- 0.3 vs 2.4 +/- 0.2, respectively, P <0.01. CONCLUSIONS: Compared with
      placebo, DM enabled reduction of postoperative analgesics consumption, improved
      well-being, and reduced sedation, pain intensity and primary and secondary
      thermal hyperalgesia.

PMID- 11220428
TI  - Bilateral paravertebral block: a satisfactory alternative for labour analgesia.
AB  - PURPOSE: To describe a new technique of paravertebral block for labour analgesia
      and to report the successful use of bilateral paravertebral block in four
      parturients with contraindications to conventional labour epidural analgesia.
      CLINICAL FEATURES: Four parturients with contraindications to lumbar epidural
      analgesia, who were seen either in consultation prenatally or after requesting
      analgesia when in labour, consented to paravertebral blocks for the management of
      first stage of labour pain. Bilateral paravertebral blocks were performed at T10
      L1 level, initially blocking all four levels with 4 ml bupivacaine 0.5% with
      epinephrine 1:200000 and then reducing the number of levels blocked to two and
      finally one. With the entry point 2 cm lateral to the inferior edge of the T11
      spinous process, a 22G spinal needle was advanced perpendicular to all planes
      until contact was made with the transverse/superior articular process of T12, at
      a depth of 3-5 cm. The needle was then walked superiorly (T11) and inferiorly
      (T12 nerve root) off the transverse/articular process and advanced 1.5 cm into
      the paravertebral space. All four patients had relief of pain such that they were
      "comfortable" and able to cope with labour although they continued to experience
      deep pelvic and rectal pain. The patients tolerated the initiation of the blocks
      well, remained hemodynamically stable, and did not suffer any adverse effects.
      CONCLUSION: Bilateral paravertebral block provides adequate analgesia for the
      first stage of labour and could be an alternative analgesic technique for some
      parturients with contraindications to conventional labour epidurals.

PMID- 11220430
TI  - Oral transmucosal midazolam premedication for preschool children.
AB  - PURPOSE: To evaluate the acceptance and effectiveness of 0.2 mg x kg(-1) of oral
      transmucosal midazolam as a premedicant in infants and preschool children.
      METHOD: In a randomized, prospective double-blind placebo controlled study, 44
      healthy children, between the ages of eight months to six years, presenting for
      elective surgery were divided in two groups. The medicated group received 0.2 mg
      x kg(-1) of injectable midazolam mixed with an equal volume of strawberry syrup
      and the placebo group received plain syrup 0.08 ml x kg(-1). Medications were
      placed on the anterosuperior aspect of the child's tongue in 3-5 aliquots of 0.2
      0.4 ml. A blinded observer assessed the acceptance of the medication by
      willingness to open the mouth for the next aliquot and the efficacy of the
      medication was assessed by ease of separation from the parent. RESULTS: Ninety
      six percent of the children in the placebo group and 95% in the midazolam group
      willingly accepted the medication. Separation of children from parents was
      successful in 95% of the medicated children compared with 59% in the placebo
      group (P = 0.006). CONCLUSION: Oral midazolam in thick strawberry syrup,
      administered in small aliquots via the oral transmucosal route was well accepted
      and proved to be an effective premedicant in infants and preschool children.

PMID- 11220429
TI  - Dexamethasone prophylaxis of nausea and vomiting after epidural morphine for post
      Cesarean analgesia.
AB  - PURPOSE: To determine the minimum effective dose of dexamethasone in preventing
      nausea and vomiting associated with epidural morphine for post-Cesarean
      analgesia. METHOD: One hundred and eighty parturients (n=45 in each of four
      groups) requiring epidural morphine for post-Cesarean analgesia were enrolled in
      this randomized, double-blinded, placebo-controlled study. At the end of surgery,
      parturients received either dexamethasone, at doses of 10 mg, 5 mg, 2.5 mg, or
      saline i.v.. Three milligrams epidural morphine were given to all parturients for
      postoperative analgesia. The incidence of PONV and side effects were estimated
      for 24 hr after delivery by blinded, trained nurse anesthetists. RESULTS:
      Parturients who received dexamethasone, either 10 mg or 5 mg were different from
      those who received saline alone in the following parameters: the total incidence
      of nausea and vomiting, incidence of > 4 vomiting episodes, number the of
      parturients requiring rescue antiemetics, and the total number of parturients
      with no vomiting and/or no antiemetic medication (P < 0.05 to P < 0.01). The
      differences between dexamethasone 10 mg and 5 mg were not significant.
      Dexamethasone 2.5 mg was partially effective. CONCLUSION: Dexamethasone, 5 mg
      i.v., is suggested as the minimum effective dose in preventing nausea and
      vomiting associated with epidural morphine for post-Cesarean analgesia.

PMID- 11220431
TI  - Difficult separation from cardiopulmonary bypass and deltaPCO2.
AB  - PURPOSE: Veno-arterial and regional differences of the partial pressure in CO2
      (deltaPCO2), may be used as index to evaluate the adequacy of the cardiac output
      to the oxygen consumption. To determine the incidence of elevated deltaPCO2 and
      its relationship with difficult separation from bypass (DSB) in patients
      undergoing cardiac surgery, we conducted a prospective observational cohort
      study. METHODS: Data were collected from 58 consecutive patients undergoing
      various cardiac operations requiring cardiopulmonary bypass (CPB). During the
      procedure, arterial and venous blood gases and lactate were sampled. Blood was
      drawn after induction of anesthesia, during bypass and at the closure of the
      chest wall. Difficult separation from bypass was defined as a systolic arterial
      pressure < 80 mmHg, and diastolic pulmonary artery pressure > 15 mmHg during
      progressive separation from CPB with inotropic or mechanical support of cardiac
      function, or hemodynamic instability resulting in reintroduction of extra
      corporeal circulation or insertion of an intra-aortic balloon pump. RESULTS: In
      our study, 65% of the samples were associated with elevated deltaPCO2 (> 6 mmHg).
      Variables associated with difficult weaning were LVEF; duration of bypass and
      aortic cross-clamping, pre-bypass deltaPCO2 and in-bypass lactate values (P <
      0.05). Multivariable analysis identified the pre-bypass deltaPCO2 and the
      duration of bypass as predictors of DSB. CONCLUSION: Elevated deltaPCO2 is
      frequently observed during cardiac surgery and values obtained before bypass were
      associated with DSB. The deltaPCO2 gradients could be used as marker of the
      adequacy of tissue perfusion during cardiac surgery.

PMID- 11220432
TI  - Bilateral transient radial nerve palsies in an infant after cardiac surgery.
AB  - PURPOSE: To describe the case of an infant who suffered bilateral transient
      radial nerve palsies after cardiac surgery. CLINICAL FEATURES: A one-month-old
      baby was found to have bilateral wrist and finger drop after the removal of
      splints that has been applied to the right hand for 14 days and to the right hand
      for six days during perioperative management of Blalock-Taussig shunt surgery.
      The hand splints had been applied to the forearms with adhesive silky tape to
      keep peripheral vascular lines in place. The patient also suffered from several
      episodes of cardiogenic shock, hypoxemia and generalized edema relating to
      cardiac dysfunction during this fine period. Given the findings of no impairment
      of median or ulnar nerves and brachioradial muscle, it was suspected that
      bandaging with adhesive tapes caused peripheral radial nerve damage at the level
      of posterior interosseus nerve on forearm. Diminished oxygen delivery and edema
      may additionally have contributed to peripheral nerve ischemia. The
      aforementioned neurologic symptoms resolved spontaneously after several days.
      CONCLUSION: Prolonged compression by bandaging of splints on forearm may have
      resulted in ischemic damage to the posterior interosseus nerve branch combined
      with extensor carpi radialis longus nerve branch of the radial nerve. We should
      attempt to reduce the frequency and duration of splinting of the extremities,
      especially in sedated, paralyzed babies, given the potential risk of compression
      neuropathy.

PMID- 11220433
TI  - Successful management of venous air embolism with inotropic support.
AB  - PURPOSE: Since venous air embolism may occur during many different types of
      surgery, management of this clinical emergency can be required in patients who do
      not have a previously established central venous access for aspiration of air.
      Recent reviews suggest that management of right heart syndromes in patients with
      embolism is critical in improving outcome. CLINICAL FEATURES: Abrupt decreases in
      oxygen saturation (from 98% to 40%) and end-tidal carbon dioxide tension (from 24
      to 6 mm Hg), compatible with venous air embolism were observed in a 73-yr-old
      woman during craniotomy for meningioma in the supine position. Since no access
      for aspiration of air was readily available, therapy was directed at inotropic
      support of the right heart using a bolus of ephedrine. Cardiorespiratory
      variables rapidly returned to normal, and the patient recovered from anesthesia
      and surgery without sequelae. CONCLUSIONS: Venous air embolism places an acute
      load on the right ventricle and may provoke right heart failure, even in the
      absence of total cardiovascular collapse. Treatment that supports right heart
      function may allow sufficient time for redistribution of embolized air and
      produce a good outcome when access for central aspiration of air is not
      available.

PMID- 11220435
TI  - Difficult airway management with the combination of a fibreoptic stylet and McCoy
      laryngoscope.

PMID- 11220436
TI  - Subcutaneous tunnelling of interscalene catheters.

PMID- 11220437
TI  - Postoperative bronchospasm in a patient with Parkinson's disease.

PMID- 11220438
TI  - Hidden misconnection of the pulse oximeter probe on a Seimens Medical Systems,
      Inc. KION anesthesia machine.

PMID- 11220439
TI  - Relationship orientation as a moderator of the effects of social power.
AB  - This research examined the hypothesis that the concept of power is mentally
      associated with different goals for individuals with a communal versus an
      exchange relationship orientation (M. S. Clark & J. Mills, 1979). It was
      predicted that communals associate power with social-responsibility goals,
      whereas exchangers link power with self-interest goals. Thus, when power is
      activated, distinct goals should be ignited for communals and exchangers. Power
      was primed unobtrusively using semantic cues in Study 1 and using naturally
      occurring, environmental cues in Studies 2 and 3. Across studies, power-primed
      communals responded in socially responsible ways, whereas power-primed exchangers
      acted more in line with their self-interests. These power-goal effects occurred
      nonconsciously. Overall, the data support taking a Person x Situation approach-
      one that allows for moderators such as relationship orientation--to understand
      power's positive and negative effects.

PMID- 11220440
TI  - Memory for in-group and out-group information in a minimal group context: the
      self as an informational base.
AB  - The authors argue that persons derive in-group expectancies from self-knowledge.
      This implies that perceivers process information about novel in-groups on the
      basis of the self-congruency of this information and not simply its valence. In
      Experiment 1, participants recalled more negative self-discrepant behaviors about
      an in-group than about an out-group. Experiment 2 replicated this effect under
      low cognitive load but not under high load. Experiment 3 replicated the effect
      using an idiographic procedure. These findings suggest that perceivers engage in
      elaborative inconsistency processing when they encounter negative self-discrepant
      information about an in-group but not when they encounter negative self-congruent
      information. Participants were also more likely to attribute self-congruent
      information to the in-group than to the out-group, regardless of information
      valence. Implications for models of social memory and self-categorization theory
      are discussed.

PMID- 11220441
TI  - Guilty pleasures and grim necessities: affective attitudes in dilemmas of self
      control.
AB  - Do self-control situations pit controlled reason against impulsive emotion, or do
      some emotions support the controlled choice? A pilot study of self-control
      attitudes found ambivalence between hedonic affect associated with short-term
      perspectives and self-conscious affect associated with the long term. In Study 1,
      negative self-conscious affect accompanied higher self-control among delayed-cost
      dilemmas ("guilty pleasures") but not delayed-benefit dilemmas ("grim
      necessities"). Study 2 showed that hedonic affect was more accessible than was
      self-conscious affect, but this difference was less among high self-control
      dilemmas. In Study 3, unobtrusively primed self-conscious emotion words caused
      dieters to eat less if the emotions were negative, more if positive. Hedonic
      positive and negative emotion words had the opposite effect. Self-conscious
      emotional associations, then, can support self-control if brought to mind before
      the chance to act.

PMID- 11220442
TI  - Covariational influences on goal-based explanation: an integrative model.
AB  - Covariational and goal-based approaches to social attribution have been treated
      as competitive or incommensurable. This article integrates key aspects of each
      approach. Four studies examined preferences for motivating factors (or goals) and
      enabling factors (or preconditions) as explanations of intentional actions. The
      studies manipulated (Studies 1-3) and measured (Study 4) the perceived
      covariation of these goal-based causes with target actions. Causes that covaried
      with actions were preferred explanations, in contrast with the goal-based view
      that motivating factors are generally preferred to enabling factors. Combining
      goal-based beliefs and covariational reasoning resolves problems faced by each
      individual approach and generates a novel explanatory typology that combines
      strengths of goal-based and covariational typologies.

PMID- 11220443
TI  - The connubial crucible: newlywed years as predictors of marital delight,
      distress, and divorce.
AB  - This study showed that couples' newlywed marriages and changes in their union
      over the first 2 years foreshadow their long-term marital fate after 13 years.
      Consistent with the enduring dynamics model, differences in the intensity of
      newlyweds' romance as well as the extent to which they expressed negative
      feelings toward each other predicted (a) whether or not they were happy 13 years
      later (among those who stayed married) and (b) how long their marriage lasted
      prior to separation (for those who divorced). The results provide little support
      for the idea that emergence of distress (e.g., increasing negativity) early in
      marriage leads to marital failure but instead show that disillusionment--as
      reflected in an abatement of love, a decline in overt affection, a lessening of
      the conviction that one's spouse is responsive, and an increase in ambivalence-
      distinguishes couples headed for divorce from those who establish a stable
      marital bond.

PMID- 11220444
TI  - Perceiver threat in social interactions with stigmatized others.
AB  - The extent to which stigmatized interaction partners engender perceivers' threat
      reactions (i.e., stigma-threat hypothesis) was examined. Experiments 1 and 2
      included the manipulation of stigma using facial birthmarks. Experiment 3
      included manipulations of race and socioeconomic status. Threat responses were
      measured physiologically, behaviorally, and subjectively. Perceivers interacting
      with stigmatized partners exhibited cardiovascular reactivity consistent with
      threat and poorer performance compared with participants interacting with
      nonstigmatized partners, who exhibited challenge reactivity. In Experiment 3,
      intergroup contact moderated physiological reactivity such that participants who
      reported more contact with Black persons exhibited less physiological threat when
      interacting with them. These results support the stigma-threat hypothesis and
      suggest the utility of a biopsychosocial approach to the study of stigma and
      related constructs.

PMID- 11220445
TI  - The dyadic nature of social information processing in boys' reactive and
      proactive aggression.
AB  - The correlation between boys' social cognitions and their aggressive behavior
      toward peers was examined as being actor driven, partner driven, or dyadic
      relationship driven. Eleven groups of 6 familiar boys each (N = 165 dyads) met
      for 5 consecutive days to participate in play sessions and social-cognitive
      interviews. With a variance partitioning procedure, boys' social-cognitive
      processes were found to vary reliably across their dyadic relationships.
      Furthermore, mixed models regression analyses indicated that hostile
      attributional biases toward a particular peer were related to directly observed
      reactive aggression toward that peer even after controlling for actor and partner
      effects, suggesting that these phenomena are dyadic or relationship oriented. On
      the other hand, the relation between outcome expectancies for aggression and the
      display of proactive aggression appeared to be more actor driven and partner
      driven that dyadic.

PMID- 11220446
TI  - Perceiving unfairness in the family: cause or consequence of marital distress?
AB  - This research tests a model suggesting that marital distress leads individuals to
      scrutinize what is given and received in the relationship. This scrutiny elicits
      perceptions of unfairness that maintain or exacerbate marital distress. In a 3
      panel longitudinal study tracking married couples across the transition to
      parenthood, both wives' and husbands' reports of marital conflict and wives'
      marital dissatisfaction at Time 1 positively predicted perceived unfairness of
      the allocation of household tasks at Time 2, controlling for earlier perceptions
      of unfairness. In addition, there was evidence of perceived unfairness of
      division of labor at Time 2 predicting marital conflict and marital
      dissatisfaction for wives at Time 3, controlling for earlier conflict and
      dissatisfaction. This model of relationship distress and perceptions of
      unfairness is contrasted with prior interpretations of links between perceived
      injustice and distress in relationships.

PMID- 11220447
TI  - Why introverts can't always tell who likes them: multitasking and nonverbal
      decoding.
AB  - Despite personality theories suggesting that extraversion correlates with social
      skill, most studies have not found a positive correlation between extraversion
      and nonverbal decoding. The authors propose that introverts are less able to
      multitask and thus are poorer at nonverbal decoding, but only when it is a
      secondary task. Prior research has uniformly extracted the nonverbal decoding
      from its multitasking context and, consequently, never tested this hypothesis. In
      Studies 1-3, introverts exhibited a nonverbal decoding deficit, relative to
      extraverts, but only when decoding was a secondary rather than a primary task
      within a multitasking context. In Study 4, extraversion was found to correlate
      with central executive efficiency (r = .42) but not with storage capacity (r =
      .04). These results are discussed in terms of arousal theories of extraversion
      and the role of catecholamines (dopamine and norepinephrine) in prefrontal
      function.

PMID- 11220448
TI  - Distinguishing BIS-mediated and BAS-mediated disinhibition mechanisms: a
      comparison of disinhibition models of Gray (1981, 1987) and of Patterson and
      Newman (1993).
AB  - The theoretical framework developed by J. A. Gray (1981, 1987a, 1987b) was used
      to study disinhibitory behavior. Using a point-scoring reaction time procedure, 4
      different experiments were conducted to differentiate 2 disinhibitory mechanisms
      associated with the behavioral activation system (BAS) and the behavioral
      inhibition system (BIS). Consistent with the work of C. M. Patterson and J. P.
      Newman (1993), the BAS-mediated mechanism was related to a lack of inhibition in
      reward-directed behavior after introducing an occasional aversive contingency and
      to deficits in learning from aversive cues when responding for reward
      (Experiments 1-3). The BIS-mediated mechanism was related to a higher ability to
      extinguish aversive associations (Experiment 1), a lower aversive generalization
      gradient (Experiment 3), and a lower interference with appetitive behavior in the
      presence of aversive stimuli (Experiment 4).

PMID- 11220449
TI  - What is satisfying about satisfying events? Testing 10 candidate psychological
      needs.
AB  - Three studies compared 10 candidate psychological needs in an attempt to
      determine which are truly most fundamental for humans. Participants described
      "most satisfying events" within their lives and then rated the salience of each
      of the 10 candidate needs within these events. Supporting self-determination
      theory postulates (Ryan & Deci, 2000)--autonomy, competence, and relatedness,
      were consistently among the top 4 needs, in terms of both their salience and
      their association with event-related affect. Self-esteem was also important,
      whereas self-actualization or meaning, physical thriving, popularity or
      influence, and money-luxury were less important. This basic pattern emerged
      within three different time frames and within both U.S. and South Korean samples
      and also within a final study that asked, "What's unsatisfying about unsatisfying
      events?" Implications for hierarchical theories of needs are discussed.

PMID- 11220450
TI  - Positive illusions about the self: short-term benefits and long-term costs.
AB  - Two studies addressed parallel questions about the correlates and consequences of
      self-enhancement bias. Study 1 was conducted in a laboratory context and examined
      self-enhancing evaluations of performance in a group-interaction task. Study 2
      assessed students' illusory beliefs about their academic ability when they first
      entered college and then followed them longitudinally to test claims about the
      long-term benefits of positive illusions. Both studies showed that self
      enhancement bias was related to narcissism, ego involvement, self-serving
      attributions, and positive affect. Study 2 found that self-enhancement was
      associated with decreasing levels of self-esteem and well-being as well as with
      increasing disengagement from the academic context. Self-enhancement did not
      predict higher academic performance or higher graduate rates. Thus, the findings
      suggest that self-enhancing beliefs may be adaptive in the short term but not in
      the long term.

PMID- 11220451
TI  - Should we offer semen cryopreservation to men with testicular cancer?

PMID- 11220452
TI  - What is a practical approach to outpatient evaluation of diarrhea in a previously
      healthy, middle-aged patient?

PMID- 11220453
TI  - Changing patterns of morbidity and mortality in HIV disease.
AB  - In patients with HIV infection, highly active antiretroviral therapy is improving
      survival, but at the price of a variety of metabolic side effects. Patterns of
      morbidity and mortality are changing: the leading cause of death is now kidney or
      liver failure instead of opportunistic infections.

PMID- 11220454
TI  - Preventing sudden death in coronary cardiomyopathy: implantable defibrillators
      lead the way.
AB  - The Multicenter Unsustained Tachycardia Trial (MUSTT) demonstrated that
      electrophysiologic testing (EP)-guided therapy significantly reduces arrhythmic
      death and cardiac arrest in patients with coronary artery disease, a left
      ventricular ejection fraction of 40% or less, nonsustained ventricular
      tachycardia, and inducible ventricular arrhythmia on EP testing-but only if the
      therapy includes an implantable defibrillator. All patients who meet the MUSTT
      inclusion criteria should undergo an EP test and if positive, should undergo
      defibrillator implantation.

PMID- 11220455
TI  - Aggressive treatment of dyslipidemia: a review of supporting evidence.
AB  - Clinical trial data are now sufficient to support aggressive treatment of
      dyslipidemia. Cholesterol-lowering therapy is known to reduce the risk of
      clinical events across a wide range of lipid levels, even in patients with
      "normal" levels. Current data support lowering low-density lipoprotein
      cholesterol (LDL-C) levels at least to those recommended by the National
      Cholesterol Education Program, but perhaps even more aggressively in some
      patients. Of the available cholesterol-lowering agents, statins produce the
      greatest reductions in LDL-C levels and coronary events and are currently the
      best treatment option for most patients.

PMID- 11220456
TI  - Strategies to prevent progression of renal disease.
AB  - Clinical studies show that several strategies can prevent or slow the progression
      of renal disease in patients with or without diabetes. This paper reviews current
      theories of how renal disease develops and progresses and what clinical studies
      indicate about how to prevent or slow the process.

PMID- 11220457
TI  - Multiple sclerosis: the importance of early recognition and treatment.
AB  - Primary practitioners need to know how to expedite the diagnosis and treatment of
      multiple sclerosis (MS), because treatments that can slow its course appear to be
      most effective when started early. Several lines of evidence demonstrate that
      tissue damage occurs very early in the disease, and much of this damage is
      clinically silent.

PMID- 11220458
TI  - A lung-transplant recipient with infiltrates.

PMID- 11220459
TI  - Atrial septal defect repair.

PMID- 11220460
TI  - New findings in multiple sclerosis: a message for primary care clinicians.

PMID- 11220461
TI  - What is the risk of complications from cataract surgery in patients taking
      anticoagulants?

PMID- 11220462
TI  - Side branch preservation during endovascular aortic aneurysm repair.

PMID- 11220463
TI  - Fenestration in endovascular grafts for aortic aneurysm repair: new horizons for
      preserving blood flow in branch vessels.
AB  - PURPOSE: To describe techniques for deploying fenestrated stent-grafts that use
      partial graft deployment and guided tracking of the fenestration to the arterial
      orifice. TECHNIQUE: Fenestrations have been added to custom-made tube grafts and
      commercially manufactured Zenith stent-graft systems to preserve perfusion of
      aortic side branches. Partial device deployment, orientation markers on the
      endograft, and intraoperative angiography enable maneuvering of the fenestration
      over the orifice of the target vessel with the aid of guiding catheters.
      Placement of a Palmaz stent overlapping the fenestration and vessel orifice
      secures the junction. Two variations of fenestration have preserved blood flow in
      renal arteries during endovascular repair of abdominal aortic aneurysms (AAAs);
      similar techniques have maintained flow to the celiac axis in a thoracic aortic
      aneurysm. CONCLUSIONS: Accurate placement of a fenestration over the orifice of a
      target vessel is feasible, but long-term maintenance of position is dependent on
      secure graft fixation. This capability brings us a step closer to overcoming the
      problem of inadequate necks in infra-renal AAAs, especially when the neck is
      foreshortened by asymmetry of the renal origins. It may also pave the way for the
      eventual replacement of the entire aorta with an endoluminal graft.

PMID- 11220464
TI  - An endovascular system for thoracoabdominal aortic aneurysm repair.
AB  - PURPOSE: To describe a stent-graft system for endovascular repair of
      thoracoabdominal aortic aneurysm (TAAA) that preserves side branch perfusion.
      TECHNIQUE: The modular endograft system includes 3 components. The primary stent
      graft is custom-made from conventional graft fabric and Gianturco Z-stents.
      Covered nitinol Smart Stents are used for the visceral and renal extensions, and
      the distal extension is made from a modified Zenith system. With the supine
      patient under general anesthesia, the components are delivered sequentially
      through surgically exposed femoral and right brachial arteries in an operation
      that requires prolonged periods of magnified high-resolution imaging. This system
      was first used in a 76-year-old man with a contained rupture of a supraceliac
      ulcer and a large abdominal aortic aneurysm ending proximally at the celiac
      artery. The endograft was implanted successfully, but the patient developed
      paraplegia on day 2; imaging documented an excluded aneurysm and excellent flow
      through the endograft and all prosthetic branches. DISCUSSION: Endovascular
      repair of TAAA appears to be feasible. If there are no serious, specific,
      unavoidable complications, the potential advantages are enormous.

PMID- 11220465
TI  - Endoluminal aortic grafting with renal and superior mesenteric artery
      incorporation by graft fenestration.
AB  - PURPOSE: To explore the use of juxta- and suprarenal aortic segments for
      endograft fixation in abdominal aortic aneurysm (AAA) patients and to develop
      methods of graft implantation that use endograft fenestrations to preserve renal
      and visceral vessel perfusion. METHODS: From August 1998 to May 2000, 13 AAA
      patients with unsuitable infrarenal aortic necks were treated with custom
      designed endovascular grafts employing the juxta- and suprarenal aortic segments
      for proximal sealing. Flow to 33 renal and superior mesenteric arteries was
      maintained via graft fenestrations that were aligned by use of radiopaque graft
      markers. The fenestration-orifice interface for renal arteries was secured with
      modified balloon-expandable stents. RESULTS: All fenestrated grafts were deployed
      as planned, and all target vessels (33/33) were preserved. Two patients did not
      receive any stents, one being the first in the series and another who had
      incorporation of a renal accessory artery only. Without the use of transgraft
      stenting, 5 renal arteries would have been occluded by the endograft or poorly
      perfused. Procedural success was 100%. No conversion to open operation or graft
      related complications occurred. There was no primary endoleak in any patient by
      angiographic criteria. Two patients required additional surgical procedures
      related to access vessels. Periprocedural mortality at 30 days was nil. Follow-up
      ranging from 3 to 24 months on all patients has not demonstrated any proximal or
      distal endoleaks. One stented renal vessel has occluded; all other arteries
      remain patent at last examination. CONCLUSIONS: This study has demonstrated the
      ability to successfully place a multifenestrated endoluminal graft in an aortic
      aneurysm using juxta- and suprarenal aortic segments to obtain a satisfactory
      seal. Stenting of the fenestration-renal ostium junction has helped to maintain
      renal patency.

PMID- 11220466
TI  - Geometric changes in aortic endografts over a 2-year observation period.
AB  - PURPOSE: To report geometric changes in bifurcated aortic endografts observed
      over a 2-year follow-up period. METHODS: Twenty-two patients (21 men; mean age 68
      years, range 57-83) with abdominal aortic aneurysms were treated with an
      endovascular stent-graft. Follow-up examinations included spiral computed
      tomographic scanning postoperatively and at 3, 6, 9, 12, 18, and 24 months after
      treatment. Geometric changes were measured using 3-dimensional reconstructed
      images in anteroposterior (AP) and lateral projections. Locations for the
      measurements were the proximal neck, the midportion of the endograft, and the
      graft limbs at the origin of the iliac arteries. RESULTS: Lateral changes
      predominated, demonstrating maximum angles on the side of the inserted left limb.
      For the proximal neck, the stent angle changed by a mean -0.71 degrees in the AP
      and 4.0 degrees in the lateral projection. At the midgraft, changes were -0.56
      degrees for AP and 12.5 degrees for lateral. The right limb showed an angle of
      6.43 degrees in AP and -0.43 degrees in lateral, whereas the left limb angles
      changed 1.38 degrees in AP and 11.71 degrees in the lateral plane after 2 years.
      There was no statistically significance difference in these changes from
      baseline. CONCLUSIONS: Aortic endografts are exposed to a significant amount of
      movement after insertion, but the resultant changes are very inhomogeneous,
      unpredictable, and ongoing even after 2 years. The most vulnerable location seems
      to be the attachment zone of the modular graft limb. These geometric changes
      might be one cause for late complications, including leaks and limb dislocations.

PMID- 11220467
TI  - Carotid artery stenting in patients with high-risk anatomy for carotid
      endarterectomy.
AB  - PURPOSE: To report the results of carotid artery stenting (CAS) in patients
      considered to have high-risk anatomical characteristics for carotid
      endarterectomy. METHODS: CAS was performed in 39 carotid arteries of 37
      consecutive patients (26 men; mean age 72 +/- 8 years, range 56-88) who met the
      criteria for high-risk surgical anatomy: previous ipsilateral carotid
      endarterectomy (20/39, 51.3%), common carotid bifurcation above the mandibular
      angle (5/39, 12.8%), contralateral carotid artery occlusion (15/39, 38.5%), or
      previous radiation therapy to the neck (1/39, 2.6%). Palmaz, Integra, or
      Wallstents were deployed via a percutaneous femoral artery access. Independent
      neurological evaluation was performed at specified time points, and a dedicated
      committee adjudicated all clinical events. RESULTS: Procedural success was 100%,
      with no major in-hospital complications. Neurological events were rare. Only 1
      (2.6%) transient ischemic attack occurred prior to discharge; at 30 days, 1
      (2.6%) additional minor stroke had been observed, giving a 2.6% cumulative 30-day
      "death plus any stroke" rate. Over a mean 11 +/- 6-month follow-up, 2 (5.4%)
      patients died of nonneurological causes, but there were no strokes. CONCLUSIONS:
      CAS is a viable endovascular revascularization technique that can be performed
      safely and effectively in patients with high-risk anatomy for carotid
      endarterectomy.

PMID- 11220468
TI  - Characterizing the carotid revascularization candidate: will plaque morphology be
      important?

PMID- 11220469
TI  - The ICAROS registry of carotid artery stenting. Imaging in Carotid Angioplasties
      and Risk of Stroke.
AB  - ICAROS (Imaging in Carotid Angioplasties and Risk Of Stroke) is a multicenter
      international registry of carotid artery stenting designed to determine the
      criteria for identifying patients at higher or lower risk of periprocedural
      stroke and restenosis at 1 year. The aim of the registry is to improve patient
      selection and consequently reduce the risk of cerebral embolization during
      carotid stenting. The registry is open to all interventionists performing carotid
      stenting, and the participants are free to apply their own endovascular
      techniques and devices, including cerebral protection mechanisms. All cerebral
      ischemic events following the procedure will be reported. Follow-up surveillance
      to 1 year will include periodic duplex scanning and neurological examinations.
      Echographic plaque images will be standardized for comparison, processed for
      echodensity, and analyzed by computer at the Registry Center. Correlation will be
      investigated between the echographic index (gray-scale median) and the risk of
      embolism and outcome of carotid stenting.

PMID- 11220470
TI  - Endoluminal stent placement and coil embolization for the management of carotid
      artery pseudoaneurysms.
AB  - PURPOSE: To present a series of carotid artery pseudoaneurysms treated
      successfully using an endovascular approach. METHODS: From April 1995 to November
      1999, 5 patients with neurological symptoms not explained by computed tomography
      of the head were identified by carotid angiography as having internal carotid
      artery (ICA) pseudoaneurysms. Three patients had sustained blunt trauma, and 2
      had previous elective carotid endarterectomies for atherosclerotic disease. The
      time between injury and treatment ranged from 3 days to 10 years. The patients
      were treated with endovascular stent placement for exclusion of the
      pseudoaneurysm, followed by filling of the cavity with multiple detachable coils.
      Patients were maintained on oral antiplatelet agents or anticoagulant therapy
      after the procedure. RESULTS: Primary technical success was 100%. No patient
      suffered permanent neurological sequelae. Postprocedure angiography demonstrated
      a patent ICA in all cases, with complete obliteration of the pseudoaneurysm. At a
      mean 8.4-month follow-up (range 2-21), all patients remained symptom free;
      angiograms in 3 patients at a mean 11.7 months demonstrated continued ICA
      patency. One patient had a 60% focal narrowing of the distal common carotid
      artery, which was treated successfully with balloon dilation and stenting.
      CONCLUSIONS: Endovascular treatment of carotid artery pseudoaneurysms is a useful
      alternative to standard surgical repair. This modality avoids the necessity for
      surgical exposure at the skull base with its inherent morbidity.

PMID- 11220471
TI  - Combined endovascular and open surgery for four-vessel cerebrovascular occlusive
      disease.
AB  - PURPOSE: To report a case of bilateral simultaneous percutaneous transluminal
      angioplasty and stenting of the intracranial vertebral arteries prior to staged
      bilateral carotid endarterectomy. CASE REPORT: A 68-year-old man presented with a
      3-month history of recurrent, intermittent left-sided weakness and diplopia.
      Imaging defined bilateral 80% to 99% internal carotid artery stenoses and >90%
      stenoses of both distal vertebral arteries at the level of the foramen magnum.
      Bilateral intracranial vertebral artery stenting was performed, followed by
      staged carotid endarterectomies. No complications occurred, and the patient
      recovered uneventfully from all 3 procedures. He remains symptom- and event-free
      20 months later. CONCLUSIONS: Our initial success in this case indicates a role
      for percutaneous transluminal angioplasty and stenting as an alternative to open
      surgery for intracranial vertebral artery stenosis.

PMID- 11220472
TI  - Intracranial vertebral artery intervention: impressive and controversial.

PMID- 11220473
TI  - Percutaneous access and closure of femoral artery access sites associated with
      endoluminal repair of abdominal aortic aneurysms.
AB  - PURPOSE: To report longer follow-up and further experience using the Prostar XL
      Percutaneous Vascular Surgery (PVS) device for access and closure of large bore
      femoral artery access sites during endovascular repair of abdominal aortic
      aneurysms (AAAs). METHODS: One hundred forty-four patients (128 men; mean age 72
      years, range 56-89) undergoing endovascular AAA repair had percutaneous access
      and closure of their 16-F femoral artery access sites using a 10-F PVS device.
      The first 54 patients were enrolled in the phase III trial of the AneuRx stent
      graft for AAA treatment. RESULTS: The femoral artery access site was successfully
      closed in 136 (94.4%) patients, with only 8 patients in whom adequate hemostasis
      could not be obtained. One-month follow-up was available in 144 patients, 6-month
      in 100, and 1-year in 59. No groin or lower extremity complications have been
      observed in any patient who had successful closure of the femoral artery access
      site. CONCLUSIONS: Large-bore femoral artery access sites can be percutaneously
      repaired using this device, which minimizes the invasiveness of the endograft
      procedure.

PMID- 11220474
TI  - Percutaneous profundaplasty in the treatment of lower extremity ischemia: results
      of long-term surveillance.
AB  - PURPOSE: To assess the procedural and long-term clinical outcomes of balloon
      angioplasty of the profunda femoris artery in patients with severe limb ischemia.
      METHODS: Thirty-one consecutive patients were evaluated for severe ischemia in 32
      limbs: 13 (41%) were categorized Fontaine class 2B, and 19 (59%) were class 3 or
      4. The superficial femoral artery was occluded in 20 (62%) limbs; an additional
      vessel was treated in 22 (69%) limbs. RESULTS: Procedural success was achieved in
      91% (31/32) of limbs. The ankle-brachial index increased from 0.5 +/- 0.2 at
      baseline to 0.7 +/- 0.2 after intervention (p < 0.01). In-hospital limb salvage
      was 94% (30/32), and in-hospital event-free survival was 90% (28/31). At a mean
      follow-up of 34 +/- 20 months, no additional amputations were necessary; 3
      patients required repeat revascularization, and 5 patients died. Freedom from
      revascularization was 88% in the 25 survivors. At follow-up, 88% of the patients
      had Fontaine class 1 or 2A symptoms, and only 12% had Fontaine class 2B or higher
      (p < 0.001 compared with baseline). CONCLUSIONS: These data suggest that
      percutaneous profundaplasty is safe, effective, and may be considered as an
      alternative to surgical therapy in patients with anatomically suitable lesions.

PMID- 11220475
TI  - Seat belt aorta: endovascular management with a stent-graft.
AB  - PURPOSE: To report the endovascular treatment of a relatively uncommon type of
      deceleration injury to the abdominal aorta. CASE REPORT: A 21-year-old backseat
      passenger was wearing a single lap belt without shoulder harness when the car was
      involved in a collision. He sustained a transverse (Chance) fracture of the third
      lumbar vertebra and a circumferential dissection of the infrarenal abdominal
      aorta with pseudoaneurysm. As an interim measure while a stent-graft was
      obtained, a Wallstent was deployed to tack down the dissection and prevent distal
      embolization. Thirty-six hours later, an AneuRx endograft was successfully
      implanted inside the Wallstent to seal the pseudoaneurysm. The patient's recovery
      was uneventful, and the endograft remains secure and the pseudoaneurysm excluded
      at 10 months after the accident. CONCLUSIONS: Endovascular repair of "seat belt
      aorta" is a minimally invasive, straightforward method of management for this
      type of aortic injury. The potential for infection in a contaminated peritoneal
      cavity and the long-term outcome of this treatment have not been determined.

PMID- 11220476
TI  - Sequential coil embolization of bilateral internal iliac artery aneurysms prior
      to endovascular abdominal aortic aneurysm repair.
AB  - PURPOSE: To report the endovascular repair of concomitant aneurysms of the
      abdominal aorta and both internal iliac arteries. CASE REPORT: A 72-year-old man
      with a 5.5-cm abdominal aortic aneurysm (AAA) extending to the right common iliac
      artery also presented with separate aneurysms of both internal iliac arteries.
      The patient refused conventional surgery, so an endovascular strategy was
      devised. Initially, the iliac aneurysms were sequentially coil embolized,
      allowing several weeks to elapse between the embolization sessions to encourage
      collateral development. A bifurcated Talent endograft was inserted successfully 8
      months after the initial intervention; no evidence of endoleaks or mesenteric
      ischemia has been seen over a 1-year follow-up. CONCLUSIONS: This case
      illustrates the feasibility of inducing collateralization prior to endovascular
      AAA repair that would jeopardize internal iliac artery circulation bilaterally.
      Sequential embolization of the internal iliac arteries over several months
      initiates this response, paving the way for eventual endovascular repair of the
      primary aortic aneurysm.

PMID- 11220477
TI  - "Accordion" deformity of a tortuous external iliac artery after stent-graft
      placement.
AB  - PURPOSE: To identify a complication of endograft deployment in aneurysmal iliac
      arteries. CASE REPORT: A 71-year-old man was referred for endovascular treatment
      of a 60-mm-diameter right common iliac artery aneurysm; however, deployment of a
      homemade covered stent (Palmaz-Schatz and polytetrafluoroethylene) induced
      shortening of the tortuous external iliac artery, causing an "accordion"
      deformity. The anomaly proved difficult to treat with serial Wallstent
      deployment, because the convolution tightened and migrated caudally with each
      stent deployed, threatening outflow. Finally, after 3 Wallstents were implanted,
      the contour of the external iliac artery was straight, and flow was unimpeded.
      However, 3 weeks later, the external iliac artery had recoiled to its original
      redundant appearance, but flow remained satisfactory. The aneurysm remains
      excluded, with satisfactory distal flow after 24 months. CONCLUSIONS: Implanting
      endografts in redundant, tortuous arterial segments may prove problematic, since
      induced straightening by the device precipitates kinking in the redundant system.
      Although treatment may be required in some situations, the vessels may return to
      a noncompressed state by removing the delivery system and guidewire.

PMID- 11220478
TI  - Can the Gram's stain be used as a diagnostic tool?

PMID- 11220479
TI  - Evaluation of the strep B OIA test compared to standard culture methods for
      detection of group B streptococci.

PMID- 11220480
TI  - Vaginal-rectal colonization with group A streptococci in late pregnancy.
AB  - OBJECTIVE: To determine the vaginal-rectal colonization rate with group A
      streptococci in late pregnancy. METHODS: All patients delivering at a northern
      New England hospital over a 38 month period had 35-37 week vaginal-rectal swabs
      cultured for group A and group B streptococci, using selective media and slide
      agglutination. RESULTS: Six thousand nine hundred forty-four screening cultures
      were obtained. Among these 1,393 were positive for group B streptococci and 2 for
      group A streptococci, yielding colonization rates of 20.1% and 0.03%,
      respectively. CONCLUSIONS: Vaginal-rectal colonization with group A streptococci
      is rare, arguing against the need for establishing group A streptococcal
      screening programs in pregnancy. An approach for managing this uncommon finding
      is presented.

PMID- 11220481
TI  - Intrauterine infection and spontaneous midgestation abortion: is the spectrum of
      microorganisms similar to that in preterm labor?
AB  - OBJECTIVE: To determine whether microorganisms associated with intrauterine
      infection and preterm labor play a contributing role in midgestation abortion.
      METHODS: A 4 year retrospective review of spontaneous midgestation abortions for
      which autopsy and microbiological cultures of placental and fetal tissue were
      performed was conducted for a tertiary obstetrics hospital, which included a
      regional referral service for perinatal and fetal pathology. One hundred twenty
      nine spontaneously delivered, nonmacerated, midgestation fetuses or stillbirths
      (of between 16 and 26 weeks' gestation) and placentas were examined and cultured
      for aerobic and anaerobic bacteria, yeasts, and genital mycoplasmas. RESULTS:
      Microorganisms were recovered in 85 (66%) cases (57% placentas, 49% fetuses).
      Among the culture positive cases, 81% had histological chorioamnionitis, 28%
      fetal pneumonitis, 38% clinical signs of infection, and 62% ruptured membranes at
      the time of miscarriage. These differed significantly from culture-negative cases
      (44%, 5%, 13%, and 34%, respectively). Group B streptococcus (GBS) was the most
      significant pathogen, recovered in 21 cases, 13 as the sole isolate, 94% with
      chorioamnionitis, and 47% in women with intact membranes. Escherichia coli and
      Ureaplasma urealyticum (22 and 24 cases, respectively) occurred mostly as mixed
      infections, with ruptured membranes. GBS, MU urealyticum, and Streptococcus
      anginosus group were individually associated with chorioamnionitis,
      Bacteroides/Prevotella and S. anginosus with fetal pneumonitis. The spectrum of
      microorganisms was similar to that in preterm labor at later gestations; however,
      GBS appeared to be the most significant pathogen in midgestation miscarriage,
      especially with intact membranes. CONCLUSIONS: Unsuspected intrauterine infection
      underlies many spontaneous midgestation abortions. GBS is a key pathogen in this
      setting.

PMID- 11220483
TI  - Wound infection in gynecologic surgery.
AB  - OBJECTIVE: We sought to determine the wound infection rate among patients
      undergoing elective gynecologic surgery at a single tertiary care center and to
      determine the predictive value of various factors that contribute to infection.
      We further investigated the adequacy of hospital records in documenting infection
      rates as well as the timing of presentation of wound infections. METHODS: The
      records of 115 patients undergoing elective gynecologic surgery at our
      institution were reviewed. Patients were further subdivided based on route of
      surgery. We analyzed the importance of antibiotic prophylaxis, route of surgery,
      smoking, diabetes, and body mass index (BMI). RESULTS: The overall wound
      infection rate was 12.17% with no significant difference in the subgroups by
      route of surgery. Overall, antibiotic prophylaxis significantly decreased
      infection rates (P = 0.0118), but the route of surgery, BMI, smoking, and
      diabetes were not significant predictors of infection. Only one case of infection
      was detected during the initial hospital stay (6.1%). Fifty percent of the
      patients with infection required readmission, and of these 35.7% required an
      additional surgical procedure. The average length of hospital stay was 2.4 days
      longer in patients with infection. CONCLUSIONS: Antibiotic prophylaxis has a role
      in the management of patients undergoing abdominal gynecologic surgery. In
      today's environment of cost containment, an increased hospital stay and the added
      likelihood of additional surgical intervention associated with wound infection
      are important targets for prevention. Most patients with wound infection were
      diagnosed after discharge from the hospital. In our population, among whom
      transportation problems and remote residence are prevalent, strategies for
      infection surveillance should be integral to discharge planning.

PMID- 11220482
TI  - Ex vivo human placental transfer of trovafloxacin.
AB  - OBJECTIVE: The purpose of this study was to determine the ex vivo human placental
      transfer of trovafloxacin from the maternal circulation to the fetal circulation.
      METHODS: Six placentas from uncomplicated, term, vaginal or cesarean deliveries
      were studied using the ex vivo isolated cotyledon perfusion chamber; 14C
      antipyrine was used as a reference compound to determine the clearance index (CI)
      of trovafloxacin. RESULTS: The CI of trovafloxacin was 0.19 +/- 0.13 at a mean
      trough concentration of 1.38 +/- 0.22 microg/ml and 0.16 +/- 0.10 at a mean peak
      concentration of 7.48 +/- 2.3 microg/ml as determined by our newly developed high
      pressure liquid chromatographic assay. Tissue concentration did not exceed
      maternal concentration, and there was little or no accumulation when the
      perfusion system was closed for 1 hr. CONCLUSIONS: Trovafloxacin crosses the
      placenta by simple diffusion and does not accumulate in the media to any extent,
      nor does it bind to tissue or accumulate in the placenta.

PMID- 11220484
TI  - Prevalence of human papillomavirus, Chlamydia trachomatis, and Neisseria
      gonorrhoeae in commercial sex workers in Japan.
AB  - OBJECTIVE: We used the hybrid capture assays to investigate the prevalence of
      human papillomavirus (HPV), Chlamydia trachomatis and Neisseria gonorrhoeae among
      commercial sex workers in Tokyo. METHODS: Five hundred forty-six consecutive
      commercial sex workers (CSW) who visited an STD clinic for STD checkup in 1998
      and 1999 were studied. A control group consisted of 233 consecutive women who
      visited a general gynecological clinic for annual checkup. A cervical sample was
      obtained for hybrid capture assays for HPV-A (low-oncogenic-risk types), HPV-B
      (intermediate- and high-oncogenic-risk types), C. trachomatis, and N.
      gonorrhoeae. Fisher's exact test was used for statistical analyses. RESULTS: The
      positive rate for HPV-B among the CSW was 48.4%, significantly higher than the
      6.0% among the control subjects. The positive rates for HPV-A, C. trachomatis,
      and N. gonorrhoeae were also significantly higher among the CSW than among the
      control subjects. Among the microorganisms tested, the positive rate for HPV-B
      was the highest in both the STD and control groups. CONCLUSIONS: The high
      prevalence of HPV, C. trachomatis, and N. gonorrhoeae infection in CSW poses a
      risk of further transmission of STD to the general public, suggesting the need
      for further education and screening for CSW and the general public. We found high
      and intermediate-oncogenic-type HPV to be the most prevalent infection among
      both CSW and control subjects. Screening for HPV may be necessary in STD and
      general clinics to predict the risk of cervical malignancy. Hybrid capture
      assays, which permit simultaneous detection of HPV and other STD with high
      sensitivity, may be a useful diagnostic method.

PMID- 11220485
TI  - Terconazole cream for non-Candida albicans fungal vaginitis: results of a
      retrospective analysis.
AB  - OBJECTIVE: Although it is FDA-approved for use in vulvovaginal candidiasis caused
      by non-Candida albicans species, terconazole cream has not been been studied in
      patients with these infections. We sought to assess the clinical and mycological
      efficacy of terconazole cream in women with non-C. albicans vaginitis. METHODS:
      The records of patients who had received a 7-day course of terconazole cream for
      culture-proved non-C. albicans vaginitis were reviewed. Data with regard to
      patient demographics, clinical and mycologic response to therapy within 1 month
      of treatment, and outcome with other antifungal therapies were analyzed. RESULTS:
      Twenty-eight patients received terconazole cream for non-C. albicans infections.
      Three patients did not return for follow-up. The median age was 45 years. Seven
      (28%) patients were nulliparous. The median duration of symptoms was 3 years.
      Nine patients (36%) had received terconazole within the 6 months prior to
      referral. Overall, there were 20 C. glabrata cases, 3 C. parapsilosis, and 2 C.
      lusitaniae. Fourteen (56%) patients achieved a mycologic cure; 11 (44%) noted a
      resolution of their symptoms. Prior terconazole use was not associated with
      treatment failure (P = 0.09). Ten failures received boric acid suppositories as
      subsequent treatment; a cure was effected in 4 (40%). Two of three patients (67%)
      were eventually cured with flucytosine cream. Five (20 %) patients remained
      uncured. CONCLUSIONS: Terconazole cream may be an appropriate first-line
      treatment for non C. albicans vaginitis, even in patients who have previously
      received the drug.

PMID- 11220486
TI  - Value of Candida polymerase chain reaction and vaginal cytokine analysis for the
      differential diagnosis of women with recurrent vulvovaginitis.
AB  - OBJECTIVES: Recurrent vulvovaginitis remains difficult to diagnose accurately and
      to treat. The present investigation evaluated the utility of testing vaginal
      specimens from women with symptomatic recurrent vulvovaginitis for Candida
      species by polymerase chain reaction (PCR) and for cytokine responses. METHODS:
      Sixty-one consecutive symptomatic women with pruritus, erythema, and/or a thick
      white discharge and a history of recurrent vulvovaginitis and 31 asymptomatic
      women with no such history were studied. Vaginal swabs were tested for Candida
      species by PCR, for the antiinflammatory cytokine interleukin (IL)-10, and for
      the proinflammatory cytokine IL-12. RESULTS: C. albicans was detected in 19
      (31.1%) of the patients as well as in three (9.7%) controls (P = 0.03). Both IL
      10 (31.1% vs. 0%) and IL-12 (42.6% vs. 6.5%) were also more prevalent in the
      recurrent vulvovaginitis patients (P < 0.001). However, there was no relation
      between the presence or absence of Candida and either cytokine. Detection of IL
      12 in 14 women indicated the stimulation of a vaginal cell-mediated immune
      response possibly from an infectious agent. The presence of only IL-10 in six
      patients indicated a suppression of vaginal cell-mediated immunity and was
      consistent with a possible allergic etiology. The absence of both IL-10 and IL-12
      in other patients, similar to that found in healthy controls, suggested a
      noninfectious, nonallergic etiology of their symptoms. CONCLUSION: Many women
      with recurrent vulvovaginitis are not infected with Candida. Testing for Candida
      should be required in this population. Treatment with only anti-Candida
      medication will clearly be inadequate for the majority of women with this
      condition.

PMID- 11220487
TI  - Systematic review of diagnostic tests for vaginal trichomoniasis.
AB  - OBJECTIVE: To review critically and to summarize the evidence of diagnostic tests
      and culture media for the diagnosis of Trichomonas vaginitis. METHODS: We
      performed a systematic review of literature indexed in MEDLINE of studies that
      used Trichomonas culture as the reference standard (9,882 patients, 35 studies).
      Level I studies (5,047 patients, 13 studies) fulfilled at least two of three
      criteria: 1) consecutive patients were evaluated prospectively, 2) decision to
      culture was not influenced by test results, and 3) there was independent and
      blind comparison to culture. RESULTS: The sensitivity of the polymerase chain
      reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98%
      (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients).
      The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to
      90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the
      direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was
      99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's,
      96% for Hollander, and 95% for CPLM. CONCLUSIONS: The sensitivity and specificity
      of tests to diagnose trichomoniasis vary widely.

PMID- 11220488
TI  - Dihydropyridine receptors functioning as voltage sensors in cardiac myocytes.
AB  - Isolated, superfused with [Ca2+]0 = 2.5-3 mM (T = 37 degrees C) and voltage
      clamped ventricular myocytes of guinea-pig hearts were stimulated by pulses from
      a holding potential -40 mV to +5 mV (duration 300 ms). They activated L-type Ca2+
      current and a biphasic contractile response: a phasic component of amplitude
      approximately 7% of resting cell length (duration approximately 150 ms) and a
      tonic component of amplitude approximately 3% of resting cell length. The phasic
      component was inhibited by 10(-6) M thapsigargin (Tg). Pulses from -40 mV to +5
      mV stimulated a similar bi-phasic contractile response in 74% of cells (n = 126)
      superfused from the beginning of a 30 s period of rest with 5-10 mM Ni2+ which
      blocked the Ca2+ current and Na+ -Ca2+ exchanger (Ni2+-contractions). Thus, the
      Ni2+-contractions could be activated only by intracellular Ca2+ release. The
      phasic component of control contractions showed the bell-shaped voltage relation
      at [Ca]0 = 2 mM and sigmoid relation at [Ca]0 = 3 mM. The phasic component o Ni2+
      contractions showed a sigmoid relation at voltages from -40mV to +100 mV and
      could not be activated at [Ca]0 = 2 mM. It was inhibited by 20 microM nifedipine,
      a blocker of dihydropyridine receptors, even when activated by the pulses to +70
      mV, during which the Ca2+ current does not flow. We proved that nifedipine does
      not affect Na+-Ca2+ exchange. The phasic component of Ni2+-contractions was also
      inhibited by 2 nM indolizinesulphone SR33557, another dihydropyridine receptor
      blocker, which halved the phasic component of contractions in sontrol cells
      without any significant effect on the Ca2+ current. Stimulation did not activate
      contraction in any of 19 cells in which 20 microM nifedipine was superfused from
      the beginning of 30 s rest instead of 5 mM Ni2+. These cells were depolarized to
      +5 mV over the rest period in order to prevent intracellular Ca2+ loss by Na+ 
      Ca2+ exchange. Residual Ca2+ currents were much stronger in cells superfused with
      nifedipine than residual currents in cells superfused with Ni2+ (hardly visible
      in the records). Our results suggest that a vestigial remnant of a voltage
      sensing mechanism similar to that in the skeletal muscle may trigger the Ca2+
      release from the SR of cardiac myocytes under specific experimental conditions.
      In normal cells it may be complementary to calcium induced calcium release
      (CICR).

PMID- 11220489
TI  - ATP-induced CA2+-signaling enhances rat gastric microvascular endothelial cell
      migration.
AB  - The effects of exogenous ATP on Ca2+ signaling and wound healing were
      investigated in rat gastric microvascular endothelial cells (RGMEC). ATP (10
      microM) triggered a significant rise in intracellular Ca2+ concentration
      ([Ca2+]i) from 46+/-2 nM at baseline to peak values averaging 283+/-31 nM (n = 5
      experiments, 132 cells). Return to the basal [Ca2+]i was delayed by slowly
      declining plateau phase that persisted for 200+/-30 s. Removal of extracellular
      Ca2+ did not significantly affect the peak rise in [Ca2+]i, but reduced the
      plateau. ATP (10 microM) also significantly increased the migration of RGMEC in a
      wounded monolayer. Addition of the non-subtype selective purinergic receptor
      antagonist, suramin, abrogated the effects of ATP on [Ca2+]i and migration. We
      conclude that local elevation of ATP acting through purinergic receptors induce
      Ca2+ signals in RGMEC and may contribute to endothelial cell migration.

PMID- 11220490
TI  - Isolation and characterization of rat gastric microvascular endothelial cells as
      a model for studying gastric angiogenesis in vitro.
AB  - We have previously characterized morphologic features of wounding-induced
      angiogenesis that occurs in response to acute and chronic gastric mucosal injury.
      As a means of investigating the molecular mechanisms underlying gastric
      angiogenesis, microvascular endothelial cells were isolated from stomachs of
      normal (non-injured) rats. The isolation procedure adapted and combined aspects
      of previous methods and employed positive selection using magnetic beads coated
      with monoclonal antibody specific for rat CD31 (PECAM-1), a cell surface marker
      restricted to platelets, monocytes, T lymphocytes and endothelial cells. The
      isolated microvascular endothelial cells expressed vascular endothelium-specific
      antigen and the endothelial-specific receptors, Tie2 and flt-1 (VEGFR1). When
      plated on growth factor-reduced matrigel, the isolated microvascular endothelial
      cells formed capillary-like structures reflecting in vitro angiogenesis. These
      cells were also responsive to vascular endothelial growth factor, VEGF, further
      verifying their endothelial nature. The rat microvascular endothelial cells
      isolated by this procedure should be useful in delineating molecular mechanisms
      and regulation of the angiogenesis that is essential for the healing of acute and
      chronic gastric injury.

PMID- 11220491
TI  - Sources of activator Ca2+ for galanin-induced contractions of rat gastric fundus,
      jejunum and colon.
AB  - Galanin (Gal) evoked reproducible contractions of isolated rat gastric fundus,
      colon and jejunum longitudinal strips in concentrations ranging from 1 nM to 3
      microM. EC50 of Gal equalled 12.63, 23.27 and 56.02 nM, respectively. Hill's
      coefficients were not different from unity in any of the tissues examined.
      Experiments have been performed in the presence of protease and peptidase
      inhibitors, a variety of specific antagonists and tetrodotoxin (TTX) to exclude
      the non-specific stimulatory or inhibitory action of Gal. Gal-evoked contractions
      were attenuated by diminished extracellular Ca2+ concentration and by diltiazem.
      Gal activity in gastric fundus and colon, but not in jejunum was inhibited by
      depleting intracellular Ca2+ stores, thapsigargin, dantrolene, ryanodine, TMB-8,
      neomycin and U-73122. Our data confirmed that Gal contracts rat fundus, jejunum
      and colon by stimulating specific receptors, which are coupled both to Ca2+
      influx through the voltage-dependent calcium channels and intracellular Ca2+
      release from ryanodine- and IP3-sensitive stores (stomach and colon) or the
      extracellular Ca2+ influx only (jejunum). Phosphatidylinositol-specific
      phospholipase C (PI-PLC) plays a crucial role in the former but not in the latter
      signal transduction cascade.

PMID- 11220492
TI  - 5-HT1A receptor agonists buspirone and gepirone attenuate apomorphine-induced
      aggressive behaviour in adult male Wistar rats.
AB  - We have studied the effects of acute serotonin (5-HT) 5-HT1A receptor agonist
      buspirone (0.5, 1.0, 2.5 and 5.0 mg/kg, s.c.), gepirone (5.0 and 10 mg/kg, s.c.),
      and 8-OH-DPAT (0.1, 0.25, and 0.5 mg/kg, i.p.) treatment on the apomorphine
      induced aggressive behaviour in adult male Wistar rats. Buspirone in doses of 2.5
      and 5.0 mg/kg completely blocked, gepirone (10 mg/kg) significantly attenuated
      the aggressiveness, and 8-OH-DPAT abolished aggressive behaviour only in the
      lowest dose used (0.1 mg/kg) which effect disappeared in higher doses. The
      antiaggressive effect of buspirone (2.5 mg/kg) and gepirone (10 mg/kg) was not
      reversed by a 5-HT1A receptor antagonist WAY 100635 (0.3 mg/kg). All 5-HT1A
      receptor agonists tested dose-dependently decreased the exploratory behaviour of
      experimentally naive rats, while buspirone (2.5 mg/kg) and gepirone (10 mg/kg)
      had only a weak effect on the locomotor activity and stereotyped behaviour in the
      apomorphine-pre-sensitised rats. In conclusion, our experiments demonstrate the 5
      HTIA receptors may be involved in the mediation of the apomorphine-induced
      aggressive behaviour in adult male Wistar rats. However, the prominent
      antiaggressive effect of buspirone, and to a lesser extent--gepirone, seems to be
      mediated by some other mechanisms, evidently via the dopamine D2 receptors.

PMID- 11220493
TI  - The influence of increasing and decreasing frequency of stimulation on the
      contraction of motor units in rat medial gastrocnemius muscle.
AB  - Motoneurons during their activity can generate firings at changing rate.
      Therefore, the present paper aimed at studying the evoked contractions of
      different types of motor units to stimulation at progressively decreasing or
      increasing interpulse intervals. The influence of both patterns of stimulation on
      the tension, the duration and the tension-time area of motor units in rat medial
      gastrocnemius muscle was studied. The decreasing stimulation frequency resulted
      in generation of a bigger tension-time area although a slightly lower tension and
      a shorter duration of a contraction were observed in majority of studied units.
      For fast units a bigger tension-time area observed during the stimulation at
      decreasing frequency is probably due to the potentiation resulting from the
      initial high-frequency stimulation. On the other hand, at increasing frequency of
      stimulation the influence of the initial low-frequency stimulation can depress
      the tension-time area. The decreasing rate of stimulation during relaxation
      appeared to support the tension more effectively in slow-twitch motor units than
      in fast ones. Therefore, slow motor units are well suited to support the tension
      of tonic contractions.

PMID- 11220494
TI  - Effects of different intensities of cold stress on certain physiological
      phenomena related to skeletal health in a hypogonadal rat model.
AB  - Intestinal transference pattern of calcium and associated changes in the
      activities of intestinal mucosal enzymes, rate of bone turnover and bone
      metabolism were evaluated in ovariectomized rats exposed to cold stress of
      various intensities i.e., mild (15 degrees C) or stronger (8 degrees C and 4
      degrees C) for 5 min everyday for 7 consecutive days. Except mild cold stress
      induced group (15 degrees C), rats of other two groups (8 degrees C and 4 degrees
      C) showed considerable decrease in the rate of in situ intestinal transference of
      calcium. Likewise, in these groups, the activities of intestinal mucosal enzymes,
      alkaline phosphatase (AP) and calcium ATPase (Ca2+-ATPase) were decreased
      significantly in all the segments of small intestine in a descending gradient.
      Also significant changes in bone turnover and bone resorption were confirmed in
      these animals by marked alterations in plasma AP activity, urinary calcium and
      phosphate excretion and urinary calcium to creatinine ratio (Ca: Cr). The
      skeletal changes were further ascertained by examining other physical and
      biochemical parameters of bone metabolism viz., body mass, bone density, ratio of
      mineral to matrix and mineral content of bone ash (calcium and phosphate) in the
      ovariectomized rat model. All these results suggest that stronger cold stress (8
      degrees C and 4 degrees C) may be an important ecological factor in the
      development of earlier bone loss in hypogonadal rats.

PMID- 11220495
TI  - Age dependent changes of insulin receptors in rat tissues.
AB  - Aging is associated with insulin resistance but the exact molecular mechanism is
      still unknown. Tissue insulin resistance can be evoked by the decreased
      sensitivity to insulin, the decreased responsiveness to hormone or both. As the
      first step in insulin action is its binding to alfa subunits of the receptor we,
      therefore, studied the insulin binding kinetics in plasma membranes of the liver,
      heart and skeletal muscle in order to establish whether their ability to bind the
      hormone is altered with aging. Plasma membranes were prepared and purified
      according to Havrankowa and binding assay was performed using (125I)-iodoinsulin.
      The kinetic parameters of the hormone-receptor interaction were analysed by the
      method of Scatchard using the LIGAND-Pc v.3.1. computer program. The binding
      potency of insulin was calculated as IC50 using ALLFIT-Pc v.2.7. computer
      program. We have shown that there are striking differences in insulin binding
      kinetics in newborn and old rats, depending on kind of tissue tested. The liver
      plasma membranes ability for insulin binding, number of high (HAIR) and low
      (LAIR) affinity insulin receptors, values of the dissociation constants and
      products of association constants and number of insulin receptors, were almost
      the same, being not dependent on age of the rats. By contrast, there is less high
      affinity insulin receptors in skeletal muscle of the old animals. The most
      dramatic changes in insulin binding occur in the heart where both high and low
      affinity insulin receptors are greatly affected by aging. Our results indicate
      that the response of the three tissues tested to hyperglycemia and
      hyperinsulinemia, observed in the old rats, has not been identical and probably
      can be accounted for by the different distribution of insulin receptor isoforms
      in the liver, heart and skeletal muscles as shown recently by Vidal et al.

PMID- 11220496
TI  - The effect of dietary-induced obesity on lipid peroxidation, antioxidant enzymes
      and total plasma antioxidant capacity.
AB  - The aim of this study was to examine the effect of dietary-induced obesity on
      some parameters of oxidative stress and antioxidant defence. The studies were
      performed in adult male Wistar rats. Control group received normal laboratory
      chow (62% calories as carbohydrates, 26% protein and 12% fat). High-calorie high
      fat group (HCHF) was fed standard chow supplemented with lard (48% calories as
      carbohydrates, 20% as protein and 32% as fat) and high-calorie normal-fat group
      (HCNF) received standard chow and liquid diet containing sucrose, glucose, whole
      milk powder and soybean powder (60% carbohydrates, 26% protein, 14% fat). After 8
      weeks body weight of HCHF and HCNF-fed rats was higher than body weight of
      controls by 9.3% and 15.2%, respectively. Plasma concentration of thiobarbituric
      acid-reactive substances (TBARS) increased in these groups by 43% and 52%,
      respectively. The activity of superoxide dismutase (SOD) decreased in HCHF group
      by 47.5% and in HCNF group by 21.1%. Glutathione peroxidase (GPx) activity in the
      blood tended to increase in both experimental groups but this was not
      significant. Plasma total antioxidant status (TAS) measuring the combined free
      radicals scavenging ability of nonenzymatic antioxidants was lower in HCHF and in
      HCNF group compared to control (-8.8% and -9%, respectively). The major observed
      lipid abnormalities were hypertriglyceridemia in HCHF group and decreased HDL
      cholesterol in HCNF group. TBARS correlated negatively with SOD (r = -0.84, p <
      0.001) and with TAS (r = -0.47, p < 0.05). These results indicate that obesity
      leads to oxidative stress which can contribute to obesity-associated diseases
      such as atherosclerosis, diabetes mellitus and arterial hypertension.

PMID- 11220497
TI  - Central single and chronic administration of morphine stimulates corticosterone
      and interleukin (IL)-6 in adjuvant-induced arthritis.
AB  - Adjuvant-induced arthritis (AA) in the rat is a chronic inflammatory stress in
      which circulating corticosterone and interleukin (IL)-6 levels are elevated. In
      addition, there are profound neuroendocrine changes associated with the
      development of hind-paw inflammation which have major implications for the
      ability of the rat to respond to stress. Central injection of morphine is able to
      increase plasma corticosterone and circulating IL-6 concentration in control
      animals. In present study we have determined the effects of a single and repeated
      injection of morphine into the lateral ventricle of control and AA animals on
      plasma corticosterone, circulating IL-6 levels and course of hind-paw
      inflammation in AA rats. In the present study we found a sustained increase in
      plasma corticosterone both after single and repeated injection of morphine in
      control and AA rats and an increase of the level of circulating IL-6 in AA rats
      after repeated injection of morphine. These data suggest that alternative systems
      distinct from Athose activated in response to acute stress are activated by
      morphine in the AA animals. The similarity with the sustained increase in
      corticosterone following LPS injection suggest that central opiates may be
      involved in mediating HPA axis and cytokines response to inflammatory stress.

PMID- 11220498
TI  - Involvement of nitric oxide in central histaminergic stimulation of the
      hypothalamic-pituitary-adrenal axis.
AB  - Brain histamine participates in central regulation of the hypothalamic-pituitary
      adrenal (HPA) axis. Endogenous nitric oxide (NO) modulates signal transduction of
      some neurotransmitters involved in activation of the HPA axis. In the present
      study we investigated whether endogenous NO and histaminergic systems in the rat
      brain interact in their regulation of ACTH and corticosterone secretion.
      Histamine (50 microg), histamine-trifluoromethyl-toluidide derivative (HTMT, 75
      microg) a selective and potent H1-receptor agonist, and amthamine (75 microg) a
      H2-receptor agonist given intracerebroventricularly (i.c.v.) considerably
      increased ACTH and corticosterone secretion 1 h after administration. A potent
      and competitive inhibitor of rat brain neuronal NO synthase, (NOS), 7
      nitroindazole (7-NI), given i.p. 15 min before histamine moderately increased the
      histamine-induced ACTH secretion and did not substantially alter the histamine
      induced corticosterone secretion. Pretreatment with 7-NI totally abolished the
      HTMT-induced increase in ACTH and corticosterone secretion. The amthamine-evoked
      rise in ACTH secretion was moderately diminished and the amthamine-induced
      corticosterone secretion was not substantially altered by preatreatment with 7
      NI. These results suggest that the histamine H -receptor transmited central
      stimulation of the HPA axis is considerably mediated by endogenous NO, whereas
      stimulation by histamine and via H2-receptor does not significantly depend on
      endogenous NO mediation.

PMID- 11220499
TI  - LH/hCG receptors in the porcine uterus--a new evidence of their presence in the
      cervix.
AB  - High-affinity LH/hCG binding sites have been characterized in bovine, lepine,
      murine, human uteri and porcine myometrium and endometrium. In the present
      studies we analyzed these receptors in the porcine cervix. Radioreceptor ligand
      assays were performed with cell membrane preparations of the cervix which were
      analyzed for binding sites specificity, capacity and affinity. Corpus luteum and
      myometrium were used as positive control tissues. In the cervix there was little
      competition for receptor occupancy between hCG and porcine FSH (1.2%) or
      bovineTSH, porcine GH and porcine PRL (0.1%, 0.1% and < 0.001%; respectively) but
      porcine LH could completely inhibit the binding of [125I] hCG. There was not
      binding for LH/hCG in crude membrane preparations of kidney or skeletal muscle.
      The concentration (fmol/mg protein) of cervical LH/hCG receptor did not vary
      significantly during particular phases of the estrous cycle, except the early
      luteal phase (Days 6-7) when the level of LH receptors was very low (p < 0.05).
      The affinity of uterine LH/hCG binding sites in the cervix and the myometrium was
      not different from the affinity of LH/hCG binding sites in luteal cells. The
      porcine cervix as well as the myometrium contains a 75- and 48-kDa immunoreactive
      LH/cCG receptor proteins similar to corpus luteum. Southern blot of RT-PCR
      products performed to enhance the specificity and sensitivity of LH receptor
      transcripts determination in uterine tissues revealed that expected fragments of
      740 and 470 bp were present in myometrium and corpus luteum. The cervix showed
      only 740 bp fragment. In situ hydridization showed the expression of mRNA for LH
      receptor in the epithelium of the cervix. Immunoreactive staining for LH/hCG
      receptors was also observed only in epithelial cells of the cervical tissue. Our
      studies are probably the first evidence demonstrating the specific LH/hCG binding
      sites in female cervix.

PMID- 11220500
TI  - Role of calcitonin gene related peptide in the modulation of intestinal
      circulatory, metabolic, and myoelectric activity during ischemia/reperfusion.
AB  - Calcitonin gene related peptide (CGRP) is widely distributed in the myenteric
      neurons along GI tract. Biological effects of CGRP on gastrointestinal tract
      include increase in the intestinal blood flow, relaxation of the smoth muscle and
      slight increase in the slow wave amplitude (SWA) with no effect on frequency
      (SWF) of intestinal myoelectric activity (IMA). The aim of this study was to
      evaluate the possible protective effects of endo- and exogenous CGRP against
      ischemia/reperfusion (I/R) induced bowel injury in rats. Experiments were
      performed on 30 fasted anesthetized Wistar rats. Systemic arterial blood pressure
      (AP), mesenteric blood flow (MBF) and microcirculatory intestinal blood flow
      (LDBF) were measured. Oxygen consumption (VO2) was estimated from MBF and
      mesenteric AVO2 difference. IMA was recorded by 4 monopolar electrodes in
      proximal jejunum and analyzed using computer program with Fourrier analysis of
      SWF. Control ischemia induced by 30 min total occlusion of anterior mesenteric
      artery (AMA) reduced SWA by 25+/-5% and SWF by 24+/-4%. At the end of 60 minute
      reperfusion period SWA and SWF values were restored to control values but SWF
      showed instability. At the 15th minute of reperfusion period MBF, LDBF and VO2
      increased to 109+/-6, 119+/-11 and 120+/-7% of control values respectively.
      Infusion of exogenous CGRP (0,16 microg/kg/min i.a.) increased MBF, LDBF and VO2
      by 26+/-6, 31+/-9 and 20+/-4% respectively in comparison to control values. In
      the same experimental group SWA increase of 14% was observed with not significant
      changes in SWF. In the group where CGRP was administrated before and during 30
      min period of intestinal ischemia MBF, LDBF and VO2 values at 15th minute of
      reperfusion were significantly higher by 24+/-6, 32+/-7 and 17+/-5% respectively
      in comparison to the values observed in the control reperfusion. In that group
      SWA values were restored to preocclusion values at 15th minute of reperfusion yet
      and SWF showed much more stability. Infusion of CGRP receptor antagonist (CGRP 8
      37) reduced MBF, LDBF and VO2 by 12+/-7, 14+/-8 and 11+/-6% respectively
      (differences not significant versus control). In I/R group when CGRP 8-37 was
      given hemodynamic parameters (during reperfusion) were significantly lower and
      IMA parameters were not restored to preocclusion values. We conclude, that
      endogenous and exogenous CGRP attenuate circulatory parameters of the small
      intestine during ischemia and reperfusion. A direct correlation exists between
      hemodynamic, metabolic and myoelectric effects of CGRP.

PMID- 11220501
TI  - Gender differences in sexual behaviors and factors associated with nonuse of
      condoms among homeless and runaway youths.
AB  - Few studies have examined gender-specific factors associated with the nonuse of
      condoms among homeless and runaway youths (HRYs)-a population at high risk for
      HIV infection. In this article, we evaluate these factors and explore gender
      differences in background experiences, psychosocial functioning, and risk
      behaviors among HRYs from four U.S. metropolitan areas. Of 879 sexually active
      HRYs sampled, approximately 70% reported unprotected sexual intercourse during a
      6-month period, and nearly a quarter reported never using condoms in the same
      period. Among males and females, having only one sex partner in the previous 6
      months had the strongest association with nonuse of condoms. Among males, nonuse
      was also associated with having ever caused pregnancy, frequent marijuana use,
      prior physical victimization, and low self-control and sociability. Among
      females, nonuse was associated with knowledge of HIV status, prior sexual
      victimization, low social support, and infrequent marijuana use. These findings
      highlight the ongoing need for HIV prevention services for HRYs. Implications for
      the scope and content of these services are discussed.

PMID- 11220502
TI  - Examining communication and assertiveness as predictors of condom use:
      implications for HIV prevention.
AB  - The current study explored the relationship between communication and
      assertiveness in general and sexual contexts and examined each construct's
      differential ability to predict reported condom use among college students. The
      results suggest that the constructs are positively related to each other, but
      general communication does not predict sexual assertiveness. Although sexual
      assertiveness is a better predictor of condom use than general assertiveness,
      general communication, and sexual communication, it needs to be considered within
      the context of other variables (e.g., normative beliefs regarding condom use).
      HIV prevention programs and models of health behavior should incorporate
      individual characteristics such as sexual assertiveness. The results of this
      study suggest that sexual assertiveness, social norm perceptions of condom use,
      self-efficacy for HIV prevention, and condom attitudes are among the critical
      variables that should be examined in an integrated model of sexual health
      behavior.

PMID- 11220503
TI  - The impact of sexuality and race/ethnicity on HIV/AIDS risk among Asian and
      Pacific Island American (A/PIA) gay and bisexual men in Hawai'i.
AB  - The prevalence of HIV/AIDS in Asian and Pacific Island Americans (A/PIAs) has
      been relatively low in proportion to other racial/ethnic groups in the United
      States. However, HIV infection among A/PIA gay and bisexual men, and men who have
      sex with men has steadily increased in urban and other geographic areas with
      large Asian and Pacific Island populations. In this study of race/ethnicity and
      HIV risk among A/PIA gay and bisexual men in Hawai'i, respondents reported
      significant conflicts between loyalty to one's A/PIA family of origin and the
      enactment of individual sexual identity. Idealization of love and intimacy,
      intentional decisions to suspend safer sex practices, and Pacific Island cultural
      expressions of giving to others are all factors that may compromise HIV risk
      reduction in this population. Implications for HIV/AIDS prevention focus on
      integrating A/PIA, gay/bisexual, and "local" (born and raised in Hawai'i)
      identities in the development of multilevel interventions.

PMID- 11220504
TI  - Differences in disclosure of sexuality among African American and White
      gay/bisexual men: implications for HIV/AIDS prevention.
AB  - Gay and bisexual men were asked if they had disclosed their sexuality to family
      members, heterosexual friends, gay friends, coworkers, health care workers, and
      members of their church; if they had been associated with groups made up of gays,
      bisexuals, and lesbians; and if they had gay/bisexual friends. White men were
      much more likely to disclose their sexuality, to have associated with groups and
      to have gay/bisexual friends. As education increased, white men were more likely,
      and African American men less likely, to disclose sexuality and associate with
      groups. Having gay/bisexual friends increased with education with both groups.
      The difference in disclosure can be traced to the higher social stigma apparently
      attached to being gay in the African American community, which may be exacerbated
      for more educated men. As a result, African American gay men may be less likely
      to participate in the fight against HIV/AIDS.

PMID- 11220505
TI  - Women with HIV: conflicts and synergy of prayer within the realm of medical care.
AB  - In a recent survey of women with HIV, prayer was mentioned as a very important
      source in decision making about HIV antiretroviral therapy. As a follow-up to
      this finding, we conducted in-depth interviews with 51 women attending a
      comprehensive HIV care center to better understand the role of prayer in their
      decisions about taking antiretroviral therapy. The sample consisted predominately
      of African American (80%) women with a median age of 31 years from St. Louis and
      surrounding areas. Forty-seven (92%) reported that prayer was an important source
      for HIV medication decision making, with 30 (59%) considering prayer more
      important than the physician. Twenty-nine (57%) perceived a qualitative
      difference between prayer and the physician, which created a sense of conflict
      for some. Thirty (59%) wished that the physician knew more about the role of
      prayer in their lives. Our findings reveal compelling issues: (a) the willingness
      of the women to talk about prayer as a resource and its importance in HIV disease
      management, (b) the roles that prayer and the physician play in HIV medication
      decision-making, and (c) ways prayer can be addressed in a medical setting.

PMID- 11220506
TI  - Preventive attitudes towards the threat of AIDS: process and determinants in
      rural Senegal.
AB  - This report is intended to identify the determinants of preventive attitudes and
      thereby enable the further elaboration of effective prevention programs in a
      country where the HIV epidemic has remained controlled. Across-sectional survey
      using a standardized questionnaire was conducted among a sample of 866 adults of
      the general population of the rural area of Niakhar, Senegal. The analysis
      identified psychosocial determinants related to preventive attitudes and the
      influence of sociodemographic characteristics and of sources of AIDS information
      on these determinants. Psychosocial determinants of preventive attitudes differed
      according to gender: Among men, personal risk perception was associated with
      preventive attitudes. Among women, level of AIDS-related knowledge, communication
      about AIDS, and optimism about the future were associated with preventive
      attitudes. Sociodemographic factors and sources of information were similar for
      men and women: Preventive attitudes were adopted primarily by young, educated
      subjects who had been exposed to urban life. Religion appeared to be a major
      obstacle to preventive attitudes. Preventive messages broadcast on radio or
      television may be determinative. Our results call for a strengthened
      collaboration with religious leaders and a focus on risk perception to
      rationalize preventive actions. We also encourage the targeting of vulnerable
      populations, such as women in rural areas, by developing preventive messages to
      be delivered through national media (radio, television) and by staff from health
      centers, which most women visit, at least for prenatal care.

PMID- 11220507
TI  - Risk factors and characteristics of youth living with, or at high risk for, HIV.
AB  - Over 8,000 adolescents and young adults (4,111 males; 4,085 females) reported on
      several HIV-related risk behaviors during enrollment into 10 service
      demonstration projects targeted to youth living with, or at risk for, HIV.
      Distinct risk patterns emerged by gender when predicting HIV serostatus (versus
      unknown serostatus/negative serostatus). Males who had injection drug risk
      histories, had sex with an HIV positive partner, had sexually transmitted
      diseases, had sex with males, and/or were homeless had an inflated risk of being
      HIV positive. Females who engaged in sex with an HIV partner, had sex with an
      injection drug user, and/or had sexually transmitted diseases, were at the
      highest HIV risk. For both samples, engaging in sex with women reduced the
      likelihood of HIV positive status. Very basic information about risk factors
      obtained at service intake offers important information about HIV status of "high
      risk" youth presenting for care in community programs, as well as suggests clear
      risk factors for targeted preventive efforts.

PMID- 11220508
TI  - Differences in treatment and metabolic abnormalities between normo- and
      hypertensive patients with type 2 diabetes: the Skaraborg Hypertension and
      Diabetes Project.
AB  - AIM: To examine treatment and glucose control in type 2 diabetes patients with
      and without hypertension, and to explore differences in markers for insulin
      resistance and beta cell function. METHODS: A community-based, cross-sectional
      observational study was carried out at the hypertension and diabetes outpatient
      clinic in primary health care, Skara, Sweden. The subjects were all the 400
      patients with type 2 diabetes (202 men, 198 women) who underwent annual follow-up
      from May 1992 through September 1993; 204 of these also had hypertension.
      RESULTS: The patients with both type 2 diabetes and hypertension had a higher
      b.m.i. (mean; 28.9 kg m(-2) (s.d.; 4.4) vs. 27.4 kg m(-2)(4.6)), higher
      triglycerides (2.0 mmol l(-1)(1.1) vs. 1.7 mmol l(-1)(1.1)), higher LDL/HDL
      cholesterol ratio (4.3(1.4) vs. 4.1(1.2)) and higher fasting insulin (8.5 mU l(
      1)(1.1) vs. 6.6 mU l(-1)(1.1)). Conversely, glucose levels were lower; HbA1c
      (6.4%(1.4) vs. 6.8%(1.6)) and fasting blood glucose (8.1 mmol l(-1)(2.3) vs. 8.9
      mmol l(-1)(2.7)) than in patients with type 2 diabetes alone. By the homeostasis
      model assessment (HOMA), patients with type 2 diabetes alone had more impaired
      beta cell function. They also had a higher frequency of insulin treatment (20%
      vs. 12%) and were less often treated non-pharmacologically (33% vs. 50%).
      CONCLUSIONS: Patients with type 2 diabetes and hypertension constitute a high
      risk category with a more atherogenic risk factor profile related to the insulin
      resistance syndrome. Patients with type 2 diabetes without hypertension seem to
      constitute a subgroup of type 2 diabetes with predominately impaired beta cell
      function.

PMID- 11220513
TI  - FDA reviews troglitazone.

PMID- 11220509
TI  - Gliclazide reduces the induction of human monocyte adhesion to endothelial cells
      by glycated albumin.
AB  - OBJECTIVE: To examine the kinetic of human monocyte adhesion to endothelial cells
      stimulated by glycated albumin, the contributive role of cell adhesion molecules
      to this effect, and the effect of gliclazide--an hypoglycemic drug with
      antioxidant properties--on these parameters. METHODS: In-vitro experiments
      performed in the presence and absence of gliclazide consisted of: (1) time
      dependent determination of human monocyte adhesion to human endothelial cells
      (ECs) pre-exposed to glycated albumin; (2) evaluation of adhesion after
      incubation of ECs with antibodies against cell surface adhesion molecules; and
      (3) determination of EC surface adhesion molecules and of the activity of the
      transcription factor NF-kappaB. RESULTS: Exposition of human ECs for 1-48 h to
      100 microg/ml glycated albumin led to a time-dependent increase in human monocyte
      adhesion to endothelium. Pretreatment of ECs with 10 microg/ml gliclazide
      significantly decreased the glycated albumin-stimulated monocyte adhesion to
      these cells. Anti-antibodies against E-selectin (ELAM-1), vascular cell adhesion
      molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) also reduced
      the stimulatory effect of glycated albumin on monocyte adhesion. In glycated
      albumin-treated ECs, an induction of both soluble and cell associated expression
      of ELAM-1, VCAM-1 and ICAM-1, an augmentation in the levels of these molecule
      transcripts and an increase in the DNA binding activity for NF-kappaB in the
      promoters of these antigens were observed. Gliclazide markedly inhibited the
      induction of all these parameters. CONCLUSIONS: Glycated albumin stimulates human
      monocyte adhesion to ECs by inducing cell associated ELAM-1, ICAM-1 and VCAM-1.
      Gliclazide effectively inhibits monocyte adhesion to ECs by reducing glycated
      albumin induction of EC adhesion molecules and NF-kappaB activation. These
      results suggest that gliclazide may be beneficial in the prevention of
      endothelial disturbances associated with hyperglycemia in diabetic patients.

PMID- 11220514
TI  - Early intensive insulin treatment for induction of long-term glycaemic control in
      type 2 diabetes.

PMID- 11220515
TI  - In-vivo and in-vitro models of type 2 diabetes in pharmaceutical drug discovery.

PMID- 11220516
TI  - Isolation of human islets and beta-cells for pharmacological studies.

PMID- 11220517
TI  - A beta3-adrenergic agonist increases muscle GLUT1/GLUT4 ratio, and regulates
      liver glucose utilization in diabetic rats.
AB  - AIM: Previous studies have reported that beta3-adrenergic agonists reduce plasma
      glucose levels in situations of hyperglycaemia and diabetes in rodents.
      Nevertheless, the mechanisms still remain unclear. In this context Trecadrine, a
      novel compound with affinity for beta3-adrenergic receptors, has been tested in
      alloxan-diabetic rats for its potential use as an anti-diabetic drug, but also to
      elucidate the role of muscle/liver glucose utilization in the process. METHODS
      AND RESULTS: Daily oral administration (1 mg/kg) to alloxan-diabetic Wistar rats
      (n = 10) for 4 days caused a significant reduction in plasma glucose levels (from
      15.0 to 8.3 mmol/l) with no apparent effects on insulin secretion. Furthermore,
      Trecadrine administration tended to normalize glucose storage (estimated by
      measuring glucokinase activity) and output (by measuring glucose-6-phosphatase
      activity) in the liver of diabetic animals. On the other hand, Trecadrine
      administration for 4 days resulted in an increase in GLUT1 gene expression in
      gastrocnemius muscle as compared to insulin-dependent glucose transporter GLUT4.
      Furthermore, a significant stimulation of 2-deoxy-D-glucose uptake in extensor
      digitorum longus muscle and, in a lesser degree, in gastrocnemius, but not in
      soleus muscle and in white adipose tissue, occurs. CONCLUSIONS: Trecadrine
      reduces glucose output from the liver, thus thus contributing to the reduction of
      plasma glucose levels to achieve the values of control rats. Furthermore,
      Trecadrine administration stimulates glucose uptake in skeletal muscle,
      especially in those muscles with predominant glycolytic fast-twitched fibres,
      apparently by a direct non-insulin-dependent mechanism, involving a relative
      increase in the content of GLUT1 in the plasma membrane as compared with GLUT4.
      In conclusion, Trecadrine shows a potent hypoglycaemic effect in the alloxan
      induced model of diabetes in rats by decreasing hepatic glucose output and
      improving muscle glucose uptake.

PMID- 11220518
TI  - Maintenance of sinus rhythm as a therapy goal.
AB  - Despite recent advances in our understanding of the mechanisms and consequences
      of atrial fibrillation, appropriate management of this common condition presents
      something of a dilemma. Control of ventricular rate alone is a common strategy,
      considered by many physicians to be the safest treatment option and a relatively
      simple approach to preserving left ventricular function. Rhythm control using
      antiarrhythmic agents, however, offers a number of important advantages, with the
      potential to correct abnormal physiology, increase exercise tolerance, reduce
      thromboembolic risk, prevent atrial remodelling and eliminate the risk of
      tachycardia-induced cardiomyopathy. Selection of an appropriate antiarrhythmic
      agent for such long-term prophylaxis is however problematic. Class I agents are
      associated with an unacceptable proarrhythmic risk especially in patients with
      structural heart disease and long-term therapy with the class III agent
      amiodarone can result in serious non-cardiac adverse effects. It is apparent,
      therefore, that there is little consensus on appropriate management strategies
      for atrial fibrillation and less still on the antiarrhythmic agent to be used. A
      number of studies are, however, ongoing which attempt to determine the benefits
      of rhythm versus rate control. These include the PIAF (Pharmacological
      Intervention in Atrial Fibrillation), AFFIRM (Atrial Fibrillation Follow-up
      Investigation of Rhythm Management) and RACE (Rate Control versus Electrical
      Cardioversion) studies, which should provide valuable answers which will help to
      guide physicians in their therapy choices.

PMID- 11220519
TI  - The role of class III antiarrhythmic agents in maintaining sinus rhythm.
AB  - The last decade has seen considerable changes in both attitude and approach to
      the management of arrhythmia. Much of this has resulted from trials such as the
      CAST (Cardiac Arrhythmia Suppression Trial) and the CASH (Cardiac Arrhythmia
      Study Hamburg), which demonstrated the potentially lethal consequences of using
      class I sodium channel blockers in patients with structural heart disease. The
      subsequent popularity of the class III agents and recognition that they are the
      best available therapy has led to the popularity of amiodarone and sotalol in the
      treatment of arrhythmia. Although these agents can achieve good efficacy in the
      suppression of atrial fibrillation their use is not without problems. Sotalol
      requires careful patient selection due to the risk of proarrhythmia and although
      cardiac effects are rare with amiodarone therapy, potentially serious non-cardiac
      adverse effects can limit the long-term use of this agent. Although treatment
      guidelines have helped to clarify our current knowledge and outline appropriate
      clinical application of antiarrhythmic agents, the need for antiarrhythmic agents
      which marry efficacy with improved safety and clinical applicability is apparent.

PMID- 11220520
TI  - Clinical differences between the newer antiarrhythmic agents.
AB  - In the light of studies demonstrating the serious safety problems of
      antiarrhythmic agents with class I activity, research and development efforts
      have focused largely on drugs with a class III mechanism of action. Most of the
      newer agents target the rapid component of the delayed rectifier potassium
      current (I(Kr)). In the case of dofetilide, the mechanism of action is relatively
      pure, with single I(Kr) channel blocking activity. Other agents have a wider
      spectrum of activity. Azimilide blocks both the rapid I(Kr) and slow I(Ks)
      potassium currents and ibutilide also augments the inward sodium current.
      Clinical investigation of these agents has shown them to be effective
      antiarrhythmic drugs with a number of advantages over existing agents,
      particularly in terms of safety. Dronedarone and tedisamil also have multichannel
      blocking actions and are in earlier stages of clinical development. Until now,
      therapeutic choices have been limited and far from ideal. It is hoped that the
      availability of the newer class III agents will at least provide greater choice
      of therapy and hopefully will bring us closer to therapeutic ideals in the
      management of arrhythmia.

PMID- 11220521
TI  - Mechanisms of action of class III agents and their clinical relevance.
AB  - Antiarrhythmic agents are broadly classified according to their mode of action in
      order to provide a basis for rational drug choice when managing particular rhythm
      disturbances. However, a great deal of variability exists within each drug class
      and treatment decisions require a greater understanding of the pharmacological
      characteristics of individual drugs in order to tailor treatment to a specific
      clinical presentation. Class III drugs in particular form a heterogeneous group
      of agents, some of which selectively block ion channels while others have multi
      channel blocking properties. An improved understanding of the relevance of the
      specific mechanism of action is now proving essential in predicting the value of
      individual drugs in clinical practice. Selective I(Kr) blocking agents increase
      action potential duration and refractoriness to the greatest extent at slow
      rates. Therefore, efficacy may be reduced at higher heart rates, the situation in
      which serious arrhythmias are most likely to occur. This so-called 'reverse use
      dependence' can be overcome with certain drug combinations, such as sotalol plus
      either quinidine or procainamide, drugs with multi-channel blocking properties,
      such as amiodarone, and possibly with drugs which block the I(Ks) as well as the
      I(Kr) potassium current, such as azimilide and ambasilide.

PMID- 11220524
TI  - Shape up and drop 10.

PMID- 11220523
TI  - Rosiglitazone.

PMID- 11220522
TI  - Sibutramine is effective for weight loss and diabetic control in obesity with
      type 2 diabetes: a randomised, double-blind, placebo-controlled study.
AB  - AIM: To assess the efficacy and tolerability of sibutramine 15 mg once daily as a
      weight reduction agent in overweight and obese patients (body mass index (b.m.i.)
      > 26 kg/m2) with type 2 diabetes when given with a customised, reduced-calorie
      diet, and to evaluate the influence of weight loss on diabetic control. METHODS:
      Randomised, placebo-controlled, double-blind, parallel-group, 12-week study
      conducted at two hospital-based obesity/diabetes clinics. Patients were men and
      women aged 30-65 years, with b.m.i. > 26 kg/m2 and < or = 35 kg/m2 and treated or
      untreated type 2 diabetes diagnosed > or = 6 months previously. Each patient was
      given sibutramine 15 mg or placebo once daily and advised to follow a customised
      diet of 500 kcal/day less than the individual's energy needs. The principal
      measure of efficacy was change in body weight (b.w.). Additional efficacy
      measurements were changes in b.m.i., body composition as measured by dual-energy
      X-ray absorptiometry, and change in waist and hip measurements. Changes in
      diabetic control were assessed by blood glucose levels fasting and after a
      standard test meal, fasting insulin level, and glycosylated haemoglobin level.
      Adverse events (AEs) were monitored at each visit, and routine laboratory safety
      tests were done at 4-week intervals. RESULTS: Ninety-one patients were randomised
      into the study, 44 to placebo and 47 to sibutramine 15 mg once daily. Eighty
      three patients (91%) completed the study, 40 (91%) on placebo and 43 (91%) on
      sibutramine. Mean weight reduction from baseline was statistically significantly
      greater with sibutramine than with placebo at every measurement and at the end of
      the study (2.4 vs. 0.1 kg at week 12; p < 0.001; intent-to-treat). The proportion
      of patients who lost > 5% of their baseline b.w. was 19% in the sibutramine group
      and 0% in the placebo group (p < 0.001; 95% confidence interval: 9, 30). Patients
      receiving sibutramine lost significantly more fat mass compared with those
      receiving placebo, as a percentage (1.0% vs. 0.1%; p < 0.05) and in absolute
      terms (1.8 vs. 0.2 kg, p < 0.001). Loss of lean mass was not significantly
      different between the groups. Mean peak blood glucose concentration after a
      standard test meal decreased by 1.1 mmol/l in the sibutramine treatment group but
      increased by 0.5 mmol/l in the placebo group (p = 0.04; difference in means, 1.6,
      95% confidence interval: -3.3, -0.1). Mean fasting blood glucose decreased by 0.3
      mmol/l with sibutramine and increased by 1.4 mmol/l with placebo. Mean
      glycosylated haemoglobin levels decreased by 0.3% units with sibutramine
      treatment, and were unchanged with placebo. However, more sibutramine-treated
      patients (33%) than placebo-treated patients (5%) achieved decreases in
      glycosylated haemoglobin of 1% unit or more (p < 0.05). Sibutramine 15 mg was
      safe and well tolerated, and AEs were mostly mild or moderate in severity. No
      significant differences were found between treatment groups in blood pressure. No
      clinically significant conduction or rhythm abnormalities were observed on ECG.
      CONCLUSIONS: Sibutramine 15 mg once daily with a customised, reduced-calorie diet
      significantly reduced weight compared with placebo in overweight and obese
      patients (b.m.i. > 26 kg/m2) with type 2 diabetes. Sibutramine was well
      tolerated, and significant improvement in diabetic control was seen in
      conjunction with weight reduction on sibutramine treatment.

PMID- 11220525
TI  - Expanding immuno-therapies for type 1 diabetes.

PMID- 11220527
TI  - Hypoglycaemia and associated hypokalaemia in diabetes: mechanisms, clinical
      implications and prevention.

PMID- 11220526
TI  - Cardiovascular effects of sulphonylureas: role of K(ATP) channels.

PMID- 11220528
TI  - The future of leptin and leptin analogues in the treatment of obesity.

PMID- 11220529
TI  - Ethnicity and risk factors for coronary heart disease in diabetes mellitus.
AB  - INTRODUCTION: The Framingham equation can be used to predict the risk of coronary
      heart disease (CHD) and so to target risk factor intervention. Reservations have
      been applied to its use in south Asian populations since the high CHD mortality
      in this group may not be accounted for by traditional risk factors. METHODS: We
      applied the Framingham equation to 1826 patients with diabetes of whom 1215 were
      of white Caucasian and 611 south Asian origin. Having calculated the 10-year CHD
      risks the contribution of risk factors were compared between ethnic groups.
      RESULTS: Mean 10-year CHD risk was the same in the two ethnic groups (20.7 vs.
      21.5%, white Caucasian vs. south Asian men and 16.5 vs. 15.9%, white Caucasian
      vs. south Asian women). However, the risk factor profile was different between
      the two groups. Mean total cholesterol was lower in south Asians (5.23 vs. 5.41
      mmol/l, south Asian vs. white Caucasian men (p = 0.01) and 5.38 vs. 5.68 mmol/l,
      south Asian vs. white Caucasian women (p < 0.001)). HDL cholesterol levels were
      also lower (median HDL cholesterol 0.94 vs. 1.11 mmol/l, south Asian vs. white
      Caucasian men (p < 0.001) and 1.07 vs. 1.3 mmol/l, south Asian vs. white
      Caucasian women (p < 0.0001)) leading to higher total: HDL cholesterol ratios
      (5.48 vs. 4.78, south Asian vs. white Caucasian men (p = 0.032) and 4.91 vs.
      4.26, south Asian vs. white Caucasian women (p < 0.001). CONCLUSION: Calculated
      10-year CHD risks are the same in south Asian and white Caucasian diabetic
      patients but the factors contributing to this risk differ. Different management
      of these risk factors may account for the higher mortality from CHD in those of
      south Asian origin.

PMID- 11220530
TI  - Disturbed release of gastrointestinal peptides in anorexia nervosa and in
      obesity.
AB  - AIM: It is commonly accepted that some neuropeptides play an important role in
      the control of appetite and hormonal secretion. Several gastrointestinal peptides
      may affect on central control of appetite via vagal and spinal nerves. The aim of
      this study was to evaluate the release of gastrointestinal peptides in anorexia
      nervosa and in obesity, because in these diseases the disturbances in the control
      of appetite and hormonal secretion were found. Material consisted of 30 women
      with anorexia nervosa aged 16-29 years (mean 22 years) and 23 women with obesity
      aged 19-33 years (mean 29 years) and 25 lean women of control group. METHODS: In
      women with anorexia nervosa as compared with control group we observed a
      significant increase of plasma vasoactive intestinal peptide (VIP) levels (p <
      0.01) and a significant decrease of leptin (p < 0.001), beta-endorphin (p <
      0.01), gastrin (p < 0.05), cholecystokinin (CCK; p < 0.05) and somatostatin (S-S;
      p < 0.01). In obese women we found a significant increase of neuropeptide Y (NPY;
      p < 0.001), leptin (p < 0.01), galanin (p < 0.001), beta-endorphin (p < 0.001),
      gastrin (p < 0.01), CCK (p < 0.001) and S-S (p < 0.01) and a significant decrease
      of VIP concentrations (p < 0.001) as compared with control group. CONCLUSION: Our
      results indicate that the release of gastrointestinal peptides is disturbed in
      obesity and in anorexia nervosa. These findings suggests that dysfunction of
      brain-gut axis may be also an important factor in the abnormal control of
      appetite axcept of hypothalamic dysfunction.

PMID- 11220532
TI  - Atrioventricular junctional ablation and pacing for paroxysmal atrial
      fibrillation: the Barcelona recommendations.

PMID- 11220531
TI  - Prospective, randomized study of atrioventricular ablation and mode-switching,
      dual chamber pacemaker implantation versus medical therapy in drug-resistant
      paroxysmal atrial fibrillation. The PAF study. Paroxysmal Atrial Fibrillation.
AB  - We performed a prospective randomized 6-month evaluation of the clinical effects
      of atrioventricular junctional ablation together with placement of a DDDR mode
      switching pacemaker vs pharmacological treatment in 43 patients with intolerable
      paroxysmal atrial fibrillation not controlled with antiarrhythmic drugs. Ablation
      and pacemaker treatment were highly effective and superior to drug therapy in
      controlling symptoms and improving quality of life. However, discontinuation of
      drug therapy exposed patients to further recurrences of paroxysmal atrial
      fibrillation and the risk of developing permanent atrial fibrillation.

PMID- 11220533
TI  - Prospective, randomized study of atrioventricular node ablation and mode
      switching, dual chamber pacemaker implantation using two different algorithms in
      patients with paroxysmal atrial fibrillation.

PMID- 11220534
TI  - The North American experience with the Ablate and Pace Trial (APT) for medically
      refractory atrial fibrillation.
AB  - The Ablate and Pace Trial (APT) was a prospective registry study of clinical
      outcomes and survival following ablation and pacing therapy for medically
      refractory atrial fibrillation. One hundred and fifty-six patients were enrolled
      at 16 centres in North America. The mean patient age was 66 +/- 11 years, with
      mean left ventricular ejection fraction of 48% +/- 18%. Seventy-eight percent of
      the patients had structural heart disease. During one year of follow up, multiple
      measures of quality-of-life showed significant and sustained improvement
      following ablation and pacing therapy. Also, left ventricular ejection increased
      significantly for patients with baseline left ventricular ejection fraction <45%.
      Metabolic exercise testing showed trends toward improved exercise tolerance;
      however, these did not achieve statistical significance. The one year overall
      survival was 85%, with 3% of patients experiencing sudden death. In summary, this
      large, non-randomized, trial showed significant improvement in quality of life
      and left ventricular function following ablation and pacing therapy. Ablation and
      pacing therapy is a viable strategy for palliative management of patients with
      medically refractory, highly symptomatic atrial fibrillation.

PMID- 11220535
TI  - Ablation of the atrioventricular junction: technique, acute and long-term results
      in 115 consecutive patients.
AB  - Atrioventricular junctional ablation is an attempt to interrupt conduction from
      the atrium to the ventricle using radiofrequency energy. The objective is to
      ablate the compact atrioventricular node as high as possible, leaving a stable
      ventricular escape rhythm. The compact node is identified in part by its relation
      to His recordings and partly through the known anatomy. In our series of 115
      consecutive patients, atrioventricular block was achieved from the right side in
      96% of patients and the remainder had the atrioventricular node ablated from the
      left side. Long-term success, i.e. complete heart block, was achieved in all
      patients. Complications in this and other series are rare, but there remains
      concern about sudden death in these patients.

PMID- 11220536
TI  - Chronic atrial fibrillation in patients with paroxysmal atrial fibrillation,
      atrioventricular node ablation and pacemakers: determinants and treatment.
AB  - AIMS: This study examined the factors associated with the development of chronic
      (or permanent) atrial fibrillation (AF) in patients who had undergone
      atrioventricular (AV) node ablation with permanent pacing because of paroxysmal
      AF. METHODS: A retrospective review of case notes of all 65 consecutive patients
      identified as having had paroxysmal atrial arrhythmias, AV node ablation and
      permanent pacemaker implantation was performed. Atrial rhythm was established
      from all pacing records and from the surface ECG. Treatment with anti-arrhythmic
      drugs and with warfarin was recorded. A multivariate analysis was undertaken,
      using atrial rhythm on final ECG and chronic AF as outcome measures. RESULTS:
      During a mean follow-up of 30 months, 42% of patients with paroxysmal AF had
      developed chronic AF. Multivariate analysis showed that increasing age, history
      of electrical cardioversion and VVI pacing all contributed to the development of
      chronic AF. 25/62 patients were taking warfarin, and four had had strokes
      (2.5%/year). CONCLUSION: The majority of patients with paroxysmal atrial
      arrhythmias treated with AV node ablation and pacing develop chronic AF
      eventually. Stroke remains a risk, particularly in those who develop chronic AF.

PMID- 11220537
TI  - Determinants of development of permanent atrial fibrillation and its treatment.
AB  - We evaluated the rate of progression of permanent atrial fibrillation (AF) and
      identified clinical factors that predict this event in 63 consecutive patients
      who had undergone AV junctional ablation and DDDR pacemaker implantation for drug
      refractory paroxysmal atrial fibrillation/ flutter. Immediately after ablation,
      anti-arrhythmic drugs were discontinued in all cases. Permanent AF was considered
      to have developed if AF was present on two consecutive 6-monthly examinations
      with no interim documented sinus rhythm. During a mean follow-up of 23 +/- 16
      months, 22 (35%) of the 63 patients developed permanent AF. The actuarial
      estimate of progression of permanent AF was 22%, 40% and 56%, respectively, 1, 2
      and 3 years after ablation. Age and underlying heart disease were independent
      predictors of progression of permanent AF. Only one (6%) of 16 patients with
      idiopathic AF had permanent AF (low risk group). Among the 47 patients with
      structural heart disease, permanent AF developed in 18 (62%) of the 29 who were
      aged >75 years or had >12 arrhythmic episodes per year and a symptom duration >4
      years (high risk group), but only in three (17%) of the remaining 18 patients who
      did not (intermediate risk group). In conclusion, during a 3-year follow-up
      period, about half of the patients with a history of drug-refractory paroxysmal
      AF did not develop permanent AF after AV junctional ablation and dual-chamber
      pacemaker implantation, even in the absence of anti-arrhythmic drug therapy.
      Moreover, subgroups of patients whose risk of permanent AF progression differed
      were identified on the basis of simple baseline clinical variables. The results
      of this study form the necessary background for the correct management of
      patients after AV junction ablation and for the planning of future trials in this
      field.

PMID- 11220538
TI  - The Atrial Pacing Peri-ablation for Paroxysmal Atrial Fibrillation (PA3) Study:
      rationale and study design.
AB  - The Canadian Atrial Pacing Peri-Ablation for Paroxysmal Atrial Fibrillation Study
      tested the hypotheses that atrial pacing prevents paroxysmal atrial fibrillation
      (PAF) in patients without symptomatic bradycardia and that DDDR pacing is more
      likely to prevent PAF following total atrioventricular (AV) node ablation
      compared to VDD pacing. Patients with PAF who were refractory to or intolerant of
      antiarrhythmic drug therapy received a Medtronic Thera DR pacemaker 3 months
      prior to a planned total AV node ablation. Patients were randomized to atrial
      pacing or no pacing therapy. The time to first recurrence of sustained PAF was
      the primary study outcome event. Following AV node ablation, patients were
      randomized to the DDDR or VDD mode in a crossover study design. Patients were
      followed in each mode for 6 months. The time course of PAF recurrence was
      compared for each pacing mode.

PMID- 11220539
TI  - Third-degree inter-atrial block and supraventricular tachyarrhythmias.

PMID- 11220540
TI  - Assessment of left ventricular pacing in patients with severe cardiac failure
      after atrioventricular node ablation and right ventricular pacing for permanent
      atrial fibrillation.

PMID- 11220542
TI  - Ablate and pace therapy for paroxysmal atrial fibrillation, too much too late.

PMID- 11220541
TI  - Mode switching in dual chamber pacemakers: effect of onset criteria on arrhythmia
      related symptoms.
AB  - AIMS: Various mode-switching algorithms are available with different
      tachyarrhythmia detection criteria to be satisfied to initiate mode-switching.
      This study evaluated three different mode-switching algorithms in patients with
      paroxysmal atrial fibrillation. METHODS AND RESULTS: Seventeen patients completed
      the study. Three mode-switching algorithms were downloaded as software into the
      pacemaker, each for 1 month in a single-blind, randomized sequence. The criteria
      to initiate mode-switching were: mean atrial rate ('standard'), '4-of-7' or '1-of
      1' atrial intervals to exceed the atrial detection rate. Symptoms for each were
      measured using the Symptom Checklist Frequency and Severity index. The median
      number of mode-switch episodes increased from 20 for 'standard' to 39 for '4-of
      7' (P=0.029 vs 'standard') and 103 for '1-of-1' (P=0.0012 vs 'standard') onset
      criteria. Median duration of episodes decreased from 2.5 min with 'standard' to
      1.4 min with '4-of-7' and 0.4 min with '1-of-1' onset criteria. Frequency of
      symptoms was lower using '4-of-7' (18.2 +/- 12.0 vs 23 +/- 12.0, P=0.08) or '1-of
      1' (20.4 +/- 12.4 vs 23 +/- 12.0, P=0.07) than 'standard' onset criteria.
      Severity of arrhythmia tended to be less with either '4-of-7' (16 +/- 10.4 vs
      19.1 +/- 19.4, P=0.12) or '1-of-1' (17.5 +/- 10.3 vs 19.1 +/- 9.4, P=0.18) than
      with 'standard' onset criteria. CONCLUSIONS: The more sensitive onset criteria
      for detection of atrial tachyarrhythmias were associated with lower frequency and
      severity of symptoms.

PMID- 11220543
TI  - Assessment of accessory pathway and atrial refractoriness by transoesophageal and
      intracardiac atrial stimulation: an analysis of methodological agreement.
AB  - AIMS: Measurement of the refractory properties of asymptomatic overt accessory
      pathways is performed to assess the risk for significant arrhythmias. We
      hypothesized that a transoesophageal atrial stimulation (TAS) protocol would
      accurately predict simultaneously measured invasive intra cardiac stimulation
      (ICS) of the anterograde effective refractory period of the accessory pathway (AP
      ERP) METHODS AND RESULTS: Fourteen single pathway Wolff-Parkinson-White (WPW)
      syndrome patients underwent TAS during ICS and 24 h prior to it. The AP-ERP was
      measured using incremental atrial extra stimuli from TAS, the right atrium (RA)
      and the coronary sinus (CS) using drive trains of 500 and 600 ms. Stimulus
      latency was measured from intracardiac electrocardiograms. For methodological
      comparison, Altman-Bland analysis was used to create the limits of agreement
      (within-patient mean of differences +/- two standard deviations). There were no
      or small differences in the AP-ERP, as assessed by TAS, compared to RA and CS.
      Methodological disagreement between the three sites were common, however, and the
      limits of agreement ranged from +/- 30 to +/- 76 ms. The concordance between TAS
      and RA, with regards to the AP-ERP value of 270 ms, was 63% when measured as S1S2
      and was 67% when measured as A1A2. The stimulation site delay was significantly
      shorter for TAS compared to RA and CS sites. The two TAS procedures performed a
      day apart, revealed a coefficient of variation of 9% and a coefficient of
      reproducibility of 63 ms. CONCLUSIONS: Despite adequate reproducibility, TAS
      fails to predict the AP-ERP by ICS. Differences in stimulus latency is
      responsible, in part, for the disagreement. Invasive ICS cannot be replaced by
      TAS for risk stratifying WPW patients.

PMID- 11220544
TI  - Clinical usefulness of head-up tilt test in patients with syncope and
      intraventricular conduction defect.
AB  - Head-up tilt test was performed in 99 patients with syncope of unknown origin and
      intraventricular conduction defect. Twenty-five per cent had a positive response
      to tilt with reproduction of spontaneous clinical symptoms. Holter recording
      revealed paroxysmal atrioventricular (AV) block in three patients. Carotid sinus
      massage was positive in four patients. An electrophysiological study was
      performed in 76 patients with abnormal findings in 17 (22%). Thus, vasovagal
      syncope was the discharge diagnosis in 25 patients (25%). Therefore, tilt test
      should be considered in patients with intraventricular conduction defect
      presenting with syncope of unknown origin, especially if clinical findings
      suggest the possibility of a vasovagal mechanism, or if the results of the
      electrophysiological study are inconclusive.

PMID- 11220545
TI  - SAFE PACE 2: Syncope and Falls in the Elderly--Pacing and Carotid Sinus
      Evaluation: a randomized controlled trial of cardiac pacing in older patients
      with falls and carotid sinus hypersensitivity.
AB  - SAFE PACE is a multicentre randomized controlled trial to assess the efficacy of
      dual-chamber pacing in older patients with carotid sinus hypersensitivity and
      recurrent unexplained falls. Patients are eligible if they have had two or more
      unexplained falls (+/- up to one syncope) and if they have a cardio-inhibitory
      response (>3 s asystole) to carotid sinus massage. Patients will be randomized to
      receive either a Medtronic Kappa 700(Europe)/Kappa 400(North America) pacemaker
      or an implantable loop recorder (ILR)(control group). Patients will be required
      to complete weekly fall diaries. The primary outcome measure is the number of
      patients who fall in the 24-month follow-up period. Recruitment began in October
      1998 and continues for 12 months; the follow-up is for 24 months.

PMID- 11220546
TI  - Report of a study group on ablate and pace therapy for paroxysmal atrial
      fibrillation. Barcelona Discussion Group. Working Group on Arrhythmias of the
      European Society of Cardiology.
AB  - Atrioventricular junctional (AVJ) catheter ablation followed by pacemaker
      implantation is now widely accepted for patients affected by paroxysmal atrial
      fibrillation (PAF) not controlled by antiarrhythmic drugs. However, few data
      exist on its indications, optimal methodology and complications. Therefore a
      study group examined current practice in Europe and North America, using a
      questionnaire, followed by a Study Group Meeting to discuss the results. Based
      upon this, class I, class II and class III indications were proposed. Class I
      indications (for which general agreement existed) include drug-refractory PAF,
      correlating with important symptoms, the bradycardia tachycardia syndrome already
      treated with a pacemaker, and continued PAF. Large differences exist in the
      current methodology, but consensus was reached on the technical approaches of
      right and left-sided AVJ ablation, and on the timing of pacemaker implant in
      relation to ablation. No complete agreement was reached on technical features
      such as catheter choice and heparin use. The recommended pacing mode was DDDR
      with mode switching.

PMID- 11220547
TI  - Metabolic consequences of weight loss on glucose metabolism and insulin action in
      type 2 diabetes.

PMID- 11220548
TI  - Metformin and lactic acidosis in diabetic humans.

PMID- 11220549
TI  - Using dose-response characteristics of therapeutics agents for treatment
      decisions in type 2 diabetes.

PMID- 11220550
TI  - Cosegregation of obesity with familial aggregation of type 2 diabetes mellitus.
AB  - OBJECTIVE: We have shown that a positive family history of diabetes, and the
      variables of general and central obesity are independent risk factors for type 2
      diabetes in our population. This study was done to evaluate whether a familial
      predisposition to diabetes resulted in a tendency for adverse anthropometric and
      haemodynamic profiles in south Indian non-diabetic subjects. METHODS: The
      analysis was carried out on 2463 subjects (M: F, 1196: 1267) with normal glucose
      tolerance (NGT). The study subjects were selected from population surveys for
      diabetes. Details of age, sex, family history of diabetes, body mass index
      (b.m.i.), waist-to-hip ratio (WHR) and blood pressure were recorded. Serum
      cholesterol and triglycerides were estimated. RESULTS: A positive family history
      of diabetes was present in 24.7% of our subjects. Mean b.m.i. and percentage of
      obesity were significantly higher in families with a positive family history
      (group 2) vs. families with no family history (group 1). Subjects in group 2 had
      a higher 2-h plasma glucose (p < 0.001) and higher prevalence of hypertension
      (chi2 = 6.91, p = 0.0086). Factor analysis with principle components analysis
      (PCA) showed that a family history of diabetes clustered with WHR in men, and
      with b.m.i. and WHR in women. The b.m.i. formed a different domain with blood
      pressure in both sexes. WHR and b.m.i. clustered with cholesterol and
      triglycerides in another domain. CONCLUSIONS: In this population, general and
      central obesity are associated with a family history of diabetes. A family
      history of diabetes may increase the risk of hypertension and hyperlipidaemia
      indirectly through its connection with b.m.i.

PMID- 11220551
TI  - Lipid lowering explains the insulin sensitivity enhancing effects of a
      thiazolidinedione, 5-(4-(2-(2-phenyl-4-oxazolyl)ethoxy)benzyl)-2,4
      thiazolidinedione.
AB  - AIM: Insulin resistance is a characteristic feature of type 2 diabetes and
      obesity. The present study examined the effects of TZD300512, a
      thiazolidinedione, on glucose and lipid metabolism in the fatty Zucker rat
      (fa/fa), a rat model of insulin resistance. METHODS: TZD300512 was administered
      (2.0 mg/kg/day) in the diet for 1 week to chronically catheterized Zucker fa/fa
      rats. We measured triglyceride clearance rate and hepatic triglyceride output. We
      assessed baseline glucose metabolism, and insulin-mediated glucose uptake. We
      also determined whether the insulin sensitivity enhancing effects of TZD300512
      could be reversed by infusion of Intralipid. RESULTS: TZD300512 treatment
      markedly reduced fasting plasma triglyceride by 72% and nonesterified free fatty
      acids by 46%. Moreover, treatment significantly enhanced plasma triglyceride
      clearance (AUC; 60.36+/-11.50 v 131.44+/-18.45 mM/min), but hepatic triglyceride
      output was not altered. Drug treatment significantly reduced fasting plasma
      glucose by 25%, plasma insulin by 73%, and had no effect on glucagon levels.
      Glucose infusion rate (GIR) needed to maintain euglycemia during hyperinsulinemic
      clamp was significantly increased from 34.96+/-3.94 micromol/kg/min to 123.80+/
      4.80 micromol/kg/min, while whole body glucose uptake was more than doubled
      (58.49+/-2.86 control vs. 126.97+/-3.8 treated micromol/kg/min). Insulin-induced
      suppression of hepatic glucose production was nearly complete with treatment.
      Intralipid infusion reversed drug-induced improvement in insulin sensitivity.
      CONCLUSIONS: These results suggest that TZD300512-favourable alterations in lipid
      metabolism have a significant impact on its effectiveness in enhancing insulin
      sensitivity in a severely insulin resistant rodent model of type 2 diabetes.

PMID- 11220552
TI  - Diabetes-induced biochemical changes in rat lens: attenuation of cataractogenesis
      by pyruvate.
AB  - AIM: Studies have been conducted to determine the effect of pyruvate
      administration on the biochemistry of rat lens and the status of its transparency
      as affected by diabetic conditions. METHODS: Sprague-Dawley rats were rendered
      diabetic by intravenous (i.v.) injection of streptozotocin (55 mg/kg body weight
      (b.w.)) and treated with sodium pyruvate (2%) in drinking water. The levels of
      glucose, fructose, sorbitol, ATP, GSH, MDA as well as glycated proteins in the
      lenses were determined at various intervals after the onset of diabetes and the
      values compared with untreated diabetic controls. The progress of cataract
      formation and associated histological changes in the tissue were also monitored.
      RESULTS: Studies show that the pyruvate treatment decreased the extent of several
      biochemical changes known to be associated with cataract formation, such as the
      elevation in the levels of glycated proteins, sorbitol, lipid peroxidation (MDA)
      and inhibition of the cation pump. The progress of cataract was also
      significantly delayed. CONCLUSION: Exogenous administration of this compound
      hence was found to exert an overall protective effect against cataract formation
      induced by the diabetic conditions.

PMID- 11220553
TI  - Weight loss with sibutramine improves glycaemic control and other metabolic
      parameters in obese patients with type 2 diabetes mellitus.
AB  - AIM: To determine the efficacy and tolerability of sibutramine hydrochloride in
      obese patients whose type 2 diabetes was poorly controlled on diet alone or with
      an oral antidiabetic agent. METHODS: This study was a 24-week, double-blind,
      multicentre trial following a 5-week placebo run-in period. One hundred and
      seventy-five obese (body mass index (b.m.i.) > or =27 kg/m2) patients with poorly
      controlled type 2 diabetes mellitus were randomized either to sibutramine (n =
      89; mean age 53.5 years; mean weight 99.3 kg) or placebo (n = 86; mean age 55
      years; mean weight 98.2 kg) at 16 participating centres. To achieve moderate
      calorie restriction (deficit > or = 250-500 kcal/day), individual dietary
      counselling was accompanied by either placebo or sibutramine (initial dosage of 5
      mg/day titrated up by 5 mg biweekly through week 6, and maintained at 20 mg
      through week 24). The main outcome measures included changes in weight, b.m.i.,
      waist and hip circumference, glycaemic control, lipid profile, and quality of
      life, and evaluation of reported adverse events. RESULTS: Sixty-seven per cent of
      sibutramine patients and 71% of placebo patients completed the study. At week 24
      when comparing those who completed the course, sibutramine compared with placebo
      patients showed significantly greater (p < 0.001) absolute (-4.3 vs. -0.4 kg) and
      percentage (-4.5% vs. -0.5%) weight loss. Weight loss > or =5% or 10% was
      achieved by 33% and 8% of sibutramine patients, respectively, but no placebo
      patients (p < 0.03 or better). Improvement in glycaemic control was correlated
      with weight loss (p < 0.001). In 5% and 10% weight-loss responders, mean
      treatment differences were -0.53% and -1.65% (p < or = 0.05), respectively, for
      HbA1c, and -1.4 mmol/l (p < or =0.05) and -3.8 (p < or =0.05) mmol/l for fasting
      plasma glucose. Sibutramine patients also showed improvements in fasting insulin,
      triglycerides, HDL cholesterol, and quality-of-life assessments. Overall,
      sibutramine was well tolerated compared with the placebo. Sibutramine treatment
      was associated with small mean increases in blood pressure (BP) and pulse,
      although an increase in BP was not seen in sibutramine-treated patients who lost
      > or = 5% of their weight. CONCLUSIONS: Sibutramine produced statistically and
      clinically significant weight loss when used in combination with recommendations
      for moderate caloric restriction. This weight loss was associated with
      improvements in metabolic control and quality of life, and sibutramine was
      generally well tolerated in obese patients with type 2 diabetes.

PMID- 11220554
TI  - Troglitazone reduces plasma levels of tumour necrosis factor-alpha in obese
      patients with type 2 diabetes.
AB  - We evaluated the effect of troglitazone (given orally 400 mg/day) on glucose
      intolerance and on the plasma levels of tumour necrosis factor-alpha (TNF-alpha)
      in 12 obese patients with type 2 diabetes for 12 weeks. Troglitazone
      significantly decreased fasting plasma glucose, serum C-peptide, serum insulin
      and HbA1c levels. Plasma levels of TNF-alpha were significantly reduced by
      troglitazone administered for 8 and 12 weeks. Troglitazone administration
      significantly improved insulin resistance, but did not affect pancreatic beta
      cell function as evaluated by the homeostasis model assessment (HOMA). In the
      present study, we reported for the first time that troglitazone administration
      significantly reduces plasma levels of TNF-alpha in obese patients with type 2
      diabetes.

PMID- 11220555
TI  - Is rate response superior to single rate pacing in atrial arrhythmia control?

PMID- 11220556
TI  - Positive head-up tilt table test in patients with the long QT syndrome.
AB  - AIMS: Syncope in patients with the long QT syndrome is commonly attributed to a
      ventricular arrhythmia (torsades de pointes). The susceptibility of patients with
      the long QT syndrome (LQTS) to neurally mediated syncope is currently unknown.
      METHODS AND RESULTS: Head-up tilt table testing (70 degrees) was performed in six
      patients with the long QT syndrome and a history of syncope. All patients had
      syncope with a mixed response. The RR interval was significantly decreased 2 min
      before the onset of syncope (980 +/- 125 ms vs 630 +/- 91 ms, P=0.003), and
      significantly increased during syncope (983.17 +/- 224.71; P=0.006). Non
      significant changes in QT intervals were observed. Baseline QT was 513 +/- 86 ms
      and decreased to 450 +/- 59 ms 2 min before the onset of syncope (P=0.11).
      Although not statistically significant, QT intervals during syncope were longer
      than at 2 min before syncope (485 +/- 85 ms vs 450 +/- 59 ms; P=0.29).
      CONCLUSION: Our results suggest that patients with the LQTS are susceptible to
      neurally mediated syncope. Whether this susceptibility differs from control
      populations remains unresolved. From a clinical standpoint, neurocardiogenic
      syncope should be considered a diagnostic alternative in patients with LQTS.

PMID- 11220557
TI  - Unravelling the mechanisms of symptoms in patients at risk of genetically
      determined cardiac arrhythmias.

PMID- 11220558
TI  - Antiarrhythmic benefits of dual chamber stimulation with rate-response in
      patients with paroxysmal atrial fibrillation and chronotropic incompetence: a
      prospective, multicentre study.
AB  - BACKGROUND: While the haemodynamic benefits of DDDR pacing compared with DDD
      pacing in patients with brady-tachy syndrome and chronotropic incompetence (CI)
      are well demonstrated, the antiarrhythmic advantage is controversial and so far
      not clearly demonstrated. AIM: We have performed a prospective, randomized,
      multicentre study to evaluate the efficacy of DDDR and DDD pacing modes in
      preventing paroxysmal atrial fibrillation (PAF) episodes in patients with brady
      tachy syndrome and CI. METHODS AND RESULTS: Seventy-eight patients were included
      in the study. All patients had a dual chamber pacemaker implanted and were
      randomly programmed to DDD or DDDR with a cross over (DDD --> DDDR or vice versa)
      at 3 months. The final evaluation was performed at 6 months by means of two self
      administered symptom questionnaires to evaluate activity. Symptoms of
      palpitations were analysed and scored. The patients were less symptomatic with
      the DDDR mode. The number of mode-switch activations compared with symptomatic
      episodes of PAF confirmed the high rate of asymptomatic PAF episodes in patients
      with brady-tachy syndrome. We conclude that in a small but well defined
      population of patients affected by sick sinus syndrome with CI and severely
      symptomatic PAF, DDDR pacing compared with DDD pacing may offer an additional
      antiarrhythmic benefit and should be considered the primary mode of pacing.

PMID- 11220559
TI  - An epidemiological study of symptomatic paroxysmal atrial fibrillation in
      northwest Greece.
AB  - AIM: Although atrial fibrillation (AF) is the most commonly sustained arrhythmia,
      information about its incidence in the general population is sparse. Even more
      sparse is information on an important variety of AF, paroxysmal AF. The aim of
      this study is to assess the frequency of new cases of symptomatic paroxysmal AF
      per year ('incidence') in a general unselected population and to compare other
      epidemiological features with chronic AF patients. METHODS AND RESULTS: Over a 4
      year period, we conducted a prospective, population-based survey of cases of AF
      in a defined geographical area with a known population size stratified for age
      and sex. Sources of identification were the two hospitals which serve the area
      and all the primary care settings. Patients with AF of less than 7 days duration
      were characterized as paroxysmal AF and all others as chronic AF. During the
      study period we identified 1551 patients with chronic AF (51.7% male, mean age 71
      +/- 10.4 years and 48.3% females, mean age 73.1 +/- 10.8 years) and 443 patients
      with paroxysmal AF (59.6% male, mean age 59.6 +/- 13.3 years and 40.4% female,
      mean age 65.2 +/- 10.1 years). There was no underlying cardiovascular disease in
      15.6% and 32.3% of patients with chronic and paroxysmal AF, respectively. The
      mean annual occurrence of new cases of paroxysmal AF was 6.2/10,000/year, and was
      higher (P<0.01) for men (7.2/10,000/year) than for women (5.3/10,000/year). The
      frequency of new paroxysmal AF cases rises with age, reaching a peak at 70-79
      years and then declines. CONCLUSIONS: We conclude that paroxysmal AF is a
      relatively common arrhythmia, the occurrence of which increases with age and is
      more frequent in younger men than in women. Patients with chronic AF are older
      and more often have underlying heart and other disease than patients with
      paroxysmal AF.

PMID- 11220561
TI  - Incidence and clinical significance of transformation of atrial fibrillation to
      atrial flutter in patients undergoing long-term antiarrhythmic drug treatment.
AB  - AIMS: To investigate the rate of transformation of atrial fibrillation to atrial
      flutter in patients taking antiarrhythmic drugs for the prophylaxis of atrial
      fibrillation, we retrospectively analysed data from 305 consecutive patients with
      paroxysmal atrial fibrillation (155 male; mean age 63 +/- 11 years) treated with
      ventricular rate controlling drugs, antiarrhythmic drugs, or without drugs.
      METHODS AND RESULTS: At a mean follow-up of 9 months (range 1-24) all patients
      experienced recurrence of arrhythmia: 48 (14.6%, Group A) suffered Type 1 atrial
      flutter, and 257 (85.4%, Group B) atrial fibrillation. The relative rate of
      recurrence of atrial flutter vs atrial fibrillation was similar in patients
      without treatment or with ventricular rate controlling drugs (from 6.8% to 14.6%,
      P=ns). However, recurrence was higher (25%) in patients administered
      antiarrhythmic drug therapy. The relative risk in these patients was 3.02 times
      greater, compared with patients without treatment, or treated with rate
      controlling drugs (P<0.001). There were no differences between groups concerning
      the baseline clinical characteristics and the clinical consequences of the
      recurrence; patients with atrial flutter had a lower rate of conversion to sinus
      rhythm (42% vs 64%) and a higher rate of hospital admission (69% vs 36%) compared
      with those with atrial fibrillation. Six patients (8.5%) experienced 1:1
      atrioventricular conduction during atrial flutter with a ventricular rate of 240
      280 beats x min(-1). CONCLUSION: Our data suggest that the use of antiarrhythmic
      drugs for the prophylaxis of atrial fibrillation is associated with a threefold
      increase in the probability of Type 1 atrial flutter recurrence, as opposed to
      atrial fibrillation, which may have important clinical consequences, but which
      did not in our study.

PMID- 11220560
TI  - Attenuation of electrical remodelling in chronic atrial fibrillation following
      oral treatment with verapamil.
AB  - AIMS: Electrical remodelling with shortening of the atrial refractory period and
      increased fibrillatory rate occurs after onset of atrial fibrillation and can be
      attenuated by pre-treatment with intravenous verapamil. The aim of the present
      study was to investigate whether already established fibrillatory-induced
      shortening of atrial fibrillatory cycle length could be reversed with oral
      verapamil. METHODS AND RESULTS: Thirteen patients (nine men; mean age 67 years)
      with chronic atrial fibrillation (CAF) were studied. The dominant atrial cycle
      length (DACL) was estimated non-invasively using the frequency analysis of
      fibrillatory ECG (FAF-ECG) method. Measurements were repeated following treatment
      with slow release oral verapamil. DACL increased from 147 +/- 13 ms to 156 +/- 21
      ms after 1 day (P=0.02), to 164 +/- 18 ms after 5 days (P=0.005) and finally to
      160 +/- 16 ms after 6 weeks (P=0.008). CONCLUSION: Long-term oral treatment with
      verapamil increases the DACL significantly in patients with CAF. The prolongation
      is evident after 1 day and is further developed during the first 5 days of
      treatment. Since DACL is believed to be an index of refractoriness, the findings
      of the present study suggest that this treatment increases the atrial refractory
      period in patients with CAF.

PMID- 11220563
TI  - Impaired arterial baroreceptor sensitivity before tilt-induced syncope.
AB  - Autonomic dysfunction seems to play a central role in the pathophysiology of
      neurocardiogenic syncope (NCS) but conflicting data have recently become
      available. We evaluated autonomic nervous system (ANS) function (heart rate
      variability (HRV), systolic blood pressure variability (SBPV) and baroreceptor
      gain (BRG)) and non-invasive haemodynamics (cardiac output and total peripheral
      resistance) in patients with neurocardiogenic syncope. Retrospectively, we
      evaluated 12 NCS patients (positive head-up tilt without pharmacological
      provocation) in the basal state and at initial tilt, 12 non-NCS patients with
      tilt-negative syncope and 12 aged-matched normal controls. Prospectively, we
      evaluated 16 NCS patients to analyse the haemodynamics and ANS activity
      throughout the tilt test (beginning of tilt and before syncope occurs). HRV and
      SBPV were accessed by fast Fourier transforms (FFT) and spontaneous BRG by
      temporal sequences, slope and a index. Modelflow was used to quantify the non
      invasive haemodynamics. None of the autonomic and haemodynamic parameters at
      baseline or in the first 10 min of tilt was different among the respective NCS,
      non-NCS syncope and normal control groups, except for SBP, which was higher at
      baseline in controls. Throughout the tilt test in the prospective NCS group, the
      heart rate increased (88-95 beats x min(-1), P<0.05), systolic blood pressure
      decreased (123-109 mmHg, P<0.01), and arterial baroreceptor gain was reduced (7.6
      to 5.5 ms mmHg(-1), P<0.01) and the absolute high frequency component of HRV (HF
      HRV) decreased (150-80 ms(-2), P<0.05), before syncope occurred. There was no
      change in the low frequency component of HRV (LF HRV), SBPV, cardiac output (CO)
      or total peripheral resistance (TPR). Tilt-induced syncope could not be predicted
      by non-invasive haemodynamic or autonomic parameters at rest or in the initial
      minutes of tilt. The decrease in arterial baroreceptor gain could be a precocious
      expression of the transient autonomic dysfunction that characterizes the
      occurrence of neurocardiogenic syncope.

PMID- 11220562
TI  - Effect of cardiac exposure by median sternotomy on atrial fibrillation cycle
      length.
AB  - BACKGROUND: Epicardial mapping is a powerful tool that has enabled us to gain
      insight into the electrical phenomena perpetuating atrial fibrillation and has
      guided the design of surgical and catheter-based therapeutic strategies. However,
      epicardial data are acquired during abnormal physiological conditions; the
      patients are anaesthetized, their chests opened, dislocating the heart and
      exposing it to air of room temperature, and the autonomic tone is modulated due
      to the surgery. The effect of intra-operative conditions on atrial
      electrophysiological properties have not been investigated before. Thus in the
      present study we assessed the atrial cycle length, shown to be an index of atrial
      refractoriness, and the ventricular rate before and during open-heart surgery in
      10 patients with chronic atrial fibrillation and an underlying heart disease.
      METHODS AND RESULTS: Using a newly introduced and validated ECG method known as
      frequency analysis of fibrillatory ECG (FAF-ECG), the atrial cycle length and the
      ventricular rate were determined just before surgery. After anaesthesia and
      median sternotomy, epicardial mapping of the entire right atrial free wall was
      performed. The mean ventricular rate as well as the dominant atrial fibrillation
      cycle length consistently increased, the former from 71 to 92 beats x min(-1)
      (mean of all patients, P<0.05) and the latter from 156 to 172 ms (P<0.05).
      CONCLUSIONS: Atrial fibrillation cycle length, an index of atrial refractoriness,
      is increased as an effect of anaesthesia and heart exposure during open-heart
      surgery in patients with chronic atrial fibrillation, implying that atrial
      activation might be altered, which must be considered when interpreting data from
      epicardial conduction analysis.

PMID- 11220564
TI  - An abdominal active can defibrillator may facilitate a successful generator
      change when a lead failure is present.
AB  - AIMS: Defibrillator generator changes are frequently performed on patients with
      an implantable cardioverter defibrillator in an abdominal pocket. These patients
      usually have epicardial patches or older endocardial lead systems. At the time of
      a defibrillator generator change defibrillation may be unsuccessful as a result
      of lead failure. We tested the hypothesis that an active can defibrillator
      implanted in the abdominal pocket could replace a non-functioning endocardial
      lead or epicardial patch. METHODS AND RESULTS: An abdominal defibrillator
      generator change was performed in 10 patients, (mean age = 67 +/- 13 years, nine
      men). Initially, a defibrillation threshold (DFT) was obtained using a passive
      defibrillator and the chronic endocardial or epicardial lead system. DFTs were
      then performed using an active can emulator and one chronic lead to simulate
      endocardial or epicardial lead failure. We tested 30 lead configurations (nine
      endocardial and 21 epicardial). Although a DFT of 7.3 +/- 4.2 joules was obtained
      with the intact chronic lead system, the active can emulator and one endocardial
      or epicardial lead still yielded an acceptable DFT of 19.9 +/- 6.1 joules. In
      addition, a successful implant (DFT < or = 24 joules) could have been
      accomplished in 28 of 30 (93%) lead configurations. CONCLUSION: An active can
      defibrillator in an abdominal pocket may allow for a successful generator change
      in patients with defibrillator lead malfunction. This would be simpler than
      abandoning the abdominal implant and moving to a new pectoral device and lead or
      tunnelling a new endocardial electrode. However, loss of defibrillation
      capability with a particular complex lead may be a warning of impending loss of
      other functions (eg. sensing and/or pacing).

PMID- 11220565
TI  - Multiple hardware complications in a patient with an ICD.
AB  - Hardware-related complications in implantable cardioverter/defibrillators (ICD)
      are still a common problem. Identifying underlying reasons becomes more and more
      difficult as the complexity of ICD systems increases. We report a patient with a
      dual chamber ICD (DDD-ICD) who suffered multiple complications. These included:
      ventricular oversensing causing inappropriate shocks and episodes of asystole; an
      insulation defect resulting in ineffective shocks as a consequence of a short
      circuit between the active can device and a defective high voltage cable; and
      device dysfunction requiring several hospitalizations and operative system
      revisions.

PMID- 11220566
TI  - Atrial flutter in the recipient atrium induced by premature beats arising from
      the donor atrium 10 years after orthotopic heart transplantation.
AB  - BACKGROUND: Several mechanisms for the genesis of supraventricular arrhythmias in
      patients after orthotopic heart transplantation have been reported. METHODS AND
      RESULTS: We describe a 58-year-old male patient in whom atrial flutter occurred
      10 years after orthotopic heart transplantation. During an electrophysiological
      study, bidirectional conduction between the recipient and donor atria was found.
      Atrial flutter in the recipient atrium was induced by programmed stimulation of
      the donor atrium using a single extrastimulus. The clinical symptoms were caused
      by atrial flutter arising from the recipient atrium with 1:1 to 3:1 conduction to
      the donor atrium. Mapping the anastomosis between the two atria indicated
      fragmented potentials at a discrete site of conduction. Delivery of
      radiofrequency energy at this site terminated conduction in both directions.
      Subsequent atrial pacing of the donor and recipient atria, respectively,
      demonstrated bidirectional conduction block. CONCLUSION: Symptomatic arrhythmias
      in patients after heart transplantation can indirectly originate from the donor
      atrium via bidirectional recipient-donor atrial conduction. This type of
      arrhythmia can be successfully treated with radiofrequency ablation.

PMID- 11220567
TI  - Rare association of hypertrophic cardiomyopathy and complete atrioventricular
      block with prompt disappearance of outflow gradient after DDD pacing.
AB  - Although arrhythmias are common in hypertrophic cardiomyopathy (HCM), complete
      atrioventricular (AV) block is very unusual. A 27-year-old female presented with
      a recent history of syncope and exercise intolerance. ECG demonstrated complete
      AV block. Two-dimensional Doppler echocardiography revealed HCM with a 60 mmHg
      left ventricular outflow tract (LVOT) gradient. A temporary transvenous
      ventricular pacemaker was inserted urgently, and subsequently replaced by a
      permanent DDD pacemaker. All symptoms were eliminated. This symptomatic
      improvement was associated with complete disappearance of LVOT gradient at the
      time of implantation. No gradient was observed during early follow-up and at 6
      months after DDD pacemaker implantation.

PMID- 11220568
TI  - Slow pathway ablation in a patient with common AV nodal reentrant tachycardia and
      complete situs inversus.
AB  - A 72-year-old woman with complete situs inversus underwent successful slow
      pathway ablation of typical AV nodal reentrant tachycardia. Catheter ablation of
      AV nodal reentrant tachycardia in dextrocardia required a lengthy procedure but
      was safe and without complications.

PMID- 11220569
TI  - Experimental setup for the determination of analytes contained in ultrasonically
      levitated drops.
AB  - An automated technique for the determination of analytes in an ultrasonically
      levitated sample of 2 to 5 microL volume has been developed. Contactless dosing
      of reagents or solvents into an ultrasonically levitated drop was realized via
      piezoelectric micropumps. Drop size was continually controlled with a programmed
      CCD camera. A diode array spectrometer designed for the use with optical fibers
      was used for absorption and fluorescence measurements. Determinations via direct
      absorption measurements following the method of standard addition and acid-base
      titrations with an absorption indicator and a fluorescent indicator were carried
      out. The mean consumption of sodium hydroxide added via a piezoelectric micropump
      in five successive titrations with 18 nmol of sulfuric acid inside a levitated
      drop (indicator bromothymol blue) had a relative standard deviation of 0.7% and
      differed only by 0.2% from the expected value.

PMID- 11220570
TI  - Non-invasive identification of chemical compounds by energy dispersive X-ray
      fluorescence spectrometry, combined with chemometric methods of data evaluation.
AB  - Chemicals from customers' returns have to be analyzed before they can be reused
      as raw materials in production. A procedure for non-invasive qualitative analysis
      of compounds in a closed container based on energy dispersive X-ray fluorescence
      (EDXRF) spectrometry is described. EDXRF was chosen as method for noninvasive
      analysis of chemicals through PE bottle walls without opening the bottle. This
      analysis aims for a quick proof of correspondence between the declaration of a
      reagent on the label of the bottle and its content. This analytical result cannot
      be achieved by a mere evaluation of characteristic element lines in EDXRF-spectra
      in combination with the method of matrix correction or the method of mean atomic
      number. These methods take into account only a small part of the total
      information available in an X-ray spectrum. It is shown here that valuable
      additional information is extractable from the spectral ranges of the Compton
      scattering and Rayleigh-scattering areas by the use of methods of multivariate
      data analysis, especially by principle component analysis (PCA). Regularized
      discriminant analysis (RDA) was employed to establish a classification scheme for
      unknown samples.

PMID- 11220571
TI  - Kinetics and stoichiometry in the Karl Fischer solution.
AB  - The mechanisms of the Karl Fischer (K.F.) reaction are reviewed and further
      investigated. Both kinetic measurements of the iodine concentration and
      chromatographic determinations of the reaction products were performed. In
      alcoholic solutions mainly alkyl sulfite is oxidized, and a reaction via partial
      formation of sulfur trioxide is proposed. In methanol an exact 1:1 stoichiometry
      (H2O:I2) has been verified. In the aprotic, dipolar solvents acetonitrile, DMF
      and propylene carbonate HSO3- is oxidized by iodine. Based on formation and
      subsequent hydrolysis of base - SO3 adducts the stoichiometric factor for water
      is determined by type and concentration of the base, by the concentration of
      water and by the solvent itself. - In K.F. reagents the oxidation of SO2 by
      aerial oxygen to sulfate and alkyl sulfate takes place as a side reaction.

PMID- 11220572
TI  - Comparative performance study of ICP mass spectrometers by means of U "isotopic
      measurements".
AB  - The performance of four commercially available ICPMS instruments of three
      different types was compared by means of uranium "isotopic measurements".
      Examined were two quadrupole sector (different generation, different
      manufacturer), one single detector double focusing magnetic sector and one
      multiple collector double focusing magnetic sector instruments. The same samples
      of the IRMM-072 series were used under routine conditions to measure the
      233U/235U and the 233U/238U ratios which, in these samples, vary over almost
      three orders of magnitude from approximately 1 to approximately 2 x 10(-3).
      Within expanded (k = 2) uncertainties, good agreement was observed between the
      certified values and the data internally corrected for mass-discrimination
      effects. The magnitude of the evaluated uncertainties was different for each type
      of instrument. With the multiple collector instrument, expanded uncertainties
      varied from +/- 0.04% to +/- 0.24% for the 233U/235U ratio, and from +/- 0.08% to
      +/- 0.27% for the 233U/238U ratio. They were approximately 1 to 5 times larger
      with the single detector magnetic sector instrument, and approximately 10 to 25
      times larger with both quadrupole sector instruments. With the multiple collector
      instrument, repeatability of the measurements seemed to be limited by the
      difficulty of correcting properly for instrumental background, whereas with the
      single detector magnetic sector instrument the counting statistics was the only
      limitation (on smallest ratios). Apparent mass-discrimination was clearly found
      to be larger but more reproducible (and hence easier to correct for) in the case
      of magnetic sector instruments than for both quadrupole sector instruments. If
      space charge effects were the main source of mass-discrimination for all
      instruments, these results are in contradiction with the hypothesis of the size
      of mass-discrimination decreasing with the acceleration voltage. With the single
      detector magnetic sector instrument in particular (when operated by changing the
      ion energy only), our results pointed at more than only one major source of mass
      discrimination, with variable size depending on the ratios measured.

PMID- 11220573
TI  - Noise power spectra and recovery rates obtained with different nebulizer systems
      in ICP atomic emission spectrometric analyses in the case of different types of
      salts and salt contents.
AB  - The features of different nebulizer systems (cross-flow-, Meinhard- and GMK
      system) in the ICP atomic emission spectrometric analyses of solutions with
      different contents of different salts were evaluated. As basis for the comparison
      of the nebulizer systems the recovery rates and noise power spectra were used.
      Both showed that the GMK-system could be used for the widest diversity of salts
      (sodium chloride, ammonium sulfate and sodium tetraborate) and concentration
      range (0-10%, (m/v)) followed by the cross-flow-system and the Meinhard-system in
      ICP-OES using a 1 kW argon ICP. Of all nebulizer systems the nebulizer according
      to Meinhard has the lowest performance for the salts investigated. The noise
      power spectra of all nebulizer systems are dominated by interference noise from
      the sample introduction system. This noise increases with the salt concentration
      of the solution and the GMK-system shows the lowest increase, followed by the
      cross-flow- and Meinhard-system.

PMID- 11220574
TI  - Determination of arsenic by inductively coupled plasma mass spectrometry-
      comparison of sample introduction techniques.
AB  - A comparison is made of four sample introduction techniques for the determination
      of As by inductively coupled plasma mass spectrometry. The techniques studied
      were 1) flow injection with pneumatic nebulization (FIA-PN), 2) direct
      electrothermal vaporization (ETV), 3) continuous hydride generation (HG) and 4)
      hydride generation with in situ trapping followed by electrothermal vaporization
      (HG-ETV). It was found that FIA-PN and ETV gave similar detection limits in
      concentration units (about 20 pg mL(-1)), although ETV had a much lower absolute
      detection limit (0.2 pg). Sample introduction by hydride generation gave an
      inferior detection limit (100-200 pg mL(-1)), also in combination with in situ
      trapping and ETV, owing to the blank signal from traces of As in NaBH4 which is
      difficult to eliminate. The results indicate that the more elaborate sample
      introduction techniques based on ETV and HG may not offer significant advantages
      compared to normal solution nebulization for the determination of As in simple
      sample matrices such as natural fresh waters, where matrix removal is not
      required.

PMID- 11220575
TI  - Improvement of the model for calculation of relative sensitivity coefficients in
      inductively coupled plasma mass spectrometry.
AB  - Relative sensitivity coefficients (RSCs) were determined for 68 elements in
      inductively coupled plasma mass spectrometry (ICP-MS). It was shown that the Saha
      equation gives a rough description of ionization processes in ICP. A dependence
      of RSCs on the absolute electronegativity of atoms was found. This parameter is
      substantially affecting the accuracy of RSCs calculation for chemically active
      elements. Taking into account absolute electronegativities of the atoms for the
      calculation of RSCs, the ion formation processes in ICP-MS could be better
      described than by using first ionization potentials. The mean relative systematic
      error of RSCs calculation using absolute electronegativity was improved to 0.30.

PMID- 11220576
TI  - A new strategy of solution calibration in laser ablation inductively coupled
      plasma mass spectrometry for multielement trace analysis of geological samples.
AB  - Because multielement trace analysis by laser ablation inductively coupled plasma
      mass spectrometry (LA-ICP-MS) is often limited by the lack of suitable reference
      materials with a similar matrix composition, a novel quantification strategy
      using solution calibration was developed. For mass spectrometric multielement
      determination in geological samples a quadrupole-based LA-ICP-MS is coupled with
      an ultrasonic nebulizer (USN). In order to arrange matrix matching the standard
      solutions are nebulized with a USN during solution calibration and simultaneously
      a blank target (e.g. lithium borate) is ablated with a focused laser beam. The
      homogeneous geological samples were measured using the same experimental
      arrangement where a 2% nitric acid is simultaneously nebulized with the USN.
      Homogeneous targets were prepared from inhomogeneous geological samples by
      powdering, homogenizing and fusing with a lithium borate mixture in a muffle
      furnace at 1050 degrees C. Furthermore, a homogeneous geological glass was also
      investigated. The quantification of analytical results was performed by external
      calibration using calibration curves measured on standard solutions. In order to
      compare two different approaches for the quantification of analytical results in
      LA-ICP-MS, measured concentrations in homogeneous geological targets were also
      corrected with relative sensitivity coefficients (RSCs) determined using one
      standard solution only. The analytical results of LA-ICP-MS on various geological
      samples are in good agreement with the reference values and the results of other
      trace analytical methods. The relative standard deviation (RSD) for trace element
      determination (N = 6) is between 2 and 10%.

PMID- 11220577
TI  - Detection of heavy metals in water by fluorescence spectroscopy: on the way to a
      suitable sensor system.
AB  - In order to develop a fiber optical heavy metal ion detection system, the
      applicability of selected complexing agents with fluorescent properties has been
      studied. Beginning with the application of known chelators, like BTC-5N, Newport
      Green, neocuproine, and chromotropic acid, a sensor configuration has been found,
      which allows the detection of Cd2+, Ni2+, and Cu2+ well below the chemical
      parameter threshold values of the new Water Quality Directive 98/83/EU. The
      sensor itself uses a membrane separation of the chelator flow from the sample
      volume. The diffusion across the membrane limits the response time to about 15 to
      20 min. Applications are seen in monitoring networks.

PMID- 11220578
TI  - Dyeless optical detection of ammonia in the gaseous phase using a pH-responsive
      polymer--characterization of the sorption process.
AB  - pH-responsive polymers enable the dyeless optical detection of acidic or basic
      pollutants in air. The characterization of the sorption process and the
      optimization of the response time of the sensitive layers were high-lighted. The
      swelling of a pH-responsive polysiloxane induced by sorption of gaseous ammonia
      was investigated by measurement techniques such as spectroscopic ellipsometry
      (SE) and infrared spectroscopy (IR). Furthermore, the pH-responsive polymer was
      applied for the detection of gaseous ammonia using the LED-based reflectometric
      interference spectroscopy set-up (RIfS4lambda). A limit of detection of 0.30
      mg/m3 ammonia and a response time (t90%) of 35 s could be verified. The
      application of pH-responsive polymers can be a powerful alternative to dye-based
      optical sensing, since photobleaching or leaching of the sensitive functional
      unit cannot occur applying this approach, and since the properties of the
      sensitive layer proved to be very promising.

PMID- 11220579
TI  - Optical sensor for seawater salinity.
AB  - An optical sensor for the measurement of salinity in seawater has been developed.
      It is based on a chloride-quenchable fluorescent probe (lucigenin) immobilized on
      a Nafion film. Two approaches for measuring salinity via chloride concentration
      are presented. In the first, a change in salinity corresponds to a change in the
      fluorescence intensity of lucigenin. In the second, the fluorescence intensity
      information is converted into a phase angle information by adding an inert
      phosphorescent reference luminophore (a ruthenium complex entrapped in
      poly(acrylonitrile) beads). Under these conditions, the chloride-dependent
      fluorescence intensity of lucigenin can be converted into a chloride-dependent
      fluorescence phase shift which serves as the analytical information. This scheme
      is referred to as dual lifetime referencing (DLR). The sensor was used to
      determine the salinity in seawater and brackish water of the North Sea.

PMID- 11220580
TI  - Novel teststrip with increased accuracy.
AB  - A new type of a simple and cheap teststrip for liquid samples is described. It is
      based on microchromatography or microtitration on a porous, capillary-active
      substrate (e.g., filter paper or a similar absorbent material). In case of
      microchromatography an analyte-selective indicator (and other auxiliary reagents)
      is impregnated or immobilized on the capillary-active substrate; in case of micro
      titration the capillary-active substrate contains a titrant which reacts
      stoichiometrically with the analyte. Quantitative analysis is performed by
      measurement of an area (which had changed its color) rather than by evaluation of
      the shade or intensity of a color (like in conventional teststrips). In order to
      show the broad applicability of this new principle teststrips for different
      analytes like Quaternary Ammonium Compounds (QACs), the cation Ni2+, the anion
      SO4(2-) and H2O2 are described. The detection limit and working range of the
      novel teststrip can be adjusted by variation of its size.

PMID- 11220581
TI  - Sulfur speciation by capillary zone electrophoresis: conditions for sulfite
      stabilization and determination in the presence of sulfate, thiosulfate and
      peroxodisulfate.
AB  - Capillary zone electrophoresis (CZE) was used for the separation of the sulfur
      species SO3(2-), SO4(2-), S2O(3-) and S2O8(2-). Using an electrolyte system with
      9.5 mmol L(-1) potassium chromate as UV-absorbing probe and 1 mmol L(-1)
      diethylenetriamine (DETA) as electroosmotic flow modifier, various possibilities
      for the stabilization of sulfite and electrophoretic separation of the sulfur
      anions were investigated. By adding 5% propanol as a stabilizer to both the
      working electrolyte and the sample solution, a good stabilization for sulfite and
      a separation of the sulfur anions in a short analysis time (4 min) was achieved.
      The advantages by using propanol instead of other stabilizers often used in
      analytical techniques are discussed. The electrophoretic separation of the sulfur
      anions was optimized with respect to the pH of the working electrolyte and
      concentration of the electroosmotic flow modifier (DETA). The detection limits
      achieved for SO3(2-), SO4(2-), S2O3(2-) and S2O8(2-) were 0.35, 0.25, 0.78 and
      0.80 mg L(-1), respectively.

PMID- 11220583
TI  - Depth profile analysis of various titanium based coatings on steel and tungsten
      carbide using laser ablation inductively coupled plasma--"time of flight" mass
      spectrometry.
AB  - A homogenized 193 nm ArF* laser ablation system coupled to an inductively coupled
      plasma-"Time of Flight"-mass spectrometer (LA-ICP-TOFMS) was tested for depth
      profiling analysis on different single-layer Ti based coatings on steel and W
      carbides. Laser parameters, such as repetition rate, pulse energy and spatial
      resolution were tested to allow optimum depth related calibration curves. The
      ablation process using a laser repetition rate of 3 Hz, 120 microm crater
      diameter, and 100 mJ output energy, leads to linear calibration curves
      independent of the drill time or peak area used for calibrating the thickness of
      the layer. The best depth resolution obtained (without beam splitter) was 0.20
      microm per laser shot. The time resolution of the ICP-TOFMS of 102 ms integration
      time per isotope was sufficient for the determination of the drill time of the
      laser through the coatings into the matrix with better than 2.6% RSD (about 7
      microm coating thickness, n = 7). Variation of the volume of the ablation cell
      was not influencing the depth resolution, which suggests that the depth
      resolution is governed by the ablation process. However, the application on the
      Ti(N,C) based single layer shows the potential of LA-ICP-TOFMS as a complementary
      technique for fast depth determinations on various coatings in the low to medium
      microm region.

PMID- 11220582
TI  - Stability studies of arsenic, selenium, antimony and tellurium species in water,
      urine, fish and soil extracts using HPLC/ICP-MS.
AB  - The stability of arsenic, selenium, antimony and tellurium species in water and
      urine (NIST SRM 2670n) as well as in extracts of fish and soil certified
      reference materials (DORM-2 and NIST SRM 2710) has been investigated. Stability
      studies were carried out with As(III), As(V), arsenobetaine, monomethylarsonic
      acid (MMA), dimethylarsinic acid (DMA), phenylarsonic acid (PAA), Se(IV), Se(VI),
      selenomethionine, Sb(III), Sb(V) and Te(VI). Speciation analysis was performed by
      on-line coupling of anion exchange high-performance liquid chromatography (HPLC)
      with inductively coupled plasma mass spectrometry (ICP-MS). Best storage of
      aqueous mixtures of the examined species was achieved at 3 degrees C whereas at 
      20 degrees C species transformation especially of selenomethionine and Sb(V) took
      place and a new selenium species appeared within a period of 30 days. Losses and
      species transformations during extraction processes were investigated. Extraction
      of the spiked fish material with methanol/water led to partial conversion of
      Sb(III), Sb(V) and selenomethionine to two new antimony and one new selenium
      species. The other arsenic, selenium and tellurium species were almost
      quantitatively extracted. For soil spiked with MMA, PAA, Se(IV) and Sb(III),
      recoveries after extraction with water and sulfuric acid (0.01 mol/L) were below
      20%.

PMID- 11220584
TI  - Direct solid sampling electrothermal atomic absorption spectrometry for the
      analysis of high-purity niobium pentaoxide.
AB  - A direct solid sampling electrothermal atomic absorption spectrometry (SoS-ETAAS)
      method for ultratrace analysis of powdered niobium pentaoxide for Al, Co, Cr, Cu,
      Fe, K, Mg, Mn, Na, Ni and Zn has been developed. The elements K, Mg, Na and Zn
      could be determined without any chemical modification. However, in the
      determination of the elements Al, Co, Cr, Cu, Fe, Mn and Ni, serious matrix
      caused non-spectral interferences and background occurred which made their
      determination impossible. This problem was remedied by conversion of the niobium
      pentaoxide matrix into the thermally stable niobium carbide by using methane
      atmosphere during the pyrolysis stage. The development resulted in establishing
      an extraordinary powerful method for the analysis of niobium pentaoxide in term
      of limits of detection, accuracy, simplicity and analysis time. Quantification
      was performed using calibration curves measured with aqueous standard solutions.
      The accuracy was checked by comparing the results with those obtained by ETAAS in
      analysis of slurries and digests of the sample. Due to almost complete freedom of
      blank and high applicable sample amounts (up to 15 mg), extremely low limits of
      detection (0.5-2 ng/g) were achieved.

PMID- 11220585
TI  - Determination of metal additives and bromine in recycled thermoplasts from
      electronic waste by TXRF analysis.
AB  - A new method for analysis of metal additives in recycled thermoplasts from
      electronic waste was developed, based on dissolving the samples in an organic
      solvent and subsequent analysis of the corresponding solutions or suspensions by
      total-reflection X-ray fluorescence spectroscopy (TXRF). The procedure proved to
      be considerably less time consuming than the conventional digestion of the
      polymer matrix. Additives containing Ti, Zn, Br, Cd, Sn, Sb, and Pb were analyzed
      in a hundred randomly selected samples from recycling, which provided an overview
      of the range of elemental concentrations in thermoplasts utilized for consumer
      electronics. The results were validated independently by instrumental neutron
      activation analysis (INAA), subsequent regression analysis confirmed the trueness
      of the chosen approach.

PMID- 11220586
TI  - Determination of palladium in gasoline by neutron activation analysis and
      automated column extraction.
AB  - Palladium in gasoline was determined by means of neutron activation analysis
      (NAA) and selective sorbent extraction. Unleaded gasoline consistent with DIN EN
      228, RON 95 was irradiated at a thermal neutron flux of phith = 1.68 x 10(13)s(
      1)cm(-2) and an epithermal neutron flux of 3.32 x 10(11)s(-1)cm(-2) for t(irr) =
      12 h. The irradiated gasoline was digested with nitric acid and palladium was
      then separated as N,N-diethyl-N'-benzoylthiourea complex by an automated column
      pre-concentration procedure. The eluate of 50 microL was dried on a filter paper
      and the 88.03 keV photons resulting from the decay of 109Pd were detected in a
      low level HPGe spectrometer with an efficiency of 35.5%. Severe interferences
      with other matrix constituents, especially 82Br could be overcome and the
      detection limit for palladium was improved to 3.4 ng/L at a confidence level of
      90%. Although the analytical procedure applied yielded the lowest detection limit
      for palladium obtained in gasoline up to now, no indications for the presence of
      palladium were found.

PMID- 11220587
TI  - Multifunctional organic nitrates as constituents in European and US urban photo
      smog.
AB  - Air samples of the atmospheric ground layer in the cities of Ulm in Germany, Las
      Vegas, Nevada, and Salt Lake City, Utah, in the US were analyzed for organic
      nitrates. The air samples were taken around noon in summer at sunny weather
      conditions. 43 (C6-C13) alkyl mononitrates, 24 (C3-C6) alkyl dinitrates, and 19
      (C2-C6) hydroxy alkyl nitrates have been identified. The analytical protocol
      included high-volume-sampling, NP-HPLC group separation, high resolution
      capillary gas chromatography, and detection by the highly selective mass
      spectrometer detector (SIM mode, m/z = 46). The levels of the sum of 15 (C6-C10)
      alkyl mononitrates ranged from 2.9 to 11.0 parts per trillion (ppt(v)). The
      levels of the sum of 21 (C3-C6) alkyl dinitrates ranged from 2.3 to 10.5 ppt(v),
      and the levels of the sum of 7 (C2-C4) hydroxy alkyl nitrates ranged from 7.3 to
      28 ppt(v), respectively, in the urban air samples. These results emphazise the
      contribution of the alkyl dinitrates and hydroxy alkyl nitrates besides the alkyl
      mononitrates to the budget of NO(Y) compounds. No major differences in levels and
      pattern of the organic nitrates are present in air of the German and the US
      cities.

PMID- 11220588
TI  - Copper-complexation index as a polarographic summation parameter for the
      determination of chelating agents in water.
AB  - Polarography of the copper(II)-complexes of chelating agents is shown to be a
      suitable basis for a summation parameter for the total concentration of these
      chemicals in water (expressed as the copper-complexation index). Using 12
      chelating agents (ATMP, BAED, CDTA, DTPA, DTPMP, EDTA, EDTMP, EDTP, EGTA, HEDP,
      NTA, PBTC) all listed in DIN 38409-H26 and DIN 38413-P5 a satisfactory
      reproducibility of the method used was obtained. In addition several commercial
      tensides, detergents in washing and deliming products were investigated.

PMID- 11220589
TI  - Simultaneous multi-element analysis of trace elements in soil samples by means of
      high-resolution inductively coupled plasma sector field mass spectrometry (SF-ICP
      MS).
AB  - The potential of SF-ICP-MS for trace element analysis in complex environmental
      matrices such as soil solutions was investigated. Spectral interferences found in
      mass spectra of soil matrices are presented in detail. Furthermore, the
      influences of single components of the soil matrix on the signal intensity of
      selected elements were studied. Detection limits of different elements are
      presented with respect to the composition of the matrix. A fast and accurate
      method for quasi-simultaneous determination of Al, Si, P, V, Cr, Mn, Fe, Ni, Co,
      Cu, Zn, As, Se, Sr, Mo, Cd, Sn, Hg and Pb in aqueous soil extracts was
      established.

PMID- 11220590
TI  - Metal(loid)organic compounds in contaminated soil.
AB  - 13 samples of soils contaminated with petrol, coaly residues, shredder and
      domestic waste have been investigated by low temperature gas chromatography with
      plasma mass spectrometry detection after sample derivatisation by hydride
      generation (HG/LT-GC/ICP-MS). 24 organic compounds of 9 elements could be
      analysed, one fifth of them exceeding the concentration of 1 microg/kg. These
      results are roughly comparable with those on harbour and river sediments, and are
      discussed in respect to a preliminary evaluation of the emission potential of
      solid waste and contaminated soil as well as waste treatment processes.

PMID- 11220591
TI  - Retention behavior of humic substances in reversed phase HPLC.
AB  - Recovery as well as appearance and abundance (in percent) of different fractions
      of humic substances are found to depend on injected sample amounts in reversed
      phase HPLC. Sample amounts have been varied both by varying sample concentration
      and sample volume. In case of lowest amounts injected only two fractions were
      obtained for a commercial humic acid sodium salt, i.e. one for excluded molecules
      and one for hydrophobic components. The abundance of excluded molecules decreases
      upon increasing amounts injected. Another three fractions are obtained upon
      increasing amount injected: a hydrophilic fraction and two hydrophobic ones. This
      behavior is explained by auxiliary equilibria between excluded components and
      humic molecules previously adsorbed on the stationary phase.

PMID- 11220592
TI  - Structural and elemental investigations of isolated aquatic humic substances
      using X-ray photoelectron spectroscopy.
AB  - Structural and elemental investigations of aquatic humic substances (HS) by means
      of X-ray photoelectron spectroscopy (XPS) are described. For that purpose small
      amounts (10-50 microg) of dissolved reference HS, which were characterized within
      the German research program DFG-ROSIG, were dried as thin films on small pieces
      of a high-purity silicon wafer. The photoelectrons from such HS layers exhibited
      characteristic signals of carbon C1s, nitrogen N1s, oxygen O1s and sulfur S2s,
      which could be fitted by Gaussian curves and used for the quantification of
      various moieties of HS: carbon (C-C, C-O, C=O, O=C-O), oxygen (C-O, C=O),
      nitrogen (C-N, C-N+) and sulfur. Moreover, by adding up the element signals of
      the HS samples their elemental composition of C, O, N and S was assessed. A
      comparison of the data based on solution state NMR and conventional elementary
      analysis revealed a satisfactory accuracy with those obtained by XPS.

PMID- 11220593
TI  - Characterization of high molecular weight cadmium species in contaminated
      vegetable food.
AB  - Spinach and radish grown from seeds were each contaminated with 4 different
      amounts of cadmium. After a cell breakdown of the eatable parts and
      centrifugation of the resulting homogenates all supernatants (cytosols) were
      separated by gel permeation chromatography (GPC). The size-range of the GPC
      method used was about 20-8000 kDa for globular proteins. The high molecular
      weight (HMW-Cd-SP, 150-700 kDa) and the low molecular weight Cd species (LMW-Cd
      SP, < 150 kDa) in all plant cytosols eluted at about the same retention volume by
      GPC. The most important Cd binding form in the cytosols of all plants was found
      to be HMW-Cd-SP. The Cd elution maxima were detected in the range of about 200
      kDa. The Cd determinations were performed with ET-AAS by means of matrix
      modifier. By incubating chosen cytosols with a proteinase before the GPC it was
      verified that the HMW-Cd-SP in both vegetables are Cd proteins. The molar
      proportions protein/Cd were about 2-6 in the respective GPC fractions of the HMW
      Cd-SP of the highest contaminated plants. The GPC fractions of the HMW-Cd-SP of
      spinach and radish were further separated by a preparative, native and continuous
      polyacrylamide gel electrophoresis (PAGE) method. At pH 8 the species were
      negatively charged, had only a small UV-absorption at 280 nm and showed a very
      similar elution behavior in all analyzed cytosols. Therefore, we suppose that the
      HMW-Cd-SP of these two different vegetable foodstuffs have a very similar
      chemical structure.

PMID- 11220594
TI  - Electrothermal atomic absorption spectrometric determination of cobalt in
      biological samples and natural waters using a flow injection system with on-line
      preconcentration by ion-pair adsorption in a knotted reactor.
AB  - An on-line flow injection preconcentration-ETAAS method is developed for trace
      determination of cobalt in biological materials and natural samples by ion-pair
      sorption on the inner walls of a PTFE knotted reactor. The ion-pair is formed
      between the negatively charged cobalt-nitroso-R-salt complex and the
      tetrabutylammonium counter-ion. An enhancement factor of 15, a sampling frequency
      of 17 and a concentration efficiency of 4 are obtained for a preconcentration
      time of 60 s and a sample loading flow rate of 5 mL min(-1). The detection limit
      (3sigma) is 5 ng L(-1). The relative standard deviation at the 0.2 microg L(-1)
      level is 2.3%. The analytical results obtained for standard reference materials
      are in good agreement with the certified or indicated values and satisfactory
      recoveries of spiked cobalt in tap water are obtained.

PMID- 11220595
TI  - Study of the binding of 114mIn radiotracer to human serum components by
      ultrafiltration and chromatography.
AB  - The chemical speciation of indium in serum was studied. Ultrafiltration was used
      to investigate the influence of several buffer systems on the binding
      characteristics of indium in serum and to study the association of indium with
      transferrin and albumin. This was performed by means of batch incubation
      experiments with a 114mIn tracer. Different buffer systems were investigated. A
      series of bicarbonate, Tris:HCl and HEPES buffers were found to fit for this
      purpose. Phosphate buffer was not suitable, as it is capable of disrupting the
      binding between indium and transferrin. Batch ultrafiltration experiments with
      114mIn incubated solutions of transferrin and albumin showed that both proteins
      are capable of binding indium to a high degree. Three chromatographic techniques
      (SEC, AEC, AC) were used to study the different chemically active species of
      indium in serum. It is concluded that next to transferrin, albumin is also
      responsible for the binding and transport of indium in serum.

PMID- 11220597
TI  - Stable isotope dilution analyses of molybdenum in meteorites.
AB  - Isotope dilution mass spectrometry is an ideal analytical technique to measure
      the elemental abundance of Mo in C1 carbonaceous chondrites and the metallic and
      troilite phases of iron meteorites. The mean abundance of Mo in two C1 meteorites
      is 0.909+/-0.040 microg/g which corresponds to a value of 2.55 atoms Mo with
      respect to Si equal to 10(6) atoms, which is identical to the currently accepted
      solar system abundance. The partitioning of Mo between the metallic and sulfide
      phases in the Mundrabilla iron meteorite was found to be 6.0+/-0.2 microg/g and
      8.6+/-0.3 microg/g, respectively. A new, precise Mo concentration of 1.54+/-0.04
      microg/g for the Geochemical Reference Standard BCR-1 is also reported.

PMID- 11220598
TI  - Analytical information needs in the XXI century.

PMID- 11220596
TI  - Low-molecular-weight organoiodine and organobromine compounds released by polar
      macroalgae--the influence of abiotic factors.
AB  - The influence of temperature, light, salinity and nutrient availability on the
      release of volatile halogenated hydrocarbons was investigated in the Antarctic
      red macroalgal species Gymnogongrus antarcticus Skottsberg. Compared to standard
      culture condition, an increase in the release rates of iodocompounds was
      generally found for the exposure of the alga to altered environmental conditions.
      Macroalgae exhibited higher release rates after adaptation for two months to the
      changed factors, than after short-term exposure. Monitoring the release rates
      during a 24 h incubation period (8.25 h light, 15.75 h darkness) showed that
      changes between light and dark periods had no influence on the release of
      volatile halocarbons. Compounds like bromoform and 1-iodobutane exhibited
      constant release rates during the 24 h period. The formation mechanisms and
      biological role of volatile organohalogens are discussed. Although marine
      macroalgae are not considered to be the major source of biogenically-produced
      volatile organohalogens, they contribute significantly to the bromine and iodine
      cycles in the environment. Under possible environmental changes like global
      warming and uncontrolled entrophication of the oceans their significance may be
      increase.

PMID- 11220599
TI  - A systematic approach to optimum working conditions with inductively coupled
      plasma atomic emission spectrometry.
AB  - Optimum experimental factors were determined for the analytical determination of
      Al, Cd, Fe, Pb, and Zn by ICP atomic emission spectrometry. Based on
      systematically determined factor levels, working conditions were found that gave
      similar, and sometimes better results compared with the hitherto used levels of
      factors. All measurements were performed with a sampling time of 150 ms as often
      used in routine analysis in the laboratory. This optimization resulted in a
      reduced outer plasma gas flow from 15 L/min argon to 12 L/min without any
      relevant changes of the achievable detection limits. A serious problem was that
      only one analytical line of Al could be used. A comparison with the lower limit
      of application (comparable with the detection limit) from German directive DIN
      38406, part 22 ([1]), showed that the detection limits of Al and Fe are superior,
      whereas for Cd there was only little improvement. The detection limits of Zn and
      especially Pb are always higher than the lower range of application under these
      conditions. Therefore, the use of two device-parameter sets for hard and soft
      lines, respectively, is strongly suggested. Maps with the observed signal-to
      noise-ratios were systematically acquired for each element analyzed in connection
      with different strategies for optimum search. mon compromise condition (combined
      analysis) and the limits of quantification demanded in the German directive DIN
      38406, part 22 [1]. Only four, but the most important, experimental factors were
      changed, the other experimental factors were always kept constant (Tables 1 and
      2).

PMID- 11220600
TI  - Indirect fluorescence detection of phenolic compounds by capillary
      electrophoresis on a glass device.
AB  - A micromachined capillary electrophoresis system has been fabricated on a glass
      device for the separation and indirect fluorescence detection of phenols. Using
      this device two phenols viz., 2,4-dichlorophenol and pentachlorophenol, were
      separated within 12 s compared to under 19 min on a conventional capillary
      electrophoresis system using direct ultraviolet detection. The precision of the
      glass device ranged from 12.7%-16.7% compared to 0.42%-4.9% for the conventional
      system. Both systems showed good linearity in the concentration range of 0.8-6.38
      mM for the glass device and 5-130 microM for the conventional system. The
      relationship between temperature and high voltage with baseline drift was also
      investigated. These results provide a foundation for the development of a
      miniaturised chemical analysis system for the on-line analysis of phenols in
      water.

PMID- 11220602
TI  - Applications of a versatile sol-gel derived renewable electrode for capillary
      electrophoresis.
AB  - A new electrode has been developed and applied for amperometric detection in
      capillary electrophoresis (CE), comprised of carbon sol-gel composite material.
      The versatility of the sol-gel technique permits the flexible configuration of
      the electrode. The performance of such a sol-gel carbon composite electrode (CCE)
      is first evaluated in a typical CE application for the detection of purine-based
      compounds. Application of the CCE is also demonstrated for the detection of
      phenolic compounds in a micellar system. Separation resolution for non-ionic
      phenolic compounds can significantly be enhanced by introducing sodium dodecyl
      sulfate (SDS) at a concentration above its critical micelle concentration (cmc)
      to the buffer. Another design of the CCE incorporating the electrocatalyst Cu2O
      is employed for the analysis of sugars and organic acids based on dynamic
      modification with cetyltrimethylammonium bromide (CTAB). It has been found that
      the presence of surfactant in the separation buffer does not adversely influence
      the electrochemical detection using a sol-gel derived carbon electrode.

PMID- 11220601
TI  - Needle-type glucose microbiosensor based on glucose oxidase immobilised in an
      overoxidised polypyrrole film (an in-vitro study).
AB  - A fast response, needle-type glucose microbiosensor has been fabricated by a one
      step electrochemical immobilisation of glucose oxidase in a polypyrrole film. The
      sensor shows a remarkable rejection of electroactive interferences, especially
      paracetamol. The maximum bias observed in the worst situation never exceeded the
      value of 6%. The fabrication procedure delivered very reproducible devices and
      the sensitivity of a newly prepared biosensor was typically 650 nA mM(-1) cm(-2).
      The kinetic parameters, obtained from an existing model, permitted to understand
      the sensor behaviour.

PMID- 11220603
TI  - Soil-modified carbon paste electrode: a useful tool in environmental assessment
      of heavy metal ion binding interactions.
AB  - Carbon paste electrodes (CPEs) modified with different soils in their native form
      were prepared to create a soil-like solid phase suitable for application in
      studies of heavy metal ion uptake and binding interactions. The preparation of
      CPEs modified with five different soils was examined and their heavy metal ion
      uptake behavior investigated using a model Cu(II) aqueous solution. Metal ions
      were accumulated under open circuit conditions and were determined after a medium
      exchange using differential pulse anodic stripping voltammetry, applying
      preelectrolysis at -0.7 V. The soil-modified CPE accumulation behavior, including
      the linearity of the current response versus Cu(II) concentration, the influence
      of the pH on the solution, and the uptake kinetics, was thoroughly investigated.
      The correlation between the soil-modified CPE uptake capability and the standard
      soil parameters, such as ion exchange capacity, soil pH, organic matter and clay
      content, were evaluated for all five examined soils. The influence of selected
      endogenous cations (K(I), Ca(II), Fe(III)) on the transfer of Cu(II) ions from a
      solution to the simulated soil solid phase was examined and is discussed.
      Preliminary examinations of the soil-modified CPE uptake behavior with some
      exogenous heavy metal ions of strong environmental interest (Pb(II), Hg(II),
      Cd(II) and Ag(I)) are also presented. This work demonstrates some attractive
      possibilities for the application of a soil-modified CPE in studying soil-heavy
      metal ion binding interactions, with a further potential use as a new
      environmental sensor appropriate for fist on-site testing of polluted soils.

PMID- 11220604
TI  - Determination of underivatized amino acids by high-performance liquid
      chromatography and electrochemical detection at an amino acid oxidase immobilized
      CuPtCI6 modified electrode.
AB  - An amperometric sensor for amino acids based on the immobilization of amino acid
      oxidase on the surface of a CuPtCl(6)/GC is described. The amperometric current
      is due to the oxidation of H2O2 liberated during the enzyme reaction on the
      surface of the enzyme electrode. The electrode response characteristics as well
      as kinetic parameters have been evaluated. The enzyme electrode was characterized
      as an electrochemical biosensor, which was used as detector in high performance
      liquid chromatography (HPLC) for the determination of a mixture of amino acids
      with satisfactory results.

PMID- 11220605
TI  - Effects of various salts on the determination of arsenic by graphite furnace
      atomic absorption spectrometry. Direct determination in seawater.
AB  - The effect of Na, Mg, Ca and Sr as their nitrate, chloride and sulfate salts and
      seasalt, with and without the use of palladium, on the determination of arsenic
      by electrothermal atomic absorption spectrometry was investigated. In the absence
      of any stabilizing agent, arsenic was partially lost as molecular species at low
      temperatures. The effect of salts on the shape of the atomization signal, the
      integrated absorbance and the stabilizing effect were highly dependent both on
      their nature and mass. By trapping arsenic, oxide species resulting from the
      decomposition of nitrate salts induced a high stabilization effect depending on
      their vaporization temperatures: MgO approximately CaO>SrO>Na2O. The
      stabilization effect of chlorides occurred about 200 degrees C lower and depended
      on mass, volatility and hydrolytic properties: SrCl2>CaCl2>MgCl2 approximately
      NaCl. The effect of sulfates was mainly dependent on their
      decomposition/vaporization mechanisms, and in the presence of Na2SO4 or CaSO4 a
      strong chemical interference effect was observed. Palladium stabilized arsenic in
      the presence of nitrates, chlorides or even sulfates, leading to a similar
      delaying effect, signal shape and integrated absorbance. Seasalt induced also
      important modifications to the atomization signal of As. Moreover, an
      interference effect was observed, which could probably be attributed to the
      simultaneous vaporization of sulfate in seasalt. In seawater, Pd suppressed this
      interference effect and permitted to use a high pyrolysis temperature up to 1400
      C to remove the major part of the seawater matrix before atomization. Under
      optimized conditions, the detection limit for As obtained in unmodified seawater
      in the presence of Pd was 0.34 microg L(-1) for a 10 microl sample.

PMID- 11220606
TI  - Determination of cobalt in sewage sludge using ultrasonic slurry sampling
      graphite furnace atomic absorption spectrometry.
AB  - Cobalt in sludge of domestic and industrial origin, with high iron contents (> 17
      g/kg), was determined by slurry sampling graphite furnace atomic absorption
      spectrometry (GF-AAS). Slurries prepared by ultrasonic stirring were adequately
      diluted to cover the variation in cobalt content in the sludge samples. The
      diluent was 5% HNO3. Standard atomisation conditions for cobalt determination
      were used and no matrix modifier was applied. Slurry sampling GF-AAS results in
      the sludge were verified by analysing totally digested samples by inductively
      coupled plasma atomic emission spectrometry (ICP-AES) and by GF-AAS. The
      procedure was validated by analysing the certified reference material BCR 146 R,
      a sewage sludge of industrial origin. Recoveries for cobalt in the spiked
      slurried sludge samples ranged from 92 to 96%, with a relative standard deviation
      of 10%. Recoveries in the certified sludge using slurry sampling GF-AAS technique
      were about 103% for a cobalt content of 7.39 mg/kg.

PMID- 11220607
TI  - Rapid determination of lead and cadmium in sewage sludge samples using
      electrothermal atomic absorption spectrometry with slurry sample introduction.
AB  - Lead and cadmium concentrations in sewage sludge samples are determined by
      suspending the ground samples in a solution containing 10% (v/v) concentrated
      hydrofluoric acid, 1% (v/v) concentrated nitric acid, 0.5% (m/v) dihydrogen
      ammonium phosphate and 0.1% (m/v) sodium hexametaphosphate. Aliquots of 20 microL
      of these suspensions (4 mg/mL) are diluted to 1000 microL with the same solution
      and then injected into the electrothermal atomizer. The drying stage is performed
      by programming a 400 degrees C temperature, a ramp time of 20 s and a hold time
      of 15 s on the power supply of the atomizer. No ashing step is used. Platform
      atomization is carried out at 1600 and 1800 degrees C for Pb and Cd,
      respectively. Calibration is performed using aqueous standards in the 5-75 and
      0.2-5 microg/L Pb and Cd ranges, respectively. Results obtained for three
      certified reference materials and four samples demonstrate the reliability of the
      procedures described.

PMID- 11220608
TI  - Optimization and comparison of MAE, ASE and Soxhlet extraction for the
      determination of HCH isomers in soil samples.
AB  - The microwave-assisted extraction (MAE), accelerated solvent extraction (ASE) and
      Soxhlet extraction of two isomers of hexachlorocyclohexane, alpha-HCH and gamma
      HCH, from a polluted landfill soil have been optimized following different
      experimental designs. In the case of microwave-assisted extraction, the following
      variables were considered: pressure, extraction time, microwave power, percentage
      of acetone in n-hexane mixture and solvent volume. When ASE extraction was
      studied the variables were pressure, temperature and extraction time. Finally,
      the percentage of acetone in n-hexane mixture and the extraction time were the
      only variables studied for Soxhlet extraction. The concentrations obtained by the
      three extraction techniques were, within their experimental uncertainties, in
      good agreement. This fact assures the possibility of using both ASE and MAE
      techniques in the routine determination of lindane in polluted soils and
      sediments.

PMID- 11220609
TI  - Graphite furnace-atomic absorption spectrophotometric determination of palladium
      in soil.
AB  - A new and sensitive procedure for the graphite furnace-atomic absorption
      spectrophotometric (GF-AAS) determination of Pd in soil at nanogram level is
      described. The method is based on prior separation and enrichment of the metal as
      Pd(II)-SnCl3- -N-butylacetamide (BAA) complex into 1-pentanol (PN) by solvent
      extraction method. The value of the molar absorptivity of the complex in three
      solvents, i.e. ethyl acetate, 1-pentanol, chloroform, lie in the range of (0.70
      2.75) x 10(4) L mol(-1) cm(-1) at lambda(max) 360-440 nm. The metal could be
      enriched into organic solvent, i.e. PN, up to 10-folds. The sensitivity (A =
      0.0044) of the method in the term of the peak height was 0.5 ng Pd/mL of the
      aqueous solution at an enrichment factor (EF) of 5. Optimization of analytical
      variables during enrichment and GF-AAS determination of the metal are discussed.
      The method has been applied for the analysis of Pd to soil samples derived from
      roads and highways in Germany.

PMID- 11220610
TI  - A DANREF certified reference plastic for measurement of overall migration into
      the food simulant olive oil by single sided testing.
AB  - A reference material for the determination of overall migration from a plastic
      coextrudate into the fatty food simulant olive oil was produced and certified in
      an interlaboratory study. The analyses were carried out according to the ENV 1186
      standard from the European Committee for Standardization (CEN) [ 1, 2, 3] with
      exposure of the coextrudate to olive oil for 10 days at 40 degrees C. After an
      initial preliminary interlaboratory study eight laboratories participated in the
      certification round, and two different methods were used to obtain single sided
      exposure of the plastic to the oil. The certified value was determined as the
      mean of laboratory mean values. No outliers were found. A reference value of 8.6
      mg/dm2 +/- 1.4 mg/dm2 (+/- half width of the 95% confidence interval) was
      obtained which is within the range relevant for the regulatory limit (10 mg/
      dm2), making this reference material suitable for laboratories measuring
      according to the EU overall migration limit [4]. The material has been found
      stable over 45 months.

PMID- 11220611
TI  - Determination of some trace elements in human tooth enamel.
AB  - Determination of seven elements (Cu, Fe, Mg, Mn, Pb, Sr and Zn) in whole enamel
      and surface layers of extracted non-carious human teeth by FAAS, ETA AAS, ICP-AES
      and ICP-MS (Pb) is demonstrated. Techniques are described for obtaining whole
      enamel and its acid dissolution. Fifty microm width enamel layers from outer
      enamel surface to a 200 microm depth were successively etched in 1 mL of 3 M
      HClO4 for 3 min dissolution periods. Enamel samples were analyzed for populations
      under and over 20 years of age and enamel from Bronze Age teeth. Concentrations
      of microelements in the whole enamel and in the first surface layer (50 microm
      depth) were compared. With exception of Sr and Mg, all elements show
      significantly higher concentrations in the first layer than in whole enamel and
      higher concentration in teeth of individuals over 20 years, which demonstrate the
      cumulative effect of these elements. The Cu, Fe, Mn, Pb and Zn concentrations in
      four layers of erupted and non-erupted teeth decreased while Mg and Sr
      concentrations increased toward enamel-dentine junction. The concentrations of
      most elements were almost constant as they approached the 150 microm layer. This
      concentration gradient may result from interaction between saliva and teeth and
      supports the hypothesis that the surface de- and re-mineralization process is
      effective at most to 150 microm from the enamel surface.

PMID- 11220612
TI  - The determination of certain major and minor elements in geological samples by
      inductively coupled plasma atomic emission spectrometry. Some interference
      problems with the analysis of geological standard reference materials and
      nutrition supplements.
AB  - Direct ICP-AES measurements of the digested geological standard reference
      material samples yielded the wrong information about their composition. The
      differences between certified and measured concentrations of the samples were due
      to the complicated sample matrix. The measured concentrations can be successfully
      corrected by using a multiple linear regression technique. The correction is
      based on the multiple regression line calculated from the analytical results at
      synthetic mixtures of matrix elements, where concentrations varied on five
      levels. There were no significant (P = 0.05) differences between certified and
      measured concentrations in standard reference materials after the correction. The
      same method was used in the analysis of nutrition supplements.

PMID- 11220613
TI  - How faster and cheaper to determine chromium by adsorptive cathodic stripping
      voltammetry in the presence of DTPA and nitrate.
AB  - A modification of the voltammetric procedure for the determination of chromium in
      the presence of DTPA and nitrates was proposed. Morpholinoethanesulfonic (MES)
      acid and its sodium salt were used for stabilisation of pH instead of acetate
      buffer. In the presence of MES the determination of chromium can be carried out
      in the presence of dissolved oxygen without decrease of sensitivity of the
      measurements. Elimination of the purge step decreases total analysis time and
      saves gas.

PMID- 11220614
TI  - Analytical control of silica glass production. Voltammetric determination of
      titanium and iron in raw materials and silica glass samples.
AB  - Adsorptive stripping voltammetric (AdSV) methods are presented for the
      determination of titanium and iron in quartz and silica glass samples obtained
      after pressure decomposition. Mandelic acid and catechol were used as complexing
      agents for titanium and iron, respectively. The method for titanium determination
      is based on the catalytic effect of chlorate ions. An insoluble residue remaining
      after decomposition of quartz and silica glass samples in HF+H2SO4 mixture was
      checked by energy-dispersive X-ray analyses. ET-AAS was applied as a reference
      method to AdSV measurements.

PMID- 11220615
TI  - A cell biology approach to microbial pathogenesis.

PMID- 11220616
TI  - EMBO-EBNIC workshop on cellular microbiology 'Host cell-pathogen interactions in
      infectious disease'.

PMID- 11220617
TI  - Immunogenetic aspects of the cellular immune response of Drosophilia against
      parasitoids.
AB  - Host-parasite relationships represent integrating adaptations of considerable
      complexity involving the host's immune capacity to both recognize and destroy the
      parasite, and the latter's ability to successfully invade the host and to
      circumvent its immune response. Compatibility in Drosophila-parasitic wasp
      (parasitoid) associations has been shown to have a genetic basis, and to be both
      species and strain specific. Studies using resistant and susceptible strains of
      Drosophila melanogaster infected with virulent and avirulent strains of the wasp
      Leptopilina boulardi demonstrate that the success of the host cellular immune
      response depends on the genetic status of both host and parasitoid.
      Immunological, physiological, biochemical, and genetic data form the bases of a
      two-component model proposed here to account for the observed specificity and
      complexity of two coevolved adaptations, host nonself recognition and parasitoid
      virulence.

PMID- 11220618
TI  - Population coverage by HLA class-I restricted cytotoxic T-lymphocyte epitopes.
AB  - Vaccination using cytotoxic T-lymphocyte (CTL) epitopes has become a widely used
      immunization strategy, especially because their structure makes them an
      attractive alternative to the delivery of whole proteins as immunogens.
      Nonetheless, their use is limited, in particular because of their specificity,
      being recognized only by cognate HLA alleles. The potential for immunizing a
      substantial portion of an ethnically diverse population using a modest number of
      peptides has been aided by the identification of HLA supertypes. However, the
      derivation of epitopes is often guided by methods that do not guarantee cross
      reactivity, so we consider the feasibility of providing vaccine coverage to a
      multi-ethnic population under different assumptions. In particular, two large
      datasets are used to estimate the number of peptides needed to provide > or =90%
      group-specific coverage of a multiethnic population, when specificity is assumed
      to be either to a single serologic or molecular type. These assumptions are
      evaluated utilizing a clinically important epitope repertoire derived from two
      human cytomegalovirus proteins, and data on the in vitro memory response elicited
      by these peptides is presented. In summary, our combined theoretical and empiric
      studies suggest that 90% coverage of some ethnic groups is attainable with 11
      uniquely defined HLA-restricted CTL epitopes. The derivation of four or more
      additional CTL epitopes is needed to attain 90% coverage of Blacks or Asians, the
      minimally covered groups. Ninety percent coverage of all major ethnic groups in a
      multi-ethnic population appears feasible without relying on cross-reactivity, but
      may require two to three times more CTL epitopes than estimated for serologic
      data, homogenous populations, or HLA alleles grouped as supertypes.

PMID- 11220619
TI  - Characterization of the MHC class I region of the Japanese pufferfish (Fugu
      rubripes).
AB  - A BAC map of the Japanese pufferfish (Fugu) MHC class I region was constructed
      using a mixture of sequence scanning and sequence-tagged site mapping
      methodologies. The Fugu MHC class Ia genes are linked to genes which are found
      within the human classical MHC class II and extended class II regions, a
      situation which has been found in the MHC of all teleosts mapped so far. The 300
      kb contig comprises 24 MHC-related genes and is bounded by six non-MHC genes,
      which are thought to represent an evolutionary breakpoint within the region.
      Comparative analysis with both human and zebrafish MHC maps indicates two blocks
      of genes (KNSL2, ZNF297, DAXX, TAPBP, FLOTILLIN; and PSMB8, PSMB10, PSMB9, ABCB3,
      FABGL, BRD2, COL11A2, RXRB) which have remained linked over 400 million years and
      may represent an ancestral arrangement of the vertebrate MHC. Zebrafish and Fugu
      diverged between 100-200 million years ago and differences exist between these
      two fish species. The position and number of MHC class Ia genes is not conserved
      between species, there is an inversion of a block of nine genes centering on the
      PSMB cluster, and additional genes are present in zebrafish coding for a
      transport-associated protein and a beta proteasome subunit. The extent of these
      differences has implications for the extrapolation of fish model organism data to
      commercial aquaculture species. The data presented here represent the most
      extensive analysis of a fish MHC class Ia region described so far and clearly
      delimit the extent of this region in Fugu and, potentially, all teleosts.

PMID- 11220620
TI  - Haplotype-specific sequence encoding the protein kinase, interferon-inducible
      double-stranded RNA-dependent activator in the human leukocyte antigen class II
      region.
AB  - The protein kinase, interferon-inducible double-stranded (ds)RNA-dependent
      activator (PRKRA) is a dsRNA-binding protein which activates a protein kinase
      participating in the antiviral activity of interferon. Our previous studies
      indicated that the nucleotide sequence encoding PRKRA, which appeared to be an
      intronless gene, was present in PAC HS265J14 containing the human leukocyte
      antigen (HLA) DR subregion. In this study, we further investigated and
      characterized the PRKRA gene on the human genome by means of Southern blotting
      and polymerase chain reaction with homozygous typing cell lines for HLA genes.
      Results indicated that the presence of PRKRA in the DR subregion was dependent on
      the DR53 group. Consistently, fluorescence in situ hybridization profiles with
      PRKRA as a probe showed that the hybridization signal on Chromosome (Chr) 6p21.3
      was seen only in the samples carrying the DR haplotypes that belonged to the DR53
      group. Interestingly, another hybridization signal, which was mapped on Chr
      2q31.2-q32.1, was always detected in the samples examined, i.e., even in the
      samples negative for the DR53 group. The outcome of a sequence-database homology
      search further indicated that the PRKRA gene with introns appeared to be present
      in a recently opened draft-sequence, RP11-65L3 (GenBank accession number
      AC009948), which is located between D2S335 and D2S2257. Together, the data
      presented here indicate that the PRKRA gene in the DR subregion is a processed
      pseudogene (PRKRApsi), which could have been generated only on the DR53 common
      ancestor's genome, and that the master copy of PRKRApsi is most probably present
      on Chr 2q31.2-q32.1.

PMID- 11220621
TI  - Distribution of natural killer cell immunoglobulin-like receptor sequences in
      three ethnic groups.
AB  - Killer cell immunoglobulin-like receptors (KIRs) are members of a group of
      molecules that specifically recognize HLA class I ligands and are found on
      subsets of human lymphopoetic cells. The number of KIR loci can vary between
      individuals, resulting in a heterogeneous array of possible KIR genes. The range
      of observed profiles has been explained by the occurrence of two haplotype
      families termed A and B which can be distinguished on the basis of certain KIR
      sequences. Here we attempted to determine whether the frequencies of putative KIR
      loci and the two haplotype groups vary in three ethnically defined, healthy, and
      unrelated control populations, namely UK Caucasoid (n=136), Palestinian (n=105)
      and Thai (n=119). We molecularly typed genomic DNA for the presence of 12
      putative KIR loci, KIR2DL1, KIR2DL2, KIR2DL3, KIR2DL4, KIR3DL1, KIR3DL2, KIR2DS1,
      KIR2DS2, KIR2DS3, KIR2DS4, KIR2DS5, and KIR3DS1, using modified PCR sequence
      specific primers. The patterns of KIR locus frequencies combined with the similar
      linkage disequilibrium values suggest that there was a distinction in the
      distribution of the two broad haplotype groups between the populations studied.
      The A haplotype was always the most prevalent, but the ratio of A to B varied
      between populations. The frequency of B haplotype was highest in the Palestinians
      and lowest in the Thais (Pc<0.0001).

PMID- 11220622
TI  - Genomic structure, alternative splicing, and physical mapping of the killer cell
      lectin-like receptor G1 gene (KLRG1), the mouse homologue of MAFA.
AB  - The mouse killer cell lectin-like receptor G1 (KLRG1), the mouse homologue of the
      mast cell function-associated antigen (MAFA), is an inhibitory C-type lectin
      expressed on natural killer (NK) cells and activated CD8 T cells. Here we report
      the complete nucleotide sequence, alternatively spliced variants, and the
      physical mapping of the KLRG1 gene in the mouse. The gene spans about 13 kb and
      consists of five exons. Short interspersed repeats of the B1 and B2 family, a
      LINE-1-like element, and a (CTT)170 triplet repeat were found in intron
      sequences. In contrast to human KLRG1 and to the murine KLR family members, mouse
      KLRG1 locates outside the NK complex on Chromosome 6 between the genes encoding
      CD9 and CD4.

PMID- 11220623
TI  - Functional analysis of 5' and 3' regions of the closely related Ly49c and j
      genes.
AB  - The Ly49 multigene family consists of at least 14 closely related genes located
      in the natural killer (NK) gene complex on mouse Chromosome 6. Reverse
      transcriptase (RT)-PCR on single NK cells has shown that Ly49c is expressed on
      approximately 50% of NK cells, whereas the closely related Ly49j gene is
      expressed on 5-8% of NK cells. In this study, we examined three regions to
      determine whether they contain cis-acting elements involved in regulating the
      expression of these two closely related Ly49 genes within NK cells. Luciferase
      reporter assays in EL-4 cells suggested that the 5' regions of Ly49c and j
      contain promoter elements and repressor sequences. In addition, luciferase assays
      suggest that Ly49j also contains an active promoter in the first intron, although
      the transcripts produced from this promoter appear to be severely truncated.
      Finally, comparisons of the 3' noncoding regions of Ly49c and j revealed that the
      sequence of Ly49j diverges completely from Ly49c 130 bp downstream of the
      termination codon. The polyadenylation signal for Ly49j is located downstream of
      the Ly49c poly(A) site, which results in a much longer 3' untranslated region
      (UTR). When the Ly49j 3'UTR was used to provide the polyadenylation signal for
      the green fluorescent protein (GFP) reporter gene, GFP expression was reduced
      twofold. These results suggest that both internal promoters, repressors, and 3'
      regions play a role in regulating Ly49 gene expression.

PMID- 11220624
TI  - Preferential ADV-AJ association during recombination in the mouse T-cell receptor
      alpha/delta locus.
AB  - The gene coding for a T-cell receptor (TCR) alpha chain is assembled from
      variable (ADV) and joining (AJ) genes located on Chromosome 14. Each of the 90
      ADV genes can rearrange with any one of the 61 AJ genes. We have previously
      demonstrated that ADV and AJ gene segment use evolves with time, with a
      progressive opening of ADV and AJ regions of the locus. To define the rules
      governing the use of AJ genes by ADV genes belonging to one family, we carried
      out a detailed analysis of 268 combinations of ADV2 BALB/c transcripts. We found
      that the different ADV2 members use different sets of AJ genes depending on their
      location within the ADV locus: ADV2S7 (the most AJ proximal ADV2 member)
      rearranges mainly with the AJ genes located close to the TEA element, whereas 50%
      of the sequences for ADV2S8, which is distal to the AJ locus, use the most distal
      AJ genes. ADV2S5, an ADV2 member located in the middle of the ADV locus, is
      associated with a wider set of AJ genes, located in the center of the AJ locus.
      Taken together, our results indicate that, in addition to the progressive opening
      of the ADV and AJ loci, the chromosomal location of ADV and AJ genes is a factor
      affecting AJ use in BALB/c mice.

PMID- 11220625
TI  - DNA methylation contributes to tissue- and allele-specific expression of the T
      cell differentiation marker RT6.
AB  - We investigated the role of DNA methylation in gene regulation of the rat T-cell
      differentiation marker RT6. Analysis of the methylation status of various tissues
      revealed that the RT6 promoter was hypomethylated in RT6-expressing tissues, and
      methylated in nonexpressing ones. Remarkably, among RT6-nonexpressing tissues,
      the extent of methylated regions varied greatly between lymphatic tissues, where
      regions larger than 23 kb were methylated, and nonlymphatic tissues, where
      methylation was restricted to a 3- to 4-kb region surrounding the promoter. We
      have previously shown that cis-regulatory elements determine differential
      expression of the two RT6 alleles in a subpopulation of T cells. We now show that
      the RT6 alleles in these cells differed in their methylation status. The promoter
      region of the silent allele was methylated, while that of the transcribed allele
      was not. Upon treatment of RT6-nonexpressing thymoma cells with the
      methyltransferase inhibitor 5-azacytidine, RT6 expression was induced. In RT6
      heterozygous hybridoma cells, expressing only one RT6 allele, induction of the
      silent, methylated RT6 allele was observed. Sensitivity of the RT6 promoter to
      DNA methylation was demonstrated by promoter-specific in vitro methylation, which
      inhibited RT6 promoter activity, while that of the SV40 promoter was not
      influenced. Our findings indicate that DNA methylation plays an important role in
      the control of monoallelic and tissue-specific RT6 expression.

PMID- 11220626
TI  - The first constant-domain (CH1) exon of human IGHG2 is polymorphic and in strong
      linkage disequilibrium with the CH2 exon polymorphism encoding the G2m(n+)
      allotype in Caucasians.
AB  - Here we describe a hitherto unknown proline/threonine polymorphism at residue 72
      of the human IgG2 CH1 domain (EU numbering 189) and show that it is linked to the
      known valine/methionine polymorphism at residue 52 of CH2 (EU numbering 282)
      defining the G2m(n+)/G2m(n-) allotypes. We sequenced the entire constant region
      of the heavy-chain gene for secreted IgG2 in five IGHG2*02 homozygous individuals
      covering CH1, hinge, CH2, and CH3 regions (approximately 2 kb). Proline 72 in CH1
      of G2m(n-) is changed to threonine in the G2m(n+) [G2m(23)] allotype. Based on
      the crystal structure of human IgG1, this amino acid position is expected to be
      surface exposed in IgG2. Besides this structural difference, we identified two
      silent nucleotide polymorphisms in the CH1 region and seven in the introns.
      Finally, we developed a sequence-specific PCR typing system detecting the
      polymorphisms in the CH1 and CH2 regions. We typed 64 Danish Caucasians and found
      that the CH1 and CH2 region polymorphisms are in complete linkage disequilibrium
      in this population.

PMID- 11220627
TI  - Ethnic differences in allelic associations of the interleukin-1 gene cluster in
      South African patients with inflammatory bowel disease (IBD) and in control
      individuals.
AB  - The allelic frequencies of TaqI, PstI, and variable number of tandem repeat
      (VNTR) polymorphisms of the IL-1beta, IL-1 receptor (IL-1Re), and IL-1 receptor
      antagonist (IL-1Ra) respectively, were investigated in black and white patients
      with inflammatory bowel diseases (IBD) and compared with control individuals.
      Plasma concentrations of IL-1beta and IL-1Ra were also determined in these
      individuals. The IL-1beta TaqI(-) allele was significantly more frequent in 50
      white IBD patients (60%) compared with 47 white controls (17%), and 20 black
      patients (20%) (P=0.00001 and P=0.0001, respectively). The IL-1Re PstI(-) allele
      was significantly more frequent in 20 black patients (75%) compared with 50 white
      patients (44%) (P=0.0001). The frequency of the IL-1Ra 240-bp allele was lower in
      black (12%) compared with white controls (25%), (P=0.0151), and the 410-bp allele
      was more frequent in black (87%) compared with white (73%) controls (P=0.0096).
      Linkage disequilibrium was found in black individuals homozygous for the 410-bp
      allele of IL-1Ra, and the PstI(-) allele of IL-1Re (84%) (P=0.0032). There was a
      significantly increased level of IL-1Ra in black patients compared with white
      patients and black controls (P=0.0006 and P=0.0008, respectively). The population
      differences in allelic frequencies of the IL-1 gene cluster and IL-1Ra
      concentrations suggest that genetic and environmental factors play an important
      role in susceptibility to IBD.

PMID- 11220628
TI  - Molecular cloning of the complement (C1r/C1s/MASP2-like serine proteases from the
      common carp (Cyprinus carpio).
AB  - The classical pathway of complement composed of C1, C4, and C2 is an antibody
      dependent activation cascade that is present in jawed vertebrates. C1 is a Ca2+
      dependent complex of C1q, C1r, and C1s, and analogous to an initiation complex of
      the lectin pathway of complement, which consists of the mannose-binding lectin
      (MBL) homologous to C1q and the MBL-associated serine proteases (MASPs)
      homologous to C1r and C1s. Thus divergence of Clq and MBL and that of C1r, C1s
      and the MASPs are considered to be crucial events in the establishment and
      evolution of the classical complement pathway. However, molecular information on
      the C1 subcomponents is very limited in lower vertebrates. Here we describe two
      distinct C1r/C1s/MASP2-like cDNA clones (C1r/s-A, C1r/s-B) isolated from the
      common carp (Cyprinus carpio). They share 83% identity at the amino acid level
      and have a domain structure similar to that of C1r/C1s/MASPs from other species.
      The serine protease domain of the carp homologues lacks the histidine loop and is
      encoded by a single exon containing an AGY codon for the active serine residue,
      as in mammalian C1r, C1s, and MASP2. Southern blot and PCR analyses indicated
      that the carp has at least three copies of the C1r/s-A gene and a single C1r/s-B
      gene. Although phylogenetic tree analysis does not definitively assign carp C1r/s
      A and C1r/s-B, they might represent ancestral molecules which later diverged into
      C1r, C1s, and MASP2 of higher vertebrates.

PMID- 11220629
TI  - The recombination-activating gene 1 of Pleurodeles waltl (urodele amphibian) is
      transcribed in lymphoid tissues and in the central nervous system.
AB  - The recombination-activating gene 1 (RAG1) product is required for the somatic
      rearrangement of immunoglobulin and T-cell receptor genes. We cloned and
      sequenced the large continuous open reading frame coding for the salamander
      Pleurodeles waltl RAG1 protein. Semi-quantitative RT-PCR experiments were
      performed to quantify the expression of RAG1 in different tissues. The strongest
      signal was observed in the thymus of juvenile animals, confirming the primary
      lymphoid nature of that organ. Weaker expression was observed in the spleen,
      brain, and eyes of adults. Signals in these tissues represented 5.5%, 4.6%, and
      2.0%, respectively, of the signal detected in the thymus. Expression in brain was
      confirmed by in situ hybridization. Similarly, low amounts of RAG1 transcripts
      were previously detected in the mouse brain. Moreover, the transcription of RAG1
      begins as early as the neurula stages of development. These data suggest that the
      RAG1 protein could play a role in the central nervous system of vertebrates.

PMID- 11220630
TI  - The CD45 locus in cattle: allelic polymorphism and evidence for exceptional
      positive natural selection.
AB  - Cattle in Africa are a genetically diverse population that has resulted from
      successive introduction of Asian Bos indicus and European B. taurus cattle.
      However, analysis of mitochondrial genetic diversity in African cattle identified
      three lineages, one associated with Asian B. indicus, one with European B.
      taurus, and a third ascribed to an indigenous African sub-species of cattle. Due
      to their extended coevolution, indigenous African herbivores are generally
      tolerant to endemic African pathogens. We are interested in identifying alleles
      derived from the indigenous African cattle that may be associated with tolerance
      to African pathogens. An analysis of the locus which encodes the abundant plasma
      membrane-associated tyrosine phosphatase, CD45, identified three highly divergent
      allelic families in Kenya Boran cattle. Analysis of allelic distribution in a
      diverse range of cattle populations suggests a European B. taurus, an Asian B.
      indicus, and an African origin. This demonstrates not only significant allelic
      polymorphism at the CD45 locus in cattle but also convincing autosomal evidence
      for a distinct African sub-species of cattle. Furthermore, maximum-likelihood
      analysis of selection pressures revealed that the CD45 locus is subject to
      exceptionally strong natural selection which we suggest may be pathogen driven.

PMID- 11220631
TI  - Localization of the Rh50-like protein to the contractile vacuole in
      Dictyostelium.
AB  - The human Rhesus (Rh) family consists of three polytopic membrane proteins
      present at the cell surface of red blood cells. Although Rh proteins are
      essential for the expression of the blood group system their biological function
      remains unclear. In this study, the gene encoding a protein homologous to Rh50 in
      Dictyostelium discoideum was sequenced. The Rh50-like protein was localized to
      the contractile vacuole, the organelle responsible for maintenance of osmotic
      equilibrium within the cell. However, Rh50-like-deficient mutants in which the
      Rh50-like gene was disrupted did not appear to exhibit a phenotype related to
      osmoregulation. Nevertheless, these mutants may provide a valuable tool for
      studying the function of the rhesus protein.

PMID- 11220632
TI  - Haplotypic single nucleotide polymorphisms in the central MHC gene IKBL, a
      potential regulator of NF-kappaB function.

PMID- 11220634
TI  - Negative association of the HLA-DRB1*1502-DQB1*0601 haplotype with human
      narcolepsy.

PMID- 11220633
TI  - Mapping of the chicken and mouse genes for toll-like receptor 2 (TLR2) to an
      evolutionarily conserved chromosomal segment.

PMID- 11220635
TI  - Molecular cloning of CS1, a novel human natural killer cell receptor belonging to
      the CD2 subset of the immunoglobulin superfamily.

PMID- 11220636
TI  - Mechanism of the inhibitory effect of protease inhibitor on tumor necrosis factor
      alpha production of monocytes.
AB  - If the inflammatory response becomes excessive or uncontrolled by some stimuli,
      inappropriate inflammatory responses occur. Monocytes are extremely important
      cells for regulating the cytokine network and tumor necrosis factor alpha
      (TNFalpha) and interleukin- (IL) 10, which are mainly synthesized by monocytes,
      are representative cytokines that play a central role in the cytokine network.
      Protease inhibitors such as gabexate mesilate (GM) and ulinastatin (UTI) have
      been shown to have various beneficial effects by inhibiting the activation of
      leukocytes, but the mechanism for this has yet to be fully elucidated. In this
      study we investigated the mechanism of the inhibitory effect of protease
      inhibitors on the proinflammatory cytokine production of lipopolysaccharide-
      (LPS) stimulated monocytes. LPS-stimulated monocytes were treated with GM or UTI.
      The value of TNFalpha and IL-10 in the culture medium of monocytes was measured
      and each mRNA expression was assayed. The inhibitory effect of protease
      inhibitors on the activity of intracellular signal transduction pathways such as
      protein kinase C (PKC) and nuclear factor kappa B (NFkappaB) were also evaluated.
      GM decreased the TNFalpha production of LPS-stimulated monocytes as shown by the
      inhibition of mRNA expression and increased the IL-10 production of LPS
      stimulated monocytes. GM also suppressed the NFkappaB activity of LPS-stimulated
      monocytes. UTI decreased the TNFalpha production of LPS-stimulated monocytes, but
      did not inhibit the TNFalpha mRNA expression. The present study shows that the
      inhibitory effect of GM on the TNFalpha production of activated human monocytes
      is mediated by the suppression of NFkappaB activation, while the mechanism of UTI
      inhibiting TNFalpha production of human monocytes may be due to the inhibition of
      either the translation or secretion of TNFalpha.

PMID- 11220638
TI  - Protective effect of allopurinol on hepatic energy metabolism in ischemic and
      reperfused rat liver.
AB  - Reactive oxygen species generated by xanthine oxidase during reperfusion of
      ischemic liver might in part be responsible for ischemic organ injury. In
      normothermic ischemia/reperfusion rat model, we investigated whether allopurinol
      pretreatment improved ischemia-induced mitochondrial dysfunction. Rats were
      subjected to 60 min of hepatic ischemia and to 1 h and 5 h of reperfusion
      thereafter. At 18 h and 1 h before ischemia, the animals received 0.25 mL of
      either saline or allopurinol (50 mg/kg) i.p. In saline-treated ischemic rats,
      serum aspartate aminotransferase levels increased significantly at 5 h (4685 +/-
      310 IU/L) and were significantly reduced with allopurinol pretreatment.
      Similarly, mitochondrial lipid peroxidation was elevated in the saline-treated
      ischemic group, but this elevation was prevented by allopurinol. In contrast,
      mitochondrial glutamate dehydrogenase activity and ketone body ratio decreased in
      the saline-treated group, but this decrease was also inhibited by allopurinol.
      Hepatic ATP levels in the saline-treated rats were 42% lower 5 h after
      reperfusion. However, treatment with allopurinol resulted in significantly higher
      ATP levels. Allopurinol treatment preserved the concentration of AMP in ischemic
      liver but inhibited the accumulation of xanthine in reperfused liver. Our
      findings suggest allopurinol protects against mitochondrial injury, which
      prevents a mitochondrial oxidant stress and lipid peroxidation and preserves the
      hepatic energy metabolism.

PMID- 11220637
TI  - Simultaneous measurement of hepatic tissue pH, venous oxygen saturation and
      hemoglobin by near infrared spectroscopy.
AB  - The purpose of this study was to investigate the feasibility of using near
      infrared (NIR) spectroscopy of the liver to simultaneously assess oxygen content
      in combination with tissue pH, an indicator of anaerobic metabolism. Six
      anesthetized swine were subjected to 45 min of hemorrhagic shock followed by
      resuscitation with blood and crystalloid. Calibration models between NIR spectra
      and reference measurements of tissue pH, hepatic venous oxygen saturation
      (S(V)O2), and blood hemoglobin concentration (Hb) were developed using partial
      least-squares regression. Model accuracy was assessed using cross validation. The
      average correlation (R2) between NIR and reference measurements was 0.87, 0.68,
      and 0.93, respectively for pH, Hb, and S(V)O2. Estimated accuracy, the root mean
      squared deviation between spectral, and reference measurements was 0.03 pH units,
      0.3 g/dL, and 6%. NIR determination of hepatic oxygen content and tissue pH
      during shock and resuscitation demonstrated that there can be a variance between
      hepatic venous oxygenation and regional tissue acidosis. NIR spectroscopy
      provides a technique to explore the implications of post-shock depression of
      tissue pH and evaluate new methods of resuscitation.

PMID- 11220639
TI  - Immune potential of lymph node-derived lymphocytes in uncontrolled hemorrhagic
      shock.
AB  - The state of T cell immunity was evaluated in rats in early (1-4 h) hemorrhagic
      shock induced by a massive splenic injury. T cell subpopulations from treated and
      untreated shocked animals were tested by flow cytometry and the results were
      compared with healthy controls. A fall in CD4+ T lymphocyte and natural killer
      (NKR-P1+) cell number, marked decline in the T helper (CD4+) to T suppressor
      (CD8+) ratio, and decrease of interleukin-2 receptor (IL-2R) bearing cells in
      peripheral blood, mesenteric, and popliteal lymph nodes of rats was found in the
      early stages of hemorrhagic shock. The same phenotype profile was also revealed
      in lymphocytes of rats in hemorrhagic shock following massive splenic injury
      treated with Ringer's lactate. The number of TCRalpha beta and TCR-gamma delta
      positive cells, as well as the percentage of CD4 and CD8 positive cells in the
      thymus, was similar in all groups of rats. Culture of lymph node cells taken from
      rats following hemorrhage in the presence of 100 U/mL hrIL-2 resulted in a marked
      increase in the number of NKR-PI+ positive cells from 4.2% to 30.5% (P < 0.001).
      Magnet separated NKR-P1+ fractions lysed the allogeneic fibroblasts in the same
      manner as IL-2-activated NKR-P1 cells from the control rats. Popliteal lymph node
      (PLNi) CD8b+ lymphocytes from rats in hemorrhagic shock preinfected into the
      footpad with cytomegalovirus (CMV) 6 days prior to injury lost their ability to
      lyse the CMV-infected fibroblasts and protect the monolayer from CMV infection
      when compared with PLNi cells from control infected rats. The possible mechanisms
      for the observed cellular dysfunction following hemorrhage are discussed.

PMID- 11220640
TI  - Binding specificity of polymyxin B, BPI, LALF, and anti-deep core/lipid a
      monoclonal antibody to lipopolysaccharide partial structures.
AB  - The deep core/lipid A (DCLA) region of gram-negative bacterial lipopolysaccharide
      (LPS) is common to most gram-negative pathogens and contains anionic phosphoryl
      groups plus numerous acyl chains as part of the toxic lipid A moiety. Several
      disparate agents that antagonize the effects of LPS exhibit extensive
      physicochemical similarities (hydrophobicity, cationic charge) within their
      binding domains. It is presumed that binding to the DCLA region by each of these
      antagonists-cross-reactive anti-LPS monoclonal antibodies (mAbs), polymyxin B
      (PmB), plus bactericidal permeability-increasing protein (BPI) and Limulus anti
      LPS factor (LALF)-may be related to these properties. Therefore, we hypothesized
      that in addition to secondary and tertiary protein conformation, electrostatic
      interactions involving the negatively charged phosphoryl groups, hydrophobic
      interactions involving the acyl chains of lipid A, or both might be important
      factors that promote LPS antagonism. Binding of PmB, BPI, LALF, or anti-DCLA mAb
      1B6 to Salmonella minnesota monophosphoryl lipid A (MPLA), diphosphoryl lipid A
      (DPLA), and Salmonella minnesota Re (which possess a common structural moiety,
      but vary considerably in structure and charge) was examined. Highly
      phosphorylated DNA and bovine serum albumin served as unrelated structural
      controls. BPI bound MPLA, which is hydrophobic and minimally charged, while mAb
      1B6 bound anionic DNA; neither PmB nor LALF were reactive with MPLA or DNA. We
      surmised that hydrophobic interactions play a role in BPI binding to LPS, and
      although electrostatic interactions appear to be important for binding of mAb 1B6
      to DCLA, they may not contribute to as great an extent for PmB, BPI, or LALF.
      Thus our data support the contention that the contribution of these specific
      physicochemical factors varies among endotoxin antagonists.

PMID- 11220641
TI  - The decrease of PKCalpha is associated with hepatic apoptosis at early and late
      phases of polymicrobial sepsis.
AB  - The present study investigates the relationship between the PKC-alpha and hepatic
      apoptosis during sepsis. Cecal ligation and puncture- (CLP) induced animal model
      of polymicrobial sepsis was used, with early and late sepsis referring to those
      animals sacrificed at 9 and 18 h, respectively, after CLP. The expressions of
      PKCalpha and Bcl-2 family proteins as well as poly(ADP-ribose) polymerase (PARP)
      cleavage were quantified to evaluate the possible factors involved in the hepatic
      cell death during sepsis. The apoptosis of hepatocytes under septic condition or
      hepatocytes treated with PKCalpha antisense was evaluated by gel electrophoresis
      and/or flow cytometry after Annexin-V-Fluos and propidium iodide staining. The
      results indicated that (1) the protein expression of membrane-associated PKCalpha
      was decreased at early (P < 0.05) and late (P < 0.01) sepsis; (2) the protein
      expressions of Bcl-2 and Bcl-xL were decreased, whereas Bax expression was
      increased at late sepsis; (3) the percentage of PARP cleavage was increased at
      early (P < 0.05) and late (P < 0.01) sepsis; (4) severe DNA fragmentation was
      observed at late sepsis; (5) the apoptotic cell population was increased at early
      and late sepsis; and (6) the percentage of apoptotic cell population in PKCalpha
      antisense-treated cells was significantly higher than that in untreated cells.
      These results suggest that inactivation of PKCalpha may play an important role in
      modulating hepatic apoptosis during sepsis and the apoptosis is closely
      associated with the alterations of Bcl-2 family proteins.

PMID- 11220642
TI  - A cell wall component from pathogenic and non-pathogenic gram-positive bacteria
      (peptidoglycan) synergises with endotoxin to cause the release of tumour necrosis
      factor-alpha, nitric oxide production, shock, and multiple organ
      injury/dysfunction in the rat.
AB  - The incidence of sepsis and septic shock due to gram-positive organisms has
      increased dramatically over the last two decades. Interestingly, many patients
      with sepsis/septic shock have both gram-positive and gram-negative bacteria
      present in the bloodstream and these polymicrobial or "mixed" infections often
      have a higher mortality than infection due to a single organism. The reason for
      this observation is unclear. The aim of this study was to investigate whether
      cell wall fragments from gram-positive and gram-negative bacteria could synergise
      to cause the release of cytokines, shock, and organ injury/ dysfunction in vivo.
      Male Wistar rats were anaesthetised and received an intravenous bolus of vehicle
      (saline), lipopolysaccharide (LPS) from Escherichia coli (0.1 mg/kg),
      peptidoglycan (Pep G) from Staphylococcus aureus (S10 mg/kg), co-administration
      of LPS (0.1 mg/kg) and PepG from S. aureus (10 mg/kg), LPS (10 mg/kg), PepG from
      Bacillus subtilis, or co-administration of LPS and PepG from B. subtilis. Blood
      pressure and heart rate were monitored for 6 h before plasma samples were taken
      for the measurement of TNF-alpha, total nitrite, and biochemical indices of organ
      injury. Peptidoglycan from both pathogenic (S. aureus) and non-pathogenic (B.
      subtilis) gram-positive bacteria synergised with endotoxin to cause formation of
      TNF-alpha, nitrite, shock, and organ injury. Synergism between PepG and LPS may
      partly explain the high mortality associated with mixed bacterial infections, as
      well as the deleterious effects of translocation of bacteria, or their cell wall
      components from the gut lumen in patients with sepsis.

PMID- 11220643
TI  - Time-frequency analysis of arterial pressure oscillations in anesthetized dogs:
      effects of standardized hemorrhages.
AB  - The purpose of this preliminary study was to investigate the advantages of the
      time-frequency analysis through the Continuous Wavelet Transform (CWT) compared
      to classical Fourier analysis using the Fast Fourier Transform (FFT) in arterial
      pressure signals from anesthetized mongrel dogs before and during standardized
      hemorrhages. Systemic arterial pressure pulsations were recorded using catheter
      tip manometers. CWT and FFT were applied to arterial pressure pulsations to
      obtain module coefficients of this transformation and its associated contours
      during the evolution of progressive hemorrhages, in amounts of 15, 34, and 66% of
      the estimated total blood volume. This mathematical analysis enabled us to
      identify the evolution of the frequency components of aortic valve functions,
      heart dynamics, respiratory influences, and vasomotor activities. Furthermore, we
      isolated the modulating signal of amplitude modulation phenomenon present in the
      arterial pressure records, as described in previous papers, being the heart rate
      carrier frequency. The CWT is a very sensitive and reliable procedure to analyze
      (time-frequency) the oscillatory phenomena in two dimensions, and to provide more
      information than the FFT. This new analytical procedure may provide new insights
      in the study of shock pathophysiology.

PMID- 11220644
TI  - Inhibition of inducible nitric oxide synthase (iNOS) prevents lung neutrophil
      deposition and damage in burned rats.
AB  - This study was designed to investigate the role of NO and effect of iNOS
      inhibitor on the lung neutrophil deposition and damage after burn. In Experiment
      1, specific pathogen-free (SPF) Sprague-Dawley rats underwent 35% total body
      surface area (TBSA) burn. On the 4th, 8th, 16th, and 24th h after burn, blood was
      collected for peroxynitrite-mediated dihydrorhodamine 123 (DHR 123) oxidation
      assay, and lung tissues were harvested for myeloperoxidase (MPO) test and
      histologic study. Pulmonary microvascular dysfunction was quantitated by
      measuring the extravasation of Evans blue dye (EBD). In Experiment 2, S
      methylisothiourea (SMT) was given (7.5 mg/kg, intraperitoneal immediately post
      burn) to suppress iNOS activity. On the 8th h after burn, the effect of SMT on
      blood DHR 123 oxidation, lung MPO, lung damage, and lung iNOS expression were
      evaluated. Lung MPO activity increased up to a maximum of 2-fold 8 h after burn.
      Blood DHR 123 oxidation increased up to a maximum of 2-fold 8 h after burn. Lung
      permeability increased up to a maximum of 2.5-fold 4 h after burn. SMT
      significantly decreased lung MPO activity, blood DHR 123 oxidation, and lung
      permeability by 31%, 41%, and 54%, respectively. SMT markedly decreased the
      thermal injury-induced perivascular and interstitial inflammatory cell
      infiltration and iNOS staining in bronchiolar epithelium, endothelial cells, and
      perivascular and interstitial inflammatory cells. In conclusion, thermal injury
      induces blood DHR 123 oxidation, lung neutrophil deposition, lung iNOS
      expression, and lung damage. Peroxynitrite might play an important role in
      thermal injury-induced lung neutrophil deposition and damage. Specific inhibition
      of lung iNOS expression and blood DHR 123 oxidation with SMT on thermal injury
      not only attenuated the lung neutrophil deposition, but also reduced lung damage.

PMID- 11220645
TI  - Effects of Ringer-acetate and Ringer-dextran solutions on the microcirculation
      after LPS challenge: observations in the hamster cheek pouch.
AB  - The effects of NaCl 0.9%, Ringer-acetate, and Ringer-dextran given as intravenous
      infusions in the microcirculatory changes observed in early stages of endotoxemia
      were investigated in male hamsters treated with Escherichia coli
      lipopolysaccharide (LPS). The cheek pouch was studied in vivo by means of
      intravital microscopy. Mean arterial (MAP) and venous pressures (CVP), heart
      rate, mean arteriolar internal diameter, spontaneous arteriolar vasomotion (AV),
      red blood cell velocity (RBCV) in these vessels, and long-term effects of LPS
      were evaluated in animals treated with either LPS alone or the combination of LPS
      with NaCl 0.9%, Ringer-acetate and Ringer-dextran. The intravenous injection of
      LPS (0.3 mg/kg) elicited a significant reduction in MAP and CVP, cessation of AV
      and a decrease in RBCV. In our study, the heart rate and the arteriolar diameter
      did not change significantly, compared with the control values obtained before
      the LPS injection. No improvement in the MAP could be detected with infusions of
      NaCl 0.9% or Ringer-acetate but the infusion of Ringer-dextran increased it
      significantly. All infusions tested maintained the CVP until the end of the
      observation period and the Ringer-dextran increased it significantly. The heart
      rate was maintained around 360 beats/min with a tendency to decrease 70 min after
      the LPS infusion in all groups studied except the group which received NaCl 0.9%
      where the heart rate decreased significantly. In all the four groups, the mean
      arteriolar diameter did not change significantly with time during the observed
      period. RBCV decrease with the combination LPS + NaCl 0.9% and the infusions of
      Ringer-acetate and Ringer-dextran maintained it until the end of the observation
      period. The combination of LPS + NaCl 0.9% maintained the spontaneous arteriolar
      vasomotion during 50 min after LPS injection and the infusion of Ringer-acetate
      maintained it for the 3-h observation period. The infusion of Ringer-dextran
      maintained the amplitude of the spontaneous arteriolar vasomotion and increased
      its frequency significantly. The long-term effects of LPS showed weight loss and
      pus on the periorbital area. Our results suggest that the best solution to
      maintain the microcirculatory parameters during the early stage of endotoxemia
      after LPS injection was the Ringer-dextran.

PMID- 11220646
TI  - Base deficit development and its prognostic significance in posttrauma critical
      illness: an analysis by the trauma registry of the Deutsche Gesellschaft fur
      unfallchirurgie.
AB  - This prospective, multi-center, observational study of 2069 multiple trauma
      patients evaluated the prognostic significance of the posttrauma base deficit
      (BD) on hospital and intensive care unit (ICU) admission to hemodynamic changes,
      volume and transfusion requirements, lactate and coagulation, as well as
      mortality. Furthermore, the importance of the BD development throughout a
      patient's course of critical illness from the time of injury to ICU admission is
      analyzed as a prognostic factor for fatal outcome. The data were obtained by the
      trauma registry of the 'Deutsche Gesellschaft fur Unfallchirurgie.' The patients
      were subdivided into five categories of increasing BD values on hospital and ICU
      admission: Category I, BD < or = -2; Category II, -2 < BD < or = 2; Category III,
      2 < BD < or = 6; Category IV, 6 < BD < or = 10; and Category V, BD > 10. A
      statistical analysis was performed by means of the ANOVA and chi-square tests. In
      1264 (61.1%) of 2069 multiple trauma patients (age 39 +/- 19 years, 70.0% males,
      injury severity score 22 +/- 13, 18.6% mortality), the BD was documented on
      hospital and in 1536 (74.2%) patients on ICU admission. At both points in time,
      an increase in the BD category was associated with a significant decrease in
      systolic blood pressure and prothrombin time as well as increases in heart rate,
      lactate level and mortality (P < 0.0001). Also transfusion requirements (Category
      I: 4.5 +/- 7.7 and Category V: 13.7 +/- 13.0 packed red blood cells) increased
      significantly on hospital admission (P < 0.0001) with a worsening in the BD
      category. Mortality increased significantly (P < 0.0001) with a worsening of BD
      from hospital to ICU admission (from a mortality of 13% in patients with a
      hospital and an ICU admission BD of <6 to 45% in patients with a hospital and an
      ICU admission BD of >6). These data show that the base deficit is an early
      available important indicator to identify trauma patients with hemodynamic
      instability, high transfusion requirements, metabolic and coagulatory
      decompensation, as well as a high probability of death. The base deficit
      development may help to guide an early and aggressive therapy for the
      trauma/hemorrhage induced tissue hypoxia.

PMID- 11220647
TI  - Oxygen radical generation by emigrated, intra-abdominal, and circulating PMNLs
      during human secondary peritonitis.
AB  - The purpose of the study was to characterize oxygen radical generation by
      emigrated, intraabdominal and circulating polymorphonuclear leukocytes (ePMNLs
      and cPMNLs) during peritonitis, as well as to assess any differences between
      oxygen radical production in patients with low Mannheim peritonitis index (MPI <
      26, group 1) or high Mannheim peritonitis index (MPI > or = 26, group 2).
      Lucigenin-enhanced chemiluminescence was used to determine spontaneous and
      stimulated (FMLP, PMA, and A23 187) oxygen radical generation by ePMNLs and
      cPMNLs. In group 1 spontaneous and stimulated oxygen radical generation by
      emigrated PMNLs was markedly enhanced compared to circulating PMNLs (e.g.,
      spontaneous oxygen radical generation: 30.3 +/- 11.8 cpm/cPMNLs versus 107 +/- 46
      cpm/ePMNLs, P < 0.05) . In group 2 oxygen radical generation by cPMNLs markedly
      increased within 48 h after diagnosis of peritonitis and surgery, contrary to
      radical generation by ePMNLs (e.g., A23 187-stimulated oxygen radical generation
      993.7 +/- 350 cpm/cPMNLs versus 285.6 +/- 77 cpm/ePMNLs, P < 0.05. In conclusion,
      cPMNLs and ePMNLs exhibit marked polymorphism in their capacity to generate
      oxygen radicals in response to secondary peritonitis. Severe peritonitis (MPI -
      26) was associated with a strong increase in oxygen radical generation by cPMNLs
      without a parallel activity being manifest by ePMNLs.

PMID- 11220649
TI  - Biomarkers in cancer chemoprevention. Workshop report.

PMID- 11220648
TI  - The value of immune modulating parameters in predicting the progression from
      peritonitis to septic shock.
AB  - Intra-abdominal infection is one of the major causes of septic shock and multiple
      organ failure. To date, what causes the disease's progression remains unclear and
      therefore the relevance of immune modulating therapies remains speculative. The
      primary outcome measure of this study was to investigate immune modulating
      mediators at the onset of peritonitis before the development of subsequent septic
      shock. The secondary outcome measure was to investigate the usefulness of these
      immune parameters in predicting progression from peritonitis to septic shock.
      Fifty-eight peritonitis patients were included in this study: 14 patients
      subsequently developed septic shock. All patients were examined on "diagnosis of
      peritonitis" (<4 h within establishment of diagnosis), during "early septic
      shock" (<12 h following the onset of septic shock), and once again during "late
      septic shock" (within 72-98 h following the onset of septic shock). The immune
      modulating parameters tumor necrosis factor-alpha (TNF-alpha), the soluble TNF
      alpha receptors I and II (sTNF-alpha RI and sTNF-alpha RII), interleukines (IL) 
      1beta, -6, -8, and -10, and the adhesions molecules endothelial-leukocyte
      adhesion-molecule (E-Selectin), intercellular-adhesion-molecule-1 (ICAM-1), and
      vascular-adhesion-molecule-1 (VCAM-1), in addition to nitrate and nitrite, were
      determined. In the peritonitis group with subsequent septic shock, TNF-alpha,
      sTNF-alpha RI + RII IL-1beta, IL-8, IL-10, and nitrate were significantly
      increased before the onset of septic shock. TNF-alpha had an area under the
      receiver operating characteristics curve (AUC) of 0.84 and was reliable in
      predicting the progression from peritonitis to septic shock. The AUC of the other
      immune modulating parameters, despite being significantly elevated, ranged from
      0.71 to 0.76. The AUC of the conventional laboratory markers such as leukocytes
      and C-reactive protein ranged from 0.64 to 0.68. In peritonitis that progressed
      to septic shock, an early immune response had already occurred before the onset
      of septic shock. The progression was best predicted by TNF-alpha. Therefore,
      mediator therapy might be considered in high-risk peritonitis patients who show
      an exaggerated immune response before the progression to septic shock.

PMID- 11220650
TI  - Biomarkers in colorectal cancer.
AB  - Epidemiological studies have revealed that the major dietary constituents
      implicated in colorectal carcinogenesis are fat/red meat (causative) and
      calcium/fibre (protective). Biomarkers have been used in both animal studies and
      clinical trials to investigate the effect of dietary factors and chemotherapeutic
      agents on colon carcinogenesis. They can be used as short-term end-points when
      investigations based on the development of cancer are not feasible. Although they
      can help in elucidating dietary or pharmacological effects, important results
      should be confirmed with longer-term studies. Colon cancer develops through an
      adenoma-carcinoma sequence. The appearance of colonic polyps in individuals at
      risk for colon cancer has been used as an end-point in clinical trials to assess
      diets and pharmacological agents for their effect on colon carcinogenesis. Normal
      appearing mucosa can contain small foci of aberrant crypts, which can be
      dysplastic and thought of as microadenomas. The appearance and growth of such
      foci have been used to assess the effect of dietary factors and chemopreventive
      agents in experimental animals. Increased proliferation both increases the
      sensitivity of the colon to carcinogenesis and may represent an early step in
      colon carcinogenesis. Etheno-DNA adducts are an end-product of lipid peroxidation
      processes, and are strongly pro-mutagenic lesions. High dietary levels of n-6
      fatty acids appear to be important here and may also increase eicosanoid or
      isoprostane exposure and provide a selective growth stimulus for tumour precursor
      cells. Low dietary calcium may lead to inhibition of apoptosis and possibly to an
      increase in cell proliferation. In three recently completed intervention trials,
      calcium moderately reduced the recurrence of adenomas, but in one study fibre
      increased recurrence dramatically.

PMID- 11220651
TI  - Intermediate effect markers for colorectal cancer.
AB  - Recurrence or regression of adenomatous polyps is considered to be both a
      biomarker of risk and an intermediate (surrogate) end-point. The observational
      epidemiology of adenomas resembles closely that of invasive cancer, and the
      findings in chemoprevention trials that have been completed closely mirror that
      common epidemiology. Although it is possible that both the clinical trials and
      the epidemiology may be wrong, these common findings suggest that adenomas in
      general are valid end-points. Aberrant crypt foci show promise as biomarkers,
      both as markers of risk and as intermediate end-points for chemoprevention
      trials. If issues of cost can be overcome, assessment of ras mutations in stool
      appears to be a promising technique for screening for large bowel neoplasms. The
      lack of specificity of the technique limits its utility as a sole end-point in
      prevention studies, however. Mucosal proliferation has been used both as a
      biomarker of risk and as an intermediate end-point. The utility of these measures
      is not clear, however, since there has been discordance between the
      epidemiological findings regarding proliferation and established risk factors for
      colorectal neoplasia. The inherent variability of the measures and the technical
      problems associated with their use are further impediments. However, rectal
      mucosal proliferation may be suitable for studies in single institutions, or in
      consortia with very aggressive quality control.

PMID- 11220652
TI  - Surrogate end-point biomarkers in chemopreventive drug development.
AB  - Relevant and feasible surrogate end-points are needed for the evaluation of
      intervention strategies against cancer and other chronic, life-threatening
      diseases. Carcinogenesis can be viewed as a process of progressive
      disorganization. This process is characterized by the accumulation of genotypic
      lesions and corresponding tissue and cellular abnormalities, including loss of
      proliferation and apoptosis controls. Potential surrogate end-points for cancer
      incidence include both phenotypic and genotypic biomarkers of this progression.
      In the US National Cancer Institute chemoprevention programme, histological
      modulation of a precancer (intraepithelial neoplasia) has so far been the primary
      phenotypic surrogate end-point in chemoprevention trials. Additionally, high
      priority has been given to biomarkers measuring specific and general genotypic
      changes correlated with the carcinogenesis progression model for the targeted
      cancer (e.g., progressive genomic instability as measured by loss of
      heterozygosity or amplification at specific microsatellite loci). Other potential
      surrogate end-points include proliferation and differentiation indices, specific
      gene and general chromosome damage, cell growth regulatory molecules, and
      biochemical activities (e.g., enzyme inhibition). Serum biomarkers thought to be
      associated with cancer progression (e.g., prostate-specific antigen) are
      particularly appealing surrogate end-points because of accessibility. Potentially
      chemopreventive effects of the test agent may also be measured (e.g., tissue and
      serum estrogen levels in studies of steroid aromatase inhibitors). To establish
      chemopreventive efficacy, prevention of virtually all biomarker lesions, or of
      those lesions with particular propensity for progression, may be required.
      Ideally, the phenotype and genotype of any new or remaining precancers in the
      target tissue of chemopreventive agent-treated subjects would show less, and
      certainly no greater, potential for progression than those of placebo-treated
      subjects.

PMID- 11220653
TI  - Susceptibility markers in colorectal cancer.
AB  - Many susceptibility factors contribute to an individual's risk of developing
      colorectal cancer. Family history of colorectal cancer (particularly with early
      age of onset), maleness and increasing age are all factors associated with
      increasing risk. About three quarters of colorectal cancers are thought to be due
      to somatic mutations, and both high- and low-penetrance predisposing genes
      contribute to the remaining quarter of cases. Many of the highly penetrant
      dominant genes are known, but others remain to be identified. Describing the
      contribution of individual genes is likely to be very complex, as some modify the
      impact of other genes and other environmental factors rather than incurring a
      direct, easily attributable effect. The two dominant predisposing syndromes are
      familial adenomatous polyposis and Lynch syndrome, the first due to a mutant
      tumour-suppressor gene APC, and the second due to mutations in a number of genes
      responsible for mismatch repair in DNA at cell division. Establishing genetic
      susceptibility for colorectal cancer will soon be possible, and could save lives
      by allowing targetting of screening and the encouragement of preventive
      behaviours. However, there will always be a risk of making healthy people "sick"
      through the identification of predisposing genes, and there are many potential
      ways by which a gene carrier may be stigmatized by society, insurance companies
      and employers.

PMID- 11220654
TI  - Endogenous hormone metabolism as an exposure marker in breast cancer
      chemoprevention studies.
AB  - There is overwhelming evidence that alterations in endogenous hormone metabolism-
      as a form of endogenous exposure-may be an important metabolic risk factor for
      the development of breast cancer. This chapter reviews current theories and major
      epidemiological findings that link endogenous hormones (sex steroids and their
      metabolites, but also insulin, and insulin-like growth factor-I (IGF-I)) to
      breast cancer risk. Knowledge about these metabolic risk factors can be used to
      identify women at increased risk of breast cancer, who might benefit most from
      chemoprevention. In addition, modification of high-risk endocrine profiles may
      itself become a central target of chemoprevention. Possible intervention
      strategies include improvement of insulin sensitivity, reducing concentrations of
      IGF-I in blood and breast tissue, reducing ovarian overproduction of androgens,
      inhibiting the activity of aromatase and other enzymes involved in estrogen
      formation within the breast, and modifying estrogen metabolism within the breast
      (e.g., decreasing 16alpha- and 4alpha-hydroxylation, and increasing O-methylation
      of catecholestrogens). Several of these possible strategies are illustrated with
      examples of chemopreventive agents currently in use or proposed for use to
      prevent breast cancer.

PMID- 11220655
TI  - Mammographic density as a marker of susceptibility to breast cancer: a
      hypothesis.
AB  - We propose that radiological features of breast tissue provide an index of
      cumulative exposure to the current and past hormonal and reproductive events that
      influence breast cancer incidence. The changes in breast tissue that occur with
      ageing, and changes in the associated radiological features of the breast, are
      similar to the concept of "breast tissue ageing" proposed by Pike, and may
      explain features of the age-specific incidence of breast cancer, both within the
      population and between populations. These radiological features can be observed
      and measured, can be related directly to risk of breast cancer, and are likely to
      be of value in research into the etiology of breast cancer. Identification of the
      sources of variation in this radiological characteristic of the breast is likely
      to lead to a better understanding of the factors that cause breast cancer and to
      new approaches to prevention of the disease.

PMID- 11220656
TI  - Intermediate histological effect markers for breast cancer.
AB  - The evidence that ductal carcinoma of the breast (DCIS) is an obligate precursor
      of invasive breast cancer and thus qualifies as an intermediate effect marker in
      chemoprevention research is reviewed. Much of the evidence on the natural history
      of DCIS has been derived from the era before the introduction of mammographic
      screening. Thus it may not be applicable in the present situation when women are
      likely to be under mammographic surveillance in chemoprevention trials. Further,
      the data that are becoming available from breast screening trials suggest that at
      least over follow-up periods now exceeding a decade, detection and treatment of
      DCIS has no impact on subsequent incidence of breast cancer. Although there are
      some indications that other biomarkers of malignancy are expressed similarly in
      DCIS and invasive cancer of similar grade, this evidence may not be sufficient to
      allow exclusive reliance on DCIS as an intermediate-effect marker in
      chemoprevention research.

PMID- 11220657
TI  - Inherited genetic susceptibility to breast cancer.
AB  - Inherited genetic susceptibility to breast cancer can be due both to genes which
      confer a high degree of risk and to polygenes which have a smaller effect on
      disease risk. An estimated 5-10% of breast cancer is considered to be due to
      mutations in genes conferring high risk which results in hereditary patterns of
      disease. Two major breast cancer susceptibility genes, BRCA1 and BRCA2, which
      were identified using linkage analysis in large extended breast and/or ovarian
      cancer pedigrees, are estimated to account for the majority of large families
      with breast/ovarian cancer predisposition and about two-thirds of large breast
      cancer families. The associated lifetime risk for breast cancer in mutation
      carriers ranges from 40% to 90%, depending on the extent of family history and
      the population. Other genetic factors, such as HRAS or CAG repeats of AR, as well
      as reproductive and hormonal factors may therefore modify cancer risk. Women at
      particularly high risk of developing breast cancer represent a group in whom
      expensive and rigorous screening programmes are cost-effective and who may
      benefit from trials of chemoprevention. There are only preliminary data on the
      efficacy of increased surveillance and on risk reduction due to prophylactic
      surgery. However, for chemoprevention to be equivalent to prophylactic
      mastectomy, it will be necessary to strive for an equivalent reduction. The
      efficacy of chemoprevention in this high-risk population is unknown. Existing and
      new agents for chemoprevention need to be carefully assessed in properly designed
      clinical trials among such women. In the process, other factors modifying the
      penetrance in mutation carriers need to be taken into account in order to
      evaluate the true effect of the chemopreventive agents. Polygenes confer much
      lower levels of risk and may be relevant for risk assessment when the effects of
      multiple loci, possibly in conjunction with environmental factors, are understood
      and quantified. At present, it seems unlikely that the genetic information at
      single polygenes will be clinically relevant for risk assessment and management.

PMID- 11220658
TI  - High-grade prostatic intraepithelial neoplasia as an exposure biomarker for
      prostate cancer chemoprevention research.
AB  - There is a tremendous need for exposure biomarkers, which need to function as
      intermediate end-points in cancer chemoprevention studies. Likely candidates
      include process biomarkers, atypical adenomatous hyperplasia, and a newly
      identified atrophic state. High-grade prostatic intraepithelial neoplasia (HGPIN)
      has the potential to be a useful exposure biomarker, having substantial
      predictive value for prostate cancer in chemoprevention trials. A limitation of
      the use of HGPIN as a biomarker is accessibility, since it requires the use of a
      highly invasive procedure that would not normally be applied unless malignancy is
      suspected to be present. However, most other biomarkers of prostatic tissue are
      similarly invasive. The HGPIN lesion appears to be highly measurable; however,
      problems of sampling coupled with the heterogeneity of the prostate raise
      questions about the degree to which the presence of HGPIN can be seen to
      characterize a given person's prostate gland. HGPIN has the advantage that it
      appears to be quite highly proximal to the development of cancer and to be
      modifiable. It remains less clear to what degree it reflects the exposures that
      are believed to alter prostate cancer risk. HGPIN has been identified as a
      clinical entity only recently and much additional research on the utility of this
      marker is needed.

PMID- 11220659
TI  - Intermediate biomarkers for chemoprevention of prostate cancer.
AB  - Use of high-grade prostatic intraepithelial neoplasia (PIN) as an intermediate
      biomarker for prostate cancer requires additional data concerning its natural
      biological behaviour. Moreover, it should be recognized that a proportion of PIN
      lesions may represent intraductal spread of an accompanying prostate cancer
      rather than a precancerous lesion. The detection rate of isolated PIN in the
      general population is low, and its clinical significance in the short term may be
      limited. Additional long-term studies on the significance of isolated PIN
      detected during population screening are required. Due to inadequate tissue
      sampling by current biopsy procedures, the presence of an accompanying prostate
      cancer is difficult to rule out. Endocrine therapy changes the morphology of PIN,
      hampering its identification by making it more closely resemble the normal benign
      glands. In addition, endocrine therapy may lead to molecular changes in PIN, with
      a potential risk of induction of resistance to endocrine therapy. Prolonged
      androgen deprivation (for six months) does not generally lead to eradication of
      PIN. Cessation of endocrine therapy is likely to lead to renewed expansion of
      PIN, since PIN continues to express androgen receptors and the cell-cycle protein
      MIB-1 under conditions of low androgen levels. Recent findings indicate that most
      high-grade prostate cancers seem to develop from low-grade cancers. The
      development of a high-grade focus of prostate cancer within a clinically latent
      low-grade tumour might be a suitable target for future intervention studies,
      provided that appropriate monitoring for development of high-grade cancer can be
      achieved in individual patients.

PMID- 11220660
TI  - The role of molecular genetics in chemoprevention studies of prostate cancer.
AB  - Research into the molecular genetics of prostate cancer to date has largely
      focused on the possible existence of one or several single-locus high-penetrance
      susceptibility genes and several candidate regions have been Identified, but
      confirmatory studies of these regions have been inconclusive. Increasingly,
      attention has turned to identification of candidate genes which may increase
      prostate cancer risk because their products play an important role in possible
      etiological pathways for prostate cancer. Of various such pathways which have
      been suggested for prostate cancer, the best studied in terms of molecular
      genetics is the androgen signalling pathway. Two genes in this pathway, the
      androgen receptor (AR) gene and the steroid 5-alpha reductase type II (SRD5A2)
      gene, have been under particular scrutiny and polymorphic markers in each of
      these genes that reproducibly predict prostate cancer risk have been identified.
      Such studies may have important implications for prostate cancer chemoprevention
      trials. As etiological pathways become better understood at the molecular level,
      piecing together multiple genetic variants in a pathway will allow identification
      of high-risk individuals and potential targets for chemopreventive interventions.
      Moreover, understanding the role of these genes in prostate cancer etiology may
      help in defining heterogeneity in response to such interventions. Finally, these
      genes or their products may themselves be legitimate targets for building a
      chemoprevention strategy.

PMID- 11220662
TI  - Significance of hepatic preneoplasia for cancer chemoprevention.
AB  - Hepatic preneoplasia represents an early stage in neoplastic development,
      preceding both benign and malignant neoplasia. This applies particularly to foci
      of altered hepatocytes (FAH), that precede the manifestation of hepatocellular
      adenomas and carcinomas in all species investigated. Morphological,
      microbiochemical and molecular biological approaches in situ have provided
      evidence for striking similarities in specific changes of the cellular phenotype
      of preneoplastic FAH emerging in experimental and human hepatocarcinogenesis,
      irrespective of whether this was elicited by chemicals, hormones, radiation,
      viruses or, in animal models, by transgenic oncogenes or Helicobacter hepaticus.
      Different types of FAH have been distinguished and related to three main
      preneoplastic hepatocellular lineages: (1) the glycogenotic-basophilic cell
      lineage, (2) its xenomorphic-tigroid cell variant, and (3) the amphophilic
      basophilic cell lineage. The predominant glycogenotic-basophilic and tigroid cell
      lineages develop especially after exposure to DNA-reactive chemicals, radiation,
      hepadnaviridae, transgenic oncogenes and local hyperinsulinism, their phenotype
      indicating initiation by insulin or insulinomimetic effects of the oncogenic
      agents. In contrast, the amphophilic cell lineage of hepatocarcinogenesis has
      been observed mainly after exposure of rodents to peroxisome proliferators that
      are not directly DNA-reactive or to hepadnaviridae, the biochemical pattern
      mimicking an effect of thyroid hormone, including mitochondrial proliferation and
      activation of mitochondrial enzymes. Hepatic preneoplastic lesions are
      increasingly used as end-points in carcinogenicity testing, particularly in
      medium-term carcinogenesis bioassays. This has been complemented more recently by
      the use of FAH as indicators of chemoprevention, although possible pitfalls of
      this approach have to be considered carefully. Our ever-increasing knowledge on
      the metabolic and molecular changes that characterize preneoplastic lesions and
      their progression to neoplasia provides a new basis for rational approaches to
      chemoprevention by drugs, hormones or components of the diet.

PMID- 11220661
TI  - Exposure biomarkers in chemoprevention studies of liver cancer.
AB  - Hepatocellular carcinoma (HCC) is the most common type of liver cancer, the major
      risk factors being hepatitis B and C viruses and aflatoxins; other factors such
      as alcohol are also of importance in some populations. Aflatoxin exposure
      biomarkers include urinary aflatoxin metabolites and aflatoxin-albumin adducts in
      peripheral blood. These biomarkers are well validated and have been applied in
      studies of many populations worldwide. They are proving to be valuable end-points
      in intervention studies, including chemoprevention studies. The biomarkers permit
      assessment of primary prevention measures to reduce aflatoxin intake. In
      addition, the determination of individual urinary aflatoxin metabolite profiles
      means that the effectiveness of chemopreventive agents designed to modulate
      aflatoxin metabolism can also be evaluated. Both aflatoxin-albumin adducts and
      urinary aflatoxin metabolites have been associated with increased HCC risk in
      prospective studies, indicating the predictive value of these biomarkers at the
      group level. However, given the multifactorial and multistep nature of HCC, it is
      unlikely that these exposure biomarkers will be predictive at the individual
      level or be of value as surrogate end-points in longer-term intervention trials
      aimed at reducing disease incidence. Aflatoxin-related mutations at codon 249 of
      the p53 gene in plasma may be more relevant in this regard but their application
      requires further understanding of the temporal appearance of this biomarker in
      relation to the natural history of the disease.

PMID- 11220663
TI  - Hepatocellular carcinoma: susceptibility markers.
AB  - Genetic polymorphisms of the carcinogen-metabolizing enzymes cytochrome P450
      (CYP), glutathione S-transferase (GST) M1 and N-acetyltransferase (NAT2) as well
      as p53 polymorphisms have been studied experimentally as susceptibility markers
      for hepatocellular carcinoma development in hepatocellular carcinoma cell lines
      and in mouse hepatocellular carcinomas. In addition, these susceptibility markers
      have been studied in hepatocellular carcinoma patients, in the context of
      coexisting alcohol consumption, smoking and/or HBV infection. To date, there is
      no clear evidence that susceptibility markers have an overall impact on
      hepatocarcinogenesis, but in subgroups of individuals, such as smokers,
      susceptibility markers are emerging indicators for hepatocellular carcinoma risk
      definition.

PMID- 11220664
TI  - Carcinogen biomarkers for lung or oral cancer chemoprevention trials.
AB  - The potential applicability of specific carcinogen-derived biomarkers in
      chemoprevention trials against lung and oral cancer is discussed. At present,
      there are no examples of the use of these biomarkers in chemoprevention trials,
      but the principle has been established in chemoprevention trials directed at
      aflatoxin B1-induced liver cancer. Polycyclic aromatic hydrocarbons (PAHs) and
      tobacco-specific nitrosamines are among the most important carcinogens invoked as
      causes of lung and oral cancer. Biomarkers that are potentially practical for
      current application in chemoprevention trials are 7,8-dihydroxy-9,10-epoxy
      7,8,9,10-tetrahydrobenzo[a]pyrene-DNA adducts, as determined by HPLC with
      fluorescence detection, nitrosamino acids in urine, 4-(methylnitrosamino)-1-(3
      pyridyl)-1-butanol and its glucuronides in urine, nicotine metabolites in urine,
      and metabolites of cytochrome P450 substrates in urine. Biomarkers that need
      further development or exploration before application in trials include 7
      methylguanine in DNA, tobacco-specific nitrosamine-DNA adducts,
      acrolein/crotonaldehyde-DNA adducts, PAH-protein adducts, acetaldehyde-protein
      adducts, pyrene metabolites in urine and benzo[a]pyrene metabolites in urine.
      Such carcinogen derived-biomarkers could be applied in chemoprevention trials to
      test the hypothesis that chemopreventive agents alter carcinogen metabolic
      activation and detoxification and, ultimately, risk for cancer.

PMID- 11220665
TI  - Lung cancer: chemoprevention and intermediate effect markers.
AB  - Even after smoking cessation, genetic damage in the airways epithelium may lead
      to focal progression of lung carcinogenesis. Some centres now report as many new
      lung cancer cases among former smokers as among current smokers. Chemoprevention
      is a potential approach to diminish the progression of pre-clinical genetic
      damage. The most intensively studied lung cancer chemoprevention agents are the
      retinoids, including vitamin A and its synthetic analogues and precursors. While
      effective in suppressing lung carcinogenesis in animal models, retinoids have
      failed to inhibit carcinogenesis in human chemoprevention trials with
      premalignant end-points (sputum atypia, bronchial metaplasia). In trials with
      lung cancer end-points, administration of retinoids either was ineffective or, in
      the case of beta-carotene, led to greater lung cancer incidence and mortality. In
      view of these findings, markers of specific retinoid effect (i.e., levels of RAR
      beta) become less relevant. Other markers of genetic instability and
      proliferation may be useful for both early detection and potentially as
      intermediate-effect markers for new chemoprevention trials. Cytological atypia,
      bronchial metaplasia, protein (hnRNP A2/B1) overexpression, ras oncogene
      activation and tumour-suppressor gene deletion, genomic instability (loss of
      heterozygosity, microsatellite alterations), abnormal methylation, helical CT
      detection of atypical adenomatous hyperplasia and fluorescent bronchoscopic
      detection of angiogenic squamous dysplasia offer great promise for molecular
      diagnosis of lung cancer far in advance of clinical presentation. These end
      points can now be evaluated as monitors of response to chemoprevention as
      potential intermediate-effect markers.

PMID- 11220667
TI  - Metabolic polymorphisms as susceptibility markers for lung and oral cavity
      cancer.
AB  - Lung and oral cavity cancers are causally associated with tobacco use. Alcohol is
      an independent risk factor for oral cavity cancer. Major classes of carcinogens
      present in tobacco and tobacco smoke are converted into DNA-reactive metabolites
      by cytochrome P450 (CYP)-related enzymes, several of which display genetic
      polymorphism. Individual susceptibility to cancer is likely to be modified by the
      genotype for enzymes involved in the activation or detoxification of carcinogens
      in tobacco and repair of DNA damage. Molecular epidemiological studies to assess
      the risk associated with metabolic polymorphisms for cancers of the lung and head
      and neck have shown that the overall effect of common polymorphisms is moderate
      in terms of penetrance and relative risk. However, some gene combinations like
      mutated CYP1A1/GSTM1-null genotype seem to predispose the lung and oral cavity of
      smokers to an even higher risk for cancer or DNA damage, although these results
      require confirmation in larger well defined studies that take into account the
      existence of ethnic variations even within the commonly defined groups.
      Retinoids, isothiocyanates and tea polyphenols have been identified as possible
      chemopreventive agents for cancers of the lung and oral cavity. While a number of
      trials have been conducted with retinoids or beta-carotene, the results were
      ambiguous and the causes are still being debated. The possible interaction of
      chemopreventive agents with metabolic polymorphisms as biomarkers in
      chemoprevention trials is discussed.

PMID- 11220666
TI  - Biomarkers and surrogacy: relevance to chemoprevention.
AB  - Clinical cancer prevention trials that use disease as the end-point are of
      necessity large, lengthy and costly. While such trials will always remain the
      'gold standard' for establishing efficacy, they are unwieldy and inefficient for
      the rapid translation of our accelerating understanding of the molecular basis of
      cancer into preventive strategies. The inclusion of biomarkers in the process of
      chemopreventive agent development is crucial for the advancement of the field.
      This overview highlights the types of approach that are being used in the
      development and application of biomarkers in chemoprevention studies. Biomarkers,
      which measure exposure, susceptibility or risk factors, can be used in selecting
      study cohorts, assessing participant compliance and/or determining agent
      efficacy. Key features of biomarkers include reliability, precision, accuracy and
      validity. Not all biomarkers are suitable for all purposes and are likely to be
      imperfect in any single setting. Judicious selection and matching of biomarkers
      with agents and study cohorts is required for their effective utilization. A
      critical but non-dichotomous element of risk biomarkers is their degree of
      surrogacy. A classification scheme is provided that relates the degree of
      surrogacy of risk biomarkers to their utility in preventive interventions.

PMID- 11220668
TI  - Development of difluoromethyl-ornithine and Bowman-Birk inhibitor as
      chemopreventive agents by assessment of relevant biomarker modulation: some
      lessons learned.
AB  - A major goal in the development of chemopreventive agents has been to develop
      markers that reflect the underlying process of carcinogenesis and which are
      modulatable by the agent under study. An important application of such markers
      will be to select cohorts that are at elevated risk for cancer development, which
      should allow use of smaller sample sizes in definitive phase III trials as well
      as shorter duration (and lower cost), without loss of statistical power.
      Susceptibility and surrogate end-point biomarkers are particularly important in
      this respect. Intermediate markers are probably best assessed in terms of
      proportionate rather than relative risk. The systematic development of
      difluoromethylornithine for use in chemoprevention against human cancer has
      involved pilot, phase IIa and IIb trials using participants with prior colonic
      polyps as the study group. A unique feature of the phase IIa study was the use of
      a dose de-escalation design which allowed selection of the lowest effective non
      toxic dose of difluoromethylornithine. The phase IIb trial now in progress is
      using a combination of sulindac with difluoromethylornithine; the rationale for
      selection of markers for this study and for a randomized phase III registration
      trial is discussed. We also review the findings in phase I and IIa trials of
      Bowman-Birk inhibitor concentrate, in which patients with measurable oral
      leukoplakia are the study group.

PMID- 11220669
TI  - Selection and validation of biomarkers for chemoprevention: the contribution of
      epidemiology.
AB  - This chapter considers the epidemiological contribution of DNA adducts as an
      example of markers for use in chemoprevention studies, and highlights the
      potential biases inherent in the conduct of epidemiological studies with
      molecular markers. Although adducts have been interpreted mainly as biomarkers of
      exposure, 'bulky' DNA adducts such as those measured by 32P-postlabelling or
      ELISA in white blood cells are more correctly interpretable as markers of
      cumulative unrepaired DNA damage. The latter concept can prove useful in cancer
      epidemiology, since it is consistent with existing knowledge on the importance of
      duration of exposure in the etiology of chemically-induced cancers. Increasing
      evidence suggests that in addition to prolonged exposure to genotoxic chemicals,
      inter-individual variability in carcinogen metabolism and DNA repair is
      predictive of cancer risk. Also from this point of view, measurements of 'bulky'
      DNA adducts can be useful as biomarkers for studies in populations, since they
      express the amount of carcinogen linked to DNA after repair, taking into account
      individual repair capacity. Finally, we suggest a theory of causality based on
      the work of Wesley Salmon and the concept of 'propagating mark', which is
      particularly attractive for molecular epidemiologists.

PMID- 11220670
TI  - Ultraviolet radiation-induced photoproducts in human skin DNA as biomarkers of
      damage and its repair.
AB  - We have developed a 32P-postlabelling method for quantifying ultraviolet
      irradiation (UV)-induced cyclobutane dimers and 6-4 photoproducts in human skin
      in situ. We review the application of the method in studies with human
      volunteers, demonstrating dose-response relationships over a wide range of
      administered doses, repair kinetics of UV-damaged DNA among healthy individuals
      and melanoma patients, and modulation by sunscreens, tan and constitutive
      pigmentation of damage induction. A notable finding is the wide interindividual
      variation in DNA damage immediately after irradiation and in its repair.
      Moreover, the protective effects of sunscreens against erythema and DNA damage
      also show wide interindividual variation. These results cannot be explained by
      variation in the experimental methods used. The worst-case scenario is that the
      differences between individuals are multiplicative, resulting in 1000-fold
      differences in sensitivity in the population, which would be likely to translate
      into differences in risk of skin cancer.

PMID- 11220672
TI  - Genetically determined susceptibility markers in skin cancer and their
      application to chemoprevention.
AB  - Development of skin cancer is a result of interactions between genetic and
      environmental factors. Exposure to sunlight is an established cause of non
      melanoma skin cancer as well as of melanoma. Other additional factors such as
      exposure to environmental chemicals (e.g., chimney soot, arsenic compounds),
      chronic irritation of the skin, viral infections and the immune status of the
      host may predispose to skin cancer. The high incidence of skin cancer highlights
      the need for development of more effective chemopreventive agents. This requires
      a better understanding of genetically determined host susceptibility, which is
      increasingly acknowledged as a major factor in the causation of skin tumours.

PMID- 11220671
TI  - Intermediate-effect biomarkers in prevention of skin cancer.
AB  - Skin cancers, both non-melanoma and melanoma, usually progress through sequential
      steps towards malignant transformation, leading to mutant clones and precancerous
      lesions. Prevention of skin cancers relies on reduction of exposure to solar
      radiation and may be evaluated by measuring induction of intermediate-effect
      biomarkers such as sunburn cells or p53 mutations in the epidermis, actinic
      (solar) keratoses, UV-induced immunosuppression or naevi. Sunburn cells
      (apoptotic keratinocytes) and p53 mutations are indicators of UV-induced DNA
      lesions as early steps of malignant transformation of epidermal keratinocytes.
      Actinic keratoses are premalignant sun-induced skin lesions, characterized as
      keratinized patches with aberrant cell differentiation and proliferation; they
      represent risk factors for basal-cell carcinoma and melanoma and are precursors
      of squamous-cell carcinoma. Studies in humans have investigated UV-induced
      immunosuppression and its modulation by topical sunscreen application, focusing
      on contact hypersensitivity as measured by immunization or response to haptens,
      or on modulation of stimulation of allogeneic lymphocytes by epidermal cells, or
      local release of immunomodulatory molecules such as cis-urocanic acid or
      interleukin-10. Naevi are focal collections of melanocytes, usually found at the
      junction of the epidermis and dermis or at various depths in the dermis. Common
      acquired naevi arise after birth both spontaneously and in response to sun
      exposure. Most acquired naevi are clonal, while most melanocytes in non-naeval
      areas are not. Although it is not yet certain whether naevi represent
      premalignant lesions or risk factors, many melanomas arise in acquired naevi, and
      the number of naevi constitutes the best predictor of individual risk of
      melanoma. The presence of large (i.e., >5 mm) or atypical naevi (i.e., large
      naevi with non-uniform colour and irregular borders) is associated with elevated
      melanoma risk, independently of the number of smaller naevi. Children seem
      particularly vulnerable to sun-induced biological events involved in the genesis
      of melanoma, and the greatest increase in naevus numbers per unit of skin surface
      occurs before adolescence. Therefore, the distribution of naevi and their
      development in children are relevant to understanding melanoma occurrence in
      adults.

PMID- 11220673
TI  - Characterization and identification of Borrelia isolates as Borrelia valaisiana
      in Taiwan and Kinmen Islands.
AB  - Eleven pure cultures of Borrelia from 3 species of wild rodents (Apodemus
      agrarius, Mus formosanus, Rattus losea) captured in Taichung, located in the
      center of Taiwan island, and on Kinmen Island were characterized. Five isolates
      showed restriction fragment length polymorphism (RFLP) patterns of 5S-23S rRNA
      gene intergenic spacer sequences identical to those of strains 5MT and 10MT,
      identified as Borrelia valaisiana, which were isolated in the southern tip of
      South Korea. Although the remaining six isolates showed novel RFLP patterns,
      these isolates showed more similarity to members of B. valaisiana from Korea,
      Japan and Europe based on 16S rRNA gene and flagellin gene sequences. This led us
      to speculate that transmission and proliferation of this type of borrelia
      occurred between Taiwan and the southern part of South Korea.

PMID- 11220674
TI  - Acute primary infection with cytomegalovirus (CMV) in kidney transplant
      recipients results in the appearance of a phenotypically aberrant CD8+ T cell
      population.
AB  - Human cytomegalovirus (CMV) is a beta-herpesvirus that causes a chronic
      subclinical infection in healthy man. The immune system is unable to eliminate
      the virus completely, allowing virus to persist in a latent state. In the
      immunocompromised host, this equilibrium is disturbed, resulting in a clinical
      infection. In immunocompromised rats, clinical CMV infection is associated with
      an increase in NK cells and CD8+ T cells, including a phenotypically aberrant
      CD8+ T cell population. Using flow cytometry, we examined the effect of acute CMV
      infection on the composition of leukocyte subsets in immunocompromised patients.
      Therefore, we used peripheral blood of CMV seronegative patients receiving a
      kidney from a seronegative (control group) or a seropositive donor. Of the
      patients receiving a seropositive kidney, only the patients undergoing acute CMV
      infection were included (experimental group). Special attention was paid to the
      phenotype of the cytotoxic T cells. The development of acute CMV infection
      resulted in an increased NK cell number and an activation of both CD4+ and CD8+ T
      cells, as determined by HLA-DR expression. An aberrant CD8+ T cell subset with
      decreased expression of CD8 and TCR alphabeta appeared in the infected patients.
      Furthermore, the size of this subpopulation of CD8+ T cells is positively
      correlated with the viral load.

PMID- 11220675
TI  - A VSV-G pseudotyped HIV vector mediates efficient transduction of human pulmonary
      artery smooth muscle cells.
AB  - Attempts were made to infect human vascular smooth muscle cells derived from the
      pulmonary artery (hPASMC) with two different human immunodeficiency virus (HIV)
      vector systems. ADA/Luc or HXB2/Luc were generated by cotransfection of
      luciferase reporter gene vector, pNL4-3-Luc-E- R-, and one of two envelope
      expressing vectors, pSMADA (R5) or pSMHXB2 (X4). The VSV-G/Luc or VSV-G/GFP were
      produced by a three-plasmid expression system which consisted of vesicular
      stomatitis virus G protein (VSV-G) expressing vector, packaging plasmid, and one
      of two reporter genes (pHR'-CMV-Luc or pHR'-CMV-GFP). We used hPASMC,
      U87.CD4.CCR5 and U87.CD4.CXCR4 for infection. Neither ADA/Luc nor HXB2/Luc could
      infect hPASMC, though they could infect U87.CD4 with corresponding coreceptors.
      On the other hand, the transduction of both VSV-G/Luc and VSV-G/GFP to hPASMC was
      remarkable. At day 3, the relative proportion of positive cells of hPASMC
      infected with VSV-G/GFP was 15%. The above finding indicates a direct role of HIV
      1 infection in pulmonary hypertension 'a rare complication of HIV-1 infection'
      and HIV-based vectors could introduce foreign genes into hPASMC for gene therapy
      of pulmonary hypertension.

PMID- 11220676
TI  - IL-12, IFN-gamma, and TNF-alpha released from mononuclear cells inhibit the
      spread of varicella-zoster virus at an early stage of varicella.
AB  - The activity of mononuclear cells to inhibit plaque formation of varicella-zoster
      virus (VZV) was investigated by an in vitro infectious center assay. Peripheral
      blood mononuclear cells (PBMC) inhibited VZV plaque formation by co-cultivation
      with VZV-infected fibroblasts. As compared to mononuclear cells from normal
      individuals, mononuclear cells from umbilical cord blood and from patients
      receiving corticosteroids showed a significant decrease in the ability to inhibit
      viral replication. This ability was significantly increased for mononuclear cells
      collected during the acute phase of varicella. PBMC obtained from patients in the
      acute phase of varicella produced significantly higher amounts of interferon
      (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-12 in the
      supernatant compared with those of healthy individuals. These data suggest that
      the cytokines have an important role in the inhibition of the spread of VZV at an
      early stage of varicella. Th1 type adaptive immunity might play a major role in
      VZV infection.

PMID- 11220677
TI  - Circulating soluble CD4 directly prevents host resistance and delayed-type
      hypersensitivity response to Cryptococcus neoformans in mice.
AB  - In the present study, we examined the effect of soluble CD4 (sCD4) on host
      resistance and delayed-type hypersensitivity (DTH) response to Cryptococcus
      neoformans using a novel mutant mouse that exhibits a defect in the expression of
      membrane-bound CD4 but secretes high levels of sCD4 in the serum. In these mice,
      host resistance to this pathogen was impaired as indicated by an increased number
      of live pathogens in the lung. To elucidate the mechanism of immunodeficiency,
      three different sets of experiments were conducted. First, administration of anti
      CD4 mAb restored the attenuated host defense. Second, in CD4 gene-disrupted
      (CD4KO) mice, host resistance was not attenuated compared to control mice. Third,
      implantation of sCD4 gene-transfected myeloma cells rendered the CD4KO mice
      susceptible to this infection, while similar treatment with mock-transfected
      cells did not show such an effect. These results indicated that immunodeficiency
      in the mutant mice was attributed to the circulating sCD4 rather than to the lack
      of CD4+ T cells. In addition, DTH response to C. neoformans evaluated by footpad
      swelling was reduced in the mutant mice compared to that in the control, and the
      reduced response was restored by the administration of anti-CD4 mAb. Finally,
      serum levels of IFN-gamma, IL-12 and IL-18 in the mutant mice were significantly
      reduced, while there was no difference in Th2 cytokines, such as IL-4 and IL-10.
      Considered collectively, our results demonstrated that sCD4 could directly
      prevent host resistance and DTH response to C. neoformans through interference
      with the production of Th1-type cytokines.

PMID- 11220678
TI  - NK cells eliminate Cryptococcus neoformans by potentiating the fungicidal
      activity of macrophages rather than by directly killing them upon stimulation
      with IL-12 and IL-18.
AB  - In the present study, we examined whether natural killer (NK) cells have direct
      fungicidal activity against Cryptococcus neoformans. Splenic NK cells were
      obtained from SCID mice and stimulated with a combination of interleukin (IL)-12
      and IL-18 in flat culture plates or round tubes. They were then or at the same
      time cultured with the yeast cells and the number of viable yeast cells was
      examined. We could not detect direct fungicidal activity by NK cells under any
      culture condition, although they produced a large amount of IFN-gamma and exerted
      marked cytotoxic activity against YAC-1 cells. On the other hand, NK cells
      significantly potentiated the nitric oxide-mediated cryptococcocidal activity of
      thioglycolate-elicited peritoneal macrophages obtained from SCID mice upon
      stimulation with IL-12 and IL-18. The culture supernatants of NK cells stimulated
      with IL-12 and IL-18 provided similar results when used in place of NK cells. The
      induction of macrophage anticryptococcal activity by NK cells and NK cell culture
      supernatants were both mediated by IFN-gamma because the specific mAb almost
      completely abrogated such effect. Considered collectively, our results suggested
      that NK cells may play a regulatory role in potentiating macrophage-mediated
      fungicidal mechanisms in host resistance to infection with C. neoformans rather
      than exerting a direct killing activity against the fungal pathogen.

PMID- 11220679
TI  - Molecular cloning of rat NK target structure--the possibility of CD44 involvement
      in NK cell-mediated lysis.
AB  - The nature of target molecules of natural killer (NK) cell-mediated lysis remains
      to be elucidated. As we previously reported, mAb 109 recognizes one of the tumor
      associated antigens, designated as 109 antigen (Ag), expressed on the cell
      surface of rat fibrosarcomas W31 and W14, which are transformants of WFB (rat
      fetal fibroblast cell line) with H-ras oncogene. 109Ag was thought to be a target
      structure of NK cells since mAb 109 inhibited NK cell-mediated lysis against W31
      and W14. Here, we demonstrate by molecular cloning that 109Ag is identical to rat
      CD44. Immunoprecipitation and immunoblotting studies also showed that mAb 109 and
      anti-rat CD44 mAb OX-50 recognize the same protein of W31 cell lysates with an 86
      kDa molecular size. CD44 was suggested to be a target structure of NK cell
      mediated lysis; however, rat CD44 cDNA transfection alone into CD44 null cell
      lines did not result in up-regulation of target cell susceptibility to NK cell
      mediated lysis. Our results therefore indicated that CD44 may play a crucial role
      as one of the target structures in our rat fibrosarcoma system though the cell
      surface expression of CD44 alone does not affect NK susceptibility of the target
      cells.

PMID- 11220680
TI  - Apoptosis observed in murine peritoneal macrophages treated with interferon gamma
      through staphylococcal enterotoxin-dependent cell-mediated cytotoxicity.
AB  - The concept of superantigens is well-known and widely accepted. In this brief
      communication, we analyze the behaviour of antigen-presenting cells after T-cell
      activation by staphylococcal enterotoxin B, a representative superantigen. We
      tried to activate murine T cells by inflammatory mouse peritoneal macrophage in
      the presence of staphylococcal enterotoxin B, but no T-cell activation was
      observed. We, therefore, analyzed surface-specific antigens of the macrophages.
      They expressed insufficient amounts of MHC class II, CD80 and CD86 molecules on
      the surface of the cells. On the contrary, increased amounts of MHC class II and
      CD86 molecules on the cell surfaces were observed after incubation with
      interferon gamma. Interferon gamma-primed macrophages were found to be competent
      to activate T cells in the presence of staphylococcal enterotoxin B. To our
      surprise, these macrophages underwent apoptosis in parallel with T-cell
      activation.

PMID- 11220682
TI  - Size conversion of a linear plasmid in the relapsing fever agent Borrelia
      duttonii.
AB  - Borreliae have genomes composed of both linear and circular replicons. We have
      characterized the organization of linear DNA molecules from the Borrelia duttonii
      strain Ly. It contains a linear one megabase chromosome and 12 linear plasmids of
      11 to 200 kb in size. A variant of the strain obtained after successive in vitro
      cultivation in BSKII medium had a 69 kb molecule instead of the 44 kb linear
      plasmid. No detectable differences in the growth rates and cellular structures
      were found. Southern hybridization using the vsp33 gene sequence from Borrelia
      hermsii as a probe showed that both plasmids (69 and 44 kb molecules) contained a
      similar part of the sequence. The spirochetes of the parental strain cause
      erythrocytes to aggregate in mice blood, but the variant did not form such
      aggregates and seemed to have lost its infectivity in mice. Size conversion of
      the linear plasmid may be associated with the host-parasite relationship in
      mammals.

PMID- 11220681
TI  - A simple and rapid method for purifying staphylococcal exfoliative toxin A.
AB  - A rapid and efficient method of purification of staphylococcal exfoliative toxin
      A, the causative agent of staphylococcal scalded skin syndrome (SSSS), has been
      developed. It is based on ammonium sulfate precipitation of the culture
      supernatant and hydrophobic interaction chromatography on Phenyl-Sepharose CL-4B.
      This procedure results in 87-fold purification of this toxin, which appears as a
      single band in sodium dodecyl sulfate-polyacrylamide gels.

PMID- 11220683
TI  - High-dose corticosteroid administration induces increase of serum macrophage
      migration inhibitory factor in patients with Vogt-Koyanagi-Harada's disease.
AB  - To investigate the influence of corticosteroid administration on the serum level
      of macrophage migration inhibitory factor (MIF), sera obtained from 9 patients
      with Vogt-Koyanagi-Harada's disease who had been treated with high-dose
      corticosteroid were analyzed. The serum MIF levels of most patients were
      prominently increased on day 7 and/or day 14 after corticosteroid treatment. No
      TNF-alpha was detected in the sera. The average serum MIF level of nine patients
      at the highest stages after corticosteroid administration was significantly
      higher than that before the corticosteroid treatment. It seems that MIF is a
      unique cytokine and acts together with corticosteroid to regulate inflammation
      and immunity.

PMID- 11220685
TI  - IL-4 is required for defense against mycobacterial infection.
AB  - Although the involvement of T helper (Th1) cells is central to protection against
      intracellular bacteria, including Mycobacterium tuberculosis, the involvement of
      Th2 cells, characterized by potent interleukin (IL)-4 secretion in mycobacterial
      infection is still unclear. In order to clarify the role of IL-4 in murine
      tuberculosis, IL-4-deficient mutant mice, IL-4 knockout (IL-4 KO) mice, were
      utilized. The mice were infected with H37Rv, Kurono or BCG Pasteur via an
      airborne infection route by placing them in the exposure chamber of a Middlebrook
      airborne infection apparatus. Their capacity to control mycobacterial growth,
      granuloma formation, cytokine secretion, and nitric oxide (NO) production were
      examined. These mice developed large granulomas, but not necrotic lesions in the
      lungs, liver or spleen (P<0.05). This was consistent with a significant increase
      in lung colony-forming units (CFU). Compared with levels in wild-type mice, upon
      stimulation with mycobacteria, splenic IL-10 levels were low and IL-6 levels were
      intermediate, but interferon (IFN)-gamma and IL-12 levels were significantly
      higher. IL-18 levels were within the normal range. The level of NO production by
      alveolar macrophages of the IL-4 KO mice was similar to that of the wild-type
      mice. Granulomatous lesion development by IL-4 KO mice was inhibited
      significantly by treatment with exogenous recombinant IL-4. These findings were
      not specific to the IL-4 KO mice used. Our data show that IL-4 may play a
      protective role in defense against mycobacteria, although IFN-gamma and TNF-alpha
      play major roles in it. Our data do not rule out an IFN-gamma-independent
      function of IL-4 in controlling tuberculosis.

PMID- 11220684
TI  - Characterization of Vibrio parahaemolyticus manganese-resistant mutants in
      reference to the function of the ferric uptake regulatory protein.
AB  - In many bacteria, the ferric uptake regulatory protein (Fur) has a central role
      in the negative regulation of genes affected by iron limitation. In this study,
      Vibrio parahaemolyticus strains carrying mutations in the fur gene encoding Fur
      were isolated by the manganese selection method to assess the function of Fur in
      connection with alternations in the coordinate expression of the siderophore
      vibrioferrin (VF) and iron-repressible outer membrane proteins (IROMPs). Ten out
      of 25 manganese-resistant mutants constitutively produced VF and expressed at
      least two IROMPs irrespective of the iron concentration in the medium. PCR-direct
      DNA sequencing of the fur genes in these mutants identified four different point
      mutations causing amino acid changes. Moreover, a fur overexpressing plasmid was
      constructed to prepare antiserum against V. parahaemolyticus Fur. Western
      blotting with this antiserum revealed that the intracellular abundance of the
      wild-type Fur was not significantly affected by the iron concentrations in the
      growth medium, and that the Fur proteins of the mutant strains occurred at
      substantially smaller amounts and/or migrated more rapidly in sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis than the wild-type Fur. These data
      afford an additional insight into the structure-function relationship of Fur and
      imply its involvement in the iron acquisition systems of V. parahaemolyticus,
      although it is yet unknown whether its action on the target genes is direct or
      indirect.

PMID- 11220686
TI  - Serological properties of Abiotrophia and Granulicatella species (nutritionally
      variant streptococci).
AB  - Serological variations were examined among 12 type or reference strains and 91
      oral isolates of vitamin B6-dependent Abiotrophia and Granulicatella spp. Rabbits
      were immunized with whole cells of 12 selected strains and 10 typing antisera
      were obtained, which were unreactive with the Lancefield group A to G antigen
      preparations. The reactivity of the antisera and autoclaved cell surface antigen
      extracts was tested by double diffusion in agar gel and a capillary precipitin
      test. These typing antisera categorized all Abiotrophia defectiva strains, all
      except one Granulicatella elegans strain, three-quarters of the Granulicatella
      adiacens, and half of the Granulicatella paraadiacens into 8 serotypes and 2
      subserotypes. The Granulicatella balaenopterae type strain was unserotypable. All
      A. defectiva strains were serotype I, some of which were divided into subserotype
      I-1 and/or I-5. The G. adiacens strains generally belonged to serotype II or III,
      and the G. paraadiacens strains to serotype IV, V or VI. All G. adiacens or G.
      paraadiacens serotype II strains were also subserotype I-5. The G. elegans
      strains were serotype VII or VIII. These Abiotrophia and Granulicatella serotypes
      were undetectable among 33 strains of the other 11 species including the
      bacteriolytic enzyme-producing but vitamin B6-independent strains of
      Streptococcus, Enterococcus, Dolosigranulum and Aerococcus. The proposed
      serotyping system for Abiotrophia and Granulicatella spp. would be helpful in the
      identification and classification of these unique coccal isolates in ecological
      and epidemiological studies.

PMID- 11220687
TI  - Salmonella typhimurium induces apoptosis in human monocyte-derived macrophages.
AB  - Salmonella species represent a leading cause of gastroenteritis worldwide. More
      recently, they have been proposed as putative vaccine delivery vehicles in
      humans. Oral infection with Salmonella leads to invasion of the intestinal
      epithelial barrier and subsequent interaction with mucosal macrophages. In this
      study, we investigated the fate of Salmonella typhimurium-infected human
      macrophages differentiated from blood monocytes by GM-CSF. Wild type S.
      typhimurium strain SL1344 induced macrophage surface blebbing and caused the
      release of host cytoplasmic lactate dehydrogenase beginning 30 min post
      infection. Three hours later more than 80% of the macrophages in the culture were
      killed. In contrast, during the same period, macrophages infected with the non
      invasive S. typhimurium strain BJ66 remained viable. Chromatin fragmentation is a
      hallmark of cells undergoing apoptosis. Using TUNEL analysis, we observed
      chromatin fragmentation in macrophages infected with SL1344 but not in BJ66
      infected cells. Consistent with this observation, we found that pretreatment of
      human macrophages with an inhibitor of caspase-3, a member of the pro-apoptotic
      enzyme family shown to be involved in S. typhimurium-induced killing of mouse
      macrophages, reduced SL1344-mediated cytotoxicity by 40%. Our study provides the
      first evidence that invasive S. typhimurium induces apoptosis in human
      macrophages that were differentiated from blood monocytes by GM-CSF, and that
      cell death is a caspase-dependent phenomenon.

PMID- 11220688
TI  - Effect of sulbactam on anti-pseudomonal activity of beta-lactam antibiotics in
      cells producing various levels of the MexAB-OprM efflux pump and beta-lactamase.
AB  - The beta-lactamase inhibitor, sulbactam, was tested for beta-lactamase inhibitory
      activity in Pseudomonas aeruginosa cells producing various levels of both the
      MexAB-OprM efflux pump and beta-lactamase. We found that sulbactam lowered the
      MICs of cefoperazone and piperacillin by inhibiting the beta-lactamase 8-fold in
      the cell producing a constitutively high level of AmpC-type beta-lactamase and a
      wild-type level of MexAB-OprM pump compared with that without sulbactam. The MICs
      of cefoperazone and piperacillin in the cell producing a constitutively high
      level of both the efflux pump and beta-lactamase under the presence of sulbactam
      were 8 and 4 times, respectively, lower than that without sulbactam. The MICs of
      sulbactam in the cell producing a constitutively high and a wild-type level of
      the efflux pump were 16- and 8-fold higher, respectively, than that in the mutant
      lacking the efflux pump. We concluded that sulbactam exerts potent beta-lactamase
      inhibitory activity in the cell producing a high level of efflux pump, in spite
      of the fact that sulbactam serves as a substrate of the MexAB-OprM pump.
      Increasing amounts of sulbactam over the weight of beta-lactams further
      strengthen the effect of beta-lactam antibiotics.

PMID- 11220689
TI  - Early ontogenic disturbances in cell migration in mentally disabled adult.
AB  - Disturbances in cell migration are heterogenic disorders of brain development
      commonly associated with epilepsy and mental retardation. We report a 45-year-old
      oligophrenic man with defect of lower limbs and family history of mental
      retardation who died because of brainstem hemorrhage. At post-mortem and
      histopathological examination, complex brain malformation characterized by
      bilateral periventricular heterotopia, cortical dysgenesia, partial agenesia of
      corpus callosum and thin-walled blood vessels was found. Immunohistochemical
      examination revealed the presence of fibronectin, collagen IV and laminin in wall
      of pathological vessels. Cyclooxygenase-2 (COX-2) expression in neurons within
      heterotopias and dysgenic cortex was negative. It may indicate their maturity and
      indirectly, normal activity of postsynaptic NMDA receptors that explains absence
      of epileptic attacks in our patient. The presence of COX-2-negative neurons and
      compounds of basal lamina in fetal-like vessels within heterotopias and dysgenic
      cortex, suggests that these probably initially immature structures became mature
      during 45 years of patient's life.

PMID- 11220690
TI  - Does PRNP gene control the clinical and pathological phenotype of human
      spongiform transmissible encephalopathies?
AB  - BACKGROUND: Human spongiform transmissible encephalopathies (TSE) are a group of
      neurodegenerative diseases caused by a transmissible not yet recognized agent;
      their distinctive neuropathological features are astrocytosis, spongiform lesions
      of the neuropil, neuronal loss and occasionally amyloid plaques in the cortical
      and subcortical gray matter. TSE are biochemically characterized by the
      deposition in the nervous system of an amyloid-type protein, PrPres derived from
      the post-translational modification of a normal protein, PrPsen. The expression
      of this protein is controlled by the PRNP gene mapped on chromosome 20 in man. A
      number of point mutations of the PRNP gene have been described in the familial
      forms of these TSE. Some of these mutations have been associated with differences
      in the phenotypic expression of the disease. MATERIAL AND METHODS: This study was
      designed to verify whether it was possible to identify a selective phenotype
      depending upon a given PRNP modified genotye; for this purpose, a group of
      familial TSE cases (CJD 210ILE, CJD 201LYS, FFI 178ASN) were selected and their
      neuropathological profiles have been compared with those of a large series of
      sporadic CJD cases. RESULTS: No significant differences were found between the
      topography and severity of lesions in the cerebral cortex, cerebellum,
      hippocampus, basal ganglia and thalamus between the two groups. Two differences
      were found: the clinical duration of the disease which appeared significantly (p
      = 0.02) shorter in the 210ILE-mutated cases compared to that of non-mutated
      sporadic cases. The highly selective vulnerability of thalamus in FFI showing a
      severe pathology especially in its dorso-medial part in comparison with that of
      the sporadic CJD cases. CONCLUSION: The results of this study confirm that the
      different polymorphism at codon 129 of the PRNP gene, which could be involved in
      the structural "domains" of human PrP, might modulate the pathological phenotype
      of TSE.

PMID- 11220691
TI  - A contemporary case of encephalitis lethargica.
AB  - We present a clinicopathological report of a recent fatal case of a 27-year-old
      woman whom we consider to have had encephalitis lethargica. Clinical features of
      note were a presentation with vertigo, persistent vomiting and sleep disturbance
      including marked daytime somnolence and vivid nightmares. On examination, she had
      impaired slow pursuit vertical eye movements, dysarthria, an expressionless face
      and slow tongue movements. She went on to develop gross supranuclear gaze palsy,
      neck rigidity, bradykinesia, blepharospasm, profound somnolence and anarthria but
      no tremor, weakness or impairment of cognition. She died after an illness lasting
      12 months. On investigation, the cerebrospinal fluid was found to contain a very
      high level of IgG with oligoclonal bands but no cells. Post-mortem examination
      revealed an active encephalitis, mainly centered on the upper brainstem and
      diencephalon with extensive Purkinje cell loss and marked plasma cell infiltrates
      and morula cells. No virus was recovered.

PMID- 11220692
TI  - Expression of matrix metalloproteinases in a series of 12 meningiomas.
AB  - The expression of metalloproteinases was evaluated in a series of 12 meningiomas
      of various histological subtypes including 3 meningotheliomatous, 3 fibroblastic,
      4 transitional and one psammomatous meningioma (WHO grade I) as well as one
      anaplastic meningioma (WHO grade III). No gelatinolytic activity could be
      detected in all tumor samples pointing towards no or very low activity of both
      MMP-2 and MMP-9. At least MMP-2 mRNA could be found in 10 out of 12 tumor samples
      by the reverse transcription PCR method (RT-PCR) followed by electrophoresis on
      silver-stained polyacrylamide gels, which allows the detection even of small
      traces of a specific mRNA. The PCR products were identified as MMP-2 sequences
      without introns (mRNA-derived) by direct sequencing, thereby demonstrating a low
      transcriptional activity of the gene. The translation of these mRNAs, however,
      did not result in amounts of protein detectable by immunohistochemistry or
      Western blotting. Therefore, neither MMP-2 nor MMP-9 should play a major role for
      tumor growth within dura mater or bone structures or for brain infiltration in
      our tumor series. Therefore, other mechanisms must be responsible for
      extracellular matrix degradation at least in a fraction of meningiomas.

PMID- 11220694
TI  - Pseudogliomatous growth pattern of anaplastic small cell carcinomas metastatic to
      the brain.
AB  - Carcinomas metastatic to the brain usually grow very well circumscribed, with
      sharp delineation. Radiosurgery takes advantage of this fact by using the gamma
      knife for definitive treatment of small metastases. We report a systematic study
      of the growth pattern of cerebral metastases, focusing on tumor delineation. In
      26 cases of 66 metastatic anaplastic small cell carcinomas and in one case of
      adenocarcinoma, we observed poorly defined borders and a highly diffuse pattern
      of invasion. Infiltrating carcinoma cells changed to an elongated shape adapting
      to preexisting tissue structures. This pseudogliomatous growth pattern of some
      brain metastases--apparently most likely in neuroendocrine carcinomas--is of
      potential importance for therapeutic strategies in the treatment of brain
      metastases, especially when considering treatment with radiosurgery and gamma
      knife.

PMID- 11220693
TI  - Supratentorial giant cell ependymoma.
AB  - Ependymomas account for 3 to 9% of all neuroepithelial tumors and, although
      occurring most often within the ventricular system, they may arise from the
      extraventricular parenchyma as well. Several histologic patterns of these
      neoplasm are well known, but little attention has been devoted to a variant
      composed of giant elements. We describe the case of a 13-year-old girl
      experiencing a 3-month history of partial seizures in whom cranial magnetic
      resonance imaging showed an extraventricular, right parietotemporal neoplasm,
      adherent to the overlying dura mater. Histologic, immunohistochemical and
      ultrastructural findings were consistent with those of a high-grade ependymoma.
      The tumor was characterized by the presence of a major component of pleomorphic
      giant cells, as also seen in pleomorphic xantoastrocytoma, subependymal giant
      cell astrocytoma and glioblastoma multiforme. Similar elements have been
      described in two filum terminale and one supratentorial, intraventricular
      ependymoma, respectively. Histologic and evolutional data of those and of our own
      case suggest that isolated giant cells are not necessarily linked to a bad
      prognosis in ependymomas.

PMID- 11220695
TI  - Primary intracerebral malignant melanoma with leptomeningeal spread, extradural
      extension and lung metastasis.
AB  - A rare primary intracerebral solitary malignant melanoma with extracranial
      metastasis is reported. The patient was a 66-year-old man who was revealed to
      have a tumor in the right temporal lobe by MRI. The tumor was totally resected
      and the histopathological diagnosis was malignant melanoma. Despite postoperative
      treatment with chemo-radiotherapy, tumor recurred with multiple subarachnoid
      dissemination. Complete autopsy showed marked leptomeningeal dissemination of
      tumor in the cerebro-spinal compartment. In the outside of the central nervous
      system, a microscopic metastatic nodule was found in the right lung. Metastatic
      tumor in the spinal cord showed the extradural extension which might have led to
      hematogenous metastasis to the lung.

PMID- 11220696
TI  - A case of frontotemporal dementia and parkinsonism of early onset with
      progressive supranuclear palsy-like features.
AB  - We report a patient with frontotemporal degeneration and parkinsonism with mental
      retardation. The patient was a 54-year-old man who had parkinsonism that
      resembled progressive supranuclear palsy, frontotemporal degeneration and
      myoclonus. His family included many affected members. Neuropathologically, there
      was degeneration of the frontal and temporal cortices, the basal ganglia, the
      brainstem and the cerebellum. Microscopically, neuronal loss was severe in the
      frontal and temporal cortex, the globus pallidus, substantia nigra, red nucleus
      and dentate nucleus. Fibrillary changes were found in neurons and glia that were
      immunostained for tau. Although we could not define the genetic abnormalities, we
      thought that this case might have involved frontotemporal dementia and
      parkinsonism linked to chromosome 17.

PMID- 11220697
TI  - Breakage of insulin syringe needle in subcutaneous tissue.
AB  - We report the case of a young girl with diabetes mellitus whose insulin syringe
      needle broke and became embedded in subcutaneous tissue.

PMID- 11220698
TI  - Deletion of the long arm of the Y chromosome in an adolescent with short stature
      and hypogonadism.
AB  - We describe a patient with short stature more than that expected for non-treated
      congenital adrenal hyperplasia due to nonclassic 21-hydroxylase deficiency with
      deletions in the long arm of the Y chromosome including the CGY gene and the AZF
      subregions.

PMID- 11220699
TI  - Bilateral galactocele in a male infant: a rare cause of gynecomastia in
      childhood.
AB  - A galactocele is a rare benign breast lesion usually occurring in females during
      or following lactation. These lesions are a rare cause of breast enlargement in
      infants and children. In this article we present a 10 month-old boy who was
      admitted with a two-month history of bilateral progressive breast enlargement,
      and diagnosed as having galactocele. Our purpose was to emphasize the importance
      of galactocele as a benign condition in the differential diagnosis of
      gynecomastia in childhood.

PMID- 11220700
TI  - Present status of the use of growth hormone in short children with bone diseases
      (diseases of the skeleton).
AB  - Skeletal dysplasias are genetic disorders of bone and cartilage development,
      mainly characterized by disproportionate short stature. Achondroplasia is the
      commonest and best described form of skeletal dysplasia, leading to a mean final
      height of 131+/-5.6 cm for males and 124+/-5.9 cm for females. Growth hormone
      (GH) has been used in different studies in patients with achondroplasia in order
      to ameliorate their height, and short term results range from rather positive to
      moderate. However, disproportionate advancement of bone age has been observed
      that can compromise the positive effect of such treatment. Furthermore, concern
      exists about the aggravation of body disproportion necessitating a later leg
      lengthening procedure in order to achieve proportionate adult stature. In
      hypochondroplasia, GH treatment seems to give better results when administered at
      puberty. No data on final height yet exist, however, so that more studies with
      greater numbers of patients need to be performed before a consensus on GH use in
      achondroplasia and hypochondroplasia can be reached. Other forms of skeletal
      dysplasias are quite rare, so that no conclusion on GH use in such patients can
      be drawn. Finally, in osteogenesis imperfecta, GH administration significantly
      ameliorates bone density but does not clearly seem to affect final height
      positively.

PMID- 11220701
TI  - Molecular characterization of mutations in Indian children with congenital
      adrenal hyperplasia due to steroid 21-hydroxylase deficiency.
AB  - Congenital adrenal hyperplasia (CAH) is the commonest cause of female
      pseudohermaphroditism. It is most often due to steroid 21-hydroxylase deficiency
      resulting from mutations in the CYP21 gene. This study was conducted to
      characterize mutations in the CYP21 gene, determine their frequency and correlate
      genotype with phenotype in Indian children with CAH. Twenty-eight patients with
      salt-wasting (SW) or simple-virilizing (SV) forms of the disease as well as
      parents and siblings were studied. Allele specific PCR was carried out and rapid
      characterization of six mutations was achieved in 23 patients. Twelve patients
      were homozygous for the mutations and 11 were heterozygous, of whom eight were
      compound heterozygotes and three were hemizygotes; no mutation was found in five
      patients. The homozygosity of the mutations was found to be high in our
      population. The most common mutation was Ile173Asn (31.8%), followed by intron2
      splice (27.2%), Gln319stop (22.7%), gene deletion (15.9%) and Pro31Leu (2.2%).
      Genotype-phenotype correlations showed that the most frequent mutations in the SW
      group were intron2 splice and Gln319stop mutations (33.3% each) and Ile173Asn
      (71.4%) in the SV group.

PMID- 11220703
TI  - IGF-I resistance and Turner's syndrome.
AB  - The pathogenesis of growth failure in Turner's syndrome is not clear but might be
      attributed to a decreased sensitivity to insulin-like growth factor-I (IGF-I) in
      distinct cell lines or to its reduced autocrine/paracrine action. Growth hormone
      (GH) therapy leads to increments in IGF-I levels and to growth acceleration. In
      order to evaluate the pattern of overcoming IGF-I resistance through childhood
      and adolescence, we measured IGF-I in 78 girls with Turner's syndrome aged 4.6
      18.3 years on 160 occasions without or during GH (1 IU/kg/week [0.33 mg/kg/week])
      or GH+estradiol (E2) therapy and compared them with local IGF-I standards. In
      untreated patients, IGF-I levels were low normal (-0.71+/-0.18 SDS, mean +/-
      SEM). In both GH or GH+E2 treated girls, circulating IGF-I levels were
      persistently supraphysiological (GH only: +3.61+/-0.23 SDS; GH + estradiol:
      +3.18+/-0.31 SDS). The age-dependent pattern of IGF-I secretion was conserved but
      the pubertal increase occurred earlier. The highest standardized IGF-I levels
      were observed at age 8.5-9.4 years (+6.62+/-1.00 SDS) and 9.5-10.4 years (+5.61+/
      1.03 SDS). GH+E2 substitution had no additional effect on circulating IGF-I. We
      conclude that high IGF-I levels are needed to overcome the IGF-resistance in
      Turner's syndrome. They reflect the action of GH therapy but not of estrogens.
      The earlier pubertal increase of IGF-I might be caused by exaggerated adrenal
      androgens.

PMID- 11220702
TI  - Advances in the molecular genetics of hypogonadotropic hypogonadism.
AB  - Mutations in several genes have been shown to cause hypogonadotropic hypogonadism
      (HHG) in humans. This condition may result from abnormalities in hypothalamic
      gonadotropin-releasing hormone (GnRH) secretion, impaired pituitary gonadotropin
      release, or both. Here, we consider mutations in KAL in X-linked Kallmann
      syndrome; DAX1 in X-linked adrenal hypoplasia congenita; the related orphan
      nuclear receptor, steroidogenic factor-1; leptin and prohormone convertase-1,
      which may influence GnRH release and processing; the GnRH receptor; the pituitary
      transcription factors, HESX-1, LHX3 and PROP-1; and the gonadotropins, follicle
      stimulating hormone (FSH) and luteinizing hormone (LH). Identifying naturally
      occurring mutations in these genes provides important information about the role
      of these factors in the development and function of the hypothalamic-pituitary
      gonadal axis in humans. Different approaches to treatment and counseling may be
      needed, depending on the condition. Furthermore, the pathophysiological basis of
      HHG in the majority of individuals remains unclear, despite recent advances.
      Other candidate genes may be involved in these patients.

PMID- 11220704
TI  - Seasonal variation of birth month and breastfeeding in children with diabetes
      mellitus.
AB  - OBJECTIVE: As breastfeeding is suggested to protect against diabetes mellitus we
      decided to investigate whether the seasonal variation of month of birth of
      diabetic children, with more diabetes in children born in summer, can be
      explained to some extent by a seasonal variation of exclusive breastfeeding.
      PATIENTS: A population-based group of 297 children who had been diagnosed with
      diabetes mellitus before the age of 15 years was compared with 792 matched
      healthy subjects. RESULTS: There was no difference in duration of breast-feeding
      between children who later got diabetes and the controls. Children (both
      diabetics and controls) born during the summer were exclusively breastfed for a
      mean period of 2.2 months. Corresponding figures for children born during winter
      were 2.8 months (p<0.04), spring 2.5 months (n.s.) and autumn 2.7 months
      (p<0.05). Seasonality was most pronounced in children who developed diabetes
      between the ages of 10 and 15 years. CONCLUSION: These results indicate that
      children born during the summer, who have increased risk of developing diabetes
      mellitus, have also been exclusively breastfed for a shorter time.

PMID- 11220705
TI  - Seasonality of birth in children (0-14 years) with type 1 diabetes mellitus in
      Slovenia.
AB  - The aim of this study was to find out whether there is seasonality of month of
      birth of children with diabetes in Slovenia and if so whether it differs from
      that of the general population. A cohort of 849 children and adolescents (0-14
      years) with type 1 diabetes mellitus born between 1956 and 1998 were included in
      the study. Monthly and seasonal patterns of birth of the patients with diabetes
      were compared with the pattern of normal live births (n = 1,345,921) and the
      pattern of disease onset. Statistical analysis was made using Student's t-test to
      compare the means between the four seasons of the year, and single cosinor
      analysis for a period of 12 months. The children and adolescents with diabetes
      had a statistically significant different seasonality of month of birth compared
      to that of the general population, and an opposite pattern from the seasonality
      of month of onset of disease. The observations made are in accordance with
      observations made recently in other countries and support the hypothesis that a
      virus infection transmitted by the mother to the fetus during the annual viral
      epidemic induces the autoimmune process in the pancreatic beta-cells in
      genetically susceptible individuals who will subsequently develop clinical
      diabetes during childhood.

PMID- 11220706
TI  - Early detection of impaired glucose tolerance in patients with cystic fibrosis
      and predisposition factors.
AB  - INTRODUCTION: The number of patients with glucose tolerance alterations
      associated with cystic fibrosis (CF) has increased, probably due to the greater
      survival rate among sufferers of this disease. We studied impaired glucose
      tolerance (IGT) in patients with CF and investigated whether its appearance has
      any relationship with age, sex, genetic mutation and/or the degree of clinical
      involvement. We assessed the parameters that might allow early detection.
      PATIENTS AND METHODS: In 28 patients with CF (14 M, 14 F; aged 22 months to 18
      years), sex, genetic mutation, nutritional status and the degree of pancreatic
      and pulmonary involvement were recorded. The metabolic study included
      glycosylated hemoglobin (HbA1c) determination, oral glucose tolerance test (OGTT)
      and intravenous glucose tolerance tests (IVGTT). RESULTS: In the patients with
      CF, 35.71% showed impaired glucose tolerance (IGT) and 3.57% had diabetes
      mellitus. The patients with IGT and CF were 3.2 years older than those with
      normal glucose tolerance (NGT; p<0.05), but no significant differences were found
      regarding sex, anthropometric measurements, percentage of pulmonary gammagraphic
      involvement, Shwachman-Kulczycki test or HbA1c. In the OGTT, the patients
      homozygous for the deltaF508 mutation had higher blood glucose values than the
      heterozygous group (p=0.03), but these values were not higher than those in
      patients with other mutations. During the OGTT, blood insulin values at 30' were
      reduced in patients with IGT compared to patients with NGT (p<0.02) and the
      insulin peak occurred at 100.9+/-24.3 min compared to 65.3+/-21.8, respectively
      (p<0.05). In the IVGTT, 82.14% of the patients had reduced insulin levels at 1
      and 3 min (I1'+3'). No differences in the blood glucose levels during the OGTT
      were found between patients with normal I1'+3' values and patients with reduced
      values. CONCLUSIONS: A high percentage of patients with CF also present with IGT.
      This increases with age and is more common among patients homozygous for the
      deltaF508 mutation and is not related to clinical status. Alterations in the
      kinetics of insulin secretion play an important role in the appearance of IGT and
      CF. We suggest that the OGTT is a more sensitive method than IVGTT for
      identifying early alterations in CF-related diabetes mellitus.

PMID- 11220707
TI  - Real-time sonography for screening of gallbladder dysfunction in children with
      type 1 diabetes mellitus.
AB  - The aim of this study was to evaluate the occurrence of gallbladder dysfunction
      in children with type 1 diabetes mellitus using real-time ultrasonography. The
      study population consisted of 20 diabetic children (11 male, 9 female; age 11.7+/
      2.8 years; diabetes duration 0.5-7 years) with clinically negative neuropathy
      findings and 15 healthy controls (11 male, 4 female; age 10.5+/-3.7 years). Three
      dimensional measurements of the gallbladder were made before and 15, 30, 45, 60
      min after intake of diet chocolate. Gallbladder volumes were calculated by the
      ellipsoid formula. Fasting gallbladder volume of diabetic children (16.9+/-9.5
      ml) was significantly greater than that of the controls (10.6+/-5.3 ml; p=0.017).
      Ejection fraction and maximal contraction showed no significant difference
      between the two groups. Diabetic patients with multiple microvascular
      complications had diminished gallbladder motility. There was a negative
      correlation between BMI and maximal contraction (p<0.05). Nerve conduction
      velocity was diminished in 45% of the diabetic patients. In conclusion,
      gallbladder function is preserved in pediatric type 1 diabetic patients with a
      disease duration less then 10 years, but dilated gallbladder at rest may be an
      early sign of gastrointestinal autonomic neuropathy and a risk factor for
      gallstone formation.

PMID- 11220708
TI  - Celiac disease and short stature--not always cause and effect.
AB  - Four children with familial short stature were diagnosed with celiac disease (CD)
      by positive serology for antigliadin and antiendomysial antibodies and
      characteristic intestinal biopsy findings. These patients complied well with
      their diet as evidenced by their parents' reports, increase in weight standard
      deviation scores in all but one child, and reversion to seronegativity for
      antigliadin and antiendomysial antibodies in all four. However, typical catch-up
      for linear growth did not occur. In our view, the poor response of linear growth
      is evidence that the original stunting was not due to CD. Since the advent of
      sensitive tests for antiendomysial antibodies, many asymptomatic children have
      been diagnosed as having CD. Some of these children are short and despite a
      history of familial short stature their growth stunting may be wrongly attributed
      to CD. This report highlights this new problem and emphasizes the need for
      caution when predicting growth response to a gluten-free diet.

PMID- 11220709
TI  - High-impact loading training induces bone hyperresorption activity in young elite
      female gymnasts.
AB  - The aim of this study was to investigate the effect of intensive exercise on bone
      turnover (as reflected by bone resorption) in young elite female gymnasts. Forty
      five healthy girls including 24 gymnasts (11.9+/-2 yr) and 21 controls (12.3+/
      1.4 yr) were studied. Body weight, height, bone age and body composition were
      measured. Bone mineral density (BMD) was assessed at the whole body, lumbar
      vertebrae, hip and radius by means of DXA. Volumetric density (BMAD) was
      calculated. Bone velocity (SOS) and attenuation (BUA) were measured by QUS at the
      calcaneus. Urinary androstenedione (delta4), dehydroepiandrosterone sulfate (DHEA
      S), and CrossLaps (CTx) were measured. BMD and BMAD were significantly greater in
      the gymnasts at all sites except whole body. SOS was found significantly higher.
      Delta4 values were significantly lower in the gymnasts. The distribution of the
      subjects according to Tanner stages was not different between groups. CTx levels
      were significantly higher in the gymnasts (989.08+/-154.63 microg/mmol Cr.) vs
      controls (580.25+/-123.99 microg/mmol Cr., p=0.02). CTx values decreased from
      Tanner stage 1 to stage 4 in each group, the gymnasts' levels always being higher
      than those of the controls. In conclusion, gymnastics seems to stimulate bone
      resorption activity in highly-trained young females. The coexistence of bone
      hyperresorption and higher BMD in gymnasts suggests increased bone turnover
      resulting in increased bone density in these subjects.

PMID- 11220710
TI  - The influence of weight loss on fibrinolytic and metabolic parameters in obese
      children and adolescents.
AB  - We studied i) whether short-term weight loss alters plasminogen activator
      inhibitor-1 antigen (PAI-1-Ag) and tissue-type plasminogen activator antigen (tPA
      Ag) in obese children, and ii) whether changes in body composition and/or
      abdominal adiposity are responsible for changes in PAI-1 and tPA-Ag. 20 obese
      boys (mean age 11.9 yr) and 40 obese girls (mean age 12 yr) were studied before
      and after three weeks of low-caloric diet and physical activity. Body composition
      was assessed by means of bioelectrical impedance, and the waist-to-hip ratio
      (WHR) was measured. Blood samples were determined for insulin, glucose,
      triglycerides, PAI-1-Ag, tPA-Ag, and the fasting insulin resistance index (FIRI)
      was calculated. Boys had a greater WHR, higher levels of glucose, and a slightly
      greater FIRI than girls. Estimates of adiposity, insulin, and triglycerides were
      correlated with PAI-1 and tPA-Ag. WHR was significantly correlated with
      fibrinolytic parameters only in girls. Insulin and tPA-Ag contributed to PAI-1
      (adj. R2 = 0.36, p <0.0001), whereas percentage fat mass and triglycerides
      contributed to tPA-Ag (adj. R2 = 0.469, p <0.0001). The weight loss program
      significantly reduced adiposity, abdominal adiposity, and lowered fibrinolytic
      and metabolic parameters. Initial levels of PAI-1 and changes in body mass
      contributed to the fall in PAI-1 (adj. R2 = 0.18, p = 0.0016) and initial levels
      of tPA-Ag contributed significantly to changes in tPA-Ag (adj. R2 = 0.57, p
      <0.0001). The results suggest that changes in fibrinolytic parameters are
      associated with the loss in body mass but can occur independently of a
      concomitant reduction in fatness. Although initial PAI-1 and tPA-Ag predict the
      changes of these fibrinolytic parameters, the results do not exclude the
      possibility that the improvement in metabolic state and changes in unmeasured
      parameters related to physical activity and low-caloric diet could have
      influenced our findings.

PMID- 11220712
TI  - Thyroid eye disease in children and adolescents--new therapeutic approaches.

PMID- 11220713
TI  - "Insignificant" mechanism of injury: not to be taken lightly.
AB  - BACKGROUND: Trauma resources should be spent rationally. The mechanism of trauma
      is used extensively to triage patients to appropriate levels of care. We examine
      the hypothesis that patients with "insignificant" mechanism of trauma may have
      major injuries that require expert trauma care. STUDY DESIGN: Over 9 months at a
      high-volume Level I trauma center, a prospective study was done on patients who
      sustained ground-level falls (GLF), low-level falls (LLF) from less than 10 feet,
      or were found down (FD) with no external evidence of significant trauma, and
      required evaluation by the trauma team. Of 301 patients included, 110 (37%) had
      GLF, 95 (31%) LLF, and 96 (32%) FD. Our main outcomes measure was significant
      injuries, defined as visceral or intracranial injuries, long-bone, pelvic,
      facial, or spinal fractures. RESULTS: One hundred ten patients (37%) had
      significant injuries, 20 (7%) were admitted to the ICU, 14 (5%) required an
      operation, and 4 (1%) died. The most common injuries were intracranial and
      skeletal. Almost all patients were evaluated by CT (95%), but only one-quarter
      had abnormal findings on it. LLF, age more than 55 years, and the absence of
      severe intoxication (blood alcohol level of less than 200 mg/dL) were independent
      risk factors for significant injuries. A statistical prediction model showed
      that, when all risk factors are present, the probability of significant injuries
      is 73%; when all risk factors are absent, there is still a 16% chance for
      significant injuries. Patients with significant injuries had more operations,
      longer hospital stays, and higher hospitalization costs compared with patients
      without significant injuries. CONCLUSIONS: Low-energy trauma may produce
      significant injuries, predominantly intracranial and skeletal. Trauma care
      providers should be cautious about dismissing such patients based on the trivial
      mechanism of injury. Patients with LLF who are older than 55 years and not
      severely intoxicated have a high likelihood for significant injuries. Resources
      should be spent rationally for patients who do not have these characteristics,
      because the probability of significant injuries among them is low, but not zero.

PMID- 11220711
TI  - Seasonality of month of birth of children (0-14 years old) with type 1 diabetes
      mellitus in the District of Catania, Sicily.

PMID- 11220714
TI  - An evaluation of risk factors for mortality after burn trauma and the
      identification of gender-dependent differences in outcomes.
AB  - BACKGROUND: The primary objective of this study was to determine an objective
      method for estimating the risk of mortality after burn trauma, and secondarily,
      to evaluate the relationship between gender and mortality, in the setting of a
      quantifiable inflammatory stimulus. Previously reported estimates of mortality
      risk after burn trauma may no longer be applicable, given the overall reduction
      in case-fatality rates after burn trauma. We expect that future advances in burn
      trauma research will require careful and ongoing quantification of mortality risk
      factors to measure the importance of newly identified factors and to determine
      the impact of new therapies. Conflicting clinical reports regarding the impact of
      gender on survival after sepsis and critical illness may in part, be from
      different study designs, patient samples, or failure to adequately control for
      additional factors contributing to the development ofsepsis and mortality. STUDY
      DESIGN: Data from the prospectively maintained burn registry for patients
      admitted to the Parkland Memorial Hospital burn unit between January 1, 1989 and
      December 31, 1998 were analyzed. Logistic regression was used to generate
      estimates of the probability of death in half of the study sample, and this model
      was validated on the second half of the sample. Risk factors evaluated for their
      relationship with mortality were: age, inhalation injury, burn size, body mass
      (weight), preexisting medical conditions, nonburn injuries, and gender. RESULTS:
      Of 4,927 patients, 5.3% died. The best model for estimating mortality included
      the percent of total body surface area burned; the percent of full-thickness burn
      size; the presence of an inhalation injury; age categories of: < 30 years, 30 to
      59 years, > or = 60 years; and gender. The risk of death was approximately two
      fold higher in women aged 30 to 59 years compared with men of the same age.
      CONCLUSIONS: We have provided a detailed method for estimating the risk of
      mortality after burn trauma, based on a large, contemporary cohort of patients.
      These estimates were validated on a second sample and proved to predict mortality
      accurately. We have identified an increased mortality risk in women of 30 to 59
      years of age.

PMID- 11220715
TI  - A potentially expanded role for enoxaparin in preventing venous thromboembolism
      in high risk blunt trauma patients.
AB  - BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially life
      threatening complication after trauma. The purpose of this study is to
      investigate the effectiveness of enoxaparin in preventing deep venous thrombosis
      (DVT) and pulmonary embolism (PE) after injury in patients who are at high risk
      for developing VTE. STUDY DESIGN: A prospective single-cohort observational study
      was initiated for seriously injured blunt trauma patients admitted to a Level I
      trauma center during a 7-month period. Patients were eligible for the study if
      time hospitalized was > or = 72 hours, Injury Severity Score (ISS) was > or = 9,
      enoxaparin was started within 24 hours after admission, and one or more of the
      following high risk criteria were met: age > 50 years, ISS > or = 16, presence of
      a femoral vein catheter, Abbreviated Injury Score (AIS) > or = 3 for any body
      region, Glasgow Coma Scale (GCS) Score < or = 8, presence of major pelvic, femur,
      or tibia fracture, and presence of direct blunt mechanism venous injury. Patients
      with closed head injuries and nonoperatively treated solid abdominal organ
      injuries were also potential participants. The primary outcomes measured were
      thromboembolic events--either a documented lower extremity DVT by duplex color
      flow doppler ultrasonography or a PE documented by rapid infusion CT pulmonary
      angiography or conventional pulmonary angiography. RESULTS: There were 118
      patients enrolled in the study. Two patients (2%) developed DVT, one of which was
      proximal to the calf (95% confidence interval, 0% to 6%). Two of 12 patients
      (17%) with splenic injuries who received enoxaparin failed initial nonoperative
      management. There were no other bleeding complications, and no clinical evidence
      or documented episodes of PE. One patient died from multiple system organ
      failure. CONCLUSIONS: Enoxaparin is a practical and effective method for reducing
      the incidence of VTE in high risk, seriously injured patients. This study
      supports further investigation into the safety of enoxaparin prophylaxis in
      patients with closed head injuries and nonoperatively treated solid abdominal
      organ injuries.

PMID- 11220716
TI  - Safety and accuracy of bedside carbon dioxide cavography for insertion of
      inferior vena cava filters in the intensive care unit.
AB  - BACKGROUND: Bedside insertion of inferior vena caval filters (IVCFs) avoids risks
      associated with transporting these critically ill patients to the operating room
      or to the radiology suite. But because IVCF insertion requires preinsertion caval
      imaging, the risk of contrast-induced renal failure remains a concern. Carbon
      dioxide (CO2) as a contrast agent does not cause renal failure, but its accuracy
      in determining vena caval diameter (a critical factor in filter selection) and
      its safety in the critical care population are unknown. This study is designed to
      assess the safety of using CO2 as a contrast agent in this patient population and
      to evaluate its accuracy in determining the diameter of the inferior vena cava
      when used at the bedside. STUDY DESIGN: A prospective study comparing CO2 with
      iodinated contrast (IC) material was performed in critically ill patients
      undergoing vena cavography before bedside IVCF placement. CO2 cavagrams were
      performed with one or more hand injections of 60 mL of CO2; a single injection of
      40 mL of IC material was used. Digital subtraction techniques were used for all
      of the studies. Blood pressure, pulse rate, and arterial oxygen saturation, end
      tidal CO2, and intracranial pressure (when available) were recorded before,
      during, and after contrast injection. Statistical analysis was performed using
      the paired t-test, with p < 0.05 being considered significant. Data are expressed
      as mean +/- SD. RESULTS: Twenty-three patients were studied. Mean transverse
      inferior vena cava (IVC) diameters measured 20.4 +/- 0.7mm (IC) and 20.0 +/-
      0.7mm (CO2); p = 0.003. The difference in the measurements was 0.4 +/- 0.1 mm,
      with the largest difference being 1.7mm. In the remaining 10 patients, CO2
      differed from IC in determining IVC diameter by only 0.4mm, a statistically
      significant (p < 0.05) but clinically insignificant difference. No adverse
      effects on blood pressure, pulse, arterial oxygen saturation, end-tidal CO2, or
      intracranial pressure were noted with the use of CO2. CONCLUSIONS: Carbon dioxide
      as a contrast agent is safe and provides accurate determination of vena caval
      diameter and anatomy. Carbon dioxide should be considered the contrast agent of
      choice in critically ill patients.

PMID- 11220717
TI  - Continued (5-year) followup of a randomized clinical study comparing antireflux
      surgery and omeprazole in gastroesophageal reflux disease.
AB  - BACKGROUND: The efficacy of antireflux surgery (ARS) and proton pump inhibitor
      therapy in the control of gastroesophageal reflux disease is well established. A
      direct comparison between these therapies is warranted to assess the benefits of
      respective therapies. STUDY DESIGN: There were 310 patients with erosive
      esophagitis enrolled in the trial. There were 155 patients randomized to
      continuous omeprazole therapy and 155 to open antireflux surgery, of whom 144
      later had an operation. Because of various withdrawals during the study course,
      122 patients originally having an antireflux operation completed the 5-year
      followup; the corresponding figure in the omeprazole group was 133. Symptoms,
      endoscopy, and quality-of-life questionnaires were used to document clinical
      outcomes. Treatment failure was defined to occur if at least one of the following
      criteria were fulfilled: Moderate or severe heartburn or acid regurgitation
      during the last 7 days before the respective visit; Esophagitis of at least grade
      2; Moderate or severe dysphagia or odynophagia symptoms reported in combination
      with mild heartburn or regurgitation; If randomized to surgery and subsequently
      required omeprazole for more than 8 weeks to control symptoms, or having a
      reoperation; If randomized to omeprazole and considered by the responsible
      physician to require antireflux surgery to control symptoms; If randomized to
      omeprazole and the patient, for any reason, preferred antireflux surgery during
      the course of the study. Treatment failure was the primary outcomes variable.
      RESULTS: When the time to treatment failure was analyzed by use of the intention
      to treat approach, applying the life table analysis technique, a highly
      significant difference between the two strategies was revealed (p < 0.001), with
      more treatment failures in patients who originally were randomized to omeprazole
      treatment. The protocol also allowed dose adjustment in patients allocated to
      omeprazole therapy to either 40 or 60 mg daily in case of symptom recurrence. The
      curves subsequently describing the failure rates still remained separated in
      favor of surgery, although the difference did not reach statistical significance
      (p = 0.088). Quality of life assessment revealed values within normal ranges in
      both therapy arms during the 5 years. CONCLUSIONS: In this randomized multicenter
      trial with a 5-year followup, we found antireflux surgery to be more effective
      than omeprazole in controlling gastroesophageal reflux disease as measured by the
      treatment failure rates. But if the dose of omeprazole was adjusted in case of
      relapse, the two therapeutic strategies reached levels of efficacy that were not
      statistically different.

PMID- 11220718
TI  - Incidental appendectomy in the era of managed care and laparoscopy.
AB  - BACKGROUND: In a study carried out before laparoscopy or managed care, there was
      no cost or patient benefit for routine incidental appendectomy. With the onset
      oflaparoscopy, a change in indications for surgery, and increased prevalence of
      capitated contracts, a reanalysis of the cost-effectiveness of incidental
      appendectomy is warranted. STUDY DESIGN: Financial data from 251 patients
      undergoing appendectomy for acute appendicitis without complication at a single
      institution were identified. Age-specific epidemiology data from the Centers for
      Disease Control, Atlanta, were applied to assess risk and cost of future
      appendectomy. The net cost or savings for incidental appendectomies necessary to
      prevent one case of acute appendectomy was determined and stratified by gender
      and age to the population as a whole. Further adjustment was made for the
      variable level of surgeon reimbursement for incidental appendectomy. RESULTS: At
      10% surgeon reimbursement, open incidental appendectomy was cost-effective in
      those less than 25 years of age (< 35 years of age in a capitated system).
      Applied to the general population, open incidental appendectomy in those less
      than 25 years represented savings of up to $1,100 per 10,000 population per year.
      A surgeon fee of greater than 50%, or the laparoscopic approach using staplers,
      accrued no savings in any age groups. CONCLUSIONS: Open incidental appendectomy
      at low physician reimbursement is a cost-effective procedure for patients of less
      than 35 years of age. A decrease in equipment cost for laparoscopic approach will
      extend these indications.

PMID- 11220719
TI  - Laparoscopic cholecystectomy does not demonstrably decrease survival of patients
      with serendipitously treated gallbladder cancer.
AB  - BACKGROUND: The purpose of this study was to evaluate the possibility that
      laparoscopic cholecystectomy has worsened the prognosis of patients with resected
      gallbladder cancer; particularly for patients whose cancer was accidentally
      resected. STUDY DESIGN: We conducted a retrospective review of Connecticut Tumor
      Registry data and data extracted from individual patient records at 15 of 30
      hospitals in Connecticut reporting data to the Registry, at two separate time
      points, 1985-1988 (immediate prelaparoscopic era) and 1992-95 (laparoscopic
      cholecystectomy well established). There were 194 and 208 patients in each 3-year
      period, respectively. Additional information was extracted from hospital records
      in 82 and 91 patients, respectively. Twenty-five percent of patients in both data
      sets presented with "local" or Tis, T1, T2 disease. RESULTS: Three-year survival
      for localized disease was 29% in the prelaparoscopic period and 34% once
      laparoscopic cholecystectomy was established. But analysis of individual patient
      records indicated that 36% of patients from the laparoscopic period did not
      actually undergo a laparoscopic procedure. Fifty-nine patients had their
      gallbladder cancer discovered in the specimen postoperatively (serendipitously
      treated). A higher proportion of cancers were discovered postoperatively in the
      laparoscopic era (44% versus 24%). Three-year survival for these patients was
      25%. If the data from the two eras are grouped according to whether or not the
      cancer-bearing gallbladder was manipulated laparoscopically, 24 of 59 patients
      (41%) turned out to be at risk for the possibility of increased laparoscopic
      dissemination of tumor. Survival of these patients (11-month median survival) was
      not statistically different from survival of patients whose serendipitously
      discovered gallbladder cancer was never manipulated laparoscopically (16-month
      median survival); p = 0.54 by log rank test. CONCLUSIONS: The widespread adoption
      of laparoscopic cholecystectomy did not worsen the survival of patients with
      gallbladder cancer, and patients with serendipitously treated gallbladder cancers
      did not have a worse survival after laparoscopic manipulation than after a
      standard open cholecystectomy. The laparoscopic aspects of operative manipulation
      of a gallbladder with cancer in it do not appear to be a proximate cause of the
      poor prognosis in this disease.

PMID- 11220720
TI  - Ductal carcinoma in situ (DCIS) of the breast: diagnostic and therapeutic
      controversies.

PMID- 11220721
TI  - Benjamin Church: physician, patriot, and spy.

PMID- 11220722
TI  - Systemic treatment after sentinel lymph node biopsy in breast cancer: who, what,
      and why?
AB  - SLNB, although subject to numerous technical problems, has nonetheless shown
      great promise in predicting the status of the remaining axillary lymph nodes. The
      growing use of SLNB has presented the opportunity of using immunohistochemical
      and molecular markers to detect occult micrometastases. These micrometastases may
      be important for more accurate staging and prediction of patient outcomes.
      Current standards for the use of systemic therapy recommend multidrug
      chemotherapy for all but the most favorable disease (T1a/b, NO). The detection of
      micrometastases by SLNB in this low-risk group may change treatment
      recommendations to include systemic therapy. Because of the significant frequency
      of false-negative results in SLNB, which will depend upon the surgeon's
      experience, caution is urged in determining when ALND can be safely eliminated in
      patients with a negative SLNB.

PMID- 11220723
TI  - Fullterm abdominal pregnancy, mother and infant survival.

PMID- 11220724
TI  - Boerhaave's syndrome.

PMID- 11220725
TI  - Transposition of the basilic vein for arteriovenous fistula: an endoscopic
      approach.

PMID- 11220726
TI  - Domino liver transplantation with end-to-side infrahepatic vena cavocavostomy.

PMID- 11220727
TI  - What's new in burns and metabolism.

PMID- 11220728
TI  - What's new in vascular surgery.

PMID- 11220730
TI  - NIH consensus panel recommends a range of adjuvant therapies for women with
      breast cancer.

PMID- 11220729
TI  - What's new in trauma and critical care.

PMID- 11220731
TI  - Yet another paraneoplastic antibody.

PMID- 11220732
TI  - Deep brain stimulation for Parkinson's disease.

PMID- 11220733
TI  - The case of the missing tau, or, why didn't the mRNA bark?

PMID- 11220734
TI  - CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related
      autoimmunity.
AB  - We have defined a new paraneoplastic immunoglobulin G (IgG) autoantibody specific
      for CRMP-5, a previously unknown 62-kd neuronal cytoplasmic protein of the
      collapsin response-mediator family. CRMP-5 is in adult central and peripheral
      neurons, including synapses, and in small-cell lung carcinomas. Since 1993, our
      Clinical Neuroimmunology Laboratory has detected CRMP-5-IgG in 121 patients among
      approximately 68,000 whose sera were submitted for standardized
      immunofluorescence screening because a subacute neurological presentation was
      suspected to be paraneoplastic. This makes CRMP-5 autoantibody as frequent as PCA
      1 (anti-Yo) autoantibody, second only to ANNA-1 (anti-Hu). Clinical information,
      obtained for 116 patients, revealed multifocal neurological signs. Most
      remarkable were the high frequencies of chorea (11%) and cranial neuropathy (17%,
      including 10% loss of olfaction/taste, 7% optic neuropathy). Other common signs
      were peripheral neuropathy (47%), autonomic neuropathy (31%), cerebellar ataxia
      (26%), subacute dementia (25%), and neuromuscular junction disorders (12%).
      Spinal fluid was inflammatory in 86%, and CRMP-5-IgG in 37% equaled or
      significantly exceeded serum titers. Lung carcinoma (mostly limited small-cell)
      was found in 77% of patients; thymoma was in 6%. Half of those remaining had
      miscellaneous neoplasms; all but two were smokers. Serum IgG in all cases bound
      to recombinant CRMP-5 (predominantly N-terminal epitopes), but not to human CRMP
      2 or CRMP-3.

PMID- 11220735
TI  - Functional correlates of pallidal stimulation for Parkinson's disease.
AB  - We measured regional cerebral blood flow with H2 15O and positron emission
      tomography (PET) scanning at rest and during a motor task to study the mechanism
      of motor improvement induced by deep brain stimulation of the internal globus
      pallidus in Parkinson's disease. Six right-handed patients with Parkinson's
      disease were scanned while performing a predictable paced sequence of reaching
      movements and while observing the same screen displays and tones. PET studies
      were performed ON and OFF stimulation in a medication-free state. Internal globus
      pallidus deep brain stimulation improved off-state United Parkinson's Disease
      Rating Scale motor ratings (37%, p < 0.002) and reduced timing errors (movement
      onset time, 55%, p < 0.01) as well as spatial errors (10%, p < 0.02). Concurrent
      regional cerebral blood flow recordings revealed a significant enhancement of
      motor activation responses in the left sensorimotor cortex (Brodmann area [BA]
      4), bilaterally in the supplementary motor area (BA 6), and in the right anterior
      cingulate cortex (BA 24/32). Significant correlations were evident between the
      improvement in motor performance and the regional cerebral blood flow changes
      mediated by stimulation. With internal globus pallidus deep brain stimulation,
      improved movement initiation correlated with regional cerebral blood flow
      increases in the left sensorimotor cortex and ventrolateral thalamus and in the
      contralateral cerebellum. By contrast, improved spatial accuracy correlated with
      regional cerebral blood flow increases in both cerebellar hemispheres and in the
      left sensorimotor cortex. These results suggest that internal globus pallidus
      deep brain stimulation may selectively improve different aspects of motor
      performance. Multiple, overlapping neural pathways may be modulated by this
      intervention.

PMID- 11220736
TI  - Loss of brain tau defines novel sporadic and familial tauopathies with
      frontotemporal dementia.
AB  - Dementia lacking distinctive histopathology (DLDH) or frontotemporal lobe
      degeneration (FTLD) is the most common neuropathological diagnosis for sporadic
      frontotemporal dementias (FTDs). The hallmarks of DLDH are neuron loss and
      gliosis in the absence of any disease-specific brain lesion. Similar brain
      pathology is also seen in a familial FTD pedigree known as hereditary dysphasic
      disinhibition dementia 2 (HDDD2). Abnormality in the function or isoform
      composition of the microtubule binding protein tau is a prominent feature in the
      brains of many patients with sporadic and hereditary FTDs. Therefore, we studied
      the tau protein in different brain regions from DLDH and HDDD2 patients. Our
      results indicate that a selective loss of all six tau isoforms, but not tau mRNA,
      occurs in these brains compared to normal control and Alzheimer's disease brains.
      Loss of tau protein was identified by Western blot analysis of protein extracts
      from DLDH and HDDD2 brains in regions both with and without neuronal
      degeneration. Functionally, this loss of tau protein may be equivalent to
      pathogenic mutations in the tau gene identified in familial FTD with parkinsonism
      linked to chromosome 17 (FTDP-17). Thus, DLDH and HDDD2 are novel tauopathies
      with a unique mechanism of pathogenesis. The presence of tau mRNA in these brains
      suggests that the level of tau protein may be controlled posttranscriptionally,
      at the level of either translation or mRNA stability.

PMID- 11220737
TI  - Increased expression of the pro-inflammatory enzyme cyclooxygenase-2 in
      amyotrophic lateral sclerosis.
AB  - Mutations in the copper/zinc superoxide dismutase (mSOD1) gene are associated
      with a familial form of amyotrophic lateral sclerosis (ALS), and their expression
      in transgenic mice produces an ALS-like syndrome. Recent observations suggest a
      role for inflammatory-related events in the progression and propagation of the
      neurodegenerative process in ALS. Consistent with this view, the present study
      demonstrates that, during the course of the disease, the expression of
      cyclooxygenase type 2 (Cox-2), a key enzyme in the synthesis of prostanoids,
      which are potent mediators of inflammation, is dramatically increased. In both
      early symptomatic and end-stage transgenic mSOD1 mice, neurons and, to a lesser
      extent, glial cells in the anterior horn of the spinal cord exhibit robust Cox-2
      immunoreactivity. Cox-2 mRNA and protein levels and catalytic activity are also
      significantly increased in the spinal cord of the transgenic mSOD1 mice. The time
      course of the spinal cord Cox-2 upregulation parallels that of motor neuronal
      loss in transgenic mSOD1 mice. We also show that Cox-2 activity is dramatically
      increased in postmortem spinal cord samples from sporadic ALS patients. We
      speculate that Cox-2 upregulation, through its pivotal role in inflammation, is
      instrumental in the ALS neurodegenerative process and that Cox-2 inhibition may
      be a valuable therapeutic avenue for the treatment of ALS.

PMID- 11220738
TI  - Evolution of phenotypes in adult male patients with X-linked
      adrenoleukodystrophy.
AB  - Our objective was to study the phenotype evolution of X-linked
      adrenoleukodystrophy (X-ALD) and the relation between axonal degeneration and
      cerebral demyelination. Although different X-ALD phenotypes are recognized,
      little is known about their evolution. Neuropathological and electrophysiological
      studies have shown that X-ALD is a disease with mixed features of axonal
      degeneration, leading to myeloneuropathy, and a severe inflammatory reaction in
      the cerebral white matter, resulting in demyelination. Retrospectively, 129 men
      with X-ALD were studied who were 1) at least 20 years presently or at the time of
      death, and 2) regularly monitored. Phenotype assignments were made at diagnosis
      and at present, or at death, using medical history and findings of neurological
      examination. Handicap was studied with the modified Rankin scale, and cerebral
      abnormalities with the X-ALD MRI severity (Loes) score. The mean follow-up
      interval was 10.1 +/- 5.0 years. Among 32 patients neurologically asymptomatic at
      diagnosis, 16 (50%) developed neurological deficits. Among 68
      adrenomyeloneuropathy (AMN) patients initially without clinical brain
      involvement, 13 (19%) additionally developed cerebral demyelination. In a subset
      of 60 AMN patients, a moderate handicap evolved over a period of 16.2 +/- 8.9
      years. Among 13 AMN patients with additional definite or probable cerebral
      involvement at diagnosis, eight died and one remained in a vegetative state. Most
      of the 16 patients with the cerebral phenotypes deteriorated. There is a high
      risk for adult neurologically asymptomatic patients to develop neurological
      deficits and for AMN patients to develop cerebral demyelination. Axonal
      degeneration and cerebral demyelination emerge in X-ALD independently of each
      other. This may have implications for the phenotype classification, the search
      for modifying factors, and the development and evaluation of new therapies.

PMID- 11220739
TI  - Mutations in the complex I NDUFS2 gene of patients with cardiomyopathy and
      encephalomyopathy.
AB  - Human complex I is built up and regulated by genes encoded by the mitochondrial
      DNA (mtDNA) as well as the nuclear DNA (nDNA). In recent years, attention mainly
      focused on the relation between complex I deficiency and mtDNA mutations.
      However, a high percentage of consanguinity and an autosomal-recessive mode of
      inheritance observed within our patient group as well as the absence of common
      mtDNA mutations make a nuclear genetic cause likely. The NDUFS2 protein is part
      of complex I of many pro- and eukaryotes. The nuclear gene coding for this
      protein is therefore an important candidate for mutational detection studies in
      enzymatic complex I deficient patients. Screening of patient NDUFS2 cDNA by
      reverse transcriptase-polymerase chain reaction (RT-PCR) in combination with
      direct DNA sequencing revealed three missense mutations resulting in the
      substitution of conserved amino acids in three families.

PMID- 11220740
TI  - Loss and atrophy of layer II entorhinal cortex neurons in elderly people with
      mild cognitive impairment.
AB  - Layer II of the entorhinal cortex contains the cells of origin for the perforant
      path, plays a critical role in memory processing, and consistently degenerates in
      end-stage Alzheimer's disease. The extent to which neuron loss in layer II of
      entorhinal cortex is related to mild cognitive impairment without dementia has
      not been extensively investigated. We analyzed 29 participants who came to
      autopsy from our ongoing longitudinal study of aging and dementia composed of
      religious clergy (Religious Orders Study). All individuals underwent detailed
      clinical evaluation within 12 months of death and were categorized as having no
      cognitive impairment (n = 8), mild cognitive impairment (n = 10), or mild or
      moderate Alzheimer's disease (n = 11). Sections through the entorhinal cortex
      were immunoreacted with an antibody directed against a neuron-specific nuclear
      protein (NeuN). Stereological counts of NeuN-immunoreactive stellate cells, their
      volume, and the volume of layer II entorhinal cortex were estimated. Cases
      exhibiting no cognitive impairment averaged 639,625 +/- 184,600 layer II stellate
      neurons in the right entorhinal cortex. Individuals with mild cognitive
      impairment (63.5%; p < 0.0003) and mild or moderate Alzheimer's disease (46.06%;
      p < 0.0017) displayed significant losses of layer II entorhinal cortex neurons
      relative to those with no cognitive impairment but not relative to each other (p
      > 0.33). There was also significant atrophy of layer II entorhinal cortex neurons
      in individuals with mild cognitive impairment (24.1%) and Alzheimer's disease
      (25.1%). The volume of layer II was also reduced in individuals with mild
      cognitive impairment (26.5%), with a further reduction in those with Alzheimer's
      disease (46.4%). The loss and atrophy of layer II entorhinal cortex neurons
      significantly correlated with performance on clinical tests of declarative
      memory. Atrophy of layer II entorhinal cortex and the neurons within this layer
      significantly correlated with performance on the Mini Mental Status Examination.
      These data indicate that atrophy and loss of layer II entorhinal cortex neurons
      occur in elderly subjects with mild cognitive impairment prior to the onset of
      dementia and suggests that these changes are not exacerbated in early Alzheimer's
      disease.

PMID- 11220741
TI  - Paraneoplastic anti-CV2 antibodies react with peripheral nerve and are associated
      with a mixed axonal and demyelinating peripheral neuropathy.
AB  - Subacute sensory neuronopathy with anti-Hu antibodies is the best-characterized
      paraneoplastic peripheral neuropathy associated with carcinoma. Anti-CV2
      antibodies, another group of paraneoplastic antibodies, react with a 66-kd brain
      protein belonging to the family of Ulip/CRMP proteins. The manifestations
      associated with anti-CV2 antibodies include cerebellar degeneration, uveitis, and
      peripheral neuropathy. Some of these patients also have anti-Hu antibodies. We
      have compared the clinical, electrophysiological, and pathological
      characteristics of the peripheral neuropathy in 9 patients with anti-CV2
      antibodies (3 of whom also had anti-Hu antibodies) and 12 patients with only anti
      Hu antibodies. Data for patients with anti-Hu antibodies alone indicated subacute
      sensory neuronopathy. Patients with anti-CV2 antibodies had a mixed axonal and
      demyelinating sensory motor neuropathy that was sometimes superimposed on
      subacute sensory neuronopathy when both anti-CV2 and anti-Hu antibodies were
      present. Unlike anti-Hu antibodies, anti-CV2 antibodies reacted with peripheral
      nerve antigens, as shown by their ability to bind to a 66-kd protein in human and
      rat nerve on Western blot analysis and to immunolabel peripheral nerve axons and
      sensory neurons on immunohistochemical study.

PMID- 11220742
TI  - Improved cerebrovascular patency following therapy in patients with sickle cell
      disease: initial results in 4 patients who received HLA-identical hematopoietic
      stem cell allografts.
AB  - To test whether magnetic resonance angiography can document the evolution of
      vasculopathy in patients with sickle cell disease, we reviewed records to
      identify all patients who underwent magnetic resonance angiography from 1993 to
      1999. Of 512 angiographies performed, 105 were of sickle cell disease patients,
      and 24 sickle cell disease patients 7 years of age or older underwent baseline
      and follow-up examinations. Films were paired by patient, blinded as to
      examination date and treatment, and quantitatively compared. Four patients who
      received allogeneic bone marrow transplantation were compared to 7 patients who
      received other therapy and to 13 untreated patients. Quantitative analysis
      revealed a 10% increase in the measured diameter of 64 vessels (p = 0.001)
      following any treatment. Patients who had undergone allogeneic bone marrow
      transplantation exhibited a 12% increase in the lumen of 22 vessels (p = 0.041),
      whereas patients treated with chronic transfusion or hydroxyurea exhibited an 8%
      increase in 42 vessels (p = 0.016). In 2 patients with severe stenosis, the
      artery normalized after transplantation, and the blood flow rate was reduced in
      all patients who underwent transplantation. In untreated patients, there was a
      trend for the size of the arterial lumen to decrease, which is consistent with
      disease progression. Results suggest that treatment can reverse progression of
      vasculopathy. Bone marrow transplantation may enable stenoses to heal and can
      substantially reduce cranial blood velocity, suggesting that allogeneic bone
      marrow transplantation may prevent infarction or brain damage.

PMID- 11220743
TI  - HIV-1 Tat neurotoxicity is prevented by matrix metalloproteinase inhibitors.
AB  - The release of potentially neurotoxic molecules by HIV-infected brain macrophages
      is accompanied by neuronal injury and death that results in the development of
      HIV-associated dementia (HAD). Among the potential neurotoxins implicated in the
      development of HAD is the HIV-1 transactivating protein, Tat. To investigate the
      mechanism by which Tat causes neurotoxicity, brain-derived Tat sequences from
      nondemented (Tat-ND) and demented (Tat-HAD) AIDS patients, which differed
      primarily in the augmenting region of Tat, were expressed in U937 monoblastoid
      cells and primary human macrophages. Cells expressing Tat-HAD protein exhibited
      elevated matrix metalloproteinase (MMP)-2 and -7 release and activation, but
      cells expressing Tat-ND did not exhibit enhanced MMP expression. Conditioned
      media from Tat-HAD-transfected cells caused significantly greater neuronal death
      (15.4 +/- 4.3%) than did Tat-ND (4.4 +/- 2.1%) or nontransfected (2.1 +/- 0.8%)
      cell-derived conditioned media. The neurotoxicity induced by Tat-HAD was
      inhibited by anti-MMP-2 or -7 antibodies (p < 0.005) but not by antibodies
      against MMP-9 or Tat. Similarly, scid/nod mice receiving striatal implants of Tat
      HAD-transfected cells exhibited greater neurobehavioral abnormalities and
      neuronal loss (p < 0.005) than did animals receiving Tat-ND or nontransfected
      cells, which were reduced by treatment with the MMP inhibitor prinomastat (p <
      0.005). These findings indicate that Tat causes neuronal death through an
      indirect mechanism that is Tat sequence dependent and involves the induction of
      MMPs.

PMID- 11220744
TI  - Abnormal activity in the globus pallidus in off-period dystonia.
AB  - Pallidotomy was performed in a parkinsonian patient with off-period foot
      dystonia. Dystonia appeared at the beginning of surgery and disappeared after the
      first microelectrode penetration of the globus pallidus, perhaps a
      micropallidotomy effect. Neuronal recording during dystonia revealed that the
      mean firing rates were low in both the internal and external segments of the
      globus pallidus, and that firing was irregular in the internal segment of the
      globus pallidus, compared with firing patterns in offstate parkinsonian patients
      without dystonia. These firing patterns immediately changed into those of
      nondystonic, off-state parkinsonism after relief of dystonia These results
      suggest that off-period dystonia results from the same physiological change in
      the basal ganglia as that in primary dystonia.

PMID- 11220745
TI  - Further evidence that neurofilament light chain gene mutations can cause Charcot
      Marie-Tooth disease type 2E.
AB  - A missense mutation in the neurofilament light chain gene (NEFL, NF-L) at
      chromosome 8p21 was recently reported in a single Charcot-Marie-Tooth type 2
      family (CMT2). This new CMT2 variant is designated CMT2E. The NEFL gene mutation
      showed co-segregation with the disease phenotype and is thus most likely the
      disease-causing mutation. However, the possibility that it is a closely linked
      rare polymorphism can not be ruled out with certainty. We observed a novel NEFL
      missense mutation in a second CMT family, providing supporting evidence that
      CMT2E is caused by NEFL gene mutations.

PMID- 11220746
TI  - Anti-Yo antibodies and cerebellar degeneration in a man with adenocarcinoma of
      the esophagus.
AB  - Serum antibodies to the Yo antigen are usually associated with paraneoplastic
      cerebellar degeneration arising in female patients with gynecological or breast
      malignancy and are rarely associated with other tumors. We report a male patient
      who presented with paraneoplastic cerebellar degeneration and anti-Yo antibodies
      following removal of an esophageal adenocarcinoma. This is only the third report
      of anti-Yo antibodies occurring in a male patient. The Yo antigen was expressed
      by the esophageal tumor but not in a frontal lobe cerebral metastasis identified
      at postmortem. Interestingly, CD8+ T-cell infiltration was also found in the
      tumor, but not in the metastasis, consistent with down-regulation of Yo
      expression by the tumor cells leading to evasion from immune-mediated tumor
      surveillance.

PMID- 11220747
TI  - 14-3-3 protein cerebrospinal fluid detection in human growth hormone-treated
      Creutzfeldt-Jakob disease patients.
AB  - The usefulness of the detection of 14-3-3 protein in the cerebrospinal fluid
      (CSF) in the diagnosis of Creutzfeldt-Jakob disease transmitted from human growth
      hormone was evaluated in 20 French patients. The 14-3-3 protein was rarely
      detectable within the first 3 months of the disease but always positive after 7
      months associated with the aggravation of the disease and the occurrence of
      dementia. 14-3-3 detection was not predictive of the survival time of the
      patients. The genotype at PRNP codon 129 could influence the timing of appearance
      of the 14-3-3 protein in the CSF.

PMID- 11220748
TI  - Propofol in subanesthetic doses terminates status epilepticus in a rodent model.
AB  - Status epilepticus is commonly refractory to first-line therapy, and thus better
      treatments are needed. We have investigated an experimental model of drug
      resistant self-sustaining status epilepticus (SSSE) induced by 2 hours of
      perforant path stimulation. Propofol in subanesthetic doses administered shortly
      after the end of stimulation and also after a further 3 hours of SSSE terminated
      the SSSE without recurrence. This finding calls for a trial of propofol in
      refractory status epilepticus and also raises the possibility of using it as
      first-line therapy.

PMID- 11220749
TI  - Familial atypical progressive supranuclear palsy associated with homozigosity for
      the delN296 mutation in the tau gene.
AB  - Heterozygous missense and splice-site mutations in the tau gene have been
      previously identified in familial frontotemporal dementia with autosomal dominant
      inheritance. Here we report a Spanish kindred in which two brothers born from a
      third-degree consanguineous marriage were both affected with atypical progressive
      supranuclear palsy. A homozygous deletion at codon 296 (delN296) was identified
      in one of the affected siblings. Among the heterozygous carriers, two members
      with probable Parkinson's disease were identified, but none of heterozygotes
      developed atypical parkinsonism. The delN296 mutation lies in the sequence
      corresponding to the second tubulin-binding repeat of tau protein and affects one
      asparagine residue absolutely conserved in other species. This finding indicates
      that homozygous mutations in the tau gene may also cause hereditary tauopathies.

PMID- 11220750
TI  - Compound heterozygous D90A and D96N SOD1 mutations in a recessive amyotrophic
      lateral sclerosis family.
AB  - We describe a French amyotrophic lateral sclerosis (ALS) family with two distinct
      mutations in the Cu/Zn superoxide dismutase (SOD1) gene. The D90A mutation has
      been well described and clearly shown to cause recessive ALS. In this family,
      affected individuals are heterozygous for the D90A mutation and also carry a
      single copy of a novel SOD1 mutation, D96N. We propose that in this family both
      mutations are required for the development of disease.

PMID- 11220751
TI  - Laforin is a cell membrane and endoplasmic reticulum-associated protein tyrosine
      phosphatase.
AB  - Lafora disease (LD) is the only progressive myoclonus epilepsy with polyglucosan
      bodies. Among conditions with polyglucosan bodies, LD is unique for the
      subcellular location of its polyglucosans in neuronal perikarya and dendrites and
      not in axons. Here we report that the protein encoded by the EPM2A gene, which is
      mutated in LD, localizes at the plasma membrane and the endoplasmic reticulum and
      that it is a functional protein tyrosine phosphatase. The significance of these
      findings in the epilepsy of LD and in the origin and characteristic subcellular
      location of Lafora bodies is discussed.

PMID- 11220752
TI  - Role for peroxisome proliferator-activated receptor-gamma in Alzheimer's disease.

PMID- 11220753
TI  - No evidence of association between a dopamine transporter gene polymorphism
      (1215A/G) and Parkinson's disease.

PMID- 11220754
TI  - Care should be taken in interpretation of visual field tests in children.

PMID- 11220755
TI  - Therapeutic efficacy of a combination of artemether and lumefantrine (co
      artemether) versus chloroquine in treatment of uncomplicated cases of Plasmodium
      falciparum malaria.

PMID- 11220756
TI  - Virus-expressed, recombinant single-chain antibody blocks sporozoite infection of
      salivary glands in Plasmodium gallinaceum-infected Aedes aegypti.
AB  - Transgenic mosquitoes resistant to malaria parasites are being developed to test
      the hypothesis that they may be used to control disease transmission. We have
      developed an effector portion of an antiparasite gene that can be used to test
      malaria resistance in transgenic mosquitoes. Mouse monoclonal antibodies that
      recognize the circumsporozoite protein of Plasmodium gallinaceum can block
      sporozoite invasion of Aedes aegypti salivary glands. An anti-circumsporozoite
      monoclonal antibody, N2H6D5, whose corresponding heavy- and light-chain gene
      variable regions were engineered as a single-chain antibody construct, binds to
      P. gallinaceum sporozoites and prevents infection of Ae. aegypti salivary glands
      when expressed from a Sindbis virus. Mean intensities of sporozoite infections of
      salivary glands in mosquitoes expressing N2scFv were reduced as much as 99.9%
      when compared to controls.

PMID- 11220757
TI  - PCR-RFLP analysis of the ITS2 region to identify Schistosoma haematobium and S.
      bovis from Kenya.
AB  - Schistosoma haematobium, primarily a human parasite, and the closely related
      Schistosoma bovis from ruminants, are sympatric in many African countries such as
      Kenya. Because these two species 1) can inhabit the same Bulinus snails, 2) may
      be found in the same freshwater habitat, and 3) have morphologically similar
      cercariae, better means are needed to tell them apart. The second internal
      transcribed spacer (ITS2) region of the ribosomal gene complex (rDNA) of recent
      Kenyan isolates of both species was sequenced and found to be a 98% match. The S.
      bovis sequences were nearly identical (99%) to conspecific sequences from Niger;
      the S. haematobium sequences were nearly identical (99%) to conspecific sequences
      from Egypt, Mali, and Niger. Restriction fragment length polymorphism (RFLP)
      analysis of a 480 base pair (bp) PCR product containing the ITS2 region using two
      restriction enzymes, Taq1 and Sau3A1, yielded species-specific fragment patterns
      that allowed successful identification of a single S. haematobium cercaria. The
      protocol outlined here is useful in providing a rapid, one-day identification of
      S. haematobium (and likely S. bovis) cercariae (the infective larval stage)
      and/or other life cycle stages in a basic molecular biology laboratory. By
      helping to determine whether schistosome-infected bulinid snails in a particular
      body of water are transmitting a human or an animal schistosome, or both, this
      analysis will aid in disease control and in ongoing epidemiological studies.

PMID- 11220758
TI  - Molecular typing of Trichomonas vaginalis isolates by HSP70 restriction fragment
      length polymorphism.
AB  - Subtyping isolates of Trichomonas vaginalis is an essential tool for
      understanding the epidemiology of this common sexually-transmitted disease.
      Restriction fragment length polymorphism (RFLP) analysis employing a probe from
      the heat-inducible cytoplasmic HSP70 gene family hybridized with EcoR I-digested
      genomic DNA was used in the molecular typing of Trichomonas isolates. Analysis of
      five American Type Culture Collection (ATCC) reference strains and 31 Jackson,
      Mississippi, isolates from six male and 21 female patients, revealed 10 distinct
      RFLP pattern subtypes of Trichomonas. The subtypes were temporally stable and
      cosmopolitan. The RFLP profiles seen in Maryland, Ohio, Massachusetts, and New
      York ATCC strains were identical to those of some Mississippi isolates, even
      though the samples were isolated 10-35 years apart. There was no correlation
      between metronidazole resistance and RFLP subtype with resistant isolates from
      eight patients distributed among six different subtypes.

PMID- 11220759
TI  - Genetic variation of Japanese encephalitis virus in Taiwan.
AB  - A 280-nucleotide sequence from the capsid-premembrane (C/preM) gene region of 44
      Japanese encephalitis (JE) virus strains isolated in Taiwan from mosquitoes from
      1983 to 1994, and 3 strains, (Ling [1965], Chang [1965], and HV1 [1958]) isolated
      from human brain were analyzed by direct sequencing of reverse transcription
      polymerase chain reaction (RT-PCR) amplified products and compared with the
      corresponding sequences of reference strains. The overall sequence homology of
      the 47 isolates was > or = 93.3%. Taking 12% nucleotide divergence as a cut-off
      value, all isolates fell into genotype 3, which included strains from Japan,
      China, the Philippines, Sri Lanka, India, and Nepal. High nucleotide homology was
      observed among isolates from different regions of Taiwan and different time
      periods; on the other hand, high variation existed among isolates from the same
      region and time period. Phylogenetic analysis showed that the 47 Taiwan isolates
      fell into three clusters. Twenty-five isolates formed cluster 1, 18 isolates
      cluster 2, and four isolates cluster 3. Isolates in cluster 1 showed greater (<
      or = 2.9%) intragroup divergence compared to those in cluster 2 (< or = 1.1%) or
      cluster 3 (< or = 0.7%). The majority of isolates from northern (73.3%) and
      central (60%) Taiwan belonged to cluster 1, whereas most isolates (66.7%) from
      southern Taiwan belonged to cluster 2. Comparison with other Asian JE virus
      strains showed that isolates of cluster 1 were more specific to Taiwan than
      isolates of cluster 2 and cluster 3.

PMID- 11220760
TI  - Erhaia (Gastropoda: Rissooidea): phylogenetic relationships and the question of
      Paragonimus coevolution in Asia.
AB  - The human lung fluke Paragonimus is transmitted by gastropod taxa of two
      superfamilies: Ceritheoidea and Rissooidea. The question whether or not
      Paragonimus shows the same specificity of host-parasite coevolved relationship as
      the human blood fluke Schistosoma was inspired by the finding of two sympatric
      snail species as hosts for Paragonimus skrjabini in Fujian Province, China:
      Gammatricula and Erhaia. The former species can clearly be classified as
      Pomatiopsidae: Triculinae. The latter has previously been classified as
      Pomatiopsidae: Pomatiopsinae. However, this classification based on anatomical
      characteristics is uncertain. In order to obtain a robust phylogenetic hypothesis
      for Erhaia, we have studied three gene fragments from this taxon as well as from
      twelve related taxa. The data show that the species involved represent four
      families: Pomatiopsidae, Hydrobiidae, Cochliopidae (here raised to family
      status), and Amnicolidae. Erhaia fits securely into the Amnicolidae. This
      indicates that P. skrjabini has not coevolved with snail lineages. However, P.
      skrjabini has so far only been reported from rissooidean snails, whereas members
      of the Paragonimus westermani complex have only been found in ceritheoidean
      snails. The implication is that there is a host specificity on the superfamily
      level. However, Asian freshwater species of the Ceritheoidea and Rissooidea
      usually are not sympatric and often prefer different habitats. It is therefore
      possible that ecological niche partitioning plays the primary role for
      Paragonimus evolution.

PMID- 11220761
TI  - Phylogeny and molecular taxonomy of the Rhodniini derived from mitochondrial and
      nuclear DNA sequences.
AB  - Eleven species of Rhodnius and one of Psammolestes were compared by DNA sequence
      analysis of fragments of the mitochondrial large subunit ribosomal RNA
      (mtlsurRNA), the mitochondrial cytochrome b (mtCytb), and the D2 variable region
      of the 28S nuclear RNA (D2), totaling 1,429 base pairs. The inferred phylogeny,
      using Triatoma infestans as an outgroup, revealed two main clades within the
      Rhodniini--one, including the prolixus group of species (Rhodnius prolixus,
      Rhodnius robustus, Rhodnius neglectus, and Rhodnius nasutus) together with
      Rhodnius domesticus and Rhodnius neivai, and the other comprising two groups
      formed by Rhodnius pictipes plus Rhodnius brethesi, and Rhodnius ecuadoriensis
      plus Rhodnius pallescens. Psammolestes tertius appeared most closely related to
      the prolixus group. The analysis strongly supports the validity of R. robustus as
      a species distinct from others of the prolixus group, but suggests higher genetic
      structuring of R. robustus populations compared to the other species. Although R.
      robustus has been found naturally infected by Trypanosoma cruzi, the fact that it
      is apparently entirely sylvatic and unable to establish in homes suggests that it
      is of no great importance as a Chagas disease vector in humans.

PMID- 11220762
TI  - Efficacy of vaccines containing rhoptry-associated proteins RAP1 and RAP2 of
      Plasmodium falciparum in Saimiri boliviensis monkeys.
AB  - A vaccine trial was conducted with rhoptry-associated proteins 1 and 2 (RAP1 and
      RAP2) of Plasmodium falciparum in Saimiri boliviensis monkeys to compare the
      ability of parasite-derived (PfRAP1 and 2) and recombinant proteins (rRAP1 and 2)
      to induce protective immune responses and to find adjuvants suitable for use in
      humans. Eight groups of 6 monkeys each were immunized with parasite-derived or
      recombinant RAP1 and 2 with Freund's complete adjuvant (FCA) followed by Freund's
      incomplete adjuvant (FIA), Montanide ISA720 adjuvant, or CRL1005 adjuvant.
      Recombinant RAP1 and RAP2 were also administered separately, with Montanide
      ISA720. After 3 immunizations, monkeys were challenged by iv inoculation of
      50,000 parasites of the Uganda Palo Alto strain of P. falciparum. Of the animals
      vaccinated using FCA/FIA, 1 of 6 control monkeys, 3 of 6 immunized with PfRAP1
      and 2, and 2 of 6 with rRAP1 and 2 did not require drug treatment. Of the monkeys
      vaccinated with Montanide ISA720 adjuvant, 0 of the 6 control monkeys, 2 of 6
      immunized with RAP1 and 2, 1 of 6 immunized with rRAP1, and 4 of 6 immunized with
      RAP2 did not require drug treatment. Two of 6 monkeys immunized with PfRAP1 and 2
      with CRL1005 did not require treatment. All groups receiving RAP1, RAP2, or both
      had a significant decrease in initial parasite multiplication rates and there was
      a significant negative correlation between anti-RAP2 antibody and multiplication
      rates. Animals were rechallenged with the homologous parasite 126 days after the
      first challenge. Of the monkeys that did not require drug treatment after the
      first challenge, none developed detectable parasitemia following rechallenge.

PMID- 11220763
TI  - Growth characteristics of the chimeric Japanese encephalitis virus vaccine
      candidate, ChimeriVax-JE (YF/JE SA14--14--2), in Culex tritaeniorhynchus, Aedes
      albopictus, and Aedes aegypti mosquitoes.
AB  - The Japanese encephalitis (JE) virus vaccine candidate, ChimeriVax-JE, which
      consists of a yellow fever (YF) 17D virus backbone containing the prM and E genes
      from the JE vaccine strain JE SA14--14--2, exhibits restricted replication in non
      human primates, producing only a low-level viremia following peripheral
      inoculation. Although this reduces the likelihood that hematophagous insects
      could become infected by feeding on a vaccinated host, it is prudent to
      investigate the replication kinetics of the vaccine virus in mosquito species
      that are known to vector the viruses from which the chimera is derived. In this
      study ChimeriVax-JE virus was compared to its parent viruses, as well as to wild
      type JE virus, for its ability to replicate in Culex tritaeniorhynchus, Aedes
      albopictus, and Aedes aegypti mosquitoes. Individual mosquitoes were exposed to
      the viruses by oral ingestion of a virus-laden blood meal or by intrathoracic
      (IT) virus inoculation. ChimeriVax-JE virus did not replicate following ingestion
      by any of the three mosquito species. Additionally, replication was not detected
      after IT inoculation of ChimeriVax-JE in the primary JE virus vector, Cx.
      tritaeniorhynchus. ChimeriVax-JE exhibited moderate growth following IT
      inoculation into Ae. aegypti and Ae. albopictus, reaching titers of 3.6-5.0
      log(10) PFU/mosquito. There was no change in the virus genotype associated with
      replication in mosquitoes. Similar results were observed in mosquitoes of all
      three species that were IT inoculated or had orally ingested the YF 17D vaccine
      virus. In contrast, all mosquitoes either IT inoculated with or orally fed wild
      type and vaccine JE viruses became infected, reaching maximum titers of 5.4-7.3
      log(10) PFU/mosquito. These results indicate that ChimeriVax-JE virus is
      restricted in its ability to infect and replicate in these mosquito vectors. The
      low viremia caused by ChimeriVax-JE in primates and poor infectivity for
      mosquitoes are safeguards against secondary spread of the vaccine virus.

PMID- 11220764
TI  - Randomized trial of the immunogenicity of fractional dose regimens of PRP-T
      Haemophilus influenzae type b conjugate vaccine.
AB  - To assess the immunogenicity of more economical regimens of Haemophilus
      influenzae type b (Hib) conjugate vaccine, a randomized trial of fractional doses
      of polyribosylribitol phosphate-tetanus toxoid (PRP-T) Hib vaccine was undertaken
      in the Dominican Republic. Six hundred children were assigned to one of six
      regimens with PRP-T vaccine: full-dose, half-dose, and one-third-dose of Hib
      vaccine given separately or combined with diphtheria, tetanus, and pertussis
      (DTP) vaccine at ages 2, 4, and 6 months. Regimens that elicited antibody levels
      > 1.0 microg/mL in >70% of children and < or = 0.15 microg/mL in > 90% of
      children were considered acceptable. At 1 month post Dose 3, all regimens met the
      criteria for acceptable response. Among those who received Hib as a separate
      injection, geometric mean concentrations of anti-PRP bodies (GMCs) at age 1 month
      post Dose 3 were 11.2, 11.9, and 16.3 in the full, half, and one-third dose
      groups, respectively. Among those who received Hib and DTP combined, the GMCs
      were 6.4, 5.2, and 5.7 in the full-, half-, and one-third-dose groups
      respectively.

PMID- 11220765
TI  - Adaptation of a chloroquine-resistant strain of Plasmodium vivax from Indonesia
      to New World monkeys.
AB  - The spread of chloroquine-resistant Plasmodium vivax from Papua New Guinea and
      Indonesia poses a serious health threat to areas of Southeast Asia where this
      species of malaria parasite is endemic. A strain of P. vivax from Indonesia was
      adapted to develop in splenectomized Aotus lemurinus griseimembra, Aotus
      vociferans, Aotus nancymai, and Saimiri boliviensis monkeys. Transmission to
      splenectomized Saimiri monkeys was obtained via sporozoites. Chemotherapeutic
      studies indicated that the strain was resistant to chloroquine and amodiaquine
      while sensitive to mefloquine. Infections of chloroquine-resistant P.vivax in New
      World monkeys should be useful for the development of alternative treatments.

PMID- 11220766
TI  - Economic hardship and sexually transmitted diseases in Haiti's rural Artibonite
      Valley.
AB  - A study was conducted to determine the prevalence rate and risk factors for
      sexually transmitted diseases (STDs) in Haiti's rural Artibonite Valley. Women
      attending antenatal services at Hospital Albert Schweitzer from October to
      December 1996 were tested for gonorrhea, chlamydia, trichomonas, syphilis, and
      human immunodeficiency virus (HIV). Of the 476 women tested, 121 (25.4%) had
      trichomonas, 11/475 (2.3%) had gonorrhea, 51/475 (10.7%) had chlamydia, 32/474
      (6.8%) were seropositive for syphilis, 20/469 (4.3%) were seropositive for HIV,
      and 191 (40.1%) had at least one STD. Nearly 30% of the women reported having
      entered a sexual relationship out of economic necessity and had increased odds of
      HIV infection, Odds Ratio (OR) 6.3 (P < 0.001). We postulate that due to recent
      economic hardship in rural Haiti, women are entering into sexual relationships
      out of economic necessity and that this trend is contributing to the growing HIV
      epidemic. We recommend STD prevention and development programs that target young
      people and economically disadvantaged women.

PMID- 11220767
TI  - Evaluation of the whole blood filariasis ICT test for short-term monitoring after
      antifilarial treatment.
AB  - The immunochromatographic (ICT) filariasis test is a rapid screening tool that
      will be useful for defining the prevalence and distribution of Wuchereria
      bancrofti as part of the global program to eliminate lymphatic filariasis. To
      address questions about its usefulness for monitoring control programs, we used
      the ICT filariasis test to assess residual antigen levels following antifilarial
      treatment. Our results demonstrate that antigen levels persist in microfilaria
      negative persons for up to three years after treatment. Different strategies for
      monitoring control programs may have to be considered.

PMID- 11220768
TI  - Effect of Plasmodium falciparum parasitemia density on hemoglobin concentrations
      among full-term, normal birth weight children in western Kenya, IV. The Asembo
      Bay Cohort Project.
AB  - The relative importance of acute high-density versus persistent low-density
      Plasmodium falciparum parasitemia in contributing to the public health problem of
      malarial anemia remains unclear. The Asembo Bay Cohort Project in western Kenya
      collected monthly hemoglobin (Hb) and parasitologic measurements and biweekly
      assessments of antimalarial drug use among 942 singleton live births between 1992
      and 1996. A mixed-model analysis appropriate for repeated measures data was used
      to study how time-varying parasitemia and antimalarial drug exposures influenced
      mean Hb profiles. Incidence of World Health Organization-defined severe malarial
      anemia was 28.1 per 1,000 person-years. Among children aged less than 24 months,
      concurrent parasitemia was significantly associated with lower mean Hb,
      especially when compared to children with no concurrent parasitemia. Increased
      densities of the 90-day history of parasitemia preceding Hb measurement was more
      strongly associated with mean Hb levels than concurrent parasitemia density.
      While the highest quartile of 90-day parasitemia history was associated with
      lowest mean Hb levels, children in the lowest 90-day exposure quartile still
      experienced significantly lower Hb levels when compared to children who remained
      parasitemia-free for the same 90-day period. The results highlight the importance
      of collecting and analyzing longitudinal Hb and parasitologic data when studying
      the natural history of malarial anemia.

PMID- 11220769
TI  - New insights on the emergence of cholera in Latin America during 1991: the
      Peruvian experience.
AB  - After a century of absence, in late January 1991, Vibrio cholerae invaded the
      Western Hemisphere by way of Peru. Although a number of theories have been
      proposed, it is still not understood how that invasion took place. We reviewed
      the clinical records of persons attending hospital emergency departments in the
      major coastal cities of Peru from September through January of 1989/1990 and
      1990/1991. We identified seven adults suffering from severe, watery diarrhea
      compatible with a clinical diagnosis of cholera during the four months preceding
      the cholera outbreak, but none during the previous year. The patients were
      scattered among five coastal cities along a 1,000 km coastline. We postulate that
      cholera vibrios, autochthonous to the aquatic environment, were present in
      multiple coastal locations, and resulted from environmental conditions that
      existed during an El Nino phenomenon. Once introduced into the coastal
      communities in concentrations large enough for human infection to occur, cholera
      spread by the well-known means of contaminated water and food.

PMID- 11220770
TI  - Detection of Fasciola hepatica infection in a community located in the Ecuadorian
      Andes.
AB  - The presence of fascioliasis was assessed in four Andean communities using an
      enzyme-linked immunosorbent assay (ELISA) test to measure antibodies against
      Fasciola hepatica excretion-secretion antigens. Six percent (9 out of 150) of the
      individuals in one community were ELISA-positive for these antibodies. Fecal
      samples from two of the ELISA-positive individuals contained F. hepatica ova. All
      of the ELISA-positive cases, except for one, were children within the ages of 9
      to 12 years.

PMID- 11220771
TI  - Prevalence of antibodies to hepatitis E in two rural Egyptian communities.
AB  - A population-based serosurvey in two rural Egyptian communities was used to
      assess age-specific prevalence of antibody to hepatitis E virus (anti-HEV). One
      community is in the Nile Delta (11,182 inhabitants; 3,997 participants) and the
      other in Upper Egypt (10,970 inhabitants; 6,029 participants). Samples were
      tested for anti-HEV with a commercial enzyme-linked immunoassay (ELISA) based on
      antigens derived from open reading frame (ORF)2 and ORF3. Although there was a
      clear difference in sensitivity among the lots of the commercial test used, it
      was still possible to determine the seroprevalence. The seroprevalence of anti
      HEV exceeded 60% in the first decade of life, peaked at 76% in the second decade
      and remained above 60% until the eighth decade. Prevalence of this magnitude is
      among the highest reported in the world, with an age-specific pattern more
      similar to hyperendemic hepatitis A virus transmission than generally described.
      Lot-to-lot variation in the sensitivity of the commercial ELISA kit highlights a
      problem when comparing seroepidemiologic studies of different populations.

PMID- 11220772
TI  - A randomized controlled trial of artemotil (beta-arteether) in Zambian children
      with cerebral malaria.
AB  - The efficacy and safety of intramuscular artemotil (ARTECEF) was compared to
      intravenous quinine in African children with cerebral malaria. This prospective
      block randomized open-label study was conducted at two centers in Zambia.
      Subjects were children aged 0 to 10 years of age with cerebral malaria and a
      Blantyre Coma Score of 2 or less. Ninety two children were studied; 48 received
      artemotil and 44 quinine. No significant differences in survival, coma resolution
      time, neurologic sequelae, parasite clearance time, and fever resolution time
      were seen between the two regimens. Rates for negative malaria smears one month
      after therapy were similar in both groups. Artemotil was a well-tolerated drug in
      the 48 patients in this study. It appears to be at least therapeutically
      equivalent to quinine for the treatment of pediatric cerebral malaria. It has the
      advantage of being able to be given intramuscularly once daily for only five
      days.

PMID- 11220773
TI  - Expression of proinflammatory cytokines in four regions of the brain in Macaque
      mulatta (rhesus) monkeys infected with Plasmodium coatneyi.
AB  - We have characterized brain cytokine expression profiles in the Plasmodium
      coatneyi/rhesus (Macaque mulatta) malaria model. Eight rhesus monkeys were
      included in the study; four were infected with P. coatneyi, and four were used as
      uninfected controls. All inoculated animals became infected. Eleven days after
      parasite inoculation, the rhesus monkeys were killed and tissue samples from 4
      regions of the brain (cortex and white matter of the cerebrum, cerebellum, and
      midbrain) were collected for quantitation of mRNA expression of cytokines,
      adhesion molecules, and inducible nitric oxide synthetase (iNOS) by reverse
      transcriptase-polymerase chain reaction (RT-PCR). The expression levels of tumor
      necrosis actor-alpha (TNF-alpha), gamma interferon (IFN-gamma), interleukin-1
      beta (IL-1beta), intercellular adhesion molecule-1 (ICAM-1) and inducible nitric
      oxide synethetase (iNOS) were highest in the cerebellum of infected animals,
      correlating well with pathologic observations of sequestration of parasitized
      erythrocytes in this region of the brain. Infected animals also had higher TNF
      alpha expression levels in the cortex and IL-1beta expression levels in the
      cortex, white matter, and midbrain. Thus, the expression of pro-inflammatory and
      T helper-1 (TH-1) cytokines, adhesion molecules, and iNOS appears to predominate
      in the cerebellum of infected rhesus monkeys.

PMID- 11220774
TI  - 5HT7 receptors in the rodent suprachiasmatic nucleus.
AB  - Serotonergic modulation of circadian rhythms in rodent model preparations has
      received considerable attention over the past decade. Investigators have also
      been trying to determine which of the many serotonin receptor subtypes may be
      mediating the effects of serotonin in the suprachiasmatic nucleus, the location
      of the biological clock that generates the circadian rhythms. A single study in
      1993 using the in vitro rat hypothalamic slice preparation suggested that
      serotonergic modulation of circadian rhythms at the level of the suprachiasmatic
      nucleus was acting via the newly discovered 5HT7 receptor subtype. Since that
      initial claim, serotonin modulation of circadian rhythms at the level of the
      suprachiasmatic nucleus has generally been attributed to 5HT7 receptor
      activation. However, when trying to cite relevant literature in support of 5HT7
      involvement, it becomes evident that attributing rhythm-related serotonin
      activity in the suprachiasmatic nucleus to 5HT7 receptors may be somewhat
      premature. There are issues related to pharmacological specificity, species
      specific results, and significant knowledge gaps that necessitate a careful
      review of the literature to make a judgment as to whether 5HT7 receptors are
      responsible for serotonergic activity in the rodent suprachiasmatic nucleus. In
      addition, there is sufficient data available at present to make an initial
      determination as to the degree of 5HT7 receptor involvement at any level in the
      generation or modulation of circadian rhythms in rodent species.

PMID- 11220775
TI  - Serotonergic modulation of retinal input to the mouse suprachiasmatic nucleus
      mediated by 5-HT1B and 5-HT7 receptors.
AB  - Serotonin (5-HT) and 5-HT receptor agonists can modify the response of the
      mammalian suprachiasmatic nucleus (SCN) to light. It remains uncertain which 5-HT
      receptor subtypes mediate these effects. The effects of 5-HT receptor activation
      on optic nerve-mediated input to SCN neurons were examined using whole-cell patch
      clamp recordings in horizontal slices of ventral hypothalamus from the male
      mouse. The hypothesis that 5-HT reduces the effect of retinohypothalamic tract
      (RHT) input to the SCN by acting at 5-HT1B receptors was tested first. As
      previously described in the hamster, a mixed 5-HT(1A/1B) receptor agonist, 1-[3
      (trifluoromethyl)phenyl]-piperazine hydrochloride (TFMPP), reduced the amplitude
      of glutamatergic excitatory postsynaptic currents (EPSCs) evoked by selectively
      stimulating the optic nerve of wild-type mice. The agonist was negligibly
      effective in a 5-HT1B receptor knockout mouse, suggesting minimal contribution of
      5-HT1A receptors to the TFMPP-induced reduction in the amplitude of the optic
      nerve-evoked EPSC. We next tested the hypothesis that 5-HT also reduces RHT input
      to the SCN via activation of 5-HT7 receptors. The mixed 5-HT(1A/7) receptor
      agonist, R(+)-8-hydroxy-2-(di-n-propylamino) tetralin hydrobromide (8-OH-DPAT),
      reduced the evoked EPSC amplitude in both wild-type and 5-HT1B receptor knockout
      mice. This effect of 8-OH-DPAT was minimally attenuated by the selective 5-HT1A
      receptor antagonist WAY 100635 but was reversibly and significantly reduced in
      the presence of ritanserin, a mixed 5-HT(2/7) receptor antagonist. Taken together
      with the authors' previous ultrastructural studies of 5-HT1B receptors in the
      mouse SCN, these results indicate that in the mouse, 5-HT reduces RHT input to
      the SCN by acting at 5-HT1B receptors located on RHT terminals. Moreover,
      activation of 5-HT7 receptors in the mouse SCN, but not 5-HT1A receptors, also
      results in a reduction in the amplitude of the optic nerve-evoked EPSC. The
      findings indicate that 5-HT may modulate RHT glutamatergic input to the SCN
      through 2 or more 5-HT receptors. The likely mechanism of altered RHT
      glutamatergic input to SCN neurons is an alteration of photic effects on the SCN
      circadian oscillator.

PMID- 11220776
TI  - What do reviewers really want?

PMID- 11220778
TI  - Fifty years of fun.

PMID- 11220777
TI  - Direct innervation of GnRH neurons by encephalic photoreceptors in birds.
AB  - In nonmammalian vertebrates, photic cues that regulate the timing of seasonal
      reproductive cyclicity are detected by nonretinal, nonpineal deep brain
      photoreceptors. It has long been assumed that the underlying mechanism involves
      the transmission of photic information from the photoreceptor to a circadian
      system, and thence to the reproductive axis. An alternative hypothesis is that
      there is direct communication between the brain photoreceptor and the
      reproductive axis. In the present study, light and confocal microscopy reveal
      that gonadotropin releasing hormone (GnRH) neurons and processes are scattered
      among photoreceptor cells (identified by their opsin-immunoreactivity) in the
      lateral septum (SL). In the median eminence (ME), opsin and GnRH immunoreactive
      fibers overlap extensively. Single and double label ultrastructural
      immunocytochemistry indicate that in the SL and preoptic area (POA), opsin
      positive terminals form axo-dendritic synapses onto GnRH dendrites. In the ME,
      opsin and GnRH terminals lie adjacent to each other, make contact with tanycytes,
      or terminate on the hypophyseal portal capillaries. These results reveal
      thatbrain photoreceptors communicate directly with GnRH-neurons; this represents
      a means by which photoperiodic information reaches the reproductive axis.

PMID- 11220779
TI  - Influence of light on feeding anticipatory activity in goldfish.
AB  - Most animals when presented with food on a periodic basis develop feeding
      anticipatory activity (FAA). The objective of the present study was to
      investigate the synchronization of activity rhythms to light and feeding in
      single goldfish given a single daily meal and exposed to different light regimes.
      In the 1st experiment, the group of fish fed at the end of the day showed a
      longer FAA (228 +/- 27 min) than the group fed 1 h after lights-on (97 +/- 31
      min). In the 2nd experiment, goldfish under conflicting zeitgebers, LD (T = 26)
      and feeding (T = 24) cycles, initially synchronized to the light cycle although
      feeding time gradually assumed greater importance as the experiment progressed.
      In the 3rd experiment, after altering the feeding cycles by advancing or delaying
      feeding time by 4 h in LD 0.25:23.75, most goldfish resynchronized to the feeding
      stimulus and developed FAA. In conclusion, the authors' results revealed that FAA
      in goldfish is driven by an endogenous timing system that is entrainable by
      periodic feeding and influenced by the light regime.

PMID- 11220780
TI  - Differential effects of meal size and food energy density on feeding entrainment
      in goldfish.
AB  - The synchronizing stimulus, its transduction site, and the afferent pathways
      responsible for feeding entrainment remain unknown. In fish, the role of the diet
      in the development of feeding anticipatory activity (FAA) is not well understood
      and fundamental questions on the mechanisms of feeding entrainment, such as the
      meal characteristics required to develop FAA, remain unexplored. To test the
      entraining properties of daily meals with different sizes and energy densities,
      activity rhythms were studied after a 12-h shift of the feeding cycle in
      individual goldfish under constant light. In the 1st experiment, the energy
      content of a control diet (16.7 kJ/g) was diluted by replacing 50% (8.3 kJ/g) or
      90% (1.7 kJ/g) of the diet with cellulose. However, the number of days required
      to stabilize FAA after the shift did not differ statistically between diets. In
      the 2nd experiment, meal size was modified by reducing the daily feeding ration
      to 0.5% and 0.1% b.wt.d(-1). In this case, differences in the entraining
      properties of the two feeding rations appeared because goldfish fed at 0.1%
      b.wt.d(-1) resynchronized faster than those fed at 0.5% b.wt.d(-1). These results
      revealed that the dilution of the dietary energy up to 1.7 kJ/g had no
      significant effect on the entraining properties of the feeding-entrainable
      oscillator (FEO), whereas the reduction of the meal size to 0.1% b.wt.d(-1)
      provoked a faster resynchronization after shifting the daily meal cycle. Taken
      together, these results suggest that gut distension may be involved in feeding
      entrainment, as a reduction in meal size but not in the amount of dietary energy
      supplied significantly shortened the time required for resynchronization and
      highlighted the different synchronizing properties of meal size and energy
      density as zeitgebers for the FEO.

PMID- 11220781
TI  - Scheduled voluntary wheel running activity modulates free-running circadian body
      temperature rhythms in Octodon degus.
AB  - Entrainment of the circadian pacemaker to nonphotic stimuli, such as scheduled
      wheel-running activity, is well characterized in nocturnal rodents, but little is
      known about activity-dependent entrainment in diurnal or crepuscular species. In
      the present study, effects of scheduled voluntary wheel-running activity on
      circadian timekeeping were investigated in Octodon degus, a hystricomorph rodent
      that exhibits robust crepuscular patterns of wakefulness. When housed in constant
      darkness, O. degus exhibited circadian rhythms in wheel-running activity and body
      temperature (Tb) with an average period length (tau) of 23.39 +/- 0.11 h. When
      wheel running was restricted to a fixed 2-h schedule every 24 h, tau increased on
      average 0.39 +/- 0.09 h but did not result in steady-state entrainment. Instead,
      relative coordination between the fixed running schedule and circadian timing was
      observed. Tau was greatest when scheduled wheel running occurred at CT 20.5 (0.4
      h greater than DD baseline tau). Scheduled running activity also influenced Tb
      waveform symmetry, reflecting concomitant changes in the circadian activity-rest
      ratio (alpha:rho). Aftereffects of the scheduled wheel-running paradigm were also
      observed. In 2 animals, tau lengthened from 23.20 and 23.80 h to 24.14 and 24.15
      h, respectively, and remained relatively stable for approximately 1 month during
      the wheel schedule. Although behavioral activity appears to be a weak zeitgeber
      in this species, these data suggest that nonphotic stimuli can phase delay the
      circadian pacemaker in O. degus at similar times of the day as in nocturnal
      hamsters and mice, and in humans.

PMID- 11220782
TI  - Low ambient temperature accelerates short-day responses in Siberian hamsters by
      altering responsiveness to melatonin.
AB  - Exposure to low ambient temperatures (Ta) accelerates appearance of the winter
      phenotype in Siberian hamsters transferred from long to short day lengths.
      Because melatonin transduces the effects of day length on the neuroendocrine
      axis, the authors assessed whether low Ta promotes the transition to winterlike
      traits by accelerating the onset of increased nocturnal melatonin secretion or by
      enhancing responsiveness to melatonin in short day lengths. Male hamsters were
      transferred from 16L (16 h light/day) to 8L (8 h light/day) photoperiods and held
      at 5 degrees C or 22 degrees C. Locomotor activity was recorded continuously, and
      body mass, testis size, and pelage color were determined biweekly for 8 weeks.
      The duration of nocturnal locomotion (alpha), a reliable indicator of the
      duration of nocturnal melatonin secretion, lengthened significantly earlier in
      hamsters exposed to a Ta of 5 degrees C than 22 degrees C. Cold exposure
      increased the proportion of hamsters that were photoresponsive: gonadal
      regression in short days increased from 44% at 22 degrees C to 81% at 5 degrees C
      (p < 0.05); low Ta did not, however, accelerate testicular regression in animals
      that were photoresponsive. Nonphotoresponsive animals at 5 degrees C temporarily
      had longer alphas during the first 4 weeks in short days and significant
      decreases in body mass and testicular size that were reversed during the ensuing
      weeks when alpha decreased. In a 2nd experiment, pinealectomized male hamsters
      infused for 10 h/day with melatonin for 2 weeks had significantly lower body and
      testes masses when maintained at 5 degrees C but not 22 degrees C. Low-ambient
      temperature appears to accelerate the appearance of the winter phenotype
      primarily by increasing target tissue responsiveness to melatonin and to a lesser
      extent by augmenting the rate at which the duration of nocturnal melatonin
      secretion increases in short day lengths.

PMID- 11220783
TI  - Effects of aging on the intrinsic circadian period of totally blind humans.
AB  - Age-related changes in the intrinsic circadian period (tau) have been
      hypothesized to account for sleep symptoms in the elderly such as early morning
      awakening. The authors sought to determine whether the aging process produced
      quantifiable differences in the tau of totally blind men who had free-running
      circadian rhythms. The melatonin onset was used as the indicator of circadian
      phase. Melatonin rhythms had been characterized about a decade previously when
      the participants were 38 +/- 6 (SD) years old. Both previous and current
      assessments of tau were derived from at least 3 serial measurements of the 24-h
      melatonin profile from which the melatonin onset was determined. All 6
      participants exhibited a longer tau in the 2nd assessment (mean increase +/- SD
      of 0.13 +/- 0.08 h; p < 0.01). Four participants exhibited differences in tau
      with nonoverlapping 95% confidence intervals. The results do not support the
      commonly held view that tau shortens during human aging. On the contrary, tau
      appears to slightly, but significantly, lengthen during at least 1 decade in
      midlife.

PMID- 11220784
TI  - Perinatal expression of heat-shock protein 27 in brain regions and nonneural
      tissues of the piglet.
AB  - Important stressful events occur at birth or within the few hours that follow
      this event. To unravel a possible involvement of stress proteins, it is important
      to determine their levels of expression. Expression of HSP27 protein was
      determined by Western blotting in several nonneural tissues and in brain regions
      of the developing pig (fetal to adult). Maximum levels of expression were
      observed in heart, liver, and lung. In kidney, the expression was reduced during
      the first hours of life. Brain parts included whole brain, cerebellum, cortex,
      hippocampus, hypothalamus, and striatum. HSP27 immunogenicity was observed in all
      the brain regions studied. In whole brain, cerebellum, cortex, hippocampus, and
      hypothalamus extracts, the levels of HSP27 were decreased during the first hours
      of age (4 h to 2 d). In striatum, levels of expression were very low--if
      detectable--during the early postnatal days of life. Changes in environmental
      parameters, like temperature and/or hypoxia can be possibly related to
      differential expressions of HSPs, which can result in severe adverse
      developmental outcomes. The results are discussed in terms of using the newborn
      piglet as a model to study different forms of stress on the heat-shock protein
      postnatal expression.

PMID- 11220785
TI  - Localization of mRNAs for novel, atypical as well as conventional protein kinase
      C (PKC) isoforms in the brain of developing and mature rats.
AB  - Using in situ hybridization histochemistry, the localization of mRNAs for 10
      isoforms of protein kinase C (PKC) in the rat brain was studied at embryonic and
      postnatal stages. In the embryonic brain, the gene expression was positive only
      for PKCepsilon, mu, lambda, and zeta with the former three more evident: The
      expression for PKCmu and lambda in the ventricular germinal zone and that for
      PKCepsilon, zeta, and lambda in the mantle zone. In the postnatal brain, the
      expression for PKCdelta, eta, and theta was detected differentially in a few
      circumscribed loci such as the thalamus, the habenula, the septum, and the
      cerebellar granule cells, whereas that for the other isoforms was seen widely in
      various loci of the gray matter with different intensity. The expression in the
      cerebellar external granule cell layer was positive only for PKCbeta (betaI and
      betaII), mu, and lambda with that for PKCbeta confined to its inner zone. There
      is a general tendency for all PKC isoforms that the expression levels reach at
      peaks in early postnatal brain and decreases more or less in adult specimens.
      This is the first report on the spatio-temporal heterogeneity in the gene
      expression for the whole members of PKC family in the brain throughout
      development, especially at embryonic days.

PMID- 11220786
TI  - Canavan's spongiform leukodystrophy: a clinical anatomy of a genetic metabolic
      CNS disease.
AB  - Canavan disease (CD) is a globally distributed early-onset leukodystrophy. It is
      genetic in nature, and results from an autosomally inherited recessive trait that
      is characterized by loss of the axon's myelin sheath while leaving the axons
      intact, and spongiform degeneration especially in white matter. There is also a
      buildup of N-acetyl-L-aspartate (NAA) in brain, as well as NAA acidemia and NAA
      aciduria. The cause of the altered NAA metabolism has been traced to several
      mutations in the gene for the production of aspartoacylase, located on chromosome
      17, which is the primary enzyme involved in the catabolic metabolism of NAA. In
      this review, an attempt is made to correlate the change in NAA metabolism that
      results from the genetic defects in CD with the processes involved in the
      development of the CD syndrome. In addition, present efforts to counter the
      results of the genetic defects in this disease are also considered.

PMID- 11220787
TI  - Loss of oxidation-reduction specificity in amyotrophic lateral sclerosis
      associated CuZnSOD mutants.
AB  - Both transgenic mouse and cell culture models of familial amyotrophic lateral
      sclerosis (FALS) support a gain-of-function effect for the mutations in copper
      zinc superoxide dismutase (CuZnSOD) associated with FALS, but the nature of the
      function gained remains incompletely characterized. We previously reported an
      enhanced peroxidase activity for FALS-associated CuZnSOD mutants. Because one of
      the targets of such activity is CuZnSOD itself, we examined peroxide-mediated
      inactivation of wild-type and mutant CuZnSODs, and found that the mutants are
      more readily inactivated. Inactivation of the mutants was associated with
      fragmentation, which did not occur in the wild-type enzyme under these
      conditions. Furthermore, the reduction of the FALS-associated mutants by
      ascorbate was enhanced markedly when compared to the wild-type enzyme. The
      visible spectra of the mutants showed a consistent blue shift of the peak at 680
      nm in the wild-type enzyme, suggesting an alteration in copper-site geometry.
      These results extend previous studies demonstrating enhanced peroxidase activity
      in the mutants, and suggest that the toxic function that leads to motor neuron
      degeneration may result from a loss of specificity of the redox reactions
      catalyzed by CuZnSOD.

PMID- 11220788
TI  - Pivotal role for acidic sphingomyelinase in cerebral ischemia-induced ceramide
      and cytokine production, and neuronal apoptosis.
AB  - Stroke is a major cause of long-term disability, the severity of which is
      directly related to the numbers of neurons that succumb to the ischemic insult.
      The signaling cascades activated by cerebral ischemia that may either promote or
      protect against neuronal death are not well understood. One injury-responsive
      signaling pathway that has recently been characterized in studies of non-neural
      cells involves cleavage of membrane sphingomyelin by acidic and/or neutral
      sphingomyelinase (ASMase) resulting in generation of the second messenger
      ceramide. We now report that transient focal cerebral ischemia induces large
      increases in ASMase activity, ceramide levels, and production of inflammatory
      cytokines in wild-type mice, but not in mice lacking ASMase. The extent of brain
      tissue damage is decreased and behavioral outcome improved in mice lacking
      ASMase. Neurons lacking ASMase exhibit decreased vulnerability to excitotoxicity
      and hypoxia, which is associated with decreased levels of intracellular calcium
      and oxyradicals. Treatment of mice with a drug that inhibits ASMase activity and
      ceramide production reduces ischemic neuronal injury and improves behavioral
      outcome, suggesting that drugs that inhibit this signaling pathway may prove
      beneficial in stroke patients.

PMID- 11220790
TI  - Musculoskeletal images. Bilateral insufficiency fracture of the femoral neck.

PMID- 11220789
TI  - Dietary restriction increases the number of newly generated neural cells, and
      induces BDNF expression, in the dentate gyrus of rats.
AB  - The adult brain contains neural stem cells that are capable of proliferating,
      differentiating into neurons or glia, and then either surviving or dying. This
      process of neural-cell production (neurogenesis) in the dentate gyrus of the
      hippocampus is responsive to brain injury, and both mental and physical activity.
      We now report that neurogenesis in the dentate gyrus can also be modified by
      diet. Previous studies have shown that dietary restriction (DR) can suppress age
      related deficits in learning and memory, and can increase resistance of neurons
      to degeneration in experimental models of neurodegenerative disorders. We found
      that maintenance of adult rats on a DR regimen results in a significant increase
      in the numbers of newly produced neural cells in the dentate gyrus of the
      hippocampus, as determined by stereologic analysis of cells labeled with the DNA
      precursor analog bromodeoxyuridine. The increase in neurogenesis in rats
      maintained on DR appears to result from decreased death of newly produced cells,
      rather than from increased cell proliferation. We further show that the
      expression of brain-derived neurotrophic factor, a trophic factor recently
      associated with neurogenesis, is increased in hippocampal cells of rats
      maintained on DR. Our data are the first evidence that diet can affect the
      process of neurogenesis, as well as the first evidence that diet can affect
      neurotrophic factor production. These findings provide insight into the
      mechanisms whereby diet impacts on brain plasticity, aging and neurodegenerative
      disorders.

PMID- 11220791
TI  - Soft-tissue images. Video-assisted thrombectomy of a mechanical prosthetic valve.

PMID- 11220792
TI  - Musculoskeletal case 14. Presentation. Multiple enchondromatosis.

PMID- 11220793
TI  - Soft-tissue case 37. Presentation. Recurrent gallbladder carcinoma along the
      laparoscopic cholecystectomy port track.

PMID- 11220794
TI  - Users' guides to the surgical literature: how to use an article about a
      diagnostic test. Evidence-Based Surgery Working Group.

PMID- 11220795
TI  - Carcinoid syndrome symposium on treatment modalities for gastrointestinal
      carcinoid tumours: symposium summary.
AB  - OBJECTIVE: To develop a collaborative approach for the treatment of
      gastrointestinal carcinoid tumours and carcinoid syndrome. PARTICIPANTS: Leaders
      in the medical, endocrine, radiologic and surgical treatment of carcinoid disease
      were selected to present papers at the Carcinoid Syndrome Symposium on Treatment
      Modalities for Gastrointestinal Carcinoid Tumours and participate in the workshop
      that followed. EVIDENCE: A multidisciplinary symposium with experts in the field
      of carcinoid syndrome was organized at the University of Calgary. Data presented,
      participation of the attendees and a review of the literature were used in the
      workshop to develop a collaborative approach to the management of carcinoid
      tumours. BENEFITS: Carcinoid tumours are rare and few centres have large
      experiences in their treatment. Before the development of this collaboration,
      patients with carcinoid tumours received a unidisciplinary approach depending on
      referral patterns. The development of a multidisciplinary neuroendocrine clinic
      helped to unify the approach to these patients, yet a consensus on the treatment
      of carcinoid tumours was lacking. The expertise at the symposium allowed for
      consensus and the development of treatment algorithms, including biochemical
      screening, radiographic localization and surgical intervention, for
      gastrointestinal carcinoid tumours. The role of medical and hormonal therapy
      after cytoreducion is presented. RECOMMENDATION: Patients with carcinoid tumours
      require a multidisciplinary approach to their care.

PMID- 11220796
TI  - The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty.
AB  - OBJECTIVE: In lower-extremity surgery there are significant risks associated with
      the use of tourniquets. This prospective study was done to assess to what extent
      these risks may be offset by the potential advantages of tourniquets, namely
      reductions in blood loss, length of hospital stay and complication rates. DESIGN:
      A prospective case study. SETTING: A major urban hospital. PATIENTS: Sixty-three
      consecutive patients scheduled for primary cemented total knee arthroplasty (TKA)
      were blindly randomized into tourniqet (n = 33) and non-tourniquet (n = 30)
      groups. INTERVENTION: TKA during which a pneumatic tourniquet was applied or not
      applied to control blood loss. MAIN OUTCOME MEASURES: Perioperative blood loss,
      operating time, complication rates, hospital stay and transfusion needs. RESULTS:
      Differences in the total measured blood loss, intraoperative blood loss and the
      Hemovac drainage blood loss between the 2 groups were not significantly different
      (p > 0.25). The calculated total blood loss was actually lower in the non
      tourniquet group (p = 0.02). Between the groups there were no statistical
      differences in surgical time, length of hospital stay, transfusion requirements
      or rate of complications (although there was a trend to more complications in the
      tourniquet group (p = 0.06)). CONCLUSION: The effectiveness of a pneumatic
      tourniquet to control blood loss in TKA is questionable.

PMID- 11220797
TI  - Outpatient laparoscopic cholecystectomy: home visit versus telephone follow-up.
AB  - OBJECTIVES: To investigate the post-discharge follow-up required for patients who
      have undergone laparoscopic cholecystectomy on an outpatient basis and to
      determine if there was a significant difference in mean concern scores and
      satisfaction level of patients followed up by a home visit versus a telephone
      call. DESIGN: Prospective 2-group comparison. SETTING: A 221-bed acute care
      community hospital in western Canada. PATIENTS: One hundred and forty-nine
      patients who had undergone laparoscopic cholecystectomy and agreed to be
      discharged on the day of operation. INTERVENTIONS: Subjects were systematically
      allocated to receive either a home visit (HV, n = 72) or a telephone call (TC, n
      = 77) from a registered nurse on the evening of operation. During the follow-up,
      patient concerns were self-rated, interventions provided by the nurse were
      recorded, and nurses' perceptions of the need for the home visit were reported. A
      48-hour telephone survey was used to determine patient satisfaction. OUTCOME
      MEASURES: Patient concern scores, patient satisfaction with follow-up,
      readmission rates and use of emergency room services within 30 days of operation.
      RESULTS: Subjects in the TC group had a significantly lower mean concern score (p
      < 0.001) and were significantly more satisfied with their follow-up (p = 0.034)
      than those in the HV group. Nurses perceived that 75% of the home visits were not
      necessary. Readmission rate was less than 1% (1 HV) and use of emergency room
      services was 6% (3 HV, 6 TC). CONCLUSIONS: Telephone contact is an acceptable
      method of follow-up for patients who have undergone outpatient laparoscopic
      cholecystectomy. The call should be made later in the evening on the day of
      operation or the next morning.

PMID- 11220798
TI  - RAVECAB: improving outcome in off-pump minimal access surgery with robotic
      assistance and video enhancement.
AB  - OBJECTIVE: To determine the efficacy of using the harmonic scalpel and robotic
      assistance to facilitate thoracoscopic harvest of the internal thoracic artery
      (ITA). DESIGN: A case series. SETTING: London Health Sciences Centre, University
      of Western Ontario, London, Ont. PATIENTS AND METHODS: Fifteen consecutive
      patients requiring harvest of the ITA for coronary artery bypass grafting.
      INTERVENTION: Robot-assisted, video-enhanced coronary artery bypass (RAVECAB)
      through limited-access incisions, using the harmonic scalpel and a voice
      activated robotic assistant. MAIN OUTCOME MEASURES: Ease and duration of the
      harvesting technique, complications of the procedure, graft flow and patency, and
      duration of postoperative hospitalization. RESULTS: RAVECAB facilitated
      thoracoscopic dissection of the ITA with the harmonic scalpel in all cases. There
      were no conversions to a standard approach and no reoperations for bleeding. The
      mean (and standard deviation) ITA harvest time was 64.1 (22.9) minutes (range
      from 40 to 118 minutes). Robotic voice command capture rate was greater than 95%.
      Mean (and SD) intraoperative graft flows were 33.1 (26.8) mL/min (range from 14
      to 126 mL/min). There was 100% graft patency on postoperative angiography. There
      were no deaths, perioperaive myocardial infarction or arrhythmias. Mean (and SD)
      postoperative hospitalization was 3.3 (0.8) days. CONCLUSIONS: RAVECAB is a
      demanding procedure that addresses many of the disadvantages of the
      "conventional" minimally invasive coronary artery bypass. It allows complete
      pedicle dissection with minimal ITA manipulation and assures sufficient conduit
      length and a tension-free coronary artery anastomosis. All anastomoses were
      performed under direct vision through a 5- to 8-cm inferior mammary incision.

PMID- 11220799
TI  - Maintenance of certification program.

PMID- 11220800
TI  - Outcomes after the regionalization of major surgical procedures in the Alberta
      Capital Health Region (Edmonton).
AB  - OBJECTIVE: To evaluate the impact of regionalization on the outcomes of 16
      surgical procedures performed in the Capital Health Region (Edmonton) of Alberta.
      DESIGN: A computer search of hospital discharge abstracts coded for the Canadian
      Institute for Health Information. SETTING: Two major hospitals in Edmonton.
      PATIENTS: The study population comprised 9250 patients (9727 procedures [4524,
      pre-regionalization, 5203 post-regionalization]) who underwent any of 16 major
      procedures in the 2 years before and the 2 years after restructuring. OUTCOME
      MEASURES: Demographic data, Charlson's comorbidity index, number of urgent and
      emergent cases, death rate, average length of hospital stay and the readmission
      rate. RESULTS: The post-regionalization patient group was slightly older, had a
      higher comorbidity index, and fewer urgent and emergent cases. The case volume
      increased by 15%, and 43.6% of patients used some form of community-based health
      care services. The median length of hospital stay decreased from 8.0 days pre
      regionalization to 7.0 days post-regionalization (p < 0.001). Overall and for
      specific procedures the death rate was unchanged (3.1% pre-regionalization, 2.4%
      post-regionalization, p = 0.06). The readmission rates were similar for both
      groups (8.0% versus 7.0%). CONCLUSIONS: The consolidation of these 16 major
      surgical procedures had minimal impact on death and readmission rates even though
      patients in the post-regionalization group were slightly older and had greater
      comorbidity. There was a significant decline in the length of hospital stay,
      which occurred nationally over the same period, and a corresponding increase in
      the use of community-based services.

PMID- 11220801
TI  - Reversible anastomotic stenosis after minimally invasive coronary artery bypass
      grafting.

PMID- 11220802
TI  - Instability resulting from a missed Chance fracture.

PMID- 11220803
TI  - Education versus service.

PMID- 11220804
TI  - Accessory bile duct in the gallbladder bed.

PMID- 11220805
TI  - "Who says there is a deficiency in care?".

PMID- 11220806
TI  - Curriculum for residents' education.

PMID- 11220807
TI  - The economic consequences of widowhood on elderly women in the United States and
      Germany.
AB  - PURPOSE: Different countries have different goals for social welfare policy.
      Consequently, it is reasonable to expect different outcomes after certain events.
      This article examines changes in the economic well-being of elderly women at
      widowhood in the United States and Germany. DESIGN AND METHODS: Longitudinal data
      from the U.S. Panel Study of Income Dynamics and the German Socioeconomic Panel
      were used to prepare a sample of elderly widows. Economic wellbeing the year
      before the husband's death was compared with economic well-being the year after
      the husband's death. RESULTS: Although the prevalence of poverty is different in
      the two countries, most widows in both countries experienced a decline in living
      standards, and many actually fell into poverty at widowhood. A fall in Social
      Security and pension income was the largest contributor to the fall in living
      standards. IMPLICATIONS: The retirement income system in both countries seems to
      be adequate for married couples but appears to fail for widows.

PMID- 11220808
TI  - Ageism, age relations, and garment industry work in Montreal.
AB  - This study examined the complexities of age relations at work. Garment workers
      believed that their fate was linked to ageism and that their work experience was
      discounted by management. Managers wanted to be rid of older workers because they
      commanded higher wages than younger workers. The issue was cost reduction, and
      age was implicated unintendedly. Still, managers seemed to use stereotypical
      images to discourage older workers and they did not organize work routines to
      facilitate the adaptation of them. Instead, they subcontracted the easy jobs,
      relying on the experience of the older employees for difficult work while not
      adapting the workplace. Theoretically, the authors argue that ageism and age
      discrimination can best be understood through a recognition of the importance of
      structured age relations and human agency.

PMID- 11220809
TI  - Preference for place of death in a continuing care retirement community.
AB  - PURPOSE: To describe death-related planning and preferences for place of death
      among well elders in a community characterized by a low rate of hospital deaths.
      DESIGN AND METHODS: Cross-sectional prevalence survey of independent-living
      residents (n = 219) of a continuing-care retirement community (CCRC) in Central
      North Carolina characterized by a low rate of hospital deaths. RESULTS: Death
      related planning played a part in the decision of 40% of residents to move to the
      CCRC. A majority of residents reported a clear preference for place of death, and
      a majority of these preferred to die on the CCRC campus. Most residents wanted to
      discuss their preferences for place of death with their health care provider.
      Preferences for place of death appear consistent across age cohorts and are
      relevant to elders' long-term care decisions. IMPLICATIONS: Given the striking
      discrepancy between patients' preferences for nonhospital deaths and the high
      prevalence of hospital deaths in the United States, this often-neglected issue
      should be routinely addressed in end-of-life planning. The CCRC may be a practice
      model that is particularly compatible with personal preferences for place of
      death.

PMID- 11220810
TI  - Extending gerontological research through linking investigators' studies to
      public-use datasets.
AB  - PURPOSE: Public-use datasets can extend data collected by individual
      investigators in various ways: making external comparisons, providing additional
      data on individual respondents, and creating internal comparison groups. The
      authors describe the advantages and limitations of these methods and practical
      and conceptual issues in combining investigator-initiated and public-use
      datasets. DESIGN AND METHODS: These issues are illustrated with a study of
      functional decline among 674 patients following hospitalization for hip fracture
      that was augmented with data from a public-use dataset, the Established
      Populations for Epidemiologic Studies of the Elderly (EPESE). RESULTS: By
      creating an internal comparison group of EPESE respondents, frequency matched to
      hip fracture patients on age, sex, and baseline functional limitations, the
      authors formed a single dataset and performed multivariable analyses of factors
      associated with functional decline. IMPLICATIONS: Gerontological research may
      benefit by applying these methods to program evaluations and longitudinal
      analyses of health outcomes with numerous public-use datasets.

PMID- 11220811
TI  - Want to understand how Americans viewed long-term care in 1998? Start with media
      coverage.
AB  - PURPOSE: This analysis describes media coverage of long-term care in 1998. DESIGN
      AND METHODS: Several sources were used to place coverage of long-term care in
      1998 in the context of recent years and other health issues. For the primary
      analysis, stories in which long-term care was a major topic were collected from
      Lexis-Nexis Academic Universe. Media sources included major newspapers, network
      news, CNN, and NPR. Stories were coded for topic, details about the topic,
      physical placement within the overall coverage, and underlying issues. RESULTS: A
      small percentage of media coverage in 1998 concerned long-term care. Among long
      term care topics, nursing homes received the most coverage. A small percentage of
      long-term care topics were reported on the front page, and few underlying issues
      framed these topics. IMPLICATIONS: To ensure that Americans receive a
      comprehensive view of long-term care issues, gerontologists must work with
      reporters to influence how they report on long-term care.

PMID- 11220812
TI  - Medicaid estate planning: perceptions of morality and necessity.
AB  - PURPOSE: Although several studies have examined the magnitude and prevalence of
      Medicaid estate planning (MEP), little is known about factors that influence
      individual behaviors in this area. Normative data regarding public perceptions of
      and motivations for MEP are nonexistent. This study explored views about MEP
      among community-dwelling older adults and family caregivers. DESIGN AND METHODS:
      Eighteen focus groups were completed (N = 155), with a stratified homogeneous
      sample to ensure representation from individuals of varying race/ethnicity,
      experience with nursing home and home care services, and socioeconomic status.
      Analyses of transcripts were completed with NUD*IST 4.0 software. RESULTS:
      Disincentives for MEP included losing control of one's assets, Medicaid stigma,
      and perceived immorality of MEP. Incentives for MEP included preservation of
      one's estate and protection of a spouse. Finally, variability in accessibility to
      and awareness of MEP was described. IMPLICATIONS: This exploratory study
      identifies motivations for individual behaviors and describes evolving social
      norms regarding MEP; implications for policy and research are discussed.

PMID- 11220813
TI  - A randomized, controlled trial of a home environmental intervention: effect on
      efficacy and upset in caregivers and on daily function of persons with dementia.
AB  - PURPOSE OF STUDY: The authors determined short-term effects of a home
      environmental intervention on self-efficacy and upset in caregivers and daily
      function of dementia patients. They also determined if treatment effect varied by
      caregiver gender, race, and relationship to patient. DESIGN AND METHODS: Families
      (N = 171) of dementia patients were randomized to intervention or usual care
      control group. The intervention involved 5 90-min home visits by occupational
      therapists who provided education and physical and social environmental
      modifications. RESULTS: Compared with controls, intervention caregivers reported
      fewer declines in patients' instrumental activities of daily living (p = .030)
      and less decline in self-care and fewer behavior problems in patients at 3 months
      post-test. Also, intervention spouses reported reduced upset (p = .049), women
      reported enhanced self-efficacy in managing behaviors (p = .038), and women (p =
      .049) and minorities (p = .037) reported enhanced self-efficacy in managing
      functional dependency. IMPLICATIONS: The environmental program appears to have a
      modest effect on dementia patients' IADL dependence. Also, among certain
      subgroups of caregivers the program improves self-efficacy and reduces upset in
      specific areas of caregiving.

PMID- 11220814
TI  - Aging in place in assisted living: philosophy versus policy.
AB  - PURPOSE: Support of older adults' capacity to age in place is a core concept of
      the assisted living philosophy. This research examined implementation of the
      aging-in-place philosophy in 1 midwestern state (Kansas). DESIGN AND METHODS:
      This study was part of a larger state agency and university collaborative project
      to examine admission and discharge policies in these settings. Data analysis was
      conducted with descriptive statistics. Kansas findings were compared to national
      findings. RESULTS: Residents' capacity to age in place was limited by facility
      admission and discharge policies that were more restrictive than state
      regulations in the areas of behavioral problems, incontinence, and cognition. In
      general, assisted living facility policies in Kansas were more restrictive than
      admission and discharge policies found nationally. IMPLICATIONS: More inclusive
      assisted living admission and discharge criteria, and concomitant staffing and
      funding, are necessary if the aging-in-place philosophy is to be more fully
      implemented.

PMID- 11220815
TI  - Support for physician-assisted suicide: exploring the impact of ethnicity and
      attitudes toward planning for death.
AB  - The authors interviewed adults in five ethnic groups, used factor analysis to
      quantify attitudes toward planning for death, and used path analysis to test the
      relative influence of respondent characteristics, including ethnicity, and
      attitude factors (Advocacy to Discuss/Document Wishes, Trust in Family and
      Physician to Make Decisions, Reliance on Religious Guidance, Fears and Anxiety
      About Life's End, and Fatalism About Death's Timing) on support for physician
      assisted suicide (PAS). Findings verified that attitude factors had a direct
      effect on PAS support but that, contrary to the hypothesis, ethnicity had a
      direct effect on support for PAS as well.

PMID- 11220816
TI  - Data from long-term care ombudsman programs in six states: the implications of
      collecting resident demographics.
AB  - PURPOSE: This article focuses on why it is important for longterm care ombudsmen
      to collect resident demographics. DESIGN AND METHODS: The authors analyzed a
      cross-sectional, 6-state database to show the importance of ombudsman programs'
      collecting demographic information about the residents of long-term care
      facilities whom they serve. To demonstrate the importance of collecting
      demographic data about residents, the authors examined the relationships between
      race, gender, and types of complaints lodged, verified, and fully resolved.
      RESULTS: A higher percentage of complaints lodged on behalf of racial minorities
      was verified, yet a lower percentage was fully resolved. IMPLICATIONS: Ombudsman
      databases are a potential resource for identifying residents' characteristics
      that increase their vulnerability in long-term care settings.

PMID- 11220817
TI  - The unique contribution of key existential factors to the prediction of
      psychological well-being of older adults following spousal loss.
AB  - PURPOSE: This study examined the unique contribution of key existential factors
      to the prediction of psychological well-being of older adults following spousal
      loss. DESIGN AND METHOD: A number of measures to assess psychological well-being,
      sociodemographic standing, social resources, and religious and spiritual
      resources were administered to a volunteer sample of widows and widowers to test
      the hypothesis that existential factors such as personal meaning, religiosity,
      and spirituality are more potent predictors of psychological well-being than are
      previously hypothesized variables of sociodemographic, social support, and
      physical factors. RESULTS: A hierarchical regression analysis of the data
      supported the hypothesis that existential factors are major contributors to
      psychological well-being of older adults following spousal loss. Findings showed
      that widowers, compared to widows, scored lower on the measure of psychological
      well-being. IMPLICATIONS: Implications of the findings are discussed for
      practitioners working with bereaved spouses; suggestions for further research
      concerning bereavement and psychological well-being are made.

PMID- 11220819
TI  - Reminiscence, personality, and psychological functioning in older adults.
AB  - PURPOSE: The present study examined the relationships between the frequency and
      functions of reminiscence, personality styles, and psychological functioning.
      There is little research on the psychological factors that correlate with
      reminiscence, especially in relationship to clinical constructs such as
      depression and anxiety. Research in the area of reminiscence functions may
      facilitate a better understanding of the factors affecting change in reminiscence
      therapies. DESIGN AND METHODS: Seventy-seven healthy older adults completed the
      following self-report scales: Reminiscence Functions Scale, NEO Five Factor
      Personality Inventory, Beck Depression Inventory-Second Edition, State-Trait
      Anxiety Inventory, and the Templer-McMordie Death Anxiety Scale. RESULTS: Using
      canonical correlation techniques, results indicated that individuals with
      negative psychological functioning frequently reminisce as a way to refresh
      bitter memories, reduce boredom, and prepare for death. IMPLICATIONS: The present
      study provides implications for both researchers and clinicians. Contrary to
      previous studies, results indicate that depressed and anxious older adults
      commonly use reminiscence and therefore may be appropriate candidates for
      reminiscence treatments.

PMID- 11220818
TI  - Unmet need for personal assistance with activities of daily living among older
      adults.
AB  - PURPOSE: This study examined the prevalence, correlates, and negative
      consequences of unmet need for personal assistance with activities of daily
      living (ADLs) among older adults. DESIGN AND METHODS: The authors analyzed cross
      sectional data from the 1994 National Health Interview Survey's Supplement on
      Aging. Data were weighted to be representative of the noninstitutionalized
      population aged 70 years and older. RESULTS: Overall, 20.7% of those needing help
      to perform 1 or more ADLs (an estimated 629,000 persons) reported receiving
      inadequate assistance; for individual ADLs, the prevalence of unmet need ranged
      from 10.2% (eating) to 20.1% (transferring). The likelihood of having 1 or more
      unmet needs was associated with lower household income, multiple ADL
      difficulties, and living alone. Nearly half of those with unmet needs reported
      experiencing a negative consequence (e.g., unable to eat when hungry) as a result
      of their unmet need. IMPLICATIONS: Greater, targeted efforts are needed to reduce
      the prevalence and consequences of unmet need for ADL assistance in elderly
      persons.

PMID- 11220821
TI  - 2000 Winter Conference on Plasma Spectrochemistry--a time to refresh.

PMID- 11220822
TI  - Development of an ICP-IDMS method for accurate routine analyses of toxic heavy
      metals in polyolefins and comparison with results by TI-IDMS.
AB  - An inductively coupled plasma isotope dilution mass spectrometric (ICP-IDMS)
      method was developed as a suitable method - with respect to its sensitivity,
      precision, accuracy, and time-consumption - for the analysis of toxic heavy metal
      traces (Pb, Cd, Cr, and Hg) in polyolefins. Results for Pb, Cd, and Cr were
      compared with those obtained by thermal ionization isotope dilution mass
      spectrometry (TI-IDMS), which was used as a reference method. Because of its high
      first ionization potential and its high volatility mercury could not be
      determined by TI-IDMS. A multi-element spike solution, containing isotopically
      enriched 206Pb, 116Cd, 53Cr, and 201Hg, was used for the isotope dilution step.
      Decomposition of the polyolefin samples was carried out with concentrated HNO3 at
      temperatures of about 300 degrees C in a high pressure asher (HPA). This
      procedure decomposes polyolefins completely and allows isotopic equilibration
      between sample and spike isotopes. Detection limits of 16 ng/g, 5 ng/g, 164 ng/g,
      and 9 ng/g were obtained for Pb, Cd, Cr, and Hg by ICP-IDMS using only sample
      weights of 0.25 g. In different commercially available polyethylene samples heavy
      metal concentrations in the range of < 5 ng/g to 4 x 10(3) ng/g were analyzed.
      Both mass spectrometric methods were applied within the EU project "Polymeric
      Elemental Reference Material (PERM)" for the certification of two polyethylene
      reference materials. The ICP-IDMS results agreed very well with those of TI-IDMS
      which demonstrates the accuracy of the ICP-IDMS method also suitable for routine
      analyses.

PMID- 11220820
TI  - "Going home" or "leaving home"? The impact of person and place ties on
      anticipated counterstream migration.
AB  - PURPOSE: The probability of anticipated return migration in retirees is explored.
      DESIGN AND METHODS: Survey data were analyzed from interviews with a sample of
      elderly European Americans who migrated to a metropolitan city on Florida's east
      coast following retirement. RESULTS: Results are consistent with the
      specification of the 2nd move in E. Litwak and C. F. Longino's (1987) life course
      model of retirement migration. Respondents were unlikely to anticipate a return
      move unless ties to the back home community made such a move possible.
      IMPLICATIONS: Ties with children, both back home and in Florida, significantly
      influence consideration of a return move.

PMID- 11220823
TI  - Isotope dilution inductively coupled plasma quadrupole mass spectrometry in
      connection with a chromatographic separation for ultra trace determinations of
      platinum group elements (Pt, Pd, Ru, Ir) in environmental samples.
AB  - An isotope dilution inductively coupled plasma quadrupole mass spectrometric (ID
      ICP-QMS) method was developed for the simultaneous determination of the platinum
      group elements Pt, Pd, Ru, and Ir in environmental samples. Spike solutions,
      enriched with the isotopes 194Pt, 108Pd, 99Ru, and 191Ir, were used for the
      isotope dilution step. Interfering elements were eliminated by chromatographic
      separation using an anion-exchange resin. Samples were dissolved with aqua regia
      in a high pressure asher. Additional dissolution of possible silicate portions by
      hydrofluoric acid was usually not necessary. Detection limits of 0.15 ng x g(-1),
      0.075 ng x g(-1), and 0.015 ng x g(-1) were achieved for Pt, Pd, Ru, and Ir,
      respectively, using sample weights of only 0.2 g. The reliability of the ID-ICP
      QMS method was demonstrated by analyzing a Canadian geological reference material
      and by participating in an interlaboratory study for the determination of
      platinum and palladium in a homogenized road dust sample. Surface soil, sampled
      at different distances from a highway, showed concentrations in the range of 0.1
      87 ng x g(-1). An exponential decrease of the platinum and palladium
      concentration with increasing distance and a small anthropogenic contribution to
      the natural background concentration of ruthenium and iridium was found in these
      samples.

PMID- 11220825
TI  - Mass spectrometry with plasma sources at atmospheric pressure--state-of-the-art
      and some developmental trends.
AB  - The state-of-the art and trends of development in ICP-MS are presented. Special
      reference is made to progress in plasma sources, which can be used as ion sources
      and, especially, the inductively coupled plasma and new microwave plasma sources.
      Further, progress in sample introduction for plasma mass spectrometry is
      discussed with special reference to new pneumatic nebulizers, enabling, e.g.,
      work with microflows of solutions at high efficiency, new developments in
      ultrasonic nebulization, in electrothermal evaporation, laser ablation and
      hydride generation. Innovation in the types of mass spectrometers used is
      discussed with special reference to the use of reaction and collision cells,
      sector field mass spectrometry, time-of-flight mass spectrometry and
      multicollector mass spectrometers. Challenging applications in the field of
      speciation, especially in environmental samples with the example of the chromium
      speciation, and in materials analysis, with special reference to the analysis of
      ceramic powders with and without on-line matrix removal, are also discussed.

PMID- 11220826
TI  - Precise and accurate isotope ratio measurements by ICP-MS.
AB  - The precise and accurate determination of isotope ratios by inductively coupled
      plasma mass spectrometry (ICP-MS) and laser ablation ICP-MS (LA-ICP-MS) is
      important for quite different application fields (e.g. for isotope ratio
      measurements of stable isotopes in nature, especially for the investigation of
      isotope variation in nature or age dating, for determining isotope ratios of
      radiogenic elements in the nuclear industry, quality assurance of fuel material,
      for reprocessing plants, nuclear material accounting and radioactive waste
      control, for tracer experiments using stable isotopes or long-lived radionuclides
      in biological or medical studies). Thermal ionization mass spectrometry (TIMS),
      which used to be the dominant analytical technique for precise isotope ratio
      measurements, is being increasingly replaced for isotope ratio measurements by
      ICP-MS due to its excellent sensitivity, precision and good accuracy.
      Instrumental progress in ICP-MS was achieved by the introduction of the collision
      cell interface in order to dissociate many disturbing argon-based molecular ions,
      thermalize the ions and neutralize the disturbing argon ions of plasma gas (Ar+).
      The application of the collision cell in ICP-QMS results in a higher ion
      transmission, improved sensitivity and better precision of isotope ratio
      measurements compared to quadrupole ICP-MS without the collision cell [e.g., for
      235U/238U approximately 1 (10 microg x L(-1) uranium) 0.07% relative standard
      deviation (RSD) vs. 0.2% RSD in short-term measurements (n = 5)]. A significant
      instrumental improvement for ICP-MS is the multicollector device (MC-ICP-MS) in
      order to obtain a better precision of isotope ratio measurements (with a
      precision of up to 0.002%, RSD). CE- and HPLC-ICP-MS are used for the separation
      of isobaric interferences of long-lived radionuclides and stable isotopes by
      determination of spallation nuclide abundances in an irradiated tantalum target.

PMID- 11220824
TI  - Arsenic metabolism in seaweed-eating sheep from Northern Scotland.
AB  - Cation exchange and anion exchange liquid chromatography were coupled to an ICP
      MS and optimised for the separation of 13 different arsenic species in body
      fluids (arsenite, arsenate, dimethylarsinic acid (DMAA), monomethylarsonic acid
      (MMAA), trimethylarsine oxide (TMAO), tetramethylarsonium ion (TMA),
      arsenobetaine (AsB), arsenocholine (AsC), dimethylarsinoyl ethanol (DMAE) and
      four common dimethylarsinoylribosides (arsenosugars). The arsenic species were
      determined in seaweed extracts and in the urine and blood serum of seaweed-eating
      sheep from Northern Scotland. The sheep eat 2-4 kg of seaweed daily which is
      washed ashore on the most northern Island of Orkney. The urine, blood and wool of
      20 North Ronaldsay sheep and kidney, liver and muscle from 11 sheep were sampled
      and analysed for their arsenic species. In addition five Dorset Finn sheep, which
      lived entirely on grass, were used as a control group. The sheep have a body
      burden of approximately 45-90 mg arsenic daily. Since the metabolism of arsenic
      species varies with the arsenite and arsenate being the most toxic, and
      organoarsenic compounds such as arsenobetaine the least toxic compounds, the
      determination of the arsenic species in the diet and their body fluids are
      important. The major arsenic species in their diet are arsenoribosides. The major
      metabolite excreted into urine and blood is DMAA (95 +/- 4.1%) with minor amounts
      of MMAA, riboside X, TMA and an unidentified species. The occurrence of MMAA is
      assumed to be a precursor of the exposure to inorganic arsenic, since
      demethylation of dimethylated or trimethylated organoarsenic compounds is not
      known (max. MMAA concentration 259 microg/L). The concentrations in the urine
      (3179 +/- 2667 microg/L) and blood (44 +/- 19 microg/kg) are at least two orders
      of magnitude higher than the level of arsenic in the urine of the control sheep
      or literature levels of blood for the unexposed sheep. The tissue samples (liver:
      292 +/- 99 microg/kg, kidney: 565 +/- 193 microg/kg, muscle: 680 +/- 224
      microg/kg) and wool samples (10470 +/- 5690 microg/kg) show elevated levels which
      are also 100 times higher than the levels for the unexposed sheep.

PMID- 11220827
TI  - Bulk analysis by IR laser ablation inductively coupled plasma atomic emission
      spectrometry.
AB  - Two laser ablation systems dedicated to bulk analysis were evaluated for steel
      and PVC samples, using inductively coupled plasma atomic emission spectrometry
      detection. These systems were characterized by the use of a Nd:YAG laser
      operating at 1064 nm, the absence of observation device and a large laser spot
      size. The 1064 nm wavelength was selected to avoid the use of frequency
      multiplying optics, and to be less critical to the sampling position. Calibration
      graphs and limits of detection are given for both types of materials. LODs were
      in the range 3-120 microg/g for steel, and in the range 0.07-15 microg/g for PVC.
      In the case of steel samples, similar calibration graph slopes were obtained
      between polished and unpolished samples.

PMID- 11220828
TI  - Optimization of a laser ablation-inductively coupled plasma "time of flight" mass
      spectrometry system for short transient signal acquisition.
AB  - Simultaneous ion sampling and sequential detection offered by inductively coupled
      plasma 'time of flight' mass spectrometry (ICP-TOFMS) provides advantages for the
      analysis of short transient concentration-variable signals as produced in laser
      ablation. In order to investigate the capabilities of ICP-TOFMS in combination
      with an excimer laser ablation system, ablation studies on reference materials
      and geological samples were carried out. Various ICP-TOFMS parameters were
      optimized for laser-induced aerosols. Transverse rejection ion pulse was used to
      extend the dynamic range in concentration. A reduced volume ablation cell was
      designed and used in order to increase the sample density in the ICP. Results for
      63 simultaneously measured isotopes (SRM 610 from NIST) lead to limits of
      detection in the 1-100 microg/g range for a 80 microm crater diameter (10 Hz, 1.2
      mJ pulse energy). The reproducibility of signal ratios was determined to be
      better than 2% RSD for transient signals using 102 ms integration time. These
      optimized parameters were then used for the analysis of tin-rich fluid
      inclusions. Preliminary results of multielement analysis and isotopic ratio
      determinations on individual fluid inclusions (63 isotopes, 102 ms integration
      time) demonstrate the capabilities of ICP-TOFMS in combination with laser
      ablation.

PMID- 11220829
TI  - Recent trends and developments in laser ablation-ICP-mass spectrometry.
AB  - The increased interest in laser technology (e.g. for micro-machining, for medical
      applications, light shows, CD-players) is a tremendous driving force for the
      development of new laser types and optical set-ups. This directly influences
      their use in analytical chemistry. For direct analysis of the elemental
      composition of solids, mostly solid state lasers, such as Nd:YAG laser systems
      operating at 1064 nm (fundamental wavelength), 266 nm (frequency quadrupled) and
      even 213 nm (frequency quintupled) have been investigated in combination with all
      available inductively coupled plasma mass spectrometers. The trend towards
      shorter wavelengths (1064 nm - 157 nm) was initiated by access to high quality
      optical materials which led to the incorporation of UV gas lasers, such as
      excimer lasers (XeCl 308 nm, KrF 248 nm, ArF 193 nm, and F2 157 nm) into laser
      ablation set-ups. The flexibility in laser wavelengths, output energy, repetition
      rate, and spatial resolution allows qualitative and quantitative local and bulk
      elemental analysis as well as the determination of isotope ratios. However, the
      ablation process and the ablation behavior of various solid samples are different
      and no laser wavelength was found suitable for all types of solid samples. This
      article highlights some of the successfully applied systems in LA-ICP-MS. The
      current fields of applications are explained on selected examples using 266 nm
      and 193 nm laser ablation systems.

PMID- 11220830
TI  - A possible steady state kinetic model for the atomization and excitation
      processes during inductively coupled plasma atomic emission spectrometry:
      application to interference effects of lithium on calcium.
AB  - A possible steady state kinetic model is presented for the atomization and
      excitation processes during inductively coupled plasma atomic emission
      spectrometry. The model takes into account the relative rates of (a) thermal
      dissociation of analyte salt, (b) recombination of counter atom and analyte
      atoms, (c) charge transfer between analyte and interferent species, (d) charge
      transfer between analyte and argon species, and (e) ion/electron collisional de
      ionization. Number density ratio data, n(u)'/n(u), where n(u) denotes the excited
      state and the prime denotes the presence of an interferent element, are presented
      showing that the predictions of the model are consistent with the signal
      enhancement observed at low analyte concentrations when Ca is determined by ICP
      in the presence of excess Li.

PMID- 11220831
TI  - A novel high-temperature (360 degrees C)/high-pressure (30 MPa) flow system for
      online sample digestion applied to ICP spectrometry.
AB  - A flow injection sample digestion system has been developed comprising an
      indirectly electrically heated Pt/Ir capillary. Such a capillary allows reaction
      temperatures of up to 360 degrees C and pressures of up to 30 MPa (300 bar) and
      withstands concentrated acids. This temperature is 130 degrees C to 160 degrees C
      higher compared to the operating temperatures of microwave heated flow systems. A
      combination of an ultrasonic nebulizer and membrane desolvator serves as an
      interface between the flow digestion system and an ICP/AES spectrometer. The
      membrane desolvator removes interfering gaseous digestion products so effectively
      before the sample stream enters the plasma that the measured residual carbon
      concentration falls in the region of the detection limit of ICP/OES measurements.
      Sewage sludge samples were digested using nitric acid and the elemental traces
      online determined. The detection limits related to the original dry substances
      amount to the lower microg/g range.

PMID- 11220832
TI  - A simple co-precipitation inductively coupled plasma mass spectrometric method
      for the determination of uranium in seawater.
AB  - Inductively coupled plasma mass spectrometry (ICP-MS) was used in the
      determination of 238uranium in seawater after concentration by a simplified co
      precipitation with iron hydroxide. Ocean water and reference seawater were used
      in the study. The co-precipitation method required a smaller sample volume (10
      fold less), and less column separation to recover the uranium from the seawater
      matrix, compared to the original iron hydroxide method. The direct seawater
      dilution technique requires only a small seawater volume (0.5 mL) and offers a
      rapid, reliable method for uranium analysis in seawater compared to traditional
      methods. Comparison of the results for simple co-precipitation, direct dilution
      of seawater, and theoretical uranium values based on salinity concentrations,
      yielded negligible differences. Data from this work show that the certified value
      for NASS-4 is low.

PMID- 11220833
TI  - Speciation of antimony(III) and antimony(V) in cell extracts by anion
      chromatography/inductively coupled plasma mass spectrometry.
AB  - An analytical method for the separation and quantification of Sb(III) and Sb(V)
      using anion chromatography with ICP-MS is presented. The optimum conditions for
      the separation of the antimony species were established with 15 mmol/L nitric
      acid at pH 6 as eluent system on a PRP-X100 column. The retention times for
      antimony(V) and antimony(III) were 85 s and 300 s with detection limits of 0.06
      microg/L and 0.29 microg/L, respectively. The proposed method was applied to cell
      extracts of Leishmania donovani, which were incubated with antimony(III) and
      antimony(V). Some metabolism seemed to occur within the cells.

PMID- 11220834
TI  - A new HG/LT-GC/ICP-MS multi-element speciation technique for real samples in
      different matrices.
AB  - An improved speciation technique is presented for metal(loid)organic compounds,
      enabling identification and quantification of species from twelve elements:
      germanium, arsenic, selenium, molybdenum, tin, antimony, tellurium, iodine,
      tungsten, mercury, lead and bismuth. At this time it is possible to identify 29
      species with boiling points between -88.5 degrees C and 250 C in gaseous, liquid
      and solid samples in a few minutes. This study shows as an example results from
      measurements of soil samples from municipal waste deposits. The HG/LT-GC/ICP-MS
      (hydride generation/low temperature-gas chromatography/inductively coupled plasma
      mass spectrometry) apparatus contains a home-built gas chromatograph that enables
      satisfactory separation of various species with a boiling point difference of >
      or = 14 degrees C. The absolute detection limits for the elements mentioned above
      were below 0.7 pg.

PMID- 11220835
TI  - Automated in situ trace element analysis of silicate materials by laser ablation
      inductively coupled plasma mass spectrometry.
AB  - This paper describes the automated in situ trace element analysis of solid
      materials by laser ablation (LA) inductively coupled plasma mass spectrometry
      (ICP-MS). A compact computer-controlled solid state Nd:YAG Merchantek EO UV laser
      ablation (LA) system has been coupled with the high sensitivity VG PQII S ICP-MS.
      A two-directional communication was interfaced in-house between the ICP-MS and
      the LA via serial RS-232 port. Each LA-ICP-MS analysis at a defined point
      includes a 60 s pre-ablation delay, a 60 s ablation, and a 90 s flush delay. The
      execution of each defined time setting by LA was corresponding to the ICP-MS data
      acquisition allowing samples to be run in automated cycle sequences like solution
      auto-sampler ICP-MS analysis. Each analytical cycle consists of four standards,
      one control reference material, and 15 samples, and requires about 70 min. Data
      produced by Time Resolved Analysis (TRA) from ICP-MS were later reduced off-line
      by in-house written software. Twenty-two trace elements from four reference
      materials (NIST SRM 613, and fused glass chips of BCR-2, SY-4, and G-2) were
      determined by the automated LA-ICP-MS method. NIST SRM 610 or NIST SRM 613 was
      used as an external calibration standard, and Ca as an internal standard to
      correct for drift, differences in transport efficiency and sampling yield. Except
      for Zr and Hf in G-2, relative standard deviations for all other elements are
      less than 10%. Results compare well with the data reported from literature with
      average limits of detection from 1 ng x g(-1) to 455 ng x g(-1) and less than 100
      ng x g(-1) for most trace elements.

PMID- 11220836
TI  - Determination of trace elements in zeolites by laser ablation ICP-MS.
AB  - Laser ablation inductively coupled plasma mass spectrometry using a quadrupole
      based mass spectrometer (LA-ICP-QMS) was applied for the analysis of powdered
      zeolites (microporous aluminosilicates) used for clean-up procedures. For the
      quantitative determination of trace element concentrations three geological
      reference materials, granite NIM-G, lujavrite NIM-L and syenite NIM-S, from the
      National Institute for Metallurgy (South Africa) with a matrix composition
      corresponding to the zeolites were employed. Both the zeolites and reference
      materials were fused with a lithium borate mixture to increase the homogeneity
      and to eliminate mineralogical effects. In order to compare two different
      approaches for the quantification of analytical results in LA-ICP-MS relative
      sensitivity coefficients (RSCs) of chemical elements and calibration curves were
      measured using the geostandards. The experimentally obtained RSCs are in the
      range of 0.2-6 for all elements of interest. Calibration curves for trace
      elements were measured without and with Li or Ti as internal standard element.
      With a few exceptions the regression coefficients of the calibration curves are
      better than 0.993 with internal standardization. NIM-G granite reference material
      was employed to evaluate the accuracy of the technique. Therefore, the measured
      concentrations were corrected with RSCs which were determined using lujavrite
      reference material NIM-L. This quantification method provided analytical results
      with deviations of 1-11% from the recommended and proposed values in granite
      reference material NIM-G, except for Co, Cs, La and Tb. The relative standard
      deviation (RSD) of the determination of the trace element concentration (n = 5)
      is about 1% to 6% using Ti as internal standard element. Detection limits of LA
      ICP-QMS in the lower microg/g range (from 0.03 microg/g for Lu, Ta and Th to 7.3
      microg/g for Cu, with the exception of La) have been achieved for all elements of
      interest. Under the laser ablation conditions employed (lambda: 266 nm,
      repetition frequency: 10 Hz, pulse energy: 10 mJ, laser power density: 6 x 10(9)
      W/cm2) fractionation effects of the determined elements relative to the internal
      standard element Ti were not observed.

PMID- 11220837
TI  - Ion chromatography inductively coupled plasma mass spectrometry (IC-ICP-MS) and
      radiometric techniques for the determination of actinides in aqueous leachate
      solutions from uranium oxide.
AB  - The choice of the analytical method for the determination of actinide isotopes in
      leachate solutions has to be made considering several parameters: detection limit
      for each isotope, sample preparation procedure in terms of duration and
      complexity, counting time and interferences. A leachate solution obtained by
      keeping a pellet of UO2 doped with 238Pu in contact with distilled water was
      investigated for the content of U and Pu isotopes by radiometric methods (alpha-,
      gamma-spectrometry and liquid scintillation counting). The results of the
      radiometric methods were compared with those obtained from the analysis performed
      by inductively coupled plasma mass spectrometry on-line to a system for
      chromatographic separation (IC-ICP-MS). The comparison confirmed that IC-ICP-MS
      is a powerful method for the detection of long-lived radionuclides. The
      radiometric methods have a detection limit two orders of magnitude lower than IC
      ICP-MS in the case of short-lived radioisotopes mostly due to the low background
      in the detector. On the other hand, the sample preparation and the analysis
      duration are more time-consuming compared to IC-ICP-MS; moreover, not all
      isotopes can be determined by using only one radiometric technique.

PMID- 11220838
TI  - Comparison between the use of direct current glow discharge mass spectrometry and
      inductively coupled plasma quadrupole mass spectrometry for the analysis of trace
      elements in nuclear samples.
AB  - The quantitative determination of trace elements in nuclear samples by GDMS and
      ICP-MS is presented and compared. Spectral interferences, matrix effects,
      detection limits, precision and accuracy are discussed. Results for selected
      samples demonstrated that both techniques are complementary. The use of a multi
      standard solution provides the most accurate results in ICP-MS, whereas in GDMS
      this is achieved by relative sensitivity factors (RSF) matrix matched.
      Nevertheless, the use of standard RSF allows a fast screening.

PMID- 11220839
TI  - Effective management of daytime wetting.
AB  - Voiding dysfunction is important in the genesis of wetting and urinary tract
      infections but cure is not often achieved with the brief interventions possible
      from a busy outpatient clinic. Our aim was to establish a planned programme of
      care based on a physiological and psychological assessment. We studied 100
      children: 70 per cent had daytime enuresis; 11 per cent nocturnal enuresis alone
      and 19 per cent had recurrent urinary tract infections. Following assessment we
      found that 48 per cent had a significant post micturition residue. After six
      months of treatment 79 per cent were either completely dry or had only an
      occasional accident. Treatment for this condition is usually considered to be
      very time consuming, but by using a non-invasive bladder assessment and
      biofeedback methods which reinforce the child's and family's understanding of
      bladder function, success can be achieved for some of the more difficult wetters.

PMID- 11220840
TI  - Comparing the use of ketamine and midazolam in emergency settings.

PMID- 11220841
TI  - Are nurses respecting and upholding the human rights of children and young people
      in their care?
AB  - Children's nurses may assume that the care they provide for children and their
      families is family centred and meets their holistic needs. However, very little
      objective evaluation has been undertaken with children and young people regarding
      the health services and nursing care they receive. In this study, data were
      collected from 18 young ventilator-dependent people and their families in order
      to evaluate their experiences of health and social care. The UN Convention and
      other policy documents advocating client-focused services were used as benchmarks
      for analysis, demonstrating that the needs and aspirations of the young people
      are not being addressed and raising questions for nurses and other professionals.

PMID- 11220842
TI  - Safe staffing levels for children's wards.

PMID- 11220843
TI  - Informed refusal is as important as informed consent.

PMID- 11220844
TI  - Family nursing: minimising discontinuity for hospitalised children and their
      families.

PMID- 11220845
TI  - Preparation for renal biopsy: a play package.

PMID- 11220846
TI  - Preparation therapy in A&E: a student reflection.

PMID- 11220847
TI  - The rise and fall of children's consent to surgery.

PMID- 11220848
TI  - President's message. A mission that's possible.

PMID- 11220849
TI  - After the flood.

PMID- 11220850
TI  - In the footsteps of Mary Breckinridge. A glorious 75th anniversary celebration.

PMID- 11220851
TI  - Reaching outside the box. An academic-community model to prepare nurses for the
      future.

PMID- 11220852
TI  - Creating an adolescent health promotion Internet.site. A community partnership
      between university nursing students and an inner-city high school.

PMID- 11220853
TI  - Introducing complementary/alternative strategies in a baccalaureate curriculum.

PMID- 11220854
TI  - A reflective teaching-learning process to enhance personal knowing.

PMID- 11220855
TI  - Clinical teaching strategies for a caring curriculum.

PMID- 11220856
TI  - What is an interim report? Why is it used?

PMID- 11220857
TI  - CHAP and the Department of Veterans Affairs.

PMID- 11220858
TI  - Paediatric coma scoring researched and benchmarked.

PMID- 11220859
TI  - Choking: a review of resuscitation protocols.

PMID- 11220860
TI  - Adolescent health care: the Irish experience.

PMID- 11220861
TI  - Jamie: living with cystinosis.

PMID- 11220862
TI  - Consent and the teenage Jehovah's Witness.

PMID- 11220863
TI  - Protecting children--a core skill.

PMID- 11220864
TI  - Visiting children in hospital: a vision from the past.

PMID- 11220865
TI  - Supporting learning in a specialist unit.

PMID- 11220866
TI  - Fever management in children.
AB  - Treating a child with a fever is a skilled nursing activity. This article
      explains the underlying physiological mechanisms of a fever and relates these to
      the clinical signs, symptoms and care of children.

PMID- 11220867
TI  - Child protection: why continuing education for nurses is important.

PMID- 11220868
TI  - [Thyroid status and clinical features of osteoarthrosis in the region of goiter
      endemia].
AB  - AIM: The study of osteoarthrosis (OA) course in the region of goiter endemia
      regarding thyroid status. MATERIAL AND METHODS: The examination of 62 females
      with OA included enzyme immunoassay of blood TTH, T4, T3 and ultrasound
      investigation of the thyroid. RESULTS: OA patients were found to have subnormal
      levels of thyroid hormones and low thyroid index. Blood TTH rose with thyroid
      size. Joint changes were also directly related to thyroid size. CONCLUSION:
      Alterations in the thyroid status influence the course of degenerative-dystrophic
      process in the joints.

PMID- 11220869
TI  - [Nervous system changes in adrenal failure].
AB  - AIM: To study nervous systems in chronic adrenal failure (CAF). MATERIAL AND
      METHODS: 262 patients with CAF were studied clinically, biochemically and
      electrophysiologically before and after treatment. RESULTS: The patients were
      found to have syndromes of vegetovascular dystonia by hypotonic type, syncopal
      paroxysms, myastenic, minor strokes, dyscirculatory-dysmetabolic encephalopathy,
      polyneuropathy. A direct correlation was established between the severity and
      duration of adrenal failure (AF), lowering of adrenal cortex hormones,
      coefficient Na/K and clinical manifestations of the neurological syndromes.
      Adequate hormone replacing and symptomatic therapy promoted a regress of
      neurological disorders in most of the patients especially in mild and moderate
      AF. CONCLUSION: Adequate therapy corrects neurological disturbances in patients
      with chronic NN.

PMID- 11220870
TI  - [Clinical effect and tolerance of paxil (paroxetine) in management of panic
      disorders].
AB  - AIM: To determine clinical efficiency and tolerance of paxil (paroxetin) in the
      treatment of panic disorders. MATERIAL AND METHODS: An open, non-comparative 7
      week study entered 60 patients (mean age 36.6 +/- 3.22 years) with panic
      disorders and agoraphobias with panic disorders. Paroxetin was given in a single
      daily dose 20-60 mg/day in the morning. The results were assessed by Hamilton and
      Sihan scales, scale of clinical impression, by reduction of panic attacks.
      RESULTS: In 72.2% of patients panic attacks ceased or occurred less frequently
      (by 50%). Anxiety relieved by 67 +/- 4.6%. The number of the responders was
      greater while the effect occurred faster in patients with panic disorders. The
      drug was well tolerated, side effects occurred in 43.3% of cases. They were mild
      or moderate. CONCLUSION: Paroxetin has a prominent anxiolytic and antiphobic
      action, is well tolerated and is effective in panic disorders and agoraphobia
      with panic disorders.

PMID- 11220872
TI  - [Mitral prolapse as a psychosomatic problem (review)].

PMID- 11220871
TI  - [Role of grandaxin in the treatment of functional gastrointestinal diseases].
AB  - AIM: To assess efficacy of grandaxine in correction of anxiety syndrome and
      vegetative dysfunction in patients with gastrointestinal diseases. MATERIAL AND
      METHODS: The trial included 59 patients with functional gastrointestinal,
      emotional and vegetative disorders who failed standard therapy. 43 patients of
      the test group received standard therapy in combination with grandaxine. RESULTS:
      Anxiety (Spilberg-Khanin scale), vegetative dysfunction (Vein scale) reduced in
      90% of the patients of the test group more significantly than in the control
      group. Intestinal passage in patients with irritable colon syndrome improved
      also. CONCLUSION: A pronounced role of psychovegetative disorders was confirmed
      in development of functional gastrointestinal disorders. Grandaxine proved
      efficient in correction of such disorders irrespective of location of the
      pathology and prevalent tonicity of the autonomic nervous system.

PMID- 11220873
TI  - [Atopy and group of atopic and pseudo-atopic diseases. I. General understanding
      (lecture)].

PMID- 11220874
TI  - [Allergic reactions to antibiotics (lecture)].

PMID- 11220875
TI  - [Immunological indices in development of periodic disease].
AB  - AIM: To specify immune changes in periodical disease (PD) in different periods of
      PD development as well as peculiarities of their changes in colchicin therapy.
      MATERIAL AND METHODS: Clinicoimmunological investigations including blast
      transformation of lymphocytes with lymphocytic mitogen and renal antigen,
      leukocyte migration inhibition with renal antigen, spontaneous and complementary
      rossette formation were made in 828 PD patients and 43 donors. RESULTS: Decreased
      functional activity and quantity of T-lymphocytes, their suppressory
      subpopulation was found in PD. The indices did not correlate with the disease
      variants and gender but with age and PD complication. In amyloidosis
      immunological indices deteriorate with positive trend after colchicin treatment.
      CONCLUSION: PD is characterized by strain in immunological process.

PMID- 11220876
TI  - [Viral hepatitis C and pregnancy].
AB  - AIM: To evaluate course and outcomes of hepatitis C in gravidae; introduction of
      optimal management of pregnancy, postpartum period in mothers and newborns in
      viral hepatitis C. MATERIAL AND METHODS: Case histories, general and obstetric
      statuses, obstetric and extragenital pathology, pregnancy course and outcomes
      were studied in 76 pregnant women with viral hepatitis C. RESULTS: A complicated
      course of pregnancy was observed in 38.2, 13.1 and 24.3% of women in trimester I,
      II and III, respectively. Therapeutic policy of removing symptoms of the
      pathology with consideration of hepatitis C severity and stage allowed to keep
      pregnancy in all the women. CONCLUSION: Hepatitis C virus can complicate
      pregnancy but the latter does not aggrevate the course of hepatitis C.

PMID- 11220877
TI  - [Atenolol use in gestosis: clinical and hemodynamic aspects].
AB  - AIM: To study clinical efficiency of atenolol in pregnancy hypertension with
      consideration of its cardiodynamic effects. MATERIAL AND METHODS: The trial
      included 36 women aged 19 to 41 years on pregnancy week 32 to 38. This study
      group had gestosis of the 1st and 2nd degree. Control group consisted of 14
      healthy women with physiological pregnancy. All the examinees underwent atenolol
      test: measurement of heart rate, arterial pressure and ECG before, 30 and 90 min
      after introduction of a single atenolol dose 50 mg. Echo-CG was registered before
      and 90 min after administration of 50 mg amenolol, and on the treatment day 5.
      RESULTS: The response to atenolol in combined therapy of gestosis is the highest
      in gravidae with hyperkinetic type of circulation. CONCLUSION: Determination of
      the hemodynamic type is necessary for selection of antihypertensive drugs for
      treatment of gestosis.

PMID- 11220878
TI  - [New classification, diagnostic criteria and compensation of diabetes mellitus].

PMID- 11220879
TI  - [Safety and clinical efficiency of long-term complete blockade of renin
      angiotensin-aldosterone system in patients with chronic obstructive pulmonary
      diseases].
AB  - AIM: To study a corrective influence of a complete blockade of renin-angiotensin
      aldosterone system (RAAS) on right ventricular failure in patients with chronic
      obstructive pulmonary diseases (COPD). MATERIAL AND METHODS: 91 COPD patients
      were randomised into 3 groups who received standard therapy (ST), ST + losartan,
      ST + losartan + aldactone. The duration of the follow-up was 24 months. RESULTS:
      A complete RAAS blockade produced a significant decline in the pressure in the
      pulmonary artery, improved diastolic and systolic right ventricular function.
      This led to decreased number of hospitalizations because of progressing right
      ventricular failure. CONCLUSION: Safety of therapy with ACE inhibitor and
      aldactone was proved by a comparison of the number of side effects in the three
      groups.

PMID- 11220880
TI  - [Low back pain as a multidisciplinary problem (review)].

PMID- 11220881
TI  - [Effect of vazaprostan on microcirculation in patients with scleroderma
      systematic].
AB  - AIM: To investigate the effect of vazaprostan (alprostadil) on skin blood flow in
      patients with sclerodermia systematica (SS). MATERIAL AND METHODS: A total of 51
      patients with SS aged 33-70 years were included in the study. 33 of them received
      a 3-hour infusion of vazaprostan at the standard dose for 20 consecutive days.
      The rest 18 patients received low molecular dextran solution. Before and at the
      end of the treatment digital skin microcirculation was measured with a laser
      Doppler flowmeter. The laser probe was attached to the distal pad of the ring
      finger on the left hand. Baseline blood flow and vascular reactivity in the tests
      with sympathetic stimulation, local heating and during orthostasis were
      evaluated. RESULTS: Baseline blood flow and vascular response to functional tests
      were significantly reduced in all the patients. At the end of the treatment the
      flow increased only in patients treated with vazaprostan. Vascular reactivity was
      not changed after the treatment in both groups of patients. CONCLUSION:
      Vazaprostan increases baseline blood flow and contributes to the improvement of
      microcirculation in patients with SS.

PMID- 11220882
TI  - [Morpho-functional condition of heart in patients with lymphogranulomatosis late
      after chemoradiotherapy].
AB  - AIM: The study of clinical and echocardiographic status of the heart in patients
      with lymphogranulomatosis (LGM) late after chemoradiotherapy. MATERIAL AND
      METHODS: 44 patients with IIA-IV stage of LGM exposed to irradiation of lymph
      nodes and polychemotherapy according to the schemes ACOP, ABVD, COPP, CHOP, CVPP
      were examined. Echocardiography was carried out on the unit Sigma-44 and Toshiba.
      RESULTS: Some changes in the heart by type of myocardiodystrophy or
      endomyocardial fibrosis were found. The latter are characterized by diminution of
      the left and (or) right ventricles due to apex obliteration, hardening and
      thickening of the endocardium and subvalvular structures, diastolic dysfunction
      and pulmonary hypertension. The main and additional signs are distinguished. The
      reasons of endomyocardial fibrosis are discussed: severity of the disease,
      frequent exacerbations and, consequently, higher doses of specific
      chemoradiotherapy. CONCLUSION: It is necessary to employ sparing policy in
      planning radiotherapy after high loading antracycline antibiotics.

PMID- 11220883
TI  - [Skin symptoms in malignant hemopathies].
AB  - AIM: To investigate specific and non-specific skin lesions in malignant
      hemopathies. MATERIAL AND METHODS: The study enrolled 862 patients (394 females
      and 468 males) with hematological malignancies treated in the hematological
      clinic from 1990 to 1998. The patients were divided into three groups according
      to the primary disorder: lymphoproliferative processes (541 patients),
      myeloproliferative processes (296 patients) and bone marrow hypoplasia (25
      patients). RESULTS: The non-specific skin lesions showed high variability in
      morphology, location. Combinations of different lesions were also present.
      Specific lesions were less variable and more characteristic for
      lymphoproliferative processes. Skin lesions (specific or non-specific) were not
      found related to a particular disease. CONCLUSION: Skin lesions in
      oncohematological disorders appear in great variability. They are essential for
      diagnosis and may appear a single initial diagnostic marker in these conditions.

PMID- 11220885
TI  - [Some pathological aspects of viscera in parapsoriasis nodosus].

PMID- 11220884
TI  - [Medicaments as ointments in combined treatment of osteoarthrosis].

PMID- 11220886
TI  - [The ACE inhibitor spirapril in chronic renal failure, hypertension and diabetic
      nephropathy].
AB  - The evidence from recent clinical outcome trials in arterial hypertension (AH)
      and the treatment guidelines from national and international authorities have
      placed a clear emphasis on "tight" blood pressure (BP) control. This has been
      particularly well illustrated in the treatment of patients with diabetes mellitus
      and AH where "tight" BP control clearly improves the outcome with reduced numbers
      of fatal and non-fatal cardiovascular events. Whilst the clinical trials in AH
      have identified benefits through BP reduction with a range of antihypertensive
      drugs there is a considerable volume of evidence to suggest that the optimal
      treatment for diabetic nephropathy and microalbuminuria should be based upon ACE
      inhibition. It is widely held that inhibition of intra-renal renin angiotensin
      systems leads to greater benefit than can be achieved by hemodynamic changes
      alone. Thus, management of AH and nephropathy in both DM and other forms of renal
      disease revolves around BP reduction through an ACE inhibitor-based treatment
      regimen. Where there is renal failure it may be prudent to administer a drug such
      as spirapril which has non-renal elimination mechanisms and which has been shown
      to have no accumulation problems or increased adverse effects.

PMID- 11220887
TI  - [Spirapril - a new long-acting ACE inhibitor: efficacy and safety in patients
      with arterial hypertension in combination with diabetes mellitus and impaired
      kidney function].
AB  - AIM: To examine effectiveness and safety of quadropril. MATERIAL AND METHODS:
      Changes in blood pressure (BP), heart rate (HR), levels of glucose, potassium and
      creatinine, creatinine clearance were studied in 120 patients (48 males and 72
      females, mean age 60.6 +/- 0.7 years) with mild to moderate arterial hypertension
      (AH) with average duration 13.8 +/- 0.7 years. The patients were divided into 3
      groups: with AH (n = 40), AH + noninsulindependent diabetes mellitus (DM) (n =
      43), AH and nephropathy (n = 37). 8-week treatment was performed with a standard
      dose of 6 mg/day (1 tablet of quadropril). Control examinations were made 2, 4
      and 8 weeks after the treatment. RESULTS: After 8 weeks of treatment a decrease
      in systolic blood pressure in AH group was 24.0 +/- 3.0 mm Hg and in diastolic
      blood pressure 16.3 +/- 1.3 mm Hg (P < 0.001). In the group with DM this decrease
      was 22.4 +/- 2.8 mm Hg and 15.7 +/- 1.4 mm Hg (p < 0.001), respectively. In the
      group with nephropathy this decrease was 26.4 +/- 2.4 and 16.5 +/- 1.3 mm Hg (p <
      0.001), respectively. Heart rate changed significantly only in diabetics: from
      75.1 +/- 1.7 to 72.9 +/- 1.3 beats/min. Biochemical parameters in the
      hypertensive and diabetic patients did not change significantly. In the
      nephropathy group there was a significant decrease in creatinine and increase in
      creatinine clearance. Their level of glucose and potassium changed
      insignificantly. CONCLUSION: The treatment with quadropril results in a
      significant decrease in blood pressure, does not influence parameters of
      carbohydrate metabolism, improves nitrogen eliminating function of the kidneys.

PMID- 11220889
TI  - [Spirapril in patients with hypertension: clinical experience in Germany].
AB  - AIM: To examine efficacy and tolerability of a single daily dose of 6 mg
      quadropril (spirapril). MATERIAL AND METHODS: An open multicenter study enrolled
      5000 out-door patients with hypertension. All the patients received an ACE
      inhibitor quadropril for 3 months with four control visits (on week 0, 4, 8 and
      12). RESULTS: Quadropril caused a marked decrease in systolic and diastolic blood
      pressure. At the end of the study 89.4% of patients had a systolic blood pressure
      reduction of at least 15 mm Hg and 85.4% had a diastolic blood pressure reduction
      of at least 10 mm Hg. There were no clinically significant heart rate changes.
      The overall tolerability of the drug was estimated as good or very good in 95.3%
      of patients. Only 2.9% of patients had side effects during treatment with once
      daily dose of 6 mg quadropril. No serious side effects were observed. CONCLUSION:
      6 mg daily dose of quadropril is an effective and safe therapy for arterial
      hypertension.

PMID- 11220888
TI  - [Comparative study of spirapril (quadropril) and amlodipine efficacy. Results of
      randomized trial in patients with mild to moderate arterial hypertension].
AB  - AIM: To compare in the non-blind randomised parallel study the efficiency of
      quadropril and amlodipine in the treatment of mild to moderate arterial
      hypertension. MATERIAL AND METHODS: A total of 80 patients (57.6 +/- 1.0 years)
      were included in this study. The patients were randomised in two groups, 40
      patients each. Patients of group 1 received monotherapy with quadropril, while
      those of group 2 were treated with amlodipine. The treatment duration was 8 weeks
      in both groups. Quadropril was given in a fixed dose of 6 mg once daily. The
      initial dose of amlodipine was 5 mg/day. In case of insufficient effect the dose
      was elevated to 10 mg/day. The efficacy was evaluated by changes in blood
      pressure (BP) measured at rest. Moreover, in 50 randomly chosen patients 24-h
      monitoring of BP was performed at the start and end of the treatment. RESULTS: In
      the quadropril group baseline systolic BP reached 158.6 +/- 2.1 mm Hg, diastolic
      BP--101.8 +/- 0.8 mm Hg, heart rate was 74.3 +/- 1.6 beats/min. In the amlodipine
      group baseline systolic BP was 159.9 +/- 2.4 mm Hg, diastolic BP--101.8 +/- 1.0
      mm Hg, heart rate was 71.3 +/- 1.0 beats/min. Systolic BP decreased at the end of
      quadropril therapy to 138.5 +/- 2.2 mm Hg, diastolic BP to 88.1 +/- 1.4 mm Hg. No
      significant change of the heart rate was observed. Under 5 mg of amlodipine
      systolic BP decreased to 137.9 +/- 2.5 mm Hg and diastolic BP to 87.1 +/- 1.6 mm
      Hg. Heart rate increased to 73.3 +/- 2.2 beats/min. Under therapy with 10 mg
      amlodipine systolic BP decreased to 145.9 +/- 3.8 mm Hg, diastolic BP to 89.7 +/-
      3.4 mm Hg. Heart rate increased to 77.3 +/- 4.0 beats/min (p < 0.01). The
      hypotensive effect of quadropril remained stable while the effect of amlodipine
      decreased by the 8th week of therapy (p < 0.01). Side effects were observed
      significantly more often in the amlodipine group, then in the quadropril group.
      The main quadropril side effect was cough. Side effects observed in the
      amlodipine group were edemas, tachycardia, weakness. CONCLUSION: Both quadropril
      and amlodipine demonstrated a comparable antihypertensive effect although in 11
      of 40 patients in the amlodipine group a dose increase was necessary and
      tolerability of quadropril was better.

PMID- 11220890
TI  - [Efficacy of quadropril (spirapril) vs capropril in treatment of essential
      hypertension].
AB  - AIM: To compare the efficacy of monotherapy with quadropril (spirapril) vs
      captopril in essential hypertension. MATERIAL AND METHODS: 20 female patients
      aged 55 +/- 2 years with moderate hypertension (WHO classification) were included
      in the study. 16 patients had congestive heart failure stage II NYHA and 4
      patients stage III NYHA. ECG and echocardiography were performed in all the
      patients. Two patient groups of 10 patients were treated for 6 weeks. Group 1
      received 6 mg quadropril once daily. Group 2 received 25 mg captopril 3 times
      daily. The therapy was considered to be efficient if diastolic pressure (BP) was
      reduced to 90 +/- 5 mm Hg and systolic BP to 140 +/- 10 mm Hg from baseline
      values in the range of 210/120-170/100 mm Hg. RESULTS: The hypotensive effect of
      quadropril resulted in stabilisation of BP during the second week of therapy. A
      significant BP decrease was achieved at the end of 6 week therapy. Systolic BP
      fell from 178.8 +/- 3.2 to 145 +/- 5.6 mm Hd and diastolic BP from 109.7 +/- 1.2
      to 92.4 +/- 1.7 mm Hg. Central and cardiac hemodynamic parameters improved. In
      one patient the condition improved from CHF stage III to stage II NYHA. No
      adverse effects were observed. A hypotensive effect of captopril reduced
      significantly systolic blood pressure from 182.1 +/- 2.7 to 150 +/- 4.6 mm Hg and
      diastolic BP from 110.4 +/- 1.1 to 100.1 +/- 1.9 mm Hg. Two patients developed
      adverse effects: cough and chest dyscomfort. CONCLUSION: Quadropril monotherapy
      showed to be more effective in diastolic BP decrease compared with captopril
      monotherapy and had advantages in one daily dose regimen, absence of the first
      dose effect and side effects.

PMID- 11220891
TI  - [Left ventricular myocardial hypertrophy in arterial hypertension: clinical
      significance, diagnosis, effects of antihypertensive drugs].

PMID- 11220892
TI  - [The role of renin-angiotensin system in pathogenesis of pulmonary hypertension
      in patients with chronic obstructive pulmonary disease].
AB  - Renin-angiotensin system (RAS) and hemodynamics in pulmonary artery (PA) were
      assessed in 25 patients with chronic non-obstructive bronchitis and 73 patients
      with chronic obstructive pulmonary diseases (COPD). RAS in COPD patients was
      activated. The degree of this activation rose with progression of respiratory
      failure. Hypertension in PA was secondary to RAS activation. The data were
      obtained on the essential role of RAS in the onset and progression of pulmonary
      hypertension. This allows to design new approaches to pathogenetic treatment of
      secondary pulmonary hypertension.

PMID- 11220893
TI  - [Poseidonol in the treatment of patients with hyperlipidemia].
AB  - An antilipidemic effect of poseidonol was tested in 123 patients with ischemic
      heart disease, stable angina of effort (II-III functional class), 40 patients
      with secondary pyelonephritis and 40 patients with chronic hepatosis-hepatitis
      associated with chronic alcoholism or diabetes mellitus. The patients had also
      hyperlipidemia. A positive effect of poseidonol was established: cholesterol
      content fell by 25.4, 20.6 and 18.7%, respectively; triglycerides level decreased
      by 63, 42 and 21.4%, respectively; B-lipoproteins fell by 55.5, 36.9 and 13.1%,
      respectively. High density lipoproteins rose by 40.2, 27 and 69.9%, respectively.
      No adverse effects either on the liver or kidney functions were observed.

PMID- 11220894
TI  - [Psychopharmacotherapy and management of psychiatric care in somatic hospital].
AB  - A clinical trial was made of 1994 patients admitted to a large general hospital
      in Moscow during a day in two seasons (spring, autumn). The aim of the study was
      to detect patients of a general hospital in need of psychotropic drugs, to assess
      their psychic condition and to develop recommendations for optimization of
      psychiatrist's consulting. It was found that 49.3% of the examinees need
      psychotropic drugs (at least one). 37.5% need tranquilizers, 20.7%--nootropic
      drugs, 21.2%--antidepressants, 5.9%--neuroleptics.

PMID- 11220895
TI  - [Multiple endocrine neoplasia of the first type (Wermer's syndrome)].
AB  - 11 patients with Wermer's syndrome (WS) aged 24-67 years were treated. They had a
      total of 30 tumors: 4(13.3%) hypophyseal, 11(36.7%) pancreatic, 9(30%)
      parathyroid, 4(13.3%) adrenal and 2(6.7%) duodenal. Each patient had two tumors
      minimum and 8 tumors maximum. In 8 cases WS presented clinically as hypoglycemia,
      in 3 cases as Zollinger-Ellison syndrome. The diagnosis was made using
      ultrasonography, CT, MRT and angiography. Cytogenetic examination was made in 2
      cases. All the patients were operated. Six of them were operated two times, one-
      four times. The following surgery was made: 4 removals of parathyroid adenomas, 4
      adrenalectomies, 1 removal of the hypophysis, 4 enucleations of pancreatic
      insulinomas, 5 distal hemipancreatectomies, 1 distal subtotal resection of the
      pancreas, 1 gastropancreatoduodenal resection. Clinically symptomatic tumors
      should be operated first.

PMID- 11220896
TI  - [Local cellular and humoral immunity in pneumonia patients].
AB  - The paper reports a study of some local immunity factors in pneumonia aimed at
      specification of mechanisms inducing respiratory immunodeficiency and their
      effects on the disease course. Local cellular immunity of the lungs was studied
      by estimation of the total number of cells in the bronchoalveolar lavage, their
      viability, alveolar macrophages (AM), neutrophils, T- and B-lymphocytes, AM and
      neutrophil phagocytic index and number, receptor apparatus. The lavage IgA, IgM,
      IgG, lysozyme were estimated. It was found that local cellular and humoral
      immunity depend on clinicoetiological form of pneumonia. Cellular and humoral
      immunodeficiency was the greatest in staphylococcal infection. The role of
      cellular and humoral immunity dysfunction in the lungs in genesis of
      bronchoobstructive syndrome is specified. Recovery of cellular and humoral
      immunity in pneumonia reconvalescents is behind clinical recovery. Grave
      immunodeficiency in severe or lingering pneumonia may be a pathogenetic factor of
      chronic inflammation in the lungs. To evaluate functional condition of local
      immunity of the lungs it is valid to study cellular and humoral factors of local
      pulmonary immunity in bronchoalveolar lavage.

PMID- 11220897
TI  - [Effects of antihypertensive drugs with different mechanism of action on cardiac
      hemodynamics in patients with artificial pacemaker].
AB  - Cardiohemodynamic effects of obsidan, nifedipin, captopril and prasosine were
      compared when the drugs were given in a 4-week course regarding circulation type
      and stimulation regime to 74 patients with artificial pacemaker suffering from
      mild or moderate essential hypertension. A peculiar action of obsidan, nifedipin
      and prasosine in cardiac pacing found at echocardiography is explained by the
      absence of frequency-dependent (chronotropic) cardiohemodynamic effects. Obsidan
      lowered blood pressure most effectively in hyperkinetic circulation. Nifedipine,
      captopril and prasosine were more potent in eu- and hypokinetic circulation.
      Reduction of arterial pressure by the above peripheral vasodilators in patients
      with hyperkinetic circulation results from a fall of total peripheral vascular
      resistance initially elevated by 16.5%, on the average. In isolated ventricular
      stimulation (regime VVI) vs atrial one (AAI regime) hypotensive action of the
      above drugs was more potent, but side effects were more frequent.

PMID- 11220898
TI  - [Mineral corticism syndrome: classification, etiology and pathogenesis].

PMID- 11220899
TI  - [Renitec and ednit in the treatment of cardiac failure associated with duodenal
      ulcer].
AB  - The influence of renitec and ednit on duodenal ulcer was studied in 25 patients
      with cardiac failure. It was found that renitec and ednit lowered both systolic
      and diastolic pressure, relieved gastralgia and dyspepsia. Duodenal ulcer healed
      in 87% of the patients. Contracting and pump function of the right ventricle
      improved. Plasma levels of angiotensin and aldosteron decreased while
      prostaglandin E2 increased.

PMID- 11220900
TI  - [Treatment of irritable bowel syndrome with dicetelium and spasmomen].
AB  - The aim of the study was to compare clinical efficacy of new spasmolytics-
      pinaverium bromide (dicetel, Solvay Pharma) and otilonium bromide (spasmomen,
      Menarini-Berlin-Chemie)--in the treatment of irritable bowel syndrome. Effects
      appearing during the treatment with anxiolytic drug tofisopam (grandaxin, Egis)
      after using dicetel and spasmomen were also studied. The results indicate marked
      clinical efficiency of dicetel and spasmomen which improve vegetative functions
      and psychoemotional status. Grandaxin provides further improvement of clinical
      symptoms and additionally corrects psychoemotional status.

PMID- 11220901
TI  - [Fliformine effects on blood lipid spectrum and lipid peroxidation in obese
      patients].
AB  - Blood lipid spectrum and lipid peroxidation are compared in patients with
      different obesity types. Diet treatment is compared to biguanides derivatives
      (gliformine) in patients with body obesity combined with dislipidemia. Gliformine
      proved more effective in correction of changed lipid spectrum of atherogenic
      origin, improves lipid peroxidation. Biguanides seem perspective in management of
      lipid disbolism in patients with body obesity.

PMID- 11220902
TI  - [Respiratory distress syndrome in patients with sepsis].

PMID- 11220903
TI  - [Information necessary for a doctor using a computer].

PMID- 11220904
TI  - [Primary antiphospolipid syndrome causing thrombosis of hepatic vein].

PMID- 11220906
TI  - [Gastroesophageal reflux disease and Helicobacter pylori].

PMID- 11220905
TI  - [Effectiveness of thrombolysis and balloon angioplasty in a patient with a
      combined infarction of the left and right cardiac ventricle].

PMID- 11220907
TI  - [Hyponatremia syndrome in patients with chronic cardiac failure].

PMID- 11220908
TI  - [History of the idea of staged clinical education. Communication. 1. Events of
      1835-1840].

PMID- 11220909
TI  - [Spectro-fluorescence analysis of ALA-induced protoporphyrin IX in differential
      diagnosis of stomach disease].
AB  - The results of examination of 47 patients with confirmed diagnosis of cancer of
      the stomach (21 patients) or 26 suspects were analyzed. 2-4 hours after oral
      taking of Alasence in the dose 5-10 mg/kg, gastroscopy with spectrofluorescence
      analysis of ALA-induced protoporphyrin IX was performed. There were no toxic
      complications due to Alasence taking. The standard spectrodetector LESA-7 was
      used for fluorescence record registration. The fluorescence spectra were recorded
      in the range of 650-850 nm. The specific for protoporphyrin IX peak at 700 nm
      wavelength was analyzed. Fluorescent endoscopic diagnosis allowed to confirm
      stomach cancer in 21 patients, and to detect cancer in 7 patients, including 2
      cases of cancer in situ. The contrast of protoporphyrin IX accumulation
      (tumor/norm ratio) ranged from 2.5 to 18, that was enough for differential
      diagnosis in the majority of cases. In analysis of spectrograms for correct
      contrast calculation it is necessary to take into account the own fluorescence,
      with was high in some cases.

PMID- 11220910
TI  - [Choice of surgical treatment method for peptic ulcer of operated stomach].
AB  - The analysis of immediate and long-term results of surgical treatment in 98
      patients with peptic ulcer of operated stomach is presented. The choice of
      surgical method was determined by the disease cause. Reconstructive stomach
      resection by Bilrot-II in Roux modification was operation of choice in peptic
      ulcer with non-hormonal factors of ulcerogenesis. When hormonal cause of
      ulcerogenesis was suspected, even in unknown origin of hypergastrinemia, the
      extirpation of gastric stump is indicated. Trunkal vagotomy can be performed as
      an additional surgical method only. Favorable surgical outcomes were seen in 90
      (91.8%) patients. Long-term results from 2 to 15 years were studied in 74 (82.2%)
      patients. They were recognized as good in 48 (53.3%) patients, as satisfactory-
      in 12 (13.3%). The recurrence of the disease was seen in 4 (4.4%) patients. 10
      patients died due to causes not associated with stomach diseases.

PMID- 11220911
TI  - [Differential diagnosis of pancreatic head cancer].
AB  - The results of clinical, instrumental and laboratory examinations were analyzed
      for 99 patients. 59 of them had pancreatic head cancer, 40--chronic
      pseudotumorous pancreatitis. The importance of complex ultrasonic diagnosis in
      detection of pancreatic diseases (98%), in true diagnosis of unresectable tumors
      (96.7%), and also in determination of bile ducts lesion level in obstructive
      jaundice is shown. It was revealed that spiral computed tomography (SCT) had an
      advantage over computed tomography in diagnosis of pancreatic tumors and in
      assessment of their resectability. Sensitivity of combined use of US, SCT and
      tumor marker CA 19-9 in pancreatic cancer diagnosis increases to 95.2%. High
      diagnostic value of laparoscopy with laparoscopic ultrasonic examination as a
      method of final assessment of tumor resectability is shown.

PMID- 11220912
TI  - [Experience of laparoscopic cholecystectomy in calculous cholecystitis].
AB  - Laparoscopic cholecystectomy (LCE) was performed in 330 patients aged from 14 to
      77 years; it was completed successfully in 308 (93.3%) patients. Conversion to
      laparotomy and standard cholecystectomy was carried out in 22 patients (6.7%) due
      chiefly (86.4%) to inflammatory disorders of infrahepatic area. 188 (61%) LCE
      were performed for chronic calculous cholecystitis, 120--for acute calculous
      cholecystitis. In the latter group destructive forms of cholecystitis were
      revealed in 34.2% patients. Combined with LCE interventions were performed in 13
      patients (4.2%). There were no lethal outcomes after LCE. Severe intra- and
      postoperative complications occurred in 26 (8.4%) patients; laparotomy for
      removing these complications was necessary in 3 patients (1%).

PMID- 11220913
TI  - [Correction of lymph circulation in liver cirrhosis].
AB  - The approach to surgical correction of lymph circulation in hepatic cirrhosis is
      described. The main criteria in the choice of operations draining neck lymphatic
      duct were hyperkinetic central hemodynamics with high functional pressure in
      thoracic lymphatic duct and lymphovenous pressure gradient, central or mixed type
      of intrahepatic lymph flow. All the 26 patients underwent transvenous external
      internal drainage of thoracic duct as a temporal measure for stabilization of
      patients state. Reinfusion of lymph after lymphosorption promoted detoxication in
      hepatic failure in patients with cirrhosis, complicated by resistant ascites. Low
      pressure indices of central lymphodynamics and mixed intrahepatic lymph flow are
      indications for anastomosis creation between right lumbar vein and right
      lymphatic duct. In this case it is possible to save the behind-hepatic portion of
      cava inferior in potential recipients of liver transplants.

PMID- 11220914
TI  - [Laparoscopic treatment of hydatid liver cysts].
AB  - Laparoscopic hepatic hydatidectomy (LHE) was performed in 37 patients. Conversion
      to laparotomy in one case was caused by intrahepatic location of liver cyst. In
      36 patients after LHE, the postoperative period was significantly easier than
      after standard operation. There were the following complications: bile efflux in
      abdominal cavity (1), bile efflux from residual cavity (2), suppuration of
      residual cavity (1). The complications were removed without laparotomy, all the
      patients recovered. The patients were discharged on day 5.6 on the average. LHE
      is a promising method of surgical treatment for uncomplicated liver
      echinococcosis.

PMID- 11220916
TI  - [Thermal trauma in a combination with respiratory tract burn].
AB  - The detection rate of microbial contamination of burn wounds after flame burn was
      studied in dynamics to 3 weeks in 56 patients forming 2 similar groups: basic-
      with thermo-inhalation lesions (TIL) and control--without TIL. General area of
      skin burns in all the patients was less than 50% of the body surface, on average
      it was 40%, the area of deep burns was 23%. Cytological and bacteriologic methods
      were used for study microphlora in the sputum and in bronchoalveolar lavage.
      There were 186 cases of wound microbial contamination (gram-negative
      microorganisms--64.4% cases, gram-positive--34%, pathogenic fungi--1.6%). In 80%
      cases the microphlora of the wounds was polymicrobial, in 47% cases the
      microphlora were detected on the second week. Microphlora was detected 2 times
      more often in the basic group than in the control, corresponded to skin burn
      area; the greatest exceeding of critical level of wound contamination was
      revealed on the first 2 weeks. In TIL besides wound contamination, polymicrobial
      microphlora revealed in tracheobronchial tree, presented on the first 2 weeks
      with association of gram-positive and gram-negative microorganisms, combining on
      week 3 with fungal phlora. Early leukocytosis, not reducing during first 3 weeks
      of the study, due to intoxication by burn products, occurred in TIL. Early
      lymphopenia in TIL was the sign of resistant immunodeficiency.

PMID- 11220915
TI  - [Use of CO2-laser in the treatment of liver hydatid echinococcosis].
AB  - The results of laser scalpel use in 226 patients with hepatic echinococcosis are
      analyzed. Laser beam produces coagulation of the small vessels and intrahepatic
      bile ducts, destroys alive protoscolexes, suppresses microphlora. It ensures
      easier postoperative period, reduces postoperative complications rate 4 times,
      hospital stay 2 times.

PMID- 11220917
TI  - [Treatment of heart wounds].
AB  - Care results in 48 patients (male--38, female--10) with heart wounds (HW) were
      analyzed. 40 (83.2%) patients had stab-incised wounds, 7 (14.7%)--stab wounds, 1
      (2.1%)--gunshot wounds. 23 (47.8%) patients were hospitalized in consciousness,
      17 (35.3%)--in unconsciousness, 8 (16.9%)--in twilight state. The lethality among
      the latter two groups of the patients was 64%, in the former group--13%. 19
      patients from 48 died: in preoperative period--3, during operation--10, in early
      postoperative period (more than 10 days)--2 patients. The suspected of HW
      patients must be transported in the nearest surgical hospital. In unstable
      hemodynamics it is necessary to carry out adequate infusion therapy, in obvious
      signs of heart tamponade the pericardium puncture must be performed. In agonizing
      patients, and in case of general anesthesia delay, it is necessary to begin
      thoracotomy before general anesthesia.

PMID- 11220918
TI  - [Lumbar sympathectomy in atherosclerosis obliterance of lower limb arteries and
      age of the patients].
AB  - In the elderly and old patients with atherosclerosis of lower limb arteries,
      ultrasonic dopplerography assisted study of hemodynamics in foot with use of
      Valsalva and corinfar tests was carried out. It is revealed that these patients
      retain high reaction to sympathetic influences. The obtained data were the base
      for use of lumbar sympathectomy in 419 patients over 65 years as an independent
      method of surgical treatment and in combination with reconstructive operations on
      major arteries. Good results were obtained in 70.1% operated patients,
      satisfactory results--in 22.7%. There were no significant differences in the
      results of lumbar sympathectomy between this age group and younger patients.

PMID- 11220919
TI  - [Health care standards for surgical patients in clinical hospital].
AB  - In Russian Federation the Obligatory Health Insurance Standards are based on the
      a priori expert assessments but not on statistical analysis of really recorded
      cases. This leads to the essential standard incompleteness, indistinctness and
      heterogeneity. In Vishnevsky Institute of surgery the "Automatized system for
      care registration in hospital" was designed, and data base on more than 10,000
      patients treated in 1995 to 1999 was created giving now the starting-point for
      further efforts for overcoming the above standards insufficiency.

PMID- 11220920
TI  - [Posterior mediastinal esophagoplasty with by operated stomach in a patient with
      single lung].

PMID- 11220921
TI  - [Tuberculous omentitis].

PMID- 11220922
TI  - [Aneurysm of pancreatoduodenal artery associated with celiac trunk occlusion].

PMID- 11220923
TI  - [Risk evaluation of extracardiac operation in patients with concomitant
      cardiovascular diseases (review)].

PMID- 11220924
TI  - [Surgery in Ancient Rome].

PMID- 11220925
TI  - [Experimental, morphological and clinical aspects of transmyocardial laser
      revascularization].
AB  - Experimental, pathomorphological and clinical data substantiating use of
      transmyocardial laser revascularisation in the treatment of coronary heart
      disease (CHD) are presented. It is shown that the objective criterion of clinical
      efficacy of transmyocardial laser revascularisation in 58 patients with CHD is an
      increase of myocardial perfusion due to neoangiogenesis. This leads to
      improvement of cardiac function and general state of the patients. Surgical
      intervention has no substantial influence on contractile function of left
      ventricular myocardium in patients with CHD.

PMID- 11220926
TI  - [Clinical experience with low- and minimal-flow isoflurane in extensive
      resections of the liver and liver transplantation].
AB  - A comparative study was performed of general balanced anesthesia on the basis of
      neuroleptic analgesia (NLA) and inhalation low- and minimal-flow anesthesia with
      isoflurane in anesthesiological management of extensive operations on the liver.
      A total of 75 anesthesias were conducted. Because of low hepatotoxicity, absence
      of its metabolites' pharmacological activity, fast elimination from the body
      unchanged, isoflurane is effective in long and traumatic operations on the liver.
      Low-flow isoflurane significantly lowers pharmacological load with opiates,
      myorelaxants which is essential in patients with hepatic diseases. This leads to
      more rapid recovery of adequate spontaneous respiration and activation of the
      patient in low risk of postoperative iatrogenic complications.

PMID- 11220927
TI  - [Anesthesia, changes in hemodynamics and metabolism in surgical treatment of
      thoracic and abdominal aortic aneurysms].
AB  - 45 patients aged 32-63 years operated on for dissecting aneurysm of the
      thoracoabdominal part of the aorta were divided into 2 groups. Group 1 patients
      (n = 36) were operated on with application of the bypass using centrifuge pump.
      Group 2 patients (n = 9) were operated on without the bypass. The results
      evidence that the employed anesthesia and infusion therapy in combination with
      the bypass maintained by the pump provide stable intraoperative hemodynamics and
      prevent renal failure. Usage of the bypass in combination with liquor drainage
      reliably protects spinal cord from ischemia, especially in patients with long
      term aortic ligature.

PMID- 11220928
TI  - [Functional state of the right and left heart at different stages of anesthesia
      in patients with ischemic heart disease during myocardial revascularization
      surgery].
AB  - 57 ischemic heart disease (IHD) patients entered the study of right and left
      heart function at different stages of anesthesia and operation to reveal possible
      reasons of myocardial dysfunction and to propose effective prevention of this
      dysfunction. All the patients were operated on under multicomponent balanced
      anesthesia (relanium, fentanyl, arduan, nitric oxide with oxygen 1:1). Left
      ventricular function was assessed at Doppler echocardiography, right ventricular
      function--at catheterization of the lung artery with a Swan-Ganz catheter with
      low time constant. Hemodynamic monitoring was made with a domestic MX-04 monitor.
      It was found that in the preperfusion period diastolic function of the right and
      left ventricles is impaired much more than the systolic one. The conditions of
      anesthesia and operation affect right ventricular function more than the left
      one. Diastolic and systolic right ventricular dysfunctions were observed at all
      stages and three stages of the operation, respectively. Diastolic and systolic
      left ventricular dysfunction was observed at four and one stages, respectively.
      Basic causes of the above systolic and diastolic disorders in the preperfusion
      period may be tachycardia, arterial hypertension, reduction of the preloading and
      increased postloading (for the right ventricle) in artificial lung ventilation.

PMID- 11220929
TI  - [Epidemiology and prevention of anaphylactoid reactions in heart surgery
      patients].
AB  - A retrospective analysis of the incidence, severity, and causes of anaphylactoid
      reactions (AR) in 1504 cardiosurgical patients operated on at Research Center of
      Surgery in 1995-1999 showed that AR occurred in 109 (7.4%) patients: 60% during
      aortocoronary bypass operations, 27.2% during correction of acquired heart
      diseases, and 12.8% during correction of congenital heart diseases. Skin symptoms
      predominated in the structure of AR (59.7%); cardiovascular episodes ranked
      second (38.5%), and the incidence of pulmonary reactions was lowest (1.8%). The
      causes of AR during anesthesia and surgery were platelet-rich plasma and fresh
      frozen plasma (35.3%), antibiotics (12.1%), protamine (12.1%), myorelaxants
      (9.9%), colloid plasma substitutes (8.8%), dioxidine (3.3%), heparin (2.2%),
      aprotinin (1.1%), diazepam (2.2%), and other agents (7.6%). A history of AR and
      repeated interventions are risk factors of AR. The protocol of AR prevention in
      cardiosurgical patients includes determination of risk factors, selection of the
      least hazardous agents, strict adherence to the rate of infusion of histamine
      releasing drugs, minimum utilization of donor blood components (platelets and
      plasma), use of H1 and H2 blockers, corticosteroids (celestone) during
      premedication and operation. Such treatment helped decrease the severity and
      incidence of AR in cardiosurgical patients to 4.7%.

PMID- 11220930
TI  - [Anesthetic management of the surgical correction of heart valve defects combined
      with myocardial revascularization].
AB  - Thermodilution volumetry of the right ventricle (RV) in the course of combined
      operations has demonstrated significance of RV function and identified signs of
      its dysfunction when other parameters of hemodynamic monitoring were low
      informative. Of late, introduction of updated anesthetic modalities and
      intraoperative monitoring have noticeably improved surgical outcomes of combined
      lesions of the heart as shown by decreased hospital lethality.

PMID- 11220931
TI  - [Use of clofelin in the prevention of perioperative myocardial dysfunction in
      patients with ischemic heart disease].
AB  - The purpose of this study was to evaluate the possibility of using clofeline in
      anesthesiological protocol for myocardial revascularization as a drug preventing
      hemodynamic disorders and perioperative myocardial dysfunction. In group 1 (27
      pts.) clofelin was used in premedication (150 micrograms at night on the eve of
      surgery and before the operation), group 2 (29 pts.) was control. Clofelin
      improved the stability of the cardiovascular system, decreased the incidence of
      hyperdynamic reactions, episodes of myocardial ischemia, and cardiac arrhythmia
      during surgery. Use of clofelin for premedication decreased the need in inotropic
      support during the postperfusion period from 49 to 37% and ensured a higher
      cardiac production during transfer from artificial to spontaneous circulation.

PMID- 11220932
TI  - [Autonomic reactivity and intraoperative arterial hypertension in patients with
      ischemic heart disease].
AB  - As patients with ischemic heart disease (IHD) may develop intraoperative
      hypertensive and hyperdynamic reactions provoking myocardial ischemia, the
      authors estimated reactivity of the autonomic nervous system before giving
      anesthesia. This was made for prediction of intraoperative hypertensive reactions
      and choice of an optimal anesthesia variant. Combination of spectral analysis of
      variability of the heart rhythm and active orthostatic test was employed for this
      purpose in 50 IHD patients undergoing myocardial revascularization.

PMID- 11220934
TI  - [Human factor in anesthesiology].
AB  - The authors analyze the role of "human factor" in anesthesiology as a combination
      of characteristics which can influence the efficiency of physician's work.
      Anesthesiologists should possess professional skills directly concerned with
      mental adaptation of personality responsible for decision making in stress or
      emergency. Examination of 37 anesthesiologists who had given their informed
      consent helped determine the psychodiagnostic criteria of professional skills and
      gave grounds for forming groups liable to maladaptation under high
      psychoemotional strain. Relationships between age, sex and professional activity
      were assessed. It is recommended to introduce a system of professional selection
      of candidates wishing to become an anesthesiologist, of individual approach to
      optimization of the work intensity for practicing anesthesiologists.
      Psychological relaxation for anesthesiologists is also essential.

PMID- 11220933
TI  - [Prevention of negative hemodynamic effects of protamine sulfate by simultaneous
      infusion of microdoses of adrenaline].
AB  - Two groups of coronary patients subjected to revascularization of the myocardium
      were examined in order to detect the negative hemodynamic effects of protamine
      sulfate (PS) and the possibility of their correction by simultaneous infusion of
      adrenaline microdoses. In group 1 (27 pts.) heparin was neutralized by infusion
      of PS alone (6 mg/kg) and in group 2 (27 pts.) by simultaneous infusion of PS and
      adrenaline (15 ng/kg/min). The functions of the right and left ventricles were
      evaluated by catheterization of the pulmonary artery by a Swan-Ganz catheter and
      transesophageal Doppler echocardiography. These methods provided volume and
      velocity characteristics of the right and left compartments of the heart. PS
      deteriorated the systolic function of the right ventricle, particularly in
      patients with initial dysfunction of the right heart. Infusion of adrenaline
      simultaneously with PS leveled its negative effects, thus preventing myocardial
      dysfunction.

PMID- 11220935
TI  - [Results of the treatment of cardiac surgery patients with postoperative acute
      respiratory distress syndrome by prone-position pulmonary ventilation].
AB  - Prone position ventilation (PPV) became an effective method of management of ARDS
      since 1974. Its positive effects on arterial oxygenation have been amply
      described, but its impact on the results of treatment and hospital mortality
      remains a disputable point. We observed 2 groups of patients, 36 pts. each, with
      ARDS after cardiovascular surgery. The main causes of ARDS were shock syndrome,
      massive blood loss and transfusion, previous COPD, and postcardiopulmonary bypass
      ALI. Because of impaired lung function (PaO2/FiO2 < 200), all patients were
      supported by special methods of ventilation including PEEP, high FiO2, and PCV
      with inverse I:E ratio. In the main group, PPV was started on days 3.6 +/- 1.2
      postoperation. Daily duration of PPV was 4-12 h, after which the patients were
      turned into a supine position. Controls were treated in a supine position. The
      groups were identical by age, sex, types of surgery, severity of ARF, and
      manifestations of MOSF. PPV improved lung function and arterial oxygenation.
      Clinical outcomes were better in the PPV group than in the controls: a lower
      frequency of threatening arrhythmia, better results of MOSF treatment, and lower
      mortality (69 and 33.4%, respectively). Prone position is an effective measure
      improving arterial oxygenation in patients with ARDS after cardiovascular
      surgery. The main results of PPV are decrease in complications induced by hypoxia
      and higher survival rate.

PMID- 11220937
TI  - [Analysis of complications and the problem of airtightness of the respiratory
      contour during the use of laryngeal masks in children].
AB  - Feasibility of adequate gas exchange in artificial lung ventilation (ALV) through
      laryngeal mask (LM) is investigated in view of high occurrence of leakage of the
      respiratory contour. Adequate anesthesiological techniques of LM usage are
      proposed. It is shown that airtightness at the site of LM cuff contact with the
      upper larynx is not complete. The magnitude of respiratory mixture loss in
      audible leakage permissible for adequate ventilation and gas exchange is
      estimated.

PMID- 11220936
TI  - [Correction of secondary immunodeficiency as a method of prevention of
      suppurative-septic complications after surgery with artificial blood
      circulation].
AB  - Eighty-five patients with acquired heart diseases with and without infective
      endocarditis (IE) were examined. In one group of patients traditional therapy was
      supplemented by the Russian drug immunofan, a synthetic hexapeptide with
      immunomodulating, antiinflammatory, and detoxifying effects. A course consisted
      of 10 intramuscular injections every other day (1 ml of 0.005% solution). The
      drug was prescribed after immunological studies on a laser flow cytometer (Becton
      Dickinson, USA). Correction was carried out before and after the operation. The
      postoperative period was uneventful in patients treated with immunofan; the
      incidence of clinical manifestations of IE was decreased. The concentrations of
      cytokines (IL-1, IL-6, TNF-alpha) in the blood were increased in patients with
      IE. In patients treated with immunofan, the concentrations of cytokines were
      decreased and immune parameters were normalized. Changes in the cytokine status
      can be used as a laboratory test for evaluating the efficiency of treatment in
      cardiosurgical patients with IE.

PMID- 11220938
TI  - [Use of new respiratory technologies in solving problems of artificial one-lung
      ventilation in thoracic surgery in high-risk patients].
AB  - The authors proposed a separate independent (or differentiated) artificial lung
      ventilation as an appropriate alternative variant of artificial lung ventilation
      (ALV). This approach implies bulky ALV of the operated lung and high-frequency
      ventilation of the contralateral lung. In patients with associated respiratory
      diseases and stage II-III respiratory insufficiency, ALV initiates high pulmonary
      hypertension, intrapulmonary bypass of 50% cardiac output. The differentiated ALV
      on principal operation stage optimizes homeostatic parameters vs both one-lung
      and conventional ALV. For patients with stage II-III respiratory insufficiency
      and cardiovascular disease ALV is contraindicated. Differentiated ALV is the only
      alternative allowing surgical treatment of lung diseases in high risk patients.

PMID- 11220940
TI  - [Introduction and development of artificial circulation at the Russian Research
      Center of Surgery RAMN].

PMID- 11220939
TI  - [Prevention of hemodynamic disorders during anesthesia in middle-aged and elderly
      patients with essential hypertension. Components of anesthesia. II].
AB  - Hemodynamic parameters were evaluated during various stages of anesthesia in two
      groups of patients aged 60-85 years with mild essential hypertension. In group 1,
      routine preoperative treatment with hypotensive drugs was carried out and in
      group 2 differentiated preoperative treatment with calcium antagonists was
      carried out with consideration for a hemodynamic type. Group I patients were
      operated on under traditional neuroleptic analgesia (NLA), group 2 under NLA with
      40% lower drug doses than in group 1 and with addition of calcium antagonists. To
      patients with hypo- and eukinetic hemodynamics, nifedipine was injected (bolus
      injection) in a dose of 14.2 micrograms/kg before induction and then was infused
      in a dose of 6.0-14.2 micrograms/kg/min. Patients with hyperkinetic hemodynamics
      were injected verapamil in a dose of 70-140 micrograms/kg (bolus injection) and
      then the same dose every hour of the operation. Differentiated use of calcium
      antagonists during anesthesia helped transform the hyper- and hypokinetic types
      of hemodynamics into a more rational eukinetic type, which was associated with a
      decrease of MVO2. Calcium antagonists, exerting analgesic, automatic stabilizing,
      and antihypoxic effects, prevented the hyperdynamic reactions complicating NLA in
      30% cases and precluded complications of concomitant ischemic diseases, which
      were observed in 40% of group 1 patients.

PMID- 11220942
TI  - [Perfusion management in liver transplantation].
AB  - Veno-venous bypass (VVB) with a Biopump centrifugal pump (Biomedicus, USA) was
      used in 36 patients with liver diseases during orthotopic transplantation of the
      liver. Volume rate of perfusion (VR), systolic, diastolic, and mean arterial
      pressure (AP), and central venous pressure (CVP) were monitored. VR during liver
      free period was 850-1350 (1064.2 +/- 87.5) ml/min in femoral-axillary bypass and
      1700-3500 (2630.5 +/- 112.3) ml/min in femoral-porto-axillary bypass. A trend to
      a decrease of the mean AP to 65 mm Hg was observed at the end of liver-free
      period (p < 0.05), while CVP decreased to 2 mm Hg (p < 0.05); there was a trend
      to a moderate tachycardia. No significant shifts in acid-base balance, oxygen
      balance, and blood electrolytes were observed during the liver-free period.
      Maximum blood loss occurred during the liver-free period and reperfusion of the
      transplant. Blood loss was evaluated by the amount of washed autoerythrocytes
      obtained after processing of collected blood in the Cell-Saver device. VVB had a
      favorable impact on the course of orthotopic transplantation of the liver,
      maintaining stable hemodynamic and biochemical parameters and preventing ischemia
      of the abdominal organs. Preservation of autoerythrocytes by the Cell-Saver
      device minimized the need in donor erythrocytes, thus ruling out the
      complications associated with homologous blood transfusion.

PMID- 11220941
TI  - [Causes of myoglobinemia in surgery with artificial circulation].
AB  - Release of myoglobin (Mg) into the plasma and increase of its concentration
      during perfusion are a result of muscle cell injury during artificial
      circulation. High values of oxygen tension and hypothermia during cardiosurgery
      are sources of active oxygen forms damaging the biomembranes. We investigated
      release of Mg into the blood and relationship of this parameter with oxygen
      tension and depth of cooling. 95 patients were tested during open-heart surgery
      and operations on the main vessels: 25 perfusions at 30-32 degrees C, 41 at 26-29
      degrees C, and 20 at 12-14 degrees C. The patients were divided into subgroups
      depending on arterial blood oxygen pressure. Myoglobin release into the blood was
      minimum under mild hypothermia and moderate PaO2. The degree of myoglobinemia
      increased with elevation in PaO2. As body temperature decreased, the
      concentration of Mg increased and differences between the groups with different
      PaO2 leveled. Critical myoglobinemia (30-fold vs. the initial value) was observed
      in the group with the deepest hypothermia (14 degrees C). Since the myocardium
      contains high amounts of Mg, it is clear that loss of this heme-containing
      protein impairs the feeding of the myocardium and, hence, decreases its
      contractility.

PMID- 11220943
TI  - [Anesthesiologist and chronic pain].
AB  - Effective therapy of chronic frequently recurring pain is a complex important
      problem from practical medical, social, and economic viewpoints. Organization of
      specialized "pain clinics" and pain control centers is discussed. These
      institutions will take care of patients with chronic pain syndromes. The role of
      anesthesiologists and reanimatologists at such clinics is analyzed. Experience
      gained at department of therapy of painful syndromes at the Russian Center of
      Surgery of the Russian Academy of Medical Sciences and the Integrative Medicine
      Center attached to it is reviewed. The authors offer recommendations on the use
      of traditional and nontraditional methods of pain relief. New highly effective
      integrative diagnostic methods (computer pulsometry) and therapies (resonance
      electropuncture analgesia and therapy) are used in various pain syndromes,
      including chronic frequently relapsing, which are usually resistant to common
      methods. Integrative methods of clinical reflex therapy create conditions for
      replacing traumatic surgical and radiological methods used in the treatment of
      critically ill patients by methods of integrative medicine.

PMID- 11220944
TI  - [Prevention of postoperative pain: pathogenetic bases and clinical aspects].
AB  - The trial aimed at development of pathogenetically sound complex of therapeutic
      measures to prevent postoperative pain or relieve it significantly included 1912
      patients after elective surgical interventions on the lower part of the body. It
      is shown that basic factors in postoperative pain prevention are the following:
      a) adequate relief of preoperative pain syndrome; b) use of spinal or spinal
      epidural anesthesia as the leading anesthesia method; c) preoperative epidural
      administration of opioid analgetic drugs; d) pre-, intra- and postoperative
      administrations of drugs affecting N-methyl-D-aspartate-receptors (ketamine,
      magnesium sulphate) as well as inhibitors of kininogenesis and
      prostaglandinogenesis. The success lies in a multimodality approach to prevention
      of postoperative pain syndrome, i.e. maximal eradication of all the factors
      promoting onset of pain during pre-, intra- and postoperative period with a
      simultaneous impact on peripheral and central mechanisms of acute pain. Such an
      approach resulted in a complete prevention of postoperative pain in 46.2%
      patients while the rest patients had much less intensive pain.

PMID- 11220945
TI  - [Continuous epidural infusion of ropivacaine in the postoperative period].

PMID- 11220946
TI  - [Use of laryngeal masks: variants of hemodynamic response to various methods of
      anesthesia].
AB  - Choice of induction agent is the decisive factor in utilization of a laryngeal
      mask (LM) under spontaneous respiration, as insufficient relaxation and unwanted
      laryngopharyngeal reflexes deteriorate the efficiency of LM functioning during
      operation and anesthesia. 132 anesthesias with LM were performed, 86 of these for
      laparoscopic cholecystectomies (LCE) (group 1) and 42 for saphenectomies (group
      2). Control group consisted of 60 patients anesthetized for LCE by means of an
      endotracheal tube (ETT). Combined induction intravenous anesthesia with ketamine,
      barbiturates, and diprivan was used in group 1 and controls. In group 2 induction
      anesthesia was based on ketamine and diprivan. Group 1 and control group were
      matched for demographic characteristics and concomitant diseases. All groups were
      divided into subgroups, depending on anesthesia. In all groups pipecuronium
      bromide (0.06 mg/kg) was administered before insertion of EET or LM after
      injection of induction agents. In total myoplegia, installation of LM was simple,
      involving no untoward laryngo-pharyngeal reflexes. LM was correctly installed
      from the first attempt in 98.7% cases. In combined intravenous ketamine-based
      anesthesia, pressor reaction to LM installation consisted in an increase of heart
      rate by 5.6% (1K group--control), by 10.2% in 2K group (fractionated ketamine
      (1.5-2 mg/kg) + diazepam (0.1 mg/kg) and fentanyl (2.6 micrograms/kg); after
      barbiturates heart rate increased by 6.7% in 1B group (control), after diprivan
      it did not increase in 1D group (control), while the mean arterial pressure in 2D
      group (fractionated diprivan (1 mg/kg) + ketamine (25-50 mg), diazepam (0.08
      mg/kg) and fentanyl (2.6 micrograms/kg) increased by 10% and heart rate by 6.6%.
      Reaction to tracheal intubation was pronounced in all types of induction
      anesthesia. No regurgitation or aspiration was observed in any case. Hence, use
      of total myoplegia in installation of LM allows the use of various modern
      anesthetics in optimal doses and notably simplifies the utilization of LM.

PMID- 11220947
TI  - [Hazards and complications of central segmental blockade. I. Epidural anesthesia
      (retrospective analysis)].
AB  - A total of 700 reports about complications of epidural anesthesia over more than
      30 years are analyzed. Four groups of complications have been distinguished: 1)
      errors and complications caused by technological errors; 2) complications caused
      by atypical dissemination of an anesthetic; 3) complications caused by side and
      toxic effects of local anesthetics or effects of epidural block; and 4)
      complications caused by damage to nerve structures. Causes, pathogenesis,
      prevention and treatment of complications are discussed. The cause-and-effect
      analysis of complications of epidural anesthesia helped objectively formulate and
      validate the relative and absolute contraindications to the use of this method.

PMID- 11220948
TI  - [Anesthesia in one-stage surgery of the carotid and coronary arteries].

PMID- 11220949
TI  - [Acridonacetic acid: pharmacological properties and clinical use].
AB  - The summarized data on the biological activity of acridoneacetic acid, a low
      molecular interferon inducer are presented: the amount and type of induced
      interferon, producer cells, interaction with viruses; the antiviral, antitumoral
      and anti-inflammatory activity of the preparation has been demonstrated. The
      specific features of interferon induction by virus (a biological inducer), in
      contrast to acridoneacetic acid (a chemical inducer) have been noted. The
      possible mechanisms of interferon induction by low-molecular interferonogen are
      considered. A number of interferonogens, salts of acridoneacetic acid, proposed
      as medicinal preparations are considered. The results of the clinical use of
      Cycloferon, a medicinal form of acridoneacetic acid, are presented.

PMID- 11220950
TI  - [Compatibility of vaccines in combined and associated immunization].

PMID- 11220951
TI  - [Microflora of patients with purulent septic diseases in the Moscow region].
AB  - The microflora of clinical material (blood, wound discharge, abdominal exudate,
      pleural exudate, milk in mastitis, as well as feces in dysbiosis of the large
      intestine), obtained from patients with purulent septic diseases in the Moscow
      region was studied. The study revealed the change of microflora from surface
      biotopes to closed cavities of the body. Gram-positive cocci, primarily coagulase
      negative staphylococci, mainly epidermal, were shown to play the leading
      etiological role in the development of purulent septic diseases. The development
      of bacteriemia was found to be caused by the penetration of staphylococci from
      local pyoinflammatory foci (appearing in purulent mastitis, wounds, peritonitis,
      pleural empyema and pleuritis), as well as by the translocation of staphylococci
      and Escherichia coli from the large intestine in dysbiosis.

PMID- 11220952
TI  - [Use of vaccination for prevention of viral hepatitis among students of
      vocational schools].

PMID- 11220953
TI  - [Isolation v E. coli O157:H7, the causative agent of acute enteric infections
      with hemolytic-uremic syndrome in the Tula region].

PMID- 11220954
TI  - [Water route of transmission of acute intestinal infections in Armenia].

PMID- 11220955
TI  - [Epidemiological surveillance of outbreaks of acute intestinal infections: basic
      principles].

PMID- 11220957
TI  - [Antilysozyme activity of anaerobic bacteria from fecal microflora in man].
AB  - For the first time anaerobic bacteria of the fecal microflora in man have been
      found be capable of inactivating lysozyme. The presence of this antilysozyme sign
      has been noted in both Gram-positive anaerobes (Bifidobacterium,
      Propionibacterium, Eubacterium, Actinomyces israelii) and in Gram-negative
      anaerobes (Bacteroids, Prevotella melaninogenica). The expression of antilysozyme
      activity in the anaerobes under study has been determined. The possible
      biological role of this sign of the indigenous intestinal microflora has been
      discussed.

PMID- 11220956
TI  - [Common epitopes of protein antigens in Neisseria and Moraxella].
AB  - Cross reactions between N. meningitidis and M. catarrhalis proteins were studied
      with the use of a panel of monoclonal antibodies to M. catarrhalis protein
      antigens. All antigenic preparations under study were shown to give cross
      reactions between N. meningitidis serotype porin of 39 kD (strain B125) and M.
      catarrhalis proteins of 40-41 kD. These M. catarrhalis proteins belonged to main
      proteins of class F and had the function of porins in the cell. In addition, the
      epitope of 41-kD antigen, detected by monoclonal antibodies 3E10, is common for
      both N. meningitidis porin and N. meningitidis iron-regulated proteins of 70 and
      50 kD. The epitope of M. catarrhalis protein of 67 kD, detected by monoclonal
      antibodies 1G6, is common for N. meningitidis porin and N. meningitidis iron
      regulated proteins of 50 and 55 kD.

PMID- 11220958
TI  - [Microbiological monitoring of causative agents of sapronoses in the water of the
      Bogatinskoe water reservoir].
AB  - The results of the microbiological monitoring of potential causative agents of
      sapronoses in the water of the Bogatinskoye reservoir revealed that in the summer
      period of 1998 the mass accumulation of virulent Aeromonas sobria (up to 25% of
      the total number of heterotrophic bacteria) took place. The autumn period was
      characterized by a decrease in the number of A. sobria and the detection of
      bacteria of the genus Vibrio (up to 22%) with V. mimicus and V. metschnikovii
      identified among them in the water ecosystems of the southern regions of the
      Maritime Territory.

PMID- 11220959
TI  - [Cholera in the Far East of Russia. Communication 1. Epidemiological
      characteristics of the outbreak of cholera El tor in Vladivostok].
AB  - The materials on the investigation of the outbreak cholera eltor in Vladivostok,
      caused by the import of infection from China. The leading role of the water route
      of transmission of this infection is shown due to the contamination of water
      sources with non-decontaminated sewage water. The complex of antiepidemic
      measures was carried out, which made it possible to arrest the spread of cholera
      and liquidate its foci.

PMID- 11220960
TI  - [Autoregulation of expression of secreted proteins in Listeria monocytogenes].
AB  - The spectrum of proteins secreted by L. monocytogenes greatly depends on the
      composition of the cultivation medium. The introduction of activated charcoal
      (AC) into brain heart infusion (BHI) leads to the secretion of a number of
      additional proteins with mol.wt. ranging between 20 and 100 kD, whose production
      is not observed in pure BHI. The effect depends on the absorption capacity of AC:
      when adsorption capacity is reduced due to a decrease in the concentration of AC
      or its preliminary saturation with the components of the cultivation medium a
      drop in the level of the production of additional proteins is observed. The
      preliminary treatment of the medium with AC with its subsequent elimination prior
      to inoculation doses not change the spectrum of secreted proteins, though greatly
      inhibits the growth of L. monocytogenes. The data obtained in this investigation
      indicate that the effect produced by AC is based on the elimination of some
      product of L. monocytogenes vital activity from the cultivation medium; this
      product acts as the autoregulator of the synthesis of a number of secreted
      proteins.

PMID- 11220961
TI  - [Cholera in the Far East of Russia. Communication 2. Epidemiological
      characteristics of the outbreak of cholera El tor in Iuzhno-Sakhalinsk].
AB  - The outbreak of cholera eltor in Yuzhno-Sakhalinsk has been analyzed. The fact of
      the import of this infection from China and its transmission mainly by the water
      route due to the intensive contamination of environmental objects has been
      substantiated. The effective purification decontamination of sewage water plays
      decisive role on the system of anticholera measures. The conclusion on the
      necessity of increasing the effectiveness of measures for the sanitary protection
      of the territory has been made.

PMID- 11220962
TI  - [Spread of infection with hepatitis B and C viruses in different population
      groups of north-western Ukraine].
AB  - The detection rate of specific markers of hepatitides B and C among the child and
      adult population, including 487 children in 5 boarding schools, 338 oncological,
      hematological, urological patients and 206 medical staff members in Rovno and the
      Rovno region (North-Western Ukraine), was determined. In boarding-school the
      markers of HB (HBsAg, anti-HBs, summary anti-HBc) were detected 3.5 times more
      often than among the child population in general (in 28.3 and 8.0% respectively).
      In children staying in a boarding school for up to 1 year (126 children) these
      markers were determined in 23% of cases, and in those who stayed there for 3-5
      years, in 58.1% of cases. Among the members of the groups where children with
      HBsAg were found the markers of HB occurred 3.3 more often then among the
      children in the groups having no HBsAg carriers (45.3 and 13.9% respectively).
      The detection rates of the markers of HB in children with various kinds of C.N.S.
      pathology (first of all, with mongolism) and without concomitant diseases were
      sharply different (they were found, respectively, in 52.9 and 19.6%, including
      HBsAg in 17.4 and 2.7%). At the same time the detection rate of anti-HCV among
      boarding-school children (including those with C.N.S. lesions) was no different
      from that among the child population in general, which was indicative of great
      differences in the activity of the nonartificial transmission routes HB and HC
      viruses. Patients with oncological, hematological and urological diseases who had
      great "parenteral load", as well as medical staff members, formed a high risk
      group for being infected with both HB and HC viruses.

PMID- 11220963
TI  - [Comparative evaluation of the reactogenicity and immunogenicity of inactivated
      influenza vaccines in the elderly].
AB  - A comparative study was carried out to assess reactogenicity and immunogenicity
      of inactivated influenza vaccines (Begrivac, Vaxigrip, Grippol, Influvac, and
      Fluarix), licensed in Russia. Immunization of the elderly demonstrated low
      reactogenicity and high immunogenicity for all vaccines. Concomitant chronic
      diseases had no influence on the vaccine immunogenicity levels, which testifies
      to the benefit of vaccination in this age group. In the group of vaccinated the
      highest seroconversion to all vaccine strains was found for Vaxigrip (82-89% for
      group A viruses and 86% for group B virus); the vaccine demonstrated the highest
      level of diagnostic increase of antibody titers to all 3 viruses, i.e. 69.0% (p <
      .05), with 22.0% of vaccinees gained antibodies to 2 vaccine viruses (91.0% in
      total). The number of positive responses to 3 and 2 strains in subjects immunized
      with Fluarix, Begrivac and Influvac reached 85.0%, 85.0% and 83.0% respectively.
      It is noteworthy that the combination of surface antigens of A and B flu viruses
      in low concentration with polyoxidonium immune modulator in Grippol induced
      intensive immune response.

PMID- 11220964
TI  - [Characteristics of immune response to diphtheria anatoxin in children with
      different immune status during the second age-scheduled revaccination].
AB  - The dynamics of the intensity of specific antidiphtheria immunity after the
      second age-scheduled revaccination was studied in 129 practically healthy
      children. The study revealed that the formation of immunity depended on the
      initial functional state of the immune system before the injection of diphtheria
      toxoid. Three variants of immune response were determined and the immune status
      corresponding to each of these variants was characterized. As shown in this
      study, children with the hyperergic character of immune response were
      characterized by relatively high initial titers of antitoxin, and the injection
      of an additional dose of the antigen led to the prolonged state of
      hyperimmunization with the subsequent decrease of the intensity of immunity by
      half, registered in the catamnestic observation for 4 years. Children with the
      hypo- and normoergic variants of immune response were characterized by the most
      stable immune response to diphtheria toxoid, and during the catamnestic
      observation they formed the levels of antibody titers 2.5- to 3-fold higher than
      before immunization. But the protection characteristics in children with the
      third variant were the lowest among the children under study.

PMID- 11220965
TI  - [Protective efficacy of combined administration of the multicomponent vaccine and
      the immunomodulator myelopid in experimental infections in mice].
AB  - The influence of myelopid (MP) on the protective activity of polycomponent
      vaccine VP-4 prepared from the antigens of opportunistic bacteria was studied on
      experimental infections of mice, caused by Klebsiella pneumoniae, Salmonella
      typhimurium and Staphylococcus aureus. In staphylococcal and Klebsiella
      infections the joint administration of vaccine VP-4 and MP produced more
      pronounced protective effect than each of these preparations, introduced alone.
      The protective action of vaccine VP-4 was specially enforced by MP in cases of
      local staphylococcal infection. Recommendations on the joint use of two or more
      immunomodulating agents are possible only on the basis of the experimental
      substantiation of their effect in definite infections.

PMID- 11220966
TI  - [Changes in the functional activity of neutrophils during their interaction with
      Yersinia pestis in vitro].
AB  - The functional state and electrochemical properties of human blood neutrophil
      leukocytes after their in vitro interaction with Y. pestis cells, strain EV, was
      analyzed. A considerable decrease in the electrophoretic mobility of neutrophil
      leukocytes and a considerable increase in their phagocytic indices was shown. At
      the same time the maximum phagocytic activity in the total pool of isolated
      neutrophil leukocytes was registered in fractions having higher electrophoretic
      mobility. The dependence of electrophoretic mobility on the state of neutrophil
      membranes, as well as the degree of their activation, is discussed.

PMID- 11220967
TI  - [The role of the protein with molecular weight of 22 kD in the phagocytosis of
      vaccine strain of Yersinia pestis EV].
AB  - The comparative study of different stages of the phagocytosis of vaccine strain
      Y. pestis EV and its achromogenic variants (AV), has been carried out with the
      use of peritoneal macrophages as an in vitro experimental model. As revealed in
      this study, AV whose outer membrane contains no protein with a molecular weight
      of 22 kD exhibit lower capacity for adherence and for being ingested by
      phagocytes than the initial strain. The absence of this protein does not inhibit
      the multiplication of AV inside phagocytes, leading to incomplete phagocytosis,
      which is characteristic of the initial strain. The suggestion is made that the 22
      kD protein may be one of the adhesion factors, necessary for ensuring the initial
      stages of phagocytosis.

PMID- 11220968
TI  - [The use of liposomal form of phenylimide of cis-aconitic acid in herpes
      therapy].
AB  - The results of study of the antiviral activity and pharmacokinetics of
      phenylimide of cis-aconitic acid (PCAA) is presented. The 20% increase of the
      antiviral activity of PCAA incorporated into liposomes in comparison with the
      antiviral activity of the pure substance was shown. Liposomes with PCAA were
      tropic to lymphocytes and macrophages with maximum fluorescence being observed in
      the spleen, while empty liposomes were accumulated mainly in the liver. After the
      treatment with liposomal PCAA the symptoms of herpetic meningoencephalitis became
      less severe with 100% survival of the experimental animals. In the control group
      of rabbits 50% of the animals died, and in the surviving animals blindness or
      paralysis developed.

PMID- 11220969
TI  - [Possibility of existence and multiplication of Mycobacteria in the soil].
AB  - The time of the survival of Mycobacterium bovis in the soil of pastures depended
      on the physicochemical composition and biological activity of the soil. In clay
      soils M. bovis retained their virulence for as long as 2 months (at the depth of
      2 cm in high- and medium-posted solonetz) to 12 months (at the depth of 10 cm in
      crust solonetz). The M. bovis strains under study multiplied in soil extracts
      (the term of observation was 8 months). The cultures grown at 20-24 degrees C
      were found to have the prolonged exponential phase in comparison with that of the
      cultures grown at 37.5-38.5 degrees C. In the deep litter and the soil under it
      M. avium remained viable for 10 years.

PMID- 11220970
TI  - [Microbial biocenosis of the nasal mucosa in healthy persons and in
      Staphylococcus carriers].
AB  - The normal microflora of the nasal mucosa in man is differentiated into main,
      complementary and casual microflora, taking into account its isolation rate and
      characteristics of microbial contamination. The main microflora of adults, in
      contrast to children, is represented, in addition to coagulaso-negative (CN)
      staphylococci, by bacteria of the genus Corynebacterium. In staphylococcal
      carrier state a decrease in the isolation rate and the amount of bacteria
      belonging to the main and complementary microflora (CN staphylococci,
      Micrococcus, Streptococcus, Bacillus) was observed. Moreover, in carriers the
      weakening of the degree of association between CN staphylococci, Micrococcus,
      Corynebacterium, Streptococcus in symbiotic pairs was noted. In the absence of S.
      aureus carrier state the main and complementary microflora was characterized by
      the combination of the factors of antagonism and persistence, while in carrier
      state the complex of colonization factors was defective in the main microflora
      and well pronounced in coagulase-positive staphylococcal strains and
      enterobacteria.

PMID- 11220971
TI  - [The use of biological preparations for correction of microbial status in
      pregnant women].
AB  - 15 pregnant women with pregnancy lasting 28-32 weeks, whose medico-laboratory
      data (the positive result of the amino test, high pH value and the detection of
      "key" cells) suggested the presence of bacterial vaginosis, were placed under
      observation. The bacteriological study of vaginal microflora in all these women
      revealed pronounced disturbances simultaneously with the development of
      intestinal dysbacteriosis. The local application of the bacterial preparation
      "Zhlemik" containing freeze-dried live lactic acid bacteria of vaginal origin and
      the oral administration of lactic acid bifidumbacterin containing live
      bifidobacteria of intestinal origin permitted the successful restoration of
      vaginal and intestinal microbiocenosis. The capacity of biotherapeutic
      preparations for inducing non-specific immunostimulation led to a significant
      rise in the levels of IgA, IgM and IgG in vaginal secretions.

PMID- 11220972
TI  - [Comparative characteristics of protein G gene in Streptococci of groups C and G
      isolated from humans].
AB  - The treatment of streptococci, groups C and G, with bromocyanogen made it
      possible to isolate surface G protein, capable of binding human serum albumin
      (HSA) and polyclonal IgG. In this work the presence of G protein in all
      staphylococcal strains, groups C and G, is shown. The differences between the
      strains by the level of expression, molecular weight and functional activity of G
      protein, extracted from streptococci of groups C and G, permitted the
      identification of 3 groups of strains, containing the molecules of G protein with
      different numbers of IgG- and HSA-binding domains: with 3 IgG- and HSA-binding
      domains, with 2 IgG- and HSA-binding domains and with only 2 IgG-binding domains.
      Each strain under study expressed only one of the molecule of G protein. The work
      shows the possibility of the identification of streptococci, groups C and G, by
      the molecular characteristics of G proteins themselves and their respective
      coding genes.

PMID- 11220973
TI  - [The use of polymerase chain reaction in the diagnosis of diphtheria infection].
AB  - 624 Corynebacterium diphtheriae strains, newly isolated from patients and
      carriers, were studied with the use of the methods of gel immunodiffusion (Elek's
      test) and polymerase chain reaction (PCR). In the evaluation of 388 C. diptheriae
      strains, found to be toxigenic in PCR, the results of Elek's test coincided with
      those of PCR on 98% of cases. In 38 out of 143 strains (26.5%), nontoxigenic
      according to the results of Elek's test, the presence of the A-fragment of the
      tox-gene was established. Subculturing in nutrient media made it possible to
      determine the presence of toxin in 19 out of 38 of these strains; the remaining
      strains, isolated mainly from carriers, were found to have the "silent" gene. The
      advantage of using PCR for the detection of toxigenic and nontoxigenic C.
      diphtheriae strains of different origin was shown.

PMID- 11220974
TI  - [The use if Francisella tularensis lipopolysaccharide in the dot solid phase
      enzyme immunoassay].
AB  - To determine antitularemia antibodies in the sera of humans and animale, the
      possibility of using dot immunoassay with the use of F. tularensis
      lipopolysaccharide (LPS) as antigen-containing preparation was ascertained.
      Experiments demonstrated that this method made it possible to determine specific
      antitularemia antibodies in the sera of sick and immunized humans and animals.
      Investigetions carried out with the use of heterologous antisera to F. novicida,
      F. novicida-like and F. philomiragia, as well as Brucellf abortus, Vibrio
      cholerae and Yersinia enterocolitica, revealed that F. tularensis S-LPS was
      highly specific. The results obtained in this investigation are indicative of
      good prospects of using F. tularensis LPS in dot blotting for the laboratory
      diagnostics of tularemia in humans.

PMID- 11220975
TI  - [Allergic sensitivity in different groups of patients with atopic dermatitis].
AB  - 69 patients with atopic dermatitis, aged 16-42 years, were examined. The patients
      were divided into two groups: group 1 consisted of patients with atopic
      dermatitis and bronchial asthma and/or allergic rhinitis (25 patients), group 2
      consisted of patients without the respiratory syndrome (44 patients).
      Scarification skin tests made it possible to find out the essential difference in
      the sensitivity of the examinees in these two groups. In group 1 the prevalence
      of sensitization to house-dust mites in 23 patients (92%) with monosensitization
      in 8 patients (32% of the group) was observed. In group 2 sensitivity of house
      dust mites was lower: it was registered in 16 patients (36%) with
      monosensitization in 2 patients (4% of the group). The presence of cross
      sensitivity between mite allergens and Candida albicans was established. In
      accordance with the results of scarification skin tests, treatment included the
      use of antihistamine preparations, antipruritic remedies and hormonal ointments
      as well as the elimination of sensitizing allergens. Improvement was registered
      in 21 patients.

PMID- 11220976
TI  - [The role of oleic acid in the process of induced destruction of Escherichia coli
      M-17].
AB  - The influence of oleic acid on the process of the destruction of E. coli, induced
      by the transfer of the bacteria from the growth medium into solution without
      nutrient substances and their treatment with oleic acid at a temperature of 45
      degrees C, was studied. Oleic acid at a concentration of 200 nmol/ml accelerated
      the destruction of E. coli in comparison with the control organisms, but did not
      lead to the significant increase of the final degree of the destruction of
      biomass. The dynamics of the inclusion of labeled oleic acid into E. coli cell
      fractions after the induction of autolysis was analyzed. The radioactive label
      was most actively included into the lipid (chloroform) fraction of bacterial
      biopolymers. Simultaneously with the destruction of some cells in the population
      the inclusion of labeled oleic acid into intact cells was found to occur.

PMID- 11220977
TI  - [Bactericidal properties of the Vibrio cholerae non O1 bacteriolysin].
AB  - The influence of the preparation of hemocytolysin, obtained from V. cholerae non
      O1 (strain P-11702), on the growth of V. cholerae cells was studied. The study
      revealed that hemocytolysin is capable of inducing partial or complete bacterial
      lysis on the place of its application, depending on the protein load of the
      substance and the inoculation dose of microbes. Two electrophoretic fractions
      with molecular weights of 14 and 14.5 kD induced the cytolysis of sheep, rabbit,
      guinea-pig red blood cells and showed a bactericidal effect. The different
      sensitivity of Vct+ and Vct- strains of V. cholerae to different doses of
      hemocytolysin was studied.

PMID- 11220978
TI  - [Genetic markers of epidemic strains of Vibrio cholerae].
AB  - In this review new data on the key pathogenicity genes of V. cholerae are
      presented. As shown on the basis of the analysis of the latest information on the
      structure of the genomes of different V. cholerae strains, structural genes ctxAB
      coding cholera toxin may not serve as the only marker of epidemically dangerous
      strains. More complete and reliable information for the evaluation of the
      epidemic potential of V. cholerae isolated from the environment may be obtained
      by the simultaneous detection of 4 genetic markers: genes ctxAB, tcpA and hap
      coding, respectively, cholera toxin, toxin-corregulated adhesion pili and soluble
      hemagglutinin/protease, as well as regulatory virulence gene toxR.

PMID- 11220979
TI  - [Factors and genetics of pathogenicity of group B Streptococci].
AB  - In this review data on the pathogenicity factors of streptococci and their
      genetic control are presented. Attention is paid mainly to protein antigens alpha
      and beta, C5a peptidase, CAMP factor, R, Rib and X proteins. The problems of
      making the genetic and physical charts of the genome of group B streptococci, the
      genetic regulation of the synthesis of pathogenicity factors and the specific
      features of the damaging action of the infective agent are discussed.

PMID- 11220980
TI  - [Immunity in listeriosis].
AB  - In this review modern concepts on the formation of specific immunity to
      listeriosis are presented. Numerous data indicate that in Listeria monocytogenes
      virulence and the capacity for inducing specific protection is ensured by the
      protein listeriolysin O. The importance of gamma-interferon, tumor necrosis
      factor alpha, interleukin 12 and other mediators in ensuring the differentiation
      of (CD4(+) T-cells into Th1-helpers and cytotoxic T-lymphocytes in animals
      infected with L. monocytogenes is described in detail. The safety and effective
      preparations for specific prophylaxis of listeriosis were not developed. Hopeful
      results have been obtained in experiments on the immunization of mice with killed
      bacteria with listeriolysin O or interleukin 12. Works describing the use of
      modified L. monocytogenes strains as vectors for the creation of vaccines against
      different infections seem to show good prospects.

PMID- 11220981
TI  - Child abuse--a political, parental and religious syndrome.

PMID- 11220982
TI  - Sildenafil citrate (Viagra) is effective and well tolerated for treating erectile
      dysfunction of psychogenic or mixed aetiology.
AB  - Sildenafil citrate (Viagra) has been shown to be an effective treatment for
      erectile dysfunction (ED) of organic aetiology. This study assessed the efficacy
      and tolerability of sildenafil for treating ED of psychogenic and mixed
      psychogenic/organic aetiology. Men with ED of psychogenic and mixed aetiology
      were randomised in a double-blind, fixed-dose study to placebo (n = 95) or
      sildenafil 10 mg (n = 90), 25 mg (n = 85), or 50 mg (n = 81) once daily for 28
      days. Efficacy was evaluated with two global efficacy questions, a patient log of
      erectile activity, a sexual function questionnaire and a partner questionnaire.
      Patients receiving sildenafil had significantly more grade 3 (hard enough for
      penetration) or grade 4 (fully hard) erections per week than patients receiving
      placebo, and a greater proportion of patients receiving sildenafil reported that
      treatment had improved their erections (p < 0.001). Results of the sexual
      function questionnaire demonstrated significant improvement for patients with ED
      receiving sildenafil compared with patients receiving placebo for frequency,
      hardness and duration of erections (p < 0.01), and for enjoyment of sexual
      intercourse and satisfaction with sex life (p < 0.05). The results of the partner
      questionnaire were consistent with the results reported by patients and showed
      that treatment with sildenafil was associated with significant improvement in the
      partners' own sex lives (p < 0.001). Adverse events were mostly mild to moderate
      in nature. The commonest adverse events were headache, dyspepsia, flushing,
      myalgia, arthralgia and flu syndrome. Discontinuations due to treatment-related
      adverse events were few, ranging from 1.1% to 6.2% for patients receiving
      different doses of sildenafil and 4.2% for patients receiving placebo. Sildenafil
      is an effective and well-tolerated treatment for ED of psychogenic or mixed
      aetiology with once-daily dosing.

PMID- 11220983
TI  - Multicentric study of the effect of milk fermented by Lactobacillus casei on the
      incidence of diarrhoea.
AB  - The aim of this study was to determine if supplementation of healthy children
      with milk fermented by yogurt cultures and Lactobacillus casei strain DN-114 001
      could affect the incidence of acute diarrhoea when compared with traditional
      yogurt. The study was a multicentre, randomised, double-blind trial, conducted
      over four months, on 928 children aged, at inclusion, 6-24 months. The study
      consisted of two periods: supplementation and observation. Subjects were
      supplemented daily with 100 g of one of the two dairy products being tested:
      standard yogurt and milk fermented by yogurt cultures and Lactobacillus casei
      (10(8) cfu/ml). Frequency or duration of any diarrhoea episode was evaluated. As
      far as frequency was concerned there was a statistically significant difference
      between the groups, the incidence of diarrhoea being significantly reduced by
      supplementation with L. casei fermented milk (15.9%) compared with yogurt (22%)
      (p = 0.03). These results suggest an additional benefit of L. casei in acute
      diarrhoea in children compared with standard yogurt.

PMID- 11220984
TI  - The impact of a structured programme of asthma care in general practice.
AB  - The impact of a new GP programme of asthma care was examined using: a) a
      retrospective pre- and post-casenote survey of 400 asthma patients, comparing
      patients in practices using the health board programme (HBP) and other programmes
      (OP); and b) a patient satisfaction questionnaire, completed by 532 people on
      asthma clinic lists in HBP and OP practices. Outcomes assessed were health
      service use, perceived change in symptoms and asthma self-management. The
      casenote survey indicated improved health service use by patients in HBP
      practices, with fewer patient-initiated (p < 0.05), emergency (p < 0.05) and
      other chest-related attendances (p < 0.01) and increased clinic attendance (p <
      0.05) post intervention. OP practices also showed reduced patient-initiated (p <
      0.01) and increased asthma clinic use (p < 0.01). Increased use of management
      plans (p < 0.01) and peak flow diaries (p < 0.01) was noted post intervention for
      HBP practices. Responders to the questionnaire survey perceived that clinic
      attendance improved asthma symptoms, including severity and control, sleep
      disturbance and early morning wheeze. People in HBP practices were more likely
      than those in OP practices to possess a peak flow meter, a diary and a personal
      management plan (all p < 0.01 or above) but were not more likely to use a peak
      flow diary. Notwithstanding methodological difficulties in the selection of
      practices, both studies showed trends towards improvement in health service use
      and asthma self-management. The HBP was associated with greater improvement in
      self-management processes and outcomes, and greater patient satisfaction with
      asthma care.

PMID- 11220985
TI  - Latex allergy: an emerging problem in theatres.
AB  - With the increasing use of natural rubber products, latex allergy is becoming a
      major health concern among patients and healthcare workers. The aim of this study
      was to determine the availability of a latex allergy protocol and essential latex
      free products in theatres. The number of latex allergy complaints among patients
      and theatre personnel were also studied. Postal questionnaires were sent to
      theatre managers in 205 hospitals in England, Scotland and Wales, 120 (58.5%) of
      which were returned. Nearly two-thirds of the theatres did not have a latex
      allergy protocol. Overall less than one-third of theatres in the UK have latex
      free products set aside for use. A total of 505 patients with latex allergy
      underwent surgery; of these, there were four deaths, 18 major anaphylaxes and 483
      minor complaints such as skin rash; 239 theatre personnel reported latex allergic
      reactions and one had a severe anaphylactic reaction. The number of cases with
      latex-related complications might be reduced if all hospitals had a latex allergy
      protocol and a range of essential latex-free products.

PMID- 11220986
TI  - Oral antimicrobial susceptibilities of Streptococcus pyogenes recently isolated
      in five countries.
AB  - Between July 1998 and July 1999 1050 clinical isolates of Streptococcus pyogenes
      were collected from 11 study centres in five countries. Isolates were shipped to
      a co-ordinating laboratory for NCCLS specified broth microdilution susceptibility
      testing for penicillin, cefaclor, azithromycin, clarithromycin, erythromycin and
      roxithromycin. All 1050 isolates of S. pyogenes tested were susceptible to
      penicillin (MIC < or = 0.12 microgram/ml) and cefaclor (MIC < or = 0.25
      microgram/ml). Azithromycin, clarithromycin and erythromycin resistance rates
      were 15.9%, 15.4% and 15.8%, respectively. MIC90S for penicillin, cefaclor,
      azithromycin, clarithromycin, erythromycin, and roxithromycin were 0.015, 0.12, >
      4, 8, > 1 and 16 micrograms/ml, respectively. Macrolide (erythromycin) resistance
      rates were highest in study centres in Italy (31.0%) and Spain (26.6%). Lower
      macrolide resistance rates were identified in study centres in Turkey (4.8%),
      France (3.8%), and Sweden (3.7%). In conclusion, the isolates of S. pyogenes
      tested were universally susceptible to beta-lactam antibiotics such as penicillin
      and cefaclor, while resistance to macrolides was significant and ranged from 3.2%
      to 31%.

PMID- 11220987
TI  - Growth factors in clinical practice.
AB  - Wound repair consists of a complex interaction of cellular and biochemical
      events. Several growth factors have been identified as regulatory polypeptides co
      ordinating the healing process. Although it is not known precisely why chronic
      wounds do not follow the normal pattern of healing, diminished growth factor
      content and accelerated growth factor degradation may contribute to poor healing.
      Topical application of different factors exert stimulatory effects on wounds in
      animal models. Human data are limited but the most investigated compound is
      recombinant human platelet-derived growth factor-BB (rhPDGF-BB). PDGF-BB enhances
      granulation tissue formation and facilitates epithelialisation. Clinical trials
      in patients with 'hard to heal' diabetic foot ulcers demonstrated significant
      improvement in the 'healing rate' and the 'time to healing' compared with
      controls. Refinement of therapeutic strategies with growth factors will take
      place in the future.

PMID- 11220988
TI  - Steroidal contraception for men.
AB  - This article is a review of the development of male steroidal contraceptives
      during the past 25 years. Numerous studies have been conducted on male volunteers
      with oral and/or injectable preparations of single or combined steroids.
      Progestogen, androgen alone, or progestogen and androgen combinations have been
      used as weekly or monthly injectable formulations. Most of the studies involved
      small numbers of subjects. There was reversible suppression of spermatogenesis to
      oligospermia and/or azoospermia during the treatment period. Alteration of LH,
      FSH and testosterone levels in the blood was observed in most of these studies,
      depending on the steroid or combination of steroids used. There were reports
      about decreased or increased libido and weight gain during treatment with
      steroids. No other serious side-effects were found. Attention has recently
      focused on developing an androgen-only male contraceptive, because testosterone
      ester has shown promising results. The development of an effective and reliable
      steroidal contraceptive for men may be possible but this requires further
      research.

PMID- 11220989
TI  - Neuraminidase inhibitors: progress in the management of influenza.
AB  - Influenza is a serious respiratory illness and represents a significant clinical
      burden. As well as being debilitating, influenza can often cause complications
      leading to hospitalisation and death. Prophylaxis by vaccination is the preferred
      method of disease management, but because influenza viruses are constantly
      changing their antigenic properties, influenza outbreaks occur regularly as
      epidemics. Neuraminidase inhibitors are a new class of anti-influenza drugs
      designed to block influenza virus replication. Two neuraminidase inhibitors,
      zanamivir and oseltamivir, have been licensed for clinical use in the treatment
      of influenza. Both drugs significantly reduce the severity and duration of the
      illness when treatment is started within two days of the onset of symptoms.
      However, while zanamivir and oseltamivir have apparently similar efficacy, they
      differ in their modes of delivery and tolerability. Zanamivir is delivered direct
      to the lungs by inhalation and is well tolerated. Oseltamivir is taken in the
      form of a pill but has the side-effect of producing nausea and vomiting in some
      patients. In the absence of a demonstrable difference in efficacy, uptake of the
      two drugs will depend on evaluation of the relative merits of mode of delivery
      and tolerability.

PMID- 11220990
TI  - Prostate-specific antigen and prostate cancer.
AB  - Serum prostate-specific antigen (PSA) measurement is used to investigate patients
      with lower urinary tract symptoms and to screen for prostatic malignancy in
      symptom-free males over 50 years of age. Approximately 60% of patients with early
      (prostate-confined) occult malignancy show increased serum PSA levels, as do some
      20% of patients with prostatic symptoms from benign prostatic disease. When PSA
      is only slightly raised, serial PSA measurements, correction for prostatic volume
      and especially measurement of free (unbound) PSA (which is reduced in prostatic
      malignancy) may assist the differentiation of prostatic cancer from benign
      hypertrophy. Serial measurements are also of value for monitoring treatment of
      prostate cancer and for post-treatment surveillance.

PMID- 11220991
TI  - Pioglitazone.
AB  - Pioglitazone is a thiazolidinedione. As a PPAR-gamma agonist it alters the
      expression of a number of genes, resulting in a reduction in insulin resistance.
      Clinical trial data involving over 4500 patients with type 2 diabetes suggest it
      is effective both as monotherapy and in combination with sulphonylureas,
      metformin and insulin, producing both significant falls in HbA1c and favourable
      improvements in lipid parameters. It is well tolerated, with a low incidence of
      side-effects. Unlike troglitazone, its use has not been associated with
      hepatotoxicity. It has recently been licensed in the US for use as monotherapy
      and in combination with insulin, metformin and sulphonylureas. Its European
      license is more restrictive, allowing use in combination with metformin, and in
      combination with sulphonylureas in those intolerant of metformin. It provides a
      useful new option in the treatment of type 2 diabetes mellitus.

PMID- 11220992
TI  - A case of recurrent impetigo herpetiformis with a positive family history.
AB  - Impetigo herpetiformis is a rare non-infectious pustular dermatosis of pregnancy.
      A few non-gestational cases due to oral contraceptive use have also been
      reported. Although the disorder is not thought to have a genetic background,
      there are some familial case reports in the literature. We describe a case of
      recurrent impetigo herpetiformis in an 18-year-old pregnant woman who had normal
      serum calcium levels and responded well to prednisolone therapy. Interestingly,
      the patient's mother had also experienced a generalised pustular dermatosis
      associated with hypocalcaemia during oral contraceptive use, which was diagnosed
      clinically and histologically as impetigo herpetiformis.

PMID- 11220993
TI  - Recurrent encephalopathy and generalised seizures associated with relapses of
      thyrotoxicosis.
AB  - Seizures or encephalopathy associated with thyrotoxicosis are very rare. A 30
      year-old man with thyrotoxicosis and strongly positive thyroid antibodies
      presented with generalised seizures preceded by an encephalopathic illness of a
      few days duration. CSF protein was raised and EEG showed bilateral slowing of
      activity. Antithyroid drug treatment rendered him biochemically euthyroid, his
      cognitive state returned to normal and his seizures stopped. Subsequently he had
      a recurrence of both encephalopathy and seizures on two occasions, coinciding
      with relapses of the thyrotoxicosis. This supports the view that the hyperthyroid
      state caused this serious neurological condition. Treatment with 131I caused
      hypothyroidism and he has remained seizure free and well for six years on
      thyroxine replacement. Corticosteroids may have been helpful in the management of
      his encephalopathy.

PMID- 11220994
TI  - A case of isolated ACTH deficiency presenting with hypercalcaemia.
AB  - A 76-year-old man presented with a subacute history of weight loss, malaise and
      anorexia. Laboratory investigations revealed serially increasing hypercalcaemia,
      correlating with deterioration in his clinical status. He was subsequently shown
      to have hypocortisolaemia, which improved with the administration of intravenous
      steroids. Subsequent biochemical testing revealed the endocrinological defect to
      be one of isolated ACTH deficiency, which, unlike Addison's disease, does not
      classically include hypercalcaemia in its presentation.

PMID- 11220995
TI  - Strangulated inguinal hernia complicating colonoscopy.

PMID- 11220996
TI  - [Ehrlichiosis--new infectious pathology in Russia].

PMID- 11220997
TI  - [Ecological aspects of human pathogens Ehrlichia and Bartonella].
AB  - The review presents data on the natural circulation of Bartonellas and Erlichias
      with the participation of lice, fleas, mosquitoes, Ixodes ticks, as well as
      rodents, large wild mammals, and domestic animals. It outlines the human
      infection routes that are mainly associated with the attack of infected carriers
      and with the contacts with different warm-blooded animals. The risk of
      bartonellosis spread is evidenced by the data showing that 12.3% of clothes lice
      collected from homeless individuals in Moscow turned out to be infected. In a
      focus of erlichiasis, the infection rates of Ambliomma americanum and Ixodes
      scapularis were 4.9 and as high as 20%, respectively; 100% of white-tailed deers
      (Odocoileus virginianus) were seropositive. However, many issues associated with
      the preservation of these natural vectors, with the route of their transmission
      to human beings and animals are to be studied.

PMID- 11220998
TI  - [Relationship between zoonotic cutaneous leishmaniasis morbidity in the Murgab
      oasis and hydrometeorological factors].
AB  - The relationships of changes in the incidence of zoonotic cutaneous leishmaniasis
      (ZCL) in the Mary velayat, Turkmenistan, to those in hydrometeroelogical factors
      in 1951 to 1993 were first analyzed and the regularities found were evaluated.
      There is an inverse relationship of the incidence to the temperatures of the
      preceding winter. The long persistence of sun shining seems to have a negative
      impact on the foci of ZCL. There is an insignificant correlation of humidity,
      precipitation, and winds. In the years marked by high waters in the valley foci,
      increased soil moisture content causes a reduction in their epidemic activity.

PMID- 11220999
TI  - [Landscape and geographical distribution of natural reservoirs of human vector
      borne diseases in Southern Kazakhstan and Kirghizia].
AB  - The paper presents data available in the literature on the natural foci of
      plague, tularemia, tick-borne spirochetosis, Crimean hemorrhagic fever, tick
      typhus, Q fever, zoonotic cutaneous leishmaniasis. The largest number of
      transmissible infections is shown to be in the natural areas of deserts and
      piedmont semiarid lands.

PMID- 11221000
TI  - [Actual problems in diagnosis and treatment of imported malaria].
AB  - Analyzing 66 cases of imported malaria, recorded among the patients treated at
      Moscow Infective Clinical Hospital No. 1 has indicated that despite its typical
      clinical picture and specific epidemiological history, the prehospital diagnosis
      of tropical and vivax malaria was correctly made in 20 and 22% of patients,
      respectively. As few as 3 patients had chemoprophylaxis on an individual basis
      during their stay in the focus, but they did not comply with the regimen
      recommended. The severity of the disease, in non-immunized patients with tropical
      malaria, in particular, is related to the time of admittance (diagnosis) and to
      that of the initiation of adequate specific treatment.

PMID- 11221001
TI  - [Establishment of the plague control system in Russia].
AB  - The specialized plague control facilities which began being founded as a system
      of institutions in Russia in 1897 have made a great contribution to
      epidemiological well-being against quarantine and particularly menacing diseases.
      The developmental stages of plague control service in different periods of the
      country's social life and its place in the general governmental preventive and
      antiepidemic measures are shown. The paper emphasizes that it is expedient to
      maintain the antiepidemic readiness of plaque control facilities due the fact
      that the epidemic situation is due menacing and zoonosis is expected to aggravate
      in the late 20th to the early 21st centuries.

PMID- 11221002
TI  - [Culture of Plasmodium berghei with the short life span in mouse erythrocytes:
      evaluation of chloroquine resistance in three strains of the malaria parasite].
AB  - This comparative study was made to examine chroloquine inhibition of C14
      hypoxanthine incorporation (preferably nucleic acid precursor for plasmodium) in
      the short-living red blood cell cultures in mice infected with P. berghei strains
      differently sensitive to the agent 24 hours after incubation. These included 1)
      chloroquine-sensitive H strain; 2) LNK-65 strain having a spontaneously 2-3-fold
      decreased sensitivity to the agent; 3) strain LNK-65 ChR selected for high
      resistance to chloroquine. IC50 (chloroquine concentrations that ensure 50%
      inhibition of the incorporation of nucleic acid precursor into the cells of the
      parasite) was estimated for 3 P. berghei strains that were differently sensitive
      to chloroquine. These in vitro values adequately reflect the sensitivity of these
      strains to the agent in vivo.

PMID- 11221003
TI  - [Clinical and morphological characteristics of migrating erythema in patients
      with Ixodes tick-borne Lyme disease].
AB  - Patients with erythematous Ixodes tick-borne relapsing fever were examined and
      their skin biopsy specimens were morphologically studied to reveal clinical,
      immunological and morphological features of erythematous Ixodes tick-borne
      relapsing fever. Two types of development of erythema migrans were identified.
      These include 1) a typical type that appears as an area of homogenous hyperemia
      or that of annular shape and 2) an atypical one that presents as minor vesicles.
      There were elevated serum immunoglobulins A levels at the height of the disease.
      Morphologically, at the early stage of the disease, the center of erythema shows
      disturbances characterized by epidermal dystrophic processes, koilocytosis,
      subhorny and epidermal vesicles. The dermis displays solid perivascular
      lymphocytic infiltrates admixed with fibroblasts, fibrocytes, macrophages,
      plasmocytes, eosinophils, degranulated labrocytes. The interstitium exhibits
      scanty infiltrates. These changes are less pronounced at the periphery. Electron
      microscopy shows the structures morphologically similar to those of Borrelia. The
      late stage (days 15-23) of the disease is marked by insignificant dystrophy and
      perivascular fibrosis. There were no interstitial infiltrates. By and large, the
      pattern of clinical and immunological manifestations in patients with erythema
      migrans correlates with dermal morphological changes.

PMID- 11221004
TI  - [Enzyme immunoassay in diagnosis of opisthorchiasis. Communication 2. Enzyme
      immunoassay test system for diagnosis of acute opisthorchiasis].
AB  - A standard, highly specific and sensitive enzyme immunoassay test system has been
      developed for the diagnosis of acute opisthorchiasis, which is based on indirect
      solid-phase enzyme immunoassay for determination IgM antibodies to the antigen
      derived from Opisthorchis felineus marita extracts. The sensitivity of the test
      system is 87%, its specificity is 96.8%.

PMID- 11221005
TI  - [Synthesis and ovicidal effect of 8-aryloxyquinoline derivatives].

PMID- 11221006
TI  - [Trichinella pseudospiralis--a possible trichinellosis pathogen in Russia].

PMID- 11221007
TI  - [Use of the recombinant bacterial strain to control blood-sucking mosquito
      larvae].
AB  - The recombinant strain of Methylobacillus flagellatum with the cloned synthesis
      gene Cry 4B of the toxic Bac. thuringiensis var. israelensis protein proved to be
      effective against larvae of the Anopheles stephensi, An. atroparvus, An.
      pulcherrimus, An. superpictus, and An. sacharovi cultured in the laboratory. The
      use of M. flagellatum in combination with T. pyriformis may greatly expand the
      scope of use of the recombinant strain to control malaria mosquito larvae. Their
      combined use shows a 6-fold increase in the rate of strain action and a 4-fold
      decrease in the concentration of the agent. The optimum effects are shown
      following 24-hour combined intubation of M. flagellatum and Tetrahymena
      pyriformis.

PMID- 11221008
TI  - [Characteristics of phagocytosis of Yersinia pseudotuberculosis with various sets
      of plasmids].
AB  - The study used the selected aplasmid strain of Y. Pseudotuberculosis 53 and I
      716, which contains plasmids that have molecular weights of 48 and 82 mD, and I
      727 that has only virulence plasmid pYV48. The study has indicated that the fact
      that Yersinias have pVM82 and pYV48 enhances their resistance to phagocytosis.
      The Y. pseudotuberculosis strains carrying these plasmids suppress the
      responsiveness of phagocytes, inhibit an "oxidative explosion", lower the
      activities of superoxide dismutase and myeloperoxidase, thus suppressing their
      bactericidal capacity.

PMID- 11221009
TI  - [Criteria for classification of infectious diseases and infections which require
      measures for sanitary protection over the territory of the Russian Federation].

PMID- 11221010
TI  - Combined quality improvement ratio: a method for a more robust evaluation of
      changes in screening rates.
AB  - INTRODUCTION: It has been proposed that a ratio of the discordant cells from a
      McNemar's Chi-square table be used as a measure of quality improvement, and that
      this measure be called the Quality Improvement Ratio (QuIR). As proposed,
      patients enrolled in only one year of a two-year study are excluded from the
      McNemar's table of the QuIR. Since the original proposal of the McNemar's Chi
      square in 1947 included application to matched pair data, a more comprehensive
      analysis would be possible if the single-year enrollees were matched into pairs.
      METHODS: Patients enrolled in only the first study year are matched and paired
      with patients enrolled in only the second study year. The pairs are matched on
      variables important to the disease or process being evaluated. The matched pairs
      are combined with the repeatedly measured subjects to increase the statistical
      power of the analysis. The Combined Quality Improvement Ratio (CQuIR) is
      demonstrated with parameters from the original articles, in a--Markov chain Monte
      Carlo simulation, so a direct comparison can be made. RESULTS: CQuIR improved
      statistical power, especially in simulations of small populations. In some
      simulations the statistical power was double that of the QuIR alone. DISCUSSION:
      Although the QuIR provides important information, the CQuIR allows more of the
      data to be used to evaluate the effect of interventions in policy, delivery, and
      practice. The increase in statistical power of the CQuIR over the QuIR can
      facilitate successful evaluation of health care services.

PMID- 11221011
TI  - Using quality management to balance the economic and humane imperatives in
      behavioral health care.
AB  - The authors describe how quality management can be used to achieve an ethical
      balance between economic pressures and high-quality patient care.

PMID- 11221012
TI  - Quality improvement in chronic illness care: a collaborative approach.
AB  - BACKGROUND: Despite rapid advances in the clinical and psycho-educational
      management of diabetes, the quality of care received by the average patient with
      diabetes remains lackluster. The "collaborative" approach--the Breakthrough
      Series (BTS; Institute for Healthcare Improvement [IHI]; Boston)--coupled with a
      Chronic Care Model was used in an effort to improve clinical care of diabetes in
      26 health care organizations. METHODS: Descriptive and pre-post data are
      presented from 23 health care organizations participating in the 13-month (August
      1998-September 1999) BTS to improve diabetes care. The BTS combined the system
      changes suggested by the chronic care model, rapid cycle improvement, and
      evidence-based clinical content to assist teams with change efforts. The
      characteristics of organizations participating in the diabetes BTS, the
      collaborative process and content, and results of system-level changes are
      described. RESULTS: Twenty-three of 26 teams completed participation. Both chart
      review and self-report data on care processes and clinical outcomes suggested
      improvement based on changes teams made in the collaborative. Many of the
      organizations evidencing the largest improvements were community health centers,
      which had the fewest resources and the most challenged populations. DISCUSSION:
      The initial Chronic Illness BTS was sufficiently encouraging that replication and
      evaluation of the BTS collaborative model is being conducted in more than 50
      health care systems for diabetes, congestive heart failure, depression, and
      asthma. This model represents a feasible method of improving the quality of care
      across different health care organizations and across multiple chronic illnesses.

PMID- 11221013
TI  - Increasing understanding of patient needs during and after hospitalization.
AB  - BACKGROUND: The value of patient satisfaction surveys in health care improvement
      remains controversial. This study examined the value of alternative ways of
      identifying patient needs and estimating importance of those needs in improving
      the impact of satisfaction surveys. METHODS: Ninety-one acute myocardial
      infarction (AMI) patients from three southeast U.S. community hospitals were
      surveyed in 1992. Critical incident and person-focused interviews were used to
      identify patient needs. Besides overall/global satisfaction with care, patients
      rated satisfaction with and importance of 12 care delivery and 18 information and
      support needs. Unmet need scores (importance minus satisfaction) were estimated.
      Derived importance scores were assessed by correlating global satisfaction with
      individual need satisfaction scores. A two-step process for identifying priority
      areas for improvement was proposed. RESULTS: Patients identified and assigned
      greater scores to unmet needs for information and support needs (not included in
      typical satisfaction surveys) compared to typically assessed care delivery needs
      (p < 0.0001). Direct importance ratings differed substantially from those derived
      through correlation analyses (r = 0.28, p > 0.3 for care delivery needs and r = 
      0.17, p > 0.4 for information and support needs). Needs that received high
      importance and low satisfaction scores were all information and support needs.
      DISCUSSION: Needs that patients consider very important are usually ignored in
      typical patient surveys. Derived approaches typically used to assess importance
      of need from satisfaction data may provide misleading results. If satisfaction
      surveys are to result in real performance improvement, a fresh examination of the
      content and importance assessment strategies, as proposed, is needed.

PMID- 11221014
TI  - Federal efforts to improve quality of care: the Quality Interagency Coordination
      Task Force (QuIC).
AB  - FORMATION OF THE QUIC: The Quality Interagency Coordination Task Force (QuIC) was
      established in 1998 to enable the participating federal agencies to coordinate
      their activities to study, measure, and improve the quality of care delivered by
      federal health programs; provide people with information to help them in making
      more informed choices about their care; and develop the research base and
      infrastructure needed to improve the health care system, including knowledgeable
      and empowered workers, well-designed systems of care, and useful information
      systems. STUDY, MEASURE, AND IMPROVE CARE: The QuIC's initial efforts to improve
      the care delivered in federal health care programs have focused on diabetes,
      depression, and the effect of working conditions on quality of care. More
      recently, patient safety efforts are under way to establish a coordinating center
      that will enable those who are testing methods of reducing errors to share
      information across their projects and with experts in error reduction. DEVELOP A
      RESEARCH BASE AND INFRASTRUCTURE: The QuIC has coordinated efforts in
      credentialing, information on measures of quality, a taxonomy of quality
      improvement methods, and errors data collection. PROVIDE INFORMATION TO AMERICANS
      ABOUT HEALTH CARE QUALITY: The QuIC agencies are developing products that will
      enhance their ability to communicate with the American people about their health
      care choices: improved gateways for consumer information available from federal
      agencies, a glossary of commonly used terms, and guidance for producing report
      cards on quality of care. MOVING THE QUALITY IMPROVEMENT AGENDA FORWARD: Federal
      efforts to improve quality of care are moving forward in a more integrated
      fashion on a wide number of fronts.

PMID- 11221015
TI  - Irinotecan in small-cell lung cancer: the US experience.
AB  - There will be approximately 40,000 new cases of small-cell lung cancer this year.
      Prior to 1990, there were several agents with single-agent response rates of 30%
      to nearly 90% in the untreated small-cell lung cancer population and
      approximately 10% to 20% in relapsed patients. During the 1990s, several new
      chemotherapy agents have displayed activity in small-cell lung cancer (paclitaxel
      [Taxol], gemcitabine [Gemzar], vinorelbine [Navelbine], topotecan [Hycamtin], and
      irinotecan [Camptosar, CPT-11]). The majority of studies with irinotecan have
      been conducted in Japan. The US experience is limited to a single multi
      institution trial that was conducted in patients with previously treated small
      cell lung cancer. A total of 44 patients were entered in the study. Patients were
      stratified by response to prior therapy. Responses occurred in 7 of 44 patients
      for an overall response rate of 14%. The overall median survival was 4.8 months.

PMID- 11221016
TI  - Establishment of the standard regimen for non-small-cell lung cancer in Japan.
AB  - Preclinical data suggest that irinotecan (Camptosar, CPT-11), a novel
      topoisomerase I inhibitor, has exhibited promising activity in the treatment of
      lung cancer. In a phase II study of non-small-cell lung cancer, irinotecan
      demonstrated a 32% response rate. Combinations of irinotecan and cisplatin
      (Platinol) have also demonstrated synergistic activity against non-small-cell
      lung cancer. A phase I trial of irinotecan combined with cisplatin in previously
      untreated non-small-cell lung cancer patients showed an encouraging response rate
      of 54%, with irinotecan at 60 mg/m2 on days 1, 8, and 15, plus cisplatin at 80
      mg/m2. In a phase II study of chemotherapy-naive patients with stage IIIB/IV non
      small-cell lung cancer, irinotecan/cisplatin yielded a response rate of 52% and a
      mean survival time of 44 weeks. Data from a phase III trial comparing cisplatin
      at 80 mg/m2 on day 1 plus vindesine at 3 mg/m2 on days 1, 8, and 15 with two
      irinotecan-containing regimens--cisplatin at 80 mg/m2 on day 1 plus irinotecan at
      60 mg/m2 on days 1, 8, and 15, and single-agent irinotecan at 100 mg/m2 on days
      1, 8, and 15--have also been reported. Responses were observed in 32%, 44%, and
      21% of patients for the vindesine/cisplatin, irinotecan/cisplatin, and irinotecan
      arms, respectively, with corresponding median survival times of 45.6, 50.0, and
      46.0 weeks; there were no significant differences in response rate or survival
      between treatment groups for all patients. However, subset analysis of stage IV
      patients indicated a significant survival advantage for irinotecan/cisplatin; the
      median survival time was 50 weeks for patients receiving irinotecan/cisplatin,
      36.4 weeks for vindesine/cisplatin, and 42.1 weeks for irinotecan (P = .004 for
      the irinotecan/cisplatin arm vs vindesine/cisplatin; P = .018 for irinotecan vs
      vindesine/cisplatin). Another phase III study compared irinotecan/cisplatin and
      vindesine/cisplatin. There was no difference in overall median survival time, and
      the median survival times were not significantly different for stage IV patients
      in the respective irinotecan/cisplatin and vindesine/cisplatin arms (44.7 vs 45.3
      weeks). Further studies are needed to determine whether irinotecan/cisplatin
      combinations improve survival in comparison with other promising platinum
      containing regimens.

PMID- 11221017
TI  - Treatment of non-small-cell lung cancer in North America: the emerging role of
      irinotecan.
AB  - Topoisomerase I inhibitors have demonstrated significant activity in non-small
      cell lung cancer. In phase II studies, particularly in Japan, single-agent
      irinotecan (Camptosar, CPT-11) has produced response rates as high as 35%. In
      combinations with cisplatin (Platinol), it has also resulted in overall response
      rates of 41% to 52%, with median survival of 10.2 to 13 months, and 1-year
      survival rates of 33% and 58%. A Japanese phase III randomized trial of
      irinotecan, either alone or in combination with cisplatin vs vindesine/cisplatin
      in previously untreated stage IIIB/IV non-small-cell lung cancer, demonstrated
      that survival among stage IV patients was significantly better in the irinotecan
      arms compared to the vindesine/cisplatin group. However, another Japanese phase
      III study comparing irinotecan/cisplatin to vindesine/cisplatin failed to show a
      survival difference. Initial North American efforts recapitulated this work,
      while a follow-up study incorporated weekly irinotecan with weekly cisplatin,
      yielding a response rate of 36%, median survival of 11.6 months, and a 1-year
      survival rate of 46%. Irinotecan/taxane combinations have also shown promise.
      Phase I/II studies in advanced non-small-cell lung cancer with paclitaxel
      (Taxol), irinotecan, and carboplatin (Paraplatin) produced a response rate of
      38%, median survival of 11 months, and a 1-year survival rate of 47%; other
      trials with irinotecan and paclitaxel are ongoing. Phase I data for
      irinotecan/docetaxel (Taxotere) have indicated an overall response rate of 32%,
      median survival of 39 weeks, and a 1-year survival rate of 38%; subsequent phase
      II trials used either cisplatin or irinotecan in combination with docetaxel and
      yielded a promising median survival of 45.6 weeks, comparable to the standard
      cisplatin/docetaxel combination. Phase I trials with irinotecan and gemcitabine
      (Gemzar) have also yielded promising results. Follow-up efforts include phase II
      studies in both chemonaive advanced non-small-cell lung cancer and progressive
      small-cell lung cancer (salvage therapy). Clearly, clinical trial data have
      demonstrated the utility of irinotecan in the treatment of advanced non-small
      cell lung cancer. Planned combinations with new chemotherapeutic agents and
      biological response modifiers may provide additional treatment options.

PMID- 11221018
TI  - Rationale and dose-finding studies of the combination of irinotecan and a taxane
      on a weekly schedule.
AB  - Cisplatin (Platinol)-based chemotherapy has been the standard systemic therapy
      for both non-small-cell and small-cell lung cancer for the past 2 decades, though
      the efficacy and benefit remain modest. Recently, several novel agents have been
      introduced that have single-agent activity comparable to cisplatin and offer the
      possibility of improved therapy for lung cancer. Camptothecin and taxane
      derivatives are associated with both different mechanisms of action and
      nonhematologic toxicities, and have demonstrated additive or synergistic activity
      when used in combination in preclinical studies. We review pertinent clinical
      studies of these agents in lung cancer and present our experience in combining
      irinotecan (Camptosar, CPT-11) with taxanes on a weekly schedule in dose-finding
      and efficacy studies. When chemotherapy is delivered for 4 consecutive weeks
      followed by a 2-week rest, hematologic toxicity is dose limiting and most
      prominent during weeks 3 and 4. Dose intensification is feasible if the schedule
      is modified so the chemotherapy is given on days 1 and 8, with cycles repeated
      every 3 weeks. The most common nonhematologic toxicities remain asthenia,
      neuropathy, and diarrhea. Future studies will explore and better define the role
      of these drug combinations in the treatment of lung cancer.

PMID- 11221020
TI  - Docetaxel followed by gemcitabine and irinotecan in solid tumors.
AB  - Docetaxel (Taxotere), gemcitabine (Gemzar), and irinotecan (Camptosar, CPT-11)
      are active single agents in a variety of solid tumors. In combination, synergism
      may be schedule dependent. Preclinical studies suggested synergistic interactions
      when docetaxel was administered 24 hours before gemcitabine or irinotecan. The
      objective of this phase I trial in patients with refractory solid tumors was to
      determine the maximum tolerated dose of docetaxel followed 24 hours later by
      gemcitabine and irinotecan. Two different schedules were tested: docetaxel
      escalated by 5 mg/m2/cohort from an initial dose of 20 mg/m2 on days 1 and 8
      (schedule A) or escalated by 15 mg/m2/cohort from 45 mg/m2 on day 8 only
      (schedule B). In both schedules, docetaxel was given over 1 hour. Gemcitabine and
      irinotecan were given on days 2 and 9 (arm A) or 1 and 9 (arm B) at fixed doses
      of 1,000 mg/m2 over 30 minutes and 100 mg/m2 over 90 minutes, respectively.
      Escalation of docetaxel was planned in groups of three patients, with three
      additional patients added at the first indication of dose-limiting toxicity. Four
      dose levels in arm A and one dose level in arm B have been tested. Seventeen
      patients were evaluable in arm A; one died of an unrelated cause on cycle 1, and
      another withdrew consent before beginning treatment. Five of six patients were
      evaluable in arm B; one patient inadvertently received G-CSF on cycle 1. Forty
      two cycles have been delivered in arm A (mean; 2.2 cycles/patient), and 25 cycles
      in arm B (mean, 4.2 cycles/patient); the maximum tolerated dose of docetaxel on
      arm A was 20 mg/m2. The dose-limiting toxicities were grade 3 diarrhea in one
      patient, grade 3 infection in two patients, and grade 4 neutropenia for > 4 days
      in one patient at the 25 mg/m2 level. The dose-limiting toxicities on arm B
      occurred at the first dose level and included grade 3 diarrhea in one patient,
      grade 4 diarrhea in one patient, and grade 4 neutropenia for 4 days in another
      patient. Accrual to schedule B was closed after testing the cohort 1 dose level
      because testing of a single deescalated docetaxel dose given on day 8 was not
      considered clinically relevant.

PMID- 11221021
TI  - Irinotecan: summary and future directions.

PMID- 11221019
TI  - Irinotecan in combined-modality therapy for locally advanced non-small-cell lung
      cancer.
AB  - The management of non-small-cell lung cancer is undergoing rapid evolution.
      Although the advent of combined-modality therapy has led to improved survival,
      most patients eventually succumb to the disease. The arrival of a new generation
      of chemotherapeutic agents--including the taxanes, gemcitabine (Gemzar), and
      topoisomerase inhibitors such as irinotecan (Camptosar, CPT-11)--offers the hope
      of advances against this malignancy. Irinotecan, a camptothecin derivative, has
      shown impressive activity in a variety of solid tumors, including non-small-cell
      lung cancer. It is believed to act by stabilizing the topoisomerase-DNA complex
      formed during diverse cellular processes, including replication and
      transcription. A considerable body of evidence also demonstrates that
      camptothecin and its derivatives possess substantial radiosensitization
      properties. This article will review the in vitro and in vivo data on
      irinotecan's ability to render tumors more susceptible to ionizing radiation. It
      will then focus on experience with irinotecan and thoracic radiation in the
      treatment of non-small-cell lung cancer, which has yielded acceptable toxicity
      results and response rates in excess of 60% in early trials. It is hoped that
      newer treatment strategies--such as the combination of radiation and irinotecan
      in lung cancer--will significantly impact cure rates in the future.

PMID- 11221022
TI  - Current status of irinotecan in lung cancer.
AB  - Survival in lung cancer patients has not improved over the past 2 decades.
      Irinotecan (Camptosar, CPT-11), a semisynthetic analog of the quinoline-based
      alkaloid camptothecin, is one of several new drugs that have demonstrated
      promising activity in the treatment of lung cancer in recent years. This article
      gives a brief overview of the mechanism, development history, and current uses of
      this agent.

PMID- 11221023
TI  - New state of the art in small-cell lung cancer.
AB  - Chemotherapy is currently the main treatment for all stages of small-cell lung
      cancer. In extensive disease, etoposide/cisplatin (Platinol) is standard
      treatment, and in limited disease, etoposide/cisplatin with early concurrent
      thoracic radiotherapy twice daily is a typical regimen. Therapeutic outcomes,
      however, leave substantial room for improvement. The topoisomerase I inhibitor
      irinotecan (Camptosar, CPT-11) is one of the most active agents against small
      cell lung cancer. In a phase II study, irinotecan yielded response rates of 33%
      to 50%, depending on prior treatment status. Combinations with cisplatin have
      resulted in a median survival of 14.3 months in patients with limited disease and
      13.0 months in extensive disease. A phase III study in extensive-disease small
      cell lung cancer compared irinotecan/cisplatin and standard etoposide/cisplatin
      regimens, and demonstrated a significant difference in survival in the irinotecan
      containing arm (411 vs 282 days). Planned phase III studies in North America will
      confirm and extend these results. Based on these promising data,
      irinotecan/cisplatin regimens represent a new standard treatment for extensive
      disease small-cell lung cancer.

PMID- 11221024
TI  - [Kidney obstruction: potential use of ultrasonography and Doppler color
      ultrasonography].
AB  - Ultrasonography is the first imaging approach in evaluation of patients with
      urinary obstruction. Presence of hydronephrosis, urinomas and inflammatory
      complications can be assessed. Moreover, the level and the cause of obstruction
      are often identified. The major limits of ultrasonography are poor visibility of
      the lumbar portion of the urinary tract and lack of specificity in detection of
      pyelocaliectasis. These limits are partially overcome with Doppler studies.
      Several factors can bias diagnostic accuracy of colour Doppler ultrasonography in
      evaluating renal obstruction; in particular, partial or intermittent obstruction
      cause minimum hemodynamic changes in patients with renal colic. Sensitivity of
      colour Doppler ultrasonography to detect obstruction decreases following medical
      treatment with NSAID and increases following hydration and diuretics
      administration. Diuretic ultrasound, colour Doppler evaluation of ureteral jets
      and evaluation of the twinkling artefact of stones are useful imaging techniques
      as well. Tissue harmonic imaging is a new imaging technique available in most
      latest generation US equipments. Evaluation of the kidney and of the urinary
      tract improves using this technique due to artefact reduction and increased
      contrast resolution.

PMID- 11221025
TI  - [Ultrasonography and Doppler color ultrasonography in kidney neoplasms: the
      demands of the clinician].
AB  - The high number of diagnostic methods for images (ultrasound, computer tomography
      -CT, magnetic nuclear resonance--MNR) has allowed the urologist diagnosis more
      precocious of renal masses contributing to increase the survival rate and quality
      of life of patients affected by renal carcinoma. Although many are the advantages
      that the ultrasound scan gives to the urologist, still today in presence of
      ultrasound scan results showing expansive renal masses, probably malignant, many
      perform a CT or MNR for diagnostic confirmation and tumor extension.

PMID- 11221026
TI  - [Diagnostic approach to newborns with prenatal diagnosis of hydronephrosis].
AB  - Prenatal ultrasound examination has radically changed physician's attitude toward
      hydronephrosis. Fetal hydronephrosis must be searched out and looked at with a
      wider vision than it was done in the past. A mechanical obstruction must be
      suspected indeed, but often we have to face a functional dilatation, caused by
      immaturity, which can clear up in uterus or which will simply require a careful
      follow-up during the post natal period. Vesicoureteral reflux may count for 10 to
      33% of urinary tract dilatations. There are no pathological limit values clearly
      stated in literature: a pyelectasis can only be the expression of a normal
      anatomical variability, without features of disease. In creating a diagnostic
      protocol for the newborn with prenatal diagnosis of hydronephrosis, all these
      possibilities must be accounted for the risk of focusing on mechanical
      obstruction is to overestimate and over-treat children that will never obtain any
      benefit from a surgical procedure.

PMID- 11221027
TI  - [Fragments of prostatic biopsy: characteristics, dimensions, and number].
AB  - Prostate needle biopsy can give important clinical information on tumor extension
      and grading, useful prognostic parameters for the therapeutic choice and
      prognostic definition. Currently about the 25% of positive biopsies for carcinoma
      contain only small foci of cancer that makes histopathological evaluation often
      the difficult and less reliable. We reviewed the literature about different
      methods to perform needle biopsies and methods to improve histologic yield of
      prostatic biopsies in order to obtain more histopathological information on the
      specimens to improve diagnostic accuracy on core biopsy. We report our initial
      experience using the preembedding methods proposed by Rogatsch. The best method
      to perform a prostate biopsy includes the use of using 18-gauges needles, single
      specimen identification and subsequent orientation of every bioptic fragment by
      inking its proximal end. We performed the preembedding technique of the
      fragments, proposed by Rogatsch et al., stretching the fragment between two nylon
      meshes enclosed in a tissue cassette in formalin. The full length of the biopsy
      is within the section plane. This technique partially modified in our preliminary
      experience with the employment of two sponges containing 10% buffered formalin
      placed in a tissue cassette (2.8 x 3.3 cm). This "sandwich" technique has
      furnished evident advantages for the pathologist, optimizing the visible area for
      section plane in comparison to that obtainable from free floating core biopsies.
      In conclusion, routinely application of the preembedding prostatic core biopsies
      could improve the accuracy of the histopathological examination and therefore
      provide more reliable data on tumor extension and grade.

PMID- 11221028
TI  - [Prostate biopsy: assessment of current indications and techniques].
AB  - Following pulmonary carcinoma, prostate cancer in the second leading cause of
      death due to neoplastic diseases and accounts for approximately 10% of all
      malignant neoplasms in the european male population. This disease is strictly and
      age related pathology and as such destined to be increasingly relevant in an
      ageing general population. The preventive measures and strategies being developed
      and refined are aimed at diagnosing tumours at an earlier stage and as a
      consequence increasing life. At this moment in time ultrasound (US) guided
      transrectal prostate sextant biopsies, described by Hodge as early as 1989,
      represent the most diffusely employed technique for the diagnosis of prostate
      cancer. Even if transrectal ultrasound (TRUS) markedly increases the US
      resolution capacity with respect to those obtainable transperineally or
      suprapubically, initial enthusiasm associated in performing biopsies of
      hypoechogenic zones for the diagnosis of early prostate cancers weaned after
      follow-up studies of this technique became available. Studies from different
      authors reveal how TRUS is inadequate in precisely pin-pointing prostate cancers
      above all early ones. According to the data published in the literature between
      30 and 57% of hypoechogenic lesions discovered at US are not tumours but rather
      non-neoplastic prostatic tissue diseases such as acute or chronic
      infections/inflammations, atrophy, infarcts or prostatic intraepithelial
      neoplasms (PIN). Furthermore, Chang et al. have shown how sextant biopsies have a
      greater specificity in diagnosing prostate cancer with respect to single biopsies
      aimed at hypoechogenic areas, these values being 76 and 50% respectively. Having
      observed how many repeat prostate biopsies revealed the presence of a prostatic
      carcinoma following an initial negative prostate biopsy in patients with pre
      existing elevated prostate specific antigen (PSA) levels has induced many authors
      to exceed the number samplings, as suggested by Hodge, performed during biopsies.
      Different diagnostic results obtained by biopsy sampling in different positions
      and in different numbers (up to a maximum of 18) have recently been compared in
      different studies. This concept follows the principle that increasing the number
      of samplings will invariably be associated by an increased diagnostic potential
      of prostate carcinomas, above all in those "grey zone" patients with PSA values
      less than 10 ng/ml, thus identifying the prostatic cancer at an earlier stage
      reducing morbility and correlated mortality, increasing specificity and reducing
      the quote of unnecessary biopsies.

PMID- 11221029
TI  - [Alternative for ultrasonographic assessment: role of magnetic resonance with
      endorectal coil for prostate and seminal vesicle biopsy].
AB  - The early enthusiasm for widespread application of magnetic resonance imaging
      (MRI) with endorectal coil to clinical staging of prostatic cancer has not been
      substantiated to result in enhanced stage assignment primarily due to the lack of
      predictive value in the detection of extraprostatic extension. The authors report
      their experience of this imaging modality both for the evaluation of seminal
      vesicles invasion and as a guide for rebiopsy in men with suspicious prostate
      specific antigen (PSA) and a prior negative prostatic mapping.

PMID- 11221030
TI  - [Digital tridimensional ultrasonography in urology].
AB  - Three dimensional ultrasound has gained a firm foothold in the urological field
      in the last ten years, although it has up to now been used more with scientific
      and research aims than for clinical and diagnostic purposes. 3D devices can
      acquire a huge number of images in a very short time (about 4 seconds); the
      monitor displays the 3 views, of the sagittal, transverse and coronal planes,
      simultaneously. 3D US can also enable Doppler studies of the arteries and veins
      and the dedicated software can apply image subtraction techniques, displaying the
      entire vascular tract cleared of the superimposed images of the other organic
      systems acquired at the same time. In urology, 3D US devices are most often
      employed in diseases of the prostate, as the clear view of transition zone on the
      coronal plane makes it possible to carry out precise guided biopsies, resulting
      in a proven improvement in early diagnosis of carcinoma in this zone. 3D US can
      overcome the difficulties left open by conventional TRUS for local staging of
      cancer. The possibility of following the whole course of the ejaculatory ducts
      makes it possible to identify any invasion, the first step towards involvement of
      the seminal vesicles and a negative prognostic factor. The method has also been
      used in the follow-up of kidney transplant patients. 3D US provides good imaging
      of the arterial and venous anastomoses and of the course of the vessels down to
      the smallest ramifications and thus enables more precise assessment of the
      resistance index, an essential parameter for evaluating rejection.

PMID- 11221031
TI  - [Tridimensional ultrasonography in andrology].
AB  - Three-dimensional ultrasound has already been employed to improve detection and
      characterization of the masses in various organs. The system can also be expected
      to improve qualitative evaluation of vessel pathology. Three-dimensional
      ultrasound could offer an additional contribution even in Andrology, in at least
      three fields: in the best evaluation of the anatomical structures; in most
      accurate measurement of the volumes of the organs; in the study of the Peyronie's
      disease, for the availability of the coronal plain.

PMID- 11221032
TI  - [Color Doppler and ultrasound-guided prostate biopsy in the diagnosis of
      prostatic neoplasm].
AB  - The diagnosis of prostate neoplasm is still limited today by the variable power
      of prediction of the three main surveys used: prostate-specific antigen (PSA),
      digito rectal exploration (DRE) and ultrasound transrectal (TRUS). The study
      aimed to estimate the benefits and the diagnostic impact of the color Doppler
      ultrasonography on the diagnosis of prostate neoplasm through biopsies targeted
      on areas with abnormal flow. With this purpose, 222 biopsies performed on 71
      patients between 1997 and 1999 were considered, which led to a diagnosis of
      neoplasm in 36 patients. Of the 84 biopsies that revealed prostate
      adenocarcinoma, 74 (64.3%) were correlated to hypoechoic lesions with abnormal
      flow signals while 41 (35.6%) showed a benign pathology (prostatitis or benign
      prostatic hyperplasia) (p < 0.0011). In five patients (13%) who did not present
      any evident lesions at a first transrectal ultrasound, the diagnosis of neoplasm
      was made only through biopsies targeted on areas with abnormal flow. Therefore,
      the color Doppler exam can be used during prostate ultrasonography either to
      consolidate the diagnosis or to give a useful target in case of isoechoic
      lesions.

PMID- 11221033
TI  - [Does PSA density of the transition zone represent a useful parameter in the
      diagnosis of prostate carcinoma?].
AB  - Prostate specific antigen (PSA) has unequivocally proved its clinical usefulness
      ad a serum marker for prostate cancer. In order to enhance the specificity of
      serum PSA, several diagnostic parameters have been employed including PSA density
      of transition zone (TZ). The authors report their experience on the efficacy of
      PSA density TZ with level of PSA < 4 ng/ml, between 4-10 ng/ml, > 10 ng/ml, in
      the diagnostic of prostate cancer. The PSA density of TZ resulted uscless for PSA
      levels < 4 ng/ml, but improved the diagnostic specificity associated to PSA serum
      in the PSA levels ranging between 4-10 ng/ml and > 10 ng/ml.

PMID- 11221034
TI  - [Validity of PSA density of the transition zone in the diagnosis of prostate
      cancer].
AB  - One hundred four patients (mean age 70.6 years) with prostatic specific antigen
      (PSA) values between 4 and 10 ng/ml (average 7.9 ng/ml), and with no suspects for
      neoplasia by digital rectal examination (DRE) and transrectal ultrasound (TRUS)
      were studied. In all patients PSA density for the entire prostate (PSAD) and PSA
      density for the transition zone (PSAT) were calculated. TRUS was performed using
      a 5 MHz probe. Prostate and transition zone volumes were obtained by ellipsoid
      formula. Aim of the study was to evaluate the PSAT predictivity for prostate
      cancer compared to the PSAD. Sixteen out of 104 patients (15.4%) had
      histologically confirmed prostate cancer, and 88 (84.6%) had benign prostatic
      hyperplasia. When cut-off for PSAD was 0.15 ng/ml/cc, specificity and sensitivity
      were respectively 75% and 68% with positive and negative predictive values of 54%
      and 17%; when cut-off for PSAT was 0.34% ng/ml/cc, sensitivity and specificity
      were respectively 100% and 68% with positive and negative predictive values of
      60% and 18%. Our results, according to the literature data, suggest that PSAT
      seems to have a higher predictivity for prostate cancer than PSAD, providing an
      optimization for the employ of prostatic biopsy, especially for those patients
      with PSA values between 4 and 10 ng/ml.

PMID- 11221035
TI  - [Pelvic ultrasound monitoring of lymphocele in patients treated with radical
      prostatectomy].
AB  - Pelvic lymphoceles, occurred in patients undergone radical retropubic
      prostatectomy, are believed to increase the risk of deep venous thrombosis and so
      thromboembolic complications. The authors' aim is to evaluate the usefulness of
      pelvic ultrasonography in the diagnosis and in the possible early treatment of
      pelvic lymphoceles. Fifty-eight patients undergone radical prostatectomy and
      pelvic lymphadenectomy, between January '98 and December '99, underwent a pelvic
      ultrasonography in VII post-operative day. When a symptomatic or large (over 5
      cm) lymphocele was found, it was treated with ultrasound (US) guided drainage. In
      the study, the following parameters were considered: lymphocele occurrence, size,
      location and treatment and thromboembolic complication. Statistical analysis was
      carried out with Fisher's exact test. Pelvic US showed a lymphocele in 23 out of
      58 (40%) patients. Mean size was 5 cm. Deep venous thrombosis occurred in 4
      patients, all with pelvic lymphoceles. No thromboembolic complications were
      recorded. In our experience, pelvic ultrasound has shown to be an easy e reliable
      tool for diagnosis and percutaneous treatment of pelvic lymphoceles.

PMID- 11221036
TI  - [Repeated ultrasound-guided transrectal prostate biopsy in patients with negative
      histologic test].
AB  - The screening programs for prostate cancer will affect a number increasing of
      patients over 50 years with consequence rising the bioptic demand. Nevertheless
      the istopathologic results are negatives for carcinoma in the most part of
      patients. It's evident that a part of carcinomas are lost at biopsy. Two hundred
      four patients where submitted at second bioptic session after a maximum of 12
      months. Our results show a percent probability of positive findings in 12%. In
      75% cancer diagnosed in that second session had clinically significance. Prostate
      specific antigen (PSA) value, in our study, is the most positive predictive
      parameter for prostate cancer at second biopsy. Patients with PSA > 10 ng/ml have
      a risk 7 times greater of having a prostatic cancer respect to patients with PSA
      < 10 ng/ml. PSA density, PSA velocity and the presence of ipoecoic areas
      previously biopsied, aren't risk factors for detection of prostate cancer at
      second bioptic session.

PMID- 11221037
TI  - [Transrectal ultrasonography in the early diagnosis of prostate carcinoma: use of
      a new ultrasonography technique with endorectal probe].
AB  - Seventy-80% of prostatic carcinoma develops in the peripheral gland. Transrectal
      ultrasound (TRUS) has the capacity to identify nodules or hypoechogenic areas in
      the peripheral zone, suspected to be carcinoma. We describe a new echographic
      technic with endorectal probe (target compression test), to study hypoechogenic
      areas or nodules in the peripheral gland, during TRUS examination. Thirty-three
      patients, aged 49-77 years, with prostatic peripheral hypoechoic lesion at
      transrectal ultrasound, were studied. All patients underwent prostatic biopsy.
      Ten of the 11 positive patients (non compressible lesion) at the target
      compression test resulted to be affected by adenocarcinoma. Only 3 of the 22
      negative patients (compressible lesion) at the target compression test resulted
      to be affected by adenocarcinoma. Even if our data have to be confirmed by
      further studies, they suggest that the target compression test may be a useful
      complementary test, during TRUS, in the evaluation of hypoechogenic areas in the
      peripheral gland.

PMID- 11221038
TI  - [Renal Doppler color ultrasonography in the study of diabetic nephropathy].
AB  - The traditional ultrasound approach in the field of diabetic nephropathy provides
      only partial clinical information; moreover, the data obtained are merely
      descriptive, in particular regarding the involvement of the intrarenal arteries,
      which is however the area mainly involved. The aim of our study was to assess the
      data provided by Doppler ultrasound and in particular the role of the Resistive
      Index (RI) in a population of 160 type 2 diabetics (NIDDM), divided into 4 groups
      according to the severity of diabetic nephropathy. The assessment of RI has
      enabled us to detect among patients in the early stages of diabetic nephropathy
      (64 patients of group 1), a subgroup of 28 subjects (43.8%) showing RI values
      equal to or above the threshold value of 0.7. The determination of renal size and
      of renal parenchyma echogenicity proved to be of little value. The most relevant
      clinical information is provided by the RI, a parameter that will allow the early
      detection of patients affected by NIDDM, who show renal vascular involvement
      without however any other alterations of the traditional ultrasound parameters.

PMID- 11221039
TI  - [Traditional ultrasonography, directional Doppler power, and levovist in the
      morphological and functional evaluation of single kidney].
AB  - Either the color and the power Doppler have given important information on renal
      haemodynamics, but these methods are limited. The power directional Doppler (pdD)
      surpasses such limits; again, administration of Levovist increases the intensity
      of vascular signal. The aim of this study is the evaluation, in subjects with a
      solitary kidney, but without evident nephropathies, the morphology, the cortical
      vascularization and the functional status of the kidney. We studied 21 patients
      divided into three groups. Group A: subjects with normal renal function; group B:
      patients with caliceal and pielic dilation; group C: patient with chronic renal
      failure (CRF). In all subjects, a pdD was effected. Only in three patients it was
      necessary to administer Levovist, in order to emphasize the parenchymal
      vascularization. The A group subjects, on echographic B-mode examination,
      presented a normal morphology and volume of the kidney; on pdD exam, a regular
      intense and homogeneous parenchymal vascularization, with resistance index (RI) =
      0.53 divided by 0.66. In B group, pdD showed an irregular vascularization, with
      RI > 0.7; also the glomerular filtration rate (GFR) was reduced (70 ml/min). In C
      group, at the pdD it was relevant a reduced and irregular vascularization in
      whole renal tissue. If possible, the echographic B-mode examination must be
      completed with the pdD, with or without Levovist, in order to identify unknown
      renal pathologies, moreover in subjects with a single kidney.

PMID- 11221040
TI  - [Incidental kidney neoplasm: anatomopathologic characteristics and clinical
      behavior].
AB  - In the last 20 years, the wide use of abdominal ultrasound and CT scans to
      diagnose non renal disease has caused an increase in the number of kidney tumours
      discovered by chance. Our study aimed to compare the anatomopathological features
      and clinical evolution of kidney tumours discovered incidentally with those of
      symptomatic kidney tumours. We retrospectively analyzed 338 patients subjected to
      radical nephrectomy in our Institute between 1979 and 1999, subdivided into two
      groups: patients with symptomatic tumours vs those with incidentalomas. The
      following parameters were taken into account: histological type, pathological
      stage, Furhman's grade and tumour diameter. Finally, overall survival was
      compared. Of a total of 338 patients, 160 (47.4%), were symptomatic (group 1) and
      the other 178 (52.6%) had tumours discovered incidentally (group 2), during US in
      144 patients (81%), CT in 32 cases (18%), and urography in 2 cases (1%). No
      significant differences were found as regards the histological type. When the
      patients were stratified by stage, a greater incidence of tumours in stage T1 was
      found in group 2 (42.1% vs 29.4%), while advanced forms were more frequent in
      group 1 (15.6% vs 9%). There were no differences in histological grade between
      the two subpopulations. The mean size of incidental tumours was 6.1 cm (range:
      1.5-20), vs 7.6 cm of symptomatic tumours (range: 2-25 cm). Analysis of overall
      survival showed a statistically significant difference between the two groups:
      there were 37 deaths (23.1%) in group 1 vs 24 deaths (13.5%) in group 2 (p <
      0.03). Progression of the disease occurred in 47 (29.3%) subjects in group 1 and
      41 (23%) in group 2 (p: ns). This study demonstrated significantly longer
      survival among patients with kidney tumours discovered incidentally. This should
      be attributed to the lower stage and smaller size of incidentalomas in comparison
      with symptomatic tumours.

PMID- 11221041
TI  - [Acquired cystic kidney disease (ACKD): experience of a dialysis center].
AB  - Acquired cystic kidney disease (ACKD) is characterized by the substitution of
      renal parenchyma with multiple cysts in patients either with end stage renal
      disease who are treated for uremia with dialysis (as on haemodialysis--HD--as on
      peritoneal dialysis--PD) due to non cystic kidney diseases. The aim of our study
      was to value the prevalence of ACKD in our haemodialysed patients (with exclusion
      of polycystic disease and obstructive nephropathy), its relationship between
      clinical and bioumoral parameters, and its complications in the follow-up. We
      have studied 56 uremic patients (32f and 24m) on bicarbonate HD three in a week.
      All our patients underwent renal echography using ECO B mode ALOKA SSD500 with
      electronic convex sector probe 3.5 MHz for to diagnose ACKD. We divided the
      population of the study in two groups: the group A includes 23 patients with
      ACKD; the group B includes 33 patients without ACKD. We analyzed in all patients
      body mass index (BMI), protein catabolic rate normalized (nPCR), dialitic
      adequacy index (KT/V), Hb, the serum levels of EPO by ELISA test (MEDAL GmbH, GE,
      Diagnostika, Hamburg; normal values 5 divided by 30 mUI/ml). We have found a
      prevalence of 42% for ACKD and statistical significance between the two groups
      for the duration of HD and BMI (Anova p < 0.01). The EPO serum concentration was
      higher in the group A (p < 0.05), while their rhuEPO requirement was lower. In
      two patients of group with ACKD we have found renal carcinoma. In conclusion, by
      our experience should be opportune to carry out a renal echography at the start
      of dialysis treatment and every six months for patients with ACKD and every year
      for those without ACKD. It is necessary to perform the echography of the kidney
      in all uremic patients before the start of haemo or peritoneal dialysis and
      report this examination in those patients with ACKD every six months and every
      year in those without ACKD.

PMID- 11221042
TI  - [Ultrasonography of the upper urinary tract in patients with spinal cord injury].
AB  - A lesion of the upper urinary tract (UUT) is a possible outcome of the bladder
      dysfunction following a spinal cord injury (SCI). The most common findings are
      hydronephrosis, bladder-ureteral reflux and pyelonephritis. Aim of the study was
      to evaluate the prevalence of UUT abnormalities, evaluable by ultrasound (US), in
      a population of SCI patients; furthermore we correlated the presence of such
      abnormalities to clinical findings. We evaluated 115 consecutive patients who
      underwent US scan of UUT. Mean time between injury and our evaluation was 81.5 +/
      100.2 months. Lesion level was cervical (38/115), dorsal (59/115) and lumbar
      (18/115). Eight patients emptied their bladder spontaneously, 105 by means of
      intermittent catheterization, while 2 were wearing indwelling catheter. Seventy
      four patients used anticholinergics drugs. It was evaluated the presence of:
      hydronephrosis, renal stones and chronic pyelonephritis using US. Afterward the
      presence of such alterations was correlated to sex and age of patients, time
      between injury and our evaluation, method of bladder emptying and use of
      anticholinergics drugs. In 25/115 patients (21.7%) were found abnormalities of
      UUT. A significative correlation was found between presence of UUT lesions and
      older age. In our series, prevalence of UUT abnormalities observed by means of US
      in SCI patients is 21.7%. This finding could be due to correct management and
      strict follow up of the patients.

PMID- 11221043
TI  - [Translabial ultrasonography in the diagnosis of stress urinary incontinence in
      women].
AB  - The target of this work is to evaluate the translabial ultrasonography (US)
      reliability as valid alternative to chain cystography in the pre and post
      operative assessment of patients with stress urinary incontinence (SUI). From
      June 1996 to May 1999, we studied 448 patients ranging in age from 35 to 90 years
      old with SUI from defect of anatomic support. Patients underwent translabial
      ultrasonography. The translabial US was performed with the patient in lithotomic
      position using a linear 7.5 MHz probe. The bladder was slightly filled, and the
      probe positioned longitudinally at the introitus to evaluate downwards and
      posterior rotation of bladder neck and urethra in basal conditions as well as
      during the abdominal strain. The evaluation of the anterior urethral angle of the
      448 patients who underwent translabial US showed that, during the abdominal
      strain, all the patients with SUI had a very significative rotation of the
      urethral axis compared to continent women. Translabial US is a quick, simple,
      reliable non-invasive procedure. It may be used routinely for the pre and post
      operative evaluation of anti-incontinence surgery.

PMID- 11221044
TI  - [Voiding ultrasonographic cystourethrography].
AB  - Transvaginal ultrasonography examines the bladder base, the urethral anatomy and
      the relationship between these structures. This procedure particularly evaluates
      the striated sphincter and periutrehral structures, during micturition attention
      is focused on elasticity of urethral walls, deviation of urethral axis, the
      presence of fibrotic rings, fibrosis extending to the whole urethra and on
      urethral diverticuli. At che present, the literature available does not provide
      certain diagnostical criteria for the identification of female vaiding disorders.
      The high number of proposed therapeutical solutions indicate that the solution to
      this problem is yet to be found.

PMID- 11221045
TI  - [Usefulness of ultrasonography in the diagnosis of acute scrotal edema].
AB  - Ultrasonography has gained an important role for the diagnosis of acute and
      chronic scrotal lesions. We report our experience on 6 cases of acute scrotal
      edema. The etiology of edema was congestive cardiopathy (two patients),
      glomerulonephrosis (three patients) and lumboaortic lymphnode metastases from
      bladder transitional cell carcinoma (one patient). Ultrasound scan scrotal
      appearances were similar in all examined patients, and the only pathologic
      findings observed were "onion" like appearance and a thickened scrotal wall.
      Therefore, to define acute scrotal edema etiology, it isn't enough an ultrasound
      examination, but it's necessary to extend the ultrasound scan assessment to other
      organs.

PMID- 11221046
TI  - [Erectile dysfunction: a missed opportunity?].
AB  - The increasing of andrological valuation for erectile dysfunction (ED), happened
      in the last ten years, and induced chemical industries and sanitary system to
      supply correct answers from cultural, diagnostic and therapeutic views. All these
      events allowed the people to approach easily to uro-andrological valuations. This
      situation is perhaps a unique way to involve a great number of men in a wide uro
      andrological screeening, that is useful, with a total patient and couple
      involvement, not only for a ED causes research, but also for incidental pathology
      screening (neoplastic or dismethabolic). Even if more expensive than a simplified
      diagnostic ED protocol (95% of the patients accept it, if there is a good
      counseling), this way of diagnostic valuation permit to hit the targets and to
      add permanently andrology to scientific specialty, as the science that studies
      the sexuality behaviour of the man and all its pathology.

PMID- 11221047
TI  - [Unexplained male infertility and testicular microlithiasis].
AB  - In this study we analyse the frequency of testicular microlithiasis in a group of
      otherwise infertile healthy men, visited at the Andrology Service of Prato
      Hospital. Here the ultrasound machine is located in the ambulatory and it is
      possible to use it during the first visit of the patient, as we have done in 250
      consecutive infertile men. This examination, easy and not invasive, has been
      performed to evaluate the pampiniform plexus to find possible varicocele,
      epydidimis for obstructive signs and testes for the presence or absence of
      parenchymal calcifications or masses. We found 106 positive sonographic records
      (42.4%) for scrotal diseases. Between them, two cases of testicular
      microlithiasis (0.8% of 250 consecutive ultrasound examinations and 1.7% in the
      last twelve months). Our data, although with a lower incidence than literature,
      show the importance of ultrasound examination in absence of specific diagnostic
      questions too, in the study of male infertility. Clinical management of
      testicular microlithiasis is difficult, due to loss of treatment and to cancer
      risk. A long term follow up is request, with periodical (6-12 months) sonographic
      controls. A classification (here we propose) can be useful for a more precise
      monitoring.

PMID- 11221048
TI  - [Complications of multiple transrectal ultrasound-guided biopsy of the prostate].
AB  - The screening programs for prostate cancer will affect a number increasing of
      patients over 50 years with consequence rising the bioptic demand. For these
      reason it's important to know the real morbidity correlate with these widespread
      diagnostic method that will know a larger use in the future. Our study involve
      1.467 patients with median age of 66.7 years (range 45-93). Forty-five were
      diabetics, 80 took a chronic anti-aggregant salicylic therapy, 25 took a chronic
      coumarolic anticoagulation therapy, 54 had a recent history of prostatitis. Our
      major complication rate was 0.7% of patients requesting hospital admission and
      care. An intermediate category of complications was considered, with complication
      rate of 6.9% and indication for out-patient treatment. Minor complication rate
      was 76% without need of therapy. In spite of high number of biopsies per patient,
      our major complication rate is similar of that demonstrate from other authors. In
      conclusion, whole complication rate is high, but the incidence of major
      complications is very low. The complications that need out-patient treatment are
      limited and acceptable.

PMID- 11221049
TI  - [Ultrasonographic, serologic, and clinical characteristics of a case of prostatic
      malacoplakia].
AB  - An additional case of malakoplakia of the prostate in described to highlight its
      clinical, echographic and serum features. It's a rarest disease especially when
      prostate is involved, but well known in world literature. This case is reported
      to describe more accurately its echographic patterns and also for growing up
      precision in linguistical expressions used by echographists. We hope to
      contribute in collecting data about an uncommon pathology. At last we discuss
      about differential diagnosis when biopsy is negative for neoplasia and how it's
      possible to end further biopsies.

PMID- 11221050
TI  - [Ultrasound-guided transrectal biopsy of the prostate].
AB  - The author proposes his personal experience through this metodology matured as
      person in charge of "Modulo di ecografia uro-andrologica ed ecointerventistica",
      besides a case histories of about 1,000 biopsy exams practiced.

PMID- 11221051
TI  - [Ultrasound-guided biopsy: screening of prostate cancer with a single set of 14
      systematic biopsies].
AB  - Standard sextant prostate biopsy may underestimate cancer in men in whom clinical
      finding and transrectal ultrasound are negative and prostate-specific antigen
      (PSA) value suspicious for localized prostate cancer (4-10 ng/ml). We describe
      our experience with a 14 systematic multisite biopsy scheme to detect carcinoma
      of the prostate (stage T1c). Between January 1999 and February 2000, a total of
      177 consecutive patients (mean age 64.1 +/- 7.7 years) underwent systematic
      transrectal ultrasound (TRUS) guided biopsy for normal digital rectal
      examination, normal TRUS and abnormal prostate specific antigen 4 ng/ml or
      greater (4-13 ng/ml). Fourteen core/patient were obtained not depending on
      prostate size. Biopsies were obtained from conventional sextant biopsies (6 core)
      and 3 alternate sites which included: the right and left extreme lateral
      peripheral zone between anterior tissue and posterior gland base (2 core); the
      right and left transition zone, immediately adjacent to the urethra anterior and
      posterior (4 core) and the right and left central gland in the mid zone typical
      of benign prostatic hyperplasia (BPH) (2 core). All specimens were separated for
      specific location identification. Adenocarcinoma was identified in 61 patients
      (34.46%). Traditional sextant biopsies showed 23 patients (37.7%) with positive
      core to detect cancer, while a sextant regimen incorporating lateral peripheral
      zone biopsies and transitional zone detected 19 cancer (31.1%). The combination
      of lateral peripheral and transitional zone alone detected cancer in 19 patients.
      No cancer was detected in central gland. The lateral peripheral zone was the most
      frequently positive site biopsy with 11 patients (57.9%) followed by the
      transitional zone with 8 patients (42.1%) in the group of the alternate biopsies
      sites. Complications of extensive biopsy included hematuria, hematospermia and
      limited rectal blending in 95% of patients; 1 case of fever (> 38.5 degrees C)
      for 3 days. Biopsies of the alternate sites are easy, feasible and reproducible.
      This strategy enhance prostate cancer detection of a 30% compared to conventional
      sextant biopsies alone. In conclusion, the 6 systematic biopsy of the peripheral
      zone are inadequate and a minimum of 12 with extensive core in peripheral and
      transitional zone should routinely be performed to detect a more significant
      number of men with prostate cancer at stage T1c.

PMID- 11221052
TI  - [Intraprostatic spread of prostatic carcinoma: stereographic representation based
      on ultrasonography and biopsy findings].
AB  - The aim of this study is to identify and evaluate a scheme of graphic
      representation of the prostate, that allows the reconstruction of cancer
      diffusion based on ultrasound findings and on histological biopsy findings. A
      graphical representation of the prostate using transversal and longitudinal
      sections is represented by the US-operator, who write severy single performed
      biopsies (site, directions, and angle) and draws the US relieves. Biopsy
      specimens are separately prepared on a paper-support and marked at one extremity
      with china ink. The histopathological examination on every single specimen allows
      to identify the tumor extent, Gleason grading and the percentage occupied by the
      neoplasia. Were performed 50 transrectal echo-guided mapping biopsies. Comparing
      biopsy results with the pathological analysis on 13 whole-mount radical
      prostatectomy: pathological stage was predicted in 6 of 7 cases, Gleason grading
      was predicted in 85% of cases. In 5 cases in which the core biopsy histological
      analysis showed only atypical glands suspicious for cancer it has been possible
      to repeat new biopsies in the same site of the gland. Tumor was this time
      diagnosed in 3 of 5 cases (60%). The proposed approach can be useful to reduce
      variables linked to operator, technique, and single clinical situation, but it
      needs an employment on a higher number of cases and a verification on more
      surgical specimens. The scheme proposed has been of easy complication and
      immediate interpretation by clinicians and pathologists.

PMID- 11221053
TI  - [Ultrasound-guided cryosurgery of the prostate: short- and long-term experience].
AB  - We have assessed 24 patients consecutively treated with cryosurgery and chosen
      according to the guidelines of the European Study Group of Urologic Cryosurgeons.
      Of the 24 patients (average age about 70, range 61-79), all were not considered
      candidates for radical prostatectomy, 9 (37%) were clinical stage cT2 N0M0, 15
      (63%) cT3 N0M0 who had not received any prior treatment, except 1 patient (61
      years old) who was treated with TCT and successive recurrence of the disease
      (cT2). Of the 24 chosen patients, 13 (55%) were over the age of 71, 11 (45%) had
      important factors of co-morbidity and an elevated risk of surgery (ASA 3). The
      average PSA was of 19.3 ng/ml (range 2.2-61). Gleason score was 2-5 in 9 cases, 6
      7 in 14 and 8-10 in 1 case. In the follow-up, we evaluated serum PSA every 3
      months and transrectal ultrasound and the echoguided prostatic biopsies at 6, 12
      and 24 months. Post-operative complications included: ecchymosis and edema of
      external genitals (16/24), fever > 38 degrees C (1/24), sloughing syndrome
      (6/24), urinary tract infections (10/24) acute urine retention (1/24). In 2
      cases, 6 months after treatment, a transrectal resection was carried out. After a
      follow-up at 6 months, the PSA was 0.4 ng/ml (range 0.1-0.9), in 1 case. In
      positive core biopsy out of 6 showed neoplastic cells with fibrous tissue; the
      patient had a PSA of 0.58 ng/ml. At 12 months there were 11 assessable patients.
      The average PSA was 0.3 ng/ml (range 0.1-0.9). At 24 months there were 4
      assessable patients, 1 of 4 showed serum PSA level of 4 ng/ml and cancer in
      apical biopsy. Erectile dysfunction was assessed on 8 patients affective before
      surgery: 1 referred to sufficient erections at penetration (1/8, 12.5%). After
      removal of the catheter, 4 of the 20 patients suffered stress and urge
      incontinence with the use of 1 pad a day. In 1 case, 18 months from surgery,
      slight stress incontinence was found (1 pad/day). Cryoablation is an efficient
      method and is given to slight post-operative morbidity and no intra-operative
      mortality, also in patients with high risk for open surgery. Indications may be
      found in patients with the following conditions: older than 72 years, severe co
      morbidity and high risk for surgery, neoplasia at high risk of progression, and
      disease recurrence after radiotherapy. Our case history is at the moment
      encouraging and a larger number of cases as well as longer follow-up are needed.

PMID- 11221054
TI  - [Role of transrectal ultrasonography in the follow-up of patients treated with
      prostatic cryosurgery].
AB  - Cryosurgery of prostate is a minimally invasive treatment for localized cancer.
      Imaging techniques (transrectal ultrasound (TRUS) or magnetic resonance) have
      been proposed to evaluate tumor persistence/recurrence after cryosurgical
      treatment other than serum PSA and prostate biopsies. Actually, criteria to
      identify cancer after cryosurgical ablation are not well assessed. Aim of this
      study is to evaluate the clinical significance and role of TRUS in detecting
      tumor within the former prostate gland after cryoablation. We evaluated
      ultrasound (US) features and imaging, serum PSA and biopsies in 20 patients
      treated by cryosurgery at our Hospital with a mean follow-up of 18 months. Twenty
      patients (mean age 70 years, PSA 25.9 ng/ml, clinical stage: 10 T2 N0M0 and 10 T3
      N0M0) were followed up for a mean of 16 months. Ultrasound findings (gland
      volume, capsule, hypoechoic area, post-voided urine volume, seminal vesicles)
      were correlated to PSA levels (every 3 months) and prostate biopsies (6, 12 and
      24 months). All cases were evaluated by the same ultrasound scanner (Eidos,
      Hitachi-5-6.5 MHz) and by two operators. Prostate capsule was interrupted by hypo
      hyperechoic areas in all cases. Transition zone was no more recognizable.
      Ultrasound findings showed in all cases hypoechoic areas, but US did not
      identified tumor recurrence in 2 patients. During follow-up, PSA below 0.5 ng/ml
      was recorded in 75% of cases. We detected tumor in 2 cases, respectively 12 and
      18 months after cryosurgery: in the first case few residual cancer cells within
      fibrous tissue were found in 1 out of 6 biopsies at 6 months (PSA 0.58 ng/ml), in
      the second one, tumor with viable normal prostatic glands was found in one biopsy
      of the apex at 18 months (PSA 4.0 ng/ml). TRUS showed several anaechoic foci with
      necrotic tissue and coalescence of liquid areas in 2 patients (one developed
      acute urinary retention). Actually, serum PSA is the best marker in order to
      detect clinically significant tumor after cryosurgery. Hypoechoic areas and
      capsule interruptions observed by ultrasound imaging of prostate gland after
      cryosurgery are not correlated with tumor recurrence or tumor persistence. TRUS
      is only indicated for ultrasound-guided biopsies during follow-up and to confirm
      urologic complications.

PMID- 11221055
TI  - [Role of Doppler color ultrasonography in the diagnosis of renovascular
      abnormalities associated with stenosis of the pyeloureteral junction].
AB  - The obstruction of the pielo-ureteral junction, in most of the cases, recognizes
      an intrinsic etiopathogenesis, the presence of a segment ureteral aperistaltic
      and alteration of the ureteral musculature. The association of GPU stenosis and
      the presence of vascular anomalous shanks are frequent. The knowledge of this
      anatomical situation is important for choosing the therapeutic strategy and the
      surgical technique. The pre-operative diagnosis of the anomalous vase could
      condition the choice of the technique (endoscopic technique, laparoscopic),
      opting for open surgery to have a better control of the vascular shank. We have
      examined the use of the echo-color Doppler to diagnose the presence of anomalous
      vase. We have studied 13 patients (6 men and 7 women) between 18 and 62 years of
      age (average 35 years); the side interested by the obstruction was in 8 cases the
      right and in 5 cases the left. During surgery in 4 cases out of 13 examined
      anomalous vases were present. The pre-operative color Doppler found 3 anomalous
      shanks with a negative false, a positive false and 8 negative trues, showing a
      sensibility of 75%, a specificity of 88% with a global diagnostic ability of the
      84%. We therefore believe that the echo-color Doppler is reliable enough in the
      pre-operative diagnosis of vascular anomalies associated to stenosis of the GPU
      and that could be used for pre-operative diagnosis of this urological affection.

PMID- 11221056
TI  - Non neoplastic diseases of the prostate from transrectal biopsy.
AB  - Two hundred-seventy-six were screened with one or all diagnostic deviated
      parameters: neoplastic lesions were 115 (41.7%), non neoplastic were 144 (52.1%),
      unfit or suspicious were 17 (6.2%). These results are agreed with recent
      literature and confirm the effectiveness of methodology.

PMID- 11221057
TI  - [Unusual ultrasonography of scrotal pathology].
AB  - The potentialities of ultrasonography in scrotal diseases, with help of color
      Doppler and angio-power, as well as their sensibility and specificity are
      discussed presenting three rather rare cases occurred with acute symptoms. It
      emphasises the utility of emergency scrotal scanning.

PMID- 11221058
TI  - A renal metastasis from primary peripheral chondrosarcoma presenting as
      spontaneous retroperitoneal hematoma.
AB  - The authors describe a case of renal metastasis from chondrosarcoma originating
      from the rib, with acute clinical onset characterised by serious anaemia
      secondary to retroperitoneal perineal haemorrhage. No similar cases have been
      reported in the literature. The interest of this case lies in both the symptoms
      of onset and in the metastatic site. From a diagnostic point of view an
      intraoperative ultrasound scan was useful, revealing the presence of a roundish
      neoformation, irregularly hypogenic, with a different appearance from anything
      observed by the authors in the other intraoperative ultrasound examinations of
      renal masses.

PMID- 11221059
TI  - Permanent brachytherapy: prostate seed implants as an out-patient treatment.
AB  - Upto April 1999 interstitial seed implants were being performed throughout Europe
      only as an in-patient treatment. Consequently, we questioned whether this same
      method could be performed as an out-patient treatment without forfeiting the
      required quality and safety normally observed with in-patients. Since April 1999
      we have treated 73 patients with iodine 125 seed implants (RAPID strand). The
      average patient age was 65 yrs, the average PSA was 11.5 ng/ml, tumor stage was
      either T1 or T2. All treatments were carried out in general anesthesia under
      ultrasound and flouroscopy monitoring. Pre- and post implant dosimetry was
      planned using the Variplan 6.7 computer program (former MMS). All patients
      tolerated the out-patient treatment very well. The average duration for
      anesthesia was 76 minutes, total time per patient spent in the center on implant
      day was 250 minutes. 54 patients were treated with a monotherapy 145 Gy, while 19
      patients received external beam radiotherapy (45 Gy) plus the iodine seed boost
      (100 Gy). Almost 75% of the patients experienced some form of voiding discomfort
      during the 4-10th post implant week. In the CT post plan dosimetry performed 4
      weeks after the implant, 95% of the patients obtained a good coverage of the
      prostate with the planned prescription dose. Iodine seed implants can be
      considered a safe out-patient form of treatment with a low complication and
      morbidity rate and a high standard of quality. The technical improvements in
      computer dosimetry software, modified application methods, constantly updated
      equipment and critical quality assessment has lead to improved overall long term
      results.

PMID- 11221060
TI  - Cryosurgical ablation therapy for prostate cancer.
AB  - Adenocarcinoma of the prostate in the most common malignancy in men and still the
      leading cause of death from cancer in American men. Current data and published
      reports indicate that cryotherapy for clinically localized prostate cancer can be
      an effective treatment method in selective patients. Since 1993, 643 cryosurgical
      procedures have been performed, including 68 patients who failed radiation
      therapy, and 20 patients who failed initial cryotherapy. Recently developed
      targeted cryotherapy techniques, using 6-8 probes, shows promising initial
      results. The complication rates are also compared favorably to the established
      therapies for prostate cancer. It is a minimally invasive procedure with a high
      patient's acceptance rate. It is a highly operator-dependant procedure with a
      steep learning curve coupled with constantly evolving technology.

PMID- 11221061
TI  - Patient-reported complications after cryoablation therapy for prostate cancer.
AB  - To define the patient-reported complications after cryoablation therapy for
      prostate cancer and to compare these results to previously published patient
      reported complications for radical prostatectomy and external beam irradiation. A
      questionnaire similar to previously published patient-reported complication
      studies was sent to the first 290 patients treated by cryoablation therapy at our
      Institution. The questionnaire was returned by 267 patients. Forty-four patients
      were excluded from analysis because of prior irradiation, transurethral
      prostatectomy, or cryoablation, resulting in a study group of 223 patients. Of
      the 208 patients with good urinary control preoperatively, 9 (4.3%) patients used
      incontinence pads after cryoablation. Seven of the 8 patients who used one pad
      daily reported leakage of only a few drops. Impotency, defined as an inability to
      obtain erections adequate for vaginal penetration, occurred in 85% of men who
      were potent preoperatively. Urethrorectal fistula occurred in 1 patient (0.4%).
      Bladder outlet obstruction caused by stricture of sloughed necrotic prostatic
      tissue required dilation or transurethral resection in 10% of patients. Scrotal
      swelling, penile tingling, and pelvic pain occurred in 18, 15, and 12% of
      patients, respectively; typically, these resolved spontaneously within 3 months.
      Patient-reported complications for cryoblation compared favorably to those
      reported for radical prostatectomy and external beam irradiation. Patient
      satisfaction was high; 96% of patients reported that they would choose
      cryosurgery as a treatment option again.

PMID- 11221062
TI  - Local control of prostate cancer by transrectal HIFU-therapy.
AB  - Transrectal high intensity focused ultrasound (HIFU) as a minimal invasive
      treatment approach of localized prostate cancer was evaluated concerning its
      efficacy and security. Post-operative monitoring included PSA-levels and
      histological results of control random biopsies. Seventy-three HIFU sessions were
      performed on 62 patients during the period from November 1997 to April 2000.
      Patients were classified in 4 indication groups: 1) localized prostate cancer, T1
      T2, initial PSA < 15 ng/ml, Gleason score < 7, volume < 30 cc, no more than 4 of
      6 random biopsies affected by cancer, not suitable for radical prostatectomy; 2)
      localized prostate cancer, T1-T3, no PSA or Gleason score limitation; 3) local
      recurrence after first line therapy (RPE, radiation, hormonal ablation); 4) for
      local debulking. Mean plus or minus standard deviation for patient age was 67.5
      +/- 7.48 years, for PSA was 7.64 +/- 5.26 ng/ml and for prostate volume was 21.3
      +/- 7.9 cc. Median follow up was 15 months (range 5-29) and included PSA
      development, control sextant biopsies and transrectal color coded duplex
      sonography (TCCDS) at 1, 3, 6, 12 and 24 months. At least 1 control biopsy result
      was available in 48 patients. We evaluated the therapy in 3 categories: 1) group
      1 (complete response) included 33/48 patients (68.7%) with no residual cancer and
      PSA < 4 ng/ml; 2) group 2 (biochemical control) 8/48 patients (16.7%) with small
      residual cancer and PSA < 4 ng/ml; 3) group 3 (failure) 7/48 patients (14.6%)
      with residual cancer and PSA > 4 ng/ml (4 of them received hormone therapy). As
      major complications 2 urethrorectal fistulas occurred, both in post-radiation
      patients, 3 stress-incontinences II-III after TUR post HIFU. In 20 patients
      (32.3%) transurethral manoeuvres were necessary to remove obstructive necrotic
      tissue or because of bladderneck or urethral strictures. 11 of these patients
      were among the first 20 treated patients. Regarding the individual learning curve
      about technique, indication and the technical developments HIFU treatment can
      currently be considered as a valid alternative treatment strategy for patients
      with localized prostate cancer, who are not suitable for radical surgery. HIFU
      treatment can be repeated depending on biopsy result and PSA development. Local
      control of the localized prostate cancer was observed in group 1 and 2 (85%).

PMID- 11221063
TI  - [Transrectal ultrasound-guided biopsy of the prostate].
AB  - The early detection of prostatic neoplasm is nowadays a primary need in the
      urological field. The availability of transrectal ultrasound equipment alongside
      with bioptic tools made possible that transrectal ultrasound-guided biopsy of the
      prostate became the standard procedure to achieve this goal. With this work we
      would like to confirm the efficacy of this method which is also associated with a
      good tolerance and low complications rate. 82 patients that came to our
      Department between 1997 and 1999 were submitted to this procedure, 25 resulted
      positive for prostatic adenocarcinoma. Only 2 of them did not tolerate the
      procedure while all the others referred only mild discomfort at the moment of the
      puncture; 9 patients afterwards had to be admitted to the hospital due to fever
      (1 patient), acute retention of urine (3 patients) and persistent macroscopic
      hematuria (5 patients). Transrectal ultrasound-guided biopsy of the prostate
      reveals to be a safe and accurate method to obtain tissue samples of the prostate
      along with high tolerance and low incidence of serious complications.

PMID- 11221064
TI  - [Ultrasound-guided percutaneous nephrostomy].
AB  - Percutaneous nephrostomy is a mini-invasive technique that creates an external
      outlet from the renal excretory tract through a catheter inserted through the
      flank. Indications for this procedure are of both diagnostic and therapeutic
      type. The nephrostomic catheter is generally positioned under ultrasound
      guidance, which has the advantages of showing the localization of the renal
      cavities and the depth of the kidney, and can be used during pregnancy and in
      subjects with allergy to contrast medium or with reduced renal function. When
      possible, it is best to associate US with fluoroscopic guidance, as this
      association has been found to guarantee a success rate exceeding 98%. Within the
      kidney, the zone known as Broedel's avascular plane, where the terminal branches
      of the posterior and anterior arterial systems meet, is the safest place to pass
      the nephrostomic catheter through, as there is little vascularization in this
      zone. Access is generally posterior and at the level of the inferior calyx, by
      means of Seldinger's, the one step or a mixed access technique involving a
      catheter sheathing a metal cannula. Seldinger's access technique is most commonly
      used, entailing explorative puncture of the renal cavity with a 22 G needle. We
      prefer to puncture the kidney direct, under US guidance and using an 18 G needle:
      a metal wire is passed through the needle and then after withdrawing the needle,
      the fascia dilators are inserted, of scaled widths increasing up to 2 G wider
      than the nephrostomic catheter. Care must be taken not to go beyond the curve of
      the guide wire to avoid trauma to the renal parenchyma. The most critical moment
      is when the catheter is inserted along the wire at the point of passage through
      the peri-renal fat: the catheter tends to deflect the point of the guide wire
      away from the desired direction as the peri-renal fat offers less resistance. The
      metal wire may be of variable rigidity and length, hydrophilic. The catheter may
      also be made of various materials: the ideal catheter should slide easily, be
      flexible, soft and resist encrustation. Each material has its own characteristics
      but polyurethane is the most ductile and is generally used for nephrostomic
      catheters. The catheter can also feature different types of point and width and
      may be autostatic like the Foley catheter or else a cope loop.

PMID- 11221065
TI  - [Radiofrequency percutaneous ablation in prostatic hypertrophy].
AB  - The authors describe both procedure details and results in treating benign
      prostatic hyperplasia (BPH) by a transcutaneous radiofrequency ablation (TRAP).
      Using a "cool-tip" needle/electrode, they obtained a large cavitation or a
      collapse (urethral damage free) of the adenoma, the different result depending on
      the utilized radiofrequency (RF) energy and the site of application. In this
      procedure, the US control of the RF effect appears more careful than the "lassic
      transurethral treatment (TUNA) and it's suitable in prostate's peripheral zone
      also. The manoeuvre is performed with local or peripheral anaesthesia, is well
      deobtruent and have not risk of bleeding or other peri-operative complications.

PMID- 11221066
TI  - [Ultrasonographic study of detrusor thickness in patients with obstruction].
AB  - The diagnostic work up of patients with symptomatic benign prostatic hyperplasia
      is not always useful for diagnosing bladder outlet obstruction, especially if
      they are compared with pressure-flow studies. The authors make a review of the
      literature and a clinical study to demonstrate that alternative less invasive
      methods (ultrasound estimated bladder weight) can often replace pressure/flow
      studies.

PMID- 11221067
TI  - [Ultrasonographic assessment of urethrovesical mobility in women].
AB  - It is widely accepted that preoperative evaluation of women with stress urinary
      incontinence should include an assessment of urethrovesical mobility. In the last
      few decades a variety of methods have been used to this purpose: the so-called Q
      tip test, radiologic techniques and ultrasonic studies. Transvaginal and perineal
      ultrasonography allows the assessment of bladder neck and urethral axis mobility
      at rest, during cough, Valsalva maneuvre and pelvic floor contraction. The
      technique is simple, not invasive and without discomfort for the patients. Aim of
      this study is to assess the reproducibility of an ultrasonic technique that
      allows the measurement of bladder neck mobility (alpha-angle variation) and the
      angle of the mobile proximal tract of urethra (beta-angle). A total of 58 women
      were included: 23 with stress incontinence and 35 continent and asymptomatic
      controls. The technique allows reproducible measurement of alpha and beta angles.
      In stress incontinent group bladder neck mobility is significantly larger while
      urethral angle (beta-angle) is significantly smaller and is lowered by straining.

PMID- 11221068
TI  - [Ultrasonographic study of urethral sphincter in vesico-sphincter dyssynergia].
AB  - The ultrasound study of bladder neck and urethral sphincter in men could be
      performed by means of transrectal ultrasound scan in longitudinal scanning or by
      probing the surface in transperineal scanning. The endocavitary ultrasound scan
      study gives the best indications in the evaluation of the bladder neck in men.
      The neuromuscular bladder dysfunctions' (neurologic bladder), which can be
      studied by ultrasound scan are dyssinergia, striped detrusor, detrusor-bladder
      neck dyssinergia, detrusorial iper-reflexy bladder instability. In paraplegic
      subjects the exam should be performed in gynecological position or in side
      decubitus, and micturition is obtained by means of sovrapubic percussion and
      compression or with prevailing action of the abdominal press. The detrusor
      striped dyssinergia is the dysfunction of the bladder where the ultrasound scan
      results are more meaningful and give the best elements. In these cases, already
      in basal conditions, could be present a bladder neck half-opened. During
      micturition there is an ample opening of the bladder neck and of the prostatic
      urethra, but scarce relaxation of the membranous urethra; sometimes a protrusion
      of the back lip of the bladder neck could be present too. In iper-reflexy
      (unstable bladders) and in detrusorial ipo-reflexy, ultrasound scans could result
      poorly specific and non-significative.

PMID- 11221069
TI  - [Normal ultrasonographic anatomy and measurement of the scrotum].
AB  - In this study we reported scrotal ultrasound examination findings and their
      clinical applications. We describe the normal ultrasound structure patterns, the
      size measurements and the imaging findings about each anatomic part of male's
      gonadal gland: scrotal sac, testis, epididymys, spermatic funiculus.

PMID- 11221070
TI  - [Ultrasonography in the prediction of sperm presence in the epididymis].
AB  - Azoospermia represents approximately 10% of case of male infertility.
      Identification of etiological aspects is very important for prognostic and
      therapeutic evaluation. After the testicular analysis with fine needle aspiration
      cytology (FNAC) we reviewed the scrotal sonograms of 639 azoospermic patients. In
      the group of patients with obstructive azoospermia we have found a particular
      sonographic appearance. This consisted in a normal aspect of the testis, the
      epididymis have an enlargement, development of cysts and an inhomogeneous echo
      pattern. However we have found this particular sonographic appearance in same
      patients with other kinds of azoospermia. In conclusion, scrotal sonogram is a
      fundamental step in the diagnostic work-up of the azoospermic patient, but it
      does not allow to distinguish unequivocally patients affected by obstructive
      azoospermia.

PMID- 11221071
TI  - [Minimally invasive treatment of intraprostatic cysts].
AB  - Prostatic cysts are rare; they are to be considered in the evaluation of
      obstructive azoospermia. A correct diagnosis is based on transrectal ultrasound
      of the prostate. Herein we describe our experience with perineal ultrasound cyst
      aspiration. During the last 10 years, 21 infertile patients underwent ultrasound
      puncture of an intraprostatic cyst. Patients were placed in the lithotomy
      position, a 16 G needle was adopted; by means of ultrasound was possible to
      follow the needle entering the cyst. The content was aspirated and, if no
      spermatozoa were detected in the cystic liquid, sclerosing agents were
      introduced. The technique was performed successfully in all patients with
      symptomatic cyst within the prostate. Follow-up prostatic ultrasound and semen
      analysis were performed in 17 patients. There was 1 recurrence that was aspirated
      again. In 12 cases an increase in sperms number and motility was obtained, in 3
      cases oligoastenospermia remained unchanged and 2 patients are still azoospermic.
      In 3 cases the partners become pregnant.

PMID- 11221072
TI  - [Doppler color ultrasonography in the diagnosis of erectile dysfunction of
      vascular origin].
AB  - The aim of this paper is to evaluate whether echo-color Doppler diagnostics
      allows to detect the different evolutionary stages of arteriopathy affecting the
      cavernous arteries of the penis. 124 patients with erectile deficiency were
      examined. All of them were evaluated by andrologic and psychologic anamnesis. An
      echo-color Doppler examination was performed on cavernous arteries before (basal)
      and after (dynamic) an injection of Prostaglandin E1 (10 micrograms). The penile
      circulation has been observed for twenty minutes after the injection to detect
      anomalous collateral vessels of the cavernous arteries. The population was
      divided into 4 groups according to the basal and dynamic peak systolic velocity
      (PSV). Cardiovascular risk factor incidence in patients with normal basal and
      dynamic PSV values (group A) and in patients with pathologic basal and dynamic
      PSV values (group C) is 10% and 44% respectively (p < 0.002). Psychologic
      disorder in group A and C is 41% and 26% respectively (p < 0.05). Patients with
      pathologic basal PSV and normal dynamic PSV (group B) show an intermediate (26%)
      incidence of cardiovascular disorders as compared to A and C. Anomalous side
      branches are equally represented in A and B (41% and 38%) and to a lesser extent
      in C (26%). Based on anamnestic and instrumental data, Group B ranges at an
      intermediate position between A and C. In this group, the presence of incipient
      arteriopathy affecting the penile circulation may be suspected. The ability to
      detect patients with vascular diseases still at a subclinical stage, as it
      already happens for other organs, would allow a prompt therapeutic action.

PMID- 11221073
TI  - [Doppler color ultrasonography of the normal penis].
AB  - The penile blood vessels arise from the internal pudendal artery. After the
      arcuate ligament the artery is usually called the main penile artery. Afterwards
      the vessel is divided into the dorsal penile artery, which is thin, and the
      cavernosal artery, which enter the corpus cavernosum on the supero-medial surface
      of the penis. The branches of this artery are called the arteriae helicinas that
      subsequently divide in smaller vessels that communicate with the lacunae of the
      corpus cavernosum. The venous blood flow is drained into the venous plexus
      beneath the tunica albuginea. The emissary veins perforate the albuginea and the
      blood is drained by the venae circumflexae into the deep dorsal vein. Color
      Doppler sonography allows actually to depict all these vessels and to study the
      blood flow in these structures with the exclusion of the lacunar spaces. To
      detect slow flows the technical parameters are very important and the Doppler
      angle must be always less than 60 degrees. During pharmacologically induced
      erection the peak systolic velocity in the cavernosal artery shows different
      values, according to the time of measurements. Initially high systolic velocity
      is detected (over 35 cm/s) and high diastolic flow (8-15 cm/s) due to low
      intracavernosal resistance. After veno-occlusive mechanism activation, an
      increase of flow is normally observed with peak systolic velocity up to 80-120
      cm/s associated to progressive decrease of diastolic flow. In the initial phase
      of the erection the venous flow is characterized with elevated blood velocity in
      the circumflex and deep dorsal veins. Afterwards with progressive erection the
      venous flow reduces to disappear completely with full rigidity. Three dimensional
      US allows a better visualization of the morphology, number and distribution of
      the vascular tree of the penis.

PMID- 11221074
TI  - [Doppler color ultrasonography in patients with erectile dysfunction].
AB  - The introduction of new oral therapy doesn't change the rule of color Doppler US
      in the screening modality of the diagnosis of vasculogenic impotence. The
      hemodynamic changes can be non invasively evaluated with color and energy Doppler
      US and with spectral analysis following injection of a vaso-active
      pharmacological agent. The new high sensitive US equipment allows an easy
      detection of the cavernous artery. Duplex Doppler can quantify the systolic
      diastolic flow changes after the intra-cavernous vaso-active drugs injection. It
      is then possible to establish the diagnosis of arterial or venous vasculogenic
      impotence. The organic cause can also be excluded. The pick systolic velocity
      less than 0.30 m/sec is indicative of arterial origin. The absence of flow
      reversal in the diastolic phase, 30 minutes after the injection, is significant
      for a venous type problem. Elicine arteries can be visualised and analysed using
      high sensitive color Doppler energy US equipment.

PMID- 11221075
TI  - [Ultrasonographic study of Peyronie's disease].
AB  - Induratio penis plastica (IPP) is a degenerative disease, which consists in a
      thickening of the albuginea tunica of cavernous corpora, especially on the dorsal
      aspect. In 25% of the cases a calcified deposit is present. This disease can
      determine a bending of the penis, usually upward, pain during erection and
      impotentia coeundi. It is associated with Dupuytren's disease in 25% of the
      cases. IPP is of unknown etiological origin. The more reliable etiological
      theories are the degenerative one (micro trauma and inflammation) and the
      autoimmune one. The assessment of IPP is based on story, physical examination,
      autophotography (which are necessary) and on imaging techniques such as
      ultrasound, color Doppler, CT, MRI and X-ray in mammography. Color Doppler has
      demonstrated to be the best technique because of its cost/benefit and
      cost/effectiveness ratio. RMI with gadolinium can determine plaques activity but
      it has a lower cost/benefit ratio. Color Doppler can determine the presence of an
      IPP plaque and its status, which is size, location, and degree of calcification.
      Some authors sustain that inflammation can be suggested by the presence of micro
      vascularization around the plaque. US can be very useful to detect plaque in a
      size not easily accessible by physical examination (on the dorsal aspect of the
      penis) and to demonstrate plaques in different evolution moment. Ultrasonography
      is the better technique to show directly albuginea tunica. Authors illustrate the
      methodology, which use intra-cavernous injection of prostaglandin E1 (PGE1) to
      induce erection and its semeiotic findings.

PMID- 11221076
TI  - [Ultrasound-guided ESWT in Peyronie's disease plaques].
AB  - The aim of the study was to check the efficiency of shock waves in the treatment
      of Peyronie's disease. The instrument, because of its lithotriptic power, already
      used in the treatment of orthopedic disease and salivary stones, can be used to
      break plaques in induratio penis plastica. A total of 481 patients affected with
      Peyronie's disease were entered into a prospective trial. Patients with big
      plaques or with an initial stage of degeneration were excluded. We divided the
      patients into three treatment groups: a) shock waves alone in 56 patients; b) a
      combination of shock waves and calcioantagonist (perilesional injection) in 324
      patients; c) calcioantagonist alone in 101 patients. The group of 101 patients
      (group C) treated during the previous 2 years with a medical therapy based only
      on the injection of calcioantagonist, was used as a control group. Ultrasound
      evaluation of the treated plaques showed a reduction of size in 27/56 patients of
      the group A, in 159/324 patients of the group B and in 39/101 patients of group
      C. Painful erection improved in the 91.5% of group B, against the 45.7% of group
      C. Furthermore, we pointed out, with interviews to the patients, a considerable
      improvement of the pain and of the sexual performances. The therapeutic
      association of shock waves with calcioantagonist injections is an effective non
      operative treatment for the stabilization of Peyronie's disease.

PMID- 11221077
TI  - [Peyronie's disease: ultrasonographic follow-up of ESWT].
AB  - The application of a small-sized lithotriptor for the extracorporeal shock-wave
      treatment (ESWT) of La Peyronie's disease (PD) was originally suggested by Butz,
      in 1996. In November 1996 we started to use this method with the aim of checking
      its tolerability and effectiveness. From April 1998, we standardized our protocol
      treatment as follow: higher treatment frequency: each every other day; higher
      energy density value: at least level "4" (= 0.11 mJ/sqmm). From March 1998 to May
      2000, 82 patients with PD, aged between 44 and 74 (average age 53.8) were treated
      according to this protocol. A case history was drafted for each patient and they
      all underwent an objective examination, a dynamic ultrasonic scan of the penis
      and a photograph of the penis after drug-induced erection. The complaint had
      lasted for a period of time varying from a minimum of 3 to a maximum of 120
      months (average time 23.3 months). 44 patients reported painful erections and 78
      patients showed bending of the penis during erection. The pre-treatment dynamic
      ultrasonic scan of the penis revealed plaques with calcific features in 36
      patients, while for the remaining 46 cases the ultrasonic images were compatible
      with fibrotic thickening. On completion of the 4th treatment session, the
      patients were given a questionnaire to fill in so that we could obtain a
      subjective evaluation of the results achieved. All the patients underwent
      photograph and dynamic ultrasonic scan of the penis (both performed after drug
      induced erection, pre- and post treatment). Slight alteration often appeared on
      the skin of the penis (petechias), which disappeared spontaneously within 48
      hours. On completion of the 4th treatment session, 37 patients out of 82 (45%)
      reported subjective improvement described as "stoppage" in the progression and/or
      partial regression of the disease" with a filling of a saller size of the plaque
      on-self examination. As far as concerns pain, this symptom disappeared in 31 out
      of the 44 patients concerned (70.4%). At the clinical check, based on the
      ultrasonic scans carried out after ESWT, in 34 cases of 82 (41%), it was possible
      to note a reduction in the echogenicity or in the size of the treated plaque. In
      32 patients (39%) an unchanged plaque was observed, and in 16 case a larger
      plaque or a calcific evolution was established. For what the bending of the penis
      concerns, the comparison between the photographs revealed a reduction of the
      curvature in 24 patients out of 78 (30.7%). Of the 46 patients in whom the
      disease had non-calcific characteristics, according to the ultrasonic scans, 21
      (46%) showed improved disease since in 25 (54%) the treated plaque had stabilized
      or worsened. In the group of 36 patients with the calcific plaques, 13 (36%)
      improved while 23 (64%) resulted unchanged or worsened.

PMID- 11221078
TI  - [Efficacy of bacteriophages in complex treatment of patients with burn wounds].
AB  - Results of clinical and laboratory evaluation of the treatment with
      pyobacteriophage in tablets of the patients with burn wounds are presented. It
      was shown that phagotherapy provided more rapid cure of pyoseptic complications,
      temperature normalization, wounds purification and lower lethality
      Bacteriological analysis of wound secretions revealed that after the treatment
      staphylococci and streptococci were cultured 2 times rarely, Proteus spp. Were
      isolated 1.5 times rarely, E. coli was not isolated. The amount of positive
      haemocultures also diminished. Investigation of immunologic status demonstrated
      statistically significant normalization of immunity on cell level. Phagocytosis
      level didn't change while in control group (without bacteriophage use) it became
      lower. Antibody level enhanced but less extensively than in control group. The
      results of trial demonstrates positive effect of phagotherapy use at the patients
      with burns.

PMID- 11221079
TI  - [Comparative antibiotic susceptibility in vitro of microbial isolates from
      patients with complications after gastrectomy for stomach carcinoma and from
      contents of their large intestine].
AB  - Antibiotic susceptibility of the main isolates from the large intestine contents
      and pathological substrates of 12 patients after gastroectomy for stomach
      carcinoma was studied. Three of them developed esophagoenterostomy incompetence,
      4 had intraabdominal abscesses and in 5 infection of the operation wound was
      stated. In all, 30 isolates of enterobacteria, 28 isolates of enterococci and 38
      isolates of bacteroides were tested. Antibiotic susceptibility of the isolates
      from various sources was practically identical, which showed that before surgical
      operations for stomach carcinoma it was necessary that data on the patients
      intestine microbiocenosis and antibioticograms of the main isolates should be
      available to correct severe dysbiotic disorders.

PMID- 11221080
TI  - [Risk factors of fatal outcome in community-acquired pneumonia].

PMID- 11221081
TI  - [Pneumonia caused by Chlamydophila (Chlamydia) pneumoniae: clinical data,
      diagnosis, and therapy].

PMID- 11221082
TI  - [Cephalosporin antibiotics: the first ones by their significance and complexity
      of their discovery].

PMID- 11221083
TI  - [Tamoxifen in prophylaxis of breast cancer].

PMID- 11221084
TI  - [Current problems in etiotropic therapy of mycoses].

PMID- 11221085
TI  - [Oxadin effect on actinomycetes strains].
AB  - The results of research show that oxadin has mutagenous effect on the tested
      actinomyces strains, in particular on Streptomyces albus--producer of the
      polyether antibiotic salinomycin. The colonies grown up after spores treatment
      with oxadin, have been tested for auxotrophy, morphological mutations and
      biosynthesis of the antibiotic salinomycin. Treatment of Streptomyces albus
      strain with 10% oxadin for 10 or 20 min provided the isolation of highly active
      strains. Dispersion analysis data revealed statistically significant differences
      between the control (non treated) and the oxadin-treated Streptomyces albus
      populations.

PMID- 11221086
TI  - Single lesion paucibacillary leprosy: baseline profile of the Brazilian
      Multicenter Cohort Study.
AB  - In Brazil, there is little information about the clinical and epidemiological
      characteristics of paucibacillary, single skin lesion leprosy patients (SSL-PB).
      Only recently has the official notification system distinguished leprosy patients
      with a single lesion as a clinical entity, for whom the single-dose ROM
      (rifampin, ofloxacin and minocycline) regimen has been recommended. In this
      paper, we describe the baseline clinical features and the immunological
      background of a multicenter cohort of SSL-PB leprosy cases enrolled between
      December 1997-1998. Patients were recruited at health centers located in the
      following regions: Southeast = Rio de Janeiro; North = Amazon and Rondonia states
      and Center-West = Goias state. Eligible cases were newly detected, untreated
      single-lesion leprosy patients without thickened nerve involvement, and were
      assessed by clinical, bacilloscopic and histopathological exams. The Mitsuda skin
      test and anti-PGL-I serology (ELISA) were also performed. Of the 299 SSL-PB
      leprosy patients, 259 (86.6%) fulfilled the criteria for single-dose ROM
      intervention. Our results showed that patients recruited from different sites had
      similar features, considering the clinical and immunological profiles. There was
      a predominance of adults (mean age 32.4; S.D. = 16.0), and a BCG scar was
      detected in 76.7% of the children (< or = 15 years old). Only 7 cases were
      diagnosed as the multibacillary type, representing less than 3% of the patients
      being misclassified. Our data indicate that in Brazil SSL-PB case ascertainment
      based on clinical and bacilloscopic criteria can be accurately defined under a
      routine control program; 75.0% of SSL-PB cases were Mitsuda positive (> or = 5
      mm) and seropositivity for anti-PGL-I was detected in 17.3% of the patients.
      These data are compatible with effective cell-mediated immunity and low bacillary
      load, suggesting favorable clinical outcomes for most SSL-PB participants of this
      cohort.

PMID- 11221087
TI  - Leydig cell hyperplasia and the maintenance of bone volume: bone histomorphometry
      and testicular histopathology in 29 male leprosy autopsy cases.
AB  - This study was conducted to determine if osteoporosis in male leprosy patients is
      caused by testicular atrophy. Bone volume (BV/TV), trabecular number (TbN),
      trabecular thickness (TbTh), and trabecular separation (TbSp) were measured in
      two areas in decalcified paraffin sections of lumbar bones from 29 male leprosy
      and 6 male nonleprosy autopsy cases. We found significant differences in the
      average BV/TV measurements among the 7 patients with nodular Leydig cell
      hyperplasia (BV/TV 12.24%) and the 22 patients without hyperplasia (BV/TV 7.35%)
      and 6 patients without leprosy (BV/TV 12.98%). Bone volume was maintained in
      patients with nodular Leydig cell hyperplasia, and we determined no clinical
      factor other than the Leydig cell hyperplasia that reflected the bone volume. The
      osteoporosis of male leprosy patients was attributed to secondary gonadal
      dysfunction due to testicular atrophy, and Leydig cell hyperplasia appears to
      preserve bone volume.

PMID- 11221088
TI  - Histoid, a clinical variant of multibacillary leprosy: report from so-called
      nonendemic areas.
AB  - This is a hospital-based study of 25 biopsy-proven cases of histoid leprosy in
      the arid, northwest Rajasthan region of India. Over an 11-year span, a total of
      893 new cases of leprosy were diagnosed at our institution. These 25 histoid
      cases thus make up 2.8% of our new patients. Various clinical and laboratory
      observations are summarized and compared to other published series.

PMID- 11221089
TI  - Relapse as histoid leprosy after receiving multidrug therapy (MDT); a report of
      three cases.
AB  - The histoid type of leprosy has been described as occurring in lepromatous
      leprosy patients who relapse after many years of apparently successful dapsone
      monotherapy. Three patients who had received the World Health Organization
      recommended regimens of multidrug therapy (WHO/MDT) relapsed as histoid leprosy
      12-15 years after completion of treatment. In one patient, through mouse foot pad
      studies, the bacilli were found to be sensitive to rifampin and clofazimine and
      resistant to dapsone. In the other two patients mouse foot pad studies were
      inconclusive. The patients were re-started on WHO/MDT. Two patients took regular
      treatment and improved, both clinically and bacteriologically. One patient was
      irregular in treatment, and 1 year after re-starting WHO/MDT nodules were still
      present although the bacterial index had fallen slightly.

PMID- 11221090
TI  - Serious side effects of rifampin on the course of WHO/MDT: a case report.
AB  - A male born in 1935 was diagnosed as having lepromatous leprosy when he was 17
      years old. In addition to dapsone (DDS) monotherapy, he had been treated with
      rifampin (RMP) for 2 terms: first with 450 mg a day for 2 years when he was 39
      years old; second with 150 mg a day for 2 months after a 1-year interval from the
      first regimen. During these entire courses with RMP, no complication was noted.
      When he was 64 years old in 1999, a diagnosis of relapsed borderline tuberculoid
      (BT) leprosy was made, and he was started on the multibacillary (MB) regimen of
      the World Health Organization multidrug therapy (WHO/MDT). After the third dose
      of monthly RMP, he developed a flu-like syndrome and went into shock. A few hours
      later, intravascular hemolysis occurred followed by acute renal failure. He was
      placed on hemodialysis for 7 series and recovered almost completely about 2
      months later. The immune complexes with anti-RMP antibody followed by complement
      binding may have accounted for these symptoms. Twenty-four reported cases of
      leprosy who had developed side effects of RMP under an intermittent regimen were
      analyzed; 9 of the cases had had prior treatment with RMP but 15 had not. Adverse
      effects were more likely to occur in MB cases and were more frequent during the
      first 6 doses of intermittent regimens. The cases with prior treatment with RMP
      had had a higher incidence of serious complications such as marked hypotension,
      hemolysis and acute renal failure. However, many exceptions were also found, and
      we could not verify any fully dependable factor(s) to predict the side effects of
      RMP. More field investigation is desirable, and monthly administration of RMP
      must be conducted under direct observation through the course of WHO/MDT.

PMID- 11221091
TI  - Efficacy of single-dose ROM therapy plus low-dose convit vaccine as an adjuvant
      for treatment of paucibacillary leprosy patients with a single skin lesion.
AB  - The recent World Health Organization multicentric field study on the treatment of
      paucibacillary (PB) leprosy patients with single skin lesion (SSL) and a single
      dose of rifampin-ofloxacin-minocycline (ROM) brought new hope to those who are
      engaged in the eradication of leprosy from India. Being encouraged by the WHO
      report, we undertook the present hospital-based study and found that PB leprosy
      patients with SSL were morphologically and histopathologically heterogeneous. The
      histological spectrum of SSL ranged from indeterminate through tuberculoid (TT)
      to borderline tuberculoid (BT) leprosy, and most patients had active BT leprosy.
      Ninety new, untreated PB leprosy patients with SSL were included in the present
      study for comparative assessment of the efficacies of ROM and ROM plus Convit
      vaccine therapies. Children, pregnant women, lactating mothers and patients with
      any thickening of nerves were excluded. All patients were bacteriologically
      negative (skin-smear test) but lepromin reactive. The patients were divided into
      two groups after proper matching for morphological and histological status of
      SSL: a) The test group included 60 patients and the control group included 30
      patients. The test group was given a single dose of ROM initially and two
      injections of low-dose Convit vaccine, one initially and the other at the end of
      3 months. b) The control group was given only a single dose of ROM initially.
      Both groups were followed clinically every 2 weeks for 6 months and retested for
      histological, bacteriological and lepromin status at the end of 6 months.
      Thereafter, they were followed clinically every month for another 6 months. In
      the test group, the SSL resolved in 33.3%, regressed in 48.3%, and remained
      active in 18.3% of the patients, while the granuloma disappeared in 70% of the
      cases. Only one patient developed neuritis, and in another patient the disease
      relapsed on the eighth month. On the other hand, the SSL in the control patients
      resolved, regressed and remained active in 13.3%, 63.3% and 23.3% of the cases,
      respectively, while the granuloma disappeared in 53.3% of the cases. In the seven
      patients who remained active, the disease course was progressive, and two of them
      developed neuritis. The clinical outcome of the patients treated with ROM plus
      low-dose Convit vaccine was statistically superior to those treated with single
      dose ROM therapy alone.

PMID- 11221092
TI  - Sensory testing with monofilaments in Hansen's disease and normal control
      subjects.
AB  - Sensory testing with Semmes-Weinstein filaments was conducted on: 112 normal
      subjects to determine the effects of age, gender and occupation on threshold
      perception, 27 Hansen's disease (HD) patients to determine inter-observer and
      intra-observer reliability of testing, and 101 patients with HD and a history of
      hand and/or foot ulceration to identify thresholds for injury risk. Filament
      thresholds were found related to age (p < 0.002) and occupation (p < 0.001) but
      not gender (p > 0.1). Inter-observer and intra-observer reliability was found to
      be high (intraclass correlation coefficient = 0.88-0.93). The 4.93 (7.0-7.7 g)
      filament had 97% sensitivity and 100% specificity for identifying a history of
      foot injuries, and the 4.17 (1.2-1.6 g) filament had 100% sensitivity and 100%
      specificity for identifying hand injuries.

PMID- 11221093
TI  - Knowledge and attitude of health professionals in relation to the integration of
      leprosy control into the general health service in Ethiopia.
AB  - Since the introduction of multidrug therapy for leprosy patients, the integration
      of leprosy control in the general health service (GHS) system has been an issue
      of debate. In Ethiopia, the present policy stresses integrated management of
      diseases. In spite of the policy, however, leprosy control was a vertical program
      until 1998 in most parts of the country. A descriptive cross-section study was
      conducted in the southern region of Ethiopia from October 1996 to March 1997 to
      determine the levels of involvement of the GHS staff and to identify obstacles to
      their involvement in the management of leprosy patients. Through a written
      questionnaire, data were collected from 240 GHS staff, including doctors, nurses
      and health assistants. It was found that 6% of the GHS staff was involved in
      leprosy control activities, mainly case finding and health education. Negative
      attitudes toward leprosy workers were held by 13% of the GHS staff while 40% had
      intermediate attitudes and the remaining 47% had positive attitudes.
      Statistically significant differences were found with regard to the level of
      knowledge among different health professionals, type of health institutions and
      years of service. The levels of involvement, knowledge and attitude of GHS staff
      showed that lack of integration and training were core problems. Hence, policy
      makers should give due attention to promoting the involvement of the GHS staff by
      integrating the program into the GHS system using the approach already in place
      in certain parts of the country.

PMID- 11221095
TI  - Leprosy at a turning point?

PMID- 11221094
TI  - Hansen's disease in a patient with a history of sarcoidosis.
AB  - We report a rare case of concomitant Hansen's disease (HD) and sarcoidosis.
      Reticulin staining may be a helpful diagnostic tool in establishing the diagnosis
      of sarcoidosis in skin lesions. The diagnosis of HD can be established despite
      negative polymerase chain reaction results for the detection of Mycobacterium
      leprae DNA. Finally, a well-established diagnosis of sarcoidosis does not
      preclude the development of another granulomatous disorder. Hence, when new
      lesions developed in a patient with sarcoidosis despite appropriate therapy,
      other concurrent diagnoses should be pursued.

PMID- 11221096
TI  - Development of TT leprosy in a BCG-vaccinated individual: immunological response
      during disease and after spontaneous healing.

PMID- 11221097
TI  - Dapsone drug resistance in the MDT era.

PMID- 11221098
TI  - Tumor necrosis factor promoter polymorphism (TNF2) seems to protect against
      development of severe forms of leprosy in a pilot study in Brazilian patients.

PMID- 11221099
TI  - Single-dose treatment for single lesion leprosy; histopathological observations.

PMID- 11221101
TI  - A simple splint.

PMID- 11221100
TI  - Childhood leprosy in Chandigarh; clinico-histopathological correlation.

PMID- 11221102
TI  - [Past, present and future of occupational medicine].
AB  - The author retraces development of occupational pathology as an important part of
      general pathology in Russian Federation. The article covers priority directions
      in occupational pathology research to preserve and improve workers' health in
      Russia.

PMID- 11221103
TI  - [The state of free-radical oxidation in workers engaged in oil-processing
      industry].
AB  - The author represent evaluation of free-radical oxidation in RBC, serum and urine
      among workers engaged into pyromellitic dianhydride. Individuals contacting
      chemical pollutants during pyromellitic dianhydride production de monstrate
      significant changes in free-radical oxidation parameters of RBC, serum and urine.

PMID- 11221104
TI  - [Berlition R 300 oral -- alpha-lipoic acid preparation for the correction of body
      changes associated with high serum iron content].
AB  - Medication Berlition 300 oral, produced by "Berlin-Hemie", induces lower serum
      iron content, decrease in transferrin content of whole blood and serum
      proportionally to increased urinary iron excretion and lower serum bilirubin and
      normalizes serum glucose level. Berlition 300 oral, lipoic acid preparation made
      by "Berlin-He mie" (Menarini group), could be recommended for treatment of high
      serum iron content and iron overload, especially in association with diabetes
      mellitus.

PMID- 11221105
TI  - [Features of respiratory diseases in ecologically unfavorable region].
AB  - Examination of 400 workers in Bratsk aluminium plant proved respiratory diseases
      formation to be influenced by both occupational factors and various toxic
      chemicals that are released into atmosphere by other industrial polluters.
      Structure of respiratory diseases is represented mainly by diffuse pneumoconiosis
      caused by toxic and dust factors. Prophylaxis of those diseases should be aimed
      not only to better work conditions, but also to specify measures improving
      regional ecologic situation.

PMID- 11221106
TI  - [Combined effects caused by chronic exposure to vinyl chloride and
      dichloroethane].
AB  - The authors studied solitary and combined effects of vinyl chloride and
      dichloroethane in chronic (4 months) inhalation experiment using concentrations
      of 50 and 500 mg/m3. The experiment revealed general toxic effects including
      disorders of central nervous system and liver. Those disorders are caused by
      reductive-oxidative reactions disturbances and dystrophic processes. The authors
      determined safe combinations of vinyl chloride and dichloroethane concentrations
      for associated action.

PMID- 11221107
TI  - [Carcinogenic danger of nickel and its compounds (review of literature)].

PMID- 11221108
TI  - [Improving the system of medical examinations in individuals working with
      occupational hazards nowadays].
AB  - To solve the problem of medical examinations system improvement according to
      Russian Federation Health Ministry Order No. 90, the Department for Occupational
      Hygiene Supervision specified several directions: -cooperation with medical
      commissions of health care facilities and with occupational safety divisions at
      industrial enterprises to determine contingents and volume of further research; -
      organization of conferences in municipal health care department with
      representatives of health care facilities and employers; - cooperation with
      specialists in public hygiene and occupational center for complex inspection of
      health care facilities; - preparation of information for and participation for
      and participation in interdepartmental commission conference based on clinical
      expert commission in occupational pathology center and in municipal department on
      work safety; - cooperation with occupational pathology center in activities of
      license committee.

PMID- 11221109
TI  - [On the evaluation of gene toxicity and mutagenicity of mullite refractories].

PMID- 11221110
TI  - [Experience in treatment of chronic toxic hepatitis by ursodeoxicholic acid].

PMID- 11221111
TI  - Steps and strategies.

PMID- 11221112
TI  - Developing qualitative databases for multiple users.
AB  - Conventionally, anthropological data are collected and analyzed by individuals,
      and although researchers may use data managers to organize their information,
      there is little need to classify and code systems to be accessible to others.
      Recently, however, qualitative and quantitative data have been collected in
      projects with multiple researchers. Difficulties with the establishment,
      verification, and management of databases for multiple users, particularly in
      longitudinal studies, are considerable if the rules underlying coding schemes are
      difficult to identify or if the documentation is cumbersome. Drawing on the
      authors' experiences in Australia, the use of computer packages for data
      management is discussed, and the importance of preserving the integrity of data
      and maintaining context while facilitating its continued and varied use is
      emphasized.

PMID- 11221113
TI  - When the visit to the emergency department is medically nonurgent: provider
      ideologies and patient advice.
AB  - It is estimated that more than half of pediatric hospital emergency department
      (ED) visits are medically nonurgent. Anecdotal impressions suggest that ED
      providers castigate medically nonurgent visits, yet studies on such visits are
      scarce. This study explored the perspectives of 26 providers working in the EDs
      of two urban hospitals regarding medically nonurgent pediatric ED visits and
      advising parents or guardians on appropriate ED use. Three provider ideologies
      regarding the appropriateness of medically nonurgent ED use were identified and
      found to be linked to particular communication strategies that providers employed
      with ED users: restrictive, pragmatic, and all-inclusive. The analysis resulted
      in the development of a typology of provider ideological orientations toward ED
      use, distinguished according to different orientations toward professional
      dominance.

PMID- 11221114
TI  - Reflections on validity and epistemology in a study of working relations between
      deaf and hearing professionals.
AB  - In this article, a research study that examined the working relationships between
      Deaf and hearing professionals in health and educational services in the United
      Kingdom is addressed. These service providers worked in bilingual organizations
      where both British Sign Language and English were used and in which Deaf people's
      identity as a cultural-linguistic minority was accepted. The focus of this
      article is on issues of validity and epistemology that arose for the Deaf and
      hearing research team in the course of this study. In particular, it examines the
      influence of identity attributions on the research process for researchers
      operating within a context of historical oppression, minority language use and
      legitimization of research knowledge, and challenges to the interpretative
      analysis used in the study that arose from the dynamics of majority-minority
      power relations in the wider social world.

PMID- 11221115
TI  - Empowerment and Australian community health nurses' work with aboriginal clients:
      the sociopolitical context.
AB  - A portion of a study designed to explore community health nurses' (CHNs)
      perceptions of the concept of empowerment in their work with Australian
      Aboriginal clients is discussed in this article. The 12 study participants were
      identified through purposive convenience sampling. During this exploration,
      contentions regarding the concept of empowerment emerged, revealing the
      sociopolitical context of CHN's work with Aboriginal people that shaped their
      practice in crucial ways. These issues emerged from the participants' discussions
      regarding the meaning of empowerment in their work with Aboriginal clients and
      the strategies for and challenges to working in empowering ways within the
      context of Aboriginal health. Selected components of Habermas's works provided a
      useful framework to facilitate an understanding of the forces that underpin
      community health nursing practice.

PMID- 11221116
TI  - Team collaboration: a case study of an early intervention team.
AB  - The study described in this article sought to examine the workings of an
      interdisciplinary team as a research entity and as a service provider. There were
      two levels of analysis in the study: the process of collaborating on the research
      and the results of the research observation of an interdisciplinary team in a
      clinical setting. An interdisciplinary research team studied the interaction of a
      single clinical team over a 6-month period working with one child in a hospital
      based early intervention program. The data were collected through intensive
      interviews, direct observations of the family and team members, and selected
      videotaping of team meetings. Qualitative data analysis methods were used, and
      five themes emerged: who takes the lead, the classroom as a way station, we like
      our freedom but..., who is giving and who is taking advice, and communication
      comes in few forms.

PMID- 11221117
TI  - Moving them on and in: the process of searching for and selecting an aged care
      facility.
AB  - This exploratory, descriptive study examined the search and selection process for
      an aged care facility following discharge of a family member from an acute
      setting. Few studies have examined this process and its effects on families.
      Individuals from 25 families where a family member had been recently admitted to
      an aged care facility following discharge from an acute setting were interviewed.
      This article reports participants' perceptions of the search and selection
      process and its effect on the family. Five major themes emerged from the data:
      good fortune, wear and tear on the sponsor, dealing with the system, urgency, and
      adjusting. The results can be used to inform and assist families and health
      professionals working with families in this situation.

PMID- 11221118
TI  - Low-income African American adolescents who avoid pregnancy: tough girls who
      rewrite negative scripts.
AB  - The purpose of this research was to generate a grounded theory that explains the
      social-psychological processes of low-income African American adolescents who
      avoided pregnancy. Data collection included focus groups and in-depth interviews
      with 17 women aged 19 to 26. Data analysis using the grounded theory method
      revealed that these girls were the recipients of negative social-psychological
      scripts, putting them at risk for poverty and early childbearing. The "tough
      girls" struggled to rewrite these scripts by recognizing their negativity, being
      disenchanted with the scripts, determining to be different, and creating better
      lives. These aware, introspective young women believed in self-responsibility,
      self-protection, education, and financial independence. Practice implications and
      considerations for programmatic interventions can be based on this analysis.

PMID- 11221119
TI  - Enhancing the rigor of grounded theory: incorporating reflexivity and
      relationality.
AB  - Some proponents of the grounded theory method appear to treat interview and
      participant observation data as though they mirror informants' realities. Others
      claim that grounded theory incorporates reflexivity. It is claimed in this
      article that the principal texts on grounded theory do not attend to the effects
      of interactions between researchers and participants in interview and participant
      observation contexts. Descriptions of the effects of interactions on interview
      data and attention to relationships between interviewers and interviewees are
      necessary for attending to the rigor of grounded theory findings. Therefore, it
      is argued that reflexivity and relationality, which are defined as attending to
      the effects of researcher-participant interactions on the construction of data
      and to power and trust relationships between researchers and participants, should
      be incorporated into grounded theory.

PMID- 11221120
TI  - Engaging with phenomenology: is it more of a challenge than it needs to be?
AB  - When seeking to understand the human condition, with all the problems this
      enterprise poses for traditional scientific research approaches, qualitative
      research is held to be in some ways superior to rigidly quantitative research. As
      a result, many beginning health researchers plan to employ a qualitative approach
      to explore topics that were previously inaccessible via traditional scientific
      means. However, implementing a qualitative approach is not an easy process and,
      in many cases, researchers must look long and hard to find material to assist
      them in developing their research plans. This may be particularly so in
      phenomenological research. This article examines some of the problems and
      pitfalls faced by phenomenological researchers new to the approach. Through
      accounts of personal experience, it highlights some of the areas where
      phenomenological researchers could be helpful by being less reticent about the
      process of implementing a phenomenological study.

PMID- 11221121
TI  - Patterns of sexual mixing: mechanisms for or limits to the spread of STIs?

PMID- 11221123
TI  - Operational performance of an STD control programme in Mwanza Region, Tanzania.
AB  - OBJECTIVES: To describe important details of the design and operational features
      of the Mwanza sexually transmitted diseases (STD) control programme. To assess
      the feasibility of the intervention, the distribution of STD syndromes observed,
      the clinical effectiveness of syndromic STD case management, the utilisation of
      STD services by the population, and the quality of syndromic STD services
      delivered at rural health units. METHODS: The intervention was integrated into
      rural primary healthcare (PHC) units. It comprised improved STD case management
      using the syndromic approach, facilitated by a regional programme office which
      ensured the training of health workers, a reliable supply of effective drugs, and
      regular support supervision. Five studies were performed to evaluate operational
      performance: (i) a survey of register books to collect data on patients
      presenting with STDs and reproductive tract infections (RTIs) to rural health
      units with improved STD services, (ii) a survey of register books from health
      units in communities without improved services, (iii) a survey of register books
      from referral clinics, (iv) a home based cross sectional study of STD patients
      who did not return to the intervention health units for follow up, (v) a cross
      sectional survey of reported STD treatment seeking behaviour in a random cohort
      of 8845 adults served by rural health units. RESULTS: During the 2 years of the
      Mwanza trial, 12,895 STD syndromes were treated at the 25 intervention health
      units. The most common syndromes were urethral discharge (67%) and genital ulcers
      (26%) in men and vaginal discharge (50%), lower abdominal tenderness (33%), and
      genital ulcers (13%) in women. Clinical treatment effectiveness was high in
      patients from whom complete follow up data were available, reaching between 81%
      and 98% after first line treatment and 97%-99% after first, second, and third
      line treatment. Only 26% of patients referred to higher levels of health care had
      presented to their referral institutions. During the trial period, data from the
      cohort showed that 12.8% of men and 8.6% of women in the intervention communities
      experienced at least one STD syndrome. Based on various approaches, utilisation
      of the improved health units by symptomatic STD patients in these communities was
      estimated at between 50% and 75%. During the first 6 months of intervention
      attendance at intervention units increased by 53%. Thereafter, the average
      attendance rate was about 25% higher than in comparison communities. Home visits
      to 367 non-returners revealed that 89% had been free of symptoms after treatment,
      but 28% became symptomatic again within 3 months of treatment. 100% of these
      patients reported that they had received treatment, but only 74% had been
      examined, only 57% had been given health education, and only 30% were offered
      condoms. Patients did not fully recall which treatment they had been given, but
      possibly only 63% had been treated exactly according to guidelines. CONCLUSIONS:
      This study demonstrated that it is feasible to integrate effective STD services
      into the existing PHC structure of a developing country. Improved services
      attract more patients, but additional educational efforts are needed to further
      improve treatment seeking behaviour. Furthermore, clear treatment guidelines, a
      reliable drug supply system, and regular supervision are critical. All efforts
      should be made to treat patients on the spot, without delay, as referral to
      higher levels of care led to a high number of dropouts. The syndromic approach to
      STD control should be supported by at least one reference clinic and laboratory
      per country to ensure monitoring of prevalent aetiologies, of the development of
      bacterial resistance, and of the effectiveness of the syndromic algorithms in
      use.

PMID- 11221124
TI  - Vaginal yeasts in the era of "over the counter" antifungals.
AB  - OBJECTIVE: To establish whether there has been any rise in the prevalence of non
      albicans Candida species isolated from vaginal swabs since the introduction of
      "over the counter" antifungal treatments. METHOD: A retrospective review looking
      at all positive vaginal yeast isolates collected from women attending one
      genitourinary medicine clinic during the 6 year period from 1993 to 1998
      inclusive. All positive vaginal yeast isolates were included, regardless of
      whether or not the patients were symptomatic. Isolates from HIV positive women
      were excluded from the analysis. RESULTS: No increase in non-albicans vaginal
      yeast isolates was shown during the period studied. The proportion of non
      albicans yeasts remained constant at approximately 5% of the total yeasts
      isolated. The most common non-albicans yeast isolated was C glabrata. CONCLUSION:
      There is no evidence from this study to suggest that the increasing use of "over
      the counter" antifungal treatment has selected for atypical, possibly inherently
      azole resistant, strains of vaginal yeasts in HIV seronegative women.

PMID- 11221125
TI  - Syndromic management of urethral discharge in Ghanaian pharmacies.
AB  - OBJECTIVES: To evaluate the training of pharmacists in Accra, Ghana, in the
      syndromic management of STIs. METHODS: We randomly selected 50 pharmacy outlets
      that had received the training (intervention) and 50 outlets that had not
      received the training (no intervention). Simulated clients described the symptoms
      of urethral discharge to the first pharmacy staff encountered and completed a
      standardised questionnaire after each encounter. RESULTS: Correct drug provision
      for urethral discharge improved with the educational intervention but remained
      relatively low (no intervention 18%; intervention 39%; p < 0.05). More
      encouraging, treatment for gonorrhoea was usually correct without the
      intervention (64%) and improved further in the intervention outlets (76%). The
      treatment for chlamydia was less often appropriate but also improved (31% and
      41%). Condom promotion was poor, with almost no outlets offering condoms.
      CONCLUSIONS: The current training led to improvements in the treatment of
      urethral discharge. Future training needs to be improved, especially with regard
      to condom promotion. Moreover, since less than one third of simulated clients
      were seen by pharmacists, the training should be expanded to other pharmacy
      staff. With enhanced training of all pharmacy staff, the role of pharmacy outlets
      in STI management and prevention in Ghana and elsewhere can be optimised.

PMID- 11221126
TI  - Cerebrospinal fluid tau concentrations in HIV infected patients with suspected
      neurological disease.
AB  - OBJECTIVES: To measure cerebrospinal fluid (CSF) tau in HIV infected patients
      with acute neurological episodes and to correlate the findings with the type and
      severity of neurological disease. METHODS: CSF tau was prospectively measured in
      76 consecutive HIV infected patients admitted to a specialist unit at UCL
      Hospitals, London, for investigation of acute neurological episodes: the results
      were compared with the clinical diagnoses. RESULTS: 24 patients had HIV
      associated dementia complex (HADC), 10 had lymphoma (including four with primary
      CNS lymphoma), 20 had cerebral infections (including five with CMV encephalitis,
      five with VZV infection, seven with cryptococcal meningitis, two with
      toxoplasmosis, and one with progressive multifocal leucoencephalopathy); 22
      patients had miscellaneous conditions, including nine with self limiting
      headache/fever. 62 patients (82%) had normal CSF tau concentration and 14
      patients (18%) had elevated tau. In those with HADC, there was no correlation
      between the degree of dementia or atrophy on magnetic resonance imaging and CSF
      tau. Elevated CSF tau was associated with poor outcome as six of eight patients
      who died within 4 weeks of lumbar puncture had elevated tau (p = 0.0024, two
      tailed Fisher's exact test). CONCLUSIONS: CSF tau levels are not elevated in the
      majority of HIV infected patients presenting with acute neurological episodes.
      CSF tau levels show no correlation with severity of dementia/atrophy on magnetic
      resonance imaging. Although elevated CSF tau was observed in some patients with
      conditions causing cerebral necrosis, the finding did not delineate underlying
      pathology but was associated with poor outcome.

PMID- 11221127
TI  - STI prevention and the male sex industry in London: evaluating a pilot peer
      education programme.
AB  - OBJECTIVE: To evaluate the effectiveness of a pilot peer education STI prevention
      programme with male sex workers. DESIGN: A process and outcome evaluation of the
      pilot programme undertaken in three London male escort agencies, using a quasi
      experimental design. SUBJECTS: Workers in three London escort agencies, including
      88 who completed a questionnaire, five peer educators, and a further 16 men
      (including management) working in two of these agencies. METHODS: A peer
      education STI prevention programme run by the Working Men Project (WMP), a
      specialist sexual health service for male sex workers, was piloted in two London
      escort agencies. Five male sex workers participated in a 2 day peer education
      training programme. They then returned to their respective agencies to
      disseminate information and condoms, in an attempt to influence norms of
      behaviour. An outcome evaluation aimed to assess changes in STI related
      knowledge, high risk sexual behaviour, and attendance at a sexual health service.
      A pre-intervention questionnaire assessing variables such as STI related
      knowledge, sexual behaviour, and demographic information was administered in both
      agency A and agency B and a third agency, C, which acted as a control. Ten weeks
      after the peer educators returned to their agencies, the same questionnaire was
      administered in the same agencies. Peer educator referrals to the WMP were also
      recorded over this time period. The process evaluation involved interviews and
      focus groups with peer educators, and the completion of diaries about their
      experiences in the role. A further 16 men working in the agencies (including
      managers and an owner) were interviewed about their experience of the programme.
      Participant observation was also undertaken through regular outreach work to the
      agencies. RESULTS: 57 men completed the questionnaire at time 1 and 44 at time 2.
      Unfortunately, only 13 of these were matched, precluding any meaningful analysis
      of change in STI related knowledge and sexual behaviour. The questionnaire
      provided a profile of the men working in the agencies. Of the 88 men who
      completed the questionnaire at least once, the majority were homosexual, and in
      their late teens/early 20s. Most were of a "white" ethnic group, though there was
      some range within these categories. Most preferred to speak English and education
      levels were high. Relative STI knowledge revealed a high understanding of HIV and
      hepatitis B, moderate understanding of gonorrhoea, syphilis, genital warts and
      herpes, and little knowledge of non-specific urethritis (NSU) or chlamydia.
      Sexual behaviour suggested a highly sexually active population with both male and
      female paying and non-paying partners. Condom use was highest for paying
      partners, particularly for anal sex. Condom use for oral sex with all partners
      was less consistent, and condom use for all types of sex with regular partners
      was lower than with other partners. The small number of men engaging in vaginal
      sex with paying and regular partners were less likely to use condoms. 26 new
      patients registered at the WMP as a result of peer educator referrals,
      representing 65% of all new contacts over the study period. The process
      evaluation revealed that while the training programme was considered adequate and
      while peer educators felt the programme and their roles to be a success, their
      experience of the role was difficult. The role of management support was crucial
      in supporting the programme. The assumption that "peers" are particularly
      effective educators was not borne out by the results. While peers were considered
      suitable to discuss some aspects of the industry, many preferred to consult
      "professionals" about health related matters. The concept of "peers" was
      problematic with most of the men drawing "peers" from subgroups within the
      agencies. Other constraints on behaviour such as a lack of power, particularly
      with regard to a lack of management support, or poverty, had a substantial impact
      on behaviour which were not influenced by the peer educators. CONCLUSIONS: The
      study illustrated the difficulties of utilising quasi-experimental evaluation
      methodology with this client group. It also demonstrated the limitations of peer
      education based on information provision health education models which focus on
      individual behaviour change. Suggestions are given for future interventions.

PMID- 11221128
TI  - Baseline STD prevalence in a community intervention trial of the female condom in
      Kenya.
AB  - OBJECTIVE: We present baseline sexually transmitted disease (STD) prevalence
      rates from an ongoing intervention trial at Kenyan agricultural sites. METHODS:
      After gaining the cooperation of management, we identified six matched pairs of
      tea, coffee, and flower plantations and enrolled approximately 160 women at each
      site. Six intervention sites received an information programme and distributed
      female and male condoms, while six control sites received male condoms only and
      similar information about them. At clinic visits, we tested participants for
      cervical gonorrhoea (GC) and Chlamydia trachomatis (CT) by ligase chain reaction
      on urine specimens, and Trichomonas vaginalis (TV) by culture. The study has 80%
      power to detect a 10% prevalence difference during follow up, assuming a combined
      STD prevalence of 20%, 25% loss to follow up and intracluster correlation
      coefficient (ICC) of 0.03. RESULTS: Participants at intervention and control
      sites (total 1929) were similar at baseline. Mean age was 33 years, the majority
      were married, more than half currently used family planning, 78% had never used
      male condoms, and 9% reported more than one sexual partner in the 3 months before
      the study. Prevalences of GC, CT, and TV were 2.6%, 3.2%, and 20.4% respectively
      (23.9% overall), and were similar at intervention and control sites. The ICC for
      STD prevalence was 0.0011. Baseline STD was associated with unmarried status, non
      use of family planning, alcohol use, and more than one recent sexual partner, but
      the highest odds ratio was 1.5. CONCLUSIONS: Baseline results confirm a high
      prevalence of trichomoniasis and bacterial STD at these Kenyan rural sites.
      Improved STD management is urgently needed there. Our ongoing female condom
      intervention trial is feasible as designed.

PMID- 11221129
TI  - The association between abuse in childhood and STD/HIV risk behaviours in female
      genitourinary (GU) clinic attendees.
AB  - OBJECTIVES: To compare and contrast women with a history of child abuse with
      those who have no history of child abuse on STI/HIV risk behaviours and safer sex
      beliefs in an inner city UK sample. DESIGN: Cross sectional sample survey.
      METHODS: Routine female clinic attendees were invited to complete an anonymous
      self report questionnaire which included background information, sexual and drug
      risk behaviour, self reported sexually transmitted infections (STIs),
      psychological distress (Hospital and Anxiety Depression Scale; HADS), Sexual Risk
      Cognitions Questionnaire (SRCQ), and history of child sexual, physical, and
      emotional abuse. RESULTS: 137 (45%) of 303 women reported a history of child
      abuse; all three forms of child abuse--sexual (26%), physical (20%), and
      emotional (27%) abuse--overlapped. The majority of women reported one sexual
      partner in the past month, and the majority did not use condoms. Women reporting
      a history of child abuse were more likely to have had previous STIs (p = 0.007)
      and to have had more than one STI (p = 0.04) compared with women who had not
      experienced child abuse. Injecting drug use and commercial sex work were of low
      prevalence across the whole sample and no group differences were found. Women
      reporting a history of child abuse had higher HADS anxiety (p = 0.03) compared
      with women with no history of child abuse. Confidence in using condoms with a
      sexual partner was not related to child abuse. Women with a history of child
      abuse reported significantly higher frequency of thoughts reflecting anticipated
      negative reactions from partners to suggesting condom use (p = 0.02) and judging
      a partner's risk by their appearance (p = 0.05) compared with women with no
      history of child abuse. CONCLUSIONS: Comparable rates of child sexual abuse with
      US studies were found in this UK inner city population of women attending sexual
      health services. Women who had experienced child abuse were more likely to report
      ever having had an STI and having had more than one STI. Complex psychological
      and social factors contribute to difficulties for women in negotiating safer sex
      including emotional distress, abuse histories, and anticipating a negative
      reaction from partners. Multifaceted prevention models are needed.

PMID- 11221130
TI  - Predictors of syphilis seroreactivity and prevalence of HIV among street
      recruited injection drug users in Los Angeles County, 1994-6.
AB  - OBJECTIVES: To describe HIV prevalence and the association between syphilis
      incidence and sexual and drug injection risk behaviours in a cohort of street
      recruited injecting drug users (IDUs) in Los Angeles County, between 1994 and
      1996. METHODS: During the study period, 513 street recruited African-American and
      Latino IDUs were screened for syphilis and antibodies to HIV. Subjects were
      administered a risk behaviour survey at baseline and followed up at 6 month
      intervals for 18 months with repeated interviews and serological screening. Rate
      ratios were used to examine associations between syphilis incidence and
      demographic characteristics and risk behaviours. A proportional hazard model was
      used to identify predictors of syphilis incidence independent of demographic
      characteristics. RESULTS: 74% of the sample were male, 70% African-American, 30%
      Latino; and the median age was 43 years. Overall baseline serological prevalence
      of HIV was 2.5% and of syphilis 5.7%. None of the participants were co-infected
      for HIV and syphilis at baseline or at any of the 6 month follow ups. Among 390
      eligible IDUs retained for analysis of incidence data, the overall syphilis
      incidence was 26.0 per 1000 person years. Higher syphilis incidence was found for
      women compared with men (RR = 2.70; 95% CI 1.60, 4.55), and for those 44 years of
      age or younger compared with those 45 years of age and older (RR = 2.26; 95% CI
      1.25, 4.08). African-Americans were more likely to be syphilis incident cases
      when compared with Latinos, although the difference did not reach statistical
      significance (RR = 1.27; 95% CI 0.72, 2.23). In bivariate analysis, risk
      behaviours significantly associated with higher syphilis incidence included
      injection of cocaine, "speedball" and heroin, "crack" smoking, recency of first
      injection event, backloading of syringes, injecting with others, exchanging drugs
      or money for sex, multiple sex partners, and non-heterosexual sexual preference.
      Variables that significantly predicted syphilis infection at follow up in the
      multivariate analysis included multiple sex partners (RR = 7.8; 95% CI 2.4,
      25.0), exchanging money for sex (RR = 3.0; 95% CI 0.9, 9.6), and recent
      initiation to injection drug use (RR = 4.6; 95% CI 1.1, 18.8). CONCLUSION:
      Syphilis transmission among IDUs in Los Angeles County remains a serious public
      health concern, particularly among IDUs who engage in trading of sex for money or
      drugs. Although low, the prevalence of HIV observed in this study constitutes a
      serious concern because of the potential for expanded HIV transmission in this
      susceptible population of IDUs with high syphilis incidence. Enhanced case
      finding screening efforts and prevention of transmission of sexually transmitted
      infections should specifically target hard to reach IDUs and their sexual
      partners.

PMID- 11221131
TI  - Assessment of risk for pelvic inflammatory disease in an urban sexual health
      population.
AB  - OBJECTIVES: To determine the sexual and demographic risk factors for the
      acquisition of presumptive pelvic inflammatory disease (PID). METHODS: A
      retrospective, case-control study in women, who attended the Sydney Sexual Health
      Centre (SSHC), between April 1991 and December 1997. Logistic regression analysis
      was used to adjust for confounding variables. RESULTS: 741 women with PID and an
      equal number of controls were included. Cases were significantly younger than
      controls (p < 0.001). 42% of cases were born in north or South East Asia,
      compared with 12% of the controls (p < 0.001). The adjusted odds ratio for being
      born in north or South East Asia was 2.8 (95% CI 1.70-4.46), for not speaking
      English at home was 1.6 (95% CI 1.02-2.55), for having had previous PID was 5.9
      (95% CI 3.59-9.73), and for being employed in the commercial sex industry and
      being born in north or South East Asia was 2.8 (95% CI 1.22-6.22). Women aged 15
      19 were at considerable risk of developing PID (OR 5.3 (95% CI 2.76-10.11)).
      Women with previous human papillomavirus infection were significantly less likely
      to develop PID (OR 0.6 (95% CI 0.42-0.79)). The use of IUCDs (OR 4.5 (95% CI 2.14
      9.39)), condoms (OR 1.4 (95% CI 1.03-1.87)), and not using contraception (OR 1.8
      (95% CI 1.20-2.76)) was each associated with an increased risk. CONCLUSIONS:
      Several measures may help to reduce the burden of PID. Women should be encouraged
      to delay the onset of sexual activity and IUCDs should not be used in young
      women. Sexual health services for women whose home language is not English, and
      for commercial sex workers born in north or South East Asia should be improved.

PMID- 11221132
TI  - Circumcision and STD in the United States: cross sectional and cohort analyses.
AB  - BACKGROUND: Male circumcision status has been shown to be associated with
      sexually transmitted disease (STD) acquisition in some, but not all, studies.
      Most studies have been cross sectional. OBJECTIVES: We examined the association
      between circumcision status and the prevalence and incidence of gonorrhoea,
      chlamydia, and syphilis. METHODS: We analysed cross sectional and cohort study
      data from a multicentre controlled trial in the United States. Between July 1993
      and September 1996, 2021 men visiting public inner city STD clinics in the United
      States were examined by a clinician at enrolment and 1456 were examined at follow
      up visits 6 and 12 months later. At each visit, men had laboratory tests for
      gonorrhoea, chlamydia, and syphilis and were examined for circumcision status. We
      used multiple logistic regression to compare STD risk among circumcised and
      uncircumcised men adjusted for potentially confounding factors. RESULTS:
      Uncircumcised men were significantly more likely than circumcised men to have
      gonorrhoea in the multivariate analyses, adjusted for age, race, and site, in
      both the cross sectional (odds ratio (OR), 1.3; 95% confidence interval (CI), 0.9
      to 1.7) and in the cohort analysis (OR, 1.6; 95% CI, 1.0 to 2.6). There was no
      association between lack of circumcision and chlamydia in either the cross
      sectional (OR, 1.0; 95% CI 0.7-1.4) or the cohort analysis (OR, 0.9; 95% CI 0.5
      1.5). The magnitude of association between lack of circumcision and syphilis was
      similar in the cross sectional (OR, 1.4; 95% CI 0.6 to 3.3) and cohort analysis
      (OR, 1.5; 95% CI 0.4 to 6.1). CONCLUSION: Uncircumcised men in the United States
      may be at increased risk for gonorrhoea and syphilis, but chlamydia risk appears
      similar in circumcised and uncircumcised men. Our results suggest that risk
      estimates from cross sectional studies would be similar to cohort findings.

PMID- 11221133
TI  - Preliminary safety and acceptability of a carrageenan gel for possible use as a
      vaginal microbicide.
AB  - OBJECTIVE: We sought to determine the safety and acceptability of vaginal gel
      formulation PC-503 among low risk, abstinent women. The active ingredient was 2%
      pharmaceutical grade lambda carrageenan, a sulphated polymer that is generally
      recognised as safe by the US Food and Drug Administration. METHODS: 35 women in
      five sites applied 5 ml of the PC-503 gel vaginally once a day for 7 days while
      abstaining from sexual intercourse. Visual vaginal examinations were performed on
      days 1, 4, and 8. STI testing and vaginal pool Gram stain preparations were done
      on days 1 and 8. Participants were asked about product acceptability. RESULTS: 34
      of the 35 women enrolled completed 7 days' use. Following product use, five
      reported mild symptoms including "bladder fullness," "genital warmth," or
      discomfort, and lower abdominal pain, and one had moderate pale yellow cervical
      discharge. Using the Nugent criteria, three women had bacterial vaginosis (BV)
      before and after use; three had BV before but not after, and two had BV after but
      not before. Most of the women found PC-503 to be pleasant or neutral in feel and
      smell and considered extra lubrication to be an advantage; however, one third
      found it to be messy. CONCLUSIONS: Vaginal use of PC-503 gel did not cause
      significant adverse effects in a small number of low risk, sexually abstinent
      women. Further testing in larger numbers of sexually active women is planned. A
      smaller volume of gel may be more acceptable to some women.

PMID- 11221135
TI  - The management of Chlamydia trachomatis: combined community and hospital study.

PMID- 11221134
TI  - Helicobacter pylori infection transmitted sexually via oral-genital contact: a
      hypothetical model.
AB  - OBJECTIVES: To postulate that Helicobacter pylori infection may be transmitted
      sexually, using the human female vagina as a reservoir for transmission. METHODS:
      A literature search was performed using Medline, Embase, Biological Abstracts,
      and Currents Contents (January 1983 to August 2000). Relevant keywords were used
      and additional manual searches were made using the reference lists from the
      selected articles to retrieve other papers relevant to the topic. CONCLUSIONS:
      Helicobacter pylori infection could be transmitted sexually with the vagina
      acting as a potential temporary/permanent reservoir given the right environmental
      conditions.

PMID- 11221136
TI  - Retrospective study of male lichen sclerosus and outcome in Leicester: 1995-9
      inclusive: experience of a genitourinary medicine clinic.

PMID- 11221137
TI  - Chaperoning male patients.

PMID- 11221138
TI  - Ciprofloxacin 250 mg for treating gonococcal urethritis and cervicitis.

PMID- 11221139
TI  - Investigation of the increased incidence of gonorrhoea diagnosed in GUM clinics
      in England, in 1994-6.

PMID- 11221140
TI  - Perceptions of disease and therapy are factors influencing adherence to
      antiretroviral therapy.

PMID- 11221141
TI  - The power of information and contraceptive choice in a family planning setting in
      Mexico.

PMID- 11221142
TI  - AIDS and globalisation.

PMID- 11221143
TI  - WSW status needs further definition.

PMID- 11221144
TI  - The role of the lecturer in the preceptor model of clinical teaching.
AB  - Preceptorship models of clinical teaching are becoming increasingly popular in
      undergraduate nursing education. According to the literature the role of the
      lecturer is very unclear in this model of clinical teaching. This article reports
      on a descriptive study undertaken within a school of nursing where the author was
      formerly employed. The study explored the role of the lecturer. The findings
      demonstrate the educational orientation of the lecturer role and also highlight
      the tension that continues to exist between the world of education and the world
      of practice.

PMID- 11221145
TI  - Creating a child abuse policy that reflects an ethic of care.
AB  - The primary purpose of child abuse policy is to guide the action of health care
      providers and so ensure that the fundamental rights of those the policy intended
      to protect are not compromised. This discussion paper explores the ethical
      considerations underlying child abuse policy from bioethical and from caring
      ethical perspectives, both of which are outlined briefly. A process that could be
      used to create or analyse existing child abuse policy, in relation to underlying
      ethical considerations, definitions of child abuse, level of health care,
      resourcing needs and relationship to employment policy is outlined. A
      hypothetical example of such a policy is used to illustrate elements of this
      process. Assuming that policy is designed to direct action, it is argued that if
      child abuse policies were rewritten to reflect an ethic of care the quality and
      scope of health care provided to children and their families would improve.
      Consequently, stated government objectives of improving child health services, as
      well as primary health care aims of achieving equitable, accessible and
      affordable health care for children in New Zealand would be better facilitated.

PMID- 11221146
TI  - Negotiating the ethical minefield of psychiatric nursing practice.
AB  - Psychiatric nursing practice can be likened to an ethical minefield. Nurses are
      often in the middle of the minefield and are pushed and pulled by forces, which
      are sometimes beyond their control. This paper signposts some of the more
      problematic areas of practice so that nurses may be equipped with at least a
      broad over-view of the ethical terrain.

PMID- 11221147
TI  - Changing practice through action research: an interview with Rachel Stevenson. 
      Interview by Pamela J. Wood, Lynne S. Giddings.
AB  - Nurses and midwives in Aotearoa/New Zealand use a broad range of research
      methodologies to explore aspects of practice. This is the second article in a
      series based on interviews with nursing and midwifery researchers, designed to
      offer the beginning researcher a first-hand account of the experience of using
      particular methodologies. This article focuses on action research. After
      describing briefly the key elements of this methodology, the article presents an
      interview with Rachel Stevenson (RGON, MA) who used action research to explore
      the experience of nurses and people with asthma in the secondary care setting.

PMID- 11221148
TI  - Re-introducing Mabel Mahinarangi Kewene, MBE, QSO. Interviewed by Yvonne
      Shadbolt.

PMID- 11221149
TI  - Coronary risk factors in Malaysia: precious little is known, ... still.

PMID- 11221150
TI  - Comparison of Fluvoxamine alone, Fluvoxamine and cognitive psychotherapy and
      psychotherapy alone in the treatment of panic disorder in Kelantan--implications
      for management by family doctors.
AB  - This paper reports the result of a brief therapy attempt at treating panic in a
      busy outpatient psychiatric clinic. The patients were cases of panic referred
      from the various outpatient clinics within the hospital complex. The patients
      were divided into three groups at random using one of three modalities of
      treatment, i.e. cognitive behaviour therapy (CBT), CBT and Fluvoxamine (FVX), and
      FVX alone. The therapy was aimed for a maximum of nine sessions after which the
      patients were to be discharged. There were 14 patients in each group. The results
      show that all the groups were similar in the severity and scores pre treatment
      but after the different types of treatment there was a significant difference
      among them. The FVX alone group, showed significant improvement from the
      pretreatment levels but did not show as much improvement as the other groups and
      the mean score was only 9.07 after nine sessions. The best group was the CBT in
      combination with FVX. This indicates that the best way to treat panic is to
      combine drug treatment and psychological treatment. It is also shown from the
      study that the combination group requires less FVX than the FVX alone group. This
      finding has implications for the treatment of panic at the family physician
      clinic.

PMID- 11221151
TI  - Genetic causes of familial hypercholesterolaemia in a Malaysian population.
AB  - A total of 86 unrelated Malaysian patients with familial hypercholesterolaemia
      (FH) were studied for mutations in their low-density lipoprotein receptor (LDL-R)
      gene. Amongst them, 23 had a LDL-R gene mutation, while none having an
      Apolipoprotein B-3500 (Apo B-3500) mutation. Patients with the LDL-R gene defect
      appeared to have a higher level of low-density lipoprotein cholesterol (LDL-C),
      an increased incidence of xanthomas and coronary heart disease (CHD), but no
      relationships were found between the type of LDL-R gene mutations and their lipid
      levels or clinical signs of CHD. In contrast to Western data, our findings seemed
      to indicate a predominance of mutations in the ligand binding domain and an
      absence of Apo B-3500 gene mutation. The latter finding may offer a genetic basis
      as to why Asian patients with familial hypercholesterolaemia have lower LDL-C
      levels and less premature CHD than their Western counterparts.

PMID- 11221152
TI  - Parental response and understanding towards febrile convulsion.
AB  - A questionnaire survey was conducted on parents of 58 patients admitted with
      febrile convulsion (FC) over a 4 month period to the University of Malaya Medical
      Centre, Kuala Lumpur to determine parental response towards febrile convulsion in
      their child and their understanding of home management of FC. RESULTS: The
      majority of parents (93%) were frightened or were in a panic state on witnessing
      FC in their child. Most (77.6%) of them were able to bring their child to medical
      attention within 30 minutes, with delays attributed to transport problems.
      Parental understanding on FC was deficient, particularly with regard to home
      management of acute seizures. The parents' main source of information was friends
      and relatives. CONCLUSIONS: Urgent intervention to counsel and allay fears of
      parents who have just witnessed an acute FC in their child is required. More
      effort must be made to educate parents about FC, with particular reference to
      home management of seizures.

PMID- 11221153
TI  - Pattern of congenital heart disease and access to tertiary cardiac care in
      Malaysia.
AB  - This prospective, descriptive study was carried out to determine the pattern and
      the type of congenital heart disease seen in the Paediatric Departments in 4
      government hospitals. The accessibility of surgical or transcatheter
      interventional treatment was also assessed. Consecutive new patients seen for
      suspected congenital heart disease from 1/1/95 till 31/12/95 (Group I) were
      registered. Records of patients seen from 1/1/95 to 31/8/95 (Group Ia) were
      reviewed 6 months after presentation to determine the nature of treatment
      received. Group II were cardiac patients who were first seen prior to the year
      1995 and had undergone cardiac surgery or transcatheter interventional procedures
      in 1995. Of the 375 patients registered in the 4 hospitals, 250 were new patients
      and 125 were patients first seen prior to 1995 and had surgery or transcatheter
      interventional procedures in 1995. Of the 250 new patients, 83.2% had acyanotic
      cardiac lesions and 16.8% had cyanotic lesions. Ventricular septal defect was the
      commonest lesion, constituting 37.2%, followed by patent arterial duct (18.8%)
      and atrial septal defects (9.6%). At 6 month review, access to close-heart
      surgery or transcatheter interventional treatment were readily available.
      However, for patients with ventricular septal defects, 42.1% who required closure
      were still waiting for surgery 6 months after presentation. Of the 4 patients
      with Fallot's Tetralogy who required surgery, 2 had modified Blalock-Taussig
      shunt and 2 were awaiting surgery. In 1995, a total of 204 cardiac procedures
      were performed, there were 114 (55.9%) open heart procedures, 50 (24.5%) surgical
      ligation of the arterial duct, 28 (13.7%) modified Blalock-Taussig shunts, 11
      (5.4%) transcatheter duct occlusion and 1 (0.5%) balloon valvuloplasty. The mean
      age of Fallot's Tetralogy repair was 6.4 years. No corrective surgery was
      performed for patients with complex cardiac lesions from the 4 hospitals in 1995.
      In conclusion, the pattern of congenital heart disease was similar to that seen
      world wide. Except for patent arterial duct, access to surgical treatment was
      inadequate.

PMID- 11221154
TI  - The role of preoperative magnetic resonance imaging in internal derangement of
      the knee.
AB  - We attempted to compare the accuracy of our clinical examination and the usage of
      magnetic resonance imaging (MRI) in evaluating patients suspected of having
      internal derangement of the knee who were seen in our Orthopaedic clinic. This
      was done using the findings of arthroscopy as the 'gold standard'. The accuracy
      of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for
      clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to
      48-65% for clinical examination. We thus propose that MRI examination is an
      effective first-line investigation for patients with suspected internal knee
      derangement, especially menisci injuries; allowing arthroscopy to be reserved for
      patients in whom surgery is truly indicated.

PMID- 11221156
TI  - Preferential utilization of healthcare systems by a Malaysian rural community for
      the treatment of musculoskeletal injuries.
AB  - The preferential utilization of healthcare systems by a rural Malaysian community
      in Perlis for the treatment of musculoskeletal injuries was studied using focus
      group discussions. The objectives of the study were to explore the pattern of
      utilization of healthcare systems, the factors influencing the choice of a
      healthcare provider, rural residents' expectations of their healthcare provider
      and their views on integrating traditional and modern scientific healthcare
      systems. Most participants considered traditional and modern scientific
      healthcare systems as complementing each other. For musculoskeletal injuries, the
      traditional system was considered the primary choice of healthcare regardless of
      the participants' socioeconomic and educational levels. Key factors for
      preferring traditional care were the nature of treatment, the perceived shorter
      duration for recovery and inclusion of spiritual elements in the therapy.
      Barriers to seeking hospital treatment were the perceived longer duration for
      recovery, fear of surgery, use of metallic implants and casts that were
      culturally unacceptable and objections from elders. For perceived life
      threatening situations, in children, pregnancy, and where injuries to internal
      organs were suspected, hospital treatment was preferred as the primary choice.
      Discussions on integrating traditional and modern scientific systems were
      inconclusive.

PMID- 11221155
TI  - Blood pressure, body mass index, heart rate and levels of blood cholesterol and
      glucose of volunteers during National Heart Weeks, 1995-1997.
AB  - The paper presents the results of a health screening programme conducted in 10
      major centers in Malaysia--Kuala Lumpur, Penang, Ipoh, Johor Bahru, Alor Star,
      Kuala Terengganu, Malacca, Kota Bahru, Kuching and Kota Kinabalu during the
      National Heart Weeks, 1995-1997. There were 6,858 participants of both sexes aged
      between 6 years to 81 years old. The parameters involved in the screening
      programme were body mass index, blood pressure, heart rate, cholesterol and
      glucose. The following are the results of the study:- 1. The mean and standard
      deviation for the body mass index (BMI), systolic blood pressure (SBP), diastolic
      blood pressure (DBP), heart rate (HR), total cholesterol (TC) and non fasting
      (random) blood glucose (GL) of the volunteers studied were 24.3 +/- 4.0 kg/m2,
      128.3 +/- 21.1 mmHg, 79.6 +/- 11.9 mmHg, 77.2 +/- 12.1 bpm, 5.33 +/- 1.37 mmol/l
      and 5.11 +/- 1.97 mmol/l respectively. 2. There was a rising trend for BMI, SBP,
      DBP, TC and GL with age. The HR was higher in the younger age group of those
      below 20 years. Males tended to have higher mean values than females except for
      HR which was similar in both sexes. 3. The Malays, Chinese and Indians seemed to
      have closely similar mean values for SBP, DBP and HR but the Indians possessed
      the highest BMI (25.62 +/- 3.90 kg/m2), TC (5.61 +/- 1.48 mmol/l) and GL (5.41 +/
      2.43 mmol/l) among the three major ethnic groups. While the Ibans had highest TC
      (6.07 + 1.09 mmol/l), their GL level was the lowest (4.76 +/- 1.15 mmol/l). The
      Kadazans had the lowest TC level (4.94 +/- 1.39 mmol/l) among all the ethnic
      groups. 4. Among the participants screened, 31.9% were overweight (BMI > or =
      25), 7.6% were obese (BMI > or = 30); 26.8% had raised SBP (> or = 140 mmHg) and
      19.3% had raised DBP (> or = 90 mmHg); 13.6% of the participants had increased HR
      (> or = 90 bpm), 22% had raised TC (> or = 6.20 mmol/l) and 2% had raised GL (>
      or = 11.00 mmol/l). There was a higher prevalence for abnormal values with
      increasing age until between the ages of 60 or 70 years, when the values began to
      fall. 5. Age was positively correlated with SBP (r = 0.41***, df = 4351), DBP (r
      = 0.27***, df = 4351), TC (r = 0.22***, df = 3303) and GL (r = 0.16***, df =
      2442) but negatively correlated with HR (r = -0.13***, df = 4351). The BMI was
      positively correlated with SBP (r = 0.29***, df = 2769), DBP (r = 0.31***, df =
      2769), TC (r = 0.16***, df = 2137) and GL (r = 0.11**, df = 1637) but there was
      no correlation with HR (r = 0.03NS, df = 2771). The SBP and DBP were highly
      correlated with each other (r = 0.75***, df = 4351) and they also showed highly
      significant positive correlation (r = 0.08***-0.13***, df = 2441-3301) with TC
      and GL. TC was positively correlated with GL (r = 0.05* df = 2319) but only at
      the 5% probability level.

PMID- 11221157
TI  - Neurological manifestations of children with systemic lupus erythematosus.
AB  - In a cross-sectional study of 21 children with Systemic Lupus Erythematosus, 15
      (71%) were found to have neuropsychiatric manifestations. The most common finding
      was generalised seizures (42.8%) followed by encephalopathy (19%) and
      hallucinations (19%). One child (4.76%) had hemichorea. In 3 children
      neurological manifestations were the first symptom of SLE. Computerised Axial
      Tomograms (CAT scans) showed cerebral atrophy in 7 of 12 scans available for
      review. Ten children had abnormal EEGs. Although none of the children had
      clinical evidence of a peripheral neuropathy, 8 had neurophysiological evidence
      of a neuropathy. One child died of intracranial haemorrhage. Six children had
      residual neuropsychiatric sequalae.

PMID- 11221158
TI  - The yield for colorectal cancer and adenoma by indication at colonoscopy.
AB  - Colonoscopy is an integral part of the clinician armamentarium in the diagnosis
      of colorectal cancer and its precursor, the adenoma. Polypoid lesions when
      identified can be excised at colonoscopy and in turn reduce the risk of
      colorectal cancer. We prospectively evaluated the yield of colorectal cancer and
      adenomatous polyps by indication for colonoscopy over a one-year period. A total
      of 375 colonoscopies were carried out. The more common indications of colonoscopy
      were rectal bleeding, abdominal pain, surveillance of colorectal cancer and
      altered bowel habit. The highest yield for cancer was for rectal bleeding with
      12.5% while surveillance of patients with a history of polyps yielded the highest
      percentage of new polyps. We conclude that rectal bleeding as an indication for
      colonoscopy yielded the highest number of cancers.

PMID- 11221159
TI  - Transradial coronary angioplasty and stenting--immediate results and 3-month
      clinical follow-up in the first 50 patients performed at the National Heart
      Institute.
AB  - AIM: To explore the safety and feasibility of coronary angioplasty and stenting
      via the radial artery in a heterogenous group of patients and to report the
      immediate and 3-month clinical follow-up. BACKGROUND: The use of the transradial
      approach for coronary angiography was first described by Lucien Campeau in 1989.
      Based on the favourable initial results, this technique has gained widespread
      acceptance worldwide. Ferdinand Kiemeneij's work in transradial angioplasty and
      stenting has taken invasive cardiology into the exciting new era of "minimally
      invasive coronary intervention". METHODS AND RESULTS: Fifty consecutive patients
      underwent Transradial Percutaneous Transluminal Coronary Angioplasty (PTCA) with
      or without stenting from mid March 98-December 98. The right radial approach was
      utilised in 41 patients (80%) while the left in 9 patients. Ninety percent of the
      procedures was done on an adhoc basis. Diabetes mellitus was present in 38% of
      patients. Eighty percent of patients had unstable angina pectoris and 60% had a
      prior history of acute myocardial infarction. The commonest vessel involved was
      the LAD (51%) and type B lesions predominated (54%). PTCA was successful in 96%.
      One patient had a total LAD occlusion, which could not be wired, and another
      developed severe spasm during catheter manipulation. The latter had successful
      PTCA via the right femoral route Stents were utilised in 57% of patients. The
      commonest indication for stenting was suboptimal PTCA results (89%) and
      dissection (14%). There was no stent embolisation and all stents were
      successfully deployed (100%). One patient developed acute stent thrombosis
      necessitating repeat PTCA and another patient sustained an acute anteroseptal
      myocardial infarction 5 days post procedure as a result of subacute stent
      thrombosis and died. Two patients had successful primary PTCA. There was no
      bleeding or vascular complications. 60% of patients were treated on an outpatient
      basis. At 3-months follow up, 1 patient required CABG's for disease progression.
      Three patients had absent radial pulses without adverse consequence. No patient
      required repeat PTCA at follow up. CONCLUSION: In summary, adhoc PTCA and
      stenting is safe and feasible in our patient population. A study on the cost
      effectiveness of the procedure compared to conventional femoral PTCA is
      warranted.

PMID- 11221161
TI  - The health care professional's attitudes towards brain death and cadaveric organ
      transplantation: the influence of cadaveric donor and transplantation programs--a
      Malaysian survey.
AB  - One of the main reasons for poor response in organ donation is the lack of
      positive attitudes and knowledge present in health care professionals. Definite
      legislation, policies and programmes dealing with brain death and cadaveric organ
      transplantation have shown some favourable results in terms of increasing donor
      rates. These programmes are mainly Western based; therefore adopting such
      programmes to be used locally may not be adequate or proper. To address this
      issue, we decided to carry out a questionnaire in two tertiary hospitals in
      Malaysia, one with a well establish brain death and cadaveric organ
      transplantation programme and one with none.

PMID- 11221160
TI  - Intrahepatic stones: the UKM experience.
AB  - Intrahepatic stones remain a major source of morbidity and mortality. With
      improving techniques in hepatobiliary surgery, the management and the outcome of
      intrahepatic calculi is reviewed. Forty-nine cases referred from all over
      Malaysia between January 1993 to June 1996 were analyzed retrospectively. There
      were thirty-two females and seventeen males. The median age was 46 years. Biliary
      diseases encountered in association with intrahepatic calculi included benign
      strictures (n = 14), ascariasis (n = 3), cholangiocarcinoma (n = 1), Caroli's
      disease (n = 1), and thalassaemia, (n = 1), fifty-six percent of stones were
      located in both the intrahepatic ducts while 34% were found in the left
      intrahepatic duct. Thirty-one patients underwent common bile duct exploration
      either alone or in combination with liver resection or bilioenteric anastomosis.
      Despite the various combinations of surgical and non-surgical intervention 28
      (57.1%) patients had residual stones. Despite the availability of newer
      techniques in hepatobiliary surgery, residual stones were common, resulting in
      higher treatment costs.

PMID- 11221162
TI  - A study of clinical questions in primary care.
AB  - This is a prospective study of clinical questions generated in primary care
      consultations and a comparison of two approaches to answering those clinical
      questions. Twenty-one doctors in a university-based primary care clinic submitted
      78 clinical questions arising from patient consultations during 24 clinic days
      (0.01 question per patient encounter). These doctors subsequently found answers
      to 40% of their questions but were satisfied with only 67% of these answers. The
      investigators were able to provide answers for 95% of the questions asked and the
      doctors rated these answers as satisfactory in 86% of instances. Answers obtained
      by investigators had significantly higher satisfaction score than those obtained
      by doctors' search (p = 0.002). The two main findings of this study are (1)
      almost all questions arising in clinic setting could be answered by intensive
      search; (2) answers found by intensive searches were judged to be more
      satisfactory than those found routinely by doctors. Provision of an information
      retrieval service in addition to training in the searching and appraisal of
      medical literature are possible solutions to the information needs of busy
      clinicians.

PMID- 11221163
TI  - Combined oral and parenteral iron chelation in beta thalassaemia major.
AB  - Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too
      expensive and cumbersome for long term compliance. The efficacy and tolerability
      of the oral chelator deferiprone, and the effects of using a combination therapy
      in our patients were studied. Ten patients completed the study and the mean serum
      ferritin reduced from 7066.11 ug/L (2577-12,896 ug/L) to 3242.24 ug/L (955-6120
      ug/L). The liver iron concentration did not show a significant drop (19.6 vs 18.2
      mg/g dry weight) although 3 patients showed reductions ranging from 30-40%.
      Concomitant use of desferrioxamine increased the urinary excretion from a mean of
      13.66 mg/day to 27.38 mg/day. Main side effects seen were nausea and rashes.

PMID- 11221164
TI  - Upper gastrointestinal bleeding in Kuala Lumpur Hospital, Malaysia.
AB  - Despite advancements in endoscopy and pharmacology in the treatment of peptic
      ulcer disease the overall mortality has remained constant at 10% for the past
      four decades. The aim of this study was to determine the age, gender, racial
      distribution, incidence and causes of endoscopically diagnosed cases of upper
      gastrointestinal (UGI) bleeding to summarise treatments undertaken and to report
      their outcome. A prospective study of UGI bleeding in 128 patients was performed
      in two surgical wards of Kuala Lumpur Hospital, involving both elective and
      emergency admissions. The study group comprised of 113 (88.2%) males and 15
      (11.7%) females. The mean age was 51.9 years (range 14 to 85 years) and 37.5% (48
      of 128 patients) were older than 60 years. The Indian race was over-represented
      in all disease categories. Smoking (50.1%), alcohol consumption (37.5%), non
      steroidal anti-inflammatory drugs (NSAIDs) (17.2%), traditional remedies (5.5%),
      anti-coagulants (2.3%) and steroids (0.8%) were among the risk factors reported.
      Common presenting symptoms and signs included malaena (68.8%), haematemesis
      (59.4%) and fresh per rectal bleeding (33.6%). The commonest causes of UGI
      bleeding were duodenal ulcer (32%), gastric ulcer (29.7%), erosions (duodenal and
      gastric) (21.9%), oesophageal varices (10.9%) and malignancy (3.9%). UGI bleeding
      was treated non-surgically in 90.6% of cases. Blood transfusions were required in
      62.6% (67/107) of peptic ulcer disease patients. Surgical intervention for
      bleeding peptic ulcer occurred in around 10% of cases and involved under-running
      of the bleeding vessel in most high risk duodenal and gastric ulcer patients. The
      overall mortality from bleeding peptic ulcer disease was 4.7%. Six patients died
      from torrential UGI haemorrhage soon after presentation, without the
      establishment of a cause. Active resuscitative protocols, early endoscopy, more
      aggressive interventional therapy, early surgery by more senior surgeons,
      increasing intensive care unit beds and more active participation of
      multidisciplinary teams in co-ordinating management are among remedial measures
      advocated. Broader educational preventive strategies should target the causes of
      UGI bleeding.

PMID- 11221165
TI  - Blood pressure values in healthy Malaysian children aged 6-12 years.
AB  - Blood pressure examination was done manually in 1756 healthy school children aged
      6-12 years. Korotkoff 1 represented the systolic blood pressure (SBP) and
      Korotkoff 5 was taken as the diastolic blood pressure (DBP). Blood pressure
      percentile charts were then drawn up based on age group and sex regardless of
      ethnicity. There was a significant correlation between both SBP and DBP to
      increasing height, weight and body mass index.

PMID- 11221166
TI  - Successful pregnancy in a patient with familial sea-blue histiocyte syndrome.
AB  - A 27-year-old Indian woman at 23 weeks' gestation presented with decompensated
      liver cirrhosis, coagulopathy, restrictive lung disease with cor pulmonale and
      preeclampsia. She was diagnosed to have sea-blue histiocyte syndrome (SBHS) at
      the age of 13 years and was treated conservatively. There was worsening liver,
      respiratory and bone marrow function as the pregnancy progressed. She underwent a
      successful pregnancy despite her poor medical condition and advanced disease
      state. We described the first case of familial SBHS in a pregnant patient from
      Asia.

PMID- 11221168
TI  - Resection of large primary chest wall chondrosarcoma with reconstruction: 2 case
      reports.
AB  - We report two cases of large chest wall primary chondrosarcoma, one of the
      sternum and the other of the lateral chest wall. Both were treated by radical
      resection and reconstruction using marlex mesh and methyl methacrylate "sandwich"
      prosthesis and pedicled latissiumus dorsi flap.

PMID- 11221167
TI  - Transient hyperthyroidism following L-asparaginase therapy for acute
      lymphoblastic leukemia.
AB  - The effect of L-asparaginase on the thyroid gland has not been well documented.
      We report the first two cases of hyperthyroidism associated with thyroid nodule
      following L-asparaginase therapy for acute lymphoblastic leukemia (ALL). The
      thyroid function abnormalities were not severe, short-lived and did not require
      specific therapy.

PMID- 11221169
TI  - Pneumonia presenting as acute abdomen in children: a report of three cases.
AB  - From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic
      Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with
      lung collapse secondary to pneumonia. The dominant initial clinical presentation
      in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two
      cases post-operatively after surgical contributory causes were excluded intra
      operatively. Thoracotomy, evacuation of infected debris and decortication of the
      collapsed lung was done in all three cases. In children presenting with acute
      abdominal pain, basal pneumonia should be considered as a possible contributory
      cause.

PMID- 11221171
TI  - Life threatening pancreatitis following varicella vaccination: cause, association
      or co-incidence?

PMID- 11221170
TI  - Neuropsychiatric profile of a case of post traumatic stress disorder following an
      electric shock.
AB  - Exposure to extraordinary stressors or life-threatening events has been shown to
      result in negative cognitive, behavioural and emotional outcomes including the
      cluster of symptoms constituting Post Traumatic Stress Disorder (PTSD). This
      disorder has most often been studied in military veterans and victims of abuse
      who also show high rates of comorbid conditions. We report a case of PTSD
      following an electrical injury in a patient with no past psychiatric history.
      Implications for a full range of examinations including comprehensive
      neuropsychiatric testing are discussed. Results suggest that such approach
      addresses the complexity of a differential diagnosis between organic and
      psychiatric dysfunctions.

PMID- 11221173
TI  - Faculty matters. Rose Ann Dimaria.

PMID- 11221172
TI  - Primary pulmonary hypertension. World Health Organization.
AB  - Primary pulmonary hypertension (PPH) is a rare disease. The annual incidence in
      the West is 1-2 cases per million population per year. A recent WHO symposium in
      1998 has produced a consensus on classification, methods of screening, risk
      assessment and treatment. PPH is a diagnosis of exclusion after all other
      secondary causes of pulmonary hypertension are ruled out. Current treatment
      strategy involves acute vasodilator drug trial where positive responders are
      treated with high dose calcium channel blockers and anticoagulation. Those who do
      not show positive response may be commenced on intravenous prostacyclin. Surgical
      treatment is one option for patients with severe PPH or for symptomatic relief.
      Prognosis in general is very poor.

PMID- 11221174
TI  - Why women and men choose nursing.
AB  - The purpose of this study was to compare and contrast why women and men choose
      nursing. Male and female nursing students enrolled in a baccalaureate nursing
      program at every class level were interviewed over a two-year period. The
      interviews enabled the subjects to give voice to their motivations, needs, and
      expectations. Data were obtained and analyzed using grounded theory methodology.
      The analyses, performed both by the author and by a second intercoder, included
      constant comparison with substantive and categorical coding for the purpose of
      theory generation. While male and female students demonstrated comparable
      commitment to care for their patients, differences emerged within the construct
      of power. In addition, there was a strong contrast between male and female
      students regarding practical motivations for choosing nursing (e.g., salary and
      working conditions).

PMID- 11221175
TI  - Building roads with a clear vision and a wide perspective.

PMID- 11221176
TI  - Partnerships in primary health care. A process for re-visioning nursing
      education.
AB  - This article describes the process of curriculum change in a baccalaureate
      nursing program and the design of a competency-oriented learning system in
      primary health care, community-focused nursing education.

PMID- 11221177
TI  - Community partnership. A school of nursing creates nursing centers for older
      adults.
AB  - A southeastern university school of nursing responded to a request by a local
      housing authority to provide nursing care and health promotion to the residents
      of three high-rise complexes for independent living for seniors. This service
      learning partnership offers differing educational benefits to graduate and
      undergraduate nursing students while helping residents remain as well as
      possible.

PMID- 11221178
TI  - A proposed framework for differentiating the 21 Pew competencies by level of
      nursing education.
AB  - Now nearly a decade old, the original Pew Health Professions Commission
      Competencies have stood up well to the test of time. The competencies were
      designed to provide all health professionals, from physicians to physical
      therapists, with a general guide to the values, skills, and knowledge they would
      need to be successful in the health care system that was beginning to emerge in
      the late 1980s. They have been used across the range of health professions and in
      many practice settings to create a framework for curricular change, work
      redesign, and assessment of professional competence. The interpretation of the
      competencies offered here should prove to be a useful tool to nurses and health
      system leaders as they carry on the hard work of adapting the current model of
      nursing practice to the demands and realties of the contemporary and continually
      evolving health care environment. This work is important for two reasons. First,
      many of the skills and attributes of the professional nurse are not adequately
      used or valued by the health care system because the profession is both
      fragmented and poorly differentiated and articulated. Without markers that define
      and promote collaborative practice within nursing, the full potential of nurses
      at all levels of preparation will continue to be inadequately and inappropriately
      deployed. This model exacerbates the current nursing shortage because it fails to
      use nurses in appropriate, well-delineated, and challenging roles. Without this
      kind of differentiation, one that can be owned and supported by all nurses, there
      will continue to be suboptimal use of the nursing workforce in the United States.
      The framework of differentiated Pew competencies and the companion teaching
      learning strategies proposed here offer one approach to rationalizing both
      nursing education and practice, with the potential for improving the quality of
      care, and reducing fragmentation, cost, and public confusion.

PMID- 11221179
TI  - Listen to your students.

PMID- 11221180
TI  - Why accreditation? Quality care is everyone's responsibility.

PMID- 11221181
TI  - What is the relationship of collegiality to accreditation.

PMID- 11221182
TI  - Weekly rounds.

PMID- 11221183
TI  - The advancement of baccalaureate and graduate nursing education: 1952-1972.

PMID- 11221184
TI  - Drug treatment of neuropathic pain.
AB  - Neuropathic pain results from damage to or dysfunction in the nervous system. The
      term usually refers to pain caused by a primary abnormality in the peripheral
      nervous system, while pain caused by damage to the central nervous system tends
      to be called central pain. Once established, neuropathic pain frequently runs a
      chronic course and can be severe and difficult to treat. Most doctors (but
      especially GPs, neurologists, neurosurgeons, oncologists and pain clinic
      specialists) will encounter patients with neuropathic pain. Management, ideally
      in a multidisciplinary pain-relief clinic, often involves the combined use of a
      range of pharmacological and non-drug approaches, the latter including
      transcutaneous electrical nerve stimulation, psychological treatments, and
      specialist procedures to stimulate, block or destroy discrete areas of the
      nervous system. Here, we review just the drug treatments for neuropathic pain.

PMID- 11221185
TI  - Why bother about cytochrome P450 enzymes?
AB  - The cytochrome P450 system is a group of enzymes, found mainly in the liver and
      gut mucosa, that controls the concentrations of many endogenous substances and
      drugs. The activity of the individual enzymes can vary over time and from person
      to person in response to diet, medicines or exposure to environmental pollutants.
      Here, we review the cytochrome P450 system and consider its relevance to
      prescribing.

PMID- 11221186
TI  - Treatment notes--an update.
AB  - In January 2000, we launched Treatment Notes--our series of leaflets for
      patients. By December, we had published 10 issues and were pleased to be able to
      supply a free sample copy of each one with Drug and Therapeutics Bulletin (DTB).
      However, the cost of printing complimentary copies (over 125,000 of each issue)
      has become prohibitive and, for the time being at least, Treatment Notes will
      only be available by order. Here, we review the origin and development of the
      series and explain the changes.

PMID- 11221187
TI  - Tackling polycystic ovary syndrome.
AB  - Up to one-third of women in the UK have polycystic ovaries (i.e. 10 or more
      follicles per ovary detected on ultrasound). An estimated one-third of these
      women have polycystic ovary syndrome, usually defined in the UK as polycystic
      ovaries together with one or more characteristic features (hirsutism, male
      pattern baldness, acne, oligomenorrhoea or amenorrhoea, obesity, or raised serum
      concentrations of testosterone and/or luteinising hormone [LH]). The metabolic
      abnormalities often associated with polycystic ovary syndrome (insulin resistance
      and abnormal serum lipid concentrations) also put some women with the syndrome at
      increased risk of developing diabetes mellitus. Here, we review the management of
      women with polycystic ovary syndrome.

PMID- 11221188
TI  - What to do about medically unexplained symptoms.
AB  - Around one in five new consultations in primary care are by patients with
      physical symptoms for which no specific organic cause is found (medically
      unexplained symptoms). While many of these symptoms are transient, over one-third
      persist and can cause distress and disability. Here, we discuss strategies for
      the management of adults with medically unexplained symptoms.

PMID- 11221189
TI  - [Prevention and rehabilitation instead of hospitalization and treatment].

PMID- 11221190
TI  - [Nursing research has patients and nurses in view].

PMID- 11221191
TI  - [Nurses as movers in a successful interdisciplinary cooperation].

PMID- 11221192
TI  - [Well founded knowledge in gerontology and social rules are the basis of
      geriatric nursing].

PMID- 11221193
TI  - [Managing chronic pain. Relieving pain by relaxation].

PMID- 11221194
TI  - [The patient is rarely informed about his examination and care].

PMID- 11221195
TI  - [Latex allergy is occurring ever more often].

PMID- 11221196
TI  - [Living in darkness--treating the blind].

PMID- 11221197
TI  - [Fire safety in hospitals: 26 questions to the fire fighters].

PMID- 11221198
TI  - [Diagnosis Related Groups inspire multiprofessional patient care team].

PMID- 11221199
TI  - [Managing ever growing demand for supervisory leading personnel].

PMID- 11221200
TI  - [Women, leaving school, considering the nursing profession].

PMID- 11221201
TI  - [Criticism is often hidden behind friendliness].

PMID- 11221202
TI  - [Voice of nurses from all over the world].

PMID- 11221203
TI  - [Where nursing services still are missing].

PMID- 11221204
TI  - [Reflections on phenomenological research in nursing].
AB  - This essay is concerned with the question which philosophical traditions underpin
      the phenomenological perspective in nursing research. The word phenomenology is
      often used synonymously on the level of the theory of science as well as on the
      level of research methods. Besides the similarity in the designation of
      phenomenology as a philosophical tradition and as a research method, there are to
      be found a number of terms in the nursing literature, such as hermeneutic,
      interpretive or interpretative phenomenology. Therefore it is hard to
      differentiate between the various accounts and to use them for a concrete inquiry
      in nursing. The differences and the resulting consequences for phenomenological
      research methods shall be described whereby the ideas of Edmund Husserl and
      Martin Heidegger are taken into account.

PMID- 11221205
TI  - [The care of adults in persistent vegetative state--a new challenge to nursing
      science?].
AB  - German scientists assume that new problems in nursing practice can be credited to
      an increasing number of accident-based long-term handicaps (Robert Bosch Stiftung
      1996). This hypothesis is supported by epidemiological data as elaborated in the
      following article. Furthermore the critical examination of the terms "apallic
      syndrome" and "persistent vegetative state" leads up to the question which
      medical assumptions in relation to the phenomenon of the apallic syndrome are
      transferred to nursing. According to Feuser (1995) and for noted reason the
      medical perspective on the apallic syndrome appears to be similar to what can be
      observed in the practice of psychiatric care. This inheritance of medicine offers
      a new challenge to the nursing discipline which consequently will have to
      strengthen the own science.

PMID- 11221206
TI  - [Nursing relevance of the bases of the concept of Salutogenesis].
AB  - The objectives of nursing are closely tied with the meaning of health. This means
      for the development of nursing science to come to an understanding of new
      concepts of health which have been developed in health sciences recently.
      Therefore the model of Salutogenese is presented. The author discusses the key
      concepts like the health-disease-continuum, the sense of coherence and the
      generalized resistance resources in regard to relevance for nursing in theory and
      practise.

PMID- 11221207
TI  - [Advanced and continuing education is an important indicator of professional
      satisfaction in nursing].
AB  - The subject of this quantitative study is the job-satisfaction of nursing staff
      at the Freiburg Tumorbiology Clinic. The aim was to identify factors which
      influenced job-satisfaction. Originally 127 questionnaires were distributed and
      the final evaluation was based on 89 completed returns. With the information,
      using factor analysis, we identified nine factors. One of the factors, continuing
      education was interpreted and evaluated in detail. The results showed that in
      general women including managers and supervisors have a more positive attitude
      toward further training than men. The data could not confirm if a positive
      attitude toward training positively influenced job-satisfaction or that a prior
      satisfaction with the job leads to a positive attitude towards training. What is
      clear is that continuing education enables employees to be more competent and
      handle more responsibility. From the point of view of both the employees and
      employers it is necessary to have constantly updated knowledge to ensure highest
      quality of nursing care.

PMID- 11221208
TI  - [Long-term job satisfaction in direct nursing care].
AB  - In this study the qualitative method of grounded theory was employed to
      investigate what enables nurses to work long-term in direct nursing care and
      being satisfied. This question is of actual importance in the present situation
      of rising costs in the health care system and increasing work pressure for the
      nursing staff. Five nurses with at least ten years of work experience
      participated in seven interviews. Data analysis revealed coping with difficulties
      as the core concept. All respondents had to deal with difficult situations in
      their daily working routine, which occasionally have been experienced as
      overwhelming. Important conditions for coping with difficulties are the personal
      development, the cooperation with others and the taking care of oneself. If this
      can be done successfully, it is possible to take over central responsibilities in
      nursing care, to act in a competent and purposeful way, and to care for others,
      which is a condition for long-term job satisfaction. The focuses described in the
      literature--cooperation, engagement and coping with stress--were found as central
      contents in this investigation. The findings for the most part are congruent with
      the results of other studies. The implications for practice focus on working
      conditions and possibilities of support, which help nurses to deal with the
      difficulties encountered in their daily work.

PMID- 11221209
TI  - [Reliability and validity of the Braden Scale for predicting pressure sore risk].
AB  - For more accurate and objective pressure sore risk assessment various risk
      assessment tools were developed mainly in the USA and Great Britain. The Braden
      Scale for Predicting Pressure Sore Risk is one such example. By means of a
      literature analysis of German and English texts referring to the Braden Scale the
      scientific control criteria reliability and validity will be traced and
      consequences for application of the scale in Germany will be demonstrated.
      Analysis of 4 reliability studies shows an exclusive focus on interrater
      reliability. Further, even though examination of 19 validity studies occurs in
      many different settings, such examination is limited to the criteria sensitivity
      and specificity (accuracy). The range of sensitivity and specificity level is 35
      100%. The recommended cut off points rank in the field of 10 to 19 points. The
      studies prove to be not comparable with each other. Furthermore, distortions in
      these studies can be found which affect accuracy of the scale. The results of the
      here presented analysis show an insufficient proof for reliability and validity
      in the American studies. In Germany, the Braden scale has not yet been tested
      under scientific criteria. Such testing is needed before using the scale in
      different German settings. During the course of such testing, construction and
      study procedures of the American studies can be used as a basis as can the
      problems be identified in the analysis presented below.

PMID- 11221210
TI  - [The institutionalized elderly. How do we perceive old age?].
AB  - It is a commonly-held belief to associate old age with physical deterioration,
      loss of mental capacity and a downhill slide toward death. Although one cannot
      deny some aspects of truth in this belief, what is certain is that the perception
      which each person holds about old age, as well as each person's real life
      situation, will make each individual live this stage of life in very diverse
      manners. We may affirm that quality of life is a criteria set and evaluated by
      each human being, and in order to evaluate it, one's personal opinion and
      satisfaction are indispensable. What does quality of life mean for an elderly
      person who is institutionalized? What do the business administrators, managers
      and caretaking personnel understand quality of life to be for an elderly person
      who is institutionalized? Are there differences perceiving quality of life
      between personnel and elderly? The authors carry out this study in order to
      answer these kinds of questions by means of a descriptive and transversal method;
      one objective is to evaluate the perception of quality of life for
      institutionalized elderly held by each of the aforementioned groups. The study
      group for this research project was composed of elderly people living as
      permanent residents in an institution and the business administrators, managers
      and caretaking personnel in three geriatric centers in Navarra; there was a total
      of 90 people in the sample group.

PMID- 11221212
TI  - [Nursing education in the United States].

PMID- 11221211
TI  - [Poisoning by organophosphate insecticides. Epidemiology and prevention].
AB  - In an agrarian environment, exposure to anticholinesterasic insecticides is a
      potential health problem. Acute or chronic intoxication may cause serious health
      problems due to its frequency or its severity. Extremadura is, as are other
      Spanish autonomous regions, mainly a rural environment which means that this
      problems carries special relevance there. In this article, the authors evaluate
      the number of cases of intoxication, the validity of the measures taken, and they
      describe the pedagogical programs which exist dealing with this problem. They
      review the physiopathological causes of this intoxication, its symptoms and its
      treatment. The authors reveal the results obtained from a questionnaire given to
      a group of Extremaduran farmers. Furthermore, the authors provide information to
      health professionals responsible for the treatment and prevention of this
      intoxication; the authors consider health education, especially in an agrarian
      environment, to be one of the most important action plans in order to prevent
      this intoxication and to reduce its mortality and chronic manifestations due to
      exposure to these agents.

PMID- 11221213
TI  - [Neutralization of odors in colostomized patients. (multicenter study)].
AB  - The purpose of this study is to run a comparative, multi-centric study as a way
      to research and test two odor neutralizing agents having distinct forms, capsules
      or liquids. The objective is to identify an odor neutralizing agent which brings
      a solution to an as yet unsatisfactorily resolved problem, by this means
      providing greater security and discretion to a patient having undergone a
      colostomy and increasing that patient's quality of life. This study concludes
      that the capsule neutralizing agent appears to be the most desired treatment form
      both in the opinion of those having undergone a colostomy as among the
      researchers due to its efficiency and ease of use.

PMID- 11221214
TI  - [Professional unemployment in Andalucia. Expectations and difficulties in the
      nursing profession].
AB  - The primary objective of this article is to know the professional, academic and
      formative expectations in Nursing and those problems which hinder the performance
      of this profession among the Andalucian public health centers. The authors
      carried out an extensive descriptive study during the years 1994-1996 based on a
      sampling of 1020 nursing professionals pertaining to the Andalucian Health
      Service. These samples were obtained by means of a random stratification by
      provinces and care level, with an affixation proportional to the size of the
      stratum, having a 95% confidence rate and a 3.5% error rate. The data were
      acquired by means of a self-administered questionnaire sent in by mail. Among the
      most significant results, the authors highlight that fact that the professional,
      academic and performance expectations among Andalucian Nursing professionals
      center on research and investigation (71.5%), postgraduate courses (75%),
      possible Licentiate in Nursing (82.4%) and some nursing specialty (78.7%). Among
      the difficulties identified for professional performance, the items which stands
      out were those derived from the absence of a legal definition for Nursing
      functions (90.8%).

PMID- 11221215
TI  - [Cardiotocographic recording during labor: problems and alternatives].
AB  - Over the past few years there has been a notable decrease in fetal morbid
      mortality due to intrauterine asphyxia. Currently there is a controversy about
      the role which electronic monitoring of uterine contractions and of fetal cardiac
      frequency during birth has played in the aforementioned decrease. The frequent
      nonspecificness and/or the subjectivity in interpreting these recordings, coupled
      with the risk of reducing the direct contact with the mother, are a few of the
      limitations which can reduce the efficiency of electronic monitoring. Various
      complementary fetal control methods, some of which in current clinical usage such
      as fetal scalp pH, fetal EKG, fetal pulsimeter readings, doppler flux metering,
      or vibra-acoustic stimulation and others which are undergoing testing such as
      infrared spectroscope can increase the predictive efficiency of electronic
      monitoring. Some of the ideas included in this article were presented in the VII
      Course for "New Perspectives in Obstetrics and Gynecology" held in Salamanca.

PMID- 11221216
TI  - [Nursing concept for AIDS patients].

PMID- 11221217
TI  - [Improving the nursing process is in the interest of most nurses].

PMID- 11221218
TI  - [Palliative care: improving quality of life instead of prolonging suffering].

PMID- 11221219
TI  - [Nursing of patients with chronic pain. I. To understand, evaluate and fight
      pain].

PMID- 11221220
TI  - [Pain in hospitalized tumor patients: not to be taken lightly].

PMID- 11221221
TI  - [Financing hospital costs: nursing services must be taken into account].

PMID- 11221222
TI  - [What does the introduction of the DRG system mean to hospitals].

PMID- 11221223
TI  - [Psychological aspects of fighting stress: activity and relaxation must be well
      balanced].

PMID- 11221224
TI  - [Burnout in the nursing profession: there is help in burnout].

PMID- 11221225
TI  - [Nursing of AIDS patients: reflexions on home care of stress].

PMID- 11221226
TI  - [Nursing duties in suicide prevention: the patient has right to freedom].

PMID- 11221227
TI  - [Death with dignity in the old age home: consideration for the needs of demented
      patients].

PMID- 11221229
TI  - [Aging and physical activity].

PMID- 11221228
TI  - [Nutrition and physical capacity in the aged].

PMID- 11221230
TI  - [Physical activity and aging in the Auvergne region].

PMID- 11221231
TI  - [Equilibrium in the aged, the Troyes experience].

PMID- 11221232
TI  - [Light exercise].

PMID- 11221233
TI  - [Dietetics. Milk, yogurt and cheese].

PMID- 11221234
TI  - [What is the priority for the aged living in an institution?].

PMID- 11221235
TI  - [Physical activity at advanced age].

PMID- 11221236
TI  - [Water--source of health and wellbeing of the aged].

PMID- 11221237
TI  - [New face of the nursing profession in the world, psycho-medical assistance].

PMID- 11221239
TI  - [Impact of physical activity on mental and physical health in the aged].

PMID- 11221238
TI  - [Aging and physical capacity].

PMID- 11221240
TI  - [Nursing care. Keeping and treating elderly incontinent patients at home].

PMID- 11221241
TI  - [Low-friction intermittent urinary catheterization].

PMID- 11221242
TI  - [United kingdom, distinction between the actual role of nurses and their
      professional recognition].

PMID- 11221243
TI  - [Nursing strategy: 10 commandments for better care of leg ulcer].

PMID- 11221244
TI  - [Home care, the nursing network].

PMID- 11221245
TI  - [Reflexions on the quality of life in palliative care].

PMID- 11221246
TI  - [Following the patient and his nurses].

PMID- 11221247
TI  - [End of life at the hospital, psychological questions].

PMID- 11221248
TI  - [Mutual protection, a curb in communication].

PMID- 11221249
TI  - [Nursing strategy: touching and the end of life].

PMID- 11221250
TI  - [Nursing care and spiritual needs of the patient at the end of life].

PMID- 11221251
TI  - [Nursing care: palliative care in specialized geriatric nursing].

PMID- 11221252
TI  - [The globule diameter and various electron and conformational properties of the
      flavoprotein fragment of mitochondrial NADH dehydrogenase studied by fluorescence
      spectroscopy].
AB  - The globule dimensions and some electron and conformational properties of the
      flavoprotein (peripheral) fragment of the mitochondrial NADH dehydrogenase were
      determined by the time-resolved, phase-modulating, and polarization fluorescence
      spectroscopies, as well as correlated confocal microscopy. The rotational and the
      diffusion (translocation) diameters of the protein fragment were shown to be no
      less than 44 A and approximately 72 A, respectively. The diameter of
      protomitochondrial particles from the bovine heart, which were used for the
      isolation of the fraction of peripheral fragments, was no less than 2300 A. The
      fluorescence from tryptophan and flavin fluorophores in the fragment is strongly
      quenched by iron of the iron-sulfur clusters, which suggests that a strong
      electron-vibrational interaction of iron with Trp residues and flavin takes
      place. An overlapping of the electron clouds of iron-sulfur clusters, Trp
      residues, and flavin is likely to facilitate the electron transfer through the
      protein. The heat inactivation of the enzyme was accompanied by neither its
      substantial conformational changes, nor a considerable release of iron ions from
      the clusters located near the Trp residues.

PMID- 11221253
TI  - [Cleavage of RNA in hybrid duplexes by ribonuclease H from E. coli. I. Substrate
      properties of complexes formed by RNA and tandem of short
      oligodeoxyribonucleotides].
AB  - We studied the E. coli RNase H cleavage of a 5'-labeled RNA fragment within two
      hybrid duplexes with identical sequences, one of which is formed by RNA and a 20
      mer oligodeoxyribonucleotide (RNA/p20), whereas the second, by RNA and a tandem
      of short oligodeoxyribonucleotides (octanucleotide: (RNA/tandem). It was shown
      that RNA in the RNA/p20 complex is hydrolyzed from the 3'-end to yield
      consecutively the 17-, 14-, 11-, 8-, and 5-mer 5'-labeled fragments. On
      hydrolysis of RNA in complex RNA/tandem, the same products were registered, but
      their accumulation rates in this case differed. Thus, the initial rates of
      accumulation of the 17- and 8-mer were close. Moreover, the accumulation of the
      final 5-mer differed considerably: in the RNA/tandem complex it appeared within
      first minutes of the reaction, but only after a considerable lag period in
      complex RNA/p20. These data testify that the tandem is involved not only in the
      consecutive accumulation of the shortened products (which is characteristic of
      complexes including extended oligonucleotides) but also in the parallel
      accumulation. This results from hydrolysis of each duplex segment formed by RNA
      and the short oligonucleotide of the tandem. Although the order of recognition
      and cleavage of RNA target by ribonuclease H depends on the type of the hybrid
      duplex, the destruction of RNA target within complex RNA/tandem and in complex
      with the full-size oligonucleotide occurs with a close effectiveness.

PMID- 11221255
TI  - [Structure and physiological activity of lemnan, Lemna minor L. pectin].
AB  - A pectic polysaccharide, lemnan, was isolated from freshly collected duckweed
      Lemna minor L. Its sugar chain was shown to be mainly composed of the residues of
      D-galacturonic acid (64%), galactose, arabinose, xylose, and D-apiose, a branched
      chain sugar. The high content of D-apiose (25%) indicated that lemnan is an
      apiogalacturonan type pectin similar to zosteran, a pectic polysaccharide from a
      sea phanerogam of the Zosteraceae family. The results of partial acidic
      hydrolysis, pectinase digestion, and NMR studies of lemnan demonstrated that its
      macromolecule contains regions of the linear alpha-1,4-D-galacturonan and
      branched apiogalacturonan. The side chains of apiogalacturonan were found to be
      formed of single and 1,5-linked residues of D-apiofuranose attached to 2- and 3
      positions of the D-galacturonic acid residues of the apiogalacturonan backbone.
      Lemnan was shown to exhibit an immunomodulatory effect by activating the system
      of phagocytosis.

PMID- 11221254
TI  - [Polymethylene derivatives of nucleic bases with omega-functional groups.
      Pyrimidine derivatives].
AB  - N1-Acyclic derivatives of pyrimidine bases (uracil, thymine, and cytosine) with
      hydrophobic polymethylene chains containing various functional groups in an omega
      position of the alkyl substituent were synthesized. Their physicochemical
      properties and inhibitory effect on the HIV reverse transcriptase and human DNA
      topoisomerase I were studied.

PMID- 11221256
TI  - [Molecular biology in the year 2000: prediction, realities, and more
      predictions].

PMID- 11221257
TI  - [Molecular biology in the year 2000. 1970].

PMID- 11221258
TI  - [Francis Crick: predictions for the year 2000 (Molecular biology in the year
      2000) were almost absolutely correct].

PMID- 11221259
TI  - [Molecular biology from the year 1970 to 2000 and beyond].

PMID- 11221260
TI  - [F. Crick's predictions are not the only ones worth remembering].

PMID- 11221261
TI  - [Physico-chemical biology in the first quarter of the XXI century].

PMID- 11221262
TI  - [Signal cellular systems and genome].

PMID- 11221263
TI  - [Francis Crick about gene activity regulation research].

PMID- 11221264
TI  - [Molecular immunology--from immunoglobulin genes to artificial antibodies, from
      antibodies to biomedicine].

PMID- 11221265
TI  - [The unlimited complexity of biological systems and the astonishing diversity of
      living organisms will remain the driving force behind physico-chemical biology in
      the first third of the XXI century].

PMID- 11221266
TI  - [Life in dynamics].

PMID- 11221267
TI  - [Molecular biology at the turn of the third millenium].

PMID- 11221268
TI  - [Frontiers of the year 2000 in science and technology].

PMID- 11221269
TI  - [Some comments regarding F. Crick's paper].

PMID- 11221270
TI  - [Effect of S-adenosyl-L-methionine and its analogs on site-specific binding DNA
      (adenine-N6)-methyltransferase from T4 phage to the oligonucleotide substrate].
AB  - Using fluorescence of 2-aminopurine-substituted oligonucleotide duplexes,
      "flipping" of the target base in the process of interaction of T4 DNA-(adenine
      N6)-methyltransferase (EC 2.1.1.72) with the substrate double-stranded DNA was
      revealed. It was shown that S-adenosyl-L-methionine, the methyl group donor,
      induces the reorientation of the enzyme relative to the asymmetrically modified
      recognition site.

PMID- 11221271
TI  - Statins early in acute coronary syndromes.

PMID- 11221272
TI  - Transoesophageal echocardiography: a role for district hospitals?

PMID- 11221273
TI  - Transoesophageal echocardiography: its role in the management of patients in a
      district general hospital.
AB  - The aim of this study was to assess the value of a transoesophageal
      echocardiography (TOE) service in a district general hospital (DGH). A series of
      151 consecutive cases was analysed retrospectively to determine the relative
      additional benefit of TOE over transthoracic echocardiography (TTE) in
      establishing diagnoses and making therapeutic decisions. Of the 151 cases, 140
      were suitable for the two procedures to be compared. In 56%, TOE provided useful
      information for patient management. This consisted of the detection of new major
      findings (33%) and the exclusion of significant abnormalities (23%), suspected
      either clinically or by TTE. TOE made a minor clinical contribution in 8% of
      cases, while in 30% there was concordance between the two studies. Finally, in 6%
      both examinations were inconclusive. We conclude that TOE has a significant
      complementary role to TTE in terms of clinical diagnosis and patient management
      in the DGH setting.

PMID- 11221274
TI  - A cross-sectional survey of the clinical and psychological features of low back
      pain and consequent work handicap: use of the Quebec Task Force classification.
AB  - A hospital-based cross-sectional study examined 657 consecutive referrals with
      low back pain over two years to a district rheumatology service serving a
      population of about 250,000 people. Five hundred and thirty-eight had
      mechanical/degenerative low back pain. The mean age was 48.6 (range 18-80 SD
      15.3) years; 64% were women. Patients with radiating pain or neurological deficit
      (Quebec Task Force classification) were significantly more disabled (Roland
      disability score p < 0.001) and depressed (Modified Zung score p < 0.05) than
      those without radiating pain. Women were more impaired (p = 0.02) than men but
      had similar disabilities (mean Roland score 11.7, range 0-24 SD 6.5). Fifty-three
      per cent of patients were receiving benefits and were significantly more likely
      to have musculoskeletal comorbidities than those in work (p < 0.025). It is
      concluded that the Quebec Task Force classification of low back pain impairment
      is a helpful descriptor and related to both physical and psychological disability
      and handicap in employment.

PMID- 11221275
TI  - A validation study of the Siriraj Stroke Score.
AB  - A cross-sectional study was conducted on 160 Malaysian patients to validate the
      usefulness of the Siriraj Stroke Score (SSS) for differentiating intracerebral
      haemorrhage and infarction following acute strokes. Our results indicate that the
      score lacks sensitivity and specificity. It should thus not be used in
      epidemiological studies to determine stroke types in a community. More
      importantly, in the absence of information from neuroimaging of the brain, it
      cannot be used safely by physicians to assess the need or otherwise of
      thrombolytic and/or anticoagulant therapy after an acute stroke.

PMID- 11221276
TI  - The epidemiology of hysterectomy and irritable bowel syndrome in a UK population.
AB  - The prevalence of hysterectomy in the UK general population has not been
      previously reported. In addition, although it is known that many women with
      irritable bowel syndrome (IBS) have had a hysterectomy, the relationship between
      these two conditions has never been quantified. A random community sample of 2238
      women aged 20-69 from Teesside was surveyed to determine the prevalence of
      hysterectomy and of IBS, the relationship between these and the influence of
      socioeconomic status and consultation behaviour on these variables. We analysed
      data from 1718 women, 13.6% of whom had a hysterectomy, 22.9% had IBS and neither
      condition was related to socioeconomic status. More women with IBS reported
      having had a hysterectomy than did non-sufferers, odds ratio 1.6 (1.1-2.2), p <
      0.01; this association was also unaffected by socioeconomic status and was not
      fully explained by consultation behaviour. This is the first study to determine
      the prevalence of hysterectomy in a UK general population. The procedure is
      common and the excess of hysterectomy among women with IBS is considerable.
      Possible explanations include misdiagnosis of IBS resulting in hysterectomy, IBS
      symptoms occurring as a result of hysterectomy, a single underlying disorder
      which produces symptoms in both gastrointestinal and genitourinary tracts, or a
      combination of these factors.

PMID- 11221277
TI  - Are preoperative serum gastrin levels related to resectability and survival in
      gastric cancer?
AB  - The aim of this study was to determine the correlation between serum gastrin and
      resectability in patients with gastric cancer, and to see whether any difference
      could be demonstrated according to the histologic type and survival. Between 1994
      and 1996 records of 34 consecutive patients with gastric carcinoma serum gastrin
      levels were measured and correlated with age, gender, lymph node positiveness,
      metastasis, Lauren's classification and survival. The mean serum gastrin level of
      patients was 98.38 pg/ml (normal range: 25-125 pg/ml). Twenty-six of 34 patients
      (76.5%) had normal gastrin levels and eight patients (23.5%) had high gastrin
      levels. Sixty-five per cent of patients with normogastrinaemia underwent
      resection with extended lymphadenectomy, while 38% patients with
      hypergastrinaemia underwent extended resection. All the hypergastrinaemic
      patients died within the first year, but in the normogastrinaemic group one, two
      and five-year survival rates were 39%, 23% and 4%, respectively. Even though
      these results are not statistically significantly different in regard to
      preoperative serum gastrin levels, we conclude that preoperative
      hypergastrinaemia is associated with unresectability and poor survival in
      patients with gastric cancer.

PMID- 11221278
TI  - An epidemiological study of falls on integrated general medical wards.
AB  - Reducing falls in hospital requires an environmental as well as a patient
      orientated approach. We studied patient and ward characteristics relating to
      falls in an acute setting. In a prospective open observational study, we examined
      fall characteristics in two nuclear designed wards (A and B) and a longitudinal
      ward (C). We recorded 63 falls among 1609 patients. Ward C had the most falls (31
      vs 18/14; p = 0.01), fall positive days (29 vs 15/10; p = 0.002) and fallers (27
      vs 13/12; p = 0.001; OR 2.54, CI--1.41-4.57). Ward C had a higher cumulative risk
      of falls (p = 0.006) and fall positive days (p = 0.003). Choice of ward was a
      significant independent risk factor for falls (p = 0.01) when controlled for age,
      sex, and diagnostic variation between the wards. Most falls were intrinsic (A
      66.7%, B 64.2%, C 61.3%, p = 0.45). A significantly higher proportion of falls on
      ward C occurred by the bed (p = 0.04). Significant differences exist between the
      wards, and fall reduction programmes should identify and compensate for adverse
      ward-related factors to increase the effectiveness of patient-targeted fall risk
      assessments.

PMID- 11221279
TI  - Myocardial stunning and hibernation in clinical practice.
AB  - Myocardial stunning and hibernation are both clinically important causes of
      myocardial dysfunction and are caused by episodes of myocardial ischaemia.
      Stunning tends to occur acutely and may produce transient but clinically
      important reductions in left ventricular function in the setting of myocardial
      infarction, post coronary artery bypass grafting and even following episodes of
      effort induced angina. Hibernation refers to a chronic down-regulation of
      myocardial function in response to chronic myocardial ischaemia. Hibernating
      myocardium may be present in up to 50% of patients with significantly impaired
      left ventricular function and evidence of heart failure. Importantly, both these
      entities can be either prevented or ameliorated by preventing or lessening
      ischaemic burden. There is also evidence that there may be an overlap between
      these two entities and that hibernating myocardium may result from repeated
      episodes of myocardial ischaemia causing chronic stunning.

PMID- 11221280
TI  - Management of advanced breast cancer with endocrine therapy: the role of the
      primary healthcare team.
AB  - Of the 25,000 new cases of breast cancer annually in the UK, at least half will
      develop metastases at some time. Approximately one-third of these will be hormone
      sensitive and thus suitable for endocrine manipulation. Such patients may live
      for several years. Care should be patient-centred and evidence-based, with
      primary care playing an integral part in the multidisciplinary team. Quality of
      life is paramount, and largely determines decisions to change endocrine therapy.
      Tamoxifen remains the first choice treatment, but newer agents, in particular the
      oral aromatase inhibitors, have successfully extended the range of therapy
      available. Ovarian ablation can be effectively achieved using LHRH analogues,
      which have the advantage of being reversible if ineffective. In future, further
      improvements in outcome are likely with new pure antioestrogens and the
      possibility of sequential or combined use of existing drugs.

PMID- 11221281
TI  - Pharmacology and efficacy of eletriptan for the treatment of migraine attacks.
AB  - Sumatriptan, a 5-HT 1B/1D agonist, was introduced 10 years ago and was the most
      effective therapy for migraine attacks at that time. Eletriptan is a new 5-HT
      1B/1D agonist with high potency and selectivity at 5-HT 1B/1D receptors. It is
      effective in animal models in which the vascular and neurogenic mechanisms
      implicated in migraine were measured. Eletriptan is selective for the
      intracranial blood vessels over other extracranial vasculature, in particular
      coronary arteries. Eletriptan has a rapid and complete oral absorption and a good
      oral bioavailability in migraineurs. In comparative trials 20 mg, 40 mg and 80 mg
      eletriptan, 100 mg sumatritpan and placebo were compared for the treatment of
      migraine attacks. All three doses of eletriptan were statistically superior to
      placebo for headache response and headache-free patients. The 80 mg dose of
      eletriptan was also superior to sumatriptan 100 mg. Headache recurrence, defined
      as return of moderate or severe headache within 24 hours of dosing and following
      a headache response at two hours after initial dosing, occurred in 33% of the
      patients following 100 mg sumatriptan and in 28%, 34% and 32% after 20 mg, 40 mg
      and 80 mg eletriptan. In another large trial, headache response rates were
      significantly higher for both doses of eletriptan (64% for 40 mg and 67% for 80
      mg) than for two doses of sumatriptan (50% for 50 mg and 53% for 100 mg).
      Eletriptan 40 mg or 80 mg was also superior to ergotamine plus caffeine
      (Cafergot). In summary, eletriptan is a highly effective and fast-acting drug for
      the treatment of acute migraine attacks.

PMID- 11221282
TI  - Extracranial arterial aneurysms: a cause of crescendo transient ischaemic
      attacks.
AB  - Crescendo transient ischaemic attacks (TIAs) should be regarded as a medical
      emergency. Patients require hospitalisation with urgent assessment and symptom
      control with anticoagulant therapy. We report on three patients, all of whom had
      atherosclerotic aneurysmal disease of the extracranial arterial circulation who
      presented with crescendo TIAs. The possibility of extracranial aneurysmal disease
      should always be considered and excluded.

PMID- 11221283
TI  - The treatment of extracranial aneurysms of the carotid artery.

PMID- 11221284
TI  - Haemoglobin SC disease presenting with a compartment syndrome secondary to a deep
      vein thrombosis.
AB  - A patient presented with a deep vein thrombosis (DVT), which resulted in a
      compartment syndrome of both the thigh and the calf. Subsequently, the patient
      was found to have haemoglobin SC disease. Prompt fasciotomies were performed;
      however, some muscle and nerve damage was later clinically apparent. This case
      highlights the value of prompt diagnosis of compartment syndrome and the need for
      urgent formal fasciotomies. The case also demonstrates the value of seeking an
      underlying cause for a DVT when none is apparent.

PMID- 11221285
TI  - Solitary calcaneal metastasis in superficial bladder carcinoma.
AB  - We report a case of a solitary calcaneal metastasis in a patient with superficial
      bladder carcinoma. The patient underwent transurethral tumor resection twice
      because of local recurrence. Both histologic examinations revealed a grade 2 PT1
      superficial transitional cell carcinoma of the bladder. The metastasis was
      detected four months after the initial cystoscopy, due to severe leg pain. The
      lesion was curetted and filled with bone cement. A year later, a below knee
      amputation was performed because of local recurrence. This case deserves special
      attention, for two reasons. First, metastatic carcinoma to the bones of the foot
      is very rare. Although bony metastasis by transitional cell carcinoma of the
      bladder can be seen, presenting as a symptomatic solitary lesion after
      superficial bladder carcinoma is extremely unusual. Second, failure to control
      bladder tumours by local means might be an indication for an early cystectomy,
      even in tumours with no evidence of muscle invasion, in order to prevent distant
      metastasis.

PMID- 11221286
TI  - Interferon treatment for thrombocytopenia associated with chronic HCV infection.
AB  - Thrombocytopenia is commonly seen in patients with chronic liver disease, due
      mainly to hypersplenism secondary to portal hypertension. We report a case of
      chronic hepatitis C admitted with thrombocytopenia of unknown cause. The patient
      s symptoms and platelet count improved markedly with interferon treatment. We
      conclude that interferon treatment in chronic C hepatitis may improve HCV-induced
      thrombocytopenia.

PMID- 11221287
TI  - Metastatic tumour of the tunica vaginalis testis from carcinoma of the stomach.
AB  - A 50-year-old man with advanced inoperable gastric adenocarcinoma and diffuse
      peritoneal metastasis received six cycles of palliative chemotherapy and
      responded clinically with weight gain. Two months after the completion of
      chemotherapy, however, he developed a left hydrocele. Aspiration yielded 70 ml of
      yellowish hydrocele fluid, which contained metastatic adenocarcinoma cells,
      consistent with a gastric primary tumour. A diagnosis of malignant hydrocele was
      made. Two weeks later, he developed a painful recurrent left hydrocele with
      increasing pain and swelling. Left orchidectomy was performed. Tiny white mural
      nodules measuring 1 mm in size were noted on the tunica vaginalis. No focal
      lesion was noted in the testis. On microscopic examination, the tunica vaginalis
      showed reactive mesothelial hyperplasia and extensive lymphatic permeation by
      poorly differentiated adenocarcinoma, consistent with a gastric primary tumour.

PMID- 11221288
TI  - Barnidipine: a step towards safer blood pressure control?

PMID- 11221289
TI  - Treatment of hypertension in the very old.
AB  - The objective of this study was to compare the long-term efficacy and safety of 6
      months' treatment with barnidipine and hydrochlorothiazide (HCTZ) as monotherapy
      in patients aged > or = 75 years with mild to moderate essential hypertension.
      This was a randomised, double-blind, dose-titration study performed at 62 centres
      in 8 countries. A total of 397 patients were enrolled. Following a 4 week single
      blind placebo runin, 315 patients with a sitting diastolic blood pressure (SiDBP)
      of 95-115 mmHg and a systolic blood pressure of 150-200 mmHg were randomised to
      receive barnidipine 10 mg (n = 159) or HCTZ 12.5 mg (n = 155) once daily. In
      patients who had not responded (SiDBP > 90 mmHg) after 6 weeks of double-blind
      treatment, the dose was titrated upwards to barnidipine 20 mg or HCTZ 25 mg.
      After 18 weeks, those who did not respond to the higher dose had enalapril (up to
      10 mg once daily) added to their regimen. Statistically equivalent reductions in
      SiDBP were achieved with barnidipine and HCTZ monotherapy. At week 18 of double
      blind treatment on monotherapy, 84% of patients in both groups were responders.
      The addition of enalapril in non-responders produced a further reduction in blood
      pressure. Both drugs were well tolerated. The incidence of drug-related adverse
      events was greater in the barnidipine than HCTZ-treated group but they were
      consistent with vasodilation and were categorised as mild to moderate. In
      conclusion, barnidipine and HCTZ are well tolerated and have equivalent long-term
      antihypertensive efficacy in older hypertensive patients. For patients whose
      blood pressure is inadequately controlled on monotherapy, combination therapy
      with enalapril is effective.

PMID- 11221290
TI  - Barnidipine, a long-acting slow onset calcium antagonist.
AB  - Barnidipine is a stereochemically pure dihydropyridine calcium antagonist with a
      high potency. The drug showed a slow onset and long-lasting vasorelaxating effect
      in vitro, and strong antihypertensive activity in hypertension models.
      Barnidipine was shown to have a high vasoselectivity and offered protection in
      cardiac and renal ischaemia models. The in vitro drug:drug interaction profile
      suggests a low potential for clinically relevant interactions with concomitant
      medication. It can be anticipated that barnidipine is an attractive calcium
      antagonist, offering good blood pressure control without compensatory baroreflex
      activity.

PMID- 11221291
TI  - The long-term efficacy and safety profile of barnidipine.
AB  - Two multicentre trials have investigated the efficacy and tolerability of
      treatment with once-daily barnidipine, in patients with mild to moderate
      essential hypertension. The long-term efficacy and safety of barnidipine were
      demonstrated in a long-term, multicentre, open-label study. In total, 106, 79 and
      32 patients were followed for the first, second and third year, respectively.
      Patients received barnidipine at a dose titrated to achieve a sitting DBP > or =
      90 mmHg or a decrease in sitting BDP > or = 10 mmHg. If necessary, another
      antihypertensive agent was added to achieve normalisation of blood pressure. In
      the first year, normalisation of blood pressure was achieved in 91% of patients.
      This was maintained in 91% and 81% of patients in the second and third years,
      respectively. At the end of treatment in both years, over 60% of patients
      remained on barnidipine monotherapy (10 or 20 mg/day). A low incidence of adverse
      events possibly or probably related to barnidipine (10 or 20 mg/day) monotherapy
      was reported in the first and second years with headache, peripheral oedema and
      palpitations the most commonly reported. In the third year of follow-up, only one
      adverse event, an ECG abnormality, was considered to be possibly related to the
      study medication. The effective 24 hour control of blood pressure with
      barnidipine monotherapy was confirmed in a randomised, double-blind, placebo
      controlled, cross-over study of 20 patients. These patients were given 6 week
      regimens of both barnidipine (20 mg/day) and placebo. Office and 24 hour
      ambulatory blood pressures were recorded at the end of each treatment phase.
      Barnidipine lowered blood pressure to a significantly greater extent than placebo
      both at night and during the day. Adverse events were classified as mild or
      moderate and fewer adverse events were reported with barnidipine treatment
      compared with placebo. Barnidipine monotherapy (20 mg/day) is safe and effective
      in providing 24 hour control of blood pressure. Furthermore, the efficacy and
      tolerability of barnidipine monotherapy (10 or 20 mg/day) are maintained for at
      least 2 years.

PMID- 11221292
TI  - Barnidipine monotherapy and combination therapy in older patients with essential
      hypertension: a long-term study.
AB  - The long-term (2 year) safety and efficacy of barnidipine was assessed in an open
      label, dose-titration, multicentre study of 236 patients aged > or = 75 years
      with a sitting diastolic blood pressure (DBP) > or = 95 mmHg. All eligible
      patients started treatment with barnidipine 10 mg once daily. After at least 4
      weeks treatment, the dose of barnidipine was titrated upwards to 20 mg daily in
      patients who did not achieve normalisation of blood pressure (sitting DBP < 90
      mmHg). After at least another 4 weeks of treatment an ACE inhibitor or diuretic
      was added if necessary. Barnidipine monotherapy was the final treatment in 74% of
      patients in the ITT population (50% barnidipine 10 mg, 24% barnidipine 20 mg).
      The overall response rate was 84.1% at endpoint. Overall mean sitting DBP
      decreased by 18.4 mmHg from 102.1 mmHg at baseline to 83.7 mmHg at endpoint.
      Although a total of 82.2% of patients reported at least one adverse event, only
      37.4% of patients experienced an adverse event that was possibly or probably
      related to the study medication. Many patients experienced adverse events
      associated with co-existing diseases common in older people. It can be concluded
      that barnidipine as monotherapy or in combination with ACE inhibitors or
      diuretics is safe and effective in older patients with essential hypertension.

PMID- 11221293
TI  - Interaction profile and tolerability of barnidipine.
AB  - INTRODUCTION: Barnidipine is a new dihydropyridine calcium antagonist that is
      presented in modified-release capsules containing a single S-S optical isomer of
      the molecule. Its characteristics are of interest, as there is evidence of
      differences in kinetics, dynamics, interactions and safety of individual
      enantiomers in traditional racemic preparations of calcium antagonists. The
      safety of barnidipine and its interaction profile are reviewed. SAFETY: Adverse
      events with barnidipine are of mild to moderate intensity, most commonly of type
      I and occur in the early phase of treatment. Furthermore, safety results in
      elderly patients are comparable with those in the general population, indicating
      that barnidipine can be used without dose adjustment in elderly hypertensive
      patients. INTERACTIONS: Barnidipine has a pharmacokinetic interaction profile
      that compares favourably with those from other calcium antagonists. The
      pharmacokinetic properties of barnidipine are unaffected by food. Minor increases
      in its availability may occur with concomitant use of alcohol or grapefruit
      juice, but these are unlikely to have clinical relevance. In contrast with
      several other calcium antagonists, barnidipine does not affect the steady-state
      kinetics of digoxin, whereas, like other calcium antagonists its bioavailability
      may be increased by the concomitant administration of cimetidine. In addition,
      the potential of barnidipine and its major metabolites to affect the metabolism
      of concomitant medication is unlikely to be of clinical relevance. CONCLUSION:
      The interaction and tolerability profile of barnidipine is well established in
      all age groups.

PMID- 11221294
TI  - Hypertension guidelines and goals of treatment: role of calcium antagonists.

PMID- 11221295
TI  - Are there any relevant differences within the calcium antagonist class?

PMID- 11221296
TI  - ["One would say: a family"].

PMID- 11221297
TI  - [Ethics of the isolation chamber].

PMID- 11221298
TI  - [Community regulations and encounters].

PMID- 11221300
TI  - [The unquantifiable--militarism of the past facing technocratical catechism].

PMID- 11221299
TI  - [Violence, ultimate reaction to anxiety?].

PMID- 11221301
TI  - [Fists and hands glued to the cigarette--2].

PMID- 11221302
TI  - [The procedure of hospital admission].

PMID- 11221303
TI  - ["Pain, physical or mental health?"].

PMID- 11221304
TI  - [The law, rules and customs].

PMID- 11221305
TI  - [Limits of the law, ethics].

PMID- 11221306
TI  - Three approaches to use of questioning by clinical lecturers: a pilot study.
AB  - In the current health care climate nurses require very good problem solving and
      critical thinking skills. Questioning as a teaching strategy is viewed as one way
      to promote such student learning. Using a comparative descriptive quantitative
      and a qualitative approach, this pilot study investigated the types of questions
      asked of students by lecturers working within the preceptorship model in the
      clinical setting. A convenience sample of five volunteer nursing lecturers were
      tape recorded during their interactions with undergraduate students (n = 8).
      Initially two auditing approaches were used to analyse the interview data:
      relevant parts of Mogan and Warbinek's (1994) Observation of Nursing Teachers in
      Clinical Settings instrument (ONTICS Tool) and Craig and Page's (1981) conceptual
      framework as adapted by Sellappah, Hussey, Blackmore and McMurray (1998). The
      data were further analysed by qualitative content analysis. This study supported
      the findings of the ONTICS tool and Sellappah et al's framework that teachers
      asked predominantly directive style and low level questions. What the two
      approaches did not adequately capture was the complexity of the lecturers'
      questioning behaviours or the effects of contextual factors. The content analysis
      process however, identified three broad categories forming a model that
      effectively integrated aspects of the context of the lecturer/student
      interaction. It also represented lecturer questioning behaviours more
      comprehensively. The preliminary model offered has the potential to highlight the
      importance of lecturers asking questions that lead students to extend their
      thinking about practice. It could also contribute to student learning by
      assisting lecturers to understand the value and critical nature of their
      questioning and serve as a framework for staff development.

PMID- 11221307
TI  - Post-anaesthetic shaking. A review of the literature.
AB  - This paper describes the phenomenon of post-anaesthetic shaking (PAS) as it is
      discussed in the literature. Literature was obtained via computerised searches of
      the Cochrane Library, Medline, and Cumulative Index of Nursing and Allied Health
      Literature (CINAHL) databases. This review considers PAS in adults, who have had
      either a general or regional anaesthetic. It focuses on the controversy regarding
      the cause of the condition, the role of anaesthetics in hypothermia,
      pharmacological interventions, and non-pharmacological interventions. The key
      conclusion to emerge is that nurses must take patients' shaking seriously and
      initiate treatment for it. If PAS is associated with hypothermia then the patient
      needs to be rewarmed, and if it is associated with pain, analgesia needs to be
      administered.

PMID- 11221308
TI  - Am I dying nurse?
AB  - Tensions exist with regard to truth-telling about dying. Attitudes and opinions
      of doctors and nurses impact upon patients and their families. While
      traditionally doctors have assumed the role of telling patients and/or families,
      the nurse practitioner often has a closer relationship with the patient and may
      be the most appropriate person to answer the question "Am I dying?" If nurses
      accept they have a moral obligation to tell the truth then it is imperative that
      clinicians, researchers, educators, and the consumers of health services,
      deliberate on what truth-telling is. Cultural implications of both-truth telling
      and dying are little understood in New Zealand. The multi-cultural nature of New
      Zealand provides an opportunity for nurse researchers to address the many issues
      raised by the question "Am I dying, nurse?"

PMID- 11221309
TI  - Cultural safety/Kawa Whakaruruhau ten years on: a personal overview.

PMID- 11221310
TI  - Emergency departments and the inappropriate attender--is it time for a
      reconceptualisation of the role of primary care in emergency facilities?
AB  - The appropriateness of Emergency Department (ED) usage is often questioned, with
      recognition at an international level of the growing prevalence of 'inappropriate
      attenders'. This term is used to describe individuals who present for treatment
      that could more appropriately be provided in the primary health care setting.
      This is an issue of concern for staff working in New Zealand Emergency
      Departments. The present article offers a review of currently identified issues
      concerning ED attendance, and examines the core question of the role of primary
      care in the Emergency Department. It asks whether this is an appropriate use of
      ED resources, and if so, what are the implications for the role of the emergency
      nurse?

PMID- 11221311
TI  - The Workbook Portfolio: facilitating undergraduate student learning in the mental
      health clinical area.
AB  - Undergraduate nursing students are confronted with a multitude of challenges
      during their mental health clinical placements. Many of the required skills are
      dissimilar to other areas of nursing and students must also develop the cognitive
      skills that influence the behavioural ones. However, mental health and mental
      health nursing are influenced and determined by a complex, and sometimes
      contradictory, range of external influences. Such ambiguity can be confusing for
      even the most experienced practitioner, let alone an undergraduate student. This
      article describes the use of a model that has been developed to assist the
      student in tackling such complex issues. The Workbook Portfolio has identifiable
      components that encourage the development of reflective and analytical skills.
      Our article explains the workings of this model in a fashion that allows other
      educators to utilise it to benefit students in the mental health setting.

PMID- 11221312
TI  - The clinical performance of new degree graduates.
AB  - Since the transfer of nursing education from hospitals to tertiary institutions,
      debate regarding the competence of new graduates has continued. To date this
      issue has not been thoroughly researched. The lack of research related to the
      competence of degree graduates in New Zealand provided the impetus for this
      study, which was aimed toward identifying how graduates perceived their clinical
      performance during their first year of practice. A convenience sample of 30
      graduates was surveyed after 3 months and 7 months in practice, using an adapted
      form of a questionnaire devised by Ryan and Hodson (1992). The results showed
      that over time, graduates generally required less direction in all areas of
      clinical competence. After 7 months in practice, the majority of the graduates
      rated their performance in nursing skills, communication skills, and
      professionalism at the expected level or above. However, some still required
      direction with using theory and research in practice, with meeting client's
      psychosocial needs and with teaching clients. In the leadership competency, after
      7 months, most graduates saw themselves functioning at the expected level related
      to client care and needed less direction in unit management skills. However, many
      of the unit management skills were rated as 'not applicable' indicating that new
      graduates are not initially placed in a management role. Implications for nursing
      education and limitations of the research are discussed.

PMID- 11221313
TI  - Advanced nursing practice: experience, education and something else.
AB  - The purpose of this paper is to stimulate discussion and debate about the
      'concept' of 'advanced practice' and the wider issue of 'advancing' nursing
      practice. Defining, credentialling and regulating advanced practice promises rich
      fruits for nursing. Advancing nursing practice will be a consequence only if the
      right conditions are fostered for the development and provision of nursing
      expertise in practice. A conscious and collective effort must be made to ensure
      that the expertise of all nurses is recognised and developed. One process which
      has shown promise in psychiatric and mental health nursing is 'clinical
      supervision'. Evolving nursing leadership roles and more education can provide
      only a partial solution to the problem of advanced and advancing practice.

PMID- 11221314
TI  - An emergency nurse's experience: David's story.

PMID- 11221315
TI  - Expert public health nursing practice: a complex tapestry.
AB  - The research outlined in this paper used Heideggerian phenomenology, as
      interpreted and utilised by Benner (1984) to examine the phenomenon of expert
      public health nursing practice within a New Zealand community health setting.
      Narrative interviews were conducted with eight identified expert practitioners
      who are currently practising in this speciality area. Data analysis led to the
      identification and description of themes which were supported by paradigm cases
      and exemplars. Four key themes were identified which captured the essence of the
      phenomenon of expert public health nursing practice as this was revealed in the
      practice of the research participants. The themes describe the finely tuned
      recognition and assessment skills demonstrated by these nurses; their ability to
      form, sustain and close relationships with clients over time; the skillful
      coaching undertaken with clients; and the way in which they coped with the dark
      side of their work with integrity and courage. It was recognised that neither the
      themes nor the various threads described within each theme exist in isolation
      from each other. Each theme is closely interrelated with others, and integrated
      into the complex tapestry of expert public health nursing practice that emerged
      in this study. Although the research findings supported much of what is reported
      in other published studies that have explored both expert and public health
      nursing practice, differences were apparent. This suggests that nurses should be
      cautious about using models or concepts developed in contexts that are often
      vastly different to the New Zealand nursing scene, without carefully evaluating
      their relevance.

PMID- 11221316
TI  - Clinical professorial appointments in nursing.

PMID- 11221317
TI  - Neonatal nurse practitioners--a model for expanding the boundaries of nursing
      culture in New Zealand.
AB  - The development and terminology of what constitutes advanced practice nursing
      roles in New Zealand has been the subject of recent debate within nursing. This
      article outlines the development of the neonatal nurse practitioner role in New
      Zealand as an example of one advanced practice nursing role. A model of how
      nursing culture changes to include roles that incorporate components that
      historically have been considered the domain of other health professionals is
      proposed. This article outlines some of the issues surrounding the neonatal nurse
      practitioner role, including the educational requirements for this role in New
      Zealand.

PMID- 11221318
TI  - Factors influencing health and well-being in the older adult.
AB  - Both in New Zealand and internationally there are increasing numbers of people
      living well into their senior years. Not only are more individuals reaching late
      adulthood, more are living beyond this stage. Because of corresponding increases
      in illness and/or disability this phenomenon has implications for the provision
      of health care to communities. This article offers a literature review of
      selected factors influencing the health and well-being of older people, with a
      particular emphasis on the older male. Implications for nursing practice in New
      Zealand are discussed.

PMID- 11221319
TI  - Women planning and experiencing pregnancy and childbirth: information needs and
      sources.
AB  - This paper reports the preliminary findings of a study of women planning a
      pregnancy and perinatal women with respect to their information needs and the
      sources of information they use. Fifty women, 7 planning a pregnancy, 30 pregnant
      and 13 postnatal, completed a questionnaire including questions about who they
      had approached for information about pregnancy issues, who had given them advice
      and why it was or was not useful, what they would currently like to know, and
      what they wished they had known during the previous three months. Results
      highlighted differences in the type of information provided by various sources:
      doctors and specialists were seen as primarily providing factual information;
      midwives also supplied information but more importantly gave reassurance and
      support; partners did not provide information but were valued for their support
      in a shared experience; and mothers and friends were primarily useful due to
      their own experiences. The findings also suggested the importance of information
      that is relevant to the women's current stage of pregnancy.

PMID- 11221320
TI  - Re-introducing Mavis Helena ('Pat') Paton.

PMID- 11221321
TI  - Are the 'faces scales' used to measure pain intensity in children comparable?

PMID- 11221322
TI  - Diet therapy--a forgotten art?
AB  - This study evaluated paediatric nursing students' knowledge of diet therapy to
      establish whether it was sufficient to prepare them for practice. A questionnaire
      sampled 19 1st-year and nine 4th-year students' diet therapy knowledge in
      relation to chronic renal failure, cystic fibrosis, juvenile diabetes mellitus
      and liver disease. The knowledge of 1st and 4th-year students was compared and
      then evaluated against criteria, devised by the researcher to measure whether
      this knowledge level was sufficient for practice. The Mann-Whitney Utest showed a
      significant difference between the 1st and 4th-years' diet therapy knowledge. The
      mean score for overall diet therapy knowledge of 4th-year students was 46 per
      cent. The results suggest that knowledge of diet therapy is insufficient to
      prepare nursing students for practice and that this topic needs further emphasis
      in paediatric nurse education.

PMID- 11221323
TI  - Mouth care for children with cancer.

PMID- 11221324
TI  - Do not resuscitate: critical incident reflection.

PMID- 11221325
TI  - Enteral feeding: practice guidance.

PMID- 11221326
TI  - Time to focus on practice.

PMID- 11221327
TI  - Basic infant life support: retention of knowledge and skill.
AB  - Successful resuscitation depends upon several factors including the underlying
      cause for the cardiac arrest and the availability of advanced life support.
      Another key factor is the ability of those first on the scene to administer basic
      life support. Knowledge and skills in basic life support were tested in six
      registered children's nurses, who were randomly chosen to take part in a small
      exploratory study. Knowledge was tested by means of a questionnaire and skill was
      tested with a practical test using an infant manikin. The Resuscitation Council
      (RC) (1997) guidelines were used as a guide. The results demonstrated that the
      knowledge and skills of those assessed were unsatisfactory, so a resuscitation
      update was arranged. The sample group was re-tested using the same questionnaire
      and practical test immediately following the resuscitation update and again six
      weeks later. Knowledge and skills improved in five of the six participants,
      although the order in which they were performing aspects of basic infant life
      support was beginning to alter by the six-week retest.

PMID- 11221328
TI  - Infant nutrition: Part Two.

PMID- 11221329
TI  - Reflection on practice: a student perspective.

PMID- 11221330
TI  - The future for nursing education: UKCC review has relevance for New Zealand.
AB  - The strategic review of undergraduate nursing education recently commissioned by
      the Nursing Council of New Zealand (NCNZ) will provide a focus for nursing
      education in Aotearoa/New Zealand in the immediate future. Recently the United
      Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC)
      completed its own review of undergraduate nursing education. The published report
      'Fitness for Practice', has many areas of relevance for New Zealand educators in
      outlining possible strategies for nursing education. Issues such as recruitment
      and access to education; retention; clinical assessment and placements; clinical
      skill acquisition and partnership are valid concerns for educators here also.
      Internationally the commonalties in issues of concern are remarkable and lend
      validity to the concept of the global village and the necessity for a global
      perspective in health care workforce planning, including educational preparation.
      Discussion of some of the recommendations informs nursing education of the
      possibilities for forward progress in these times of continual change in health
      care delivery systems.

PMID- 11221331
TI  - Quality in undergraduate nursing programmes: the role of Nursing Council.
AB  - This paper looks broadly at issues to do with quality monitoring in higher
      education and considers the role and focus of the Nursing Council of New Zealand
      in the approval of and ongoing monitoring of undergraduate nursing degree
      programmes. It is suggested that the approach taken by the Nursing Council is
      accountability-led where minimal attention is given to teaching and learning and
      actual graduate outcomes. This may lead to a mistaken belief that Nursing
      Council's monitoring focuses on quality or that the outcomes of their monitoring
      might contribute to programme enhancement. A shift to emphasise learning
      processes, students and continual improvement in order to enhance programme
      quality is proposed.

PMID- 11221332
TI  - Credentialing: setting standards for advanced nursing practice.
AB  - While the document Framework, Guidelines and Competencies for Post-Registration
      Nursing Education (Nursing Council of New Zealand, 1999) provides for approval of
      programmes preparing nurses for advanced practice, the related credentialing and
      titling of individual nurses in advanced practice has not been addressed. This
      article examines professional regulation with particular reference to advanced
      practice. As well as providing an overview of credentialing and other aspects of
      professional regulation, including licensure, certification, registration, and
      titling, the question of how much regulation, and by whom, will be explored. The
      paper has been prepared independently of the Nursing Council, and may not
      necessarily reflect the Council's views.

PMID- 11221333
TI  - The methodological journey of a grounded theorist: an interview with Denise
      Dignam. Interview by Lynne S. Giddings, Pamela J. Wood.
AB  - Nurses and midwives in Aotearoa/New Zealand are making a unique contribution to
      the development and application of various research approaches (methodologies) to
      nursing and midwifery practice. This is the first of a series of articles based
      on interviews with nursing and midwifery researchers, giving stories of their
      research journeys in relation to a particular methodology. The articles will give
      beginning researchers some real life examples of what it is like to carry out
      research. They are not in-depth explorations of the various methodologies. What
      we have attempted to capture is how real people actually use the various research
      methodologies we read about in textbooks and that frame the research which
      influences our practice. The stories are presented in interview format so that
      each interviewee's unique style and approach can emerge. The first researcher in
      our series is Denise Dignam (RGON, BA, DipSocSci) who in her PhD research is
      using a grounded theory approach to investigate issues related to breastfeeding.

PMID- 11221334
TI  - [Contemporary state and perspectives in neuroroentgenology].

PMID- 11221335
TI  - [Diffusion-weighted image in the study of brain tumors and peritumoral edema].
AB  - The informative value of the technique of diffusion-weighted images (DWI) and
      diffusion maps was studied in diagnosing supratentorial tumors of the brain.
      Sixty four patients were examined. Among them there were 35 patients with glial
      brain neoplasms of varying malignancy [benign astrocytomas (asc) in 15 patients,
      anaplastic asc in 10, and glioblastomas in 10)], 15 patients with meningiomas, 5
      with hydrocephalus, 9 with cerebral circulatory disorders. To obtain DWI,
      diffusion-weighted echo-planar impulse sequence was used. ADC was within (1.52 +/
      0.34) x 10(-3) mm2/sec for fibrillary astrocytomes. The anaplastic astrocytoma
      group showed variations in ADC values: ADC was higher in the contrasted part of
      the tumor than in the non-contrasted one and averaged (1.23 +/- 0.32) x 10(-3)
      mm2/sec. Glioblastomas were also noted for a higher variation in ADC that
      averaged (1.18 +/- 0.29) x 10(-3) mm2/sec. Meningiomas had a greater MR signal in
      response to DWI and low ADC values [(0.97 +/- 0.17) x 10(-3) mm2/sec]. Particular
      emphasis is laid on the study of different types of brain edema. ADC in the area
      of vasogenic (peritumoral), cytotactic (ischemic), and interstitial edema was
      (1.30 +/- 0.11) x 10(-3), (1.04 +/- 0.05) x 10(-3), and (1.91 +/- 0.1) x 10(-3)
      mm2/sec, respectively (p < 0.05) and sharply distinct in ADC maps.

PMID- 11221336
TI  - [Proton magnetic resonance spectroscopy in diagnostics of tumorous and
      nontumorous lesions in brain].
AB  - Whether proton magnetic resonance spectroscopy (1H-MRS) can be used in the
      diagnosis of tumorous and nontumorous lesions of the brain was studied. The
      results of studies were analyzed in 80 patients, including 54 patients with brain
      tumors (astrocytomas and meningiomas), 20 with nontumorous lesions of the brain,
      and 6 apparently healthy individuals (controls). The nontumorous lesions of the
      brain involved cerebral circulatory disorders as ischemia (n = 14) and
      postradiation changes (n = 6). The studies were performed on a 1.5-T Signa
      Horizont magnetic resonance tomograph by using the PROBE/SV programme package.
      The peak ratios of the following metabolites: N-acetylaspartate (NAA), choline
      (Cho), creatine, lactate (Lac), lipids (Lip) were examined in the spectra
      obtained. The spectra of astrocytomas showed a reduced peak of NAA, an elevated
      peak Cho; there was an increase in the peak of Lac along with higher tumor
      malignancy stage. The spectra of meningiomas presented a high peak of Cho along
      with a noticeable reduction in the peaks of other metabolites, the peak of NAA
      was not visualized. In ischemic lesion of the brain, the peak of Lac appeared
      within the first hours when the peaks of other metabolites were unchanged. A rise
      in the peak of Lac and a reduction in that of other metabolites were detectable
      with time. In radiation-induced lesions, the spectrum displayed a high peak of
      Lac and the peak of Lip appeared with virtually complete reduction in the peaks
      of other metabolites. 1H-MRS should be considered as an axillary technique used
      in combination with routine MRI in the diagnosis of various lesions of the brain,
      which can estimate chemical compositions, time-course of metabolic changes in the
      study tissue.

PMID- 11221337
TI  - [The use of chronic epidural electrostimulation of the spinal cord in children
      with spastic diplegia--a type of infantile cerebral palsy].
AB  - The authors' first experience with spinal cord stimulation (SCS) at the lumbar
      level in the treatment of cerebral palsies (CP) in children aged 3-11 years who
      had lower spastic paraparesis of varying severity is presented. Complex clinical
      and physiological studies of all 9 children were made before and after surgery
      (follow-ups lasting 6-12 months). Preliminary results have indicated that the
      most significant changes occur primarily in pathological postural tonic reflexes.
      SCS has virtually no effect on fixed limb deformities, which requires further
      orthopedic surgical correction. A medical care schedule for CP children affected
      predominantly with lower spastic paraparesis should include, among its first
      priorities, electrode implantation for SCS. Due to the specific rehabilitative
      dynamics of motor functions, SCS should be made to treat these children before
      the deformities in the lower extremity joints get fixed.

PMID- 11221338
TI  - [Mapping of the motor-sensory cortex by functional magnetic resonance tomography
      in frontoparietal tumors].
AB  - The potentialities of functional magnetic resonance imaging (FM-RI) in the
      preoperative mapping of the motor-sensory cortex of the brain in 24 patients with
      frontoparietal tumors and 5 healthy volunteers were studied. A good
      reproducibility of results was achieved while using a simple irritation paradigm
      as finger flexion-extension. The obtained activation maps were projected to the
      region of anterior and posterior central gyri and to the central sulcus.
      Imposition of the maps of motor-sensory cortical activation with routine T1
      weighed images allows a surgeon to gain an insight into the mutual location of a
      tumor and a functionally significant portion of the cortex, by reducing the
      intraoperative risk of damage to this area. The intraoperative determination of
      the central sulcus by the evoked potential method in 4 patients confirmed the
      results obtained after FMRI. The relationship of the obtained activation maps to
      the presence of venous structures in the area concerned requires further studies
      on the modes of clarifying the site of functionally significant cortical areas in
      the brain.

PMID- 11221339
TI  - [The use of three-dimensional reconstruction in neuroroentgenology].
AB  - The recent advent of spiral computed tomography (CT) and new fast impulse
      sequences in magnetic resonance imaging (MRI) into diagnostic practice has
      expanded the range of brain and spinal diseases detected by these techniques.
      This has also expanded the field of use of three-dimensional images obtained on
      the basis of mathematical algorithms for processing CT and MRI data. At present,
      not only neurotraumatology and maxillofacial surgery are the main areas in
      applying three-dimensional models. Spatial representation of bulky formations of
      the brain, their mutual location with the adjacent anatomic structures (with
      ventricles of the brain) may be useful in choosing a surgical access and in
      planning the scope of a surgical intervention. CT- and MR-angiographies that are
      now successfully used in diagnosing vascular pathology, providing high-solution
      angiograms not only can be competitive with direct angiography, but can replace
      this sophisticated study for vascular stenotic processes in the neck. Moreover,
      analyzing the internal surface of the vascular wall on the basis of virtual
      endoscopy may be useful in direct surgical and endovascular interventions. The
      purpose of this study was to pool long-term experience in using three-dimensional
      images in the qualitative improvement of diagnostic methods in examining
      neurosurgical patients and to define the most promising lines of their use in
      neurosurgery as a whole.

PMID- 11221340
TI  - [Diagnosis of cerebral arterial aneurysms in acute and subacute subarachnoid
      hemorrhage].
AB  - The paper pools experience in using computed tomographic and magnetic resonance
      angiographies in patients with intracranial berry aneurysms in different periods
      following subarachnoid hemorrhage. The new low-invasive techniques for
      visualization of arterial vessels have been found to detect the aneurysm and to
      define its topographic and anatomic location in most cases (as high as 90%) by
      being on a par with direct cerebral angiography and to compare favourably with
      the latter. Based on the analysis of complex studies (angiography, CT- and MR
      angiographies), the authors have developed algorithms for diagnosing intracranial
      aneurysms by the stage of subarachnoid hemorrhage.

PMID- 11221341
TI  - [A study of the spinal fluid flow by magnetic resonance imaging].
AB  - The study was undertaken to examine the potentialities of new MRI techniques (MR
      myelocysternoventriculography and phasic contrast-enhanced MRI with reference to
      a cardiac cycle) in visualizing the spinal fluid system and flow in different
      groups of neurosurgical patients. MR-myelocysternoventriculography was based on
      the sequences of SSFP-3D (Signa, GE, 1.5 T) and PSIF-3D (Magnetom 42SP, Siemens,
      1.0 T). These regimens were applied to obtain highly T2*-weighed images. These
      techniques were used in 280 patients. Phasic contrast-enhanced MRI with reference
      to a cardiac cycle was performed in the axial (through the aqueduct of the
      cerebrum) and sagittal projects (CINE-2D mode, Signa GE). This technique was
      employed to study 30 patients and 5 healthy volunteers. MRI-cysternography based
      on SSFP-3D- and PSIF-3D sequences is recommended as the method of choice in
      evaluating the 3rd ventriculostoma and, in combination with spiral computed
      tomography, in detecting fistulas of the base of the skull. Phasic contrast
      enhanced MRI with reference to a cardiac cycle yielded the values of spinal fluid
      flow through the aqueduct of the cerebrum in health: Vsyst max = 4.1 +/- 1.3
      cm/sec; Vsyst mean = 2.5 +/- 1.4 cm/sec; Vdiast max = 3.4 +/- 1.5 cm/sec; Vdist
      mean = 2.5 +/- 1.7 cm/sec (N = 5). The prospect of the technique is to develop
      recommendations and to predict prognosis while making bypass surgery for
      ventriculostomas and cystostomas.

PMID- 11221342
TI  - [Calcified giant aneurysm of the middle cerebral artery].
AB  - A rare case of calcified giant aneurysm of the middle cerebral artery is
      presented. This is a 28-year-old female with seizures and right-sided hemiparesis
      in whom plain scull films and computed tomography revealed a large calcified
      lesion (measuring 7.5 x 5.5 x 4.5 cm) of the left cerebral hemisphere. The lesion
      was removed by the pterional transsylvian approach and found to be a calcified
      giant thrombotic aneurysm of the middle cerebral artery. The CT characteristics
      of these rare lesions and the success of surgery in this case are briefly
      discussed.

PMID- 11221345
TI  - [Rumania, a potential mine of economic crisis].

PMID- 11221346
TI  - [For a liberal public health medicine].

PMID- 11221344
TI  - [The new pathogenetic treatment of cervical dystonia: rationale, methods,
      outcomes].
AB  - The paper presents data obtained from studies of the impact of the otolithic
      apparatus of the inner ear on the degree of symptoms of cervical dystonia. The
      findings make it possible to substantiate a pathogenetic treatment of this
      disease, which involves intratimpanal unilateral injection of the vestibulotoxic
      antibiotic streptomycin. The results achieved and the mechanisms of the
      therapeutical effect observed are discussed.

PMID- 11221343
TI  - [Recovery of the spinal function: current potentialities and research prospects].

PMID- 11221347
TI  - [Nursing ethics and practice in oncology].

PMID- 11221348
TI  - [Patients with enterostomy, nurses: a good ensemble].

PMID- 11221349
TI  - [Nutrition and cancer].

PMID- 11221350
TI  - [Nursing care of patients with chronic terminal renal insufficiency].

PMID- 11221351
TI  - [Cultivating our specificity, let us be autonomous and organized].

PMID- 11221352
TI  - [IRCT (chronic terminal renal insufficiency) needs anal treatment strategies].

PMID- 11221353
TI  - [Hemodialysis method and nursing care].

PMID- 11221354
TI  - [Hemodialysis equipment].

PMID- 11221355
TI  - [Methodologic guide to controlling water].

PMID- 11221356
TI  - [Nursing strategy: concerning hemodialysis].

PMID- 11221357
TI  - [Peritoneal dialysis, method, education, role of the nurse].

PMID- 11221358
TI  - [Controlling pain in renal transplantation].

PMID- 11221360
TI  - [Albania, to get out of a perverted health care system].

PMID- 11221359
TI  - [Safety of injections].

PMID- 11221361
TI  - [Government policy about drugs].

PMID- 11221362
TI  - [End of life, euthanasia or palliative care?].

PMID- 11221363
TI  - [What kind of death do we desire?].

PMID- 11221364
TI  - [An astonishing report of the CCNE (National Ethics Committee].

PMID- 11221365
TI  - [For or against exceptional euthanasia].

PMID- 11221366
TI  - [Decisions concerning end of life, euthanasia questioned].

PMID- 11221367
TI  - [How to respond to demands of euthanasia?].

PMID- 11221368
TI  - [New aspects in drug therapy of ocular allergies].
AB  - Ophthalmic allergoses belong to highly prevalent ocular diseases. According to
      the records of the first center of allergic diseases of the eye set up in 1971 at
      Helmholtz Institute of Ocular Diseases in Moscow, the most prevalent clinical
      forms are seasonal pollenosis conjunctivitis, drug allergies, spring
      keratoconjunctivitis, large-papillary conjunctivitis, chronic allergic
      conjunctivitis, allergy associated with the "dry eye" syndrome, atopic
      keratoconjunctivitis, and ocular involvement in systemic immune diseases. Therapy
      of ocular allergies is based on the three main principles: removal of the
      allergen responsible for disease, immunotherapy, and symptomatic drug therapy.
      The main agents used in local antiallergic therapy are antihistaminic drugs
      (antasoline and acelastin), drugs inhibiting mast cell degranulation
      (chromoglycates and lodoxamide), and accessory drugs: corticosteroids
      (dexamethasone and deosonide), nonsteroid antiinflammatory agents (diclofenak),
      immunosuppressants (cyclosporin), and vasoconstrictors (tetrisoline).
      Antiallergic drugs can be used as monotherapy or in combinations, as they differ
      by the mechanism of action. Antiallergic drugs are used with good results in
      combined therapy of infectious conjunctivitis and keratitis.

PMID- 11221369
TI  - [New aspects in the problem of retinal and optic nerve diseases].
AB  - Main trends in research and practical activities of Department of Retinal and
      Optic Nerve Diseases of Moscow Helmholtz Institute of Ocular Diseases are
      reviewed: vascular, inflammatory, and dystrophic diseases of the retina, choroid,
      and optic nerve, results of recent studies of the pathogenesis, diagnosis, and
      treatment of diabetic retinopathies, vascular abnormalities, uveitis, diseases of
      the optic nerve, and hereditary diseases of the retina are presented. Problems in
      surgical treatment of diseases of the retina and vascular tract and complications
      thereof are discussed.

PMID- 11221370
TI  - [The concept of ophthalmologic oncology development].
AB  - The authors review the research results concerning the diagnosis and treatment of
      ocular tumors over 25 years of activities of Department of Ophthalmooncology and
      Radiology and analyze the perspective trends for future studies.

PMID- 11221371
TI  - [Clinical picture and treatment of diplopia].
AB  - A total of 203 patients with stable binocular diplopia were observed.
      Examinations included coordimetry, analysis of double images, and investigation
      of the doubling field in the gaze field. All examinations were performed using an
      original method with a serial computer. The treatment included therapy of the
      underlying disease, choice of correcting prisms, exercises aimed at extension of
      separate vision field, and operation on the oculomotor muscles. Three main forms
      of diplopia were distinguished: 1) muscular; 2) sensory; and 3) mixed. The first
      form includes diplopias in paresis of n.III and n.IV, n.VI, late development of
      convergent squint, orbital injuries, endocrine ophthalmopathy, and myasthenia.
      The second form includes diplopias developing after delayed operations for
      convergent squint, and the third form are diplopias after operations for
      detachment of the retina and implantation of intraocular lenses. The treatment
      led to complete neutralization of doubling in 18.7% cases, neutralization in the
      main part of the gaze field in 53.7%, the same with prism correction in 12.8%
      cases; in 14.8% patients adaptation to diplopia was attained after suppression of
      the second image. Diplopia in late squint is prognostically the most favorable,
      and the following conditions are listed in the order of more or less good
      prognosis: paresis of n.VI, n.IV, orbital injuries, endocrine ophthalmopathy, and
      artiphakia. The least favorable prognoses are for patients after delayed
      operation for squint and detachment of the retina. A new operation, plastic
      repair of the external m. rectus, was used in 96 patients with pareses of n.VI;
      no compensation was attained in only 2 patients.

PMID- 11221372
TI  - [Ultrasound in ophthalmology].
AB  - Research activities of Department of Ultrasound are carried out in cooperation
      with other departments of the institute. This paper sums up 30-year activities of
      the department on the utilization of ultrasound in ophthalmology with diagnostic
      and therapeutic purposes. Ultrasound is a highly informative diagnostic and
      effective treatment modality in various ocular diseases.

PMID- 11221373
TI  - [Pathogenetic factors of destructive process in trabecular tissues in primary
      open-angle glaucoma].
AB  - Trabecular endothelium and collagen fibers of the posterior wall of Schlemm's
      channel, obtained in sinusotrabeculectomy from patients with various stages of
      primary open-angle glaucoma were examined by electron microscopic and biochemical
      methods. Endothelial cell destruction, damage, rejection, and dissociation in
      intertrabecular space, progressing in severity, were observed. "Denudation" and
      degradation of collagen fibers and fibrils were observed. The content of lipid
      peroxides in aqueous humor and blocks of Schlemm's channel trabecular wall
      increased from stage to stage, while the level of biogenic antioxidant
      glutathione decreased.

PMID- 11221374
TI  - [Remote results of proxopheline therapy of patients with primary open-angle
      glaucoma].
AB  - Effects of an original Russian combined preparation proxofelin, consisting of 1%
      proxodolol and 0.25% clofelin solutions, on intraocular pressure (IOP),
      hydrodynamics, ocular function, arterial pressure, and heart rate have been
      evaluated in 42 patients (59 eyes) with primary open-angle glaucoma for up to 2
      years. Examinations were carried out before proxofelin therapy and after 6, 12,
      18, and 24 months of regular therapy (twice a day). Pronounced hypotensive effect
      on IOP (10.0 +/- 0.3-11.2 +/- 0.2 mm Hg) was due to a significant increase (p <
      0.01) in the discharge easiness coefficient (by 50-77% in comparison with the
      initial value) and suppressed production of aqueous humor (by 40-50% of the
      initial level). Visual acuity did not change, visual field was significantly (p <
      0.05) extended during all terms of examinations, changes in arterial pressure and
      heart rate during long-term therapy were negligible. The hypotensive effect of
      proxofelin was insufficient in 20% patients; in such cases its combination with
      pilocarpin was effective. In the rest patients tolerant IOP was attained by
      instillations of the monopreparation. Hence, proxofelin is an effective drug for
      treating primary open-angle glaucoma; its efficiency is apparently due to its
      hypotensive action.

PMID- 11221375
TI  - [Effect of therapy with blood component (activated autoplasma) on blood
      glutathione level in patients with vascular abnormalities on the fundus oculi].
AB  - Thirty-three patients with central chorioretinal dystrophy, 18 with proliferative
      diabetic retinopathy, and 15 controls without ocular diseases were examined. All
      patients were treated by blood components. The treatment started with activation
      of blood plasma platelets. Glutathione was measured in two portions of plasma:
      intact and containing platelet activation products. The content of glutathione
      was higher in activated autoplasma of 21 patients with central chorioretinal
      dystrophy and 6 patients with diabetic retinopathy than in intact plasma by 107
      and 72%, respectively. A decrease in glutathione level in activated autoplasma
      was observed in 1 patient with central chorioretinal dystrophy and in 9 with
      diabetic retinopathy. Hence, antioxidant defense is decreased in diabetic
      retinopathy, since glutathione is involved in reduction of organic
      hydroperoxides.

PMID- 11221376
TI  - [Moscow Gel'mgol'ts Institute of Ocular Diseases: the past and present].

PMID- 11221378
TI  - [Efficiency of detection and preventive treatment of retinopathy in premature
      neonates].
AB  - A total of 580 preterm babies born weighing 540-2500 g at terms less than 35
      weeks were examined. The mean incidence of neonatal retinopathy under standard
      conditions of care in Moscow is 26%. The incidence of disease depends on body
      weight at birth and term of gestation. Risk factors conducive to the development
      of neonatal retinopathy are maternal diseases (gestosis, chronic somatic and
      gynecological diseases, hemorrhages in labor, detachment of placenta), and
      diseases of babies other than low body weight at birth and those due to preterm
      delivery (bronchopulmonary dysplasia, periventricular leukomalacia, intragastric
      hemorrhages, severe infection, early anemia, periods of hypercapnia and long
      oxygen therapy). The disease spontaneously regressed in 78% babies with stages I
      II. In 32 (22%) babies the condition progressed to stage III. Preventive
      cryocoagulation was performed in 24 babies (48 eyes). The efficiency of
      preventive treatment is 70.4% and depends on the disease pattern. Cooperation of
      neonatologists and ophthalmologists essentially improves the diagnosis and
      prevention of severe forms of retinopathy neonatorum.

PMID- 11221377
TI  - [Experimental validation of licopin-containing drug tomatol use in combined
      therapy of patients with diabetic retinopathy].
AB  - Effects of tomatol on metabolic changes in the blood and lacrimal fluid and
      ocular capillaries of rabbits with alloxane diabetes were studied. Tomatol is a
      drug containing licopin carotenoid characterized by a high biological activity.
      The intensity of lipid peroxidation was notably decreased, antioxidant activity
      of the blood increased, lipid metabolism parameters in the blood and some
      parameters of proteinase inhibitory balance in the blood and lacrimal fluid
      normalized in diabetic rabbits treated with tomatol in comparison with untreated
      rabbits. Changes in perilimbic capillaries were less expressed in treated vs.
      untreated animals. Hence, tomatol is recommended for combined therapy of patients
      with diabetes as a drug normalizing metabolism and probably decelerating the
      development of diabetic retinopathy.

PMID- 11221379
TI  - [Sympathetic ophthalmia as an autoimmune disease].
AB  - Discusses published reports and one's own findings indicating that sympathetic
      ophthalmia can be regarded as an autoimmune disease.

PMID- 11221381
TI  - [Scleroplasty with plasma-modified homoslceral grafts: experimental morphological
      study].
AB  - Healing of homoscleral grafts treated by gas discharge low-temperature plasma has
      been studied. Such treatment leads to formation of a modified surface layer in
      scleral tissue; the presence of such a layer improves the hydrophilic properties
      and biocompatibility of the sclera, thus promoting better adaptation of the graft
      to further restructuring and healing during the postoperative period. Experiments
      on 32 eyes of chinchilla rabbits showed that after scleroplasty with thus treated
      transplants, complete replacement of fibroblasts and collagen carcass of the
      graft was observed as early as after 7.5 months (vs. 12 months in the control);
      the graft was stabilized and tightly grown into the sclera to form a solid sclera
      graft complex which fortifies the scleral membrane of the eye. Use of plasma
      modified transplants may improve the efficiency of scleroplastic operations in
      progressive myopia and ocular injuries.

PMID- 11221380
TI  - [Diagnosis, immunopathogenesis, clinical picture and treatment of uveitis in
      nephropathies].
AB  - Complex clinical and immunological studies in 39 patients with uveitis and a
      history of nephropathies disclosed a relationship between renal diseases and
      vascular tract of the eyes. Specific features in the clinical symptomatology and
      immunological disorders were detected. Anterior and generalized forms, bilateral
      involvement, Tyndall's symptom, combined vitreolenticular changes, often with the
      exudative hemorrhagic component, predominated in the clinical picture of uveitis
      in patients with nephropathies. Uveitis ran a protracted course resistant to
      therapy, with frequent relapses. The disease occurred mainly in women.
      Predominant disorders in immunopathogenesis were disorders in the complex
      formation system. Uveitis in patients with nephropathies should be treated with
      due consideration for the etiology of nephropathy, clinical course of uveitis,
      and immunological disorders. Diseases of the vascular tract associated with
      nephropathy are rare in the etiological structure of uveitis and retinovasculitis
      (3.24%).

PMID- 11221382
TI  - [Postradiation atrophy of anophthalmic orbit after treatment of retinoblastoma.
      System of surgical rehabilitation].
AB  - A system of surgical treatment of patients with radiation atrophy of orbital
      tissues has been developed in order to attain a stable position of the prosthesis
      in the cavity and improve the patients' appearances. A total of 366 interventions
      were performed in 242 patients. The operations were as follows: formation of
      conjunctival cavity by autotransplants of the mucosa from the lips (242), delayed
      plasty of the stump (81), contour plasty of the temple and external edge of the
      orbit (32), correction of eyelids (11). Single-stage treatment was carried out in
      156 patients and 2-7 stages in 86 patients. Positive results were attained in all
      cases: the depth of the vault increased, lagophthalmos decreased, falling-in
      defect of prosthesis, eyelids, and temple were reduced, and stable position of
      the prosthesis in the cavity was attained. Surgical treatment of this condition
      differs greatly from plastic repair for other diseases because of changes in
      tissues after radiotherapy. Functional and cosmetic rehabilitation of patients
      with postradiation atrophy of orbital tissues after treatment of retinoblastoma
      with good effect can be attained only by staged surgical treatment.

PMID- 11221383
TI  - [Computer method for evaluating disorders in sense of color].
AB  - A new method for evaluating disorders in the sense of color has been developed
      and offered for practice. A total of 340 patients with diseases of the retina and
      optic nerve and 80 normal subjects were examined. The results indicate that
      different conditions of examination, selection of combination by the color,
      brightness, and deepness of the stimulus and background allow detection of
      decreased sensitivity of one, two, or three color perceptors (disorders in sense
      of color--color blindness) and permit a quantitative evaluation of functional
      disorders in the color channels of visual system. The new method can be used in
      the diagnosis of the initial pathological processes of different origin,
      involving the cone system at any level of visual route and associated with
      acquired disorders in color vision.

PMID- 11221384
TI  - [Department of Traumatology, Reconstructive and Plastic Surgery and Ocular
      prosthetics, Gel'mgol'ts Moscow Institute of Ocular Diseases: four recent
      decades].
AB  - Main trends in research and practical activities of the department are reviewed:
      treatment of injuries, removal of foreign bodies, introduction of new
      microsurgical technologies and equipment, development of reconstructive laser
      operations, development of concept of pathogenesis of burn disease, and
      ophthalmoplasty.

PMID- 11221385
TI  - [Prevalence and clinical significance of active cytomegalovirus infection in
      patients with inflammatory ophthalmopathy].
AB  - A total of 374 patients with different inflammatory diseases of the eyes were
      examined (227 children and 147 adults). For detecting active cytomegalovirus
      (CMV) infection, sera were tested for antibodies to nonstructural intact CMV
      proteins. Antibodies were detected in 26 of 147 adults (17.7%) and 15 of 227
      children (6.6%). Difference in the frequency of detection of active CMV infection
      in adults and children is statistically significant (p < 0.01). Three groups of
      patients with active CMV were distinguished: children with congenital diseases,
      immunocompromised patients, and the most numerous group of patients with isolated
      ocular diseases without manifest signs of immunodepression. In this latter group
      active CMV was detected in patients with different clinical diagnoses, including
      ophthalmic herpes. Russian commercial enzyme immunoassay kit CMV-Control proved
      to be a highly sensitive, simple, and cheap test for the diagnosis of
      exacerbations of chronic CMV infection.

PMID- 11221386
TI  - [Significance of lacrimal fluid peroxidation and anti-radical defense parameters
      for prediction and treatment of complicated myopia].
AB  - Study of lipid peroxidation and antiradical defense parameters in the lacrimal
      fluid from 270 eyes of children and adolescents with progressive myopia
      demonstrated a relationship between the development of peripheral
      vitreochorioretinal dystrophies and imbalance between antioxidant activity (AOA)
      of lacrimal fluid and intensity of radical formation evaluated by
      chemiluminescence (CL) intensity. The AOA/CL ratio is proposed as a reliable
      indicator for predicting the course of progressive myopia. A value < 30 indicates
      poor level of antioxidant defense of ocular media and tissues and is a
      prognostically unfavorable sign as regards development of peripheral
      vitreochorioretinal dystrophy. A local antioxidant remedy has been developed and
      clinically tried for preventing and treating complicated myopia: ocular medicinal
      films with emoxipin and pyridoxine hydrochloride.

PMID- 11221387
TI  - [Refractory glaucoma: peculiarities of treatment].
AB  - Refractory glaucoma is a clinical variety of glaucoma remarkable for its
      resistance to therapy. This determined special approaches to choice of drugs and
      methods ensuring a stable hypotensive effect as one of the conditions of
      preserving the visual functions. Original methods for surgical treatment of
      refractory glaucoma are proposed. New effective operations prevent excessive
      cicatrices at the site of intervention, one of the major causes of failure of
      antiglaucoma operations. Ultrasonic cyclodialysis is an effective method for
      surgical treatment of glaucoma in an aphakic eye. A principally new approach to
      treatment of refractory glaucoma is based on the use of high-frequency focussed
      ultrasound, a noninvasive method (sclerocyclodestruction) for attaining the
      hypotensive effect. The efficiency of the natural cytokine complex in the
      treatment of refractory glaucoma is due to effects of immunopeptides on repair
      processes at the site of intervention, which inhibit cell growth and prevent
      excessive development of cicatricial tissue round newly created routes of humor
      discharge.

PMID- 11221388
TI  - A vision of how ethical and clinical knowledge articulate in the effort to serve
      patients better.

PMID- 11221389
TI  - Ethics and education.
AB  - In the debate concerning the education of nurses that is currently taking place
      in Denmark, two widely differing views are apparent regarding the best way of
      training nurses such that the ethical aspect of their work is adequately
      considered. The first of these is based on the premise that practical care is
      fundamental to and justified by theories on nursing, care and ethics, which is
      why the theoretical part of nurse education deserves a higher priority. The
      second view is based on the premise that social care cannot be taught by means of
      theories, but can be learnt only through practice. The master-apprentice
      principle of ancient Greece is stressed in connection with this as being a viable
      alternative to the theoretical model of education. These two very different views
      can be traced back to Plato's and Aristotle's ideas on ethics and teaching
      respectively; indeed, those engaged in the debate make specific reference to
      these philosophers. In Denmark, a third fundamental viewpoint exists, known as
      'ontological ethics'. Phenomenologist KE Logstrup is one of the best-known
      representatives of this view. Basing the line of argument on Logstrup's ethics
      and the view of education associated with this, this article questions the
      relevance of ancient Greek thought to today's world by illustrating a number of
      problems that are connected with the theoretical model of nurse education and
      with the master-apprentice principle. Logstrup associates ethics with the
      aesthetic principle that 'the useless is the most useful' in human life and with
      the view we also see in Kierkegaard's and NFS Grundtvig's writings that ethics
      can be imparted only by indirect means. Logstrup bases his understanding of
      ethics on the Judaeo-Christian concept of Genesis and the view that human beings
      were created with an ethical potential that is best nourished by aesthetic
      impressions.

PMID- 11221390
TI  - A socratic dialogue on the question 'what is love in nursing?
AB  - It is the thesis of the authors that the caring ethic and moral state of being of
      nurses ideally suffuses their professional caring and is thus implicit in their
      ethical decision making. Socratic dialogue is a technique that allows such moral
      attitudes to be made explicit. This article describes a Socratic dialogue
      conducted with nurses on the topic: 'What is love in nursing?' The conclusions
      drawn were based on the belief that the current western-style health care system
      restricts the practice of nursing in such a way as to limit professional caring
      and loving possibilities. Nurses who love in the practice of caring go beyond the
      role definition of the duty of care; they are people who are prepared to think
      differently about their practice as professionals, and are identified as
      competent risk takers committed to the betterment of the other. From this
      dialogue, 'love in nursing' was understood as the willingness and commitment of
      the nurse to want the good of the other before the self, without reciprocity.

PMID- 11221391
TI  - An African ethic for nursing?
AB  - This article derives from a doctoral thesis in which a particular discourse was
      used as a 'paradigm case'. From this discourse an ethic set within a South
      African culture arose. Using many cultural 'voices' to aid the understanding of
      this narrative, the ethic shows that one can build on both a 'justice' and a
      'care' ethic. With further development based on African culture one can take the
      ethic of care deeper and reveal 'layers of understanding'. Care, together with
      compassion, forms the foundation of morality. Nursing ethics has followed
      particular western moral philosophers. Often nursing ethics has been taught along
      the lines of Kohlberg's theory of morality, with its emphasis on rules, rights,
      duties and general obligations. These principles were universalistic, masculine
      and noncontextual. However, there is a new ethical movement among Thomist
      philosophers along the lines to be expounded in this article. Nurses such as
      Benner, Bevis, Dunlop, Fry and Gadow--to name but a few--have welcomed the
      concept of an 'ethic of care'. Gilligan's work gave a feminist view and situated
      ethics in the everyday aspects of responsiveness, responsibility, context and
      concern. Shutte's search for a 'philosophy for Africa' has resulted in finding
      similarities in Setiloane and in Senghor with those of Thomist philosophers.
      Using this African philosophy and a research participant's narrative, an African
      ethic evolves out of the African proverb: 'A person is a person through other
      persons', or its alternative rendering: 'I am because we are: we are because I
      am.' This hermeneutic narrative reveals 'the way affect imbues activity with
      ethical meaning' within the context of a black nursing sister in a rural South
      African hospital. It expands upon the above proverb and incorporates the South
      African constitutional idea of 'Ubuntu' (compassion and justice or humanness).

PMID- 11221392
TI  - The experiences of elderly people in geriatric care with special reference to
      integrity.
AB  - The aim of this study was to obtain an increased understanding of the experiences
      of elderly people in geriatric care, with special reference to integrity. Data
      were collected through qualitative interviews with elderly people and, in order
      to obtain a description of caregivers' integrity-promoting or non-promoting
      behaviours, participant observations and qualitative interviews with nursing
      students were undertaken. Earlier studies on the integrity of elderly people
      mainly concentrated on their personal and territorial space, so Kihlgren and
      Thorsen opened up the possibility of considering the concept of integrity from a
      broader view by recognizing its relationship to the larger framework of the self
      concept. Based on this, findings in the present study indicate that elderly
      people's integrity relating to their corporal self were the least violated. On
      the other hand, their psychological, information and cultural selves were the
      most exposed. The study also identified a further dimension (i.e. one relating to
      social self), which should be included in the concept of integrity because
      respecting elderly people's social self reduces their feelings of loneliness,
      isolation and seclusion. In summary, the results indicate that the concept of
      integrity is complex and has several dimensions.

PMID- 11221393
TI  - Moral sensitivity: some differences between nurses and physicians.
AB  - We report the results of an investigation of nurses' and physicians' sensitivity
      to ethical dimensions of clinical practice. The sample consisted of 113
      physicians working in general medical settings, 665 psychiatrists, 150 nurses
      working in general medical settings, and 145 nurses working in psychiatry. The
      instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting
      Likert-type questionnaire consisting of 30 assumptions related to moral
      sensitivity in health care practice. Each of these assumptions was categorized
      into a theoretical dimension of moral sensitivity: relational orientation,
      structuring moral meaning, expressing benevolence, modifying autonomy,
      experiencing moral conflict, and following the rules. Significant differences in
      responses were found between health care professionals from general medical
      settings and those working in psychiatry. The former agreed to a greater extent
      with the assumptions in the categories 'meaning' and 'autonomy' and to a lesser
      degree with the categories 'benevolence' and 'conflict'. Moreover, those from the
      psychiatric sector agreed to a greater extent to the use of coercion if
      necessary. Significant differences were also found for some of the MSQ
      categories, between physicians and nurses, and between males and females.

PMID- 11221394
TI  - Improving the quality of clinical practice.

PMID- 11221395
TI  - Patients in persistent vegetative state ... and what of their relatives?

PMID- 11221396
TI  - Speed kills: amphetamines, children and nurses.

PMID- 11221397
TI  - Withdrawing or withholding artificial hydration and nutrition.

PMID- 11221398
TI  - Determination of moral negligence in the context of the undermedication of pain
      by nurses.
AB  - The problem of undermedication of pain in health care is widely recognized and
      acknowledged; however, there is an obvious lack of exploration of this problem
      from an ethical perspective. When undermedication is raised as a moral concern,
      the underlying premise is that a patient may experience harm or not benefit from
      ineffective pain management practices. I will argue that the harm is of a
      particular type, that is, moral negligence. My intention is to increase nurses'
      awareness of both the type of moral harm they are causing, and their professional
      and moral duties to provide appropriate medication, more particularly to avoid
      undermedication. I hope that this heightened awareness will be incorporated into
      practice. As a nurse, I chose to focus on nursing for this article, but my claims
      are applicable to other health professions, such as medicine.

PMID- 11221399
TI  - Ethical implications of pain management in a nursing home: a discussion.
AB  - Pain is the most frequently communicated complaint among elderly people.
      Discussion of the ethics of pain management in nursing home residents has not
      appeared in the literature. The purpose of this article is to present an
      ethically-based pain management action plan for elderly nursing home residents.
      Nurses empowered with the latest information and cognizant and comfortable with
      their own views about pain are likely to effectuate a positive patient outcome.
      Further research will add to the current knowledge base while laying the
      groundwork for new interventions.

PMID- 11221400
TI  - The attitude of Canadian nurses towards advance directives.
AB  - This article seeks to shed light on the beliefs that influence nurses' intention
      of respecting or not respecting an advance directive document, namely a living
      will or a durable power of attorney. Nurses' beliefs were measured using a 44
      statement questionnaire. The sample was made up of 306 nurses working either in a
      long-term care centre or in a hospital centre offering general and specialized
      care in the province of Quebec. The results indicate that nurses have a strong
      intention of complying with advance directives written by patients. The analysis
      also shows that four variables determine the strength of this intention: respect
      for autonomy; the location of the workplace; justice; and the dimension of
      relationships and emotions. Although these documents favour the expression of
      patients' wishes, nurses should be aware that they do not systematically
      guarantee respect of a patient's autonomy, nor do they replace a relationship
      based on trust between patients and health care professionals.

PMID- 11221401
TI  - Policy implications of the biological model of mental disorder.
AB  - The current dominant paradigm of mental disorder is that psychopathology is a
      deviation from normal physiological functioning of the brain. This paradigm is
      closely allied to the identity theory of mind in philosophy, which holds that
      mental phenomena are identical with the physical state of the brain. The
      assumptions of the biological model have policy implications, regardless of the
      utility or 'truth' of the paradigm, which should be made explicit for the
      assessment of ethics in mental health policy formulation. The nature of mental
      phenomena has been debated throughout history, without consensus. Several
      critiques of the biological model are offered to encourage enquiring scepticism.
      The policy implications discussed are political conservatism, broadened
      rationales for forced treatment, utility in managed care, and the use of medical
      necessity criteria to allocate treatment.

PMID- 11221402
TI  - Ethical issues in public health nursing.
AB  - This qualitative study was designed to explore ethical issues in public health
      nursing in the Canadian context, and to begin to identify strategies to support
      ethical practice. Twenty-two public health nurses, 11 in rural and 11 in urban
      settings, were asked to describe ethical problems they had experienced in the
      course of their work. These participants most often described situations that
      required a relational response rather than an active choice between options.
      Their goal was to optimize the good, while at the same time maintaining a
      supportive relationship. Analysis revealed five interrelated themes, each with
      several subthemes: relationships with health care professionals; systems issues;
      character of relationships; respect for persons; and putting self at risk. It was
      clear that all aspects of public health nursing have ethical components.

PMID- 11221403
TI  - The Helsinki Declaration: why all the fuss?
AB  - Since 1964, the Declaration of Helsinki has been accepted internationally as the
      cornerstone for research ethics. As such it has been incorporated into a number
      of guidance documents for research undertaken on human subjects. In 1999, the
      American Medical Association put forward a proposal for wide-ranging revision of
      the document, which would significantly weaken the rights of research subjects
      and lower the standards for research on human subjects. This article discusses
      the probable effects of the most significant proposals for change and argues
      against them. It also urges nurses, especially those involved in research, to
      become involved in the international consultation currently being undertaken by
      the World Medical Association.

PMID- 11221404
TI  - Case study. The right to die?

PMID- 11221405
TI  - Scientifically-based clinical practice guidelines or best practices.

PMID- 11221406
TI  - An ethical insight into nursing research in Turkey.
AB  - Scientific and technological improvements are accomplished only because of much
      research. The increase in the number of research studies causes a rise in ethical
      problems. Nursing research is no exception to this. The aim of this study is to
      identify and analyse ethical problems in nursing studies. This research is
      descriptive and partly analytical. It is retrospective in the sense that 169
      Master of Science and 66 doctoral theses written between 1972 and 1998 in the
      Department of Nursing, Institute of Health Sciences, Hacettepe University,
      Ankara, Turkey, were examined. The following ethical rules were used as criteria:
      that no harm should be caused to the subject; the subject was informed about the
      research topic; permission was obtained from the subject; and the privacy of the
      subject was maintained. The evaluation was carried out by distributing the theses
      among background variables and by employing nonparametric tests. The research
      associated with the theses was not harmful to the participants in 93.2%, while
      6.8% were considered to have caused harm. In 72.7% of the theses the subjects
      were not informed of the research; in 73.6%, the researchers did not obtain
      permission from the subjects; and in 8.5% their privacy was not kept. An ethical
      score was assigned to each thesis, which varied between 0 and 15. The mean score
      was 5.02.

PMID- 11221407
TI  - Patient participation in decision making at the end of life as seen by a close
      relative.
AB  - The aim of the present study was to describe variations in patient participation
      in decisions about care planning during the final phase of life for a group of
      gravely ill patients, and how the different actors' manner of acting promotes or
      impedes patient participation. Thirty-seven qualitative research interviews were
      conducted with relatives of the patients. The patients' participation in the
      decisions could be categorized into four variations: self-determination, co
      determination, delegation and nonparticipation. The manner in which patients,
      relatives and caregivers acted differed in the respective variations; this seemed
      either to promote or to impede the patients' opportunities of participating in
      the decision making. The possibility for participation seems to be context
      dependent and affected by many factors such as the dying patient's personality,
      the social network, the availability of different forms of care, cultural values,
      and the extent to which nurses and other caregivers of the different forms of
      care can and want to support the wishes of the patients and relatives in the
      decision-making process.

PMID- 11221408
TI  - Users' views on palliative care services: ethical implications.
AB  - This article is based on the findings of a study that elicited the views of
      terminally ill patients (n = 15), their carers (n = 10) and bereaved carers (n =
      19) on the palliative care services they received. It explores the range of
      ethical issues revealed by the data. Although the focus of the original study was
      on community services, the participants frequently commented on all aspects of
      their experience. They described some of its positive and negative aspects. Of
      concern was the reported lack of sensitivity to the role of the family among
      health professionals. The family, as carers, service users and advocates,
      represent a challenge to professional boundaries and the ethical norms of
      confidentiality and best interest. The accounts reveal the complexity of the
      ethical issues that characterize terminal care, issuing specific ethical
      challenges to nurses and other health professionals involved in this field.

PMID- 11221410
TI  - Comprehensive STD/HIV prevention education targeting US adolescents: review of an
      ethical dilemma and proposed ethical framework.
AB  - Adolescents are increasingly at risk for sexually transmitted diseases (STDs),
      including human immunodeficiency virus (HIV) infection. The prolonged latency
      period, sometimes in excess of five years, and the incubation period of up to 10
      years before the manifestation of symptoms, may foster adolescents' false sense
      of invincibility and denial as they often do not see the devastating effects of
      the disease in their peers until they are older. In turn, their practice of safer
      sex may be hindered and thereby contribute to the escalation of this public
      health crisis among sexually active adolescents. Prevention-focused
      recommendations were made in the USA as a result of this crisis. Recommendations
      were made to: (1) include STD/HIV education in the curricula of grades
      kindergarten to 12; (2) increase to at least 75% the proportion of primary care
      and mental health professionals who provide age-appropriate STD/HIV prevention
      counselling to adolescents; and (3) expand HIV prevention services to include age
      appropriate HIV education curricula for students in grades 4-12 in 95% of
      schools. Yet, in the USA, the provision of school-based comprehensive STD/HIV
      education has been difficult to achieve owing to certain limitations and, in some
      instances, legal action. These limitations include: limited student access;
      restricted content; and the implementation of sporadic and/or brief educational
      programmes. Given these recommendations and the fact that adolescents are
      acquiring STDs and HIV infections at increasing rates, and despite the
      limitations and legal actions, do health care professionals not have an ethical
      obligation to provide adolescents with comprehensive STD/HIV prevention
      education? This ethical dilemma will be discussed using the ethical decision
      making principles of 'autonomy' and 'beneficence', and a decision-making model
      proposed by Thompson and Thompson, and by Chally and Loric.

PMID- 11221409
TI  - Development of an instrument to investigate parents' perceptions of research with
      newborn babies.
AB  - Neonatal intensive care nurses are often involved in research protocols as
      investigators, research assistants or staff nurses implementing the protocol and
      providing support and explanations to families. It is important, therefore, that
      nurses have information about parents' understanding of and attitudes towards the
      research process. The purpose of this study was to begin an exploration of
      parents' perceptions about research with newborn babies through the development
      and validation of a survey instrument. The questionnaire included: demographic
      questions; scaled items about research with newborn babies; scenarios describing
      research studies that varied in degree of risk and benefit to the newborn baby;
      questions about parents' willingness to enrol their newborn baby in the studies
      described; and questions regarding circumstances under which consent should be
      sought. Content and face validity were established by an expert panel and a pilot
      test conducted with a small group of health care professionals and lay persons. A
      convenience sample of 231 parents of newborn babies completed the final version
      of the questionnaire. Factor analysis revealed seven factors corresponding to
      issues identified in the literature, providing evidence of construct validity.
      Parents appeared to have no difficulty in completing the instrument and all
      questions were answered by the majority of participants. It was concluded that
      the questionnaire had adequate psychometric properties and that a mixed method
      approach can be fruitful in exploring sensitive issues.

PMID- 11221411
TI  - Ethical dimensions of supervision: the supervisors' experiences.
AB  - Group-orientated supervision is provided continually to student nurses during
      their education. In the supervision process it is necessary to create a
      relationship between the supervisor and the supervisee that is based on an
      ethical, trusting relationship. The aim of the study was to investigate
      supervisors' (n = 18) experiences of the ethical dimensions of ongoing group
      orientated supervision. An additional aim was to describe the supervisors' values
      by which they are guided in supervision. Data were collected by means of an open
      ended questionnaire and analysed using the hermeneutic transformative process.
      The findings revealed the following themes: respect and responsibility;
      carefulness and sensitivity; reflection and confirmation; and genuineness and
      fairness. The values guiding the supervisors were dignity, normative ethics,
      privacy and confidentiality.

PMID- 11221412
TI  - Nurses' ethical conflicts: what is really known about them?
AB  - The purpose of this article is to report what can be learned about nurses'
      ethical conflicts by the systematic analysis of methodologically similar studies.
      Five studies were identified and analysed for: (1) the character of ethical
      conflicts experienced; (2) similarities and differences in how the conflicts were
      experienced and how they were resolved; and (3) ethical conflict themes
      underlying four specialty areas of nursing practice (diabetes education,
      paediatric nurse practitioner, rehabilitation and nephrology). The predominant
      character of the ethical conflicts was disagreement with the quality of medical
      care given to patients. A significant number of ethical conflicts were
      experienced as 'moral distress', the resolution of which was variable, depending
      on the specialty area of practice. Ethical conflict themes underlying the
      specialty areas included: differences in the definition of adequacy of care among
      professionals, the institution and society; differences in the philosophical
      orientations of nurses, physicians and other health professionals involved in
      patient care; a lack of respect for the knowledge and expertise of nurses in
      specialty practice; and difficulty in carrying out the nurse's advocacy role for
      patients.

PMID- 11221414
TI  - [Containers of perfusion fluid: plastic bottles].

PMID- 11221415
TI  - [ONCO-RESE 19, a coordinated oncologic network].

PMID- 11221416
TI  - [Superficial scars and hydrocolloids].

PMID- 11221417
TI  - [Hungary, nurses fighting for their salary].

PMID- 11221419
TI  - [Hygiene and nosocomial infections].

PMID- 11221418
TI  - [Education of the diabetic patient: hypoglycemia and weight gain].

PMID- 11221420
TI  - [To be a nurse-hygienist].

PMID- 11221421
TI  - [Nosocomial infections and the nurse's responsibility].

PMID- 11221422
TI  - [Taking blood samples: wearing gloves to prevent accidental exposure to blood].

PMID- 11221423
TI  - [A practical course of implementing isolation of patients with infectious
      diseases].

PMID- 11221424
TI  - [Isolation of patients with infection caused by multi-resistant bacteria].

PMID- 11221425
TI  - [Handwashing--at the dawn of the third millenium].

PMID- 11221426
TI  - Learning an invented inflectional morpheme in Spanish by children with typical
      language skills and with specific language impairment (SLI).
AB  - Cross-linguistic research on SLI has suggested that how the disorder is
      manifested depends on the ambient language. For example, research on Italian
      indicates that SLI children do not present difficulties with verb inflection,
      when compared with MLU-matched peers. This pattern contrasts with what has been
      reported for English-speaking children. The present investigation sought to
      examine SLI children's use of inflectional morphology through a language teaching
      task similar to that used by Connell (1987) and Connell and Stone (1992). To
      address cross-linguistic differences, children were speakers of a language
      similar to Italian in its verb agreement paradigm. Sixteen Puerto Rican Spanish
      speaking with SLI and 16 age-matched controls were taught a subject-verb
      agreement suffix that established the subject's gender. Half the children in each
      group were taught the new form via imitation. The rest of the participants were
      trained via a modeling procedure. Both comprehension and production of the target
      form were assessed. Results indicated significant differences across the SLI and
      typical groups for both comprehension and production of the inflectional
      morpheme, regardless of instructional strategy. These findings contradict what
      has been observed in previous studies on teaching an invented rule to children
      with SLI. They also suggest that inflectional morphology may be problematic even
      for children who are learning a morphologically rich language. The explanatory
      power of the process account and the linguistic account of SLI are explored as
      these pertain to the present findings, and suggestions for further research are
      discussed.

PMID- 11221427
TI  - Views of young people using augmentative and alternative communication systems.
AB  - Children with physical impairments who cannot use intelligible speech are often
      recommended augmentative and alternative communication (AAC) systems. In England
      and Wales, it is usually the job of speech and language therapists to support
      development in AAC skills. This paper reports findings from discussion with
      children and young people who use AAC systems concerning their attitudes and
      opinions towards the organization of speech and language therapy, the role of the
      speech and language therapist in school and issues concerned with AAC systems
      themselves. Six young adults and 17 children from London education authorities
      were interviewed on a one-to-one basis and in focus groups. Children were
      interviewed who had a communication aid incorporating at least 20 symbols and/or
      pictures and/or written words, language understanding at the two-word level and
      above, i.e. they demonstrated understanding of adult requests with at least two
      information carrying words. For children using communication aids, it is
      conceivable that their communication systems do not contain appropriate symbol
      vocabulary to express complex ideas, opinions and feelings. Consequently, a
      symbol-based interview tool was designed to allow children to express complex
      issues through visual means. Most children interviewed reported that their AAC
      system was useful to them. Further analysis of opinions revealed that negative
      attitudes towards AAC systems were primarily associated with operational issues
      (technical skills required to operate an AAC system) and issues of self
      image/identity, and to some degree, with a lack of perceived benefit in
      interaction. In apparent contrast to therapists' preferred models of working,
      children and young people identified a preference for therapy organized on a one
      to-one basis targeting linguistic and operational skills. It is suggested that
      more acceptable and individualized design of AAC systems could have implications
      for their use in school and other contexts. The value of service users' views in
      service planning and evaluation are discussed.

PMID- 11221428
TI  - A review of Clinical Terms Version 3 (Read Codes) for speech and language record
      keeping.
AB  - There may be bugs, there may be viruses, but computers are here to stay. Access
      to computers may vary greatly from 'seen one once' to daily usage. However, with
      an increasing dependence on electronic records, even the most remote therapist
      will ultimately be faced with computerization. To make this process as painless
      as possible some commonality in approach is logical. A common vocabulary, for
      instance, would ensure that dysphasia in Cape Town is the same as dysphasia in
      Dundee. This is great in theory but is Clinical Terms Version 3 (Read Codes)
      (CTV3) sufficient to encode records in clinical practice? It is to this end that
      the Speech and Language Therapy Department at Burton Hospital took part in a
      multidisciplinary project with the NHS Centre for Coding and Classification (NHS
      CCC). (NHS CCC became the NHS Information Authority, Coding and Classification on
      1 April 1999.) Their CTV3 offers a standardized clinical terminology. An audit of
      patient case-notes found that 78% of the terms used by therapists were available
      in CTV3. Although there are many issues raised concerning electronic patient
      records, CTV3 presented as a potential vocabulary for recording patient
      information in this acute setting.

PMID- 11221429
TI  - Re: Evaluation of voice quality.

PMID- 11221430
TI  - Re: WILSTAAR.

PMID- 11221431
TI  - Re: Treatment of hypernasality.

PMID- 11221432
TI  - A preliminary account of phonological and morphophonological perception in young
      children with and without otitis media.
AB  - This investigation examined the effects of otitis media with effusion (OME) and
      its associated fluctuating conductive hearing loss on the perception of
      phonological and morphophonological /s/ and /z/ in young children. We predicted
      that children free of OME (OME-) would perform better than children with
      histories of OME (OME+). We also predicted that for the OME+ group morphological
      perception would be harder than phonological perception, because the former
      category carries an additional linguistic load (i.e., plurality). Sixteen
      children, ages 26 to 28 months (M = 26.5, SD = 0.6) were divided into two groups,
      the OME- (n = 8) and OME+ (n = 8) based on OME history during the first year of
      life. Subjects in the OME- group were free of the disease for 4/5 visits and pure
      tone average (PTA) was 12.6 dB HL (SD = 4.8). Subjects in the OME+ group had the
      disease on 3/5 visits and PTA was 23 dB HL (SD = 2.7). Experimental stimuli were
      six monosyllabic novel word-pairs. Members of each word-pair differed only in the
      presence of final voiced or voiceless fricative, marking the targets
      phonologically (e.g., [g [symbol: see text]]/[g [symbol: see text] s] as in
      'law', 'loss') or morphophonologically (e.g., [daep]/[daeps] as in 'map' 'maps').
      Subjects were taught the unfamiliar word pairs using a fast mapping procedure.
      Perception was tested with the bimodal preferential looking paradigm. Children in
      the OME- group performed significantly better than their OME+ counterparts.
      Individual word-pair analyses showed that OME+ group performed more poorly than
      the OME- group on one phonological and on two morphological targets, all ending
      with [s]. For the OME+ group, targets with final [s] posed greater difficulty
      than those with final [z], especially on morphophonological plural-(s) targets.
      The results suggested that the fluctuating hearing loss associated with OME might
      have a negative impact on speech perception.

PMID- 11221433
TI  - Prevalence and developmental course of 'secret language'.
AB  - The prevalence and developmental course of supposed 'secret language' was
      examined in a cohort of twins and closely spaced singletons pairs, with
      systematic assessments at 20 months and again at 36 months. Two forms of apparent
      'secret language' were examined: (1) shared understanding--speech directed
      generally but unintelligible to the parent, although apparently clearly
      understood within the child pair, and (2) private language directed exclusively
      to the other twin/sibling--not intelligible to the parent, but apparently clearly
      understood and used only within the child pair. Both occurred in singleton pairs,
      but the rate was much higher in twins. In most cases it seemed to be a
      developmental phenomenon occurring in the second year of life with the emergence
      of immature speech, and decreasing considerably over the next 16 months. A small
      group of children, primarily male twins, was reported to use a private language
      at 36 months. This group had poorer cognitive and language functioning, and was
      characterized by highly dependent relationships. Some aspects of the twins' home
      environment were less stimulating and less responsive, most probably reflecting
      the abilities and relationships of the children. A follow-up of these children
      when they were approximately 6 years of age showed that language outcome was poor
      for the subgroup (n = 4) who did not develop normal language alongside the use of
      a private language.

PMID- 11221434
TI  - Nature of phonological delay in children with specific language impairment.
AB  - This study investigated the nature of phonological delay in a group of children
      with specific language impairment. It was asked whether phonological errors in
      this group of children were generated by a slow but normal language learning
      process or whether they reflected a selective impairment in some representations
      that enhance normal acquisition and use of a language phonology. A group of 10
      children with SLI (mean age = 5.1) was compared with three groups of normal
      children who were matched in age (age control group, mean age = 5.1), in sentence
      comprehension and recalling (grammar control group, mean age = 3.7), or who
      exhibited a phonological performance lower than the age average (group with low
      phonological performance, mean age = 4.4). The four groups of children were
      assessed in terms of: (1) responses to a mispronunciation detection task; and (2)
      error profiles with complex and simple syllabic structures. Performance on the
      mispronunciation detection task showed that the group with SLI could distinguish
      a target lexical item from acoustic non-word stimuli that were highly similar to
      it in terms of phonetic characteristics. An analysis of overall error rate at
      this task showed, however, that four children with SLI had a much lower
      performance than normal children of the same age, even when the auditory stimuli
      were tokens of the target word, or non-words that were phonetically different
      from the target. A difficulty in coordinating vocal actions in an articulatory
      plan accounted for error profiles with simple syllabic structures both for some
      children with SLI and normal children with phonological performance lower than
      the age average. A severe difficulty with representing complex syllabic
      structures was a homogeneous characteristic of the group with SLI and worked as
      the main indicator of impaired, rather than simply slow, phonological
      development.

PMID- 11221435
TI  - Direct and indirect therapy for word sound deafness.
AB  - This paper evaluates two therapy programmes conducted with PK, an aphasic
      individual with word sound deafness. The first aimed directly to improve
      discrimination skills, using minimal pair tasks supported with lip reading.
      Disappointingly, there were no changes on discrimination tests after this
      therapy, even when PK could benefit from lip reading information. The second,
      indirect, programme of therapy aimed to change the communication behaviours of
      PK's wife. Strategies such as writing and simplifying information were modelled
      and practiced. A detailed information booklet, outlining the target strategies
      and explaining PK's main strengths and weaknesses supported the programme.
      Evaluation of this therapy involved pre- and post-therapy analysis of
      interactions between PK and his wife, with biographical questions forming the
      basis of the interactions. There were several changes after therapy on this
      measure. The number and length of communication breakdowns were reduced, and more
      questions were answered accurately. This study suggests that, in some cases of
      severe word sound deafness, indirect therapies may be most effective.

PMID- 11221436
TI  - Current concepts in the treatment of prostate cancer.

PMID- 11221437
TI  - MSNJ acts to improve services.

PMID- 11221438
TI  - A new strategy for MSNJ. Results of an organizational development study.

PMID- 11221440
TI  - Using CPT frequency reports to analyze E&M use.
AB  - Evaluation and management utilization is a significant compliance concern in the
      current health care environment. Understanding utilization patterns will assist
      the physician in determining whether significant differences exist between the
      physician's billed services and group or national norms.

PMID- 11221439
TI  - State-of-the-art prostate cancer treatment and research. A report from the Cancer
      Institute of New Jersey.
AB  - Prostate cancer is a devastating disease that will be diagnosed in approximately
      200,000 men in 2001. New methods for screening, prevention, and treatment are
      being developed. In addition, novel agents for the treatment of resistant
      prostate cancer are being developed in clinical trials. This review summarizes
      the recent efforts in diet, screening, novel systemic therapies, and alternative
      medicine for prostate cancer.

PMID- 11221441
TI  - Disease and injury reporting requirements for NJ physicians.

PMID- 11221442
TI  - MSNJ launches enhanced HMO complaint system.

PMID- 11221444
TI  - Above all, do no harm. The national imperative: improve health care quality and
      reduce medical errors.

PMID- 11221443
TI  - Harrison S. Martland, MD. The Radium watch-dial workers and the evolution of
      industrial medicine.

PMID- 11221445
TI  - [Use of electrosurgery in patients with pacemaker and implanted defibrillator].

PMID- 11221446
TI  - [The value of exercise test in acute coronary syndrome].
AB  - In general, exercise testing in acute coronary syndrome (ACS) has been used in
      the assessment of physical capacity and to obtain prognostic information. Within
      recent years, however, a number of randomized studies have addressed the role of
      exercise testing in identifying patients, who may benefit from an invasive versus
      a conservative treatment strategy. According to the literature, a normal exercise
      test result after ACS is associated with an excellent clinical outcome. Patients
      who for clinical reasons are unable to perform an exercise test comprise a high
      risk group for future cardiac events. An invasive strategy is warranted in
      patients who continue to have angina and exhibit significant ST-segment
      depression in the exercise-ecg or reversible defects on perfusion scintigraphy.
      Based on the results of a recent, large scale randomized study, patients with
      unstable angina or acute non-Q-wave infarction appear to benefit from an early
      invasive treatment strategy--regardless of the results of a preceding exercise
      test.

PMID- 11221447
TI  - [Three-dimensional ultrasonography in obstetrics and gynecology].
AB  - Medical ultrasound has during the last decades experienced enormous technological
      progress, and in obstetrics and gynaecology it has become an integral part of the
      clinical work. Within the last years several new ultrasound techniques have
      appeared. Three-dimensional ultrasound scanning (3DUS), in which there has been
      great interest, is one of them. Especially within obstetrics and gynaecology
      several papers on that topic describe promising results. Foetal diagnostics
      relying on morphological signs and accurate distance and volume measurements is
      one of the areas, believed to benefit from 3DUS. However, until now only few
      prospective works have been published, most of them counted as preliminary. One
      of the main reasons might be the huge technological challenge. It is proposed
      that technological progress over the next few years will allow feasible real-time
      3D scanning. Thereby obstetrical and gynaecological ultrasound scanning will
      undoubtedly take another giant leap forward.

PMID- 11221448
TI  - [Mortality after administration of human albumin to critically ill patients with
      hypovolemia. An analysis of a systematic Cochrane review].
AB  - A systematic Cochrane review strongly suggested that the administration of human
      albumin to critically ill patients with hypovolaemia increases mortality. This
      review has been widely criticised and the aim of the present paper was to analyse
      the original studies with regard to 1) the randomisation procedure, 2) the
      blinding procedure, 3) the indication of treatment, 4) whether treatment was
      clearly defined and consistent, 5) how normovolaemia was defined, and 6) the
      length of the follow-up period. None of the twelve studies analysed fulfilled
      common criteria in relation to evidence-based medicine. Consequently, there is no
      scientific evidence to support the conclusion that human albumin administered to
      critically ill patients with hypovolaemia increases the mortality. Thus, the
      validity and quality control of systematic Cochrane reviews may be questioned.

PMID- 11221449
TI  - [Sexual activity in ischemic heart disease. Risk and therapeutic possibilities].
AB  - A major concern of patients with ischaemic heart disease is whether sexual
      activity is safe. In addition, patients are often reluctant to discuss sexual
      problems, including erectile dysfunction. Fear of sexual failure or fear of an
      acute ischaemic cardiac event as a result of sexual activity may create anxiety
      and lead to avoidance of sexual activity, which can significantly affect quality
      of life. In patients with a recent acute myocardial infarction the participation
      in a cardiac rehabilitation program should be strongly encouraged. The results
      are an improvement in physical capacity and self confidence. The performance of
      an exercise test at the time of hospital discharge following acute myocardial
      infarction is mandatory, and can be used in both risk stratification and cardiac
      rehabilitation. Patients who can manage a work capacity of at least 100 Watt
      without evidence of myocardial ischaemia or arrhythmias may without concerns take
      part in an active sexual life. Comprehensive information and appropriate use of
      pharmacologic agents for erectile dysfunction can add significantly to quality of
      life.

PMID- 11221450
TI  - [Surgical strategy in treatment of renal tumor complicated by tumor thrombosis in
      inferior vena cava].
AB  - INTRODUCTION: In Denmark 650 renal cell carcinoma cases are diagnosed every year,
      and in 5-9% of the cases there is spread of the tumour in the form of tumour
      thrombosis in the inferior vena cava inferior. AIM: The purpose of this work is
      to describe the methods and outcome of operation regarding patients with such
      tumour thrombosis. According to the literature, the survival of these patients is
      not reduced provided there are no metastases to regional glands nor any distant
      metastases. METHODS: We describe 13 cases operated in the urological ward at
      Rigshospitalet (the Danish national hospital) during a nine-year period. RESULTS:
      In all 13 cases radical nephrectomy was performed and the tumour thrombus
      removed. In three cases the thrombus stretched into the right atrium, and the
      operations on these patients were performed in extra-corporal circulation. In one
      case the operation was performed in veno-venous bypass. There were two peri
      operative deaths; one patient died during the operation from uncontrollable
      bleeding, the other on the ninth postoperative day. In both cases the thrombus
      stretched into the atrium. There were minor complications in three out of the
      remaining 11 cases, and in the last eight cases there were no complications. The
      two year survival was estimated at 50%. CONCLUSION: On the basis the literature
      and our own results we recommend that patients with kidney tumour and tumour
      thrombus in the inferior vena cava are evaluated with a view to operation.

PMID- 11221451
TI  - [Use of outcome measures in physical medicine/rheumatological rehabilitation.
      Results of a questionnaire study].
AB  - BACKGROUND: As part of the EU-project ProESOR (Project for the European
      Standardisation of Outcome Measurement in Rehabilitation), a survey was
      undertaken to investigate the use of Outcome Measures (OM) within rehabilitation
      across Europe. This paper presents some of the Danish results of this survey.
      AIM: Evaluate the extent of use of OMs in rehabilitation. MATERIAL: All 37
      Rheumatology/Physical Medicine and Rehabilitation departments and institutions in
      Denmark. METHOD: A questionnaire was mailed to the institutions. This included
      questions about the institution and its personnel, and nine diagnostic groups:
      Low back pain, multiple sclerosis, neuromuscular disorders, rheumatoid arthritis,
      spinal cord lesions, stroke, traumatic brain injury, hip and knee replacement,
      and lower limb amputees, with estimation of the number of patients treated and
      the extent of use of OMs. RESULTS: The majority of the departments treated more
      than 200 in- and out-patients per year. Patients with low back pain and
      rheumatoid arthritis were the largest patient groups, followed by patients with
      hip and knee replacement and stroke. OMs were most frequently used with
      rheumatoid arthritis and, to a lesser extent, patients with low back pain.
      Although many departments used one or more OM, several did not use any at all.
      For each diagnostic group more OMs were used if the patient was treated in a
      department specialised for patients with the particular diagnosis. More OMs were
      used with patients who tended to have longer inpatient stays. CONCLUSION: There
      is little consensus regarding which OMs should be used. We recommend that this
      challenge be taken up.

PMID- 11221452
TI  - [Ultrasonic dissection in laparoscopic cholecystectomy. A safe alternative to
      patients with pacemaker].
AB  - Use of electrocautery for laparoscopic surgery in patients with implanted
      pacemakers can create serious pace dysfunction. In these patients, the innovation
      of ultrasonic coagulation shears has provided the potential for safe routine
      laparoscopic cholecystectomy. We present a case where laparoscopic
      cholecystectomy was performed with the ultrasonic dissecting hook. The operation
      was converted to laparotomy due to unclear anatomy with further dissection using
      the ultrasonic hook. The intra- and postoperative courses were uneventful with no
      cardiac arrhythmias. More attention should be drawn towards this new surgical
      device so that patients with pacemakers may undergo routine laparoscopic surgery.

PMID- 11221453
TI  - [Three-dimensional ultrasonography of monoamniotic twins].
AB  - A case of monoamniotic twins is described. Three-dimensional ultrasound scanning
      (3DUS) was used to visualise the fetuses lying in a single amniotic cavity.
      Entanglement of the umbilical cords with several knots was also visualised. The
      infants were delivered by elective caesarean section at 32 + 2 weeks with an
      uncomplicated postpartum course. Several knots found between the two umbilical
      cords, with separate placental insertion, were consistent with the ultrasound
      scan. We suggest that dedicated software solutions for volumetric ultrasound and
      knot analysis could contribute to a more precise description of the entanglement,
      which again would be a useful prognostic tool in the antenatal management and
      delivery of monoamniotic twins.

PMID- 11221454
TI  - [Picture of the month: subcutaneous emphysema].

PMID- 11221455
TI  - [Ear implantations].

PMID- 11221456
TI  - [Leukemia examination of personnel who were stationed in the Balkans. A statement
      from the Forsvarets Sundhedstjeneste].

PMID- 11221457
TI  - [Use of depleted uranium and the risks in war].

PMID- 11221458
TI  - [Reform of the borderline concept--a paradigmatic shift?].

PMID- 11221459
TI  - [Ritual circumcision--a medico-social problem].

PMID- 11221460
TI  - [The rubric "Picture of the month"].

PMID- 11221461
TI  - [Circumcision].

PMID- 11221462
TI  - [Ritual circumcision].

PMID- 11221463
TI  - [Circumcision].

PMID- 11221464
TI  - [Health screening--of "value" for the individual?].

PMID- 11221465
TI  - [Chemokines and chemokine receptors. Review article].
AB  - Chemokines form a new superfamily of small glycoproteins. They are key molecules
      that activate and direct the migration of different types of leukocytes from the
      blood stream into sites of infection and inflammation. In addition to this role
      certain chemokines have been reported to act on different types of cells (e.g.
      hematopoietic progenitor cells, dendritic cells, fibroblasts, keratinocytes).
      Other of them also play a role in wound healing, in angiogenesis and in viral
      infections. These molecules have a high degree of amino acid sequence homology
      and they have four conserved cysteins forming two essential disulphide bonds.
      They are divided into four classes (families) depending on the position of the
      first two cystein residues. Chemokines mediate their proinflammatory effects by
      binding to a variety of specific receptors, belonging to the G protein-coupled
      superfamily of seven-transmembrane (serpentine) receptors. Some of this receptors
      serve as coreceptors for HIV-viruses, some of them could be expressed as markers
      preferentially in Th1 or Th2 subpopulations. This paper summarizes data on
      chemokines and their receptors, target cells and production in physiological and
      pathological conditions.

PMID- 11221466
TI  - EEG spectrum as information carrier.
AB  - Spontaneous and provoked changes of vigilance and consciousness are determined by
      TCS (thalamocortical system) activity. This is relatively easy to monitor using
      EEG, which is a complex curve but open to analysis, e.g., by means of FFT (fast
      Fourier transformation). Twenty six persons (six normal controls, twelve
      epileptics, eight dements) had EEG recorded during rest, reaction to sound, and
      perception to simple tones or chords from Smetana's symphonic poem Vysehrad. The
      length of reaction time was found dependent on FFT changes: the longer the time,
      the higher are the delta and the lower the alpha activities in the EEG spectrum.
      However, with alpha increasing during relaxation, the reaction time grew longer
      regardless of whether delta had increased due to hyperventilation, sleep or
      subclinical epileptic discharges. During the perception of tones, FFT showed
      changes in the alpha and delta bands different from those during the perception
      of chords, and different again during relaxation, and that in both normal
      controls and epileptics. The demented persons revealed no discernible FFT
      differences in the perception of either tones or chords, the only differences
      were found in the resting sections of the spectrum. One and the same stimulus
      produced a stereotype FFT response, i.e., different stimuli elicited different
      FFT response in healthy and epileptic persons. The dements responded to identical
      stimuli differently, and had stereotype FFT response elicited by the same
      stimuli. The results suggest that FFT can represent the information content of
      the EEG curve and, indirectly, also that of micro-EEG as it reverberates between
      the thalamus and the cortex in the form of neuronal activity impulsations. This
      interneuronal impulsation coding is disordered in dements with atrophy of the
      cortex; it is marked, on the one hand, by increased variability in the perception
      of identical stimuli, and, on the other hand, by impaired differentiation, and,
      consequently, by increasingly stereotype responses to different stimuli.

PMID- 11221467
TI  - The evaluation of thyroid and islet autoantibodies in type 1 diabetes mellitus.
AB  - Type 1 diabetes mellitus is an autoimmune disease in which the presence of
      different autoantigens can often be found. The aim of our study was to evaluate
      the prevalence of antibodies against insulin (IA) and autoantibodies against
      glutamic acid decarboxylase (anti-GAD), tyrosine phosphatase IA-2 (anti-IA-2),
      thyroid microsomal peroxidase (anti-TPO) and thyroglobulin (anti-TG) in 55
      randomly selected Type 1 diabetic patients (34 males, 21 females). Mean age of
      these patients was 39 +/- 12 yrs, mean duration of diabetes 18 +/- 13 yrs.
      Positivity of anti-GAD was found in 29 (58%) patients, anti-IA-2 in 13 (25%)
      patients, IA in 46 (85%) patients, anti-TPO in 10 (21%) and anti-TG in 11 (23%)
      patients. Simultaneous positivity of thyroid and islet autoantibodies was found
      in 6 (11%) patients whereas the positivity at least one of them was in 38 (69%)
      patients. No relationship between glycated hemoglobin and autoantibody
      concentration was found in the whole group of patients. The autoimmune thyroid
      disease was newly detected in 4 patients from high concentration of thyroid
      autoantibodies together with impaired TSH and T4 values and ultrasonography
      finding. No clinical evidence of thyroid disease was previously found in these
      patients. Positivity of anti-GAD or anti-IA-2 was found in almost 65% and of any
      thyroid autoantibody in almost 30% of our patients. Four patients with autoimmune
      thyroid disease were newly identified. We conclude that the evaluation of thyroid
      autoantibodies in Type 1 diabetic patients may improve the diagnosis of thyroid
      disease in very early stage and thus prevent consequent complications.

PMID- 11221468
TI  - The influence of methylene blue and L-NAME on the development of streptozotocin
      induced diabetes in rats.
AB  - The cytokine-induced overproduction of nitric oxide by immunocompetent cells with
      subsequent development of oxidative stress is suggested to be one of important
      pathophysiological mechanisms of the pancreatic beta cells damage in
      streptozotocin-induced experimental diabetes. The aim of our study was to compare
      the influence of two nitric oxide inhibiting compounds: methylene blue and L-NAME
      (N-omega-nitro-L-arginine-methyl ester) on the streptozotocin diabetes
      development and the oxidative stress parameters in male rats. Blood glucose,
      glycated haemoglobin, serum malondialdehyde concentration and erythrocyte
      superoxide dismutase activity were measured in control, diabetic (streptozotocin
      70 mg/kg i.p.), methylene blue (50 mg/kg in the food), and diabetic group treated
      simultaneously with methylene blue (10 animals in each group). In the second
      experiment the L-NAME was used instead of methylene blue. It was found that both
      methylene blue and L-NAME partially suppressed the development of diabetes, but
      did not unambiguously influence the oxidative stress parameters. We conclude,
      that both methylene blue and L-NAME partially suppress the development of
      streptozotocin-induced diabetes in rats. The precise mechanism of this effect is
      not clear. We failed to demonstrate clear effect of methylene blue and/or L-NAME
      on oxidative stress development in diabetic rats.

PMID- 11221469
TI  - Effect of exogenous estrogen on male rats bone.
AB  - Not only androgens however but also estrogens may be important for the growth and
      maintenance of the male skeleton. The estradiol treatment of intact male rats
      significantly decreased serum testosterone concentrations and the weight of
      seminal vesicles, however, not to the level of castrated animals. In spite of a
      low serum testosterone the administration of estradiol did not produce changes in
      the density, ash weight and mineral content of the tibia. In castrated rats with
      low serum testosterone bone density, ash weight and mineral content of the tibia
      were decreased, compared with intact controls. These our observation indicate
      that estrogen has a important role to retain bone mass in males as well as
      females.

PMID- 11221470
TI  - [Effect of growth hormone and other hormones on trabecular bone structure in
      acromegaly].
AB  - The influence of growth hormone upon trabecular bone remodelation is not
      definitely clear. The authors of this study compared static and dynamic
      histomorphometric data of bone patterns of 28 numbered group of acromegalics and
      35 numbered group of healthy individuals. They correlated also levels of growth
      hormone, thyroxine, prolactin and testosterone in men with histomorphometric
      parameters in acromegalic patients. The results showed statistically significant
      differences between normal and acromegalic trabecular bone, which has comparable
      trabecular volume, but significantly wider bone trabeculae and lower mean
      trabecular density. There were no correlations found between growth hormone
      levels and levels of thyroxine, prolactin, measured testosterone and
      histomorphometric parameters.

PMID- 11221471
TI  - [Duration of the effect of growth hormone on spongious bone].
AB  - The influence of duration of growth hormone action (length of history of
      acromegaly) upon acromegalic trabecular bone histology was followed in 28 biopted
      active acromegalics. The histology of trabecular bone was standardized by
      histomorphometric parameters. No statistically significant relation between
      length of acromegalic history and any of measured histomorphometric parameters
      (trabecular volume, trabecular thickness, absolute osteoid volume and osteoid
      surface) was found. The reason of this finding is probably consequence of serum
      growth hormone level, which changes during period of history in each acromegalic
      patient. With aim to find out if growth hormone influences bone histomorphometry
      of acromegalics after causal treatment (removal of hypophyseal adenoma causing
      overproduction of growth hormone), the comparison of histomorphometry from bone
      bioptic patterns of six active acromegalics with their bone patterns average 9.3
      years after hypophyseal operation was done. With the exception of one eugonadal
      woman, all acromegalics were hypogonadal in time of second biopsy. Nevertheless
      no statistically significant differences between histomorphometric data
      (trabecular volume, trabecular thickness, surface and absolute volume of osteoid)
      were found. With knowledge of fact that there is low number of rebiopted
      acromegalics, these results could support idea of protective action of growth
      hormone upon trabecular bone of acromegalics during nine years after treatment.

PMID- 11221472
TI  - [Electronic medical journals are a reality of today].
AB  - Internet is changing the way that science is communicated. The future of medical
      publishing is going electronic. Publishing medical electronic journals is
      becoming a standard routine for all prominent publishers. Present-day trends in
      the publishing of medical electronic journals are outlined.

PMID- 11221473
TI  - [Medical schools and science].

PMID- 11221474
TI  - [Perspectives in gene therapy of polycystic kidney disease].
AB  - An overview concerning principles and development of gene therapy from
      experimental models to first trials of application gene therapy in clinical
      medicine is provided. Increased attention is focused on specific methods of gene
      transfer into kidneys. Renal hereditary diseases represent an important subgroup
      of the diseases of the kidney, leading non rarely to chronic renal failure;
      (autosomal dominant) polycystic kidney disease remains to be one of the most
      frequent and clinically important. Preliminary conditions, including technical
      tools and pathophysiological insights to be fulfilled, as prerequisites for an
      application of gene therapy in polycystic kidney disease, are discussed.

PMID- 11221475
TI  - [Pathophysiology of development of acute pancreatitis].
AB  - Acute pancreatitis is a severe illness with unclear prognosis and mortality rate
      ranging from 5 to 70%. Dynamic observation of changes in systemic inflammatory
      response of the body may be helpful in estimating the development of acute
      pancreatitis as well as giving an idea of therapeutical possibilities. It is
      obvious, that the intensive therapeutic intervention may reduce the influence of
      secondary insults (ischemic-reperfusion syndrome, hypoxia, disrupted
      physiological function of the bowel) on pancreatic tissue. Surgery is limited
      only for precisely specified indications in the latter stage of acute
      pancreatitis (secondary inflammation of the necrosis). In this paper we conclude
      some pathophysiological mechanisms involved in the development of acute
      pancreatitis.

PMID- 11221476
TI  - Supracondylar fracture of the humerus in children--closed pinning.
AB  - The supracondylar fracture of the humerus is one of the most common in children,
      approximately one hundred per year, in Kuwait. The treatment consists in
      manipulation and fixation by plaster of Paris in the most stable position,
      usually maximal possible flexion in the elbow joint. For irreducible or unstable
      cases a percutaneous fixation by Kirschner wires was introduced in September
      1993. Two or three Kirschner wires were used either parallel from radial condyle
      or cross fixation from ulnar and radial condyle. Cross fixation was used in older
      children without swelling of the elbow. This method has helped to reduce and
      stabilize the fracture allowing fixation of the elbow at 90 degrees flexion
      reducing the risk of the blood supply disturbance. The aim of this study was to
      find rules for proper selection of these two types of fixation.

PMID- 11221477
TI  - [Laparoscopic method of surgical treatment of inguinal hernia].
AB  - Authors present the both method of laparoscopic inquinal hernia repair. They
      prefer laparoscopic praeperitoneal approach using prolene mesh 6 x 11 cm.

PMID- 11221478
TI  - [Antibiotic prophylaxis in hip joint surgery].
AB  - Nosocomial deep wound infections are serious complications after hip joint
      surgery. Our aim was to determine whether there is a difference in rates of
      nosocomial infections between group of patients after elective surgery of hip
      replacement and group of patients with hip replacement after trauma. Both groups
      of patients had perioperative prophylaxis with amoxycillin. We found that the
      overall trauma patients infection rate was 0.9 per cent compared with 1.5 per
      cent for elective surgery infections. In both groups of patients a postsurgery
      stress was documented according to increase of acute phase proteins (C-reactive
      protein, orosomucoid and fibrinogen) in plasma for a minimum 10 days after
      surgery. We conclude, that both groups of patients had benefit from amoxycillin
      prophylaxis therapy.

PMID- 11221479
TI  - [Evaluation of the effect of plastic casts from the aspect of prevention of
      thromboembolic disease].
AB  - Immobilization after trauma escalates risk of thrombosis. Our objective was to
      determine whether there is a difference in rates of deep vein thrombosis (DVT)
      after immobilization with plastic casts or routinely plaster of Paris in trauma
      patients. Despite both groups of patients do not show difference in blood
      coagulation tests (APTT, TT, PT, levels of fibrinogen and of D-dimer in plasma)
      during time of immobilization the evidence of DVT according to scintigraphy was
      lower in group of patients with plastic casts (3 per cent to 10 per cent).

PMID- 11221480
TI  - [Traumatic asphyxia with an unusual etiology. Case report].
AB  - The authors present a casuistry of the injury endangering the life, which was
      caused by the unusual mechanism. The injured person was pulled inside of a
      conveyer and while shifting, not only his arm and physical (brachial) plexus was
      damaged, but he was also and especially, strangled by his clothes and he was
      seriously asphyxiated, which origin was in the first phase unexplainable.

PMID- 11221481
TI  - [EEG findings in patients with systemic lupus erythematosus].
AB  - We have examined electroencephalography (EEG) and Mini-Mental State Examination
      (MMSE) in 38 patients with verified diagnosis of systemic lupus erythematosus
      (SLE). In the clinical neurological finding there were epileptic attacks in 9
      patients, 10 patients suffered from stroke, 15 patients from lupus headache, 4
      patients from psychosis, in 15 patients cranial neuropathy was present, in one
      person extrapyramidal syndrome. EEG findings were in 12 patients normal (32%), in
      26 patients abnormal (66%). In 3 cases there were focal abnormalities (8%), in 19
      cases episodic ones (48%), four times abnormalities were diffuse (10%). Diffuse
      abnormalities correlated in EEG findings with case history of GM attacks.

PMID- 11221482
TI  - [Anatomic illustration and its authors at the Medical School in Prague].
AB  - This article is a longer version of the introductory address opening the
      exhibition of anatomical illustration in the Academic Club of First Medical
      Faculty of Charles University in May 1999. The history of anatomical
      illustration, its significance and its two main forms, scientific drawing and
      didactical illustration, are shortly introduced. The development of this form of
      art at the Medical Faculty in Prague is shown and is demonstrated by examples of
      illustrations. Two old authors of illustrations are mentioned: an unknown author
      of illustrations of the first illustrated textbook of anatomy in Prague that was
      written by Ch. S. a Zeidlern, and F. Belopotocky who illustrated the Atlas of
      Anatomy by W. Stanek written in Czech in 1840. In more detail are discussed the
      following artists and anatomical illustrators of 20th century connected with the
      Institute of Anatomy of Charles University: J. Rejsek, E. Illing, S. Machacek, M.
      Med, V. Seichert, I. Helekal a J. Kacvinsky.

PMID- 11221483
TI  - [What your personal archive should contain. Practical suggestions for the young
      (and not so young) researcher].
AB  - In science it is indispensable to be able to organise knowledge. It is a
      prerequisite of efficient scientific research to have also a good system of
      filing and organisation for relevant documents. This means that the researcher
      must be able to identify and properly file--right from the start of his or her
      career--all documentation and records which will also be useful to future
      research. This paper contains a number of practical recommendations on how to
      establish and maintain the scientist's personal archive; how to classify and
      select documents; and how to archive them in a way which allows for easy
      retrieval. The aim of this paper is to eliminate all errors and omissions, as
      subsequent rectification can be laborious and time consuming. Documents are
      arranged beginning with those which are important for the researcher as an
      employee (representing his personal portfolio) and are followed by documents
      attesting to his scientific competence and experimental skills (presentations at
      conferences, published papers, teaching activities, grant projects, etc.). It is
      important and useful to conduct an occasional review of one's personal archive,
      to update and revise some documents, and to discard others. A change of
      employment or affiliation usually presents a good opportunity for such a review.
      An archive which is systematically maintained throughout a researcher's career is
      a valuable source of objective personal reminiscences and reviews of scientific
      development.

PMID- 11221484
TI  - [Arnold Jirasek and his Clinic in the fatal years of 1939 to 1959].

PMID- 11221485
TI  - Change: chaos or challenge?

PMID- 11221486
TI  - Neuropsychopharmacology of pathological aggression and sexuality.

PMID- 11221487
TI  - The neurobiology, neuropharmacology, and pharmacological treatment of the
      paraphilias and compulsive sexual behaviour.
AB  - There has been increasing interest in the treatment of sexual disorders in recent
      years. Sexual disorders are classified in DSM-IV as sexual dysfunctions,
      paraphilias, and gender identity disorders. The sexual dysfunctions are
      nondeviant or nonparaphillic. The sexual dysfunction disorders should include
      "hyperactive sexual desire disorder" under sexual desire disorders. Further,
      there should be a specifier for paraphilias of "with hypersexuality" or "without
      hypersexuality." There is still incomplete understanding of the neurobiology of
      sexual disorders although functional neuroanatomy and neoropharmcological
      research has exposed the neurotransmitters, receptors, and hormones that are
      involved in sexual desire. Various pharmacological agents including serotonin
      reuptake inhibitors, antiandrogens, LHRH agonists, and others have been
      documented as reducing sexual desire. An algorithm for the use of these drugs in
      the treatment of the paraphilias as well nonparaphilic hypersexuality is
      outlined. The modes of action, dosages, aims of treatment, and usual methods of
      prescribing these agents is reviewed in this article. Some future directions of
      research in pharmacological treatment is also discussed.

PMID- 11221488
TI  - The neuropsychopharmacology of criminality and aggression.
AB  - Although the idea that aggression has biological components is not a new one,
      recent research in genetics, neuropsychopharmacology, and neuroimaging has helped
      clarify the biological contributions to aggression. Studies to date have focused
      on serotonergic function and impulsive aggression. Reduced levels of
      cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) are associated with
      impulsive aggression. Pharmacochallenge studies have found decreased serotonergic
      responsiveness associated with impulsive aggression. Neuroimaging studies suggest
      a role for the prefrontal cortex, along with other regions of the brain, in the
      expression of aggression. Serotonin is not the only aspect of brain function
      implicated in impulsive aggression, and further work is being done on other
      neurotransmitters and neuropeptides.

PMID- 11221489
TI  - A social problem index for Canada.
AB  - OBJECTIVE: To construct an index that represents the general level of social
      problems among Canadian provinces and territories. METHOD: Factor weights were
      used to combine provincial and territorial rates for homicide, attempted murder,
      assault, sexual assault, robbery, divorce, suicide, and alcoholism into a single
      Social Problem Index. RESULTS: The resulting index demonstrated strong positive
      intercorrelations among its factors across provinces. That is, provinces that
      showed high rates on one factor tended to show high rates on the others as well.
      The validity of the Social Problem Index is demonstrated by its positive
      correlation with an independent measure of the likelihood of having experienced
      personal trauma. CONCLUSIONS: The robust nature and apparent validity of the
      Social Problem Index suggest that it can be well used for needs assessments and
      theoretical studies and as a feedback mechanism to national, provincial, and
      community leaders on the social problem status of their particular jurisdictions.

PMID- 11221490
TI  - [Introduction to genetic psychiatry: progress in uncovering genetic
      susceptibility to psychiatric disorders].
AB  - The recent progress in human genetics suggests major benefits in clinical
      practice, including psychiatry. This article introduces the research methodology
      used in psychiatric genetics and explains how it is applied, for a better
      understanding of the challenges facing psychiatric genetics and the strategies
      being used to overcome them. We will review the evidence of genetic factors in
      psychiatric disorder etiology as well as the specificity or non-specificity of
      their expression. We will discuss problems associated with the approximate nature
      of diagnostic methods, the incomplete penetrance and the genetic heterogeneity of
      psychiatric disorders, the presence of phenocopies and our uncertainty concerning
      the mode of inheritance of psychiatric disorders. Finally, we will provide an
      overview of the most promising results and set out priorities for future studies.

PMID- 11221491
TI  - Is schizophrenia on the decline in Canada?
AB  - OBJECTIVE: To examine changes in prevalence rates of treated schizophrenia over
      10 years in a small urban teaching centre using data from the Kingston
      Psychiatric Record Linkage System (KPRLS). METHOD: The KPRLS, a psychiatric case
      register established in 1984, collects and links demographic, diagnostic, and
      service use information for all psychiatric inpatients, outpatients and emergency
      contacts at the 3 hospitals in Kingston, Ontario. A preliminary comparison of
      first admissions for schizophrenia used chart review (1976-1978) and KPRLS data
      (1996-1998). The KPRLS data were used to calculate population-based prevalence
      rates of treated schizophrenia in 3 census years (1986, 1991, 1996) for patients
      in the 2 counties closest to Kingston. RESULTS: The preliminary comparison showed
      a 42% decrease in the number of first-admission schizophrenia cases over 20
      years. In the main study, the annual inpatient prevalence rates decreased
      significantly (52%) from 1986 to 1996 with no corresponding change in outpatient
      rates, regardless of sex. Although total major affective disorders increased,
      this was due to an increase in major depression, not bipolar disorder.
      CONCLUSIONS: This is the first Canadian case-register study to support the widely
      reported falling rates of schizophrenia in other parts of the world over the last
      40 years. Since this is a geographically limited prevalence study based on only
      10 years of data, further research over longer periods of time in other regions
      of the country is required to support or refute these findings.

PMID- 11221492
TI  - Serum lipid concentrations in patients with comorbid generalized anxiety disorder
      and major depressive disorder.
AB  - OBJECTIVE: To examine the lipid levels in a sample of patients with comorbid
      generalized anxiety disorder (GAD) and major depressive disorder (MDD). METHODS:
      Serum lipid concentrations were examined in 40 patients with both GAD and MDD, in
      27 patients with MDD only, in 26 patients with GAD only, and in 24 healthy
      control subjects. RESULTS: All mean serum cholesterol concentrations are
      presented in Table 1. The mean serum total cholesterol concentration in patients
      with both GAD and MDD was significantly higher than in MDD-only patients, GAD
      only patients, and control subjects. The triglyceride concentration was also
      significantly higher in patients with both GAD and MDD than in MDD-only patients,
      GAD-only patients, and control subjects. Patients with both GAD and MDD had a
      lower mean high-density lipoprotein cholesterol (HDL-C) concentration than did
      patients with GAD only and control subjects. The serum concentration of low
      density lipoprotein cholesterol (LDL-C) was higher in patients with both GAD and
      MDD than in patients with MDD only and GAD only and healthy control subjects.
      CONCLUSIONS: Our findings indicate that the patients with both GAD and MDD have
      increased serum cholesterol, triglyceride, and LDL-C and reduced HDL-C levels.
      These patients may have a greater risk of mortality from coronary artery disease
      (CAD) than do patients with either depression or anxiety disorder.

PMID- 11221493
TI  - Regression toward the mean: its etiology, diagnosis, and treatment.
AB  - This paper explores the phenomenon of "regression toward the mean." The primary
      effect of this is to affect scores on retesting so that they are closer to the
      population mean. Thus, people who are selected for inclusion in a study because
      their scores on some measure are above (or below) some criterion have values on
      retesting that are less extreme. This may make it appear that the study
      participants have improved; this will occur even in the absence of an effective
      intervention. We explore the reasons for regression toward the mean and how it
      can be detected and discuss some methods that may minimize its effects.

PMID- 11221494
TI  - Adverse reactions to St John's Wort.
AB  - OBJECTIVE: To report 2 cases of adverse reactions to St John's wort, a popular
      herbal treatment for depression. METHOD: We present 2 case histories and review
      the existing literature regarding St John's wort. RESULTS: St John's wort may
      cause serotonin syndrome in sensitive patients. In addition, St John's wort may
      be associated with hair loss. CONCLUSIONS: For clinical reasons, it is important
      to recognize and report adverse reactions to herbal remedies and to document that
      these treatments have side effects commensurate with their potent action on brain
      neurochemistry.

PMID- 11221495
TI  - Is the minimum duration of hypomania in bipolar II disorder 4 days?

PMID- 11221496
TI  - Combination risperidone and quetiapine therapy in refractory schizophrenia.

PMID- 11221497
TI  - Supersensitivity psychosis in patients with schizophrenia after sudden olanzapine
      withdrawal.

PMID- 11221498
TI  - Galactorrhea induced by paroxetine.

PMID- 11221499
TI  - Obsessive-compulsive symptoms secondary to methylphenidate treatment.

PMID- 11221500
TI  - "Internet delusion" in a patient with a schizoaffective disorder.

PMID- 11221501
TI  - The postsurgical lumbosacral spine. Magnetic resonance imaging evaluation
      following intervertebral disk surgery, surgical decompression, intervertebral
      bony fusion, and spinal instrumentation.
AB  - It should be clear to those who perform and interpret medical images of the spine
      following one or more forms of surgical therapy that the images are often
      difficult to interpret in part because of the superimposition of the original
      disease process, alteration engendered by the surgery, or a complication of the
      surgical procedure. Although long-term experience in this area is helpful in
      regard to improving interpretive skills, certain sequela can be predicted
      regardless of the interpreter's background. Once the normal or expected
      postsurgical findings are understood, the subtle and gross changes that depart
      from these observations can be analyzed better. The importance of a high level of
      competence in the domain of post-therapeutic neurodiagnostic imaging is in the
      knowledge that the patient returning for restudy may be acutely in distress or
      even in medical danger (e.g., postoperative spondylitis). In fact, the clinical
      presentation posttherapeutically may well be more severe or dire than was
      observed pretherapeutically. An indepth appreciation of the broad range of
      clinicoradiologic possibilities as presented [figure: see text] here should place
      the medical imaging physician in an excellent position to provide an experienced
      diagnostic evaluation in the patient presenting with recurrent or new signs and
      symptoms following any one of the spectrum of possible spinal surgical
      procedures.

PMID- 11221502
TI  - Imaging of lumbar degenerative changes involving structures other than disk
      space.
AB  - Degenerative changes in the lumbar spine involve intervertebral disks and
      intervertebral posterior elements at different extents. Much less attention has
      been directed toward degenerative changes of the posterior vertebral elements,
      however, when compared with intervertebral disk degeneration. These changes may
      involve the apophyseal joints, the bony elements of the neural arch, the
      intervening soft tissues, and the spinal longitudinal ligament. Roentgenographic,
      CT, and MR findings in these changes are depicted.

PMID- 11221503
TI  - Imaging of spinal infection.
AB  - MR imaging is the modality of choice for the detection, staging, and differential
      diagnosis of inflammatory disorders of the spine. Infectious spondylitis is
      characterized by the involvement of two adjacent vertebrae and the intervening
      disk with severe BME and early destruction of the end plates. The disk space is
      narrowed and typically exhibits water-equivalent signal intensity on T2-weighted
      or STIR images. Prevertebral and epidural extensions, abscess formation,
      enhancement of the BME, the disk space, and the surrounding granulation tissue
      are well demonstrated by gadolinium-enhanced images. Cervical spondylitis
      frequently involves more than one level. Bone marrow abnormalities may be subtle
      at this level and increased signal intensity of the disk space on T2-weighted or
      STIR images is an important finding. The risk for neurologic complications is
      increased. Granulomatous infections caused by tuberculosis, brucellosis, fungi,
      and parasites, including hydatid disease (Echinococcus), are frequently
      associated with imaging findings different from those seen with nonspecific
      bacterial infection. In patients with chronic infectious spondylitis, diffuse
      reactive bone marrow changes with decreased signal intensity on T1-weighted
      images, increased signal intensity on T2-weighted and STIR images, and increased
      uptake after gadolinium administration may occur. This phenomenon is probably
      caused by reactive bone marrow stimulation, simulating diffuse hematologic
      neoplastic disease. Erosive intervertebral osteochondrosis with bandlike disk
      gadolinium enhancement and BME, which is commonly associated with local pain, is
      the most important differential diagnosis of bacterial spondylitis.

PMID- 11221504
TI  - Vertebral tumors and pseudotumors.
AB  - This article discusses lesions that may present as vertebral tumors at radiologic
      examination. Conditions are discussed in order of decreasing frequency:
      pseudotumoral lesions, vertebral metastases, bone marrow diseases, and primary
      vertebral tumors, which are relatively uncommon. The differential diagnosis
      between nontraumatic benign and malignant vertebral collapses is also discussed.

PMID- 11221505
TI  - Imaging lumbar spinal stenosis.
AB  - The entire concept of spinal stenosis is based on the assumption that there is a
      minimal space necessary for the function of the neural content of the spinal
      canal, and this space, under certain circumstances, gets too small. This may seem
      self evident, but it was not until the middle of the previous century that there
      was sufficient focus on this concept to establish the diagnosis of lumbar spine
      stenosis.

PMID- 11221506
TI  - Radiologic assessment of lumbar intervertebral instability and degenerative
      spondylolisthesis.
AB  - Despite many efforts, there is no clear and widely accepted definition of lumbar
      instability because there are no unquestionable and currently applicable clinical
      or radiologic criteria available for this entity. This article reviews the
      current concepts of lumbar instability and the different imaging modalities used
      to make the diagnosis as evident as possible.

PMID- 11221508
TI  - The histologic diagnosis of melanoma.
AB  - The pathologic diagnosis of melanoma is of crucial importance because it provides
      the patient and his or her attending physician with the knowledge of a
      potentially life-threatening or an almost curable condition. The histopathologic
      diagnosis of melanoma is based on the simultaneous or systematic assessment of
      several well-known histopathologic features. This article discusses the author's
      approach to the histopathologic diagnosis of melanoma for specific situations.

PMID- 11221507
TI  - Acquired degenerative changes of the intervertebral segments at and suprajacent
      to the lumbosacral junction. A radioanatomic analysis of the nondiskal structures
      of the spinal column and perispinal soft tissues.
AB  - In earlier evolutionary times, mammals were primarily quadrupeds. However, other
      bipeds have also been represented during the course of the Earth's several
      billion year history. In many cases, either the bipedal stance yielded a large
      tail and hypoplastic upper extremities (e.g., Tyrannosaurus rex and the
      kangaroo), or it culminated in hypoplasia of the tail and further development and
      specialization of the upper extremities (e.g., nonhuman primates and human
      beings). In the human species this relatively recently acquired posture resulted
      in a more or less pronounced lumbosacral kyphosis. In turn, certain compensatory
      anatomic features have since occurred. These include the normal characteristic
      posteriorly directed wedge-shape of the L5 vertebral body and the L5-S1
      intervertebral disk; the L4 vertebral body and the L4-L5 disk may be similarly
      visibly affected. These compensatory mechanisms, however, have proved to be
      functionally inadequate over the long term of the human life span. Upright
      posture also leads to increased weight bearing in humans that progressively
      causes excess stresses at and suprajacent to the lumbosacral junction. These
      combined factors result in accelerated aging and degenerative changes and a
      predisposition to frank biomechanical failure of the subcomponents of the spinal
      column in these spinal segments. One other specific problem that occurs at the
      lumbosacral junction that predisposes toward premature degeneration is the
      singular relationship that exists between a normally mobile segment of spine
      (i.e., the lumbar spine) and a normally immobile one (i.e., the sacrum). It is
      well known that mobile spinal segments adjacent to congenitally or acquired fused
      segments have a predilection toward accelerated degenerative changes. The only
      segment of the spine in which this is invariably normally true is at the
      lumbosacral junction (i.e., the unfused lumbar spine adjoining the fused sacrum).
      Nevertheless, biomechanical failures of the human spine are not lethal traits; in
      most cases today, mankind reaches sexual maturity before spinal biomechanical
      failure precludes sexual reproduction. For this gene-preserving reason,
      degenerative spinal disorders will likely be a part of modern societies for the
      foreseeable eternity of the race. The detailed alterations accruing from the
      interrelated consequences of and phenomena contributing to acquired degenerative
      changes of the lumbosacral intervertebral segments as detailed in this discussion
      highlight the extraordinary problems that are associated with degenerative
      disease in this region of the spine. Further clinicoradiologic research in this
      area will progressively determine the clinical applications and clinical efficacy
      of the various traditional and newer methods of therapy in patients presenting
      with symptomatic acquired collapse of the intervertebral disks at and suprajacent
      to the lumbosacral junction and the interrelated degenerative alterations of the
      nondiskal structures of the spine.

PMID- 11221509
TI  - The genetics of cutaneous melanoma.
AB  - Although germline mutations in CDKN2A are present in approximately 25% of large
      multicase melanoma families, germline mutations are much rarer in the smaller
      melanoma families that make up most individuals reporting a family history of
      this disease. In addition, only three families worldwide have been reported with
      germline mutations in a gene other than CDKN2A (i.e., CDK4). Accordingly, current
      genomewide scans underway at the National Human Genome Research Institute hope to
      reveal linkage to one or more chromosomal regions, and ultimately lead to the
      identification of novel genes involved in melanoma predisposition. Both CDKN2A
      and PTEN have been identified as genes involved in sporadic melanoma development;
      however, mutations are more common in cell lines than uncultured tumors. A
      combination of cytogenetic, molecular, and functional studies suggests that
      additional genes involved in melanoma development are located to chromosomal
      regions 1p, 6q, 7p, 11q, and possibly also 9p and 10q. With the near completion
      of the human genome sequencing effort, combined with the advent of high
      throughput mutation analyses and new techniques including cDNA and tissue
      microarrays, the identification and characterization of additional genes involved
      in melanoma pathogenesis seem likely in the near future.

PMID- 11221510
TI  - Dysplastic melanocytic nevi and prognostically indeterminate nevomelanomatoid
      proliferations.
AB  - This article reviews the concept of dysplasia and the distinguishing features of
      dysplastic nevi, including their premalignant potential, their biologic markers
      of tumor progression, and their reproducibly recognizable clinical and histologic
      characteristics.  An additional emphasis is placed on describing gray zone
      melanocytic neoplasms with hybrid histopathologic and biologic characteristics
      between nevi and melanoma.  In particular, dysplastic nevi with high-grade and
      dermal dysplasia and other potentially related, prognostically indeterminate,
      nevomelanomatoid proliferations (PINM tumors), including the more recently
      recognized nevoid melanoma and minimal deviation neoplasms, are discussed. 
      Because of their overlapping features with more overtly benign and malignant
      neoplasms, these lesions may confound precise determination of biologic outcome. 
      Accordingly, the concept of prognostic indeterminacy and the use of the term PINM
      tumors to connote these problematic lesions are introduced.

PMID- 11221511
TI  - Thin melanomas.
AB  - Thin melanoma refers to that grouping of melanomas that statistically have a good
      prognosis and survival rate. A small but significant percentage of these lesions
      metastasize and cause mortality. Histologically, these lesions comprise a diverse
      grouping of tumors of any intraepidermal growth pattern; in the radial or
      vertical growth phase; or in anatomic level I, II, III, or IV. Additional
      histologic findings may also be variably present, such as regression, tumor
      infiltrating lymphocytes, and mitoses. Molecular studies suggest that thin
      melanomas may have different properties to thicker and metastatic melanomas. The
      factors governing the ability of thin melanomas to metastasize and cause
      mortality are not known. Certain histologic and molecular parameters, some of
      which have been alluded to previously, may provide clues to understanding the
      parameters governing the aggressive nature of some of these lesions. Further
      research is required to enhance our understanding of thin melanomas.

PMID- 11221512
TI  - Primary noncutaneous melanoma.
AB  - Primary noncutaneous melanomas are rare neoplasms that affect patients in an
      older age group than primary cutaneous melanomas. The prognosis is worse than
      primary cutaneous melanomas because of the advanced stage at the time of
      diagnosis, the rich vascular and lymphatic supply of mucosal sites, and the lack
      of clinical suspicion of the tumor because of its rarity. The initial treatment
      is surgical resection but the location may make it technically difficult to
      obtain complete tumor removal. Unlike cutaneous melanoma, sun exposure is not a
      risk factor for noncutaneous melanomas. Darker-skinned individuals may have a
      higher incidence of some noncutaneous melanomas, such as anorectal melanomas. It
      is important for clinicians and pathologists to recognize primary noncutaneous
      melanomas to provide early detection and optimum management.

PMID- 11221513
TI  - Minimal deviation melanoma. Borderline and intermediate melanocytic neoplasia.
AB  - In the concept of MDM, the term melanoma has been reserved for lesions showing a
      vertical growth component. Vertical growth, divorced from any prognostic
      implications, is simply a morphologic designation. Such a maneuver also serves to
      validate the category of MDM, although it might then be inappropriate to
      characterize such lesions as melanoma. From my view, the modifier "minimal
      deviation" takes the onus of prognosis out of the equation. For common melanomas,
      size of a vertical growth component has relativity to prognosis. It is unlikely
      that, in comparable size-ranges, the MDM have a more aggressive nature than the
      common melanoma. It seems appropriate to propose that MDM measuring less than 1.5
      mm in vertical dimensions could be characterized as melanocytic neoplasia of
      indeterminant malignant potential. Those less than 1 mm in vertical dimensions
      would be borderline variants and those in the range of 1 to 1.5 mm would be
      intermediate examples. Those greater than 1.5 mm could be characterized as
      melanocytic neoplasias of indeterminant (uncertain) malignant potential without
      additional qualifications.

PMID- 11221514
TI  - The shifting patterns of metastatic melanoma.
AB  - Management of cutaneous melanoma becomes more difficult as tumor cells
      metastasize to sites that are remote from the primary tumor. There is a hierarchy
      of risk associated with cancer spread by different routes and to different
      organs. Differences in clinical outcome indicate critical variations in
      pathobiology at different stages in disease evolution. Prevention of the
      evolution of melanoma is critical, especially beyond the stage of nodal
      involvement.

PMID- 11221515
TI  - Classification and staging of melanoma.
AB  - Although a standardized and uniformly accepted cancer staging system is an
      essential and fundamental requirement to enable meaningful comparisons across
      patient populations, the sometimes capricious biologic behavior of melanoma makes
      developing such a staging system particularly difficult. Since the earliest well
      documented attempts at classifying patients with cutaneous melanoma were
      described more than 50 years ago, the identification of increasingly powerful
      prognostic factors has led to sequential modifications of the cutaneous melanoma
      staging system. The current AJCC staging system is based on relatively well
      established prognostic factors; however, several recent reports have identified
      additional prognostic factors not included in the current system, and other
      studies support the re-evaluation of some of the currently employed staging
      criteria. Some of the more controversial areas include the relevance of level of
      invasion versus tumor thickness, optimal cutoffs for tumor thickness, importance
      of ulceration, the grouping of satellites with in-transit metastases, the
      inclusion of microsatellites and local recurrences as a separate staging
      criterion, the replacement of size of nodal mass with number of positive nodes,
      the importance of nodal metastases in more than one nodal basin, and the
      prognostic significance of distant metastases. Future modifications of the
      staging system are anticipated to better incorporate these observations. Stage
      specific staging recommendations for the patient with melanoma provide the
      clinician with a framework to most efficiently assess extent of disease in an era
      of cost-conscious clinical practice. In the asymptomatic patient with primary
      melanoma (stage I or II), we recommend a chest roentgenogram and evaluation of
      alkaline phosphatase and LDH levels; extensive radiologic evaluations are not
      indicated, because the rate of detection in this population is extremely low.
      Additional staging information should also be obtained by the technique of
      lymphatic mapping and sentinel lymphadenectomy. For patients with local-regional
      disease (stage III, satellites, and local recurrence), a selective approach to
      imaging studies is warranted. For this patient population, we recommend complete
      blood count, liver function tests including alkaline phosphatase and LDH, a chest
      roentgenogram, and a CT scan of the abdomen. Although the yield of these tests,
      particularly CT of the abdomen, in detecting distant metastases in asymptomatic
      patients is low, they may identify false-positive abnormalities and provide an
      important baseline for future studies in this high-risk population. For patients
      with disease below the waist or in the head and neck region, we recommend CT of
      the pelvis and CT of the neck, respectively. Additional studies should be done
      only if clinically indicated. Finally, patients with known systemic disease
      (stage IV) should be more comprehensively evaluated, because the likelihood of
      detecting asymptomatic metastases is higher. Accordingly, in addition to the work
      up outlined previously for stage III patients, we also perform a CT scan of the
      chest and MR imaging of the brain; other studies (e.g., bone scan,
      gastrointestinal series) are performed on the basis of symptoms.

PMID- 11221516
TI  - Update of diagnostic and prognostic markers in cutaneous malignant melanoma.
AB  - The biomolecules described in this article generally have been studied as
      possible diagnostic or clinically prognostic markers in the context of melanoma
      disease progression as measured by the gold standards of tumor thickness and
      development of metastasis. Most of the markers showed variations in expression
      phenotype only during the deeply invasive or metastatic stage of tumor
      progression and were thus predictive of clinical outcome only for these subgroups
      of patients. Some of the markers may have utility in identifying patients with
      deeply invasive primary tumors who are likely to develop metastasis and thus
      should receive earlier, more aggressive treatments. In addition, some of the
      markers may identify patients likely to respond better to a new type of therapy
      (e.g., anti-angiogenic therapy in a patient whose tumor is overexpressing VEGF or
      immunotherapy for a patient whose tumor is expressing high levels of MART-1). In
      the future, it will probably be possible to employ new techniques, such as laser
      guided microdissection of tissues, to isolate individual melanocytes in order to
      identify the earliest stage-specific defects that contribute to an aggressive
      biological behavior. Identifying the subset of patients with superficially
      invasive melanomas who will develop metastatic disease will continue to provide a
      challenge.

PMID- 11221518
TI  - Managing obstructive sleep apnoea.

PMID- 11221517
TI  - Managing pneumonia in general practice.

PMID- 11221519
TI  - Passing the MRCGP: a winning strategy.

PMID- 11221521
TI  - Asthma's link with affluence.

PMID- 11221522
TI  - A care-home patient with incontinence.

PMID- 11221523
TI  - What causes asthma and can it be prevented?

PMID- 11221524
TI  - Key developments in respiratory medicine.

PMID- 11221525
TI  - Casebook: shortness of breath.

PMID- 11221526
TI  - Drug treatments and topics: the year in review.
AB  - In 2000, more than 100 new drugs and devices were approved for use in the United
      States. Many drugs were reformulated to provide new uses, more effective dosing,
      or improved costs. In an effort to ensure safe prescribing practices, the Food
      and Drug Administration has increased drug and device monitoring and services
      available to clinicians.

PMID- 11221527
TI  - Avoiding Medicare fraud. Part 2.
AB  - In 1997, Congress authorized payments to nurse practitioners (NPs) for Medicare
      provided services. NP services are now reimbursed at 85% of the physician fee
      schedule. As this source of reimbursement was realized, so was a new area of
      liability for NPs. Failure to follow billing rules can result in payment denial,
      repayment of fees already paid, mandated educational activities, fines, fraud
      prosecution, loss of Medicare-billing ability, and loss of employment.
      Appropriate billing entails adhering to guidelines for selecting procedure codes
      and proper medical documentation. This article identifies high-risk areas for NPs
      who bill Medicare and provides resources for accessing additional information.

PMID- 11221528
TI  - Treatment options for the menopausal woman.
AB  - Hormone replacement therapy (HRT) is not benign; its adverse effects can be as
      serious as the health threats it was designed to prevent. An element of trial and
      error exists when tailoring a patient treatment regimen. Lack of clinician
      knowledge and poor clinician-patient communication can result in incorrect or
      suboptimal HRT decisions. This article presents a comprehensive assessment of
      options for women entering menopause; recent epidemiologic findings and various
      HRTs are discussed.

PMID- 11221529
TI  - Replacing New York State dentists.

PMID- 11221530
TI  - Focal dermal hypoplasia. Goltz syndrome. A case report.
AB  - Focal dermal hypoplasia (Goltz syndrome) is a rare syndrome comprising
      developmental anomalies of tissues and organs of mesoectodermal origin. As a
      result, there are abnormalities of the eyes, skin, oral structures,
      musculoskeletal system and central nervous system. This article describes the
      case of a four-year-old female with focal dermal hypoplasia (FDH) who displayed
      many of the oral features associated with this syndrome. Her condition was
      complicated by recurrent episodes of facial cellulitis in relation to skin
      lesions of the face. This is an unusually severe case of FDH with previously
      unreported association of cutaneous anomalies and facial cellulitis.

PMID- 11221531
TI  - A dynasty of doctors.

PMID- 11221533
TI  - Proper training should precede injections.

PMID- 11221532
TI  - Answers, please.

PMID- 11221534
TI  - Seller beware.

PMID- 11221535
TI  - Support for instruction about homosexuality in South Carolina public schools.
AB  - Research has demonstrated that recognition of sexual orientation begins in
      adolescence. However, students who identify as gay or lesbian report that the
      subject of homosexuality is virtually absent from classroom instruction. In South
      Carolina public schools, the subject of homosexuality may not be discussed except
      during instruction about sexually transmitted diseases. In 1997, survey data were
      obtained from 534 South Carolina registered voters to determine level of support
      for school-based sexuality education, including support for instruction about
      homosexuality. Overall, support for sexuality education was strong, however,
      homosexuality was the least-supported subject in the survey. In addition,
      registered voters were less sure as to what grade level instruction about
      homosexuality should begin. Characteristics of voters who supported and opposed
      instruction about homosexuality in the public schools were examined and compared.
      These data may be useful in building support for sexuality education programs
      that address this controversial topic.

PMID- 11221536
TI  - Patterns of health-risk behavior among Japanese high school students.
AB  - This study explored patterns of health-risk behaviors among Japanese high school
      students and examined if a cluster and an accumulation of health-risk behaviors
      existed. Self-administered questionnaires were employed in 1999 using a sample of
      1,466 students (male 50.5%, female 49.5%) in grades 10 through 12 at seven public
      senior high schools in Okinawa, Japan. Health-risk behaviors studied included
      cigarette smoking, alcohol use, thinner use, nonuse of seat belts, suicide
      ideation, sexual intercourse, weight loss practices, and physical inactivity.
      Among male and female students, cigarette smoking, alcohol use, and sexual
      intercourse clustered. Accumulation of these risk behaviors also occurred because
      the observed proportion was greater than the expected proportion assuming
      independent occurrence. Vocational high school students and upper graders were
      strongly associated with accumulation of health risk behaviors. These findings
      identify a high-risk target group among Japanese adolescents and suggest that
      preventive intervention strategies should take into consideration the cluster and
      accumulation of health-risk behaviors.

PMID- 11221537
TI  - The role of academic discipline and gender in high school teachers' AIDS-related
      knowledge and attitudes.
AB  - Adolescents represent the fastest growing segment of HIV+ individuals in the
      United States. Therefore, high school teachers should be both knowledgeable of
      and comfortable with issues related to HIV/AIDS. This study examined high school
      teachers' AIDS-related knowledge and attitudes. One hundred forty-one high school
      teachers from nine central Massachusetts high schools participated. Participants
      completed the "HIV/AIDS Knowledge and Attitudes Scales for Teachers," as well as
      questions regarding their teaching experience and academic disciplines. Results
      indicated a direct relationship between teachers' knowledge of HIV/AIDS and
      positive or supportive attitudes toward HIV/AIDS. Significant differences were
      found based on academic discipline, with allied health teachers scoring
      significantly higher on the knowledge scale than teachers in any other
      discipline. Specific examples are discussed, as is the need for increased teacher
      training and comprehensive AIDS education.

PMID- 11221538
TI  - Health-risk behaviors among middle school students in a large majority-minority
      school district.
AB  - Since 1991, the Centers for Disease Control and Prevention has administered the
      Youth Risk Behavior Survey (YRBS) biennially to representative samples of high
      school students. YRBS results indicate that health-risk behaviors often developed
      during middle school years. To date, few state and local education agencies have
      administered the YRBS-Middle School. This study measured prevalence of health
      risk behaviors among middle school students in a large, majority-minority school
      district (n = 1,783). Results indicated that young adolescents (ages 11-14) are
      engaging in multiple health-risk behaviors. For example, 24.4% seriously
      considered committing suicide in the previous year, 53.3% had been in a physical
      fight, 50.2% ever drank alcohol, 17.9% ever used marijuana, and 13.4% had already
      had sex. Such behaviors potentially could lead to serious consequences related to
      their educational achievement and overall health status. Health-related policy
      and program applications are discussed.

PMID- 11221539
TI  - Addressing the threats of MDMA (Ecstasy): implications for school health
      professionals, parents, and community members.

PMID- 11221540
TI  - Creating awareness of the relationship between racial and ethnic stereotypes and
      health.

PMID- 11221541
TI  - Asthma outcomes at an inner-city school-based health center.
AB  - Childhood asthma has reached near-epidemic levels in the US cities. Innovative
      strategies to identify children with asthma and prevent asthma morbidity are
      needed. This study measured asthma outcomes after initiation of an inner-city
      elementary school health center with a schoolwide focus on asthma detection and
      treatment. The site was an inner-city elementary school in Minneapolis, Minn. The
      study design incorporated a pre and post comparison with a longitudinal cohort of
      children (n = 67) and a cross-sectional cohort of children before (n = 156) and
      after (n = 114) the intervention. Hospitalization rates for asthma decreased 75%
      to 80% over the study period. Outpatient visits for care in the absence of asthma
      symptoms doubled (p < .01), and the percentage of students seeing a specialist
      for asthma increased (p < .01). Use of peak flow meters, use of asthma care
      plans, and use of inhalers also improved (p < .01). While no change occurred in
      school absenteeism, parents reported that their children had less awakening with
      asthma and that asthma was less disruptive to family plans. This schoolwide
      intervention that included identification of children with asthma, education,
      family support, and clinical care using an elementary school health center was
      effective in improving asthma outcomes for children.

PMID- 11221542
TI  - Biotransformation of 13(Z)-retinoic acid in mouse skin and human keratinocyte
      cultures.
AB  - The metabolism of 13-(CIS) in mouse skin in vivo which was treated with TPA (or
      vehicle) typically showed that the retinoid was oxidized to 4-hydroxy, 5,6-epoxy
      13-CIS, 5,8-oxy-13-CIS and undergoes geometric isomerization to RA. Applied 13
      (CIS) in human keratinocyte cultures showed that the retinoid was oxidized to 5,6
      epoxy-13-CIS, 5,8-oxy-13-CIS, and isomers. Pretreatment with the antioxidant
      butylated hydroxyanisole(BHA) resulted in a large decrease in formation of the
      oxirane and increased formation of the alcohol in mouse skin. Proposed mechanisms
      suggested the involvement of peroxyl radicals and prostaglandin H synthase for
      the biotransformation of retinoids.

PMID- 11221543
TI  - The influence of age and gender on HLA-DR in Chinese child-onset type 1 diabetes
      mellitus patients.
AB  - To further clarify the association of HLA DR alleles with type 1 diabetes
      mellitus and the influence of age-onset and gender on type 1 diabetes, we
      investigated HLA-DR in 76 child onset Chinese (36 males) type 1 diabetes patients
      and 154 normal controls by using PCR-SSP (sequence specific primer). The mean age
      of onset of diabetes patients was 8.43 +/- 3.96 year-old. Our results revealed
      that the frequencies of DR3, DR4 and DR9 in diabetes patients were significantly
      higher than those in control group (all P < 0.01). The susceptible alleles were
      DR3, DR4, DR9, with relative risks of 8.25, 2.57 and 2.67, respectively. The
      protective alleles to type 1 diabetes were DR 2, DR8, DR11 and DR12 with relative
      risk of 0.24, 0.15, 0.16 and 0.39, respectively. There were no significant
      differences between the frequencies of HLA DR 3, DR4, DR9, DR3/4, DR3/9 and DR4/9
      in male and female diabetic children. We divided the diabetes patients into three
      groups according to their age of onset (1-5 years old, 6-10 years old and 11-17
      years old). There was a trend that the frequencies of DR9 decreased with the
      increase of age at onset, but there was no significant difference of DR3, DR4,
      DR9, DR3/4, DR3/9 and DR4/9 frequencies between diabetes children with age onset
      0-10 years and 11-17 years. As to the influence of gender on the HLA genotypes,
      the frequency of DR3/4 decreased with the increase of age at onset for male
      patients and the frequency of DR3/4 increased with the increase of age at onset
      for female patients.

PMID- 11221544
TI  - Craniofacial growth changes of Mongolian children with normal occlusion from 8 to
      12 years.
AB  - The purpose of this study is to quantify the changes of craniofacial skeleton in
      Mongolian children born in Taiwan. They had normal occlusion and pleasing
      profiles, received no previous orthodontic treatment, and were aged 8 to 12
      years. The subjects included 24 boys and 24 girls from whom lateral cephalograms
      were taken for the study. After measurements and statistical analysis, the
      findings in this investigation indicated the following: 1. Although the growth of
      the mandible showed forward and upward rotation, the growth pattern of
      craniofacial portion from ages 8 to 12 was stable with no significant difference
      in angular measurements. Nevertheless, there were significant differences in
      linear measurements. The linear dimensions exhibited a gradual increase with age
      for both boys and girls. This fact should be considered in the diagnosis and
      treatment plan for young patients under 12 years old with anteroposterior
      discrepancies. 2. There was a considerable degree of sexual dimorphism with boys
      showing greater angles in the maxilla-mandibular relationship and greater late
      skeletal and dental changes. Most of the changes in various parameters occurred
      earlier in girls, and in boys these changes were distributed more evenly over the
      entire period of study.

PMID- 11221546
TI  - Ocular manifestations in children with developmental delay preliminary report.
AB  - To investigate systemic diseases and ocular problems among children with
      developmental delay, forty-one children (28 boys and 13 girls with a mean age of
      3.53 +/- 2.25 y/o) were enrolled in this study. In addition to ocular
      examinations, we used centrality, steadiness, fixation and flash visual evoked
      potentials (VEPs) tests on all of the children. We found that 23 children
      (56.10%) had ocular problems with optic atrophy and strabismus being the two most
      common ocular abnormalities. The two major clinical manifestations of
      developmentally delayed children were mental and motor retardation. The primary
      test of centrality, steadiness and fixation and visual evoked potentials could be
      useful tools in evaluating the visual pathway and ocular motility. Preliminary
      results showed that more than half of the children with developmental delay had
      certain ocular abnormalities. The high incidence of ocular abnormalities deserves
      careful attention when these children are brought to seek medical help. Further
      study of ocular problems among developmentally delayed children and a search for
      more reliable examination method should be encouraged.

PMID- 11221545
TI  - Familial breast cancer in southern Taiwan.
AB  - The purpose of this study is to evaluate whether there are pathobiologic
      differences and differences in overall rates survival between familial and non
      familial breast cancer patients in Taiwan. A retrospective study was performed
      evaluating 76 familial breast cancer patients in 69 families, which included two
      BRCA1 related cases and six BRCA2 related cases. Patients were compared with 425
      non-familial sporadic cases. Familial breast cancer patients had similar ages and
      stages as non-familial patients (mean, 46.6 years vs 48.9 years, p = 0.306).
      However, the familial breast cancer patients with BRCA1 and BRCA2 related cases
      presented at lower stages (p = 0.034) and younger ages than non-familial patients
      (mean, 45.1 years vs 48.9 years P = 0.042). The occurrence of infiltrating ductal
      carcinoma and lobular carcinoma in situ was not significantly different in the
      two groups. Mucinous carcinoma was represented with 6.7% (4/76) and 1.3% (1/76)
      medullary carcinoma. The overall grade of familial breast cancer, including BRCA1
      and BRCA2 related cases in 8 infiltrating ductal carcinoma, was significantly
      higher than that of controls. The mean follow up was 4.5 years for familial
      breast cancers. Five- and 10-year overall survival rates were 69% and 61% for
      those with a family history, compared with 86% and 64% for those in the control
      group (p = 0.644). There were no statistically significant differences in disease
      free survival rates between the two groups at 5 or 10 years (69% vs 78% in 5
      years; 48% vs 58% in 10 years) (p = 0.862). Despite the younger ages and earlier
      stages at presentation in familial breast cancer patients with BRCA1 and BRCA2
      related cases, the familial breast cancer patients had higher grade
      patholobiologic characteristics, but similar prognoses when compared with
      sporadic breast cancer patients. Owing to the limited number of familial cases in
      this study, more cases and longer follow up are needed.

PMID- 11221547
TI  - Focal cerebral hyper-perfusion in phantom limbs: assessed by Tc-99m HMPAO SPECT.
AB  - Phantom limb pain is a common experience for patients who have received
      amputation. However, the definite mechanism is still not clear. Here, we describe
      a patient who suffered from phantom limb pain after left above-elbow amputation.
      The Tc-99m hexamethylpropylene amine oxime (HMPAO) brain single photon emission
      computed tomography (SPECT) study revealed increased regional cerebral blood flow
      in the right parietal cortex. This finding may imply the involvement of cerebral
      cortex in the development of phantom limb pain. Further study is worthwhile to
      elucidate the utility of SPECT and the role of cortex in phantom limb pain.

PMID- 11221548
TI  - Peritoneal scintigraphy for diagnosing periumbilical leakage in a patient on
      continuous ambulatory peritoneal dialysis.
AB  - Continuous ambulatory peritoneal dialysis (CAPD) offers several advantages over
      hemodialysis for patients with end-stage renal disease; however, this technique
      also includes many documented complications. A case with clinical suspicion of
      dialysate leakage on CAPD was investigated by peritoneal scintigraphy using
      technetium-99m macroaggregated human albumin (99mTc-MAA). Peritoneal scintigraphy
      showed radiotracer accumulation over the periumbilical area at 2 hours 30 minutes
      after intraperitoneal infusion of 99mTc-MAA. Six hours of imaging revealed more
      apparent radioactivity at the same site. This study is to illustrate the simple
      diagnostic helpfulness of peritoneal scintigraphy in a patient with a CAPD
      related structural defect.

PMID- 11221549
TI  - Peripheral retinal angioma presenting as macular pucker--case report.
AB  - A 36-year-old Taiwanese male, who denied any history of ocular trauma,
      intraocular inflammation or surgery, had a macular pucker associated with a
      peripheral retinal angioma. The yellow-white macular pucker, which extended from
      the temporal disc to the macular area, was thicker and with more prominent
      retinal striaes than found among the elderly. Regression of the macular pucker
      did not occur with incomplete laser photocoagulation of the angioma. Retinal
      angioma should be considered in the differential diagnosis of macular pucker
      without posterior vitreous detachment (PVD) in healthy young patients. Management
      of this association is primarily complete obliteration of the angioma.

PMID- 11221550
TI  - [Development of neurobiology effects the future of psychotherapy].

PMID- 11221551
TI  - [Prospects in psychotherapy research].
AB  - The point of departure for this discussion is a critical review of the philosophy
      of randomized controlled trials (RCT) and their specific errors when applied to
      psychotherapeutic methods. There is a gap between the highly artificial settings
      of psychotherapy RCT and naturalistic psychotherapy procedures, which are
      grounded more in personality than in technique, less regulated, and mostly
      eclectic. Although RCT are necessary for general assessments of efficacy, they
      should be complemented by efficiency studies and evaluation of whole health care
      systems which include psychotherapy. We argue against overstretching the analogy
      of good clinical practice (GCP) research for the purpose of admitting new
      psychotropic drugs to psychotherapy research. A rational approach to
      psychotherapy for indication, quality ascertainment, and allocation of resources
      needs research which is methodologically explicable, replicable, and relevant to
      practice. The Cochrane Collaboration is a means of distributing such knowledge
      and making it work for practitioners. However, Cochrane also sheds light on
      psychological and practical obstacles which must be overcome before public health
      care systems can utilize new scientific results. The discussion of disorder
      specific psychotherapy versus general psychotherapy ends by emphasizing the
      importance of more detailed psychopathology and pathopsychology of dysfunctions
      that cannot be sufficiently explained in manuals. Such dysfunctions--not
      necessarily specific for diagnoses or abnormality at all--can then be matched to
      specific psychotherapy tools. Further innovations can be expected from
      neurosciences, and some of the most promising paradigms are discussed. Finally,
      the lasting importance of hermeneutics is stressed not only with regard to the
      generation of new hypotheses but also to guiding the psychotherapeutic process.

PMID- 11221552
TI  - [What is science-based psychotherapy? On the discussion of guidelines for
      psychotherapy research].
AB  - The scientific nature of psychotherapy can be defined by two partially
      interrelated criteria: validity of the theory underlying a therapy and efficacy
      or effectiveness of a therapy. To enhance the scientific basis of a
      psychotherapeutic approach, research is needed on therapeutic objectives,
      principles, and processes, measuring methods, process-outcome relationships, and
      efficacy and effectiveness of therapies. Determination of efficacy requires
      randomized clinical trials (RCT). The scientific basis must be seen as the
      continuous development of a psychotherapeutic approach. In contrast, the question
      of whether a psychotherapeutic approach is well established is dichotomous. In
      addition to scientific criteria, those deriving from mental health policy and
      economics are also important. This paper presents various approaches to
      ascertaining efficacy. According to the criteria of the American Psychological
      Association Task Force, to be "well-established," treatments for specific
      disorders must be shown efficacious in at least two independent randomized
      clinical trials. Although comparability is limited, we propose that
      psychotherapeutic research be conceptualized into phases, as in
      pharmacotherapeutic research.

PMID- 11221553
TI  - [Experience guided neuronal plasticity. Significance for pathogenesis and therapy
      of psychiatric diseases].
AB  - Whereas the basic wiring of the mammalian central nervous system is genetically
      predefined, its fine tuning throughout different phases of infancy, childhood,
      and adulthood are highly experience-dependent. There is growing evidence from a
      variety of experimental data that juvenile experience and learning events
      modulate the functional maturation of the brain, thereby shaping the neuronal
      substrate for the development of intellectual and socioemotional capacities.
      Since early experiences occur during phases of elevated neuronal and synaptic
      plasticity, they induce an "imprinting" of synaptic connectivity and neural
      circuitry in the infant brain. Results from experimental research support the
      hypothesis that impoverished intellectual stimulation and traumatic
      socioemotional experience during early childhood may impair the formation of
      functional brain pathways, in particular of the limbic circuits, which play a
      major role in emotional behavior and learning. Such defective systems,
      representing functional "scars" in the brain, may be the neuronal basis of a
      variety of mental disorders and clinical symptoms caused by early stressful
      psychosocial environments. A basic thesis of this paper is that mechanisms
      involved in neuronal learning and memory are not only used and reused in
      structuring the CNS during the initial establishment of connections in the
      immature brain but also can be employed in molding personality and behavior
      during psychotherapy in adulthood.

PMID- 11221554
TI  - [Conflict-centered individual therapy or integration of psychotherapy methods.
      Process of change in client-centered psychotherapy with and without behavioral
      exposure therapy in agoraphobia with panic disorder].
AB  - The mechanisms of change due to different psychotherapeutic treatments of anxiety
      disorders are the subject of the present study. Sixty-eight patients with
      agoraphobia and panic (DSM III R No. 300.21, ICD 10 No. F 40.01) were included,
      exclusively treated with client-centered treatment (n = 28) or with additional
      behavioral exposure treatment (n = 40) in an inpatient setting. The patients were
      examined on admission, at discharge, and at 6 and 12 months follow-ups with the
      Structured Clinical Interview for DSM III R (SKID), the Freiburg Personality
      Inventory (FPI R), and the Giessen Test (GIESS). Both treatment modalities
      significantly reduced panic and avoidance. Differences were found in personality
      scales. The support of autonomy was superior by client-centered treatment alone:
      client-centered treated (CCT) patients felt less dependent on the expectations of
      others, less under stress, and had fewer psychosomatic complaints. Patients with
      additional exposure treatment feel accepted by their social environment earlier.
      The results are discussed with regard to open questions of therapy integration
      and different mechanisms of change.

PMID- 11221555
TI  - [Computer-assisted patient survey as the basis for modern quality assurance in
      psychiatry. Results of pilot studies].
AB  - We report on a novel computer system for psychiatric patients that runs an
      interview procedure on the outcome and quality of care (e.g. well-being, mood,
      satisfaction with treatment). Patients are asked to perform the interviews on a
      daily basis and on their own initiative. The information is meant to provide
      feedback to the therapeutic team. In the pilot studies we investigated the
      feasibility and acceptance of the computerised interviews. Four computer systems
      with touchscreen input were integrated into the routine of an open inpatient ward
      and of the day hospital of a psychiatric university clinic for a period of 17
      weeks. The patients' attendance and the acceptance of the interviews were good.
      Patients were able to interact with the touchscreen terminals without greater
      problems. Accurate and valid data were recorded. Because of some problems with
      the administration of the patients' identification numbers we develop suggestions
      how to improve the computer systems. Possible applications of the computerised
      interview system in quality assurance and research are discussed.

PMID- 11221556
TI  - [Non-fatal effect of highly toxic amitriptyline level after suicide attempt. A
      case report].
AB  - Pharmacotherapeutic intervention in psychiatric patients often bears the risk of
      drug abuse for suicide attempts. Especially intoxication with tricyclic
      antidepressants, e.g., amitriptyline, may cause severe complications such as
      cardiac arrhythmia. Even under intensive care conditions, 2-3% of intoxicated
      patients still die. Here, we report on a depressed female patient who, thanks to
      timely and intense intervention, survived a suicide attempt with amitriptyline
      despite highly toxic plasma levels.

PMID- 11221558
TI  - [The concept of evidence-based medicine in psychiatry].

PMID- 11221557
TI  - [Therapeutic effectiveness. Effects, effectiveness and value of therapeutic
      interventions].
AB  - Terms such as efficacy and efficiency of treatment are presently taking on
      growing importance for medical practice. Two examples are the increasing
      limitation of cost reimbursement to evidence-based, scientifically proven
      therapeutic measures and assessment of efficiency in terms of budgeting. We
      briefly discuss the definition and application of important terms and concepts in
      this context and ethical and methodological problems involved.

PMID- 11221559
TI  - Bovine spongiform encephalopathy (BSE).

PMID- 11221560
TI  - 'Defence' against emergency diseases.

PMID- 11221561
TI  - Trying to contain antibiotic resistance.

PMID- 11221562
TI  - Revised hens policy another AVA cop-out.

PMID- 11221563
TI  - Use of anticholinergics in veterinary anaesthesia.
AB  - This viewpoint examines the time-honoured and popular use of anti-cholinergics in
      veterinary anaesthesia. The disadvantages of routine use and specific indications
      for the use of these useful drugs are discussed.

PMID- 11221564
TI  - Preanaesthetic use of atropine in small animals.
AB  - Although it is unwise to recommend any preanaesthetic drug or regimen to be used
      routinely without consideration for the individual patient, the procedure being
      undertaken or the other drugs that will be used during the anaesthetic, of all
      anaesthetic-related drugs that might be under review, atropine is probably one of
      the least 'toxic' and least likely to cause life-threatening complications when
      used correctly. In most small veterinary practices there isn't the luxury of a
      dedicated anaesthetist available to monitor and manage each anaesthetised patient
      and the best form of cardiac monitor available may be an audible rate monitor. In
      this situation the advantages combined with the usual indications probably far
      outweigh the disadvantages of using atropine prophylactically. If a choice must
      be made, a sinus tachycardia under anaesthesia is probably preferable to a
      profound bradyarrhythmia. Absolute contraindications for using atropine are rare;
      the drug, when used alone, has low incidence of toxicity at clinically
      recommended doses in dogs and cats. Further, the new inhalation agents available
      to veterinarians (enflurane and isoflurane) do not sensitise the heart to the
      effect of catecholamines, so that the predominance of sympathetic tone produced
      when atropine is used is unlikely to precipitate dysarrthythmias during gaseous
      anaesthesia. Rhythm disturbances that occur under halothane anaesthesia when
      atropine is used, suggest there is some other cause, or agent, that is
      arrhythmogenic, such as an alpha 2 agonist, excessively deep level of
      anaesthesia, hypercapnia or hypoxaemia. Notwithstanding the above arguments, my
      preference, as a specialist anaesthetist, is that a drug is given only as
      required (not before) and that when, for example, any unusual heart rhythm
      occurs, all possible reasons for the occurrence (such as excessively deep
      anaesthesia or hypoventilation) are eliminated before other drugs like atropine
      or antiarrhythmics are administered.

PMID- 11221565
TI  - Surgical arthrodesis of distal tarsal joints in 17 horses clinically affected
      with osteoarthritis.
AB  - OBJECTIVE: To evaluate the outcome of 17 horses that underwent surgical
      arthrodesis of the tarsometatarsal and distal intertarsal joints for treatment of
      lameness due to osteoarthritis. DESIGN: Retrospective clinical study using client
      owned animals. PROCEDURE: Horses with hindlimb lameness were diagnosed with
      osteoarthritis of the distal tarsal joints following relief of lameness after
      intra-articular anaesthesia or intra-articular corticosteroid injection. Surgery
      to stimulate ankylosis was performed on 27 hocks by placing 3 diverging 3.2 mm
      drill holes approximately 3 cm through the tarsometatarsal and distal intertarsal
      joints from the medial aspect of the limb. The results of surgery were assessed
      by postoperative examinations, telephone communication with clients and analysis
      of race results. RESULTS: In 71% of horses, surgery was considered to be
      successful as determined by clinical examination or telephone communication with
      clients: six of these horses had unilateral surgery and six had bilateral
      surgery. This represented 85% (6/7) of horses undergoing unilateral surgery and
      60% (6/10) of horses having bilateral surgery. All (8/8) racing Standardbreds and
      67% (4/6) of racing Thoroughbreds were considered a success. The average time
      between surgery and a return to racing was 9.5 months. CONCLUSIONS: The surgical
      technique used here can provide resolution of lameness from osteoarthritis of
      distal tarsal joints with a success rate similar to other reported surgical
      arthrodesis techniques that are more invasive and have a greater morbidity.

PMID- 11221566
TI  - Treatment of canine leproid granuloma syndrome: preliminary findings in seven
      dogs.
AB  - OBJECTIVE: To determine effective treatment strategies for patients with
      refractory canine leproid granuloma syndrome. DESIGN: Multi-institutional
      retrospective/prospective case series using client-owned dogs. PROCEDURE: Seven
      dogs (four Boxers, one Dobermann, one Bullmastiff and one Bullmastiff cross-bred;
      ages 3 to 11 years) with leproid granulomas were treated successfully using a
      variety of treatment regimens. These cases were recruited because: lesions were
      either widely distributed over the dog; progressive, despite routine therapy, or
      were associated with particularly disfiguring lesions. The treatment regimen
      evolved during the course of the clinical study. RESULTS: Combination therapy
      using rifampicin (5 to 15 mg/kg p.o., every 24 h) and clarithromycin (8 to 24
      mg/kg p.o. daily; dose divided every 8 or every 12 h) was used most frequently
      and proved to be effective and free from side effects. Total daily doses of
      clarithromycin in excess of 14 mg/kg were considered optimal and long treatment
      courses, in the order of 1 to 3 months, were used. Combination therapy using
      rifampicin (25 mg/kg; that is, higher than the recommended dose) and clofazimine
      was effective in one case, but resulted in hepatotoxicity. A topical formulation
      of clofazimine in petroleum jelly was used as an adjunct to oral rifampicin and
      doxycycline in another patient treated successfully. CONCLUSION: Based on our
      evolving clinical experience, a combination of rifampicin (10 to 15 mg/kg p.o.,
      every 24 h) and clarithromycin (15 to 25 mg/kg p.o. total daily dose; given
      divided every 8 to 12 h) is currently recommended for treating severe or
      refractory cases of canine leproid granuloma syndrome. Treatment should be
      continued (typically for 4 to 8 weeks) until lesions are substantially reduced in
      size and ideally until lesions have resolved completely. A topical formulation,
      containing clofazimine in petroleum jelly may be used as an adjunct to systemic
      drug therapy. Further work is required to determine the most cost effective
      treatment regimen for this condition.

PMID- 11221567
TI  - Eisenmenger's complex in a Holstein-Friesian cow.
AB  - A 4.5-year-old, Holstein-Friesian cow presented with a 1-month history of severe
      exercise intolerance. Rectal examination and transrectal ultrasonography revealed
      a large mass in the left retroperitoneum. The heart rate was 70 to 80/min.
      Premature ventricular complexes and ventricular bigeminy were present on an
      electrocardiogram. Erythrocytosis was present and blood gas analysis revealed
      marked hypoxaemia. An echocardiogram demonstrated a large ventricular septal
      defect, a partially dextroposed aorta, and concentric hypertrophy of the right
      ventricular free wall. Colour flow Doppler echocardiography and a contrast
      echocardiographic study demonstrated a right-to-left shunt through the
      ventricular septal defect. Eisenmenger's complex was diagnosed. The patient was
      euthanased. Necropsy confirmed the gross cardiac lesions identified by
      echocardiography and an abscess in the apex of the left ventricle. Severe
      pulmonary arterial lesions were present, consistent with a marked increased in
      pulmonary vascular resistance. Actinomyces pyogenes was cultured from abscesses
      of the retroperitoneum and the ventricular apex.

PMID- 11221568
TI  - Characterisation of lymphosarcomas in Australian cats using polymerase chain
      reaction and immunohistochemical examination.
AB  - OBJECTIVE: To examine tumour tissue of cats with lymphosarcoma for the presence
      of feline leukaemia virus and feline immunodeficiency virus and analyse the
      immunophenotype of the tumours. DESIGN: A retrospective study of feline
      lymphosarcoma cases. METHODS: Formalin-fixed, paraffin-embedded tumour tissue of
      14 feline lymphosarcomas was examined for the presence of feline leukaemia virus
      and feline immunodeficiency virus by polymerase chain reaction and
      immunohistochemistry. Using polyclonal and monoclonal antibodies against T and B
      lymphocytes, the phenotypic expression of the tumours was characterised. RESULTS:
      No feline leukaemia virus antigen or proviral sequences were detected. Feline
      immunodeficiency virus proviral sequences were detected in two cases by
      polymerase chain reaction. Immunophenotyping of all 14 cases resulted in seven
      cases being classified as B-cell phenotype, four as T-cell phenotype, and the
      remaining three undetermined. CONCLUSIONS: In contrast to previous reports
      overseas, our results suggest that feline leukaemia virus infection appears to be
      an infrequent cause of lymphosarcoma in the cats that were necropsied. Feline
      immunodeficiency virus may have a role in lymphomagenesis. The potential role of
      feline immunodeficiency virus needs to be explored in more depth. Compared with
      most previous reports, B-cell tumours were more common than T-cell tumours in
      this series of cats.

PMID- 11221569
TI  - Comparison of DNA probe test and cultivation methods for detection of
      Mycobacterium avium subsp paratuberculosis in caprine and ovine faeces.
AB  - OBJECTIVE: To compare a DNA probe test with two cultivation methods for the
      detection of Mycobacterium avium subsp paratuberculosis in goat and sheep faeces.
      DESIGN: Comparison of the results of the three methods with histological
      examination as the reference standard. PROCEDURE: Faecal specimens were obtained
      from goats and sheep originating from flocks known to be affected with
      paratuberculosis and tested for Mycobacterium avium subsp paratuberculosis with a
      DNA probe test and two cultivation methods (old conventional culture and new
      double incubation method in Herrold's and Lowenstein-Jensen medium). RESULTS: In
      goats, the sensitivity of the various tests were for the DNA probe test 17.2%,
      for the double incubation culture method 25.4% and for the old conventional
      culture method 22.8% using the histopathological results as reference. In sheep
      the sensitivity of the various tests were for the DNA probe test 13.2%, for the
      double incubation culture method 8.8% and for the old conventional culture method
      5.9% using the histopathological results as reference. The specificity of the
      above tests was 100% in goats and sheep and the specificity of the double
      incubation culture method in goats was 91%. CONCLUSIONS: The DNA probe test is a
      rapid and specific test that could be used in a control program if the
      sensitivity of the test were improved and possibly in combination with another
      test.

PMID- 11221570
TI  - Our first anti-docking law already in place!

PMID- 11221571
TI  - Prevention of blowfly strike on coarse and fine woolled sheep with the insect
      growth regulator dicyclanil.
AB  - OBJECTIVE: To assess a ready-to-use formulation of dicyclanil to prevent blowfly
      strike on coarse and fine woolled sheep under New Zealand conditions. DESIGN:
      Randomized clinical field trials. PROCEDURE: In a first field trial, coarse
      wooled sheep treated with a ready-to-use, 5% dicyclanil formulation were compared
      with untreated control sheep for up to 21 weeks. In a second field trial, fine
      woolled sheep, treated with the same dicyclanil formulation, were compared with
      untreated sheep for up to 19 weeks. Efficacy was assessed by calculating the
      aggregated cumulative strike rate. RESULTS: For trial 1 (coarse woolled sheep)
      the aggregated cumulative strike rate at the end of the trial at week 21 after
      treatment reached 3.9% and 19.1% for treated and untreated sheep, respectively.
      For the treated animals the aggregated cumulative strike rate reached the 1% and
      2% benchmarks between weeks 11 and 12. For trial 2 (fine woolled sheep) the
      aggregated cumulative strike rate at the end of the trial at week 19 reached 0.6%
      and 7.5% for treated and untreated sheep, respectively. Wool length at the time
      of application did not substantially influence the efficacy of dicyclanil.
      CONCLUSION: Under New Zealand field conditions, a ready-to-use 5% spray-on
      formulation of dicyclanil protected coarse woolled sheep for at least 12 weeks
      and fine woolled sheep for at least 19 weeks.

PMID- 11221572
TI  - Cardiovascular and haemodynamic effects of intramuscular doses of xylazine in
      conscious sheep.
AB  - OBJECTIVE: To determine if a commonly used analgesic dose of xylazine has
      detrimental cardiovascular or haemodynamic effects in sheep. DESIGN: A
      physiological study following intramuscular administration of xylazine.
      PROCEDURE: Xylazine (50 micrograms/kg) was injected intramuscularly into six
      healthy Merino ewes. For 60 min heart rate, mean arterial blood pressure and
      cardiac output were recorded; arterial blood samples for the measurement of blood
      gas tensions were also collected. RESULTS: There were no significant changes in
      heart rate, mean arterial blood pressure, cardiac output or arterial carbon
      dioxide tension. A slight degree of arterial hypoxaemia was noted with a 10%
      reduction in arterial oxygen tension values at 30 min. CONCLUSION: The minimal
      changes to cardiovascular and respiratory values in this study verify the safety
      of previously suggested analgesic dosing regimens for sheep. Previously reported
      hypoxaemic effects in sheep as a result of intravenous xylazine administration
      appear to be reduced as a result of intramuscular administration.

PMID- 11221573
TI  - Inclusions in the erythrocytes of eastern water dragons (Physignathus lesueurii).

PMID- 11221574
TI  - Family risk and resiliency factors, substance use, and the drug resistance
      process in adolescence.
AB  - Recent approaches to drug prevention have emphasized risk and resiliency factors.
      Two models have been developed to explain these factors, one which posits that
      separate elements make up each set and the other which posits that a single
      factor can be either a risk or a resiliency factor depending on, for example, if
      it is present (resiliency) or absent (risk). This study tested these models and
      attempted to compare the effects of risk and resiliency across gender and
      ethnicity. Results support the model in which risk and resiliency are discrete
      sets of factors and demonstrate that overall resiliency factors play a larger
      role than risk factors in substance use and drug resistance processes. However,
      gender proved to be an important moderator of these effects. For adolescent
      males, resiliency has an indirect effect on overall substance use through age of
      first use, while risk has a direct effect on overall substance use. For
      adolescent females, resiliency has a direct effect on overall substance use and
      risk has an indirect effect through age of first use. This indicates that while
      early interventions are important for both genders, resiliency factors must be
      dealt with before initiation of substance use for males. Findings did not differ
      substantially across ethnicity, although the small African-American sample size
      may have limited power to detect differences.

PMID- 11221575
TI  - Interactive multimedia preventive alcohol education: a technology application in
      higher education.
AB  - This article summarizes the process of implementation and short-term impact on
      knowledge and attitudes of an interactive multimedia software program on
      preventive alcohol education for young adults. The three factors related to
      behavioral change addressed in the software are self-efficacy in maintaining
      personal control and safety while using alcohol, attitudes and related
      expectations regarding the physiological and behavioral consequences of alcohol
      consumption, and peer norms regarding alcohol consumption. As compared to
      alternative alcohol education and a no-alcohol education groups, students using
      the interactive computer lesson reported learning more about dose-response and
      ways to intervene with friends in peril. The article concludes with consideration
      of the import of this technology for informing students about the consequences of
      alcohol use, and the utility to higher education institutions of using this
      technology in an era when pressures increase for due diligence around student
      safety but with few additional institutional resources.

PMID- 11221576
TI  - Methamphetamine use: hazards and social influences.
AB  - Use of methamphetamine, a potent central nervous system stimulant, increased in
      the early- to mid-1990s in the United States, concentrated in the west, midwest,
      and south. The use and trade of methamphetamine was facilitated by a fairly
      simple production process and the involvement of numerous small entrepreneurs as
      well as drug-trafficking syndicates. National data from the 1994 Drug Abuse
      Warning network revealed that for the period from 1991 to 1994 methamphetamine
      use among short-stay hospital patients more than tripled, and methamphetamine
      related deaths reported by medical examiner offices nearly tripled. In addition,
      the Treatment Episode Data Set revealed a 43 percent increase in treatment
      program admissions in which clients identified methamphetamine as the primary
      drug of abuse. Nonetheless, methamphetamine use did not become widespread in the
      U.S. population. Low-income and unemployed young white men continue to be the
      group most likely to use methamphetamine, but by the mid-1990s the drug had
      increased in popularity in more diverse populations and regions. Economic and
      social pressures experienced by a broad array of Americans may partially explain
      expanded methamphetamine use; for example, depressed economic conditions in rural
      and semi-rural areas have contributed to methamphetamine's appeal as a source of
      income. A "war against drugs" approach has characterized the policy response,
      with increased criminal justice penalties. A public health approach is
      recommended, including prevention campaigns, harm-reduction outreach and
      treatment approaches, and pharmacologic and abstinence-based drug treatment
      approaches.

PMID- 11221577
TI  - Physical training as a substance abuse prevention intervention for youth.
AB  - Program evaluation data from school and community applications of a physical
      fitness drug prevention program is presented. A train-the-trainer methodology was
      applied to install the program in twenty-two settings within the state of
      Illinois. The physical training program consisted of exercise and educational
      modules delivered over a twelve-week time period that focused on learning values
      and life skills through exercise. Complete pre-post data were obtained on 329
      participating youth at six school and community based sites. Significant
      increases were demonstrated in physical activity and physical fitness
      (cardiovascular endurance, strength, and flexibility). Youth self-report data
      indicated significant decreases in risk factors such as low self-concept, poor
      school attendance, anxiety, depression, and number of friends who use alcohol and
      drugs. There were significant reductions in the percentage of youth who used
      cigarettes, smokeless tobacco, and alcohol. It was concluded that a strong
      relationship was demonstrated for increased fitness leading to lowered risk
      factors and usage patterns. Likewise, the train-the-trainer model was shown to be
      an effective installation approach to expand fitness programming within
      prevention settings.

PMID- 11221578
TI  - News coverage of alcohol and other drugs in U.S. college newspapers.
AB  - This study investigated the substance use-related content of a sample of student
      run college newspapers. Two independent coders examined 157 news stories,
      features, editorials, commentaries, letters, photographs, and cartoons. Items
      about alcohol appeared in one out of every two issues, while items about other
      drugs appeared in one out of every five issues. Basic information about alcohol
      and other drug (AOD) use was reported in about one-fifth of the items, while
      three-fourths dealt with social, legal, safety, or health problems associated
      with AOD use, especially alcohol consumption. Just over half referred to some
      type of control policy, most often an enforcement action. Around one-fourth
      mentioned educational efforts to promote AOD prevention. Very few dealt with
      detection, intervention, or treatment. Most college newspapers are missing good
      opportunities for more extensive coverage of AOD issues that would better inform
      their readers, especially about factors contributing to campus AOD problems and
      specific program and policy options.

PMID- 11221579
TI  - Boater training, drinking and boating, and other unsafe boating practices.
AB  - OBJECTIVES: Identify associations between lack of formal boater training,
      drinking and boating, and other unsafe boating practices. METHODS: A telephone
      survey queried respondents (age 16 or older in continental United States) about
      boating experience, type of boat used, and training. RESULTS: Of the 3,042
      boaters surveyed (70% response), most had no formal training (73%). Boaters with
      formal training failed to use PFDs about as often as those without formal
      training and were equally or more likely to use alcohol while boating.
      CONCLUSIONS: The unexpected association between formal training and unsafe
      boating practices is probably due to reduced risk perception and inadequacies of
      boater training programs. Such programs seldom mention the risks of alcohol use
      while boating. Decisions to mandate formal training should be informed by these
      results; if mandated, training should address the risks of alcohol use while
      boating, and should be renewed frequently enough to offset reductions in risk
      perception.

PMID- 11221580
TI  - Isozyme diversity in cassava cultivars (Manihot esculenta Crantz).
AB  - Isoenzyme electrophoresis was used as a method to determine genetic diversity in
      various M. esculenta cultivars collected in the Southwestern (SW) and
      Northwestern (NW) regions of the State of Parana, in the South region of Brazil,
      and in cultivars produced at the Agronomic Institute of Campinas (IAC), Sao Paulo
      State, Southeastern region of Brazil. The cultivars have been maintained by
      vegetative propagation for 5 years and are useful in production programs. A total
      of 28 loci in the acid phosphatase (ACP; EC 3.1.3.2), esterases (EST; EC
      3.1.1.1), malate dehydrogenase (MDH; EC 1.1.1.37), and shikimate dehydrogenase
      (SKDH; EC 1.1.1.15) isozymes was analyzed. The proportion of polymorphic loci for
      NW, SW, and IAC cultivars was 57.14, 50.0, and 53.6% respectively. Genetic
      diversity calculated by Nei's genetic identity (I) showed high I values for the
      three M. esculenta subpopulations. The high degree of polymorphism expressed by
      cassava cultivars is highly relevant to stimulate breeding programs with M.
      esculenta species.

PMID- 11221581
TI  - Secondary analysis of perceptions and meanings of type 2 diabetes among Mexican
      American women.
AB  - PURPOSE: The purpose of this study was to explore explanatory models of diabetes
      from the perspective of Mexican American women with type 2 diabetes. METHODS: In
      depth interviews were conducted in a secondary analysis of an interpretive
      interactionism study to investigate the meanings of diabetes from the
      perspectives of Mexican American women with type 2 diabetes. The sensitizing
      concept used was Kleinman's explanatory models of illness. The original study
      sample included 20 Mexican American women between the ages of 27 and 45 with
      varying lengths of time since diagnosis. RESULTS: Data analysis was an
      interactive process. The data were collapsed into explanatory models of diabetes
      categorized as defining, getting, having, describing, or taking care of diabetes.
      The meaning of having diabetes was viewed as a life threat with complications and
      a shortened life. CONCLUSIONS: Diabetes complications, viewed as symptoms, were
      structured in the explanatory models developed from the contextual arenas of
      family and community. Given the family and community history of diabetes, genetic
      predisposition to the disease, and perceived life threat, understanding Mexican
      American women's explanatory models about diabetes serves as a basis for
      negotiating therapeutic interventions.

PMID- 11221582
TI  - [The ANMCO (National Association of Hospital Cardiologists) in a changing health
      care system. Consensus development of the Organizing Symposium of the XXXI
      National Congress of Cardiology--ANMCO; Florence, May 21, 2000].
AB  - This year's symposium, while following the 30-year-old tradition of
      Organizational Symposia which have become a trademark of the National Association
      of Hospital Cardiologists (ANMCO) annual meetings, is characterized by a novel
      approach in terms of method and content. Prompted by the profound changes
      affecting the socio-cultural, organizational and economic context in which the
      Health Service operates, the Board of the Association decided to invite the
      community of hospital-based cardiologists to reflect on and make proposals
      concerning a number of leading topics not strictly related to the organization of
      hospital-based cardiology, but of a wider relevance pertaining to the whole issue
      of the relationship between a Scientific Society and the other components of the
      Health Service: national and regional institutions, other doctors, the lay public
      and the pharmaceutical industry, etc. The main aim of this exercise was to
      stimulate the Society to adapt to a changing environment and so render it more
      capable of effectively fulfilling its duties. Naturally the larger the consensus
      regarding the strategies to adopt the greater this efficacy will be. Out of the
      many possible subjects, four were chosen as preeminent: 1. ANMCO and research:
      what fields of research should be prioritized, and with what kind of internal
      organization, and external relations? 2. ANMCO and professional training: what
      should be the professional standards governing the cardiologist in a changing
      society, what strategies for continuing education and institutional
      accreditation? 3. ANMCO and the community-based Health Service: the need to
      establish clear and efficient organizational relations with community-based
      cardiology and especially with general practitioners, in order to ensure that the
      health service is in tune with the real world, guarantee real continuity of care
      and reduce unnecessary hospital admissions; 4. ANMCO and the general population:
      how to support the citizen-user in the imperfect health-market, how to first
      inform the patient and then guarantee true freedom of choice, how to respect the
      values of the patient, transcending ideological limits and proposing
      organizational solutions and a return to ethical guidelines. In order to be able
      to approach topics of this importance and complexity with some probability of
      success it is fundamental that a proper consensus is reached among the
      cardiological community which formulates and attempts to carry out any proposed
      strategy. Working hypotheses designed by a minority of the Society, even if
      authoritative, and "imposed" on the majority are destined to have a difficult and
      short life. These premises gave rise to the innovative method characterizing this
      Symposium: each of the four topics, once identified, was assigned to an expert
      member who produced a preliminary draft including some proposals. These drafts
      were circulated to all members of the Association some months prior to the
      conference, in order to allow for any new comments, proposals and criticisms.
      This interaction with the members allowed us to collect grass-root opinions which
      were then organized into their respective topics by one discussant for each
      topic, who acted as spokesman at the conference. During the Symposium the expert
      member for each topic summarized his proposals and initial thoughts (already
      known to all members) while the discussant represented the opinions of the
      members; finally each topic was open to debate. The last step of this complex
      procedure was a meeting of the symposium panel made up of the chairmen, speakers
      and discussants who drafted a consensus document representative of all the
      opinions discussed at the Symposium. What follows is the consensus document on
      the four chosen topics for the general information of all the members and for
      proposal to the Board of the Society who will take the executive decisions.
      Chapter 1. The speed with which technology is improving and medical knowledge
      increasing is creating a gap between biological research and clinical research
      and another gap between clinical research and its application in daily practice.
      The task any medico-scientific society must set itself is to bridge these gaps by
      integrating research and the diffusion of its results - i.e. training. ANMCO
      actively carries out both functions but lacks the organs which could produce far
      reaching scientific research strategies. This document reports the aims and ways
      of resolving this structural problem. Chapter 2. Continuing medical education
      aimed at maintaining and developing the knowledge of a medical professional,
      represents a cultural requirement and now it has become a legislative duty also
      in Italy. During a symposium held on the occas

PMID- 11221583
TI  - [Interactions between physical training and pharmacologic treatment in the
      prevention of ventricular remodelling in patients with left ventricular
      dysfunction].
AB  - Exercise training is a recommended treatment for chronic heart failure. So far,
      randomized clinical trials showed that exercise training can improve peak oxygen
      consumption and reduce neurohormonal and adrenergic activation, nevertheless, the
      effect on left ventricular remodeling is still controversial. The present study
      reviewed the randomized clinical trials that investigated the effects of exercise
      training on left ventricular remodeling. After a first study that showed a
      worsening of left ventricular function, the following studies showed a neutral
      effect, and finally, the ELVD-CHF study showed both a reduction in left
      ventricular dilation and an improvement of ejection fraction. These different
      results could be explained by the pharmacological treatment before exercise
      training: in the first study patients did not assume ACE-inhibitors, in the
      following studies most patients assumed ACE-inhibitors and, finally, in ELVD-CHF,
      patients assumed ACE-inhibitors and about one fifth of them were on beta-blockers
      too. In conclusion, exercise training may improve peak oxygen consumption and
      reduce neurohormonal and adrenergic activation in patients with chronic heart
      failure. Further studies are necessary to assess if exercise training, associated
      with ACE-inhibitors and beta-blockers, can reverse or prevent left ventricular
      remodeling.

PMID- 11221584
TI  - [Single-lead DDD cardiac pacing: state of the art and future perspectives].
AB  - The electrical treatment of advanced atrioventricular block, with normal sinus
      node function, can be successfully and safely performed with single-lead atrial
      floating electrode VDD pacing. In comparison with two-lead DDD pacing, it offers
      some important advantages: easier and less time-consuming implantation
      procedures, simpler follow-up controls, and lower medium and long-term
      complication rates. However, should sinus node dysfunction develop, the atrium
      cannot be paced with this special kind of cardiac stimulation. For this reason,
      in the last few years, a particular research field has developed to overcome this
      problem. In this paper, the literature is reviewed, with special attention to the
      studies analyzing the commercially available leads and some prototypes implanted,
      outlining the pros and cons. The high stimulation energy, the inconstant atrial
      capture, and phrenic nerve stimulation are still unresolved problems. The
      reliability and efficacy of single-lead DDD pacing will presumably depend, in the
      future, on the development of preshaped, new-designed electrodes, with stable
      contact with the atrial wall, and on new stimulation waveforms. In this context,
      however, particular attention should be devoted to the correct atrial signal
      detection.

PMID- 11221585
TI  - [Digital revolution in the echocardiography laboratory. Current status and future
      perspectives]  .
AB  - Echocardiography is changing from an operative modality in which most images are
      stored in analog fashion on videotape into one with most data stored digitally.
      This transition is accelerating today, fueled by several factors. First, there is
      widespread recognition of the value of digital storage of echocardiograms,
      including random access to studies as well as to images within a study, side-by
      side comparison with prior studies, easier quantification, and multiplication and
      remote transmission of images without degradation. Second, continuous improvement
      of the cost/performance ratio of modern computers makes routine digital
      echocardiography both feasible and affordable. Finally, the formulation and
      acceptance within the industry of the DICOM image formatting standard for
      echocardiography. The acceptance of this standard allows the echo-labs around the
      world to be free to choose individual echo-machines on the basis of their
      individual merits for their laboratories with the assurance that these machines
      will be able to communicate with each other by an internationally agreed upon
      standard. Advantages of digital echocardiography are overwhelming and there is
      little doubt that this approach will be essential for the proper utilization of
      this technique. The technology will undoubtedly continue to change. Those who are
      waiting for it to be perfected may be waiting for a long time.

PMID- 11221586
TI  - [Chlamydia pneumoniae and Helicobacter pylori infections in acute myocardial
      infarction].
AB  - BACKGROUND: Increasing evidence suggests an acute or chronic linkage between
      infection and acute coronary syndromes. The aim of this study was to assess the
      frequency of Chlamydia pneumoniae (CP) and Helicobacter pylori (HP) antibodies in
      patients with angiographically defined acute myocardial infarction and in
      population controls. Case patients and controls were drawn from the same
      geographic area (city of Messina and its province). METHODS: Blood samples were
      collected in 206 incident cases of acute myocardial infarction presenting to the
      Coronary Care Unit (196 men, 10 women, mean age 58+/-7 years) in the period from
      March 1997 to June 1999. Case patients were selected if they were non-smokers,
      non-diabetic and if they had no history of hypertension. The control group
      consisted of 142 healthy subjects, without a known history of smoking, diabetes,
      and hypertension. Controls were matched to acute myocardial infarction patients
      for age, sex and socio-economic status. Commercial ELISA assay was used to
      measure IgG antibody to HP (positive titer > 8 IU/ml) and indirect
      immunofluorescence method was used to assess IgG antibody anti-CP (IgG titer >
      1:64 was considered a marker of chronic infection). RESULTS: No significant
      difference was observed in the frequency of HP antibodies in acute myocardial
      infarction patients and in the control group (43.3 vs 41.5%, p = NS, odds ratio
      OR 1, 95% confidence interval-CI 0.7-1.6). On the contrary, CP titers were
      increased in 83% of acute myocardial infarction patients, and in 57% of control
      subjects (p < 0.001, OR 3.6, 95% CI 2.2-5.7). In acute myocardial infarction
      patients seropositivity for CP was associated with increased basal fibrinogen
      levels (539 vs 445 mg/dl). No correlation was found between seropositivity to CP
      and C-reactive protein, and with total or fractionated cholesterol and
      triglyceride concentrations. CONCLUSIONS: The present data indicate that, in our
      sample, acute myocardial infarction was associated with an increased frequency of
      CP seropositivity. The presence of CP antibodies was not associated with elevated
      levels of C-reactive protein. Our data support the need for controlled studies to
      investigate the role of these infective agents as a trigger of acute coronary
      syndromes.

PMID- 11221587
TI  - [Functional heart murmur and echocardiography: a solved problem?].
AB  - BACKGROUND: Is it really vanished the need for echocardiography in the
      differential diagnosis of functional pediatric murmurs? METHODS: To this aim 260
      children (132 males, 128 females; age range 1-84 months) were examined with
      auscultatory cardiac murmur. All children underwent a clinical and instrumental
      evaluation (ECG and echocardiography) from two pediatric cardiologists with
      independent assessment. RESULTS: Two hundred and ten patients (Group A) were
      evaluated clinically with functional murmur, 45 patients (Group B) with
      pathological murmur, 5 patients (Group C) with uncertain pathology. ECG showed
      changes in 1 Group B patient. Echocardiography showed pathology in 15 Group A
      patients (6 patients with patent foramen ovale, 5 patients with interatrial
      defect, 2 patients with bicuspid aortic valve, 1 patient with mitral
      insufficiency, 1 patient with restrictive cardiomyopathy). Pathology was excluded
      in 3 Group B patients, and in 2 Group C patients. In our clinical analysis
      echocardiography showed sensitivity 75%, specificity 97%, positive predictive
      value 90%, and negative predictive value 92%. CONCLUSIONS: In our experience we
      suggest to perform echocardiographic examination in children with functional
      murmur for complete assessment.

PMID- 11221588
TI  - [Kissing-stent technique for the treatment of spontaneous coronary artery
      dissection].
AB  - A 60-year-old woman referred to our hospital because of increasing dyspnea and
      angina. Her past history included an anterior myocardial infarction, associated
      with a large coronary dissection of the proximal left anterior descending
      coronary artery. The infarction resulted in a ventricular aneurysm which was
      treated with surgical excision without coronary revascularization. Coronary
      angiography showed a linear filling defect involving the left anterior descending
      coronary artery. Intracoronary ultrasound revealed a long intimal tear dividing
      the artery into two separated lumens. A kissing-stent technique was used to
      preserve the anatomical and functional integrity of the main vessel as well as of
      the diagonal branch. Two premounted stents were positioned covering the origin of
      both branches of the bifurcation. Simultaneous inflation of the two balloons
      created a metallic new-carina, 1 cm proximal to the bifurcation. Five months
      later the patient was readmitted with chest pain and repeat coronary angiography
      demonstrated a severe in-stent restenosis. Re-coronary angioplasty resulted in a
      good angiographic result. At 4 months from the last procedure there is no
      complaint of angina.

PMID- 11221590
TI  - [Guideline for the diagnosis and treatment of unstable angina. Update 2000].

PMID- 11221589
TI  - [Myocardial revascularization may resolve arrhythmic warm-up in patients with
      implantable cardioverter-defibrillator: 2 case reports].
AB  - Patients with ventricular arrhythmias and coronary artery disease may have a poor
      clinical outcome because of an increased risk of sudden cardiac death. In these
      patients therapeutic approaches include two main strategies: automatic
      implantable cardioverter-defibrillator (ICD) and antiarrhythmic drugs (when left
      ventricular function is preserved). Patients with arrhythmic warm-up sustained by
      ischemic attacks may be stabilized after percutaneous or surgical
      revascularization. We report the cases of 2 ICD patients, in whom the correction
      of myocardial ischemia was successful in preventing further ICD discharges. In
      the first patient with known coronary artery disease (previous acute myocardial
      infarction and left ventricular ejection fraction 30%) a sudden arrhythmic warm
      up was reported with 70 ICD discharges in 24 hours; the patient underwent
      coronary artery bypass surgery and only few isolated episodes of ventricular
      tachycardia were observed during the following 34 months. In the second patient
      with a history of dorsal acute myocardial infarction and two previous
      interventions of coronary artery bypass graft surgery, we observed a sudden and
      unexpected arrhythmic instabilization with several ICD discharges. After
      percutaneous transluminal angioplasty of a graft stenosis, the clinical situation
      was stabilized and no more ICD activations were observed during the follow-up. In
      selected patients arrhythmic warm-up can rely on an ischemic substrate, then a
      careful re-evaluation for ischemia is mandatory in order to resolve the
      situation.

PMID- 11221591
TI  - [Legal implications of medical guidelines. A Task Force of the European Society
      of Cardiology].

PMID- 11221592
TI  - [Interactions between ACE-inhibitors and aspirin].

PMID- 11221593
TI  - [Effects of CPAP ventilation on cardiovascular outcome in patients with chronic
      heart failure with or without Cheyne-Stokes periodic respiration during sleep].

PMID- 11221594
TI  - [Prognostic significance of the electrophysiologic study in the identification of
      patients with ischemic cardiopathy in high risk of sudden death].

PMID- 11221595
TI  - [Association of hostility and calcification of coronary arteries in young
      people].

PMID- 11221596
TI  - [Ventricular hypertrophy and risk of sudden death in hypertrophic
      cardiomyopathy].

PMID- 11221598
TI  - [The meeting of Dante and Virgil with Pier delle Vigne: an example of clinical
      experimentation].

PMID- 11221597
TI  - [Treatment of patients with acute coronary syndrome in the United States with
      glycoprotein IIb/IIIa inhibitors. Data provided by the PURSUIT study].

PMID- 11221599
TI  - [Percussion of the cardiac area, literature and history of medicine].

PMID- 11221600
TI  - Dietary supplements: an advertising guide for industry.

PMID- 11221601
TI  - The facts about weight loss products and programs.

PMID- 11221602
TI  - Human CYP1B1 Leu432Val gene polymorphism: ethnic distribution in African
      Americans, Caucasians and Chinese; oestradiol hydroxylase activity; and
      distribution in prostate cancer cases and controls.
AB  - Cytochrome P4501B1 (CYP1B1) is involved in the activation of many carcinogens and
      in the metabolism of steroid hormones, including 17beta-oestradiol (E2) and
      testosterone. We report a significant difference in the allele frequencies of two
      point mutations in the coding region of the CYP1B1 gene among Caucasian (n =
      189), African-American (n = 52) and Chinese (Linxian) (n = 109) populations. A (C
      to G) transversion at position 1666 in exon 3, which results in an amino acid
      substitution of Leu432 to Val, was present in African-Americans with an allele
      frequency for Va1432 of 0.75, in Caucasians of 0.43, and in Chinese of 0.17. A (C
      to T) transition at position 1719 in exon 3, with no amino acid change (Asp449),
      appeared to be closely linked with the Val432 variant. Results using human lung
      microsomal preparations from individuals with the CYP1B1Val/Val and CYP1B1Leu/Leu
      genotypes indicate that Val432 variant may be a high activity allele and thus may
      contribute to the interindividual differences in CYP1B1 activity. Because CYP1B1
      is involved in hormone and carcinogen metabolism, and given the disparate rates
      of prostate cancer among ethnic groups, we also evaluated the association of the
      CYP1B1 Leu432Val polymorphism with prostate cancer risk in a pilot case-control
      study. Among Caucasians, 34% of men with cancer (n = 50) were homozygous for the
      Val432 polymorphism, while only 12% of matched control subjects (n = 50) had this
      genotype. These preliminary data indicate that genetic polymorphisms in CYP1B1
      might play an important role in human prostate carcinogenesis.

PMID- 11221603
TI  - Hyperglycemic crises in patients with diabetes mellitus.

PMID- 11221604
TI  - A pain in the back.

PMID- 11221605
TI  - A pain in the back.

PMID- 11221606
TI  - A pain in the back.

PMID- 11221607
TI  - Ibuprofen versus indomethacin for closure of patent ductus arteriosus.

PMID- 11221608
TI  - Absence of cardiac toxicity of zidovudine in infants.

PMID- 11221609
TI  - Polymorphisms in the factor VII gene and the risk of myocardial infarction.

PMID- 11221610
TI  - Depression and suicide in patients treated with isotretinoin.

PMID- 11221611
TI  - Obtaining informed consent in Bangladesh.

PMID- 11221612
TI  - Improve survival with plasma exchange thrombotic thrombopenic purpura-hemolytic
      uremic syndrome.

PMID- 11221613
TI  - Defamatory article by Martin Walker.

PMID- 11221614
TI  - Multiple complex coronary plaques in patients with acute myocardial infarction.

PMID- 11221615
TI  - Multiple complex coronary plaques in patients with acute myocardial infarction.

PMID- 11221616
TI  - Zanamivir to prevent influenza.

PMID- 11221617
TI  - Zanamivir to prevent influenza.

PMID- 11221618
TI  - Treating opioid dependence.

PMID- 11221619
TI  - Treating opioid dependence.

PMID- 11221620
TI  - Obesity, hypertension, and renal cancer.

PMID- 11221621
TI  - Transplantation of a tissue-engineered pulmonary artery.

PMID- 11221622
TI  - A fatal complication of noninvasive ventilation.

PMID- 11221623
TI  - Legalized physician-assisted suicide in Oregon, 1998-2000.

PMID- 11221624
TI  - Asthma, corticosteroids, and growth.

PMID- 11221625
TI  - Asthma, corticosteroids, and growth.

PMID- 11221626
TI  - Psychological factors and coronary artery disease.

PMID- 11221627
TI  - Psychological factors and coronary artery disease.

PMID- 11221628
TI  - Psychological factors and coronary artery disease.

PMID- 11221629
TI  - Psychological factors and coronary artery disease.

PMID- 11221630
TI  - Idiopathic clubbing.

PMID- 11221631
TI  - AIDS among heterosexuals in surveillance reports.

PMID- 11221632
TI  - George L. Weid, M.D., D.Sc. (hon), F.I.A.C. A tribute on his 80th birthday.

PMID- 11221633
TI  - Heart attacks: 10 things you should know.

PMID- 11221634
TI  - Diagnostic dilemma. Emphysematous cystitis.

PMID- 11221635
TI  - Administration of heme arginate, but not hematin, caused anaphylactic shock.

PMID- 11221636
TI  - Hemolytic anemia after acetaminophen overdose in patient with glucose-6-phosphate
      dehydrogenase deficiency.

PMID- 11221637
TI  - Diagnosing osteoporosis in Japanese American women.

PMID- 11221638
TI  - Chronic fatigue syndrome symptoms common in patient with vasovagal syncope.

PMID- 11221639
TI  - Lousy diagnostics in the emergency room.

PMID- 11221640
TI  - Public knowledge, attitudes, and experiences with antibiotic use for acute
      bronchitis.

PMID- 11221641
TI  - Apparent digestibility and proteic quality of the basic diet of Rio de Janeiro
      State complemented with multimixture.
AB  - Some factors in food can influence the protein digestibility positively or
      negatively. The protein quality is related to the protein synthesis capacity,
      growth, maintenance, reproduction and reconstitution of an organism. This work
      aims to determine the apparent digestibility coefficient and the protein quality
      of the standard basic diet of Rio de Janeiro State (HERJ), complemented with 2%
      of the multimixture (HERJ + MM), during rats' gestation and lactation periods.
      The results indicated a lower apparent digestibility coefficient (P < 0.05)
      during the gestation and lactation periods in HERJ diets (82.4% +/- 0.55; 80.64%
      +/- 1.7) and HERJ + MM (80.9% +/- 3.28; 81.7% +/- 1.2), in comparison to the
      casein diet (91.8% +/- 0.6; 93.9% +/- 0.4). There was no significant difference
      (P < 0.05) between HERJ diet (2.75 +/- 0.14) and HERJ + MM diet (2.53 +/- 0.18).
      However, the casein diet has showed a higher lactation value (3.27 +/- 0.3) in
      comparison with the two above mentioned groups. Therefore the use of the
      multimixture at 2% level neither impairs the apparent digestibility coefficient
      nor does it change the protein quality of the standard diet of Rio de Janeiro
      State.

PMID- 11221642
TI  - [Cloverleaf skull syndrome].

PMID- 11221644
TI  - The 5th Asia-Pacific Congress on Animal, Plant and Microbial Toxins. October 12
      15, 1999. Abstracts.

PMID- 11221643
TI  - [Approach to the border area--chronic coughs].

PMID- 11221645
TI  - Bibliography of toxinology.

PMID- 11221647
TI  - Proceedings of the 8th International Conference on Intelligent Systems for
      Molecular Biology (ISMB 2000). San Diego, California, USA. August 19-23, 2000.

PMID- 11221646
TI  - Selected titles.

PMID- 11221648
TI  - Birth, The Beginning of Developmental Freedom. Jubilaeum Congress. Jerusalem,
      Assisi, Rome, September 2000. Abstracts.

PMID- 11221649
TI  - 18th International Congress of Biochemistry and Molecular Biology. 16-20 July
      2000, Birmingham, United Kingdom. Abstracts.

PMID- 11221650
TI  - Second International Conference on Signal Transduction, Croatia May 2000.

PMID- 11221651
TI  - The 10th International Conference on Oral Iron Chelators in the treatment of beta
      thalassemia and other diseases and biomed meeting.
AB  - Development of oral iron (Fe) chelation therapy remains an important goal for the
      treatment of Fe-overload disease and perhaps other conditions. For many years,
      the major problem with Fe chelation therapy has been that the drug in clinical
      use. desferrioxamine (DFO), requires long sc. infusions (12-24 h day, 5-6 days
      per week). In addition, DFO is not orally effective, is highly expensive and does
      not easily permeate cell membranes to bind intracellular Fe pools. Obviously, the
      development of an orally effective and economical drug is vital. The recent 10th
      International Conference on Oral Iron Chelators (ICOC) discussed the latest
      findings in this challenging field. The conference was particularly focused to
      discuss recent investigations with the orally effective chelator, deferiprone
      (also) known as Li, DMHP or 1, 2-dimethylhydroxypyridone).

PMID- 11221652
TI  - A questionable diagnosis: thrombosis of the right common iliac vein.

PMID- 11221653
TI  - Aboriginal dance.

PMID- 11221654
TI  - Oral aspirin in post-operative pain: a quantitative, systematic review. Edwards
      et al.,PAIN 81 (1999) 289-297.

PMID- 11221656
TI  - The important time parameter is missing. Comment on Sindrup and Jensen, PAIN 83
      (1999) 389-400.

PMID- 11221655
TI  - Neural toxicity of ketamine and othe NMDA antagonists.

PMID- 11221657
TI  - A unique method for oral administration of medications to infants.

PMID- 11221659
TI  - Postoperative neurologic deficit despite normal cerebral oximetry during carotid
      endarterectomy.

PMID- 11221658
TI  - Ineffectiveness of propofol on intraoperative seizure activity in a patient with
      medial temporal lobe epilepsy.

PMID- 11221660
TI  - Lamotrigine in refractory cancer pain. A case report.

PMID- 11221661
TI  - Intubation problems due to fiberoptic bronchoscope defect.

PMID- 11221662
TI  - Single point mutations in either gene encoding the subunits of the
      heterooctameric yeast phosphofructokinase abolish allosteric inhibition by ATP.
AB  - Yeast phosphofructokinase is a heterooctameric enzyme subject to a complex
      allosteric regulation. A mutation in the PFK1 gene, encoding the larger 
      subunits, rendering the enzyme insensitive to allosteric inhibition by ATP was
      found to be caused by an exchange of proline 728 for a leucine residue. By in
      vitro mutagenesis, we introduced this mutation in either PFK1 or PFK2 and found
      that the exchange in either subunit drastically reduced the sensitivity of the
      holoenzyme to ATP inhibition. This was accompanied by a lack of allosteric
      activation by AMP, fructose 2,6-bisphosphate, or ammonium and an increased
      resistance to heat inactivation. Yeast cells carrying either one mutation or both
      in conjunction did not display a strong phenotype when grown on fermentable
      carbon sources and did not show any significant changes in intermediary
      metabolites. Growth on non-fermentable carbon sources was clearly impaired. The
      strain carrying both mutant alleles was more sensitive to Congo Red than the wild
      type strain or the single mutants indicating differences in cell wall
      composition. In addition, we found single pfk null mutants to be less viable than
      wild type at different storage temperatures and a pfk2 null mutant to be
      temperature-sensitive for growth at 37 degrees C. The latter mutant was shown to
      be respiration-dependent for growth on glucose.

PMID- 11221664
TI  - Headache World 2000. London, United Kingdom, 3-7 September 2000. Abstracts.

PMID- 11221663
TI  - A joint endeavor of the American Academy of Nursing and the American Nurses
      Foundation, established in 1998.

PMID- 11221665
TI  - The accident.

PMID- 11221666
TI  - On the death of my father.

PMID- 11221667
TI  - On the death of my father.

PMID- 11221668
TI  - Proceedings of the 41st Congress of The International Psychoanalytical
      Association. Santiago, Chile, 1999.

PMID- 11221669
TI  - Addressing issues for early detection and screening in ethnic populations. 1997.

PMID- 11221670
TI  - Turning point: environmental health in Brazil.

PMID- 11221671
TI  - Environmental and public health: pulling the pieces together.

PMID- 11221672
TI  - Fresh ideas for food safety.

PMID- 11221673
TI  - Smoke-filled rooms. ETS causes menstrual pain.

PMID- 11221674
TI  - A clearer look at PM(10): multiday assessment provides better data.

PMID- 11221676
TI  - Addiction treatment works how research helps to overcome ideology.

PMID- 11221675
TI  - Childhood tooth decay: is it linked to lead?

PMID- 11221677
TI  - Imino sugar therapy for type 1 Gaucher disease.

PMID- 11221679
TI  - Centers for Disease Control says arenavirus spread unlikely.

PMID- 11221678
TI  - How proapoptotic proteins can escape from mitochondria?

PMID- 11221680
TI  - Misuse and resistance to antibacterial drug products addressed in labeling.

PMID- 11221681
TI  - HLA-G and HLA-E: fundamental and pathophysiological aspects.

PMID- 11221682
TI  - Innate immunity: a primitive system in humans.

PMID- 11221683
TI  - Immunoregulation in parasitic infection: insights for therapeutic intervention.

PMID- 11221684
TI  - Perforin deficiency: fighting unarmed?

PMID- 11221685
TI  - On the pathogenesis of perforin defects and related immunodeficiencies.

PMID- 11221687
TI  - Bibliography of toxinology.

PMID- 11221686
TI  - Incidence of cancer among commercial airline pilots.

PMID- 11221690
TI  - Should tuberculosis prophylaxis be given to chronically dialyzed patients?

PMID- 11221689
TI  - [Genetic study of multiple sclerosis].

PMID- 11221688
TI  - Discovered by Carlos Chagas in 1909 in Brazil, America trypanosomiasis has
      scourged vast area of the country.

PMID- 11221692
TI  - [Circular anopexia: a new approach to surgical treatment of hemorrhoid disease].

PMID- 11221691
TI  - [Risks incurred by the first intravenous drug injection].
AB  - AIMS: The objectives of the study were to describe the circumstances surrounding
      the initiation of intravenous drug use, the role of the introducer and to
      evaluate intravenous drug users risk behaviors at the first injection of drug.
      DESIGN: In 1997, we conducted a cross-sectional survey using a structured
      questionnaire concerning the initiation process into intravenous drug abuse. IDUs
      were interviewed in four treatment drug abuse and psychosocial centers in Paris
      and in one prison. PARTICIPANTS: Of the 152 consecutive IDUs interviewed, 143
      completed the questionnaire, 83 were male. FINDINGS: The mean age at first opiate
      use and at first injection were 19 years (SD: 4.3) and 20 years (SD: 4.3). At
      first injection, heroin was the main used drug (91%), the subject was with others
      persons (91%), asked himself for injection (70%) albeit had not planned this
      injection (40%). The subject injected at a friend's home (31%). The introducer
      was an IDU (93%), mean age 23.4 (SD: 5.2). He or she was a friend (61%) or a
      sexual partner (14%). The preparation of the first injection and the injection
      were made by the introducer in 72 % and 74 % of cases. The injecting equipment
      had been borrowed (22%) from an IDU whose HIV status and HCV status were unknown
      in 83 % and 85 % of cases. CONCLUSION: Our study shows novel results about the
      first injection, they are of prime importance for harm reduction. The introducer
      plays a major role in preventing risk-behavior at the first injection and for
      education about safe injecting practices.

PMID- 11221693
TI  - [What is the importance of liver fibrosis in overweight patients?].

PMID- 11221694
TI  - Proceedings of the 9th International Symposium on New Frontiers of Neurochemistry
      and Biophysics in the Acute and Chronic Neurological Diseases. Marin, Slovak
      Republic, 16-19 August 1999.

PMID- 11221695
TI  - American Board of Prosthodontics.

PMID- 11221697
TI  - [Poliomyelitis].

PMID- 11221696
TI  - [Rift Valley fever].

PMID- 11221698
TI  - [Lymphatic filariasis].

PMID- 11221699
TI  - [Concerning tuberculosis].

PMID- 11221701
TI  - [A third of deaths caused by malaria in Africa are imputable to conflicts and
      natural disasters].

PMID- 11221700
TI  - [Progress of medicine threatened by drug resistance].

PMID- 11221702
TI  - [Fight against malaria and the fiscal matters: appeal to African countries].

PMID- 11221703
TI  - [In Sydney the athletes suffering from malaria appeal for reinforcement of action
      against it].

PMID- 11221704
TI  - Urine stone formation during treatment with zonisamide.

PMID- 11221705
TI  - Periventricular leukomalacia and tumor necrosis factor.

PMID- 11221706
TI  - Arthritis.

PMID- 11221707
TI  - Cardiovascular disease.

PMID- 11221708
TI  - Cancer multidrug resistance.

PMID- 11221709
TI  - Malaria.

PMID- 11221710
TI  - Antibacterial and antifungal drug discovery.

PMID- 11221711
TI  - Progress against HIV.

PMID- 11221712
TI  - Bioinformatics.

PMID- 11221713
TI  - Data mining.

PMID- 11221714
TI  - Signal transduction as a drug-discovery platform.

PMID- 11221715
TI  - Pharmacogenomics.

PMID- 11221716
TI  - Biochips.

PMID- 11221717
TI  - Proteomics.

PMID- 11221718
TI  - Lead validation platforms.

PMID- 11221719
TI  - Combinatorial chemistry.

PMID- 11221721
TI  - Agricultural biotechnology.

PMID- 11221720
TI  - Tissue engineering.

PMID- 11221722
TI  - Autoimmune disease.

PMID- 11221723
TI  - Heading towards the light.

PMID- 11221724
TI  - Prevalence of the vanB2 gene cluster in vanB glycopeptide-resistant enterococci
      in the United Kingdom and the Republic of Ireland and its association with a
      Tn5382-like element.

PMID- 11221725
TI  - Need for additional, specific information in studies with echinacea.

PMID- 11221726
TI  - Macrolide resistance in Campylobacter coli of animal origin in Denmark.

PMID- 11221727
TI  - Study patients and routine practice patients.

PMID- 11221728
TI  - Long-term anticoagulation therapy?

PMID- 11221729
TI  - An unusual experience with posterior pericardiotomy.

PMID- 11221731
TI  - Aortic root replacement with coronary button reimplantation.

PMID- 11221730
TI  - Neuroprotective effects of pre-treatment with systemic steroids in a neonatal
      piglet model of cardiopulmonary bypass with deep hypothermic circulatory arrest.

PMID- 11221732
TI  - Transhiatal simultaneous resection of a benign mediastinal pseudotumor and hiatal
      hernia repair.

PMID- 11221733
TI  - Radicality of thoracoscopic thymectomy--an anatomical study.

PMID- 11221734
TI  - Early and long-term complaints following video-assisted thoracoscopic surgery:
      evaluation in 173 patients.

PMID- 11221736
TI  - Is Brazil entering a new age?

PMID- 11221735
TI  - Mitral annuloplasty with a suture technique.

PMID- 11221737
TI  - Letter from the guest editor. Colorectal carcinoma.

PMID- 11221738
TI  - [La Revue Neurologique has received the following correspondence].

PMID- 11221739
TI  - Interdisciplinary research: what, why and how.

PMID- 11221740
TI  - Comments on patterns of academic achievement among early treated patients with
      phenylketonuria.

PMID- 11221741
TI  - Comments on in vivo proton magnetic resonance spectroscopy in phenylketonuria.

PMID- 11221742
TI  - Comments on diet and compliance in phenylketonuria.

PMID- 11221743
TI  - Comments on final intelligence in late treated patients with phenylketonuria.

PMID- 11221744
TI  - Comments on the International Collaborative Study of Maternal Phenylketonuria:
      status report 1998.

PMID- 11221745
TI  - Phenylketonuria: evidence-based clinical practice. Summary of the roundtable
      discussion.

PMID- 11221746
TI  - The effect of a phenylalanine-restricted diet on phenylketonuria.

PMID- 11221747
TI  - Comments on neuropsychological approaches to treatment policy issues in
      phenylketonuria.

PMID- 11221748
TI  - Comments on behavior in early treated phenylketonuria.

PMID- 11221749
TI  - Basal ganglia, Parkinson's disease and levodopa therapy. Proceedings of a
      meeting. St Thomas, Virgin Islands, January 2000.

PMID- 11221750
TI  - Whatever it takes.

PMID- 11221751
TI  - Lab ventilation standard revisited. The user-friendly ANSI/AIHA Z9.5 Standard
      will affect every lab. American National Standards Institute/American Industrial
      Hygiene Association.

PMID- 11221752
TI  - Quiz case. Avascular necrosis of the metacarpal head III.

PMID- 11221754
TI  - The supersite - digital methadone.

PMID- 11221753
TI  - Reactivity to a 35% CO(2) challenge in healthy first-degree relatives of patients
      with panic disorder.

PMID- 11221755
TI  - A case of chronic inflammatory demyelinating polyneuropathy with
      antigalactocerebroside antibody.

PMID- 11221756
TI  - Disseminating information about new therapies for Parkinson's disease:
      misunderstanding or misconduct?

PMID- 11221757
TI  - [R. Degos, E. Rivalier, P. Lefort: "Griseofulvin". 1960].

PMID- 11221758
TI  - [A. Bazex, A. Dupre: "Prurigo strophulus, a parasitic syndrome due to insect
      bites. Etiological, clinical and development modalities". 1965].

PMID- 11221759
TI  - [G. Orth, D. Dompmartin, P. Agache, M. Faure, O. Croissant: "The plurality of
      human papillomaviruses". 1978].

PMID- 11221760
TI  - [D. Wallach, C. Foldes, F. Cottenot: "Subcorneal pustulosis, superficial
      acantholysis and monoclonal IgA". 1982].

PMID- 11221762
TI  - [13 decades of history of the Annales and of Dermatology].

PMID- 11221761
TI  - [M. Bagot, N. Terki, S. Bacha, D. Moyse, C. Suck, J. Revuz: "Per os
      desensitization in nickel contact eczema: a double-blind placebo-controlled
      clinico-biological study. 1999].

PMID- 11221763
TI  - [Joseph Rollet: "Inoculated syphillis". 1873-1874].

PMID- 11221764
TI  - [Alfred Fournier: "Syphilitic locomotor ataxia". 1882].

PMID- 11221765
TI  - [Jean Darier: "Papillary and pigmentary dystrophy. Acanthosis nigricans". 1895].

PMID- 11221766
TI  - [C. Levaditi: "New means of microbial and serological diagnosis of syphilis".
      1909].

PMID- 11221767
TI  - [L.A. Longin: "Contribution to the study of so-called facts of congelation of
      feet". 1914-1915].

PMID- 11221768
TI  - [Jean Darier: "The three planes of dermatological diagnosis". 1923].

PMID- 11221769
TI  - [Jean Darier: "Historical considerations on the development of dermatology".
      1936].

PMID- 11221770
TI  - [James Marshall: "Penicillin treatment of syphilis". 1945].

PMID- 11221771
TI  - Intragraft thrombus: an early CT finding in aortic graft infection.

PMID- 11221772
TI  - Curricular and extracurricular activities of medical students during war, Zagreb
      University School of Medicine, 1991-1995.
AB  - War, as a major human disaster, affects many aspects of life, including medical
      education. This report describes curricular and extracurricular activities of the
      students at the Zagreb University School of Medicine during the wars in Croatia
      and neighboring Bosnia and Herzegovina. Although condensed versions of the
      curricula were prepared in case of a major breakdown in civilian life, the school
      maintained the continuity and quality of its curriculum throughout the war.
      Students engaged in extracurricular activities related to medical aspects of the
      war, including organization of resuscitation and first aid courses, collecting
      medical documentation on war victims, humanitarian help to refugees, and peace
      promoting activities. Some students joined mobile surgical teams on the
      battlefronts. After army service, most of them returned to the school and
      successfully continued with their studies. The school also accepted guest
      students from other new states emerged from former Yugoslavia. The authors found
      that the students' engagement in extracurricular activities related to medicine
      was enormously beneficial both to the psychological well-being of the students
      and to the region's peace-building efforts.

PMID- 11221773
TI  - Radiosurgery for trigeminal neuralgia.

PMID- 11221774
TI  - Timeline: endovascular therapy for arteriovenous malformations.

PMID- 11221775
TI  - Society merger?

PMID- 11221776
TI  - Evolving cell death in the virus-infected nervous system.

PMID- 11221777
TI  - First dose hypotension after myocardial infarction.

PMID- 11221778
TI  - Persistent left superior vena cava in Holt-Oram syndrome.

PMID- 11221779
TI  - Are physicians recommending coronary angiographies more than necessary in atrial
      fibrillation.

PMID- 11221780
TI  - Serotonin syndrome risk with antiobesity drug.

PMID- 11221781
TI  - Partnering with industry: fences and good neighbors.

PMID- 11221782
TI  - History and evolution of computerized electroencephalography.

PMID- 11221783
TI  - Fundamental scientific factors in electrical stimulation of the nervous system.

PMID- 11221785
TI  - Motor nerve conduction studies: measurement principles and interpretation of
      findings.
AB  - Motor nerve conduction studies are reviewed. The principles of electrode
      placement, stimulus intensity, algorithms for measurement of parameters, causes
      of variability, reference values, and reporting are discussed. A rigorous
      standardization of methods has several advantages. The sensitivity of each method
      is increased without loss of specificity. In addition, reference values obtained
      in one laboratory can be used in other laboratories as well. Pathophysiological
      interpretation of findings in different types of neuropathies is also presented.

PMID- 11221784
TI  - Assessment of intraspinal and intracranial conduction by P30 and P39 tibial nerve
      somatosensory evoked potentials in cervical cord, brainstem, and hemispheric
      lesions.
AB  - In routine recordings of tibial nerve somatosensory evoked potentials (SEPs), a
      global central conduction time is evaluated by measuring the interval between the
      segmental spinal N22 potential, recorded in the lumbar region, and the cortical
      P39 potential. In this study, we tested the reliability of the scalp far-field
      P30 potential, which originates in the vicinity of the cervico-medullary
      junction, in order to evaluate separately intraspinal and intracranial conduction
      in normal subjects and patients with cervical cord and intracranial lesions. P30
      and cortical P39 potentials were studied in 23 healthy subjects and in 70
      patients with cervical cord (n = 47), brainstem (n = 11) or hemispheric lesions
      (n = 12) selected on the basis of neuroimaging--computed tomography (CT) or
      magnetic resonance (MR)--findings. Median nerve SEPs were also recorded in all
      patients. Of the several montages tested to obtain the P30 potential, the Fpz-Cv6
      derivation gave the highest signal-to-noise ratio; it permitted to obtain a P30
      potential that peaked at 29.2 +/- 1.6 ms in all normal subjects. P30
      abnormalities were observed only in patients with cervical or cervico-medullary
      lesions; these were associated with a normal P39 in only two of 33 abnormal
      recordings. Conversely, P30 was consistently normal in lesions situated above the
      cervico-medullary junction whether associated with normal, delayed, or reduced
      P39. P30 abnormalities were subclinical in 42% of abnormal recordings. All
      patients with normal tibial and median nerve SEPs on both sides had normal touch,
      joint, and vibration sensation in the four limbs. There was a strong correlation
      between tibial nerve P30 and median nerve P14 data in the whole series of
      patients; both potentials behaved similarly in all cases of intracranial
      supramedullary lesions. Combined abnormalities of P30 and P39 potentials thus
      indicate that conduction is impaired at the spinal level and proved to be
      particularly informative for detecting spinal cord dysfunction in patients with
      neuroimaging evidence of a narrowed cervical canal. Recording of abnormal N13,
      P14, or P30 potentials provided evidence of a cervical cord dysfunction in 66% of
      patients who had a suspected spondylotic myelopathy. Recording of tibial nerve
      P30 potential has proven to give reliable and useful information when a separate
      assessment of intraspinal and intracranial somatosensory conduction is needed; it
      merits inclusion, as does the upper limb N13 potential, in the evaluation of
      patients whose MR image indicates cervical canal narrowing.

PMID- 11221786
TI  - Temporal intermittent rhythmic delta activity in electroencephalograms.
AB  - Temporal intermittent rhythmic delta activity (TIRDA) has been reported to be
      highly specific for diagnosing complex partial epilepsy. Of 12,198
      electroencephalographic (EEG) recordings performed at the Mayo Clinic between May
      1, 1990 and May 1, 1991, 33 records from 27 patients (18 women and nine men; mean
      age, 41.5 years; range, 13-82 years) showed TIRDA. Clinical seizures were
      diagnosed in all patients, and complex partial epilepsy was well documented in
      23. In a control group of 100 patients without TIRDA and matched for age and sex,
      generalized seizures were diagnosed in 25 and partial seizures in 15. Differences
      between TIRDA and control groups were highly statistically significant. Focal
      temporal sharp waves or spikes occurred in 23 patients with EEG recordings that
      contained TIRDA; three of these patients also exhibited generalized atypical
      spike-and-wave discharges. Four patients had TIRDA but no other epileptiform
      activity, although earlier EEGs of three of these patients contained spikes or
      sharp waves. These findings confirm earlier work, and we conclude that TIRDA
      represents an important epileptogenic abnormality.

PMID- 11221787
TI  - Quantitative analysis of the electroencephalogram in the intracarotid amobarbital
      procedure: II. Coherence analysis.
AB  - Thirty-seven subjects underwent bilateral internal carotid artery injections of
      amobarbital before surgery for intractable epilepsy. The electroencephalograms
      (EEG) of these patients were continuously monitored during these 74 procedures
      and were later subjected to quantitative analysis. Analysis of interhemispheric
      coherence in the delta, theta, alpha, and beta 1 bands was performed. Prominent
      changes occurred in interhemispheric coherence, which showed a precipitous drop
      in the first 2 min after amobarbital injection, followed by a gradual return to
      near baseline levels. These results suggest that interhemispheric relationships
      are significantly disrupted by intracarotid amobarbital injection.

PMID- 11221788
TI  - Middle-latency somatosensory evoked potentials after stimulation of the radial
      and median nerves: component structure and scalp topography.
AB  - Somatosensory evoked potentials (SEPs) after radial nerve stimulation are studied
      less frequently than those after median nerve stimulation. Therefore, little is
      known about their component structure and scalp topography. We investigated
      radial nerve SEPs after electrical stimulation at the left wrist. For comparison,
      the median nerve was also stimulated at the wrist. SEPs were recorded with 15
      scalp electrodes (bandpass 0.5-200 Hz) in 27 healthy subjects. The waveform of
      the radial nerve SEP at a contralateral parietal lead was comparable to that of
      the median nerve SEP, consisting of P14, N20, P30, and N60. In spite of
      comparable stimulus intensities, SEP amplitudes were smaller after radial than
      after median nerve stimulation. Significant latency differences were found only
      for N20 (earlier for median nerve) and P30 (earlier for radial nerve). The
      duration of the primary complex N20-P30 thus was significantly shorter for the
      radial nerve. Whereas N20 and P30 were present with either earlobe or frontal
      reference, N60 had a prerolandic maximum and was best recorded with a bipolar
      transverse derivation. In addition, another middle-latency negativity (N110) was
      found near the secondary somatosensory cortex, which had previously been
      described only for radial nerve stimulation. In standard SEP derivations, the
      N110 is riding on the ascending limb of the vertex negativity. It could best be
      recorded in low temporal leads versus a midline reference. The scalp topographies
      of P30, N60, and N110 were similar for radial and median nerve stimulation.

PMID- 11221789
TI  - Ambulatory cassette polysomnography: findings from a large cohort of drug-free
      insomnia patients.
AB  - Technology for conducting ambulatory polysomnography (APSG) has been available
      for more than a decade, but relatively few studies have used this technology to
      study the sleep of subjects in their usual home sleeping environments. Herein we
      suggest the usefulness of this technology for the study of normal sleepers and
      insomniacs, and we report our APSG findings with a large cohort (n = 117) of drug
      free insomnia outpatients. All patients completed a sleep-history questionnaire,
      a clinical interview with a sleep-disorders clinician, and one night of APSG in
      their homes. Most sleep parameters derived were consistent with previously
      reported laboratory PSG findings for insomniacs, except that values of rapid-eye
      movement sleep latencies were generally shorter than typically found in
      laboratory studies. Moreover, results showed that APSG served to differentiate
      major age groups and diagnostic subtypes within our larger sample, and patient
      tolerance for APSG was within acceptable limits. We conclude that APSG is a
      useful technique for evaluating insomnia complaints.

PMID- 11221790
TI  - XIII Meeting on ADP-Ribosylation Processes. Torino, Italy, October 8-9, 2000.
      Abstracts.

PMID- 11221791
TI  - Strength through unity: why become a mentor for podiatric medicine?

PMID- 11221793
TI  - Solar-powered device decontaminates human immunodeficiency virus (HIV)-infected
      breast milk.

PMID- 11221792
TI  - Re: Wight et al. Aging, serum estradiol levels, and pregnancy differentially
      affect vascular reactivity of the rat uterine artery. J Soc Gynecol Investig
      2000;7:1060-113.

PMID- 11221794
TI  - [Concerning "Arthroscopic debridement of full-thickness tears of the rotator
      cuff: a retrospective multicenter study of 283 cases with 3-year follow-up"].

PMID- 11221795
TI  - [Concerning: "Effectiveness of postoperative drainage after bipolar sealed
      endoprosthetic arthroplasty for femur neck fracture. Results of a prospective
      randomized study of 86 cases"].

PMID- 11221796
TI  - [Concerning "Aggressive osteoblastoma of the carpal scaphoid bone"].

PMID- 11221797
TI  - Impact of the new WHO classification and diagnostic criteria.
AB  - The World Health Organisation (WHO) [1] consultation group and the American
      Diabetes Association (ADA) [2] have recently published revised criteria for the
      classification and diagnosis of diabetes. If widely implemented, these
      recommendations, together with earlier and improved treatment, could have a
      profound impact on the morbidity and mortality associated with the disease. The
      changes in classification stem from an increased knowledge of the aetiology and
      pathogenesis of diabetes, which signals the move away from a classification
      system based on pharmacological dependency towards one that is based on the
      underlying causes of the disease.

PMID- 11221798
TI  - The role of blood glucose-lowering drugs in the light of the UKPDS. United
      Kingdom Prospective Diabetes Study.

PMID- 11221800
TI  - Atherothrombosis in diabetes--its evolution and management.

PMID- 11221799
TI  - Cardiovascular risk in type 2 diabetes.

PMID- 11221801
TI  - The natural history of diabetes-related complications: the UKPDS experience.
      United Kingdom Prospective Diabetes Study.

PMID- 11221802
TI  - Absence of echovirus sequences in brain and spinal cord of amyotrophic lateral
      sclerosis patients.
AB  - The role of enteroviruses in pathogenesis of amyotrophic lateral sclerosis (ALS)
      is controversial. A recent study, based on reverse transcription-polymerase chain
      reaction (RT-PCR) analysis of spinal cord, reported identification of a novel
      echovirus in 15 of 17 French subjects with ALS and only 1 of 29 subjects with
      other neurologic diseases. We established a real-time RT-PCR method based on this
      novel echovirus sequence and used this method and that previously employed for
      analysis of the French subjects to determine the prevalence of echoviral
      sequences in spinal cord and motor cortex of sporadic ALS subjects from the
      United States. No echoviral sequences were found in 20 spinal cord and 10 motor
      cortex samples from autopsy-confirmed cases of ALS or 13 spinal cord and 5 motor
      cortex samples from subjects with no motor neuron disease.

PMID- 11221803
TI  - The role of the oncology nurse in cancer gentic counseling. Oncology Nursing
      Society.

PMID- 11221804
TI  - Cancer predisposition genetic testing and risk assessment counseling. Oncology
      Nursing Society.

PMID- 11221805
TI  - Characterization of microsatellite loci in the eastern oyster, Crassostrea
      virginica.

PMID- 11221806
TI  - [Analytical comment on the article: "Iridology: not useful and potentially
      harmful." E. Ernst, (Edin)--Arch Ophthalmol. 2000, 118: 120-1021].

PMID- 11221807
TI  - UKPDS and beyond: into the next millennium. United Kingdom Prospective Diabetes
      Study.

PMID- 11221808
TI  - Serum leptin levels are not influenced by physical training in type 2 diabetes
      mellitus patients.
AB  - AIM: To investigate the effect of physical training on leptin levels in elderly,
      obese patients with type 2 diabetes mellitus. METHODS: Twenty men and 38 women
      with type 2 diabetes mellitus with a body mass index (BMI) of > 25 kg/m2
      participated in a prospective randomized study. Patients were either on oral
      glucose lowering drugs (n = 39) or insulin therapy (n = 19). Physical training
      consisted of a guided, standardized, 6-week training programme performed in the
      hospital on a cyclo ergometer followed by a 6-week period of guided training at
      home and ended in a 12-week period of training at home without supervision.
      Clinical data and laboratory samples including fasting insulin and leptin levels
      and maximal aerobic capacity were assessed at the start of the study and at 6 and
      26 weeks thereafter. RESULTS: Physical training resulted in significantly
      positive changes in maximal aerobic capacity (VO2max) and maximum work load. No
      effects of physical training on serum leptin levels and insulin concentrations
      were detected. Leptin levels were strongly correlated with body mass index (r =
      0.63), body fat content (r = 0.61), and fasting insulin concentrations (r =
      0.38). Women had threefold higher leptin levels than men. No differences in
      leptin levels between patients on insulin therapy and patients on oral glucose
      lowering drugs were found. CONCLUSIONS: No effect of physical training on leptin
      levels was detectable in elderly, obese type 2 diabetes mellitus patients.

PMID- 11221810
TI  - Nerve regeneration in diabetic neuropathy.

PMID- 11221809
TI  - Acarbose vs. bedtime NPH insulin in the treatment of secondary failures to
      sulphonylurea-metformin therapy in type 2 diabetes mellitus.
AB  - OBJECTIVE: To evaluate the efficacy of acarbose in the treatment of secondary
      failures to sulphonylurea-metformin therapy, its comparison against bedtime NPH
      insulin, and to measure the changes in postprandial metabolism resulting from
      both treatments. METHODS: One hundred type 2 diabetic patients in a secondary
      failure were included. The study begun with a run-in diet period of 6 weeks, in
      which an isocaloric diet was prescribed. Only subjects who continued
      hyperglycaemic were randomly assigned to placebo and acarbose (n = 17) or bedtime
      NPH insulin (n = 12). Acarbose (300 mg/day) or placebo were administered using a
      randomized, double blind, crossover design. Treatment periods of 3 months were
      separated by a 3-week washout period. Insulin was administered during 3 months.
      At the beginning and the end of each treatment period, an i.v. glucose tolerance
      test and a meal test were performed. Safety tests were done every 4 weeks.
      RESULTS: Acarbose resulted in a small but significant improvement in fasting
      plasma glucose (13.5 +/- 2.4 vs. 11.3 +/- 3.9 mmol/l, p = 0.05), HbA1c (11.1 +/-
      3.4 vs. 10.3 +/- 2.5%, P = 0.3) and in a decreased plasma glucose during the meal
      test. Bedtime insulin significantly decreased fasting plasma glucose (13.1 +/-
      2.9 vs. 8.2 +/- 2.3 mmol/l, p < 0.01), HbA1c (11.7 +/- 2.9 vs. 9.4 +/- 2.7%, p <
      0.01) and plasma cholesterol. No change in insulin secretion resulted from
      insulin and acarbose treatment. CONCLUSIONS: Acarbose decreases blood glucose in
      secondary failure to sulphonylurea-metformin therapy; however, the decrease is
      not enough to reach the desired metabolic control. Bedtime NPH insulin is, by
      far, a more effective alternative.

PMID- 11221811
TI  - Cilostazol, a phosphodiesterase inhibitor, improves insulin sensitivity in the
      Otsuka Long-Evans Tokushima Fatty Rat, a model of spontaneous NIDDM.
AB  - AIM: Angiotensin converting enzyme inhibitors and alpha1-adrenergic blockers
      improve insulin sensitivity, the mechanism of which was considered, at least in
      part, to be due to the increased blood flow to muscle. The present study aimed to
      clarify whether cilostazol, a phosphodiesterase inhibitor, improves insulin
      sensitivity in a model of spontaneous non-insulin dependent diabetes mellitus
      (NIDDM), Otsuka Long-Evans Tokushima Fatty (OLETF) rat. METHODS: OLETF rats were
      divided into the two groups at the age of 16 weeks: the cilostazol-supplemented
      group (cilostazol 40 mg/kg/day) and the normal-diet group. As a non-diabetic
      control, we used Long-Evans-Tokushima-Otsuka rats (non-diabetic rats). Oral
      glucose tolerance test and hyperinsulinemic euglycemic clamp was performed at the
      ages of 23 and 25 weeks, respectively. Serum levels of lipids and leptin were
      measured. RESULTS: Body weight and abdominal fat was increased in OLETF rats but
      cilostazol supplementation did not alter them. Insulin sensitivity, as measured
      by the hyperinsulinemic euglycemic clamp technique, was significantly decreased
      in OLETF rats (glucose infusion rate: 73.5 +/- 10.0 vs. 41.5 +/- 9.8
      micromol/min/kg body weight, p < 0.01). Cilostazol supplementation improved
      insulin sensitivity partially but significantly 51.0 +/- 5.7 micromol/min/kg body
      weight, p < 0.05) in OLETF rats at 25 weeks of age, although it did not decrease
      serum levels of glucose, lipids or leptin. However, this effect was not observed
      in non-diabetic rats. CONCLUSION: Cilostazol, which is used in diabetic patients
      for the treatment of obstructive disease of artery, is expected to have a
      beneficial effect on insulin sensitivity in NIDDM.

PMID- 11221813
TI  - Lowering of circulating insulin and leptin is closely associated following weight
      reduction after vertical banded gastroplasty in obese women.
AB  - AIM: To explore whether the lowering of insulin relates to changes in leptin
      following weight reduction after vertical banded gastroplasty (VBG) in seven
      grossly obese women (BMI 45.9 +/- 1.5 kg/m2). RESULTS: At 6-24 months after VBG,
      BMI was reduced to 31.3 +/- 0.9 kg/m2 (p < 0.018), leptin from 43 +/- 9 to 12 +/-
      2 ng/ml (p < 0.018) and insulin from 172 +/- 19 to 71 +/- 2 pmol/l (p=0.018). The
      reduction in leptin correlated to the reduction in insulin (r = 0.94, p = 0.002)
      but not to that of BMI (r = 0.05, NS). CONCLUSION: Reduction in insulin seems
      more important for reduction in leptin than lowering of BMI, suggesting a close
      association between leptin and insulin in obese subjects.

PMID- 11221812
TI  - Clenbuterol stimulates neurotrophic support in streptozotocin-diabetic rats.
AB  - BACKGROUND: The diabetic neuropathies are characterized by axonal degeneration of
      peripheral nerves. The commonest variant of this condition is distal symmetrical
      polyneuropathy, in which the principal presenting features can be explained by
      impaired neurotrophic support of sensory neurones. AIMS: The aims of these
      experiments were to determine whether deficits in nerve growth factor (NGF)
      content and the products of its target genes (substance P and calcitonin-gene
      related peptide; CGRP) in the sciatic nerve of streptozotocin-induced rats could
      be prevented using clenbuterol, which has been demonstrated to induce NGF
      synthesis in vitro. RESULTS: Diabetes of 8 weeks duration produced a reduction in
      measurable sciatic nerve NGF-like immunoreactivity (NGF-LI) content of 53% (p <
      0.01). This was accompanied by depletion of substance P (of 43%; p < 0.01) and
      CGRP (of 45%; p < 0.01). Treatment with clenbuterol (30 microg/kg, 100 microg/kg
      and 300 microg/kg; daily subcutaneous injection) significantly increased the NGF
      LI and neuropeptide content of the sciatic nerve, with 30 microg/kg of
      clenbuterol normalising the levels in diabetic animals. The alterations in steady
      state sciatic nerve NGF-LI were proportionally related to the amount of NGF-LI
      delivered to the primary afferent neurones via retrograde transport. Thus, there
      was a significant reduction in accumulation of NGF-LI distal to a 12-h ligature
      in diabetic untreated rats (p < 0.01), which was normalized by clenbuterol (30
      microg/kg; p < 0.05). Treatment of control or diabetic rats with clenbuterol did
      not affect the local production of NGF-LI in the sciatic nerve adjacent to and
      triggered by an occluding ligature. The change in NGF-LI content of neuronal
      tissue in the clenbuterol treated rats was a reflection of the capture of NGF
      derived from the peripheral targets of the sciatic nerve. The soleus and EDL
      muscles showed reductions in NGF-LI in untreated diabetic animals. Clenbuterol
      significantly (p < 0.05) increased NGF-LI in the soleus muscle. CONCLUSION:
      Clenbuterol could be a useful tool in alleviating the deficits in neurotrophin
      support in diabetes.

PMID- 11221814
TI  - Smoking habits and circulating leptin in postmenopausal non-obese women.
AB  - This study examined whether smoking habits affect the correlation between serum
      leptin levels and body mass index (BMI) in 101 postmenopausal Caucasian non-obese
      women, all aged 57-59years. Mean serum leptin level in the entire group was 19.8
      +/- 12.3 ng/ml (mean +/- s.d.) and mean BMI was 25.3 +/- 3.5 kg/m2. These
      parameters correlated significantly to each other (r = 0.70, p < 0.001). Between
      those who have smoked regularly for more than 2 years (n = 26) and those who are
      ex-smokers or have never smoked (n = 75), serum leptin levels or BMI did not
      differ and the correlation between serum leptin and BMI was identical. This
      suggests that smoking habits do not influence circulating leptin in Caucasian
      postmenopausal non-obese women.

PMID- 11221815
TI  - Reflections on "a longitudinal study of the effects of graduate medical education
      on hospital operating costs".

PMID- 11221816
TI  - How would mental health parity affect the marginal price of care?
AB  - OBJECTIVE: To determine the impact of parity in mental health benefits on the
      marginal prices that consumers face for mental health treatment. DATA
      SOURCES/DATA COLLECTION: We used detailed information on health plan benefits for
      a nationally representative sample of the privately insured population under age
      65 taken from the 1987 National Medical Expenditure Survey (Edwards and Berlin
      1989). The survey was carefully aged and reweighted to represent 1995 population
      and coverage characteristics. STUDY DESIGN: We computed marginal out-of-pocket
      costs from the cost-sharing benefits described by policy booklets under current
      coverage and under parity for various mental health treatment expenditure levels
      using the MEDSIM health care microsimulation model developed by researchers at
      the Agency for Healthcare Research and Quality. Descriptive analyses and two
      limit Tobit regression models are used to examine how insurance generosity varies
      across individuals by demographic and socioeconomic characteristics. Our analyses
      are limited to a description of how parity would change the marginal incentives
      faced by consumers under their existing plan's cost-sharing arrangements for
      mental and physical health care. We do not attempt to simulate how parity might
      affect the level of benefits, including whether benefits are offered at all, or
      the level of managed care that affects the actual benefits that plan members
      receive. Rather, we focus only on the nominal benefits described in their policy
      booklets. PRINCIPAL FINDINGS: Our results show that as of 1995 parity coverage
      would substantially reduce the share of mental health expenditures that consumers
      would pay at the margin under their existing plan's cost-sharing provisions, with
      larger changes for outpatient care than for inpatient care. Because current
      mental health coverage generally becomes less generous as expenditures rise,
      while coverage for other medical care becomes more generous (due to stop-loss
      provisions), the difference in incentives between current mental health coverage
      and the assumed parity coverage widens as total expenditure grows. We also find
      that the impact of parity on marginal incentives would vary greatly across the
      privately insured population. CONCLUSIONS: Based on the large variation in the
      impact of parity on marginal incentives across the population under current plan
      cost-sharing arrangements, changes in the demand for mental health treatment will
      likely also vary across the population.

PMID- 11221817
TI  - Evaluating large and complex demonstrations: the CHAMPUS reform initiative
      experience. Civilian Health and Medical Program of the Uniformed Services.
AB  - OBJECTIVE: To examine the evaluation process for the CHAMPUS Reform Initiative
      (CRI) both to highlight issues that evaluators must consider when undertaking
      such projects and to provide policymakers with tools to better assess
      demonstration project evaluations. DATA SOURCES: The CRI evaluation. STUDY
      DESIGN: Case study. DATA COLLECTION: Review of CRI evaluation reports. PRINCIPAL
      FINDINGS: Although policymakers increasingly rely on the evaluations of
      demonstration projects to determine whether to extend the scope and funding of
      many public programs, the results of these evaluations are often difficult to
      assess. Despite its analytical sophistication, the CRI evaluation was no
      exception. The somewhat artificial time constraints imposed by policymakers made
      projection of the CRI's performance beyond the demonstration period particularly
      difficult. CONCLUSIONS: Much uncertainty generally remains even after well
      planned and well-executed evaluations of demonstration projects.

PMID- 11221818
TI  - Comparing mortality and time until death for medicare HMO and FFS beneficiaries.
AB  - OBJECTIVE: To compare adjusted mortality rates of TEFRA-risk HMO enrollees and
      disenrollees with rates of beneficiaries enrolled in the Medicare fee-for-service
      sector (FFS), and to compare the time until death for decedents in these three
      groups. DATA SOURCE: Data are from the 124 counties with the largest TEFRA-risk
      HMO enrollment using 1993-1994 Medicare Denominator files for beneficiaries
      enrolled in the FFS and TEFRA-risk HMO sectors. STUDY DESIGN: A retrospective
      study that tracks the mortality rates and time until death of a random sample of
      1,240,120 Medicare beneficiaries in the FFS sector and 1,526,502 enrollees in
      HMOs between April 1, 1993 and April 1, 1994. A total of 58,201 beneficiaries
      switched from an HMO to the FFS sector and were analyzed separately. PRINCIPAL
      FINDINGS: HMO enrollees have lower relative odds of mortality than a comparable
      group of FFS beneficiaries. Conversely, HMO disenrollees have higher relative
      odds of mortality than comparable FFS beneficiaries. Among decedents in the three
      groups, HMO enrollees lived longer than FFS beneficiaries, who in turn lived
      longer than HMO disenrollees. CONCLUSIONS: Medicare TEFRA-risk HMO enrollees
      appear to be, on average, healthier than beneficiaries enrolled in the FFS
      sector, who appear to be in turn healthier than HMO disenrollees. These health
      status differences persist, even after controlling for beneficiary demographics
      and county-level variables that might confound the relationship between mortality
      and the insurance sector.

PMID- 11221819
TI  - A longitudinal study of the effects of graduate medical education on hospital
      operating costs.
AB  - OBJECTIVE: To examine the effect of graduate medical education sponsorship on
      hospital operating costs over a seven-year period, to test for a longitudinal
      association between teaching intensity and cost, and to determine whether the
      indirect medical education (IME) payment adjustments made under Medicare's
      Prospective Payment System are appropriate. DATA SOURCES: Medicare cost and
      payment data from the Hospital Cost Report Information System and other related
      HCFA files, from FFY 1989 through 1995. The study population consists of all
      short-stay hospitals (approximately 5,000) participating in Medicare and
      receiving case payments by diagnosis-related groups. STUDY DESIGN: The original
      cost functions used to develop indirect medical education payment adjustments
      under PPS are re-estimated with panel data. Specification changes are included
      based on findings from critiques of the original hospital cost model. Additional
      variations on the model are explored to test for differences by hospital status,
      to control for the effect of additional disproportionate share and outlier
      payments, and to isolate the effects of improved case-mix measurement on model
      results. PRINCIPAL FINDINGS: Fixed effects regression produces no evidence of a
      significant within-hospital association between increased sponsorship of medical
      residents and increased cost per case. In models designed to capture a cross
      sectional association, operating costs are positively related to teaching
      activity, but the association shows a decline in strength over time. In all
      years, the strength of the association is significantly greater among hospitals
      eligible for disproportionate share adjustments and among major teaching
      hospitals. Controlling for secular trends of increased teaching intensity results
      in a pattern of declining cross-sectional teaching coefficients that supports a
      theory that observed teaching effects are the result of unmeasured case severity.
      CONCLUSIONS: A significant but declining cost differential is observed between
      teaching and nonteaching hospitals. The association appears to be related to
      hospital and patient characteristics that cannot be controlled using currently
      available case-mix and wage indices. Longitudinal models do not provide evidence
      to support a payment adjustment formula that allows individual hospitals to
      recompute their IME adjustment rates as their teaching ratios rise or fall from
      year to year. Cross-sectional findings suggest that re-estimations of the
      teaching effect may be appropriate when significant improvements occur in
      Medicare case-mix measurement.

PMID- 11221820
TI  - Differences in rehabilitation services and outcomes among stroke patients cared
      for in veterans hospitals.
AB  - OBJECTIVE: To examine the relationship of services for post-acute care (PAC) to
      stroke patient outcomes. DATA SOURCES/STUDY SETTING: Veterans Health
      Administration (VHA) hospitals from two facility-level surveys and extant data
      files. STUDY DESIGN: Cross-sectional study of veterans hospitalized with acute
      stroke during the period June 1995 through May 1996 in one of 182 geographically
      distinct locations within the VHA. Study variables included (1) a typological
      classification of hospitals according to the level of PAC; (2) a taxonomy of
      rehabilitation characteristics, including personnel, physical facilities,
      coordination of care, and hospital characteristics; and (3) patient outcomes
      (discharge destination, length of stay). DATA COLLECTION/EXTRACTION METHODS: Data
      were collected from two mailed surveys and extant data files. Rehabilitation
      variables were identified for the study in conjunction with a panel of expert
      rehabilitation researchers and clinicians, using an a priori model for measuring
      rehabilitation characteristics. Two sets of variables were derived to categorize
      these rehabilitation characteristics: (1) a rehabilitation typology, classifying
      the VA hospitals according to the continuum of PAC settings in the facility, and
      (2) a rehabilitation taxonomy that used an empirical approach to derive a list of
      key rehabilitation characteristics. PRINCIPAL FINDINGS: Twenty-seven percent of
      veterans with acute stroke were cared for in VA hospitals with neither a
      geriatric nor a rehabilitation unit, and 50 percent were cared for in hospitals
      without a rehabilitation unit. Hospitals with rehabilitation units had the
      greatest sophistication, and those with geriatric units had intermediate
      sophistication in rehabilitation organization and resources. Statistically
      significant differences were found in outcomes for stroke patients cared for in
      hospitals classified according to the continuum of post-acute care on site.
      Exploratory multivariable analyses revealed independent associations between
      stroke patient outcomes and (1) staffing ratios for nurses and physicians, (2)
      the diversity of physician and rehabilitation staff, (3) presence of a simulated
      home environment, and (4) the total number of care settings on site. CONCLUSIONS:
      The PAC continuum defines an important hierarchy of stroke rehabilitation
      services.

PMID- 11221821
TI  - The quick and the dead: "managing" inpatient care in British Columbia hospitals,
      1969-1995/96.
AB  - OBJECTIVE: To examine changes in hospital use in British Columbia during a decade
      of capacity reductions. DATA SOURCES/STUDY SETTING: The data used are all
      separation records for British Columbia hospitals for the years 1969, 1978,
      1985/86, 1993/94, and 1995/96. Separation records include acute care,
      rehabilitation, extended care, and surgical day care hospital encounters in
      British Columbia that were concluded during the years of interest. STUDY DESIGN:
      Analyses were based on per capita use of services for five-year age groups of the
      population to ages 90+; the emphasis was on looking at changes in the use of
      specific types of hospital services over the 26 years of study, with a particular
      focus on the most recent decade. DATA COLLECTION/EXTRACTION METHODS: Data were
      extracted from hospital separations files owned by the British Columbia Ministry
      of Health and housed at the Centre for Health Services and Policy Research. All
      separation records for the years of interest were included in the study.
      PRINCIPAL FINDINGS: Acute care use continued to fall over the last decade. The
      rate of decline increased during the last time period of study and affected
      seniors to the same degree as younger patients. At the same time, use of extended
      care decreased, compared to steady increases in earlier years. The result was
      that by 1995/96 nearly 40 percent of inpatient days were used by people who died
      in hospital, compared to 9 percent in 1969. These people, however, still
      represent a small proportion of separations. CONCLUSIONS: The "bed blocker"
      problem common to many hospital systems appears to have been largely alleviated
      in British Columbia over the decade 1985-95. The concurrent decrease in extended
      care use, however, makes it difficult to say where and how these people are now
      being cared for. Care for the dying has become a bigger issue for hospitals, but
      whether this is because of heroic interventions at the end of life is not clear.
      A "top-down," capacity-driven management approach to hospital use in British
      Columbia has produced effects that may seem familiar to those involved in more
      "bottom-up" managed care approaches in the United States.

PMID- 11221822
TI  - The use of monetary incentives in a community survey: impact on response rates,
      data quality, and cost.
AB  - OBJECTIVES: To assess the effect of incentive size on response rates, data
      quality, and cost in a digestive health status mail survey of a community sample
      of health plan enrollees. DATA SOURCES/SETTING: The study population was selected
      from a database of enrollees in various health plans obligated to receive care at
      Park Nicollet Clinic-HealthSystem Minnesota, a large, multispecialty group in
      Minneapolis, Minnesota, and the nearby suburbs. STUDY DESIGN: A total of 1,800
      HealthSystem Minnesota enrollees were randomly assigned to receive a survey with
      an incentive of $5 or $2. The response rates for each incentive level were
      determined. Data quality, as indicated by item nonresponse and scale scores, was
      measured. Total cost and cost per completed survey were calculated. PRINCIPAL
      FINDINGS: The response rate among enrollees receiving $5 (74.3 percent) was
      significantly higher than among those receiving $2 (67.4 percent); differences
      were more pronounced in the first wave of data collection. Data quality did not
      differ between the two incentive groups. The total cost per completed survey was
      higher in the $5 condition than in the $2 condition. CONCLUSIONS: A $5 incentive
      resulted in a higher response rate among a community patient sample with one
      mailing than did a $2 incentive. However, the response rates in the $2 condition
      approached the level of the $5 incentive, and costs were significantly lower when
      the full follow-up protocol was completed. Response rates were marginally
      increased by follow-up phone calls. The incentive level did not influence data
      quality. The results suggest if a survey budget is limited and a timeline is not
      critical, a $2 incentive provides an affordable means of increasing
      participation.

PMID- 11221823
TI  - Reported response rates to mailed physician questionnaires.
AB  - OBJECTIVE: To examine response rate information from mailed physician
      questionnaires reported in published articles. DATA SOURCES/STUDY SETTING:
      Citations for articles published between 1985 and 1995 were obtained using a key
      word search of the Medline, PsychLit, and Sociofile databases. STUDY DESIGN: A 5
      percent random sample of relevant citations was selected from each year. DATA
      COLLECTION/EXTRACTION METHODS: Citations found to be other than physician surveys
      were discarded and replaced with the next randomly assigned article. Selected
      articles were abstracted using a standardized variable list. PRINCIPAL FINDINGS:
      The average response rate for mailed physician questionnaires was 61 percent. The
      average response rate for large sample surveys (> 1,000 observations) was 52
      percent. In addition, only 44 percent of the abstracted articles reported a
      discussion of response bias, and only 54 percent reported any type of follow-up.
      CONCLUSIONS: (1) Response rates have remained somewhat constant over time, and
      (2) researchers need to document the efforts used to increase response rates to
      mailed physician questionnaires.

PMID- 11221824
TI  - Methodological biases in estimating the burden of out-of-pocket expenses.

PMID- 11221825
TI  - A molecular variant of the APC gene at codon 1822: its association with diet,
      lifestyle, and risk of colon cancer.
AB  - The adenomatous polyposis coli (APC) gene is important in the etiology of colon
      cancer. Although germ-line mutations of this gene rarely occur in the population,
      less penetrant variants of the gene have been reported. One variant, producing an
      aspartate to valine change at codon 1822 (D1822V) [corrected] has been previously
      reported as having an allele frequency of 10%. The purpose of this study was to
      determine whether this D1822V [corrected] variant of the APC gene is associated
      with colon cancer and whether its association is influenced by other genetic or
      environmental factors. We used data collected as part of a multicenter study of
      1,585 incident cases of colon cancer and 1,945 age- and sex-matched population
      based controls to evaluate genetic, dietary, and environmental associations with
      the D1822V [corrected] variant of the APC gene. The frequency of the
      valine/valine allele at codon 1,822 was 22.8% in this population. In the control
      population, 61.5% were homozygote wild type, 33.3% were heterozygotes, and 5.2%
      were homozygote variant. Cases were slightly less likely to have the homozygous
      variant APC genotype than were controls [odds ratio (OR), 0.8; 95% confidence
      interval (CI), 0.6-1.1]; for those diagnosed after age 65, the homozygous APC
      variant was associated with reduced risk of colon cancer (OR, 0.6; 95% CI, 0.4
      1.0). Assessment of the homozygous APC variant with dietary, genetic, and
      environmental factors showed that individuals with this genotype were at lower
      risk if they consumed a low-fat diet (OR, 0.2; 95% CI, 0.1-0.5) relative to those
      who were homozygous wild type and ate a high-fat diet. This finding was specific
      to a low-fat diet and was unrelated to other dietary variables. These results
      suggest that the codon 1,822 variant of the APC gene may have functional
      significance. Individuals who have the valine/valine variant of this gene may be
      at reduced risk of colon cancer if they eat a low-fat diet.